|
Inj, cefepime hcl (b braun)
|
$166.45 |
$166.45 |
$166.45 |
$69.85
|
|
Inj, clindamycin (baxter)
|
$59.67 |
$59.67 |
$59.67 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$680.20 |
$680.20 |
$680.20 |
$436.80
|
|
Inj dx for sinogram
|
$320.90 |
$320.90 |
$320.90 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,977.25 |
$1,977.25 |
$1,977.25 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,214.55 |
$1,214.55 |
$1,214.55 |
$503.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,714.20 |
$1,714.20 |
$1,714.20 |
$458.15
|
|
Injection epidural blood patch or clot
|
$946.40 |
$946.40 |
$946.40 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$125.40 |
$125.40 |
$125.40 |
$436.00
|
|
Injection for bladder x-ray
|
$884.30 |
$884.30 |
$884.30 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$632.25 |
$632.25 |
$632.25 |
$497.76
|
|
Injection for ureter x-ray
|
$1,159.15 |
$1,159.15 |
$1,159.15 |
$515.21
|
|
Injection, fulvestrant
|
$2,948.72 |
$2,948.72 |
$2,948.72 |
$1,719.16
|
|
Injection into brain canal
|
$1,366.90 |
$1,366.90 |
$1,366.90 |
$844.50
|
|
Injection,onabotulinumtoxina
|
$3,929.49 |
$3,929.49 |
$3,929.49 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$529.80 |
$529.80 |
$529.80 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,421.70 |
$2,421.70 |
$2,421.70 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$558.05 |
$558.05 |
$558.05 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,615.05 |
$2,615.05 |
$2,615.05 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$896.50 |
$896.50 |
$896.50 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,527.50 |
$2,527.50 |
$2,527.50 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$545.55 |
$545.55 |
$545.55 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,615.05 |
$2,615.05 |
$2,615.05 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,114.10 |
$2,114.10 |
$2,114.10 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,114.10 |
$2,114.10 |
$2,114.10 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$208.95 |
$208.95 |
$208.95 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$412.50 |
$412.50 |
$412.50 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$412.50 |
$412.50 |
$412.50 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$175.35 |
$175.35 |
$175.35 |
$145.60
|
|
Inject sacroiliac joint
|
$1,375.60 |
$1,375.60 |
$1,375.60 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$2,114.10 |
$2,114.10 |
$2,114.10 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$2,114.10 |
$2,114.10 |
$2,114.10 |
$1,450.84
|
|
Inj herzuma 10 mg
|
$11,943.58 |
$11,943.58 |
$11,943.58 |
$7,775.46
|
|
Inj intralesional <= 7 lsn(s)
|
$618.10 |
$618.10 |
$618.10 |
$235.13
|
|
Inj, invega hafyera/trinza
|
$21,710.95 |
$21,710.95 |
$21,710.95 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$11,452.70 |
$11,452.70 |
$11,452.70 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$197.06 |
$197.06 |
$197.06 |
$136.62
|
|
Inj, levothyroxine, hikma
|
$379.83 |
$379.83 |
$379.83 |
$42.89
|
|
Inj, lidocaine w epinephrine
|
$1.73 |
$1.73 |
$1.73 |
$45.60
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$2,068.70 |
$2,068.70 |
$2,068.70 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$84.31 |
$84.31 |
$84.31 |
$34.34
|
|
Inj, meropenem (b. braun)
|
$166.78 |
$166.78 |
$166.78 |
$71.14
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$14,259.97 |
$14,259.97 |
$14,259.97 |
$8,304.04
|
|
Inj multihance
|
$119.77 |
$119.77 |
$119.77 |
$70.54
|
|
Inj naloxone hydrochloride
|
$167.28 |
$167.28 |
$167.28 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,012.55 |
$2,012.55 |
$2,012.55 |
$1,413.35
|
|
Inj ontruzant 10 mg
|
$11,280.68 |
$11,280.68 |
$11,280.68 |
$6,706.27
|
|
Inj proc elbow arthro
|
$113.20 |
$113.20 |
$113.20 |
$432.00
|
|
Inj proc myelogram lumbar
|
$785.90 |
$785.90 |
$785.90 |
$838.30
|
|
Inj retro urethrocysto
|
$1,085.40 |
$1,085.40 |
$1,085.40 |
$447.74
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$128.00 |
$128.00 |
$128.00 |
$436.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$3,063.86 |
$3,063.86 |
$3,063.86 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$3,063.86 |
$3,063.86 |
$3,063.86 |
$818.00
|
|
Inj, vegzelma, 10 mg
|
$8,240.98 |
$8,240.98 |
$8,240.98 |
$1,186.35
|
|
Inj w/fluor eval cv device
|
$428.70 |
$428.70 |
$428.70 |
$504.40
|
|
Insert cath pleura without image
|
$5,272.35 |
$5,272.35 |
$5,272.35 |
$2,099.70
|
|
Insertion catheter bladder non indwelling
|
$233.25 |
$233.25 |
$233.25 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,353.70 |
$2,353.70 |
$2,353.70 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,088.10 |
$2,088.10 |
$2,088.10 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,553.20 |
$2,553.20 |
$2,553.20 |
$2,453.83
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$17,353.10 |
$17,353.10 |
$17,353.10 |
$7,183.68
|
|
Insert pessary/other device
|
$567.15 |
$567.15 |
$567.15 |
$278.90
|
|
In situ hybridization per specimen each additional single probe stain
|
$1,100.90 |
$1,100.90 |
$1,100.90 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$1,100.90 |
$1,100.90 |
$1,100.90 |
$338.40
|
|
Insti hexaminolevulinate hcl
|
$3,357.71 |
$3,357.71 |
$3,357.71 |
$2,356.80
|
|
Instillation anticarcinogenic agent bladder
|
$364.00 |
$364.00 |
$364.00 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$9,803.80 |
$9,803.80 |
$9,803.80 |
$4,218.00
|
|
Insulin total
|
$128.15 |
$128.15 |
$128.15 |
$66.64
|
|
Interrog evl pm/ldls pm ip
|
$107.45 |
$107.45 |
$107.45 |
$127.20
|
|
Intranasal biopsy 30100
|
$4,155.40 |
$4,155.40 |
$4,155.40 |
$2,265.00
|
|
Intraoral i+d tongue/floor lingual 41000
|
$227.50 |
$227.50 |
$227.50 |
$1,331.45
|
|
Intrinsic factor antibody
|
$146.15 |
$146.15 |
$146.15 |
$65.00
|
|
Intro long gi tube w/mult fluo
|
$873.65 |
$873.65 |
$873.65 |
$469.00
|
|
Intubation endotracheal emergency procedure
|
$466.40 |
$466.40 |
$466.40 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$1,893.99 |
$1,893.99 |
$1,893.99 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$921.33 |
$921.33 |
$921.33 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$26,999.12 |
$26,999.12 |
$26,999.12 |
$62,692.46
|
|
Ip/obs cnsltj new/est low 45
|
$231.85 |
$231.85 |
$231.85 |
$174.20
|
|
Ip/obs cnsltj new/est mod 60
|
$284.45 |
$284.45 |
$284.45 |
$284.45
|
|
Ip/obs consltj new/est hi 80
|
$922.05 |
$922.05 |
$922.05 |
$332.80
|
|
Ip/obs consltj new/est sf 35
|
$181.95 |
$181.95 |
$181.95 |
$134.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$84.59 |
$84.59 |
$84.59 |
$173.98
|
|
Iron
|
$71.50 |
$71.50 |
$71.50 |
$75.00
|
|
Iron binding capacity
|
$97.05 |
$97.05 |
$97.05 |
$63.91
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$575.61 |
$575.61 |
$575.61 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$226.50 |
$226.50 |
$226.50 |
$146.11
|
|
IV Fluids (each additional hour)
|
$532.50 |
$532.50 |
$532.50 |
$133.90
|
|
IV Fluids (first hour)
|
$757.55 |
$757.55 |
$757.55 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$404.35 |
$404.35 |
$404.35 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$444.80 |
$444.80 |
$444.80 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$465.15 |
$465.15 |
$465.15 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$489.30 |
$489.30 |
$489.30 |
$439.56
|
|
IV njx tst vasc flo flap/grf
|
$1,158.65 |
$1,158.65 |
$1,158.65 |
$476.00
|
|
IV Push Injection (each additional drug)
|
$175.35 |
$175.35 |
$175.35 |
$167.50
|
|
IV Push Injection (first drug)
|
$412.50 |
$412.50 |
$412.50 |
$252.76
|
|
Ivp w/nephrotomography
|
$1,064.90 |
$1,064.90 |
$1,064.90 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$1,015.10 |
$1,015.10 |
$1,015.10 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$416.55 |
$416.55 |
$416.55 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$320.90 |
$320.90 |
$320.90 |
$362.05
|
|
John cunningham antibody
|
$105.40 |
$105.40 |
$105.40 |
$78.00
|