|
Infect ag na herpes simplex quant
|
$168.50 |
$168.50 |
$168.50 |
$168.50
|
|
Infect ag na hpv high-risk types
|
$156.00 |
$156.00 |
$304.20 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$92.00 |
$92.00 |
$332.40 |
$217.88
|
|
Infect ag na orthopoxvirus amp prb each
|
$38.50 |
$38.50 |
$38.50 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$258.00 |
$258.00 |
$258.00 |
$845.40
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$2,471.50 |
$2,471.50 |
$2,471.50 |
$886.26
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$135.00 |
$135.00 |
$135.00 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$10.50 |
$10.50 |
$128.40 |
$81.90
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$39.50 |
$39.50 |
$72.00 |
$69.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$76.50 |
$76.50 |
$76.50 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$57.50 |
$57.50 |
$91.80 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$75.50 |
$75.50 |
$75.50 |
$95.34
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$52.00 |
$52.00 |
$108.60 |
$80.50
|
|
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
|
$124.00 |
$124.00 |
$160.80 |
$129.68
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$75.50 |
$75.50 |
$75.50 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$38.00 |
$38.00 |
$73.20 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$209.40 |
$209.40 |
$538.00 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$168.50 |
$168.50 |
$196.20 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$35.00 |
$35.00 |
$192.00 |
$166.40
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$463.50 |
$463.50 |
$1,862.40 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$186.60 |
$186.60 |
$267.50 |
$181.35
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$146.50 |
$146.50 |
$146.50 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$166.00 |
$166.00 |
$196.20 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$54.00 |
$54.00 |
$130.20 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$125.00 |
$125.00 |
$218.40 |
$217.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$150.00 |
$150.00 |
$150.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$115.80 |
$115.80 |
$115.80 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$166.00 |
$166.00 |
$190.20 |
$108.21
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$350.00 |
$350.00 |
$350.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$116.50 |
$116.50 |
$1,058.40 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$618.50 |
$618.50 |
$618.50 |
$285.60
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$191.00 |
$191.00 |
$292.80 |
$237.70
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$192.00 |
$192.00 |
$199.50 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$329.00 |
$329.00 |
$329.00 |
$373.60
|
|
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
|
$4,379.33 |
$4,379.33 |
$4,379.33 |
$2,043.22
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$3,548.55 |
$3,548.55 |
$3,548.55 |
$1,537.84
|
|
Infuse radioactive materials
|
$931.00 |
$931.00 |
$931.00 |
$744.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$210.00 |
$210.00 |
$210.00 |
$293.25
|
|
Initial foot exam pt lops
|
$162.50 |
$162.50 |
$162.50 |
$155.50
|
|
Initiation & management bipap/cpap initial day
|
$507.50 |
$507.50 |
$1,119.00 |
$570.00
|
|
Inj, abilify asimtufii, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$5,168.00
|
|
Inj allopurinol sodium 1 mg
|
$25,596.93 |
$25,596.93 |
$25,596.93 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$11,296.39 |
$11,296.39 |
$11,296.39 |
$1,280.74
|
|
Inj anifrolumab-fnia 1mg
|
$20,402.40 |
$20,402.40 |
$20,402.40 |
$9,878.82
|
|
Inj., aristada initio, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$4,052.45
|
|
Inj., benralizumab, 1 mg
|
$21,926.44 |
$21,926.44 |
$21,926.44 |
$11,239.97
|
|
Inj bulking agent anal canal
|
$851.29 |
$851.29 |
$851.29 |
$9,525.70
|
|
Inj, bupivacaine liposome
|
$639.88 |
$639.88 |
$639.88 |
$699.38
|
|
Inj ceftolozane tazobactam
|
$1,119.40 |
$1,119.40 |
$1,119.40 |
$381.60
|
|
Inj, clindamycin (baxter)
|
$83.78 |
$83.78 |
$83.78 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$89.00 |
$89.00 |
$282.00 |
$436.80
|
|
Inj, cyclophosphamd, sandoz
|
$1,830.35 |
$1,830.35 |
$1,830.35 |
$735.20
|
|
Inj disk cerv-thor ea lev
|
$1,892.00 |
$1,892.00 |
$1,892.00 |
$957.60
|
|
Inj dupuytren cord w/enzyme
|
$609.50 |
$609.50 |
$609.50 |
$416.00
|
|
Inj dx for sinogram
|
$875.50 |
$875.50 |
$875.50 |
$413.82
|
|
Inject for sacroiliac joint
|
$457.50 |
$457.50 |
$457.50 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$399.00 |
$399.00 |
$1,601.40 |
$498.50
|
|
Injection, cangrelor
|
$6,427.70 |
$6,427.70 |
$6,427.70 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$302.50 |
$302.50 |
$302.50 |
$504.90
|
|
Injection, doxercalciferol
|
$24.00 |
$24.00 |
$24.00 |
$23.83
|
|
Injection during cath supravalvular aortography
|
$1,966.00 |
$1,966.00 |
$1,966.00 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,033.50 |
$1,033.50 |
$1,383.00 |
$1,153.03
|
|
Injection eye drug
|
$644.50 |
$644.50 |
$644.50 |
$648.96
|
|
Injection for arthrography wrist (both sides)
|
$304.80 |
$304.80 |
$399.00 |
$438.00
|
|
Injection for bladder x-ray
|
$75.60 |
$75.60 |
$399.00 |
$459.20
|
|
Injection for hip x-ray
|
$222.50 |
$222.50 |
$222.50 |
$662.40
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$526.20 |
$526.20 |
$1,344.50 |
$494.65
|
|
Injection for spleen x-ray
|
$2,524.50 |
$2,524.50 |
$2,524.50 |
$471.19
|
|
Injection for tear sac x-ray
|
$1,045.50 |
$1,045.50 |
$1,045.50 |
$212.55
|
|
Injection for ureter x-ray
|
$1,915.00 |
$1,915.00 |
$1,915.00 |
$415.80
|
|
Injection for ureter x-ray
|
$1,412.50 |
$1,412.50 |
$1,412.50 |
$515.21
|
|
Injection, fulvestrant
|
$196.50 |
$196.50 |
$196.50 |
$1,719.16
|
|
Injection glatiramer acetate
|
$889.25 |
$889.25 |
$889.25 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$13,453.99 |
$13,453.99 |
$13,453.99 |
$6,679.35
|
|
Injection into brain canal
|
$1,683.00 |
$1,683.00 |
$1,683.00 |
$844.50
|
|
Injection into hemorrhoid(s)
|
$1,433.00 |
$1,433.00 |
$1,433.00 |
$1,432.81
|
|
Injection of sinus tract
|
$1,207.00 |
$1,207.00 |
$1,207.00 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$4,882.50 |
$4,882.50 |
$4,882.50 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$543.50 |
$543.50 |
$543.50 |
$699.68
|
|
Injection, renflexis
|
$2,825.21 |
$2,825.21 |
$2,825.21 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$765.50 |
$765.50 |
$1,344.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$382.00 |
$382.00 |
$1,344.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,157.00 |
$1,157.00 |
$1,897.80 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,824.50 |
$1,824.50 |
$2,396.40 |
$2,031.18
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,497.60 |
$1,497.60 |
$1,526.00 |
$1,007.19
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,776.00 |
$1,776.00 |
$1,967.50 |
$1,781.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,239.60 |
$1,239.60 |
$1,964.00 |
$984.48
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,776.00 |
$1,776.00 |
$1,867.00 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,344.00 |
$1,344.00 |
$1,938.00 |
$1,783.60
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,685.00 |
$1,685.00 |
$2,158.20 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$63.60 |
$63.60 |
$367.50 |
$478.20
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$378.00 |
$378.00 |
$622.00 |
$546.40
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$378.00 |
$378.00 |
$454.00 |
$634.40
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$208.20 |
$208.20 |
$220.50 |
$163.83
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$163.20 |
$163.20 |
$220.50 |
$145.60
|
