|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$46.80 |
$46.80 |
$46.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$46.80 |
$46.80 |
$46.80 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$28.08 |
$28.08 |
$28.08 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$22.88 |
$22.88 |
$22.88 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$125.84 |
$125.84 |
$125.84 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$81.12 |
$81.12 |
$81.12 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$83.20 |
$83.20 |
$83.20 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$914.68 |
$914.68 |
$914.68 |
$861.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$105.04 |
$105.04 |
$105.04 |
$151.25
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$81.12 |
$81.12 |
$81.12 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$96.72 |
$96.72 |
$96.72 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$260.52 |
$260.52 |
$260.52 |
$217.70
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$260.52 |
$260.52 |
$260.52 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$48.88 |
$48.88 |
$48.88 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$48.36 |
$48.36 |
$48.36 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$69.68 |
$69.68 |
$69.68 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$807.56 |
$807.56 |
$807.56 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$223.60 |
$223.60 |
$223.60 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$461.76 |
$461.76 |
$461.76 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$488.28 |
$488.28 |
$488.28 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$131.56 |
$131.56 |
$131.56 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$242.32 |
$242.32 |
$242.32 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$206.96 |
$206.96 |
$206.96 |
$374.50
|
|
Infliximab 100 mg intravenous solution
|
$685.15 |
$685.15 |
$685.15 |
$2,080.86
|
|
Influenza dna amp prob addl
|
$46.28 |
$46.28 |
$46.28 |
$64.26
|
|
Initiation & management bipap/cpap initial day
|
$426.92 |
$426.92 |
$426.92 |
$576.00
|
|
Inj, acetaminophen (b braun)
|
$22.04 |
$22.04 |
$22.04 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$21.84 |
$21.84 |
$21.84 |
$38.87
|
|
Inj, acetaminophen (hikma)
|
$16.38 |
$16.38 |
$16.38 |
$68.30
|
|
Inj allopurinol sodium 1 mg
|
$3,427.49 |
$3,427.49 |
$3,427.49 |
$6,968.99
|
|
Inj, bortezomib freseniuskab
|
$1,851.10 |
$1,851.10 |
$1,851.10 |
$2,464.14
|
|
Inj, bortezomib, hospira
|
$72.01 |
$72.01 |
$72.01 |
$175.35
|
|
Inj cefazolin sodium, baxter
|
$45.24 |
$45.24 |
$45.24 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$18.94 |
$18.94 |
$18.94 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$14.04 |
$14.04 |
$14.04 |
$18.30
|
|
Inj. cefepime hcl (baxter)
|
$207.48 |
$207.48 |
$207.48 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$107.69 |
$107.69 |
$107.69 |
$69.85
|
|
Inj, clindamycin (baxter)
|
$23.79 |
$23.79 |
$23.79 |
$48.39
|
|
Inj cyclophos dr.reddy's 5mg
|
$5,460.00 |
$5,460.00 |
$5,460.00 |
$4,725.00
|
|
Inj cyclophosphamd auromedic
|
$363.65 |
$363.65 |
$363.65 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$2,114.22 |
$2,114.22 |
$2,114.22 |
$742.72
|
|
Inj, daptomycin (hospira)
|
$128.08 |
$128.08 |
$128.08 |
$110.83
|
|
Inj daptomycin (xellia)
|
$46.92 |
$46.92 |
$46.92 |
$56.04
|
|
Inj, decitabine (sun pharma)
|
$144.32 |
$144.32 |
$144.32 |
$295.94
|
|
Injection, edaravone, 1 mg
|
$519.48 |
$519.48 |
$519.48 |
$1,136.59
|
|
Injection, fulvestrant
|
$2,495.56 |
$2,495.56 |
$2,495.56 |
$1,719.16
|
|
Injection glatiramer acetate
|
$234.51 |
$234.51 |
$234.51 |
$830.51
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$444.08 |
$444.08 |
$444.08 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,096.68 |
$1,096.68 |
$1,096.68 |
$1,939.60
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$346.84 |
$346.84 |
$346.84 |
$460.94
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$121.16 |
$121.16 |
$121.16 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$146.64 |
$146.64 |
$146.64 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$62.92 |
$62.92 |
$62.92 |
$135.20
|
|
Inj, epinephrine (belcher)
|
$3,169.72 |
$3,169.72 |
$3,169.72 |
$6.24
|
|
Inj, fosaprepitant (teva)
|
$103.01 |
$103.01 |
$103.01 |
$152.10
|
|
Inj, fulvestrant (fresenius)
|
$1,322.89 |
$1,322.89 |
$1,322.89 |
$1,065.08
|
|
Inj gemcitabine hcl (accord)
|
$150.98 |
$150.98 |
$150.98 |
$113.90
|
|
Inj glycopyrrolate fres kabi
|
$31.67 |
$31.67 |
$31.67 |
$12.18
|
|
Inj heparin, pfizer, 1000u
|
$22.46 |
$22.46 |
$22.46 |
$24.28
|
|
Inj, idacio, 1 mg
|
$1,297.39 |
$1,297.39 |
$1,297.39 |
$14.63
|
|
Inj intralesional <= 7 lsn(s)
|
$289.64 |
$289.64 |
$289.64 |
$235.13
|
|
Inj labetalol hcl hikma, 5mg
|
$11.36 |
$11.36 |
$11.36 |
$40.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$8,803.25 |
$8,803.25 |
$8,803.25 |
$11,648.70
|
|
Inj levoleucovorin nos 0.5mg
|
$248.51 |
$248.51 |
$248.51 |
$103.60
|
|
Inj, linezolid (hospira)
|
$234.00 |
$234.00 |
$234.00 |
$153.30
|
|
Inj melpha hydroch nos 50 mg
|
$1,493.82 |
$1,493.82 |
$1,493.82 |
$2,375.23
|
|
Inj, meropenem (b. braun)
|
$107.91 |
$107.91 |
$107.91 |
$71.14
|
|
Inj meropenem (wg crit care)
|
$112.78 |
$112.78 |
$112.78 |
$77.97
|
|
Inj, micafungin (par pharm)
|
$140.84 |
$140.84 |
$140.84 |
$89.40
|
|
Inj. mycophenolate mofetil
|
$261.57 |
$261.57 |
$261.57 |
$252.66
|
|
Inj pantoprazole(hikma) 40mg
|
$47.45 |
$47.45 |
$47.45 |
$34.61
|
|
Inj pemetrexed (accord) 10mg
|
$1,507.40 |
$1,507.40 |
$1,507.40 |
$33.79
|
|
Inj pemetrexed (sandoz) 10mg
|
$71.60 |
$71.60 |
$71.60 |
$95.26
|
|
Inj pemetrexed (teva) 10mg
|
$2,290.89 |
$2,290.89 |
$2,290.89 |
$200.85
|
|
Inj romidepsin non-lyo 0.1mg
|
$11,484.81 |
$11,484.81 |
$11,484.81 |
$9,892.69
|
|
Inj. tigecycline (accord)
|
$451.81 |
$451.81 |
$451.81 |
$182.46
|
|
Inj, vancomycin hcl (mylan)
|
$152.84 |
$152.84 |
$152.84 |
$76.59
|
|
Inj, vancomycin hcl (xellia)
|
$53.04 |
$53.04 |
$53.04 |
$85.20
|
|
Inj vasopressin (am reg) 1 u
|
$90.16 |
$90.16 |
$90.16 |
$40.24
|
|
Insert cath pleura without image
|
$1,009.32 |
$1,009.32 |
$1,009.32 |
$2,019.00
|
|
Insertion catheter bladder non indwelling
|
$96.72 |
$96.72 |
$96.72 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$96.72 |
$96.72 |
$96.72 |
$229.32
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,907.88 |
$1,907.88 |
$1,907.88 |
$4,731.80
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$567.32 |
$567.32 |
$567.32 |
$2,511.00
|
|
Insertion of heart electrode 33211
|
$9,437.48 |
$9,437.48 |
$9,437.48 |
$7,392.84
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$895.96 |
$895.96 |
$895.96 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,137.76 |
$1,137.76 |
$1,137.76 |
$2,414.10
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$10,253.36 |
$10,253.36 |
$10,253.36 |
$7,513.67
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,280.76 |
$1,280.76 |
$1,280.76 |
$1,609.25
|
|
Ins tun cv cath wo subq prt/pm
|
$140.92 |
$140.92 |
$140.92 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$140.92 |
$140.92 |
$140.92 |
$4,202.70
|
|
Insulin total
|
$27.04 |
$27.04 |
$27.04 |
$66.64
|
|
Intubation endotracheal emergency procedure
|
$391.56 |
$391.56 |
$391.56 |
$589.60
|
|
Iron
|
$15.08 |
$15.08 |
$15.08 |
$74.40
|
|
Iron binding capacity
|
$42.64 |
$42.64 |
$42.64 |
$63.79
|
|
Irrigation implantable venous access device for drug delivery systems
|
$93.60 |
$93.60 |
$93.60 |
$142.20
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$58.76 |
$58.76 |
$58.76 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$89.44 |
$89.44 |
$89.44 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$136.76 |
$136.76 |
$136.76 |
$439.56
|
|
Ivp w/wo kub w/wo tomography
|
$192.40 |
$192.40 |
$192.40 |
$692.18
|