|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$26.42 |
$26.42 |
$26.42 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$41.51 |
$41.51 |
$41.51 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$47.17 |
$47.17 |
$47.17 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$145.30 |
$145.30 |
$145.30 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$53.47 |
$53.47 |
$53.47 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$54.72 |
$54.72 |
$54.72 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$98.75 |
$98.75 |
$98.75 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$22.64 |
$22.64 |
$22.64 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$40.26 |
$40.26 |
$40.26 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$325.82 |
$325.82 |
$325.82 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$72.33 |
$72.33 |
$72.33 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$70.45 |
$70.45 |
$70.45 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$786.88 |
$786.88 |
$786.88 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$66.67 |
$66.67 |
$66.67 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$66.67 |
$66.67 |
$66.67 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$79.25 |
$79.25 |
$79.25 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$66.67 |
$66.67 |
$66.67 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$96.87 |
$96.87 |
$96.87 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$60.38 |
$60.38 |
$60.38 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$66.67 |
$66.67 |
$66.67 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$69.82 |
$69.82 |
$69.82 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$786.88 |
$786.88 |
$786.88 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$242.16 |
$242.16 |
$242.16 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$496.28 |
$496.28 |
$496.28 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$172.98 |
$172.98 |
$172.98 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$81.14 |
$81.14 |
$81.14 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$92.46 |
$92.46 |
$92.46 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$161.02 |
$161.02 |
$161.02 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$269.21 |
$269.21 |
$269.21 |
$304.20
|
|
Inj., benralizumab, 1 mg
|
$256.98 |
$256.98 |
$256.98 |
$11,310.00
|
|
Inj cntr knee arthro incl ct/mri
|
$166.05 |
$166.05 |
$166.05 |
$436.80
|
|
Injection arthrography hip without anesthesia (both sides)
|
$253.13 |
$253.13 |
$253.13 |
$503.50
|
|
Injection epidural blood patch or clot
|
$650.03 |
$650.03 |
$650.03 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$327.38 |
$327.38 |
$327.38 |
$436.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$392.18 |
$392.18 |
$392.18 |
$497.76
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$220.46 |
$220.46 |
$220.46 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$177.58 |
$177.58 |
$177.58 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,577.15 |
$2,577.15 |
$2,577.15 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,445.18 |
$1,445.18 |
$1,445.18 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,577.15 |
$2,577.15 |
$2,577.15 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,813.73 |
$1,813.73 |
$1,813.73 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,171.15 |
$3,171.15 |
$3,171.15 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,657.80 |
$1,657.80 |
$1,657.80 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,146.83 |
$1,146.83 |
$1,146.83 |
$1,685.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$94.87 |
$94.87 |
$94.87 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$387.70 |
$387.70 |
$387.70 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$100.20 |
$100.20 |
$100.20 |
$145.60
|
|
Inject sacroiliac joint
|
$1,394.55 |
$1,394.55 |
$1,394.55 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$1,160.33 |
$1,160.33 |
$1,160.33 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$903.15 |
$903.15 |
$903.15 |
$1,450.84
|
|
Inj, fulvestrant (fresenius)
|
$25.80 |
$25.80 |
$25.80 |
$905.30
|
|
Inj ivig privigen 500 mg
|
$17.55 |
$17.55 |
$17.55 |
$6,967.29
|
|
Inj proc ankle arthr
|
$193.73 |
$193.73 |
$193.73 |
$405.31
|
|
Inj proc elbow arthro
|
$244.35 |
$244.35 |
$244.35 |
$432.00
|
|
Inj proc myelogram lumbar
|
$434.03 |
$434.03 |
$434.03 |
$838.30
|
|
Inj retacrit esrd on dialysi
|
$4.16 |
$4.16 |
$4.16 |
$349.45
|
|
Inj w/fluor eval cv device
|
$577.80 |
$577.80 |
$577.80 |
$504.40
|
|
Ins cerv dilator (sep proc)
|
$366.72 |
$366.72 |
$366.72 |
$490.73
|
|
Insertion catheter bladder non indwelling
|
$158.62 |
$158.62 |
$158.62 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$236.16 |
$236.16 |
$236.16 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,337.18 |
$1,337.18 |
$1,337.18 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,844.10 |
$1,844.10 |
$1,844.10 |
$2,453.83
|
|
Insitu hybridization manual
|
$495.42 |
$495.42 |
$495.42 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$147.66 |
$147.66 |
$147.66 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$237.36 |
$237.36 |
$237.36 |
$338.40
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,298.03 |
$1,298.03 |
$1,298.03 |
$1,690.00
|
|
Insulin total
|
$35.06 |
$35.06 |
$35.06 |
$66.64
|
|
Intracranial limited study
|
$388.02 |
$388.02 |
$388.02 |
$467.50
|
|
Intrinsic factor antibody
|
$41.06 |
$41.06 |
$41.06 |
$65.00
|
|
Intro long gi tube w/mult fluo
|
$325.25 |
$325.25 |
$325.25 |
$469.00
|
|
Intubation endotracheal emergency procedure
|
$397.43 |
$397.43 |
$397.43 |
$601.28
|
|
Iron
|
$127.92 |
$127.92 |
$127.92 |
$75.00
|
|
Iron binding capacity
|
$16.60 |
$16.60 |
$16.60 |
$63.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$155.19 |
$155.19 |
$155.19 |
$146.11
|
|
IV Fluids (each additional hour)
|
$76.95 |
$76.95 |
$76.95 |
$133.90
|
|
IV Fluids (first hour)
|
$286.20 |
$286.20 |
$286.20 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$170.78 |
$170.78 |
$170.78 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$89.78 |
$89.78 |
$89.78 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$82.35 |
$82.35 |
$82.35 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$303.75 |
$303.75 |
$303.75 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$135.64 |
$135.64 |
$135.64 |
$167.50
|
|
IV Push Injection (first drug)
|
$195.52 |
$195.52 |
$195.52 |
$252.76
|
|
Ivp w/nephrotomography
|
$980.67 |
$980.67 |
$980.67 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$1,085.57 |
$1,085.57 |
$1,085.57 |
$713.40
|
|
Jak2 targeted sequence analysis
|
$597.14 |
$597.14 |
$597.14 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$274.56 |
$274.56 |
$274.56 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$349.89 |
$349.89 |
$349.89 |
$362.05
|
|
John cunningham antibody
|
$35.50 |
$35.50 |
$35.50 |
$78.00
|
|
Ketamine and metabolite screen - quest
|
$89.17 |
$89.17 |
$89.17 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$37.52 |
$37.52 |
$37.52 |
$58.56
|
|
Kidney imaging morphology
|
$485.78 |
$485.78 |
$485.78 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$1,054.10 |
$1,054.10 |
$1,054.10 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$664.84 |
$664.84 |
$664.84 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$859.60 |
$859.60 |
$859.60 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$282.07 |
$282.07 |
$282.07 |
$490.75
|
|
Knee MRI (with and without contrast)
|
$2,778.38 |
$2,778.38 |
$2,778.38 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,315.70 |
$2,315.70 |
$2,315.70 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,852.25 |
$1,852.25 |
$1,852.25 |
$2,130.88
|
|
Knee X-ray
|
$411.84 |
$411.84 |
$411.84 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$221.76 |
$221.76 |
$221.76 |
$290.40
|