|
Injection, necitumumab, 1 mg
|
$39.84 |
$39.84 |
$43.30 |
$8,572.91
|
|
Injection of sinus tract
|
$535.50 |
$535.50 |
$535.50 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$594.32 |
$594.32 |
$646.00 |
$2,277.65
|
|
Injection, peramivir
|
$7.29 |
$7.29 |
$7.92 |
$744.75
|
|
Injection radioactive tracer sentinel node (both sides)
|
$393.76 |
$393.76 |
$475.00 |
$670.64
|
|
Injection, renflexis
|
$161.29 |
$161.29 |
$175.32 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$565.00 |
$565.00 |
$565.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$810.06 |
$810.06 |
$880.50 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$529.00 |
$529.00 |
$529.00 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$487.14 |
$487.14 |
$588.50 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$507.50 |
$507.50 |
$507.50 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,353.50 |
$1,353.50 |
$1,353.50 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,353.50 |
$1,353.50 |
$1,353.50 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,353.50 |
$1,353.50 |
$1,353.50 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$883.00 |
$883.00 |
$883.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,044.00 |
$1,044.00 |
$1,044.00 |
$1,681.24
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$177.10 |
$177.10 |
$208.00 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$37.72 |
$37.72 |
$145.50 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$125.50 |
$125.50 |
$126.04 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$157.78 |
$157.78 |
$227.50 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$50.60 |
$50.60 |
$104.50 |
$135.60
|
|
Inject sacroiliac joint
|
$514.74 |
$514.74 |
$751.50 |
$1,028.95
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$1,295.64 |
$1,295.64 |
$1,408.31 |
$32,176.93
|
|
Inj epidural sgl lumb-sacral without img
|
$979.50 |
$979.50 |
$979.50 |
$1,415.50
|
|
Inj, etelcalcetide, 0.1 mg
|
$75.21 |
$75.21 |
$81.75 |
$343.35
|
|
Inj. fe derisomaltose 10 mg
|
$138.68 |
$138.68 |
$150.74 |
$3,221.52
|
|
Inj fluphenazine hcl 1.25 mg
|
$4.62 |
$4.62 |
$5.02 |
$39.54
|
|
Inj for ext venography
|
$350.52 |
$350.52 |
$511.50 |
$649.95
|
|
Inj for mammo ductogram
|
$192.00 |
$192.00 |
$192.00 |
$399.60
|
|
Inj gemcitabine hcl (accord)
|
$5.35 |
$5.35 |
$5.81 |
$130.65
|
|
Inj glofitamab gxbm, 2.5 mg
|
$470.08 |
$470.08 |
$510.95 |
$4,760.67
|
|
Inj glycopyrrolate, glyrx-pf
|
$0.85 |
$0.85 |
$0.93 |
$11.23
|
|
Inj, granisetron, xr, 0.1 mg
|
$765.12 |
$765.12 |
$831.65 |
$5.71
|
|
Inj., guselkumab, 1 mg
|
$6,466.05 |
$6,466.05 |
$7,028.31 |
$29,130.83
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$912.18 |
$912.18 |
$1,919.00 |
$1,439.90
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,701.00 |
$1,701.00 |
$1,701.00 |
$1,827.74
|
|
Inj hrt cath w/s&i sel hrt art
|
$260.00 |
$260.00 |
$260.00 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$1,013.38 |
$1,013.38 |
$1,069.00 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$759.92 |
$759.92 |
$1,253.00 |
$965.33
|
|
Inj imip 4 cilas 4 releb 2mg
|
$132.97 |
$132.97 |
$144.53 |
$739.77
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$1,877.00 |
$1,877.00 |
$1,877.00 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$140.50 |
$140.50 |
$140.50 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$186.00 |
$186.00 |
$186.00 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$3.35 |
$3.35 |
$3.64 |
$6,967.29
|
|
Inj, lecanemab-irmb, 1 mg
|
$58.61 |
$58.61 |
$63.71 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$3.28 |
$3.28 |
$3.56 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$6.01 |
$6.01 |
$6.53 |
$303.45
|
|
Inj, levothyroxine, hikma
|
$23.77 |
$23.77 |
$25.84 |
$38.01
|
|
Inj, lidocaine w epinephrine
|
$0.44 |
$0.44 |
$0.47 |
$46.52
|
|
Inj melpha hydroch nos 50 mg
|
$86.29 |
$86.29 |
$93.79 |
$1,847.89
|
|
Inj mepivacaine hcl/10 ml
|
$0.15 |
$0.15 |
$0.16 |
$33.86
|
|
Inj, meropenem (b. braun)
|
$8.63 |
$8.63 |
$9.38 |
$71.14
|
|
Inj., meropenem, vaborbactam
|
$81.83 |
$81.83 |
$88.94 |
$558.08
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$294.20 |
$294.20 |
$319.78 |
$1,496.55
|
|
Inj, moxifloxacin 100 mg
|
$0.08 |
$0.08 |
$0.09 |
$107.25
|
|
Inj multihance
|
$0.72 |
$0.72 |
$0.79 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$30.68 |
$30.68 |
$33.35 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,843.00 |
$2,843.00 |
$2,843.00 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$1.52 |
$1.52 |
$1.65 |
$452.89
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$825.64 |
$825.64 |
$897.44 |
$66,582.27
|
|
Inj ogivri 10 mg
|
$686.44 |
$686.44 |
$746.13 |
$4,492.28
|
|
Inj., patisiran, 0.1 mg
|
$874.00 |
$874.00 |
$950.00 |
$17,613.00
|
|
Inj. pemetrexed, 10 mg
|
$84.30 |
$84.30 |
$91.63 |
$104.72
|
|
Inj pemetrexed (sandoz) 10mg
|
$1.05 |
$1.05 |
$1.14 |
$95.26
|
|
Inj, pemivibart, 4500 mg
|
$73.80 |
$73.80 |
$80.21 |
$1,235.55
|
|
Inj proc elbow arthro
|
$198.72 |
$198.72 |
$216.00 |
$419.60
|
|
Inj proc lumbr disk ea lvl
|
$558.00 |
$558.00 |
$558.00 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$786.00 |
$786.00 |
$786.00 |
$830.50
|
|
Inj proc sialogram
|
$239.00 |
$239.00 |
$239.00 |
$373.00
|
|
Inj progesterone per 50 mg
|
$1.28 |
$1.28 |
$1.39 |
$14.93
|
|
Inj, releuko 1 mcg
|
$82.07 |
$82.07 |
$89.20 |
$473.25
|
|
Inj retacrit esrd on dialysi
|
$161.68 |
$161.68 |
$175.74 |
$349.45
|
|
Inj retro urethrocysto
|
$360.00 |
$360.00 |
$360.00 |
$443.50
|
|
Inj scleros sol mult veins
|
$167.44 |
$167.44 |
$202.50 |
$675.00
|
|
Inj scleros sol sgl vein
|
$316.00 |
$316.00 |
$316.00 |
$558.97
|
|
Inj secretin synthetic human
|
$304.06 |
$304.06 |
$330.50 |
$1,275.00
|
|
Inj secukinumab intrav 1mg
|
$1,693.76 |
$1,693.76 |
$1,841.04 |
$4,413.21
|
|
Inj, spesolimab-sbzo, 1 mg
|
$1,568.08 |
$1,568.08 |
$1,704.44 |
$90,007.62
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$1,076.50 |
$1,076.50 |
$1,076.50 |
$436.80
|
|
Inj teplizumab mzwv 5 mcg
|
$2,491.21 |
$2,491.21 |
$2,707.84 |
$22,340.08
|
|
Inj. teprotumumab-trbw 10 mg
|
$7,116.94 |
$7,116.94 |
$7,735.80 |
$35,034.78
|
|
Inj testosterone cypionate
|
$9.23 |
$9.23 |
$10.03 |
$64.80
|
|
Inj., tildrakizumab, 1 mg
|
$6,126.19 |
$6,126.19 |
$6,658.90 |
$26,635.60
|
|
Inj, tofidence, 1 mg
|
$51.06 |
$51.06 |
$55.50 |
$86.87
|
|
Inj, tyenne, 1 mg
|
$41.28 |
$41.28 |
$44.87 |
$3,525.12
|
|
Inj, uzedy, 1 mg
|
$3,670.49 |
$3,670.49 |
$3,989.67 |
$11,475.96
|
|
Inj w/fluor eval cv device
|
$274.50 |
$274.50 |
$274.50 |
$503.92
|
|
Ins cath ren art 1st bi
|
$2,410.86 |
$2,410.86 |
$2,544.00 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$2,317.00 |
$2,317.00 |
$2,524.94 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$2,936.64 |
$2,936.64 |
$3,093.50 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$6,444.50 |
$6,444.50 |
$6,444.50 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$194.12 |
$194.12 |
$228.50 |
$480.28
|
|
Insert balloon device
|
$11,052.88 |
$11,052.88 |
$11,052.88 |
$2,535.00
|
|
Insert cath pleura with image
|
$610.42 |
$610.42 |
$1,434.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$395.14 |
$395.14 |
$444.50 |
$2,073.18
|
|
Insert epicardial lead open 33202
|
$702.42 |
$702.42 |
$702.42 |
$3,775.20
|
|
Insert hepatic shunt (tips)
|
$1,619.00 |
$1,619.00 |
$1,619.00 |
$7,571.20
|
|
Insert intracorporeal device
|
$2,159.24 |
$2,159.24 |
$2,159.24 |
$6,261.00
|
|
Insert intrauterine device iud
|
$150.50 |
$150.50 |
$150.50 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$91.54 |
$91.54 |
$132.50 |
$205.40
|
