|
Hysterosalpingography s&i
|
$585.00 |
$585.00 |
$585.00 |
$636.00
|
|
I-123 sod iodide diag per 100 uci
|
$105.00 |
$105.00 |
$105.00 |
$136.66
|
|
I125 iothalamate, dx
|
$830.00 |
$830.00 |
$830.00 |
$830.00
|
|
I131 iodide cap, rx
|
$65.00 |
$65.00 |
$65.00 |
$75.00
|
|
Iadna legionella pneumophila amplified probe tq
|
$115.00 |
$115.00 |
$115.00 |
$110.55
|
|
Idh1 common variants
|
$560.00 |
$560.00 |
$560.00 |
$400.40
|
|
Idh2 common variants
|
$560.00 |
$560.00 |
$560.00 |
$463.45
|
|
Igh gene rearrange amp meth
|
$347.50 |
$347.50 |
$347.50 |
$444.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$150.00 |
$150.00 |
$150.00 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$207.50 |
$207.50 |
$207.50 |
$318.75
|
|
Ihc/icc per specimen initial single antibody stain
|
$210.00 |
$210.00 |
$210.00 |
$266.76
|
|
Ikbkap gene
|
$142.50 |
$142.50 |
$142.50 |
$168.00
|
|
Immob elbow child sm
|
$70.00 |
$70.00 |
$70.00 |
$70.00
|
|
Immobilizer shldr cntor adlt
|
$75.00 |
$75.00 |
$75.00 |
$163.80
|
|
Immobilizer shldr dlx str 24-36in med
|
$147.50 |
$147.50 |
$147.50 |
$92.12
|
|
Immune complex assay
|
$40.00 |
$40.00 |
$40.00 |
$108.00
|
|
Immunoassay tumor antigen quantitative ca 125
|
$117.50 |
$117.50 |
$117.50 |
$126.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$110.00 |
$110.00 |
$110.00 |
$110.00
|
|
Immunodiff gel qual ea antigen/ab
|
$60.00 |
$60.00 |
$60.00 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$142.50 |
$142.50 |
$142.50 |
$135.07
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$100.00 |
$100.00 |
$100.00 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$160.00 |
$160.00 |
$160.00 |
$231.40
|
|
Immunoglobulin assay
|
$125.00 |
$125.00 |
$125.00 |
$69.60
|
|
Impreg gauze no h20/sal/yard
|
$2.09 |
$2.09 |
$2.09 |
$11.90
|
|
In-111 autol wbc diag per dose
|
$3,210.00 |
$3,210.00 |
$3,210.00 |
$3,513.76
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,345.00 |
$1,345.00 |
$1,345.00 |
$2,441.34
|
|
In-111 pentetreotide
|
$4,165.00 |
$4,165.00 |
$4,165.00 |
$4,944.55
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$935.00 |
$935.00 |
$935.00 |
$2,056.93
|
|
Incision of achilles tendon
|
$2,660.00 |
$2,660.00 |
$2,660.00 |
$2,854.00
|
|
Incision of foot fascia
|
$2,545.00 |
$2,545.00 |
$2,545.00 |
$4,547.40
|
|
Incision of hip tendon
|
$2,365.00 |
$2,365.00 |
$2,365.00 |
$2,653.75
|
|
Incision of tendon & muscle
|
$3,770.00 |
$3,770.00 |
$3,770.00 |
$5,376.00
|
|
Incision of thigh tendon
|
$2,365.00 |
$2,365.00 |
$2,365.00 |
$3,899.36
|
|
Incision of thigh tendons
|
$3,785.00 |
$3,785.00 |
$3,785.00 |
$4,499.12
|
|
Infect ag drug suscept pheno predict
|
$320.00 |
$320.00 |
$320.00 |
$320.00
|
|
Infect ag genotype na hiv-1 other region
|
$475.00 |
$475.00 |
$475.00 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$715.00 |
$715.00 |
$715.00 |
$603.75
|
|
Infect ag ia direct hiv-1 antgn
|
$75.00 |
$75.00 |
$75.00 |
$95.55
|
|
Infect ag ia optc obs influenza
|
$85.00 |
$85.00 |
$85.00 |
$70.40
|
|
Infect ag if pneumocystis carinii
|
$137.50 |
$137.50 |
$137.50 |
$66.00
|
|
Infect ag na hep b amp
|
$180.00 |
$180.00 |
$180.00 |
$120.50
|
|
Infect ag na hpv high-risk types
|
$137.50 |
$137.50 |
$137.50 |
$137.65
|
|
Infect ag na influenza r/amp 1st 2 types
|
$227.50 |
$227.50 |
$227.50 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$147.50 |
$147.50 |
$147.50 |
$96.78
|
|
Infect ag na resp virus 12-25 targets
|
$715.00 |
$715.00 |
$715.00 |
$845.40
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$47.50 |
$47.50 |
$47.50 |
$47.50
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$62.50 |
$62.50 |
$62.50 |
$81.40
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$40.00 |
$40.00 |
$40.00 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$125.00 |
$125.00 |
$125.00 |
$89.05
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$85.00 |
$85.00 |
$85.00 |
$80.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$60.00 |
$60.00 |
$60.00 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$100.00 |
$100.00 |
$100.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$115.00 |
$115.00 |
$115.00 |
$124.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$72.50 |
$72.50 |
$72.50 |
$93.60
|
|
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
|
$540.00 |
$540.00 |
$540.00 |
$270.80
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$112.50 |
$112.50 |
$112.50 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$115.00 |
$115.00 |
$115.00 |
$165.57
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$860.00 |
$860.00 |
$860.00 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$145.00 |
$145.00 |
$145.00 |
$179.55
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$97.50 |
$97.50 |
$97.50 |
$148.80
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$250.00 |
$250.00 |
$250.00 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$105.00 |
$105.00 |
$105.00 |
$133.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$87.50 |
$87.50 |
$87.50 |
$99.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$155.00 |
$155.00 |
$155.00 |
$199.73
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$165.00 |
$165.00 |
$165.00 |
$230.75
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$92.50 |
$92.50 |
$92.50 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$117.50 |
$117.50 |
$117.50 |
$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 |
$530.00 |
$695.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$252.50 |
$252.50 |
$252.50 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$337.50 |
$337.50 |
$337.50 |
$279.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$180.00 |
$180.00 |
$180.00 |
$214.40
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$195.00 |
$195.00 |
$195.00 |
$250.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$375.00 |
$375.00 |
$375.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$220.00 |
$220.00 |
$220.00 |
$298.35
|
|
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
|
|
Initiation & management bipap/cpap initial day
|
$370.00 |
$370.00 |
$370.00 |
$600.00
|
|
Inj, bupivacaine liposome
|
$2.98 |
$2.98 |
$2.98 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$9.28 |
$9.28 |
$9.28 |
$32.94
|
|
Inj cntr knee arthro incl ct/mri
|
$460.00 |
$460.00 |
$460.00 |
$436.80
|
|
Inj dx for sinogram
|
$380.00 |
$380.00 |
$380.00 |
$393.03
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,160.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$460.00 |
$460.00 |
$460.00 |
$475.20
|
|
Injection epidural blood patch or clot
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$1,149.13
|
|
Injection for arthrography wrist (both sides)
|
$460.00 |
$460.00 |
$460.00 |
$414.05
|
|
Injection for bladder x-ray
|
$380.00 |
$380.00 |
$380.00 |
$455.03
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$460.00 |
$460.00 |
$460.00 |
$482.85
|
|
Injection radioactive tracer sentinel node (both sides)
|
$257.50 |
$257.50 |
$257.50 |
$636.00
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,195.00 |
$1,195.00 |
$1,195.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$515.00 |
$515.00 |
$515.00 |
$1,023.50
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$580.00 |
$580.00 |
$580.00 |
$457.91
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$895.00 |
$895.00 |
$895.00 |
$508.00
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$90.00 |
$90.00 |
$90.00 |
$166.52
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$90.00 |
$90.00 |
$90.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$90.00 |
$90.00 |
$90.00 |
$250.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$55.00 |
$55.00 |
$55.00 |
$135.20
|
