|
Inj. mycophenolate mofetil
|
$317.15 |
$317.15 |
$317.15 |
$387.27
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,650.30 |
$2,650.30 |
$2,650.30 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$9,625.06 |
$9,625.06 |
$9,625.06 |
$91.01
|
|
Inj ontruzant 10 mg
|
$13,584.88 |
$13,584.88 |
$13,584.88 |
$34.96
|
|
Inj., patisiran, 0.1 mg
|
$35,780.35 |
$35,780.35 |
$35,780.35 |
$36,180.04
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$12,783.49 |
$12,783.49 |
$12,783.49 |
$1,695.87
|
|
Inj proc ankle arthr
|
$261.30 |
$261.30 |
$261.30 |
$405.60
|
|
Inj proc elbow arthro
|
$295.10 |
$295.10 |
$295.10 |
$483.15
|
|
Inj proc lumbr disk ea lvl
|
$3,647.80 |
$3,647.80 |
$3,647.80 |
$1,218.51
|
|
Inj proc myelogram lumbar
|
$6,615.70 |
$6,615.70 |
$6,615.70 |
$1,026.35
|
|
Inj proc sialogram
|
$474.50 |
$474.50 |
$474.50 |
$419.34
|
|
Inj progesterone per 50 mg
|
$131.23 |
$131.23 |
$131.23 |
$35.00
|
|
Inj, releuko 1 mcg
|
$1,112.88 |
$1,112.88 |
$1,112.88 |
$775.12
|
|
Inj retro urethrocysto
|
$1,314.34 |
$1,314.34 |
$1,314.34 |
$569.60
|
|
Inj scleros sol mult veins
|
$1,077.70 |
$1,077.70 |
$1,077.70 |
$614.00
|
|
Inj scleros sol sgl vein
|
$439.40 |
$439.40 |
$439.40 |
$534.40
|
|
Inj secukinumab intrav 1mg
|
$8,235.53 |
$8,235.53 |
$8,235.53 |
$31.80
|
|
Inj, sutimlimab-jome, 10 mg
|
$7,667.95 |
$7,667.95 |
$7,667.95 |
$18.13
|
|
Inj teclistamab cqyv 0.5 mg
|
$39,612.75 |
$39,612.75 |
$39,612.75 |
$33.27
|
|
Inj testosterone cypionate
|
$124.79 |
$124.79 |
$124.79 |
$78.79
|
|
Inj thiotepa nos 1 mg
|
$2,592.85 |
$2,592.85 |
$2,592.85 |
$8,689.13
|
|
Inj, tofidence, 1 mg
|
$7,086.04 |
$7,086.04 |
$7,086.04 |
$1,167.32
|
|
Inj, tyenne, 1 mg
|
$1,466.56 |
$1,466.56 |
$1,466.56 |
$12.60
|
|
Inj, uzedy, 1 mg
|
$17,791.34 |
$17,791.34 |
$17,791.34 |
$2,836.80
|
|
Inj, vasopressin (baxter)
|
$328.09 |
$328.09 |
$328.09 |
$2.94
|
|
Inj, vegzelma, 10 mg
|
$2,510.29 |
$2,510.29 |
$2,510.29 |
$43.62
|
|
Inj w/fluor eval cv device
|
$392.87 |
$392.87 |
$392.87 |
$573.00
|
|
Ins cath ren art 1st bi
|
$8,110.70 |
$8,110.70 |
$8,110.70 |
$6,012.50
|
|
Ins cath ren art 1st uni
|
$18,330.72 |
$18,330.72 |
$18,330.72 |
$4,628.00
|
|
Ins cath ren art 2nd+ uni
|
$3,211.65 |
$3,211.65 |
$3,211.65 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$284.05 |
$284.05 |
$284.05 |
$557.60
|
|
Insert cath pleura with image
|
$3,612.83 |
$3,612.83 |
$3,612.83 |
$2,239.02
|
|
Insert hepatic shunt (tips)
|
$5,935.80 |
$5,935.80 |
$5,935.80 |
$9,754.48
|
|
Insert intrauterine device iud
|
$10,436.48 |
$10,436.48 |
$10,436.48 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$19,380.71 |
$19,380.71 |
$19,380.71 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$17,343.53 |
$17,343.53 |
$17,343.53 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,095.32 |
$5,095.32 |
$5,095.32 |
$4,923.19
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$4,955.60 |
$4,955.60 |
$4,955.60 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,391.00 |
$1,391.00 |
$1,391.00 |
$2,457.24
|
|
Insertion of catheter vein
|
$885.30 |
$885.30 |
$885.30 |
$2,214.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$17,659.85 |
$17,659.85 |
$17,659.85 |
$14,777.24
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$14,608.75 |
$14,608.75 |
$14,608.75 |
$13,806.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$5,701.55 |
$5,701.55 |
$5,701.55 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,063.10 |
$2,063.10 |
$2,063.10 |
$2,367.00
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$42,215.55 |
$42,215.55 |
$42,215.55 |
$32,608.80
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,921.15 |
$4,921.15 |
$4,921.15 |
$7,513.67
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$17,553.25 |
$17,553.25 |
$17,553.25 |
$9,824.59
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$10,099.70 |
$10,099.70 |
$10,099.70 |
$5,423.04
|
|
Insert multi-comp penis pros
|
$50,259.40 |
$50,259.40 |
$50,259.40 |
$21,998.10
|
|
Insert nasal septal button
|
$4,870.65 |
$4,870.65 |
$4,870.65 |
$1,639.57
|
|
Insert semi-rigid prosthesis
|
$26,143.34 |
$26,143.34 |
$26,143.34 |
$10,037.15
|
|
Insert swan-ganz cath
|
$3,956.55 |
$3,956.55 |
$3,956.55 |
$2,269.00
|
|
Insert uro/ves nck sphincter
|
$37,098.26 |
$37,098.26 |
$37,098.26 |
$9,417.14
|
|
Insert uteri tandem/ovoids
|
$22,508.77 |
$22,508.77 |
$22,508.77 |
$3,940.41
|
|
Insitu hybridization auto
|
$240.50 |
$240.50 |
$240.50 |
$328.79
|
|
Insitu hybridization manual
|
$697.45 |
$697.45 |
$697.45 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$5,696.59 |
$5,696.59 |
$5,696.59 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$6,149.66 |
$6,149.66 |
$6,149.66 |
$364.00
|
|
Ins lv lead exist pm/icd
|
$10,829.65 |
$10,829.65 |
$10,829.65 |
$12,270.00
|
|
Ins mark abd/pel for right perq
|
$2,434.90 |
$2,434.90 |
$2,434.90 |
$2,000.78
|
|
Ins pq tunnld ip cath w/img
|
$6,757.71 |
$6,757.71 |
$6,757.71 |
$5,597.45
|
|
Ins/rplc spi npg/rcvr pocket
|
$49,017.47 |
$49,017.47 |
$49,017.47 |
$33,303.98
|
|
Ins/rpl pm gen exist dual lead
|
$14,270.10 |
$14,270.10 |
$14,270.10 |
$11,583.66
|
|
Ins/rpl prph sac/gstr npg/r
|
$32,149.97 |
$32,149.97 |
$32,149.97 |
$23,436.14
|
|
Insrt/redo neurostim 1 array
|
$24,012.98 |
$24,012.98 |
$24,012.98 |
$14,695.12
|
|
Insti hexaminolevulinate hcl
|
$5,905.57 |
$5,905.57 |
$5,905.57 |
$2,356.80
|
|
Instillation anticarcinogenic agent bladder
|
$719.55 |
$719.55 |
$719.55 |
$721.50
|
|
Instll rx agnt into rnal tub
|
$83,703.88 |
$83,703.88 |
$83,703.88 |
$509.60
|
|
Ins tun cv cath wo subq prt/pm
|
$4,793.52 |
$4,793.52 |
$4,793.52 |
$4,314.75
|
|
Ins tun intraperit dia cath
|
$7,339.08 |
$7,339.08 |
$7,339.08 |
$4,657.46
|
|
Insulin total
|
$30.55 |
$30.55 |
$30.55 |
$72.15
|
|
Ins vag brachytx device
|
$25,064.58 |
$25,064.58 |
$25,064.58 |
$909.35
|
|
Interdiscal perq aspir dx
|
$2,708.23 |
$2,708.23 |
$2,708.23 |
$1,222.26
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$33,167.33 |
$33,167.33 |
$33,167.33 |
$104.31
|
|
Interstitial brachy inter
|
$3,658.20 |
$3,658.20 |
$3,658.20 |
$1,348.20
|
|
Intra-atrial recording
|
$7,400.90 |
$7,400.90 |
$7,400.90 |
$5,252.30
|
|
Intracard echo interv w/s&i
|
$4,656.60 |
$4,656.60 |
$4,656.60 |
$4,328.45
|
|
Intracran angioplsty w/stent
|
$19,517.54 |
$19,517.54 |
$19,517.54 |
$9,045.05
|
|
Intracranial complete study
|
$680.55 |
$680.55 |
$680.55 |
$903.50
|
|
Intracranial limited study
|
$396.50 |
$396.50 |
$396.50 |
$398.34
|
|
Intrapul surf admin endo tube
|
$328.25 |
$328.25 |
$328.25 |
$220.80
|
|
Intrauterine transfusion ftl
|
$1,021.15 |
$1,021.15 |
$1,021.15 |
$1,004.25
|
|
Intrinsic factor antibody
|
$162.50 |
$162.50 |
$162.50 |
$76.77
|
|
Intro cath dialysis circuit
|
$6,643.31 |
$6,643.31 |
$6,643.31 |
$2,161.90
|
|
Intro cath dialysis circuit w/pta
|
$9,041.61 |
$9,041.61 |
$9,041.61 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$21,445.19 |
$21,445.19 |
$21,445.19 |
$18,260.50
|
|
Intro catheter aorta
|
$1,432.60 |
$1,432.60 |
$1,432.60 |
$1,963.80
|
|
Intro cath svc/ivc
|
$1,236.30 |
$1,236.30 |
$1,236.30 |
$1,942.50
|
|
Intro long gi tube
|
$1,489.80 |
$1,489.80 |
$1,489.80 |
$880.75
|
|
Intro long gi tube w/mult fluo
|
$1,007.50 |
$1,007.50 |
$1,007.50 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$1,907.75 |
$1,907.75 |
$1,907.75 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,416.35 |
$1,416.35 |
$1,416.35 |
$1,633.03
|
|
Intubation endotracheal emergency procedure
|
$1,626.30 |
$1,626.30 |
$1,626.30 |
$565.00
|
|
Ionm in operatng room 15 min
|
$157.95 |
$157.95 |
$157.95 |
$238.00
|
|
Ionm remote/>1 pt or per hr
|
$1,114.10 |
$1,114.10 |
$1,114.10 |
$622.70
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$84.76 |
$84.76 |
$84.76 |
$4.59
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$426.95 |
$426.95 |
$426.95 |
$145.52
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$134,989.56 |
$134,989.56 |
$134,989.56 |
$261.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$401.07 |
$401.07 |
$401.07 |
$254.59
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$11,188.36 |
$11,188.36 |
$11,188.36 |
$111.98
|