|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$37.00 |
$37.00 |
$37.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$508.50 |
$508.50 |
$508.50 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$80.00 |
$80.00 |
$80.00 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$43.00 |
$43.00 |
$43.00 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$442.00 |
$442.00 |
$442.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$40.00 |
$40.00 |
$40.00 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$178.00 |
$178.00 |
$178.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$232.00 |
$232.00 |
$232.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$80.00 |
$80.00 |
$80.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$65.00 |
$65.00 |
$65.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$100.00 |
$100.00 |
$100.00 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$278.50 |
$278.50 |
$278.50 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$101.00 |
$101.00 |
$101.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$82.00 |
$82.00 |
$82.00 |
$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
|
$533.50 |
$533.50 |
$533.50 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$367.00 |
$367.00 |
$367.00 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$292.00 |
$292.00 |
$292.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$113.00 |
$113.00 |
$113.00 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$120.00 |
$120.00 |
$120.00 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$107.50 |
$107.50 |
$107.50 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$283.00 |
$283.00 |
$283.00 |
$303.59
|
|
Infliximab-axxq 100 mg intravenous solution
|
$6,284.25 |
$6,284.25 |
$6,284.25 |
$1,062.00
|
|
Influenza virus vaccine, live trivalent intranasal
|
$24.50 |
$24.50 |
$24.50 |
$36.50
|
|
Inf thrc fascial pln blk bi w/wo image
|
$320.00 |
$320.00 |
$320.00 |
$593.50
|
|
Inf thrc fascial pln blk uni w/wo image
|
$187.50 |
$187.50 |
$187.50 |
$780.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$401.50 |
$401.50 |
$401.50 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$202.50 |
$202.50 |
$202.50 |
$576.00
|
|
Init pm e/m new pat 65+ yrs
|
$128.00 |
$128.00 |
$128.00 |
$185.90
|
|
Init/sub psych care m 1st 30
|
$105.00 |
$105.00 |
$105.00 |
$94.34
|
|
Inj, abilify asimtufii, 1 mg
|
$12.50 |
$12.50 |
$12.50 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$14.50 |
$14.50 |
$14.50 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$10.80 |
$10.80 |
$10.80 |
$33.31
|
|
Inj acetaminophen -fresenius
|
$8.78 |
$8.78 |
$8.78 |
$36.60
|
|
Inj, adstiladrin, per tx dos
|
$80,745.00 |
$80,745.00 |
$80,745.00 |
$63,354.77
|
|
Inj, aflibercept hd, 1 mg
|
$768.50 |
$768.50 |
$768.50 |
$2,794.18
|
|
Inj anifrolumab-fnia 1mg
|
$41.00 |
$41.00 |
$41.00 |
$9,878.82
|
|
Inj avacincaptad pegol 0.1mg
|
$236.50 |
$236.50 |
$236.50 |
$3,409.64
|
|
Inj., benralizumab, 1 mg
|
$439.00 |
$439.00 |
$439.00 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$103.00 |
$103.00 |
$103.00 |
$7,612.43
|
|
Inj bimatoprost itc imp1mcg
|
$456.00 |
$456.00 |
$456.00 |
$3,287.96
|
|
Inj, bupivacaine liposome
|
$807.35 |
$807.35 |
$807.35 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$21.27 |
$21.27 |
$21.27 |
$28.08
|
|
Inj ceftolozane tazobactam
|
$18.50 |
$18.50 |
$18.50 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$740.00 |
$740.00 |
$740.00 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$301.50 |
$301.50 |
$301.50 |
$875.28
|
|
Inj, durolane 1 mg
|
$4,500.00 |
$4,500.00 |
$4,500.00 |
$1,950.93
|
|
Inj dx for sinogram
|
$226.00 |
$226.00 |
$226.00 |
$422.59
|
|
Inject for sacroiliac joint
|
$1,216.50 |
$1,216.50 |
$1,216.50 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,431.50 |
$1,431.50 |
$1,431.50 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$759.00 |
$759.00 |
$759.00 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$635.00 |
$635.00 |
$635.00 |
$450.72
|
|
Injection, casimersen, 10 mg
|
$271.50 |
$271.50 |
$271.50 |
$2,598.44
|
|
Injection during cath supravalvular aortography
|
$2,753.50 |
$2,753.50 |
$2,753.50 |
$952.66
|
|
Injection epidural blood patch or clot
|
$811.50 |
$811.50 |
$811.50 |
$1,156.80
|
|
Injection eye drug
|
$641.00 |
$641.00 |
$641.00 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$496.50 |
$496.50 |
$496.50 |
$428.40
|
|
Injection for bladder x-ray
|
$286.00 |
$286.00 |
$286.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,448.00 |
$1,448.00 |
$1,448.00 |
$494.65
|
|
Injection for ureter x-ray
|
$437.00 |
$437.00 |
$437.00 |
$515.21
|
|
Injection, fulvestrant
|
$416.25 |
$416.25 |
$416.25 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$7,608.20 |
$7,608.20 |
$7,608.20 |
$6,679.35
|
|
Injection into brain canal
|
$592.00 |
$592.00 |
$592.00 |
$836.40
|
|
Injection of sinus tract
|
$2,766.00 |
$2,766.00 |
$2,766.00 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$1,292.00 |
$1,292.00 |
$1,292.00 |
$2,277.65
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$9,659.75 |
$9,659.75 |
$9,659.75 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,298.50 |
$1,298.50 |
$1,298.50 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,850.00 |
$2,850.00 |
$2,850.00 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,774.00 |
$1,774.00 |
$1,774.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,909.50 |
$1,909.50 |
$1,909.50 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$3,399.00 |
$3,399.00 |
$3,399.00 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$12,292.00 |
$12,292.00 |
$12,292.00 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,899.00 |
$2,899.00 |
$2,899.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,636.50 |
$1,636.50 |
$1,636.50 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$814.00 |
$814.00 |
$814.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$6,453.50 |
$6,453.50 |
$6,453.50 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$3,039.50 |
$3,039.50 |
$3,039.50 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$252.00 |
$252.00 |
$252.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$225.00 |
$225.00 |
$225.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$533.50 |
$533.50 |
$533.50 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$441.00 |
$441.00 |
$441.00 |
$135.60
|
|
Injection treatment of eye
|
$4,082.00 |
$4,082.00 |
$4,082.00 |
$2,665.60
|
|
Injection treatment of nerve
|
$3,398.00 |
$3,398.00 |
$3,398.00 |
$3,219.20
|
|
Injection treatment of nerve
|
$1,860.50 |
$1,860.50 |
$1,860.50 |
$2,025.45
|
|
Inject sacroiliac joint
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$1,028.95
|
|
Inject/treat eye socket
|
$375.00 |
$375.00 |
$375.00 |
$381.13
|
|
Inject/treat eye socket
|
$500.50 |
$500.50 |
$500.50 |
$670.02
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$73.50 |
$73.50 |
$73.50 |
$32,176.93
|
|
Inj epidural sgl lumb-sacral without img
|
$1,231.50 |
$1,231.50 |
$1,231.50 |
$1,415.50
|
|
Inj., eravacycline, 1 mg
|
$3.50 |
$3.50 |
$3.50 |
$206.64
|
|
Inj, faricimab-svoa, 0.1mg
|
$88.50 |
$88.50 |
$88.50 |
$4,103.29
|
|
Inj. fe derisomaltose 10 mg
|
$6,564.20 |
$6,564.20 |
$6,564.20 |
$3,221.52
|
|
Inj for ext venography
|
$773.50 |
$773.50 |
$773.50 |
$649.95
|
|
Inj intralesional <= 7 lsn(s)
|
$400.50 |
$400.50 |
$400.50 |
$235.13
|
|
Inj, invega hafyera/trinza
|
$28.50 |
$28.50 |
$28.50 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$11,680.00 |
$11,680.00 |
$11,680.00 |
$6,967.29
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$936.50 |
$936.50 |
$936.50 |
$784.00
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$118.50 |
$118.50 |
$118.50 |
$1,496.55
|
|
Inj naloxone hydrochloride
|
$63.44 |
$63.44 |
$63.44 |
$83.16
|
