|
Infect ag if influenza a
CPT 87276
|
$10.00
|
$40.00
|
$15.43 – $45.00
|
68 |
|
Infect ag if influenza b
CPT 87275
|
$9.25
|
$37.00
|
$11.76 – $34.30
|
68 |
|
Infect ag if legionella pneumophila
CPT 87278
|
$28.50
|
$114.00
|
$14.98 – $43.68
|
68 |
|
Infect ag if nos ea
CPT 87299
|
$12.50
|
$50.00
|
$15.46 – $45.08
|
68 |
|
Infect ag if varicella zoster
CPT 87290
|
$16.75
|
$67.00
|
$12.88 – $37.58
|
68 |
|
Infect ag na herpes simplex quant
CPT 87530
|
$257.75
|
$1,031.00
|
$41.13 – $119.95
|
68 |
|
Infect ag na hpv high-risk types
CPT 87624
|
$28.50
|
$114.00
|
$33.69 – $98.25
|
68 |
|
Infect ag na influenza r/amp 1st 2 types
CPT 87502
|
$91.75
|
$367.00
|
$91.97 – $268.24
|
68 |
|
Infect ag na orthopoxvirus amp prb each
CPT 87593
|
$29.50
|
$118.00
|
$49.26 – $143.67
|
68 |
|
Infect ag na resp virus 12-25 targets
CPT 87633
|
$467.25
|
$1,869.00
|
$400.11 – $1,166.98
|
68 |
|
Infect ag phenotype na hiv-1 1-10 drugs
CPT 87903
|
$396.50
|
$1,586.00
|
$469.11 – $1,368.25
|
68 |
|
Infect ag phenotype na hiv-1 ea addl drg
CPT 87904
|
$21.00
|
$84.00
|
$25.03 – $73.00
|
68 |
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
CPT 87811
|
$37.00
|
$148.00
|
$39.72 – $115.86
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
CPT 87324
|
$109.50
|
$438.00
|
$11.50 – $33.54
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
CPT 87328
|
$85.75
|
$343.00
|
$13.27 – $38.70
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step giardia
CPT 87329
|
$85.75
|
$343.00
|
$11.50 – $33.54
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
CPT 87338
|
$68.00
|
$272.00
|
$13.80 – $40.26
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
CPT 87340
|
$80.50
|
$322.00
|
$9.92 – $28.92
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
CPT 87389
|
$26.00
|
$104.00
|
$23.12 – $67.42
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
CPT 87449
|
$116.75
|
$467.00
|
$11.50 – $33.54
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
CPT 87425
|
$63.25
|
$253.00
|
$11.50 – $33.54
|
68 |
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
CPT 87427
|
$17.50
|
$70.00
|
$11.50 – $33.54
|
68 |
|
Infectious agent nucleic acid amplified probe
CPT 87798
|
$433.75
|
$1,735.00
|
$33.69 – $98.25
|
68 |
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
CPT 87491
|
$58.75
|
$235.00
|
$33.69 – $98.25
|
68 |
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
CPT 87493
|
$39.50
|
$158.00
|
$35.78 – $104.36
|
68 |
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
CPT 87483
|
$439.75
|
$1,759.00
|
$400.11 – $1,166.98
|
68 |
|
Infectious agent nucleic acid amplified probe hsv-1
CPT 87529
|
$62.50
|
$250.00
|
$33.69 – $98.25
|
68 |
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
CPT 87641
|
$39.50
|
$158.00
|
$33.69 – $98.25
|
68 |
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
CPT 87556
|
$429.00
|
$1,716.00
|
$40.01 – $116.70
|
68 |
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
CPT 87591
|
$58.75
|
$235.00
|
$33.69 – $98.25
|
68 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
CPT 87635
|
$46.50
|
$186.00
|
$49.26 – $143.67
|
68 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
CPT 87636
|
$125.25
|
$501.00
|
$136.92 – $399.36
|
68 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
CPT 87637
|
$125.25
|
$501.00
|
$136.92 – $399.36
|
68 |
|
Infectious agent nucleic acid amplified probe streptococcus group a
CPT 87651
|
$24.50
|
$98.00
|
$33.69 – $98.25
|
68 |
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
CPT 87661
|
$38.00
|
$152.00
|
$33.69 – $98.25
|
68 |
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
CPT 87564
|
$57.50
|
$230.00
|
$73.70 – $214.96
|
66 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
CPT 87507
|
$376.00
|
$1,504.00
|
$400.11 – $1,166.98
|
68 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
CPT 87505
|
$107.50
|
$430.00
|
$123.16 – $359.21
|
68 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
CPT 87506
|
$222.00
|
$888.00
|
$252.47 – $736.37
|
68 |
|
Infectious agent nucleic acid quantification bk virus
CPT 87799
|
$453.75
|
$1,815.00
|
$41.13 – $119.95
|
68 |
|
Infectious agent nucleic acid quantification hepatitis b
CPT 87517
|
$121.50
|
$486.00
|
$41.13 – $119.95
|
68 |
|
Infectious agent nucleic acid quantification hepatitis c
CPT 87522
|
$255.50
|
$1,022.00
|
$41.13 – $119.95
|
68 |
|
Infectious agent nucleic acid quantification hiv-1
CPT 87536
|
$154.75
|
$619.00
|
$81.70 – $238.28
|
68 |
|
Infliximab 100 mg intravenous solution
HCPCS J1745
|
$329.40
|
$1,317.60
|
$29.31 – $85.48
|
68 |
|
Influenza dna amp prob addl
CPT 87503
|
$22.50
|
$90.00
|
$28.05 – $81.82
|
68 |
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
CPT 94642
|
$98.50
|
$394.00
|
$155.00 – $520.91
|
68 |
|
Initiation & management bipap/cpap initial day
CPT 94660
|
$141.50
|
$566.00
|
$155.00 – $520.91
|
68 |
|
Inj, acetaminophen (b braun)
HCPCS J0136
|
$10.59
|
$42.38
|
$0.05 – $0.08
|
4 |
|
Inj acetaminophen -fresenius
HCPCS J0134
|
$10.50
|
$42.00
|
$0.04 – $0.09
|
4 |
|
Inj, acetaminophen (hikma)
HCPCS J0137
|
$7.88
|
$31.50
|
$0.05 – $0.09
|
4 |
|
Inj allopurinol sodium 1 mg
HCPCS J0206
|
$1,647.83
|
$6,591.33
|
$4.22 – $12.32
|
68 |
|
Inj, bortezomib freseniuskab
HCPCS J9048
|
$889.95
|
$3,559.80
|
$15.84 – $51.46
|
68 |
|
Inj, bortezomib, hospira
HCPCS J9049
|
$34.62
|
$138.48
|
$1.49 – $1.82
|
4 |
|
Inj calcitriol per 0.1 mcg
HCPCS J0636
|
$11.35
|
$45.41
|
$0.99 – $0.99
|
1 |
|
Inj cefazolin sodium, baxter
HCPCS J0689
|
$21.75
|
$87.00
|
$1.26 – $1.93
|
4 |
|
Inj cefazolin sodium, hikma
HCPCS J0688
|
$9.11
|
$36.43
|
$0.96 – $2.80
|
66 |
|
Inj cefazolin (wg crit care)
HCPCS J0687
|
$6.75
|
$26.99
|
$1.07 – $3.11
|
67 |
|
Inj. cefepime hcl (baxter)
HCPCS J0701
|
$99.75
|
$399.00
|
$5.83 – $9.41
|
4 |
|
Inj, cefepime hcl (b braun)
HCPCS J0703
|
$51.78
|
$207.11
|
$4.97 – $6.75
|
4 |
|
Inj, clindamycin (baxter)
HCPCS J0737
|
$11.44
|
$45.75
|
$2.34 – $3.39
|
4 |
|
Inj cntr knee arthro incl ct/mri
CPT 27369
|
$118.50
|
$474.00
|
$35.65 – $426.00
|
2 |
|
Inj cyclophos dr.reddy's 5mg
HCPCS J9072
|
$2,625.00
|
$10,500.00
|
$3.29 – $4.10
|
4 |
|
Inj cyclophosphamd auromedic
HCPCS J9071
|
$174.83
|
$699.33
|
$0.67 – $2.85
|
68 |
|
Inj cyclophosphamd (ingenus)
HCPCS J9073
|
$1,016.45
|
$4,065.81
|
$1.04 – $6.13
|
68 |
|
Inj, daptomycin (hospira)
HCPCS J0877
|
$61.58
|
$246.30
|
$0.06 – $0.12
|
4 |
|
Inj daptomycin (xellia)
HCPCS J0873
|
$22.56
|
$90.22
|
$0.04 – $0.11
|
66 |
|
Inj, decitabine (sun pharma)
HCPCS J0893
|
$69.38
|
$277.53
|
$1.56 – $2.25
|
4 |
|
Inj dx for sinogram
CPT 20501
|
$68.00
|
$272.00
|
$33.50 – $426.00
|
2 |
|
Injection arthrography hip without anesthesia (both sides)
CPT 27093
|
$97.75
|
$391.00
|
$61.58 – $426.00
|
2 |
|
Injection carpal tunnel therapeutic (both sides)
CPT 20526
|
$125.75
|
$503.00
|
$259.20 – $756.00
|
67 |
|
Injection, doxercalciferol
HCPCS J1270
|
$6.94
|
$27.75
|
$0.38 – $0.38
|
1 |
|
Injection during cath supravalvular aortography
CPT 93567
|
$62.00
|
$248.00
|
$51.88 – $426.00
|
2 |
|
Injection, edaravone, 1 mg
HCPCS J1301
|
$249.75
|
$999.00
|
$20.81 – $60.70
|
68 |
|
Injection epidural blood patch or clot
CPT 62273
|
$451.25
|
$1,805.00
|
$608.09 – $1,773.60
|
67 |
|
Injection eye drug
CPT 67028
|
$122.00
|
$488.00
|
$291.25 – $849.49
|
66 |
|
Injection for arthrography wrist (both sides)
CPT 25246
|
$143.25
|
$573.00
|
$66.50 – $426.00
|
2 |
|
Injection for bladder x-ray
CPT 51600
|
$53.00
|
$212.00
|
$48.18 – $426.00
|
2 |
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
CPT 23350
|
$143.25
|
$573.00
|
$45.08 – $426.00
|
2 |
|
Injection for ureter x-ray
CPT 50684
|
$556.25
|
$2,225.00
|
$54.11 – $426.00
|
2 |
|
Injection for ureter x-ray
CPT 50690
|
$82.50
|
$330.00
|
$75.21 – $426.00
|
2 |
|
Injection, fulvestrant
HCPCS J9395
|
$1,199.79
|
$4,799.16
|
$6.39 – $18.65
|
68 |
|
Injection glatiramer acetate
HCPCS J1595
|
$112.75
|
$450.99
|
$51.75 – $480.40
|
68 |
|
Injection radioactive tracer sentinel node (both sides)
CPT 38792
|
$174.00
|
$696.00
|
$352.85 – $1,029.14
|
67 |
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
HCPCS G0260
|
$361.50
|
$1,446.00
|
$608.09 – $1,773.60
|
67 |
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
CPT 64447
|
$470.25
|
$1,881.00
|
$608.09 – $1,773.60
|
67 |
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
CPT 64450
|
$293.75
|
$1,175.00
|
$608.09 – $1,773.60
|
67 |
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
CPT 64483
|
$500.50
|
$2,002.00
|
$780.00 – $2,280.12
|
67 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
CPT 64491
|
$443.00
|
$1,772.00
|
$57.91 – $426.00
|
2 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
CPT 64490
|
$885.50
|
$3,542.00
|
$780.00 – $2,280.12
|
67 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
CPT 64494
|
$202.75
|
$811.00
|
$49.86 – $426.00
|
2 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
CPT 64493
|
$715.50
|
$2,862.00
|
$780.00 – $2,280.12
|
67 |
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
CPT 62321
|
$426.00
|
$1,704.00
|
$608.09 – $1,773.60
|
67 |
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
CPT 62323
|
$472.75
|
$1,891.00
|
$608.09 – $1,773.60
|
67 |
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
CPT 20550
|
$177.00
|
$708.00
|
$259.20 – $756.00
|
67 |
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
CPT 20552
|
$134.75
|
$539.00
|
$259.20 – $756.00
|
67 |
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
CPT 20553
|
$234.75
|
$939.00
|
$259.20 – $756.00
|
67 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
CPT 96375
|
$96.75
|
$387.00
|
$40.51 – $356.00
|
67 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
CPT 96376
|
$96.75
|
$387.00
|
$10.30 – $356.00
|
2 |
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
CPT 96374
|
$200.00
|
$800.00
|
$185.00 – $539.59
|
67 |
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
CPT 96372
|
$28.50
|
$114.00
|
$62.50 – $356.00
|
68 |