|
Implant cartilage 10mm synthetic
|
$8,602.73 |
$8,602.73 |
$8,602.73 |
$8,184.00
|
|
Implant cochlear osia osi300
|
$57,900.00 |
$57,900.00 |
$57,900.00 |
$16,200.89
|
|
Implant nerve end
|
$20,536.72 |
$20,536.72 |
$20,536.72 |
$2,152.40
|
|
Implant neuroelectrodes
|
$132,204.27 |
$132,204.27 |
$132,204.27 |
$18,334.40
|
|
Implant neuroelectrodes
|
$88,340.15 |
$88,340.15 |
$88,340.15 |
$7,766.27
|
|
Implant spine infusion pump
|
$15,704.54 |
$15,704.54 |
$15,704.54 |
$17,270.40
|
|
Implant ureth bulk agent
|
$9,495.60 |
$9,495.60 |
$9,495.60 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$17,154.01 |
$17,154.01 |
$17,154.01 |
$3,974.88
|
|
Impl neurostim electr perc
|
$30,031.74 |
$30,031.74 |
$30,031.74 |
$7,672.50
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,107.60 |
$1,107.60 |
$1,107.60 |
$2,581.82
|
|
In-111 pentetate dtpa / 0.5 mci
|
$669.60 |
$669.60 |
$669.60 |
$2,598.17
|
|
In-111 pentetreotide
|
$3,015.00 |
$3,015.00 |
$3,015.00 |
$5,201.00
|
|
Incise thigh tendon & fascia
|
$12,892.85 |
$12,892.85 |
$12,892.85 |
$3,839.54
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$2,056.93
|
|
Incision of anal sphincter
|
$11,085.08 |
$11,085.08 |
$11,085.08 |
$3,245.23
|
|
Incision of breast lesion
|
$2,083.80 |
$2,083.80 |
$2,083.80 |
$2,560.80
|
|
Incision of burn scab initi
|
$518.40 |
$518.40 |
$518.40 |
$494.40
|
|
Incision of foot tendon 28234
|
$12,093.89 |
$12,093.89 |
$12,093.89 |
$2,116.27
|
|
Incision of heel bone
|
$96,064.09 |
$96,064.09 |
$96,064.09 |
$5,339.00
|
|
Incision of metatarsal
|
$66,144.69 |
$66,144.69 |
$66,144.69 |
$4,176.43
|
|
Incision of metatarsal
|
$39,517.45 |
$39,517.45 |
$39,517.45 |
$3,591.33
|
|
Incision of midfoot bones
|
$69,030.02 |
$69,030.02 |
$69,030.02 |
$6,839.00
|
|
Incision of palm tendon
|
$23,743.04 |
$23,743.04 |
$23,743.04 |
$3,821.05
|
|
Incision of tendon sheath
|
$6,781.25 |
$6,781.25 |
$6,781.25 |
$2,211.05
|
|
Incision of tongue fold
|
$9,177.70 |
$9,177.70 |
$9,177.70 |
$1,792.50
|
|
Incision tendon sheath
|
$13,616.56 |
$13,616.56 |
$13,616.56 |
$3,073.20
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$2,868.00 |
$2,868.00 |
$2,868.00 |
$766.66
|
|
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
|
$743.40 |
$743.40 |
$743.40 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$810.60 |
$810.60 |
$810.60 |
$661.80
|
|
Infect ag genotype na dna hepatitis b
|
$1,273.80 |
$1,273.80 |
$1,273.80 |
$405.30
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,152.00 |
$1,152.00 |
$1,152.00 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$68.40 |
$68.40 |
$68.40 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$147.60 |
$147.60 |
$147.60 |
$72.58
|
|
Infect ag if pneumocystis carinii
|
$68.40 |
$68.40 |
$68.40 |
$66.00
|
|
Infect ag if varicella zoster
|
$89.40 |
$89.40 |
$89.40 |
$70.70
|
|
Infect ag na hpv high-risk types
|
$304.20 |
$304.20 |
$304.20 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$332.40 |
$332.40 |
$332.40 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$51.00 |
$51.00 |
$51.00 |
$99.36
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$128.40 |
$128.40 |
$128.40 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$81.00 |
$81.00 |
$81.00 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$102.00 |
$102.00 |
$102.00 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$159.00 |
$159.00 |
$159.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$124.20 |
$124.20 |
$124.20 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$228.00 |
$228.00 |
$228.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$73.20 |
$73.20 |
$73.20 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$140.40 |
$140.40 |
$140.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$366.60 |
$366.60 |
$366.60 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$84.60 |
$84.60 |
$84.60 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$73.20 |
$73.20 |
$73.20 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$490.20 |
$490.20 |
$490.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$198.00 |
$198.00 |
$198.00 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$192.00 |
$192.00 |
$192.00 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,862.40 |
$1,862.40 |
$1,862.40 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$195.60 |
$195.60 |
$195.60 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$192.00 |
$192.00 |
$192.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$232.20 |
$232.20 |
$232.20 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$207.00 |
$207.00 |
$207.00 |
$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
|
$218.40 |
$218.40 |
$218.40 |
$206.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$190.20 |
$190.20 |
$190.20 |
$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
|
$262.20 |
$262.20 |
$262.20 |
$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
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$372.00 |
$372.00 |
$372.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$468.60 |
$468.60 |
$468.60 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$360.60 |
$360.60 |
$360.60 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$436.80 |
$436.80 |
$436.80 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$495.00 |
$495.00 |
$495.00 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$5,430.37 |
$5,430.37 |
$5,430.37 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$2,325.00 |
$2,325.00 |
$2,325.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$4,400.20 |
$4,400.20 |
$4,400.20 |
$1,537.84
|
|
Initiation & management bipap/cpap initial day
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
$576.00
|
|
Inj alymsys 10 mg
|
$11,900.02 |
$11,900.02 |
$11,900.02 |
$1,280.74
|
|
Inj., benralizumab, 1 mg
|
$27,188.78 |
$27,188.78 |
$27,188.78 |
$11,239.97
|
|
Inj, bupivacaine liposome
|
$616.98 |
$616.98 |
$616.98 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$62.92 |
$62.92 |
$62.92 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$34.99 |
$34.99 |
$34.99 |
$18.05
|
|
Inj, clindamycin (baxter)
|
$93.57 |
$93.57 |
$93.57 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$282.00 |
$282.00 |
$282.00 |
$436.80
|
|
Inj, cyclophos (baxter) 5mg
|
$2,423.08 |
$2,423.08 |
$2,423.08 |
$2,584.85
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,601.40 |
$1,601.40 |
$1,601.40 |
$495.84
|
|
Injection, cangrelor
|
$7,178.59 |
$7,178.59 |
$7,178.59 |
$1,889.78
|
|
Injection during cath supravalvular aortography
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$952.66
|
|
Injection epidural blood patch or clot
|
$1,383.00 |
$1,383.00 |
$1,383.00 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$304.80 |
$304.80 |
$304.80 |
$428.40
|
|
Injection for bladder x-ray
|
$777.60 |
$777.60 |
$777.60 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,359.00 |
$1,359.00 |
$1,359.00 |
$494.65
|
|
Injection, fulvestrant
|
$4,013.84 |
$4,013.84 |
$4,013.84 |
$1,817.65
|
|
Injection glatiramer acetate
|
$1,102.67 |
$1,102.67 |
$1,102.67 |
$830.51
|
|
Injection,onabotulinumtoxina
|
$6,054.30 |
$6,054.30 |
$6,054.30 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$855.60 |
$855.60 |
$855.60 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$49,149.44 |
$49,149.44 |
$49,149.44 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$758.40 |
$758.40 |
$758.40 |
$1,023.50
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,497.60 |
$1,497.60 |
$1,497.60 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,776.00 |
$1,776.00 |
$1,776.00 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,239.60 |
$1,239.60 |
$1,239.60 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,776.00 |
$1,776.00 |
$1,776.00 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,817.24
|
