|
Infectious agent nucleic acid quantification hepatitis c
|
$90.72 |
$90.72 |
$90.72 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$290.08 |
$290.08 |
$290.08 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$167.44 |
$167.44 |
$167.44 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$74.86 |
$74.86 |
$74.86 |
$178.95
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$64.09 |
$64.09 |
$64.09 |
$157.14
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$412.72 |
$412.72 |
$412.72 |
$344.50
|
|
Initiation & management bipap/cpap initial day
|
$266.00 |
$266.00 |
$266.00 |
$608.40
|
|
Inj, abilify maintena, 1 mg
|
$973.93 |
$973.93 |
$973.93 |
$3,138.28
|
|
Inj ceftolozane tazobactam
|
$0.28 |
$0.28 |
$0.28 |
$248.93
|
|
Inj, clevidipine butyrate
|
$3.39 |
$3.39 |
$3.39 |
$4.86
|
|
Inj, durolane 1 mg
|
$678.16 |
$678.16 |
$678.16 |
$12.72
|
|
Inj dx for sinogram
|
$754.88 |
$754.88 |
$754.88 |
$484.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,221.36 |
$1,221.36 |
$1,221.36 |
$609.20
|
|
Injection, cangrelor
|
$10.61 |
$10.61 |
$10.61 |
$1,305.72
|
|
Injection, daratumumab 10 mg
|
$25.49 |
$25.49 |
$25.49 |
$85.20
|
|
Injection during cath supravalvular aortography
|
$3,022.88 |
$3,022.88 |
$3,022.88 |
$1,604.20
|
|
Injection for arthrography wrist (both sides)
|
$1,011.92 |
$1,011.92 |
$1,011.92 |
$521.18
|
|
Injection for bladder x-ray
|
$597.52 |
$597.52 |
$597.52 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$353.92 |
$353.92 |
$353.92 |
$514.36
|
|
Injection for spleen x-ray
|
$745.36 |
$745.36 |
$745.36 |
$341.60
|
|
Injection for ureter x-ray
|
$636.16 |
$636.16 |
$636.16 |
$544.50
|
|
Injection, fulvestrant
|
$32.80 |
$32.80 |
$32.80 |
$166.25
|
|
Injection glatiramer acetate
|
$171.93 |
$171.93 |
$171.93 |
$458.43
|
|
Injection into brain canal
|
$765.52 |
$765.52 |
$765.52 |
$961.20
|
|
Injection jugular
|
$789.60 |
$789.60 |
$789.60 |
$1,134.12
|
|
Injection,onabotulinumtoxina
|
$415.49 |
$415.49 |
$415.49 |
$12.88
|
|
Injection radioactive tracer sentinel node (both sides)
|
$607.04 |
$607.04 |
$607.04 |
$787.50
|
|
Injection, renflexis
|
$51.35 |
$51.35 |
$51.35 |
$632.98
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,044.40 |
$1,044.40 |
$1,044.40 |
$1,066.24
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$786.80 |
$786.80 |
$786.80 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$786.80 |
$786.80 |
$786.80 |
$1,017.28
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,271.20 |
$1,271.20 |
$1,271.20 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,257.92 |
$2,257.92 |
$2,257.92 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,271.20 |
$1,271.20 |
$1,271.20 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,257.92 |
$2,257.92 |
$2,257.92 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,317.12 |
$1,317.12 |
$1,317.12 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$303.52 |
$303.52 |
$303.52 |
$460.94
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$89.60 |
$89.60 |
$89.60 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$89.60 |
$89.60 |
$89.60 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$89.60 |
$89.60 |
$89.60 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$44.80 |
$44.80 |
$44.80 |
$130.19
|
|
Inj epidural sgl lumb-sacral without img
|
$1,366.96 |
$1,366.96 |
$1,366.96 |
$1,260.60
|
|
Inj for ext venography
|
$1,651.44 |
$1,651.44 |
$1,651.44 |
$946.64
|
|
Inj for mammo ductogram
|
$813.68 |
$813.68 |
$813.68 |
$469.16
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,013.76 |
$2,013.76 |
$2,013.76 |
$1,646.97
|
|
Inj ivig privigen 500 mg
|
$57.52 |
$57.52 |
$57.52 |
$6,144.00
|
|
Inj melpha hydroch nos 50 mg
|
$1,279.49 |
$1,279.49 |
$1,279.49 |
$1,713.99
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,582.72 |
$2,582.72 |
$2,582.72 |
$1,522.56
|
|
Inj proc ankle arthr
|
$927.36 |
$927.36 |
$927.36 |
$405.60
|
|
Inj proc elbow arthro
|
$1,034.32 |
$1,034.32 |
$1,034.32 |
$483.15
|
|
Inj proc for lymphang
|
$382.48 |
$382.48 |
$382.48 |
$1,718.73
|
|
Inj proc lumbr disk ea lvl
|
$1,979.60 |
$1,979.60 |
$1,979.60 |
$1,218.51
|
|
Inj proc myelogram lumbar
|
$1,180.48 |
$1,180.48 |
$1,180.48 |
$1,026.35
|
|
Inj retro urethrocysto
|
$691.60 |
$691.60 |
$691.60 |
$569.60
|
|
Inj secretin synthetic human
|
$238.14 |
$238.14 |
$238.14 |
$610.89
|
|
Inj w/fluor eval cv device
|
$266.56 |
$266.56 |
$266.56 |
$573.00
|
|
Ins cath ren art 1st bi
|
$9,990.40 |
$9,990.40 |
$9,990.40 |
$6,012.50
|
|
Ins cath ren art 1st uni
|
$5,037.20 |
$5,037.20 |
$5,037.20 |
$4,628.00
|
|
Ins cath ren art 2nd+ bi
|
$11,159.12 |
$11,159.12 |
$11,159.12 |
$5,251.20
|
|
Ins cath ren art 2nd+ uni
|
$6,817.44 |
$6,817.44 |
$6,817.44 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$188.72 |
$188.72 |
$188.72 |
$557.60
|
|
Insert cath pleura with image
|
$2,514.96 |
$2,514.96 |
$2,514.96 |
$2,239.02
|
|
Insert hepatic shunt (tips)
|
$4,285.68 |
$4,285.68 |
$4,285.68 |
$9,754.48
|
|
Insertion catheter bladder temporary simple
|
$59.92 |
$59.92 |
$59.92 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$6,110.72 |
$6,110.72 |
$6,110.72 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$5,387.20 |
$5,387.20 |
$5,387.20 |
$2,346.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$12,015.36 |
$12,015.36 |
$12,015.36 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$938.00 |
$938.00 |
$938.00 |
$2,457.24
|
|
Insertion of catheter vein
|
$2,750.16 |
$2,750.16 |
$2,750.16 |
$2,214.00
|
|
Insertion of catheter vein
|
$2,489.76 |
$2,489.76 |
$2,489.76 |
$1,079.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$15,978.48 |
$15,978.48 |
$15,978.48 |
$14,777.24
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$15,554.56 |
$15,554.56 |
$15,554.56 |
$13,806.24
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$10,655.12 |
$10,655.12 |
$10,655.12 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,494.64 |
$1,494.64 |
$1,494.64 |
$2,079.43
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$56,556.64 |
$56,556.64 |
$56,556.64 |
$32,608.80
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$6,361.04 |
$6,361.04 |
$6,361.04 |
$7,513.67
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$6,361.04 |
$6,361.04 |
$6,361.04 |
$8,460.40
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$2,423.12 |
$2,423.12 |
$2,423.12 |
$5,423.04
|
|
Insert picvad cath
|
$2,904.72 |
$2,904.72 |
$2,904.72 |
$4,201.80
|
|
Insert pm/icd lead dual
|
$6,361.04 |
$6,361.04 |
$6,361.04 |
$7,885.34
|
|
Insert prost urethral stent
|
$227.36 |
$227.36 |
$227.36 |
$1,804.00
|
|
Insert/repl sq defib w/eltrd
|
$91,280.00 |
$91,280.00 |
$91,280.00 |
$33,948.20
|
|
Insert sq defib electrode
|
$15,509.20 |
$15,509.20 |
$15,509.20 |
$8,366.80
|
|
Insert swan-ganz cath
|
$2,073.68 |
$2,073.68 |
$2,073.68 |
$2,269.00
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$3,483.20 |
$3,483.20 |
$3,483.20 |
$4,705.13
|
|
Insert tunneled cv cath
|
$3,483.20 |
$3,483.20 |
$3,483.20 |
$4,350.11
|
|
Insert uteri tandem/ovoids
|
$4,216.24 |
$4,216.24 |
$4,216.24 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$1,080.80 |
$1,080.80 |
$1,080.80 |
$5,135.65
|
|
Insert vad art access left hrt art & vein access
|
$1,080.80 |
$1,080.80 |
$1,080.80 |
$7,330.95
|
|
Ins icd gen exist mlt leads
|
$42,182.56 |
$42,182.56 |
$42,182.56 |
$31,488.80
|
|
Ins icd gen exist sgl lead
|
$33,746.16 |
$33,746.16 |
$33,746.16 |
$26,433.98
|
|
Insitu hybridization (fish)
|
$294.00 |
$294.00 |
$294.00 |
$481.60
|
|
Insitu hybridization manual
|
$227.36 |
$227.36 |
$227.36 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$90.16 |
$90.16 |
$90.16 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$142.24 |
$142.24 |
$142.24 |
$364.00
|
|
Ins lv lead exist pm/icd
|
$8,524.88 |
$8,524.88 |
$8,524.88 |
$12,270.00
|
|
Ins picad w subq port 5yr>
|
$2,904.72 |
$2,904.72 |
$2,904.72 |
$4,312.97
|
|
Ins pm gen exist dual lead
|
$33,746.16 |
$33,746.16 |
$33,746.16 |
$25,546.94
|
|
Ins pm gen w/exist mlt leads
|
$14,721.28 |
$14,721.28 |
$14,721.28 |
$17,191.21
|
|
Ins pq tunnld ip cath w/img
|
$5,845.28 |
$5,845.28 |
$5,845.28 |
$5,597.45
|
