|
Incision of hip tendon
|
$2,365.00 |
$2,365.00 |
$2,365.00 |
$3,460.88
|
|
Incision of tendon & muscle
|
$3,770.00 |
$3,770.00 |
$3,770.00 |
$5,624.45
|
|
Incision of thigh tendon
|
$2,365.00 |
$2,365.00 |
$2,365.00 |
$4,491.50
|
|
Incision of thigh tendons
|
$3,785.00 |
$3,785.00 |
$3,785.00 |
$4,844.84
|
|
Incision of urethra
|
$6,256.80 |
$6,256.80 |
$6,256.80 |
$2,899.60
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$48.71 |
$48.71 |
$48.71 |
$766.66
|
|
Infect ag drug suscept pheno predict
|
$143.22 |
$143.22 |
$320.00 |
$323.20
|
|
Infect ag eia influenza a or b ea
|
$71.94 |
$71.94 |
$71.94 |
$71.50
|
|
Infect ag genotype na hiv-1 other region
|
$475.00 |
$475.00 |
$475.00 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$86.46 |
$86.46 |
$715.00 |
$603.75
|
|
Infect ag ia direct hiv-1 antgn
|
$75.00 |
$75.00 |
$75.00 |
$91.70
|
|
Infect ag ia optc obs influenza
|
$85.00 |
$85.14 |
$85.14 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$75.24 |
$75.24 |
$75.24 |
$62.80
|
|
Infect ag if influenza a
|
$96.36 |
$96.36 |
$96.36 |
$41.30
|
|
Infect ag if influenza b
|
$96.36 |
$96.36 |
$96.36 |
$40.08
|
|
Infect ag if legionella pneumophila
|
$59.40 |
$59.40 |
$59.40 |
$72.58
|
|
Infect ag if pneumocystis carinii
|
$99.00 |
$99.00 |
$137.50 |
$66.00
|
|
Infect ag if varicella zoster
|
$96.36 |
$96.36 |
$96.36 |
$70.70
|
|
Infect ag na hep b amp
|
$180.00 |
$180.00 |
$180.00 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$178.86 |
$178.86 |
$178.86 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$137.50 |
$138.60 |
$138.60 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$227.50 |
$227.50 |
$227.50 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$87.12 |
$87.12 |
$147.50 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$715.00 |
$911.46 |
$911.46 |
$835.80
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,135.00 |
$1,135.00 |
$1,135.00 |
$943.80
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$85.00 |
$85.00 |
$85.00 |
$75.63
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$47.50 |
$47.50 |
$47.50 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$62.50 |
$96.36 |
$96.36 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$96.36 |
$96.36 |
$96.36 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$40.00 |
$42.90 |
$42.90 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$59.40 |
$59.40 |
$59.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$118.14 |
$118.14 |
$125.00 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$68.64 |
$68.64 |
$85.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$60.00 |
$68.64 |
$68.64 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$99.00 |
$99.00 |
$100.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$115.00 |
$316.80 |
$316.80 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$68.64 |
$68.64 |
$72.50 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$57.50 |
$57.50 |
$57.50 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$495.00 |
$495.00 |
$540.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$112.50 |
$217.14 |
$217.14 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$115.00 |
$237.60 |
$237.60 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$860.00 |
$1,684.32 |
$1,684.32 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$145.00 |
$158.40 |
$158.40 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$97.50 |
$199.32 |
$199.32 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$198.00 |
$198.00 |
$250.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$105.00 |
$237.60 |
$237.60 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$87.50 |
$126.06 |
$126.06 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$155.00 |
$317.46 |
$317.46 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$165.00 |
$363.00 |
$363.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$92.50 |
$219.12 |
$219.12 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$117.50 |
$150.48 |
$150.48 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$117.50 |
$117.50 |
$198.00 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$530.00 |
$833.58 |
$833.58 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$252.50 |
$388.08 |
$388.08 |
$286.06
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$535.26 |
$535.26 |
$535.26 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$287.76 |
$287.76 |
$337.50 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$180.00 |
$327.36 |
$327.36 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$195.00 |
$287.76 |
$287.76 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$287.76 |
$287.76 |
$375.00 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$220.00 |
$425.70 |
$425.70 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$102.10 |
$102.10 |
$226.60 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$97.02 |
$97.02 |
$105.35 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$102.39 |
$102.39 |
$183.62 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$140.00 |
$234.96 |
$234.96 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$250.00 |
$428.34 |
$428.34 |
$576.00
|
|
Inj, acetaminophen (b braun)
|
$0.40 |
$0.40 |
$0.40 |
$33.31
|
|
Inj acetaminophen -fresenius
|
$0.47 |
$0.47 |
$0.47 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$0.59 |
$0.59 |
$0.59 |
$58.50
|
|
Inj anifrolumab-fnia 1mg
|
$35.19 |
$35.19 |
$35.19 |
$9,878.82
|
|
Inj, aspara, rylaze, 0.1 mg
|
$100.10 |
$100.10 |
$100.10 |
$10,458.00
|
|
Inj atezolizumb 5mg hya-tqjs
|
$58.24 |
$58.24 |
$58.24 |
$18,716.52
|
|
Inj aval alfa-nqpt 4mg
|
$151.15 |
$151.15 |
$151.15 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$486.24 |
$486.24 |
$486.24 |
$11,239.97
|
|
Inj, bupivacaine liposome
|
$2.92 |
$7.30 |
$7.30 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$7.13 |
$7.13 |
$7.13 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$5.39 |
$5.39 |
$5.39 |
$18.05
|
|
Inj. cefepime hcl (baxter)
|
$56.96 |
$56.96 |
$56.96 |
$86.84
|
|
Inj, cefiderocol, 10 mg
|
$6.27 |
$6.27 |
$6.27 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$28.66 |
$28.66 |
$364.86 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$460.00 |
$583.44 |
$583.44 |
$436.80
|
|
Inj, cyclophosphamd, sandoz
|
$9.67 |
$9.67 |
$9.67 |
$735.20
|
|
Inj disk cerv-thor ea lev
|
$1,087.68 |
$1,087.68 |
$1,230.00 |
$875.28
|
|
Inj dx for sinogram
|
$380.00 |
$413.82 |
$413.82 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$460.00 |
$611.16 |
$611.16 |
$495.84
|
|
Injection, cangrelor
|
$49.96 |
$49.96 |
$49.96 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$815.00 |
$815.00 |
$815.00 |
$450.72
|
|
Injection, daratumumab 10 mg
|
$163.49 |
$163.49 |
$238.55 |
$5,239.24
|
|
Injection during cath supravalvular aortography
|
$696.96 |
$696.96 |
$696.96 |
$952.66
|
|
Injection epidural blood patch or clot
|
$1,000.00 |
$1,087.02 |
$1,087.02 |
$1,156.80
|
|
Injection eye drug
|
$555.00 |
$555.00 |
$555.00 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$460.00 |
$611.16 |
$611.16 |
$428.40
|
|
Injection for bladder x-ray
|
$380.00 |
$557.04 |
$557.04 |
$459.20
|
|
Injection for hip x-ray
|
$611.16 |
$611.16 |
$611.16 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$460.00 |
$611.16 |
$611.16 |
$494.65
|
|
Injection for tear sac x-ray
|
$275.00 |
$275.00 |
$609.18 |
$225.20
|
|
Injection for ureter x-ray
|
$1,615.00 |
$1,615.00 |
$1,615.00 |
$427.70
|
|
Injection for ureter x-ray
|
$568.92 |
$568.92 |
$640.00 |
$515.21
|
|
Injection, fulvestrant
|
$14.27 |
$14.27 |
$29.70 |
$1,817.65
|
|
Injection, glucarpidase
|
$838.89 |
$838.89 |
$838.89 |
$74,113.20
|