|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$859.30 |
$859.30 |
$859.30 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$859.30 |
$859.30 |
$859.30 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$183.95 |
$183.95 |
$183.95 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$137.80 |
$137.80 |
$137.80 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$201.50 |
$201.50 |
$201.50 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$163.80 |
$163.80 |
$163.80 |
$141.60
|
|
Injection treatment of nerve
|
$2,769.00 |
$2,769.00 |
$2,769.00 |
$3,016.15
|
|
Injection treatment of nerve
|
$1,771.90 |
$1,771.90 |
$1,771.90 |
$2,037.10
|
|
Inj epidural sgl lumb-sacral without img
|
$1,457.30 |
$1,457.30 |
$1,457.30 |
$1,450.84
|
|
Inj, evinacumab-dgnb, 5mg
|
$119,532.46 |
$119,532.46 |
$119,532.46 |
$186.31
|
|
Inj fluphenazine hcl 1.25 mg
|
$37.93 |
$37.93 |
$37.93 |
$37.93
|
|
Inj for ext venography
|
$4,607.20 |
$4,607.20 |
$4,607.20 |
$737.55
|
|
Inj for mammo ductogram
|
$1,394.90 |
$1,394.90 |
$1,394.90 |
$433.50
|
|
Inj herzuma 10 mg
|
$0.42 |
$0.42 |
$0.42 |
$60.44
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,754.70 |
$2,754.70 |
$2,754.70 |
$1,482.00
|
|
Inj hrt cath w/s&i sel right vent
|
$937.95 |
$937.95 |
$937.95 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$3,173.25 |
$3,173.25 |
$3,173.25 |
$3,180.35
|
|
Inj intralesional <= 7 lsn(s)
|
$198.25 |
$198.25 |
$198.25 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$7,803.44 |
$7,803.44 |
$7,803.44 |
$7,298.71
|
|
Inj, lanreotide, (cipla) 1mg
|
$128.30 |
$128.30 |
$128.30 |
$12,160.05
|
|
Inj levocarnitine per 1 gm
|
$97.01 |
$97.01 |
$97.01 |
$138.96
|
|
Inj, levothyroxine, freskabi
|
$236.50 |
$236.50 |
$236.50 |
$302.07
|
|
Inj mepivacaine hcl/10 ml
|
$39.88 |
$39.88 |
$39.88 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$740.32 |
$740.32 |
$740.32 |
$618.43
|
|
Inj meropenem (wg crit care)
|
$104.29 |
$104.29 |
$104.29 |
$104.29
|
|
Inj. mycophenolate mofetil
|
$240.44 |
$240.44 |
$240.44 |
$344.84
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$4,304.30 |
$4,304.30 |
$4,304.30 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$656.50 |
$656.50 |
$656.50 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$656.50 |
$656.50 |
$656.50 |
$2,164.64
|
|
Inj ontruzant 10 mg
|
$113.02 |
$113.02 |
$113.02 |
$34.17
|
|
Inj pantoprazole(hikma) 40mg
|
$30.47 |
$30.47 |
$30.47 |
$36.04
|
|
Inj pemetrexed (accord) 10mg
|
$11.24 |
$11.24 |
$11.24 |
$9.74
|
|
Inj pemetrexed, hospira 10mg
|
$213.59 |
$213.59 |
$213.59 |
$0.62
|
|
Inj peritoneal venous shunt
|
$1,101.75 |
$1,101.75 |
$1,101.75 |
$386.88
|
|
Inj proc ankle arthr
|
$695.50 |
$695.50 |
$695.50 |
$405.31
|
|
Inj proc elbow arthro
|
$1,111.50 |
$1,111.50 |
$1,111.50 |
$453.60
|
|
Inj proc for lymphang
|
$1,172.60 |
$1,172.60 |
$1,172.60 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$1,511.25 |
$1,511.25 |
$1,511.25 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$477.10 |
$477.10 |
$477.10 |
$922.80
|
|
Inj proc sialogram
|
$1,114.75 |
$1,114.75 |
$1,114.75 |
$380.80
|
|
Inj progesterone per 50 mg
|
$21.71 |
$21.71 |
$21.71 |
$48.51
|
|
Inj retacrit esrd on dialysi
|
$3.05 |
$3.05 |
$3.05 |
$307.40
|
|
Inj retro urethrocysto
|
$1,006.20 |
$1,006.20 |
$1,006.20 |
$551.29
|
|
Inj scleros sol mult veins
|
$741.00 |
$741.00 |
$741.00 |
$687.96
|
|
Inj scleros sol sgl vein
|
$741.00 |
$741.00 |
$741.00 |
$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
|
$39.65 |
$39.65 |
$39.65 |
$436.64
|
|
Inj. teprotumumab-trbw 10 mg
|
$48,637.22 |
$48,637.22 |
$48,637.22 |
$47,971.67
|
|
Inj testosterone cypionate
|
$28.14 |
$28.14 |
$28.14 |
$77.15
|
|
Inj., tildrakizumab, 1 mg
|
$58,274.68 |
$58,274.68 |
$58,274.68 |
$24,563.40
|
|
Inj, tyenne, 1 mg
|
$5,110.62 |
$5,110.62 |
$5,110.62 |
$860.68
|
|
Inj, uzedy, 1 mg
|
$18,429.26 |
$18,429.26 |
$18,429.26 |
$24.77
|
|
Inj w/fluor eval cv device
|
$2,256.80 |
$2,256.80 |
$2,256.80 |
$588.90
|
|
Ins cath ren art 1st bi
|
$6,368.70 |
$6,368.70 |
$6,368.70 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$5,389.15 |
$5,389.15 |
$5,389.15 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$4,353.05 |
$4,353.05 |
$4,353.05 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$3,146.65 |
$3,146.65 |
$3,146.65 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$411.45 |
$411.45 |
$411.45 |
$544.00
|
|
Insert abdomen-venous drain
|
$1,513.20 |
$1,513.20 |
$1,513.20 |
$4,391.00
|
|
Insert cath pleura with image
|
$4,669.60 |
$4,669.60 |
$4,669.60 |
$2,239.02
|
|
Insert cath pleura without image
|
$2,935.40 |
$2,935.40 |
$2,935.40 |
$2,212.00
|
|
Insert drug delivery implant
|
$523.90 |
$523.90 |
$523.90 |
$285.80
|
|
Insert hepatic shunt (tips)
|
$8,505.90 |
$8,505.90 |
$8,505.90 |
$9,754.48
|
|
Insert intrauterine device iud
|
$791.05 |
$791.05 |
$791.05 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$205.40 |
$205.40 |
$205.40 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$250.25 |
$250.25 |
$250.25 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,258.45 |
$3,258.45 |
$3,258.45 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,916.55 |
$2,916.55 |
$2,916.55 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,862.95 |
$3,862.95 |
$3,862.95 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,275.00 |
$2,275.00 |
$2,275.00 |
$2,618.40
|
|
Insertion of catheter vein
|
$581.75 |
$581.75 |
$581.75 |
$1,749.80
|
|
Insertion of catheter vein
|
$99.45 |
$99.45 |
$99.45 |
$858.05
|
|
Insertion of heart electrode 33211
|
$8,132.15 |
$8,132.15 |
$8,132.15 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$17,552.60 |
$17,552.60 |
$17,552.60 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$17,552.60 |
$17,552.60 |
$17,552.60 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$19,119.10 |
$19,119.10 |
$19,119.10 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,625.00 |
$1,625.00 |
$1,625.00 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$18,911.75 |
$18,911.75 |
$18,911.75 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$8,537.10 |
$8,537.10 |
$8,537.10 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$16,489.20 |
$16,489.20 |
$16,489.20 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$15,513.55 |
$15,513.55 |
$15,513.55 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$10,127.00 |
$10,127.00 |
$10,127.00 |
$5,470.54
|
|
Insert pm/icd lead dual
|
$17,313.40 |
$17,313.40 |
$17,313.40 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$18,567.25 |
$18,567.25 |
$18,567.25 |
$33,948.20
|
|
Insert sq defib electrode
|
$16,993.60 |
$16,993.60 |
$16,993.60 |
$8,167.68
|
|
Insert swan-ganz cath
|
$5,697.90 |
$5,697.90 |
$5,697.90 |
$2,164.52
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$10,127.00 |
$10,127.00 |
$10,127.00 |
$4,705.13
|
|
Insert uteri tandem/ovoids
|
$4,351.10 |
$4,351.10 |
$4,351.10 |
$3,986.00
|
|
Insert vad art access left hrt arterial access
|
$1,088.75 |
$1,088.75 |
$1,088.75 |
$5,062.80
|
|
Insert vad art access left hrt art & vein access
|
$1,088.75 |
$1,088.75 |
$1,088.75 |
$6,740.80
|
|
Ins icd gen exist mlt leads
|
$14,257.10 |
$14,257.10 |
$14,257.10 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$20,488.65 |
$20,488.65 |
$20,488.65 |
$24,159.72
|
|
Insitu hybridization auto
|
$692.90 |
$692.90 |
$692.90 |
$398.16
|
|
Insitu hybridization manual
|
$703.30 |
$703.30 |
$703.30 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$503.75 |
$503.75 |
$503.75 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$653.90 |
$653.90 |
$653.90 |
$338.40
|
|
Insj stablj dev w/dcmprn
|
$18,074.55 |
$18,074.55 |
$18,074.55 |
$16,139.55
|
|
Insj stablj dev without dcmprn
|
$18,074.55 |
$18,074.55 |
$18,074.55 |
$15,226.08
|
|
Ins lv lead exist pm/icd
|
$27,299.35 |
$27,299.35 |
$27,299.35 |
$12,384.25
|
