|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$141.95 |
$141.95 |
$141.95 |
$105.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,679.60 |
$1,679.60 |
$1,679.60 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$517.65 |
$517.65 |
$517.65 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$1,059.10 |
$1,059.10 |
$1,059.10 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$195.50 |
$195.50 |
$195.50 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$172.55 |
$172.55 |
$172.55 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$172.55 |
$172.55 |
$172.55 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$343.40 |
$343.40 |
$343.40 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$575.45 |
$575.45 |
$575.45 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$3,101.31 |
$3,101.31 |
$3,101.31 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,513.79 |
$2,513.79 |
$2,513.79 |
$1,617.43
|
|
Influenza dna amp prob addl
|
$118.15 |
$118.15 |
$118.15 |
$64.26
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$95.70 |
$95.70 |
$95.70 |
$102.83
|
|
Influenza virus vaccine, live trivalent intranasal
|
$31.06 |
$31.06 |
$31.06 |
$37.80
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$127.50 |
$127.50 |
$127.50 |
$293.04
|
|
Initial nursing facility care/day 35 minutes
|
$353.60 |
$353.60 |
$353.60 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$482.80 |
$482.80 |
$482.80 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$213.35 |
$213.35 |
$213.35 |
$128.00
|
|
Initiation & management bipap/cpap initial day
|
$502.35 |
$502.35 |
$502.35 |
$576.00
|
|
Inj, abilify asimtufii, 1 mg
|
$5,933.55 |
$5,933.55 |
$5,933.55 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$7,706.83 |
$7,706.83 |
$7,706.83 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$7.95 |
$7.95 |
$7.95 |
$32.79
|
|
Inj. acthar gel to 40 units
|
$4,629.51 |
$4,629.51 |
$4,629.51 |
$7,918.32
|
|
Inj, adalimumab, 1 mg
|
$18,363.12 |
$18,363.12 |
$18,363.12 |
$12,098.05
|
|
Inj, adstiladrin, per tx dos
|
$15,538.00 |
$15,538.00 |
$15,538.00 |
$63,354.77
|
|
Inj, aflibercept-ayyh, 1 mg
|
$1,749.27 |
$1,749.27 |
$1,749.27 |
$2,771.44
|
|
Inj, aflibercept hd, 1 mg
|
$2,794.18 |
$2,794.18 |
$2,794.18 |
$4,433.46
|
|
Inj, afstyla, 1 i.u
|
$5.83 |
$5.83 |
$5.83 |
$6.76
|
|
Inj, alfentanil hcl, 500mcg
|
$58.76 |
$58.76 |
$58.76 |
$35.94
|
|
Inj allopurinol sodium 1 mg
|
$10,577.93 |
$10,577.93 |
$10,577.93 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$741.48 |
$741.48 |
$741.48 |
$1,483.29
|
|
Inj, amisulpride, 1 mg
|
$52.91 |
$52.91 |
$52.91 |
$98.96
|
|
Inj andexxa, 10 mg
|
$2,558.50 |
$2,558.50 |
$2,558.50 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$14,432.83 |
$14,432.83 |
$14,432.83 |
$10,052.58
|
|
Inj, aponvie, 1 mg
|
$84.96 |
$84.96 |
$84.96 |
$3.00
|
|
Inj., aristada initio, 1 mg
|
$2,492.42 |
$2,492.42 |
$2,492.42 |
$4,052.45
|
|
Inj, artesunate, 1mg
|
$4,580.23 |
$4,580.23 |
$4,580.23 |
$14,460.21
|
|
Inj. asceniv
|
$4,932.04 |
$4,932.04 |
$4,932.04 |
$7,833.92
|
|
Inj, aspara, rylaze, 0.1 mg
|
$5,424.70 |
$5,424.70 |
$5,424.70 |
$10,458.00
|
|
Inj atezolizumb 5mg hya-tqjs
|
$11,829.66 |
$11,829.66 |
$11,829.66 |
$18,716.52
|
|
Inj avacincaptad pegol 0.1mg
|
$2,150.50 |
$2,150.50 |
$2,150.50 |
$3,409.64
|
|
Inj aval alfa-nqpt 4mg
|
$1,994.85 |
$1,994.85 |
$1,994.85 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$15,510.63 |
$15,510.63 |
$15,510.63 |
$11,604.71
|
|
Inj, bezlotoxumab, 10 mg
|
$3,884.50 |
$3,884.50 |
$3,884.50 |
$7,612.43
|
|
Inj bimatoprost itc imp1mcg
|
$2,074.00 |
$2,074.00 |
$2,074.00 |
$3,287.96
|
|
Inj, biorphen, 20 micrograms
|
$4.00 |
$4.00 |
$4.00 |
$17.12
|
|
Inj, bortezomib freseniuskab
|
$1,643.55 |
$1,643.55 |
$1,643.55 |
$2,464.14
|
|
Inj, bortezomib, hospira
|
$91.29 |
$91.29 |
$91.29 |
$175.35
|
|
Inj., brexanolone, 1 mg
|
$7,607.50 |
$7,607.50 |
$7,607.50 |
$13,019.44
|
|
Inj, brixadi, 7 days or less
|
$444.04 |
$444.04 |
$444.04 |
$748.85
|
|
Inj brixadi, more than 7 day
|
$1,750.66 |
$1,750.66 |
$1,750.66 |
$2,846.40
|
|
Inj, brolucizumab-dbll, 1 mg
|
$2,133.56 |
$2,133.56 |
$2,133.56 |
$3,382.69
|
|
Inj bulking agent anal canal
|
$15,570.86 |
$15,570.86 |
$15,570.86 |
$9,525.70
|
|
Inj, bupivacaine liposome
|
$1,061.56 |
$1,061.56 |
$1,061.56 |
$699.38
|
|
Inj. byooviz, 0.1 mg
|
$720.81 |
$720.81 |
$720.81 |
$1,135.59
|
|
Inj calcitriol per 0.1 mcg
|
$31.35 |
$31.35 |
$31.35 |
$22.69
|
|
Inj, carmustine (accord)
|
$5,758.78 |
$5,758.78 |
$5,758.78 |
$9,875.08
|
|
Inj cefazolin sodium, baxter
|
$11.14 |
$11.14 |
$11.14 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$34.68 |
$34.68 |
$34.68 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$12.64 |
$12.64 |
$12.64 |
$18.30
|
|
Inj. cefepime hcl (baxter)
|
$134.56 |
$134.56 |
$134.56 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$72.50 |
$72.50 |
$72.50 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$621.75 |
$621.75 |
$621.75 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$466.65 |
$466.65 |
$466.65 |
$408.00
|
|
Inj., cerliponase alfa 1 mg
|
$6,128.50 |
$6,128.50 |
$6,128.50 |
$21,448.67
|
|
Inj. cetirizine hcl 0.5mg
|
$107.45 |
$107.45 |
$107.45 |
$159.98
|
|
Inj, cipaglucosidase, 5 mg
|
$5,010.75 |
$5,010.75 |
$5,010.75 |
$3,278.80
|
|
Inj, clindamycin (baxter)
|
$49.48 |
$49.48 |
$49.48 |
$48.39
|
|
Inj cntr knee arthro incl ct/mri
|
$855.95 |
$855.95 |
$855.95 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$5,367.18 |
$5,367.18 |
$5,367.18 |
$9,204.29
|
|
Inj crotalidae im f(ab')2 eq
|
$1,354.90 |
$1,354.90 |
$1,354.90 |
$2,613.60
|
|
Inj cutaquig 100 mg
|
$224.46 |
$224.46 |
$224.46 |
$348.81
|
|
Inj cuvitru, 100 mg
|
$2,437.55 |
$2,437.55 |
$2,437.55 |
$4,163.61
|
|
Inj, cyclophos (baxter) 5mg
|
$3,923.43 |
$3,923.43 |
$3,923.43 |
$2,584.85
|
|
Inj, cyclophosphamd, sandoz
|
$456.01 |
$456.01 |
$456.01 |
$735.20
|
|
Inj daptomycin (xellia)
|
$187.85 |
$187.85 |
$187.85 |
$56.04
|
|
Inj daxibotulinumtoxina-lanm
|
$436.90 |
$436.90 |
$436.90 |
$736.62
|
|
Inj, donanemab-azbt, 2 mg
|
$1,906.19 |
$1,906.19 |
$1,906.19 |
$1,233.44
|
|
Inj, durolane 1 mg
|
$1,145.80 |
$1,145.80 |
$1,145.80 |
$1,950.93
|
|
Inj dx for sinogram
|
$629.85 |
$629.85 |
$629.85 |
$413.82
|
|
Inject for sacroiliac joint
|
$1,503.65 |
$1,503.65 |
$1,503.65 |
$1,101.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$974.10 |
$974.10 |
$974.10 |
$500.50
|
|
Injection, belinostat, 10mg
|
$2,589.39 |
$2,589.39 |
$2,589.39 |
$4,446.10
|
|
Injection, burosumab-twza 1m
|
$35,420.01 |
$35,420.01 |
$35,420.01 |
$20,002.09
|
|
Injection, cangrelor
|
$1,029.73 |
$1,029.73 |
$1,029.73 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$22,736.35 |
$22,736.35 |
$22,736.35 |
$16,642.50
|
|
Injection, casimersen, 10 mg
|
$1,640.50 |
$1,640.50 |
$1,640.50 |
$2,598.44
|
|
Injection, daratumumab 10 mg
|
$7,838.59 |
$7,838.59 |
$7,838.59 |
$5,164.24
|
|
Injection, delafloxacin
|
$399.28 |
$399.28 |
$399.28 |
$244.26
|
|
Injection, doxercalciferol
|
$10.29 |
$10.29 |
$10.29 |
$23.12
|
|
Injection during cath supravalvular aortography
|
$501.50 |
$501.50 |
$501.50 |
$904.17
|
|
Injection, edaravone, 1 mg
|
$669.55 |
$669.55 |
$669.55 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$1,936.30 |
$1,936.30 |
$1,936.30 |
$1,156.80
|
|
Injection eye drug
|
$947.75 |
$947.75 |
$947.75 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$732.70 |
$732.70 |
$732.70 |
$441.12
|
|
Injection for bladder x-ray
|
$997.90 |
$997.90 |
$997.90 |
$459.20
|
|
Injection for hip x-ray
|
$1,340.45 |
$1,340.45 |
$1,340.45 |
$669.24
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$673.20 |
$673.20 |
$673.20 |
$494.65
|
|
Injection for spleen x-ray
|
$3,183.25 |
$3,183.25 |
$3,183.25 |
$423.41
|
|
Injection for ureter x-ray
|
$836.40 |
$836.40 |
$836.40 |
$515.21
|
