|
Infectious agent nucleic acid amplified probe
|
$366.60 |
$366.60 |
$366.60 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$221.00 |
$221.00 |
$221.00 |
$144.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$100.75 |
$100.75 |
$100.75 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$856.70 |
$856.70 |
$856.70 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$100.75 |
$100.75 |
$100.75 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$100.75 |
$100.75 |
$100.75 |
$148.80
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$238.55 |
$238.55 |
$238.55 |
$217.10
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$104.65 |
$104.65 |
$104.65 |
$134.55
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$130.00 |
$130.00 |
$130.00 |
$109.18
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$178.75 |
$178.75 |
$178.75 |
$194.40
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$256.75 |
$256.75 |
$256.75 |
$211.09
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$65.00 |
$65.00 |
$65.00 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$153.40 |
$153.40 |
$153.40 |
$135.00
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$178.10 |
$178.10 |
$178.10 |
$296.71
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$143.00 |
$143.00 |
$143.00 |
$248.18
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$358.80 |
$358.80 |
$358.80 |
$1,069.61
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$718.25 |
$718.25 |
$718.25 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$478.40 |
$478.40 |
$478.40 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$123.50 |
$123.50 |
$123.50 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$154.70 |
$154.70 |
$154.70 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$224.90 |
$224.90 |
$224.90 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$399.75 |
$399.75 |
$399.75 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$2,663.29 |
$2,663.29 |
$2,663.29 |
$178.95
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$89.49
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,159.29 |
$2,159.29 |
$2,159.29 |
$157.14
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$204.10 |
$204.10 |
$204.10 |
$344.50
|
|
Initiation & management bipap/cpap initial day
|
$817.05 |
$817.05 |
$817.05 |
$608.40
|
|
Inj anifrolumab-fnia 1mg
|
$12,569.62 |
$12,569.62 |
$12,569.62 |
$1,038.87
|
|
Inj, aspara, rylaze, 0.1 mg
|
$12,678.25 |
$12,678.25 |
$12,678.25 |
$99.60
|
|
Inj., benralizumab, 1 mg
|
$13,707.62 |
$13,707.62 |
$13,707.62 |
$12,417.10
|
|
Inj, bezlotoxumab, 10 mg
|
$8,651.50 |
$8,651.50 |
$8,651.50 |
$39.83
|
|
Inj brixadi, more than 7 day
|
$3,578.65 |
$3,578.65 |
$3,578.65 |
$1,716.62
|
|
Inj calcitriol per 0.1 mcg
|
$9.25 |
$9.25 |
$9.25 |
$11.21
|
|
Inj cefazolin sodium, hikma
|
$27.10 |
$27.10 |
$27.10 |
$66.38
|
|
Inj, cefiderocol, 10 mg
|
$762.03 |
$762.03 |
$762.03 |
$79.20
|
|
Inj ceftolozane tazobactam
|
$591.66 |
$591.66 |
$591.66 |
$248.93
|
|
Inj crotalidae im f(ab')2 eq
|
$2,659.80 |
$2,659.80 |
$2,659.80 |
$2,388.06
|
|
Inj cyclophosphamd (ingenus)
|
$2,672.80 |
$2,672.80 |
$2,672.80 |
$1.16
|
|
Inj. denosumab-bbdz, 1 mg
|
$7,305.30 |
$7,305.30 |
$7,305.30 |
$6,618.42
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,175.12 |
$1,175.12 |
$1,175.12 |
$1,165.32
|
|
Injection during cath supravalvular aortography
|
$1,175.20 |
$1,175.20 |
$1,175.20 |
$1,604.20
|
|
Injection, edaravone, 1 mg
|
$1,307.53 |
$1,307.53 |
$1,307.53 |
$1,721.40
|
|
Injection epidural blood patch or clot
|
$1,748.58 |
$1,748.58 |
$1,748.58 |
$1,470.60
|
|
Injection for bladder x-ray
|
$1,855.75 |
$1,855.75 |
$1,855.75 |
$585.00
|
|
Injection for ureter x-ray
|
$434.20 |
$434.20 |
$434.20 |
$544.50
|
|
Injection, fulvestrant
|
$461.50 |
$461.50 |
$461.50 |
$166.25
|
|
Injection glatiramer acetate
|
$732.15 |
$732.15 |
$732.15 |
$458.43
|
|
Injection, inclisiran, 1 mg
|
$7,518.45 |
$7,518.45 |
$7,518.45 |
$12.72
|
|
Injection,onabotulinumtoxina
|
$1,311.76 |
$1,311.76 |
$1,311.76 |
$12.88
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$16,567.29 |
$16,567.29 |
$16,567.29 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$9,161.06 |
$9,161.06 |
$9,161.06 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,447.44 |
$1,447.44 |
$1,447.44 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,185.83 |
$1,185.83 |
$1,185.83 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,185.83 |
$1,185.83 |
$1,185.83 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,197.24 |
$1,197.24 |
$1,197.24 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,197.24 |
$1,197.24 |
$1,197.24 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,459.13 |
$1,459.13 |
$1,459.13 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,476.03 |
$1,476.03 |
$1,476.03 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$37.05 |
$37.05 |
$37.05 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$140.40 |
$140.40 |
$140.40 |
$517.24
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$136.50 |
$136.50 |
$136.50 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$136.50 |
$136.50 |
$136.50 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$136.50 |
$136.50 |
$136.50 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$104.00 |
$104.00 |
$104.00 |
$130.19
|
|
Inj fluphenazine hcl 1.25 mg
|
$29.65 |
$29.65 |
$29.65 |
$29.65
|
|
Inj for ext venography
|
$4,658.54 |
$4,658.54 |
$4,658.54 |
$946.64
|
|
Inj., guselkumab, 1 mg
|
$34,802.08 |
$34,802.08 |
$34,802.08 |
$74.86
|
|
Inj heparin, pfizer, 1000u
|
$18.49 |
$18.49 |
$18.49 |
$18.49
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,235.00 |
$1,235.00 |
$1,235.00 |
$1,646.97
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,425.45 |
$1,425.45 |
$1,425.45 |
$2,471.00
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,053.65 |
$1,053.65 |
$1,053.65 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$1,407.25 |
$1,407.25 |
$1,407.25 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$1,407.25 |
$1,407.25 |
$1,407.25 |
$1,352.65
|
|
Inj levocarnitine per 1 gm
|
$110.14 |
$110.14 |
$110.14 |
$87.51
|
|
Inj, levothyroxine, freskabi
|
$743.22 |
$743.22 |
$743.22 |
$244.63
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$16,778.04 |
$16,778.04 |
$16,778.04 |
$625.00
|
|
Inj mepivacaine hcl/10 ml
|
$43.54 |
$43.54 |
$43.54 |
$28.41
|
|
Inj meropenem (wg crit care)
|
$92.62 |
$92.62 |
$92.62 |
$20.78
|
|
Inj multihance
|
$91.53 |
$91.53 |
$91.53 |
$86.40
|
|
Inj. mycophenolate mofetil
|
$223.85 |
$223.85 |
$223.85 |
$387.27
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,996.15 |
$1,996.15 |
$1,996.15 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$5,978.49 |
$5,978.49 |
$5,978.49 |
$91.01
|
|
Inj proc lumbr disk ea lvl
|
$8,853.16 |
$8,853.16 |
$8,853.16 |
$1,218.51
|
|
Inj, releuko 1 mcg
|
$785.46 |
$785.46 |
$785.46 |
$775.12
|
|
Inj sulf hexa lipid microsph
|
$448.46 |
$448.46 |
$448.46 |
$336.56
|
|
Inj, sutimlimab-jome, 10 mg
|
$4,759.65 |
$4,759.65 |
$4,759.65 |
$18.13
|
|
Inj testosterone cypionate
|
$55.44 |
$55.44 |
$55.44 |
$78.79
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,252.02 |
$1,252.02 |
$1,252.02 |
$1,471.50
|
|
Inj, tofidence, 1 mg
|
$4,397.25 |
$4,397.25 |
$4,397.25 |
$1,167.32
|
|
Inj, tyenne, 1 mg
|
$4,461.86 |
$4,461.86 |
$4,461.86 |
$12.60
|
|
Inj w/fluor eval cv device
|
$405.60 |
$405.60 |
$405.60 |
$573.00
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$55,503.47 |
$55,503.47 |
$55,503.47 |
$2,698.05
|
|
Ins cath ren art 1st bi
|
$10,673.91 |
$10,673.91 |
$10,673.91 |
$6,012.50
|
|
Ins cath ren art 1st uni
|
$16,123.82 |
$16,123.82 |
$16,123.82 |
$4,628.00
|
|
Ins cerv dilator (sep proc)
|
$237.25 |
$237.25 |
$237.25 |
$557.60
|
|
Insert cath pleura with image
|
$1,784.25 |
$1,784.25 |
$1,784.25 |
$2,239.02
|
|
Insert intrauterine device iud
|
$3,913.09 |
$3,913.09 |
$3,913.09 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$19,823.47 |
$19,823.47 |
$19,823.47 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$17,576.54 |
$17,576.54 |
$17,576.54 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,535.89 |
$4,535.89 |
$4,535.89 |
$4,923.19
|