|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$69.76 |
$108.28 |
$250.76 |
|
|
Infliximab 100 mg intravenous solution
|
$1,873.71 |
$2,766.92 |
$3,192.42 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$50.37 |
$50.37 |
$1,366.80 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,873.71 |
$2,374.64 |
$2,587.01 |
|
|
Influenza virus vaccine, live trivalent intranasal
|
$28.20 |
$28.20 |
$28.20 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$54.46 |
$65.71 |
$258.22 |
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$525.34 |
$525.34 |
$525.34 |
|
|
Initial nursing facility care/day 35 minutes
|
$206.28 |
$206.28 |
$206.28 |
|
|
Initial nursing facility care/day 45 minutes
|
$281.22 |
$281.22 |
$281.22 |
|
|
Initial nursing facility care/day low severity 99304
|
$127.63 |
$127.63 |
$127.63 |
|
|
Init pm e/m new pat 65+ yrs
|
$235.96 |
$235.96 |
$235.96 |
|
|
Inj alymsys 10 mg
|
$5,270.84 |
$5,270.84 |
$7,857.50 |
|
|
Inj, artesunate, 1mg
|
$6,806.67 |
$6,806.67 |
$6,806.67 |
|
|
Inj aval alfa-nqpt 4mg
|
$3,144.63 |
$4,687.86 |
$8,276.27 |
|
|
Inj., benralizumab, 1 mg
|
$4,983.72 |
$5,429.42 |
$15,366.08 |
|
|
Inj, bezlotoxumab, 10 mg
|
$30.55 |
$3,926.16 |
$14,072.03 |
|
|
Inj, bortezomib, hospira
|
$0.15 |
$0.15 |
$3.76 |
|
|
Inj, bupivacaine liposome
|
$752.76 |
$820.08 |
$2,519.84 |
|
|
Inj calcitriol per 0.1 mcg
|
$25.10 |
$25.10 |
$65.30 |
|
|
Inj cefazolin sodium, baxter
|
$80.15 |
$86.45 |
$89.79 |
|
|
Inj cefazolin sodium, hikma
|
$54.91 |
$54.91 |
$54.91 |
|
|
Inj, cefiderocol, 10 mg
|
$476.26 |
$476.26 |
$518.85 |
|
|
Inj ceftolozane tazobactam
|
$181.07 |
$247.97 |
$882.24 |
|
|
Inj. cetirizine hcl 0.5mg
|
$568.42 |
$568.42 |
$568.42 |
|
|
Inj, clevidipine butyrate
|
$106.58 |
$106.58 |
$106.58 |
|
|
Inj, clindamycin (baxter)
|
$30.69 |
$33.10 |
$57.14 |
|
|
Inj cntr knee arthro incl ct/mri
|
$88.35 |
$164.61 |
$2,164.42 |
|
|
Inj crotalidae im f(ab')2 eq
|
$3,083.26 |
$3,325.61 |
$5,259.30 |
|
|
Inj, cyclophos (baxter) 5mg
|
$1,141.94 |
$1,141.94 |
$1,141.94 |
|
|
Inj cyclophosphamd (ingenus)
|
$6.12 |
$6.12 |
$6.12 |
|
|
Inj, daptomycin (baxter)
|
$438.53 |
$438.53 |
$438.53 |
|
|
Inj disk cerv-thor ea lev
|
$170.81 |
$321.84 |
$945.31 |
|
|
Inj, donanemab-azbt, 2 mg
|
$1,901.73 |
$1,901.73 |
$1,901.73 |
|
|
Inj dx for sinogram
|
$51.87 |
$89.47 |
$243.34 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$352.45 |
$558.66 |
$1,047.07 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$103.41 |
$226.21 |
$872.60 |
|
|
Injection, cangrelor
|
$592.86 |
$592.86 |
$592.86 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$115.76 |
$115.76 |
$291.63 |
|
|
Injection, daratumumab 10 mg
|
$3,885.33 |
$3,885.33 |
$3,885.33 |
|
|
Injection during cath supravalvular aortography
|
$163.88 |
$302.80 |
$3,677.77 |
|
|
Injection, edaravone, 1 mg
|
$888.92 |
$888.92 |
$888.92 |
|
|
Injection epidural blood patch or clot
|
$272.94 |
$486.32 |
$1,502.55 |
|
|
Injection for arthrography wrist (both sides)
|
$111.17 |
$245.21 |
$983.90 |
|
|
Injection for bladder x-ray
|
$96.90 |
$177.14 |
$1,100.39 |
|
|
Injection for hip x-ray
|
$124.10 |
$273.64 |
$2,217.10 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$119.95 |
$238.49 |
$1,857.97 |
|
|
Injection for spleen x-ray
|
$165.78 |
$191.16 |
$371.69 |
|
|
Injection for tear sac x-ray
|
$78.28 |
$78.54 |
$98.68 |
|
|
Injection for ureter x-ray
|
$60.80 |
$114.56 |
$374.17 |
|
|
Injection for ureter x-ray
|
$64.82 |
$80.03 |
$2,187.42 |
|
|
Injection, fulvestrant
|
$611.41 |
$611.41 |
$1,777.83 |
|
|
Injection glatiramer acetate
|
$259.76 |
$259.76 |
$259.76 |
|
|
Injection, glucarpidase
|
$8.78 |
$8.78 |
$8.78 |
|
|
Injection into brain canal
|
$296.51 |
$296.51 |
$327.29 |
|
|
Injection into brain canal
|
$192.09 |
$357.89 |
$763.24 |
|
|
Injection into hemorrhoid(s)
|
$1,432.81 |
$1,432.81 |
$1,432.81 |
|
|
Injection, isavuconazonium
|
$578.35 |
$578.35 |
$862.16 |
|
|
Injection jaw joint x-ray
|
$34.58 |
$55.87 |
$70.43 |
|
|
Injection jugular
|
$105.05 |
$218.74 |
$525.19 |
|
|
Injection, necitumumab, 1 mg
|
$7,783.64 |
$7,783.64 |
$7,783.64 |
|
|
Injection of sinus tract
|
$933.27 |
$933.27 |
$1,081.52 |
|
|
Injection,onabotulinumtoxina
|
$0.87 |
$1,438.90 |
$2,776.57 |
|
|
Injection px peyronie ds
|
$179.57 |
$179.57 |
$435.48 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$58.61 |
$526.40 |
$1,251.02 |
|
|
Injection, renflexis
|
$1,209.03 |
$1,890.51 |
$2,305.40 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$857.31 |
$933.98 |
$990.15 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$130.60 |
$351.62 |
$1,011.84 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$393.98 |
$595.59 |
$1,270.31 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$734.71 |
$936.74 |
$1,501.07 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$262.34 |
$328.16 |
$1,106.33 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$298.85 |
$373.82 |
$1,676.92 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$541.96 |
$745.71 |
$1,285.43 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$910.04 |
$1,364.62 |
$1,720.22 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$812.78 |
$982.22 |
$1,903.23 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$174.87 |
$948.00 |
$2,212.65 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$186.78 |
$225.72 |
$729.39 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$83.60 |
$155.76 |
$792.46 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$89.04 |
$171.00 |
$654.35 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$30.96 |
$74.53 |
$301.26 |
|
|
Injection treatment of nerve
|
$1,682.14 |
$1,682.14 |
$1,682.14 |
|
|
Injection treatment of nerve
|
$313.87 |
$759.40 |
$1,196.08 |
|
|
Inject sacroiliac joint
|
$372.84 |
$476.48 |
$1,534.62 |
|
|
Inj., emapalumab-lzsg, 1 mg
|
$78.25 |
$78.25 |
$78.25 |
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$16,749.47 |
$16,749.47 |
$16,749.47 |
|
|
Inj epidural sgl cerv-thor without img
|
$155.08 |
$711.89 |
$1,183.44 |
|
|
Inj epidural sgl lumb-sacral without img
|
$148.54 |
$687.76 |
$1,172.05 |
|
|
Inj fluphenazine hcl 1.25 mg
|
$312.39 |
$312.39 |
$312.39 |
|
|
Inj for ext venography
|
$122.66 |
$257.71 |
$4,102.52 |
|
|
Inj for mammo ductogram
|
$50.43 |
$542.51 |
$741.88 |
|
|
Inj, fosaprepitant (teva)
|
$483.23 |
$483.23 |
$483.23 |
|
|
Inj, gadopiclenol, 1 ml
|
$4.60 |
$19.10 |
$512.69 |
|
|
Inj glofitamab gxbm, 2.5 mg
|
$18,737.87 |
$18,737.87 |
$18,737.87 |
|
|
Inj. herceptin hylecta, 10mg
|
$8,572.85 |
$8,572.85 |
$8,572.85 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$184.34 |
$328.80 |
$707.85 |
|
|
Inj hrt cath w/s&i sel hrt ang
|
$180.21 |
$444.00 |
$582.47 |
|
|
Inj hrt cath w/s&i sel hrt art
|
$189.98 |
$475.19 |
$614.27 |
|
|
Inj hrt cath w/s&i sel left vent
|
$139.27 |
$257.35 |
$699.83 |
|
|
Inj hrt cath w/s&i sel right vent
|
$144.21 |
$274.00 |
$727.91 |
|
|
Inj hydroxocobalamin IV 25mg
|
$1,830.17 |
$2,504.28 |
$6,681.71 |
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$278.54 |
$489.69 |
$567.34 |
|
