|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$100.20 |
$203.00 |
$425.00 |
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$136.80 |
$167.00 |
$211.00 |
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$484.00 |
$722.00 |
$1,539.85 |
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$165.60 |
$248.50 |
$1,288.50 |
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$52.00 |
$71.50 |
$422.40 |
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$294.00 |
$392.00 |
$826.00 |
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$49.80 |
$203.00 |
$425.00 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$25.00 |
$66.00 |
$191.50 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$427.80 |
$427.80 |
$427.80 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$148.80 |
$306.50 |
$346.00 |
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$83.00 |
$111.00 |
$190.00 |
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$32.00 |
$148.00 |
$295.50 |
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$74.00 |
$403.00 |
$815.00 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$378.00 |
$757.00 |
$2,200.00 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$384.60 |
$384.60 |
$384.60 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$789.00 |
$789.00 |
$789.00 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$460.20 |
$779.00 |
$982.00 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$225.00 |
$308.00 |
$1,229.00 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$220.50 |
$369.00 |
$1,401.50 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$340.80 |
$646.00 |
$1,781.00 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$424.50 |
$576.50 |
$581.50 |
|
|
Infliximab 100 mg intravenous solution
|
$4,904.84 |
$5,605.54 |
$9,682.00 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$2,100.00 |
$2,100.00 |
$2,400.00 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$3,974.38 |
$3,974.38 |
$4,542.14 |
|
|
Infuse radioactive materials
|
$167.50 |
$216.50 |
$216.50 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$234.50 |
$324.00 |
$822.00 |
|
|
Init bk ptb plaster direct
|
$2,694.50 |
$2,694.50 |
$2,694.50 |
|
|
Initial nursing facility care/day 35 minutes
|
$82.14 |
$82.14 |
$82.14 |
|
|
Init/sub psych care m 1st 30
|
$52.00 |
$72.00 |
$72.00 |
|
|
Inj, adstiladrin, per tx dos
|
$63,945.00 |
$63,945.00 |
$73,080.00 |
|
|
Inj allopurinol sodium 1 mg
|
$7,616.00 |
$7,616.00 |
$7,616.00 |
|
|
Inj, artesunate, 1mg
|
$26,893.00 |
$26,893.00 |
$26,893.00 |
|
|
Inj, aspara, rylaze, 0.1 mg
|
$26,443.80 |
$26,443.80 |
$30,267.00 |
|
|
Inj, bortezomib, hospira
|
$0.01 |
$0.01 |
$0.01 |
|
|
Inj cefazolin sodium, hikma
|
$72.92 |
$72.92 |
$81.61 |
|
|
Inj cefazolin (wg crit care)
|
$91.41 |
$91.41 |
$102.30 |
|
|
Inj ceftolozane tazobactam
|
$556.00 |
$556.00 |
$1,621.55 |
|
|
Inj, clindamycin (baxter)
|
$108.45 |
$108.45 |
$121.37 |
|
|
Inj cntr knee arthro incl ct/mri
|
$220.00 |
$304.00 |
$467.50 |
|
|
Inj crotalidae im f(ab')2 eq
|
$3,667.00 |
$3,667.00 |
$3,667.00 |
|
|
Inj, cyclophos (baxter) 5mg
|
$2,914.72 |
$2,914.72 |
$3,336.12 |
|
|
Inj disk cerv-thor ea lev
|
$305.00 |
$365.00 |
$505.50 |
|
|
Inj dx for sinogram
|
$217.00 |
$431.50 |
$5,074.00 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$618.50 |
$855.00 |
$1,662.00 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$158.00 |
$358.50 |
$526.50 |
|
|
Injection, belinostat, 10mg
|
$12,600.80 |
$12,600.80 |
$14,422.60 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$211.00 |
$292.00 |
$12,958.33 |
|
|
Injection, doxercalciferol
|
$45.00 |
$45.00 |
$45.00 |
|
|
Injection during cath supravalvular aortography
|
$497.00 |
$1,269.00 |
$3,592.50 |
|
|
Injection epidural blood patch or clot
|
$512.50 |
$891.00 |
$1,813.00 |
|
|
Injection eye drug
|
$211.00 |
$312.50 |
$9,807.23 |
|
|
Injection for arthrography wrist (both sides)
|
$142.00 |
$236.00 |
$644.50 |
|
|
Injection for bladder x-ray
|
$61.00 |
$324.00 |
$13,061.36 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$200.50 |
$390.50 |
$808.00 |
|
|
Injection for spleen x-ray
|
$359.00 |
$595.50 |
$595.50 |
|
|
Injection for tear sac x-ray
|
$52.00 |
$86.00 |
$86.00 |
|
|
Injection for ureter x-ray
|
$43.50 |
$73.00 |
$73.00 |
|
|
Injection for ureter x-ray
|
$43.50 |
$73.00 |
$708.00 |
|
|
Injection, fulvestrant
|
$4,828.24 |
$5,526.29 |
$16,063.00 |
|
|
Injection, glucarpidase
|
$359,266.23 |
$359,266.23 |
$402,066.90 |
|
|
Injection into brain canal
|
$664.50 |
$919.00 |
$919.00 |
|
|
Injection into brain canal
|
$415.50 |
$574.50 |
$1,128.00 |
|
|
Injection, isavuconazonium
|
$1,785.00 |
$1,785.00 |
$1,785.00 |
|
|
Injection jaw joint x-ray
|
$170.00 |
$282.00 |
$282.00 |
|
|
Injection jugular
|
$329.50 |
$3,534.50 |
$4,363.50 |
|
|
Injection of sinus tract
|
$199.50 |
$902.50 |
$1,248.00 |
|
|
Injection,onabotulinumtoxina
|
$2,734.20 |
$2,734.20 |
$3,124.80 |
|
|
Injection, peramivir
|
$1,862.38 |
$1,862.38 |
$1,862.38 |
|
|
Injection px peyronie ds
|
$226.00 |
$226.00 |
$226.00 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$182.00 |
$507.50 |
$29,128.58 |
|
|
Injection, renflexis
|
$3,075.00 |
$3,075.00 |
$3,616.27 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$369.00 |
$512.50 |
$1,459.20 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$369.00 |
$604.00 |
$1,296.00 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$625.00 |
$1,466.50 |
$6,789.49 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$292.00 |
$404.00 |
$1,142.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$823.50 |
$1,138.50 |
$2,250.50 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$292.00 |
$404.00 |
$1,108.80 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$823.50 |
$1,138.50 |
$2,250.50 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$935.00 |
$1,293.00 |
$6,900.00 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$935.00 |
$1,293.00 |
$6,900.00 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$200.00 |
$276.50 |
$91,005.71 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$200.00 |
$276.50 |
$556.80 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$231.00 |
$319.00 |
$672.60 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$52.00 |
$114.50 |
$208.50 |
|
|
Injection treatment of eye
|
$821.50 |
$1,217.50 |
$1,217.50 |
|
|
Injection treatment of eye
|
$834.00 |
$1,235.50 |
$1,235.50 |
|
|
Injection treatment of nerve
|
$753.50 |
$1,041.50 |
$1,041.50 |
|
|
Inject sacroiliac joint
|
$132.00 |
$219.00 |
$1,883.50 |
|
|
Inject/treat eye socket
|
$153.00 |
$227.00 |
$227.00 |
|
|
Inject/treat eye socket
|
$487.00 |
$721.00 |
$721.00 |
|
|
Inj, eculizumab-aagh, 2 mg
|
$22,600.00 |
$22,600.00 |
$22,600.00 |
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$105,495.20 |
$105,495.20 |
$118,063.22 |
|
|
Inj epidural sgl lumb-sacral without img
|
$935.00 |
$1,293.00 |
$2,014.50 |
|
|
Inj for ext venography
|
$177.50 |
$219.00 |
$1,150.50 |
|
|
Inj for mammo ductogram
|
$241.00 |
$358.00 |
$1,197.60 |
|
|
Inj herzuma 10 mg
|
$15,209.42 |
$15,209.42 |
$17,408.37 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$622.50 |
$2,555.50 |
$3,576.00 |
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,101.00 |
$1,359.50 |
$1,359.50 |
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,255.50 |
$1,550.00 |
$1,550.00 |
|
|
Inj hrt cath w/s&i sel left vent
|
$42.00 |
$875.50 |
$3,686.00 |
|
