|
Incisn windpipe
|
$2,151.10 |
$2,151.10 |
$2,151.10 |
$3,837.72
|
|
Induced abortion d&c
|
$2,537.15 |
$2,537.15 |
$2,537.15 |
$3,649.80
|
|
Infect ag eia influenza a or b ea
|
$60.20 |
$60.20 |
$60.20 |
$69.03
|
|
Infect ag ia optc obs influenza
|
$60.20 |
$60.20 |
$60.20 |
$66.72
|
|
Infect ag na hpv high-risk types
|
$34.30 |
$34.30 |
$34.30 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$140.00 |
$140.00 |
$140.00 |
$227.96
|
|
Infect ag na resp virus 12-25 targets
|
$528.85 |
$528.85 |
$528.85 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$37.45 |
$37.45 |
$37.45 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$230.30 |
$230.30 |
$230.30 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$123.20 |
$123.20 |
$123.20 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$86.80 |
$86.80 |
$86.80 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$107.27 |
$107.27 |
$107.27 |
$132.60
|
|
Infectious agent nucleic acid amplified probe
|
$90.30 |
$90.30 |
$90.30 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$43.05 |
$43.05 |
$43.05 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$112.35 |
$112.35 |
$112.35 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$528.85 |
$528.85 |
$528.85 |
$855.45
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$51.10 |
$51.10 |
$51.10 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$43.05 |
$43.05 |
$43.05 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$83.30 |
$83.30 |
$83.30 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$667.80 |
$667.80 |
$667.80 |
$222.60
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$63.70 |
$63.70 |
$63.70 |
$98.15
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$463.75 |
$463.75 |
$463.75 |
$727.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$175.00 |
$175.00 |
$175.00 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$4,195.34 |
$4,195.34 |
$4,195.34 |
$2,102.08
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,383.33 |
$1,383.33 |
$1,383.33 |
$1,096.55
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,617.43 |
$1,617.43 |
$1,617.43 |
$1,432.80
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$341.95 |
$341.95 |
$341.95 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$681.10 |
$681.10 |
$681.10 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$8,989.54 |
$8,989.54 |
$8,989.54 |
$7,176.71
|
|
Inj, bortezomib, dr. reddy's
|
$5,785.79 |
$5,785.79 |
$5,785.79 |
$48.55
|
|
Inj, bortezomib freseniuskab
|
$5,374.89 |
$5,374.89 |
$5,374.89 |
$16.50
|
|
Inj, bupivacaine liposome
|
$69.14 |
$69.14 |
$69.14 |
$638.07
|
|
Inj calcitriol per 0.1 mcg
|
$33.36 |
$33.36 |
$33.36 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$33.05 |
$33.05 |
$33.05 |
$34.59
|
|
Inj ceftolozane tazobactam
|
$649.05 |
$649.05 |
$649.05 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$293.30 |
$293.30 |
$293.30 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$4,560.02 |
$4,560.02 |
$4,560.02 |
$2,735.85
|
|
Inj cyclophosphamd auromedic
|
$868.86 |
$868.86 |
$868.86 |
$231.57
|
|
Inj cyclophosphamd (ingenus)
|
$1,839.25 |
$1,839.25 |
$1,839.25 |
$493.23
|
|
Inj disk cerv-thor ea lev
|
$335.30 |
$335.30 |
$335.30 |
$869.80
|
|
Inj dx for sinogram
|
$240.10 |
$240.10 |
$240.10 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$747.25 |
$747.25 |
$747.25 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$364.70 |
$364.70 |
$364.70 |
$507.10
|
|
Injection, cangrelor
|
$3,591.36 |
$3,591.36 |
$3,591.36 |
$1,943.40
|
|
Injection carpal tunnel therapeutic (both sides)
|
$525.35 |
$525.35 |
$525.35 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$10,586.32 |
$10,586.32 |
$10,586.32 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$1,217.30 |
$1,217.30 |
$1,217.30 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,161.30 |
$1,161.30 |
$1,161.30 |
$1,473.12
|
|
Injection eye drug
|
$307.30 |
$307.30 |
$307.30 |
$648.90
|
|
Injection for arthrography wrist (both sides)
|
$364.70 |
$364.70 |
$364.70 |
$441.12
|
|
Injection for bladder x-ray
|
$364.70 |
$364.70 |
$364.70 |
$585.00
|
|
Injection for hip x-ray
|
$1,333.15 |
$1,333.15 |
$1,333.15 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$364.70 |
$364.70 |
$364.70 |
$504.00
|
|
Injection for ureter x-ray
|
$665.35 |
$665.35 |
$665.35 |
$444.95
|
|
Injection for ureter x-ray
|
$665.35 |
$665.35 |
$665.35 |
$515.21
|
|
Injection, fulvestrant
|
$3,240.61 |
$3,240.61 |
$3,240.61 |
$1,817.65
|
|
Injection glatiramer acetate
|
$852.32 |
$852.32 |
$852.32 |
$646.72
|
|
Injection into hemorrhoid(s)
|
$767.55 |
$767.55 |
$767.55 |
$1,278.72
|
|
Injection, isavuconazonium
|
$1,309.75 |
$1,309.75 |
$1,309.75 |
$863.93
|
|
Injection jugular
|
$370.30 |
$370.30 |
$370.30 |
$1,048.20
|
|
Injection,onabotulinumtoxina
|
$4,711.84 |
$4,711.84 |
$4,711.84 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$231.35 |
$231.35 |
$231.35 |
$717.20
|
|
Injection, renflexis
|
$1,388.27 |
$1,388.27 |
$1,388.27 |
$1,356.10
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$649.60 |
$649.60 |
$649.60 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$649.60 |
$649.60 |
$649.60 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$915.60 |
$915.60 |
$915.60 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$862.05 |
$862.05 |
$862.05 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,723.40 |
$1,723.40 |
$1,723.40 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$862.05 |
$862.05 |
$862.05 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,723.40 |
$1,723.40 |
$1,723.40 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$967.05 |
$967.05 |
$967.05 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$790.30 |
$790.30 |
$790.30 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$359.80 |
$359.80 |
$359.80 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$616.35 |
$616.35 |
$616.35 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$626.15 |
$626.15 |
$626.15 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$186.20 |
$186.20 |
$186.20 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$186.20 |
$186.20 |
$186.20 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$252.35 |
$252.35 |
$252.35 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$186.20 |
$186.20 |
$186.20 |
$141.60
|
|
Injection treatment of eye
|
$1,365.70 |
$1,365.70 |
$1,365.70 |
$2,698.92
|
|
Inject sacroiliac joint
|
$1,325.80 |
$1,325.80 |
$1,325.80 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$705.95 |
$705.95 |
$705.95 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$796.25 |
$796.25 |
$796.25 |
$1,450.84
|
|
Inj., fibryga, 1 mg
|
$3,364.61 |
$3,364.61 |
$3,364.61 |
$1.21
|
|
Inj for ext venography
|
$555.10 |
$555.10 |
$555.10 |
$737.55
|
|
Inj for mammo ductogram
|
$358.40 |
$358.40 |
$358.40 |
$433.50
|
|
Inj, fulvestrant (fresenius)
|
$1,539.59 |
$1,539.59 |
$1,539.59 |
$1,242.20
|
|
Inj heparin, pfizer, 1000u
|
$32.70 |
$32.70 |
$32.70 |
$26.85
|
|
Inj intralesional <= 7 lsn(s)
|
$164.50 |
$164.50 |
$164.50 |
$241.74
|
|
Inj levocarnitine per 1 gm
|
$139.67 |
$139.67 |
$139.67 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$256.37 |
$256.37 |
$256.37 |
$303.45
|
|
Inj mepivacaine hcl/10 ml
|
$33.18 |
$33.18 |
$33.18 |
$31.28
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,620.85 |
$1,620.85 |
$1,620.85 |
$1,522.56
|
|
Inj, nithiodote, 3mg / 125mg
|
$85.17 |
$85.17 |
$85.17 |
$228.00
|
|
Inj ogivri 10 mg
|
$2,614.15 |
$2,614.15 |
$2,614.15 |
$4,096.71
|
|
Inj pantoprazole(hikma) 40mg
|
$33.52 |
$33.52 |
$33.52 |
$33.52
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$8,363.84 |
$8,363.84 |
$8,363.84 |
$6,244.73
|
|
Inj pemetrexed (accord) 10mg
|
$1,540.91 |
$1,540.91 |
$1,540.91 |
$11.34
|
|
Inj proc ankle arthr
|
$364.70 |
$364.70 |
$364.70 |
$405.31
|
|
Inj proc elbow arthro
|
$364.70 |
$364.70 |
$364.70 |
$453.60
|
