|
Injection, inclisiran, 1 mg
|
$7,100.99 |
$7,100.99 |
$7,100.99 |
$6,679.35
|
|
Injection into brain canal
|
$187.74 |
$187.74 |
$187.74 |
$1,289.60
|
|
Injection into brain canal
|
$744.66 |
$744.66 |
$744.66 |
$836.40
|
|
Injection, isavuconazonium
|
$756.51 |
$756.51 |
$756.51 |
$787.67
|
|
Injection jugular
|
$205.38 |
$205.38 |
$205.38 |
$790.00
|
|
Injection, necitumumab, 1 mg
|
$9,092.48 |
$9,092.48 |
$9,092.48 |
$8,572.91
|
|
Injection of sinus tract
|
$911.82 |
$911.82 |
$911.82 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$2,713.20 |
$2,713.20 |
$2,713.20 |
$2,277.65
|
|
Injection, peramivir
|
$664.99 |
$664.99 |
$664.99 |
$744.75
|
|
Injection radioactive tracer sentinel node (both sides)
|
$400.68 |
$400.68 |
$400.68 |
$670.64
|
|
Injection, renflexis
|
$901.81 |
$901.81 |
$901.81 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$490.56 |
$490.56 |
$490.56 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$813.96 |
$813.96 |
$813.96 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$618.66 |
$618.66 |
$618.66 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,243.20 |
$1,243.20 |
$1,243.20 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$548.94 |
$548.94 |
$548.94 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$796.74 |
$796.74 |
$796.74 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$429.66 |
$429.66 |
$429.66 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$876.54 |
$876.54 |
$876.54 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,098.30 |
$1,098.30 |
$1,098.30 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,144.08 |
$1,144.08 |
$1,144.08 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$519.96 |
$519.96 |
$519.96 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$180.18 |
$180.18 |
$180.18 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$225.12 |
$225.12 |
$225.12 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$120.54 |
$120.54 |
$120.54 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$120.12 |
$120.12 |
$120.12 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$148.26 |
$148.26 |
$148.26 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$109.62 |
$109.62 |
$109.62 |
$135.60
|
|
Injection treatment of nerve
|
$669.48 |
$669.48 |
$669.48 |
$2,025.45
|
|
Inject sacroiliac joint
|
$578.76 |
$578.76 |
$578.76 |
$1,028.95
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$33,123.30 |
$33,123.30 |
$33,123.30 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$640.92 |
$640.92 |
$640.92 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$686.28 |
$686.28 |
$686.28 |
$1,415.50
|
|
Inj, etelcalcetide, 0.1 mg
|
$343.35 |
$343.35 |
$343.35 |
$343.35
|
|
Inj. fe derisomaltose 10 mg
|
$6,330.79 |
$6,330.79 |
$6,330.79 |
$3,221.52
|
|
Inj fluphenazine hcl 1.25 mg
|
$210.70 |
$210.70 |
$210.70 |
$39.54
|
|
Inj for ext venography
|
$447.30 |
$447.30 |
$447.30 |
$649.95
|
|
Inj for mammo ductogram
|
$206.64 |
$206.64 |
$206.64 |
$399.60
|
|
Inj, fulvestrant (fresenius)
|
$172.87 |
$172.87 |
$172.87 |
$1,043.05
|
|
Inj gemcitabine hcl (accord)
|
$200.93 |
$200.93 |
$200.93 |
$130.65
|
|
Inj glofitamab gxbm, 2.5 mg
|
$21,459.86 |
$21,459.86 |
$21,459.86 |
$4,760.67
|
|
Inj glycopyrrolate, glyrx-pf
|
$41.79 |
$41.79 |
$41.79 |
$11.23
|
|
Inj, granisetron, xr, 0.1 mg
|
$1,397.18 |
$1,397.18 |
$1,397.18 |
$5.71
|
|
Inj., guselkumab, 1 mg
|
$29,518.89 |
$29,518.89 |
$29,518.89 |
$29,130.83
|
|
Inj heparin, pfizer, 1000u
|
$41.79 |
$41.79 |
$41.79 |
$26.26
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$459.90 |
$459.90 |
$459.90 |
$1,439.90
|
|
Inj hrt cath w/s&i sel right vent
|
$459.90 |
$459.90 |
$459.90 |
$965.33
|
|
Inj hydroxyprogst capoat nos
|
$215.59 |
$215.59 |
$215.59 |
$1,228.59
|
|
Inj imip 4 cilas 4 releb 2mg
|
$607.01 |
$607.01 |
$607.01 |
$739.77
|
|
Inj. inebilizumab-cdon, 1 mg
|
$91,699.86 |
$91,699.86 |
$91,699.86 |
$70,014.65
|
|
Inj ivig privigen 500 mg
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$41.79 |
$41.79 |
$41.79 |
$38.94
|
|
Inj, lanreotide, (cipla) 1mg
|
$14,308.92 |
$14,308.92 |
$14,308.92 |
$11,648.70
|
|
Inj, lecanemab-irmb, 1 mg
|
$1,337.75 |
$1,337.75 |
$1,337.75 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$74.67 |
$74.67 |
$74.67 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$161.49 |
$161.49 |
$161.49 |
$303.45
|
|
Inj, levothyroxine, hikma
|
$108.51 |
$108.51 |
$108.51 |
$42.89
|
|
Inj, lidocaine w epinephrine
|
$41.79 |
$41.79 |
$41.79 |
$47.52
|
|
Inj melpha hydroch nos 50 mg
|
$393.92 |
$393.92 |
$393.92 |
$1,791.90
|
|
Inj mepivacaine hcl/10 ml
|
$41.79 |
$41.79 |
$41.79 |
$33.86
|
|
Inj, meropenem (b. braun)
|
$86.84 |
$86.84 |
$86.84 |
$71.14
|
|
Inj., meropenem, vaborbactam
|
$373.55 |
$373.55 |
$373.55 |
$558.08
|
|
Inj, micafungin (par pharm)
|
$46.10 |
$46.10 |
$46.10 |
$89.40
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$20,145.77 |
$20,145.77 |
$20,145.77 |
$1,496.55
|
|
Inj, moxifloxacin 100 mg
|
$86.84 |
$86.84 |
$86.84 |
$107.25
|
|
Inj multihance
|
$64.31 |
$64.31 |
$64.31 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$140.05 |
$140.05 |
$140.05 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$622.44 |
$622.44 |
$622.44 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$413.66 |
$413.66 |
$413.66 |
$462.04
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$3,781.68 |
$3,781.68 |
$3,781.68 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,288.98 |
$1,288.98 |
$1,288.98 |
$2,609.38
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$86,692.03 |
$86,692.03 |
$86,692.03 |
$66,582.27
|
|
Inj octafluoropropane mic,ml
|
$133.14 |
$133.14 |
$133.14 |
$211.40
|
|
Inj ogivri 10 mg
|
$3,133.75 |
$3,133.75 |
$3,133.75 |
$4,492.28
|
|
Inj pantoprazole(hikma) 40mg
|
$41.79 |
$41.79 |
$41.79 |
$34.67
|
|
Inj., patisiran, 0.1 mg
|
$19,950.00 |
$19,950.00 |
$19,950.00 |
$17,613.00
|
|
Inj, pedmark, 100 mg
|
$41.79 |
$41.79 |
$41.79 |
$132.57
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$6,269.68 |
$6,269.68 |
$6,269.68 |
$6,403.59
|
|
Inj. pemetrexed, 10 mg
|
$7,696.59 |
$7,696.59 |
$7,696.59 |
$104.72
|
|
Inj pemetrexed (sandoz) 10mg
|
$95.26 |
$95.26 |
$95.26 |
$95.26
|
|
Inj, pemivibart, 4500 mg
|
$1,347.51 |
$1,347.51 |
$1,347.51 |
$1,235.55
|
|
Inj peritoneal venous shunt
|
$413.70 |
$413.70 |
$413.70 |
$413.70
|
|
Inj proc ankle arthr
|
$100.38 |
$100.38 |
$100.38 |
$405.31
|
|
Inj proc elbow arthro
|
$176.82 |
$176.82 |
$176.82 |
$419.60
|
|
Inj proc for lymphang
|
$129.36 |
$129.36 |
$129.36 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$485.10 |
$485.10 |
$485.10 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$721.56 |
$721.56 |
$721.56 |
$830.50
|
|
Inj proc sialogram
|
$196.14 |
$196.14 |
$196.14 |
$373.00
|
|
Inj progesterone per 50 mg
|
$41.79 |
$41.79 |
$41.79 |
$15.00
|
|
Inj, releuko 1 mcg
|
$299.72 |
$299.72 |
$299.72 |
$473.25
|
|
Inj retacrit esrd on dialysi
|
$738.09 |
$738.09 |
$738.09 |
$349.45
|
|
Inj retro urethrocysto
|
$338.52 |
$338.52 |
$338.52 |
$443.50
|
|
Inj scleros sol mult veins
|
$144.06 |
$144.06 |
$144.06 |
$675.00
|
|
Inj scleros sol sgl vein
|
$146.58 |
$146.58 |
$146.58 |
$558.97
|
|
Inj secretin synthetic human
|
$1,388.10 |
$1,388.10 |
$1,388.10 |
$1,285.20
|
|
Inj secukinumab intrav 1mg
|
$4,485.92 |
$4,485.92 |
$4,485.92 |
$4,413.21
|
|
Inj, spesolimab-sbzo, 1 mg
|
$53,689.66 |
$53,689.66 |
$53,689.66 |
$90,007.62
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$255.36 |
$255.36 |
$255.36 |
$436.80
|
|
Inj teplizumab mzwv 5 mcg
|
$22,745.80 |
$22,745.80 |
$22,745.80 |
$22,340.08
|
|
Inj. teprotumumab-trbw 10 mg
|
$32,490.36 |
$32,490.36 |
$32,490.36 |
$35,034.78
|
