|
Iliac/fem angio cath insert
|
$675.40 |
$675.40 |
$675.40 |
$1,571.50
|
|
Iliac revasc add-on 37222
|
$3,191.65 |
$3,191.65 |
$3,191.65 |
$6,513.10
|
|
Img rta detc/mntr ds poc aly
|
$52.80 |
$52.80 |
$52.80 |
$70.29
|
|
Immobilizer shldr dlx str 24-36in med
|
$25.85 |
$25.85 |
$25.85 |
$67.77
|
|
Immune complex assay
|
$127.60 |
$127.60 |
$127.60 |
$89.25
|
|
Immunoassay tumor antigen quantitative ca 125
|
$92.40 |
$92.40 |
$92.40 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$92.40 |
$92.40 |
$92.40 |
$111.07
|
|
Immunodiff gel qual ea antigen/ab
|
$7.15 |
$7.15 |
$7.15 |
$53.95
|
|
Immunodiffusion nes
|
$98.45 |
$98.45 |
$98.45 |
$63.05
|
|
Immunofixation electrophoresis serum
|
$197.45 |
$197.45 |
$197.45 |
$133.38
|
|
Immunofluorescence per specimen initial single antibody stain
|
$226.60 |
$226.60 |
$226.60 |
$248.64
|
|
Immunoglobulin assay
|
$24.20 |
$24.20 |
$24.20 |
$74.15
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,387.65 |
$1,387.65 |
$1,387.65 |
$2,568.98
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,365.10 |
$1,365.10 |
$1,365.10 |
$2,106.00
|
|
In-111 pentetreotide
|
$2,544.30 |
$2,544.30 |
$2,544.30 |
$6,269.30
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,086.70 |
$2,086.70 |
$2,086.70 |
$2,086.70
|
|
Incision of breast lesion
|
$2,649.90 |
$2,649.90 |
$2,649.90 |
$2,742.00
|
|
Incision of tongue fold
|
$2,895.20 |
$2,895.20 |
$2,895.20 |
$1,792.50
|
|
Incisn of toe tndn
|
$4,481.40 |
$4,481.40 |
$4,481.40 |
$2,298.99
|
|
Infect ag drug suscept pheno predict
|
$130.35 |
$130.35 |
$130.35 |
$373.63
|
|
Infect ag genotype na hiv-1 other region
|
$146.30 |
$146.30 |
$146.30 |
$303.66
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$226.60 |
$226.60 |
$226.60 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$54.45 |
$54.45 |
$54.45 |
$65.58
|
|
Infect ag if influenza a
|
$9.90 |
$9.90 |
$9.90 |
$40.61
|
|
Infect ag if influenza b
|
$7.70 |
$7.70 |
$7.70 |
$35.25
|
|
Infect ag if nos ea
|
$9.90 |
$9.90 |
$9.90 |
$55.93
|
|
Infect ag if varicella zoster
|
$30.80 |
$30.80 |
$30.80 |
$64.63
|
|
Infect ag na hpv high-risk types
|
$39.60 |
$39.60 |
$39.60 |
$139.75
|
|
Infect ag na orthopoxvirus amp prb each
|
$242.00 |
$242.00 |
$242.00 |
$103.50
|
|
Infect ag na resp virus 12-25 targets
|
$886.60 |
$886.60 |
$886.60 |
$836.00
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$297.55 |
$297.55 |
$297.55 |
$718.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$77.55 |
$77.55 |
$77.55 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$41.80 |
$41.80 |
$41.80 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$105.05 |
$105.05 |
$105.05 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$95.70 |
$95.70 |
$95.70 |
$76.20
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$40.70 |
$40.70 |
$40.70 |
$84.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$73.70 |
$73.70 |
$73.70 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$39.05 |
$39.05 |
$39.05 |
$56.78
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$160.05 |
$160.05 |
$160.05 |
$99.04
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$130.90 |
$130.90 |
$130.90 |
$137.40
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$108.90 |
$108.90 |
$108.90 |
$93.60
|
|
Infectious agent nucleic acid amplified probe
|
$508.75 |
$508.75 |
$508.75 |
$278.95
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$238.70 |
$238.70 |
$238.70 |
$143.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$57.75 |
$57.75 |
$57.75 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$763.95 |
$763.95 |
$763.95 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$505.45 |
$505.45 |
$505.45 |
$173.60
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$73.15 |
$73.15 |
$73.15 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$201.85 |
$201.85 |
$201.85 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$216.70 |
$216.70 |
$216.70 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$103.95 |
$103.95 |
$103.95 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$482.35 |
$482.35 |
$482.35 |
$221.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$482.35 |
$482.35 |
$482.35 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$83.60 |
$83.60 |
$83.60 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$200.20 |
$200.20 |
$200.20 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,430.00 |
$1,430.00 |
$1,430.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$96.25 |
$96.25 |
$96.25 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$458.15 |
$458.15 |
$458.15 |
$228.38
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$382.80 |
$382.80 |
$382.80 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$129.25 |
$129.25 |
$129.25 |
$381.55
|
|
Initiation & management bipap/cpap initial day
|
$174.90 |
$174.90 |
$174.90 |
$627.00
|
|
Inj cntr knee arthro incl ct/mri
|
$238.70 |
$238.70 |
$238.70 |
$461.25
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$164.34 |
$164.34 |
$164.34 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$170.50 |
$170.50 |
$170.50 |
$562.20
|
|
Injection during cath supravalvular aortography
|
$1,350.80 |
$1,350.80 |
$1,350.80 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,395.35 |
$1,395.35 |
$1,395.35 |
$1,447.86
|
|
Injection for arthrography wrist (both sides)
|
$191.95 |
$191.95 |
$191.95 |
$471.00
|
|
Injection for bladder x-ray
|
$65.45 |
$65.45 |
$65.45 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$155.10 |
$155.10 |
$155.10 |
$504.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$295.90 |
$295.90 |
$295.90 |
$773.19
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,791.15 |
$3,791.15 |
$3,791.15 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$920.70 |
$920.70 |
$920.70 |
$999.81
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$48.31 |
$48.31 |
$48.31 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$494.45 |
$494.45 |
$494.45 |
$539.55
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$541.75 |
$541.75 |
$541.75 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$104.50 |
$104.50 |
$104.50 |
$168.17
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$144.65 |
$144.65 |
$144.65 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$184.25 |
$184.25 |
$184.25 |
$270.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$123.75 |
$123.75 |
$123.75 |
$140.29
|
|
Inj for ext venography
|
$601.70 |
$601.70 |
$601.70 |
$699.06
|
|
Inj for mammo ductogram
|
$504.90 |
$504.90 |
$504.90 |
$452.41
|
|
Inj proc ankle arthr
|
$155.10 |
$155.10 |
$155.10 |
$405.31
|
|
Inj proc elbow arthro
|
$739.75 |
$739.75 |
$739.75 |
$456.17
|
|
Inj proc myelogram lumbar
|
$568.70 |
$568.70 |
$568.70 |
$960.30
|
|
Inj w/fluor eval cv device
|
$325.60 |
$325.60 |
$325.60 |
$593.60
|
|
Ins cath ren art 1st bi
|
$5,779.95 |
$5,779.95 |
$5,779.95 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$2,890.25 |
$2,890.25 |
$2,890.25 |
$4,628.00
|
|
Ins cath ren art 2nd+ bi
|
$7,914.50 |
$7,914.50 |
$7,914.50 |
$5,349.00
|
|
Ins cath ren art 2nd+ uni
|
$3,956.70 |
$3,956.70 |
$3,956.70 |
$5,528.94
|
|
Insertion catheter bladder non indwelling
|
$314.60 |
$314.60 |
$314.60 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$332.20 |
$332.20 |
$332.20 |
$250.80
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,736.70 |
$3,736.70 |
$3,736.70 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,104.40 |
$1,104.40 |
$1,104.40 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$5,348.20 |
$5,348.20 |
$5,348.20 |
$6,832.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,148.85 |
$2,148.85 |
$2,148.85 |
$2,505.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$18,935.40 |
$18,935.40 |
$18,935.40 |
$13,588.90
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$14,738.35 |
$14,738.35 |
$14,738.35 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$27,062.75 |
$27,062.75 |
$27,062.75 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,071.75 |
$3,071.75 |
$3,071.75 |
$2,079.43
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$23,188.00 |
$23,188.00 |
$23,188.00 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$7,413.45 |
$7,413.45 |
$7,413.45 |
$7,216.00
|