|
Injection for tear sac x-ray
|
$145.50 |
$269.50 |
$269.50 |
|
|
Injection for ureter x-ray
|
$134.50 |
$134.50 |
$134.50 |
|
|
Injection for ureter x-ray
|
$131.50 |
$437.00 |
$1,204.50 |
|
|
Injection, fulvestrant
|
$155.39 |
$487.50 |
$4,210.16 |
|
|
Injection, inclisiran, 1 mg
|
$18.00 |
$7,608.20 |
$12,534.00 |
|
|
Injection into brain canal
|
$454.50 |
$844.50 |
$851.00 |
|
|
Injection into hemorrhoid(s)
|
$186.00 |
$208.00 |
$332.80 |
|
|
Injection into vocal cord
|
$499.50 |
$499.50 |
$499.50 |
|
|
Injection jugular
|
$118.50 |
$118.50 |
$240.50 |
|
|
Injection of sinus tract
|
$1,990.50 |
$1,990.50 |
$2,766.00 |
|
|
Injection,onabotulinumtoxina
|
$7.00 |
$1,000.00 |
$3,230.00 |
|
|
Injection, pentamidine iseth
|
$321.94 |
$321.94 |
$321.94 |
|
|
Injection px peyronie ds
|
$90.50 |
$239.50 |
$544.00 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$32.00 |
$660.60 |
$8,327.76 |
|
|
Injection, renflexis
|
$3,993.72 |
$3,993.72 |
$8,985.87 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$676.50 |
$2,135.00 |
$3,125.00 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$678.50 |
$2,014.50 |
$18,770.50 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$483.00 |
$1,298.50 |
$6,712.50 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$112.00 |
$2,930.00 |
$4,247.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$93.60 |
$1,761.67 |
$5,784.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$169.00 |
$1,731.50 |
$12,920.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$80.00 |
$981.67 |
$5,784.00 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$144.50 |
$3,332.00 |
$12,920.00 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$676.50 |
$1,522.40 |
$2,990.50 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$108.00 |
$1,488.80 |
$2,297.00 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$67.80 |
$779.63 |
$4,745.00 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$65.40 |
$687.00 |
$6,453.50 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$35.40 |
$597.00 |
$3,039.50 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$45.00 |
$316.80 |
$849.00 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$23.50 |
$291.00 |
$1,501.50 |
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$148.00 |
$417.00 |
$603.00 |
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$67.00 |
$244.00 |
$524.00 |
|
|
Injection treatment of eye
|
$2,947.50 |
$2,947.50 |
$2,947.50 |
|
|
Injection treatment of eye
|
$2,834.50 |
$3,111.00 |
$5,072.50 |
|
|
Injection treatment of nerve
|
$2,244.50 |
$2,359.50 |
$6,176.00 |
|
|
Injection treatment of nerve
|
$2,197.00 |
$2,197.00 |
$9,861.00 |
|
|
Injection treatment of nerve
|
$1,001.50 |
$1,017.00 |
$1,860.50 |
|
|
Injection treatment of nose
|
$68.40 |
$68.40 |
$68.40 |
|
|
Inject sacroiliac joint
|
$110.50 |
$1,014.00 |
$2,673.00 |
|
|
Inject/treat eye socket
|
$62.50 |
$312.50 |
$1,658.58 |
|
|
Inject/treat eye socket
|
$280.00 |
$304.50 |
$2,412.17 |
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$49.00 |
$73.50 |
$31,546.00 |
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$52,895.68 |
$52,895.68 |
$52,895.68 |
|
|
Inj epidural sgl cerv-thor without img
|
$160.80 |
$895.00 |
$1,425.00 |
|
|
Inj epidural sgl lumb-sacral without img
|
$854.50 |
$1,136.50 |
$8,425.50 |
|
|
Inj, epinephrine (belcher)
|
$5.43 |
$5.79 |
$675.00 |
|
|
Inj., eravacycline, 1 mg
|
$2.50 |
$3.50 |
$4.00 |
|
|
Inj, erzofri, 1 mg
|
$7,046.94 |
$7,046.94 |
$7,046.94 |
|
|
Inj, eteplirsen, 10 mg
|
$13,440.00 |
$13,440.00 |
$13,440.00 |
|
|
Inj, evinacumab-dgnb, 5mg
|
$51,679.69 |
$73,828.13 |
$90,000.00 |
|
|
Inj., evomela, 1 mg
|
$24,414.50 |
$24,414.50 |
$24,414.50 |
|
|
Inj, faricimab-svoa, 0.1mg
|
$36.00 |
$88.50 |
$10,080.00 |
|
|
Inj. fe derisomaltose 10 mg
|
$6,564.20 |
$7,099.83 |
$7,573.15 |
|
|
Inj for ext venography
|
$49.50 |
$301.00 |
$7,137.00 |
|
|
Inj for mammo ductogram
|
$88.50 |
$355.50 |
$489.00 |
|
|
Inj, fulvestrant (fresenius)
|
$371.95 |
$1,378.05 |
$2,067.08 |
|
|
Inj, gadopiclenol, 1 ml
|
$24.66 |
$71.02 |
$87.00 |
|
|
Inj givosiran 0.5 mg
|
$79,201.84 |
$79,201.84 |
$79,201.84 |
|
|
Inj glofitamab gxbm, 2.5 mg
|
$55,259.14 |
$55,259.14 |
$55,259.14 |
|
|
Inj., guselkumab, 1 mg
|
$27,745.60 |
$27,745.60 |
$27,745.60 |
|
|
Inj heparin, pfizer, 1000u
|
$3.23 |
$3.23 |
$48.00 |
|
|
Inj. herceptin hylecta, 10mg
|
$10,519.29 |
$10,519.29 |
$10,519.29 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$112.50 |
$112.50 |
$2,619.00 |
|
|
Inj hrt cath w/s&i sel hrt ang
|
$2,013.50 |
$2,013.50 |
$2,805.50 |
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,781.00 |
$1,781.00 |
$1,781.00 |
|
|
Inj hrt cath w/s&i sel left vent
|
$112.50 |
$112.50 |
$2,619.00 |
|
|
Inj hrt cath w/s&i sel right vent
|
$112.50 |
$112.50 |
$2,619.00 |
|
|
Inj. inebilizumab-cdon, 1 mg
|
$140,248.50 |
$140,248.50 |
$140,248.50 |
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$1,017.50 |
$1,017.50 |
$1,204.00 |
|
|
Inj intralesional <= 7 lsn(s)
|
$27.50 |
$229.00 |
$1,636.75 |
|
|
Inj intralesional > 7 lsns
|
$50.50 |
$231.00 |
$257.00 |
|
|
Inj, invega hafyera/trinza
|
$19.00 |
$28.50 |
$30.40 |
|
|
Inj ivig privigen 500 mg
|
$55.00 |
$6,570.00 |
$23,652.00 |
|
|
Inj, ixinity, 1 i.u
|
$23,035.20 |
$23,035.20 |
$23,035.20 |
|
|
Inj, kovaltry, 1 i.u
|
$3,262.50 |
$3,262.50 |
$18,258.40 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$11,228.36 |
$11,228.36 |
$13,474.03 |
|
|
Inj, lecanemab-irmb, 1 mg
|
$1,195.14 |
$2,586.20 |
$4,299.89 |
|
|
Inj, lenacapavir, 1 mg
|
$39,000.00 |
$39,000.00 |
$39,000.00 |
|
|
Inj, levothyroxine, freskabi
|
$184.39 |
$184.39 |
$368.67 |
|
|
Inj, lidocaine w epinephrine
|
$37.20 |
$37.20 |
$37.20 |
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$729.00 |
$875.00 |
$1,224.80 |
|
|
Inj mepivacaine hcl/10 ml
|
$14.04 |
$14.04 |
$17.15 |
|
|
Inj, meropenem (b. braun)
|
$24.82 |
$24.83 |
$37.24 |
|
|
Inj., meropenem, vaborbactam
|
$575.40 |
$575.40 |
$575.40 |
|
|
Inj, micafungin (par pharm)
|
$49.61 |
$55.81 |
$601.80 |
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$79.00 |
$118.50 |
$126.40 |
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$40,018.61 |
$40,018.61 |
$77,288.19 |
|
|
Inj multihance
|
$6.00 |
$6.00 |
$6.00 |
|
|
Inj multihance multipack
|
$3.39 |
$23.49 |
$69.17 |
|
|
Inj naloxone hydrochloride
|
$7.44 |
$22.56 |
$63.44 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$807.50 |
$1,235.00 |
$7,275.00 |
|
|
Inj, nithiodote, 3mg / 125mg
|
$443.21 |
$443.21 |
$443.21 |
|
|
Inj nivolumab 2 mg hyaluron
|
$31,772.32 |
$31,772.32 |
$31,772.32 |
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$160.00 |
$1,485.50 |
$3,403.50 |
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$127.00 |
$1,368.50 |
$3,403.50 |
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$67.50 |
$101.00 |
$72,243.36 |
|
|
Inj octafluoropropane mic,ml
|
$478.50 |
$478.50 |
$478.50 |
|
|
Inj onase abepar-xioi treat
|
$1,883,468.18 |
$1,883,468.18 |
$1,883,468.18 |
|
|
Inj pantoprazole(hikma) 40mg
|
$2.79 |
$8.78 |
$26.34 |
|
|
Inj, panzyga, 500 mg
|
$14,068.20 |
$14,068.20 |
$14,068.20 |
|
