|
Inj acetaminophen -fresenius
|
$3.60 |
$3.60 |
$3.60 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$21.60 |
$21.60 |
$21.60 |
$58.50
|
|
Inj aval alfa-nqpt 4mg
|
$201.91 |
$201.91 |
$201.91 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$505.19 |
$505.19 |
$505.19 |
$11,239.97
|
|
Inj, bupivacaine liposome
|
$7.39 |
$7.39 |
$7.39 |
$699.38
|
|
Inj cefazolin (wg crit care)
|
$7.20 |
$7.20 |
$7.20 |
$18.05
|
|
Inj, cefiderocol, 10 mg
|
$6.03 |
$6.03 |
$6.03 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$37.66 |
$37.66 |
$37.66 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$149.76 |
$149.76 |
$149.76 |
$436.80
|
|
Inj daptomycin (xellia)
|
$0.52 |
$0.52 |
$0.52 |
$56.04
|
|
Inj dx for sinogram
|
$669.60 |
$669.60 |
$669.60 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,028.96 |
$2,028.96 |
$2,028.96 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$110.88 |
$110.88 |
$110.88 |
$495.84
|
|
Injection, cangrelor
|
$51.90 |
$51.90 |
$51.90 |
$1,889.78
|
|
Injection during cath supravalvular aortography
|
$560.88 |
$560.88 |
$560.88 |
$952.66
|
|
Injection epidural blood patch or clot
|
$2,095.20 |
$2,095.20 |
$2,095.20 |
$1,156.80
|
|
Injection eye drug
|
$884.88 |
$884.88 |
$884.88 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$100.80 |
$100.80 |
$100.80 |
$428.40
|
|
Injection for bladder x-ray
|
$100.80 |
$100.80 |
$100.80 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$122.40 |
$122.40 |
$122.40 |
$494.65
|
|
Injection for ureter x-ray
|
$912.24 |
$912.24 |
$912.24 |
$427.70
|
|
Injection for ureter x-ray
|
$1,036.80 |
$1,036.80 |
$1,036.80 |
$515.21
|
|
Injection, fulvestrant
|
$25.92 |
$25.92 |
$25.92 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$31.49 |
$31.49 |
$31.49 |
$6,679.35
|
|
Injection into brain canal
|
$2,593.44 |
$2,593.44 |
$2,593.44 |
$836.40
|
|
Injection into hemorrhoid(s)
|
$1,969.20 |
$1,969.20 |
$1,969.20 |
$1,432.81
|
|
Injection, isavuconazonium
|
$4.13 |
$4.13 |
$4.13 |
$787.67
|
|
Injection jugular
|
$8,354.16 |
$8,354.16 |
$8,354.16 |
$790.00
|
|
Injection of sinus tract
|
$5,086.08 |
$5,086.08 |
$5,086.08 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$16.88 |
$16.88 |
$16.88 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,096.56 |
$1,096.56 |
$1,096.56 |
$670.64
|
|
Injection, renflexis
|
$195.28 |
$195.28 |
$195.28 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,245.76 |
$3,245.76 |
$3,245.76 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,904.40 |
$1,904.40 |
$1,904.40 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,301.04 |
$1,301.04 |
$1,301.04 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,579.12 |
$3,579.12 |
$3,579.12 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,333.44 |
$1,333.44 |
$1,333.44 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,317.68 |
$2,317.68 |
$2,317.68 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,923.12 |
$1,923.12 |
$1,923.12 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,876.40 |
$2,876.40 |
$2,876.40 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,548.08 |
$2,548.08 |
$2,548.08 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$554.40 |
$554.40 |
$554.40 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$732.96 |
$732.96 |
$732.96 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$637.92 |
$637.92 |
$637.92 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$222.48 |
$222.48 |
$222.48 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$219.60 |
$219.60 |
$219.60 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$396.00 |
$396.00 |
$396.00 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$208.80 |
$208.80 |
$208.80 |
$135.60
|
|
Inject sacroiliac joint
|
$1,205.28 |
$1,205.28 |
$1,205.28 |
$1,028.95
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$82.74 |
$82.74 |
$82.74 |
$32,176.93
|
|
Inj eflapegrastim-xnst 0.1mg
|
$88.37 |
$88.37 |
$88.37 |
$22.75
|
|
Inj epidural sgl lumb-sacral without img
|
$2,442.24 |
$2,442.24 |
$2,442.24 |
$1,415.50
|
|
Inj., eravacycline, 1 mg
|
$5.80 |
$5.80 |
$5.80 |
$206.64
|
|
Inj. fe derisomaltose 10 mg
|
$94.67 |
$94.67 |
$94.67 |
$3,221.52
|
|
Inj fluphenazine hcl 1.25 mg
|
$41.49 |
$41.49 |
$41.49 |
$39.54
|
|
Inj for ext venography
|
$660.96 |
$660.96 |
$660.96 |
$649.95
|
|
Inj for mammo ductogram
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$399.60
|
|
Inj., guselkumab, 1 mg
|
$188.78 |
$188.78 |
$188.78 |
$29,130.83
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$3,317.76 |
$3,317.76 |
$3,317.76 |
$1,439.90
|
|
Inj hrt cath w/s&i sel right vent
|
$3,194.64 |
$3,194.64 |
$3,194.64 |
$965.33
|
|
Inj hydroxocobalamin IV 25mg
|
$12.93 |
$12.93 |
$12.93 |
$2,452.32
|
|
Inj ivig privigen 500 mg
|
$248.65 |
$248.65 |
$248.65 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$21.60 |
$21.60 |
$21.60 |
$38.94
|
|
Inj, levothyroxine, freskabi
|
$38.32 |
$38.32 |
$38.32 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$8.64 |
$8.64 |
$8.64 |
$47.52
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$547.92 |
$547.92 |
$547.92 |
$784.00
|
|
Inj mepivacaine hcl/10 ml
|
$16.06 |
$16.06 |
$16.06 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$9.33 |
$9.33 |
$9.33 |
$558.08
|
|
Inj multihance
|
$26.93 |
$26.93 |
$26.93 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$6.26 |
$6.26 |
$6.26 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,594.80 |
$1,594.80 |
$1,594.80 |
$1,413.35
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$116.31 |
$116.31 |
$116.31 |
$66,582.27
|
|
Inj proc ankle arthr
|
$100.80 |
$100.80 |
$100.80 |
$405.31
|
|
Inj proc elbow arthro
|
$100.80 |
$100.80 |
$100.80 |
$419.60
|
|
Inj proc lumbr disk ea lvl
|
$1,878.48 |
$1,878.48 |
$1,878.48 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$843.84 |
$843.84 |
$843.84 |
$830.50
|
|
Inj proc sialogram
|
$242.64 |
$242.64 |
$242.64 |
$373.00
|
|
Inj, releuko 1 mcg
|
$686.88 |
$686.88 |
$686.88 |
$473.25
|
|
Inj retro urethrocysto
|
$87.84 |
$87.84 |
$87.84 |
$443.50
|
|
Inj scleros sol sgl vein
|
$863.28 |
$863.28 |
$863.28 |
$558.97
|
|
Inj teclistamab cqyv 0.5 mg
|
$88.28 |
$88.28 |
$88.28 |
$17,517.56
|
|
Inj testosterone cypionate
|
$0.48 |
$0.48 |
$0.48 |
$64.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$154.80 |
$154.80 |
$154.80 |
$1,152.97
|
|
Inj thrc fascial pln blk uni w/wo image
|
$139.68 |
$139.68 |
$139.68 |
$837.50
|
|
Inj, tyenne, 1 mg
|
$12.69 |
$12.69 |
$12.69 |
$3,525.12
|
|
Inj w/fluor eval cv device
|
$396.00 |
$396.00 |
$396.00 |
$503.92
|
|
Ins cath ren art 1st bi
|
$9,732.24 |
$9,732.24 |
$9,732.24 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$9,732.24 |
$9,732.24 |
$9,732.24 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$11,124.00 |
$11,124.00 |
$11,124.00 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$11,676.24 |
$11,676.24 |
$11,676.24 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$1,044.72 |
$1,044.72 |
$1,044.72 |
$480.28
|
|
Insert abdomen-venous drain
|
$16,246.80 |
$16,246.80 |
$16,246.80 |
$3,147.06
|
|
Insert and remove bone pin
|
$6,094.08 |
$6,094.08 |
$6,094.08 |
$4,410.60
|
|
Insert cath pleura with image
|
$6,580.08 |
$6,580.08 |
$6,580.08 |
$2,194.40
|
|
Insert cath pleura without image
|
$4,389.84 |
$4,389.84 |
$4,389.84 |
$2,073.18
|
|
Insert eye socket implant
|
$8,915.04 |
$8,915.04 |
$8,915.04 |
$5,067.20
|
|
Insert hepatic shunt (tips)
|
$14,651.28 |
$14,651.28 |
$14,651.28 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$501.12 |
$501.12 |
$501.12 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$600.48 |
$600.48 |
$600.48 |
$232.25
|
