|
Infect ag phenotype na hiv-1 ea addl drg
|
$122.39 |
$122.39 |
$135.60 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$41.40 |
$41.40 |
$144.53 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$57.60 |
$57.60 |
$135.17 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$66.60 |
$66.60 |
$144.53 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$74.40 |
$74.40 |
$144.53 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$82.80 |
$82.80 |
$180.59 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$82.80 |
$82.80 |
$129.30 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$29.40 |
$29.40 |
$128.45 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$69.60 |
$69.60 |
$241.26 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$127.80 |
$127.80 |
$1,133.72 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$143.36 |
$143.36 |
$184.20 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$31.80 |
$31.80 |
$144.53 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$301.80 |
$301.80 |
$3,174.75 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$144.00 |
$144.00 |
$441.65 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$127.20 |
$127.20 |
$441.65 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$799.20 |
$799.20 |
$1,664.35 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$186.00 |
$186.00 |
$562.88 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$241.80 |
$241.80 |
$521.48 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$187.80 |
$187.80 |
$441.65 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$133.80 |
$133.80 |
$150.38 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$122.40 |
$122.40 |
$208.07 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$219.18 |
$219.18 |
$273.60 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$219.18 |
$219.18 |
$219.18 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$90.60 |
$90.60 |
$236.27 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$100.80 |
$100.80 |
$131.65 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$937.50 |
$937.50 |
$937.50 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$595.10 |
$595.10 |
$595.10 |
$185.00
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$1,143.75 |
$1,143.75 |
$1,143.75 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$756.00 |
$756.00 |
$1,824.95 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$433.80 |
$433.80 |
$1,784.09 |
$286.06
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$617.40 |
$617.40 |
$674.73 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$712.80 |
$712.80 |
$1,587.11 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$259.80 |
$259.80 |
$539.56 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$266.40 |
$266.40 |
$449.86 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$296.40 |
$296.40 |
$1,239.93 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$334.80 |
$334.80 |
$2,092.40 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$1,073.79 |
$1,073.79 |
$3,433.44 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$495.91 |
$495.91 |
$1,470.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$536.39 |
$536.39 |
$2,782.08 |
$1,537.84
|
|
Influenza dna amp prob addl
|
$222.54 |
$222.54 |
$222.54 |
$64.26
|
|
Infuse radioactive materials
|
$2,381.32 |
$2,381.32 |
$2,381.32 |
$640.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$348.99 |
$348.99 |
$358.20 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$327.60 |
$327.60 |
$560.46 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$0.06 |
$0.06 |
$27,060.87 |
$5,355.30
|
|
Inj, acetaminophen (hikma)
|
$0.77 |
$0.77 |
$0.77 |
$58.50
|
|
Inj, adalimumab, 1 mg
|
$49,791.96 |
$49,791.96 |
$49,791.96 |
$12,098.05
|
|
Inj, alfentanil hcl, 500mcg
|
$109.20 |
$109.20 |
$109.20 |
$35.94
|
|
Inj allopurinol sodium 1 mg
|
$16,629.80 |
$16,629.80 |
$19,616.34 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$163.42 |
$163.42 |
$163.42 |
$1,280.74
|
|
Inj, amisulpride, 1 mg
|
$90.74 |
$90.74 |
$90.74 |
$91.89
|
|
Inj anifrolumab-fnia 1mg
|
$183.32 |
$183.32 |
$15,995.52 |
$9,878.82
|
|
Inj atezolizumb 5mg hya-tqjs
|
$325.21 |
$325.21 |
$325.21 |
$18,716.52
|
|
Inj aval alfa-nqpt 4mg
|
$5,725.38 |
$5,725.38 |
$21,034.66 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$2,036.57 |
$2,036.57 |
$2,036.57 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$39,443.59 |
$39,443.59 |
$39,443.59 |
$7,612.43
|
|
Inj, bupivacaine liposome
|
$423.42 |
$423.42 |
$3,650.03 |
$699.38
|
|
Inj calcitriol per 0.1 mcg
|
$67.23 |
$67.23 |
$67.23 |
$23.28
|
|
Inj cefazolin sodium, baxter
|
$15.45 |
$15.45 |
$45.78 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$7.71 |
$7.71 |
$43.20 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$7.61 |
$7.61 |
$7.61 |
$18.05
|
|
Inj, cefepime hcl (b braun)
|
$96.84 |
$96.84 |
$96.84 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$24.47 |
$24.47 |
$24.47 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$97.31 |
$97.31 |
$97.31 |
$380.80
|
|
Inj, clindamycin (baxter)
|
$30.64 |
$30.64 |
$52.68 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$235.20 |
$235.20 |
$235.20 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$54,532.37 |
$54,532.37 |
$54,532.37 |
$9,204.29
|
|
Inj crotalidae im f(ab')2 eq
|
$13,667.35 |
$13,667.35 |
$13,667.35 |
$2,613.60
|
|
Inj, cyclophos (baxter) 5mg
|
$1,857.72 |
$1,857.72 |
$1,857.72 |
$2,584.85
|
|
Inj cyclophosphamd auromedic
|
$8.92 |
$8.92 |
$8.92 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$10.99 |
$10.99 |
$10.99 |
$742.72
|
|
Inj, cyclophosphamd, sandoz
|
$382.20 |
$382.20 |
$382.20 |
$735.20
|
|
Inj daptomycin (xellia)
|
$176.40 |
$176.40 |
$176.40 |
$56.04
|
|
Inj. denosumab-bbdz, 1 mg
|
$238.88 |
$238.88 |
$238.88 |
$4,615.43
|
|
Inj, donanemab-azbt, 2 mg
|
$41.65 |
$41.65 |
$4,141.68 |
$1,233.44
|
|
Inj, durolane 1 mg
|
$184.22 |
$184.22 |
$184.22 |
$1,950.93
|
|
Inj dx for sinogram
|
$258.60 |
$258.60 |
$258.60 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$752.40 |
$752.40 |
$752.40 |
$495.84
|
|
Injection, cangrelor
|
$198.71 |
$198.71 |
$4,925.94 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$524.40 |
$524.40 |
$524.40 |
$450.72
|
|
Injection, daratumumab 10 mg
|
$30,530.69 |
$30,530.69 |
$30,530.69 |
$5,239.24
|
|
Injection, doxercalciferol
|
$9.00 |
$9.00 |
$68.96 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$1,255.80 |
$1,255.80 |
$3,139.21 |
$952.66
|
|
Injection, edaravone, 1 mg
|
$12,202.73 |
$12,202.73 |
$12,202.73 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$2,271.60 |
$2,271.60 |
$2,271.60 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$226.20 |
$226.20 |
$226.20 |
$428.40
|
|
Injection for bladder x-ray
|
$685.20 |
$685.20 |
$685.20 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$425.40 |
$425.40 |
$425.40 |
$494.65
|
|
Injection for ureter x-ray
|
$287.40 |
$287.40 |
$287.40 |
$427.70
|
|
Injection, fulvestrant
|
$4,115.67 |
$4,115.67 |
$4,115.67 |
$1,817.65
|
|
Injection glatiramer acetate
|
$697.20 |
$697.20 |
$5,649.96 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$126.26 |
$126.26 |
$10,547.94 |
$6,679.35
|
|
Injection into brain canal
|
$3,140.46 |
$3,140.46 |
$3,140.46 |
$836.40
|
|
Injection, isavuconazonium
|
$3,197.15 |
$3,197.15 |
$3,197.15 |
$787.67
|
|
Injection jugular
|
$237.00 |
$237.00 |
$1,265.87 |
$790.00
|
|
Injection, necitumumab, 1 mg
|
$45,140.55 |
$45,140.55 |
$45,140.55 |
$8,572.91
|
|
Injection,onabotulinumtoxina
|
$68.09 |
$68.09 |
$3,827.88 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$702.60 |
$702.60 |
$2,011.63 |
$670.64
|
|
Injection, renflexis
|
$2,215.02 |
$2,215.02 |
$3,963.19 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,960.20 |
$1,960.20 |
$1,960.20 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,669.80 |
$1,669.80 |
$1,669.80 |
$1,348.56
|