|
Inj., tildrakizumab, 1 mg
|
$170.82 |
$170.82 |
$170.82 |
|
|
Inj, tislelizumab-jsgr
|
$80.55 |
$80.55 |
$80.55 |
|
|
Inj tofersen intrathec 1 mg
|
$220.81 |
$220.81 |
$220.81 |
|
|
Inj, tofidence, 1 mg
|
$7.71 |
$7.71 |
$7.71 |
|
|
Inj travoprost intra impl
|
$270.79 |
$270.79 |
$270.79 |
|
|
Inj triamcinolone ace X-ray 1mg
|
$25.64 |
$25.64 |
$25.64 |
|
|
Inj., triluron, 1 mg
|
$13.96 |
$13.96 |
$13.96 |
|
|
Inj., triptorelin X-ray 3.75 mg
|
$5,195.68 |
$5,195.68 |
$5,195.68 |
|
|
Inj, trivisc 1 mg
|
$4.98 |
$4.98 |
$4.98 |
|
|
Inj, tyenne, 1 mg
|
$5.79 |
$5.79 |
$5.79 |
|
|
Inj ustekinumab-aekn, 1 mg
|
$59.62 |
$59.62 |
$59.62 |
|
|
Inj ustekinumab-kfce, 1 mg
|
$34.06 |
$34.06 |
$34.06 |
|
|
Inj ustekinumab-stba, 1 mg
|
$16.36 |
$16.36 |
$16.36 |
|
|
Inj, uzedy, 1 mg
|
$34.56 |
$34.56 |
$34.56 |
|
|
Inj vancomycin (xellia) 10mg
|
$0.18 |
$0.18 |
$0.18 |
|
|
Inj vasopressin (am reg) 1 u
|
$1.19 |
$1.19 |
$1.19 |
|
|
Inj, vasopressin (baxter)
|
$3.07 |
$3.07 |
$3.07 |
|
|
Inj, vegzelma, 10 mg
|
$52.66 |
$52.66 |
$52.66 |
|
|
Inj velmanase alfa-tycv 1 mg
|
$642.02 |
$642.02 |
$642.02 |
|
|
Inj., vestronidase alfa-vjbk
|
$386.53 |
$386.53 |
$386.53 |
|
|
Inj vocal cord bulking agent
|
$72.88 |
$72.88 |
$72.88 |
|
|
Inj w/fluor eval cv device
|
$227.36 |
$420.00 |
$1,839.20 |
|
|
Inj. xembify, 100 mg
|
$20.78 |
$20.78 |
$20.78 |
|
|
Inj xipere 1 mg
|
$66.03 |
$66.03 |
$66.03 |
|
|
Inj., yutiq, 0.01 mg
|
$731.25 |
$731.25 |
$731.25 |
|
|
Inj zanidatamab-hrii, 2 mg
|
$34.50 |
$34.50 |
$34.50 |
|
|
Inj zenocutuzumab-zbco 1 mg
|
$46.32 |
$46.32 |
$46.32 |
|
|
Inner skull vessel surgery
|
$6,000.92 |
$6,000.92 |
$6,000.92 |
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$3,887.14 |
$3,887.14 |
$3,887.14 |
|
|
Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
|
$56.46 |
$56.46 |
$56.46 |
|
|
Inpt/ed teleconsult30
|
$121.50 |
$121.50 |
$121.50 |
|
|
Inpt/ed teleconsult50
|
$167.97 |
$167.97 |
$167.97 |
|
|
Inpt/ed teleconsult70
|
$239.71 |
$239.71 |
$239.71 |
|
|
Inpt/tele follow up 15
|
$51.93 |
$51.93 |
$51.93 |
|
|
Inpt/tele follow up 25
|
$91.19 |
$91.19 |
$91.19 |
|
|
Inpt/tele follow up 35
|
$133.75 |
$133.75 |
$133.75 |
|
|
Ins cath ren art 1st bi
|
$4,341.66 |
$5,440.00 |
$9,990.40 |
|
|
Ins cath ren art 1st uni
|
$3,539.20 |
$4,628.00 |
$9,334.00 |
|
|
Ins cath ren art 2nd+ bi
|
$4,341.66 |
$4,341.66 |
$11,161.92 |
|
|
Ins cath ren art 2nd+ uni
|
$4,540.48 |
$6,675.00 |
$7,651.38 |
|
|
Ins cerv dilator (sep proc)
|
$188.72 |
$529.00 |
$3,176.00 |
|
|
Ins device for right guide open
|
$113.62 |
$113.62 |
$113.62 |
|
|
Insemination of oocytes
|
$234.27 |
$234.27 |
$234.27 |
|
|
Insert abdomen-venous drain
|
$1,119.03 |
$1,119.03 |
$1,119.03 |
|
|
Insert and remove bone pin
|
$3,717.00 |
$3,717.00 |
$4,499.12 |
|
|
Insert ant drainage device
|
$5,683.61 |
$5,683.61 |
$5,683.61 |
|
|
Insert balloon device
|
$701.50 |
$701.50 |
$2,067.52 |
|
|
Insert brain-fluid device 61215
|
$12,067.12 |
$12,067.12 |
$12,067.12 |
|
|
Insert cannula hemo oth 36815
|
$7,651.38 |
$7,651.38 |
$7,651.38 |
|
|
Insert cannula vein-to-vein hemodialysis
|
$7,651.38 |
$11,387.00 |
$11,729.00 |
|
|
Insert cath pleura with image
|
$1,098.72 |
$4,582.00 |
$6,746.00 |
|
|
Insert cath pleura without image
|
$974.40 |
$2,047.00 |
$6,442.00 |
|
|
Insert cv cath inf & sup app
|
$11,104.24 |
$11,104.24 |
$11,104.24 |
|
|
Insert drug del implant, >=4
|
$614.27 |
$614.27 |
$614.27 |
|
|
Insert drug delivery implant
|
$115.00 |
$182.95 |
$451.00 |
|
|
Insert electrodes for eeg
|
$108.74 |
$108.74 |
$108.74 |
|
|
Insert epicard eltrd endo 33203
|
$1,163.01 |
$1,163.01 |
$1,163.01 |
|
|
Insert epicardial lead open 33202
|
$1,113.12 |
$1,113.12 |
$1,113.12 |
|
|
Insert eye socket implant
|
$5,405.82 |
$5,405.82 |
$5,405.82 |
|
|
Insert hepatic shunt (tips)
|
$4,285.68 |
$13,433.00 |
$39,559.00 |
|
|
Insert heyman uteri capsule
|
$6,878.55 |
$6,878.55 |
$6,878.55 |
|
|
Insert intervert bimech device 22854
|
$470.11 |
$470.11 |
$470.11 |
|
|
Insert intracorporeal device
|
$2,713.63 |
$2,713.63 |
$7,588.56 |
|
|
Insert intrauterine device iud
|
$74.00 |
$175.00 |
$434.00 |
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$4,341.66 |
$4,341.66 |
$4,341.66 |
|
|
Insertion catheter bladder non indwelling
|
$102.93 |
$367.00 |
$451.00 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,987.60 |
$4,923.19 |
$12,861.00 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$343.19 |
$2,032.00 |
$5,387.20 |
|
|
Insertion intra-aortic circulation dev 33970
|
$481.33 |
$481.33 |
$481.33 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$7,315.00 |
$7,651.38 |
$16,254.00 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$938.00 |
$3,636.00 |
$6,746.00 |
|
|
Insertion of cannula
|
$4,341.66 |
$4,341.66 |
$4,341.66 |
|
|
Insertion of cannula(s)
|
$1,989.39 |
$1,989.39 |
$1,989.39 |
|
|
Insertion of catheter vein
|
$410.03 |
$2,214.00 |
$9,458.00 |
|
|
Insertion of catheter vein
|
$241.29 |
$1,210.00 |
$2,489.76 |
|
|
Insertion of heart electrode 33211
|
$5,155.36 |
$11,378.97 |
$11,378.97 |
|
|
Insertion of infusion pump
|
$7,651.38 |
$7,651.38 |
$7,651.38 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,105.60 |
$19,028.00 |
$36,253.00 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$9,105.60 |
$15,995.00 |
$36,253.00 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$601.89 |
$4,699.00 |
$50,803.00 |
|
|
Insertion palate prosthesis
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,494.64 |
$2,164.52 |
$6,746.00 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,577.52 |
$2,367.00 |
$6,746.00 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$23,654.40 |
$43,160.87 |
$114,158.00 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,639.76 |
$13,176.00 |
$27,835.00 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$6,361.04 |
$9,463.00 |
$27,024.00 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$8,651.29 |
$13,627.00 |
$28,733.00 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$2,423.12 |
$8,051.00 |
$11,463.00 |
|
|
Insertion ureth cath
|
$2,874.36 |
$2,874.36 |
$2,874.36 |
|
|
Insert lens prosthesis
|
$3,173.34 |
$3,173.34 |
$3,173.34 |
|
|
Insert major vessel graft
|
$2,051.87 |
$2,051.87 |
$2,051.87 |
|
|
Insert major vessel graft with bypass 33335
|
$2,672.54 |
$2,672.54 |
$2,672.54 |
|
|
Insert multi-comp penis pros
|
$28,499.19 |
$28,499.19 |
$28,499.19 |
|
|
Insert nasal septal button
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
|
|
Insert ocular implant
|
$5,405.82 |
$5,405.82 |
$5,405.82 |
|
|
Insert ocular implant
|
$5,405.82 |
$5,405.82 |
$5,405.82 |
|
|
Insert palate implants
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
|
|
Insert pelv fixation device
|
$490.25 |
$490.25 |
$490.25 |
|
|
Insert pessary/other device
|
$53.00 |
$253.00 |
$688.00 |
|
|
Insert picvad cath
|
$2,904.72 |
$4,341.66 |
$4,341.66 |
|
