|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$153.20 |
$153.20 |
$153.20 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$84.83 |
$84.83 |
$84.83 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$179.24 |
$179.24 |
$179.24 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$96.52 |
$96.52 |
$96.52 |
$135.60
|
|
Injection treatment of nerve
|
$674.53 |
$674.53 |
$674.53 |
$2,025.45
|
|
Inj epidural sgl cerv-thor without img
|
$813.05 |
$813.05 |
$813.05 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$846.46 |
$846.46 |
$846.46 |
$1,415.50
|
|
Inj glofitamab gxbm, 2.5 mg
|
$18,375.36 |
$18,375.36 |
$18,375.36 |
$4,760.67
|
|
Inj., guselkumab, 1 mg
|
$24,944.37 |
$24,944.37 |
$24,944.37 |
$29,130.83
|
|
Inj heparin, pfizer, 1000u
|
$22.31 |
$22.31 |
$22.31 |
$26.26
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$255.72 |
$255.72 |
$255.72 |
$1,439.90
|
|
Inj hrt cath w/s&i sel hrt ang
|
$1,771.14 |
$1,771.14 |
$1,771.14 |
$1,827.74
|
|
Inj hrt cath w/s&i sel hrt art
|
$441.07 |
$441.07 |
$441.07 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$1,197.92 |
$1,197.92 |
$1,197.92 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$193.94 |
$193.94 |
$193.94 |
$965.33
|
|
Inj hydroxocobalamin IV 25mg
|
$1,156.01 |
$1,156.01 |
$1,156.01 |
$2,452.32
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$840.13 |
$840.13 |
$840.13 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$76.35 |
$76.35 |
$76.35 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$26,013.62 |
$26,013.62 |
$26,013.62 |
$6,967.29
|
|
Inj labetalol hcl hikma, 5mg
|
$383.51 |
$383.51 |
$383.51 |
$38.94
|
|
Inj, lecanemab-irmb, 1 mg
|
$2,181.53 |
$2,181.53 |
$2,181.53 |
$1,174.88
|
|
Inj levocarnitine per 1 gm
|
$170.69 |
$170.69 |
$170.69 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$251.41 |
$251.41 |
$251.41 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$69.00 |
$69.00 |
$69.00 |
$47.52
|
|
Inj, melphalan (apotex) 1 mg
|
$34,260.77 |
$34,260.77 |
$34,260.77 |
$64.78
|
|
Inj mepivacaine hcl/10 ml
|
$8.36 |
$8.36 |
$8.36 |
$33.86
|
|
Inj., meropenem, vaborbactam
|
$777.10 |
$777.10 |
$777.10 |
$558.08
|
|
Inj, micafungin (par pharm)
|
$53.13 |
$53.13 |
$53.13 |
$89.40
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$40,131.78 |
$40,131.78 |
$40,131.78 |
$8,304.04
|
|
Inj multihance
|
$146.01 |
$146.01 |
$146.01 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$280.26 |
$280.26 |
$280.26 |
$252.66
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$517.27 |
$517.27 |
$517.27 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$305.71 |
$305.71 |
$305.71 |
$462.04
|
|
Inj nivolumab 2 mg hyaluron
|
$28,005.48 |
$28,005.48 |
$28,005.48 |
$15,599.68
|
|
Inj, olaratumab, 10 mg
|
$8,088.71 |
$8,088.71 |
$8,088.71 |
$4,127.04
|
|
Inj., patisiran, 0.1 mg
|
$40,657.66 |
$40,657.66 |
$40,657.66 |
$17,613.00
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$7,059.02 |
$7,059.02 |
$7,059.02 |
$6,403.59
|
|
Inj pemetrexed (accord) 10mg
|
$4,655.27 |
$4,655.27 |
$4,655.27 |
$579.77
|
|
Inj peritoneal venous shunt
|
$211.46 |
$211.46 |
$211.46 |
$413.70
|
|
Inj proc for lymphang
|
$292.44 |
$292.44 |
$292.44 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$464.48 |
$464.48 |
$464.48 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$274.86 |
$274.86 |
$274.86 |
$830.50
|
|
Inj proc sialogram
|
$318.41 |
$318.41 |
$318.41 |
$373.00
|
|
Inj progesterone per 50 mg
|
$12.99 |
$12.99 |
$12.99 |
$15.00
|
|
Inj, releuko 1 mcg
|
$908.99 |
$908.99 |
$908.99 |
$473.25
|
|
Inj retro urethrocysto
|
$201.58 |
$201.58 |
$201.58 |
$443.50
|
|
Inj scleros sol sgl vein
|
$283.29 |
$283.29 |
$283.29 |
$558.97
|
|
Inj secretin synthetic human
|
$787.72 |
$787.72 |
$787.72 |
$1,285.20
|
|
Inj secukinumab intrav 1mg
|
$3,840.81 |
$3,840.81 |
$3,840.81 |
$4,413.21
|
|
Inj, spesolimab-sbzo, 1 mg
|
$93,787.81 |
$93,787.81 |
$93,787.81 |
$90,007.62
|
|
Inj teclistamab cqyv 0.5 mg
|
$16,908.86 |
$16,908.86 |
$16,908.86 |
$17,517.56
|
|
Inj. teprotumumab-trbw 10 mg
|
$26,793.43 |
$26,793.43 |
$26,793.43 |
$35,034.78
|
|
Inj testosterone cypionate
|
$68.40 |
$68.40 |
$68.40 |
$64.80
|
|
Inj thiotepa nos 1 mg
|
$21,963.57 |
$21,963.57 |
$21,963.57 |
$3,170.16
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,152.97 |
$1,152.97 |
$1,152.97 |
$1,152.97
|
|
Inj. tigecycline (accord)
|
$281.41 |
$281.41 |
$281.41 |
$188.03
|
|
Inj, tofidence, 1 mg
|
$3,989.26 |
$3,989.26 |
$3,989.26 |
$92.13
|
|
Inj w/fluor eval cv device
|
$315.15 |
$315.15 |
$315.15 |
$503.92
|
|
Inj zanidatamab-hrii, 2 mg
|
$40,579.07 |
$40,579.07 |
$40,579.07 |
$11,091.60
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$35,755.13 |
$35,755.13 |
$35,755.13 |
$44,026.28
|
|
Ins cath ren art 1st bi
|
$5,284.12 |
$5,284.12 |
$5,284.12 |
$5,753.10
|
|
Ins cath ren art 2nd+ bi
|
$8,348.90 |
$8,348.90 |
$8,348.90 |
$5,500.86
|
|
Ins cerv dilator (sep proc)
|
$273.99 |
$273.99 |
$273.99 |
$480.28
|
|
Insert cath pleura with image
|
$1,152.73 |
$1,152.73 |
$1,152.73 |
$2,194.40
|
|
Insert cath pleura without image
|
$933.72 |
$933.72 |
$933.72 |
$2,073.18
|
|
Insert drug delivery implant
|
$92.25 |
$92.25 |
$92.25 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$3,152.32 |
$3,152.32 |
$3,152.32 |
$7,571.20
|
|
Insert intrauterine device iud
|
$91.30 |
$91.30 |
$91.30 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$144.09 |
$144.09 |
$144.09 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$179.18 |
$179.18 |
$179.18 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,171.59 |
$2,171.59 |
$2,171.59 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,470.09 |
$1,470.09 |
$1,470.09 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,189.05 |
$6,189.05 |
$6,189.05 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,398.45 |
$1,398.45 |
$1,398.45 |
$2,505.60
|
|
Insertion of catheter vein
|
$492.88 |
$492.88 |
$492.88 |
$1,477.00
|
|
Insertion of heart electrode 33211
|
$3,199.52 |
$3,199.52 |
$3,199.52 |
$6,903.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$8,081.22 |
$8,081.22 |
$8,081.22 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$6,545.79 |
$6,545.79 |
$6,545.79 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,067.72 |
$7,067.72 |
$7,067.72 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,288.59 |
$1,288.59 |
$1,288.59 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,673.49 |
$1,673.49 |
$1,673.49 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$12,688.14 |
$12,688.14 |
$12,688.14 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$3,808.95 |
$3,808.95 |
$3,808.95 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,209.60 |
$2,209.60 |
$2,209.60 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,566.59 |
$3,566.59 |
$3,566.59 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$2,601.89 |
$2,601.89 |
$2,601.89 |
$5,223.20
|
|
Insert pessary/other device
|
$86.55 |
$86.55 |
$86.55 |
$278.50
|
|
Insert picvad cath
|
$1,539.61 |
$1,539.61 |
$1,539.61 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$2,253.80 |
$2,253.80 |
$2,253.80 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$5,085.76 |
$5,085.76 |
$5,085.76 |
$32,800.04
|
|
Insert sq defib electrode
|
$2,590.18 |
$2,590.18 |
$2,590.18 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,618.68 |
$1,618.68 |
$1,618.68 |
$2,210.50
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$2,601.89 |
$2,601.89 |
$2,601.89 |
$4,803.00
|
|
Insert tunneled cv cath
|
$2,867.94 |
$2,867.94 |
$2,867.94 |
$4,520.00
|
|
Insert tunneled cv cath
|
$2,601.89 |
$2,601.89 |
$2,601.89 |
$5,983.35
|
|
Insert vad art access left hrt arterial access
|
$2,428.37 |
$2,428.37 |
$2,428.37 |
$4,270.75
|
|
Insert vad art access left hrt art & vein access
|
$4,249.65 |
$4,249.65 |
$4,249.65 |
$3,677.40
|
|
Ins icd gen exist mlt leads
|
$5,592.36 |
$5,592.36 |
$5,592.36 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$5,592.36 |
$5,592.36 |
$5,592.36 |
$23,230.50
|
|
Insitu hybridization auto
|
$289.75 |
$289.75 |
$289.75 |
$377.37
|
