|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$76.48 |
$76.48 |
$76.48 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$108.80 |
$108.80 |
$108.80 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$36.16 |
$36.16 |
$36.16 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$107.20 |
$107.20 |
$107.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$113.28 |
$113.28 |
$113.28 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$110.72 |
$110.72 |
$110.72 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$576.00 |
$576.00 |
$576.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$47.68 |
$47.68 |
$47.68 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$107.20 |
$107.20 |
$107.20 |
$147.55
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$113.28 |
$113.28 |
$113.28 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$114.88 |
$114.88 |
$114.88 |
$103.20
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$48.96 |
$48.96 |
$48.96 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$157.12 |
$157.12 |
$157.12 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$171.84 |
$171.84 |
$171.84 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$256.00 |
$256.00 |
$256.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$185.60 |
$185.60 |
$185.60 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$71.68 |
$71.68 |
$71.68 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$67.52 |
$67.52 |
$67.52 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$48.00 |
$48.00 |
$48.00 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$65.92 |
$65.92 |
$65.92 |
$374.00
|
|
Infliximab 100 mg intravenous solution
|
$1,273.57 |
$1,273.57 |
$1,273.57 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$545.28 |
$545.28 |
$545.28 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,031.98 |
$1,031.98 |
$1,031.98 |
$1,537.84
|
|
Initiation & management bipap/cpap initial day
|
$277.12 |
$277.12 |
$277.12 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$3,167.47 |
$3,167.47 |
$3,167.47 |
$5,355.30
|
|
Inj, adalimumab, 1 mg
|
$1,329.14 |
$1,329.14 |
$1,329.14 |
$12,098.05
|
|
Inj, adstiladrin, per tx dos
|
$64,201.27 |
$64,201.27 |
$64,201.27 |
$63,354.77
|
|
Inj allopurinol sodium 1 mg
|
$4,348.12 |
$4,348.12 |
$4,348.12 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$3,134.71 |
$3,134.71 |
$3,134.71 |
$1,280.74
|
|
Inj, artesunate, 1mg
|
$5,430.99 |
$5,430.99 |
$5,430.99 |
$14,460.21
|
|
Inj beta interferon sq 1 mcg
|
$351.63 |
$351.63 |
$351.63 |
$2,856.95
|
|
Inj, bezlotoxumab, 10 mg
|
$4,144.13 |
$4,144.13 |
$4,144.13 |
$7,612.43
|
|
Inj calcitriol per 0.1 mcg
|
$17.52 |
$17.52 |
$17.52 |
$23.28
|
|
Inj, cefiderocol, 10 mg
|
$253.93 |
$253.93 |
$253.93 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$190.15 |
$190.15 |
$190.15 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$122.88 |
$122.88 |
$122.88 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$22,467.28 |
$22,467.28 |
$22,467.28 |
$9,204.29
|
|
Inj cyclophosphamd (ingenus)
|
$1,278.14 |
$1,278.14 |
$1,278.14 |
$742.72
|
|
Inj. denosumab-bbdz, 1 mg
|
$3,498.80 |
$3,498.80 |
$3,498.80 |
$4,615.43
|
|
Inj, durolane 1 mg
|
$428.16 |
$428.16 |
$428.16 |
$1,950.93
|
|
Inj dx for sinogram
|
$53.76 |
$53.76 |
$53.76 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$256.32 |
$256.32 |
$256.32 |
$495.84
|
|
Injection, belinostat, 10mg
|
$2,350.84 |
$2,350.84 |
$2,350.84 |
$4,446.10
|
|
Injection, caplacizumab-yhdp
|
$9,347.93 |
$9,347.93 |
$9,347.93 |
$16,375.33
|
|
Injection, daratumumab 10 mg
|
$3,207.66 |
$3,207.66 |
$3,207.66 |
$5,239.24
|
|
Injection, doxercalciferol
|
$15.60 |
$15.60 |
$15.60 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$126.08 |
$126.08 |
$126.08 |
$952.66
|
|
Injection epidural blood patch or clot
|
$346.24 |
$346.24 |
$346.24 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$132.80 |
$132.80 |
$132.80 |
$428.40
|
|
Injection for bladder x-ray
|
$86.72 |
$86.72 |
$86.72 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$256.32 |
$256.32 |
$256.32 |
$494.65
|
|
Injection for ureter x-ray
|
$602.56 |
$602.56 |
$602.56 |
$515.21
|
|
Injection, fulvestrant
|
$1,057.32 |
$1,057.32 |
$1,057.32 |
$1,817.65
|
|
Injection glatiramer acetate
|
$195.96 |
$195.96 |
$195.96 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$3,912.64 |
$3,912.64 |
$3,912.64 |
$6,679.35
|
|
Injection, isavuconazonium
|
$397.68 |
$397.68 |
$397.68 |
$787.67
|
|
Injection jugular
|
$160.96 |
$160.96 |
$160.96 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$1,419.91 |
$1,419.91 |
$1,419.91 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$261.76 |
$261.76 |
$261.76 |
$670.64
|
|
Injection, renflexis
|
$821.62 |
$821.62 |
$821.62 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$692.48 |
$692.48 |
$692.48 |
$1,582.12
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$433.60 |
$433.60 |
$433.60 |
$1,952.40
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$396.80 |
$396.80 |
$396.80 |
$1,681.24
|
|
Injection, siltuximab
|
$7,163.76 |
$7,163.76 |
$7,163.76 |
$10,680.75
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$150.40 |
$150.40 |
$150.40 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$24.00 |
$24.00 |
$24.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$24.00 |
$24.00 |
$24.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$104.32 |
$104.32 |
$104.32 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$35.20 |
$35.20 |
$35.20 |
$135.60
|
|
Inject sacroiliac joint
|
$692.48 |
$692.48 |
$692.48 |
$1,028.95
|
|
Inj, eculizumab-aagh, 2 mg
|
$4,979.50 |
$4,979.50 |
$4,979.50 |
$7,980.52
|
|
Inj., eravacycline, 1 mg
|
$124.68 |
$124.68 |
$124.68 |
$206.64
|
|
Inj, etelcalcetide, 0.1 mg
|
$225.15 |
$225.15 |
$225.15 |
$343.35
|
|
Inj. fe derisomaltose 10 mg
|
$3,540.79 |
$3,540.79 |
$3,540.79 |
$3,221.52
|
|
Inj fluphenazine hcl 1.25 mg
|
$356.97 |
$356.97 |
$356.97 |
$39.54
|
|
Inj for ext venography
|
$160.96 |
$160.96 |
$160.96 |
$649.95
|
|
Inj for mammo ductogram
|
$138.24 |
$138.24 |
$138.24 |
$399.60
|
|
Inj fosnetupitant, palonoset
|
$610.71 |
$610.71 |
$610.71 |
$1,110.99
|
|
Inj glofitamab gxbm, 2.5 mg
|
$11,144.41 |
$11,144.41 |
$11,144.41 |
$4,760.67
|
|
Inj glycopyrrolate, glyrx-pf
|
$7.40 |
$7.40 |
$7.40 |
$11.23
|
|
Inj. herceptin hylecta, 10mg
|
$5,098.63 |
$5,098.63 |
$5,098.63 |
$7,690.59
|
|
Inj hydroxocobalamin IV 25mg
|
$1,142.91 |
$1,142.91 |
$1,142.91 |
$2,452.32
|
|
Inj. inebilizumab-cdon, 1 mg
|
$50,983.14 |
$50,983.14 |
$50,983.14 |
$70,014.65
|
|
Inj ivig privigen 500 mg
|
$13,997.19 |
$13,997.19 |
$13,997.19 |
$6,967.29
|
|
Inj, kovaltry, 1 i.u
|
$5.40 |
$5.40 |
$5.40 |
$5.07
|
|
Inj, lanreotide, (cipla) 1mg
|
$9,697.98 |
$9,697.98 |
$9,697.98 |
$11,648.70
|
|
Inj, levothyroxine, freskabi
|
$32.97 |
$32.97 |
$32.97 |
$303.45
|
|
Inj melpha hydroch nos 50 mg
|
$1,791.90 |
$1,791.90 |
$1,791.90 |
$1,791.90
|
|
Inj meropenem (wg crit care)
|
$61.15 |
$61.15 |
$61.15 |
$77.97
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$4,623.30 |
$4,623.30 |
$4,623.30 |
$8,304.04
|
|
Inj multihance
|
$235.71 |
$235.71 |
$235.71 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$117.76 |
$117.76 |
$117.76 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$683.84 |
$683.84 |
$683.84 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$439.17 |
$439.17 |
$439.17 |
$462.04
|
|
Inj, nyposi 1 mcg
|
$327.53 |
$327.53 |
$327.53 |
$0.55
|
|
Inj octafluoropropane mic,ml
|
$260.94 |
$260.94 |
$260.94 |
$211.40
|
|
Inj ogivri 10 mg
|
$4,032.08 |
$4,032.08 |
$4,032.08 |
$4,492.28
|
|
Inj., omadacycline, 1 mg
|
$520.81 |
$520.81 |
$520.81 |
$865.34
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$4,281.03 |
$4,281.03 |
$4,281.03 |
$6,403.59
|
|
Inj peritoneal venous shunt
|
$127.68 |
$127.68 |
$127.68 |
$413.70
|