|
Injection for bladder x-ray
|
$593.40 |
$593.40 |
$593.40 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$756.60 |
$756.60 |
$756.60 |
$514.36
|
|
Injection, fulvestrant
|
$1,660.11 |
$1,660.11 |
$1,660.11 |
$166.25
|
|
Injection glatiramer acetate
|
$332.78 |
$332.78 |
$332.78 |
$458.43
|
|
Injection, inclisiran, 1 mg
|
$5,431.58 |
$5,431.58 |
$5,431.58 |
$12.72
|
|
Injection, isavuconazonium
|
$634.28 |
$634.28 |
$634.28 |
$634.28
|
|
Injection, necitumumab, 1 mg
|
$8.12 |
$8.12 |
$8.12 |
$5.73
|
|
Injection,onabotulinumtoxina
|
$12.88 |
$12.88 |
$12.88 |
$12.88
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$635.40 |
$635.40 |
$635.40 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$723.60 |
$723.60 |
$723.60 |
$654.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$223.80 |
$223.80 |
$223.80 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$210.00 |
$210.00 |
$210.00 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$270.60 |
$270.60 |
$270.60 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$126.60 |
$126.60 |
$126.60 |
$130.19
|
|
Inject sacroiliac joint
|
$2,400.60 |
$2,400.60 |
$2,400.60 |
$1,028.95
|
|
Inj fluphenazine hcl 1.25 mg
|
$266.49 |
$266.49 |
$266.49 |
$29.65
|
|
Inj for ext venography
|
$1,475.40 |
$1,475.40 |
$1,475.40 |
$946.64
|
|
Inj for mammo ductogram
|
$606.60 |
$606.60 |
$606.60 |
$469.16
|
|
Inj hydroxocobalamin IV 25mg
|
$1,593.19 |
$1,593.19 |
$1,593.19 |
$1,593.19
|
|
Inj intralesional <= 7 lsn(s)
|
$331.20 |
$331.20 |
$331.20 |
$238.77
|
|
Inj ivig privigen 500 mg
|
$7,298.71 |
$7,298.71 |
$7,298.71 |
$6,144.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$12,160.05 |
$12,160.05 |
$12,160.05 |
$12,160.05
|
|
Inj levocarnitine per 1 gm
|
$53.36 |
$53.36 |
$53.36 |
$87.51
|
|
Inj melpha hydroch nos 50 mg
|
$2,513.20 |
$2,513.20 |
$2,513.20 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$41.81 |
$41.81 |
$41.81 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$426.85 |
$426.85 |
$426.85 |
$426.85
|
|
Inj. mycophenolate mofetil
|
$188.11 |
$188.11 |
$188.11 |
$387.27
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$3,367.80 |
$3,367.80 |
$3,367.80 |
$1,522.56
|
|
Inj proc ankle arthr
|
$444.60 |
$444.60 |
$444.60 |
$405.60
|
|
Inj proc elbow arthro
|
$626.40 |
$626.40 |
$626.40 |
$483.15
|
|
Inj proc myelogram lumbar
|
$1,762.80 |
$1,762.80 |
$1,762.80 |
$1,026.35
|
|
Inj retacrit esrd on dialysi
|
$1,074.20 |
$1,074.20 |
$1,074.20 |
$307.40
|
|
Inj retro urethrocysto
|
$823.80 |
$823.80 |
$823.80 |
$569.60
|
|
Inj, rimabotulinumtoxinb
|
$762.65 |
$762.65 |
$762.65 |
$16.56
|
|
Inj secretin synthetic human
|
$1,234.65 |
$1,234.65 |
$1,234.65 |
$610.89
|
|
Inj secukinumab intrav 1mg
|
$31.10 |
$31.10 |
$31.10 |
$31.80
|
|
Inj testosterone cypionate
|
$78.79 |
$78.79 |
$78.79 |
$78.79
|
|
Inj w/fluor eval cv device
|
$1,666.80 |
$1,666.80 |
$1,666.80 |
$573.00
|
|
Ins cath ren art 1st bi
|
$19,716.60 |
$19,716.60 |
$19,716.60 |
$6,012.50
|
|
Ins cath ren art 1st uni
|
$10,697.40 |
$10,697.40 |
$10,697.40 |
$4,628.00
|
|
Ins cath ren art 2nd+ uni
|
$11,134.80 |
$11,134.80 |
$11,134.80 |
$5,528.94
|
|
Insert cath pleura with image
|
$3,736.20 |
$3,736.20 |
$3,736.20 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,374.00 |
$1,374.00 |
$1,374.00 |
$2,157.58
|
|
Insertion catheter bladder non indwelling
|
$435.00 |
$435.00 |
$435.00 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$494.40 |
$494.40 |
$494.40 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$825.60 |
$825.60 |
$825.60 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,247.80 |
$3,247.80 |
$3,247.80 |
$2,346.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$12,232.80 |
$12,232.80 |
$12,232.80 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,955.00 |
$2,955.00 |
$2,955.00 |
$2,457.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,703.60 |
$2,703.60 |
$2,703.60 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,324.00 |
$3,324.00 |
$3,324.00 |
$2,367.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,080.60 |
$4,080.60 |
$4,080.60 |
$7,513.67
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$12,852.00 |
$12,852.00 |
$12,852.00 |
$9,824.59
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$7,111.80 |
$7,111.80 |
$7,111.80 |
$5,423.04
|
|
Insitu hybridization manual
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$286.80 |
$286.80 |
$286.80 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$1,336.80 |
$1,336.80 |
$1,336.80 |
$364.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$3,931.80 |
$3,931.80 |
$3,931.80 |
$1,483.95
|
|
Ins pq tunnld ip cath w/img
|
$10,328.40 |
$10,328.40 |
$10,328.40 |
$5,597.45
|
|
Instillation anticarcinogenic agent bladder
|
$1,382.40 |
$1,382.40 |
$1,382.40 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$5,677.20 |
$5,677.20 |
$5,677.20 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$6,175.20 |
$6,175.20 |
$6,175.20 |
$4,314.75
|
|
Insulin total
|
$192.60 |
$192.60 |
$192.60 |
$72.15
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$1,570.20 |
$1,570.20 |
$1,570.20 |
$6,018.75
|
|
Interdiscal perq aspir dx
|
$2,149.80 |
$2,149.80 |
$2,149.80 |
$1,222.26
|
|
Interferon beta-1a inj
|
$12,503.22 |
$12,503.22 |
$12,503.22 |
$2,203.14
|
|
Intrinsic factor antibody
|
$172.20 |
$172.20 |
$172.20 |
$76.77
|
|
Intro cath dialysis circuit
|
$12,693.60 |
$12,693.60 |
$12,693.60 |
$2,161.90
|
|
Intro cath dialysis circuit w/pta
|
$26,451.60 |
$26,451.60 |
$26,451.60 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$41,074.20 |
$41,074.20 |
$41,074.20 |
$18,260.50
|
|
Intro catheter aorta
|
$1,941.60 |
$1,941.60 |
$1,941.60 |
$1,963.80
|
|
Intro cath svc/ivc
|
$4,588.20 |
$4,588.20 |
$4,588.20 |
$1,942.50
|
|
Intro long gi tube
|
$901.80 |
$901.80 |
$901.80 |
$880.75
|
|
Intro long gi tube w/mult fluo
|
$258.00 |
$258.00 |
$258.00 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$5,692.20 |
$5,692.20 |
$5,692.20 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$4,692.00 |
$4,692.00 |
$4,692.00 |
$1,633.03
|
|
Intubation endotracheal emergency procedure
|
$1,160.40 |
$1,160.40 |
$1,160.40 |
$565.00
|
|
Ionm in operatng room 15 min
|
$264.60 |
$264.60 |
$264.60 |
$238.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$0.63 |
$0.63 |
$0.63 |
$4.59
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.67 |
$0.67 |
$0.67 |
$145.52
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$261.10 |
$261.10 |
$261.10 |
$261.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$181.38 |
$181.38 |
$181.38 |
$254.59
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$111.98 |
$111.98 |
$111.98 |
$111.98
|
|
Iron
|
$107.40 |
$107.40 |
$107.40 |
$67.50
|
|
Iron binding capacity
|
$48.00 |
$48.00 |
$48.00 |
$55.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$660.70 |
$660.70 |
$660.70 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$271.80 |
$271.80 |
$271.80 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$107.40 |
$107.40 |
$107.40 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$181.20 |
$181.20 |
$181.20 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$145.20 |
$145.20 |
$145.20 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$181.20 |
$181.20 |
$181.20 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$723.60 |
$723.60 |
$723.60 |
$476.50
|
|
Ixabepilone 15 mg intravenous solution
|
$197.51 |
$197.51 |
$197.51 |
$189.96
|
|
Jak2 targeted sequence analysis
|
$333.60 |
$333.60 |
$333.60 |
$465.74
|
|
John cunningham antibody
|
$970.80 |
$970.80 |
$970.80 |
$39.65
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$147.00 |
$147.00 |
$147.00 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$165.89 |
$165.89 |
$165.89 |
$17.11
|
|
Kidney imag w/bld flow multi
|
$2,363.40 |
$2,363.40 |
$2,363.40 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$1,489.80 |
$1,489.80 |
$1,489.80 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$319.20 |
$319.20 |
$319.20 |
$618.54
|
