|
Inj intralesional <= 7 lsn(s)
|
$34.07 |
$50.40 |
$108.26 |
|
|
Inj intralesional > 7 lsns
|
$91.49 |
$91.49 |
$154.36 |
|
|
Inj ivig privigen 500 mg
|
$3.59 |
$4,070.60 |
$23,928.76 |
|
|
Inj, kovaltry, 1 i.u
|
$4.68 |
$4.68 |
$5.10 |
|
|
Inj, lidocaine w epinephrine
|
$12.37 |
$24.83 |
$51.20 |
|
|
Inj melpha hydroch nos 50 mg
|
$4,595.85 |
$4,595.85 |
$4,595.85 |
|
|
Inj mepivacaine hcl/10 ml
|
$18.76 |
$19.19 |
$45.27 |
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$6,949.35 |
$6,949.35 |
$6,949.35 |
|
|
Inj, moxifloxacin 100 mg
|
$0.84 |
$0.84 |
$84.43 |
|
|
Inj multihance
|
$0.36 |
$0.36 |
$44.70 |
|
|
Inj. mycophenolate mofetil
|
$198.26 |
$271.10 |
$295.34 |
|
|
Inj naloxone hydrochloride
|
$217.74 |
$298.16 |
$324.82 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$292.45 |
$697.73 |
$1,086.15 |
|
|
Inj, nithiodote, 3mg / 125mg
|
$348.39 |
$476.75 |
$519.39 |
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$7,558.02 |
$7,558.02 |
$7,558.02 |
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$5,064.15 |
$5,064.15 |
$5,064.15 |
|
|
Inj octafluoropropane mic,ml
|
$1,153.81 |
$1,153.81 |
$1,153.81 |
|
|
Inj ogivri 10 mg
|
$2,429.14 |
$3,323.96 |
$3,621.22 |
|
|
Inj, olaratumab, 10 mg
|
$4,327.30 |
$4,327.30 |
$4,327.30 |
|
|
Inj, omacetaxine mep, 0.01mg
|
$2,440.60 |
$2,440.60 |
$2,440.60 |
|
|
Inj, panzyga, 500 mg
|
$5,763.34 |
$5,763.34 |
$5,763.34 |
|
|
Inj peritoneal venous shunt
|
$79.50 |
$101.60 |
$809.46 |
|
|
Inj proc ankle arthr
|
$116.40 |
$257.18 |
$1,601.98 |
|
|
Inj proc elbow arthro
|
$146.70 |
$239.32 |
$1,729.61 |
|
|
Inj proc for lymphang
|
$304.85 |
$355.49 |
$1,660.05 |
|
|
Inj proc lumbr disk ea lvl
|
$179.36 |
$334.18 |
$1,040.29 |
|
|
Inj proc myelogram lumbar
|
$166.91 |
$347.13 |
$513.82 |
|
|
Inj proc sialogram
|
$73.70 |
$146.13 |
$214.68 |
|
|
Inj progesterone per 50 mg
|
$75.03 |
$75.03 |
$75.03 |
|
|
Inj prohance multipack
|
$14.76 |
$27.48 |
$45.84 |
|
|
Inj, releuko 1 mcg
|
$466.81 |
$638.37 |
$695.46 |
|
|
Inj retacrit esrd on dialysi
|
$0.46 |
$1.24 |
$2,381.82 |
|
|
Inj retro urethrocysto
|
$49.21 |
$92.72 |
$2,242.33 |
|
|
Inj, rimabotulinumtoxinb
|
$12.65 |
$12.65 |
$20.81 |
|
|
Inj scleros sol mult veins
|
$144.33 |
$180.54 |
$1,238.40 |
|
|
Inj scleros sol sgl vein
|
$72.16 |
$90.27 |
$619.57 |
|
|
Inj secretin synthetic human
|
$496.60 |
$496.60 |
$496.60 |
|
|
Inj sulf hexa lipid microsph
|
$161.21 |
$363.84 |
$396.38 |
|
|
Inj testosterone cypionate
|
$43.93 |
$60.03 |
$65.40 |
|
|
Inj thrc fascial pln blk bi w/wo image
|
$602.22 |
$602.22 |
$602.22 |
|
|
Inj thrc fascial pln blk uni w/wo image
|
$401.48 |
$401.48 |
$401.48 |
|
|
Inj., tildrakizumab, 1 mg
|
$14,921.17 |
$14,921.17 |
$14,921.17 |
|
|
Inj tofersen intrathec 1 mg
|
$26,092.13 |
$26,092.13 |
$26,092.13 |
|
|
Inj, tyenne, 1 mg
|
$4,013.48 |
$4,013.48 |
$4,013.48 |
|
|
Inj, vancomycin hcl (mylan)
|
$20.18 |
$44.32 |
$61.01 |
|
|
Inj vancomycin (xellia) 10mg
|
$224.83 |
$224.83 |
$224.83 |
|
|
Inj vasopressin (am reg) 1 u
|
$0.21 |
$0.21 |
$0.21 |
|
|
Inj w/fluor eval cv device
|
$131.86 |
$237.35 |
$2,063.07 |
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$34,288.32 |
$34,288.32 |
$34,288.32 |
|
|
Ins cath ren art 1st bi
|
$2,018.43 |
$2,703.17 |
$7,531.30 |
|
|
Ins cath ren art 1st uni
|
$1,686.38 |
$2,082.10 |
$6,660.56 |
|
|
Ins cath ren art 2nd+ bi
|
$2,818.20 |
$3,633.18 |
$11,382.28 |
|
|
Ins cath ren art 2nd+ uni
|
$1,816.47 |
$2,666.92 |
$7,606.99 |
|
|
Ins cerv dilator (sep proc)
|
$323.61 |
$1,061.07 |
$1,464.78 |
|
|
Insert abdomen-venous drain
|
$2,286.90 |
$2,875.81 |
$3,320.10 |
|
|
Insert balloon device
|
$757.59 |
$757.59 |
$757.59 |
|
|
Insert brain-fluid device 61215
|
$802.85 |
$802.85 |
$802.85 |
|
|
Insert cannula vein-to-vein hemodialysis
|
$5,869.97 |
$5,869.97 |
$5,869.97 |
|
|
Insert cath pleura with image
|
$587.10 |
$1,056.78 |
$4,265.80 |
|
|
Insert cath pleura without image
|
$732.40 |
$926.50 |
$3,007.49 |
|
|
Insert drug delivery implant
|
$100.17 |
$100.17 |
$196.79 |
|
|
Insert epicard eltrd endo 33203
|
$1,230.98 |
$1,230.98 |
$1,230.98 |
|
|
Insert epicardial lead open 33202
|
$1,174.59 |
$1,174.59 |
$1,174.59 |
|
|
Insert hepatic shunt (tips)
|
$2,319.04 |
$2,963.69 |
$5,864.98 |
|
|
Insert intervert bimech device 22854
|
$513.47 |
$513.47 |
$513.47 |
|
|
Insert intrauterine device iud
|
$157.31 |
$157.31 |
$157.31 |
|
|
Insertion catheter bladder non indwelling
|
$39.14 |
$68.24 |
$218.89 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$971.46 |
$1,573.20 |
$5,928.64 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,168.86 |
$1,904.36 |
$5,346.11 |
|
|
Insertion intra-aortic circulation dev 33970
|
$222.99 |
$222.99 |
$496.40 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,909.36 |
$2,440.12 |
$10,677.38 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$440.12 |
$1,256.22 |
$5,016.81 |
|
|
Insertion of catheter vein
|
$472.01 |
$582.77 |
$4,425.29 |
|
|
Insertion of catheter vein
|
$265.44 |
$339.74 |
$625.02 |
|
|
Insertion of heart electrode 33211
|
$255.99 |
$255.99 |
$255.99 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,818.38 |
$7,519.79 |
$18,000.92 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$4,014.84 |
$5,130.88 |
$18,000.92 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$4,314.00 |
$5,575.49 |
$24,554.51 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$428.09 |
$969.61 |
$2,767.66 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$443.48 |
$976.41 |
$3,954.12 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$6,091.51 |
$7,872.78 |
$58,582.39 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$1,984.43 |
$2,536.06 |
$12,253.39 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,209.91 |
$2,856.12 |
$12,841.06 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,089.94 |
$3,948.87 |
$17,259.67 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$414.01 |
$4,349.27 |
$9,717.98 |
|
|
Insert multi-comp penis pros
|
$1,144.17 |
$1,144.17 |
$1,144.17 |
|
|
Insert pessary/other device
|
$115.76 |
$115.76 |
$115.76 |
|
|
Insert picvad cath
|
$2,847.55 |
$3,441.20 |
$4,537.96 |
|
|
Insert pm/icd lead dual
|
$2,547.85 |
$3,292.88 |
$12,841.06 |
|
|
Insert/repl sq defib w/eltrd
|
$793.94 |
$5,276.92 |
$40,169.21 |
|
|
Insert spine fixation device
|
$534.99 |
$534.99 |
$534.99 |
|
|
Insert sq defib electrode
|
$3,395.15 |
$4,294.93 |
$13,478.11 |
|
|
Insert swan-ganz cath
|
$414.71 |
$1,198.05 |
$3,904.15 |
|
|
Insert tissue expander(s)
|
$1,313.36 |
$1,313.36 |
$2,091.26 |
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$413.07 |
$2,576.29 |
$3,761.73 |
|
|
Insert tunneled cv cath
|
$1,953.83 |
$2,471.63 |
$6,779.74 |
|
|
Insert tunneled cv cath
|
$1,814.94 |
$2,530.84 |
$3,179.98 |
|
|
Insert uteri tandem/ovoids
|
$433.79 |
$531.35 |
$2,426.47 |
|
|
Insert vad art access left hrt arterial access
|
$827.21 |
$1,131.20 |
$11,288.10 |
|
|
Insert vad art access left hrt art & vein access
|
$1,207.84 |
$1,510.87 |
$26,752.61 |
|