|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$182.50 |
$182.50 |
$182.50 |
$208.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$182.50 |
$182.50 |
$182.50 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$177.50 |
$177.50 |
$177.50 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$204.50 |
$204.50 |
$204.50 |
$112.50
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$491.00 |
$491.00 |
$491.00 |
$217.60
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$492.50 |
$492.50 |
$492.50 |
$200.20
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$1,019.50 |
$1,019.50 |
$1,019.50 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,694.00 |
$1,694.00 |
$1,694.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$673.00 |
$673.00 |
$673.00 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$1,266.50 |
$1,266.50 |
$1,266.50 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$440.00 |
$440.00 |
$440.00 |
$280.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$309.50 |
$309.50 |
$309.50 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$253.00 |
$253.00 |
$253.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$553.00 |
$553.00 |
$553.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$760.00 |
$760.00 |
$760.00 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$157.30 |
$157.30 |
$157.30 |
$2,043.22
|
|
Infliximab-axxq 100 mg intravenous solution
|
$65.40 |
$65.40 |
$65.40 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$60.04 |
$60.04 |
$60.04 |
$1,537.84
|
|
Influenza dna amp prob addl
|
$155.50 |
$155.50 |
$155.50 |
$64.26
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$762.00 |
$762.00 |
$762.00 |
$762.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$593.50 |
$593.50 |
$593.50 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$770.00 |
$770.00 |
$770.00 |
$780.00
|
|
Ingest challenge ea addl 60 min
|
$310.50 |
$310.50 |
$310.50 |
$289.64
|
|
Ingest challenge ini 120 min
|
$1,182.50 |
$1,182.50 |
$1,182.50 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$276.00 |
$276.00 |
$276.00 |
$299.65
|
|
Inj, abilify maintena, 1 mg
|
$8.93 |
$8.93 |
$8.93 |
$5,355.30
|
|
Inj, adzynma, 10 iu
|
$50.48 |
$50.48 |
$50.48 |
$34.60
|
|
Inj alymsys 10 mg
|
$57.53 |
$57.53 |
$57.53 |
$1,280.74
|
|
Inj, artesunate, 1mg
|
$68.25 |
$68.25 |
$68.25 |
$14,460.21
|
|
Inj, aspara, rylaze, 0.1 mg
|
$73.43 |
$73.43 |
$73.43 |
$10,458.00
|
|
Inj, bupivacaine liposome
|
$2.15 |
$2.15 |
$2.15 |
$699.38
|
|
Inj calcitriol per 0.1 mcg
|
$1.70 |
$1.70 |
$1.70 |
$22.69
|
|
Inj, cefiderocol, 10 mg
|
$2.36 |
$2.36 |
$2.36 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$10.91 |
$10.91 |
$10.91 |
$358.56
|
|
Inj cntr knee arthro incl ct/mri
|
$1,297.00 |
$1,297.00 |
$1,297.00 |
$441.88
|
|
Inj disk cerv-thor ea lev
|
$304.50 |
$304.50 |
$304.50 |
$875.28
|
|
Inj dx for sinogram
|
$276.00 |
$276.00 |
$276.00 |
$447.50
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$4,063.00 |
$4,063.00 |
$4,063.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,121.00 |
$1,121.00 |
$1,121.00 |
$504.00
|
|
Injection, cangrelor
|
$25.48 |
$25.48 |
$25.48 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$967.00 |
$967.00 |
$967.00 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$106.00 |
$106.00 |
$106.00 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$319.00 |
$319.00 |
$319.00 |
$1,028.00
|
|
Injection epidural blood patch or clot
|
$695.50 |
$695.50 |
$695.50 |
$1,192.80
|
|
Injection for arthrography wrist (both sides)
|
$527.00 |
$527.00 |
$527.00 |
$438.00
|
|
Injection for bladder x-ray
|
$381.50 |
$381.50 |
$381.50 |
$460.00
|
|
Injection for hip x-ray
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$750.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,157.00 |
$1,157.00 |
$1,157.00 |
$503.30
|
|
Injection for spleen x-ray
|
$307.50 |
$307.50 |
$307.50 |
$595.50
|
|
Injection for tear sac x-ray
|
$117.00 |
$117.00 |
$117.00 |
$212.55
|
|
Injection for ureter x-ray
|
$187.00 |
$187.00 |
$187.00 |
$415.80
|
|
Injection for ureter x-ray
|
$234.50 |
$234.50 |
$234.50 |
$527.70
|
|
Injection, fulvestrant
|
$125.71 |
$125.71 |
$125.71 |
$1,719.16
|
|
Injection into brain canal
|
$3,222.50 |
$3,222.50 |
$3,222.50 |
$844.50
|
|
Injection, isavuconazonium
|
$1.36 |
$1.36 |
$1.36 |
$787.67
|
|
Injection jugular
|
$751.00 |
$751.00 |
$751.00 |
$790.00
|
|
Injection of sinus tract
|
$441.50 |
$441.50 |
$441.50 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$9.03 |
$9.03 |
$9.03 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$724.00 |
$724.00 |
$724.00 |
$694.20
|
|
Injection, renflexis
|
$56.33 |
$56.33 |
$56.33 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,022.00 |
$1,022.00 |
$1,022.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,403.00 |
$3,403.00 |
$3,403.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,172.00 |
$1,172.00 |
$1,172.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,017.00 |
$3,017.00 |
$3,017.00 |
$2,071.80
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,505.00 |
$1,505.00 |
$1,505.00 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,989.00 |
$2,989.00 |
$2,989.00 |
$1,888.80
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$893.00 |
$893.00 |
$893.00 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,017.00 |
$3,017.00 |
$3,017.00 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,932.50 |
$1,932.50 |
$1,932.50 |
$1,826.80
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$1,685.00
|
|
Injection, siltuximab
|
$219.98 |
$219.98 |
$219.98 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$821.00 |
$821.00 |
$821.00 |
$485.28
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$410.50 |
$410.50 |
$410.50 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$429.00 |
$429.00 |
$429.00 |
$638.95
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$187.50 |
$187.50 |
$187.50 |
$145.60
|
|
Injection treatment of nerve
|
$2,466.50 |
$2,466.50 |
$2,466.50 |
$2,050.30
|
|
Inj., emapalumab-lzsg, 1 mg
|
$506.87 |
$506.87 |
$506.87 |
$3,181.80
|
|
Inj epidural sgl cerv-thor without img
|
$1,329.00 |
$1,329.00 |
$1,329.00 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,415.50 |
$1,415.50 |
$1,415.50 |
$1,450.84
|
|
Inj., fibryga, 1 mg
|
$1.11 |
$1.11 |
$1.11 |
$4.93
|
|
Inj for ext venography
|
$267.00 |
$267.00 |
$267.00 |
$631.80
|
|
Inj for mammo ductogram
|
$736.00 |
$736.00 |
$736.00 |
$397.80
|
|
Inj glofitamab gxbm, 2.5 mg
|
$3,709.35 |
$3,709.35 |
$3,709.35 |
$4,760.67
|
|
Inj. herceptin hylecta, 10mg
|
$108.76 |
$108.76 |
$108.76 |
$8,193.78
|
|
Inj herzuma 10 mg
|
$116.99 |
$116.99 |
$116.99 |
$7,775.46
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$201.50 |
$201.50 |
$201.50 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$254.50 |
$254.50 |
$254.50 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$260.00 |
$260.00 |
$260.00 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$197.50 |
$197.50 |
$197.50 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$196.50 |
$196.50 |
$196.50 |
$999.96
|
|
Inj imip 4 cilas 4 releb 2mg
|
$2.53 |
$2.53 |
$2.53 |
$739.77
|
|
Inj intralesional <= 7 lsn(s)
|
$264.00 |
$264.00 |
$264.00 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$782.50 |
$782.50 |
$782.50 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$55.46 |
$55.46 |
$55.46 |
$6,967.29
|
|
Inj, lanreotide, (cipla) 1mg
|
$65.49 |
$65.49 |
$65.49 |
$11,648.70
|
|
Inj levocarnitine per 1 gm
|
$34.70 |
$34.70 |
$34.70 |
$136.62
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$387.00 |
$387.00 |
$387.00 |
$794.70
|
|
Inj melpha hydroch nos 50 mg
|
$158.57 |
$158.57 |
$158.57 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$15.09 |
$15.09 |
$15.09 |
$34.00
|
|
Inj., meropenem, vaborbactam
|
$2.80 |
$2.80 |
$2.80 |
$556.87
|
