|
Implant ureth bulk agent
|
$1,902.99 |
$1,902.99 |
$1,902.99 |
$2,168.00
|
|
Incise bile duct sphincter
|
$2,836.11 |
$2,836.11 |
$2,836.11 |
$1,802.57
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,216.78 |
$1,216.78 |
$1,216.78 |
$2,056.93
|
|
Incision of anal sphincter
|
$673.96 |
$673.96 |
$673.96 |
$3,245.23
|
|
Incision of breast lesion
|
$2,083.30 |
$2,083.30 |
$2,083.30 |
$2,560.80
|
|
Incision of eardrum
|
$443.22 |
$443.22 |
$443.22 |
$552.75
|
|
Incision of tongue fold
|
$991.02 |
$991.02 |
$991.02 |
$1,792.50
|
|
Incision of windpipe
|
$1,030.86 |
$1,030.86 |
$1,030.86 |
$6,465.11
|
|
Incision of windpipe
|
$2,232.70 |
$2,232.70 |
$2,232.70 |
$5,855.00
|
|
Incisn of toe tndn
|
$544.48 |
$544.48 |
$544.48 |
$2,627.96
|
|
Incisn windpipe
|
$688.90 |
$688.90 |
$688.90 |
$3,810.50
|
|
Incobotulinumtoxin a
|
$407.17 |
$407.17 |
$407.17 |
$1,339.57
|
|
Infec agen detec ampli probe
|
$24.90 |
$24.90 |
$24.90 |
$26.00
|
|
Infect ag eia influenza a or b ea
|
$31.54 |
$31.54 |
$31.54 |
$71.50
|
|
Infect ag ia direct hiv-1 antgn
|
$227.42 |
$227.42 |
$227.42 |
$91.70
|
|
Infect ag ia optc obs influenza
|
$84.66 |
$84.66 |
$84.66 |
$72.93
|
|
Infect ag na hpv high-risk types
|
$92.96 |
$92.96 |
$92.96 |
$139.75
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$105.41 |
$105.41 |
$105.41 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$207.50 |
$207.50 |
$207.50 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$147.74 |
$147.74 |
$147.74 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$97.94 |
$97.94 |
$97.94 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$211.65 |
$211.65 |
$211.65 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$68.89 |
$68.89 |
$68.89 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$64.74 |
$64.74 |
$64.74 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$170.15 |
$170.15 |
$170.15 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$576.85 |
$576.85 |
$576.85 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$172.64 |
$172.64 |
$172.64 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$61.42 |
$61.42 |
$61.42 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$265.60 |
$265.60 |
$265.60 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$147.74 |
$147.74 |
$147.74 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$92.96 |
$92.96 |
$92.96 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,357.05 |
$1,357.05 |
$1,357.05 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$299.63 |
$299.63 |
$299.63 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$151.89 |
$151.89 |
$151.89 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$493.02 |
$493.02 |
$493.02 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$147.74 |
$147.74 |
$147.74 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$156.87 |
$156.87 |
$156.87 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$384.29 |
$384.29 |
$384.29 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$83.00 |
$83.00 |
$83.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$166.00 |
$166.00 |
$166.00 |
$108.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,049.12 |
$1,049.12 |
$1,049.12 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$386.78 |
$386.78 |
$386.78 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$287.18 |
$287.18 |
$287.18 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$156.04 |
$156.04 |
$156.04 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,321.36 |
$1,321.36 |
$1,321.36 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$479.74 |
$479.74 |
$479.74 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$934.91 |
$934.91 |
$934.91 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$380.27 |
$380.27 |
$380.27 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$407.44 |
$407.44 |
$407.44 |
$1,537.84
|
|
Influenza virus vaccine, live trivalent intranasal
|
$21.13 |
$21.13 |
$21.13 |
$36.50
|
|
Initial observation care
|
$226.59 |
$226.59 |
$226.59 |
$156.00
|
|
Initial observation care
|
$308.76 |
$308.76 |
$308.76 |
$268.20
|
|
Initial observation care
|
$418.32 |
$418.32 |
$418.32 |
$369.00
|
|
Initiation & management bipap/cpap initial day
|
$835.81 |
$835.81 |
$835.81 |
$576.00
|
|
Inj, abilify asimtufii, 1 mg
|
$1,322.89 |
$1,322.89 |
$1,322.89 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$2,116.62 |
$2,116.62 |
$2,116.62 |
$5,355.30
|
|
Inj alymsys 10 mg
|
$75.29 |
$75.29 |
$75.29 |
$1,280.74
|
|
Inj anifrolumab-fnia 1mg
|
$2,170.19 |
$2,170.19 |
$2,170.19 |
$9,878.82
|
|
Inj, artesunate, 1mg
|
$4,464.16 |
$4,464.16 |
$4,464.16 |
$14,460.21
|
|
Inj, aspara, rylaze, 0.1 mg
|
$8,266.80 |
$8,266.80 |
$8,266.80 |
$10,458.00
|
|
Inj aval alfa-nqpt 4mg
|
$1,616.35 |
$1,616.35 |
$1,616.35 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$4,711.71 |
$4,711.71 |
$4,711.71 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$3,154.00 |
$3,154.00 |
$3,154.00 |
$7,612.43
|
|
Inj, bortezomib freseniuskab
|
$973.93 |
$973.93 |
$973.93 |
$2,527.00
|
|
Inj cefazolin sodium, baxter
|
$0.10 |
$0.10 |
$0.10 |
$27.38
|
|
Inj cefazolin (wg crit care)
|
$2.72 |
$2.72 |
$2.72 |
$18.05
|
|
Inj. cefepime hcl (baxter)
|
$0.45 |
$0.45 |
$0.45 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$22.66 |
$22.66 |
$22.66 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$176.76 |
$176.76 |
$176.76 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$132.36 |
$132.36 |
$132.36 |
$380.80
|
|
Inj, clevidipine butyrate
|
$1.32 |
$1.32 |
$1.32 |
$4.86
|
|
Inj, clindamycin (baxter)
|
$0.20 |
$0.20 |
$0.20 |
$48.96
|
|
Inj crotalidae im f(ab')2 eq
|
$963.56 |
$963.56 |
$963.56 |
$2,613.60
|
|
Inj, donanemab-azbt, 2 mg
|
$28.87 |
$28.87 |
$28.87 |
$1,233.44
|
|
Inj dx for sinogram
|
$313.74 |
$313.74 |
$313.74 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$873.16 |
$873.16 |
$873.16 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$543.65 |
$543.65 |
$543.65 |
$495.84
|
|
Injection, burosumab-twza 1m
|
$10,556.28 |
$10,556.28 |
$10,556.28 |
$20,002.09
|
|
Injection, cangrelor
|
$758.51 |
$758.51 |
$758.51 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$6,577.75 |
$6,577.75 |
$6,577.75 |
$16,375.33
|
|
Injection carpal tunnel therapeutic (both sides)
|
$160.19 |
$160.19 |
$160.19 |
$450.72
|
|
Injection, daratumumab 10 mg
|
$127.67 |
$127.67 |
$127.67 |
$5,239.24
|
|
Injection, doxercalciferol
|
$2.65 |
$2.65 |
$2.65 |
$23.86
|
|
Injection, edaravone, 1 mg
|
$4.79 |
$4.79 |
$4.79 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$737.87 |
$737.87 |
$737.87 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$448.20 |
$448.20 |
$448.20 |
$428.40
|
|
Injection for bladder x-ray
|
$590.13 |
$590.13 |
$590.13 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$424.96 |
$424.96 |
$424.96 |
$494.65
|
|
Injection for ureter x-ray
|
$646.57 |
$646.57 |
$646.57 |
$515.21
|
|
Injection, fulvestrant
|
$147.20 |
$147.20 |
$147.20 |
$1,817.65
|
|
Injection, glucarpidase
|
$34,174.42 |
$34,174.42 |
$34,174.42 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$1,871.06 |
$1,871.06 |
$1,871.06 |
$6,679.35
|
|
Injection into brain canal
|
$730.40 |
$730.40 |
$730.40 |
$1,289.60
|
|
Injection into hemorrhoid(s)
|
$748.66 |
$748.66 |
$748.66 |
$1,432.81
|
|
Injection, isavuconazonium
|
$299.00 |
$299.00 |
$299.00 |
$787.67
|
|
Injection, necitumumab, 1 mg
|
$71.88 |
$71.88 |
$71.88 |
$8,572.91
|
|
Injection,onabotulinumtoxina
|
$1,072.36 |
$1,072.36 |
$1,072.36 |
$2,277.65
|
|
Injection, peramivir
|
$13.15 |
$13.15 |
$13.15 |
$744.75
|
|
Injection radioactive tracer sentinel node (both sides)
|
$760.28 |
$760.28 |
$760.28 |
$670.64
|
|
Injection, renflexis
|
$291.03 |
$291.03 |
$291.03 |
$1,341.52
|