|
Incision of achilles tendon
|
$607.80 |
$607.80 |
$607.80 |
$3,591.33
|
|
Incision of breast lesion
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$2,577.85
|
|
Incision of eardrum
|
$153.00 |
$153.00 |
$153.00 |
$552.75
|
|
Incision of foot fascia
|
$557.40 |
$557.40 |
$557.40 |
$4,599.40
|
|
Incision of foot tendon 28234
|
$495.00 |
$495.00 |
$495.00 |
$2,211.05
|
|
Incision of heel bone
|
$1,222.20 |
$1,222.20 |
$1,222.20 |
$6,004.47
|
|
Incision of hip tendon
|
$792.60 |
$792.60 |
$792.60 |
$3,885.29
|
|
Incision of metatarsal
|
$767.40 |
$767.40 |
$767.40 |
$4,881.00
|
|
Incision of metatarsal
|
$719.40 |
$719.40 |
$719.40 |
$3,786.00
|
|
Incision of midfoot bones
|
$1,027.80 |
$1,027.80 |
$1,027.80 |
$6,004.47
|
|
Incision of small bowel 44010
|
$1,488.60 |
$1,488.60 |
$1,488.60 |
$1,362.00
|
|
Incision of spinal nerve 64772
|
$1,014.60 |
$1,014.60 |
$1,014.60 |
$2,685.07
|
|
Incision of tendon sheath
|
$787.80 |
$787.80 |
$787.80 |
$2,263.68
|
|
Incision of thigh tendons
|
$1,019.40 |
$1,019.40 |
$1,019.40 |
$3,839.54
|
|
Incision of tibia & fibula
|
$2,137.80 |
$2,137.80 |
$2,137.80 |
$13,148.80
|
|
Incision of toe tendons 28011
|
$573.00 |
$573.00 |
$573.00 |
$2,119.12
|
|
Incision of windpipe
|
$1,304.40 |
$1,304.40 |
$1,304.40 |
$5,855.00
|
|
Incision tendon sheath
|
$748.20 |
$748.20 |
$748.20 |
$3,073.20
|
|
Incisn of toe tndn
|
$743.40 |
$743.40 |
$743.40 |
$2,667.00
|
|
Infect ag eia influenza a or b ea
|
$54.60 |
$54.60 |
$54.60 |
$71.20
|
|
Infect ag ia optc obs influenza
|
$53.40 |
$53.40 |
$53.40 |
$72.93
|
|
Infect ag na hpv high-risk types
|
$310.80 |
$310.80 |
$310.80 |
$139.20
|
|
Infect ag na resp virus 12-25 targets
|
$561.60 |
$561.60 |
$561.60 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$70.20 |
$70.20 |
$70.20 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$107.40 |
$107.40 |
$107.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$53.40 |
$53.40 |
$53.40 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$198.00 |
$198.00 |
$198.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$102.60 |
$102.60 |
$102.60 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$110.40 |
$110.40 |
$110.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$70.20 |
$70.20 |
$70.20 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$111.60 |
$111.60 |
$111.60 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$105.00 |
$105.00 |
$105.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$310.80 |
$310.80 |
$310.80 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$161.40 |
$161.40 |
$161.40 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$163.80 |
$163.80 |
$163.80 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$160.20 |
$160.20 |
$160.20 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$131.40 |
$131.40 |
$131.40 |
$149.13
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$161.40 |
$161.40 |
$161.40 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$93.00 |
$93.00 |
$93.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$196.80 |
$196.80 |
$196.80 |
$236.08
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$161.40 |
$161.40 |
$161.40 |
$112.45
|
|
Infectious agent nucleic acid quantification bk virus
|
$584.40 |
$584.40 |
$584.40 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$400.80 |
$400.80 |
$400.80 |
$253.00
|
|
Infliximab 100 mg intravenous solution
|
$2,907.60 |
$2,907.60 |
$2,907.60 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,245.00 |
$1,245.00 |
$1,245.00 |
$1,062.00
|
|
Influenza virus vaccine, live trivalent intranasal
|
$42.60 |
$42.60 |
$42.60 |
$36.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$276.00 |
$276.00 |
$276.00 |
$296.00
|
|
Initial observation care
|
$115.20 |
$115.20 |
$115.20 |
$156.00
|
|
Initial observation care
|
$211.20 |
$211.20 |
$211.20 |
$268.20
|
|
Init pm e/m new pat 65+ yrs
|
$192.60 |
$192.60 |
$192.60 |
$189.15
|
|
Inj anifrolumab-fnia 1mg
|
$13,281.60 |
$13,281.60 |
$13,281.60 |
$10,052.58
|
|
Inj belantamab mafodot blmf
|
$33,801.60 |
$33,801.60 |
$33,801.60 |
$21,726.12
|
|
Inj, bezlotoxumab, 10 mg
|
$9,462.00 |
$9,462.00 |
$9,462.00 |
$7,612.43
|
|
Inj ceftolozane tazobactam
|
$218.40 |
$218.40 |
$218.40 |
$364.86
|
|
Inj, cyclophosphamd, sandoz
|
$2,408.40 |
$2,408.40 |
$2,408.40 |
$735.20
|
|
Inj, decitabine (sun pharma)
|
$4,596.00 |
$4,596.00 |
$4,596.00 |
$310.09
|
|
Inj dupuytren cord w/enzyme
|
$55.20 |
$55.20 |
$55.20 |
$416.00
|
|
Inj, durolane 1 mg
|
$24.00 |
$24.00 |
$24.00 |
$1,950.93
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$320.40 |
$320.40 |
$320.40 |
$1,214.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$86.40 |
$86.40 |
$86.40 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$7,323.60 |
$7,323.60 |
$7,323.60 |
$5,324.34
|
|
Injection epidural blood patch or clot
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$1,182.33
|
|
Injection, fosphenytoin sodi
|
$90.00 |
$90.00 |
$90.00 |
$165.20
|
|
Injection, fulvestrant
|
$2,398.80 |
$2,398.80 |
$2,398.80 |
$1,719.16
|
|
Injection,onabotulinumtoxina
|
$810.00 |
$810.00 |
$810.00 |
$2,277.65
|
|
Injection px peyronie ds
|
$105.00 |
$105.00 |
$105.00 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$80.40 |
$80.40 |
$80.40 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$134.40 |
$134.40 |
$134.40 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$478.20 |
$478.20 |
$478.20 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$280.20 |
$280.20 |
$280.20 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$147.00 |
$147.00 |
$147.00 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$351.60 |
$351.60 |
$351.60 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$126.00 |
$126.00 |
$126.00 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$522.60 |
$522.60 |
$522.60 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$181.20 |
$181.20 |
$181.20 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$165.60 |
$165.60 |
$165.60 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$478.20 |
$478.20 |
$478.20 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$183.00 |
$183.00 |
$183.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$79.20 |
$79.20 |
$79.20 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$111.00 |
$111.00 |
$111.00 |
$145.60
|
|
Inject sacroiliac joint
|
$318.00 |
$318.00 |
$318.00 |
$1,029.04
|
|
Inj, gadopiclenol, 1 ml
|
$17.40 |
$17.40 |
$17.40 |
$37.63
|
|
Inj. herceptin hylecta, 10mg
|
$2,328.00 |
$2,328.00 |
$2,328.00 |
$8,193.78
|
|
Inj intralesional <= 7 lsn(s)
|
$44.40 |
$44.40 |
$44.40 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$7,636.80 |
$7,636.80 |
$7,636.80 |
$6,967.29
|
|
Inj, linezolid (hospira)
|
$100.20 |
$100.20 |
$100.20 |
$153.30
|
|
Inj., meropenem, vaborbactam
|
$258.00 |
$258.00 |
$258.00 |
$556.87
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$11,674.80 |
$11,674.80 |
$11,674.80 |
$8,304.04
|
|
Inj naloxone hydrochloride
|
$41.40 |
$41.40 |
$41.40 |
$83.16
|
|
Inj nivolumab 2 mg hyaluron
|
$19,390.20 |
$19,390.20 |
$19,390.20 |
$15,599.68
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$9,774.60 |
$9,774.60 |
$9,774.60 |
$6,614.40
|
|
Inj. pemetrexed, 10 mg
|
$11,086.80 |
$11,086.80 |
$11,086.80 |
$104.72
|
|
Inj retro urethrocysto
|
$105.60 |
$105.60 |
$105.60 |
$447.74
|
|
Inj scleros sol mult veins
|
$156.60 |
$156.60 |
$156.60 |
$692.90
|
|
Inj secretin synthetic human
|
$85.20 |
$85.20 |
$85.20 |
$1,253.09
|
|
Inj teclistamab cqyv 0.5 mg
|
$25,086.00 |
$25,086.00 |
$25,086.00 |
$17,517.56
|
|
Inj testosterone cypionate
|
$6.00 |
$6.00 |
$6.00 |
$64.96
|
|
Inj, vancomycin hcl (mylan)
|
$30.00 |
$30.00 |
$30.00 |
$72.33
|
|
Inj w/fluor eval cv device
|
$596.40 |
$596.40 |
$596.40 |
$504.40
|
|
Ins cerv dilator (sep proc)
|
$385.80 |
$385.80 |
$385.80 |
$490.73
|
