|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,958.50 |
$2,114.98 |
$2,114.98 |
|
|
Ins pm gen exist dual lead
|
$15,679.00 |
$15,679.00 |
$42,990.00 |
|
|
Ins pm gen w/exist mlt leads
|
$16,501.50 |
$16,501.50 |
$16,501.50 |
|
|
Ins pq tunnld ip cath w/img
|
$3,764.50 |
$4,459.93 |
$4,459.93 |
|
|
Ins/rplcm prq eltrd ra pn ea
|
$9,698.38 |
$9,698.38 |
$9,698.38 |
|
|
Ins/rplcmt prq eltrd ra pn 1
|
$10,237.75 |
$10,237.75 |
$10,237.75 |
|
|
Ins/rplc spi npg/rcvr pocket
|
$2,382.00 |
$7,784.10 |
$7,784.10 |
|
|
Ins/rpl ldless pm right vent w img & eval
|
$26,560.50 |
$37,942.58 |
$37,942.58 |
|
|
Ins/rpl pm gen exist dual lead
|
$14,349.00 |
$14,349.00 |
$14,349.00 |
|
|
Ins/rpl pm gen exist sgl lead
|
$12,477.50 |
$12,477.50 |
$12,477.50 |
|
|
Ins/rpl pm w/tv ld atrl
|
$4,420.98 |
$4,420.98 |
$15,834.50 |
|
|
Ins/rpl prph sac/gstr npg/r
|
$11,167.59 |
$11,167.59 |
$11,167.59 |
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$18,479.30 |
$18,479.30 |
$47,011.00 |
|
|
Inst fibrinolysis agent ini day
|
$826.15 |
$826.15 |
$925.00 |
|
|
Inst fibrinolysis agent sbsq d
|
$826.15 |
$826.15 |
$972.00 |
|
|
Insti hexaminolevulinate hcl
|
$2,162.50 |
$2,162.50 |
$2,162.50 |
|
|
Instillation anticarcinogenic agent bladder
|
$894.20 |
$894.20 |
$1,313.00 |
|
|
Instill, bupivac and meloxic
|
$422.30 |
$687.60 |
$687.60 |
|
|
Instill pharm renal pelvis
|
$3,463.15 |
$3,463.15 |
$3,463.15 |
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$6,444.00 |
$6,444.00 |
$31,593.00 |
|
|
Ins tun cv cath wo subq prt/pm
|
$1,538.15 |
$1,538.15 |
$2,665.00 |
|
|
Ins tun cv cath wo subq prt/pm
|
$2,044.48 |
$2,044.48 |
$10,744.00 |
|
|
Ins tun intraperit dia cath
|
$3,025.50 |
$3,025.50 |
$3,025.50 |
|
|
Inst via cath agent pleurds
|
$207.98 |
$207.98 |
$2,134.00 |
|
|
Insulin total
|
$75.00 |
$116.50 |
$116.50 |
|
|
Ins vag brachytx device
|
$1,339.18 |
$1,339.18 |
$1,339.18 |
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$240.00 |
$240.00 |
$240.00 |
|
|
Intens cardiac rehab no exer
|
$140.50 |
$232.65 |
$232.65 |
|
|
Intens cardiac rehab w/exerc
|
$140.50 |
$232.65 |
$232.65 |
|
|
Interdental wirg oth/thn fx
|
$1,005.50 |
$1,005.50 |
$1,005.50 |
|
|
Interdiscal perq aspir dx
|
$748.33 |
$748.33 |
$891.00 |
|
|
Interferon alfa-2b inj
|
$2,855.75 |
$2,855.75 |
$2,855.75 |
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$15,971.30 |
$15,971.30 |
$15,971.30 |
|
|
Intermediate visual field xm
|
$160.50 |
$160.50 |
$160.50 |
|
|
Interrogate subq defib
|
$60.50 |
$60.50 |
$60.50 |
|
|
Interrogation vad in person
|
$221.03 |
$221.03 |
$221.03 |
|
|
Interrog dev eval icpms ip
|
$71.50 |
$106.80 |
$106.80 |
|
|
Interrog dev eval scrms ip
|
$239.00 |
$239.00 |
$239.00 |
|
|
Interrog device eval heart
|
$180.50 |
$180.50 |
$321.00 |
|
|
Interrog evl pm/ldls pm ip
|
$92.00 |
$130.00 |
$130.00 |
|
|
Interrog&prgrmg ipnss
|
$761.83 |
$761.83 |
$761.83 |
|
|
Interrog&prgrmg ipnss polysm
|
$2,105.53 |
$2,105.53 |
$2,105.53 |
|
|
Interrog without prgrmg ipnss
|
$380.93 |
$380.93 |
$380.93 |
|
|
Interstitial brachy inter
|
$1,394.75 |
$1,394.75 |
$1,394.75 |
|
|
Intra-atrial pacing
|
$3,818.00 |
$3,818.00 |
$3,818.00 |
|
|
Intra-atrial recording
|
$3,420.00 |
$3,420.00 |
$3,420.00 |
|
|
Intracard echo interv w/s&i
|
$2,218.93 |
$2,218.93 |
$3,213.00 |
|
|
Intracran angioplsty w/stent
|
$7,725.00 |
$9,045.05 |
$9,045.05 |
|
|
Intracranial angioplasty
|
$4,910.63 |
$4,910.63 |
$8,309.00 |
|
|
Intracranial complete study
|
$795.30 |
$795.30 |
$801.50 |
|
|
Intracranial limited study
|
$425.00 |
$425.00 |
$425.00 |
|
|
Intranasal biopsy 30100
|
$1,336.78 |
$1,336.78 |
$11,990.00 |
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,182.15 |
$1,182.15 |
$1,445.00 |
|
|
Intrapul surf admin endo tube
|
$124.58 |
$124.58 |
$124.58 |
|
|
Intrauterine transfusion ftl
|
$1,151.00 |
$1,164.88 |
$4,510.00 |
|
|
Intrinsic factor antibody
|
$101.64 |
$119.25 |
$231.00 |
|
|
Intrm oph exam est patient
|
$146.00 |
$146.00 |
$146.00 |
|
|
Intro cath dialysis circuit
|
$534.70 |
$534.70 |
$1,879.00 |
|
|
Intro cath dialysis circuit w/pta
|
$4,873.75 |
$4,873.75 |
$9,081.00 |
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$18,352.50 |
$21,832.30 |
$21,832.30 |
|
|
Intro catheter aorta
|
$342.00 |
$1,941.13 |
$1,941.13 |
|
|
Intro cath svc/ivc
|
$344.00 |
$634.93 |
$634.93 |
|
|
Intro long gi tube
|
$171.33 |
$171.33 |
$1,126.00 |
|
|
Intro long gi tube w/mult fluo
|
$171.00 |
$477.85 |
$772.00 |
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$1,833.53 |
$1,833.53 |
$4,134.50 |
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,633.03 |
$1,633.03 |
$3,475.50 |
|
|
Intubation endotracheal emergency procedure
|
$475.63 |
$475.63 |
$1,762.74 |
|
|
Io anal gast n-stim subsq
|
$245.43 |
$245.43 |
$245.43 |
|
|
Iodine i-123 sod iodide mil
|
$223.03 |
$223.03 |
$223.03 |
|
|
Io ga n-stim subsq w/reprog
|
$187.43 |
$187.43 |
$187.43 |
|
|
Ionm in operatng room 15 min
|
$67.50 |
$67.50 |
$67.50 |
|
|
Ionm remote/>1 pt or per hr
|
$260.00 |
$260.00 |
$260.00 |
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$483.60 |
$760.50 |
$760.50 |
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$753.66 |
$1,022.50 |
$1,022.50 |
|
|
Io rad tx delivery by x-ray
|
$3,906.50 |
$3,906.50 |
$3,906.50 |
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$36,997.93 |
$71,042.45 |
$71,042.45 |
|
|
Ipratropium bromide non-comp
|
$1.70 |
$1.70 |
$8.31 |
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$114.64 |
$254.65 |
$311.60 |
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,024.09 |
$5,837.00 |
$5,837.00 |
|
|
Iron
|
$57.50 |
$85.93 |
$110.00 |
|
|
Iron binding capacity
|
$75.00 |
$120.60 |
$120.60 |
|
|
Iron dextran 50 mg/ml injection solution
|
$60.47 |
$120.95 |
$120.95 |
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$130.84 |
$169.30 |
$255.91 |
|
|
Irradiation of blood product each unit reference
|
$43.00 |
$140.80 |
$454.65 |
|
|
Irrigation implantable venous access device for drug delivery systems
|
$42.58 |
$42.58 |
$273.00 |
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$8,273.35 |
$8,273.35 |
$18,863.10 |
|
|
Ivc venogram s&i
|
$2,043.98 |
$2,043.98 |
$3,837.50 |
|
|
IV Fluids (each additional hour)
|
$27.15 |
$27.15 |
$773.96 |
|
|
IV Fluids (first hour)
|
$140.15 |
$140.15 |
$773.96 |
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$39.15 |
$39.15 |
$773.96 |
|
|
IV inj ra drug dx study
|
$335.83 |
$335.83 |
$395.50 |
|
|
IV Medicine Infusion (additional drug)
|
$41.45 |
$41.45 |
$773.96 |
|
|
IV Medicine Infusion (each additional hour)
|
$27.15 |
$27.15 |
$773.96 |
|
|
IV Medicine Infusion (first hour)
|
$378.00 |
$3,567.08 |
$3,567.08 |
|
|
IV njx tst vasc flo flap/grf
|
$684.00 |
$684.00 |
$684.00 |
|
|
IV Push Injection (each additional drug)
|
$27.15 |
$27.15 |
$425.00 |
|
|
IV Push Injection (first drug)
|
$140.15 |
$140.15 |
$661.19 |
|
|
Ivp w/nephrotomography
|
$1,178.00 |
$1,178.00 |
$1,178.00 |
|
|
Ivp w/wo kub w/wo tomography
|
$692.18 |
$692.18 |
$1,363.00 |
|
|
Ixabepilone 15 mg intravenous solution
|
$12,112.38 |
$12,112.38 |
$12,112.38 |
|
