|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$196.50 |
$196.50 |
$196.50 |
$70.20
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$60.75 |
$60.75 |
$60.75 |
$64.35
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$96.00 |
$96.00 |
$96.00 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$87.00 |
$87.00 |
$87.00 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$64.50 |
$64.50 |
$64.50 |
$78.51
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$88.50 |
$88.50 |
$88.50 |
$113.10
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$420.75 |
$420.75 |
$420.75 |
$129.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$126.00 |
$126.00 |
$126.00 |
$97.50
|
|
Infectious agent nucleic acid amplified probe
|
$751.50 |
$751.50 |
$751.50 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$173.25 |
$173.25 |
$173.25 |
$157.30
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$141.00 |
$141.00 |
$141.00 |
$187.50
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$861.00 |
$861.00 |
$861.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$306.75 |
$306.75 |
$306.75 |
$190.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$129.00 |
$129.00 |
$129.00 |
$157.30
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$596.25 |
$596.25 |
$596.25 |
$253.80
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$168.75 |
$168.75 |
$168.75 |
$144.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$141.00 |
$141.00 |
$141.00 |
$109.69
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$299.25 |
$299.25 |
$299.25 |
$182.50
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$299.25 |
$299.25 |
$299.25 |
$210.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$88.50 |
$88.50 |
$88.50 |
$100.10
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$129.00 |
$129.00 |
$129.00 |
$137.60
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$357.75 |
$357.75 |
$357.75 |
$248.18
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$984.00 |
$984.00 |
$984.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$436.50 |
$436.50 |
$436.50 |
$313.95
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$261.75 |
$261.75 |
$261.75 |
$526.40
|
|
Infectious agent nucleic acid quantification bk virus
|
$1,929.00 |
$1,929.00 |
$1,929.00 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$307.50 |
$307.50 |
$307.50 |
$250.25
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$1,154.25 |
$1,154.25 |
$1,154.25 |
$259.80
|
|
Infectious agent nucleic acid quantification hiv-1
|
$588.00 |
$588.00 |
$588.00 |
$434.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$225.75 |
$225.75 |
$225.75 |
$309.40
|
|
Infliximab 100 mg intravenous solution
|
$1,702.78 |
$1,702.78 |
$1,702.78 |
$1,702.78
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,713.99 |
$1,713.99 |
$1,713.99 |
$1,713.99
|
|
Ingest challenge ea addl 60 min
|
$274.50 |
$274.50 |
$274.50 |
$274.50
|
|
Ingest challenge ini 120 min
|
$547.50 |
$547.50 |
$547.50 |
$624.87
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$386.25 |
$386.25 |
$386.25 |
$357.05
|
|
Initiation & management bipap/cpap initial day
|
$576.00 |
$576.00 |
$576.00 |
$608.40
|
|
Inj, abilify maintena, 1 mg
|
$9,281.66 |
$9,281.66 |
$9,281.66 |
$9,281.66
|
|
Inj allopurinol sodium 1 mg
|
$5,937.23 |
$5,937.23 |
$5,937.23 |
$5,937.23
|
|
Inj anifrolumab-fnia 1mg
|
$20,116.77 |
$20,116.77 |
$20,116.77 |
$20,116.77
|
|
Inj, artesunate, 1mg
|
$39,774.01 |
$39,774.01 |
$39,774.01 |
$39,774.01
|
|
Inj., benralizumab, 1 mg
|
$19,707.27 |
$19,707.27 |
$19,707.27 |
$19,707.27
|
|
Inj bimatoprost itc imp1mcg
|
$7,487.44 |
$7,487.44 |
$7,487.44 |
$7,487.44
|
|
Inj, bupivacaine liposome
|
$1,326.75 |
$1,326.75 |
$1,326.75 |
$7.20
|
|
Inj calcitriol per 0.1 mcg
|
$22.16 |
$22.16 |
$22.16 |
$22.16
|
|
Inj, cefiderocol, 10 mg
|
$846.06 |
$846.06 |
$846.06 |
$846.06
|
|
Inj ceftolozane tazobactam
|
$597.69 |
$597.69 |
$597.69 |
$487.80
|
|
Inj cntr knee arthro incl ct/mri
|
$461.25 |
$461.25 |
$461.25 |
$461.25
|
|
Inj disk cerv-thor ea lev
|
$3,232.50 |
$3,232.50 |
$3,232.50 |
$828.00
|
|
Inj dupuytren cord w/enzyme
|
$592.50 |
$592.50 |
$592.50 |
$416.00
|
|
Inj, durolane 1 mg
|
$4,122.72 |
$4,122.72 |
$4,122.72 |
$4,122.72
|
|
Inj dx for sinogram
|
$1,089.75 |
$1,089.75 |
$1,089.75 |
$484.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$678.75 |
$678.75 |
$678.75 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$660.00 |
$660.00 |
$660.00 |
$591.50
|
|
Injection, belinostat, 10mg
|
$9,355.72 |
$9,355.72 |
$9,355.72 |
$9,355.72
|
|
Injection, cangrelor
|
$3,425.21 |
$3,425.21 |
$3,425.21 |
$3,425.21
|
|
Injection carpal tunnel therapeutic (both sides)
|
$853.50 |
$853.50 |
$853.50 |
$518.54
|
|
Injection, doxercalciferol
|
$23.86 |
$23.86 |
$23.86 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$2,211.75 |
$2,211.75 |
$2,211.75 |
$1,492.80
|
|
Injection epidural blood patch or clot
|
$1,618.50 |
$1,618.50 |
$1,618.50 |
$1,591.85
|
|
Injection eye drug
|
$387.00 |
$387.00 |
$387.00 |
$709.80
|
|
Injection for arthrography wrist (both sides)
|
$551.25 |
$551.25 |
$551.25 |
$521.18
|
|
Injection for bladder x-ray
|
$498.00 |
$498.00 |
$498.00 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$540.75 |
$540.75 |
$540.75 |
$514.36
|
|
Injection for ureter x-ray
|
$544.50 |
$544.50 |
$544.50 |
$544.50
|
|
Injection, fulvestrant
|
$3,584.82 |
$3,584.82 |
$3,584.82 |
$3,584.82
|
|
Injection glatiramer acetate
|
$1,749.29 |
$1,749.29 |
$1,749.29 |
$1,749.29
|
|
Injection into hemorrhoid(s)
|
$1,058.25 |
$1,058.25 |
$1,058.25 |
$1,278.72
|
|
Injection, isavuconazonium
|
$1,350.22 |
$1,350.22 |
$1,350.22 |
$1,350.22
|
|
Injection jugular
|
$1,890.00 |
$1,890.00 |
$1,890.00 |
$1,134.12
|
|
Injection of sinus tract
|
$1,670.25 |
$1,670.25 |
$1,670.25 |
$1,639.57
|
|
Injection,onabotulinumtoxina
|
$4,814.15 |
$4,814.15 |
$4,814.15 |
$4,156.80
|
|
Injection, peramivir
|
$1,257.68 |
$1,257.68 |
$1,257.68 |
$1,257.68
|
|
Injection px peyronie ds
|
$287.25 |
$287.25 |
$287.25 |
$343.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$787.50 |
$787.50 |
$787.50 |
$787.50
|
|
Injection, renflexis
|
$2,582.56 |
$2,582.56 |
$2,582.56 |
$1,720.20
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,471.50 |
$1,471.50 |
$1,471.50 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,567.50 |
$1,567.50 |
$1,567.50 |
$1,139.12
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,668.00 |
$1,668.00 |
$1,668.00 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,236.75 |
$1,236.75 |
$1,236.75 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,777.50 |
$1,777.50 |
$1,777.50 |
$2,138.08
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,334.25 |
$1,334.25 |
$1,334.25 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,512.75 |
$1,512.75 |
$1,512.75 |
$2,165.84
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,233.50 |
$2,233.50 |
$2,233.50 |
$1,967.40
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,943.25 |
$1,943.25 |
$1,943.25 |
$1,824.76
|
|
Injection, siltuximab
|
$23,535.37 |
$23,535.37 |
$23,535.37 |
$23,535.37
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$255.00 |
$255.00 |
$255.00 |
$468.98
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,078.50 |
$1,078.50 |
$1,078.50 |
$604.00
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$656.25 |
$656.25 |
$656.25 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$573.00 |
$573.00 |
$573.00 |
$162.50
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$573.00 |
$573.00 |
$573.00 |
$164.96
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$609.75 |
$609.75 |
$609.75 |
$309.40
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$174.00 |
$174.00 |
$174.00 |
$141.00
|
|
Injection treatment of nerve
|
$2,238.00 |
$2,238.00 |
$2,238.00 |
$2,792.73
|
|
Injection treatment of nerve
|
$2,708.25 |
$2,708.25 |
$2,708.25 |
$1,744.19
|
|
Inject sacroiliac joint
|
$492.00 |
$492.00 |
$492.00 |
$1,029.04
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$58,842.17 |
$58,842.17 |
$58,842.17 |
$58,842.17
|
|
Inj epidural sgl cerv-thor without img
|
$2,184.75 |
$2,184.75 |
$2,184.75 |
$1,429.80
|
|
Inj epidural sgl lumb-sacral without img
|
$1,623.75 |
$1,623.75 |
$1,623.75 |
$1,415.50
|
|
Inj, factor x, (human), 1iu
|
$33.28 |
$33.28 |
$33.28 |
$33.28
|
|
Inj for ext venography
|
$1,434.75 |
$1,434.75 |
$1,434.75 |
$873.60
|