|
Inj, releuko 1 mcg
|
$976.92 |
$976.92 |
$976.92 |
$461.20
|
|
Inj retro urethrocysto
|
$593.40 |
$593.40 |
$593.40 |
$450.00
|
|
Inj sulf hexa lipid microsph
|
$196.14 |
$196.14 |
$196.14 |
$256.14
|
|
Inj testosterone cypionate
|
$28.20 |
$28.20 |
$28.20 |
$62.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$869.40 |
$869.40 |
$869.40 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$869.40 |
$869.40 |
$869.40 |
$818.00
|
|
Inj. tigecycline (accord)
|
$474.00 |
$474.00 |
$474.00 |
$182.46
|
|
Inj, tyenne, 1 mg
|
$7,520.28 |
$7,520.28 |
$7,520.28 |
$3,525.12
|
|
Inj, uzedy, 1 mg
|
$9,337.74 |
$9,337.74 |
$9,337.74 |
$11,475.96
|
|
Inj vocal cord bulking agent
|
$1,928.80 |
$1,928.80 |
$1,928.80 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$246.00 |
$246.00 |
$246.00 |
$463.40
|
|
Ins cath ren art 1st bi
|
$6,723.60 |
$6,723.60 |
$6,723.60 |
$5,741.00
|
|
Ins cath ren art 1st uni
|
$6,723.60 |
$6,723.60 |
$6,723.60 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$9,541.20 |
$9,541.20 |
$9,541.20 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$7,568.40 |
$7,568.40 |
$7,568.40 |
$5,419.00
|
|
Insert cath pleura with image
|
$4,065.00 |
$4,065.00 |
$4,065.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$3,629.40 |
$3,629.40 |
$3,629.40 |
$2,019.00
|
|
Insert cv cath inf & sup app
|
$13,644.00 |
$13,644.00 |
$13,644.00 |
$9,763.31
|
|
Insert hepatic shunt (tips)
|
$7,210.80 |
$7,210.80 |
$7,210.80 |
$8,367.70
|
|
Insert intrauterine device iud
|
$6,113.46 |
$6,113.46 |
$6,113.46 |
$366.65
|
|
Insertion catheter bladder temporary simple
|
$271.80 |
$271.80 |
$271.80 |
$229.32
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,568.00 |
$2,568.00 |
$2,568.00 |
$4,731.80
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$12,886.20 |
$12,886.20 |
$12,886.20 |
$7,034.50
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$5,172.60 |
$5,172.60 |
$5,172.60 |
$2,511.00
|
|
Insertion of catheter vein
|
$2,141.40 |
$2,141.40 |
$2,141.40 |
$1,657.32
|
|
Insertion of catheter vein
|
$631.20 |
$631.20 |
$631.20 |
$836.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$10,558.80 |
$10,558.80 |
$10,558.80 |
$12,508.08
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$1,710.60 |
$1,710.60 |
$1,710.60 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,705.20 |
$1,705.20 |
$1,705.20 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,058.60 |
$2,058.60 |
$2,058.60 |
$2,414.10
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$7,899.60 |
$7,899.60 |
$7,899.60 |
$7,513.67
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$14,490.00 |
$14,490.00 |
$14,490.00 |
$7,342.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$7,899.60 |
$7,899.60 |
$7,899.60 |
$9,397.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$7,800.21 |
$7,800.21 |
$7,800.21 |
$5,236.80
|
|
Insert sq defib electrode
|
$18,802.80 |
$18,802.80 |
$18,802.80 |
$8,167.68
|
|
Insert uteri tandem/ovoids
|
$8,586.00 |
$8,586.00 |
$8,586.00 |
$3,905.20
|
|
Insert vad art access left hrt arterial access
|
$4,360.80 |
$4,360.80 |
$4,360.80 |
$4,221.97
|
|
Insert vad art access left hrt art & vein access
|
$4,039.80 |
$4,039.80 |
$4,039.80 |
$2,889.60
|
|
Insitu hybridization (fish)
|
$483.00 |
$483.00 |
$483.00 |
$481.60
|
|
Insitu hybridization manual
|
$166.80 |
$166.80 |
$166.80 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$145.20 |
$145.20 |
$145.20 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$368.40 |
$368.40 |
$368.40 |
$326.04
|
|
Insj biomechanical device 22853
|
$54,816.74 |
$54,816.74 |
$54,816.74 |
$622.40
|
|
Insole orthotic freedom sz6 6816
|
$174.51 |
$174.51 |
$174.51 |
$84.00
|
|
Ins picad w subq port 5yr>
|
$4,287.00 |
$4,287.00 |
$4,287.00 |
$3,912.93
|
|
Ins pq tunnld ip cath w/img
|
$8,578.80 |
$8,578.80 |
$8,578.80 |
$5,377.00
|
|
Ins/rplc spi npg/rcvr pocket
|
$135,678.33 |
$135,678.33 |
$135,678.33 |
$23,746.69
|
|
Ins/rpl ldless pm right vent w img & eval
|
$29,827.80 |
$29,827.80 |
$29,827.80 |
$23,369.00
|
|
Ins/rpl pm w/tv ld atrl
|
$8,430.00 |
$8,430.00 |
$8,430.00 |
$12,371.40
|
|
Ins/rpl prph sac/gstr npg/r
|
$47,385.28 |
$47,385.28 |
$47,385.28 |
$15,339.48
|
|
Inst fibrinolysis agent ini day
|
$1,197.60 |
$1,197.60 |
$1,197.60 |
$1,090.80
|
|
Inst fibrinolysis agent sbsq d
|
$1,197.60 |
$1,197.60 |
$1,197.60 |
$1,018.47
|
|
Instillation anticarcinogenic agent bladder
|
$10,260.84 |
$10,260.84 |
$10,260.84 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$6,436.71 |
$6,436.71 |
$6,436.71 |
$4,202.70
|
|
Inst via cath agent pleurds
|
$1,449.00 |
$1,449.00 |
$1,449.00 |
$1,093.50
|
|
Insulin total
|
$26.40 |
$26.40 |
$26.40 |
$66.64
|
|
Ins vag brachytx device
|
$550.20 |
$550.20 |
$550.20 |
$897.75
|
|
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
|
$13,121.10 |
$13,121.10 |
$13,121.10 |
$3,825.00
|
|
Interdental fixation
|
$2,591.40 |
$2,591.40 |
$2,591.40 |
$2,162.05
|
|
Interdiscal perq aspir dx
|
$3,041.40 |
$3,041.40 |
$3,041.40 |
$1,180.84
|
|
Interfyl, 1 mg
|
$5,248.44 |
$5,248.44 |
$5,248.44 |
$5,118.52
|
|
Intracran angioplsty w/stent
|
$8,621.40 |
$8,621.40 |
$8,621.40 |
$8,440.20
|
|
Intracranial angioplasty
|
$8,075.40 |
$8,075.40 |
$8,075.40 |
$5,099.25
|
|
Intrapul surf admin endo tube
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$220.80
|
|
Intrinsic factor antibody
|
$23.40 |
$23.40 |
$23.40 |
$66.60
|
|
Intro cath dialysis circuit
|
$1,710.60 |
$1,710.60 |
$1,710.60 |
$2,035.00
|
|
Intro cath dialysis circuit w/pta
|
$15,149.40 |
$15,149.40 |
$15,149.40 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$30,212.40 |
$30,212.40 |
$30,212.40 |
$15,805.00
|
|
Intro catheter aorta
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,654.05
|
|
Intro cath svc/ivc
|
$1,110.60 |
$1,110.60 |
$1,110.60 |
$1,329.90
|
|
Intro long gi tube
|
$711.00 |
$711.00 |
$711.00 |
$990.00
|
|
Intro long gi tube w/mult fluo
|
$602.40 |
$602.40 |
$602.40 |
$449.40
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$3,482.40 |
$3,482.40 |
$3,482.40 |
$3,303.76
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,367.60 |
$2,367.60 |
$2,367.60 |
$1,633.03
|
|
Intubation endotracheal emergency procedure
|
$550.20 |
$550.20 |
$550.20 |
$589.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$236.52 |
$236.52 |
$236.52 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1,440.18 |
$1,440.18 |
$1,440.18 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$134,734.26 |
$134,734.26 |
$134,734.26 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$1.50 |
$1.50 |
$1.50 |
$3.75
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$118.50 |
$118.50 |
$118.50 |
$163.87
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$11,743.26 |
$11,743.26 |
$11,743.26 |
$5,476.68
|
|
Iron
|
$57.60 |
$57.60 |
$57.60 |
$74.40
|
|
Iron binding capacity
|
$73.20 |
$73.20 |
$73.20 |
$63.79
|
|
Iron dextran 50 mg/ml injection solution
|
$75.00 |
$75.00 |
$75.00 |
$80.95
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$187.06
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$17,146.14 |
$17,146.14 |
$17,146.14 |
$8,273.35
|
|
Ivc venogram s&i
|
$2,845.80 |
$2,845.80 |
$2,845.80 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$258.60 |
$258.60 |
$258.60 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$258.60 |
$258.60 |
$258.60 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$258.60 |
$258.60 |
$258.60 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$438.60 |
$438.60 |
$438.60 |
$439.56
|
|
Ivp w/nephrotomography
|
$1,194.00 |
$1,194.00 |
$1,194.00 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$489.60 |
$489.60 |
$489.60 |
$379.87
|
|
John cunningham antibody
|
$24.60 |
$24.60 |
$24.60 |
$72.60
|
|
Kafo dbl solid stirrup band/
|
$2,607.45 |
$2,607.45 |
$2,607.45 |
$2,185.15
|
|
Kafo dbl solid stirrup without j
|
$2,562.92 |
$2,562.92 |
$2,562.92 |
$2,562.92
|
|
Kafo fem fx cast molded to p
|
$3,838.16 |
$3,838.16 |
$3,838.16 |
$3,130.66
|
