|
Inj proc elbow arthro
|
$61.65 |
$61.65 |
$61.65 |
$419.60
|
|
Inj proc for lymphang
|
$661.50 |
$661.50 |
$661.50 |
$682.00
|
|
Inj proc myelogram lumbar
|
$368.55 |
$368.55 |
$368.55 |
$830.50
|
|
Inj, releuko 1 mcg
|
$366.91 |
$366.91 |
$366.91 |
$473.25
|
|
Inj retro urethrocysto
|
$66.90 |
$66.90 |
$66.90 |
$443.50
|
|
Inj scleros sol sgl vein
|
$267.00 |
$267.00 |
$267.00 |
$558.97
|
|
Inj sulf hexa lipid microsph
|
$86.15 |
$86.15 |
$86.15 |
$256.14
|
|
Inj w/fluor eval cv device
|
$241.50 |
$241.50 |
$241.50 |
$503.92
|
|
Ins cath ren art 1st bi
|
$1,818.15 |
$1,818.15 |
$1,818.15 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$1,559.10 |
$1,559.10 |
$1,559.10 |
$4,660.00
|
|
Ins cath ren art 2nd+ uni
|
$1,594.50 |
$1,594.50 |
$1,594.50 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$311.70 |
$311.70 |
$311.70 |
$480.28
|
|
Insert and remove bone pin
|
$506.70 |
$506.70 |
$506.70 |
$4,410.60
|
|
Insert cath pleura with image
|
$517.35 |
$517.35 |
$517.35 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,059.30 |
$1,059.30 |
$1,059.30 |
$2,073.18
|
|
Insert hepatic shunt (tips)
|
$3,418.65 |
$3,418.65 |
$3,418.65 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$34.95 |
$34.95 |
$34.95 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$43.20 |
$43.20 |
$43.20 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,377.90 |
$1,377.90 |
$1,377.90 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,593.50 |
$2,593.50 |
$2,593.50 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,952.70 |
$1,952.70 |
$1,952.70 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$539.10 |
$539.10 |
$539.10 |
$2,505.60
|
|
Insertion of catheter vein
|
$546.75 |
$546.75 |
$546.75 |
$1,477.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$4,345.65 |
$4,345.65 |
$4,345.65 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$3,981.15 |
$3,981.15 |
$3,981.15 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$2,714.40 |
$2,714.40 |
$2,714.40 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$514.50 |
$514.50 |
$514.50 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,046.85 |
$1,046.85 |
$1,046.85 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$15,687.75 |
$15,687.75 |
$15,687.75 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$1,898.55 |
$1,898.55 |
$1,898.55 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$1,898.55 |
$1,898.55 |
$1,898.55 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$4,215.15 |
$4,215.15 |
$4,215.15 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,087.95 |
$1,087.95 |
$1,087.95 |
$5,223.20
|
|
Insert pm/icd lead dual
|
$1,898.55 |
$1,898.55 |
$1,898.55 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$14,695.35 |
$14,695.35 |
$14,695.35 |
$32,800.04
|
|
Insert swan-ganz cath
|
$1,818.15 |
$1,818.15 |
$1,818.15 |
$2,210.50
|
|
Insert uteri tandem/ovoids
|
$834.90 |
$834.90 |
$834.90 |
$3,905.20
|
|
Insert vad art access left hrt arterial access
|
$5,365.20 |
$5,365.20 |
$5,365.20 |
$4,270.75
|
|
Insert vad art access left hrt art & vein access
|
$2,745.90 |
$2,745.90 |
$2,745.90 |
$3,677.40
|
|
Ins icd gen exist mlt leads
|
$13,264.80 |
$13,264.80 |
$13,264.80 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$14,763.15 |
$14,763.15 |
$14,763.15 |
$23,230.50
|
|
Insitu hybridization auto
|
$222.45 |
$222.45 |
$222.45 |
$377.37
|
|
In situ hybridization per specimen each additional single probe stain
|
$93.30 |
$93.30 |
$93.30 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$134.85 |
$134.85 |
$134.85 |
$331.69
|
|
Insj perq vad r hrt venous
|
$414.00 |
$414.00 |
$414.00 |
$3,796.00
|
|
Insj phrnc nrv stim sys
|
$13,975.20 |
$13,975.20 |
$13,975.20 |
$52,995.29
|
|
Insj phrnc nrv stim transvns
|
$5,332.95 |
$5,332.95 |
$5,332.95 |
$13,142.86
|
|
Ins left heart vent thor inscn ecmo
|
$463.05 |
$463.05 |
$463.05 |
$1,901.60
|
|
Ins lv lead exist pm/icd
|
$2,714.40 |
$2,714.40 |
$2,714.40 |
$12,384.25
|
|
Ins picad w subq port 5yr>
|
$855.60 |
$855.60 |
$855.60 |
$3,985.20
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,079.10 |
$1,079.10 |
$1,079.10 |
$1,690.00
|
|
Ins pm gen w/exist mlt leads
|
$4,020.60 |
$4,020.60 |
$4,020.60 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$1,120.80 |
$1,120.80 |
$1,120.80 |
$5,377.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$6,987.45 |
$6,987.45 |
$6,987.45 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$4,157.25 |
$4,157.25 |
$4,157.25 |
$11,005.50
|
|
Ins/rpl pm w/tv ld atrl
|
$3,981.15 |
$3,981.15 |
$3,981.15 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$16,704.15 |
$16,704.15 |
$16,704.15 |
$25,694.00
|
|
Instillation anticarcinogenic agent bladder
|
$201.90 |
$201.90 |
$201.90 |
$621.40
|
|
Instll rx agnt into rnal tub
|
$129.00 |
$129.00 |
$129.00 |
$619.20
|
|
Ins tun cv cath wo subq prt/pm
|
$814.65 |
$814.65 |
$814.65 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$775.65 |
$775.65 |
$775.65 |
$4,202.70
|
|
Insulin total
|
$19.95 |
$19.95 |
$19.95 |
$66.64
|
|
Ins vag brachytx device
|
$335.10 |
$335.10 |
$335.10 |
$935.50
|
|
Integra meshed bil wound mat
|
$74.73 |
$74.73 |
$74.73 |
$9,924.16
|
|
Intens cardiac rehab no exer
|
$56.85 |
$56.85 |
$56.85 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$56.85 |
$56.85 |
$56.85 |
$238.40
|
|
Interdiscal perq aspir dx
|
$267.00 |
$267.00 |
$267.00 |
$1,222.26
|
|
Interrog dev eval scrms ip
|
$513.90 |
$513.90 |
$513.90 |
$124.80
|
|
Interrog&prgrmg ipnss
|
$47.55 |
$47.55 |
$47.55 |
$200.00
|
|
Interrog&prgrmg ipnss polysm
|
$147.00 |
$147.00 |
$147.00 |
$422.32
|
|
Interrog without prgrmg ipnss
|
$147.00 |
$147.00 |
$147.00 |
$147.00
|
|
Intracard echo interv w/s&i
|
$513.90 |
$513.90 |
$513.90 |
$3,461.04
|
|
Intracran angioplsty w/stent
|
$2,838.75 |
$2,838.75 |
$2,838.75 |
$8,145.50
|
|
Intracranial angioplasty
|
$1,912.80 |
$1,912.80 |
$1,912.80 |
$4,962.40
|
|
Intracranial complete study
|
$317.55 |
$317.55 |
$317.55 |
$874.99
|
|
Intracranial limited study
|
$229.50 |
$229.50 |
$229.50 |
$465.01
|
|
Intrapul surf admin endo tube
|
$58.65 |
$58.65 |
$58.65 |
$220.80
|
|
Intrinsic factor antibody
|
$26.40 |
$26.40 |
$26.40 |
$63.15
|
|
Intro cath dialysis circuit
|
$736.65 |
$736.65 |
$736.65 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$2,648.25 |
$2,648.25 |
$2,648.25 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$5,352.30 |
$5,352.30 |
$5,352.30 |
$16,262.40
|
|
Intro catheter aorta
|
$67.35 |
$67.35 |
$67.35 |
$1,654.05
|
|
Intro cath svc/ivc
|
$1,818.15 |
$1,818.15 |
$1,818.15 |
$1,323.27
|
|
Intro long gi tube
|
$329.25 |
$329.25 |
$329.25 |
$957.18
|
|
Intro long gi tube w/mult fluo
|
$71.70 |
$71.70 |
$71.70 |
$466.00
|
|
Intubation endotracheal emergency procedure
|
$235.05 |
$235.05 |
$235.05 |
$598.80
|
|
Iodine i-123 sod iodide mil
|
$49.95 |
$49.95 |
$49.95 |
$371.18
|
|
Ionm in operatng room 15 min
|
$77.55 |
$77.55 |
$77.55 |
$200.16
|
|
Ionm remote/>1 pt or per hr
|
$265.35 |
$265.35 |
$265.35 |
$622.70
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$45.83 |
$45.83 |
$45.83 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$60.90 |
$60.90 |
$60.90 |
$288.11
|
|
Ip/obs cnsltj new/est low 45
|
$72.15 |
$72.15 |
$72.15 |
$174.20
|
|
Ipratropium bromide non-comp
|
$1.09 |
$1.09 |
$1.09 |
$3.75
|
|
Iron
|
$11.40 |
$11.40 |
$11.40 |
$72.29
|
|
Iron binding capacity
|
$15.45 |
$15.45 |
$15.45 |
$63.60
|
|
Irradiation of blood product each unit reference
|
$122.10 |
$122.10 |
$122.10 |
$114.40
|
|
Irrigation implantable venous access device for drug delivery systems
|
$29.40 |
$29.40 |
$29.40 |
$144.62
|
|
Ivc venogram s&i
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$43.95 |
$43.95 |
$43.95 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$25.65 |
$25.65 |
$25.65 |
$159.00
|
