|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$149.13 |
$149.13 |
$149.13 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$263.61 |
$263.61 |
$263.61 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$233.91 |
$233.91 |
$233.91 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$40.68 |
$40.68 |
$40.68 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$152.19 |
$152.19 |
$152.19 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$76.14 |
$76.14 |
$76.14 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$3,232.35 |
$3,232.35 |
$3,232.35 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$285.66 |
$285.66 |
$285.66 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$314.10 |
$314.10 |
$314.10 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$363.96 |
$363.96 |
$363.96 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$294.39 |
$294.39 |
$294.39 |
$381.55
|
|
Infliximab 100 mg intravenous solution
|
$205.20 |
$205.20 |
$205.20 |
$2,791.24
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,654.83 |
$1,654.83 |
$1,654.83 |
$1,654.83
|
|
Initial foot exam pt lops
|
$125.64 |
$125.64 |
$125.64 |
$152.50
|
|
Initiation & management bipap/cpap initial day
|
$696.33 |
$696.33 |
$696.33 |
$645.79
|
|
Inj, abilify asimtufii, 1 mg
|
$784.17 |
$784.17 |
$784.17 |
$5.95
|
|
Inj, abilify maintena, 1 mg
|
$1,613.97 |
$1,613.97 |
$1,613.97 |
$6,324.82
|
|
Inj anifrolumab-fnia 1mg
|
$1,038.87 |
$1,038.87 |
$1,038.87 |
$9,878.82
|
|
Inj., aristada initio, 1 mg
|
$1,052.01 |
$1,052.01 |
$1,052.01 |
$1,052.01
|
|
Inj, aspara, rylaze, 0.1 mg
|
$1,896.48 |
$1,896.48 |
$1,896.48 |
$81.97
|
|
Inj calcitriol per 0.1 mcg
|
$3.42 |
$3.42 |
$3.42 |
$33.36
|
|
Inj, cefiderocol, 10 mg
|
$79.20 |
$79.20 |
$79.20 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$163.62 |
$163.62 |
$163.62 |
$447.36
|
|
Inj, clevidipine butyrate
|
$4.86 |
$4.86 |
$4.86 |
$3.39
|
|
Inj crotalidae im f(ab')2 eq
|
$2,388.06 |
$2,388.06 |
$2,388.06 |
$2,836.95
|
|
Inj dx for sinogram
|
$275.67 |
$275.67 |
$275.67 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$454.68 |
$454.68 |
$454.68 |
$507.10
|
|
Injection, belinostat, 10mg
|
$2,863.53 |
$2,863.53 |
$2,863.53 |
$5,341.40
|
|
Injection, cangrelor
|
$1,305.72 |
$1,305.72 |
$1,305.72 |
$2,546.20
|
|
Injection, daratumumab 10 mg
|
$3,147.75 |
$3,147.75 |
$3,147.75 |
$7,107.73
|
|
Injection, doxercalciferol
|
$58.41 |
$58.41 |
$58.41 |
$30.35
|
|
Injection during cath supravalvular aortography
|
$7,393.68 |
$7,393.68 |
$7,393.68 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,936.98 |
$1,936.98 |
$1,936.98 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$165.06 |
$165.06 |
$165.06 |
$441.12
|
|
Injection for bladder x-ray
|
$53.64 |
$53.64 |
$53.64 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$390.78 |
$390.78 |
$390.78 |
$504.00
|
|
Injection for spleen x-ray
|
$207.90 |
$207.90 |
$207.90 |
$686.40
|
|
Injection for ureter x-ray
|
$83.16 |
$83.16 |
$83.16 |
$444.95
|
|
Injection, fulvestrant
|
$107.55 |
$107.55 |
$107.55 |
$2,756.47
|
|
Injection glatiramer acetate
|
$1,210.77 |
$1,210.77 |
$1,210.77 |
$405.93
|
|
Injection, inclisiran, 1 mg
|
$5.22 |
$5.22 |
$5.22 |
$10,366.61
|
|
Injection into brain canal
|
$702.45 |
$702.45 |
$702.45 |
$970.61
|
|
Injection into brain canal
|
$672.66 |
$672.66 |
$672.66 |
$933.60
|
|
Injection, isavuconazonium
|
$477.45 |
$477.45 |
$477.45 |
$646.20
|
|
Injection,onabotulinumtoxina
|
$16.56 |
$16.56 |
$16.56 |
$2,154.07
|
|
Injection, peramivir
|
$553.86 |
$553.86 |
$553.86 |
$1,257.68
|
|
Injection radioactive tracer sentinel node (both sides)
|
$240.48 |
$240.48 |
$240.48 |
$717.20
|
|
Injection, renflexis
|
$325.53 |
$325.53 |
$325.53 |
$1,457.42
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,112.85 |
$1,112.85 |
$1,112.85 |
$1,160.25
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$681.75 |
$681.75 |
$681.75 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$533.34 |
$533.34 |
$533.34 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$681.75 |
$681.75 |
$681.75 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,355.22 |
$1,355.22 |
$1,355.22 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,064.07 |
$1,064.07 |
$1,064.07 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,245.06 |
$1,245.06 |
$1,245.06 |
$1,758.12
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$180.00 |
$180.00 |
$180.00 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$169.20 |
$169.20 |
$169.20 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$309.60 |
$309.60 |
$309.60 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$166.05 |
$166.05 |
$166.05 |
$141.60
|
|
Inject sacroiliac joint
|
$271.98 |
$271.98 |
$271.98 |
$1,090.00
|
|
Inj., emapalumab-lzsg, 1 mg
|
$607.86 |
$607.86 |
$607.86 |
$381.64
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$15,669.18 |
$15,669.18 |
$15,669.18 |
$15,669.18
|
|
Inj, factor x, (human), 1iu
|
$4.23 |
$4.23 |
$4.23 |
$9.91
|
|
Inj for ext venography
|
$456.75 |
$456.75 |
$456.75 |
$737.55
|
|
Inj, granisetron, xr, 0.1 mg
|
$83.97 |
$83.97 |
$83.97 |
$5.71
|
|
Inj., guselkumab, 1 mg
|
$6,292.71 |
$6,292.71 |
$6,292.71 |
$74.86
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$912.15 |
$912.15 |
$912.15 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$4,339.89 |
$4,339.89 |
$4,339.89 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$5,370.30 |
$5,370.30 |
$5,370.30 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$4,339.89 |
$4,339.89 |
$4,339.89 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$4,339.89 |
$4,339.89 |
$4,339.89 |
$947.65
|
|
Inj human fibrinogen con nos
|
$4.41 |
$4.41 |
$4.41 |
$1.52
|
|
Inj hydroxyprogst capoat nos
|
$1,495.98 |
$1,495.98 |
$1,495.98 |
$1,495.98
|
|
Inj. inebilizumab-cdon, 1 mg
|
$565.92 |
$565.92 |
$565.92 |
$494.43
|
|
Inj ivig privigen 500 mg
|
$7,173.90 |
$7,173.90 |
$7,173.90 |
$7,298.71
|
|
Inj levocarnitine per 1 gm
|
$38.61 |
$38.61 |
$38.61 |
$138.96
|
|
Inj melpha hydroch nos 50 mg
|
$503.55 |
$503.55 |
$503.55 |
$1,518.68
|
|
Inj mepivacaine hcl/10 ml
|
$16.38 |
$16.38 |
$16.38 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$77.04 |
$77.04 |
$77.04 |
$618.43
|
|
Inj, moxifloxacin 100 mg
|
$100.44 |
$100.44 |
$100.44 |
$190.81
|
|
Inj multihance
|
$4.05 |
$4.05 |
$4.05 |
$119.25
|
|
Inj. naxitamab-gqgk, 1 mg
|
$947.70 |
$947.70 |
$947.70 |
$642.15
|
|
Inj ogivri 10 mg
|
$38.16 |
$38.16 |
$38.16 |
$3,968.67
|
|
Inj ontruzant 10 mg
|
$39.24 |
$39.24 |
$39.24 |
$34.17
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$1,695.87 |
$1,695.87 |
$1,695.87 |
$6,403.59
|
|
Inj proc ankle arthr
|
$268.11 |
$268.11 |
$268.11 |
$405.31
|
|
Inj proc elbow arthro
|
$268.11 |
$268.11 |
$268.11 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$235.53 |
$235.53 |
$235.53 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$136.35 |
$136.35 |
$136.35 |
$922.80
|
|
Inj proc sialogram
|
$91.53 |
$91.53 |
$91.53 |
$380.80
|
|
Inj progesterone per 50 mg
|
$8.91 |
$8.91 |
$8.91 |
$48.51
|
|
Inj retro urethrocysto
|
$213.66 |
$213.66 |
$213.66 |
$551.29
|
|
Inj, rimabotulinumtoxinb
|
$16.56 |
$16.56 |
$16.56 |
$16.56
|
|
Inj secretin synthetic human
|
$233.82 |
$233.82 |
$233.82 |
$741.75
|
|
Inj sulf hexa lipid microsph
|
$39.60 |
$39.60 |
$39.60 |
$315.78
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$47,819.16 |
$47,819.16 |
$47,819.16 |
$92,981.70
|
|
Inj. teprotumumab-trbw 10 mg
|
$147.06 |
$147.06 |
$147.06 |
$47,971.67
|
|
Inj testostero enanthate 1mg
|
$50.85 |
$50.85 |
$50.85 |
$50.85
|
|
Inj testosterone cypionate
|
$72.99 |
$72.99 |
$72.99 |
$77.15
|
|
Inj., tildrakizumab, 1 mg
|
$74.52 |
$74.52 |
$74.52 |
$24,563.40
|