|
Infect ag if legionella pneumophila
|
$32.40 |
$32.40 |
$32.40 |
$72.58
|
|
Infect ag if pneumocystis carinii
|
$31.20 |
$31.20 |
$31.20 |
$66.00
|
|
Infect ag if varicella zoster
|
$31.20 |
$31.20 |
$31.20 |
$70.70
|
|
Infect ag na herpes simplex quant
|
$108.00 |
$108.00 |
$108.00 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$49.20 |
$49.20 |
$49.20 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$197.60 |
$197.60 |
$197.60 |
$219.70
|
|
Infect ag na influenza revr/amp ea type
|
$92.00 |
$92.00 |
$92.00 |
$158.06
|
|
Infect ag na orthopoxvirus amp prb each
|
$103.20 |
$103.20 |
$103.20 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$446.40 |
$446.40 |
$446.40 |
$835.80
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$785.20 |
$785.20 |
$785.20 |
$943.80
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$60.40 |
$60.40 |
$60.40 |
$75.63
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$72.40 |
$72.40 |
$72.40 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$31.20 |
$31.20 |
$31.20 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$31.20 |
$31.20 |
$31.20 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$31.20 |
$31.20 |
$31.20 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$33.20 |
$33.20 |
$33.20 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$26.00 |
$26.00 |
$26.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$26.00 |
$26.00 |
$26.00 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$50.40 |
$50.40 |
$50.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$31.20 |
$31.20 |
$31.20 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$31.20 |
$31.20 |
$31.20 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$31.20 |
$31.20 |
$31.20 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$81.60 |
$81.60 |
$81.60 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$68.40 |
$68.40 |
$68.40 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$68.40 |
$68.40 |
$68.40 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$734.00 |
$734.00 |
$734.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$81.60 |
$81.60 |
$81.60 |
$179.92
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$88.40 |
$88.40 |
$88.40 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$68.40 |
$68.40 |
$68.40 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$142.40 |
$142.40 |
$142.40 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$177.60 |
$177.60 |
$177.60 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$289.20 |
$289.20 |
$289.20 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$79.60 |
$79.60 |
$79.60 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$40.00 |
$40.00 |
$40.00 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$137.20 |
$137.20 |
$137.20 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$213.60 |
$213.60 |
$213.60 |
$185.00
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$941.20 |
$941.20 |
$941.20 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$535.20 |
$535.20 |
$535.20 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$137.20 |
$137.20 |
$137.20 |
$286.06
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$389.60 |
$389.60 |
$389.60 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$99.60 |
$99.60 |
$99.60 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$99.60 |
$99.60 |
$99.60 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$99.60 |
$99.60 |
$99.60 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$197.60 |
$197.60 |
$197.60 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$153.20 |
$153.20 |
$153.20 |
$303.59
|
|
Influenza dna amp prob addl
|
$52.00 |
$52.00 |
$52.00 |
$64.26
|
|
Influenza virus vaccine, live trivalent intranasal
|
$18.00 |
$18.00 |
$18.00 |
$36.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$232.80 |
$232.80 |
$232.80 |
$293.25
|
|
Initial custom socket insert
|
$806.00 |
$806.00 |
$806.00 |
$1,453.20
|
|
Initiation & management bipap/cpap initial day
|
$1,946.40 |
$1,946.40 |
$1,946.40 |
$576.00
|
|
Inj acetaminophen -fresenius
|
$5.08 |
$5.08 |
$5.08 |
$36.60
|
|
Inj, aponvie, 1 mg
|
$3.71 |
$3.71 |
$3.71 |
$3.00
|
|
Inj, bupivacaine liposome
|
$3.77 |
$3.77 |
$3.77 |
$699.38
|
|
Inj cefazolin sodium, baxter
|
$12.14 |
$12.14 |
$12.14 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$6.28 |
$6.28 |
$6.28 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$6.28 |
$6.28 |
$6.28 |
$18.05
|
|
Inj, cefiderocol, 10 mg
|
$3.75 |
$3.75 |
$3.75 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$14.40 |
$14.40 |
$14.40 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$262.80 |
$262.80 |
$262.80 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$1,009.20 |
$1,009.20 |
$1,009.20 |
$875.28
|
|
Inj dx for sinogram
|
$200.00 |
$200.00 |
$200.00 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,027.60 |
$2,027.60 |
$2,027.60 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$351.60 |
$351.60 |
$351.60 |
$495.84
|
|
Injection, caplacizumab-yhdp
|
$1,062.68 |
$1,062.68 |
$1,062.68 |
$16,375.33
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,593.60 |
$1,593.60 |
$1,593.60 |
$450.72
|
|
Injection during cath supravalvular aortography
|
$2,247.20 |
$2,247.20 |
$2,247.20 |
$952.66
|
|
Injection epidural blood patch or clot
|
$1,072.80 |
$1,072.80 |
$1,072.80 |
$1,156.80
|
|
Injection eye drug
|
$1,643.60 |
$1,643.60 |
$1,643.60 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$306.80 |
$306.80 |
$306.80 |
$428.40
|
|
Injection for bladder x-ray
|
$430.00 |
$430.00 |
$430.00 |
$459.20
|
|
Injection for hip x-ray
|
$1,824.80 |
$1,824.80 |
$1,824.80 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$336.00 |
$336.00 |
$336.00 |
$494.65
|
|
Injection for tear sac x-ray
|
$225.20 |
$225.20 |
$225.20 |
$225.20
|
|
Injection for ureter x-ray
|
$141.60 |
$141.60 |
$141.60 |
$427.70
|
|
Injection for ureter x-ray
|
$261.20 |
$261.20 |
$261.20 |
$515.21
|
|
Injection into brain canal
|
$1,319.20 |
$1,319.20 |
$1,319.20 |
$836.40
|
|
Injection jugular
|
$169.20 |
$169.20 |
$169.20 |
$790.00
|
|
Injection of sinus tract
|
$2,261.60 |
$2,261.60 |
$2,261.60 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$11.02 |
$11.02 |
$11.02 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$231.20 |
$231.20 |
$231.20 |
$670.64
|
|
Injection, renflexis
|
$96.59 |
$96.59 |
$96.59 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,231.60 |
$1,231.60 |
$1,231.60 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,119.60 |
$2,119.60 |
$2,119.60 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$712.40 |
$712.40 |
$712.40 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,038.00 |
$2,038.00 |
$2,038.00 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$712.40 |
$712.40 |
$712.40 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$896.80 |
$896.80 |
$896.80 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,879.20 |
$1,879.20 |
$1,879.20 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,874.80 |
$1,874.80 |
$1,874.80 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$868.00 |
$868.00 |
$868.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$678.40 |
$678.40 |
$678.40 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$545.60 |
$545.60 |
$545.60 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$109.60 |
$109.60 |
$109.60 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$127.60 |
$127.60 |
$127.60 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$527.60 |
$527.60 |
$527.60 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$162.40 |
$162.40 |
$162.40 |
$135.60
|
|
Injection treatment of nerve
|
$6,866.40 |
$6,866.40 |
$6,866.40 |
$3,219.20
|
|
Injection treatment of nerve
|
$6,866.40 |
$6,866.40 |
$6,866.40 |
$4,350.00
|
|
Inject sacroiliac joint
|
$2,087.20 |
$2,087.20 |
$2,087.20 |
$1,028.95
|