|
Inj daptomycin (xellia)
|
$54.60 |
$54.60 |
$54.60 |
$56.04
|
|
Inj disk cerv-thor ea lev
|
$2,561.14 |
$2,561.14 |
$2,561.14 |
$875.28
|
|
Inj dupuytren cord w/enzyme
|
$48.10 |
$48.10 |
$48.10 |
$416.00
|
|
Inj dx for sinogram
|
$3,124.28 |
$3,124.28 |
$3,124.28 |
$447.50
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$60.06 |
$60.06 |
$60.06 |
$1,231.28
|
|
Injection arthrography hip without anesthesia (both sides)
|
$856.92 |
$856.92 |
$856.92 |
$504.00
|
|
Injection, cangrelor
|
$911.09 |
$911.09 |
$911.09 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$830.28 |
$830.28 |
$830.28 |
$463.20
|
|
Injection, doxercalciferol
|
$6.33 |
$6.33 |
$6.33 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$6,783.58 |
$6,783.58 |
$6,783.58 |
$1,030.00
|
|
Injection epidural blood patch or clot
|
$1,947.68 |
$1,947.68 |
$1,947.68 |
$1,192.80
|
|
Injection eye drug
|
$66.30 |
$66.30 |
$66.30 |
$654.00
|
|
Injection for arthrography wrist (both sides)
|
$701.52 |
$701.52 |
$701.52 |
$439.50
|
|
Injection for bladder x-ray
|
$2,053.50 |
$2,053.50 |
$2,053.50 |
$462.90
|
|
Injection for hip x-ray
|
$59.28 |
$59.28 |
$59.28 |
$750.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,249.86 |
$1,249.86 |
$1,249.86 |
$503.30
|
|
Injection for spleen x-ray
|
$93.86 |
$93.86 |
$93.86 |
$595.50
|
|
Injection for tear sac x-ray
|
$37.18 |
$37.18 |
$37.18 |
$225.20
|
|
Injection for ureter x-ray
|
$36.66 |
$36.66 |
$36.66 |
$427.70
|
|
Injection for ureter x-ray
|
$1,778.22 |
$1,778.22 |
$1,778.22 |
$527.70
|
|
Injection into brain canal
|
$82.68 |
$82.68 |
$82.68 |
$1,261.40
|
|
Injection into brain canal
|
$830.28 |
$830.28 |
$830.28 |
$844.50
|
|
Injection into hemorrhoid(s)
|
$133.38 |
$133.38 |
$133.38 |
$1,433.00
|
|
Injection into spinal artery
|
$707.46 |
$707.46 |
$707.46 |
$1,710.80
|
|
Injection into vocal cord
|
$95.42 |
$95.42 |
$95.42 |
$459.51
|
|
Injection intraop add-on
|
$77.48 |
$77.48 |
$77.48 |
$214.48
|
|
Injection jaw joint x-ray
|
$455.10 |
$455.10 |
$455.10 |
$340.00
|
|
Injection of sinus tract
|
$4,165.46 |
$4,165.46 |
$4,165.46 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$592.41 |
$592.41 |
$592.41 |
$2,277.65
|
|
Injection, pentamidine iseth
|
$151.87 |
$151.87 |
$151.87 |
$321.94
|
|
Injection px peyronie ds
|
$64.48 |
$64.48 |
$64.48 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,129.98 |
$1,129.98 |
$1,129.98 |
$699.68
|
|
Injection, renflexis
|
$685.59 |
$685.59 |
$685.59 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$88.92 |
$88.92 |
$88.92 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,947.68 |
$1,947.68 |
$1,947.68 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,947.68 |
$1,947.68 |
$1,947.68 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,503.42 |
$2,503.42 |
$2,503.42 |
$2,092.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,877.38 |
$1,877.38 |
$1,877.38 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,503.42 |
$2,503.42 |
$2,503.42 |
$1,890.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,877.38 |
$1,877.38 |
$1,877.38 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,503.42 |
$2,503.42 |
$2,503.42 |
$2,035.20
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$78.00 |
$78.00 |
$78.00 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,434.60 |
$2,434.60 |
$2,434.60 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$830.28 |
$830.28 |
$830.28 |
$504.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,037.48 |
$1,037.48 |
$1,037.48 |
$554.40
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$30.16 |
$30.16 |
$30.16 |
$652.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$130.24 |
$130.24 |
$130.24 |
$145.60
|
|
Injection treatment of eye
|
$94.12 |
$94.12 |
$94.12 |
$2,822.40
|
|
Injection treatment of eye
|
$79.56 |
$79.56 |
$79.56 |
$2,698.92
|
|
Injection treatment of nerve
|
$312.52 |
$312.52 |
$312.52 |
$3,219.20
|
|
Injection treatment of nerve
|
$352.30 |
$352.30 |
$352.30 |
$4,446.30
|
|
Injection treatment of nerve
|
$161.20 |
$161.20 |
$161.20 |
$2,050.30
|
|
Injection treatment of nose
|
$43.94 |
$43.94 |
$43.94 |
$859.59
|
|
Inject sacroiliac joint
|
$2,582.60 |
$2,582.60 |
$2,582.60 |
$1,029.04
|
|
Inject/treat eye socket
|
$47.06 |
$47.06 |
$47.06 |
$381.13
|
|
Inject/treat eye socket
|
$51.74 |
$51.74 |
$51.74 |
$750.70
|
|
Inject/treat eye socket
|
$33.54 |
$33.54 |
$33.54 |
$670.02
|
|
Inj epidural sgl cerv-thor without img
|
$1,947.68 |
$1,947.68 |
$1,947.68 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$2,503.42 |
$2,503.42 |
$2,503.42 |
$1,450.84
|
|
Inj for ext venography
|
$840.64 |
$840.64 |
$840.64 |
$649.80
|
|
Inj for mammo ductogram
|
$54.86 |
$54.86 |
$54.86 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$6,783.58 |
$6,783.58 |
$6,783.58 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$6,783.58 |
$6,783.58 |
$6,783.58 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$6,783.58 |
$6,783.58 |
$6,783.58 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$6,783.58 |
$6,783.58 |
$6,783.58 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$6,783.58 |
$6,783.58 |
$6,783.58 |
$982.40
|
|
Inj hydroxocobalamin IV 25mg
|
$953.68 |
$953.68 |
$953.68 |
$2,452.32
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$103.22 |
$103.22 |
$103.22 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$558.70 |
$558.70 |
$558.70 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$32.76 |
$32.76 |
$32.76 |
$231.00
|
|
Inj levocarnitine per 1 gm
|
$35.38 |
$35.38 |
$35.38 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$21.39 |
$21.39 |
$21.39 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,947.68 |
$1,947.68 |
$1,947.68 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$13.76 |
$13.76 |
$13.76 |
$33.86
|
|
Inj naloxone hydrochloride
|
$84.63 |
$84.63 |
$84.63 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,877.38 |
$1,877.38 |
$1,877.38 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$109.20 |
$109.20 |
$109.20 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$86.32 |
$86.32 |
$86.32 |
$2,726.90
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$35.36 |
$35.36 |
$35.36 |
$1,058.98
|
|
Inj, pedmark, 100 mg
|
$218.40 |
$218.40 |
$218.40 |
$96.08
|
|
Inj peritoneal venous shunt
|
$28.60 |
$28.60 |
$28.60 |
$406.80
|
|
Inj proc ankle arthr
|
$763.68 |
$763.68 |
$763.68 |
$405.60
|
|
Inj proc elbow arthro
|
$720.76 |
$720.76 |
$720.76 |
$438.00
|
|
Inj proc for lymphang
|
$1,879.60 |
$1,879.60 |
$1,879.60 |
$767.40
|
|
Inj proc lumbr disk ea lvl
|
$4,158.06 |
$4,158.06 |
$4,158.06 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$1,833.72 |
$1,833.72 |
$1,833.72 |
$856.00
|
|
Inj proc sialogram
|
$44.72 |
$44.72 |
$44.72 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$100.37 |
$100.37 |
$100.37 |
$307.40
|
|
Inj retro urethrocysto
|
$47.32 |
$47.32 |
$47.32 |
$450.00
|
|
Inj scleros sol mult veins
|
$1,404.52 |
$1,404.52 |
$1,404.52 |
$719.34
|
|
Inj scleros sol sgl vein
|
$1,123.32 |
$1,123.32 |
$1,123.32 |
$567.60
|
|
Inj secretin synthetic human
|
$477.75 |
$477.75 |
$477.75 |
$1,234.65
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$290.94 |
$290.94 |
$290.94 |
$436.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$2,920.78 |
$2,920.78 |
$2,920.78 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,947.68 |
$1,947.68 |
$1,947.68 |
$996.15
|
|
Inj vasopressin (am reg) 1 u
|
$45.50 |
$45.50 |
$45.50 |
$41.79
|
|
Inj w/fluor eval cv device
|
$592.74 |
$592.74 |
$592.74 |
$504.40
|
|
Inner skull vessel surgery
|
$2,949.18 |
$2,949.18 |
$2,949.18 |
$6,000.92
|
|
Inpt/ed teleconsult30
|
$67.34 |
$67.34 |
$67.34 |
$156.60
|
|
Inpt/ed teleconsult50
|
$94.90 |
$94.90 |
$94.90 |
$223.80
|