|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$46.90 |
$46.90 |
$46.90 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$18.38 |
$18.38 |
$18.38 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$58.45 |
$58.45 |
$58.45 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$59.15 |
$59.15 |
$59.15 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$37.80 |
$37.80 |
$37.80 |
$174.06
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$32.38 |
$32.38 |
$32.38 |
$178.00
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$68.78 |
$68.78 |
$68.78 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$59.15 |
$59.15 |
$59.15 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$75.08 |
$75.08 |
$75.08 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$111.13 |
$111.13 |
$111.13 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$36.23 |
$36.23 |
$36.23 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$303.45 |
$303.45 |
$303.45 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$97.13 |
$97.13 |
$97.13 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$119.00 |
$119.00 |
$119.00 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$130.73 |
$130.73 |
$130.73 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$164.85 |
$164.85 |
$164.85 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$151.90 |
$151.90 |
$151.90 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$115.85 |
$115.85 |
$115.85 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$198.14 |
$198.14 |
$198.14 |
$2,791.24
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$47.97 |
$47.97 |
$47.97 |
$1,654.83
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$170.63 |
$170.63 |
$170.63 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$372.40 |
$372.40 |
$372.40 |
$645.79
|
|
Inj, bezlotoxumab, 10 mg
|
$665.00 |
$665.00 |
$665.00 |
$9,702.65
|
|
Inj, cefiderocol, 10 mg
|
$33.21 |
$33.21 |
$33.21 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$14.53 |
$14.53 |
$14.53 |
$447.36
|
|
Inj cntr knee arthro incl ct/mri
|
$32.38 |
$32.38 |
$32.38 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$203.16 |
$203.16 |
$203.16 |
$2,836.95
|
|
Inj disk cerv-thor ea lev
|
$2,993.73 |
$2,993.73 |
$2,993.73 |
$869.80
|
|
Inj dx for sinogram
|
$149.98 |
$149.98 |
$149.98 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$255.33 |
$255.33 |
$255.33 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$54.43 |
$54.43 |
$54.43 |
$507.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$151.73 |
$151.73 |
$151.73 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$315.00 |
$315.00 |
$315.00 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$619.85 |
$619.85 |
$619.85 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$499.98 |
$499.98 |
$499.98 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$113.58 |
$113.58 |
$113.58 |
$441.12
|
|
Injection for bladder x-ray
|
$214.20 |
$214.20 |
$214.20 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$120.93 |
$120.93 |
$120.93 |
$504.00
|
|
Injection for ureter x-ray
|
$43.05 |
$43.05 |
$43.05 |
$444.95
|
|
Injection for ureter x-ray
|
$120.05 |
$120.05 |
$120.05 |
$515.21
|
|
Injection, fulvestrant
|
$73.34 |
$73.34 |
$73.34 |
$2,756.47
|
|
Injection into brain canal
|
$164.85 |
$164.85 |
$164.85 |
$933.60
|
|
Injection, isavuconazonium
|
$47.84 |
$47.84 |
$47.84 |
$646.20
|
|
Injection jugular
|
$29.40 |
$29.40 |
$29.40 |
$1,048.20
|
|
Injection,onabotulinumtoxina
|
$221.90 |
$221.90 |
$221.90 |
$2,154.07
|
|
Injection, renflexis
|
$61.37 |
$61.37 |
$61.37 |
$1,457.42
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$225.23 |
$225.23 |
$225.23 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$530.78 |
$530.78 |
$530.78 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$637.53 |
$637.53 |
$637.53 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$579.43 |
$579.43 |
$579.43 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$423.15 |
$423.15 |
$423.15 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$742.35 |
$742.35 |
$742.35 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$448.53 |
$448.53 |
$448.53 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$756.18 |
$756.18 |
$756.18 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$205.63 |
$205.63 |
$205.63 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$191.63 |
$191.63 |
$191.63 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$217.70 |
$217.70 |
$217.70 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$103.25 |
$103.25 |
$103.25 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$71.23 |
$71.23 |
$71.23 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$247.45 |
$247.45 |
$247.45 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$95.90 |
$95.90 |
$95.90 |
$141.60
|
|
Injection treatment of nerve
|
$707.18 |
$707.18 |
$707.18 |
$3,986.00
|
|
Inject sacroiliac joint
|
$368.90 |
$368.90 |
$368.90 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$345.63 |
$345.63 |
$345.63 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$314.13 |
$314.13 |
$314.13 |
$1,450.84
|
|
Inj for ext venography
|
$525.88 |
$525.88 |
$525.88 |
$737.55
|
|
Inj heparin, pfizer, 1000u
|
$0.24 |
$0.24 |
$0.24 |
$24.28
|
|
Inj hrt cath w/s&i sel right vent
|
$375.03 |
$375.03 |
$375.03 |
$947.65
|
|
Inj hydroxyprogst capoat nos
|
$60.87 |
$60.87 |
$60.87 |
$1,495.98
|
|
Inj intralesional <= 7 lsn(s)
|
$40.25 |
$40.25 |
$40.25 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$562.38 |
$562.38 |
$562.38 |
$7,298.71
|
|
Inj., meropenem, vaborbactam
|
$26.14 |
$26.14 |
$26.14 |
$618.43
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$1,678.82 |
$1,678.82 |
$1,678.82 |
$39.54
|
|
Inj multihance
|
$5.44 |
$5.44 |
$5.44 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$370.13 |
$370.13 |
$370.13 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$261.15 |
$261.15 |
$261.15 |
$3,968.67
|
|
Inj, pedmark, 100 mg
|
$14.18 |
$14.18 |
$14.18 |
$96.08
|
|
Inj proc elbow arthro
|
$118.83 |
$118.83 |
$118.83 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$797.65 |
$797.65 |
$797.65 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$548.98 |
$548.98 |
$548.98 |
$922.80
|
|
Inj proc sialogram
|
$85.93 |
$85.93 |
$85.93 |
$380.80
|
|
Inj retacrit esrd on dialysi
|
$24.42 |
$24.42 |
$24.42 |
$307.40
|
|
Inj retro urethrocysto
|
$75.95 |
$75.95 |
$75.95 |
$551.29
|
|
Inj, rimabotulinumtoxinb
|
$101.68 |
$101.68 |
$101.68 |
$16.56
|
|
Inj testostero enanthate 1mg
|
$0.01 |
$0.01 |
$0.01 |
$50.85
|
|
Inj testosterone cypionate
|
$2.98 |
$2.98 |
$2.98 |
$77.15
|
|
Inj, vancomycin hcl (mylan)
|
$0.39 |
$0.39 |
$0.39 |
$63.82
|
|
Inj w/fluor eval cv device
|
$237.48 |
$237.48 |
$237.48 |
$588.90
|
|
Ins cath ren art 1st bi
|
$2,889.25 |
$2,889.25 |
$2,889.25 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$2,080.40 |
$2,080.40 |
$2,080.40 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$3,380.48 |
$3,380.48 |
$3,380.48 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$2,889.25 |
$2,889.25 |
$2,889.25 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$124.25 |
$124.25 |
$124.25 |
$544.00
|
|
Insert and remove bone pin
|
$1,079.05 |
$1,079.05 |
$1,079.05 |
$4,335.60
|
|
Insert cannula vein-to-vein hemodialysis
|
$3,269.00 |
$3,269.00 |
$3,269.00 |
$6,642.90
|
|
Insert cath pleura without image
|
$275.45 |
$275.45 |
$275.45 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$1,684.03 |
$1,684.03 |
$1,684.03 |
$9,754.48
|
|
Insertion catheter bladder non indwelling
|
$75.95 |
$75.95 |
$75.95 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$67.20 |
$67.20 |
$67.20 |
$273.60
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,145.38 |
$1,145.38 |
$1,145.38 |
$2,549.95
|