|
Inj., benralizumab, 1 mg
|
$10,772.97 |
$10,772.97 |
$10,772.97 |
|
|
Inj cefazolin sodium, hikma
|
$24.93 |
$24.93 |
$24.93 |
|
|
Inj ceftolozane tazobactam
|
$809.64 |
$809.64 |
$809.64 |
|
|
Inj crotalidae im f(ab')2 eq
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
|
|
Inj cyclophosphamd (ingenus)
|
$1,317.15 |
$1,317.15 |
$1,317.15 |
|
|
Inj. denosumab-bbdz, 1 mg
|
$5,742.57 |
$5,742.57 |
$5,742.57 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$448.80 |
$448.80 |
$24,195.07 |
|
|
Injection during cath supravalvular aortography
|
$1,079.65 |
$1,079.65 |
$1,268.40 |
|
|
Injection epidural blood patch or clot
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
|
|
Injection for bladder x-ray
|
$1,520.61 |
$1,520.61 |
$1,520.61 |
|
|
Injection for ureter x-ray
|
$341.20 |
$341.20 |
$341.20 |
|
|
Injection, inclisiran, 1 mg
|
$8,488.57 |
$8,488.57 |
$8,488.57 |
|
|
Injection, renflexis
|
$1,354.49 |
$1,354.49 |
$1,354.49 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$714.80 |
$750.40 |
$27,627.47 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$494.40 |
$519.20 |
$19,992.17 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$714.80 |
$714.80 |
$750.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$665.20 |
$665.20 |
$698.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,004.00 |
$1,004.00 |
$1,054.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$665.20 |
$665.20 |
$698.40 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,004.00 |
$1,004.00 |
$1,054.40 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,140.80 |
$1,140.80 |
$1,198.00 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,140.80 |
$1,140.80 |
$1,198.00 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$112.00 |
$112.00 |
$398.80 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$274.00 |
$274.00 |
$302.40 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$287.60 |
$287.60 |
$368.80 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$62.40 |
$110.80 |
$135.85 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$62.40 |
$86.40 |
$124.15 |
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$143.20 |
$152.00 |
$182.65 |
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$59.20 |
$76.40 |
$99.45 |
|
|
Inject sacroiliac joint
|
$688.00 |
$722.40 |
$1,028.95 |
|
|
Inj epidural sgl cerv-thor without img
|
$750.40 |
$750.40 |
$750.40 |
|
|
Inj epidural sgl lumb-sacral without img
|
$750.40 |
$750.40 |
$750.40 |
|
|
Inj, fulvestrant (fresenius)
|
$1,795.30 |
$1,795.30 |
$1,795.30 |
|
|
Inj heparin, pfizer, 1000u
|
$25.30 |
$25.30 |
$25.30 |
|
|
Inj herzuma 10 mg
|
$5,467.01 |
$5,467.01 |
$5,467.01 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,738.45 |
$2,738.45 |
$2,738.45 |
|
|
Inj hydroxocobalamin IV 25mg
|
$4,427.80 |
$4,427.80 |
$4,427.80 |
|
|
Inj intralesional > 7 lsns
|
$156.65 |
$156.65 |
$156.65 |
|
|
Inj ivig privigen 500 mg
|
$8,991.71 |
$8,991.71 |
$8,991.71 |
|
|
Inj, kovaltry, 1 i.u
|
$17,130.75 |
$17,130.75 |
$17,130.75 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$15,903.43 |
$15,903.43 |
$15,903.43 |
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$31,664.74 |
$31,664.74 |
$31,664.74 |
|
|
Inj mepivacaine hcl/10 ml
|
$59.57 |
$59.57 |
$59.57 |
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$8,727.30 |
$8,727.30 |
$8,727.30 |
|
|
Inj, moxifloxacin 100 mg
|
$181.67 |
$181.67 |
$181.67 |
|
|
Inj ogivri 10 mg
|
$4,700.08 |
$4,700.08 |
$4,700.08 |
|
|
Inj ontruzant 10 mg
|
$2,375.63 |
$2,375.63 |
$2,375.63 |
|
|
Inj proc lumbr disk ea lvl
|
$1,197.60 |
$1,197.60 |
$1,197.60 |
|
|
Inj, releuko 1 mcg
|
$1,074.84 |
$1,074.84 |
$1,074.84 |
|
|
Inj retro urethrocysto
|
$2,503.05 |
$2,503.05 |
$2,503.05 |
|
|
Inj, tofidence, 1 mg
|
$801.45 |
$801.45 |
$801.45 |
|
|
Inj triamcinolone ace X-ray 1mg
|
$1,595.32 |
$1,595.32 |
$1,595.32 |
|
|
Inj, tyenne, 1 mg
|
$707.93 |
$707.93 |
$707.93 |
|
|
Inj, vegzelma, 10 mg
|
$4,851.21 |
$4,851.21 |
$4,851.21 |
|
|
Inj w/fluor eval cv device
|
$598.65 |
$598.65 |
$598.65 |
|
|
Ins cath ren art 1st bi
|
$22,802.43 |
$22,802.43 |
$22,802.43 |
|
|
Ins cerv dilator (sep proc)
|
$1,248.65 |
$1,248.65 |
$1,248.65 |
|
|
Insert hepatic shunt (tips)
|
$5,304.40 |
$5,304.40 |
$5,304.40 |
|
|
Insert intrauterine device iud
|
$15,121.47 |
$15,121.47 |
$15,121.47 |
|
|
Insertion catheter bladder non indwelling
|
$108.55 |
$116.00 |
$166.40 |
|
|
Insertion catheter bladder temporary simple
|
$73.20 |
$193.60 |
$17,044.86 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$22,197.16 |
$22,197.16 |
$22,197.16 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,940.00 |
$7,940.00 |
$7,940.00 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,113.60 |
$1,113.60 |
$3,701.48 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,357.60 |
$1,357.60 |
$1,357.60 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$15,939.95 |
$15,939.95 |
$15,939.95 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$6,947.60 |
$6,947.60 |
$12,971.19 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$9,995.64 |
$9,995.64 |
$9,995.64 |
|
|
Insertion ureth cath
|
$10,564.08 |
$10,564.08 |
$10,564.08 |
|
|
Insert swan-ganz cath
|
$4,044.95 |
$4,044.95 |
$4,044.95 |
|
|
Insitu hybridization auto
|
$158.40 |
$158.40 |
$158.40 |
|
|
Insitu hybridization manual
|
$160.80 |
$160.80 |
$160.80 |
|
|
In situ hybridization per specimen each additional single probe stain
|
$13,991.45 |
$13,991.45 |
$13,991.45 |
|
|
In situ hybridization per specimen initial single probe stain
|
$15,355.76 |
$15,355.76 |
$15,355.76 |
|
|
Ins pq tunnld ip cath w/img
|
$10,458.32 |
$10,458.32 |
$10,458.32 |
|
|
Ins/rpl ldless pm right vent w img & eval
|
$3,372.80 |
$3,372.80 |
$3,372.80 |
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$3,174.80 |
$3,174.80 |
$3,174.80 |
|
|
Insti hexaminolevulinate hcl
|
$5,703.75 |
$5,703.75 |
$5,703.75 |
|
|
Instillation anticarcinogenic agent bladder
|
$549.60 |
$549.60 |
$19,486.68 |
|
|
Ins tun cv cath wo subq prt/pm
|
$2,289.60 |
$2,289.60 |
$2,289.60 |
|
|
Ins tun intraperit dia cath
|
$14,044.15 |
$14,044.15 |
$14,044.15 |
|
|
Insulin total
|
$60.00 |
$69.55 |
$78.00 |
|
|
Interdiscal perq aspir dx
|
$498.00 |
$498.00 |
$498.00 |
|
|
Interrog dev eval scrms ip
|
$48.75 |
$48.75 |
$48.75 |
|
|
Interrog device eval heart
|
$95.55 |
$95.55 |
$95.55 |
|
|
Interrog evl pm/ldls pm ip
|
$94.25 |
$94.25 |
$94.25 |
|
|
Intracard echo interv w/s&i
|
$3,829.80 |
$3,829.80 |
$3,829.80 |
|
|
Intrinsic factor antibody
|
$152.00 |
$152.00 |
$152.00 |
|
|
Intro catheter aorta
|
$8,525.17 |
$8,525.17 |
$8,525.17 |
|
|
Intro long gi tube w/mult fluo
|
$852.80 |
$852.80 |
$852.80 |
|
|
Intubation endotracheal emergency procedure
|
$287.60 |
$287.60 |
$494.00 |
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$33.12 |
$33.12 |
$33.12 |
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$189.46 |
$189.46 |
$189.46 |
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$16,516.85 |
$16,516.85 |
$16,516.85 |
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$47.07 |
$47.07 |
$47.07 |
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$5,465.04 |
$5,465.04 |
$5,465.04 |
|
|
Iron
|
$20.80 |
$28.80 |
$63.05 |
|
|
Iron binding capacity
|
$30.80 |
$32.40 |
$84.50 |
|
|
Iron dextran 50 mg/ml injection solution
|
$41.35 |
$41.35 |
$41.35 |
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$274.37 |
$274.37 |
$274.37 |
|