|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$430.80 |
$430.80 |
$430.80 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$56.80 |
$56.80 |
$56.80 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$50.80 |
$50.80 |
$50.80 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$284.40 |
$284.40 |
$284.40 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$85.20 |
$85.20 |
$85.20 |
$135.60
|
|
Inject sacroiliac joint
|
$736.40 |
$736.40 |
$736.40 |
$1,028.95
|
|
Inj epidural sgl cerv-thor without img
|
$806.40 |
$806.40 |
$806.40 |
$1,318.80
|
|
Inj, epinephrine (belcher)
|
$2.10 |
$2.10 |
$2.10 |
$6.55
|
|
Inj. fe derisomaltose 10 mg
|
$57.03 |
$57.03 |
$57.03 |
$3,221.52
|
|
Inj, focinvez, 1mg
|
$5.84 |
$5.84 |
$5.84 |
$3.63
|
|
Inj for ext venography
|
$267.20 |
$267.20 |
$267.20 |
$649.95
|
|
Inj for mammo ductogram
|
$110.00 |
$110.00 |
$110.00 |
$399.60
|
|
Inj heparin, pfizer, 1000u
|
$6.72 |
$6.72 |
$6.72 |
$26.26
|
|
Inj, hercessi, 10 mg
|
$192.75 |
$192.75 |
$192.75 |
$6,033.42
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$40.40 |
$40.40 |
$40.40 |
$1,439.90
|
|
Inj. inebilizumab-cdon, 1 mg
|
$143.44 |
$143.44 |
$143.44 |
$70,014.65
|
|
Inj intralesional <= 7 lsn(s)
|
$228.00 |
$228.00 |
$228.00 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$106.72 |
$106.72 |
$106.72 |
$6,967.29
|
|
Inj, lecanemab-irmb, 1 mg
|
$5.12 |
$5.12 |
$5.12 |
$1,174.88
|
|
Inj, levothyroxine, freskabi
|
$13.50 |
$13.50 |
$13.50 |
$303.45
|
|
Inj, lidocaine w epinephrine
|
$1.07 |
$1.07 |
$1.07 |
$47.52
|
|
Inj, micafungin (par pharm)
|
$0.58 |
$0.58 |
$0.58 |
$89.40
|
|
Inj multihance
|
$12.66 |
$12.66 |
$12.66 |
$73.49
|
|
Inj naloxone hydrochloride
|
$45.50 |
$45.50 |
$45.50 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,213.20 |
$2,213.20 |
$2,213.20 |
$1,413.35
|
|
Inj nivolumab 2 mg hyaluron
|
$47.54 |
$47.54 |
$47.54 |
$15,599.68
|
|
Inj proc elbow arthro
|
$258.00 |
$258.00 |
$258.00 |
$419.60
|
|
Inj proc lumbr disk ea lvl
|
$234.80 |
$234.80 |
$234.80 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$247.60 |
$247.60 |
$247.60 |
$830.50
|
|
Inj progesterone per 50 mg
|
$30.32 |
$30.32 |
$30.32 |
$15.00
|
|
Inj, releuko 1 mcg
|
$0.94 |
$0.94 |
$0.94 |
$473.25
|
|
Inj retacrit esrd on dialysi
|
$8.93 |
$8.93 |
$8.93 |
$349.45
|
|
Inj retro urethrocysto
|
$501.20 |
$501.20 |
$501.20 |
$443.50
|
|
Inj, sutimlimab-jome, 10 mg
|
$37.82 |
$37.82 |
$37.82 |
$3,453.73
|
|
Inj testosterone cypionate
|
$0.26 |
$0.26 |
$0.26 |
$64.80
|
|
Inj., tildrakizumab, 1 mg
|
$300.62 |
$300.62 |
$300.62 |
$26,635.60
|
|
Inj triamcinolone ace X-ray 1mg
|
$39.00 |
$39.00 |
$39.00 |
$1,090.75
|
|
Inj, tyenne, 1 mg
|
$9.59 |
$9.59 |
$9.59 |
$3,525.12
|
|
Inj, vegzelma, 10 mg
|
$177.48 |
$177.48 |
$177.48 |
$1,291.28
|
|
Inj vocal cord bulking agent
|
$794.00 |
$794.00 |
$794.00 |
$1,480.00
|
|
Inj w/fluor eval cv device
|
$628.40 |
$628.40 |
$628.40 |
$503.92
|
|
Ins cath ren art 1st bi
|
$7,252.80 |
$7,252.80 |
$7,252.80 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$7,252.80 |
$7,252.80 |
$7,252.80 |
$4,660.00
|
|
Ins cerv dilator (sep proc)
|
$66.40 |
$66.40 |
$66.40 |
$480.28
|
|
Insert cath pleura with image
|
$1,921.60 |
$1,921.60 |
$1,921.60 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,056.00 |
$2,056.00 |
$2,056.00 |
$2,073.18
|
|
Insert drug delivery implant
|
$66.00 |
$66.00 |
$66.00 |
$280.00
|
|
Insert intrauterine device iud
|
$51.20 |
$51.20 |
$51.20 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$194.80 |
$194.80 |
$194.80 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$199.20 |
$199.20 |
$199.20 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$6,204.00 |
$6,204.00 |
$6,204.00 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,382.80 |
$2,382.80 |
$2,382.80 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$7,600.00 |
$7,600.00 |
$7,600.00 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,635.20 |
$3,635.20 |
$3,635.20 |
$2,505.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$6,110.80 |
$6,110.80 |
$6,110.80 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$8,188.40 |
$8,188.40 |
$8,188.40 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,252.80 |
$7,252.80 |
$7,252.80 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,789.60 |
$1,789.60 |
$1,789.60 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,409.20 |
$1,409.20 |
$1,409.20 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$44,692.00 |
$44,692.00 |
$44,692.00 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,382.80 |
$2,382.80 |
$2,382.80 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$5,948.40 |
$5,948.40 |
$5,948.40 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,548.00 |
$3,548.00 |
$3,548.00 |
$5,223.20
|
|
Insert pm/icd lead dual
|
$5,948.40 |
$5,948.40 |
$5,948.40 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$23,122.00 |
$23,122.00 |
$23,122.00 |
$32,800.04
|
|
Insert swan-ganz cath
|
$1,856.00 |
$1,856.00 |
$1,856.00 |
$2,210.50
|
|
Insert uteri tandem/ovoids
|
$3,917.20 |
$3,917.20 |
$3,917.20 |
$3,905.20
|
|
Insert vad art access left hrt arterial access
|
$4,756.80 |
$4,756.80 |
$4,756.80 |
$4,270.75
|
|
Insitu hybridization manual
|
$369.60 |
$369.60 |
$369.60 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$32.00 |
$32.00 |
$32.00 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$189.20 |
$189.20 |
$189.20 |
$331.69
|
|
Insj perq vad r hrt venous
|
$4,138.40 |
$4,138.40 |
$4,138.40 |
$3,796.00
|
|
Ins lv lead exist pm/icd
|
$5,407.20 |
$5,407.20 |
$5,407.20 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$1,603.20 |
$1,603.20 |
$1,603.20 |
$2,414.36
|
|
Insole orthotic freedom sz6 6816
|
$37.60 |
$37.60 |
$37.60 |
$84.00
|
|
Ins picad w subq port 5yr>
|
$3,551.20 |
$3,551.20 |
$3,551.20 |
$3,985.20
|
|
Ins pm gen exist dual lead
|
$25,382.80 |
$25,382.80 |
$25,382.80 |
$23,665.85
|
|
Ins pq tunnld ip cath w/img
|
$6,689.20 |
$6,689.20 |
$6,689.20 |
$5,377.00
|
|
Ins/rplc spi npg/rcvr pocket
|
$6,917.60 |
$6,917.60 |
$6,917.60 |
$24,061.80
|
|
Ins/rpl ldless pm right vent w img & eval
|
$4,424.00 |
$4,424.00 |
$4,424.00 |
$24,135.54
|
|
Ins/rpl pm w/tv ld atrl
|
$6,110.80 |
$6,110.80 |
$6,110.80 |
$11,583.66
|
|
Ins tun cv cath wo subq prt/pm
|
$3,548.00 |
$3,548.00 |
$3,548.00 |
$4,202.70
|
|
Insulin total
|
$30.80 |
$30.80 |
$30.80 |
$66.64
|
|
Ins vag brachytx device
|
$708.40 |
$708.40 |
$708.40 |
$935.50
|
|
Integra meshed bil wound mat
|
$9,740.40 |
$9,740.40 |
$9,740.40 |
$9,924.16
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$972.00 |
$972.00 |
$972.00 |
$3,803.11
|
|
Interfyl, 1 mg
|
$2,257.20 |
$2,257.20 |
$2,257.20 |
$4,656.80
|
|
Interrogate subq defib
|
$102.40 |
$102.40 |
$102.40 |
$119.60
|
|
Interrog dev eval icpms ip
|
$47.20 |
$47.20 |
$47.20 |
$103.50
|
|
Interrog dev eval scrms ip
|
$44.80 |
$44.80 |
$44.80 |
$124.80
|
|
Interrog device eval heart
|
$44.80 |
$44.80 |
$44.80 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$44.80 |
$44.80 |
$44.80 |
$124.80
|
|
Intra-atrial pacing
|
$951.60 |
$951.60 |
$951.60 |
$4,780.80
|
|
Intracard echo interv w/s&i
|
$150.80 |
$150.80 |
$150.80 |
$3,461.04
|
|
Intracranial complete study
|
$275.20 |
$275.20 |
$275.20 |
$874.99
|
|
Intracranial limited study
|
$159.20 |
$159.20 |
$159.20 |
$465.01
|
|
Intrapul surf admin endo tube
|
$238.40 |
$238.40 |
$238.40 |
$220.80
|
|
Intraventricular pacing
|
$1,213.20 |
$1,213.20 |
$1,213.20 |
$5,456.17
|
|
Intrinsic factor antibody
|
$17.60 |
$17.60 |
$17.60 |
$63.15
|
