|
Injection radioactive tracer sentinel node (both sides)
|
$822.25 |
$822.25 |
$822.25 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,372.60 |
$3,372.60 |
$3,372.60 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$786.50 |
$786.50 |
$786.50 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,647.80 |
$1,647.80 |
$1,647.80 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$4,455.00 |
$4,455.00 |
$4,455.00 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,955.05 |
$3,955.05 |
$3,955.05 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,495.70 |
$4,495.70 |
$4,495.70 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$3,955.05 |
$3,955.05 |
$3,955.05 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,495.70 |
$4,495.70 |
$4,495.70 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,696.75 |
$1,696.75 |
$1,696.75 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,708.85 |
$1,708.85 |
$1,708.85 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$937.75 |
$937.75 |
$937.75 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$717.75 |
$717.75 |
$717.75 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$811.80 |
$811.80 |
$811.80 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$213.40 |
$213.40 |
$213.40 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$213.40 |
$213.40 |
$213.40 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$213.40 |
$213.40 |
$213.40 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$59.40 |
$59.40 |
$59.40 |
$141.60
|
|
Inject sacroiliac joint
|
$1,721.50 |
$1,721.50 |
$1,721.50 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$1,097.80 |
$1,097.80 |
$1,097.80 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,072.50 |
$1,072.50 |
$1,072.50 |
$1,450.84
|
|
Inj for ext venography
|
$396.55 |
$396.55 |
$396.55 |
$737.55
|
|
Inj for mammo ductogram
|
$231.00 |
$231.00 |
$231.00 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,439.90 |
$1,439.90 |
$1,439.90 |
$1,482.00
|
|
Inj hrt cath w/s&i sel left vent
|
$1,072.50 |
$1,072.50 |
$1,072.50 |
$1,214.40
|
|
Inj intralesional <= 7 lsn(s)
|
$380.60 |
$380.60 |
$380.60 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$406.45 |
$406.45 |
$406.45 |
$234.00
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$3,866.50 |
$3,866.50 |
$3,866.50 |
$625.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$931.70 |
$931.70 |
$931.70 |
$1,522.56
|
|
Inj peritoneal venous shunt
|
$61.60 |
$61.60 |
$61.60 |
$386.88
|
|
Inj proc ankle arthr
|
$326.70 |
$326.70 |
$326.70 |
$405.31
|
|
Inj proc elbow arthro
|
$139.15 |
$139.15 |
$139.15 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$1,736.90 |
$1,736.90 |
$1,736.90 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$2,264.35 |
$2,264.35 |
$2,264.35 |
$922.80
|
|
Inj retro urethrocysto
|
$335.50 |
$335.50 |
$335.50 |
$551.29
|
|
Inj scleros sol mult veins
|
$399.96 |
$399.96 |
$399.96 |
$687.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$7,733.00 |
$7,733.00 |
$7,733.00 |
$1,483.20
|
|
Inj thrc fascial pln blk uni w/wo image
|
$3,866.50 |
$3,866.50 |
$3,866.50 |
$1,252.02
|
|
Inj w/fluor eval cv device
|
$382.80 |
$382.80 |
$382.80 |
$588.90
|
|
Ins cath ren art 1st bi
|
$6,617.60 |
$6,617.60 |
$6,617.60 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$3,309.90 |
$3,309.90 |
$3,309.90 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$9,092.60 |
$9,092.60 |
$9,092.60 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$4,569.40 |
$4,569.40 |
$4,569.40 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$371.80 |
$371.80 |
$371.80 |
$544.00
|
|
Insert cath pleura with image
|
$1,554.85 |
$1,554.85 |
$1,554.85 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,437.15 |
$1,437.15 |
$1,437.15 |
$2,212.00
|
|
Insert drug delivery implant
|
$221.10 |
$221.10 |
$221.10 |
$285.80
|
|
Insert hepatic shunt (tips)
|
$10,632.05 |
$10,632.05 |
$10,632.05 |
$9,754.48
|
|
Insertion catheter bladder non indwelling
|
$309.10 |
$309.10 |
$309.10 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$476.85 |
$476.85 |
$476.85 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,747.60 |
$4,747.60 |
$4,747.60 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,529.45 |
$2,529.45 |
$2,529.45 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,366.00 |
$3,366.00 |
$3,366.00 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,288.65 |
$1,288.65 |
$1,288.65 |
$2,618.40
|
|
Insertion of catheter vein
|
$616.55 |
$616.55 |
$616.55 |
$1,749.80
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,939.45 |
$5,939.45 |
$5,939.45 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$5,940.00 |
$5,940.00 |
$5,940.00 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$21,765.15 |
$21,765.15 |
$21,765.15 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,525.70 |
$1,525.70 |
$1,525.70 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,943.15 |
$1,943.15 |
$1,943.15 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$20,031.00 |
$20,031.00 |
$20,031.00 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,831.65 |
$5,831.65 |
$5,831.65 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$6,231.50 |
$6,231.50 |
$6,231.50 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$7,699.45 |
$7,699.45 |
$7,699.45 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$4,302.65 |
$4,302.65 |
$4,302.65 |
$5,470.54
|
|
Insert pessary/other device
|
$155.65 |
$155.65 |
$155.65 |
$278.90
|
|
Insert pm/icd lead dual
|
$7,115.90 |
$7,115.90 |
$7,115.90 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$20,867.00 |
$20,867.00 |
$20,867.00 |
$33,948.20
|
|
Insert sq defib electrode
|
$7,342.50 |
$7,342.50 |
$7,342.50 |
$8,167.68
|
|
Insert vad art access left hrt arterial access
|
$2,709.85 |
$2,709.85 |
$2,709.85 |
$5,062.80
|
|
Ins icd gen exist mlt leads
|
$20,461.10 |
$20,461.10 |
$20,461.10 |
$31,286.77
|
|
Insitu hybridization (fish)
|
$1,121.45 |
$1,121.45 |
$1,121.45 |
$481.60
|
|
Insj rx elut implt lac canal
|
$262.35 |
$262.35 |
$262.35 |
$2,582.26
|
|
Ins lv lead exist pm/icd
|
$21,388.40 |
$21,388.40 |
$21,388.40 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$1,264.45 |
$1,264.45 |
$1,264.45 |
$2,070.00
|
|
Ins mark thor for right perq
|
$1,294.70 |
$1,294.70 |
$1,294.70 |
$2,396.35
|
|
Ins picad w subq port 5yr>
|
$2,494.80 |
$2,494.80 |
$2,494.80 |
$4,341.66
|
|
Ins pm gen w/exist mlt leads
|
$3,353.35 |
$3,353.35 |
$3,353.35 |
$15,600.75
|
|
Ins pq tunnld ip cath w/img
|
$3,232.90 |
$3,232.90 |
$3,232.90 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$13,364.45 |
$13,364.45 |
$13,364.45 |
$24,135.54
|
|
Ins/rpl pm gen exist sgl lead
|
$2,857.25 |
$2,857.25 |
$2,857.25 |
$9,746.29
|
|
Ins/rpl pm w/tv ld atrl
|
$5,883.35 |
$5,883.35 |
$5,883.35 |
$12,384.25
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$33,184.25 |
$33,184.25 |
$33,184.25 |
$25,106.90
|
|
Inst fibrinolysis agent ini day
|
$712.25 |
$712.25 |
$712.25 |
$1,095.00
|
|
Inst fibrinolysis agent sbsq d
|
$712.25 |
$712.25 |
$712.25 |
$898.12
|
|
Instillation anticarcinogenic agent bladder
|
$548.29 |
$548.29 |
$548.29 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$11,149.60 |
$11,149.60 |
$11,149.60 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$2,621.85 |
$2,621.85 |
$2,621.85 |
$4,748.00
|
|
Inst via cath agent pleurds
|
$1,576.85 |
$1,576.85 |
$1,576.85 |
$1,074.68
|
|
Insulin total
|
$100.10 |
$100.10 |
$100.10 |
$67.60
|
|
Integra meshed bil wound mat
|
$3,306.93 |
$3,306.93 |
$3,306.93 |
$24,354.93
|
|
Interdiscal perq aspir dx
|
$556.05 |
$556.05 |
$556.05 |
$1,222.26
|
|
Interrog dev eval icpms ip
|
$144.10 |
$144.10 |
$144.10 |
$106.80
|
|
Interrog dev eval scrms ip
|
$133.10 |
$133.10 |
$133.10 |
$124.80
|
|
Interrog device eval heart
|
$168.30 |
$168.30 |
$168.30 |
$150.00
|
|
Interrog evl pm/ldls pm ip
|
$143.00 |
$143.00 |
$143.00 |
$127.20
|
|
Intra-atrial recording
|
$7,333.70 |
$7,333.70 |
$7,333.70 |
$5,707.00
|
|
Intracard echo interv w/s&i
|
$5,370.75 |
$5,370.75 |
$5,370.75 |
$3,982.59
|
|
Intrinsic factor antibody
|
$83.60 |
$83.60 |
$83.60 |
$59.95
|
|
Intro cath dialysis circuit
|
$672.10 |
$672.10 |
$672.10 |
$2,317.80
|
