|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$280.35 |
$280.35 |
$280.35 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$869.05 |
$869.05 |
$869.05 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,057.70 |
$1,057.70 |
$1,057.70 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,536.10 |
$2,536.10 |
$2,536.10 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$822.15 |
$822.15 |
$822.15 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$554.40 |
$554.40 |
$554.40 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$637.35 |
$637.35 |
$637.35 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$100.10 |
$100.10 |
$100.10 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$100.10 |
$100.10 |
$100.10 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$189.70 |
$189.70 |
$189.70 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$132.65 |
$132.65 |
$132.65 |
$141.60
|
|
Injection treatment of eye
|
$1,754.55 |
$1,754.55 |
$1,754.55 |
$2,698.92
|
|
Inject sacroiliac joint
|
$1,419.25 |
$1,419.25 |
$1,419.25 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$1,057.70 |
$1,057.70 |
$1,057.70 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,160.60 |
$1,160.60 |
$1,160.60 |
$1,450.84
|
|
Inj for ext venography
|
$263.20 |
$263.20 |
$263.20 |
$737.55
|
|
Inj for mammo ductogram
|
$206.50 |
$206.50 |
$206.50 |
$433.50
|
|
Inj hrt cath w/s&i sel hrt ang
|
$436.10 |
$436.10 |
$436.10 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$285.60 |
$285.60 |
$285.60 |
$1,192.50
|
|
Inj hrt cath w/s&i sel right vent
|
$252.00 |
$252.00 |
$252.00 |
$947.65
|
|
Inj, immphentiv, 20 mcg
|
$32.87 |
$32.87 |
$32.87 |
$38.40
|
|
Inj intralesional <= 7 lsn(s)
|
$547.40 |
$547.40 |
$547.40 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$547.40 |
$547.40 |
$547.40 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$8,868.61 |
$8,868.61 |
$8,868.61 |
$7,173.90
|
|
Inj levocarnitine per 1 gm
|
$139.67 |
$139.67 |
$139.67 |
$136.62
|
|
Inj melphalan (hepzato) 1 mg
|
$65,625.00 |
$65,625.00 |
$65,625.00 |
$787.79
|
|
Inj mepivacaine hcl/10 ml
|
$32.96 |
$32.96 |
$32.96 |
$31.28
|
|
Inj. mycophenolate mofetil
|
$248.38 |
$248.38 |
$248.38 |
$291.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,336.65 |
$1,336.65 |
$1,336.65 |
$1,522.56
|
|
Inj, nithiodote, 3mg / 125mg
|
$85.17 |
$85.17 |
$85.17 |
$228.00
|
|
Inj ogivri 10 mg
|
$4,764.75 |
$4,764.75 |
$4,764.75 |
$4,096.71
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$8,363.84 |
$8,363.84 |
$8,363.84 |
$6,244.73
|
|
Inj proc ankle arthr
|
$159.60 |
$159.60 |
$159.60 |
$405.31
|
|
Inj proc elbow arthro
|
$142.10 |
$142.10 |
$142.10 |
$453.60
|
|
Inj proc for lymphang
|
$252.00 |
$252.00 |
$252.00 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$510.65 |
$510.65 |
$510.65 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$436.10 |
$436.10 |
$436.10 |
$922.80
|
|
Inj proc sialogram
|
$154.35 |
$154.35 |
$154.35 |
$380.80
|
|
Inj progesterone per 50 mg
|
$32.97 |
$32.97 |
$32.97 |
$19.53
|
|
Inj, releuko 1 mcg
|
$587.49 |
$587.49 |
$587.49 |
$519.53
|
|
Inj retro urethrocysto
|
$196.35 |
$196.35 |
$196.35 |
$551.29
|
|
Inj scleros sol sgl vein
|
$473.20 |
$473.20 |
$473.20 |
$534.40
|
|
Inj tedizolid phosphate
|
$1,118.14 |
$1,118.14 |
$1,118.14 |
$866.93
|
|
Inj testosterone cypionate
|
$43.75 |
$43.75 |
$43.75 |
$82.58
|
|
Inj thiotepa nos 1 mg
|
$544.95 |
$544.95 |
$544.95 |
$4,601.24
|
|
Inj w/fluor eval cv device
|
$299.95 |
$299.95 |
$299.95 |
$588.90
|
|
Ins cath ren art 1st bi
|
$3,102.75 |
$3,102.75 |
$3,102.75 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$2,066.40 |
$2,066.40 |
$2,066.40 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$3,245.20 |
$3,245.20 |
$3,245.20 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$1,027.25 |
$1,027.25 |
$1,027.25 |
$544.00
|
|
Insert and remove bone pin
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$4,335.60
|
|
Insert cath pleura with image
|
$7,214.90 |
$7,214.90 |
$7,214.90 |
$2,239.02
|
|
Insert cath pleura without image
|
$5,410.65 |
$5,410.65 |
$5,410.65 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$4,159.75 |
$4,159.75 |
$4,159.75 |
$9,754.48
|
|
Insert intrauterine device iud
|
$288.40 |
$288.40 |
$288.40 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$209.30 |
$209.30 |
$209.30 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$383.25 |
$383.25 |
$383.25 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$7,280.00 |
$7,280.00 |
$7,280.00 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,330.00 |
$1,330.00 |
$1,330.00 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$4,838.05 |
$4,838.05 |
$4,838.05 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$5,015.15 |
$5,015.15 |
$5,015.15 |
$2,618.40
|
|
Insertion of catheter vein
|
$77.00 |
$77.00 |
$77.00 |
$1,749.80
|
|
Insertion of catheter vein
|
$1,078.70 |
$1,078.70 |
$1,078.70 |
$858.05
|
|
Insertion of heart electrode 33211
|
$5,244.75 |
$5,244.75 |
$5,244.75 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$4,192.30 |
$4,192.30 |
$4,192.30 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$2,841.65 |
$2,841.65 |
$2,841.65 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$8,223.25 |
$8,223.25 |
$8,223.25 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,041.20 |
$2,041.20 |
$2,041.20 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$11,309.20 |
$11,309.20 |
$11,309.20 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,244.75 |
$5,244.75 |
$5,244.75 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,374.05 |
$2,374.05 |
$2,374.05 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,115.00 |
$3,115.00 |
$3,115.00 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$7,777.00 |
$7,777.00 |
$7,777.00 |
$5,470.54
|
|
Insertion ureth cath
|
$1,628.90 |
$1,628.90 |
$1,628.90 |
$2,424.12
|
|
Insert pessary/other device
|
$213.15 |
$213.15 |
$213.15 |
$278.90
|
|
Insert pm/icd lead dual
|
$3,199.35 |
$3,199.35 |
$3,199.35 |
$7,562.63
|
|
Insert prost urethral stent
|
$2,193.80 |
$2,193.80 |
$2,193.80 |
$2,424.12
|
|
Insert/repl sq defib w/eltrd
|
$9,903.95 |
$9,903.95 |
$9,903.95 |
$33,948.20
|
|
Insert sq defib electrode
|
$3,199.35 |
$3,199.35 |
$3,199.35 |
$8,167.68
|
|
Insert swan-ganz cath
|
$718.90 |
$718.90 |
$718.90 |
$2,164.52
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$3,992.10 |
$3,992.10 |
$3,992.10 |
$4,705.13
|
|
Insert tunneled cv cath
|
$7,946.75 |
$7,946.75 |
$7,946.75 |
$6,028.07
|
|
Insert vad art access left hrt arterial access
|
$1,419.95 |
$1,419.95 |
$1,419.95 |
$5,062.80
|
|
Ins icd gen exist sgl lead
|
$10,862.60 |
$10,862.60 |
$10,862.60 |
$24,159.72
|
|
Insitu hybridization auto
|
$50.75 |
$50.75 |
$50.75 |
$398.16
|
|
Insitu hybridization manual
|
$50.75 |
$50.75 |
$50.75 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$549.85 |
$549.85 |
$549.85 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$549.85 |
$549.85 |
$549.85 |
$338.40
|
|
Insj perq vad r hrt venous
|
$1,330.00 |
$1,330.00 |
$1,330.00 |
$4,981.60
|
|
Ins lv lead exist pm/icd
|
$8,223.25 |
$8,223.25 |
$8,223.25 |
$12,384.25
|
|
Ins picad w subq port 5yr>
|
$8,915.55 |
$8,915.55 |
$8,915.55 |
$4,341.66
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$2,346.05 |
$2,346.05 |
$2,346.05 |
$1,483.95
|
|
Ins pm gen w/exist mlt leads
|
$5,906.95 |
$5,906.95 |
$5,906.95 |
$15,600.75
|
|
Ins pq tunnld ip cath w/img
|
$8,024.10 |
$8,024.10 |
$8,024.10 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$13,436.15 |
$13,436.15 |
$13,436.15 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$5,759.60 |
$5,759.60 |
$5,759.60 |
$11,593.70
|
|
Ins/rpl pm gen exist sgl lead
|
$2,282.70 |
$2,282.70 |
$2,282.70 |
$9,746.29
|
|
Ins/rpl pm w/tv ld atrl
|
$2,841.65 |
$2,841.65 |
$2,841.65 |
$12,384.25
|
|
Inst fibrinolysis agent ini day
|
$481.60 |
$481.60 |
$481.60 |
$1,095.00
|
