|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$117.60 |
$117.60 |
$117.60 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$390.40 |
$390.40 |
$390.40 |
$221.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$468.00 |
$468.00 |
$468.00 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$44.00 |
$44.00 |
$44.00 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$844.80 |
$844.80 |
$844.80 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$844.80 |
$844.80 |
$844.80 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$459.20 |
$459.20 |
$459.20 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$485.60 |
$485.60 |
$485.60 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$276.00 |
$276.00 |
$276.00 |
$228.38
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$1,024.00 |
$1,024.00 |
$1,024.00 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$292.00 |
$292.00 |
$292.00 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$428.80 |
$428.80 |
$428.80 |
$297.01
|
|
Infliximab 100 mg intravenous solution
|
$2,925.44 |
$2,925.44 |
$2,925.44 |
$1,702.78
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,168.25 |
$1,168.25 |
$1,168.25 |
$1,654.83
|
|
Influenza dna amp prob addl
|
$155.20 |
$155.20 |
$155.20 |
$69.60
|
|
Ingest challenge ea addl 60 min
|
$128.00 |
$128.00 |
$128.00 |
$274.50
|
|
Ingest challenge ini 120 min
|
$185.60 |
$185.60 |
$185.60 |
$627.89
|
|
Initial foot exam pt lops
|
$96.00 |
$96.00 |
$96.00 |
$152.50
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$497.60 |
$497.60 |
$497.60 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$184.80 |
$184.80 |
$184.80 |
$244.00
|
|
Initial nursing facility care/day 45 minutes
|
$236.80 |
$236.80 |
$236.80 |
$322.20
|
|
Initial nursing facility care/day low severity 99304
|
$128.00 |
$128.00 |
$128.00 |
$162.40
|
|
Initiation & management bipap/cpap initial day
|
$243.20 |
$243.20 |
$243.20 |
$627.00
|
|
Inj, abilify maintena, 1 mg
|
$5.60 |
$5.60 |
$5.60 |
$4,402.80
|
|
Inj dupuytren cord w/enzyme
|
$128.00 |
$128.00 |
$128.00 |
$416.00
|
|
Inj, durolane 1 mg
|
$891.20 |
$891.20 |
$891.20 |
$4,082.24
|
|
Inj dx for sinogram
|
$265.60 |
$265.60 |
$265.60 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$335.20 |
$335.20 |
$335.20 |
$562.20
|
|
Injection carpal tunnel therapeutic (both sides)
|
$121.60 |
$121.60 |
$121.60 |
$541.96
|
|
Injection, daratumumab 10 mg
|
$3,863.11 |
$3,863.11 |
$3,863.11 |
$4,017.00
|
|
Injection epidural blood patch or clot
|
$684.80 |
$684.80 |
$684.80 |
$1,447.86
|
|
Injection for arthrography wrist (both sides)
|
$630.40 |
$630.40 |
$630.40 |
$471.00
|
|
Injection for bladder x-ray
|
$536.00 |
$536.00 |
$536.00 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$565.60 |
$565.60 |
$565.60 |
$504.55
|
|
Injection for ureter x-ray
|
$452.00 |
$452.00 |
$452.00 |
$515.21
|
|
Injection, fulvestrant
|
$332.73 |
$332.73 |
$332.73 |
$2,618.94
|
|
Injection glatiramer acetate
|
$646.72 |
$646.72 |
$646.72 |
$358.05
|
|
Injection into hemorrhoid(s)
|
$475.20 |
$475.20 |
$475.20 |
$1,133.20
|
|
Injection into vocal cord
|
$189.60 |
$189.60 |
$189.60 |
$457.30
|
|
Injection,onabotulinumtoxina
|
$8.80 |
$8.80 |
$8.80 |
$2,154.07
|
|
Injection px peyronie ds
|
$176.80 |
$176.80 |
$176.80 |
$343.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$122.40 |
$122.40 |
$122.40 |
$773.19
|
|
Injection, renflexis
|
$1,242.18 |
$1,242.18 |
$1,242.18 |
$1,407.02
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$474.40 |
$474.40 |
$474.40 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$192.00 |
$192.00 |
$192.00 |
$999.81
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$916.00 |
$916.00 |
$916.00 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$208.00 |
$208.00 |
$208.00 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,365.60 |
$1,365.60 |
$1,365.60 |
$1,957.80
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$208.00 |
$208.00 |
$208.00 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$996.00 |
$996.00 |
$996.00 |
$2,005.52
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$872.00 |
$872.00 |
$872.00 |
$1,871.25
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$872.00 |
$872.00 |
$872.00 |
$1,771.20
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$86.40 |
$86.40 |
$86.40 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$350.40 |
$350.40 |
$350.40 |
$539.55
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$411.20 |
$411.20 |
$411.20 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$80.00 |
$80.00 |
$80.00 |
$168.17
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$176.80 |
$176.80 |
$176.80 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$264.80 |
$264.80 |
$264.80 |
$270.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$170.40 |
$170.40 |
$170.40 |
$140.29
|
|
Inject sacroiliac joint
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$1,071.68
|
|
Inj epidural sgl cerv-thor without img
|
$841.60 |
$841.60 |
$841.60 |
$1,429.80
|
|
Inj epidural sgl lumb-sacral without img
|
$841.60 |
$841.60 |
$841.60 |
$1,415.50
|
|
Inj intralesional <= 7 lsn(s)
|
$84.00 |
$84.00 |
$84.00 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$104.00 |
$104.00 |
$104.00 |
$228.80
|
|
Inj ivig privigen 500 mg
|
$12,146.40 |
$12,146.40 |
$12,146.40 |
$7,298.71
|
|
Inj levocarnitine per 1 gm
|
$202.89 |
$202.89 |
$202.89 |
$122.28
|
|
Inj, nithiodote, 3mg / 125mg
|
$45.56 |
$45.56 |
$45.56 |
$653.00
|
|
Inj ogivri 10 mg
|
$1,731.50 |
$1,731.50 |
$1,731.50 |
$3,358.00
|
|
Inj pantoprazole(hikma) 40mg
|
$74.16 |
$74.16 |
$74.16 |
$30.47
|
|
Inj proc myelogram lumbar
|
$949.60 |
$949.60 |
$949.60 |
$960.30
|
|
Inj progesterone per 50 mg
|
$68.01 |
$68.01 |
$68.01 |
$49.00
|
|
Inj, releuko 1 mcg
|
$428.54 |
$428.54 |
$428.54 |
$461.20
|
|
Inj teclistamab cqyv 0.5 mg
|
$11,915.64 |
$11,915.64 |
$11,915.64 |
$3,345.00
|
|
Inj. teprotumumab-trbw 10 mg
|
$47,971.67 |
$47,971.67 |
$47,971.67 |
$47,280.05
|
|
Inj testosterone cypionate
|
$0.80 |
$0.80 |
$0.80 |
$82.58
|
|
Inj triamcinolone ace X-ray 1mg
|
$1,688.78 |
$1,688.78 |
$1,688.78 |
$17.75
|
|
Inj, vasopressin (baxter)
|
$209.00 |
$209.00 |
$209.00 |
$3.77
|
|
Inj w/fluor eval cv device
|
$1,046.40 |
$1,046.40 |
$1,046.40 |
$593.60
|
|
Ins cerv dilator (sep proc)
|
$159.20 |
$159.20 |
$159.20 |
$529.00
|
|
Insert cath pleura with image
|
$3,509.60 |
$3,509.60 |
$3,509.60 |
$2,239.02
|
|
Insert cath pleura without image
|
$4,170.40 |
$4,170.40 |
$4,170.40 |
$2,168.17
|
|
Insert drug delivery implant
|
$149.60 |
$149.60 |
$149.60 |
$282.00
|
|
Insert intrauterine device iud
|
$166.40 |
$166.40 |
$166.40 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$85.60 |
$85.60 |
$85.60 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$92.00 |
$92.00 |
$92.00 |
$250.80
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,719.20 |
$1,719.20 |
$1,719.20 |
$2,505.60
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$834.40 |
$834.40 |
$834.40 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,816.80 |
$1,816.80 |
$1,816.80 |
$2,367.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$235.20 |
$235.20 |
$235.20 |
$7,216.00
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$5,833.60 |
$5,833.60 |
$5,833.60 |
$9,746.29
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,520.80 |
$1,520.80 |
$1,520.80 |
$5,423.04
|
|
Insert pessary/other device
|
$110.40 |
$110.40 |
$110.40 |
$277.99
|
|
Insitu hybridization auto
|
$170.40 |
$170.40 |
$170.40 |
$398.16
|
|
Insitu hybridization manual
|
$168.00 |
$168.00 |
$168.00 |
$411.33
|
|
In situ hybridization per specimen each additional single probe stain
|
$239.20 |
$239.20 |
$239.20 |
$264.00
|
|
In situ hybridization per specimen initial single probe stain
|
$288.80 |
$288.80 |
$288.80 |
$341.90
|
|
Ins/rpl prph sac/gstr npg/r
|
$616.80 |
$616.80 |
$616.80 |
$22,662.25
|
|
Instillation anticarcinogenic agent bladder
|
$132.80 |
$132.80 |
$132.80 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$1,280.80 |
$1,280.80 |
$1,280.80 |
$4,341.66
|
|
Insulin total
|
$131.20 |
$131.20 |
$131.20 |
$67.50
|
