|
Initial nursing facility care/day 35 minutes
|
$271.20 |
$271.20 |
$271.20 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$347.10 |
$347.10 |
$347.10 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$192.80 |
$192.80 |
$192.80 |
$128.00
|
|
Inj, abilify maintena, 1 mg
|
$7,645.07 |
$7,645.07 |
$7,645.07 |
$5,355.30
|
|
Inj acetaminophen -fresenius
|
$116.63 |
$116.63 |
$116.63 |
$36.60
|
|
Inj, adalimumab, 1 mg
|
$9,110.87 |
$9,110.87 |
$9,110.87 |
$12,098.05
|
|
Inj alymsys 10 mg
|
$7,566.00 |
$7,566.00 |
$7,566.00 |
$1,280.74
|
|
Inj., aristada initio, 1 mg
|
$6,409.97 |
$6,409.97 |
$6,409.97 |
$4,052.45
|
|
Inj., benralizumab, 1 mg
|
$15,390.61 |
$15,390.61 |
$15,390.61 |
$11,310.00
|
|
Inj, bupivacaine liposome
|
$1,116.18 |
$1,116.18 |
$1,116.18 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$106.61 |
$106.61 |
$106.61 |
$27.38
|
|
Inj, cefepime hcl (b braun)
|
$239.09 |
$239.09 |
$239.09 |
$69.85
|
|
Inj ceftolozane tazobactam
|
$926.75 |
$926.75 |
$926.75 |
$364.86
|
|
Inj, clindamycin (baxter)
|
$130.00 |
$130.00 |
$130.00 |
$48.30
|
|
Injection epidural blood patch or clot
|
$264.60 |
$264.60 |
$264.60 |
$1,182.33
|
|
Injection for bladder x-ray
|
$413.05 |
$413.05 |
$413.05 |
$459.20
|
|
Injection, fulvestrant
|
$265.76 |
$265.76 |
$265.76 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$9,080.41 |
$9,080.41 |
$9,080.41 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$2,289.04 |
$2,289.04 |
$2,289.04 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,725.45 |
$1,725.45 |
$1,725.45 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$154.85 |
$154.85 |
$154.85 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$219.80 |
$219.80 |
$219.80 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$674.85 |
$674.85 |
$674.85 |
$2,040.36
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$514.30 |
$514.30 |
$514.30 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$504.75 |
$504.75 |
$504.75 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$110.60 |
$110.60 |
$110.60 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$186.20 |
$186.20 |
$186.20 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$232.15 |
$232.15 |
$232.15 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$120.05 |
$120.05 |
$120.05 |
$145.60
|
|
Inj epidural sgl cerv-thor without img
|
$348.20 |
$348.20 |
$348.20 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$325.25 |
$325.25 |
$325.25 |
$1,450.84
|
|
Inj herzuma 10 mg
|
$10,336.65 |
$10,336.65 |
$10,336.65 |
$7,775.46
|
|
Inj intralesional <= 7 lsn(s)
|
$134.95 |
$134.95 |
$134.95 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$19,823.63 |
$19,823.63 |
$19,823.63 |
$6,967.29
|
|
Inj, lanreotide, (cipla) 1mg
|
$23,407.26 |
$23,407.26 |
$23,407.26 |
$11,648.70
|
|
Inj, lidocaine w epinephrine
|
$68.04 |
$68.04 |
$68.04 |
$45.60
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,073.10 |
$1,073.10 |
$1,073.10 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$135.22 |
$135.22 |
$135.22 |
$34.34
|
|
Inj meropenem (wg crit care)
|
$399.70 |
$399.70 |
$399.70 |
$82.42
|
|
Inj, moxifloxacin 100 mg
|
$103.88 |
$103.88 |
$103.88 |
$101.31
|
|
Inj naloxone hydrochloride
|
$400.92 |
$400.92 |
$400.92 |
$83.16
|
|
Inj, nithiodote, 3mg / 125mg
|
$559.79 |
$559.79 |
$559.79 |
$468.10
|
|
Inj ogivri 10 mg
|
$6,909.66 |
$6,909.66 |
$6,909.66 |
$4,492.28
|
|
Inj ontruzant 10 mg
|
$9,762.94 |
$9,762.94 |
$9,762.94 |
$6,706.27
|
|
Inj, pemivibart, 4500 mg
|
$2,500.07 |
$2,500.07 |
$2,500.07 |
$1,235.55
|
|
Inj secukinumab intrav 1mg
|
$5,679.00 |
$5,679.00 |
$5,679.00 |
$4,413.21
|
|
Inj testosterone cypionate
|
$10.64 |
$10.64 |
$10.64 |
$64.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,241.30 |
$1,241.30 |
$1,241.30 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,241.30 |
$1,241.30 |
$1,241.30 |
$818.00
|
|
Inj, vancomycin hcl (mylan)
|
$244.20 |
$244.20 |
$244.20 |
$72.33
|
|
Inj vocal cord bulking agent
|
$715.00 |
$715.00 |
$715.00 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$1,271.35 |
$1,271.35 |
$1,271.35 |
$504.40
|
|
Insertion catheter bladder non indwelling
|
$136.40 |
$136.40 |
$136.40 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$530.90 |
$530.90 |
$530.90 |
$4,897.20
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$515.05 |
$515.05 |
$515.05 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,858.55 |
$1,858.55 |
$1,858.55 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,221.10 |
$2,221.10 |
$2,221.10 |
$2,453.83
|
|
Insert lens prosthesis
|
$1,159.80 |
$1,159.80 |
$1,159.80 |
$3,333.13
|
|
Insert pessary/other device
|
$287.90 |
$287.90 |
$287.90 |
$278.90
|
|
In situ hybridization per specimen each additional single probe stain
|
$724.30 |
$724.30 |
$724.30 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$724.30 |
$724.30 |
$724.30 |
$338.40
|
|
Ins tun cv cath wo subq prt/pm
|
$4,521.45 |
$4,521.45 |
$4,521.45 |
$4,218.00
|
|
Insulin total
|
$153.85 |
$153.85 |
$153.85 |
$66.64
|
|
Interrog evl pm/ldls pm ip
|
$50.70 |
$50.70 |
$50.70 |
$127.20
|
|
Intranasal biopsy 30100
|
$2,104.10 |
$2,104.10 |
$2,104.10 |
$2,265.00
|
|
Intraoral i+d tongue/floor lingual 41000
|
$211.25 |
$211.25 |
$211.25 |
$1,331.45
|
|
Intrinsic factor antibody
|
$154.50 |
$154.50 |
$154.50 |
$65.00
|
|
Intro long gi tube w/mult fluo
|
$899.80 |
$899.80 |
$899.80 |
$469.00
|
|
Intubation endotracheal emergency procedure
|
$257.80 |
$257.80 |
$257.80 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$414.18 |
$414.18 |
$414.18 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$603.00 |
$603.00 |
$603.00 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$23,366.57 |
$23,366.57 |
$23,366.57 |
$62,692.46
|
|
Ip/obs cnsltj new/est low 45
|
$264.80 |
$264.80 |
$264.80 |
$174.20
|
|
Ip/obs cnsltj new/est mod 60
|
$381.75 |
$381.75 |
$381.75 |
$284.45
|
|
Ip/obs consltj new/est hi 80
|
$460.15 |
$460.15 |
$460.15 |
$332.80
|
|
Ip/obs consltj new/est sf 35
|
$173.45 |
$173.45 |
$173.45 |
$134.46
|
|
Iron
|
$113.40 |
$113.40 |
$113.40 |
$75.00
|
|
Iron binding capacity
|
$129.65 |
$129.65 |
$129.65 |
$63.91
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$670.45 |
$670.45 |
$670.45 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$156.55 |
$156.55 |
$156.55 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$202.45 |
$202.45 |
$202.45 |
$146.11
|
|
IV Fluids (each additional hour)
|
$178.15 |
$178.15 |
$178.15 |
$133.90
|
|
IV Fluids (first hour)
|
$533.10 |
$533.10 |
$533.10 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$153.85 |
$153.85 |
$153.85 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$159.35 |
$159.35 |
$159.35 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$178.15 |
$178.15 |
$178.15 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$533.10 |
$533.10 |
$533.10 |
$439.56
|
|
IV njx tst vasc flo flap/grf
|
$555.60 |
$555.60 |
$555.60 |
$476.00
|
|
IV Push Injection (each additional drug)
|
$120.05 |
$120.05 |
$120.05 |
$167.50
|
|
IV Push Injection (first drug)
|
$120.05 |
$120.05 |
$120.05 |
$252.76
|
|
Ivp w/nephrotomography
|
$1,477.95 |
$1,477.95 |
$1,477.95 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$1,029.80 |
$1,029.80 |
$1,029.80 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$473.75 |
$473.75 |
$473.75 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$645.15 |
$645.15 |
$645.15 |
$362.05
|
|
John cunningham antibody
|
$106.65 |
$106.65 |
$106.65 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$110.05 |
$110.05 |
$110.05 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$69.25 |
$69.25 |
$69.25 |
$23.52
|
|
Kidney imaging morphology
|
$2,411.90 |
$2,411.90 |
$2,411.90 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$2,389.00 |
$2,389.00 |
$2,389.00 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$2,411.90 |
$2,411.90 |
$2,411.90 |
$1,433.22
|
