|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$306.84 |
$306.84 |
$541.61 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$541.61 |
$541.61 |
$541.61 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$268.70 |
$268.70 |
$268.70 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,608.25 |
$1,608.25 |
$1,608.25 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$1,980.15 |
$1,980.15 |
$1,980.15 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$232.00 |
$4,059.25 |
$4,059.25 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$261.60 |
$661.24 |
$2,151.91 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$87.00 |
$98.10 |
$661.24 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$661.24 |
$661.24 |
$661.24 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,313.52 |
$1,313.52 |
$1,313.52 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$2,201.49 |
$2,201.49 |
$2,201.49 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$2,712.21 |
$2,712.21 |
$2,712.21 |
$2,102.08
|
|
Infuse radioactive materials
|
$1,581.48 |
$1,581.48 |
$1,581.48 |
$600.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$624.97 |
$1,819.13 |
$1,819.13 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$1,785.80 |
$1,785.80 |
$1,785.80 |
$645.79
|
|
Inj, abilify maintena, 1 mg
|
$6,557.09 |
$6,557.09 |
$6,557.09 |
$6,796.39
|
|
Inj allopurinol sodium 1 mg
|
$4,417.65 |
$4,417.65 |
$8,700.00 |
$7,176.71
|
|
Inj, amisulpride, 1 mg
|
$315.06 |
$315.06 |
$315.06 |
$9.66
|
|
Inj., benralizumab, 1 mg
|
$39,323.12 |
$39,323.12 |
$43,717.35 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$8,820.46 |
$8,820.46 |
$9,804.69 |
$8,698.20
|
|
Inj calcitriol per 0.1 mcg
|
$116.60 |
$116.60 |
$116.60 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$108.87 |
$117.61 |
$143.65 |
$34.59
|
|
Inj, cefiderocol, 10 mg
|
$455.40 |
$455.40 |
$656.25 |
$596.08
|
|
Inj ceftolozane tazobactam
|
$246.00 |
$246.00 |
$756.39 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$542.63 |
$542.63 |
$542.63 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$2,735.85 |
$2,735.85 |
$3,960.00 |
$2,735.85
|
|
Inj daptomycin (xellia)
|
$3.95 |
$3.95 |
$3.95 |
$0.42
|
|
Inj disk cerv-thor ea lev
|
$1,268.09 |
$1,268.09 |
$1,268.09 |
$869.80
|
|
Inj dupuytren cord w/enzyme
|
$1,358.89 |
$1,358.89 |
$1,358.89 |
$416.00
|
|
Inj, durolane 1 mg
|
$4,164.70 |
$4,164.70 |
$4,628.45 |
$2,181.77
|
|
Inj dx for sinogram
|
$988.14 |
$988.14 |
$988.14 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$5,410.92 |
$5,410.92 |
$5,410.92 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$2,822.35 |
$2,822.35 |
$2,822.35 |
$507.10
|
|
Injection, cangrelor
|
$1,888.00 |
$1,888.00 |
$1,888.00 |
$1,943.40
|
|
Injection carpal tunnel therapeutic (both sides)
|
$2,505.56 |
$2,505.56 |
$2,505.56 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$23,687.10 |
$23,687.10 |
$23,870.47 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$3,449.01 |
$3,449.01 |
$3,449.01 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$2,170.13 |
$2,170.13 |
$2,170.13 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$882.21 |
$882.21 |
$882.21 |
$441.12
|
|
Injection for bladder x-ray
|
$1,709.65 |
$1,709.65 |
$1,709.65 |
$585.00
|
|
Injection for hip x-ray
|
$2,648.04 |
$2,648.04 |
$2,648.04 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$2,505.56 |
$2,505.56 |
$2,505.56 |
$504.00
|
|
Injection for tear sac x-ray
|
$1,414.28 |
$1,414.28 |
$1,414.28 |
$386.00
|
|
Injection for ureter x-ray
|
$2,247.25 |
$2,247.25 |
$2,247.25 |
$444.95
|
|
Injection for ureter x-ray
|
$2,556.19 |
$2,556.19 |
$2,556.19 |
$515.21
|
|
Injection, fulvestrant
|
$4,530.41 |
$14,685.88 |
$15,337.97 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$27,816.57 |
$27,816.57 |
$30,924.45 |
$6,830.50
|
|
Injection into brain canal
|
$4,998.30 |
$4,998.30 |
$4,998.30 |
$933.60
|
|
Injection, isavuconazonium
|
$4.00 |
$4.00 |
$4.00 |
$863.93
|
|
Injection jugular
|
$4,390.39 |
$4,390.39 |
$4,390.39 |
$1,048.20
|
|
Injection of sinus tract
|
$15,514.83 |
$15,514.83 |
$15,514.83 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,904.38 |
$2,904.38 |
$2,932.00 |
$2,154.07
|
|
Injection px peyronie ds
|
$1,824.22 |
$1,824.22 |
$1,824.22 |
$343.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,205.06 |
$1,205.06 |
$1,205.06 |
$717.20
|
|
Injection, renflexis
|
$2,179.63 |
$2,179.63 |
$2,179.63 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$5,410.92 |
$5,410.92 |
$5,410.92 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,876.88 |
$1,876.88 |
$1,876.88 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,876.88 |
$1,876.88 |
$1,876.88 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,962.67 |
$2,962.67 |
$2,962.67 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,971.66 |
$1,971.66 |
$1,971.66 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$9,323.14 |
$9,323.14 |
$9,323.14 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,142.04 |
$1,142.04 |
$1,142.04 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,719.69 |
$2,719.69 |
$2,782.37 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$5,410.92 |
$5,410.92 |
$5,410.92 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,269.59 |
$2,269.59 |
$2,269.59 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,358.89 |
$1,358.89 |
$1,358.89 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,358.89 |
$1,358.89 |
$1,358.89 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,358.89 |
$1,358.89 |
$1,358.89 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$368.30 |
$368.30 |
$368.30 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$335.85 |
$335.85 |
$335.85 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$479.72 |
$479.72 |
$479.72 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$270.10 |
$270.10 |
$270.10 |
$141.60
|
|
Injection treatment of nerve
|
$20,662.96 |
$20,662.96 |
$20,662.96 |
$3,016.15
|
|
Injection treatment of nerve
|
$20,662.96 |
$20,662.96 |
$20,662.96 |
$3,986.00
|
|
Injection treatment of nerve
|
$9,323.14 |
$9,323.14 |
$9,323.14 |
$2,037.10
|
|
Inject sacroiliac joint
|
$1,879.14 |
$1,879.14 |
$1,879.14 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$127,124.73 |
$127,124.73 |
$141,334.63 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$5,410.92 |
$5,410.92 |
$5,410.92 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$5,410.92 |
$5,410.92 |
$5,410.92 |
$1,450.84
|
|
Inj for ext venography
|
$1,610.19 |
$1,610.19 |
$1,610.19 |
$737.55
|
|
Inj for mammo ductogram
|
$1,032.21 |
$1,032.21 |
$1,032.21 |
$433.50
|
|
Inj, fulvestrant (fresenius)
|
$2,931.54 |
$2,931.54 |
$3,061.25 |
$1,242.20
|
|
Inj glycopyrrolate fres kabi
|
$77.09 |
$77.09 |
$82.85 |
$47.05
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$3,067.42 |
$3,067.42 |
$3,067.42 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$4,456.36 |
$4,456.36 |
$4,456.36 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,563.15 |
$1,563.15 |
$1,563.15 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$3,854.60 |
$3,854.60 |
$3,854.60 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$4,016.30 |
$4,016.30 |
$4,016.30 |
$947.65
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$2,956.81 |
$2,956.81 |
$2,956.81 |
$1,901.25
|
|
Inj intralesional <= 7 lsn(s)
|
$1,343.11 |
$1,343.11 |
$1,343.11 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$2,037.30 |
$2,037.30 |
$2,037.30 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$28,096.19 |
$28,096.19 |
$32,314.67 |
$7,173.90
|
|
Inj levocarnitine per 1 gm
|
$231.12 |
$231.12 |
$865.00 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$320.80 |
$320.80 |
$598.65 |
$303.45
|
|
Inj mepivacaine hcl/10 ml
|
$18.43 |
$18.43 |
$18.62 |
$31.28
|
|
Inj., meropenem, vaborbactam
|
$473.00 |
$473.00 |
$666.28 |
$586.20
|
|
Inj meropenem (wg crit care)
|
$15.82 |
$15.82 |
$15.82 |
$99.20
|
|
Inj, moxifloxacin 100 mg
|
$227.00 |
$227.00 |
$227.00 |
$153.27
|
|
Inj multihance
|
$154.11 |
$154.11 |
$410.96 |
$119.25
|
|
Inj. mycophenolate mofetil
|
$501.00 |
$501.00 |
$501.00 |
$291.54
|
