|
Inj. herceptin hylecta, 10mg
|
$7,690.59 |
$7,690.59 |
$7,690.59 |
$8,193.78
|
|
Inj hydroxocobalamin IV 25mg
|
$1,838.83 |
$1,838.83 |
$1,838.83 |
$2,452.32
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$374.42 |
$374.42 |
$374.42 |
$1,938.00
|
|
Inj ivig privigen 500 mg
|
$7,084.34 |
$7,084.34 |
$7,084.34 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$25.86 |
$25.86 |
$25.86 |
$41.79
|
|
Inj, lanreotide, (cipla) 1mg
|
$7,766.50 |
$7,766.50 |
$7,766.50 |
$11,648.70
|
|
Inj, levothyroxine, freskabi
|
$778.62 |
$778.62 |
$778.62 |
$308.21
|
|
Inj, lidocaine w epinephrine
|
$49.63 |
$49.63 |
$49.63 |
$45.60
|
|
Inj melpha hydroch nos 50 mg
|
$512.25 |
$512.25 |
$512.25 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$196.76 |
$196.76 |
$196.76 |
$34.34
|
|
Inj, moxifloxacin 100 mg
|
$29.46 |
$29.46 |
$29.46 |
$101.31
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$446.32 |
$446.32 |
$446.32 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,607.09 |
$1,607.09 |
$1,607.09 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,263.81 |
$1,263.81 |
$1,263.81 |
$2,726.90
|
|
Inj octafluoropropane mic,ml
|
$89.10 |
$89.10 |
$89.10 |
$211.40
|
|
Inj, olaratumab, 10 mg
|
$4,698.06 |
$4,698.06 |
$4,698.06 |
$4,127.04
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$7,256.50 |
$7,256.50 |
$7,256.50 |
$6,614.40
|
|
Inj proc ankle arthr
|
$552.89 |
$552.89 |
$552.89 |
$405.31
|
|
Inj proc elbow arthro
|
$252.06 |
$252.06 |
$252.06 |
$432.00
|
|
Inj proc lumbr disk ea lvl
|
$522.82 |
$522.82 |
$522.82 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$775.77 |
$775.77 |
$775.77 |
$838.30
|
|
Inj proc sialogram
|
$582.12 |
$582.12 |
$582.12 |
$373.00
|
|
Inj progesterone per 50 mg
|
$25.80 |
$25.80 |
$25.80 |
$13.76
|
|
Inj scleros sol mult veins
|
$796.32 |
$796.32 |
$796.32 |
$692.90
|
|
Inj scleros sol sgl vein
|
$589.62 |
$589.62 |
$589.62 |
$561.88
|
|
Inj secukinumab intrav 1mg
|
$4,104.83 |
$4,104.83 |
$4,104.83 |
$4,413.21
|
|
Inj sulf hexa lipid microsph
|
$7.56 |
$7.56 |
$7.56 |
$256.14
|
|
Inj. teprotumumab-trbw 10 mg
|
$26,629.57 |
$26,629.57 |
$26,629.57 |
$35,034.78
|
|
Inj testosterone cypionate
|
$72.95 |
$72.95 |
$72.95 |
$64.96
|
|
Inj, tyenne, 1 mg
|
$4,768.85 |
$4,768.85 |
$4,768.85 |
$3,525.12
|
|
Inj vancomycin (xellia) 10mg
|
$76.59 |
$76.59 |
$76.59 |
$76.59
|
|
Inj, vegzelma, 10 mg
|
$2,739.76 |
$2,739.76 |
$2,739.76 |
$1,186.35
|
|
Inj w/fluor eval cv device
|
$775.77 |
$775.77 |
$775.77 |
$504.40
|
|
Ins cerv dilator (sep proc)
|
$245.78 |
$245.78 |
$245.78 |
$490.73
|
|
Insert cath pleura with image
|
$2,829.12 |
$2,829.12 |
$2,829.12 |
$2,194.40
|
|
Insert hepatic shunt (tips)
|
$7,455.00 |
$7,455.00 |
$7,455.00 |
$7,571.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$5,594.74 |
$5,594.74 |
$5,594.74 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,479.67 |
$3,479.67 |
$3,479.67 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$764.01 |
$764.01 |
$764.01 |
$2,585.25
|
|
Insertion of catheter vein
|
$1,245.89 |
$1,245.89 |
$1,245.89 |
$1,525.80
|
|
Insertion of catheter vein
|
$391.61 |
$391.61 |
$391.61 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$13,144.54 |
$13,144.54 |
$13,144.54 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$14,359.58 |
$14,359.58 |
$14,359.58 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,601.66 |
$1,601.66 |
$1,601.66 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,309.26 |
$3,309.26 |
$3,309.26 |
$2,453.83
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,476.41 |
$5,476.41 |
$5,476.41 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$4,102.22 |
$4,102.22 |
$4,102.22 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$8,282.74 |
$8,282.74 |
$8,282.74 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,016.55 |
$3,016.55 |
$3,016.55 |
$5,236.80
|
|
Insert picvad cath
|
$1,073.86 |
$1,073.86 |
$1,073.86 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$4,102.22 |
$4,102.22 |
$4,102.22 |
$7,115.90
|
|
Insert tunneled cv cath
|
$3,094.56 |
$3,094.56 |
$3,094.56 |
$4,520.00
|
|
Ins icd gen exist sgl lead
|
$6,866.61 |
$6,866.61 |
$6,866.61 |
$23,230.50
|
|
Insitu hybridization (fish)
|
$525.78 |
$525.78 |
$525.78 |
$481.00
|
|
In situ hybridization per specimen each additional single probe stain
|
$113.51 |
$113.51 |
$113.51 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$2,279.26 |
$2,279.26 |
$2,279.26 |
$338.40
|
|
Ins lv lead exist pm/icd
|
$16,240.45 |
$16,240.45 |
$16,240.45 |
$12,384.25
|
|
Insole orthotic freedom sz6 6816
|
$159.43 |
$159.43 |
$159.43 |
$84.00
|
|
Ins picad w subq port 5yr>
|
$2,184.45 |
$2,184.45 |
$2,184.45 |
$4,078.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$3,144.62 |
$3,144.62 |
$3,144.62 |
$1,690.00
|
|
Ins pq tunnld ip cath w/img
|
$1,852.98 |
$1,852.98 |
$1,852.98 |
$5,486.00
|
|
Ins/rpl pm gen exist dual lead
|
$12,314.57 |
$12,314.57 |
$12,314.57 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$7,979.66 |
$7,979.66 |
$7,979.66 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$7,607.49 |
$7,607.49 |
$7,607.49 |
$11,583.66
|
|
Instll rx agnt into rnal tub
|
$415.18 |
$415.18 |
$415.18 |
$619.20
|
|
Ins tun cv cath wo subq prt/pm
|
$920.02 |
$920.02 |
$920.02 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$1,580.60 |
$1,580.60 |
$1,580.60 |
$4,218.00
|
|
Ins tun intraperit dia cath
|
$1,123.14 |
$1,123.14 |
$1,123.14 |
$4,570.00
|
|
Insulin total
|
$26.94 |
$26.94 |
$26.94 |
$66.64
|
|
Interferon alfa-2b inj
|
$2,098.04 |
$2,098.04 |
$2,098.04 |
$1,409.92
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$2,323.57 |
$2,323.57 |
$2,323.57 |
$10,427.90
|
|
Interrogate subq defib
|
$102.59 |
$102.59 |
$102.59 |
$119.60
|
|
Interrog dev eval icpms ip
|
$108.30 |
$108.30 |
$108.30 |
$104.00
|
|
Interrog dev eval scrms ip
|
$108.30 |
$108.30 |
$108.30 |
$124.80
|
|
Interrog device eval heart
|
$108.30 |
$108.30 |
$108.30 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$108.30 |
$108.30 |
$108.30 |
$127.20
|
|
Interstitial brachy inter
|
$1,194.42 |
$1,194.42 |
$1,194.42 |
$1,194.42
|
|
Intl custm cong/latyp insert
|
$2,770.32 |
$2,770.32 |
$2,770.32 |
$1,453.20
|
|
Intra-atrial pacing
|
$7,143.92 |
$7,143.92 |
$7,143.92 |
$4,850.82
|
|
Intra-atrial recording
|
$7,143.92 |
$7,143.92 |
$7,143.92 |
$5,252.30
|
|
Intracard echo interv w/s&i
|
$2,996.00 |
$2,996.00 |
$2,996.00 |
$3,436.00
|
|
Intracranial complete study
|
$719.82 |
$719.82 |
$719.82 |
$881.50
|
|
Intracranial limited study
|
$479.81 |
$479.81 |
$479.81 |
$467.50
|
|
Intraventricular pacing
|
$7,143.92 |
$7,143.92 |
$7,143.92 |
$5,456.17
|
|
Intrinsic factor antibody
|
$56.11 |
$56.11 |
$56.11 |
$65.00
|
|
Intro cath svc/ivc
|
$251.27 |
$251.27 |
$251.27 |
$1,323.27
|
|
Intro long gi tube w/mult fluo
|
$246.29 |
$246.29 |
$246.29 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$3,832.14 |
$3,832.14 |
$3,832.14 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$3,372.99 |
$3,372.99 |
$3,372.99 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$987.28 |
$987.28 |
$987.28 |
$601.28
|
|
Iodine i-123 sod iodide mil
|
$433.05 |
$433.05 |
$433.05 |
$386.37
|
|
Iodine i-125 sodium iodide
|
$94.25 |
$94.25 |
$94.25 |
$245.64
|
|
Ionm in operatng room 15 min
|
$125.10 |
$125.10 |
$125.10 |
$200.78
|
|
Ionm remote/>1 pt or per hr
|
$416.98 |
$416.98 |
$416.98 |
$622.70
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$0.84 |
$0.84 |
$0.84 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$17.40 |
$17.40 |
$17.40 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$56,633.47 |
$56,633.47 |
$56,633.47 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$239.43 |
$239.43 |
$239.43 |
$173.98
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$5,517.12 |
$5,517.12 |
$5,517.12 |
$5,517.12
|
|
Iron
|
$23.52 |
$23.52 |
$23.52 |
$75.00
|