|
Icatibant injection
|
$2,572.33 |
$2,572.33 |
$2,572.33 |
$8,695.05
|
|
Idarubicin hcl injection
|
$89.30 |
$89.30 |
$89.30 |
$447.02
|
|
Ifosfamide 1 gram intravenous solution
|
$61.89 |
$61.89 |
$61.89 |
$243.78
|
|
Igh gene rearrang dir probe
|
$53.36 |
$53.36 |
$53.36 |
$82.26
|
|
Ihc/icc per specimen each additional single antibody stain
|
$32.20 |
$32.20 |
$32.20 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$115.23 |
$115.23 |
$115.23 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$115.23 |
$115.23 |
$115.23 |
$274.86
|
|
Iliac revasc add-on 37222
|
$3,621.81 |
$3,621.81 |
$3,621.81 |
$6,082.65
|
|
Immobilizer shldr sling med
|
$9.89 |
$9.89 |
$9.89 |
$99.45
|
|
Immune complex assay
|
$167.90 |
$167.90 |
$167.90 |
$109.20
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$562.90 |
$562.90 |
$562.90 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$60.95 |
$60.95 |
$60.95 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$57.96 |
$57.96 |
$57.96 |
$116.40
|
|
Immunofixation electrophoresis serum
|
$54.28 |
$54.28 |
$54.28 |
$138.60
|
|
Immunofluorescence per specimen initial single antibody stain
|
$115.23 |
$115.23 |
$115.23 |
$232.05
|
|
Impedence cardiogram
|
$37.95 |
$37.95 |
$37.95 |
$152.54
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,309.34 |
$1,309.34 |
$1,309.34 |
$2,568.98
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$384.56 |
$384.56 |
$384.56 |
$2,080.80
|
|
Incision of breast lesion
|
$1,015.91 |
$1,015.91 |
$1,015.91 |
$2,577.85
|
|
Incision of burn scab initi
|
$227.70 |
$227.70 |
$227.70 |
$494.40
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$48.53 |
$48.53 |
$48.53 |
$131.20
|
|
Infect ag genotype na dna hepatitis b
|
$199.64 |
$199.64 |
$199.64 |
$427.43
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$542.80 |
$542.80 |
$542.80 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$37.26 |
$37.26 |
$37.26 |
$72.93
|
|
Infect ag if varicella zoster
|
$25.07 |
$25.07 |
$25.07 |
$72.00
|
|
Infect ag na herpes simplex quant
|
$166.98 |
$166.98 |
$166.98 |
$169.65
|
|
Infect ag na orthopoxvirus amp prb each
|
$27.14 |
$27.14 |
$27.14 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$269.56 |
$269.56 |
$269.56 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$364.78 |
$364.78 |
$364.78 |
$855.60
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$19.32 |
$19.32 |
$19.32 |
$77.00
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$34.04 |
$34.04 |
$34.04 |
$51.31
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$44.39 |
$44.39 |
$44.39 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$13.11 |
$13.11 |
$13.11 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$130.87 |
$130.87 |
$130.87 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$125.12 |
$125.12 |
$125.12 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$23.92 |
$23.92 |
$23.92 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$107.41 |
$107.41 |
$107.41 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$58.42 |
$58.42 |
$58.42 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$16.79 |
$16.79 |
$16.79 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$204.24 |
$204.24 |
$204.24 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$47.61 |
$47.61 |
$47.61 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$100.74 |
$100.74 |
$100.74 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$404.57 |
$404.57 |
$404.57 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$37.72 |
$37.72 |
$37.72 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$36.34 |
$36.34 |
$36.34 |
$151.25
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$47.61 |
$47.61 |
$47.61 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$42.78 |
$42.78 |
$42.78 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$115.23 |
$115.23 |
$115.23 |
$217.70
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$115.23 |
$115.23 |
$115.23 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$22.54 |
$22.54 |
$22.54 |
$94.53
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$52.90 |
$52.90 |
$52.90 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$357.19 |
$357.19 |
$357.19 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$98.90 |
$98.90 |
$98.90 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$204.24 |
$204.24 |
$204.24 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$242.88 |
$242.88 |
$242.88 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$125.58 |
$125.58 |
$125.58 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$195.27 |
$195.27 |
$195.27 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$204.24 |
$204.24 |
$204.24 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$106.49 |
$106.49 |
$106.49 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$303.05 |
$303.05 |
$303.05 |
$2,080.86
|
|
Initiation & management bipap/cpap initial day
|
$137.08 |
$137.08 |
$137.08 |
$576.00
|
|
Inj, acetaminophen (b braun)
|
$9.75 |
$9.75 |
$9.75 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$9.66 |
$9.66 |
$9.66 |
$38.87
|
|
Inj, acetaminophen (hikma)
|
$7.24 |
$7.24 |
$7.24 |
$68.30
|
|
Inj allopurinol sodium 1 mg
|
$1,516.01 |
$1,516.01 |
$1,516.01 |
$6,968.99
|
|
Inj, bortezomib freseniuskab
|
$818.75 |
$818.75 |
$818.75 |
$2,464.14
|
|
Inj, bortezomib, hospira
|
$31.85 |
$31.85 |
$31.85 |
$175.35
|
|
Inj calcitriol per 0.1 mcg
|
$10.44 |
$10.44 |
$10.44 |
$22.69
|
|
Inj cefazolin sodium, baxter
|
$20.01 |
$20.01 |
$20.01 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$8.38 |
$8.38 |
$8.38 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$6.21 |
$6.21 |
$6.21 |
$18.30
|
|
Inj. cefepime hcl (baxter)
|
$91.77 |
$91.77 |
$91.77 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$47.63 |
$47.63 |
$47.63 |
$69.85
|
|
Inj, clindamycin (baxter)
|
$10.52 |
$10.52 |
$10.52 |
$48.39
|
|
Inj cyclophos dr.reddy's 5mg
|
$2,415.00 |
$2,415.00 |
$2,415.00 |
$4,725.00
|
|
Inj cyclophosphamd auromedic
|
$160.85 |
$160.85 |
$160.85 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$935.14 |
$935.14 |
$935.14 |
$742.72
|
|
Inj, daptomycin (hospira)
|
$56.65 |
$56.65 |
$56.65 |
$110.83
|
|
Inj daptomycin (xellia)
|
$20.75 |
$20.75 |
$20.75 |
$56.04
|
|
Inj, decitabine (sun pharma)
|
$63.83 |
$63.83 |
$63.83 |
$295.94
|
|
Inj dx for sinogram
|
$62.56 |
$62.56 |
$62.56 |
$413.82
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$269.79 |
$269.79 |
$269.79 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$109.02 |
$109.02 |
$109.02 |
$500.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$115.69 |
$115.69 |
$115.69 |
$504.90
|
|
Injection, doxercalciferol
|
$6.38 |
$6.38 |
$6.38 |
$23.12
|
|
Injection during cath supravalvular aortography
|
$54.74 |
$54.74 |
$54.74 |
$904.17
|
|
Injection, edaravone, 1 mg
|
$229.77 |
$229.77 |
$229.77 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$420.90 |
$420.90 |
$420.90 |
$1,156.80
|
|
Injection eye drug
|
$107.64 |
$107.64 |
$107.64 |
$644.50
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$105.34 |
$105.34 |
$105.34 |
$494.65
|
|
Injection, fulvestrant
|
$1,103.81 |
$1,103.81 |
$1,103.81 |
$1,719.16
|
|
Injection glatiramer acetate
|
$103.73 |
$103.73 |
$103.73 |
$830.51
|
|
Injection radioactive tracer sentinel node (both sides)
|
$184.00 |
$184.00 |
$184.00 |
$683.28
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$648.14 |
$648.14 |
$648.14 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$205.62 |
$205.62 |
$205.62 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$485.07 |
$485.07 |
$485.07 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$407.56 |
$407.56 |
$407.56 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$299.00 |
$299.00 |
$299.00 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$598.00 |
$598.00 |
$598.00 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$391.92 |
$391.92 |
$391.92 |
$1,842.00
|