|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$40.20 |
$40.20 |
$40.20 |
|
|
Infectious agent nucleic acid amplified probe
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$72.60 |
$72.60 |
$72.60 |
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$72.60 |
$72.60 |
$72.60 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$72.60 |
$72.60 |
$72.60 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$292.20 |
$292.20 |
$292.20 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$97.20 |
$97.20 |
$97.20 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$194.40 |
$194.40 |
$194.40 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$259.80 |
$259.80 |
$259.80 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$259.80 |
$259.80 |
$259.80 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$259.80 |
$259.80 |
$259.80 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$259.80 |
$259.80 |
$259.80 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$97.20 |
$97.20 |
$97.20 |
|
|
Infliximab 100 mg intravenous solution
|
$540.60 |
$540.60 |
$540.60 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$55.80 |
$55.80 |
$55.80 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$75.60 |
$75.60 |
$75.60 |
|
|
Infuse radioactive materials
|
$186.60 |
$186.60 |
$186.60 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$95.40 |
$95.40 |
$95.40 |
|
|
Inj., benralizumab, 1 mg
|
$5,853.00 |
$5,853.00 |
$5,853.00 |
|
|
Inj, cefepime hcl (b braun)
|
$20.40 |
$20.40 |
$20.40 |
|
|
Inj ceftolozane tazobactam
|
$164.40 |
$164.40 |
$164.40 |
|
|
Inj, clevidipine butyrate
|
$94.20 |
$94.20 |
$94.20 |
|
|
Inj cntr knee arthro incl ct/mri
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj crotalidae im f(ab')2 eq
|
$1,134.60 |
$1,134.60 |
$1,134.60 |
|
|
Inj dx for sinogram
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection, cangrelor
|
$1,013.40 |
$1,013.40 |
$1,013.40 |
|
|
Injection, daratumumab 10 mg
|
$3,195.00 |
$3,195.00 |
$3,195.00 |
|
|
Injection during cath supravalvular aortography
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection for bladder x-ray
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection for ureter x-ray
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection, fulvestrant
|
$71.40 |
$71.40 |
$71.40 |
|
|
Injection into brain canal
|
$117.00 |
$117.00 |
$117.00 |
|
|
Injection,onabotulinumtoxina
|
$721.20 |
$721.20 |
$721.20 |
|
|
Injection, renflexis
|
$798.00 |
$798.00 |
$798.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$0.60 |
$0.60 |
$0.60 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$28.80 |
$28.80 |
$28.80 |
|
|
Inj for ext venography
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj hrt cath w/s&i sel left vent
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj hrt cath w/s&i sel right vent
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj hydroxocobalamin IV 25mg
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
|
|
Inj ivig privigen 500 mg
|
$4,935.60 |
$4,935.60 |
$4,935.60 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$8,487.60 |
$8,487.60 |
$8,487.60 |
|
|
Inj levocarnitine per 1 gm
|
$16.20 |
$16.20 |
$16.20 |
|
|
Inj., lumoxiti, 0.01 mg
|
$31.20 |
$31.20 |
$31.20 |
|
|
Inj melpha hydroch nos 50 mg
|
$1,156.20 |
$1,156.20 |
$1,156.20 |
|
|
Inj., meropenem, vaborbactam
|
$198.00 |
$198.00 |
$198.00 |
|
|
Inj meropenem (wg crit care)
|
$34.20 |
$34.20 |
$34.20 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj ogivri 10 mg
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$5,157.00 |
$5,157.00 |
$5,157.00 |
|
|
Inj peritoneal venous shunt
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj retro urethrocysto
|
$0.60 |
$0.60 |
$0.60 |
|
|
Inj secretin synthetic human
|
$630.00 |
$630.00 |
$630.00 |
|
|
Inj, sutimlimab-jome, 10 mg
|
$2,256.00 |
$2,256.00 |
$2,256.00 |
|
|
Inj, tislelizumab-jsgr
|
$64.20 |
$64.20 |
$64.20 |
|
|
Inj w/fluor eval cv device
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins cath ren art 1st bi
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins cath ren art 1st uni
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins cath ren art 2nd+ bi
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins cath ren art 2nd+ uni
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert abdomen-venous drain
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert hepatic shunt (tips)
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion catheter bladder non indwelling
|
$117.00 |
$117.00 |
$117.00 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion of catheter vein
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion of catheter vein
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert picvad cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert pm/icd lead dual
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert/repl sq defib w/eltrd
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert sq defib electrode
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert swan-ganz cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert tunneled cv cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert tunneled cv cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insert vad art access left hrt arterial access
|
$0.60 |
$0.60 |
$0.60 |
|