|
Inj cyclophosphamd auromedic
|
$1,858.33 |
$1,858.33 |
$1,858.33 |
$1.16
|
|
Inj cyclophosphamd (ingenus)
|
$4,426.75 |
$4,426.75 |
$4,426.75 |
$1,040.94
|
|
Inj. denosumab-bbdz, 1 mg
|
$18,233.40 |
$18,233.40 |
$18,233.40 |
$6,636.36
|
|
Inj, donanemab-azbt, 2 mg
|
$4,621.34 |
$4,621.34 |
$4,621.34 |
$121.74
|
|
Inj dx for sinogram
|
$392.28 |
$392.28 |
$392.28 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$907.62 |
$907.62 |
$907.62 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$205.80 |
$205.80 |
$205.80 |
$507.10
|
|
Injection, cangrelor
|
$4,599.63 |
$4,599.63 |
$4,599.63 |
$2,546.20
|
|
Injection carpal tunnel therapeutic (both sides)
|
$383.46 |
$383.46 |
$383.46 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$13,545.49 |
$13,545.49 |
$13,545.49 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$598.92 |
$598.92 |
$598.92 |
$1,148.80
|
|
Injection, edaravone, 1 mg
|
$6,723.24 |
$6,723.24 |
$6,723.24 |
$2,345.85
|
|
Injection epidural blood patch or clot
|
$2,095.80 |
$2,095.80 |
$2,095.80 |
$1,473.12
|
|
Injection eye drug
|
$529.20 |
$529.20 |
$529.20 |
$648.90
|
|
Injection for arthrography wrist (both sides)
|
$205.80 |
$205.80 |
$205.80 |
$441.12
|
|
Injection for bladder x-ray
|
$373.80 |
$373.80 |
$373.80 |
$585.00
|
|
Injection for hip x-ray
|
$205.80 |
$205.80 |
$205.80 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$254.10 |
$254.10 |
$254.10 |
$504.00
|
|
Injection for ureter x-ray
|
$186.06 |
$186.06 |
$186.06 |
$515.21
|
|
Injection, fulvestrant
|
$370.35 |
$370.35 |
$6,160.46 |
$2,756.47
|
|
Injection glatiramer acetate
|
$351.28 |
$351.28 |
$351.28 |
$405.93
|
|
Injection, inclisiran, 1 mg
|
$22,244.53 |
$22,244.53 |
$22,244.53 |
$10,366.61
|
|
Injection into hemorrhoid(s)
|
$1,170.54 |
$1,170.54 |
$1,170.54 |
$1,278.72
|
|
Injection, isavuconazonium
|
$2,638.21 |
$2,638.21 |
$2,851.64 |
$646.20
|
|
Injection,onabotulinumtoxina
|
$4,259.72 |
$4,259.72 |
$7,925.99 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$270.48 |
$384.72 |
$384.72 |
$717.20
|
|
Injection, renflexis
|
$3,476.45 |
$3,476.45 |
$3,476.45 |
$1,457.42
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$385.14 |
$385.14 |
$385.14 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$907.62 |
$907.62 |
$907.62 |
$1,017.28
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$422.94 |
$422.94 |
$422.94 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,190.28 |
$1,190.28 |
$1,190.28 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$907.62 |
$907.62 |
$907.62 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$907.62 |
$907.62 |
$907.62 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$717.78 |
$717.78 |
$717.78 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$419.58 |
$419.58 |
$419.58 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$532.98 |
$532.98 |
$532.98 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$280.56 |
$280.56 |
$280.56 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$280.56 |
$280.56 |
$280.56 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$250.32 |
$250.32 |
$250.32 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$236.04 |
$236.04 |
$236.04 |
$141.60
|
|
Injection treatment of eye
|
$2,879.10 |
$2,879.10 |
$2,879.10 |
$2,698.92
|
|
Inject sacroiliac joint
|
$254.52 |
$254.52 |
$254.52 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$57,550.36 |
$57,550.36 |
$57,550.36 |
$66,229.74
|
|
Inj epidural sgl cerv-thor without img
|
$907.62 |
$907.62 |
$907.62 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,200.78 |
$1,200.78 |
$1,200.78 |
$1,450.84
|
|
Inj. fe derisomaltose 10 mg
|
$13,628.48 |
$13,628.48 |
$13,628.48 |
$21.05
|
|
Inj., fibryga, 1 mg
|
$5,659.76 |
$5,659.76 |
$5,659.76 |
$1.11
|
|
Inj fluphenazine hcl 1.25 mg
|
$56.70 |
$56.70 |
$56.70 |
$37.93
|
|
Inj for ext venography
|
$808.92 |
$808.92 |
$808.92 |
$737.55
|
|
Inj, fulvestrant (fresenius)
|
$788.48 |
$788.48 |
$788.48 |
$1,713.99
|
|
Inj, fulvestrant (teva)
|
$1,479.06 |
$1,479.06 |
$1,479.06 |
$26.57
|
|
Inj heparin, pfizer, 1000u
|
$56.70 |
$56.70 |
$96.63 |
$24.28
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$295.68 |
$295.68 |
$295.68 |
$1,482.00
|
|
Inj intralesional <= 7 lsn(s)
|
$254.52 |
$254.52 |
$254.52 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$14,906.40 |
$14,906.40 |
$14,906.40 |
$7,298.71
|
|
Inj, kovaltry, 1 i.u
|
$18,577.60 |
$18,577.60 |
$18,577.60 |
$1.48
|
|
Inj, lecanemab-irmb, 1 mg
|
$4,327.71 |
$4,327.71 |
$4,327.71 |
$1,729.21
|
|
Inj levocarnitine per 1 gm
|
$285.08 |
$285.08 |
$285.08 |
$138.96
|
|
Inj, levothyroxine, freskabi
|
$523.27 |
$523.27 |
$1,171.91 |
$302.07
|
|
Inj melpha hydroch nos 50 mg
|
$1,518.68 |
$1,518.68 |
$1,518.68 |
$1,518.68
|
|
Inj mepivacaine hcl/10 ml
|
$56.70 |
$56.70 |
$56.70 |
$28.41
|
|
Inj meropenem (wg crit care)
|
$229.17 |
$229.17 |
$239.04 |
$104.29
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$16,713.90 |
$16,713.90 |
$16,713.90 |
$788.73
|
|
Inj. mycophenolate mofetil
|
$506.97 |
$506.97 |
$506.97 |
$344.84
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,316.70 |
$1,316.70 |
$1,316.70 |
$1,522.56
|
|
Inj, nithiodote, 3mg / 125mg
|
$69.30 |
$69.30 |
$69.30 |
$389.50
|
|
Inj ogivri 10 mg
|
$9,090.36 |
$9,090.36 |
$9,090.36 |
$3,968.67
|
|
Inj pantoprazole(hikma) 40mg
|
$56.70 |
$56.70 |
$56.70 |
$36.04
|
|
Inj, panzyga, 500 mg
|
$25,944.09 |
$25,944.09 |
$25,944.09 |
$67.46
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$10,187.54 |
$10,187.54 |
$10,187.54 |
$6,403.59
|
|
Inj pemetrexed (accord) 10mg
|
$6,634.78 |
$6,634.78 |
$6,634.78 |
$9.74
|
|
Inj pemetrexed, hospira 10mg
|
$928.16 |
$928.16 |
$928.16 |
$0.62
|
|
Inj proc elbow arthro
|
$114.24 |
$114.24 |
$114.24 |
$453.60
|
|
Inj proc for lymphang
|
$270.48 |
$270.48 |
$270.48 |
$1,372.00
|
|
Inj proc myelogram lumbar
|
$558.18 |
$558.18 |
$558.18 |
$922.80
|
|
Inj progesterone per 50 mg
|
$56.70 |
$56.70 |
$56.70 |
$48.51
|
|
Inj, releuko 1 mcg
|
$1,199.09 |
$1,199.09 |
$1,199.11 |
$557.11
|
|
Inj retro urethrocysto
|
$283.50 |
$283.50 |
$283.50 |
$551.29
|
|
Inj scleros sol sgl vein
|
$443.10 |
$443.10 |
$443.10 |
$534.40
|
|
Inj secretin synthetic human
|
$3,461.85 |
$3,461.85 |
$3,461.85 |
$741.75
|
|
Inj teclistamab cqyv 0.5 mg
|
$24,643.71 |
$24,643.71 |
$24,643.71 |
$14,653.61
|
|
Inj. teprotumumab-trbw 10 mg
|
$62,876.51 |
$62,876.51 |
$62,876.51 |
$47,971.67
|
|
Inj testosterone cypionate
|
$88.68 |
$88.68 |
$96.18 |
$77.15
|
|
Inj, vasopressin (baxter)
|
$241.61 |
$241.61 |
$241.61 |
$32.40
|
|
Inj, vegzelma, 10 mg
|
$12,912.86 |
$12,912.86 |
$12,912.86 |
$10,892.59
|
|
Inj w/fluor eval cv device
|
$326.76 |
$326.76 |
$326.76 |
$588.90
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$54,969.61 |
$54,969.61 |
$54,969.61 |
$3,429.94
|
|
Ins cath ren art 1st bi
|
$8,876.28 |
$8,876.28 |
$8,876.28 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$7,442.82 |
$7,442.82 |
$7,442.82 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$3,237.36 |
$3,237.36 |
$3,237.36 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$411.60 |
$411.60 |
$411.60 |
$544.00
|
|
Insert and remove bone pin
|
$4,192.86 |
$4,192.86 |
$4,192.86 |
$4,335.60
|
|
Insert cath pleura with image
|
$2,095.80 |
$2,095.80 |
$2,095.80 |
$2,239.02
|
|
Insert cath pleura without image
|
$3,762.78 |
$3,762.78 |
$3,762.78 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$3,491.46 |
$3,491.46 |
$3,491.46 |
$9,754.48
|
|
Insert intrauterine device iud
|
$117.60 |
$117.60 |
$117.60 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$370.02 |
$370.02 |
$370.02 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$399.00 |
$399.00 |
$399.00 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,495.28 |
$5,495.28 |
$5,495.28 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$2,549.95
|