|
Initial foot exam pt lops
|
$142.17 |
$142.17 |
$142.17 |
|
|
Initial nursing facility care/day 35 minutes
|
$188.50 |
$198.25 |
$299.00 |
|
|
Initial nursing facility care/day 45 minutes
|
$226.20 |
$254.15 |
$391.00 |
|
|
Initial nursing facility care/day low severity 99304
|
$145.60 |
$145.60 |
$224.00 |
|
|
Initiation & management bipap/cpap initial day
|
$103.69 |
$445.90 |
$1,046.50 |
|
|
Inj, abilify maintena, 1 mg
|
$2,488.27 |
$2,488.27 |
$9,742.05 |
|
|
Inj, adzynma, 10 iu
|
$5,340.66 |
$5,340.66 |
$5,340.66 |
|
|
Inj allopurinol sodium 1 mg
|
$12,983.87 |
$12,983.87 |
$12,983.87 |
|
|
Inj alymsys 10 mg
|
$2,660.80 |
$2,660.80 |
$8,414.12 |
|
|
Inj anifrolumab-fnia 1mg
|
$20,208.53 |
$20,208.53 |
$20,208.53 |
|
|
Inj., benralizumab, 1 mg
|
$17,622.23 |
$19,608.78 |
$22,035.84 |
|
|
Inj, bezlotoxumab, 10 mg
|
$46.58 |
$46.58 |
$13,917.15 |
|
|
Inj, bupivacaine liposome
|
$816.31 |
$816.31 |
$886.63 |
|
|
Inj calcitriol per 0.1 mcg
|
$11.21 |
$11.21 |
$28.63 |
|
|
Inj cefazolin sodium, hikma
|
$38.39 |
$38.39 |
$38.39 |
|
|
Inj cefazolin (wg crit care)
|
$23.79 |
$23.79 |
$23.79 |
|
|
Inj, cefiderocol, 10 mg
|
$1,079.68 |
$1,079.68 |
$1,203.20 |
|
|
Inj ceftolozane tazobactam
|
$164.93 |
$164.93 |
$934.20 |
|
|
Inj. cetirizine hcl 0.5mg
|
$424.35 |
$424.35 |
$424.35 |
|
|
Inj, clevidipine butyrate
|
$17.45 |
$17.45 |
$793.97 |
|
|
Inj cntr knee arthro incl ct/mri
|
$218.40 |
$218.40 |
$352.30 |
|
|
Inj crotalidae im f(ab')2 eq
|
$4,298.58 |
$4,298.58 |
$4,298.58 |
|
|
Inj cyclophosphamd (ingenus)
|
$1,720.55 |
$1,720.55 |
$2,711.57 |
|
|
Inj, daptomycin (hospira)
|
$243.75 |
$243.75 |
$243.75 |
|
|
Inj daptomycin (xellia)
|
$174.98 |
$174.98 |
$174.98 |
|
|
Inj. denosumab-bbdz, 1 mg
|
$4,698.58 |
$9,390.67 |
$11,755.53 |
|
|
Inj, donanemab-azbt, 2 mg
|
$2,633.18 |
$2,633.18 |
$2,633.18 |
|
|
Inj, durolane 1 mg
|
$5,435.63 |
$5,435.63 |
$5,435.63 |
|
|
Inj dx for sinogram
|
$139.12 |
$139.12 |
$576.55 |
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,715.83 |
$2,715.83 |
$2,729.35 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$212.66 |
$212.66 |
$344.50 |
|
|
Injection, cangrelor
|
$19.75 |
$19.75 |
$19.75 |
|
|
Injection carpal tunnel therapeutic (both sides)
|
$243.10 |
$424.02 |
$424.02 |
|
|
Injection, daratumumab 10 mg
|
$12,083.13 |
$12,083.13 |
$12,083.13 |
|
|
Injection, doxercalciferol
|
$30.43 |
$30.43 |
$30.43 |
|
|
Injection during cath supravalvular aortography
|
$430.59 |
$1,022.45 |
$2,401.00 |
|
|
Injection epidural blood patch or clot
|
$402.84 |
$402.84 |
$1,828.45 |
|
|
Injection eye drug
|
$3,779.10 |
$3,779.10 |
$3,779.10 |
|
|
Injection for arthrography wrist (both sides)
|
$175.29 |
$175.29 |
$480.35 |
|
|
Injection for bladder x-ray
|
$128.95 |
$128.95 |
$2,679.43 |
|
|
Injection for hip x-ray
|
$202.48 |
$202.48 |
$202.48 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$141.06 |
$141.06 |
$280.15 |
|
|
Injection for ureter x-ray
|
$107.86 |
$107.86 |
$1,873.95 |
|
|
Injection for ureter x-ray
|
$99.81 |
$99.81 |
$7,201.20 |
|
|
Injection, fulvestrant
|
$163.24 |
$163.24 |
$583.70 |
|
|
Injection glatiramer acetate
|
$272.52 |
$272.52 |
$1,037.34 |
|
|
Injection, inclisiran, 1 mg
|
$9,943.76 |
$10,913.88 |
$12,150.78 |
|
|
Injection into brain canal
|
$459.45 |
$459.45 |
$459.45 |
|
|
Injection into brain canal
|
$421.43 |
$421.43 |
$4,909.39 |
|
|
Injection into hemorrhoid(s)
|
$193.05 |
$193.05 |
$193.05 |
|
|
Injection, isavuconazonium
|
$389.92 |
$389.92 |
$1,776.97 |
|
|
Injection of sinus tract
|
$1,773.41 |
$1,773.41 |
$1,773.41 |
|
|
Injection,onabotulinumtoxina
|
$17.91 |
$17.91 |
$2,119.98 |
|
|
Injection, peramivir
|
$9.71 |
$9.71 |
$9.71 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,007.33 |
$1,007.33 |
$2,594.15 |
|
|
Injection, renflexis
|
$592.94 |
$592.94 |
$2,787.89 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$543.53 |
$543.53 |
$2,405.65 |
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$744.81 |
$744.81 |
$27,537.07 |
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$254.15 |
$1,110.37 |
$19,273.96 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$560.30 |
$1,285.20 |
$6,399.97 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$341.25 |
$1,855.01 |
$4,272.29 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$577.20 |
$1,985.61 |
$4,272.29 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$306.15 |
$349.28 |
$4,924.13 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$507.65 |
$992.80 |
$4,924.13 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$660.73 |
$660.73 |
$3,125.91 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$660.73 |
$660.73 |
$2,589.02 |
|
|
Injection, siltuximab
|
$24,631.77 |
$24,631.77 |
$24,631.77 |
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$339.30 |
$416.07 |
$5,395.65 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$131.95 |
$263.90 |
$1,112.15 |
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$193.70 |
$319.77 |
$1,033.50 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$75.11 |
$103.35 |
$252.20 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$75.48 |
$103.35 |
$163.80 |
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$84.55 |
$103.35 |
$369.20 |
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$25.00 |
$66.95 |
$149.00 |
|
|
Injection torsemide 10 mg/ml
|
$16.02 |
$16.02 |
$16.02 |
|
|
Injection treatment of eye
|
$2,911.53 |
$2,911.53 |
$2,911.53 |
|
|
Injection treatment of nerve
|
$3,857.10 |
$3,857.10 |
$3,857.10 |
|
|
Inject sacroiliac joint
|
$170.57 |
$170.57 |
$791.05 |
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$59,982.32 |
$59,982.32 |
$59,982.32 |
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$20,238.04 |
$20,238.04 |
$20,238.04 |
|
|
Inj epidural sgl cerv-thor without img
|
$516.89 |
$516.89 |
$516.89 |
|
|
Inj epidural sgl lumb-sacral without img
|
$520.31 |
$520.31 |
$9,225.45 |
|
|
Inj, evinacumab-dgnb, 5mg
|
$163,496.87 |
$163,496.87 |
$163,496.87 |
|
|
Inj. fe derisomaltose 10 mg
|
$16,615.53 |
$16,615.53 |
$18,516.57 |
|
|
Inj for ext venography
|
$395.53 |
$395.53 |
$6,711.34 |
|
|
Inj for mammo ductogram
|
$312.65 |
$469.16 |
$492.70 |
|
|
Inj. herceptin hylecta, 10mg
|
$17,114.40 |
$17,114.40 |
$17,114.40 |
|
|
Inj herzuma 10 mg
|
$8,939.74 |
$8,939.74 |
$8,939.74 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$983.74 |
$1,580.80 |
$2,519.00 |
|
|
Inj hrt cath w/s&i sel hrt ang
|
$407.56 |
$1,606.15 |
$3,786.90 |
|
|
Inj hrt cath w/s&i sel hrt art
|
$722.52 |
$1,037.40 |
$1,596.00 |
|
|
Inj hrt cath w/s&i sel left vent
|
$1,589.25 |
$1,916.20 |
$2,445.00 |
|
|
Inj hrt cath w/s&i sel right vent
|
$965.33 |
$980.85 |
$2,081.00 |
|
|
Inj hydroxocobalamin IV 25mg
|
$4,584.48 |
$4,584.48 |
$5,109.00 |
|
|
Inj hydroxyprogst capoat nos
|
$97.69 |
$97.69 |
$97.69 |
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$3,579.55 |
$3,579.55 |
$4,106.02 |
|
|
Inj intralesional <= 7 lsn(s)
|
$159.19 |
$159.19 |
$403.00 |
|
|
Inj, invega hafyera/trinza
|
$23,804.37 |
$23,804.37 |
$23,804.37 |
|
|
Inj ivig privigen 500 mg
|
$520.15 |
$520.15 |
$25,741.98 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$26,017.53 |
$26,017.53 |
$32,520.64 |
|
