|
Impres&prep oral surg splint
|
$3,701.00 |
$3,701.00 |
$3,701.00 |
$1,751.20
|
|
Impres&prep orbital prosth
|
$6,571.50 |
$6,571.50 |
$6,571.50 |
$7,000.36
|
|
Impres&prep paltl aug prosth
|
$7,515.00 |
$7,515.00 |
$7,515.00 |
$3,837.72
|
|
Impres&prep paltl lft prosth
|
$8,608.50 |
$8,608.50 |
$8,608.50 |
$3,837.72
|
|
Impres&prep sp aid prosth
|
$7,515.00 |
$7,515.00 |
$7,515.00 |
$4,054.40
|
|
Impres&prep surg obt prosth
|
$4,816.50 |
$4,816.50 |
$4,816.50 |
$2,945.12
|
|
Incise inner ear
|
$2,755.50 |
$2,755.50 |
$2,755.50 |
$2,186.08
|
|
Incise inner eye adhesions
|
$607.50 |
$607.50 |
$607.50 |
$1,202.90
|
|
Incise inner eye adhesions
|
$2,079.00 |
$2,079.00 |
$2,079.00 |
$2,698.92
|
|
Incise nerve back of head
|
$1,459.00 |
$1,459.00 |
$1,459.00 |
$2,685.07
|
|
Incise tear duct opening 68440
|
$421.00 |
$421.00 |
$421.00 |
$507.20
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,366.00 |
$1,366.00 |
$1,366.00 |
$2,056.93
|
|
Incision of breast lesion
|
$3,070.00 |
$3,070.00 |
$3,070.00 |
$2,560.80
|
|
Incision of eardrum
|
$592.00 |
$592.00 |
$592.00 |
$552.75
|
|
Incision of eardrum
|
$2,878.50 |
$2,878.50 |
$2,878.50 |
$3,827.50
|
|
Incision of eyelid
|
$1,399.00 |
$1,399.00 |
$1,399.00 |
$1,488.50
|
|
Incision of lymph channels
|
$3,407.00 |
$3,407.00 |
$3,407.00 |
$4,570.46
|
|
Incision of tongue fold
|
$1,515.50 |
$1,515.50 |
$1,515.50 |
$1,792.50
|
|
Incision tendon sheath
|
$2,876.50 |
$2,876.50 |
$2,876.50 |
$3,073.20
|
|
Incisn windpipe
|
$3,010.50 |
$3,010.50 |
$3,010.50 |
$3,810.50
|
|
Induced abortion d&c
|
$3,298.50 |
$3,298.50 |
$3,298.50 |
$3,762.53
|
|
Infect ag drug suscept pheno predict
|
$676.00 |
$676.00 |
$676.00 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$1,183.50 |
$1,183.50 |
$1,183.50 |
$661.80
|
|
Infect ag genotype na hiv-1 other region
|
$473.50 |
$473.50 |
$473.50 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,317.50 |
$1,317.50 |
$1,317.50 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$149.00 |
$149.00 |
$149.00 |
$72.93
|
|
Infect ag if hep delta agent
|
$248.50 |
$248.50 |
$248.50 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$160.00 |
$160.00 |
$160.00 |
$72.58
|
|
Infect ag na herpes simplex quant
|
$220.00 |
$220.00 |
$220.00 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$203.00 |
$203.00 |
$203.00 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$158.00 |
$158.00 |
$158.00 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$173.00 |
$173.00 |
$173.00 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$520.50 |
$520.50 |
$520.50 |
$835.80
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$39.00 |
$39.00 |
$39.00 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$262.50 |
$262.50 |
$262.50 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$129.50 |
$129.50 |
$129.50 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$36.00 |
$36.00 |
$36.00 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$83.50 |
$83.50 |
$83.50 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$421.50 |
$421.50 |
$421.50 |
$129.00
|
|
Infectious agent nucleic acid amplified probe
|
$1,156.00 |
$1,156.00 |
$1,156.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$203.00 |
$203.00 |
$203.00 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$204.50 |
$204.50 |
$204.50 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$662.50 |
$662.50 |
$662.50 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$235.00 |
$235.00 |
$235.00 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$71.50 |
$71.50 |
$71.50 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$403.00 |
$403.00 |
$403.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$203.00 |
$203.00 |
$203.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$34.00 |
$34.00 |
$34.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$306.50 |
$306.50 |
$306.50 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$126.00 |
$126.00 |
$126.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$203.00 |
$203.00 |
$203.00 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$553.00 |
$553.00 |
$553.00 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$517.50 |
$517.50 |
$517.50 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$785.00 |
$785.00 |
$785.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$308.00 |
$308.00 |
$308.00 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$302.50 |
$302.50 |
$302.50 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$646.00 |
$646.00 |
$646.00 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$581.50 |
$581.50 |
$581.50 |
$303.59
|
|
Infuse radioactive materials
|
$216.50 |
$216.50 |
$216.50 |
$640.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$324.00 |
$324.00 |
$324.00 |
$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
|
$1,267.00 |
$1,267.00 |
$1,267.00 |
$576.00
|
|
Init/sub psych care m 1st 30
|
$72.00 |
$72.00 |
$72.00 |
$94.34
|
|
Inj cntr knee arthro incl ct/mri
|
$304.00 |
$304.00 |
$304.00 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$505.50 |
$505.50 |
$505.50 |
$875.28
|
|
Inj dx for sinogram
|
$300.00 |
$300.00 |
$300.00 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$855.00 |
$855.00 |
$855.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$374.00 |
$374.00 |
$374.00 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$292.00 |
$292.00 |
$292.00 |
$450.72
|
|
Injection during cath supravalvular aortography
|
$1,269.00 |
$1,269.00 |
$1,269.00 |
$952.66
|
|
Injection epidural blood patch or clot
|
$709.00 |
$709.00 |
$709.00 |
$1,156.80
|
|
Injection eye drug
|
$312.50 |
$312.50 |
$312.50 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$236.00 |
$236.00 |
$236.00 |
$428.40
|
|
Injection for bladder x-ray
|
$101.50 |
$101.50 |
$101.50 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$492.00 |
$492.00 |
$492.00 |
$494.65
|
|
Injection for spleen x-ray
|
$595.50 |
$595.50 |
$595.50 |
$529.57
|
|
Injection for tear sac x-ray
|
$86.00 |
$86.00 |
$86.00 |
$225.20
|
|
Injection for ureter x-ray
|
$73.00 |
$73.00 |
$73.00 |
$427.70
|
|
Injection for ureter x-ray
|
$73.00 |
$73.00 |
$73.00 |
$515.21
|
|
Injection into brain canal
|
$919.00 |
$919.00 |
$919.00 |
$1,289.60
|
|
Injection into brain canal
|
$574.50 |
$574.50 |
$574.50 |
$836.40
|
|
Injection jaw joint x-ray
|
$282.00 |
$282.00 |
$282.00 |
$307.80
|
|
Injection jugular
|
$4,363.50 |
$4,363.50 |
$4,363.50 |
$790.00
|
|
Injection of sinus tract
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$1,627.60
|
|
Injection px peyronie ds
|
$226.00 |
$226.00 |
$226.00 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$302.50 |
$302.50 |
$302.50 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$510.00 |
$510.00 |
$510.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$510.00 |
$510.00 |
$510.00 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$864.00 |
$864.00 |
$864.00 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$404.00 |
$404.00 |
$404.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,138.50 |
$1,138.50 |
$1,138.50 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$404.00 |
$404.00 |
$404.00 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,138.50 |
$1,138.50 |
$1,138.50 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,293.00 |
$1,293.00 |
$1,293.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,293.00 |
$1,293.00 |
$1,293.00 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$276.50 |
$276.50 |
$276.50 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$276.50 |
$276.50 |
$276.50 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$319.00 |
$319.00 |
$319.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$56.50 |
$56.50 |
$56.50 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$64.00 |
$64.00 |
$64.00 |
$145.60
|
