|
Inj, bezlotoxumab, 10 mg
|
$8,646.49 |
$8,646.49 |
$8,646.49 |
$9,702.65
|
|
Inj cefazolin sodium, hikma
|
$107.61 |
$107.61 |
$107.61 |
$56.70
|
|
Inj cntr knee arthro incl ct/mri
|
$219.23 |
$219.23 |
$219.23 |
$464.28
|
|
Inj, durolane 1 mg
|
$4,082.24 |
$4,082.24 |
$4,082.24 |
$3,382.31
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,866.92 |
$1,866.92 |
$1,866.92 |
$507.10
|
|
Injection, daratumumab 10 mg
|
$21,576.55 |
$21,576.55 |
$21,576.55 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$3,095.44 |
$3,095.44 |
$3,095.44 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$877.79 |
$877.79 |
$877.79 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$271.85 |
$271.85 |
$271.85 |
$441.12
|
|
Injection for bladder x-ray
|
$310.41 |
$310.41 |
$310.41 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$291.09 |
$291.09 |
$291.09 |
$504.00
|
|
Injection, fulvestrant
|
$12,177.93 |
$12,177.93 |
$12,177.93 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$27,269.21 |
$27,269.21 |
$27,269.21 |
$10,366.61
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,252.23 |
$2,252.23 |
$2,252.23 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$979.80 |
$979.80 |
$979.80 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,110.80 |
$3,110.80 |
$3,110.80 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,679.27 |
$1,679.27 |
$1,679.27 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,467.56 |
$3,467.56 |
$3,467.56 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,196.84 |
$2,196.84 |
$2,196.84 |
$1,758.12
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$979.80 |
$979.80 |
$979.80 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$390.48 |
$390.48 |
$390.48 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$437.34 |
$437.34 |
$437.34 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$443.85 |
$443.85 |
$443.85 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$390.48 |
$390.48 |
$390.48 |
$141.60
|
|
Inject sacroiliac joint
|
$2,088.21 |
$2,088.21 |
$2,088.21 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$124,625.37 |
$124,625.37 |
$124,625.37 |
$66,229.74
|
|
Inj for ext venography
|
$522.35 |
$522.35 |
$522.35 |
$737.55
|
|
Inj, fulvestrant (fresenius)
|
$2,437.18 |
$2,437.18 |
$2,437.18 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$76.03 |
$76.03 |
$76.03 |
$96.70
|
|
Inj ivig privigen 500 mg
|
$36,893.98 |
$36,893.98 |
$36,893.98 |
$7,298.71
|
|
Inj mepivacaine hcl/10 ml
|
$17.51 |
$17.51 |
$17.51 |
$28.41
|
|
Inj multihance
|
$154.11 |
$154.11 |
$154.11 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,846.11 |
$1,846.11 |
$1,846.11 |
$1,522.56
|
|
Inj retro urethrocysto
|
$700.17 |
$700.17 |
$700.17 |
$551.29
|
|
Inj secukinumab intrav 1mg
|
$17,060.32 |
$17,060.32 |
$17,060.32 |
$9,077.39
|
|
Inj, spesolimab-sbzo, 1 mg
|
$412,055.72 |
$412,055.72 |
$412,055.72 |
$253,022.14
|
|
Inj testosterone cypionate
|
$166.42 |
$166.42 |
$166.42 |
$77.15
|
|
Inj, tislelizumab-jsgr
|
$76,303.02 |
$76,303.02 |
$76,303.02 |
$45,250.97
|
|
Inj, vancomycin hcl (mylan)
|
$56.54 |
$56.54 |
$56.54 |
$63.82
|
|
Inj, vegzelma, 10 mg
|
$18,815.66 |
$18,815.66 |
$18,815.66 |
$10,892.59
|
|
Inj w/fluor eval cv device
|
$1,099.23 |
$1,099.23 |
$1,099.23 |
$588.90
|
|
Ins cath ren art 1st bi
|
$6,559.67 |
$6,559.67 |
$6,559.67 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$6,132.38 |
$6,132.38 |
$6,132.38 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$6,188.37 |
$6,188.37 |
$6,188.37 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$9,363.66 |
$9,363.66 |
$9,363.66 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$672.57 |
$672.57 |
$672.57 |
$544.00
|
|
Insert cath pleura with image
|
$1,894.36 |
$1,894.36 |
$1,894.36 |
$2,239.02
|
|
Insert hepatic shunt (tips)
|
$23,451.45 |
$23,451.45 |
$23,451.45 |
$9,754.48
|
|
Insertion catheter bladder non indwelling
|
$254.04 |
$254.04 |
$254.04 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$313.79 |
$313.79 |
$313.79 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$15,105.33 |
$15,105.33 |
$15,105.33 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$5,453.93 |
$5,453.93 |
$5,453.93 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$7,691.20 |
$7,691.20 |
$7,691.20 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,726.18 |
$4,726.18 |
$4,726.18 |
$2,618.40
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$20,269.97 |
$20,269.97 |
$20,269.97 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$36,090.42 |
$36,090.42 |
$36,090.42 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$20,269.97 |
$20,269.97 |
$20,269.97 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$4,182.18 |
$4,182.18 |
$4,182.18 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,182.18 |
$4,182.18 |
$4,182.18 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$103,439.67 |
$103,439.67 |
$103,439.67 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$980.64 |
$980.64 |
$980.64 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$19,118.42 |
$19,118.42 |
$19,118.42 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$33,127.26 |
$33,127.26 |
$33,127.26 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$10,992.10 |
$10,992.10 |
$10,992.10 |
$5,470.54
|
|
Insert tunneled cv cath
|
$10,153.40 |
$10,153.40 |
$10,153.40 |
$4,520.00
|
|
Insert vad art access left hrt arterial access
|
$5,453.93 |
$5,453.93 |
$5,453.93 |
$5,062.80
|
|
In situ hybridization per specimen each additional single probe stain
|
$209.93 |
$209.93 |
$209.93 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$527.53 |
$527.53 |
$527.53 |
$338.40
|
|
Ins mark abd/pel for right perq
|
$3,545.27 |
$3,545.27 |
$3,545.27 |
$2,070.00
|
|
Ins pq tunnld ip cath w/img
|
$10,512.69 |
$10,512.69 |
$10,512.69 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$56,222.10 |
$56,222.10 |
$56,222.10 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$20,289.61 |
$20,289.61 |
$20,289.61 |
$11,593.70
|
|
Ins/rpl pm w/tv ld atrl
|
$43,399.53 |
$43,399.53 |
$43,399.53 |
$12,384.25
|
|
Instillation anticarcinogenic agent bladder
|
$1,385.15 |
$1,385.15 |
$1,385.15 |
$721.50
|
|
Instill, bupivac and meloxic
|
$1,104.85 |
$1,104.85 |
$1,104.85 |
$1,127.61
|
|
Ins tun cv cath wo subq prt/pm
|
$16,913.77 |
$16,913.77 |
$16,913.77 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$9,806.83 |
$9,806.83 |
$9,806.83 |
$4,748.00
|
|
Insulin total
|
$18.03 |
$18.03 |
$18.03 |
$67.60
|
|
Intens cardiac rehab no exer
|
$63.51 |
$63.51 |
$63.51 |
$149.00
|
|
Intens cardiac rehab w/exerc
|
$411.71 |
$411.71 |
$411.71 |
$226.98
|
|
Interdiscal perq aspir dx
|
$1,007.83 |
$1,007.83 |
$1,007.83 |
$1,222.26
|
|
Intracard echo interv w/s&i
|
$4,301.58 |
$4,301.58 |
$4,301.58 |
$3,982.59
|
|
Intrapul surf admin endo tube
|
$715.93 |
$715.93 |
$715.93 |
$239.52
|
|
Intraventricular pacing
|
$2,775.64 |
$2,775.64 |
$2,775.64 |
$5,775.22
|
|
Intrinsic factor antibody
|
$27.88 |
$27.88 |
$27.88 |
$59.95
|
|
Intro cath dialysis circuit
|
$1,635.32 |
$1,635.32 |
$1,635.32 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$16,973.85 |
$16,973.85 |
$16,973.85 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$34,307.93 |
$34,307.93 |
$34,307.93 |
$15,625.00
|
|
Intro catheter aorta
|
$2,272.02 |
$2,272.02 |
$2,272.02 |
$1,861.61
|
|
Intro cath svc/ivc
|
$1,102.02 |
$1,102.02 |
$1,102.02 |
$1,350.75
|
|
Intro long gi tube
|
$891.63 |
$891.63 |
$891.63 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$401.27 |
$401.27 |
$401.27 |
$477.85
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,987.14 |
$4,987.14 |
$4,987.14 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$3,601.55 |
$3,601.55 |
$3,601.55 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$545.32 |
$545.32 |
$545.32 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$184.87 |
$184.87 |
$184.87 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$288.11 |
$288.11 |
$288.11 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$86,901.85 |
$86,901.85 |
$86,901.85 |
$52,615.16
|
|
Ipratropium bromide non-comp
|
$8.06 |
$8.06 |
$8.06 |
$7.57
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$417.88 |
$417.88 |
$417.88 |
$227.39
|
