|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$87.80 |
$87.80 |
$11,586.15 |
$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 |
$2,698.92
|
|
Injection treatment of eye
|
$852.80 |
$852.80 |
$852.80 |
$2,685.92
|
|
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 |
$2,956.90 |
$1,029.04
|
|
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
|
$1,681.24 |
$1,681.24 |
$1,681.24 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,681.24 |
$1,681.24 |
$1,681.24 |
$1,450.84
|
|
Inj, epinephrine (belcher)
|
$71.76 |
$71.76 |
$71.76 |
$6.55
|
|
Inj fluphenazine hcl 1.25 mg
|
$50.39 |
$50.39 |
$50.39 |
$40.33
|
|
Inj follitropin beta 75 iu
|
$307.20 |
$307.20 |
$307.20 |
$207.20
|
|
Inj for ext venography
|
$1,177.80 |
$1,177.80 |
$1,444.80 |
$631.80
|
|
Inj for mammo ductogram
|
$833.60 |
$833.60 |
$833.60 |
$397.80
|
|
Inj., fremanezumab-vfrm 1 mg
|
$3.20 |
$3.20 |
$3.20 |
$1,322.20
|
|
Inj, gadopiclenol, 1 ml
|
$27.31 |
$27.31 |
$27.31 |
$37.63
|
|
Inj gemcitabine hcl (accord)
|
$68.13 |
$68.13 |
$68.13 |
$131.21
|
|
Inj heparin, pfizer, 1000u
|
$7.55 |
$7.55 |
$7.55 |
$25.30
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$386.75 |
$386.75 |
$2,550.44 |
$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
|
$98.40 |
$98.40 |
$98.40 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$313.60 |
$313.60 |
$313.60 |
$999.96
|
|
Inj hydroxocobalamin IV 25mg
|
$4,819.80 |
$4,819.80 |
$4,819.80 |
$2,452.32
|
|
Inj hydroxyprogst capoat nos
|
$17.60 |
$17.60 |
$17.60 |
$1,228.59
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$757.60 |
$757.60 |
$757.60 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$136.00 |
$136.00 |
$154.05 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$171.20 |
$171.20 |
$171.20 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$69.60 |
$69.60 |
$69.60 |
$6,967.29
|
|
Inj, lanreotide, (cipla) 1mg
|
$119.16 |
$119.16 |
$119.16 |
$11,648.70
|
|
Inj, lecanemab-irmb, 1 mg
|
$10,565.10 |
$10,565.10 |
$10,565.10 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$70.48 |
$70.48 |
$178.80 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$25.23 |
$25.23 |
$25.23 |
$320.80
|
|
Inj, lidocaine w epinephrine
|
$3.56 |
$3.56 |
$3.56 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$326.00 |
$326.00 |
$422.40 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$51.30 |
$51.30 |
$51.30 |
$34.00
|
|
Inj multihance
|
$5.52 |
$5.52 |
$5.52 |
$70.54
|
|
Inj naloxone hydrochloride
|
$95.36 |
$95.36 |
$95.36 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,267.20 |
$1,267.20 |
$1,267.20 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$984.90 |
$984.90 |
$984.90 |
$472.76
|
|
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 ontruzant 10 mg
|
$147.67 |
$147.67 |
$147.67 |
$6,706.27
|
|
Inj pantoprazole(hikma) 40mg
|
$80.40 |
$80.40 |
$80.40 |
$34.67
|
|
Inj peritoneal venous shunt
|
$100.80 |
$100.80 |
$100.80 |
$406.80
|
|
Inj proc ankle arthr
|
$982.40 |
$982.40 |
$982.40 |
$405.31
|
|
Inj proc elbow arthro
|
$883.20 |
$883.20 |
$965.25 |
$433.00
|
|
Inj proc for lymphang
|
$742.40 |
$742.40 |
$742.40 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$872.80 |
$872.80 |
$872.80 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$488.00 |
$488.00 |
$1,149.85 |
$840.00
|
|
Inj proc sialogram
|
$380.80 |
$380.80 |
$380.80 |
$369.45
|
|
Inj progesterone per 50 mg
|
$3.20 |
$3.20 |
$15.00 |
$13.76
|
|
Inj protirelin per 250 mcg
|
$24.00 |
$24.00 |
$24.00 |
$24.00
|
|
Inj, releuko 1 mcg
|
$1.24 |
$1.24 |
$1.24 |
$475.36
|
|
Inj retacrit esrd on dialysi
|
$926.00 |
$926.00 |
$926.00 |
$307.40
|
|
Inj retro urethrocysto
|
$551.29 |
$551.29 |
$551.29 |
$447.74
|
|
Inj, rimabotulinumtoxinb
|
$15.20 |
$15.20 |
$15.20 |
$714.24
|
|
Inj scleros sol mult veins
|
$955.20 |
$955.20 |
$955.20 |
$707.85
|
|
Inj scleros sol sgl vein
|
$534.40 |
$534.40 |
$534.40 |
$561.88
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$113.60 |
$113.60 |
$113.60 |
$436.80
|
|
Inj sulf hexa lipid microsph
|
$73.40 |
$73.40 |
$73.40 |
$256.14
|
|
Inj teclistamab cqyv 0.5 mg
|
$51.06 |
$51.06 |
$51.06 |
$17,517.56
|
|
Inj testostero enanthate 1mg
|
$0.20 |
$0.20 |
$0.20 |
$123.09
|
|
Inj testosterone cypionate
|
$0.85 |
$0.85 |
$165.03 |
$64.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$257.60 |
$257.60 |
$398.00 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$345.00 |
$345.00 |
$446.40 |
$837.50
|
|
Inj., tildrakizumab, 1 mg
|
$282.29 |
$282.29 |
$282.29 |
$26,635.60
|
|
Inj triamcinolone ace X-ray 1mg
|
$21.60 |
$21.60 |
$1,837.91 |
$1,090.75
|
|
Inj, tyenne, 1 mg
|
$8.72 |
$8.72 |
$8.72 |
$3,525.12
|
|
Inj, uzedy, 1 mg
|
$41.56 |
$41.56 |
$41.56 |
$11,475.96
|
|
Inj, vancomycin hcl (mylan)
|
$85.52 |
$85.52 |
$85.52 |
$70.84
|
|
Inj, vancomycin hcl (xellia)
|
$47.80 |
$47.80 |
$47.80 |
$85.20
|
|
Inj vancomycin (xellia) 10mg
|
$1.20 |
$1.20 |
$1.20 |
$76.59
|
|
Inj w/fluor eval cv device
|
$593.60 |
$593.60 |
$1,306.50 |
$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
|
|
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
|
|
Inpt/tele follow up 35
|
$230.40 |
$230.40 |
$230.40 |
$168.96
|
|
Ins cath ren art 1st bi
|
$4,206.26 |
$4,206.26 |
$5,276.05 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$3,395.20 |
$3,395.20 |
$9,750.00 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$5,251.20 |
$5,251.20 |
$5,251.20 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$5,395.20 |
$5,395.20 |
$5,395.20 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$571.35 |
$571.35 |
$673.11 |
$488.35
|
|
Insemination of oocytes
|
$314.40 |
$314.40 |
$314.40 |
$314.40
|
|
Insert abdomen-venous drain
|
$1,777.60 |
$1,777.60 |
$1,777.60 |
$3,758.23
|
|
Insert and remove bone pin
|
$2,441.78 |
$2,441.78 |
$2,441.78 |
$4,433.36
|
|
Insert ant drainage device
|
$5,108.80 |
$5,108.80 |
$5,108.80 |
$5,108.80
|
|
Insert brain-fluid device 61215
|
$1,197.60 |
$1,197.60 |
$1,197.60 |
$7,181.20
|
|
Insert cannula hemo oth 36815
|
$329.60 |
$329.60 |
$329.60 |
$5,983.35
|
|
Insert cannula vein-to-vein hemodialysis
|
$310.40 |
$310.40 |
$310.40 |
$7,279.50
|
|
Insert cath pleura with image
|
$3,022.40 |
$3,022.40 |
$3,096.60 |
$2,194.40
|
