|
Inj romidepsin non-lyo 0.1mg
|
$28.52 |
$28.52 |
$33.91 |
|
|
Inj, rykindo, 0.5 mg
|
$13.03 |
$13.03 |
$13.03 |
|
|
Inj scleros sol mult veins
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Inj scleros sol sgl vein
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Inj, sculptra, 0.5mg
|
$1.00 |
$1.00 |
$1.00 |
|
|
Inj sebelipase alfa 1 mg
|
$539.42 |
$539.69 |
$539.69 |
|
|
Inj secretin synthetic human
|
$42.57 |
$43.79 |
$43.79 |
|
|
Inj secukinumab intrav 1mg
|
$17.54 |
$17.84 |
$17.84 |
|
|
Inj, sezaby, 1 mg
|
$1.15 |
$1.15 |
$1.41 |
|
|
Inj, spesolimab-sbzo, 1 mg
|
$61.43 |
$65.73 |
$65.73 |
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Inj, susvimo 0.1 mg
|
$78.43 |
$78.43 |
$79.08 |
|
|
Inj, sutimlimab-jome, 10 mg
|
$18.11 |
$18.11 |
$18.13 |
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$339.03 |
$348.62 |
$348.62 |
|
|
Inj, taliglucerace alfa 10 u
|
$41.06 |
$41.06 |
$42.58 |
|
|
Inj teclistamab cqyv 0.5 mg
|
$31.98 |
$33.27 |
$33.27 |
|
|
Inj tedizolid phosphate
|
$1.81 |
$1.91 |
$1.91 |
|
|
Inj teplizumab mzwv 5 mcg
|
$36.90 |
$37.65 |
$37.65 |
|
|
Inj. teprotumumab-trbw 10 mg
|
$343.89 |
$359.09 |
$359.09 |
|
|
Inj, testosterone, azmiro
|
$1.33 |
$1.33 |
$1.33 |
|
|
Inj thiotepa nos 1 mg
|
$12.24 |
$12.24 |
$12.24 |
|
|
Inj., tildrakizumab, 1 mg
|
$126.24 |
$126.24 |
$135.92 |
|
|
Inj, tislelizumab-jsgr
|
$57.42 |
$57.42 |
$551.62 |
|
|
Inj tofersen intrathec 1 mg
|
$153.66 |
$155.34 |
$155.34 |
|
|
Inj, tofidence, 1 mg
|
$5.72 |
$5.79 |
$5.79 |
|
|
Inj travoprost intra impl
|
$195.25 |
$195.25 |
$197.16 |
|
|
Inj triamcinolone ace X-ray 1mg
|
$17.75 |
$18.21 |
$18.21 |
|
|
Inj., triluron, 1 mg
|
$10.16 |
$10.16 |
$10.36 |
|
|
Inj., triptorelin X-ray 3.75 mg
|
$3,418.49 |
$3,772.85 |
$3,772.85 |
|
|
Inj, trivisc 1 mg
|
$5.45 |
$5.45 |
$6.67 |
|
|
Inj, tyenne, 1 mg
|
$4.69 |
$4.69 |
$5.04 |
|
|
Inj ustekinumab-aekn, 1 mg
|
$47.80 |
$47.80 |
$47.80 |
|
|
Inj ustekinumab-kfce, 1 mg
|
$3.17 |
$3.17 |
$3.17 |
|
|
Inj ustekinumab-stba, 1 mg
|
$2.41 |
$2.41 |
$2.41 |
|
|
Inj, uzedy, 1 mg
|
$24.77 |
$25.08 |
$25.08 |
|
|
Inj, vasopressin (baxter)
|
$2.94 |
$2.94 |
$3.77 |
|
|
Inj, vegzelma, 10 mg
|
$43.62 |
$43.62 |
$56.82 |
|
|
Inj velmanase alfa-tycv 1 mg
|
$442.00 |
$465.05 |
$465.05 |
|
|
Inj vocal cord bulking agent
|
$347.42 |
$407.64 |
$574.47 |
|
|
Inj w/fluor eval cv device
|
$230.26 |
$3,986.00 |
$6,839.00 |
|
|
Inj. xembify, 100 mg
|
$14.30 |
$14.91 |
$14.91 |
|
|
Inj xipere 1 mg
|
$48.00 |
$48.00 |
$48.40 |
|
|
Inj., yutiq, 0.01 mg
|
$527.97 |
$532.58 |
$532.58 |
|
|
Inj zanidatamab-hrii, 2 mg
|
$25.08 |
$25.08 |
$25.08 |
|
|
Inj zenocutuzumab-zbco 1 mg
|
$32.62 |
$32.62 |
$32.62 |
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$2,618.85 |
$2,698.05 |
$2,698.05 |
|
|
Ins cath ren art 1st bi
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Ins cath ren art 1st uni
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Ins cath ren art 2nd+ bi
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Ins cath ren art 2nd+ uni
|
$3,786.00 |
$5,907.78 |
$6,839.00 |
|
|
Ins cerv dilator (sep proc)
|
$332.44 |
$3,986.00 |
$6,839.00 |
|
|
Insemination of oocytes
|
$187.28 |
$189.67 |
$201.80 |
|
|
Insert abdomen-venous drain
|
$5,419.00 |
$5,741.00 |
$6,311.00 |
|
|
Insert and remove bone pin
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Insert ant drainage device
|
$3,786.00 |
$4,627.00 |
$6,839.00 |
|
|
Insert brain-fluid device 61215
|
$3,786.00 |
$6,311.00 |
$7,541.82 |
|
|
Insert cannula hemo oth 36815
|
$3,786.00 |
$5,907.78 |
$6,839.00 |
|
|
Insert cannula vein-to-vein hemodialysis
|
$3,786.00 |
$5,907.78 |
$6,839.00 |
|
|
Insert cath pleura with image
|
$1,697.72 |
$3,986.00 |
$6,839.00 |
|
|
Insert cath pleura without image
|
$2,073.18 |
$3,986.00 |
$6,839.00 |
|
|
Insert cv cath inf & sup app
|
$9,016.81 |
$9,132.15 |
$9,716.28 |
|
|
Insert drug del implant, >=4
|
$436.10 |
$441.68 |
$469.93 |
|
|
Insert drug delivery implant
|
$140.87 |
$3,986.00 |
$6,839.00 |
|
|
Insert electrodes for eeg
|
$158.98 |
$158.98 |
$158.98 |
|
|
Insert eye socket implant
|
$3,786.00 |
$4,440.96 |
$6,839.00 |
|
|
Insert hepatic shunt (tips)
|
$3,786.00 |
$5,339.00 |
$6,311.00 |
|
|
Insert heyman uteri capsule
|
$3,786.00 |
$5,463.96 |
$6,839.00 |
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Insertion catheter bladder non indwelling
|
$140.87 |
$3,986.00 |
$6,839.00 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,786.00 |
$4,156.03 |
$6,839.00 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,786.00 |
$5,907.78 |
$6,839.00 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Insertion of cannula
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Insertion of catheter vein
|
$3,786.00 |
$4,881.00 |
$6,311.00 |
|
|
Insertion of catheter vein
|
$3,786.00 |
$5,419.00 |
$6,839.00 |
|
|
Insertion of heart electrode 33211
|
$3,786.00 |
$6,311.00 |
$9,746.29 |
|
|
Insertion of infusion pump
|
$3,786.00 |
$5,907.78 |
$6,839.00 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$3,786.00 |
$6,311.00 |
$12,324.60 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$3,786.00 |
$6,311.00 |
$12,324.60 |
|
|
Insertion palate prosthesis
|
$3,786.00 |
$6,311.00 |
$6,966.64 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,697.72 |
$3,986.00 |
$6,839.00 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,697.72 |
$3,986.00 |
$6,839.00 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$3,786.00 |
$6,311.00 |
$37,757.64 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$3,786.00 |
$6,311.00 |
$9,746.29 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$3,786.00 |
$6,311.00 |
$9,746.29 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,786.00 |
$6,311.00 |
$9,746.29 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Insertion ureth cath
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Insert lens prosthesis
|
$2,492.56 |
$3,986.00 |
$6,839.00 |
|
|
Insert multi-comp penis pros
|
$3,786.00 |
$6,311.00 |
$23,704.60 |
|
|
Insert nasal septal button
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Insert ocular implant
|
$3,786.00 |
$4,440.96 |
$6,839.00 |
|
|
Insert ocular implant
|
$3,786.00 |
$4,440.96 |
$6,839.00 |
|
|
Insert palate implants
|
$1,618.86 |
$1,639.57 |
$1,744.44 |
|
|
Insert pessary/other device
|
$219.85 |
$3,986.00 |
$6,839.00 |
|
|
Insert picvad cath
|
$3,439.84 |
$3,986.00 |
$6,839.00 |
|
|
Insert pm/icd lead dual
|
$3,786.00 |
$6,311.00 |
$9,746.29 |
|
|
Insert prost urethral stent
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Insert/repl sq defib w/eltrd
|
$3,786.00 |
$6,311.00 |
$37,757.64 |
|
|
Insert self-contd prosthesis
|
$3,786.00 |
$6,311.00 |
$23,704.60 |
|
