|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$5,176.30 |
$5,176.30 |
$5,176.30 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,872.35 |
$2,872.35 |
$2,872.35 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$315.25 |
$315.25 |
$315.25 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$538.00 |
$538.00 |
$538.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$196.95 |
$196.95 |
$196.95 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$10,167.30 |
$10,167.30 |
$10,167.30 |
$145.60
|
|
Inj for ext venography
|
$1,177.80 |
$1,177.80 |
$1,177.80 |
$628.80
|
|
Inj hydroxocobalamin IV 25mg
|
$4,819.80 |
$4,819.80 |
$4,819.80 |
$2,452.32
|
|
Inj intralesional <= 7 lsn(s)
|
$136.50 |
$136.50 |
$136.50 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$409.00 |
$409.00 |
$409.00 |
$234.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$14,128.15 |
$14,128.15 |
$14,128.15 |
$11,648.70
|
|
Inj levocarnitine per 1 gm
|
$178.80 |
$178.80 |
$178.80 |
$136.62
|
|
Inj mepivacaine hcl/10 ml
|
$64.80 |
$64.80 |
$64.80 |
$34.34
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,246.40 |
$2,246.40 |
$2,246.40 |
$1,413.35
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$130,285.75 |
$130,285.75 |
$130,285.75 |
$66,582.27
|
|
Inj., omadacycline, 1 mg
|
$2,262.70 |
$2,262.70 |
$2,262.70 |
$865.34
|
|
Inj pantoprazole(hikma) 40mg
|
$16.80 |
$16.80 |
$16.80 |
$34.67
|
|
Inj proc lumbr disk ea lvl
|
$1,472.90 |
$1,472.90 |
$1,472.90 |
$1,106.93
|
|
Inj testosterone cypionate
|
$200.00 |
$200.00 |
$200.00 |
$64.96
|
|
Inj., tildrakizumab, 1 mg
|
$53,884.35 |
$53,884.35 |
$53,884.35 |
$26,635.60
|
|
Inj, tofidence, 1 mg
|
$9,495.10 |
$9,495.10 |
$9,495.10 |
$86.87
|
|
Inj, tyenne, 1 mg
|
$4,503.35 |
$4,503.35 |
$4,503.35 |
$3,525.12
|
|
Inj ustekinumab-kfce, 1 mg
|
$1,103.70 |
$1,103.70 |
$1,103.70 |
$5,244.37
|
|
Inj, vegzelma, 10 mg
|
$981.40 |
$981.40 |
$981.40 |
$1,186.35
|
|
Inj w/fluor eval cv device
|
$972.40 |
$972.40 |
$972.40 |
$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 cath ren art 1st bi
|
$11,329.50 |
$11,329.50 |
$11,329.50 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$6,861.40 |
$6,861.40 |
$6,861.40 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$10,134.15 |
$10,134.15 |
$10,134.15 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$729.95 |
$729.95 |
$729.95 |
$490.73
|
|
Insert cath pleura with image
|
$3,018.60 |
$3,018.60 |
$3,018.60 |
$2,194.40
|
|
Insert cath pleura without image
|
$795.00 |
$795.00 |
$795.00 |
$2,099.70
|
|
Insert drug delivery implant
|
$247.00 |
$247.00 |
$247.00 |
$280.00
|
|
Insert intervert bimech device 22854
|
$1,103.00 |
$1,103.00 |
$1,103.00 |
$1,573.00
|
|
Insert intrauterine device iud
|
$150.00 |
$150.00 |
$150.00 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$466.00 |
$466.00 |
$466.00 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,615.35 |
$5,615.35 |
$5,615.35 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,772.90 |
$2,772.90 |
$2,772.90 |
$2,447.63
|
|
Insertion intra-aortic circulation dev 33970
|
$544.05 |
$544.05 |
$544.05 |
$1,752.40
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$10,497.50 |
$10,497.50 |
$10,497.50 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$46,553.78 |
$46,553.78 |
$46,553.78 |
$2,585.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$37,332.15 |
$37,332.15 |
$37,332.15 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$11,748.10 |
$11,748.10 |
$11,748.10 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$87,550.37 |
$87,550.37 |
$87,550.37 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$4,031.95 |
$4,031.95 |
$4,031.95 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,331.90 |
$3,331.90 |
$3,331.90 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$88,295.28 |
$88,295.28 |
$88,295.28 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,230.15 |
$2,230.15 |
$2,230.15 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$8,460.40 |
$8,460.40 |
$8,460.40 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$24,432.80 |
$24,432.80 |
$24,432.80 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$19,881.96 |
$19,881.96 |
$19,881.96 |
$5,236.80
|
|
Insert nasal septal button
|
$1,007.50 |
$1,007.50 |
$1,007.50 |
$1,783.50
|
|
Insert pelv fixation device
|
$1,193.00 |
$1,193.00 |
$1,193.00 |
$874.40
|
|
Insert pessary/other device
|
$295.10 |
$295.10 |
$295.10 |
$278.90
|
|
Insert pm/icd lead dual
|
$8,732.10 |
$8,732.10 |
$8,732.10 |
$7,115.90
|
|
Insert spine fixation device
|
$2,692.00 |
$2,692.00 |
$2,692.00 |
$1,965.60
|
|
Insert swan-ganz cath
|
$1,787.50 |
$1,787.50 |
$1,787.50 |
$2,164.52
|
|
Insert vad art access left hrt arterial access
|
$2,570.10 |
$2,570.10 |
$2,570.10 |
$4,276.00
|
|
Insitu hybridization manual
|
$174.85 |
$174.85 |
$174.85 |
$401.28
|
|
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
|
|
Insj biomechanical device
|
$139,655.26 |
$139,655.26 |
$139,655.26 |
$1,573.00
|
|
Insj biomechanical device 22853
|
$81,726.33 |
$81,726.33 |
$81,726.33 |
$622.40
|
|
Ins lv lead exist pm/icd
|
$11,204.05 |
$11,204.05 |
$11,204.05 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$1,674.40 |
$1,674.40 |
$1,674.40 |
$2,477.24
|
|
Insole orthotic freedom sz6 6816
|
$44.30 |
$44.30 |
$44.30 |
$84.00
|
|
Ins pm gen exist dual lead
|
$26,230.10 |
$26,230.10 |
$26,230.10 |
$24,159.72
|
|
Ins pq tunnld ip cath w/img
|
$7,079.80 |
$7,079.80 |
$7,079.80 |
$5,486.00
|
|
Ins/rpl pm gen exist dual lead
|
$20,512.05 |
$20,512.05 |
$20,512.05 |
$11,005.50
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$28,931.50 |
$28,931.50 |
$28,931.50 |
$27,318.11
|
|
Insrt/redo neurostim 1 array
|
$96,437.55 |
$96,437.55 |
$96,437.55 |
$21,817.60
|
|
Inst fibrinolysis agent ini day
|
$216.00 |
$216.00 |
$216.00 |
$1,043.35
|
|
Inst fibrinolysis agent sbsq d
|
$193.00 |
$193.00 |
$193.00 |
$997.05
|
|
Instillation anticarcinogenic agent bladder
|
$49,254.64 |
$49,254.64 |
$49,254.64 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$10,418.20 |
$10,418.20 |
$10,418.20 |
$4,218.00
|
|
Inst via cath agent pleurds
|
$428.09 |
$428.09 |
$428.09 |
$1,074.68
|
|
Insulin total
|
$86.45 |
$86.45 |
$86.45 |
$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
|
|
Interdiscal perq aspir dx
|
$1,584.05 |
$1,584.05 |
$1,584.05 |
$1,222.26
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$10,427.90 |
$10,427.90 |
$10,427.90 |
$10,427.90
|
|
Interrogate subq defib
|
$31.85 |
$31.85 |
$31.85 |
$119.60
|
|
Interrog dev eval scrms ip
|
$36.40 |
$36.40 |
$36.40 |
$124.80
|
|
Interrog device eval heart
|
$36.40 |
$36.40 |
$36.40 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$36.40 |
$36.40 |
$36.40 |
$127.20
|
|
Intracard echo interv w/s&i
|
$2,535.65 |
$2,535.65 |
$2,535.65 |
$3,436.00
|
|
Intraoral periapical first
|
$43,266.90 |
$43,266.90 |
$43,266.90 |
$54.88
|
|
Intrapul surf admin endo tube
|
$189.80 |
$189.80 |
$189.80 |
$220.80
|
|
Intrinsic factor antibody
|
$89.05 |
$89.05 |
$89.05 |
$65.00
|
|
Intro cath dialysis circuit
|
$14,265.68 |
$14,265.68 |
$14,265.68 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$17,940.44 |
$17,940.44 |
$17,940.44 |
$8,690.50
|
|
Intro catheter aorta
|
$1,197.95 |
$1,197.95 |
$1,197.95 |
$1,678.05
|
|
Intro cath svc/ivc
|
$1,152.45 |
$1,152.45 |
$1,152.45 |
$1,323.27
|
|
Intro long gi tube
|
$1,871.35 |
$1,871.35 |
$1,871.35 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$342.55 |
$342.55 |
$342.55 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$80,481.39 |
$80,481.39 |
$80,481.39 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$91,192.46 |
$91,192.46 |
$91,192.46 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$13,305.70 |
$13,305.70 |
$13,305.70 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$192.00 |
$192.00 |
$192.00 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$227.50 |
$227.50 |
$227.50 |
$279.10
|