|
Incobotulinumtoxin a
|
$127.50 |
$127.50 |
$127.50 |
$1,339.57
|
|
Infect ag drug suscept pheno predict
|
$63.50 |
$63.50 |
$63.50 |
$323.20
|
|
Infect ag eia influenza a or b ea
|
$35.00 |
$35.00 |
$35.00 |
$71.50
|
|
Infect ag genotype na hiv-1 other region
|
$185.00 |
$185.00 |
$185.00 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$125.00 |
$125.00 |
$125.00 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$31.00 |
$31.00 |
$31.00 |
$72.93
|
|
Infect ag if varicella zoster
|
$77.00 |
$77.00 |
$77.00 |
$70.70
|
|
Infect ag na hpv high-risk types
|
$50.00 |
$50.00 |
$50.00 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$155.50 |
$155.50 |
$155.50 |
$219.70
|
|
Infect ag na resp virus 12-25 targets
|
$534.00 |
$534.00 |
$534.00 |
$835.80
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$67.00 |
$67.00 |
$67.00 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$124.50 |
$124.50 |
$124.50 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$72.00 |
$72.00 |
$72.00 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$59.00 |
$59.00 |
$59.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$32.50 |
$32.50 |
$32.50 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$133.50 |
$133.50 |
$133.50 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$30.00 |
$30.00 |
$30.00 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$68.00 |
$68.00 |
$68.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$98.00 |
$98.00 |
$98.00 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$56.00 |
$56.00 |
$56.00 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$24.00 |
$24.00 |
$24.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$617.00 |
$617.00 |
$617.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$97.50 |
$97.50 |
$97.50 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$151.50 |
$151.50 |
$151.50 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$622.50 |
$622.50 |
$622.50 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$163.50 |
$163.50 |
$163.50 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$65.50 |
$65.50 |
$65.50 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$174.00 |
$174.00 |
$174.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$97.50 |
$97.50 |
$97.50 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$71.50 |
$71.50 |
$71.50 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$393.00 |
$393.00 |
$393.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$132.50 |
$132.50 |
$132.50 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$158.50 |
$158.50 |
$158.50 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$293.00 |
$293.00 |
$293.00 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$744.50 |
$744.50 |
$744.50 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$689.50 |
$689.50 |
$689.50 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$190.00 |
$190.00 |
$190.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$161.50 |
$161.50 |
$161.50 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$336.50 |
$336.50 |
$336.50 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$139.50 |
$139.50 |
$139.50 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$370.00 |
$370.00 |
$370.00 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$6,758.34 |
$6,758.34 |
$6,758.34 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$5,586.00 |
$5,586.00 |
$5,586.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$4,984.65 |
$4,984.65 |
$4,984.65 |
$1,537.84
|
|
Influenza virus vaccine, live trivalent intranasal
|
$36.50 |
$36.50 |
$36.50 |
$36.50
|
|
Inf thrc fascial pln blk bi w/wo image
|
$266.50 |
$266.50 |
$266.50 |
$593.50
|
|
Inf thrc fascial pln blk uni w/wo image
|
$156.50 |
$156.50 |
$156.50 |
$780.00
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$368.00 |
$368.00 |
$368.00 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$144.00 |
$144.00 |
$144.00 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$185.00 |
$185.00 |
$185.00 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$82.50 |
$82.50 |
$82.50 |
$128.00
|
|
Initiation & management bipap/cpap initial day
|
$419.00 |
$419.00 |
$419.00 |
$576.00
|
|
Init pm e/m new pat 65+ yrs
|
$132.50 |
$132.50 |
$132.50 |
$185.90
|
|
Init/sub psych care m 1st 30
|
$38.50 |
$38.50 |
$38.50 |
$94.34
|
|
Inj, abilify asimtufii, 1 mg
|
$8.50 |
$8.50 |
$8.50 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$10.00 |
$10.00 |
$10.00 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$7.20 |
$7.20 |
$7.20 |
$33.31
|
|
Inj acetaminophen -fresenius
|
$5.85 |
$5.85 |
$5.85 |
$36.60
|
|
Inj, adstiladrin, per tx dos
|
$69,210.00 |
$69,210.00 |
$69,210.00 |
$63,354.77
|
|
Inj, aflibercept hd, 1 mg
|
$5,800.00 |
$5,800.00 |
$5,800.00 |
$2,794.18
|
|
Inj anifrolumab-fnia 1mg
|
$7,844.06 |
$7,844.06 |
$7,844.06 |
$9,878.82
|
|
Inj avacincaptad pegol 0.1mg
|
$157.50 |
$157.50 |
$157.50 |
$3,409.64
|
|
Inj., benralizumab, 1 mg
|
$7,761.96 |
$7,761.96 |
$7,761.96 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$68.50 |
$68.50 |
$68.50 |
$7,612.43
|
|
Inj bimatoprost itc imp1mcg
|
$304.00 |
$304.00 |
$304.00 |
$3,287.96
|
|
Inj, bupivacaine liposome
|
$740.89 |
$740.89 |
$740.89 |
$699.38
|
|
Inj, cefepime hcl (b braun)
|
$25.82 |
$25.82 |
$25.82 |
$69.85
|
|
Inj ceftolozane tazobactam
|
$12.50 |
$12.50 |
$12.50 |
$380.80
|
|
Inj disk cerv-thor ea lev
|
$238.50 |
$238.50 |
$238.50 |
$875.28
|
|
Inj dupuytren cord w/enzyme
|
$67.00 |
$67.00 |
$67.00 |
$416.00
|
|
Inj, durolane 1 mg
|
$1,445.72 |
$1,445.72 |
$1,445.72 |
$1,950.93
|
|
Inj dx for sinogram
|
$36.00 |
$36.00 |
$36.00 |
$422.59
|
|
Inject for sacroiliac joint
|
$805.00 |
$805.00 |
$805.00 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,590.50 |
$2,590.50 |
$2,590.50 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$393.00 |
$393.00 |
$393.00 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$57.50 |
$57.50 |
$57.50 |
$450.72
|
|
Injection, casimersen, 10 mg
|
$181.00 |
$181.00 |
$181.00 |
$2,598.44
|
|
Injection epidural blood patch or clot
|
$1,047.00 |
$1,047.00 |
$1,047.00 |
$1,156.80
|
|
Injection eye drug
|
$843.00 |
$843.00 |
$843.00 |
$644.50
|
|
Injection for bladder x-ray
|
$844.50 |
$844.50 |
$844.50 |
$459.20
|
|
Injection for hip x-ray
|
$81.50 |
$81.50 |
$81.50 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$48.50 |
$48.50 |
$48.50 |
$494.65
|
|
Injection, fulvestrant
|
$487.50 |
$487.50 |
$487.50 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$18.00 |
$18.00 |
$18.00 |
$6,679.35
|
|
Injection into hemorrhoid(s)
|
$208.00 |
$208.00 |
$208.00 |
$1,432.81
|
|
Injection jugular
|
$118.50 |
$118.50 |
$118.50 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$2,277.65
|
|
Injection px peyronie ds
|
$91.50 |
$91.50 |
$91.50 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$712.00 |
$712.00 |
$712.00 |
$670.64
|
|
Injection, renflexis
|
$3,993.72 |
$3,993.72 |
$3,993.72 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,022.50 |
$1,022.50 |
$1,022.50 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$4,368.00 |
$4,368.00 |
$4,368.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$4,928.00 |
$4,928.00 |
$4,928.00 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,491.50 |
$1,491.50 |
$1,491.50 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$507.00 |
$507.00 |
$507.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$402.50 |
$402.50 |
$402.50 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$805.00 |
$805.00 |
$805.00 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,394.00 |
$1,394.00 |
$1,394.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,025.34 |
$1,025.34 |
$1,025.34 |
$1,681.24
|
