|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$52.46 |
$52.46 |
$52.46 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$193.98 |
$193.98 |
$193.98 |
$99.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$93.94 |
$93.94 |
$93.94 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$42.70 |
$42.70 |
$42.70 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$54.29 |
$54.29 |
$54.29 |
$101.43
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$219.60 |
$219.60 |
$219.60 |
$129.68
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$104.92 |
$104.92 |
$104.92 |
$99.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$65.88 |
$65.88 |
$65.88 |
$56.70
|
|
Infectious agent nucleic acid amplified probe
|
$297.68 |
$297.68 |
$297.68 |
$268.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$49.41 |
$49.41 |
$49.41 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$170.80 |
$170.80 |
$170.80 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$511.79 |
$511.79 |
$511.79 |
$860.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$145.79 |
$145.79 |
$145.79 |
$184.80
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$115.90 |
$115.90 |
$115.90 |
$153.00
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$124.44 |
$124.44 |
$124.44 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$49.41 |
$49.41 |
$49.41 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$93.33 |
$93.33 |
$93.33 |
$102.57
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$228.14 |
$228.14 |
$228.14 |
$233.40
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$35.99 |
$35.99 |
$35.99 |
$94.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$124.44 |
$124.44 |
$124.44 |
$108.21
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$505.69 |
$505.69 |
$505.69 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$459.33 |
$459.33 |
$459.33 |
$440.26
|
|
Infectious agent nucleic acid quantification bk virus
|
$251.32 |
$251.32 |
$251.32 |
$287.76
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$384.91 |
$384.91 |
$384.91 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$325.74 |
$325.74 |
$325.74 |
$258.05
|
|
Infectious agent nucleic acid quantification hiv-1
|
$489.22 |
$489.22 |
$489.22 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$183.61 |
$183.61 |
$183.61 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$687.10 |
$687.10 |
$687.10 |
$2,069.44
|
|
Infliximab-axxq 100 mg intravenous solution
|
$279.48 |
$279.48 |
$279.48 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$299.44 |
$299.44 |
$299.44 |
$1,537.84
|
|
Influenza virus vaccine, live trivalent intranasal
|
$15.53 |
$15.53 |
$15.53 |
$37.80
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$154.33 |
$154.33 |
$154.33 |
$302.94
|
|
Initiation & management bipap/cpap initial day
|
$733.83 |
$733.83 |
$733.83 |
$576.00
|
|
Inj, abilify asimtufii, 1 mg
|
$972.25 |
$972.25 |
$972.25 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$1,555.59 |
$1,555.59 |
$1,555.59 |
$5,355.30
|
|
Inj alymsys 10 mg
|
$55.34 |
$55.34 |
$55.34 |
$1,280.74
|
|
Inj anifrolumab-fnia 1mg
|
$1,594.96 |
$1,594.96 |
$1,594.96 |
$10,052.58
|
|
Inj, artesunate, 1mg
|
$3,280.89 |
$3,280.89 |
$3,280.89 |
$14,460.21
|
|
Inj, aspara, rylaze, 0.1 mg
|
$6,075.60 |
$6,075.60 |
$6,075.60 |
$10,458.00
|
|
Inj aval alfa-nqpt 4mg
|
$1,187.92 |
$1,187.92 |
$1,187.92 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$3,462.82 |
$3,462.82 |
$3,462.82 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$2,318.00 |
$2,318.00 |
$2,318.00 |
$7,612.43
|
|
Inj, bortezomib freseniuskab
|
$715.78 |
$715.78 |
$715.78 |
$2,464.14
|
|
Inj cefazolin sodium, baxter
|
$0.07 |
$0.07 |
$0.07 |
$27.38
|
|
Inj cefazolin (wg crit care)
|
$2.00 |
$2.00 |
$2.00 |
$15.87
|
|
Inj. cefepime hcl (baxter)
|
$0.33 |
$0.33 |
$0.33 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$16.66 |
$16.66 |
$16.66 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$129.91 |
$129.91 |
$129.91 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$97.28 |
$97.28 |
$97.28 |
$390.44
|
|
Inj, clevidipine butyrate
|
$0.97 |
$0.97 |
$0.97 |
$4.86
|
|
Inj, clindamycin (baxter)
|
$0.15 |
$0.15 |
$0.15 |
$48.03
|
|
Inj cntr knee arthro incl ct/mri
|
$242.17 |
$242.17 |
$242.17 |
$436.80
|
|
Inj crotalidae im f(ab')2 eq
|
$708.16 |
$708.16 |
$708.16 |
$2,613.60
|
|
Inj, cyclophosphamd, sandoz
|
$63.60 |
$63.60 |
$63.60 |
$735.20
|
|
Inj disk cerv-thor ea lev
|
$972.95 |
$972.95 |
$972.95 |
$957.60
|
|
Inj, donanemab-azbt, 2 mg
|
$21.22 |
$21.22 |
$21.22 |
$1,233.44
|
|
Inj dx for sinogram
|
$328.18 |
$328.18 |
$328.18 |
$420.00
|
|
Inject for sacroiliac joint
|
$547.78 |
$547.78 |
$547.78 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$716.14 |
$716.14 |
$716.14 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$611.22 |
$611.22 |
$611.22 |
$504.00
|
|
Injection, burosumab-twza 1m
|
$7,758.23 |
$7,758.23 |
$7,758.23 |
$20,002.09
|
|
Injection, cangrelor
|
$557.46 |
$557.46 |
$557.46 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$4,834.25 |
$4,834.25 |
$4,834.25 |
$16,642.50
|
|
Injection, daratumumab 10 mg
|
$93.83 |
$93.83 |
$93.83 |
$5,239.24
|
|
Injection, doxercalciferol
|
$1.95 |
$1.95 |
$1.95 |
$23.83
|
|
Injection during cath supravalvular aortography
|
$990.03 |
$990.03 |
$990.03 |
$990.03
|
|
Injection, edaravone, 1 mg
|
$3.52 |
$3.52 |
$3.52 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$880.84 |
$880.84 |
$880.84 |
$1,170.45
|
|
Injection for arthrography wrist (both sides)
|
$155.55 |
$155.55 |
$155.55 |
$448.20
|
|
Injection for bladder x-ray
|
$503.86 |
$503.86 |
$503.86 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$497.76 |
$497.76 |
$497.76 |
$494.65
|
|
Injection for ureter x-ray
|
$930.25 |
$930.25 |
$930.25 |
$427.70
|
|
Injection for ureter x-ray
|
$1,090.07 |
$1,090.07 |
$1,090.07 |
$527.70
|
|
Injection, fulvestrant
|
$108.19 |
$108.19 |
$108.19 |
$1,719.16
|
|
Injection, glucarpidase
|
$25,116.14 |
$25,116.14 |
$25,116.14 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$1,375.12 |
$1,375.12 |
$1,375.12 |
$6,679.35
|
|
Injection into brain canal
|
$1,393.24 |
$1,393.24 |
$1,393.24 |
$1,638.00
|
|
Injection, isavuconazonium
|
$219.75 |
$219.75 |
$219.75 |
$787.67
|
|
Injection jugular
|
$231.19 |
$231.19 |
$231.19 |
$790.00
|
|
Injection, necitumumab, 1 mg
|
$52.83 |
$52.83 |
$52.83 |
$8,572.91
|
|
Injection of sinus tract
|
$622.81 |
$622.81 |
$622.81 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$788.12 |
$788.12 |
$788.12 |
$2,241.61
|
|
Injection, peramivir
|
$9.66 |
$9.66 |
$9.66 |
$775.82
|
|
Injection radioactive tracer sentinel node (both sides)
|
$624.03 |
$624.03 |
$624.03 |
$704.50
|
|
Injection, renflexis
|
$213.89 |
$213.89 |
$213.89 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$795.44 |
$795.44 |
$795.44 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,750.70 |
$1,750.70 |
$1,750.70 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$882.67 |
$882.67 |
$882.67 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,468.88 |
$1,468.88 |
$1,468.88 |
$2,031.18
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$605.12 |
$605.12 |
$605.12 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,635.41 |
$1,635.41 |
$1,635.41 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,808.04 |
$1,808.04 |
$1,808.04 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,808.04 |
$1,808.04 |
$1,808.04 |
$1,984.32
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,557.33 |
$1,557.33 |
$1,557.33 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,848.30 |
$1,848.30 |
$1,848.30 |
$1,696.20
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$208.62 |
$208.62 |
$208.62 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$261.08 |
$261.08 |
$261.08 |
$538.00
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$332.45 |
$332.45 |
$332.45 |
$637.35
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$183.00 |
$183.00 |
$183.00 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$143.35 |
$143.35 |
$143.35 |
$147.00
|