|
Inj, releuko 1 mcg
|
$136.52 |
$159.74 |
$369.28 |
|
|
Inj retacrit esrd on dialysi
|
$343.53 |
$343.53 |
$532.80 |
|
|
Inj retro urethrocysto
|
$290.40 |
$290.40 |
$569.60 |
|
|
Inj scleros sol mult veins
|
$557.60 |
$557.60 |
$734.40 |
|
|
Inj scleros sol sgl vein
|
$592.00 |
$592.00 |
$638.40 |
|
|
Inj secretin synthetic human
|
$1,125.01 |
$1,125.01 |
$1,444.23 |
|
|
Inj secukinumab intrav 1mg
|
$2,592.65 |
$2,592.65 |
$2,592.65 |
|
|
Inj, sezaby, 1 mg
|
$187.24 |
$187.24 |
$396.76 |
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$468.80 |
$468.80 |
$620.00 |
|
|
Inj sulf hexa lipid microsph
|
$348.03 |
$348.03 |
$348.03 |
|
|
Inj teclistamab cqyv 0.5 mg
|
$11,635.94 |
$11,635.94 |
$11,635.94 |
|
|
Inj. teprotumumab-trbw 10 mg
|
$16,183.16 |
$16,183.16 |
$16,183.16 |
|
|
Inj testostero enanthate 1mg
|
$123.24 |
$123.24 |
$229.16 |
|
|
Inj testosterone cypionate
|
$29.96 |
$29.96 |
$30.89 |
|
|
Inj thiotepa nos 1 mg
|
$4,601.24 |
$4,601.24 |
$4,601.24 |
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
|
|
Inj thrc fascial pln blk uni w/wo image
|
$988.80 |
$988.80 |
$1,483.20 |
|
|
Inj. tigecycline (accord)
|
$94.68 |
$94.68 |
$94.68 |
|
|
Inj., tildrakizumab, 1 mg
|
$13,898.52 |
$13,898.52 |
$13,898.52 |
|
|
Inj tofersen intrathec 1 mg
|
$22,881.85 |
$22,881.85 |
$22,881.85 |
|
|
Inj., triptorelin X-ray 3.75 mg
|
$17,400.00 |
$17,400.00 |
$47,360.00 |
|
|
Inj, tyenne, 1 mg
|
$2,658.87 |
$2,658.87 |
$2,658.87 |
|
|
Inj ustekinumab-stba, 1 mg
|
$677.68 |
$677.68 |
$677.68 |
|
|
Inj, vancomycin hcl (mylan)
|
$28.92 |
$28.92 |
$28.92 |
|
|
Inj vasopressin (am reg) 1 u
|
$26.36 |
$26.36 |
$34.43 |
|
|
Inj w/fluor eval cv device
|
$515.20 |
$515.20 |
$683.20 |
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$21,777.78 |
$21,777.78 |
$40,703.86 |
|
|
Ins cath ren art 1st bi
|
$7,254.40 |
$7,254.40 |
$8,440.80 |
|
|
Ins cath ren art 1st uni
|
$7,116.80 |
$7,116.80 |
$7,418.40 |
|
|
Ins cath ren art 2nd+ bi
|
$6,908.80 |
$6,908.80 |
$8,516.00 |
|
|
Ins cath ren art 2nd+ uni
|
$7,599.20 |
$7,599.20 |
$8,320.80 |
|
|
Ins cerv dilator (sep proc)
|
$544.00 |
$544.00 |
$557.60 |
|
|
Insemination of oocytes
|
$216.00 |
$216.00 |
$216.00 |
|
|
Insert and remove bone pin
|
$3,316.00 |
$3,316.00 |
$3,945.60 |
|
|
Insert cath pleura with image
|
$1,911.20 |
$1,911.20 |
$2,047.20 |
|
|
Insert cath pleura without image
|
$2,036.80 |
$2,036.80 |
$2,156.00 |
|
|
Insert drug delivery implant
|
$295.20 |
$295.20 |
$1,243.20 |
|
|
Insert hepatic shunt (tips)
|
$10,957.60 |
$10,957.60 |
$14,569.60 |
|
|
Insertion catheter bladder non indwelling
|
$230.40 |
$230.40 |
$444.00 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,692.80 |
$5,692.80 |
$5,955.20 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,768.80 |
$3,768.80 |
$3,860.80 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,697.60 |
$8,697.60 |
$9,282.40 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,454.40 |
$2,454.40 |
$2,505.60 |
|
|
Insertion of catheter vein
|
$3,840.00 |
$3,840.00 |
$4,292.80 |
|
|
Insertion of catheter vein
|
$856.80 |
$856.80 |
$2,584.00 |
|
|
Insertion of heart electrode 33211
|
$9,659.20 |
$9,659.20 |
$9,659.20 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$17,909.60 |
$17,909.60 |
$20,841.60 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$16,240.00 |
$16,240.00 |
$20,568.00 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,667.20 |
$7,667.20 |
$16,158.40 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,313.60 |
$2,313.60 |
$2,507.20 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,648.00 |
$2,648.00 |
$3,168.80 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$21,900.00 |
$21,900.00 |
$23,950.40 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,932.80 |
$5,932.80 |
$9,512.00 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$10,610.40 |
$10,610.40 |
$12,596.80 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$12,445.60 |
$12,445.60 |
$14,421.60 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$5,543.20 |
$5,543.20 |
$5,835.20 |
|
|
Insert pessary/other device
|
$218.40 |
$218.40 |
$218.40 |
|
|
Insert picvad cath
|
$4,302.40 |
$4,302.40 |
$4,302.40 |
|
|
Insert pm/icd lead dual
|
$11,026.40 |
$11,026.40 |
$13,167.20 |
|
|
Insert/repl sq defib w/eltrd
|
$18,233.60 |
$18,233.60 |
$21,373.60 |
|
|
Insert sq defib electrode
|
$14,566.40 |
$14,566.40 |
$14,566.40 |
|
|
Insert swan-ganz cath
|
$3,329.60 |
$3,329.60 |
$3,478.40 |
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$4,997.60 |
$4,997.60 |
$4,997.60 |
|
|
Insert tunneled cv cath
|
$4,079.20 |
$4,079.20 |
$5,698.40 |
|
|
Insert uteri tandem/ovoids
|
$3,141.60 |
$3,141.60 |
$3,141.60 |
|
|
Insert vad art access left hrt arterial access
|
$3,967.20 |
$3,967.20 |
$22,890.40 |
|
|
Insert vad art access left hrt art & vein access
|
$2,967.20 |
$2,967.20 |
$26,520.80 |
|
|
Ins icd gen exist mlt leads
|
$45,630.40 |
$45,630.40 |
$45,630.40 |
|
|
Ins icd gen exist sgl lead
|
$31,941.60 |
$31,941.60 |
$31,941.60 |
|
|
Insitu hybridization manual
|
$288.80 |
$318.40 |
$508.00 |
|
|
In situ hybridization per specimen each additional single probe stain
|
$251.20 |
$251.20 |
$251.20 |
|
|
In situ hybridization per specimen initial single probe stain
|
$338.40 |
$338.40 |
$372.00 |
|
|
Insj perq vad r hrt venous
|
$24,640.00 |
$24,640.00 |
$24,640.00 |
|
|
Ins lv lead exist pm/icd
|
$6,132.80 |
$6,132.80 |
$16,273.60 |
|
|
Ins mark abd/pel for right perq
|
$2,538.40 |
$2,538.40 |
$2,740.00 |
|
|
Ins mark thor for right perq
|
$2,492.80 |
$2,492.80 |
$2,492.80 |
|
|
Insole orthotic freedom sz6 6816
|
$18.03 |
$18.03 |
$25.87 |
|
|
Ins picad w subq port 5yr>
|
$3,909.60 |
$3,909.60 |
$4,943.20 |
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$2,359.20 |
$2,359.20 |
$2,663.20 |
|
|
Ins pm gen exist dual lead
|
$31,037.60 |
$31,037.60 |
$31,037.60 |
|
|
Ins pm gen w/exist mlt leads
|
$21,776.80 |
$21,776.80 |
$21,776.80 |
|
|
Ins pq tunnld ip cath w/img
|
$6,458.40 |
$6,458.40 |
$6,776.00 |
|
|
Ins/rpl ldless pm right vent w img & eval
|
$24,168.00 |
$24,168.00 |
$27,700.80 |
|
|
Ins/rpl pm gen exist dual lead
|
$14,918.40 |
$14,918.40 |
$18,231.20 |
|
|
Ins/rpl pm gen exist sgl lead
|
$11,091.20 |
$11,091.20 |
$11,091.20 |
|
|
Ins/rpl pm w/tv ld atrl
|
$15,964.80 |
$15,964.80 |
$18,231.20 |
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$15,452.00 |
$15,452.00 |
$26,516.80 |
|
|
Inst fibrinolysis agent ini day
|
$1,433.60 |
$1,433.60 |
$1,528.00 |
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$7,539.20 |
$7,539.20 |
$7,539.20 |
|
|
Ins tun cv cath wo subq prt/pm
|
$5,707.20 |
$5,707.20 |
$6,080.80 |
|
|
Ins tun cv cath wo subq prt/pm
|
$4,590.40 |
$4,590.40 |
$4,882.40 |
|
|
Ins tun intraperit dia cath
|
$8,147.20 |
$8,147.20 |
$8,147.20 |
|
|
Inst via cath agent pleurds
|
$1,153.60 |
$1,153.60 |
$1,572.00 |
|
|
Insulin total
|
$84.80 |
$84.80 |
$84.80 |
|
|
Ins vag brachytx device
|
$816.00 |
$816.00 |
$816.00 |
|
|
Interdiscal perq aspir dx
|
$1,797.60 |
$1,797.60 |
$1,945.60 |
|
|
Interferon alfa-2b inj
|
$851.75 |
$851.75 |
$2,711.56 |
|
|
Interrogate subq defib
|
$112.00 |
$112.00 |
$112.00 |
|
|
Interrog dev eval icpms ip
|
$77.60 |
$77.60 |
$134.40 |
|
|
Interrog dev eval scrms ip
|
$70.40 |
$70.40 |
$160.00 |
|
