|
Inj, bupivacaine liposome
|
$7.60 |
$7.60 |
$7.60 |
$699.38
|
|
Inj calcitriol per 0.1 mcg
|
$26.40 |
$26.40 |
$26.40 |
$22.69
|
|
Inj, cefiderocol, 10 mg
|
$5.80 |
$5.80 |
$5.80 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$487.80 |
$487.80 |
$487.80 |
$364.86
|
|
Inj, clevidipine butyrate
|
$839.40 |
$839.40 |
$839.40 |
$4.86
|
|
Inj cntr knee arthro incl ct/mri
|
$969.00 |
$969.00 |
$969.00 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$352.80 |
$352.80 |
$352.80 |
$9,204.29
|
|
Inj cyclophosphamd (ingenus)
|
$13.20 |
$13.20 |
$13.20 |
$742.72
|
|
Inj, donanemab-azbt, 2 mg
|
$7.20 |
$7.20 |
$7.20 |
$1,233.44
|
|
Inj, durolane 1 mg
|
$22.80 |
$22.80 |
$22.80 |
$1,950.93
|
|
Inj dx for sinogram
|
$1,942.20 |
$1,942.20 |
$1,942.20 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$750.00 |
$750.00 |
$750.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$969.00 |
$969.00 |
$969.00 |
$503.50
|
|
Injection, cangrelor
|
$41,627.40 |
$41,627.40 |
$41,627.40 |
$1,889.78
|
|
Injection, caplacizumab-yhdp
|
$2,329.60 |
$2,329.60 |
$2,329.60 |
$16,319.16
|
|
Injection carpal tunnel therapeutic (both sides)
|
$293.40 |
$293.40 |
$293.40 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$314.40 |
$314.40 |
$314.40 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$436.80 |
$436.80 |
$436.80 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,470.60 |
$1,470.60 |
$1,470.60 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$969.00 |
$969.00 |
$969.00 |
$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)
|
$969.00 |
$969.00 |
$969.00 |
$497.76
|
|
Injection, fulvestrant
|
$589.60 |
$589.60 |
$589.60 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$39.20 |
$39.20 |
$39.20 |
$6,679.35
|
|
Injection, isavuconazonium
|
$4.80 |
$4.80 |
$4.80 |
$787.67
|
|
Injection of sinus tract
|
$343.20 |
$343.20 |
$343.20 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$2,783.40 |
$2,783.40 |
$2,783.40 |
$2,277.65
|
|
Injection, renflexis
|
$1,624.80 |
$1,624.80 |
$1,624.80 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,242.00 |
$1,242.00 |
$1,242.00 |
$1,582.12
|
|
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)
|
$1,470.60 |
$1,470.60 |
$1,470.60 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,461.00 |
$1,461.00 |
$1,461.00 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,481.60 |
$2,481.60 |
$2,481.60 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,481.60 |
$2,481.60 |
$2,481.60 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,481.60 |
$2,481.60 |
$2,481.60 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,481.60 |
$2,481.60 |
$2,481.60 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$1,817.24
|
|
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)
|
$616.20 |
$616.20 |
$616.20 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$825.60 |
$825.60 |
$825.60 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$654.00 |
$654.00 |
$654.00 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$147.00 |
$147.00 |
$147.00 |
$145.60
|
|
Inject sacroiliac joint
|
$2,370.00 |
$2,370.00 |
$2,370.00 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$1,627.80 |
$1,627.80 |
$1,627.80 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,260.60 |
$1,260.60 |
$1,260.60 |
$1,450.84
|
|
Inj., evomela, 1 mg
|
$105.60 |
$105.60 |
$105.60 |
$17.37
|
|
Inj, factor x, (human), 1iu
|
$32.40 |
$32.40 |
$32.40 |
$26.74
|
|
Inj. fe derisomaltose 10 mg
|
$141.60 |
$141.60 |
$141.60 |
$3,221.52
|
|
Inj, focinvez, 1mg
|
$5.40 |
$5.40 |
$5.40 |
$3.63
|
|
Inj for ext venography
|
$438.00 |
$438.00 |
$438.00 |
$628.80
|
|
Inj., fremanezumab-vfrm 1 mg
|
$6.00 |
$6.00 |
$6.00 |
$1,322.20
|
|
Inj. herceptin hylecta, 10mg
|
$413.40 |
$413.40 |
$413.40 |
$8,193.78
|
|
Inj hrt cath w/s&i sel hrt ang
|
$943.20 |
$943.20 |
$943.20 |
$1,818.15
|
|
Inj hrt cath w/s&i sel left vent
|
$871.20 |
$871.20 |
$871.20 |
$1,250.34
|
|
Inj imip 4 cilas 4 releb 2mg
|
$7.20 |
$7.20 |
$7.20 |
$739.77
|
|
Inj. inebilizumab-cdon, 1 mg
|
$864.00 |
$864.00 |
$864.00 |
$70,014.65
|
|
Inj intralesional <= 7 lsn(s)
|
$387.00 |
$387.00 |
$387.00 |
$235.13
|
|
Inj levocarnitine per 1 gm
|
$205.60 |
$205.60 |
$205.60 |
$136.62
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$107.40 |
$107.40 |
$107.40 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$8.60 |
$8.60 |
$8.60 |
$34.34
|
|
Inj., meropenem, vaborbactam
|
$991.20 |
$991.20 |
$991.20 |
$556.87
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$558.40 |
$558.40 |
$558.40 |
$8,304.04
|
|
Inj multihance
|
$40.80 |
$40.80 |
$40.80 |
$70.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$845.40 |
$845.40 |
$845.40 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$3.60 |
$3.60 |
$3.60 |
$468.10
|
|
Inj nivolumab 2 mg hyaluron
|
$48.00 |
$48.00 |
$48.00 |
$15,599.68
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$85.20 |
$85.20 |
$85.20 |
$66,582.27
|
|
Inj ogivri 10 mg
|
$234.00 |
$234.00 |
$234.00 |
$4,492.28
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$1,264.80 |
$1,264.80 |
$1,264.80 |
$6,614.40
|
|
Inj. pemetrexed, 10 mg
|
$152.40 |
$152.40 |
$152.40 |
$104.72
|
|
Inj, pemivibart, 4500 mg
|
$10,914.60 |
$10,914.60 |
$10,914.60 |
$1,235.55
|
|
Inj peritoneal venous shunt
|
$553.80 |
$553.80 |
$553.80 |
$406.80
|
|
Inj proc elbow arthro
|
$969.00 |
$969.00 |
$969.00 |
$432.00
|
|
Inj proc for lymphang
|
$475.20 |
$475.20 |
$475.20 |
$742.40
|
|
Inj retro urethrocysto
|
$3,691.20 |
$3,691.20 |
$3,691.20 |
$447.74
|
|
Inj secukinumab intrav 1mg
|
$31.80 |
$31.80 |
$31.80 |
$4,413.21
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$540.00 |
$540.00 |
$540.00 |
$67,538.30
|
|
Inj teclistamab cqyv 0.5 mg
|
$58.20 |
$58.20 |
$58.20 |
$17,517.56
|
|
Inj tedizolid phosphate
|
$1,282.20 |
$1,282.20 |
$1,282.20 |
$664.72
|
|
Inj. teprotumumab-trbw 10 mg
|
$726.00 |
$726.00 |
$726.00 |
$35,034.78
|
|
Inj testosterone cypionate
|
$0.80 |
$0.80 |
$0.80 |
$64.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$133.80 |
$133.80 |
$133.80 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$118.80 |
$118.80 |
$118.80 |
$818.00
|
|
Inj., tildrakizumab, 1 mg
|
$424.00 |
$424.00 |
$424.00 |
$26,635.60
|
|
Inj, tislelizumab-jsgr
|
$102.00 |
$102.00 |
$102.00 |
$9,764.09
|
|
Inj, tyenne, 1 mg
|
$12.60 |
$12.60 |
$12.60 |
$3,525.12
|
|
Inj, vancomycin hcl (xellia)
|
$10.20 |
$10.20 |
$10.20 |
$85.20
|
|
Inj w/fluor eval cv device
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$504.40
|
|
Ins cath ren art 1st bi
|
$4,600.80 |
$4,600.80 |
$4,600.80 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$2,781.00 |
$2,781.00 |
$2,781.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$4,097.40 |
$4,097.40 |
$4,097.40 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$3,054.00 |
$3,054.00 |
$3,054.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$2,562.00 |
$2,562.00 |
$2,562.00 |
$490.73
|
|
Insert and remove bone pin
|
$5,275.20 |
$5,275.20 |
$5,275.20 |
$4,433.36
|
|
Insert cath pleura with image
|
$2,040.00 |
$2,040.00 |
$2,040.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,977.80 |
$2,977.80 |
$2,977.80 |
$2,099.70
|
|
Insert drug delivery implant
|
$255.60 |
$255.60 |
$255.60 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$9,621.60 |
$9,621.60 |
$9,621.60 |
$7,571.20
|
|
Insert intrauterine device iud
|
$280.80 |
$280.80 |
$280.80 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$247.20 |
$247.20 |
$247.20 |
$208.01
|
