|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$2,278.00 |
$2,278.00 |
$2,278.00 |
$3,036.25
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$5,089.50 |
$5,089.50 |
$5,089.50 |
$1,754.00
|
|
Implant cartilage 10mm synthetic
|
$18,599.00 |
$18,599.00 |
$18,599.00 |
$8,184.00
|
|
Implant cochlear osia osi300
|
$20,196.50 |
$20,196.50 |
$20,196.50 |
$16,200.89
|
|
Implant ureth bulk agent
|
$5,394.50 |
$5,394.50 |
$5,394.50 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$3,737.50 |
$3,737.50 |
$3,737.50 |
$3,974.88
|
|
Impl neurostim electr perc
|
$16,716.00 |
$16,716.00 |
$16,716.00 |
$7,672.50
|
|
Implt neurostim elctr each
|
$8,134.00 |
$8,134.00 |
$8,134.00 |
$4,579.99
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,363.00 |
$3,363.00 |
$3,363.00 |
$2,056.93
|
|
Incision of breast lesion
|
$4,414.00 |
$4,414.00 |
$4,414.00 |
$2,560.80
|
|
Infect ag drug suscept pheno predict
|
$165.00 |
$165.00 |
$165.00 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$1,343.50 |
$1,343.50 |
$1,343.50 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$2,489.50 |
$2,489.50 |
$2,489.50 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$121.50 |
$121.50 |
$121.50 |
$72.93
|
|
Infect ag if hep delta agent
|
$246.50 |
$246.50 |
$246.50 |
$125.97
|
|
Infect ag na herpes simplex quant
|
$180.00 |
$180.00 |
$180.00 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$44.00 |
$44.00 |
$44.00 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$157.00 |
$157.00 |
$157.00 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$171.50 |
$171.50 |
$171.50 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$414.50 |
$414.50 |
$414.50 |
$835.80
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$219.00 |
$219.00 |
$219.00 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$147.50 |
$147.50 |
$147.50 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$270.50 |
$270.50 |
$270.50 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$29.50 |
$29.50 |
$29.50 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$122.00 |
$122.00 |
$122.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$312.50 |
$312.50 |
$312.50 |
$129.00
|
|
Infectious agent nucleic acid amplified probe
|
$573.00 |
$573.00 |
$573.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$246.50 |
$246.50 |
$246.50 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$167.00 |
$167.00 |
$167.00 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$656.50 |
$656.50 |
$656.50 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$377.00 |
$377.00 |
$377.00 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$58.00 |
$58.00 |
$58.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$330.00 |
$330.00 |
$330.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$246.50 |
$246.50 |
$246.50 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$27.50 |
$27.50 |
$27.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$283.00 |
$283.00 |
$283.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$103.00 |
$103.00 |
$103.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$166.00 |
$166.00 |
$166.00 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$452.50 |
$452.50 |
$452.50 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$681.00 |
$681.00 |
$681.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$779.00 |
$779.00 |
$779.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$299.00 |
$299.00 |
$299.00 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$1,401.50 |
$1,401.50 |
$1,401.50 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,781.00 |
$1,781.00 |
$1,781.00 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$576.50 |
$576.50 |
$576.50 |
$303.59
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$466.00 |
$466.00 |
$466.00 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$289.50 |
$289.50 |
$289.50 |
$576.00
|
|
Init/sub psych care m 1st 30
|
$72.00 |
$72.00 |
$72.00 |
$94.34
|
|
Inj cntr knee arthro incl ct/mri
|
$437.50 |
$437.50 |
$437.50 |
$436.80
|
|
Inj dx for sinogram
|
$431.50 |
$431.50 |
$431.50 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$526.50 |
$526.50 |
$526.50 |
$495.84
|
|
Injection during cath supravalvular aortography
|
$2,119.00 |
$2,119.00 |
$2,119.00 |
$952.66
|
|
Injection epidural blood patch or clot
|
$1,019.50 |
$1,019.50 |
$1,019.50 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$644.50 |
$644.50 |
$644.50 |
$428.40
|
|
Injection for bladder x-ray
|
$639.00 |
$639.00 |
$639.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$808.00 |
$808.00 |
$808.00 |
$494.65
|
|
Injection for ureter x-ray
|
$708.00 |
$708.00 |
$708.00 |
$515.21
|
|
Injection jugular
|
$329.50 |
$329.50 |
$329.50 |
$790.00
|
|
Injection radioactive tracer sentinel node (both sides)
|
$526.50 |
$526.50 |
$526.50 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$733.50 |
$733.50 |
$733.50 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,806.00 |
$1,806.00 |
$1,806.00 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,250.50 |
$2,250.50 |
$2,250.50 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$701.50 |
$701.50 |
$701.50 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,250.50 |
$2,250.50 |
$2,250.50 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$6,900.00 |
$6,900.00 |
$6,900.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$6,900.00 |
$6,900.00 |
$6,900.00 |
$1,681.24
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$259.50 |
$259.50 |
$259.50 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$208.50 |
$208.50 |
$208.50 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$208.50 |
$208.50 |
$208.50 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$227.50 |
$227.50 |
$227.50 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$156.00 |
$156.00 |
$156.00 |
$135.60
|
|
Inject sacroiliac joint
|
$1,883.50 |
$1,883.50 |
$1,883.50 |
$1,028.95
|
|
Inj for ext venography
|
$1,150.50 |
$1,150.50 |
$1,150.50 |
$649.95
|
|
Inj for mammo ductogram
|
$598.50 |
$598.50 |
$598.50 |
$399.60
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$3,576.00 |
$3,576.00 |
$3,576.00 |
$1,439.90
|
|
Inj hrt cath w/s&i sel left vent
|
$1,579.00 |
$1,579.00 |
$1,579.00 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$1,338.00 |
$1,338.00 |
$1,338.00 |
$965.33
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$6,084.00 |
$6,084.00 |
$6,084.00 |
$1,413.35
|
|
Inj proc elbow arthro
|
$644.50 |
$644.50 |
$644.50 |
$419.60
|
|
Inj proc myelogram lumbar
|
$2,041.00 |
$2,041.00 |
$2,041.00 |
$830.50
|
|
Inj proc sialogram
|
$857.50 |
$857.50 |
$857.50 |
$373.00
|
|
Inj retro urethrocysto
|
$394.00 |
$394.00 |
$394.00 |
$443.50
|
|
Inj, susvimo 0.1 mg
|
$12,080.00 |
$12,080.00 |
$12,080.00 |
$2,598.44
|
|
Inj vocal cord bulking agent
|
$1,579.00 |
$1,579.00 |
$1,579.00 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$648.50 |
$648.50 |
$648.50 |
$503.92
|
|
Ins cath ren art 1st bi
|
$5,791.00 |
$5,791.00 |
$5,791.00 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$5,324.50 |
$5,324.50 |
$5,324.50 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$4,440.00 |
$4,440.00 |
$4,440.00 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$7,205.00 |
$7,205.00 |
$7,205.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$473.50 |
$473.50 |
$473.50 |
$480.28
|
|
Insert abdomen-venous drain
|
$529.00 |
$529.00 |
$529.00 |
$3,147.06
|
|
Insert cannula vein-to-vein hemodialysis
|
$3,508.00 |
$3,508.00 |
$3,508.00 |
$7,279.50
|
|
Insert cath pleura with image
|
$2,645.50 |
$2,645.50 |
$2,645.50 |
$2,194.40
|
|
Insert intrauterine device iud
|
$470.00 |
$470.00 |
$470.00 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$200.00 |
$200.00 |
$200.00 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$200.00 |
$200.00 |
$200.00 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$13,449.00 |
$13,449.00 |
$13,449.00 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$6,144.00 |
$6,144.00 |
$6,144.00 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$7,858.50 |
$7,858.50 |
$7,858.50 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,150.00 |
$3,150.00 |
$3,150.00 |
$2,505.60
|
