|
Infectious agent nucleic acid quantification hiv-1
|
$292.00 |
$292.00 |
$292.00 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$196.80 |
$196.80 |
$428.80 |
|
|
Infliximab 100 mg intravenous solution
|
$2,925.44 |
$2,925.44 |
$2,925.44 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,168.25 |
$1,168.25 |
$1,168.25 |
|
|
Influenza dna amp prob addl
|
$155.20 |
$155.20 |
$155.20 |
|
|
Ingest challenge ea addl 60 min
|
$128.00 |
$128.00 |
$128.00 |
|
|
Ingest challenge ini 120 min
|
$185.60 |
$185.60 |
$185.60 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$407.20 |
$407.20 |
$407.20 |
|
|
Initial foot exam pt lops
|
$96.00 |
$96.00 |
$96.00 |
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$497.60 |
$497.60 |
$497.60 |
|
|
Initial nursing facility care/day 35 minutes
|
$184.80 |
$184.80 |
$184.80 |
|
|
Initial nursing facility care/day 45 minutes
|
$236.80 |
$236.80 |
$236.80 |
|
|
Initial nursing facility care/day low severity 99304
|
$128.00 |
$128.00 |
$128.00 |
|
|
Initiation & management bipap/cpap initial day
|
$243.20 |
$243.20 |
$655.20 |
|
|
Inj, abilify maintena, 1 mg
|
$5.60 |
$5.60 |
$6,894.64 |
|
|
Inj, bezlotoxumab, 10 mg
|
$10,168.48 |
$10,168.48 |
$10,168.48 |
|
|
Inj, cefiderocol, 10 mg
|
$636.20 |
$636.20 |
$636.20 |
|
|
Inj ceftolozane tazobactam
|
$943.85 |
$943.85 |
$943.85 |
|
|
Inj cyclophosphamd (ingenus)
|
$1,967.44 |
$1,967.44 |
$1,967.44 |
|
|
Inj dupuytren cord w/enzyme
|
$128.00 |
$128.00 |
$128.00 |
|
|
Inj, durolane 1 mg
|
$891.20 |
$891.20 |
$891.20 |
|
|
Inj dx for sinogram
|
$262.40 |
$262.40 |
$265.60 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$889.60 |
$889.60 |
$889.60 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$335.20 |
$335.20 |
$440.00 |
|
|
Injection, cangrelor
|
$2,513.75 |
$2,513.75 |
$2,513.75 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$121.60 |
$121.60 |
$375.20 |
|
|
Injection, daratumumab 10 mg
|
$3,863.11 |
$3,863.11 |
$3,863.11 |
|
|
Injection, doxercalciferol
|
$69.76 |
$69.76 |
$69.76 |
|
|
Injection during cath supravalvular aortography
|
$2,839.20 |
$2,839.20 |
$2,839.20 |
|
|
Injection, edaravone, 1 mg
|
$4,581.86 |
$4,581.86 |
$4,581.86 |
|
|
Injection epidural blood patch or clot
|
$684.80 |
$684.80 |
$933.60 |
|
|
Injection eye drug
|
$459.20 |
$459.20 |
$459.20 |
|
|
Injection for arthrography wrist (both sides)
|
$516.00 |
$516.00 |
$630.40 |
|
|
Injection for bladder x-ray
|
$286.40 |
$286.40 |
$536.00 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$420.00 |
$420.00 |
$565.60 |
|
|
Injection for ureter x-ray
|
$322.40 |
$322.40 |
$452.00 |
|
|
Injection, fulvestrant
|
$332.73 |
$332.73 |
$332.73 |
|
|
Injection glatiramer acetate
|
$235.06 |
$235.06 |
$646.72 |
|
|
Injection, inclisiran, 1 mg
|
$9,079.62 |
$9,079.62 |
$9,079.62 |
|
|
Injection into hemorrhoid(s)
|
$475.20 |
$475.20 |
$1,147.20 |
|
|
Injection into vocal cord
|
$189.60 |
$189.60 |
$189.60 |
|
|
Injection,onabotulinumtoxina
|
$8.80 |
$8.80 |
$8.80 |
|
|
Injection, peramivir
|
$911.87 |
$911.87 |
$911.87 |
|
|
Injection px peyronie ds
|
$176.80 |
$176.80 |
$176.80 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$122.40 |
$122.40 |
$596.80 |
|
|
Injection, renflexis
|
$1,242.18 |
$1,242.18 |
$1,242.18 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$474.40 |
$474.40 |
$889.60 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$192.00 |
$192.00 |
$377.60 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$916.00 |
$916.00 |
$2,134.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$208.00 |
$208.00 |
$465.60 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$476.00 |
$476.00 |
$1,365.60 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$208.00 |
$208.00 |
$465.60 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$996.00 |
$996.00 |
$1,310.40 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$872.00 |
$872.00 |
$1,030.40 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$872.00 |
$872.00 |
$1,030.40 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$86.40 |
$86.40 |
$375.20 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$344.80 |
$344.80 |
$350.40 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$344.80 |
$344.80 |
$411.20 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$80.00 |
$80.00 |
$108.80 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$115.20 |
$115.20 |
$176.80 |
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$264.80 |
$264.80 |
$276.80 |
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$136.80 |
$136.80 |
$170.40 |
|
|
Injection treatment of eye
|
$2,980.00 |
$2,980.00 |
$2,980.00 |
|
|
Inject sacroiliac joint
|
$817.60 |
$817.60 |
$1,104.00 |
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$43,913.65 |
$43,913.65 |
$43,913.65 |
|
|
Inj epidural sgl cerv-thor without img
|
$841.60 |
$841.60 |
$889.60 |
|
|
Inj epidural sgl lumb-sacral without img
|
$841.60 |
$841.60 |
$991.20 |
|
|
Inj fluphenazine hcl 1.25 mg
|
$83.90 |
$83.90 |
$83.90 |
|
|
Inj for ext venography
|
$780.80 |
$780.80 |
$780.80 |
|
|
Inj heparin, pfizer, 1000u
|
$65.06 |
$65.06 |
$65.06 |
|
|
Inj hrt cath w/s&i sel left vent
|
$1,083.20 |
$1,083.20 |
$1,083.20 |
|
|
Inj imip 4 cilas 4 releb 2mg
|
$840.28 |
$840.28 |
$840.28 |
|
|
Inj intralesional <= 7 lsn(s)
|
$84.00 |
$84.00 |
$249.60 |
|
|
Inj intralesional > 7 lsns
|
$104.00 |
$104.00 |
$104.00 |
|
|
Inj ivig privigen 500 mg
|
$6,106.08 |
$6,106.08 |
$12,146.40 |
|
|
Inj levocarnitine per 1 gm
|
$202.89 |
$202.89 |
$202.89 |
|
|
Inj, levothyroxine, freskabi
|
$363.97 |
$363.97 |
$363.97 |
|
|
Inj mepivacaine hcl/10 ml
|
$70.42 |
$70.42 |
$70.42 |
|
|
Inj. mycophenolate mofetil
|
$324.78 |
$324.78 |
$324.78 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$940.00 |
$940.00 |
$940.00 |
|
|
Inj, nithiodote, 3mg / 125mg
|
$45.56 |
$45.56 |
$45.56 |
|
|
Inj ogivri 10 mg
|
$1,731.50 |
$1,731.50 |
$1,731.50 |
|
|
Inj pantoprazole(hikma) 40mg
|
$74.16 |
$74.16 |
$74.34 |
|
|
Inj proc elbow arthro
|
$461.60 |
$461.60 |
$461.60 |
|
|
Inj proc for lymphang
|
$1,062.40 |
$1,062.40 |
$1,062.40 |
|
|
Inj proc myelogram lumbar
|
$704.00 |
$704.00 |
$949.60 |
|
|
Inj proc sialogram
|
$143.20 |
$143.20 |
$143.20 |
|
|
Inj progesterone per 50 mg
|
$68.01 |
$68.01 |
$68.01 |
|
|
Inj, releuko 1 mcg
|
$428.54 |
$428.54 |
$466.21 |
|
|
Inj retro urethrocysto
|
$279.20 |
$279.20 |
$279.20 |
|
|
Inj secretin synthetic human
|
$1,468.56 |
$1,468.56 |
$1,468.56 |
|
|
Inj teclistamab cqyv 0.5 mg
|
$11,915.64 |
$11,915.64 |
$11,915.64 |
|
|
Inj. teprotumumab-trbw 10 mg
|
$47,971.67 |
$47,971.67 |
$47,971.67 |
|
|
Inj testostero enanthate 1mg
|
$46.06 |
$46.06 |
$46.06 |
|
|
Inj testosterone cypionate
|
$0.80 |
$0.80 |
$71.18 |
|
|
Inj thiotepa nos 1 mg
|
$2,298.83 |
$2,298.83 |
$2,298.83 |
|
|
Inj tofersen intrathec 1 mg
|
$38,088.33 |
$38,088.33 |
$38,088.33 |
|
|
Inj triamcinolone ace X-ray 1mg
|
$1,688.78 |
$1,688.78 |
$1,688.78 |
|
|
Inj, vasopressin (baxter)
|
$209.00 |
$209.00 |
$209.00 |
|
|
Inj w/fluor eval cv device
|
$777.60 |
$777.60 |
$1,046.40 |
|
