|
Injection during cath supravalvular aortography
|
$992.16 |
$992.16 |
$992.16 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,301.04 |
$1,301.04 |
$1,301.04 |
$1,161.14
|
|
Injection for arthrography wrist (both sides)
|
$381.60 |
$381.60 |
$381.60 |
$438.00
|
|
Injection for bladder x-ray
|
$72.00 |
$72.00 |
$72.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$439.20 |
$439.20 |
$439.20 |
$494.65
|
|
Injection for ureter x-ray
|
$929.52 |
$929.52 |
$929.52 |
$515.21
|
|
Injection, fulvestrant
|
$18.90 |
$18.90 |
$18.90 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$21.83 |
$21.83 |
$21.83 |
$6,679.35
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,640.88 |
$1,640.88 |
$1,640.88 |
$699.68
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$6,627.60 |
$6,627.60 |
$6,627.60 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,242.16 |
$3,242.16 |
$3,242.16 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$3,572.64 |
$3,572.64 |
$3,572.64 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$6,433.92 |
$6,433.92 |
$6,433.92 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,044.08 |
$2,044.08 |
$2,044.08 |
$1,023.75
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,600.80 |
$4,600.80 |
$4,600.80 |
$1,791.00
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,507.68 |
$1,507.68 |
$1,507.68 |
$1,002.76
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,370.40 |
$4,370.40 |
$4,370.40 |
$1,973.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,995.28 |
$3,995.28 |
$3,995.28 |
$1,808.64
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,951.28 |
$2,951.28 |
$2,951.28 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$848.16 |
$848.16 |
$848.16 |
$485.28
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$759.60 |
$759.60 |
$759.60 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,014.48 |
$1,014.48 |
$1,014.48 |
$637.35
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$318.96 |
$318.96 |
$318.96 |
$163.83
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$228.96 |
$228.96 |
$228.96 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$455.04 |
$455.04 |
$455.04 |
$261.25
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$262.80 |
$262.80 |
$262.80 |
$136.00
|
|
Inject sacroiliac joint
|
$1,532.88 |
$1,532.88 |
$1,532.88 |
$1,029.04
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$55.16 |
$55.16 |
$55.16 |
$32,176.93
|
|
Inj epidural sgl lumb-sacral without img
|
$1,956.24 |
$1,956.24 |
$1,956.24 |
$1,415.50
|
|
Inj fluphenazine hcl 1.25 mg
|
$47.88 |
$47.88 |
$47.88 |
$39.54
|
|
Inj for ext venography
|
$884.16 |
$884.16 |
$884.16 |
$654.00
|
|
Inj for mammo ductogram
|
$1,036.08 |
$1,036.08 |
$1,036.08 |
$397.80
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$2,106.72 |
$2,106.72 |
$2,106.72 |
$1,928.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$176.38 |
$176.38 |
$176.38 |
$11,648.70
|
|
Inj, lecanemab-irmb, 1 mg
|
$2.82 |
$2.82 |
$2.82 |
$1,009.20
|
|
Inj, levothyroxine, hikma
|
$38.01 |
$38.01 |
$38.01 |
$38.01
|
|
Inj, lidocaine w epinephrine
|
$0.83 |
$0.83 |
$0.83 |
$45.60
|
|
Inj meropenem (wg crit care)
|
$11.75 |
$11.75 |
$11.75 |
$77.97
|
|
Inj multihance
|
$17.94 |
$17.94 |
$17.94 |
$70.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,754.64 |
$1,754.64 |
$1,754.64 |
$1,413.35
|
|
Inj ogivri 10 mg
|
$96.00 |
$96.00 |
$96.00 |
$4,492.28
|
|
Inj proc lumbr disk ea lvl
|
$1,643.04 |
$1,643.04 |
$1,643.04 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$870.48 |
$870.48 |
$870.48 |
$854.00
|
|
Inj retro urethrocysto
|
$72.00 |
$72.00 |
$72.00 |
$450.00
|
|
Inj scleros sol sgl vein
|
$1,740.96 |
$1,740.96 |
$1,740.96 |
$561.88
|
|
Inj., tildrakizumab, 1 mg
|
$310.38 |
$310.38 |
$310.38 |
$26,635.60
|
|
Inj vancomycin (xellia) 10mg
|
$1.31 |
$1.31 |
$1.31 |
$76.59
|
|
Inj w/fluor eval cv device
|
$527.04 |
$527.04 |
$527.04 |
$504.40
|
|
Ins cath ren art 1st bi
|
$7,015.68 |
$7,015.68 |
$7,015.68 |
$5,855.00
|
|
Ins cath ren art 1st uni
|
$6,798.24 |
$6,798.24 |
$6,798.24 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$6,798.24 |
$6,798.24 |
$6,798.24 |
$5,565.95
|
|
Ins cath ren art 2nd+ uni
|
$11,676.24 |
$11,676.24 |
$11,676.24 |
$5,395.20
|
|
Insert cath pleura with image
|
$4,839.12 |
$4,839.12 |
$4,839.12 |
$2,194.40
|
|
Insert cath pleura without image
|
$4,097.52 |
$4,097.52 |
$4,097.52 |
$2,073.18
|
|
Insertion catheter bladder non indwelling
|
$283.68 |
$283.68 |
$283.68 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$332.64 |
$332.64 |
$332.64 |
$235.20
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$7,622.64 |
$7,622.64 |
$7,622.64 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,865.60 |
$2,865.60 |
$2,865.60 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$11,676.24 |
$11,676.24 |
$11,676.24 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$6,798.24 |
$6,798.24 |
$6,798.24 |
$2,515.80
|
|
Insertion of heart electrode 33211
|
$17,876.16 |
$17,876.16 |
$17,876.16 |
$7,048.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$20,852.64 |
$20,852.64 |
$20,852.64 |
$12,824.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$22,605.12 |
$22,605.12 |
$22,605.12 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$4,884.48 |
$4,884.48 |
$4,884.48 |
$10,285.70
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,418.56 |
$3,418.56 |
$3,418.56 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,047.12 |
$4,047.12 |
$4,047.12 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$69,253.20 |
$69,253.20 |
$69,253.20 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$17,876.16 |
$17,876.16 |
$17,876.16 |
$7,216.00
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$17,876.16 |
$17,876.16 |
$17,876.16 |
$7,388.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$15,544.80 |
$15,544.80 |
$15,544.80 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,883.20 |
$6,883.20 |
$6,883.20 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$17,876.16 |
$17,876.16 |
$17,876.16 |
$7,264.40
|
|
Insert swan-ganz cath
|
$3,355.20 |
$3,355.20 |
$3,355.20 |
$2,337.00
|
|
Ins icd gen exist mlt leads
|
$69,253.20 |
$69,253.20 |
$69,253.20 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$48,484.08 |
$48,484.08 |
$48,484.08 |
$23,285.34
|
|
Insitu hybridization auto
|
$769.68 |
$769.68 |
$769.68 |
$393.13
|
|
Insitu hybridization manual
|
$743.76 |
$743.76 |
$743.76 |
$401.10
|
|
In situ hybridization per specimen each additional single probe stain
|
$687.60 |
$687.60 |
$687.60 |
$241.80
|
|
In situ hybridization per specimen initial single probe stain
|
$687.60 |
$687.60 |
$687.60 |
$337.20
|
|
Ins lv lead exist pm/icd
|
$22,605.12 |
$22,605.12 |
$22,605.12 |
$12,384.25
|
|
Ins pm gen exist dual lead
|
$48,484.08 |
$48,484.08 |
$48,484.08 |
$23,285.34
|
|
Ins pm gen w/exist mlt leads
|
$41,193.36 |
$41,193.36 |
$41,193.36 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$7,622.64 |
$7,622.64 |
$7,622.64 |
$5,419.00
|
|
Ins/rpl pm gen exist dual lead
|
$22,605.12 |
$22,605.12 |
$22,605.12 |
$11,412.00
|
|
Ins/rpl pm gen exist sgl lead
|
$17,876.16 |
$17,876.16 |
$17,876.16 |
$9,705.00
|
|
Ins/rpl pm w/tv ld atrl
|
$22,605.12 |
$22,605.12 |
$22,605.12 |
$11,747.25
|
|
Instillation anticarcinogenic agent bladder
|
$1,441.44 |
$1,441.44 |
$1,441.44 |
$664.20
|
|
Ins tun cv cath wo subq prt/pm
|
$11,676.24 |
$11,676.24 |
$11,676.24 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$7,876.80 |
$7,876.80 |
$7,876.80 |
$4,218.00
|
|
Insulin total
|
$105.12 |
$105.12 |
$105.12 |
$66.64
|
|
Intens cardiac rehab no exer
|
$272.16 |
$272.16 |
$272.16 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$272.16 |
$272.16 |
$272.16 |
$238.40
|
|
Interdiscal perq aspir dx
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$1,222.26
|
|
Interrog evl pm/ldls pm ip
|
$241.92 |
$241.92 |
$241.92 |
$124.80
|
|
Intracranial angioplasty
|
$3,791.52 |
$3,791.52 |
$3,791.52 |
$5,089.80
|
|
Intracranial complete study
|
$1,242.72 |
$1,242.72 |
$1,242.72 |
$883.30
|
|
Intracranial limited study
|
$262.08 |
$262.08 |
$262.08 |
$467.50
|
|
Intrinsic factor antibody
|
$163.44 |
$163.44 |
$163.44 |
$63.15
|
|
Intro cath dialysis circuit
|
$2,917.44 |
$2,917.44 |
$2,917.44 |
$2,053.14
|
|
Intro cath dialysis circuit w/pta
|
$10,709.28 |
$10,709.28 |
$10,709.28 |
$8,761.00
|
