|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$28.71 |
$28.71 |
$28.71 |
$94.53
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$142.39 |
$142.39 |
$142.39 |
$250.50
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$155.73 |
$155.73 |
$155.73 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$232.00 |
$232.00 |
$232.00 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$64.96 |
$64.96 |
$64.96 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$61.19 |
$61.19 |
$61.19 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$43.50 |
$43.50 |
$43.50 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$59.74 |
$59.74 |
$59.74 |
$374.50
|
|
Infliximab 100 mg intravenous solution
|
$1,154.18 |
$1,154.18 |
$1,154.18 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$494.16 |
$494.16 |
$494.16 |
$1,095.60
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$935.23 |
$935.23 |
$935.23 |
$1,617.43
|
|
Initiation & management bipap/cpap initial day
|
$251.14 |
$251.14 |
$251.14 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$2,870.52 |
$2,870.52 |
$2,870.52 |
$5,355.30
|
|
Inj, adalimumab, 1 mg
|
$1,204.54 |
$1,204.54 |
$1,204.54 |
$12,098.05
|
|
Inj, adstiladrin, per tx dos
|
$58,182.40 |
$58,182.40 |
$58,182.40 |
$63,354.77
|
|
Inj allopurinol sodium 1 mg
|
$3,940.49 |
$3,940.49 |
$3,940.49 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$2,840.83 |
$2,840.83 |
$2,840.83 |
$1,483.29
|
|
Inj, artesunate, 1mg
|
$4,921.83 |
$4,921.83 |
$4,921.83 |
$14,460.21
|
|
Inj beta interferon sq 1 mcg
|
$318.66 |
$318.66 |
$318.66 |
$2,856.95
|
|
Inj, bezlotoxumab, 10 mg
|
$3,755.62 |
$3,755.62 |
$3,755.62 |
$7,612.43
|
|
Inj calcitriol per 0.1 mcg
|
$15.88 |
$15.88 |
$15.88 |
$22.69
|
|
Inj, cefiderocol, 10 mg
|
$230.12 |
$230.12 |
$230.12 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$172.32 |
$172.32 |
$172.32 |
$408.00
|
|
Inj cntr knee arthro incl ct/mri
|
$222.14 |
$222.14 |
$222.14 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$20,360.97 |
$20,360.97 |
$20,360.97 |
$9,204.29
|
|
Inj cyclophosphamd (ingenus)
|
$1,158.31 |
$1,158.31 |
$1,158.31 |
$742.72
|
|
Inj. denosumab-bbdz, 1 mg
|
$3,170.78 |
$3,170.78 |
$3,170.78 |
$4,416.07
|
|
Inj, durolane 1 mg
|
$388.02 |
$388.02 |
$388.02 |
$1,950.93
|
|
Inj dx for sinogram
|
$48.72 |
$48.72 |
$48.72 |
$413.82
|
|
Inject for sacroiliac joint
|
$64.67 |
$64.67 |
$64.67 |
$1,101.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$232.29 |
$232.29 |
$232.29 |
$500.50
|
|
Injection, belinostat, 10mg
|
$2,130.45 |
$2,130.45 |
$2,130.45 |
$4,446.10
|
|
Injection, caplacizumab-yhdp
|
$8,471.56 |
$8,471.56 |
$8,471.56 |
$16,642.50
|
|
Injection, daratumumab 10 mg
|
$2,906.95 |
$2,906.95 |
$2,906.95 |
$5,164.24
|
|
Injection, doxercalciferol
|
$14.14 |
$14.14 |
$14.14 |
$23.12
|
|
Injection during cath supravalvular aortography
|
$114.26 |
$114.26 |
$114.26 |
$904.17
|
|
Injection epidural blood patch or clot
|
$313.78 |
$313.78 |
$313.78 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$240.99 |
$240.99 |
$240.99 |
$441.12
|
|
Injection for bladder x-ray
|
$78.59 |
$78.59 |
$78.59 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$232.29 |
$232.29 |
$232.29 |
$494.65
|
|
Injection for ureter x-ray
|
$546.07 |
$546.07 |
$546.07 |
$515.21
|
|
Injection, fulvestrant
|
$958.20 |
$958.20 |
$958.20 |
$1,719.16
|
|
Injection glatiramer acetate
|
$177.58 |
$177.58 |
$177.58 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$3,545.83 |
$3,545.83 |
$3,545.83 |
$6,679.35
|
|
Injection, isavuconazonium
|
$360.40 |
$360.40 |
$360.40 |
$787.67
|
|
Injection jugular
|
$145.87 |
$145.87 |
$145.87 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$1,286.79 |
$1,286.79 |
$1,286.79 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$237.22 |
$237.22 |
$237.22 |
$683.28
|
|
Injection, renflexis
|
$744.59 |
$744.59 |
$744.59 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$313.78 |
$313.78 |
$313.78 |
$1,582.12
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$392.95 |
$392.95 |
$392.95 |
$1,939.60
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$359.60 |
$359.60 |
$359.60 |
$1,704.78
|
|
Injection, siltuximab
|
$6,492.16 |
$6,492.16 |
$6,492.16 |
$10,680.75
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$21.75 |
$21.75 |
$21.75 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$21.75 |
$21.75 |
$21.75 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$94.54 |
$94.54 |
$94.54 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$31.90 |
$31.90 |
$31.90 |
$135.20
|
|
Inject sacroiliac joint
|
$313.78 |
$313.78 |
$313.78 |
$963.00
|
|
Inj, eculizumab-aagh, 2 mg
|
$4,512.67 |
$4,512.67 |
$4,512.67 |
$7,410.48
|
|
Inj., eravacycline, 1 mg
|
$112.99 |
$112.99 |
$112.99 |
$206.64
|
|
Inj, etelcalcetide, 0.1 mg
|
$204.04 |
$204.04 |
$204.04 |
$343.35
|
|
Inj. fe derisomaltose 10 mg
|
$3,208.84 |
$3,208.84 |
$3,208.84 |
$3,540.79
|
|
Inj fluphenazine hcl 1.25 mg
|
$323.50 |
$323.50 |
$323.50 |
$37.93
|
|
Inj for ext venography
|
$291.16 |
$291.16 |
$291.16 |
$654.00
|
|
Inj for mammo ductogram
|
$125.28 |
$125.28 |
$125.28 |
$433.50
|
|
Inj fosnetupitant, palonoset
|
$553.46 |
$553.46 |
$553.46 |
$1,110.99
|
|
Inj glofitamab gxbm, 2.5 mg
|
$10,099.62 |
$10,099.62 |
$10,099.62 |
$4,760.67
|
|
Inj glycopyrrolate, glyrx-pf
|
$6.71 |
$6.71 |
$6.71 |
$11.23
|
|
Inj. herceptin hylecta, 10mg
|
$4,620.63 |
$4,620.63 |
$4,620.63 |
$8,193.78
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$114.26 |
$114.26 |
$114.26 |
$1,237.50
|
|
Inj hrt cath w/s&i sel right vent
|
$114.26 |
$114.26 |
$114.26 |
$947.05
|
|
Inj hydroxocobalamin IV 25mg
|
$1,035.76 |
$1,035.76 |
$1,035.76 |
$2,452.32
|
|
Inj. inebilizumab-cdon, 1 mg
|
$46,203.47 |
$46,203.47 |
$46,203.47 |
$75,400.39
|
|
Inj ivig privigen 500 mg
|
$12,684.95 |
$12,684.95 |
$12,684.95 |
$6,967.29
|
|
Inj, kovaltry, 1 i.u
|
$4.90 |
$4.90 |
$4.90 |
$5.10
|
|
Inj, lanreotide, (cipla) 1mg
|
$8,788.79 |
$8,788.79 |
$8,788.79 |
$11,648.70
|
|
Inj, levothyroxine, freskabi
|
$29.88 |
$29.88 |
$29.88 |
$363.97
|
|
Inj melpha hydroch nos 50 mg
|
$1,623.91 |
$1,623.91 |
$1,623.91 |
$2,375.23
|
|
Inj meropenem (wg crit care)
|
$55.41 |
$55.41 |
$55.41 |
$77.97
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$4,189.86 |
$4,189.86 |
$4,189.86 |
$8,304.04
|
|
Inj multihance
|
$213.61 |
$213.61 |
$213.61 |
$79.42
|
|
Inj. mycophenolate mofetil
|
$106.72 |
$106.72 |
$106.72 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$310.01 |
$310.01 |
$310.01 |
$1,414.40
|
|
Inj, nithiodote, 3mg / 125mg
|
$398.00 |
$398.00 |
$398.00 |
$452.89
|
|
Inj, nyposi 1 mcg
|
$296.83 |
$296.83 |
$296.83 |
$0.55
|
|
Inj octafluoropropane mic,ml
|
$236.48 |
$236.48 |
$236.48 |
$211.40
|
|
Inj ogivri 10 mg
|
$3,654.08 |
$3,654.08 |
$3,654.08 |
$4,492.28
|
|
Inj., omadacycline, 1 mg
|
$471.98 |
$471.98 |
$471.98 |
$865.34
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$3,879.68 |
$3,879.68 |
$3,879.68 |
$6,371.38
|
|
Inj peritoneal venous shunt
|
$115.71 |
$115.71 |
$115.71 |
$406.80
|
|
Inj proc ankle arthr
|
$231.42 |
$231.42 |
$231.42 |
$405.31
|
|
Inj proc elbow arthro
|
$232.29 |
$232.29 |
$232.29 |
$432.00
|
|
Inj proc sialogram
|
$144.71 |
$144.71 |
$144.71 |
$373.00
|
|
Inj progesterone per 50 mg
|
$40.65 |
$40.65 |
$40.65 |
$14.93
|
|
Inj, releuko 1 mcg
|
$251.43 |
$251.43 |
$251.43 |
$461.20
|
|
Inj retro urethrocysto
|
$68.73 |
$68.73 |
$68.73 |
$450.00
|
|
Inj, rimabotulinumtoxinb
|
$627.66 |
$627.66 |
$627.66 |
$714.24
|
|
Inj romidepsin non-lyo 0.1mg
|
$8,693.58 |
$8,693.58 |
$8,693.58 |
$9,892.69
|
|
Inj secretin synthetic human
|
$653.28 |
$653.28 |
$653.28 |
$1,285.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$27,577.37 |
$27,577.37 |
$27,577.37 |
$83,709.85
|
