|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
CPT 87340
|
$17.40
|
$116.00
|
$5.17 – $22.52
|
17 |
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
CPT 87341
|
$17.40
|
$116.00
|
$5.17 – $22.52
|
17 |
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
CPT 87389
|
$42.15
|
$281.00
|
$10.33 – $52.49
|
17 |
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
CPT 87449
|
$20.10
|
$134.00
|
$5.99 – $26.12
|
17 |
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
CPT 87425
|
$20.10
|
$134.00
|
$5.99 – $26.12
|
17 |
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
CPT 87427
|
$20.10
|
$134.00
|
$5.99 – $26.12
|
17 |
|
Infectious agent nucleic acid amplified probe
CPT 87798
|
$61.50
|
$410.00
|
$17.55 – $76.50
|
17 |
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
CPT 87491
|
$61.50
|
$410.00
|
$17.55 – $76.50
|
17 |
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
CPT 87493
|
$61.50
|
$410.00
|
$18.64 – $81.25
|
17 |
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
CPT 87483
|
$733.80
|
$4,892.00
|
$188.35 – $908.58
|
17 |
|
Infectious agent nucleic acid amplified probe hsv-1
CPT 87529
|
$61.50
|
$410.00
|
$17.55 – $76.50
|
17 |
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
CPT 87641
|
$61.50
|
$410.00
|
$17.55 – $76.50
|
17 |
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
CPT 87556
|
$61.50
|
$410.00
|
$20.84 – $90.86
|
17 |
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
CPT 87591
|
$61.50
|
$410.00
|
$17.55 – $76.50
|
17 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
CPT 87635
|
$15.00
|
$100.00
|
$25.66 – $111.86
|
17 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
CPT 87636
|
$47.10
|
$314.00
|
$60.91 – $310.93
|
17 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
CPT 87637
|
$61.50
|
$410.00
|
$60.91 – $310.93
|
17 |
|
Infectious agent nucleic acid amplified probe streptococcus group a
CPT 87651
|
$61.50
|
$410.00
|
$17.55 – $76.50
|
17 |
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
CPT 87661
|
$30.90
|
$206.00
|
$17.55 – $76.50
|
17 |
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
CPT 87564
|
$34.80
|
$232.00
|
$38.39 – $167.36
|
16 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
CPT 87507
|
$402.60
|
$2,684.00
|
$188.35 – $908.58
|
17 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
CPT 87505
|
$224.10
|
$1,494.00
|
$64.15 – $279.67
|
17 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
CPT 87506
|
$372.75
|
$2,485.00
|
$131.50 – $573.32
|
17 |
|
Infectious agent nucleic acid quantification bk virus
CPT 87799
|
$75.15
|
$501.00
|
$21.42 – $93.39
|
17 |
|
Infectious agent nucleic acid quantification hepatitis b
CPT 87517
|
$75.15
|
$501.00
|
$21.42 – $93.39
|
17 |
|
Infectious agent nucleic acid quantification hepatitis c
CPT 87522
|
$75.15
|
$501.00
|
$21.42 – $93.39
|
17 |
|
Infectious agent nucleic acid quantification hiv-1
CPT 87536
|
$148.95
|
$993.00
|
$42.55 – $185.52
|
17 |
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
CPT 87631
|
$124.20
|
$828.00
|
$71.32 – $310.93
|
17 |
|
Infliximab 100 mg intravenous solution
HCPCS J1745
|
$1,297.97
|
$8,653.11
|
$31.71 – $1,213.89
|
17 |
|
Infliximab-dyyb 100 mg intravenous solution
HCPCS Q5103
|
$1,052.69
|
$7,017.92
|
$10.66 – $1,213.89
|
17 |
|
Influenza dna amp prob addl
CPT 87503
|
$36.45
|
$243.00
|
$14.61 – $63.70
|
17 |
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
CPT 94642
|
$53.55
|
$357.00
|
$73.63 – $445.45
|
17 |
|
Initiation & management bipap/cpap initial day
CPT 94660
|
$234.75
|
$1,565.00
|
$56.16 – $445.45
|
17 |
|
Inj acetaminophen -fresenius
HCPCS J0134
|
$51.35
|
$342.36
|
$0.05 – $0.11
|
3 |
|
Inj., benralizumab, 1 mg
HCPCS J0517
|
$5,924.23
|
$39,494.85
|
$150.34 – $5,455.46
|
17 |
|
Inj calcitriol per 0.1 mcg
HCPCS J0636
|
$24.33
|
$162.21
|
$1.42 – $1.78
|
2 |
|
Inj, cefiderocol, 10 mg
HCPCS J0699
|
$287.35
|
$1,915.67
|
$1.81 – $152.34
|
17 |
|
Inj ceftolozane tazobactam
HCPCS J0695
|
$189.44
|
$1,262.93
|
$3.85 – $152.34
|
17 |
|
Inj cntr knee arthro incl ct/mri
CPT 27369
|
$169.05
|
$1,127.00
|
$438.84 – $456.39
|
5 |
|
Inj, daptomycin (baxter)
HCPCS J0874
|
$161.40
|
$1,076.00
|
$0.09 – $0.11
|
2 |
|
Inj dx for sinogram
CPT 20501
|
$202.65
|
$1,351.00
|
$438.84 – $456.39
|
5 |
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
CPT 64454
|
$312.90
|
$2,086.00
|
$508.69 – $1,435.94
|
17 |
|
Injection arthrography hip without anesthesia (both sides)
CPT 27093
|
$169.05
|
$1,127.00
|
$438.84 – $456.39
|
5 |
|
Injection, cangrelor
HCPCS C9460
|
$922.96
|
$6,153.07
|
$14.29 – $609.91
|
17 |
|
Injection carpal tunnel therapeutic (both sides)
CPT 20526
|
$165.90
|
$1,106.00
|
$56.91 – $624.42
|
17 |
|
Injection, daratumumab 10 mg
HCPCS J9145
|
$3,268.71
|
$21,791.41
|
$42.23 – $5,455.46
|
17 |
|
Injection, doxercalciferol
HCPCS J1270
|
$7.34
|
$48.91
|
$0.62 – $5.81
|
2 |
|
Injection during cath supravalvular aortography
CPT 93567
|
$67.35
|
$449.00
|
$126.86 – $456.39
|
5 |
|
Injection epidural blood patch or clot
CPT 62273
|
$352.95
|
$2,353.00
|
$172.83 – $1,435.94
|
17 |
|
Injection for arthrography wrist (both sides)
CPT 25246
|
$60.75
|
$405.00
|
$37.67 – $456.39
|
5 |
|
Injection for bladder x-ray
CPT 51600
|
$66.90
|
$446.00
|
$438.84 – $456.39
|
5 |
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
CPT 23350
|
$197.40
|
$1,316.00
|
$438.84 – $456.39
|
5 |
|
Injection for ureter x-ray
CPT 50690
|
$264.30
|
$1,762.00
|
$438.84 – $456.39
|
5 |
|
Injection, fulvestrant
HCPCS J9395
|
$1,293.80
|
$8,625.36
|
$8.73 – $148.42
|
6 |
|
Injection, glucarpidase
HCPCS C9293
|
$40,574.83
|
$270,498.89
|
$210.36 – $21,177.31
|
17 |
|
Injection, isavuconazonium
HCPCS J1833
|
$496.16
|
$3,307.75
|
$0.57 – $242.39
|
17 |
|
Injection,onabotulinumtoxina
HCPCS J0585
|
$1,403.87
|
$9,359.11
|
$4.84 – $609.91
|
17 |
|
Injection radioactive tracer sentinel node (both sides)
CPT 38792
|
$482.85
|
$3,219.00
|
$331.93 – $813.24
|
17 |
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
HCPCS G0260
|
$471.15
|
$3,141.00
|
$516.15 – $1,435.94
|
17 |
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
CPT 64450
|
$293.70
|
$1,958.00
|
$57.16 – $1,435.94
|
17 |
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
CPT 64483
|
$352.80
|
$2,352.00
|
$211.82 – $1,799.24
|
17 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
CPT 64491
|
$787.50
|
$5,250.00
|
$968.11 – $1,006.83
|
5 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
CPT 64490
|
$828.90
|
$5,526.00
|
$638.50 – $1,799.24
|
17 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
CPT 64494
|
$129.90
|
$866.00
|
$79.67 – $1,006.83
|
5 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
CPT 64493
|
$552.30
|
$3,682.00
|
$154.89 – $1,799.24
|
17 |
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
CPT 62321
|
$152.25
|
$1,015.00
|
$396.87 – $1,435.94
|
17 |
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
CPT 62323
|
$447.90
|
$2,986.00
|
$516.15 – $1,435.94
|
17 |
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
CPT 20550
|
$235.35
|
$1,569.00
|
$47.63 – $624.42
|
17 |
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
CPT 20552
|
$245.85
|
$1,639.00
|
$56.91 – $624.42
|
17 |
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
CPT 20553
|
$235.35
|
$1,569.00
|
$56.91 – $624.42
|
17 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
CPT 96375
|
$27.75
|
$185.00
|
$21.16 – $95.26
|
17 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
CPT 96376
|
$43.65
|
$291.00
|
$12.41 – $68.15
|
5 |
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
CPT 96374
|
$59.70
|
$398.00
|
$31.33 – $432.69
|
17 |
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
CPT 96372
|
$31.95
|
$213.00
|
$19.18 – $146.47
|
17 |
|
Inject sacroiliac joint
CPT 27096
|
$342.15
|
$2,281.00
|
$393.75 – $588.69
|
5 |
|
Inj epidural sgl cerv-thor without img
CPT 62320
|
$138.45
|
$923.00
|
$360.89 – $1,435.94
|
17 |
|
Inj for ext venography
CPT 36005
|
$552.45
|
$3,683.00
|
$852.69 – $886.80
|
5 |
|
Inj for mammo ductogram
CPT 19030
|
$242.10
|
$1,614.00
|
$438.84 – $456.39
|
5 |
|
Inj hrt cath w/s&i nonsel p-art angrp
CPT 93568
|
$1,818.15
|
$12,121.00
|
$134.44 – $456.39
|
5 |
|
Inj intralesional <= 7 lsn(s)
CPT 11900
|
$83.55
|
$557.00
|
$14.13 – $408.14
|
17 |
|
Inj ivig privigen 500 mg
HCPCS J1459
|
$13,007.99
|
$86,719.91
|
$30.96 – $1,577.79
|
17 |
|
Inj levocarnitine per 1 gm
HCPCS J1955
|
$87.23
|
$581.53
|
$36.29 – $41.55
|
2 |
|
Inj, lidocaine w epinephrine
HCPCS J2004
|
$18.05
|
$120.32
|
$7.62 – $7.62
|
1 |
|
Inj mepivacaine hcl/10 ml
HCPCS J0670
|
$18.19
|
$121.29
|
$2.17 – $6.95
|
2 |
|
Inj., meropenem, vaborbactam
HCPCS J2186
|
$296.63
|
$1,977.52
|
$1.49 – $152.34
|
17 |
|
Inj nephrosto/ureterogram w/img exstng access
CPT 50431
|
$702.45
|
$4,683.00
|
$507.61 – $1,418.48
|
17 |
|
Inj peritoneal venous shunt
CPT 49427
|
$54.90
|
$366.00
|
$366.00 – $456.39
|
5 |
|
Inj proc elbow arthro
CPT 24220
|
$61.65
|
$411.00
|
$411.00 – $456.39
|
5 |
|
Inj proc for lymphang
CPT 38790
|
$661.50
|
$4,410.00
|
$438.84 – $456.39
|
5 |
|
Inj proc myelogram lumbar
CPT 62284
|
$368.55
|
$2,457.00
|
$438.84 – $456.39
|
5 |
|
Inj, releuko 1 mcg
HCPCS Q5125
|
$366.91
|
$2,446.06
|
$0.34 – $152.34
|
17 |
|
Inj retro urethrocysto
CPT 51610
|
$66.90
|
$446.00
|
$438.84 – $456.39
|
5 |
|
Inj scleros sol sgl vein
CPT 36470
|
$267.00
|
$1,780.00
|
$295.23 – $826.95
|
17 |
|
Inj sulf hexa lipid microsph
HCPCS Q9950
|
$86.15
|
$574.35
|
$0.24 – $29.75
|
2 |
|
Inj testosterone cypionate
HCPCS J1071
|
$51.35
|
$342.36
|
$0.05 – $0.05
|
1 |
|
Inj w/fluor eval cv device
CPT 36598
|
$241.50
|
$1,610.00
|
$181.52 – $438.84
|
17 |
|
Ins cath ren art 1st bi
CPT 36252
|
$1,818.15
|
$12,121.00
|
$2,367.84 – $6,423.11
|
17 |
|
Ins cath ren art 1st uni
CPT 36251
|
$1,559.10
|
$10,394.00
|
$2,367.84 – $6,423.11
|
17 |
|
Ins cath ren art 2nd+ uni
CPT 36253
|
$1,594.50
|
$10,630.00
|
$4,051.26 – $11,319.56
|
17 |
|
Ins cerv dilator (sep proc)
CPT 59200
|
$311.70
|
$2,078.00
|
$254.90 – $750.23
|
17 |