|
Injection for arthrography wrist (both sides)
|
$398.50 |
$398.50 |
$398.50 |
$448.20
|
|
Injection for bladder x-ray
|
$532.50 |
$532.50 |
$532.50 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$492.50 |
$492.50 |
$492.50 |
$494.65
|
|
Injection, fulvestrant
|
$155.39 |
$155.39 |
$155.39 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$27.00 |
$27.00 |
$27.00 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$646.00 |
$646.00 |
$646.00 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$897.00 |
$897.00 |
$897.00 |
$704.50
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,526.00 |
$2,526.00 |
$2,526.00 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,088.50 |
$1,088.50 |
$1,088.50 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,539.00 |
$1,539.00 |
$1,539.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$4,247.00 |
$4,247.00 |
$4,247.00 |
$2,031.18
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$877.00 |
$877.00 |
$877.00 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$8,128.00 |
$8,128.00 |
$8,128.00 |
$1,984.32
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,623.00 |
$2,623.00 |
$2,623.00 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$1,696.20
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$624.00 |
$624.00 |
$624.00 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$605.50 |
$605.50 |
$605.50 |
$538.00
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$624.00 |
$624.00 |
$624.00 |
$637.35
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$457.50 |
$457.50 |
$457.50 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$354.00 |
$354.00 |
$354.00 |
$147.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$517.00 |
$517.00 |
$517.00 |
$259.49
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$404.00 |
$404.00 |
$404.00 |
$136.20
|
|
Inject sacroiliac joint
|
$818.00 |
$818.00 |
$818.00 |
$984.39
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$73.50 |
$73.50 |
$73.50 |
$32,176.93
|
|
Inj epidural sgl lumb-sacral without img
|
$1,465.50 |
$1,465.50 |
$1,465.50 |
$1,424.00
|
|
Inj, epinephrine (belcher)
|
$5.43 |
$5.43 |
$5.43 |
$6.24
|
|
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
|
$762.50 |
$762.50 |
$762.50 |
$654.00
|
|
Inj. herceptin hylecta, 10mg
|
$10,519.29 |
$10,519.29 |
$10,519.29 |
$8,193.78
|
|
Inj intralesional <= 7 lsn(s)
|
$410.00 |
$410.00 |
$410.00 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$50.50 |
$50.50 |
$50.50 |
$231.00
|
|
Inj, invega hafyera/trinza
|
$28.50 |
$28.50 |
$28.50 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$4,927.50 |
$4,927.50 |
$4,927.50 |
$6,967.29
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$919.00 |
$919.00 |
$919.00 |
$783.50
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$118.50 |
$118.50 |
$118.50 |
$1,496.55
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,058.00 |
$2,058.00 |
$2,058.00 |
$2,485.20
|
|
Inj, pegcetacoplan, 1mg
|
$338.50 |
$338.50 |
$338.50 |
$3,944.73
|
|
Inj., perseris, 0.5 mg
|
$25.00 |
$25.00 |
$25.00 |
$5,372.48
|
|
Inj proc myelogram lumbar
|
$676.50 |
$676.50 |
$676.50 |
$882.70
|
|
Inj retacrit esrd on dialysi
|
$2.50 |
$2.50 |
$2.50 |
$352.22
|
|
Inj retro urethrocysto
|
$169.00 |
$169.00 |
$169.00 |
$450.00
|
|
Inj, rimabotulinumtoxinb
|
$13.00 |
$13.00 |
$13.00 |
$746.79
|
|
Inj scleros sol mult veins
|
$1,431.00 |
$1,431.00 |
$1,431.00 |
$614.00
|
|
Inj scleros sol sgl vein
|
$698.00 |
$698.00 |
$698.00 |
$550.00
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$859.00 |
$859.00 |
$859.00 |
$436.80
|
|
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 |
$36,300.60
|
|
Inj testostero enanthate 1mg
|
$0.50 |
$0.50 |
$0.50 |
$157.81
|
|
Inj testosterone cypionate
|
$0.50 |
$0.50 |
$0.50 |
$64.72
|
|
Inj thrc fascial pln blk bi w/wo image
|
$976.00 |
$976.00 |
$976.00 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$818.00 |
$818.00 |
$818.00 |
$818.00
|
|
Inj triamcinolone ace X-ray 1mg
|
$48.50 |
$48.50 |
$48.50 |
$1,090.75
|
|
Inj, trivisc 1 mg
|
$37.50 |
$37.50 |
$37.50 |
$6.67
|
|
Inj, uzedy, 1 mg
|
$50.50 |
$50.50 |
$50.50 |
$11,475.96
|
|
Inj, vancomycin hcl (mylan)
|
$40.31 |
$40.31 |
$40.31 |
$76.59
|
|
Inj w/fluor eval cv device
|
$345.00 |
$345.00 |
$345.00 |
$490.00
|
|
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
|
$6,939.50 |
$6,939.50 |
$6,939.50 |
$5,809.50
|
|
Ins cath ren art 1st uni
|
$2,772.50 |
$2,772.50 |
$2,772.50 |
$4,667.63
|
|
Ins cerv dilator (sep proc)
|
$353.00 |
$353.00 |
$353.00 |
$473.90
|
|
Insert cath pleura with image
|
$4,081.50 |
$4,081.50 |
$4,081.50 |
$2,164.52
|
|
Insert cath pleura without image
|
$2,205.50 |
$2,205.50 |
$2,205.50 |
$2,019.81
|
|
Insert drug delivery implant
|
$147.00 |
$147.00 |
$147.00 |
$280.00
|
|
Insert epicardial lead open 33202
|
$9,790.00 |
$9,790.00 |
$9,790.00 |
$3,775.20
|
|
Insert intrauterine device iud
|
$3,325.00 |
$3,325.00 |
$3,325.00 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$293.00 |
$293.00 |
$293.00 |
$209.30
|
|
Insertion catheter bladder temporary simple
|
$4,250.00 |
$4,250.00 |
$4,250.00 |
$235.80
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$7,719.50 |
$7,719.50 |
$7,719.50 |
$4,747.60
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,690.50 |
$2,690.50 |
$2,690.50 |
$2,565.36
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$12,092.50 |
$12,092.50 |
$12,092.50 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,359.00 |
$4,359.00 |
$4,359.00 |
$2,595.45
|
|
Insertion of heart electrode 33211
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
$7,048.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$4,988.50 |
$4,988.50 |
$4,988.50 |
$12,450.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$24,286.00 |
$24,286.00 |
$24,286.00 |
$10,010.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,409.50 |
$3,409.50 |
$3,409.50 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,409.50 |
$3,409.50 |
$3,409.50 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$16,164.50 |
$16,164.50 |
$16,164.50 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
$7,413.45
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
$7,539.00
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$18,214.50 |
$18,214.50 |
$18,214.50 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$12,053.00 |
$12,053.00 |
$12,053.00 |
$5,236.80
|
|
Insert pessary/other device
|
$77.50 |
$77.50 |
$77.50 |
$275.80
|
|
Insert pm/icd lead dual
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
$7,429.39
|
|
Insert/repl sq defib w/eltrd
|
$10,482.00 |
$10,482.00 |
$10,482.00 |
$32,800.04
|
|
Insert sq defib electrode
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,809.50 |
$1,809.50 |
$1,809.50 |
$2,269.00
|
|
Insert vad art access left hrt arterial access
|
$3,956.50 |
$3,956.50 |
$3,956.50 |
$4,504.50
|
|
Ins icd gen exist sgl lead
|
$4,988.50 |
$4,988.50 |
$4,988.50 |
$23,742.75
|
|
In situ hybridization per specimen each additional single probe stain
|
$255.50 |
$255.50 |
$255.50 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$345.00 |
$345.00 |
$345.00 |
$326.04
|
|
Ins lv lead exist pm/icd
|
$4,988.50 |
$4,988.50 |
$4,988.50 |
$12,384.25
|
|
Ins pq tunnld ip cath w/img
|
$7,352.00 |
$7,352.00 |
$7,352.00 |
$5,486.00
|
|
Ins/rpl pm gen exist dual lead
|
$4,988.50 |
$4,988.50 |
$4,988.50 |
$11,408.40
|
|
Ins/rpl prph sac/gstr npg/r
|
$4,502.83 |
$4,502.83 |
$4,502.83 |
$18,129.80
|
|
Instillation anticarcinogenic agent bladder
|
$801.50 |
$801.50 |
$801.50 |
$637.50
|
|
Ins tun cv cath wo subq prt/pm
|
$6,939.50 |
$6,939.50 |
$6,939.50 |
$4,218.00
|
|
Insulin total
|
$69.50 |
$69.50 |
$69.50 |
$66.64
|
|
Interrogate subq defib
|
$42.00 |
$42.00 |
$42.00 |
$126.00
|
