|
Immunoassay tumor antigen quantitative ca 125
|
$172.20 |
$172.20 |
$172.20 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$172.20 |
$172.20 |
$172.20 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$20.40 |
$20.40 |
$20.40 |
$48.50
|
|
Immunofixation electrophoresis serum
|
$346.80 |
$346.80 |
$346.80 |
$138.60
|
|
In-111 satumomab pend
|
$42.60 |
$42.60 |
$42.60 |
$3,113.04
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,052.60 |
$2,052.60 |
$2,052.60 |
$2,080.80
|
|
Incision of breast lesion
|
$627.60 |
$627.60 |
$627.60 |
$2,577.85
|
|
Incision tendon sheath
|
$661.20 |
$661.20 |
$661.20 |
$3,073.20
|
|
Infect ag genotype na dna hepatitis b
|
$981.00 |
$981.00 |
$981.00 |
$427.43
|
|
Infect ag ia optc obs influenza
|
$55.80 |
$55.80 |
$55.80 |
$72.93
|
|
Infect ag na hpv high-risk types
|
$44.40 |
$44.40 |
$44.40 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$180.00 |
$180.00 |
$180.00 |
$219.70
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$40.80 |
$40.80 |
$40.80 |
$69.44
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$47.40 |
$47.40 |
$47.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$186.00 |
$186.00 |
$186.00 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$42.60 |
$42.60 |
$42.60 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$231.60 |
$231.60 |
$231.60 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$215.40 |
$215.40 |
$215.40 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$45.60 |
$45.60 |
$45.60 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$20.40 |
$20.40 |
$20.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$337.80 |
$337.80 |
$337.80 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$60.00 |
$60.00 |
$60.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$84.60 |
$84.60 |
$84.60 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$975.60 |
$975.60 |
$975.60 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$87.00 |
$87.00 |
$87.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$91.20 |
$91.20 |
$91.20 |
$151.25
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$60.00 |
$60.00 |
$60.00 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$146.40 |
$146.40 |
$146.40 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$84.60 |
$84.60 |
$84.60 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$60.00 |
$60.00 |
$60.00 |
$105.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$279.00 |
$279.00 |
$279.00 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$239.40 |
$239.40 |
$239.40 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$439.20 |
$439.20 |
$439.20 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$187.80 |
$187.80 |
$187.80 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$703.80 |
$703.80 |
$703.80 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$262.80 |
$262.80 |
$262.80 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$3,894.60 |
$3,894.60 |
$3,894.60 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$3,155.40 |
$3,155.40 |
$3,155.40 |
$1,617.43
|
|
Influenza dna amp prob addl
|
$115.20 |
$115.20 |
$115.20 |
$64.26
|
|
Initial nursing facility care/day 35 minutes
|
$136.80 |
$136.80 |
$136.80 |
$188.50
|
|
Initial nursing facility care/day low severity 99304
|
$96.00 |
$96.00 |
$96.00 |
$128.00
|
|
Initiation & management bipap/cpap initial day
|
$452.40 |
$452.40 |
$452.40 |
$576.00
|
|
Inj andexxa, 10 mg
|
$20,193.00 |
$20,193.00 |
$20,193.00 |
$4,370.80
|
|
Inj., benralizumab, 1 mg
|
$16,081.80 |
$16,081.80 |
$16,081.80 |
$11,604.71
|
|
Inj, bezlotoxumab, 10 mg
|
$14,655.60 |
$14,655.60 |
$14,655.60 |
$7,612.43
|
|
Inj, bupivacaine liposome
|
$1,500.90 |
$1,500.90 |
$1,500.90 |
$699.38
|
|
Inj daptomycin (xellia)
|
$154.80 |
$154.80 |
$154.80 |
$56.04
|
|
Injection arthrography hip without anesthesia (both sides)
|
$642.60 |
$642.60 |
$642.60 |
$500.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$60.00 |
$60.00 |
$60.00 |
$504.90
|
|
Injection epidural blood patch or clot
|
$927.00 |
$927.00 |
$927.00 |
$1,156.80
|
|
Injection for bladder x-ray
|
$844.80 |
$844.80 |
$844.80 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$524.40 |
$524.40 |
$524.40 |
$494.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$616.80 |
$616.80 |
$616.80 |
$683.28
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$454.80 |
$454.80 |
$454.80 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,141.80 |
$1,141.80 |
$1,141.80 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,115.40 |
$1,115.40 |
$1,115.40 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$534.60 |
$534.60 |
$534.60 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$934.80 |
$934.80 |
$934.80 |
$1,704.78
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$280.80 |
$280.80 |
$280.80 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$97.80 |
$97.80 |
$97.80 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$53.40 |
$53.40 |
$53.40 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$83.40 |
$83.40 |
$83.40 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$83.40 |
$83.40 |
$83.40 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$229.20 |
$229.20 |
$229.20 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$83.40 |
$83.40 |
$83.40 |
$135.20
|
|
Inject sacroiliac joint
|
$963.00 |
$963.00 |
$963.00 |
$963.00
|
|
Inj., eravacycline, 1 mg
|
$146.40 |
$146.40 |
$146.40 |
$206.64
|
|
Inj, lidocaine w epinephrine
|
$37.20 |
$37.20 |
$37.20 |
$44.96
|
|
Inj., meropenem, vaborbactam
|
$575.40 |
$575.40 |
$575.40 |
$536.27
|
|
Inj octafluoropropane mic,ml
|
$541.80 |
$541.80 |
$541.80 |
$211.40
|
|
Inj., omadacycline, 1 mg
|
$1,498.20 |
$1,498.20 |
$1,498.20 |
$865.34
|
|
Inj tedizolid phosphate
|
$21.90 |
$21.90 |
$21.90 |
$664.72
|
|
Inj vancomycin (xellia) 10mg
|
$458.40 |
$458.40 |
$458.40 |
$79.21
|
|
Inj w/fluor eval cv device
|
$178.80 |
$178.80 |
$178.80 |
$463.40
|
|
Insert cath pleura without image
|
$887.40 |
$887.40 |
$887.40 |
$2,019.00
|
|
Insertion catheter bladder non indwelling
|
$207.00 |
$207.00 |
$207.00 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$207.00 |
$207.00 |
$207.00 |
$229.32
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,615.80 |
$1,615.80 |
$1,615.80 |
$2,511.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,759.20 |
$1,759.20 |
$1,759.20 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,497.80 |
$2,497.80 |
$2,497.80 |
$2,414.10
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$5,236.80
|
|
In situ hybridization per specimen initial single probe stain
|
$165.60 |
$165.60 |
$165.60 |
$326.04
|
|
Ins picad w subq port 5yr>
|
$1,236.60 |
$1,236.60 |
$1,236.60 |
$3,912.93
|
|
Ins tun cv cath wo subq prt/pm
|
$2,393.40 |
$2,393.40 |
$2,393.40 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$780.60 |
$780.60 |
$780.60 |
$4,202.70
|
|
Insulin total
|
$60.60 |
$60.60 |
$60.60 |
$66.64
|
|
Intraop colon lavage add-on
|
$309.60 |
$309.60 |
$309.60 |
$416.80
|
|
Intrinsic factor antibody
|
$263.40 |
$263.40 |
$263.40 |
$66.60
|
|
Intubation endotracheal emergency procedure
|
$764.40 |
$764.40 |
$764.40 |
$589.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$368.40 |
$368.40 |
$368.40 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$696.00 |
$696.00 |
$696.00 |
$279.10
|
|
Ip/obs cnsltj new/est low 45
|
$110.40 |
$110.40 |
$110.40 |
$174.20
|
|
Ip/obs cnsltj new/est mod 60
|
$180.60 |
$180.60 |
$180.60 |
$284.45
|
|
Ip/obs consltj new/est hi 80
|
$238.80 |
$238.80 |
$238.80 |
$332.80
|
|
Ip/obs consltj new/est sf 35
|
$88.20 |
$88.20 |
$88.20 |
$134.46
|
|
Iron
|
$102.60 |
$102.60 |
$102.60 |
$74.40
|
|
Iron binding capacity
|
$121.80 |
$121.80 |
$121.80 |
$63.79
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$321.00 |
$321.00 |
$321.00 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$168.00 |
$168.00 |
$168.00 |
$142.20
|
