|
Inj andexxa, 10 mg
|
$751.80 |
$751.80 |
$751.80 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$34.80 |
$34.80 |
$34.80 |
$10,052.58
|
|
Inj, aspara, rylaze, 0.1 mg
|
$99.60 |
$99.60 |
$99.60 |
$10,458.00
|
|
Inj atezolizumb 5mg hya-tqjs
|
$54.60 |
$54.60 |
$54.60 |
$18,716.52
|
|
Inj aval alfa-nqpt 4mg
|
$157.20 |
$157.20 |
$157.20 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$12,255.60 |
$12,255.60 |
$12,255.60 |
$11,310.00
|
|
Inj, bezlotoxumab, 10 mg
|
$11,010.60 |
$11,010.60 |
$11,010.60 |
$7,612.43
|
|
Inj., brexanolone, 1 mg
|
$17,099.40 |
$17,099.40 |
$17,099.40 |
$13,019.44
|
|
Inj, bupivacaine liposome
|
$2.40 |
$2.40 |
$2.40 |
$699.38
|
|
Inj calcitriol per 0.1 mcg
|
$1.20 |
$1.20 |
$1.20 |
$22.69
|
|
Inj, cefepime hcl (b braun)
|
$44.80 |
$44.80 |
$44.80 |
$69.85
|
|
Inj cyclophosphamd (ingenus)
|
$3.00 |
$3.00 |
$3.00 |
$742.72
|
|
Inj, donanemab-azbt, 2 mg
|
$7.20 |
$7.20 |
$7.20 |
$1,233.44
|
|
Injection, caplacizumab-yhdp
|
$19,956.00 |
$19,956.00 |
$19,956.00 |
$16,319.16
|
|
Injection carpal tunnel therapeutic (both sides)
|
$621.00 |
$621.00 |
$621.00 |
$458.15
|
|
Injection epidural blood patch or clot
|
$3,754.80 |
$3,754.80 |
$3,754.80 |
$1,182.33
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$808.20 |
$808.20 |
$808.20 |
$497.76
|
|
Injection, inclisiran, 1 mg
|
$43.60 |
$43.60 |
$43.60 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$2,128.80 |
$2,128.80 |
$2,128.80 |
$2,277.65
|
|
Injection, renflexis
|
$228.80 |
$228.80 |
$228.80 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$932.40 |
$932.40 |
$932.40 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$454.20 |
$454.20 |
$454.20 |
$1,043.72
|
|
Injection, siltuximab
|
$467.40 |
$467.40 |
$467.40 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$680.40 |
$680.40 |
$680.40 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$402.00 |
$402.00 |
$402.00 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$125.40 |
$125.40 |
$125.40 |
$145.60
|
|
Inj, epinephrine (belcher)
|
$25.80 |
$25.80 |
$25.80 |
$6.55
|
|
Inj, factor x, (human), 1iu
|
$36.00 |
$36.00 |
$36.00 |
$26.74
|
|
Inj., fremanezumab-vfrm 1 mg
|
$6.00 |
$6.00 |
$6.00 |
$1,322.20
|
|
Inj imip 4 cilas 4 releb 2mg
|
$5.40 |
$5.40 |
$5.40 |
$739.77
|
|
Inj. inebilizumab-cdon, 1 mg
|
$871.80 |
$871.80 |
$871.80 |
$70,014.65
|
|
Inj ivig privigen 500 mg
|
$3,868.20 |
$3,868.20 |
$3,868.20 |
$6,967.29
|
|
Inj, lanreotide, (cipla) 1mg
|
$96.60 |
$96.60 |
$96.60 |
$11,648.70
|
|
Inj, lidocaine w epinephrine
|
$0.04 |
$0.04 |
$0.04 |
$45.60
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$108.00 |
$108.00 |
$108.00 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$6.60 |
$6.60 |
$6.60 |
$34.34
|
|
Inj., meropenem, vaborbactam
|
$2,563.20 |
$2,563.20 |
$2,563.20 |
$556.87
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$691.20 |
$691.20 |
$691.20 |
$8,304.04
|
|
Inj, moxifloxacin 100 mg
|
$100.20 |
$100.20 |
$100.20 |
$101.31
|
|
Inj multihance
|
$42.80 |
$42.80 |
$42.80 |
$70.54
|
|
Inj naloxone hydrochloride
|
$66.00 |
$66.00 |
$66.00 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,092.80 |
$2,092.80 |
$2,092.80 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$3.60 |
$3.60 |
$3.60 |
$468.10
|
|
Inj nivolumab 2 mg hyaluron
|
$48.60 |
$48.60 |
$48.60 |
$15,599.68
|
|
Inj ogivri 10 mg
|
$242.40 |
$242.40 |
$242.40 |
$4,492.28
|
|
Inj., patisiran, 0.1 mg
|
$244.80 |
$244.80 |
$244.80 |
$17,613.00
|
|
Inj., plazomicin, 5 mg
|
$85.80 |
$85.80 |
$85.80 |
$607.16
|
|
Inj., rolapitant, 0.5 mg
|
$1.80 |
$1.80 |
$1.80 |
$1.80
|
|
Inj. teprotumumab-trbw 10 mg
|
$768.00 |
$768.00 |
$768.00 |
$35,034.78
|
|
Inj testosterone cypionate
|
$82.80 |
$82.80 |
$82.80 |
$64.96
|
|
Inj, tislelizumab-jsgr
|
$103.20 |
$103.20 |
$103.20 |
$9,764.09
|
|
Inj, tyenne, 1 mg
|
$12.80 |
$12.80 |
$12.80 |
$3,525.12
|
|
Inj, vancomycin hcl (xellia)
|
$9.60 |
$9.60 |
$9.60 |
$85.20
|
|
Inj w/fluor eval cv device
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$504.40
|
|
Ins cerv dilator (sep proc)
|
$1,416.00 |
$1,416.00 |
$1,416.00 |
$490.73
|
|
Insert cath pleura with image
|
$2,611.20 |
$2,611.20 |
$2,611.20 |
$2,194.40
|
|
Insertion catheter bladder non indwelling
|
$318.00 |
$318.00 |
$318.00 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,445.20 |
$3,445.20 |
$3,445.20 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,403.40 |
$1,403.40 |
$1,403.40 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,026.00 |
$4,026.00 |
$4,026.00 |
$2,453.83
|
|
Insitu hybridization manual
|
$424.80 |
$424.80 |
$424.80 |
$401.28
|
|
In situ hybridization per specimen initial single probe stain
|
$76.20 |
$76.20 |
$76.20 |
$338.40
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$6,166.80 |
$6,166.80 |
$6,166.80 |
$7,826.00
|
|
Ins tun cv cath wo subq prt/pm
|
$5,619.60 |
$5,619.60 |
$5,619.60 |
$4,218.00
|
|
Insulin total
|
$66.60 |
$66.60 |
$66.60 |
$66.64
|
|
Int hrhc lig 1 hroid without img
|
$1,271.40 |
$1,271.40 |
$1,271.40 |
$3,491.25
|
|
Intrinsic factor antibody
|
$100.20 |
$100.20 |
$100.20 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$601.28
|
|
Ionm in operatng room 15 min
|
$191.40 |
$191.40 |
$191.40 |
$200.78
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$5.40 |
$5.40 |
$5.40 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$19.80 |
$19.80 |
$19.80 |
$279.10
|
|
Ipratropium bromide non-comp
|
$19.20 |
$19.20 |
$19.20 |
$4.06
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$1,143.20 |
$1,143.20 |
$1,143.20 |
$173.98
|
|
Iron
|
$41.40 |
$41.40 |
$41.40 |
$75.00
|
|
Iron binding capacity
|
$58.80 |
$58.80 |
$58.80 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$91.20 |
$91.20 |
$91.20 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$682.20 |
$682.20 |
$682.20 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$238.80 |
$238.80 |
$238.80 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$149.40 |
$149.40 |
$149.40 |
$146.11
|
|
IV Fluids (each additional hour)
|
$84.60 |
$84.60 |
$84.60 |
$133.90
|
|
IV Fluids (first hour)
|
$243.00 |
$243.00 |
$243.00 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$168.00 |
$168.00 |
$168.00 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$178.20 |
$178.20 |
$178.20 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$100.20 |
$100.20 |
$100.20 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$292.80 |
$292.80 |
$292.80 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$125.40 |
$125.40 |
$125.40 |
$167.50
|
|
IV Push Injection (first drug)
|
$235.20 |
$235.20 |
$235.20 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$288.60 |
$288.60 |
$288.60 |
$713.40
|
|
Ixabepilone 15 mg intravenous solution
|
$139.20 |
$139.20 |
$139.20 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$175.80 |
$175.80 |
$175.80 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$108.00 |
$108.00 |
$108.00 |
$362.05
|
|
John cunningham antibody
|
$103.80 |
$103.80 |
$103.80 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$71.40 |
$71.40 |
$71.40 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$48.80 |
$48.80 |
$48.80 |
$23.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,695.60 |
$1,695.60 |
$1,695.60 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$808.80 |
$808.80 |
$808.80 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$652.20 |
$652.20 |
$652.20 |
$490.75
|
|
Kit lead specify 5-6-5
|
$7,272.00 |
$7,272.00 |
$7,272.00 |
$16,672.10
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,965.60 |
$1,965.60 |
$1,965.60 |
$1,635.87
|
