|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$969.10 |
$969.10 |
$969.10 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$700.00 |
$700.00 |
$700.00 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,009.33 |
$1,009.33 |
$1,009.33 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$701.34 |
$701.34 |
$701.34 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,307.03 |
$1,307.03 |
$1,307.03 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$670.50 |
$670.50 |
$670.50 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,470.63 |
$1,470.63 |
$1,470.63 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,123.31 |
$1,123.31 |
$1,123.31 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,172.48 |
$1,172.48 |
$1,172.48 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$309.32 |
$309.32 |
$309.32 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$237.36 |
$237.36 |
$237.36 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$270.44 |
$270.44 |
$270.44 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$28.34 |
$28.34 |
$28.34 |
$145.60
|
|
Injection treatment of nerve
|
$1,744.19 |
$1,744.19 |
$1,744.19 |
$2,054.00
|
|
Inject sacroiliac joint
|
$1,215.84 |
$1,215.84 |
$1,215.84 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$768.39 |
$768.39 |
$768.39 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$923.50 |
$923.50 |
$923.50 |
$1,450.84
|
|
Inj for ext venography
|
$339.27 |
$339.27 |
$339.27 |
$628.80
|
|
Inj for mammo ductogram
|
$209.20 |
$209.20 |
$209.20 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$440.73 |
$440.73 |
$440.73 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$434.63 |
$434.63 |
$434.63 |
$1,818.15
|
|
Inj hrt cath w/s&i sel right vent
|
$344.43 |
$344.43 |
$344.43 |
$999.96
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$718.78 |
$718.78 |
$718.78 |
$1,938.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,049.56 |
$1,049.56 |
$1,049.56 |
$1,413.35
|
|
Inj proc ankle arthr
|
$246.30 |
$246.30 |
$246.30 |
$405.31
|
|
Inj proc elbow arthro
|
$242.72 |
$242.72 |
$242.72 |
$432.00
|
|
Inj proc for lymphang
|
$303.07 |
$303.07 |
$303.07 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$383.08 |
$383.08 |
$383.08 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$203.38 |
$203.38 |
$203.38 |
$838.30
|
|
Inj proc sialogram
|
$170.31 |
$170.31 |
$170.31 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$0.69 |
$0.69 |
$0.69 |
$349.45
|
|
Inj retro urethrocysto
|
$158.68 |
$158.68 |
$158.68 |
$447.74
|
|
Inj scleros sol mult veins
|
$1,382.12 |
$1,382.12 |
$1,382.12 |
$692.90
|
|
Inj scleros sol sgl vein
|
$411.69 |
$411.69 |
$411.69 |
$561.88
|
|
Inj w/fluor eval cv device
|
$162.26 |
$162.26 |
$162.26 |
$504.40
|
|
Ins cath ren art 1st bi
|
$2,734.30 |
$2,734.30 |
$2,734.30 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$1,765.65 |
$1,765.65 |
$1,765.65 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$6,505.64 |
$6,505.64 |
$6,505.64 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$3,054.35 |
$3,054.35 |
$3,054.35 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$376.38 |
$376.38 |
$376.38 |
$490.73
|
|
Insert abdomen-venous drain
|
$3,349.37 |
$3,349.37 |
$3,349.37 |
$4,039.47
|
|
Insert cath pleura with image
|
$1,296.30 |
$1,296.30 |
$1,296.30 |
$2,194.40
|
|
Insert hepatic shunt (tips)
|
$6,038.08 |
$6,038.08 |
$6,038.08 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$87.17 |
$87.17 |
$87.17 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,102.69 |
$2,102.69 |
$2,102.69 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,970.38 |
$1,970.38 |
$1,970.38 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,341.77 |
$3,341.77 |
$3,341.77 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,414.31 |
$1,414.31 |
$1,414.31 |
$2,585.25
|
|
Insertion of catheter vein
|
$1,369.61 |
$1,369.61 |
$1,369.61 |
$1,525.80
|
|
Insertion of catheter vein
|
$396.04 |
$396.04 |
$396.04 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,345.43 |
$9,345.43 |
$9,345.43 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$8,368.73 |
$8,368.73 |
$8,368.73 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$4,983.16 |
$4,983.16 |
$4,983.16 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$866.29 |
$866.29 |
$866.29 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,039.28 |
$1,039.28 |
$1,039.28 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$13,183.37 |
$13,183.37 |
$13,183.37 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,759.78 |
$2,759.78 |
$2,759.78 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$4,401.61 |
$4,401.61 |
$4,401.61 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,446.37 |
$3,446.37 |
$3,446.37 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$2,995.79 |
$2,995.79 |
$2,995.79 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$4,793.18 |
$4,793.18 |
$4,793.18 |
$7,115.90
|
|
Insert/repl sq defib w/eltrd
|
$26,045.80 |
$26,045.80 |
$26,045.80 |
$33,593.55
|
|
Insert sq defib electrode
|
$5,677.79 |
$5,677.79 |
$5,677.79 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,119.33 |
$1,119.33 |
$1,119.33 |
$2,164.52
|
|
Insert uteri tandem/ovoids
|
$1,293.62 |
$1,293.62 |
$1,293.62 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$2,513.48 |
$2,513.48 |
$2,513.48 |
$4,276.00
|
|
Ins icd gen exist mlt leads
|
$26,824.47 |
$26,824.47 |
$26,824.47 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$13,372.01 |
$13,372.01 |
$13,372.01 |
$23,230.50
|
|
Insitu hybridization auto
|
$303.42 |
$303.42 |
$303.42 |
$377.37
|
|
Insitu hybridization (fish)
|
$518.22 |
$518.22 |
$518.22 |
$481.00
|
|
Insitu hybridization manual
|
$303.42 |
$303.42 |
$303.42 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$245.60 |
$245.60 |
$245.60 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$331.69 |
$331.69 |
$331.69 |
$338.40
|
|
Insj perq vad r hrt venous
|
$2,470.57 |
$2,470.57 |
$2,470.57 |
$3,796.00
|
|
Insj phrnc nrv stim sys
|
$24,346.30 |
$24,346.30 |
$24,346.30 |
$53,251.79
|
|
Insj phrnc nrv stim transvns
|
$603.45 |
$603.45 |
$603.45 |
$13,142.86
|
|
Ins lv lead exist pm/icd
|
$6,258.00 |
$6,258.00 |
$6,258.00 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$1,186.34 |
$1,186.34 |
$1,186.34 |
$2,477.24
|
|
Ins mark thor for right perq
|
$1,118.84 |
$1,118.84 |
$1,118.84 |
$2,503.80
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,013.80 |
$1,013.80 |
$1,013.80 |
$1,690.00
|
|
Ins pm gen exist dual lead
|
$25,546.94 |
$25,546.94 |
$25,546.94 |
$24,159.72
|
|
Ins pm gen w/exist mlt leads
|
$7,939.61 |
$7,939.61 |
$7,939.61 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$2,899.24 |
$2,899.24 |
$2,899.24 |
$5,486.00
|
|
Ins/rplcm prq eltrd ra pn ea
|
$2,681.11 |
$2,681.11 |
$2,681.11 |
$2,681.11
|
|
Ins/rplcmt prq eltrd ra pn 1
|
$7,622.24 |
$7,622.24 |
$7,622.24 |
$14,685.79
|
|
Ins/rplc spi npg/rcvr pocket
|
$3,849.12 |
$3,849.12 |
$3,849.12 |
$24,061.80
|
|
Ins/rpl ldless pm right vent w img & eval
|
$11,635.86 |
$11,635.86 |
$11,635.86 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$7,608.83 |
$7,608.83 |
$7,608.83 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$7,246.76 |
$7,246.76 |
$7,246.76 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$7,955.26 |
$7,955.26 |
$7,955.26 |
$11,583.66
|
|
Ins/rpl prph sac/gstr npg/r
|
$4,354.23 |
$4,354.23 |
$4,354.23 |
$18,129.80
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$24,213.03 |
$24,213.03 |
$24,213.03 |
$27,318.11
|
|
Inst fibrinolysis agent ini day
|
$678.99 |
$678.99 |
$678.99 |
$1,043.35
|
|
Inst fibrinolysis agent sbsq d
|
$607.03 |
$607.03 |
$607.03 |
$997.05
|
|
Instillation anticarcinogenic agent bladder
|
$388.40 |
$388.40 |
$388.40 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$1,765.65 |
$1,765.65 |
$1,765.65 |
$4,218.00
|
|
Inst via cath agent pleurds
|
$670.95 |
$670.95 |
$670.95 |
$1,074.68
|
|
Insulin total
|
$13.11 |
$13.11 |
$13.11 |
$66.64
|
|
Ins vag brachytx device
|
$441.19 |
$441.19 |
$441.19 |
$950.00
|
|
Interdiscal perq aspir dx
|
$516.28 |
$516.28 |
$516.28 |
$1,222.26
|