|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$67.47 |
$67.47 |
$67.47 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$193.13 |
$193.13 |
$193.13 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$25.75 |
$25.75 |
$25.75 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$90.13 |
$90.13 |
$90.13 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$64.38 |
$64.38 |
$64.38 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$163.26 |
$163.26 |
$163.26 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$51.50 |
$51.50 |
$51.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$242.57 |
$242.57 |
$242.57 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$183.86 |
$183.86 |
$183.86 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$47.38 |
$47.38 |
$47.38 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$21.25 |
$21.25 |
$21.25 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$64.38 |
$64.38 |
$64.38 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$649.93 |
$649.93 |
$649.93 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$97.44 |
$97.44 |
$97.44 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$351.75 |
$351.75 |
$351.75 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$105.06 |
$105.06 |
$105.06 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$25.75 |
$25.75 |
$25.75 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$46.35 |
$46.35 |
$46.35 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$57.68 |
$57.68 |
$57.68 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$343.51 |
$343.51 |
$343.51 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$2,814.99 |
$2,814.99 |
$2,814.99 |
$2,102.08
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,205.10 |
$1,205.10 |
$1,205.10 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,280.94 |
$2,280.94 |
$2,280.94 |
$1,440.60
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$104.55 |
$104.55 |
$104.55 |
$76.00
|
|
Infuse radioactive materials
|
$351.75 |
$351.75 |
$351.75 |
$600.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$231.24 |
$231.24 |
$231.24 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$895.59 |
$895.59 |
$895.59 |
$645.79
|
|
Inj alymsys 10 mg
|
$4,017.00 |
$4,017.00 |
$4,017.00 |
$676.74
|
|
Inj anifrolumab-fnia 1mg
|
$5,945.16 |
$5,945.16 |
$5,945.16 |
$7,499.98
|
|
Inj., benralizumab, 1 mg
|
$5,962.16 |
$5,962.16 |
$5,962.16 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$4,696.80 |
$4,696.80 |
$4,696.80 |
$7,612.43
|
|
Inj, bupivacaine liposome
|
$759.63 |
$759.63 |
$759.63 |
$507.76
|
|
Inj calcitriol per 0.1 mcg
|
$24.21 |
$24.21 |
$24.21 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$22.15 |
$22.15 |
$22.15 |
$34.59
|
|
Inj, cefiderocol, 10 mg
|
$457.84 |
$457.84 |
$457.84 |
$550.68
|
|
Inj ceftolozane tazobactam
|
$238.45 |
$238.45 |
$238.45 |
$415.50
|
|
Inj cntr knee arthro incl ct/mri
|
$461.96 |
$461.96 |
$461.96 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$3,181.67 |
$3,181.67 |
$3,181.67 |
$2,735.85
|
|
Inj cyclophosphamd (ingenus)
|
$15.45 |
$15.45 |
$15.45 |
$479.42
|
|
Inj dx for sinogram
|
$90.64 |
$90.64 |
$90.64 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$949.66 |
$949.66 |
$949.66 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$364.62 |
$364.62 |
$364.62 |
$507.10
|
|
Injection, daratumumab 10 mg
|
$4,017.00 |
$4,017.00 |
$4,017.00 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$1,782.93 |
$1,782.93 |
$1,782.93 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,668.09 |
$1,668.09 |
$1,668.09 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$274.50 |
$274.50 |
$274.50 |
$441.12
|
|
Injection for bladder x-ray
|
$1,019.70 |
$1,019.70 |
$1,019.70 |
$585.00
|
|
Injection for hip x-ray
|
$274.50 |
$274.50 |
$274.50 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$672.59 |
$672.59 |
$672.59 |
$504.00
|
|
Injection for spleen x-ray
|
$2,881.43 |
$2,881.43 |
$2,881.43 |
$686.40
|
|
Injection for ureter x-ray
|
$945.54 |
$945.54 |
$945.54 |
$444.95
|
|
Injection for ureter x-ray
|
$1,316.34 |
$1,316.34 |
$1,316.34 |
$515.21
|
|
Injection, fulvestrant
|
$4,017.00 |
$4,017.00 |
$4,017.00 |
$1,817.65
|
|
Injection into brain canal
|
$1,458.48 |
$1,458.48 |
$1,458.48 |
$933.60
|
|
Injection jugular
|
$838.42 |
$838.42 |
$838.42 |
$1,048.20
|
|
Injection of sinus tract
|
$1,901.90 |
$1,901.90 |
$1,901.90 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$1,395.65 |
$1,395.65 |
$1,395.65 |
$2,034.90
|
|
Injection radioactive tracer sentinel node (both sides)
|
$406.34 |
$406.34 |
$406.34 |
$717.20
|
|
Injection, renflexis
|
$1,815.89 |
$1,815.89 |
$1,815.89 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$929.06 |
$929.06 |
$929.06 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,090.26 |
$1,090.26 |
$1,090.26 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,090.26 |
$1,090.26 |
$1,090.26 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,170.60 |
$1,170.60 |
$1,170.60 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,474.45 |
$1,474.45 |
$1,474.45 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$839.97 |
$839.97 |
$839.97 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,788.08 |
$1,788.08 |
$1,788.08 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,061.93 |
$1,061.93 |
$1,061.93 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$92.19 |
$92.19 |
$92.19 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$456.81 |
$456.81 |
$456.81 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$456.81 |
$456.81 |
$456.81 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$376.98 |
$376.98 |
$376.98 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$349.69 |
$349.69 |
$349.69 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$376.98 |
$376.98 |
$376.98 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$376.98 |
$376.98 |
$376.98 |
$141.60
|
|
Inj epidural sgl cerv-thor without img
|
$929.06 |
$929.06 |
$929.06 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$929.06 |
$929.06 |
$929.06 |
$1,450.84
|
|
Inj fluphenazine hcl 1.25 mg
|
$23.18 |
$23.18 |
$23.18 |
$44.95
|
|
Inj for ext venography
|
$876.02 |
$876.02 |
$876.02 |
$737.55
|
|
Inj for mammo ductogram
|
$291.49 |
$291.49 |
$291.49 |
$433.50
|
|
Inj., guselkumab, 1 mg
|
$14,080.10 |
$14,080.10 |
$14,080.10 |
$620.75
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$540.75 |
$540.75 |
$540.75 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,997.17 |
$1,997.17 |
$1,997.17 |
$1,837.17
|
|
Inj hrt cath w/s&i sel left vent
|
$42.75 |
$42.75 |
$42.75 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$43.78 |
$43.78 |
$43.78 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$2,405.57 |
$2,405.57 |
$2,405.57 |
$2,452.32
|
|
Inj. inebilizumab-cdon, 1 mg
|
$57,782.49 |
$57,782.49 |
$57,782.49 |
$871.80
|
|
Inj intralesional <= 7 lsn(s)
|
$296.13 |
$296.13 |
$296.13 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$294.58 |
$294.58 |
$294.58 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$4,017.00 |
$4,017.00 |
$4,017.00 |
$5,274.00
|
|
Inj mepivacaine hcl/10 ml
|
$26.27 |
$26.27 |
$26.27 |
$30.04
|
|
Inj., meropenem, vaborbactam
|
$429.51 |
$429.51 |
$429.51 |
$566.68
|
|
Inj multihance
|
$35.54 |
$35.54 |
$35.54 |
$119.25
|
|
Inj. mycophenolate mofetil
|
$260.59 |
$260.59 |
$260.59 |
$271.10
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,648.00 |
$1,648.00 |
$1,648.00 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,884.00 |
$2,884.00 |
$2,884.00 |
$2,371.50
|
|
Inj ogivri 10 mg
|
$3,193.00 |
$3,193.00 |
$3,193.00 |
$3,968.67
|
|
Inj., patisiran, 0.1 mg
|
$11,742.00 |
$11,742.00 |
$11,742.00 |
$16,651.53
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$4,852.33 |
$4,852.33 |
$4,852.33 |
$6,244.73
|
|
Inj pemetrexed, hospira 10mg
|
$4,337.85 |
$4,337.85 |
$4,337.85 |
$64.35
|
|
Inj peritoneal venous shunt
|
$867.26 |
$867.26 |
$867.26 |
$386.88
|