|
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 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$112.50 |
$112.50 |
$217.14 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$115.00 |
$115.00 |
$237.60 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$860.00 |
$860.00 |
$1,684.32 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$145.00 |
$145.00 |
$158.40 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$97.50 |
$97.50 |
$199.32 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$198.00 |
$198.00 |
$250.00 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$105.00 |
$105.00 |
$237.60 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$87.50 |
$87.50 |
$126.06 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$155.00 |
$155.00 |
$317.46 |
$217.70
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$165.00 |
$165.00 |
$363.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$92.50 |
$92.50 |
$219.12 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$117.50 |
$117.50 |
$150.48 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$117.50 |
$117.50 |
$117.50 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$530.00 |
$530.00 |
$833.58 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$252.50 |
$252.50 |
$388.08 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$535.26 |
$535.26 |
$535.26 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$287.76 |
$287.76 |
$337.50 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$180.00 |
$180.00 |
$327.36 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$195.00 |
$195.00 |
$287.76 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$287.76 |
$287.76 |
$375.00 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$220.00 |
$220.00 |
$425.70 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$102.61 |
$102.61 |
$226.60 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$97.02 |
$97.02 |
$106.34 |
$1,095.60
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$103.50 |
$103.50 |
$183.62 |
$1,617.43
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$780.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$780.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$140.00 |
$140.00 |
$234.96 |
$293.04
|
|
Initiation & management bipap/cpap initial day
|
$370.00 |
$370.00 |
$428.34 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$14.15 |
$14.15 |
$14.15 |
$5,355.30
|
|
Inj acetaminophen -fresenius
|
$0.47 |
$0.47 |
$0.47 |
$38.87
|
|
Inj, acetaminophen (hikma)
|
$0.59 |
$0.59 |
$0.59 |
$68.30
|
|
Inj, bupivacaine liposome
|
$2.99 |
$2.99 |
$7.30 |
$699.38
|
|
Inj cefazolin sodium, baxter
|
$16.37 |
$16.37 |
$16.37 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$7.13 |
$7.13 |
$11.27 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$5.39 |
$5.39 |
$5.39 |
$18.30
|
|
Inj, clindamycin (baxter)
|
$36.19 |
$36.19 |
$36.19 |
$48.39
|
|
Inj cntr knee arthro incl ct/mri
|
$460.00 |
$460.00 |
$583.44 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$1,087.68 |
$1,087.68 |
$1,087.68 |
$945.00
|
|
Inj dx for sinogram
|
$380.00 |
$380.00 |
$413.82 |
$413.82
|
|
Inject for sacroiliac joint
|
$1,482.36 |
$1,482.36 |
$1,482.36 |
$1,101.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,060.00 |
$1,060.00 |
$1,370.82 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$460.00 |
$460.00 |
$611.16 |
$500.50
|
|
Injection during cath supravalvular aortography
|
$696.96 |
$696.96 |
$696.96 |
$904.17
|
|
Injection epidural blood patch or clot
|
$1,000.00 |
$1,000.00 |
$1,087.02 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$460.00 |
$460.00 |
$611.16 |
$441.12
|
|
Injection for bladder x-ray
|
$380.00 |
$380.00 |
$557.04 |
$459.20
|
|
Injection for hip x-ray
|
$611.16 |
$611.16 |
$611.16 |
$669.24
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$611.16 |
$611.16 |
$920.00 |
$494.65
|
|
Injection for spleen x-ray
|
$245.00 |
$245.00 |
$245.00 |
$423.41
|
|
Injection for ureter x-ray
|
$568.92 |
$568.92 |
$640.00 |
$515.21
|
|
Injection jaw joint x-ray
|
$541.20 |
$541.20 |
$541.20 |
$307.80
|
|
Injection jugular
|
$790.00 |
$790.00 |
$790.00 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$16.24 |
$16.24 |
$16.24 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$257.50 |
$257.50 |
$787.38 |
$683.28
|
|
Injection, renflexis
|
$93.32 |
$93.32 |
$93.32 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,679.70 |
$1,679.70 |
$1,679.70 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$739.86 |
$739.86 |
$1,195.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$515.00 |
$515.00 |
$799.92 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,779.36 |
$1,779.36 |
$1,779.36 |
$1,939.60
|
|
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 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$454.74 |
$454.74 |
$454.74 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,281.62 |
$2,281.62 |
$2,281.62 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,878.36 |
$1,878.36 |
$1,878.36 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,704.78 |
$1,704.78 |
$1,704.78 |
$1,704.78
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$341.22 |
$341.22 |
$341.22 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$355.08 |
$355.08 |
$895.00 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$395.34 |
$395.34 |
$1,120.00 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$115.00 |
$115.00 |
$143.88 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$115.00 |
$115.00 |
$143.88 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$115.00 |
$115.00 |
$205.92 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$55.00 |
$55.00 |
$105.60 |
$135.20
|
|
Injection treatment of nerve
|
$2,035.00 |
$2,035.00 |
$2,035.00 |
$3,754.40
|
|
Injection treatment of nerve
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$2,054.00
|
|
Inject sacroiliac joint
|
$1,318.02 |
$1,318.02 |
$2,250.00 |
$963.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$70.69 |
$70.69 |
$70.69 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$1,415.50
|
|
Inj for ext venography
|
$576.18 |
$576.18 |
$610.00 |
$654.00
|
|
Inj for mammo ductogram
|
$290.40 |
$290.40 |
$290.40 |
$433.50
|
|
Inj, gadopiclenol, 1 ml
|
$18.80 |
$18.80 |
$18.80 |
$66.94
|
|
Inj. herceptin hylecta, 10mg
|
$173.38 |
$173.38 |
$173.38 |
$8,193.78
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,028.94 |
$1,028.94 |
$1,028.94 |
$1,237.50
|
|
Inj hrt cath w/s&i sel left vent
|
$793.32 |
$793.32 |
$793.32 |
$1,071.00
|
|
Inj hrt cath w/s&i sel right vent
|
$856.68 |
$856.68 |
$856.68 |
$947.05
|
|
Inj intralesional <= 7 lsn(s)
|
$229.68 |
$229.68 |
$229.68 |
$235.13
|
|
Inj, lidocaine w epinephrine
|
$1.62 |
$1.62 |
$1.62 |
$44.96
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$650.00 |
$650.00 |
$650.00 |
$783.50
|
|
Inj mepivacaine hcl/10 ml
|
$30.13 |
$30.13 |
$30.13 |
$33.86
|
|
Inj meropenem (wg crit care)
|
$8.01 |
$8.01 |
$8.01 |
$77.97
|
|
Inj multihance
|
$10.10 |
$10.10 |
$10.10 |
$79.42
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$809.82 |
$809.82 |
$925.00 |
$1,414.40
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$975.00 |
$975.00 |
$975.00 |
$2,485.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$885.00 |
$885.00 |
$885.00 |
$2,431.74
|
|
Inj octafluoropropane mic,ml
|
$160.00 |
$160.00 |
$160.00 |
$211.40
|
|
Inj ogivri 10 mg
|
$171.21 |
$171.21 |
$171.21 |
$4,492.28
|
|
Inj pemetrexed, hospira 10mg
|
$9.37 |
$9.37 |
$9.37 |
$64.35
|
