|
Homocysteine
|
$27.96 |
$27.96 |
$27.96 |
$125.40
|
|
Homovanillic acid (hva)
|
$32.78 |
$32.78 |
$32.78 |
$59.95
|
|
H pylori (c-13) breath
|
$97.85 |
$97.85 |
$97.85 |
$212.25
|
|
Human epididymis protein 4 (he4)
|
$55.87 |
$55.87 |
$55.87 |
$157.32
|
|
Hysterosalpingography s&i
|
$428.80 |
$428.80 |
$428.80 |
$669.12
|
|
I-123 sod iodide diag per 100 uci
|
$58.08 |
$58.08 |
$58.08 |
$147.46
|
|
Iaadi respiratory synctial virus
|
$31.86 |
$31.86 |
$31.86 |
$54.58
|
|
Iadna legionella pneumophila amplified probe tq
|
$56.29 |
$56.29 |
$56.29 |
$109.80
|
|
Ia nfct ab sarscov2 covid19
|
$78.34 |
$78.34 |
$78.34 |
$62.49
|
|
Icd cobalt xt dr MRI is1 df1
|
$74,657.18 |
$74,657.18 |
$74,657.18 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$70,520.30 |
$70,520.30 |
$70,520.30 |
$39,070.50
|
|
Icd crtp serena MRI
|
$24,887.24 |
$24,887.24 |
$24,887.24 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$18,891.05 |
$18,891.05 |
$18,891.05 |
$9,264.83
|
|
Ifnl3 gene
|
$107.41 |
$107.41 |
$107.41 |
$147.20
|
|
Igh gene rearrange amp meth
|
$288.68 |
$288.68 |
$288.68 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$429.62 |
$429.62 |
$429.62 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$252.23 |
$252.23 |
$252.23 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$60.28 |
$60.28 |
$60.28 |
$191.52
|
|
Ihc/icc per specimen initial single antibody stain
|
$160.60 |
$160.60 |
$160.60 |
$277.90
|
|
Immune complex assay
|
$42.62 |
$42.62 |
$42.62 |
$101.60
|
|
Immunoassay tumor antigen quantitative ca 125
|
$36.29 |
$36.29 |
$36.29 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$36.29 |
$36.29 |
$36.29 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$32.26 |
$32.26 |
$32.26 |
$48.57
|
|
Immunodiffusion nes
|
$31.68 |
$31.68 |
$31.68 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$81.79 |
$81.79 |
$81.79 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$83.16 |
$83.16 |
$83.16 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$160.60 |
$160.60 |
$160.60 |
$234.27
|
|
Immunoglobulin assay
|
$135.94 |
$135.94 |
$135.94 |
$78.00
|
|
Implant cartilage 10mm synthetic
|
$55,409.30 |
$55,409.30 |
$55,409.30 |
$8,332.51
|
|
Implant ureth bulk agent
|
$1,769.85 |
$1,769.85 |
$1,769.85 |
$2,168.00
|
|
In-111 oxyquinolin per 0.5 mci
|
$51.74 |
$51.74 |
$51.74 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,065.50 |
$1,065.50 |
$1,065.50 |
$2,598.17
|
|
In-111 pentetreotide
|
$2,283.60 |
$2,283.60 |
$2,283.60 |
$5,294.90
|
|
Infect ag eia influenza a or b ea
|
$22.83 |
$22.83 |
$22.83 |
$71.20
|
|
Infect ag genotype na cytomegalovirus
|
$410.46 |
$410.46 |
$410.46 |
$665.40
|
|
Infect ag genotype na dna hepatitis b
|
$410.46 |
$410.46 |
$410.46 |
$409.27
|
|
Infect ag genotype na hiv-1 other region
|
$205.50 |
$205.50 |
$205.50 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$410.46 |
$410.46 |
$410.46 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$26.55 |
$26.55 |
$26.55 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$31.86 |
$31.86 |
$31.86 |
$68.40
|
|
Infect ag if hep delta agent
|
$92.93 |
$92.93 |
$92.93 |
$125.97
|
|
Infect ag if influenza a
|
$31.86 |
$31.86 |
$31.86 |
$41.30
|
|
Infect ag if influenza b
|
$31.86 |
$31.86 |
$31.86 |
$37.95
|
|
Infect ag if pneumocystis carinii
|
$40.36 |
$40.36 |
$40.36 |
$66.06
|
|
Infect ag if varicella zoster
|
$31.86 |
$31.86 |
$31.86 |
$72.00
|
|
Infect ag na hep b amp
|
$71.68 |
$71.68 |
$71.68 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$68.50 |
$68.50 |
$68.50 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$56.29 |
$56.29 |
$56.29 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$152.93 |
$152.93 |
$152.93 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$81.77 |
$81.77 |
$81.77 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$664.28 |
$664.28 |
$664.28 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$31.86 |
$31.86 |
$31.86 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$22.30 |
$22.30 |
$22.30 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$35.05 |
$35.05 |
$35.05 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$39.83 |
$39.83 |
$39.83 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$122.66 |
$122.66 |
$122.66 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$45.14 |
$45.14 |
$45.14 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$46.20 |
$46.20 |
$46.20 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$83.37 |
$83.37 |
$83.37 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$19.12 |
$19.12 |
$19.12 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$33.98 |
$33.98 |
$33.98 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$275.06 |
$275.06 |
$275.06 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$61.07 |
$61.07 |
$61.07 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$59.47 |
$59.47 |
$59.47 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$664.28 |
$664.28 |
$664.28 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$56.29 |
$56.29 |
$56.29 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$56.29 |
$56.29 |
$56.29 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$66.91 |
$66.91 |
$66.91 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$56.29 |
$56.29 |
$56.29 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$81.77 |
$81.77 |
$81.77 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$50.98 |
$50.98 |
$50.98 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$56.29 |
$56.29 |
$56.29 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$58.94 |
$58.94 |
$58.94 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$664.28 |
$664.28 |
$664.28 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$146.02 |
$146.02 |
$146.02 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$68.50 |
$68.50 |
$68.50 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$78.06 |
$78.06 |
$78.06 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$135.94 |
$135.94 |
$135.94 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$227.27 |
$227.27 |
$227.27 |
$304.20
|
|
Inj cntr knee arthro incl ct/mri
|
$118.22 |
$118.22 |
$118.22 |
$436.80
|
|
Inj dx for sinogram
|
$63.63 |
$63.63 |
$63.63 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$753.56 |
$753.56 |
$753.56 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$122.09 |
$122.09 |
$122.09 |
$503.50
|
|
Injection epidural blood patch or clot
|
$337.60 |
$337.60 |
$337.60 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$158.92 |
$158.92 |
$158.92 |
$436.00
|
|
Injection for bladder x-ray
|
$139.54 |
$139.54 |
$139.54 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$164.73 |
$164.73 |
$164.73 |
$497.76
|
|
Injection into brain canal
|
$374.68 |
$374.68 |
$374.68 |
$844.50
|
|
Injection radioactive tracer sentinel node (both sides)
|
$232.24 |
$232.24 |
$232.24 |
$685.44
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$349.81 |
$349.81 |
$349.81 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$957.37 |
$957.37 |
$957.37 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$417.32 |
$417.32 |
$417.32 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$883.73 |
$883.73 |
$883.73 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$800.39 |
$800.39 |
$800.39 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$490.31 |
$490.31 |
$490.31 |
$1,685.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$36.97 |
$36.97 |
$36.97 |
$145.60
|
|
Inject sacroiliac joint
|
$642.12 |
$642.12 |
$642.12 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$448.32 |
$448.32 |
$448.32 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$336.24 |
$336.24 |
$336.24 |
$1,450.84
|
|
Inj for ext venography
|
$115.96 |
$115.96 |
$115.96 |
$628.80
|