|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$92.04 |
$92.04 |
$92.04 |
$144.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$77.42 |
$77.42 |
$77.42 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$372.96 |
$372.96 |
$372.96 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$157.62 |
$157.62 |
$157.62 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$13.60 |
$13.60 |
$13.60 |
$148.80
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$165.58 |
$165.58 |
$165.58 |
$217.10
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$92.04 |
$92.04 |
$92.04 |
$134.55
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$37.46 |
$37.46 |
$37.46 |
$109.18
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$58.74 |
$58.74 |
$58.74 |
$135.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$462.63 |
$462.63 |
$462.63 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$197.40 |
$197.40 |
$197.40 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$203.50 |
$203.50 |
$203.50 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$222.28 |
$222.28 |
$222.28 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$200.08 |
$200.08 |
$200.08 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$443.35 |
$443.35 |
$443.35 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$178.95 |
$178.95 |
$178.95 |
$178.95
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$96.50 |
$96.50 |
$96.50 |
$157.14
|
|
Influenza dna amp prob addl
|
$75.80 |
$75.80 |
$75.80 |
$75.80
|
|
Initial foot exam pt lops
|
$142.17 |
$142.17 |
$142.17 |
$142.64
|
|
Initiation & management bipap/cpap initial day
|
$103.69 |
$103.69 |
$103.69 |
$608.40
|
|
Inj, abilify maintena, 1 mg
|
$2,488.27 |
$2,488.27 |
$2,488.27 |
$3,138.28
|
|
Inj, bezlotoxumab, 10 mg
|
$46.58 |
$46.58 |
$46.58 |
$39.83
|
|
Inj calcitriol per 0.1 mcg
|
$11.21 |
$11.21 |
$11.21 |
$11.21
|
|
Inj ceftolozane tazobactam
|
$164.93 |
$164.93 |
$164.93 |
$248.93
|
|
Inj, clevidipine butyrate
|
$17.45 |
$17.45 |
$17.45 |
$4.86
|
|
Inj dx for sinogram
|
$139.12 |
$139.12 |
$139.12 |
$484.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$212.66 |
$212.66 |
$212.66 |
$609.20
|
|
Injection, cangrelor
|
$19.75 |
$19.75 |
$19.75 |
$1,305.72
|
|
Injection carpal tunnel therapeutic (both sides)
|
$424.02 |
$424.02 |
$424.02 |
$441.60
|
|
Injection epidural blood patch or clot
|
$402.84 |
$402.84 |
$402.84 |
$1,470.60
|
|
Injection for arthrography wrist (both sides)
|
$175.29 |
$175.29 |
$175.29 |
$521.18
|
|
Injection for bladder x-ray
|
$128.95 |
$128.95 |
$128.95 |
$585.00
|
|
Injection for hip x-ray
|
$202.48 |
$202.48 |
$202.48 |
$1,189.34
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$141.06 |
$141.06 |
$141.06 |
$514.36
|
|
Injection for ureter x-ray
|
$99.81 |
$99.81 |
$99.81 |
$544.50
|
|
Injection, fulvestrant
|
$163.24 |
$163.24 |
$163.24 |
$166.25
|
|
Injection glatiramer acetate
|
$272.52 |
$272.52 |
$272.52 |
$458.43
|
|
Injection into brain canal
|
$459.45 |
$459.45 |
$459.45 |
$791.62
|
|
Injection into brain canal
|
$421.43 |
$421.43 |
$421.43 |
$961.20
|
|
Injection into hemorrhoid(s)
|
$193.05 |
$193.05 |
$193.05 |
$1,133.20
|
|
Injection, isavuconazonium
|
$389.92 |
$389.92 |
$389.92 |
$634.28
|
|
Injection,onabotulinumtoxina
|
$17.91 |
$17.91 |
$17.91 |
$12.88
|
|
Injection, peramivir
|
$9.71 |
$9.71 |
$9.71 |
$857.20
|
|
Injection, renflexis
|
$592.94 |
$592.94 |
$592.94 |
$632.98
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$543.53 |
$543.53 |
$543.53 |
$1,066.24
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$744.81 |
$744.81 |
$744.81 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,110.37 |
$1,110.37 |
$1,110.37 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,285.20 |
$1,285.20 |
$1,285.20 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,985.61 |
$1,985.61 |
$1,985.61 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$349.28 |
$349.28 |
$349.28 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$992.80 |
$992.80 |
$992.80 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$660.73 |
$660.73 |
$660.73 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$660.73 |
$660.73 |
$660.73 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$416.07 |
$416.07 |
$416.07 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$263.90 |
$263.90 |
$263.90 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$319.77 |
$319.77 |
$319.77 |
$654.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$75.11 |
$75.11 |
$75.11 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$75.48 |
$75.48 |
$75.48 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$84.55 |
$84.55 |
$84.55 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$61.14 |
$61.14 |
$61.14 |
$130.19
|
|
Injection torsemide 10 mg/ml
|
$16.02 |
$16.02 |
$16.02 |
$40.67
|
|
Injection treatment of eye
|
$2,911.53 |
$2,911.53 |
$2,911.53 |
$2,370.28
|
|
Inject sacroiliac joint
|
$170.57 |
$170.57 |
$170.57 |
$1,028.95
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$20,238.04 |
$20,238.04 |
$20,238.04 |
$39,043.20
|
|
Inj epidural sgl cerv-thor without img
|
$516.89 |
$516.89 |
$516.89 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$520.31 |
$520.31 |
$520.31 |
$1,260.60
|
|
Inj for mammo ductogram
|
$469.16 |
$469.16 |
$469.16 |
$469.16
|
|
Inj intralesional <= 7 lsn(s)
|
$159.19 |
$159.19 |
$159.19 |
$238.77
|
|
Inj ivig privigen 500 mg
|
$520.15 |
$520.15 |
$520.15 |
$6,144.00
|
|
Inj levocarnitine per 1 gm
|
$65.60 |
$65.60 |
$65.60 |
$87.51
|
|
Inj mepivacaine hcl/10 ml
|
$19.37 |
$19.37 |
$19.37 |
$28.41
|
|
Inj, moxifloxacin 100 mg
|
$73.08 |
$73.08 |
$73.08 |
$100.44
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$702.35 |
$702.35 |
$702.35 |
$1,522.56
|
|
Inj peritoneal venous shunt
|
$47.55 |
$47.55 |
$47.55 |
$329.49
|
|
Inj proc ankle arthr
|
$316.54 |
$316.54 |
$316.54 |
$405.60
|
|
Inj proc elbow arthro
|
$302.66 |
$302.66 |
$302.66 |
$483.15
|
|
Inj proc myelogram lumbar
|
$446.68 |
$446.68 |
$446.68 |
$1,026.35
|
|
Inj proc sialogram
|
$130.24 |
$130.24 |
$130.24 |
$419.34
|
|
Inj progesterone per 50 mg
|
$35.00 |
$35.00 |
$35.00 |
$35.00
|
|
Inj retro urethrocysto
|
$111.28 |
$111.28 |
$111.28 |
$569.60
|
|
Inj scleros sol sgl vein
|
$213.86 |
$213.86 |
$213.86 |
$534.40
|
|
Inj secretin synthetic human
|
$610.89 |
$610.89 |
$610.89 |
$610.89
|
|
Inj testosterone cypionate
|
$32.30 |
$32.30 |
$32.30 |
$78.79
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$2,540.29 |
$2,540.29 |
$2,540.29 |
$2,698.05
|
|
Insert cannula vein-to-vein hemodialysis
|
$2,016.78 |
$2,016.78 |
$2,016.78 |
$7,279.50
|
|
Insert cath pleura with image
|
$1,600.99 |
$1,600.99 |
$1,600.99 |
$2,239.02
|
|
Insert cath pleura without image
|
$4,113.48 |
$4,113.48 |
$4,113.48 |
$2,157.58
|
|
Insertion catheter bladder non indwelling
|
$103.14 |
$103.14 |
$103.14 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$113.78 |
$113.78 |
$113.78 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,662.23 |
$1,662.23 |
$1,662.23 |
$4,923.19
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,018.15 |
$1,018.15 |
$1,018.15 |
$2,457.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,159.86 |
$1,159.86 |
$1,159.86 |
$2,079.43
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,494.54 |
$2,494.54 |
$2,494.54 |
$7,513.67
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,720.69 |
$1,720.69 |
$1,720.69 |
$5,423.04
|
|
Insert pessary/other device
|
$177.42 |
$177.42 |
$177.42 |
$277.99
|
|
Insert swan-ganz cath
|
$1,373.35 |
$1,373.35 |
$1,373.35 |
$2,269.00
|
|
Insitu hybridization (fish)
|
$254.01 |
$254.01 |
$254.01 |
$481.60
|
|
In situ hybridization per specimen each additional single probe stain
|
$181.69 |
$181.69 |
$181.69 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$240.83 |
$240.83 |
$240.83 |
$364.00
|
|
Ins mark abd/pel for right perq
|
$1,549.19 |
$1,549.19 |
$1,549.19 |
$2,000.78
|
