|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,158.20 |
$2,158.20 |
$2,158.20 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$16,286.82 |
$16,286.82 |
$16,286.82 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$378.00 |
$378.00 |
$378.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$378.00 |
$378.00 |
$378.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$208.20 |
$208.20 |
$208.20 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$163.20 |
$163.20 |
$163.20 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$294.60 |
$294.60 |
$294.60 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$228.60 |
$228.60 |
$228.60 |
$135.60
|
|
Inj epidural sgl lumb-sacral without img
|
$1,591.20 |
$1,591.20 |
$1,591.20 |
$1,415.50
|
|
Inj for ext venography
|
$893.40 |
$893.40 |
$893.40 |
$649.95
|
|
Inj gemcitabine hcl (accord)
|
$397.51 |
$397.51 |
$397.51 |
$130.65
|
|
Inj. herceptin hylecta, 10mg
|
$19,355.50 |
$19,355.50 |
$19,355.50 |
$7,690.59
|
|
Inj herzuma 10 mg
|
$12,643.97 |
$12,643.97 |
$12,643.97 |
$7,775.46
|
|
Inj, immphentiv, 20 mcg
|
$21.00 |
$21.00 |
$21.00 |
$18.44
|
|
Inj ivig privigen 500 mg
|
$17,842.98 |
$17,842.98 |
$17,842.98 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$278.74 |
$278.74 |
$278.74 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$1,725.97 |
$1,725.97 |
$1,725.97 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$168.50 |
$168.50 |
$168.50 |
$47.52
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,477.80 |
$1,477.80 |
$1,477.80 |
$784.00
|
|
Inj mepivacaine hcl/10 ml
|
$21.00 |
$21.00 |
$21.00 |
$33.86
|
|
Inj meropenem (wg crit care)
|
$235.90 |
$235.90 |
$235.90 |
$77.97
|
|
Inj, moxifloxacin 100 mg
|
$315.48 |
$315.48 |
$315.48 |
$107.25
|
|
Inj moxifloxacin (fres kabi)
|
$329.82 |
$329.82 |
$329.82 |
$95.62
|
|
Inj multihance
|
$196.31 |
$196.31 |
$196.31 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$774.20 |
$774.20 |
$774.20 |
$252.66
|
|
Inj, nithiodote, 3mg / 125mg
|
$2,366.10 |
$2,366.10 |
$2,366.10 |
$462.04
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$3,448.80 |
$3,448.80 |
$3,448.80 |
$2,609.38
|
|
Inj ogivri 10 mg
|
$10,867.71 |
$10,867.71 |
$10,867.71 |
$4,492.28
|
|
Inj proc lumbr disk ea lvl
|
$370.20 |
$370.20 |
$370.20 |
$1,106.93
|
|
Inj progesterone per 50 mg
|
$21.00 |
$21.00 |
$21.00 |
$15.00
|
|
Inj prohance multipack
|
$725.90 |
$725.90 |
$725.90 |
$9.59
|
|
Inj, releuko 1 mcg
|
$1,182.96 |
$1,182.96 |
$1,182.96 |
$473.25
|
|
Inj retro urethrocysto
|
$574.20 |
$574.20 |
$574.20 |
$443.50
|
|
Inj sulf hexa lipid microsph
|
$1,241.89 |
$1,241.89 |
$1,241.89 |
$256.14
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,477.80 |
$1,477.80 |
$1,477.80 |
$1,152.97
|
|
Inj thrc fascial pln blk uni w/wo image
|
$739.80 |
$739.80 |
$739.80 |
$837.50
|
|
Inj. tigecycline (accord)
|
$171.77 |
$171.77 |
$171.77 |
$188.03
|
|
Inj, tyenne, 1 mg
|
$9,106.56 |
$9,106.56 |
$9,106.56 |
$3,525.12
|
|
Inj vancomycin (xellia) 10mg
|
$200.76 |
$200.76 |
$200.76 |
$76.59
|
|
Inj vocal cord bulking agent
|
$3,404.52 |
$3,404.52 |
$3,404.52 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$685.20 |
$685.20 |
$685.20 |
$503.92
|
|
Ins cath ren art 1st bi
|
$7,935.60 |
$7,935.60 |
$7,935.60 |
$5,753.10
|
|
Ins cath ren art 2nd+ uni
|
$1,674.60 |
$1,674.60 |
$1,674.60 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$679.20 |
$679.20 |
$679.20 |
$480.28
|
|
Insert and remove bone pin
|
$4,135.80 |
$4,135.80 |
$4,135.80 |
$4,410.60
|
|
Insert cath pleura with image
|
$2,205.60 |
$2,205.60 |
$2,205.60 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,419.80 |
$2,419.80 |
$2,419.80 |
$2,073.18
|
|
Insert hepatic shunt (tips)
|
$13,275.00 |
$13,275.00 |
$13,275.00 |
$7,571.20
|
|
Insert intrauterine device iud
|
$9,993.23 |
$9,993.23 |
$9,993.23 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$165.60 |
$165.60 |
$165.60 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$277.20 |
$277.20 |
$277.20 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,999.20 |
$4,999.20 |
$4,999.20 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,883.00 |
$2,883.00 |
$2,883.00 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,590.80 |
$8,590.80 |
$8,590.80 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,127.00 |
$2,127.00 |
$2,127.00 |
$2,505.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$21,831.60 |
$21,831.60 |
$21,831.60 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$13,957.80 |
$13,957.80 |
$13,957.80 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$12,770.40 |
$12,770.40 |
$12,770.40 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,984.80 |
$1,984.80 |
$1,984.80 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$6,441.00 |
$6,441.00 |
$6,441.00 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$38,239.20 |
$38,239.20 |
$38,239.20 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$6,328.20 |
$6,328.20 |
$6,328.20 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$7,342.20 |
$7,342.20 |
$7,342.20 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$12,470.40 |
$12,470.40 |
$12,470.40 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$12,760.41 |
$12,760.41 |
$12,760.41 |
$5,223.20
|
|
Insert multi-comp penis pros
|
$85,701.14 |
$85,701.14 |
$85,701.14 |
$21,998.10
|
|
Insert swan-ganz cath
|
$178.80 |
$178.80 |
$178.80 |
$2,210.50
|
|
Insert vad art access left hrt arterial access
|
$5,178.00 |
$5,178.00 |
$5,178.00 |
$4,270.75
|
|
Ins icd gen exist mlt leads
|
$73,398.00 |
$73,398.00 |
$73,398.00 |
$31,286.77
|
|
Insitu hybridization auto
|
$239.40 |
$239.40 |
$239.40 |
$377.37
|
|
Insitu hybridization (fish)
|
$318.60 |
$318.60 |
$318.60 |
$481.60
|
|
Insitu hybridization manual
|
$304.20 |
$304.20 |
$304.20 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$351.60 |
$351.60 |
$351.60 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$318.60 |
$318.60 |
$318.60 |
$331.69
|
|
Insj biomechanical device 22853
|
$96,007.62 |
$96,007.62 |
$96,007.62 |
$622.40
|
|
Insole orthotic freedom sz6 6816
|
$308.03 |
$308.03 |
$308.03 |
$84.00
|
|
Ins pq tunnld ip cath w/img
|
$7,374.60 |
$7,374.60 |
$7,374.60 |
$5,377.00
|
|
Ins/rplc spi npg/rcvr pocket
|
$126,327.19 |
$126,327.19 |
$126,327.19 |
$24,061.80
|
|
Ins/rpl ldless pm right vent w img & eval
|
$3,829.20 |
$3,829.20 |
$3,829.20 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$19,431.60 |
$19,431.60 |
$19,431.60 |
$11,005.50
|
|
Ins/rpl prph sac/gstr npg/r
|
$85,291.10 |
$85,291.10 |
$85,291.10 |
$21,857.50
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$6,526.20 |
$6,526.20 |
$6,526.20 |
$25,694.00
|
|
Instillation anticarcinogenic agent bladder
|
$17,708.54 |
$17,708.54 |
$17,708.54 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$4,099.80 |
$4,099.80 |
$4,099.80 |
$4,202.70
|
|
Insulin total
|
$87.00 |
$87.00 |
$87.00 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$21,399.24 |
$21,399.24 |
$21,399.24 |
$8,629.72
|
|
Integra meshed bil wound mat
|
$70,189.90 |
$70,189.90 |
$70,189.90 |
$9,924.16
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$16,142.52 |
$16,142.52 |
$16,142.52 |
$3,803.11
|
|
Interdental fixation
|
$1,929.00 |
$1,929.00 |
$1,929.00 |
$2,133.48
|
|
Interdiscal perq aspir dx
|
$1,330.80 |
$1,330.80 |
$1,330.80 |
$1,222.26
|
|
Interferon beta-1b / .25 mg
|
$3,304.10 |
$3,304.10 |
$3,304.10 |
$1,662.71
|
|
Interfyl, 1 mg
|
$9,264.00 |
$9,264.00 |
$9,264.00 |
$4,656.80
|
|
Int hrhc lig 2+hroid without img
|
$13,340.93 |
$13,340.93 |
$13,340.93 |
$3,245.23
|
|
Intracard echo interv w/s&i
|
$4,497.60 |
$4,497.60 |
$4,497.60 |
$3,461.04
|
|
Intrapul surf admin endo tube
|
$96.00 |
$96.00 |
$96.00 |
$220.80
|
|
Intrinsic factor antibody
|
$118.80 |
$118.80 |
$118.80 |
$63.15
|
|
Intro cath dialysis circuit
|
$1,671.60 |
$1,671.60 |
$1,671.60 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$13,641.60 |
$13,641.60 |
$13,641.60 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$18,300.00 |
$18,300.00 |
$18,300.00 |
$16,262.40
|
|
Intro catheter aorta
|
$2,761.20 |
$2,761.20 |
$2,761.20 |
$1,654.05
|
