|
Infect ag if pneumocystis carinii
|
$224.28 |
$224.28 |
$224.28 |
$68.40
|
|
Infect ag if varicella zoster
|
$221.76 |
$221.76 |
$221.76 |
$72.00
|
|
Infect ag na hpv high-risk types
|
$272.16 |
$272.16 |
$272.16 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$404.88 |
$404.88 |
$404.88 |
$219.50
|
|
Infect ag na resp virus 12-25 targets
|
$1,918.56 |
$1,918.56 |
$1,918.56 |
$854.40
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$232.68 |
$232.68 |
$232.68 |
$81.90
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$183.12 |
$183.12 |
$183.12 |
$72.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$160.44 |
$160.44 |
$160.44 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$178.92 |
$178.92 |
$178.92 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$231.84 |
$231.84 |
$231.84 |
$96.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$162.96 |
$162.96 |
$162.96 |
$80.60
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$49.56 |
$49.56 |
$49.56 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$201.60 |
$201.60 |
$201.60 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$686.28 |
$686.28 |
$686.28 |
$129.68
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$230.16 |
$230.16 |
$230.16 |
$98.40
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$89.04 |
$89.04 |
$89.04 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$428.40 |
$428.40 |
$428.40 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$170.52 |
$170.52 |
$170.52 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$289.80 |
$289.80 |
$289.80 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,359.12 |
$1,359.12 |
$1,359.12 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$687.12 |
$687.12 |
$687.12 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$143.64 |
$143.64 |
$143.64 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$157.92 |
$157.92 |
$157.92 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$150.36 |
$150.36 |
$150.36 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$165.48 |
$165.48 |
$165.48 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$355.32 |
$355.32 |
$355.32 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$149.52 |
$149.52 |
$149.52 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$156.24 |
$156.24 |
$156.24 |
$109.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,083.60 |
$1,083.60 |
$1,083.60 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$528.36 |
$528.36 |
$528.36 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$433.44 |
$433.44 |
$433.44 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$716.52 |
$716.52 |
$716.52 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,389.36 |
$1,389.36 |
$1,389.36 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$543.48 |
$543.48 |
$543.48 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$4,730.84 |
$4,730.84 |
$4,730.84 |
$2,052.00
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,924.23 |
$1,924.23 |
$1,924.23 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,061.70 |
$2,061.70 |
$2,061.70 |
$1,537.84
|
|
Influenza dna amp prob addl
|
$99.96 |
$99.96 |
$99.96 |
$64.26
|
|
Influenza virus vaccine, live trivalent intranasal
|
$37.80 |
$37.80 |
$37.80 |
$36.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$183.12 |
$183.12 |
$183.12 |
$293.25
|
|
Initial observation care
|
$229.32 |
$229.32 |
$229.32 |
$156.00
|
|
Initial observation care
|
$312.48 |
$312.48 |
$312.48 |
$268.20
|
|
Initial observation care
|
$423.36 |
$423.36 |
$423.36 |
$369.00
|
|
Initiation & management bipap/cpap initial day
|
$184.80 |
$184.80 |
$184.80 |
$570.50
|
|
Inj, abilify asimtufii, 1 mg
|
$21,421.23 |
$21,421.23 |
$21,421.23 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$10,710.59 |
$10,710.59 |
$10,710.59 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$83.58 |
$83.58 |
$83.58 |
$33.73
|
|
Inj acetaminophen -fresenius
|
$83.58 |
$83.58 |
$83.58 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$83.58 |
$83.58 |
$83.58 |
$58.50
|
|
Inj, adstiladrin, per tx dos
|
$83.58 |
$83.58 |
$83.58 |
$63,354.77
|
|
Inj, alfentanil hcl, 500mcg
|
$83.58 |
$83.58 |
$83.58 |
$35.94
|
|
Inj alymsys 10 mg
|
$6,095.31 |
$6,095.31 |
$6,095.31 |
$1,280.74
|
|
Inj anifrolumab-fnia 1mg
|
$21,963.36 |
$21,963.36 |
$21,963.36 |
$9,878.82
|
|
Inj, artesunate, 1mg
|
$45,179.40 |
$45,179.40 |
$45,179.40 |
$14,460.21
|
|
Inj, aspara, rylaze, 0.1 mg
|
$20,916.00 |
$20,916.00 |
$20,916.00 |
$10,458.00
|
|
Inj aval alfa-nqpt 4mg
|
$8,179.08 |
$8,179.08 |
$8,179.08 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$23,842.35 |
$23,842.35 |
$23,842.35 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$15,960.00 |
$15,960.00 |
$15,960.00 |
$7,612.43
|
|
Inj, bortezomib, dr. reddy's
|
$115.92 |
$115.92 |
$115.92 |
$48.55
|
|
Inj, bortezomib freseniuskab
|
$4,928.28 |
$4,928.28 |
$4,928.28 |
$2,464.14
|
|
Inj calcitriol per 0.1 mcg
|
$83.58 |
$83.58 |
$83.58 |
$23.28
|
|
Inj cefazolin sodium, baxter
|
$173.67 |
$173.67 |
$173.67 |
$27.38
|
|
Inj cefazolin (wg crit care)
|
$173.67 |
$173.67 |
$173.67 |
$17.00
|
|
Inj. cefepime hcl (baxter)
|
$173.67 |
$173.67 |
$173.67 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$173.67 |
$173.67 |
$173.67 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$894.42 |
$894.42 |
$894.42 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$669.76 |
$669.76 |
$669.76 |
$382.72
|
|
Inj, clevidipine butyrate
|
$331.80 |
$331.80 |
$331.80 |
$4.86
|
|
Inj, clindamycin (baxter)
|
$173.67 |
$173.67 |
$173.67 |
$48.96
|
|
Inj crotalidae im f(ab')2 eq
|
$4,875.83 |
$4,875.83 |
$4,875.83 |
$2,613.60
|
|
Inj cyclophosphamd auromedic
|
$922.32 |
$922.32 |
$922.32 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$1,048.70 |
$1,048.70 |
$1,048.70 |
$683.35
|
|
Inj, cyclophosphamd, sandoz
|
$437.90 |
$437.90 |
$437.90 |
$735.20
|
|
Inj daptomycin (xellia)
|
$83.58 |
$83.58 |
$83.58 |
$56.04
|
|
Inj, decitabine (sun pharma)
|
$1,469.79 |
$1,469.79 |
$1,469.79 |
$310.09
|
|
Inj, donanemab-azbt, 2 mg
|
$2,921.78 |
$2,921.78 |
$2,921.78 |
$1,233.44
|
|
Inj dupuytren cord w/enzyme
|
$333.48 |
$333.48 |
$333.48 |
$416.00
|
|
Inject for sacroiliac joint
|
$414.12 |
$414.12 |
$414.12 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$874.44 |
$874.44 |
$874.44 |
$1,214.78
|
|
Injection, burosumab-twza 1m
|
$53,417.28 |
$53,417.28 |
$53,417.28 |
$20,002.09
|
|
Injection, cangrelor
|
$3,838.24 |
$3,838.24 |
$3,838.24 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$33,285.00 |
$33,285.00 |
$33,285.00 |
$16,319.16
|
|
Injection carpal tunnel therapeutic (both sides)
|
$272.16 |
$272.16 |
$272.16 |
$484.90
|
|
Injection, daratumumab 10 mg
|
$12,920.04 |
$12,920.04 |
$12,920.04 |
$5,188.91
|
|
Injection, doxercalciferol
|
$83.58 |
$83.58 |
$83.58 |
$23.83
|
|
Injection, edaravone, 1 mg
|
$1,936.04 |
$1,936.04 |
$1,936.04 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$671.16 |
$671.16 |
$671.16 |
$1,161.14
|
|
Injection for bladder x-ray
|
$313.32 |
$313.32 |
$313.32 |
$459.20
|
|
Injection, fulvestrant
|
$3,724.27 |
$3,724.27 |
$3,724.27 |
$1,719.16
|
|
Injection, glucarpidase
|
$172,930.80 |
$172,930.80 |
$172,930.80 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$14,201.97 |
$14,201.97 |
$14,201.97 |
$6,679.35
|
|
Injection into hemorrhoid(s)
|
$757.68 |
$757.68 |
$757.68 |
$1,432.81
|
|
Injection, isavuconazonium
|
$1,513.01 |
$1,513.01 |
$1,513.01 |
$787.67
|
|
Injection jugular
|
$247.80 |
$247.80 |
$247.80 |
$790.00
|
|
Injection, necitumumab, 1 mg
|
$18,184.95 |
$18,184.95 |
$18,184.95 |
$8,572.91
|
|
Injection of sinus tract
|
$833.28 |
$833.28 |
$833.28 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$5,426.40 |
$5,426.40 |
$5,426.40 |
$2,277.65
|
|
Injection, peramivir
|
$1,329.98 |
$1,329.98 |
$1,329.98 |
$775.82
|
|
Injection radioactive tracer sentinel node (both sides)
|
$493.08 |
$493.08 |
$493.08 |
$699.68
|
|
Injection, renflexis
|
$1,803.61 |
$1,803.61 |
$1,803.61 |
$1,341.52
|