|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$83.40 |
$83.40 |
$83.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$64.20 |
$64.20 |
$64.20 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$102.60 |
$102.60 |
$102.60 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$29.40 |
$29.40 |
$29.40 |
$57.60
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$206.40 |
$206.40 |
$206.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$127.80 |
$127.80 |
$127.80 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$102.00 |
$102.00 |
$102.00 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$96.60 |
$96.60 |
$96.60 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$147.60 |
$147.60 |
$147.60 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$116.40 |
$116.40 |
$116.40 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$151.20 |
$151.20 |
$151.20 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,971.00 |
$1,971.00 |
$1,971.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$70.80 |
$70.80 |
$70.80 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$156.00 |
$156.00 |
$156.00 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$392.40 |
$392.40 |
$392.40 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$116.40 |
$116.40 |
$116.40 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$122.40 |
$122.40 |
$122.40 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$273.60 |
$273.60 |
$273.60 |
$217.70
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$82.80 |
$82.80 |
$82.80 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$121.80 |
$121.80 |
$121.80 |
$105.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$574.20 |
$574.20 |
$574.20 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$384.60 |
$384.60 |
$384.60 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$617.40 |
$617.40 |
$617.40 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$178.80 |
$178.80 |
$178.80 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$117.00 |
$117.00 |
$117.00 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$602.40 |
$602.40 |
$602.40 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$435.60 |
$435.60 |
$435.60 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$372.60 |
$372.60 |
$372.60 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$3,258.24 |
$3,258.24 |
$3,258.24 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,640.18 |
$2,640.18 |
$2,640.18 |
$1,617.43
|
|
Infuse radioactive materials
|
$6,450.00 |
$6,450.00 |
$6,450.00 |
$744.00
|
|
Initiation & management bipap/cpap initial day
|
$845.40 |
$845.40 |
$845.40 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$0.06 |
$0.06 |
$0.06 |
$5,355.30
|
|
Inj alymsys 10 mg
|
$7,985.10 |
$7,985.10 |
$7,985.10 |
$1,483.29
|
|
Inj., aristada initio, 1 mg
|
$0.06 |
$0.06 |
$0.06 |
$4,052.45
|
|
Inj aval alfa-nqpt 4mg
|
$5,433.30 |
$5,433.30 |
$5,433.30 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$16,313.28 |
$16,313.28 |
$16,313.28 |
$11,604.71
|
|
Inj beta interferon sq 1 mcg
|
$2,247.12 |
$2,247.12 |
$2,247.12 |
$2,856.95
|
|
Inj, biorphen, 20 micrograms
|
$9.00 |
$9.00 |
$9.00 |
$17.12
|
|
Inj, bupivacaine liposome
|
$351.12 |
$351.12 |
$351.12 |
$699.38
|
|
Inj cefazolin sodium, baxter
|
$21.42 |
$21.42 |
$21.42 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$9.00 |
$9.00 |
$9.00 |
$29.10
|
|
Inj, clindamycin (baxter)
|
$53.28 |
$53.28 |
$53.28 |
$48.39
|
|
Inj cntr knee arthro incl ct/mri
|
$229.80 |
$229.80 |
$229.80 |
$436.80
|
|
Inj, cyclophos (baxter) 5mg
|
$1,304.22 |
$1,304.22 |
$1,304.22 |
$2,584.85
|
|
Inj disk cerv-thor ea lev
|
$870.60 |
$870.60 |
$870.60 |
$945.00
|
|
Inj, durolane 1 mg
|
$3,110.88 |
$3,110.88 |
$3,110.88 |
$1,950.93
|
|
Inj dx for sinogram
|
$100.20 |
$100.20 |
$100.20 |
$413.82
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$322.80 |
$322.80 |
$322.80 |
$500.50
|
|
Injection epidural blood patch or clot
|
$3,943.20 |
$3,943.20 |
$3,943.20 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$96.00 |
$96.00 |
$96.00 |
$441.12
|
|
Injection for bladder x-ray
|
$193.80 |
$193.80 |
$193.80 |
$459.20
|
|
Injection for hip x-ray
|
$281.40 |
$281.40 |
$281.40 |
$669.24
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$436.80 |
$436.80 |
$436.80 |
$494.65
|
|
Injection for ureter x-ray
|
$916.20 |
$916.20 |
$916.20 |
$515.21
|
|
Injection, fulvestrant
|
$2,693.40 |
$2,693.40 |
$2,693.40 |
$1,719.16
|
|
Injection glatiramer acetate
|
$661.62 |
$661.62 |
$661.62 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$10,009.80 |
$10,009.80 |
$10,009.80 |
$6,679.35
|
|
Injection into brain canal
|
$986.40 |
$986.40 |
$986.40 |
$836.40
|
|
Injection into spinal artery
|
$759.00 |
$759.00 |
$759.00 |
$1,710.80
|
|
Injection jaw joint x-ray
|
$153.60 |
$153.60 |
$153.60 |
$307.80
|
|
Injection jugular
|
$253.20 |
$253.20 |
$253.20 |
$790.00
|
|
Injection of sinus tract
|
$2,552.40 |
$2,552.40 |
$2,552.40 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$3,632.58 |
$3,632.58 |
$3,632.58 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$407.40 |
$407.40 |
$407.40 |
$683.28
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,033.20 |
$1,033.20 |
$1,033.20 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,615.40 |
$2,615.40 |
$2,615.40 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$22,021.36 |
$22,021.36 |
$22,021.36 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,660.28 |
$2,660.28 |
$2,660.28 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,467.40 |
$3,467.40 |
$3,467.40 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,310.60 |
$2,310.60 |
$2,310.60 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$11,600.64 |
$11,600.64 |
$11,600.64 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$21,984.96 |
$21,984.96 |
$21,984.96 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,660.26 |
$1,660.26 |
$1,660.26 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$3,123.60 |
$3,123.60 |
$3,123.60 |
$1,704.78
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$466.80 |
$466.80 |
$466.80 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$2,354.34 |
$2,354.34 |
$2,354.34 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$2,045.40 |
$2,045.40 |
$2,045.40 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$291.00 |
$291.00 |
$291.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$291.00 |
$291.00 |
$291.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$291.00 |
$291.00 |
$291.00 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$307.20 |
$307.20 |
$307.20 |
$135.20
|
|
Inject sacroiliac joint
|
$3,548.40 |
$3,548.40 |
$3,548.40 |
$963.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,402.20 |
$1,402.20 |
$1,402.20 |
$1,415.50
|
|
Inj. fe derisomaltose 10 mg
|
$5,094.84 |
$5,094.84 |
$5,094.84 |
$3,540.79
|
|
Inj for ext venography
|
$219.00 |
$219.00 |
$219.00 |
$654.00
|
|
Inj, immphentiv, 20 mcg
|
$9.00 |
$9.00 |
$9.00 |
$18.44
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$1,928.00
|
|
Inj, invega hafyera/trinza
|
$29,873.82 |
$29,873.82 |
$29,873.82 |
$32,073.55
|
|
Inj, lanreotide, (cipla) 1mg
|
$24,810.54 |
$24,810.54 |
$24,810.54 |
$11,648.70
|
|
Inj, lecanemab-irmb, 1 mg
|
$1,822.14 |
$1,822.14 |
$1,822.14 |
$923.69
|
|
Inj levocarnitine per 1 gm
|
$158.64 |
$158.64 |
$158.64 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$982.14 |
$982.14 |
$982.14 |
$363.97
|
|
Inj, lidocaine w epinephrine
|
$95.58 |
$95.58 |
$95.58 |
$44.96
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,254.60 |
$1,254.60 |
$1,254.60 |
$783.50
|
|
Inj mepivacaine hcl/10 ml
|
$9.00 |
$9.00 |
$9.00 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$673.20 |
$673.20 |
$673.20 |
$536.27
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$13,285.50 |
$13,285.50 |
$13,285.50 |
$8,304.04
|
|
Inj. mycophenolate mofetil
|
$295.80 |
$295.80 |
$295.80 |
$252.66
|
