|
Infliximab 100 mg intravenous solution
|
$3,721.02 |
$3,721.02 |
$3,721.02 |
$2,791.24
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,869.27 |
$1,869.27 |
$1,869.27 |
$1,654.83
|
|
Influenza dna amp prob addl
|
$41.60 |
$41.60 |
$41.60 |
$69.60
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$942.50 |
$942.50 |
$942.50 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$210.60 |
$210.60 |
$210.60 |
$645.79
|
|
Inj anifrolumab-fnia 1mg
|
$17,666.71 |
$17,666.71 |
$17,666.71 |
$9,878.82
|
|
Inj., benralizumab, 1 mg
|
$18,984.78 |
$18,984.78 |
$18,984.78 |
$16,865.48
|
|
Inj, cefepime hcl (b braun)
|
$81.41 |
$81.41 |
$81.41 |
$81.41
|
|
Inj ceftolozane tazobactam
|
$546.94 |
$546.94 |
$546.94 |
$447.36
|
|
Inj cntr knee arthro incl ct/mri
|
$2,388.10 |
$2,388.10 |
$2,388.10 |
$464.28
|
|
Inj cyclophosphamd auromedic
|
$1.73 |
$1.73 |
$1.73 |
$1.16
|
|
Inj cyclophosphamd (ingenus)
|
$614.70 |
$614.70 |
$614.70 |
$1,040.94
|
|
Inj disk cerv-thor ea lev
|
$1,932.45 |
$1,932.45 |
$1,932.45 |
$869.80
|
|
Inj dx for sinogram
|
$2,514.20 |
$2,514.20 |
$2,514.20 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$4,573.40 |
$4,573.40 |
$4,573.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$2,126.80 |
$2,126.80 |
$2,126.80 |
$507.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,030.90 |
$1,030.90 |
$1,030.90 |
$536.00
|
|
Injection during cath supravalvular aortography
|
$1,342.90 |
$1,342.90 |
$1,342.90 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$2,562.95 |
$2,562.95 |
$2,562.95 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$893.10 |
$893.10 |
$893.10 |
$441.12
|
|
Injection for bladder x-ray
|
$1,056.25 |
$1,056.25 |
$1,056.25 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,387.10 |
$1,387.10 |
$1,387.10 |
$504.00
|
|
Injection for spleen x-ray
|
$128.70 |
$128.70 |
$128.70 |
$686.40
|
|
Injection for ureter x-ray
|
$1,540.50 |
$1,540.50 |
$1,540.50 |
$444.95
|
|
Injection for ureter x-ray
|
$1,424.80 |
$1,424.80 |
$1,424.80 |
$515.21
|
|
Injection, fulvestrant
|
$14.18 |
$14.18 |
$14.18 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$11,657.30 |
$11,657.30 |
$11,657.30 |
$10,366.61
|
|
Injection into brain canal
|
$96.20 |
$96.20 |
$96.20 |
$933.60
|
|
Injection jugular
|
$196.95 |
$196.95 |
$196.95 |
$1,048.20
|
|
Injection of sinus tract
|
$1,240.20 |
$1,240.20 |
$1,240.20 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,154.07 |
$2,154.07 |
$2,154.07 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,502.80 |
$1,502.80 |
$1,502.80 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$4,846.40 |
$4,846.40 |
$4,846.40 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,047.20 |
$3,047.20 |
$3,047.20 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$972.40 |
$972.40 |
$972.40 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,809.30 |
$2,809.30 |
$2,809.30 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,387.10 |
$1,387.10 |
$1,387.10 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$5,632.90 |
$5,632.90 |
$5,632.90 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,317.55 |
$1,317.55 |
$1,317.55 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$5,647.20 |
$5,647.20 |
$5,647.20 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$4,390.10 |
$4,390.10 |
$4,390.10 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$3,945.50 |
$3,945.50 |
$3,945.50 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$3,372.20 |
$3,372.20 |
$3,372.20 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,238.90 |
$1,238.90 |
$1,238.90 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,412.45 |
$1,412.45 |
$1,412.45 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$200.85 |
$200.85 |
$200.85 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$152.10 |
$152.10 |
$152.10 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$221.00 |
$221.00 |
$221.00 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$141.70 |
$141.70 |
$141.70 |
$141.60
|
|
Injection treatment of nerve
|
$5,313.10 |
$5,313.10 |
$5,313.10 |
$3,016.15
|
|
Injection treatment of nerve
|
$3,421.60 |
$3,421.60 |
$3,421.60 |
$2,037.10
|
|
Inj epidural sgl cerv-thor without img
|
$2,886.65 |
$2,886.65 |
$2,886.65 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$2,816.45 |
$2,816.45 |
$2,816.45 |
$1,450.84
|
|
Inj for ext venography
|
$2,412.80 |
$2,412.80 |
$2,412.80 |
$737.55
|
|
Inj for mammo ductogram
|
$2,605.20 |
$2,605.20 |
$2,605.20 |
$433.50
|
|
Inj glofitamab gxbm, 2.5 mg
|
$29,284.42 |
$29,284.42 |
$29,284.42 |
$2,770.57
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,469.00 |
$1,469.00 |
$1,469.00 |
$1,482.00
|
|
Inj hrt cath w/s&i sel right vent
|
$500.50 |
$500.50 |
$500.50 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$3,180.35 |
$3,180.35 |
$3,180.35 |
$3,180.35
|
|
Inj intralesional <= 7 lsn(s)
|
$340.60 |
$340.60 |
$340.60 |
$241.74
|
|
Inj, invega hafyera/trinza
|
$22,194.48 |
$22,194.48 |
$22,194.48 |
$12.66
|
|
Inj levocarnitine per 1 gm
|
$89.24 |
$89.24 |
$89.24 |
$138.96
|
|
Inj., meropenem, vaborbactam
|
$740.32 |
$740.32 |
$740.32 |
$618.43
|
|
Inj meropenem (wg crit care)
|
$104.29 |
$104.29 |
$104.29 |
$104.29
|
|
Inj multihance
|
$20.28 |
$20.28 |
$20.28 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$5,504.20 |
$5,504.20 |
$5,504.20 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,296.75 |
$1,296.75 |
$1,296.75 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,296.75 |
$1,296.75 |
$1,296.75 |
$2,164.64
|
|
Inj ontruzant 10 mg
|
$4,554.03 |
$4,554.03 |
$4,554.03 |
$34.17
|
|
Inj pantoprazole(hikma) 40mg
|
$31.03 |
$31.03 |
$31.03 |
$36.04
|
|
Inj peritoneal venous shunt
|
$1,770.60 |
$1,770.60 |
$1,770.60 |
$386.88
|
|
Inj proc ankle arthr
|
$889.20 |
$889.20 |
$889.20 |
$405.31
|
|
Inj proc elbow arthro
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$453.60
|
|
Inj proc for lymphang
|
$1,502.80 |
$1,502.80 |
$1,502.80 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$1,932.45 |
$1,932.45 |
$1,932.45 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$596.70 |
$596.70 |
$596.70 |
$922.80
|
|
Inj proc sialogram
|
$1,424.80 |
$1,424.80 |
$1,424.80 |
$380.80
|
|
Inj retacrit esrd on dialysi
|
$3.22 |
$3.22 |
$3.22 |
$307.40
|
|
Inj retro urethrocysto
|
$1,261.00 |
$1,261.00 |
$1,261.00 |
$551.29
|
|
Inj scleros sol mult veins
|
$741.00 |
$741.00 |
$741.00 |
$687.96
|
|
Inj scleros sol sgl vein
|
$741.00 |
$741.00 |
$741.00 |
$534.40
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$370.50 |
$370.50 |
$370.50 |
$436.64
|
|
Inj. teprotumumab-trbw 10 mg
|
$48,637.22 |
$48,637.22 |
$48,637.22 |
$47,971.67
|
|
Inj testosterone cypionate
|
$39.32 |
$39.32 |
$39.32 |
$77.15
|
|
Inj, tyenne, 1 mg
|
$5,110.56 |
$5,110.56 |
$5,110.56 |
$860.68
|
|
Inj, vancomycin hcl (mylan)
|
$27.85 |
$27.85 |
$27.85 |
$63.82
|
|
Inj w/fluor eval cv device
|
$2,124.20 |
$2,124.20 |
$2,124.20 |
$588.90
|
|
Ins cath ren art 1st bi
|
$7,993.05 |
$7,993.05 |
$7,993.05 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$6,765.20 |
$6,765.20 |
$6,765.20 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$5,565.95 |
$5,565.95 |
$5,565.95 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$4,024.15 |
$4,024.15 |
$4,024.15 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$780.65 |
$780.65 |
$780.65 |
$544.00
|
|
Insert abdomen-venous drain
|
$2,385.50 |
$2,385.50 |
$2,385.50 |
$4,391.00
|
|
Insert cath pleura with image
|
$8,855.60 |
$8,855.60 |
$8,855.60 |
$2,239.02
|
|
Insert cath pleura without image
|
$7,398.30 |
$7,398.30 |
$7,398.30 |
$2,212.00
|
|
Insert drug delivery implant
|
$1,015.30 |
$1,015.30 |
$1,015.30 |
$285.80
|
|
Insert hepatic shunt (tips)
|
$16,433.95 |
$16,433.95 |
$16,433.95 |
$9,754.48
|
|
Insert intrauterine device iud
|
$1,528.15 |
$1,528.15 |
$1,528.15 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$341.90 |
$341.90 |
$341.90 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$360.75 |
$360.75 |
$360.75 |
$273.60
|