|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$67.20 |
$67.20 |
$67.20 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$97.60 |
$97.60 |
$97.60 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$176.80 |
$176.80 |
$176.80 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$92.00 |
$92.00 |
$92.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$106.40 |
$106.40 |
$106.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$139.20 |
$139.20 |
$139.20 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$80.00 |
$80.00 |
$80.00 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$90.40 |
$90.40 |
$90.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$120.80 |
$120.80 |
$120.80 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$172.00 |
$172.00 |
$172.00 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$202.40 |
$202.40 |
$202.40 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$151.20 |
$151.20 |
$151.20 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$107.20 |
$107.20 |
$107.20 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$185.60 |
$185.60 |
$185.60 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$108.00 |
$108.00 |
$108.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$124.80 |
$124.80 |
$124.80 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$349.60 |
$349.60 |
$349.60 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$460.80 |
$460.80 |
$460.80 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$112.00 |
$112.00 |
$112.00 |
$96.00
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$280.00 |
$280.00 |
$280.00 |
$217.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,227.20 |
$1,227.20 |
$1,227.20 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$312.80 |
$312.80 |
$312.80 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$704.00 |
$704.00 |
$704.00 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$113.60 |
$113.60 |
$113.60 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$104.80 |
$104.80 |
$104.80 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$455.20 |
$455.20 |
$455.20 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$427.20 |
$427.20 |
$427.20 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$348.00 |
$348.00 |
$348.00 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$1,587.80 |
$1,587.80 |
$1,587.80 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$691.41 |
$691.41 |
$691.41 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$804.90 |
$804.90 |
$804.90 |
$1,537.84
|
|
Inj, acetaminophen (b braun)
|
$214.84 |
$214.84 |
$214.84 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$129.19 |
$129.19 |
$129.19 |
$36.60
|
|
Inj, adalimumab, 1 mg
|
$1,679.01 |
$1,679.01 |
$1,679.01 |
$12,098.05
|
|
Inj alymsys 10 mg
|
$2,727.24 |
$2,727.24 |
$2,727.24 |
$1,280.74
|
|
Inj., benralizumab, 1 mg
|
$8,205.27 |
$8,205.27 |
$8,205.27 |
$11,310.00
|
|
Inj, bortezomib freseniuskab
|
$1,926.94 |
$1,926.94 |
$1,926.94 |
$2,624.08
|
|
Inj, daptomycin (baxter)
|
$223.17 |
$223.17 |
$223.17 |
$1.83
|
|
Inj daptomycin (xellia)
|
$69.80 |
$69.80 |
$69.80 |
$56.04
|
|
Injection, doxercalciferol
|
$69.36 |
$69.36 |
$69.36 |
$23.86
|
|
Injection glatiramer acetate
|
$388.64 |
$388.64 |
$388.64 |
$830.51
|
|
Injection, renflexis
|
$689.86 |
$689.86 |
$689.86 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,210.40 |
$1,210.40 |
$1,210.40 |
$1,043.72
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$552.00 |
$552.00 |
$552.00 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$668.00 |
$668.00 |
$668.00 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$169.60 |
$169.60 |
$169.60 |
$145.60
|
|
Inj. fe derisomaltose 10 mg
|
$3,160.69 |
$3,160.69 |
$3,160.69 |
$3,221.52
|
|
Inj., guselkumab, 1 mg
|
$22,143.30 |
$22,143.30 |
$22,143.30 |
$29,130.83
|
|
Inj heparin, pfizer, 1000u
|
$60.87 |
$60.87 |
$60.87 |
$25.30
|
|
Inj hydroxocobalamin IV 25mg
|
$1,521.86 |
$1,521.86 |
$1,521.86 |
$2,452.32
|
|
Inj, invega hafyera/trinza
|
$15,517.48 |
$15,517.48 |
$15,517.48 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$2,277.60 |
$2,277.60 |
$2,277.60 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$64.23 |
$64.23 |
$64.23 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$0.87 |
$0.87 |
$0.87 |
$45.60
|
|
Inj octafluoropropane mic,ml
|
$205.59 |
$205.59 |
$205.59 |
$211.40
|
|
Inj pantoprazole(hikma) 40mg
|
$62.10 |
$62.10 |
$62.10 |
$34.67
|
|
Insert cath pleura with image
|
$2,908.80 |
$2,908.80 |
$2,908.80 |
$2,194.40
|
|
Insertion catheter bladder non indwelling
|
$283.20 |
$283.20 |
$283.20 |
$208.01
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,640.80 |
$2,640.80 |
$2,640.80 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,280.80 |
$3,280.80 |
$3,280.80 |
$2,453.83
|
|
In situ hybridization per specimen initial single probe stain
|
$412.00 |
$412.00 |
$412.00 |
$338.40
|
|
Ins pq tunnld ip cath w/img
|
$7,283.20 |
$7,283.20 |
$7,283.20 |
$5,486.00
|
|
Insulin total
|
$95.20 |
$95.20 |
$95.20 |
$66.64
|
|
Intrinsic factor antibody
|
$56.80 |
$56.80 |
$56.80 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$744.00 |
$744.00 |
$744.00 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$100.00 |
$100.00 |
$100.00 |
$279.10
|
|
Ipratropium bromide non-comp
|
$3.89 |
$3.89 |
$3.89 |
$4.06
|
|
Iron
|
$84.00 |
$84.00 |
$84.00 |
$75.00
|
|
Iron binding capacity
|
$105.60 |
$105.60 |
$105.60 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$82.79 |
$82.79 |
$82.79 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$66.40 |
$66.40 |
$66.40 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$160.80 |
$160.80 |
$160.80 |
$146.11
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$5,053.68 |
$5,053.68 |
$5,053.68 |
$8,273.35
|
|
IV Fluids (each additional hour)
|
$190.40 |
$190.40 |
$190.40 |
$133.90
|
|
IV Fluids (first hour)
|
$632.80 |
$632.80 |
$632.80 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$187.20 |
$187.20 |
$187.20 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$376.80 |
$376.80 |
$376.80 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$190.40 |
$190.40 |
$190.40 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$705.60 |
$705.60 |
$705.60 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$184.80 |
$184.80 |
$184.80 |
$167.50
|
|
IV Push Injection (first drug)
|
$484.80 |
$484.80 |
$484.80 |
$252.76
|
|
Ivp w/nephrotomography
|
$1,202.40 |
$1,202.40 |
$1,202.40 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$1,087.20 |
$1,087.20 |
$1,087.20 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$425.60 |
$425.60 |
$425.60 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$492.80 |
$492.80 |
$492.80 |
$362.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$46.40 |
$46.40 |
$46.40 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$62.40 |
$62.40 |
$62.40 |
$23.52
|
|
Kidney function study
|
$2,088.00 |
$2,088.00 |
$2,088.00 |
$935.22
|
|
Kidney img w/bldflw sgl without rx
|
$1,356.80 |
$1,356.80 |
$1,356.80 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,017.60 |
$1,017.60 |
$1,017.60 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$700.00 |
$700.00 |
$700.00 |
$490.75
|
|
Knee MRI (with and without contrast)
|
$3,895.20 |
$3,895.20 |
$3,895.20 |
$3,022.20
|
|
Knee MRI (without contrast)
|
$3,237.60 |
$3,237.60 |
$3,237.60 |
$2,130.88
|
|
Knee X-ray
|
$468.80 |
$468.80 |
$468.80 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$329.60 |
$329.60 |
$329.60 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$373.60 |
$373.60 |
$373.60 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$324.80 |
$324.80 |
$324.80 |
$251.20
|
|
Kyleena, 19.5 mg
|
$845.72 |
$845.72 |
$845.72 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$60.38 |
$60.38 |
$60.38 |
$33.60
|