|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$1.93 |
$1.93 |
$2.55 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$88.95 |
$88.95 |
$117.51 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$57.56 |
$57.56 |
$76.04 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$88.08 |
$88.08 |
$116.36 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$167.21 |
$167.21 |
$220.90 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$13.40 |
$13.40 |
$17.71 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$93.74 |
$93.74 |
$123.84 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$82.41 |
$82.41 |
$108.87 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$57.56 |
$57.56 |
$76.04 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$34.45 |
$34.45 |
$45.51 |
$103.20
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$58.43 |
$58.43 |
$77.19 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$27.25 |
$27.25 |
$36.00 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$264.66 |
$264.66 |
$349.64 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$8.69 |
$8.69 |
$11.48 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$8.36 |
$8.36 |
$11.04 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$8.49 |
$8.49 |
$11.22 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$13.08 |
$13.08 |
$17.28 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$159.36 |
$159.36 |
$210.53 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$1,222.11 |
$1,222.11 |
$1,614.53 |
$2,102.08
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$990.38 |
$990.38 |
$990.38 |
$1,440.60
|
|
Initiation & management bipap/cpap initial day
|
$962.04 |
$962.04 |
$1,270.95 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$4,171.65 |
$4,171.65 |
$5,511.17 |
$7,176.71
|
|
Inj, artesunate, 1mg
|
$2,605.54 |
$2,605.54 |
$2,605.54 |
$13,446.00
|
|
Inj., benralizumab, 1 mg
|
$5,047.36 |
$5,047.36 |
$6,668.07 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$3,976.32 |
$3,976.32 |
$5,253.12 |
$7,612.43
|
|
Inj, bupivacaine liposome
|
$329.62 |
$329.62 |
$435.46 |
$507.76
|
|
Inj calcitriol per 0.1 mcg
|
$10.90 |
$10.90 |
$14.40 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$10.90 |
$10.90 |
$14.98 |
$34.59
|
|
Inj, cefiderocol, 10 mg
|
$198.60 |
$198.60 |
$262.37 |
$550.68
|
|
Inj ceftolozane tazobactam
|
$103.34 |
$103.34 |
$136.52 |
$415.50
|
|
Inj cntr knee arthro incl ct/mri
|
$71.51 |
$71.51 |
$94.47 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$1,381.25 |
$1,381.25 |
$1,381.25 |
$2,735.85
|
|
Inj cyclophosphamd (ingenus)
|
$6.76 |
$6.76 |
$6.76 |
$479.42
|
|
Inj dx for sinogram
|
$170.48 |
$170.48 |
$225.22 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$539.77 |
$539.77 |
$713.09 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$85.46 |
$85.46 |
$112.90 |
$507.10
|
|
Injection, cangrelor
|
$826.22 |
$826.22 |
$826.22 |
$1,847.53
|
|
Injection, daratumumab 10 mg
|
$2,217.28 |
$2,217.28 |
$2,217.28 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$702.18 |
$702.18 |
$927.65 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$811.40 |
$811.40 |
$1,071.94 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$74.78 |
$74.78 |
$98.79 |
$441.12
|
|
Injection for bladder x-ray
|
$114.89 |
$114.89 |
$151.78 |
$585.00
|
|
Injection for hip x-ray
|
$128.41 |
$128.41 |
$169.64 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$162.41 |
$162.41 |
$214.56 |
$504.00
|
|
Injection for ureter x-ray
|
$63.01 |
$63.01 |
$83.24 |
$444.95
|
|
Injection for ureter x-ray
|
$85.46 |
$85.46 |
$112.90 |
$515.21
|
|
Injection, fulvestrant
|
$1,825.97 |
$1,825.97 |
$1,825.97 |
$1,817.65
|
|
Injection glatiramer acetate
|
$5,047.79 |
$5,047.79 |
$6,668.64 |
$620.97
|
|
Injection, isavuconazonium
|
$330.06 |
$330.06 |
$436.04 |
$832.85
|
|
Injection,onabotulinumtoxina
|
$606.04 |
$606.04 |
$800.64 |
$2,034.90
|
|
Injection radioactive tracer sentinel node (both sides)
|
$161.11 |
$161.11 |
$212.84 |
$717.20
|
|
Injection, renflexis
|
$788.51 |
$788.51 |
$1,041.70 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$703.27 |
$703.27 |
$929.09 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$229.99 |
$229.99 |
$303.84 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,048.58 |
$1,048.58 |
$1,385.28 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$515.14 |
$515.14 |
$680.55 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$805.08 |
$805.08 |
$1,063.59 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$805.08 |
$805.08 |
$1,063.59 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,207.51 |
$1,207.51 |
$1,595.24 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$840.18 |
$840.18 |
$1,109.96 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$840.18 |
$840.18 |
$1,109.96 |
$1,758.12
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$219.09 |
$219.09 |
$289.44 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$174.40 |
$174.40 |
$230.40 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$158.49 |
$158.49 |
$209.38 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$158.71 |
$158.71 |
$209.67 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$111.62 |
$111.62 |
$147.46 |
$141.60
|
|
Injection torsemide 10 mg/ml
|
$10.90 |
$10.90 |
$14.40 |
$16.02
|
|
Inj fluphenazine hcl 1.25 mg
|
$10.90 |
$10.90 |
$14.40 |
$44.95
|
|
Inj for ext venography
|
$434.04 |
$434.04 |
$573.41 |
$737.55
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$702.18 |
$702.18 |
$927.65 |
$1,482.00
|
|
Inj hrt cath w/s&i sel left vent
|
$2,920.99 |
$2,920.99 |
$3,858.92 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$3,208.96 |
$3,208.96 |
$4,239.36 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$1,044.44 |
$1,044.44 |
$1,379.81 |
$2,452.32
|
|
Inj ivig privigen 500 mg
|
$1,161.51 |
$1,161.51 |
$1,534.47 |
$5,274.00
|
|
Inj, kovaltry, 1 i.u
|
$3.17 |
$3.17 |
$3.17 |
$4.68
|
|
Inj mepivacaine hcl/10 ml
|
$14.69 |
$14.69 |
$14.69 |
$30.04
|
|
Inj, moxifloxacin 100 mg
|
$48.18 |
$48.18 |
$63.65 |
$120.04
|
|
Inj multihance
|
$2.88 |
$2.88 |
$110.09 |
$119.25
|
|
Inj. mycophenolate mofetil
|
$113.15 |
$113.15 |
$149.48 |
$271.10
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$517.97 |
$517.97 |
$684.29 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,474.77 |
$1,474.77 |
$1,948.32 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,474.77 |
$1,474.77 |
$1,948.32 |
$2,164.64
|
|
Inj ogivri 10 mg
|
$92.87 |
$92.87 |
$92.87 |
$3,968.67
|
|
Inj proc myelogram lumbar
|
$782.19 |
$782.19 |
$1,033.35 |
$922.80
|
|
Inj progesterone per 50 mg
|
$57.89 |
$57.89 |
$57.89 |
$20.15
|
|
Inj prohance multipack
|
$2.88 |
$2.88 |
$10.90 |
$51.48
|
|
Inj, releuko 1 mcg
|
$351.94 |
$351.94 |
$351.94 |
$461.20
|
|
Inj retacrit esrd on dialysi
|
$305.00 |
$305.00 |
$305.00 |
$266.26
|
|
Inj retro urethrocysto
|
$63.01 |
$63.01 |
$83.24 |
$551.29
|
|
Inj scleros sol mult veins
|
$206.89 |
$206.89 |
$273.32 |
$687.96
|
|
Inj scleros sol sgl vein
|
$206.89 |
$206.89 |
$273.32 |
$534.40
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$245.91 |
$245.91 |
$324.87 |
$436.64
|
|
Inj sulf hexa lipid microsph
|
$201.03 |
$201.03 |
$201.03 |
$281.30
|
|
Inj testosterone cypionate
|
$33.12 |
$33.12 |
$121.65 |
$77.15
|
|
Inj, vancomycin hcl (mylan)
|
$436.00 |
$436.00 |
$576.00 |
$89.83
|
|
Inj w/fluor eval cv device
|
$814.45 |
$814.45 |
$1,075.97 |
$588.90
|
|
Ins cath ren art 1st bi
|
$3,442.44 |
$3,442.44 |
$4,547.81 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$2,458.83 |
$2,458.83 |
$3,248.36 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$3,983.30 |
$3,983.30 |
$5,262.34 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$3,344.12 |
$3,344.12 |
$4,417.92 |
$5,528.94
|