|
Inj, bortezomib freseniuskab
|
$2,825.93 |
$2,825.93 |
$2,825.93 |
$2,527.00
|
|
Inj, bortezomib, hospira
|
$188.84 |
$188.84 |
$188.84 |
$175.35
|
|
Inj., brexanolone, 1 mg
|
$13,019.44 |
$13,019.44 |
$13,019.44 |
$13,019.44
|
|
Inj, brixadi, 7 days or less
|
$748.85 |
$748.85 |
$748.85 |
$748.85
|
|
Inj brixadi, more than 7 day
|
$2,397.90 |
$2,397.90 |
$2,987.02 |
$2,858.76
|
|
Inj, brolucizumab-dbll, 1 mg
|
$3,642.90 |
$3,642.90 |
$3,642.90 |
$3,382.69
|
|
Inj bulking agent anal canal
|
$10,258.44 |
$10,258.44 |
$10,258.44 |
$9,525.70
|
|
Inj, bupivacaine liposome
|
$699.38 |
$699.38 |
$699.38 |
$699.38
|
|
Inj, bupivacaine (posimir)
|
$44.80 |
$44.80 |
$44.80 |
$0.50
|
|
Inj. byooviz, 0.1 mg
|
$1,222.94 |
$1,222.94 |
$1,222.94 |
$1,135.59
|
|
Inj calcitriol per 0.1 mcg
|
$15.79 |
$15.79 |
$20.65 |
$23.28
|
|
Inj, carmustine (accord)
|
$9,875.08 |
$9,875.08 |
$9,875.08 |
$9,875.08
|
|
Inj cefazolin sodium, baxter
|
$17.67 |
$17.67 |
$23.93 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$22.85 |
$22.85 |
$22.85 |
$28.08
|
|
Inj cefazolin (wg crit care)
|
$13.95 |
$13.95 |
$13.95 |
$18.05
|
|
Inj. cefepime hcl (baxter)
|
$88.65 |
$88.65 |
$88.65 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$46.21 |
$46.21 |
$47.76 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$409.62 |
$409.62 |
$409.62 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$307.44 |
$307.44 |
$307.44 |
$380.80
|
|
Inj. cetirizine hcl 0.5mg
|
$172.29 |
$172.29 |
$172.29 |
$159.98
|
|
Inj, cipaglucosidase, 5 mg
|
$3,278.80 |
$3,278.80 |
$3,278.80 |
$3,278.80
|
|
Inj, clindamycin (baxter)
|
$21.42 |
$21.42 |
$32.60 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$152.85 |
$152.85 |
$436.80 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$9,204.29 |
$9,204.29 |
$9,204.29 |
$9,204.29
|
|
Inj crotalidae im f(ab')2 eq
|
$2,309.10 |
$2,309.10 |
$2,309.10 |
$2,613.60
|
|
Inj cutaquig 100 mg
|
$375.64 |
$375.64 |
$375.64 |
$348.81
|
|
Inj cuvitru, 100 mg
|
$4,163.61 |
$4,163.61 |
$4,163.61 |
$4,163.61
|
|
Inj, cyclophos (baxter) 5mg
|
$2,584.85 |
$2,584.85 |
$2,584.85 |
$2,584.85
|
|
Inj cyclophosphamd (ingenus)
|
$2.97 |
$2.97 |
$2.97 |
$742.72
|
|
Inj, cyclophosphamd, sandoz
|
$791.76 |
$791.76 |
$791.76 |
$735.20
|
|
Inj, daptomycin (baxter)
|
$60.37 |
$60.37 |
$60.37 |
$1.83
|
|
Inj daptomycin (xellia)
|
$123.76 |
$123.76 |
$123.76 |
$56.04
|
|
Inj daxibotulinumtoxina-lanm
|
$736.62 |
$736.62 |
$736.62 |
$736.62
|
|
Inj disk cerv-thor ea lev
|
$289.80 |
$289.80 |
$957.60 |
$875.28
|
|
Inj, donanemab-azbt, 2 mg
|
$1,233.44 |
$1,233.44 |
$1,233.44 |
$1,233.44
|
|
Inj dupuytren cord w/enzyme
|
$1,136.80 |
$1,136.80 |
$1,136.80 |
$416.00
|
|
Inj, durolane 1 mg
|
$100.50 |
$100.50 |
$1,950.93 |
$1,950.93
|
|
Inj dx for sinogram
|
$190.65 |
$190.65 |
$851.20 |
$422.59
|
|
Inject for sacroiliac joint
|
$1,556.80 |
$1,556.80 |
$1,556.80 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,825.60 |
$1,825.60 |
$1,825.60 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$322.50 |
$322.50 |
$1,747.20 |
$495.84
|
|
Injection, belinostat, 10mg
|
$4,446.10 |
$4,446.10 |
$4,446.10 |
$4,446.10
|
|
Injection, burosumab-twza 1m
|
$21,540.71 |
$21,540.71 |
$21,540.71 |
$20,002.09
|
|
Injection, cangrelor
|
$952.50 |
$952.50 |
$1,752.09 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$13,827.21 |
$13,827.21 |
$13,827.21 |
$16,375.33
|
|
Injection carpal tunnel therapeutic (both sides)
|
$73.50 |
$73.50 |
$1,120.00 |
$450.72
|
|
Injection, casimersen, 10 mg
|
$2,798.32 |
$2,798.32 |
$2,798.32 |
$2,598.44
|
|
Injection, cimetidine hydroc
|
$14.00 |
$14.00 |
$14.00 |
$14.00
|
|
Injection, daratumumab 10 mg
|
$5,164.24 |
$5,164.24 |
$5,164.24 |
$5,239.24
|
|
Injection, delafloxacin
|
$263.05 |
$263.05 |
$263.05 |
$244.26
|
|
Injection, doxercalciferol
|
$6.78 |
$6.78 |
$6.78 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$694.40 |
$694.40 |
$882.90 |
$952.66
|
|
Injection, edaravone, 1 mg
|
$1,136.59 |
$1,136.59 |
$1,136.59 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$834.00 |
$834.00 |
$4,547.20 |
$1,156.80
|
|
Injection eye drug
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$75.60 |
$75.60 |
$532.00 |
$428.40
|
|
Injection for bladder x-ray
|
$190.50 |
$190.50 |
$459.20 |
$459.20
|
|
Injection for hip x-ray
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$329.40 |
$329.40 |
$784.00 |
$494.65
|
|
Injection for spleen x-ray
|
$358.40 |
$358.40 |
$358.40 |
$529.57
|
|
Injection for tear sac x-ray
|
$178.08 |
$178.08 |
$178.08 |
$225.20
|
|
Injection for ureter x-ray
|
$179.55 |
$179.55 |
$324.80 |
$427.70
|
|
Injection for ureter x-ray
|
$285.60 |
$285.60 |
$285.60 |
$515.21
|
|
Injection, fosphenytoin sodi
|
$165.20 |
$165.20 |
$165.20 |
$165.20
|
|
Injection, fulvestrant
|
$40.50 |
$40.50 |
$1,719.16 |
$1,817.65
|
|
Injection glatiramer acetate
|
$894.40 |
$894.40 |
$894.40 |
$830.51
|
|
Injection, glucarpidase
|
$69,728.98 |
$69,728.98 |
$69,728.98 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$3,430.76 |
$3,430.76 |
$6,271.28 |
$6,679.35
|
|
Injection into brain canal
|
$2,598.40 |
$2,598.40 |
$2,598.40 |
$1,289.60
|
|
Injection into brain canal
|
$3,298.40 |
$3,298.40 |
$3,298.40 |
$836.40
|
|
Injection into hemorrhoid(s)
|
$4,172.00 |
$4,172.00 |
$4,172.00 |
$1,432.81
|
|
Injection into spinal artery
|
$3,337.60 |
$3,337.60 |
$3,337.60 |
$1,710.80
|
|
Injection into vocal cord
|
$1,226.40 |
$1,226.40 |
$1,226.40 |
$499.50
|
|
Injection intraop add-on
|
$214.48 |
$214.48 |
$214.48 |
$214.48
|
|
Injection, isavuconazonium
|
$691.86 |
$691.86 |
$691.86 |
$787.67
|
|
Injection jaw joint x-ray
|
$884.80 |
$884.80 |
$884.80 |
$307.80
|
|
Injection jugular
|
$163.80 |
$163.80 |
$2,038.40 |
$790.00
|
|
Injection, khapzory, 0.5 mg
|
$2,162.76 |
$2,162.76 |
$2,162.76 |
$2,162.76
|
|
Injection, necitumumab, 1 mg
|
$7,590.14 |
$7,590.14 |
$7,590.14 |
$8,572.91
|
|
Injection of sinus tract
|
$3,511.20 |
$3,511.20 |
$3,511.20 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$527.31 |
$527.31 |
$2,277.65 |
$2,277.65
|
|
Injection, peramivir
|
$556.08 |
$556.08 |
$556.08 |
$744.75
|
|
Injection, piperacillin sodi
|
$14.00 |
$14.00 |
$14.00 |
$14.00
|
|
Injection px peyronie ds
|
$840.00 |
$840.00 |
$840.00 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$694.20 |
$694.20 |
$2,889.60 |
$670.64
|
|
Injection, renflexis
|
$1,341.52 |
$1,341.52 |
$1,341.52 |
$1,341.52
|
|
Injection, ruconest
|
$14,111.44 |
$14,111.44 |
$14,111.44 |
$14,111.44
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$4,424.00 |
$4,424.00 |
$4,424.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$438.75 |
$438.75 |
$7,957.60 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$172.50 |
$172.50 |
$3,701.60 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,365.60 |
$3,365.60 |
$3,365.60 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,691.20 |
$1,691.20 |
$1,691.20 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,508.00 |
$4,508.00 |
$4,508.00 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,618.40 |
$1,618.40 |
$1,618.40 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,026.40 |
$4,026.40 |
$4,026.40 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$898.05 |
$898.05 |
$5,079.20 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,487.40 |
$1,487.40 |
$3,662.40 |
$1,681.24
|
|
Injection, siltuximab
|
$11,502.35 |
$11,502.35 |
$11,502.35 |
$10,680.75
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$73.50 |
$73.50 |
$1,002.40 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$144.00 |
$144.00 |
$840.00 |
$548.80
|
