|
Inj levocarnitine per 1 gm
|
$136.62 |
$136.62 |
$136.62 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$570.13 |
$570.13 |
$570.13 |
$320.80
|
|
Inj, lidocaine w epinephrine
|
$48.60 |
$48.60 |
$48.60 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$820.87 |
$820.87 |
$820.87 |
$794.70
|
|
Inj melpha hydroch nos 50 mg
|
$1,380.00 |
$1,380.00 |
$1,380.00 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$35.21 |
$35.21 |
$35.21 |
$34.00
|
|
Inj., meropenem, vaborbactam
|
$586.20 |
$586.20 |
$586.20 |
$556.87
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$8,304.04 |
$8,304.04 |
$8,304.04 |
$8,304.04
|
|
Inj, moxifloxacin 100 mg
|
$165.60 |
$165.60 |
$165.60 |
$101.31
|
|
Inj multihance
|
$283.77 |
$283.77 |
$283.77 |
$70.54
|
|
Inj. mycophenolate mofetil
|
$291.54 |
$291.54 |
$291.54 |
$252.66
|
|
Inj naloxone hydrochloride
|
$40.39 |
$40.39 |
$40.39 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,177.23 |
$2,177.23 |
$2,177.23 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,377.49 |
$2,377.49 |
$2,377.49 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,567.69 |
$2,567.69 |
$2,567.69 |
$2,726.90
|
|
Inj octafluoropropane mic,ml
|
$379.08 |
$379.08 |
$379.08 |
$211.40
|
|
Inj ontruzant 10 mg
|
$6,706.27 |
$6,706.27 |
$6,706.27 |
$6,706.27
|
|
Inj., patisiran, 0.1 mg
|
$17,613.00 |
$17,613.00 |
$17,613.00 |
$17,613.00
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$7,082.75 |
$7,082.75 |
$7,082.75 |
$6,614.40
|
|
Inj peritoneal venous shunt
|
$69.39 |
$69.39 |
$69.39 |
$406.80
|
|
Inj proc ankle arthr
|
$232.66 |
$232.66 |
$232.66 |
$405.31
|
|
Inj proc elbow arthro
|
$331.58 |
$331.58 |
$331.58 |
$433.00
|
|
Inj proc for lymphang
|
$1,526.96 |
$1,526.96 |
$1,526.96 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$547.14 |
$547.14 |
$547.14 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$266.48 |
$266.48 |
$266.48 |
$840.00
|
|
Inj proc sialogram
|
$146.27 |
$146.27 |
$146.27 |
$369.45
|
|
Inj progesterone per 50 mg
|
$10.76 |
$10.76 |
$10.76 |
$13.76
|
|
Inj prohance multipack
|
$283.77 |
$283.77 |
$283.77 |
$10.40
|
|
Inj retro urethrocysto
|
$125.71 |
$125.71 |
$125.71 |
$447.74
|
|
Inj scleros sol mult veins
|
$517.41 |
$517.41 |
$517.41 |
$707.85
|
|
Inj scleros sol sgl vein
|
$561.88 |
$561.88 |
$561.88 |
$561.88
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$392.39 |
$392.39 |
$392.39 |
$436.80
|
|
Inj teclistamab cqyv 0.5 mg
|
$17,517.56 |
$17,517.56 |
$17,517.56 |
$17,517.56
|
|
Inj testosterone cypionate
|
$85.64 |
$85.64 |
$85.64 |
$64.96
|
|
Inj theophylline per 40 mg
|
$14.40 |
$14.40 |
$14.40 |
$31.90
|
|
Inj thrc fascial pln blk bi w/wo image
|
$2,774.06 |
$2,774.06 |
$2,774.06 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$1,677.65 |
$1,677.65 |
$1,677.65 |
$837.50
|
|
Inj, tyenne, 1 mg
|
$3,525.12 |
$3,525.12 |
$3,525.12 |
$3,525.12
|
|
Inj, vancomycin hcl (mylan)
|
$89.83 |
$89.83 |
$89.83 |
$70.84
|
|
Inj vancomycin (xellia) 10mg
|
$13.80 |
$13.80 |
$13.80 |
$76.59
|
|
Inj, vasopressin (baxter)
|
$202.50 |
$202.50 |
$202.50 |
$202.50
|
|
Inj w/fluor eval cv device
|
$624.49 |
$624.49 |
$624.49 |
$504.40
|
|
Ins cath ren art 1st bi
|
$6,815.98 |
$6,815.98 |
$6,815.98 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$4,667.63 |
$4,667.63 |
$4,667.63 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$5,663.98 |
$5,663.98 |
$5,663.98 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$5,797.66 |
$5,797.66 |
$5,797.66 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$682.65 |
$682.65 |
$682.65 |
$488.35
|
|
Insemination of oocytes
|
$457.23 |
$457.23 |
$457.23 |
$314.40
|
|
Insert and remove bone pin
|
$4,804.25 |
$4,804.25 |
$4,804.25 |
$4,433.36
|
|
Insert ant drainage device
|
$5,198.12 |
$5,198.12 |
$5,198.12 |
$5,108.80
|
|
Insert brain-fluid device 61215
|
$7,281.98 |
$7,281.98 |
$7,281.98 |
$7,181.20
|
|
Insert cannula hemo oth 36815
|
$7,514.70 |
$7,514.70 |
$7,514.70 |
$5,983.35
|
|
Insert cannula vein-to-vein hemodialysis
|
$6,267.62 |
$6,267.62 |
$6,267.62 |
$7,279.50
|
|
Insert cath pleura with image
|
$1,952.51 |
$1,952.51 |
$1,952.51 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,157.58 |
$2,157.58 |
$2,157.58 |
$2,101.52
|
|
Insert drug delivery implant
|
$239.98 |
$239.98 |
$239.98 |
$280.00
|
|
Insert eye socket implant
|
$4,834.49 |
$4,834.49 |
$4,834.49 |
$5,067.20
|
|
Insert hepatic shunt (tips)
|
$3,699.59 |
$3,699.59 |
$3,699.59 |
$7,571.20
|
|
Insert intervert bimech device 22854
|
$3,909.68 |
$3,909.68 |
$3,909.68 |
$1,103.00
|
|
Insert intrauterine device iud
|
$113.39 |
$113.39 |
$113.39 |
$330.72
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$3,594.47 |
$3,594.47 |
$3,594.47 |
$3,594.47
|
|
Insertion catheter bladder non indwelling
|
$190.37 |
$190.37 |
$190.37 |
$209.30
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,943.21 |
$4,943.21 |
$4,943.21 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,507.27 |
$1,507.27 |
$1,507.27 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$7,210.78 |
$7,210.78 |
$7,210.78 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,723.01 |
$2,723.01 |
$2,723.01 |
$2,595.45
|
|
Insertion of cannula
|
$4,767.41 |
$4,767.41 |
$4,767.41 |
$4,322.40
|
|
Insertion of catheter vein
|
$3,128.00 |
$3,128.00 |
$3,128.00 |
$1,525.80
|
|
Insertion of catheter vein
|
$658.69 |
$658.69 |
$658.69 |
$858.05
|
|
Insertion of heart electrode 33211
|
$8,358.70 |
$8,358.70 |
$8,358.70 |
$6,839.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$19,320.87 |
$19,320.87 |
$19,320.87 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$17,466.97 |
$17,466.97 |
$17,466.97 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$17,706.20 |
$17,706.20 |
$17,706.20 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,079.43 |
$2,079.43 |
$2,079.43 |
$2,109.00
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,992.46 |
$2,992.46 |
$2,992.46 |
$2,463.50
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$42,510.52 |
$42,510.52 |
$42,510.52 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$9,127.60 |
$9,127.60 |
$9,127.60 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$11,687.71 |
$11,687.71 |
$11,687.71 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$14,985.87 |
$14,985.87 |
$14,985.87 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,873.92 |
$6,873.92 |
$6,873.92 |
$5,236.80
|
|
Insertion ureth cath
|
$1,579.40 |
$1,579.40 |
$1,579.40 |
$2,365.38
|
|
Insert lens prosthesis
|
$3,333.13 |
$3,333.13 |
$3,333.13 |
$3,173.34
|
|
Insert multi-comp penis pros
|
$9,258.61 |
$9,258.61 |
$9,258.61 |
$9,495.20
|
|
Insert nasal septal button
|
$2,051.94 |
$2,051.94 |
$2,051.94 |
$1,783.50
|
|
Insert ocular implant
|
$4,169.11 |
$4,169.11 |
$4,169.11 |
$4,462.45
|
|
Insert ocular implant
|
$3,939.04 |
$3,939.04 |
$3,939.04 |
$4,462.45
|
|
Insert pessary/other device
|
$294.09 |
$294.09 |
$294.09 |
$278.90
|
|
Insert picvad cath
|
$2,353.85 |
$2,353.85 |
$2,353.85 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$7,749.97 |
$7,749.97 |
$7,749.97 |
$7,115.90
|
|
Insert prost urethral stent
|
$1,780.46 |
$1,780.46 |
$1,780.46 |
$2,467.08
|
|
Insert/repl sq defib w/eltrd
|
$59,661.21 |
$59,661.21 |
$59,661.21 |
$33,593.55
|
|
Insert self-contd prosthesis
|
$9,754.56 |
$9,754.56 |
$9,754.56 |
$22,279.50
|
|
Insert semi-rigid prosthesis
|
$10,037.15 |
$10,037.15 |
$10,037.15 |
$14,199.16
|
|
Insert spine infusion device 62360
|
$6,531.84 |
$6,531.84 |
$6,531.84 |
$17,262.84
|
|
Insert sq defib electrode
|
$12,415.17 |
$12,415.17 |
$12,415.17 |
$8,167.68
|
|
Insert swan-ganz cath
|
$3,952.26 |
$3,952.26 |
$3,952.26 |
$2,164.52
|
|
Insert tandem cuff
|
$9,445.19 |
$9,445.19 |
$9,445.19 |
$22,279.50
|
|
Insert tissue expander(s)
|
$3,703.68 |
$3,703.68 |
$3,703.68 |
$4,311.38
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$5,256.31 |
$5,256.31 |
$5,256.31 |
$5,018.25
|
|
Insert tunneled cv cath
|
$5,024.38 |
$5,024.38 |
$5,024.38 |
$4,580.61
|
