|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$123.94 |
$123.94 |
$123.94 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$217.85 |
$217.85 |
$217.85 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$115.48 |
$115.48 |
$115.48 |
$136.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$63.88 |
$63.88 |
$63.88 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$133.25 |
$133.25 |
$133.25 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$776.21 |
$776.21 |
$776.21 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$295.26 |
$295.26 |
$295.26 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$113.79 |
$113.79 |
$113.79 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$177.66 |
$177.66 |
$177.66 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$304.56 |
$304.56 |
$304.56 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$205.58 |
$205.58 |
$205.58 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$241.11 |
$241.11 |
$241.11 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$3,598.60 |
$3,598.60 |
$3,598.60 |
$2,102.08
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,502.20 |
$1,502.20 |
$1,502.20 |
$1,432.80
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$555.40 |
$555.40 |
$555.40 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$207.27 |
$207.27 |
$207.27 |
$645.79
|
|
Inj alymsys 10 mg
|
$2,248.09 |
$2,248.09 |
$2,248.09 |
$676.74
|
|
Inj anifrolumab-fnia 1mg
|
$9,064.26 |
$9,064.26 |
$9,064.26 |
$9,648.88
|
|
Inj., benralizumab, 1 mg
|
$15,455.35 |
$15,455.35 |
$15,455.35 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$11,726.34 |
$11,726.34 |
$11,726.34 |
$8,698.20
|
|
Inj calcitriol per 0.1 mcg
|
$31.80 |
$31.80 |
$31.80 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$31.29 |
$31.29 |
$31.29 |
$34.59
|
|
Inj cefazolin (wg crit care)
|
$25.79 |
$25.79 |
$25.79 |
$25.00
|
|
Inj ceftolozane tazobactam
|
$281.62 |
$281.62 |
$281.62 |
$431.36
|
|
Inj, clindamycin (baxter)
|
$33.89 |
$33.89 |
$33.89 |
$57.48
|
|
Inj cntr knee arthro incl ct/mri
|
$424.70 |
$424.70 |
$424.70 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$2,090.45 |
$2,090.45 |
$2,090.45 |
$2,735.85
|
|
Inj, cyclophosphamd, sandoz
|
$512.02 |
$512.02 |
$512.02 |
$5.30
|
|
Inj disk cerv-thor ea lev
|
$1,047.78 |
$1,047.78 |
$1,047.78 |
$869.80
|
|
Inj, donanemab-azbt, 2 mg
|
$1,261.94 |
$1,261.94 |
$1,261.94 |
$24.05
|
|
Inj dx for sinogram
|
$60.07 |
$60.07 |
$60.07 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$399.74 |
$399.74 |
$399.74 |
$507.10
|
|
Injection, cangrelor
|
$1,575.02 |
$1,575.02 |
$1,575.02 |
$1,943.40
|
|
Injection, caplacizumab-yhdp
|
$20,237.67 |
$20,237.67 |
$20,237.67 |
$18,673.20
|
|
Injection, daratumumab 10 mg
|
$7,911.90 |
$7,911.90 |
$7,911.90 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$99.83 |
$99.83 |
$99.83 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,161.14 |
$1,161.14 |
$1,161.14 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$324.02 |
$324.02 |
$324.02 |
$441.12
|
|
Injection for bladder x-ray
|
$129.44 |
$129.44 |
$129.44 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$390.43 |
$390.43 |
$390.43 |
$504.00
|
|
Injection for ureter x-ray
|
$87.14 |
$87.14 |
$87.14 |
$444.95
|
|
Injection for ureter x-ray
|
$188.66 |
$188.66 |
$188.66 |
$515.21
|
|
Injection, fulvestrant
|
$3,082.30 |
$3,082.30 |
$3,082.30 |
$1,817.65
|
|
Injection, glucarpidase
|
$125,593.03 |
$125,593.03 |
$125,593.03 |
$84,585.36
|
|
Injection, inclisiran, 1 mg
|
$5,970.36 |
$5,970.36 |
$5,970.36 |
$6,830.50
|
|
Injection into brain canal
|
$989.82 |
$989.82 |
$989.82 |
$970.61
|
|
Injection, isavuconazonium
|
$646.20 |
$646.20 |
$646.20 |
$863.93
|
|
Injection of sinus tract
|
$414.97 |
$414.97 |
$414.97 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,044.12 |
$2,044.12 |
$2,044.12 |
$2,154.07
|
|
Injection, peramivir
|
$1,714.86 |
$1,714.86 |
$1,714.86 |
$857.98
|
|
Injection radioactive tracer sentinel node (both sides)
|
$415.81 |
$415.81 |
$415.81 |
$717.20
|
|
Injection, renflexis
|
$1,457.42 |
$1,457.42 |
$1,457.42 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$905.65 |
$905.65 |
$905.65 |
$1,496.00
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,072.31 |
$1,072.31 |
$1,072.31 |
$1,471.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$907.34 |
$907.34 |
$907.34 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$670.04 |
$670.04 |
$670.04 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$590.51 |
$590.51 |
$590.51 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$931.87 |
$931.87 |
$931.87 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$714.87 |
$714.87 |
$714.87 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,753.34 |
$1,753.34 |
$1,753.34 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$561.33 |
$561.33 |
$561.33 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$432.31 |
$432.31 |
$432.31 |
$472.76
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$134.94 |
$134.94 |
$134.94 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$64.30 |
$64.30 |
$64.30 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$210.66 |
$210.66 |
$210.66 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$130.71 |
$130.71 |
$130.71 |
$141.60
|
|
Inj for ext venography
|
$835.85 |
$835.85 |
$835.85 |
$737.55
|
|
Inj, gadopiclenol, 1 ml
|
$42.39 |
$42.39 |
$42.39 |
$70.20
|
|
Inj heparin, pfizer, 1000u
|
$29.35 |
$29.35 |
$29.35 |
$26.85
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$99.83 |
$99.83 |
$99.83 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$92.64 |
$92.64 |
$92.64 |
$1,837.17
|
|
Inj hrt cath w/s&i sel left vent
|
$45.69 |
$45.69 |
$45.69 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$56.69 |
$56.69 |
$56.69 |
$947.65
|
|
Inj imip 4 cilas 4 releb 2mg
|
$553.29 |
$553.29 |
$553.29 |
$743.18
|
|
Inj. inebilizumab-cdon, 1 mg
|
$139,377.52 |
$139,377.52 |
$139,377.52 |
$871.80
|
|
Inj intralesional <= 7 lsn(s)
|
$309.64 |
$309.64 |
$309.64 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$309.64 |
$309.64 |
$309.64 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$10,895.97 |
$10,895.97 |
$10,895.97 |
$7,173.90
|
|
Inj labetalol hcl hikma, 5mg
|
$26.15 |
$26.15 |
$26.15 |
$25.20
|
|
Inj, lecanemab-irmb, 1 mg
|
$2,089.88 |
$2,089.88 |
$2,089.88 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$62.55 |
$62.55 |
$62.55 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$141.72 |
$141.72 |
$141.72 |
$303.45
|
|
Inj mepivacaine hcl/10 ml
|
$34.20 |
$34.20 |
$34.20 |
$31.28
|
|
Inj., meropenem, vaborbactam
|
$339.88 |
$339.88 |
$339.88 |
$586.20
|
|
Inj meropenem (wg crit care)
|
$27.65 |
$27.65 |
$27.65 |
$99.20
|
|
Inj, micafungin (par pharm)
|
$78.52 |
$78.52 |
$78.52 |
$93.73
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$29,376.54 |
$29,376.54 |
$29,376.54 |
$1,496.55
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$765.63 |
$765.63 |
$765.63 |
$1,522.56
|
|
Inj, nithiodote, 3mg / 125mg
|
$325.82 |
$325.82 |
$325.82 |
$228.00
|
|
Inj nivolumab 2 mg hyaluron
|
$24,350.82 |
$24,350.82 |
$24,350.82 |
$16,980.81
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$4,120.87 |
$4,120.87 |
$4,120.87 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$4,120.87 |
$4,120.87 |
$4,120.87 |
$2,164.64
|
|
Inj ogivri 10 mg
|
$4,759.24 |
$4,759.24 |
$4,759.24 |
$4,096.71
|
|
Inj pantoprazole(hikma) 40mg
|
$27.19 |
$27.19 |
$27.19 |
$33.52
|
|
Inj peritoneal venous shunt
|
$552.87 |
$552.87 |
$552.87 |
$386.88
|
|
Inj proc elbow arthro
|
$281.30 |
$281.30 |
$281.30 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$1,428.90 |
$1,428.90 |
$1,428.90 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$370.98 |
$370.98 |
$370.98 |
$922.80
|
|
Inj retacrit esrd on dialysi
|
$611.47 |
$611.47 |
$611.47 |
$343.53
|
|
Inj retro urethrocysto
|
$508.03 |
$508.03 |
$508.03 |
$551.29
|