|
Injection, isavuconazonium
|
$3.32 |
$3.32 |
$3.32 |
$787.67
|
|
Injection of sinus tract
|
$500.00 |
$500.00 |
$500.00 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$16.14 |
$16.24 |
$23.61 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$257.50 |
$257.50 |
$787.38 |
$670.64
|
|
Injection, renflexis
|
$92.74 |
$92.74 |
$146.19 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,679.70 |
$1,679.70 |
$1,679.70 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$739.86 |
$739.86 |
$1,195.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$515.00 |
$799.92 |
$799.92 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,779.36 |
$1,779.36 |
$1,779.36 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$395.34 |
$395.34 |
$395.34 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,273.70 |
$2,273.70 |
$2,273.70 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$454.74 |
$454.74 |
$454.74 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,281.62 |
$2,281.62 |
$2,281.62 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,878.36 |
$1,878.36 |
$1,878.36 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,704.78 |
$1,704.78 |
$1,704.78 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$341.22 |
$341.22 |
$580.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$355.08 |
$355.08 |
$895.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$395.34 |
$395.34 |
$1,120.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$90.00 |
$143.88 |
$143.88 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$90.00 |
$143.88 |
$143.88 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$90.00 |
$205.92 |
$205.92 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$55.00 |
$105.60 |
$105.60 |
$135.60
|
|
Inject sacroiliac joint
|
$1,318.02 |
$1,318.02 |
$2,250.00 |
$1,028.95
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$61.94 |
$61.94 |
$70.66 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$1,415.50
|
|
Inj for ext venography
|
$576.18 |
$576.18 |
$610.00 |
$649.95
|
|
Inj for mammo ductogram
|
$290.40 |
$290.40 |
$290.40 |
$399.60
|
|
Inj, gadopiclenol, 1 ml
|
$18.80 |
$18.80 |
$19.25 |
$37.63
|
|
Inj. herceptin hylecta, 10mg
|
$147.25 |
$147.25 |
$147.25 |
$7,690.59
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,028.94 |
$1,028.94 |
$1,028.94 |
$1,439.90
|
|
Inj hrt cath w/s&i sel hrt ang
|
$7,695.60 |
$7,695.60 |
$7,695.60 |
$1,827.74
|
|
Inj hrt cath w/s&i sel left vent
|
$793.32 |
$793.32 |
$793.32 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$856.68 |
$856.68 |
$856.68 |
$965.33
|
|
Inj. inebilizumab-cdon, 1 mg
|
$907.13 |
$907.13 |
$907.13 |
$70,014.65
|
|
Inj intralesional <= 7 lsn(s)
|
$229.68 |
$229.68 |
$229.68 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$284.92 |
$284.92 |
$284.92 |
$6,967.29
|
|
Inj, kovaltry, 1 i.u
|
$5.23 |
$5.23 |
$5.23 |
$5.07
|
|
Inj labetalol hcl hikma, 5mg
|
$1.70 |
$1.70 |
$8.09 |
$38.94
|
|
Inj, lanreotide, (cipla) 1mg
|
$146.88 |
$146.88 |
$146.88 |
$11,648.70
|
|
Inj, lecanemab-irmb, 1 mg
|
$2.86 |
$2.86 |
$3.52 |
$1,174.88
|
|
Inj, lidocaine w epinephrine
|
$1.80 |
$1.80 |
$10.78 |
$47.52
|
|
Inj mepivacaine hcl/10 ml
|
$30.13 |
$30.13 |
$30.13 |
$33.86
|
|
Inj moxifloxacin (fres kabi)
|
$61.17 |
$61.17 |
$61.17 |
$95.62
|
|
Inj multihance
|
$10.10 |
$10.10 |
$10.10 |
$73.49
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$809.82 |
$809.82 |
$925.00 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$975.00 |
$975.00 |
$975.00 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$885.00 |
$885.00 |
$885.00 |
$2,609.38
|
|
Inj., patisiran, 0.1 mg
|
$189.87 |
$189.87 |
$189.87 |
$17,613.00
|
|
Inj pemetrexed, hospira 10mg
|
$10.28 |
$10.28 |
$10.28 |
$64.35
|
|
Inj peritoneal venous shunt
|
$453.42 |
$453.42 |
$485.00 |
$413.70
|
|
Inj proc ankle arthr
|
$460.00 |
$611.16 |
$611.16 |
$405.31
|
|
Inj proc elbow arthro
|
$460.00 |
$611.16 |
$611.16 |
$419.60
|
|
Inj proc for lymphang
|
$195.00 |
$195.00 |
$195.00 |
$682.00
|
|
Inj proc lumbr disk ea lvl
|
$1,230.00 |
$1,760.88 |
$1,760.88 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$580.00 |
$859.98 |
$859.98 |
$830.50
|
|
Inj proc sialogram
|
$395.34 |
$395.34 |
$395.34 |
$373.00
|
|
Inj retro urethrocysto
|
$450.00 |
$528.00 |
$528.00 |
$443.50
|
|
Inj scleros sol mult veins
|
$425.00 |
$461.34 |
$461.34 |
$675.00
|
|
Inj scleros sol sgl vein
|
$142.50 |
$142.50 |
$461.34 |
$558.97
|
|
Inj sebelipase alfa 1 mg
|
$990.57 |
$990.57 |
$990.57 |
$539.69
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$125.00 |
$125.00 |
$125.00 |
$436.80
|
|
Inj teclistamab cqyv 0.5 mg
|
$65.30 |
$65.30 |
$71.53 |
$17,517.56
|
|
Inj, tyenne, 1 mg
|
$13.19 |
$13.19 |
$13.19 |
$3,525.12
|
|
Inj vancomycin (xellia) 10mg
|
$0.88 |
$0.88 |
$0.90 |
$76.59
|
|
Inj w/fluor eval cv device
|
$377.50 |
$583.44 |
$583.44 |
$503.92
|
|
Ins cath ren art 1st bi
|
$3,635.28 |
$3,635.28 |
$4,195.00 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$3,004.98 |
$3,004.98 |
$3,355.00 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$4,195.00 |
$4,195.00 |
$4,195.00 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$3,355.00 |
$6,243.60 |
$6,243.60 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$382.50 |
$382.50 |
$382.50 |
$480.28
|
|
Insert and remove bone pin
|
$7,810.44 |
$7,810.44 |
$7,810.44 |
$4,410.60
|
|
Insert cath pleura with image
|
$1,240.00 |
$2,046.00 |
$2,046.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,120.00 |
$2,191.20 |
$2,191.20 |
$2,073.18
|
|
Insert drug delivery implant
|
$305.00 |
$305.00 |
$305.00 |
$280.00
|
|
Insert hepatic shunt (tips)
|
$11,055.00 |
$11,864.82 |
$11,864.82 |
$7,571.20
|
|
Insert intrauterine device iud
|
$267.30 |
$267.30 |
$570.00 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$117.50 |
$215.82 |
$215.82 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$195.00 |
$215.82 |
$215.82 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,125.00 |
$4,434.54 |
$4,434.54 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,571.46 |
$1,571.46 |
$1,571.46 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$4,210.00 |
$7,679.10 |
$7,679.10 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,085.00 |
$3,161.40 |
$3,161.40 |
$2,505.60
|
|
Insertion of catheter vein
|
$880.00 |
$1,367.52 |
$1,367.52 |
$1,477.00
|
|
Insertion of catheter vein
|
$760.00 |
$925.32 |
$925.32 |
$836.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$7,330.62 |
$7,330.62 |
$7,330.62 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$12,087.24 |
$12,087.24 |
$12,087.24 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$5,838.36 |
$5,838.36 |
$5,838.36 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,085.00 |
$1,560.24 |
$1,560.24 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,015.00 |
$3,082.86 |
$3,082.86 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$15,899.40 |
$15,899.40 |
$15,899.40 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$9,558.78 |
$9,558.78 |
$9,558.78 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$9,558.78 |
$9,558.78 |
$9,558.78 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$5,034.48 |
$5,034.48 |
$5,034.48 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$4,180.00 |
$5,794.80 |
$5,794.80 |
$5,223.20
|
|
Insert picvad cath
|
$6,232.38 |
$6,232.38 |
$6,232.38 |
$4,195.00
|
|
Insert pm/icd lead dual
|
$9,769.32 |
$9,769.32 |
$9,769.32 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$20,743.80 |
$20,743.80 |
$20,743.80 |
$32,800.04
|
|
Insert sq defib electrode
|
$10,827.96 |
$10,827.96 |
$10,827.96 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,871.10 |
$1,871.10 |
$4,215.00 |
$2,210.50
|