|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$141.06 |
$141.06 |
$141.06 |
$514.36
|
|
Injection for ureter x-ray
|
$99.81 |
$99.81 |
$99.81 |
$544.50
|
|
Injection, fulvestrant
|
$163.24 |
$163.24 |
$163.24 |
$166.25
|
|
Injection glatiramer acetate
|
$272.52 |
$272.52 |
$272.52 |
$458.43
|
|
Injection into brain canal
|
$459.45 |
$459.45 |
$459.45 |
$791.62
|
|
Injection into brain canal
|
$421.43 |
$421.43 |
$421.43 |
$961.20
|
|
Injection, isavuconazonium
|
$389.92 |
$389.92 |
$389.92 |
$634.28
|
|
Injection,onabotulinumtoxina
|
$17.91 |
$17.91 |
$17.91 |
$12.88
|
|
Injection, peramivir
|
$9.71 |
$9.71 |
$9.71 |
$857.20
|
|
Injection, renflexis
|
$592.94 |
$592.94 |
$592.94 |
$632.98
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$543.53 |
$543.53 |
$543.53 |
$1,066.24
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$744.81 |
$744.81 |
$744.81 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,110.37 |
$1,110.37 |
$1,110.37 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,285.20 |
$1,285.20 |
$1,285.20 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,985.61 |
$1,985.61 |
$1,985.61 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$349.28 |
$349.28 |
$349.28 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$992.80 |
$992.80 |
$992.80 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$660.73 |
$660.73 |
$660.73 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$660.73 |
$660.73 |
$660.73 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$416.07 |
$416.07 |
$416.07 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$263.90 |
$263.90 |
$263.90 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$319.77 |
$319.77 |
$319.77 |
$654.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$75.11 |
$75.11 |
$75.11 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$75.48 |
$75.48 |
$75.48 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$84.55 |
$84.55 |
$84.55 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$61.14 |
$61.14 |
$61.14 |
$130.19
|
|
Injection torsemide 10 mg/ml
|
$16.02 |
$16.02 |
$16.02 |
$40.67
|
|
Injection treatment of eye
|
$2,911.53 |
$2,911.53 |
$2,911.53 |
$2,370.28
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$20,238.04 |
$20,238.04 |
$20,238.04 |
$39,043.20
|
|
Inj epidural sgl cerv-thor without img
|
$516.89 |
$516.89 |
$516.89 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$520.31 |
$520.31 |
$520.31 |
$1,260.60
|
|
Inj for mammo ductogram
|
$469.16 |
$469.16 |
$469.16 |
$469.16
|
|
Inj intralesional <= 7 lsn(s)
|
$159.19 |
$159.19 |
$159.19 |
$238.77
|
|
Inj ivig privigen 500 mg
|
$520.15 |
$520.15 |
$520.15 |
$6,144.00
|
|
Inj levocarnitine per 1 gm
|
$65.60 |
$65.60 |
$65.60 |
$87.51
|
|
Inj mepivacaine hcl/10 ml
|
$19.37 |
$19.37 |
$19.37 |
$28.41
|
|
Inj, moxifloxacin 100 mg
|
$73.08 |
$73.08 |
$73.08 |
$100.44
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$702.35 |
$702.35 |
$702.35 |
$1,522.56
|
|
Inj peritoneal venous shunt
|
$47.55 |
$47.55 |
$47.55 |
$329.49
|
|
Inj proc ankle arthr
|
$316.54 |
$316.54 |
$316.54 |
$405.60
|
|
Inj proc elbow arthro
|
$302.66 |
$302.66 |
$302.66 |
$483.15
|
|
Inj proc myelogram lumbar
|
$446.68 |
$446.68 |
$446.68 |
$1,026.35
|
|
Inj proc sialogram
|
$130.24 |
$130.24 |
$130.24 |
$419.34
|
|
Inj progesterone per 50 mg
|
$35.00 |
$35.00 |
$35.00 |
$35.00
|
|
Inj retro urethrocysto
|
$111.28 |
$111.28 |
$111.28 |
$569.60
|
|
Inj scleros sol sgl vein
|
$213.86 |
$213.86 |
$213.86 |
$534.40
|
|
Inj secretin synthetic human
|
$610.89 |
$610.89 |
$610.89 |
$610.89
|
|
Inj testosterone cypionate
|
$32.30 |
$32.30 |
$32.30 |
$78.79
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$2,540.29 |
$2,540.29 |
$2,540.29 |
$2,698.05
|
|
Ins cerv dilator (sep proc)
|
$154.85 |
$154.85 |
$154.85 |
$557.60
|
|
Insert cannula vein-to-vein hemodialysis
|
$2,016.78 |
$2,016.78 |
$2,016.78 |
$7,279.50
|
|
Insert cath pleura with image
|
$1,600.99 |
$1,600.99 |
$1,600.99 |
$2,239.02
|
|
Insert cath pleura without image
|
$4,113.48 |
$4,113.48 |
$4,113.48 |
$2,157.58
|
|
Insertion catheter bladder non indwelling
|
$103.14 |
$103.14 |
$103.14 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$113.78 |
$113.78 |
$113.78 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,662.23 |
$1,662.23 |
$1,662.23 |
$4,923.19
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,018.15 |
$1,018.15 |
$1,018.15 |
$2,457.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,159.86 |
$1,159.86 |
$1,159.86 |
$2,079.43
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,494.54 |
$2,494.54 |
$2,494.54 |
$7,513.67
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,720.69 |
$1,720.69 |
$1,720.69 |
$5,423.04
|
|
Insert pessary/other device
|
$177.42 |
$177.42 |
$177.42 |
$277.99
|
|
Insert swan-ganz cath
|
$1,373.35 |
$1,373.35 |
$1,373.35 |
$2,269.00
|
|
Insitu hybridization (fish)
|
$254.01 |
$254.01 |
$254.01 |
$481.60
|
|
In situ hybridization per specimen each additional single probe stain
|
$181.69 |
$181.69 |
$181.69 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$240.83 |
$240.83 |
$240.83 |
$364.00
|
|
Ins mark abd/pel for right perq
|
$1,549.19 |
$1,549.19 |
$1,549.19 |
$2,000.78
|
|
Ins mark thor for right perq
|
$833.70 |
$833.70 |
$833.70 |
$2,477.45
|
|
Ins picad w subq port 5yr>
|
$1,161.15 |
$1,161.15 |
$1,161.15 |
$4,312.97
|
|
Instillation anticarcinogenic agent bladder
|
$481.56 |
$481.56 |
$481.56 |
$721.50
|
|
Inst via cath agent pleurds
|
$524.57 |
$524.57 |
$524.57 |
$970.40
|
|
Insulin total
|
$48.66 |
$48.66 |
$48.66 |
$72.15
|
|
Integra meshed bil wound mat
|
$9,955.85 |
$9,955.85 |
$9,955.85 |
$11,119.26
|
|
Interdental wirg oth/thn fx
|
$810.12 |
$810.12 |
$810.12 |
$1,809.68
|
|
Interdiscal perq aspir dx
|
$633.07 |
$633.07 |
$633.07 |
$1,222.26
|
|
Interferon alfa-2b inj
|
$473.03 |
$473.03 |
$473.03 |
$51.21
|
|
Intracard echo interv w/s&i
|
$857.66 |
$857.66 |
$857.66 |
$4,328.45
|
|
Intracranial complete study
|
$336.61 |
$336.61 |
$336.61 |
$903.50
|
|
Intracranial limited study
|
$238.37 |
$238.37 |
$238.37 |
$398.34
|
|
Intrapul surf admin endo tube
|
$100.64 |
$100.64 |
$100.64 |
$220.80
|
|
Intrinsic factor antibody
|
$59.66 |
$59.66 |
$59.66 |
$76.77
|
|
Intro long gi tube
|
$481.00 |
$481.00 |
$481.00 |
$880.75
|
|
Intubation endotracheal emergency procedure
|
$263.53 |
$263.53 |
$263.53 |
$565.00
|
|
Ionm in operatng room 15 min
|
$82.79 |
$82.79 |
$82.79 |
$238.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$11.99 |
$11.99 |
$11.99 |
$4.59
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$153.98 |
$153.98 |
$153.98 |
$145.52
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$230.57 |
$230.57 |
$230.57 |
$261.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$25.55 |
$25.55 |
$25.55 |
$254.59
|
|
Iron
|
$70.67 |
$70.67 |
$70.67 |
$67.50
|
|
Iron binding capacity
|
$24.14 |
$24.14 |
$24.14 |
$55.00
|
|
Iron dextran 50 mg/ml injection solution
|
$62.12 |
$62.12 |
$62.12 |
$38.16
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$53.50 |
$53.50 |
$53.50 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$71.04 |
$71.04 |
$71.04 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$100.36 |
$100.36 |
$100.36 |
$149.00
|
|
Irrigation vagina and/or appl medicament tx disease
|
$255.21 |
$255.21 |
$255.21 |
$132.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$75.94 |
$75.94 |
$75.94 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$71.87 |
$71.87 |
$71.87 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$67.62 |
$67.62 |
$67.62 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$229.40 |
$229.40 |
$229.40 |
$476.50
|
|
Ivp w/nephrotomography
|
$322.92 |
$322.92 |
$322.92 |
$673.90
|
|
Ivp w/wo kub w/wo tomography
|
$330.32 |
$330.32 |
$330.32 |
$687.80
|