|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$192.15 |
$192.15 |
$192.15 |
$166.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$192.15 |
$192.15 |
$192.15 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$192.15 |
$192.15 |
$192.15 |
$257.24
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$146.85 |
$146.85 |
$146.85 |
$136.00
|
|
Injection treatment of nerve
|
$2,346.60 |
$2,346.60 |
$2,346.60 |
$3,219.20
|
|
Inject sacroiliac joint
|
$2,255.55 |
$2,255.55 |
$2,255.55 |
$990.00
|
|
Inj epidural sgl cerv-thor without img
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$1,311.74
|
|
Inj epidural sgl lumb-sacral without img
|
$1,001.25 |
$1,001.25 |
$1,001.25 |
$1,415.50
|
|
Inj., eravacycline, 1 mg
|
$237.60 |
$237.60 |
$237.60 |
$206.64
|
|
Inj, etelcalcetide, 0.1 mg
|
$212.36 |
$212.36 |
$212.36 |
$343.35
|
|
Inj for ext venography
|
$518.10 |
$518.10 |
$518.10 |
$654.00
|
|
Inj herzuma 10 mg
|
$7,775.46 |
$7,775.46 |
$7,775.46 |
$7,775.46
|
|
Inj hrt cath w/s&i sel right vent
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$947.65
|
|
Inj human fibrinogen con nos
|
$3.95 |
$3.95 |
$3.95 |
$3.95
|
|
Inj hydroxyprogst capoat nos
|
$1,589.94 |
$1,589.94 |
$1,589.94 |
$1,228.59
|
|
Inj imip 4 cilas 4 releb 2mg
|
$662.97 |
$662.97 |
$662.97 |
$662.97
|
|
Inj ivig privigen 500 mg
|
$6,967.29 |
$6,967.29 |
$6,967.29 |
$6,967.29
|
|
Inj levoleucovorin nos 0.5mg
|
$117.00 |
$117.00 |
$117.00 |
$103.60
|
|
Inj, levothyroxine, freskabi
|
$59.87 |
$59.87 |
$59.87 |
$329.93
|
|
Inj. meloxicam 1 mg
|
$203.04 |
$203.04 |
$203.04 |
$167.04
|
|
Inj melpha hydroch nos 50 mg
|
$4,962.63 |
$4,962.63 |
$4,962.63 |
$1,791.90
|
|
Inj mepivacaine hcl/10 ml
|
$33.86 |
$33.86 |
$33.86 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$466.56 |
$466.56 |
$466.56 |
$536.27
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$8,922.99 |
$8,922.99 |
$8,922.99 |
$8,304.04
|
|
Inj, moxifloxacin 100 mg
|
$107.25 |
$107.25 |
$107.25 |
$107.25
|
|
Inj. mycophenolate mofetil
|
$466.47 |
$466.47 |
$466.47 |
$252.66
|
|
Inj naloxone hydrochloride
|
$83.16 |
$83.16 |
$83.16 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,657.05 |
$1,657.05 |
$1,657.05 |
$1,413.35
|
|
Inj octafluoropropane mic,ml
|
$421.20 |
$421.20 |
$421.20 |
$211.40
|
|
Inj ogivri 10 mg
|
$5,197.61 |
$5,197.61 |
$5,197.61 |
$4,492.28
|
|
Inj., omadacycline, 1 mg
|
$865.34 |
$865.34 |
$865.34 |
$865.34
|
|
Inj ontruzant 10 mg
|
$7,343.90 |
$7,343.90 |
$7,343.90 |
$6,706.27
|
|
Inj proc ankle arthr
|
$469.05 |
$469.05 |
$469.05 |
$405.60
|
|
Inj proc elbow arthro
|
$497.55 |
$497.55 |
$497.55 |
$438.00
|
|
Inj proc lumbr disk ea lvl
|
$401.10 |
$401.10 |
$401.10 |
$1,136.00
|
|
Inj proc myelogram lumbar
|
$651.90 |
$651.90 |
$651.90 |
$859.98
|
|
Inj progesterone per 50 mg
|
$6.00 |
$6.00 |
$6.00 |
$14.93
|
|
Inj retro urethrocysto
|
$384.60 |
$384.60 |
$384.60 |
$450.00
|
|
Inj, rimabotulinumtoxinb
|
$672.44 |
$672.44 |
$672.44 |
$746.79
|
|
Inj, sezaby, 1 mg
|
$288.11 |
$288.11 |
$288.11 |
$235.85
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$237.15 |
$237.15 |
$237.15 |
$436.80
|
|
Inj tedizolid phosphate
|
$664.72 |
$664.72 |
$664.72 |
$664.72
|
|
Inj testostero enanthate 1mg
|
$8.29 |
$8.29 |
$8.29 |
$157.81
|
|
Inj testosterone cypionate
|
$54.70 |
$54.70 |
$54.70 |
$64.80
|
|
Inj, vancomycin hcl (xellia)
|
$70.56 |
$70.56 |
$70.56 |
$85.20
|
|
Inj w/fluor eval cv device
|
$198.60 |
$198.60 |
$198.60 |
$504.40
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$44,026.28 |
$44,026.28 |
$44,026.28 |
$44,026.28
|
|
Ins cath ren art 1st bi
|
$5,395.20 |
$5,395.20 |
$5,395.20 |
$5,820.00
|
|
Ins cath ren art 1st uni
|
$5,395.20 |
$5,395.20 |
$5,395.20 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$5,395.20 |
$5,395.20 |
$5,395.20 |
$5,475.60
|
|
Ins cath ren art 2nd+ uni
|
$5,395.20 |
$5,395.20 |
$5,395.20 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$261.15 |
$261.15 |
$261.15 |
$473.90
|
|
Insert cath pleura with image
|
$2,414.10 |
$2,414.10 |
$2,414.10 |
$2,164.52
|
|
Insert cath pleura without image
|
$2,825.70 |
$2,825.70 |
$2,825.70 |
$2,026.58
|
|
Insert hepatic shunt (tips)
|
$4,419.15 |
$4,419.15 |
$4,419.15 |
$7,606.50
|
|
Insertion catheter bladder temporary simple
|
$188.70 |
$188.70 |
$188.70 |
$234.40
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,035.45 |
$4,035.45 |
$4,035.45 |
$4,747.60
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,803.15 |
$1,803.15 |
$1,803.15 |
$2,565.36
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,028.15 |
$8,028.15 |
$8,028.15 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,899.95 |
$2,899.95 |
$2,899.95 |
$2,523.30
|
|
Insertion of catheter vein
|
$1,953.90 |
$1,953.90 |
$1,953.90 |
$1,657.32
|
|
Insertion of catheter vein
|
$1,241.85 |
$1,241.85 |
$1,241.85 |
$856.80
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$18,985.80 |
$18,985.80 |
$18,985.80 |
$12,843.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$16,493.55 |
$16,493.55 |
$16,493.55 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$33,423.45 |
$33,423.45 |
$33,423.45 |
$10,309.20
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,510.55 |
$2,510.55 |
$2,510.55 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,414.10 |
$2,414.10 |
$2,414.10 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$51,832.80 |
$51,832.80 |
$51,832.80 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$9,426.60 |
$9,426.60 |
$9,426.60 |
$7,388.80
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$9,426.60 |
$9,426.60 |
$9,426.60 |
$7,447.01
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$9,277.20 |
$9,277.20 |
$9,277.20 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,648.15 |
$3,648.15 |
$3,648.15 |
$5,236.80
|
|
Insert pessary/other device
|
$234.30 |
$234.30 |
$234.30 |
$275.80
|
|
Insert pm/icd lead dual
|
$9,134.25 |
$9,134.25 |
$9,134.25 |
$7,312.80
|
|
Insert swan-ganz cath
|
$3,286.50 |
$3,286.50 |
$3,286.50 |
$2,327.53
|
|
Insitu hybridization (fish)
|
$922.80 |
$922.80 |
$922.80 |
$481.60
|
|
Insitu hybridization manual
|
$318.00 |
$318.00 |
$318.00 |
$398.16
|
|
In situ hybridization per specimen each additional single probe stain
|
$416.40 |
$416.40 |
$416.40 |
$243.00
|
|
In situ hybridization per specimen initial single probe stain
|
$609.30 |
$609.30 |
$609.30 |
$337.20
|
|
Ins lv lead exist pm/icd
|
$33,423.45 |
$33,423.45 |
$33,423.45 |
$12,384.25
|
|
Ins picad w subq port 5yr>
|
$3,167.85 |
$3,167.85 |
$3,167.85 |
$3,985.20
|
|
Ins pm gen exist dual lead
|
$42,952.50 |
$42,952.50 |
$42,952.50 |
$24,530.99
|
|
Ins pm gen w/exist mlt leads
|
$15,107.85 |
$15,107.85 |
$15,107.85 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$5,882.10 |
$5,882.10 |
$5,882.10 |
$5,377.00
|
|
Ins/rplcm prq eltrd ra pn ea
|
$14,173.20 |
$14,173.20 |
$14,173.20 |
$1,856.40
|
|
Ins/rplcmt prq eltrd ra pn 1
|
$28,346.25 |
$28,346.25 |
$28,346.25 |
$13,802.89
|
|
Ins/rplc spi npg/rcvr pocket
|
$24,061.80 |
$24,061.80 |
$24,061.80 |
$24,061.80
|
|
Ins/rpl pm gen exist dual lead
|
$14,063.40 |
$14,063.40 |
$14,063.40 |
$11,412.00
|
|
Ins/rpl pm gen exist sgl lead
|
$13,247.55 |
$13,247.55 |
$13,247.55 |
$9,705.00
|
|
Ins/rpl pm w/tv ld atrl
|
$15,654.45 |
$15,654.45 |
$15,654.45 |
$11,969.00
|
|
Ins/rpl prph sac/gstr npg/r
|
$45,520.80 |
$45,520.80 |
$45,520.80 |
$18,129.80
|
|
Inst fibrinolysis agent ini day
|
$1,036.05 |
$1,036.05 |
$1,036.05 |
$1,036.05
|
|
Instill, bupivac and meloxic
|
$637.01 |
$637.01 |
$637.01 |
$687.60
|
|
Ins tun cv cath wo subq prt/pm
|
$3,045.90 |
$3,045.90 |
$3,045.90 |
$4,218.00
|
|
Insulin total
|
$22.14 |
$22.14 |
$22.14 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$5,124.80 |
$5,124.80 |
$5,124.80 |
$8,658.35
|
|
Integra meshed bil wound mat
|
$486.69 |
$486.69 |
$486.69 |
$9,924.00
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$4,440.00 |
$4,440.00 |
$4,440.00 |
$3,803.11
|
|
Interdiscal perq aspir dx
|
$830.10 |
$830.10 |
$830.10 |
$1,212.50
|
|
Interferon alfa-2b inj
|
$1,409.92 |
$1,409.92 |
$1,409.92 |
$1,409.92
|
