|
Inj, moxifloxacin 100 mg
|
$43.12 |
$43.12 |
$43.12 |
$101.31
|
|
Inj. mycophenolate mofetil
|
$4.09 |
$4.09 |
$4.09 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,676.00 |
$2,676.00 |
$2,676.00 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$11,412.00 |
$11,412.00 |
$11,412.00 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$8,080.00 |
$8,080.00 |
$8,080.00 |
$2,726.90
|
|
Inj ogivri 10 mg
|
$56.80 |
$56.80 |
$56.80 |
$4,492.28
|
|
Inj olipudase alfa-rpcp 1mg
|
$520.34 |
$520.34 |
$520.34 |
$13,239.99
|
|
Inj., omadacycline, 1 mg
|
$5.96 |
$5.96 |
$5.96 |
$865.34
|
|
Inj ontruzant 10 mg
|
$96.56 |
$96.56 |
$96.56 |
$6,706.27
|
|
Inj. pemetrexed, 10 mg
|
$104.72 |
$104.72 |
$104.72 |
$104.72
|
|
Inj peritoneal venous shunt
|
$124.00 |
$124.00 |
$124.00 |
$406.80
|
|
Inj proc ankle arthr
|
$479.00 |
$479.00 |
$479.00 |
$405.31
|
|
Inj proc elbow arthro
|
$1,076.00 |
$1,076.00 |
$1,076.00 |
$433.00
|
|
Inj proc for lymphang
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$319.50 |
$319.50 |
$319.50 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$289.50 |
$289.50 |
$289.50 |
$840.00
|
|
Inj proc sialogram
|
$482.50 |
$482.50 |
$482.50 |
$369.45
|
|
Inj prohance multipack
|
$3.79 |
$3.79 |
$3.79 |
$10.40
|
|
Inj retro urethrocysto
|
$540.00 |
$540.00 |
$540.00 |
$447.74
|
|
Inj, rimabotulinumtoxinb
|
$17.73 |
$17.73 |
$17.73 |
$714.24
|
|
Inj scleros sol mult veins
|
$614.00 |
$614.00 |
$614.00 |
$707.85
|
|
Inj scleros sol sgl vein
|
$614.00 |
$614.00 |
$614.00 |
$561.88
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$125.00 |
$125.00 |
$125.00 |
$436.80
|
|
Inj sulf hexa lipid microsph
|
$32.03 |
$32.03 |
$32.03 |
$256.14
|
|
Inj teclistamab cqyv 0.5 mg
|
$47.42 |
$47.42 |
$47.42 |
$17,517.56
|
|
Inj thiotepa nos 1 mg
|
$209.84 |
$209.84 |
$209.84 |
$3,170.16
|
|
Inj thrc fascial pln blk bi w/wo image
|
$236.50 |
$236.50 |
$236.50 |
$1,059.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$409.00 |
$409.00 |
$409.00 |
$837.50
|
|
Inj, tislelizumab-jsgr
|
$77.42 |
$77.42 |
$77.42 |
$9,764.09
|
|
Inj w/fluor eval cv device
|
$261.00 |
$261.00 |
$261.00 |
$504.40
|
|
Inj zanidatamab-hrii, 2 mg
|
$33.08 |
$33.08 |
$33.08 |
$8,532.00
|
|
Inj zenocutuzumab-zbco 1 mg
|
$49.49 |
$49.49 |
$49.49 |
$19,177.20
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$3,504.62 |
$3,504.62 |
$3,504.62 |
$41,083.73
|
|
Ins cath ren art 1st bi
|
$3,764.00 |
$3,764.00 |
$3,764.00 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$2,666.00 |
$2,666.00 |
$2,666.00 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$2,666.00 |
$2,666.00 |
$2,666.00 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$2,666.00 |
$2,666.00 |
$2,666.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$342.00 |
$342.00 |
$342.00 |
$488.35
|
|
Insert abdomen-venous drain
|
$1,887.00 |
$1,887.00 |
$1,887.00 |
$3,758.23
|
|
Insert cannula vein-to-vein hemodialysis
|
$7,279.50 |
$7,279.50 |
$7,279.50 |
$7,279.50
|
|
Insert cath pleura with image
|
$2,500.00 |
$2,500.00 |
$2,500.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,483.00 |
$1,483.00 |
$1,483.00 |
$2,101.52
|
|
Insert drug delivery implant
|
$564.50 |
$564.50 |
$564.50 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$1,569.50 |
$1,569.50 |
$1,569.50 |
$7,571.20
|
|
Insert intrauterine device iud
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$330.72
|
|
Insertion catheter bladder non indwelling
|
$159.00 |
$159.00 |
$159.00 |
$209.30
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,670.50 |
$5,670.50 |
$5,670.50 |
$4,923.19
|
|
Insertion intra aortic balloon assist device percutaneous
|
$557.50 |
$557.50 |
$557.50 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,087.00 |
$3,087.00 |
$3,087.00 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,871.00 |
$1,871.00 |
$1,871.00 |
$2,595.45
|
|
Insertion of cannula(s)
|
$2,505.50 |
$2,505.50 |
$2,505.50 |
$1,989.39
|
|
Insertion of catheter vein
|
$851.00 |
$851.00 |
$851.00 |
$1,525.80
|
|
Insertion of catheter vein
|
$359.50 |
$359.50 |
$359.50 |
$858.05
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$11,016.50 |
$11,016.50 |
$11,016.50 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$10,723.00 |
$10,723.00 |
$10,723.00 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$4,466.50 |
$4,466.50 |
$4,466.50 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,109.00
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,609.00 |
$2,609.00 |
$2,609.00 |
$2,463.50
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$30,737.00 |
$30,737.00 |
$30,737.00 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,249.50 |
$4,249.50 |
$4,249.50 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$6,693.00 |
$6,693.00 |
$6,693.00 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$9,332.50 |
$9,332.50 |
$9,332.50 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$10,118.00 |
$10,118.00 |
$10,118.00 |
$5,236.80
|
|
Insertion ureth cath
|
$577.50 |
$577.50 |
$577.50 |
$2,365.38
|
|
Insert pessary/other device
|
$467.50 |
$467.50 |
$467.50 |
$278.90
|
|
Insert picvad cath
|
$6,828.00 |
$6,828.00 |
$6,828.00 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$6,693.00 |
$6,693.00 |
$6,693.00 |
$7,115.90
|
|
Insert/repl sq defib w/eltrd
|
$35,655.00 |
$35,655.00 |
$35,655.00 |
$33,593.55
|
|
Insert sq defib electrode
|
$5,074.50 |
$5,074.50 |
$5,074.50 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,028.50 |
$1,028.50 |
$1,028.50 |
$2,164.52
|
|
Insert tunneled cv cath
|
$8,959.00 |
$8,959.00 |
$8,959.00 |
$4,580.61
|
|
Insert tunneled cv cath
|
$4,294.00 |
$4,294.00 |
$4,294.00 |
$6,075.30
|
|
Insert uteri tandem/ovoids
|
$7,575.00 |
$7,575.00 |
$7,575.00 |
$3,940.41
|
|
Insert vad art access left hrt arterial access
|
$1,016.50 |
$1,016.50 |
$1,016.50 |
$4,276.00
|
|
Insert vad art access left hrt art & vein access
|
$1,324.00 |
$1,324.00 |
$1,324.00 |
$3,777.27
|
|
Ins icd gen exist mlt leads
|
$34,864.00 |
$34,864.00 |
$34,864.00 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$33,204.00 |
$33,204.00 |
$33,204.00 |
$23,230.50
|
|
Insitu hybridization auto
|
$697.00 |
$697.00 |
$697.00 |
$372.81
|
|
Insitu hybridization (fish)
|
$481.00 |
$481.00 |
$481.00 |
$481.00
|
|
Insitu hybridization manual
|
$498.00 |
$498.00 |
$498.00 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$243.50 |
$243.50 |
$243.50 |
$243.00
|
|
In situ hybridization per specimen initial single probe stain
|
$298.00 |
$298.00 |
$298.00 |
$340.00
|
|
Insj perq vad r hrt venous
|
$1,019.00 |
$1,019.00 |
$1,019.00 |
$3,796.00
|
|
Ins left heart vent thor inscn ecmo
|
$2,437.00 |
$2,437.00 |
$2,437.00 |
$1,901.60
|
|
Ins lv lead exist pm/icd
|
$4,736.50 |
$4,736.50 |
$4,736.50 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$1,445.50 |
$1,445.50 |
$1,445.50 |
$2,477.24
|
|
Ins mark thor for right perq
|
$1,220.00 |
$1,220.00 |
$1,220.00 |
$2,492.80
|
|
Ins picad w subq port 5yr>
|
$6,828.00 |
$6,828.00 |
$6,828.00 |
$4,195.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,194.00 |
$1,194.00 |
$1,194.00 |
$1,690.00
|
|
Ins pm gen exist dual lead
|
$24,696.00 |
$24,696.00 |
$24,696.00 |
$24,159.72
|
|
Ins pm gen w/exist mlt leads
|
$7,472.00 |
$7,472.00 |
$7,472.00 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$5,377.00 |
$5,377.00 |
$5,377.00 |
$5,486.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$26,483.50 |
$26,483.50 |
$26,483.50 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$7,115.00 |
$7,115.00 |
$7,115.00 |
$11,198.55
|
|
Ins/rpl pm gen exist sgl lead
|
$6,489.00 |
$6,489.00 |
$6,489.00 |
$9,558.78
|
|
Ins/rpl pm w/tv ld atrl
|
$8,925.00 |
$8,925.00 |
$8,925.00 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$36,985.50 |
$36,985.50 |
$36,985.50 |
$27,318.11
|
|
Ins subq extnsn pertneal cath
|
$1,204.50 |
$1,204.50 |
$1,204.50 |
$2,479.93
|
|
Inst fibrinolysis agent ini day
|
$493.50 |
$493.50 |
$493.50 |
$1,043.35
|
|
Inst fibrinolysis agent sbsq d
|
$472.00 |
$472.00 |
$472.00 |
$997.05
|
