|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$177.60 |
$213.12 |
$461.76 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$86.10 |
$320.64 |
$570.00 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$42.21 |
$111.78 |
$352.00 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$42.00 |
$198.00 |
$658.56 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$35.28 |
$155.20 |
$323.04 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$72.66 |
$92.60 |
$273.28 |
|
|
Infliximab 100 mg intravenous solution
|
$263.52 |
$540.22 |
$1,451.90 |
|
|
Influenza dna amp prob addl
|
$22.50 |
$22.50 |
$46.28 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$73.92 |
$98.50 |
$290.25 |
|
|
Initial nursing facility care/day 35 minutes
|
$112.00 |
$112.00 |
$112.00 |
|
|
Initial nursing facility care/day 45 minutes
|
$142.40 |
$142.40 |
$142.40 |
|
|
Initial nursing facility care/day low severity 99304
|
$79.20 |
$79.20 |
$79.20 |
|
|
Initial observation care
|
$80.80 |
$80.80 |
$80.80 |
|
|
Initial observation care
|
$109.60 |
$109.60 |
$109.60 |
|
|
Initial observation care
|
$151.20 |
$151.20 |
$151.20 |
|
|
Initiation & management bipap/cpap initial day
|
$113.20 |
$239.20 |
$476.80 |
|
|
Init pm e/m new pat 65+ yrs
|
$77.07 |
$80.74 |
$146.80 |
|
|
Inj, acetaminophen (b braun)
|
$8.47 |
$10.59 |
$40.00 |
|
|
Inj acetaminophen -fresenius
|
$8.40 |
$10.50 |
$40.00 |
|
|
Inj, acetaminophen (hikma)
|
$6.30 |
$7.88 |
$40.00 |
|
|
Inj allopurinol sodium 1 mg
|
$1,318.27 |
$1,647.83 |
$5,273.06 |
|
|
Inj., benralizumab, 1 mg
|
$14,169.17 |
$14,169.17 |
$14,169.17 |
|
|
Inj, bortezomib freseniuskab
|
$711.96 |
$889.95 |
$2,847.84 |
|
|
Inj, bortezomib, hospira
|
$27.70 |
$34.62 |
$110.78 |
|
|
Inj calcitriol per 0.1 mcg
|
$9.08 |
$10.90 |
$40.00 |
|
|
Inj cefazolin sodium, baxter
|
$17.40 |
$21.75 |
$69.60 |
|
|
Inj cefazolin sodium, hikma
|
$7.29 |
$9.11 |
$40.00 |
|
|
Inj cefazolin (wg crit care)
|
$5.40 |
$6.75 |
$40.00 |
|
|
Inj. cefepime hcl (baxter)
|
$79.80 |
$99.75 |
$319.20 |
|
|
Inj, cefepime hcl (b braun)
|
$41.42 |
$51.78 |
$165.68 |
|
|
Inj, clindamycin (baxter)
|
$9.15 |
$11.44 |
$40.00 |
|
|
Inj cntr knee arthro incl ct/mri
|
$68.04 |
$103.96 |
$118.50 |
|
|
Inj cyclophos dr.reddy's 5mg
|
$2,100.00 |
$2,625.00 |
$8,400.00 |
|
|
Inj cyclophosphamd auromedic
|
$139.87 |
$174.83 |
$559.46 |
|
|
Inj cyclophosphamd (ingenus)
|
$813.16 |
$1,016.45 |
$3,252.65 |
|
|
Inj, daptomycin (hospira)
|
$49.26 |
$61.58 |
$197.04 |
|
|
Inj daptomycin (xellia)
|
$18.04 |
$22.56 |
$72.18 |
|
|
Inj, decitabine (sun pharma)
|
$55.51 |
$69.38 |
$222.02 |
|
|
Inj, durolane 1 mg
|
$3,863.81 |
$3,863.81 |
$3,863.81 |
|
|
Inj dx for sinogram
|
$54.40 |
$68.00 |
$227.93 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$232.98 |
$413.10 |
$800.00 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$91.98 |
$99.36 |
$1,401.20 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$114.77 |
$125.75 |
$374.40 |
|
|
Injection, doxercalciferol
|
$5.55 |
$6.66 |
$40.00 |
|
|
Injection during cath supravalvular aortography
|
$47.00 |
$62.00 |
$2,191.20 |
|
|
Injection, edaravone, 1 mg
|
$199.80 |
$249.75 |
$799.20 |
|
|
Injection epidural blood patch or clot
|
$338.88 |
$451.25 |
$1,078.65 |
|
|
Injection eye drug
|
$103.00 |
$122.00 |
$222.75 |
|
|
Injection for arthrography wrist (both sides)
|
$69.09 |
$103.96 |
$143.25 |
|
|
Injection for bladder x-ray
|
$52.14 |
$84.41 |
$260.82 |
|
|
Injection for hip x-ray
|
$58.60 |
$58.60 |
$81.48 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$87.40 |
$136.85 |
$1,401.20 |
|
|
Injection for ureter x-ray
|
$556.25 |
$556.25 |
$556.25 |
|
|
Injection for ureter x-ray
|
$66.00 |
$82.50 |
$1,402.00 |
|
|
Injection, fulvestrant
|
$959.83 |
$1,151.80 |
$2,495.56 |
|
|
Injection glatiramer acetate
|
$90.20 |
$112.75 |
$360.79 |
|
|
Injection, inclisiran, 1 mg
|
$8,420.03 |
$8,420.03 |
$8,420.03 |
|
|
Injection of sinus tract
|
$339.48 |
$482.58 |
$1,627.60 |
|
|
Injection,onabotulinumtoxina
|
$2,620.80 |
$2,620.80 |
$2,620.80 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$152.40 |
$174.00 |
$306.08 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$231.84 |
$361.50 |
$650.70 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$111.36 |
$376.20 |
$470.25 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$178.80 |
$362.88 |
$1,002.88 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$306.90 |
$506.16 |
$1,180.16 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$156.64 |
$234.00 |
$443.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$313.50 |
$570.00 |
$1,180.16 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$183.26 |
$221.49 |
$333.20 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$324.45 |
$633.45 |
$1,180.16 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$376.38 |
$413.10 |
$1,180.16 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$232.98 |
$413.10 |
$1,180.16 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$123.97 |
$273.47 |
$510.40 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$61.80 |
$165.27 |
$482.40 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$148.50 |
$193.44 |
$414.72 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$28.38 |
$64.80 |
$121.16 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$29.48 |
$73.80 |
$96.75 |
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$88.15 |
$160.00 |
$313.60 |
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$26.22 |
$59.04 |
$102.40 |
|
|
Inject sacroiliac joint
|
$376.38 |
$413.10 |
$689.28 |
|
|
Inj epidural sgl cerv-thor without img
|
$191.36 |
$244.86 |
$423.60 |
|
|
Inj epidural sgl lumb-sacral without img
|
$166.40 |
$199.68 |
$558.00 |
|
|
Inj, epinephrine (belcher)
|
$1,219.12 |
$1,523.91 |
$4,876.50 |
|
|
Inj for ext venography
|
$88.62 |
$184.00 |
$1,457.20 |
|
|
Inj for mammo ductogram
|
$88.78 |
$88.78 |
$88.78 |
|
|
Inj, fosaprepitant (teva)
|
$39.62 |
$49.52 |
$158.47 |
|
|
Inj, fulvestrant (fresenius)
|
$508.80 |
$610.57 |
$1,322.89 |
|
|
Inj gemcitabine hcl (accord)
|
$58.07 |
$72.59 |
$232.27 |
|
|
Inj glycopyrrolate fres kabi
|
$12.18 |
$15.23 |
$48.73 |
|
|
Inj heparin, pfizer, 1000u
|
$8.64 |
$10.80 |
$40.00 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$49.60 |
$387.03 |
$423.89 |
|
|
Inj hrt cath w/s&i sel left vent
|
$60.26 |
$60.26 |
$60.26 |
|
|
Inj hrt cath w/s&i sel right vent
|
$54.56 |
$57.04 |
$99.20 |
|
|
Inj, idacio, 1 mg
|
$499.00 |
$623.74 |
$1,995.98 |
|
|
Inj intralesional <= 7 lsn(s)
|
$64.00 |
$139.38 |
$289.64 |
|
|
Inj ivig privigen 500 mg
|
$4,391.46 |
$4,391.46 |
$4,391.46 |
|
|
Inj labetalol hcl hikma, 5mg
|
$4.37 |
$5.46 |
$40.00 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$3,385.87 |
$4,232.33 |
$13,543.46 |
|
|
Inj levoleucovorin nos 0.5mg
|
$95.58 |
$119.47 |
$382.32 |
|
|
Inj, linezolid (hospira)
|
$90.00 |
$112.50 |
$360.00 |
|
|
Inj melpha hydroch nos 50 mg
|
$574.55 |
$718.18 |
$2,298.18 |
|
|
Inj, meropenem (b. braun)
|
$41.50 |
$51.88 |
$166.02 |
|
