|
Injection during cath supravalvular aortography
|
$2,786.49 |
$2,786.49 |
$2,786.49 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$2,622.84 |
$2,622.84 |
$2,622.84 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$167.64 |
$167.64 |
$167.64 |
$441.12
|
|
Injection for bladder x-ray
|
$372.90 |
$372.90 |
$372.90 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$145.86 |
$145.86 |
$145.86 |
$504.00
|
|
Injection for ureter x-ray
|
$154.44 |
$154.44 |
$154.44 |
$515.21
|
|
Injection into brain canal
|
$543.18 |
$543.18 |
$543.18 |
$933.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$207.90 |
$207.90 |
$207.90 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,622.84 |
$2,622.84 |
$2,622.84 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,116.06 |
$1,116.06 |
$1,116.06 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$5,031.84 |
$5,031.84 |
$5,031.84 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$524.04 |
$524.04 |
$524.04 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,561.92 |
$4,561.92 |
$4,561.92 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$707.52 |
$707.52 |
$707.52 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,051.84 |
$3,051.84 |
$3,051.84 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,626.90 |
$1,626.90 |
$1,626.90 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,425.60 |
$1,425.60 |
$1,425.60 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$53.06 |
$53.06 |
$53.06 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$646.14 |
$646.14 |
$646.14 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$939.84 |
$939.84 |
$939.84 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$218.35 |
$218.35 |
$218.35 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$234.30 |
$234.30 |
$234.30 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$284.90 |
$284.90 |
$284.90 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$240.35 |
$240.35 |
$240.35 |
$141.60
|
|
Inj epidural sgl cerv-thor without img
|
$1,115.40 |
$1,115.40 |
$1,115.40 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,288.32 |
$1,288.32 |
$1,288.32 |
$1,450.84
|
|
Inj for ext venography
|
$82.56 |
$82.56 |
$82.56 |
$737.55
|
|
Inj for mammo ductogram
|
$265.98 |
$265.98 |
$265.98 |
$433.50
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,146.36 |
$1,146.36 |
$1,146.36 |
$1,837.17
|
|
Inj hrt cath w/s&i sel left vent
|
$1,146.36 |
$1,146.36 |
$1,146.36 |
$1,214.40
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$3,281.82 |
$3,281.82 |
$3,281.82 |
$1,901.25
|
|
Inj intralesional <= 7 lsn(s)
|
$40.70 |
$40.70 |
$40.70 |
$241.74
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,341.12 |
$1,341.12 |
$1,341.12 |
$1,522.56
|
|
Inj proc elbow arthro
|
$161.70 |
$161.70 |
$161.70 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$446.82 |
$446.82 |
$446.82 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$613.14 |
$613.14 |
$613.14 |
$922.80
|
|
Inj proc sialogram
|
$142.56 |
$142.56 |
$142.56 |
$380.80
|
|
Inj retro urethrocysto
|
$546.48 |
$546.48 |
$546.48 |
$551.29
|
|
Inj w/fluor eval cv device
|
$328.02 |
$328.02 |
$328.02 |
$588.90
|
|
Ins cath ren art 1st bi
|
$6,334.02 |
$6,334.02 |
$6,334.02 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$3,168.00 |
$3,168.00 |
$3,168.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$4,752.00 |
$4,752.00 |
$4,752.00 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$404.58 |
$404.58 |
$404.58 |
$544.00
|
|
Insert cath pleura with image
|
$1,254.66 |
$1,254.66 |
$1,254.66 |
$2,239.02
|
|
Insert cath pleura without image
|
$771.54 |
$771.54 |
$771.54 |
$2,212.00
|
|
Insert heyman uteri capsule
|
$2,839.96 |
$2,839.96 |
$2,839.96 |
$5,463.96
|
|
Insert intrauterine device iud
|
$125.53 |
$125.53 |
$125.53 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$170.94 |
$170.94 |
$170.94 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$186.78 |
$186.78 |
$186.78 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$8,097.54 |
$8,097.54 |
$8,097.54 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$490.63 |
$490.63 |
$490.63 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,082.42 |
$6,082.42 |
$6,082.42 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,571.16 |
$4,571.16 |
$4,571.16 |
$2,618.40
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,675.92 |
$5,675.92 |
$5,675.92 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$7,052.70 |
$7,052.70 |
$7,052.70 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$8,768.07 |
$8,768.07 |
$8,768.07 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,973.40 |
$1,973.40 |
$1,973.40 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,332.24 |
$4,332.24 |
$4,332.24 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$24,665.66 |
$24,665.66 |
$24,665.66 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,675.92 |
$5,675.92 |
$5,675.92 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$6,069.36 |
$6,069.36 |
$6,069.36 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$10,836.13 |
$10,836.13 |
$10,836.13 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$5,527.50 |
$5,527.50 |
$5,527.50 |
$5,470.54
|
|
Insert pessary/other device
|
$290.40 |
$290.40 |
$290.40 |
$278.90
|
|
Insert pm/icd lead dual
|
$7,843.77 |
$7,843.77 |
$7,843.77 |
$7,562.63
|
|
Insert swan-ganz cath
|
$2,586.90 |
$2,586.90 |
$2,586.90 |
$2,164.52
|
|
Insert uteri tandem/ovoids
|
$1,678.08 |
$1,678.08 |
$1,678.08 |
$3,986.00
|
|
Ins icd gen exist mlt leads
|
$27,770.35 |
$27,770.35 |
$27,770.35 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$27,891.57 |
$27,891.57 |
$27,891.57 |
$24,159.72
|
|
Insitu hybridization auto
|
$250.80 |
$250.80 |
$250.80 |
$398.16
|
|
Insitu hybridization (fish)
|
$632.50 |
$632.50 |
$632.50 |
$481.60
|
|
Insitu hybridization manual
|
$158.95 |
$158.95 |
$158.95 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$72.05 |
$72.05 |
$72.05 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$214.50 |
$214.50 |
$214.50 |
$338.40
|
|
Ins lv lead exist pm/icd
|
$12,395.79 |
$12,395.79 |
$12,395.79 |
$12,384.25
|
|
Ins pm gen exist dual lead
|
$27,770.35 |
$27,770.35 |
$27,770.35 |
$24,696.00
|
|
Ins pm gen w/exist mlt leads
|
$9,503.23 |
$9,503.23 |
$9,503.23 |
$15,600.75
|
|
Ins pq tunnld ip cath w/img
|
$10,035.96 |
$10,035.96 |
$10,035.96 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$22,187.96 |
$22,187.96 |
$22,187.96 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$9,296.84 |
$9,296.84 |
$9,296.84 |
$11,593.70
|
|
Ins/rpl pm gen exist sgl lead
|
$8,677.16 |
$8,677.16 |
$8,677.16 |
$9,746.29
|
|
Ins/rpl pm w/tv ld atrl
|
$10,836.13 |
$10,836.13 |
$10,836.13 |
$12,384.25
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$6,682.25 |
$6,682.25 |
$6,682.25 |
$25,106.90
|
|
Instillation anticarcinogenic agent bladder
|
$589.38 |
$589.38 |
$589.38 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$4,762.56 |
$4,762.56 |
$4,762.56 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$3,758.86 |
$3,758.86 |
$3,758.86 |
$4,657.46
|
|
Insulin total
|
$191.40 |
$191.40 |
$191.40 |
$67.60
|
|
Ins vag brachytx device
|
$441.90 |
$441.90 |
$441.90 |
$909.35
|
|
Interdiscal perq aspir dx
|
$1,824.90 |
$1,824.90 |
$1,824.90 |
$1,222.26
|
|
Interrog evl pm/ldls pm ip
|
$55.45 |
$55.45 |
$55.45 |
$127.20
|
|
Interstitial brachy inter
|
$759.38 |
$759.38 |
$759.38 |
$1,244.40
|
|
Intrinsic factor antibody
|
$114.40 |
$114.40 |
$114.40 |
$59.95
|
|
Intro cath dialysis circuit
|
$2,528.38 |
$2,528.38 |
$2,528.38 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$4,285.02 |
$4,285.02 |
$4,285.02 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$12,826.00 |
$12,826.00 |
$12,826.00 |
$15,625.00
|
|
Intro catheter aorta
|
$2,012.34 |
$2,012.34 |
$2,012.34 |
$1,861.61
|
|
Intro cath svc/ivc
|
$267.96 |
$267.96 |
$267.96 |
$1,350.75
|
|
Intro long gi tube
|
$535.92 |
$535.92 |
$535.92 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$380.82 |
$380.82 |
$380.82 |
$477.85
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$2,295.56 |
$2,295.56 |
$2,295.56 |
$3,510.75
|
