|
Inj ceftolozane tazobactam
|
$91.84 |
$91.84 |
$101.70 |
|
|
Inj, clevidipine butyrate
|
$166.87 |
$166.87 |
$184.78 |
|
|
Inj cntr knee arthro incl ct/mri
|
$118.22 |
$253.59 |
$353.79 |
|
|
Inj crotalidae im f(ab')2 eq
|
$920.45 |
$920.45 |
$1,019.23 |
|
|
Inj disk cerv-thor ea lev
|
$312.83 |
$312.83 |
$312.83 |
|
|
Inj dx for sinogram
|
$63.63 |
$291.92 |
$407.27 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$753.56 |
$753.56 |
$753.56 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$122.09 |
$351.78 |
$389.54 |
|
|
Injection, cangrelor
|
$1,105.98 |
$1,105.98 |
$1,224.67 |
|
|
Injection, caplacizumab-yhdp
|
$2,693.70 |
$2,693.70 |
$2,982.78 |
|
|
Injection during cath supravalvular aortography
|
$734.72 |
$734.72 |
$813.57 |
|
|
Injection epidural blood patch or clot
|
$337.60 |
$715.86 |
$792.69 |
|
|
Injection for arthrography wrist (both sides)
|
$158.92 |
$253.59 |
$353.79 |
|
|
Injection for bladder x-ray
|
$139.54 |
$326.16 |
$455.03 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$164.73 |
$253.59 |
$353.79 |
|
|
Injection for ureter x-ray
|
$357.52 |
$357.52 |
$357.52 |
|
|
Injection for ureter x-ray
|
$291.72 |
$291.72 |
$323.03 |
|
|
Injection, glucarpidase
|
$30,205.93 |
$30,205.93 |
$33,447.55 |
|
|
Injection into brain canal
|
$374.68 |
$374.68 |
$374.68 |
|
|
Injection, isavuconazonium
|
$291.93 |
$291.93 |
$291.93 |
|
|
Injection jaw joint x-ray
|
$111.32 |
$111.32 |
$155.30 |
|
|
Injection,onabotulinumtoxina
|
$597.58 |
$597.58 |
$661.71 |
|
|
Injection, peramivir
|
$349.94 |
$349.94 |
$387.49 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$232.24 |
$402.83 |
$446.06 |
|
|
Injection, renflexis
|
$921.62 |
$921.62 |
$921.62 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$404.26 |
$404.26 |
$564.00 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$383.97 |
$383.97 |
$425.18 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$634.48 |
$702.57 |
$885.17 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$571.95 |
$633.33 |
$797.94 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$349.81 |
$349.81 |
$349.81 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$387.45 |
$540.54 |
$957.37 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$168.92 |
$187.05 |
$417.32 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$312.83 |
$346.41 |
$883.73 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$388.48 |
$430.17 |
$800.39 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$388.48 |
$430.17 |
$541.97 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$223.04 |
$223.04 |
$311.17 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$36.97 |
$149.24 |
$208.21 |
|
|
Injection torsemide 10 mg/ml
|
$10.46 |
$10.46 |
$11.58 |
|
|
Inject sacroiliac joint
|
$642.12 |
$642.12 |
$642.12 |
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$6,452.03 |
$6,452.03 |
$6,452.03 |
|
|
Inj epidural sgl cerv-thor without img
|
$448.32 |
$448.32 |
$448.32 |
|
|
Inj epidural sgl lumb-sacral without img
|
$336.24 |
$336.24 |
$336.24 |
|
|
Inj, factor x, (human), 1iu
|
$9.99 |
$9.99 |
$9.99 |
|
|
Inj fluphenazine hcl 1.25 mg
|
$10.66 |
$10.66 |
$11.81 |
|
|
Inj for ext venography
|
$115.96 |
$651.49 |
$721.41 |
|
|
Inj for mammo ductogram
|
$125.00 |
$125.00 |
$125.00 |
|
|
Inj, gadopiclenol, 1 ml
|
$103.06 |
$103.06 |
$103.06 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$661.33 |
$661.33 |
$661.33 |
|
|
Inj hrt cath w/s&i sel hrt ang
|
$822.87 |
$822.87 |
$822.87 |
|
|
Inj hrt cath w/s&i sel hrt art
|
$859.57 |
$859.57 |
$859.57 |
|
|
Inj hrt cath w/s&i sel left vent
|
$653.95 |
$653.95 |
$653.95 |
|
|
Inj hrt cath w/s&i sel right vent
|
$653.95 |
$653.95 |
$653.95 |
|
|
Inj hydroxocobalamin IV 25mg
|
$920.45 |
$1,019.23 |
$1,284.14 |
|
|
Inj intralesional <= 7 lsn(s)
|
$43.26 |
$43.26 |
$43.26 |
|
|
Inj levoleucovorin nos 0.5mg
|
$203.36 |
$225.19 |
$283.72 |
|
|
Inj, lidocaine w epinephrine
|
$14.35 |
$15.89 |
$20.02 |
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$219.76 |
$219.76 |
$243.35 |
|
|
Inj mepivacaine hcl/10 ml
|
$8.41 |
$8.41 |
$9.31 |
|
|
Inj., meropenem, vaborbactam
|
$197.01 |
$197.01 |
$218.15 |
|
|
Inj, moxifloxacin 100 mg
|
$50.84 |
$50.84 |
$56.30 |
|
|
Inj multihance
|
$116.24 |
$128.71 |
$162.17 |
|
|
Inj. mycophenolate mofetil
|
$132.12 |
$132.12 |
$132.12 |
|
|
Inj naloxone hydrochloride
|
$56.63 |
$91.43 |
$101.25 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$605.16 |
$670.11 |
$844.28 |
|
|
Inj ogivri 10 mg
|
$108.74 |
$108.74 |
$108.74 |
|
|
Inj peritoneal venous shunt
|
$76.23 |
$76.23 |
$76.23 |
|
|
Inj proc ankle arthr
|
$121.77 |
$121.77 |
$121.77 |
|
|
Inj proc elbow arthro
|
$153.10 |
$153.10 |
$153.10 |
|
|
Inj proc for lymphang
|
$602.29 |
$602.29 |
$602.29 |
|
|
Inj proc lumbr disk ea lvl
|
$312.83 |
$312.83 |
$312.83 |
|
|
Inj proc myelogram lumbar
|
$182.17 |
$292.95 |
$408.70 |
|
|
Inj proc sialogram
|
$129.77 |
$129.77 |
$181.04 |
|
|
Inj progesterone per 50 mg
|
$33.21 |
$33.21 |
$36.78 |
|
|
Inj, releuko 1 mcg
|
$281.06 |
$311.22 |
$392.11 |
|
|
Inj retacrit esrd on dialysi
|
$3.30 |
$121.98 |
$170.17 |
|
|
Inj retro urethrocysto
|
$519.06 |
$519.06 |
$519.06 |
|
|
Inj secretin synthetic human
|
$38.34 |
$38.34 |
$42.45 |
|
|
Inj testostero enanthate 1mg
|
$26.24 |
$26.24 |
$26.24 |
|
|
Inj testosterone cypionate
|
$81.39 |
$81.39 |
$90.12 |
|
|
Inj theophylline per 40 mg
|
$14.56 |
$14.56 |
$16.12 |
|
|
Inj, vancomycin hcl (mylan)
|
$0.91 |
$9.02 |
$37.18 |
|
|
Inj, vancomycin hcl (xellia)
|
$259.12 |
$259.12 |
$259.12 |
|
|
Inj w/fluor eval cv device
|
$490.98 |
$490.98 |
$543.67 |
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$7,107.35 |
$7,107.35 |
$7,870.09 |
|
|
Ins cath ren art 1st bi
|
$3,357.90 |
$3,357.90 |
$3,718.26 |
|
|
Ins cath ren art 1st uni
|
$2,535.44 |
$2,535.44 |
$2,807.54 |
|
|
Ins cath ren art 2nd+ bi
|
$3,940.31 |
$3,940.31 |
$4,363.17 |
|
|
Ins cath ren art 2nd+ uni
|
$3,426.37 |
$3,426.37 |
$3,794.08 |
|
|
Ins cerv dilator (sep proc)
|
$236.54 |
$236.54 |
$290.32 |
|
|
Insert cath pleura with image
|
$359.79 |
$886.31 |
$1,558.13 |
|
|
Insert cath pleura without image
|
$500.41 |
$500.41 |
$554.11 |
|
|
Insert hepatic shunt (tips)
|
$5,038.49 |
$5,038.49 |
$5,038.49 |
|
|
Insertion catheter bladder non indwelling
|
$57.20 |
$149.45 |
$165.49 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,310.76 |
$2,310.76 |
$2,558.75 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$907.33 |
$907.33 |
$1,004.71 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,810.95 |
$3,810.95 |
$4,219.93 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,290.68 |
$1,290.68 |
$1,429.20 |
|
|
Insertion of catheter vein
|
$1,133.04 |
$1,133.04 |
$1,133.04 |
|
|
Insertion of catheter vein
|
$345.02 |
$345.02 |
$345.02 |
|
|
Insertion of heart electrode 33211
|
$5,926.76 |
$5,926.76 |
$5,926.76 |
|
