|
Infect ag drug suscept pheno predict
|
$536.40 |
$536.40 |
$536.40 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$405.30 |
$405.30 |
$405.30 |
$661.80
|
|
Infect ag genotype na dna hepatitis b
|
$636.90 |
$636.90 |
$636.90 |
$405.30
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$600.90 |
$600.90 |
$600.90 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$90.00 |
$90.00 |
$90.00 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$200.40 |
$200.40 |
$200.40 |
$72.58
|
|
Infect ag if pneumocystis carinii
|
$88.80 |
$88.80 |
$88.80 |
$66.00
|
|
Infect ag na hpv high-risk types
|
$60.90 |
$60.90 |
$60.90 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$210.60 |
$210.60 |
$210.60 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$40.20 |
$40.20 |
$40.20 |
$99.36
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$57.60 |
$57.60 |
$57.60 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$67.20 |
$67.20 |
$67.20 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$21.60 |
$21.60 |
$21.60 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$37.20 |
$37.20 |
$37.20 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$48.00 |
$48.00 |
$48.00 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$32.10 |
$32.10 |
$32.10 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$52.80 |
$52.80 |
$52.80 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$266.40 |
$266.40 |
$266.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$250.80 |
$250.80 |
$250.80 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$95.40 |
$95.40 |
$95.40 |
$98.02
|
|
Infectious agent nucleic acid amplified probe
|
$259.20 |
$259.20 |
$259.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$293.40 |
$293.40 |
$293.40 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$110.70 |
$110.70 |
$110.70 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$689.10 |
$689.10 |
$689.10 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$778.80 |
$778.80 |
$778.80 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$110.70 |
$110.70 |
$110.70 |
$147.55
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$311.10 |
$311.10 |
$311.10 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$60.60 |
$60.60 |
$60.60 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$136.80 |
$136.80 |
$136.80 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$61.20 |
$61.20 |
$61.20 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$91.50 |
$91.50 |
$91.50 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$115.20 |
$115.20 |
$115.20 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$338.70 |
$338.70 |
$338.70 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$201.90 |
$201.90 |
$201.90 |
$286.06
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$529.20 |
$529.20 |
$529.20 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$361.20 |
$361.20 |
$361.20 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$234.30 |
$234.30 |
$234.30 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$515.70 |
$515.70 |
$515.70 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$640.50 |
$640.50 |
$640.50 |
$374.00
|
|
Initiation & management bipap/cpap initial day
|
$448.50 |
$448.50 |
$448.50 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$5,355.30
|
|
Inj, adstiladrin, per tx dos
|
$68,969.25 |
$68,969.25 |
$68,969.25 |
$63,354.77
|
|
Inj, bupivacaine liposome
|
$1,187.15 |
$1,187.15 |
$1,187.15 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$48.00 |
$48.00 |
$48.00 |
$28.08
|
|
Inj, cefepime hcl (b braun)
|
$193.66 |
$193.66 |
$193.66 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$2,291.15 |
$2,291.15 |
$2,291.15 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$1,715.71 |
$1,715.71 |
$1,715.71 |
$380.80
|
|
Inj, clindamycin (baxter)
|
$69.86 |
$69.86 |
$69.86 |
$48.96
|
|
Inj, cyclophosphamd, sandoz
|
$664.61 |
$664.61 |
$664.61 |
$735.20
|
|
Inj, daptomycin (hospira)
|
$357.87 |
$357.87 |
$357.87 |
$113.35
|
|
Inj dx for sinogram
|
$2,376.60 |
$2,376.60 |
$2,376.60 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,016.70 |
$1,016.70 |
$1,016.70 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$24,883.44 |
$24,883.44 |
$24,883.44 |
$450.72
|
|
Injection, daratumumab 10 mg
|
$4,281.48 |
$4,281.48 |
$4,281.48 |
$5,239.24
|
|
Injection, doxercalciferol
|
$48.00 |
$48.00 |
$48.00 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$3,261.60 |
$3,261.60 |
$3,261.60 |
$952.66
|
|
Injection epidural blood patch or clot
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$1,016.70 |
$1,016.70 |
$1,016.70 |
$428.40
|
|
Injection for bladder x-ray
|
$2,335.20 |
$2,335.20 |
$2,335.20 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,016.70 |
$1,016.70 |
$1,016.70 |
$494.65
|
|
Injection glatiramer acetate
|
$226.50 |
$226.50 |
$226.50 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$16,252.42 |
$16,252.42 |
$16,252.42 |
$6,679.35
|
|
Injection of sinus tract
|
$495.30 |
$495.30 |
$495.30 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$2,949.03 |
$2,949.03 |
$2,949.03 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$470.70 |
$470.70 |
$470.70 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,005.00 |
$1,005.00 |
$1,005.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$594.00 |
$594.00 |
$594.00 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$680.70 |
$680.70 |
$680.70 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$153.60 |
$153.60 |
$153.60 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$887.70 |
$887.70 |
$887.70 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$639.60 |
$639.60 |
$639.60 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$887.70 |
$887.70 |
$887.70 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,055.70 |
$1,055.70 |
$1,055.70 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,647.60 |
$1,647.60 |
$1,647.60 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$12,778.71 |
$12,778.71 |
$12,778.71 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$113.40 |
$113.40 |
$113.40 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$113.40 |
$113.40 |
$113.40 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$151.20 |
$151.20 |
$151.20 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$188.70 |
$188.70 |
$188.70 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$190.20 |
$190.20 |
$190.20 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$151.20 |
$151.20 |
$151.20 |
$135.60
|
|
Inj epidural sgl cerv-thor without img
|
$536.10 |
$536.10 |
$536.10 |
$1,318.80
|
|
Inj for ext venography
|
$2,782.80 |
$2,782.80 |
$2,782.80 |
$649.95
|
|
Inj hydroxocobalamin IV 25mg
|
$4,747.44 |
$4,747.44 |
$4,747.44 |
$2,452.32
|
|
Inj levocarnitine per 1 gm
|
$382.53 |
$382.53 |
$382.53 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$5,194.64 |
$5,194.64 |
$5,194.64 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$22,424.93 |
$22,424.93 |
$22,424.93 |
$47.52
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$703.80 |
$703.80 |
$703.80 |
$784.00
|
|
Inj mepivacaine hcl/10 ml
|
$48.00 |
$48.00 |
$48.00 |
$33.86
|
|
Inj multihance
|
$193.88 |
$193.88 |
$193.88 |
$73.49
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,589.00 |
$2,589.00 |
$2,589.00 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$3,247.20 |
$3,247.20 |
$3,247.20 |
$462.04
|
|
Inj, releuko 1 mcg
|
$1,152.43 |
$1,152.43 |
$1,152.43 |
$473.25
|
|
Inj sulf hexa lipid microsph
|
$949.94 |
$949.94 |
$949.94 |
$256.14
|
|
Inj thrc fascial pln blk bi w/wo image
|
$703.80 |
$703.80 |
$703.80 |
$1,152.97
|
|
Inj thrc fascial pln blk uni w/wo image
|
$378.00 |
$378.00 |
$378.00 |
$837.50
|
|
Inj. tigecycline (accord)
|
$192.18 |
$192.18 |
$192.18 |
$188.03
|
|
Inj, tyenne, 1 mg
|
$8,871.55 |
$8,871.55 |
$8,871.55 |
$3,525.12
|
|
Inj vocal cord bulking agent
|
$1,956.94 |
$1,956.94 |
$1,956.94 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$436.20 |
$436.20 |
$436.20 |
$503.92
|