|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$105.27 |
$105.27 |
$716.80 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$112.84 |
$114.19 |
$7,131.42 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$116.86 |
$116.86 |
$116.86 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$113.36 |
$113.36 |
$3,968.30 |
$1,537.84
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$780.00 |
$780.00 |
$780.00 |
$762.00
|
|
Infratemporal approach/skull
|
$104,002.59 |
$104,002.59 |
$104,002.59 |
$13,453.70
|
|
Inf thrc fascial pln blk bi w/wo image
|
$780.00 |
$780.00 |
$780.00 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$780.00 |
$780.00 |
$780.00 |
$770.00
|
|
Infuse radioactive materials
|
$373.89 |
$544.60 |
$1,085.00 |
$739.50
|
|
Ingest challenge ea addl 60 min
|
$313.60 |
$313.60 |
$313.60 |
$289.64
|
|
Ingest challenge ini 120 min
|
$822.50 |
$822.50 |
$822.50 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$121.77 |
$121.77 |
$449.40 |
$296.00
|
|
Inj, abilify maintena, 1 mg
|
$15.65 |
$15.65 |
$1,832.61 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$197.57 |
$197.57 |
$197.57 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$130.55 |
$130.55 |
$130.55 |
$36.60
|
|
Inj, adalimumab, 1 mg
|
$28,302.75 |
$28,302.75 |
$28,302.75 |
$12,098.05
|
|
Inj, adzynma, 10 iu
|
$103.89 |
$103.89 |
$23,628.15 |
$34.60
|
|
Inj, alfentanil hcl, 500mcg
|
$10.32 |
$10.32 |
$10.32 |
$35.94
|
|
Inj allopurinol sodium 1 mg
|
$10,443.30 |
$10,443.30 |
$10,443.30 |
$6,968.99
|
|
Inj anifrolumab-fnia 1mg
|
$43.43 |
$43.43 |
$6,703.14 |
$10,052.58
|
|
Inj, artesunate, 1mg
|
$33,677.35 |
$33,677.35 |
$33,677.35 |
$14,460.21
|
|
Inj, aspara, rylaze, 0.1 mg
|
$33,248.42 |
$33,248.42 |
$33,248.42 |
$10,458.00
|
|
Inj beta interferon sq 1 mcg
|
$56.75 |
$56.75 |
$7,649.95 |
$2,397.11
|
|
Inj, betibeglogene autotemce
|
$14,973,577.00 |
$14,973,577.00 |
$14,973,577.00 |
$4,057,157.07
|
|
Inj, bezlotoxumab, 10 mg
|
$16,099.47 |
$16,099.47 |
$16,099.47 |
$7,612.43
|
|
Inj, bortezomib freseniuskab
|
$2,301.11 |
$2,301.11 |
$2,301.11 |
$2,624.08
|
|
Inj, brixadi, 7 days or less
|
$1,809.15 |
$1,809.15 |
$1,809.15 |
$748.85
|
|
Inj brixadi, more than 7 day
|
$10,813.60 |
$10,813.60 |
$10,813.60 |
$2,858.76
|
|
Inj, bupivacaine liposome
|
$4.07 |
$4.10 |
$803.76 |
$699.38
|
|
Inj cefazolin sodium, baxter
|
$44.45 |
$44.45 |
$44.45 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$19.42 |
$19.42 |
$19.42 |
$27.38
|
|
Inj, cefiderocol, 10 mg
|
$2,009.70 |
$2,009.70 |
$2,009.70 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$516.97 |
$516.97 |
$1,067.85 |
$364.86
|
|
Inj, clindamycin (baxter)
|
$86.51 |
$86.51 |
$86.51 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$332.50 |
$332.50 |
$459.90 |
$436.80
|
|
Inj. denosumab-bbdz, 1 mg
|
$10,663.10 |
$10,663.10 |
$10,663.10 |
$4,615.43
|
|
Inj disk cerv-thor ea lev
|
$365.00 |
$365.00 |
$392.50 |
$875.28
|
|
Inj dx for sinogram
|
$135.00 |
$380.00 |
$975.10 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,135.00 |
$1,630.00 |
$4,981.02 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$332.50 |
$332.50 |
$1,226.40 |
$503.50
|
|
Injection, cangrelor
|
$7,927.15 |
$7,927.15 |
$7,927.15 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$53,318.65 |
$53,318.65 |
$53,318.65 |
$16,319.16
|
|
Injection carpal tunnel therapeutic (both sides)
|
$345.00 |
$345.00 |
$423.50 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$182.18 |
$182.18 |
$28,898.45 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$32.20 |
$570.00 |
$570.00 |
$1,027.26
|
|
Injection, edaravone, 1 mg
|
$7,058.10 |
$7,058.10 |
$7,058.10 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$820.00 |
$995.00 |
$5,050.50 |
$1,182.33
|
|
Injection eye drug
|
$36,480.79 |
$36,480.79 |
$36,480.79 |
$654.00
|
|
Injection for arthrography wrist (both sides)
|
$332.50 |
$332.50 |
$610.40 |
$436.00
|
|
Injection for bladder x-ray
|
$380.00 |
$380.00 |
$1,529.67 |
$459.20
|
|
Injection for hip x-ray
|
$490.00 |
$490.00 |
$490.00 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$332.50 |
$332.50 |
$904.40 |
$497.76
|
|
Injection for spleen x-ray
|
$118,571.21 |
$118,571.21 |
$118,571.21 |
$686.40
|
|
Injection for tear sac x-ray
|
$2,455.20 |
$2,455.20 |
$2,455.20 |
$225.20
|
|
Injection for ureter x-ray
|
$275.00 |
$275.00 |
$1,450.40 |
$415.80
|
|
Injection for ureter x-ray
|
$390.00 |
$390.00 |
$18,886.03 |
$515.21
|
|
Injection, fulvestrant
|
$26.28 |
$368.41 |
$8,942.15 |
$1,719.16
|
|
Injection glatiramer acetate
|
$2,906.05 |
$2,906.05 |
$2,906.05 |
$830.51
|
|
Injection, glucarpidase
|
$119,124.07 |
$119,124.07 |
$119,124.07 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$29.42 |
$29.47 |
$15,033.02 |
$6,679.35
|
|
Injection into brain canal
|
$3,929.10 |
$3,929.10 |
$3,929.10 |
$1,289.60
|
|
Injection into brain canal
|
$477.50 |
$477.50 |
$477.50 |
$844.50
|
|
Injection into hemorrhoid(s)
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$1,433.00
|
|
Injection, isavuconazonium
|
$3.06 |
$3.06 |
$1,225.00 |
$787.67
|
|
Injection jugular
|
$780.00 |
$780.00 |
$38,363.12 |
$790.00
|
|
Injection of sinus tract
|
$435.40 |
$435.40 |
$625.00 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$19.29 |
$910.11 |
$3,670.10 |
$2,277.65
|
|
Injection, peramivir
|
$4.72 |
$4.72 |
$1,341.72 |
$744.75
|
|
Injection radioactive tracer sentinel node (both sides)
|
$335.00 |
$645.00 |
$3,868.90 |
$685.44
|
|
Injection, renflexis
|
$1,093.81 |
$1,093.81 |
$3,792.25 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,727.20 |
$2,727.20 |
$2,727.20 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,400.00 |
$1,870.00 |
$81,986.32 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$735.00 |
$910.00 |
$4,682.78 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,510.00 |
$1,510.00 |
$3,376.80 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$605.00 |
$770.00 |
$8,887.20 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,540.00 |
$1,540.00 |
$8,881.77 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$940.00 |
$1,090.00 |
$4,437.43 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,820.00 |
$1,820.00 |
$8,948.80 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,145.00 |
$1,145.00 |
$1,934.06 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,145.00 |
$1,145.00 |
$2,781.62 |
$1,685.00
|
|
Injection, siltuximab
|
$38,338.65 |
$38,338.65 |
$38,338.65 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$412.50 |
$412.50 |
$423.50 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$423.50 |
$500.00 |
$500.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$625.00 |
$625.00 |
$923.30 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$42.24 |
$152.50 |
$275.10 |
$145.60
|
|
Injection treatment of eye
|
$16,944.16 |
$16,944.16 |
$16,944.16 |
$2,698.92
|
|
Injection treatment of eye
|
$30,586.53 |
$30,586.53 |
$30,586.53 |
$2,685.92
|
|
Injection treatment of nerve
|
$2,775.00 |
$2,775.00 |
$33,523.65 |
$3,219.20
|
|
Injection treatment of nerve
|
$14,537.10 |
$14,537.10 |
$14,537.10 |
$4,446.30
|
|
Injection treatment of nerve
|
$1,255.00 |
$1,255.00 |
$1,255.00 |
$2,054.00
|
|
Inject sacroiliac joint
|
$957.60 |
$990.00 |
$1,500.00 |
$1,029.04
|
|
Inject/treat eye socket
|
$27,405.51 |
$27,405.51 |
$27,405.51 |
$670.02
|
|
Inj, eculizumab-aagh, 2 mg
|
$15,870.57 |
$15,870.57 |
$15,870.57 |
$7,980.52
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$58.74 |
$58.74 |
$22,642.14 |
$32,176.93
|
|
Inj., emapalumab-lzsg, 1 mg
|
$153,859.81 |
$153,859.81 |
$153,859.81 |
$3,181.80
|
|
Inj epidural sgl cerv-thor without img
|
$895.00 |
$895.00 |
$2,876.30 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$895.00 |
$895.00 |
$23,212.63 |
$1,450.84
|
|
Inj, eteplirsen, 10 mg
|
$33,520.72 |
$33,520.72 |
$33,520.72 |
$2,598.44
|
|
Inj, evinacumab-dgnb, 5mg
|
$310.20 |
$310.20 |
$310.20 |
$20,751.13
|
|
Inj., evomela, 1 mg
|
$4,701.72 |
$4,701.72 |
$4,701.72 |
$17.37
|
