|
Inj disk cerv-thor ea lev
|
$2,287.20 |
$2,287.20 |
$2,287.20 |
$875.28
|
|
Inj dx for sinogram
|
$631.20 |
$631.20 |
$631.20 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$712.80 |
$712.80 |
$712.80 |
$503.50
|
|
Injection during cath supravalvular aortography
|
$1,148.80 |
$1,148.80 |
$1,148.80 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,732.00 |
$1,732.00 |
$1,732.00 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$919.20 |
$919.20 |
$919.20 |
$436.00
|
|
Injection for bladder x-ray
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$459.20
|
|
Injection for hip x-ray
|
$239.20 |
$239.20 |
$239.20 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$648.80 |
$648.80 |
$648.80 |
$497.76
|
|
Injection for ureter x-ray
|
$891.20 |
$891.20 |
$891.20 |
$515.21
|
|
Injection jaw joint x-ray
|
$296.80 |
$296.80 |
$296.80 |
$307.80
|
|
Injection, pentamidine iseth
|
$207.88 |
$207.88 |
$207.88 |
$383.03
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,268.80 |
$1,268.80 |
$1,268.80 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$940.00 |
$940.00 |
$940.00 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,888.00 |
$1,888.00 |
$1,888.00 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,071.20 |
$1,071.20 |
$1,071.20 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,857.60 |
$1,857.60 |
$1,857.60 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,043.20 |
$1,043.20 |
$1,043.20 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,857.60 |
$1,857.60 |
$1,857.60 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,982.40 |
$1,982.40 |
$1,982.40 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,982.40 |
$1,982.40 |
$1,982.40 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$466.40 |
$466.40 |
$466.40 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$503.20 |
$503.20 |
$503.20 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$170.40 |
$170.40 |
$170.40 |
$145.60
|
|
Inject sacroiliac joint
|
$1,711.20 |
$1,711.20 |
$1,711.20 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$1,195.20 |
$1,195.20 |
$1,195.20 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$917.60 |
$917.60 |
$917.60 |
$1,450.84
|
|
Inj for ext venography
|
$836.00 |
$836.00 |
$836.00 |
$628.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,222.40 |
$2,222.40 |
$2,222.40 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$2,626.40 |
$2,626.40 |
$2,626.40 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,772.80 |
$1,772.80 |
$1,772.80 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$1,772.00 |
$1,772.00 |
$1,772.00 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$1,610.40 |
$1,610.40 |
$1,610.40 |
$999.96
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$987.20 |
$987.20 |
$987.20 |
$1,413.35
|
|
Inj proc elbow arthro
|
$878.40 |
$878.40 |
$878.40 |
$432.00
|
|
Inj proc for lymphang
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$2,474.40 |
$2,474.40 |
$2,474.40 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$1,808.00 |
$1,808.00 |
$1,808.00 |
$838.30
|
|
Inj proc sialogram
|
$546.40 |
$546.40 |
$546.40 |
$373.00
|
|
Inj retro urethrocysto
|
$862.40 |
$862.40 |
$862.40 |
$447.74
|
|
Inj scleros sol mult veins
|
$676.00 |
$676.00 |
$676.00 |
$692.90
|
|
Inj scleros sol sgl vein
|
$447.20 |
$447.20 |
$447.20 |
$561.88
|
|
Inj w/fluor eval cv device
|
$903.20 |
$903.20 |
$903.20 |
$504.40
|
|
Ins cath ren art 1st bi
|
$8,614.40 |
$8,614.40 |
$8,614.40 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$4,404.00 |
$4,404.00 |
$4,404.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$8,564.00 |
$8,564.00 |
$8,564.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$276.80 |
$276.80 |
$276.80 |
$490.73
|
|
Insert cath pleura with image
|
$2,674.40 |
$2,674.40 |
$2,674.40 |
$2,194.40
|
|
Insert hepatic shunt (tips)
|
$11,761.60 |
$11,761.60 |
$11,761.60 |
$7,571.20
|
|
Insert intrauterine device iud
|
$1,358.40 |
$1,358.40 |
$1,358.40 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$170.40 |
$170.40 |
$170.40 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,706.40 |
$4,706.40 |
$4,706.40 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,292.00 |
$2,292.00 |
$2,292.00 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$9,819.20 |
$9,819.20 |
$9,819.20 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$2,585.25
|
|
Insertion of catheter vein
|
$2,976.00 |
$2,976.00 |
$2,976.00 |
$1,525.80
|
|
Insertion of catheter vein
|
$1,676.80 |
$1,676.80 |
$1,676.80 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$10,281.60 |
$10,281.60 |
$10,281.60 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$5,110.40 |
$5,110.40 |
$5,110.40 |
$12,324.60
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,128.00 |
$2,128.00 |
$2,128.00 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,229.60 |
$3,229.60 |
$3,229.60 |
$2,453.83
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$6,986.40 |
$6,986.40 |
$6,986.40 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$4,276.80 |
$4,276.80 |
$4,276.80 |
$7,267.20
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,286.40 |
$6,286.40 |
$6,286.40 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$2,492.80 |
$2,492.80 |
$2,492.80 |
$7,115.90
|
|
Insert swan-ganz cath
|
$3,176.80 |
$3,176.80 |
$3,176.80 |
$2,164.52
|
|
In situ hybridization per specimen each additional single probe stain
|
$291.20 |
$291.20 |
$291.20 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$340.00 |
$340.00 |
$340.00 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$4,876.00 |
$4,876.00 |
$4,876.00 |
$4,078.00
|
|
Ins pq tunnld ip cath w/img
|
$5,593.60 |
$5,593.60 |
$5,593.60 |
$5,486.00
|
|
Ins/rpl pm gen exist sgl lead
|
$3,384.00 |
$3,384.00 |
$3,384.00 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$4,896.80 |
$4,896.80 |
$4,896.80 |
$11,583.66
|
|
Inst fibrinolysis agent ini day
|
$760.80 |
$760.80 |
$760.80 |
$1,043.35
|
|
Inst fibrinolysis agent sbsq d
|
$725.60 |
$725.60 |
$725.60 |
$997.05
|
|
Instillation anticarcinogenic agent bladder
|
$712.80 |
$712.80 |
$712.80 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$4,644.80 |
$4,644.80 |
$4,644.80 |
$4,218.00
|
|
Ins tun intraperit dia cath
|
$4,609.60 |
$4,609.60 |
$4,609.60 |
$4,570.00
|
|
Inst via cath agent pleurds
|
$970.40 |
$970.40 |
$970.40 |
$1,074.68
|
|
Interdiscal perq aspir dx
|
$2,049.60 |
$2,049.60 |
$2,049.60 |
$1,222.26
|
|
Intracard echo interv w/s&i
|
$5,442.40 |
$5,442.40 |
$5,442.40 |
$3,436.00
|
|
Intracranial angioplasty
|
$4,962.40 |
$4,962.40 |
$4,962.40 |
$5,181.00
|
|
Intracranial complete study
|
$1,158.40 |
$1,158.40 |
$1,158.40 |
$881.50
|
|
Intracranial limited study
|
$696.80 |
$696.80 |
$696.80 |
$467.50
|
|
Intro cath dialysis circuit
|
$5,300.80 |
$5,300.80 |
$5,300.80 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$18,717.60 |
$18,717.60 |
$18,717.60 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$26,658.40 |
$26,658.40 |
$26,658.40 |
$16,262.40
|
|
Intro catheter aorta
|
$1,625.60 |
$1,625.60 |
$1,625.60 |
$1,678.05
|
|
Intro cath svc/ivc
|
$1,622.40 |
$1,622.40 |
$1,622.40 |
$1,323.27
|
|
Intro long gi tube
|
$1,256.00 |
$1,256.00 |
$1,256.00 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$765.60 |
$765.60 |
$765.60 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,484.80 |
$4,484.80 |
$4,484.80 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,654.40 |
$2,654.40 |
$2,654.40 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$589.60 |
$589.60 |
$589.60 |
$601.28
|
|
Iodine i-123 sod iodide mil
|
$658.40 |
$658.40 |
$658.40 |
$386.37
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$200.00 |
$200.00 |
$200.00 |
$279.10
|
|
Ipratropium bromide non-comp
|
$3.60 |
$3.60 |
$3.60 |
$4.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$167.20 |
$167.20 |
$167.20 |
$146.11
|
|
Ivc venogram s&i
|
$5,008.80 |
$5,008.80 |
$5,008.80 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$146.40 |
$146.40 |
$146.40 |
$133.90
|
