|
Inj ivig privigen 500 mg
|
$13,122.36 |
$13,122.36 |
$13,122.36 |
$6,967.29
|
|
Inj, kovaltry, 1 i.u
|
$5.07 |
$5.07 |
$5.07 |
$5.10
|
|
Inj, lanreotide, (cipla) 1mg
|
$9,091.85 |
$9,091.85 |
$9,091.85 |
$11,648.70
|
|
Inj, levothyroxine, freskabi
|
$30.91 |
$30.91 |
$30.91 |
$363.97
|
|
Inj melpha hydroch nos 50 mg
|
$1,679.90 |
$1,679.90 |
$1,679.90 |
$1,791.90
|
|
Inj meropenem (wg crit care)
|
$57.32 |
$57.32 |
$57.32 |
$77.97
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$4,334.34 |
$4,334.34 |
$4,334.34 |
$8,304.04
|
|
Inj multihance
|
$220.98 |
$220.98 |
$220.98 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$110.40 |
$110.40 |
$110.40 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$641.10 |
$641.10 |
$641.10 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$411.72 |
$411.72 |
$411.72 |
$472.76
|
|
Inj, nyposi 1 mcg
|
$307.06 |
$307.06 |
$307.06 |
$0.55
|
|
Inj octafluoropropane mic,ml
|
$244.63 |
$244.63 |
$244.63 |
$211.40
|
|
Inj ogivri 10 mg
|
$3,780.08 |
$3,780.08 |
$3,780.08 |
$4,492.28
|
|
Inj., omadacycline, 1 mg
|
$488.26 |
$488.26 |
$488.26 |
$865.34
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$4,013.47 |
$4,013.47 |
$4,013.47 |
$6,371.38
|
|
Inj peritoneal venous shunt
|
$119.70 |
$119.70 |
$119.70 |
$413.70
|
|
Inj proc ankle arthr
|
$119.70 |
$119.70 |
$119.70 |
$407.50
|
|
Inj proc elbow arthro
|
$119.70 |
$119.70 |
$119.70 |
$438.00
|
|
Inj proc myelogram lumbar
|
$218.40 |
$218.40 |
$218.40 |
$859.98
|
|
Inj proc sialogram
|
$149.70 |
$149.70 |
$149.70 |
$380.80
|
|
Inj progesterone per 50 mg
|
$42.05 |
$42.05 |
$42.05 |
$14.93
|
|
Inj, releuko 1 mcg
|
$260.10 |
$260.10 |
$260.10 |
$461.20
|
|
Inj retro urethrocysto
|
$71.10 |
$71.10 |
$71.10 |
$450.00
|
|
Inj, rimabotulinumtoxinb
|
$649.31 |
$649.31 |
$649.31 |
$746.79
|
|
Inj romidepsin non-lyo 0.1mg
|
$8,993.36 |
$8,993.36 |
$8,993.36 |
$9,892.69
|
|
Inj secretin synthetic human
|
$675.81 |
$675.81 |
$675.81 |
$1,285.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$28,528.31 |
$28,528.31 |
$28,528.31 |
$83,709.85
|
|
Inj teclistamab cqyv 0.5 mg
|
$10,681.58 |
$10,681.58 |
$10,681.58 |
$17,517.56
|
|
Inj testosterone cypionate
|
$16.58 |
$16.58 |
$16.58 |
$64.80
|
|
Inj thiotepa nos 1 mg
|
$2,402.64 |
$2,402.64 |
$2,402.64 |
$3,170.16
|
|
Inj, tislelizumab-jsgr
|
$5,698.18 |
$5,698.18 |
$5,698.18 |
$9,764.09
|
|
Inj triamcinolone ace X-ray 1mg
|
$702.89 |
$702.89 |
$702.89 |
$1,090.75
|
|
Inj, tyenne, 1 mg
|
$2,002.27 |
$2,002.27 |
$2,002.27 |
$3,525.12
|
|
Inj, vegzelma, 10 mg
|
$2,770.30 |
$2,770.30 |
$2,770.30 |
$1,430.67
|
|
Inj w/fluor eval cv device
|
$307.20 |
$307.20 |
$307.20 |
$504.40
|
|
Ins cath ren art 1st bi
|
$1,451.70 |
$1,451.70 |
$1,451.70 |
$5,855.00
|
|
Ins cath ren art 1st uni
|
$1,451.70 |
$1,451.70 |
$1,451.70 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$2,558.40 |
$2,558.40 |
$2,558.40 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$140.10 |
$140.10 |
$140.10 |
$464.75
|
|
Insert cath pleura with image
|
$885.60 |
$885.60 |
$885.60 |
$2,164.52
|
|
Insertion catheter bladder temporary simple
|
$61.20 |
$61.20 |
$61.20 |
$234.40
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,074.60 |
$1,074.60 |
$1,074.60 |
$4,747.60
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,024.80 |
$1,024.80 |
$1,024.80 |
$2,585.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,338.30 |
$1,338.30 |
$1,338.30 |
$7,082.35
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$350.10 |
$350.10 |
$350.10 |
$2,549.95
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$3,533.70 |
$3,533.70 |
$3,533.70 |
$12,843.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$3,533.70 |
$3,533.70 |
$3,533.70 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$1,081.80 |
$1,081.80 |
$1,081.80 |
$10,309.20
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$350.10 |
$350.10 |
$350.10 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$490.20 |
$490.20 |
$490.20 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$8,643.90 |
$8,643.90 |
$8,643.90 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,618.70 |
$2,618.70 |
$2,618.70 |
$7,394.45
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,618.70 |
$2,618.70 |
$2,618.70 |
$7,447.01
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$2,752.20 |
$2,752.20 |
$2,752.20 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$886.20 |
$886.20 |
$886.20 |
$5,236.80
|
|
Insert swan-ganz cath
|
$256.80 |
$256.80 |
$256.80 |
$2,271.60
|
|
Insert uteri tandem/ovoids
|
$782.70 |
$782.70 |
$782.70 |
$3,940.41
|
|
Insitu hybridization auto
|
$73.50 |
$73.50 |
$73.50 |
$377.37
|
|
Insitu hybridization (fish)
|
$195.90 |
$195.90 |
$195.90 |
$481.60
|
|
Insitu hybridization manual
|
$99.00 |
$99.00 |
$99.00 |
$393.13
|
|
In situ hybridization per specimen each additional single probe stain
|
$117.00 |
$117.00 |
$117.00 |
$243.00
|
|
In situ hybridization per specimen initial single probe stain
|
$125.40 |
$125.40 |
$125.40 |
$335.00
|
|
Ins pq tunnld ip cath w/img
|
$927.60 |
$927.60 |
$927.60 |
$5,377.00
|
|
Ins/rpl pm gen exist dual lead
|
$3,533.70 |
$3,533.70 |
$3,533.70 |
$11,437.35
|
|
Ins/rpl pm gen exist sgl lead
|
$2,333.40 |
$2,333.40 |
$2,333.40 |
$9,705.00
|
|
Instillation anticarcinogenic agent bladder
|
$293.10 |
$293.10 |
$293.10 |
$645.05
|
|
Ins tun cv cath wo subq prt/pm
|
$886.20 |
$886.20 |
$886.20 |
$4,218.00
|
|
Insulin total
|
$33.90 |
$33.90 |
$33.90 |
$66.64
|
|
Ins vag brachytx device
|
$165.00 |
$165.00 |
$165.00 |
$909.35
|
|
Intens cardiac rehab no exer
|
$79.50 |
$79.50 |
$79.50 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$79.50 |
$79.50 |
$79.50 |
$238.40
|
|
Interdiscal perq aspir dx
|
$601.80 |
$601.80 |
$601.80 |
$1,212.50
|
|
Intrinsic factor antibody
|
$20.10 |
$20.10 |
$20.10 |
$64.41
|
|
Intro cath dialysis circuit
|
$274.80 |
$274.80 |
$274.80 |
$2,073.03
|
|
Intro cath dialysis circuit w/pta
|
$1,938.90 |
$1,938.90 |
$1,938.90 |
$8,761.00
|
|
Intro catheter aorta
|
$140.40 |
$140.40 |
$140.40 |
$1,678.05
|
|
Intro cath svc/ivc
|
$140.40 |
$140.40 |
$140.40 |
$1,346.13
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$944.70 |
$944.70 |
$944.70 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$944.70 |
$944.70 |
$944.70 |
$1,764.10
|
|
Intubation endotracheal emergency procedure
|
$108.90 |
$108.90 |
$108.90 |
$600.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$296.31 |
$296.31 |
$296.31 |
$173.40
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$974.46 |
$974.46 |
$974.46 |
$288.11
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$37,030.19 |
$37,030.19 |
$37,030.19 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$338.72 |
$338.72 |
$338.72 |
$171.37
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,121.39 |
$3,121.39 |
$3,121.39 |
$5,476.68
|
|
Iron
|
$19.50 |
$19.50 |
$19.50 |
$75.40
|
|
Iron dextran 50 mg/ml injection solution
|
$64.96 |
$64.96 |
$64.96 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$226.30 |
$226.30 |
$226.30 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$7.50 |
$7.50 |
$7.50 |
$117.14
|
|
Irrigation implantable venous access device for drug delivery systems
|
$27.00 |
$27.00 |
$27.00 |
$142.56
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$4,447.02 |
$4,447.02 |
$4,447.02 |
$8,273.35
|
|
Ivc venogram s&i
|
$1,451.70 |
$1,451.70 |
$1,451.70 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$33.00 |
$33.00 |
$33.00 |
$192.40
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$11.10 |
$11.10 |
$11.10 |
$160.05
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$21.60 |
$21.60 |
$21.60 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$97.80 |
$97.80 |
$97.80 |
$443.20
|
|
IV inj ra drug dx study
|
$183.90 |
$183.90 |
$183.90 |
$549.70
|
|
Ivp w/wo kub w/wo tomography
|
$190.50 |
$190.50 |
$190.50 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$6,179.06 |
$6,179.06 |
$6,179.06 |
$10,695.32
|