|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$121.20 |
$121.20 |
$121.20 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$154.20 |
$154.20 |
$154.20 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$106.20 |
$106.20 |
$106.20 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$222.60 |
$222.60 |
$222.60 |
$217.70
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$225.00 |
$225.00 |
$225.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$90.60 |
$90.60 |
$90.60 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$70.80 |
$70.80 |
$70.80 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$184.80 |
$184.80 |
$184.80 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$831.60 |
$831.60 |
$831.60 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$406.20 |
$406.20 |
$406.20 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$484.20 |
$484.20 |
$484.20 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$244.80 |
$244.80 |
$244.80 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$87.00 |
$87.00 |
$87.00 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$147.60 |
$147.60 |
$147.60 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$269.40 |
$269.40 |
$269.40 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$331.80 |
$331.80 |
$331.80 |
$303.59
|
|
Influenza dna amp prob addl
|
$51.00 |
$51.00 |
$51.00 |
$64.26
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$203.40 |
$203.40 |
$203.40 |
$293.04
|
|
Initiation & management bipap/cpap initial day
|
$239.40 |
$239.40 |
$239.40 |
$576.00
|
|
Inj, bupivacaine liposome
|
$449.76 |
$449.76 |
$449.76 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$39.60 |
$39.60 |
$39.60 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$22.02 |
$22.02 |
$22.02 |
$18.30
|
|
Inj, cefiderocol, 10 mg
|
$1,050.60 |
$1,050.60 |
$1,050.60 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$786.72 |
$786.72 |
$786.72 |
$408.00
|
|
Inj, clindamycin (baxter)
|
$48.30 |
$48.30 |
$48.30 |
$48.39
|
|
Inj cntr knee arthro incl ct/mri
|
$342.60 |
$342.60 |
$342.60 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$1,833.60 |
$1,833.60 |
$1,833.60 |
$945.00
|
|
Inj dx for sinogram
|
$295.20 |
$295.20 |
$295.20 |
$413.82
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,445.40 |
$1,445.40 |
$1,445.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$414.00 |
$414.00 |
$414.00 |
$500.50
|
|
Injection, cangrelor
|
$4,517.46 |
$4,517.46 |
$4,517.46 |
$1,889.78
|
|
Injection epidural blood patch or clot
|
$1,484.40 |
$1,484.40 |
$1,484.40 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$370.80 |
$370.80 |
$370.80 |
$441.12
|
|
Injection for bladder x-ray
|
$225.00 |
$225.00 |
$225.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$520.20 |
$520.20 |
$520.20 |
$494.65
|
|
Injection for ureter x-ray
|
$235.20 |
$235.20 |
$235.20 |
$515.21
|
|
Injection into brain canal
|
$1,101.00 |
$1,101.00 |
$1,101.00 |
$836.40
|
|
Injection jaw joint x-ray
|
$295.20 |
$295.20 |
$295.20 |
$307.80
|
|
Injection of sinus tract
|
$1,546.20 |
$1,546.20 |
$1,546.20 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$2,812.32 |
$2,812.32 |
$2,812.32 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$683.28
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,596.60 |
$1,596.60 |
$1,596.60 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,522.40 |
$2,522.40 |
$2,522.40 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,870.20 |
$1,870.20 |
$1,870.20 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,137.20 |
$2,137.20 |
$2,137.20 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$7,441.20 |
$7,441.20 |
$7,441.20 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,024.00 |
$3,024.00 |
$3,024.00 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$3,400.80 |
$3,400.80 |
$3,400.80 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,951.80 |
$1,951.80 |
$1,951.80 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,362.80 |
$2,362.80 |
$2,362.80 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,250.00 |
$2,250.00 |
$2,250.00 |
$1,704.78
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,233.60 |
$1,233.60 |
$1,233.60 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,233.60 |
$1,233.60 |
$1,233.60 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$251.40 |
$251.40 |
$251.40 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$117.00 |
$117.00 |
$117.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$224.40 |
$224.40 |
$224.40 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$306.00 |
$306.00 |
$306.00 |
$135.20
|
|
Inject sacroiliac joint
|
$751.20 |
$751.20 |
$751.20 |
$963.00
|
|
Inject/treat eye socket
|
$2,624.40 |
$2,624.40 |
$2,624.40 |
$381.13
|
|
Inj epidural sgl cerv-thor without img
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,666.20 |
$1,666.20 |
$1,666.20 |
$1,415.50
|
|
Inj for ext venography
|
$414.60 |
$414.60 |
$414.60 |
$654.00
|
|
Inj, gadopiclenol, 1 ml
|
$298.74 |
$298.74 |
$298.74 |
$66.94
|
|
Inj hydroxocobalamin IV 25mg
|
$4,527.36 |
$4,527.36 |
$4,527.36 |
$2,452.32
|
|
Inj, levothyroxine, freskabi
|
$543.12 |
$543.12 |
$543.12 |
$363.97
|
|
Inj, lidocaine w epinephrine
|
$49.86 |
$49.86 |
$49.86 |
$44.96
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$2,190.00 |
$2,190.00 |
$2,190.00 |
$783.50
|
|
Inj mepivacaine hcl/10 ml
|
$6.00 |
$6.00 |
$6.00 |
$33.86
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,126.20 |
$1,126.20 |
$1,126.20 |
$1,414.40
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,881.20 |
$2,881.20 |
$2,881.20 |
$2,485.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,881.20 |
$2,881.20 |
$2,881.20 |
$2,431.74
|
|
Inj proc ankle arthr
|
$286.80 |
$286.80 |
$286.80 |
$405.31
|
|
Inj proc elbow arthro
|
$350.40 |
$350.40 |
$350.40 |
$432.00
|
|
Inj proc lumbr disk ea lvl
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$1,139.40
|
|
Inj proc myelogram lumbar
|
$1,265.40 |
$1,265.40 |
$1,265.40 |
$856.00
|
|
Inj proc sialogram
|
$324.00 |
$324.00 |
$324.00 |
$373.00
|
|
Inj scleros sol mult veins
|
$1,475.40 |
$1,475.40 |
$1,475.40 |
$602.50
|
|
Inj scleros sol sgl vein
|
$1,167.60 |
$1,167.60 |
$1,167.60 |
$534.40
|
|
Inj secretin synthetic human
|
$2,855.52 |
$2,855.52 |
$2,855.52 |
$1,285.20
|
|
Inj sulf hexa lipid microsph
|
$380.28 |
$380.28 |
$380.28 |
$256.14
|
|
Inj thrc fascial pln blk bi w/wo image
|
$2,190.00 |
$2,190.00 |
$2,190.00 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,095.60 |
$1,095.60 |
$1,095.60 |
$818.00
|
|
Inj, tyenne, 1 mg
|
$8,460.30 |
$8,460.30 |
$8,460.30 |
$3,525.12
|
|
Inj vancomycin (xellia) 10mg
|
$126.36 |
$126.36 |
$126.36 |
$79.21
|
|
Inj vocal cord bulking agent
|
$1,928.80 |
$1,928.80 |
$1,928.80 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$412.80 |
$412.80 |
$412.80 |
$463.40
|
|
Ins cath ren art 1st uni
|
$5,941.20 |
$5,941.20 |
$5,941.20 |
$4,692.00
|
|
Insert cath pleura with image
|
$4,102.80 |
$4,102.80 |
$4,102.80 |
$2,194.40
|
|
Insert cath pleura without image
|
$3,940.80 |
$3,940.80 |
$3,940.80 |
$2,019.00
|
|
Insert hepatic shunt (tips)
|
$17,757.60 |
$17,757.60 |
$17,757.60 |
$8,367.70
|
|
Insertion catheter bladder non indwelling
|
$216.60 |
$216.60 |
$216.60 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$216.60 |
$216.60 |
$216.60 |
$229.32
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,197.60 |
$4,197.60 |
$4,197.60 |
$4,731.80
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$6,815.40 |
$6,815.40 |
$6,815.40 |
$2,511.00
|
|
Insertion of catheter vein
|
$1,371.00 |
$1,371.00 |
$1,371.00 |
$1,657.32
|
|
Insertion of catheter vein
|
$542.40 |
$542.40 |
$542.40 |
$836.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,278.40 |
$9,278.40 |
$9,278.40 |
$12,508.08
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$8,144.40 |
$8,144.40 |
$8,144.40 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$10,309.20 |
$10,309.20 |
$10,309.20 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,109.00 |
$2,109.00 |
$2,109.00 |
$2,079.43
|
