|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$78.66 |
$78.66 |
$78.66 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,026.64 |
$2,026.64 |
$2,026.64 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,026.64 |
$2,026.64 |
$2,026.64 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,604.91 |
$2,604.91 |
$2,604.91 |
$2,092.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,953.49 |
$1,953.49 |
$1,953.49 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,604.91 |
$2,604.91 |
$2,604.91 |
$1,890.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,953.49 |
$1,953.49 |
$1,953.49 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,604.91 |
$2,604.91 |
$2,604.91 |
$2,035.20
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,533.30 |
$2,533.30 |
$2,533.30 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,533.30 |
$2,533.30 |
$2,533.30 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$863.94 |
$863.94 |
$863.94 |
$504.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,079.54 |
$1,079.54 |
$1,079.54 |
$554.40
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,079.54 |
$1,079.54 |
$1,079.54 |
$652.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$135.52 |
$135.52 |
$135.52 |
$145.60
|
|
Injection treatment of eye
|
$83.26 |
$83.26 |
$83.26 |
$2,822.40
|
|
Injection treatment of eye
|
$70.38 |
$70.38 |
$70.38 |
$2,698.92
|
|
Injection treatment of nerve
|
$276.46 |
$276.46 |
$276.46 |
$3,219.20
|
|
Injection treatment of nerve
|
$311.65 |
$311.65 |
$311.65 |
$4,446.30
|
|
Injection treatment of nerve
|
$142.60 |
$142.60 |
$142.60 |
$2,050.30
|
|
Injection treatment of nose
|
$38.87 |
$38.87 |
$38.87 |
$859.59
|
|
Inject sacroiliac joint
|
$2,687.30 |
$2,687.30 |
$2,687.30 |
$1,029.04
|
|
Inject/treat eye socket
|
$41.63 |
$41.63 |
$41.63 |
$381.13
|
|
Inject/treat eye socket
|
$45.77 |
$45.77 |
$45.77 |
$750.70
|
|
Inject/treat eye socket
|
$29.67 |
$29.67 |
$29.67 |
$670.02
|
|
Inj epidural sgl cerv-thor without img
|
$2,026.64 |
$2,026.64 |
$2,026.64 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$2,604.91 |
$2,604.91 |
$2,604.91 |
$1,450.84
|
|
Inj for ext venography
|
$874.72 |
$874.72 |
$874.72 |
$649.80
|
|
Inj for mammo ductogram
|
$774.62 |
$774.62 |
$774.62 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$7,058.59 |
$7,058.59 |
$7,058.59 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$32.66 |
$32.66 |
$32.66 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$34.96 |
$34.96 |
$34.96 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$22.08 |
$22.08 |
$22.08 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$22.77 |
$22.77 |
$22.77 |
$982.40
|
|
Inj hydroxocobalamin IV 25mg
|
$843.64 |
$843.64 |
$843.64 |
$2,452.32
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$91.31 |
$91.31 |
$91.31 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$581.35 |
$581.35 |
$581.35 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$28.98 |
$28.98 |
$28.98 |
$231.00
|
|
Inj levocarnitine per 1 gm
|
$31.30 |
$31.30 |
$31.30 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$12.39 |
$12.39 |
$12.39 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$2,026.64 |
$2,026.64 |
$2,026.64 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$9.95 |
$9.95 |
$9.95 |
$33.86
|
|
Inj naloxone hydrochloride
|
$26.56 |
$26.56 |
$26.56 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,953.49 |
$1,953.49 |
$1,953.49 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$96.60 |
$96.60 |
$96.60 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$76.36 |
$76.36 |
$76.36 |
$2,726.90
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$31.28 |
$31.28 |
$31.28 |
$1,058.98
|
|
Inj, pedmark, 100 mg
|
$193.20 |
$193.20 |
$193.20 |
$96.08
|
|
Inj. pemetrexed, 10 mg
|
$400.76 |
$400.76 |
$400.76 |
$104.72
|
|
Inj peritoneal venous shunt
|
$25.30 |
$25.30 |
$25.30 |
$406.80
|
|
Inj proc ankle arthr
|
$794.64 |
$794.64 |
$794.64 |
$405.60
|
|
Inj proc elbow arthro
|
$749.98 |
$749.98 |
$749.98 |
$438.00
|
|
Inj proc for lymphang
|
$52.90 |
$52.90 |
$52.90 |
$767.40
|
|
Inj proc lumbr disk ea lvl
|
$100.97 |
$100.97 |
$100.97 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$1,908.06 |
$1,908.06 |
$1,908.06 |
$856.00
|
|
Inj proc sialogram
|
$39.56 |
$39.56 |
$39.56 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$88.79 |
$88.79 |
$88.79 |
$307.40
|
|
Inj retro urethrocysto
|
$1,761.76 |
$1,761.76 |
$1,761.76 |
$450.00
|
|
Inj scleros sol mult veins
|
$1,461.46 |
$1,461.46 |
$1,461.46 |
$719.34
|
|
Inj scleros sol sgl vein
|
$1,168.86 |
$1,168.86 |
$1,168.86 |
$567.60
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$257.37 |
$257.37 |
$257.37 |
$436.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$3,039.19 |
$3,039.19 |
$3,039.19 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$2,026.64 |
$2,026.64 |
$2,026.64 |
$996.15
|
|
Inj vancomycin (xellia) 10mg
|
$12.88 |
$12.88 |
$12.88 |
$76.59
|
|
Inj vasopressin (am reg) 1 u
|
$40.25 |
$40.25 |
$40.25 |
$41.79
|
|
Inj w/fluor eval cv device
|
$616.77 |
$616.77 |
$616.77 |
$504.40
|
|
Inner skull vessel surgery
|
$2,608.89 |
$2,608.89 |
$2,608.89 |
$6,000.92
|
|
Inpt/ed teleconsult30
|
$59.57 |
$59.57 |
$59.57 |
$156.60
|
|
Inpt/ed teleconsult50
|
$83.95 |
$83.95 |
$83.95 |
$223.80
|
|
Inpt/ed teleconsult70
|
$119.60 |
$119.60 |
$119.60 |
$315.00
|
|
Inpt/tele follow up 15
|
$26.22 |
$26.22 |
$26.22 |
$64.80
|
|
Inpt/tele follow up 25
|
$46.69 |
$46.69 |
$46.69 |
$116.80
|
|
Inpt/tele follow up 35
|
$67.16 |
$67.16 |
$67.16 |
$168.96
|
|
Ins cath ren art 1st bi
|
$9,209.97 |
$9,209.97 |
$9,209.97 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$9,209.97 |
$9,209.97 |
$9,209.97 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$9,209.97 |
$9,209.97 |
$9,209.97 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$15,817.34 |
$15,817.34 |
$15,817.34 |
$5,509.80
|
|
Ins cerv dilator (sep proc)
|
$43.47 |
$43.47 |
$43.47 |
$495.43
|
|
Ins device for right guide open
|
$52.90 |
$52.90 |
$52.90 |
$487.20
|
|
Insemination of oocytes
|
$257.60 |
$257.60 |
$257.60 |
$314.40
|
|
Insert abdomen-venous drain
|
$506.46 |
$506.46 |
$506.46 |
$3,882.51
|
|
Insert and remove bone pin
|
$109.48 |
$109.48 |
$109.48 |
$4,433.36
|
|
Insert ant drainage device
|
$649.06 |
$649.06 |
$649.06 |
$5,108.80
|
|
Insert balloon device
|
$316.48 |
$316.48 |
$316.48 |
$2,067.52
|
|
Insert brain-fluid device 61215
|
$339.48 |
$339.48 |
$339.48 |
$7,181.20
|
|
Insert cannula hemo oth 36815
|
$86.02 |
$86.02 |
$86.02 |
$5,983.35
|
|
Insert cannula vein-to-vein hemodialysis
|
$77.05 |
$77.05 |
$77.05 |
$7,279.50
|
|
Insert cath pleura with image
|
$4,545.31 |
$4,545.31 |
$4,545.31 |
$2,194.40
|
|
Insert cath pleura without image
|
$5,550.93 |
$5,550.93 |
$5,550.93 |
$2,101.52
|
|
Insert drug delivery implant
|
$377.30 |
$377.30 |
$377.30 |
$280.00
|
|
Insert electrodes for eeg
|
$58.65 |
$58.65 |
$58.65 |
$564.20
|
|
Insert epicard eltrd endo 33203
|
$516.81 |
$516.81 |
$516.81 |
$3,053.00
|
|
Insert epicardial lead open 33202
|
$491.51 |
$491.51 |
$491.51 |
$3,775.20
|
|
Insert eye socket implant
|
$678.27 |
$678.27 |
$678.27 |
$5,067.20
|
|
Insert hepatic shunt (tips)
|
$515.89 |
$515.89 |
$515.89 |
$7,606.50
|
|
Insert heyman uteri capsule
|
$323.84 |
$323.84 |
$323.84 |
$5,813.46
|
|
Insert intervert bimech device 22854
|
$215.97 |
$215.97 |
$215.97 |
$1,103.00
|
|
Insert intracorporeal device
|
$1,228.43 |
$1,228.43 |
$1,228.43 |
$4,520.75
|
|
Insert intrauterine device iud
|
$34.27 |
$34.27 |
$34.27 |
$347.10
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$74.98 |
$74.98 |
$74.98 |
$3,594.47
|
|
Insertion catheter bladder non indwelling
|
$377.30 |
$377.30 |
$377.30 |
$209.30
|