|
Injection for spleen x-ray
|
$341.60 |
$341.60 |
$341.60 |
$595.50
|
|
Injection for tear sac x-ray
|
$392.00 |
$392.00 |
$392.00 |
$225.20
|
|
Injection for ureter x-ray
|
$614.28 |
$614.28 |
$614.28 |
$444.95
|
|
Injection for ureter x-ray
|
$268.80 |
$268.80 |
$268.80 |
$535.70
|
|
Injection, fosphenytoin sodi
|
$106.92 |
$106.92 |
$106.92 |
$165.20
|
|
Injection, fulvestrant
|
$119.20 |
$119.20 |
$119.20 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$19.49 |
$19.49 |
$19.49 |
$6,679.35
|
|
Injection into brain canal
|
$261.60 |
$261.60 |
$261.60 |
$1,261.40
|
|
Injection into brain canal
|
$304.00 |
$304.00 |
$304.00 |
$844.50
|
|
Injection into hemorrhoid(s)
|
$731.20 |
$731.20 |
$731.20 |
$1,433.00
|
|
Injection into spinal artery
|
$2,231.20 |
$2,231.20 |
$2,231.20 |
$1,710.80
|
|
Injection into vocal cord
|
$323.20 |
$323.20 |
$323.20 |
$459.51
|
|
Injection jaw joint x-ray
|
$964.80 |
$964.80 |
$964.80 |
$340.00
|
|
Injection of HIV prep drug
|
$33.60 |
$33.60 |
$33.60 |
$78.84
|
|
Injection of sinus tract
|
$282.40 |
$282.40 |
$282.40 |
$1,656.00
|
|
Injection,onabotulinumtoxina
|
$10.69 |
$10.69 |
$10.69 |
$2,277.65
|
|
Injection px peyronie ds
|
$275.20 |
$275.20 |
$275.20 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$699.68 |
$699.68 |
$699.68 |
$699.68
|
|
Injection, renflexis
|
$122.30 |
$122.30 |
$122.30 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,594.50 |
$3,594.50 |
$3,594.50 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,006.34 |
$1,006.34 |
$1,006.34 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,134.95 |
$2,134.95 |
$2,134.95 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,351.88 |
$3,351.88 |
$3,351.88 |
$2,083.90
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,199.46 |
$1,199.46 |
$1,199.46 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,690.63 |
$2,690.63 |
$2,690.63 |
$1,890.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,199.46 |
$1,199.46 |
$1,199.46 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,664.76 |
$2,664.76 |
$2,664.76 |
$2,033.40
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$517.24 |
$517.24 |
$517.24 |
$504.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$517.24 |
$517.24 |
$517.24 |
$554.40
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$517.24 |
$517.24 |
$517.24 |
$652.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$92.20 |
$92.20 |
$92.20 |
$145.60
|
|
Injection torsemide 10 mg/ml
|
$4.00 |
$4.00 |
$4.00 |
$16.02
|
|
Injection treatment of eye
|
$955.20 |
$955.20 |
$955.20 |
$2,822.40
|
|
Injection treatment of eye
|
$852.80 |
$852.80 |
$852.80 |
$2,698.92
|
|
Injection treatment of nerve
|
$3,219.20 |
$3,219.20 |
$3,219.20 |
$3,219.20
|
|
Injection treatment of nerve
|
$3,731.20 |
$3,731.20 |
$3,731.20 |
$4,446.30
|
|
Injection treatment of nerve
|
$1,368.00 |
$1,368.00 |
$1,368.00 |
$2,050.30
|
|
Injection treatment of nose
|
$273.60 |
$273.60 |
$273.60 |
$859.59
|
|
Inject sacroiliac joint
|
$801.60 |
$801.60 |
$801.60 |
$1,030.00
|
|
Inject/treat eye socket
|
$366.40 |
$366.40 |
$366.40 |
$381.13
|
|
Inject/treat eye socket
|
$414.40 |
$414.40 |
$414.40 |
$750.70
|
|
Inject/treat eye socket
|
$342.40 |
$342.40 |
$342.40 |
$670.02
|
|
Inj epidural sgl cerv-thor without img
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$1,450.84
|
|
Inj, epinephrine (belcher)
|
$6.24 |
$6.24 |
$6.24 |
$6.55
|
|
Inj follitropin beta 75 iu
|
$307.20 |
$307.20 |
$307.20 |
$207.20
|
|
Inj for ext venography
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$649.80
|
|
Inj for mammo ductogram
|
$833.60 |
$833.60 |
$833.60 |
$399.60
|
|
Inj., fremanezumab-vfrm 1 mg
|
$3.20 |
$3.20 |
$3.20 |
$1,322.20
|
|
Inj, gadopiclenol, 1 ml
|
$4.57 |
$4.57 |
$4.57 |
$37.63
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,616.29 |
$2,616.29 |
$2,616.29 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$127.20 |
$127.20 |
$127.20 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$132.00 |
$132.00 |
$132.00 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$564.78 |
$564.78 |
$564.78 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$564.78 |
$564.78 |
$564.78 |
$982.40
|
|
Inj hydroxyprogst capoat nos
|
$17.60 |
$17.60 |
$17.60 |
$1,228.59
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$3,211.17 |
$3,211.17 |
$3,211.17 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$330.93 |
$330.93 |
$330.93 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$171.20 |
$171.20 |
$171.20 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$154.73 |
$154.73 |
$154.73 |
$6,967.29
|
|
Inj, lecanemab-irmb, 1 mg
|
$2.16 |
$2.16 |
$2.16 |
$1,174.88
|
|
Inj, lidocaine w epinephrine
|
$0.62 |
$0.62 |
$0.62 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$422.40 |
$422.40 |
$422.40 |
$794.70
|
|
Inj multihance
|
$11.92 |
$11.92 |
$11.92 |
$70.54
|
|
Inj naloxone hydrochloride
|
$86.90 |
$86.90 |
$86.90 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,633.23 |
$1,633.23 |
$1,633.23 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$8,129.60 |
$8,129.60 |
$8,129.60 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$7,323.20 |
$7,323.20 |
$7,323.20 |
$2,726.90
|
|
Inj octafluoropropane mic,ml
|
$60.00 |
$60.00 |
$60.00 |
$211.40
|
|
Inj peritoneal venous shunt
|
$100.80 |
$100.80 |
$100.80 |
$406.80
|
|
Inj proc ankle arthr
|
$982.40 |
$982.40 |
$982.40 |
$405.60
|
|
Inj proc elbow arthro
|
$883.20 |
$883.20 |
$883.20 |
$438.00
|
|
Inj proc for lymphang
|
$934.53 |
$934.53 |
$934.53 |
$767.40
|
|
Inj proc lumbr disk ea lvl
|
$1,178.10 |
$1,178.10 |
$1,178.10 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$754.02 |
$754.02 |
$754.02 |
$856.00
|
|
Inj proc sialogram
|
$478.43 |
$478.43 |
$478.43 |
$373.00
|
|
Inj progesterone per 50 mg
|
$3.20 |
$3.20 |
$3.20 |
$13.76
|
|
Inj protirelin per 250 mcg
|
$24.00 |
$24.00 |
$24.00 |
$24.00
|
|
Inj retro urethrocysto
|
$360.04 |
$360.04 |
$360.04 |
$450.00
|
|
Inj, rimabotulinumtoxinb
|
$15.20 |
$15.20 |
$15.20 |
$714.24
|
|
Inj scleros sol mult veins
|
$955.20 |
$955.20 |
$955.20 |
$719.34
|
|
Inj scleros sol sgl vein
|
$534.40 |
$534.40 |
$534.40 |
$567.60
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$113.60 |
$113.60 |
$113.60 |
$436.80
|
|
Inj sulf hexa lipid microsph
|
$67.20 |
$67.20 |
$67.20 |
$256.14
|
|
Inj testostero enanthate 1mg
|
$0.20 |
$0.20 |
$0.20 |
$123.09
|
|
Inj testosterone cypionate
|
$0.20 |
$0.20 |
$0.20 |
$64.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$257.60 |
$257.60 |
$257.60 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$446.40 |
$446.40 |
$446.40 |
$996.15
|
|
Inj., tildrakizumab, 1 mg
|
$160.00 |
$160.00 |
$160.00 |
$26,635.60
|
|
Inj triamcinolone ace X-ray 1mg
|
$21.60 |
$21.60 |
$21.60 |
$1,090.75
|
|
Inj, vancomycin hcl (mylan)
|
$138.52 |
$138.52 |
$138.52 |
$70.84
|
|
Inj vocal cord bulking agent
|
$552.41 |
$552.41 |
$552.41 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$593.60 |
$593.60 |
$593.60 |
$504.40
|
|
Inpt/ed teleconsult30
|
$221.60 |
$221.60 |
$221.60 |
$156.60
|
|
Inpt/ed teleconsult50
|
$301.60 |
$301.60 |
$301.60 |
$223.80
|
|
Inpt/ed teleconsult70
|
$446.40 |
$446.40 |
$446.40 |
$315.00
|
|
Inpt/tele follow up 15
|
$87.20 |
$87.20 |
$87.20 |
$64.80
|
|
Inpt/tele follow up 25
|
$160.00 |
$160.00 |
$160.00 |
$116.80
|
