|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$972.00 |
$972.00 |
$972.00 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$1,318.00 |
$1,318.00 |
$1,318.00 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$203.58 |
$203.58 |
$1,595.00 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$87.09 |
$87.40 |
$1,438.00 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$1,465.00 |
$1,465.00 |
$1,465.00 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$630.00 |
$630.00 |
$630.00 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$4,630.00 |
$4,630.00 |
$5,000.25 |
$2,791.24
|
|
Influenza virus vaccine, live trivalent intranasal
|
$198.75 |
$198.75 |
$198.75 |
$40.89
|
|
Infuse radioactive materials
|
$1,900.00 |
$1,900.00 |
$1,900.00 |
$600.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$486.18 |
$530.50 |
$688.00 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$2,238.00 |
$2,341.45 |
$2,559.50 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$3,273.20 |
$3,273.20 |
$3,273.20 |
$5,948.29
|
|
Inj, artesunate, 1mg
|
$10,956.00 |
$10,956.00 |
$10,956.00 |
$19,423.99
|
|
Inj., benralizumab, 1 mg
|
$50,606.14 |
$50,606.14 |
$50,606.14 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$8,360.00 |
$8,360.00 |
$11,334.91 |
$9,702.65
|
|
Inj, bupivacaine liposome
|
$1,575.95 |
$1,575.95 |
$1,575.95 |
$816.31
|
|
Inj calcitriol per 0.1 mcg
|
$127.75 |
$127.75 |
$127.75 |
$33.36
|
|
Inj cefazolin sodium, hikma
|
$29.85 |
$36.68 |
$159.01 |
$56.70
|
|
Inj, cefiderocol, 10 mg
|
$1,094.75 |
$1,094.75 |
$1,106.60 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$501.00 |
$501.00 |
$786.25 |
$447.36
|
|
Inj cntr knee arthro incl ct/mri
|
$723.00 |
$723.00 |
$723.00 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$2,400.75 |
$2,400.75 |
$3,323.00 |
$2,836.95
|
|
Inj disk cerv-thor ea lev
|
$598.00 |
$598.00 |
$598.00 |
$869.80
|
|
Inj dupuytren cord w/enzyme
|
$985.00 |
$985.00 |
$985.00 |
$416.00
|
|
Inj, durolane 1 mg
|
$5,340.76 |
$5,340.76 |
$5,340.76 |
$3,382.31
|
|
Inj dx for sinogram
|
$561.00 |
$561.00 |
$561.00 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$3,343.00 |
$3,343.00 |
$3,343.00 |
$507.10
|
|
Injection, cangrelor
|
$2,945.00 |
$2,945.00 |
$2,945.00 |
$2,546.20
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$23,349.06 |
$23,349.06 |
$23,349.06 |
$7,107.73
|
|
Injection, doxercalciferol
|
$34.25 |
$34.25 |
$34.25 |
$30.35
|
|
Injection during cath supravalvular aortography
|
$5,740.00 |
$5,740.00 |
$5,740.00 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$723.00 |
$723.00 |
$723.00 |
$441.12
|
|
Injection for bladder x-ray
|
$445.00 |
$445.00 |
$445.00 |
$585.00
|
|
Injection for hip x-ray
|
$2,198.00 |
$2,198.00 |
$2,198.00 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$723.00 |
$723.00 |
$723.00 |
$504.00
|
|
Injection for tear sac x-ray
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$386.00
|
|
Injection for ureter x-ray
|
$474.00 |
$474.00 |
$474.00 |
$444.95
|
|
Injection for ureter x-ray
|
$366.00 |
$366.00 |
$366.00 |
$515.21
|
|
Injection, fulvestrant
|
$19,537.31 |
$19,537.31 |
$19,537.31 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$35,791.81 |
$35,791.81 |
$35,791.81 |
$10,366.61
|
|
Injection into brain canal
|
$909.00 |
$909.00 |
$909.00 |
$933.60
|
|
Injection, isavuconazonium
|
$1,357.50 |
$1,357.50 |
$1,357.50 |
$646.20
|
|
Injection jugular
|
$1,406.00 |
$1,406.00 |
$1,406.00 |
$1,048.20
|
|
Injection of sinus tract
|
$5,107.00 |
$5,107.00 |
$5,107.00 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,034.90 |
$2,034.90 |
$3,075.00 |
$2,154.07
|
|
Injection, peramivir
|
$1,433.00 |
$1,433.00 |
$1,433.00 |
$1,257.68
|
|
Injection px peyronie ds
|
$1,005.00 |
$1,005.00 |
$1,005.00 |
$343.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,426.00 |
$1,426.00 |
$1,426.00 |
$717.20
|
|
Injection, renflexis
|
$1,988.00 |
$1,988.00 |
$1,988.00 |
$1,457.42
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,343.00 |
$3,343.00 |
$3,343.00 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,343.00 |
$3,343.00 |
$3,343.00 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,343.00 |
$3,343.00 |
$3,343.00 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$3,343.00 |
$3,343.00 |
$3,343.00 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,343.00 |
$3,343.00 |
$3,343.00 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$406.00 |
$406.00 |
$406.00 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$404.00 |
$404.00 |
$404.00 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$476.00 |
$476.00 |
$476.00 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$280.00 |
$280.00 |
$280.00 |
$141.60
|
|
Injection treatment of nerve
|
$6,863.00 |
$6,863.00 |
$6,863.00 |
$3,016.15
|
|
Injection treatment of nerve
|
$6,863.00 |
$6,863.00 |
$6,863.00 |
$3,986.00
|
|
Injection treatment of nerve
|
$3,107.00 |
$3,107.00 |
$3,107.00 |
$2,037.10
|
|
Inject sacroiliac joint
|
$3,343.00 |
$3,343.00 |
$3,343.00 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$77,295.58 |
$77,295.58 |
$77,295.58 |
$66,229.74
|
|
Inj epidural sgl cerv-thor without img
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,450.84
|
|
Inj for ext venography
|
$486.00 |
$486.00 |
$486.00 |
$737.55
|
|
Inj for mammo ductogram
|
$637.00 |
$637.00 |
$637.00 |
$433.50
|
|
Inj, fulvestrant (fresenius)
|
$4,346.10 |
$4,346.10 |
$4,346.10 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$103.03 |
$103.03 |
$103.03 |
$96.70
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$6,616.00 |
$6,616.00 |
$6,616.00 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$7,100.00 |
$7,100.00 |
$7,100.00 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$8,760.00 |
$8,760.00 |
$8,760.00 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$2,991.00 |
$2,991.00 |
$2,991.00 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$2,991.00 |
$2,991.00 |
$2,991.00 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$3,267.50 |
$3,267.50 |
$3,267.50 |
$3,180.35
|
|
Inj intralesional <= 7 lsn(s)
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$26,968.14 |
$26,968.14 |
$26,968.14 |
$7,298.71
|
|
Inj levocarnitine per 1 gm
|
$307.00 |
$307.00 |
$331.50 |
$138.96
|
|
Inj, levothyroxine, freskabi
|
$374.23 |
$374.23 |
$374.25 |
$302.07
|
|
Inj mepivacaine hcl/10 ml
|
$3.40 |
$3.40 |
$190.00 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$937.40 |
$937.40 |
$937.40 |
$618.43
|
|
Inj meropenem (wg crit care)
|
$168.46 |
$168.46 |
$168.46 |
$104.29
|
|
Inj, moxifloxacin 100 mg
|
$427.75 |
$427.75 |
$427.75 |
$190.81
|
|
Inj multihance
|
$456.89 |
$456.89 |
$456.89 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,454.00 |
$1,454.00 |
$1,454.00 |
$1,522.56
|
|
Inj pantoprazole(hikma) 40mg
|
$8.55 |
$8.55 |
$8.55 |
$36.04
|
|
Inj peritoneal venous shunt
|
$538.00 |
$538.00 |
$538.00 |
$386.88
|
