|
Inj. mycophenolate mofetil
|
$121.44 |
$121.44 |
$121.44 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$705.21 |
$705.21 |
$705.21 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$452.89 |
$452.89 |
$452.89 |
$462.04
|
|
Inj, nyposi 1 mcg
|
$337.77 |
$337.77 |
$337.77 |
$0.55
|
|
Inj octafluoropropane mic,ml
|
$269.10 |
$269.10 |
$269.10 |
$211.40
|
|
Inj ogivri 10 mg
|
$4,158.09 |
$4,158.09 |
$4,158.09 |
$4,492.28
|
|
Inj., omadacycline, 1 mg
|
$537.08 |
$537.08 |
$537.08 |
$865.34
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$4,414.81 |
$4,414.81 |
$4,414.81 |
$6,403.59
|
|
Inj peritoneal venous shunt
|
$131.67 |
$131.67 |
$131.67 |
$413.70
|
|
Inj proc ankle arthr
|
$263.34 |
$263.34 |
$263.34 |
$405.31
|
|
Inj proc elbow arthro
|
$264.33 |
$264.33 |
$264.33 |
$419.60
|
|
Inj proc sialogram
|
$164.67 |
$164.67 |
$164.67 |
$373.00
|
|
Inj progesterone per 50 mg
|
$46.25 |
$46.25 |
$46.25 |
$15.00
|
|
Inj, releuko 1 mcg
|
$286.11 |
$286.11 |
$286.11 |
$473.25
|
|
Inj retro urethrocysto
|
$78.21 |
$78.21 |
$78.21 |
$443.50
|
|
Inj, rimabotulinumtoxinb
|
$714.24 |
$714.24 |
$714.24 |
$746.79
|
|
Inj romidepsin non-lyo 0.1mg
|
$9,892.69 |
$9,892.69 |
$9,892.69 |
$9,892.69
|
|
Inj secretin synthetic human
|
$743.39 |
$743.39 |
$743.39 |
$1,285.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$31,381.15 |
$31,381.15 |
$31,381.15 |
$90,007.62
|
|
Inj teclistamab cqyv 0.5 mg
|
$11,749.73 |
$11,749.73 |
$11,749.73 |
$17,517.56
|
|
Inj testosterone cypionate
|
$18.23 |
$18.23 |
$18.23 |
$64.80
|
|
Inj thiotepa nos 1 mg
|
$2,642.90 |
$2,642.90 |
$2,642.90 |
$3,170.16
|
|
Inj, tislelizumab-jsgr
|
$6,267.99 |
$6,267.99 |
$6,267.99 |
$9,764.09
|
|
Inj triamcinolone ace X-ray 1mg
|
$773.18 |
$773.18 |
$773.18 |
$1,090.75
|
|
Inj, tyenne, 1 mg
|
$2,202.50 |
$2,202.50 |
$2,202.50 |
$3,525.12
|
|
Inj, vegzelma, 10 mg
|
$3,047.33 |
$3,047.33 |
$3,047.33 |
$1,291.28
|
|
Inj w/fluor eval cv device
|
$337.92 |
$337.92 |
$337.92 |
$503.92
|
|
Ins cath ren art 1st bi
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$4,660.00
|
|
Ins cath ren art 2nd+ uni
|
$2,814.24 |
$2,814.24 |
$2,814.24 |
$5,395.20
|
|
Insert cath pleura with image
|
$974.16 |
$974.16 |
$974.16 |
$2,194.40
|
|
Insertion catheter bladder temporary simple
|
$67.32 |
$67.32 |
$67.32 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,182.06 |
$1,182.06 |
$1,182.06 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,127.28 |
$1,127.28 |
$1,127.28 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,472.13 |
$1,472.13 |
$1,472.13 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$385.11 |
$385.11 |
$385.11 |
$2,505.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$3,887.07 |
$3,887.07 |
$3,887.07 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$3,887.07 |
$3,887.07 |
$3,887.07 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$1,189.98 |
$1,189.98 |
$1,189.98 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$385.11 |
$385.11 |
$385.11 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$539.22 |
$539.22 |
$539.22 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$9,508.29 |
$9,508.29 |
$9,508.29 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,880.57 |
$2,880.57 |
$2,880.57 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,880.57 |
$2,880.57 |
$2,880.57 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,027.42 |
$3,027.42 |
$3,027.42 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$974.82 |
$974.82 |
$974.82 |
$5,223.20
|
|
Insert pm/icd lead dual
|
$2,880.57 |
$2,880.57 |
$2,880.57 |
$7,115.20
|
|
Insert swan-ganz cath
|
$282.48 |
$282.48 |
$282.48 |
$2,210.50
|
|
Insitu hybridization auto
|
$80.85 |
$80.85 |
$80.85 |
$377.37
|
|
Insitu hybridization (fish)
|
$215.49 |
$215.49 |
$215.49 |
$481.60
|
|
Insitu hybridization manual
|
$108.90 |
$108.90 |
$108.90 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$107.91 |
$107.91 |
$107.91 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$137.94 |
$137.94 |
$137.94 |
$331.69
|
|
Ins lv lead exist pm/icd
|
$5,282.64 |
$5,282.64 |
$5,282.64 |
$12,384.25
|
|
Ins pm gen w/exist mlt leads
|
$6,923.07 |
$6,923.07 |
$6,923.07 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$1,020.36 |
$1,020.36 |
$1,020.36 |
$5,377.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$7,085.10 |
$7,085.10 |
$7,085.10 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$3,887.07 |
$3,887.07 |
$3,887.07 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$2,566.74 |
$2,566.74 |
$2,566.74 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$3,887.07 |
$3,887.07 |
$3,887.07 |
$11,583.66
|
|
Instillation anticarcinogenic agent bladder
|
$322.41 |
$322.41 |
$322.41 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$974.82 |
$974.82 |
$974.82 |
$4,202.70
|
|
Insulin total
|
$11.88 |
$11.88 |
$11.88 |
$66.64
|
|
Intens cardiac rehab no exer
|
$87.45 |
$87.45 |
$87.45 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$87.45 |
$87.45 |
$87.45 |
$238.40
|
|
Interdiscal perq aspir dx
|
$661.98 |
$661.98 |
$661.98 |
$1,222.26
|
|
Intrinsic factor antibody
|
$22.11 |
$22.11 |
$22.11 |
$63.15
|
|
Intro cath dialysis circuit
|
$302.28 |
$302.28 |
$302.28 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$2,132.79 |
$2,132.79 |
$2,132.79 |
$8,690.50
|
|
Intro catheter aorta
|
$154.44 |
$154.44 |
$154.44 |
$1,654.05
|
|
Intro cath svc/ivc
|
$154.44 |
$154.44 |
$154.44 |
$1,323.27
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$1,039.17 |
$1,039.17 |
$1,039.17 |
$3,409.29
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,039.17 |
$1,039.17 |
$1,039.17 |
$1,747.80
|
|
Intubation endotracheal emergency procedure
|
$119.79 |
$119.79 |
$119.79 |
$598.80
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$325.94 |
$325.94 |
$325.94 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1,071.91 |
$1,071.91 |
$1,071.91 |
$288.11
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$40,733.21 |
$40,733.21 |
$40,733.21 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$372.59 |
$372.59 |
$372.59 |
$174.47
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,433.52 |
$3,433.52 |
$3,433.52 |
$5,517.12
|
|
Iron
|
$55.77 |
$55.77 |
$55.77 |
$72.29
|
|
Iron binding capacity
|
$29.04 |
$29.04 |
$29.04 |
$63.60
|
|
Iron dextran 50 mg/ml injection solution
|
$71.46 |
$71.46 |
$71.46 |
$81.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$248.93 |
$248.93 |
$248.93 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$8.25 |
$8.25 |
$8.25 |
$114.40
|
|
Irrigation implantable venous access device for drug delivery systems
|
$29.70 |
$29.70 |
$29.70 |
$144.62
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$4,891.72 |
$4,891.72 |
$4,891.72 |
$8,273.35
|
|
Ivc venogram s&i
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$36.30 |
$36.30 |
$36.30 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$12.21 |
$12.21 |
$12.21 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$23.76 |
$23.76 |
$23.76 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$107.58 |
$107.58 |
$107.58 |
$437.45
|
|
IV inj ra drug dx study
|
$202.29 |
$202.29 |
$202.29 |
$552.60
|
|
Ivp w/wo kub w/wo tomography
|
$209.55 |
$209.55 |
$209.55 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$6,796.96 |
$6,796.96 |
$6,796.96 |
$10,695.32
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$5.53 |
$5.53 |
$5.53 |
$23.77
|
|
Kidney imag w/bld flow multi
|
$274.56 |
$274.56 |
$274.56 |
$1,557.41
|
|
Kidney img w/bldflw sgl without rx
|
$329.01 |
$329.01 |
$329.01 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$95.70 |
$95.70 |
$95.70 |
$673.36
|
|
Kit gene analys d816 variant
|
$260.37 |
$260.37 |
$260.37 |
$366.03
|
|
Kit lead specify 5-6-5
|
$5,009.40 |
$5,009.40 |
$5,009.40 |
$16,965.41
|