|
Inj, ixinity, 1 i.u
|
$28,062.85 |
$28,062.85 |
$28,062.85 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$444.82 |
$10,396.32 |
$12,160.05 |
|
|
Inj, lecanemab-irmb, 1 mg
|
$10.78 |
$1,618.56 |
$1,618.56 |
|
|
Inj, lenacapavir, 1 mg
|
$24,398.00 |
$24,398.00 |
$24,398.00 |
|
|
Inj levocarnitine per 1 gm
|
$53.36 |
$129.48 |
$225.14 |
|
|
Inj levoleucovorin nos 0.5mg
|
$401.08 |
$528.08 |
$582.50 |
|
|
Inj, levothyroxine, freskabi
|
$173.14 |
$173.14 |
$173.14 |
|
|
Inj, lidocaine w epinephrine
|
$1.14 |
$44.96 |
$132.40 |
|
|
Inj, linezolid (hospira)
|
$153.62 |
$153.62 |
$153.62 |
|
|
Inj melpha hydroch nos 50 mg
|
$720.06 |
$2,513.20 |
$2,513.20 |
|
|
Inj mepivacaine hcl/10 ml
|
$40.76 |
$66.20 |
$84.60 |
|
|
Inj., meropenem, vaborbactam
|
$426.85 |
$1,005.00 |
$2,259.90 |
|
|
Inj meropenem (wg crit care)
|
$12.97 |
$12.97 |
$12.97 |
|
|
Inj, micafungin (par pharm)
|
$3.87 |
$167.62 |
$167.62 |
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$331.93 |
$24,009.05 |
$24,009.05 |
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$2,233.42 |
$9,643.12 |
$9,643.12 |
|
|
Inj, moxifloxacin 100 mg
|
$249.58 |
$262.28 |
$490.46 |
|
|
Inj multihance
|
$24.16 |
$126.98 |
$126.98 |
|
|
Inj multihance multipack
|
$16.21 |
$16.21 |
$16.21 |
|
|
Inj. mycophenolate mofetil
|
$5.37 |
$117.28 |
$643.72 |
|
|
Inj naloxone hydrochloride
|
$85.34 |
$99.22 |
$99.22 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,483.00 |
$2,632.80 |
$3,367.80 |
|
|
Inj, nithiodote, 3mg / 125mg
|
$2,044.65 |
$2,044.65 |
$2,044.65 |
|
|
Inj nivolumab 2 mg hyaluron
|
$278.07 |
$278.07 |
$278.07 |
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$990.60 |
$990.60 |
$1,135.20 |
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,518.00 |
$1,518.00 |
$2,090.40 |
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$459.34 |
$459.34 |
$459.34 |
|
|
Inj ogivri 10 mg
|
$582.27 |
$4,371.95 |
$4,371.95 |
|
|
Inj, olaratumab, 10 mg
|
$10.84 |
$14.09 |
$14.09 |
|
|
Inj, omacetaxine mep, 0.01mg
|
$13,469.40 |
$13,469.40 |
$13,469.40 |
|
|
Inj., omadacycline, 1 mg
|
$1,487.48 |
$1,487.48 |
$1,487.48 |
|
|
Inj ontruzant 10 mg
|
$505.36 |
$8,113.58 |
$8,113.58 |
|
|
Inj, pafolacianine, 0.1 mg
|
$199.92 |
$199.92 |
$199.92 |
|
|
Inj, panzyga, 500 mg
|
$11,237.00 |
$11,237.00 |
$11,237.00 |
|
|
Inj., patisiran, 0.1 mg
|
$146.78 |
$23,776.00 |
$23,776.00 |
|
|
Inj, pedmark, 100 mg
|
$64.75 |
$64.75 |
$64.75 |
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$5,688.86 |
$9,640.55 |
$9,640.55 |
|
|
Inj pemetrexed ditromethamin
|
$4,604.99 |
$4,604.99 |
$4,604.99 |
|
|
Inj, pemivibart, 4500 mg
|
$1,527.92 |
$1,527.92 |
$1,527.92 |
|
|
Inj peritoneal venous shunt
|
$582.60 |
$681.00 |
$1,422.04 |
|
|
Inj., perseris, 0.5 mg
|
$6,775.10 |
$6,775.10 |
$6,775.10 |
|
|
Inj., plazomicin, 5 mg
|
$1,589.55 |
$1,589.55 |
$1,589.55 |
|
|
Inj proc ankle arthr
|
$110.50 |
$421.50 |
$588.60 |
|
|
Inj proc elbow arthro
|
$110.50 |
$446.50 |
$639.60 |
|
|
Inj proc for lymphang
|
$2,400.00 |
$3,809.40 |
$7,618.80 |
|
|
Inj proc lumbr disk ea lvl
|
$4,177.80 |
$4,177.80 |
$4,177.80 |
|
|
Inj proc myelogram lumbar
|
$281.40 |
$1,491.60 |
$3,172.46 |
|
|
Inj proc sialogram
|
$1,032.60 |
$1,032.60 |
$1,032.60 |
|
|
Inj progesterone per 50 mg
|
$9.86 |
$66.30 |
$120.00 |
|
|
Inj prohance multipack
|
$4.82 |
$4.82 |
$4.82 |
|
|
Inj, releuko 1 mcg
|
$1.50 |
$435.98 |
$435.98 |
|
|
Inj retacrit esrd on dialysi
|
$307.40 |
$307.40 |
$1,074.20 |
|
|
Inj retro urethrocysto
|
$436.50 |
$640.80 |
$1,413.60 |
|
|
Inj, rimabotulinumtoxinb
|
$762.65 |
$2,328.70 |
$3,296.06 |
|
|
Inj scleros sol mult veins
|
$460.80 |
$460.80 |
$460.80 |
|
|
Inj scleros sol sgl vein
|
$987.60 |
$987.60 |
$1,677.00 |
|
|
Inj sebelipase alfa 1 mg
|
$804.04 |
$804.04 |
$804.04 |
|
|
Inj secretin synthetic human
|
$1,234.65 |
$3,773.82 |
$7,266.00 |
|
|
Inj secukinumab intrav 1mg
|
$31.10 |
$31.10 |
$144.86 |
|
|
Inj, spesolimab-sbzo, 1 mg
|
$36,539.13 |
$36,539.13 |
$36,539.13 |
|
|
Inj sulf hexa lipid microsph
|
$162.14 |
$162.14 |
$162.14 |
|
|
Inj, sutimlimab-jome, 10 mg
|
$191.31 |
$4,820.02 |
$4,820.02 |
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$80,398.50 |
$80,398.50 |
$80,398.50 |
|
|
Inj teclistamab cqyv 0.5 mg
|
$250.10 |
$17,678.92 |
$17,678.92 |
|
|
Inj teplizumab mzwv 5 mcg
|
$19,420.00 |
$19,420.00 |
$19,420.00 |
|
|
Inj. teprotumumab-trbw 10 mg
|
$3,762.84 |
$42,570.05 |
$42,570.05 |
|
|
Inj testostero enanthate 1mg
|
$197.08 |
$227.37 |
$227.37 |
|
|
Inj testosterone cypionate
|
$60.05 |
$77.15 |
$1,434.31 |
|
|
Inj., tildrakizumab, 1 mg
|
$1,296.41 |
$24,162.46 |
$24,563.40 |
|
|
Inj tofersen intrathec 1 mg
|
$19,952.01 |
$19,952.01 |
$19,952.01 |
|
|
Inj, tofidence, 1 mg
|
$42.13 |
$42.13 |
$42.13 |
|
|
Inj triamcinolone ace X-ray 1mg
|
$194.14 |
$1,878.22 |
$1,878.22 |
|
|
Inj ustekinumab-aekn, 1 mg
|
$107.90 |
$107.90 |
$107.90 |
|
|
Inj, vancomycin hcl (mylan)
|
$70.84 |
$70.84 |
$70.84 |
|
|
Inj vancomycin (xellia) 10mg
|
$1.29 |
$1.29 |
$1.29 |
|
|
Inj, vasopressin (baxter)
|
$20.81 |
$20.81 |
$20.81 |
|
|
Inj, vegzelma, 10 mg
|
$537.68 |
$5,170.88 |
$5,170.88 |
|
|
Inj vocal cord bulking agent
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
|
|
Inj w/fluor eval cv device
|
$427.50 |
$872.40 |
$2,904.21 |
|
|
Inj zanidatamab-hrii, 2 mg
|
$253.28 |
$253.28 |
$253.28 |
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$3,406.33 |
$62,655.04 |
$62,655.04 |
|
|
Ins cath ren art 1st bi
|
$5,245.00 |
$17,988.00 |
$19,716.60 |
|
|
Ins cath ren art 1st uni
|
$3,443.00 |
$9,374.40 |
$10,697.40 |
|
|
Ins cath ren art 2nd+ bi
|
$5,603.40 |
$18,044.40 |
$18,786.60 |
|
|
Ins cath ren art 2nd+ uni
|
$3,443.00 |
$10,158.60 |
$11,134.80 |
|
|
Insert abdomen-venous drain
|
$8,817.00 |
$8,817.00 |
$8,817.00 |
|
|
Insert cath pleura with image
|
$1,101.60 |
$3,266.40 |
$3,736.20 |
|
|
Insert cath pleura without image
|
$1,374.00 |
$1,911.00 |
$1,911.00 |
|
|
Insert drug delivery implant
|
$1,880.50 |
$1,910.50 |
$1,975.50 |
|
|
Insert hepatic shunt (tips)
|
$5,600.40 |
$9,354.60 |
$37,347.00 |
|
|
Insert intrauterine device iud
|
$63.18 |
$63.18 |
$1,602.62 |
|
|
Insertion catheter bladder non indwelling
|
$37.45 |
$343.80 |
$521.40 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$726.00 |
$825.60 |
$5,950.50 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,247.80 |
$3,859.20 |
$6,434.26 |
|
|
Insertion intra-aortic circulation dev 33970
|
$4,191.60 |
$4,191.60 |
$4,191.60 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,933.50 |
$11,380.80 |
$12,232.80 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$471.50 |
$3,296.40 |
$5,391.76 |
|
|
Insertion of catheter vein
|
$955.20 |
$1,907.40 |
$3,693.80 |
|
|
Insertion of catheter vein
|
$2,128.80 |
$2,487.60 |
$3,947.40 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$11,599.50 |
$12,064.20 |
$72,203.90 |
|
