|
Injection, cangrelor
|
$61.45 |
$61.45 |
$61.45 |
$1,847.53
|
|
Injection carpal tunnel therapeutic (both sides)
|
$661.70 |
$661.70 |
$661.70 |
$536.00
|
|
Injection during cath supravalvular aortography
|
$2,346.50 |
$2,346.50 |
$2,346.50 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,720.55 |
$1,720.55 |
$1,720.55 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$441.12
|
|
Injection for bladder x-ray
|
$1,734.85 |
$1,734.85 |
$1,734.85 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,241.50 |
$1,241.50 |
$1,241.50 |
$504.00
|
|
Injection for spleen x-ray
|
$183.95 |
$183.95 |
$183.95 |
$686.40
|
|
Injection for ureter x-ray
|
$2,237.30 |
$2,237.30 |
$2,237.30 |
$444.95
|
|
Injection for ureter x-ray
|
$2,067.00 |
$2,067.00 |
$2,067.00 |
$515.21
|
|
Injection, fulvestrant
|
$142.32 |
$142.32 |
$142.32 |
$1,817.65
|
|
Injection glatiramer acetate
|
$119.18 |
$119.18 |
$119.18 |
$620.97
|
|
Injection, inclisiran, 1 mg
|
$11,657.30 |
$11,657.30 |
$11,657.30 |
$5,696.58
|
|
Injection into brain canal
|
$208.00 |
$208.00 |
$208.00 |
$933.60
|
|
Injection jugular
|
$333.45 |
$333.45 |
$333.45 |
$1,048.20
|
|
Injection of sinus tract
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,154.07 |
$2,154.07 |
$2,154.07 |
$2,034.90
|
|
Injection radioactive tracer sentinel node (both sides)
|
$2,223.00 |
$2,223.00 |
$2,223.00 |
$717.20
|
|
Injection, renflexis
|
$105.60 |
$105.60 |
$105.60 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,190.20 |
$3,190.20 |
$3,190.20 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,208.70 |
$2,208.70 |
$2,208.70 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$982.80 |
$982.80 |
$982.80 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,862.90 |
$1,862.90 |
$1,862.90 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,859.00 |
$1,859.00 |
$1,859.00 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,777.80 |
$3,777.80 |
$3,777.80 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$845.00 |
$845.00 |
$845.00 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,620.50 |
$3,620.50 |
$3,620.50 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,307.20 |
$3,307.20 |
$3,307.20 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,973.75 |
$2,973.75 |
$2,973.75 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$2,163.20 |
$2,163.20 |
$2,163.20 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$923.65 |
$923.65 |
$923.65 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$923.65 |
$923.65 |
$923.65 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$147.55 |
$147.55 |
$147.55 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$110.50 |
$110.50 |
$110.50 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$160.55 |
$160.55 |
$160.55 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$131.30 |
$131.30 |
$131.30 |
$141.60
|
|
Injection treatment of nerve
|
$3,507.40 |
$3,507.40 |
$3,507.40 |
$3,016.15
|
|
Injection treatment of nerve
|
$2,253.55 |
$2,253.55 |
$2,253.55 |
$2,037.10
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$106.54 |
$106.54 |
$106.54 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$2,174.25 |
$2,174.25 |
$2,174.25 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,854.45 |
$1,854.45 |
$1,854.45 |
$1,450.84
|
|
Inj for ext venography
|
$4,214.60 |
$4,214.60 |
$4,214.60 |
$737.55
|
|
Inj for mammo ductogram
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,521.35 |
$2,521.35 |
$2,521.35 |
$1,482.00
|
|
Inj hrt cath w/s&i sel right vent
|
$671.45 |
$671.45 |
$671.45 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$2,930.52 |
$2,930.52 |
$2,930.52 |
$2,452.32
|
|
Inj. inebilizumab-cdon, 1 mg
|
$1,296.36 |
$1,296.36 |
$1,296.36 |
$871.80
|
|
Inj intralesional <= 7 lsn(s)
|
$251.55 |
$251.55 |
$251.55 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$1,979.51 |
$1,979.51 |
$1,979.51 |
$5,274.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$116.89 |
$116.89 |
$116.89 |
$11,648.70
|
|
Inj, levothyroxine, freskabi
|
$24.30 |
$24.30 |
$24.30 |
$287.45
|
|
Inj., meropenem, vaborbactam
|
$740.32 |
$740.32 |
$740.32 |
$566.68
|
|
Inj meropenem (wg crit care)
|
$104.29 |
$104.29 |
$104.29 |
$98.70
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$7,979.40 |
$7,979.40 |
$7,979.40 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,316.25 |
$1,316.25 |
$1,316.25 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,316.25 |
$1,316.25 |
$1,316.25 |
$2,164.64
|
|
Inj ontruzant 10 mg
|
$1,661.08 |
$1,661.08 |
$1,661.08 |
$2,976.40
|
|
Inj pantoprazole(hikma) 40mg
|
$33.86 |
$33.86 |
$33.86 |
$33.52
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$879.58 |
$879.58 |
$879.58 |
$6,244.73
|
|
Inj peritoneal venous shunt
|
$1,802.45 |
$1,802.45 |
$1,802.45 |
$386.88
|
|
Inj proc ankle arthr
|
$1,288.30 |
$1,288.30 |
$1,288.30 |
$405.31
|
|
Inj proc elbow arthro
|
$2,059.20 |
$2,059.20 |
$2,059.20 |
$453.60
|
|
Inj proc for lymphang
|
$2,182.70 |
$2,182.70 |
$2,182.70 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$2,801.50 |
$2,801.50 |
$2,801.50 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$882.70 |
$882.70 |
$882.70 |
$922.80
|
|
Inj proc sialogram
|
$2,067.00 |
$2,067.00 |
$2,067.00 |
$380.80
|
|
Inj retacrit esrd on dialysi
|
$3.11 |
$3.11 |
$3.11 |
$266.26
|
|
Inj retro urethrocysto
|
$1,863.55 |
$1,863.55 |
$1,863.55 |
$551.29
|
|
Inj scleros sol mult veins
|
$692.90 |
$692.90 |
$692.90 |
$687.96
|
|
Inj scleros sol sgl vein
|
$692.90 |
$692.90 |
$692.90 |
$534.40
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$313.30 |
$313.30 |
$313.30 |
$436.64
|
|
Inj, sutimlimab-jome, 10 mg
|
$58.87 |
$58.87 |
$58.87 |
$38.81
|
|
Inj testosterone cypionate
|
$0.19 |
$0.19 |
$0.19 |
$77.15
|
|
Inj, uzedy, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$11,291.75
|
|
Inj, vancomycin hcl (mylan)
|
$23.86 |
$23.86 |
$23.86 |
$89.83
|
|
Inj w/fluor eval cv device
|
$4,182.10 |
$4,182.10 |
$4,182.10 |
$588.90
|
|
Ins cath ren art 1st bi
|
$7,086.30 |
$7,086.30 |
$7,086.30 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$5,998.20 |
$5,998.20 |
$5,998.20 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$8,073.65 |
$8,073.65 |
$8,073.65 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$5,838.30 |
$5,838.30 |
$5,838.30 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$524.55 |
$524.55 |
$524.55 |
$544.00
|
|
Insert abdomen-venous drain
|
$2,475.85 |
$2,475.85 |
$2,475.85 |
$4,391.00
|
|
Insert cath pleura with image
|
$5,938.40 |
$5,938.40 |
$5,938.40 |
$2,239.02
|
|
Insert cath pleura without image
|
$2,657.20 |
$2,657.20 |
$2,657.20 |
$2,212.00
|
|
Insert drug delivery implant
|
$564.20 |
$564.20 |
$564.20 |
$285.80
|
|
Insert hepatic shunt (tips)
|
$10,821.20 |
$10,821.20 |
$10,821.20 |
$9,754.48
|
|
Insert intrauterine device iud
|
$1,005.55 |
$1,005.55 |
$1,005.55 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$261.30 |
$261.30 |
$261.30 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$319.15 |
$319.15 |
$319.15 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,143.75 |
$4,143.75 |
$4,143.75 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,668.25 |
$2,668.25 |
$2,668.25 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,319.95 |
$6,319.95 |
$6,319.95 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,920.75 |
$1,920.75 |
$1,920.75 |
$2,618.40
|
|
Insertion of catheter vein
|
$530.40 |
$530.40 |
$530.40 |
$1,749.80
|
|
Insertion of catheter vein
|
$163.80 |
$163.80 |
$163.80 |
$858.05
|
|
Insertion of heart electrode 33211
|
$7,035.60 |
$7,035.60 |
$7,035.60 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$16,055.65 |
$16,055.65 |
$16,055.65 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$16,055.65 |
$16,055.65 |
$16,055.65 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$15,217.15 |
$15,217.15 |
$15,217.15 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,134.90 |
$1,134.90 |
$1,134.90 |
$2,079.43
|
