|
Inj octafluoropropane mic,ml
|
$304.91 |
$304.91 |
$304.91 |
|
|
Inj ogivri 10 mg
|
$6,176.37 |
$6,176.37 |
$6,176.37 |
|
|
Inj olipudase alfa-rpcp 1mg
|
$17,732.13 |
$17,732.13 |
$17,732.13 |
|
|
Inj, omacetaxine mep, 0.01mg
|
$3,148.06 |
$3,148.06 |
$3,148.06 |
|
|
Inj., omadacycline, 1 mg
|
$1,121.25 |
$1,121.25 |
$1,121.25 |
|
|
Inj, pafolacianine, 0.1 mg
|
$9,948.75 |
$9,948.75 |
$9,948.75 |
|
|
Inj, panzyga, 500 mg
|
$10,769.70 |
$10,769.70 |
$10,769.70 |
|
|
Inj, pasireotide long acting
|
$45,195.32 |
$45,195.32 |
$45,195.32 |
|
|
Inj., patisiran, 0.1 mg
|
$21,139.35 |
$21,139.35 |
$21,139.35 |
|
|
Inj, pedmark, 100 mg
|
$25,897.65 |
$25,897.65 |
$25,897.65 |
|
|
Inj, pegcetacoplan, 1mg
|
$5,283.12 |
$5,283.12 |
$5,283.12 |
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$9,189.49 |
$9,189.49 |
$9,189.49 |
|
|
Inj. pemetrexed, 10 mg
|
$10,452.64 |
$10,452.64 |
$10,452.64 |
|
|
Inj pemetrexed ditromethamin
|
$1,198.70 |
$1,198.70 |
$1,198.70 |
|
|
Inj pemetrexed (sandoz) 10mg
|
$8,246.10 |
$8,246.10 |
$8,246.10 |
|
|
Inj, pemivibart, 4500 mg
|
$1,654.76 |
$1,654.76 |
$1,654.76 |
|
|
Inj., perseris, 0.5 mg
|
$6,787.04 |
$6,787.04 |
$6,787.04 |
|
|
Inj plasminogen tvmh 1mg
|
$6,428.08 |
$6,428.08 |
$6,428.08 |
|
|
Inj., plazomicin, 5 mg
|
$813.16 |
$813.16 |
$813.16 |
|
|
Inj proc lumbr disk ea lvl
|
$407.04 |
$407.04 |
$893.25 |
|
|
Inj proc sialogram
|
$169.60 |
$169.60 |
$169.60 |
|
|
Inj progesterone per 50 mg
|
$4.74 |
$4.74 |
$4.74 |
|
|
Inj retro urethrocysto
|
$169.60 |
$169.60 |
$321.75 |
|
|
Inj, rimabotulinumtoxinb
|
$746.79 |
$746.79 |
$746.79 |
|
|
Inj roctavian ml 2x10^13vc g
|
$187,598.85 |
$187,598.85 |
$187,598.85 |
|
|
Inj romidepsin non-lyo 0.1mg
|
$18,083.74 |
$18,083.74 |
$18,083.74 |
|
|
Inj scleros sol sgl vein
|
$592.50 |
$592.50 |
$592.50 |
|
|
Inj secretin synthetic human
|
$1,027.50 |
$1,027.50 |
$1,027.50 |
|
|
Inj secukinumab intrav 1mg
|
$5,153.29 |
$5,153.29 |
$5,153.29 |
|
|
Inj, sezaby, 1 mg
|
$315.87 |
$315.87 |
$315.87 |
|
|
Inj, spesolimab-sbzo, 1 mg
|
$120,545.93 |
$120,545.93 |
$120,545.93 |
|
|
Inj sulf hexa lipid microsph
|
$343.05 |
$343.05 |
$343.05 |
|
|
Inj, susvimo 0.1 mg
|
$3,747.75 |
$3,747.75 |
$3,747.75 |
|
|
Inj, sutimlimab-jome, 10 mg
|
$4,625.54 |
$4,625.54 |
$4,625.54 |
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$72,948.12 |
$72,948.12 |
$72,948.12 |
|
|
Inj, taliglucerace alfa 10 u
|
$2,107.06 |
$2,107.06 |
$2,107.06 |
|
|
Inj teclistamab cqyv 0.5 mg
|
$22,600.46 |
$22,600.46 |
$22,600.46 |
|
|
Inj tedizolid phosphate
|
$870.68 |
$870.68 |
$870.68 |
|
|
Inj teplizumab mzwv 5 mcg
|
$29,919.75 |
$29,919.75 |
$29,919.75 |
|
|
Inj. teprotumumab-trbw 10 mg
|
$38,924.69 |
$38,924.69 |
$38,924.69 |
|
|
Inj testostero enanthate 1mg
|
$379.98 |
$379.98 |
$379.98 |
|
|
Inj testosterone cypionate
|
$33.31 |
$33.31 |
$33.31 |
|
|
Inj theophylline per 40 mg
|
$46.02 |
$46.02 |
$46.02 |
|
|
Inj thiotepa nos 1 mg
|
$4,245.75 |
$4,245.75 |
$4,245.75 |
|
|
Inj, tislelizumab-jsgr
|
$13,076.91 |
$13,076.91 |
$13,076.91 |
|
|
Inj triamcinolone ace X-ray 1mg
|
$1,460.82 |
$1,460.82 |
$1,460.82 |
|
|
Inj., triptorelin X-ray 3.75 mg
|
$48,196.72 |
$48,196.72 |
$48,196.72 |
|
|
Inj, tyenne, 1 mg
|
$4,586.41 |
$4,586.41 |
$4,586.41 |
|
|
Inj ustekinumab-kfce, 1 mg
|
$7,023.71 |
$7,023.71 |
$7,023.71 |
|
|
Inj, uzedy, 1 mg
|
$15,369.60 |
$15,369.60 |
$15,369.60 |
|
|
Inj vancomycin (xellia) 10mg
|
$89.43 |
$89.43 |
$89.43 |
|
|
Inj, vasopressin (baxter)
|
$97.92 |
$97.92 |
$354.75 |
|
|
Inj, vegzelma, 10 mg
|
$1,588.87 |
$1,588.87 |
$2,185.02 |
|
|
Inj velmanase alfa-tycv 1 mg
|
$10,274.01 |
$10,274.01 |
$10,274.01 |
|
|
Inj. viltolarsen
|
$3,303.15 |
$3,303.15 |
$3,303.15 |
|
|
Inj vocal cord bulking agent
|
$472.50 |
$472.50 |
$472.50 |
|
|
Inj w/fluor eval cv device
|
$179.84 |
$179.84 |
$687.00 |
|
|
Inj. xembify, 100 mg
|
$4,622.91 |
$4,622.91 |
$4,622.91 |
|
|
Inj xipere 1 mg
|
$432.75 |
$432.75 |
$432.75 |
|
|
Inj., yutiq, 0.01 mg
|
$19,726.35 |
$19,726.35 |
$19,726.35 |
|
|
Inj zanidatamab-hrii, 2 mg
|
$8,352.45 |
$8,352.45 |
$8,352.45 |
|
|
Inj zenocutuzumab-zbco 1 mg
|
$25,683.75 |
$25,683.75 |
$25,683.75 |
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$51,692.21 |
$51,692.21 |
$51,692.21 |
|
|
Ins cath ren art 1st bi
|
$3,045.44 |
$3,045.44 |
$4,020.00 |
|
|
Ins cath ren art 1st uni
|
$2,522.24 |
$2,522.24 |
$3,752.25 |
|
|
Ins cath ren art 2nd+ bi
|
$2,374.40 |
$2,374.40 |
$2,374.40 |
|
|
Ins cath ren art 2nd+ uni
|
$3,256.32 |
$3,256.32 |
$6,027.00 |
|
|
Ins cerv dilator (sep proc)
|
$169.60 |
$169.60 |
$964.50 |
|
|
Insert cannula vein-to-vein hemodialysis
|
$7,014.75 |
$7,014.75 |
$7,014.75 |
|
|
Insert cath pleura with image
|
$1,176.96 |
$1,176.96 |
$3,461.25 |
|
|
Insert cath pleura without image
|
$720.96 |
$720.96 |
$3,177.75 |
|
|
Insert drug delivery implant
|
$109.44 |
$109.44 |
$279.75 |
|
|
Insert hepatic shunt (tips)
|
$1,899.52 |
$1,899.52 |
$2,934.75 |
|
|
Insert intrauterine device iud
|
$38.72 |
$38.72 |
$225.00 |
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$5,613.75 |
$5,613.75 |
$5,613.75 |
|
|
Insertion catheter bladder non indwelling
|
$56.64 |
$56.64 |
$114.00 |
|
|
Insertion catheter bladder temporary simple
|
$75.84 |
$75.84 |
$166.50 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,264.00 |
$3,264.00 |
$6,976.50 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$824.25 |
$824.25 |
$2,238.72 |
|
|
Insertion intra-aortic circulation dev 33970
|
$123.52 |
$123.52 |
$123.52 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,256.32 |
$3,256.32 |
$7,585.50 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,791.04 |
$1,791.04 |
$3,864.00 |
|
|
Insertion of catheter vein
|
$508.80 |
$508.80 |
$5,335.50 |
|
|
Insertion of catheter vein
|
$471.00 |
$471.00 |
$471.00 |
|
|
Insertion of heart electrode 33211
|
$9,716.25 |
$9,716.25 |
$9,716.25 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,291.52 |
$5,291.52 |
$8,202.00 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$9,109.12 |
$9,109.12 |
$11,747.25 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$1,969.92 |
$1,969.92 |
$3,698.25 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$883.84 |
$883.84 |
$3,054.75 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,159.68 |
$1,159.68 |
$3,084.00 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$21,708.80 |
$21,708.80 |
$25,472.25 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,797.76 |
$5,797.76 |
$9,716.25 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$7,944.00 |
$7,944.00 |
$9,716.25 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$5,620.48 |
$5,620.48 |
$15,150.00 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$2,021.76 |
$2,021.76 |
$5,140.50 |
|
|
Insert multi-comp penis pros
|
$639.68 |
$639.68 |
$639.68 |
|
|
Insert pessary/other device
|
$35.52 |
$35.52 |
$35.52 |
|
|
Insert pm/icd lead dual
|
$3,799.04 |
$3,799.04 |
$9,716.25 |
|
|
Insert/repl sq defib w/eltrd
|
$19,754.88 |
$19,754.88 |
$37,100.25 |
|
|
Insert sq defib electrode
|
$9,716.25 |
$9,716.25 |
$9,716.25 |
|
