|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$349.60 |
$349.60 |
$349.60 |
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$460.80 |
$460.80 |
$460.80 |
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$105.60 |
$105.60 |
$114.40 |
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$105.60 |
$105.60 |
$110.40 |
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$266.40 |
$296.00 |
$320.80 |
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$131.20 |
$131.20 |
$131.20 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,227.20 |
$1,227.20 |
$1,227.20 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$58.40 |
$312.80 |
$312.80 |
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$592.00 |
$696.80 |
$757.60 |
|
|
Infectious agent nucleic acid quantification bk virus
|
$179.20 |
$275.20 |
$275.20 |
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$84.80 |
$100.00 |
$100.00 |
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$101.60 |
$137.60 |
$664.00 |
|
|
Infectious agent nucleic acid quantification hiv-1
|
$354.40 |
$413.60 |
$517.60 |
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$348.00 |
$348.00 |
$348.00 |
|
|
Infliximab 100 mg intravenous solution
|
$1,587.80 |
$1,587.80 |
$3,306.57 |
|
|
Infliximab-axxq 100 mg intravenous solution
|
$753.01 |
$763.25 |
$1,350.69 |
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$791.51 |
$801.01 |
$2,599.74 |
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$57.58 |
$57.58 |
$57.58 |
|
|
Influenza virus vaccine, live trivalent intranasal
|
$29.52 |
$29.52 |
$29.52 |
|
|
Inf thrc fascial pln blk bi w/wo image
|
$1,497.60 |
$1,497.60 |
$1,497.60 |
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,497.60 |
$1,497.60 |
$1,497.60 |
|
|
Ingest challenge ea addl 60 min
|
$277.60 |
$277.60 |
$277.60 |
|
|
Ingest challenge ini 120 min
|
$640.00 |
$640.00 |
$640.00 |
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$330.40 |
$333.60 |
$351.20 |
|
|
Inj, acetaminophen (b braun)
|
$113.97 |
$173.29 |
$363.89 |
|
|
Inj acetaminophen -fresenius
|
$75.72 |
$108.34 |
$317.12 |
|
|
Inj, acetaminophen (hikma)
|
$139.40 |
$139.40 |
$326.96 |
|
|
Inj, adalimumab, 1 mg
|
$14,245.32 |
$14,245.32 |
$14,245.32 |
|
|
Inj allopurinol sodium 1 mg
|
$9,092.21 |
$9,092.21 |
$9,092.21 |
|
|
Inj alymsys 10 mg
|
$1,142.79 |
$1,142.79 |
$1,154.47 |
|
|
Inj anifrolumab-fnia 1mg
|
$13,001.40 |
$13,001.40 |
$13,001.40 |
|
|
Inj, artesunate, 1mg
|
$13,999.86 |
$13,999.86 |
$13,999.86 |
|
|
Inj, aspara, rylaze, 0.1 mg
|
$14,410.75 |
$14,410.75 |
$14,410.75 |
|
|
Inj aval alfa-nqpt 4mg
|
$4,921.72 |
$4,921.72 |
$4,921.72 |
|
|
Inj., benralizumab, 1 mg
|
$7,828.28 |
$7,893.17 |
$14,666.09 |
|
|
Inj, bezlotoxumab, 10 mg
|
$10,759.89 |
$10,759.89 |
$10,759.89 |
|
|
Inj, bortezomib freseniuskab
|
$3,665.96 |
$3,665.96 |
$3,665.96 |
|
|
Inj, bupivacaine liposome
|
$120.00 |
$120.00 |
$120.00 |
|
|
Inj calcitriol per 0.1 mcg
|
$316.03 |
$316.03 |
$316.03 |
|
|
Inj cefazolin sodium, hikma
|
$63.90 |
$63.90 |
$63.90 |
|
|
Inj, cefepime hcl (b braun)
|
$103.44 |
$139.30 |
$319.48 |
|
|
Inj, cefiderocol, 10 mg
|
$724.36 |
$724.36 |
$724.36 |
|
|
Inj ceftolozane tazobactam
|
$380.80 |
$380.80 |
$380.80 |
|
|
Inj, clevidipine butyrate
|
$408.64 |
$408.64 |
$408.64 |
|
|
Inj, clindamycin (baxter)
|
$137.88 |
$137.88 |
$155.59 |
|
|
Inj cntr knee arthro incl ct/mri
|
$640.80 |
$640.80 |
$640.80 |
|
|
Inj crotalidae im f(ab')2 eq
|
$1,943.36 |
$1,943.36 |
$3,292.52 |
|
|
Inj cyclophosphamd (ingenus)
|
$1,148.28 |
$1,148.28 |
$1,148.28 |
|
|
Inj, daptomycin (baxter)
|
$181.63 |
$181.63 |
$280.06 |
|
|
Inj, daptomycin (hospira)
|
$85.70 |
$85.70 |
$330.24 |
|
|
Inj daptomycin (xellia)
|
$345.92 |
$345.92 |
$345.92 |
|
|
Inj disk cerv-thor ea lev
|
$2,287.20 |
$2,287.20 |
$2,775.20 |
|
|
Inj dupuytren cord w/enzyme
|
$395.20 |
$395.20 |
$395.20 |
|
|
Inj dx for sinogram
|
$631.20 |
$631.20 |
$638.40 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,743.20 |
$1,743.20 |
$1,743.20 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$712.80 |
$712.80 |
$766.40 |
|
|
Injection, cangrelor
|
$2,075.24 |
$2,075.24 |
$2,075.24 |
|
|
Injection, caplacizumab-yhdp
|
$20,560.00 |
$20,560.00 |
$20,560.00 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$444.80 |
$444.80 |
$444.80 |
|
|
Injection, daratumumab 10 mg
|
$2,731.59 |
$2,731.59 |
$8,083.01 |
|
|
Injection, doxercalciferol
|
$320.31 |
$320.31 |
$320.31 |
|
|
Injection during cath supravalvular aortography
|
$1,148.80 |
$1,148.80 |
$1,648.80 |
|
|
Injection, edaravone, 1 mg
|
$10,458.72 |
$10,458.72 |
$10,458.72 |
|
|
Injection epidural blood patch or clot
|
$1,732.00 |
$1,887.20 |
$2,073.60 |
|
|
Injection for arthrography wrist (both sides)
|
$919.20 |
$919.20 |
$1,208.00 |
|
|
Injection for bladder x-ray
|
$1,176.00 |
$1,305.60 |
$1,456.80 |
|
|
Injection for hip x-ray
|
$239.20 |
$239.20 |
$266.40 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$648.80 |
$648.80 |
$929.60 |
|
|
Injection for ureter x-ray
|
$891.20 |
$891.20 |
$941.60 |
|
|
Injection, fulvestrant
|
$467.77 |
$1,568.57 |
$2,656.81 |
|
|
Injection glatiramer acetate
|
$695.12 |
$695.12 |
$695.12 |
|
|
Injection, glucarpidase
|
$42,003.60 |
$42,003.60 |
$42,003.60 |
|
|
Injection, inclisiran, 1 mg
|
$5,260.16 |
$5,260.16 |
$9,220.28 |
|
|
Injection into brain canal
|
$450.40 |
$450.40 |
$450.40 |
|
|
Injection, isavuconazonium
|
$1,112.65 |
$1,112.65 |
$1,112.65 |
|
|
Injection jaw joint x-ray
|
$296.80 |
$296.80 |
$340.00 |
|
|
Injection jugular
|
$1,745.60 |
$1,745.60 |
$1,745.60 |
|
|
Injection of sinus tract
|
$1,494.40 |
$1,494.40 |
$1,494.40 |
|
|
Injection,onabotulinumtoxina
|
$960.00 |
$960.00 |
$960.00 |
|
|
Injection, pentamidine iseth
|
$207.88 |
$227.92 |
$383.03 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,140.00 |
$1,140.00 |
$1,232.80 |
|
|
Injection, renflexis
|
$676.21 |
$689.86 |
$1,211.11 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,789.60 |
$1,789.60 |
$1,789.60 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,268.80 |
$1,268.80 |
$1,665.60 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$520.80 |
$1,136.00 |
$1,312.80 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,080.80 |
$1,888.00 |
$2,200.80 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,071.20 |
$1,071.20 |
$1,270.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,857.60 |
$1,857.60 |
$2,243.20 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,043.20 |
$1,043.20 |
$1,178.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,857.60 |
$1,857.60 |
$2,035.20 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,982.40 |
$1,982.40 |
$2,174.40 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,982.40 |
$1,982.40 |
$2,091.20 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$466.40 |
$500.00 |
$680.80 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$503.20 |
$607.20 |
$674.40 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$680.80 |
$680.80 |
$680.80 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$112.00 |
$168.00 |
$371.20 |
|
|
Injection treatment of nose
|
$1,000.80 |
$1,000.80 |
$1,000.80 |
|
|
Inject sacroiliac joint
|
$1,096.80 |
$1,144.00 |
$1,711.20 |
|
|
Inj., emapalumab-lzsg, 1 mg
|
$40,644.12 |
$40,644.12 |
$40,644.12 |
|
|
Inj epidural sgl cerv-thor without img
|
$1,195.20 |
$1,195.20 |
$2,098.40 |
|