|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$143.10 |
$143.10 |
$206.17 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$143.10 |
$143.10 |
$219.95 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$226.31 |
$289.91 |
$289.91 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$39.75 |
$197.69 |
$197.69 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$136.21 |
$136.21 |
$279.31 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$190.80 |
$190.80 |
$296.27 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$297.33 |
$297.33 |
$619.04 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$233.20 |
$233.20 |
$571.87 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$104.78 |
$104.78 |
$161.91 |
$2,102.08
|
|
Infliximab-axxq 100 mg intravenous solution
|
$82.91 |
$82.91 |
$83.21 |
$1,096.55
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$154.50 |
$157.14 |
$157.48 |
$1,432.80
|
|
Influenza dna amp prob addl
|
$111.83 |
$111.83 |
$111.83 |
$69.60
|
|
Ingest challenge ini 120 min
|
$328.07 |
$328.07 |
$328.07 |
$627.89
|
|
Initiation & management bipap/cpap initial day
|
$213.06 |
$213.06 |
$1,311.22 |
$645.79
|
|
Inj, abilify maintena, 1 mg
|
$4.92 |
$10.88 |
$11.85 |
$6,796.39
|
|
Inj., benralizumab, 1 mg
|
$73.09 |
$73.09 |
$87.86 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$20.65 |
$20.65 |
$20.65 |
$8,698.20
|
|
Inj calcitriol per 0.1 mcg
|
$1.55 |
$1.55 |
$1.55 |
$31.69
|
|
Inj, clevidipine butyrate
|
$262.15 |
$262.15 |
$262.15 |
$4.86
|
|
Inj cntr knee arthro incl ct/mri
|
$451.56 |
$464.28 |
$464.28 |
$464.28
|
|
Inj, donanemab-azbt, 2 mg
|
$6.62 |
$6.62 |
$6.62 |
$24.05
|
|
Inj dx for sinogram
|
$311.64 |
$311.64 |
$902.59 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,724.09 |
$1,724.09 |
$1,724.09 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,217.94 |
$1,217.94 |
$1,217.94 |
$507.10
|
|
Injection, cangrelor
|
$27.75 |
$27.75 |
$27.75 |
$1,943.40
|
|
Injection, daratumumab 10 mg
|
$76.92 |
$96.91 |
$98.28 |
$5,324.34
|
|
Injection, doxercalciferol
|
$3.23 |
$5.95 |
$7.29 |
$31.83
|
|
Injection during cath supravalvular aortography
|
$495.55 |
$495.55 |
$3,691.45 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$756.31 |
$756.31 |
$1,853.94 |
$1,473.12
|
|
Injection eye drug
|
$628.05 |
$628.05 |
$646.07 |
$648.90
|
|
Injection for bladder x-ray
|
$456.33 |
$456.33 |
$888.28 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$341.32 |
$341.32 |
$1,300.09 |
$504.00
|
|
Injection, fulvestrant
|
$88.11 |
$88.11 |
$150.50 |
$1,817.65
|
|
Injection glatiramer acetate
|
$112.56 |
$112.56 |
$112.56 |
$646.72
|
|
Injection into brain canal
|
$657.20 |
$657.20 |
$657.20 |
$933.60
|
|
Injection, isavuconazonium
|
$1.71 |
$1.71 |
$600.68 |
$863.93
|
|
Injection of sinus tract
|
$822.56 |
$1,015.48 |
$1,015.48 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$10.02 |
$10.02 |
$10.29 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$365.17 |
$365.17 |
$607.38 |
$717.20
|
|
Injection, renflexis
|
$111.37 |
$111.37 |
$111.37 |
$1,356.10
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,596.89 |
$1,596.89 |
$1,596.89 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$655.08 |
$655.08 |
$655.08 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$930.68 |
$930.68 |
$1,539.12 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$663.56 |
$663.56 |
$663.56 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,423.05 |
$1,423.05 |
$1,605.90 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$643.42 |
$643.42 |
$1,002.76 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,453.79 |
$1,453.79 |
$2,005.52 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,487.71 |
$1,487.71 |
$1,487.71 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,053.64 |
$1,053.64 |
$1,351.50 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$657.20 |
$657.20 |
$657.20 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$253.34 |
$260.23 |
$260.23 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$384.25 |
$384.25 |
$384.25 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$117.66 |
$148.93 |
$148.93 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$109.18 |
$109.18 |
$117.66 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$182.85 |
$395.91 |
$395.91 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$342.38 |
$342.38 |
$420.29 |
$141.60
|
|
Inject sacroiliac joint
|
$1,299.56 |
$1,336.66 |
$1,336.66 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$26.85 |
$26.85 |
$26.85 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,034.56 |
$1,034.56 |
$1,034.56 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,005.41 |
$1,005.41 |
$1,005.41 |
$1,450.84
|
|
Inj for ext venography
|
$743.06 |
$743.06 |
$1,556.08 |
$737.55
|
|
Inj for mammo ductogram
|
$1,312.81 |
$1,312.81 |
$1,312.81 |
$433.50
|
|
Inj., guselkumab, 1 mg
|
$85.12 |
$85.12 |
$121.21 |
$100.65
|
|
Inj. herceptin hylecta, 10mg
|
$129.68 |
$129.68 |
$129.68 |
$3,272.67
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$495.55 |
$495.55 |
$2,173.00 |
$1,482.00
|
|
Inj hrt cath w/s&i sel right vent
|
$510.39 |
$510.39 |
$3,024.71 |
$947.65
|
|
Inj intralesional <= 7 lsn(s)
|
$491.84 |
$491.84 |
$491.84 |
$241.74
|
|
Inj, invega hafyera/trinza
|
$24.16 |
$24.16 |
$24.16 |
$18,652.11
|
|
Inj ivig privigen 500 mg
|
$135.29 |
$135.29 |
$135.29 |
$7,173.90
|
|
Inj, lecanemab-irmb, 1 mg
|
$82.58 |
$82.58 |
$82.58 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$75.97 |
$76.17 |
$77.24 |
$136.62
|
|
Inj mepivacaine hcl/10 ml
|
$3.64 |
$3.64 |
$3.64 |
$31.28
|
|
Inj., meropenem, vaborbactam
|
$3.77 |
$3.77 |
$3.77 |
$586.20
|
|
Inj, moxifloxacin 100 mg
|
$25.65 |
$25.65 |
$26.38 |
$153.27
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$913.19 |
$913.19 |
$2,214.87 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,803.06 |
$1,803.06 |
$1,803.06 |
$2,164.64
|
|
Inj ogivri 10 mg
|
$104.02 |
$104.02 |
$104.02 |
$4,096.71
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$123.59 |
$123.59 |
$123.59 |
$6,244.73
|
|
Inj proc for lymphang
|
$913.19 |
$913.19 |
$913.19 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$584.59 |
$584.59 |
$584.59 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$669.92 |
$721.33 |
$721.33 |
$922.80
|
|
Inj proc sialogram
|
$288.32 |
$288.32 |
$613.21 |
$380.80
|
|
Inj progesterone per 50 mg
|
$4.66 |
$4.66 |
$4.66 |
$19.53
|
|
Inj retro urethrocysto
|
$890.40 |
$890.40 |
$890.40 |
$551.29
|
|
Inj, rimabotulinumtoxinb
|
$21.14 |
$21.14 |
$21.14 |
$1,486.10
|
|
Inj scleros sol mult veins
|
$422.94 |
$422.94 |
$1,201.51 |
$687.96
|
|
Inj scleros sol sgl vein
|
$401.21 |
$401.21 |
$610.03 |
$534.40
|
|
Inj secretin synthetic human
|
$54.61 |
$54.61 |
$54.61 |
$1,459.08
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$474.88 |
$474.88 |
$474.88 |
$436.64
|
|
Inj testostero enanthate 1mg
|
$0.53 |
$0.53 |
$0.53 |
$35.40
|
|
Inj testosterone cypionate
|
$0.15 |
$0.22 |
$0.28 |
$82.58
|
|
Inj triamcinolone ace X-ray 1mg
|
$20.14 |
$20.14 |
$20.14 |
$21.45
|
|
Inj w/fluor eval cv device
|
$246.45 |
$246.45 |
$1,121.48 |
$588.90
|
|
Ins cath ren art 1st bi
|
$14,166.37 |
$14,166.37 |
$14,166.37 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$4,059.80 |
$4,059.80 |
$4,059.80 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$15,499.32 |
$15,499.32 |
$15,499.32 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$11,717.77 |
$11,717.77 |
$11,717.77 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$541.13 |
$541.13 |
$541.13 |
$544.00
|
|
Insert cath pleura with image
|
$1,228.54 |
$1,228.54 |
$1,537.00 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,172.36 |
$1,172.36 |
$1,438.42 |
$2,212.00
|
