|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$527.80 |
$527.80 |
$527.80 |
$504.00
|
|
Injection for spleen x-ray
|
$209.95 |
$209.95 |
$209.95 |
$686.40
|
|
Injection for ureter x-ray
|
$2,554.50 |
$2,554.50 |
$2,554.50 |
$444.95
|
|
Injection for ureter x-ray
|
$151.45 |
$151.45 |
$151.45 |
$515.21
|
|
Injection into brain canal
|
$59.15 |
$59.15 |
$59.15 |
$933.60
|
|
Injection jugular
|
$176.15 |
$176.15 |
$176.15 |
$1,048.20
|
|
Injection of sinus tract
|
$245.70 |
$245.70 |
$245.70 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,154.07 |
$2,154.07 |
$2,154.07 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,392.30 |
$1,392.30 |
$1,392.30 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,165.80 |
$2,165.80 |
$2,165.80 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,165.80 |
$2,165.80 |
$2,165.80 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,165.80 |
$2,165.80 |
$2,165.80 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$520.00 |
$520.00 |
$520.00 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,315.00 |
$3,315.00 |
$3,315.00 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,103.70 |
$1,103.70 |
$1,103.70 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,082.90 |
$1,082.90 |
$1,082.90 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$975.00 |
$975.00 |
$975.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$487.50 |
$487.50 |
$487.50 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$487.50 |
$487.50 |
$487.50 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$114.40 |
$114.40 |
$114.40 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$95.55 |
$95.55 |
$95.55 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$241.80 |
$241.80 |
$241.80 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$100.75 |
$100.75 |
$100.75 |
$141.60
|
|
Injection treatment of nerve
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$3,016.15
|
|
Injection treatment of nerve
|
$1,931.80 |
$1,931.80 |
$1,931.80 |
$2,037.10
|
|
Inj epidural sgl lumb-sacral without img
|
$1,588.60 |
$1,588.60 |
$1,588.60 |
$1,450.84
|
|
Inj for mammo ductogram
|
$400.40 |
$400.40 |
$400.40 |
$433.50
|
|
Inj hydroxocobalamin IV 25mg
|
$3,180.35 |
$3,180.35 |
$3,180.35 |
$3,180.35
|
|
Inj intralesional <= 7 lsn(s)
|
$216.45 |
$216.45 |
$216.45 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$216.45 |
$216.45 |
$216.45 |
$234.00
|
|
Inj, levothyroxine, freskabi
|
$28.03 |
$28.03 |
$28.03 |
$302.07
|
|
Inj, levothyroxine, hikma
|
$191.72 |
$191.72 |
$191.72 |
$5.14
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$7,452.90 |
$7,452.90 |
$7,452.90 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$715.00 |
$715.00 |
$715.00 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$715.00 |
$715.00 |
$715.00 |
$2,164.64
|
|
Inj pantoprazole(hikma) 40mg
|
$29.84 |
$29.84 |
$29.84 |
$36.04
|
|
Inj peritoneal venous shunt
|
$1,293.50 |
$1,293.50 |
$1,293.50 |
$386.88
|
|
Inj proc ankle arthr
|
$512.20 |
$512.20 |
$512.20 |
$405.31
|
|
Inj proc elbow arthro
|
$694.20 |
$694.20 |
$694.20 |
$453.60
|
|
Inj proc for lymphang
|
$2,493.40 |
$2,493.40 |
$2,493.40 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$375.70 |
$375.70 |
$375.70 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$282.75 |
$282.75 |
$282.75 |
$922.80
|
|
Inj proc sialogram
|
$2,360.80 |
$2,360.80 |
$2,360.80 |
$380.80
|
|
Inj retro urethrocysto
|
$260.00 |
$260.00 |
$260.00 |
$551.29
|
|
Inj scleros sol mult veins
|
$257.40 |
$257.40 |
$257.40 |
$687.96
|
|
Inj scleros sol sgl vein
|
$257.40 |
$257.40 |
$257.40 |
$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
|
$42.25 |
$42.25 |
$42.25 |
$436.64
|
|
Inj w/fluor eval cv device
|
$1,952.60 |
$1,952.60 |
$1,952.60 |
$588.90
|
|
Ins cerv dilator (sep proc)
|
$449.80 |
$449.80 |
$449.80 |
$544.00
|
|
Insert abdomen-venous drain
|
$1,777.10 |
$1,777.10 |
$1,777.10 |
$4,391.00
|
|
Insert cath pleura with image
|
$3,916.90 |
$3,916.90 |
$3,916.90 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,129.70 |
$1,129.70 |
$1,129.70 |
$2,212.00
|
|
Insert drug delivery implant
|
$572.00 |
$572.00 |
$572.00 |
$285.80
|
|
Insert hepatic shunt (tips)
|
$9,274.85 |
$9,274.85 |
$9,274.85 |
$9,754.48
|
|
Insert intrauterine device iud
|
$861.90 |
$861.90 |
$861.90 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$209.30 |
$209.30 |
$209.30 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$209.30 |
$209.30 |
$209.30 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,319.20 |
$2,319.20 |
$2,319.20 |
$4,943.21
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,730.00 |
$2,730.00 |
$2,730.00 |
$2,618.40
|
|
Insertion of catheter vein
|
$280.15 |
$280.15 |
$280.15 |
$1,749.80
|
|
Insertion of catheter vein
|
$477.75 |
$477.75 |
$477.75 |
$858.05
|
|
Insertion of heart electrode 33211
|
$3,936.40 |
$3,936.40 |
$3,936.40 |
$9,090.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,958.45 |
$1,958.45 |
$1,958.45 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,179.45 |
$2,179.45 |
$2,179.45 |
$2,527.91
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$7,466.55 |
$7,466.55 |
$7,466.55 |
$9,793.46
|
|
Insert uteri tandem/ovoids
|
$1,569.10 |
$1,569.10 |
$1,569.10 |
$3,986.00
|
|
Insitu hybridization auto
|
$890.50 |
$890.50 |
$890.50 |
$398.16
|
|
Insitu hybridization manual
|
$445.25 |
$445.25 |
$445.25 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$357.50 |
$357.50 |
$357.50 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$490.75 |
$490.75 |
$490.75 |
$338.40
|
|
Insj stablj dev w/dcmprn
|
$21,352.50 |
$21,352.50 |
$21,352.50 |
$16,139.55
|
|
Insj stablj dev without dcmprn
|
$21,352.50 |
$21,352.50 |
$21,352.50 |
$15,226.08
|
|
Ins mark thor for right perq
|
$1,298.70 |
$1,298.70 |
$1,298.70 |
$2,396.35
|
|
Ins pq tunnld ip cath w/img
|
$2,319.20 |
$2,319.20 |
$2,319.20 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$8,228.35 |
$8,228.35 |
$8,228.35 |
$24,135.54
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$8,613.15 |
$8,613.15 |
$8,613.15 |
$25,106.90
|
|
Insrt/redo neurostim 1 array
|
$23,641.80 |
$23,641.80 |
$23,641.80 |
$23,436.14
|
|
Inst fibrinolysis agent ini day
|
$685.10 |
$685.10 |
$685.10 |
$1,095.00
|
|
Inst fibrinolysis agent sbsq d
|
$673.40 |
$673.40 |
$673.40 |
$898.12
|
|
Instillation anticarcinogenic agent bladder
|
$617.50 |
$617.50 |
$617.50 |
$721.50
|
|
Instll rx agnt into rnal tub
|
$1,095.90 |
$1,095.90 |
$1,095.90 |
$619.20
|
|
Ins tun intraperit dia cath
|
$3,722.55 |
$3,722.55 |
$3,722.55 |
$4,657.46
|
|
Inst via cath agent pleurds
|
$1,220.05 |
$1,220.05 |
$1,220.05 |
$1,074.68
|
|
Insulin total
|
$33.15 |
$33.15 |
$33.15 |
$67.60
|
|
Ins vag brachytx device
|
$728.00 |
$728.00 |
$728.00 |
$909.35
|
|
Interdiscal perq aspir dx
|
$3,686.15 |
$3,686.15 |
$3,686.15 |
$1,222.26
|
|
Intracran angioplsty w/stent
|
$16,768.70 |
$16,768.70 |
$16,768.70 |
$11,364.78
|
|
Intracranial angioplasty
|
$2,851.55 |
$2,851.55 |
$2,851.55 |
$7,149.60
|
|
Intracranial complete study
|
$690.95 |
$690.95 |
$690.95 |
$883.30
|
|
Intracranial limited study
|
$616.85 |
$616.85 |
$616.85 |
$423.52
|
|
Intraop epicard/endocard/pace/map/ 93631
|
$161.20 |
$161.20 |
$161.20 |
$3,690.00
|
|
Intrauterine transfusion ftl
|
$395.85 |
$395.85 |
$395.85 |
$1,004.25
|
|
Intrinsic factor antibody
|
$126.10 |
$126.10 |
$126.10 |
$59.95
|
|
Intro cath dialysis circuit
|
$1,821.30 |
$1,821.30 |
$1,821.30 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$6,193.85 |
$6,193.85 |
$6,193.85 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$13,308.10 |
$13,308.10 |
$13,308.10 |
$15,625.00
|