|
Immunoglobulin assay
|
$178.42 |
$178.42 |
$178.42 |
$78.00
|
|
Implant cartilage 10mm synthetic
|
$95,882.18 |
$95,882.18 |
$95,882.18 |
$8,332.51
|
|
Implant ureth bulk agent
|
$3,062.61 |
$3,062.61 |
$3,062.61 |
$2,168.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$863.75 |
$863.75 |
$863.75 |
$2,598.17
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$332.25 |
$332.25 |
$332.25 |
$2,086.70
|
|
Infect ag eia influenza a or b ea
|
$30.19 |
$30.19 |
$30.19 |
$71.20
|
|
Infect ag genotype na cytomegalovirus
|
$542.65 |
$542.65 |
$542.65 |
$665.40
|
|
Infect ag genotype na hiv-1 other region
|
$271.67 |
$271.67 |
$271.67 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$542.65 |
$542.65 |
$542.65 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$35.10 |
$35.10 |
$35.10 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$42.12 |
$42.12 |
$42.12 |
$68.40
|
|
Infect ag if influenza a
|
$42.12 |
$42.12 |
$42.12 |
$41.30
|
|
Infect ag if influenza b
|
$42.12 |
$42.12 |
$42.12 |
$37.95
|
|
Infect ag if pneumocystis carinii
|
$53.35 |
$53.35 |
$53.35 |
$66.06
|
|
Infect ag if varicella zoster
|
$42.12 |
$42.12 |
$42.12 |
$72.00
|
|
Infect ag na hep b amp
|
$94.77 |
$94.77 |
$94.77 |
$120.50
|
|
Infect ag na hpv high-risk types
|
$74.41 |
$74.41 |
$74.41 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$202.18 |
$202.18 |
$202.18 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$108.11 |
$108.11 |
$108.11 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$878.20 |
$878.20 |
$878.20 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$42.12 |
$42.12 |
$42.12 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$29.48 |
$29.48 |
$29.48 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$46.33 |
$46.33 |
$46.33 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$52.65 |
$52.65 |
$52.65 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$162.16 |
$162.16 |
$162.16 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$59.67 |
$59.67 |
$59.67 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$61.07 |
$61.07 |
$61.07 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$110.21 |
$110.21 |
$110.21 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$25.27 |
$25.27 |
$25.27 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$44.93 |
$44.93 |
$44.93 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$295.54 |
$295.54 |
$295.54 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$80.73 |
$80.73 |
$80.73 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$78.62 |
$78.62 |
$78.62 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$878.20 |
$878.20 |
$878.20 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$74.41 |
$74.41 |
$74.41 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$74.41 |
$74.41 |
$74.41 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$88.45 |
$88.45 |
$88.45 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$74.41 |
$74.41 |
$74.41 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$108.11 |
$108.11 |
$108.11 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$67.39 |
$67.39 |
$67.39 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$74.41 |
$74.41 |
$74.41 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$77.92 |
$77.92 |
$77.92 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$878.20 |
$878.20 |
$878.20 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$270.27 |
$270.27 |
$270.27 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$553.88 |
$553.88 |
$553.88 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$193.05 |
$193.05 |
$193.05 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$90.56 |
$90.56 |
$90.56 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$103.19 |
$103.19 |
$103.19 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$179.71 |
$179.71 |
$179.71 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$300.46 |
$300.46 |
$300.46 |
$304.20
|
|
Inj dx for sinogram
|
$169.34 |
$169.34 |
$169.34 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$260.25 |
$260.25 |
$260.25 |
$503.50
|
|
Injection epidural blood patch or clot
|
$668.32 |
$668.32 |
$668.32 |
$1,182.33
|
|
Injection for bladder x-ray
|
$252.62 |
$252.62 |
$252.62 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$403.21 |
$403.21 |
$403.21 |
$497.76
|
|
Injection,onabotulinumtoxina
|
$13.10 |
$13.10 |
$13.10 |
$2,277.65
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$284.34 |
$284.34 |
$284.34 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$976.60 |
$976.60 |
$976.60 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,649.69 |
$2,649.69 |
$2,649.69 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,402.36 |
$1,402.36 |
$1,402.36 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,500.79 |
$2,500.79 |
$2,500.79 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,864.78 |
$1,864.78 |
$1,864.78 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,260.41 |
$3,260.41 |
$3,260.41 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,704.46 |
$1,704.46 |
$1,704.46 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,179.11 |
$1,179.11 |
$1,179.11 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$468.98 |
$468.98 |
$468.98 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$108.50 |
$108.50 |
$108.50 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$455.26 |
$455.26 |
$455.26 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$110.37 |
$110.37 |
$110.37 |
$145.60
|
|
Inject sacroiliac joint
|
$1,433.80 |
$1,433.80 |
$1,433.80 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$1,125.94 |
$1,125.94 |
$1,125.94 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$876.39 |
$876.39 |
$876.39 |
$1,450.84
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$928.57 |
$928.57 |
$928.57 |
$1,938.00
|
|
Inj mepivacaine hcl/10 ml
|
$3.96 |
$3.96 |
$3.96 |
$34.34
|
|
Inj proc myelogram lumbar
|
$446.24 |
$446.24 |
$446.24 |
$838.30
|
|
Inj retacrit esrd on dialysi
|
$4.95 |
$4.95 |
$4.95 |
$349.45
|
|
Ins cerv dilator (sep proc)
|
$436.24 |
$436.24 |
$436.24 |
$490.73
|
|
Insertion catheter bladder non indwelling
|
$163.09 |
$163.09 |
$163.09 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$304.59 |
$304.59 |
$304.59 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,374.81 |
$1,374.81 |
$1,374.81 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,896.01 |
$1,896.01 |
$1,896.01 |
$2,453.83
|
|
Insitu hybridization auto
|
$573.68 |
$573.68 |
$573.68 |
$377.37
|
|
Insitu hybridization manual
|
$573.68 |
$573.68 |
$573.68 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$170.99 |
$170.99 |
$170.99 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$274.86 |
$274.86 |
$274.86 |
$338.40
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,334.56 |
$1,334.56 |
$1,334.56 |
$1,690.00
|
|
Insulin total
|
$37.91 |
$37.91 |
$37.91 |
$66.64
|
|
Intrapul surf admin endo tube
|
$101.29 |
$101.29 |
$101.29 |
$220.80
|
|
Intrinsic factor antibody
|
$44.60 |
$44.60 |
$44.60 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$512.58 |
$512.58 |
$512.58 |
$601.28
|
|
Iron
|
$138.32 |
$138.32 |
$138.32 |
$75.00
|
|
Iron binding capacity
|
$17.96 |
$17.96 |
$17.96 |
$63.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$170.94 |
$170.94 |
$170.94 |
$146.11
|
|
IV Fluids (each additional hour)
|
$103.17 |
$103.17 |
$103.17 |
$133.90
|
|
IV Fluids (first hour)
|
$383.72 |
$383.72 |
$383.72 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$228.96 |
$228.96 |
$228.96 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$120.37 |
$120.37 |
$120.37 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$110.41 |
$110.41 |
$110.41 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$407.25 |
$407.25 |
$407.25 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$149.41 |
$149.41 |
$149.41 |
$167.50
|