|
Inj ogivri 10 mg
|
$1,296.20 |
$1,296.20 |
$1,296.20 |
$4,492.28
|
|
Inj ontruzant 10 mg
|
$4,096.20 |
$4,096.20 |
$4,096.20 |
$6,706.27
|
|
Inj pantoprazole(hikma) 40mg
|
$26.64 |
$26.64 |
$26.64 |
$34.67
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$3,028.52 |
$3,028.52 |
$3,028.52 |
$6,614.40
|
|
Inj proc ankle arthr
|
$559.20 |
$559.20 |
$559.20 |
$405.31
|
|
Inj proc elbow arthro
|
$467.20 |
$467.20 |
$467.20 |
$432.00
|
|
Inj proc for lymphang
|
$1,591.20 |
$1,591.20 |
$1,591.20 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$1,004.80 |
$1,004.80 |
$1,004.80 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$708.00 |
$708.00 |
$708.00 |
$838.30
|
|
Inj proc sialogram
|
$362.40 |
$362.40 |
$362.40 |
$373.00
|
|
Inj, releuko 1 mcg
|
$369.28 |
$369.28 |
$369.28 |
$475.36
|
|
Inj retacrit esrd on dialysi
|
$343.53 |
$343.53 |
$343.53 |
$349.45
|
|
Inj retro urethrocysto
|
$290.40 |
$290.40 |
$290.40 |
$447.74
|
|
Inj scleros sol mult veins
|
$734.40 |
$734.40 |
$734.40 |
$692.90
|
|
Inj scleros sol sgl vein
|
$592.00 |
$592.00 |
$592.00 |
$561.88
|
|
Inj secretin synthetic human
|
$1,125.01 |
$1,125.01 |
$1,125.01 |
$1,253.09
|
|
Inj secukinumab intrav 1mg
|
$2,592.65 |
$2,592.65 |
$2,592.65 |
$4,413.21
|
|
Inj, sezaby, 1 mg
|
$187.24 |
$187.24 |
$187.24 |
$235.85
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$468.80 |
$468.80 |
$468.80 |
$436.80
|
|
Inj. teprotumumab-trbw 10 mg
|
$16,183.16 |
$16,183.16 |
$16,183.16 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$123.24 |
$123.24 |
$123.24 |
$123.09
|
|
Inj testosterone cypionate
|
$30.89 |
$30.89 |
$30.89 |
$64.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$988.80 |
$988.80 |
$988.80 |
$818.00
|
|
Inj. tigecycline (accord)
|
$94.68 |
$94.68 |
$94.68 |
$188.03
|
|
Inj., tildrakizumab, 1 mg
|
$13,898.52 |
$13,898.52 |
$13,898.52 |
$26,635.60
|
|
Inj., triptorelin X-ray 3.75 mg
|
$17,400.00 |
$17,400.00 |
$17,400.00 |
$33,416.39
|
|
Inj ustekinumab-stba, 1 mg
|
$677.68 |
$677.68 |
$677.68 |
$16.36
|
|
Inj vasopressin (am reg) 1 u
|
$26.36 |
$26.36 |
$26.36 |
$41.79
|
|
Inj w/fluor eval cv device
|
$515.20 |
$515.20 |
$515.20 |
$504.40
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$21,777.78 |
$21,777.78 |
$21,777.78 |
$41,083.73
|
|
Ins cath ren art 1st bi
|
$7,254.40 |
$7,254.40 |
$7,254.40 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$7,116.80 |
$7,116.80 |
$7,116.80 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$6,908.80 |
$6,908.80 |
$6,908.80 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$7,599.20 |
$7,599.20 |
$7,599.20 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$544.00 |
$544.00 |
$544.00 |
$490.73
|
|
Insert and remove bone pin
|
$3,316.00 |
$3,316.00 |
$3,316.00 |
$4,433.36
|
|
Insert cath pleura with image
|
$2,047.20 |
$2,047.20 |
$2,047.20 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,156.00 |
$2,156.00 |
$2,156.00 |
$2,099.70
|
|
Insert drug delivery implant
|
$295.20 |
$295.20 |
$295.20 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$14,569.60 |
$14,569.60 |
$14,569.60 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$270.40 |
$270.40 |
$270.40 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,692.80 |
$5,692.80 |
$5,692.80 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,860.80 |
$3,860.80 |
$3,860.80 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$9,282.40 |
$9,282.40 |
$9,282.40 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,454.40 |
$2,454.40 |
$2,454.40 |
$2,585.25
|
|
Insertion of catheter vein
|
$4,292.80 |
$4,292.80 |
$4,292.80 |
$1,525.80
|
|
Insertion of catheter vein
|
$856.80 |
$856.80 |
$856.80 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$20,841.60 |
$20,841.60 |
$20,841.60 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$20,568.00 |
$20,568.00 |
$20,568.00 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,667.20 |
$7,667.20 |
$7,667.20 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,313.60 |
$2,313.60 |
$2,313.60 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,648.00 |
$2,648.00 |
$2,648.00 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$23,950.40 |
$23,950.40 |
$23,950.40 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,932.80 |
$5,932.80 |
$5,932.80 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$12,596.80 |
$12,596.80 |
$12,596.80 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$14,421.60 |
$14,421.60 |
$14,421.60 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$5,835.20 |
$5,835.20 |
$5,835.20 |
$5,236.80
|
|
Insert pessary/other device
|
$218.40 |
$218.40 |
$218.40 |
$278.90
|
|
Insert picvad cath
|
$4,302.40 |
$4,302.40 |
$4,302.40 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$13,167.20 |
$13,167.20 |
$13,167.20 |
$7,115.90
|
|
Insert/repl sq defib w/eltrd
|
$21,373.60 |
$21,373.60 |
$21,373.60 |
$33,593.55
|
|
Insert sq defib electrode
|
$14,566.40 |
$14,566.40 |
$14,566.40 |
$8,167.68
|
|
Insert swan-ganz cath
|
$3,329.60 |
$3,329.60 |
$3,329.60 |
$2,164.52
|
|
Insert tunneled cv cath
|
$5,698.40 |
$5,698.40 |
$5,698.40 |
$4,520.00
|
|
Insert vad art access left hrt arterial access
|
$22,890.40 |
$22,890.40 |
$22,890.40 |
$4,276.00
|
|
Insert vad art access left hrt art & vein access
|
$26,520.80 |
$26,520.80 |
$26,520.80 |
$3,915.72
|
|
Insitu hybridization manual
|
$508.00 |
$508.00 |
$508.00 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$251.20 |
$251.20 |
$251.20 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$372.00 |
$372.00 |
$372.00 |
$338.40
|
|
Insj perq vad r hrt venous
|
$24,640.00 |
$24,640.00 |
$24,640.00 |
$3,796.00
|
|
Ins lv lead exist pm/icd
|
$6,132.80 |
$6,132.80 |
$6,132.80 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$2,740.00 |
$2,740.00 |
$2,740.00 |
$2,477.24
|
|
Insole orthotic freedom sz6 6816
|
$18.03 |
$18.03 |
$18.03 |
$84.00
|
|
Ins picad w subq port 5yr>
|
$4,943.20 |
$4,943.20 |
$4,943.20 |
$4,078.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$2,359.20 |
$2,359.20 |
$2,359.20 |
$1,690.00
|
|
Ins pq tunnld ip cath w/img
|
$6,458.40 |
$6,458.40 |
$6,458.40 |
$5,486.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$27,700.80 |
$27,700.80 |
$27,700.80 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$18,231.20 |
$18,231.20 |
$18,231.20 |
$11,005.50
|
|
Ins/rpl pm w/tv ld atrl
|
$18,231.20 |
$18,231.20 |
$18,231.20 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$15,452.00 |
$15,452.00 |
$15,452.00 |
$27,318.11
|
|
Inst fibrinolysis agent ini day
|
$1,433.60 |
$1,433.60 |
$1,433.60 |
$1,043.35
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$7,539.20 |
$7,539.20 |
$7,539.20 |
$7,826.00
|
|
Ins tun cv cath wo subq prt/pm
|
$6,080.80 |
$6,080.80 |
$6,080.80 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$4,882.40 |
$4,882.40 |
$4,882.40 |
$4,218.00
|
|
Inst via cath agent pleurds
|
$1,153.60 |
$1,153.60 |
$1,153.60 |
$1,074.68
|
|
Interdiscal perq aspir dx
|
$1,945.60 |
$1,945.60 |
$1,945.60 |
$1,222.26
|
|
Interferon alfa-2b inj
|
$851.75 |
$851.75 |
$851.75 |
$1,409.92
|
|
Interrog dev eval icpms ip
|
$77.60 |
$77.60 |
$77.60 |
$104.00
|
|
Interrog dev eval scrms ip
|
$70.40 |
$70.40 |
$70.40 |
$124.80
|
|
Interrog device eval heart
|
$85.60 |
$85.60 |
$85.60 |
$162.40
|
|
Intra-atrial pacing
|
$8,999.20 |
$8,999.20 |
$8,999.20 |
$4,850.82
|
|
Intracard echo interv w/s&i
|
$3,343.20 |
$3,343.20 |
$3,343.20 |
$3,436.00
|
|
Intracran angioplsty w/stent
|
$13,536.00 |
$13,536.00 |
$13,536.00 |
$8,145.50
|
|
Intracranial angioplasty
|
$10,228.00 |
$10,228.00 |
$10,228.00 |
$5,181.00
|
|
Intranasal biopsy 30100
|
$2,425.60 |
$2,425.60 |
$2,425.60 |
$2,265.00
|
|
Intrapul surf admin endo tube
|
$268.80 |
$268.80 |
$268.80 |
$220.80
|
|
Intrauterine transfusion ftl
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$1,063.50
|
|
Intro cath dialysis circuit
|
$2,485.60 |
$2,485.60 |
$2,485.60 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$12,646.40 |
$12,646.40 |
$12,646.40 |
$8,690.50
|
