|
Inj meropenem (wg crit care)
|
$43.38 |
$54.22 |
$173.51 |
|
|
Inj, micafungin (par pharm)
|
$54.17 |
$67.71 |
$216.68 |
|
|
Inj, moxifloxacin 100 mg
|
$61.12 |
$73.35 |
$244.50 |
|
|
Inj. mycophenolate mofetil
|
$100.60 |
$125.75 |
$402.41 |
|
|
Inj naloxone hydrochloride
|
$55.36 |
$66.44 |
$221.46 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$102.27 |
$277.15 |
$1,457.20 |
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$669.00 |
$669.00 |
$702.45 |
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$702.45 |
$702.45 |
$702.45 |
|
|
Inj pantoprazole(hikma) 40mg
|
$18.25 |
$22.81 |
$73.00 |
|
|
Inj pemetrexed (accord) 10mg
|
$579.77 |
$724.71 |
$2,319.07 |
|
|
Inj pemetrexed (sandoz) 10mg
|
$27.54 |
$34.42 |
$110.16 |
|
|
Inj pemetrexed (teva) 10mg
|
$881.11 |
$1,101.39 |
$3,524.45 |
|
|
Inj proc ankle arthr
|
$103.96 |
$103.96 |
$108.48 |
|
|
Inj proc elbow arthro
|
$68.04 |
$108.48 |
$1,401.20 |
|
|
Inj proc for lymphang
|
$236.50 |
$236.50 |
$236.50 |
|
|
Inj proc lumbr disk ea lvl
|
$157.75 |
$157.75 |
$157.75 |
|
|
Inj proc myelogram lumbar
|
$209.20 |
$309.81 |
$336.75 |
|
|
Inj progesterone per 50 mg
|
$44.05 |
$52.87 |
$176.22 |
|
|
Inj retro urethrocysto
|
$53.46 |
$70.75 |
$260.82 |
|
|
Inj romidepsin non-lyo 0.1mg
|
$4,417.23 |
$5,521.54 |
$17,668.94 |
|
|
Inj scleros sol mult veins
|
$84.20 |
$92.19 |
$109.75 |
|
|
Inj scleros sol sgl vein
|
$84.20 |
$84.20 |
$101.25 |
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$72.00 |
$72.00 |
$90.00 |
|
|
Inj testostero enanthate 1mg
|
$164.12 |
$196.95 |
$656.50 |
|
|
Inj testosterone cypionate
|
$217.10 |
$260.52 |
$868.40 |
|
|
Inj. tigecycline (accord)
|
$173.77 |
$217.22 |
$695.09 |
|
|
Inj triamcinolone ace X-ray 1mg
|
$1,918.30 |
$1,918.30 |
$1,918.30 |
|
|
Inj, vancomycin hcl (mylan)
|
$58.79 |
$73.48 |
$235.15 |
|
|
Inj, vancomycin hcl (xellia)
|
$20.40 |
$25.50 |
$81.60 |
|
|
Inj vasopressin (am reg) 1 u
|
$34.68 |
$43.35 |
$138.71 |
|
|
Inj w/fluor eval cv device
|
$134.20 |
$167.75 |
$652.40 |
|
|
Ins cath ren art 1st bi
|
$1,354.10 |
$2,122.26 |
$2,507.00 |
|
|
Ins cath ren art 1st uni
|
$1,743.72 |
$2,142.63 |
$3,170.40 |
|
|
Ins cath ren art 2nd+ bi
|
$2,159.20 |
$2,483.08 |
$2,699.00 |
|
|
Ins cath ren art 2nd+ uni
|
$1,354.10 |
$2,159.20 |
$2,699.00 |
|
|
Ins cerv dilator (sep proc)
|
$170.60 |
$196.19 |
$341.20 |
|
|
Insert cath pleura with image
|
$447.26 |
$738.30 |
$1,635.06 |
|
|
Insert cath pleura without image
|
$229.60 |
$658.25 |
$1,009.32 |
|
|
Insert hepatic shunt (tips)
|
$3,192.86 |
$5,805.20 |
$8,753.43 |
|
|
Insertion catheter bladder non indwelling
|
$38.60 |
$96.72 |
$496.00 |
|
|
Insertion catheter bladder temporary simple
|
$38.60 |
$96.72 |
$496.00 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$665.50 |
$1,428.00 |
$1,907.88 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,332.05 |
$3,322.58 |
$9,050.80 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,903.20 |
$2,251.04 |
$4,092.80 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$386.54 |
$872.34 |
$1,869.30 |
|
|
Insertion of catheter vein
|
$570.80 |
$599.34 |
$631.12 |
|
|
Insertion of catheter vein
|
$154.10 |
$154.10 |
$167.50 |
|
|
Insertion of heart electrode 33211
|
$2,860.00 |
$4,355.76 |
$9,437.48 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$4,859.80 |
$8,836.00 |
$12,265.00 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$6,597.78 |
$9,591.46 |
$12,265.00 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,597.04 |
$10,334.00 |
$13,812.80 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$344.60 |
$444.80 |
$1,869.30 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$503.24 |
$1,137.76 |
$2,462.00 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$15,759.04 |
$19,617.16 |
$28,652.80 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$291.72 |
$4,320.09 |
$10,253.36 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$3,037.44 |
$3,629.80 |
$6,548.40 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,601.62 |
$5,965.28 |
$6,548.40 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,354.10 |
$2,033.89 |
$4,610.16 |
|
|
Insert picvad cath
|
$1,774.71 |
$1,774.71 |
$1,774.71 |
|
|
Insert pm/icd lead dual
|
$2,832.28 |
$3,218.50 |
$5,149.60 |
|
|
Insert/repl sq defib w/eltrd
|
$7,190.40 |
$12,871.80 |
$16,206.75 |
|
|
Insert sq defib electrode
|
$2,793.00 |
$2,793.00 |
$3,692.00 |
|
|
Insert swan-ganz cath
|
$701.75 |
$717.60 |
$1,276.80 |
|
|
Insert tissue expander(s)
|
$1,166.55 |
$1,166.55 |
$1,166.55 |
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$793.10 |
$1,135.28 |
$1,797.20 |
|
|
Insert tunneled cv cath
|
$1,797.20 |
$1,797.20 |
$2,033.89 |
|
|
Insert vad art access left hrt arterial access
|
$464.52 |
$1,474.00 |
$3,791.50 |
|
|
Ins icd gen exist mlt leads
|
$9,737.07 |
$15,821.40 |
$19,776.75 |
|
|
Ins icd gen exist sgl lead
|
$13,353.25 |
$14,520.00 |
$19,007.73 |
|
|
Insitu hybridization auto
|
$129.15 |
$198.72 |
$630.20 |
|
|
Insitu hybridization (fish)
|
$127.20 |
$127.20 |
$127.20 |
|
|
Insitu hybridization manual
|
$70.77 |
$125.00 |
$143.75 |
|
|
In situ hybridization per specimen each additional single probe stain
|
$30.36 |
$72.87 |
$86.75 |
|
|
In situ hybridization per specimen initial single probe stain
|
$58.74 |
$72.87 |
$386.64 |
|
|
Ins lv lead exist pm/icd
|
$8,011.29 |
$10,850.60 |
$12,917.50 |
|
|
Ins mark abd/pel for right perq
|
$777.63 |
$777.63 |
$976.71 |
|
|
Ins mark thor for right perq
|
$616.00 |
$616.00 |
$976.71 |
|
|
Ins picad w subq port 5yr>
|
$1,202.90 |
$1,354.10 |
$2,462.00 |
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$522.20 |
$591.12 |
$1,611.12 |
|
|
Ins pm gen exist dual lead
|
$9,737.07 |
$15,821.40 |
$19,776.75 |
|
|
Ins pm gen w/exist mlt leads
|
$2,945.88 |
$9,812.00 |
$12,265.00 |
|
|
Ins pq tunnld ip cath w/img
|
$1,235.22 |
$2,336.20 |
$5,243.60 |
|
|
Ins/rplc spi npg/rcvr pocket
|
$23,205.59 |
$23,205.59 |
$25,469.55 |
|
|
Ins/rpl ldless pm right vent w img & eval
|
$7,507.20 |
$7,882.56 |
$13,874.80 |
|
|
Ins/rpl pm gen exist dual lead
|
$6,288.66 |
$7,489.25 |
$8,448.59 |
|
|
Ins/rpl pm gen exist sgl lead
|
$5,347.02 |
$7,489.25 |
$8,448.59 |
|
|
Ins/rpl pm w/tv ld atrl
|
$6,344.10 |
$9,526.50 |
$11,283.80 |
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$16,084.64 |
$21,582.96 |
$29,244.80 |
|
|
Inst fibrinolysis agent ini day
|
$432.60 |
$464.73 |
$540.75 |
|
|
Inst fibrinolysis agent sbsq d
|
$425.60 |
$446.88 |
$532.00 |
|
|
Instillation anticarcinogenic agent bladder
|
$160.20 |
$213.15 |
$878.40 |
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$1,267.40 |
$1,267.40 |
$1,267.40 |
|
|
Ins tun cv cath wo subq prt/pm
|
$140.92 |
$1,405.80 |
$1,675.00 |
|
|
Ins tun cv cath wo subq prt/pm
|
$140.92 |
$1,354.10 |
$2,462.00 |
|
|
Ins tun intraperit dia cath
|
$842.60 |
$1,532.00 |
$2,271.25 |
|
|
Inst via cath agent pleurds
|
$247.60 |
$260.19 |
$324.00 |
|
|
Insulin total
|
$15.33 |
$36.57 |
$108.75 |
|
|
Ins vag brachytx device
|
$1,430.10 |
$1,430.10 |
$1,430.10 |
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$528.20 |
$528.20 |
$528.20 |
|
|
Intens cardiac rehab no exer
|
$111.40 |
$111.40 |
$128.11 |
|
