|
Injection for arthrography wrist (both sides)
|
$1,034.32 |
$1,034.32 |
$1,034.32 |
$521.18
|
|
Injection for bladder x-ray
|
$2,709.28 |
$2,709.28 |
$2,709.28 |
$585.00
|
|
Injection for hip x-ray
|
$2,536.80 |
$2,536.80 |
$2,536.80 |
$1,189.34
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$582.40 |
$582.40 |
$582.40 |
$514.36
|
|
Injection glatiramer acetate
|
$172.26 |
$172.26 |
$172.26 |
$458.43
|
|
Injection jugular
|
$524.72 |
$524.72 |
$524.72 |
$1,134.12
|
|
Injection,onabotulinumtoxina
|
$4.11 |
$4.11 |
$4.11 |
$12.88
|
|
Injection radioactive tracer sentinel node (both sides)
|
$620.48 |
$620.48 |
$620.48 |
$787.50
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,066.24 |
$1,066.24 |
$1,066.24 |
$1,066.24
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$638.96 |
$638.96 |
$638.96 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$803.04 |
$803.04 |
$803.04 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,297.68 |
$2,297.68 |
$2,297.68 |
$2,251.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,514.24 |
$1,514.24 |
$1,514.24 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,495.76 |
$1,495.76 |
$1,495.76 |
$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
|
$99.68 |
$99.68 |
$99.68 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$99.68 |
$99.68 |
$99.68 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$114.24 |
$114.24 |
$114.24 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$48.72 |
$48.72 |
$48.72 |
$130.19
|
|
Inj epidural sgl lumb-sacral without img
|
$1,454.88 |
$1,454.88 |
$1,454.88 |
$1,260.60
|
|
Inj for ext venography
|
$3,593.52 |
$3,593.52 |
$3,593.52 |
$946.64
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,948.80 |
$1,948.80 |
$1,948.80 |
$1,646.97
|
|
Inj hrt cath w/s&i sel right vent
|
$1,268.96 |
$1,268.96 |
$1,268.96 |
$1,352.65
|
|
Inj ivig privigen 500 mg
|
$58.70 |
$58.70 |
$58.70 |
$6,144.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$3,158.40 |
$3,158.40 |
$3,158.40 |
$1,522.56
|
|
Inj proc ankle arthr
|
$947.52 |
$947.52 |
$947.52 |
$405.60
|
|
Inj proc elbow arthro
|
$100.80 |
$100.80 |
$100.80 |
$483.15
|
|
Inj proc for lymphang
|
$1,477.84 |
$1,477.84 |
$1,477.84 |
$1,718.73
|
|
Inj proc myelogram lumbar
|
$1,377.04 |
$1,377.04 |
$1,377.04 |
$1,026.35
|
|
Inj w/fluor eval cv device
|
$277.20 |
$277.20 |
$277.20 |
$573.00
|
|
Ins cath ren art 1st bi
|
$6,088.32 |
$6,088.32 |
$6,088.32 |
$6,012.50
|
|
Ins cath ren art 1st uni
|
$3,539.20 |
$3,539.20 |
$3,539.20 |
$4,628.00
|
|
Ins cath ren art 2nd+ bi
|
$5,642.00 |
$5,642.00 |
$5,642.00 |
$5,251.20
|
|
Ins cath ren art 2nd+ uni
|
$4,540.48 |
$4,540.48 |
$4,540.48 |
$5,528.94
|
|
Insert cath pleura with image
|
$1,466.64 |
$1,466.64 |
$1,466.64 |
$2,239.02
|
|
Insert hepatic shunt (tips)
|
$4,285.68 |
$4,285.68 |
$4,285.68 |
$9,754.48
|
|
Insertion catheter bladder temporary simple
|
$68.88 |
$68.88 |
$68.88 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$6,244.00 |
$6,244.00 |
$6,244.00 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,617.44 |
$2,617.44 |
$2,617.44 |
$2,346.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$7,600.88 |
$7,600.88 |
$7,600.88 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,156.40 |
$1,156.40 |
$1,156.40 |
$2,457.24
|
|
Insertion of catheter vein
|
$2,630.32 |
$2,630.32 |
$2,630.32 |
$2,214.00
|
|
Insertion of heart electrode 33211
|
$5,155.36 |
$5,155.36 |
$5,155.36 |
$9,537.90
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$17,925.04 |
$17,925.04 |
$17,925.04 |
$14,777.24
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$15,193.36 |
$15,193.36 |
$15,193.36 |
$13,806.24
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$20,009.36 |
$20,009.36 |
$20,009.36 |
$9,855.00
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$50,503.04 |
$50,503.04 |
$50,503.04 |
$32,608.80
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$7,183.68 |
$7,183.68 |
$7,183.68 |
$7,513.67
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$7,504.00 |
$7,504.00 |
$7,504.00 |
$8,460.40
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,512.32 |
$3,512.32 |
$3,512.32 |
$5,423.04
|
|
Insert pm/icd lead dual
|
$6,252.40 |
$6,252.40 |
$6,252.40 |
$7,885.34
|
|
Insert prost urethral stent
|
$232.96 |
$232.96 |
$232.96 |
$1,804.00
|
|
Insert/repl sq defib w/eltrd
|
$84,790.72 |
$84,790.72 |
$84,790.72 |
$33,948.20
|
|
Insert sq defib electrode
|
$15,008.00 |
$15,008.00 |
$15,008.00 |
$8,366.80
|
|
Insert swan-ganz cath
|
$2,754.64 |
$2,754.64 |
$2,754.64 |
$2,269.00
|
|
Insert uteri tandem/ovoids
|
$3,248.00 |
$3,248.00 |
$3,248.00 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$1,103.76 |
$1,103.76 |
$1,103.76 |
$5,135.65
|
|
Insert vad art access left hrt art & vein access
|
$1,103.76 |
$1,103.76 |
$1,103.76 |
$7,330.95
|
|
Ins icd gen exist mlt leads
|
$31,488.80 |
$31,488.80 |
$31,488.80 |
$31,488.80
|
|
Ins icd gen exist sgl lead
|
$31,488.80 |
$31,488.80 |
$31,488.80 |
$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
|
$16,672.88 |
$16,672.88 |
$16,672.88 |
$12,270.00
|
|
Ins picad w subq port 5yr>
|
$2,921.52 |
$2,921.52 |
$2,921.52 |
$4,312.97
|
|
Ins pm gen exist dual lead
|
$31,488.80 |
$31,488.80 |
$31,488.80 |
$25,546.94
|
|
Ins pm gen w/exist mlt leads
|
$10,547.60 |
$10,547.60 |
$10,547.60 |
$17,191.21
|
|
Ins pq tunnld ip cath w/img
|
$5,973.52 |
$5,973.52 |
$5,973.52 |
$5,597.45
|
|
Ins/rpl pm gen exist dual lead
|
$12,656.00 |
$12,656.00 |
$12,656.00 |
$11,583.66
|
|
Ins/rpl pm gen exist sgl lead
|
$10,547.60 |
$10,547.60 |
$10,547.60 |
$9,824.59
|
|
Ins/rpl pm w/tv ld atrl
|
$14,447.44 |
$14,447.44 |
$14,447.44 |
$12,442.95
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$9,021.60 |
$9,021.60 |
$9,021.60 |
$6,396.57
|
|
Ins tun cv cath wo subq prt/pm
|
$2,921.52 |
$2,921.52 |
$2,921.52 |
$4,314.75
|
|
Insulin total
|
$28.56 |
$28.56 |
$28.56 |
$72.15
|
|
Ins vag brachytx device
|
$402.64 |
$402.64 |
$402.64 |
$909.35
|
|
Interdiscal perq aspir dx
|
$1,115.52 |
$1,115.52 |
$1,115.52 |
$1,222.26
|
|
Interferon alfa-2b inj
|
$10.44 |
$10.44 |
$10.44 |
$51.21
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$88.03 |
$88.03 |
$88.03 |
$104.31
|
|
Interrogate subq defib
|
$108.08 |
$108.08 |
$108.08 |
$148.00
|
|
Interrog dev eval scrms ip
|
$119.28 |
$119.28 |
$119.28 |
$152.50
|
|
Interrog device eval heart
|
$167.44 |
$167.44 |
$167.44 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$154.56 |
$154.56 |
$154.56 |
$130.00
|
|
Interstitial brachy inter
|
$106.40 |
$106.40 |
$106.40 |
$1,348.20
|
|
Intra-atrial pacing
|
$3,482.08 |
$3,482.08 |
$3,482.08 |
$4,614.35
|
|
Intra-atrial recording
|
$3,482.08 |
$3,482.08 |
$3,482.08 |
$5,252.30
|
|
Intracard echo interv w/s&i
|
$3,073.28 |
$3,073.28 |
$3,073.28 |
$4,328.45
|
|
Intrapul surf admin endo tube
|
$275.52 |
$275.52 |
$275.52 |
$220.80
|
|
Intraventricular pacing
|
$3,969.84 |
$3,969.84 |
$3,969.84 |
$5,625.00
|
|
Intrinsic factor antibody
|
$19.60 |
$19.60 |
$19.60 |
$76.77
|
|
Intro cath dialysis circuit
|
$272.16 |
$272.16 |
$272.16 |
$2,161.90
|
|
Intro cath dialysis circuit w/pta
|
$11,681.60 |
$11,681.60 |
$11,681.60 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$34,023.36 |
$34,023.36 |
$34,023.36 |
$18,260.50
|
|
Intro catheter aorta
|
$354.48 |
$354.48 |
$354.48 |
$1,963.80
|
|
Intro cath svc/ivc
|
$237.44 |
$237.44 |
$237.44 |
$1,942.50
|
|
Intro long gi tube w/mult fluo
|
$231.28 |
$231.28 |
$231.28 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$5,234.88 |
$5,234.88 |
$5,234.88 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,268.40 |
$1,268.40 |
$1,268.40 |
$1,633.03
|
|
Io anal gast n-stim subsq
|
$63.84 |
$63.84 |
$63.84 |
$129.56
|
|
Io ga n-stim subsq w/reprog
|
$98.56 |
$98.56 |
$98.56 |
$187.43
|