|
Injection for ureter x-ray
|
$1,540.80 |
$1,540.80 |
$1,540.80 |
$415.80
|
|
Injection for ureter x-ray
|
$1,540.80 |
$1,540.80 |
$1,540.80 |
$527.70
|
|
Injection, fulvestrant
|
$115.80 |
$115.80 |
$115.80 |
$1,719.16
|
|
Injection, glucarpidase
|
$23,088.00 |
$23,088.00 |
$23,088.00 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$1,348.80 |
$1,348.80 |
$1,348.80 |
$6,679.35
|
|
Injection into brain canal
|
$961.20 |
$961.20 |
$961.20 |
$844.50
|
|
Injection into spinal artery
|
$1,852.80 |
$1,852.80 |
$1,852.80 |
$1,710.80
|
|
Injection, isavuconazonium
|
$229.20 |
$229.20 |
$229.20 |
$787.67
|
|
Injection jaw joint x-ray
|
$67.80 |
$67.80 |
$67.80 |
$340.00
|
|
Injection of sinus tract
|
$2,046.00 |
$2,046.00 |
$2,046.00 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$380.40 |
$380.40 |
$380.40 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$837.60 |
$837.60 |
$837.60 |
$694.20
|
|
Injection, renflexis
|
$451.80 |
$451.80 |
$451.80 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,647.20 |
$2,647.20 |
$2,647.20 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,346.60 |
$2,346.60 |
$2,346.60 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$948.00 |
$948.00 |
$948.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,647.20 |
$2,647.20 |
$2,647.20 |
$2,071.80
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,318.80 |
$1,318.80 |
$1,318.80 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,456.20 |
$1,456.20 |
$1,456.20 |
$1,888.80
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,318.80 |
$1,318.80 |
$1,318.80 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,318.80 |
$1,318.80 |
$1,318.80 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,048.40 |
$2,048.40 |
$2,048.40 |
$1,826.80
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,048.40 |
$2,048.40 |
$2,048.40 |
$1,685.00
|
|
Injection, siltuximab
|
$3,603.00 |
$3,603.00 |
$3,603.00 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$894.60 |
$894.60 |
$894.60 |
$485.28
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$396.60 |
$396.60 |
$396.60 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$766.20 |
$766.20 |
$766.20 |
$638.95
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$108.00 |
$108.00 |
$108.00 |
$145.60
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$1,723.20 |
$1,723.20 |
$1,723.20 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,920.60 |
$1,920.60 |
$1,920.60 |
$1,329.00
|
|
Inj., eravacycline, 1 mg
|
$36.60 |
$36.60 |
$36.60 |
$206.64
|
|
Inj, factor x, (human), 1iu
|
$6.60 |
$6.60 |
$6.60 |
$26.74
|
|
Inj. fe derisomaltose 10 mg
|
$194.40 |
$194.40 |
$194.40 |
$3,221.52
|
|
Inj for ext venography
|
$1,152.60 |
$1,152.60 |
$1,152.60 |
$631.80
|
|
Inj for mammo ductogram
|
$306.60 |
$306.60 |
$306.60 |
$397.80
|
|
Inj, gadopiclenol, 1 ml
|
$6.60 |
$6.60 |
$6.60 |
$37.63
|
|
Inj glofitamab gxbm, 2.5 mg
|
$612.60 |
$612.60 |
$612.60 |
$4,760.67
|
|
Inj heparin, pfizer, 1000u
|
$3.00 |
$3.00 |
$3.00 |
$25.30
|
|
Inj. herceptin hylecta, 10mg
|
$561.00 |
$561.00 |
$561.00 |
$8,193.78
|
|
Inj herzuma 10 mg
|
$841.20 |
$841.20 |
$841.20 |
$7,775.46
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,230.00 |
$1,230.00 |
$1,230.00 |
$1,492.00
|
|
Inj imip 4 cilas 4 releb 2mg
|
$183.60 |
$183.60 |
$183.60 |
$739.77
|
|
Inj. insulin (fiasp)
|
$16.80 |
$16.80 |
$16.80 |
$177.00
|
|
Inj ivig privigen 500 mg
|
$5,274.00 |
$5,274.00 |
$5,274.00 |
$6,967.29
|
|
Inj, lanreotide, (cipla) 1mg
|
$10,671.00 |
$10,671.00 |
$10,671.00 |
$11,648.70
|
|
Inj levocarnitine per 1 gm
|
$4.20 |
$4.20 |
$4.20 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$10.20 |
$10.20 |
$10.20 |
$320.80
|
|
Inj, melphalan flufenami 1mg
|
$5,700.00 |
$5,700.00 |
$5,700.00 |
$5,700.00
|
|
Inj, meropenem (b. braun)
|
$12.00 |
$12.00 |
$12.00 |
$71.14
|
|
Inj., meropenem, vaborbactam
|
$129.60 |
$129.60 |
$129.60 |
$556.87
|
|
Inj, micafungin (par pharm)
|
$89.40 |
$89.40 |
$89.40 |
$79.08
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$540.60 |
$540.60 |
$540.60 |
$8,304.04
|
|
Inj multihance
|
$3.00 |
$3.00 |
$3.00 |
$70.54
|
|
Inj. mycophenolate mofetil
|
$64.20 |
$64.20 |
$64.20 |
$252.66
|
|
Inj naloxone hydrochloride
|
$9.00 |
$9.00 |
$9.00 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$1,413.35
|
|
Inj nivolumab 2 mg hyaluron
|
$4,611.60 |
$4,611.60 |
$4,611.60 |
$15,599.68
|
|
Inj ogivri 10 mg
|
$564.00 |
$564.00 |
$564.00 |
$4,492.28
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$3,925.20 |
$3,925.20 |
$3,925.20 |
$6,614.40
|
|
Inj, pemivibart, 4500 mg
|
$96.00 |
$96.00 |
$96.00 |
$1,235.55
|
|
Inj peritoneal venous shunt
|
$1,665.60 |
$1,665.60 |
$1,665.60 |
$406.80
|
|
Inj proc ankle arthr
|
$405.60 |
$405.60 |
$405.60 |
$405.31
|
|
Inj proc elbow arthro
|
$461.40 |
$461.40 |
$461.40 |
$433.00
|
|
Inj proc lumbr disk ea lvl
|
$3,214.20 |
$3,214.20 |
$3,214.20 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$518.40 |
$518.40 |
$518.40 |
$840.00
|
|
Inj proc sialogram
|
$612.60 |
$612.60 |
$612.60 |
$369.45
|
|
Inj progesterone per 50 mg
|
$1.80 |
$1.80 |
$1.80 |
$13.76
|
|
Inj, releuko 1 mcg
|
$190.80 |
$190.80 |
$190.80 |
$475.36
|
|
Inj retro urethrocysto
|
$504.00 |
$504.00 |
$504.00 |
$447.74
|
|
Inj scleros sol mult veins
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$707.85
|
|
Inj scleros sol sgl vein
|
$1,108.20 |
$1,108.20 |
$1,108.20 |
$561.88
|
|
Inj secukinumab intrav 1mg
|
$253.80 |
$253.80 |
$253.80 |
$4,413.21
|
|
Inj, sezaby, 1 mg
|
$79.80 |
$79.80 |
$79.80 |
$235.85
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$602.40 |
$602.40 |
$602.40 |
$436.80
|
|
Inj, sutimlimab-jome, 10 mg
|
$52.20 |
$52.20 |
$52.20 |
$3,453.73
|
|
Inj teclistamab cqyv 0.5 mg
|
$3,345.00 |
$3,345.00 |
$3,345.00 |
$17,517.56
|
|
Inj tedizolid phosphate
|
$184.20 |
$184.20 |
$184.20 |
$664.72
|
|
Inj. teprotumumab-trbw 10 mg
|
$9,829.20 |
$9,829.20 |
$9,829.20 |
$35,034.78
|
|
Inj testosterone cypionate
|
$12.60 |
$12.60 |
$12.60 |
$64.96
|
|
Inj thiotepa nos 1 mg
|
$450.00 |
$450.00 |
$450.00 |
$3,170.16
|
|
Inj., tildrakizumab, 1 mg
|
$10,342.20 |
$10,342.20 |
$10,342.20 |
$26,635.60
|
|
Inj, tyenne, 1 mg
|
$58.20 |
$58.20 |
$58.20 |
$3,525.12
|
|
Inj vasopressin (am reg) 1 u
|
$30.00 |
$30.00 |
$30.00 |
$41.79
|
|
Inj w/fluor eval cv device
|
$417.00 |
$417.00 |
$417.00 |
$504.40
|
|
Inpatient consultation
|
$73.80 |
$73.80 |
$73.80 |
$73.80
|
|
Ins cath ren art 1st bi
|
$6,300.60 |
$6,300.60 |
$6,300.60 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$6,300.60 |
$6,300.60 |
$6,300.60 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$6,300.60 |
$6,300.60 |
$6,300.60 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$10,450.20 |
$10,450.20 |
$10,450.20 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$678.00 |
$678.00 |
$678.00 |
$488.35
|
|
Insert cannula vein-to-vein hemodialysis
|
$6,966.60 |
$6,966.60 |
$6,966.60 |
$7,279.50
|
|
Insert cath pleura with image
|
$10,384.20 |
$10,384.20 |
$10,384.20 |
$2,194.40
|
|
Insert drug delivery implant
|
$254.40 |
$254.40 |
$254.40 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$11,241.60 |
$11,241.60 |
$11,241.60 |
$7,571.20
|
|
Insert intrauterine device iud
|
$254.40 |
$254.40 |
$254.40 |
$330.72
|
|
Insertion catheter bladder non indwelling
|
$558.60 |
$558.60 |
$558.60 |
$209.30
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$8,638.80 |
$8,638.80 |
$8,638.80 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,600.00 |
$3,600.00 |
$3,600.00 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$9,498.60 |
$9,498.60 |
$9,498.60 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,732.40 |
$2,732.40 |
$2,732.40 |
$2,595.45
|
