|
Infectious agent nucleic acid quantification hiv-1
|
$315.60 |
$315.60 |
$315.60 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$298.20 |
$298.20 |
$298.20 |
$303.59
|
|
Influenza dna amp prob addl
|
$103.20 |
$103.20 |
$103.20 |
$64.26
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$187.20 |
$187.20 |
$187.20 |
$293.25
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$663.00 |
$663.00 |
$663.00 |
$629.60
|
|
Initiation & management bipap/cpap initial day
|
$509.40 |
$509.40 |
$509.40 |
$571.20
|
|
Inj cntr knee arthro incl ct/mri
|
$1,377.60 |
$1,377.60 |
$1,377.60 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$5,589.00 |
$5,589.00 |
$5,589.00 |
$945.31
|
|
Inj dx for sinogram
|
$1,377.60 |
$1,377.60 |
$1,377.60 |
$416.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$3,032.40 |
$3,032.40 |
$3,032.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$504.00
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,169.40 |
$1,169.40 |
$1,169.40 |
$504.90
|
|
Injection during cath supravalvular aortography
|
$645.60 |
$645.60 |
$645.60 |
$1,028.88
|
|
Injection epidural blood patch or clot
|
$1,828.20 |
$1,828.20 |
$1,828.20 |
$1,153.03
|
|
Injection for arthrography wrist (both sides)
|
$1,186.80 |
$1,186.80 |
$1,186.80 |
$441.12
|
|
Injection for bladder x-ray
|
$1,186.80 |
$1,186.80 |
$1,186.80 |
$459.20
|
|
Injection for hip x-ray
|
$1,355.40 |
$1,355.40 |
$1,355.40 |
$709.15
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$494.65
|
|
Injection for ureter x-ray
|
$1,267.80 |
$1,267.80 |
$1,267.80 |
$515.21
|
|
Injection of sinus tract
|
$1,501.20 |
$1,501.20 |
$1,501.20 |
$1,627.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$2,161.80 |
$2,161.80 |
$2,161.80 |
$699.68
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,063.40 |
$2,063.40 |
$2,063.40 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,968.80 |
$2,968.80 |
$2,968.80 |
$1,939.97
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,069.60 |
$3,069.60 |
$3,069.60 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,413.40 |
$3,413.40 |
$3,413.40 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,545.00 |
$1,545.00 |
$1,545.00 |
$1,011.89
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,968.80 |
$2,968.80 |
$2,968.80 |
$1,951.80
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,079.20 |
$3,079.20 |
$3,079.20 |
$1,808.64
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$3,079.20 |
$3,079.20 |
$3,079.20 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$820.80 |
$820.80 |
$820.80 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$712.80 |
$712.80 |
$712.80 |
$541.00
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$820.80 |
$820.80 |
$820.80 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$265.80 |
$265.80 |
$265.80 |
$166.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$257.40 |
$257.40 |
$257.40 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$298.80 |
$298.80 |
$298.80 |
$257.24
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$182.40 |
$182.40 |
$182.40 |
$136.00
|
|
Injection treatment of nerve
|
$5,637.60 |
$5,637.60 |
$5,637.60 |
$2,054.00
|
|
Inject sacroiliac joint
|
$2,347.20 |
$2,347.20 |
$2,347.20 |
$990.00
|
|
Inj epidural sgl cerv-thor without img
|
$2,281.20 |
$2,281.20 |
$2,281.20 |
$1,311.74
|
|
Inj epidural sgl lumb-sacral without img
|
$1,982.40 |
$1,982.40 |
$1,982.40 |
$1,415.50
|
|
Inj for ext venography
|
$952.80 |
$952.80 |
$952.80 |
$654.00
|
|
Inj for mammo ductogram
|
$525.00 |
$525.00 |
$525.00 |
$397.80
|
|
Inj intralesional <= 7 lsn(s)
|
$280.80 |
$280.80 |
$280.80 |
$235.13
|
|
Inj multihance
|
$7.80 |
$7.80 |
$7.80 |
$72.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$3,213.00 |
$3,213.00 |
$3,213.00 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$4,281.60 |
$4,281.60 |
$4,281.60 |
$2,484.00
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$4,607.40 |
$4,607.40 |
$4,607.40 |
$2,373.55
|
|
Inj proc lumbr disk ea lvl
|
$5,589.00 |
$5,589.00 |
$5,589.00 |
$1,136.00
|
|
Inj proc myelogram lumbar
|
$1,428.00 |
$1,428.00 |
$1,428.00 |
$859.98
|
|
Inj prohance multipack
|
$14.40 |
$14.40 |
$14.40 |
$9.60
|
|
Inj retro urethrocysto
|
$1,085.40 |
$1,085.40 |
$1,085.40 |
$450.00
|
|
Inj scleros sol mult veins
|
$762.60 |
$762.60 |
$762.60 |
$643.65
|
|
Inj scleros sol sgl vein
|
$746.40 |
$746.40 |
$746.40 |
$558.97
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$640.20 |
$640.20 |
$640.20 |
$436.80
|
|
Inj w/fluor eval cv device
|
$705.00 |
$705.00 |
$705.00 |
$504.40
|
|
Ins cath ren art 1st bi
|
$8,555.40 |
$8,555.40 |
$8,555.40 |
$5,820.00
|
|
Ins cath ren art 1st uni
|
$6,357.00 |
$6,357.00 |
$6,357.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$9,181.80 |
$9,181.80 |
$9,181.80 |
$5,475.60
|
|
Ins cath ren art 2nd+ uni
|
$6,747.00 |
$6,747.00 |
$6,747.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$618.60 |
$618.60 |
$618.60 |
$473.90
|
|
Insert cath pleura with image
|
$4,372.80 |
$4,372.80 |
$4,372.80 |
$2,164.52
|
|
Insert cath pleura without image
|
$3,291.60 |
$3,291.60 |
$3,291.60 |
$2,026.58
|
|
Insert hepatic shunt (tips)
|
$4,759.20 |
$4,759.20 |
$4,759.20 |
$7,606.50
|
|
Insert heyman uteri capsule
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$5,841.60
|
|
Insertion catheter bladder non indwelling
|
$145.20 |
$145.20 |
$145.20 |
$207.00
|
|
Insertion catheter bladder temporary simple
|
$145.20 |
$145.20 |
$145.20 |
$234.40
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$7,893.60 |
$7,893.60 |
$7,893.60 |
$4,747.60
|
|
Insertion intra aortic balloon assist device percutaneous
|
$4,201.20 |
$4,201.20 |
$4,201.20 |
$2,565.36
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,866.80 |
$8,866.80 |
$8,866.80 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,187.60 |
$2,187.60 |
$2,187.60 |
$2,523.30
|
|
Insertion of catheter vein
|
$1,119.60 |
$1,119.60 |
$1,119.60 |
$856.80
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,568.80 |
$9,568.80 |
$9,568.80 |
$12,843.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$7,108.80 |
$7,108.80 |
$7,108.80 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$9,774.00 |
$9,774.00 |
$9,774.00 |
$10,309.20
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,712.60 |
$2,712.60 |
$2,712.60 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,889.80 |
$3,889.80 |
$3,889.80 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$22,631.40 |
$22,631.40 |
$22,631.40 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$12,690.60 |
$12,690.60 |
$12,690.60 |
$7,388.80
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$5,618.40 |
$5,618.40 |
$5,618.40 |
$7,447.01
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$6,665.40 |
$6,665.40 |
$6,665.40 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$4,360.20 |
$4,360.20 |
$4,360.20 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$5,618.40 |
$5,618.40 |
$5,618.40 |
$7,312.80
|
|
Insert/repl sq defib w/eltrd
|
$8,259.60 |
$8,259.60 |
$8,259.60 |
$32,280.00
|
|
Insert swan-ganz cath
|
$1,303.80 |
$1,303.80 |
$1,303.80 |
$2,327.53
|
|
Insert uteri tandem/ovoids
|
$810.60 |
$810.60 |
$810.60 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$5,193.00 |
$5,193.00 |
$5,193.00 |
$4,504.50
|
|
Ins icd gen exist mlt leads
|
$8,097.60 |
$8,097.60 |
$8,097.60 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$15,804.00 |
$15,804.00 |
$15,804.00 |
$23,742.75
|
|
Insitu hybridization auto
|
$1,302.00 |
$1,302.00 |
$1,302.00 |
$377.37
|
|
Insitu hybridization (fish)
|
$719.40 |
$719.40 |
$719.40 |
$481.60
|
|
Insitu hybridization manual
|
$807.00 |
$807.00 |
$807.00 |
$398.16
|
|
In situ hybridization per specimen each additional single probe stain
|
$706.20 |
$706.20 |
$706.20 |
$243.00
|
|
In situ hybridization per specimen initial single probe stain
|
$999.00 |
$999.00 |
$999.00 |
$337.20
|
|
Ins lv lead exist pm/icd
|
$9,774.00 |
$9,774.00 |
$9,774.00 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$1,854.00 |
$1,854.00 |
$1,854.00 |
$2,414.36
|
|
Ins mark thor for right perq
|
$1,854.00 |
$1,854.00 |
$1,854.00 |
$2,492.80
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,450.80 |
$1,450.80 |
$1,450.80 |
$1,609.25
|
|
Ins pm gen exist dual lead
|
$7,933.80 |
$7,933.80 |
$7,933.80 |
$24,530.99
|
|
Ins pm gen w/exist mlt leads
|
$6,304.20 |
$6,304.20 |
$6,304.20 |
$14,804.40
|
