|
Infect ag if influenza b
|
$59.80 |
$59.80 |
$59.80 |
$45.50
|
|
Infect ag if varicella zoster
|
$96.20 |
$96.20 |
$96.20 |
$68.25
|
|
Infect ag na hpv high-risk types
|
$85.15 |
$85.15 |
$85.15 |
$147.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$268.45 |
$268.45 |
$268.45 |
$248.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$105.30 |
$105.30 |
$105.30 |
$127.50
|
|
Infect ag na resp virus 12-25 targets
|
$417.30 |
$417.30 |
$417.30 |
$878.20
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$97.50 |
$97.50 |
$97.50 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$99.45 |
$99.45 |
$99.45 |
$74.10
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$42.90 |
$42.90 |
$42.90 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$42.90 |
$42.90 |
$42.90 |
$73.45
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$135.85 |
$135.85 |
$135.85 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$37.05 |
$37.05 |
$37.05 |
$75.27
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$65.00 |
$65.00 |
$65.00 |
$60.95
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$48.75 |
$48.75 |
$48.75 |
$107.90
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$193.70 |
$193.70 |
$193.70 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$101.40 |
$101.40 |
$101.40 |
$98.40
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$72.80 |
$72.80 |
$72.80 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$500.50 |
$500.50 |
$500.50 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$185.90 |
$185.90 |
$185.90 |
$144.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$128.70 |
$128.70 |
$128.70 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$514.80 |
$514.80 |
$514.80 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$102.70 |
$102.70 |
$102.70 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$100.75 |
$100.75 |
$100.75 |
$148.80
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$150.15 |
$150.15 |
$150.15 |
$217.10
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$91.00 |
$91.00 |
$91.00 |
$134.55
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$149.50 |
$149.50 |
$149.50 |
$109.18
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$178.75 |
$178.75 |
$178.75 |
$194.40
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$256.75 |
$256.75 |
$256.75 |
$211.09
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$65.00 |
$65.00 |
$65.00 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$118.30 |
$118.30 |
$118.30 |
$135.00
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$125.45 |
$125.45 |
$125.45 |
$296.71
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$143.00 |
$143.00 |
$143.00 |
$248.18
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$479.70 |
$479.70 |
$479.70 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$273.65 |
$273.65 |
$273.65 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$235.30 |
$235.30 |
$235.30 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$191.10 |
$191.10 |
$191.10 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$190.45 |
$190.45 |
$190.45 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$367.90 |
$367.90 |
$367.90 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$1,395.87 |
$1,395.87 |
$1,395.87 |
$178.95
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,469.00 |
$1,469.00 |
$1,469.00 |
$89.49
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,774.37 |
$2,774.37 |
$2,774.37 |
$157.14
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,682.20 |
$1,682.20 |
$1,682.20 |
$1,153.60
|
|
Ingest challenge ea addl 60 min
|
$289.90 |
$289.90 |
$289.90 |
$274.50
|
|
Ingest challenge ini 120 min
|
$863.85 |
$863.85 |
$863.85 |
$619.82
|
|
Initiation & management bipap/cpap initial day
|
$445.90 |
$445.90 |
$445.90 |
$608.40
|
|
Inj alymsys 10 mg
|
$8,414.12 |
$8,414.12 |
$8,414.12 |
$42.60
|
|
Inj., benralizumab, 1 mg
|
$17,622.23 |
$17,622.23 |
$17,622.23 |
$12,417.10
|
|
Inj, bupivacaine liposome
|
$816.31 |
$816.31 |
$816.31 |
$3.22
|
|
Inj cefazolin (wg crit care)
|
$23.79 |
$23.79 |
$23.79 |
$1.00
|
|
Inj ceftolozane tazobactam
|
$934.20 |
$934.20 |
$934.20 |
$248.93
|
|
Inj cntr knee arthro incl ct/mri
|
$218.40 |
$218.40 |
$218.40 |
$505.20
|
|
Inj cyclophosphamd (ingenus)
|
$1,720.55 |
$1,720.55 |
$1,720.55 |
$1.16
|
|
Inj. denosumab-bbdz, 1 mg
|
$9,390.67 |
$9,390.67 |
$9,390.67 |
$6,618.42
|
|
Inj, durolane 1 mg
|
$5,435.63 |
$5,435.63 |
$5,435.63 |
$12.72
|
|
Inj dx for sinogram
|
$576.55 |
$576.55 |
$576.55 |
$484.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,715.83 |
$2,715.83 |
$2,715.83 |
$1,165.32
|
|
Injection arthrography hip without anesthesia (both sides)
|
$270.40 |
$270.40 |
$270.40 |
$609.20
|
|
Injection carpal tunnel therapeutic (both sides)
|
$243.10 |
$243.10 |
$243.10 |
$441.60
|
|
Injection during cath supravalvular aortography
|
$1,022.45 |
$1,022.45 |
$1,022.45 |
$1,604.20
|
|
Injection epidural blood patch or clot
|
$1,828.45 |
$1,828.45 |
$1,828.45 |
$1,470.60
|
|
Injection for arthrography wrist (both sides)
|
$480.35 |
$480.35 |
$480.35 |
$521.18
|
|
Injection for bladder x-ray
|
$875.55 |
$875.55 |
$875.55 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$205.40 |
$205.40 |
$205.40 |
$514.36
|
|
Injection for ureter x-ray
|
$1,625.00 |
$1,625.00 |
$1,625.00 |
$349.55
|
|
Injection for ureter x-ray
|
$376.35 |
$376.35 |
$376.35 |
$544.50
|
|
Injection, fulvestrant
|
$299.00 |
$299.00 |
$299.00 |
$166.25
|
|
Injection, inclisiran, 1 mg
|
$9,943.76 |
$9,943.76 |
$9,943.76 |
$12.72
|
|
Injection,onabotulinumtoxina
|
$1,734.91 |
$1,734.91 |
$1,734.91 |
$12.88
|
|
Injection radioactive tracer sentinel node (both sides)
|
$2,328.95 |
$2,328.95 |
$2,328.95 |
$787.50
|
|
Injection, renflexis
|
$2,210.17 |
$2,210.17 |
$2,210.17 |
$632.98
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,353.30 |
$1,353.30 |
$1,353.30 |
$1,066.24
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$27,537.07 |
$27,537.07 |
$27,537.07 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$19,273.96 |
$19,273.96 |
$19,273.96 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$6,399.97 |
$6,399.97 |
$6,399.97 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,855.01 |
$1,855.01 |
$1,855.01 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,855.01 |
$1,855.01 |
$1,855.01 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$4,924.13 |
$4,924.13 |
$4,924.13 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,924.13 |
$4,924.13 |
$4,924.13 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,125.91 |
$3,125.91 |
$3,125.91 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,589.02 |
$2,589.02 |
$2,589.02 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$339.30 |
$339.30 |
$339.30 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,112.15 |
$1,112.15 |
$1,112.15 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,033.50 |
$1,033.50 |
$1,033.50 |
$654.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$163.80 |
$163.80 |
$163.80 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$163.80 |
$163.80 |
$163.80 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$321.10 |
$321.10 |
$321.10 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$135.85 |
$135.85 |
$135.85 |
$130.19
|
|
Injection treatment of nerve
|
$3,857.10 |
$3,857.10 |
$3,857.10 |
$1,636.00
|
|
Inj epidural sgl lumb-sacral without img
|
$3,958.50 |
$3,958.50 |
$3,958.50 |
$1,260.60
|
|
Inj. fe derisomaltose 10 mg
|
$18,516.57 |
$18,516.57 |
$18,516.57 |
$21.05
|
|
Inj for ext venography
|
$631.80 |
$631.80 |
$631.80 |
$946.64
|
|
Inj for mammo ductogram
|
$492.70 |
$492.70 |
$492.70 |
$469.16
|
|
Inj herzuma 10 mg
|
$8,939.74 |
$8,939.74 |
$8,939.74 |
$77.49
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,870.70 |
$1,870.70 |
$1,870.70 |
$1,646.97
|
|
Inj hrt cath w/s&i sel left vent
|
$2,299.70 |
$2,299.70 |
$2,299.70 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$980.85 |
$980.85 |
$980.85 |
$1,352.65
|
|
Inj hydroxocobalamin IV 25mg
|
$5,109.00 |
$5,109.00 |
$5,109.00 |
$1,593.19
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$3,579.55 |
$3,579.55 |
$3,579.55 |
$1,673.66
|
|
Inj intralesional <= 7 lsn(s)
|
$403.00 |
$403.00 |
$403.00 |
$238.77
|
|
Inj ivig privigen 500 mg
|
$21,066.29 |
$21,066.29 |
$21,066.29 |
$6,144.00
|