|
Inj, levothyroxine, freskabi
|
$533.89 |
$533.89 |
$533.89 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$2.22 |
$2.22 |
$2.22 |
$43.73
|
|
Inj, linezolid (hospira)
|
$0.66 |
$0.66 |
$0.66 |
$152.75
|
|
Inj., lumoxiti, 0.01 mg
|
$7,724.50 |
$7,724.50 |
$7,724.50 |
$23.39
|
|
Inj melpha hydroch nos 50 mg
|
$674.14 |
$674.14 |
$674.14 |
$1,713.99
|
|
Inj, melphalan flufenami 1mg
|
$33,250.00 |
$33,250.00 |
$33,250.00 |
$5,700.00
|
|
Inj mepivacaine hcl/10 ml
|
$1.10 |
$1.10 |
$1.10 |
$31.28
|
|
Inj, meropenem (b. braun)
|
$46.13 |
$46.13 |
$46.13 |
$77.28
|
|
Inj, micafungin (par pharm)
|
$78.54 |
$78.54 |
$78.54 |
$93.73
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$2,238.42 |
$2,238.42 |
$2,238.42 |
$1,496.55
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$3,002.65 |
$3,002.65 |
$3,002.65 |
$2,984.20
|
|
Inj, motixafortide, 0.25 mg
|
$20,650.00 |
$20,650.00 |
$20,650.00 |
$25.22
|
|
Inj multihance multipack
|
$5.59 |
$5.59 |
$5.59 |
$803.75
|
|
Inj. mycophenolate mofetil
|
$237.25 |
$237.25 |
$237.25 |
$291.54
|
|
Inj naloxone hydrochloride
|
$21.32 |
$21.32 |
$21.32 |
$95.36
|
|
Inj. naxitamab-gqgk, 1 mg
|
$8,526.23 |
$8,526.23 |
$8,526.23 |
$2,263.30
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$3,770.00 |
$3,770.00 |
$3,770.00 |
$1,522.56
|
|
Inj, ocriplasmin, 0.125 mg
|
$41,482.00 |
$41,482.00 |
$41,482.00 |
$41,482.00
|
|
Inj octafluoropropane mic,ml
|
$92.17 |
$92.17 |
$92.17 |
$169.22
|
|
Inj ogivri 10 mg
|
$8,241.21 |
$8,241.21 |
$8,241.21 |
$4,096.71
|
|
Inj, olaratumab, 10 mg
|
$171.92 |
$171.92 |
$171.92 |
$443.95
|
|
Inj olipudase alfa-rpcp 1mg
|
$5,099.40 |
$5,099.40 |
$5,099.40 |
$5,099.40
|
|
Inj, omacetaxine mep, 0.01mg
|
$4,541.71 |
$4,541.71 |
$4,541.71 |
$4,541.71
|
|
Inj., omadacycline, 1 mg
|
$1,449.48 |
$1,449.48 |
$1,449.48 |
$1,151.01
|
|
Inj, pafolacianine, 0.1 mg
|
$9,296.88 |
$9,296.88 |
$9,296.88 |
$6,215.63
|
|
Inj., patisiran, 0.1 mg
|
$5,096.88 |
$5,096.88 |
$5,096.88 |
$17,613.00
|
|
Inj, pedmark, 100 mg
|
$5.79 |
$5.79 |
$5.79 |
$96.08
|
|
Inj, pegcetacoplan, 1mg
|
$76,650.00 |
$76,650.00 |
$76,650.00 |
$4,436.30
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$14,288.93 |
$14,288.93 |
$14,288.93 |
$6,244.73
|
|
Inj. pemetrexed, 10 mg
|
$683.74 |
$683.74 |
$683.74 |
$104.72
|
|
Inj pemetrexed (accord) 10mg
|
$33.79 |
$33.79 |
$33.79 |
$11.34
|
|
Inj pemetrexed, hospira 10mg
|
$10.91 |
$10.91 |
$10.91 |
$64.35
|
|
Inj pemetrexed (sandoz) 10mg
|
$20.15 |
$20.15 |
$20.15 |
$97.50
|
|
Inj pemetrexed (teva) 10mg
|
$65.87 |
$65.87 |
$65.87 |
$5.52
|
|
Inj, pemivibart, 4500 mg
|
$561.46 |
$561.46 |
$561.46 |
$1,295.85
|
|
Inj., perseris, 0.5 mg
|
$9,486.47 |
$9,486.47 |
$9,486.47 |
$5,372.48
|
|
Inj proc lumbr disk ea lvl
|
$635.00 |
$635.00 |
$635.00 |
$1,224.30
|
|
Inj progesterone per 50 mg
|
$10.15 |
$10.15 |
$10.15 |
$19.53
|
|
Inj prohance multipack
|
$4.52 |
$4.52 |
$4.52 |
$51.48
|
|
Inj recombin esperoct per iu
|
$7.67 |
$7.67 |
$7.67 |
$6.63
|
|
Inj, releuko 1 mcg
|
$461.20 |
$461.20 |
$461.20 |
$519.53
|
|
Inj, rimabotulinumtoxinb
|
$2,179.17 |
$2,179.17 |
$2,179.17 |
$1,486.10
|
|
Inj secretin synthetic human
|
$2,249.10 |
$2,249.10 |
$2,249.10 |
$1,459.08
|
|
Inj, sezaby, 1 mg
|
$402.22 |
$402.22 |
$402.22 |
$292.85
|
|
Inj, spesolimab-sbzo, 1 mg
|
$12,169.65 |
$12,169.65 |
$12,169.65 |
$178,150.09
|
|
Inj sulf hexa lipid microsph
|
$283.47 |
$283.47 |
$283.47 |
$281.30
|
|
Inj, susvimo 0.1 mg
|
$280,000.00 |
$280,000.00 |
$280,000.00 |
$79.08
|
|
Inj, sutimlimab-jome, 10 mg
|
$305.07 |
$305.07 |
$305.07 |
$34.80
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$112,522.17 |
$112,522.17 |
$112,522.17 |
$105,320.75
|
|
Inj, taliglucerace alfa 10 u
|
$3,054.35 |
$3,054.35 |
$3,054.35 |
$42.58
|
|
Inj teclistamab cqyv 0.5 mg
|
$14,653.61 |
$14,653.61 |
$14,653.61 |
$17,517.56
|
|
Inj tedizolid phosphate
|
$1,001.48 |
$1,001.48 |
$1,001.48 |
$866.93
|
|
Inj teplizumab mzwv 5 mcg
|
$24,969.47 |
$24,969.47 |
$24,969.47 |
$37.65
|
|
Inj. teprotumumab-trbw 10 mg
|
$59,561.67 |
$59,561.67 |
$59,561.67 |
$42,164.34
|
|
Inj testostero enanthate 1mg
|
$1,021.67 |
$1,021.67 |
$1,021.67 |
$35.40
|
|
Inj testosterone cypionate
|
$77.70 |
$77.70 |
$77.70 |
$82.58
|
|
Inj theophylline per 40 mg
|
$0.03 |
$0.03 |
$0.03 |
$14.40
|
|
Inj., tildrakizumab, 1 mg
|
$47,573.05 |
$47,573.05 |
$47,573.05 |
$31,164.94
|
|
Inj triamcinolone ace X-ray 1mg
|
$2,312.77 |
$2,312.77 |
$2,312.77 |
$21.45
|
|
Inj., triptorelin X-ray 3.75 mg
|
$71,598.03 |
$71,598.03 |
$71,598.03 |
$5,195.68
|
|
Inj, trivisc 1 mg
|
$593.10 |
$593.10 |
$593.10 |
$5.45
|
|
Inj, tyenne, 1 mg
|
$327.47 |
$327.47 |
$327.47 |
$3,525.12
|
|
Inj, uzedy, 1 mg
|
$27,853.88 |
$27,853.88 |
$27,853.88 |
$11,643.18
|
|
Inj, vancomycin hcl (mylan)
|
$63.82 |
$63.82 |
$63.82 |
$89.83
|
|
Inj w/fluor eval cv device
|
$4,912.00 |
$4,912.00 |
$4,912.00 |
$588.90
|
|
Inj xipere 1 mg
|
$14,350.00 |
$14,350.00 |
$14,350.00 |
$4,290.00
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$78,991.57 |
$78,991.57 |
$78,991.57 |
$45,841.00
|
|
Ins cerv dilator (sep proc)
|
$456.00 |
$456.00 |
$456.00 |
$544.00
|
|
Insert cath pleura with image
|
$5,105.00 |
$5,105.00 |
$5,105.00 |
$2,239.02
|
|
Insert cath pleura without image
|
$6,175.00 |
$6,175.00 |
$6,175.00 |
$2,212.00
|
|
Insertion catheter bladder non indwelling
|
$454.00 |
$454.00 |
$454.00 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$273.60
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$13,102.00 |
$13,102.00 |
$13,102.00 |
$2,618.40
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$45,333.76 |
$45,333.76 |
$45,333.76 |
$14,158.20
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$7,756.00 |
$7,756.00 |
$7,756.00 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$6,644.03 |
$6,644.03 |
$6,644.03 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$44,592.25 |
$44,592.25 |
$44,592.25 |
$29,997.52
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$27,526.29 |
$27,526.29 |
$27,526.29 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,852.92 |
$6,852.92 |
$6,852.92 |
$5,470.54
|
|
Insitu hybridization (fish)
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$481.60
|
|
In situ hybridization per specimen each additional single probe stain
|
$426.00 |
$426.00 |
$426.00 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$1,240.00 |
$1,240.00 |
$1,240.00 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$4,195.00 |
$4,195.00 |
$4,195.00 |
$4,341.66
|
|
Insti hexaminolevulinate hcl
|
$3,080.00 |
$3,080.00 |
$3,080.00 |
$2,359.80
|
|
Instill, bupivac and meloxic
|
$69.14 |
$69.14 |
$69.14 |
$786.78
|
|
Instll rx agnt into rnal tub
|
$789.00 |
$789.00 |
$789.00 |
$619.20
|
|
Ins tun cv cath wo subq prt/pm
|
$7,890.00 |
$7,890.00 |
$7,890.00 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$13,132.00 |
$13,132.00 |
$13,132.00 |
$4,657.46
|
|
Insulin for insulin pump use
|
$0.36 |
$0.36 |
$0.36 |
$107.10
|
|
Insulin total
|
$223.00 |
$223.00 |
$223.00 |
$67.60
|
|
Intens behave ther cardio dx
|
$91.00 |
$91.00 |
$91.00 |
$38.70
|
|
Interferon alfa-2b inj
|
$1,048.67 |
$1,048.67 |
$1,048.67 |
$559.83
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$28,207.17 |
$28,207.17 |
$28,207.17 |
$5,977.59
|
|
Interrog dev eval scrms ip
|
$92.00 |
$92.00 |
$92.00 |
$124.80
|
|
Interrog evl pm/ldls pm ip
|
$238.00 |
$238.00 |
$238.00 |
$127.20
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,754.00 |
$1,754.00 |
$1,754.00 |
$1,182.15
|
|
Intrauterine transfusion ftl
|
$4,669.00 |
$4,669.00 |
$4,669.00 |
$1,004.25
|
|
Intrinsic factor antibody
|
$25.00 |
$25.00 |
$25.00 |
$59.95
|
|
Intro cath dialysis circuit
|
$2,481.00 |
$2,481.00 |
$2,481.00 |
$2,317.80
|
|
Intro catheter aorta
|
$2,729.00 |
$2,729.00 |
$2,729.00 |
$1,861.61
|
