|
Inj, amisulpride, 1 mg
|
$91.89 |
$91.89 |
$91.89 |
$91.89
|
|
Inj andexxa, 10 mg
|
$4,058.60 |
$4,058.60 |
$4,058.60 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$8,829.50 |
$8,829.50 |
$8,829.50 |
$9,878.82
|
|
Inj., aristada initio, 1 mg
|
$3,953.49 |
$3,953.49 |
$3,953.49 |
$4,052.45
|
|
Inj, artesunate, 1mg
|
$13,427.34 |
$13,427.34 |
$13,427.34 |
$14,460.21
|
|
Inj. asceniv
|
$7,833.92 |
$7,833.92 |
$7,833.92 |
$7,833.92
|
|
Inj, aspara, rylaze, 0.1 mg
|
$8,638.34 |
$8,638.34 |
$8,638.34 |
$10,458.00
|
|
Inj atezolizumb 5mg hya-tqjs
|
$17,379.63 |
$17,379.63 |
$17,379.63 |
$18,716.52
|
|
Inj avacincaptad pegol 0.1mg
|
$3,409.64 |
$3,409.64 |
$3,409.64 |
$3,409.64
|
|
Inj aval alfa-nqpt 4mg
|
$3,162.06 |
$3,162.06 |
$3,162.06 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$9,488.86 |
$9,488.86 |
$9,488.86 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$6,167.72 |
$6,167.72 |
$6,167.72 |
$7,612.43
|
|
Inj bimatoprost itc imp1mcg
|
$3,287.96 |
$3,287.96 |
$3,287.96 |
$3,287.96
|
|
Inj, biorphen, 20 micrograms
|
$4.72 |
$4.72 |
$4.72 |
$17.12
|
|
Inj, bortezomib freseniuskab
|
$2,624.08 |
$2,624.08 |
$2,624.08 |
$2,527.00
|
|
Inj, bortezomib, hospira
|
$175.35 |
$175.35 |
$175.35 |
$175.35
|
|
Inj., brexanolone, 1 mg
|
$12,089.48 |
$12,089.48 |
$12,089.48 |
$13,019.44
|
|
Inj, brixadi, 7 days or less
|
$695.36 |
$695.36 |
$695.36 |
$748.85
|
|
Inj brixadi, more than 7 day
|
$2,773.66 |
$2,773.66 |
$2,773.66 |
$2,858.76
|
|
Inj, brolucizumab-dbll, 1 mg
|
$3,382.69 |
$3,382.69 |
$3,382.69 |
$3,382.69
|
|
Inj bulking agent anal canal
|
$9,525.70 |
$9,525.70 |
$9,525.70 |
$9,525.70
|
|
Inj, bupivacaine liposome
|
$649.42 |
$649.42 |
$649.42 |
$699.38
|
|
Inj. byooviz, 0.1 mg
|
$1,135.59 |
$1,135.59 |
$1,135.59 |
$1,135.59
|
|
Inj calcitriol per 0.1 mcg
|
$19.18 |
$19.18 |
$19.18 |
$23.28
|
|
Inj, carmustine (accord)
|
$9,169.72 |
$9,169.72 |
$9,169.72 |
$9,875.08
|
|
Inj cefazolin sodium, baxter
|
$22.22 |
$22.22 |
$22.22 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$21.22 |
$21.22 |
$21.22 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$12.95 |
$12.95 |
$12.95 |
$18.05
|
|
Inj. cefepime hcl (baxter)
|
$82.32 |
$82.32 |
$82.32 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$44.35 |
$44.35 |
$44.35 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$380.36 |
$380.36 |
$380.36 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$285.48 |
$285.48 |
$285.48 |
$380.80
|
|
Inj. cetirizine hcl 0.5mg
|
$159.98 |
$159.98 |
$159.98 |
$159.98
|
|
Inj, cipaglucosidase, 5 mg
|
$3,044.60 |
$3,044.60 |
$3,044.60 |
$3,278.80
|
|
Inj, clindamycin (baxter)
|
$30.27 |
$30.27 |
$30.27 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$457.60 |
$457.60 |
$457.60 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$8,546.84 |
$8,546.84 |
$8,546.84 |
$9,204.29
|
|
Inj crotalidae im f(ab')2 eq
|
$2,144.17 |
$2,144.17 |
$2,144.17 |
$2,613.60
|
|
Inj cutaquig 100 mg
|
$348.81 |
$348.81 |
$348.81 |
$348.81
|
|
Inj cuvitru, 100 mg
|
$3,866.21 |
$3,866.21 |
$3,866.21 |
$4,163.61
|
|
Inj, cyclophos (baxter) 5mg
|
$2,400.22 |
$2,400.22 |
$2,400.22 |
$2,584.85
|
|
Inj, cyclophosphamd, sandoz
|
$735.20 |
$735.20 |
$735.20 |
$735.20
|
|
Inj daptomycin (xellia)
|
$114.92 |
$114.92 |
$114.92 |
$56.04
|
|
Inj daxibotulinumtoxina-lanm
|
$684.01 |
$684.01 |
$684.01 |
$736.62
|
|
Inj disk cerv-thor ea lev
|
$1,903.20 |
$1,903.20 |
$1,903.20 |
$875.28
|
|
Inj, donanemab-azbt, 2 mg
|
$1,145.34 |
$1,145.34 |
$1,145.34 |
$1,233.44
|
|
Inj dupuytren cord w/enzyme
|
$540.80 |
$540.80 |
$540.80 |
$416.00
|
|
Inj, durolane 1 mg
|
$1,811.58 |
$1,811.58 |
$1,811.58 |
$1,950.93
|
|
Inj dx for sinogram
|
$546.00 |
$546.00 |
$546.00 |
$422.59
|
|
Inject for sacroiliac joint
|
$1,440.40 |
$1,440.40 |
$1,440.40 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,882.40 |
$1,882.40 |
$1,882.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$566.80 |
$566.80 |
$566.80 |
$495.84
|
|
Injection, belinostat, 10mg
|
$4,128.52 |
$4,128.52 |
$4,128.52 |
$4,446.10
|
|
Injection, burosumab-twza 1m
|
$20,002.09 |
$20,002.09 |
$20,002.09 |
$20,002.09
|
|
Injection, cangrelor
|
$1,626.94 |
$1,626.94 |
$1,626.94 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$12,839.55 |
$12,839.55 |
$12,839.55 |
$16,375.33
|
|
Injection carpal tunnel therapeutic (both sides)
|
$540.80 |
$540.80 |
$540.80 |
$450.72
|
|
Injection, casimersen, 10 mg
|
$2,598.44 |
$2,598.44 |
$2,598.44 |
$2,598.44
|
|
Injection, daratumumab 10 mg
|
$4,795.37 |
$4,795.37 |
$4,795.37 |
$5,239.24
|
|
Injection, delafloxacin
|
$244.26 |
$244.26 |
$244.26 |
$244.26
|
|
Injection, doxercalciferol
|
$6.29 |
$6.29 |
$6.29 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$1,721.20 |
$1,721.20 |
$1,721.20 |
$952.66
|
|
Injection, edaravone, 1 mg
|
$1,055.40 |
$1,055.40 |
$1,055.40 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$1,320.80 |
$1,320.80 |
$1,320.80 |
$1,156.80
|
|
Injection eye drug
|
$868.40 |
$868.40 |
$868.40 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$452.40 |
$452.40 |
$452.40 |
$428.40
|
|
Injection for bladder x-ray
|
$405.60 |
$405.60 |
$405.60 |
$459.20
|
|
Injection for hip x-ray
|
$1,570.40 |
$1,570.40 |
$1,570.40 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$462.80 |
$462.80 |
$462.80 |
$494.65
|
|
Injection for spleen x-ray
|
$754.00 |
$754.00 |
$754.00 |
$529.57
|
|
Injection for ureter x-ray
|
$1,274.00 |
$1,274.00 |
$1,274.00 |
$427.70
|
|
Injection for ureter x-ray
|
$899.60 |
$899.60 |
$899.60 |
$515.21
|
|
Injection, fulvestrant
|
$1,596.36 |
$1,596.36 |
$1,596.36 |
$1,817.65
|
|
Injection glatiramer acetate
|
$830.51 |
$830.51 |
$830.51 |
$830.51
|
|
Injection, glucarpidase
|
$64,748.34 |
$64,748.34 |
$64,748.34 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$5,823.33 |
$5,823.33 |
$5,823.33 |
$6,679.35
|
|
Injection into brain canal
|
$1,705.60 |
$1,705.60 |
$1,705.60 |
$1,289.60
|
|
Injection into brain canal
|
$795.60 |
$795.60 |
$795.60 |
$836.40
|
|
Injection into hemorrhoid(s)
|
$1,768.00 |
$1,768.00 |
$1,768.00 |
$1,432.81
|
|
Injection into spinal artery
|
$1,710.80 |
$1,710.80 |
$1,710.80 |
$1,710.80
|
|
Injection into vocal cord
|
$1,289.60 |
$1,289.60 |
$1,289.60 |
$499.50
|
|
Injection, isavuconazonium
|
$642.44 |
$642.44 |
$642.44 |
$787.67
|
|
Injection jaw joint x-ray
|
$488.80 |
$488.80 |
$488.80 |
$307.80
|
|
Injection, khapzory, 0.5 mg
|
$2,008.28 |
$2,008.28 |
$2,008.28 |
$2,162.76
|
|
Injection, necitumumab, 1 mg
|
$7,047.99 |
$7,047.99 |
$7,047.99 |
$8,572.91
|
|
Injection of sinus tract
|
$1,944.80 |
$1,944.80 |
$1,944.80 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$2,114.96 |
$2,114.96 |
$2,114.96 |
$2,277.65
|
|
Injection, peramivir
|
$516.36 |
$516.36 |
$516.36 |
$744.75
|
|
Injection px peyronie ds
|
$551.20 |
$551.20 |
$551.20 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,097.20 |
$1,097.20 |
$1,097.20 |
$670.64
|
|
Injection, renflexis
|
$1,245.70 |
$1,245.70 |
$1,245.70 |
$1,341.52
|
|
Injection, ruconest
|
$13,103.48 |
$13,103.48 |
$13,103.48 |
$14,111.44
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,320.80 |
$1,320.80 |
$1,320.80 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,939.60 |
$1,939.60 |
$1,939.60 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$967.20 |
$967.20 |
$967.20 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,710.80 |
$1,710.80 |
$1,710.80 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$977.60 |
$977.60 |
$977.60 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,059.20 |
$2,059.20 |
$2,059.20 |
$1,995.00
|
