|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$30.69 |
$30.69 |
$30.69 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$74.26 |
$74.26 |
$74.26 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$34.25 |
$34.25 |
$34.25 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$22.75 |
$22.75 |
$22.75 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$49.32 |
$49.32 |
$49.32 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$40.01 |
$40.01 |
$40.01 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$57.54 |
$57.54 |
$57.54 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$2.42 |
$2.42 |
$2.42 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$111.80 |
$111.80 |
$111.80 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$72.34 |
$72.34 |
$72.34 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$110.70 |
$110.70 |
$110.70 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$210.16 |
$210.16 |
$210.16 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$16.85 |
$16.85 |
$16.85 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$117.82 |
$117.82 |
$117.82 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$103.58 |
$103.58 |
$103.58 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$72.34 |
$72.34 |
$72.34 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$43.30 |
$43.30 |
$43.30 |
$103.20
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$73.44 |
$73.44 |
$73.44 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$34.25 |
$34.25 |
$34.25 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$332.64 |
$332.64 |
$332.64 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$10.93 |
$10.93 |
$10.93 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$10.51 |
$10.51 |
$10.51 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$10.67 |
$10.67 |
$10.67 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$16.44 |
$16.44 |
$16.44 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$200.30 |
$200.30 |
$200.30 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$1,536.05 |
$1,536.05 |
$1,536.05 |
$2,791.24
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,244.79 |
$1,244.79 |
$1,244.79 |
$1,654.83
|
|
Initiation & management bipap/cpap initial day
|
$1,209.17 |
$1,209.17 |
$1,209.17 |
$645.79
|
|
Inj, abilify maintena, 1 mg
|
$2,991.81 |
$2,991.81 |
$2,991.81 |
$6,324.82
|
|
Inj allopurinol sodium 1 mg
|
$5,243.27 |
$5,243.27 |
$5,243.27 |
$5,948.29
|
|
Inj alymsys 10 mg
|
$3,780.66 |
$3,780.66 |
$3,780.66 |
$928.80
|
|
Inj anifrolumab-fnia 1mg
|
$6,325.84 |
$6,325.84 |
$6,325.84 |
$9,878.82
|
|
Inj, artesunate, 1mg
|
$3,274.85 |
$3,274.85 |
$3,274.85 |
$19,423.99
|
|
Inj., benralizumab, 1 mg
|
$6,343.93 |
$6,343.93 |
$6,343.93 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$4,997.76 |
$4,997.76 |
$4,997.76 |
$9,702.65
|
|
Inj, bupivacaine liposome
|
$414.29 |
$414.29 |
$414.29 |
$816.31
|
|
Inj calcitriol per 0.1 mcg
|
$13.70 |
$13.70 |
$13.70 |
$33.36
|
|
Inj cefazolin sodium, hikma
|
$14.25 |
$14.25 |
$14.25 |
$56.70
|
|
Inj, cefiderocol, 10 mg
|
$249.62 |
$249.62 |
$249.62 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$129.88 |
$129.88 |
$129.88 |
$447.36
|
|
Inj cntr knee arthro incl ct/mri
|
$89.88 |
$89.88 |
$89.88 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$1,736.07 |
$1,736.07 |
$1,736.07 |
$2,836.95
|
|
Inj cyclophosphamd (ingenus)
|
$8.50 |
$8.50 |
$8.50 |
$1,040.94
|
|
Inj dx for sinogram
|
$214.27 |
$214.27 |
$214.27 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$678.43 |
$678.43 |
$678.43 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$107.41 |
$107.41 |
$107.41 |
$507.10
|
|
Injection, cangrelor
|
$1,038.46 |
$1,038.46 |
$1,038.46 |
$2,546.20
|
|
Injection, daratumumab 10 mg
|
$2,786.86 |
$2,786.86 |
$2,786.86 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$882.56 |
$882.56 |
$882.56 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,019.83 |
$1,019.83 |
$1,019.83 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$93.99 |
$93.99 |
$93.99 |
$441.12
|
|
Injection for bladder x-ray
|
$144.40 |
$144.40 |
$144.40 |
$585.00
|
|
Injection for hip x-ray
|
$161.39 |
$161.39 |
$161.39 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$204.13 |
$204.13 |
$204.13 |
$504.00
|
|
Injection for ureter x-ray
|
$79.19 |
$79.19 |
$79.19 |
$444.95
|
|
Injection for ureter x-ray
|
$107.41 |
$107.41 |
$107.41 |
$515.21
|
|
Injection, fulvestrant
|
$2,295.03 |
$2,295.03 |
$2,295.03 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$4,274.40 |
$4,274.40 |
$4,274.40 |
$10,366.61
|
|
Injection,onabotulinumtoxina
|
$761.72 |
$761.72 |
$761.72 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$202.49 |
$202.49 |
$202.49 |
$717.20
|
|
Injection, renflexis
|
$991.06 |
$991.06 |
$991.06 |
$1,457.42
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$883.93 |
$883.93 |
$883.93 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$289.07 |
$289.07 |
$289.07 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,317.94 |
$1,317.94 |
$1,317.94 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$647.47 |
$647.47 |
$647.47 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,011.89 |
$1,011.89 |
$1,011.89 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,011.89 |
$1,011.89 |
$1,011.89 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,517.69 |
$1,517.69 |
$1,517.69 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$1,758.12
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$275.37 |
$275.37 |
$275.37 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$219.20 |
$219.20 |
$219.20 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$199.20 |
$199.20 |
$199.20 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$199.48 |
$199.48 |
$199.48 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$140.29 |
$140.29 |
$140.29 |
$141.60
|
|
Injection torsemide 10 mg/ml
|
$13.70 |
$13.70 |
$13.70 |
$19.11
|
|
Inj., emapalumab-lzsg, 1 mg
|
$22,207.43 |
$22,207.43 |
$22,207.43 |
$381.64
|
|
Inj fluphenazine hcl 1.25 mg
|
$13.70 |
$13.70 |
$13.70 |
$37.93
|
|
Inj for ext venography
|
$545.54 |
$545.54 |
$545.54 |
$737.55
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$882.56 |
$882.56 |
$882.56 |
$1,482.00
|
|
Inj hrt cath w/s&i sel left vent
|
$3,671.33 |
$3,671.33 |
$3,671.33 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$4,033.28 |
$4,033.28 |
$4,033.28 |
$947.65
|
|
Inj human fibrinogen con nos
|
$1.65 |
$1.65 |
$1.65 |
$1.52
|
|
Inj hydroxocobalamin IV 25mg
|
$1,312.74 |
$1,312.74 |
$1,312.74 |
$3,180.35
|
|
Inj. inebilizumab-cdon, 1 mg
|
$61,485.06 |
$61,485.06 |
$61,485.06 |
$494.43
|
|
Inj mepivacaine hcl/10 ml
|
$13.70 |
$13.70 |
$13.70 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$234.55 |
$234.55 |
$234.55 |
$618.43
|
|
Inj meropenem (wg crit care)
|
$47.41 |
$47.41 |
$47.41 |
$104.29
|
|
Inj, moxifloxacin 100 mg
|
$60.56 |
$60.56 |
$60.56 |
$190.81
|
|
Inj multihance
|
$138.37 |
$138.37 |
$138.37 |
$119.25
|
|
Inj. mycophenolate mofetil
|
$142.21 |
$142.21 |
$142.21 |
$344.84
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$651.03 |
$651.03 |
$651.03 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,853.61 |
$1,853.61 |
$1,853.61 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,853.61 |
$1,853.61 |
$1,853.61 |
$2,164.64
|
|
Inj ogivri 10 mg
|
$1,742.37 |
$1,742.37 |
$1,742.37 |
$3,968.67
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$5,162.99 |
$5,162.99 |
$5,162.99 |
$6,403.59
|
|
Inj proc myelogram lumbar
|
$983.12 |
$983.12 |
$983.12 |
$922.80
|
|
Inj progesterone per 50 mg
|
$55.08 |
$55.08 |
$55.08 |
$48.51
|
|
Inj prohance multipack
|
$2.74 |
$2.74 |
$2.74 |
$51.48
|
|
Inj, releuko 1 mcg
|
$334.83 |
$334.83 |
$334.83 |
$557.11
|