|
Infectious agent nucleic acid quantification hiv-1
|
$2,128.50 |
$2,128.50 |
$2,128.50 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$188.00 |
$188.00 |
$188.00 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$3,379.17 |
$3,379.17 |
$3,379.17 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$4,189.50 |
$4,189.50 |
$4,189.50 |
$1,062.00
|
|
Influenza virus vaccine, live trivalent intranasal
|
$36.50 |
$36.50 |
$36.50 |
$36.50
|
|
Inf thrc fascial pln blk bi w/wo image
|
$266.50 |
$266.50 |
$266.50 |
$593.50
|
|
Inf thrc fascial pln blk uni w/wo image
|
$156.50 |
$156.50 |
$156.50 |
$780.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$33.50 |
$33.50 |
$33.50 |
$293.25
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$368.00 |
$368.00 |
$368.00 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$200.50 |
$200.50 |
$200.50 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$197.00 |
$197.00 |
$197.00 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$87.00 |
$87.00 |
$87.00 |
$128.00
|
|
Initiation & management bipap/cpap initial day
|
$281.00 |
$281.00 |
$281.00 |
$576.00
|
|
Init pm e/m new pat 65+ yrs
|
$132.50 |
$132.50 |
$132.50 |
$185.90
|
|
Init/sub psych care m 1st 30
|
$41.50 |
$41.50 |
$41.50 |
$94.34
|
|
Inj, abilify asimtufii, 1 mg
|
$8.50 |
$8.50 |
$8.50 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$10.00 |
$10.00 |
$10.00 |
$5,355.30
|
|
Inj, adstiladrin, per tx dos
|
$69,210.00 |
$69,210.00 |
$69,210.00 |
$63,354.77
|
|
Inj, aflibercept hd, 1 mg
|
$344.00 |
$344.00 |
$344.00 |
$2,794.18
|
|
Inj anifrolumab-fnia 1mg
|
$8,160.96 |
$8,160.96 |
$8,160.96 |
$9,878.82
|
|
Inj avacincaptad pegol 0.1mg
|
$157.50 |
$157.50 |
$157.50 |
$3,409.64
|
|
Inj., benralizumab, 1 mg
|
$292.50 |
$292.50 |
$292.50 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$68.50 |
$68.50 |
$68.50 |
$7,612.43
|
|
Inj bimatoprost itc imp1mcg
|
$304.00 |
$304.00 |
$304.00 |
$3,287.96
|
|
Inj, bupivacaine liposome
|
$538.23 |
$538.23 |
$538.23 |
$699.38
|
|
Inj ceftolozane tazobactam
|
$12.50 |
$12.50 |
$12.50 |
$380.80
|
|
Inj disk cerv-thor ea lev
|
$219.50 |
$219.50 |
$219.50 |
$875.28
|
|
Inj dupuytren cord w/enzyme
|
$395.50 |
$395.50 |
$395.50 |
$416.00
|
|
Inj, durolane 1 mg
|
$1,445.72 |
$1,445.72 |
$1,445.72 |
$1,950.93
|
|
Inj dx for sinogram
|
$39.50 |
$39.50 |
$39.50 |
$422.59
|
|
Inject for sacroiliac joint
|
$901.50 |
$901.50 |
$901.50 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$361.50 |
$361.50 |
$361.50 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,133.00 |
$1,133.00 |
$1,133.00 |
$450.72
|
|
Injection, casimersen, 10 mg
|
$181.00 |
$181.00 |
$181.00 |
$2,598.44
|
|
Injection epidural blood patch or clot
|
$676.00 |
$676.00 |
$676.00 |
$1,156.80
|
|
Injection eye drug
|
$93.00 |
$93.00 |
$93.00 |
$644.50
|
|
Injection for bladder x-ray
|
$179.50 |
$179.50 |
$179.50 |
$459.20
|
|
Injection for hip x-ray
|
$85.50 |
$85.50 |
$85.50 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$228.50 |
$228.50 |
$228.50 |
$494.65
|
|
Injection, inclisiran, 1 mg
|
$5,085.60 |
$5,085.60 |
$5,085.60 |
$6,679.35
|
|
Injection into hemorrhoid(s)
|
$192.50 |
$192.50 |
$192.50 |
$1,432.81
|
|
Injection jugular
|
$118.50 |
$118.50 |
$118.50 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$969.00 |
$969.00 |
$969.00 |
$2,277.65
|
|
Injection px peyronie ds
|
$321.00 |
$321.00 |
$321.00 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$33.50 |
$33.50 |
$33.50 |
$670.64
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,135.00 |
$2,135.00 |
$2,135.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,653.00 |
$1,653.00 |
$1,653.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,196.00 |
$1,196.00 |
$1,196.00 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,703.00 |
$3,703.00 |
$3,703.00 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,548.00 |
$3,548.00 |
$3,548.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,703.00 |
$3,703.00 |
$3,703.00 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,415.00 |
$1,415.00 |
$1,415.00 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,703.00 |
$3,703.00 |
$3,703.00 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,653.00 |
$1,653.00 |
$1,653.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,630.00 |
$1,630.00 |
$1,630.00 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,194.00 |
$1,194.00 |
$1,194.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$687.00 |
$687.00 |
$687.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$597.00 |
$597.00 |
$597.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$456.00 |
$456.00 |
$456.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$430.00 |
$430.00 |
$430.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$172.50 |
$172.50 |
$172.50 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$264.00 |
$264.00 |
$264.00 |
$135.60
|
|
Inject sacroiliac joint
|
$1,067.50 |
$1,067.50 |
$1,067.50 |
$1,028.95
|
|
Inject/treat eye socket
|
$69.50 |
$69.50 |
$69.50 |
$381.13
|
|
Inject/treat eye socket
|
$280.00 |
$280.00 |
$280.00 |
$670.02
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$49.00 |
$49.00 |
$49.00 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,425.00 |
$1,425.00 |
$1,425.00 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$911.50 |
$911.50 |
$911.50 |
$1,415.50
|
|
Inj., eravacycline, 1 mg
|
$2.50 |
$2.50 |
$2.50 |
$206.64
|
|
Inj, faricimab-svoa, 0.1mg
|
$36.00 |
$36.00 |
$36.00 |
$4,103.29
|
|
Inj for ext venography
|
$50.00 |
$50.00 |
$50.00 |
$649.95
|
|
Inj intralesional <= 7 lsn(s)
|
$200.50 |
$200.50 |
$200.50 |
$235.13
|
|
Inj, invega hafyera/trinza
|
$19.00 |
$19.00 |
$19.00 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$8,700.00 |
$8,700.00 |
$8,700.00 |
$6,967.29
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$729.00 |
$729.00 |
$729.00 |
$784.00
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$79.00 |
$79.00 |
$79.00 |
$1,496.55
|
|
Inj naloxone hydrochloride
|
$14.10 |
$14.10 |
$14.10 |
$83.16
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$161.50 |
$161.50 |
$161.50 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$128.00 |
$128.00 |
$128.00 |
$2,609.38
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$67.50 |
$67.50 |
$67.50 |
$66,582.27
|
|
Inj, pegcetacoplan, 1mg
|
$226.00 |
$226.00 |
$226.00 |
$3,662.96
|
|
Inj., perseris, 0.5 mg
|
$17.00 |
$17.00 |
$17.00 |
$5,146.85
|
|
Inj proc for lymphang
|
$85.50 |
$85.50 |
$85.50 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$162.50 |
$162.50 |
$162.50 |
$1,106.93
|
|
Inj prohance multipack
|
$38.01 |
$38.01 |
$38.01 |
$9.59
|
|
Inj retacrit esrd on dialysi
|
$1.50 |
$1.50 |
$1.50 |
$349.45
|
|
Inj retro urethrocysto
|
$67.00 |
$67.00 |
$67.00 |
$443.50
|
|
Inj, rimabotulinumtoxinb
|
$19.50 |
$19.50 |
$19.50 |
$746.79
|
|
Inj scleros sol mult veins
|
$80.50 |
$80.50 |
$80.50 |
$675.00
|
|
Inj scleros sol sgl vein
|
$41.00 |
$41.00 |
$41.00 |
$558.97
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$59.00 |
$59.00 |
$59.00 |
$436.80
|
|
Inj, susvimo 0.1 mg
|
$86.00 |
$86.00 |
$86.00 |
$2,598.44
|
|
Inj. teprotumumab-trbw 10 mg
|
$541.00 |
$541.00 |
$541.00 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$0.50 |
$0.50 |
$0.50 |
$123.24
|
|
Inj testosterone cypionate
|
$100.00 |
$100.00 |
$100.00 |
$64.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$77.50 |
$77.50 |
$77.50 |
$1,152.97
|
|
Inj thrc fascial pln blk uni w/wo image
|
$649.00 |
$649.00 |
$649.00 |
$837.50
|
|
Inj triamcinolone ace X-ray 1mg
|
$32.50 |
$32.50 |
$32.50 |
$1,090.75
|
|
Inj, trivisc 1 mg
|
$25.00 |
$25.00 |
$25.00 |
$6.67
|
