|
Immunodiffusion nes
|
$12.04 |
$12.04 |
$15.16 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$72.42 |
$72.42 |
$91.24 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$161.17 |
$161.17 |
$203.06 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$161.17 |
$161.17 |
$203.06 |
$250.00
|
|
Immunoglobulin assay
|
$34.74 |
$34.74 |
$43.76 |
$74.00
|
|
Implant cartilage 10mm synthetic
|
$46,774.26 |
$46,774.26 |
$46,774.26 |
$11,704.00
|
|
Implant ureth bulk agent
|
$1,154.53 |
$1,154.53 |
$1,154.53 |
$2,003.82
|
|
In-111 capromab pendet
|
$1,277.33 |
$1,277.33 |
$1,609.33 |
$3,941.34
|
|
In-111 pentetate dtpa / 0.5 mci
|
$249.48 |
$249.48 |
$314.32 |
$2,135.29
|
|
In-111 pentetreotide
|
$684.64 |
$684.64 |
$862.58 |
$6,617.05
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,067.59 |
$1,067.59 |
$1,345.06 |
$2,261.20
|
|
Incision of toe tendons 28011
|
$938.88 |
$938.88 |
$938.88 |
$2,068.30
|
|
Incision of windpipe
|
$4,160.91 |
$4,160.91 |
$4,160.91 |
$5,293.68
|
|
Incisn of toe tndn
|
$938.88 |
$938.88 |
$938.88 |
$2,298.99
|
|
Incisn windpipe
|
$2,071.61 |
$2,071.61 |
$2,071.61 |
$3,837.72
|
|
Incobotulinumtoxin a
|
$606.78 |
$606.78 |
$606.78 |
$1,195.74
|
|
Infect ag drug suscept pheno predict
|
$70.83 |
$70.83 |
$89.24 |
$325.00
|
|
Infect ag eia influenza a or b ea
|
$11.58 |
$11.58 |
$14.59 |
$69.03
|
|
Infect ag genotype na cytomegalovirus
|
$192.27 |
$192.27 |
$242.25 |
$603.41
|
|
Infect ag genotype na dna hepatitis b
|
$190.68 |
$190.68 |
$240.24 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$330.06 |
$330.06 |
$415.85 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$286.02 |
$286.02 |
$360.36 |
$574.60
|
|
Infect ag ia optc obs influenza
|
$46.09 |
$46.09 |
$58.06 |
$66.72
|
|
Infect ag if influenza b
|
$10.45 |
$10.45 |
$13.16 |
$34.67
|
|
Infect ag if legionella pneumophila
|
$9.31 |
$9.31 |
$11.73 |
$75.79
|
|
Infect ag if nos ea
|
$17.71 |
$17.71 |
$22.31 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$40.18 |
$40.18 |
$50.63 |
$62.29
|
|
Infect ag na herpes simplex quant
|
$32.24 |
$32.24 |
$40.62 |
$145.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$89.67 |
$89.67 |
$112.97 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$68.10 |
$68.10 |
$85.80 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$476.70 |
$476.70 |
$600.60 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$51.31 |
$51.31 |
$64.64 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$51.31 |
$51.31 |
$64.64 |
$77.00
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$23.84 |
$23.84 |
$30.03 |
$47.50
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$18.39 |
$18.39 |
$23.17 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$25.20 |
$25.20 |
$31.75 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$44.27 |
$44.27 |
$55.77 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$19.30 |
$19.30 |
$24.31 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$37.46 |
$37.46 |
$47.19 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$39.73 |
$39.73 |
$50.05 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$40.18 |
$40.18 |
$50.63 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$24.52 |
$24.52 |
$30.89 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$143.70 |
$143.70 |
$181.04 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$17.03 |
$17.03 |
$21.45 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$25.20 |
$25.20 |
$31.75 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$217.92 |
$217.92 |
$274.56 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$39.05 |
$39.05 |
$49.20 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$81.72 |
$81.72 |
$102.96 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$350.49 |
$350.49 |
$441.59 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$70.15 |
$70.15 |
$88.38 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$30.65 |
$30.65 |
$38.61 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$218.83 |
$218.83 |
$275.71 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$39.05 |
$39.05 |
$49.20 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$75.14 |
$75.14 |
$94.67 |
$103.20
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$35.42 |
$35.42 |
$44.62 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$32.69 |
$32.69 |
$41.19 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$26.34 |
$26.34 |
$33.18 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$178.43 |
$178.43 |
$224.80 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$139.61 |
$139.61 |
$175.89 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$144.38 |
$144.38 |
$181.90 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$70.15 |
$70.15 |
$88.38 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$70.15 |
$70.15 |
$88.38 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$72.87 |
$72.87 |
$91.81 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$134.62 |
$134.62 |
$169.60 |
$298.35
|
|
Initiation & management bipap/cpap initial day
|
$204.30 |
$204.30 |
$257.40 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$1,628.96 |
$1,628.96 |
$1,628.96 |
$7,176.71
|
|
Inj andexxa, 10 mg
|
$336.42 |
$336.42 |
$336.42 |
$4,387.50
|
|
Inj, artesunate, 1mg
|
$2,034.83 |
$2,034.83 |
$2,034.83 |
$13,446.00
|
|
Inj, bezlotoxumab, 10 mg
|
$1,552.68 |
$1,552.68 |
$1,552.68 |
$7,612.43
|
|
Inj, bortezomib, dr. reddy's
|
$731.63 |
$731.63 |
$731.63 |
$48.55
|
|
Inj, bupivacaine liposome
|
$385.45 |
$385.45 |
$385.45 |
$507.76
|
|
Inj calcitriol per 0.1 mcg
|
$12.26 |
$12.26 |
$12.26 |
$31.69
|
|
Inj, cefiderocol, 10 mg
|
$224.28 |
$224.28 |
$282.57 |
$550.68
|
|
Inj ceftolozane tazobactam
|
$101.70 |
$101.70 |
$101.70 |
$415.50
|
|
Inj, clevidipine butyrate
|
$184.78 |
$184.78 |
$184.78 |
$4.86
|
|
Inj cntr knee arthro incl ct/mri
|
$353.79 |
$353.79 |
$353.79 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$1,019.23 |
$1,019.23 |
$1,019.23 |
$2,735.85
|
|
Inj dx for sinogram
|
$323.25 |
$323.25 |
$407.27 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$389.54 |
$389.54 |
$389.54 |
$507.10
|
|
Injection, cangrelor
|
$1,224.67 |
$1,224.67 |
$1,224.67 |
$1,847.53
|
|
Injection during cath supravalvular aortography
|
$813.57 |
$813.57 |
$813.57 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$792.69 |
$792.69 |
$792.69 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$353.79 |
$353.79 |
$353.79 |
$441.12
|
|
Injection for bladder x-ray
|
$361.16 |
$361.16 |
$455.03 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$280.80 |
$280.80 |
$353.79 |
$504.00
|
|
Injection for ureter x-ray
|
$323.03 |
$323.03 |
$323.03 |
$515.21
|
|
Injection, isavuconazonium
|
$291.93 |
$291.93 |
$291.93 |
$832.85
|
|
Injection,onabotulinumtoxina
|
$661.71 |
$661.71 |
$661.71 |
$2,034.90
|
|
Injection, peramivir
|
$387.49 |
$387.49 |
$387.49 |
$857.98
|
|
Injection radioactive tracer sentinel node (both sides)
|
$446.06 |
$446.06 |
$446.06 |
$717.20
|
|
Injection, renflexis
|
$921.62 |
$921.62 |
$921.62 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$564.00 |
$564.00 |
$564.00 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$425.18 |
$425.18 |
$425.18 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$702.57 |
$702.57 |
$885.17 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$633.33 |
$633.33 |
$797.94 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$540.54 |
$540.54 |
$540.54 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$187.05 |
$187.05 |
$187.05 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$346.41 |
$346.41 |
$436.44 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$430.17 |
$430.17 |
$541.97 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$430.17 |
$430.17 |
$541.97 |
$1,758.12
|