|
Inj pegfilgrastim-bmez 0.5mg
|
$10,815.07 |
$10,815.07 |
$10,815.07 |
$6,244.73
|
|
Inj pemetrexed, hospira 10mg
|
$565.97 |
$565.97 |
$565.97 |
$64.35
|
|
Inj., perseris, 0.5 mg
|
$2,463.24 |
$2,463.24 |
$2,463.24 |
$5,372.48
|
|
Inj proc elbow arthro
|
$608.94 |
$608.94 |
$608.94 |
$453.60
|
|
Inj proc myelogram lumbar
|
$698.19 |
$698.19 |
$698.19 |
$922.80
|
|
Inj, releuko 1 mcg
|
$519.53 |
$519.53 |
$519.53 |
$519.53
|
|
Inj retro urethrocysto
|
$284.58 |
$284.58 |
$284.58 |
$551.29
|
|
Inj testosterone cypionate
|
$85.68 |
$85.68 |
$85.68 |
$82.58
|
|
Inj, vegzelma, 10 mg
|
$5,635.73 |
$5,635.73 |
$5,635.73 |
$1,444.45
|
|
Inj w/fluor eval cv device
|
$643.11 |
$643.11 |
$643.11 |
$588.90
|
|
Ins cath ren art 1st bi
|
$13,927.59 |
$13,927.59 |
$13,927.59 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$9,104.52 |
$9,104.52 |
$9,104.52 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$12,411.36 |
$12,411.36 |
$12,411.36 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$1,771.23 |
$1,771.23 |
$1,771.23 |
$544.00
|
|
Insert and remove bone pin
|
$6,700.38 |
$6,700.38 |
$6,700.38 |
$4,335.60
|
|
Insert cath pleura with image
|
$4,162.11 |
$4,162.11 |
$4,162.11 |
$2,239.02
|
|
Insert cath pleura without image
|
$4,072.35 |
$4,072.35 |
$4,072.35 |
$2,212.00
|
|
Insert intrauterine device iud
|
$2,472.99 |
$2,472.99 |
$2,472.99 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$1,145.97 |
$1,145.97 |
$1,145.97 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$1,297.44 |
$1,297.44 |
$1,297.44 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$7,972.83 |
$7,972.83 |
$7,972.83 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$10,556.49 |
$10,556.49 |
$10,556.49 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$10,120.44 |
$10,120.44 |
$10,120.44 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,328.37 |
$4,328.37 |
$4,328.37 |
$2,618.40
|
|
Insertion of heart electrode 33211
|
$15,840.09 |
$15,840.09 |
$15,840.09 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$22,043.73 |
$22,043.73 |
$22,043.73 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$19,382.04 |
$19,382.04 |
$19,382.04 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$33,316.77 |
$33,316.77 |
$33,316.77 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$5,483.01 |
$5,483.01 |
$5,483.01 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,483.01 |
$5,483.01 |
$5,483.01 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$72,027.81 |
$72,027.81 |
$72,027.81 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$15,840.09 |
$15,840.09 |
$15,840.09 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$11,834.04 |
$11,834.04 |
$11,834.04 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$14,083.14 |
$14,083.14 |
$14,083.14 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,705.99 |
$6,705.99 |
$6,705.99 |
$5,470.54
|
|
Insertion ureth cath
|
$4,087.65 |
$4,087.65 |
$4,087.65 |
$2,424.12
|
|
Insert pessary/other device
|
$400.86 |
$400.86 |
$400.86 |
$278.90
|
|
Insert prost urethral stent
|
$4,175.37 |
$4,175.37 |
$4,175.37 |
$2,424.12
|
|
Insert swan-ganz cath
|
$2,628.03 |
$2,628.03 |
$2,628.03 |
$2,164.52
|
|
Insert vad art access left hrt arterial access
|
$7,553.61 |
$7,553.61 |
$7,553.61 |
$5,062.80
|
|
Ins icd gen exist mlt leads
|
$58,773.42 |
$58,773.42 |
$58,773.42 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$40,281.84 |
$40,281.84 |
$40,281.84 |
$24,159.72
|
|
Insitu hybridization auto
|
$571.71 |
$571.71 |
$571.71 |
$398.16
|
|
Insitu hybridization manual
|
$611.49 |
$611.49 |
$611.49 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$163.71 |
$163.71 |
$163.71 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$402.90 |
$402.90 |
$402.90 |
$338.40
|
|
Ins lv lead exist pm/icd
|
$33,111.75 |
$33,111.75 |
$33,111.75 |
$12,384.25
|
|
Ins picad w subq port 5yr>
|
$6,205.68 |
$6,205.68 |
$6,205.68 |
$4,341.66
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$2,270.52 |
$2,270.52 |
$2,270.52 |
$1,483.95
|
|
Ins pm gen exist dual lead
|
$58,773.42 |
$58,773.42 |
$58,773.42 |
$24,696.00
|
|
Ins pm gen w/exist mlt leads
|
$23,962.86 |
$23,962.86 |
$23,962.86 |
$15,600.75
|
|
Ins/rpl ldless pm right vent w img & eval
|
$24,293.85 |
$24,293.85 |
$24,293.85 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$23,962.86 |
$23,962.86 |
$23,962.86 |
$11,593.70
|
|
Ins/rpl pm gen exist sgl lead
|
$21,783.63 |
$21,783.63 |
$21,783.63 |
$9,746.29
|
|
Ins/rpl pm w/tv ld atrl
|
$19,382.04 |
$19,382.04 |
$19,382.04 |
$12,384.25
|
|
Inst fibrinolysis agent ini day
|
$2,341.92 |
$2,341.92 |
$2,341.92 |
$1,095.00
|
|
Inst fibrinolysis agent sbsq d
|
$1,817.64 |
$1,817.64 |
$1,817.64 |
$898.12
|
|
Instillation anticarcinogenic agent bladder
|
$697.17 |
$697.17 |
$697.17 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$11,569.86 |
$11,569.86 |
$11,569.86 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$6,705.99 |
$6,705.99 |
$6,705.99 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$7,805.04 |
$7,805.04 |
$7,805.04 |
$4,657.46
|
|
Inst via cath agent pleurds
|
$1,171.47 |
$1,171.47 |
$1,171.47 |
$1,074.68
|
|
Insulin total
|
$13.80 |
$13.80 |
$13.80 |
$67.60
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$13,603.05 |
$13,603.05 |
$13,603.05 |
$9,970.16
|
|
Integra meshed bil wound mat
|
$36,637.92 |
$36,637.92 |
$36,637.92 |
$25,450.30
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$4,112.64 |
$4,112.64 |
$4,112.64 |
$2,908.50
|
|
Interdental fixation
|
$3,124.77 |
$3,124.77 |
$3,124.77 |
$2,133.48
|
|
Interdiscal perq aspir dx
|
$1,941.57 |
$1,941.57 |
$1,941.57 |
$1,222.26
|
|
Int hrhc lig 1 hroid without img
|
$5,783.91 |
$5,783.91 |
$5,783.91 |
$3,245.23
|
|
Intracard echo interv w/s&i
|
$4,619.07 |
$4,619.07 |
$4,619.07 |
$3,982.59
|
|
Intranasal biopsy 30100
|
$3,124.77 |
$3,124.77 |
$3,124.77 |
$1,850.94
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,028.67 |
$1,028.67 |
$1,028.67 |
$1,182.15
|
|
Intrapul surf admin endo tube
|
$257.04 |
$257.04 |
$257.04 |
$239.52
|
|
Intraventricular pacing
|
$6,041.97 |
$6,041.97 |
$6,041.97 |
$5,775.22
|
|
Intrinsic factor antibody
|
$48.20 |
$48.20 |
$48.20 |
$59.95
|
|
Intro cath dialysis circuit
|
$2,628.03 |
$2,628.03 |
$2,628.03 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$9,262.62 |
$9,262.62 |
$9,262.62 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$18,771.57 |
$18,771.57 |
$18,771.57 |
$15,625.00
|
|
Intro catheter aorta
|
$1,024.08 |
$1,024.08 |
$1,024.08 |
$1,861.61
|
|
Intro long gi tube
|
$1,858.44 |
$1,858.44 |
$1,858.44 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$1,602.42 |
$1,602.42 |
$1,602.42 |
$477.85
|
|
Intro windpipe wire/tube
|
$3,523.08 |
$3,523.08 |
$3,523.08 |
$2,316.30
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$6,928.86 |
$6,928.86 |
$6,928.86 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$6,300.03 |
$6,300.03 |
$6,300.03 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$1,157.19 |
$1,157.19 |
$1,157.19 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$156.63 |
$156.63 |
$156.63 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$112.91 |
$112.91 |
$112.91 |
$182.21
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$82,783.25 |
$82,783.25 |
$82,783.25 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$5.61 |
$5.61 |
$5.61 |
$4.77
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$507.20 |
$507.20 |
$507.20 |
$203.92
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$9,139.59 |
$9,139.59 |
$9,139.59 |
$5,837.00
|
|
Iron
|
$215.22 |
$215.22 |
$215.22 |
$70.72
|
|
Iron binding capacity
|
$186.66 |
$186.66 |
$186.66 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$73.22
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$105.83 |
$105.83 |
$105.83 |
$169.30
|
|
Irrigation implantable venous access device for drug delivery systems
|
$240.21 |
$240.21 |
$240.21 |
$154.50
|
|
Ivc venogram s&i
|
$4,628.76 |
$4,628.76 |
$4,628.76 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$230.01 |
$230.01 |
$230.01 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$230.01 |
$230.01 |
$230.01 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$1,011.84 |
$1,011.84 |
$1,011.84 |
$155.00
|
