|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$158.50 |
$200.13 |
$1,619.00 |
|
|
Initial care training 30 m
|
$163.30 |
$163.30 |
$163.30 |
|
|
Initial foot exam pt lops
|
$155.50 |
$155.50 |
$155.50 |
|
|
Init pm e/m new pat 65+ yrs
|
$196.88 |
$196.88 |
$196.88 |
|
|
Inj, abilify maintena, 1 mg
|
$5,168.00 |
$5,168.00 |
$5,168.00 |
|
|
Inj, acetaminophen (b braun)
|
$16.80 |
$16.80 |
$43.15 |
|
|
Inj acetaminophen -fresenius
|
$12.00 |
$12.00 |
$33.75 |
|
|
Inj, acetaminophen (hikma)
|
$12.60 |
$12.60 |
$52.13 |
|
|
Inj. acthar gel to 40 units
|
$79,282.00 |
$79,282.00 |
$79,282.00 |
|
|
Inj, adalimumab, 1 mg
|
$13,429.90 |
$13,429.90 |
$13,429.90 |
|
|
Inj, adstiladrin, per tx dos
|
$120,025.00 |
$120,025.00 |
$120,025.00 |
|
|
Inj, aflibercept hd, 1 mg
|
$5,367.50 |
$5,367.50 |
$5,367.50 |
|
|
Inj, afstyla, 1 i.u
|
$22.50 |
$22.50 |
$22.50 |
|
|
Inj, alfentanil hcl, 500mcg
|
$19.53 |
$19.53 |
$19.53 |
|
|
Inj alymsys 10 mg
|
$3,984.20 |
$3,984.20 |
$3,984.20 |
|
|
Inj, amisulpride, 1 mg
|
$216.10 |
$216.10 |
$216.10 |
|
|
Inj andexxa, 10 mg
|
$4,387.50 |
$4,387.50 |
$4,387.50 |
|
|
Inj anifrolumab-fnia 1mg
|
$10,680.43 |
$10,680.43 |
$10,680.43 |
|
|
Inj., aristada initio, 1 mg
|
$4,052.45 |
$4,052.45 |
$4,052.45 |
|
|
Inj, artesunate, 1mg
|
$21,514.00 |
$21,514.00 |
$21,514.00 |
|
|
Inj, aspara, rylaze, 0.1 mg
|
$10,491.68 |
$10,491.68 |
$10,491.68 |
|
|
Inj atezolizumb 5mg hya-tqjs
|
$22,503.65 |
$22,503.65 |
$22,503.65 |
|
|
Inj aval alfa-nqpt 4mg
|
$3,907.30 |
$3,907.30 |
$3,907.30 |
|
|
Inj., benralizumab, 1 mg
|
$10,349.30 |
$10,349.30 |
$23,676.27 |
|
|
Inj, bezlotoxumab, 10 mg
|
$3,238.60 |
$7,612.43 |
$7,612.43 |
|
|
Inj, bortezomib, dr. reddy's
|
$3,230.98 |
$3,230.98 |
$3,230.98 |
|
|
Inj bulking agent anal canal
|
$851.29 |
$851.29 |
$851.29 |
|
|
Inj, bupivacaine liposome
|
$894.40 |
$894.40 |
$894.40 |
|
|
Inj calcitriol per 0.1 mcg
|
$19.83 |
$19.83 |
$19.83 |
|
|
Inj cefazolin sodium, baxter
|
$47.30 |
$47.30 |
$47.30 |
|
|
Inj cefazolin sodium, hikma
|
$27.08 |
$27.08 |
$45.15 |
|
|
Inj cefazolin (wg crit care)
|
$25.00 |
$25.00 |
$25.00 |
|
|
Inj, cefepime hcl (b braun)
|
$94.70 |
$94.70 |
$94.70 |
|
|
Inj, cefiderocol, 10 mg
|
$550.68 |
$550.68 |
$550.68 |
|
|
Inj ceftolozane tazobactam
|
$415.50 |
$415.50 |
$415.50 |
|
|
Inj, cimerli, 0.1 mg
|
$2,665.60 |
$2,665.60 |
$2,665.60 |
|
|
Inj, clindamycin (baxter)
|
$27.80 |
$27.80 |
$59.34 |
|
|
Inj cntr knee arthro incl ct/mri
|
$67.50 |
$511.08 |
$1,840.00 |
|
|
Inj., copanlisib, 1 mg
|
$10,124.20 |
$10,124.20 |
$10,124.20 |
|
|
Inj cyclophos dr.reddy's 5mg
|
$7,025.00 |
$7,025.00 |
$7,025.00 |
|
|
Inj cyclophosphamd auromedic
|
$249.68 |
$249.68 |
$249.68 |
|
|
Inj cyclophosphamd (ingenus)
|
$493.23 |
$493.23 |
$493.23 |
|
|
Inj, daptomycin (hospira)
|
$209.50 |
$209.50 |
$209.50 |
|
|
Inj daptomycin (xellia)
|
$43.55 |
$43.55 |
$43.55 |
|
|
Inj, decitabine (sun pharma)
|
$225.00 |
$225.00 |
$225.00 |
|
|
Inj delandistrogene mox rokl
|
$8,000,000.00 |
$8,000,000.00 |
$8,000,000.00 |
|
|
Inj disk cerv-thor ea lev
|
$1,768.00 |
$1,768.00 |
$1,768.00 |
|
|
Inj dupuytren cord w/enzyme
|
$530.00 |
$530.00 |
$530.00 |
|
|
Inj, durolane 1 mg
|
$1,534.16 |
$1,866.50 |
$2,512.11 |
|
|
Inj dx for sinogram
|
$72.50 |
$364.75 |
$364.75 |
|
|
Inject for sacroiliac joint
|
$346.00 |
$346.00 |
$346.00 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$877.00 |
$1,214.78 |
$3,613.00 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$137.00 |
$591.20 |
$1,488.00 |
|
|
Injection, belinostat, 10mg
|
$4,985.88 |
$4,985.88 |
$4,985.88 |
|
|
Injection, burosumab-twza 1m
|
$18,749.35 |
$18,749.35 |
$18,749.35 |
|
|
Injection, cangrelor
|
$1,847.53 |
$1,847.53 |
$1,847.53 |
|
|
Injection, caplacizumab-yhdp
|
$17,155.88 |
$17,155.88 |
$17,155.88 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$263.00 |
$389.58 |
$2,346.00 |
|
|
Injection, daratumumab 10 mg
|
$6,198.98 |
$6,198.98 |
$15,464.33 |
|
|
Injection, delafloxacin
|
$176.50 |
$176.50 |
$176.50 |
|
|
Injection, doxercalciferol
|
$31.83 |
$31.83 |
$31.83 |
|
|
Injection during cath supravalvular aortography
|
$475.50 |
$2,520.70 |
$2,520.70 |
|
|
Injection epidural blood patch or clot
|
$744.00 |
$1,149.13 |
$1,963.00 |
|
|
Injection eye drug
|
$540.00 |
$1,326.58 |
$1,326.58 |
|
|
Injection for arthrography wrist (both sides)
|
$111.50 |
$1,103.25 |
$1,103.25 |
|
|
Injection for bladder x-ray
|
$107.00 |
$436.33 |
$1,144.50 |
|
|
Injection for hip x-ray
|
$208.00 |
$208.00 |
$208.00 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$137.00 |
$504.55 |
$723.24 |
|
|
Injection for spleen x-ray
|
$2,359.50 |
$2,359.50 |
$2,359.50 |
|
|
Injection for tear sac x-ray
|
$212.55 |
$212.55 |
$977.00 |
|
|
Injection for ureter x-ray
|
$1,789.50 |
$1,789.50 |
$1,789.50 |
|
|
Injection for ureter x-ray
|
$682.38 |
$682.38 |
$682.38 |
|
|
Injection, fulvestrant
|
$1,817.65 |
$1,817.65 |
$10,451.77 |
|
|
Injection glatiramer acetate
|
$548.08 |
$548.08 |
$548.08 |
|
|
Injection, glucarpidase
|
$82,360.50 |
$82,360.50 |
$82,360.50 |
|
|
Injection, inclisiran, 1 mg
|
$6,830.50 |
$6,830.50 |
$16,749.72 |
|
|
Injection into hemorrhoid(s)
|
$1,083.50 |
$1,286.90 |
$1,286.90 |
|
|
Injection, isavuconazonium
|
$832.85 |
$832.85 |
$832.85 |
|
|
Injection jugular
|
$648.75 |
$648.75 |
$648.75 |
|
|
Injection of sinus tract
|
$912.50 |
$912.50 |
$912.50 |
|
|
Injection,onabotulinumtoxina
|
$2,596.50 |
$2,596.50 |
$2,596.50 |
|
|
Injection, peramivir
|
$804.15 |
$804.15 |
$804.15 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$348.70 |
$348.70 |
$1,539.00 |
|
|
Injection, renflexis
|
$1,371.78 |
$1,371.78 |
$1,371.78 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$916.80 |
$916.80 |
$1,033.50 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$332.00 |
$1,391.40 |
$3,981.00 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$632.78 |
$632.78 |
$1,407.00 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,586.50 |
$2,207.48 |
$3,406.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,154.00 |
$1,611.33 |
$2,515.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,488.00 |
$2,546.65 |
$6,417.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,119.88 |
$1,119.88 |
$1,972.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,326.00 |
$2,226.90 |
$3,996.00 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,465.00 |
$2,788.70 |
$4,568.45 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,065.00 |
$2,207.98 |
$5,615.00 |
|
|
Injection, siltuximab
|
$12,360.70 |
$12,360.70 |
$12,360.70 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$319.50 |
$445.18 |
$4,798.08 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$359.00 |
$794.45 |
$794.45 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$425.50 |
$794.45 |
$1,239.00 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$24.88 |
$24.88 |
$757.58 |
|
|
Injection treatment of eye
|
$1,215.50 |
$1,215.50 |
$1,215.50 |
|
