|
Injection for arthrography wrist (both sides)
|
$1,965.60 |
$1,965.60 |
$1,965.60 |
$441.12
|
|
Injection for bladder x-ray
|
$1,011.40 |
$1,011.40 |
$1,011.40 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$2,236.00 |
$2,236.00 |
$2,236.00 |
$504.00
|
|
Injection for spleen x-ray
|
$338.65 |
$338.65 |
$338.65 |
$686.40
|
|
Injection for ureter x-ray
|
$3,326.70 |
$3,326.70 |
$3,326.70 |
$444.95
|
|
Injection for ureter x-ray
|
$1,463.80 |
$1,463.80 |
$1,463.80 |
$515.21
|
|
Injection, fulvestrant
|
$184.89 |
$184.89 |
$184.89 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$11,657.30 |
$11,657.30 |
$11,657.30 |
$10,366.61
|
|
Injection into brain canal
|
$83.20 |
$83.20 |
$83.20 |
$933.60
|
|
Injection jugular
|
$157.95 |
$157.95 |
$157.95 |
$1,048.20
|
|
Injection of sinus tract
|
$984.10 |
$984.10 |
$984.10 |
$1,651.20
|
|
Injection radioactive tracer sentinel node (both sides)
|
$2,363.40 |
$2,363.40 |
$2,363.40 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,845.40 |
$3,845.40 |
$3,845.40 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,835.30 |
$2,835.30 |
$2,835.30 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$838.50 |
$838.50 |
$838.50 |
$1,017.28
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,119.95 |
$1,119.95 |
$1,119.95 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,557.80 |
$4,557.80 |
$4,557.80 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,017.90 |
$1,017.90 |
$1,017.90 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,365.40 |
$4,365.40 |
$4,365.40 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,919.50 |
$3,919.50 |
$3,919.50 |
$1,829.28
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$2,587.00 |
$2,587.00 |
$2,587.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$828.10 |
$828.10 |
$828.10 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$973.70 |
$973.70 |
$973.70 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$241.80 |
$241.80 |
$241.80 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$180.70 |
$180.70 |
$180.70 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$265.85 |
$265.85 |
$265.85 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$215.15 |
$215.15 |
$215.15 |
$141.60
|
|
Injection treatment of nerve
|
$3,396.90 |
$3,396.90 |
$3,396.90 |
$3,016.15
|
|
Injection treatment of nerve
|
$2,716.35 |
$2,716.35 |
$2,716.35 |
$2,037.10
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$53,243.74 |
$53,243.74 |
$53,243.74 |
$66,229.74
|
|
Inj epidural sgl lumb-sacral without img
|
$2,233.40 |
$2,233.40 |
$2,233.40 |
$1,450.84
|
|
Inj for mammo ductogram
|
$2,142.40 |
$2,142.40 |
$2,142.40 |
$433.50
|
|
Inj. herceptin hylecta, 10mg
|
$12,659.04 |
$12,659.04 |
$12,659.04 |
$63.79
|
|
Inj intralesional <= 7 lsn(s)
|
$304.20 |
$304.20 |
$304.20 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$304.20 |
$304.20 |
$304.20 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$1,979.51 |
$1,979.51 |
$1,979.51 |
$7,298.71
|
|
Inj multihance
|
$6.18 |
$6.18 |
$6.18 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$8,482.50 |
$8,482.50 |
$8,482.50 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,004.90 |
$1,004.90 |
$1,004.90 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,004.90 |
$1,004.90 |
$1,004.90 |
$2,164.64
|
|
Inj ontruzant 10 mg
|
$4,554.03 |
$4,554.03 |
$4,554.03 |
$34.17
|
|
Inj pantoprazole(hikma) 40mg
|
$29.28 |
$29.28 |
$29.28 |
$36.04
|
|
Inj peritoneal venous shunt
|
$1,616.55 |
$1,616.55 |
$1,616.55 |
$386.88
|
|
Inj proc ankle arthr
|
$1,918.80 |
$1,918.80 |
$1,918.80 |
$405.31
|
|
Inj proc elbow arthro
|
$2,187.90 |
$2,187.90 |
$2,187.90 |
$453.60
|
|
Inj proc for lymphang
|
$4,018.30 |
$4,018.30 |
$4,018.30 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$1,985.75 |
$1,985.75 |
$1,985.75 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$1,314.30 |
$1,314.30 |
$1,314.30 |
$922.80
|
|
Inj proc sialogram
|
$1,463.80 |
$1,463.80 |
$1,463.80 |
$380.80
|
|
Inj retro urethrocysto
|
$1,320.15 |
$1,320.15 |
$1,320.15 |
$551.29
|
|
Inj scleros sol mult veins
|
$907.40 |
$907.40 |
$907.40 |
$687.96
|
|
Inj scleros sol sgl vein
|
$604.50 |
$604.50 |
$604.50 |
$534.40
|
|
Inj secukinumab intrav 1mg
|
$7,158.68 |
$7,158.68 |
$7,158.68 |
$9,077.39
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$302.25 |
$302.25 |
$302.25 |
$436.64
|
|
Inj testosterone cypionate
|
$27.33 |
$27.33 |
$27.33 |
$77.15
|
|
Inj., tildrakizumab, 1 mg
|
$58,274.68 |
$58,274.68 |
$58,274.68 |
$24,563.40
|
|
Inj, trivisc 1 mg
|
$1,108.64 |
$1,108.64 |
$1,108.64 |
$6.67
|
|
Inj, tyenne, 1 mg
|
$5,110.50 |
$5,110.50 |
$5,110.50 |
$860.68
|
|
Inj, vancomycin hcl (mylan)
|
$25.71 |
$25.71 |
$25.71 |
$63.82
|
|
Ins cerv dilator (sep proc)
|
$632.45 |
$632.45 |
$632.45 |
$544.00
|
|
Insert abdomen-venous drain
|
$2,221.05 |
$2,221.05 |
$2,221.05 |
$4,391.00
|
|
Insert cath pleura with image
|
$7,157.80 |
$7,157.80 |
$7,157.80 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,587.30 |
$1,587.30 |
$1,587.30 |
$2,212.00
|
|
Insert drug delivery implant
|
$804.05 |
$804.05 |
$804.05 |
$285.80
|
|
Insert hepatic shunt (tips)
|
$13,042.25 |
$13,042.25 |
$13,042.25 |
$9,754.48
|
|
Insert intrauterine device iud
|
$1,212.25 |
$1,212.25 |
$1,212.25 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$314.60 |
$314.60 |
$314.60 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$384.15 |
$384.15 |
$384.15 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,997.85 |
$4,997.85 |
$4,997.85 |
$4,943.21
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,987.70 |
$1,987.70 |
$1,987.70 |
$2,618.40
|
|
Insertion of catheter vein
|
$251.55 |
$251.55 |
$251.55 |
$1,749.80
|
|
Insertion of catheter vein
|
$146.90 |
$146.90 |
$146.90 |
$858.05
|
|
Insertion of heart electrode 33211
|
$3,542.50 |
$3,542.50 |
$3,542.50 |
$9,090.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,190.15 |
$1,190.15 |
$1,190.15 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,000.70 |
$2,000.70 |
$2,000.70 |
$2,527.91
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$6,719.70 |
$6,719.70 |
$6,719.70 |
$9,793.46
|
|
Insert uteri tandem/ovoids
|
$2,925.00 |
$2,925.00 |
$2,925.00 |
$3,986.00
|
|
Insitu hybridization auto
|
$712.40 |
$712.40 |
$712.40 |
$398.16
|
|
Insitu hybridization manual
|
$722.80 |
$722.80 |
$722.80 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$517.40 |
$517.40 |
$517.40 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$672.10 |
$672.10 |
$672.10 |
$338.40
|
|
Insj stablj dev w/dcmprn
|
$26,690.30 |
$26,690.30 |
$26,690.30 |
$16,139.55
|
|
Insj stablj dev without dcmprn
|
$26,690.30 |
$26,690.30 |
$26,690.30 |
$15,226.08
|
|
Ins mark thor for right perq
|
$1,069.25 |
$1,069.25 |
$1,069.25 |
$2,396.35
|
|
Ins/rpl ldless pm right vent w img & eval
|
$7,405.45 |
$7,405.45 |
$7,405.45 |
$24,135.54
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$7,751.25 |
$7,751.25 |
$7,751.25 |
$25,106.90
|
|
Insrt/redo neurostim 1 array
|
$33,246.20 |
$33,246.20 |
$33,246.20 |
$23,436.14
|
|
Inst fibrinolysis agent ini day
|
$672.75 |
$672.75 |
$672.75 |
$1,095.00
|
|
Inst fibrinolysis agent sbsq d
|
$661.70 |
$661.70 |
$661.70 |
$898.12
|
|
Instillation anticarcinogenic agent bladder
|
$508.30 |
$508.30 |
$508.30 |
$721.50
|
|
Instll rx agnt into rnal tub
|
$1,368.90 |
$1,368.90 |
$1,368.90 |
$619.20
|
|
Ins tun intraperit dia cath
|
$4,652.70 |
$4,652.70 |
$4,652.70 |
$4,657.46
|
|
Inst via cath agent pleurds
|
$922.35 |
$922.35 |
$922.35 |
$1,074.68
|
|
Insulin total
|
$68.25 |
$68.25 |
$68.25 |
$67.60
|
|
Ins vag brachytx device
|
$1,173.25 |
$1,173.25 |
$1,173.25 |
$909.35
|
|
Interdiscal perq aspir dx
|
$5,183.75 |
$5,183.75 |
$5,183.75 |
$1,222.26
|
|
Intracran angioplsty w/stent
|
$20,960.55 |
$20,960.55 |
$20,960.55 |
$11,364.78
|
|
Intracranial angioplasty
|
$3,563.95 |
$3,563.95 |
$3,563.95 |
$7,149.60
|
|
Intracranial complete study
|
$823.55 |
$823.55 |
$823.55 |
$883.30
|
|
Intracranial limited study
|
$629.85 |
$629.85 |
$629.85 |
$423.52
|