|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$162.30 |
$162.30 |
$162.30 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$89.87 |
$89.87 |
$89.87 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$189.88 |
$189.88 |
$189.88 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$102.25 |
$102.25 |
$102.25 |
$135.60
|
|
Injection treatment of nerve
|
$714.59 |
$714.59 |
$714.59 |
$2,025.45
|
|
Inj epidural sgl cerv-thor without img
|
$861.32 |
$861.32 |
$861.32 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$896.72 |
$896.72 |
$896.72 |
$1,415.50
|
|
Inj glofitamab gxbm, 2.5 mg
|
$19,466.42 |
$19,466.42 |
$19,466.42 |
$4,760.67
|
|
Inj., guselkumab, 1 mg
|
$26,425.47 |
$26,425.47 |
$26,425.47 |
$29,130.83
|
|
Inj heparin, pfizer, 1000u
|
$23.64 |
$23.64 |
$23.64 |
$26.26
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$270.90 |
$270.90 |
$270.90 |
$1,439.90
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,876.30 |
$1,876.30 |
$1,876.30 |
$1,827.74
|
|
Inj hrt cath w/s&i sel hrt art
|
$467.26 |
$467.26 |
$467.26 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$1,269.05 |
$1,269.05 |
$1,269.05 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$205.45 |
$205.45 |
$205.45 |
$965.33
|
|
Inj hydroxocobalamin IV 25mg
|
$1,224.65 |
$1,224.65 |
$1,224.65 |
$2,452.32
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$890.02 |
$890.02 |
$890.02 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$80.88 |
$80.88 |
$80.88 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$27,558.22 |
$27,558.22 |
$27,558.22 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$406.28 |
$406.28 |
$406.28 |
$38.94
|
|
Inj, lecanemab-irmb, 1 mg
|
$2,311.06 |
$2,311.06 |
$2,311.06 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$180.82 |
$180.82 |
$180.82 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$266.34 |
$266.34 |
$266.34 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$73.09 |
$73.09 |
$73.09 |
$47.52
|
|
Inj, melphalan (apotex) 1 mg
|
$36,295.05 |
$36,295.05 |
$36,295.05 |
$64.78
|
|
Inj mepivacaine hcl/10 ml
|
$8.86 |
$8.86 |
$8.86 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$823.24 |
$823.24 |
$823.24 |
$558.08
|
|
Inj, micafungin (par pharm)
|
$56.28 |
$56.28 |
$56.28 |
$89.40
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$42,514.66 |
$42,514.66 |
$42,514.66 |
$8,304.04
|
|
Inj multihance
|
$154.68 |
$154.68 |
$154.68 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$296.90 |
$296.90 |
$296.90 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$547.99 |
$547.99 |
$547.99 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$323.87 |
$323.87 |
$323.87 |
$462.04
|
|
Inj nivolumab 2 mg hyaluron
|
$29,668.35 |
$29,668.35 |
$29,668.35 |
$15,599.68
|
|
Inj, olaratumab, 10 mg
|
$8,568.98 |
$8,568.98 |
$8,568.98 |
$4,127.04
|
|
Inj., patisiran, 0.1 mg
|
$43,071.76 |
$43,071.76 |
$43,071.76 |
$17,613.00
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$7,478.16 |
$7,478.16 |
$7,478.16 |
$6,403.59
|
|
Inj pemetrexed (accord) 10mg
|
$4,931.68 |
$4,931.68 |
$4,931.68 |
$579.77
|
|
Inj peritoneal venous shunt
|
$224.01 |
$224.01 |
$224.01 |
$413.70
|
|
Inj proc for lymphang
|
$309.80 |
$309.80 |
$309.80 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$492.06 |
$492.06 |
$492.06 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$291.18 |
$291.18 |
$291.18 |
$830.50
|
|
Inj proc sialogram
|
$337.31 |
$337.31 |
$337.31 |
$373.00
|
|
Inj progesterone per 50 mg
|
$13.76 |
$13.76 |
$13.76 |
$15.00
|
|
Inj, releuko 1 mcg
|
$962.96 |
$962.96 |
$962.96 |
$473.25
|
|
Inj retro urethrocysto
|
$213.55 |
$213.55 |
$213.55 |
$443.50
|
|
Inj scleros sol sgl vein
|
$300.11 |
$300.11 |
$300.11 |
$558.97
|
|
Inj secretin synthetic human
|
$834.50 |
$834.50 |
$834.50 |
$1,285.20
|
|
Inj secukinumab intrav 1mg
|
$4,068.87 |
$4,068.87 |
$4,068.87 |
$4,413.21
|
|
Inj, spesolimab-sbzo, 1 mg
|
$99,356.59 |
$99,356.59 |
$99,356.59 |
$90,007.62
|
|
Inj teclistamab cqyv 0.5 mg
|
$17,912.85 |
$17,912.85 |
$17,912.85 |
$17,517.56
|
|
Inj. teprotumumab-trbw 10 mg
|
$28,384.33 |
$28,384.33 |
$28,384.33 |
$35,034.78
|
|
Inj testosterone cypionate
|
$72.47 |
$72.47 |
$72.47 |
$64.80
|
|
Inj thiotepa nos 1 mg
|
$23,267.68 |
$23,267.68 |
$23,267.68 |
$3,170.16
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,221.43 |
$1,221.43 |
$1,221.43 |
$1,152.97
|
|
Inj. tigecycline (accord)
|
$298.12 |
$298.12 |
$298.12 |
$188.03
|
|
Inj, tofidence, 1 mg
|
$4,226.13 |
$4,226.13 |
$4,226.13 |
$92.13
|
|
Inj w/fluor eval cv device
|
$333.86 |
$333.86 |
$333.86 |
$503.92
|
|
Inj zanidatamab-hrii, 2 mg
|
$42,988.51 |
$42,988.51 |
$42,988.51 |
$11,091.60
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$37,878.14 |
$37,878.14 |
$37,878.14 |
$44,026.28
|
|
Ins cath ren art 1st bi
|
$5,597.87 |
$5,597.87 |
$5,597.87 |
$5,753.10
|
|
Ins cath ren art 2nd+ bi
|
$8,844.63 |
$8,844.63 |
$8,844.63 |
$5,500.86
|
|
Ins cerv dilator (sep proc)
|
$290.25 |
$290.25 |
$290.25 |
$480.28
|
|
Insert cath pleura with image
|
$1,221.18 |
$1,221.18 |
$1,221.18 |
$2,194.40
|
|
Insert cath pleura without image
|
$989.16 |
$989.16 |
$989.16 |
$2,073.18
|
|
Insert drug delivery implant
|
$97.73 |
$97.73 |
$97.73 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$3,339.49 |
$3,339.49 |
$3,339.49 |
$7,571.20
|
|
Insert intrauterine device iud
|
$96.72 |
$96.72 |
$96.72 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$152.64 |
$152.64 |
$152.64 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$189.82 |
$189.82 |
$189.82 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,300.54 |
$2,300.54 |
$2,300.54 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,557.38 |
$1,557.38 |
$1,557.38 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,556.54 |
$6,556.54 |
$6,556.54 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,481.48 |
$1,481.48 |
$1,481.48 |
$2,505.60
|
|
Insertion of catheter vein
|
$522.14 |
$522.14 |
$522.14 |
$1,477.00
|
|
Insertion of heart electrode 33211
|
$3,389.49 |
$3,389.49 |
$3,389.49 |
$6,903.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$8,561.05 |
$8,561.05 |
$8,561.05 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$6,934.46 |
$6,934.46 |
$6,934.46 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,487.38 |
$7,487.38 |
$7,487.38 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,365.10 |
$1,365.10 |
$1,365.10 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,772.86 |
$1,772.86 |
$1,772.86 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$13,441.52 |
$13,441.52 |
$13,441.52 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,035.11 |
$4,035.11 |
$4,035.11 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,340.80 |
$2,340.80 |
$2,340.80 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,778.36 |
$3,778.36 |
$3,778.36 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$2,756.38 |
$2,756.38 |
$2,756.38 |
$5,223.20
|
|
Insert pessary/other device
|
$91.68 |
$91.68 |
$91.68 |
$278.50
|
|
Insert picvad cath
|
$1,631.03 |
$1,631.03 |
$1,631.03 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$2,387.62 |
$2,387.62 |
$2,387.62 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$5,387.73 |
$5,387.73 |
$5,387.73 |
$32,800.04
|
|
Insert sq defib electrode
|
$2,743.98 |
$2,743.98 |
$2,743.98 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,714.79 |
$1,714.79 |
$1,714.79 |
$2,210.50
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$2,756.38 |
$2,756.38 |
$2,756.38 |
$4,803.00
|
|
Insert tunneled cv cath
|
$3,038.23 |
$3,038.23 |
$3,038.23 |
$4,520.00
|
|
Insert tunneled cv cath
|
$2,756.38 |
$2,756.38 |
$2,756.38 |
$5,983.35
|
|
Insert vad art access left hrt arterial access
|
$2,572.56 |
$2,572.56 |
$2,572.56 |
$4,270.75
|
|
Insert vad art access left hrt art & vein access
|
$4,501.98 |
$4,501.98 |
$4,501.98 |
$3,677.40
|
|
Ins icd gen exist mlt leads
|
$5,924.42 |
$5,924.42 |
$5,924.42 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$5,924.42 |
$5,924.42 |
$5,924.42 |
$23,230.50
|
|
Insitu hybridization auto
|
$306.96 |
$306.96 |
$306.96 |
$377.37
|
