|
Immunodiffusion nes
|
$170.00 |
$170.00 |
$170.00 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$41.00 |
$41.00 |
$41.00 |
$141.60
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$39.00 |
$39.00 |
$39.00 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$548.00 |
$548.00 |
$548.00 |
$232.96
|
|
Immunoglobulin assay
|
$41.00 |
$41.00 |
$41.00 |
$74.15
|
|
Implant neuroelectrodes
|
$9,772.50 |
$9,772.50 |
$9,772.50 |
$7,270.51
|
|
Impl neurostim electr perc
|
$6,574.50 |
$6,574.50 |
$6,574.50 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$3,138.50 |
$3,138.50 |
$3,138.50 |
$5,110.00
|
|
Implt neurostim elctr each
|
$350.35 |
$350.35 |
$350.35 |
$4,449.13
|
|
Impreg gauze no h20/sal/yard
|
$11.50 |
$11.50 |
$11.50 |
$11.90
|
|
In-111 autol wbc diag per dose
|
$2,430.50 |
$2,430.50 |
$2,430.50 |
$3,523.65
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,456.50 |
$2,456.50 |
$2,456.50 |
$2,565.10
|
|
In-111 pentetreotide
|
$2,344.50 |
$2,344.50 |
$2,344.50 |
$4,961.43
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,856.50 |
$1,856.50 |
$1,856.50 |
$2,080.80
|
|
Incision of breast lesion
|
$1,881.50 |
$1,881.50 |
$1,881.50 |
$2,577.85
|
|
Incision of burn scab initi
|
$261.50 |
$261.50 |
$261.50 |
$494.40
|
|
Incision of foot tendon 28234
|
$1,737.00 |
$1,737.00 |
$1,737.00 |
$2,116.27
|
|
Incision of tongue fold
|
$1,662.00 |
$1,662.00 |
$1,662.00 |
$1,792.50
|
|
Incision tendon sheath
|
$3,598.00 |
$3,598.00 |
$3,598.00 |
$3,073.20
|
|
Incisn of toe tndn
|
$2,247.50 |
$2,247.50 |
$2,247.50 |
$2,539.80
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$1,434.00 |
$1,434.00 |
$1,434.00 |
$1,881.75
|
|
Infect ag drug suscept pheno predict
|
$255.50 |
$255.50 |
$255.50 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$247.00 |
$247.00 |
$247.00 |
$340.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$474.50 |
$474.50 |
$474.50 |
$603.75
|
|
Infect ag ia direct hiv-1 antgn
|
$34.50 |
$34.50 |
$34.50 |
$95.55
|
|
Infect ag ia optc obs influenza
|
$149.00 |
$149.00 |
$149.00 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$33.00 |
$33.00 |
$33.00 |
$68.40
|
|
Infect ag if legionella pneumophila
|
$50.50 |
$50.50 |
$50.50 |
$72.58
|
|
Infect ag na hep b amp
|
$120.50 |
$120.50 |
$120.50 |
$108.44
|
|
Infect ag na herpes simplex quant
|
$146.50 |
$146.50 |
$146.50 |
$168.50
|
|
Infect ag na hpv high-risk types
|
$135.50 |
$135.50 |
$135.50 |
$139.32
|
|
Infect ag na influenza r/amp 1st 2 types
|
$80.00 |
$80.00 |
$80.00 |
$217.88
|
|
Infect ag na orthopoxvirus amp prb each
|
$38.50 |
$38.50 |
$38.50 |
$100.46
|
|
Infect ag na resp virus 12-25 targets
|
$258.00 |
$258.00 |
$258.00 |
$845.40
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$946.00 |
$946.00 |
$946.00 |
$886.26
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$59.00 |
$59.00 |
$59.00 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$10.50 |
$10.50 |
$10.50 |
$82.50
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$56.00 |
$56.00 |
$56.00 |
$72.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$25.50 |
$25.50 |
$25.50 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$50.50 |
$50.50 |
$50.50 |
$75.40
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$65.50 |
$65.50 |
$65.50 |
$96.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$59.00 |
$59.00 |
$59.00 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$139.00 |
$139.00 |
$139.00 |
$130.90
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$65.50 |
$65.50 |
$65.50 |
$99.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$33.00 |
$33.00 |
$33.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$468.00 |
$468.00 |
$468.00 |
$275.00
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$36.00 |
$36.00 |
$36.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$35.00 |
$35.00 |
$35.00 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$403.00 |
$403.00 |
$403.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$232.50 |
$232.50 |
$232.50 |
$184.50
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$146.50 |
$146.50 |
$146.50 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$84.00 |
$84.00 |
$84.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$54.00 |
$54.00 |
$54.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$125.00 |
$125.00 |
$125.00 |
$217.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$150.00 |
$150.00 |
$150.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$84.00 |
$84.00 |
$84.00 |
$110.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$350.00 |
$350.00 |
$350.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$116.50 |
$116.50 |
$116.50 |
$429.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$538.00 |
$538.00 |
$538.00 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$198.00 |
$198.00 |
$198.00 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$173.50 |
$173.50 |
$173.50 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$286.00 |
$286.00 |
$286.00 |
$375.00
|
|
Infuse radioactive materials
|
$931.00 |
$931.00 |
$931.00 |
$744.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$158.50 |
$158.50 |
$158.50 |
$293.25
|
|
Initial foot exam pt lops
|
$155.50 |
$155.50 |
$155.50 |
$155.50
|
|
Initiation & management bipap/cpap initial day
|
$312.50 |
$312.50 |
$312.50 |
$571.20
|
|
Inj bulking agent anal canal
|
$851.29 |
$851.29 |
$851.29 |
$9,525.70
|
|
Inj cntr knee arthro incl ct/mri
|
$67.50 |
$67.50 |
$67.50 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$1,768.00 |
$1,768.00 |
$1,768.00 |
$945.31
|
|
Inj dupuytren cord w/enzyme
|
$530.00 |
$530.00 |
$530.00 |
$416.00
|
|
Inj dx for sinogram
|
$72.50 |
$72.50 |
$72.50 |
$416.00
|
|
Inject for sacroiliac joint
|
$346.00 |
$346.00 |
$346.00 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$877.00 |
$877.00 |
$877.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$137.00 |
$137.00 |
$137.00 |
$504.00
|
|
Injection carpal tunnel therapeutic (both sides)
|
$263.00 |
$263.00 |
$263.00 |
$504.90
|
|
Injection during cath supravalvular aortography
|
$475.50 |
$475.50 |
$475.50 |
$1,028.88
|
|
Injection epidural blood patch or clot
|
$744.00 |
$744.00 |
$744.00 |
$1,153.03
|
|
Injection eye drug
|
$540.00 |
$540.00 |
$540.00 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$111.50 |
$111.50 |
$111.50 |
$441.12
|
|
Injection for bladder x-ray
|
$107.00 |
$107.00 |
$107.00 |
$459.20
|
|
Injection for hip x-ray
|
$208.00 |
$208.00 |
$208.00 |
$709.15
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$137.00 |
$137.00 |
$137.00 |
$494.65
|
|
Injection for spleen x-ray
|
$2,359.50 |
$2,359.50 |
$2,359.50 |
$471.19
|
|
Injection for tear sac x-ray
|
$977.00 |
$977.00 |
$977.00 |
$212.55
|
|
Injection for ureter x-ray
|
$1,789.50 |
$1,789.50 |
$1,789.50 |
$415.80
|
|
Injection into hemorrhoid(s)
|
$1,083.50 |
$1,083.50 |
$1,083.50 |
$1,381.92
|
|
Injection of sinus tract
|
$912.50 |
$912.50 |
$912.50 |
$1,627.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$422.00 |
$422.00 |
$422.00 |
$699.68
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,033.50 |
$1,033.50 |
$1,033.50 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$332.00 |
$332.00 |
$332.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,006.00 |
$1,006.00 |
$1,006.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,586.50 |
$1,586.50 |
$1,586.50 |
$1,939.97
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,154.00 |
$1,154.00 |
$1,154.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,488.00 |
$1,488.00 |
$1,488.00 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$1,011.89
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$1,951.80
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,465.00 |
$1,465.00 |
$1,465.00 |
$1,808.64
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$319.50 |
$319.50 |
$319.50 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$541.00 |
$541.00 |
$541.00 |
$541.00
|
