|
Infect ag phenotype na hiv-1 ea addl drg
|
$90.15 |
$90.15 |
$90.15 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$113.29 |
$113.29 |
$113.29 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$56.89 |
$56.89 |
$56.89 |
$63.70
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$38.09 |
$38.09 |
$38.09 |
$76.20
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$110.40 |
$110.40 |
$110.40 |
$84.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$66.53 |
$66.53 |
$66.53 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$39.53 |
$39.53 |
$39.53 |
$56.78
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$27.48 |
$27.48 |
$27.48 |
$99.04
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$155.71 |
$155.71 |
$155.71 |
$137.40
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$41.46 |
$41.46 |
$41.46 |
$93.60
|
|
Infectious agent nucleic acid amplified probe
|
$52.07 |
$52.07 |
$52.07 |
$278.95
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$136.43 |
$136.43 |
$136.43 |
$143.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$103.65 |
$103.65 |
$103.65 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$527.37 |
$527.37 |
$527.37 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$153.78 |
$153.78 |
$153.78 |
$173.60
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$36.16 |
$36.16 |
$36.16 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$237.18 |
$237.18 |
$237.18 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$101.24 |
$101.24 |
$101.24 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$69.42 |
$69.42 |
$69.42 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$172.10 |
$172.10 |
$172.10 |
$221.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$180.78 |
$180.78 |
$180.78 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$70.87 |
$70.87 |
$70.87 |
$97.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$44.35 |
$44.35 |
$44.35 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$476.27 |
$476.27 |
$476.27 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$328.77 |
$328.77 |
$328.77 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$211.63 |
$211.63 |
$211.63 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$512.91 |
$512.91 |
$512.91 |
$228.38
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$225.61 |
$225.61 |
$225.61 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$180.78 |
$180.78 |
$180.78 |
$381.55
|
|
Infliximab 100 mg intravenous solution
|
$3,671.48 |
$3,671.48 |
$3,671.48 |
$1,702.78
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,519.87 |
$1,519.87 |
$1,519.87 |
$1,654.83
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$638.73 |
$638.73 |
$638.73 |
$780.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$466.15 |
$466.15 |
$466.15 |
$624.00
|
|
Inf thrc fascial pln blk uni w/wo image
|
$467.60 |
$467.60 |
$467.60 |
$820.80
|
|
Initiation & management bipap/cpap initial day
|
$292.61 |
$292.61 |
$292.61 |
$627.00
|
|
Inj., benralizumab, 1 mg
|
$14,880.67 |
$14,880.67 |
$14,880.67 |
$18,984.78
|
|
Inj calcitriol per 0.1 mcg
|
$36.24 |
$36.24 |
$36.24 |
$29.35
|
|
Inj, cefepime hcl (b braun)
|
$56.02 |
$56.02 |
$56.02 |
$81.41
|
|
Inj, cefiderocol, 10 mg
|
$367.81 |
$367.81 |
$367.81 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$250.62 |
$250.62 |
$250.62 |
$333.00
|
|
Inj cntr knee arthro incl ct/mri
|
$85.33 |
$85.33 |
$85.33 |
$461.25
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$503.75 |
$503.75 |
$503.75 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$105.57 |
$105.57 |
$105.57 |
$562.20
|
|
Injection, cangrelor
|
$1,459.40 |
$1,459.40 |
$1,459.40 |
$2,161.85
|
|
Injection carpal tunnel therapeutic (both sides)
|
$679.22 |
$679.22 |
$679.22 |
$541.96
|
|
Injection, daratumumab 10 mg
|
$8,075.57 |
$8,075.57 |
$8,075.57 |
$4,017.00
|
|
Injection, doxercalciferol
|
$34.95 |
$34.95 |
$34.95 |
$28.25
|
|
Injection epidural blood patch or clot
|
$1,072.09 |
$1,072.09 |
$1,072.09 |
$1,447.86
|
|
Injection for arthrography wrist (both sides)
|
$268.99 |
$268.99 |
$268.99 |
$471.00
|
|
Injection for bladder x-ray
|
$328.28 |
$328.28 |
$328.28 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$171.62 |
$171.62 |
$171.62 |
$504.55
|
|
Injection, fulvestrant
|
$3,143.02 |
$3,143.02 |
$3,143.02 |
$2,618.94
|
|
Injection, isavuconazonium
|
$616.86 |
$616.86 |
$616.86 |
$634.28
|
|
Injection,onabotulinumtoxina
|
$2,084.29 |
$2,084.29 |
$2,084.29 |
$2,154.07
|
|
Injection, renflexis
|
$1,485.24 |
$1,485.24 |
$1,485.24 |
$1,407.02
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$267.55 |
$267.55 |
$267.55 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$220.79 |
$220.79 |
$220.79 |
$999.81
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$902.41 |
$902.41 |
$902.41 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$637.76 |
$637.76 |
$637.76 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$851.31 |
$851.31 |
$851.31 |
$1,957.80
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$542.32 |
$542.32 |
$542.32 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$919.28 |
$919.28 |
$919.28 |
$2,005.52
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$815.64 |
$815.64 |
$815.64 |
$1,871.25
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$819.50 |
$819.50 |
$819.50 |
$1,771.20
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$433.37 |
$433.37 |
$433.37 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$607.39 |
$607.39 |
$607.39 |
$539.55
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$749.60 |
$749.60 |
$749.60 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$126.30 |
$126.30 |
$126.30 |
$168.17
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$141.73 |
$141.73 |
$141.73 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$142.69 |
$142.69 |
$142.69 |
$270.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$146.55 |
$146.55 |
$146.55 |
$140.29
|
|
Inject sacroiliac joint
|
$1,104.39 |
$1,104.39 |
$1,104.39 |
$1,071.68
|
|
Inject/treat eye socket
|
$353.83 |
$353.83 |
$353.83 |
$366.40
|
|
Inj epidural sgl lumb-sacral without img
|
$737.07 |
$737.07 |
$737.07 |
$1,415.50
|
|
Inj heparin, pfizer, 1000u
|
$30.50 |
$30.50 |
$30.50 |
$19.04
|
|
Inj levocarnitine per 1 gm
|
$75.34 |
$75.34 |
$75.34 |
$122.28
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$650.78 |
$650.78 |
$650.78 |
$625.00
|
|
Inj mepivacaine hcl/10 ml
|
$38.22 |
$38.22 |
$38.22 |
$22.38
|
|
Inj., meropenem, vaborbactam
|
$9,360.97 |
$9,360.97 |
$9,360.97 |
$618.43
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$703.32 |
$703.32 |
$703.32 |
$1,522.56
|
|
Inj., omadacycline, 1 mg
|
$778.23 |
$778.23 |
$778.23 |
$3.80
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$9,436.86 |
$9,436.86 |
$9,436.86 |
$2,572.03
|
|
Inj proc elbow arthro
|
$156.19 |
$156.19 |
$156.19 |
$456.17
|
|
Inj proc myelogram lumbar
|
$838.30 |
$838.30 |
$838.30 |
$960.30
|
|
Inj retacrit esrd on dialysi
|
$337.13 |
$337.13 |
$337.13 |
$307.40
|
|
Inj scleros sol mult veins
|
$446.87 |
$446.87 |
$446.87 |
$648.45
|
|
Inj testosterone cypionate
|
$92.16 |
$92.16 |
$92.16 |
$82.58
|
|
Inj thrc fascial pln blk bi w/wo image
|
$478.68 |
$478.68 |
$478.68 |
$1,483.20
|
|
Inj thrc fascial pln blk uni w/wo image
|
$475.79 |
$475.79 |
$475.79 |
$1,252.02
|
|
Inj w/fluor eval cv device
|
$743.33 |
$743.33 |
$743.33 |
$593.60
|
|
Insert cath pleura with image
|
$1,271.18 |
$1,271.18 |
$1,271.18 |
$2,239.02
|
|
Insert cath pleura without image
|
$2,019.81 |
$2,019.81 |
$2,019.81 |
$2,168.17
|
|
Insertion catheter bladder non indwelling
|
$343.71 |
$343.71 |
$343.71 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$60.26 |
$60.26 |
$60.26 |
$250.80
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,591.53 |
$2,591.53 |
$2,591.53 |
$4,782.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$965.08 |
$965.08 |
$965.08 |
$6,832.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$773.70 |
$773.70 |
$773.70 |
$2,505.60
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$627.16 |
$627.16 |
$627.16 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$639.69 |
$639.69 |
$639.69 |
$2,367.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$965.08 |
$965.08 |
$965.08 |
$7,216.00
|