|
Inj hydroxocobalamin IV 25mg
|
$3,292.44 |
$3,292.44 |
$3,292.44 |
$2,452.32
|
|
Inj, invega hafyera/trinza
|
$24,696.58 |
$24,696.58 |
$24,696.58 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$3,563.50 |
$3,563.50 |
$3,563.50 |
$6,967.29
|
|
Inj, lanreotide, (cipla) 1mg
|
$10,396.32 |
$10,396.32 |
$10,396.32 |
$11,648.70
|
|
Inj, lecanemab-irmb, 1 mg
|
$1,618.56 |
$1,618.56 |
$1,618.56 |
$923.69
|
|
Inj, lenacapavir, 1 mg
|
$24,398.00 |
$24,398.00 |
$24,398.00 |
$24,398.00
|
|
Inj levocarnitine per 1 gm
|
$129.48 |
$129.48 |
$129.48 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$132.40 |
$132.40 |
$132.40 |
$45.14
|
|
Inj mepivacaine hcl/10 ml
|
$66.20 |
$66.20 |
$66.20 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$1,005.00 |
$1,005.00 |
$1,005.00 |
$536.27
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$24,009.05 |
$24,009.05 |
$24,009.05 |
$331.93
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$9,643.12 |
$9,643.12 |
$9,643.12 |
$8,304.04
|
|
Inj, moxifloxacin 100 mg
|
$249.58 |
$249.58 |
$249.58 |
$107.25
|
|
Inj multihance
|
$126.98 |
$126.98 |
$126.98 |
$70.54
|
|
Inj. mycophenolate mofetil
|
$117.28 |
$117.28 |
$117.28 |
$252.66
|
|
Inj naloxone hydrochloride
|
$99.22 |
$99.22 |
$99.22 |
$83.16
|
|
Inj ogivri 10 mg
|
$4,371.95 |
$4,371.95 |
$4,371.95 |
$4,492.28
|
|
Inj., omadacycline, 1 mg
|
$1,487.48 |
$1,487.48 |
$1,487.48 |
$865.34
|
|
Inj ontruzant 10 mg
|
$8,113.58 |
$8,113.58 |
$8,113.58 |
$6,706.27
|
|
Inj, panzyga, 500 mg
|
$11,237.00 |
$11,237.00 |
$11,237.00 |
$8,041.38
|
|
Inj., patisiran, 0.1 mg
|
$23,776.00 |
$23,776.00 |
$23,776.00 |
$17,613.00
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$9,640.55 |
$9,640.55 |
$9,640.55 |
$6,371.38
|
|
Inj, pemivibart, 4500 mg
|
$1,527.92 |
$1,527.92 |
$1,527.92 |
$1,235.55
|
|
Inj., perseris, 0.5 mg
|
$6,775.10 |
$6,775.10 |
$6,775.10 |
$5,146.85
|
|
Inj., plazomicin, 5 mg
|
$1,589.55 |
$1,589.55 |
$1,589.55 |
$607.16
|
|
Inj proc ankle arthr
|
$401.50 |
$401.50 |
$401.50 |
$405.60
|
|
Inj proc elbow arthro
|
$425.00 |
$425.00 |
$425.00 |
$433.00
|
|
Inj proc myelogram lumbar
|
$815.00 |
$815.00 |
$815.00 |
$843.84
|
|
Inj progesterone per 50 mg
|
$66.30 |
$66.30 |
$66.30 |
$14.93
|
|
Inj, releuko 1 mcg
|
$435.98 |
$435.98 |
$435.98 |
$461.20
|
|
Inj retro urethrocysto
|
$436.50 |
$436.50 |
$436.50 |
$450.00
|
|
Inj, rimabotulinumtoxinb
|
$2,328.70 |
$2,328.70 |
$2,328.70 |
$746.79
|
|
Inj secretin synthetic human
|
$3,773.82 |
$3,773.82 |
$3,773.82 |
$1,285.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$36,539.13 |
$36,539.13 |
$36,539.13 |
$83,709.85
|
|
Inj, sutimlimab-jome, 10 mg
|
$4,820.02 |
$4,820.02 |
$4,820.02 |
$3,453.73
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$80,398.50 |
$80,398.50 |
$80,398.50 |
$67,538.30
|
|
Inj teclistamab cqyv 0.5 mg
|
$17,678.92 |
$17,678.92 |
$17,678.92 |
$17,517.56
|
|
Inj teplizumab mzwv 5 mcg
|
$19,420.00 |
$19,420.00 |
$19,420.00 |
$22,340.08
|
|
Inj. teprotumumab-trbw 10 mg
|
$42,570.05 |
$42,570.05 |
$42,570.05 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$227.37 |
$227.37 |
$227.37 |
$157.81
|
|
Inj testosterone cypionate
|
$60.05 |
$60.05 |
$60.05 |
$64.80
|
|
Inj., tildrakizumab, 1 mg
|
$24,162.46 |
$24,162.46 |
$24,162.46 |
$26,635.60
|
|
Inj tofersen intrathec 1 mg
|
$19,952.01 |
$19,952.01 |
$19,952.01 |
$422.10
|
|
Inj triamcinolone ace X-ray 1mg
|
$1,878.22 |
$1,878.22 |
$1,878.22 |
$1,090.75
|
|
Inj, vancomycin hcl (mylan)
|
$70.84 |
$70.84 |
$70.84 |
$76.59
|
|
Inj, vegzelma, 10 mg
|
$5,170.88 |
$5,170.88 |
$5,170.88 |
$1,291.28
|
|
Inj vocal cord bulking agent
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
$1,480.00
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$62,655.04 |
$62,655.04 |
$62,655.04 |
$44,026.28
|
|
Insert drug delivery implant
|
$1,880.50 |
$1,880.50 |
$1,880.50 |
$283.20
|
|
Insertion catheter bladder temporary simple
|
$403.00 |
$403.00 |
$403.00 |
$235.20
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,534.50 |
$1,534.50 |
$1,534.50 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,159.50 |
$2,159.50 |
$2,159.50 |
$2,414.10
|
|
Insitu hybridization auto
|
$431.50 |
$431.50 |
$431.50 |
$393.13
|
|
Insitu hybridization manual
|
$270.50 |
$270.50 |
$270.50 |
$398.51
|
|
In situ hybridization per specimen each additional single probe stain
|
$141.50 |
$141.50 |
$141.50 |
$241.80
|
|
In situ hybridization per specimen initial single probe stain
|
$229.50 |
$229.50 |
$229.50 |
$337.20
|
|
Ins mark abd/pel for right perq
|
$2,795.50 |
$2,795.50 |
$2,795.50 |
$2,393.43
|
|
Ins mark thor for right perq
|
$2,795.50 |
$2,795.50 |
$2,795.50 |
$2,492.80
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,833.00 |
$1,833.00 |
$1,833.00 |
$1,627.45
|
|
Insulin total
|
$60.50 |
$60.50 |
$60.50 |
$66.64
|
|
Integra meshed bil wound mat
|
$9,924.16 |
$9,924.16 |
$9,924.16 |
$9,924.16
|
|
Interferon alfa-n3 inj
|
$661.02 |
$661.02 |
$661.02 |
$59.64
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$19,967.35 |
$19,967.35 |
$19,967.35 |
$10,427.90
|
|
Interferon beta-1b / .25 mg
|
$841.69 |
$841.69 |
$841.69 |
$1,662.71
|
|
Intracranial complete study
|
$1,114.50 |
$1,114.50 |
$1,114.50 |
$880.50
|
|
Intracranial limited study
|
$893.50 |
$893.50 |
$893.50 |
$459.25
|
|
Intrapul surf admin endo tube
|
$113.00 |
$113.00 |
$113.00 |
$222.28
|
|
Intrinsic factor antibody
|
$137.00 |
$137.00 |
$137.00 |
$62.70
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$212.28 |
$212.28 |
$212.28 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$764.75 |
$764.75 |
$764.75 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$87,057.20 |
$87,057.20 |
$87,057.20 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$109.59 |
$109.59 |
$109.59 |
$173.40
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$7,113.50 |
$7,113.50 |
$7,113.50 |
$5,476.68
|
|
Iron
|
$47.00 |
$47.00 |
$47.00 |
$72.29
|
|
Iron binding capacity
|
$43.50 |
$43.50 |
$43.50 |
$63.60
|
|
Iron dextran 50 mg/ml injection solution
|
$113.28 |
$113.28 |
$113.28 |
$78.46
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$535.58 |
$535.58 |
$535.58 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$139.50 |
$139.50 |
$139.50 |
$117.14
|
|
Irrigation implantable venous access device for drug delivery systems
|
$182.50 |
$182.50 |
$182.50 |
$143.81
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$9,919.62 |
$9,919.62 |
$9,919.62 |
$8,273.35
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$230.00 |
$230.00 |
$230.00 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$172.00 |
$172.00 |
$172.00 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$172.00 |
$172.00 |
$172.00 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$480.50 |
$480.50 |
$480.50 |
$441.75
|
|
Ivp w/nephrotomography
|
$634.00 |
$634.00 |
$634.00 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$483.50 |
$483.50 |
$483.50 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$2,835.60 |
$2,835.60 |
$2,835.60 |
$10,695.32
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$76.50 |
$76.50 |
$76.50 |
$58.56
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$27.20 |
$27.20 |
$27.20 |
$23.66
|
|
Kidney img w/bldflw sgl without rx
|
$1,433.50 |
$1,433.50 |
$1,433.50 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$477.00 |
$477.00 |
$477.00 |
$664.20
|
|
Kit case 4.2mm spinejack
|
$11,056.60 |
$11,056.60 |
$11,056.60 |
$7,686.60
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$13,865.00 |
$13,865.00 |
$13,865.00 |
$9,482.25
|
|
Kit hfx iq ipg bundle
|
$67,500.00 |
$67,500.00 |
$67,500.00 |
$31,352.76
|
|
Kit lead specify 5-6-5
|
$27,426.00 |
$27,426.00 |
$27,426.00 |
$16,433.66
|
|
Knee MRI (with and without contrast)
|
$1,361.00 |
$1,361.00 |
$1,361.00 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$1,135.00 |
$1,135.00 |
$1,135.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$945.50 |
$945.50 |
$945.50 |
$2,110.76
|
|
Knee X-ray
|
$315.50 |
$315.50 |
$315.50 |
$425.55
|
|
Kras gene addl variants
|
$413.00 |
$413.00 |
$413.00 |
$387.20
|
