|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$779.63 |
$779.63 |
$779.63 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,145.50 |
$1,145.50 |
$1,145.50 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$904.34 |
$904.34 |
$904.34 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$370.00 |
$370.00 |
$370.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$126.00 |
$126.00 |
$126.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$417.00 |
$417.00 |
$417.00 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$72.00 |
$72.00 |
$72.00 |
$135.60
|
|
Inject sacroiliac joint
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$1,028.95
|
|
Inject/treat eye socket
|
$62.50 |
$62.50 |
$62.50 |
$381.13
|
|
Inject/treat eye socket
|
$304.00 |
$304.00 |
$304.00 |
$670.02
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$49.00 |
$49.00 |
$49.00 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,047.00 |
$1,047.00 |
$1,047.00 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$854.50 |
$854.50 |
$854.50 |
$1,415.50
|
|
Inj, epinephrine (belcher)
|
$12.06 |
$12.06 |
$12.06 |
$6.55
|
|
Inj., eravacycline, 1 mg
|
$2.50 |
$2.50 |
$2.50 |
$206.64
|
|
Inj, faricimab-svoa, 0.1mg
|
$2,250.00 |
$2,250.00 |
$2,250.00 |
$4,103.29
|
|
Inj for ext venography
|
$49.50 |
$49.50 |
$49.50 |
$649.95
|
|
Inj, fulvestrant (fresenius)
|
$1,378.05 |
$1,378.05 |
$1,378.05 |
$1,043.05
|
|
Inj, gadopiclenol, 1 ml
|
$24.66 |
$24.66 |
$24.66 |
$37.63
|
|
Inj intralesional <= 7 lsn(s)
|
$207.50 |
$207.50 |
$207.50 |
$235.13
|
|
Inj, invega hafyera/trinza
|
$19.00 |
$19.00 |
$19.00 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$6,022.50 |
$6,022.50 |
$6,022.50 |
$6,967.29
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$783.50 |
$783.50 |
$783.50 |
$784.00
|
|
Inj, meropenem (b. braun)
|
$24.82 |
$24.82 |
$24.82 |
$71.14
|
|
Inj, micafungin (par pharm)
|
$55.81 |
$55.81 |
$55.81 |
$89.40
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$79.00 |
$79.00 |
$79.00 |
$1,496.55
|
|
Inj multihance multipack
|
$23.49 |
$23.49 |
$23.49 |
$2.80
|
|
Inj naloxone hydrochloride
|
$7.44 |
$7.44 |
$7.44 |
$83.16
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$160.00 |
$160.00 |
$160.00 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$127.00 |
$127.00 |
$127.00 |
$2,609.38
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$67.50 |
$67.50 |
$67.50 |
$66,582.27
|
|
Inj pantoprazole(hikma) 40mg
|
$8.78 |
$8.78 |
$8.78 |
$34.67
|
|
Inj, pegcetacoplan, 1mg
|
$226.00 |
$226.00 |
$226.00 |
$3,662.96
|
|
Inj pemetrexed, hospira 10mg
|
$650.94 |
$650.94 |
$650.94 |
$64.35
|
|
Inj., perseris, 0.5 mg
|
$17.00 |
$17.00 |
$17.00 |
$5,146.85
|
|
Inj proc for lymphang
|
$86.00 |
$86.00 |
$86.00 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$162.00 |
$162.00 |
$162.00 |
$1,106.93
|
|
Inj retacrit esrd on dialysi
|
$1.50 |
$1.50 |
$1.50 |
$349.45
|
|
Inj retro urethrocysto
|
$65.00 |
$65.00 |
$65.00 |
$443.50
|
|
Inj, rimabotulinumtoxinb
|
$19.50 |
$19.50 |
$19.50 |
$746.79
|
|
Inj scleros sol mult veins
|
$389.50 |
$389.50 |
$389.50 |
$675.00
|
|
Inj scleros sol sgl vein
|
$389.50 |
$389.50 |
$389.50 |
$558.97
|
|
Inj secukinumab intrav 1mg
|
$12,560.56 |
$12,560.56 |
$12,560.56 |
$4,413.21
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$59.00 |
$59.00 |
$59.00 |
$436.80
|
|
Inj, susvimo 0.1 mg
|
$86.00 |
$86.00 |
$86.00 |
$2,598.44
|
|
Inj. teprotumumab-trbw 10 mg
|
$113,475.30 |
$113,475.30 |
$113,475.30 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$0.50 |
$0.50 |
$0.50 |
$123.24
|
|
Inj testosterone cypionate
|
$14.06 |
$14.06 |
$14.06 |
$64.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$79.00 |
$79.00 |
$79.00 |
$1,152.97
|
|
Inj thrc fascial pln blk uni w/wo image
|
$697.50 |
$697.50 |
$697.50 |
$837.50
|
|
Inj., tildrakizumab, 1 mg
|
$20,032.59 |
$20,032.59 |
$20,032.59 |
$26,635.60
|
|
Inj triamcinolone ace X-ray 1mg
|
$32.50 |
$32.50 |
$32.50 |
$1,090.75
|
|
Inj, trivisc 1 mg
|
$25.00 |
$25.00 |
$25.00 |
$6.67
|
|
Inj, uzedy, 1 mg
|
$34.00 |
$34.00 |
$34.00 |
$11,475.96
|
|
Inj, vancomycin hcl (xellia)
|
$18.30 |
$18.30 |
$18.30 |
$85.20
|
|
Inj vancomycin (xellia) 10mg
|
$36.60 |
$36.60 |
$36.60 |
$76.59
|
|
Inj w/fluor eval cv device
|
$212.50 |
$212.50 |
$212.50 |
$503.92
|
|
Inj xipere 1 mg
|
$62.00 |
$62.00 |
$62.00 |
$93.00
|
|
Inj., yutiq, 0.01 mg
|
$772.50 |
$772.50 |
$772.50 |
$14,458.60
|
|
Inpatient consultation
|
$73.00 |
$73.00 |
$73.00 |
$73.80
|
|
Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
|
$45.50 |
$45.50 |
$45.50 |
$54.24
|
|
Inpt/ed teleconsult30
|
$135.00 |
$135.00 |
$135.00 |
$164.40
|
|
Inpt/ed teleconsult50
|
$143.00 |
$143.00 |
$143.00 |
$223.80
|
|
Inpt/ed teleconsult70
|
$202.00 |
$202.00 |
$202.00 |
$330.60
|
|
Inpt/tele follow up 15
|
$41.50 |
$41.50 |
$41.50 |
$64.80
|
|
Inpt/tele follow up 25
|
$73.00 |
$73.00 |
$73.00 |
$118.80
|
|
Inpt/tele follow up 35
|
$107.00 |
$107.00 |
$107.00 |
$171.60
|
|
Ins cath ren art 1st bi
|
$373.00 |
$373.00 |
$373.00 |
$5,753.10
|
|
Ins cath ren art 2nd+ bi
|
$436.50 |
$436.50 |
$436.50 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$358.00 |
$358.00 |
$358.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$416.00 |
$416.00 |
$416.00 |
$480.28
|
|
Insert cannula vein-to-vein hemodialysis
|
$124.50 |
$124.50 |
$124.50 |
$7,279.50
|
|
Insert cath pleura with image
|
$151.00 |
$151.00 |
$151.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$137.50 |
$137.50 |
$137.50 |
$2,073.18
|
|
Insert drug delivery implant
|
$178.50 |
$178.50 |
$178.50 |
$280.00
|
|
Insert epicardial lead open 33202
|
$8,770.00 |
$8,770.00 |
$8,770.00 |
$3,775.20
|
|
Insert intrauterine device iud
|
$1,026.67 |
$1,026.67 |
$1,026.67 |
$347.10
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$113.50 |
$113.50 |
$113.50 |
$3,706.68
|
|
Insertion catheter bladder non indwelling
|
$201.00 |
$201.00 |
$201.00 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$138.50 |
$138.50 |
$138.50 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,590.50 |
$2,590.50 |
$2,590.50 |
$4,782.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$225.50 |
$225.50 |
$225.50 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,510.50 |
$2,510.50 |
$2,510.50 |
$2,505.60
|
|
Insertion of cannula
|
$203.00 |
$203.00 |
$203.00 |
$4,341.66
|
|
Insertion of cannula(s)
|
$1,550.50 |
$1,550.50 |
$1,550.50 |
$1,989.39
|
|
Insertion of heart electrode 33211
|
$2,690.00 |
$2,690.00 |
$2,690.00 |
$6,903.60
|
|
Insertion of infusion pump
|
$734.00 |
$734.00 |
$734.00 |
$5,907.78
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$570.50 |
$570.50 |
$570.50 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$496.50 |
$496.50 |
$496.50 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$474.00 |
$474.00 |
$474.00 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,042.50 |
$4,042.50 |
$4,042.50 |
$2,419.65
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$169.00 |
$169.00 |
$169.00 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,690.00 |
$2,690.00 |
$2,690.00 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$2,690.00 |
$2,690.00 |
$2,690.00 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$4,004.00 |
$4,004.00 |
$4,004.00 |
$5,223.20
|
|
Insertion ureth cath
|
$518.50 |
$518.50 |
$518.50 |
$2,412.45
|
|
Insert lens prosthesis
|
$720.50 |
$720.50 |
$720.50 |
$3,173.34
|
|
Insert multi-comp penis pros
|
$835.00 |
$835.00 |
$835.00 |
$21,998.10
|
|
Insert pessary/other device
|
$198.00 |
$198.00 |
$198.00 |
$278.50
|
