|
Inj, abilify maintena, 1 mg
|
$13.72 |
$13.72 |
$13.72 |
$5,355.30
|
|
Inj, aflibercept hd, 1 mg
|
$625.98 |
$625.98 |
$625.98 |
$2,794.18
|
|
Inj anifrolumab-fnia 1mg
|
$38.31 |
$38.31 |
$38.31 |
$10,052.58
|
|
Inj., benralizumab, 1 mg
|
$364.38 |
$364.38 |
$364.38 |
$11,310.00
|
|
Inj, brolucizumab-dbll, 1 mg
|
$651.35 |
$651.35 |
$651.35 |
$3,382.69
|
|
Inj, cimerli, 0.1 mg
|
$563.11 |
$563.11 |
$563.11 |
$201.01
|
|
Inj cntr knee arthro incl ct/mri
|
$277.15 |
$277.15 |
$277.15 |
$436.80
|
|
Inj. denosumab-bbdz, 1 mg
|
$51.45 |
$51.45 |
$51.45 |
$4,615.43
|
|
Inj dupuytren cord w/enzyme
|
$332.02 |
$332.02 |
$332.02 |
$416.00
|
|
Inj, durolane 1 mg
|
$39.26 |
$39.26 |
$39.26 |
$1,950.93
|
|
Inj dx for sinogram
|
$153.22 |
$153.22 |
$153.22 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,231.28 |
$1,231.28 |
$1,231.28 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$221.70 |
$221.70 |
$221.70 |
$503.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$418.44 |
$418.44 |
$418.44 |
$458.15
|
|
Injection, doxercalciferol
|
$3.43 |
$3.43 |
$3.43 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$132.92 |
$132.92 |
$132.92 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,231.28 |
$1,231.28 |
$1,231.28 |
$1,182.33
|
|
Injection eye drug
|
$842.09 |
$842.09 |
$842.09 |
$654.00
|
|
Injection for arthrography wrist (both sides)
|
$97.21 |
$97.21 |
$97.21 |
$436.00
|
|
Injection for bladder x-ray
|
$143.24 |
$143.24 |
$143.24 |
$459.20
|
|
Injection for hip x-ray
|
$221.70 |
$221.70 |
$221.70 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$263.95 |
$263.95 |
$263.95 |
$497.76
|
|
Injection for ureter x-ray
|
$204.68 |
$204.68 |
$204.68 |
$415.80
|
|
Injection for ureter x-ray
|
$650.23 |
$650.23 |
$650.23 |
$515.21
|
|
Injection, inclisiran, 1 mg
|
$25.22 |
$25.22 |
$25.22 |
$6,679.35
|
|
Injection into hemorrhoid(s)
|
$2,393.41 |
$2,393.41 |
$2,393.41 |
$1,433.00
|
|
Injection jugular
|
$1,623.58 |
$1,623.58 |
$1,623.58 |
$790.00
|
|
Injection of sinus tract
|
$3,762.02 |
$3,762.02 |
$3,762.02 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$13.75 |
$13.75 |
$13.75 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$732.74 |
$732.74 |
$732.74 |
$685.44
|
|
Injection, renflexis
|
$88.84 |
$88.84 |
$88.84 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$852.20 |
$852.20 |
$852.20 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,276.42 |
$1,276.42 |
$1,276.42 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$852.20 |
$852.20 |
$852.20 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$583.90 |
$583.90 |
$583.90 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$608.93 |
$608.93 |
$608.93 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$852.20 |
$852.20 |
$852.20 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$852.20 |
$852.20 |
$852.20 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$418.44 |
$418.44 |
$418.44 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$418.44 |
$418.44 |
$418.44 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$418.44 |
$418.44 |
$418.44 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$168.98 |
$168.98 |
$168.98 |
$145.60
|
|
Injection treatment of nerve
|
$3,552.48 |
$3,552.48 |
$3,552.48 |
$4,446.30
|
|
Injection treatment of nerve
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$2,054.00
|
|
Injection treatment of nose
|
$1,152.40 |
$1,152.40 |
$1,152.40 |
$859.59
|
|
Inject sacroiliac joint
|
$1,467.95 |
$1,467.95 |
$1,467.95 |
$1,029.04
|
|
Inject/treat eye socket
|
$918.99 |
$918.99 |
$918.99 |
$381.13
|
|
Inject/treat eye socket
|
$918.99 |
$918.99 |
$918.99 |
$670.02
|
|
Inj epidural sgl cerv-thor without img
|
$1,276.42 |
$1,276.42 |
$1,276.42 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,129.76 |
$1,129.76 |
$1,129.76 |
$1,450.84
|
|
Inj, etelcalcetide, 0.1 mg
|
$8.03 |
$8.03 |
$8.03 |
$343.35
|
|
Inj, faricimab-svoa, 0.1mg
|
$82.63 |
$82.63 |
$82.63 |
$4,103.29
|
|
Inj fe-based mr contrast,1ml
|
$41.37 |
$41.37 |
$41.37 |
$56.56
|
|
Inj for ext venography
|
$895.63 |
$895.63 |
$895.63 |
$628.80
|
|
Inj for mammo ductogram
|
$236.57 |
$236.57 |
$236.57 |
$397.80
|
|
Inj, gadopiclenol, 1 ml
|
$7.27 |
$7.27 |
$7.27 |
$37.63
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,694.30 |
$1,694.30 |
$1,694.30 |
$1,492.00
|
|
Inj hydroxyprogst capoat nos
|
$5.85 |
$5.85 |
$5.85 |
$1,228.59
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,938.00
|
|
Inj intralesional <= 7 lsn(s)
|
$384.21 |
$384.21 |
$384.21 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$584.21 |
$584.21 |
$584.21 |
$234.00
|
|
Inj levocarnitine per 1 gm
|
$29.58 |
$29.58 |
$29.58 |
$136.62
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$2,129.44 |
$2,129.44 |
$2,129.44 |
$794.70
|
|
Inj, moxifloxacin 100 mg
|
$53.81 |
$53.81 |
$53.81 |
$101.31
|
|
Inj multihance
|
$3.46 |
$3.46 |
$3.46 |
$70.54
|
|
Inj naloxone hydrochloride
|
$20.70 |
$20.70 |
$20.70 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,966.48 |
$1,966.48 |
$1,966.48 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,313.36 |
$2,313.36 |
$2,313.36 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,313.36 |
$2,313.36 |
$2,313.36 |
$2,726.90
|
|
Inj octafluoropropane mic,ml
|
$98.86 |
$98.86 |
$98.86 |
$211.40
|
|
Inj, pegcetacoplan, 1mg
|
$317.74 |
$317.74 |
$317.74 |
$3,662.96
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$34.68 |
$34.68 |
$34.68 |
$6,614.40
|
|
Inj peritoneal venous shunt
|
$277.83 |
$277.83 |
$277.83 |
$406.80
|
|
Inj proc ankle arthr
|
$263.95 |
$263.95 |
$263.95 |
$405.31
|
|
Inj proc elbow arthro
|
$199.53 |
$199.53 |
$199.53 |
$432.00
|
|
Inj proc for lymphang
|
$341.08 |
$341.08 |
$341.08 |
$742.40
|
|
Inj proc myelogram lumbar
|
$504.22 |
$504.22 |
$504.22 |
$838.30
|
|
Inj proc sialogram
|
$195.07 |
$195.07 |
$195.07 |
$373.00
|
|
Inj prohance multipack
|
$2.78 |
$2.78 |
$2.78 |
$10.40
|
|
Inj retacrit esrd on dialysi
|
$1.92 |
$1.92 |
$1.92 |
$349.45
|
|
Inj retro urethrocysto
|
$229.88 |
$229.88 |
$229.88 |
$447.74
|
|
Inj, rimabotulinumtoxinb
|
$24.55 |
$24.55 |
$24.55 |
$714.24
|
|
Inj scleros sol mult veins
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$692.90
|
|
Inj scleros sol sgl vein
|
$1,107.30 |
$1,107.30 |
$1,107.30 |
$561.88
|
|
Inj secretin synthetic human
|
$63.17 |
$63.17 |
$63.17 |
$1,253.09
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$911.47 |
$911.47 |
$911.47 |
$436.80
|
|
Inj sulf hexa lipid microsph
|
$52.29 |
$52.29 |
$52.29 |
$256.14
|
|
Inj testosterone cypionate
|
$0.10 |
$0.10 |
$0.10 |
$64.96
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,712.95 |
$1,712.95 |
$1,712.95 |
$818.00
|
|
Inj triamcinolone ace X-ray 1mg
|
$38.12 |
$38.12 |
$38.12 |
$1,090.75
|
|
Inj, trivisc 1 mg
|
$13.33 |
$13.33 |
$13.33 |
$6.67
|
|
Inj w/fluor eval cv device
|
$503.92 |
$503.92 |
$503.92 |
$504.40
|
|
Inj., yutiq, 0.01 mg
|
$1,050.19 |
$1,050.19 |
$1,050.19 |
$14,458.60
|
|
Ins cath ren art 1st bi
|
$6,509.50 |
$6,509.50 |
$6,509.50 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$6,509.50 |
$6,509.50 |
$6,509.50 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$6,509.50 |
$6,509.50 |
$6,509.50 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$12,290.60 |
$12,290.60 |
$12,290.60 |
$5,395.20
|
