|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$62.70 |
$62.70 |
$110.00 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$54.45 |
$54.45 |
$126.50 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$216.15 |
$216.15 |
$412.50 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$66.00 |
$66.00 |
$78.65 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$74.80 |
$74.80 |
$74.80 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$346.50 |
$346.50 |
$660.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$143.00 |
$143.00 |
$166.10 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$172.15 |
$172.15 |
$198.00 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$945.45 |
$945.45 |
$945.45 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$126.50 |
$126.50 |
$151.80 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$74.25 |
$74.25 |
$74.25 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$137.50 |
$137.50 |
$3,465.00 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$166.10 |
$166.10 |
$187.00 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$77.00 |
$77.00 |
$104.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$212.85 |
$212.85 |
$212.85 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$212.85 |
$212.85 |
$269.50 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$49.50 |
$49.50 |
$100.10 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$132.00 |
$132.00 |
$165.00 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$200.20 |
$200.20 |
$200.20 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,004.85 |
$1,004.85 |
$1,595.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$151.80 |
$151.80 |
$616.00 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$232.10 |
$232.10 |
$422.40 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$187.00 |
$187.00 |
$212.30 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$181.50 |
$181.50 |
$220.00 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$146.85 |
$146.85 |
$361.90 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$218.90 |
$218.90 |
$261.25 |
$298.35
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$5,290.45 |
$5,290.45 |
$5,290.45 |
$780.00
|
|
Ingest challenge ea addl 60 min
|
$495.50 |
$495.50 |
$495.50 |
$274.50
|
|
Ingest challenge ini 120 min
|
$116.42 |
$116.42 |
$1,379.24 |
$627.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$309.10 |
$309.10 |
$376.09 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$669.96 |
$669.96 |
$846.45 |
$645.79
|
|
Inj cntr knee arthro incl ct/mri
|
$106.70 |
$106.70 |
$486.20 |
$464.28
|
|
Inj disk cerv-thor ea lev
|
$356.07 |
$356.07 |
$356.07 |
$869.80
|
|
Inj dupuytren cord w/enzyme
|
$499.95 |
$499.95 |
$499.95 |
$416.00
|
|
Inj dx for sinogram
|
$338.80 |
$338.80 |
$510.51 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,156.65 |
$1,156.65 |
$1,156.65 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$368.50 |
$368.50 |
$486.20 |
$507.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$378.40 |
$378.40 |
$502.64 |
$536.00
|
|
Injection during cath supravalvular aortography
|
$88.00 |
$88.00 |
$8,795.42 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,321.32 |
$1,321.32 |
$2,228.05 |
$1,473.12
|
|
Injection eye drug
|
$768.90 |
$768.90 |
$1,495.78 |
$648.90
|
|
Injection for arthrography wrist (both sides)
|
$335.50 |
$335.50 |
$502.64 |
$441.12
|
|
Injection for bladder x-ray
|
$644.22 |
$644.22 |
$1,089.00 |
$585.00
|
|
Injection for hip x-ray
|
$669.24 |
$669.24 |
$669.24 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$388.24 |
$388.24 |
$1,089.00 |
$504.00
|
|
Injection for spleen x-ray
|
$2,342.45 |
$2,342.45 |
$2,342.45 |
$686.40
|
|
Injection for ureter x-ray
|
$294.58 |
$294.58 |
$1,089.00 |
$515.21
|
|
Injection into brain canal
|
$918.06 |
$918.06 |
$918.06 |
$933.60
|
|
Injection into spinal artery
|
$1,026.30 |
$1,026.30 |
$1,026.30 |
$1,468.18
|
|
Injection into vocal cord
|
$415.80 |
$415.80 |
$415.80 |
$457.30
|
|
Injection jugular
|
$715.00 |
$715.00 |
$715.00 |
$1,048.20
|
|
Injection of sinus tract
|
$1,419.99 |
$1,419.99 |
$1,419.99 |
$1,651.20
|
|
Injection radioactive tracer sentinel node (both sides)
|
$470.80 |
$470.80 |
$470.80 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$589.05 |
$589.05 |
$1,848.28 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,450.25 |
$2,450.25 |
$2,450.25 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,688.12 |
$1,688.12 |
$2,562.45 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,597.75 |
$1,597.75 |
$2,794.00 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$419.70 |
$419.70 |
$1,258.95 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,487.92 |
$1,487.92 |
$4,068.35 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$388.24 |
$388.24 |
$2,228.05 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,927.64 |
$1,927.64 |
$5,424.65 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,487.55 |
$3,487.55 |
$3,487.55 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,743.88 |
$1,743.88 |
$1,948.10 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$571.45 |
$571.45 |
$719.29 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$632.78 |
$632.78 |
$1,113.75 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$935.94 |
$935.94 |
$1,336.50 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$97.53 |
$97.53 |
$184.80 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$73.93 |
$73.93 |
$137.50 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$267.30 |
$267.30 |
$337.15 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$99.55 |
$99.55 |
$161.15 |
$141.60
|
|
Injection treatment of eye
|
$3,843.95 |
$3,843.95 |
$3,843.95 |
$2,698.27
|
|
Injection treatment of eye
|
$2,935.90 |
$2,935.90 |
$2,935.90 |
$2,698.92
|
|
Inject/treat eye socket
|
$61.04 |
$61.04 |
$61.04 |
$670.02
|
|
Inj epidural sgl cerv-thor without img
|
$1,963.50 |
$1,963.50 |
$1,963.50 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,316.15 |
$1,316.15 |
$1,713.25 |
$1,450.84
|
|
Inj for ext venography
|
$400.01 |
$400.01 |
$935.00 |
$737.55
|
|
Inj for mammo ductogram
|
$117.70 |
$117.70 |
$117.70 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$77.00 |
$77.00 |
$8,795.42 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$3,678.31 |
$3,678.31 |
$3,678.31 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,590.36 |
$1,590.36 |
$1,590.36 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$297.00 |
$297.00 |
$4,078.32 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$38.50 |
$38.50 |
$7,836.22 |
$947.65
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$2,842.84 |
$2,842.84 |
$2,842.84 |
$1,901.25
|
|
Inj intralesional <= 7 lsn(s)
|
$275.28 |
$275.28 |
$341.55 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$30.80 |
$30.80 |
$293.15 |
$234.00
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$5,290.45 |
$5,290.45 |
$5,290.45 |
$625.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,359.50 |
$2,359.50 |
$3,100.35 |
$1,522.56
|
|
Inj peritoneal venous shunt
|
$46.20 |
$46.20 |
$46.20 |
$386.88
|
|
Inj proc ankle arthr
|
$373.94 |
$373.94 |
$373.94 |
$405.31
|
|
Inj proc elbow arthro
|
$301.02 |
$301.02 |
$1,005.95 |
$453.60
|
|
Inj proc for lymphang
|
$501.22 |
$501.22 |
$1,172.60 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$569.80 |
$569.80 |
$1,842.56 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$232.38 |
$232.38 |
$770.00 |
$922.80
|
|
Inj retro urethrocysto
|
$376.75 |
$376.75 |
$930.22 |
$551.29
|
|
Inj scleros sol mult veins
|
$948.75 |
$948.75 |
$1,047.48 |
$687.96
|
|
Inj scleros sol sgl vein
|
$391.60 |
$391.60 |
$864.44 |
$534.40
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$301.95 |
$301.95 |
$312.46 |
$436.64
|
|
Inj thrc fascial pln blk bi w/wo image
|
$8,468.35 |
$8,468.35 |
$8,468.35 |
$1,483.20
|
|
Inj w/fluor eval cv device
|
$621.34 |
$621.34 |
$1,340.90 |
$588.90
|
|
Ins cath ren art 1st bi
|
$3,690.83 |
$3,690.83 |
$6,284.30 |
$6,033.75
|