|
Infect ag phenotype na hiv-1 ea addl drg
|
$347.12 |
$347.12 |
$347.12 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$309.64 |
$309.64 |
$309.64 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$346.89 |
$346.89 |
$346.89 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$421.51 |
$421.51 |
$421.51 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$421.51 |
$421.51 |
$421.51 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$357.51 |
$357.51 |
$357.51 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$146.64 |
$146.64 |
$146.64 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$467.08 |
$467.08 |
$467.08 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$440.32 |
$440.32 |
$440.32 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$609.47 |
$609.47 |
$609.47 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$261.93 |
$261.93 |
$261.93 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$170.07 |
$170.07 |
$170.07 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$1,553.23 |
$1,553.23 |
$1,553.23 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$485.11 |
$485.11 |
$485.11 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$228.75 |
$228.75 |
$228.75 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,082.12 |
$1,082.12 |
$1,082.12 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$807.42 |
$807.42 |
$807.42 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$552.67 |
$552.67 |
$552.67 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$1,553.23 |
$1,553.23 |
$1,553.23 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$485.11 |
$485.11 |
$485.11 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$479.18 |
$479.18 |
$479.18 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$1,044.10 |
$1,044.10 |
$1,044.10 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$1,345.33 |
$1,345.33 |
$1,345.33 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$528.90 |
$528.90 |
$528.90 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$435.99 |
$435.99 |
$435.99 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$383.85 |
$383.85 |
$383.85 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,269.30 |
$1,269.30 |
$1,269.30 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$2,039.74 |
$2,039.74 |
$2,039.74 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$894.36 |
$894.36 |
$894.36 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$1,708.41 |
$1,708.41 |
$1,708.41 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,200.15 |
$1,200.15 |
$1,200.15 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$986.18 |
$986.18 |
$986.18 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$865.80 |
$865.80 |
$865.80 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$1,322.87 |
$1,322.87 |
$1,322.87 |
$298.35
|
|
Infuse radioactive materials
|
$2,019.59 |
$2,019.59 |
$2,019.59 |
$600.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$1,334.21 |
$1,334.21 |
$1,334.21 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$2,826.40 |
$2,826.40 |
$2,826.40 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$16,770.41 |
$16,770.41 |
$16,770.41 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$3,767.44 |
$3,767.44 |
$3,767.44 |
$9,702.65
|
|
Inj cefazolin sodium, hikma
|
$63.29 |
$63.29 |
$63.29 |
$56.70
|
|
Inj cntr knee arthro incl ct/mri
|
$208.92 |
$208.92 |
$208.92 |
$464.28
|
|
Inj disk cerv-thor ea lev
|
$2,373.99 |
$2,373.99 |
$2,373.99 |
$869.80
|
|
Inj dupuytren cord w/enzyme
|
$978.42 |
$978.42 |
$978.42 |
$416.00
|
|
Inj, durolane 1 mg
|
$1,782.73 |
$1,782.73 |
$1,782.73 |
$3,382.31
|
|
Inj dx for sinogram
|
$362.26 |
$362.26 |
$362.26 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,977.45 |
$2,977.45 |
$2,977.45 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$235.54 |
$235.54 |
$235.54 |
$507.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,933.51 |
$1,933.51 |
$1,933.51 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$12,803.22 |
$12,803.22 |
$12,803.22 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$2,970.99 |
$2,970.99 |
$2,970.99 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,128.12 |
$1,128.12 |
$1,128.12 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$226.77 |
$226.77 |
$226.77 |
$441.12
|
|
Injection for bladder x-ray
|
$803.97 |
$803.97 |
$803.97 |
$585.00
|
|
Injection for hip x-ray
|
$2,372.43 |
$2,372.43 |
$2,372.43 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$290.78 |
$290.78 |
$290.78 |
$504.00
|
|
Injection for tear sac x-ray
|
$101.43 |
$101.43 |
$101.43 |
$386.00
|
|
Injection for ureter x-ray
|
$3,341.11 |
$3,341.11 |
$3,341.11 |
$444.95
|
|
Injection for ureter x-ray
|
$366.81 |
$366.81 |
$366.81 |
$515.21
|
|
Injection, fulvestrant
|
$8,263.03 |
$8,263.03 |
$8,263.03 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$11,865.29 |
$11,865.29 |
$11,865.29 |
$10,366.61
|
|
Injection into brain canal
|
$3,235.86 |
$3,235.86 |
$3,235.86 |
$933.60
|
|
Injection jugular
|
$4,658.76 |
$4,658.76 |
$4,658.76 |
$1,048.20
|
|
Injection of sinus tract
|
$15,964.21 |
$15,964.21 |
$15,964.21 |
$1,651.20
|
|
Injection px peyronie ds
|
$1,161.93 |
$1,161.93 |
$1,161.93 |
$343.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$320.11 |
$320.11 |
$320.11 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$5,573.77 |
$5,573.77 |
$5,573.77 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,633.47 |
$3,633.47 |
$3,633.47 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$763.53 |
$763.53 |
$763.53 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$4,518.81 |
$4,518.81 |
$4,518.81 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,579.01 |
$1,579.01 |
$1,579.01 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,518.81 |
$4,518.81 |
$4,518.81 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,386.76 |
$1,386.76 |
$1,386.76 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,518.81 |
$4,518.81 |
$4,518.81 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,043.12 |
$3,043.12 |
$3,043.12 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,219.48 |
$1,219.48 |
$1,219.48 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,399.79 |
$1,399.79 |
$1,399.79 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$966.60 |
$966.60 |
$966.60 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,163.80 |
$1,163.80 |
$1,163.80 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$411.21 |
$411.21 |
$411.21 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$411.21 |
$411.21 |
$411.21 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$367.14 |
$367.14 |
$367.14 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$411.21 |
$411.21 |
$411.21 |
$141.60
|
|
Injection treatment of nerve
|
$11,008.52 |
$11,008.52 |
$11,008.52 |
$3,016.15
|
|
Injection treatment of nerve
|
$14,903.22 |
$14,903.22 |
$14,903.22 |
$3,986.00
|
|
Injection treatment of nerve
|
$4,971.89 |
$4,971.89 |
$4,971.89 |
$2,037.10
|
|
Inject sacroiliac joint
|
$837.00 |
$837.00 |
$837.00 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$54,199.36 |
$54,199.36 |
$54,199.36 |
$66,229.74
|
|
Inj epidural sgl cerv-thor without img
|
$3,280.41 |
$3,280.41 |
$3,280.41 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$3,280.41 |
$3,280.41 |
$3,280.41 |
$1,450.84
|
|
Inj for ext venography
|
$289.47 |
$289.47 |
$289.47 |
$737.55
|
|
Inj for mammo ductogram
|
$1,063.28 |
$1,063.28 |
$1,063.28 |
$433.50
|
|
Inj, fulvestrant (fresenius)
|
$1,660.39 |
$1,660.39 |
$1,660.39 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$47.05 |
$47.05 |
$47.05 |
$96.70
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$3,159.73 |
$3,159.73 |
$3,159.73 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$4,840.31 |
$4,840.31 |
$4,840.31 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,610.19 |
$1,610.19 |
$1,610.19 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$3,970.61 |
$3,970.61 |
$3,970.61 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$1,532.59 |
$1,532.59 |
$1,532.59 |
$947.65
|
|
Inj intralesional <= 7 lsn(s)
|
$531.63 |
$531.63 |
$531.63 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$11,853.36 |
$11,853.36 |
$11,853.36 |
$7,298.71
|