|
Injection, peramivir
|
$4.88 |
$4.88 |
$4.88 |
$744.75
|
|
Injection radioactive tracer sentinel node (both sides)
|
$447.50 |
$447.50 |
$447.50 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,060.00 |
$2,060.00 |
$2,060.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,220.00 |
$1,220.00 |
$1,220.00 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$392.50 |
$392.50 |
$392.50 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$775.00 |
$775.00 |
$775.00 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$790.00 |
$790.00 |
$790.00 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,820.00 |
$1,820.00 |
$1,820.00 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,145.00 |
$1,145.00 |
$1,145.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,145.00 |
$1,145.00 |
$1,145.00 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$412.50 |
$412.50 |
$412.50 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$500.00 |
$500.00 |
$500.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$625.00 |
$625.00 |
$625.00 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$240.00 |
$240.00 |
$240.00 |
$145.60
|
|
Inject sacroiliac joint
|
$990.00 |
$990.00 |
$990.00 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$895.00 |
$895.00 |
$895.00 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$895.00 |
$895.00 |
$895.00 |
$1,450.84
|
|
Inj, epinephrine (belcher)
|
$5.45 |
$5.45 |
$5.45 |
$6.55
|
|
Inj for ext venography
|
$575.00 |
$575.00 |
$575.00 |
$628.80
|
|
Inj for mammo ductogram
|
$267.50 |
$267.50 |
$267.50 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$555.00 |
$555.00 |
$555.00 |
$1,492.00
|
|
Inj ivig privigen 500 mg
|
$134.48 |
$134.48 |
$134.48 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$59.08 |
$59.08 |
$59.08 |
$41.79
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$625.00 |
$625.00 |
$625.00 |
$794.70
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$2,726.90
|
|
Inj proc ankle arthr
|
$332.50 |
$332.50 |
$332.50 |
$405.31
|
|
Inj proc elbow arthro
|
$332.50 |
$332.50 |
$332.50 |
$432.00
|
|
Inj proc for lymphang
|
$222.50 |
$222.50 |
$222.50 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$515.00 |
$515.00 |
$515.00 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$365.00 |
$365.00 |
$365.00 |
$838.30
|
|
Inj proc sialogram
|
$262.50 |
$262.50 |
$262.50 |
$373.00
|
|
Inj retro urethrocysto
|
$242.50 |
$242.50 |
$242.50 |
$447.74
|
|
Inj scleros sol mult veins
|
$565.00 |
$565.00 |
$565.00 |
$692.90
|
|
Inj scleros sol sgl vein
|
$550.00 |
$550.00 |
$550.00 |
$561.88
|
|
Inj thrc fascial pln blk bi w/wo image
|
$740.00 |
$740.00 |
$740.00 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$625.00 |
$625.00 |
$625.00 |
$818.00
|
|
Inj w/fluor eval cv device
|
$325.00 |
$325.00 |
$325.00 |
$504.40
|
|
Ins cath ren art 1st bi
|
$4,215.00 |
$4,215.00 |
$4,215.00 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$3,770.00 |
$3,770.00 |
$3,770.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$5,200.00 |
$5,200.00 |
$5,200.00 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$3,630.00 |
$3,630.00 |
$3,630.00 |
$5,395.20
|
|
Insert and remove bone pin
|
$3,630.00 |
$3,630.00 |
$3,630.00 |
$4,433.36
|
|
Insert cath pleura with image
|
$1,545.00 |
$1,545.00 |
$1,545.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$3,490.00 |
$3,490.00 |
$3,490.00 |
$2,099.70
|
|
Insertion catheter bladder non indwelling
|
$220.00 |
$220.00 |
$220.00 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,685.00 |
$4,685.00 |
$4,685.00 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,585.00 |
$2,585.00 |
$2,585.00 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,260.00 |
$6,260.00 |
$6,260.00 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,580.00 |
$1,580.00 |
$1,580.00 |
$2,585.25
|
|
Insertion of catheter vein
|
$965.00 |
$965.00 |
$965.00 |
$1,525.80
|
|
Insertion of catheter vein
|
$505.00 |
$505.00 |
$505.00 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$13,075.00 |
$13,075.00 |
$13,075.00 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$8,155.00 |
$8,155.00 |
$8,155.00 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$5,620.00 |
$5,620.00 |
$5,620.00 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,910.00 |
$1,910.00 |
$1,910.00 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$34,430.00 |
$34,430.00 |
$34,430.00 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,245.00 |
$5,245.00 |
$5,245.00 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$10,095.00 |
$10,095.00 |
$10,095.00 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$10,635.00 |
$10,635.00 |
$10,635.00 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$5,520.00 |
$5,520.00 |
$5,520.00 |
$5,236.80
|
|
Insert picvad cath
|
$4,185.00 |
$4,185.00 |
$4,185.00 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$7,795.00 |
$7,795.00 |
$7,795.00 |
$7,115.90
|
|
Insert/repl sq defib w/eltrd
|
$34,045.00 |
$34,045.00 |
$34,045.00 |
$33,593.55
|
|
Insert sq defib electrode
|
$7,740.00 |
$7,740.00 |
$7,740.00 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,390.00 |
$1,390.00 |
$1,390.00 |
$2,164.52
|
|
Insert tunneled cv cath
|
$4,185.00 |
$4,185.00 |
$4,185.00 |
$4,520.00
|
|
Insert uteri tandem/ovoids
|
$3,370.00 |
$3,370.00 |
$3,370.00 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$1,355.00 |
$1,355.00 |
$1,355.00 |
$4,276.00
|
|
Ins icd gen exist mlt leads
|
$20,645.00 |
$20,645.00 |
$20,645.00 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$12,875.00 |
$12,875.00 |
$12,875.00 |
$23,230.50
|
|
Insitu hybridization auto
|
$565.00 |
$565.00 |
$565.00 |
$377.37
|
|
Insitu hybridization (fish)
|
$785.00 |
$785.00 |
$785.00 |
$481.00
|
|
Insitu hybridization manual
|
$540.00 |
$540.00 |
$540.00 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$327.50 |
$327.50 |
$327.50 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$415.00 |
$415.00 |
$415.00 |
$338.40
|
|
Insj perq vad r hrt venous
|
$1,355.00 |
$1,355.00 |
$1,355.00 |
$3,796.00
|
|
Ins lv lead exist pm/icd
|
$8,845.00 |
$8,845.00 |
$8,845.00 |
$12,384.25
|
|
Ins picad w subq port 5yr>
|
$3,020.00 |
$3,020.00 |
$3,020.00 |
$4,078.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$1,690.00
|
|
Ins pm gen exist dual lead
|
$30,175.00 |
$30,175.00 |
$30,175.00 |
$24,159.72
|
|
Ins pm gen w/exist mlt leads
|
$6,245.00 |
$6,245.00 |
$6,245.00 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$5,486.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$17,845.00 |
$17,845.00 |
$17,845.00 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$9,090.00 |
$9,090.00 |
$9,090.00 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$4,150.00 |
$4,150.00 |
$4,150.00 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$10,685.00 |
$10,685.00 |
$10,685.00 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$49,155.00 |
$49,155.00 |
$49,155.00 |
$27,318.11
|
|
Inst fibrinolysis agent ini day
|
$1,070.00 |
$1,070.00 |
$1,070.00 |
$1,043.35
|
|
Inst fibrinolysis agent sbsq d
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$997.05
|
|
Instillation anticarcinogenic agent bladder
|
$387.50 |
$387.50 |
$387.50 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$6,960.00 |
$6,960.00 |
$6,960.00 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$3,670.00 |
$3,670.00 |
$3,670.00 |
$4,218.00
|
|
Ins tun intraperit dia cath
|
$4,570.00 |
$4,570.00 |
$4,570.00 |
$4,570.00
|
|
Inst via cath agent pleurds
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$1,074.68
|
|
Insulin total
|
$67.50 |
$67.50 |
$67.50 |
$66.64
|
|
Ins vag brachytx device
|
$615.00 |
$615.00 |
$615.00 |
$950.00
|
|
Interdiscal perq aspir dx
|
$695.00 |
$695.00 |
$695.00 |
$1,222.26
|
