|
Inj. cefepime hcl (baxter)
|
$185.34 |
$185.34 |
$185.34 |
$86.84
|
|
Inj, clindamycin (baxter)
|
$30.90 |
$30.90 |
$30.90 |
$48.39
|
|
Inj cntr knee arthro incl ct/mri
|
$333.00 |
$333.00 |
$333.00 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$903.60 |
$903.60 |
$903.60 |
$945.00
|
|
Inj dx for sinogram
|
$473.40 |
$473.40 |
$473.40 |
$413.82
|
|
Injection arthrography hip without anesthesia (both sides)
|
$333.00 |
$333.00 |
$333.00 |
$500.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$10,438.98 |
$10,438.98 |
$10,438.98 |
$504.90
|
|
Injection epidural blood patch or clot
|
$1,886.40 |
$1,886.40 |
$1,886.40 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$355.80 |
$355.80 |
$355.80 |
$441.12
|
|
Injection for bladder x-ray
|
$473.40 |
$473.40 |
$473.40 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$355.80 |
$355.80 |
$355.80 |
$494.65
|
|
Injection, fulvestrant
|
$158.22 |
$158.22 |
$158.22 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$13,497.06 |
$13,497.06 |
$13,497.06 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$2,449.08 |
$2,449.08 |
$2,449.08 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$728.40 |
$728.40 |
$728.40 |
$683.28
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,228.40 |
$2,228.40 |
$2,228.40 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,347.00 |
$1,347.00 |
$1,347.00 |
$1,045.65
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$5,354.40 |
$5,354.40 |
$5,354.40 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$6,136.80 |
$6,136.80 |
$6,136.80 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$5,354.40 |
$5,354.40 |
$5,354.40 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$6,136.80 |
$6,136.80 |
$6,136.80 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,722.80 |
$2,722.80 |
$2,722.80 |
$1,704.78
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$391.20 |
$391.20 |
$391.20 |
$517.24
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$91.20 |
$91.20 |
$91.20 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$140.40 |
$140.40 |
$140.40 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$341.40 |
$341.40 |
$341.40 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$174.00 |
$174.00 |
$174.00 |
$135.20
|
|
Inject/treat eye socket
|
$2,077.80 |
$2,077.80 |
$2,077.80 |
$381.13
|
|
Inj for ext venography
|
$252.00 |
$252.00 |
$252.00 |
$654.00
|
|
Inj for mammo ductogram
|
$334.80 |
$334.80 |
$334.80 |
$433.50
|
|
Inj hydroxocobalamin IV 25mg
|
$3,942.60 |
$3,942.60 |
$3,942.60 |
$2,452.32
|
|
Inj labetalol hcl hikma, 5mg
|
$13.08 |
$13.08 |
$13.08 |
$40.00
|
|
Inj, lidocaine w epinephrine
|
$101.88 |
$101.88 |
$101.88 |
$44.96
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$788.40 |
$788.40 |
$788.40 |
$783.50
|
|
Inj., meropenem, vaborbactam
|
$967.92 |
$967.92 |
$967.92 |
$536.27
|
|
Inj multihance
|
$175.74 |
$175.74 |
$175.74 |
$79.42
|
|
Inj. mycophenolate mofetil
|
$469.74 |
$469.74 |
$469.74 |
$252.66
|
|
Inj, nithiodote, 3mg / 125mg
|
$1,435.50 |
$1,435.50 |
$1,435.50 |
$452.89
|
|
Inj ogivri 10 mg
|
$9,765.24 |
$9,765.24 |
$9,765.24 |
$4,492.28
|
|
Inj proc ankle arthr
|
$333.00 |
$333.00 |
$333.00 |
$405.31
|
|
Inj proc elbow arthro
|
$259.20 |
$259.20 |
$259.20 |
$432.00
|
|
Inj proc lumbr disk ea lvl
|
$903.60 |
$903.60 |
$903.60 |
$1,139.40
|
|
Inj proc myelogram lumbar
|
$916.20 |
$916.20 |
$916.20 |
$856.00
|
|
Inj proc sialogram
|
$444.00 |
$444.00 |
$444.00 |
$373.00
|
|
Inj, releuko 1 mcg
|
$957.06 |
$957.06 |
$957.06 |
$461.20
|
|
Inj retro urethrocysto
|
$473.40 |
$473.40 |
$473.40 |
$450.00
|
|
Inj sulf hexa lipid microsph
|
$191.88 |
$191.88 |
$191.88 |
$256.14
|
|
Inj testosterone cypionate
|
$25.92 |
$25.92 |
$25.92 |
$62.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$788.40 |
$788.40 |
$788.40 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$788.40 |
$788.40 |
$788.40 |
$818.00
|
|
Inj. tigecycline (accord)
|
$435.00 |
$435.00 |
$435.00 |
$182.46
|
|
Inj, tyenne, 1 mg
|
$7,367.52 |
$7,367.52 |
$7,367.52 |
$3,525.12
|
|
Inj vancomycin (xellia) 10mg
|
$121.80 |
$121.80 |
$121.80 |
$79.21
|
|
Inj vocal cord bulking agent
|
$1,928.80 |
$1,928.80 |
$1,928.80 |
$1,480.00
|
|
Insert cath pleura with image
|
$2,975.40 |
$2,975.40 |
$2,975.40 |
$2,194.40
|
|
Insert cath pleura without image
|
$3,456.60 |
$3,456.60 |
$3,456.60 |
$2,019.00
|
|
Insertion catheter bladder non indwelling
|
$205.80 |
$205.80 |
$205.80 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$197.40 |
$197.40 |
$197.40 |
$229.32
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,926.00 |
$4,926.00 |
$4,926.00 |
$2,511.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,564.40 |
$2,564.40 |
$2,564.40 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,857.60 |
$1,857.60 |
$1,857.60 |
$2,414.10
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$13,498.80 |
$13,498.80 |
$13,498.80 |
$7,513.67
|
|
Insert swan-ganz cath
|
$2,829.60 |
$2,829.60 |
$2,829.60 |
$2,210.50
|
|
Insitu hybridization (fish)
|
$483.00 |
$483.00 |
$483.00 |
$481.60
|
|
Insitu hybridization manual
|
$159.00 |
$159.00 |
$159.00 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$145.20 |
$145.20 |
$145.20 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$317.40 |
$317.40 |
$317.40 |
$326.04
|
|
Insole orthotic freedom sz6 6816
|
$174.51 |
$174.51 |
$174.51 |
$84.00
|
|
Instillation anticarcinogenic agent bladder
|
$463.20 |
$463.20 |
$463.20 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$3,139.80 |
$3,139.80 |
$3,139.80 |
$4,202.70
|
|
Insulin total
|
$29.40 |
$29.40 |
$29.40 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$12,123.56 |
$12,123.56 |
$12,123.56 |
$8,629.72
|
|
Integra meshed bil wound mat
|
$39,765.49 |
$39,765.49 |
$39,765.49 |
$9,924.00
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$13,121.10 |
$13,121.10 |
$13,121.10 |
$3,825.00
|
|
Intens cardiac rehab no exer
|
$285.60 |
$285.60 |
$285.60 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$285.60 |
$285.60 |
$285.60 |
$238.40
|
|
Interdental fixation
|
$2,467.80 |
$2,467.80 |
$2,467.80 |
$2,162.05
|
|
Interfyl, 1 mg
|
$5,248.44 |
$5,248.44 |
$5,248.44 |
$5,118.52
|
|
Intraoral i+d tongue/floor lingual 41000
|
$824.40 |
$824.40 |
$824.40 |
$1,445.00
|
|
Intrapul surf admin endo tube
|
$349.80 |
$349.80 |
$349.80 |
$220.80
|
|
Intrinsic factor antibody
|
$15.00 |
$15.00 |
$15.00 |
$66.60
|
|
Intro long gi tube
|
$553.80 |
$553.80 |
$553.80 |
$990.00
|
|
Intubation endotracheal emergency procedure
|
$714.00 |
$714.00 |
$714.00 |
$589.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$60.00 |
$60.00 |
$60.00 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1,440.18 |
$1,440.18 |
$1,440.18 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$134,734.26 |
$134,734.26 |
$134,734.26 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$1.50 |
$1.50 |
$1.50 |
$3.75
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$422.94 |
$422.94 |
$422.94 |
$163.87
|
|
Iron
|
$64.20 |
$64.20 |
$64.20 |
$74.40
|
|
Iron binding capacity
|
$79.80 |
$79.80 |
$79.80 |
$63.79
|
|
Iron dextran 50 mg/ml injection solution
|
$75.00 |
$75.00 |
$75.00 |
$80.95
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$112.74 |
$112.74 |
$112.74 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$183.00 |
$183.00 |
$183.00 |
$142.20
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$16,180.56 |
$16,180.56 |
$16,180.56 |
$8,273.35
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$142.20 |
$142.20 |
$142.20 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$162.00 |
$162.00 |
$162.00 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$162.00 |
$162.00 |
$162.00 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$274.80 |
$274.80 |
$274.80 |
$439.56
|
|
Ivp w/wo kub w/wo tomography
|
$997.80 |
$997.80 |
$997.80 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$489.60 |
$489.60 |
$489.60 |
$379.87
|
