|
Inj levocarnitine per 1 gm
|
$18.19 |
$18.19 |
$18.19 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$103.76 |
$103.76 |
$103.76 |
$308.21
|
|
Inj, lidocaine w epinephrine
|
$3.04 |
$3.04 |
$3.04 |
$45.60
|
|
Inj, lovotibeglogene autotem
|
$9,672,000.00 |
$9,672,000.00 |
$9,672,000.00 |
$4,488,461.15
|
|
Inj melpha hydroch nos 50 mg
|
$3,583.63 |
$3,583.63 |
$3,583.63 |
$1,713.99
|
|
Inj melphalan (hepzato) 1 mg
|
$117,998.40 |
$117,998.40 |
$117,998.40 |
$787.79
|
|
Inj mepivacaine hcl/10 ml
|
$1.44 |
$1.44 |
$1.44 |
$34.34
|
|
Inj, meropenem (b. braun)
|
$69.99 |
$69.99 |
$69.99 |
$71.14
|
|
Inj., meropenem, vaborbactam
|
$536.27 |
$536.27 |
$536.27 |
$556.87
|
|
Inj meropenem (wg crit care)
|
$76.99 |
$76.99 |
$76.99 |
$82.42
|
|
Inj, micafungin (par pharm)
|
$350.06 |
$350.06 |
$350.06 |
$79.08
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$1,496.55 |
$1,496.55 |
$1,496.55 |
$1,496.55
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$2,984.20 |
$2,984.20 |
$2,984.20 |
$8,304.04
|
|
Inj, motixafortide, 0.25 mg
|
$13,806.00 |
$13,806.00 |
$13,806.00 |
$25.22
|
|
Inj, moxifloxacin 100 mg
|
$0.43 |
$0.43 |
$0.43 |
$101.31
|
|
Inj moxifloxacin (fres kabi)
|
$0.43 |
$0.43 |
$0.43 |
$95.62
|
|
Inj multihance
|
$14.30 |
$14.30 |
$14.30 |
$70.54
|
|
Inj. mycophenolate mofetil
|
$252.66 |
$252.66 |
$252.66 |
$252.66
|
|
Inj. naxitamab-gqgk, 1 mg
|
$8,132.57 |
$8,132.57 |
$8,132.57 |
$42,064.28
|
|
Inj, nithiodote, 3mg / 125mg
|
$7.64 |
$7.64 |
$7.64 |
$468.10
|
|
Inj, nogapendekin pmln, 1mcg
|
$209,430.00 |
$209,430.00 |
$209,430.00 |
$94.12
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$4,199.99 |
$4,199.99 |
$4,199.99 |
$66,582.27
|
|
Inj octafluoropropane mic,ml
|
$100.39 |
$100.39 |
$100.39 |
$211.40
|
|
Inj ogivri 10 mg
|
$8,190.16 |
$8,190.16 |
$8,190.16 |
$4,492.28
|
|
Inj olipudase alfa-rpcp 1mg
|
$18,260.23 |
$18,260.23 |
$18,260.23 |
$13,239.99
|
|
Inj., omadacycline, 1 mg
|
$1,151.01 |
$1,151.01 |
$1,151.01 |
$865.34
|
|
Inj onase abepar-xioi treat
|
$4,972,500.00 |
$4,972,500.00 |
$4,972,500.00 |
$3,572,794.09
|
|
Inj ontruzant 10 mg
|
$11,572.21 |
$11,572.21 |
$11,572.21 |
$6,706.27
|
|
Inj, pafolacianine, 0.1 mg
|
$6,215.63 |
$6,215.63 |
$6,215.63 |
$6,897.80
|
|
Inj pantoprazole(hikma) 40mg
|
$11.88 |
$11.88 |
$11.88 |
$34.67
|
|
Inj, pasireotide long acting
|
$50,915.83 |
$50,915.83 |
$50,915.83 |
$33,745.84
|
|
Inj., patisiran, 0.1 mg
|
$4,579.38 |
$4,579.38 |
$4,579.38 |
$17,613.00
|
|
Inj, pegcetacoplan, 1mg
|
$54,905.53 |
$54,905.53 |
$54,905.53 |
$3,662.96
|
|
Inj pemetrexed (accord) 10mg
|
$12,614.16 |
$12,614.16 |
$12,614.16 |
$579.77
|
|
Inj pemetrexed, hospira 10mg
|
$64.35 |
$64.35 |
$64.35 |
$64.35
|
|
Inj, pemivibart, 4500 mg
|
$412.76 |
$412.76 |
$412.76 |
$1,235.55
|
|
Inj., perseris, 0.5 mg
|
$6,783.29 |
$6,783.29 |
$6,783.29 |
$5,146.85
|
|
Inj progesterone per 50 mg
|
$7.57 |
$7.57 |
$7.57 |
$13.76
|
|
Inj prohance multipack
|
$21.45 |
$21.45 |
$21.45 |
$10.40
|
|
Inj recombin esperoct per iu
|
$6.63 |
$6.63 |
$6.63 |
$6.63
|
|
Inj, rimabotulinumtoxinb
|
$1,486.10 |
$1,486.10 |
$1,486.10 |
$714.24
|
|
Inj romidepsin non-lyo 0.1mg
|
$4,740.40 |
$4,740.40 |
$4,740.40 |
$9,892.69
|
|
Inj secretin synthetic human
|
$1,546.74 |
$1,546.74 |
$1,546.74 |
$1,253.09
|
|
Inj secukinumab intrav 1mg
|
$1,029.91 |
$1,029.91 |
$1,029.91 |
$4,413.21
|
|
Inj sulf hexa lipid microsph
|
$339.30 |
$339.30 |
$339.30 |
$256.14
|
|
Inj, susvimo 0.1 mg
|
$187,200.00 |
$187,200.00 |
$187,200.00 |
$2,598.44
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$105,320.75 |
$105,320.75 |
$105,320.75 |
$67,538.30
|
|
Inj, taliglucerace alfa 10 u
|
$2,208.47 |
$2,208.47 |
$2,208.47 |
$1,573.27
|
|
Inj teclistamab cqyv 0.5 mg
|
$19,174.32 |
$19,174.32 |
$19,174.32 |
$17,517.56
|
|
Inj tedizolid phosphate
|
$866.93 |
$866.93 |
$866.93 |
$664.72
|
|
Inj. teprotumumab-trbw 10 mg
|
$42,164.34 |
$42,164.34 |
$42,164.34 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$33.13 |
$33.13 |
$33.13 |
$123.09
|
|
Inj testosterone cypionate
|
$55.67 |
$55.67 |
$55.67 |
$64.96
|
|
Inj thiotepa nos 1 mg
|
$5,616.00 |
$5,616.00 |
$5,616.00 |
$3,170.16
|
|
Inj. tigecycline (accord)
|
$365.04 |
$365.04 |
$365.04 |
$188.03
|
|
Inj., tildrakizumab, 1 mg
|
$42,029.77 |
$42,029.77 |
$42,029.77 |
$26,635.60
|
|
Inj tofersen intrathec 1 mg
|
$2,355.07 |
$2,355.07 |
$2,355.07 |
$293.34
|
|
Inj, tofidence, 1 mg
|
$346.32 |
$346.32 |
$346.32 |
$86.87
|
|
Inj, tyenne, 1 mg
|
$2,647.24 |
$2,647.24 |
$2,647.24 |
$3,525.12
|
|
Inj ustekinumab-aekn, 1 mg
|
$126.01 |
$126.01 |
$126.01 |
$47.80
|
|
Inj ustekinumab-kfce, 1 mg
|
$7,019.96 |
$7,019.96 |
$7,019.96 |
$5,244.37
|
|
Inj ustekinumab-stba, 1 mg
|
$27.34 |
$27.34 |
$27.34 |
$16.36
|
|
Inj, uzedy, 1 mg
|
$21,951.72 |
$21,951.72 |
$21,951.72 |
$11,475.96
|
|
Inj, vancomycin hcl (mylan)
|
$211.20 |
$211.20 |
$211.20 |
$72.33
|
|
Inj, vancomycin hcl (xellia)
|
$497.25 |
$497.25 |
$497.25 |
$85.20
|
|
Inj, vegzelma, 10 mg
|
$528.37 |
$528.37 |
$528.37 |
$1,186.35
|
|
Inj velmanase alfa-tycv 1 mg
|
$10,578.36 |
$10,578.36 |
$10,578.36 |
$7,123.31
|
|
Inj xipere 1 mg
|
$4,290.00 |
$4,290.00 |
$4,290.00 |
$93.00
|
|
Inj., yutiq, 0.01 mg
|
$14,458.60 |
$14,458.60 |
$14,458.60 |
$14,458.60
|
|
Inj zanidatamab-hrii, 2 mg
|
$11,091.60 |
$11,091.60 |
$11,091.60 |
$8,532.00
|
|
Inj zenocutuzumab-zbco 1 mg
|
$1,993.78 |
$1,993.78 |
$1,993.78 |
$19,177.20
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$76,110.11 |
$76,110.11 |
$76,110.11 |
$41,083.73
|
|
Insert cannula vein-to-vein hemodialysis
|
$20,203.95 |
$20,203.95 |
$20,203.95 |
$7,279.50
|
|
Insert cath pleura with image
|
$4,644.90 |
$4,644.90 |
$4,644.90 |
$2,194.40
|
|
Insert cath pleura without image
|
$5,671.90 |
$5,671.90 |
$5,671.90 |
$2,099.70
|
|
Insert electrodes for eeg
|
$564.20 |
$564.20 |
$564.20 |
$564.20
|
|
Insertion catheter bladder non indwelling
|
$385.45 |
$385.45 |
$385.45 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$10,552.10 |
$10,552.10 |
$10,552.10 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,039.70 |
$2,039.70 |
$2,039.70 |
$2,447.63
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$2,585.25
|
|
Insertion of heart electrode 33211
|
$30,931.55 |
$30,931.55 |
$30,931.55 |
$6,820.50
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$5,805.80 |
$5,805.80 |
$5,805.80 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,805.80 |
$5,805.80 |
$5,805.80 |
$2,453.83
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$30,931.55 |
$30,931.55 |
$30,931.55 |
$7,183.68
|
|
Insert picvad cath
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,195.00
|
|
Insitu hybridization (fish)
|
$768.30 |
$768.30 |
$768.30 |
$481.00
|
|
In situ hybridization per specimen initial single probe stain
|
$437.45 |
$437.45 |
$437.45 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,078.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$2,310.75 |
$2,310.75 |
$2,310.75 |
$1,690.00
|
|
Insti hexaminolevulinate hcl
|
$63.18 |
$63.18 |
$63.18 |
$2,356.80
|
|
Ins tun cv cath wo subq prt/pm
|
$20,203.95 |
$20,203.95 |
$20,203.95 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,218.00
|
|
Insulin suppression panel
|
$742.95 |
$742.95 |
$742.95 |
$386.07
|
|
Insulin total
|
$51.35 |
$51.35 |
$51.35 |
$66.64
|
|
Intens behave ther cardio dx
|
$133.90 |
$133.90 |
$133.90 |
$47.60
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$5,053.11 |
$5,053.11 |
$5,053.11 |
$10,427.90
|
|
Interferon beta-1b / .25 mg
|
$1,662.71 |
$1,662.71 |
$1,662.71 |
$1,662.71
|
|
Interferon gamma 1-b inj
|
$26,394.13 |
$26,394.13 |
$26,394.13 |
$9,879.00
|
|
Interrogation vad in person
|
$343.20 |
$343.20 |
$343.20 |
$296.80
|
|
Interrog&prgrmg ipnss
|
$411.45 |
$411.45 |
$411.45 |
$200.00
|
