|
Immobilizer shldr cntor adlt
|
$115.50 |
$115.50 |
$115.50 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$141.90 |
$141.90 |
$141.90 |
$114.60
|
|
Immune complex assay
|
$166.32 |
$166.32 |
$166.32 |
$100.80
|
|
Immunoassay tumor antigen quantitative ca 125
|
$151.80 |
$151.80 |
$151.80 |
$131.95
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$139.92 |
$139.92 |
$139.92 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$116.82 |
$116.82 |
$116.82 |
$48.38
|
|
Immunofixation electrophoresis serum
|
$207.90 |
$207.90 |
$207.90 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$188.76 |
$188.76 |
$188.76 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$172.26 |
$172.26 |
$172.26 |
$231.40
|
|
Immunoglobulin assay
|
$89.10 |
$89.10 |
$89.10 |
$75.88
|
|
Immunology procedure
|
$55.44 |
$55.44 |
$55.44 |
$142.56
|
|
Implant ureth bulk agent
|
$1,442.10 |
$1,442.10 |
$1,442.10 |
$2,168.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,046.00 |
$2,046.00 |
$2,046.00 |
$2,056.93
|
|
Infect ag eia influenza a or b ea
|
$71.94 |
$71.94 |
$71.94 |
$71.50
|
|
Infect ag ia optc obs influenza
|
$88.44 |
$88.44 |
$88.44 |
$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 |
$99.00 |
$66.00
|
|
Infect ag if varicella zoster
|
$96.36 |
$96.36 |
$96.36 |
$70.70
|
|
Infect ag na herpes simplex quant
|
$178.86 |
$178.86 |
$178.86 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$138.60 |
$138.60 |
$138.60 |
$139.75
|
|
Infect ag na orthopoxvirus amp prb each
|
$87.12 |
$87.12 |
$87.12 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$911.46 |
$911.46 |
$911.46 |
$835.80
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$84.48 |
$84.48 |
$84.48 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$96.36 |
$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
|
$73.26 |
$73.26 |
$73.26 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$73.26 |
$73.26 |
$73.26 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$118.14 |
$118.14 |
$118.14 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$68.64 |
$68.64 |
$68.64 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$68.64 |
$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 |
$99.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$316.80 |
$316.80 |
$316.80 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$68.64 |
$68.64 |
$68.64 |
$98.02
|
|
Infectious agent nucleic acid amplified probe
|
$495.00 |
$495.00 |
$495.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$217.14 |
$217.14 |
$217.14 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$237.60 |
$237.60 |
$237.60 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,684.32 |
$1,684.32 |
$1,684.32 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$158.40 |
$158.40 |
$158.40 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$199.32 |
$199.32 |
$199.32 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$198.00 |
$198.00 |
$198.00 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$237.60 |
$237.60 |
$237.60 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$126.06 |
$126.06 |
$126.06 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$317.46 |
$317.46 |
$317.46 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$363.00 |
$363.00 |
$363.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$219.12 |
$219.12 |
$219.12 |
$92.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$388.08 |
$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 |
$287.76 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$327.36 |
$327.36 |
$327.36 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$287.76 |
$287.76 |
$287.76 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$287.76 |
$287.76 |
$287.76 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$425.70 |
$425.70 |
$425.70 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$226.60 |
$226.60 |
$226.60 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$183.62 |
$183.62 |
$183.62 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$234.96 |
$234.96 |
$234.96 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$428.34 |
$428.34 |
$428.34 |
$576.00
|
|
Inj, acetaminophen (hikma)
|
$0.59 |
$0.59 |
$0.59 |
$58.50
|
|
Inj, bupivacaine liposome
|
$7.30 |
$7.30 |
$7.30 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$7.13 |
$7.13 |
$7.13 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$8.09 |
$8.09 |
$8.09 |
$18.05
|
|
Inj ceftolozane tazobactam
|
$28.66 |
$28.66 |
$28.66 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$583.44 |
$583.44 |
$583.44 |
$436.80
|
|
Inj dx for sinogram
|
$413.82 |
$413.82 |
$413.82 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$611.16 |
$611.16 |
$611.16 |
$495.84
|
|
Injection epidural blood patch or clot
|
$1,087.02 |
$1,087.02 |
$1,087.02 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$611.16 |
$611.16 |
$611.16 |
$428.40
|
|
Injection for bladder x-ray
|
$557.04 |
$557.04 |
$557.04 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$611.16 |
$611.16 |
$611.16 |
$494.65
|
|
Injection,onabotulinumtoxina
|
$16.24 |
$16.24 |
$16.24 |
$2,277.65
|
|
Injection, renflexis
|
$146.19 |
$146.19 |
$146.19 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$739.86 |
$739.86 |
$739.86 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$799.92 |
$799.92 |
$799.92 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,779.36 |
$1,779.36 |
$1,779.36 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$395.34 |
$395.34 |
$395.34 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,273.70 |
$2,273.70 |
$2,273.70 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$454.74 |
$454.74 |
$454.74 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,281.62 |
$2,281.62 |
$2,281.62 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,878.36 |
$1,878.36 |
$1,878.36 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,704.78 |
$1,704.78 |
$1,704.78 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$341.22 |
$341.22 |
$341.22 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$355.08 |
$355.08 |
$355.08 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$143.88 |
$143.88 |
$143.88 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$143.88 |
$143.88 |
$143.88 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$205.92 |
$205.92 |
$205.92 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$105.60 |
$105.60 |
$105.60 |
$135.60
|
|
Inject sacroiliac joint
|
$1,318.02 |
$1,318.02 |
$1,318.02 |
$1,028.95
|
|
Inj epidural sgl cerv-thor without img
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$1,415.50
|
|
Inj heparin, pfizer, 1000u
|
$3.23 |
$3.23 |
$3.23 |
$26.26
|
|
Inj intralesional <= 7 lsn(s)
|
$229.68 |
$229.68 |
$229.68 |
$235.13
|
|
Inj labetalol hcl hikma, 5mg
|
$1.71 |
$1.71 |
$1.71 |
$38.94
|
|
Inj, lecanemab-irmb, 1 mg
|
$3.52 |
$3.52 |
$3.52 |
$1,174.88
|
|
Inj, levothyroxine, freskabi
|
$26.34 |
$26.34 |
$26.34 |
$303.45
|
|
Inj, levothyroxine, hikma
|
$36.50 |
$36.50 |
$36.50 |
$42.89
|
|
Inj, lidocaine w epinephrine
|
$1.62 |
$1.62 |
$1.62 |
$47.52
|
|
Inj mepivacaine hcl/10 ml
|
$30.13 |
$30.13 |
$30.13 |
$33.86
|