|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$248.00 |
$248.00 |
$248.00 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$165.60 |
$165.60 |
$165.60 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$278.40 |
$278.40 |
$278.40 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$294.40 |
$294.40 |
$294.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$535.20 |
$535.20 |
$535.20 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$231.20 |
$231.20 |
$231.20 |
$98.58
|
|
Infectious agent nucleic acid amplified probe
|
$1,275.20 |
$1,275.20 |
$1,275.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$1,290.40 |
$1,290.40 |
$1,290.40 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$410.40 |
$410.40 |
$410.40 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,604.00 |
$1,604.00 |
$1,604.00 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$420.00 |
$420.00 |
$420.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$296.80 |
$296.80 |
$296.80 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$527.20 |
$527.20 |
$527.20 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$299.20 |
$299.20 |
$299.20 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$69.60 |
$69.60 |
$69.60 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$353.60 |
$353.60 |
$353.60 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$157.60 |
$157.60 |
$157.60 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$211.20 |
$211.20 |
$211.20 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$96.80 |
$96.80 |
$96.80 |
$217.60
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$2,289.60 |
$2,289.60 |
$2,289.60 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$522.40 |
$522.40 |
$522.40 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$348.80 |
$348.80 |
$348.80 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$591.20 |
$591.20 |
$591.20 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$394.40 |
$394.40 |
$394.40 |
$304.20
|
|
Influenza dna amp prob addl
|
$80.80 |
$80.80 |
$80.80 |
$64.26
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$162.40 |
$162.40 |
$162.40 |
$296.00
|
|
Inj cntr knee arthro incl ct/mri
|
$824.00 |
$824.00 |
$824.00 |
$436.80
|
|
Inj dx for sinogram
|
$506.40 |
$506.40 |
$506.40 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,099.20 |
$1,099.20 |
$1,099.20 |
$503.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$427.20 |
$427.20 |
$427.20 |
$458.15
|
|
Injection during cath supravalvular aortography
|
$1,352.00 |
$1,352.00 |
$1,352.00 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,637.60 |
$1,637.60 |
$1,637.60 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$898.40 |
$898.40 |
$898.40 |
$436.00
|
|
Injection for bladder x-ray
|
$707.20 |
$707.20 |
$707.20 |
$459.20
|
|
Injection for hip x-ray
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$703.20 |
$703.20 |
$703.20 |
$497.76
|
|
Injection into brain canal
|
$1,571.20 |
$1,571.20 |
$1,571.20 |
$844.50
|
|
Injection of sinus tract
|
$1,708.80 |
$1,708.80 |
$1,708.80 |
$1,640.99
|
|
Injection radioactive tracer sentinel node (both sides)
|
$4,431.20 |
$4,431.20 |
$4,431.20 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,396.00 |
$1,396.00 |
$1,396.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,165.60 |
$1,165.60 |
$1,165.60 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$5,192.00 |
$5,192.00 |
$5,192.00 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,660.00 |
$1,660.00 |
$1,660.00 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,824.80 |
$2,824.80 |
$2,824.80 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$5,971.20 |
$5,971.20 |
$5,971.20 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,953.60 |
$3,953.60 |
$3,953.60 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$3,438.40 |
$3,438.40 |
$3,438.40 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,071.20 |
$1,071.20 |
$1,071.20 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,216.00 |
$1,216.00 |
$1,216.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$258.40 |
$258.40 |
$258.40 |
$145.60
|
|
Inject sacroiliac joint
|
$3,944.00 |
$3,944.00 |
$3,944.00 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$2,732.80 |
$2,732.80 |
$2,732.80 |
$1,329.00
|
|
Inj for ext venography
|
$683.20 |
$683.20 |
$683.20 |
$628.80
|
|
Inj for mammo ductogram
|
$564.00 |
$564.00 |
$564.00 |
$397.80
|
|
Inj multihance
|
$18.40 |
$18.40 |
$18.40 |
$70.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,414.40 |
$2,414.40 |
$2,414.40 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,673.60 |
$1,673.60 |
$1,673.60 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,673.60 |
$1,673.60 |
$1,673.60 |
$2,726.90
|
|
Inj proc ankle arthr
|
$827.20 |
$827.20 |
$827.20 |
$405.31
|
|
Inj proc elbow arthro
|
$822.40 |
$822.40 |
$822.40 |
$432.00
|
|
Inj proc lumbr disk ea lvl
|
$2,106.40 |
$2,106.40 |
$2,106.40 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$2,352.00 |
$2,352.00 |
$2,352.00 |
$838.30
|
|
Inj proc sialogram
|
$1,046.40 |
$1,046.40 |
$1,046.40 |
$373.00
|
|
Inj prohance multipack
|
$17.60 |
$17.60 |
$17.60 |
$10.40
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$1,460.80 |
$1,460.80 |
$1,460.80 |
$436.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$2,812.80 |
$2,812.80 |
$2,812.80 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,875.20 |
$1,875.20 |
$1,875.20 |
$818.00
|
|
Inj w/fluor eval cv device
|
$1,839.20 |
$1,839.20 |
$1,839.20 |
$504.40
|
|
Ins cath ren art 1st bi
|
$8,027.20 |
$8,027.20 |
$8,027.20 |
$5,974.80
|
|
Insert cath pleura with image
|
$3,935.20 |
$3,935.20 |
$3,935.20 |
$2,194.40
|
|
Insertion catheter bladder non indwelling
|
$163.20 |
$163.20 |
$163.20 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$8,537.60 |
$8,537.60 |
$8,537.60 |
$4,897.20
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,900.00 |
$2,900.00 |
$2,900.00 |
$2,585.25
|
|
Insertion of catheter vein
|
$1,692.80 |
$1,692.80 |
$1,692.80 |
$1,525.80
|
|
Insertion of catheter vein
|
$550.40 |
$550.40 |
$550.40 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,105.60 |
$9,105.60 |
$9,105.60 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$9,105.60 |
$9,105.60 |
$9,105.60 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$8,668.00 |
$8,668.00 |
$8,668.00 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,527.20 |
$2,527.20 |
$2,527.20 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,432.80 |
$3,432.80 |
$3,432.80 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$28,276.80 |
$28,276.80 |
$28,276.80 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$13,997.60 |
$13,997.60 |
$13,997.60 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$7,196.00 |
$7,196.00 |
$7,196.00 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$16,301.60 |
$16,301.60 |
$16,301.60 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$7,274.40 |
$7,274.40 |
$7,274.40 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$7,196.00 |
$7,196.00 |
$7,196.00 |
$7,115.90
|
|
Insert swan-ganz cath
|
$4,500.00 |
$4,500.00 |
$4,500.00 |
$2,164.52
|
|
Ins icd gen exist mlt leads
|
$28,980.00 |
$28,980.00 |
$28,980.00 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$20,242.40 |
$20,242.40 |
$20,242.40 |
$23,230.50
|
|
Insitu hybridization auto
|
$602.40 |
$602.40 |
$602.40 |
$377.37
|
|
Insitu hybridization (fish)
|
$827.20 |
$827.20 |
$827.20 |
$481.00
|
|
Insitu hybridization manual
|
$758.40 |
$758.40 |
$758.40 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$684.80 |
$684.80 |
$684.80 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$607.20 |
$607.20 |
$607.20 |
$338.40
|
|
Ins/rpl ldless pm right vent w img & eval
|
$28,980.00 |
$28,980.00 |
$28,980.00 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$13,612.00 |
$13,612.00 |
$13,612.00 |
$11,005.50
|
|
Ins/rpl pm w/tv ld atrl
|
$14,822.40 |
$14,822.40 |
$14,822.40 |
$11,583.66
|
