|
In-111 autol wbc diag per dose
|
$4,109.55 |
$4,109.55 |
$4,109.55 |
$3,493.75
|
|
In-111 oxyquinolin per 0.5 mci
|
$2,200.95 |
$2,200.95 |
$2,200.95 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$4,134.10 |
$4,134.10 |
$4,134.10 |
$2,598.17
|
|
In-111 pentetreotide
|
$9,236.30 |
$9,236.30 |
$9,236.30 |
$5,294.90
|
|
Inactivated je vacc im
|
$474.05 |
$474.05 |
$474.05 |
$481.34
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,073.40 |
$3,073.40 |
$3,073.40 |
$2,086.70
|
|
Incision of breast lesion
|
$4,124.45 |
$4,124.45 |
$4,124.45 |
$2,577.85
|
|
Incision of burn scab initi
|
$641.65 |
$641.65 |
$641.65 |
$494.40
|
|
Incision of foot fascia
|
$666.10 |
$666.10 |
$666.10 |
$4,599.40
|
|
Incision of foot tendon 28234
|
$3,441.30 |
$3,441.30 |
$3,441.30 |
$2,211.05
|
|
Incision of lymph channels
|
$5,223.80 |
$5,223.80 |
$5,223.80 |
$4,570.46
|
|
Incision of tongue fold
|
$2,511.45 |
$2,511.45 |
$2,511.45 |
$1,792.50
|
|
Incisn of toe tndn
|
$7,142.85 |
$7,142.85 |
$7,142.85 |
$2,667.00
|
|
Induced ab 1+vag supp d&c
|
$1,540.70 |
$1,540.70 |
$1,540.70 |
$1,194.40
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$2,417.60 |
$2,417.60 |
$2,417.60 |
$1,997.99
|
|
Induced abortion d&c
|
$2,312.95 |
$2,312.95 |
$2,312.95 |
$3,762.53
|
|
Induced abortion dilat&evac
|
$2,416.80 |
$2,416.80 |
$2,416.80 |
$4,451.18
|
|
Infect ag drug suscept pheno predict
|
$518.45 |
$518.45 |
$518.45 |
$325.00
|
|
Infect ag genotype na cytomegalovirus
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$665.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$915.90 |
$915.90 |
$915.90 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$130.85 |
$130.85 |
$130.85 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$242.80 |
$242.80 |
$242.80 |
$73.45
|
|
Infect ag na hpv high-risk types
|
$283.90 |
$283.90 |
$283.90 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$346.75 |
$346.75 |
$346.75 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$266.15 |
$266.15 |
$266.15 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$144.55 |
$144.55 |
$144.55 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$145.25 |
$145.25 |
$145.25 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$145.25 |
$145.25 |
$145.25 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$609.60 |
$609.60 |
$609.60 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$200.75 |
$200.75 |
$200.75 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$570.10 |
$570.10 |
$570.10 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$241.85 |
$241.85 |
$241.85 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$474.65 |
$474.65 |
$474.65 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$389.50 |
$389.50 |
$389.50 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$130.85 |
$130.85 |
$130.85 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$287.20 |
$287.20 |
$287.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$328.40 |
$328.40 |
$328.40 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$362.70 |
$362.70 |
$362.70 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$452.70 |
$452.70 |
$452.70 |
$181.35
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$607.65 |
$607.65 |
$607.65 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$328.40 |
$328.40 |
$328.40 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$86.85 |
$86.85 |
$86.85 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$169.70 |
$169.70 |
$169.70 |
$206.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$320.55 |
$320.55 |
$320.55 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$160.45 |
$160.45 |
$160.45 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$303.20 |
$303.20 |
$303.20 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$622.20 |
$622.20 |
$622.20 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$392.85 |
$392.85 |
$392.85 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$726.35 |
$726.35 |
$726.35 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$539.00 |
$539.00 |
$539.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$797.55 |
$797.55 |
$797.55 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$380.20 |
$380.20 |
$380.20 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$4,871.58 |
$4,871.58 |
$4,871.58 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$4,181.98 |
$4,181.98 |
$4,181.98 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$4,642.81 |
$4,642.81 |
$4,642.81 |
$1,537.84
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$1,205.50 |
$1,205.50 |
$1,205.50 |
$762.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$1,222.44 |
$1,222.44 |
$1,222.44 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,222.44 |
$1,222.44 |
$1,222.44 |
$770.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$309.90 |
$309.90 |
$309.90 |
$296.00
|
|
Initial care training 30 m
|
$66.65 |
$66.65 |
$66.65 |
$49.89
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$1,255.15 |
$1,255.15 |
$1,255.15 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$305.75 |
$305.75 |
$305.75 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$418.10 |
$418.10 |
$418.10 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$266.95 |
$266.95 |
$266.95 |
$128.00
|
|
Init pm e/m new pat 65+ yrs
|
$309.95 |
$309.95 |
$309.95 |
$189.15
|
|
Inj, abilify maintena, 1 mg
|
$8,259.07 |
$8,259.07 |
$8,259.07 |
$5,355.30
|
|
Inj. acthar gel to 40 units
|
$50,446.60 |
$50,446.60 |
$50,446.60 |
$7,918.32
|
|
Inj, adalimumab, 1 mg
|
$9,842.58 |
$9,842.58 |
$9,842.58 |
$12,098.05
|
|
Inj., aristada initio, 1 mg
|
$6,924.77 |
$6,924.77 |
$6,924.77 |
$4,052.45
|
|
Inj, artesunate, 1mg
|
$9,219.52 |
$9,219.52 |
$9,219.52 |
$14,460.21
|
|
Inj, aspara, rylaze, 0.1 mg
|
$9,069.63 |
$9,069.63 |
$9,069.63 |
$10,458.00
|
|
Inj, brixadi, 7 days or less
|
$4,346.61 |
$4,346.61 |
$4,346.61 |
$748.85
|
|
Inj brixadi, more than 7 day
|
$6,129.20 |
$6,129.20 |
$6,129.20 |
$2,858.76
|
|
Inj, bupivacaine liposome
|
$2,456.19 |
$2,456.19 |
$2,456.19 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$89.33 |
$89.33 |
$89.33 |
$27.38
|
|
Inj, cefiderocol, 10 mg
|
$2,370.18 |
$2,370.18 |
$2,370.18 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$2,662.33 |
$2,662.33 |
$2,662.33 |
$364.86
|
|
Inj, clindamycin (baxter)
|
$56.45 |
$56.45 |
$56.45 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$729.95 |
$729.95 |
$729.95 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$664.60 |
$664.60 |
$664.60 |
$875.28
|
|
Inj dx for sinogram
|
$886.95 |
$886.95 |
$886.95 |
$436.00
|
|
Inject for sacroiliac joint
|
$215.10 |
$215.10 |
$215.10 |
$1,025.77
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,730.85 |
$1,730.85 |
$1,730.85 |
$503.50
|
|
Injection, burosumab-twza 1m
|
$17,869.09 |
$17,869.09 |
$17,869.09 |
$20,002.09
|
|
Injection, cangrelor
|
$4,699.52 |
$4,699.52 |
$4,699.52 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$787.15 |
$787.15 |
$787.15 |
$458.15
|
|
Injection, casimersen, 10 mg
|
$5,317.84 |
$5,317.84 |
$5,317.84 |
$2,598.44
|
|
Injection, daratumumab 10 mg
|
$6,869.31 |
$6,869.31 |
$6,869.31 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$940.35 |
$940.35 |
$940.35 |
$1,027.26
|
|
Injection, edaravone, 1 mg
|
$4,335.74 |
$4,335.74 |
$4,335.74 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$1,165.05 |
$1,165.05 |
$1,165.05 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$793.95 |
$793.95 |
$793.95 |
$436.00
|
|
Injection for bladder x-ray
|
$1,265.65 |
$1,265.65 |
$1,265.65 |
$459.20
|
|
Injection for hip x-ray
|
$2,319.65 |
$2,319.65 |
$2,319.65 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,244.20 |
$1,244.20 |
$1,244.20 |
$497.76
|
|
Injection for ureter x-ray
|
$606.10 |
$606.10 |
$606.10 |
$415.80
|
|
Injection for ureter x-ray
|
$636.45 |
$636.45 |
$636.45 |
$515.21
|
|
Injection, fulvestrant
|
$4,666.82 |
$4,666.82 |
$4,666.82 |
$1,719.16
|
|
Injection into brain canal
|
$1,700.20 |
$1,700.20 |
$1,700.20 |
$844.50
|
|
Injection jugular
|
$1,132.80 |
$1,132.80 |
$1,132.80 |
$790.00
|