|
Implant cochlear osia osi300
HCPCS L8690
|
$19,311.26
|
$34,484.40
|
$189.15 – $9,457.34
|
8 |
|
Implant pulse generator remede el
HCPCS C1823
|
$43,752.80
|
$78,130.00
|
$34,200.63 – $63,893.93
|
6 |
|
In-111 autol wbc diag per dose
HCPCS A9570
|
$1,265.71
|
$2,260.20
|
$989.38 – $5,966.12
|
10 |
|
In-111 capromab pendet
HCPCS A9507
|
$4,657.35
|
$8,316.70
|
$1,643.78 – $6,977.58
|
10 |
|
In-111 ibritumomab tiux dx
HCPCS A9542
|
$4,231.92
|
$7,557.00
|
$3,308.00 – $18,571.51
|
8 |
|
In-111 oxyquinolin per 0.5 mci
HCPCS A9547
|
$2,301.21
|
$4,109.30
|
$789.89 – $4,277.18
|
10 |
|
In-111 pentetate dtpa / 0.5 mci
HCPCS A9548
|
$836.53
|
$1,493.80
|
$572.39 – $1,730.75
|
10 |
|
In-111 pentetreotide
HCPCS A9572
|
$4,693.70
|
$8,381.60
|
$1,900.89 – $6,747.58
|
10 |
|
In-111 satumomab pend
HCPCS A4642
|
$1,575.06
|
$2,812.60
|
$1,231.19 – $4,410.74
|
8 |
|
Incision of tongue fold
CPT 41010
|
$219.86
|
$392.60
|
$171.86 – $1,599.04
|
10 |
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
CPT 87626
|
$236.38
|
$422.10
|
$65.36 – $179.26
|
9 |
|
Infect ag drug suscept pheno predict
CPT 87900
|
$501.82
|
$896.10
|
$26.98 – $506.54
|
10 |
|
Infect ag genotype na hiv-1 other region
CPT 87906
|
$1,003.63
|
$1,792.20
|
$32.67 – $499.83
|
10 |
|
Infect ag genotype na hiv-1 revr trn/prt
CPT 87901
|
$636.78
|
$1,137.10
|
$26.98 – $568.20
|
10 |
|
Infect ag ia optc obs influenza
CPT 87804
|
$53.48
|
$95.50
|
$15.41 – $78.10
|
10 |
|
Infect ag na hpv high-risk types
CPT 87624
|
$173.66
|
$310.10
|
$26.98 – $92.34
|
10 |
|
Infect ag na influenza r/amp 1st 2 types
CPT 87502
|
$145.94
|
$260.60
|
$32.67 – $213.12
|
10 |
|
Infect ag na orthopoxvirus amp prb each
CPT 87593
|
$186.76
|
$333.50
|
$47.77 – $102.31
|
9 |
|
Infect ag na resp virus 12-25 targets
CPT 87633
|
$1,950.20
|
$3,482.50
|
$26.98 – $2,847.95
|
10 |
|
Infect ag phenotype na hiv-1 1-10 drugs
CPT 87903
|
$1,072.12
|
$1,914.50
|
$26.98 – $1,565.66
|
10 |
|
Infect ag phenotype na hiv-1 ea addl drg
CPT 87904
|
$63.00
|
$112.50
|
$24.27 – $92.34
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
CPT 87324
|
$156.52
|
$279.50
|
$11.15 – $81.58
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
CPT 87327
|
$58.24
|
$104.00
|
$12.49 – $81.58
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
CPT 87328
|
$68.88
|
$123.00
|
$12.86 – $81.57
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step giardia
CPT 87329
|
$61.71
|
$110.20
|
$11.15 – $81.58
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
CPT 87338
|
$95.26
|
$170.10
|
$13.39 – $81.58
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
CPT 87340
|
$39.87
|
$71.20
|
$9.61 – $81.57
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
CPT 87341
|
$101.58
|
$181.40
|
$9.61 – $148.35
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
CPT 87389
|
$46.26
|
$82.60
|
$19.74 – $81.57
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
CPT 87449
|
$296.63
|
$529.70
|
$11.15 – $81.58
|
10 |
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
CPT 87427
|
$34.66
|
$61.90
|
$11.15 – $81.58
|
10 |
|
Infectious agent nucleic acid amplified probe
CPT 87798
|
$510.16
|
$911.00
|
$23.24 – $92.33
|
10 |
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
CPT 87491
|
$150.64
|
$269.00
|
$17.25 – $81.58
|
10 |
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
CPT 87493
|
$128.52
|
$229.50
|
$23.83 – $166.01
|
10 |
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
CPT 87483
|
$1,094.74
|
$1,954.90
|
$26.98 – $1,598.70
|
10 |
|
Infectious agent nucleic acid amplified probe hsv-1
CPT 87529
|
$432.26
|
$771.90
|
$26.98 – $97.24
|
10 |
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
CPT 87641
|
$133.22
|
$237.90
|
$26.98 – $141.48
|
10 |
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
CPT 87556
|
$537.04
|
$959.00
|
$26.98 – $503.43
|
10 |
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
CPT 87591
|
$150.64
|
$269.00
|
$17.25 – $92.34
|
10 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
CPT 87635
|
$151.31
|
$270.20
|
$39.29 – $196.19
|
10 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
CPT 87636
|
$333.82
|
$596.10
|
$109.23 – $487.48
|
10 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
CPT 87637
|
$423.47
|
$756.20
|
$109.23 – $546.20
|
10 |
|
Infectious agent nucleic acid amplified probe streptococcus group a
CPT 87651
|
$165.31
|
$295.20
|
$26.98 – $149.08
|
10 |
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
CPT 87661
|
$198.97
|
$355.30
|
$26.98 – $92.34
|
10 |
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
CPT 87494
|
$93.63
|
$167.20
|
$33.79 – $69.68
|
9 |
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
CPT 87564
|
$423.47
|
$756.20
|
$71.47 – $618.41
|
9 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
CPT 87506
|
$316.46
|
$565.10
|
$26.98 – $311.33
|
10 |
|
Infectious agent nucleic acid quantification bk virus
CPT 87799
|
$291.93
|
$521.30
|
$26.98 – $215.65
|
10 |
|
Infectious agent nucleic acid quantification hepatitis b
CPT 87517
|
$186.87
|
$333.70
|
$26.98 – $247.46
|
10 |
|
Infectious agent nucleic acid quantification hepatitis c
CPT 87522
|
$172.70
|
$308.40
|
$26.98 – $208.54
|
10 |
|
Infectious agent nucleic acid quantification hiv-1
CPT 87536
|
$170.80
|
$305.00
|
$26.98 – $181.22
|
10 |
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
CPT 87631
|
$649.94
|
$1,160.60
|
$26.98 – $949.13
|
10 |
|
Infliximab 100 mg intravenous solution
HCPCS J1745
|
$2,171.51
|
$3,877.69
|
$30.80 – $1,475.78
|
11 |
|
Infliximab-dyyb 100 mg intravenous solution
HCPCS Q5103
|
$945.52
|
$1,688.42
|
$16.20 – $1,380.77
|
11 |
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
CPT 94642
|
$131.15
|
$234.20
|
$56.03 – $225.67
|
10 |
|
Init ak ischal plstr direct
HCPCS L5505
|
$3,289.10
|
$5,873.40
|
$1,487.74 – $4,803.21
|
10 |
|
Init bk ptb plaster direct
HCPCS L5500
|
$2,338.06
|
$4,175.10
|
$1,057.59 – $3,414.35
|
10 |
|
Initial custom socket insert
HCPCS L5683
|
$2,085.61
|
$3,724.30
|
$943.37 – $3,045.70
|
10 |
|
Inj, abilify maintena, 1 mg
HCPCS J0401
|
$4,765.94
|
$8,510.60
|
$6.91 – $5,227.90
|
10 |
|
Inj acetaminophen -fresenius
HCPCS J0134
|
$32.93
|
$58.80
|
$0.05 – $48.09
|
8 |
|
Inj beta interferon sq 1 mcg
HCPCS Q3028
|
$1,721.76
|
$3,074.58
|
$43.22 – $2,514.36
|
8 |
|
Inj, bortezomib, dr. reddy's
HCPCS J9046
|
$135.52
|
$242.00
|
$3.29 – $197.91
|
10 |
|
Inj, bupivacaine liposome
HCPCS J0666
|
$732.96
|
$1,308.86
|
$1.45 – $1,070.37
|
8 |
|
Inj cefazolin sodium, hikma
HCPCS J0688
|
$31.39
|
$56.05
|
$1.00 – $40.35
|
8 |
|
Inj, clindamycin (baxter)
HCPCS J0737
|
$81.49
|
$145.52
|
$2.58 – $49.85
|
8 |
|
Inj cntr knee arthro incl ct/mri
CPT 27369
|
$678.10
|
$1,210.90
|
$102.66 – $990.26
|
8 |
|
Inj. denosumab-bbdz, 1 mg
HCPCS Q5136
|
$5,215.73
|
$9,313.81
|
$26.82 – $3,870.13
|
9 |
|
Inj dx for sinogram
CPT 20501
|
$400.12
|
$714.50
|
$57.88 – $584.31
|
8 |
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
CPT 64454
|
$414.06
|
$739.40
|
$198.46 – $727.47
|
10 |
|
Injection arthrography hip without anesthesia (both sides)
CPT 27093
|
$678.10
|
$1,210.90
|
$106.74 – $990.26
|
8 |
|
Injection, daratumumab 10 mg
HCPCS J9145
|
$5,023.56
|
$8,970.65
|
$67.25 – $2,110.21
|
11 |
|
Injection epidural blood patch or clot
CPT 62273
|
$374.36
|
$668.50
|
$219.26 – $864.90
|
10 |
|
Injection for arthrography wrist (both sides)
CPT 25246
|
$529.20
|
$945.00
|
$114.71 – $772.81
|
8 |
|
Injection for bladder x-ray
CPT 51600
|
$1,808.30
|
$3,229.10
|
$68.51 – $2,640.73
|
8 |
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
CPT 23350
|
$678.10
|
$1,210.90
|
$128.98 – $990.26
|
8 |
|
Injection, fulvestrant
HCPCS J9395
|
$3,402.24
|
$6,075.42
|
$7.37 – $188.69
|
9 |
|
Injection radioactive tracer sentinel node (both sides)
CPT 38792
|
$403.59
|
$720.70
|
$84.23 – $589.38
|
10 |
|
Injection, renflexis
HCPCS Q5104
|
$880.05
|
$1,571.52
|
$26.37 – $1,285.17
|
11 |
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
HCPCS G0260
|
$1,008.90
|
$1,801.60
|
$666.98 – $2,100.11
|
10 |
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
CPT 64447
|
$993.44
|
$1,774.00
|
$666.98 – $2,799.71
|
10 |
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
CPT 64450
|
$993.44
|
$1,774.00
|
$666.98 – $4,248.37
|
10 |
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
CPT 64483
|
$1,520.51
|
$2,715.20
|
$279.90 – $1,440.46
|
10 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
CPT 64491
|
$140.17
|
$250.30
|
$54.59 – $456.32
|
8 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
CPT 64490
|
$1,520.51
|
$2,715.20
|
$265.86 – $2,010.86
|
10 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
CPT 64494
|
$164.70
|
$294.10
|
$54.72 – $3,460.01
|
8 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
CPT 64493
|
$1,520.51
|
$2,715.20
|
$769.07 – $3,460.01
|
10 |
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
CPT 62321
|
$893.26
|
$1,595.10
|
$691.10 – $2,079.30
|
10 |
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
CPT 62323
|
$949.48
|
$1,695.50
|
$589.42 – $1,633.91
|
10 |
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
CPT 20550
|
$732.59
|
$1,308.20
|
$300.52 – $5,896.68
|
10 |
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
CPT 20552
|
$660.35
|
$1,179.20
|
$300.52 – $1,008.07
|
10 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
CPT 96376
|
$97.44
|
$174.00
|
$14.79 – $124.06
|
9 |
|
Inj epidural sgl cerv-thor without img
CPT 62320
|
$594.16
|
$1,061.00
|
$347.92 – $4,168.80
|
10 |
|
Inj epidural sgl lumb-sacral without img
CPT 62322
|
$658.50
|
$1,175.90
|
$385.52 – $4,211.47
|
10 |
|
Inj fluphenazine hcl 1.25 mg
HCPCS J2679
|
$225.43
|
$402.56
|
$7.28 – $329.21
|
8 |
|
Inj for ext venography
CPT 36005
|
$678.10
|
$1,210.90
|
$74.34 – $990.26
|
8 |
|
Inj heparin, pfizer, 1000u
HCPCS J1643
|
$46.82
|
$83.60
|
$2.99 – $43.29
|
8 |
|
Inj ivig privigen 500 mg
HCPCS J1459
|
$4,026.46
|
$7,190.10
|
$47.77 – $2,982.11
|
12 |
|
Inj, lanreotide, (cipla) 1mg
HCPCS J1932
|
$7,229.26
|
$12,909.39
|
$25.88 – $10,557.17
|
11 |
|
Inj levoleucovorin nos 0.5mg
HCPCS J0641
|
$122.64
|
$219.00
|
$0.02 – $108.41
|
9 |
|
Inj, levothyroxine, freskabi
HCPCS J0651
|
$177.88
|
$317.64
|
$6.52 – $259.76
|
10 |