|
Ihc/icc per specimen each multiplex antibody stain
|
$728.00 |
$728.00 |
$728.00 |
$322.55
|
|
Ihc/icc per specimen initial single antibody stain
|
$353.00 |
$353.00 |
$353.00 |
$272.30
|
|
Immobilizer shldr cntor adlt
|
$226.12 |
$226.12 |
$226.12 |
$175.47
|
|
Immobilizer shldr dlx str 24-36in med
|
$281.97 |
$281.97 |
$281.97 |
$110.00
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$3,070.08 |
$3,070.08 |
$3,070.08 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$1,967.33 |
$1,967.33 |
$1,967.33 |
$3,092.46
|
|
Immunoassay tumor antigen quantitative ca 125
|
$95.00 |
$95.00 |
$95.00 |
$131.57
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$95.00 |
$95.00 |
$95.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$56.50 |
$56.50 |
$56.50 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$95.00 |
$95.00 |
$95.00 |
$141.60
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$470.50 |
$470.50 |
$470.50 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$470.50 |
$470.50 |
$470.50 |
$232.96
|
|
Implant cochlear osia osi300
|
$14,014.00 |
$14,014.00 |
$14,014.00 |
$17,698.33
|
|
Implant pulse generator remede el
|
$68,750.00 |
$68,750.00 |
$68,750.00 |
$46,034.74
|
|
Implant ureth bulk agent
|
$3,680.00 |
$3,680.00 |
$3,680.00 |
$2,141.57
|
|
Impl neurostim electr perc
|
$8,445.50 |
$8,445.50 |
$8,445.50 |
$7,672.50
|
|
In-111 oxyquinolin per 0.5 mci
|
$7.05 |
$7.05 |
$7.05 |
$2,581.82
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,227.92 |
$2,227.92 |
$2,227.92 |
$2,565.10
|
|
In-111 pentetreotide
|
$4,730.98 |
$4,730.98 |
$4,730.98 |
$4,961.43
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,752.00 |
$1,752.00 |
$1,752.00 |
$2,080.80
|
|
Incobotulinumtoxin a
|
$1,328.60 |
$1,328.60 |
$1,328.60 |
$1,339.57
|
|
Infect ag drug suscept pheno predict
|
$787.00 |
$787.00 |
$787.00 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$773.00 |
$773.00 |
$773.00 |
$340.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$603.75
|
|
Infect ag ia direct hiv-1 antgn
|
$206.50 |
$206.50 |
$206.50 |
$95.55
|
|
Infect ag na hpv high-risk types
|
$234.50 |
$234.50 |
$234.50 |
$139.32
|
|
Infect ag na influenza r/amp 1st 2 types
|
$580.00 |
$580.00 |
$580.00 |
$217.88
|
|
Infect ag na orthopoxvirus amp prb each
|
$248.50 |
$248.50 |
$248.50 |
$100.46
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$82.50 |
$82.50 |
$82.50 |
$82.50
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$96.50 |
$96.50 |
$96.50 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$82.50 |
$82.50 |
$82.50 |
$75.40
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$96.50 |
$96.50 |
$96.50 |
$96.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$82.50 |
$82.50 |
$82.50 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$152.00 |
$152.00 |
$152.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$276.50 |
$276.50 |
$276.50 |
$130.90
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$82.50 |
$82.50 |
$82.50 |
$99.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$82.50 |
$82.50 |
$82.50 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$234.50 |
$234.50 |
$234.50 |
$275.00
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$234.50 |
$234.50 |
$234.50 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$234.50 |
$234.50 |
$234.50 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,145.00 |
$1,145.00 |
$1,145.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$234.50 |
$234.50 |
$234.50 |
$184.50
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$234.50 |
$234.50 |
$234.50 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$262.50 |
$262.50 |
$262.50 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$234.50 |
$234.50 |
$234.50 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$257.50 |
$257.50 |
$257.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$398.50 |
$398.50 |
$398.50 |
$236.08
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$234.50 |
$234.50 |
$234.50 |
$110.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$2,473.50 |
$2,473.50 |
$2,473.50 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$1,450.50 |
$1,450.50 |
$1,450.50 |
$429.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$441.50 |
$441.50 |
$441.50 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$456.50 |
$456.50 |
$456.50 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$276.50 |
$276.50 |
$276.50 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$525.00 |
$525.00 |
$525.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$870.50 |
$870.50 |
$870.50 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$1,137.33 |
$1,137.33 |
$1,137.33 |
$2,080.85
|
|
Infliximab-axxq 100 mg intravenous solution
|
$780.32 |
$780.32 |
$780.32 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$716.62 |
$716.62 |
$716.62 |
$1,537.84
|
|
Initiation & management bipap/cpap initial day
|
$230.00 |
$230.00 |
$230.00 |
$571.20
|
|
Inj, abilify maintena, 1 mg
|
$0.50 |
$0.50 |
$0.50 |
$5,168.00
|
|
Inj, acetaminophen (hikma)
|
$22.00 |
$22.00 |
$22.00 |
$56.70
|
|
Inj. acthar gel to 40 units
|
$30,249.70 |
$30,249.70 |
$30,249.70 |
$7,918.32
|
|
Inj allopurinol sodium 1 mg
|
$1,765.94 |
$1,765.94 |
$1,765.94 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$2,600.04 |
$2,600.04 |
$2,600.04 |
$1,280.74
|
|
Inj andexxa, 10 mg
|
$3,250.00 |
$3,250.00 |
$3,250.00 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$6,798.18 |
$6,798.18 |
$6,798.18 |
$9,878.82
|
|
Inj., aristada initio, 1 mg
|
$2,863.64 |
$2,863.64 |
$2,863.64 |
$4,052.45
|
|
Inj, aspara, rylaze, 0.1 mg
|
$6,669.00 |
$6,669.00 |
$6,669.00 |
$10,458.00
|
|
Inj., benralizumab, 1 mg
|
$7,379.78 |
$7,379.78 |
$7,379.78 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$4,940.00 |
$4,940.00 |
$4,940.00 |
$7,612.43
|
|
Inj, biorphen, 20 micrograms
|
$7.23 |
$7.23 |
$7.23 |
$17.12
|
|
Inj cefazolin sodium, baxter
|
$10.50 |
$10.50 |
$10.50 |
$27.18
|
|
Inj, cefiderocol, 10 mg
|
$332.57 |
$332.57 |
$332.57 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$258.67 |
$258.67 |
$258.67 |
$381.60
|
|
Inj, clindamycin (baxter)
|
$11.10 |
$11.10 |
$11.10 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$395.00 |
$395.00 |
$395.00 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$6,829.68 |
$6,829.68 |
$6,829.68 |
$9,204.29
|
|
Inj cyclophosphamd (ingenus)
|
$193.54 |
$193.54 |
$193.54 |
$683.35
|
|
Inj, durolane 1 mg
|
$1,302.06 |
$1,302.06 |
$1,302.06 |
$1,950.93
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$993.00 |
$993.00 |
$993.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$498.50 |
$498.50 |
$498.50 |
$504.00
|
|
Injection, belinostat, 10mg
|
$3,122.38 |
$3,122.38 |
$3,122.38 |
$4,446.10
|
|
Injection, caplacizumab-yhdp
|
$11,571.77 |
$11,571.77 |
$11,571.77 |
$16,319.16
|
|
Injection, daratumumab 10 mg
|
$3,237.08 |
$3,237.08 |
$3,237.08 |
$5,188.91
|
|
Injection during cath supravalvular aortography
|
$329.00 |
$329.00 |
$329.00 |
$1,028.88
|
|
Injection for arthrography wrist (both sides)
|
$439.50 |
$439.50 |
$439.50 |
$441.12
|
|
Injection for bladder x-ray
|
$461.00 |
$461.00 |
$461.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$343.00 |
$343.00 |
$343.00 |
$494.65
|
|
Injection, fulvestrant
|
$97.06 |
$97.06 |
$97.06 |
$1,719.16
|
|
Injection glatiramer acetate
|
$264.96 |
$264.96 |
$264.96 |
$830.51
|
|
Injection, glucarpidase
|
$53,526.20 |
$53,526.20 |
$53,526.20 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$4,440.26 |
$4,440.26 |
$4,440.26 |
$6,679.35
|
|
Injection, isavuconazonium
|
$578.96 |
$578.96 |
$578.96 |
$787.67
|
|
Injection, necitumumab, 1 mg
|
$5,628.68 |
$5,628.68 |
$5,628.68 |
$8,572.91
|
|
Injection,onabotulinumtoxina
|
$1,679.60 |
$1,679.60 |
$1,679.60 |
$2,277.65
|
|
Injection, peramivir
|
$514.58 |
$514.58 |
$514.58 |
$775.82
|
|
Injection, renflexis
|
$670.88 |
$670.88 |
$670.88 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$990.00 |
$990.00 |
$990.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,269.00 |
$1,269.00 |
$1,269.00 |
$1,939.97
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$873.50 |
$873.50 |
$873.50 |
$1,029.45
|
