|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,776.00 |
$1,776.00 |
$1,776.00 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,797.20 |
$2,797.20 |
$2,797.20 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$186.00 |
$186.00 |
$186.00 |
$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
|
|
Inject sacroiliac joint
|
$1,345.20 |
$1,345.20 |
$1,345.20 |
$1,028.95
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$60,331.72 |
$60,331.72 |
$60,331.72 |
$32,176.93
|
|
Inj for ext venography
|
$3,177.00 |
$3,177.00 |
$3,177.00 |
$649.95
|
|
Inj gemcitabine hcl (accord)
|
$355.93 |
$355.93 |
$355.93 |
$130.65
|
|
Inj., guselkumab, 1 mg
|
$93,516.55 |
$93,516.55 |
$93,516.55 |
$29,130.83
|
|
Inj. herceptin hylecta, 10mg
|
$18,373.70 |
$18,373.70 |
$18,373.70 |
$7,690.59
|
|
Inj herzuma 10 mg
|
$12,002.62 |
$12,002.62 |
$12,002.62 |
$7,775.46
|
|
Inj, invega hafyera/trinza
|
$40,152.94 |
$40,152.94 |
$40,152.94 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$28,779.00 |
$28,779.00 |
$28,779.00 |
$6,967.29
|
|
Inj, lecanemab-irmb, 1 mg
|
$2,449.05 |
$2,449.05 |
$2,449.05 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$249.58 |
$249.58 |
$249.58 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$3,558.67 |
$3,558.67 |
$3,558.67 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$82.31 |
$82.31 |
$82.31 |
$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
|
$24.00 |
$24.00 |
$24.00 |
$33.86
|
|
Inj multihance
|
$188.74 |
$188.74 |
$188.74 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$179.52 |
$179.52 |
$179.52 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$10,767.25 |
$10,767.25 |
$10,767.25 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$2,118.60 |
$2,118.60 |
$2,118.60 |
$462.04
|
|
Inj octafluoropropane mic,ml
|
$192.35 |
$192.35 |
$192.35 |
$211.40
|
|
Inj ogivri 10 mg
|
$10,316.45 |
$10,316.45 |
$10,316.45 |
$4,492.28
|
|
Inj proc elbow arthro
|
$393.00 |
$393.00 |
$393.00 |
$419.60
|
|
Inj proc for lymphang
|
$34,757.88 |
$34,757.88 |
$34,757.88 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$370.20 |
$370.20 |
$370.20 |
$1,106.93
|
|
Inj, releuko 1 mcg
|
$954.00 |
$954.00 |
$954.00 |
$473.25
|
|
Inj retro urethrocysto
|
$574.20 |
$574.20 |
$574.20 |
$443.50
|
|
Inj scleros sol mult veins
|
$777.60 |
$777.60 |
$777.60 |
$675.00
|
|
Inj, spesolimab-sbzo, 1 mg
|
$167,419.67 |
$167,419.67 |
$167,419.67 |
$90,007.62
|
|
Inj sulf hexa lipid microsph
|
$1,168.06 |
$1,168.06 |
$1,168.06 |
$256.14
|
|
Inj testosterone cypionate
|
$38.18 |
$38.18 |
$38.18 |
$64.80
|
|
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, tyenne, 1 mg
|
$7,344.00 |
$7,344.00 |
$7,344.00 |
$3,525.12
|
|
Inj ustekinumab-stba, 1 mg
|
$7,830.81 |
$7,830.81 |
$7,830.81 |
$16.36
|
|
Inj vancomycin (xellia) 10mg
|
$179.76 |
$179.76 |
$179.76 |
$76.59
|
|
Inj vasopressin (am reg) 1 u
|
$24.00 |
$24.00 |
$24.00 |
$41.79
|
|
Inj, vasopressin (baxter)
|
$481.50 |
$481.50 |
$481.50 |
$228.24
|
|
Inj vocal cord bulking agent
|
$3,173.00 |
$3,173.00 |
$3,173.00 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$713.40 |
$713.40 |
$713.40 |
$503.92
|
|
Ins cath ren art 1st bi
|
$9,277.20 |
$9,277.20 |
$9,277.20 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$7,807.80 |
$7,807.80 |
$7,807.80 |
$4,660.00
|
|
Ins cath ren art 2nd+ uni
|
$1,674.60 |
$1,674.60 |
$1,674.60 |
$5,395.20
|
|
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)
|
$47,145.60 |
$47,145.60 |
$47,145.60 |
$7,571.20
|
|
Insert intrauterine device iud
|
$1,161.60 |
$1,161.60 |
$1,161.60 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$398.40 |
$398.40 |
$398.40 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$277.20 |
$277.20 |
$277.20 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$6,945.60 |
$6,945.60 |
$6,945.60 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,883.00 |
$2,883.00 |
$2,883.00 |
$2,529.45
|
|
Insertion intra-aortic circulation dev 33970
|
$1,750.20 |
$1,750.20 |
$1,750.20 |
$1,752.40
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$10,044.60 |
$10,044.60 |
$10,044.60 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,553.60 |
$2,553.60 |
$2,553.60 |
$2,505.60
|
|
Insertion of catheter vein
|
$603.00 |
$603.00 |
$603.00 |
$1,477.00
|
|
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
|
$25,000.80 |
$25,000.80 |
$25,000.80 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$16,479.00 |
$16,479.00 |
$16,479.00 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$4,015.80 |
$4,015.80 |
$4,015.80 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$10,940.65 |
$10,940.65 |
$10,940.65 |
$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
|
$12,178.80 |
$12,178.80 |
$12,178.80 |
$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)
|
$19,235.09 |
$19,235.09 |
$19,235.09 |
$5,223.20
|
|
Insert pm/icd lead dual
|
$11,597.40 |
$11,597.40 |
$11,597.40 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$66,838.20 |
$66,838.20 |
$66,838.20 |
$32,800.04
|
|
Insert tunneled cv cath
|
$5,380.20 |
$5,380.20 |
$5,380.20 |
$4,520.00
|
|
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
|
|
Ins icd gen exist sgl lead
|
$47,547.60 |
$47,547.60 |
$47,547.60 |
$23,230.50
|
|
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
|
$405.60 |
$405.60 |
$405.60 |
$331.69
|
|
Insj biomechanical device 22853
|
$58,578.21 |
$58,578.21 |
$58,578.21 |
$622.40
|
|
Insole orthotic freedom sz6 6816
|
$287.08 |
$287.08 |
$287.08 |
$84.00
|
|
Ins pm gen exist dual lead
|
$52,931.40 |
$52,931.40 |
$52,931.40 |
$23,665.85
|
|
Ins pm gen w/exist mlt leads
|
$38,685.00 |
$38,685.00 |
$38,685.00 |
$14,804.40
|
|
Ins/rplc spi npg/rcvr pocket
|
$138,105.77 |
$138,105.77 |
$138,105.77 |
$24,061.80
|
|
Ins/rpl ldless pm right vent w img & eval
|
$6,441.00 |
$6,441.00 |
$6,441.00 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$19,431.60 |
$19,431.60 |
$19,431.60 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$15,641.40 |
$15,641.40 |
$15,641.40 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$4,178.40 |
$4,178.40 |
$4,178.40 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$6,526.20 |
$6,526.20 |
$6,526.20 |
$25,694.00
|
|
Insrt/redo neurostim 1 array
|
$152,908.82 |
$152,908.82 |
$152,908.82 |
$21,817.60
|
|
Instillation anticarcinogenic agent bladder
|
$18,549.17 |
$18,549.17 |
$18,549.17 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$3,601.80 |
$3,601.80 |
$3,601.80 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$31,706.01 |
$31,706.01 |
$31,706.01 |
$4,202.70
|
