|
Infliximab-axxq 100 mg intravenous solution
|
$89.49 |
$89.49 |
$89.49 |
$1,144.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$169.36 |
$169.36 |
$169.36 |
$1,654.83
|
|
Influenza dna amp prob addl
|
$26.79 |
$26.79 |
$26.79 |
$69.60
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$982.11 |
$982.11 |
$982.11 |
$629.60
|
|
Initiation & management bipap/cpap initial day
|
$489.06 |
$489.06 |
$489.06 |
$645.79
|
|
Inj, abilify maintena, 1 mg
|
$10.47 |
$10.47 |
$10.47 |
$6,324.82
|
|
Inj anifrolumab-fnia 1mg
|
$27.86 |
$27.86 |
$27.86 |
$9,878.82
|
|
Inj, bezlotoxumab, 10 mg
|
$22.62 |
$22.62 |
$22.62 |
$9,702.65
|
|
Inj calcitriol per 0.1 mcg
|
$2.50 |
$2.50 |
$2.50 |
$33.36
|
|
Inj, clevidipine butyrate
|
$295.21 |
$295.21 |
$295.21 |
$3.39
|
|
Inj cntr knee arthro incl ct/mri
|
$823.65 |
$823.65 |
$823.65 |
$464.28
|
|
Inj dx for sinogram
|
$670.89 |
$670.89 |
$670.89 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$934.80 |
$934.80 |
$934.80 |
$507.10
|
|
Injection, cangrelor
|
$29.84 |
$29.84 |
$29.84 |
$2,546.20
|
|
Injection, daratumumab 10 mg
|
$109.86 |
$109.86 |
$109.86 |
$7,107.73
|
|
Injection, doxercalciferol
|
$1.88 |
$1.88 |
$1.88 |
$30.35
|
|
Injection during cath supravalvular aortography
|
$307.23 |
$307.23 |
$307.23 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$892.05 |
$892.05 |
$892.05 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$661.20 |
$661.20 |
$661.20 |
$441.12
|
|
Injection for bladder x-ray
|
$1,067.61 |
$1,067.61 |
$1,067.61 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$803.13 |
$803.13 |
$803.13 |
$504.00
|
|
Injection for ureter x-ray
|
$547.77 |
$547.77 |
$547.77 |
$515.21
|
|
Injection, fulvestrant
|
$39.39 |
$39.39 |
$39.39 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$19.45 |
$19.45 |
$19.45 |
$10,366.61
|
|
Injection into brain canal
|
$1,457.49 |
$1,457.49 |
$1,457.49 |
$933.60
|
|
Injection,onabotulinumtoxina
|
$10.76 |
$10.76 |
$10.76 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$897.75 |
$897.75 |
$897.75 |
$717.20
|
|
Injection, renflexis
|
$135.08 |
$135.08 |
$135.08 |
$1,457.42
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$780.33 |
$780.33 |
$780.33 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$596.22 |
$596.22 |
$596.22 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,337.22 |
$1,337.22 |
$1,337.22 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$739.86 |
$739.86 |
$739.86 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,010.96 |
$2,010.96 |
$2,010.96 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$661.77 |
$661.77 |
$661.77 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,340.07 |
$1,340.07 |
$1,340.07 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,946.55 |
$1,946.55 |
$1,946.55 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,946.55 |
$1,946.55 |
$1,946.55 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$542.64 |
$542.64 |
$542.64 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$384.18 |
$384.18 |
$384.18 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$117.42 |
$117.42 |
$117.42 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$117.42 |
$117.42 |
$117.42 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$120.27 |
$120.27 |
$120.27 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$79.23 |
$79.23 |
$79.23 |
$141.60
|
|
Inject sacroiliac joint
|
$984.39 |
$984.39 |
$984.39 |
$1,090.00
|
|
Inj for ext venography
|
$1,852.50 |
$1,852.50 |
$1,852.50 |
$737.55
|
|
Inj for mammo ductogram
|
$335.16 |
$335.16 |
$335.16 |
$433.50
|
|
Inj., guselkumab, 1 mg
|
$91.93 |
$91.93 |
$91.93 |
$74.86
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$446.88 |
$446.88 |
$446.88 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$307.23 |
$307.23 |
$307.23 |
$1,837.17
|
|
Inj hrt cath w/s&i sel left vent
|
$1,927.17 |
$1,927.17 |
$1,927.17 |
$1,214.40
|
|
Inj ivig privigen 500 mg
|
$145.50 |
$145.50 |
$145.50 |
$7,298.71
|
|
Inj levocarnitine per 1 gm
|
$81.19 |
$81.19 |
$81.19 |
$138.96
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,287.63 |
$1,287.63 |
$1,287.63 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$159.71 |
$159.71 |
$159.71 |
$3,968.67
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$132.92 |
$132.92 |
$132.92 |
$6,403.59
|
|
Inj proc elbow arthro
|
$383.04 |
$383.04 |
$383.04 |
$453.60
|
|
Inj proc for lymphang
|
$497.04 |
$497.04 |
$497.04 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$1,800.06 |
$1,800.06 |
$1,800.06 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$1,719.69 |
$1,719.69 |
$1,719.69 |
$922.80
|
|
Inj retro urethrocysto
|
$969.57 |
$969.57 |
$969.57 |
$551.29
|
|
Inj scleros sol mult veins
|
$719.34 |
$719.34 |
$719.34 |
$687.96
|
|
Inj scleros sol sgl vein
|
$688.56 |
$688.56 |
$688.56 |
$534.40
|
|
Inj teclistamab cqyv 0.5 mg
|
$56.73 |
$56.73 |
$56.73 |
$14,653.61
|
|
Inj. teprotumumab-trbw 10 mg
|
$271.75 |
$271.75 |
$271.75 |
$47,971.67
|
|
Inj testosterone cypionate
|
$171.00 |
$171.00 |
$171.00 |
$77.15
|
|
Inj triamcinolone ace X-ray 1mg
|
$37.11 |
$37.11 |
$37.11 |
$17.75
|
|
Inj w/fluor eval cv device
|
$621.30 |
$621.30 |
$621.30 |
$588.90
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$4,187.38 |
$4,187.38 |
$4,187.38 |
$3,429.94
|
|
Ins cath ren art 1st bi
|
$8,319.15 |
$8,319.15 |
$8,319.15 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$7,588.98 |
$7,588.98 |
$7,588.98 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$10,202.43 |
$10,202.43 |
$10,202.43 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$226.29 |
$226.29 |
$226.29 |
$544.00
|
|
Insert cath pleura with image
|
$3,452.49 |
$3,452.49 |
$3,452.49 |
$2,239.02
|
|
Insert cath pleura without image
|
$2,758.80 |
$2,758.80 |
$2,758.80 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$11,082.51 |
$11,082.51 |
$11,082.51 |
$9,754.48
|
|
Insertion catheter bladder non indwelling
|
$196.08 |
$196.08 |
$196.08 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$121.98 |
$121.98 |
$121.98 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,821.41 |
$5,821.41 |
$5,821.41 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,753.10 |
$2,753.10 |
$2,753.10 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,483.88 |
$8,483.88 |
$8,483.88 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,600.91 |
$2,600.91 |
$2,600.91 |
$2,618.40
|
|
Insertion of catheter vein
|
$1,322.97 |
$1,322.97 |
$1,322.97 |
$1,749.80
|
|
Insertion of catheter vein
|
$1,492.83 |
$1,492.83 |
$1,492.83 |
$858.05
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$30,829.02 |
$30,829.02 |
$30,829.02 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$25,392.36 |
$25,392.36 |
$25,392.36 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$33,872.82 |
$33,872.82 |
$33,872.82 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,645.94 |
$2,645.94 |
$2,645.94 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,419.65 |
$2,419.65 |
$2,419.65 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$80,740.50 |
$80,740.50 |
$80,740.50 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$16,097.94 |
$16,097.94 |
$16,097.94 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$16,097.94 |
$16,097.94 |
$16,097.94 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$17,204.31 |
$17,204.31 |
$17,204.31 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$7,579.29 |
$7,579.29 |
$7,579.29 |
$5,470.54
|
|
Insert pm/icd lead dual
|
$16,097.94 |
$16,097.94 |
$16,097.94 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$71,190.72 |
$71,190.72 |
$71,190.72 |
$33,948.20
|
|
Insert swan-ganz cath
|
$2,391.15 |
$2,391.15 |
$2,391.15 |
$2,164.52
|
|
Insert uteri tandem/ovoids
|
$9,112.59 |
$9,112.59 |
$9,112.59 |
$3,986.00
|
|
Insert vad art access left hrt arterial access
|
$76,071.06 |
$76,071.06 |
$76,071.06 |
$5,062.80
|
|
Ins icd gen exist sgl lead
|
$42,140.67 |
$42,140.67 |
$42,140.67 |
$24,159.72
|
|
Insitu hybridization auto
|
$524.97 |
$524.97 |
$524.97 |
$398.16
|
