|
Injection into hemorrhoid(s)
|
$748.66 |
$757.68 |
$766.70 |
|
|
Injection, isavuconazonium
|
$165.72 |
$756.51 |
$1,531.02 |
|
|
Injection jaw joint x-ray
|
$517.43 |
$517.43 |
$517.43 |
|
|
Injection jugular
|
$205.38 |
$205.38 |
$250.75 |
|
|
Injection, necitumumab, 1 mg
|
$39.84 |
$9,092.48 |
$18,401.44 |
|
|
Injection of sinus tract
|
$535.50 |
$843.20 |
$911.82 |
|
|
Injection,onabotulinumtoxina
|
$594.32 |
$2,713.20 |
$5,491.00 |
|
|
Injection, peramivir
|
$7.29 |
$664.99 |
$1,345.81 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$393.76 |
$400.68 |
$760.28 |
|
|
Injection, renflexis
|
$161.29 |
$901.81 |
$1,825.08 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$399.00 |
$490.56 |
$795.44 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$215.35 |
$813.96 |
$1,750.70 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$173.46 |
$618.66 |
$1,033.60 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$487.14 |
$1,243.20 |
$2,031.18 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$427.56 |
$548.94 |
$1,147.06 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$796.74 |
$819.00 |
$2,031.18 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$429.66 |
$752.64 |
$1,808.04 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$876.54 |
$1,185.24 |
$2,499.34 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$880.87 |
$1,098.30 |
$1,557.33 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$880.87 |
$1,144.08 |
$1,848.30 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$208.62 |
$380.91 |
$519.96 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$177.10 |
$208.00 |
$327.18 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$225.12 |
$321.55 |
$808.42 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$93.32 |
$121.80 |
$143.35 |
|
|
Injection treatment of nerve
|
$669.48 |
$669.48 |
$1,180.00 |
|
|
Inject sacroiliac joint
|
$435.12 |
$578.76 |
$1,189.39 |
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$1,295.64 |
$33,123.30 |
$67,035.25 |
|
|
Inj epidural sgl cerv-thor without img
|
$640.92 |
$640.92 |
$1,557.33 |
|
|
Inj epidural sgl lumb-sacral without img
|
$227.74 |
$686.28 |
$1,848.30 |
|
|
Inj, etelcalcetide, 0.1 mg
|
$75.21 |
$343.35 |
$694.88 |
|
|
Inj. fe derisomaltose 10 mg
|
$138.68 |
$6,330.79 |
$12,812.31 |
|
|
Inj fluphenazine hcl 1.25 mg
|
$4.62 |
$210.70 |
$426.41 |
|
|
Inj for ext venography
|
$220.92 |
$447.30 |
$710.65 |
|
|
Inj for mammo ductogram
|
$192.00 |
$206.64 |
$239.12 |
|
|
Inj, fulvestrant (fresenius)
|
$172.87 |
$172.87 |
$349.85 |
|
|
Inj gemcitabine hcl (accord)
|
$5.35 |
$200.93 |
$406.64 |
|
|
Inj glofitamab gxbm, 2.5 mg
|
$470.08 |
$21,459.86 |
$43,430.67 |
|
|
Inj glycopyrrolate, glyrx-pf
|
$0.85 |
$41.79 |
$84.58 |
|
|
Inj, granisetron, xr, 0.1 mg
|
$765.12 |
$1,397.18 |
$2,827.61 |
|
|
Inj., guselkumab, 1 mg
|
$6,466.05 |
$29,518.89 |
$59,740.60 |
|
|
Inj heparin, pfizer, 1000u
|
$41.79 |
$41.79 |
$84.58 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$459.90 |
$459.90 |
$2,970.70 |
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,701.00 |
$1,701.00 |
$1,701.00 |
|
|
Inj hrt cath w/s&i sel hrt art
|
$260.00 |
$260.00 |
$260.00 |
|
|
Inj hrt cath w/s&i sel left vent
|
$1,013.38 |
$1,013.38 |
$1,069.00 |
|
|
Inj hrt cath w/s&i sel right vent
|
$459.90 |
$459.90 |
$1,941.02 |
|
|
Inj hydroxyprogst capoat nos
|
$215.59 |
$215.59 |
$436.31 |
|
|
Inj imip 4 cilas 4 releb 2mg
|
$132.97 |
$607.01 |
$1,228.46 |
|
|
Inj. inebilizumab-cdon, 1 mg
|
$91,699.86 |
$91,699.86 |
$185,583.05 |
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$1,877.00 |
$1,877.00 |
$1,877.00 |
|
|
Inj intralesional <= 7 lsn(s)
|
$29.79 |
$113.90 |
$140.50 |
|
|
Inj intralesional > 7 lsns
|
$110.88 |
$112.20 |
$186.00 |
|
|
Inj ivig privigen 500 mg
|
$3.35 |
$6,115.20 |
$12,376.00 |
|
|
Inj labetalol hcl hikma, 5mg
|
$41.79 |
$41.79 |
$84.58 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$14,308.92 |
$14,308.92 |
$28,958.53 |
|
|
Inj, lecanemab-irmb, 1 mg
|
$58.61 |
$1,337.75 |
$2,707.34 |
|
|
Inj levocarnitine per 1 gm
|
$3.28 |
$74.67 |
$151.12 |
|
|
Inj, levothyroxine, freskabi
|
$6.01 |
$161.49 |
$326.83 |
|
|
Inj, levothyroxine, hikma
|
$23.77 |
$108.51 |
$219.60 |
|
|
Inj, lidocaine w epinephrine
|
$0.44 |
$41.79 |
$84.58 |
|
|
Inj melpha hydroch nos 50 mg
|
$86.29 |
$393.92 |
$797.22 |
|
|
Inj mepivacaine hcl/10 ml
|
$0.15 |
$41.79 |
$84.58 |
|
|
Inj, meropenem (b. braun)
|
$8.63 |
$86.84 |
$175.74 |
|
|
Inj., meropenem, vaborbactam
|
$81.83 |
$373.55 |
$755.99 |
|
|
Inj, micafungin (par pharm)
|
$46.10 |
$46.10 |
$93.29 |
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$294.20 |
$20,145.77 |
$40,771.19 |
|
|
Inj, moxifloxacin 100 mg
|
$0.08 |
$86.84 |
$175.74 |
|
|
Inj multihance
|
$0.72 |
$64.31 |
$130.14 |
|
|
Inj. mycophenolate mofetil
|
$30.68 |
$140.05 |
$283.43 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$622.44 |
$622.44 |
$2,843.00 |
|
|
Inj, nithiodote, 3mg / 125mg
|
$1.52 |
$413.66 |
$837.17 |
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,662.86 |
$3,781.68 |
$3,781.68 |
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,288.98 |
$1,288.98 |
$1,662.86 |
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$825.64 |
$86,692.03 |
$175,448.16 |
|
|
Inj octafluoropropane mic,ml
|
$133.14 |
$133.14 |
$133.14 |
|
|
Inj ogivri 10 mg
|
$686.44 |
$3,133.75 |
$6,342.11 |
|
|
Inj pantoprazole(hikma) 40mg
|
$41.79 |
$41.79 |
$84.58 |
|
|
Inj., patisiran, 0.1 mg
|
$874.00 |
$19,950.00 |
$40,375.00 |
|
|
Inj, pedmark, 100 mg
|
$41.79 |
$41.79 |
$84.58 |
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$6,269.68 |
$6,269.68 |
$12,688.63 |
|
|
Inj. pemetrexed, 10 mg
|
$84.30 |
$7,696.59 |
$15,576.42 |
|
|
Inj pemetrexed (sandoz) 10mg
|
$1.05 |
$95.26 |
$192.78 |
|
|
Inj, pemivibart, 4500 mg
|
$73.80 |
$1,347.51 |
$2,727.09 |
|
|
Inj peritoneal venous shunt
|
$276.94 |
$413.70 |
$413.70 |
|
|
Inj proc ankle arthr
|
$100.38 |
$100.38 |
$535.35 |
|
|
Inj proc elbow arthro
|
$176.82 |
$176.82 |
$269.01 |
|
|
Inj proc for lymphang
|
$129.36 |
$129.36 |
$519.72 |
|
|
Inj proc lumbr disk ea lvl
|
$485.10 |
$485.10 |
$692.96 |
|
|
Inj proc myelogram lumbar
|
$721.56 |
$721.56 |
$995.92 |
|
|
Inj proc sialogram
|
$196.14 |
$196.14 |
$297.07 |
|
|
Inj progesterone per 50 mg
|
$1.28 |
$41.79 |
$84.58 |
|
|
Inj, releuko 1 mcg
|
$82.07 |
$299.72 |
$606.56 |
|
|
Inj retacrit esrd on dialysi
|
$4.04 |
$738.09 |
$1,493.75 |
|
|
Inj retro urethrocysto
|
$173.88 |
$338.52 |
$447.74 |
|
|
Inj scleros sol mult veins
|
$144.06 |
$144.06 |
$204.96 |
|
|
Inj scleros sol sgl vein
|
$97.44 |
$146.58 |
$316.00 |
|
|
Inj secretin synthetic human
|
$304.06 |
$1,388.10 |
$2,809.25 |
|
|
Inj secukinumab intrav 1mg
|
$1,693.76 |
$4,485.92 |
$9,078.64 |
|
|
Inj, spesolimab-sbzo, 1 mg
|
$1,568.08 |
$53,689.66 |
$108,657.65 |
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$255.36 |
$255.36 |
$1,076.50 |
|
