|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$1,099.05 |
$1,099.05 |
$1,099.05 |
$1,099.05
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$4,954.30 |
$4,954.30 |
$4,954.30 |
$1,997.99
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$65.65 |
$65.65 |
$65.65 |
$137.15
|
|
Infect ag drug suscept pheno predict
|
$493.35 |
$493.35 |
$493.35 |
$325.00
|
|
Infect ag eia influenza a or b ea
|
$171.60 |
$171.60 |
$171.60 |
$69.03
|
|
Infect ag genotype na cytomegalovirus
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$603.41
|
|
Infect ag genotype na dna hepatitis b
|
$926.25 |
$926.25 |
$926.25 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$863.20 |
$863.20 |
$863.20 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$973.05 |
$973.05 |
$973.05 |
$574.60
|
|
Infect ag ia optc obs influenza
|
$130.65 |
$130.65 |
$130.65 |
$66.72
|
|
Infect ag if hep delta agent
|
$302.25 |
$302.25 |
$302.25 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$115.70 |
$115.70 |
$115.70 |
$75.79
|
|
Infect ag if pneumocystis carinii
|
$250.90 |
$250.90 |
$250.90 |
$62.29
|
|
Infect ag na herpes simplex quant
|
$265.85 |
$265.85 |
$265.85 |
$145.20
|
|
Infect ag na hpv high-risk types
|
$112.45 |
$112.45 |
$112.45 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$265.85 |
$265.85 |
$265.85 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$187.20 |
$187.20 |
$187.20 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$611.00 |
$611.00 |
$611.00 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,845.35 |
$1,845.35 |
$1,845.35 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$98.15 |
$98.15 |
$98.15 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$124.80 |
$124.80 |
$124.80 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$132.60 |
$132.60 |
$132.60 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$134.55 |
$134.55 |
$134.55 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$110.50 |
$110.50 |
$110.50 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$20.15 |
$20.15 |
$20.15 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$87.75 |
$87.75 |
$87.75 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$58.50 |
$58.50 |
$58.50 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$262.60 |
$262.60 |
$262.60 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$68.25 |
$68.25 |
$68.25 |
$97.50
|
|
Infectious agent nucleic acid amplified probe
|
$513.50 |
$513.50 |
$513.50 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$59.15 |
$59.15 |
$59.15 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$1,120.60 |
$1,120.60 |
$1,120.60 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$988.00 |
$988.00 |
$988.00 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$85.15 |
$85.15 |
$85.15 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$407.55 |
$407.55 |
$407.55 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$352.95 |
$352.95 |
$352.95 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$59.15 |
$59.15 |
$59.15 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$168.35 |
$168.35 |
$168.35 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$278.85 |
$278.85 |
$278.85 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$230.75 |
$230.75 |
$230.75 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$124.80 |
$124.80 |
$124.80 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$97.50 |
$97.50 |
$97.50 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$300.95 |
$300.95 |
$300.95 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$860.60 |
$860.60 |
$860.60 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$148.20 |
$148.20 |
$148.20 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$860.60 |
$860.60 |
$860.60 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$614.90 |
$614.90 |
$614.90 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$165.75 |
$165.75 |
$165.75 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$819.65 |
$819.65 |
$819.65 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$725.40 |
$725.40 |
$725.40 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$348.40 |
$348.40 |
$348.40 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$1,452.46 |
$1,452.46 |
$1,452.46 |
$2,791.24
|
|
Infliximab-axxq 100 mg intravenous solution
|
$161.95 |
$161.95 |
$161.95 |
$1,144.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$182.53 |
$182.53 |
$182.53 |
$1,654.83
|
|
Influenza dna amp prob addl
|
$64.35 |
$64.35 |
$64.35 |
$69.60
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$1,413.10 |
$1,413.10 |
$1,413.10 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$528.45 |
$528.45 |
$528.45 |
$645.79
|
|
Inj andexxa, 10 mg
|
$6,794.00 |
$6,794.00 |
$6,794.00 |
$6,794.00
|
|
Inj anifrolumab-fnia 1mg
|
$17,666.71 |
$17,666.71 |
$17,666.71 |
$9,878.82
|
|
Inj., aristada initio, 1 mg
|
$2.44 |
$2.44 |
$2.44 |
$1,052.01
|
|
Inj, artesunate, 1mg
|
$148.83 |
$148.83 |
$148.83 |
$19,423.99
|
|
Inj., benralizumab, 1 mg
|
$538.18 |
$538.18 |
$538.18 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$10,299.15 |
$10,299.15 |
$10,299.15 |
$9,702.65
|
|
Inj, bupivacaine liposome
|
$638.07 |
$638.07 |
$638.07 |
$816.31
|
|
Inj, cefepime hcl (b braun)
|
$81.41 |
$81.41 |
$81.41 |
$81.41
|
|
Inj, cefiderocol, 10 mg
|
$7.03 |
$7.03 |
$7.03 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$546.94 |
$546.94 |
$546.94 |
$447.36
|
|
Inj cntr knee arthro incl ct/mri
|
$1,789.45 |
$1,789.45 |
$1,789.45 |
$464.28
|
|
Inj cyclophosphamd auromedic
|
$1.87 |
$1.87 |
$1.87 |
$1.16
|
|
Inj cyclophosphamd (ingenus)
|
$410.77 |
$410.77 |
$410.77 |
$1,040.94
|
|
Inj, daptomycin (hospira)
|
$0.27 |
$0.27 |
$0.27 |
$167.85
|
|
Inj disk cerv-thor ea lev
|
$3,405.35 |
$3,405.35 |
$3,405.35 |
$869.80
|
|
Inj dx for sinogram
|
$3,766.75 |
$3,766.75 |
$3,766.75 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$4,925.70 |
$4,925.70 |
$4,925.70 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$3,018.60 |
$3,018.60 |
$3,018.60 |
$507.10
|
|
Injection, cangrelor
|
$3,033.22 |
$3,033.22 |
$3,033.22 |
$2,546.20
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,807.00 |
$1,807.00 |
$1,807.00 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$192.40 |
$192.40 |
$192.40 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$2,117.70 |
$2,117.70 |
$2,117.70 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$3,841.50 |
$3,841.50 |
$3,841.50 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$1,575.60 |
$1,575.60 |
$1,575.60 |
$441.12
|
|
Injection for bladder x-ray
|
$2,481.70 |
$2,481.70 |
$2,481.70 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,851.20 |
$1,851.20 |
$1,851.20 |
$504.00
|
|
Injection for spleen x-ray
|
$804.70 |
$804.70 |
$804.70 |
$686.40
|
|
Injection for ureter x-ray
|
$2,714.40 |
$2,714.40 |
$2,714.40 |
$444.95
|
|
Injection for ureter x-ray
|
$2,510.95 |
$2,510.95 |
$2,510.95 |
$515.21
|
|
Injection, fulvestrant
|
$127.92 |
$127.92 |
$127.92 |
$2,756.47
|
|
Injection glatiramer acetate
|
$349.21 |
$349.21 |
$349.21 |
$405.93
|
|
Injection, inclisiran, 1 mg
|
$11,657.30 |
$11,657.30 |
$11,657.30 |
$10,366.61
|
|
Injection into brain canal
|
$139.75 |
$139.75 |
$139.75 |
$933.60
|
|
Injection, isavuconazonium
|
$3.30 |
$3.30 |
$3.30 |
$646.20
|
|
Injection jugular
|
$309.40 |
$309.40 |
$309.40 |
$1,048.20
|
|
Injection of sinus tract
|
$1,855.10 |
$1,855.10 |
$1,855.10 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,154.07 |
$2,154.07 |
$2,154.07 |
$2,154.07
|
|
Injection, peramivir
|
$5.26 |
$5.26 |
$5.26 |
$1,257.68
|
|
Injection radioactive tracer sentinel node (both sides)
|
$2,646.80 |
$2,646.80 |
$2,646.80 |
$717.20
|
|
Injection, renflexis
|
$99.34 |
$99.34 |
$99.34 |
$1,457.42
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$6,043.70 |
$6,043.70 |
$6,043.70 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,346.20 |
$3,346.20 |
$3,346.20 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,570.10 |
$2,570.10 |
$2,570.10 |
$1,017.28
|