|
Infect ag na resp virus 12-25 targets
CPT 87633
|
$373.80
|
$1,869.00
|
$395.94 – $1,166.98
|
75 |
|
Infect ag phenotype na hiv-1 1-10 drugs
CPT 87903
|
$317.20
|
$1,586.00
|
$464.23 – $1,368.25
|
75 |
|
Infect ag phenotype na hiv-1 ea addl drg
CPT 87904
|
$16.80
|
$84.00
|
$24.77 – $73.00
|
75 |
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
CPT 87811
|
$29.60
|
$148.00
|
$39.31 – $115.86
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
CPT 87324
|
$105.60
|
$528.00
|
$11.38 – $33.54
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step giardia
CPT 87329
|
$6.60
|
$33.00
|
$11.38 – $33.54
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
CPT 87338
|
$74.00
|
$370.00
|
$13.66 – $40.26
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
CPT 87340
|
$123.20
|
$616.00
|
$9.81 – $28.92
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
CPT 87389
|
$20.80
|
$104.00
|
$22.88 – $67.42
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
CPT 87449
|
$123.20
|
$616.00
|
$11.38 – $33.54
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
CPT 87425
|
$83.20
|
$416.00
|
$11.38 – $33.54
|
75 |
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
CPT 87427
|
$14.00
|
$70.00
|
$11.38 – $33.54
|
75 |
|
Infectious agent nucleic acid amplified probe
CPT 87798
|
$330.40
|
$1,652.00
|
$33.34 – $98.25
|
75 |
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
CPT 87491
|
$47.00
|
$235.00
|
$33.34 – $98.25
|
75 |
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
CPT 87493
|
$87.60
|
$438.00
|
$35.41 – $104.36
|
75 |
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
CPT 87483
|
$351.80
|
$1,759.00
|
$395.94 – $1,166.98
|
75 |
|
Infectious agent nucleic acid amplified probe hsv-1
CPT 87529
|
$37.40
|
$187.00
|
$33.34 – $98.25
|
75 |
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
CPT 87641
|
$31.60
|
$158.00
|
$33.34 – $98.25
|
75 |
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
CPT 87556
|
$202.20
|
$1,011.00
|
$39.60 – $116.70
|
75 |
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
CPT 87591
|
$47.00
|
$235.00
|
$33.34 – $98.25
|
75 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
CPT 87635
|
$37.20
|
$186.00
|
$48.74 – $143.67
|
75 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
CPT 87636
|
$100.20
|
$501.00
|
$135.50 – $399.36
|
75 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
CPT 87637
|
$100.20
|
$501.00
|
$135.50 – $399.36
|
75 |
|
Infectious agent nucleic acid amplified probe streptococcus group a
CPT 87651
|
$25.20
|
$126.00
|
$33.34 – $98.25
|
75 |
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
CPT 87661
|
$48.00
|
$240.00
|
$33.34 – $98.25
|
75 |
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
CPT 87564
|
$46.00
|
$230.00
|
$72.93 – $214.96
|
73 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
CPT 87507
|
$310.60
|
$1,553.00
|
$395.94 – $1,166.98
|
75 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
CPT 87505
|
$86.00
|
$430.00
|
$121.88 – $359.21
|
75 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
CPT 87506
|
$177.60
|
$888.00
|
$249.84 – $736.37
|
75 |
|
Infectious agent nucleic acid quantification bk virus
CPT 87799
|
$486.00
|
$2,430.00
|
$40.70 – $119.95
|
75 |
|
Infectious agent nucleic acid quantification hepatitis b
CPT 87517
|
$315.20
|
$1,576.00
|
$40.70 – $119.95
|
75 |
|
Infectious agent nucleic acid quantification hepatitis c
CPT 87522
|
$199.40
|
$997.00
|
$40.70 – $119.95
|
75 |
|
Infectious agent nucleic acid quantification hiv-1
CPT 87536
|
$187.00
|
$935.00
|
$80.84 – $238.28
|
75 |
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
CPT 87631
|
$92.60
|
$463.00
|
$135.50 – $399.36
|
75 |
|
Infliximab 100 mg intravenous solution
HCPCS J1745
|
$263.52
|
$1,317.60
|
$29.00 – $85.48
|
75 |
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
CPT 94642
|
$79.60
|
$398.00
|
$166.00 – $521.47
|
75 |
|
Initiation & management bipap/cpap initial day
CPT 94660
|
$113.20
|
$566.00
|
$166.00 – $521.47
|
75 |
|
Inj, acetaminophen (b braun)
HCPCS J0136
|
$8.47
|
$42.38
|
$0.05 – $0.08
|
4 |
|
Inj acetaminophen -fresenius
HCPCS J0134
|
$8.40
|
$42.00
|
$0.04 – $0.09
|
4 |
|
Inj, acetaminophen (hikma)
HCPCS J0137
|
$6.30
|
$31.50
|
$0.03 – $0.09
|
4 |
|
Inj allopurinol sodium 1 mg
HCPCS J0206
|
$1,318.27
|
$6,591.33
|
$4.18 – $12.32
|
75 |
|
Inj, bortezomib freseniuskab
HCPCS J9048
|
$711.96
|
$3,559.80
|
$15.68 – $51.46
|
75 |
|
Inj, bortezomib, hospira
HCPCS J9049
|
$27.70
|
$138.48
|
$1.49 – $1.82
|
4 |
|
Inj calcitriol per 0.1 mcg
HCPCS J0636
|
$9.08
|
$45.41
|
$0.99 – $0.99
|
1 |
|
Inj cefazolin sodium, baxter
HCPCS J0689
|
$17.40
|
$87.00
|
$1.26 – $1.93
|
4 |
|
Inj cefazolin sodium, hikma
HCPCS J0688
|
$7.29
|
$36.43
|
$0.95 – $2.80
|
73 |
|
Inj cefazolin (wg crit care)
HCPCS J0687
|
$5.40
|
$26.99
|
$1.05 – $3.11
|
74 |
|
Inj. cefepime hcl (baxter)
HCPCS J0701
|
$79.80
|
$399.00
|
$5.83 – $9.41
|
4 |
|
Inj, cefepime hcl (b braun)
HCPCS J0703
|
$41.42
|
$207.11
|
$4.97 – $6.75
|
4 |
|
Inj, clindamycin (baxter)
HCPCS J0737
|
$9.15
|
$45.75
|
$2.34 – $3.39
|
4 |
|
Inj cntr knee arthro incl ct/mri
CPT 27369
|
$94.80
|
$474.00
|
$35.65 – $628.00
|
2 |
|
Inj cyclophos dr.reddy's 5mg
HCPCS J9072
|
$2,100.00
|
$10,500.00
|
$3.29 – $11.46
|
4 |
|
Inj cyclophosphamd auromedic
HCPCS J9071
|
$139.87
|
$699.33
|
$0.67 – $2.85
|
75 |
|
Inj cyclophosphamd (ingenus)
HCPCS J9073
|
$813.16
|
$4,065.81
|
$1.04 – $6.13
|
75 |
|
Inj, daptomycin (hospira)
HCPCS J0877
|
$49.26
|
$246.30
|
$0.06 – $0.12
|
4 |
|
Inj daptomycin (xellia)
HCPCS J0873
|
$18.04
|
$90.22
|
$0.03 – $0.11
|
73 |
|
Inj, decitabine (sun pharma)
HCPCS J0893
|
$55.51
|
$277.53
|
$0.98 – $2.25
|
4 |
|
Inj dx for sinogram
CPT 20501
|
$54.40
|
$272.00
|
$33.50 – $628.00
|
2 |
|
Injection arthrography hip without anesthesia (both sides)
CPT 27093
|
$94.80
|
$474.00
|
$61.58 – $628.00
|
2 |
|
Injection, doxercalciferol
HCPCS J1270
|
$5.55
|
$27.75
|
$0.38 – $0.48
|
2 |
|
Injection during cath supravalvular aortography
CPT 93567
|
$47.00
|
$235.00
|
$51.88 – $628.00
|
2 |
|
Injection, edaravone, 1 mg
HCPCS J1301
|
$199.80
|
$999.00
|
$20.60 – $60.70
|
75 |
|
Injection epidural blood patch or clot
CPT 62273
|
$344.40
|
$1,722.00
|
$602.43 – $1,775.59
|
73 |
|
Injection eye drug
CPT 67028
|
$103.00
|
$515.00
|
$288.54 – $850.44
|
72 |
|
Injection for arthrography wrist (both sides)
CPT 25246
|
$94.80
|
$474.00
|
$66.50 – $628.00
|
2 |
|
Injection for bladder x-ray
CPT 51600
|
$52.60
|
$263.00
|
$48.18 – $628.00
|
2 |
|
Injection for hip x-ray
CPT 27095
|
$58.60
|
$293.00
|
$73.52 – $628.00
|
2 |
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
CPT 23350
|
$87.40
|
$437.00
|
$45.08 – $628.00
|
2 |
|
Injection for ureter x-ray
CPT 50690
|
$66.00
|
$330.00
|
$75.21 – $628.00
|
2 |
|
Injection, fulvestrant
HCPCS J9395
|
$959.83
|
$4,799.16
|
$6.33 – $18.65
|
75 |
|
Injection glatiramer acetate
HCPCS J1595
|
$90.20
|
$450.99
|
$51.75 – $480.40
|
75 |
|
Injection of sinus tract
CPT 20500
|
$1,627.60
|
$8,138.00
|
$1,288.59 – $3,797.95
|
73 |
|
Injection radioactive tracer sentinel node (both sides)
CPT 38792
|
$152.40
|
$762.00
|
$349.56 – $1,030.29
|
73 |
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
CPT 64447
|
$376.20
|
$1,881.00
|
$602.43 – $1,775.59
|
73 |
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
CPT 64450
|
$178.80
|
$894.00
|
$602.43 – $1,775.59
|
73 |
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
CPT 64483
|
$422.00
|
$2,110.00
|
$774.48 – $2,282.67
|
73 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
CPT 64490
|
$354.40
|
$1,772.00
|
$774.48 – $2,282.67
|
73 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
CPT 64493
|
$354.40
|
$1,772.00
|
$774.48 – $2,282.67
|
73 |
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
CPT 62323
|
$393.40
|
$1,967.00
|
$602.43 – $1,775.59
|
73 |
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
CPT 20550
|
$141.60
|
$708.00
|
$256.79 – $756.87
|
73 |
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
CPT 20552
|
$61.80
|
$309.00
|
$256.79 – $756.87
|
73 |
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
CPT 20553
|
$169.20
|
$846.00
|
$256.79 – $756.87
|
72 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
CPT 96375
|
$73.80
|
$369.00
|
$40.14 – $380.00
|
74 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
CPT 96376
|
$73.80
|
$369.00
|
$10.30 – $380.00
|
3 |
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
CPT 96374
|
$160.00
|
$800.00
|
$183.28 – $540.20
|
74 |
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
CPT 96372
|
$56.20
|
$281.00
|
$61.91 – $380.00
|
75 |
|
Inj epidural sgl lumb-sacral without img
CPT 62322
|
$166.40
|
$832.00
|
$774.48 – $2,282.67
|
73 |
|
Inj, epinephrine (belcher)
HCPCS J0173
|
$1,219.12
|
$6,095.62
|
$0.86 – $2.85
|
4 |
|
Inj for ext venography
CPT 36005
|
$184.00
|
$920.00
|
$49.57 – $628.00
|
2 |
|
Inj, fosaprepitant (teva)
HCPCS J1456
|
$39.62
|
$198.09
|
$0.42 – $2.16
|
75 |
|
Inj, fulvestrant (fresenius)
HCPCS J9394
|
$508.80
|
$2,544.02
|
$4.20 – $45.00
|
75 |
|
Inj gemcitabine hcl (accord)
HCPCS J9196
|
$58.07
|
$290.34
|
$4.49 – $10.95
|
4 |
|
Inj glycopyrrolate fres kabi
HCPCS J1598
|
$12.18
|
$60.91
|
$1.92 – $5.66
|
74 |
|
Inj heparin, pfizer, 1000u
HCPCS J1643
|
$8.64
|
$43.20
|
$0.26 – $4.60
|
4 |
|
Inj hrt cath w/s&i nonsel p-art angrp
CPT 93568
|
$49.60
|
$248.00
|
$47.44 – $628.00
|
2 |
|
Inj, idacio, 1 mg
HCPCS Q5144
|
$499.00
|
$2,494.98
|
$14.27 – $42.06
|
74 |
|
Inj intralesional <= 7 lsn(s)
CPT 11900
|
$123.60
|
$618.00
|
$172.85 – $509.46
|
73 |
|
Inj labetalol hcl hikma, 5mg
HCPCS J1921
|
$4.37
|
$21.86
|
$1.63 – $2.51
|
4 |
|
Inj, lanreotide, (cipla) 1mg
HCPCS J1932
|
$3,385.87
|
$16,929.33
|
$29.15 – $85.90
|
75 |
|
Inj levoleucovorin nos 0.5mg
HCPCS J0641
|
$95.58
|
$477.90
|
$0.02 – $0.21
|
4 |