|
Incision & drainage hematoma/seroma/fluid collection
|
$214.50 |
$355.00 |
$3,521.65 |
|
|
Incision of breast lesion
|
$921.10 |
$2,377.90 |
$4,684.45 |
|
|
Incision of burn scab initi
|
$456.80 |
$584.10 |
$1,150.80 |
|
|
Incision of tongue fold
|
$290.15 |
$290.15 |
$342.85 |
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$3,186.60 |
$3,186.60 |
$3,186.60 |
|
|
Infect ag drug suscept pheno predict
|
$377.30 |
$415.95 |
$1,372.70 |
|
|
Infect ag genotype na cytomegalovirus
|
$643.65 |
$643.65 |
$1,503.50 |
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$576.35 |
$745.30 |
$855.25 |
|
|
Infect ag ia optc obs influenza
|
$26.00 |
$29.00 |
$79.00 |
|
|
Infect ag if legionella pneumophila
|
$46.20 |
$93.60 |
$195.75 |
|
|
Infect ag na hpv high-risk types
|
$137.65 |
$227.70 |
$315.40 |
|
|
Infect ag na influenza r/amp 1st 2 types
|
$189.00 |
$257.80 |
$286.45 |
|
|
Infect ag na orthopoxvirus amp prb each
|
$183.05 |
$228.80 |
$407.65 |
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$51.55 |
$89.00 |
$89.00 |
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$14.85 |
$33.30 |
$92.10 |
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$91.80 |
$128.15 |
$156.10 |
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$72.85 |
$153.85 |
$161.05 |
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$83.50 |
$129.60 |
$369.10 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$60.30 |
$98.55 |
$165.00 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$98.40 |
$114.55 |
$546.95 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$62.05 |
$96.95 |
$248.35 |
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$160.60 |
$285.20 |
$393.05 |
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$45.05 |
$145.60 |
$360.30 |
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$56.70 |
$128.15 |
$267.45 |
|
|
Infectious agent nucleic acid amplified probe
|
$109.20 |
$124.75 |
$339.90 |
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$150.50 |
$174.55 |
$275.35 |
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$128.15 |
$142.60 |
$275.35 |
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$71.70 |
$253.35 |
$363.30 |
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$231.45 |
$430.85 |
$730.90 |
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$78.30 |
$174.55 |
$275.35 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$83.65 |
$84.45 |
$107.00 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$166.60 |
$166.60 |
$331.10 |
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$79.00 |
$79.00 |
$79.00 |
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$112.15 |
$251.05 |
$315.35 |
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$122.05 |
$191.95 |
$460.60 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,702.10 |
$1,702.10 |
$1,702.10 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$356.25 |
$471.85 |
$855.00 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$730.30 |
$953.60 |
$1,752.65 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$134.15 |
$310.30 |
$548.30 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$237.70 |
$391.85 |
$695.15 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$226.35 |
$421.70 |
$846.30 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$169.80 |
$530.40 |
$753.20 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$152.10 |
$370.85 |
$890.05 |
|
|
Infliximab 100 mg intravenous solution
|
$1,432.10 |
$3,073.94 |
$5,085.74 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$613.15 |
$1,520.70 |
$2,322.60 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,160.43 |
$2,878.02 |
$4,395.66 |
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$855.90 |
$1,120.50 |
$2,068.70 |
|
|
Inf thrc fascial pln blk bi w/wo image
|
$268.15 |
$1,241.30 |
$3,063.86 |
|
|
Inf thrc fascial pln blk uni w/wo image
|
$268.15 |
$1,241.30 |
$3,063.86 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$291.20 |
$576.65 |
$956.00 |
|
|
Initial care training 30 m
|
$84.05 |
$84.05 |
$84.05 |
|
|
Initial nursing facility care/day 35 minutes
|
$271.20 |
$289.00 |
$357.35 |
|
|
Initial nursing facility care/day 45 minutes
|
$338.80 |
$381.95 |
$456.70 |
|
|
Initial nursing facility care/day low severity 99304
|
$174.00 |
$205.20 |
$249.80 |
|
|
Initial observation care
|
$250.65 |
$250.65 |
$250.65 |
|
|
Initial observation care
|
$341.75 |
$341.75 |
$341.75 |
|
|
Initial observation care
|
$467.80 |
$467.80 |
$467.80 |
|
|
Inj, abilify maintena, 1 mg
|
$3,561.72 |
$6,935.22 |
$12,593.07 |
|
|
Inj acetaminophen -fresenius
|
$58.40 |
$111.39 |
$116.63 |
|
|
Inj, acetaminophen (hikma)
|
$147.49 |
$147.49 |
$147.49 |
|
|
Inj, adalimumab, 1 mg
|
$9,110.87 |
$9,110.87 |
$9,110.87 |
|
|
Inj alymsys 10 mg
|
$7,566.00 |
$7,566.00 |
$7,566.00 |
|
|
Inj., aristada initio, 1 mg
|
$6,409.97 |
$6,409.97 |
$6,409.97 |
|
|
Inj., benralizumab, 1 mg
|
$13,961.59 |
$15,277.76 |
$15,390.61 |
|
|
Inj, bezlotoxumab, 10 mg
|
$4,659.94 |
$4,659.94 |
$4,659.94 |
|
|
Inj, bortezomib, hospira
|
$788.36 |
$788.36 |
$788.36 |
|
|
Inj, bupivacaine liposome
|
$1,087.43 |
$1,116.18 |
$1,762.02 |
|
|
Inj cefazolin sodium, baxter
|
$36.96 |
$36.96 |
$36.96 |
|
|
Inj cefazolin sodium, hikma
|
$44.20 |
$61.77 |
$125.02 |
|
|
Inj, cefepime hcl (b braun)
|
$166.45 |
$239.09 |
$291.33 |
|
|
Inj ceftolozane tazobactam
|
$926.75 |
$926.75 |
$926.75 |
|
|
Inj, clindamycin (baxter)
|
$59.67 |
$82.38 |
$138.43 |
|
|
Inj cntr knee arthro incl ct/mri
|
$172.50 |
$680.20 |
$1,189.15 |
|
|
Inj cyclophosphamd (ingenus)
|
$1,650.58 |
$1,650.58 |
$1,650.58 |
|
|
Inj, cyclophosphamd, sandoz
|
$687.17 |
$687.17 |
$1,338.03 |
|
|
Inj, decitabine (sun pharma)
|
$975.98 |
$975.98 |
$975.98 |
|
|
Inj disk cerv-thor ea lev
|
$869.80 |
$869.80 |
$869.80 |
|
|
Inj dx for sinogram
|
$172.50 |
$222.15 |
$943.45 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,977.25 |
$1,998.85 |
$1,998.85 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$172.50 |
$778.70 |
$1,214.55 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,714.20 |
$1,714.20 |
$1,714.20 |
|
|
Injection, daratumumab 10 mg
|
$1,852.05 |
$1,852.05 |
$1,852.05 |
|
|
Injection during cath supravalvular aortography
|
$264.30 |
$264.30 |
$264.30 |
|
|
Injection epidural blood patch or clot
|
$94.95 |
$753.10 |
$1,947.60 |
|
|
Injection for arthrography wrist (both sides)
|
$125.40 |
$223.60 |
$1,189.15 |
|
|
Injection for bladder x-ray
|
$224.65 |
$413.05 |
$884.30 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$172.50 |
$626.25 |
$1,189.15 |
|
|
Injection for ureter x-ray
|
$218.40 |
$218.40 |
$943.45 |
|
|
Injection for ureter x-ray
|
$334.55 |
$527.70 |
$1,159.15 |
|
|
Injection, fulvestrant
|
$265.76 |
$1,585.97 |
$4,503.64 |
|
|
Injection glatiramer acetate
|
$487.99 |
$487.99 |
$487.99 |
|
|
Injection, inclisiran, 1 mg
|
$9,080.41 |
$9,080.41 |
$9,080.41 |
|
|
Injection into brain canal
|
$1,366.90 |
$1,765.25 |
$1,765.25 |
|
|
Injection,onabotulinumtoxina
|
$792.19 |
$2,210.29 |
$5,626.54 |
|
|
Injection, pentamidine iseth
|
$1,162.88 |
$1,162.88 |
$1,628.81 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$143.05 |
$218.40 |
$1,725.45 |
|
|
Injection, renflexis
|
$1,798.95 |
$1,798.95 |
$1,798.95 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$154.85 |
$282.10 |
$2,421.70 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$164.40 |
$380.60 |
$1,826.80 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$546.60 |
$2,603.45 |
$2,615.05 |
|