|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$166.80 |
$166.80 |
$166.80 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$92.36 |
$92.36 |
$92.36 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$195.15 |
$195.15 |
$195.15 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$105.08 |
$105.08 |
$105.08 |
$135.60
|
|
Injection treatment of nerve
|
$734.40 |
$734.40 |
$734.40 |
$2,025.45
|
|
Inj epidural sgl cerv-thor without img
|
$885.21 |
$885.21 |
$885.21 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$921.58 |
$921.58 |
$921.58 |
$1,415.50
|
|
Inj glofitamab gxbm, 2.5 mg
|
$20,006.22 |
$20,006.22 |
$20,006.22 |
$4,760.67
|
|
Inj., guselkumab, 1 mg
|
$27,158.25 |
$27,158.25 |
$27,158.25 |
$29,130.83
|
|
Inj heparin, pfizer, 1000u
|
$24.29 |
$24.29 |
$24.29 |
$26.26
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$278.42 |
$278.42 |
$278.42 |
$1,439.90
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,928.33 |
$1,928.33 |
$1,928.33 |
$1,827.74
|
|
Inj hrt cath w/s&i sel hrt art
|
$480.22 |
$480.22 |
$480.22 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$1,304.24 |
$1,304.24 |
$1,304.24 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$211.15 |
$211.15 |
$211.15 |
$965.33
|
|
Inj hydroxocobalamin IV 25mg
|
$1,258.61 |
$1,258.61 |
$1,258.61 |
$2,452.32
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$914.70 |
$914.70 |
$914.70 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$83.13 |
$83.13 |
$83.13 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$28,322.41 |
$28,322.41 |
$28,322.41 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$417.55 |
$417.55 |
$417.55 |
$38.94
|
|
Inj, lecanemab-irmb, 1 mg
|
$2,375.14 |
$2,375.14 |
$2,375.14 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$185.84 |
$185.84 |
$185.84 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$273.72 |
$273.72 |
$273.72 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$75.12 |
$75.12 |
$75.12 |
$47.52
|
|
Inj, melphalan (apotex) 1 mg
|
$37,301.52 |
$37,301.52 |
$37,301.52 |
$64.78
|
|
Inj mepivacaine hcl/10 ml
|
$9.11 |
$9.11 |
$9.11 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$846.07 |
$846.07 |
$846.07 |
$558.08
|
|
Inj, micafungin (par pharm)
|
$57.84 |
$57.84 |
$57.84 |
$89.40
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$43,693.59 |
$43,693.59 |
$43,693.59 |
$8,304.04
|
|
Inj multihance
|
$158.97 |
$158.97 |
$158.97 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$305.14 |
$305.14 |
$305.14 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$563.18 |
$563.18 |
$563.18 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$332.85 |
$332.85 |
$332.85 |
$462.04
|
|
Inj nivolumab 2 mg hyaluron
|
$30,491.05 |
$30,491.05 |
$30,491.05 |
$15,599.68
|
|
Inj, olaratumab, 10 mg
|
$8,806.60 |
$8,806.60 |
$8,806.60 |
$4,127.04
|
|
Inj., patisiran, 0.1 mg
|
$44,266.14 |
$44,266.14 |
$44,266.14 |
$17,613.00
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$7,685.53 |
$7,685.53 |
$7,685.53 |
$6,403.59
|
|
Inj pemetrexed (accord) 10mg
|
$5,068.44 |
$5,068.44 |
$5,068.44 |
$579.77
|
|
Inj peritoneal venous shunt
|
$230.23 |
$230.23 |
$230.23 |
$413.70
|
|
Inj proc for lymphang
|
$318.39 |
$318.39 |
$318.39 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$505.71 |
$505.71 |
$505.71 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$299.25 |
$299.25 |
$299.25 |
$830.50
|
|
Inj proc sialogram
|
$346.67 |
$346.67 |
$346.67 |
$373.00
|
|
Inj progesterone per 50 mg
|
$14.14 |
$14.14 |
$14.14 |
$15.00
|
|
Inj, releuko 1 mcg
|
$989.66 |
$989.66 |
$989.66 |
$473.25
|
|
Inj retro urethrocysto
|
$219.47 |
$219.47 |
$219.47 |
$443.50
|
|
Inj scleros sol sgl vein
|
$308.43 |
$308.43 |
$308.43 |
$558.97
|
|
Inj secretin synthetic human
|
$857.64 |
$857.64 |
$857.64 |
$1,285.20
|
|
Inj secukinumab intrav 1mg
|
$4,181.70 |
$4,181.70 |
$4,181.70 |
$4,413.21
|
|
Inj, spesolimab-sbzo, 1 mg
|
$102,111.75 |
$102,111.75 |
$102,111.75 |
$90,007.62
|
|
Inj teclistamab cqyv 0.5 mg
|
$18,409.57 |
$18,409.57 |
$18,409.57 |
$17,517.56
|
|
Inj. teprotumumab-trbw 10 mg
|
$29,171.43 |
$29,171.43 |
$29,171.43 |
$35,034.78
|
|
Inj testosterone cypionate
|
$74.48 |
$74.48 |
$74.48 |
$64.80
|
|
Inj thiotepa nos 1 mg
|
$23,912.90 |
$23,912.90 |
$23,912.90 |
$3,170.16
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,255.30 |
$1,255.30 |
$1,255.30 |
$1,152.97
|
|
Inj. tigecycline (accord)
|
$306.39 |
$306.39 |
$306.39 |
$188.03
|
|
Inj, tofidence, 1 mg
|
$4,343.32 |
$4,343.32 |
$4,343.32 |
$92.13
|
|
Inj w/fluor eval cv device
|
$343.12 |
$343.12 |
$343.12 |
$503.92
|
|
Inj zanidatamab-hrii, 2 mg
|
$44,180.58 |
$44,180.58 |
$44,180.58 |
$11,091.60
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$38,928.50 |
$38,928.50 |
$38,928.50 |
$44,026.28
|
|
Ins cath ren art 1st bi
|
$5,753.10 |
$5,753.10 |
$5,753.10 |
$5,753.10
|
|
Ins cath ren art 2nd+ bi
|
$9,089.89 |
$9,089.89 |
$9,089.89 |
$5,500.86
|
|
Ins cerv dilator (sep proc)
|
$298.30 |
$298.30 |
$298.30 |
$480.28
|
|
Insert cath pleura with image
|
$1,255.04 |
$1,255.04 |
$1,255.04 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,016.58 |
$1,016.58 |
$1,016.58 |
$2,073.18
|
|
Insert drug delivery implant
|
$100.44 |
$100.44 |
$100.44 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$3,432.10 |
$3,432.10 |
$3,432.10 |
$7,571.20
|
|
Insert intrauterine device iud
|
$99.40 |
$99.40 |
$99.40 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$156.88 |
$156.88 |
$156.88 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$195.08 |
$195.08 |
$195.08 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,364.33 |
$2,364.33 |
$2,364.33 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,600.56 |
$1,600.56 |
$1,600.56 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,738.35 |
$6,738.35 |
$6,738.35 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,522.56 |
$1,522.56 |
$1,522.56 |
$2,505.60
|
|
Insertion of catheter vein
|
$536.62 |
$536.62 |
$536.62 |
$1,477.00
|
|
Insertion of heart electrode 33211
|
$3,483.48 |
$3,483.48 |
$3,483.48 |
$6,903.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$8,798.45 |
$8,798.45 |
$8,798.45 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$7,126.75 |
$7,126.75 |
$7,126.75 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,695.00 |
$7,695.00 |
$7,695.00 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,402.96 |
$1,402.96 |
$1,402.96 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,822.02 |
$1,822.02 |
$1,822.02 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$13,814.25 |
$13,814.25 |
$13,814.25 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,147.00 |
$4,147.00 |
$4,147.00 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,405.71 |
$2,405.71 |
$2,405.71 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,883.14 |
$3,883.14 |
$3,883.14 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$2,832.81 |
$2,832.81 |
$2,832.81 |
$5,223.20
|
|
Insert pessary/other device
|
$94.23 |
$94.23 |
$94.23 |
$278.50
|
|
Insert picvad cath
|
$1,676.26 |
$1,676.26 |
$1,676.26 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$2,453.83 |
$2,453.83 |
$2,453.83 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$5,537.13 |
$5,537.13 |
$5,537.13 |
$32,800.04
|
|
Insert sq defib electrode
|
$2,820.07 |
$2,820.07 |
$2,820.07 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,762.34 |
$1,762.34 |
$1,762.34 |
$2,210.50
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$2,832.81 |
$2,832.81 |
$2,832.81 |
$4,803.00
|
|
Insert tunneled cv cath
|
$3,122.48 |
$3,122.48 |
$3,122.48 |
$4,520.00
|
|
Insert tunneled cv cath
|
$2,832.81 |
$2,832.81 |
$2,832.81 |
$5,983.35
|
|
Insert vad art access left hrt arterial access
|
$2,643.90 |
$2,643.90 |
$2,643.90 |
$4,270.75
|
|
Insert vad art access left hrt art & vein access
|
$4,626.82 |
$4,626.82 |
$4,626.82 |
$3,677.40
|
|
Ins icd gen exist mlt leads
|
$6,088.70 |
$6,088.70 |
$6,088.70 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$6,088.70 |
$6,088.70 |
$6,088.70 |
$23,230.50
|
|
Insitu hybridization auto
|
$315.47 |
$315.47 |
$315.47 |
$377.37
|
