|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$20,115.07 |
$20,115.07 |
$20,115.07 |
$6,106.32
|
|
Immunoassay tumor antigen quantitative ca 125
|
$120.00 |
$120.00 |
$120.00 |
$131.95
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$193.80 |
$193.80 |
$193.80 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$83.40 |
$83.40 |
$83.40 |
$48.38
|
|
Immunofixation electrophoresis serum
|
$235.80 |
$235.80 |
$235.80 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$208.80 |
$208.80 |
$208.80 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$310.20 |
$310.20 |
$310.20 |
$231.40
|
|
Immunology procedure
|
$106.20 |
$106.20 |
$106.20 |
$142.56
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$13,267.85 |
$13,267.85 |
$13,267.85 |
$3,036.25
|
|
Implant cartilage 10mm synthetic
|
$9,655.79 |
$9,655.79 |
$9,655.79 |
$8,184.00
|
|
Implant cochlear osia osi300
|
$64,987.50 |
$64,987.50 |
$64,987.50 |
$16,200.89
|
|
Implant neuroelectrodes
|
$153,823.48 |
$153,823.48 |
$153,823.48 |
$18,334.40
|
|
Implant neuroelectrodes
|
$96,112.00 |
$96,112.00 |
$96,112.00 |
$7,766.27
|
|
Implant ureth bulk agent
|
$10,657.95 |
$10,657.95 |
$10,657.95 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$19,253.82 |
$19,253.82 |
$19,253.82 |
$3,974.88
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$178,326.40 |
$178,326.40 |
$178,326.40 |
$1,072.00
|
|
In-111 oxyquinolin per 0.5 mci
|
$994.20 |
$994.20 |
$994.20 |
$2,581.82
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,707.20 |
$2,707.20 |
$2,707.20 |
$2,598.17
|
|
In-111 pentetreotide
|
$1,057.80 |
$1,057.80 |
$1,057.80 |
$5,201.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,687.60 |
$3,687.60 |
$3,687.60 |
$2,056.93
|
|
Incision of achilles tendon
|
$118,429.69 |
$118,429.69 |
$118,429.69 |
$3,561.39
|
|
Incision of breast lesion
|
$10,629.40 |
$10,629.40 |
$10,629.40 |
$2,560.80
|
|
Incision of burn scab initi
|
$311.40 |
$311.40 |
$311.40 |
$494.40
|
|
Incision of eye
|
$21,578.49 |
$21,578.49 |
$21,578.49 |
$4,190.40
|
|
Incision tendon sheath
|
$9,886.58 |
$9,886.58 |
$9,886.58 |
$3,073.20
|
|
Incisn windpipe
|
$5,928.60 |
$5,928.60 |
$5,928.60 |
$3,810.50
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$221.40 |
$221.40 |
$221.40 |
$137.15
|
|
Infect ag drug suscept pheno predict
|
$393.60 |
$393.60 |
$393.60 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$810.60 |
$810.60 |
$810.60 |
$661.80
|
|
Infect ag genotype na dna hepatitis b
|
$810.60 |
$810.60 |
$810.60 |
$405.30
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,484.40 |
$1,484.40 |
$1,484.40 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$142.80 |
$142.80 |
$142.80 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$162.00 |
$162.00 |
$162.00 |
$72.58
|
|
Infect ag if pneumocystis carinii
|
$177.60 |
$177.60 |
$177.60 |
$66.00
|
|
Infect ag if varicella zoster
|
$69.60 |
$69.60 |
$69.60 |
$70.70
|
|
Infect ag na hpv high-risk types
|
$121.80 |
$121.80 |
$121.80 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$430.80 |
$430.80 |
$430.80 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$80.40 |
$80.40 |
$80.40 |
$99.36
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$331.20 |
$331.20 |
$331.20 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$134.40 |
$134.40 |
$134.40 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$116.40 |
$116.40 |
$116.40 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$104.40 |
$104.40 |
$104.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$170.40 |
$170.40 |
$170.40 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$148.20 |
$148.20 |
$148.20 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$156.60 |
$156.60 |
$156.60 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$306.60 |
$306.60 |
$306.60 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$184.20 |
$184.20 |
$184.20 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$114.00 |
$114.00 |
$114.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$490.20 |
$490.20 |
$490.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$187.80 |
$187.80 |
$187.80 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$224.40 |
$224.40 |
$224.40 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,375.80 |
$1,375.80 |
$1,375.80 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$568.20 |
$568.20 |
$568.20 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$115.80 |
$115.80 |
$115.80 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$189.00 |
$189.00 |
$189.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$190.20 |
$190.20 |
$190.20 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$130.20 |
$130.20 |
$130.20 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$300.60 |
$300.60 |
$300.60 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$122.40 |
$122.40 |
$122.40 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$183.00 |
$183.00 |
$183.00 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$230.40 |
$230.40 |
$230.40 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$280.80 |
$280.80 |
$280.80 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$403.80 |
$403.80 |
$403.80 |
$286.06
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$2,000.40 |
$2,000.40 |
$2,000.40 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$475.80 |
$475.80 |
$475.80 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$501.00 |
$501.00 |
$501.00 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$480.00 |
$480.00 |
$480.00 |
$374.00
|
|
Infliximab 100 mg intravenous solution
|
$6,726.65 |
$6,726.65 |
$6,726.65 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$5,450.57 |
$5,450.57 |
$5,450.57 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$403.80 |
$403.80 |
$403.80 |
$293.25
|
|
Initial foot exam pt lops
|
$250.20 |
$250.20 |
$250.20 |
$155.50
|
|
Initiation & management bipap/cpap initial day
|
$1,385.40 |
$1,385.40 |
$1,385.40 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$5,355.30
|
|
Inj. acthar gel to 40 units
|
$39,958.13 |
$39,958.13 |
$39,958.13 |
$7,918.32
|
|
Inj, adalimumab, 1 mg
|
$19,937.15 |
$19,937.15 |
$19,937.15 |
$12,098.05
|
|
Inj., benralizumab, 1 mg
|
$33,679.01 |
$33,679.01 |
$33,679.01 |
$11,239.97
|
|
Inj beta interferon sq 1 mcg
|
$2,856.95 |
$2,856.95 |
$2,856.95 |
$2,856.95
|
|
Inj, bezlotoxumab, 10 mg
|
$21,888.00 |
$21,888.00 |
$21,888.00 |
$7,612.43
|
|
Inj, bupivacaine liposome
|
$1,140.10 |
$1,140.10 |
$1,140.10 |
$699.38
|
|
Inj, cefiderocol, 10 mg
|
$2,200.34 |
$2,200.34 |
$2,200.34 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$1,647.70 |
$1,647.70 |
$1,647.70 |
$380.80
|
|
Inj, clindamycin (baxter)
|
$67.10 |
$67.10 |
$67.10 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$801.00 |
$801.00 |
$801.00 |
$436.80
|
|
Inj, cyclophos (baxter) 5mg
|
$3,406.36 |
$3,406.36 |
$3,406.36 |
$2,584.85
|
|
Inj cyclophosphamd auromedic
|
$1,455.00 |
$1,455.00 |
$1,455.00 |
$249.68
|
|
Inj daptomycin (xellia)
|
$345.60 |
$345.60 |
$345.60 |
$56.04
|
|
Inj dx for sinogram
|
$4,753.20 |
$4,753.20 |
$4,753.20 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,068.60 |
$1,068.60 |
$1,068.60 |
$495.84
|
|
Injection, cangrelor
|
$9,461.32 |
$9,461.32 |
$9,461.32 |
$1,889.78
|
|
Injection during cath supravalvular aortography
|
$279.60 |
$279.60 |
$279.60 |
$952.66
|
|
Injection epidural blood patch or clot
|
$2,190.00 |
$2,190.00 |
$2,190.00 |
$1,156.80
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,279.20 |
$1,279.20 |
$1,279.20 |
$494.65
|
|
Injection for ureter x-ray
|
$702.60 |
$702.60 |
$702.60 |
$515.21
|
|
Injection, fulvestrant
|
$5,642.64 |
$5,642.64 |
$5,642.64 |
$1,817.65
|
|
Injection glatiramer acetate
|
$1,365.89 |
$1,365.89 |
$1,365.89 |
$830.51
|
|
Injection,onabotulinumtoxina
|
$3,749.76 |
$3,749.76 |
$3,749.76 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$19,231.58 |
$19,231.58 |
$19,231.58 |
$670.64
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,554.70 |
$2,554.70 |
$2,554.70 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$1,348.56
|
