|
Initiation & management bipap/cpap initial day
|
$355.80 |
$355.80 |
$355.80 |
$570.00
|
|
Inj., benralizumab, 1 mg
|
$17,541.18 |
$17,541.18 |
$17,541.18 |
$11,239.97
|
|
Inj, bupivacaine liposome
|
$322.74 |
$322.74 |
$322.74 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$32.94 |
$32.94 |
$32.94 |
$28.51
|
|
Inj cefazolin (wg crit care)
|
$18.30 |
$18.30 |
$18.30 |
$17.00
|
|
Inj, clindamycin (baxter)
|
$48.96 |
$48.96 |
$48.96 |
$48.96
|
|
Inj cntr knee arthro incl ct/mri
|
$375.00 |
$375.00 |
$375.00 |
$436.80
|
|
Inj, cyclophos (baxter) 5mg
|
$1,815.60 |
$1,815.60 |
$1,815.60 |
$2,584.85
|
|
Inj daptomycin (xellia)
|
$120.00 |
$120.00 |
$120.00 |
$56.04
|
|
Inj dx for sinogram
|
$219.00 |
$219.00 |
$219.00 |
$413.82
|
|
Injection arthrography hip without anesthesia (both sides)
|
$463.20 |
$463.20 |
$463.20 |
$498.50
|
|
Injection, doxercalciferol
|
$9.00 |
$9.00 |
$9.00 |
$23.83
|
|
Injection during cath supravalvular aortography
|
$73.20 |
$73.20 |
$73.20 |
$1,027.26
|
|
Injection, edaravone, 1 mg
|
$3,893.40 |
$3,893.40 |
$3,893.40 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$1,128.60 |
$1,128.60 |
$1,128.60 |
$1,153.03
|
|
Injection for arthrography wrist (both sides)
|
$489.00 |
$489.00 |
$489.00 |
$438.00
|
|
Injection for bladder x-ray
|
$166.20 |
$166.20 |
$166.20 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$895.20 |
$895.20 |
$895.20 |
$494.65
|
|
Injection, fulvestrant
|
$131.88 |
$131.88 |
$131.88 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$10,763.22 |
$10,763.22 |
$10,763.22 |
$6,679.35
|
|
Injection jugular
|
$250.80 |
$250.80 |
$250.80 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$1,953.00 |
$1,953.00 |
$1,953.00 |
$2,277.65
|
|
Injection px peyronie ds
|
$255.00 |
$255.00 |
$255.00 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,110.00 |
$1,110.00 |
$1,110.00 |
$699.68
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,544.78 |
$2,544.78 |
$2,544.78 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$56,793.64 |
$56,793.64 |
$56,793.64 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$53,867.27 |
$53,867.27 |
$53,867.27 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,517.30 |
$2,517.30 |
$2,517.30 |
$2,031.18
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$1,007.19
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$1,781.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$984.48
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$5,700.00 |
$5,700.00 |
$5,700.00 |
$1,783.60
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,579.10 |
$2,579.10 |
$2,579.10 |
$1,685.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$209.40 |
$209.40 |
$209.40 |
$546.40
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$616.20 |
$616.20 |
$616.20 |
$634.40
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$189.60 |
$189.60 |
$189.60 |
$163.83
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$57.60 |
$57.60 |
$57.60 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$193.80 |
$193.80 |
$193.80 |
$259.49
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$74.40 |
$74.40 |
$74.40 |
$136.00
|
|
Inject/treat eye socket
|
$3,279.60 |
$3,279.60 |
$3,279.60 |
$381.13
|
|
Inj for ext venography
|
$2,188.80 |
$2,188.80 |
$2,188.80 |
$654.00
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,361.40 |
$1,361.40 |
$1,361.40 |
$1,439.90
|
|
Inj hrt cath w/s&i sel left vent
|
$438.00 |
$438.00 |
$438.00 |
$1,146.36
|
|
Inj hydroxocobalamin IV 25mg
|
$3,144.00 |
$3,144.00 |
$3,144.00 |
$2,452.32
|
|
Inj, immphentiv, 20 mcg
|
$9.00 |
$9.00 |
$9.00 |
$18.44
|
|
Inj ivig privigen 500 mg
|
$11,511.60 |
$11,511.60 |
$11,511.60 |
$6,967.29
|
|
Inj, levothyroxine, freskabi
|
$1,979.70 |
$1,979.70 |
$1,979.70 |
$322.98
|
|
Inj, lidocaine w epinephrine
|
$88.14 |
$88.14 |
$88.14 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$2,571.60 |
$2,571.60 |
$2,571.60 |
$788.40
|
|
Inj meropenem (wg crit care)
|
$123.42 |
$123.42 |
$123.42 |
$77.97
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,158.20 |
$2,158.20 |
$2,158.20 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,323.00 |
$1,323.00 |
$1,323.00 |
$2,484.00
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,323.00 |
$1,323.00 |
$1,323.00 |
$2,373.55
|
|
Inj ogivri 10 mg
|
$8,142.96 |
$8,142.96 |
$8,142.96 |
$4,492.28
|
|
Inj ontruzant 10 mg
|
$11,505.48 |
$11,505.48 |
$11,505.48 |
$6,706.27
|
|
Inj proc myelogram lumbar
|
$514.20 |
$514.20 |
$514.20 |
$854.00
|
|
Inj proc sialogram
|
$180.00 |
$180.00 |
$180.00 |
$380.00
|
|
Inj, releuko 1 mcg
|
$763.20 |
$763.20 |
$763.20 |
$461.20
|
|
Inj scleros sol mult veins
|
$514.20 |
$514.20 |
$514.20 |
$676.00
|
|
Inj scleros sol sgl vein
|
$514.20 |
$514.20 |
$514.20 |
$561.88
|
|
Inj sulf hexa lipid microsph
|
$511.56 |
$511.56 |
$511.56 |
$256.14
|
|
Inj thrc fascial pln blk bi w/wo image
|
$2,571.60 |
$2,571.60 |
$2,571.60 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,071.00 |
$1,071.00 |
$1,071.00 |
$837.50
|
|
Inj. tigecycline (accord)
|
$89.88 |
$89.88 |
$89.88 |
$182.46
|
|
Inj., tildrakizumab, 1 mg
|
$53,884.32 |
$53,884.32 |
$53,884.32 |
$26,635.60
|
|
Inj travoprost intra impl
|
$52,312.50 |
$52,312.50 |
$52,312.50 |
$197.16
|
|
Inj, tyenne, 1 mg
|
$5,875.20 |
$5,875.20 |
$5,875.20 |
$3,525.12
|
|
Inj vancomycin (xellia) 10mg
|
$105.00 |
$105.00 |
$105.00 |
$76.59
|
|
Inj vocal cord bulking agent
|
$2,241.20 |
$2,241.20 |
$2,241.20 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$433.80 |
$433.80 |
$433.80 |
$504.40
|
|
Ins cath ren art 1st bi
|
$10,881.00 |
$10,881.00 |
$10,881.00 |
$5,820.00
|
|
Ins cath ren art 1st uni
|
$9,347.40 |
$9,347.40 |
$9,347.40 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$9,523.80 |
$9,523.80 |
$9,523.80 |
$5,475.60
|
|
Ins cath ren art 2nd+ uni
|
$11,235.00 |
$11,235.00 |
$11,235.00 |
$5,395.20
|
|
Insert and remove bone pin
|
$4,055.40 |
$4,055.40 |
$4,055.40 |
$4,421.00
|
|
Insert cath pleura with image
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$3,111.60 |
$3,111.60 |
$3,111.60 |
$2,048.67
|
|
Insert drug delivery implant
|
$220.80 |
$220.80 |
$220.80 |
$283.20
|
|
Insert intrauterine device iud
|
$264.60 |
$264.60 |
$264.60 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$202.80 |
$202.80 |
$202.80 |
$205.80
|
|
Insertion catheter bladder temporary simple
|
$202.80 |
$202.80 |
$202.80 |
$235.20
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,445.40 |
$4,445.40 |
$4,445.40 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,468.20 |
$1,468.20 |
$1,468.20 |
$2,565.36
|
|
Insertion intra-aortic circulation dev 33970
|
$11,696.40 |
$11,696.40 |
$11,696.40 |
$866.40
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,136.20 |
$6,136.20 |
$6,136.20 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$5,172.60 |
$5,172.60 |
$5,172.60 |
$2,510.50
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$21,571.80 |
$21,571.80 |
$21,571.80 |
$12,508.08
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,583.60 |
$2,583.60 |
$2,583.60 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,603.20 |
$1,603.20 |
$1,603.20 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$41,503.80 |
$41,503.80 |
$41,503.80 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$19,217.40 |
$19,217.40 |
$19,217.40 |
$7,216.00
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$17,530.20 |
$17,530.20 |
$17,530.20 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$24,866.93 |
$24,866.93 |
$24,866.93 |
$5,236.80
|
|
Insert picvad cath
|
$6,672.00 |
$6,672.00 |
$6,672.00 |
$4,201.80
|
|
Insert pm/icd lead dual
|
$7,933.20 |
$7,933.20 |
$7,933.20 |
$7,221.50
|
|
Insert swan-ganz cath
|
$12,639.60 |
$12,639.60 |
$12,639.60 |
$2,346.51
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$6,138.00 |
$6,138.00 |
$6,138.00 |
$5,018.25
|
|
Insert tunneled cv cath
|
$8,526.00 |
$8,526.00 |
$8,526.00 |
$4,580.61
|
|
Insert tunneled cv cath
|
$6,138.00 |
$6,138.00 |
$6,138.00 |
$6,028.07
|
