|
Icd reliance df4 ib 64cm
|
$11,785.00 |
$11,785.00 |
$11,785.00 |
$9,267.72
|
|
Idh1 common variants
|
$303.00 |
$303.00 |
$303.00 |
$412.10
|
|
Idh2 common variants
|
$303.00 |
$303.00 |
$303.00 |
$486.00
|
|
Igh gene rearrange amp meth
|
$1,175.50 |
$1,175.50 |
$1,175.50 |
$464.00
|
|
Igk rearrangeabn clonal pop
|
$411.50 |
$411.50 |
$411.50 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$140.50 |
$140.50 |
$140.50 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$192.50 |
$192.50 |
$192.50 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$318.50 |
$318.50 |
$318.50 |
$272.30
|
|
Iliac revasc add-on 37222
|
$5,421.50 |
$5,421.50 |
$5,421.50 |
$6,082.65
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$502.00 |
$502.00 |
$502.00 |
$259.20
|
|
Immobilizer shldr cntor adlt
|
$364.00 |
$364.00 |
$364.00 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$149.00 |
$149.00 |
$149.00 |
$114.60
|
|
Immune complex assay
|
$105.00 |
$105.00 |
$105.00 |
$100.80
|
|
Immunoassay tumor antigen quantitative ca 125
|
$181.00 |
$181.00 |
$181.00 |
$131.95
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$115.50 |
$115.50 |
$115.50 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$53.00 |
$53.00 |
$53.00 |
$48.38
|
|
Immunofixation electrophoresis serum
|
$222.00 |
$222.00 |
$222.00 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$110.00 |
$110.00 |
$110.00 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$110.00 |
$110.00 |
$110.00 |
$231.40
|
|
Immunoglobulin assay
|
$124.50 |
$124.50 |
$124.50 |
$75.88
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$3,036.25
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$7,365.50 |
$7,365.50 |
$7,365.50 |
$1,754.00
|
|
Implant cartilage 10mm synthetic
|
$3,882.00 |
$3,882.00 |
$3,882.00 |
$8,184.00
|
|
Implant cochlear osia osi300
|
$18,017.50 |
$18,017.50 |
$18,017.50 |
$16,200.89
|
|
Implant ureth bulk agent
|
$3,388.00 |
$3,388.00 |
$3,388.00 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$4,833.00 |
$4,833.00 |
$4,833.00 |
$3,974.88
|
|
Implt neurostim elctr each
|
$14,112.00 |
$14,112.00 |
$14,112.00 |
$4,579.99
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,602.50 |
$2,602.50 |
$2,602.50 |
$2,056.93
|
|
Incision of breast lesion
|
$2,527.00 |
$2,527.00 |
$2,527.00 |
$2,560.80
|
|
Infect ag drug suscept pheno predict
|
$218.00 |
$218.00 |
$218.00 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$1,215.50 |
$1,215.50 |
$1,215.50 |
$661.80
|
|
Infect ag genotype na hiv-1 other region
|
$1,596.50 |
$1,596.50 |
$1,596.50 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,419.50 |
$1,419.50 |
$1,419.50 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$232.00 |
$232.00 |
$232.00 |
$72.93
|
|
Infect ag if hep delta agent
|
$212.50 |
$212.50 |
$212.50 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$66.00 |
$66.00 |
$66.00 |
$72.58
|
|
Infect ag na herpes simplex quant
|
$213.50 |
$213.50 |
$213.50 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$208.00 |
$208.00 |
$208.00 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$172.50 |
$172.50 |
$172.50 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$188.50 |
$188.50 |
$188.50 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$571.00 |
$571.00 |
$571.00 |
$835.80
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$191.50 |
$191.50 |
$191.50 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$255.00 |
$255.00 |
$255.00 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$164.00 |
$164.00 |
$164.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$37.50 |
$37.50 |
$37.50 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$145.00 |
$145.00 |
$145.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$433.00 |
$433.00 |
$433.00 |
$129.00
|
|
Infectious agent nucleic acid amplified probe
|
$681.50 |
$681.50 |
$681.50 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$243.00 |
$243.00 |
$243.00 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$199.00 |
$199.00 |
$199.00 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$722.00 |
$722.00 |
$722.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$248.50 |
$248.50 |
$248.50 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$186.50 |
$186.50 |
$186.50 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$392.00 |
$392.00 |
$392.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$243.00 |
$243.00 |
$243.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$191.50 |
$191.50 |
$191.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$331.50 |
$331.50 |
$331.50 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$190.00 |
$190.00 |
$190.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$295.50 |
$295.50 |
$295.50 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$538.00 |
$538.00 |
$538.00 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$899.00 |
$899.00 |
$899.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$779.00 |
$779.00 |
$779.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$247.50 |
$247.50 |
$247.50 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$529.00 |
$529.00 |
$529.00 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$628.50 |
$628.50 |
$628.50 |
$374.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$296.00 |
$296.00 |
$296.00 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$188.00 |
$188.00 |
$188.00 |
$576.00
|
|
Inj cntr knee arthro incl ct/mri
|
$273.50 |
$273.50 |
$273.50 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$365.00 |
$365.00 |
$365.00 |
$875.28
|
|
Inj dx for sinogram
|
$5,074.00 |
$5,074.00 |
$5,074.00 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$158.00 |
$158.00 |
$158.00 |
$495.84
|
|
Injection during cath supravalvular aortography
|
$622.50 |
$622.50 |
$622.50 |
$952.66
|
|
Injection epidural blood patch or clot
|
$667.50 |
$667.50 |
$667.50 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$188.50 |
$188.50 |
$188.50 |
$428.40
|
|
Injection for bladder x-ray
|
$483.00 |
$483.00 |
$483.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$200.50 |
$200.50 |
$200.50 |
$494.65
|
|
Injection of sinus tract
|
$199.50 |
$199.50 |
$199.50 |
$1,627.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$507.50 |
$507.50 |
$507.50 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,067.50 |
$1,067.50 |
$1,067.50 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,466.50 |
$1,466.50 |
$1,466.50 |
$1,952.40
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$938.50 |
$938.50 |
$938.50 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$938.50 |
$938.50 |
$938.50 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$534.00 |
$534.00 |
$534.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$486.00 |
$486.00 |
$486.00 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$61.00 |
$61.00 |
$61.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$58.50 |
$58.50 |
$58.50 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$209.00 |
$209.00 |
$209.00 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$97.50 |
$97.50 |
$97.50 |
$135.60
|
|
Inject sacroiliac joint
|
$161.50 |
$161.50 |
$161.50 |
$1,028.95
|
|
Inj epidural sgl lumb-sacral without img
|
$1,730.00 |
$1,730.00 |
$1,730.00 |
$1,415.50
|
|
Inj for ext venography
|
$325.00 |
$325.00 |
$325.00 |
$649.95
|
|
Inj for mammo ductogram
|
$276.50 |
$276.50 |
$276.50 |
$399.60
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$622.50 |
$622.50 |
$622.50 |
$1,439.90
|
|
Inj hrt cath w/s&i sel left vent
|
$776.50 |
$776.50 |
$776.50 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$700.00 |
$700.00 |
$700.00 |
$965.33
|
|
Inj intralesional <= 7 lsn(s)
|
$137.00 |
$137.00 |
$137.00 |
$235.13
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$574.00 |
$574.00 |
$574.00 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,672.00 |
$2,672.00 |
$2,672.00 |
$2,609.38
|
|
Inj proc elbow arthro
|
$191.50 |
$191.50 |
$191.50 |
$419.60
|
|
Inj proc lumbr disk ea lvl
|
$340.50 |
$340.50 |
$340.50 |
$1,106.93
|
