|
Injection for bladder x-ray
|
$202.30 |
$202.30 |
$202.30 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$542.85 |
$542.85 |
$542.85 |
$504.00
|
|
Injection for spleen x-ray
|
$1,254.05 |
$1,254.05 |
$1,254.05 |
$686.40
|
|
Injection for ureter x-ray
|
$173.60 |
$173.60 |
$173.60 |
$444.95
|
|
Injection for ureter x-ray
|
$173.60 |
$173.60 |
$173.60 |
$515.21
|
|
Injection glatiramer acetate
|
$1,650.82 |
$1,650.82 |
$1,650.82 |
$620.97
|
|
Injection, inclisiran, 1 mg
|
$13,223.92 |
$13,223.92 |
$13,223.92 |
$6,359.40
|
|
Injection into brain canal
|
$389.90 |
$389.90 |
$389.90 |
$970.61
|
|
Injection into hemorrhoid(s)
|
$603.05 |
$603.05 |
$603.05 |
$1,278.72
|
|
Injection of sinus tract
|
$1,169.35 |
$1,169.35 |
$1,169.35 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,532.32 |
$2,532.32 |
$2,532.32 |
$2,054.40
|
|
Injection radioactive tracer sentinel node (both sides)
|
$270.20 |
$270.20 |
$270.20 |
$717.20
|
|
Injection, renflexis
|
$1,388.27 |
$1,388.27 |
$1,388.27 |
$1,356.10
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$491.75 |
$491.75 |
$491.75 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$549.15 |
$549.15 |
$549.15 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$754.60 |
$754.60 |
$754.60 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,594.25 |
$1,594.25 |
$1,594.25 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,187.45 |
$3,187.45 |
$3,187.45 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,594.25 |
$1,594.25 |
$1,594.25 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,187.45 |
$3,187.45 |
$3,187.45 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,379.00 |
$1,379.00 |
$1,379.00 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,407.70 |
$1,407.70 |
$1,407.70 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$446.60 |
$446.60 |
$446.60 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$275.80 |
$275.80 |
$275.80 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$275.80 |
$275.80 |
$275.80 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$168.00 |
$168.00 |
$168.00 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$168.00 |
$168.00 |
$168.00 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$214.55 |
$214.55 |
$214.55 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$168.00 |
$168.00 |
$168.00 |
$141.60
|
|
Injection treatment of eye
|
$1,246.35 |
$1,246.35 |
$1,246.35 |
$2,698.92
|
|
Inject sacroiliac joint
|
$2,016.35 |
$2,016.35 |
$2,016.35 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$549.15 |
$549.15 |
$549.15 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$985.95 |
$985.95 |
$985.95 |
$1,450.84
|
|
Inj for ext venography
|
$325.85 |
$325.85 |
$325.85 |
$737.55
|
|
Inj for mammo ductogram
|
$156.45 |
$156.45 |
$156.45 |
$433.50
|
|
Inj heparin, pfizer, 1000u
|
$32.84 |
$32.84 |
$32.84 |
$30.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,104.95 |
$1,104.95 |
$1,104.95 |
$1,482.00
|
|
Inj hrt cath w/s&i sel right vent
|
$1,429.05 |
$1,429.05 |
$1,429.05 |
$947.65
|
|
Inj intralesional <= 7 lsn(s)
|
$242.20 |
$242.20 |
$242.20 |
$241.74
|
|
Inj levocarnitine per 1 gm
|
$139.67 |
$139.67 |
$139.67 |
$124.79
|
|
Inj, levothyroxine, freskabi
|
$302.07 |
$302.07 |
$302.07 |
$302.07
|
|
Inj mepivacaine hcl/10 ml
|
$33.18 |
$33.18 |
$33.18 |
$30.04
|
|
Inj, moxifloxacin 100 mg
|
$193.87 |
$193.87 |
$193.87 |
$120.04
|
|
Inj. mycophenolate mofetil
|
$248.38 |
$248.38 |
$248.38 |
$281.88
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,341.55 |
$1,341.55 |
$1,341.55 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$4,798.78 |
$4,798.78 |
$4,798.78 |
$3,990.07
|
|
Inj peritoneal venous shunt
|
$687.40 |
$687.40 |
$687.40 |
$386.88
|
|
Inj proc ankle arthr
|
$304.15 |
$304.15 |
$304.15 |
$405.31
|
|
Inj proc elbow arthro
|
$304.15 |
$304.15 |
$304.15 |
$453.60
|
|
Inj proc for lymphang
|
$334.25 |
$334.25 |
$334.25 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$878.15 |
$878.15 |
$878.15 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$397.60 |
$397.60 |
$397.60 |
$922.80
|
|
Inj proc sialogram
|
$184.80 |
$184.80 |
$184.80 |
$380.80
|
|
Inj progesterone per 50 mg
|
$33.65 |
$33.65 |
$33.65 |
$21.68
|
|
Inj, releuko 1 mcg
|
$367.19 |
$367.19 |
$367.19 |
$466.81
|
|
Inj retro urethrocysto
|
$116.55 |
$116.55 |
$116.55 |
$551.29
|
|
Inj scleros sol sgl vein
|
$275.80 |
$275.80 |
$275.80 |
$534.40
|
|
Inj sulf hexa lipid microsph
|
$121.87 |
$121.87 |
$121.87 |
$281.30
|
|
Inj testosterone cypionate
|
$43.75 |
$43.75 |
$43.75 |
$80.28
|
|
Inj w/fluor eval cv device
|
$718.55 |
$718.55 |
$718.55 |
$588.90
|
|
Ins cath ren art 1st bi
|
$6,379.80 |
$6,379.80 |
$6,379.80 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$3,113.95 |
$3,113.95 |
$3,113.95 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$6,221.25 |
$6,221.25 |
$6,221.25 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$3,113.95 |
$3,113.95 |
$3,113.95 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$242.20 |
$242.20 |
$242.20 |
$544.00
|
|
Insert and remove bone pin
|
$2,150.75 |
$2,150.75 |
$2,150.75 |
$4,335.60
|
|
Insert cath pleura with image
|
$1,041.95 |
$1,041.95 |
$1,041.95 |
$2,239.02
|
|
Insert cath pleura without image
|
$992.25 |
$992.25 |
$992.25 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$5,786.90 |
$5,786.90 |
$5,786.90 |
$9,754.48
|
|
Insert intrauterine device iud
|
$190.75 |
$190.75 |
$190.75 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$250.60 |
$250.60 |
$250.60 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$275.80 |
$275.80 |
$275.80 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,623.15 |
$4,623.15 |
$4,623.15 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,899.10 |
$1,899.10 |
$1,899.10 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,493.80 |
$8,493.80 |
$8,493.80 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,424.45 |
$2,424.45 |
$2,424.45 |
$2,618.40
|
|
Insertion of catheter vein
|
$806.75 |
$806.75 |
$806.75 |
$1,749.80
|
|
Insertion of catheter vein
|
$1,401.75 |
$1,401.75 |
$1,401.75 |
$858.05
|
|
Insertion of heart electrode 33211
|
$5,172.30 |
$5,172.30 |
$5,172.30 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,715.85 |
$5,715.85 |
$5,715.85 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$5,715.85 |
$5,715.85 |
$5,715.85 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$3,498.60 |
$3,498.60 |
$3,498.60 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,374.05 |
$2,374.05 |
$2,374.05 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,434.60 |
$2,434.60 |
$2,434.60 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$9,055.20 |
$9,055.20 |
$9,055.20 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$7,535.15 |
$7,535.15 |
$7,535.15 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$3,411.80 |
$3,411.80 |
$3,411.80 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,713.85 |
$3,713.85 |
$3,713.85 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,185.90 |
$6,185.90 |
$6,185.90 |
$5,470.54
|
|
Insertion ureth cath
|
$1,503.25 |
$1,503.25 |
$1,503.25 |
$2,424.12
|
|
Insert pessary/other device
|
$275.80 |
$275.80 |
$275.80 |
$278.90
|
|
Insert pm/icd lead dual
|
$3,411.80 |
$3,411.80 |
$3,411.80 |
$7,562.63
|
|
Insert prost urethral stent
|
$1,359.75 |
$1,359.75 |
$1,359.75 |
$2,424.12
|
|
Insert/repl sq defib w/eltrd
|
$14,616.70 |
$14,616.70 |
$14,616.70 |
$33,948.20
|
|
Insert sq defib electrode
|
$3,411.80 |
$3,411.80 |
$3,411.80 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,851.85 |
$1,851.85 |
$1,851.85 |
$2,164.52
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$6,185.90 |
$6,185.90 |
$6,185.90 |
$4,705.13
|
|
Insert tunneled cv cath
|
$6,185.90 |
$6,185.90 |
$6,185.90 |
$4,520.00
|
|
Insert tunneled cv cath
|
$10,447.15 |
$10,447.15 |
$10,447.15 |
$6,028.07
|
|
Insert vad art access left hrt arterial access
|
$1,899.10 |
$1,899.10 |
$1,899.10 |
$5,062.80
|
