|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,943.25 |
$1,943.25 |
$1,943.25 |
$1,685.00
|
|
Injection, siltuximab
|
$23,535.37 |
$23,535.37 |
$23,535.37 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$255.00 |
$255.00 |
$255.00 |
$504.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,078.50 |
$1,078.50 |
$1,078.50 |
$554.40
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$656.25 |
$656.25 |
$656.25 |
$652.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$573.00 |
$573.00 |
$573.00 |
$145.60
|
|
Injection treatment of nerve
|
$2,238.00 |
$2,238.00 |
$2,238.00 |
$3,219.20
|
|
Injection treatment of nerve
|
$2,708.25 |
$2,708.25 |
$2,708.25 |
$2,050.30
|
|
Inject sacroiliac joint
|
$492.00 |
$492.00 |
$492.00 |
$1,029.04
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$58,842.17 |
$58,842.17 |
$58,842.17 |
$54,322.53
|
|
Inj epidural sgl cerv-thor without img
|
$2,184.75 |
$2,184.75 |
$2,184.75 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,623.75 |
$1,623.75 |
$1,623.75 |
$1,450.84
|
|
Inj., eravacycline, 1 mg
|
$248.03 |
$248.03 |
$248.03 |
$206.64
|
|
Inj, etelcalcetide, 0.1 mg
|
$1,404.58 |
$1,404.58 |
$1,404.58 |
$343.35
|
|
Inj, factor x, (human), 1iu
|
$33.28 |
$33.28 |
$33.28 |
$26.74
|
|
Inj for ext venography
|
$1,434.75 |
$1,434.75 |
$1,434.75 |
$649.80
|
|
Inj for mammo ductogram
|
$150.00 |
$150.00 |
$150.00 |
$397.80
|
|
Inj., fremanezumab-vfrm 1 mg
|
$2,588.63 |
$2,588.63 |
$2,588.63 |
$1,322.20
|
|
Inj, fulvestrant (fresenius)
|
$1,713.99 |
$1,713.99 |
$1,713.99 |
$905.30
|
|
Inj givosiran 0.5 mg
|
$162,298.07 |
$162,298.07 |
$162,298.07 |
$76,708.80
|
|
Inj glycopyrrolate, glyrx-pf
|
$8.22 |
$8.22 |
$8.22 |
$11.23
|
|
Inj. herceptin hylecta, 10mg
|
$17,286.71 |
$17,286.71 |
$17,286.71 |
$8,193.78
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,110.00 |
$1,110.00 |
$1,110.00 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$2,622.00 |
$2,622.00 |
$2,622.00 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,192.50 |
$1,192.50 |
$1,192.50 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$5,894.25 |
$5,894.25 |
$5,894.25 |
$982.40
|
|
Inj human fibrinogen con nos
|
$4,326.08 |
$4,326.08 |
$4,326.08 |
$3.95
|
|
Inj imip 4 cilas 4 releb 2mg
|
$1,083.72 |
$1,083.72 |
$1,083.72 |
$739.77
|
|
Inj. inebilizumab-cdon, 1 mg
|
$172,856.28 |
$172,856.28 |
$172,856.28 |
$70,014.65
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$2,233.50 |
$2,233.50 |
$2,233.50 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$206.25 |
$206.25 |
$206.25 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$222.75 |
$222.75 |
$222.75 |
$231.00
|
|
Inj ivig privigen 500 mg
|
$4,194.45 |
$4,194.45 |
$4,194.45 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$122.28 |
$122.28 |
$122.28 |
$136.62
|
|
Inj levoleucovorin nos 0.5mg
|
$76.51 |
$76.51 |
$76.51 |
$110.40
|
|
Inj, levothyroxine, freskabi
|
$244.63 |
$244.63 |
$244.63 |
$320.80
|
|
Inj, lidocaine w epinephrine
|
$37.17 |
$37.17 |
$37.17 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,471.50 |
$1,471.50 |
$1,471.50 |
$794.70
|
|
Inj melpha hydroch nos 50 mg
|
$1,713.99 |
$1,713.99 |
$1,713.99 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$28.41 |
$28.41 |
$28.41 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$759.87 |
$759.87 |
$759.87 |
$556.87
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$17,682.90 |
$17,682.90 |
$17,682.90 |
$8,304.04
|
|
Inj multihance
|
$166.47 |
$166.47 |
$166.47 |
$70.54
|
|
Inj. mycophenolate mofetil
|
$387.27 |
$387.27 |
$387.27 |
$252.66
|
|
Inj. naxitamab-gqgk, 1 mg
|
$96,378.67 |
$96,378.67 |
$96,378.67 |
$42,064.28
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$522.75 |
$522.75 |
$522.75 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,569.00 |
$1,569.00 |
$1,569.00 |
$2,726.90
|
|
Inj octafluoropropane mic,ml
|
$340.18 |
$340.18 |
$340.18 |
$211.40
|
|
Inj ogivri 10 mg
|
$8,661.59 |
$8,661.59 |
$8,661.59 |
$4,492.28
|
|
Inj, omacetaxine mep, 0.01mg
|
$4,831.38 |
$4,831.38 |
$4,831.38 |
$2,686.80
|
|
Inj., patisiran, 0.1 mg
|
$36,180.04 |
$36,180.04 |
$36,180.04 |
$17,613.00
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$12,400.57 |
$12,400.57 |
$12,400.57 |
$6,614.40
|
|
Inj proc ankle arthr
|
$219.00 |
$219.00 |
$219.00 |
$405.60
|
|
Inj proc elbow arthro
|
$212.25 |
$212.25 |
$212.25 |
$438.00
|
|
Inj proc lumbr disk ea lvl
|
$3,232.50 |
$3,232.50 |
$3,232.50 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$1,300.50 |
$1,300.50 |
$1,300.50 |
$856.00
|
|
Inj progesterone per 50 mg
|
$123.09 |
$123.09 |
$123.09 |
$13.76
|
|
Inj retro urethrocysto
|
$629.25 |
$629.25 |
$629.25 |
$450.00
|
|
Inj, rimabotulinumtoxinb
|
$2,348.22 |
$2,348.22 |
$2,348.22 |
$714.24
|
|
Inj scleros sol mult veins
|
$520.50 |
$520.50 |
$520.50 |
$719.34
|
|
Inj scleros sol sgl vein
|
$489.00 |
$489.00 |
$489.00 |
$567.60
|
|
Inj secretin synthetic human
|
$2,444.05 |
$2,444.05 |
$2,444.05 |
$1,234.65
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$467.25 |
$467.25 |
$467.25 |
$436.80
|
|
Inj sulf hexa lipid microsph
|
$336.56 |
$336.56 |
$336.56 |
$256.14
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$124,816.51 |
$124,816.51 |
$124,816.51 |
$67,538.30
|
|
Inj. teprotumumab-trbw 10 mg
|
$66,625.08 |
$66,625.08 |
$66,625.08 |
$35,034.78
|
|
Inj testosterone cypionate
|
$473.66 |
$473.66 |
$473.66 |
$64.96
|
|
Inj thiotepa nos 1 mg
|
$8,689.13 |
$8,689.13 |
$8,689.13 |
$3,170.16
|
|
Inj thrc fascial pln blk bi w/wo image
|
$2,207.25 |
$2,207.25 |
$2,207.25 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,471.50 |
$1,471.50 |
$1,471.50 |
$996.15
|
|
Inj vancomycin (xellia) 10mg
|
$93.18 |
$93.18 |
$93.18 |
$76.59
|
|
Inj vocal cord bulking agent
|
$1,653.75 |
$1,653.75 |
$1,653.75 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$504.40
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$88,429.23 |
$88,429.23 |
$88,429.23 |
$41,083.73
|
|
Ins cath ren art 1st bi
|
$6,033.75 |
$6,033.75 |
$6,033.75 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$5,074.50 |
$5,074.50 |
$5,074.50 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$7,922.25 |
$7,922.25 |
$7,922.25 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$5,184.00 |
$5,184.00 |
$5,184.00 |
$5,509.80
|
|
Ins cerv dilator (sep proc)
|
$1,127.25 |
$1,127.25 |
$1,127.25 |
$495.43
|
|
Insert abdomen-venous drain
|
$7,121.25 |
$7,121.25 |
$7,121.25 |
$3,882.51
|
|
Insert cath pleura with image
|
$1,734.75 |
$1,734.75 |
$1,734.75 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,019.00 |
$2,019.00 |
$2,019.00 |
$2,101.52
|
|
Insert drug delivery implant
|
$1,418.25 |
$1,418.25 |
$1,418.25 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$10,536.00 |
$10,536.00 |
$10,536.00 |
$7,606.50
|
|
Insert intrauterine device iud
|
$723.75 |
$723.75 |
$723.75 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$327.75 |
$327.75 |
$327.75 |
$209.30
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,782.00 |
$4,782.00 |
$4,782.00 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,576.75 |
$3,576.75 |
$3,576.75 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,702.00 |
$6,702.00 |
$6,702.00 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,712.75 |
$2,712.75 |
$2,712.75 |
$2,595.45
|
|
Insertion of catheter vein
|
$2,687.25 |
$2,687.25 |
$2,687.25 |
$1,626.83
|
|
Insertion of catheter vein
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$888.46
|
|
Insertion of heart electrode 33211
|
$6,820.50 |
$6,820.50 |
$6,820.50 |
$6,839.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$11,024.25 |
$11,024.25 |
$11,024.25 |
$12,508.08
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$8,834.25 |
$8,834.25 |
$8,834.25 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$9,855.00 |
$9,855.00 |
$9,855.00 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,077.25 |
$3,077.25 |
$3,077.25 |
$2,109.00
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,242.75 |
$1,242.75 |
$1,242.75 |
$2,474.22
|
