|
Inj, levothyroxine, freskabi
|
$1,086.18 |
$1,086.18 |
$1,086.18 |
$363.97
|
|
Inj, lidocaine w epinephrine
|
$49.86 |
$49.86 |
$49.86 |
$44.96
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$2,190.00 |
$2,190.00 |
$2,190.00 |
$783.50
|
|
Inj mepivacaine hcl/10 ml
|
$6.00 |
$6.00 |
$6.00 |
$33.86
|
|
Inj meropenem (wg crit care)
|
$148.50 |
$148.50 |
$148.50 |
$77.97
|
|
Inj multihance
|
$120.60 |
$120.60 |
$120.60 |
$79.42
|
|
Inj. mycophenolate mofetil
|
$327.12 |
$327.12 |
$327.12 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,496.40 |
$1,496.40 |
$1,496.40 |
$1,414.40
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,881.20 |
$2,881.20 |
$2,881.20 |
$2,485.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,881.20 |
$2,881.20 |
$2,881.20 |
$2,431.74
|
|
Inj octafluoropropane mic,ml
|
$122.40 |
$122.40 |
$122.40 |
$211.40
|
|
Inj ogivri 10 mg
|
$13,387.80 |
$13,387.80 |
$13,387.80 |
$4,492.28
|
|
Inj proc ankle arthr
|
$286.80 |
$286.80 |
$286.80 |
$405.31
|
|
Inj proc elbow arthro
|
$350.40 |
$350.40 |
$350.40 |
$432.00
|
|
Inj proc for lymphang
|
$2,300.40 |
$2,300.40 |
$2,300.40 |
$805.80
|
|
Inj proc myelogram lumbar
|
$1,265.40 |
$1,265.40 |
$1,265.40 |
$856.00
|
|
Inj proc sialogram
|
$324.00 |
$324.00 |
$324.00 |
$373.00
|
|
Inj progesterone per 50 mg
|
$6.00 |
$6.00 |
$6.00 |
$14.93
|
|
Inj retro urethrocysto
|
$225.00 |
$225.00 |
$225.00 |
$450.00
|
|
Inj scleros sol mult veins
|
$1,475.40 |
$1,475.40 |
$1,475.40 |
$602.50
|
|
Inj scleros sol sgl vein
|
$1,167.60 |
$1,167.60 |
$1,167.60 |
$534.40
|
|
Inj secretin synthetic human
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$1,285.20
|
|
Inj secukinumab intrav 1mg
|
$17,142.84 |
$17,142.84 |
$17,142.84 |
$4,485.92
|
|
Inj sulf hexa lipid microsph
|
$388.74 |
$388.74 |
$388.74 |
$256.14
|
|
Inj testosterone cypionate
|
$26.88 |
$26.88 |
$26.88 |
$62.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$2,190.00 |
$2,190.00 |
$2,190.00 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,095.60 |
$1,095.60 |
$1,095.60 |
$818.00
|
|
Inj. tigecycline (accord)
|
$88.14 |
$88.14 |
$88.14 |
$182.46
|
|
Inj, tyenne, 1 mg
|
$8,460.30 |
$8,460.30 |
$8,460.30 |
$3,525.12
|
|
Inj, vasopressin (baxter)
|
$338.40 |
$338.40 |
$338.40 |
$245.96
|
|
Inj vocal cord bulking agent
|
$1,928.80 |
$1,928.80 |
$1,928.80 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$595.20 |
$595.20 |
$595.20 |
$463.40
|
|
Ins cath ren art 1st bi
|
$6,487.80 |
$6,487.80 |
$6,487.80 |
$5,741.00
|
|
Ins cath ren art 1st uni
|
$5,941.20 |
$5,941.20 |
$5,941.20 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$7,426.80 |
$7,426.80 |
$7,426.80 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$7,426.80 |
$7,426.80 |
$7,426.80 |
$5,419.00
|
|
Insert and remove bone pin
|
$6,061.80 |
$6,061.80 |
$6,061.80 |
$4,421.00
|
|
Insert cath pleura with image
|
$4,102.80 |
$4,102.80 |
$4,102.80 |
$2,194.40
|
|
Insert cath pleura without image
|
$3,940.80 |
$3,940.80 |
$3,940.80 |
$2,019.00
|
|
Insert hepatic shunt (tips)
|
$17,757.60 |
$17,757.60 |
$17,757.60 |
$8,367.70
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,197.60 |
$4,197.60 |
$4,197.60 |
$4,731.80
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$10,500.00 |
$10,500.00 |
$10,500.00 |
$7,034.50
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$6,815.40 |
$6,815.40 |
$6,815.40 |
$2,511.00
|
|
Insertion of catheter vein
|
$1,371.00 |
$1,371.00 |
$1,371.00 |
$1,657.32
|
|
Insertion of catheter vein
|
$542.40 |
$542.40 |
$542.40 |
$836.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,278.40 |
$9,278.40 |
$9,278.40 |
$12,508.08
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$10,309.20 |
$10,309.20 |
$10,309.20 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,109.00 |
$2,109.00 |
$2,109.00 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,481.20 |
$3,481.20 |
$3,481.20 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$131,581.03 |
$131,581.03 |
$131,581.03 |
$29,146.96
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$6,076.80 |
$6,076.80 |
$6,076.80 |
$7,513.67
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$6,076.80 |
$6,076.80 |
$6,076.80 |
$7,342.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$8,203.80 |
$8,203.80 |
$8,203.80 |
$9,397.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$14,206.43 |
$14,206.43 |
$14,206.43 |
$5,236.80
|
|
Insert sq defib electrode
|
$12,890.40 |
$12,890.40 |
$12,890.40 |
$8,167.68
|
|
Insert vad art access left hrt arterial access
|
$3,677.40 |
$3,677.40 |
$3,677.40 |
$4,221.97
|
|
Insert vad art access left hrt art & vein access
|
$3,677.40 |
$3,677.40 |
$3,677.40 |
$2,889.60
|
|
Insitu hybridization (fish)
|
$568.80 |
$568.80 |
$568.80 |
$481.60
|
|
Insitu hybridization manual
|
$187.20 |
$187.20 |
$187.20 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$117.00 |
$117.00 |
$117.00 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$506.40 |
$506.40 |
$506.40 |
$326.04
|
|
Insj perq vad r hrt venous
|
$4,876.20 |
$4,876.20 |
$4,876.20 |
$3,345.87
|
|
Ins mark abd/pel for right perq
|
$3,214.20 |
$3,214.20 |
$3,214.20 |
$2,376.00
|
|
Insole orthotic freedom sz6 6816
|
$174.51 |
$174.51 |
$174.51 |
$84.00
|
|
Ins picad w subq port 5yr>
|
$2,904.60 |
$2,904.60 |
$2,904.60 |
$3,912.93
|
|
Ins pq tunnld ip cath w/img
|
$9,992.40 |
$9,992.40 |
$9,992.40 |
$5,377.00
|
|
Ins/rplc spi npg/rcvr pocket
|
$69,173.69 |
$69,173.69 |
$69,173.69 |
$23,746.69
|
|
Ins/rpl ldless pm right vent w img & eval
|
$31,950.60 |
$31,950.60 |
$31,950.60 |
$23,369.00
|
|
Ins/rpl pm gen exist dual lead
|
$8,416.80 |
$8,416.80 |
$8,416.80 |
$11,408.40
|
|
Ins/rpl pm w/tv ld atrl
|
$8,144.40 |
$8,144.40 |
$8,144.40 |
$12,371.40
|
|
Ins/rpl prph sac/gstr npg/r
|
$61,979.36 |
$61,979.36 |
$61,979.36 |
$15,339.48
|
|
Inst fibrinolysis agent ini day
|
$1,284.60 |
$1,284.60 |
$1,284.60 |
$1,090.80
|
|
Insti hexaminolevulinate hcl
|
$3,357.66 |
$3,357.66 |
$3,357.66 |
$2,356.80
|
|
Ins tun cv cath wo subq prt/pm
|
$2,904.60 |
$2,904.60 |
$2,904.60 |
$4,202.70
|
|
Ins tun intraperit dia cath
|
$5,850.00 |
$5,850.00 |
$5,850.00 |
$4,657.46
|
|
Insulin total
|
$28.20 |
$28.20 |
$28.20 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$12,123.56 |
$12,123.56 |
$12,123.56 |
$8,629.72
|
|
Integra meshed bil wound mat
|
$39,765.49 |
$39,765.49 |
$39,765.49 |
$9,924.00
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$9,145.40 |
$9,145.40 |
$9,145.40 |
$3,825.00
|
|
Interdental fixation
|
$2,956.20 |
$2,956.20 |
$2,956.20 |
$2,162.05
|
|
Interdiscal perq aspir dx
|
$3,070.20 |
$3,070.20 |
$3,070.20 |
$1,180.84
|
|
Interfyl, 1 mg
|
$5,248.44 |
$5,248.44 |
$5,248.44 |
$5,118.52
|
|
Intracran angioplsty w/stent
|
$8,257.80 |
$8,257.80 |
$8,257.80 |
$8,440.20
|
|
Intrinsic factor antibody
|
$37.20 |
$37.20 |
$37.20 |
$66.60
|
|
Intro cath dialysis circuit
|
$2,475.00 |
$2,475.00 |
$2,475.00 |
$2,035.00
|
|
Intro cath dialysis circuit w/pta
|
$8,121.00 |
$8,121.00 |
$8,121.00 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$21,241.20 |
$21,241.20 |
$21,241.20 |
$15,805.00
|
|
Intro catheter aorta
|
$1,604.40 |
$1,604.40 |
$1,604.40 |
$1,654.05
|
|
Intro cath svc/ivc
|
$1,131.00 |
$1,131.00 |
$1,131.00 |
$1,329.90
|
|
Intro long gi tube
|
$954.00 |
$954.00 |
$954.00 |
$990.00
|
|
Intro long gi tube w/mult fluo
|
$1,355.40 |
$1,355.40 |
$1,355.40 |
$449.40
|
|
Intubation endotracheal emergency procedure
|
$1,993.80 |
$1,993.80 |
$1,993.80 |
$589.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$240.00 |
$240.00 |
$240.00 |
$279.10
|
|
Ipratropium bromide non-comp
|
$3.00 |
$3.00 |
$3.00 |
$3.75
|
|
Iron
|
$45.60 |
$45.60 |
$45.60 |
$74.40
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$324.48 |
$324.48 |
$324.48 |
$187.06
|
|
Ivc venogram s&i
|
$3,663.60 |
$3,663.60 |
$3,663.60 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$241.80 |
$241.80 |
$241.80 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$301.20 |
$301.20 |
$301.20 |
$157.50
|
