|
Inj ceftolozane tazobactam
|
$17.06 |
$17.06 |
$17.06 |
|
|
Inj crotalidae im f(ab')2 eq
|
$2,836.95 |
$2,836.95 |
$2,836.95 |
|
|
Injection arthrography hip without anesthesia (both sides)
|
$395.33 |
$395.33 |
$395.33 |
|
|
Injection, cangrelor
|
$41.03 |
$41.03 |
$41.03 |
|
|
Injection, daratumumab 10 mg
|
$158.04 |
$158.04 |
$158.04 |
|
|
Injection during cath supravalvular aortography
|
$201.12 |
$201.12 |
$201.12 |
|
|
Injection epidural blood patch or clot
|
$1,008.83 |
$1,079.42 |
$1,079.45 |
|
|
Injection for arthrography wrist (both sides)
|
$395.57 |
$395.57 |
$395.57 |
|
|
Injection for bladder x-ray
|
$327.38 |
$327.38 |
$327.38 |
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$395.57 |
$395.57 |
$395.57 |
|
|
Injection, fulvestrant
|
$208.37 |
$208.37 |
$208.37 |
|
|
Injection glatiramer acetate
|
$387.62 |
$387.62 |
$387.62 |
|
|
Injection, inclisiran, 1 mg
|
$25.83 |
$25.83 |
$25.83 |
|
|
Injection into hemorrhoid(s)
|
$713.27 |
$713.27 |
$713.27 |
|
|
Injection,onabotulinumtoxina
|
$13.88 |
$13.88 |
$13.88 |
|
|
Injection radioactive tracer sentinel node (both sides)
|
$347.75 |
$347.75 |
$347.75 |
|
|
Injection, renflexis
|
$161.93 |
$161.93 |
$161.93 |
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$725.12 |
$761.37 |
$775.85 |
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,258.05 |
$1,258.05 |
$1,258.05 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$758.24 |
$758.24 |
$758.24 |
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,572.59 |
$1,572.59 |
$1,572.59 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$758.24 |
$758.24 |
$758.24 |
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,572.59 |
$1,572.59 |
$1,572.59 |
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,191.69 |
$1,191.69 |
$1,191.69 |
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$984.14 |
$984.14 |
$1,002.87 |
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$422.87 |
$422.87 |
$422.87 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$55.98 |
$55.98 |
$55.98 |
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$55.98 |
$55.98 |
$56.00 |
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$127.74 |
$127.74 |
$127.74 |
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$55.98 |
$56.00 |
$90.32 |
|
|
Inj epidural sgl cerv-thor without img
|
$937.22 |
$937.22 |
$937.22 |
|
|
Inj epidural sgl lumb-sacral without img
|
$937.22 |
$937.22 |
$937.22 |
|
|
Inj fluphenazine hcl 1.25 mg
|
$20.63 |
$20.63 |
$20.63 |
|
|
Inj for ext venography
|
$1,330.34 |
$1,330.34 |
$1,330.34 |
|
|
Inj for mammo ductogram
|
$327.03 |
$327.03 |
$327.03 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$410.82 |
$410.82 |
$410.82 |
|
|
Inj hrt cath w/s&i sel right vent
|
$201.12 |
$201.12 |
$201.12 |
|
|
Inj levocarnitine per 1 gm
|
$81.56 |
$81.56 |
$81.56 |
|
|
Inj mepivacaine hcl/10 ml
|
$11.66 |
$11.66 |
$11.66 |
|
|
Inj. mycophenolate mofetil
|
$3.12 |
$3.12 |
$3.12 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,246.05 |
$1,246.05 |
$1,333.28 |
|
|
Inj proc ankle arthr
|
$395.57 |
$395.57 |
$395.57 |
|
|
Inj proc elbow arthro
|
$395.57 |
$395.57 |
$395.57 |
|
|
Inj proc lumbr disk ea lvl
|
$1,356.77 |
$1,356.77 |
$1,356.77 |
|
|
Inj progesterone per 50 mg
|
$7.31 |
$7.31 |
$7.31 |
|
|
Inj testosterone cypionate
|
$0.24 |
$0.24 |
$0.24 |
|
|
Inj w/fluor eval cv device
|
$1,228.01 |
$1,228.01 |
$1,228.01 |
|
|
Ins cath ren art 1st bi
|
$9,064.91 |
$9,064.91 |
$9,064.91 |
|
|
Ins cath ren art 1st uni
|
$5,641.92 |
$5,641.92 |
$5,641.92 |
|
|
Ins cath ren art 2nd+ bi
|
$11,134.17 |
$11,134.17 |
$11,134.17 |
|
|
Ins cath ren art 2nd+ uni
|
$6,583.25 |
$6,583.25 |
$6,583.25 |
|
|
Ins cerv dilator (sep proc)
|
$207.93 |
$207.93 |
$207.93 |
|
|
Insert cath pleura with image
|
$1,808.99 |
$1,808.99 |
$1,808.99 |
|
|
Insert cath pleura without image
|
$1,364.58 |
$1,364.58 |
$1,364.58 |
|
|
Insert hepatic shunt (tips)
|
$10,352.70 |
$10,352.70 |
$10,352.70 |
|
|
Insertion catheter bladder non indwelling
|
$127.59 |
$131.54 |
$131.54 |
|
|
Insertion catheter bladder temporary simple
|
$131.54 |
$131.54 |
$131.54 |
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,792.47 |
$1,792.47 |
$1,792.47 |
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,184.52 |
$3,184.52 |
$3,184.52 |
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$5,914.86 |
$5,914.86 |
$5,914.86 |
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,274.12 |
$1,274.12 |
$2,419.55 |
|
|
Insertion of catheter vein
|
$1,002.95 |
$1,002.95 |
$1,002.95 |
|
|
Insertion of catheter vein
|
$736.16 |
$736.16 |
$736.16 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,107.53 |
$5,107.53 |
$5,107.53 |
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$4,659.54 |
$4,659.54 |
$4,659.54 |
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,557.30 |
$7,557.30 |
$7,557.30 |
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,417.76 |
$1,417.76 |
$1,417.76 |
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,714.17 |
$1,714.17 |
$1,714.17 |
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$14,799.87 |
$14,799.87 |
$14,799.87 |
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,069.53 |
$4,069.53 |
$4,069.53 |
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$4,069.52 |
$4,069.52 |
$4,069.52 |
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,523.34 |
$3,523.34 |
$3,523.34 |
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,790.03 |
$1,790.03 |
$1,790.03 |
|
|
Insert pm/icd lead dual
|
$4,069.52 |
$4,069.52 |
$4,069.52 |
|
|
Insert/repl sq defib w/eltrd
|
$14,799.87 |
$14,799.87 |
$14,799.87 |
|
|
Insert sq defib electrode
|
$4,069.53 |
$4,069.53 |
$4,069.53 |
|
|
Insert swan-ganz cath
|
$1,880.60 |
$1,880.60 |
$1,880.60 |
|
|
Insert vad art access left hrt arterial access
|
$557.21 |
$557.21 |
$557.21 |
|
|
Ins icd gen exist mlt leads
|
$14,799.87 |
$14,799.87 |
$14,799.87 |
|
|
Ins icd gen exist sgl lead
|
$10,568.81 |
$10,568.81 |
$10,568.81 |
|
|
In situ hybridization per specimen each additional single probe stain
|
$251.55 |
$251.55 |
$264.15 |
|
|
In situ hybridization per specimen initial single probe stain
|
$251.55 |
$251.55 |
$264.15 |
|
|
Insj perq vad r hrt venous
|
$557.21 |
$557.21 |
$557.21 |
|
|
Ins lv lead exist pm/icd
|
$7,557.30 |
$7,557.30 |
$7,557.30 |
|
|
Ins mark abd/pel for right perq
|
$1,342.05 |
$1,342.05 |
$1,342.05 |
|
|
Ins picad w subq port 5yr>
|
$3,160.46 |
$3,160.46 |
$3,160.46 |
|
|
Ins pm gen exist dual lead
|
$10,568.81 |
$10,568.81 |
$10,568.81 |
|
|
Ins pm gen w/exist mlt leads
|
$8,405.85 |
$8,405.85 |
$8,405.85 |
|
|
Ins pq tunnld ip cath w/img
|
$3,024.83 |
$3,024.83 |
$3,024.83 |
|
|
Ins/rpl ldless pm right vent w img & eval
|
$7,657.76 |
$7,657.76 |
$7,657.76 |
|
|
Ins/rpl pm gen exist dual lead
|
$4,659.54 |
$4,659.54 |
$4,659.54 |
|
|
Ins/rpl pm gen exist sgl lead
|
$4,069.52 |
$4,069.52 |
$4,069.52 |
|
|
Ins/rpl pm w/tv ld atrl
|
$4,659.54 |
$4,659.54 |
$4,659.54 |
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$13,701.56 |
$13,701.56 |
$13,701.56 |
|
|
Instillation anticarcinogenic agent bladder
|
$491.82 |
$491.82 |
$491.82 |
|
|
Ins tun cv cath wo subq prt/pm
|
$1,842.26 |
$1,842.26 |
$1,842.26 |
|
|
Insulin total
|
$72.20 |
$72.20 |
$72.20 |
|
|
Integra meshed bil wound mat
|
$155.94 |
$155.94 |
$266.48 |
|
|
Interdiscal perq aspir dx
|
$775.85 |
$775.85 |
$1,658.43 |
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$124.05 |
$124.05 |
$124.05 |
|