|
Infect ag if varicella zoster
|
$27.50 |
$56.00 |
$96.36 |
|
|
Infect ag na chlamydia trachomatis qnt
|
$100.70 |
$100.70 |
$100.70 |
|
|
Infect ag na hep b amp
|
$114.48 |
$180.00 |
$260.80 |
|
|
Infect ag na herpes simplex quant
|
$71.55 |
$178.86 |
$178.86 |
|
|
Infect ag na hpv high-risk types
|
$48.23 |
$137.50 |
$404.32 |
|
|
Infect ag na influenza r/amp 1st 2 types
|
$113.43 |
$227.50 |
$388.80 |
|
|
Infect ag na influenza revr/amp ea type
|
$177.02 |
$177.02 |
$177.02 |
|
|
Infect ag na orthopoxvirus amp prb each
|
$86.35 |
$147.50 |
$177.65 |
|
|
Infect ag na resp virus 12-25 targets
|
$448.91 |
$715.00 |
$2,521.21 |
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$301.40 |
$1,135.00 |
$3,395.71 |
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$30.21 |
$85.00 |
$226.84 |
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$47.50 |
$47.50 |
$105.28 |
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$29.70 |
$62.50 |
$212.18 |
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$18.15 |
$81.60 |
$96.36 |
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$15.96 |
$42.40 |
$159.77 |
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$13.11 |
$59.40 |
$159.77 |
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$28.50 |
$125.00 |
$263.48 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$25.65 |
$85.00 |
$149.48 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$17.60 |
$60.00 |
$118.80 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$54.15 |
$100.00 |
$223.85 |
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$35.00 |
$138.05 |
$545.90 |
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$29.07 |
$72.50 |
$229.60 |
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$22.55 |
$57.50 |
$92.80 |
|
|
Infectious agent nucleic acid amplified probe
|
$131.44 |
$495.00 |
$1,138.50 |
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$106.02 |
$113.42 |
$335.39 |
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$80.37 |
$115.00 |
$467.68 |
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$394.90 |
$860.00 |
$1,836.33 |
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$78.09 |
$145.00 |
$376.75 |
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$34.10 |
$97.50 |
$563.35 |
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$47.88 |
$198.00 |
$682.00 |
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$105.00 |
$113.42 |
$383.35 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$74.67 |
$109.18 |
$488.44 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$79.20 |
$222.60 |
$607.75 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$165.00 |
$264.00 |
$726.50 |
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$92.50 |
$92.50 |
$219.12 |
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$40.47 |
$117.50 |
$240.80 |
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$117.50 |
$117.50 |
$307.20 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$530.00 |
$530.00 |
$1,700.80 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$128.15 |
$252.50 |
$523.20 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$432.63 |
$535.26 |
$1,144.55 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$39.75 |
$287.76 |
$645.96 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$121.41 |
$180.00 |
$467.50 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$102.03 |
$195.00 |
$637.06 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$189.75 |
$375.00 |
$627.45 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$108.35 |
$220.00 |
$584.65 |
|
|
Infliximab 100 mg intravenous solution
|
$72.96 |
$116.96 |
$255.20 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$81.13 |
$105.35 |
$168.00 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$102.39 |
$157.14 |
$317.95 |
|
|
Influenza dna amp prob addl
|
$26.79 |
$47.50 |
$111.83 |
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$44.80 |
$51.94 |
$79.80 |
|
|
Influenza virus vaccine, live trivalent intranasal
|
$30.78 |
$30.78 |
$44.00 |
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$1,060.00 |
$1,060.00 |
$1,205.60 |
|
|
Inf thrc fascial pln blk bi w/wo image
|
$1,060.00 |
$1,060.00 |
$1,240.00 |
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,060.00 |
$1,060.00 |
$1,220.00 |
|
|
Ingest challenge ea addl 60 min
|
$309.52 |
$309.52 |
$539.20 |
|
|
Ingest challenge ini 120 min
|
$328.07 |
$549.60 |
$619.04 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$140.00 |
$140.00 |
$479.60 |
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$982.11 |
$982.11 |
$982.11 |
|
|
Initial nursing facility care/day 35 minutes
|
$231.42 |
$231.42 |
$400.80 |
|
|
Initial nursing facility care/day 45 minutes
|
$432.00 |
$432.00 |
$432.00 |
|
|
Initial nursing facility care/day low severity 99304
|
$165.30 |
$165.30 |
$252.80 |
|
|
Init pm e/m new pat 65+ yrs
|
$75.00 |
$274.17 |
$402.40 |
|
|
Init/sub psych care m 1st 30
|
$122.40 |
$122.40 |
$122.40 |
|
|
Inj, abilify maintena, 1 mg
|
$4.92 |
$10.88 |
$14.15 |
|
|
Inj, acetaminophen (b braun)
|
$0.40 |
$0.40 |
$204.52 |
|
|
Inj acetaminophen -fresenius
|
$0.47 |
$0.47 |
$63.70 |
|
|
Inj, acetaminophen (hikma)
|
$0.59 |
$0.59 |
$265.95 |
|
|
Inj, afstyla, 1 i.u
|
$3.08 |
$3.08 |
$3.08 |
|
|
Inj, alfentanil hcl, 500mcg
|
$6.69 |
$6.69 |
$6.69 |
|
|
Inj anifrolumab-fnia 1mg
|
$27.86 |
$35.19 |
$62.14 |
|
|
Inj., aristada initio, 1 mg
|
$3.71 |
$3.71 |
$5.72 |
|
|
Inj, aspara, rylaze, 0.1 mg
|
$100.10 |
$100.10 |
$100.10 |
|
|
Inj atezolizumb 5mg hya-tqjs
|
$58.24 |
$58.24 |
$58.24 |
|
|
Inj aval alfa-nqpt 4mg
|
$119.69 |
$119.69 |
$151.15 |
|
|
Inj., benralizumab, 1 mg
|
$73.09 |
$486.24 |
$9,818.04 |
|
|
Inj, bezlotoxumab, 10 mg
|
$20.65 |
$61.74 |
$2,211.12 |
|
|
Inj bulking agent anal canal
|
$1,310.69 |
$1,310.69 |
$1,310.69 |
|
|
Inj, bupivacaine liposome
|
$2.84 |
$4.45 |
$7.30 |
|
|
Inj calcitriol per 0.1 mcg
|
$1.55 |
$2.32 |
$2.50 |
|
|
Inj cefazolin sodium, baxter
|
$16.37 |
$16.37 |
$16.37 |
|
|
Inj cefazolin sodium, hikma
|
$7.13 |
$9.37 |
$41.32 |
|
|
Inj cefazolin (wg crit care)
|
$5.39 |
$5.39 |
$8.09 |
|
|
Inj. cefepime hcl (baxter)
|
$56.96 |
$56.96 |
$56.96 |
|
|
Inj, cefiderocol, 10 mg
|
$3.87 |
$3.87 |
$6.27 |
|
|
Inj ceftolozane tazobactam
|
$14.44 |
$286.86 |
$558.33 |
|
|
Inj, clevidipine butyrate
|
$6.47 |
$234.74 |
$295.21 |
|
|
Inj, clindamycin (baxter)
|
$16.56 |
$36.19 |
$254.13 |
|
|
Inj cntr knee arthro incl ct/mri
|
$225.50 |
$460.00 |
$823.65 |
|
|
Inj., copanlisib, 1 mg
|
$62.54 |
$62.54 |
$62.54 |
|
|
Inj cyclophosphamd auromedic
|
$3.64 |
$3.64 |
$3.64 |
|
|
Inj, cyclophosphamd, sandoz
|
$7.06 |
$7.06 |
$9.67 |
|
|
Inj disk cerv-thor ea lev
|
$231.00 |
$1,230.00 |
$1,918.40 |
|
|
Inj, donanemab-azbt, 2 mg
|
$6.62 |
$6.62 |
$6.62 |
|
|
Inj dupuytren cord w/enzyme
|
$410.40 |
$410.40 |
$410.40 |
|
|
Inj, durolane 1 mg
|
$12.72 |
$58.08 |
$1,050.04 |
|
|
Inj dx for sinogram
|
$128.70 |
$380.00 |
$1,118.56 |
|
|
Inject for sacroiliac joint
|
$1,482.36 |
$1,482.36 |
$3,145.64 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$175.43 |
$1,060.00 |
$1,918.40 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$152.90 |
$460.00 |
$1,217.94 |
|
|
Injection, cangrelor
|
$27.75 |
$33.70 |
$65.20 |
|
