|
Injection during cath supravalvular aortography
|
$315.25 |
$315.25 |
$315.25 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,832.35 |
$1,832.35 |
$1,832.35 |
$1,182.33
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$892.45 |
$892.45 |
$892.45 |
$497.76
|
|
Injection, fulvestrant
|
$328.60 |
$328.60 |
$328.60 |
$1,719.16
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,372.20 |
$3,372.20 |
$3,372.20 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$4,245.93 |
$4,245.93 |
$4,245.93 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,047.85 |
$3,047.85 |
$3,047.85 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,023.75 |
$1,023.75 |
$1,023.75 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,281.50 |
$2,281.50 |
$2,281.50 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$4,972.21 |
$4,972.21 |
$4,972.21 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,972.21 |
$4,972.21 |
$4,972.21 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,675.76 |
$2,675.76 |
$2,675.76 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,582.71 |
$2,582.71 |
$2,582.71 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$272.00 |
$272.00 |
$272.00 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$167.70 |
$167.70 |
$167.70 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$170.30 |
$170.30 |
$170.30 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$12,791.19 |
$12,791.19 |
$12,791.19 |
$145.60
|
|
Injection treatment of nose
|
$329.55 |
$329.55 |
$329.55 |
$859.59
|
|
Inj, etelcalcetide, 0.1 mg
|
$1,083.90 |
$1,083.90 |
$1,083.90 |
$343.35
|
|
Inj gemcitabine hcl (accord)
|
$485.70 |
$485.70 |
$485.70 |
$131.21
|
|
Inj heparin, pfizer, 1000u
|
$55.10 |
$55.10 |
$55.10 |
$25.30
|
|
Inj intralesional <= 7 lsn(s)
|
$196.95 |
$196.95 |
$196.95 |
$235.13
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,095.90 |
$1,095.90 |
$1,095.90 |
$794.70
|
|
Inj, nithiodote, 3mg / 125mg
|
$984.90 |
$984.90 |
$984.90 |
$468.10
|
|
Inj nivolumab 2 mg hyaluron
|
$48,611.65 |
$48,611.65 |
$48,611.65 |
$15,599.68
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,606.80 |
$1,606.80 |
$1,606.80 |
$2,726.90
|
|
Inj pantoprazole(hikma) 40mg
|
$16.80 |
$16.80 |
$16.80 |
$34.67
|
|
Inj retacrit esrd on dialysi
|
$33,902.60 |
$33,902.60 |
$33,902.60 |
$349.45
|
|
Inj testosterone cypionate
|
$208.65 |
$208.65 |
$208.65 |
$64.96
|
|
Inj, vegzelma, 10 mg
|
$981.40 |
$981.40 |
$981.40 |
$1,186.35
|
|
Inj w/fluor eval cv device
|
$588.90 |
$588.90 |
$588.90 |
$504.40
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$73,182.85 |
$73,182.85 |
$73,182.85 |
$41,083.73
|
|
Ins cerv dilator (sep proc)
|
$570.70 |
$570.70 |
$570.70 |
$490.73
|
|
Insert drug delivery implant
|
$135.00 |
$135.00 |
$135.00 |
$280.00
|
|
Insert intrauterine device iud
|
$20,142.43 |
$20,142.43 |
$20,142.43 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$145.60 |
$145.60 |
$145.60 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,781.05 |
$3,781.05 |
$3,781.05 |
$2,447.63
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$7,634.22 |
$7,634.22 |
$7,634.22 |
$2,585.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$14,561.95 |
$14,561.95 |
$14,561.95 |
$12,384.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$7,634.22 |
$7,634.22 |
$7,634.22 |
$2,103.75
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,957.55 |
$4,957.55 |
$4,957.55 |
$7,183.68
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$20,074.60 |
$20,074.60 |
$20,074.60 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$17,139.64 |
$17,139.64 |
$17,139.64 |
$5,236.80
|
|
Insert pessary/other device
|
$137.00 |
$137.00 |
$137.00 |
$278.90
|
|
In situ hybridization per specimen each additional single probe stain
|
$192.40 |
$192.40 |
$192.40 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$204.10 |
$204.10 |
$204.10 |
$338.40
|
|
Insole orthotic freedom sz6 6816
|
$44.30 |
$44.30 |
$44.30 |
$84.00
|
|
Instillation anticarcinogenic agent bladder
|
$447.20 |
$447.20 |
$447.20 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$1,102.00 |
$1,102.00 |
$1,102.00 |
$4,218.00
|
|
Insulin total
|
$87.75 |
$87.75 |
$87.75 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$2,333.79 |
$2,333.79 |
$2,333.79 |
$8,617.32
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$146.76 |
$146.76 |
$146.76 |
$3,803.11
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$10,427.90 |
$10,427.90 |
$10,427.90 |
$10,427.90
|
|
Interrog evl pm/ldls pm ip
|
$97.50 |
$97.50 |
$97.50 |
$127.20
|
|
Intro cath dialysis circuit w/pta
|
$8,717.80 |
$8,717.80 |
$8,717.80 |
$8,690.50
|
|
Intro catheter aorta
|
$1,367.60 |
$1,367.60 |
$1,367.60 |
$1,678.05
|
|
Intubation endotracheal emergency procedure
|
$25,535.62 |
$25,535.62 |
$25,535.62 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$2,675.76 |
$2,675.76 |
$2,675.76 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$431.50 |
$431.50 |
$431.50 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$110,829.85 |
$110,829.85 |
$110,829.85 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$522.90 |
$522.90 |
$522.90 |
$173.98
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$9,268.95 |
$9,268.95 |
$9,268.95 |
$5,517.12
|
|
Iron
|
$624.00 |
$624.00 |
$624.00 |
$75.00
|
|
Iron binding capacity
|
$48.75 |
$48.75 |
$48.75 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$185.90 |
$185.90 |
$185.90 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$33,187.02 |
$33,187.02 |
$33,187.02 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$137.15 |
$137.15 |
$137.15 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$201.50 |
$201.50 |
$201.50 |
$146.11
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$2,779.35 |
$2,779.35 |
$2,779.35 |
$8,273.35
|
|
IV Fluids (each additional hour)
|
$17,824.85 |
$17,824.85 |
$17,824.85 |
$133.90
|
|
IV Fluids (first hour)
|
$10,692.27 |
$10,692.27 |
$10,692.27 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$14,932.25 |
$14,932.25 |
$14,932.25 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$25,115.80 |
$25,115.80 |
$25,115.80 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$9,550.97 |
$9,550.97 |
$9,550.97 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$3,301.41 |
$3,301.41 |
$3,301.41 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$20,671.49 |
$20,671.49 |
$20,671.49 |
$167.50
|
|
IV Push Injection (first drug)
|
$2,555.15 |
$2,555.15 |
$2,555.15 |
$252.76
|
|
Ixabepilone 15 mg intravenous solution
|
$18,131.05 |
$18,131.05 |
$18,131.05 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$455.65 |
$455.65 |
$455.65 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$466.05 |
$466.05 |
$466.05 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$413.40 |
$413.40 |
$413.40 |
$362.05
|
|
Jkt lso inter
|
$41.27 |
$41.27 |
$41.27 |
$41.27
|
|
John cunningham antibody
|
$39.65 |
$39.65 |
$39.65 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$39.00 |
$39.00 |
$39.00 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$17.20 |
$17.20 |
$17.20 |
$23.52
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,005.55 |
$1,005.55 |
$1,005.55 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$414.05 |
$414.05 |
$414.05 |
$490.75
|
|
Kit case 4.2mm spinejack
|
$5,937.40 |
$5,937.40 |
$5,937.40 |
$7,177.60
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$257.21 |
$257.21 |
$257.21 |
$174.00
|
|
Kit cath f 8f w/glv + wipe ster
|
$1.31 |
$1.31 |
$1.31 |
$9.49
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$6,430.77 |
$6,430.77 |
$6,430.77 |
$9,423.50
|
|
Kit hfx iq ipg bundle
|
$26,541.53 |
$26,541.53 |
$26,541.53 |
$33,859.00
|
|
Kit ipg optimizer smart
|
$29,051.10 |
$29,051.10 |
$29,051.10 |
$49,011.18
|
|
Kit irrigator stoma cone 7721
|
$2.05 |
$2.05 |
$2.05 |
$7.20
|
|
Kit lead specify 5-6-5
|
$13,454.45 |
$13,454.45 |
$13,454.45 |
$16,672.10
|
|
Kit monitr cath camino icp w/integratd licox bolt fitting
|
$1,313.77 |
$1,313.77 |
$1,313.77 |
$1,313.77
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,391.79 |
$1,391.79 |
$1,391.79 |
$1,635.87
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$234.08 |
$234.08 |
$234.08 |
$360.12
|
|
Kit sound processor cochlear osia 2
|
$6,106.28 |
$6,106.28 |
$6,106.28 |
$8,425.00
|
