|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$818.38 |
$818.38 |
$818.38 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$818.38 |
$818.38 |
$818.38 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,108.05 |
$1,108.05 |
$1,108.05 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,147.06 |
$1,147.06 |
$1,147.06 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,794.46 |
$1,794.46 |
$1,794.46 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,172.79 |
$1,172.79 |
$1,172.79 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,185.24 |
$1,185.24 |
$1,185.24 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,291.48 |
$1,291.48 |
$1,291.48 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,201.84 |
$1,201.84 |
$1,201.84 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$252.32 |
$252.32 |
$252.32 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$250.66 |
$250.66 |
$250.66 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$808.42 |
$808.42 |
$808.42 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$144.42 |
$144.42 |
$144.42 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$126.16 |
$126.16 |
$126.16 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$263.11 |
$263.11 |
$263.11 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$202.52 |
$202.52 |
$202.52 |
$135.60
|
|
Inject sacroiliac joint
|
$1,189.39 |
$1,189.39 |
$1,189.39 |
$1,028.95
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$2,337.79 |
$2,337.79 |
$2,337.79 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,098.09 |
$1,098.09 |
$1,098.09 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$826.68 |
$826.68 |
$826.68 |
$1,415.50
|
|
Inj, etelcalcetide, 0.1 mg
|
$135.71 |
$135.71 |
$135.71 |
$343.35
|
|
Inj. fe derisomaltose 10 mg
|
$250.22 |
$250.22 |
$250.22 |
$3,221.52
|
|
Inj fluphenazine hcl 1.25 mg
|
$8.33 |
$8.33 |
$8.33 |
$39.54
|
|
Inj gemcitabine hcl (accord)
|
$9.65 |
$9.65 |
$9.65 |
$130.65
|
|
Inj glofitamab gxbm, 2.5 mg
|
$848.18 |
$848.18 |
$848.18 |
$4,760.67
|
|
Inj glycopyrrolate, glyrx-pf
|
$1.54 |
$1.54 |
$1.54 |
$11.23
|
|
Inj, granisetron, xr, 0.1 mg
|
$1,380.54 |
$1,380.54 |
$1,380.54 |
$5.71
|
|
Inj., guselkumab, 1 mg
|
$11,666.99 |
$11,666.99 |
$11,666.99 |
$29,130.83
|
|
Inj imip 4 cilas 4 releb 2mg
|
$239.91 |
$239.91 |
$239.91 |
$739.77
|
|
Inj intralesional <= 7 lsn(s)
|
$119.52 |
$119.52 |
$119.52 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$6.05 |
$6.05 |
$6.05 |
$6,967.29
|
|
Inj, lecanemab-irmb, 1 mg
|
$105.75 |
$105.75 |
$105.75 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$5.91 |
$5.91 |
$5.91 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$10.84 |
$10.84 |
$10.84 |
$303.45
|
|
Inj, levothyroxine, hikma
|
$42.89 |
$42.89 |
$42.89 |
$42.89
|
|
Inj, lidocaine w epinephrine
|
$0.78 |
$0.78 |
$0.78 |
$47.52
|
|
Inj melpha hydroch nos 50 mg
|
$155.70 |
$155.70 |
$155.70 |
$1,791.90
|
|
Inj mepivacaine hcl/10 ml
|
$0.26 |
$0.26 |
$0.26 |
$33.86
|
|
Inj, meropenem (b. braun)
|
$15.57 |
$15.57 |
$15.57 |
$71.14
|
|
Inj., meropenem, vaborbactam
|
$147.64 |
$147.64 |
$147.64 |
$558.08
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$530.83 |
$530.83 |
$530.83 |
$1,496.55
|
|
Inj, moxifloxacin 100 mg
|
$0.14 |
$0.14 |
$0.14 |
$107.25
|
|
Inj multihance
|
$1.30 |
$1.30 |
$1.30 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$55.36 |
$55.36 |
$55.36 |
$252.66
|
|
Inj, nithiodote, 3mg / 125mg
|
$2.73 |
$2.73 |
$2.73 |
$462.04
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$1,489.74 |
$1,489.74 |
$1,489.74 |
$66,582.27
|
|
Inj ogivri 10 mg
|
$1,238.58 |
$1,238.58 |
$1,238.58 |
$4,492.28
|
|
Inj., patisiran, 0.1 mg
|
$1,577.00 |
$1,577.00 |
$1,577.00 |
$17,613.00
|
|
Inj. pemetrexed, 10 mg
|
$152.10 |
$152.10 |
$152.10 |
$104.72
|
|
Inj pemetrexed (sandoz) 10mg
|
$1.89 |
$1.89 |
$1.89 |
$95.26
|
|
Inj, pemivibart, 4500 mg
|
$133.15 |
$133.15 |
$133.15 |
$1,235.55
|
|
Inj proc ankle arthr
|
$535.35 |
$535.35 |
$535.35 |
$405.31
|
|
Inj progesterone per 50 mg
|
$2.30 |
$2.30 |
$2.30 |
$15.00
|
|
Inj, releuko 1 mcg
|
$148.08 |
$148.08 |
$148.08 |
$473.25
|
|
Inj retacrit esrd on dialysi
|
$291.73 |
$291.73 |
$291.73 |
$349.45
|
|
Inj secretin synthetic human
|
$548.63 |
$548.63 |
$548.63 |
$1,285.20
|
|
Inj secukinumab intrav 1mg
|
$3,056.12 |
$3,056.12 |
$3,056.12 |
$4,413.21
|
|
Inj, spesolimab-sbzo, 1 mg
|
$2,829.36 |
$2,829.36 |
$2,829.36 |
$90,007.62
|
|
Inj teplizumab mzwv 5 mcg
|
$4,495.01 |
$4,495.01 |
$4,495.01 |
$22,340.08
|
|
Inj. teprotumumab-trbw 10 mg
|
$12,841.43 |
$12,841.43 |
$12,841.43 |
$35,034.78
|
|
Inj testosterone cypionate
|
$16.65 |
$16.65 |
$16.65 |
$64.80
|
|
Inj., tildrakizumab, 1 mg
|
$11,053.78 |
$11,053.78 |
$11,053.78 |
$26,635.60
|
|
Inj, tofidence, 1 mg
|
$92.13 |
$92.13 |
$92.13 |
$92.13
|
|
Inj, tyenne, 1 mg
|
$74.48 |
$74.48 |
$74.48 |
$3,525.12
|
|
Inj, uzedy, 1 mg
|
$6,622.84 |
$6,622.84 |
$6,622.84 |
$11,475.96
|
|
Inj w/fluor eval cv device
|
$553.61 |
$553.61 |
$553.61 |
$503.92
|
|
Inpatient consultation
|
$87.98 |
$87.98 |
$87.98 |
$73.80
|
|
Ins cerv dilator (sep proc)
|
$328.68 |
$328.68 |
$328.68 |
$480.28
|
|
Insert cath pleura with image
|
$1,612.69 |
$1,612.69 |
$1,612.69 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,801.93 |
$1,801.93 |
$1,801.93 |
$2,073.18
|
|
Insert intrauterine device iud
|
$249.83 |
$249.83 |
$249.83 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$220.78 |
$220.78 |
$220.78 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$221.61 |
$221.61 |
$221.61 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,927.26 |
$1,927.26 |
$1,927.26 |
$4,782.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,397.87 |
$2,397.87 |
$2,397.87 |
$2,505.60
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,558.21 |
$3,558.21 |
$3,558.21 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,426.77 |
$1,426.77 |
$1,426.77 |
$2,419.65
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,558.51 |
$5,558.51 |
$5,558.51 |
$7,200.05
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,282.65 |
$3,282.65 |
$3,282.65 |
$5,223.20
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$1,969.59 |
$1,969.59 |
$1,969.59 |
$4,803.00
|
|
Insert tunneled cv cath
|
$2,984.68 |
$2,984.68 |
$2,984.68 |
$4,520.00
|
|
Insert tunneled cv cath
|
$2,695.84 |
$2,695.84 |
$2,695.84 |
$5,983.35
|
|
Insitu hybridization manual
|
$668.98 |
$668.98 |
$668.98 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$556.10 |
$556.10 |
$556.10 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$528.71 |
$528.71 |
$528.71 |
$331.69
|
|
Ins picad w subq port 5yr>
|
$3,100.05 |
$3,100.05 |
$3,100.05 |
$3,985.20
|
|
Insti hexaminolevulinate hcl
|
$1,053.27 |
$1,053.27 |
$1,053.27 |
$2,224.80
|
|
Instillation anticarcinogenic agent bladder
|
$610.05 |
$610.05 |
$610.05 |
$621.40
|
|
Instill, bupivac and meloxic
|
$16.63 |
$16.63 |
$16.63 |
$687.60
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$10,439.74 |
$10,439.74 |
$10,439.74 |
$7,826.00
|
|
Ins tun cv cath wo subq prt/pm
|
$2,021.05 |
$2,021.05 |
$2,021.05 |
$4,202.70
|
|
Insulin total
|
$82.17 |
$82.17 |
$82.17 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$8,479.58 |
$8,479.58 |
$8,479.58 |
$8,629.72
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$205.80 |
$205.80 |
$205.80 |
$3,803.11
|
|
Interdiscal perq aspir dx
|
$236.55 |
$236.55 |
$236.55 |
$1,222.26
|
|
Interrogate subq defib
|
$135.29 |
$135.29 |
$135.29 |
$119.60
|
|
Interrog dev eval scrms ip
|
$144.42 |
$144.42 |
$144.42 |
$124.80
|
|
Interrog device eval heart
|
$190.07 |
$190.07 |
$190.07 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$154.38 |
$154.38 |
$154.38 |
$124.80
|
|
Intranasal biopsy 30100
|
$334.49 |
$334.49 |
$334.49 |
$2,133.48
|