|
Inf thrc fascial pln blk uni w/wo image
|
$187.50 |
$187.50 |
$187.50 |
$780.00
|
|
Infuse radioactive materials
|
$739.50 |
$739.50 |
$739.50 |
$640.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$252.00 |
$252.00 |
$252.00 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$407.50 |
$407.50 |
$407.50 |
$576.00
|
|
Init pm e/m new pat 65+ yrs
|
$9.50 |
$9.50 |
$9.50 |
$185.90
|
|
Init/sub psych care m 1st 30
|
$156.50 |
$156.50 |
$156.50 |
$94.34
|
|
Inj, abilify asimtufii, 1 mg
|
$12.50 |
$12.50 |
$12.50 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$14.50 |
$14.50 |
$14.50 |
$5,355.30
|
|
Inj, adstiladrin, per tx dos
|
$80,745.00 |
$80,745.00 |
$80,745.00 |
$63,354.77
|
|
Inj, aflibercept hd, 1 mg
|
$768.50 |
$768.50 |
$768.50 |
$2,794.18
|
|
Inj anifrolumab-fnia 1mg
|
$41.00 |
$41.00 |
$41.00 |
$9,878.82
|
|
Inj avacincaptad pegol 0.1mg
|
$236.50 |
$236.50 |
$236.50 |
$3,409.64
|
|
Inj., benralizumab, 1 mg
|
$439.00 |
$439.00 |
$439.00 |
$11,239.97
|
|
Inj, bezlotoxumab, 10 mg
|
$103.00 |
$103.00 |
$103.00 |
$7,612.43
|
|
Inj bimatoprost itc imp1mcg
|
$456.00 |
$456.00 |
$456.00 |
$3,287.96
|
|
Inj, bupivacaine liposome
|
$3.00 |
$3.00 |
$3.00 |
$699.38
|
|
Inj ceftolozane tazobactam
|
$18.50 |
$18.50 |
$18.50 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$1,454.50 |
$1,454.50 |
$1,454.50 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$305.00 |
$305.00 |
$305.00 |
$875.28
|
|
Inj dupuytren cord w/enzyme
|
$353.00 |
$353.00 |
$353.00 |
$416.00
|
|
Inj, durolane 1 mg
|
$42.00 |
$42.00 |
$42.00 |
$1,950.93
|
|
Inj dx for sinogram
|
$220.00 |
$220.00 |
$220.00 |
$422.59
|
|
Inject for sacroiliac joint
|
$1,143.50 |
$1,143.50 |
$1,143.50 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$875.50 |
$875.50 |
$875.50 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$446.50 |
$446.50 |
$446.50 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$317.50 |
$317.50 |
$317.50 |
$450.72
|
|
Injection, casimersen, 10 mg
|
$271.50 |
$271.50 |
$271.50 |
$2,598.44
|
|
Injection during cath supravalvular aortography
|
$112.50 |
$112.50 |
$112.50 |
$952.66
|
|
Injection epidural blood patch or clot
|
$977.50 |
$977.50 |
$977.50 |
$1,156.80
|
|
Injection eye drug
|
$413.50 |
$413.50 |
$413.50 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$400.00 |
$400.00 |
$400.00 |
$428.40
|
|
Injection for bladder x-ray
|
$220.00 |
$220.00 |
$220.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$313.50 |
$313.50 |
$313.50 |
$494.65
|
|
Injection for spleen x-ray
|
$900.00 |
$900.00 |
$900.00 |
$529.57
|
|
Injection for tear sac x-ray
|
$269.50 |
$269.50 |
$269.50 |
$225.20
|
|
Injection for ureter x-ray
|
$131.50 |
$131.50 |
$131.50 |
$515.21
|
|
Injection, inclisiran, 1 mg
|
$27.00 |
$27.00 |
$27.00 |
$6,679.35
|
|
Injection into brain canal
|
$844.50 |
$844.50 |
$844.50 |
$836.40
|
|
Injection jugular
|
$233.50 |
$233.50 |
$233.50 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$7.00 |
$7.00 |
$7.00 |
$2,277.65
|
|
Injection px peyronie ds
|
$287.50 |
$287.50 |
$287.50 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$529.00 |
$529.00 |
$529.00 |
$670.64
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$811.50 |
$811.50 |
$811.50 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$959.50 |
$959.50 |
$959.50 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$875.50 |
$875.50 |
$875.50 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,268.50 |
$1,268.50 |
$1,268.50 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$508.00 |
$508.00 |
$508.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,017.50 |
$1,017.50 |
$1,017.50 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$538.50 |
$538.50 |
$538.50 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,017.50 |
$1,017.50 |
$1,017.50 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$811.50 |
$811.50 |
$811.50 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$959.50 |
$959.50 |
$959.50 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$391.50 |
$391.50 |
$391.50 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$456.50 |
$456.50 |
$456.50 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$403.00 |
$403.00 |
$403.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$116.00 |
$116.00 |
$116.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$95.50 |
$95.50 |
$95.50 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$429.50 |
$429.50 |
$429.50 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$135.00 |
$135.00 |
$135.00 |
$135.60
|
|
Injection treatment of eye
|
$3,111.00 |
$3,111.00 |
$3,111.00 |
$2,665.60
|
|
Injection treatment of nerve
|
$2,244.50 |
$2,244.50 |
$2,244.50 |
$3,219.20
|
|
Injection treatment of nerve
|
$1,017.00 |
$1,017.00 |
$1,017.00 |
$2,025.45
|
|
Inject sacroiliac joint
|
$811.50 |
$811.50 |
$811.50 |
$1,028.95
|
|
Inject/treat eye socket
|
$396.00 |
$396.00 |
$396.00 |
$381.13
|
|
Inject/treat eye socket
|
$365.00 |
$365.00 |
$365.00 |
$670.02
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$73.50 |
$73.50 |
$73.50 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$811.50 |
$811.50 |
$811.50 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$1,157.50 |
$1,157.50 |
$1,157.50 |
$1,415.50
|
|
Inj., eravacycline, 1 mg
|
$3.50 |
$3.50 |
$3.50 |
$206.64
|
|
Inj, faricimab-svoa, 0.1mg
|
$88.50 |
$88.50 |
$88.50 |
$4,103.29
|
|
Inj for ext venography
|
$301.00 |
$301.00 |
$301.00 |
$649.95
|
|
Inj for mammo ductogram
|
$387.00 |
$387.00 |
$387.00 |
$399.60
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$112.50 |
$112.50 |
$112.50 |
$1,439.90
|
|
Inj hrt cath w/s&i sel left vent
|
$112.50 |
$112.50 |
$112.50 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$112.50 |
$112.50 |
$112.50 |
$965.33
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$1,017.50 |
$1,017.50 |
$1,017.50 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$231.00 |
$231.00 |
$231.00 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$231.00 |
$231.00 |
$231.00 |
$234.00
|
|
Inj, invega hafyera/trinza
|
$28.50 |
$28.50 |
$28.50 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$82.50 |
$82.50 |
$82.50 |
$6,967.29
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$941.00 |
$941.00 |
$941.00 |
$784.00
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$118.50 |
$118.50 |
$118.50 |
$1,496.55
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$915.50 |
$915.50 |
$915.50 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,609.38
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$101.00 |
$101.00 |
$101.00 |
$66,582.27
|
|
Inj, pegcetacoplan, 1mg
|
$338.50 |
$338.50 |
$338.50 |
$3,662.96
|
|
Inj., perseris, 0.5 mg
|
$25.00 |
$25.00 |
$25.00 |
$5,146.85
|
|
Inj proc ankle arthr
|
$306.00 |
$306.00 |
$306.00 |
$405.31
|
|
Inj proc elbow arthro
|
$374.50 |
$374.50 |
$374.50 |
$419.60
|
|
Inj proc lumbr disk ea lvl
|
$1,141.00 |
$1,141.00 |
$1,141.00 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$771.50 |
$771.50 |
$771.50 |
$830.50
|
|
Inj proc sialogram
|
$320.50 |
$320.50 |
$320.50 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$2.50 |
$2.50 |
$2.50 |
$349.45
|
|
Inj retro urethrocysto
|
$268.50 |
$268.50 |
$268.50 |
$443.50
|
|
Inj, rimabotulinumtoxinb
|
$13.00 |
$13.00 |
$13.00 |
$746.79
|
|
Inj scleros sol mult veins
|
$467.50 |
$467.50 |
$467.50 |
$675.00
|
|
Inj, susvimo 0.1 mg
|
$180.00 |
$180.00 |
$180.00 |
$2,598.44
|
|
Inj. teprotumumab-trbw 10 mg
|
$811.00 |
$811.00 |
$811.00 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$0.50 |
$0.50 |
$0.50 |
$123.24
|
