|
Inj., benralizumab, 1 mg
|
$199.20 |
$4,302.09 |
$34,125.70 |
|
|
Inj beta interferon sq 1 mcg
|
$56.75 |
$931.13 |
$7,649.95 |
|
|
Inj, betibeglogene autotemce
|
$14,973,577.00 |
$14,973,577.00 |
$14,973,577.00 |
|
|
Inj, bezlotoxumab, 10 mg
|
$216.76 |
$15,276.00 |
$68,161.97 |
|
|
Inj, biorphen, 20 micrograms
|
$0.69 |
$2.12 |
$14.32 |
|
|
Inj, bortezomib, dr. reddy's
|
$18.86 |
$277.06 |
$277.06 |
|
|
Inj, bortezomib freseniuskab
|
$1,559.27 |
$1,559.27 |
$2,301.11 |
|
|
Inj, bortezomib, hospira
|
$107.67 |
$107.67 |
$771.88 |
|
|
Inj., brexanolone, 1 mg
|
$287.76 |
$287.76 |
$287.76 |
|
|
Inj, brixadi, 7 days or less
|
$1,809.15 |
$1,809.15 |
$1,809.15 |
|
|
Inj brixadi, more than 7 day
|
$10,813.60 |
$10,813.60 |
$10,813.60 |
|
|
Inj, bupivacaine liposome
|
$4.07 |
$4.26 |
$803.76 |
|
|
Inj. byooviz, 0.1 mg
|
$4,678.88 |
$4,678.88 |
$4,678.88 |
|
|
Inj calcitriol per 0.1 mcg
|
$22.69 |
$33.60 |
$307.82 |
|
|
Inj cefazolin sodium, baxter
|
$4.07 |
$44.45 |
$300.82 |
|
|
Inj cefazolin sodium, hikma
|
$5.06 |
$21.17 |
$73.24 |
|
|
Inj cefazolin (wg crit care)
|
$3.41 |
$26.14 |
$36.32 |
|
|
Inj, cefepime hcl (b braun)
|
$45.62 |
$45.62 |
$315.35 |
|
|
Inj, cefiderocol, 10 mg
|
$6.03 |
$160.70 |
$2,009.70 |
|
|
Inj ceftolozane tazobactam
|
$14.44 |
$473.30 |
$1,504.82 |
|
|
Inj., cerliponase alfa 1 mg
|
$21,448.67 |
$21,448.67 |
$21,448.67 |
|
|
Inj, cimerli, 0.1 mg
|
$5,467.20 |
$5,467.20 |
$5,467.20 |
|
|
Inj, cipaglucosidase, 5 mg
|
$141.24 |
$141.24 |
$141.24 |
|
|
Inj, clevidipine butyrate
|
$13.88 |
$13.88 |
$13.88 |
|
|
Inj, clindamycin (baxter)
|
$3.54 |
$24.15 |
$260.22 |
|
|
Inj cntr knee arthro incl ct/mri
|
$88.20 |
$332.50 |
$1,708.20 |
|
|
Inj., copanlisib, 1 mg
|
$3,722.06 |
$3,722.06 |
$21,119.47 |
|
|
Inj crotalidae im f(ab')2 eq
|
$847.76 |
$847.76 |
$847.76 |
|
|
Inj cyclophosphamd auromedic
|
$3.85 |
$1,226.40 |
$4,316.37 |
|
|
Inj cyclophosphamd (ingenus)
|
$7.11 |
$1,338.80 |
$8,486.80 |
|
|
Inj, cyclophosphamd, sandoz
|
$10.74 |
$10.74 |
$4,505.34 |
|
|
Inj, daptomycin (hospira)
|
$80.91 |
$152.35 |
$255.85 |
|
|
Inj daptomycin (xellia)
|
$0.39 |
$0.52 |
$106.05 |
|
|
Inj, decitabine (sun pharma)
|
$260.16 |
$260.16 |
$1,648.85 |
|
|
Inj. denosumab-bbdz, 1 mg
|
$5,694.89 |
$10,663.10 |
$19,208.87 |
|
|
Inj disk cerv-thor ea lev
|
$365.00 |
$828.00 |
$8,904.80 |
|
|
Inj, donanemab-azbt, 2 mg
|
$529.66 |
$1,277.15 |
$12,495.52 |
|
|
Inj dupuytren cord w/enzyme
|
$768.58 |
$768.58 |
$768.58 |
|
|
Inj, durolane 1 mg
|
$16.00 |
$262.19 |
$4,482.31 |
|
|
Inj dx for sinogram
|
$135.00 |
$410.00 |
$2,065.20 |
|
|
Inject for sacroiliac joint
|
$258.60 |
$258.60 |
$1,323.20 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$414.00 |
$1,426.32 |
$4,981.02 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$100.00 |
$412.80 |
$1,680.60 |
|
|
Injection, belinostat, 10mg
|
$1,792.19 |
$1,792.19 |
$9,971.33 |
|
|
Injection, cangrelor
|
$51.90 |
$3,820.07 |
$7,927.15 |
|
|
Injection, caplacizumab-yhdp
|
$6,244.88 |
$6,244.88 |
$53,318.65 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$142.80 |
$423.50 |
$1,420.72 |
|
|
Injection, daratumumab 10 mg
|
$113.28 |
$2,094.20 |
$28,898.45 |
|
|
Injection, delafloxacin
|
$147.96 |
$147.96 |
$147.96 |
|
|
Injection, doxercalciferol
|
$23.83 |
$23.83 |
$99.05 |
|
|
Injection during cath supravalvular aortography
|
$32.20 |
$570.00 |
$3,316.80 |
|
|
Injection, edaravone, 1 mg
|
$4,275.26 |
$7,058.10 |
$8,895.60 |
|
|
Injection epidural blood patch or clot
|
$435.00 |
$1,348.56 |
$8,372.52 |
|
|
Injection estrone per 1 mg
|
$0.80 |
$0.80 |
$0.80 |
|
|
Injection eye drug
|
$450.00 |
$3,068.80 |
$36,480.79 |
|
|
Injection, famotidine, 20 mg
|
$71.56 |
$71.56 |
$71.56 |
|
|
Injection for arthrography wrist (both sides)
|
$100.00 |
$361.20 |
$1,420.00 |
|
|
Injection for bladder x-ray
|
$72.00 |
$512.40 |
$2,467.67 |
|
|
Injection for hip x-ray
|
$250.00 |
$859.20 |
$1,564.80 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$100.00 |
$477.00 |
$1,626.40 |
|
|
Injection for spleen x-ray
|
$230.00 |
$2,619.40 |
$118,571.21 |
|
|
Injection for tear sac x-ray
|
$392.00 |
$1,040.00 |
$2,455.20 |
|
|
Injection for ureter x-ray
|
$100.00 |
$912.24 |
$2,062.80 |
|
|
Injection for ureter x-ray
|
$214.56 |
$399.00 |
$18,886.03 |
|
|
Injection, fosphenytoin sodi
|
$126.20 |
$126.20 |
$126.20 |
|
|
Injection, fulvestrant
|
$18.90 |
$321.42 |
$16,199.22 |
|
|
Injection glatiramer acetate
|
$135.23 |
$135.23 |
$3,493.72 |
|
|
Injection, glucarpidase
|
$689.67 |
$126,398.65 |
$270,701.72 |
|
|
Injection, inclisiran, 1 mg
|
$19.54 |
$1,727.33 |
$22,464.57 |
|
|
Injection into brain canal
|
$261.60 |
$1,261.40 |
$3,929.10 |
|
|
Injection into brain canal
|
$304.00 |
$650.00 |
$2,593.44 |
|
|
Injection into hemorrhoid(s)
|
$731.20 |
$1,710.00 |
$12,401.00 |
|
|
Injection into spinal artery
|
$1,135.00 |
$1,135.00 |
$2,231.20 |
|
|
Injection into vocal cord
|
$323.20 |
$323.20 |
$323.20 |
|
|
Injection, isavuconazonium
|
$3.04 |
$219.25 |
$1,225.00 |
|
|
Injection jaw joint x-ray
|
$195.00 |
$964.80 |
$984.60 |
|
|
Injection jugular
|
$585.00 |
$4,524.10 |
$38,363.12 |
|
|
Injection, necitumumab, 1 mg
|
$215.84 |
$215.84 |
$215.84 |
|
|
Injection of HIV prep drug
|
$33.60 |
$33.60 |
$33.60 |
|
|
Injection of sinus tract
|
$282.40 |
$750.00 |
$5,086.08 |
|
|
Injection,onabotulinumtoxina
|
$10.50 |
$910.11 |
$7,683.55 |
|
|
Injection, peramivir
|
$4.71 |
$38.82 |
$1,341.72 |
|
|
Injection px peyronie ds
|
$275.20 |
$275.20 |
$275.20 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$78.60 |
$970.56 |
$51,629.23 |
|
|
Injection, renflexis
|
$121.87 |
$435.93 |
$3,792.25 |
|
|
Injection, ruconest
|
$61.72 |
$61.72 |
$38,164.87 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$435.00 |
$2,939.30 |
$6,627.60 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$241.20 |
$1,868.40 |
$81,986.32 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$435.00 |
$1,496.16 |
$60,149.52 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$446.25 |
$2,092.00 |
$6,433.92 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$200.00 |
$1,199.46 |
$9,202.55 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$446.25 |
$2,103.84 |
$9,202.55 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$177.80 |
$1,176.48 |
$9,181.02 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$446.25 |
$2,092.00 |
$9,170.00 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$610.80 |
$1,934.06 |
$5,398.80 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$615.00 |
$1,940.40 |
$6,749.40 |
|
|
Injection, siltuximab
|
$343.02 |
$6,198.68 |
$41,130.95 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$115.50 |
$475.80 |
$1,688.40 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$175.00 |
$554.40 |
$1,501.20 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$231.25 |
$667.44 |
$1,688.40 |
|
