|
Infect ag ia optc obs influenza
|
$40.26 |
$40.26 |
$40.26 |
$72.93
|
|
Infect ag na hep b amp
|
$63.73 |
$63.73 |
$63.73 |
$120.50
|
|
Infect ag na hpv high-risk types
|
$160.78 |
$160.78 |
$160.78 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$122.08 |
$122.08 |
$122.08 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$138.88 |
$138.88 |
$138.88 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$132.78 |
$132.78 |
$132.78 |
$854.70
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$886.26 |
$886.26 |
$886.26 |
$954.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$49.22 |
$49.22 |
$49.22 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$130.82 |
$130.82 |
$130.82 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$76.05 |
$76.05 |
$76.05 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$57.29 |
$57.29 |
$57.29 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$51.24 |
$51.24 |
$51.24 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$79.63 |
$79.63 |
$79.63 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$50.96 |
$50.96 |
$50.96 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$79.52 |
$79.52 |
$79.52 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$38.70 |
$38.70 |
$38.70 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$194.15 |
$194.15 |
$194.15 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$32.09 |
$32.09 |
$32.09 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$1,098.16 |
$1,098.16 |
$1,098.16 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$118.72 |
$118.72 |
$118.72 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$95.03 |
$95.03 |
$95.03 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$889.50 |
$889.50 |
$889.50 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$163.86 |
$163.86 |
$163.86 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$94.30 |
$94.30 |
$94.30 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$1,122.07 |
$1,122.07 |
$1,122.07 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$118.72 |
$118.72 |
$118.72 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$140.11 |
$140.11 |
$140.11 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$292.66 |
$292.66 |
$292.66 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$392.11 |
$392.11 |
$392.11 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$68.82 |
$68.82 |
$68.82 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$228.09 |
$228.09 |
$228.09 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$110.43 |
$110.43 |
$110.43 |
$217.60
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$392.11 |
$392.11 |
$392.11 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$264.60 |
$264.60 |
$264.60 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$191.13 |
$191.13 |
$191.13 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$156.91 |
$156.91 |
$156.91 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$156.91 |
$156.91 |
$156.91 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$158.76 |
$158.76 |
$158.76 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$291.82 |
$291.82 |
$291.82 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$2,248.19 |
$2,248.19 |
$2,248.19 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$927.31 |
$927.31 |
$927.31 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$974.05 |
$974.05 |
$974.05 |
$1,537.84
|
|
Influenza virus vaccine, live trivalent intranasal
|
$31.70 |
$31.70 |
$31.70 |
$36.50
|
|
Infuse radioactive materials
|
$464.07 |
$464.07 |
$464.07 |
$739.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$157.98 |
$157.98 |
$157.98 |
$296.00
|
|
Init ak ischal plstr direct
|
$4,368.90 |
$4,368.90 |
$4,368.90 |
$2,609.60
|
|
Init bk ptb plaster direct
|
$3,105.70 |
$3,105.70 |
$3,105.70 |
$2,148.48
|
|
Initial custom socket insert
|
$2,770.32 |
$2,770.32 |
$2,770.32 |
$1,453.20
|
|
Inj, abilify maintena, 1 mg
|
$4,913.05 |
$4,913.05 |
$4,913.05 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$36.18 |
$36.18 |
$36.18 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$36.60 |
$36.60 |
$36.60 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$47.58 |
$47.58 |
$47.58 |
$56.70
|
|
Inj, bupivacaine liposome
|
$756.08 |
$756.08 |
$756.08 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$35.02 |
$35.02 |
$35.02 |
$27.38
|
|
Inj, clindamycin (baxter)
|
$56.07 |
$56.07 |
$56.07 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$581.84 |
$581.84 |
$581.84 |
$436.80
|
|
Inj cyclophosphamd (ingenus)
|
$640.08 |
$640.08 |
$640.08 |
$742.72
|
|
Inj daptomycin (xellia)
|
$50.00 |
$50.00 |
$50.00 |
$56.04
|
|
Inj, decitabine (sun pharma)
|
$310.09 |
$310.09 |
$310.09 |
$310.09
|
|
Inj. denosumab-bbdz, 1 mg
|
$5,384.66 |
$5,384.66 |
$5,384.66 |
$4,615.43
|
|
Inj disk cerv-thor ea lev
|
$522.82 |
$522.82 |
$522.82 |
$875.28
|
|
Inj dx for sinogram
|
$260.23 |
$260.23 |
$260.23 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$348.82 |
$348.82 |
$348.82 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$574.28 |
$574.28 |
$574.28 |
$503.50
|
|
Injection, belinostat, 10mg
|
$4,692.36 |
$4,692.36 |
$4,692.36 |
$4,446.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$422.97 |
$422.97 |
$422.97 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$5,188.91 |
$5,188.91 |
$5,188.91 |
$5,324.34
|
|
Injection epidural blood patch or clot
|
$545.33 |
$545.33 |
$545.33 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$300.05 |
$300.05 |
$300.05 |
$436.00
|
|
Injection for hip x-ray
|
$582.12 |
$582.12 |
$582.12 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$581.84 |
$581.84 |
$581.84 |
$497.76
|
|
Injection for tear sac x-ray
|
$67.31 |
$67.31 |
$67.31 |
$225.20
|
|
Injection for ureter x-ray
|
$314.27 |
$314.27 |
$314.27 |
$415.80
|
|
Injection for ureter x-ray
|
$317.91 |
$317.91 |
$317.91 |
$515.21
|
|
Injection, fulvestrant
|
$3,518.45 |
$3,518.45 |
$3,518.45 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$6,383.95 |
$6,383.95 |
$6,383.95 |
$6,679.35
|
|
Injection into brain canal
|
$237.66 |
$237.66 |
$237.66 |
$844.50
|
|
Injection,onabotulinumtoxina
|
$2,504.21 |
$2,504.21 |
$2,504.21 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$145.04 |
$145.04 |
$145.04 |
$685.44
|
|
Injection, renflexis
|
$915.59 |
$915.59 |
$915.59 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,846.10 |
$1,846.10 |
$1,846.10 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,004.25 |
$1,004.25 |
$1,004.25 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,004.25 |
$1,004.25 |
$1,004.25 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,521.07 |
$1,521.07 |
$1,521.07 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$141.62 |
$141.62 |
$141.62 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,521.07 |
$1,521.07 |
$1,521.07 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$581.84 |
$581.84 |
$581.84 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,521.07 |
$1,521.07 |
$1,521.07 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$989.52 |
$989.52 |
$989.52 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$855.74 |
$855.74 |
$855.74 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$827.74 |
$827.74 |
$827.74 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$434.17 |
$434.17 |
$434.17 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$130.70 |
$130.70 |
$130.70 |
$145.60
|
|
Inj epidural sgl cerv-thor without img
|
$764.46 |
$764.46 |
$764.46 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$610.57 |
$610.57 |
$610.57 |
$1,450.84
|
|
Inj fluphenazine hcl 1.25 mg
|
$234.45 |
$234.45 |
$234.45 |
$40.33
|
|
Inj for mammo ductogram
|
$193.03 |
$193.03 |
$193.03 |
$397.80
|
|
Inj, fulvestrant (fresenius)
|
$462.67 |
$462.67 |
$462.67 |
$905.30
|
|
Inj, fulvestrant (teva)
|
$882.69 |
$882.69 |
$882.69 |
$136.50
|
|
Inj heparin, pfizer, 1000u
|
$53.17 |
$53.17 |
$53.17 |
$25.30
|
