|
Incision of foot fascia
|
$4,003.20 |
$4,003.20 |
$4,003.20 |
|
|
Incision of spinal nerve 64772
|
$3,185.60 |
$3,185.60 |
$3,185.60 |
|
|
Incision of tendon sheath
|
$2,176.80 |
$2,176.80 |
$3,239.20 |
|
|
Incision of tongue fold
|
$1,796.00 |
$1,796.00 |
$1,945.60 |
|
|
Incision of urethra
|
$3,384.00 |
$3,384.00 |
$3,981.60 |
|
|
Incision tendon sheath
|
$2,803.20 |
$2,803.20 |
$2,868.80 |
|
|
Incobotulinumtoxin a
|
$866.00 |
$866.00 |
$866.00 |
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$1,292.89 |
$1,292.89 |
$1,292.89 |
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$1,623.20 |
$1,623.20 |
$1,623.20 |
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$131.20 |
$131.20 |
$131.20 |
|
|
Infect ag ia optc obs influenza
|
$69.60 |
$69.60 |
$69.60 |
|
|
Infect ag na hpv high-risk types
|
$131.20 |
$131.20 |
$131.20 |
|
|
Infect ag na influenza r/amp 1st 2 types
|
$248.80 |
$248.80 |
$248.80 |
|
|
Infect ag na orthopoxvirus amp prb each
|
$144.00 |
$144.00 |
$144.00 |
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$80.80 |
$80.80 |
$80.80 |
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$72.00 |
$72.00 |
$72.00 |
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$72.00 |
$72.00 |
$72.00 |
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$164.80 |
$164.80 |
$164.80 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$60.80 |
$60.80 |
$60.80 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$67.20 |
$67.20 |
$67.20 |
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$116.80 |
$116.80 |
$116.80 |
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$169.60 |
$169.60 |
$169.60 |
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$59.20 |
$59.20 |
$59.20 |
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$63.20 |
$63.20 |
$63.20 |
|
|
Infectious agent nucleic acid amplified probe
|
$203.20 |
$203.20 |
$203.20 |
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$171.20 |
$171.20 |
$171.20 |
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$192.00 |
$192.00 |
$192.00 |
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$179.20 |
$179.20 |
$179.20 |
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$170.40 |
$170.40 |
$170.40 |
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$208.00 |
$208.00 |
$208.00 |
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$171.20 |
$171.20 |
$171.20 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$124.80 |
$124.80 |
$124.80 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$349.60 |
$349.60 |
$349.60 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$460.80 |
$460.80 |
$460.80 |
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$105.60 |
$105.60 |
$105.60 |
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$153.60 |
$153.60 |
$153.60 |
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$342.40 |
$342.40 |
$342.40 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,227.20 |
$1,227.20 |
$1,227.20 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$312.80 |
$312.80 |
$312.80 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$745.60 |
$745.60 |
$745.60 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$179.20 |
$179.20 |
$179.20 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$100.00 |
$100.00 |
$100.00 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$129.60 |
$129.60 |
$129.60 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$415.20 |
$415.20 |
$415.20 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$348.00 |
$348.00 |
$348.00 |
|
|
Infliximab 100 mg intravenous solution
|
$1,448.98 |
$1,456.41 |
$1,892.43 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$839.53 |
$839.53 |
$839.53 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$586.51 |
$1,114.15 |
$1,422.10 |
|
|
Inf thrc fascial pln blk bi w/wo image
|
$1,483.20 |
$1,483.20 |
$1,648.00 |
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,153.60 |
$1,153.60 |
$1,483.20 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$479.20 |
$479.20 |
$545.60 |
|
|
Inj, abilify asimtufii, 1 mg
|
$7,787.87 |
$7,787.87 |
$7,787.87 |
|
|
Inj, abilify maintena, 1 mg
|
$6,739.33 |
$6,739.33 |
$6,739.33 |
|
|
Inj, acetaminophen (b braun)
|
$39.33 |
$39.33 |
$68.56 |
|
|
Inj acetaminophen -fresenius
|
$19.15 |
$68.48 |
$90.88 |
|
|
Inj, acetaminophen (hikma)
|
$89.68 |
$89.68 |
$89.68 |
|
|
Inj, adalimumab, 1 mg
|
$9,356.95 |
$9,356.95 |
$9,356.95 |
|
|
Inj, adstiladrin, per tx dos
|
$16,000.00 |
$16,000.00 |
$16,000.00 |
|
|
Inj, alfentanil hcl, 500mcg
|
$25.95 |
$25.95 |
$25.95 |
|
|
Inj allopurinol sodium 1 mg
|
$4,499.41 |
$4,499.41 |
$4,499.41 |
|
|
Inj alymsys 10 mg
|
$491.24 |
$491.24 |
$2,964.29 |
|
|
Inj anifrolumab-fnia 1mg
|
$6,304.63 |
$6,304.63 |
$6,304.63 |
|
|
Inj, artesunate, 1mg
|
$5,957.07 |
$5,957.07 |
$8,735.11 |
|
|
Inj, aspara, rylaze, 0.1 mg
|
$5,806.34 |
$5,806.34 |
$8,265.12 |
|
|
Inj., benralizumab, 1 mg
|
$4,780.59 |
$5,752.12 |
$14,066.28 |
|
|
Inj, bezlotoxumab, 10 mg
|
$10,759.89 |
$10,759.89 |
$10,759.89 |
|
|
Inj, biorphen, 20 micrograms
|
$26.89 |
$26.89 |
$32.82 |
|
|
Inj, bortezomib, hospira
|
$195.60 |
$195.60 |
$195.60 |
|
|
Inj calcitriol per 0.1 mcg
|
$16.80 |
$16.80 |
$26.81 |
|
|
Inj cefazolin sodium, hikma
|
$26.94 |
$26.94 |
$29.82 |
|
|
Inj cefazolin (wg crit care)
|
$26.89 |
$26.89 |
$26.89 |
|
|
Inj, cefepime hcl (b braun)
|
$88.45 |
$116.89 |
$116.89 |
|
|
Inj, cefiderocol, 10 mg
|
$232.23 |
$232.23 |
$232.23 |
|
|
Inj ceftolozane tazobactam
|
$165.60 |
$165.60 |
$302.76 |
|
|
Inj, clevidipine butyrate
|
$120.68 |
$120.68 |
$191.40 |
|
|
Inj, clindamycin (baxter)
|
$50.44 |
$50.44 |
$90.72 |
|
|
Inj cntr knee arthro incl ct/mri
|
$524.80 |
$524.80 |
$869.60 |
|
|
Inj., copanlisib, 1 mg
|
$5,506.39 |
$5,506.39 |
$5,506.39 |
|
|
Inj crotalidae im f(ab')2 eq
|
$1,933.04 |
$1,933.04 |
$1,933.04 |
|
|
Inj, daptomycin (hospira)
|
$60.72 |
$60.72 |
$99.88 |
|
|
Inj daptomycin (xellia)
|
$35.44 |
$42.64 |
$71.92 |
|
|
Inj, decitabine (sun pharma)
|
$359.05 |
$359.05 |
$1,008.70 |
|
|
Inj disk cerv-thor ea lev
|
$831.20 |
$831.20 |
$831.20 |
|
|
Inj dx for sinogram
|
$511.20 |
$511.20 |
$549.60 |
|
|
Inject for sacroiliac joint
|
$581.60 |
$581.60 |
$581.60 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,392.80 |
$2,392.80 |
$2,648.80 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$660.00 |
$660.00 |
$794.40 |
|
|
Injection, belinostat, 10mg
|
$2,791.55 |
$2,791.55 |
$2,791.55 |
|
|
Injection, burosumab-twza 1m
|
$30,192.00 |
$30,192.00 |
$30,192.00 |
|
|
Injection, cangrelor
|
$1,280.55 |
$1,280.55 |
$1,280.55 |
|
|
Injection, caplacizumab-yhdp
|
$13,188.18 |
$13,188.18 |
$13,188.18 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$441.60 |
$441.60 |
$505.60 |
|
|
Injection, daratumumab 10 mg
|
$3,129.56 |
$3,129.56 |
$3,262.96 |
|
|
Injection, doxercalciferol
|
$30.00 |
$30.00 |
$40.68 |
|
|
Injection during cath supravalvular aortography
|
$1,492.80 |
$1,492.80 |
$2,606.40 |
|
|
Injection, edaravone, 1 mg
|
$3,817.92 |
$3,817.92 |
$3,817.92 |
|
|
Injection epidural blood patch or clot
|
$1,760.00 |
$1,760.00 |
$1,787.20 |
|
|
Injection eye drug
|
$592.80 |
$592.80 |
$592.80 |
|
|
Injection for arthrography wrist (both sides)
|
$508.00 |
$508.00 |
$587.20 |
|
|
Injection for bladder x-ray
|
$690.40 |
$690.40 |
$692.00 |
|