|
Injection epidural blood patch or clot
|
$895.00 |
$895.00 |
$895.00 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$332.50 |
$332.50 |
$332.50 |
$436.00
|
|
Injection for bladder x-ray
|
$380.00 |
$380.00 |
$380.00 |
$459.20
|
|
Injection for hip x-ray
|
$250.00 |
$250.00 |
$250.00 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$415.00 |
$415.00 |
$415.00 |
$497.76
|
|
Injection for spleen x-ray
|
$230.00 |
$230.00 |
$230.00 |
$686.40
|
|
Injection for ureter x-ray
|
$390.00 |
$390.00 |
$390.00 |
$515.21
|
|
Injection of sinus tract
|
$595.00 |
$595.00 |
$595.00 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$17.49 |
$17.49 |
$17.49 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$210.00 |
$210.00 |
$210.00 |
$685.44
|
|
Injection, ruconest
|
$61.72 |
$61.72 |
$61.72 |
$14,111.44
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$775.00 |
$775.00 |
$775.00 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$850.00 |
$850.00 |
$850.00 |
$2,040.36
|
|
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
|
$142.50 |
$142.50 |
$142.50 |
$145.60
|
|
Inject sacroiliac joint
|
$470.00 |
$470.00 |
$470.00 |
$1,029.04
|
|
Inj for ext venography
|
$377.50 |
$377.50 |
$377.50 |
$628.80
|
|
Inj for mammo ductogram
|
$490.00 |
$490.00 |
$490.00 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$555.00 |
$555.00 |
$555.00 |
$1,492.00
|
|
Inj hrt cath w/s&i sel right vent
|
$745.00 |
$745.00 |
$745.00 |
$999.96
|
|
Inj intralesional <= 7 lsn(s)
|
$332.50 |
$332.50 |
$332.50 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$167.66 |
$167.66 |
$167.66 |
$6,967.29
|
|
Inj, levothyroxine, freskabi
|
$23.67 |
$23.67 |
$23.67 |
$308.21
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$625.00 |
$625.00 |
$625.00 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$61.20 |
$61.20 |
$61.20 |
$34.34
|
|
Inj., meropenem, vaborbactam
|
$694.50 |
$694.50 |
$694.50 |
$556.87
|
|
Inj multihance
|
$5.03 |
$5.03 |
$5.03 |
$70.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,760.00 |
$1,760.00 |
$1,760.00 |
$1,413.35
|
|
Inj peritoneal venous shunt
|
$250.00 |
$250.00 |
$250.00 |
$406.80
|
|
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
|
$335.00 |
$335.00 |
$335.00 |
$742.40
|
|
Inj proc myelogram lumbar
|
$365.00 |
$365.00 |
$365.00 |
$838.30
|
|
Inj proc sialogram
|
$395.00 |
$395.00 |
$395.00 |
$373.00
|
|
Inj retro urethrocysto
|
$235.00 |
$235.00 |
$235.00 |
$447.74
|
|
Inj scleros sol mult veins
|
$192.50 |
$192.50 |
$192.50 |
$692.90
|
|
Inj scleros sol sgl vein
|
$197.50 |
$197.50 |
$197.50 |
$561.88
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$302.50 |
$302.50 |
$302.50 |
$436.80
|
|
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
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$504.40
|
|
Ins cath ren art 1st bi
|
$3,150.00 |
$3,150.00 |
$3,150.00 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$3,090.00 |
$3,090.00 |
$3,090.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$3,150.00 |
$3,150.00 |
$3,150.00 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$3,090.00 |
$3,090.00 |
$3,090.00 |
$5,395.20
|
|
Insert abdomen-venous drain
|
$2,630.00 |
$2,630.00 |
$2,630.00 |
$4,039.47
|
|
Insert cath pleura with image
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,980.00 |
$2,980.00 |
$2,980.00 |
$2,099.70
|
|
Insert hepatic shunt (tips)
|
$4,475.00 |
$4,475.00 |
$4,475.00 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$220.00 |
$220.00 |
$220.00 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,215.00 |
$2,215.00 |
$2,215.00 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,655.00 |
$3,655.00 |
$3,655.00 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,050.00 |
$6,050.00 |
$6,050.00 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$2,585.25
|
|
Insertion of catheter vein
|
$855.00 |
$855.00 |
$855.00 |
$1,525.80
|
|
Insertion of catheter vein
|
$425.00 |
$425.00 |
$425.00 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,740.00 |
$5,740.00 |
$5,740.00 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$5,740.00 |
$5,740.00 |
$5,740.00 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$5,560.00 |
$5,560.00 |
$5,560.00 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,540.00 |
$2,540.00 |
$2,540.00 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$14,660.00 |
$14,660.00 |
$14,660.00 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,185.00 |
$5,185.00 |
$5,185.00 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$4,050.00 |
$4,050.00 |
$4,050.00 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$6,185.00 |
$6,185.00 |
$6,185.00 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,350.00 |
$3,350.00 |
$3,350.00 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$3,415.00 |
$3,415.00 |
$3,415.00 |
$7,115.90
|
|
Insert/repl sq defib w/eltrd
|
$17,565.00 |
$17,565.00 |
$17,565.00 |
$33,593.55
|
|
Insert swan-ganz cath
|
$1,390.00 |
$1,390.00 |
$1,390.00 |
$2,164.52
|
|
Insert uteri tandem/ovoids
|
$3,370.00 |
$3,370.00 |
$3,370.00 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$1,745.00 |
$1,745.00 |
$1,745.00 |
$4,276.00
|
|
Ins icd gen exist mlt leads
|
$10,475.00 |
$10,475.00 |
$10,475.00 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$12,515.00 |
$12,515.00 |
$12,515.00 |
$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
|
$1,745.00 |
$1,745.00 |
$1,745.00 |
$3,796.00
|
|
Ins lv lead exist pm/icd
|
$6,080.00 |
$6,080.00 |
$6,080.00 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$2,070.00 |
$2,070.00 |
$2,070.00 |
$2,477.24
|
|
Ins mark thor for right perq
|
$1,895.00 |
$1,895.00 |
$1,895.00 |
$2,503.80
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$1,690.00
|
|
Ins pm gen exist dual lead
|
$10,385.00 |
$10,385.00 |
$10,385.00 |
$24,159.72
|
|
Ins pm gen w/exist mlt leads
|
$5,175.00 |
$5,175.00 |
$5,175.00 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$2,750.00 |
$2,750.00 |
$2,750.00 |
$5,486.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$17,830.00 |
$17,830.00 |
$17,830.00 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$4,545.00 |
$4,545.00 |
$4,545.00 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$4,505.00 |
$4,505.00 |
$4,505.00 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$5,560.00 |
$5,560.00 |
$5,560.00 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$31,310.00 |
$31,310.00 |
$31,310.00 |
$27,318.11
|
|
Inst fibrinolysis agent ini day
|
$497.50 |
$497.50 |
$497.50 |
$1,043.35
|
|
Inst fibrinolysis agent sbsq d
|
$467.50 |
$467.50 |
$467.50 |
$997.05
|
|
Instillation anticarcinogenic agent bladder
|
$315.00 |
$315.00 |
$315.00 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$2,255.00 |
$2,255.00 |
$2,255.00 |
$4,218.00
|
|
Ins tun intraperit dia cath
|
$2,630.00 |
$2,630.00 |
$2,630.00 |
$4,570.00
|
|
Inst via cath agent pleurds
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$1,074.68
|
|
Insulin total
|
$67.50 |
$67.50 |
$67.50 |
$66.64
|
