|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$15,268.20 |
$15,268.20 |
$15,268.20 |
$6,106.32
|
|
Immunoassay tumor antigen quantitative ca 125
|
$658.80 |
$658.80 |
$658.80 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$188.40 |
$188.40 |
$188.40 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$20.40 |
$20.40 |
$20.40 |
$48.50
|
|
Immunofixation electrophoresis serum
|
$349.20 |
$349.20 |
$349.20 |
$138.60
|
|
Implant cartilage 10mm synthetic
|
$3,408.05 |
$3,408.05 |
$3,408.05 |
$10,050.00
|
|
Implant cochlear device
|
$3,061.80 |
$3,061.80 |
$3,061.80 |
$34,229.98
|
|
Implant cochlear osia osi300
|
$6,703.20 |
$6,703.20 |
$6,703.20 |
$17,423.06
|
|
Impl oi implt skull perq esp
|
$2,092.80 |
$2,092.80 |
$2,092.80 |
$10,629.07
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,052.60 |
$2,052.60 |
$2,052.60 |
$2,080.80
|
|
Incision of eardrum
|
$160.20 |
$160.20 |
$160.20 |
$553.02
|
|
Incision of eardrum
|
$972.00 |
$972.00 |
$972.00 |
$3,827.50
|
|
Incision of tongue fold
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$1,792.50
|
|
Incision of windpipe
|
$1,137.00 |
$1,137.00 |
$1,137.00 |
$5,855.00
|
|
Incisn windpipe
|
$709.80 |
$709.80 |
$709.80 |
$3,819.23
|
|
Infect ag drug suscept pheno predict
|
$319.80 |
$319.80 |
$319.80 |
$320.00
|
|
Infect ag genotype na dna hepatitis b
|
$1,039.80 |
$1,039.80 |
$1,039.80 |
$427.43
|
|
Infect ag genotype na hiv-1 other region
|
$943.20 |
$943.20 |
$943.20 |
$326.20
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$954.60 |
$954.60 |
$954.60 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$52.80 |
$52.80 |
$52.80 |
$72.93
|
|
Infect ag if pneumocystis carinii
|
$45.60 |
$45.60 |
$45.60 |
$67.46
|
|
Infect ag na hpv high-risk types
|
$77.40 |
$77.40 |
$77.40 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$154.80 |
$154.80 |
$154.80 |
$219.70
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$17.40 |
$17.40 |
$17.40 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$52.80 |
$52.80 |
$52.80 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$205.20 |
$205.20 |
$205.20 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$243.00 |
$243.00 |
$243.00 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$255.00 |
$255.00 |
$255.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$415.80 |
$415.80 |
$415.80 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$45.60 |
$45.60 |
$45.60 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$20.40 |
$20.40 |
$20.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$306.00 |
$306.00 |
$306.00 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$60.00 |
$60.00 |
$60.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$85.20 |
$85.20 |
$85.20 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$984.60 |
$984.60 |
$984.60 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$261.00 |
$261.00 |
$261.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$91.20 |
$91.20 |
$91.20 |
$151.25
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$60.00 |
$60.00 |
$60.00 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$146.40 |
$146.40 |
$146.40 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$63.00 |
$63.00 |
$63.00 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$60.00 |
$60.00 |
$60.00 |
$105.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$279.00 |
$279.00 |
$279.00 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$239.40 |
$239.40 |
$239.40 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$484.20 |
$484.20 |
$484.20 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$208.20 |
$208.20 |
$208.20 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$703.80 |
$703.80 |
$703.80 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$262.80 |
$262.80 |
$262.80 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$3,894.60 |
$3,894.60 |
$3,894.60 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,819.80 |
$1,819.80 |
$1,819.80 |
$1,095.60
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$3,155.40 |
$3,155.40 |
$3,155.40 |
$1,617.43
|
|
Influenza dna amp prob addl
|
$115.20 |
$115.20 |
$115.20 |
$64.26
|
|
Initial nursing facility care/day 35 minutes
|
$136.80 |
$136.80 |
$136.80 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$173.40 |
$173.40 |
$173.40 |
$236.80
|
|
Initiation & management bipap/cpap initial day
|
$433.20 |
$433.20 |
$433.20 |
$576.00
|
|
Init pm e/m new pat 65+ yrs
|
$141.00 |
$141.00 |
$141.00 |
$180.77
|
|
Inj, abilify maintena, 1 mg
|
$6,259.20 |
$6,259.20 |
$6,259.20 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$24.60 |
$24.60 |
$24.60 |
$32.79
|
|
Inj andexxa, 10 mg
|
$20,193.00 |
$20,193.00 |
$20,193.00 |
$4,370.80
|
|
Inj., benralizumab, 1 mg
|
$16,081.80 |
$16,081.80 |
$16,081.80 |
$11,604.71
|
|
Inj, bezlotoxumab, 10 mg
|
$14,655.60 |
$14,655.60 |
$14,655.60 |
$7,612.43
|
|
Inj ceftolozane tazobactam
|
$695.70 |
$695.70 |
$695.70 |
$408.00
|
|
Inj, clindamycin (baxter)
|
$43.20 |
$43.20 |
$43.20 |
$48.39
|
|
Inj, durolane 1 mg
|
$54.35 |
$54.35 |
$54.35 |
$1,950.93
|
|
Injection carpal tunnel therapeutic (both sides)
|
$60.00 |
$60.00 |
$60.00 |
$504.90
|
|
Injection, daratumumab 10 mg
|
$6,799.80 |
$6,799.80 |
$6,799.80 |
$5,164.24
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$539.40 |
$539.40 |
$539.40 |
$494.65
|
|
Injection, fulvestrant
|
$627.00 |
$627.00 |
$627.00 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$12,534.00 |
$12,534.00 |
$12,534.00 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$22.80 |
$22.80 |
$22.80 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$660.60 |
$660.60 |
$660.60 |
$683.28
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$483.00 |
$483.00 |
$483.00 |
$1,045.65
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$67.80 |
$67.80 |
$67.80 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$65.40 |
$65.40 |
$65.40 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$35.40 |
$35.40 |
$35.40 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$91.80 |
$91.80 |
$91.80 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$91.80 |
$91.80 |
$91.80 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$258.60 |
$258.60 |
$258.60 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$95.40 |
$95.40 |
$95.40 |
$135.20
|
|
Injection treatment of nose
|
$68.40 |
$68.40 |
$68.40 |
$859.59
|
|
Inj for ext venography
|
$1,891.80 |
$1,891.80 |
$1,891.80 |
$654.00
|
|
Inj heparin, pfizer, 1000u
|
$48.00 |
$48.00 |
$48.00 |
$24.28
|
|
Inj intralesional <= 7 lsn(s)
|
$28.80 |
$28.80 |
$28.80 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$18,537.60 |
$18,537.60 |
$18,537.60 |
$6,967.29
|
|
Inj, ixinity, 1 i.u
|
$23,035.20 |
$23,035.20 |
$23,035.20 |
$6.99
|
|
Inj, lidocaine w epinephrine
|
$37.20 |
$37.20 |
$37.20 |
$44.96
|
|
Inj., meropenem, vaborbactam
|
$575.40 |
$575.40 |
$575.40 |
$536.27
|
|
Inj, panzyga, 500 mg
|
$14,068.20 |
$14,068.20 |
$14,068.20 |
$8,041.38
|
|
Inj., perseris, 0.5 mg
|
$10,179.60 |
$10,179.60 |
$10,179.60 |
$5,372.48
|
|
Inj tedizolid phosphate
|
$21.90 |
$21.90 |
$21.90 |
$664.72
|
|
Inj, uzedy, 1 mg
|
$12,780.90 |
$12,780.90 |
$12,780.90 |
$11,475.96
|
|
Inj vancomycin (xellia) 10mg
|
$114.60 |
$114.60 |
$114.60 |
$79.21
|
|
Inj w/fluor eval cv device
|
$178.80 |
$178.80 |
$178.80 |
$463.40
|
|
Ins cath ren art 1st bi
|
$5,231.40 |
$5,231.40 |
$5,231.40 |
$5,741.00
|
|
Ins cath ren art 1st uni
|
$5,231.40 |
$5,231.40 |
$5,231.40 |
$4,692.00
|
|
Insert cath pleura with image
|
$956.40 |
$956.40 |
$956.40 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,974.00 |
$1,974.00 |
$1,974.00 |
$2,019.00
|
|
Insert intrauterine device iud
|
$151.20 |
$151.20 |
$151.20 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$223.20 |
$223.20 |
$223.20 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$223.20 |
$223.20 |
$223.20 |
$229.32
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,247.00 |
$2,247.00 |
$2,247.00 |
$2,529.45
|
