|
Infectious agent nucleic acid amplified probe hsv-1
|
$57.50 |
$57.50 |
$57.50 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$36.34 |
$36.34 |
$36.34 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$418.60 |
$418.60 |
$418.60 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$68.54 |
$68.54 |
$68.54 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$42.78 |
$42.78 |
$42.78 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$115.23 |
$115.23 |
$115.23 |
$217.70
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$115.23 |
$115.23 |
$115.23 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$22.54 |
$22.54 |
$22.54 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$34.96 |
$34.96 |
$34.96 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$52.90 |
$52.90 |
$52.90 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$357.19 |
$357.19 |
$357.19 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$98.90 |
$98.90 |
$98.90 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$204.24 |
$204.24 |
$204.24 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$229.77 |
$229.77 |
$229.77 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$111.78 |
$111.78 |
$111.78 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$189.98 |
$189.98 |
$189.98 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$168.13 |
$168.13 |
$168.13 |
$374.50
|
|
Infliximab 100 mg intravenous solution
|
$303.05 |
$303.05 |
$303.05 |
$2,080.86
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$77.51 |
$77.51 |
$77.51 |
$293.04
|
|
Initiation & management bipap/cpap initial day
|
$267.49 |
$267.49 |
$267.49 |
$576.00
|
|
Inj, acetaminophen (b braun)
|
$9.75 |
$9.75 |
$9.75 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$9.66 |
$9.66 |
$9.66 |
$38.87
|
|
Inj, acetaminophen (hikma)
|
$7.24 |
$7.24 |
$7.24 |
$68.30
|
|
Inj allopurinol sodium 1 mg
|
$1,516.01 |
$1,516.01 |
$1,516.01 |
$6,968.99
|
|
Inj, bortezomib freseniuskab
|
$818.75 |
$818.75 |
$818.75 |
$2,464.14
|
|
Inj, bortezomib, hospira
|
$31.85 |
$31.85 |
$31.85 |
$175.35
|
|
Inj calcitriol per 0.1 mcg
|
$10.44 |
$10.44 |
$10.44 |
$22.69
|
|
Inj cefazolin sodium, baxter
|
$20.01 |
$20.01 |
$20.01 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$8.38 |
$8.38 |
$8.38 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$6.21 |
$6.21 |
$6.21 |
$18.30
|
|
Inj. cefepime hcl (baxter)
|
$91.77 |
$91.77 |
$91.77 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$47.63 |
$47.63 |
$47.63 |
$69.85
|
|
Inj, clindamycin (baxter)
|
$10.52 |
$10.52 |
$10.52 |
$48.39
|
|
Inj cntr knee arthro incl ct/mri
|
$103.96 |
$103.96 |
$103.96 |
$436.80
|
|
Inj cyclophos dr.reddy's 5mg
|
$2,415.00 |
$2,415.00 |
$2,415.00 |
$4,725.00
|
|
Inj cyclophosphamd auromedic
|
$160.85 |
$160.85 |
$160.85 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$935.14 |
$935.14 |
$935.14 |
$742.72
|
|
Inj, daptomycin (hospira)
|
$56.65 |
$56.65 |
$56.65 |
$110.83
|
|
Inj daptomycin (xellia)
|
$20.75 |
$20.75 |
$20.75 |
$56.04
|
|
Inj, decitabine (sun pharma)
|
$63.83 |
$63.83 |
$63.83 |
$295.94
|
|
Inj dx for sinogram
|
$227.93 |
$227.93 |
$227.93 |
$413.82
|
|
Injection arthrography hip without anesthesia (both sides)
|
$99.36 |
$99.36 |
$99.36 |
$500.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$114.77 |
$114.77 |
$114.77 |
$504.90
|
|
Injection, doxercalciferol
|
$6.38 |
$6.38 |
$6.38 |
$23.12
|
|
Injection during cath supravalvular aortography
|
$54.05 |
$54.05 |
$54.05 |
$904.17
|
|
Injection, edaravone, 1 mg
|
$229.77 |
$229.77 |
$229.77 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$347.07 |
$347.07 |
$347.07 |
$1,156.80
|
|
Injection eye drug
|
$116.15 |
$116.15 |
$116.15 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$103.96 |
$103.96 |
$103.96 |
$441.12
|
|
Injection for bladder x-ray
|
$84.41 |
$84.41 |
$84.41 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$136.85 |
$136.85 |
$136.85 |
$494.65
|
|
Injection for ureter x-ray
|
$75.90 |
$75.90 |
$75.90 |
$515.21
|
|
Injection, fulvestrant
|
$1,103.81 |
$1,103.81 |
$1,103.81 |
$1,719.16
|
|
Injection glatiramer acetate
|
$103.73 |
$103.73 |
$103.73 |
$830.51
|
|
Injection of sinus tract
|
$339.48 |
$339.48 |
$339.48 |
$1,627.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$184.00 |
$184.00 |
$184.00 |
$683.28
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$332.58 |
$332.58 |
$332.58 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$432.63 |
$432.63 |
$432.63 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$201.94 |
$201.94 |
$201.94 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$485.07 |
$485.07 |
$485.07 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$204.01 |
$204.01 |
$204.01 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$407.56 |
$407.56 |
$407.56 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$221.49 |
$221.49 |
$221.49 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$691.15 |
$691.15 |
$691.15 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$391.92 |
$391.92 |
$391.92 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$422.05 |
$422.05 |
$422.05 |
$1,704.78
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$123.97 |
$123.97 |
$123.97 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$123.97 |
$123.97 |
$123.97 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$191.59 |
$191.59 |
$191.59 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$89.01 |
$89.01 |
$89.01 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$89.01 |
$89.01 |
$89.01 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$184.00 |
$184.00 |
$184.00 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$26.22 |
$26.22 |
$26.22 |
$135.20
|
|
Inj epidural sgl cerv-thor without img
|
$191.36 |
$191.36 |
$191.36 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$191.36 |
$191.36 |
$191.36 |
$1,415.50
|
|
Inj, epinephrine (belcher)
|
$1,401.99 |
$1,401.99 |
$1,401.99 |
$6.24
|
|
Inj for ext venography
|
$221.72 |
$221.72 |
$221.72 |
$654.00
|
|
Inj for mammo ductogram
|
$88.78 |
$88.78 |
$88.78 |
$433.50
|
|
Inj, fosaprepitant (teva)
|
$45.56 |
$45.56 |
$45.56 |
$152.10
|
|
Inj, fulvestrant (fresenius)
|
$585.13 |
$585.13 |
$585.13 |
$1,065.08
|
|
Inj gemcitabine hcl (accord)
|
$66.78 |
$66.78 |
$66.78 |
$113.90
|
|
Inj glycopyrrolate fres kabi
|
$14.01 |
$14.01 |
$14.01 |
$12.18
|
|
Inj heparin, pfizer, 1000u
|
$9.94 |
$9.94 |
$9.94 |
$24.28
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$423.89 |
$423.89 |
$423.89 |
$1,237.50
|
|
Inj hrt cath w/s&i sel left vent
|
$60.26 |
$60.26 |
$60.26 |
$1,071.00
|
|
Inj hrt cath w/s&i sel right vent
|
$57.04 |
$57.04 |
$57.04 |
$947.05
|
|
Inj, idacio, 1 mg
|
$573.85 |
$573.85 |
$573.85 |
$14.63
|
|
Inj intralesional <= 7 lsn(s)
|
$139.38 |
$139.38 |
$139.38 |
$235.13
|
|
Inj labetalol hcl hikma, 5mg
|
$5.03 |
$5.03 |
$5.03 |
$40.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$3,893.75 |
$3,893.75 |
$3,893.75 |
$11,648.70
|
|
Inj levoleucovorin nos 0.5mg
|
$109.92 |
$109.92 |
$109.92 |
$103.60
|
|
Inj, linezolid (hospira)
|
$103.50 |
$103.50 |
$103.50 |
$153.30
|
|
Inj melpha hydroch nos 50 mg
|
$660.73 |
$660.73 |
$660.73 |
$2,375.23
|
|
Inj, meropenem (b. braun)
|
$47.73 |
$47.73 |
$47.73 |
$71.14
|
|
Inj meropenem (wg crit care)
|
$49.88 |
$49.88 |
$49.88 |
$77.97
|
|
Inj, micafungin (par pharm)
|
$62.29 |
$62.29 |
$62.29 |
$89.40
|
|
Inj, moxifloxacin 100 mg
|
$70.29 |
$70.29 |
$70.29 |
$107.25
|
|
Inj. mycophenolate mofetil
|
$115.69 |
$115.69 |
$115.69 |
$252.66
|
|
Inj naloxone hydrochloride
|
$63.67 |
$63.67 |
$63.67 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$277.15 |
$277.15 |
$277.15 |
$1,414.40
|