|
Infect ag na orthopoxvirus amp prb each
CPT 87593
|
$22.60
|
$113.00
|
$44.64 – $102.62
|
60 |
|
Infect ag na resp virus 12-25 targets
CPT 87633
|
$225.40
|
$1,127.00
|
$362.60 – $833.56
|
61 |
|
Infect ag phenotype na hiv-1 1-10 drugs
CPT 87903
|
$317.20
|
$1,586.00
|
$425.13 – $977.32
|
61 |
|
Infect ag phenotype na hiv-1 ea addl drg
CPT 87904
|
$16.80
|
$84.00
|
$22.68 – $52.14
|
61 |
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
CPT 87811
|
$28.40
|
$142.00
|
$36.00 – $82.76
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
CPT 87324
|
$74.60
|
$373.00
|
$10.42 – $23.96
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step giardia
CPT 87329
|
$11.00
|
$55.00
|
$10.42 – $23.96
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
CPT 87338
|
$109.40
|
$547.00
|
$12.51 – $28.76
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
CPT 87340
|
$40.00
|
$200.00
|
$8.99 – $20.66
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
CPT 87389
|
$20.00
|
$100.00
|
$20.95 – $48.16
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
CPT 87449
|
$95.00
|
$475.00
|
$10.42 – $23.96
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
CPT 87425
|
$62.00
|
$310.00
|
$10.42 – $23.96
|
61 |
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
CPT 87427
|
$38.80
|
$194.00
|
$10.42 – $23.96
|
61 |
|
Infectious agent nucleic acid amplified probe
CPT 87798
|
$270.80
|
$1,354.00
|
$30.53 – $70.18
|
61 |
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
CPT 87491
|
$31.20
|
$156.00
|
$30.53 – $70.18
|
61 |
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
CPT 87493
|
$84.20
|
$421.00
|
$32.42 – $74.54
|
61 |
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
CPT 87483
|
$338.20
|
$1,691.00
|
$362.60 – $833.56
|
61 |
|
Infectious agent nucleic acid amplified probe hsv-1
CPT 87529
|
$36.00
|
$180.00
|
$30.53 – $70.18
|
61 |
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
CPT 87641
|
$30.40
|
$152.00
|
$30.53 – $70.18
|
61 |
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
CPT 87556
|
$346.80
|
$1,734.00
|
$36.26 – $83.36
|
61 |
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
CPT 87591
|
$31.20
|
$156.00
|
$30.53 – $70.18
|
61 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
CPT 87635
|
$35.80
|
$179.00
|
$44.64 – $102.62
|
61 |
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
CPT 87637
|
$96.40
|
$482.00
|
$124.09 – $285.26
|
61 |
|
Infectious agent nucleic acid amplified probe streptococcus group a
CPT 87651
|
$18.80
|
$94.00
|
$30.53 – $70.18
|
61 |
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
CPT 87661
|
$29.20
|
$146.00
|
$30.53 – $70.18
|
61 |
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
CPT 87564
|
$46.00
|
$230.00
|
$66.79 – $153.54
|
60 |
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
CPT 87507
|
$298.60
|
$1,493.00
|
$362.60 – $833.56
|
61 |
|
Infectious agent nucleic acid quantification bk virus
CPT 87799
|
$210.80
|
$1,054.00
|
$37.27 – $85.68
|
61 |
|
Infectious agent nucleic acid quantification hepatitis b
CPT 87517
|
$383.00
|
$1,915.00
|
$37.27 – $85.68
|
61 |
|
Infectious agent nucleic acid quantification hepatitis c
CPT 87522
|
$190.40
|
$952.00
|
$37.27 – $85.68
|
61 |
|
Infectious agent nucleic acid quantification hiv-1
CPT 87536
|
$145.20
|
$726.00
|
$74.04 – $170.20
|
61 |
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
CPT 87631
|
$92.60
|
$463.00
|
$124.09 – $285.26
|
61 |
|
Infliximab 100 mg intravenous solution
HCPCS J1745
|
$263.52
|
$1,317.60
|
$26.56 – $61.06
|
61 |
|
Influenza dna amp prob addl
CPT 87503
|
$17.40
|
$87.00
|
$25.42 – $58.44
|
61 |
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
CPT 94642
|
$61.80
|
$309.00
|
$161.58 – $371.44
|
60 |
|
Initiation & management bipap/cpap initial day
CPT 94660
|
$116.60
|
$583.00
|
$161.58 – $371.44
|
60 |
|
Inj, acetaminophen (b braun)
HCPCS J0136
|
$8.47
|
$42.38
|
$0.05 – $0.08
|
3 |
|
Inj acetaminophen -fresenius
HCPCS J0134
|
$8.40
|
$42.00
|
$0.04 – $0.07
|
3 |
|
Inj, acetaminophen (hikma)
HCPCS J0137
|
$6.30
|
$31.50
|
$0.03 – $0.07
|
3 |
|
Inj allopurinol sodium 1 mg
HCPCS J0206
|
$1,318.27
|
$6,591.33
|
$3.83 – $8.80
|
61 |
|
Inj, bortezomib freseniuskab
HCPCS J9048
|
$711.96
|
$3,559.80
|
$14.36 – $33.00
|
61 |
|
Inj, bortezomib, hospira
HCPCS J9049
|
$27.70
|
$138.48
|
$1.49 – $1.84
|
3 |
|
Inj calcitriol per 0.1 mcg
HCPCS J0636
|
$9.08
|
$45.41
|
$0.99 – $1.22
|
2 |
|
Inj cefazolin sodium, baxter
HCPCS J0689
|
$17.40
|
$87.00
|
$1.26 – $1.58
|
3 |
|
Inj cefazolin sodium, hikma
HCPCS J0688
|
$7.29
|
$36.43
|
$0.87 – $2.00
|
61 |
|
Inj cefazolin (wg crit care)
HCPCS J0687
|
$5.40
|
$26.99
|
$0.97 – $2.22
|
61 |
|
Inj. cefepime hcl (baxter)
HCPCS J0701
|
$79.80
|
$399.00
|
$5.83 – $7.35
|
3 |
|
Inj, cefepime hcl (b braun)
HCPCS J0703
|
$41.42
|
$207.11
|
$4.97 – $6.38
|
3 |
|
Inj, clindamycin (baxter)
HCPCS J0737
|
$9.15
|
$45.75
|
$2.12 – $3.20
|
3 |
|
Inj cntr knee arthro incl ct/mri
CPT 27369
|
$88.00
|
$440.00
|
$35.65 – $35.65
|
1 |
|
Inj cyclophos dr.reddy's 5mg
HCPCS J9072
|
$2,100.00
|
$10,500.00
|
$3.64 – $11.46
|
3 |
|
Inj cyclophosphamd auromedic
HCPCS J9071
|
$139.87
|
$699.33
|
$0.61 – $1.40
|
61 |
|
Inj cyclophosphamd (ingenus)
HCPCS J9073
|
$813.16
|
$4,065.81
|
$1.91 – $4.38
|
61 |
|
Inj, daptomycin (hospira)
HCPCS J0877
|
$49.26
|
$246.30
|
$0.06 – $0.09
|
3 |
|
Inj daptomycin (xellia)
HCPCS J0873
|
$18.04
|
$90.22
|
$0.03 – $0.08
|
61 |
|
Inj, decitabine (sun pharma)
HCPCS J0893
|
$55.51
|
$277.53
|
$0.95 – $1.99
|
3 |
|
Inj dx for sinogram
CPT 20501
|
$52.40
|
$262.00
|
$33.50 – $33.50
|
1 |
|
Injection arthrography hip without anesthesia (both sides)
CPT 27093
|
$91.20
|
$456.00
|
$61.58 – $61.58
|
1 |
|
Injection, doxercalciferol
HCPCS J1270
|
$5.55
|
$27.75
|
$0.38 – $0.48
|
3 |
|
Injection during cath supravalvular aortography
CPT 93567
|
$47.60
|
$238.00
|
$51.88 – $51.88
|
1 |
|
Injection, edaravone, 1 mg
HCPCS J1301
|
$199.80
|
$999.00
|
$18.86 – $43.36
|
61 |
|
Injection epidural blood patch or clot
CPT 62273
|
$271.60
|
$1,358.00
|
$550.14 – $1,264.70
|
59 |
|
Injection eye drug
CPT 67028
|
$92.60
|
$463.00
|
$263.50 – $605.74
|
59 |
|
Injection for arthrography wrist (both sides)
CPT 25246
|
$48.80
|
$244.00
|
$66.50 – $66.50
|
1 |
|
Injection for bladder x-ray
CPT 51600
|
$42.00
|
$210.00
|
$48.18 – $48.18
|
1 |
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
CPT 23350
|
$88.00
|
$440.00
|
$45.08 – $45.08
|
1 |
|
Injection, fulvestrant
HCPCS J9395
|
$959.83
|
$4,799.16
|
$5.79 – $13.32
|
61 |
|
Injection glatiramer acetate
HCPCS J1595
|
$90.20
|
$450.99
|
$61.52 – $343.14
|
61 |
|
Injection radioactive tracer sentinel node (both sides)
CPT 38792
|
$153.80
|
$769.00
|
$319.22 – $733.84
|
59 |
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
HCPCS G0260
|
$289.20
|
$1,446.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
CPT 64447
|
$376.20
|
$1,881.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
CPT 64450
|
$172.00
|
$860.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
CPT 64483
|
$405.60
|
$2,028.00
|
$707.26 – $1,625.88
|
59 |
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
CPT 64490
|
$340.80
|
$1,704.00
|
$707.26 – $1,625.88
|
59 |
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
CPT 64493
|
$340.80
|
$1,704.00
|
$707.26 – $1,625.88
|
59 |
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
CPT 62323
|
$363.60
|
$1,818.00
|
$550.14 – $1,264.70
|
59 |
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
CPT 20550
|
$136.20
|
$681.00
|
$234.50 – $539.08
|
59 |
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
CPT 20552
|
$59.40
|
$297.00
|
$234.50 – $539.08
|
59 |
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
CPT 20553
|
$158.00
|
$790.00
|
$234.50 – $539.08
|
59 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
CPT 96375
|
$74.40
|
$372.00
|
$36.65 – $84.26
|
60 |
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
CPT 96376
|
$74.40
|
$372.00
|
$10.30 – $10.30
|
1 |
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
CPT 96374
|
$74.40
|
$372.00
|
$167.38 – $384.78
|
60 |
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
CPT 96372
|
$53.20
|
$266.00
|
$56.54 – $129.98
|
60 |
|
Inj epidural sgl lumb-sacral without img
CPT 62322
|
$160.00
|
$800.00
|
$707.26 – $1,625.88
|
59 |
|
Inj, epinephrine (belcher)
HCPCS J0173
|
$1,219.12
|
$6,095.62
|
$2.01 – $2.85
|
3 |
|
Inj for mammo ductogram
CPT 19030
|
$67.00
|
$335.00
|
$62.55 – $62.55
|
1 |
|
Inj, fosaprepitant (teva)
HCPCS J1456
|
$39.62
|
$198.09
|
$0.38 – $1.54
|
61 |
|
Inj, fulvestrant (fresenius)
HCPCS J9394
|
$508.80
|
$2,544.02
|
$4.20 – $24.52
|
61 |
|
Inj gemcitabine hcl (accord)
HCPCS J9196
|
$58.07
|
$290.34
|
$8.52 – $10.95
|
3 |
|
Inj glycopyrrolate fres kabi
HCPCS J1598
|
$12.18
|
$60.91
|
$1.76 – $4.04
|
61 |
|
Inj heparin, pfizer, 1000u
HCPCS J1643
|
$8.64
|
$43.20
|
$3.72 – $5.54
|
3 |
|
Inj, idacio, 1 mg
HCPCS Q5144
|
$499.00
|
$2,494.98
|
$13.07 – $30.04
|
61 |
|
Inj intralesional <= 7 lsn(s)
CPT 11900
|
$113.20
|
$566.00
|
$157.85 – $362.88
|
59 |
|
Inj labetalol hcl hikma, 5mg
HCPCS J1921
|
$4.37
|
$21.86
|
$1.63 – $3.10
|
3 |
|
Inj, lanreotide, (cipla) 1mg
HCPCS J1932
|
$3,385.87
|
$16,929.33
|
$26.69 – $61.36
|
61 |
|
Inj levoleucovorin nos 0.5mg
HCPCS J0641
|
$95.58
|
$477.90
|
$0.02 – $0.21
|
3 |
|
Inj, linezolid (hospira)
HCPCS J2021
|
$90.00
|
$450.00
|
$8.02 – $24.28
|
3 |
|
Inj melpha hydroch nos 50 mg
HCPCS J9245
|
$574.55
|
$2,872.73
|
$116.31 – $267.38
|
61 |
|
Inj, meropenem (b. braun)
HCPCS J2184
|
$41.50
|
$207.52
|
$2.10 – $2.64
|
3 |
|
Inj meropenem (wg crit care)
HCPCS J2183
|
$43.38
|
$216.88
|
$1.44 – $3.30
|
61 |