|
Inj testosterone cypionate
|
$217.10 |
$217.10 |
$217.10 |
$64.80
|
|
Inj. tigecycline (accord)
|
$173.77 |
$173.77 |
$173.77 |
$188.03
|
|
Inj, vancomycin hcl (mylan)
|
$58.79 |
$58.79 |
$58.79 |
$76.59
|
|
Inj, vancomycin hcl (xellia)
|
$20.40 |
$20.40 |
$20.40 |
$85.20
|
|
Inj vasopressin (am reg) 1 u
|
$34.68 |
$34.68 |
$34.68 |
$41.79
|
|
Inj w/fluor eval cv device
|
$134.20 |
$134.20 |
$134.20 |
$503.92
|
|
Ins cath ren art 1st bi
|
$2,005.60 |
$2,005.60 |
$2,005.60 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$2,031.00 |
$2,031.00 |
$2,031.00 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$2,159.20 |
$2,159.20 |
$2,159.20 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$2,159.20 |
$2,159.20 |
$2,159.20 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$170.60 |
$170.60 |
$170.60 |
$480.28
|
|
Insert cath pleura with image
|
$611.20 |
$611.20 |
$611.20 |
$2,194.40
|
|
Insert cath pleura without image
|
$554.80 |
$554.80 |
$554.80 |
$2,073.18
|
|
Insert hepatic shunt (tips)
|
$5,604.00 |
$5,604.00 |
$5,604.00 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$38.60 |
$38.60 |
$38.60 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$38.60 |
$38.60 |
$38.60 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,825.80 |
$1,825.80 |
$1,825.80 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,889.20 |
$2,889.20 |
$2,889.20 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,951.40 |
$1,951.40 |
$1,951.40 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$434.00 |
$434.00 |
$434.00 |
$2,505.60
|
|
Insertion of catheter vein
|
$570.80 |
$570.80 |
$570.80 |
$1,477.00
|
|
Insertion of heart electrode 33211
|
$3,943.60 |
$3,943.60 |
$3,943.60 |
$6,903.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,812.00 |
$9,812.00 |
$9,812.00 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$9,812.00 |
$9,812.00 |
$9,812.00 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$10,334.00 |
$10,334.00 |
$10,334.00 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$344.60 |
$344.60 |
$344.60 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$932.00 |
$932.00 |
$932.00 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$17,058.40 |
$17,058.40 |
$17,058.40 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$3,756.60 |
$3,756.60 |
$3,756.60 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$3,629.80 |
$3,629.80 |
$3,629.80 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$5,187.20 |
$5,187.20 |
$5,187.20 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,711.80 |
$1,711.80 |
$1,711.80 |
$5,223.20
|
|
Insert pm/icd lead dual
|
$3,629.80 |
$3,629.80 |
$3,629.80 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$12,871.80 |
$12,871.80 |
$12,871.80 |
$32,800.04
|
|
Insert swan-ganz cath
|
$863.60 |
$863.60 |
$863.60 |
$2,210.50
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$1,797.20 |
$1,797.20 |
$1,797.20 |
$4,803.00
|
|
Insert tunneled cv cath
|
$1,797.20 |
$1,797.20 |
$1,797.20 |
$5,983.35
|
|
Insert vad art access left hrt arterial access
|
$3,033.20 |
$3,033.20 |
$3,033.20 |
$4,270.75
|
|
Ins icd gen exist mlt leads
|
$15,821.40 |
$15,821.40 |
$15,821.40 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$14,520.00 |
$14,520.00 |
$14,520.00 |
$23,230.50
|
|
Insitu hybridization auto
|
$165.60 |
$165.60 |
$165.60 |
$377.37
|
|
Insitu hybridization (fish)
|
$127.20 |
$127.20 |
$127.20 |
$481.60
|
|
Insitu hybridization manual
|
$125.00 |
$125.00 |
$125.00 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$69.40 |
$69.40 |
$69.40 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$64.20 |
$64.20 |
$64.20 |
$331.69
|
|
Ins lv lead exist pm/icd
|
$10,850.60 |
$10,850.60 |
$10,850.60 |
$12,384.25
|
|
Ins mark thor for right perq
|
$616.00 |
$616.00 |
$616.00 |
$2,477.45
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$522.20 |
$522.20 |
$522.20 |
$1,690.00
|
|
Ins pm gen exist dual lead
|
$15,821.40 |
$15,821.40 |
$15,821.40 |
$23,665.85
|
|
Ins pm gen w/exist mlt leads
|
$9,812.00 |
$9,812.00 |
$9,812.00 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$2,336.20 |
$2,336.20 |
$2,336.20 |
$5,377.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$7,507.20 |
$7,507.20 |
$7,507.20 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$7,713.80 |
$7,713.80 |
$7,713.80 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$7,713.80 |
$7,713.80 |
$7,713.80 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$9,812.00 |
$9,812.00 |
$9,812.00 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$20,555.20 |
$20,555.20 |
$20,555.20 |
$25,694.00
|
|
Inst fibrinolysis agent ini day
|
$432.60 |
$432.60 |
$432.60 |
$1,036.05
|
|
Inst fibrinolysis agent sbsq d
|
$425.60 |
$425.60 |
$425.60 |
$898.12
|
|
Instillation anticarcinogenic agent bladder
|
$160.20 |
$160.20 |
$160.20 |
$621.40
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$1,267.40 |
$1,267.40 |
$1,267.40 |
$7,826.00
|
|
Ins tun cv cath wo subq prt/pm
|
$1,405.80 |
$1,405.80 |
$1,405.80 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$1,339.60 |
$1,339.60 |
$1,339.60 |
$4,202.70
|
|
Inst via cath agent pleurds
|
$247.60 |
$247.60 |
$247.60 |
$1,065.00
|
|
Insulin total
|
$52.40 |
$52.40 |
$52.40 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$528.20 |
$528.20 |
$528.20 |
$8,629.72
|
|
Intens cardiac rehab no exer
|
$111.40 |
$111.40 |
$111.40 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$111.40 |
$111.40 |
$111.40 |
$238.40
|
|
Interdiscal perq aspir dx
|
$261.20 |
$261.20 |
$261.20 |
$1,222.26
|
|
Interrogate subq defib
|
$28.20 |
$28.20 |
$28.20 |
$119.60
|
|
Interrog dev eval icpms ip
|
$40.00 |
$40.00 |
$40.00 |
$103.50
|
|
Interrog dev eval scrms ip
|
$40.00 |
$40.00 |
$40.00 |
$124.80
|
|
Interrog device eval heart
|
$40.00 |
$40.00 |
$40.00 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$28.20 |
$28.20 |
$28.20 |
$124.80
|
|
Intra-atrial pacing
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$4,780.80
|
|
Intra-atrial recording
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$5,252.30
|
|
Intracard echo interv w/s&i
|
$1,876.40 |
$1,876.40 |
$1,876.40 |
$3,461.04
|
|
Intraventricular pacing
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$5,456.17
|
|
Intrinsic factor antibody
|
$120.00 |
$120.00 |
$120.00 |
$63.15
|
|
Intro cath dialysis circuit
|
$302.00 |
$302.00 |
$302.00 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$2,127.80 |
$2,127.80 |
$2,127.80 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$4,301.40 |
$4,301.40 |
$4,301.40 |
$16,262.40
|
|
Intro catheter aorta
|
$352.80 |
$352.80 |
$352.80 |
$1,654.05
|
|
Intro cath svc/ivc
|
$432.00 |
$432.00 |
$432.00 |
$1,323.27
|
|
Intro long gi tube w/mult fluo
|
$90.80 |
$90.80 |
$90.80 |
$466.00
|
|
Intro windpipe wire/tube
|
$564.60 |
$564.60 |
$564.60 |
$2,447.43
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$2,010.00 |
$2,010.00 |
$2,010.00 |
$3,409.29
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,010.00 |
$2,010.00 |
$2,010.00 |
$1,747.80
|
|
Intubation endotracheal emergency procedure
|
$225.80 |
$225.80 |
$225.80 |
$598.80
|
|
Iodine i-123 sod iodide mil
|
$280.59 |
$280.59 |
$280.59 |
$371.18
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$56.25 |
$56.25 |
$56.25 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$209.47 |
$209.47 |
$209.47 |
$288.11
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$63.82 |
$63.82 |
$63.82 |
$174.47
|
|
Iron
|
$41.60 |
$41.60 |
$41.60 |
$72.29
|
|
Iron binding capacity
|
$23.60 |
$23.60 |
$23.60 |
$63.60
|
|
Irrigation implantable venous access device for drug delivery systems
|
$87.00 |
$87.00 |
$87.00 |
$144.62
|
|
Ivc venogram s&i
|
$1,577.80 |
$1,577.80 |
$1,577.80 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$83.60 |
$83.60 |
$83.60 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$52.40 |
$52.40 |
$52.40 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$25.20 |
$25.20 |
$25.20 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$160.00 |
$160.00 |
$160.00 |
$437.45
|
