|
Infectious agent nucleic acid quantification bk virus
|
$781.90 |
$781.90 |
$781.90 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,099.70 |
$1,099.70 |
$1,099.70 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$506.10 |
$506.10 |
$506.10 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$538.30 |
$538.30 |
$538.30 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$716.80 |
$716.80 |
$716.80 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$6,194.82 |
$6,194.82 |
$6,194.82 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$3,240.30 |
$3,240.30 |
$3,240.30 |
$1,537.84
|
|
Infuse radioactive materials
|
$544.60 |
$544.60 |
$544.60 |
$640.50
|
|
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
|
$138.60 |
$138.60 |
$138.60 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$204.40 |
$204.40 |
$204.40 |
$576.00
|
|
Inj, acetaminophen (b braun)
|
$303.97 |
$303.97 |
$303.97 |
$33.31
|
|
Inj acetaminophen -fresenius
|
$130.55 |
$130.55 |
$130.55 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$244.47 |
$244.47 |
$244.47 |
$58.50
|
|
Inj atezolizumb 5mg hya-tqjs
|
$77,372.57 |
$77,372.57 |
$77,372.57 |
$18,716.52
|
|
Inj calcitriol per 0.1 mcg
|
$307.82 |
$307.82 |
$307.82 |
$23.28
|
|
Inj cefazolin sodium, baxter
|
$116.02 |
$116.02 |
$116.02 |
$27.38
|
|
Inj, cefepime hcl (b braun)
|
$315.35 |
$315.35 |
$315.35 |
$69.85
|
|
Inj ceftolozane tazobactam
|
$1,067.85 |
$1,067.85 |
$1,067.85 |
$380.80
|
|
Inj, clindamycin (baxter)
|
$260.22 |
$260.22 |
$260.22 |
$48.96
|
|
Inj., copanlisib, 1 mg
|
$15,359.92 |
$15,359.92 |
$15,359.92 |
$9,204.29
|
|
Inj cyclophosphamd auromedic
|
$2,017.57 |
$2,017.57 |
$2,017.57 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$3,966.72 |
$3,966.72 |
$3,966.72 |
$742.72
|
|
Inj, daptomycin (hospira)
|
$255.85 |
$255.85 |
$255.85 |
$113.35
|
|
Inj, decitabine (sun pharma)
|
$722.75 |
$722.75 |
$722.75 |
$310.09
|
|
Inj. denosumab-bbdz, 1 mg
|
$16,686.07 |
$16,686.07 |
$16,686.07 |
$4,615.43
|
|
Injection arthrography hip without anesthesia (both sides)
|
$651.00 |
$651.00 |
$651.00 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$423.50 |
$423.50 |
$423.50 |
$450.72
|
|
Injection, daratumumab 10 mg
|
$20,505.45 |
$20,505.45 |
$20,505.45 |
$5,239.24
|
|
Injection during cath supravalvular aortography
|
$32.20 |
$32.20 |
$32.20 |
$952.66
|
|
Injection, edaravone, 1 mg
|
$8,895.60 |
$8,895.60 |
$8,895.60 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$5,050.50 |
$5,050.50 |
$5,050.50 |
$1,156.80
|
|
Injection eye drug
|
$3,068.80 |
$3,068.80 |
$3,068.80 |
$644.50
|
|
Injection for bladder x-ray
|
$1,529.67 |
$1,529.67 |
$1,529.67 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$452.90 |
$452.90 |
$452.90 |
$494.65
|
|
Injection for spleen x-ray
|
$2,619.40 |
$2,619.40 |
$2,619.40 |
$529.57
|
|
Injection for ureter x-ray
|
$1,450.40 |
$1,450.40 |
$1,450.40 |
$427.70
|
|
Injection, fulvestrant
|
$13,227.37 |
$13,227.37 |
$13,227.37 |
$1,817.65
|
|
Injection, glucarpidase
|
$126,398.65 |
$126,398.65 |
$126,398.65 |
$74,113.20
|
|
Injection into brain canal
|
$1,261.40 |
$1,261.40 |
$1,261.40 |
$1,289.60
|
|
Injection jugular
|
$4,524.10 |
$4,524.10 |
$4,524.10 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$4,350.67 |
$4,350.67 |
$4,350.67 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$47,263.73 |
$47,263.73 |
$47,263.73 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$75,375.29 |
$75,375.29 |
$75,375.29 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$58,359.08 |
$58,359.08 |
$58,359.08 |
$1,023.50
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$6,749.40 |
$6,749.40 |
$6,749.40 |
$1,681.24
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$141.40 |
$141.40 |
$141.40 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$141.40 |
$141.40 |
$141.40 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$172.90 |
$172.90 |
$172.90 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$109.20 |
$109.20 |
$109.20 |
$135.60
|
|
Injection treatment of eye
|
$4,273.50 |
$4,273.50 |
$4,273.50 |
$2,665.60
|
|
Injection treatment of nerve
|
$4,208.40 |
$4,208.40 |
$4,208.40 |
$4,350.00
|
|
Inj, eculizumab-aagh, 2 mg
|
$24,834.95 |
$24,834.95 |
$24,834.95 |
$7,980.52
|
|
Inj, eculizumab-aeeb, 2 mg
|
$31,931.55 |
$31,931.55 |
$31,931.55 |
$610.56
|
|
Inj epidural sgl cerv-thor without img
|
$2,876.30 |
$2,876.30 |
$2,876.30 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$2,927.40 |
$2,927.40 |
$2,927.40 |
$1,415.50
|
|
Inj for ext venography
|
$2,583.00 |
$2,583.00 |
$2,583.00 |
$649.95
|
|
Inj, fulvestrant (fresenius)
|
$6,477.97 |
$6,477.97 |
$6,477.97 |
$1,043.05
|
|
Inj glofitamab gxbm, 2.5 mg
|
$31,696.35 |
$31,696.35 |
$31,696.35 |
$4,760.67
|
|
Inj. herceptin hylecta, 10mg
|
$25,429.25 |
$25,429.25 |
$25,429.25 |
$7,690.59
|
|
Inj hrt cath w/s&i sel hrt ang
|
$3,314.50 |
$3,314.50 |
$3,314.50 |
$1,827.74
|
|
Inj hrt cath w/s&i sel left vent
|
$1,657.60 |
$1,657.60 |
$1,657.60 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$1,657.60 |
$1,657.60 |
$1,657.60 |
$965.33
|
|
Inj hydroxocobalamin IV 25mg
|
$6,418.30 |
$6,418.30 |
$6,418.30 |
$2,452.32
|
|
Inj imip 4 cilas 4 releb 2mg
|
$1,936.20 |
$1,936.20 |
$1,936.20 |
$739.77
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$5,803.00 |
$5,803.00 |
$5,803.00 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$371.00 |
$371.00 |
$371.00 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$12,573.22 |
$12,573.22 |
$12,573.22 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$79.45 |
$79.45 |
$79.45 |
$38.94
|
|
Inj levocarnitine per 1 gm
|
$245.17 |
$245.17 |
$245.17 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$450.10 |
$450.10 |
$450.10 |
$47.52
|
|
Inj mepivacaine hcl/10 ml
|
$392.52 |
$392.52 |
$392.52 |
$33.86
|
|
Inj, meropenem (b. braun)
|
$1,021.12 |
$1,021.12 |
$1,021.12 |
$71.14
|
|
Inj, micafungin (par pharm)
|
$97.30 |
$97.30 |
$97.30 |
$89.40
|
|
Inj multihance
|
$313.25 |
$313.25 |
$313.25 |
$73.49
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$11,497.73 |
$11,497.73 |
$11,497.73 |
$1,413.35
|
|
Inj nivolumab 2 mg hyaluron
|
$43,465.27 |
$43,465.27 |
$43,465.27 |
$15,599.68
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$3,824.88 |
$3,824.88 |
$3,824.88 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$3,793.89 |
$3,793.89 |
$3,793.89 |
$2,609.38
|
|
Inj ogivri 10 mg
|
$5,060.82 |
$5,060.82 |
$5,060.82 |
$4,492.28
|
|
Inj pantoprazole(hikma) 40mg
|
$46.20 |
$46.20 |
$46.20 |
$34.67
|
|
Inj peritoneal venous shunt
|
$1,262.80 |
$1,262.80 |
$1,262.80 |
$413.70
|
|
Inj proc ankle arthr
|
$128.80 |
$128.80 |
$128.80 |
$405.31
|
|
Inj proc myelogram lumbar
|
$5,741.93 |
$5,741.93 |
$5,741.93 |
$830.50
|
|
Inj proc sialogram
|
$1,299.20 |
$1,299.20 |
$1,299.20 |
$373.00
|
|
Inj retro urethrocysto
|
$12,657.50 |
$12,657.50 |
$12,657.50 |
$443.50
|
|
Inj scleros sol mult veins
|
$16,471.17 |
$16,471.17 |
$16,471.17 |
$675.00
|
|
Inj scleros sol sgl vein
|
$465.50 |
$465.50 |
$465.50 |
$558.97
|
|
Inj teclistamab cqyv 0.5 mg
|
$30,545.20 |
$30,545.20 |
$30,545.20 |
$17,517.56
|
|
Inj testostero enanthate 1mg
|
$0.01 |
$0.01 |
$0.01 |
$123.24
|
|
Inj thrc fascial pln blk bi w/wo image
|
$3,438.40 |
$3,438.40 |
$3,438.40 |
$1,152.97
|
|
Inj thrc fascial pln blk uni w/wo image
|
$5,999.70 |
$5,999.70 |
$5,999.70 |
$837.50
|
|
Inj tofersen intrathec 1 mg
|
$95,097.10 |
$95,097.10 |
$95,097.10 |
$422.10
|
|
Inj vancomycin (xellia) 10mg
|
$924.35 |
$924.35 |
$924.35 |
$76.59
|
|
Inj vasopressin (am reg) 1 u
|
$422.62 |
$422.62 |
$422.62 |
$41.79
|
|
Inj w/fluor eval cv device
|
$1,538.60 |
$1,538.60 |
$1,538.60 |
$503.92
|
|
Ins cath ren art 1st bi
|
$23,957.00 |
$23,957.00 |
$23,957.00 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$22,840.49 |
$22,840.49 |
$22,840.49 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$6,309.80 |
$6,309.80 |
$6,309.80 |
$5,500.86
|
