|
Igk rearrangeabn clonal pop
|
$919.80 |
$919.80 |
$919.80 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$72.00 |
$72.00 |
$72.00 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$128.40 |
$128.40 |
$128.40 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$189.60 |
$189.60 |
$189.60 |
$277.90
|
|
Iliac/fem angio cath insert
|
$5,502.00 |
$5,502.00 |
$5,502.00 |
$1,856.01
|
|
Immobilizer shldr cntor adlt
|
$106.20 |
$106.20 |
$106.20 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$114.60 |
$114.60 |
$114.60 |
$118.43
|
|
Immune complex assay
|
$165.00 |
$165.00 |
$165.00 |
$101.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$192.00 |
$192.00 |
$192.00 |
$6,106.32
|
|
Immunoassay tumor antigen quantitative ca 125
|
$51.00 |
$51.00 |
$51.00 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$51.00 |
$51.00 |
$51.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$52.80 |
$52.80 |
$52.80 |
$48.57
|
|
Immunodiffusion nes
|
$226.20 |
$226.20 |
$226.20 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$54.60 |
$54.60 |
$54.60 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$102.00 |
$102.00 |
$102.00 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$125.40 |
$125.40 |
$125.40 |
$234.27
|
|
Immunology procedure
|
$43.20 |
$43.20 |
$43.20 |
$150.70
|
|
Implant cartilage 10mm synthetic
|
$5,874.00 |
$5,874.00 |
$5,874.00 |
$8,332.51
|
|
Implant ureth bulk agent
|
$919.80 |
$919.80 |
$919.80 |
$2,168.00
|
|
Impl neurostim electr perc
|
$4,007.40 |
$4,007.40 |
$4,007.40 |
$7,672.50
|
|
Imported lipodox inj
|
$1,459.80 |
$1,459.80 |
$1,459.80 |
$528.86
|
|
In-111 autol wbc diag per dose
|
$4,486.80 |
$4,486.80 |
$4,486.80 |
$3,493.75
|
|
In-111 oxyquinolin per 0.5 mci
|
$139.20 |
$139.20 |
$139.20 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$638.40 |
$638.40 |
$638.40 |
$2,598.17
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$843.60 |
$843.60 |
$843.60 |
$2,086.70
|
|
Incision of breast lesion
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$2,577.85
|
|
Incision of foot tendon 28234
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$2,211.05
|
|
Incisn of toe tndn
|
$1,864.80 |
$1,864.80 |
$1,864.80 |
$2,667.00
|
|
Infect ag eia influenza a or b ea
|
$29.40 |
$29.40 |
$29.40 |
$71.20
|
|
Infect ag genotype na hiv-1 other region
|
$316.20 |
$316.20 |
$316.20 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$633.60 |
$633.60 |
$633.60 |
$603.83
|
|
Infect ag if hep delta agent
|
$235.80 |
$235.80 |
$235.80 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$28.80 |
$28.80 |
$28.80 |
$73.45
|
|
Infect ag if pneumocystis carinii
|
$108.00 |
$108.00 |
$108.00 |
$66.06
|
|
Infect ag na herpes simplex quant
|
$397.80 |
$397.80 |
$397.80 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$102.60 |
$102.60 |
$102.60 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$211.20 |
$211.20 |
$211.20 |
$219.70
|
|
Infect ag na resp virus 12-25 targets
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$67.80 |
$67.80 |
$67.80 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$29.40 |
$29.40 |
$29.40 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$29.40 |
$29.40 |
$29.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$35.40 |
$35.40 |
$35.40 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$43.80 |
$43.80 |
$43.80 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$34.20 |
$34.20 |
$34.20 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$29.40 |
$29.40 |
$29.40 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$29.40 |
$29.40 |
$29.40 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$29.40 |
$29.40 |
$29.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$85.80 |
$85.80 |
$85.80 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$85.80 |
$85.80 |
$85.80 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$99.00 |
$99.00 |
$99.00 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$85.80 |
$85.80 |
$85.80 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$99.00 |
$99.00 |
$99.00 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$85.80 |
$85.80 |
$85.80 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$85.80 |
$85.80 |
$85.80 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$75.00 |
$75.00 |
$75.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$210.00 |
$210.00 |
$210.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$99.00 |
$99.00 |
$99.00 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$211.20 |
$211.20 |
$211.20 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$138.60 |
$138.60 |
$138.60 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$454.20 |
$454.20 |
$454.20 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$1,088.40 |
$1,088.40 |
$1,088.40 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$105.00 |
$105.00 |
$105.00 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$105.00 |
$105.00 |
$105.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$105.00 |
$105.00 |
$105.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$210.60 |
$210.60 |
$210.60 |
$375.00
|
|
Infliximab 100 mg intravenous solution
|
$660.00 |
$660.00 |
$660.00 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,440.60 |
$1,440.60 |
$1,440.60 |
$1,537.84
|
|
Influenza dna amp prob addl
|
$321.00 |
$321.00 |
$321.00 |
$64.26
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$40.00 |
$40.00 |
$40.00 |
$111.51
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$127.20 |
$127.20 |
$127.20 |
$762.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$138.60 |
$138.60 |
$138.60 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$132.00 |
$132.00 |
$132.00 |
$770.00
|
|
Inj, abilify maintena, 1 mg
|
$15.40 |
$15.40 |
$15.40 |
$5,355.30
|
|
Inj andexxa, 10 mg
|
$445.80 |
$445.80 |
$445.80 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$43.80 |
$43.80 |
$43.80 |
$10,052.58
|
|
Inj, aspara, rylaze, 0.1 mg
|
$94.20 |
$94.20 |
$94.20 |
$10,458.00
|
|
Inj atezolizumb 5mg hya-tqjs
|
$51.60 |
$51.60 |
$51.60 |
$18,716.52
|
|
Inj aval alfa-nqpt 4mg
|
$148.20 |
$148.20 |
$148.20 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$12,991.20 |
$12,991.20 |
$12,991.20 |
$11,310.00
|
|
Inj, bezlotoxumab, 10 mg
|
$109.80 |
$109.80 |
$109.80 |
$7,612.43
|
|
Inj., brexanolone, 1 mg
|
$181.20 |
$181.20 |
$181.20 |
$13,019.44
|
|
Inj, bupivacaine liposome
|
$4.20 |
$4.20 |
$4.20 |
$699.38
|
|
Inj cefazolin sodium, baxter
|
$15.40 |
$15.40 |
$15.40 |
$27.38
|
|
Inj, cefepime hcl (b braun)
|
$23.40 |
$23.40 |
$23.40 |
$69.85
|
|
Inj ceftolozane tazobactam
|
$18.00 |
$18.00 |
$18.00 |
$364.86
|
|
Inj, clindamycin (baxter)
|
$6.60 |
$6.60 |
$6.60 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$201.00 |
$201.00 |
$201.00 |
$436.80
|
|
Inj cyclophosphamd (ingenus)
|
$10.80 |
$10.80 |
$10.80 |
$742.72
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$639.60 |
$639.60 |
$639.60 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$201.00 |
$201.00 |
$201.00 |
$503.50
|
|
Injection, doxercalciferol
|
$74.40 |
$74.40 |
$74.40 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$163.80 |
$163.80 |
$163.80 |
$1,027.26
|
|
Injection, edaravone, 1 mg
|
$1,401.00 |
$1,401.00 |
$1,401.00 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$480.60 |
$480.60 |
$480.60 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$201.00 |
$201.00 |
$201.00 |
$436.00
|
|
Injection for bladder x-ray
|
$201.00 |
$201.00 |
$201.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$201.00 |
$201.00 |
$201.00 |
$497.76
|
|
Injection, fulvestrant
|
$390.00 |
$390.00 |
$390.00 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$22.80 |
$22.80 |
$22.80 |
$6,679.35
|
