|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,893.00 |
$1,893.00 |
$1,893.00 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$2,563.50 |
$2,563.50 |
$2,563.50 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$960.00 |
$960.00 |
$960.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$706.00 |
$706.00 |
$706.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$714.00 |
$714.00 |
$714.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$904.00 |
$904.00 |
$904.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$487.00 |
$487.00 |
$487.00 |
$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
|
$2,673.00 |
$2,673.00 |
$2,673.00 |
$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
|
$1,336.50 |
$1,336.50 |
$1,336.50 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$1,157.50 |
$1,157.50 |
$1,157.50 |
$1,415.50
|
|
Inj, epinephrine (belcher)
|
$5.43 |
$5.43 |
$5.43 |
$6.55
|
|
Inj., eravacycline, 1 mg
|
$3.50 |
$3.50 |
$3.50 |
$206.64
|
|
Inj, erzofri, 1 mg
|
$7,046.94 |
$7,046.94 |
$7,046.94 |
$10,213.70
|
|
Inj, evinacumab-dgnb, 5mg
|
$73,828.13 |
$73,828.13 |
$73,828.13 |
$20,751.13
|
|
Inj, faricimab-svoa, 0.1mg
|
$88.50 |
$88.50 |
$88.50 |
$4,103.29
|
|
Inj for ext venography
|
$7,137.00 |
$7,137.00 |
$7,137.00 |
$649.95
|
|
Inj for mammo ductogram
|
$489.00 |
$489.00 |
$489.00 |
$399.60
|
|
Inj, gadopiclenol, 1 ml
|
$80.70 |
$80.70 |
$80.70 |
$37.63
|
|
Inj. herceptin hylecta, 10mg
|
$10,519.29 |
$10,519.29 |
$10,519.29 |
$7,690.59
|
|
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 hrt ang
|
$2,013.50 |
$2,013.50 |
$2,013.50 |
$1,827.74
|
|
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)
|
$261.50 |
$261.50 |
$261.50 |
$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
|
$9,855.00 |
$9,855.00 |
$9,855.00 |
$6,967.29
|
|
Inj, kovaltry, 1 i.u
|
$3,262.50 |
$3,262.50 |
$3,262.50 |
$5.07
|
|
Inj, lecanemab-irmb, 1 mg
|
$2,586.20 |
$2,586.20 |
$2,586.20 |
$1,174.88
|
|
Inj, levothyroxine, freskabi
|
$184.39 |
$184.39 |
$184.39 |
$303.45
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$941.00 |
$941.00 |
$941.00 |
$784.00
|
|
Inj mepivacaine hcl/10 ml
|
$14.04 |
$14.04 |
$14.04 |
$33.86
|
|
Inj, micafungin (par pharm)
|
$49.61 |
$49.61 |
$49.61 |
$89.40
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$118.50 |
$118.50 |
$118.50 |
$1,496.55
|
|
Inj multihance multipack
|
$3.39 |
$3.39 |
$3.39 |
$2.80
|
|
Inj naloxone hydrochloride
|
$42.29 |
$42.29 |
$42.29 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$915.50 |
$915.50 |
$915.50 |
$1,413.35
|
|
Inj nivolumab 2 mg hyaluron
|
$31,772.32 |
$31,772.32 |
$31,772.32 |
$15,599.68
|
|
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 pemetrexed, hospira 10mg
|
$1,038.78 |
$1,038.78 |
$1,038.78 |
$64.35
|
|
Inj pemetrexed (sandoz) 10mg
|
$164.09 |
$164.09 |
$164.09 |
$95.26
|
|
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
|
$4,751.00 |
$4,751.00 |
$4,751.00 |
$830.50
|
|
Inj proc sialogram
|
$320.50 |
$320.50 |
$320.50 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$169.54 |
$169.54 |
$169.54 |
$349.45
|
|
Inj retro urethrocysto
|
$405.00 |
$405.00 |
$405.00 |
$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 secukinumab intrav 1mg
|
$26,231.87 |
$26,231.87 |
$26,231.87 |
$4,413.21
|
|
Inj, susvimo 0.1 mg
|
$180.00 |
$180.00 |
$180.00 |
$2,598.44
|
|
Inj. teprotumumab-trbw 10 mg
|
$86,257.24 |
$86,257.24 |
$86,257.24 |
$35,034.78
|
|
Inj testostero enanthate 1mg
|
$0.50 |
$0.50 |
$0.50 |
$123.24
|
|
Inj testosterone cypionate
|
$5.27 |
$5.27 |
$5.27 |
$64.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,049.50 |
$1,049.50 |
$1,049.50 |
$1,152.97
|
|
Inj thrc fascial pln blk uni w/wo image
|
$837.50 |
$837.50 |
$837.50 |
$837.50
|
|
Inj triamcinolone ace X-ray 1mg
|
$3,093.71 |
$3,093.71 |
$3,093.71 |
$1,090.75
|
|
Inj, trivisc 1 mg
|
$37.50 |
$37.50 |
$37.50 |
$6.67
|
|
Inj, tyenne, 1 mg
|
$4,060.49 |
$4,060.49 |
$4,060.49 |
$3,525.12
|
|
Inj, uzedy, 1 mg
|
$50.50 |
$50.50 |
$50.50 |
$11,475.96
|
|
Inj w/fluor eval cv device
|
$503.50 |
$503.50 |
$503.50 |
$503.92
|
|
Inj xipere 1 mg
|
$93.00 |
$93.00 |
$93.00 |
$93.00
|
|
Inj., yutiq, 0.01 mg
|
$1,158.50 |
$1,158.50 |
$1,158.50 |
$14,458.60
|
|
Ins cath ren art 1st bi
|
$9,698.50 |
$9,698.50 |
$9,698.50 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$3,582.00 |
$3,582.00 |
$3,582.00 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$2,865.50 |
$2,865.50 |
$2,865.50 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$5,069.50 |
$5,069.50 |
$5,069.50 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$621.50 |
$621.50 |
$621.50 |
$480.28
|
|
Insert and remove bone pin
|
$3,761.00 |
$3,761.00 |
$3,761.00 |
$4,410.60
|
|
Insert cath pleura with image
|
$1,809.50 |
$1,809.50 |
$1,809.50 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,500.00 |
$2,500.00 |
$2,500.00 |
$2,073.18
|
|
Insert drug delivery implant
|
$168.00 |
$168.00 |
$168.00 |
$280.00
|
|
Insert epicardial lead open 33202
|
$10,524.50 |
$10,524.50 |
$10,524.50 |
$3,775.20
|
|
Insert intervert bimech device 22854
|
$5,586.20 |
$5,586.20 |
$5,586.20 |
$1,573.00
|
|
Insert intrauterine device iud
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$199.00 |
$199.00 |
$199.00 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$342.00 |
$342.00 |
$342.00 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,713.50 |
$3,713.50 |
$3,713.50 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$4,777.00 |
$4,777.00 |
$4,777.00 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$5,069.50 |
$5,069.50 |
$5,069.50 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,497.50 |
$3,497.50 |
$3,497.50 |
$2,505.60
|
|
Insertion of catheter vein
|
$937.50 |
$937.50 |
$937.50 |
$836.25
|
|
Insertion of heart electrode 33211
|
$3,144.00 |
$3,144.00 |
$3,144.00 |
$6,903.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$13,319.50 |
$13,319.50 |
$13,319.50 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$13,319.50 |
$13,319.50 |
$13,319.50 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$28,892.50 |
$28,892.50 |
$28,892.50 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,497.50 |
$2,497.50 |
$2,497.50 |
$2,079.50
|
