|
Injection eye drug
|
$454.19 |
$454.19 |
$454.19 |
$654.00
|
|
Injection for arthrography wrist (both sides)
|
$88.78 |
$88.78 |
$88.78 |
$439.50
|
|
Injection for bladder x-ray
|
$54.19 |
$54.19 |
$54.19 |
$462.90
|
|
Injection for hip x-ray
|
$102.63 |
$102.63 |
$102.63 |
$750.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$60.62 |
$60.62 |
$60.62 |
$503.30
|
|
Injection for spleen x-ray
|
$157.57 |
$157.57 |
$157.57 |
$595.50
|
|
Injection for tear sac x-ray
|
$64.53 |
$64.53 |
$64.53 |
$225.20
|
|
Injection for ureter x-ray
|
$66.13 |
$66.13 |
$66.13 |
$444.95
|
|
Injection for ureter x-ray
|
$88.54 |
$88.54 |
$88.54 |
$535.70
|
|
Injection, fulvestrant
|
$7.89 |
$7.89 |
$7.89 |
$1,719.16
|
|
Injection, glucarpidase
|
$619.19 |
$619.19 |
$619.19 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$17.51 |
$17.51 |
$17.51 |
$6,679.35
|
|
Injection into brain canal
|
$970.61 |
$970.61 |
$970.61 |
$1,261.40
|
|
Injection into brain canal
|
$422.07 |
$422.07 |
$422.07 |
$844.50
|
|
Injection into hemorrhoid(s)
|
$1,278.72 |
$1,278.72 |
$1,278.72 |
$1,433.00
|
|
Injection into spinal artery
|
$1,468.18 |
$1,468.18 |
$1,468.18 |
$1,710.80
|
|
Injection into vocal cord
|
$537.80 |
$537.80 |
$537.80 |
$459.51
|
|
Injection intraop add-on
|
$146.11 |
$146.11 |
$146.11 |
$214.48
|
|
Injection, isavuconazonium
|
$1.39 |
$1.39 |
$1.39 |
$787.67
|
|
Injection jaw joint x-ray
|
$56.86 |
$56.86 |
$56.86 |
$340.00
|
|
Injection, khapzory, 0.5 mg
|
$1.95 |
$1.95 |
$1.95 |
$2,162.76
|
|
Injection, necitumumab, 1 mg
|
$7.91 |
$7.91 |
$7.91 |
$8,572.91
|
|
Injection of HIV prep drug
|
$99.00 |
$99.00 |
$99.00 |
$78.84
|
|
Injection of sinus tract
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$1,656.00
|
|
Injection,onabotulinumtoxina
|
$8.98 |
$8.98 |
$8.98 |
$2,277.65
|
|
Injection, peramivir
|
$2.32 |
$2.32 |
$2.32 |
$744.75
|
|
Injection px peyronie ds
|
$343.55 |
$343.55 |
$343.55 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$549.70 |
$549.70 |
$549.70 |
$699.68
|
|
Injection, renflexis
|
$38.30 |
$38.30 |
$38.30 |
$1,341.52
|
|
Injection, ruconest
|
$50.75 |
$50.75 |
$50.75 |
$14,111.44
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$970.61 |
$970.61 |
$970.61 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$970.61 |
$970.61 |
$970.61 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$970.61 |
$970.61 |
$970.61 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$2,083.90
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$73.08 |
$73.08 |
$73.08 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,890.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$62.51 |
$62.51 |
$62.51 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$2,033.40
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$970.61 |
$970.61 |
$970.61 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$970.61 |
$970.61 |
$970.61 |
$1,685.00
|
|
Injection, siltuximab
|
$232.78 |
$232.78 |
$232.78 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$422.07 |
$422.07 |
$422.07 |
$504.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$422.07 |
$422.07 |
$422.07 |
$554.40
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$422.07 |
$422.07 |
$422.07 |
$652.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$23.00 |
$23.00 |
$23.00 |
$145.60
|
|
Injection treatment of eye
|
$3,173.34 |
$3,173.34 |
$3,173.34 |
$2,822.40
|
|
Injection treatment of eye
|
$3,173.34 |
$3,173.34 |
$3,173.34 |
$2,698.92
|
|
Injection treatment of nerve
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$3,219.20
|
|
Injection treatment of nerve
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$4,446.30
|
|
Injection treatment of nerve
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$2,050.30
|
|
Injection treatment of nose
|
$741.60 |
$741.60 |
$741.60 |
$859.59
|
|
Inject sacroiliac joint
|
$105.28 |
$105.28 |
$105.28 |
$1,030.00
|
|
Inject/treat eye socket
|
$436.44 |
$436.44 |
$436.44 |
$381.13
|
|
Inject/treat eye socket
|
$436.44 |
$436.44 |
$436.44 |
$750.70
|
|
Inject/treat eye socket
|
$436.44 |
$436.44 |
$436.44 |
$670.02
|
|
Inj, eculizumab-aagh, 2 mg
|
$43.71 |
$43.71 |
$43.71 |
$7,980.52
|
|
Inj, eculizumab-aeeb, 2 mg
|
$58.44 |
$58.44 |
$58.44 |
$610.56
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$47.08 |
$47.08 |
$47.08 |
$32,176.93
|
|
Inj eflapegrastim-xnst 0.1mg
|
$32.50 |
$32.50 |
$32.50 |
$22.75
|
|
Inj., emapalumab-lzsg, 1 mg
|
$530.10 |
$530.10 |
$530.10 |
$3,181.80
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$77.92 |
$77.92 |
$77.92 |
$54,322.53
|
|
Inj epidural sgl cerv-thor without img
|
$970.61 |
$970.61 |
$970.61 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,216.18 |
$1,216.18 |
$1,216.18 |
$1,450.84
|
|
Inj., eravacycline, 1 mg
|
$1.78 |
$1.78 |
$1.78 |
$206.64
|
|
Inj, erzofri, 1 mg
|
$21.12 |
$21.12 |
$21.12 |
$10,213.70
|
|
Inj, etelcalcetide, 0.1 mg
|
$3.17 |
$3.17 |
$3.17 |
$343.35
|
|
Inj, eteplirsen, 10 mg
|
$230.96 |
$230.96 |
$230.96 |
$2,598.44
|
|
Inj, evinacumab-dgnb, 5mg
|
$272.09 |
$272.09 |
$272.09 |
$20,751.13
|
|
Inj., evomela, 1 mg
|
$25.71 |
$25.71 |
$25.71 |
$17.37
|
|
Inj, exagamglogene autotem
|
$3,218,160.00 |
$3,218,160.00 |
$3,218,160.00 |
$3,218,160.00
|
|
Inj, factor x, (human), 1iu
|
$13.69 |
$13.69 |
$13.69 |
$26.74
|
|
Inj, faricimab-svoa, 0.1mg
|
$45.40 |
$45.40 |
$45.40 |
$4,103.29
|
|
Inj. fe derisomaltose 10 mg
|
$31.50 |
$31.50 |
$31.50 |
$3,221.52
|
|
Inj fensolvi 0.25 mg
|
$193.03 |
$193.03 |
$193.03 |
$44,262.98
|
|
Inj., fibryga, 1 mg
|
$1.69 |
$1.69 |
$1.69 |
$4.93
|
|
Inj fluphenazine hcl 1.25 mg
|
$10.20 |
$10.20 |
$10.20 |
$40.33
|
|
Inj, focinvez, 1mg
|
$3.63 |
$3.63 |
$3.63 |
$3.63
|
|
Inj for ext venography
|
$62.42 |
$62.42 |
$62.42 |
$649.80
|
|
Inj for mammo ductogram
|
$92.79 |
$92.79 |
$92.79 |
$399.60
|
|
Inj, fosaprepitant (teva)
|
$0.88 |
$0.88 |
$0.88 |
$152.10
|
|
Inj fosnetupitant, palonoset
|
$754.77 |
$754.77 |
$754.77 |
$1,110.99
|
|
Inj, fulvestrant (fresenius)
|
$37.41 |
$37.41 |
$37.41 |
$905.30
|
|
Inj, fulvestrant (teva)
|
$57.50 |
$57.50 |
$57.50 |
$136.50
|
|
Inj, gadopiclenol, 1 ml
|
$4.55 |
$4.55 |
$4.55 |
$37.63
|
|
Inj gemcitabine hcl (accord)
|
$7.30 |
$7.30 |
$7.30 |
$131.21
|
|
Inj givosiran 0.5 mg
|
$166.55 |
$166.55 |
$166.55 |
$76,708.80
|
|
Inj glofitamab gxbm, 2.5 mg
|
$3,924.15 |
$3,924.15 |
$3,924.15 |
$4,760.67
|
|
Inj glycopyrrolate fres kabi
|
$1.85 |
$1.85 |
$1.85 |
$12.18
|
|
Inj glycopyrrolate, glyrx-pf
|
$1.76 |
$1.76 |
$1.76 |
$11.23
|
|
Inj, granisetron, xr, 0.1 mg
|
$5.93 |
$5.93 |
$5.93 |
$163.28
|
|
Inj., guselkumab, 1 mg
|
$100.65 |
$100.65 |
$100.65 |
$29,130.83
|
|
Inj, hemgenix, per tx dose
|
$5,085,668.00 |
$5,085,668.00 |
$5,085,668.00 |
$4,704,002.80
|
|
Inj heparin, pfizer, 1000u
|
$2.90 |
$2.90 |
$2.90 |
$25.30
|
|
Inj. herceptin hylecta, 10mg
|
$84.27 |
$84.27 |
$84.27 |
$8,193.78
|
|
Inj, hercessi, 10 mg
|
$51.27 |
$51.27 |
$51.27 |
$6,033.42
|
|
Inj herzuma 10 mg
|
$76.49 |
$76.49 |
$76.49 |
$7,775.46
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$61.19 |
$61.19 |
$61.19 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$66.06 |
$66.06 |
$66.06 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$72.42 |
$72.42 |
$72.42 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$35.91 |
$35.91 |
$35.91 |
$1,239.00
|
