|
Impl neurostim electr perc
|
$5,172.05 |
$11,871.24 |
$12,083.80 |
|
|
Implnt spinl canal catheter 62350
|
$3,402.67 |
$34,774.71 |
$56,216.57 |
|
|
Impl oi implt sk tc esp<100
|
$30,043.75 |
$30,043.75 |
$30,043.75 |
|
|
Impl oi implt skull perq esp
|
$15,791.03 |
$15,791.03 |
$15,791.03 |
|
|
Imuglucerase injection
|
$3,415.37 |
$3,426.75 |
$4,269.21 |
|
|
In-111 autol wbc diag per dose
|
$2,729.35 |
$2,729.35 |
$2,729.35 |
|
|
In-111 capromab pendet
|
$5,156.45 |
$5,156.45 |
$5,156.45 |
|
|
In-111 ibritumomab tiux dx
|
$75,520.90 |
$75,520.90 |
$75,520.90 |
|
|
In-111 oxyquinolin per 0.5 mci
|
$2,038.40 |
$2,038.40 |
$2,038.40 |
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,581.45 |
$1,581.45 |
$1,581.45 |
|
|
In-111 pentetreotide
|
$6,905.60 |
$6,905.60 |
$6,905.60 |
|
|
Incise inner ear
|
$5,274.05 |
$5,274.05 |
$5,274.05 |
|
|
Incise inner ear nerve
|
$26,323.11 |
$26,323.11 |
$26,323.11 |
|
|
Incise inner eye adhesions
|
$2,476.50 |
$2,476.50 |
$2,476.50 |
|
|
Incise inner eye adhesions
|
$9,926.59 |
$9,926.59 |
$9,926.59 |
|
|
Incise inner eye adhesions
|
$20,998.06 |
$20,998.06 |
$20,998.06 |
|
|
Incise inner eye adhesions
|
$12,141.42 |
$12,141.42 |
$12,141.42 |
|
|
Incise nerve back of head
|
$21,660.07 |
$21,660.07 |
$21,660.07 |
|
|
Incise sperm duct pouch
|
$42,922.07 |
$42,922.07 |
$42,922.07 |
|
|
Incise tear duct opening 68440
|
$549.25 |
$549.25 |
$549.25 |
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$104.00 |
$269.10 |
$1,963.65 |
|
|
Incision & drainage open of deep abscess (subfascial) pos
|
$2,204.80 |
$2,204.80 |
$2,204.80 |
|
|
Incision of anal sphincter
|
$8,354.53 |
$8,354.53 |
$8,354.53 |
|
|
Incision of breast lesion
|
$250.90 |
$723.45 |
$993.85 |
|
|
Incision of burn scab initi
|
$1,049.10 |
$1,049.10 |
$1,049.10 |
|
|
Incision of eardrum
|
$7,381.67 |
$7,381.67 |
$7,381.67 |
|
|
Incision of eyelid
|
$5,751.17 |
$5,751.17 |
$5,751.17 |
|
|
Incision of iris
|
$11,388.22 |
$11,388.22 |
$11,388.22 |
|
|
Incision of rectal abscess
|
$8,879.37 |
$8,879.37 |
$8,879.37 |
|
|
Incision of sperm duct
|
$7,875.19 |
$7,875.19 |
$7,875.19 |
|
|
Incision of spinal nerve 64772
|
$14,739.19 |
$14,739.19 |
$21,871.89 |
|
|
Incision of tongue fold
|
$477.00 |
$477.00 |
$5,107.10 |
|
|
Incision of urethra
|
$973.05 |
$973.05 |
$973.05 |
|
|
Incision of urethra
|
$6,086.60 |
$6,086.60 |
$6,086.60 |
|
|
Incision secondary cataract
|
$12,456.76 |
$12,456.76 |
$12,456.76 |
|
|
Incisn windpipe
|
$3,138.85 |
$3,138.85 |
$3,138.85 |
|
|
Incobotulinumtoxin a
|
$609.70 |
$609.70 |
$1,999.54 |
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$113.75 |
$113.75 |
$113.75 |
|
|
Infect ag drug suscept pheno predict
|
$280.80 |
$377.65 |
$508.95 |
|
|
Infect ag eia influenza a or b ea
|
$48.00 |
$94.90 |
$136.50 |
|
|
Infect ag genotype na hiv-1 other region
|
$213.85 |
$213.85 |
$534.30 |
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$169.00 |
$549.90 |
$698.75 |
|
|
Infect ag ia direct hiv-1 antgn
|
$39.65 |
$87.75 |
$99.45 |
|
|
Infect ag ia optc obs influenza
|
$42.00 |
$60.45 |
$113.10 |
|
|
Infect ag if influenza a
|
$30.00 |
$49.40 |
$94.90 |
|
|
Infect ag if influenza b
|
$30.00 |
$49.40 |
$94.90 |
|
|
Infect ag if nos ea
|
$30.00 |
$30.00 |
$74.10 |
|
|
Infect ag if varicella zoster
|
$61.10 |
$70.85 |
$84.50 |
|
|
Infect ag na hpv high-risk types
|
$81.90 |
$110.50 |
$130.00 |
|
|
Infect ag na influenza r/amp 1st 2 types
|
$88.50 |
$213.85 |
$290.55 |
|
|
Infect ag na orthopoxvirus amp prb each
|
$100.75 |
$133.90 |
$137.80 |
|
|
Infect ag na resp virus 12-25 targets
|
$599.95 |
$616.20 |
$646.75 |
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$30.00 |
$115.70 |
$215.80 |
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$79.95 |
$118.95 |
$252.20 |
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$50.70 |
$88.40 |
$124.50 |
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$50.70 |
$86.25 |
$110.50 |
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$89.05 |
$141.00 |
$256.10 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$24.00 |
$112.45 |
$199.55 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$60.45 |
$66.95 |
$199.55 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$55.25 |
$81.25 |
$104.00 |
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$135.85 |
$141.05 |
$202.80 |
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$33.00 |
$97.50 |
$188.50 |
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$22.10 |
$30.00 |
$79.30 |
|
|
Infectious agent nucleic acid amplified probe
|
$111.00 |
$345.15 |
$564.20 |
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$91.00 |
$120.90 |
$193.70 |
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$83.25 |
$176.80 |
$237.90 |
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$492.05 |
$750.10 |
$1,021.15 |
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$88.50 |
$276.90 |
$435.50 |
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$121.55 |
$127.50 |
$183.30 |
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$180.05 |
$224.25 |
$273.65 |
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$91.00 |
$119.60 |
$143.65 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$77.25 |
$137.80 |
$146.25 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$208.00 |
$218.40 |
$254.80 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$283.40 |
$338.00 |
$354.90 |
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$33.00 |
$85.15 |
$98.15 |
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$80.60 |
$90.35 |
$137.80 |
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$81.25 |
$155.35 |
$302.25 |
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$159.90 |
$159.90 |
$159.90 |
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$397.80 |
$397.80 |
$478.40 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$517.40 |
$567.45 |
$1,292.20 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$367.25 |
$408.85 |
$526.50 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$120.25 |
$230.75 |
$477.75 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$280.80 |
$365.95 |
$492.05 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$254.80 |
$372.45 |
$494.65 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$288.60 |
$298.35 |
$313.30 |
|
|
Infliximab 100 mg intravenous solution
|
$779.67 |
$1,165.61 |
$3,058.67 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,038.05 |
$1,038.05 |
$1,313.65 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,545.50 |
$2,068.33 |
$2,479.78 |
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$129.00 |
$129.00 |
$277.81 |
|
|
Influenza virus vaccine, live trivalent intranasal
|
$44.25 |
$44.25 |
$44.25 |
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$1,788.15 |
$1,788.15 |
$1,788.15 |
|
|
Inf thrc fascial pln blk bi w/wo image
|
$3,344.25 |
$3,344.25 |
$3,344.25 |
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,963.00 |
$1,963.00 |
$1,966.90 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$167.70 |
$192.40 |
$293.15 |
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$552.50 |
$552.50 |
$552.50 |
|
|
Initial nursing facility care/day 35 minutes
|
$84.75 |
$174.85 |
$188.50 |
|
|
Initial nursing facility care/day 45 minutes
|
$106.50 |
$241.80 |
$252.20 |
|
|
Initial nursing facility care/day low severity 99304
|
$52.50 |
$130.65 |
$133.90 |
|
|
Initiation & management bipap/cpap initial day
|
$629.20 |
$664.95 |
$1,214.85 |
|
|
Inj, abilify maintena, 1 mg
|
$5,682.54 |
$5,682.54 |
$7,079.57 |
|