|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,010.37 |
$1,010.37 |
$1,165.32 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$390.00 |
$390.00 |
$390.00 |
$504.00
|
|
Injection, belinostat, 10mg
|
$3,631.78 |
$3,631.78 |
$3,631.78 |
$4,446.10
|
|
Injection, cangrelor
|
$490.50 |
$490.50 |
$1,734.77 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$410.53 |
$410.53 |
$516.78 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$5,324.34 |
$5,324.34 |
$5,324.34 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$478.75 |
$478.75 |
$478.75 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$906.21 |
$906.21 |
$2,094.67 |
$1,192.80
|
|
Injection eye drug
|
$589.00 |
$589.00 |
$589.00 |
$648.96
|
|
Injection for arthrography wrist (both sides)
|
$307.79 |
$307.79 |
$307.79 |
$437.60
|
|
Injection for bladder x-ray
|
$420.46 |
$420.46 |
$420.46 |
$460.00
|
|
Injection for hip x-ray
|
$1,210.53 |
$1,210.53 |
$1,210.53 |
$750.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$313.22 |
$313.22 |
$313.22 |
$502.04
|
|
Injection for ureter x-ray
|
$143.35 |
$143.35 |
$143.35 |
$427.70
|
|
Injection for ureter x-ray
|
$99.70 |
$99.70 |
$99.70 |
$527.70
|
|
Injection, fulvestrant
|
$3,520.29 |
$3,520.29 |
$3,520.29 |
$1,719.16
|
|
Injection, glucarpidase
|
$74,113.20 |
$74,113.20 |
$74,113.20 |
$74,113.20
|
|
Injection, inclisiran, 1 mg
|
$7.29 |
$7.29 |
$7.29 |
$6,679.35
|
|
Injection into brain canal
|
$382.23 |
$382.23 |
$933.60 |
$844.50
|
|
Injection into hemorrhoid(s)
|
$1,133.20 |
$1,133.20 |
$1,133.20 |
$1,433.00
|
|
Injection, isavuconazonium
|
$0.81 |
$0.81 |
$987.58 |
$787.67
|
|
Injection jaw joint x-ray
|
$235.74 |
$235.74 |
$235.74 |
$312.20
|
|
Injection jugular
|
$1,766.28 |
$1,766.28 |
$1,766.28 |
$790.00
|
|
Injection of sinus tract
|
$1,119.34 |
$1,119.34 |
$1,119.34 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$15.30 |
$15.30 |
$1,162.80 |
$2,277.65
|
|
Injection, peramivir
|
$857.98 |
$857.98 |
$857.98 |
$744.75
|
|
Injection px peyronie ds
|
$409.34 |
$409.34 |
$409.34 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,481.87 |
$1,481.87 |
$1,481.87 |
$685.44
|
|
Injection, renflexis
|
$1,356.10 |
$1,356.10 |
$1,356.10 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,441.04 |
$1,441.04 |
$1,441.04 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$885.42 |
$885.42 |
$2,407.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,017.28 |
$1,017.28 |
$1,365.30 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,605.87 |
$1,605.87 |
$2,284.54 |
$2,071.80
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$659.12 |
$659.12 |
$659.12 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,027.53 |
$1,027.53 |
$1,626.73 |
$1,857.60
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$856.48 |
$856.48 |
$856.48 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,398.87 |
$1,398.87 |
$1,778.98 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$707.04 |
$707.04 |
$1,140.93 |
$1,826.80
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$777.78 |
$777.78 |
$2,070.82 |
$1,685.00
|
|
Injection, siltuximab
|
$8,477.45 |
$8,477.45 |
$8,477.45 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$268.65 |
$268.65 |
$398.06 |
$478.20
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$213.30 |
$213.30 |
$684.07 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$102.78 |
$102.78 |
$703.22 |
$638.95
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$79.29 |
$79.29 |
$211.78 |
$145.60
|
|
Injection treatment of eye
|
$2,698.27 |
$2,698.27 |
$2,698.27 |
$2,698.92
|
|
Injection treatment of eye
|
$2,370.28 |
$2,370.28 |
$2,370.28 |
$2,685.92
|
|
Injection treatment of nerve
|
$3,016.15 |
$3,016.15 |
$3,016.15 |
$3,219.20
|
|
Injection treatment of nerve
|
$4,446.30 |
$4,446.30 |
$4,446.30 |
$4,446.30
|
|
Injection treatment of nerve
|
$2,380.77 |
$2,380.77 |
$2,380.77 |
$2,054.00
|
|
Injection treatment of nose
|
$859.59 |
$859.59 |
$859.59 |
$859.59
|
|
Inject sacroiliac joint
|
$1,029.04 |
$1,029.04 |
$1,288.44 |
$1,029.04
|
|
Inject/treat eye socket
|
$398.06 |
$398.06 |
$398.06 |
$381.13
|
|
Inject/treat eye socket
|
$631.90 |
$631.90 |
$631.90 |
$750.70
|
|
Inject/treat eye socket
|
$901.85 |
$901.85 |
$901.85 |
$670.02
|
|
Inj epidural sgl cerv-thor without img
|
$296.46 |
$296.46 |
$1,358.86 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$1,616.30 |
$1,616.30 |
$1,616.30 |
$1,450.84
|
|
Inj., eravacycline, 1 mg
|
$0.99 |
$0.99 |
$300.00 |
$206.64
|
|
Inj., evomela, 1 mg
|
$3,630.00 |
$3,630.00 |
$3,630.00 |
$17.37
|
|
Inj for ext venography
|
$983.75 |
$983.75 |
$983.75 |
$631.80
|
|
Inj for mammo ductogram
|
$219.68 |
$219.68 |
$219.68 |
$397.80
|
|
Inj, gadopiclenol, 1 ml
|
$904.21 |
$904.21 |
$904.21 |
$37.63
|
|
Inj givosiran 0.5 mg
|
$76,708.80 |
$76,708.80 |
$76,708.80 |
$76,708.80
|
|
Inj heparin, pfizer, 1000u
|
$36.60 |
$36.60 |
$36.60 |
$25.30
|
|
Inj herzuma 10 mg
|
$2,554.50 |
$2,554.50 |
$2,554.50 |
$7,775.46
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,613.24 |
$2,613.24 |
$2,613.24 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$148.51 |
$148.51 |
$148.51 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$145.45 |
$145.45 |
$145.45 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$110.75 |
$110.75 |
$110.75 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$354.52 |
$354.52 |
$354.52 |
$982.40
|
|
Inj hydroxocobalamin IV 25mg
|
$1,478.38 |
$1,478.38 |
$1,478.38 |
$2,452.32
|
|
Inj hydroxyprogst capoat nos
|
$1,228.59 |
$1,228.59 |
$1,228.59 |
$1,228.59
|
|
Inj, immphentiv, 20 mcg
|
$38.40 |
$38.40 |
$38.40 |
$21.00
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$439.83 |
$439.83 |
$1,565.46 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$255.02 |
$255.02 |
$255.02 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$251.02 |
$251.02 |
$251.02 |
$234.00
|
|
Inj, invega hafyera/trinza
|
$13.14 |
$13.14 |
$13.14 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$107.46 |
$107.46 |
$107.46 |
$6,967.29
|
|
Inj, kovaltry, 1 i.u
|
$24.72 |
$24.72 |
$24.72 |
$5.07
|
|
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 |
$45.60
|
|
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
|
$5.58 |
$5.58 |
$35.21 |
$34.20
|
|
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 multihance multipack
|
$70.11 |
$70.11 |
$70.11 |
$4.08
|
|
Inj. mycophenolate mofetil
|
$107.82 |
$107.82 |
$291.54 |
$252.66
|
|
Inj naloxone hydrochloride
|
$40.39 |
$40.39 |
$46.17 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$283.23 |
$283.23 |
$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 |
$2,696.40
|
|
Inj octafluoropropane mic,ml
|
$128.79 |
$128.79 |
$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
|
