|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
CPT 87425
|
$40.20
|
$67.00
|
$67.00 – $67.00
|
1 |
|
Infectious agent nucleic acid amplified probe
CPT 87798
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
CPT 87491
|
$72.60
|
$121.00
|
$121.00 – $121.00
|
1 |
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
CPT 87493
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe hsv-1
CPT 87529
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
CPT 87641
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
CPT 87556
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
CPT 87591
|
$72.60
|
$121.00
|
$121.00 – $121.00
|
1 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
CPT 87635
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
CPT 87636
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe streptococcus group a
CPT 87651
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
CPT 87661
|
$72.60
|
$121.00
|
$121.00 – $121.00
|
1 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
CPT 87507
|
$292.20
|
$487.00
|
$487.00 – $487.00
|
1 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
CPT 87505
|
$97.20
|
$162.00
|
$162.00 – $162.00
|
1 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
CPT 87506
|
$194.40
|
$324.00
|
$324.00 – $324.00
|
1 |
|
Infectious agent nucleic acid quantification bk virus
CPT 87799
|
$259.80
|
$433.00
|
$433.00 – $433.00
|
1 |
|
Infectious agent nucleic acid quantification hepatitis b
CPT 87517
|
$259.80
|
$433.00
|
$433.00 – $433.00
|
1 |
|
Infectious agent nucleic acid quantification hepatitis c
CPT 87522
|
$259.80
|
$433.00
|
$433.00 – $433.00
|
1 |
|
Infectious agent nucleic acid quantification hiv-1
CPT 87536
|
$259.80
|
$433.00
|
$433.00 – $433.00
|
1 |
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
CPT 87631
|
$97.20
|
$162.00
|
$162.00 – $162.00
|
1 |
|
Infliximab 100 mg intravenous solution
HCPCS J1745
|
$540.60
|
$901.00
|
$901.00 – $901.00
|
1 |
|
Infliximab-axxq 100 mg intravenous solution
HCPCS Q5121
|
$55.80
|
$93.00
|
$93.00 – $93.00
|
1 |
|
Infliximab-dyyb 100 mg intravenous solution
HCPCS Q5103
|
$37.80
|
$63.00
|
$63.00 – $63.00
|
1 |
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
CPT 90673
|
$75.60
|
$126.00
|
$126.00 – $126.00
|
1 |
|
Infuse radioactive materials
CPT 77750
|
$186.60
|
$311.00
|
$311.00 – $311.00
|
1 |
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
CPT 94642
|
$95.40
|
$159.00
|
$159.00 – $159.00
|
1 |
|
Inj., benralizumab, 1 mg
HCPCS J0517
|
$5,853.00
|
$9,755.00
|
$9,755.00 – $9,755.00
|
1 |
|
Inj, cefepime hcl (b braun)
HCPCS J0703
|
$20.40
|
$34.00
|
$34.00 – $34.00
|
1 |
|
Inj ceftolozane tazobactam
HCPCS J0695
|
$164.40
|
$274.00
|
$274.00 – $274.00
|
1 |
|
Inj, clevidipine butyrate
HCPCS C9248
|
$94.20
|
$157.00
|
$157.00 – $157.00
|
1 |
|
Inj cntr knee arthro incl ct/mri
CPT 27369
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj crotalidae im f(ab')2 eq
HCPCS J0841
|
$1,134.60
|
$1,891.00
|
$1,891.00 – $1,891.00
|
1 |
|
Inj dx for sinogram
CPT 20501
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection, cangrelor
HCPCS C9460
|
$1,013.40
|
$1,689.00
|
$1,689.00 – $1,689.00
|
1 |
|
Injection, daratumumab 10 mg
HCPCS J9145
|
$3,195.00
|
$5,325.00
|
$1,331.00 – $1,331.00
|
1 |
|
Injection during cath supravalvular aortography
CPT 93567
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection for bladder x-ray
CPT 51600
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection for ureter x-ray
CPT 50690
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection, fulvestrant
HCPCS J9395
|
$71.40
|
$119.00
|
$119.00 – $119.00
|
1 |
|
Injection into brain canal
CPT 61026
|
$117.00
|
$195.00
|
$195.00 – $195.00
|
1 |
|
Injection,onabotulinumtoxina
HCPCS J0585
|
$721.20
|
$1,202.00
|
$1,202.00 – $1,202.00
|
1 |
|
Injection, renflexis
HCPCS Q5104
|
$798.00
|
$1,330.00
|
$1,330.00 – $1,330.00
|
1 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
CPT 64491
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
CPT 64490
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
CPT 64494
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
CPT 64493
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
CPT 20552
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
CPT 96376
|
$28.80
|
$48.00
|
$48.00 – $48.00
|
1 |
|
Inj for ext venography
CPT 36005
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj hrt cath w/s&i nonsel p-art angrp
CPT 93568
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj hrt cath w/s&i sel left vent
CPT 93565
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj hrt cath w/s&i sel right vent
CPT 93566
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj hydroxocobalamin IV 25mg
HCPCS J3424
|
$1,125.60
|
$1,876.00
|
$1,876.00 – $1,876.00
|
1 |
|
Inj ivig privigen 500 mg
HCPCS J1459
|
$4,935.60
|
$8,226.00
|
$694.00 – $694.00
|
1 |
|
Inj, lanreotide, (cipla) 1mg
HCPCS J1932
|
$8,487.60
|
$14,146.00
|
$14,146.00 – $14,146.00
|
1 |
|
Inj levocarnitine per 1 gm
HCPCS J1955
|
$16.20
|
$27.00
|
$27.00 – $27.00
|
1 |
|
Inj., lumoxiti, 0.01 mg
HCPCS J9313
|
$31.20
|
$52.00
|
$52.00 – $52.00
|
1 |
|
Inj melpha hydroch nos 50 mg
HCPCS J9245
|
$1,156.20
|
$1,927.00
|
$1,927.00 – $1,927.00
|
1 |
|
Inj., meropenem, vaborbactam
HCPCS J2186
|
$198.00
|
$330.00
|
$330.00 – $330.00
|
1 |
|
Inj meropenem (wg crit care)
HCPCS J2183
|
$34.20
|
$57.00
|
$57.00 – $57.00
|
1 |
|
Inj nephrosto/ureterogram w/img exstng access
CPT 50431
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj ogivri 10 mg
HCPCS Q5114
|
$1,344.00
|
$2,240.00
|
$220.00 – $220.00
|
1 |
|
Inj pegfilgrastim-bmez 0.5mg
HCPCS Q5120
|
$5,157.00
|
$8,595.00
|
$8,595.00 – $8,595.00
|
1 |
|
Inj peritoneal venous shunt
CPT 49427
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj retro urethrocysto
CPT 51610
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Inj secretin synthetic human
HCPCS J2850
|
$630.00
|
$1,050.00
|
$1,050.00 – $1,050.00
|
1 |
|
Inj, sutimlimab-jome, 10 mg
HCPCS J1302
|
$2,256.00
|
$3,760.00
|
$3,760.00 – $3,760.00
|
1 |
|
Inj, tislelizumab-jsgr
HCPCS J9329
|
$64.20
|
$107.00
|
$107.00 – $107.00
|
1 |
|
Inj w/fluor eval cv device
CPT 36598
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Ins cath ren art 1st bi
CPT 36252
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Ins cath ren art 1st uni
CPT 36251
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Ins cath ren art 2nd+ bi
CPT 36254
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Ins cath ren art 2nd+ uni
CPT 36253
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert abdomen-venous drain
CPT 49425
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert hepatic shunt (tips)
CPT 37182
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion catheter bladder non indwelling
CPT 51701
|
$117.00
|
$195.00
|
$195.00 – $195.00
|
1 |
|
Insertion catheter pleural indwelling tunneled with cuff
CPT 32550
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion intra aortic balloon assist device percutaneous
CPT 33967
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
CPT 37191
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
CPT 36556
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion of catheter vein
CPT 36481
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion of catheter vein
CPT 36500
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
CPT 33208
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
CPT 33207
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
CPT 33225
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
CPT 36569
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
CPT 33249
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
CPT 33210
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
CPT 33216
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion subcutaneous cardiac rhythm monitor
CPT 33285
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
CPT 36561
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert picvad cath
CPT 36570
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert pm/icd lead dual
CPT 33217
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert/repl sq defib w/eltrd
CPT 33270
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert sq defib electrode
CPT 33271
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert swan-ganz cath
CPT 93503
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
CPT 36565
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert tunneled cv cath
CPT 36560
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert tunneled cv cath
CPT 36563
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |
|
Insert vad art access left hrt arterial access
CPT 33990
|
$0.60
|
$1.00
|
$1.00 – $1.00
|
1 |