|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$76,110.11 |
$76,110.11 |
$76,110.11 |
$41,083.73
|
|
Inpt/ed teleconsult30
|
$549.25 |
$549.25 |
$549.25 |
$164.40
|
|
Inpt/ed teleconsult50
|
$746.20 |
$746.20 |
$746.20 |
$223.80
|
|
Inpt/ed teleconsult70
|
$1,103.70 |
$1,103.70 |
$1,103.70 |
$330.60
|
|
Inpt/tele follow up 15
|
$217.10 |
$217.10 |
$217.10 |
$64.80
|
|
Inpt/tele follow up 25
|
$397.80 |
$397.80 |
$397.80 |
$116.80
|
|
Inpt/tele follow up 35
|
$572.00 |
$572.00 |
$572.00 |
$171.20
|
|
Ins cath ren art 1st bi
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$20,203.95 |
$20,203.95 |
$20,203.95 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$791.05 |
$791.05 |
$791.05 |
$488.35
|
|
Insert abdomen-venous drain
|
$7,608.25 |
$7,608.25 |
$7,608.25 |
$3,758.23
|
|
Insert and remove bone pin
|
$9,701.25 |
$9,701.25 |
$9,701.25 |
$4,433.36
|
|
Insert brain-fluid device 61215
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$7,181.20
|
|
Insert cannula vein-to-vein hemodialysis
|
$20,203.95 |
$20,203.95 |
$20,203.95 |
$7,279.50
|
|
Insert cath pleura with image
|
$4,644.90 |
$4,644.90 |
$4,644.90 |
$2,194.40
|
|
Insert cath pleura without image
|
$5,671.90 |
$5,671.90 |
$5,671.90 |
$2,099.70
|
|
Insert drug delivery implant
|
$326.30 |
$326.30 |
$326.30 |
$280.00
|
|
Insert electrodes for eeg
|
$564.20 |
$564.20 |
$564.20 |
$564.20
|
|
Insert epicardial lead open 33202
|
$3,775.20 |
$3,775.20 |
$3,775.20 |
$3,775.20
|
|
Insert hepatic shunt (tips)
|
$11,135.15 |
$11,135.15 |
$11,135.15 |
$7,571.20
|
|
Insert intervert bimech device 22854
|
$1,573.00 |
$1,573.00 |
$1,573.00 |
$1,573.00
|
|
Insert intrauterine device iud
|
$326.30 |
$326.30 |
$326.30 |
$336.00
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$3,594.47
|
|
Insertion catheter bladder non indwelling
|
$385.45 |
$385.45 |
$385.45 |
$209.30
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$10,552.10 |
$10,552.10 |
$10,552.10 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,039.70 |
$2,039.70 |
$2,039.70 |
$2,447.63
|
|
Insertion intra-aortic circulation dev 33970
|
$1,752.40 |
$1,752.40 |
$1,752.40 |
$1,752.40
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$11,946.35 |
$11,946.35 |
$11,946.35 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$2,595.45
|
|
Insertion of cannula(s)
|
$5,974.80 |
$5,974.80 |
$5,974.80 |
$1,989.39
|
|
Insertion of catheter vein
|
$888.55 |
$888.55 |
$888.55 |
$1,525.80
|
|
Insertion of catheter vein
|
$1,079.00 |
$1,079.00 |
$1,079.00 |
$858.05
|
|
Insertion of heart electrode 33211
|
$30,931.55 |
$30,931.55 |
$30,931.55 |
$6,839.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$16,670.55 |
$16,670.55 |
$16,670.55 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$18,043.35 |
$18,043.35 |
$18,043.35 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$10,799.10 |
$10,799.10 |
$10,799.10 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$5,805.80 |
$5,805.80 |
$5,805.80 |
$2,109.00
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,805.80 |
$5,805.80 |
$5,805.80 |
$2,463.50
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$36,428.60 |
$36,428.60 |
$36,428.60 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$30,931.55 |
$30,931.55 |
$30,931.55 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$19,966.05 |
$19,966.05 |
$19,966.05 |
$7,223.87
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$9,471.15 |
$9,471.15 |
$9,471.15 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$5,236.80
|
|
Insertion ureth cath
|
$2,030.60 |
$2,030.60 |
$2,030.60 |
$2,412.45
|
|
Insert major vessel graft with bypass 33335
|
$8,816.60 |
$8,816.60 |
$8,816.60 |
$3,669.00
|
|
Insert multi-comp penis pros
|
$27,300.00 |
$27,300.00 |
$27,300.00 |
$9,495.20
|
|
Insert nasal septal button
|
$413.40 |
$413.40 |
$413.40 |
$1,783.50
|
|
Insert pelv fixation device
|
$1,713.40 |
$1,713.40 |
$1,713.40 |
$777.48
|
|
Insert pessary/other device
|
$601.25 |
$601.25 |
$601.25 |
$278.90
|
|
Insert picvad cath
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$17,414.15 |
$17,414.15 |
$17,414.15 |
$7,115.90
|
|
Insert/repl sq defib w/eltrd
|
$33,948.20 |
$33,948.20 |
$33,948.20 |
$33,593.55
|
|
Insert self-contd prosthesis
|
$2,714.40 |
$2,714.40 |
$2,714.40 |
$21,998.10
|
|
Insert semi-rigid prosthesis
|
$2,384.20 |
$2,384.20 |
$2,384.20 |
$14,199.16
|
|
Insert spine fixation device
|
$3,844.10 |
$3,844.10 |
$3,844.10 |
$1,965.60
|
|
Insert spine fixation device
|
$4,696.25 |
$4,696.25 |
$4,696.25 |
$968.70
|
|
Insert sq defib electrode
|
$12,818.00 |
$12,818.00 |
$12,818.00 |
$8,167.68
|
|
Insert swan-ganz cath
|
$5,805.80 |
$5,805.80 |
$5,805.80 |
$2,164.52
|
|
Insert tissue expander(s)
|
$2,987.40 |
$2,987.40 |
$2,987.40 |
$4,311.38
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$5,018.25
|
|
Insert tunneled cv cath
|
$1,713.40 |
$1,713.40 |
$1,713.40 |
$6,028.07
|
|
Insert ureteral support
|
$4,365.40 |
$4,365.40 |
$4,365.40 |
$2,836.34
|
|
Insert uro/ves nck sphincter
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$22,279.50
|
|
Insert uteri tandem/ovoids
|
$14,760.20 |
$14,760.20 |
$14,760.20 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$5,135.65 |
$5,135.65 |
$5,135.65 |
$4,276.00
|
|
Ins icd gen exist mlt leads
|
$42,599.70 |
$42,599.70 |
$42,599.70 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$32,500.00 |
$32,500.00 |
$32,500.00 |
$23,230.50
|
|
Insitu hybridization (fish)
|
$768.30 |
$768.30 |
$768.30 |
$481.00
|
|
Insitu hybridization manual
|
$1,613.30 |
$1,613.30 |
$1,613.30 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$607.75 |
$607.75 |
$607.75 |
$243.00
|
|
In situ hybridization per specimen initial single probe stain
|
$437.45 |
$437.45 |
$437.45 |
$340.00
|
|
Insj biomechanical device
|
$1,573.00 |
$1,573.00 |
$1,573.00 |
$1,573.00
|
|
Insj biomechanical device 22853
|
$1,215.50 |
$1,215.50 |
$1,215.50 |
$622.40
|
|
Insj perq vad r hrt venous
|
$4,981.60 |
$4,981.60 |
$4,981.60 |
$3,796.00
|
|
Insj rx elut implt lac canal
|
$140.40 |
$140.40 |
$140.40 |
$2,572.70
|
|
Ins lv lead exist pm/icd
|
$19,181.50 |
$19,181.50 |
$19,181.50 |
$12,384.25
|
|
Insole orthotic freedom sz6 6816
|
$100.10 |
$100.10 |
$100.10 |
$84.00
|
|
Ins picad w subq port 5yr>
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,092.09
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$2,310.75 |
$2,310.75 |
$2,310.75 |
$1,690.00
|
|
Ins pm gen exist dual lead
|
$27,751.75 |
$27,751.75 |
$27,751.75 |
$24,003.84
|
|
Ins pm gen w/exist mlt leads
|
$29,274.05 |
$29,274.05 |
$29,274.05 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$10,552.10 |
$10,552.10 |
$10,552.10 |
$5,486.00
|
|
Ins/rplcm prq eltrd ra pn ea
|
$1,856.40 |
$1,856.40 |
$1,856.40 |
$2,681.11
|
|
Ins/rplcmt prq eltrd ra pn 1
|
$1,856.40 |
$1,856.40 |
$1,856.40 |
$14,685.79
|
|
Ins/rplc spi npg/rcvr pocket
|
$1,484.60 |
$1,484.60 |
$1,484.60 |
$24,061.80
|
|
Ins/rpl ldless pm right vent w img & eval
|
$24,705.20 |
$24,705.20 |
$24,705.20 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$16,998.80 |
$16,998.80 |
$16,998.80 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$14,779.05 |
$14,779.05 |
$14,779.05 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$17,480.45 |
$17,480.45 |
$17,480.45 |
$11,512.60
|
|
Ins/rpl prph sac/gstr npg/r
|
$1,458.60 |
$1,458.60 |
$1,458.60 |
$18,129.80
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$25,106.90 |
$25,106.90 |
$25,106.90 |
$26,770.00
|
|
Ins sk-mnt crnl nstm pg/rcvr
|
$7,364.50 |
$7,364.50 |
$7,364.50 |
$2,723.86
|
|
Install spinal shunt
|
$3,283.80 |
$3,283.80 |
$3,283.80 |
$3,283.80
|
|
Inst fibrinolysis agent ini day
|
$361.40 |
$361.40 |
$361.40 |
$1,036.05
|
|
Inst fibrinolysis agent sbsq d
|
$322.40 |
$322.40 |
$322.40 |
$972.00
|
|
Insti hexaminolevulinate hcl
|
$63.18 |
$63.18 |
$63.18 |
$2,356.80
|
|
Instillation anticarcinogenic agent bladder
|
$1,995.50 |
$1,995.50 |
$1,995.50 |
$645.01
|
|
Instll rx agnt into rnal tub
|
$509.60 |
$509.60 |
$509.60 |
$619.20
|
|
Ins trurl ablt trnsdc thr Ultrasound
|
$1,158.30 |
$1,158.30 |
$1,158.30 |
$397.60
|
