|
Inf lwr xtr fscl pln blk uni w/wo image
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$780.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$523.25
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$140.00 |
$140.00 |
$140.00 |
$293.04
|
|
Initiation & management bipap/cpap initial day
|
$170.00 |
$170.00 |
$170.00 |
$576.00
|
|
Inj, bupivacaine liposome
|
$4.33 |
$4.33 |
$4.33 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$9.24 |
$9.24 |
$9.24 |
$29.10
|
|
Inj ceftolozane tazobactam
|
$286.86 |
$286.86 |
$286.86 |
$408.00
|
|
Inj cntr knee arthro incl ct/mri
|
$460.00 |
$460.00 |
$460.00 |
$436.80
|
|
Inj dx for sinogram
|
$380.00 |
$380.00 |
$380.00 |
$413.82
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$460.00 |
$460.00 |
$460.00 |
$500.50
|
|
Injection, daratumumab 10 mg
|
$240.51 |
$240.51 |
$240.51 |
$5,164.24
|
|
Injection epidural blood patch or clot
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$460.00 |
$460.00 |
$460.00 |
$441.12
|
|
Injection for bladder x-ray
|
$380.00 |
$380.00 |
$380.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$460.00 |
$460.00 |
$460.00 |
$494.65
|
|
Injection for spleen x-ray
|
$245.00 |
$245.00 |
$245.00 |
$423.41
|
|
Injection for tear sac x-ray
|
$275.00 |
$275.00 |
$275.00 |
$269.50
|
|
Injection for ureter x-ray
|
$1,615.00 |
$1,615.00 |
$1,615.00 |
$415.80
|
|
Injection for ureter x-ray
|
$640.00 |
$640.00 |
$640.00 |
$515.21
|
|
Injection glatiramer acetate
|
$224.05 |
$224.05 |
$224.05 |
$830.51
|
|
Injection into brain canal
|
$880.00 |
$880.00 |
$880.00 |
$836.40
|
|
Injection jugular
|
$790.00 |
$790.00 |
$790.00 |
$790.00
|
|
Injection of sinus tract
|
$500.00 |
$500.00 |
$500.00 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$21.31 |
$21.31 |
$21.31 |
$2,241.61
|
|
Injection, peramivir
|
$5.27 |
$5.27 |
$5.27 |
$775.82
|
|
Injection radioactive tracer sentinel node (both sides)
|
$257.50 |
$257.50 |
$257.50 |
$683.28
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,195.00 |
$1,195.00 |
$1,195.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$515.00 |
$515.00 |
$515.00 |
$1,045.65
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$580.00 |
$580.00 |
$580.00 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$895.00 |
$895.00 |
$895.00 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$72.50 |
$72.50 |
$72.50 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$72.50 |
$72.50 |
$72.50 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$72.50 |
$72.50 |
$72.50 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$55.00 |
$55.00 |
$55.00 |
$135.20
|
|
Injection treatment of nerve
|
$2,035.00 |
$2,035.00 |
$2,035.00 |
$3,754.40
|
|
Inject sacroiliac joint
|
$2,250.00 |
$2,250.00 |
$2,250.00 |
$963.00
|
|
Inj for ext venography
|
$610.00 |
$610.00 |
$610.00 |
$654.00
|
|
Inj for mammo ductogram
|
$172.50 |
$172.50 |
$172.50 |
$433.50
|
|
Inj labetalol hcl hikma, 5mg
|
$23.88 |
$23.88 |
$23.88 |
$40.00
|
|
Inj, levothyroxine, freskabi
|
$18.73 |
$18.73 |
$18.73 |
$363.97
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$650.00 |
$650.00 |
$650.00 |
$783.50
|
|
Inj., meropenem, vaborbactam
|
$749.26 |
$749.26 |
$749.26 |
$536.27
|
|
Inj, moxifloxacin 100 mg
|
$51.13 |
$51.13 |
$51.13 |
$107.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$925.00 |
$925.00 |
$925.00 |
$1,414.40
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$975.00 |
$975.00 |
$975.00 |
$2,485.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$885.00 |
$885.00 |
$885.00 |
$2,431.74
|
|
Inj octafluoropropane mic,ml
|
$160.00 |
$160.00 |
$160.00 |
$211.40
|
|
Inj peritoneal venous shunt
|
$485.00 |
$485.00 |
$485.00 |
$406.80
|
|
Inj proc ankle arthr
|
$460.00 |
$460.00 |
$460.00 |
$405.31
|
|
Inj proc elbow arthro
|
$460.00 |
$460.00 |
$460.00 |
$432.00
|
|
Inj proc for lymphang
|
$195.00 |
$195.00 |
$195.00 |
$805.80
|
|
Inj proc myelogram lumbar
|
$580.00 |
$580.00 |
$580.00 |
$856.00
|
|
Inj retro urethrocysto
|
$450.00 |
$450.00 |
$450.00 |
$450.00
|
|
Inj scleros sol mult veins
|
$425.00 |
$425.00 |
$425.00 |
$602.50
|
|
Inj scleros sol sgl vein
|
$142.50 |
$142.50 |
$142.50 |
$534.40
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$125.00 |
$125.00 |
$125.00 |
$436.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$775.00 |
$775.00 |
$775.00 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$650.00 |
$650.00 |
$650.00 |
$818.00
|
|
Inj w/fluor eval cv device
|
$377.50 |
$377.50 |
$377.50 |
$463.40
|
|
Ins cath ren art 1st bi
|
$6,400.00 |
$6,400.00 |
$6,400.00 |
$5,741.00
|
|
Ins cath ren art 1st uni
|
$5,120.00 |
$5,120.00 |
$5,120.00 |
$4,692.00
|
|
Ins cath ren art 2nd+ bi
|
$6,400.00 |
$6,400.00 |
$6,400.00 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$5,120.00 |
$5,120.00 |
$5,120.00 |
$5,419.00
|
|
Ins cerv dilator (sep proc)
|
$382.50 |
$382.50 |
$382.50 |
$488.35
|
|
Insert abdomen-venous drain
|
$7,145.00 |
$7,145.00 |
$7,145.00 |
$3,199.20
|
|
Insert cath pleura with image
|
$1,240.00 |
$1,240.00 |
$1,240.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$2,019.00
|
|
Insert drug delivery implant
|
$305.00 |
$305.00 |
$305.00 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$11,055.00 |
$11,055.00 |
$11,055.00 |
$8,367.70
|
|
Insert intrauterine device iud
|
$570.00 |
$570.00 |
$570.00 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$117.50 |
$117.50 |
$117.50 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$195.00 |
$195.00 |
$195.00 |
$229.32
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,125.00 |
$3,125.00 |
$3,125.00 |
$4,731.80
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$4,155.00 |
$4,155.00 |
$4,155.00 |
$7,034.50
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,085.00 |
$1,085.00 |
$1,085.00 |
$2,511.00
|
|
Insertion of catheter vein
|
$880.00 |
$880.00 |
$880.00 |
$1,657.32
|
|
Insertion of catheter vein
|
$760.00 |
$760.00 |
$760.00 |
$836.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,085.00 |
$1,085.00 |
$1,085.00 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,015.00 |
$2,015.00 |
$2,015.00 |
$2,414.10
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,155.00 |
$3,155.00 |
$3,155.00 |
$5,236.80
|
|
Insert pessary/other device
|
$157.50 |
$157.50 |
$157.50 |
$273.54
|
|
Insert picvad cath
|
$2,050.00 |
$2,050.00 |
$2,050.00 |
$4,341.66
|
|
Insert swan-ganz cath
|
$2,725.00 |
$2,725.00 |
$2,725.00 |
$2,210.50
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$2,995.00 |
$2,995.00 |
$2,995.00 |
$5,018.25
|
|
Insert tunneled cv cath
|
$3,155.00 |
$3,155.00 |
$3,155.00 |
$4,580.61
|
|
Insitu hybridization auto
|
$295.00 |
$295.00 |
$295.00 |
$371.00
|
|
Insitu hybridization (fish)
|
$322.50 |
$322.50 |
$322.50 |
$481.60
|
|
Insitu hybridization manual
|
$357.50 |
$357.50 |
$357.50 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$257.50 |
$257.50 |
$257.50 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$322.50 |
$322.50 |
$322.50 |
$326.04
|
|
Ins mark abd/pel for right perq
|
$3,390.00 |
$3,390.00 |
$3,390.00 |
$2,376.00
|
|
Ins mark thor for right perq
|
$2,355.00 |
$2,355.00 |
$2,355.00 |
$2,477.45
|
|
Ins picad w subq port 5yr>
|
$2,160.00 |
$2,160.00 |
$2,160.00 |
$3,912.93
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,855.00 |
$1,855.00 |
$1,855.00 |
$1,609.25
|
|
Ins pq tunnld ip cath w/img
|
$3,490.00 |
$3,490.00 |
$3,490.00 |
$5,377.00
|
|
Inst fibrinolysis agent ini day
|
$905.00 |
$905.00 |
$905.00 |
$1,090.80
|
|
Ins tun cv cath wo subq prt/pm
|
$2,735.00 |
$2,735.00 |
$2,735.00 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$2,735.00 |
$2,735.00 |
$2,735.00 |
$4,202.70
|
