|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$204.00 |
$204.00 |
$204.00 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$130.20 |
$130.20 |
$130.20 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$115.80 |
$115.80 |
$115.80 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$457.20 |
$457.20 |
$457.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$219.60 |
$219.60 |
$219.60 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$349.80 |
$349.80 |
$349.80 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,824.00 |
$1,824.00 |
$1,824.00 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$424.20 |
$424.20 |
$424.20 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$453.60 |
$453.60 |
$453.60 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$480.60 |
$480.60 |
$480.60 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$217.20 |
$217.20 |
$217.20 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$75.00 |
$75.00 |
$75.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$210.00 |
$210.00 |
$210.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$220.80 |
$220.80 |
$220.80 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$145.80 |
$145.80 |
$145.80 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$438.00 |
$438.00 |
$438.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$968.40 |
$968.40 |
$968.40 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$427.20 |
$427.20 |
$427.20 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$361.20 |
$361.20 |
$361.20 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$609.60 |
$609.60 |
$609.60 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$607.80 |
$607.80 |
$607.80 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$745.80 |
$745.80 |
$745.80 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$429.60 |
$429.60 |
$429.60 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,360.80 |
$1,360.80 |
$1,360.80 |
$1,537.84
|
|
Influenza dna amp prob addl
|
$325.20 |
$325.20 |
$325.20 |
$64.26
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$40.00 |
$40.00 |
$40.00 |
$111.51
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$414.60 |
$414.60 |
$414.60 |
$296.00
|
|
Init pm e/m new pat 65+ yrs
|
$332.40 |
$332.40 |
$332.40 |
$189.15
|
|
Inj, abilify maintena, 1 mg
|
$24.80 |
$24.80 |
$24.80 |
$5,355.30
|
|
Inj, adalimumab, 1 mg
|
$155.20 |
$155.20 |
$155.20 |
$12,098.05
|
|
Inj, aducanumab-avwa, 2 mg
|
$24.60 |
$24.60 |
$24.60 |
$5.98
|
|
Inj andexxa, 10 mg
|
$13,400.40 |
$13,400.40 |
$13,400.40 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$10,166.40 |
$10,166.40 |
$10,166.40 |
$10,052.58
|
|
Inj, aponvie, 1 mg
|
$3.60 |
$3.60 |
$3.60 |
$3.36
|
|
Inj, aspara, rylaze, 0.1 mg
|
$96.60 |
$96.60 |
$96.60 |
$10,458.00
|
|
Inj atezolizumb 5mg hya-tqjs
|
$54.00 |
$54.00 |
$54.00 |
$18,716.52
|
|
Inj aval alfa-nqpt 4mg
|
$4,812.00 |
$4,812.00 |
$4,812.00 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$12,764.40 |
$12,764.40 |
$12,764.40 |
$11,310.00
|
|
Inj beta interferon sq 1 mcg
|
$33.40 |
$33.40 |
$33.40 |
$2,397.11
|
|
Inj, bezlotoxumab, 10 mg
|
$10,600.80 |
$10,600.80 |
$10,600.80 |
$7,612.43
|
|
Inj., brexanolone, 1 mg
|
$172.20 |
$172.20 |
$172.20 |
$13,019.44
|
|
Inj, brixadi, 7 days or less
|
$807.00 |
$807.00 |
$807.00 |
$748.85
|
|
Inj, bupivacaine liposome
|
$7.20 |
$7.20 |
$7.20 |
$699.38
|
|
Inj calcitriol per 0.1 mcg
|
$1.20 |
$1.20 |
$1.20 |
$22.69
|
|
Inj, cefepime hcl (b braun)
|
$39.40 |
$39.40 |
$39.40 |
$69.85
|
|
Inj ceftolozane tazobactam
|
$259.20 |
$259.20 |
$259.20 |
$364.86
|
|
Inj, cimerli, 0.1 mg
|
$514.20 |
$514.20 |
$514.20 |
$201.01
|
|
Inj, clevidipine butyrate
|
$423.00 |
$423.00 |
$423.00 |
$4.86
|
|
Inj cntr knee arthro incl ct/mri
|
$121.80 |
$121.80 |
$121.80 |
$436.80
|
|
Inj crotalidae im f(ab')2 eq
|
$2,314.20 |
$2,314.20 |
$2,314.20 |
$2,613.60
|
|
Inj cyclophosphamd (ingenus)
|
$12.00 |
$12.00 |
$12.00 |
$742.72
|
|
Inj, donanemab-azbt, 2 mg
|
$7.20 |
$7.20 |
$7.20 |
$1,233.44
|
|
Inj dx for sinogram
|
$640.20 |
$640.20 |
$640.20 |
$436.00
|
|
Inject for sacroiliac joint
|
$2,995.20 |
$2,995.20 |
$2,995.20 |
$1,025.77
|
|
Injection arthrography hip without anesthesia (both sides)
|
$445.80 |
$445.80 |
$445.80 |
$503.50
|
|
Injection, caplacizumab-yhdp
|
$18,673.20 |
$18,673.20 |
$18,673.20 |
$16,319.16
|
|
Injection carpal tunnel therapeutic (both sides)
|
$293.40 |
$293.40 |
$293.40 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$5,384.40 |
$5,384.40 |
$5,384.40 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$319.80 |
$319.80 |
$319.80 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$341.40 |
$341.40 |
$341.40 |
$436.00
|
|
Injection for bladder x-ray
|
$2,905.80 |
$2,905.80 |
$2,905.80 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$294.60 |
$294.60 |
$294.60 |
$497.76
|
|
Injection, fulvestrant
|
$477.60 |
$477.60 |
$477.60 |
$1,719.16
|
|
Injection glatiramer acetate
|
$811.20 |
$811.20 |
$811.20 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$42.40 |
$42.40 |
$42.40 |
$6,679.35
|
|
Injection, isavuconazonium
|
$609.00 |
$609.00 |
$609.00 |
$787.67
|
|
Injection,onabotulinumtoxina
|
$2,054.40 |
$2,054.40 |
$2,054.40 |
$2,277.65
|
|
Injection, pentamidine iseth
|
$499.20 |
$499.20 |
$499.20 |
$383.03
|
|
Injection, peramivir
|
$8.40 |
$8.40 |
$8.40 |
$744.75
|
|
Injection radioactive tracer sentinel node (both sides)
|
$483.60 |
$483.60 |
$483.60 |
$685.44
|
|
Injection, renflexis
|
$216.80 |
$216.80 |
$216.80 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$871.80 |
$871.80 |
$871.80 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$820.80 |
$820.80 |
$820.80 |
$1,043.72
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,094.60 |
$2,094.60 |
$2,094.60 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$909.00 |
$909.00 |
$909.00 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$454.20 |
$454.20 |
$454.20 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$470.40 |
$470.40 |
$470.40 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$184.20 |
$184.20 |
$184.20 |
$145.60
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$84.00 |
$84.00 |
$84.00 |
$32,176.93
|
|
Inj epidural sgl lumb-sacral without img
|
$1,629.00 |
$1,629.00 |
$1,629.00 |
$1,450.84
|
|
Inj, factor x, (human), 1iu
|
$37.80 |
$37.80 |
$37.80 |
$26.74
|
|
Inj. fe derisomaltose 10 mg
|
$88.80 |
$88.80 |
$88.80 |
$3,221.52
|
|
Inj, focinvez, 1mg
|
$5.40 |
$5.40 |
$5.40 |
$3.63
|
|
Inj for ext venography
|
$289.80 |
$289.80 |
$289.80 |
$628.80
|
|
Inj., fremanezumab-vfrm 1 mg
|
$6.00 |
$6.00 |
$6.00 |
$1,322.20
|
|
Inj., guselkumab, 1 mg
|
$367.20 |
$367.20 |
$367.20 |
$29,130.83
|
|
Inj imip 4 cilas 4 releb 2mg
|
$5.40 |
$5.40 |
$5.40 |
$739.77
|
|
Inj. inebilizumab-cdon, 1 mg
|
$864.00 |
$864.00 |
$864.00 |
$70,014.65
|
|
Inj intralesional <= 7 lsn(s)
|
$52.20 |
$52.20 |
$52.20 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$178.40 |
$178.40 |
$178.40 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$188.00 |
$188.00 |
$188.00 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$22.20 |
$22.20 |
$22.20 |
$45.60
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$107.40 |
$107.40 |
$107.40 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$35.40 |
$35.40 |
$35.40 |
$34.34
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$647.20 |
$647.20 |
$647.20 |
$8,304.04
|
|
Inj multihance
|
$30.60 |
$30.60 |
$30.60 |
$70.54
|
|
Inj naloxone hydrochloride
|
$75.00 |
$75.00 |
$75.00 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$1,413.35
|
