|
Injection of sinus tract
|
$1,212.10 |
$1,212.10 |
$1,212.10 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$4,332.74 |
$4,332.74 |
$4,332.74 |
$2,277.65
|
|
Injection, pentamidine iseth
|
$1,698.85 |
$1,698.85 |
$1,698.85 |
$321.94
|
|
Injection radioactive tracer sentinel node (both sides)
|
$766.70 |
$766.70 |
$766.70 |
$694.20
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$984.20 |
$984.20 |
$984.20 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,071.80 |
$2,071.80 |
$2,071.80 |
$2,071.80
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$853.65 |
$853.65 |
$853.65 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,392.60 |
$2,392.60 |
$2,392.60 |
$1,888.80
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$340.55 |
$340.55 |
$340.55 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,392.60 |
$2,392.60 |
$2,392.60 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,209.85 |
$1,209.85 |
$1,209.85 |
$1,826.80
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,218.20 |
$1,218.20 |
$1,218.20 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$525.05 |
$525.05 |
$525.05 |
$485.28
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$774.90 |
$774.90 |
$774.90 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$806.10 |
$806.10 |
$806.10 |
$638.95
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$211.00 |
$211.00 |
$211.00 |
$145.60
|
|
Injection treatment of nerve
|
$352.35 |
$352.35 |
$352.35 |
$3,219.20
|
|
Injection treatment of nerve
|
$352.35 |
$352.35 |
$352.35 |
$4,446.30
|
|
Inject sacroiliac joint
|
$1,818.90 |
$1,818.90 |
$1,818.90 |
$1,029.04
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$20,278.63 |
$20,278.63 |
$20,278.63 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,535.40 |
$1,535.40 |
$1,535.40 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,594.70 |
$1,594.70 |
$1,594.70 |
$1,450.84
|
|
Inj, faricimab-svoa, 0.1mg
|
$8,216.45 |
$8,216.45 |
$8,216.45 |
$4,103.29
|
|
Inj fluphenazine hcl 1.25 mg
|
$97.76 |
$97.76 |
$97.76 |
$40.33
|
|
Inj for ext venography
|
$1,132.80 |
$1,132.80 |
$1,132.80 |
$631.80
|
|
Inj for mammo ductogram
|
$579.10 |
$579.10 |
$579.10 |
$397.80
|
|
Inj. herceptin hylecta, 10mg
|
$16,777.10 |
$16,777.10 |
$16,777.10 |
$8,193.78
|
|
Inj herzuma 10 mg
|
$14,092.05 |
$14,092.05 |
$14,092.05 |
$7,775.46
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,551.75 |
$1,551.75 |
$1,551.75 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,643.25 |
$1,643.25 |
$1,643.25 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$2,752.55 |
$2,752.55 |
$2,752.55 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$1,252.70 |
$1,252.70 |
$1,252.70 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$1,511.20 |
$1,511.20 |
$1,511.20 |
$999.96
|
|
Inj hydroxocobalamin IV 25mg
|
$4,201.60 |
$4,201.60 |
$4,201.60 |
$2,452.32
|
|
Inj imip 4 cilas 4 releb 2mg
|
$3,218.12 |
$3,218.12 |
$3,218.12 |
$739.77
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$2,132.95 |
$2,132.95 |
$2,132.95 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$307.30 |
$307.30 |
$307.30 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$344.15 |
$344.15 |
$344.15 |
$234.00
|
|
Inj, invega hafyera/trinza
|
$60,779.64 |
$60,779.64 |
$60,779.64 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$27,025.75 |
$27,025.75 |
$27,025.75 |
$6,967.29
|
|
Inj, kovaltry, 1 i.u
|
$24.54 |
$24.54 |
$24.54 |
$5.07
|
|
Inj levocarnitine per 1 gm
|
$257.94 |
$257.94 |
$257.94 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$4,210.80 |
$4,210.80 |
$4,210.80 |
$320.80
|
|
Inj, lidocaine w epinephrine
|
$186.80 |
$186.80 |
$186.80 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,205.50 |
$1,205.50 |
$1,205.50 |
$794.70
|
|
Inj melpha hydroch nos 50 mg
|
$4,181.98 |
$4,181.98 |
$4,181.98 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$31.46 |
$31.46 |
$31.46 |
$34.00
|
|
Inj., meropenem, vaborbactam
|
$2,264.92 |
$2,264.92 |
$2,264.92 |
$556.87
|
|
Inj meropenem (wg crit care)
|
$334.91 |
$334.91 |
$334.91 |
$83.19
|
|
Inj multihance
|
$206.00 |
$206.00 |
$206.00 |
$70.54
|
|
Inj. mycophenolate mofetil
|
$738.01 |
$738.01 |
$738.01 |
$252.66
|
|
Inj naloxone hydrochloride
|
$335.93 |
$335.93 |
$335.93 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,579.30 |
$2,579.30 |
$2,579.30 |
$1,413.35
|
|
Inj ogivri 10 mg
|
$4,644.62 |
$4,644.62 |
$4,644.62 |
$4,492.28
|
|
Inj ontruzant 10 mg
|
$13,309.90 |
$13,309.90 |
$13,309.90 |
$6,706.27
|
|
Inj., patisiran, 0.1 mg
|
$13,769.68 |
$13,769.68 |
$13,769.68 |
$17,613.00
|
|
Inj proc ankle arthr
|
$1,471.90 |
$1,471.90 |
$1,471.90 |
$405.31
|
|
Inj proc elbow arthro
|
$729.95 |
$729.95 |
$729.95 |
$433.00
|
|
Inj proc for lymphang
|
$1,746.30 |
$1,746.30 |
$1,746.30 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$986.60 |
$986.60 |
$986.60 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$1,052.15 |
$1,052.15 |
$1,052.15 |
$840.00
|
|
Inj proc sialogram
|
$800.45 |
$800.45 |
$800.45 |
$369.45
|
|
Inj, releuko 1 mcg
|
$2,589.64 |
$2,589.64 |
$2,589.64 |
$475.36
|
|
Inj retro urethrocysto
|
$607.60 |
$607.60 |
$607.60 |
$447.74
|
|
Inj, rimabotulinumtoxinb
|
$114.95 |
$114.95 |
$114.95 |
$714.24
|
|
Inj scleros sol mult veins
|
$643.65 |
$643.65 |
$643.65 |
$707.85
|
|
Inj scleros sol sgl vein
|
$308.50 |
$308.50 |
$308.50 |
$561.88
|
|
Inj secretin synthetic human
|
$4,348.23 |
$4,348.23 |
$4,348.23 |
$1,234.65
|
|
Inj teclistamab cqyv 0.5 mg
|
$14,068.90 |
$14,068.90 |
$14,068.90 |
$17,517.56
|
|
Inj. teprotumumab-trbw 10 mg
|
$22,832.60 |
$22,832.60 |
$22,832.60 |
$35,034.78
|
|
Inj testosterone cypionate
|
$242.17 |
$242.17 |
$242.17 |
$64.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,222.44 |
$1,222.44 |
$1,222.44 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,222.44 |
$1,222.44 |
$1,222.44 |
$837.50
|
|
Inj, vancomycin hcl (mylan)
|
$191.70 |
$191.70 |
$191.70 |
$70.84
|
|
Inj, vasopressin (baxter)
|
$763.46 |
$763.46 |
$763.46 |
$202.50
|
|
Inj, vegzelma, 10 mg
|
$9,723.40 |
$9,723.40 |
$9,723.40 |
$1,186.35
|
|
Inj vocal cord bulking agent
|
$615.00 |
$615.00 |
$615.00 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$1,363.30 |
$1,363.30 |
$1,363.30 |
$504.40
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$27,320.49 |
$27,320.49 |
$27,320.49 |
$41,083.73
|
|
Inpt/ed teleconsult30
|
$285.70 |
$285.70 |
$285.70 |
$156.60
|
|
Inpt/ed teleconsult50
|
$452.80 |
$452.80 |
$452.80 |
$223.80
|
|
Inpt/ed teleconsult70
|
$547.25 |
$547.25 |
$547.25 |
$315.00
|
|
Ins cath ren art 1st bi
|
$12,200.50 |
$12,200.50 |
$12,200.50 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$12,200.50 |
$12,200.50 |
$12,200.50 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$5,598.50 |
$5,598.50 |
$5,598.50 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$12,200.50 |
$12,200.50 |
$12,200.50 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$183.95 |
$183.95 |
$183.95 |
$488.35
|
|
Insert abdomen-venous drain
|
$1,034.00 |
$1,034.00 |
$1,034.00 |
$3,758.23
|
|
Insert cath pleura with image
|
$1,572.85 |
$1,572.85 |
$1,572.85 |
$2,194.40
|
|
Insert cath pleura without image
|
$3,067.75 |
$3,067.75 |
$3,067.75 |
$2,101.52
|
|
Insert drug delivery implant
|
$282.00 |
$282.00 |
$282.00 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$31,581.60 |
$31,581.60 |
$31,581.60 |
$7,571.20
|
|
Insert intrauterine device iud
|
$2,109.20 |
$2,109.20 |
$2,109.20 |
$330.72
|
|
Insertion catheter bladder non indwelling
|
$251.75 |
$251.75 |
$251.75 |
$209.30
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$6,258.80 |
$6,258.80 |
$6,258.80 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$6,912.25 |
$6,912.25 |
$6,912.25 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$18,084.50 |
$18,084.50 |
$18,084.50 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,585.25 |
$2,585.25 |
$2,585.25 |
$2,595.45
|
|
Insertion of catheter vein
|
$747.75 |
$747.75 |
$747.75 |
$1,525.80
|