|
Incision tendon sheath
|
$1,857.00 |
$1,857.00 |
$1,857.00 |
$3,073.20
|
|
Induced abortion d&c
|
$2,385.50 |
$2,385.50 |
$2,385.50 |
$3,762.53
|
|
Infect ag drug suscept pheno predict
|
$133.50 |
$133.50 |
$133.50 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$864.50 |
$864.50 |
$864.50 |
$661.80
|
|
Infect ag genotype na hiv-1 other region
|
$346.00 |
$346.00 |
$346.00 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$962.00 |
$962.00 |
$962.00 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$108.50 |
$108.50 |
$108.50 |
$72.93
|
|
Infect ag if hep delta agent
|
$181.50 |
$181.50 |
$181.50 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$116.50 |
$116.50 |
$116.50 |
$72.58
|
|
Infect ag na herpes simplex quant
|
$160.00 |
$160.00 |
$160.00 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$148.00 |
$148.00 |
$148.00 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$115.00 |
$115.00 |
$115.00 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$126.50 |
$126.50 |
$126.50 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$407.00 |
$407.00 |
$407.00 |
$835.80
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$28.00 |
$28.00 |
$28.00 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$191.50 |
$191.50 |
$191.50 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$94.50 |
$94.50 |
$94.50 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$26.00 |
$26.00 |
$26.00 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$61.00 |
$61.00 |
$61.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$354.00 |
$354.00 |
$354.00 |
$129.00
|
|
Infectious agent nucleic acid amplified probe
|
$511.00 |
$511.00 |
$511.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$148.00 |
$148.00 |
$148.00 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$149.00 |
$149.00 |
$149.00 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$484.00 |
$484.00 |
$484.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$171.50 |
$171.50 |
$171.50 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$52.00 |
$52.00 |
$52.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$294.00 |
$294.00 |
$294.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$148.00 |
$148.00 |
$148.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$25.00 |
$25.00 |
$25.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$232.00 |
$232.00 |
$232.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$92.00 |
$92.00 |
$92.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$148.00 |
$148.00 |
$148.00 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$403.00 |
$403.00 |
$403.00 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$378.00 |
$378.00 |
$378.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$637.00 |
$637.00 |
$637.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$225.00 |
$225.00 |
$225.00 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$220.50 |
$220.50 |
$220.50 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$471.50 |
$471.50 |
$471.50 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$424.50 |
$424.50 |
$424.50 |
$303.59
|
|
Infuse radioactive materials
|
$167.50 |
$167.50 |
$167.50 |
$640.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$234.50 |
$234.50 |
$234.50 |
$293.25
|
|
Init bk ptb plaster direct
|
$2,694.50 |
$2,694.50 |
$2,694.50 |
$2,148.48
|
|
Initiation & management bipap/cpap initial day
|
$704.50 |
$704.50 |
$704.50 |
$576.00
|
|
Init/sub psych care m 1st 30
|
$52.00 |
$52.00 |
$52.00 |
$94.34
|
|
Inj cntr knee arthro incl ct/mri
|
$220.00 |
$220.00 |
$220.00 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$305.00 |
$305.00 |
$305.00 |
$875.28
|
|
Inj dx for sinogram
|
$217.00 |
$217.00 |
$217.00 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$618.50 |
$618.50 |
$618.50 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$225.50 |
$225.50 |
$225.50 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$211.00 |
$211.00 |
$211.00 |
$450.72
|
|
Injection during cath supravalvular aortography
|
$1,028.00 |
$1,028.00 |
$1,028.00 |
$952.66
|
|
Injection epidural blood patch or clot
|
$512.50 |
$512.50 |
$512.50 |
$1,156.80
|
|
Injection eye drug
|
$211.00 |
$211.00 |
$211.00 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$142.00 |
$142.00 |
$142.00 |
$428.40
|
|
Injection for bladder x-ray
|
$61.00 |
$61.00 |
$61.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$296.50 |
$296.50 |
$296.50 |
$494.65
|
|
Injection for spleen x-ray
|
$359.00 |
$359.00 |
$359.00 |
$529.57
|
|
Injection for tear sac x-ray
|
$52.00 |
$52.00 |
$52.00 |
$225.20
|
|
Injection for ureter x-ray
|
$43.50 |
$43.50 |
$43.50 |
$427.70
|
|
Injection for ureter x-ray
|
$43.50 |
$43.50 |
$43.50 |
$515.21
|
|
Injection into brain canal
|
$664.50 |
$664.50 |
$664.50 |
$1,289.60
|
|
Injection into brain canal
|
$415.50 |
$415.50 |
$415.50 |
$836.40
|
|
Injection jaw joint x-ray
|
$170.00 |
$170.00 |
$170.00 |
$307.80
|
|
Injection jugular
|
$3,534.50 |
$3,534.50 |
$3,534.50 |
$790.00
|
|
Injection of sinus tract
|
$902.50 |
$902.50 |
$902.50 |
$1,627.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$182.00 |
$182.00 |
$182.00 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$369.00 |
$369.00 |
$369.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$369.00 |
$369.00 |
$369.00 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$625.00 |
$625.00 |
$625.00 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$292.00 |
$292.00 |
$292.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$823.50 |
$823.50 |
$823.50 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$292.00 |
$292.00 |
$292.00 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$823.50 |
$823.50 |
$823.50 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$935.00 |
$935.00 |
$935.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$935.00 |
$935.00 |
$935.00 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$200.00 |
$200.00 |
$200.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$200.00 |
$200.00 |
$200.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$231.00 |
$231.00 |
$231.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$47.00 |
$47.00 |
$47.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$52.00 |
$52.00 |
$52.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$54.50 |
$54.50 |
$54.50 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$21.00 |
$21.00 |
$21.00 |
$135.60
|
|
Injection treatment of eye
|
$821.50 |
$821.50 |
$821.50 |
$2,698.92
|
|
Injection treatment of eye
|
$834.00 |
$834.00 |
$834.00 |
$2,665.60
|
|
Injection treatment of nerve
|
$753.50 |
$753.50 |
$753.50 |
$2,025.45
|
|
Inject sacroiliac joint
|
$132.00 |
$132.00 |
$132.00 |
$1,028.95
|
|
Inject/treat eye socket
|
$153.00 |
$153.00 |
$153.00 |
$381.13
|
|
Inject/treat eye socket
|
$487.00 |
$487.00 |
$487.00 |
$670.02
|
|
Inj epidural sgl lumb-sacral without img
|
$935.00 |
$935.00 |
$935.00 |
$1,415.50
|
|
Inj for ext venography
|
$177.50 |
$177.50 |
$177.50 |
$649.95
|
|
Inj for mammo ductogram
|
$343.00 |
$343.00 |
$343.00 |
$399.60
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,070.00 |
$2,070.00 |
$2,070.00 |
$1,439.90
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,101.00 |
$1,101.00 |
$1,101.00 |
$1,827.74
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,255.50 |
$1,255.50 |
$1,255.50 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$709.00 |
$709.00 |
$709.00 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$1,155.00 |
$1,155.00 |
$1,155.00 |
$965.33
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$1,081.50 |
$1,081.50 |
$1,081.50 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$122.50 |
$122.50 |
$122.50 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$157.50 |
$157.50 |
$157.50 |
$234.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$543.50 |
$543.50 |
$543.50 |
$1,413.35
|
