|
Implant power module patient cable cable 14 volt
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$3,380.00
|
|
Implant ureth bulk agent
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$2,168.00
|
|
Impl neurostim electr perc
|
$3,973.60 |
$3,973.60 |
$3,973.60 |
$7,672.50
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$5,407.20 |
$5,407.20 |
$5,407.20 |
$1,072.00
|
|
Imuglucerase injection
|
$59.30 |
$59.30 |
$59.30 |
$3,399.59
|
|
In-111 capromab pendet
|
$3,727.60 |
$3,727.60 |
$3,727.60 |
$3,141.45
|
|
In-111 oxyquinolin per 0.5 mci
|
$2,546.80 |
$2,546.80 |
$2,546.80 |
$2,581.82
|
|
In-111 pentetate dtpa / 0.5 mci
|
$3,723.46 |
$3,723.46 |
$3,723.46 |
$2,598.17
|
|
In-111 pentetreotide
|
$2,298.80 |
$2,298.80 |
$2,298.80 |
$5,201.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,787.60 |
$1,787.60 |
$1,787.60 |
$2,056.93
|
|
Incision of toe tendons 28011
|
$1,768.80 |
$1,768.80 |
$1,768.80 |
$2,119.12
|
|
Incisn of toe tndn
|
$1,768.80 |
$1,768.80 |
$1,768.80 |
$2,627.96
|
|
Incobotulinumtoxin a
|
$9.74 |
$9.74 |
$9.74 |
$1,339.57
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$156.40 |
$156.40 |
$156.40 |
$137.15
|
|
Infect ag drug suscept pheno predict
|
$87.60 |
$87.60 |
$87.60 |
$323.20
|
|
Infect ag eia influenza a or b ea
|
$48.00 |
$48.00 |
$48.00 |
$71.50
|
|
Infect ag genotype na dna hepatitis b
|
$299.60 |
$299.60 |
$299.60 |
$405.30
|
|
Infect ag ia optc obs influenza
|
$43.60 |
$43.60 |
$43.60 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$35.60 |
$35.60 |
$35.60 |
$72.58
|
|
Infect ag if nos ea
|
$27.60 |
$27.60 |
$27.60 |
$74.88
|
|
Infect ag if varicella zoster
|
$22.00 |
$22.00 |
$22.00 |
$70.70
|
|
Infect ag na herpes simplex quant
|
$68.40 |
$68.40 |
$68.40 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$42.00 |
$42.00 |
$42.00 |
$139.75
|
|
Infect ag na orthopoxvirus amp prb each
|
$82.40 |
$82.40 |
$82.40 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$447.60 |
$447.60 |
$447.60 |
$835.80
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$70.40 |
$70.40 |
$70.40 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$42.80 |
$42.80 |
$42.80 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$52.00 |
$52.00 |
$52.00 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$50.00 |
$50.00 |
$50.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$45.20 |
$45.20 |
$45.20 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$46.00 |
$46.00 |
$46.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$19.60 |
$19.60 |
$19.60 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$46.00 |
$46.00 |
$46.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$42.40 |
$42.40 |
$42.40 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$23.60 |
$23.60 |
$23.60 |
$98.02
|
|
Infectious agent nucleic acid amplified probe
|
$164.80 |
$164.80 |
$164.80 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$40.00 |
$40.00 |
$40.00 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$67.20 |
$67.20 |
$67.20 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$575.60 |
$575.60 |
$575.60 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$84.00 |
$84.00 |
$84.00 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$84.00 |
$84.00 |
$84.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$106.00 |
$106.00 |
$106.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$78.80 |
$78.80 |
$78.80 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$120.80 |
$120.80 |
$120.80 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$139.20 |
$139.20 |
$139.20 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$107.60 |
$107.60 |
$107.60 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$56.00 |
$56.00 |
$56.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$60.80 |
$60.80 |
$60.80 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$118.80 |
$118.80 |
$118.80 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$170.80 |
$170.80 |
$170.80 |
$185.00
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$752.80 |
$752.80 |
$752.80 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$442.80 |
$442.80 |
$442.80 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$287.60 |
$287.60 |
$287.60 |
$286.06
|
|
Infectious agent nucleic acid quantification bk virus
|
$80.80 |
$80.80 |
$80.80 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$228.40 |
$228.40 |
$228.40 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$160.00 |
$160.00 |
$160.00 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$65.20 |
$65.20 |
$65.20 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$228.40 |
$228.40 |
$228.40 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$221.42 |
$221.42 |
$221.42 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$72.48 |
$72.48 |
$72.48 |
$1,537.84
|
|
Initiation & management bipap/cpap initial day
|
$714.00 |
$714.00 |
$714.00 |
$576.00
|
|
Inj acetaminophen -fresenius
|
$0.56 |
$0.56 |
$0.56 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$0.48 |
$0.48 |
$0.48 |
$58.50
|
|
Inj anifrolumab-fnia 1mg
|
$29.33 |
$29.33 |
$29.33 |
$9,878.82
|
|
Inj aval alfa-nqpt 4mg
|
$30.68 |
$30.68 |
$30.68 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$337.29 |
$337.29 |
$337.29 |
$11,239.97
|
|
Inj, bupivacaine liposome
|
$4.54 |
$4.54 |
$4.54 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$7.22 |
$7.22 |
$7.22 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$4.20 |
$4.20 |
$4.20 |
$18.05
|
|
Inj ceftolozane tazobactam
|
$14.11 |
$14.11 |
$14.11 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$263.60 |
$263.60 |
$263.60 |
$436.80
|
|
Inj cyclophosphamd auromedic
|
$7.47 |
$7.47 |
$7.47 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$6.77 |
$6.77 |
$6.77 |
$742.72
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$806.40 |
$806.40 |
$806.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$544.80 |
$544.80 |
$544.80 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$331.60 |
$331.60 |
$331.60 |
$450.72
|
|
Injection during cath supravalvular aortography
|
$40.00 |
$40.00 |
$40.00 |
$952.66
|
|
Injection epidural blood patch or clot
|
$806.40 |
$806.40 |
$806.40 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$636.00 |
$636.00 |
$636.00 |
$428.40
|
|
Injection for bladder x-ray
|
$409.60 |
$409.60 |
$409.60 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$741.20 |
$741.20 |
$741.20 |
$494.65
|
|
Injection for ureter x-ray
|
$769.20 |
$769.20 |
$769.20 |
$427.70
|
|
Injection, fulvestrant
|
$20.26 |
$20.26 |
$20.26 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$21.07 |
$21.07 |
$21.07 |
$6,679.35
|
|
Injection jugular
|
$5,948.40 |
$5,948.40 |
$5,948.40 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$13.42 |
$13.42 |
$13.42 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$231.60 |
$231.60 |
$231.60 |
$670.64
|
|
Injection, renflexis
|
$139.75 |
$139.75 |
$139.75 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$806.40 |
$806.40 |
$806.40 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$806.40 |
$806.40 |
$806.40 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,044.80 |
$1,044.80 |
$1,044.80 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,008.40 |
$1,008.40 |
$1,008.40 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,050.40 |
$1,050.40 |
$1,050.40 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,040.00 |
$1,040.00 |
$1,040.00 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,050.40 |
$1,050.40 |
$1,050.40 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$806.40 |
$806.40 |
$806.40 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$806.40 |
$806.40 |
$806.40 |
$1,681.24
|
|
Injection, siltuximab
|
$275.08 |
$275.08 |
$275.08 |
$10,680.75
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$331.60 |
$331.60 |
$331.60 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$400.80 |
$400.80 |
$400.80 |
$548.80
|