|
Homogenization tissue
|
$35.72 |
$35.72 |
$35.72 |
$41.30
|
|
Homovanillic acid (hva)
|
$41.68 |
$41.68 |
$41.68 |
$59.95
|
|
Hpv types 16 & 18 only
|
$83.81 |
$83.81 |
$83.81 |
$112.00
|
|
H pylori (c-13) breath
|
$124.44 |
$124.44 |
$124.44 |
$212.25
|
|
Human epididymis protein 4 (he4)
|
$74.50 |
$74.50 |
$74.50 |
$157.32
|
|
Iaadi respiratory synctial virus
|
$41.22 |
$41.22 |
$41.22 |
$54.58
|
|
Iadna legionella pneumophila amplified probe tq
|
$72.82 |
$72.82 |
$72.82 |
$109.80
|
|
Ia nfct ab sarscov2 covid19
|
$104.45 |
$104.45 |
$104.45 |
$62.49
|
|
Icd cobalt xt dr MRI is1 df1
|
$75,425.90 |
$75,425.90 |
$75,425.90 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$81,558.26 |
$81,558.26 |
$81,558.26 |
$39,070.50
|
|
Icd crtp serena MRI
|
$25,143.50 |
$25,143.50 |
$25,143.50 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$21,847.91 |
$21,847.91 |
$21,847.91 |
$9,264.83
|
|
I&d intramural/intramuscular/submuc abscess transanal anes
|
$496.30 |
$496.30 |
$496.30 |
$3,245.23
|
|
Ifnl3 gene
|
$162.88 |
$162.88 |
$162.88 |
$147.20
|
|
Igh gene rearrange amp meth
|
$437.78 |
$437.78 |
$437.78 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$651.51 |
$651.51 |
$651.51 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$382.50 |
$382.50 |
$382.50 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$85.90 |
$85.90 |
$85.90 |
$191.52
|
|
Ihc/icc per specimen initial single antibody stain
|
$215.69 |
$215.69 |
$215.69 |
$277.90
|
|
Immunoassay tumor antigen quantitative ca 125
|
$48.38 |
$48.38 |
$48.38 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$48.38 |
$48.38 |
$48.38 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$43.01 |
$43.01 |
$43.01 |
$48.57
|
|
Immunodiffusion nes
|
$42.24 |
$42.24 |
$42.24 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$109.06 |
$109.06 |
$109.06 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$118.50 |
$118.50 |
$118.50 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$215.69 |
$215.69 |
$215.69 |
$234.27
|
|
Immunoglobulin assay
|
$181.25 |
$181.25 |
$181.25 |
$78.00
|
|
Implant cartilage 10mm synthetic
|
$64,082.06 |
$64,082.06 |
$64,082.06 |
$8,332.51
|
|
Implant spine infusion pump
|
$863.74 |
$863.74 |
$863.74 |
$17,270.40
|
|
Implant ureth bulk agent
|
$2,046.87 |
$2,046.87 |
$2,046.87 |
$2,168.00
|
|
Impl neurostim electr perc
|
$8,416.24 |
$8,416.24 |
$8,416.24 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$3,372.88 |
$3,372.88 |
$3,372.88 |
$5,095.20
|
|
In-111 pentetate dtpa / 0.5 mci
|
$330.46 |
$330.46 |
$330.46 |
$2,598.17
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$294.31 |
$294.31 |
$294.31 |
$2,086.70
|
|
Incision of eardrum
|
$166.34 |
$166.34 |
$166.34 |
$552.75
|
|
Incision of eardrum
|
$206.11 |
$206.11 |
$206.11 |
$3,837.72
|
|
Infect ag genotype na cytomegalovirus
|
$531.05 |
$531.05 |
$531.05 |
$665.40
|
|
Infect ag genotype na dna hepatitis b
|
$531.05 |
$531.05 |
$531.05 |
$409.27
|
|
Infect ag genotype na hiv-1 other region
|
$265.87 |
$265.87 |
$265.87 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$531.05 |
$531.05 |
$531.05 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$34.35 |
$34.35 |
$34.35 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$41.22 |
$41.22 |
$41.22 |
$68.40
|
|
Infect ag if influenza a
|
$41.22 |
$41.22 |
$41.22 |
$41.30
|
|
Infect ag if influenza b
|
$41.22 |
$41.22 |
$41.22 |
$37.95
|
|
Infect ag if pneumocystis carinii
|
$52.21 |
$52.21 |
$52.21 |
$66.06
|
|
Infect ag if varicella zoster
|
$41.22 |
$41.22 |
$41.22 |
$72.00
|
|
Infect ag na hep b amp
|
$92.75 |
$92.75 |
$92.75 |
$120.50
|
|
Infect ag na hpv high-risk types
|
$72.82 |
$72.82 |
$72.82 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$197.86 |
$197.86 |
$197.86 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$105.80 |
$105.80 |
$105.80 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$859.44 |
$859.44 |
$859.44 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$41.22 |
$41.22 |
$41.22 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$28.85 |
$28.85 |
$28.85 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$45.34 |
$45.34 |
$45.34 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$51.53 |
$51.53 |
$51.53 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$158.70 |
$158.70 |
$158.70 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$58.40 |
$58.40 |
$58.40 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$59.77 |
$59.77 |
$59.77 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$107.86 |
$107.86 |
$107.86 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$24.73 |
$24.73 |
$24.73 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$43.97 |
$43.97 |
$43.97 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$289.23 |
$289.23 |
$289.23 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$79.01 |
$79.01 |
$79.01 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$76.94 |
$76.94 |
$76.94 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$859.44 |
$859.44 |
$859.44 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$72.82 |
$72.82 |
$72.82 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$72.82 |
$72.82 |
$72.82 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$86.56 |
$86.56 |
$86.56 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$72.82 |
$72.82 |
$72.82 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$105.80 |
$105.80 |
$105.80 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$65.95 |
$65.95 |
$65.95 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$72.82 |
$72.82 |
$72.82 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$76.26 |
$76.26 |
$76.26 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$859.44 |
$859.44 |
$859.44 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$264.50 |
$264.50 |
$264.50 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$542.04 |
$542.04 |
$542.04 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$188.93 |
$188.93 |
$188.93 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$88.62 |
$88.62 |
$88.62 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$100.99 |
$100.99 |
$100.99 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$175.87 |
$175.87 |
$175.87 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$294.04 |
$294.04 |
$294.04 |
$304.20
|
|
Ingest challenge ea addl 60 min
|
$388.86 |
$388.86 |
$388.86 |
$289.64
|
|
Ingest challenge ini 120 min
|
$556.82 |
$556.82 |
$556.82 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$227.53 |
$227.53 |
$227.53 |
$296.00
|
|
Initial nursing facility care/day 35 minutes
|
$143.35 |
$143.35 |
$143.35 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$184.62 |
$184.62 |
$184.62 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$100.46 |
$100.46 |
$100.46 |
$128.00
|
|
Inj dx for sinogram
|
$122.49 |
$122.49 |
$122.49 |
$436.00
|
|
Injection epidural blood patch or clot
|
$547.95 |
$547.95 |
$547.95 |
$1,182.33
|
|
Injection eye drug
|
$162.79 |
$162.79 |
$162.79 |
$654.00
|
|
Injection for hip x-ray
|
$194.27 |
$194.27 |
$194.27 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$291.66 |
$291.66 |
$291.66 |
$497.76
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$215.35 |
$215.35 |
$215.35 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$173.46 |
$173.46 |
$173.46 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,031.18 |
$2,031.18 |
$2,031.18 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,139.01 |
$1,139.01 |
$1,139.01 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,031.18 |
$2,031.18 |
$2,031.18 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,429.48 |
$1,429.48 |
$1,429.48 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,499.34 |
$2,499.34 |
$2,499.34 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,306.59 |
$1,306.59 |
$1,306.59 |
$1,817.24
|