|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,918.80 |
$1,918.80 |
$1,918.80 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,220.40 |
$2,220.40 |
$2,220.40 |
$1,681.24
|
|
Injection, siltuximab
|
$10,680.75 |
$10,680.75 |
$10,680.75 |
$10,680.75
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$660.40 |
$660.40 |
$660.40 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$624.00 |
$624.00 |
$624.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$587.60 |
$587.60 |
$587.60 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$197.60 |
$197.60 |
$197.60 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$145.60 |
$145.60 |
$145.60 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$353.60 |
$353.60 |
$353.60 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$135.20 |
$135.20 |
$135.20 |
$135.60
|
|
Injection treatment of eye
|
$2,501.20 |
$2,501.20 |
$2,501.20 |
$2,665.60
|
|
Injection treatment of nerve
|
$3,754.40 |
$3,754.40 |
$3,754.40 |
$3,219.20
|
|
Injection treatment of nerve
|
$3,754.40 |
$3,754.40 |
$3,754.40 |
$4,350.00
|
|
Injection treatment of nerve
|
$2,054.00 |
$2,054.00 |
$2,054.00 |
$2,025.45
|
|
Injection treatment of nose
|
$1,497.60 |
$1,497.60 |
$1,497.60 |
$859.59
|
|
Inject sacroiliac joint
|
$520.00 |
$520.00 |
$520.00 |
$1,028.95
|
|
Inject/treat eye socket
|
$878.80 |
$878.80 |
$878.80 |
$381.13
|
|
Inject/treat eye socket
|
$878.80 |
$878.80 |
$878.80 |
$750.70
|
|
Inject/treat eye socket
|
$707.20 |
$707.20 |
$707.20 |
$670.02
|
|
Inj, eculizumab-aagh, 2 mg
|
$7,410.48 |
$7,410.48 |
$7,410.48 |
$7,980.52
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$24,578.56 |
$24,578.56 |
$24,578.56 |
$32,176.93
|
|
Inj., emapalumab-lzsg, 1 mg
|
$5,894.51 |
$5,894.51 |
$5,894.51 |
$3,712.74
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$54,322.53 |
$54,322.53 |
$54,322.53 |
$54,322.53
|
|
Inj epidural sgl cerv-thor without img
|
$1,341.60 |
$1,341.60 |
$1,341.60 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$1,648.40 |
$1,648.40 |
$1,648.40 |
$1,415.50
|
|
Inj., eravacycline, 1 mg
|
$191.88 |
$191.88 |
$191.88 |
$206.64
|
|
Inj, erzofri, 1 mg
|
$9,484.15 |
$9,484.15 |
$9,484.15 |
$10,213.70
|
|
Inj, etelcalcetide, 0.1 mg
|
$337.56 |
$337.56 |
$337.56 |
$343.35
|
|
Inj, eteplirsen, 10 mg
|
$2,598.44 |
$2,598.44 |
$2,598.44 |
$2,598.44
|
|
Inj, evinacumab-dgnb, 5mg
|
$19,268.91 |
$19,268.91 |
$19,268.91 |
$20,751.13
|
|
Inj, factor x, (human), 1iu
|
$26.74 |
$26.74 |
$26.74 |
$26.74
|
|
Inj, faricimab-svoa, 0.1mg
|
$3,810.20 |
$3,810.20 |
$3,810.20 |
$4,103.29
|
|
Inj fensolvi 0.25 mg
|
$41,101.34 |
$41,101.34 |
$41,101.34 |
$44,262.98
|
|
Inj., fibryga, 1 mg
|
$4.93 |
$4.93 |
$4.93 |
$4.93
|
|
Inj fluphenazine hcl 1.25 mg
|
$22.97 |
$22.97 |
$22.97 |
$39.54
|
|
Inj, focinvez, 1mg
|
$767.09 |
$767.09 |
$767.09 |
$3.63
|
|
Inj for ext venography
|
$1,476.80 |
$1,476.80 |
$1,476.80 |
$649.95
|
|
Inj for mammo ductogram
|
$514.80 |
$514.80 |
$514.80 |
$399.60
|
|
Inj fosnetupitant, palonoset
|
$1,110.99 |
$1,110.99 |
$1,110.99 |
$1,110.99
|
|
Inj., fremanezumab-vfrm 1 mg
|
$1,227.76 |
$1,227.76 |
$1,227.76 |
$1,322.20
|
|
Inj ganirelix acetat 250 mcg
|
$353.83 |
$353.83 |
$353.83 |
$196.00
|
|
Inj gemcitabine hcl (accord)
|
$105.77 |
$105.77 |
$105.77 |
$130.65
|
|
Inj givosiran 0.5 mg
|
$65,738.25 |
$65,738.25 |
$65,738.25 |
$76,708.80
|
|
Inj glofitamab gxbm, 2.5 mg
|
$4,420.62 |
$4,420.62 |
$4,420.62 |
$4,760.67
|
|
Inj glycopyrrolate fres kabi
|
$10.00 |
$10.00 |
$10.00 |
$12.18
|
|
Inj golodirsen 10 mg
|
$2,598.44 |
$2,598.44 |
$2,598.44 |
$2,798.32
|
|
Inj., guselkumab, 1 mg
|
$21,817.30 |
$21,817.30 |
$21,817.30 |
$29,130.83
|
|
Inj., haegarda 10 units
|
$5,893.07 |
$5,893.07 |
$5,893.07 |
$6,346.38
|
|
Inj, hemgenix, per tx dose
|
$4,368,002.60 |
$4,368,002.60 |
$4,368,002.60 |
$4,368,002.60
|
|
Inj. herceptin hylecta, 10mg
|
$7,608.51 |
$7,608.51 |
$7,608.51 |
$7,690.59
|
|
Inj, hercessi, 10 mg
|
$6,033.42 |
$6,033.42 |
$6,033.42 |
$6,033.42
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,043.60 |
$2,043.60 |
$2,043.60 |
$1,439.90
|
|
Inj hrt cath w/s&i sel hrt ang
|
$2,646.80 |
$2,646.80 |
$2,646.80 |
$1,827.74
|
|
Inj hrt cath w/s&i sel left vent
|
$1,877.20 |
$1,877.20 |
$1,877.20 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$2,532.40 |
$2,532.40 |
$2,532.40 |
$965.33
|
|
Inj human fibrinogen con nos
|
$5.82 |
$5.82 |
$5.82 |
$3.95
|
|
Inj hydroxocobalamin IV 25mg
|
$1,702.88 |
$1,702.88 |
$1,702.88 |
$2,452.32
|
|
Inj hydroxyprogst capoat nos
|
$627.41 |
$627.41 |
$627.41 |
$1,228.59
|
|
Inj., ibalizumab-uiyk, 10 mg
|
$9,896.00 |
$9,896.00 |
$9,896.00 |
$3,542.09
|
|
Inj imip 4 cilas 4 releb 2mg
|
$515.51 |
$515.51 |
$515.51 |
$739.77
|
|
Inj, imm glob bivigam, 500mg
|
$1,258.47 |
$1,258.47 |
$1,258.47 |
$1,258.47
|
|
Inj, immphentiv, 20 mcg
|
$4.72 |
$4.72 |
$4.72 |
$18.44
|
|
Inj. inebilizumab-cdon, 1 mg
|
$70,014.65 |
$70,014.65 |
$70,014.65 |
$70,014.65
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$2,054.00 |
$2,054.00 |
$2,054.00 |
$1,928.00
|
|
Inj. infugem, 100 mg
|
$1,379.73 |
$1,379.73 |
$1,379.73 |
$1,485.86
|
|
Inj. insulin (fiasp)
|
$177.00 |
$177.00 |
$177.00 |
$177.00
|
|
Inj intralesional <= 7 lsn(s)
|
$218.40 |
$218.40 |
$218.40 |
$235.13
|
|
Inj, invega hafyera/trinza
|
$32,073.55 |
$32,073.55 |
$32,073.55 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$6,228.02 |
$6,228.02 |
$6,228.02 |
$6,967.29
|
|
Inj, ixinity, 1 i.u
|
$6.99 |
$6.99 |
$6.99 |
$6.99
|
|
Inj labetalol hcl hikma, 5mg
|
$81.22 |
$81.22 |
$81.22 |
$38.94
|
|
Inj., lanadelumab-flyo, 1 mg
|
$39,468.45 |
$39,468.45 |
$39,468.45 |
$42,504.48
|
|
Inj, lecanemab-irmb, 1 mg
|
$430.65 |
$430.65 |
$430.65 |
$1,174.88
|
|
Inj lefamulin 1 mg
|
$168.90 |
$168.90 |
$168.90 |
$181.89
|
|
Inj, lenacapavir, 1 mg
|
$29,205.80 |
$29,205.80 |
$29,205.80 |
$24,398.00
|
|
Inj levocarnitine per 1 gm
|
$136.15 |
$136.15 |
$136.15 |
$136.62
|
|
Inj levoleucovorin nos 0.5mg
|
$96.20 |
$96.20 |
$96.20 |
$109.92
|
|
Inj, levothyroxine, freskabi
|
$859.08 |
$859.08 |
$859.08 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$52.46 |
$52.46 |
$52.46 |
$47.52
|
|
Inj, linezolid (hospira)
|
$153.30 |
$153.30 |
$153.30 |
$153.30
|
|
Inj. lumasiran, 0.5 mg
|
$90,006.86 |
$90,006.86 |
$90,006.86 |
$96,930.47
|
|
Inj., lumoxiti, 0.01 mg
|
$3,604.04 |
$3,604.04 |
$3,604.04 |
$3,881.27
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,939.60 |
$1,939.60 |
$1,939.60 |
$784.00
|
|
Inj. meloxicam 1 mg
|
$155.11 |
$155.11 |
$155.11 |
$167.04
|
|
Inj melpha hydroch nos 50 mg
|
$4,089.74 |
$4,089.74 |
$4,089.74 |
$1,791.90
|
|
Inj mepivacaine hcl/10 ml
|
$36.63 |
$36.63 |
$36.63 |
$33.86
|
|
Inj, meropenem (b. braun)
|
$66.06 |
$66.06 |
$66.06 |
$71.14
|
|
Inj., meropenem, vaborbactam
|
$363.58 |
$363.58 |
$363.58 |
$558.08
|
|
Inj meropenem (wg crit care)
|
$72.40 |
$72.40 |
$72.40 |
$77.97
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$16,294.54 |
$16,294.54 |
$16,294.54 |
$1,496.55
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$7,761.55 |
$7,761.55 |
$7,761.55 |
$8,304.04
|
|
Inj, moxifloxacin 100 mg
|
$88.40 |
$88.40 |
$88.40 |
$107.25
|
|
Inj moxifloxacin (fres kabi)
|
$88.79 |
$88.79 |
$88.79 |
$95.62
|
|
Inj multihance
|
$65.50 |
$65.50 |
$65.50 |
$73.49
|
|
Inj multihance multipack
|
$2.08 |
$2.08 |
$2.08 |
$2.80
|
|
Inj. mycophenolate mofetil
|
$177.78 |
$177.78 |
$177.78 |
$252.66
|
|
Inj. naxitamab-gqgk, 1 mg
|
$39,059.69 |
$39,059.69 |
$39,059.69 |
$42,064.28
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$320.35 |
$320.35 |
$320.35 |
$462.04
|
|
Inj nivolumab 2 mg hyaluron
|
$12,910.25 |
$12,910.25 |
$12,910.25 |
$15,599.68
|
