|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$37.12 |
$37.12 |
$37.12 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$39.61 |
$39.61 |
$39.61 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$334.72 |
$334.72 |
$334.72 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$147.38 |
$147.38 |
$147.38 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$137.03 |
$137.03 |
$137.03 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$175.21 |
$175.21 |
$175.21 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$88.50 |
$88.50 |
$88.50 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$176.64 |
$176.64 |
$176.64 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$477.09 |
$477.09 |
$477.09 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$2,717.78 |
$2,717.78 |
$2,717.78 |
$2,791.24
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,125.07 |
$1,125.07 |
$1,125.07 |
$1,654.83
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$472.81 |
$472.81 |
$472.81 |
$780.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$345.06 |
$345.06 |
$345.06 |
$624.00
|
|
Inf thrc fascial pln blk uni w/wo image
|
$346.14 |
$346.14 |
$346.14 |
$820.80
|
|
Infuse radioactive materials
|
$204.83 |
$204.83 |
$204.83 |
$600.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$66.73 |
$66.73 |
$66.73 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$302.60 |
$302.60 |
$302.60 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$11,015.25 |
$11,015.25 |
$11,015.25 |
$16,865.48
|
|
Inj calcitriol per 0.1 mcg
|
$26.82 |
$26.82 |
$26.82 |
$33.36
|
|
Inj, cefepime hcl (b braun)
|
$41.47 |
$41.47 |
$41.47 |
$81.41
|
|
Inj, cefiderocol, 10 mg
|
$272.27 |
$272.27 |
$272.27 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$185.52 |
$185.52 |
$185.52 |
$447.36
|
|
Inj cntr knee arthro incl ct/mri
|
$62.09 |
$62.09 |
$62.09 |
$464.28
|
|
Inj dupuytren cord w/enzyme
|
$230.88 |
$230.88 |
$230.88 |
$416.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,398.44 |
$1,398.44 |
$1,398.44 |
$507.10
|
|
Injection, cangrelor
|
$1,080.31 |
$1,080.31 |
$1,080.31 |
$2,546.20
|
|
Injection carpal tunnel therapeutic (both sides)
|
$493.15 |
$493.15 |
$493.15 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$5,977.85 |
$5,977.85 |
$5,977.85 |
$7,107.73
|
|
Injection, doxercalciferol
|
$25.88 |
$25.88 |
$25.88 |
$30.35
|
|
Injection during cath supravalvular aortography
|
$109.20 |
$109.20 |
$109.20 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$593.78 |
$593.78 |
$593.78 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$218.75 |
$218.75 |
$218.75 |
$441.12
|
|
Injection for bladder x-ray
|
$204.47 |
$204.47 |
$204.47 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$312.95 |
$312.95 |
$312.95 |
$504.00
|
|
Injection for ureter x-ray
|
$292.97 |
$292.97 |
$292.97 |
$515.21
|
|
Injection, fulvestrant
|
$2,326.59 |
$2,326.59 |
$2,326.59 |
$2,756.47
|
|
Injection, isavuconazonium
|
$456.63 |
$456.63 |
$456.63 |
$646.20
|
|
Injection,onabotulinumtoxina
|
$1,542.88 |
$1,542.88 |
$1,542.88 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$170.57 |
$170.57 |
$170.57 |
$717.20
|
|
Injection, renflexis
|
$1,099.44 |
$1,099.44 |
$1,099.44 |
$1,457.42
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$316.87 |
$316.87 |
$316.87 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$494.94 |
$494.94 |
$494.94 |
$1,017.28
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$463.18 |
$463.18 |
$463.18 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$412.51 |
$412.51 |
$412.51 |
$1,119.88
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$591.99 |
$591.99 |
$591.99 |
$1,829.28
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$314.73 |
$314.73 |
$314.73 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$175.57 |
$175.57 |
$175.57 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$80.65 |
$80.65 |
$80.65 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$57.81 |
$57.81 |
$57.81 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$134.53 |
$134.53 |
$134.53 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$67.45 |
$67.45 |
$67.45 |
$141.60
|
|
Inject/treat eye socket
|
$261.92 |
$261.92 |
$261.92 |
$365.40
|
|
Inj epidural sgl lumb-sacral without img
|
$486.37 |
$486.37 |
$486.37 |
$1,450.84
|
|
Inj for ext venography
|
$236.23 |
$236.23 |
$236.23 |
$737.55
|
|
Inj heparin, pfizer, 1000u
|
$22.58 |
$22.58 |
$22.58 |
$24.28
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$97.42 |
$97.42 |
$97.42 |
$1,482.00
|
|
Inj hrt cath w/s&i sel left vent
|
$572.37 |
$572.37 |
$572.37 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$107.41 |
$107.41 |
$107.41 |
$947.65
|
|
Inj levocarnitine per 1 gm
|
$55.77 |
$55.77 |
$55.77 |
$138.96
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$495.65 |
$495.65 |
$495.65 |
$625.00
|
|
Inj mepivacaine hcl/10 ml
|
$28.29 |
$28.29 |
$28.29 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$6,929.35 |
$6,929.35 |
$6,929.35 |
$618.43
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$520.63 |
$520.63 |
$520.63 |
$1,522.56
|
|
Inj., omadacycline, 1 mg
|
$576.08 |
$576.08 |
$576.08 |
$3.80
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$6,985.53 |
$6,985.53 |
$6,985.53 |
$6,403.59
|
|
Inj proc elbow arthro
|
$246.22 |
$246.22 |
$246.22 |
$453.60
|
|
Inj proc myelogram lumbar
|
$584.14 |
$584.14 |
$584.14 |
$922.80
|
|
Inj retacrit esrd on dialysi
|
$249.56 |
$249.56 |
$249.56 |
$307.40
|
|
Inj scleros sol mult veins
|
$324.37 |
$324.37 |
$324.37 |
$687.96
|
|
Inj testosterone cypionate
|
$68.22 |
$68.22 |
$68.22 |
$77.15
|
|
Inj thrc fascial pln blk bi w/wo image
|
$364.69 |
$364.69 |
$364.69 |
$1,483.20
|
|
Inj thrc fascial pln blk uni w/wo image
|
$362.55 |
$362.55 |
$362.55 |
$1,252.02
|
|
Inj w/fluor eval cv device
|
$83.50 |
$83.50 |
$83.50 |
$588.90
|
|
Ins cerv dilator (sep proc)
|
$163.79 |
$163.79 |
$163.79 |
$544.00
|
|
Insert cannula vein-to-vein hemodialysis
|
$1,039.47 |
$1,039.47 |
$1,039.47 |
$6,642.90
|
|
Insert cath pleura with image
|
$922.78 |
$922.78 |
$922.78 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,466.60 |
$1,466.60 |
$1,466.60 |
$2,212.00
|
|
Insertion catheter bladder non indwelling
|
$242.30 |
$242.30 |
$242.30 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$172.00 |
$172.00 |
$172.00 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,881.95 |
$1,881.95 |
$1,881.95 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$783.97 |
$783.97 |
$783.97 |
$2,549.95
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,158.65 |
$1,158.65 |
$1,158.65 |
$2,618.40
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,655.13 |
$5,655.13 |
$5,655.13 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$5,655.13 |
$5,655.13 |
$5,655.13 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$2,432.91 |
$2,432.91 |
$2,432.91 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$850.34 |
$850.34 |
$850.34 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$493.15 |
$493.15 |
$493.15 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$22,006.75 |
$22,006.75 |
$22,006.75 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$7,134.57 |
$7,134.57 |
$7,134.57 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$3,333.92 |
$3,333.92 |
$3,333.92 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$7,298.00 |
$7,298.00 |
$7,298.00 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$362.19 |
$362.19 |
$362.19 |
$5,470.54
|
|
Insert pm/icd lead dual
|
$3,333.92 |
$3,333.92 |
$3,333.92 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$26,038.28 |
$26,038.28 |
$26,038.28 |
$33,948.20
|
|
Insert sq defib electrode
|
$7,872.15 |
$7,872.15 |
$7,872.15 |
$8,167.68
|
|
Insert swan-ganz cath
|
$739.01 |
$739.01 |
$739.01 |
$2,164.52
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$2,502.49 |
$2,502.49 |
$2,502.49 |
$4,705.13
|
|
Ins icd gen exist mlt leads
|
$14,614.55 |
$14,614.55 |
$14,614.55 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$9,988.18 |
$9,988.18 |
$9,988.18 |
$24,159.72
|
|
Insitu hybridization manual
|
$102.06 |
$102.06 |
$102.06 |
$407.11
|
