|
Infect ag phenotype na hiv-1 ea addl drg
CPT 87904
|
$19.32
|
$84.00
|
$22.68 – $52.14
|
60 |
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
CPT 87811
|
$34.04
|
$148.00
|
$33.62 – $82.76
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
CPT 87324
|
$44.39
|
$193.00
|
$10.42 – $23.96
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step giardia
CPT 87329
|
$13.11
|
$57.00
|
$10.42 – $23.96
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
CPT 87338
|
$130.87
|
$569.00
|
$12.51 – $28.76
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
CPT 87340
|
$125.12
|
$544.00
|
$8.99 – $20.66
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
CPT 87389
|
$23.92
|
$104.00
|
$20.95 – $48.16
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
CPT 87449
|
$107.41
|
$467.00
|
$10.42 – $23.96
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
CPT 87425
|
$58.42
|
$254.00
|
$10.42 – $23.96
|
60 |
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
CPT 87427
|
$16.79
|
$73.00
|
$10.42 – $23.96
|
60 |
|
Infectious agent nucleic acid amplified probe
CPT 87798
|
$204.24
|
$888.00
|
$30.53 – $70.18
|
60 |
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
CPT 87491
|
$47.61
|
$207.00
|
$30.53 – $70.18
|
60 |
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
CPT 87493
|
$100.74
|
$438.00
|
$32.42 – $74.54
|
60 |
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
CPT 87483
|
$404.57
|
$1,759.00
|
$362.60 – $833.56
|
60 |
|
Infectious agent nucleic acid amplified probe hsv-1
CPT 87529
|
$37.72
|
$164.00
|
$30.53 – $70.18
|
60 |
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
CPT 87641
|
$36.34
|
$158.00
|
$30.53 – $70.18
|
60 |
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
CPT 87591
|
$47.61
|
$207.00
|
$30.53 – $70.18
|
60 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
CPT 87635
|
$42.78
|
$186.00
|
$41.68 – $102.62
|
60 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
CPT 87636
|
$115.23
|
$501.00
|
$115.88 – $285.26
|
60 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
CPT 87637
|
$115.23
|
$501.00
|
$115.88 – $285.26
|
60 |
|
Infectious agent nucleic acid amplified probe streptococcus group a
CPT 87651
|
$22.54
|
$98.00
|
$30.53 – $70.18
|
60 |
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
CPT 87564
|
$52.90
|
$230.00
|
$66.79 – $153.54
|
60 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
CPT 87507
|
$357.19
|
$1,553.00
|
$362.60 – $833.56
|
60 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
CPT 87505
|
$98.90
|
$430.00
|
$111.61 – $256.58
|
60 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
CPT 87506
|
$204.24
|
$888.00
|
$228.80 – $525.98
|
60 |
|
Infectious agent nucleic acid quantification bk virus
CPT 87799
|
$242.88
|
$1,056.00
|
$37.27 – $85.68
|
60 |
|
Infectious agent nucleic acid quantification hepatitis b
CPT 87517
|
$125.58
|
$546.00
|
$37.27 – $85.68
|
60 |
|
Infectious agent nucleic acid quantification hepatitis c
CPT 87522
|
$195.27
|
$849.00
|
$37.27 – $85.68
|
60 |
|
Infectious agent nucleic acid quantification hiv-1
CPT 87536
|
$204.24
|
$888.00
|
$74.04 – $170.20
|
60 |
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
CPT 87631
|
$106.49
|
$463.00
|
$124.09 – $285.26
|
60 |
|
Infliximab 100 mg intravenous solution
HCPCS J1745
|
$303.05
|
$1,317.60
|
$26.56 – $61.06
|
60 |
|
Initiation & management bipap/cpap initial day
CPT 94660
|
$137.08
|
$596.00
|
$48.41 – $371.44
|
60 |
|
Inj, acetaminophen (b braun)
HCPCS J0136
|
$9.75
|
$42.38
|
$0.05 – $0.12
|
4 |
|
Inj acetaminophen -fresenius
HCPCS J0134
|
$9.66
|
$42.00
|
$0.04 – $0.12
|
4 |
|
Inj, acetaminophen (hikma)
HCPCS J0137
|
$7.24
|
$31.50
|
$0.03 – $0.14
|
4 |
|
Inj allopurinol sodium 1 mg
HCPCS J0206
|
$1,516.01
|
$6,591.33
|
$3.83 – $8.80
|
60 |
|
Inj, bortezomib freseniuskab
HCPCS J9048
|
$818.75
|
$3,559.80
|
$14.36 – $33.00
|
60 |
|
Inj, bortezomib, hospira
HCPCS J9049
|
$31.85
|
$138.48
|
$1.49 – $9.98
|
4 |
|
Inj calcitriol per 0.1 mcg
HCPCS J0636
|
$10.44
|
$45.41
|
$0.99 – $1.22
|
3 |
|
Inj cefazolin sodium, baxter
HCPCS J0689
|
$20.01
|
$87.00
|
$1.26 – $3.04
|
4 |
|
Inj cefazolin sodium, hikma
HCPCS J0688
|
$8.38
|
$36.43
|
$0.87 – $2.00
|
60 |
|
Inj cefazolin (wg crit care)
HCPCS J0687
|
$6.21
|
$26.99
|
$0.97 – $2.22
|
60 |
|
Inj. cefepime hcl (baxter)
HCPCS J0701
|
$91.77
|
$399.00
|
$5.83 – $14.84
|
4 |
|
Inj, cefepime hcl (b braun)
HCPCS J0703
|
$47.63
|
$207.11
|
$4.97 – $10.64
|
4 |
|
Inj, clindamycin (baxter)
HCPCS J0737
|
$10.52
|
$45.75
|
$2.12 – $5.35
|
4 |
|
Inj cyclophos dr.reddy's 5mg
HCPCS J9072
|
$2,415.00
|
$10,500.00
|
$3.64 – $11.46
|
3 |
|
Inj cyclophosphamd auromedic
HCPCS J9071
|
$160.85
|
$699.33
|
$0.61 – $1.40
|
60 |
|
Inj cyclophosphamd (ingenus)
HCPCS J9073
|
$935.14
|
$4,065.81
|
$1.91 – $4.38
|
60 |
|
Inj, daptomycin (hospira)
HCPCS J0877
|
$56.65
|
$246.30
|
$0.06 – $0.18
|
4 |
|
Inj daptomycin (xellia)
HCPCS J0873
|
$20.75
|
$90.22
|
$0.03 – $0.08
|
60 |
|
Inj, decitabine (sun pharma)
HCPCS J0893
|
$63.83
|
$277.53
|
$0.95 – $2.46
|
4 |
|
Inj dx for sinogram
CPT 20501
|
$62.56
|
$272.00
|
$33.50 – $98.00
|
2 |
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
CPT 64454
|
$269.79
|
$1,173.00
|
$550.14 – $1,264.70
|
59 |
|
Injection arthrography hip without anesthesia (both sides)
CPT 27093
|
$109.02
|
$474.00
|
$61.58 – $98.00
|
2 |
|
Injection carpal tunnel therapeutic (both sides)
CPT 20526
|
$115.69
|
$503.00
|
$234.50 – $539.08
|
59 |
|
Injection, doxercalciferol
HCPCS J1270
|
$6.38
|
$27.75
|
$0.38 – $6.38
|
4 |
|
Injection during cath supravalvular aortography
CPT 93567
|
$54.74
|
$238.00
|
$51.88 – $98.00
|
2 |
|
Injection, edaravone, 1 mg
HCPCS J1301
|
$229.77
|
$999.00
|
$18.86 – $43.36
|
60 |
|
Injection epidural blood patch or clot
CPT 62273
|
$420.90
|
$1,830.00
|
$550.14 – $1,264.70
|
59 |
|
Injection eye drug
CPT 67028
|
$107.64
|
$468.00
|
$263.50 – $605.74
|
59 |
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
CPT 23350
|
$105.34
|
$458.00
|
$45.08 – $98.00
|
2 |
|
Injection, fulvestrant
HCPCS J9395
|
$1,103.81
|
$4,799.16
|
$5.79 – $13.32
|
60 |
|
Injection glatiramer acetate
HCPCS J1595
|
$103.73
|
$450.99
|
$61.52 – $343.14
|
60 |
|
Injection radioactive tracer sentinel node (both sides)
CPT 38792
|
$184.00
|
$800.00
|
$319.22 – $733.84
|
59 |
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
CPT 64447
|
$648.14
|
$2,818.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
CPT 64450
|
$205.62
|
$894.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
CPT 64483
|
$485.07
|
$2,109.00
|
$707.26 – $1,625.88
|
59 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
CPT 64490
|
$407.56
|
$1,772.00
|
$707.26 – $1,625.88
|
59 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
CPT 64494
|
$299.00
|
$1,300.00
|
$49.86 – $98.00
|
2 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
CPT 64493
|
$598.00
|
$2,600.00
|
$707.26 – $1,625.88
|
59 |
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
CPT 62321
|
$391.92
|
$1,704.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
CPT 62323
|
$434.93
|
$1,891.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
CPT 20550
|
$162.84
|
$708.00
|
$234.50 – $539.08
|
59 |
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
CPT 20552
|
$175.03
|
$761.00
|
$234.50 – $539.08
|
59 |
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
CPT 20553
|
$186.53
|
$811.00
|
$234.50 – $539.08
|
59 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
CPT 96375
|
$89.01
|
$387.00
|
$18.44 – $84.26
|
60 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
CPT 96376
|
$89.01
|
$387.00
|
$10.30 – $10.70
|
2 |
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
CPT 96374
|
$89.01
|
$387.00
|
$42.46 – $384.78
|
60 |
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
CPT 96372
|
$33.12
|
$144.00
|
$16.71 – $129.98
|
60 |
|
Inject sacroiliac joint
CPT 27096
|
$342.93
|
$1,491.00
|
$74.50 – $1,854.00
|
2 |
|
Inj epidural sgl cerv-thor without img
CPT 62320
|
$191.36
|
$832.00
|
$550.14 – $1,264.70
|
60 |
|
Inj epidural sgl lumb-sacral without img
CPT 62322
|
$215.05
|
$935.00
|
$707.26 – $1,625.88
|
59 |
|
Inj, epinephrine (belcher)
HCPCS J0173
|
$1,401.99
|
$6,095.62
|
$1.35 – $2.85
|
4 |
|
Inj for ext venography
CPT 36005
|
$221.72
|
$964.00
|
$49.57 – $98.00
|
2 |
|
Inj, fosaprepitant (teva)
HCPCS J1456
|
$45.56
|
$198.09
|
$0.38 – $1.54
|
60 |
|
Inj, fulvestrant (fresenius)
HCPCS J9394
|
$585.13
|
$2,544.02
|
$4.20 – $24.52
|
60 |
|
Inj gemcitabine hcl (accord)
HCPCS J9196
|
$66.78
|
$290.34
|
$8.52 – $13.64
|
4 |
|
Inj glycopyrrolate fres kabi
HCPCS J1598
|
$14.01
|
$60.91
|
$1.76 – $4.04
|
60 |
|
Inj heparin, pfizer, 1000u
HCPCS J1643
|
$9.94
|
$43.20
|
$3.72 – $5.54
|
4 |
|
Inj, idacio, 1 mg
HCPCS Q5144
|
$573.85
|
$2,494.98
|
$13.07 – $30.04
|
60 |
|
Inj intralesional <= 7 lsn(s)
CPT 11900
|
$128.11
|
$557.00
|
$157.85 – $362.88
|
59 |
|
Inj labetalol hcl hikma, 5mg
HCPCS J1921
|
$5.03
|
$21.86
|
$1.63 – $3.69
|
4 |
|
Inj, lanreotide, (cipla) 1mg
HCPCS J1932
|
$3,893.75
|
$16,929.33
|
$26.69 – $61.36
|
60 |
|
Inj levoleucovorin nos 0.5mg
HCPCS J0641
|
$109.92
|
$477.90
|
$0.02 – $0.42
|
4 |
|
Inj, linezolid (hospira)
HCPCS J2021
|
$103.50
|
$450.00
|
$8.02 – $28.62
|
4 |
|
Inj melpha hydroch nos 50 mg
HCPCS J9245
|
$660.73
|
$2,872.73
|
$116.31 – $267.38
|
60 |
|
Inj, meropenem (b. braun)
HCPCS J2184
|
$47.73
|
$207.52
|
$2.10 – $5.04
|
4 |
|
Inj meropenem (wg crit care)
HCPCS J2183
|
$49.88
|
$216.88
|
$1.44 – $3.30
|
60 |
|
Inj, micafungin (par pharm)
HCPCS J2247
|
$62.29
|
$270.85
|
$0.35 – $1.85
|
4 |
|
Inj, moxifloxacin 100 mg
HCPCS J2280
|
$70.29
|
$305.63
|
$8.73 – $11.41
|
3 |