healthcosts.net

Hospital prices in Edison, New Jersey

1 hospitals publish price files here.

Hospital Address System Priced procedures
JFK Johnson Rehabilitation Institute (JRI) 65 James Street Hackensack Meridian Health 9390

Cash prices in Edison

Procedure Lowest cash Median here Highest National median
#a/b/c/c/h pnl-candida albicans ab $12.01 $12.01 $12.01 $133.20
#acylcarnitineprfl $16.87 $16.87 $16.87 $169.20
#afb mycobacteria suscep. #1 $7.31 $7.31 $7.31 $41.40
#aptt mix-1:1 incubated $35.09 $35.09 $35.09 $256.80
#bac vag cand-c. albicans naa $35.09 $35.09 $35.09 $220.80
#cbg+cort-cbg $18.00 $18.00 $18.00 $156.75
#celiac hla-dq2 $94.74 $94.74 $94.74 $94.74
#celiac hla-dq8 $109.13 $109.13 $109.13 $1,607.40
#cf-97variants $556.60 $556.60 $556.60 $3,108.00
#cms hgb-carboxyhemoglobin $14.07 $14.07 $14.07 $14.07
#cms hgb-sulfhemoglobin $8.80 $8.80 $8.80 $132.75
#cmvcul-virus inoculation shell $19.56 $19.56 $19.56 $55.20
#covid19rsv-rsv $70.20 $70.20 $70.20 $75.75
#coxa-coxsackie a serotype a16 $13.03 $13.03 $13.03 $110.40
#creutz-prot.,western blot $29.21 $29.21 $29.21 $176.80
#fecal-sodium $4.86 $4.86 $4.86 $86.25
#hypersens-actinomyces ab $10.18 $10.18 $10.18 $10.18
#resp virpnl dfa-adenovirus $14.43 $14.43 $14.43 $139.80
#resp virpnl dfa-parainfluenza $16.43 $16.43 $16.43 $16.43
(both sides) smear without diff wbc count $3.43 $3.43 $3.43 $121.80
11-desoxycortisol - sendout $29.28 $29.28 $29.28 $148.20
17-hydroxypregnenolone $22.81 $22.81 $22.81 $168.60
17-ketosteroids $12.80 $12.80 $12.80 $249.60
1st hosp/birthing center care per day nml nb 99460 $128.87 $128.87 $128.87 $128.87
2019-ncov diagnostic p $35.92 $35.92 $35.92 $35.92
24 hr ambulatory b/p monitor $128.90 $128.90 $128.90 $162.60
2d tee w or without fol w/con,in $790.06 $790.06 $790.06 $1,641.60
2d tte w or without fol w/con,co $790.06 $790.06 $790.06 $1,278.75
3-d radiotherapy plan $1,368.26 $1,368.26 $1,368.26 $4,423.20
3d anat seg imaging preop $156.46 $156.46 $156.46 $156.46
3d bn img algor drvd fr MRI $156.46 $156.46 $156.46 $156.46
5' nucleotidase - sendout $11.15 $11.15 $11.15 $243.00
Abatacept (with maltose) 250 mg intravenous solution $44.49 $44.49 $44.49 $213.00
Abd aorta w/runoff s&i $3,147.50 $3,147.50 $3,147.50 $4,245.00
Abd paracentesis/w/o image guide 49082 $937.56 $937.56 $937.56 $1,505.25
Abdominal CT scan (with and without contrast) $178.02 $178.02 $178.02 $2,049.00
Abdominal CT scan (with contrast) $178.02 $178.02 $178.02 $1,683.63
Abdominal CT scan (without contrast) $106.34 $106.34 $106.34 $1,358.76
Abdominal MRI (with and without contrast) $357.13 $357.13 $357.13 $3,061.80
Abdominal MRI (with contrast) $357.13 $357.13 $357.13 $2,077.14
Abdominal MRI (without contrast) $241.72 $241.72 $241.72 $1,902.00
Abdominal Ultrasound (complete) $106.34 $106.34 $106.34 $755.00
Abdominal Ultrasound (limited) $106.34 $106.34 $106.34 $629.42
Abdominal paracentesis w/image guidance $937.56 $937.56 $937.56 $1,689.00
Abdominoplasty 15830 $6,521.46 $6,521.46 $6,521.46 $3,040.80
Abl1 gene $300.00 $300.00 $300.00 $1,282.20
Ablate bone tumor(s) cryo perq 20983 $7,143.73 $7,143.73 $7,143.73 $5,246.25
Ablate bone tumor(s) perq $12,866.82 $12,866.82 $12,866.82 $5,092.50
Ablate heart dysrhythm focus $7,588.10 $7,588.10 $7,588.10 $7,588.10
Ablate inf turbinate submuc 30802 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Ablate inf turbinate superf 30801 $1,481.28 $1,481.28 $1,481.28 $1,849.50
Ablate pulm tumor perq crybl $10,411.22 $10,411.22 $10,411.22 $10,411.22
Ablate pulm tumor perq rf $5,834.36 $5,834.36 $5,834.36 $5,834.36
Ablation cardiac vagal inputs atrium $156.46 $156.46 $156.46 $377.40
Ablation cryo abd perit om $937.56 $937.56 $937.56 $6,311.40
Ablation cryo adrenal tumor $5,834.36 $5,834.36 $5,834.36 $5,790.75
Ablation cryo pq chest wall tumor(s) w/guid $239.88 $239.88 $239.88 $234.00
Ablation cryo pq liver tumor(s) $10,411.22 $10,411.22 $10,411.22 $8,080.50
Ablation cryo retro lymph node $437.18 $437.18 $437.18 $437.18
Ablation cryo thigh/knee $239.88 $239.88 $239.88 $274.50
Ablation of upper extremity nerves rf $295.19 $295.19 $295.19 $2,242.80
Ablt trurl prst8 tis trnsdcr $12,992.42 $12,992.42 $12,992.42 $12,992.42
Abltj 1/+thyr ndul 1lobe prq $1,620.24 $1,620.24 $1,620.24 $1,620.24
Abltj mal prst8 tiss hifu $9,247.15 $9,247.15 $9,247.15 $9,247.15
Abobotulinumtoxina $9.17 $9.17 $9.17 $61.20
Abortion (mpr) $304.19 $304.19 $304.19 $304.19
Abrasion lesion single $198.70 $198.70 $198.70 $198.70
Abscess drain retroperitoneal surg code $1,620.24 $1,620.24 $1,620.24 $5,568.60
Acetaminophen level $18.64 $18.64 $18.64 $159.60
Acetone qualitative $4.52 $4.52 $4.52 $50.40
Acetylcholine receptor modulating antibody $12.05 $12.05 $12.05 $300.00
Acetylcholinesterase assay $12.29 $12.29 $12.29 $12.29
Acid perfusion of esophagus $530.60 $530.60 $530.60 $530.60
Acne surgery 10040 $198.70 $198.70 $198.70 $265.20
Aco annual medicare visit (awv), initial g0438aco $206.14 $206.14 $206.14 $225.00
Aco annual medicare visit (awv), subsq g0439aco $160.69 $160.69 $160.69 $160.50
Aco ccm; at least 20 min 99490aco $92.50 $92.50 $92.50 $92.50
Aco cmplx chron care without pt visit, 60 min 99487aco $160.67 $160.67 $160.67 $160.67
Aco cont gluc mnt phys/qhp eqp 95250aco $128.87 $128.87 $128.87 $417.00
Aco depression screen annual medicare g0444aco $29.79 $29.79 $29.79 $29.79
Aco med nutria tx/group, ea 30 min 97804aco $19.31 $19.31 $19.31 $30.00
Acoustic immitance testing $156.46 $156.46 $156.46 $141.75
Acoustic refl threshold tst $39.25 $39.25 $39.25 $39.25
Acromp/acromionectomy prtl $3,244.61 $3,244.61 $3,244.61 $3,244.61
Actigraphy testing $59.40 $59.40 $59.40 $59.40
Actinotherapy uv light $39.25 $39.25 $39.25 $138.75
Acup 1/> w/estim 1st 15 min $24.49 $24.49 $24.49 $42.75
Acup 1/> wo estim 1st 15 min $24.49 $24.49 $24.49 $42.75
Acute hepatitis panel $47.63 $47.63 $47.63 $490.20
Acute venous thrombus image $1,305.48 $1,305.48 $1,305.48 $632.25
Acylcarnitines qual $16.49 $16.49 $16.49 $16.49
Adapt behavior tx phys/qhp $160.67 $160.67 $160.67 $114.00
Adding walker to prev cast $157.79 $157.79 $157.79 $157.79
Adenovirus ag ia $11.98 $11.98 $11.98 $24.00
Adenovirus antibody,serum - quest $12.87 $12.87 $12.87 $84.60
Adenovirus assay w/optic $21.76 $21.76 $21.76 $21.76
Adh-sendout $33.94 $33.94 $33.94 $360.00
Adj gastric band via subq port $937.56 $937.56 $937.56 $2,977.20
Adj tis trans/see area/10.1-30sqcm 14041 $1,829.23 $1,829.23 $1,829.23 $3,955.80
Adjmt/revj ext fixj sys anes $7,143.73 $7,143.73 $7,143.73 $4,493.40
Administration chemotherapy IV infusion each additional hour $71.17 $71.17 $71.17 $269.60
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr $71.17 $71.17 $71.17 $322.20
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug $331.69 $331.69 $331.69 $771.00
Administration chemotherapy IV push single/initial substance/drug $331.69 $331.69 $331.69 $508.20
Administration chemotherapy subcutaneous/im anti neoplastic hormonal $71.17 $71.17 $71.17 $254.40
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal $71.17 $71.17 $71.17 $254.40
Administration immunization 1 vaccine $71.17 $71.17 $71.17 $12.60
Administration immunization intranasal/oral route 1 vaccine $71.17 $71.17 $71.17 $40.50
Administration vaccine hepatitis b $46.14 $46.14 $46.14 $12.60
Administration vaccine influenza virus $46.14 $46.14 $46.14 $12.00
Administration vaccine pneumococcal $46.14 $46.14 $46.14 $12.00
Ado-trastuzumab emtansine 100 mg intravenous solution $41.85 $41.85 $41.85 $106.80
Adrenal cortex & medulla img $1,305.48 $1,305.48 $1,305.48 $1,703.40
Aep hearing status deter i&r $311.40 $311.40 $311.40 $336.60
Aep neurodiagnostic i&r $311.40 $311.40 $311.40 $519.60
Aep thrshld est mlt freq i&r $311.40 $311.40 $311.40 $867.00
Afamelanotide implant, 1 mg $2,943.42 $2,943.42 $2,943.42 $6,529.20
Aflibercept injection $790.04 $790.04 $790.04 $790.04
After cataract laser surgery $548.60 $548.60 $548.60 $1,380.00
Agalsidase beta 35 mg intravenous solution $230.26 $230.26 $230.26 $27,295.80
Air conduction bilat $128.90 $128.90 $128.90 $106.50
Airway resistance by impulse oscillometry 94728 $156.46 $156.46 $156.46 $393.00
Albumin (human), 5%, 250 ml $53.08 $53.08 $53.08 $609.00
Albumin (microalbumin) 24 hour urine quantitative $5.78 $5.78 $5.78 $63.75
Albumin body fluid quantitative each specimen $7.78 $7.78 $7.78 $37.20
Albumin ischemia modified $33.94 $33.94 $33.94 $33.94
Albumin serum plasma or whole blood $4.95 $4.95 $4.95 $43.50
Albumin, human 25 % intravenous solution $21.23 $21.23 $21.23 $21.23
Alcohol (ethanol) any specimen except urine/breath $17.27 $17.27 $17.27 $56.25
Alcohol/sub misuse assess $24.49 $24.49 $24.49 $24.49
Alcohol/subs interv >30 min $160.67 $160.67 $160.67 $160.67
Aldesleukin injection $5,301.26 $5,301.26 $5,301.26 $6,538.20
Alemtuzumab 12 mg/1.2 ml intravenous solution $2,440.70 $2,440.70 $2,440.70 $8,173.80
Alkaline phosphatase $5.18 $5.18 $5.18 $45.75
All tstg perq&iq drugs/biol $39.25 $39.25 $39.25 $70.50
All tstg perq&iq w/venoms $24.49 $24.49 $24.49 $24.49
Allergen alpha lactalbumin ige $17.93 $17.93 $17.93 $57.60
Allergen egg white ige $5.22 $5.22 $5.22 $57.60
Allergen specific ige qual multi scrn ea $7.97 $7.97 $7.97 $39.00
Allergy Skin Testing $1,017.39 $1,017.39 $1,017.39 $47.44
Allergy injection; single 95115 $46.14 $46.14 $46.14 $42.75
Allergy injections; 2 or more 95117 $46.14 $46.14 $46.14 $46.14
Allg patch or app # of tests 95044 $1,017.39 $1,017.39 $1,017.39 $780.00
Allgrft implnt knee w/scope $12,866.82 $12,866.82 $12,866.82 $12,866.82
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution $5.19 $5.19 $5.19 $40.40
Alpha-fetoprotein afp-l3 frac & total $64.41 $64.41 $64.41 $326.40
Alpha-fetoprotein amniotic $17.00 $17.00 $17.00 $138.60
Alpha-fetoprotein tumor marker $16.77 $16.77 $16.77 $139.20
Alt/sgpt $5.30 $5.30 $5.30 $77.25
Alteplase 100 mg infusion from pyxis vial $94.15 $94.15 $94.15 $9,848.40
Altuviiio per factor viii iu $4.67 $4.67 $4.67 $4.67
Aluminum - quest $25.48 $25.48 $25.48 $168.00
Alveoloplasty each quadrant $3,243.07 $3,243.07 $3,243.07 $3,243.07
Alys cplx sp/pn npgt w/prgrm $91.79 $91.79 $91.79 $1,074.00
Ambl bp mntr w/sw a/r $128.90 $128.90 $128.90 $199.50
Amino acid screen, urine $13.87 $13.87 $13.87 $13.87
Amino acid single qual $14.18 $14.18 $14.18 $14.18
Amino acids quant 2-5 $19.61 $19.61 $19.61 $220.80
Aminolevulinic acid delta $16.45 $16.45 $16.45 $178.80
Aminolevulinic acid hcl top $393.87 $393.87 $393.87 $393.87
Aminolevulinic acid, 10% gel $1.81 $1.81 $1.81 $1.81
Amivantamab-vmjw 50 mg/ml intravenous solution $22.21 $22.21 $22.21 $298.20
Ammonia $14.57 $14.57 $14.57 $126.00
Amniocentesis therapeutic $304.19 $304.19 $304.19 $747.75
Amniocentesisdiagnostic 59000 $870.74 $870.74 $870.74 $870.74
Amniotic fluid scan $9.35 $9.35 $9.35 $202.80
Amp f/th 1/2 jt/phalanx w/neurect local flap $3,244.61 $3,244.61 $3,244.61 $4,150.20
Amp metatarsal w/toe single 28810 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amphotericin b lipid complex $10.30 $10.30 $10.30 $272.40
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr $22.62 $22.62 $22.62 $592.80
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis $262.99 $262.99 $262.99 $280.20
Amputate hand at wrist $1,600.41 $1,600.41 $1,600.41 $1,600.41
Amputate metacarpal bone 26910 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amputation follow-up surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amputation follow-up surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amputation follow-up surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amputation follow-up surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Amputation follow-up surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amputation follow-up surgery $1,829.23 $1,829.23 $1,829.23 $1,829.23
Amputation follow-up surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amputation of foot at ankle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Amputation thru metatarsal $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amputation toe interphalangeal joint $3,244.61 $3,244.61 $3,244.61 $3,304.80
Amputation toe metatarsophalangeal joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Amylase $6.48 $6.48 $6.48 $113.40
An cholangiogram percutaneous compl $3,529.06 $3,529.06 $3,529.06 $3,342.00
Ana ds-dna $12.11 $12.11 $12.11 $178.80
Anacaulase-bcdb 8.8% gel 1 g $58.32 $58.32 $58.32 $58.32
Anal pressure record $311.40 $311.40 $311.40 $954.00
Anal/urinary muscle study $243.21 $243.21 $243.21 $981.00
Anal/urinary muscle study $156.46 $156.46 $156.46 $580.20
Analysis complx cranial nerve pulse gen prgrmg 95977 $91.79 $91.79 $91.79 $1,058.25
Analysis gene f2 20210g>a variant $65.69 $65.69 $65.69 $2,361.60
Analysis gene f5 leiden variant $73.37 $73.37 $73.37 $1,021.80
Analysis nerve $53.43 $53.43 $53.43 $53.43
Analysis tumor $171.36 $171.36 $171.36 $171.36
Analysis; simple cranial nerv pulse gen prgrmg 95976 $37.29 $37.29 $37.29 $1,038.00
Analyze neurostimulator simple w/reprogramming 95971 $91.79 $91.79 $91.79 $670.80
Anaplsma phgcytophlm amp prb $35.09 $35.09 $35.09 $290.40
Anca screen with reflex to titer -quest $15.05 $15.05 $15.05 $103.20
Androstanediol $28.83 $28.83 $28.83 $103.80
Angio tib/peroneal/init ves/unila 37228 $11,340.57 $11,340.57 $11,340.57 $29,775.00
Angio trnslmnl balloon same artery ini $5,701.52 $5,701.52 $5,701.52 $7,740.60
Angio trnslmnl balloon same vein ini $5,701.52 $5,701.52 $5,701.52 $7,457.25
Angioplasty fem/pop unilat 37224 $5,701.52 $5,701.52 $5,701.52 $21,742.80
Angioplasty/iliac/init ves/unilat 37220 $5,701.52 $5,701.52 $5,701.52 $16,320.60
Angiotensin ii $20.52 $20.52 $20.52 $276.60
Ankle X-ray $88.05 $88.05 $88.05 $311.92
Ankle arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Ankle arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Ankle arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Ankle arthroscopy/surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Ankle arthroscopy/surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Ankle arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Ankle arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Anl sp inf pmp w/mdreprg&fil $299.91 $299.91 $299.91 $639.00
Annual alcohol screen 15 min $29.79 $29.79 $29.79 $29.79
Anodyne therapy charges pt $8.81 $8.81 $8.81 $49.50
Anogenital exam child w imag $201.17 $201.17 $201.17 $201.17
Anorectal myomectomy $2,742.39 $2,742.39 $2,742.39 $2,742.39
Anoscopy $911.71 $911.71 $911.71 $1,067.25
Anoscopy ablation lesion 46615 $2,742.39 $2,742.39 $2,742.39 $2,367.00
Anoscopy and biopsy $1,179.08 $1,179.08 $1,179.08 $1,380.00
Anoscopy and dilation 46604 $1,179.08 $1,179.08 $1,179.08 $1,179.08
Anoscopy control bleeding 46614 $1,179.08 $1,179.08 $1,179.08 $1,982.25
Anoscopy remove fb 46608 $911.71 $911.71 $911.71 $1,950.00
Anoscopy remove lesion 46610 $2,742.39 $2,742.39 $2,742.39 $2,770.50
Anoscopy remove lesions w/cautery/snare 46612 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Ans parasymp & symp w/tilt $311.40 $311.40 $311.40 $312.00
Ant colporrhaphy/rpr cyctocele 57240 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Ant sgm img i&r speclr mic $128.90 $128.90 $128.90 $128.90
Ant sgm img ir flrscn angrph $128.90 $128.90 $128.90 $128.90
Ant/post colporrhap/enterocele rpr 57265 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Anti mog serum - sendout $12.05 $12.05 $12.05 $159.00
Anti-inhibitor $2.45 $2.45 $2.45 $8.70
Anti-thymocyte glob (equine)(1:1000) intradermal test dose $5,013.11 $5,013.11 $5,013.11 $5,013.11
Antibody $15.99 $15.99 $15.99 $15.99
Antibody bacterium, not elsewhere specified $12.88 $12.88 $12.88 $76.80
Antibody elution rbc reference $171.36 $171.36 $171.36 $147.75
Antibody htlv-i $9.09 $9.09 $9.09 $85.20
Antibody htlv-ii $14.00 $14.00 $14.00 $195.00
Antibody htlv/hiv confirm test $19.35 $19.35 $19.35 $246.60
Antibody id rbc panel $359.72 $359.72 $359.72 $235.80
Antibody identification platelet antibodies heparin-pf4 igg $18.37 $18.37 $18.37 $621.00
Antibody influenza virus $13.55 $13.55 $13.55 $147.00
Antibody lymphocytic choriomeningitis $12.87 $12.87 $12.87 $111.20
Antibody screen rbc $53.43 $53.43 $53.43 $102.75
Antibody tetanus $14.80 $14.80 $14.80 $111.60
Antigen therapy services $71.17 $71.17 $71.17 $71.17
Antigen therapy services $46.14 $46.14 $46.14 $46.14
Antigen therapy services $46.14 $46.14 $46.14 $46.14
Antigen therapy services $46.14 $46.14 $46.14 $46.14
Antigen therapy services $46.14 $46.14 $46.14 $46.14
Antigen therapy services $71.17 $71.17 $71.17 $71.17
Antigen therapy services $71.17 $71.17 $71.17 $71.17
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution $1.49 $1.49 $1.49 $11.40
Antihemophilic viii/vwf comp $1.23 $1.23 $1.23 $10.20
Antineutrophil cytoplasmic antibody screen each antibody $12.05 $12.05 $12.05 $117.00
Antineutrophil cytoplasmic antibody titer each antibody $12.05 $12.05 $12.05 $156.00
Antinuclear antibodies $12.09 $12.09 $12.09 $97.50
Antinuclear antibodies titer $11.16 $11.16 $11.16 $91.20
Antiphosphatidylserine antibody $16.07 $16.07 $16.07 $204.00
Antistreptolysin o screen $5.77 $5.77 $5.77 $56.40
Antistreptolysin o titer $7.30 $7.30 $7.30 $83.40
Antithrombin iii activity $11.85 $11.85 $11.85 $157.80
Antithrombin iii injection $4.09 $4.09 $4.09 $70.20
Antithymocyte globuln rabbit $996.39 $996.39 $996.39 $4,139.25
Aortic dysfunction/dilation $1,350.19 $1,350.19 $1,350.19 $9,101.40
Aortic dysfunction/dilation $504.00 $504.00 $504.00 $7,431.60
Apc gene dup/delet variants $200.00 $200.00 $200.00 $2,299.20
Apc gene full sequence $780.00 $780.00 $780.00 $780.00
Apc gene known fam variants $280.00 $280.00 $280.00 $40.80
Aphakia prosth service temp $59.40 $59.40 $59.40 $59.40
Apheresis immunoads slctv $4,685.17 $4,685.17 $4,685.17 $4,685.17
Apheresis plasma $1,639.28 $1,639.28 $1,639.28 $3,486.60
Apheresis platelets $437.18 $437.18 $437.18 $1,177.80
Apheresis rbc $1,639.28 $1,639.28 $1,639.28 $1,639.28
Apheresis wbc $1,639.28 $1,639.28 $1,639.28 $1,168.80
Apl(pml-rara) quant - sendout $207.31 $207.31 $207.31 $765.00
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm $1,829.23 $1,829.23 $1,829.23 $1,990.50
App high cost ss t/a/l >100sq cm 1st 100sq cm $3,660.97 $3,660.97 $3,660.97 $3,154.80
App mltpln uni xtrnl fix 1st $18,390.05 $18,390.05 $18,390.05 $18,390.05
App mltpln uni xtrnl fix xch $1,600.41 $1,600.41 $1,600.41 $1,600.41
App skn cl ssp agrft t/a/l 1 $1,829.23 $1,829.23 $1,829.23 $1,829.23
App skn cll ssp f/n/g/hf 1st $1,829.23 $1,829.23 $1,829.23 $1,829.23
Appendectomy $6,239.75 $6,239.75 $6,239.75 $869.40
Appendix Removal (Laparoscopic) $5,834.36 $5,834.36 $5,834.36 $6,376.26
Appl bdy cst sho to hip 1thi $157.79 $157.79 $157.79 $157.79
Appl bdy cst sho to hip b th $265.58 $265.58 $265.58 $265.58
Appl bdy cst sho to hip head $265.58 $265.58 $265.58 $265.58
Appl body cast sho to hips $265.58 $265.58 $265.58 $265.58
Appl cast figure-of-eight $265.58 $265.58 $265.58 $265.58
Appl cast plaster velpeau $265.58 $265.58 $265.58 $265.58
Appl cast shoulder spica $265.58 $265.58 $265.58 $265.58
Appl halo type body cast $265.58 $265.58 $265.58 $265.58
Appl hip spica cast 1 leg $265.58 $265.58 $265.58 $265.58
Appl hip spica cast1&1/2 $265.58 $265.58 $265.58 $265.58
Appl long leg cast brace $265.58 $265.58 $265.58 $265.58
Appl mltpln uni ext fixj sys $12,866.82 $12,866.82 $12,866.82 $6,347.40
Appl modality 1+lllt po pain $39.25 $39.25 $39.25 $39.25
Appl modality 1/> areas paraffin bath 97018 $7.89 $7.89 $7.89 $80.40
Appl modality 1/> areas vasopneumatic devices 97016 $14.87 $14.87 $14.87 $92.25
Appl multlay comprs arm/hand $157.79 $157.79 $157.79 $378.75
Appl patllr tdn bearing cast $265.58 $265.58 $265.58 $396.75
Appl unipln uni ext fixj sys $7,143.73 $7,143.73 $7,143.73 $4,493.40
Application clubfoot cast $157.79 $157.79 $157.79 $157.79
Application finger splntstatic 29130 $128.90 $128.90 $128.90 $192.75
Application halo femoral $3,244.61 $3,244.61 $3,244.61 $3,244.61
Application halo pelvic $1,600.41 $1,600.41 $1,600.41 $1,600.41
Application long leg splint 29505 $157.79 $157.79 $157.79 $569.60
Application lower leg splint 29515 $157.79 $157.79 $157.79 $471.00
Application multi layer compression below knee (both sides) $157.79 $157.79 $157.79 $377.25
Application of body cast $265.58 $265.58 $265.58 $265.58
Application of body cast $265.58 $265.58 $265.58 $265.58
Application of cylinder cast 29365 $265.58 $265.58 $265.58 $718.80
Application of forearm cast 29075 $265.58 $265.58 $265.58 $370.80
Application of long arm cast 29065 $265.58 $265.58 $265.58 $440.40
Application of long leg cast $265.58 $265.58 $265.58 $444.00
Application of long leg cast 29345 $265.58 $265.58 $265.58 $388.50
Application of paste boot 29580 $157.79 $157.79 $157.79 $366.60
Application short leg cast 29405 $265.58 $265.58 $265.58 $359.25
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm $1,829.23 $1,829.23 $1,829.23 $2,109.00
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm $1,829.23 $1,829.23 $1,829.23 $2,109.00
Apply finger cast 29086 $157.79 $157.79 $157.79 $157.79
Apply forearm splintdynamic 29126 $128.90 $128.90 $128.90 $366.60
Apply hand/wrist cast 29085 $157.79 $157.79 $157.79 $520.80
Apply interstit radiat compl $693.81 $693.81 $693.81 $2,441.40
Apply intrcav radiat compl $693.81 $693.81 $693.81 $693.81
Apply intrcav radiat interm $578.47 $578.47 $578.47 $367.80
Apply intrcav radiat simple $578.47 $578.47 $578.47 $319.20
Apply of finger splint 29131 $59.40 $59.40 $59.40 $460.20
Apply rem fixation device $1,600.41 $1,600.41 $1,600.41 $1,600.41
Apply rigid leg cast 29445 $265.58 $265.58 $265.58 $631.20
Apply short leg castambul type 29425 $265.58 $265.58 $265.58 $323.25
Apply surf ldr radionuclide $109.50 $109.50 $109.50 $109.50
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion $1.77 $1.77 $1.77 $7.80
Aqaprn-4 antb flo cytmtry ea $37.73 $37.73 $37.73 $281.40
Aqua therapy w/exercise/ea 15 min 97113 $46.97 $46.97 $46.97 $129.75
Aquaporin-4 antibody cba each $12.05 $12.05 $12.05 $132.60
Aquaporin-4 antibody elisa $11.53 $11.53 $11.53 $132.60
Aquatic exercise - group charge $22.65 $22.65 $22.65 $95.40
Aqueous shunt eye w/graft $5,159.71 $5,159.71 $5,159.71 $5,159.71
Aqueous shunt eye without graft $5,159.71 $5,159.71 $5,159.71 $5,159.71
Argatroban nonesrd (accord) $1.82 $1.82 $1.82 $1.82
Argatroban nonesrd (auromed) $1.45 $1.45 $1.45 $668.52
Argatroban nonesrd use 1mg $0.74 $0.74 $0.74 $881.10
Aripiprazole 441 mg/1.6 ml inj $3.33 $3.33 $3.33 $579.60
Arsenic trioxide 2 mg/ml intravenous solution $5.86 $5.86 $5.86 $292.80
Art pressure waveform analys $24.49 $24.49 $24.49 $24.49
Artery to vein shunt $3,147.50 $3,147.50 $3,147.50 $3,147.50
Artery x-rays adrenal gland $3,147.50 $3,147.50 $3,147.50 $3,147.50
Artery x-rays adrenals $3,147.50 $3,147.50 $3,147.50 $3,147.50
Artery x-rays arm/leg 75710-26 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Artery x-rays arms/legs 75716-26 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Artery x-rays chest $3,147.50 $3,147.50 $3,147.50 $4,255.50
Artery x-rays lung $3,147.50 $3,147.50 $3,147.50 $2,919.00
Artery x-rays lung $3,147.50 $3,147.50 $3,147.50 $3,147.50
Artery x-rays lungs $3,147.50 $3,147.50 $3,147.50 $3,831.60
Artery x-rays spine $5,405.70 $5,405.70 $5,405.70 $4,294.50
Artery xray of abdomen 75726-26 $5,405.70 $5,405.70 $5,405.70 $4,130.40
Artery xrays of pelvis 75736 26 $5,405.70 $5,405.70 $5,405.70 $4,369.50
Artery-vein nonautograft $5,405.70 $5,405.70 $5,405.70 $5,405.70
Arthrd ant ntrbd min dsc crv $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthrd ant ntrbdy cervical $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthrd cmbn 1ntrspc lumbar $18,390.05 $18,390.05 $18,390.05 $18,390.05
Arthrd dst rad/ul jt sgm rsc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrd elbow jt autog graft $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthrd glenohumeral jt w/grf $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthrd pst tq 1ntrspc lum $18,390.05 $18,390.05 $18,390.05 $18,390.05
Arthrd si jt perq/min nvas $18,390.05 $18,390.05 $18,390.05 $2,428.20
Arthrd si jt prq wo tfxj dev $18,390.05 $18,390.05 $18,390.05 $18,390.05
Arthrd wrist complete wo grf $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrd wrist lmtd without b1 grf $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrd wrist w/sliding graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrd wrist with autograft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrd wrst iliac/oth agrft $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthro/shoul surg; w/spacer $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 $295.19 $295.19 $295.19 $514.50
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) $295.19 $295.19 $295.19 $498.00
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) $692.52 $692.52 $692.52 $625.80
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right $295.19 $295.19 $295.19 $453.60
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) $295.19 $295.19 $295.19 $723.60
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance $295.19 $295.19 $295.19 $453.60
Arthrodesis big toe joint 28760 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrodesis elbw joint local $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrodesis glenohumeral jt $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrodesis pantalar $18,390.05 $18,390.05 $18,390.05 $18,390.05
Arthrodesis subtalar $12,866.82 $12,866.82 $12,866.82 $6,347.40
Arthrodesis triple $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthroplasty finger joint 26535 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrotomy carpometacarpal joint 26070 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Arthrotomy glenhumrl jt w/bx $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrotomy glenohumeral jt $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrotomy strnclav joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrotomy/elbow/exp/drain/rmv fb 24000 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrp ntrcrp/crp/mtcr ntrps $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrp ntrcrpl/crp/mtcrp ssp $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrp prostc dstl scph crpl $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrp w/prostc dst rds&crps $18,390.05 $18,390.05 $18,390.05 $18,390.05
Arthrp w/prostc dstl rds $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthrp w/prostc dstl ulna $18,390.05 $18,390.05 $18,390.05 $18,390.05
Arthrp w/prostc lunate $12,866.82 $12,866.82 $12,866.82 $12,866.82
Arthrp w/prostc trapezium $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrs kne srg drlg ost diss $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrt ac sc jt exp/rmvl fb $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrt acrmclv/strnclav jt $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrt elbow w/synovectomy $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrt elbw capsl exc rls $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrt elbw jt expl bx rmvl $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrt elbw synovial bx only $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrt gh jt expl/drg/rmv fb $3,244.61 $3,244.61 $3,244.61 $3,244.61
Arthrt glenhumrl jt w/expl $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrt hip expl/rmv loose/fb $7,143.73 $7,143.73 $7,143.73 $7,143.73
Arthrt rdcrpl/midcarpl jt $3,244.61 $3,244.61 $3,244.61 $3,244.61
Artific inseminationintrauterine 58322 $201.17 $201.17 $201.17 $201.17
Artificial insemination $304.19 $304.19 $304.19 $304.19
Artiss fibrin sealant $142.07 $142.07 $142.07 $3,217.53
Asp & inj bone cyst $703.59 $703.59 $703.59 $703.59
Asp & inj w/heparin pleurx cath $618.26 $618.26 $618.26 $1,092.00
Asp core fat pad $198.70 $198.70 $198.70 $174.00
Asp pq spinal cord cyst/syrinx $890.29 $890.29 $890.29 $890.29
Aspa gene $47.25 $47.25 $47.25 $1,108.20
Aspir/inj thyroid cyst 60300 $703.59 $703.59 $703.59 $873.00
Aspirate bladder/sprapubic cath 51102 $2,048.51 $2,048.51 $2,048.51 $3,146.25
Aspirate pleura without imaging 32554 $618.26 $618.26 $618.26 $1,212.00
Aspirate/inj ganglion cyst 20612 $295.19 $295.19 $295.19 $491.25
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion $703.59 $703.59 $703.59 $971.40
Aspiration orbital contents $2,332.96 $2,332.96 $2,332.96 $2,332.96
Aspiration peritonsillar abscess $232.22 $232.22 $232.22 $236.25
Assay acid phosphatase $7.64 $7.64 $7.64 $62.25
Assay alkaline phosphatase $8.26 $8.26 $8.26 $63.00
Assay blood catecholamines $29.08 $29.08 $29.08 $29.08
Assay chondroitin sulfate $20.65 $20.65 $20.65 $20.65
Assay dir meas fr estradiol $27.94 $27.94 $27.94 $103.20
Assay duodenal fluid trypsin $7.20 $7.20 $7.20 $195.00
Assay free hydroxyproline $22.65 $22.65 $22.65 $97.20
Assay malate dehydrogenase $7.37 $7.37 $7.37 $7.37
Assay myeloperoxidase $50.86 $50.86 $50.86 $151.80
Assay of PSA complexed $18.39 $18.39 $18.39 $18.39
Assay of adp & amp $25.80 $25.80 $25.80 $246.75
Assay of androsterone $25.55 $25.55 $25.55 $25.55
Assay of blood lipoprotein $12.75 $12.75 $12.75 $12.75
Assay of bradykinin $5.16 $5.16 $5.16 $5.16
Assay of breath ethanol $30.00 $30.00 $30.00 $105.00
Assay of cathepsin-d $18.06 $18.06 $18.06 $18.06
Assay of chloramphenicol $12.67 $12.67 $12.67 $12.67
Assay of corticosterone $22.52 $22.52 $22.52 $40.20
Assay of digoxin free $13.28 $13.28 $13.28 $25.50
Assay of endocrine hormone $71.23 $71.23 $71.23 $71.23
Assay of estrogen $87.88 $87.88 $87.88 $87.88
Assay of etiocholanolone $26.24 $26.24 $26.24 $26.24
Assay of feces for trypsin $9.93 $9.93 $9.93 $9.93
Assay of feces porphyrins $39.11 $39.11 $39.11 $204.60
Assay of feces/urobilinogen $16.80 $16.80 $16.80 $16.80
Assay of fluoride $18.54 $18.54 $18.54 $227.40
Assay of galactose $11.20 $11.20 $11.20 $307.50
Assay of gdh enzyme $13.15 $13.15 $13.15 $13.15
Assay of glucosidase $21.48 $21.48 $21.48 $342.00
Assay of glutathione $15.45 $15.45 $15.45 $77.40
Assay of haptoglobins $26.89 $26.89 $26.89 $26.89
Assay of idh enzyme $8.85 $8.85 $8.85 $8.85
Assay of interleukin-6 (il-6) $17.27 $17.27 $17.27 $67.20
Assay of intrinsic factor $19.82 $19.82 $19.82 $19.82
Assay of lap enzyme $9.81 $9.81 $9.81 $9.81
Assay of leflunomide $38.57 $38.57 $38.57 $147.00
Assay of lrh hormone $17.19 $17.19 $17.19 $299.20
Assay of methemalbumin $10.74 $10.74 $10.74 $10.74
Assay of neonatal thyroxine $6.47 $6.47 $6.47 $6.47
Assay of osteocalcin $29.85 $29.85 $29.85 $150.60
Assay of phenylketones $3.98 $3.98 $3.98 $3.98
Assay of pregnanediol $21.27 $21.27 $21.27 $21.27
Assay of pregnanetriol $21.05 $21.05 $21.05 $21.05
Assay of procainamide w/metab $16.75 $16.75 $16.75 $129.75
Assay of progesterone $64.88 $64.88 $64.88 $64.88
Assay of prostaglandin $41.77 $41.77 $41.77 $192.00
Assay of quinine $11.63 $11.63 $11.63 $11.63
Assay of rbc pg6d enzyme $9.44 $9.44 $9.44 $9.44
Assay of salicylate $18.64 $18.64 $18.64 $159.60
Assay of semen fructose $17.34 $17.34 $17.34 $17.34
Assay of sialic acid $13.44 $13.44 $13.44 $188.40
Assay of silica $25.21 $25.21 $25.21 $194.40
Assay of somatostatin $18.28 $18.28 $18.28 $235.20
Assay of thiocyanate $11.63 $11.63 $11.63 $72.60
Assay of troponin qual $10.09 $10.09 $10.09 $10.09
Assay of tyrosine $10.63 $10.63 $10.63 $123.00
Assay of urine sulfate $5.49 $5.49 $5.49 $52.20
Assay of urine urobilinogen $6.05 $6.05 $6.05 $6.05
Assay of urine urobilinogen $9.55 $9.55 $9.55 $9.55
Assay phosphatidylglycerol $16.52 $16.52 $16.52 $16.52
Assay phosphohexose enzymes $10.73 $10.73 $10.73 $130.20
Assay rbc glutathione $9.44 $9.44 $9.44 $9.44
Assay toxin or antitoxin $19.74 $19.74 $19.74 $110.40
Asses tinnit/pitch/loud/match/mask 92625 $156.46 $156.46 $156.46 $156.46
Assess aphasia/interp/rpt/per hr 96105 $124.17 $124.17 $124.17 $449.40
Assess care plan pt w/cog impair 99483 $92.50 $92.50 $92.50 $92.50
Assessment leukocyte fecal qualitative/semiquantitative $4.27 $4.27 $4.27 $45.00
Assist oocyte fertilization $171.36 $171.36 $171.36 $171.36
Assist oocyte fertilization $816.90 $816.90 $816.90 $816.90
Assistive tech assessment, ot $48.65 $48.65 $48.65 $48.65
Ast/sgot $5.18 $5.18 $5.18 $41.25
Atezolizumab 60 mg/ml intravenous solution (wrapper) $91.02 $91.02 $91.02 $273.60
Athrectomy fem/pop/unilateral 37225 $17,956.72 $17,956.72 $17,956.72 $34,695.00
Athrectomy tib/pero/unilat/ini ves 37229 $17,956.72 $17,956.72 $17,956.72 $17,956.72
Atomic absorption $15.90 $15.90 $15.90 $15.90
Attach ocular implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Aud brainstem implt programg $156.46 $156.46 $156.46 $156.46
Audiometry air + bone $156.46 $156.46 $156.46 $138.00
Auditory function 60 min $156.46 $156.46 $156.46 $156.46
Augmentation cheek bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Augmentation lower jaw bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Augmentation lower jaw bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Augmentation of facial bones $5,915.66 $5,915.66 $5,915.66 $5,915.66
Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic $7,143.73 $7,143.73 $7,143.73 $9,145.50
Autgrft implnt knee w/scope $7,143.73 $7,143.73 $7,143.73 $7,143.73
Autochondrocyte implant knee $7,143.73 $7,143.73 $7,143.73 $7,143.73
Autoimmune rheumatoid arthr anl 12 mrk ia $840.65 $840.65 $840.65 $802.50
Autolog prp diab wound ulcer $1,829.23 $1,829.23 $1,829.23 $1,829.23
Autolog prp not diab ulcer $1,829.23 $1,829.23 $1,829.23 $1,829.23
Autologous blood op salvage $816.90 $816.90 $816.90 $240.00
Autologous blood process $171.36 $171.36 $171.36 $276.00
Automated diff wbc count $6.47 $6.47 $6.47 $32.40
Autonomic nrv adrenrg inervj $128.90 $128.90 $128.90 $128.90
Autonomic nrv parasym inervj $156.46 $156.46 $156.46 $156.46
Autonomic nrv syst funj test $128.90 $128.90 $128.90 $604.80
Av fistula revision $5,405.70 $5,405.70 $5,405.70 $5,405.70
Av fuse uppr arm basilic $5,405.70 $5,405.70 $5,405.70 $5,405.70
Av fuse uppr arm cephalic $5,405.70 $5,405.70 $5,405.70 $5,405.70
Av fusion direct any site $3,147.50 $3,147.50 $3,147.50 $3,147.50
Av fusion/forearm vein 36820 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Avelumab 20 mg/ml intravenous solution $100.30 $100.30 $100.30 $231.00
Avulsion nail plate partial/complete simple single nail plate $198.70 $198.70 $198.70 $417.00
Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial $54.08 $54.08 $54.08 $100.20
Axicabtagene ciloleucel car+ $533,076.48 $533,076.48 $533,076.48 $1,861,987.05
Axillary lymphadenect/superficial 38740 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Azathioprine parenteral $224.97 $224.97 $224.97 $771.30
B cells total count $37.73 $37.73 $37.73 $112.80
B-hexosaminidase ea assay $16.87 $16.87 $16.87 $104.25
Baclofen 2,000 mcg/ml intrathecal solution (wrapper) $175.82 $175.82 $175.82 $1,459.20
Baclofen eval charges $42.65 $42.65 $42.65 $118.20
Bacterial meningitis antigen $11.54 $11.54 $11.54 $100.80
Bacterial vaginosis pcr $70.20 $70.20 $70.20 $336.00
Bactericidal level serum $15.02 $15.02 $15.02 $15.02
Bartholin gland cyst/marsupializat 56440 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Bartonella dna pcr-sendout $35.09 $35.09 $35.09 $671.40
Basic vestibular evaluation $156.46 $156.46 $156.46 $462.60
Basiliximab $4,672.47 $4,672.47 $4,672.47 $7,420.80
Bckdhb gene $94.99 $94.99 $94.99 $94.99
Behavior counsel obesity 15min medicare g0447 $92.50 $92.50 $92.50 $20.40
Belatacept 250 mg intravenous solution $3.89 $3.89 $3.89 $3,406.85
Belimumab 120 mg intravenous solution $56.01 $56.01 $56.01 $7,881.60
Bendamustine 100 mg intravenous powder for solution $1.85 $1.85 $1.85 $56.40
Bendamustine 25 mg/ml intravenous solution (belrapzo) $11.99 $11.99 $11.99 $11.99
Bendamustine 25 mg/ml intravenous solution (bendeka) $13.12 $13.12 $13.12 $87.00
Bendamustine 25 mg/ml intravenous solution (vivimusta) $28.06 $28.06 $28.06 $28.06
Benign lesion paring 2-4 $198.70 $198.70 $198.70 $295.50
Benign lesion paring 4+ $198.70 $198.70 $198.70 $368.25
Beta 2 glycoprotein 1 antibody iga $25.45 $25.45 $25.45 $133.50
Beta-2 microglobulin $16.18 $16.18 $16.18 $91.80
Bevacizumab 25 mg/ml intravenous solution $73.05 $73.05 $73.05 $2,946.69
Bevacizumab injection $1.83 $1.83 $1.83 $1.83
Bevacizumab-awwb 25 mg/ml intravenous solution $28.85 $28.85 $28.85 $3,154.20
Bevacizumab-bvzr 25 mg/ml intravenous solution $23.93 $23.93 $23.93 $162.60
Bfb train 1st 15min cntct 90912 $55.62 $55.62 $55.62 $55.62
Bfb train ea addl 15 min 90913 $31.13 $31.13 $31.13 $31.13
Bilateral n blobk inj pudendal 64430 $890.29 $890.29 $890.29 $2,632.20
Bilateral n block inj occipital 64405 $295.19 $295.19 $295.19 $951.00
Bilateral n block inj trigeminal 64400 $295.19 $295.19 $295.19 $885.75
Bile acids cholylglycine $26.58 $26.58 $26.58 $26.58
Biliary endo perq dx w/speci $6,239.75 $6,239.75 $6,239.75 $6,068.25
Biliary endoscopy thru skin $10,411.22 $10,411.22 $10,411.22 $4,690.50
Biliary endoscopy thru skin $10,411.22 $10,411.22 $10,411.22 $10,411.22
Biliary endoscopy thru skin $3,529.06 $3,529.06 $3,529.06 $3,529.06
Biliary endoscopy thru skin $6,239.75 $6,239.75 $6,239.75 $6,068.25
Bilicheck $5.02 $5.02 $5.02 $25.20
Bilirubin direct $5.02 $5.02 $5.02 $58.80
Bilirubin total $5.02 $5.02 $5.02 $48.00
Biofeedback, pt $25.17 $25.17 $25.17 $189.00
Biopsy abdominal mass $1,620.24 $1,620.24 $1,620.24 $1,704.60
Biopsy arm/elbow soft tissue $2,862.05 $2,862.05 $2,862.05 $2,862.05
Biopsy bone trocar/needle superficial $1,620.24 $1,620.24 $1,620.24 $1,629.60
Biopsy cervixsingle/multiple 57500 $870.74 $870.74 $870.74 $7,461.60
Biopsy conjunctiva $2,332.96 $2,332.96 $2,332.96 $2,332.96
Biopsy external ear 69100 $232.22 $232.22 $232.22 $876.00
Biopsy eye muscle $3,771.00 $3,771.00 $3,771.00 $3,771.00
Biopsy eyelid & lid margin $298.93 $298.93 $298.93 $576.00
Biopsy finger joint lining $1,600.41 $1,600.41 $1,600.41 $1,600.41
Biopsy finger joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy forearm soft tissues $2,862.05 $2,862.05 $2,862.05 $2,862.05
Biopsy hand joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy knee joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy lower leg soft tissue $1,620.24 $1,620.24 $1,620.24 $3,128.40
Biopsy lower leg soft tissue 27610 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy muscle percutaneous needle $1,620.24 $1,620.24 $1,620.24 $1,629.60
Biopsy needle liver percutaneous $1,620.24 $1,620.24 $1,620.24 $1,642.50
Biopsy needle lymph node superficial $1,620.24 $1,620.24 $1,620.24 $1,533.00
Biopsy of cornea $2,332.96 $2,332.96 $2,332.96 $2,332.96
Biopsy of epididymis $1,620.24 $1,620.24 $1,620.24 $1,620.24
Biopsy of foot joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy of foot joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy of heart lining $3,147.50 $3,147.50 $3,147.50 $3,147.50
Biopsy of hip joint $1,600.41 $1,600.41 $1,600.41 $1,600.41
Biopsy of inestine 44100 $937.56 $937.56 $937.56 $937.56
Biopsy of lip 40490 $232.22 $232.22 $232.22 $529.20
Biopsy of nail unit 11755 $703.59 $703.59 $703.59 $2,493.60
Biopsy of nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Biopsy of ovary(s) 58900 $3,179.53 $3,179.53 $3,179.53 $2,203.50
Biopsy of penis $2,862.05 $2,862.05 $2,862.05 $2,862.05
Biopsy of penis 54100 $1,620.24 $1,620.24 $1,620.24 $1,978.20
Biopsy of prostate $2,048.51 $2,048.51 $2,048.51 $2,048.51
Biopsy of prostate $3,448.97 $3,448.97 $3,448.97 $3,448.97
Biopsy of rectum wall anal approach 45100 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Biopsy of sacroiliac joint $1,600.41 $1,600.41 $1,600.41 $1,600.41
Biopsy of salivary gland 42400 $703.59 $703.59 $703.59 $1,175.20
Biopsy of salivary glnd;incisional 42405 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Biopsy of tear gland $2,332.96 $2,332.96 $2,332.96 $2,332.96
Biopsy of tear sac $2,332.96 $2,332.96 $2,332.96 $2,332.96
Biopsy of testis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Biopsy of testis $2,862.05 $2,862.05 $2,862.05 $2,862.05
Biopsy of toe joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy of upper nose/throat $3,243.07 $3,243.07 $3,243.07 $3,243.07
Biopsy of urethra $2,048.51 $2,048.51 $2,048.51 $2,048.51
Biopsy of wrist joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy oocyte polar body $171.36 $171.36 $171.36 $171.36
Biopsy oocyte polar body <=5 $171.36 $171.36 $171.36 $171.36
Biopsy renal percutaneous trocar/needle (both sides) $1,620.24 $1,620.24 $1,620.24 $1,717.20
Biopsy roof of mouth $1,481.28 $1,481.28 $1,481.28 $1,404.00
Biopsy skin incisional single lesion $612.13 $612.13 $612.13 $639.00
Biopsy thigh soft tissues $2,862.05 $2,862.05 $2,862.05 $2,862.05
Biopsy tongue anterior two-thirds $509.25 $509.25 $509.25 $1,829.25
Biopsy vaginal mucosa xtnsv $3,179.53 $3,179.53 $3,179.53 $3,179.53
Biopsy vestibule of mouth 40808 $509.25 $509.25 $509.25 $981.00
Biopsy vrt bdy open lmbr/crv $7,143.73 $7,143.73 $7,143.73 $7,143.73
Biopsy vrt bdy open thoracic $3,244.61 $3,244.61 $3,244.61 $3,244.61
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) $2,862.05 $2,862.05 $2,862.05 $1,745.40
Biopsy, bone open deep $2,862.05 $2,862.05 $2,862.05 $3,819.60
Biopsy/excision of lymph node(s); open deep 38530 $3,829.28 $3,829.28 $3,829.28 $3,829.28
Biopsy/removal lymph nodes $3,829.28 $3,829.28 $3,829.28 $3,913.50
Biopsy/removal lymph nodes 38520 $3,829.28 $3,829.28 $3,829.28 $3,829.28
Biopsy/soft tissue/neck or thorax 21550 $1,620.24 $1,620.24 $1,620.24 $2,512.20
Biospy of bladder $243.21 $243.21 $243.21 $141.00
Biotinidase - quest $16.87 $16.87 $16.87 $221.40
Bis xtracell fluid analysis $156.46 $156.46 $156.46 $147.75
Bladder irrigate/lavage/instill 51700 $243.21 $243.21 $243.21 $664.20
Bld exchange truj oth thn nb $437.18 $437.18 $437.18 $437.18
Bld prd mix $171.36 $171.36 $171.36 $140.25
Bld push tfuj 2 yr/< $437.18 $437.18 $437.18 $437.18
Blepharoplasty lower 15820 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Blepharoplasty upper 15822 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Blepharoplasty upper eyelid 15823 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Blepharp lwr eyelid fat pad $1,829.23 $1,829.23 $1,829.23 $1,829.23
Blinatumomab 35 mcg intravenous solution $163.21 $163.21 $163.21 $417.00
Blind cor sinus reducer impl $11,340.57 $11,340.57 $11,340.57 $11,340.57
Blind interatrial shunt ide $17,500.50 $17,500.50 $17,500.50 $17,500.50
Blind myocar trpl bon marrow $17,500.50 $17,500.50 $17,500.50 $17,500.50
Blind/nonblind trans atrial $9,750.50 $9,750.50 $9,750.50 $9,750.50
Blinded conv. tx mdd clin tr $530.60 $530.60 $530.60 $530.60
Blink reflex test $59.40 $59.40 $59.40 $310.20
Blm gene $39.31 $39.31 $39.31 $663.60
Block brachial plexus w/cath plmt w/img $890.29 $890.29 $890.29 $1,657.20
Block femoral nerve cont infusion cath w/img $890.29 $890.29 $890.29 $1,381.20
Block paracervical nrv $692.52 $692.52 $692.52 $982.50
Block plantar digital nerve $295.19 $295.19 $295.19 $491.40
Blood Clotting (PT/INR) Test $4.29 $4.29 $4.29 $45.00
Blood Clotting (PTT) Test $6.01 $6.01 $6.01 $64.35
Blood Count (CBC) Test $7.77 $7.77 $7.77 $66.75
Blood Count (CBC) Test (without differential) $6.47 $6.47 $6.47 $56.55
Blood Culture Test $10.32 $10.32 $10.32 $112.20
Blood count spun microhematocrit $7.00 $7.00 $7.00 $7.00
Blood gases o2 saturation direct measurement $78.77 $78.77 $78.77 $225.75
Blood gases ph venous $11.00 $11.00 $11.00 $60.00
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic $15.92 $15.92 $15.92 $32.40
Blood occult feces 1-3 determinations other than neoplasm screening qualitative $4.23 $4.23 $4.23 $20.40
Blood occult feces colorectal neoplasm screening qualitative $4.38 $4.38 $4.38 $20.40
Blood occult peroxidase activity qualitative gastric $5.32 $5.32 $5.32 $32.40
Blood smear microscopic w manual differential wbc count $3.80 $3.80 $3.80 $59.40
Blood split unit $141.80 $141.80 $141.80 $247.80
Blood typing abo $128.90 $128.90 $128.90 $41.40
Blood typing ag donor ea ag $359.72 $359.72 $359.72 $102.00
Blood typing patient serum $59.40 $59.40 $59.40 $59.40
Blood typing rbc ag non abo/rh ea $359.72 $359.72 $359.72 $84.60
Blood typing rh (d) $39.25 $39.25 $39.25 $57.00
Blood typing rh phenotype complete reference $39.25 $39.25 $39.25 $53.25
Blood volume $538.27 $538.27 $538.27 $1,284.00
Blood, l/r, irradiated $84.17 $84.17 $84.17 $438.60
Bone Density Scan (DEXA) $106.34 $106.34 $106.34 $398.56
Bone biopsy open superficial $2,862.05 $2,862.05 $2,862.05 $5,396.40
Bone imaging multiple areas $401.83 $401.83 $401.83 $1,168.20
Bone marrow biopsyneedle/trocar 38221 $1,620.24 $1,620.24 $1,620.24 $1,200.00
Bone marrow harvest allogen $1,639.28 $1,639.28 $1,639.28 $91,568.25
Bone marrow harvest autolog $4,685.17 $4,685.17 $4,685.17 $4,685.17
Bone marrow imaging body $401.83 $401.83 $401.83 $2,315.40
Bone marrow imaging ltd $401.83 $401.83 $401.83 $745.20
Bone marrow imaging mult $401.83 $401.83 $401.83 $1,090.80
Bone marrow interpretation $816.90 $816.90 $816.90 $304.00
Bone marrow;aspiration only 38220 $1,620.24 $1,620.24 $1,620.24 $1,253.25
Bone survey-lead poisoning $106.34 $106.34 $106.34 $619.50
Bone/joint imaging ltd area $401.83 $401.83 $401.83 $857.40
Bone/skin graft great toe $7,143.73 $7,143.73 $7,143.73 $7,143.73
Bone/skin graft metatarsal $7,143.73 $7,143.73 $7,143.73 $7,143.73
Borrelia antibody $13.38 $13.38 $13.38 $176.40
Borrelia burgdorferi (lyme disease) antibody nonspecific $17.03 $17.03 $17.03 $94.80
Borrelia miyamotoi amp prb $35.09 $35.09 $35.09 $290.40
Bowel imaging $401.83 $401.83 $401.83 $1,365.75
Brachioplasty 15836 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Brachy source i-125 injection $37.04 $37.04 $37.04 $37.04
Brachy source iodine-125 nonstranded $35.11 $35.11 $35.11 $35.11
Brachy source palladium $69.69 $69.69 $69.69 $69.69
Brachy source palladium-103 nonstranded $79.77 $79.77 $79.77 $79.77
Brachy source yttrium-90 $17,485.10 $17,485.10 $17,485.10 $37,851.00
Brachy src nonstrand c-131 $96.56 $96.56 $96.56 $96.56
Brachy src nonstrand hdr ir-192 $342.39 $342.39 $342.39 $1,164.60
Brachy src stranded c-131 $107.86 $107.86 $107.86 $107.86
Brachytx isodose complex $366.07 $366.07 $366.07 $984.60
Brachytx isodose intermed $366.07 $366.07 $366.07 $384.00
Brachytx isodose plan simple $366.07 $366.07 $366.07 $817.20
Braf gene $175.40 $175.40 $175.40 $349.20
Brain MRA (blood vessel MRI, with and without contrast) $357.13 $357.13 $357.13 $2,604.00
Brain MRA (blood vessel MRI, with contrast) $357.13 $357.13 $357.13 $1,998.00
Brain MRA (blood vessel MRI, without contrast) $241.72 $241.72 $241.72 $1,790.00
Brain MRI (with and without contrast) $357.13 $357.13 $357.13 $2,884.20
Brain MRI (with contrast) $357.13 $357.13 $357.13 $2,224.96
Brain MRI (without contrast) $241.72 $241.72 $241.72 $1,825.59
Brain flow imaging only $538.27 $538.27 $538.27 $627.00
Brain image 4+ views $538.27 $538.27 $538.27 $1,015.80
Brain image < 4 views $401.83 $401.83 $401.83 $401.83
Brain image w/flow 4 + views $538.27 $538.27 $538.27 $1,138.20
Brain image w/flow < 4 views $401.83 $401.83 $401.83 $1,228.80
Brca1 dna gene analy known fam var $375.25 $375.25 $375.25 $235.80
Brca1 gene full dup/del alys $301.35 $301.35 $301.35 $301.35
Brca1 gene full seq alys $282.88 $282.88 $282.88 $282.88
Brca1&2 gen ful dup/del alys $584.23 $584.23 $584.23 $2,287.20
Brca1&2 gene full seq alys $468.00 $468.00 $468.00 $468.00
Brca2 dna gene analy full seq analy $185.12 $185.12 $185.12 $185.12
Brca2 dna gene analy known fam var $375.25 $375.25 $375.25 $235.80
Brca2 gene full dup/del alys $282.88 $282.88 $282.88 $282.88
Brcassure ashkenazi panel-sendout $440.00 $440.00 $440.00 $440.00
Brcassure comprehensive panel-sendout $1,824.88 $1,824.88 $1,824.88 $1,920.00
Breast Biopsy (ultrasound-guided, percutaneous) $1,620.24 $1,620.24 $1,620.24 $3,069.25
Breast augmentation 19325 $9,569.05 $9,569.05 $9,569.05 $9,569.05
Breast punct aspir cyst, bil $703.59 $703.59 $703.59 $845.40
Breast reconstruction 19357 $17,398.35 $17,398.35 $17,398.35 $17,398.35
Breast reduction $6,521.46 $6,521.46 $6,521.46 $6,521.46
Breath hydrogen test 91065 $156.46 $156.46 $156.46 $333.00
Breath recording infant $530.60 $530.60 $530.60 $530.60
Breath test analysis c-14 $94.41 $94.41 $94.41 $94.41
Breath tst attain/anal c-14 $11.06 $11.06 $11.06 $592.80
Breathing response hypoxia $156.46 $156.46 $156.46 $156.46
Brentuximab vedotin 50 mg intravenous solution $258.52 $258.52 $258.52 $25,683.00
Brexucabtagene car pos t $489,720.00 $489,720.00 $489,720.00 $1,475,302.50
Bronch ebus samplng 1/2 node $3,686.95 $3,686.95 $3,686.95 $3,686.95
Bronch ebus samplng 3/> node $3,686.95 $3,686.95 $3,686.95 $4,214.40
Bronch thermoplsty 1 lobe $6,922.47 $6,922.47 $6,922.47 $6,922.47
Bronch thermoplsty 2/> lobes $6,922.47 $6,922.47 $6,922.47 $7,765.50
Bronch w/balloon occlusion $6,922.47 $6,922.47 $6,922.47 $7,870.50
Bronch w/debrdmt subgltc & uppr trach $194.14 $194.14 $194.14 $2,203.80
Bronch/asp/tracheobronch tree/subs 31646 $388.31 $388.31 $388.31 $388.31
Bronchial allergy tests $530.60 $530.60 $530.60 $573.00
Bronchial brush biopsy $388.31 $388.31 $388.31 $388.31
Bronchial challenge $311.40 $311.40 $311.40 $761.40
Bronchial valve init insert $6,922.47 $6,922.47 $6,922.47 $6,922.47
Bronchial valve remov addl $1,724.47 $1,724.47 $1,724.47 $1,639.50
Bronchial valve remov init $3,686.95 $3,686.95 $3,686.95 $3,618.00
Bronchoscopy bronch stents $6,922.47 $6,922.47 $6,922.47 $6,922.47
Bronchoscopy clear airways 31645 $1,724.47 $1,724.47 $1,724.47 $2,487.00
Bronchoscopy dilate w/stent $6,922.47 $6,922.47 $6,922.47 $6,768.75
Bronchoscopy dilate/fx repr $3,686.95 $3,686.95 $3,686.95 $3,686.95
Bronchoscopy revise stent $6,922.47 $6,922.47 $6,922.47 $3,515.40
Bronchoscopy treat blockage $3,686.95 $3,686.95 $3,686.95 $3,686.95
Bronchoscopy w/biopsy(s) 31625 $1,724.47 $1,724.47 $1,724.47 $2,168.40
Bronchoscopy w/fb removal 31635 $1,724.47 $1,724.47 $1,724.47 $3,279.00
Bronchoscopy w/markers $6,922.47 $6,922.47 $6,922.47 $6,922.47
Bronchoscopy w/tumor excise $3,686.95 $3,686.95 $3,686.95 $3,686.95
Bronchoscopy/lung bx each 31628 $3,686.95 $3,686.95 $3,686.95 $3,686.95
Bronchoscopy/needle bx each 31629 $3,686.95 $3,686.95 $3,686.95 $3,846.60
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr $0.61 $0.61 $0.61 $8.20
Bundle his recording $7,588.10 $7,588.10 $7,588.10 $5,625.00
Bundled special stain group 1 microorganisms $53.43 $53.43 $53.43 $116.40
Bundled special stain group 2 $128.90 $128.90 $128.90 $131.25
Bupivacaine implant, 1 mg $2.64 $2.64 $2.64 $2.64
Buprenorph X-ray 100 mg or less $1,976.55 $1,976.55 $1,976.55 $7,360.99
Buprenorphine X-ray over 100 mg $1,976.55 $1,976.55 $1,976.55 $7,360.99
Busulfan injection $1.84 $1.84 $1.84 $783.10
Buttock fasciotomy $7,143.73 $7,143.73 $7,143.73 $7,143.73
Buttock fasciotomy w/dbrdmt $1,600.41 $1,600.41 $1,600.41 $1,600.41
Bx arm/elbow soft tissue supf 24065 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bx bone trocar/ndl deep $1,620.24 $1,620.24 $1,620.24 $2,179.80
Bx breast 1st lesion mr imag $1,620.24 $1,620.24 $1,620.24 $2,955.75
Bx breast 1st lesion strtctc $1,620.24 $1,620.24 $1,620.24 $3,438.75
Bx breast perq without image 19100 $1,620.24 $1,620.24 $1,620.24 $1,748.25
Bx breast pq tomo guide $3,829.28 $3,829.28 $3,829.28 $3,829.28
Bx leg/ankle soft tissue deep 27614 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Bx muscle $1,620.24 $1,620.24 $1,620.24 $250.80
Bx nasopharynx/unknown pri lesion 42806 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Bx of breast open 19101 $3,829.28 $3,829.28 $3,829.28 $3,829.28
Bx of cervix w/scope leep 57460 $3,179.53 $3,179.53 $3,179.53 $3,876.00
Bx pancreas pq ndl $1,620.24 $1,620.24 $1,620.24 $1,900.50
Bx perianal mass $911.71 $911.71 $911.71 $911.71
Bx pleura pq ndl $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bx prst8 ndl sat sampling $3,448.97 $3,448.97 $3,448.97 $3,448.97
Bx shoulder tissues deep 23066 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Bx shoulder tissues supf 23065 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bx soft tiss pelvis+hip area supf 27040 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bx soft tiss pelvis/hip deep 27041 $1,620.24 $1,620.24 $1,620.24 $1,352.80
Bx soft tissue back/flank deep 21925 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bx soft tissue back/flank supf 21920 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bx spinal cord pq ndl $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bx thigh/knee soft tiss supf 27323 $1,620.24 $1,620.24 $1,620.24 $1,566.00
Bx thyroid/percutan core needle 60100 $703.59 $703.59 $703.59 $979.50
Bx vag mucos smpl (sep proc) $870.74 $870.74 $870.74 $966.60
Bx vulva or perineum/1 lesion 56605 $870.74 $870.74 $870.74 $2,765.25
Bx/curett of cervix w/scope 57454 $304.19 $304.19 $304.19 $785.40
Bx/exc lymph node/open/deep cervic 38510 $3,829.28 $3,829.28 $3,829.28 $1,159.20
Bx/exc lymph node/open/superfic 38500 $3,829.28 $3,829.28 $3,829.28 $3,829.28
Bx/soft tis/forearm/wrist/superfic 25065 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Bypass temp external fem-fem $618.26 $618.26 $618.26 $2,349.00
C motor evoked lwr limbs $530.60 $530.60 $530.60 $457.80
C motor evoked uppr limbs $1,017.39 $1,017.39 $1,017.39 $429.00
C motor evoked upr&lwr limbs $1,017.39 $1,017.39 $1,017.39 $780.00
C-1 esterase, berinert $75.86 $75.86 $75.86 $156.00
C-1 esterase, cinryze $65.73 $65.73 $65.73 $5,831.40
C-kit mutation liquid tumor - sendout $329.51 $329.51 $329.51 $4,054.80
C-lens fitg corneosclrl lens $128.90 $128.90 $128.90 $128.90
C-lens fitg tech aphakia 1 $128.90 $128.90 $128.90 $128.90
C-lens fitg tech aphakia ou $128.90 $128.90 $128.90 $128.90
C-lens fitg tech corneosclrl $39.25 $39.25 $39.25 $39.25
C-peptide $20.81 $20.81 $20.81 $156.60
C-reactive protein $5.18 $5.18 $5.18 $126.00
C-reactive protein high sensitivity $12.95 $12.95 $12.95 $129.00
C-reactive protein, quantitative $10.64 $10.64 $10.64 $138.00
C1 esterase inhibitor func - sendout $12.00 $12.00 $12.00 $132.75
CT Angiogram of Abdomen and Pelvis $357.13 $357.13 $357.13 $2,839.85
CT Angiogram of the Chest (for blood clot) $178.02 $178.02 $178.02 $2,094.23
CT Angiogram of the Head $178.02 $178.02 $178.02 $2,094.23
CT Scan of Abdomen and Pelvis (with and without contrast) $357.13 $357.13 $357.13 $3,630.00
CT Scan of Abdomen and Pelvis (with contrast) $357.13 $357.13 $357.13 $3,180.75
CT Scan of Abdomen and Pelvis (without contrast) $241.72 $241.72 $241.72 $2,418.75
CT angio hrt w/3d image $357.13 $357.13 $357.13 $2,243.25
CT angio pelvis $178.02 $178.02 $178.02 $2,494.20
CT bone density axial $88.05 $88.05 $88.05 $88.05
CT colonography dx $106.34 $106.34 $106.34 $2,139.00
CT colonography dx w/dye $178.02 $178.02 $178.02 $2,860.20
CT colonography screening $241.72 $241.72 $241.72 $689.40
CT guid cryo ablat intramuscular $239.88 $239.88 $239.88 $879.75
CT heart w/evaluation of calcium without contrast $88.05 $88.05 $88.05 $120.00
CT hrt c+ strux cgen hrt ds $357.13 $357.13 $357.13 $2,418.75
CT hrt w/3d image $357.13 $357.13 $357.13 $2,883.00
CT limited or localized follow-up study $88.05 $88.05 $88.05 $654.40
CT lower extremity w/contrast (both sides) $178.02 $178.02 $178.02 $1,619.25
CT lower extremity without contrast (both sides) $106.34 $106.34 $106.34 $1,471.50
CT lwr extremity w/o&w/dye $178.02 $178.02 $178.02 $1,983.75
CT neck soft tissue w/contrast $178.02 $178.02 $178.02 $1,953.00
CT neck soft tissue without & w/contrast $178.02 $178.02 $178.02 $2,149.50
CT neck soft tissue without contrast $106.34 $106.34 $106.34 $1,689.75
CT orbit/sella/ or posterior outer inner or middle ear w/contrast $178.02 $178.02 $178.02 $1,834.50
CT orbit/sella/ or posterior outer inner or middle ear without contrast $106.34 $106.34 $106.34 $1,623.00
CT orbit/sella/fossa w/wo contrast $178.02 $178.02 $178.02 $1,923.00
CT t-spine w /wo contrast $178.02 $178.02 $178.02 $2,228.25
CT thoracic spine w/contrast $178.02 $178.02 $178.02 $1,732.50
CT thoracic spine without contrast $106.34 $106.34 $106.34 $1,473.75
CT thorax low dose for lung screening without contrast $106.34 $106.34 $106.34 $253.20
CT upper extremity w/contrast (both sides) $357.13 $357.13 $357.13 $1,764.00
CT upper extremity without contrast (both sides) $106.34 $106.34 $106.34 $1,518.75
CT uppr extremity w/o&w/dye $178.02 $178.02 $178.02 $2,785.80
Ca screen;flexi sigmoidscope $911.71 $911.71 $911.71 $911.71
Cabazitaxel 10 mg/ml (first dilution) intravenous solution $227.10 $227.10 $227.10 $495.60
Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er $23.63 $23.63 $23.63 $23.63
Cacna1a gene full gene seq $846.27 $846.27 $846.27 $635.25
Cadd pump refill $210.69 $210.69 $210.69 $210.69
Calcitonin (salmon) 200 unit/ml injection solution $835.80 $835.80 $835.80 $9,437.60
Calcium 24 hour urine $6.03 $6.03 $6.03 $78.60
Calcium ionized $13.68 $13.68 $13.68 $107.40
Calcium total $5.16 $5.16 $5.16 $39.60
Calculi urinary-sendout $12.87 $12.87 $12.87 $12.87
Calculus analysis qual $11.58 $11.58 $11.58 $11.58
Caloric vstblr test w/rec $156.46 $156.46 $156.46 $465.75
Calprotectin fecal $19.63 $19.63 $19.63 $250.20
Campylobacter antibody $13.12 $13.12 $13.12 $93.60
Canakinumab injection $141.00 $141.00 $141.00 $10,902.60
Candida dna $20.05 $20.05 $20.05 $197.40
Candida skin test $24.49 $24.49 $24.49 $24.49
Cannula declotting 36861 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Cantharidin top, applicator $669.59 $669.59 $669.59 $669.59
Canthotomy 67715 $2,332.96 $2,332.96 $2,332.96 $2,709.00
Capecitabine, oral, 50 mg $0.05 $0.05 $0.05 $8.40
Capsaicin 8% patch $3.38 $3.38 $3.38 $9.75
Capsular contracture release $3,244.61 $3,244.61 $3,244.61 $3,244.61
Capsulotomy mpj ea joint (sep proc) $3,244.61 $3,244.61 $3,244.61 $3,244.61
Capsulotomy; interphalangeal joint, each joint (separate proc) $1,600.41 $1,600.41 $1,600.41 $1,600.41
Car ion chnnlpath inc 10 gns $584.90 $584.90 $584.90 $584.90
Car ion chnnlpath inc 2 gns $584.90 $584.90 $584.90 $584.90
Car seat/bed test 60 minutes $39.25 $39.25 $39.25 $39.25
Car-t admn autologous $331.69 $331.69 $331.69 $828.60
Carbamazepine free $13.25 $13.25 $13.25 $117.00
Carbamazepine free -sendout $18.64 $18.64 $18.64 $168.75
Carbamazepine total therapeutic drug level $14.57 $14.57 $14.57 $113.25
Carbidopa levodopa ent 100ml $243.15 $243.15 $243.15 $243.15
Carbohydrate deficient transf - sendout $18.06 $18.06 $18.06 $111.60
Carbohydrate urine - sendout $5.50 $5.50 $5.50 $30.60
Carbon dioxide $4.88 $4.88 $4.88 $39.60
Carboxyhemoglobin quantitative $12.32 $12.32 $12.32 $102.00
Carcinoembryonic ag (cea) $18.96 $18.96 $18.96 $144.75
Cardiac MRI seg dys strain $548.30 $548.30 $548.30 $548.30
Cardiac MRI seg dys stress $548.30 $548.30 $548.30 $548.30
Cardiac MRI w/stress img $548.30 $548.30 $548.30 $3,213.60
Cardiac drug stress test $399.04 $399.04 $399.04 $399.04
Cardiac perf planar mult/ef/wm $1,305.48 $1,305.48 $1,305.48 $2,607.75
Cardiac perf planar sgl/ef/wm $1,305.48 $1,305.48 $1,305.48 $3,198.60
Cardiac perf spect sgl/ef/wm rst/strs $1,305.48 $1,305.48 $1,305.48 $3,772.20
Cardiac rehabilitation op phase 2 w/continous ecg monitoring $125.91 $125.91 $125.91 $218.40
Cardiac rehabilitation op phase 2 without continous ecg monitoring $125.91 $125.91 $125.91 $106.20
Cardiac shunt imaging $401.83 $401.83 $401.83 $1,657.80
Cardiokymography $39.25 $39.25 $39.25 $39.25
Cardiolipin antibody iga $25.45 $25.45 $25.45 $186.60
Cardioversion elective electrical conversion arrhythmia external $654.38 $654.38 $654.38 $1,461.75
Cardioversion/elective/internal 92961 $654.38 $654.38 $654.38 $865.20
Caregiver training strategies&tq 1st 30 minutes $61.33 $61.33 $61.33 $105.00
Caregiver training strategies&tq ea addl 15 min $33.04 $33.04 $33.04 $52.20
Carfilzomib 10 mg intravenous solution $55.09 $55.09 $55.09 $149.40
Carmustine 100 mg intravenous powder for solution $173.64 $173.64 $173.64 $2,713.80
Carotene $9.22 $9.22 $9.22 $85.50
Carotid Artery Ultrasound (Duplex) $241.72 $241.72 $241.72 $1,059.82
Carpal Tunnel Release Surgery $1,952.77 $1,952.77 $1,952.77 $3,503.75
Cataract Surgery $2,280.73 $2,280.73 $2,280.73 $2,715.20
Cataract surg w/iol 1 stage $2,280.73 $2,280.73 $2,280.73 $2,280.73
Catecholamines,fractionated, urine $27.30 $27.30 $27.30 $226.20
Cath combo lt&rt heart w/inj/s $3,216.41 $3,216.41 $3,216.41 $8,708.40
Cath left heart/lv gram $3,216.41 $3,216.41 $3,216.41 $7,483.80
Cath plc art ang/grft lt/rt hr $3,216.41 $3,216.41 $3,216.41 $11,503.20
Cath plc art/angio/rt hrt cath $3,216.41 $3,216.41 $3,216.41 $8,979.00
Cath plc art/grft/angio right hrt $3,216.41 $3,216.41 $3,216.41 $8,859.00
Cath right heart w/o2 sat & card $3,216.41 $3,216.41 $3,216.41 $4,762.80
Catheter declot mechanical $1,553.44 $1,553.44 $1,553.44 $1,523.25
Catheter stripping venous $3,147.50 $3,147.50 $3,147.50 $5,745.60
Catheterization collection of specimen single patient all places of service $9.09 $9.09 $9.09 $42.60
Cathj rmvl dev ischmc rmdlg $243.21 $243.21 $243.21 $243.21
Cauterization chemical granulation tissue $198.70 $198.70 $198.70 $408.60
Cauterization of cervix 57510 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Ccnd1/igh translocation alys $207.31 $207.31 $207.31 $207.31
Cdna analysis for variants $185.20 $185.20 $185.20 $1,792.80
Cdp-sot 6 cond w/i&r $128.90 $128.90 $128.90 $282.00
Cdp-sot 6 cond w/i&r mct&adt $128.90 $128.90 $128.90 $128.90
Cebpa gene full sequence $241.90 $241.90 $241.90 $1,686.00
Ceftaroline fosamil 600 mg intravenous solution $4.24 $4.24 $4.24 $552.60
Ceftazidime and avibactam $104.95 $104.95 $104.95 $991.80
Cell count body fluid $4.72 $4.72 $4.72 $60.75
Cell count w differential body fluid $5.60 $5.60 $5.60 $131.40
Cell cryopreserve/storage $13.07 $13.07 $13.07 $117.60
Cell enumeration & id $250.78 $250.78 $250.78 $250.78
Cell function assay w/stim $135.86 $135.86 $135.86 $898.80
Cell marker study $53.43 $53.43 $53.43 $212.40
Cemiplimab-rwlc 50 mg/ml intravenous solution $28.70 $28.70 $28.70 $527.40
Centralization wrist on ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Centruroides immune f(ab) $4,859.01 $4,859.01 $4,859.01 $4,859.01
Cerclage of uterine cervix nonob 57700 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Cerebrospinal fld flw imag $538.27 $538.27 $538.27 $1,124.25
Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit $4.49 $4.49 $4.49 $34.60
Cervical lymphadenectomy 38720 $6,521.46 $6,521.46 $6,521.46 $6,521.46
Cervical or vaginal cancer screening g0101 $92.50 $92.50 $92.50 $123.75
Cetuximab 100 mg/50 ml intravenous solution $78.47 $78.47 $78.47 $775.20
Cftr gene dup/delet variants $435.07 $435.07 $435.07 $918.00
Cftr gene intron poly t $168.75 $168.75 $168.75 $283.80
Cftr gene known fam variants $97.22 $97.22 $97.22 $321.00
Change cystostomy tube simple $243.21 $243.21 $243.21 $411.00
Change cystostomy tube; complex 51710 $667.47 $667.47 $667.47 $2,813.40
Change g-tube to g-j perc $1,896.99 $1,896.99 $1,896.99 $3,534.60
Change gastric port open $3,660.97 $3,660.97 $3,660.97 $3,660.97
Change nephroureteral cath $2,048.51 $2,048.51 $2,048.51 $3,154.80
Change of ureter tube/stent $2,048.51 $2,048.51 $2,048.51 $2,397.00
Change of windpipe airway 31502 $232.22 $232.22 $232.22 $472.80
Change stent via transureth $2,048.51 $2,048.51 $2,048.51 $2,048.51
Change ureter stent percut $2,048.51 $2,048.51 $2,048.51 $4,067.25
Chct for mal hyperthermia $171.36 $171.36 $171.36 $171.36
Chemical exfoliation acne 17360 $198.70 $198.70 $198.70 $198.70
Chemical peel face epiderm 15788 $399.53 $399.53 $399.53 $399.53
Chemical peel nonfacial 15793 $399.53 $399.53 $399.53 $399.53
Chemical peel nonfacial; epidermal $612.13 $612.13 $612.13 $612.13
Chemo adm cns w/lmbr punct $331.69 $331.69 $331.69 $1,119.00
Chemo extend IV infus w/pump $331.69 $331.69 $331.69 $696.00
Chemo ia infuse each addl hr $46.14 $46.14 $46.14 $184.80
Chemo ia infusion up to 1 hr $331.69 $331.69 $331.69 $335.40
Chemo ia push tecnique $331.69 $331.69 $331.69 $540.75
Chemo intralesional over 7 $210.69 $210.69 $210.69 $246.75
Chemo intralesional up to 7 96405 $71.17 $71.17 $71.17 $83.25
Chemodener muscle larynx emg $692.52 $692.52 $692.52 $668.25
Chemodenerv 1 extrem 5/> mus 64644 $692.52 $692.52 $692.52 $692.52
Chemodenerv 1 extremity 1-4 64642 $692.52 $692.52 $692.52 $692.52
Chemodenerv eccrine glands $295.19 $295.19 $295.19 $295.19
Chemodenerv eccrine glands 64650 $295.19 $295.19 $295.19 $510.00
Chemodenerv musc migraine 64615 $295.19 $295.19 $295.19 $512.25
Chemodenerv musc neck dyston 64616 $295.19 $295.19 $295.19 $819.00
Chemodenerv saliv glands bilat 64611 $295.19 $295.19 $295.19 $358.50
Chemodenerv trunk musc 1-5 64646 $692.52 $692.52 $692.52 $697.20
Chemodenerv trunk musc 6/] 64647 $692.52 $692.52 $692.52 $772.20
Chemodenervation anal musc $1,179.08 $1,179.08 $1,179.08 $1,179.08
Chemodenervation nerve of eye muscle 67345 $298.93 $298.93 $298.93 $298.93
Chemodenervation/face muscl/unilat 64612 $295.19 $295.19 $295.19 $891.75
Chemotaxis assay $15.99 $15.99 $15.99 $15.99
Chemotherapy injection 96542 $331.69 $331.69 $331.69 $331.69
Chemotx admn pertl cav impl $331.69 $331.69 $331.69 $642.75
Chest 2 vws w oblique $106.34 $106.34 $106.34 $419.40
Chest CT scan (with and without contrast) $178.02 $178.02 $178.02 $2,105.40
Chest CT scan (with contrast) $178.02 $178.02 $178.02 $1,697.25
Chest CT scan (without contrast) $106.34 $106.34 $106.34 $1,350.03
Chest X-ray $88.05 $88.05 $88.05 $303.24
Chest X-ray (single view) $88.05 $88.05 $88.05 $225.00
Chest apical lordotic proj $88.05 $88.05 $88.05 $405.00
Chg pr pul rehab for copd patients $59.40 $59.40 $59.40 $134.25
Chg radiologic exam esophagus double contrast $178.02 $178.02 $178.02 $713.40
Chimerism anal no cell selec $207.46 $207.46 $207.46 $1,437.75
Chimerism anal w/cell select $260.79 $260.79 $260.79 $759.75
Chlamydia culture $19.60 $19.60 $19.60 $109.80
Chlamydia trachomatis ag if $11.98 $11.98 $11.98 $66.60
Chlamydia type $5.57 $5.57 $5.57 $42.60
Chloride $4.60 $4.60 $4.60 $39.60
Chloride 24 hour urine $5.75 $5.75 $5.75 $60.00
Chloroprocaine opht gel, 1mg $0.60 $0.60 $0.60 $0.60
Chmotx admn plrl cav thrcnts $331.69 $331.69 $331.69 $331.69
Cholangiogram percutaneous compl $3,529.06 $3,529.06 $3,529.06 $3,529.06
Cholecystostomy complete w/supervision & interpretation $3,529.06 $3,529.06 $3,529.06 $3,529.06
Cholesterol $4.35 $4.35 $4.35 $40.80
Cholesterol (Lipid) Test $13.39 $13.39 $13.39 $100.00
Choline c-11 $2,062.94 $2,062.94 $2,062.94 $2,062.94
Cholinesterase $7.87 $7.87 $7.87 $103.20
Cholinesterase challenge $311.40 $311.40 $311.40 $311.40
Chorion biopsy $870.74 $870.74 $870.74 $870.74
Chrom analysis $34.81 $34.81 $34.81 $309.60
Chromatogram assay sugars $39.00 $39.00 $39.00 $39.00
Chromatography $18.06 $18.06 $18.06 $178.80
Chromo high res and frag x - sendout $57.04 $57.04 $57.04 $770.40
Chromogenic substrate assay $11.89 $11.89 $11.89 $158.40
Chromosome analys amniotic $173.66 $173.66 $173.66 $173.66
Chromosome analys placenta $188.57 $188.57 $188.57 $642.00
Chromosome analysis 100 $173.17 $173.17 $173.17 $519.00
Chromosome analysis 15-20 cell count $125.49 $125.49 $125.49 $988.50
Chromosome analysis 20-25 $173.17 $173.17 $173.17 $173.17
Chromosome analysis 45 $150.29 $150.29 $150.29 $1,109.60
Chromosome analysis 5 $264.34 $264.34 $264.34 $1,046.25
Chromosome analysis 50-100 $173.17 $173.17 $173.17 $519.00
Chromosome banding study $68.60 $68.60 $68.60 $68.60
Chromosome count additional $26.91 $26.91 $26.91 $57.00
Chromosome karyotype study $33.47 $33.47 $33.47 $181.80
Chromosome study additional $34.43 $34.43 $34.43 $181.50
Chronic urticaria - sendout $12.46 $12.46 $12.46 $131.40
Chylomicron screen, bf - sendout $61.50 $61.50 $61.50 $334.80
Cidofovir injection $529.38 $529.38 $529.38 $1,615.67
Ciliary transsleral therapy $2,332.96 $2,332.96 $2,332.96 $4,288.80
Ciltacabtagene car-pos t $553,378.83 $553,378.83 $553,378.83 $553,378.83
Cine/video x-rays $106.34 $106.34 $106.34 $523.20
Circum 28 days or older $2,048.51 $2,048.51 $2,048.51 $2,048.51
Circumcise/surg/28 days or < 54160 $667.47 $667.47 $667.47 $667.47
Circumcision (newborn) $2,048.51 $2,048.51 $2,048.51 $1,549.50
Cladribine 10 mg/10 ml intravenous solution $9.73 $9.73 $9.73 $355.41
Claviculectomy partial $3,244.61 $3,244.61 $3,244.61 $3,244.61
Claviculectomy total $3,244.61 $3,244.61 $3,244.61 $3,244.61
Clean out mastoid cavity $509.25 $509.25 $509.25 $509.25
Clearance of airways $203.39 $203.39 $203.39 $166.50
Clearance of tear duct $298.93 $298.93 $298.93 $298.93
Clitoroplasty intersex state $3,179.53 $3,179.53 $3,179.53 $3,179.53
Clofarabine 1 mg/ml intravenous solution $14.72 $14.72 $14.72 $11,963.49
Clos txnose fx without stablz 21315 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Close lac/mouth vest/2.5 cm or < 40830 $232.22 $232.22 $232.22 $777.60
Close mastoid fistula $1,481.28 $1,481.28 $1,481.28 $1,481.28
Close tear duct opening $298.93 $298.93 $298.93 $298.93
Close tear duct opening $298.93 $298.93 $298.93 $298.93
Close tear system fistula $2,332.96 $2,332.96 $2,332.96 $2,332.96
Closed carpo/metacarpal disl thumb w/manip $239.88 $239.88 $239.88 $273.00
Closed carpo/metacarpal fx disl thumb w/manip $1,600.41 $1,600.41 $1,600.41 $1,815.75
Closed tx humerus fx w/manip 24505 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Closed tx humerus fx with manip 23605 $1,600.41 $1,600.41 $1,600.41 $2,448.00
Closed tx humerus fx without manip 23600 $239.88 $239.88 $239.88 $447.60
Closed tx metatarsophalangeal jnt disl without anes $239.88 $239.88 $239.88 $643.20
Closed tx nose/jaw fx $1,481.28 $1,481.28 $1,481.28 $1,481.28
Closed tx orbit w/manipulj $1,481.28 $1,481.28 $1,481.28 $1,481.28
Closed tx orbit without manipulj $509.25 $509.25 $509.25 $509.25
Closed tx post hip arthroplasty disloc w/anes 27266 $1,600.41 $1,600.41 $1,600.41 $2,134.50
Closed tx septal&nose fx $3,243.07 $3,243.07 $3,243.07 $3,243.07
Closed tx sesamoid fx 28530 $239.88 $239.88 $239.88 $525.75
Closed tx vert fx w/manj $3,244.61 $3,244.61 $3,244.61 $3,244.61
Closed tx/acetabululm without manip 27220 $239.88 $239.88 $239.88 $261.75
Closed tx/talus fracture without manip 28430 $239.88 $239.88 $239.88 $327.60
Clostridium toxin a w/optic $16.00 $16.00 $16.00 $16.00
Closure laceration vestibule mouth > 2.5 cm cmplx $509.25 $509.25 $509.25 $1,663.80
Closure of eyelid by suture $968.54 $968.54 $968.54 $968.54
Closure of salivary fistula $3,243.07 $3,243.07 $3,243.07 $3,243.07
Closure of windpipe lesion 31820 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Closure paravalvlr leak pq $618.26 $618.26 $618.26 $5,734.80
Clot factor fletcher fact $18.93 $18.93 $18.93 $231.00
Clot factor viii reltd antgn $20.42 $20.42 $20.42 $288.00
Clot factor wght kininogen $18.93 $18.93 $18.93 $320.40
Clot factor xii hageman $19.35 $19.35 $19.35 $197.60
Clot factor xiii fibrin scrn $9.11 $9.11 $9.11 $47.25
Clot factor xiii fibrin stab $16.34 $16.34 $16.34 $97.20
Cls tx of heel fracture w/manip 28405 $239.88 $239.88 $239.88 $759.00
Clsd tx bimalleol ank fx without manip 27808 $239.88 $239.88 $239.88 $998.40
Clsd tx carpo/metacarpl disl thmb manip ea without anes $239.88 $239.88 $239.88 $327.60
Clsd tx clav dislc without manip 23520 $1,600.41 $1,600.41 $1,600.41 $2,055.00
Clsd tx clavicle dislocation without manip 23540 $239.88 $239.88 $239.88 $537.00
Clsd tx clavicle fracture w/manip 23505 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Clsd tx coccygeal fracture 27200 $239.88 $239.88 $239.88 $239.88
Clsd tx dist fib fx w/manip 27788 $239.88 $239.88 $239.88 $868.80
Clsd tx elbow dislocation child 24640 $239.88 $239.88 $239.88 $525.75
Clsd tx finger tendon w/wo perq pin 26432 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Clsd tx fracture of radius 25500 $239.88 $239.88 $239.88 $442.50
Clsd tx fx radius/ulna dist w/manip 25605 $1,600.41 $1,600.41 $1,600.41 $1,912.80
Clsd tx fx radius/ulna dist without manip 25600 $239.88 $239.88 $239.88 $520.80
Clsd tx fx radius/ulna w/manip 25565 $1,600.41 $1,600.41 $1,600.41 $2,055.00
Clsd tx fx radius/ulna without manip 25560 $239.88 $239.88 $239.88 $825.60
Clsd tx hip disloc without anes 27265 $239.88 $239.88 $239.88 $868.80
Clsd tx humeral fract without manip 24530 $239.88 $239.88 $239.88 $759.00
Clsd tx humerus fract without manip 24500 $239.88 $239.88 $239.88 $759.00
Clsd tx iphal jnt disl w/manip req anes $265.58 $265.58 $265.58 $3,964.20
Clsd tx mandibular fx without manip 21450 $509.25 $509.25 $509.25 $961.80
Clsd tx metacarp fx w/manip&ext fix ea bone 26607 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Clsd tx metatarsal fracture w/manip 28475 $239.88 $239.88 $239.88 $647.20
Clsd tx of ankle fracture w/manip 28435 $1,600.41 $1,600.41 $1,600.41 $1,815.75
Clsd tx patella disloc without anes 27560 $239.88 $239.88 $239.88 $998.40
Clsd tx pelvic ring fx $239.88 $239.88 $239.88 $239.88
Clsd tx pelvic ring fx $239.88 $239.88 $239.88 $1,195.80
Clsd tx prox fib/shaft fx w/manip 27781 $1,600.41 $1,600.41 $1,600.41 $1,614.60
Clsd tx radius fracture w/manip 24655 $1,600.41 $1,600.41 $1,600.41 $2,712.00
Clsd tx shoulder dislc/fx 23665 $1,600.41 $1,600.41 $1,600.41 $3,135.00
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 $1,600.41 $1,600.41 $1,600.41 $2,073.00
Clsd tx temporomandibular dislocat 21480 $239.88 $239.88 $239.88 $942.60
Clsd tx toe dislocation without anes28660 $239.88 $239.88 $239.88 $520.80
Clsd tx trimall ankle fx w/manip 27818 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Clsd tx trimall ankle fx without manip 27816 $239.88 $239.88 $239.88 $825.60
Clsd tx vert body fx without manip req &w/csting/bracing $239.88 $239.88 $239.88 $756.75
Clsd tx wrist carpal fx without manip 25630 $239.88 $239.88 $239.88 $370.80
Clsd tx wrist scaphoid fx without manip 25622 $239.88 $239.88 $239.88 $520.80
Clsd tx wrist trans-scaph fx w/manip 25680 $239.88 $239.88 $239.88 $597.60
Clsd tx wrist ulnar styloid fx 25650 $239.88 $239.88 $239.88 $672.00
Clsd tx/clavicular fx without manip 23500 $239.88 $239.88 $239.88 $819.60
Clsd tx/dis phalan fx without manip/ea 26750 $239.88 $239.88 $239.88 $370.80
Clsd tx/dis tib/wt bear no manip 27824 $239.88 $239.88 $239.88 $633.60
Clsd tx/fem shaft fx/manipulation 27502 $1,600.41 $1,600.41 $1,600.41 $2,319.00
Clsd tx/fx grt toe/phalanx/phalang 28490 $239.88 $239.88 $239.88 $370.80
Clsd tx/fx/phalanx/phalang/manip 28515 $239.88 $239.88 $239.88 $429.60
Clsd tx/grt hum tube fx without manip 23620 $239.88 $239.88 $239.88 $372.00
Clsd tx/metacar/interphal artic fx 26740 $239.88 $239.88 $239.88 $529.50
Clsd tx/metacarpal fx/sg without manip 26600 $239.88 $239.88 $239.88 $377.25
Clsd tx/metacarpal fx/sng/w manip 26605 $239.88 $239.88 $239.88 $825.60
Clsd tx/metatarsal fx without manip 28470 $239.88 $239.88 $239.88 $520.80
Clsd tx/nasal bone fx/stabilize 21320 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Clsd tx/patellar fx without manip 27520 $239.88 $239.88 $239.88 $759.00
Clsd tx/prox/mid phalnx fx/no manp 26720 $239.88 $239.88 $239.88 $327.75
Clsd tx/radial head/neck fx/no manip 24650 $239.88 $239.88 $239.88 $434.25
Clsd tx/scapular fx without manip 23570 $239.88 $239.88 $239.88 $496.20
Clsd tx/shoulder dislo/manip/anest 23655 $1,600.41 $1,600.41 $1,600.41 $2,139.60
Clsd tx/talotarsal dislocat/anes 28575 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Clsd tx/ulnar shaft fx without manip 25530 $239.88 $239.88 $239.88 $370.50
Clsd/shoulder dislo/manip/no anest 23650 $239.88 $239.88 $239.88 $856.20
Clsd/ulnar fx/prox end without manip 24670 $239.88 $239.88 $239.88 $494.40
Cltx carpl scphd fx w/mnpj $1,600.41 $1,600.41 $1,600.41 $3,184.20
Cltx gr hmrl tbrs fx w/mnpj $1,600.41 $1,600.41 $1,600.41 $1,600.41
Cltx hum epcndylr fx wo mnpj $239.88 $239.88 $239.88 $825.60
Cltx humrl cndylr fx w/mnpj $1,600.41 $1,600.41 $1,600.41 $1,815.75
Cltx humrl cndylr fx wo mnpj $239.88 $239.88 $239.88 $759.00
Cltx lunate dislc w/mnpj $1,600.41 $1,600.41 $1,600.41 $1,600.41
Cltx mndblr fx ntrdntl fixj $5,915.66 $5,915.66 $5,915.66 $5,915.66
Cltx mndblr fx w/mnpj $1,481.28 $1,481.28 $1,481.28 $1,756.50
Cltx mndblr/max alv ridge fx $3,243.07 $3,243.07 $3,243.07 $3,600.75
Cltx palatal/max fx wire fix $3,243.07 $3,243.07 $3,243.07 $3,243.07
Cltx post ankle fx $239.88 $239.88 $239.88 $333.75
Cltx post ankle fx w/mnpj $1,600.41 $1,600.41 $1,600.41 $1,198.50
Cltx scap fx w/mnpj +-tractj $1,600.41 $1,600.41 $1,600.41 $2,450.40
Cltx strnclav dislc w/mnpj $239.88 $239.88 $239.88 $239.88
Cltx thigh fx $3,244.61 $3,244.61 $3,244.61 $3,244.61
Cltx tmprmand dislc comp $1,481.28 $1,481.28 $1,481.28 $1,481.28
Cmbn ant pst colprhy $4,936.45 $4,936.45 $4,936.45 $4,936.45
Cmptr ophth dx img ant segmt $59.40 $59.40 $59.40 $59.40
Cmptr ophth img optic nerve $59.40 $59.40 $59.40 $97.50
Cmv pcr-sendout $35.09 $35.09 $35.09 $501.75
Co-treatment - group 15 mins, st $30.03 $30.03 $30.03 $108.00
Co2 monitor per day $311.40 $311.40 $311.40 $337.50
Coagulation factor viia 1,000 mcg/ml inj 1 ml $2.65 $2.65 $2.65 $16,994.46
Coagulation time activated teg $4.28 $4.28 $4.28 $31.00
Coagulation time otr method $4.49 $4.49 $4.49 $40.20
Cochlear implt f/up exam 7/> $156.46 $156.46 $156.46 $156.46
Cochlear implt f/up exam <7 $156.46 $156.46 $156.46 $156.46
Cold agglutinin screen (arc) $8.07 $8.07 $8.07 $45.00
Cold agglutinin titer $8.06 $8.06 $8.06 $85.20
Collagenase, clost hist inj $73.16 $73.16 $73.16 $26,281.91
Collection blood specimen from completely implantable venous access device $128.90 $128.90 $128.90 $131.25
Collection blood specimen using established central/peripheral catheter venous nos $128.90 $128.90 $128.90 $196.00
Collection of venous blood by venipuncture $9.09 $9.09 $9.09 $20.25
Colon motility 6 hr study $311.40 $311.40 $311.40 $311.40
Colonoscopy & polypectomy 44392 $1,179.08 $1,179.08 $1,179.08 $3,114.00
Colonoscopy (diagnostic) $911.71 $911.71 $911.71 $1,500.00
Colonoscopy (with biopsy) $1,179.08 $1,179.08 $1,179.08 $1,846.40
Colonoscopy (with polyp removal) $1,179.08 $1,179.08 $1,179.08 $1,875.00
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) $1,179.08 $1,179.08 $1,179.08 $3,043.50
Colonoscopy flex with decompression 45393 $1,179.08 $1,179.08 $1,179.08 $1,946.25
Colonoscopy for bleeding 44391 $1,179.08 $1,179.08 $1,179.08 $2,505.60
Colonoscopy for foreign body $911.71 $911.71 $911.71 $1,861.50
Colonoscopy stoma w/endo mucosal rescj 44403 $1,179.08 $1,179.08 $1,179.08 $1,286.40
Colonoscopy stoma w/snare 44394 $1,179.08 $1,179.08 $1,179.08 $2,854.80
Colonoscopy submucous njx $1,179.08 $1,179.08 $1,179.08 $3,528.00
Colonoscopy thru stoma spx $911.71 $911.71 $911.71 $1,895.40
Colonoscopy w/ablation $1,179.08 $1,179.08 $1,179.08 $2,571.00
Colonoscopy w/balloon dilat $1,179.08 $1,179.08 $1,179.08 $1,876.80
Colonoscopy w/band ligation $1,179.08 $1,179.08 $1,179.08 $2,495.25
Colonoscopy w/control bleed $1,179.08 $1,179.08 $1,179.08 $2,352.75
Colonoscopy w/decompression $911.71 $911.71 $911.71 $2,786.40
Colonoscopy w/dilation $1,179.08 $1,179.08 $1,179.08 $2,310.00
Colonoscopy w/endoscope Ultrasound $1,179.08 $1,179.08 $1,179.08 $3,201.00
Colonoscopy w/endoscopic fnb $1,179.08 $1,179.08 $1,179.08 $3,201.00
Colonoscopy w/fb removal $1,179.08 $1,179.08 $1,179.08 $2,431.20
Colonoscopy w/injection $1,179.08 $1,179.08 $1,179.08 $2,449.20
Colonoscopy w/ndl aspir/bx $1,179.08 $1,179.08 $1,179.08 $1,439.25
Colonoscopy w/resection $2,742.39 $2,742.39 $2,742.39 $2,712.75
Colonoscopy w/stent plcmt $5,952.81 $5,952.81 $5,952.81 $4,379.25
Colonoscopy w/ultrasound $1,179.08 $1,179.08 $1,179.08 $1,439.25
Colonoscopy with ablation $1,179.08 $1,179.08 $1,179.08 $1,740.00
Colonoscopy with biopsy $1,179.08 $1,179.08 $1,179.08 $1,788.60
Colonoscopy/w endoscopic stent 45389 $5,952.81 $5,952.81 $5,952.81 $4,379.25
Colpocentesis 57020 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Colpocleisis (le forte type) 57120 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Colpopexy extraperitoneal $7,394.81 $7,394.81 $7,394.81 $7,394.81
Colpopexy intraperitoneal $7,394.81 $7,394.81 $7,394.81 $7,394.81
Colpopexy, min/inv, ex-perit $4,936.45 $4,936.45 $4,936.45 $4,936.45
Colporrhapy/vag injury sut/non ob 57200 $3,179.53 $3,179.53 $3,179.53 $3,435.60
Colposcopy vulva 56820 $201.17 $201.17 $201.17 $435.00
Colposcopy vulva w/biopsy 56821 $304.19 $304.19 $304.19 $1,626.60
Colposcopy w/biopsy of cervix 57455 $304.19 $304.19 $304.19 $1,147.50
Colposcopy/cervix/ conization 57461 $3,179.53 $3,179.53 $3,179.53 $4,866.75
Colposcopy/cervix/bx vagina/cervix 57421 $870.74 $870.74 $870.74 $1,446.00
Colposcopy/cervix/inc up/adjacent vag 57452 $201.17 $201.17 $201.17 $434.40
Colpotomy drng of abscess 57010 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Colpotomy w/exploration 57000 $3,179.53 $3,179.53 $3,179.53 $3,114.00
Comp cystometrogram/void presssure 51728 $667.47 $667.47 $667.47 $933.75
Comp cystometrogram/void/uret pres 51729 $667.47 $667.47 $667.47 $1,216.50
Compatibility test each unit antiglobulin technique $171.36 $171.36 $171.36 $179.40
Compatibility test each unit electronic $171.36 $171.36 $171.36 $131.25
Compatibility test each unit immediate spin technique $171.36 $171.36 $171.36 $171.36
Compatibility test incubate $171.36 $171.36 $171.36 $1.20
Compl oph exam general anes $2,332.96 $2,332.96 $2,332.96 $2,332.96
Complement antigen each component c3 $12.00 $12.00 $12.00 $148.20
Complement fixation each $10.01 $10.01 $10.01 $84.60
Complete removal of vulva $3,179.53 $3,179.53 $3,179.53 $3,179.53
Complex cystometrogram 51726 $243.21 $243.21 $243.21 $243.21
Complex repair trunk 1.1-2.5cm 13120 $612.13 $612.13 $612.13 $1,919.40
Complex repair trunk 2.6-7.5cm 13101 $612.13 $612.13 $612.13 $2,172.00
Complex uroflowmetry (electronic) 51741 $311.40 $311.40 $311.40 $607.50
Complx repair enel 1.1-2.5 cm 13151 $612.13 $612.13 $612.13 $2,929.50
Complx repair enel 2.6-7.5 cm 13152 $612.13 $612.13 $612.13 $2,938.80
Complx repair fccmnaxghf 13131 $399.53 $399.53 $399.53 $2,172.00
Complx repair fccmnaxghf 13132 $612.13 $612.13 $612.13 $2,172.00
Complx repair trunk 1.1-2.5 cm 13100 $612.13 $612.13 $612.13 $3,769.20
Composite graft/pri close/don area 15760 $1,829.23 $1,829.23 $1,829.23 $3,734.40
Compre oph exam est pt 1/> $128.87 $128.87 $128.87 $128.87
Compre oph exam new pt 1/> $128.87 $128.87 $128.87 $128.87
Comprehensive hearing test $156.46 $156.46 $156.46 $190.50
Concentration infection agents any type $6.68 $6.68 $6.68 $42.00
Conditioning play audiometry 92582 $156.46 $156.46 $156.46 $123.00
Condylomata destruction 56420 $201.17 $201.17 $201.17 $831.60
Conization of cervix $3,179.53 $3,179.53 $3,179.53 $3,577.50
Conization/cerv/loop electrode exc 57522 $3,179.53 $3,179.53 $3,179.53 $4,198.50
Conjugated estrogens 25 mg solution for injection $390.74 $390.74 $390.74 $1,291.95
Constj trachesophgl fstl $3,243.07 $3,243.07 $3,243.07 $3,243.07
Construct thumb replacement $3,244.61 $3,244.61 $3,244.61 $3,244.61
Construct vagina with graft $4,936.45 $4,936.45 $4,936.45 $4,936.45
Construction of vagina $4,936.45 $4,936.45 $4,936.45 $4,936.45
Consult comp w/report rfrd material $171.36 $171.36 $171.36 $212.80
Consultation pathology during surgery $59.40 $59.40 $59.40 $141.75
Consultation pathology during surgery cytological exam initial site $816.90 $816.90 $816.90 $213.60
Consultation pathology during surgery frozen section first tissue block $171.36 $171.36 $171.36 $245.40
Consultation/report referred material w/preparation of slides $53.43 $53.43 $53.43 $737.40
Consultation/report referred slides prepared elsewhere $39.25 $39.25 $39.25 $213.60
Contact lens fitg aphakia 1 $399.04 $399.04 $399.04 $399.04
Contact lens fitg aphakia ou $128.90 $128.90 $128.90 $128.90
Contour cranial bone lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Contour of face bone lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Contrast baths charges $17.37 $17.37 $17.37 $96.00
Contrast exam abdominl aorta 75625-26 $3,147.50 $3,147.50 $3,147.50 $4,356.00
Contrast exam thoracic aorta $3,147.50 $3,147.50 $3,147.50 $3,147.50
Contrast exam thoracic aorta 75605-26 $5,405.70 $5,405.70 $5,405.70 $5,378.25
Contrast x-ray gallbladder $178.02 $178.02 $178.02 $719.40
Contrast x-ray of ankle $357.13 $357.13 $357.13 $868.80
Contrast x-ray of brain $790.06 $790.06 $790.06 $790.06
Contrast x-ray of brain $357.13 $357.13 $357.13 $357.13
Contrast x-ray of elbow $357.13 $357.13 $357.13 $793.80
Contrast x-ray of hip $357.13 $357.13 $357.13 $814.20
Contrast x-ray of knee joint $357.13 $357.13 $357.13 $868.80
Contrast x-ray of wrist $357.13 $357.13 $357.13 $417.75
Control nose/throat bleeding w/pst nsl packs 42970 $232.22 $232.22 $232.22 $232.22
Control nose/throat bleeding with surg ivntj 42972 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Control nosebleed pack+caut 30905 $128.90 $128.90 $128.90 $569.60
Control of nosebleed ant comp 30903 $128.90 $128.90 $128.90 $569.60
Control of nosebleedantersmpl 30901 $128.90 $128.90 $128.90 $471.00
Control oropharyngeal hemorr/simp 42960 $509.25 $509.25 $509.25 $1,546.80
Control throat bleeding $3,243.07 $3,243.07 $3,243.07 $3,243.07
Conv gtube to jtube $1,896.99 $1,896.99 $1,896.99 $3,489.75
Conversion ext bil drg cath $3,529.06 $3,529.06 $3,529.06 $3,529.06
Convert nephrostomy catheter $2,048.51 $2,048.51 $2,048.51 $2,643.00
Coombs direct $59.40 $59.40 $59.40 $75.00
Coombs indirect qualitative each reagent red cell reference $171.36 $171.36 $171.36 $171.36
Coombs indirect titer reference $171.36 $171.36 $171.36 $186.75
Copper cu 64 dotatate diag $595.10 $595.10 $595.10 $2,083.80
Cor artery disease mrna $1,050.00 $1,050.00 $1,050.00 $1,050.00
Cor hlx vlgs double osteot $7,143.73 $7,143.73 $7,143.73 $7,143.73
Cor hlx vlgs dstl mtar osteo $3,244.61 $3,244.61 $3,244.61 $3,244.61
Cor hlx vlgs prx phlx osteot $7,143.73 $7,143.73 $7,143.73 $7,143.73
Core ndl bx lng/med perq $1,620.24 $1,620.24 $1,620.24 $3,052.80
Corneal hysteresis deter $59.40 $59.40 $59.40 $59.40
Corneal smear $399.04 $399.04 $399.04 $315.75
Corneal transplant $4,022.86 $4,022.86 $4,022.86 $4,022.86
Corneal transplant $5,159.71 $5,159.71 $5,159.71 $5,159.71
Corneal transplant $4,022.86 $4,022.86 $4,022.86 $4,022.86
Corneal transplant $5,159.71 $5,159.71 $5,159.71 $5,159.71
Corneal trnspl endothelial $4,022.86 $4,022.86 $4,022.86 $4,022.86
Coronary angio/cath placement bypass graft/lv gram/lt heart $3,216.41 $3,216.41 $3,216.41 $10,920.00
Coronary angio/lv gram/lt heart $3,216.41 $3,216.41 $3,216.41 $8,070.00
Coronary angio/lv gram/rt&lt heart $3,216.41 $3,216.41 $3,216.41 $10,049.40
Coronary art/grft angio s&i $3,216.41 $3,216.41 $3,216.41 $8,006.25
Coronary catheterization w/angiography supervision & interpretation $3,216.41 $3,216.41 $3,216.41 $7,491.00
Coronary thrombolysis/iv infusion 92977 $331.69 $331.69 $331.69 $477.60
Correct bunion/keller/mcbride/mayo 28292 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Correct cock-up 5th toe/plast clos 28286 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Correct finger deformity $3,244.61 $3,244.61 $3,244.61 $3,244.61
Correct inverted nipple(s) $3,829.28 $3,829.28 $3,829.28 $3,829.28
Correct metacarpal flaw $3,244.61 $3,244.61 $3,244.61 $3,244.61
Correct rectal prolapse $2,742.39 $2,742.39 $2,742.39 $8,616.60
Correct skin color 6.0 cm/< $612.13 $612.13 $612.13 $876.00
Correction claw finger other $3,244.61 $3,244.61 $3,244.61 $3,244.61
Correction eyelid w/implant $2,332.96 $2,332.96 $2,332.96 $2,332.96
Correction hallux valgus sesamoidectomy;prox meta osteotomy $3,244.61 $3,244.61 $3,244.61 $3,244.61
Correction of astigmatism $2,332.96 $2,332.96 $2,332.96 $2,332.96
Correction of astigmatism $968.54 $968.54 $968.54 $968.54
Correction of everted punctum 68705 $298.93 $298.93 $298.93 $298.93
Correction trichiasis epilation forcep 67820 $128.90 $128.90 $128.90 $128.90
Correction trichiasis inccision lid margin 67830 $968.54 $968.54 $968.54 $968.54
Corrj halux rigdus w/implt $7,143.73 $7,143.73 $7,143.73 $3,042.00
Corrj halux rigdus without implt $3,244.61 $3,244.61 $3,244.61 $3,244.61
Cortisol acth stimulation test - sendout $32.62 $32.62 $32.62 $63.75
Cortisol total am $16.30 $16.30 $16.30 $162.00
Costotransversectomy $3,244.61 $3,244.61 $3,244.61 $3,244.61
Counseling smoke cess interm >10mins $29.79 $29.79 $29.79 $48.00
Counseling visit to discuss need for ldct g0296 $92.50 $92.50 $92.50 $92.50
Cover eye w/membrane $968.54 $968.54 $968.54 $14,438.40
Cover eye w/membrane suture $3,771.00 $3,771.00 $3,771.00 $3,771.00
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose $450.50 $450.50 $450.50 $1,020.00
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose $450.50 $450.50 $450.50 $1,020.00
Covid-19 administration immunization im inj 1st/only component $41.52 $41.52 $41.52 $24.00
Covid-19 lab test non-cdc $51.31 $51.31 $51.31 $51.31
Cptr ophth dx img post segmt $59.40 $59.40 $59.40 $97.50
Cptrized corneal topography $59.40 $59.40 $59.40 $59.40
Cptrz oph img pst sg rta oct $311.40 $311.40 $311.40 $311.40
Crbrospnl fld flw imag cistern $538.27 $538.27 $538.27 $1,859.25
Creat artery-vein fistula autograft 36825 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Create eardrum opening $1,481.28 $1,481.28 $1,481.28 $7,126.80
Create passage to kidney $3,448.97 $3,448.97 $3,448.97 $3,448.97
Create tear duct drain $3,771.00 $3,771.00 $3,771.00 $3,771.00
Create tear duct drain $3,771.00 $3,771.00 $3,771.00 $3,771.00
Create tear sac drain $3,771.00 $3,771.00 $3,771.00 $3,771.00
Creatine - sendout $4.64 $4.64 $4.64 $45.60
Creatine isoforms $11.87 $11.87 $11.87 $11.87
Creatine kinase $6.51 $6.51 $6.51 $80.25
Creatine kinase isoenzymes $13.39 $13.39 $13.39 $66.00
Creatine kinase mb $11.55 $11.55 $11.55 $114.75
Creatinine $5.12 $5.12 $5.12 $43.80
Creatinine 24 hour urine $5.18 $5.18 $5.18 $75.00
Creatinine clearance urine $9.46 $9.46 $9.46 $146.40
Cricopharyngeal myotomy 43030 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Cricotracheal resection $5,915.66 $5,915.66 $5,915.66 $5,915.66
Crisis psychotherapy 90839 $160.67 $160.67 $160.67 $263.40
Critical care 30-74 minutes $842.61 $842.61 $842.61 $2,085.75
Crizanlizumab-tmca 10 mg/ml intravenous solution $129.58 $129.58 $129.58 $436.20
Cross-over vein graft $5,405.70 $5,405.70 $5,405.70 $5,405.70
Crotalidae poly immune fab $1,861.13 $1,861.13 $1,861.13 $6,069.00
Cryo fib comp path redu each $313.77 $313.77 $313.77 $313.77
Cryoablate prostate $9,247.15 $9,247.15 $9,247.15 $9,247.15
Cryocautery of cervix 57511 $304.19 $304.19 $304.19 $304.19
Cryofibrinogen qualitative - sendout $14.14 $14.14 $14.14 $56.25
Cryoprecipitate each unit $63.57 $63.57 $63.57 $235.20
Cryopreservation embryo(s) $816.90 $816.90 $816.90 $816.90
Cryopreservation oocyte(s) $171.36 $171.36 $171.36 $171.36
Cryopreservation sperm $171.36 $171.36 $171.36 $171.36
Cryopreserve stem cells $437.18 $437.18 $437.18 $437.18
Cryopreserve testicular tiss $53.43 $53.43 $53.43 $53.43
Cryosurg ablate fa each $3,829.28 $3,829.28 $3,829.28 $3,829.28
Cryosurgery penis lesion(s) 54056 $198.70 $198.70 $198.70 $198.70
Cryotherapy of acne 17340 $59.40 $59.40 $59.40 $59.40
Cryptococcus abs qn - sendout $14.41 $14.41 $14.41 $138.60
Cryptosporidium antigen $11.98 $11.98 $11.98 $162.60
Crystal identification light microscopy $7.33 $7.33 $7.33 $58.50
Csf leakage imaging $1,305.48 $1,305.48 $1,305.48 $1,645.50
Csf shunt reprogram 62252 $299.91 $299.91 $299.91 $299.91
Csf ventriculography $538.27 $538.27 $538.27 $538.27
Cta abdomen without & /or w/contrast $178.02 $178.02 $178.02 $2,422.50
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast $178.02 $178.02 $178.02 $2,395.20
Cta lower extremity without & w/contrast (both sides) $178.02 $178.02 $178.02 $2,212.50
Cta neck without &/or w/contrast $178.02 $178.02 $178.02 $1,987.50
Cta upper extremity w &/or without contrast left $178.02 $178.02 $178.02 $2,025.75
Ctrl nosebld postir subsq 30906 $232.22 $232.22 $232.22 $2,487.00
Cult skin graft fnhfg 15155 $3,660.97 $3,660.97 $3,660.97 $3,660.97
Cult skin grft t/arm/leg $1,829.23 $1,829.23 $1,829.23 $1,829.23
Cultr oocyte/embryo <4 days $171.36 $171.36 $171.36 $171.36
Cultr oocyte/embryo <4 days $171.36 $171.36 $171.36 $171.36
Culture aerobic additional method definitive id each $8.08 $8.08 $8.08 $67.80
Culture afb any source $10.80 $10.80 $10.80 $92.80
Culture anaerobic additional method definitive id each $8.08 $8.08 $8.08 $117.00
Culture anaerobic except blood $9.47 $9.47 $9.47 $126.00
Culture bact stool aero addl path ea $9.44 $9.44 $9.44 $52.80
Culture body fluid $8.62 $8.62 $8.62 $130.50
Culture fungi definitive id mold $10.32 $10.32 $10.32 $81.75
Culture fungi definitive id yeast $10.32 $10.32 $10.32 $70.50
Culture fungi other (except blood) $8.41 $8.41 $8.41 $130.50
Culture fungi skin/hair/nail $7.71 $7.71 $7.71 $80.40
Culture mycobacteria definitive id each isolate $14.61 $14.61 $14.61 $114.60
Culture mycoplasma any source $15.39 $15.39 $15.39 $145.50
Culture quantitative aerobic other source $9.89 $9.89 $9.89 $96.75
Culture screening strep group a $6.63 $6.63 $6.63 $105.75
Culture typing added method $7.74 $7.74 $7.74 $7.74
Culture typing immunologic $5.18 $5.18 $5.18 $29.40
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets $218.06 $218.06 $218.06 $408.75
Culture typing nucleic acid probe amplified per culture/isolate each organism $35.09 $35.09 $35.09 $343.20
Culture urine each isolate $8.09 $8.09 $8.09 $74.40
Culture virus isolation $19.56 $19.56 $19.56 $19.56
Curette/treat cornea $2,332.96 $2,332.96 $2,332.96 $2,332.96
Curette/treat cornea $968.54 $968.54 $968.54 $1,200.60
Cv line/pic reposition $1,553.44 $1,553.44 $1,553.44 $1,629.75
Cyanocobalamin unsat binding capacity $14.32 $14.32 $14.32 $93.60
Cyclic citrullinated peptide antibody $12.95 $12.95 $12.95 $178.50
Cyclophosphamide 1 gram intravenous powder for solution $0.62 $0.62 $0.62 $3.75
Cyclosporine 2 hour $18.05 $18.05 $18.05 $115.50
Cyp2c19 gene com variants $291.36 $291.36 $291.36 $916.20
Cyp2c9 gene com variants $174.81 $174.81 $174.81 $1,852.80
Cyp2d6 gene com variants $450.91 $450.91 $450.91 $269.40
Cyp3a4 gene common variants $174.81 $174.81 $174.81 $328.50
Cyp3a5 gene common variants $174.81 $174.81 $174.81 $328.50
Cystatin c $18.52 $18.52 $18.52 $119.40
Cystic fibrosis cftr $499.00 $499.00 $499.00 $4,054.80
Cystine urine quantitative $22.98 $22.98 $22.98 $125.40
Cysto cgen post urtl valves $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cysto impl 4 or more $9,247.15 $9,247.15 $9,247.15 $9,247.15
Cysto insj dev ischmc rmdlg $9,247.15 $9,247.15 $9,247.15 $9,247.15
Cysto rx balo cath urtl strx $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cysto w/renal stricture tx $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cysto w/up stricture tx $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cysto w/ureter stricture tx $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cysto, litho, vacuum kidney $9,247.15 $9,247.15 $9,247.15 $9,247.15
Cysto/uretero stricture tx $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cysto/uretero w/lithotripsy $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cysto/uretero w/up stricture $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystogram >= 3 views supervision & interpretation $357.13 $357.13 $357.13 $896.40
Cystometrogram w/up 51727 $667.47 $667.47 $667.47 $667.47
Cystorrhaphy wound simple 51860 $9,247.15 $9,247.15 $9,247.15 $9,247.15
Cystoscopy & duct catheter $667.47 $667.47 $667.47 $667.47
Cystoscopy & revise urethra $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy & revise urethra $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy & ureter catheter $2,048.51 $2,048.51 $2,048.51 $3,417.00
Cystoscopy (Bladder Scope) $667.47 $667.47 $667.47 $1,636.00
Cystoscopy and biopsy $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and radiotracer $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy and treatment $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cystoscopy and treatment $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy and treatment $2,048.51 $2,048.51 $2,048.51 $4,102.20
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $667.47 $667.47 $667.47 $667.47
Cystoscopy and treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cystoscopy and treatment $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy and treatment $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cystoscopy chemodenervation $2,048.51 $2,048.51 $2,048.51 $975.75
Cystoscopy implant stent $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy inject material $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cystoscopy prostatic imp 1-3 $5,083.62 $5,083.62 $5,083.62 $5,953.80
Cystoscopy removal of clots $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystoscopy stone removal $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cystostomy cystotomy w/drainage 51040 $2,048.51 $2,048.51 $2,048.51 $4,228.80
Cystotomy excise/incise/repair 51535 $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystotomy/cystostomy fulg+/insj radact matrl 51020 $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystouretero & or pyeloscope $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystouretero w/biopsy $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cystouretero w/excise tumor $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cystouretero w/lithotripsy $5,083.62 $5,083.62 $5,083.62 $10,899.75
Cystouretero w/renal strict $5,083.62 $5,083.62 $5,083.62 $5,083.62
Cystouretero w/stone remove $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystourethro cut ejacul duct $3,448.97 $3,448.97 $3,448.97 $3,448.97
Cystourethroscop/calib/dilat stric 52281 $2,048.51 $2,048.51 $2,048.51 $3,442.20
Cystourethroscopy w/biopsy(s) 52204 $2,048.51 $2,048.51 $2,048.51 $2,048.51
Cytogenetics 25-99 $42.38 $42.38 $42.38 $292.80
Cytogenetics 3-5 $40.70 $40.70 $40.70 $40.70
Cytogenom microarray copy nmbr var $900.00 $900.00 $900.00 $900.00
Cytogenomic neo microra alys $1,160.00 $1,160.00 $1,160.00 $1,343.40
Cytomegalovirus (cmv) antibody igg $14.39 $14.39 $14.39 $146.40
Cytomegalovirus (cmv) antibody igm $16.85 $16.85 $16.85 $131.25
Cytomegalovirus dfa $13.42 $13.42 $13.42 $13.42
Cytomegalovirus imm IV /vial $1,809.44 $1,809.44 $1,809.44 $5,413.80
Cytopath c/v auto in fluid $25.37 $25.37 $25.37 $25.37
Cytopath c/v index add-on $14.65 $14.65 $14.65 $14.65
Cytopath fl nongyn filter $24.49 $24.49 $24.49 $91.20
Cytopath smear oth prep screen & interp $24.49 $24.49 $24.49 $100.20
Cytopath smear other source $53.43 $53.43 $53.43 $53.43
Cytopath smear other source $24.49 $24.49 $24.49 $54.60
Cytopath tbs c/v manual $18.19 $18.19 $18.19 $36.60
Cytopathology cellular enhancement technique non-gyn $53.43 $53.43 $53.43 $240.75
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review $26.61 $26.61 $26.61 $78.00
Cytopathology cervical/vaginal thin layer manual screening $20.26 $20.26 $20.26 $61.20
Cytopathology concentration technique smears & interpretation $39.25 $39.25 $39.25 $85.80
Cytopathology fluids/washings/brushings smears with interpretation $39.25 $39.25 $39.25 $111.00
Cytopathology fna adequacy evaluation first episode each site $171.36 $171.36 $171.36 $85.60
Cytopathology fna adequacy evaluation first episode each site interp/rpt $53.43 $53.43 $53.43 $186.75
Cytotoxic antibody screening $78.65 $78.65 $78.65 $78.65
Cytotoxic antibody screening $29.68 $29.68 $29.68 $363.75
Cytp urine 3-5 probes cmptr $171.36 $171.36 $171.36 $907.50
D&c after delivery 59160 $3,179.53 $3,179.53 $3,179.53 $3,102.00
D&c of cervical stump $3,179.53 $3,179.53 $3,179.53 $3,179.53
D&c/diagnostic/therapeutic/non ob 58120 $3,179.53 $3,179.53 $3,179.53 $2,361.75
Dactinomycin 0.5 mg intravenous solution $302.92 $302.92 $302.92 $1,624.80
Dalbavancin 500 mg intravenous solution $15.55 $15.55 $15.55 $6,061.91
Daptomycin (xellia) unrefrig $0.05 $0.05 $0.05 $0.05
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln $54.67 $54.67 $54.67 $109.20
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe $3.00 $3.00 $3.00 $5,546.48
Darbepoetin alfa, esrd use $3.00 $3.00 $3.00 $2,151.00
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution $255.09 $255.09 $255.09 $681.00
Daunorubicin 5 mg/ml intravenous solution $19.76 $19.76 $19.76 $300.73
Dbrdmt prmlg les w/pdt $198.70 $198.70 $198.70 $1,000.20
Dch glucoscan $5.04 $5.04 $5.04 $19.50
Dch pulmonary stress test $311.40 $311.40 $311.40 $650.40
Dch validity tests $3.48 $3.48 $3.48 $27.00
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide $1,952.77 $1,952.77 $1,952.77 $1,809.00
Dcmprn orbit only transcrnl $3,243.07 $3,243.07 $3,243.07 $3,243.07
Dcmprn plantar digital nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Deamidated gliadin antibody iga $12.05 $12.05 $12.05 $80.40
Debr musc/fascia 20sq cm/< 11043 $612.13 $612.13 $612.13 $997.50
Debrid ecz/inf skin up tp 10% body 11000 $612.13 $612.13 $612.13 $622.20
Debrid mastoidectomy cavity simple 69220 $198.70 $198.70 $198.70 $198.70
Debrid/rmv fgn bdy/open fx/skin/sq 11010 $703.59 $703.59 $703.59 $1,778.40
Debride nail1-5 11720 $59.40 $59.40 $59.40 $274.20
Debride nail6 or more 11721 $59.40 $59.40 $59.40 $300.75
Debride skin bone at fx site $2,862.05 $2,862.05 $2,862.05 $3,710.40
Debride/rmv fb/open fx/skin/sq/musc11011 $703.59 $703.59 $703.59 $703.59
Debridement bone <= 20 sq cm $1,620.24 $1,620.24 $1,620.24 $2,359.20
Debridement subcutaneous tissue <= 20 sq cm $399.53 $399.53 $399.53 $1,148.25
Declotting thrombolytic agent implanted vas access device 36 $331.69 $331.69 $331.69 $543.00
Decomp fasct leg ant+/lat+pst cmprt 27602 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decomp forearm 1 space 25020 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Decomp forearm 2 spaces w/debrid 25025 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Decompres spinal cord;thoracic 63055 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Decompress fasciotomyhand 26037 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompress fingers/hand $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompress forearm 1 space $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompress forearm 2 spaces $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompress optic nerve $3,771.00 $3,771.00 $3,771.00 $3,771.00
Decompress spinal cord lmbr $7,143.73 $7,143.73 $7,143.73 $7,143.73
Decompress spinal cord thrc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Decompression fasct forearm $7,143.73 $7,143.73 $7,143.73 $7,143.73
Decompression of leg $7,143.73 $7,143.73 $7,143.73 $7,143.73
Decompression of leg $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompression of leg $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompression of lower leg $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompression of lower leg $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompression of thigh/knee $1,600.41 $1,600.41 $1,600.41 $1,600.41
Decompression of thigh/knee $7,143.73 $7,143.73 $7,143.73 $7,143.73
Decompression of thigh/knee $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompression of thigh/knee $3,244.61 $3,244.61 $3,244.61 $3,244.61
Decompression of tibia nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Decompression unspecified nerve 64722 $1,952.77 $1,952.77 $1,952.77 $1,952.77
Deep muscle biopsy 20205 $2,862.05 $2,862.05 $2,862.05 $0.60
Degarelix 120 mg subcutaneous solution $4.36 $4.36 $4.36 $2,262.60
Delay flap arms/legs $1,829.23 $1,829.23 $1,829.23 $1,829.23
Delay flap eye/nos/ear/lip $1,829.23 $1,829.23 $1,829.23 $1,829.23
Delay flap fccnaxghf 15620 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Delay flap trunk 15600 $3,660.97 $3,660.97 $3,660.97 $3,660.97
Delayed breast prosthesis 19342 $9,569.05 $9,569.05 $9,569.05 $9,569.05
Delivery of placenta 59414 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Demonstrate use home inr mon $128.87 $128.87 $128.87 $128.87
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device $203.39 $203.39 $203.39 $196.50
Denervation of hip joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution $29.24 $29.24 $29.24 $10,269.00
Dentoalveolar/drain abs/cyst/hema 41800 $128.90 $128.90 $128.90 $712.80
Derm autograft face/nck/hf/g $3,660.97 $3,660.97 $3,660.97 $3,660.97
Derm autograft trnk/arm/leg $1,829.23 $1,829.23 $1,829.23 $1,829.23
Derma-fat-fascia graft 15770 $3,660.97 $3,660.97 $3,660.97 $3,660.97
Dermabrasion other than face $2,862.05 $2,862.05 $2,862.05 $2,862.05
Dermabrasion segmental face 15781 $703.59 $703.59 $703.59 $703.59
Dermabrasion suprfl any site $399.53 $399.53 $399.53 $399.53
Dermabrasion total face $2,862.05 $2,862.05 $2,862.05 $2,862.05
Dermal filler injection(s) $1,829.23 $1,829.23 $1,829.23 $1,829.23
Design custom breast implant $3,829.28 $3,829.28 $3,829.28 $3,829.28
Design mlc device for imrt $366.07 $366.07 $366.07 $1,479.60
Desmopressin 4 mcg/ml injection solution $3.89 $3.89 $3.89 $172.46
Desoxycorticosterone $30.98 $30.98 $30.98 $285.60
Dest mal lesion feenlm 0.6-1cm 17281 $198.70 $198.70 $198.70 $861.60
Dest mal lesion feenlm 1.1 - 2.0 cm 17282 $198.70 $198.70 $198.70 $246.00
Dest mal lesion feenlm <0.5cm 17280 $198.70 $198.70 $198.70 $1,044.60
Dest mal lesion snhfg 0.6-1cm 17271 $198.70 $198.70 $198.70 $198.70
Dest mal lesion snhfg 1.1-2cm 17272 $198.70 $198.70 $198.70 $198.70
Dest mal lesion snhfg <0.5cm 17270 $198.70 $198.70 $198.70 $198.70
Dest mal lesion tal 0.6-1.0cm 17261 $198.70 $198.70 $198.70 $686.40
Dest mal lesion tal 1.1-2.0cm 17262 $198.70 $198.70 $198.70 $860.40
Dest mal lesion tal 2.1-3.0cm 17263 $198.70 $198.70 $198.70 $952.80
Dest mal lesion tal <0.5 17260 $198.70 $198.70 $198.70 $366.75
Destroy cervthor facet jnt 64633 $1,952.77 $1,952.77 $1,952.77 $2,841.60
Destroy internal hemorrhoids destroy 46930 $1,179.08 $1,179.08 $1,179.08 $1,522.80
Destroy premlg lesns;1st lesn 17000 $198.70 $198.70 $198.70 $199.50
Destroy vulva lesion extensive 56515 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Destroy vulva lesion simple 56501 $1,829.23 $1,829.23 $1,829.23 $3,691.50
Destruct ben lesion 15/> 17111 $198.70 $198.70 $198.70 $228.00
Destruct cut vasl lesions 10-50cm 17107 $612.13 $612.13 $612.13 $612.13
Destruct cut vasl lesions <10cm 17106 $399.53 $399.53 $399.53 $666.75
Destruct cut vasl lesions >50cm 17108 $1,829.23 $1,829.23 $1,829.23 $1,442.25
Destruct penis les/smp/electrodesi 54055 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Destruction anal lesion(s) $1,829.23 $1,829.23 $1,829.23 $1,783.50
Destruction anal lesion(s) $2,742.39 $2,742.39 $2,742.39 $1,638.00
Destruction anal lesion(s) smpl chem 46900 $399.53 $399.53 $399.53 $468.00
Destruction benign lesions < 14 lesions $198.70 $198.70 $198.70 $268.50
Destruction by injection tx of nerve 64630 $890.29 $890.29 $890.29 $2,203.50
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) $1,952.77 $1,952.77 $1,952.77 $2,908.20
Destruction ciliary body $2,332.96 $2,332.96 $2,332.96 $2,332.96
Destruction ciliary body $2,332.96 $2,332.96 $2,332.96 $2,332.96
Destruction ciliary body $2,280.73 $2,280.73 $2,280.73 $2,280.73
Destruction cryosurgery anal lesion(s) simpl 46916 $198.70 $198.70 $198.70 $198.70
Destruction laser surgery anal lesions 46917 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Destruction les conjunctiva $2,332.96 $2,332.96 $2,332.96 $2,332.96
Destruction mal lsn s/n/h/f/g 2.1-3cm $399.53 $399.53 $399.53 $1,378.20
Destruction mal lsn s/n/h/f/g 3.1-4cm $399.53 $399.53 $399.53 $399.53
Destruction mal lsn t/a/l 3.1-4cm $399.53 $399.53 $399.53 $1,033.80
Destruction mal lsn t/a/l >4cm $399.53 $399.53 $399.53 $954.75
Destruction penis lesion(s) chem 54050 $399.53 $399.53 $399.53 $229.20
Destruction penis lesion(s) exten 54065 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Destruction premal lesions 15/> 17004 $399.53 $399.53 $399.53 $521.25
Destruction rectal tumor 45190 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Destruction vag lesions complex 57065 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Destruction vag lesions simple 57061 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Detect agent nos dna dir $30.03 $30.03 $30.03 $30.03
Detect agnt mult dna direc $43.67 $43.67 $43.67 $120.00
Devel tst phys/qhp 1st hr $156.46 $156.46 $156.46 $337.50
Dexa bone density study >=1 sites appendicular skeleton (peripheral) $88.05 $88.05 $88.05 $127.20
Dexametha opth insert 0.1 mg $101.49 $101.49 $101.49 $505.80
Dexamethasone intra implant $205.28 $205.28 $205.28 $521.40
Dexmedetomidine film, 1 mcg $0.64 $0.64 $0.64 $0.64
Dexrazoxane hcl 250 mg intravenous solution $32.09 $32.09 $32.09 $1,087.80
Dhea-s (dehydroepiand sulfate) $22.23 $22.23 $22.23 $204.00
Diab manage trn ind/group $19.66 $19.66 $19.66 $57.75
Diabetes (HbA1c) Test $9.71 $9.71 $9.71 $69.55
Diabetes training group per 30 min g0109 $29.79 $29.79 $29.79 $29.79
Diag bronchoscope/catheter $1,724.47 $1,724.47 $1,724.47 $2,379.00
Diag laparo separate proc 49320 $5,834.36 $5,834.36 $5,834.36 $853.80
Diagnostic Mammogram (both breasts) $207.95 $207.95 $207.95 $424.00
Diagnostic Mammogram (one breast) $164.52 $164.52 $164.52 $297.05
Diagnostic anoscopy $399.04 $399.04 $399.04 $399.04
Diagnostic anoscopy & biopsy $1,179.08 $1,179.08 $1,179.08 $1,179.08
Diagnostic anoscopy spx 46600 $128.90 $128.90 $128.90 $341.40
Diagnostic laryngoscopy 31505 $194.14 $194.14 $194.14 $338.40
Diagnostic laryngoscopy 31575 $194.14 $194.14 $194.14 $489.75
Diagnostic radio unlisted proc $88.05 $88.05 $88.05 $170.40
Dialysis one evaluation $425.82 $425.82 $425.82 $1,013.40
Diathermy eg microwave $9.28 $9.28 $9.28 $9.28
Difelikefalin, esrd on dialy $0.08 $0.08 $0.08 $0.08
Digoxin immune fab 40 mg intravenous solution $4,968.58 $4,968.58 $4,968.58 $11,176.20
Digoxin total therapeutic drug level $13.28 $13.28 $13.28 $126.00
Dilat xst trc ndurlgc px $3,448.97 $3,448.97 $3,448.97 $3,448.97
Dilat xst trc new access rcs $3,448.97 $3,448.97 $3,448.97 $3,448.97
Dilate esophagus $1,896.99 $1,896.99 $1,896.99 $1,896.99
Dilate esophagus 1/mult pass $937.56 $937.56 $937.56 $1,547.40
Dilate tear duct opening $399.04 $399.04 $399.04 $399.04
Dilate urethra stricture $3,448.97 $3,448.97 $3,448.97 $3,448.97
Dilate urethra stricture $243.21 $243.21 $243.21 $534.00
Dilate urethra stricture $128.90 $128.90 $128.90 $128.90
Dilate urethra stricture $243.21 $243.21 $243.21 $243.21
Dilation of anal sphincter $1,179.08 $1,179.08 $1,179.08 $1,179.08
Dilation of cervical canal 57800 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Dilation of rectal stricture 45910 $1,179.08 $1,179.08 $1,179.08 $1,375.50
Dilation of salivary duct $509.25 $509.25 $509.25 $509.25
Dilation of urethra $128.90 $128.90 $128.90 $128.90
Dilation of urethra $2,048.51 $2,048.51 $2,048.51 $2,048.51
Dilation of vagina $3,179.53 $3,179.53 $3,179.53 $3,179.53
Dilation salivary duct 42650 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Dilation/female urethra/initial 53660 $156.46 $156.46 $156.46 $156.46
Dilation/urethral strict/male/ini 53620 $667.47 $667.47 $667.47 $667.47
Dimethyl sulfoxide 50% 50 ml $742.90 $742.90 $742.90 $2,501.55
Dir nsl mucous membrane test $39.25 $39.25 $39.25 $39.25
Disability dlco $156.46 $156.46 $156.46 $234.00
Disaccharidases $22.17 $22.17 $22.17 $163.80
Disarticulation sho sec clsr $1,829.23 $1,829.23 $1,829.23 $1,829.23
Discography cerv/thor spine $1,952.77 $1,952.77 $1,952.77 $2,062.50
Dise eval slp do brth flx dx $1,724.47 $1,724.47 $1,724.47 $1,724.47
Dist revas ligation hemo $5,405.70 $5,405.70 $5,405.70 $9,842.40
Diverticulectomy/hypophar/esoph 43130 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Dmd dup/delet analysis $279.00 $279.00 $279.00 $2,106.00
Dmpk gene detc abnor allele $137.00 $137.00 $137.00 $567.75
Dna antibody native/double stranded $13.74 $13.74 $13.74 $135.75
Dna gardnerella $20.05 $20.05 $20.05 $197.40
Dna probe chlamydia $22.75 $22.75 $22.75 $82.20
Dna probe gc $26.88 $26.88 $26.88 $72.60
Dna trichomonas $20.05 $20.05 $20.05 $203.40
Docetaxel (docivyx), 1 mg $49.08 $49.08 $49.08 $49.08
Doppler upper/lower extremity arteries complete bilateral $156.46 $156.46 $156.46 $901.80
Doppler upper/lower extremity arteries limited bilateral $128.90 $128.90 $128.90 $547.20
Dostarlimab-gxly 50 mg/ml intravenous solution $243.82 $243.82 $243.82 $544.20
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension $109.28 $109.28 $109.28 $2,245.20
Dpyd gene common variants $174.81 $174.81 $174.81 $2,358.60
Drain bladder by trocar/cath $1,017.39 $1,017.39 $1,017.39 $451.20
Drain blood from under nail 11740 $128.90 $128.90 $128.90 $266.40
Drain cath image guided peri/retroperitoneal transvag/transrectal $1,620.24 $1,620.24 $1,620.24 $2,976.00
Drain cath image guided visceral pq $1,620.24 $1,620.24 $1,620.24 $4,627.80
Drain cerebro spinal fluid 62272 $692.52 $692.52 $692.52 $1,485.75
Drain chest lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Drain finger abscess;simple 26010 $198.70 $198.70 $198.70 $318.00
Drain lower leg bursa $3,244.61 $3,244.61 $3,244.61 $3,244.61
Drain lower leg lesion 27603 $2,862.05 $2,862.05 $2,862.05 $3,022.50
Drain neck/chest lesion 21501 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Drain ovarn cyst abd $3,179.53 $3,179.53 $3,179.53 $4,140.00
Drain ovary abscess open $3,179.53 $3,179.53 $3,179.53 $3,179.53
Drain penis lesion $1,620.24 $1,620.24 $1,620.24 $1,620.24
Drain shoulder bone lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Drain shoulder bursa 23031 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Drain shoulder lesion $2,862.05 $2,862.05 $2,862.05 $2,862.05
Drain thigh/knee lesion 27301 $2,862.05 $2,862.05 $2,862.05 $5,397.60
Drain thyroid/tongue cyst $1,481.28 $1,481.28 $1,481.28 $1,481.28
Drainage absc/cyst/hmtma/vestibule mouth smpl $703.59 $703.59 $703.59 $824.40
Drainage ext aud canal abscess 69020 $703.59 $703.59 $703.59 $1,440.00
Drainage external ear complex 69005 $1,620.24 $1,620.24 $1,620.24 $4,074.75
Drainage external ear simple 69000 $703.59 $703.59 $703.59 $709.50
Drainage lymph node lesion 38300 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Drainage lymph node lesion 38305 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Drainage mouth roof lesion $232.22 $232.22 $232.22 $837.00
Drainage of arm bursa 23931 $1,620.24 $1,620.24 $1,620.24 $2,638.50
Drainage of bladder abscess $2,862.05 $2,862.05 $2,862.05 $2,862.05
Drainage of eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Drainage of eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Drainage of eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Drainage of forearm bursa $1,600.41 $1,600.41 $1,600.41 $1,600.41
Drainage of kidney lesion $703.59 $703.59 $703.59 $1,989.75
Drainage of mouth lesion $1,481.28 $1,481.28 $1,481.28 $1,481.28
Drainage of mouth lesion $232.22 $232.22 $232.22 $232.22
Drainage of mouth lesion $1,481.28 $1,481.28 $1,481.28 $1,481.28
Drainage of mouth lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Drainage of mouth lesion $509.25 $509.25 $509.25 $509.25
Drainage of mouth lesion $3,243.07 $3,243.07 $3,243.07 $3,430.80
Drainage of mouth lesion $509.25 $509.25 $509.25 $509.25
Drainage of mouth lesion $1,481.28 $1,481.28 $1,481.28 $2,270.40
Drainage of mouth lesion $5,915.66 $5,915.66 $5,915.66 $4,468.20
Drainage of nose lesion int 30000 $232.22 $232.22 $232.22 $649.80
Drainage of nose lesion sept 30020 $509.25 $509.25 $509.25 $637.50
Drainage of pelvis bursa $1,600.41 $1,600.41 $1,600.41 $1,600.41
Drainage of pelvis lesion 26990 $3,244.61 $3,244.61 $3,244.61 $3,355.20
Drainage of prostate abscess $3,448.97 $3,448.97 $3,448.97 $3,448.97
Drainage of prostate abscess $3,448.97 $3,448.97 $3,448.97 $3,448.97
Drainage of prostate abscess $3,448.97 $3,448.97 $3,448.97 $3,448.97
Drainage of rectal abscess $1,179.08 $1,179.08 $1,179.08 $3,520.20
Drainage of rectal abscess 45020 $2,742.39 $2,742.39 $2,742.39 $5,376.00
Drainage of salivary gland $509.25 $509.25 $509.25 $509.25
Drainage of salivary gland $3,243.07 $3,243.07 $3,243.07 $3,243.07
Drainage of throat abscess $5,915.66 $5,915.66 $5,915.66 $5,915.66
Drainage of urethra abscess $3,448.97 $3,448.97 $3,448.97 $3,448.97
Drainage of urethra abscess 53060 $2,048.51 $2,048.51 $2,048.51 $2,048.51
Drainage of urinary leakage $2,048.51 $2,048.51 $2,048.51 $2,048.51
Drainage of urinary leakage $667.47 $667.47 $667.47 $667.47
Dress/debrid prtl-thick burn l 16030 $399.53 $399.53 $399.53 $825.60
Dress/debride pt-tck burn/5-10% bs 16025 $198.70 $198.70 $198.70 $451.20
Dress/debride pt-thick burn/<5% bs 16020 $198.70 $198.70 $198.70 $408.60
Dressing change not for burn w/anes 15852 $612.13 $612.13 $612.13 $612.13
Drng hand tendon sheath 26020 $3,244.61 $3,244.61 $3,244.61 $4,150.20
Drng of eyelid abscess 67700 $298.93 $298.93 $298.93 $3,479.40
Drng of finger abscess comp 26011 $1,620.24 $1,620.24 $1,620.24 $1,875.00
Drng of hydrocele 55000 $703.59 $703.59 $703.59 $703.59
Drng of mouth lesion 40801 $509.25 $509.25 $509.25 $3,040.20
Drng of ovarian cyst(s) 58800 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Drng of palm multi bursas 26030 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Drng of palm single bursa 26025 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Drng of pelvic abscess transrectal 45000 $1,179.08 $1,179.08 $1,179.08 $1,179.08
Drng of salivary cyst 42409 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Drng of scrotum abscess 55100 $1,620.24 $1,620.24 $1,620.24 $2,630.40
Drng salivary gland simple 42300 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Drng salivary gland submax/subling 42310 $509.25 $509.25 $509.25 $509.25
Drug assay caffeine $38.57 $38.57 $38.57 $55.50
Drug assay posaconazole $27.11 $27.11 $27.11 $171.75
Drug assay rufinamide $27.11 $27.11 $27.11 $135.75
Drug assay vedolizumab $38.57 $38.57 $38.57 $298.80
Drug assay voriconazole $27.11 $27.11 $27.11 $186.00
Drug asy hydroxychloroquine $18.64 $18.64 $18.64 $196.20
Drug of abuse screen urine $12.60 $12.60 $12.60 $48.00
Drug screen quant tiagabine $27.11 $27.11 $27.11 $188.40
Drug test def 1-7 classes $114.43 $114.43 $114.43 $316.80
Drug test def 15-21 classes $198.74 $198.74 $198.74 $198.74
Drug test def 22+ classes $246.92 $246.92 $246.92 $246.92
Drug test def 8-14 classes $156.59 $156.59 $156.59 $345.00
Drug test prsmv instrmnt $17.14 $17.14 $17.14 $17.14
Drug test(s) presumptive any class instrument chemistry analyzers $62.14 $62.14 $62.14 $383.20
Drvvt confirm - quest $17.98 $17.98 $17.98 $174.60
Dstr mal les s/n/h/f/g >4.0 $399.53 $399.53 $399.53 $399.53
Dstr mal ls f/e/e/n/l/m2.1-3 $399.53 $399.53 $399.53 $399.53
Dstr mal ls f/e/e/n/l/m3.1-4 $612.13 $612.13 $612.13 $612.13
Dstr mal ls f/e/e/n/l/m>4.0 $612.13 $612.13 $612.13 $612.13
Dstrj extensive retinopathy $3,771.00 $3,771.00 $3,771.00 $3,771.00
Dstrj nulyt agt gnclr nrv $1,952.77 $1,952.77 $1,952.77 $1,614.75
Dstry eye lesn,fdr vssl tech $548.60 $548.60 $548.60 $548.60
Ductogram sgl duct $241.72 $241.72 $241.72 $547.80
Duodenal motility study $530.60 $530.60 $530.60 $1,347.75
Dup scan/hemodialysis access 93990 $106.34 $106.34 $106.34 $684.60
Dup scan/lwr xtr vasc stdy bilat 93924 $156.46 $156.46 $156.46 $914.40
Dup scan/ue art/graft/bilat/comp 93930 $241.72 $241.72 $241.72 $840.00
Duplex scan bilateral study 93985 $241.72 $241.72 $241.72 $1,144.80
Duplex scan unilateral study 93986 $106.34 $106.34 $106.34 $643.20
Durvalumab 50 mg/ml intravenous solution $85.25 $85.25 $85.25 $213.60
Dx aly aud oi snd prcsr 1st $156.46 $156.46 $156.46 $153.00
Dx bronchoscope/brush 31623 $1,724.47 $1,724.47 $1,724.47 $2,159.25
Dx bronchoscope/lavage 31624 $1,724.47 $1,724.47 $1,724.47 $2,886.75
Dx bronchoscope/wash 31622 $1,724.47 $1,724.47 $1,724.47 $2,168.40
Dx dark adaptation exam i&r $399.04 $399.04 $399.04 $399.04
Dx duod intub w/asp spec 43756 $937.56 $937.56 $937.56 $937.56
Dx duod intub w/asp specs $937.56 $937.56 $937.56 $937.56
Dx gastr intub w/asp spec $311.40 $311.40 $311.40 $311.40
Dx gastr intub w/asp specs $156.46 $156.46 $156.46 $156.46
Dx laryngoscopy newborn $388.31 $388.31 $388.31 $388.31
Dx laryngoscopy w/oper scope $1,724.47 $1,724.47 $1,724.47 $1,724.47
Dxa bone density axl vrt fx $106.34 $106.34 $106.34 $591.75
Dynamic cavernosometry $243.21 $243.21 $243.21 $243.21
Dynamic surface emg $311.40 $311.40 $311.40 $311.40
E coli 0157 ag ia $12.66 $12.66 $12.66 $12.66
E equine encephalitis igg $13.19 $13.19 $13.19 $122.40
EKG tracing for initial prev $24.49 $24.49 $24.49 $24.49
ER Visit (level 1, minor) $88.05 $88.05 $88.05 $286.51
ER Visit (level 2) $158.36 $158.36 $158.36 $469.39
ER Visit (level 3) $276.89 $276.89 $276.89 $827.20
ER Visit (level 4) $425.82 $425.82 $425.82 $1,330.00
ER Visit (level 5, high severity) $613.10 $613.10 $613.10 $1,892.80
Ear and throat examination $509.25 $509.25 $509.25 $509.25
Ear canal biopsy 69105 $1,481.28 $1,481.28 $1,481.28 $1,353.00
Ear cartilage graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Ear irrigation 69209 $59.40 $59.40 $59.40 $128.25
Ear protector evaluation $39.25 $39.25 $39.25 $39.25
Ecallantide injection $579.99 $579.99 $579.99 $579.99
Ecg 12 lead tracing only $59.40 $59.40 $59.40 $271.80
Ecg < 30 days transmission & analysis $91.79 $91.79 $91.79 $624.75
Ecg external < 48 hours recording $128.90 $128.90 $128.90 $500.25
Ecg external < 48 hours scanning analysis w/report $59.40 $59.40 $59.40 $567.00
Ecg external > 48 hours up to 7 days recording $39.25 $39.25 $39.25 $72.60
Ecg external >7 days up to 15 days recording $39.25 $39.25 $39.25 $75.00
Ecg/1-3 leads/tracing only 93041 $59.40 $59.40 $59.40 $59.40
Echo exam of eye $106.34 $106.34 $106.34 $106.34
Echo exam of eye $88.05 $88.05 $88.05 $430.20
Echo exam of eye $106.34 $106.34 $106.34 $106.34
Echo exam of eye thickness $24.49 $24.49 $24.49 $24.49
Echo exam of fetal heart $106.34 $106.34 $106.34 $250.50
Echo exam of fetal heart $548.30 $548.30 $548.30 $548.30
Echo exam of fetal heart $241.72 $241.72 $241.72 $398.25
Echo exam of fetal heart $106.34 $106.34 $106.34 $424.80
Echo exam uterus 76831- $241.72 $241.72 $241.72 $695.40
Echo guide for artery repair $311.40 $311.40 $311.40 $1,009.20
Echo stress $548.30 $548.30 $548.30 $1,056.00
Echo tee cngntl wo ctrst probe plcmnt $548.30 $548.30 $548.30 $548.30
Echo tee probe placement image acquisition interpretation & report $548.30 $548.30 $548.30 $1,724.25
Echo transesophageal $548.30 $548.30 $548.30 $1,626.00
Echo transesophageal $548.30 $548.30 $548.30 $58.80
Echo transesophageal intraop $548.30 $548.30 $548.30 $2,142.60
Echo transthoracic $548.30 $548.30 $548.30 $1,094.40
Echo transthoracic $548.30 $548.30 $548.30 $548.30
Echo tte 2d comp wo ctrst wo clr/dplr $241.72 $241.72 $241.72 $1,026.40
Echocardiogram (Heart Ultrasound) $548.30 $548.30 $548.30 $2,021.12
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler $790.06 $790.06 $790.06 $2,126.25
Echocardiography transthoracic 2d followup/limited $241.72 $241.72 $241.72 $691.20
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast $357.13 $357.13 $357.13 $667.50
Echograp trans r pros study $106.34 $106.34 $106.34 $576.60
Ecog impltd brn npgt <30 d $37.29 $37.29 $37.29 $37.29
Ecp ciliary body destruction $2,280.73 $2,280.73 $2,280.73 $2,280.73
Eculizumab 300 mg/30 ml intravenous solution $44.77 $44.77 $44.77 $268.80
Edetate calcium disodium inj $6,454.57 $6,454.57 $6,454.57 $20,833.61
Eeg 41-60 minutes 95812-26 $311.40 $311.40 $311.40 $1,081.50
Eeg monitor/record/awake/drowsy 95816 $311.40 $311.40 $311.40 $855.60
Eeg monitoring/function test $1,017.39 $1,017.39 $1,017.39 $2,440.50
Eeg monitoring/giving drugs $530.60 $530.60 $530.60 $530.60
Eeg over 1 hour 95813 - 26 $311.40 $311.40 $311.40 $907.80
Eeg recording awake and asleep $311.40 $311.40 $311.40 $1,173.00
Eeg without vid 2-12 hr unmntr $311.40 $311.40 $311.40 $586.20
Eeg without vid 2-12hr cont mntr $311.40 $311.40 $311.40 $623.40
Eeg without vid ea 12-26hr cont $530.60 $530.60 $530.60 $1,194.00
Eeg without vid ea 12-26hr intmt $530.60 $530.60 $530.60 $1,126.20
Eeg wo vid 2-12hr intmt mntr $311.40 $311.40 $311.40 $602.40
Eeg wo vid ea 12-26hr unmntr $530.60 $530.60 $530.60 $1,126.20
Eeg/cerebral death evaluation only 95824 -26 $530.60 $530.60 $530.60 $1,177.80
Eeg/record in coma or sleep only 95822 $311.40 $311.40 $311.40 $1,095.60
Efgartigimod alfa-fcab 20 mg/ml intravenous solution $32.40 $32.40 $32.40 $79.20
Egd Ultrasound exam duodenum/jejunum $1,896.99 $1,896.99 $1,896.99 $3,414.00
Egd Ultrasound fine needle bx/aspir $1,896.99 $1,896.99 $1,896.99 $3,322.50
Egd Ultrasound fine needle bx/aspir $1,896.99 $1,896.99 $1,896.99 $3,414.00
Egd Ultrasound transmural injxn/mark $1,896.99 $1,896.99 $1,896.99 $3,127.50
Egd balloon dil esoph30 mm/> $1,896.99 $1,896.99 $1,896.99 $1,903.50
Egd control bleeding any $1,896.99 $1,896.99 $1,896.99 $2,547.00
Egd dilate stricture $1,896.99 $1,896.99 $1,896.99 $3,148.50
Egd endo mucosal resection $1,896.99 $1,896.99 $1,896.99 $1,896.99
Egd endoscopic stent place $5,952.81 $5,952.81 $5,952.81 $4,379.25
Egd esophagogastrc fndoplsty $10,411.22 $10,411.22 $10,411.22 $10,411.22
Egd flx trnsorl dplmnt balo $1,896.99 $1,896.99 $1,896.99 $1,896.99
Egd flx trnsorl rmvl balo $937.56 $937.56 $937.56 $937.56
Egd guide wire insertion $937.56 $937.56 $937.56 $2,765.25
Egd injection varices $1,896.99 $1,896.99 $1,896.99 $3,241.20
Egd lesion ablation $1,896.99 $1,896.99 $1,896.99 $3,360.75
Egd optical endomicroscopy $1,896.99 $1,896.99 $1,896.99 $1,896.99
Egd remove foreign body $937.56 $937.56 $937.56 $2,501.40
Egd remove lesion snare $1,896.99 $1,896.99 $1,896.99 $2,501.40
Egd varices ligation $1,896.99 $1,896.99 $1,896.99 $3,061.20
Egd w/thrml txmnt gerd $3,804.53 $3,804.53 $3,804.53 $6,529.80
Egd w/transmural drain cyst $5,952.81 $5,952.81 $5,952.81 $5,952.81
Egd/insert intraluminal tube/cath 43241 $1,896.99 $1,896.99 $1,896.99 $2,502.75
Egd/remov tum/polyp/hot bx forcep 43250 $1,896.99 $1,896.99 $1,896.99 $2,736.75
Egfr gene com variants $324.58 $324.58 $324.58 $808.80
Ehrlicha chaffeensis amp prb $35.09 $35.09 $35.09 $290.40
Elbow arthroscopy $3,244.61 $3,244.61 $3,244.61 $3,244.61
Elbow arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Elbow arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Elbow arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Elbow arthroscopy/surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Elbow arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Elec analys infus pump w/reprog 62368 $299.91 $299.91 $299.91 $669.75
Elec stim unattend for press $14.52 $14.52 $14.52 $14.52
Elect analysis of infusion pump 62367 $299.91 $299.91 $299.91 $508.50
Elect anlys sp inf pmp w/reprg&fill 62369 $299.91 $299.91 $299.91 $843.00
Electrical bone stim 20974 $61.91 $61.91 $61.91 $61.91
Electro-oculography w/i&r $128.90 $128.90 $128.90 $128.90
Electrocochleography $156.46 $156.46 $156.46 $349.80
Electroconvulsive therapy 90870 $530.60 $530.60 $530.60 $1,226.40
Electrode stimulation brain $1,017.39 $1,017.39 $1,017.39 $1,137.75
Electroejaculation $870.74 $870.74 $870.74 $870.74
Electrogastrography $311.40 $311.40 $311.40 $311.40
Electrogastrography w/test $128.90 $128.90 $128.90 $128.90
Electrolyte panel $7.01 $7.01 $7.01 $120.00
Electron microscopy diagnostic $816.90 $816.90 $816.90 $1,386.00
Electronic analysis with brain program first 15 min 95983 $91.79 $91.79 $91.79 $990.75
Electrophysiologic study $7,588.10 $7,588.10 $7,588.10 $5,773.20
Electrophysiology evaluation $7,588.10 $7,588.10 $7,588.10 $5,625.00
Electrophysiology evaluation $1,213.99 $1,213.99 $1,213.99 $1,735.80
Electrophysiology evaluation $7,588.10 $7,588.10 $7,588.10 $7,588.10
Elosulfase alfa, injection $306.80 $306.80 $306.80 $306.80
Elotuzumab 300 mg intravenous solution $7.88 $7.88 $7.88 $1,749.60
Elranatamab-bcmm 40 mg/ml subcutaneous solution $185.31 $185.31 $185.31 $463.20
Emb without cervical dilation 58100 $201.17 $201.17 $201.17 $2,115.00
Emb/throm/fempop/aor/ilia/leg inc 34201 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Emb/throm/pop-tib-pero art/leg inc 34203 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Embedded ip cath exit-site 49436 $1,896.99 $1,896.99 $1,896.99 $432.00
Embo or occlude vascular arterial s&i $17,956.72 $17,956.72 $17,956.72 $13,812.00
Embo or occlude vascular hemorrhage s&i $11,340.57 $11,340.57 $11,340.57 $11,680.50
Embo or occlude vascular tumor/organ/infarct s&i $11,340.57 $11,340.57 $11,340.57 $11,680.50
Embo or occlude vascular venous s&i $11,340.57 $11,340.57 $11,340.57 $12,721.80
Embryo hatching $171.36 $171.36 $171.36 $171.36
Embryo transfer intrauterine $870.74 $870.74 $870.74 $870.74
Emg 2 ext w-w/o paraspinal area 95861 $128.90 $128.90 $128.90 $665.40
Emg 3 ext w-w/o paraspinal area 95863 $156.46 $156.46 $156.46 $447.00
Emg cranial nerve bilateral $311.40 $311.40 $311.40 $529.80
Emg needle test 1-extremity $128.90 $128.90 $128.90 $362.25
Emg needle test 4-extremities $156.46 $156.46 $156.46 $1,050.00
Emg thor paraspinal without t1/t2 $311.40 $311.40 $311.40 $311.40
Encephalitis, california igg/igm $13.19 $13.19 $13.19 $122.40
Encephalitis, st louis igg/igm $13.19 $13.19 $13.19 $122.40
Encephalitis, western equine igg/igm $13.19 $13.19 $13.19 $122.40
Endo abl/incom vein/ext/laser/#1 36478 $3,147.50 $3,147.50 $3,147.50 $6,423.75
Endo abl/incom vein/ext/rad fre/#1 36475 $3,147.50 $3,147.50 $3,147.50 $6,527.25
Endo cholangiopancreatograph $3,804.53 $3,804.53 $3,804.53 $3,831.00
Endo cholangiopancreatograph $3,804.53 $3,804.53 $3,804.53 $3,546.00
Endo defect closure gi tract $10,411.22 $10,411.22 $10,411.22 $10,411.22
Endo outlet restrict w/tube $10,411.22 $10,411.22 $10,411.22 $10,411.22
Endo sleeve gastro w/tube $10,411.22 $10,411.22 $10,411.22 $10,411.22
Endocerv curettage w/scope 57456 $304.19 $304.19 $304.19 $585.00
Endocervical curettage 57505 $870.74 $870.74 $870.74 $956.25
Endome abla/them without hystero guide 58353 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Endometrial cryoablation w/us 58356 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Endoscopic Ultrasound exam esoph $1,896.99 $1,896.99 $1,896.99 $2,517.00
Endoscopic injection/implant $3,448.97 $3,448.97 $3,448.97 $3,448.97
Endoscopy bowel pouch/biop $911.71 $911.71 $911.71 $1,896.00
Endoscopy ligate perf veins 37500 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Endoscopy maxillary sinus $6,922.47 $6,922.47 $6,922.47 $6,922.47
Endoscopy of bowel pouch 44385 $911.71 $911.71 $911.71 $1,696.20
Endoscopy of ureter $3,448.97 $3,448.97 $3,448.97 $3,448.97
Endoscopy of ureter $3,448.97 $3,448.97 $3,448.97 $3,448.97
Endoscopy swallow (fees) vid $85.66 $85.66 $85.66 $510.00
Endoscpy nsl/sns w/cntrl nsl hmrrgh $1,724.47 $1,724.47 $1,724.47 $2,377.20
Endovasc tempory vessel occl $11,340.57 $11,340.57 $11,340.57 $9,294.60
Endoven ther chem adhes 1st 36482 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Endovenous mchnchem 1st vein $3,147.50 $3,147.50 $3,147.50 $4,102.20
Enfortumab vedotin-ejfv 20 mg intravenous solution $36.66 $36.66 $36.66 $64.20
Entamoeba histolytica ag eia - sendout $11.98 $11.98 $11.98 $89.25
Enzyme cell activity ra $44.03 $44.03 $44.03 $547.20
Enzyme histochemistry $816.90 $816.90 $816.90 $573.60
Ep & ablate supravent arrhyt $24,532.30 $24,532.30 $24,532.30 $24,532.30
Ep & ablate ventric tachy $24,532.30 $24,532.30 $24,532.30 $30,975.00
Ep induct arrhy by elect pacing $1,213.99 $1,213.99 $1,213.99 $3,663.00
Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution $55.66 $55.66 $55.66 $102.60
Epidrm a-grft face/nck/hf/g 15115 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Epidrm agrft t/a/l 1st 100 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Epidural lysis mult sessions $890.29 $890.29 $890.29 $890.29
Epidural lysis on single day 62264 $890.29 $890.29 $890.29 $2,673.00
Epiglottidectomy $5,915.66 $5,915.66 $5,915.66 $5,915.66
Epilepsy gen seq alys panel $2,448.56 $2,448.56 $2,448.56 $2,448.56
Epiphysl arrst dstl rds&ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Epiphysl arrst dstl rds/ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Episiotomy/vag rpr oth/thn attending phys 59300 $3,179.53 $3,179.53 $3,179.53 $2,952.75
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr $7.68 $7.68 $7.68 $255.20
Epoetin alfa-epbx 40,000 unit/ml injection solution $7.57 $7.57 $7.57 $336.66
Epoetin beta non esrd $1.41 $1.41 $1.41 $1.41
Epstein barr early antigen antibody $13.12 $13.12 $13.12 $105.00
Epstein barr nuclear antigen antibody $15.29 $15.29 $15.29 $120.75
Epstein barr viral capsid antigen antibody igm $18.14 $18.14 $18.14 $133.20
Eptinezumab-jjmr 100 mg/ml intravenous solution $19.85 $19.85 $19.85 $3,637.20
Ercp bil/panc duct; each stent plcmt 43274 $5,952.81 $5,952.81 $5,952.81 $4,282.20
Ercp ea duct/ampulla dilate $3,804.53 $3,804.53 $3,804.53 $3,882.75
Ercp lesion ablate w/dilate 43278 $3,804.53 $3,804.53 $3,804.53 $4,640.25
Ercp lithotripsy calculi $5,952.81 $5,952.81 $5,952.81 $5,378.40
Ercp remove duct calculi 43264 $3,804.53 $3,804.53 $3,804.53 $3,955.50
Ercp remove forgn body duct 43275 $1,896.99 $1,896.99 $1,896.99 $3,726.00
Ercp sphincter pressure meas $1,896.99 $1,896.99 $1,896.99 $2,771.25
Ercp stent exchange w/dilate $5,952.81 $5,952.81 $5,952.81 $4,497.75
Ercp w/specimen collection $3,804.53 $3,804.53 $3,804.53 $4,277.25
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution $104.58 $104.58 $104.58 $387.60
Esd endoscopy or colonoscopy $3,804.53 $3,804.53 $3,804.53 $4,282.20
Esoph balloon distension tst $530.60 $530.60 $530.60 $530.60
Esoph egd dilation <30 mm $1,896.99 $1,896.99 $1,896.99 $2,501.40
Esoph endoscopy dilation $1,896.99 $1,896.99 $1,896.99 $2,205.75
Esoph imped funct test > 1hr $530.60 $530.60 $530.60 $1,122.00
Esoph imped function test $311.40 $311.40 $311.40 $603.00
Esoph optical endomicroscopy $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esoph scope w/sclerosis inj $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esoph scope w/submucous inj $1,896.99 $1,896.99 $1,896.99 $3,078.00
Esophag muc integ w/eso egd $3,804.53 $3,804.53 $3,804.53 $3,804.53
Esophageal motility $401.83 $401.83 $401.83 $499.20
Esophageal recording $1,213.99 $1,213.99 $1,213.99 $1,213.99
Esophageal recording $1,213.99 $1,213.99 $1,213.99 $1,213.99
Esophagosc dilate balloon 30 $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esophagosc flex trnsn biopsy $937.56 $937.56 $937.56 $2,062.50
Esophagoscop mucosal resect $1,896.99 $1,896.99 $1,896.99 $2,992.50
Esophagoscop stent placement $5,952.81 $5,952.81 $5,952.81 $5,952.81
Esophagoscop ultrasound exam $1,896.99 $1,896.99 $1,896.99 $3,414.00
Esophagoscopy balloon <30mm $1,896.99 $1,896.99 $1,896.99 $2,794.80
Esophagoscopy control bleed $1,896.99 $1,896.99 $1,896.99 $2,598.75
Esophagoscopy flex biopsy $1,896.99 $1,896.99 $1,896.99 $2,676.75
Esophagoscopy flex dx brush $937.56 $937.56 $937.56 $1,930.50
Esophagoscopy flex remove fb $1,896.99 $1,896.99 $1,896.99 $2,361.00
Esophagoscopy lesion ablate $3,804.53 $3,804.53 $3,804.53 $3,804.53
Esophagoscopy lesion removal $1,896.99 $1,896.99 $1,896.99 $2,946.75
Esophagoscopy retro balloon $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esophagoscopy rigid balloon $3,804.53 $3,804.53 $3,804.53 $3,804.53
Esophagoscopy rigid trnso 43180 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Esophagoscopy snare les remv $1,896.99 $1,896.99 $1,896.99 $2,680.50
Esophagoscopy w/us needle bx $1,896.99 $1,896.99 $1,896.99 $3,940.50
Esophagoscopy/flex/diagnostic 43200 $937.56 $937.56 $937.56 $2,623.50
Esophagoscopy/rigid/diagnostic 43191 $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esophagoscp guide wire dilat 43196 $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esophagoscp rig trnso biopsy $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esophagoscp rig trnso inject $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esophagoscp rig trnso rem fb $1,896.99 $1,896.99 $1,896.99 $1,896.99
Esophagus endoscopy/ligation $1,896.99 $1,896.99 $1,896.99 $3,386.25
Esophagus motility study $530.60 $530.60 $530.60 $1,232.25
Essure 58565 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Estradiol total $27.94 $27.94 $27.94 $226.50
Estrogens total-sendout $21.70 $21.70 $21.70 $270.00
Etanercept injection $1,080.88 $1,080.88 $1,080.88 $1,801.80
Ethanolamine oleate 100 mg $519.52 $519.52 $519.52 $1,605.00
Ethmoidectomy extranasal total 31205 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Ethylene glycol -sendout $14.90 $14.90 $14.90 $104.40
Euflexxa inj per dose $114.48 $114.48 $114.48 $1,186.77
Euglobulin lysis $8.41 $8.41 $8.41 $61.80
Evacuate mole of uterus $3,179.53 $3,179.53 $3,179.53 $5,835.00
Eval aud rehab status/first hr 92626 $156.46 $156.46 $156.46 $156.46
Eval/fit voice prosthesis iii, st $155.22 $155.22 $155.22 $431.25
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen $98.11 $98.11 $98.11 $237.00
Evaluation of speech fluency 92521 $170.83 $170.83 $170.83 $393.00
Evaluation psychiatric diagnostic $160.67 $160.67 $160.67 $265.80
Event monitor $37.29 $37.29 $37.29 $330.00
Evoked auditory tst complete $311.40 $311.40 $311.40 $311.40
Evoked oa emissions ltd $311.40 $311.40 $311.40 $234.00
Evoked potential visual not glaucoma $311.40 $311.40 $311.40 $572.40
Evoked potentials upper limbs $311.40 $311.40 $311.40 $491.40
Ex arm/elbow tum deep 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Ex arm/elbow tum deep < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Ex palate/uvula lesion without closure 42104 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Ex sq tumor/face or scalp 2 cm/> 21012 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Ex sq tumor/face or scalp < 2 cm 21011 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exam of vagina w/scope 57420 $304.19 $304.19 $304.19 $615.60
Exam plvc w/anes othr thn lcl $3,179.53 $3,179.53 $3,179.53 $3,179.53
Exc abd les sc 3 cm/> $2,862.05 $2,862.05 $2,862.05 $1,144.80
Exc abdl tum deep 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc abdl tum deep < 5 cm $2,862.05 $2,862.05 $2,862.05 $1,464.00
Exc arm/elbo les sc <3cm 24075 $1,620.24 $1,620.24 $1,620.24 $1,880.25
Exc arm/elbo les sc >=3cm 24071 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc aurl glomus tum trnscanl $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exc aurl glomus tum trnsmstd $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exc back les sbq <3 cm 21930 $1,620.24 $1,620.24 $1,620.24 $2,531.25
Exc back tum deep 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc bartholins gland/cyst $3,179.53 $3,179.53 $3,179.53 $3,179.53
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 $703.59 $703.59 $703.59 $2,184.60
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 $1,620.24 $1,620.24 $1,620.24 $2,184.60
Exc ben+marg excep skin tag feenlm <0.5cm 11440 $703.59 $703.59 $703.59 $1,447.50
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 $703.59 $703.59 $703.59 $1,989.75
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 $1,620.24 $1,620.24 $1,620.24 $1,967.25
Exc ben+marg excep skin tag snhfg >4cm 11426 $2,862.05 $2,862.05 $2,862.05 $2,901.00
Exc ben+marg excep skin tag tal 0.6-1cm 11401 $399.53 $399.53 $399.53 $1,501.50
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 $703.59 $703.59 $703.59 $1,743.00
Exc benign feenlm 3.1-4.0cm 11444 $1,620.24 $1,620.24 $1,620.24 $2,910.75
Exc benign feenlm >4.0cm 11446 $2,862.05 $2,862.05 $2,862.05 $3,515.40
Exc benign snhfg 3.1-4.0cm 11424 $1,620.24 $1,620.24 $1,620.24 $3,417.00
Exc benign tal 0.5 < cm 11400 $703.59 $703.59 $703.59 $1,527.60
Exc breast duct fistula 19112 $3,829.28 $3,829.28 $3,829.28 $3,829.28
Exc cervix repair bowel 57556 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Exc cervix/repair vagina 57555 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Exc chest wall tumor w/ribs 21601 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc coccygl pr ulc flap clsr $3,660.97 $3,660.97 $3,660.97 $3,660.97
Exc coccygl pr ulc prim sutr $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc constrict ring finger w/mlt z-plasties 26596 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Exc excessive skin buttock $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc excessive skin hip $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc excessive skin leg $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc excessive skin thigh $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc excsv skin forearm/hand $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc excsv submental fat pad $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc ext ear/partial/simple repair 69110 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc face tum deep 2cm/> 21014 $2,862.05 $2,862.05 $2,862.05 $6,184.50
Exc face tum deep < 2 cm $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc feenl mal+mrg 0.6-1 11641 $703.59 $703.59 $703.59 $1,534.40
Exc feenl mal+mrg 2.1-3 11643 $1,620.24 $1,620.24 $1,620.24 $2,185.50
Exc foot/toe tum dep 1.5cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc foot/toe tum subq < 1.5 cm 28043 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc forearm les sc 3 cm/> $1,620.24 $1,620.24 $1,620.24 $3,778.50
Exc forearm tum deep 3 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc forearm tum deep < 3 cm $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc hand les sc < 1.5 cm $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc hand tum deep 1.5 cm/> $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc hand tum deep < 1.5 cm 26116 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc hidradenitis ing simpl 11462 $2,862.05 $2,862.05 $2,862.05 $621.60
Exc hidradenitis peri/umb comp 11471 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc hidradenitis peri/umb int 11470 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc hip/pelv tum deep 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc hip/pelv tum deep < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc im tumor/back/flank/ < 5 cm 21932 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc im tumor/foot/toe < 1.5 cm 28045 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc im tumor/shoulder area 5cm/> 23073 $2,862.05 $2,862.05 $2,862.05 $2,745.00
Exc isch pr ulc prm sut ostc $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc isch pr ulc skn flp clsr $3,660.97 $3,660.97 $3,660.97 $3,660.97
Exc isch pr ulc skn flp ostc $1,829.23 $1,829.23 $1,829.23 $1,829.23
Exc ischial pr ulc prim sutr $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Exc leg/ankle tum dep 5 cm/ > 27634 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc leg/ankle tum subfasc<5cm 27619 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc les conjunctiva <1 cm $2,332.96 $2,332.96 $2,332.96 $2,332.96
Exc les conjunctiva >1 cm $2,332.96 $2,332.96 $2,332.96 $2,332.96
Exc les conjunctiva adj scl $2,332.96 $2,332.96 $2,332.96 $2,332.96
Exc les/mucos/sub/ves mouth/no rpr 40810 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Exc mal+marg tal 1.1-2 cm 11602 $399.53 $399.53 $399.53 $2,151.75
Exc mal+marg tal 2.1-3 cm 11603 $703.59 $703.59 $703.59 $1,521.75
Exc mal+marg tal 3.1-4 cm 11604 $703.59 $703.59 $703.59 $1,891.50
Exc malig feenl 1.1-2 11642 $703.59 $703.59 $703.59 $703.59
Exc malig feenl 3.1-4.0 11644 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc malig feenl <0.5cm 11640 $703.59 $703.59 $703.59 $703.59
Exc malig feenl >4cm 11646 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc malig snhfg 0.5cm or less 11620 $1,620.24 $1,620.24 $1,620.24 $1,105.20
Exc malig snhfg 0.6-1.0 cm 11621 $703.59 $703.59 $703.59 $703.59
Exc malig snhfg 2.1-3 cm 11623 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc malig tal 0.6-1.0cm 11601 $703.59 $703.59 $703.59 $1,407.75
Exc malig tal <0.5cm 11600 $703.59 $703.59 $703.59 $1,407.75
Exc mandible 21025 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exc neck tum deep 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc neck tum deep < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc of facial bones/osteomy/abcess 21026 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exc of residual cervix via aginal approach 57550 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Exc prtl bn phlnx toe $3,244.61 $3,244.61 $3,244.61 $3,126.75
Exc rect tum transanal full $2,742.39 $2,742.39 $2,742.39 $2,742.39
Exc rect tum transanal part $2,742.39 $2,742.39 $2,742.39 $2,742.39
Exc sac pr ulc prim str ostc $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc sac pr ulc skn flp ostc $3,660.97 $3,660.97 $3,660.97 $3,660.97
Exc sacral pr ulc prim sutr $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc sacral pr ulc skn flap $3,660.97 $3,660.97 $3,660.97 $3,660.97
Exc shoulder tum deep < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc skn hdrdnt ax complex $2,862.05 $2,862.05 $2,862.05 $846.00
Exc skn hdrdnt ax smpl/ntrm $2,862.05 $2,862.05 $2,862.05 $652.80
Exc skn hdrdnt ing complex $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc snhfg mal+mrg 1.1-2 11622 $703.59 $703.59 $703.59 $2,185.50
Exc snhfg mal+mrg 3.1-4 11624 $1,620.24 $1,620.24 $1,620.24 $2,444.25
Exc snhfg mal+mrg >4 cm 11626 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc sq tum/leg or ankle area <3 cm 27618 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc sq tum/neck or ant thorax <3cm 21555 $1,620.24 $1,620.24 $1,620.24 $3,343.20
Exc sq tum/neck/ant thorax 3cm/> 21552 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc sq tum/vasc malform/hand/fngr 26111 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc sq tumor/foot or toe < 1.5 cm 28039 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc sq tumor/forearm/wrist/<3cm 25075 $1,620.24 $1,620.24 $1,620.24 $3,342.00
Exc sq tumor/leg/ankle 3cm/> 27632 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc sq tumor/shoulder area 3cm/> 23071 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc sq tumor/thigh/knee area 3cm/> 27337 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc subq tum/sft tis/pel/hip 3cm/> 27043 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc tendon sheath or cap lesion 26160 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Exc thigh/knee les sc<3cm 27327 $1,620.24 $1,620.24 $1,620.24 $1,897.50
Exc thigh/knee tum deep <5cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc thigh/knee tum dep 5cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc thrombosed hemorrhoid 46320 $1,179.08 $1,179.08 $1,179.08 $2,491.20
Exc tmr sft tiss shldr subq <3cm $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc torus mandibularis 21031 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Exc tr-ext mal+marg tal >4 cm 11606 $1,620.24 $1,620.24 $1,620.24 $2,577.75
Exc trchntr pr ulc flp clsr $1,829.23 $1,829.23 $1,829.23 $1,829.23
Exc trchntr pr ulc flp ostc $3,660.97 $3,660.97 $3,660.97 $3,660.97
Exc trchntr pr ulc prep flap $1,829.23 $1,829.23 $1,829.23 $1,829.23
Exc trchntr pr ulc prep ostc $3,660.97 $3,660.97 $3,660.97 $3,660.97
Exc trchntr pr ulc prim sutr $1,620.24 $1,620.24 $1,620.24 $1,620.24
Exc trchntric pr ulcer w/prim sutr w/ostectomy 15951 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Exc vagina lesion 57135 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Exc/crtg b1 cst/b9 tum rds $3,244.61 $3,244.61 $3,244.61 $3,244.61
Exc/crtg b1 cst/tum hum agrf $7,143.73 $7,143.73 $7,143.73 $7,143.73
Exc/crtg b1 cst/tum hum algr $7,143.73 $7,143.73 $7,143.73 $7,143.73
Exc/crtg b1 cst/tum rds agrf $3,244.61 $3,244.61 $3,244.61 $3,244.61
Exc/crtg b1 cst/tum rds algr $7,143.73 $7,143.73 $7,143.73 $7,143.73
Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Exc/curtg b1 cst/b9 tum hum $3,244.61 $3,244.61 $3,244.61 $3,244.61
Exc/pilonidal cyst/sinus/simple 11770 $2,862.05 $2,862.05 $2,862.05 $4,284.00
Exchange biliary drg cath $3,529.06 $3,529.06 $3,529.06 $3,529.06
Exchange blood transfusion newborn 36450 $437.18 $437.18 $437.18 $437.18
Exchange drainage catheter $1,896.99 $1,896.99 $1,896.99 $2,610.75
Exchange lens prosthesis $2,280.73 $2,280.73 $2,280.73 $2,280.73
Exchange nephrostomy cath $2,048.51 $2,048.51 $2,048.51 $2,572.20
Excimer lsr psriasis 250-500 $198.70 $198.70 $198.70 $198.70
Excimer lsr psriasis<250sqcm $198.70 $198.70 $198.70 $198.70
Excimer lsr psriasis>500sqcm $399.53 $399.53 $399.53 $399.53
Excis partial tal calc $3,244.61 $3,244.61 $3,244.61 $3,244.61
Excis uppr jaw cyst w/repair $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise anal ext tag/papilla $1,179.08 $1,179.08 $1,179.08 $2,813.40
Excise epiphyseal bar $3,244.61 $3,244.61 $3,244.61 $3,244.61
Excise foot tendon sheath $3,244.61 $3,244.61 $3,244.61 $3,244.61
Excise foot tendon sheath $3,244.61 $3,244.61 $3,244.61 $3,244.61
Excise inferior turbinate $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excise intraspinl lesion crv $7,143.73 $7,143.73 $7,143.73 $7,143.73
Excise intrspinl lesion lmbr $7,143.73 $7,143.73 $7,143.73 $7,143.73
Excise intrspinl lesion scrl $7,143.73 $7,143.73 $7,143.73 $7,143.73
Excise lesion testis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Excise lip or cheek fold $1,481.28 $1,481.28 $1,481.28 $1,481.28
Excise lwr jaw cyst w/repair $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise mandible lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excise max/zygoma b9 tumor $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise max/zygoma mal tumor $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise oral mucosa for graft 40818 $509.25 $509.25 $509.25 $509.25
Excise parotid gland/lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise parotid gland/lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise parotid gland/lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise parotid gland/lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise pharynx lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excise sublingual gland $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise submaxillary gland $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excise subq tumor/abd wall <3 cm 22902 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Excise tendon forearm/wrist $3,244.61 $3,244.61 $3,244.61 $3,244.61
Excise wrist tendon sheath $1,600.41 $1,600.41 $1,600.41 $1,600.41
Excise/repair mouth lesion $1,481.28 $1,481.28 $1,481.28 $1,481.28
Excision aural polyp $1,481.28 $1,481.28 $1,481.28 $1,481.28
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm $703.59 $703.59 $703.59 $2,184.60
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm $1,620.24 $1,620.24 $1,620.24 $2,064.75
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm $703.59 $703.59 $703.59 $1,520.25
Excision benign lesion trunk/arms/legs > 4.0 cm $1,620.24 $1,620.24 $1,620.24 $3,265.20
Excision breast lesion $3,829.28 $3,829.28 $3,829.28 $3,829.28
Excision floor mouth lesion 41116 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision graft extremity $3,147.50 $3,147.50 $3,147.50 $504.00
Excision gum each quadrant $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision hand/finger tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Excision lesion mouth roof $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excision lesion mouth roof $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision nasal polyp(s) simple 30110 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Excision of anal lesion(s) $2,742.39 $2,742.39 $2,742.39 $3,114.00
Excision of gum flap $1,481.28 $1,481.28 $1,481.28 $1,481.28
Excision of gum lesion $1,481.28 $1,481.28 $1,481.28 $1,481.28
Excision of gum lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of gum lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excision of gum lesion $1,481.28 $1,481.28 $1,481.28 $1,481.28
Excision of gum lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excision of gum lesion 41825 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of lingual tonsil $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excision of mouth lesion complex 40816 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of neck cyst $5,915.66 $5,915.66 $5,915.66 $5,915.66
Excision of neck cyst confined 42810 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of penis lesion(s) 54060 $1,829.23 $1,829.23 $1,829.23 $1,976.25
Excision of rectal lesion $2,742.39 $2,742.39 $2,742.39 $2,742.39
Excision of rectal stricture $1,179.08 $1,179.08 $1,179.08 $1,179.08
Excision of salivary cyst $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of tongue lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of tongue lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of tongue lesion w/closure 41113 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of tonsil tags $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of umbilicus 49250 $3,529.06 $3,529.06 $3,529.06 $3,529.06
Excision of uvula $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision of vaginal septum 57130 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Excision olecranon bursa $3,244.61 $3,244.61 $3,244.61 $2,271.60
Excision radial head $3,244.61 $3,244.61 $3,244.61 $3,244.61
Excision tongue lesion without closure 41110 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Excision tumor soft tissue back/flank subcutaneous >= 3 cm $1,620.24 $1,620.24 $1,620.24 $3,255.75
Exercise tst brncspsm w/ecg $128.90 $128.90 $128.90 $337.50
Exercise tst brncspsm wo ecg $59.40 $59.40 $59.40 $59.40
Exome sequence analysis $4,780.00 $4,780.00 $4,780.00 $7,002.00
Exp w remove/deep fb/forearm/wrist 25248 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Exploration for testis $3,529.06 $3,529.06 $3,529.06 $3,529.06
Exploration for testis $2,048.51 $2,048.51 $2,048.51 $2,048.51
Exploration maxillary sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exploration maxillary sinus $3,686.95 $3,686.95 $3,686.95 $3,686.95
Exploration of ankle joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Exploration of foot joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Exploration of foot joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Exploration of frontal sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exploration of frontal sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exploration of knee joint $3,244.61 $3,244.61 $3,244.61 $5,891.40
Exploration of middle ear $3,243.07 $3,243.07 $3,243.07 $3,243.07
Exploration of sinuses $5,915.66 $5,915.66 $5,915.66 $5,915.66
Exploration of toe joint $1,600.41 $1,600.41 $1,600.41 $1,600.41
Explore deep node(s) neck $5,834.36 $5,834.36 $5,834.36 $5,834.36
Explore epididymis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Explore inner ear $5,915.66 $5,915.66 $5,915.66 $5,915.66
Explore inner ear $5,915.66 $5,915.66 $5,915.66 $5,915.66
Explore limb vessels 35860 $3,147.50 $3,147.50 $3,147.50 $3,583.20
Explore parathyroid glands $5,915.66 $5,915.66 $5,915.66 $1,307.40
Explore penetrating wnd/extremity 20103 $1,620.24 $1,620.24 $1,620.24 $3,349.80
Explore scrotum $3,448.97 $3,448.97 $3,448.97 $3,448.97
Explore wound abdomen 20102 $1,829.23 $1,829.23 $1,829.23 $3,845.40
Explore wound neck 20100 $509.25 $509.25 $509.25 $509.25
Explore woundchest 20101 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Explore/biopsy eye socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Explore/biopsy eye socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Explore/drain eye socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Explore/drain eye socket $2,332.96 $2,332.96 $2,332.96 $2,332.96
Explore/irrigate tear ducts $298.93 $298.93 $298.93 $298.93
Explore/treat ankle joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Explore/treat eye socket $2,332.96 $2,332.96 $2,332.96 $2,332.96
Explore/treat eye socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Explore/treat eye socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Explore/treat eye socket 67413 $2,332.96 $2,332.96 $2,332.96 $2,332.96
Explore/treat finger joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Explore/treat finger joint $1,600.41 $1,600.41 $1,600.41 $4,131.00
Explore/treat knee joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Explore/treat wrist joint $3,244.61 $3,244.61 $3,244.61 $5,268.60
Explr/decompress eye socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Explr/decompress eye socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Ext ecg>48hr<7d scan a/r $128.90 $128.90 $128.90 $238.50
Ext ecg>7d<15d scan a/r $128.90 $128.90 $128.90 $238.50
Extended culture of oocytes $816.90 $816.90 $816.90 $816.90
Extended visual field xm $128.90 $128.90 $128.90 $128.90
Extensive ear canal surgery 69150 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Extensive hand surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Extensive mastoid surgery $5,915.66 $5,915.66 $5,915.66 $5,915.66
Extensive mastoid surgery $5,915.66 $5,915.66 $5,915.66 $5,915.66
Extensive surgery of throat $5,915.66 $5,915.66 $5,915.66 $5,915.66
Extensive surgery of throat $5,915.66 $5,915.66 $5,915.66 $5,915.66
Extensive testis surgery $3,448.97 $3,448.97 $3,448.97 $3,448.97
External cannula declotting $1,553.44 $1,553.44 $1,553.44 $1,553.44
External chromosome analysis 20-25 cells $144.61 $144.61 $144.61 $869.40
External ocular photography $39.25 $39.25 $39.25 $39.25
External pretreatment of serum for use in antibody identification by dilution $24.49 $24.49 $24.49 $146.40
External profiling gene expression oncology (breast) mrna 21 genes $3,873.00 $3,873.00 $3,873.00 $3,873.00
External tissue culture neoplastic disorders bone marrow/blood cells $143.75 $143.75 $143.75 $903.75
Extnd color vision xm $59.40 $59.40 $59.40 $59.40
Extractable nuclear antigen/antibody any method each antibody centromere $17.93 $17.93 $17.93 $159.00
Extraction erupted tooth/exr $1,662.63 $1,662.63 $1,662.63 $1,662.63
Extraction of lens $4,022.86 $4,022.86 $4,022.86 $4,022.86
Extraction of lens $2,280.73 $2,280.73 $2,280.73 $2,280.73
Extraction of lens 66920 $2,280.73 $2,280.73 $2,280.73 $2,280.73
Extrnl counterpulse, per tx $128.90 $128.90 $128.90 $573.75
Eye allergy tests $128.90 $128.90 $128.90 $128.90
F-18 florbetapir less than or equal to 10 mci $2,194.62 $2,194.62 $2,194.62 $5,679.38
F-18 fluciclovine per mci $268.42 $268.42 $268.42 $710.40
F9 full gene sequence $600.00 $600.00 $600.00 $600.00
Face bone graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Facial bones <3 $88.05 $88.05 $88.05 $320.40
Facial nerve function test $311.40 $311.40 $311.40 $311.40
Facility svs dental rehab $3,243.07 $3,243.07 $3,243.07 $3,243.07
Factor ix $19.04 $19.04 $19.04 $186.75
Factor ix alprolix recomb $3.63 $3.63 $3.63 $38,712.83
Factor ix complex $1.70 $1.70 $1.70 $7.80
Factor ix idelvion inj $5.34 $5.34 $5.34 $36,235.50
Factor ix non-recombinant $1.34 $1.34 $1.34 $1.34
Factor ix recomb gly rebinyn $4.58 $4.58 $4.58 $4.58
Factor ix recombinant nos $1.88 $1.88 $1.88 $34.65
Factor viii $17.90 $17.90 $17.90 $213.00
Factor viii $1.13 $1.13 $1.13 $1.13
Factor viii fc fusion recomb $2.42 $2.42 $2.42 $17,969.85
Factor viii nuwiq recomb 1iu $1.18 $1.18 $1.18 $1.18
Factor viii pegylated recomb $2.15 $2.15 $2.15 $11.10
Factor viii recomb novoeight $1.52 $1.52 $1.52 $3.40
Factor viii recomb obizur $3.23 $3.23 $3.23 $5,435.33
Factor viii recombinant nos $1.54 $1.54 $1.54 $11.10
Factor xiii anti-hem factor $10.78 $10.78 $10.78 $10.78
Factor xiii recomb a-subunit $18.29 $18.29 $18.29 $68.26
Fallopian tube recnl $3,179.53 $3,179.53 $3,179.53 $2,904.00
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution $30.00 $30.00 $30.00 $52.80
Family therapy with patient 50 min 90847 $160.67 $160.67 $160.67 $160.67
Family therapy without pt 50min 90846 $160.67 $160.67 $160.67 $160.67
Fancc gene $36.62 $36.62 $36.62 $502.20
Fat/lipids feces qualitative $5.10 $5.10 $5.10 $39.60
Fatty acids nonesterified $18.77 $18.77 $18.77 $121.50
Fecal bilirubin test $4.56 $4.56 $4.56 $4.56
Fecal microbiota prep instil $911.71 $911.71 $911.71 $911.71
Fecal microbiota, live-jslm 150 ml rectal suspension enema $64.03 $64.03 $64.03 $64.03
Fees w/laryngeal sense test $127.75 $127.75 $127.75 $127.75
Felbamate (felbatol(r)) - sendout $18.64 $18.64 $18.64 $133.50
Fem/popl revasc w/stent $11,340.57 $11,340.57 $11,340.57 $34,620.00
Feno poc $39.25 $39.25 $39.25 $153.75
Fern test $9.74 $9.74 $9.74 $9.74
Ferric carboxymaltose 50 mg iron/ml intravenous solution $1.14 $1.14 $1.14 $3,736.68
Ferritin $13.63 $13.63 $13.63 $212.40
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution $0.31 $0.31 $0.31 $3,963.60
Ferumoxytol, esrd use $0.31 $0.31 $0.31 $0.31
Fetal biophys profile w/nst 76818 $106.34 $106.34 $106.34 $656.25
Fetal chrom aneuploidy gsa panel $759.05 $759.05 $759.05 $3,621.60
Fetal contract stress test 59020 - 26 $201.17 $201.17 $201.17 $201.17
Fetal cord puncture prenatal $304.19 $304.19 $304.19 $304.19
Fetal fibronectin $64.41 $64.41 $64.41 $727.80
Fetal fluid drainage w/us $304.19 $304.19 $304.19 $304.19
Fetal hemoglobin (kleihauer betke) $7.73 $7.73 $7.73 $121.20
Fetal hemoglobin rosette $9.36 $9.36 $9.36 $78.60
Fetal lung maturity assess lam body dnst $19.32 $19.32 $19.32 $19.32
Fetal non stress test $201.17 $201.17 $201.17 $391.50
Fetal scalp blood sampling 59030 $304.19 $304.19 $304.19 $304.19
Fetal shunt placement w/us $304.19 $304.19 $304.19 $304.19
Fiasp for insulin pump use $7.76 $7.76 $7.76 $7.76
Fibrin degradation d dimer quantitative $10.18 $10.18 $10.18 $87.60
Fibrin degradation products $6.89 $6.89 $6.89 $91.80
Fibrin degrade semiquant $9.72 $9.72 $9.72 $70.20
Fibrinogen activity $9.72 $9.72 $9.72 $80.40
Fibrinolysins/coagulopathy screen interpretation/report $15.48 $15.48 $15.48 $72.00
Fibrinolytic antiplasmin $7.71 $7.71 $7.71 $81.00
Fibrinolytic plasminogen $17.19 $17.19 $17.19 $159.60
Fibrinolytic plasminogen xcpt antgnc asa $6.53 $6.53 $6.53 $83.40
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr $0.99 $0.99 $0.99 $1,964.97
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe $0.29 $0.29 $0.29 $492.48
Filgrastim-sndz 300 mcg/0.5 ml injection syringe $0.37 $0.37 $0.37 $1,504.82
Filleted finger/toe flap $1,829.23 $1,829.23 $1,829.23 $1,829.23
Filtered speech hearing test $39.25 $39.25 $39.25 $39.25
Fine needle asp without image guide 10021 $399.53 $399.53 $399.53 $722.40
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 $703.59 $703.59 $703.59 $777.00
Finger tendon transfer $3,244.61 $3,244.61 $3,244.61 $3,244.61
Finger tendon transfer $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fit aphakia spectcl monofocl $59.40 $59.40 $59.40 $59.40
Fit aphakia spectcl multifoc $59.40 $59.40 $59.40 $59.40
Fitg spect low vis 1system $39.25 $39.25 $39.25 $39.25
Fitg spect lw vis cmpnd lens $39.25 $39.25 $39.25 $39.25
Fitting of diaphragm/cap 57170 $201.17 $201.17 $201.17 $201.17
Fix g/colon tube w/device $937.56 $937.56 $937.56 $3,659.40
Fixation of ankle joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fixation of knee joint $1,600.41 $1,600.41 $1,600.41 $1,600.41
Fixation of shoulder blade $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fixtn pq skel dstl rad fx/epiphysl sep $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fl exam g/colon tube w contrast $241.72 $241.72 $241.72 $626.40
Flebogamma injection $55.76 $55.76 $55.76 $3,562.92
Flecainide (tambocor)-sendout $18.64 $18.64 $18.64 $129.60
Flexible Sigmoidoscopy $911.71 $911.71 $911.71 $1,158.00
Flexor-plasty elbow $7,143.73 $7,143.73 $7,143.73 $7,143.73
Flexor-plasty elbw w/advmnt $7,143.73 $7,143.73 $7,143.73 $7,143.73
Floor of mouth biopsy 41108 $1,620.24 $1,620.24 $1,620.24 $996.60
Florbetaben f18 diagnostic $1,273.76 $1,273.76 $1,273.76 $1,273.76
Flortaucipir inj 1 millicuri $3,710.00 $3,710.00 $3,710.00 $3,710.00
Flotufolastat f18 diag 1 mci $671.22 $671.22 $671.22 $1,173.60
Flow cytometry one marker technical component $359.72 $359.72 $359.72 $288.60
Floxuridine injection $4,125.55 $4,125.55 $4,125.55 $8,522.40
Flt3 gene $165.51 $165.51 $165.51 $277.80
Flt3 gene analysis $83.00 $83.00 $83.00 $83.00
Fludarabine 50 mg intravenous solution $71.65 $71.65 $71.65 $601.96
Fluid pressure muscle 20950 $703.59 $703.59 $703.59 $445.50
Fluidotherapy charges pt $20.16 $20.16 $20.16 $95.40
Fluocinol acet intravit imp $497.80 $497.80 $497.80 $497.80
Fluocinolone acetonide implt $339.76 $339.76 $339.76 $70,344.94
Fluorescein angioscopy i&r $530.60 $530.60 $530.60 $530.60
Fluorescein angrph mltiframe $311.40 $311.40 $311.40 $311.40
Fluorescein&icg angiography $311.40 $311.40 $311.40 $311.40
Fluorescent antibody titer dna $12.05 $12.05 $12.05 $186.60
Fluoro polarize fetal lung $18.91 $18.91 $18.91 $18.91
Fluorodopa f-18 diag per mci $498.62 $498.62 $498.62 $498.62
Fluoroestradiol f 18 $498.67 $498.67 $498.67 $1,413.00
Fluoroscopy up to 1 hour $241.72 $241.72 $241.72 $534.60
Flutemetamol f18 diagnostic $1,866.58 $1,866.58 $1,866.58 $1,866.58
Fmri brain by phys/psych $241.72 $241.72 $241.72 $1,741.80
Fmri brain by tech $241.72 $241.72 $241.72 $1,337.25
Fna bx w/ct gdn 1st les $703.59 $703.59 $703.59 $900.75
Fna bx w/mr gdn 1st les $703.59 $703.59 $703.59 $738.00
Foam stability fetal lung $18.91 $18.91 $18.91 $18.91
Folic acid $14.70 $14.70 $14.70 $117.00
Follow-up angiography $3,147.50 $3,147.50 $3,147.50 $2,599.50
Follow-up surgery of eye $2,332.96 $2,332.96 $2,332.96 $2,332.96
Followup eval of foot pt lop $128.87 $128.87 $128.87 $128.87
Fomepizole 1 gram/ml intravenous solution $6.03 $6.03 $6.03 $1,261.49
Foot X-ray $88.05 $88.05 $88.05 $339.50
Forehead flap w/vasc pedicle 15731 $3,660.97 $3,660.97 $3,660.97 $3,660.97
Forensic cytopathology $53.43 $53.43 $53.43 $53.43
Foreskn manip w/lss preputial ads+stretching 54450 $243.21 $243.21 $243.21 $285.00
Foscarnet sodium injection $15.58 $15.58 $15.58 $1,101.86
Fractionation ketosteroids $28.50 $28.50 $28.50 $28.50
Fracture assessment via dxa $88.05 $88.05 $88.05 $530.25
Fragmenting of kidney stone $3,448.97 $3,448.97 $3,448.97 $9,085.50
Frenectomy 41115 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Frenotomy 40806 $509.25 $509.25 $509.25 $509.25
Frenulotomy of penis $2,048.51 $2,048.51 $2,048.51 $2,048.51
Fresh frozen plasma 8-24 hours collection each unit $71.09 $71.09 $71.09 $243.00
Fresh frozen plasma frozen within 8 hours of collection each unit $84.29 $84.29 $84.29 $237.00
Fresh frozen plasma thawing ea un $171.36 $171.36 $171.36 $121.20
Frozen blood freeze/thaw $39.25 $39.25 $39.25 $39.25
Frozen blood prep $171.36 $171.36 $171.36 $171.36
Frozen blood thaw $171.36 $171.36 $171.36 $171.36
Frozen cell preparation $12.09 $12.09 $12.09 $12.09
Frozen plasma, pooled, sd $62.31 $62.31 $62.31 $62.31
Fructosamine glycated protein $16.76 $16.76 $16.76 $85.20
Ftl cgen abnor four anal $153.50 $153.50 $153.50 $153.50
Full field erg w/i&r $311.40 $311.40 $311.40 $311.40
Full mouth x-ray of teeth $241.72 $241.72 $241.72 $241.72
Full thick gft w/close donor fccmnaghf <=20sqcm 15240 $1,829.23 $1,829.23 $1,829.23 $3,955.80
Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Full thick gft/scalp/arm/leg/20sqcm or< 15220 $1,829.23 $1,829.23 $1,829.23 $2,910.75
Fundus photography with i&r 92250 $128.90 $128.90 $128.90 $139.80
Fusion of ankle joint open $12,866.82 $12,866.82 $12,866.82 $12,866.82
Fusion of big toe joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of big toe joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of finger joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion of finger tendons $1,600.41 $1,600.41 $1,600.41 $1,600.41
Fusion of finger tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion of foot bones $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of foot bones $12,866.82 $12,866.82 $12,866.82 $12,866.82
Fusion of foot bones $12,866.82 $12,866.82 $12,866.82 $12,866.82
Fusion of hand joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of knuckle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of knuckle joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion of knuckle joints $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of knuckle joints $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion of knuckle with graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of spermatic ducts $2,048.51 $2,048.51 $2,048.51 $2,048.51
Fusion of spermatic ducts $3,448.97 $3,448.97 $3,448.97 $3,448.97
Fusion of tendons at wrist $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion of tendons at wrist $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion of thumb $7,143.73 $7,143.73 $7,143.73 $7,143.73
Fusion of tibiofibular joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Fusion of toes $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion/graft of finger joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Fusion/graft of hand joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
G-esoph reflx tst w/electrod $530.60 $530.60 $530.60 $1,306.80
G-tube reposition $243.21 $243.21 $243.21 $865.50
G6pc gene $58.49 $58.49 $58.49 $343.80
G6pd full gene sequence $600.00 $600.00 $600.00 $600.00
G6pd gene alys cmn variant $174.81 $174.81 $174.81 $174.81
G6pd known familial variant $375.25 $375.25 $375.25 $375.25
Ga-68 gallium 68 dotatate $51.09 $51.09 $51.09 $156.00
Galac-1-phosphate uridyltran - sendout $21.07 $21.07 $21.07 $41.40
Galactokinase - sendout $21.48 $21.48 $21.48 $21.48
Galactose transferase test $11.74 $11.74 $11.74 $11.74
Galectin-3 $44.25 $44.25 $44.25 $78.00
Gallbladder Removal (Laparoscopic) $5,834.36 $5,834.36 $5,834.36 $6,672.53
Gallium ga-68 dotatoc $4.05 $4.05 $4.05 $4.05
Gallium ga-68 psma-11 ucsf $534.91 $534.91 $534.91 $534.91
Gallium ga-68 psma-11, ucla $372.17 $372.17 $372.17 $372.17
Gallium illuccix 1 millicure $973.64 $973.64 $973.64 $1,900.80
Gallium locametz 1 millicuri $873.44 $873.44 $873.44 $873.44
Gamma globulin 1 cc inj $48.42 $48.42 $48.42 $106.20
Gamma globulin > 10 cc inj $167.06 $167.06 $167.06 $167.06
Gamma glutamyltransferase $7.20 $7.20 $7.20 $88.20
Gammaglobulin iga $9.30 $9.30 $9.30 $169.50
Gammaglobulin ige $16.46 $16.46 $16.46 $144.60
Gammaplex injection $62.47 $62.47 $62.47 $6.00
Gamunex-c/gammaked $48.03 $48.03 $48.03 $338.40
Gardner vag dna quant $41.76 $41.76 $41.76 $351.20
Gastric analy w/ph ea spec $6.71 $6.71 $6.71 $6.71
Gastric emptying imag study $538.27 $538.27 $538.27 $538.27
Gastric emptying imag study $401.83 $401.83 $401.83 $373.80
Gastric motility studies $530.60 $530.60 $530.60 $1,317.00
Gastric mucosa imaging $401.83 $401.83 $401.83 $401.83
Gastrin test $17.69 $17.69 $17.69 $106.50
Gastroesophageal reflux study $401.83 $401.83 $401.83 $1,139.25
Gastroesophageal reflux test $530.60 $530.60 $530.60 $1,115.40
Gastrostomy open neonatal $937.56 $937.56 $937.56 $937.56
Gated heart multiple $401.83 $401.83 $401.83 $1,228.80
Gba gene $47.25 $47.25 $47.25 $1,191.60
Gel-one $524.02 $524.02 $524.02 $524.02
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln $236.62 $236.62 $236.62 $236.62
Genetic tstg severe inh cond $2,448.56 $2,448.56 $2,448.56 $11,208.75
Geniop sldg augmentation $3,243.07 $3,243.07 $3,243.07 $3,243.07
Geniop sldg osteot 1 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Geniop sldg osteot 2/> $5,915.66 $5,915.66 $5,915.66 $5,915.66
Genioplasty augmentation $5,915.66 $5,915.66 $5,915.66 $5,915.66
Genome sequence analysis $5,031.20 $5,031.20 $5,031.20 $4,439.40
Gentamicin peak therapeutic drug level $16.38 $16.38 $16.38 $156.75
Genvisc 850, inj, 1mg $6.02 $6.02 $6.02 $6.02
Ghs HIV antibody $13.71 $13.71 $13.71 $103.20
Ghs IV inf sq injection, on-body injector $46.14 $46.14 $46.14 $138.60
Ghs IV thrombolytics - cerebral $331.69 $331.69 $331.69 $541.50
Ghs abscess perianal iandd $911.71 $911.71 $911.71 $1,829.60
Ghs abscess postoperative iandd complex $2,862.05 $2,862.05 $2,862.05 $3,993.00
Ghs acetylcholinesterase, rbc $9.81 $9.81 $9.81 $119.25
Ghs alcohol, methyl (methanol)-medtox $17.11 $17.11 $17.11 $147.60
Ghs alpha thalasemia, 7 deletions $102.26 $102.26 $102.26 $1,687.20
Ghs analysis neurostim without reprogramming $128.90 $128.90 $128.90 $574.80
Ghs antibodies (torch) igm $14.39 $14.39 $14.39 $131.25
Ghs aspiration bladder - needle $243.21 $243.21 $243.21 $616.80
Ghs bladder cath - complex-foley $156.46 $156.46 $156.46 $492.00
Ghs bleeding time (ivy) $4.82 $4.82 $4.82 $4.82
Ghs block ilioinguinal/gentitofemoral $692.52 $692.52 $692.52 $1,260.60
Ghs central line insert < age 5, failed $3,147.50 $3,147.50 $3,147.50 $3,145.80
Ghs change cysto/gastrost $243.21 $243.21 $243.21 $1,265.40
Ghs chemo >8 hrs $331.69 $331.69 $331.69 $772.50
Ghs chemo IV push, ea addtl $71.17 $71.17 $71.17 $378.00
Ghs chemo infusion >8 hrs $331.69 $331.69 $331.69 $331.69
Ghs chlamydia pneumoniae by pcr (arup) (306630) $35.09 $35.09 $35.09 $360.00
Ghs cl tx knee disl; wo anesth $239.88 $239.88 $239.88 $1,961.40
Ghs cl tx metacarpophal disloc without anes $239.88 $239.88 $239.88 $471.75
Ghs closd tx interphalang jt disloc w/ma $239.88 $239.88 $239.88 $630.00
Ghs closed reduction ankle dislocation $239.88 $239.88 $239.88 $825.60
Ghs closed tx bimalleolar fracture w/manip $1,600.41 $1,600.41 $1,600.41 $1,635.60
Ghs closed tx radiocarpal disloc w manip $239.88 $239.88 $239.88 $273.00
Ghs closed tx tibial fracture w/manip $1,600.41 $1,600.41 $1,600.41 $1,600.41
Ghs closure surg wound/dehiscence-13160 $1,829.23 $1,829.23 $1,829.23 $2,182.50
Ghs clsd red med malleolus fx w manip $1,600.41 $1,600.41 $1,600.41 $2,632.20
Ghs clsd red med malleolus fx without manip $239.88 $239.88 $239.88 $321.00
Ghs clsd tx frac distal tibia w/manipulation $1,600.41 $1,600.41 $1,600.41 $2,319.00
Ghs community re-entry 15 minutes $40.61 $40.61 $40.61 $75.60
Ghs conjunctiva foreign body-embed bil $399.04 $399.04 $399.04 $494.40
Ghs conjunctiva foreign body-superf bil $128.90 $128.90 $128.90 $351.75
Ghs corneal fb with slit lamp bilat $128.90 $128.90 $128.90 $408.60
Ghs corneal fb without slit lamp bilat $399.04 $399.04 $399.04 $422.25
Ghs cricothyroidotomy $232.22 $232.22 $232.22 $777.60
Ghs cutdown placement age 1 and over $399.04 $399.04 $399.04 $102.60
Ghs cutdown placement under 1 yr $128.90 $128.90 $128.90 $128.90
Ghs diphtheria toxoid ab igg $15.21 $15.21 $15.21 $165.60
Ghs dislocation elbow closed treatment $239.88 $239.88 $239.88 $856.20
Ghs ed peritoneal lavage w guidance if performed $937.56 $937.56 $937.56 $3,175.50
Ghs ed rmvl or bivalving cast $265.58 $265.58 $265.58 $370.80
Ghs ed therapeutic lp, drain csf w fluoro $692.52 $692.52 $692.52 $1,439.40
Ghs eeg cont rec w/video by tec min 8 chnls $156.46 $156.46 $156.46 $586.80
Ghs elect torsion swing $156.46 $156.46 $156.46 $282.00
Ghs electrostagmgraphy $156.46 $156.46 $156.46 $931.50
Ghs epidermal shaving diameter >2.0 cm $399.53 $399.53 $399.53 $1,341.60
Ghs excision ingrown nail $399.53 $399.53 $399.53 $484.80
Ghs eye exam $128.87 $128.87 $128.87 $128.87
Ghs eyelid foreign body-embedded - bil $298.93 $298.93 $298.93 $718.20
Ghs fat & muscle $4.85 $4.85 $4.85 $33.00
Ghs fb removal - incisional $1,620.24 $1,620.24 $1,620.24 $3,182.40
Ghs fb removal - non-incisional $1,620.24 $1,620.24 $1,620.24 $1,551.00
Ghs fb removal foot - deep - left $1,620.24 $1,620.24 $1,620.24 $3,771.00
Ghs fb removal from muscle - complicated $2,862.05 $2,862.05 $2,862.05 $3,737.40
Ghs febrile agglutinns(mayo) $6.98 $6.98 $6.98 $76.50
Ghs fish cytogen $21.42 $21.42 $21.42 $186.00
Ghs fish hybrid in situ 100-300 $51.19 $51.19 $51.19 $354.60
Ghs flow volume loop $311.40 $311.40 $311.40 $223.20
Ghs gastric intub aspiration lavage $311.40 $311.40 $311.40 $304.80
Ghs hcv amplificaiton $35.09 $35.09 $35.09 $223.80
Ghs heavy metals bld (ars,lead,merc) $22.97 $22.97 $22.97 $22.97
Ghs hepatitis c virus (hcv riba) $15.49 $15.49 $15.49 $162.00
Ghs hgb stability-thal $9.47 $9.47 $9.47 $252.75
Ghs histoplasma antigen $13.25 $13.25 $13.25 $492.00
Ghs hla-dr/dq, multiple antigens $106.14 $106.14 $106.14 $458.40
Ghs i and d abscess/hematoma scrotum $2,048.51 $2,048.51 $2,048.51 $4,134.00
Ghs i and d perirectal abscess 46040 $1,179.08 $1,179.08 $1,179.08 $2,637.00
Ghs i and d pilonidal cyst complex $703.59 $703.59 $703.59 $1,572.00
Ghs i and d pilonidal cyst simple $703.59 $703.59 $703.59 $703.59
Ghs immun0electrophoresis $29.92 $29.92 $29.92 $178.50
Ghs incision thrombosed ext hemorrhoid $243.21 $243.21 $243.21 $526.50
Ghs indirect laryngoscopy/w fb removal $194.14 $194.14 $194.14 $194.14
Ghs inhibitor screen $12.87 $12.87 $12.87 $345.00
Ghs init tx 1st degree burn $198.70 $198.70 $198.70 $448.50
Ghs inj neurolytic intercostal nerve $890.29 $890.29 $890.29 $3,021.75
Ghs inj neurolytic other perph nerve $890.29 $890.29 $890.29 $1,231.20
Ghs inj tendon origin/insertion $295.19 $295.19 $295.19 $467.40
Ghs inj transforaminal cerv single bil $890.29 $890.29 $890.29 $1,957.50
Ghs insertion of needle - bone $399.04 $399.04 $399.04 $550.80
Ghs intermed repair 12.6 - 20.0 cm-12035 $399.53 $399.53 $399.53 $1,829.40
Ghs intermed repair 20.1 - 30.0 cm-12036 $612.13 $612.13 $612.13 $2,649.00
Ghs intermed repair over 30 cm - 12037 $1,829.23 $1,829.23 $1,829.23 $3,532.20
Ghs irrigate corpora cavernosa for priapism $243.21 $243.21 $243.21 $2,619.00
Ghs lac repair mouth.ant tong 2.5cm/less $399.04 $399.04 $399.04 $569.60
Ghs layer closure 2.5 cm or less - 12031 $399.53 $399.53 $399.53 $477.00
Ghs layer closure 2.5 cm or less - 12041 $399.53 $399.53 $399.53 $825.60
Ghs layer closure 2.5cm or less - 12051 $399.53 $399.53 $399.53 $520.80
Ghs layer closure 2.6 - 5.0 cm - 12052 $399.53 $399.53 $399.53 $825.60
Ghs layer closure 2.6 - 7.5 cm - 12042 $399.53 $399.53 $399.53 $825.60
Ghs layer closure 5.1 - 7.5 cm - 12053 $399.53 $399.53 $399.53 $825.60
Ghs layer closure 7.6 - 12.5 cm - 12034 $399.53 $399.53 $399.53 $998.40
Ghs layer closure 7.6 - 12.5 cm - 12044 $612.13 $612.13 $612.13 $1,212.00
Ghs layer closure 7.6 - 12.5 cm - 12054 $399.53 $399.53 $399.53 $825.60
Ghs layered repair 12.6 - 20.0 cm -12045 $612.13 $612.13 $612.13 $1,134.60
Ghs layered repair 12.6 - 20.0 cm -12055 $399.53 $399.53 $399.53 $993.00
Ghs layered repair 20.1 - 30.0 cm -12046 $612.13 $612.13 $612.13 $612.13
Ghs layered repair 20.1 - 30.0 cm -12056 $399.53 $399.53 $399.53 $471.75
Ghs layered repair over 3.0 cm -12057 $399.53 $399.53 $399.53 $471.75
Ghs layered repair over 30.0 cm -12047 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Ghs leukocyte alkaline phos (mayo) $8.60 $8.60 $8.60 $154.80
Ghs mbp $17.20 $17.20 $17.20 $143.25
Ghs nailbed repair/nail removal $612.13 $612.13 $612.13 $1,236.60
Ghs nerve blk intercostal, ea addtl level $890.29 $890.29 $890.29 $1,618.50
Ghs nerve blk intercostal, single level $692.52 $692.52 $692.52 $1,541.40
Ghs nerve block axillary nerve $890.29 $890.29 $890.29 $1,763.25
Ghs nerve block brachial plexus $890.29 $890.29 $890.29 $1,689.00
Ghs nerve block celiac plexus $890.29 $890.29 $890.29 $2,512.80
Ghs nerve block interscaline $890.29 $890.29 $890.29 $1,671.75
Ghs nerve block lumbar or thoracic symp $890.29 $890.29 $890.29 $1,787.40
Ghs nerve block sciatic nerve $692.52 $692.52 $692.52 $1,809.60
Ghs nerve block suprascapular $692.52 $692.52 $692.52 $1,131.00
Ghs ng placement w fluoro guidance $399.04 $399.04 $399.04 $589.80
Ghs o2 saturation $9.77 $9.77 $9.77 $106.50
Ghs o2 uptake rest & exercise $156.46 $156.46 $156.46 $660.60
Ghs o2 uptake rest & indirect $59.40 $59.40 $59.40 $433.50
Ghs ob unlisted IV or art inj or infusion $46.14 $46.14 $46.14 $46.14
Ghs opcc repair cvp w subq port $1,553.44 $1,553.44 $1,553.44 $4,080.00
Ghs opcc repair cvp without subq port $618.26 $618.26 $618.26 $2,205.00
Ghs optokenetic $156.46 $156.46 $156.46 $256.50
Ghs oscillating trac $311.40 $311.40 $311.40 $260.40
Ghs osteopathic manipulative tx, 1-2 regions $25.30 $25.30 $25.30 $47.80
Ghs osteopathic manipulative tx, 3-4 regions $25.30 $25.30 $25.30 $25.30
Ghs ot dds rom $10.05 $10.05 $10.05 $194.25
Ghs ot group caregiver training $14.15 $14.15 $14.15 $44.40
Ghs ot prosthetic training/15 min $52.32 $52.32 $52.32 $121.20
Ghs ot sensory integrative tech/15min $81.32 $81.32 $81.32 $124.20
Ghs pacing - transcutaneous $654.38 $654.38 $654.38 $940.50
Ghs peritonsillar abscess i andd $232.22 $232.22 $232.22 $1,080.75
Ghs phenylketonurid $5.50 $5.50 $5.50 $128.25
Ghs picc line insert < 5 $1,553.44 $1,553.44 $1,553.44 $3,226.80
Ghs plngl fx pm cl $239.88 $239.88 $239.88 $685.80
Ghs plt ct-manual $4.31 $4.31 $4.31 $43.20
Ghs polysom <6 yrs 4/> parameters $1,017.39 $1,017.39 $1,017.39 $1,017.39
Ghs pos nystagmus $128.90 $128.90 $128.90 $251.40
Ghs ppd (tb intradermal) $24.49 $24.49 $24.49 $52.50
Ghs pr without cont pulse ox $59.40 $59.40 $59.40 $134.25
Ghs prostatic acid phosphatase (mayo) $9.66 $9.66 $9.66 $83.40
Ghs protein, misc fluid $5.61 $5.61 $5.61 $5.61
Ghs protoporphyrins fract $14.35 $14.35 $14.35 $87.60
Ghs pseudocholinesterase,dibucain-inhibi $12.25 $12.25 $12.25 $108.00
Ghs quinidine $14.60 $14.60 $14.60 $24.00
Ghs refill of implantable pump $331.69 $331.69 $331.69 $774.00
Ghs removal intranasal foreign body $128.90 $128.90 $128.90 $341.40
Ghs removal pharyngeal foreign body $399.04 $399.04 $399.04 $397.50
Ghs repair extensor tendon hand, ea tendon $1,600.41 $1,600.41 $1,600.41 $2,055.00
Ghs repair tendon ext forearm/wrist ea $3,244.61 $3,244.61 $3,244.61 $5,693.40
Ghs respiratory syncytical virus igg/m $15.89 $15.89 $15.89 $168.60
Ghs reticulocyte count $4.31 $4.31 $4.31 $35.40
Ghs rsv eia (respir synctial vrs) $13.91 $13.91 $13.91 $187.80
Ghs sedimentation rate $4.27 $4.27 $4.27 $59.40
Ghs semen analysis fert $12.31 $12.31 $12.31 $88.80
Ghs semen analysis, post-vas $9.84 $9.84 $9.84 $9.84
Ghs sensitivity (per antimicro) $7.48 $7.48 $7.48 $74.40
Ghs simple repair 12.6 - 20.0 cm - 12005 $399.53 $399.53 $399.53 $819.60
Ghs simple repair 12.6 - 20.0 cm - 12016 $399.53 $399.53 $399.53 $1,230.60
Ghs simple repair 20.1 - 30.0 cm - 12006 $399.53 $399.53 $399.53 $965.40
Ghs simple repair 20.1 - 30.0 cm - 12017 $399.53 $399.53 $399.53 $2,079.60
Ghs simple repair 5.1 - 7.5 cm - 12014 $198.70 $198.70 $198.70 $589.80
Ghs simple repair 7.6 - 12.5 cm - 12004 $198.70 $198.70 $198.70 $589.80
Ghs simple repair 7.6 - 12.5 cm - 12015 $198.70 $198.70 $198.70 $589.80
Ghs simple repair over 30 cm - 12007 $198.70 $198.70 $198.70 $660.00
Ghs simple repair over 30 cm - 12018 $198.70 $198.70 $198.70 $198.70
Ghs sleep study unattended $156.46 $156.46 $156.46 $752.80
Ghs somatosensory testing lower extremit $311.40 $311.40 $311.40 $978.60
Ghs somatosensory testing upper & lower limbs $530.60 $530.60 $530.60 $855.60
Ghs sp train/fitting sp device - kx $128.79 $128.79 $128.79 $324.75
Ghs speech-gen aug dev eval iii, st $60.57 $60.57 $60.57 $188.80
Ghs sphenopalatine ganglion block $295.19 $295.19 $295.19 $901.80
Ghs spont nystagmus $128.90 $128.90 $128.90 $250.80
Ghs st - eval for alt comm $39.25 $39.25 $39.25 $99.75
Ghs st - re-eval for alt comm $93.37 $93.37 $93.37 $410.25
Ghs strapping shoulder - 29240 $128.90 $128.90 $128.90 $346.20
Ghs subcutaneous infus, for therapy ea. add. hr $46.14 $46.14 $46.14 $46.14
Ghs subcutaneous infus. for therapy init 1 hr $210.69 $210.69 $210.69 $269.25
Ghs superficial wnd dehis w packing12021 $399.53 $399.53 $399.53 $945.60
Ghs superficial wnd dehiscence simp12020 $612.13 $612.13 $612.13 $2,181.60
Ghs tracheostomy emergency - transtracheal $1,481.28 $1,481.28 $1,481.28 $5,073.00
Ghs trypsin (fecal) $7.30 $7.30 $7.30 $7.30
Ghs tx distal phalangeal fx with manipulation $239.88 $239.88 $239.88 $660.00
Ghs tx sp hip disloc abd splnt/trac wo $239.88 $239.88 $239.88 $604.00
Ghs urine, hydroxproline total $24.30 $24.30 $24.30 $251.40
Ghs urine, porphyrins quant $14.71 $14.71 $14.71 $288.60
Ghs vaginal delivery only $3,179.53 $3,179.53 $3,179.53 $3,179.53
Ghs veeg 12-26 hr intmt mont $530.60 $530.60 $530.60 $2,109.60
Ghs windowing of cast $157.79 $157.79 $157.79 $157.79
Gi endoscopic ultrasound $241.72 $241.72 $241.72 $241.72
Gi inhouse confirmation $9.44 $9.44 $9.44 $84.60
Gi protein loss $401.83 $401.83 $401.83 $401.83
Gi tract capsule endoscopy (pillcam) 91110 $937.56 $937.56 $937.56 $1,582.50
Gi trc img intral colon i&r $911.71 $911.71 $911.71 $911.71
Gi trc img intral esophagus $937.56 $937.56 $937.56 $6,183.60
Gi wireless capsule measure $937.56 $937.56 $937.56 $937.56
Giardia lamblia antibody $14.72 $14.72 $14.72 $114.00
Gingivoplasty each quadrant $3,243.07 $3,243.07 $3,243.07 $3,243.07
Gjb2 gene full sequence $101.12 $101.12 $101.12 $101.12
Gjb2 gene known fam variants $61.52 $61.52 $61.52 $61.52
Gjb6 gene com variants $35.00 $35.00 $35.00 $35.00
Glassia injection $5.71 $5.71 $5.71 $41.40
Glaucoma scrn hgh risk direc $24.49 $24.49 $24.49 $24.49
Glaucoma scrn hgh risk direc $39.25 $39.25 $39.25 $39.25
Glaucoma surgery $4,022.86 $4,022.86 $4,022.86 $4,022.86
Glaucoma surgery $2,280.73 $2,280.73 $2,280.73 $2,280.73
Glaucoma surgery $4,022.86 $4,022.86 $4,022.86 $4,022.86
Glaucoma surgery $2,280.73 $2,280.73 $2,280.73 $2,280.73
Glucagon 1 mg solution for injection $195.79 $195.79 $195.79 $1,053.60
Glucagon hcl 1 mg/ml solution for injection $144.88 $144.88 $144.88 $509.06
Glucagon plasma - sendout $14.29 $14.29 $14.29 $131.40
Glucose 1 hr post dose $4.75 $4.75 $4.75 $45.00
Glucose blood by monitoring device cleared by fda for home use $3.28 $3.28 $3.28 $30.00
Glucose blood quantitative $3.93 $3.93 $3.93 $45.00
Glucose body fluid $3.93 $3.93 $3.93 $59.25
Glucose monitoring continual min 72hr pt $59.40 $59.40 $59.40 $90.60
Glucose tolerance test (gtt) 3 specimens $12.87 $12.87 $12.87 $147.00
Glucose tolerance test (gtt) >3 specimens each additional $3.92 $3.92 $3.92 $34.80
Glucose-6-phosphate dhydrogenase screen $6.05 $6.05 $6.05 $55.50
Glycopyrrolate 0.2 mg/ml injection solution $0.43 $0.43 $0.43 $11.70
Golimumab 12.5 mg/ml intravenous solution $11.03 $11.03 $11.03 $104.80
Gonadotropin follicle stimulating hormone (fsh) $18.58 $18.58 $18.58 $171.75
Gonadotropin luteinizing hormone (lh) $18.52 $18.52 $18.52 $129.00
Gonioscopy $128.90 $128.90 $128.90 $128.90
Goniotomy $4,022.86 $4,022.86 $4,022.86 $4,022.86
Goserelin 10.8 mg subcutaneous implant $734.15 $734.15 $734.15 $1,831.20
Graft hand or finger tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Great toe with reduction 28495 $239.88 $239.88 $239.88 $825.60
Grfg autol fat lipo 25 cc/< $1,829.23 $1,829.23 $1,829.23 $1,829.23
Grfg autol fat lipo 50 cc/< $3,660.97 $3,660.97 $3,660.97 $3,660.97
Grfg autol soft tiss dir exc $3,660.97 $3,660.97 $3,660.97 $3,660.97
Group mnt 2 or more 30 mins $19.31 $19.31 $19.31 $19.31
Growth hormone antibody $15.74 $15.74 $15.74 $15.74
Growth stimulation gene 2 $75.60 $75.60 $75.60 $237.60
Gstrst open wo constj tube $1,896.99 $1,896.99 $1,896.99 $1,896.99
Gu dilat ureter/urethra s&i $2,048.51 $2,048.51 $2,048.51 $2,048.51
Guided cath fluid drainage 10030 $703.59 $703.59 $703.59 $1,600.20
Gum graft $1,481.28 $1,481.28 $1,481.28 $1,481.28
Gynecomastia (males) 19300 $3,829.28 $3,829.28 $3,829.28 $3,829.28
H pylori (c-13) blood $67.36 $67.36 $67.36 $67.36
H pylori (c-13) breath $67.36 $67.36 $67.36 $346.80
H pylori ag ia $16.00 $16.00 $16.00 $16.00
H pylori drug admin $7.86 $7.86 $7.86 $7.86
HIV 2 pcr qual - sendout $21.92 $21.92 $21.92 $21.92
HIV prep, ftc/taf 200/25mg $71.27 $71.27 $71.27 $71.27
HIV prep, ftc/tdf 200/300mg $1.74 $1.74 $1.74 $1.74
HIV prep, inj, cabotegravir $7.03 $7.03 $7.03 $7.03
Hair removal by electrolysis 17380 $612.13 $612.13 $612.13 $612.13
Hair trnspl 1-15 punch grfts $399.53 $399.53 $399.53 $399.53
Hair trnspl >15 punch grafts $399.53 $399.53 $399.53 $399.53
Hand X-ray $88.05 $88.05 $88.05 $313.04
Hand tendon reconstruction $7,143.73 $7,143.73 $7,143.73 $7,143.73
Hand tendon reconstruction $3,244.61 $3,244.61 $3,244.61 $3,244.61
Hand tendon/muscle transfer $3,244.61 $3,244.61 $3,244.61 $3,244.61
Haptoglobin quantitative $12.58 $12.58 $12.58 $135.00
Harvest auto stem cells $1,639.28 $1,639.28 $1,639.28 $1,788.00
Harvest cultured skin graft 15040 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Harvest eye tissue alograft $2,332.96 $2,332.96 $2,332.96 $2,332.96
Harvest stem cell concentrte $437.18 $437.18 $437.18 $437.18
Hast w/i&r phys/qhp $128.90 $128.90 $128.90 $275.40
Hast w/oxygen titrate $128.90 $128.90 $128.90 $226.80
Hba1/hba2 full gene sequence $600.00 $600.00 $600.00 $1,051.50
Hba1/hba2 gene dup/del vrnts $202.40 $202.40 $202.40 $714.75
Hba1/hba2 gene fam vrnt $375.25 $375.25 $375.25 $375.25
Hbb full gene sequence $324.58 $324.58 $324.58 $1,172.40
Hbb gene com variants $174.81 $174.81 $174.81 $174.81
Hbb gene dup/del variants $202.40 $202.40 $202.40 $1,672.80
Hbb gene known fam variant $375.25 $375.25 $375.25 $375.25
Hbot, full body chamber, 30m $137.90 $137.90 $137.90 $756.60
Hc fl sm bowel enteroclss tube w kub double contrast $178.02 $178.02 $178.02 $1,272.60
Hc metata joint dislocation anes $1,600.41 $1,600.41 $1,600.41 $1,600.41
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks $612.13 $612.13 $612.13 $612.13
Hc mohs trunk/arm/leg 1st stage 5 blocks $612.13 $612.13 $612.13 $3,624.00
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract $538.27 $538.27 $538.27 $538.27
Hc nm fusion spect CT unlisted $401.83 $401.83 $401.83 $679.20
Hc nm kidney imaging with flow $401.83 $401.83 $401.83 $1,228.80
Hc nm myocard infarct avid plnr tomo spect w/wo quant $538.27 $538.27 $538.27 $807.75
Hc pet myocardial imaging metabolic eval single study $1,305.48 $1,305.48 $1,305.48 $4,680.75
Hcg free betachain test $15.29 $15.29 $15.29 $15.29
Hcg qualitative $7.52 $7.52 $7.52 $85.20
Hcg quantitative $15.05 $15.05 $15.05 $145.50
Hdr rdncl ntrstl/icav brchtx $693.81 $693.81 $693.81 $886.20
Hdr rdncl ntrstl/icav brchtx $693.81 $693.81 $693.81 $693.81
Hdr rdncl ntrstl/icav brchtx $693.81 $693.81 $693.81 $2,553.60
Hdr rdncl skn surf brachytx $262.98 $262.98 $262.98 $598.20
Hdr rdncl skn surf brachytx $262.98 $262.98 $262.98 $598.20
Head CT scan (with and without contrast) $178.02 $178.02 $178.02 $1,881.36
Head CT scan (with contrast) $178.02 $178.02 $178.02 $1,587.69
Head CT scan (without contrast) $106.34 $106.34 $106.34 $1,268.90
Heart first pass multiple $538.27 $538.27 $538.27 $538.27
Heart image spect $401.83 $401.83 $401.83 $1,651.20
Heart infarct image $401.83 $401.83 $401.83 $1,094.40
Heart infarct image (ef) $538.27 $538.27 $538.27 $538.27
Heinz bodies direct $4.20 $4.20 $4.20 $4.20
Helicobacter pylori antibody igm $16.85 $16.85 $16.85 $61.20
Hemagglutination inhibition $8.19 $8.19 $8.19 $8.19
Hematocrit $2.37 $2.37 $2.37 $37.20
Hematopoietic nuclear tx $224.13 $224.13 $224.13 $746.40
Hemiepiphyseal arrest $3,244.61 $3,244.61 $3,244.61 $3,244.61
Hemin 350 mg intravenous powder for solution $34.17 $34.17 $34.17 $6,247.80
Hemodialysis one evaluation $699.72 $699.72 $699.72 $1,223.40
Hemoglobin $2.37 $2.37 $2.37 $36.75
Hemoglobin copper sulfate $4.01 $4.01 $4.01 $4.01
Hemoglobin f (fetal) chemical $10.74 $10.74 $10.74 $228.00
Hemoglobin fetal qualitative $8.00 $8.00 $8.00 $57.00
Hemoglobin methemoglobin quantitative $8.20 $8.20 $8.20 $132.75
Hemoglobin plasma $7.31 $7.31 $7.31 $61.20
Hemoglobin urine $3.95 $3.95 $3.95 $52.20
Hemoglobin-oxygen affinity $13.34 $13.34 $13.34 $686.40
Hemolysin acid $8.87 $8.87 $8.87 $8.87
Hemolysins and agglutinins incubated $12.11 $12.11 $12.11 $91.80
Hemolysins/agglutinins auto $8.77 $8.77 $8.77 $8.77
Hemophilus influenza antibdy $15.84 $15.84 $15.84 $168.00
Hemorrhoidectomy intern transanal deater 2+ 46948 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Hemorrhoidectomy intrnl lig rbbr band ligations $911.71 $911.71 $911.71 $2,925.00
Hemorrhoidopexy stapling 46947 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Hepagam b im injection $71.66 $71.66 $71.66 $586.80
Hepagam b intravenous, inj $71.66 $71.66 $71.66 $71.66
Heparin assay $13.09 $13.09 $13.09 $178.20
Heparin neutralization $11.84 $11.84 $11.84 $187.50
Hepatitis a antibody igm $11.26 $11.26 $11.26 $107.25
Hepatitis b core antibody igm $11.77 $11.77 $11.77 $127.50
Hepatitis b core antibody total $12.05 $12.05 $12.05 $111.75
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution $130.66 $130.66 $130.66 $1,109.60
Hepatitis b surface ag quan $25.32 $25.32 $25.32 $25.32
Hepatitis b surface antibody $10.74 $10.74 $10.74 $106.20
Hepatitis c antibody $14.27 $14.27 $14.27 $108.00
Hepatitis c rna dir probe $31.22 $31.22 $31.22 $31.22
Hepatitis d quantification $42.84 $42.84 $42.84 $627.00
Hepatobiliary system imaging $401.83 $401.83 $401.83 $1,494.00
Hereditary colon ca dsordrs $1,303.95 $1,303.95 $1,303.95 $3,394.80
Hernia Repair (Inguinal) $3,529.06 $3,529.06 $3,529.06 $6,210.72
Herpes simplex 1 ag if $11.98 $11.98 $11.98 $158.40
Herpes simplex 2 ag if $11.98 $11.98 $11.98 $143.40
Herpes simplex type 1 antibody igg $13.19 $13.19 $13.19 $96.00
Herpes simplex type 2 antibody igg $19.35 $19.35 $19.35 $109.80
Herpes simplex virus isolation $33.86 $33.86 $33.86 $186.60
Heterophile antibodies screening $5.18 $5.18 $5.18 $56.40
Heterophile antibodies titer $6.47 $6.47 $6.47 $6.47
Heterophile antibody absrbj $7.37 $7.37 $7.37 $7.37
Hexa gene $51.45 $51.45 $51.45 $1,336.80
Hhv-6 dna quant $41.76 $41.76 $41.76 $457.80
Hi enrgy eswt plantar fascia $1,600.41 $1,600.41 $1,600.41 $1,600.41
Hip X-ray $88.05 $88.05 $88.05 $290.00
Hip arthr0 w/debridement $7,143.73 $7,143.73 $7,143.73 $7,143.73
Hip arthr0 w/synovectomy $3,244.61 $3,244.61 $3,244.61 $3,244.61
Hip arthro acetabuloplasty $7,143.73 $7,143.73 $7,143.73 $7,143.73
Hip arthro w/fb removal $7,143.73 $7,143.73 $7,143.73 $7,143.73
Hip arthro w/femoroplasty $7,143.73 $7,143.73 $7,143.73 $7,143.73
Hip arthro w/labral repair $7,143.73 $7,143.73 $7,143.73 $7,143.73
Hip arthroscopy dx $7,143.73 $7,143.73 $7,143.73 $7,143.73
Histamine $29.53 $29.53 $29.53 $254.40
Histoplasmosis skin test $39.25 $39.25 $39.25 $39.25
Hiv-1 ag ia $24.06 $24.06 $24.06 $171.60
Hizentra injection $14.12 $14.12 $14.12 $181.20
Hla class i high defin qual $323.75 $323.75 $323.75 $435.60
Hla class i phenotype qual $95.52 $95.52 $95.52 $276.00
Hla class i semiquant panel $357.56 $357.56 $357.56 $645.00
Hla class i&ii antibody qual $64.19 $64.19 $64.19 $207.60
Hla class i/ii antibody qual $64.19 $64.19 $64.19 $418.50
Hla class ii high defin qual $325.80 $325.80 $325.80 $471.00
Hla class ii phenotype qual $81.88 $81.88 $81.88 $346.80
Hla class ii semiquant panel $322.96 $322.96 $322.96 $573.00
Hla i & ii type verify lr $404.52 $404.52 $404.52 $365.25
Hla i & ii typing hr $345.57 $345.57 $345.57 $2,453.40
Hla i & ii typing lr $402.12 $402.12 $402.12 $2,362.80
Hla i low res one antigen equiv ea $74.33 $74.33 $74.33 $791.40
Hla i typing 1 locus hr $177.25 $177.25 $177.25 $177.25
Hla i typing complete hr $335.38 $335.38 $335.38 $386.25
Hla i typing complete lr $403.59 $403.59 $403.59 $1,672.20
Hla i typing high res 1 allele grp ea $169.90 $169.90 $169.90 $688.80
Hla i typing low res one locus ea $127.43 $127.43 $127.43 $1,671.60
Hla ii typing 1 loc hr $123.68 $123.68 $123.68 $1,001.25
Hla ii typing ag equiv lr $220.74 $220.74 $220.74 $797.40
Hla typing a b or c $58.00 $58.00 $58.00 $562.20
Hla typing dr/dq $30.17 $30.17 $30.17 $210.60
Hla x-match noncytotoxc addl $36.53 $36.53 $36.53 $155.25
Hla x-math non-cytotoxic $109.49 $109.49 $109.49 $397.50
Hlth bhv assmt/reassessment $92.50 $92.50 $92.50 $144.75
Hlth bhv ivntj fam 1st 30 $29.79 $29.79 $29.79 $111.60
Hlth bhv ivntj grp 1st 30 $29.79 $29.79 $29.79 $117.00
Hlth bhv ivntj indiv 1st 30 $160.67 $160.67 $160.67 $115.50
Home sleep test/type 2 porta $156.46 $156.46 $156.46 $1,238.40
Home sleep test/type 3 porta $156.46 $156.46 $156.46 $1,045.20
Home sleep test/type 4 porta $311.40 $311.40 $311.40 $311.40
Homocysteine $17.92 $17.92 $17.92 $102.75
Homogenization tissue $5.88 $5.88 $5.88 $76.80
Homovanillic acid (hva) $22.41 $22.41 $22.41 $108.00
Hopd mntl hlt, 15-29 min $29.79 $29.79 $29.79 $29.79
Hopd mntl hlt, 30-60 min $92.50 $92.50 $92.50 $92.50
Hopd mntl hlt, grp $29.79 $29.79 $29.79 $29.79
Hpa-1 genotyping $122.22 $122.22 $122.22 $165.00
Hpa-15 genotyping $122.22 $122.22 $122.22 $165.00
Hpa-2 genotyping $122.22 $122.22 $122.22 $165.00
Hpa-3 genotyping $122.22 $122.22 $122.22 $165.00
Hpa-4 genotyping $122.22 $122.22 $122.22 $165.00
Hpa-5 genotyping $122.22 $122.22 $122.22 $165.00
Hpa-6 genotyping $122.22 $122.22 $122.22 $165.00
Hpa-9 genotyping $122.22 $122.22 $122.22 $165.00
Hpv low-risk types $35.09 $35.09 $35.09 $35.09
Hpv types 16 & 18 only $40.55 $40.55 $40.55 $228.00
Hrdtry cardmypy gene panel $584.90 $584.90 $584.90 $9,382.20
Hrdtry perph neurphy panel $584.90 $584.90 $584.90 $22,852.20
Hrv skn cll ssp agrft 1st 25 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Htt gene detc abnor alleles $137.00 $137.00 $137.00 $1,271.40
Human epididymis protein 4 (he4) $20.81 $20.81 $20.81 $180.60
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution $1.26 $1.26 $1.26 $1.26
Hydration IV infusion each additional hour $46.14 $46.14 $46.14 $214.80
Hydration IV infusion initial 31minutes - 1 hour $210.69 $210.69 $210.69 $490.20
Hydroxocobalamin im 10mcg $0.01 $0.01 $0.01 $83.64
Hydrxycorticsterds 17- (17-ohcs) $17.90 $17.90 $17.90 $165.60
Hymenotomy $3,179.53 $3,179.53 $3,179.53 $3,179.53
Hymovis injection 1 mg $17.44 $17.44 $17.44 $2,459.97
Hyoid myotomy & suspension $5,915.66 $5,915.66 $5,915.66 $5,915.66
Hyperthermia ext gen deep $693.81 $693.81 $693.81 $693.81
Hyperthermia ext gen supfc $262.98 $262.98 $262.98 $262.98
Hyperthermia gen intrcv prb $578.47 $578.47 $578.47 $578.47
Hyperthermia ntrstl prb 5/< $578.47 $578.47 $578.47 $578.47
Hyperthermia ntrstl prb>5 $578.47 $578.47 $578.47 $578.47
Hyqvia 100mg immuneglobulin $18.39 $18.39 $18.39 $18.39
Hysterosalpingography s&i $241.72 $241.72 $241.72 $1,139.25
Hysteroscopy ablation $4,936.45 $4,936.45 $4,936.45 $4,936.45
Hysteroscopy biopsy $3,179.53 $3,179.53 $3,179.53 $5,110.50
Hysteroscopy dx sep proc $3,179.53 $3,179.53 $3,179.53 $3,568.50
Hysteroscopy lysis $4,936.45 $4,936.45 $4,936.45 $4,936.45
Hysteroscopy remove fb $3,179.53 $3,179.53 $3,179.53 $5,843.25
Hysteroscopy remove myoma $4,936.45 $4,936.45 $4,936.45 $4,302.75
Hysteroscopy resect septum $4,936.45 $4,936.45 $4,936.45 $4,936.45
Hysterotomy abdominal 59100 $4,936.45 $4,936.45 $4,936.45 $3,761.40
I & d vag hematoma non-ob 57023 $2,862.05 $2,862.05 $2,862.05 $2,862.05
I&d abscss rtrphryngl/paraphryngl intraorl apprch $3,243.07 $3,243.07 $3,243.07 $3,243.07
I&d frarm&/wrst deep absc/hematoma $3,244.61 $3,244.61 $3,244.61 $3,350.40
I&d intramural/intramuscular/submuc abscess transanal anes $2,742.39 $2,742.39 $2,742.39 $2,742.39
I&d lacrimal gland $968.54 $968.54 $968.54 $968.54
I&d lacrimal sac $2,332.96 $2,332.96 $2,332.96 $2,729.25
I&d upper arm/elbow deep abscess/hematoma $2,862.05 $2,862.05 $2,862.05 $2,862.05
I&d vag hemtma obst/postpart $2,862.05 $2,862.05 $2,862.05 $2,862.05
I&d/bursa/foot 28001 $1,620.24 $1,620.24 $1,620.24 $1,620.24
I-123 iobenguane diag $2,074.81 $2,074.81 $2,074.81 $10,866.00
I-123 ioflupane diag $1,388.02 $1,388.02 $1,388.02 $8,455.20
I131 iodide cap, rx $23.13 $23.13 $23.13 $128.80
I131 iodide sol, rx $20.88 $20.88 $20.88 $78.60
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour $71.17 $71.17 $71.17 $285.60
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour $46.14 $46.14 $46.14 $298.20
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour $210.69 $210.69 $210.69 $586.50
IV inj ra drug dx study $401.83 $401.83 $401.83 $564.00
IV njx tst vasc flo flap/grf $399.04 $399.04 $399.04 $399.04
Ia infect ag ab qual/semiquant sgl step $18.09 $18.09 $18.09 $48.00
Ia nfct ab sarscov2 covid19 $45.28 $45.28 $45.28 $45.28
Iaadi respiratory synctial virus $13.42 $13.42 $13.42 $13.42
Iadna legionella pneumophila amplified probe tq $35.09 $35.09 $35.09 $329.25
Ibmfs seq alys pnl 30 genes $2,448.56 $2,448.56 $2,448.56 $2,448.56
Ibutilide fumarate 0.1 mg/ml intravenous solution $219.06 $219.06 $219.06 $1,022.55
Icatibant injection $116.41 $116.41 $116.41 $3,697.02
Icg angiography i&r uni/bi $311.40 $311.40 $311.40 $311.40
Icut allergy test drug/bug $59.40 $59.40 $59.40 $115.80
Icut allergy test-delayed $39.25 $39.25 $39.25 $39.25
Icut allergy titrate-airborn $24.49 $24.49 $24.49 $24.49
Idecabtagene vicleucel car $541,260.45 $541,260.45 $541,260.45 $541,260.45
Identify sperm tissue $53.43 $53.43 $53.43 $53.43
Idh1 common variants $193.25 $193.25 $193.25 $193.25
Idh2 common variants $295.79 $295.79 $295.79 $295.79
Idursulfase injection $558.56 $558.56 $558.56 $11,942.56
Ifnl3 gene $73.37 $73.37 $73.37 $73.37
Igh gene rearrang dir probe $68.55 $68.55 $68.55 $68.55
Igh gene rearrange amp meth $197.99 $197.99 $197.99 $464.25
Igh@ var region somatic mutation analy $294.52 $294.52 $294.52 $1,392.00
Igh@/bcl2 translocation alys $207.31 $207.31 $207.31 $207.31
Igk rearrangeabn clonal pop $172.73 $172.73 $172.73 $933.00
Ihc/icc per specimen each multiplex antibody stain $359.72 $359.72 $359.72 $318.75
Ihc/icc per specimen initial single antibody stain $171.36 $171.36 $171.36 $310.50
Ikbkap gene $39.31 $39.31 $39.31 $552.60
Imetelstat 188 mg intravenous solution $57.02 $57.02 $57.02 $98.40
Img rta detc/mntr ds phy/qhp $39.25 $39.25 $39.25 $39.25
Img rta detc/mntr ds poc aly $59.40 $59.40 $59.40 $59.40
Img rta detcj/mntr ds staff $59.40 $59.40 $59.40 $59.40
Immt breast prosthesis 19340 $6,521.46 $6,521.46 $6,521.46 $6,521.46
Immune complex assay $24.37 $24.37 $24.37 $89.25
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution $47.80 $47.80 $47.80 $623.20
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution $48.38 $48.38 $48.38 $1,080.00
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution $81.70 $81.70 $81.70 $2,778.42
Immunoassay tumor antigen quantitative ca 125 $20.81 $20.81 $20.81 $141.00
Immunoassay tumor antigen quantitative ca 19-9 $20.81 $20.81 $20.81 $159.00
Immunoassay tumor qual $25.57 $25.57 $25.57 $167.40
Immunodiff gel qual ea antigen/ab $11.98 $11.98 $11.98 $123.00
Immunodiffusion nes $14.05 $14.05 $14.05 $148.80
Immunofixation electrophoresis serum $22.34 $22.34 $22.34 $219.60
Immunofluorescence per specimen initial single antibody stain $171.36 $171.36 $171.36 $168.00
Immunoglobulin assay $12.46 $12.46 $12.46 $108.00
Imp extar knee shck absrb $18,390.05 $18,390.05 $18,390.05 $18,390.05
Impact tooth remov part bony $1,662.63 $1,662.63 $1,662.63 $1,662.63
Impedence cardiogram $128.90 $128.90 $128.90 $128.90
Impl neurostim electr perc $6,562.90 $6,562.90 $6,562.90 $6,471.60
Impl oi implt sk tc esp<100 $12,866.82 $12,866.82 $12,866.82 $12,866.82
Impl oi implt sk tc esp>=100 $12,866.82 $12,866.82 $12,866.82 $12,866.82
Impl oi implt skull perq esp $12,866.82 $12,866.82 $12,866.82 $12,866.82
Implant cochlear device $31,807.82 $31,807.82 $31,807.82 $31,807.82
Implant eye drug system $15,364.83 $15,364.83 $15,364.83 $15,364.83
Implant hormone pellet(s) 11980 $399.04 $399.04 $399.04 $399.04
Implant neuroelectrodes $21,444.39 $21,444.39 $21,444.39 $21,444.39
Implant neuroelectrodes $6,562.90 $6,562.90 $6,562.90 $4,177.20
Implant neuroelectrodes $6,562.90 $6,562.90 $6,562.90 $6,447.00
Implant neuroelectrodes $12,470.31 $12,470.31 $12,470.31 $10,672.50
Implant neurostim arrays $30,473.59 $30,473.59 $30,473.59 $30,473.59
Implant spinal canal cath $7,143.73 $7,143.73 $7,143.73 $7,143.73
Implant spine infusion pump $17,674.12 $17,674.12 $17,674.12 $17,674.12
Implant spine infusion pump $17,674.12 $17,674.12 $17,674.12 $17,674.12
Implantation iris prosthesis $16,416.44 $16,416.44 $16,416.44 $16,416.44
Implnt spinl canal catheter 62350 $6,404.07 $6,404.07 $6,404.07 $7,425.75
Impltj ntrstrml crnl rng seg $4,022.86 $4,022.86 $4,022.86 $4,022.86
Imported lipodox inj $528.86 $528.86 $528.86 $2,474.40
Impres&prep auricular prosth $3,243.07 $3,243.07 $3,243.07 $3,243.07
Impres&prep def obt prosth $3,243.07 $3,243.07 $3,243.07 $3,243.07
Impres&prep facial prosth $3,243.07 $3,243.07 $3,243.07 $3,243.07
Impres&prep intrm obt prosth $3,243.07 $3,243.07 $3,243.07 $3,243.07
Impres&prep mndbl res prosth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Impres&prep nasal prosth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Impres&prep oral surg splint $232.22 $232.22 $232.22 $232.22
Impres&prep orbital prosth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Impres&prep paltl aug prosth $3,243.07 $3,243.07 $3,243.07 $3,243.07
Impres&prep paltl lft prosth $3,243.07 $3,243.07 $3,243.07 $3,243.07
Impres&prep sp aid prosth $3,243.07 $3,243.07 $3,243.07 $3,243.07
Impres&prep surg obt prosth $1,481.28 $1,481.28 $1,481.28 $1,481.28
Imuglucerase injection $43.29 $43.29 $43.29 $343.20
In situ hybridization per specimen initial single probe stain $171.36 $171.36 $171.36 $300.00
In-111 autol wbc diag per dose $1,031.39 $1,031.39 $1,031.39 $1,031.39
In-111 ibritumomab tiux dx $798.02 $798.02 $798.02 $12,163.20
In-111 oxyquinolin per 0.5 mci $772.64 $772.64 $772.64 $2,808.00
In-111 pentetate dtpa / 0.5 mci $715.29 $715.29 $715.29 $820.20
In-111 pentetreotide $1,914.61 $1,914.61 $1,914.61 $4,204.80
Inc dp bone crtx f/arm&/wrst $7,143.73 $7,143.73 $7,143.73 $7,143.73
Inc dp opn b1 crtx hum/elbw $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incise diaphragm nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incise flexor carpi radialis $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incise hand/finger tendon $1,600.41 $1,600.41 $1,600.41 $1,600.41
Incise hip/thigh nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incise hip/thigh nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incise inner ear $1,481.28 $1,481.28 $1,481.28 $1,481.28
Incise inner ear nerve $3,243.07 $3,243.07 $3,243.07 $3,243.07
Incise inner eye adhesions $4,022.86 $4,022.86 $4,022.86 $4,022.86
Incise inner eye adhesions $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incise inner eye adhesions $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incise inner eye adhesions $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incise inner eye adhesions $548.60 $548.60 $548.60 $548.60
Incise inner eye strands $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incise nerve back of head $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incise perq finger tendon 26060 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Incise skull for treatment $6,404.07 $6,404.07 $6,404.07 $6,404.07
Incise skull/brain surgery $6,404.07 $6,404.07 $6,404.07 $6,404.07
Incise sperm duct pouch $2,048.51 $2,048.51 $2,048.51 $2,048.51
Incise tear duct opening 68440 $298.93 $298.93 $298.93 $298.93
Incise tendon(s) & muscle(s) $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incise thigh tendon & fascia $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incise wrist/forearm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incise/drain eyelid lining $968.54 $968.54 $968.54 $1,020.75
Incision & drainage hematoma/seroma/fluid collection $1,620.24 $1,620.24 $1,620.24 $2,080.80
Incision anal septum infant $2,742.39 $2,742.39 $2,742.39 $2,742.39
Incision of achilles tendon $1,600.41 $1,600.41 $1,600.41 $1,863.75
Incision of achilles tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of anal sphincter $2,742.39 $2,742.39 $2,742.39 $2,742.39
Incision of ankle bone $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incision of breast lesion $1,620.24 $1,620.24 $1,620.24 $2,715.60
Incision of brow nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incision of burn scab initi $399.53 $399.53 $399.53 $825.60
Incision of cheek nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incision of chin nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incision of eardrum $3,243.07 $3,243.07 $3,243.07 $3,243.07
Incision of eardrum $232.22 $232.22 $232.22 $2,611.20
Incision of esophagus $1,481.28 $1,481.28 $1,481.28 $1,481.28
Incision of eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incision of eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incision of eyelid $968.54 $968.54 $968.54 $968.54
Incision of facial nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incision of fibula $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of finger tendon $1,600.41 $1,600.41 $1,600.41 $1,600.41
Incision of foot fascia $3,244.61 $3,244.61 $3,244.61 $3,752.25
Incision of foot tendon 28234 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Incision of heel bone $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incision of hip tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of hip tendon $1,600.41 $1,600.41 $1,600.41 $1,600.41
Incision of hip tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incision of hip tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of iris $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incision of iris $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incision of jaw joint $3,243.07 $3,243.07 $3,243.07 $3,243.07
Incision of jaw nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incision of knee joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of lymph channels $3,829.28 $3,829.28 $3,829.28 $3,829.28
Incision of metatarsal $3,244.61 $3,244.61 $3,244.61 $669.00
Incision of metatarsal $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incision of metatarsal $7,143.73 $7,143.73 $7,143.73 $712.80
Incision of metatarsals $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incision of midfoot bones $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incision of palm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of prostate $3,448.97 $3,448.97 $3,448.97 $3,448.97
Incision of rectal abscess $2,742.39 $2,742.39 $2,742.39 $2,742.39
Incision of sperm duct $3,448.97 $3,448.97 $3,448.97 $3,448.97
Incision of spinal nerve 64772 $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incision of tendon & muscle $7,143.73 $7,143.73 $7,143.73 $8,293.50
Incision of tendon sheath $1,600.41 $1,600.41 $1,600.41 $1,600.41
Incision of thigh tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of thigh tendon $3,244.61 $3,244.61 $3,244.61 $3,752.25
Incision of thigh tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of thigh tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of thigh tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision of tibia $7,143.73 $7,143.73 $7,143.73 $7,143.73
Incision of tibia & fibula $12,866.82 $12,866.82 $12,866.82 $12,866.82
Incision of toe tendons 28011 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Incision of tongue fold $1,481.28 $1,481.28 $1,481.28 $1,481.28
Incision of tongue nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Incision of urethra $2,048.51 $2,048.51 $2,048.51 $2,048.51
Incision of urethra $2,048.51 $2,048.51 $2,048.51 $2,048.51
Incision of urethra $5,083.62 $5,083.62 $5,083.62 $5,083.62
Incision of urethra $2,048.51 $2,048.51 $2,048.51 $2,048.51
Incision of windpipe $5,915.66 $5,915.66 $5,915.66 $5,915.66
Incision of windpipe $5,915.66 $5,915.66 $5,915.66 $5,915.66
Incision of wrist capsule $3,244.61 $3,244.61 $3,244.61 $3,244.61
Incision secondary cataract $2,280.73 $2,280.73 $2,280.73 $2,280.73
Incision tendon sheath $1,600.41 $1,600.41 $1,600.41 $3,771.00
Incisn of toe tndn $1,600.41 $1,600.41 $1,600.41 $1,608.60
Incisn windpipe $3,243.07 $3,243.07 $3,243.07 $3,216.00
Incobotulinumtoxin a $5.31 $5.31 $5.31 $1,317.00
Indigotindisulfonate 8 mg/ml soln 5 ml ampule $9.96 $9.96 $9.96 $24.00
Induced abortion d&c $3,179.53 $3,179.53 $3,179.53 $3,179.53
Induced abortion dilat&evac $3,179.53 $3,179.53 $3,179.53 $6,344.25
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) $70.20 $70.20 $70.20 $215.25
Infect ag drug suscept pheno predict $130.35 $130.35 $130.35 $724.80
Infect ag eia chlamydia trachomatis $15.00 $15.00 $15.00 $15.00
Infect ag eia influenza a or b ea $14.13 $14.13 $14.13 $62.40
Infect ag genotype na cytomegalovirus $257.45 $257.45 $257.45 $1,484.40
Infect ag genotype na dna hepatitis b $257.45 $257.45 $257.45 $445.60
Infect ag genotype na hiv-1 other region $128.73 $128.73 $128.73 $1,143.60
Infect ag genotype na hiv-1 revr trn/prt $257.45 $257.45 $257.45 $1,404.00
Infect ag ia direct hiv-1 antgn $32.77 $32.77 $32.77 $32.77
Infect ag ia optc obs chlamydia trach $35.29 $35.29 $35.29 $35.29
Infect ag ia optc obs influenza $16.55 $16.55 $16.55 $101.25
Infect ag if ea plyvlnt antsrm $11.98 $11.98 $11.98 $11.98
Infect ag if hep delta agent $18.36 $18.36 $18.36 $192.60
Infect ag if influenza a $16.07 $16.07 $16.07 $124.80
Infect ag if influenza b $12.25 $12.25 $12.25 $124.80
Infect ag if legionella pneumophila $15.60 $15.60 $15.60 $85.50
Infect ag if nos ea $16.10 $16.10 $16.10 $90.60
Infect ag if pneumocystis carinii $11.98 $11.98 $11.98 $122.40
Infect ag if varicella zoster $13.42 $13.42 $13.42 $115.20
Infect ag na chlamydia trachomatis qnt $53.47 $53.47 $53.47 $53.47
Infect ag na hep b amp $35.09 $35.09 $35.09 $126.60
Infect ag na herpes simplex quant $42.84 $42.84 $42.84 $385.80
Infect ag na hpv high-risk types $35.09 $35.09 $35.09 $282.00
Infect ag na influenza r/amp 1st 2 types $95.80 $95.80 $95.80 $520.20
Infect ag na influenza revr/amp ea type $51.31 $51.31 $51.31 $51.31
Infect ag na orthopoxvirus amp prb each $51.31 $51.31 $51.31 $180.00
Infect ag na resp virus 12-25 targets $416.78 $416.78 $416.78 $1,386.00
Infect ag phenotype na hiv-1 1-10 drugs $488.66 $488.66 $488.66 $108.00
Infect ag phenotype na hiv-1 ea addl drg $26.07 $26.07 $26.07 $1,288.50
Infectious agent antigen immunoassay direct optical observation sars-cov-2 $41.38 $41.38 $41.38 $40.20
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin $11.98 $11.98 $11.98 $108.00
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans $13.42 $13.42 $13.42 $58.50
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium $13.82 $13.82 $13.82 $84.75
Infectious agent antigen immunoassay ql/sq multi step giardia $11.98 $11.98 $11.98 $98.25
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool $14.38 $14.38 $14.38 $99.00
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn $10.33 $10.33 $10.33 $76.20
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization $10.33 $10.33 $10.33 $67.80
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies $24.08 $24.08 $24.08 $168.60
Infectious agent antigen immunoassay ql/sq multi step legionella urine $11.98 $11.98 $11.98 $303.00
Infectious agent antigen immunoassay ql/sq multi step rotavirus $11.98 $11.98 $11.98 $130.50
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin $11.98 $11.98 $11.98 $108.00
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance $76.77 $76.77 $76.77 $195.60
Infectious agent nucleic acid amplified probe $35.09 $35.09 $35.09 $349.80
Infectious agent nucleic acid amplified probe chlamydia trachomatis $35.09 $35.09 $35.09 $203.40
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) $37.27 $37.27 $37.27 $286.80
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets $416.78 $416.78 $416.78 $933.00
Infectious agent nucleic acid amplified probe hsv-1 $35.09 $35.09 $35.09 $306.00
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus $35.09 $35.09 $35.09 $339.60
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis $41.68 $41.68 $41.68 $307.20
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae $35.09 $35.09 $35.09 $198.60
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 $51.31 $51.31 $51.31 $75.00
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b $142.63 $142.63 $142.63 $194.40
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv $142.63 $142.63 $142.63 $210.00
Infectious agent nucleic acid amplified probe streptococcus group a $35.09 $35.09 $35.09 $97.50
Infectious agent nucleic acid amplified probe trichomonas vaginalis $35.09 $35.09 $35.09 $195.60
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets $416.78 $416.78 $416.78 $481.80
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets $128.29 $128.29 $128.29 $128.29
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets $262.99 $262.99 $262.99 $553.20
Infectious agent nucleic acid quantification bk virus $42.84 $42.84 $42.84 $483.00
Infectious agent nucleic acid quantification hepatitis b $42.84 $42.84 $42.84 $385.80
Infectious agent nucleic acid quantification hepatitis c $42.84 $42.84 $42.84 $542.40
Infectious agent nucleic acid quantification hiv-1 $85.10 $85.10 $85.10 $739.20
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets $142.63 $142.63 $142.63 $571.20
Infliximab 100 mg intravenous solution $31.18 $31.18 $31.18 $700.20
Infliximab-axxq 100 mg intravenous solution $20.89 $20.89 $20.89 $1,012.80
Infliximab-dyyb 100 mg intravenous solution $19.68 $19.68 $19.68 $567.60
Influenza dna amp prob addl $29.22 $29.22 $29.22 $279.00
Infuse radioactive materials $262.98 $262.98 $262.98 $262.98
Ingest challenge ini 120 min $530.60 $530.60 $530.60 $530.60
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis $203.39 $203.39 $203.39 $377.40
Initial foot exam pt lops $128.87 $128.87 $128.87 $128.87
Initiation & management bipap/cpap initial day $203.39 $203.39 $203.39 $428.40
Inj acetaminoph 10mg/ibu 3mg $0.22 $0.22 $0.22 $0.22
Inj adalimumab-ryvk, 1 mg $10.64 $10.64 $10.64 $10.64
Inj allopurinol sodium 1 mg $4.54 $4.54 $4.54 $5,937.23
Inj alymsys 10 mg $42.60 $42.60 $42.60 $42.60
Inj andexxa, 10 mg $131.56 $131.56 $131.56 $13,381.20
Inj anifrolumab-fnia 1mg $18.10 $18.10 $18.10 $10,166.40
Inj avacincaptad pegol 0.1mg $105.90 $105.90 $105.90 $105.90
Inj aval alfa-nqpt 4mg $80.75 $80.75 $80.75 $5,052.80
Inj bimatoprost itc imp1mcg $212.36 $212.36 $212.36 $7,487.44
Inj brixadi, more than 7 day $1,691.31 $1,691.31 $1,691.31 $4,344.80
Inj cefazolin (wg crit care) $1.00 $1.00 $1.00 $1.00
Inj cefazolin sodium, hikma $0.91 $0.91 $0.91 $0.91
Inj ceftolozane tazobactam $9.13 $9.13 $9.13 $286.20
Inj crotalidae im f(ab')2 eq $1,044.14 $1,044.14 $1,044.14 $1,044.14
Inj cuvitru, 100 mg $17.59 $17.59 $17.59 $17.59
Inj cyclophos dr.reddy's 5mg $9.00 $9.00 $9.00 $9.00
Inj cyclophosphamd (ingenus) $1.16 $1.16 $1.16 $3.75
Inj cyclophosphamd auromedic $0.78 $0.78 $0.78 $0.78
Inj daptomycin (xellia) $0.04 $0.04 $0.04 $0.04
Inj daxibotulinumtoxina-lanm $3.11 $3.11 $3.11 $3.11
Inj delandistrogene mox rokl $3,324,571.90 $3,324,571.90 $3,324,571.90 $2,056,320.00
Inj dupuytren cord w/enzyme $295.19 $295.19 $295.19 $373.50
Inj efgart-alfa 2mg hya-qvfc $33.74 $33.74 $33.74 $79.80
Inj eflapegrastim-xnst 0.1mg $21.12 $21.12 $21.12 $21.12
Inj epidural sgl cerv-thor without img $692.52 $692.52 $692.52 $1,656.60
Inj epidural sgl lumb-sacral without img $890.29 $890.29 $890.29 $1,524.80
Inj fensolvi 0.25 mg $140.43 $140.43 $140.43 $140.43
Inj fluphenazine hcl 1.25 mg $7.43 $7.43 $7.43 $7.43
Inj fosnetupitant, palonoset $606.35 $606.35 $606.35 $606.35
Inj givosiran 0.5 mg $117.19 $117.19 $117.19 $119,349.60
Inj glofitamab gxbm, 2.5 mg $2,770.57 $2,770.57 $2,770.57 $6,717.00
Inj glycopyrrolate fres kabi $1.85 $1.85 $1.85 $1.85
Inj herzuma 10 mg $77.49 $77.49 $77.49 $77.49
Inj human fibrinogen con nos $1.52 $1.52 $1.52 $4,326.08
Inj hydroxocobalamin IV 25mg $5.18 $5.18 $5.18 $5.18
Inj imip 4 cilas 4 releb 2mg $2.61 $2.61 $2.61 $7.20
Inj intralesional <= 7 lsn(s) $198.70 $198.70 $198.70 $281.40
Inj intralesional > 7 lsns $198.70 $198.70 $198.70 $222.75
Inj ivig privigen 500 mg $50.43 $50.43 $50.43 $4,345.80
Inj luxturna 1 billion vec g $3,163.15 $3,163.15 $3,163.15 $3,163.15
Inj melpha hydroch nos 50 mg $108.03 $108.03 $108.03 $1,713.99
Inj melphalan (hepzato) 1 mg $787.79 $787.79 $787.79 $787.79
Inj meropenem (wg crit care) $1.62 $1.62 $1.62 $1.62
Inj mogamulizumab-kpkc, 1 mg $248.50 $248.50 $248.50 $558.40
Inj nephrosto/ureterogram w/img exstng access $667.47 $667.47 $667.47 $1,266.00
Inj non-compmd foam sclrsnt mlt trncl veins same leg $1,829.23 $1,829.23 $1,829.23 $1,976.25
Inj non-compmd foam sclrsnt sgl trncl vein $1,829.23 $1,829.23 $1,829.23 $1,829.23
Inj ogivri 10 mg $44.59 $44.59 $44.59 $564.00
Inj olipudase alfa-rpcp 1mg $393.82 $393.82 $393.82 $393.82
Inj onase abepar-xioi treat $2,452,115.60 $2,452,115.60 $2,452,115.60 $2,452,115.60
Inj ontruzant 10 mg $21.99 $21.99 $21.99 $21.99
Inj pegfilgrastim-bmez 0.5mg $27.99 $27.99 $27.99 $3,925.20
Inj pemetrexed (accord) 10mg $9.74 $9.74 $9.74 $9.74
Inj pemetrexed (teva) 10mg $3.79 $3.79 $3.79 $3.79
Inj pemetrexed ditromethamin $10.34 $10.34 $10.34 $10.34
Inj pemetrexed, hospira 10mg $4.93 $4.93 $4.93 $4.93
Inj plasminogen tvmh 1mg $32.31 $32.31 $32.31 $32.31
Inj recombin esperoct per iu $2.26 $2.26 $2.26 $2.26
Inj retacrit esrd on dialysi $0.76 $0.76 $0.76 $0.76
Inj roctavian ml 2x10^13vc g $12,368.21 $12,368.21 $12,368.21 $12,368.21
Inj romidepsin non-lyo 0.1mg $28.52 $28.52 $28.52 $28.52
Inj scleros sol mult veins $399.53 $399.53 $399.53 $1,108.20
Inj scleros sol sgl vein $399.53 $399.53 $399.53 $1,108.20
Inj sebelipase alfa 1 mg $539.69 $539.69 $539.69 $539.69
Inj secretin synthetic human $43.79 $43.79 $43.79 $169.20
Inj secukinumab intrav 1mg $17.84 $17.84 $17.84 $42.80
Inj teclistamab cqyv 0.5 mg $33.27 $33.27 $33.27 $85.20
Inj tedizolid phosphate $1.91 $1.91 $1.91 $1,081.80
Inj teplizumab mzwv 5 mcg $37.65 $37.65 $37.65 $37.65
Inj thiotepa nos 1 mg $12.24 $12.24 $12.24 $450.00
Inj tofersen intrathec 1 mg $155.34 $155.34 $155.34 $155.34
Inj triamcinolone ace X-ray 1mg $18.21 $18.21 $18.21 $18.21
Inj velmanase alfa-tycv 1 mg $465.05 $465.05 $465.05 $465.05
Inj w/fluor eval cv device $210.69 $210.69 $210.69 $711.00
Inj xipere 1 mg $48.00 $48.00 $48.00 $48.00
Inj zanidatamab-hrii, 2 mg $25.08 $25.08 $25.08 $44.40
Inj zenocutuzumab-zbco 1 mg $32.62 $32.62 $32.62 $32.62
Inj(s) sclerosant spider veins limb/trunk $399.53 $399.53 $399.53 $389.25
Inj, abilify asimtufii, 1 mg $6.03 $6.03 $6.03 $6.03
Inj, abilify maintena, 1 mg $7.24 $7.24 $7.24 $7,107.60
Inj, adstiladrin, per tx dos $63,431.05 $63,431.05 $63,431.05 $63,431.05
Inj, aducanumab-avwa, 2 mg $5.98 $5.98 $5.98 $5.98
Inj, adzynma, 10 iu $35.59 $35.59 $35.59 $35.59
Inj, aflibercept hd, 1 mg $319.74 $319.74 $319.74 $319.74
Inj, afstyla, 1 i.u $1.58 $1.58 $1.58 $1.58
Inj, alyglo, 500 mg $131.12 $131.12 $131.12 $131.12
Inj, amisulpride, 1 mg $9.66 $9.66 $9.66 $9.66
Inj, aponvie, 1 mg $1.92 $1.92 $1.92 $3.00
Inj, artesunate, 1mg $51.83 $51.83 $51.83 $39,774.01
Inj, aspara, rylaze, 0.1 mg $55.30 $55.30 $55.30 $96.60
Inj, bezlotoxumab, 10 mg $39.83 $39.83 $39.83 $11,671.20
Inj, bortezomib freseniuskab $16.50 $16.50 $16.50 $16.50
Inj, bortezomib, dr. reddy's $4.91 $4.91 $4.91 $4.91
Inj, brixadi, 7 days or less $422.83 $422.83 $422.83 $814.80
Inj, brolucizumab-dbll, 1 mg $346.19 $346.19 $346.19 $346.19
Inj, bupivacaine (posimir) $0.51 $0.51 $0.51 $0.51
Inj, bupivacaine liposome $1.49 $1.49 $1.49 $7.20
Inj, carmustine (accord) $259.70 $259.70 $259.70 $259.70
Inj, cefiderocol, 10 mg $2.40 $2.40 $2.40 $6.00
Inj, cimerli, 0.1 mg $86.51 $86.51 $86.51 $519.00
Inj, cipaglucosidase, 5 mg $89.80 $89.80 $89.80 $229.20
Inj, clevidipine butyrate $2.88 $2.88 $2.88 $697.20
Inj, crovalimab-akkz, 10 mg $551.51 $551.51 $551.51 $551.51
Inj, cyclophosphamd, sandoz $4.21 $4.21 $4.21 $4.21
Inj, donanemab-azbt, 2 mg $4.14 $4.14 $4.14 $7.20
Inj, durolane 1 mg $6.68 $6.68 $6.68 $106.40
Inj, evinacumab-dgnb, 5mg $189.75 $189.75 $189.75 $189.75
Inj, factor x, (human), 1iu $9.91 $9.91 $9.91 $32.40
Inj, faricimab-svoa, 0.1mg $34.48 $34.48 $34.48 $100.00
Inj, focinvez, 1mg $2.87 $2.87 $2.87 $5.40
Inj, fosaprepitant (teva) $1.13 $1.13 $1.13 $1.13
Inj, fulvestrant (fresenius) $3.32 $3.32 $3.32 $1,713.99
Inj, fulvestrant (teva) $46.21 $46.21 $46.21 $46.21
Inj, granisetron, xr, 0.1 mg $4.96 $4.96 $4.96 $4.96
Inj, hemgenix, per tx dose $3,685,266.67 $3,685,266.67 $3,685,266.67 $3,685,266.67
Inj, idacio, 1 mg $8.92 $8.92 $8.92 $8.92
Inj, immphentiv, 20 mcg $0.13 $0.13 $0.13 $0.13
Inj, invega hafyera/trinza $12.96 $12.96 $12.96 $12.96
Inj, ixinity, 1 i.u $1.91 $1.91 $1.91 $1.91
Inj, kovaltry, 1 i.u $1.58 $1.58 $1.58 $1.58
Inj, lanreotide, (cipla) 1mg $24.45 $24.45 $24.45 $96.60
Inj, lecanemab-irmb, 1 mg $1.33 $1.33 $1.33 $1.33
Inj, lenacapavir, 1 mg $22.02 $22.02 $22.02 $22.02
Inj, levothyroxine, freskabi $7.10 $7.10 $7.10 $244.63
Inj, levothyroxine, hikma $5.14 $5.14 $5.14 $5.14
Inj, mirikizumab-mrkz, 1 mg $48.27 $48.27 $48.27 $48.27
Inj, motixafortide, 0.25 mg $25.22 $25.22 $25.22 $25.22
Inj, nithiodote, 3mg / 125mg $2.17 $2.17 $2.17 $3.60
Inj, nogapendekin pmln, 1mcg $94.12 $94.12 $94.12 $94.12
Inj, oliceridine 0.1 mg $1.30 $1.30 $1.30 $1.30
Inj, palonosetron (posfrea) $58.84 $58.84 $58.84 $58.84
Inj, panzyga, 500 mg $74.46 $74.46 $74.46 $74.46
Inj, pasireotide long acting $563.79 $563.79 $563.79 $563.79
Inj, pedmark, 100 mg $95.14 $95.14 $95.14 $95.14
Inj, pegcetacoplan, 1mg $141.91 $141.91 $141.91 $141.91
Inj, pegulicianine, 1 mg $36.45 $36.45 $36.45 $36.45
Inj, pemetrexed (avyxa) 10mg $83.28 $83.28 $83.28 $83.28
Inj, pemrydi rtu, 10 mg $80.10 $80.10 $80.10 $80.10
Inj, releuko 1 mcg $0.41 $0.41 $0.41 $0.41
Inj, rimabotulinumtoxinb $13.34 $13.34 $13.34 $2,348.22
Inj, rykindo, 0.5 mg $13.03 $13.03 $13.03 $13.03
Inj, sculptra, 0.5mg $1.00 $1.00 $1.00 $1.00
Inj, sezaby, 1 mg $1.15 $1.15 $1.15 $1.15
Inj, spesolimab-sbzo, 1 mg $65.73 $65.73 $65.73 $65.73
Inj, susvimo 0.1 mg $78.43 $78.43 $78.43 $78.43
Inj, sutimlimab-jome, 10 mg $18.11 $18.11 $18.11 $34.80
Inj, taliglucerace alfa 10 u $41.06 $41.06 $41.06 $41.06
Inj, tislelizumab-jsgr $57.42 $57.42 $57.42 $102.00
Inj, tofidence, 1 mg $5.79 $5.79 $5.79 $5.79
Inj, trivisc 1 mg $5.45 $5.45 $5.45 $5.45
Inj, tyenne, 1 mg $4.69 $4.69 $4.69 $12.75
Inj, uzedy, 1 mg $25.08 $25.08 $25.08 $25.08
Inj, vasopressin (baxter) $2.94 $2.94 $2.94 $2.94
Inj, vegzelma, 10 mg $43.62 $43.62 $43.62 $43.62
Inj. asceniv $496.51 $496.51 $496.51 $496.51
Inj. byooviz, 0.1 mg $62.15 $62.15 $62.15 $62.15
Inj. cetirizine hcl 0.5mg $16.40 $16.40 $16.40 $16.40
Inj. denosumab-bbdz, 1 mg $27.54 $27.54 $27.54 $27.54
Inj. fe derisomaltose 10 mg $18.95 $18.95 $18.95 $141.60
Inj. herceptin hylecta, 10mg $62.97 $62.97 $62.97 $413.40
Inj. inebilizumab-cdon, 1 mg $494.43 $494.43 $494.43 $871.80
Inj. jivi 1 iu $2.65 $2.65 $2.65 $2.65
Inj. lumasiran, 0.5 mg $329.10 $329.10 $329.10 $329.10
Inj. naxitamab-gqgk, 1 mg $685.91 $685.91 $685.91 $96,378.67
Inj. pemetrexed, 10 mg $52.74 $52.74 $52.74 $152.40
Inj. tagraxofusp-erzs 10 mcg $348.62 $348.62 $348.62 $544.80
Inj. teprotumumab-trbw 10 mg $359.09 $359.09 $359.09 $38,425.20
Inj. xembify, 100 mg $14.91 $14.91 $14.91 $14.91
Inj., aristada initio, 1 mg $3.26 $3.26 $3.26 $3.26
Inj., benralizumab, 1 mg $168.13 $168.13 $168.13 $5,853.00
Inj., emapalumab-lzsg, 1 mg $381.64 $381.64 $381.64 $1,929.00
Inj., emicizumab-kxwh 0.5 mg $57.43 $57.43 $57.43 $39,043.20
Inj., evomela, 1 mg $17.37 $17.37 $17.37 $17.37
Inj., fibryga, 1 mg $1.21 $1.21 $1.21 $1.21
Inj., guselkumab, 1 mg $74.86 $74.86 $74.86 $675.00
Inj., ibalizumab-uiyk, 10 mg $79.39 $79.39 $79.39 $79.39
Inj., lumoxiti, 0.01 mg $23.39 $23.39 $23.39 $31.20
Inj., meropenem, vaborbactam $2.18 $2.18 $2.18 $991.20
Inj., omadacycline, 1 mg $4.01 $4.01 $4.01 $4.01
Inj., patisiran, 0.1 mg $99.82 $99.82 $99.82 $36,180.04
Inj., perseris, 0.5 mg $12.14 $12.14 $12.14 $12.14
Inj., plazomicin, 5 mg $3.57 $3.57 $3.57 $85.80
Inj., tildrakizumab, 1 mg $126.24 $126.24 $126.24 $424.00
Inj., triluron, 1 mg $10.16 $10.16 $10.16 $10.16
Inj., triptorelin X-ray 3.75 mg $3,772.85 $3,772.85 $3,772.85 $3,772.85
Inj., yutiq, 0.01 mg $532.58 $532.58 $532.58 $532.58
Inj/inf neurolyt sbst spinal canal lesion 62282 $890.29 $890.29 $890.29 $2,231.25
Inject/treat eye socket $298.93 $298.93 $298.93 $571.80
Inject/treat eye socket $298.93 $298.93 $298.93 $298.93
Inject/treat eye socket $298.93 $298.93 $298.93 $298.93
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) $692.52 $692.52 $692.52 $692.52
Injection carpal tunnel therapeutic (both sides) $295.19 $295.19 $295.19 $596.40
Injection epidural blood patch or clot $692.52 $692.52 $692.52 $1,470.60
Injection eye drug $331.69 $331.69 $331.69 $331.69
Injection glatiramer acetate $160.39 $160.39 $160.39 $1,207.20
Injection into brain canal $692.52 $692.52 $692.52 $117.00
Injection into brain canal $295.19 $295.19 $295.19 $1,094.40
Injection into hemorrhoid(s) $911.71 $911.71 $911.71 $911.71
Injection into spinal artery $890.29 $890.29 $890.29 $890.29
Injection into vocal cord $388.31 $388.31 $388.31 $388.31
Injection of HIV prep drug $71.17 $71.17 $71.17 $71.17
Injection of sinus tract $1,481.28 $1,481.28 $1,481.28 $1,481.28
Injection px peyronie ds $243.21 $243.21 $243.21 $239.25
Injection radioactive tracer sentinel node (both sides) $401.83 $401.83 $401.83 $614.40
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) $692.52 $692.52 $692.52 $1,656.60
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug $210.69 $210.69 $210.69 $238.80
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug $46.14 $46.14 $46.14 $177.60
Injection therapeutic/prophylactic/diagnostic subcutaneous/im $71.17 $71.17 $71.17 $141.00
Injection treatment of eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Injection treatment of eye $2,280.73 $2,280.73 $2,280.73 $2,851.20
Injection treatment of nerve $890.29 $890.29 $890.29 $2,706.75
Injection treatment of nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Injection treatment of nerve $1,952.77 $1,952.77 $1,952.77 $1,866.00
Injection treatment of nose $509.25 $509.25 $509.25 $509.25
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left $692.52 $692.52 $692.52 $1,021.50
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) $692.52 $692.52 $692.52 $911.25
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) $890.29 $890.29 $890.29 $1,671.75
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level $890.29 $890.29 $890.29 $1,777.50
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level $890.29 $890.29 $890.29 $1,713.00
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance $692.52 $692.52 $692.52 $2,164.80
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance $692.52 $692.52 $692.52 $2,047.80
Injection(s) tendon sheath/ligament aponeurosis single (both sides) $295.19 $295.19 $295.19 $616.20
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) $295.19 $295.19 $295.19 $595.80
Injection(s) trigger point(s) single/multiple >= 3 muscle(s) $295.19 $295.19 $295.19 $654.00
Injection, belinostat, 10mg $52.04 $52.04 $52.04 $9,355.72
Injection, burosumab-twza 1m $481.57 $481.57 $481.57 $481.57
Injection, cangrelor $19.81 $19.81 $19.81 $2,314.80
Injection, daratumumab 10 mg $69.84 $69.84 $69.84 $198.60
Injection, edaravone, 1 mg $18.84 $18.84 $18.84 $1,484.40
Injection, fulvestrant $6.98 $6.98 $6.98 $3,584.82
Injection, inclisiran, 1 mg $12.35 $12.35 $12.35 $39.20
Injection, isavuconazonium $1.01 $1.01 $1.01 $1,350.22
Injection, necitumumab, 1 mg $5.73 $5.73 $5.73 $5.73
Injection, peramivir $1.68 $1.68 $1.68 $6.75
Injection, renflexis $25.05 $25.05 $25.05 $1,624.80
Injection, ruconest $36.74 $36.74 $36.74 $36.74
Injection, siltuximab $161.96 $161.96 $161.96 $3,603.00
Injection,onabotulinumtoxina $6.50 $6.50 $6.50 $2,876.40
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln $2,698.05 $2,698.05 $2,698.05 $8,027.40
Ins cath ren art 1st bi $3,147.50 $3,147.50 $3,147.50 $6,033.75
Ins cath ren art 1st uni $3,147.50 $3,147.50 $3,147.50 $4,692.00
Ins cath ren art 2nd+ bi $3,147.50 $3,147.50 $3,147.50 $6,376.50
Ins cath ren art 2nd+ uni $5,405.70 $5,405.70 $5,405.70 $5,405.70
Ins cerv dilator (sep proc) $304.19 $304.19 $304.19 $678.00
Ins icd gen exist mlt leads $32,061.58 $32,061.58 $32,061.58 $26,801.25
Ins icd gen exist sgl lead $22,446.19 $22,446.19 $22,446.19 $33,033.60
Ins lv lead exist pm/icd $10,465.33 $10,465.33 $10,465.33 $9,178.50
Ins mark abd/pel for right perq $1,368.26 $1,368.26 $1,368.26 $2,523.00
Ins mark thor for right perq $1,368.26 $1,368.26 $1,368.26 $1,368.26
Ins picad w subq port 5yr> $3,147.50 $3,147.50 $3,147.50 $3,510.75
Ins picc wo subq prt/pmp w image guidnc <5yr $618.26 $618.26 $618.26 $728.25
Ins pm gen exist dual lead $22,446.19 $22,446.19 $22,446.19 $19,065.75
Ins pm gen w/exist mlt leads $19,071.16 $19,071.16 $19,071.16 $15,600.75
Ins pq tunnld ip cath w/img $3,529.06 $3,529.06 $3,529.06 $8,416.80
Ins tun cv cath wo subq prt/pm $5,405.70 $5,405.70 $5,405.70 $5,405.70
Ins tun cv cath wo subq prt/pm $3,147.50 $3,147.50 $3,147.50 $3,582.00
Ins tun cvad 2 cath w/subq port(s) $5,405.70 $5,405.70 $5,405.70 $5,405.70
Ins tun intraperit dia cath $3,529.06 $3,529.06 $3,529.06 $4,187.40
Ins vag brachytx device $304.19 $304.19 $304.19 $561.60
Ins/rpl ldless pm right vent w img & eval $19,071.16 $19,071.16 $19,071.16 $16,670.40
Ins/rpl pm gen exist dual lead $10,465.33 $10,465.33 $10,465.33 $10,465.33
Ins/rpl pm gen exist sgl lead $8,275.98 $8,275.98 $8,275.98 $8,275.98
Ins/rpl pm w/tv ld atrl $10,465.33 $10,465.33 $10,465.33 $15,256.20
Ins/rpl prph sac/gstr npg/r $21,444.39 $21,444.39 $21,444.39 $21,134.25
Ins/rpl wireless pulm art sensor incl s&i $28,428.33 $28,428.33 $28,428.33 $22,814.25
Ins/rplc spi npg/rcvr pocket $30,473.59 $30,473.59 $30,473.59 $29,999.25
Ins/rplcmt prq eltrd ra pn 1 $12,470.31 $12,470.31 $12,470.31 $12,470.31
Insemination of oocytes $171.36 $171.36 $171.36 $171.36
Insert and remove bone pin $3,244.61 $3,244.61 $3,244.61 $3,639.60
Insert ant drainage device $4,022.86 $4,022.86 $4,022.86 $4,022.86
Insert brain-fluid device 61215 $6,404.07 $6,404.07 $6,404.07 $6,404.07
Insert cannula hemo oth 36815 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Insert cannula vein-to-vein hemodialysis $5,405.70 $5,405.70 $5,405.70 $6,414.00
Insert cath pleura with image $1,553.44 $1,553.44 $1,553.44 $2,320.80
Insert cath pleura without image $1,896.99 $1,896.99 $1,896.99 $1,896.99
Insert cv cath inf & sup app $8,250.50 $8,250.50 $8,250.50 $8,250.50
Insert drug del implant, >=4 $399.04 $399.04 $399.04 $399.04
Insert drug delivery implant $128.90 $128.90 $128.90 $377.25
Insert eye socket implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Insert heyman uteri capsule $4,936.45 $4,936.45 $4,936.45 $4,936.45
Insert lens prosthesis $2,280.73 $2,280.73 $2,280.73 $2,280.73
Insert multi-comp penis pros $20,128.56 $20,128.56 $20,128.56 $20,128.56
Insert nasal septal button $1,481.28 $1,481.28 $1,481.28 $1,481.28
Insert ocular implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Insert ocular implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Insert palate implants $1,481.28 $1,481.28 $1,481.28 $1,481.28
Insert pessary/other device $201.17 $201.17 $201.17 $332.25
Insert picvad cath $3,147.50 $3,147.50 $3,147.50 $2,907.75
Insert pm/icd lead dual $8,275.98 $8,275.98 $8,275.98 $8,275.98
Insert prost urethral stent $2,048.51 $2,048.51 $2,048.51 $2,048.51
Insert self-contd prosthesis $20,128.56 $20,128.56 $20,128.56 $20,128.56
Insert semi-rigid prosthesis $12,992.42 $12,992.42 $12,992.42 $12,992.42
Insert spine infusion device 62360 $17,674.12 $17,674.12 $17,674.12 $17,674.12
Insert sq defib electrode $8,275.98 $8,275.98 $8,275.98 $12,994.80
Insert swan-ganz cath $1,553.44 $1,553.44 $1,553.44 $2,472.00
Insert tandem cuff $20,128.56 $20,128.56 $20,128.56 $20,128.56
Insert tissue expander(s) $3,660.97 $3,660.97 $3,660.97 $3,660.97
Insert tunneled cv 2cath 2sits without port/pmp 36565 $3,147.50 $3,147.50 $3,147.50 $4,040.25
Insert tunneled cv cath $5,405.70 $5,405.70 $5,405.70 $5,405.70
Insert tunneled cv cath $3,147.50 $3,147.50 $3,147.50 $3,252.75
Insert uro/ves nck sphincter $20,128.56 $20,128.56 $20,128.56 $20,128.56
Insert uteri tandem/ovoids $4,936.45 $4,936.45 $4,936.45 $4,936.45
Insert/repl sq defib w/eltrd $32,061.58 $32,061.58 $32,061.58 $30,741.60
Insertion catheter artery nfs ther chemotx 36640 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Insertion catheter bladder non indwelling $128.90 $128.90 $128.90 $298.40
Insertion catheter bladder temporary simple $128.90 $128.90 $128.90 $323.25
Insertion catheter pleural indwelling tunneled with cuff $3,529.06 $3,529.06 $3,529.06 $5,079.00
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance $5,405.70 $5,405.70 $5,405.70 $6,646.50
Insertion nontunneled centrally inserted central venous catheter >= 5 years old $3,147.50 $3,147.50 $3,147.50 $2,712.75
Insertion of cannula $3,147.50 $3,147.50 $3,147.50 $3,147.50
Insertion of heart electrode 33211 $8,275.98 $8,275.98 $8,275.98 $8,275.98
Insertion of infusion pump $5,405.70 $5,405.70 $5,405.70 $5,405.70
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular $10,465.33 $10,465.33 $10,465.33 $11,024.25
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular $10,465.33 $10,465.33 $10,465.33 $10,465.33
Insertion palate prosthesis $5,915.66 $5,915.66 $5,915.66 $5,915.66
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years $1,553.44 $1,553.44 $1,553.44 $2,472.00
Insertion picc without port or pump with imaging guidance=>5y $1,553.44 $1,553.44 $1,553.44 $1,553.44
Insertion single tranvenous electrode/ppm/implantable defibrillator $8,275.98 $8,275.98 $8,275.98 $7,267.20
Insertion subcutaneous cardiac rhythm monitor $8,275.98 $8,275.98 $8,275.98 $8,275.98
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) $3,147.50 $3,147.50 $3,147.50 $4,011.60
Insertion ureth cath $2,048.51 $2,048.51 $2,048.51 $2,048.51
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber $32,061.58 $32,061.58 $32,061.58 $32,061.58
Insertion/replacement temporary single chamber electrode/pacemaker catheter $8,275.98 $8,275.98 $8,275.98 $6,820.50
Insitu hybridization (fish) $171.36 $171.36 $171.36 $664.80
Insitu hybridization auto $359.72 $359.72 $359.72 $717.60
Insitu hybridization manual $359.72 $359.72 $359.72 $531.75
Insj phrnc nrv stim sys $45,000.50 $45,000.50 $45,000.50 $45,000.50
Insj rx elut implt lac canal $2,332.96 $2,332.96 $2,332.96 $2,332.96
Insj stablj dev w/dcmprn $18,390.05 $18,390.05 $18,390.05 $18,390.05
Insj stablj dev without dcmprn $12,866.82 $12,866.82 $12,866.82 $12,715.50
Insrt/redo neurostim 1 array $21,444.39 $21,444.39 $21,444.39 $6,097.20
Inst fibrinolysis agent ini day $618.26 $618.26 $618.26 $1,097.40
Inst fibrinolysis agent sbsq d $618.26 $618.26 $618.26 $1,025.25
Inst tauro 1.35mg/hep 100u $7.68 $7.68 $7.68 $7.68
Inst via cath agent pleurds $618.26 $618.26 $618.26 $2,146.80
Install spinal shunt 63741 $6,404.07 $6,404.07 $6,404.07 $6,404.07
Instill pharm renal pelvis $2,250.50 $2,250.50 $2,250.50 $2,250.50
Instill, bupivac and meloxic $0.81 $0.81 $0.81 $1.80
Instillation anticarcinogenic agent bladder $667.47 $667.47 $667.47 $897.00
Instll rx agnt into rnal tub $243.21 $243.21 $243.21 $243.21
Insulin total $11.43 $11.43 $11.43 $103.50
Int hrhc lig 1 hroid without img $2,742.39 $2,742.39 $2,742.39 $2,572.50
Int hrhc lig 2+hroid without img $2,742.39 $2,742.39 $2,742.39 $2,682.00
Intens cardiac rehab no exer $125.91 $125.91 $125.91 $125.91
Intens cardiac rehab w/exerc $125.91 $125.91 $125.91 $125.91
Interdental fixation $1,481.28 $1,481.28 $1,481.28 $1,733.25
Interdental wirg oth/thn fx $1,481.28 $1,481.28 $1,481.28 $1,481.28
Interdiscal perq aspir dx $703.59 $703.59 $703.59 $822.75
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper) $57.47 $57.47 $57.47 $4,959.00
Interferon beta-1a inj $2,203.14 $2,203.14 $2,203.14 $2,203.14
Intermediate visual field xm $59.40 $59.40 $59.40 $59.40
Interrog dev eval icpms ip $37.29 $37.29 $37.29 $112.50
Interrog dev eval scrms ip $24.49 $24.49 $24.49 $163.80
Interrog device eval heart $37.29 $37.29 $37.29 $220.20
Interrog evl pm/ldls pm ip $37.29 $37.29 $37.29 $113.25
Interrog without prgrmg ipnss $91.79 $91.79 $91.79 $90.00
Interrog&prgrmg ipnss $91.79 $91.79 $91.79 $90.00
Interrogate subq defib $37.29 $37.29 $37.29 $117.00
Interrogation vad in person $91.79 $91.79 $91.79 $91.79
Interstitial brachy inter $109.50 $109.50 $109.50 $109.50
Intra-atrial pacing $7,588.10 $7,588.10 $7,588.10 $5,625.00
Intra-atrial recording $7,588.10 $7,588.10 $7,588.10 $6,184.50
Intracranial complete study $241.72 $241.72 $241.72 $1,169.40
Intracranial limited study $106.34 $106.34 $106.34 $732.75
Intranasal biopsy 30100 $1,481.28 $1,481.28 $1,481.28 $1,481.28
Intranasal reconstruction $5,915.66 $5,915.66 $5,915.66 $5,915.66
Intraoral i+d tongue/floor lingual 41000 $509.25 $509.25 $509.25 $1,291.20
Intraoral periapical first $88.05 $88.05 $88.05 $88.05
Intrapul surf admin endo tube $203.39 $203.39 $203.39 $203.39
Intrauterine transfusion ftl $437.18 $437.18 $437.18 $645.00
Intraventricular pacing $7,588.10 $7,588.10 $7,588.10 $5,625.00
Intrinsic factor antibody $15.08 $15.08 $15.08 $117.00
Intrm oph exam est patient $128.87 $128.87 $128.87 $128.87
Intro cath dialysis circuit $1,553.44 $1,553.44 $1,553.44 $3,121.20
Intro cath dialysis circuit w/pta $5,701.52 $5,701.52 $5,701.52 $7,787.25
Intro cath dialysis circuit w/stent plcmnt $11,340.57 $11,340.57 $11,340.57 $10,578.00
Intro long gi tube $937.56 $937.56 $937.56 $684.60
Intro windpipe wire/tube $1,724.47 $1,724.47 $1,724.47 $1,724.47
Intubation endotracheal emergency procedure $232.22 $232.22 $232.22 $868.80
Io anal gast n-stim subsq $59.40 $59.40 $59.40 $59.40
Io ga n-stim subsq w/reprog $37.29 $37.29 $37.29 $37.29
Io rad tx deliver by elctrns $7,644.49 $7,644.49 $7,644.49 $7,644.49
Io rad tx delivery by x-ray $7,644.49 $7,644.49 $7,644.49 $7,644.49
Iodine i-125 sodium iodide $208.58 $208.58 $208.58 $208.58
Ipilimumab 5 mg/ml intravenous solution (wrapper) $183.41 $183.41 $183.41 $440.40
Irinotecan liposomal 4.3 mg/ml intravenous $65.26 $65.26 $65.26 $115.80
Iron $6.47 $6.47 $6.47 $60.00
Iron binding capacity $8.74 $8.74 $8.74 $89.25
Iron dextran 50 mg/ml injection solution $18.03 $18.03 $18.03 $99.00
Iron stain peripheral blood $6.88 $6.88 $6.88 $6.88
Irradiation of blood product each unit reference $39.25 $39.25 $39.25 $135.00
Irrigation implantable venous access device for drug delivery systems $59.40 $59.40 $59.40 $142.20
Irrigation sphenoid sinus $1,481.28 $1,481.28 $1,481.28 $1,481.28
Irrigation vagina and/or appl medicament tx disease $59.40 $59.40 $59.40 $59.40
Isatuximab-irfc 20 mg/ml intravenous solution $82.86 $82.86 $82.86 $149.40
Island pedicle flap graft $1,829.23 $1,829.23 $1,829.23 $1,829.23
Ivc venogram s&i $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ivp w/nephrotomography $178.02 $178.02 $178.02 $178.02
Ivp w/wo kub w/wo tomography $178.02 $178.02 $178.02 $1,283.40
Ixabepilone 15 mg intravenous solution $138.67 $138.67 $138.67 $399.60
Jak2 targeted sequence analysis $185.20 $185.20 $185.20 $1,227.60
Jaw arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Jaw arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Jejunstmy tube plcmt $1,896.99 $1,896.99 $1,896.99 $3,168.00
John cunningham antibody $16.89 $16.89 $16.89 $62.40
Keratoprosthesis $14,289.31 $14,289.31 $14,289.31 $14,289.31
Ketogenic steroids fract $15.47 $15.47 $15.47 $15.47
Ketone body(s) beta-hydroxybutyrate quantitative $8.17 $8.17 $8.17 $174.60
Ketorolac 15 mg/ml injection (wrapper) $0.35 $0.35 $0.35 $24.60
Kidney (Retroperitoneal) Ultrasound (complete) $106.34 $106.34 $106.34 $683.50
Kidney endoscopy $5,083.62 $5,083.62 $5,083.62 $3,964.20
Kidney endoscopy $5,083.62 $5,083.62 $5,083.62 $5,083.62
Kidney endoscopy $3,448.97 $3,448.97 $3,448.97 $3,448.97
Kidney endoscopy $5,083.62 $5,083.62 $5,083.62 $5,083.62
Kidney endoscopy & biopsy $3,448.97 $3,448.97 $3,448.97 $3,448.97
Kidney endoscopy & biopsy $9,247.15 $9,247.15 $9,247.15 $9,247.15
Kidney endoscopy & treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Kidney endoscopy & treatment $9,247.15 $9,247.15 $9,247.15 $9,247.15
Kidney endoscopy & treatment $9,247.15 $9,247.15 $9,247.15 $9,247.15
Kidney endoscopy & treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Kidney function study $401.83 $401.83 $401.83 $1,133.25
Kidney imag w/bld flow multi $538.27 $538.27 $538.27 $1,404.00
Kidney imaging morphology $401.83 $401.83 $401.83 $1,228.80
Kidney img w/bldflw sgl without rx $538.27 $538.27 $538.27 $1,552.20
Kit gene analys d816 variant $124.87 $124.87 $124.87 $1,111.20
Knee Arthroscopy (Cartilage Repair) $3,244.61 $3,244.61 $3,244.61 $3,545.97
Knee Arthroscopy (Meniscus Repair) $3,244.61 $3,244.61 $3,244.61 $3,591.33
Knee MRI (with and without contrast) $357.13 $357.13 $357.13 $3,008.26
Knee MRI (with contrast) $790.06 $790.06 $790.06 $2,394.58
Knee MRI (without contrast) $241.72 $241.72 $241.72 $2,205.00
Knee X-ray $106.34 $106.34 $106.34 $387.20
Knee arthroscopy dx $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/drainage $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $12,866.82 $12,866.82 $12,866.82 $12,866.82
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $1,600.41 $1,600.41 $1,600.41 $1,600.41
Knee arthroscopy/surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Knee arthroscopy/surgery $1,600.41 $1,600.41 $1,600.41 $1,600.41
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Knee arthroscopy/surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Knee arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Kras gene addl variants $193.25 $193.25 $193.25 $454.20
Kras gene variants exon 2 $193.25 $193.25 $193.25 $361.80
L hrt cath chd nm/abn nt cnj $3,216.41 $3,216.41 $3,216.41 $3,216.41
L/s ratio fetal lung $21.99 $21.99 $21.99 $194.40
Labioplasty 56800 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Lactate dehydrogenase (ldh) $6.04 $6.04 $6.04 $52.00
Lactic acid $11.57 $11.57 $11.57 $121.80
Lactoferrin fecal qualitative $19.70 $19.70 $19.70 $119.40
Lactoferrin fecal quant $19.63 $19.63 $19.63 $194.40
Lam facetec & foramot crv $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lam facetec & foramot lumbar $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lam facetec & foramot thrc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lamie excise intrspinl lesion thrc 63266 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Laminotomy single cervical $7,143.73 $7,143.73 $7,143.73 $7,143.73
Laminotomy single lumbar $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lanreotide 120 mg/0.5 ml subcutaneous syringe $36.66 $36.66 $36.66 $33,573.60
Lap enterolysis $5,834.36 $5,834.36 $5,834.36 $5,834.36
Lap fimbrioplasty 58672 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Lap impl electrode antrum $12,470.31 $12,470.31 $12,470.31 $12,470.31
Lap ing hernia repair init $5,834.36 $5,834.36 $5,834.36 $1,126.20
Lap ing hernia repair recur $5,834.36 $5,834.36 $5,834.36 $5,834.36
Lap insert tunnel ip cath $5,834.36 $5,834.36 $5,834.36 $1,267.20
Lap jejunostomy 44186 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Lap paraesoph her rpr w/mesh $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lap paraesophag hern repair $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lap place gastr adj device $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lap replace gastr adj device $5,834.36 $5,834.36 $5,834.36 $5,834.36
Lap revise/remv eltrd antrum $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lap revision perm ip cath $5,834.36 $5,834.36 $5,834.36 $979.20
Lap rmvl gastr adj all parts $3,804.53 $3,804.53 $3,804.53 $3,804.53
Lap rmvl gastr adj device $3,804.53 $3,804.53 $3,804.53 $3,804.53
Laparo ablate liver tumor rf $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo ablate renal cyst $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo ablate renal mass $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo cholecystectomy/explr $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo cholecystectomy/graph $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparo drng lymphocele 49323 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparo ligate spermatic vein $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparo new ureter/bladder $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo new ureter/bladder $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo partial nephrectomy $10,411.22 $10,411.22 $10,411.22 $4,511.40
Laparo proc abdm/per/oment 49329 $5,834.36 $5,834.36 $5,834.36 $4,308.00
Laparo sling operation 51992 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparo urethral suspension $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparo-asst vag hysterectomy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparo-myomectomy complex $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo-vag hyst incl t/o $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparo-vag hyst w/t/o compl $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparoscope proc rectum $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopic myomectomy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopic salpingostomy 58673 $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparoscopy aspiration $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy biopsy $5,834.36 $5,834.36 $5,834.36 $905.40
Laparoscopy excise lesions $5,834.36 $5,834.36 $5,834.36 $1,830.00
Laparoscopy fundoplasty $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparoscopy gastrostomy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy lymph node biop $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy lymphadenectomy $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparoscopy lymphadenectomy $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparoscopy lysis $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy orchiectomy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy orchiopexy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy pyeloplasty $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparoscopy remove adnexa $5,834.36 $5,834.36 $5,834.36 $7,589.40
Laparoscopy splenectomy $10,411.22 $10,411.22 $10,411.22 $2,479.20
Laparoscopy surg colpopexy $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laparoscopy tubal block 58671 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy ureterolithotomy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy vagus nerve $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopy vagus nerve $5,834.36 $5,834.36 $5,834.36 $5,834.36
Laparoscopye procstom 43659 $5,834.36 $5,834.36 $5,834.36 $5,688.75
Laparscpy ablat 1>lvr tum cryo $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laps abltj uterine fibroids $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laps esophgl sphnctr agmntj 43284 $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laps pelvic lymphadec $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laps surg prst8ect rpbic rad $10,411.22 $10,411.22 $10,411.22 $10,411.22
Laps surg prst8ect smpl stot $10,411.22 $10,411.22 $10,411.22 $10,411.22
Largsc w/laser dstrj les $3,686.95 $3,686.95 $3,686.95 $6,297.75
Largsc w/njx augmentation $1,724.47 $1,724.47 $1,724.47 $3,180.00
Largsc w/removal lesion $3,686.95 $3,686.95 $3,686.95 $3,686.95
Largsc w/rmvl foreign bdy(s) $388.31 $388.31 $388.31 $3,769.20
Largsc w/ther injection $1,724.47 $1,724.47 $1,724.47 $1,724.47
Laronidase injection $39.88 $39.88 $39.88 $4,116.73
Laryngeal function studies $128.90 $128.90 $128.90 $333.00
Laryngoplasty cricoid split $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoplasty fx rdctj fixj $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoplasty laryngeal sten $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoplasty laryngeal sten $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoplasty laryngeal sten $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoplasty laryngeal sten $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoplasty laryngeal web $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoplasty medialization $5,915.66 $5,915.66 $5,915.66 $5,915.66
Laryngoscop w/arytenoidectom $6,922.47 $6,922.47 $6,922.47 $6,922.47
Laryngoscop w/vc inj + scope $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laryngoscope w/vc inj $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laryngoscopic sensory vid $84.45 $84.45 $84.45 $84.45
Laryngoscopy and dilation $3,686.95 $3,686.95 $3,686.95 $3,769.20
Laryngoscopy and dilation $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laryngoscopy direct w/wo tracheoscopy dx exc newborn $1,724.47 $1,724.47 $1,724.47 $2,632.20
Laryngoscopy for treatment $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laryngoscopy telescopic $388.31 $388.31 $388.31 $907.50
Laryngoscopy w/biopsy $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laryngoscopy w/bx & op scope $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laryngoscopy w/exc of tumor $3,686.95 $3,686.95 $3,686.95 $7,290.00
Laryngoscopy w/fb & op scope $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laryngoscopy w/fb removal $1,724.47 $1,724.47 $1,724.47 $1,724.47
Laryngoscopy w/w/o tracheoscopy aspiration $388.31 $388.31 $388.31 $473.25
Laryngoscopy with biopsy $1,724.47 $1,724.47 $1,724.47 $5,543.40
Laryngoscopy with biopsy 31510 $3,686.95 $3,686.95 $3,686.95 $3,686.95
Larynscop remve cart + scop $6,922.47 $6,922.47 $6,922.47 $6,922.47
Larynscop w/tumr exc + scope $3,686.95 $3,686.95 $3,686.95 $3,686.95
Laser surg penis lesion(s) $1,829.23 $1,829.23 $1,829.23 $1,829.23
Laser surgery eye strands $548.60 $548.60 $548.60 $548.60
Laser surgery of cervix 57513 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Laser surgery of prostate $5,083.62 $5,083.62 $5,083.62 $5,083.62
Laser surgery of prostate $5,083.62 $5,083.62 $5,083.62 $5,083.62
Laser treatment of retina $4,022.86 $4,022.86 $4,022.86 $4,022.86
Laser treatment of retina $4,022.86 $4,022.86 $4,022.86 $4,022.86
Lat retinacular release open $3,244.61 $3,244.61 $3,244.61 $3,244.61
Lateral canthopexy $3,243.07 $3,243.07 $3,243.07 $3,243.07
Lavage cannulation maxillary sinus $232.22 $232.22 $232.22 $232.22
Lavh >250 gms 58553 $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lb with mastopexy 15839 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Lead capillary $12.11 $12.11 $12.11 $90.60
Lefort i-1 piece without graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Lefort i-2 piece without graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Lefort i-3/> piece without graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Lefort ii anterior intrusion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Leg Vein Ultrasound (DVT study, both legs) $241.72 $241.72 $241.72 $1,090.23
Leg vein fusion 34530 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Leishmania antibody $12.25 $12.25 $12.25 $159.00
Lengthen metacarpal/finger $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lengthen radius & ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lengthen radius or ulna $12,866.82 $12,866.82 $12,866.82 $12,866.82
Lengthening of hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Lengthening of palate $5,915.66 $5,915.66 $5,915.66 $5,915.66
Lengthening of palate+pharyngeal flap 42226 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Lengthening of thigh tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lengthening of thigh tendons $7,143.73 $7,143.73 $7,143.73 $7,143.73
Lengthening of thigh tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Leukacyte transfusion $171.36 $171.36 $171.36 $171.36
Leukocyte phagocytosis $10.39 $10.39 $10.39 $10.39
Leuprolide 3.75 mg intramuscular syringe kit $1,737.10 $1,737.10 $1,737.10 $3,559.80
Leuprolide 30 mg (4 month) intramuscular syringe kit $155.42 $155.42 $155.42 $6,209.40
Leuprolide depot cipla 7.5mg $220.74 $220.74 $220.74 $220.74
Leuprolide inj, camcevi, 1mg $51.41 $51.41 $51.41 $51.41
Levetiracetam therapeutic drug level $13.25 $13.25 $13.25 $155.25
Lidocaine therapeutic drug level $14.69 $14.69 $14.69 $104.40
Lig&div&compl strpg saph vn $3,147.50 $3,147.50 $3,147.50 $3,147.50
Lig/band angioaccess av fistula $3,147.50 $3,147.50 $3,147.50 $3,213.75
Ligate leg veins open $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligate leg veins radical 37760 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligate/strip long leg vein $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligate/strip short leg vein $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligate/transect fallopian tubes 58600 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Ligation external carotid artery 37600 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation internal jugular vein 37565 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation internal/common carotid artery 37605 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation major artery neck $3,147.50 $3,147.50 $3,147.50 $3,192.60
Ligation nasal sinus artery $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation of femoral vein $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation of inf vena cava $5,405.70 $5,405.70 $5,405.70 $5,405.70
Ligation of neck artery $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation of salivary duct $3,243.07 $3,243.07 $3,243.07 $3,243.07
Ligation upper jaw artery $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation vericose vein cluster(s) 1 leg $3,147.50 $3,147.50 $3,147.50 $3,147.50
Ligation/biopsy of temporal artery 37609 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Ligation/divis of long saph vein 37700 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Limb exercise test $156.46 $156.46 $156.46 $156.46
Limited visual field xm $59.40 $59.40 $59.40 $59.40
Lip exc/transverse wedge/w closure 40510 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Lip surgery procedure $232.22 $232.22 $232.22 $121.80
Lipase $6.89 $6.89 $6.89 $139.80
Lipoprotein blood high res frac & quant $33.86 $33.86 $33.86 $188.40
Lipoprotein blood quant $34.19 $34.19 $34.19 $280.20
Lipoprotein direct measurement hdl $8.19 $8.19 $8.19 $63.60
Lipoprotein direct measurement ldl $10.50 $10.50 $10.50 $75.00
Lipoprtn dir meas sd ldl chl $34.19 $34.19 $34.19 $34.19
Lisocabtagene mara car pos t $541,635.66 $541,635.66 $541,635.66 $541,635.66
Listeria monocytogenes $13.19 $13.19 $13.19 $13.19
Lithium therapeutic drug level $6.61 $6.61 $6.61 $82.80
Liver Function Test $8.17 $8.17 $8.17 $92.85
Liver ds alys 3 bmrk srm alg $176.19 $176.19 $176.19 $917.40
Liver elastography 91200 $156.46 $156.46 $156.46 $552.75
Liver imag w/vasclr flow $538.27 $538.27 $538.27 $1,510.20
Liver imaging $538.27 $538.27 $538.27 $901.80
Liver/spleen imag static only $401.83 $401.83 $401.83 $1,228.80
Liver/spleen imag w/vasclr flow $401.83 $401.83 $401.83 $1,228.80
Lmtd oph exam general anes $2,332.96 $2,332.96 $2,332.96 $2,332.96
Lngth/shrt tendon leg/ankle 1 tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Loncastuximab tesirine-lpyl 10 mg intravenous solution $216.74 $216.74 $216.74 $15,780.00
Loudness balance test $311.40 $311.40 $311.40 $311.40
Low back disk surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Low cost skin substitute app $612.13 $612.13 $612.13 $612.13
Low cost skin substitute app $612.13 $612.13 $612.13 $612.13
Low cost skin substitute app $1,829.23 $1,829.23 $1,829.23 $1,829.23
Low cost skin substitute app $612.13 $612.13 $612.13 $612.13
Low frequency non-thermal Ultrasound $198.70 $198.70 $198.70 $45.60
Lower Back (Lumbar Spine) CT scan (with and without contrast) $178.02 $178.02 $178.02 $1,909.80
Lower Back (Lumbar Spine) CT scan (with contrast) $357.13 $357.13 $357.13 $1,829.25
Lower Back (Lumbar Spine) CT scan (without contrast) $106.34 $106.34 $106.34 $1,517.10
Lower Back (Lumbar Spine) MRI (with and without contrast) $357.13 $357.13 $357.13 $2,713.80
Lower Back (Lumbar Spine) MRI (with contrast) $357.13 $357.13 $357.13 $2,415.68
Lower Back (Lumbar Spine) MRI (without contrast) $241.72 $241.72 $241.72 $2,013.08
Lower Back (Lumbar Spine) X-ray $106.34 $106.34 $106.34 $341.64
Lower jaw bone graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Lsh uterus 250 g or less $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lsh uterus above 250 g $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lsh w/t/o ut 250 g or less $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lsh w/t/o uterus above 250 g $10,411.22 $10,411.22 $10,411.22 $10,411.22
Lumbar Spinal Fusion (single level) $18,390.05 $18,390.05 $18,390.05 $5,428.66
Lumbar diskogram s&i $1,952.77 $1,952.77 $1,952.77 $2,409.75
Lumizyme injection $206.62 $206.62 $206.62 $3,672.96
Lung Function Test (Spirometry) $156.46 $156.46 $156.46 $296.91
Lung function test (mbc/mvv) $59.40 $59.40 $59.40 $109.60
Lung perfusion imaging $401.83 $401.83 $401.83 $700.50
Lurbinectedin 4 mg intravenous solution $206.13 $206.13 $206.13 $380.40
Luspatercept-aamt 25 mg subcutaneous solution $41.96 $41.96 $41.96 $87.60
Lutetium lu 177 dotatat ther $312.69 $312.69 $312.69 $607.20
Lutetium lu 177 vipivotide $253.18 $253.18 $253.18 $600.00
Lw ntsty Ultrasound stimj bone healg $24.49 $24.49 $24.49 $24.49
Lymph vessel x-ray arm/leg $618.26 $618.26 $618.26 $1,539.60
Lymph vessel x-ray arms/legs $1,553.44 $1,553.44 $1,553.44 $1,553.44
Lymph vessel x-ray trunk $3,147.50 $3,147.50 $3,147.50 $2,343.60
Lymph vessel x-ray trunk $3,147.50 $3,147.50 $3,147.50 $2,131.80
Lymphatics/lymph node imaging $538.27 $538.27 $538.27 $1,417.60
Lymphocyte culture mixed $36.56 $36.56 $36.56 $667.80
Lymphocyte transformation mitogen $49.03 $49.03 $49.03 $537.60
Lymphocytotoxicity assay $189.51 $189.51 $189.51 $325.20
Lysis intranasal synechia 30560 $509.25 $509.25 $509.25 $509.25
Lysis of labial adhesions $3,179.53 $3,179.53 $3,179.53 $3,179.53
Lysis penil circumic lesion $2,048.51 $2,048.51 $2,048.51 $2,048.51
M.avium-intra dna amp prob $35.09 $35.09 $35.09 $471.60
M.avium-intra dna dir prob $27.29 $27.29 $27.29 $27.29
M.tuberculo dna dir probe $26.88 $26.88 $26.88 $26.88
M/phmtrc alys ishquant/semiq $171.36 $171.36 $171.36 $435.00
M/phmtrc alys skeletal musc $171.36 $171.36 $171.36 $171.36
MRA chest w IV cont $357.13 $357.13 $357.13 $2,713.80
MRA chest wo IV cont $241.72 $241.72 $241.72 $4,193.40
MRA chest wwo IV cont $357.13 $357.13 $357.13 $2,713.80
MRA pelvis w IV cont $357.13 $357.13 $357.13 $1,597.20
MRA pelvis wo IV cont $241.72 $241.72 $241.72 $1,290.00
MRA w/cont, abd $357.13 $357.13 $357.13 $2,713.80
MRA w/cont, lwr ext $357.13 $357.13 $357.13 $2,713.80
MRA without cont, abd $241.72 $241.72 $241.72 $2,731.80
MRA without cont, lwr ext $241.72 $241.72 $241.72 $1,656.00
MRA without fol w/cont, abd $357.13 $357.13 $357.13 $2,734.20
MRA without fol w/cont, lwr ext $357.13 $357.13 $357.13 $2,713.80
MRA without fol w/cont, pelvis $357.13 $357.13 $357.13 $2,734.20
MRI brain w/dye $178.02 $178.02 $178.02 $178.02
MRI brain without & w/dye $178.02 $178.02 $178.02 $2,185.50
MRI brain without dye $548.30 $548.30 $548.30 $548.30
MRI breast c- unilateral $241.72 $241.72 $241.72 $565.80
MRI breast without cont bi $241.72 $241.72 $241.72 $565.80
MRI cardiac morph & func wo IV cont $241.72 $241.72 $241.72 $2,562.00
MRI cardiac morph & func wwo IV cont $357.13 $357.13 $357.13 $3,051.00
MRI cardiac morph & func wwo IV cont w/stress img $790.06 $790.06 $790.06 $4,758.75
MRI chest w IV cont $790.06 $790.06 $790.06 $3,051.00
MRI chest without & w/contrast $357.13 $357.13 $357.13 $3,815.40
MRI chest without contrast $241.72 $241.72 $241.72 $2,439.75
MRI fetal sngl/1st gestation $241.72 $241.72 $241.72 $241.72
MRI loex nonjt w IV cont $357.13 $357.13 $357.13 $3,051.00
MRI lower extremity other than joint without & w/contrast (both sides) $357.13 $357.13 $357.13 $3,815.40
MRI lower extremity other than joint without contrast (both sides) $241.72 $241.72 $241.72 $2,439.75
MRI orbit fac&nck w IV cont $357.13 $357.13 $357.13 $2,910.60
MRI orbit/face/neck without & w/contrast $357.13 $357.13 $357.13 $3,804.00
MRI orbit/face/neck without contrast $241.72 $241.72 $241.72 $2,307.75
MRI tmj $241.72 $241.72 $241.72 $2,332.50
MRI upper extremity other than joint without & w/contrast (both sides) $357.13 $357.13 $357.13 $3,815.40
MRI upper extremity other than joint without contrast (both sides) $241.72 $241.72 $241.72 $2,514.00
MRI upper extremity w/dye $357.13 $357.13 $357.13 $3,126.75
MRI w/cont, breast, bi $357.13 $357.13 $357.13 $357.13
MRI w/cont, breast, uni $178.02 $178.02 $178.02 $178.02
MRI without fol w/cont, breast $357.13 $357.13 $357.13 $2,913.60
MRI without fol w/cont, brst, un $357.13 $357.13 $357.13 $3,261.00
Macroscopic exam arthropod $4.27 $4.27 $4.27 $54.00
Macroscopic exam parasite $4.31 $4.31 $4.31 $51.00
Magnesium $6.70 $6.70 $6.70 $78.00
Magnetic image bone marrow $241.72 $241.72 $241.72 $1,656.00
Malaria antibody $13.19 $13.19 $13.19 $13.19
Male sling procedure $12,992.42 $12,992.42 $12,992.42 $12,992.42
Manipulat palm cord post inj $239.88 $239.88 $239.88 $492.75
Manipulate finger w/anesth $1,600.41 $1,600.41 $1,600.41 $1,600.41
Manipulate wrist w/anesthes $1,600.41 $1,600.41 $1,600.41 $1,600.41
Manipulation chest wall demonstration/evaluation subsequent $128.90 $128.90 $128.90 $186.00
Manipulation chest wall initial demonstration/evaluation $128.90 $128.90 $128.90 $235.20
Manipulation of hip joint $1,600.41 $1,600.41 $1,600.41 $1,600.41
Manipulation of spine $1,600.41 $1,600.41 $1,600.41 $1,600.41
Manual diff wbc count b-coat $5.07 $5.07 $5.07 $41.40
Margetuximab-cmkb 25 mg/ml intravenous solution $50.45 $50.45 $50.45 $94.80
Marker lymphatic sentimag magtrace 10 vial $11,379.91 $11,379.91 $11,379.91 $11,379.91
Mast mod rad $6,521.46 $6,521.46 $6,521.46 $3,126.00
Mast simple complete $6,521.46 $6,521.46 $6,521.46 $6,521.46
Mastectomy partial $3,829.28 $3,829.28 $3,829.28 $3,829.28
Mastoid surgery revision $5,915.66 $5,915.66 $5,915.66 $5,915.66
Mastoidectomy $5,915.66 $5,915.66 $5,915.66 $5,915.66
Mastoidectomy complete 69502 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Mastoids complete $106.34 $106.34 $106.34 $405.00
Mastopexy $6,521.46 $6,521.46 $6,521.46 $6,521.46
Maxillofacial fixation $5,915.66 $5,915.66 $5,915.66 $5,915.66
Mayo a1app alpha 1 antitrypsin phenotype $14.46 $14.46 $14.46 $108.60
Mayo aathr protein s free $15.32 $15.32 $15.32 $159.60
Mayo activated protein c resistance assay $15.32 $15.32 $15.32 $158.40
Mayo adalimumab (humira) therapeutic drug level $38.57 $38.57 $38.57 $205.80
Mayo alkaline phosphatase isoenzyme $14.78 $14.78 $14.78 $153.75
Mayo alpha 1 antitrypsin $13.44 $13.44 $13.44 $197.40
Mayo amikacin trough therapeutic drug level $15.08 $15.08 $15.08 $153.00
Mayo analysis gene calr common variants exon 9 $121.63 $121.63 $121.63 $1,160.40
Mayo analysis gene jak2 p.val617phe variant $91.66 $91.66 $91.66 $1,323.00
Mayo analysis gene smn1 dosage/deletion $137.00 $137.00 $137.00 $1,135.80
Mayo analysis microarray cytogenomic copy number/snp variants $1,160.00 $1,160.00 $1,160.00 $6,701.40
Mayo androstenedione $29.28 $29.28 $29.28 $186.40
Mayo angiotensin 1 converting enzyme (ace) csf $14.60 $14.60 $14.60 $74.40
Mayo antithrombin iii antigen $10.81 $10.81 $10.81 $108.60
Mayo aspergillus fumigatus antibody $15.05 $15.05 $15.05 $106.50
Mayo avwpr vw factor activity $30.86 $30.86 $30.86 $322.80
Mayo babpb infectious agent nucleic acid amplified probe babesia microti $35.09 $35.09 $35.09 $290.40
Mayo bart bartonella henselae antibody igg $10.18 $10.18 $10.18 $66.75
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative $144.84 $144.84 $144.84 $364.20
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative $214.62 $214.62 $214.62 $843.00
Mayo blastomyces antibody immunodiffusion $12.90 $12.90 $12.90 $178.20
Mayo bordetella pertussis antibody igg $13.19 $13.19 $13.19 $100.80
Mayo brcmg brucella antibody igm $8.93 $8.93 $8.93 $118.80
Mayo c1 esterase inhibitor $13.60 $13.60 $13.60 $130.80
Mayo carnitine total and free quantitative each specimen plasma $16.87 $16.87 $16.87 $166.20
Mayo cd20b mononuclear cell antigen nos quantitative each $26.78 $26.78 $26.78 $351.00
Mayo cdcom hla class ii typing low resolution one locus each $122.22 $122.22 $122.22 $465.00
Mayo ceruloplasmin $10.74 $10.74 $10.74 $97.80
Mayo chemiluminescent parathyroid related peptide $14.12 $14.12 $14.12 $294.60
Mayo chikv chikungunya antibodies igg $12.88 $12.88 $12.88 $360.60
Mayo chlap chlamydia pneumoniae antibody igg $11.82 $11.82 $11.82 $114.75
Mayo chlap chlamydia pneumoniae antibody igm $12.68 $12.68 $12.68 $82.50
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte $116.49 $116.49 $116.49 $833.40
Mayo chromium $20.28 $20.28 $20.28 $129.75
Mayo coccidioides antibody $11.47 $11.47 $11.47 $128.25
Mayo cocou cortisone urine $24.09 $24.09 $24.09 $305.40
Mayo cortisol free $16.71 $16.71 $16.71 $133.20
Mayo covid-19 antibody nucleocapsid total $42.13 $42.13 $42.13 $123.00
Mayo coxiella brunetii (q fever) igg antibody $12.12 $12.12 $12.12 $115.80
Mayo cyanide $19.40 $19.40 $19.40 $170.25
Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual $171.36 $171.36 $171.36 $171.36
Mayo deoxyribonuclease antibody titer $13.25 $13.25 $13.25 $96.00
Mayo dhea (dehydroepiandrosterone) $25.27 $25.27 $25.27 $276.75
Mayo dihydrotestosterone $29.28 $29.28 $29.28 $239.40
Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid $9.64 $9.64 $9.64 $103.80
Mayo efpo chloride stool $5.00 $5.00 $5.00 $102.00
Mayo estriol $24.18 $24.18 $24.18 $138.00
Mayo estrone $24.95 $24.95 $24.95 $157.50
Mayo ethosuximide therapeutic drug level $16.34 $16.34 $16.34 $138.75
Mayo everolimus therapeutic drug level $13.73 $13.73 $13.73 $210.00
Mayo factor ii $12.98 $12.98 $12.98 $97.20
Mayo factor v $17.65 $17.65 $17.65 $189.00
Mayo factor vii $17.90 $17.90 $17.90 $185.40
Mayo factor viii vw factor antigen $22.94 $22.94 $22.94 $176.40
Mayo factor viii vw factor multimetric analysis $22.94 $22.94 $22.94 $239.40
Mayo factor viii vw factor ristocetin cofactor $22.94 $22.94 $22.94 $243.60
Mayo factor x $17.90 $17.90 $17.90 $191.25
Mayo factor xi $17.90 $17.90 $17.90 $162.60
Mayo fat/lipids feces quantitative $16.80 $16.80 $16.80 $126.60
Mayo fbl culture fungi blood $20.46 $20.46 $20.46 $126.00
Mayo fdp/fsp paracoagulation $80.46 $80.46 $80.46 $80.46
Mayo ffspg allergen clam igg $7.82 $7.82 $7.82 $51.75
Mayo fibrinogen antigen $14.46 $14.46 $14.46 $109.80
Mayo gabapentin bld/srm/plasma therapeutic drug level $21.67 $21.67 $21.67 $129.60
Mayo hemosiderin qualitative urine $4.75 $4.75 $4.75 $50.25
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative $35.09 $35.09 $35.09 $288.60
Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 $35.09 $35.09 $35.09 $417.00
Mayo hiser histoplasma antibodies immunodiffusion $13.79 $13.79 $13.79 $161.25
Mayo hla typing a/b/c single antigen $25.81 $25.81 $25.81 $194.40
Mayo hvdip HIV 1 antibody $8.89 $8.89 $8.89 $88.20
Mayo hvdip HIV 2 antibody $13.52 $13.52 $13.52 $97.20
Mayo hydroxyprogesterone 17-d $27.17 $27.17 $27.17 $140.25
Mayo immunoassay c1 esterase inhibitor antibody quantitative $17.27 $17.27 $17.27 $259.80
Mayo immunoassay infectious agent antibody quantitative diptheria igg $14.99 $14.99 $14.99 $109.20
Mayo immunoassay tumor antigen quantitative ca 27.29 $20.81 $20.81 $20.81 $141.00
Mayo immunoassay tumor antigen quantitative chromogranin a $20.81 $20.81 $20.81 $176.40
Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance $35.09 $35.09 $35.09 $987.60
Mayo infectious agent antigen immunoassay direct optical observation cryptococcus $16.07 $16.07 $16.07 $141.75
Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal $11.98 $11.98 $11.98 $218.40
Mayo infectious agent nucleic acid amplified probe enterovirus $35.09 $35.09 $35.09 $428.40
Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine $35.09 $35.09 $35.09 $189.00
Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae $35.09 $35.09 $35.09 $349.80
Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii $35.09 $35.09 $35.09 $292.50
Mayo infectious agent nucleic acid quantification cytomegalovirus $42.84 $42.84 $42.84 $350.40
Mayo infectious disease hepatitis c chronic six biochemical assays $72.19 $72.19 $72.19 $516.60
Mayo infliximab therapeutic drug level $38.57 $38.57 $38.57 $523.20
Mayo inhab inhibin a $15.59 $15.59 $15.59 $267.75
Mayo insft insulin free $12.95 $12.95 $12.95 $117.00
Mayo insulin antibodies $21.41 $21.41 $21.41 $119.40
Mayo iodine $24.11 $24.11 $24.11 $202.20
Mayo itraconazole therapeutic drug level $27.11 $27.11 $27.11 $140.40
Mayo lacosamide therapeutic drug level $27.11 $27.11 $27.11 $199.50
Mayo lamotrigine therapeutic drug level $13.25 $13.25 $13.25 $141.00
Mayo ld_i lactate dehydrogenase isoenzymes $12.79 $12.79 $12.79 $70.80
Mayo legionella antibody $15.30 $15.30 $15.30 $104.40
Mayo leptospira antibody igm $16.20 $16.20 $16.20 $60.75
Mayo lipoprotein electrophoresis $11.26 $11.26 $11.26 $99.00
Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory $15.49 $15.49 $15.49 $180.00
Mayo manganese $26.65 $26.65 $26.65 $100.80
Mayo metanephrines plasma $16.94 $16.94 $16.94 $384.00
Mayo mgle voltage-gated calcium channel antibody each $12.05 $12.05 $12.05 $235.20
Mayo mgrm acetylcholine receptor binding antibody $18.40 $18.40 $18.40 $235.20
Mayo microsomal antibody liver-kidney $14.55 $14.55 $14.55 $136.20
Mayo mitotane (lysodren) therapeutic drug level $18.64 $18.64 $18.64 $206.40
Mayo molecular pathology procedure level 2 apoe genotype $137.00 $137.00 $137.00 $1,204.20
Mayo mpl sequence analysis exon 10 $185.20 $185.20 $185.20 $752.40
Mayo muramidase $18.75 $18.75 $18.75 $96.75
Mayo muscle-specific kinase (musk) antibody $18.40 $18.40 $18.40 $235.20
Mayo mycophenolic acid therapeutic drug level $18.05 $18.05 $18.05 $202.20
Mayo myoglobin $12.92 $12.92 $12.92 $129.75
Mayo nickel $24.51 $24.51 $24.51 $178.20
Mayo organic acid methylmalonic single quantitative $21.21 $21.21 $21.21 $298.20
Mayo organic acids qualitative each specimen $16.45 $16.45 $16.45 $102.00
Mayo oxalate 24 hour urine $14.45 $14.45 $14.45 $163.50
Mayo pancreatic elastase fecal qualitative or semi quantitative $11.53 $11.53 $11.53 $108.60
Mayo parvs parvovirus b19 antibody igg $15.03 $15.03 $15.03 $123.00
Mayo paval fluorescent antibody screen agna type 1 $12.05 $12.05 $12.05 $132.60
Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) $35.09 $35.09 $35.09 $306.00
Mayo phospholipid neutralization hexagonal lupus anticoagulant $17.98 $17.98 $17.98 $204.60
Mayo pntft phenytoin free therapeutic drug level $13.76 $13.76 $13.76 $92.25
Mayo pqnu porphobilinogen urine quantitative 24 hour urine $8.44 $8.44 $8.44 $131.25
Mayo pregnenolone $20.67 $20.67 $20.67 $222.00
Mayo prmb primidone therapeutic drug level $16.59 $16.59 $16.59 $118.80
Mayo proinsulin $26.69 $26.69 $26.69 $206.25
Mayo psaft prostate specific antigen free $18.39 $18.39 $18.39 $129.60
Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative $18.40 $18.40 $18.40 $300.00
Mayo rbcme osmotic fragility rbc incubated $13.36 $13.36 $13.36 $223.80
Mayo receptor assay transferrin soluble $36.57 $36.57 $36.57 $193.50
Mayo renin $21.99 $21.99 $21.99 $165.60
Mayo repu protein electrophoresis urine $17.83 $17.83 $17.83 $181.20
Mayo selenium $25.53 $25.53 $25.53 $168.00
Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria $15.50 $15.50 $15.50 $91.20
Mayo serotonin $30.98 $30.98 $30.98 $235.20
Mayo sfgp rickettsia rickettsii antibody igg $19.35 $19.35 $19.35 $109.50
Mayo sirolimus therapeutic drug level $13.73 $13.73 $13.73 $150.60
Mayo syphilis test non-treponemal antibody qualitative vdrl $4.27 $4.27 $4.27 $41.40
Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification $208.92 $208.92 $208.92 $859.80
Mayo tgrp testosterone free $25.47 $25.47 $25.47 $121.50
Mayo tgrp testosterone total $25.81 $25.81 $25.81 $184.20
Mayo thiopurine s-methyltransferase $22.17 $22.17 $22.17 $22.17
Mayo thyroglobulin $16.06 $16.06 $16.06 $184.20
Mayo ticks anaplasma phagocytophilum antibody igg $10.18 $10.18 $10.18 $97.80
Mayo ticks babesia microti antibody igg $12.39 $12.39 $12.39 $126.00
Mayo ttfb testosterone bioavailable direct $51.28 $51.28 $51.28 $51.28
Mayo tulab francisella tularensis antibody igg $14.16 $14.16 $14.16 $96.60
Mayo valpg valproic acid free therapeutic drug level $13.54 $13.54 $13.54 $126.00
Mayo vasoactive intestinal peptide $35.33 $35.33 $35.33 $326.25
Mayo vitamin b-2 (riboflavin) $20.24 $20.24 $20.24 $138.60
Mayo vitamin b3 (niacin) $17.06 $17.06 $17.06 $147.00
Mayo vitamin k $13.72 $13.72 $13.72 $317.25
Mayo zonisamide therapeutic drug level $13.25 $13.25 $13.25 $207.75
Mcoln1 gene $39.31 $39.31 $39.31 $227.40
Mcp joint arthroscopy dx $3,244.61 $3,244.61 $3,244.61 $3,244.61
Mcp joint arthroscopy surg $3,244.61 $3,244.61 $3,244.61 $3,244.61
Mcp joint arthroscopysurg 29902 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Mdfc flap w/prsrv vasc pedcl $3,660.97 $3,660.97 $3,660.97 $3,660.97
Meas lung vol thru 2 yrs $530.60 $530.60 $530.60 $530.60
Measure kidney pressure $667.47 $667.47 $667.47 $667.47
Measure ureter pressure $156.46 $156.46 $156.46 $156.46
Measurement post void urine by ultrasound $59.40 $59.40 $59.40 $176.40
Mecp2 gene dup/delet variant $150.00 $150.00 $150.00 $150.00
Mecp2 gene full seq $527.87 $527.87 $527.87 $527.87
Mecp2 gene known variant $120.00 $120.00 $120.00 $120.00
Med physic dos eval rad exps $530.60 $530.60 $530.60 $621.00
Medial canthopexy $3,243.07 $3,243.07 $3,243.07 $3,243.07
Mediastinoscpy w/lmph nod bx $5,834.36 $5,834.36 $5,834.36 $5,834.36
Mediastinoscpy w/medstnl bx 39401 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Meg evoked single $1,017.39 $1,017.39 $1,017.39 $1,017.39
Meg spontaneous $1,017.39 $1,017.39 $1,017.39 $1,017.39
Meniscal trnspl knee w/scpe $7,143.73 $7,143.73 $7,143.73 $7,143.73
Mepolizumab 100 mg/ml subcutaneous auto-injector $31.33 $31.33 $31.33 $8,127.60
Metabolic Blood Panel (Basic) $8.46 $8.46 $8.46 $97.20
Metabolic Blood Panel (Comprehensive) $10.56 $10.56 $10.56 $130.97
Metabolic panel ionized ca $13.73 $13.73 $13.73 $160.50
Methotrexate therapeutic drug level $38.57 $38.57 $38.57 $124.20
Methylene blue (antidote) 5 mg/ml intravenous solution $7.86 $7.86 $7.86 $1,620.00
Methylprednisolone acetate 40 mg/ml suspension for injection $0.12 $0.12 $0.12 $1.20
Methylprednisolone sodium succinate 1,000 mg intravenous solution $0.26 $0.26 $0.26 $6.80
Mgmt promoter methylation analysis $124.64 $124.64 $124.64 $227.40
Microalbumin urine screen $6.23 $6.23 $6.23 $6.23
Microbe susceptible mlc $40.17 $40.17 $40.17 $40.17
Microfluid analy tears $22.48 $22.48 $22.48 $22.48
Microsatellite instability $348.56 $348.56 $348.56 $1,154.40
Microvolt t-wave assess $156.46 $156.46 $156.46 $156.46
Microwave bronch, 3d, ebus $3,750.50 $3,750.50 $3,750.50 $3,707.40
Middle cerebral artery echo $106.34 $106.34 $106.34 $285.60
Minocycline hydrochloride $2.67 $2.67 $2.67 $403.80
Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution $69.52 $69.52 $69.52 $129.00
Mitomycin 40 mg intravenous solution $28.27 $28.27 $28.27 $1,714.80
Mitomycin instillation $317.42 $317.42 $317.42 $858.00
Mitoxantrone 2 mg/ml concentrate,intravenous $29.60 $29.60 $29.60 $437.16
Mlh1 gene $192.32 $192.32 $192.32 $1,123.80
Mlh1 gene dup/delete variant $202.40 $202.40 $202.40 $1,502.40
Mlh1 gene full seq $675.40 $675.40 $675.40 $399.00
Mlh1 gene known variants $331.00 $331.00 $331.00 $331.00
Mlt osteot rlgnm imed rd hum $12,866.82 $12,866.82 $12,866.82 $12,866.82
Mnl appl strs jt radiography $88.05 $88.05 $88.05 $88.05
Mnpj anes sho jt fixj aprats $1,600.41 $1,600.41 $1,600.41 $1,600.41
Mnpj elbow under anes $1,600.41 $1,600.41 $1,600.41 $1,600.41
Mnpj of tmj w/anesth $1,481.28 $1,481.28 $1,481.28 $1,481.28
Mnt subs tx for change dx $34.61 $34.61 $34.61 $34.61
Modification of contact lens $128.90 $128.90 $128.90 $128.90
Mog-igg1 antb flo cytmtry ea $37.73 $37.73 $37.73 $192.60
Mometasone sinus sinuva $11.35 $11.35 $11.35 $11.35
Monovisc inj per dose $528.58 $528.58 $528.58 $2,155.28
Monthly tx for dmht 20mins $128.87 $128.87 $128.87 $128.87
Mopath procedure level 1 $63.96 $63.96 $63.96 $873.75
Mopath procedure level 3 $150.33 $150.33 $150.33 $1,314.60
Mopath procedure level 5 $274.83 $274.83 $274.83 $2,734.80
Mopath procedure level 6 $301.35 $301.35 $301.35 $5,054.40
Mopath procedure level 7 $282.88 $282.88 $282.88 $8,366.40
Mopath procedure level 8 $846.27 $846.27 $846.27 $1,687.80
Mopath procedure level 9 $2,000.00 $2,000.00 $2,000.00 $2,250.00
Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain $171.36 $171.36 $171.36 $349.20
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted $359.72 $359.72 $359.72 $599.40
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual $171.36 $171.36 $171.36 $337.20
Mosunetuzumab-axgb 1 mg/ml intravenous solution $652.75 $652.75 $652.75 $924.00
Motion analysis video/3d $530.60 $530.60 $530.60 $530.60
Motion test w/ft press meas $1,017.39 $1,017.39 $1,017.39 $1,017.39
Motor &/ sens nrve cndj test $399.04 $399.04 $399.04 $399.04
Mouth vestibule bx/w complex rpr 40814 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Mpl gene analysis common variants $150.33 $150.33 $150.33 $1,227.60
Mr elastography $241.72 $241.72 $241.72 $945.00
Mr safety determination physician/other qhp $88.05 $88.05 $88.05 $160.20
Mr safety implant elec prepj $91.79 $91.79 $91.79 $166.80
Mr safety implt pos&/immoblj $59.40 $59.40 $59.40 $58.50
Mr sfty implt&/fb asmt stf 1 $24.49 $24.49 $24.49 $44.40
Mr sfty med physics xm cstmz $241.72 $241.72 $241.72 $439.80
Mr spectroscopy $88.05 $88.05 $88.05 $1,610.25
Mra, w/dye, spinal canal $357.13 $357.13 $357.13 $1,013.40
Mra, w/dye, upper extremity $357.13 $357.13 $357.13 $1,987.50
Mra, w/o&w/dye, spinal canal $357.13 $357.13 $357.13 $417.75
Mra, w/o&w/dye, upper extr $357.13 $357.13 $357.13 $1,887.00
Mra, without dye, spinal canal $241.72 $241.72 $241.72 $1,867.50
Mra, without dye, upper extr $241.72 $241.72 $241.72 $1,833.75
Mrgfus strtctc ablt trgt icr $12,470.31 $12,470.31 $12,470.31 $12,470.31
Msh2 gene dup/delete variant $213.30 $213.30 $213.30 $1,522.80
Msh2 gene full seq $381.70 $381.70 $381.70 $1,502.40
Msh2 gene known variants $337.73 $337.73 $337.73 $235.80
Msh6 gene dup/delete variant $238.00 $238.00 $238.00 $1,522.80
Msh6 gene full seq $641.85 $641.85 $641.85 $1,522.80
Msh6 gene known variants $308.00 $308.00 $308.00 $235.80
Mthfr gene analy common variants $65.34 $65.34 $65.34 $357.60
Mucin synovial fluid $5.86 $5.86 $5.86 $5.86
Mucopolysaccharides $28.50 $28.50 $28.50 $280.80
Multi family grp psychotherapy $160.67 $160.67 $160.67 $370.50
Multifocal erg w/i&r $156.46 $156.46 $156.46 $156.46
Multiple sleep latency test $530.60 $530.60 $530.60 $4,164.75
Mumps antibody igg $13.05 $13.05 $13.05 $148.50
Musc myoq/fscq flp h&n pedcl $3,660.97 $3,660.97 $3,660.97 $3,660.97
Musc/tdn transfer upr a/e 1 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Muscle test cran nerv unilat $311.40 $311.40 $311.40 $441.00
Muscle test hemidiaphragm $156.46 $156.46 $156.46 $622.20
Muscle test larynx $128.90 $128.90 $128.90 $327.60
Muscle test one fiber $156.46 $156.46 $156.46 $520.80
Muscle transfer shoulder/arm $7,143.73 $7,143.73 $7,143.73 $7,143.73
Muscle transfers $7,143.73 $7,143.73 $7,143.73 $7,143.73
Muscle-skin graft arm $1,829.23 $1,829.23 $1,829.23 $1,829.23
Muscle-skin graft leg $3,660.97 $3,660.97 $3,660.97 $3,660.97
Muscle-skin graft trunk $3,660.97 $3,660.97 $3,660.97 $3,660.97
Mycobacteria dna amp probe $48.24 $48.24 $48.24 $411.00
Mycoplasma antibody igm $13.24 $13.24 $13.24 $129.75
Myd88 gene p.leu265pro vrnt $175.40 $175.40 $175.40 $370.50
Myelogphy 2/> spine regions $790.06 $790.06 $790.06 $4,064.40
Myelography l-s spine $790.06 $790.06 $790.06 $3,447.00
Myelography neck spine $790.06 $790.06 $790.06 $3,476.40
Myelography thoracic spine $790.06 $790.06 $790.06 $2,874.60
Myelography via inj w/s&i 2+ regions $790.06 $790.06 $790.06 $2,289.60
Myelography via inj w/s&i cervical $790.06 $790.06 $790.06 $2,289.60
Myelography via inj w/s&i lumbosacral $790.06 $790.06 $790.06 $2,289.60
Myelography via inj w/s&i thoracic $790.06 $790.06 $790.06 $2,289.60
Myeloperoxidase ab multi step qualitative/semiquantitative $11.53 $11.53 $11.53 $108.60
Myocrd img pet 1 std w/ct $1,458.59 $1,458.59 $1,458.59 $1,458.59
Myocrd img pet 1std rst/strs $1,458.59 $1,458.59 $1,458.59 $4,556.25
Myocrd img pet 2rtracer CT $1,950.50 $1,950.50 $1,950.50 $1,950.50
Myocrd img pet mlt rst&strs $1,458.59 $1,458.59 $1,458.59 $5,301.00
Myocrd img pet rst/strs w/ct $1,458.59 $1,458.59 $1,458.59 $1,458.59
Myomectomy vag method $3,179.53 $3,179.53 $3,179.53 $3,179.53
Myringoplasty $3,243.07 $3,243.07 $3,243.07 $3,243.07
N block inj common digit $295.19 $295.19 $295.19 $295.19
N block inj hypogas plxs $890.29 $890.29 $890.29 $1,878.75
N-invas est c ffr sw aly cta $1,017.39 $1,017.39 $1,017.39 $1,017.39
Naltrexone, depot form $4.24 $4.24 $4.24 $5,794.40
Narcosynthesis $160.67 $160.67 $160.67 $160.67
Nasal endoscopy dx uni/bi separate proc $194.14 $194.14 $194.14 $600.00
Nasal endoscopy with removal of nasal foreign body $232.22 $232.22 $232.22 $135.00
Nasal function studies $311.40 $311.40 $311.40 $311.40
Nasal sinus therapy $1,481.28 $1,481.28 $1,481.28 $1,481.28
Nasal/sinus endo spendt remove tiss 31288 $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nasal/sinus endo surg w/concha bullosa resct 31240 $1,724.47 $1,724.47 $1,724.47 $1,724.47
Nasal/sinus endo w/ethmoidectomy part 31254 $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nasal/sinus endo w/ethmoidectomy tot 31255 $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nasal/sinus endo w/front sinus expl 31276 $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nasal/sinus endoscopy surg $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nasal/sinus endoscopy surg w/bx 31237 $1,724.47 $1,724.47 $1,724.47 $4,080.00
Nasal/sinus maxillary endoscopy dx 31233 $388.31 $388.31 $388.31 $388.31
Nasal/sinus sphenoid endoscopy dx 31235 $1,724.47 $1,724.47 $1,724.47 $1,724.47
Nasopharyngoscopy w/endoscope $194.14 $194.14 $194.14 $365.40
Natalizumab 300 mg/15 ml intravenous solution $24.13 $24.13 $24.13 $28,621.80
Natriuretic peptide $39.26 $39.26 $39.26 $273.00
Natural killer cells total count $37.73 $37.73 $37.73 $243.00
Nctrnl pen tmscn&/rgdity tst $243.21 $243.21 $243.21 $243.21
Ndl emg musc 1 xtr/non-limb $128.90 $128.90 $128.90 $241.20
Ndl insj without njx 1 or 2 musc $24.49 $24.49 $24.49 $22.50
Ndl insj without njx 3+ musc $24.49 $24.49 $24.49 $31.50
Ndl oculoelectromyography 1+ $59.40 $59.40 $59.40 $59.40
Ndsc dcmprn 1 ntrspc lumbar $7,143.73 $7,143.73 $7,143.73 $7,143.73
Neck (Cervical Spine) CT scan (with and without contrast) $178.02 $178.02 $178.02 $1,992.00
Neck (Cervical Spine) CT scan (with contrast) $357.13 $357.13 $357.13 $1,708.20
Neck (Cervical Spine) CT scan (without contrast) $106.34 $106.34 $106.34 $1,513.95
Neck (Cervical Spine) MRI (with and without contrast) $357.13 $357.13 $357.13 $2,750.00
Neck (Cervical Spine) MRI (with contrast) $357.13 $357.13 $357.13 $2,231.16
Neck (Cervical Spine) MRI (without contrast) $241.72 $241.72 $241.72 $1,914.00
Neck MRA (blood vessel MRI, with and without contrast) $357.13 $357.13 $357.13 $2,733.00
Neck MRA (blood vessel MRI, with contrast) $357.13 $357.13 $357.13 $2,030.23
Neck MRA (blood vessel MRI, without contrast) $241.72 $241.72 $241.72 $1,790.58
Neck spine disk surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Neck spine disk surgery 63075 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Neisseria meningitidis $13.19 $13.19 $13.19 $223.80
Nelarabine injection $63.38 $63.38 $63.38 $2,265.28
Nerobehav stas exam by psy/md f2f 1st hr $311.40 $311.40 $311.40 $323.25
Nerve conduction 7-8 studies $311.40 $311.40 $311.40 $1,498.80
Nerve conduction studies 1-2 $156.46 $156.46 $156.46 $210.00
Nerve conduction studies 11-12 $530.60 $530.60 $530.60 $2,280.00
Nerve conduction studies 13+ $530.60 $530.60 $530.60 $2,693.40
Nerve conduction studies 3-4 $311.40 $311.40 $311.40 $642.60
Nerve conduction studies 5-6 $311.40 $311.40 $311.40 $1,069.20
Nerve conduction studies 9-10 $530.60 $530.60 $530.60 $1,926.60
Nerve graft head/neck <4 cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nerve graft head/neck >4 cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nerve palsy fascial graft $3,660.97 $3,660.97 $3,660.97 $3,660.97
Nerve palsy microsurg graft $1,829.23 $1,829.23 $1,829.23 $1,829.23
Nerve palsy muscle graft $3,660.97 $3,660.97 $3,660.97 $3,660.97
Nerve pedicle transfer $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nerve pedicle transfer $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nerve repair w/allograft $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nerve teasing preparations $816.90 $816.90 $816.90 $356.40
Neurectomy foot $1,952.77 $1,952.77 $1,952.77 $1,952.77
Neurectomy hamstring $1,952.77 $1,952.77 $1,952.77 $1,952.77
Neurectomy popliteal $1,952.77 $1,952.77 $1,952.77 $1,952.77
Neuroeltrd stim post tibial $295.19 $295.19 $295.19 $510.75
Neurolysis celiac plexus $890.29 $890.29 $890.29 $3,501.75
Neurolysis trigeminal nerve $890.29 $890.29 $890.29 $890.29
Neuromuscular junction testing ea nerve any 1 method $156.46 $156.46 $156.46 $357.60
Neuroplasty digital 1/both same digit $1,952.77 $1,952.77 $1,952.77 $1,952.77
Neuroplasty nerve of hand or foot 64704 $1,952.77 $1,952.77 $1,952.77 $1,952.77
Neurorraphy w/vein autograft $6,404.07 $6,404.07 $6,404.07 $6,404.07
Neurovascular pedicle flap $3,660.97 $3,660.97 $3,660.97 $3,660.97
Neutrlzg antb sarscov2 scr $42.13 $42.13 $42.13 $42.13
Neutrlzg antb sarscov2 titer $79.61 $79.61 $79.61 $79.61
Neutron beam tx complex $578.47 $578.47 $578.47 $578.47
Nfct ds bv&vaginitis dna alg $262.99 $262.99 $262.99 $262.99
Nipple exploration $3,829.28 $3,829.28 $3,829.28 $3,829.28
Nipple/areola reconst 19350 $3,829.28 $3,829.28 $3,829.28 $3,829.28
Nitroblue tetrazolium dye $13.61 $13.61 $13.61 $13.61
Nivolumab 10 mg/ml intravenous solution (wrapper) $33.00 $33.00 $33.00 $104.40
Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution $197.65 $197.65 $197.65 $375.60
Njx aa&/strd lmbr plex nfs $890.29 $890.29 $890.29 $1,656.60
Njx aa&/strd nrv nrvtg si jt $692.52 $692.52 $692.52 $685.80
Njx aa&/strd sc nrv nfs img $890.29 $890.29 $890.29 $1,963.80
Njx aa&/strd vagus nrv $295.19 $295.19 $295.19 $295.19
Njx chemonucleolysis lmbr $1,952.77 $1,952.77 $1,952.77 $1,952.77
Njx interlaminar crv/thrc $890.29 $890.29 $890.29 $2,476.80
Njx interlaminar crv/thrc $890.29 $890.29 $890.29 $2,067.00
Njx interlaminar lmbr/sac $890.29 $890.29 $890.29 $1,970.25
Njx interlaminar lmbr/sac $890.29 $890.29 $890.29 $1,953.00
Njx px nfrosgrm &/urtrgrm $667.47 $667.47 $667.47 $908.40
Njx px peyronie ds exps plaq $5,083.62 $5,083.62 $5,083.62 $5,083.62
Nm imaging bone/joint 3 phase study $401.83 $401.83 $401.83 $1,684.80
Nm imaging bone/joint whole body $401.83 $401.83 $401.83 $1,474.20
Nm imaging cardiac blood pooling planar single study at rest or stress $401.83 $401.83 $401.83 $1,651.20
Nm imaging gastric emptying study $401.83 $401.83 $401.83 $1,431.75
Nm imaging gastrointestinal acute blood loss $401.83 $401.83 $401.83 $1,626.00
Nm imaging hepatobiliary system w/pharmacologic intervention $538.27 $538.27 $538.27 $1,663.20
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention $538.27 $538.27 $538.27 $1,385.40
Nm imaging pulmonary ventilation/perfusion $538.27 $538.27 $538.27 $1,574.40
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) $401.83 $401.83 $401.83 $1,335.00
Nm radiopharmaceutical therapy oral administration $224.13 $224.13 $224.13 $944.40
Non-blind interatrial shunt $27,500.50 $27,500.50 $27,500.50 $27,500.50
Non-card vasc flow imaging $401.83 $401.83 $401.83 $504.80
Non-cov proc, clinical trial $39.25 $39.25 $39.25 $39.25
Non-cov surg proc,clin trial $39.25 $39.25 $39.25 $39.25
Non-imaging heart function $538.27 $538.27 $538.27 $538.27
Non-ophthalmic fva $357.13 $357.13 $357.13 $357.13
Noninv pace analysis $299.91 $299.91 $299.91 $504.00
Noonan spectrum disorders $2,143.60 $2,143.60 $2,143.60 $2,412.00
Npm1 gene $246.52 $246.52 $246.52 $1,905.60
Nps surg dilat eust tube bi $5,915.66 $5,915.66 $5,915.66 $5,915.66
Nps surg dilat eust tube uni $5,915.66 $5,915.66 $5,915.66 $5,915.66
Npsy tst eval phsy/qhp 1st hr $530.60 $530.60 $530.60 $316.50
Nr lnr acclrtr tx max 5 sessions $1,755.91 $1,755.91 $1,755.91 $9,337.20
Nras gene variants exon 2&3 $295.79 $295.79 $295.79 $369.60
Nrv grf 1strnd arm/leg <4cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv grf 1strnd arm/leg >4 cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv grf 1strnd hnd/foot <4cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv grf 1strnd hnd/foot >4cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv grf mltst arm/leg <4 cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv grf mltst arm/leg >4 cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv grf mltst hnd/foot <4 cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv grf mltst hnd/foot >4 cm $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nrv rpr w/nrv algrft 1st $6,404.07 $6,404.07 $6,404.07 $6,404.07
Nsl/sins ndsc med&inf dcmprn $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc med/inf dcmprn $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc sphn tiss rmvl $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc surg frnt sins $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc surg frnt&sphn $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc surg max sins $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc surg on dcmprn $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc surg sphn sins $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc tot w/sphendt $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sins ndsc total $6,922.47 $6,922.47 $6,922.47 $6,922.47
Nsl/sinus endoscopy surg dcr $3,686.95 $3,686.95 $3,686.95 $3,686.95
Nsl/sinus ndsc cryoabltj pnn $5,915.66 $5,915.66 $5,915.66 $5,915.66
Nsl/sinus ndsc rf abltj pnn $5,915.66 $5,915.66 $5,915.66 $5,915.66
Nsl/sns ndsc lig sphnptn art $1,724.47 $1,724.47 $1,724.47 $1,724.47
Ntrk translocation analysis $518.28 $518.28 $518.28 $518.28
Ntsty modul rad tx dlvr cplx $578.47 $578.47 $578.47 $2,407.80
Ntsty modul rad tx dlvr smpl $578.47 $578.47 $578.47 $1,873.80
Nuclear Stress Test (Heart) $1,305.48 $1,305.48 $1,305.48 $3,799.90
Nuclear exam of tear flow $401.83 $401.83 $401.83 $637.20
Nuclear matrix protein 22 $21.78 $21.78 $21.78 $21.78
Nuclear rx IV admin $224.13 $224.13 $224.13 $1,315.50
Nuclear rx intra-arterial $224.13 $224.13 $224.13 $666.00
Nuclear rx intra-articular $224.13 $224.13 $224.13 $231.00
Nuclear rx intracav admin $224.13 $224.13 $224.13 $1,622.25
Nuclr rx interstit colloid $224.13 $224.13 $224.13 $224.13
Nudt15 gene common variants $291.36 $291.36 $291.36 $472.80
Nusinersen (pf) 12 mg/5 ml intrathecal solution $1,246.94 $1,246.94 $1,246.94 $492,978.44
Ob Ultrasound nuchal meas 1 gest $106.34 $106.34 $106.34 $519.60
Obinutuzumab 1,000 mg/40 ml intravenous solution $78.46 $78.46 $78.46 $213.60
Observation direct referral from physician office for admission $613.10 $613.10 $613.10 $141.00
Obstetrics panel $47.81 $47.81 $47.81 $310.80
Obtaining screen pap smear $24.49 $24.49 $24.49 $24.60
Occlude fallopian tube(s) device 58615 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Ocrelizumab 30 mg/ml intravenous solution $59.70 $59.70 $59.70 $156.60
Octreotide,microspheres ER 20 mg intramuscular susp, extended release $212.20 $212.20 $212.20 $8,451.00
Ocular photodynamic ther $548.60 $548.60 $548.60 $548.60
Ocular reconst transplant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Ocular reconst transplant $5,159.71 $5,159.71 $5,159.71 $5,159.71
Ocular reconst transplant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Ofatumumab 20 mg/ml intravenous solution (wrapper) $62.23 $62.23 $62.23 $201.60
Off base opioid tx 70min $160.67 $160.67 $160.67 $160.67
Off base opioid tx, 60 m $160.67 $160.67 $160.67 $160.67
Olanzapine long-acting inj $2.92 $2.92 $2.92 $76.20
Omalizumab 150 mg/ml subcutaneous syringe (wrapper) $40.56 $40.56 $40.56 $333.60
Onc brst mrna 11 genes $3,873.00 $3,873.00 $3,873.00 $3,873.00
Onc brst mrna 70 cnt 31 gene $3,873.00 $3,873.00 $3,873.00 $3,873.00
Onc thyr mrna 10,196 gen alg $3,600.00 $3,600.00 $3,600.00 $3,600.00
Onco (ovar) five proteins $897.00 $897.00 $897.00 $897.00
Onco (ovar) two proteins $260.50 $260.50 $260.50 $150.60
Oncology colon mrna $3,116.00 $3,116.00 $3,116.00 $3,116.00
Oncology colorectal scr $508.87 $508.87 $508.87 $508.87
Oncology gynecologic $579.46 $579.46 $579.46 $579.46
Oncology gynecologic $177.56 $177.56 $177.56 $177.56
Oncology prostate prob score $760.00 $760.00 $760.00 $1,501.50
Oncology tum unknown origin $3,750.00 $3,750.00 $3,750.00 $3,750.00
Oncoprotein dcp $64.41 $64.41 $64.41 $537.00
Oncoprotein her-2/neu $64.41 $64.41 $64.41 $141.75
Oocyte identification $171.36 $171.36 $171.36 $171.36
Open bx/exc inguinofem nodes $3,829.28 $3,829.28 $3,829.28 $3,829.28
Open nasoethmoid fx with fixj $5,915.66 $5,915.66 $5,915.66 $5,915.66
Open nasoethmoid fx without fixj $5,915.66 $5,915.66 $5,915.66 $5,915.66
Open periprosthetic breast capsule 19370 $3,829.28 $3,829.28 $3,829.28 $3,829.28
Open tenotomy tendon flexor foot single or multiple 28230 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Open thrombectomy of av fistula without revision 36831 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Open tx nose & septal fx $3,243.07 $3,243.07 $3,243.07 $3,243.07
Open tx nose fx w/skele fixj $5,915.66 $5,915.66 $5,915.66 $5,915.66
Open tx rib 1-3 fx w/fix 21811 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Open tx rib 4-6 fx w/fix 21812 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Open tx rib 7+ fx w/fix 21813 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Oph Ultrasound dx ant sgm Ultrasound uni/bi $106.34 $106.34 $106.34 $106.34
Oph Ultrasound dx quan a-scan only $106.34 $106.34 $106.34 $105.75
Ophth Ultrasound b & quant a $128.90 $128.90 $128.90 $128.90
Ophthalmic biometry $128.90 $128.90 $128.90 $128.90
Ophthalmodynamometry $39.25 $39.25 $39.25 $39.25
Opn impltj crnl nrv nea&pg $30,473.59 $30,473.59 $30,473.59 $30,473.59
Opn impltj nea neuromuscular $21,444.39 $21,444.39 $21,444.39 $21,444.39
Opn impltj nea perph nerve $12,470.31 $12,470.31 $12,470.31 $12,470.31
Opn impltj nea sacral nerve $6,562.90 $6,562.90 $6,562.90 $6,562.90
Opn mpltj hpglsl nstm ary pg $30,473.59 $30,473.59 $30,473.59 $30,473.59
Opn tx complx malar fx $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx complx malar w/grft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx dprsd zygomatic arch $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx nasomax fx multple $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx nasomax fx w/fixj $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit fx combined $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit fx periorbital $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit fx transantral $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit fx w/bone grft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit fx w/implant $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit fx without impl 21406 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit periorbt w/grft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opn tx orbit periorbtl implt $5,915.66 $5,915.66 $5,915.66 $5,915.66
Opps service,sched team conf $425.82 $425.82 $425.82 $425.82
Opscpy extnd on/mac draw $59.40 $59.40 $59.40 $59.40
Opscpy extnd rta draw uni/bi $59.40 $59.40 $59.40 $59.40
Optx acrclv dslc aq/chrn grf $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx acromclv dislc aqt/chrn $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx acute shoulder dislc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx carpl scphd fx int fixj $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx clavicular fx w/int fix $7,143.73 $7,143.73 $7,143.73 $5,152.80
Optx complicated mndblr fx $5,915.66 $5,915.66 $5,915.66 $5,915.66
Optx crpl fx oth/thn scph ea $3,244.61 $3,244.61 $3,244.61 $3,244.61
Optx gr hmrl tbrs fx int fix $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx lunate dislocation $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx medial ankle fx $7,143.73 $7,143.73 $7,143.73 $5,152.80
Optx mndblr cndylr fx $5,915.66 $5,915.66 $5,915.66 $5,915.66
Optx mndblr fx wo ntrdntl $5,915.66 $5,915.66 $5,915.66 $5,915.66
Optx mndblr fx xtrnl fixj $5,915.66 $5,915.66 $5,915.66 $5,915.66
Optx mndblr/max alv ridge fx $5,915.66 $5,915.66 $5,915.66 $5,915.66
Optx palatal/max fracture $5,915.66 $5,915.66 $5,915.66 $5,915.66
Optx partclr fx&/dslc elbw w $12,866.82 $12,866.82 $12,866.82 $12,866.82
Optx post ankle fx $7,143.73 $7,143.73 $7,143.73 $6,855.00
Optx prox humrl fx w/int fix $12,866.82 $12,866.82 $12,866.82 $6,347.40
Optx prx hmrl fx fix rpr rpl $18,390.05 $18,390.05 $18,390.05 $18,390.05
Optx rad/uln dislc aqt/chrnc $7,143.73 $7,143.73 $7,143.73 $4,493.40
Optx radial shaft fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Optx rdcrpl/ntrcrpl dislc 1+ $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx rdl shft fx&cltx rad/ul $7,143.73 $7,143.73 $7,143.73 $6,347.40
Optx rdl shft fx&dstl rad/ul $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx rdl&uln shft fx rds&uln $7,143.73 $7,143.73 $7,143.73 $6,405.00
Optx rdl&uln shft fx rds/uln $7,143.73 $7,143.73 $7,143.73 $5,152.80
Optx scapular fx w/int fixj $7,143.73 $7,143.73 $7,143.73 $5,152.80
Optx sho dislc fx $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx sho dislc neck fx fixj $12,866.82 $12,866.82 $12,866.82 $12,866.82
Optx strclv dslc aq/chrn grf $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx strnclav dislc aqt/chrn $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx tmprmand dislocation $3,243.07 $3,243.07 $3,243.07 $3,243.07
Optx trns-scphprlnr fx dislc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Optx ulnar shft fx int fixj $7,143.73 $7,143.73 $7,143.73 $5,152.80
Optx ulnar styloid fracture $7,143.73 $7,143.73 $7,143.73 $6,492.00
Oral busulfan $84.21 $84.21 $84.21 $24.60
Oral methotrexate (jylamvo) $18.53 $18.53 $18.53 $18.53
Oral methotrexate (xatmep) $22.66 $22.66 $22.66 $22.66
Oral netupitant, palonosetro $409.52 $409.52 $409.52 $409.52
Orchiectomy partial $3,448.97 $3,448.97 $3,448.97 $3,448.97
Orchiopexy (fowler-stephens) $3,529.06 $3,529.06 $3,529.06 $3,529.06
Orchiopexy ingun/scrot appr $3,529.06 $3,529.06 $3,529.06 $3,529.06
Organic acids total quant ea spec $23.60 $23.60 $23.60 $277.20
Oritavancin 1,200 mg intravenous solution $41.40 $41.40 $41.40 $41.40
Oritavancin 400 mg intravenous solution $28.52 $28.52 $28.52 $105.60
Oropharyngeal biopsy 42800 $1,481.28 $1,481.28 $1,481.28 $836.40
Orthop traing supvj phys/qhp $59.40 $59.40 $59.40 $59.40
Orthopantogram $88.05 $88.05 $88.05 $270.00
Orthovisc inj per dose $97.70 $97.70 $97.70 $443.85
Oscillation chest wall mechanical per session $203.39 $203.39 $203.39 $235.20
Osmolality blood $6.61 $6.61 $6.61 $63.75
Osmolality urine $6.82 $6.82 $6.82 $75.75
Ostectomy complete 1st metatarsal head 28111 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Ostectomy scapula partial $3,244.61 $3,244.61 $3,244.61 $3,244.61
Osteochondral knee allograft $12,866.82 $12,866.82 $12,866.82 $12,866.82
Osteochondral knee autograft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Osteochondral talus autogrft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Osteopath manip tx/5-6 body region 98927 $25.30 $25.30 $25.30 $25.30
Osteopath manip tx/7-8 body region 98928 $25.30 $25.30 $25.30 $25.30
Osteopath manip tx/9-10 body region98929 $25.30 $25.30 $25.30 $25.30
Osteoplasty humerus $7,143.73 $7,143.73 $7,143.73 $7,143.73
Osteot humerus w/wo int fixj $7,143.73 $7,143.73 $7,143.73 $7,143.73
Osteotomy/graft tarsal/calcaneus/talus 28305 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Ot evaluation high complexity patient/family $128.99 $128.99 $128.99 $272.40
Ot evaluation low complexity patient/family $128.99 $128.99 $128.99 $265.50
Ot evaluation moderate complexity patient/family $128.99 $128.99 $128.99 $272.40
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes $66.46 $66.46 $66.46 $119.25
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes $60.21 $60.21 $60.21 $112.50
Ot manual therpy techniques >=1 region each 15 minutes $35.04 $35.04 $35.04 $130.20
Ot re-evaluation patient/family $88.55 $88.55 $88.55 $138.00
Ot therapeutic activities direct patient contact each 15 minutes $44.62 $44.62 $44.62 $126.60
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes $28.73 $28.73 $28.73 $106.20
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes $29.70 $29.70 $29.70 $106.20
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes $37.06 $37.06 $37.06 $117.00
Ot therapeutic procedure neuromuscular reeducate each 15 minutes $41.24 $41.24 $41.24 $110.40
Ot training self care/home management direct contact each 15 minutes $40.79 $40.79 $40.79 $106.50
Oth resp proc, group $39.25 $39.25 $39.25 $144.00
Oth resp proc, indiv $24.49 $24.49 $24.49 $54.60
Other immunoelectrophoresis $23.13 $23.13 $23.13 $132.60
Otoplasty 69300 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Ovarian cystectomy 58925 $4,936.45 $4,936.45 $4,936.45 $4,936.45
P-32 sod phosphate ther per mci $179.12 $179.12 $179.12 $222.60
PSA (Prostate) Test $18.39 $18.39 $18.39 $103.85
Paclitaxel protein-bound 100 mg intravenous suspension $12.12 $12.12 $12.12 $61.80
Palb2 gene full gene seq $676.50 $676.50 $676.50 $676.50
Palb2 gene known famil vrnt $301.35 $301.35 $301.35 $301.35
Palifermin injection $35.91 $35.91 $35.91 $11,767.98
Paliperidone 117 mg/0.75 ml inj $15.08 $15.08 $15.08 $99.20
Palivizumab 50 mg/0.5 ml inj $719.87 $719.87 $719.87 $6,940.20
Panitumumab 20 mg/ml intravenous solution (wrapper) $172.55 $172.55 $172.55 $364.20
Parathormone (pth) intact $41.28 $41.28 $41.28 $226.20
Parathyrd planar w/spect&ct $538.27 $538.27 $538.27 $1,989.75
Parathyroid planar imaging $401.83 $401.83 $401.83 $1,228.80
Parathyroid planar img w/tomo spect $401.83 $401.83 $401.83 $1,859.40
Paravaginal defect repair 57284 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Parial mast w/lymph removal 19302 $6,521.46 $6,521.46 $6,521.46 $6,521.46
Paring/cutting benign hyperkeratotic lesion single $198.70 $198.70 $198.70 $251.40
Parotid duct diversion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Parotid duct diversion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Parotid duct diversion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Part exc/post vert comp/sng/thorac 22101 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Part hymenectomy/revi hymenal ring 56700 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Part removal of metatarsal $3,244.61 $3,244.61 $3,244.61 $3,244.61
Part removal of metatarsal $3,244.61 $3,244.61 $3,244.61 $3,244.61
Part removal of metatarsal 28112 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial exc bone humerus $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial excision of lip $3,243.07 $3,243.07 $3,243.07 $3,243.07
Partial removal finger bone $1,600.41 $1,600.41 $1,600.41 $4,321.20
Partial removal finger bone $1,600.41 $1,600.41 $1,600.41 $1,600.41
Partial removal foot fascia $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal leg bone(s) $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of eye fluid $2,280.73 $2,280.73 $2,280.73 $2,280.73
Partial removal of eye fluid $2,280.73 $2,280.73 $2,280.73 $2,280.73
Partial removal of fibula $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of foot bone $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of hand bone $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of lip $3,243.07 $3,243.07 $3,243.07 $3,243.07
Partial removal of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Partial removal of penis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Partial removal of pharynx 42890 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Partial removal of radius $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of radius $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of rib $7,143.73 $7,143.73 $7,143.73 $1,800.60
Partial removal of thyroid $5,834.36 $5,834.36 $5,834.36 $1,260.00
Partial removal of thyroid $5,834.36 $5,834.36 $5,834.36 $958.20
Partial removal of tibia $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of toe $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of tongue $5,915.66 $5,915.66 $5,915.66 $5,915.66
Partial removal of ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Partial removal of vaginal wall 57106 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Partial removal tear gland $3,771.00 $3,771.00 $3,771.00 $3,771.00
Partial thyroid excision $5,834.36 $5,834.36 $5,834.36 $5,834.36
Partial thyroid lobect w/contratlat stot lobec 60212 $5,834.36 $5,834.36 $5,834.36 $2,652.60
Path clin consltj high 41-60 $171.36 $171.36 $171.36 $171.36
Path clin consltj mod 21-40 $171.36 $171.36 $171.36 $447.60
Path clin consltj sf 5-20 $53.43 $53.43 $53.43 $198.60
Patient recorded spirometry $399.04 $399.04 $399.04 $399.04
Patient recorded spirometry $311.40 $311.40 $311.40 $311.40
Pdgfra gene $329.51 $329.51 $329.51 $1,189.80
Pdt dstr prmlg les phys/qhp $198.70 $198.70 $198.70 $777.00
Ped home apnea mntr att only $156.46 $156.46 $156.46 $156.46
Ped home apnea mntr dl&alys $156.46 $156.46 $156.46 $156.46
Pedcle fh/ch/ch/m/n/ax/g/h/f $1,829.23 $1,829.23 $1,829.23 $1,829.23
Pedicle enel/ntroral 15576 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Pegaspargase injection $28,424.06 $28,424.06 $28,424.06 $62,371.80
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector $58.40 $58.40 $58.40 $6,417.60
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe $132.04 $132.04 $132.04 $1,333.80
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe $136.04 $136.04 $136.04 $10,699.80
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe $229.11 $229.11 $229.11 $645.60
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe $103.71 $103.71 $103.71 $2,112.00
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe $149.21 $149.21 $149.21 $395.40
Pegloticase 8 mg/ml intravenous solution $3,638.86 $3,638.86 $3,638.86 $94,586.40
Pegunigalsidase alfa-iwxj $230.28 $230.28 $230.28 $526.20
Pelvic CT scan (with and without contrast) $178.02 $178.02 $178.02 $1,992.00
Pelvic CT scan (with contrast) $178.02 $178.02 $178.02 $1,680.60
Pelvic CT scan (without contrast) $106.34 $106.34 $106.34 $1,313.40
Pelvic MRI (with and without contrast) $357.13 $357.13 $357.13 $2,713.80
Pelvic MRI (with contrast) $357.13 $357.13 $357.13 $1,966.42
Pelvic MRI (without contrast) $241.72 $241.72 $241.72 $1,810.38
Pelvic Ultrasound (complete) $106.34 $106.34 $106.34 $647.87
Pelvic Ultrasound (limited) $106.34 $106.34 $106.34 $476.50
Pelvic ring fracture uni/bil $7,143.73 $7,143.73 $7,143.73 $7,143.73
Pembrolizumab 25 mg/ml intravenous solution $58.56 $58.56 $58.56 $7,026.00
Pemetrexed disodium 100 mg intravenous powder for solution $3.73 $3.73 $3.73 $3,134.40
Pemivibart infusion $450.50 $450.50 $450.50 $450.50
Peng benzathine/procaine inj $17.37 $17.37 $17.37 $251.40
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe $29.30 $29.30 $29.30 $1,422.60
Penicillin g procaine inj $47.19 $47.19 $47.19 $47.19
Penile injection $243.21 $243.21 $243.21 $403.80
Penile vascular study $106.34 $106.34 $106.34 $809.60
Penile vascular study $106.34 $106.34 $106.34 $435.00
Penile venous occlusion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Penis plastic surgery $3,448.97 $3,448.97 $3,448.97 $3,448.97
Penis study $311.40 $311.40 $311.40 $311.40
Pentostatin 10 mg intravenous solution $2,543.89 $2,543.89 $2,543.89 $6,720.00
Perc cryo ablate renal tum $10,411.22 $10,411.22 $10,411.22 $10,411.22
Perc d-e cor revasc chro sin $17,956.72 $17,956.72 $17,956.72 $17,956.72
Perc d-e cor revasc t cabg s $11,340.57 $11,340.57 $11,340.57 $15,411.00
Perc d-e cor stent ather s $17,956.72 $17,956.72 $17,956.72 $18,556.80
Perc drug-el cor stent sing $11,340.57 $11,340.57 $11,340.57 $15,411.00
Perc rf ablate renal tumor $5,834.36 $5,834.36 $5,834.36 $5,834.36
Percut ablate liver rf $5,834.36 $5,834.36 $5,834.36 $6,566.25
Peri-implt capslc brst compl $3,829.28 $3,829.28 $3,829.28 $3,829.28
Pericardiocentesis wwo imaging $1,553.44 $1,553.44 $1,553.44 $2,461.80
Perineoplasty rpr per nonob $3,179.53 $3,179.53 $3,179.53 $3,179.53
Peripheral vascular rehab $59.40 $59.40 $59.40 $148.50
Perit-vens shunt pat tst $401.83 $401.83 $401.83 $1,127.40
Peritoneal cath sub q resv per $5,405.70 $5,405.70 $5,405.70 $5,405.70
Peritoneogram rs&i $548.30 $548.30 $548.30 $338.40
Perq dev breast 1st mr guide $703.59 $703.59 $703.59 $2,153.40
Perq dev breast 1st strtctc $703.59 $703.59 $703.59 $1,793.40
Perq nl/pl lithotrp cplx>2cm $9,247.15 $9,247.15 $9,247.15 $0.60
Perq nl/pl lithotrp smpl<2cm $9,247.15 $9,247.15 $9,247.15 $0.60
Perq p-art revsc 1 abnor bi $11,340.57 $11,340.57 $11,340.57 $27,235.50
Perq p-art revsc 1 abnor uni $17,956.72 $17,956.72 $17,956.72 $44,278.50
Perq p-art revsc 1 nm nt bi $11,340.57 $11,340.57 $11,340.57 $27,235.50
Perq p-art revsc 1 nm nt uni $11,340.57 $11,340.57 $11,340.57 $27,235.50
Perq plmt bile duct stent $5,834.36 $5,834.36 $5,834.36 $8,839.80
Perq plmt bile duct stent $5,834.36 $5,834.36 $5,834.36 $5,834.36
Perq plmt bile duct stent $5,834.36 $5,834.36 $5,834.36 $12,221.25
Perq rplcmt g-tube req revsn gstrst trk $243.21 $243.21 $243.21 $1,159.50
Perq skel fix rad/uln dislc $3,244.61 $3,244.61 $3,244.61 $3,244.61
Perq skel fix ulnar styld fx $3,244.61 $3,244.61 $3,244.61 $3,244.61
Perq transcath closure pda $17,956.72 $17,956.72 $17,956.72 $0.60
Perq transcath cls aortic $17,956.72 $17,956.72 $17,956.72 $17,956.72
Perq transcath cls mitral $17,956.72 $17,956.72 $17,956.72 $17,956.72
Perq tx big toe fracture w/manip 28496 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Perq tx malar fracture $3,243.07 $3,243.07 $3,243.07 $3,243.07
Perq tx mndblr fx xtrnl fixj $5,915.66 $5,915.66 $5,915.66 $3,771.60
Perq tx nasoethmoid fx $3,243.07 $3,243.07 $3,243.07 $3,243.07
Pertussis ag if $11.98 $11.98 $11.98 $11.98
Pertuzu, trastuzu, 10 mg $63.39 $63.39 $63.39 $324.60
Pertuzumab 30 mg/ml desensitization $16.89 $16.89 $16.89 $22,539.60
Pet CT skull-mid thgh initial $1,458.59 $1,458.59 $1,458.59 $4,854.75
Pet CT whole body initial $1,458.59 $1,458.59 $1,458.59 $4,915.50
Pet fdg brain metoblic eval sb $1,458.59 $1,458.59 $1,458.59 $4,298.25
Pet image full body $1,458.59 $1,458.59 $1,458.59 $14,161.80
Pet image ltd area $1,305.48 $1,305.48 $1,305.48 $4,245.00
Pet image skull-thigh $1,458.59 $1,458.59 $1,458.59 $7,438.80
Pet image w/ct lmtd $1,458.59 $1,458.59 $1,458.59 $4,680.75
Pet not otherwise specified $401.83 $401.83 $401.83 $401.83
Ph body fluid $3.58 $3.58 $3.58 $39.60
Phalangectomy ea toe 28150 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Phenobarbital therapeutic drug level $15.30 $15.30 $15.30 $150.00
Phentolaine mesylate inj $436.51 $436.51 $436.51 $1,028.40
Phenylep ketorolac opth soln $97.42 $97.42 $97.42 $97.42
Phenytoin total therapeutic drug level $13.25 $13.25 $13.25 $114.00
Phleb veins 1 extrm 10-20 stab $3,147.50 $3,147.50 $3,147.50 $3,682.50
Phleb veins 1 extrm >20 stab $3,147.50 $3,147.50 $3,147.50 $3,147.50
Phlebotomy therapeutic $128.90 $128.90 $128.90 $284.40
Phosphorus $4.74 $4.74 $4.74 $56.40
Phosphorus 24 hour urine $5.78 $5.78 $5.78 $91.20
Photchmtx tar&uvb/ptrltm&uvb $59.40 $59.40 $59.40 $59.40
Photo patch test $59.40 $59.40 $59.40 $59.40
Photochemotherapy puva $59.40 $59.40 $59.40 $59.40
Photochemotherapy uv-a or b $399.53 $399.53 $399.53 $399.53
Photopheresis $4,685.17 $4,685.17 $4,685.17 $4,685.17
Photosensitivity tests $128.90 $128.90 $128.90 $128.90
Phys blood bank serv authrj $53.43 $53.43 $53.43 $53.43
Phys blood bank serv reactj $171.36 $171.36 $171.36 $398.40
Phys blood bank serv xmatch $24.49 $24.49 $24.49 $24.49
Piflu f-18, dia 1 millicurie $332.44 $332.44 $332.44 $1,252.20
Pik3ca gene trgt seq alys $274.83 $274.83 $274.83 $274.83
Pild/placebo control clin tr $7,143.73 $7,143.73 $7,143.73 $7,143.73
Pin finger dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Pin finger fracture each $3,244.61 $3,244.61 $3,244.61 $3,244.61
Pin hand dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Pin knuckle dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 $612.13 $612.13 $612.13 $612.13
Pinworm exam $4.27 $4.27 $4.27 $49.20
Place breast rad tube/caths $6,521.46 $6,521.46 $6,521.46 $6,521.46
Place cecostomy tube perc $1,179.08 $1,179.08 $1,179.08 $11,644.80
Place device/marker, non pro $1,368.26 $1,368.26 $1,368.26 $1,368.26
Place duod/jej tube perc $1,896.99 $1,896.99 $1,896.99 $4,182.60
Place endorectal app $911.71 $911.71 $911.71 $911.71
Place gastrostomy tube perc $1,896.99 $1,896.99 $1,896.99 $3,587.40
Place ndl musc/tis for right $3,244.61 $3,244.61 $3,244.61 $3,220.50
Place needles h&n for right $5,915.66 $5,915.66 $5,915.66 $5,915.66
Place needles pelvic for right $4,936.45 $4,936.45 $4,936.45 $4,936.45
Place non-slctv cath thoracic arta $3,147.50 $3,147.50 $3,147.50 $6,360.60
Place po breast cath for rad $9,569.05 $9,569.05 $9,569.05 $720.80
Place right device/marker pros $1,368.26 $1,368.26 $1,368.26 $1,368.26
Place slctv cath carotd art uni $5,405.70 $5,405.70 $5,405.70 $10,950.75
Place slctv cath carotid/inom art excrn uni $3,147.50 $3,147.50 $3,147.50 $7,552.20
Place slctv cath carotid/inom art intcrn uni $5,405.70 $5,405.70 $5,405.70 $10,549.80
Place slctv cath subclavian art $3,147.50 $3,147.50 $3,147.50 $7,476.75
Place slctv cath vertebral art uni $5,405.70 $5,405.70 $5,405.70 $10,549.80
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) $1,620.24 $1,620.24 $1,620.24 $1,562.25
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) $703.59 $703.59 $703.59 $1,564.20
Placement nephrostomy catheter (both sides) $2,048.51 $2,048.51 $2,048.51 $2,483.40
Placement of seton $2,742.39 $2,742.39 $2,742.39 $2,742.39
Placement stent(s) intravascular transcatheter artery initial $11,340.57 $11,340.57 $11,340.57 $12,780.00
Placental lactogen $20.22 $20.22 $20.22 $20.22
Plasma cryoprecipitate reduced each unit $147.30 $147.30 $147.30 $147.30
Plasma protein fract,5%,50ml $8.07 $8.07 $8.07 $8.07
Plasma volume multiple $1,305.48 $1,305.48 $1,305.48 $1,305.48
Plasma volume single $1,305.48 $1,305.48 $1,305.48 $1,305.48
Plasmaprotein fract,5%,250ml $73.72 $73.72 $73.72 $73.72
Platelet aggregation each agent teg $24.91 $24.91 $24.91 $202.80
Platelet automated $4.48 $4.48 $4.48 $38.25
Platelet deplete of harvest $437.18 $437.18 $437.18 $437.18
Platelet pheresis each unit $397.13 $397.13 $397.13 $1,015.50
Platelet pheresis irr ea $587.65 $587.65 $587.65 $1,659.00
Platelet survival $401.83 $401.83 $401.83 $401.83
Platelets each unit $75.96 $75.96 $75.96 $477.00
Platelets hla matched leukocytes reduced apheresis/pheresis each unit $777.49 $777.49 $777.49 $4,062.00
Platelets irradiated ea unit $135.78 $135.78 $135.78 $320.40
Platelets leukocytes reduced each unit $125.77 $125.77 $125.77 $241.20
Platelets leukocytes reduced irradiated each unit $205.39 $205.39 $205.39 $360.00
Platelets leukoreduced cmv negative apheresis/phresis each unit $227.25 $227.25 $227.25 $227.25
Platelets pheresis leukocytes reduced cmv negative irradiated each unit $459.23 $459.23 $459.23 $459.23
Platelets pheresis leukocytes reduced each unit $487.10 $487.10 $487.10 $2,713.80
Platelets pheresis leukocytes reduced irradiated each unit $675.66 $675.66 $675.66 $2,893.20
Platelets pheresis pathogen-reduced each unit $587.28 $587.28 $587.28 $1,791.00
Plcmnt biliary drainage cath w/img ext $3,529.06 $3,529.06 $3,529.06 $4,144.20
Plcmnt ureteral stent pq w/img exstng trct $3,448.97 $3,448.97 $3,448.97 $4,913.40
Plcmnt ureteral stent pq w/img new w/cath $3,448.97 $3,448.97 $3,448.97 $7,729.80
Plcmt sft tiss loc pq w/img 1st lsn $703.59 $703.59 $703.59 $1,039.50
Plerixafor injection $119.47 $119.47 $119.47 $1,570.80
Plethysmography lung volumes/airway resistance $311.40 $311.40 $311.40 $368.25
Plmt access bil tree sm bwl $6,239.75 $6,239.75 $6,239.75 $6,239.75
Plmt biliary drainage cath $3,529.06 $3,529.06 $3,529.06 $4,144.20
Plmt nephroureteral catheter $3,448.97 $3,448.97 $3,448.97 $4,763.40
Plmt ureteral stent prq $3,448.97 $3,448.97 $3,448.97 $7,729.80
Pm device progr eval dual $37.29 $37.29 $37.29 $237.75
Pm device progr eval multi $37.29 $37.29 $37.29 $245.25
Pm phone r-strip device eval $37.29 $37.29 $37.29 $181.50
Pml/raralpha 1 breakpoint $207.31 $207.31 $207.31 $1,114.20
Pmp22 gene dup/delet $758.36 $758.36 $758.36 $1,054.50
Pmp22 gene full sequence $769.58 $769.58 $769.58 $2,663.40
Pmp22 gene known fam variant $46.60 $46.60 $46.60 $46.60
Pms2 gene dup/delet variants $203.50 $203.50 $203.50 $1,502.40
Pms2 gene full seq analysis $676.50 $676.50 $676.50 $1,522.80
Pms2 known familial variants $331.00 $331.00 $331.00 $235.80
Pneumothrx tx-intraplrl inj ai $618.26 $618.26 $618.26 $618.26
Poct blood gases ph pco2 po2 arterial calculated o2 $26.07 $26.07 $26.07 $228.60
Polatuzumab vedotin-piiq 140 mg intravenous solution $136.23 $136.23 $136.23 $36,544.20
Polysom <6 yrs cpap/bilvl $1,017.39 $1,017.39 $1,017.39 $1,017.39
Polysom any age 1-3> param $1,017.39 $1,017.39 $1,017.39 $1,017.39
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap $1,017.39 $1,017.39 $1,017.39 $6,491.40
Porfimer sodium injection $24,228.42 $24,228.42 $24,228.42 $75,528.84
Positional change of finger $7,143.73 $7,143.73 $7,143.73 $7,143.73
Post 1 srfc resinbased cmpst $1,662.63 $1,662.63 $1,662.63 $1,662.63
Post 2 srfc resinbased cmpst $1,662.63 $1,662.63 $1,662.63 $1,662.63
Post >=4srfc resinbase cmpst $1,662.63 $1,662.63 $1,662.63 $1,662.63
Post op service lvrs min 6 $530.60 $530.60 $530.60 $598.40
Potassium 24 hour urine $4.73 $4.73 $4.73 $52.20
Potassium hydroxide preps $5.83 $5.83 $5.83 $68.40
Potassium serum/plasma/whole blood $4.76 $4.76 $4.76 $39.60
Pq kyphplsty 1 bdy lumb w/img $7,143.73 $7,143.73 $7,143.73 $8,849.25
Pq thr inj ext pse $618.26 $618.26 $618.26 $899.40
Pq vrtbrplst 1 bdy inj crv-thr w/img ini $3,244.61 $3,244.61 $3,244.61 $3,244.61
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini $3,244.61 $3,244.61 $3,244.61 $3,244.61
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr $3,244.61 $3,244.61 $3,244.61 $3,800.40
Pr application of long arm splint $157.79 $157.79 $157.79 $467.25
Pr application splint static short arm $128.90 $128.90 $128.90 $288.75
Pr assessment emotional/behavioral per instrument brief $39.25 $39.25 $39.25 $39.25
Pr biopsy skin punch single lesion $399.53 $399.53 $399.53 $399.53
Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method $12,866.82 $12,866.82 $12,866.82 $1,059.00
Pr correction hammertoe $3,244.61 $3,244.61 $3,244.61 $669.00
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes $29.79 $29.79 $29.79 $30.00
Pr cystourethroscopy with insertion indwelling ureteral stent $3,448.97 $3,448.97 $3,448.97 $3,768.60
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< $198.70 $198.70 $198.70 $378.60
Pr egd flexible transoral w/placement percutaneous gastrostomy tube $1,896.99 $1,896.99 $1,896.99 $2,795.25
Pr evaluation psychiatric diagnostic w/medical services $160.67 $160.67 $160.67 $394.50
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment $128.87 $128.87 $128.87 $130.50
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm $1,620.24 $1,620.24 $1,620.24 $1,896.00
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm $1,620.24 $1,620.24 $1,620.24 $2,709.00
Pr excision nail/nail matrix partial/complete permanent removal $399.53 $399.53 $399.53 $1,233.00
Pr incision & drainage abscess complicated/multiple $399.53 $399.53 $399.53 $712.80
Pr incision & drainage abscess simple/single $198.70 $198.70 $198.70 $484.20
Pr incision & drainage abscess vulva/perineal $304.19 $304.19 $304.19 $831.60
Pr incision & removal foreign body subcutaneous tissues simple $399.53 $399.53 $399.53 $589.80
Pr management transitional care high w/in 7 days of discharge $128.87 $128.87 $128.87 $278.40
Pr management transitional care moderate w/in 14 days of discharge $128.87 $128.87 $128.87 $229.50
Pr neuroplasty and/or transposition ulnar nerve at elbow $1,952.77 $1,952.77 $1,952.77 $1,952.77
Pr planning advance care 1st 30 minutes $92.50 $92.50 $92.50 $143.25
Pr removal drug delivery implant $399.04 $399.04 $399.04 $1,440.00
Pr removal foreign body external auditory canal without anesthesia $128.90 $128.90 $128.90 $298.40
Pr removal intrauterine device $304.19 $304.19 $304.19 $589.80
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm $399.53 $399.53 $399.53 $825.60
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm $198.70 $198.70 $198.70 $477.00
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm $198.70 $198.70 $198.70 $477.00
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm $198.70 $198.70 $198.70 $477.00
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm $198.70 $198.70 $198.70 $520.80
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child $1,829.23 $1,829.23 $1,829.23 $1,829.23
Pr tube thoracostomy w/connection to drainage open $1,553.44 $1,553.44 $1,553.44 $2,412.60
Pralatrexate injection $388.83 $388.83 $388.83 $4,072.20
Pre-op service lvrs 1-9 dos $530.60 $530.60 $530.60 $530.60
Pre-op service lvrs 10-15dos $311.40 $311.40 $311.40 $311.40
Pre-op service lvrs complete $530.60 $530.60 $530.60 $530.60
Pre-plan 3d model w/ccta $1,017.39 $1,017.39 $1,017.39 $1,017.39
Prealbumin $14.59 $14.59 $14.59 $114.00
Prefab stnlss steel crown pe $1,662.63 $1,662.63 $1,662.63 $1,662.63
Prefab stnlss steel crwn pri $1,662.63 $1,662.63 $1,662.63 $1,662.63
Pregnancy Ultrasound (complete, after first trimester) $106.34 $106.34 $106.34 $607.12
Pregnancy Ultrasound (first trimester) $106.34 $106.34 $106.34 $580.03
Pregnancy associated plasma protein-a $15.05 $15.05 $15.05 $136.20
Prep skin to 100cm2 other $612.13 $612.13 $612.13 $1,401.75
Prep skin to 100cm2 trk/ext $1,829.23 $1,829.23 $1,829.23 $1,410.00
Preparation palate mold $509.25 $509.25 $509.25 $509.25
Prepare embryo for transfer $53.43 $53.43 $53.43 $53.43
Pressure max expiratory/inspiratory $156.46 $156.46 $156.46 $156.46
Pretreat rbc absorption reference $59.40 $59.40 $59.40 $128.25
Pretreat rbc density gradient separation reference $171.36 $171.36 $171.36 $70.80
Pretreat rbc w chem/drugs reference $59.40 $59.40 $59.40 $183.60
Pretreat rbc w enzyme reference $171.36 $171.36 $171.36 $219.00
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref $171.36 $171.36 $171.36 $139.80
Prgrmg dev eval impltbl sys $37.29 $37.29 $37.29 $226.20
Prgrmg dev eval pm/ldls pm $37.29 $37.29 $37.29 $176.40
Prgrmg dev eval scrms ip $37.29 $37.29 $37.29 $225.00
Prgrmg eval implantable dfb $37.29 $37.29 $37.29 $176.40
Prgrmg eval implantable dfb $37.29 $37.29 $37.29 $265.20
Prgrmg eval implantable dfb $37.29 $37.29 $37.29 $316.80
Prim art mech thrmbc non-intracranial $17,956.72 $17,956.72 $17,956.72 $17,956.72
Probe nasolacrimal duct $298.93 $298.93 $298.93 $298.93
Probe nasolacrimal duct $2,332.96 $2,332.96 $2,332.96 $2,332.96
Probe nasolacrimal duct $2,332.96 $2,332.96 $2,332.96 $2,332.96
Probe nl duct w/balloon $2,332.96 $2,332.96 $2,332.96 $2,332.96
Procainamide 100 mg/ml injection (wrapper) $194.32 $194.32 $194.32 $225.00
Procalcitonin $27.22 $27.22 $27.22 $138.00
Proctosigmoidoscopy ablate $2,742.39 $2,742.39 $2,742.39 $2,742.39
Proctosigmoidoscopy control bleed 45317 $1,179.08 $1,179.08 $1,179.08 $1,989.75
Proctosigmoidoscopy dilate 45303 $1,179.08 $1,179.08 $1,179.08 $1,179.08
Proctosigmoidoscopy dx 45300 $911.71 $911.71 $911.71 $1,663.20
Proctosigmoidoscopy removal $2,742.39 $2,742.39 $2,742.39 $2,967.75
Proctosigmoidoscopy removal $1,179.08 $1,179.08 $1,179.08 $1,179.08
Proctosigmoidoscopy tumor removal 45315 $1,179.08 $1,179.08 $1,179.08 $1,179.08
Proctosigmoidoscopy volvul $2,742.39 $2,742.39 $2,742.39 $2,742.39
Proctosigmoidoscopy w/bx 45305 $1,179.08 $1,179.08 $1,179.08 $3,114.00
Proctosigmoidoscopy w/fb remove 45307 $2,742.39 $2,742.39 $2,742.39 $3,015.00
Proctosigmoidoscopy w/stent $5,952.81 $5,952.81 $5,952.81 $5,952.81
Progesterone $20.86 $20.86 $20.86 $105.00
Prolactin $19.38 $19.38 $19.38 $162.00
Prolonged IV inf, req pump $331.69 $331.69 $331.69 $331.69
Proph rta dtchmnt crtx dthrm $298.93 $298.93 $298.93 $298.93
Proph rta dtchmnt pc $548.60 $548.60 $548.60 $534.75
Proph tx w/wo mthylmthcrylt $12,866.82 $12,866.82 $12,866.82 $12,866.82
Prophylactic tx radius $7,143.73 $7,143.73 $7,143.73 $7,143.73
Prophylactic tx radius&ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Prophylactic tx ulna $12,866.82 $12,866.82 $12,866.82 $12,866.82
Prostate biopsy, any mthd $359.72 $359.72 $359.72 $309.00
Prostate laser enucleation $5,083.62 $5,083.62 $5,083.62 $5,083.62
Prostatectomy (turp) $5,083.62 $5,083.62 $5,083.62 $4,998.00
Prostatic microwave thermotx $3,448.97 $3,448.97 $3,448.97 $3,448.97
Prostatic rf thermotx $3,448.97 $3,448.97 $3,448.97 $3,448.97
Protein c activity $13.84 $13.84 $13.84 $121.20
Protein c concentrate $1.50 $1.50 $1.50 $123.00
Protein electrophoretic fractionation & quantitation serum $10.74 $10.74 $10.74 $139.50
Protein s total $11.61 $11.61 $11.61 $156.00
Protein total 24 hour urine $3.67 $3.67 $3.67 $39.60
Protein total body fluid $4.00 $4.00 $4.00 $67.80
Protein total serum plasma whole blood $3.67 $3.67 $3.67 $37.50
Prothrombin complex kcentra $2.14 $2.14 $2.14 $8.25
Prothrombin time substitution plasma fractions each $3.94 $3.94 $3.94 $66.00
Proton treatment complex $1,275.51 $1,275.51 $1,275.51 $1,275.51
Proton trmt intermediate $1,275.51 $1,275.51 $1,275.51 $1,275.51
Proton trmt simple w/comp $1,275.51 $1,275.51 $1,275.51 $1,275.51
Proton trmt simple without comp $578.47 $578.47 $578.47 $578.47
Protoporphyrin rbc screen $9.74 $9.74 $9.74 $9.74
Provide inr test mater/equip $128.87 $128.87 $128.87 $128.87
Prp i/hern init block >5 yr $3,529.06 $3,529.06 $3,529.06 $8,917.80
Prq av fstl crt uxtr sep acs $17,956.72 $17,956.72 $17,956.72 $33,250.80
Prq av fstl crtj uxtr 1 acs $17,956.72 $17,956.72 $17,956.72 $33,250.80
Prq revasc byp graft 1 art and/or branches $11,340.57 $11,340.57 $11,340.57 $15,411.00
Prq skel fix clcnl fx w/mnpj $7,143.73 $7,143.73 $7,143.73 $7,143.73
Prq skel fix epcndylr hum fx $1,600.41 $1,600.41 $1,600.41 $1,600.41
Prq skel fix sprcndlr hum fx $7,143.73 $7,143.73 $7,143.73 $7,143.73
Prq skel fix talus fx w/mnpj $7,143.73 $7,143.73 $7,143.73 $4,493.40
Prq skel fix tarsl fx w/mnpj $7,143.73 $7,143.73 $7,143.73 $7,143.73
Prq tcat plmt ntrac st 1 les $11,340.57 $11,340.57 $11,340.57 $12,034.50
Prq trlml c athrc st angiop1 $17,956.72 $17,956.72 $17,956.72 $23,616.60
Prq trluml c angiop 1art&/br $5,701.52 $5,701.52 $5,701.52 $9,413.25
Prq trluml c athrc 1 art&/br $11,340.57 $11,340.57 $11,340.57 $12,754.50
Prq trluml revsc ch occ ant $11,340.57 $11,340.57 $11,340.57 $20,522.25
Prtl exc bone olecrn process $3,244.61 $3,244.61 $3,244.61 $3,244.61
Prtl exc bone radial h/n $7,143.73 $7,143.73 $7,143.73 $7,143.73
Prtl exchange transfuse nb $437.18 $437.18 $437.18 $437.18
Prtl excision bone clavicle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Prtl excision bone scapula $7,143.73 $7,143.73 $7,143.73 $7,143.73
Psy/npsy phys/qhp 2> tst 1st 30 min $128.90 $128.90 $128.90 $225.60
Psych test eval svc phys/qhp 1st hr $311.40 $311.40 $311.40 $311.40
Psych/neuropsych test admin automated result 96146 $24.49 $24.49 $24.49 $24.49
Psychoanalysis $160.67 $160.67 $160.67 $160.67
Psychotherapy group therapy $92.50 $92.50 $92.50 $58.20
Psychotherapy patient individual therapy 30 minutes $160.67 $160.67 $160.67 $168.00
Psychotherapy patient individual therapy 45 minutes $160.67 $160.67 $160.67 $175.80
Psychotherapy patient individual therapy 60 minutes $160.67 $160.67 $160.67 $254.40
Psycl/nrpsyc tech 1st $399.04 $399.04 $399.04 $210.75
Pt application of modality >=1 area electrical stimulation each 15 minutes $18.62 $18.62 $18.62 $103.20
Pt application of modality >=1 area iontophoresis each 15 minutes $23.82 $23.82 $23.82 $103.20
Pt application of modality >=1 area ultrasound each 15 minutes $17.72 $17.72 $17.72 $99.00
Pt application of modality traction mechanical $18.62 $18.62 $18.62 $119.25
Pt evaluation high complexity patient/family $126.19 $126.19 $126.19 $274.20
Pt evaluation low complexity patient/family $126.19 $126.19 $126.19 $238.40
Pt evaluation moderate complexity patient/family $126.19 $126.19 $126.19 $264.00
Pt init/spiromet rec/review/interp 94016 $31.91 $31.91 $31.91 $31.91
Pt re-evaluation patient/family $86.04 $86.04 $86.04 $117.60
Pt repositioning canalith procedure(s) per day $46.75 $46.75 $46.75 $223.20
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan $15.57 $15.57 $15.57 $110.40
Pt therapeutic procedure >=1 area gait training each 15 minutes $37.06 $37.06 $37.06 $110.25
Pt therapeutic procedure >=1 area massage each 15 minutes $38.63 $38.63 $38.63 $105.00
Pt wheelchair management each 15 minutes $39.57 $39.57 $39.57 $76.20
Pten gene dup/delet variant $300.00 $300.00 $300.00 $336.60
Pten gene full sequence $600.00 $600.00 $600.00 $564.60
Pten gene known fam variant $46.60 $46.60 $46.60 $43.80
Pterygomaxillary fossa surg any appr 31040 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Pul art balloon repr percut $11,340.57 $11,340.57 $11,340.57 $10,756.50
Pulmonary vent imaging $401.83 $401.83 $401.83 $672.00
Pulse ox continuous overnight monitoring $156.46 $156.46 $156.46 $302.40
Punc of shunt for asp or inj $692.52 $692.52 $692.52 $801.75
Puncture arterial withdrawal blood for diagnosis $128.90 $128.90 $128.90 $87.60
Puncture aspiration abscess/hematoma/bulla/cyst $399.53 $399.53 $399.53 $496.20
Puncture spinal lumbar diagnostic $692.52 $692.52 $692.52 $1,212.00
Puncture/clear windpipe 31612 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Pvb thoracic cont infusion $692.52 $692.52 $692.52 $2,406.00
Pvb thoracic single inj site $692.52 $692.52 $692.52 $692.52
Pyruvate $14.48 $14.48 $14.48 $108.75
Pyruvate kinase $9.44 $9.44 $9.44 $130.80
Quan puplmtry phy/qhp uni/bi $128.90 $128.90 $128.90 $128.90
Quant diff pulm perf and vent w/imaging $538.27 $538.27 $538.27 $2,655.60
Quant diff pulm perf w/imaging $401.83 $401.83 $401.83 $1,362.40
Quest t3 uptake $6.47 $6.47 $6.47 $81.75
Quinupristin/dalfopristin $4.26 $4.26 $4.26 $4.26
R hrt cath chd abnl nt cnj $3,216.41 $3,216.41 $3,216.41 $3,216.41
R hrt cath chd nml nt cnj $3,216.41 $3,216.41 $3,216.41 $3,216.41
R&l hrt cath chd abnl nt cnj $3,216.41 $3,216.41 $3,216.41 $3,216.41
R&l hrt cath chd nml nt cnj $3,216.41 $3,216.41 $3,216.41 $3,216.41
Rabies ig heat-treated human im/subq 90376 $347.32 $347.32 $347.32 $3,103.43
Rabies ig ht&sol human im/sc $237.10 $237.10 $237.10 $8,111.40
Rabies immune globulin (pf) 300 unit/ml intramuscular solution $266.44 $266.44 $266.44 $880.00
Rabies vaccine id $264.47 $264.47 $264.47 $264.47
Rad rescj tum dstl/shft hum $7,143.73 $7,143.73 $7,143.73 $7,143.73
Rad rescj tum shoulder<5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad rescj tum tiss a/e 5 cm+ $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad rescj tum tiss a/e <5cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad resec soft tis tum/ft/toe/<3cm 28046 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad resect abd tumor 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad resect hand tumor 3 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad resect hand tumor < 3 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad resect tumor/neck/ant thor/<5cm21557 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rad resection tum radial h/n $7,143.73 $7,143.73 $7,143.73 $7,143.73
Radiation physics consult $132.77 $132.77 $132.77 $568.80
Radiation therapy dose plan $132.77 $132.77 $132.77 $571.20
Radiation treatment aid(s) $132.77 $132.77 $132.77 $132.77
Radiation treatment aid(s) $366.07 $366.07 $366.07 $1,244.40
Radiation treatment aid(s) $132.77 $132.77 $132.77 $489.00
Radiation treatment delivery $109.50 $109.50 $109.50 $698.40
Radiation treatment delivery $109.50 $109.50 $109.50 $109.50
Radiation treatment delivery $262.98 $262.98 $262.98 $952.80
Radic resect abd tumor<5cm 22904 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Radic resect shoulder tumor 5cm/> 23078 $2,862.05 $2,862.05 $2,862.05 $2,862.05
Radical resection of elbow $7,143.73 $7,143.73 $7,143.73 $7,143.73
Radiesse injection $333.42 $333.42 $333.42 $333.42
Radiotherapy dose plan imrt $1,368.26 $1,368.26 $1,368.26 $3,873.00
Radium ra223 dichl ther/uci $171.78 $171.78 $171.78 $389.40
Radphm lcl tmr plnr bdy sgl day img $1,305.48 $1,305.48 $1,305.48 $1,936.80
Radphm lcl tmr plnr bdy two day img $1,305.48 $1,305.48 $1,305.48 $2,386.20
Radphm lcl tmr spect/ct 2+ areas/2+ days $1,305.48 $1,305.48 $1,305.48 $2,767.80
Radphm lcl tomogr sgl area sgl day $1,305.48 $1,305.48 $1,305.48 $2,767.80
Radphm lcl tumor plr sgl day $401.83 $401.83 $401.83 $1,070.40
Ramucirumab 10 mg/ml intravenous solution $74.45 $74.45 $74.45 $147.60
Ranibizumab injection $91.11 $91.11 $91.11 $844.80
Rapid Strep Test $16.53 $16.53 $16.53 $72.00
Rapid desensitization $399.04 $399.04 $399.04 $399.04
Rasburicase 1.5 mg intravenous solution $376.48 $376.48 $376.48 $9,544.20
Ravulizumab-cwvz 100 mg/ml intravenous solution $225.19 $225.19 $225.19 $71,857.80
Rbc count only automated $3.02 $3.02 $3.02 $21.40
Rbc deglycerolized each unit $653.74 $653.74 $653.74 $1,263.00
Rbc depletion of harvest $437.18 $437.18 $437.18 $437.18
Rbc irradiated each unit $149.22 $149.22 $149.22 $510.60
Rbc serum pretx incubj drugs $399.04 $399.04 $399.04 $229.60
Rcnst bfrnt sp orb rm&lw fhd $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rdctj forehead cntrg only $3,243.07 $3,243.07 $3,243.07 $3,243.07
Rdctj forehead cntrg&prostc $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rdctj forehead cntrg&setback $5,915.66 $5,915.66 $5,915.66 $5,915.66
Re-explore parathyroids $5,915.66 $5,915.66 $5,915.66 $1,744.80
Realignment of tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Rebuild eardrum structures $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rebuild eardrum structures $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rebuild eardrum structures $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rebuild outer ear canal $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rebuild outer ear canal $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconst lwr jaw w/fixation $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconst lwr jaw w/graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconst lwr jaw without fixation $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconst lwr jaw without graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstr lwr jaw segment $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstr lwr jaw w/advance $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct ankle joint $18,390.05 $18,390.05 $18,390.05 $18,390.05
Reconstruct cleft foot $7,143.73 $7,143.73 $7,143.73 $7,143.73
Reconstruct cleft palate $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct cleft palate $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct cleft palate $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct cleft palate $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct cleft palate $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct cleft palate $3,243.07 $3,243.07 $3,243.07 $3,243.07
Reconstruct elbow joint $18,390.05 $18,390.05 $18,390.05 $18,390.05
Reconstruct elbow joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Reconstruct elbow joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reconstruct elbow lat ligmnt $7,143.73 $7,143.73 $7,143.73 $7,143.73
Reconstruct elbow med ligmnt $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reconstruct extra finger $3,244.61 $3,244.61 $3,244.61 $3,244.61
Reconstruct finger joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Reconstruct finger joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Reconstruct head of radius $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reconstruct head of radius $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reconstruct lip w/local flap 40525 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Reconstruct lip with flap $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct lower jaw bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct orbit/forehead $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct shoulder joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reconstruct shoulder joint $18,390.05 $18,390.05 $18,390.05 $18,390.05
Reconstruct ulna/radioulnar $7,143.73 $7,143.73 $7,143.73 $7,143.73
Reconstruct upper jaw bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruct urethra stage 1 $5,083.62 $5,083.62 $5,083.62 $5,083.62
Reconstruct urethra stage 2 $5,083.62 $5,083.62 $5,083.62 $5,083.62
Reconstruct urethra/bladder $5,083.62 $5,083.62 $5,083.62 $5,083.62
Reconstruction knee $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reconstruction knee $7,143.73 $7,143.73 $7,143.73 $7,143.73
Reconstruction knee $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reconstruction of anus $2,742.39 $2,742.39 $2,742.39 $2,742.39
Reconstruction of eyelid $3,771.00 $3,771.00 $3,771.00 $3,771.00
Reconstruction of eyelid $2,332.96 $2,332.96 $2,332.96 $2,332.96
Reconstruction of eyelid $2,332.96 $2,332.96 $2,332.96 $2,332.96
Reconstruction of eyelid $2,332.96 $2,332.96 $2,332.96 $2,332.96
Reconstruction of jaw $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of jaw $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of jaw $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of jaw $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of jaw joint $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of jaw joint $18,390.05 $18,390.05 $18,390.05 $18,390.05
Reconstruction of jaw joint $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of lower jaw $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of mouth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of mouth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of mouth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of mouth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of mouth $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of nail bed $1,829.23 $1,829.23 $1,829.23 $1,829.23
Reconstruction of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of orbit $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of throat $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reconstruction of urethra $5,083.62 $5,083.62 $5,083.62 $5,083.62
Reconstruction of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Reconstruction of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Reconstruction of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Reconstruction of urethra $5,083.62 $5,083.62 $5,083.62 $5,083.62
Reconstruction of urethra $9,247.15 $9,247.15 $9,247.15 $9,247.15
Reconstruction of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Reconstruction of urethra $5,083.62 $5,083.62 $5,083.62 $5,083.62
Reconstruction of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Reconstruction tongue fold $3,243.07 $3,243.07 $3,243.07 $3,243.07
Rectal sensation test $311.40 $311.40 $311.40 $311.40
Red blood cells each unit $144.32 $144.32 $144.32 $759.60
Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit $485.37 $485.37 $485.37 $485.37
Red blood cells leukocytes reduced cmv negative irradiated each unit $222.86 $222.86 $222.86 $397.80
Red blood cells leukocytes reduced each unit $182.00 $182.00 $182.00 $818.40
Red blood cells leukocytes reduced irradiated each unit $255.80 $255.80 $255.80 $797.40
Red blood cells washed each unit $396.87 $396.87 $396.87 $665.40
Red cell mass multiple $538.27 $538.27 $538.27 $538.27
Red cell mass single $401.83 $401.83 $401.83 $401.83
Red cell sequestration $401.83 $401.83 $401.83 $2,616.00
Red cell survival study $401.83 $401.83 $401.83 $401.83
Redo endovas vena cava filtr $3,147.50 $3,147.50 $3,147.50 $3,147.50
Reduce testis torsion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Reduction of facial bones $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reduction of procidentia 45900 $911.71 $911.71 $911.71 $1,067.25
Refill maint impl spine pump $295.19 $295.19 $295.19 $352.50
Refill/maint pump/resvr syst $210.69 $210.69 $210.69 $423.60
Reinforce clavicle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Reinforce eye wall $2,332.96 $2,332.96 $2,332.96 $2,332.96
Reinforce shoulder bones $12,866.82 $12,866.82 $12,866.82 $12,866.82
Reinforce tibia $7,143.73 $7,143.73 $7,143.73 $7,143.73
Reinforce/graft eye wall $4,022.86 $4,022.86 $4,022.86 $4,022.86
Reinnervate larynx $5,915.66 $5,915.66 $5,915.66 $5,915.66
Reinsert ocular implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Release encircling material $4,022.86 $4,022.86 $4,022.86 $4,022.86
Release eye tissue $2,332.96 $2,332.96 $2,332.96 $2,332.96
Release facial nerve $5,915.66 $5,915.66 $5,915.66 $5,915.66
Release facial nerve $5,915.66 $5,915.66 $5,915.66 $5,915.66
Release facial nerve $5,915.66 $5,915.66 $5,915.66 $5,915.66
Release finger contracture $1,600.41 $1,600.41 $1,600.41 $1,600.41
Release forearm/hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release inner ear canal $5,915.66 $5,915.66 $5,915.66 $5,915.66
Release knuckle contracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release middle ear bone $3,243.07 $3,243.07 $3,243.07 $3,243.07
Release muscles of hand $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release of eye fluid $2,280.73 $2,280.73 $2,280.73 $2,280.73
Release of foot tendon $1,600.41 $1,600.41 $1,600.41 $1,600.41
Release of foot tendon 28225 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release of foot tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release of foot tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release of lower leg tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release of lower leg tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release of midfoot joint $1,600.41 $1,600.41 $1,600.41 $1,600.41
Release of midfoot joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release of shoulder ligament $7,143.73 $7,143.73 $7,143.73 $7,143.73
Release palm & finger tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release palm contracture $1,600.41 $1,600.41 $1,600.41 $1,600.41
Release palm contracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release palm contracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release palm contracture 26045 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release palm/finger tendon $1,600.41 $1,600.41 $1,600.41 $1,600.41
Release thumb contracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Release wrist/forearm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Relieve bladder contracture $3,448.97 $3,448.97 $3,448.97 $3,448.97
Relocation of testis(es) $3,448.97 $3,448.97 $3,448.97 $3,448.97
Relocation skin pocket aicd $1,829.23 $1,829.23 $1,829.23 $3,513.00
Relocation skin pocket pm $1,829.23 $1,829.23 $1,829.23 $2,504.40
Rem endovas vena cava filter $3,147.50 $3,147.50 $3,147.50 $5,661.75
Rem interrog dev eval icpms $37.29 $37.29 $37.29 $109.50
Rem interrog dev eval scrms $37.29 $37.29 $37.29 $109.50
Rem interrog evl pm/ids $37.29 $37.29 $37.29 $189.00
Rem mntr physiol 1st dev supply ea 30 days $37.29 $37.29 $37.29 $84.00
Rem mntr physiol 1st set up pt educaj eqp $128.87 $128.87 $128.87 $115.80
Rem mntr wrls p-art prs snr $37.29 $37.29 $37.29 $37.29
Rem/biv cast full arm/leg $265.58 $265.58 $265.58 $441.00
Rem/biv cast shldr/hip spica $265.58 $265.58 $265.58 $265.58
Remdesivir 100 mg intravenous powder for solution $6.73 $6.73 $6.73 $16.80
Remote 30 day ecg tech supp $311.40 $311.40 $311.40 $1,414.20
Remov/replc penis pros comp $20,128.56 $20,128.56 $20,128.56 $20,128.56
Removal anal seton other marker 46030 $1,179.08 $1,179.08 $1,179.08 $1,179.08
Removal biliary drg cath $937.56 $937.56 $937.56 $1,398.75
Removal central venous catheter tunneled without port/pump $618.26 $618.26 $618.26 $2,172.00
Removal central venous device tunneled w/port/pump central/peripheral insertion $1,553.44 $1,553.44 $1,553.44 $2,838.00
Removal cerclage w/anes $3,179.53 $3,179.53 $3,179.53 $3,179.53
Removal cerclage without anes $201.17 $201.17 $201.17 $722.40
Removal cerumen impacted (both sides) $59.40 $59.40 $59.40 $168.00
Removal clot in graft oth/thn 35875 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Removal clot in graft xcp 35876 $5,405.70 $5,405.70 $5,405.70 $5,270.25
Removal devitalized tissue non-selective debridement without anesthesia per session $198.70 $198.70 $198.70 $276.00
Removal embedded foreign body vestibule mouth smpl $937.56 $937.56 $937.56 $937.56
Removal foreign body extrn auditory canal with anes $1,620.24 $1,620.24 $1,620.24 $1,620.24
Removal foreign body foot cmplx $1,620.24 $1,620.24 $1,620.24 $1,957.50
Removal foreign body foot subcutaneous right $703.59 $703.59 $703.59 $873.00
Removal foreign body gum 41805 $1,481.28 $1,481.28 $1,481.28 $1,692.75
Removal foreign body jawbone $1,481.28 $1,481.28 $1,481.28 $1,481.28
Removal foreign body mouth $509.25 $509.25 $509.25 $509.25
Removal implant from finger/hand 26320 $1,620.24 $1,620.24 $1,620.24 $1,620.24
Removal implant superficial separate procedure $1,620.24 $1,620.24 $1,620.24 $3,355.20
Removal mamma implant mat 19330 $3,829.28 $3,829.28 $3,829.28 $3,262.20
Removal neck/armpit lesion $3,829.28 $3,829.28 $3,829.28 $3,829.28
Removal neck/armpit lesion 38555 $6,521.46 $6,521.46 $6,521.46 $6,521.46
Removal of adenoids $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of adenoids $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of adenoids $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of adenoids <12yrs 42835 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of anal fissure $2,742.39 $2,742.39 $2,742.39 $2,742.39
Removal of anal tags $2,742.39 $2,742.39 $2,742.39 $3,128.40
Removal of ankle bone $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of ankle implant $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of ankle/heel lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of arm artery clot 34111 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Removal of artery clot 34101 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Removal of bladder lesion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of bladder stone $5,083.62 $5,083.62 $5,083.62 $5,083.62
Removal of bone for graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of bone for graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of bone lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of bone lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of bone lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of breast lesion $3,829.28 $3,829.28 $3,829.28 $3,704.25
Removal of brow wrinkles $3,660.97 $3,660.97 $3,660.97 $3,660.97
Removal of calcium deposits $2,862.05 $2,862.05 $2,862.05 $2,862.05
Removal of epididymis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of epididymis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of ethmoid sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of ethmoid sinus $1,481.28 $1,481.28 $1,481.28 $1,481.28
Removal of external ear $5,915.66 $5,915.66 $5,915.66 $5,288.40
Removal of eye $3,771.00 $3,771.00 $3,771.00 $3,771.00
Removal of eye $3,771.00 $3,771.00 $3,771.00 $3,771.00
Removal of eye lesion $2,332.96 $2,332.96 $2,332.96 $2,332.96
Removal of eye lesion $2,332.96 $2,332.96 $2,332.96 $2,332.96
Removal of eye lesion $968.54 $968.54 $968.54 $968.54
Removal of face wrinkles $3,660.97 $3,660.97 $3,660.97 $3,660.97
Removal of fascia for graft $1,829.23 $1,829.23 $1,829.23 $1,829.23
Removal of fascia for graft $1,829.23 $1,829.23 $1,829.23 $1,829.23
Removal of finger lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Removal of finger tendon $1,600.41 $1,600.41 $1,600.41 $1,600.41
Removal of foot fascia $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of foot joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of foot joint lining $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of foot lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of foot lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Removal of foot lesion $1,600.41 $1,600.41 $1,600.41 $644.40
Removal of forearm lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of forehead wrinkles $1,829.23 $1,829.23 $1,829.23 $1,829.23
Removal of foreign body $2,862.05 $2,862.05 $2,862.05 $2,862.05
Removal of frontal sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of frontal sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of frontal sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of frontal sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of frontal sinus $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of frontal sinus 31085 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of gum tissue $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of head of humerus $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of heel bone $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of heel spur $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of hip foreign body 27087 $3,244.61 $3,244.61 $3,244.61 $4,678.80
Removal of humerus lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of humerus lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of humerus lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of hydrocele $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of hydrocele $3,529.06 $3,529.06 $3,529.06 $3,529.06
Removal of hydroceles $3,529.06 $3,529.06 $3,529.06 $3,529.06
Removal of implant deep $2,862.05 $2,862.05 $2,862.05 $2,862.05
Removal of infusion pump $3,639.30 $3,639.30 $3,639.30 $3,639.30
Removal of inner eye fluid $4,022.86 $4,022.86 $4,022.86 $4,022.86
Removal of inner eye lesion $548.60 $548.60 $548.60 $548.60
Removal of intranasal lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of intranasal lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of iris $2,280.73 $2,280.73 $2,280.73 $2,280.73
Removal of iris $2,280.73 $2,280.73 $2,280.73 $2,280.73
Removal of iris $2,280.73 $2,280.73 $2,280.73 $2,280.73
Removal of iris $2,280.73 $2,280.73 $2,280.73 $2,280.73
Removal of ischial bursa $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of jaw bone lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of jaw joint $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of knee cartilage $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of knee cartilage $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of knee cyst $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of kneecap $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of kneecap bursa $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of larynx lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of larynx lesion 31512 $3,686.95 $3,686.95 $3,686.95 $3,686.95
Removal of lens lesion $2,280.73 $2,280.73 $2,280.73 $2,280.73
Removal of lens material $2,280.73 $2,280.73 $2,280.73 $2,280.73
Removal of lens material $4,022.86 $4,022.86 $4,022.86 $4,022.86
Removal of lens material $2,280.73 $2,280.73 $2,280.73 $2,280.73
Removal of lymph nodes neck $6,521.46 $6,521.46 $6,521.46 $6,521.46
Removal of metatarsal $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of metatarsal heads $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of neck wrinkles $3,660.97 $3,660.97 $3,660.97 $3,660.97
Removal of nerve lesion $1,952.77 $1,952.77 $1,952.77 $1,952.77
Removal of nerve lesion $6,404.07 $6,404.07 $6,404.07 $6,404.07
Removal of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of nose lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of nose lesion $1,481.28 $1,481.28 $1,481.28 $1,481.28
Removal of nose polyp(s) 30115 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of ocular implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Removal of palm tendon each $1,600.41 $1,600.41 $1,600.41 $1,600.41
Removal of salivary stone $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of salivary stone 42335 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Removal of scrotum $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of scrotum lesion $2,048.51 $2,048.51 $2,048.51 $2,048.51
Removal of sesamoid bone $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of shunt $3,147.50 $3,147.50 $3,147.50 $3,147.50
Removal of skin wrinkles $3,660.97 $3,660.97 $3,660.97 $3,660.97
Removal of sperm cord lesion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of spinal shunt $1,952.77 $1,952.77 $1,952.77 $1,952.77
Removal of suture from anus 46754 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Removal of tail bone $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of tear gland $3,771.00 $3,771.00 $3,771.00 $3,771.00
Removal of tear sac $3,771.00 $3,771.00 $3,771.00 $3,771.00
Removal of tendon for graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Removal of tendon lesion $3,244.61 $3,244.61 $3,244.61 $639.60
Removal of testis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of testis $3,529.06 $3,529.06 $3,529.06 $3,529.06
Removal of thyroid $5,915.66 $5,915.66 $5,915.66 $3,475.80
Removal of thyroid $5,834.36 $5,834.36 $5,834.36 $1,246.20
Removal of thyroid $5,915.66 $5,915.66 $5,915.66 $5,915.66
Removal of toe lesions $1,600.41 $1,600.41 $1,600.41 $476.40
Removal of toe lesions $1,600.41 $1,600.41 $1,600.41 $1,600.41
Removal of ureter stone $2,048.51 $2,048.51 $2,048.51 $2,048.51
Removal of urethra $5,083.62 $5,083.62 $5,083.62 $5,083.62
Removal of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of urethra gland $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of urethra gland $3,448.97 $3,448.97 $3,448.97 $3,448.97
Removal of urethra lesion $5,083.62 $5,083.62 $5,083.62 $5,083.62
Removal of urethra lesion $5,083.62 $5,083.62 $5,083.62 $5,083.62
Removal of vein clot $3,147.50 $3,147.50 $3,147.50 $3,147.50
Removal of vein clot $618.26 $618.26 $618.26 $618.26
Removal of vein clot 34490 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Removal of wrist bone $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of wrist bones $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of wrist lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of wrist prosthesis $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal of wrist prosthesis $1,600.41 $1,600.41 $1,600.41 $1,600.41
Removal prosth radial head $3,244.61 $3,244.61 $3,244.61 $3,244.61
Removal skin tags fibrocutaneous any area <= 15 lesions $198.70 $198.70 $198.70 $471.00
Removal sutr/staple req anes $1,829.23 $1,829.23 $1,829.23 $3,784.80
Removal tunnled intprtnl cath $3,147.50 $3,147.50 $3,147.50 $3,209.40
Removal w/reinsrt nonbiogrdble $399.04 $399.04 $399.04 $2,805.00
Removal/replacement ppm generator dual lead system $10,465.33 $10,465.33 $10,465.33 $10,465.33
Remove & graft wrist lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove & graft wrist lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove anal fist complex $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove anal fist inter $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove anal fist subq $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove ankle joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove ankle joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove armpit lymph nodes $5,834.36 $5,834.36 $5,834.36 $5,834.36
Remove bladder stone $3,448.97 $3,448.97 $3,448.97 $3,448.97
Remove bladder stone $3,448.97 $3,448.97 $3,448.97 $3,368.25
Remove blood clot from eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Remove brain canal fluid $295.19 $295.19 $295.19 $295.19
Remove cartilage for graft $3,660.97 $3,660.97 $3,660.97 $3,660.97
Remove cartilage for graft $612.13 $612.13 $612.13 $612.13
Remove collar bone lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove coronoid process $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove cranial cavity fluid $692.52 $692.52 $692.52 $692.52
Remove digit nerve lesion 64776 $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove drug implant $399.04 $399.04 $399.04 $399.04
Remove ear canal lesion(s) $2,862.05 $2,862.05 $2,862.05 $2,862.05
Remove ear canal lesion(s) 69140 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove epididymis lesion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Remove epididymis lesion $2,048.51 $2,048.51 $2,048.51 $2,048.51
Remove exostosis maxilla $3,243.07 $3,243.07 $3,243.07 $3,243.07
Remove ext hem groups 2+ $2,742.39 $2,742.39 $2,742.39 $3,552.60
Remove eye implant material $2,280.73 $2,280.73 $2,280.73 $2,280.73
Remove eye implant material $2,280.73 $2,280.73 $2,280.73 $2,280.73
Remove eye lesion $2,332.96 $2,332.96 $2,332.96 $2,332.96
Remove eye lesion $2,280.73 $2,280.73 $2,280.73 $2,280.73
Remove eye/attach implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Remove eye/insert implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Remove eye/revise socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Remove eye/revise socket $3,771.00 $3,771.00 $3,771.00 $3,771.00
Remove eyelid lesion $968.54 $968.54 $968.54 $968.54
Remove eyelid lesion $298.93 $298.93 $298.93 $298.93
Remove eyelid lesion(s) $2,332.96 $2,332.96 $2,332.96 $2,332.96
Remove eyelid lesions $968.54 $968.54 $968.54 $968.54
Remove eyelid lesions $298.93 $298.93 $298.93 $298.93
Remove femur lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove femur lesion/bursa $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove femur lesion/graft $12,866.82 $12,866.82 $12,866.82 $12,866.82
Remove femur lesion/graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove finger bone $1,600.41 $1,600.41 $1,600.41 $1,600.41
Remove forearm bone lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove foreign body from eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Remove foreign body from eye $2,280.73 $2,280.73 $2,280.73 $3,769.20
Remove foreign body from eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Remove gastric port open 43887 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Remove groin lymph nodes $6,521.46 $6,521.46 $6,521.46 $6,521.46
Remove hand bone lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Remove hip bone les deep $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove hip bone les super $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove hip foreign body 27086 $2,862.05 $2,862.05 $2,862.05 $417.75
Remove hip/pelvis lesion 27047 $2,862.05 $2,862.05 $2,862.05 $2,790.00
Remove humerus lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove humerus lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove implant of eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Remove in/ex hem groups 2+ $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove in/ex hem grp & fiss 46257 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove in/ex hem grp w/fistu $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove in/ex hem grps & fiss $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove in/ex hem grps w/fist $2,742.39 $2,742.39 $2,742.39 $2,742.39
Remove inner ear $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove inner ear & mastoid $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove inner ear lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove int/ext hem 1 group $2,742.39 $2,742.39 $2,742.39 $922.20
Remove intact mammary implant $3,829.28 $3,829.28 $3,829.28 $3,829.28
Remove iris and lesion $4,022.86 $4,022.86 $4,022.86 $4,022.86
Remove jaw joint cartilage $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove knee cyst $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove knee joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove knee joint lining $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove lamina/facets lumbar $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove limb nerve lesion $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove lower leg bone lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove mandible cyst complex $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove mastoid air cells $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove mastoid structures $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove maxilla cyst complex $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove middle ear nerve $3,243.07 $3,243.07 $3,243.07 $3,243.07
Remove muti-comp penis pros $3,448.97 $3,448.97 $3,448.97 $3,448.97
Remove nasal foreign body $1,481.28 $1,481.28 $1,481.28 $1,481.28
Remove nasal foreign body $3,243.07 $3,243.07 $3,243.07 $3,243.07
Remove nerve lesion $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove part lumbar vertebra $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove part of neck vertebra $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove pilonidal cyst compl $2,862.05 $2,862.05 $2,862.05 $1,492.20
Remove pilonidal cyst exten $2,862.05 $2,862.05 $2,862.05 $2,862.05
Remove prostate regrowth $5,083.62 $5,083.62 $5,083.62 $5,083.62
Remove renal tube w/fluoro $667.47 $667.47 $667.47 $1,830.00
Remove sacrum pressure sore close 15936 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Remove sacrum pressure sore ostc 15937 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Remove sciatic nerve lesion $6,404.07 $6,404.07 $6,404.07 $6,404.07
Remove self-contd penis pros $3,448.97 $3,448.97 $3,448.97 $3,448.97
Remove shoulder blade lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove shoulder fb deep $2,862.05 $2,862.05 $2,862.05 $2,862.05
Remove shoulder foreign body subq 23330 $1,620.24 $1,620.24 $1,620.24 $1,566.00
Remove skin nerve lesion $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove skin nerve lesion 64788 $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove sperm pouch lesion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Remove spinal canal catheter 62355 $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove spinal cord lesion $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove spine eltrd perq aray $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove spine eltrd plate $3,439.01 $3,439.01 $3,439.01 $3,439.01
Remove spine infusion device $6,404.07 $6,404.07 $6,404.07 $6,404.07
Remove spine lamieieiotina >2 crvcl 63015 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove spine lamina 1/2 crvl $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove spine lamina 1/2 lmbr $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove spine lamina 1/2 scrl $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove spine lamina 1/2 thrc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove spine lamina >2 lmbr $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove spine lamina >2 thrc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove stent via transureth $2,048.51 $2,048.51 $2,048.51 $2,048.51
Remove sympathetic nerves $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove sympathetic nerves $1,952.77 $1,952.77 $1,952.77 $1,952.77
Remove sympathetic nerves $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove tear gland lesion $2,332.96 $2,332.96 $2,332.96 $2,332.96
Remove tear gland lesion $3,771.00 $3,771.00 $3,771.00 $3,771.00
Remove thyroid duct lesion $5,834.36 $5,834.36 $5,834.36 $5,834.36
Remove thyroid duct lesion $5,834.36 $5,834.36 $5,834.36 $5,834.36
Remove thyroid lesion 60200 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Remove tonsils and adenoids $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove tonsils and adenoids $3,243.07 $3,243.07 $3,243.07 $3,243.07
Remove ureter calculus $3,448.97 $3,448.97 $3,448.97 $3,448.97
Remove ureter stent percut $2,048.51 $2,048.51 $2,048.51 $6,318.00
Remove uro sphincter $5,083.62 $5,083.62 $5,083.62 $5,083.62
Remove vagina tissue part $3,179.53 $3,179.53 $3,179.53 $3,179.53
Remove vaginal foreign body 57415 $3,179.53 $3,179.53 $3,179.53 $3,308.25
Remove vagus n eltrd $6,404.07 $6,404.07 $6,404.07 $6,404.07
Remove vc lesion scope/graft $6,922.47 $6,922.47 $6,922.47 $6,922.47
Remove vc lesion w/scope 31545 $3,686.95 $3,686.95 $3,686.95 $3,686.95
Remove ventilating tube $3,243.07 $3,243.07 $3,243.07 $3,243.07
Remove w insert drug implant $399.04 $399.04 $399.04 $399.04
Remove windpipe lesion $5,915.66 $5,915.66 $5,915.66 $5,915.66
Remove wrist joint cartilage $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove wrist joint implant $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove wrist joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove wrist joint lining $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove wrist tendon lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Remove wrist tendon lesion $1,600.41 $1,600.41 $1,600.41 $817.80
Remove wrist/forearm lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Remove wrist/forearm lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove/graft bone lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove/graft finger lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove/graft foot lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove/graft foot lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove/graft foot lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove/graft forearm lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Remove/graft forearm lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Remove/graft hip bone lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove/graft leg bone lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove/graft leg bone lesion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remove/repair hearing aid $3,243.07 $3,243.07 $3,243.07 $3,243.07
Remove/replace penis prosth $20,128.56 $20,128.56 $20,128.56 $20,128.56
Remove/replace ur sphincter $20,128.56 $20,128.56 $20,128.56 $20,128.56
Remove/revise male sling $5,083.62 $5,083.62 $5,083.62 $5,083.62
Remove/transplant tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Remv/repl penis contain pros $20,128.56 $20,128.56 $20,128.56 $20,128.56
Remv/replc penis pros compl $12,992.42 $12,992.42 $12,992.42 $12,992.42
Remvl peritoneal fb frm cavity $3,529.06 $3,529.06 $3,529.06 $3,529.06
Renal abscess open drng 50020 $2,048.51 $2,048.51 $2,048.51 $2,048.51
Renal cyst study s&i $548.30 $548.30 $548.30 $0.60
Renal endoscopy 50572 $667.47 $667.47 $667.47 $667.47
Renal function panel $8.68 $8.68 $8.68 $156.00
Renal scope w/tumor resect $9,247.15 $9,247.15 $9,247.15 $9,247.15
Renal venogram bil s&i $3,147.50 $3,147.50 $3,147.50 $2,859.75
Reopen fallopian tube $4,936.45 $4,936.45 $4,936.45 $4,936.45
Repair achilles tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair anal fistula $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair anorectal fist w/plug $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair arm/leg nerve $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair av fistula ext 35190 $5,405.70 $5,405.70 $5,405.70 $8,080.20
Repair biceps tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair bladder & vagina $7,394.81 $7,394.81 $7,394.81 $7,394.81
Repair bladder defect $4,936.45 $4,936.45 $4,936.45 $4,936.45
Repair bladder neck $4,936.45 $4,936.45 $4,936.45 $4,936.45
Repair bladder-vagina lesion $7,394.81 $7,394.81 $7,394.81 $7,394.81
Repair bladder-vagina lesion $4,936.45 $4,936.45 $4,936.45 $4,936.45
Repair blood ves direct neck 35201 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Repair blood vessel dir lower extr $703.59 $703.59 $703.59 $1,582.20
Repair blood vessel dir upper extr $3,147.50 $3,147.50 $3,147.50 $3,147.50
Repair blood vessel direct hand finger $3,147.50 $3,147.50 $3,147.50 $7,133.40
Repair blood vessel lesion $1,553.44 $1,553.44 $1,553.44 $1,553.44
Repair blood vessel lesion $5,405.70 $5,405.70 $5,405.70 $5,405.70
Repair blood vessel lesion $3,147.50 $3,147.50 $3,147.50 $3,147.50
Repair blood vessel lesion $3,147.50 $3,147.50 $3,147.50 $3,147.50
Repair blood vessel lesion $5,405.70 $5,405.70 $5,405.70 $5,405.70
Repair blood vessel w/graft lower extremity 35286 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Repair blood vessel w/vein graft lower extremity 35256 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Repair brow defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair carpal bone shorten $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair cleft hand $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair cleft lip/nasal $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair cleft lip/nasal $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair cleft lip/nasal $3,243.07 $3,243.07 $3,243.07 $3,243.07
Repair cleft lip/nasal $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair cleft lip/nasal $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm $612.13 $612.13 $612.13 $2,172.00
Repair corporeal tear $3,448.97 $3,448.97 $3,448.97 $3,448.97
Repair defect arm art 35045 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Repair defect of artery 35011 $5,405.70 $5,405.70 $5,405.70 $2,715.60
Repair deformity of toe $3,244.61 $3,244.61 $3,244.61 $624.60
Repair degenerated kneecap $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair dental ellis ii fx $232.22 $232.22 $232.22 $232.22
Repair detached retina $2,280.73 $2,280.73 $2,280.73 $2,280.73
Repair detached retina $4,022.86 $4,022.86 $4,022.86 $4,022.86
Repair detached retina $4,022.86 $4,022.86 $4,022.86 $4,022.86
Repair detached retina crtx $2,280.73 $2,280.73 $2,280.73 $2,280.73
Repair detached retina pc $548.60 $548.60 $548.60 $666.75
Repair eardrum structures $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair elbow deb/attch open $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair elbow perc $3,244.61 $3,244.61 $3,244.61 $3,752.25
Repair elbow w/deb open $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair esophagus opening $3,243.07 $3,243.07 $3,243.07 $3,243.07
Repair extns tendon finger without grft ea $1,600.41 $1,600.41 $1,600.41 $5,324.40
Repair extra toe(s) $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $3,771.00 $3,771.00 $3,771.00 $3,771.00
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $3,771.00 $3,771.00 $3,771.00 $3,771.00
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair eyelid wound $2,332.96 $2,332.96 $2,332.96 $2,473.50
Repair eyelid wound $2,332.96 $2,332.96 $2,332.96 $2,675.25
Repair facial nerve $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair facial nerve $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair fibula nonunion $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair finger deformity $1,600.41 $1,600.41 $1,600.41 $1,600.41
Repair finger tendon $3,244.61 $3,244.61 $3,244.61 $3,126.75
Repair finger/hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair finger/hand tendon $3,244.61 $3,244.61 $3,244.61 $3,430.80
Repair finger/hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair finger/hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair finger/hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair finger/hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair foot dislocation $7,143.73 $7,143.73 $7,143.73 $5,152.80
Repair foot dislocation $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair foot dislocation $7,143.73 $7,143.73 $7,143.73 $5,152.80
Repair forearm tendon sheath $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair forearm tendon/muscle $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair forearm tendon/muscle $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair forearm tendon/muscle $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair forearm tendon/muscle sec 25263 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair hand joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair hand joint with graft $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair hand joint with graft $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair humerus with graft $12,866.82 $12,866.82 $12,866.82 $6,347.40
Repair ing hernia sliding $3,529.06 $3,529.06 $3,529.06 $1,504.20
Repair iris & ciliary body $2,280.73 $2,280.73 $2,280.73 $2,280.73
Repair iris & ciliary body $2,280.73 $2,280.73 $2,280.73 $2,280.73
Repair lac palate<2 cm $509.25 $509.25 $509.25 $509.25
Repair leg fascia defect $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair lip full thkns =<one-half vert height $509.25 $509.25 $509.25 $1,080.75
Repair lip full thkns >one-half vert height/cmplx $1,481.28 $1,481.28 $1,481.28 $2,046.00
Repair lower leg epiphyses $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair lower leg tendons $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair lower leg tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair lumbar hernia $5,834.36 $5,834.36 $5,834.36 $5,834.36
Repair middle ear structures $3,243.07 $3,243.07 $3,243.07 $3,243.07
Repair middle ear structures $3,243.07 $3,243.07 $3,243.07 $3,243.07
Repair multi-comp penis pros $5,083.62 $5,083.62 $5,083.62 $5,083.62
Repair muscles of hand $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair nasal septum defect $3,243.07 $3,243.07 $3,243.07 $3,243.07
Repair nasal stenosis $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair nonunion carpal bone $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair nonunion hand $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair nose to lip fistula $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair of achilles tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of anal sphincter $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair of anal sphincter $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair of anal stricture $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair of ankle ligament $7,143.73 $7,143.73 $7,143.73 $4,493.40
Repair of ankle ligament $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of ankle ligaments $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of arm nerves $1,952.77 $1,952.77 $1,952.77 $1,952.77
Repair of bladder opening $3,448.97 $3,448.97 $3,448.97 $619.20
Repair of body cast $157.79 $157.79 $157.79 $157.79
Repair of circumcision $2,048.51 $2,048.51 $2,048.51 $2,048.51
Repair of digit nerve hand/foot 1 nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Repair of enterocele vaginal approach 57268 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Repair of eye socket wound $3,771.00 $3,771.00 $3,771.00 $3,771.00
Repair of eye wound $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair of eye wound $2,280.73 $2,280.73 $2,280.73 $5,442.60
Repair of eye wound $3,771.00 $3,771.00 $3,771.00 $6,308.40
Repair of eye wound $5,159.71 $5,159.71 $5,159.71 $5,159.71
Repair of eye wound $2,332.96 $2,332.96 $2,332.96 $4,080.00
Repair of eye wound $5,159.71 $5,159.71 $5,159.71 $5,322.00
Repair of facial nerve $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair of facial nerve $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair of fibula epiphysis $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of foot bones $12,866.82 $12,866.82 $12,866.82 $12,866.82
Repair of foot tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of hand or foot nerve $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair of hand or foot nerve $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair of humerus $12,866.82 $12,866.82 $12,866.82 $5,152.80
Repair of hydrocele 55060 $3,448.97 $3,448.97 $3,448.97 $3,448.97
Repair of knee cartilage $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of knee ligament $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of knee ligament $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of knee ligaments $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of kneecap tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of leg epiphyses $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of leg epiphyses $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of leg nerve $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair of leg tendon each $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of leg tendon each $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of leg tendon each $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of low back nerves $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair of metatarsals $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of nasal septum $3,243.07 $3,243.07 $3,243.07 $3,243.07
Repair of penis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Repair of rectocele 45560 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair of rectum $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair of rectum $2,742.39 $2,742.39 $2,742.39 $2,742.39
Repair of ruptured tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of shoulder $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of sperm duct $3,448.97 $3,448.97 $3,448.97 $3,448.97
Repair of thigh muscle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of tibia $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair of tibia epiphysis $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of toe dislocation $3,244.61 $3,244.61 $3,244.61 $3,126.75
Repair of ulnar motor nerve 64836 $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repair of urethra defect $5,083.62 $5,083.62 $5,083.62 $5,083.62
Repair of urethra defect $3,448.97 $3,448.97 $3,448.97 $3,448.97
Repair of urethra injury $5,083.62 $5,083.62 $5,083.62 $5,083.62
Repair of urethra injury $5,083.62 $5,083.62 $5,083.62 $5,083.62
Repair of urethra injury $5,083.62 $5,083.62 $5,083.62 $5,083.62
Repair of urethra injury 53502 $3,448.97 $3,448.97 $3,448.97 $3,448.97
Repair of urethral lesion $3,179.53 $3,179.53 $3,179.53 $3,179.53
Repair of web finger $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of web finger $1,600.41 $1,600.41 $1,600.41 $1,600.41
Repair of web finger $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair of windpipe $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair of windpipe $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair of windpipe defect $3,243.07 $3,243.07 $3,243.07 $3,243.07
Repair oronasal fistula 30600 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair palate $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair palate $5,915.66 $5,915.66 $5,915.66 $4,334.40
Repair palate pharynx/uvula $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair paravag defect lap $10,411.22 $10,411.22 $10,411.22 $10,411.22
Repair paravag defect vag 57285 $7,394.81 $7,394.81 $7,394.81 $7,394.81
Repair penis $2,048.51 $2,048.51 $2,048.51 $2,048.51
Repair penis $2,048.51 $2,048.51 $2,048.51 $2,048.51
Repair pm/icd lead dual $3,639.30 $3,639.30 $3,639.30 $3,691.50
Repair pm/icd lead sgl $3,639.30 $3,639.30 $3,639.30 $3,639.30
Repair radius & ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair radius or ulna $7,143.73 $7,143.73 $7,143.73 $5,667.60
Repair rectum & vagina $4,936.45 $4,936.45 $4,936.45 $4,936.45
Repair rectum-vagina fistula $3,179.53 $3,179.53 $3,179.53 $3,179.53
Repair recur fem hernia reduce 49555 $3,529.06 $3,529.06 $3,529.06 $3,529.06
Repair retinal detach cplx $5,159.71 $5,159.71 $5,159.71 $5,159.71
Repair rotator cuff acute $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair rotator cuff chronic $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx $232.22 $232.22 $232.22 $2,260.20
Repair rpr lip full thickness vermilion only $509.25 $509.25 $509.25 $2,097.00
Repair salivary duct $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair salivary duct $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair sciatic nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Repair shoulder capsule $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair shoulder capsule $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair shoulder capsule $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair shoulder capsule $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair shoulder capsule $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair shoulder capsule $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair stern/nuss without scope $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair sternum/nuss w/scope $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair stomach opening $3,804.53 $3,804.53 $3,804.53 $3,709.50
Repair tear ducts $2,332.96 $2,332.96 $2,332.96 $2,332.96
Repair tendon extensor foot 1/2 each tendon $3,244.61 $3,244.61 $3,244.61 $4,561.20
Repair tendon/muscle forearm/wrist prime sngl ea $3,244.61 $3,244.61 $3,244.61 $5,322.00
Repair testis injury $3,448.97 $3,448.97 $3,448.97 $3,448.97
Repair throat wound $1,481.28 $1,481.28 $1,481.28 $1,481.28
Repair toe dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair tongue lac <2.5cm past 1/3 tongue 41251 $232.22 $232.22 $232.22 $232.22
Repair umbilical lesion $3,529.06 $3,529.06 $3,529.06 $3,529.06
Repair upper arm/elbow tendon/muscle ea $7,143.73 $7,143.73 $7,143.73 $6,880.20
Repair upper jaw fistula $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair urethrovaginal lesion 57310 $7,394.81 $7,394.81 $7,394.81 $7,394.81
Repair uro sphincter $9,247.15 $9,247.15 $9,247.15 $9,247.15
Repair vagina $4,936.45 $4,936.45 $4,936.45 $4,936.45
Repair vagina/perineum $3,179.53 $3,179.53 $3,179.53 $3,179.53
Repair valve femoral vein $5,405.70 $5,405.70 $5,405.70 $5,405.70
Repair webbed toe(s) $1,600.41 $1,600.41 $1,600.41 $1,600.41
Repair windpipe opening $5,915.66 $5,915.66 $5,915.66 $5,915.66
Repair/graft achilles tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft eye lesion $5,159.71 $5,159.71 $5,159.71 $5,159.71
Repair/graft finger tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair/graft finger tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair/graft finger tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair/graft hand tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft hand tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair/graft hand tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft hand tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft kneecap tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft of foot tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft of foot tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft of thigh muscle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft of tibia $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft radius & ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repair/graft radius & ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft radius or ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft radius or ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/graft wrist bone $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/revise wrist joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repair/transpose mp nerve 64856 $6,404.07 $6,404.07 $6,404.07 $6,404.07
Repeat thyroid surgery $5,915.66 $5,915.66 $5,915.66 $2,567.40
Replace duod/jej tube perc $937.56 $937.56 $937.56 $2,618.40
Replace elbow joint $18,390.05 $18,390.05 $18,390.05 $18,390.05
Replace eye fluid $2,280.73 $2,280.73 $2,280.73 $2,280.73
Replace g-j tube perc $937.56 $937.56 $937.56 $3,105.00
Replace g/c tube perc $937.56 $937.56 $937.56 $2,695.80
Replace picvad cath $3,147.50 $3,147.50 $3,147.50 $3,903.00
Replace tissue expander w/perm prost 11970 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Replace tunneled cv cath $3,147.50 $3,147.50 $3,147.50 $4,001.25
Replace/irrigate catheter $6,404.07 $6,404.07 $6,404.07 $6,404.07
Replace/irrigate catheter $1,952.77 $1,952.77 $1,952.77 $1,952.77
Replace/revise brain shunt $6,404.07 $6,404.07 $6,404.07 $5,543.40
Replacement of contact lens $59.40 $59.40 $59.40 $59.40
Replacment pt electronic sys $1,017.39 $1,017.39 $1,017.39 $1,017.39
Replantation digit complete $1,600.41 $1,600.41 $1,600.41 $1,600.41
Repos lv lead pm/icd $3,147.50 $3,147.50 $3,147.50 $3,322.50
Repos sq defib eltrd $3,639.30 $3,639.30 $3,639.30 $4,831.80
Reposg phrnc nrv stim trnsvn $3,439.01 $3,439.01 $3,439.01 $3,353.25
Reposition intraocular lens $2,280.73 $2,280.73 $2,280.73 $2,280.73
Reposition pm/icd lead $3,147.50 $3,147.50 $3,147.50 $3,780.00
Repr elbow lat ligmnt w/tiss $3,244.61 $3,244.61 $3,244.61 $3,244.61
Repr elbw med ligmnt w/tissu $7,143.73 $7,143.73 $7,143.73 $7,143.73
Repr of anal fistula w/glue $2,742.39 $2,742.39 $2,742.39 $2,742.39
Reprogram cochlear implt 7/> $156.46 $156.46 $156.46 $156.46
Reprogram cochlear implt <7 $156.46 $156.46 $156.46 $156.46
Reptilase test $9.85 $9.85 $9.85 $87.60
Reremove wrist tendon lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Rerepair fem hernia blocked $3,529.06 $3,529.06 $3,529.06 $3,529.06
Rerepair ing hernia blocked $6,239.75 $6,239.75 $6,239.75 $5,185.20
Rerepair ing hernia reduce $3,529.06 $3,529.06 $3,529.06 $7,126.80
Resect back tum 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect back tum < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect condyle distal phalanx ea toe 28153 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect distal finger tumor $1,600.41 $1,600.41 $1,600.41 $1,600.41
Resect enlarged toe $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect enlarged toe tissue $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect face/scalp tum 2 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect face/scalp tum < 2 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect foot/toe tumor 3 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect forarm/wrist tum 3cm> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect forearm/wrist tum<3cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect hip/pelv tum 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect hip/pelv tum < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect inferior turbinate $3,243.07 $3,243.07 $3,243.07 $3,243.07
Resect leg/ankle tum 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect leg/ankle tum < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect metatarsal tumor $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect neck tumor 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect part/compl phalangeal base ea 28126 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect phalanx of toe tumor $1,600.41 $1,600.41 $1,600.41 $1,600.41
Resect prox finger tumor $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect radius/ulnar tumor $7,143.73 $7,143.73 $7,143.73 $7,143.73
Resect talus/calcaneus tum $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect tarsal tumor $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resect thigh/knee tum 5 cm/> $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resect thigh/knee tum < 5 cm $2,862.05 $2,862.05 $2,862.05 $2,862.05
Resection of elbow joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Resection palate/lesion 42120 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Resin three surfaces-anterio $1,662.63 $1,662.63 $1,662.63 $1,662.63
Reslizumab 10 mg/ml intravenous solution $10.58 $10.58 $10.58 $34.40
Resp virus 6-11 targets $218.06 $218.06 $218.06 $1,146.60
Resuscitation cardiopulmonary $311.40 $311.40 $311.40 $741.75
Resuscitation delivery/birthing room $654.38 $654.38 $654.38 $721.50
Reteplase injection $2,904.58 $2,904.58 $2,904.58 $2,904.58
Reticulated platelet assay $35.74 $35.74 $35.74 $85.50
Reticulocyte automated $3.99 $3.99 $3.99 $54.75
Reticulocyte direct measurement automated $5.57 $5.57 $5.57 $5.57
Retifanlimab-dlwr 500 mg/20 ml intravenous solution $29.98 $29.98 $29.98 $29.98
Retrieval of oocyte $870.74 $870.74 $870.74 $870.74
Retrograde ejaculation anal $19.59 $19.59 $19.59 $19.59
Rev mastoidectomy rsltg modf rad mstdc 69602 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rev-rem impl neurostim gen-rec $3,439.01 $3,439.01 $3,439.01 $3,288.00
Rev/rmv perph nstim eltrd ra $3,439.01 $3,439.01 $3,439.01 $3,439.01
Rev/rmv prph sac/gstr npg/r $3,439.01 $3,439.01 $3,439.01 $3,439.01
Rev/rplcmt sk-mnt crnl nstm $21,444.39 $21,444.39 $21,444.39 $21,444.39
Rev/rplct hpglsl nstm ary pg $12,470.31 $12,470.31 $12,470.31 $12,470.31
Revasc intra lithotrip-ather $17,956.72 $17,956.72 $17,956.72 $20,533.20
Revasc intra lithotrip-stent $17,956.72 $17,956.72 $17,956.72 $20,533.20
Revasc intravasc lithotripsy $11,340.57 $11,340.57 $11,340.57 $11,449.20
Revasc lith-sten-ath tib/per $17,956.72 $17,956.72 $17,956.72 $20,329.50
Revasc lithotr-ather tib/per $17,956.72 $17,956.72 $17,956.72 $20,329.50
Revasc lithotr-stent tib/per $17,956.72 $17,956.72 $17,956.72 $20,329.50
Revasc lithotrip tibi/perone $11,340.57 $11,340.57 $11,340.57 $12,754.50
Revasc lithotrip-stent-ather $17,956.72 $17,956.72 $17,956.72 $30,547.80
Revis reconst shoulder joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revise abdomen-venous shunt $3,529.06 $3,529.06 $3,529.06 $3,529.06
Revise aqueous shunt eye $2,280.73 $2,280.73 $2,280.73 $2,280.73
Revise arm/leg nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Revise breast reconst 19380 $6,521.46 $6,521.46 $6,521.46 $6,521.46
Revise eye $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise eye muscle $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise eye muscle $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise eye muscle(s) $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise eye socket implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise eye sockets $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise eye sockets $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise eye sockets $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise eye sockets $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise eye with implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise eyelashes $298.93 $298.93 $298.93 $298.93
Revise eyelashes $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise eyelid defect $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise eyelid lining $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise eyelid lining $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise eyelid lining $2,280.73 $2,280.73 $2,280.73 $2,280.73
Revise finger joint each $1,600.41 $1,600.41 $1,600.41 $1,600.41
Revise finger joint each $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise gastric port open 43886 $3,660.97 $3,660.97 $3,660.97 $3,660.97
Revise graft w/vein $5,405.70 $5,405.70 $5,405.70 $5,405.70
Revise graft w/vein 35881 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Revise hand/finger tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise head/neck of femur $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise hernia & sperm veins $3,529.06 $3,529.06 $3,529.06 $3,529.06
Revise kneecap $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise kneecap with implant $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revise knuckle joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise knuckle with implant $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise low back nerve(s) $1,952.77 $1,952.77 $1,952.77 $1,952.77
Revise lower leg tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise lower leg tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise lower leg tendons $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise middle ear & mastoid $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear & mastoid $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear & mastoid $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear & mastoid $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear & mastoid $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear & mastoid 69645 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise middle ear bone $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revise ocular implant $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise ocular implant $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise palsy hand tendon(s) $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise palsy hand tendon(s) $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise penis/urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revise penis/urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revise penis/urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revise prosth vag graft lap $7,394.81 $7,394.81 $7,394.81 $7,394.81
Revise radius & ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise radius & ulna $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revise radius or ulna $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise reconst elbow joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revise reconst elbow joint $18,390.05 $18,390.05 $18,390.05 $18,390.05
Revise spermatic cord veins $6,239.75 $6,239.75 $6,239.75 $6,239.75
Revise spermatic cord veins $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revise spine eltrd perq aray $6,562.90 $6,562.90 $6,562.90 $6,562.90
Revise spine eltrd plate $12,470.31 $12,470.31 $12,470.31 $12,470.31
Revise thigh muscles/tendons $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise thumb tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise thumb tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise two eye muscles $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise two eye muscles $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise ulnar nerve at wrist $1,952.77 $1,952.77 $1,952.77 $1,952.77
Revise ureter $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revise urethra stage 1 $5,083.62 $5,083.62 $5,083.62 $5,083.62
Revise urethra stage 2 $5,083.62 $5,083.62 $5,083.62 $5,083.62
Revise vag graft via vagina $3,179.53 $3,179.53 $3,179.53 $3,179.53
Revise windpipe scar $3,243.07 $3,243.07 $3,243.07 $3,243.07
Revise wrist joint $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise wrist/forearm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revise/graft eyelid lining $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise/graft eyelid lining $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise/graft eyelid lining $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise/graft eyelid lining $3,771.00 $3,771.00 $3,771.00 $3,771.00
Revise/graft eyelid lining $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revise/implant finger joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revise/remove neuroelectrode $3,439.01 $3,439.01 $3,439.01 $3,439.01
Revise/remove neuroreceiver $12,470.31 $12,470.31 $12,470.31 $12,470.31
Revise/remove sling repair $3,179.53 $3,179.53 $3,179.53 $3,179.53
Revise/repl vagus n eltrd $12,470.31 $12,470.31 $12,470.31 $12,470.31
Revision of amputation $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of ankle joint $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of aqueous shunt $2,280.73 $2,280.73 $2,280.73 $2,280.73
Revision of arm nerve(s) $1,952.77 $1,952.77 $1,952.77 $1,952.77
Revision of big toe $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of bladder neck $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revision of calf tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revision of cervix $3,179.53 $3,179.53 $3,179.53 $3,179.53
Revision of cervix $3,179.53 $3,179.53 $3,179.53 $3,179.53
Revision of collar bone $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revision of collar bone $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of colostomy $3,660.97 $3,660.97 $3,660.97 $3,660.97
Revision of cornea $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revision of cranial nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Revision of eyelid $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revision of eyelid $2,332.96 $2,332.96 $2,332.96 $3,819.60
Revision of eyelid $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revision of eyelid $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revision of eyelid $2,332.96 $2,332.96 $2,332.96 $2,332.96
Revision of foot $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revision of foot and ankle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of foot bones $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revision of foot fascia 28250 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revision of foot tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of foot tendon $1,600.41 $1,600.41 $1,600.41 $1,600.41
Revision of hip tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revision of ileostomy; simple 44312 $3,660.97 $3,660.97 $3,660.97 $3,660.97
Revision of infusion pump $3,639.30 $3,639.30 $3,639.30 $3,639.30
Revision of iris $548.60 $548.60 $548.60 $2,392.50
Revision of iris $548.60 $548.60 $548.60 $548.60
Revision of jaw muscle/bone $3,243.07 $3,243.07 $3,243.07 $3,243.07
Revision of jaw muscle/bone $1,481.28 $1,481.28 $1,481.28 $1,481.28
Revision of knee joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revision of knee joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revision of knee joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revision of knee joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revision of knee joint $12,866.82 $12,866.82 $12,866.82 $12,866.82
Revision of larynx $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision of leg vein 37780 $3,147.50 $3,147.50 $3,147.50 $3,147.50
Revision of neck muscle $703.59 $703.59 $703.59 $703.59
Revision of neck muscle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of neck muscle $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revision of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision of nose $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision of nose $3,243.07 $3,243.07 $3,243.07 $3,243.07
Revision of penis $3,448.97 $3,448.97 $3,448.97 $4,524.60
Revision of penis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revision of penis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revision of penis $3,448.97 $3,448.97 $3,448.97 $3,367.50
Revision of pharyngeal walls $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision of radius $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revision of radius $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of sciatic nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Revision of scrotum $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revision of scrotum $5,083.62 $5,083.62 $5,083.62 $5,083.62
Revision of spinal shunt $6,404.07 $6,404.07 $6,404.07 $6,404.07
Revision of testis $5,083.62 $5,083.62 $5,083.62 $5,083.62
Revision of thigh muscles $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of toe $3,244.61 $3,244.61 $3,244.61 $3,244.61
Revision of ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of unstable kneecap $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of unstable kneecap $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revision of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revision of urethra $3,448.97 $3,448.97 $3,448.97 $3,448.97
Revision of urethra $4,936.45 $4,936.45 $4,936.45 $4,936.45
Revision open av fistula without thromb $5,405.70 $5,405.70 $5,405.70 $5,405.70
Revision orbitofacial bones $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revision tips $5,701.52 $5,701.52 $5,701.52 $7,508.40
Revision/removal of kneecap $7,143.73 $7,143.73 $7,143.73 $7,143.73
Revj fem anast autog vn grf $5,405.70 $5,405.70 $5,405.70 $5,405.70
Revj fem anast nonautog grf $5,405.70 $5,405.70 $5,405.70 $5,405.70
Revj mstdc rsltg compl mstdc $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revj mstdc rsltg tympanplsty $5,915.66 $5,915.66 $5,915.66 $5,915.66
Revj prior hypspad repair $5,083.62 $5,083.62 $5,083.62 $5,083.62
Revj/rmvl nea pn w/int nstim $3,439.01 $3,439.01 $3,439.01 $3,439.01
Rezafungin 200 mg intravenous solution $10.62 $10.62 $10.62 $26.25
Rf abltj nrv nrvtg si jt $1,952.77 $1,952.77 $1,952.77 $3,768.60
Rheumatoid factor qualitative $6.14 $6.14 $6.14 $75.00
Rheumatoid factor quantitative $5.67 $5.67 $5.67 $74.40
Rhinp prim lat&alr crtlge&/elvtn nsl tip $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rho(d) immune globulin h, sd $30.77 $30.77 $30.77 $1,551.00
Rib cartilage graft $5,915.66 $5,915.66 $5,915.66 $5,915.66
Right ventric recording $1,213.99 $1,213.99 $1,213.99 $2,545.80
Risankizumab-rzaa 60 mg/ml intravenous solution $14.84 $14.84 $14.84 $26.40
Risk ascvd tst once pr 12 mo $29.79 $29.79 $29.79 $29.79
Risperidone microspheres 12.5 mg/2 ml inj $10.94 $10.94 $10.94 $4,199.40
Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln $36.96 $36.96 $36.96 $218.40
Rituximab 10 mg/ml concentrate,intravenous $75.93 $75.93 $75.93 $432.00
Rituximab-abbs 10 mg/ml intravenous solution $31.18 $31.18 $31.18 $372.60
Rituximab-arrx 10 mg/ml intravenous solution $29.92 $29.92 $29.92 $196.20
Rituximab-pvvr 10 mg/ml intravenous solution $26.50 $26.50 $26.50 $7,826.40
Rmv implant contraceptive capsule 11976 $703.59 $703.59 $703.59 $1,314.00
Rmv ntr oi imp sk tc esp<100 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Rmv ntr oi imp sk tc>=100 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Rmv ntr oi implt skl prq esp $3,244.61 $3,244.61 $3,244.61 $3,244.61
Rmv sk-mnt crnl nstm pg/rcvr $3,244.61 $3,244.61 $3,244.61 $3,244.61
Rmv&rplcmt phrnc nrv stim ld $12,470.31 $12,470.31 $12,470.31 $13,161.00
Rmv&rplcmt phrnc nrv stim pg $30,473.59 $30,473.59 $30,473.59 $30,000.00
Rmvl esophgl sphnctr dev $5,834.36 $5,834.36 $5,834.36 $5,834.36
Rmvl ext fixj sys under anes $1,600.41 $1,600.41 $1,600.41 $3,046.80
Rmvl fb upr arm/elbow deep $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rmvl fecal impaction/fb spx under anes $1,179.08 $1,179.08 $1,179.08 $2,949.60
Rmvl foreign body upper arm/elbow subcutaneous $1,620.24 $1,620.24 $1,620.24 $1,470.60
Rmvl hpglsl nstim ary pg $6,404.07 $6,404.07 $6,404.07 $6,404.07
Rmvl icd by tv extr $3,639.30 $3,639.30 $3,639.30 $4,482.75
Rmvl icd gen w/rplc icd gen dual lead sys $22,446.19 $22,446.19 $22,446.19 $22,446.19
Rmvl icd gen w/rplc icd gen mlt lead sys $32,061.58 $32,061.58 $32,061.58 $32,061.58
Rmvl icd gen w/rplc icd gen sgl lead sys $22,446.19 $22,446.19 $22,446.19 $22,446.19
Rmvl icd pulse gen only $3,639.30 $3,639.30 $3,639.30 $3,655.80
Rmvl ndwellg tun pleural cath $618.26 $618.26 $618.26 $1,826.40
Rmvl perm pm pulse gen $8,275.98 $8,275.98 $8,275.98 $4,150.50
Rmvl phrnc nrv stim pg only $3,439.01 $3,439.01 $3,439.01 $3,353.25
Rmvl phrnc nrv stim sys $3,439.01 $3,439.01 $3,439.01 $3,353.25
Rmvl phrnc nrv stim transvns $3,439.01 $3,439.01 $3,439.01 $3,287.25
Rmvl pm gen w/rplc pm gen mlt lead sys $19,071.16 $19,071.16 $19,071.16 $19,071.16
Rmvl pm gen w/rplc pm gen sgl lead sys $8,275.98 $8,275.98 $8,275.98 $8,797.50
Rmvl prosthhumrl&ulnar cmpnt $3,244.61 $3,244.61 $3,244.61 $3,244.61
Rmvl sq defib electrode $3,639.30 $3,639.30 $3,639.30 $4,551.75
Rmvl subq card rhythm mntr $703.59 $703.59 $703.59 $1,912.80
Rmvl tiss expndr without implant insrtn $2,862.05 $2,862.05 $2,862.05 $2,862.05
Rmvl tongs/halo anthr indiv $399.04 $399.04 $399.04 $399.04
Rmvl tv pm lead dual $3,639.30 $3,639.30 $3,639.30 $3,687.00
Rmvl tv pm lead sgl $3,639.30 $3,639.30 $3,639.30 $3,303.75
Rolapitant, oral, 1mg $1.56 $1.56 $1.56 $1.56
Romidepsin 10 mg/2 ml intravenous powder for solution $31.08 $31.08 $31.08 $127.20
Romiplostim 125 mcg subcutaneous solution $11.00 $11.00 $11.00 $34.60
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) $12.00 $12.00 $12.00 $8,372.44
Rotavirus antibody $18.23 $18.23 $18.23 $18.23
Routine footcare pt w lops $198.70 $198.70 $198.70 $198.70
Rozanolixizumab-noli 140 mg/ml subcutaneous solution $23.16 $23.16 $23.16 $23.16
Rp loclzj tum 2+area 1+d img $401.83 $401.83 $401.83 $1,228.80
Rp loclzj tum spect w/ct 1 $1,305.48 $1,305.48 $1,305.48 $2,767.80
Rp loclzj tum spect w/ct 2 $1,458.59 $1,458.59 $1,458.59 $3,322.20
Rp therapy unlisted px $224.13 $224.13 $224.13 $224.13
Rpl non-tun cvc wo sbq prt/pmp $1,553.44 $1,553.44 $1,553.44 $2,587.20
Rpl picc wo subq port/pump incl image guidnc w/s&i $1,553.44 $1,553.44 $1,553.44 $2,534.25
Rpl tun cvc wo subq port $3,147.50 $3,147.50 $3,147.50 $3,147.50
Rpl tun-cvad w subq port $3,147.50 $3,147.50 $3,147.50 $3,880.50
Rpl tun-cvad w subq pump $5,405.70 $5,405.70 $5,405.70 $5,405.70
Rplc oi implt sk tc esp>=100 $12,866.82 $12,866.82 $12,866.82 $12,866.82
Rplcm oi implt sk tc esp<100 $12,866.82 $12,866.82 $12,866.82 $12,866.82
Rplcmt oi implt skl prq esp $7,143.73 $7,143.73 $7,143.73 $7,143.73
Rpr aa hrn 1st 3-10 ncr/strn $5,834.36 $5,834.36 $5,834.36 $5,834.36
Rpr aa hrn 1st 3-10 rdc $6,239.75 $6,239.75 $6,239.75 $6,239.75
Rpr aa hrn 1st < 3 cm rdc $3,529.06 $3,529.06 $3,529.06 $6,856.20
Rpr aa hrn 1st < 3 ncr/strn $5,834.36 $5,834.36 $5,834.36 $10,089.00
Rpr aa hrn 1st > 10 rdc $6,239.75 $6,239.75 $6,239.75 $6,239.75
Rpr aa hrn rcr 3-10 rdc $6,239.75 $6,239.75 $6,239.75 $6,239.75
Rpr aa hrn rcr < 3 ncr/strn $5,834.36 $5,834.36 $5,834.36 $5,834.36
Rpr aa hrn rcr < 3 rdc $3,529.06 $3,529.06 $3,529.06 $3,529.06
Rpr blood ves w/vein graft/up ext 35236 $5,405.70 $5,405.70 $5,405.70 $5,405.70
Rpr blood vsl grf oth vein lo ex $5,405.70 $5,405.70 $5,405.70 $5,405.70
Rpr choanal atresia ntranasl $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rpr choanal atresia trsnpltn $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rpr fem hernia init blocked $3,529.06 $3,529.06 $3,529.06 $3,529.06
Rpr hern preemie reduc $5,834.36 $5,834.36 $5,834.36 $5,834.36
Rpr hypspad comp dsj & urtp $5,083.62 $5,083.62 $5,083.62 $5,083.62
Rpr hypspad comp simple $3,448.97 $3,448.97 $3,448.97 $3,448.97
Rpr ing hern premie blocked $3,529.06 $3,529.06 $3,529.06 $3,529.06
Rpr ing hernia baby blocked $3,529.06 $3,529.06 $3,529.06 $3,529.06
Rpr ing hernia baby reduc $3,529.06 $3,529.06 $3,529.06 $3,529.06
Rpr ing hernia init blocked $3,529.06 $3,529.06 $3,529.06 $3,529.06
Rpr ing hernia init reduce $6,239.75 $6,239.75 $6,239.75 $6,239.75
Rpr intst excl anrect fist $2,742.39 $2,742.39 $2,742.39 $2,742.39
Rpr nsl vlv collapse w/implt $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rpr nsl vlv collapse w/rmdlg $5,915.66 $5,915.66 $5,915.66 $5,915.66
Rpr rem hernia init reduce $3,529.06 $3,529.06 $3,529.06 $1,509.60
Rpr xtnsr tndn leg prim without grft ea tndn $7,143.73 $7,143.73 $7,143.73 $7,143.73
Rpr&refit spct prsth aphakia $59.40 $59.40 $59.40 $59.40
Rrp hypspad comp moblj&urtp $9,247.15 $9,247.15 $9,247.15 $9,247.15
Rsv assay w/optic $13.10 $13.10 $13.10 $13.60
Rtm 1st set-up&pt educaj eqp $128.87 $128.87 $128.87 $128.87
Rtm dev sply mscskl 16-30 d $37.29 $37.29 $37.29 $37.29
Rtm dev sply resp sys 16-30d $37.29 $37.29 $37.29 $37.29
Rubella antibody igg $14.39 $14.39 $14.39 $84.00
Rubeola antibody igg $12.88 $12.88 $12.88 $165.00
Russell viper venom diluted $9.58 $9.58 $9.58 $119.40
Rx metab gen seq alys pnl 6 $917.08 $917.08 $917.08 $917.08
S bowel endoscope w/stent $5,952.81 $5,952.81 $5,952.81 $4,379.25
Sacituzumab govitecan-hziy 180 mg intravenous solution $36.26 $36.26 $36.26 $5,043.00
Salivary gland function exam $401.83 $401.83 $401.83 $401.83
Salivary gland imaging $401.83 $401.83 $401.83 $541.50
Salivary glnd img serial img $401.83 $401.83 $401.83 $1,228.80
Salmonella antibody $13.19 $13.19 $13.19 $29.25
Salpingostomy 58770 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Same day nb discharge 99463 $128.87 $128.87 $128.87 $128.87
Sargramostim injection $56.09 $56.09 $56.09 $1,092.15
Sars-cov-2 antb quantitative $51.43 $51.43 $51.43 $51.43
Sarscov & inf vir a&b ag ia $70.29 $70.29 $70.29 $70.29
Sarscov coronavirus ag ia $35.33 $35.33 $35.33 $34.80
Sc ther infusion reset pump $71.17 $71.17 $71.17 $71.17
Scan duplex abd/pelvis/retroperitoneal complete $241.72 $241.72 $241.72 $1,126.20
Scan duplex abd/pelvis/retroperitoneal limited $106.34 $106.34 $106.34 $873.00
Scan duplex aorta/ivc/iliac or bypass grafts complete $241.72 $241.72 $241.72 $819.60
Scan duplex aorta/ivc/iliac unilateral/limited $106.34 $106.34 $106.34 $715.80
Scan duplex extracranial arteries unilateral/limited study $106.34 $106.34 $106.34 $518.40
Scan duplex extremity veins unilateral/limited study $106.34 $106.34 $106.34 $810.75
Scan duplex lower extremity arteries complete bilateral $241.72 $241.72 $241.72 $1,108.20
Scan duplex lower extremity arteries unilateral/limited study left $106.34 $106.34 $106.34 $830.25
Scan duplex upper extremity arteries unilateral/limited study left $106.34 $106.34 $106.34 $779.25
Sclerotherapy fluid collection pq w/img $1,620.24 $1,620.24 $1,620.24 $1,810.50
Scope plantar fasciotomy $3,244.61 $3,244.61 $3,244.61 $3,244.61
Scr c/v cyto,thinlayer,rescr $26.49 $26.49 $26.49 $78.00
Scr c/v cyto,thinlayer,rescr $43.97 $43.97 $43.97 $43.97
Screen cerv/vag thin layer $20.26 $20.26 $20.26 $61.20
Screen pap by tech w md supv $18.19 $18.19 $18.19 $18.19
Screening Colonoscopy (average risk) $911.71 $911.71 $911.71 $1,440.00
Screening Colonoscopy (high risk) $911.71 $911.71 $911.71 $1,864.80
Screening HIV antigen/antibody combination assay $24.08 $24.08 $24.08 $24.08
Screening Mammogram $169.06 $169.06 $169.06 $331.50
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations $18.05 $18.05 $18.05 $100.20
Screening hepatitis b non-obstetric high risk $28.27 $28.27 $28.27 $60.00
Screening hepatitis c antibody high risk $46.35 $46.35 $46.35 $46.80
Screening prostate cancer PSA $19.31 $19.31 $19.31 $96.00
Sedimentation rate erythrocyte automated $2.70 $2.70 $2.70 $51.00
Select picture audiometry $59.40 $59.40 $59.40 $56.25
Self-meas bp pt educaj/train $24.49 $24.49 $24.49 $24.49
Semen analysis presence/motility $12.05 $12.05 $12.05 $86.40
Semen analysis w/count $8.61 $8.61 $8.61 $64.20
Sensorimotor examination $59.40 $59.40 $59.40 $59.40
Sensorineural acuity lvl tst $39.25 $39.25 $39.25 $39.25
Separate eyelid adhesions $2,332.96 $2,332.96 $2,332.96 $2,332.96
Sept9 promoter methylation analysis $192.00 $192.00 $192.00 $602.40
Sequestrectomy olecrn proces $7,143.73 $7,143.73 $7,143.73 $7,143.73
Sequestrectomy radial h/n $3,244.61 $3,244.61 $3,244.61 $3,244.61
Sequestrectomy shft/dstl hum $7,143.73 $7,143.73 $7,143.73 $7,143.73
Serpina1 gene $43.65 $43.65 $43.65 $345.60
Set radiation therapy field $366.07 $366.07 $366.07 $1,485.60
Set radiation therapy field $366.07 $366.07 $366.07 $1,029.00
Set radiation therapy field $132.77 $132.77 $132.77 $655.20
Set-up cardiovert-defibrill $299.91 $299.91 $299.91 $625.80
Sever cranial nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Sex transformation f to m $3,448.97 $3,448.97 $3,448.97 $3,448.97
Sex transformation m to f $4,936.45 $4,936.45 $4,936.45 $4,936.45
Sgmdsc w/band ligation $1,179.08 $1,179.08 $1,179.08 $2,564.40
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< $198.70 $198.70 $198.70 $198.70
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm $198.70 $198.70 $198.70 $615.00
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm $399.53 $399.53 $399.53 $819.00
Shave sgl skin lsn f/e/e/n/l/m >2cm $399.53 $399.53 $399.53 $582.75
Shave sgl skin lsn s/n/h/f/g 0.5cm/< $198.70 $198.70 $198.70 $494.40
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm $198.70 $198.70 $198.70 $520.80
Shave sgl skin lsn s/n/h/f/g 1.1-2cm $198.70 $198.70 $198.70 $252.00
Shave sgl skin lsn s/n/h/f/g >2cm $399.53 $399.53 $399.53 $399.53
Shave sgl skin lsn t/a/l 0.5cm/< $399.53 $399.53 $399.53 $520.80
Shave sgl skin lsn t/a/l 0.6-1.0cm $198.70 $198.70 $198.70 $206.25
Shave sgl skin lsn t/a/l 1.1-2.0cm $198.70 $198.70 $198.70 $660.00
Shigella antibody $24.48 $24.48 $24.48 $24.48
Sho arthrs dx +- synovial bx $3,244.61 $3,244.61 $3,244.61 $3,244.61
Sho arthrs srg bicp tenodsis $7,143.73 $7,143.73 $7,143.73 $7,143.73
Sho arthrs srg capsulorraphy $7,143.73 $7,143.73 $7,143.73 $7,143.73
Sho arthrs srg compl synvct $3,244.61 $3,244.61 $3,244.61 $3,244.61
Sho arthrs srg lmtd dbrdmt $3,244.61 $3,244.61 $3,244.61 $3,244.61
Sho arthrs srg lss&rescj ads $3,244.61 $3,244.61 $3,244.61 $3,244.61
Sho arthrs srg prtl synvct $7,143.73 $7,143.73 $7,143.73 $7,143.73
Sho arthrs srg rmvl loose/fb $3,244.61 $3,244.61 $3,244.61 $3,244.61
Sho arthrs srg rpr slap les $7,143.73 $7,143.73 $7,143.73 $7,143.73
Sho arthrs srg xtnsv dbrdmt $3,244.61 $3,244.61 $3,244.61 $3,244.61
Shorten radius & ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Shorten radius or ulna $7,143.73 $7,143.73 $7,143.73 $7,143.73
Shortening of hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Shoulder Arthroscopy (Rotator Cuff Repair) $7,143.73 $7,143.73 $7,143.73 $5,272.00
Shoulder MRI (with and without contrast) $357.13 $357.13 $357.13 $2,650.10
Shoulder MRI (with contrast) $790.06 $790.06 $790.06 $2,769.75
Shoulder MRI (without contrast) $241.72 $241.72 $241.72 $1,938.28
Shoulder X-ray $88.05 $88.05 $88.05 $306.88
Shoulder prosthesis removal $2,862.05 $2,862.05 $2,862.05 $2,862.05
Shuntogram nonvascular supervision & interpretation $106.34 $106.34 $106.34 $262.80
Sialidase enzyme assay $12.22 $12.22 $12.22 $143.40
Sialography s&i $241.72 $241.72 $241.72 $547.80
Sialolithotomy 42330 $3,243.07 $3,243.07 $3,243.07 $3,732.75
Sickling rbc $5.51 $5.51 $5.51 $81.00
Sig w/tndsc balloon dilation $1,179.08 $1,179.08 $1,179.08 $2,738.25
Sigmoid/rmv tumor/polyp/hot bx for 45333 $911.71 $911.71 $911.71 $1,976.25
Sigmoidoscopy and biopsy $911.71 $911.71 $911.71 $1,831.50
Sigmoidoscopy flex decompression 45337 $911.71 $911.71 $911.71 $2,571.60
Sigmoidoscopy for bleeding $1,179.08 $1,179.08 $1,179.08 $1,885.20
Sigmoidoscopy w/ablation $1,179.08 $1,179.08 $1,179.08 $2,604.00
Sigmoidoscopy w/fb removal 45332 $1,179.08 $1,179.08 $1,179.08 $1,885.20
Sigmoidoscopy w/plcmt stent $5,952.81 $5,952.81 $5,952.81 $4,379.25
Sigmoidoscopy w/resection $2,742.39 $2,742.39 $2,742.39 $2,712.75
Sigmoidoscopy w/tumr remove $1,179.08 $1,179.08 $1,179.08 $1,885.20
Sigmoidoscopy w/ultrasound $911.71 $911.71 $911.71 $1,380.60
Sigmoidoscopy w/us guide bx $1,179.08 $1,179.08 $1,179.08 $2,106.60
Sigmoidoscopy/submucosal injection 45335 $911.71 $911.71 $911.71 $1,650.75
Signal avg ecg w or without ecg 93278 $59.40 $59.40 $59.40 $393.00
Sim ang w/prs cath rad emb $11,340.57 $11,340.57 $11,340.57 $11,340.57
Simple cystometrogram 51725 $243.21 $243.21 $243.21 $759.00
Single energy x-ray study $106.34 $106.34 $106.34 $106.34
Sinus CT scan (with and without contrast) $178.02 $178.02 $178.02 $1,871.00
Sinus CT scan (with contrast) $178.02 $178.02 $178.02 $1,566.40
Sinus CT scan (without contrast) $106.34 $106.34 $106.34 $1,275.30
Sinus/juglr venogram s&i $3,147.50 $3,147.50 $3,147.50 $2,226.60
Sinusotomy maxillary sinus 31020 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Sinusotomy sinus remove polyps 31032 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Sinusotomy sphenoid w/wo bx 31050 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Sipuleucel-t - su $55,945.97 $55,945.97 $55,945.97 $95,750.46
Sirolimus-protein bound 100 mg intravenous suspension $84.53 $84.53 $84.53 $84.53
Skin Biopsy $198.70 $198.70 $198.70 $378.65
Skin and muscle repair face $3,660.97 $3,660.97 $3,660.97 $3,660.97
Skin full graft 20sq cm less 15200 $1,829.23 $1,829.23 $1,829.23 $1,829.23
Skin pedicle flap arms/legs $3,660.97 $3,660.97 $3,660.97 $3,660.97
Skin pedicle flap trunk $1,829.23 $1,829.23 $1,829.23 $1,829.23
Skin test unlisted antigen ea $24.49 $24.49 $24.49 $24.49
Sleep Study (Polysomnography) $1,017.39 $1,017.39 $1,017.39 $4,141.16
Sleep study attended $530.60 $530.60 $530.60 $404.25
Sleep study unattended $156.46 $156.46 $156.46 $632.25
Slitting of prepuce $2,048.51 $2,048.51 $2,048.51 $4,029.00
Slitting of prepuce $3,448.97 $3,448.97 $3,448.97 $3,448.97
Slp stdy unatnd w/anal $59.40 $59.40 $59.40 $59.40
Sm-153 lexidron ther $4,314.91 $4,314.91 $4,314.91 $5,947.80
Small bowel endoscopy $1,896.99 $1,896.99 $1,896.99 $3,414.00
Small bowel endoscopy $1,896.99 $1,896.99 $1,896.99 $3,175.50
Small bowel endoscopy $1,896.99 $1,896.99 $1,896.99 $2,350.50
Small bowel endoscopy $1,896.99 $1,896.99 $1,896.99 $1,896.99
Small bowel endoscopy $1,896.99 $1,896.99 $1,896.99 $2,466.00
Small bowel endoscopy $1,896.99 $1,896.99 $1,896.99 $1,896.99
Small bowel endoscopy $937.56 $937.56 $937.56 $2,467.50
Small bowel endoscopy $1,896.99 $1,896.99 $1,896.99 $2,597.25
Small bowel endoscopy 44365 $1,896.99 $1,896.99 $1,896.99 $2,040.75
Small bowel endoscopy >2nd w/remove 44363 $1,896.99 $1,896.99 $1,896.99 $3,096.75
Small bowel endoscopy br/wa $1,896.99 $1,896.99 $1,896.99 $1,896.99
Small bowel endoscopy br/wa $937.56 $937.56 $937.56 $1,895.40
Small bowel endoscopy/biopsy $1,896.99 $1,896.99 $1,896.99 $3,414.00
Small bowel endoscopy/biopsy $1,896.99 $1,896.99 $1,896.99 $1,896.99
Small bowel endoscopy/stent 44370 $5,952.81 $5,952.81 $5,952.81 $7,896.80
Smallpox&monkeypox vac 0.5ml $0.01 $0.01 $0.01 $2.43
Smear fluorescent and/or acid fast stain $5.39 $5.39 $5.39 $81.00
Smear gram stain $4.27 $4.27 $4.27 $55.80
Smear nasal eosinophil $5.79 $5.79 $5.79 $47.25
Smear special stain inclusion bodies/parasites $5.99 $5.99 $5.99 $43.20
Smear wet mount $5.82 $5.82 $5.82 $77.25
Smn1 gene full gene sequence $301.35 $301.35 $301.35 $301.35
Smpd1 gene common variants $47.00 $47.00 $47.00 $1,189.20
Snrpn/ube3a gene $51.07 $51.07 $51.07 $376.50
So gsap cl fr cpy nmbr&mcrst $1,345.31 $1,345.31 $1,345.31 $1,345.31
So gsap cll fr dna/dna&rna $1,195.83 $1,195.83 $1,195.83 $2,242.50
So gsap cll fr mcrstl ins $3,288.51 $3,288.51 $3,288.51 $3,288.51
So gsap dna cpy nmbr&mcrstl $1,046.35 $1,046.35 $1,046.35 $1,137.00
So neo gsap dna mcrstl ins $896.87 $896.87 $896.87 $896.87
So neo gsap dna/dna&rna $2,989.55 $2,989.55 $2,989.55 $2,989.55
Sodium 24 hour urine $5.06 $5.06 $5.06 $52.20
Sodium serum/plasma/whole blood $4.81 $4.81 $4.81 $40.20
Software meas of cardiac vol $88.05 $88.05 $88.05 $88.05
Somatosensory testing $311.40 $311.40 $311.40 $760.80
Somatropin injection $48.92 $48.92 $48.92 $2,111.40
Sotalol hydrochloride IV $25.05 $25.05 $25.05 $13,396.05
Special physics consult $132.77 $132.77 $132.77 $732.00
Special radiation dosimetry $132.77 $132.77 $132.77 $471.00
Special radiation treatment $578.47 $578.47 $578.47 $1,986.00
Special teletx port plan $366.07 $366.07 $366.07 $975.60
Specific gravity body fluid $3.28 $3.28 $3.28 $25.80
Specimen fat stain $5.88 $5.88 $5.88 $60.75
Speech audiometry complete $59.40 $59.40 $59.40 $104.25
Speech evaluation complex $241.72 $241.72 $241.72 $927.00
Speech recep thresh $59.40 $59.40 $59.40 $59.40
Sperm antibody test $10.67 $10.67 $10.67 $73.80
Sperm identification $53.43 $53.43 $53.43 $53.43
Sperm isolation complex $53.43 $53.43 $53.43 $53.43
Sperm isolation simple $53.43 $53.43 $53.43 $53.43
Sperm washing 58323 $201.17 $201.17 $201.17 $201.17
Sphenoid sinus surgery $5,915.66 $5,915.66 $5,915.66 $5,915.66
Sphincteroplasty inc/prolapse adult 46750 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance $692.52 $692.52 $692.52 $1,439.40
Spine device implant surgery $12,866.82 $12,866.82 $12,866.82 $12,866.82
Spirmtry w/brnchdil inf-2 yr $311.40 $311.40 $311.40 $311.40
Spirometry bronchodilation responsiveness pre/post bronchodilator administration $311.40 $311.40 $311.40 $526.80
Spirometry up to 2 yrs old $156.46 $156.46 $156.46 $929.25
Spleen imaging $401.83 $401.83 $401.83 $401.83
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % $3,660.97 $3,660.97 $3,660.97 $3,660.97
Split blood or products $171.36 $171.36 $171.36 $303.00
Sprchoroidal spc njx rx agt $331.69 $331.69 $331.69 $331.69
Sputum specimen collection $171.36 $171.36 $171.36 $337.50
Sr-89 stront chlor ther / mci $4,146.34 $4,146.34 $4,146.34 $2,773.60
Srs linear based $7,644.49 $7,644.49 $7,644.49 $8,479.20
Srs multisource $7,644.49 $7,644.49 $7,644.49 $7,644.49
St analysis behavior qualitative voice/resonance $140.62 $140.62 $140.62 $318.75
St cognitve performance testing healthcare professional each hour $129.95 $129.95 $129.95 $330.75
St evaluate speech sound production $142.56 $142.56 $142.56 $310.20
St evaluate speech sound production comprehensive/expressive $292.08 $292.08 $292.08 $334.80
St evaluation motion fluoroscopic swallow function cine/video $113.53 $113.53 $113.53 $354.75
St evaluation swallow function $91.47 $91.47 $91.47 $383.25
St treatment speech individual $98.27 $98.27 $98.27 $203.40
St treatment swallow dysfunction/oral $107.20 $107.20 $107.20 $216.80
Staggered spondaic word test $156.46 $156.46 $156.46 $156.46
Staph a dna amp probe $35.09 $35.09 $35.09 $129.00
Stem cells total count $77.78 $77.78 $77.78 $102.75
Stenger test pure tone $59.40 $59.40 $59.40 $59.40
Stenger test speech $530.60 $530.60 $530.60 $404.25
Stent iliac/open or perc/uni/init 37221 $11,340.57 $11,340.57 $11,340.57 $17,448.00
Stent/athrectomy/fem/pop/unilat 37227 $17,956.72 $17,956.72 $17,956.72 $54,766.80
Stent/tib/peroneal/unilat/initial 37230 $17,956.72 $17,956.72 $17,956.72 $24,161.40
Stimulation of spinal cord $1,952.77 $1,952.77 $1,952.77 $1,952.77
Storage/year embryo(s) $171.36 $171.36 $171.36 $171.36
Storage/year oocyte(s) $171.36 $171.36 $171.36 $171.36
Storage/year reprod tissue $171.36 $171.36 $171.36 $171.36
Storage/year sperm/semen $171.36 $171.36 $171.36 $171.36
Str markers spec anal addl $304.81 $304.81 $304.81 $1,683.00
Str markers specimen anal $233.07 $233.07 $233.07 $1,270.50
Strapping of ankle and/or ft 29540 $157.79 $157.79 $157.79 $315.60
Strapping of chest $157.79 $157.79 $157.79 $157.79
Strapping of elbow or wrist 29260 $59.40 $59.40 $59.40 $230.25
Strapping of hand or finger $59.40 $59.40 $59.40 $272.25
Strapping of hip $128.90 $128.90 $128.90 $147.00
Strapping of knee $128.90 $128.90 $128.90 $243.60
Strapping of toes 29550 $59.40 $59.40 $59.40 $151.50
Strep a ag ia $16.81 $16.81 $16.81 $76.80
Strep a dna dir probe $20.05 $20.05 $20.05 $20.05
Strep b assay w/optic $12.73 $12.73 $12.73 $12.73
Strep b dna amp probe $35.09 $35.09 $35.09 $194.40
Streptokinase antibody $12.66 $12.66 $12.66 $12.66
Stress test pulmonary $128.90 $128.90 $128.90 $309.00
Stress tte complete $548.30 $548.30 $548.30 $1,989.60
Subdural tap fontanelle/sutur infant init 61000 $692.52 $692.52 $692.52 $692.52
Subq njx fil matrl 5.1-10cc $612.13 $612.13 $612.13 $612.13
Subq njx filling matrl 1cc/< $198.70 $198.70 $198.70 $198.70
Subtalar arthro w/deb $3,244.61 $3,244.61 $3,244.61 $3,244.61
Subtalar arthro w/exc $7,143.73 $7,143.73 $7,143.73 $7,143.73
Subtalar arthro w/fb rmvl $3,244.61 $3,244.61 $3,244.61 $3,244.61
Subtalar arthro w/fusion $12,866.82 $12,866.82 $12,866.82 $12,866.82
Suction lipectomy head&neck $3,660.97 $3,660.97 $3,660.97 $3,660.97
Suction lipectomy lwr extrem $3,660.97 $3,660.97 $3,660.97 $3,660.97
Suction lipectomy trunk $3,660.97 $3,660.97 $3,660.97 $3,660.97
Suction lipectomy upr extrem $1,829.23 $1,829.23 $1,829.23 $1,829.23
Sugars multiple quant $11.53 $11.53 $11.53 $11.53
Sugars single quant $11.53 $11.53 $11.53 $104.40
Sup of prep of antigen # of vials 95144 $46.14 $46.14 $46.14 $46.14
Supply of digital device $128.87 $128.87 $128.87 $128.87
Supprelin la implant $45,560.39 $45,560.39 $45,560.39 $185,546.55
Surg dx exam anorectal $2,742.39 $2,742.39 $2,742.39 $2,742.39
Surg tx anal fistula 2nd stage 46285 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Surgery for urethra pouch $3,448.97 $3,448.97 $3,448.97 $3,448.97
Surgery to stop leg growth $7,143.73 $7,143.73 $7,143.73 $7,143.73
Surgery to stop leg growth $7,143.73 $7,143.73 $7,143.73 $7,143.73
Surgery to stop leg growth $7,143.73 $7,143.73 $7,143.73 $7,143.73
Surgery to stop leg growth $7,143.73 $7,143.73 $7,143.73 $7,143.73
Surgical exposure prostate 55860 $5,083.62 $5,083.62 $5,083.62 $5,083.62
Surgical opening of stomach $937.56 $937.56 $937.56 $937.56
Surgical opening of throat $1,481.28 $1,481.28 $1,481.28 $1,481.28
Surgical pathology level 1 gross examination only $24.49 $24.49 $24.49 $58.20
Surgical pathology level 2 gross & microscopic examination $39.25 $39.25 $39.25 $168.75
Surgical pathology level 3 gross & microscopic examination $53.43 $53.43 $53.43 $212.40
Surgical pathology level 4 gross & microscopic examination $53.43 $53.43 $53.43 $250.20
Surgical pathology level 5 gross & microscopic examination $359.72 $359.72 $359.72 $472.50
Surgical pathology level 6 gross & microscopic examination $816.90 $816.90 $816.90 $691.20
Suscept studies macrobroth dilution ea $6.64 $6.64 $6.64 $87.00
Susceptibility agar dilution per agent $4.75 $4.75 $4.75 $69.75
Susceptibility enzyme detection per enzyme $4.75 $4.75 $4.75 $24.75
Susceptibility mic per plate $8.65 $8.65 $8.65 $88.20
Suspension of testis $3,448.97 $3,448.97 $3,448.97 $3,448.97
Svc venogram s&i $1,553.44 $1,553.44 $1,553.44 $2,241.75
Sweat collection by iontophoresis $53.43 $53.43 $53.43 $73.80
Sympathectomy cervical $1,952.77 $1,952.77 $1,952.77 $1,952.77
Sympathectomy digital artery $1,952.77 $1,952.77 $1,952.77 $1,952.77
Sympathectomy supfc palmar $3,244.61 $3,244.61 $3,244.61 $3,244.61
Synthetic sentence id test $39.25 $39.25 $39.25 $39.25
Synvisc or synvisc-one $9.09 $9.09 $9.09 $73.20
Syphilis test non-treponemal antibody quantitative rpr $4.40 $4.40 $4.40 $67.50
T cells absolute cd 4 count $26.78 $26.78 $26.78 $148.80
T cells absolute cd4/cd8 including ratio $46.98 $46.98 $46.98 $261.60
T cells total count $37.73 $37.73 $37.73 $112.80
T-cell depletion of harvest $437.18 $437.18 $437.18 $437.18
T3 (triiodothyronine) free $16.94 $16.94 $16.94 $86.40
T3 (triiodothyronine) total $14.18 $14.18 $14.18 $72.00
T4 (thyroxine) free $9.02 $9.02 $9.02 $78.00
T4 (thyroxine) total $6.87 $6.87 $6.87 $82.80
Tacrolimus 5 mg/ml intravenous solution $262.23 $262.23 $262.23 $1,588.00
Tacrolimus therapeutic drug level $13.73 $13.73 $13.73 $171.00
Tafasitamab-cxix 200 mg intravenous solution $14.08 $14.08 $14.08 $28.80
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection $73.55 $73.55 $73.55 $133.80
Talquetamab-tgvs 2 mg/ml subcutaneous solution $72.40 $72.40 $72.40 $175.20
Target gsa panel hmtlmph neop $759.53 $759.53 $759.53 $1,708.50
Target gsa panel organ neop $597.91 $597.91 $597.91 $1,643.25
Target gsa panel organ/hmtlmph neop $2,919.60 $2,919.60 $2,919.60 $5,739.00
Tarlatamab-dlle 10 mg intravenous solution $1,567.49 $1,567.49 $1,567.49 $2,828.40
Tattooing/intraderm 6.1-20.0 sq cm 11921 $612.13 $612.13 $612.13 $931.50
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells $100.00 $100.00 $100.00 $615.60
Tb test cell mediated immunity antigen response gamma interferon $61.98 $61.98 $61.98 $345.00
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe $0.30 $0.30 $0.30 $357.60
Tbs techl calculation only $88.05 $88.05 $88.05 $88.05
Tbs techl prep&transmis data $88.05 $88.05 $88.05 $88.05
Tc-99m arcitumomab $809.51 $809.51 $809.51 $2,781.60
Tc-99m bicisate $683.80 $683.80 $683.80 $697.80
Tc-99m exame autol wbc diag per dose $1,040.32 $1,040.32 $1,040.32 $1,040.32
Tc-99m exametazime diag $802.34 $802.34 $802.34 $1,461.00
Tc-99m non-heu per study dose $10.00 $10.00 $10.00 $15.00
Tca peel dermal 15789 $612.13 $612.13 $612.13 $612.13
Tcd emboli detect w/inj $106.34 $106.34 $106.34 $585.00
Tcd emboli detect without inj $106.34 $106.34 $106.34 $240.60
Tcran magn stim redetemine $311.40 $311.40 $311.40 $354.00
Tcranial magn stim tx deli $311.40 $311.40 $311.40 $354.00
Tcranial magn stim tx plan $311.40 $311.40 $311.40 $354.00
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution $217.09 $217.09 $217.09 $418.80
Tee w or without fol w/cont, mon $790.06 $790.06 $790.06 $865.50
Tee w or without fol w/cont,cong $790.06 $790.06 $790.06 $1,626.00
Telavancin injection $7.47 $7.47 $7.47 $987.60
Telethx isodose plan cplx $366.07 $366.07 $366.07 $2,237.40
Telethx isodose plan simple $366.07 $366.07 $366.07 $1,855.20
Temozolomide 100 mg intravenous solution $10.39 $10.39 $10.39 $1,714.80
Temperature gradient studies $156.46 $156.46 $156.46 $156.46
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln $32.29 $32.29 $32.29 $539.40
Tendon lengthening $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tendon lngth upr a/e ea tdn $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tendon shortening $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tendon transfer with graft $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) $171.94 $171.94 $171.94 $14,427.60
Tenodesis biceps tdn at elbw $7,143.73 $7,143.73 $7,143.73 $7,143.73
Tenolysis extensor tendon hand/finger each $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tenolysis triceps $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tenoplasty elbow to sho 1 $7,143.73 $7,143.73 $7,143.73 $7,143.73
Tenosynovectomy radic 26145 $1,600.41 $1,600.41 $1,600.41 $1,600.41
Tenotomy length/rls abductor hallucis musc 28240 $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tenotomy open tndn flxr toe sgl tndn spx $1,600.41 $1,600.41 $1,600.41 $1,600.41
Tert gene targeted seq alys $185.20 $185.20 $185.20 $347.25
Test for chlorohydrocarbons $6.01 $6.01 $6.01 $94.80
Test for porphobilinogen $5.82 $5.82 $5.82 $5.82
Test for urine cystines $9.55 $9.55 $9.55 $9.55
Test pathogen(s) for platelets reference $59.40 $59.40 $59.40 $51.00
Test stress cardiovascular tracing only $311.40 $311.40 $311.40 $1,012.50
Test urine for lactose $11.25 $11.25 $11.25 $11.25
Test urine for porphyrins $13.36 $13.36 $13.36 $25.80
Test urine urobilinogen $4.47 $4.47 $4.47 $4.47
Testicular imaging w/vasc flow $401.83 $401.83 $401.83 $1,193.40
Testosterone undecanoate 1mg $1.99 $1.99 $1.99 $1.99
Tetanus immune globulin inj $577.05 $577.05 $577.05 $1,524.00
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe $18.30 $18.30 $18.30 $48.80
Tgsap hl neo 5-50 rna alys $759.53 $759.53 $759.53 $759.53
Tgsap so neo 5-50 rna alys $597.91 $597.91 $597.91 $597.91
Tgsap so/hl 51/< rna alys $2,919.60 $2,919.60 $2,919.60 $2,157.60
Thaw cryoprsvrd reprod tiss $171.36 $171.36 $171.36 $171.36
Thaw preserved stem cells $437.18 $437.18 $437.18 $437.18
Thawing cryopresrved embryo $171.36 $171.36 $171.36 $171.36
Thawing cryopresrved oocyte $171.36 $171.36 $171.36 $171.36
Thawing cryopresrved sperm $53.43 $53.43 $53.43 $53.43
Theophylline therapeutic drug level $14.14 $14.14 $14.14 $111.00
Ther fx nasal inf turbinate $3,243.07 $3,243.07 $3,243.07 $3,243.07
Ther nma rdctj intus/obstrcj $178.02 $178.02 $178.02 $208.50
Ther/proph/diag inj ia $210.69 $210.69 $210.69 $369.00
Therapeutic procd strg endur $24.49 $24.49 $24.49 $49.20
Therapeutic pulpotomy $1,662.63 $1,662.63 $1,662.63 $1,662.63
Therapy activation ipnss $91.79 $91.79 $91.79 $90.00
Therapy nutrition individual initial f2f w/patient each 15 minutes $40.94 $40.94 $40.94 $40.94
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes $34.61 $34.61 $34.61 $25.80
Therapy photodnmc lght dstr lsn skn by staff rx per day $198.70 $198.70 $198.70 $765.00
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) $618.26 $618.26 $618.26 $1,542.40
Thoracoscopy diagnostic 32601 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Thoracoscopy w/bx med space $5,834.36 $5,834.36 $5,834.36 $5,834.36
Thoracoscopy wbx sac $10,411.22 $10,411.22 $10,411.22 $10,411.22
Thorcscpy w/biop pleura $5,834.36 $5,834.36 $5,834.36 $5,834.36
Thrcspy w/diag bp lng inf uni $10,411.22 $10,411.22 $10,411.22 $10,411.22
Thrcspy w/diag bp lng nod uni $10,411.22 $10,411.22 $10,411.22 $10,411.22
Throat x-ray & fluoroscopy $88.05 $88.05 $88.05 $88.05
Thrombectomy/inf pq dialysis circuit $5,701.52 $5,701.52 $5,701.52 $5,701.52
Thrombectomy/inf pq dialysis circuit w/pta $11,340.57 $11,340.57 $11,340.57 $8,133.75
Thrombectomy/inf pq dialysis circuit w/stent plcmnt $17,956.72 $17,956.72 $17,956.72 $12,329.25
Thrombin time $5.77 $5.77 $5.77 $86.40
Thrombin time titer $6.85 $6.85 $6.85 $6.85
Thromboendarterectomy including patch graft if preformed; $5,405.70 $5,405.70 $5,405.70 $5,405.70
Thromboplastin time partial (ptt) substitution fractions each $6.47 $6.47 $6.47 $96.60
Thromboxane urine $35.11 $35.11 $35.11 $130.80
Thumb fusion with graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Thumb fusion with graft $7,143.73 $7,143.73 $7,143.73 $7,143.73
Thumb tendon transfer $3,244.61 $3,244.61 $3,244.61 $3,244.61
Thymectomy prtl/tot transcervical appr 60520 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Thyroglobulin antibody $15.91 $15.91 $15.91 $154.80
Thyroid (TSH) Test $16.80 $16.80 $16.80 $110.00
Thyroid Ultrasound $106.34 $106.34 $106.34 $603.90
Thyroid imaging $401.83 $401.83 $401.83 $999.00
Thyroid met imaging $401.83 $401.83 $401.83 $869.40
Thyroid met imaging/studies $401.83 $401.83 $401.83 $401.83
Thyroid mets imag whole body $538.27 $538.27 $538.27 $2,013.75
Thyroid uptake measurement $401.83 $401.83 $401.83 $856.50
Thyrotropin alfa 0.9 mg intramuscular solution $2,113.24 $2,113.24 $2,113.24 $7,476.81
Thyrotropin releasing hormone $50.41 $50.41 $50.41 $50.41
Thyroxine binding globulin (tbg) $14.78 $14.78 $14.78 $96.60
Tib/per revasc stent & ather 37231 $17,956.72 $17,956.72 $17,956.72 $17,956.72
Tibial arthroscopy/surgery $12,866.82 $12,866.82 $12,866.82 $12,866.82
Tibial arthroscopy/surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Tilt table study $530.60 $530.60 $530.60 $1,428.00
Tisagenlecleucel car-pos t $578,324.58 $578,324.58 $578,324.58 $2,194,589.53
Tisotumab vedotin-tftv 40 mg intravenous solution $188.65 $188.65 $188.65 $334.80
Tissue culture placenta $150.30 $150.30 $150.30 $1,024.20
Tissue culture skin/biopsy $140.73 $140.73 $140.73 $1,299.00
Tissue culture tumor $147.52 $147.52 $147.52 $873.75
Tissue exam koh skin/hair/nails $4.27 $4.27 $4.27 $70.80
Tissue transglutaminase iga $11.53 $11.53 $11.53 $100.20
Tlh uterus 250 g or less $10,411.22 $10,411.22 $10,411.22 $10,411.22
Tlh uterus over 250 g $10,411.22 $10,411.22 $10,411.22 $10,411.22
Tlh w/t/o 250 g or less $10,411.22 $10,411.22 $10,411.22 $10,411.22
Tlh w/t/o uterus over 250 g $10,411.22 $10,411.22 $10,411.22 $10,411.22
Tnot opn elbw to sho ea tdn $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tobramycin peak therapeutic drug level $16.13 $16.13 $16.13 $115.80
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector $5.79 $5.79 $5.79 $5,861.40
Tomosynthesis breast diagnostic left $53.92 $53.92 $53.92 $108.00
Tomosynthesis breast screen bilateral $65.52 $65.52 $65.52 $65.52
Tone decay hearing test $39.25 $39.25 $39.25 $39.25
Tongue base vol reduction $3,243.07 $3,243.07 $3,243.07 $3,243.07
Tongue biopsy; posterior one-third 41105 $3,243.07 $3,243.07 $3,243.07 $2,845.50
Tongue suspension $5,915.66 $5,915.66 $5,915.66 $5,915.66
Tongue to lip surgery $3,243.07 $3,243.07 $3,243.07 $3,243.07
Tonsillectomy (age 12+) $3,243.07 $3,243.07 $3,243.07 $2,735.53
Tonsillectomy (child under 12) $5,915.66 $5,915.66 $5,915.66 $1,240.00
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution $39.50 $39.50 $39.50 $70.20
Tot disc arthrp 1ntrspc crv $18,390.05 $18,390.05 $18,390.05 $18,390.05
Total Hip Replacement $12,866.82 $12,866.82 $12,866.82 $9,613.60
Total Knee Replacement $12,866.82 $12,866.82 $12,866.82 $6,668.80
Toxoplasma antibody igg $14.39 $14.39 $14.39 $108.60
Toxoplasma antibody igm $14.41 $14.41 $14.41 $106.50
Tp53 gene full gene sequence $641.85 $641.85 $641.85 $3,902.40
Tp53 gene trgt sequence alys $329.51 $329.51 $329.51 $2,041.20
Tpmt gene com vrnts $174.81 $174.81 $174.81 $477.00
Tprnl balo cntnc dev adjmt $243.21 $243.21 $243.21 $243.21
Tprnl balo cntnc dev bi $12,992.42 $12,992.42 $12,992.42 $12,992.42
Tprnl balo cntnc dev rmvl ea $3,448.97 $3,448.97 $3,448.97 $3,448.97
Tprnl balo cntnc dev uni $9,247.15 $9,247.15 $9,247.15 $9,247.15
Tprnl plmt biodegrdabl matrl $5,083.62 $5,083.62 $5,083.62 $5,083.62
Tr retinal les preterm inf $548.60 $548.60 $548.60 $548.60
Trabectedin 1 mg intravenous solution $383.07 $383.07 $383.07 $2,068.20
Trabeculoplasty laser surg $548.60 $548.60 $548.60 $671.25
Trachelectomy (cervicectomy) 57530 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Tracheobrnchsc thru est trachs incisn $509.25 $509.25 $509.25 $1,812.00
Tracheostoma revision; simple, without flap rotation $3,243.07 $3,243.07 $3,243.07 $3,243.07
Training self management diabetes individual outpatient department per 30 minutes $68.91 $68.91 $68.91 $121.20
Transabdom amnioinfus w/us $304.19 $304.19 $304.19 $338.25
Transcath biopsy $5,405.70 $5,405.70 $5,405.70 $3,482.25
Transcath closure of asd $17,956.72 $17,956.72 $17,956.72 $15,283.20
Transcath closure of vsd $17,956.72 $17,956.72 $17,956.72 $15,782.25
Transcath occlusion non-cns $11,340.57 $11,340.57 $11,340.57 $11,340.57
Transcath rmvl perm ldss pmkr rv $3,147.50 $3,147.50 $3,147.50 $2,724.00
Transcrv abltj utrn fibrd rf $7,394.81 $7,394.81 $7,394.81 $7,394.81
Transcutaneous hgb 88738 $5.02 $5.02 $5.02 $5.02
Transfer of abdominal muscle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Transfer of embryo $304.19 $304.19 $304.19 $304.19
Transfer of iliopsoas muscle $7,143.73 $7,143.73 $7,143.73 $7,143.73
Transfer of iliopsoas muscle $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transfer of spinal muscle $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transfer skin pedicle flap $1,829.23 $1,829.23 $1,829.23 $1,829.23
Transfer tendon to pelvis $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transferrin $12.76 $12.76 $12.76 $108.00
Transfusion blood/blood component(s) $437.18 $437.18 $437.18 $1,008.60
Transorl lwr esophgl myotomy $5,952.81 $5,952.81 $5,952.81 $5,814.75
Transperi needle place pros $5,083.62 $5,083.62 $5,083.62 $5,083.62
Transplant forearm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transplant forearm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transplant hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transplant of thigh tendon $7,143.73 $7,143.73 $7,143.73 $7,143.73
Transplant palm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transplant/graft hand tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transplant/graft palm tendon $3,244.61 $3,244.61 $3,244.61 $3,244.61
Transplants of thigh tendons $7,143.73 $7,143.73 $7,143.73 $7,143.73
Transplj hematopoietic boost $1,639.28 $1,639.28 $1,639.28 $1,437.00
Transplt allo hct/donor $59,142.33 $59,142.33 $59,142.33 $3,943.20
Transplt allo lymphocytes $1,639.28 $1,639.28 $1,639.28 $1,639.28
Transplt autol hct/donor $1,639.28 $1,639.28 $1,639.28 $3,260.40
Transposition of vein valve $5,405.70 $5,405.70 $5,405.70 $5,405.70
Transurethral rf treatment $2,048.51 $2,048.51 $2,048.51 $2,048.51
Trastuzumab 150 mg intravenous solution $76.18 $76.18 $76.18 $5,762.28
Trastuzumab-anns 150 mg intravenous solution $43.28 $43.28 $43.28 $1,410.00
Trastuzumab-qyyp 150 mg intravenous solution $28.62 $28.62 $28.62 $198.00
Trauma partial team response w/critical care services level 4 $1,323.17 $1,323.17 $1,323.17 $6,448.80
Trb@ gene rearrange dirprobe $49.59 $49.59 $49.59 $49.59
Treat ankle dislocation $1,600.41 $1,600.41 $1,600.41 $1,980.00
Treat ankle dislocation $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treat ankle dislocation $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat ankle fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treat big toe fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat cheek bone fracturemalar 21360 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Treat clavicle dislocation 23545 $239.88 $239.88 $239.88 $998.40
Treat ectopic pregnancy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Treat ectopic pregnancy $5,834.36 $5,834.36 $5,834.36 $5,834.36
Treat elbow dislocation $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat elbow dislocation $1,600.41 $1,600.41 $1,600.41 $2,074.80
Treat elbow fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treat elbow fracture $12,866.82 $12,866.82 $12,866.82 $6,347.40
Treat elbow fracture $1,600.41 $1,600.41 $1,600.41 $3,135.00
Treat eyelid by injection $399.04 $399.04 $399.04 $399.04
Treat eyelid lesion 67850 $968.54 $968.54 $968.54 $968.54
Treat finger fracture each $1,600.41 $1,600.41 $1,600.41 $2,055.00
Treat finger fracture each $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat foot bone lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat foot dislocation $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat foot dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat foot dislocation $239.88 $239.88 $239.88 $261.75
Treat foot dislocation $239.88 $239.88 $239.88 $239.88
Treat foot dislocation $239.88 $239.88 $239.88 $759.00
Treat foot dislocation $239.88 $239.88 $239.88 $568.20
Treat foot dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat foot dislocation $1,600.41 $1,600.41 $1,600.41 $1,600.41
Treat fracture of radius $1,600.41 $1,600.41 $1,600.41 $1,600.41
Treat fracture of radius $1,600.41 $1,600.41 $1,600.41 $1,815.75
Treat fracture of ulna $239.88 $239.88 $239.88 $1,728.60
Treat hand bone lesion $1,600.41 $1,600.41 $1,600.41 $1,600.41
Treat hand dislocation $1,600.41 $1,600.41 $1,600.41 $1,600.41
Treat hand dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat hand dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat heel fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treat hip dislocation $1,600.41 $1,600.41 $1,600.41 $3,050.40
Treat hip dislocation $1,600.41 $1,600.41 $1,600.41 $4,051.20
Treat humerus fracture $1,600.41 $1,600.41 $1,600.41 $2,055.00
Treat humerus fracture $12,866.82 $12,866.82 $12,866.82 $7,589.40
Treat humerus fracture $12,866.82 $12,866.82 $12,866.82 $12,866.82
Treat humerus fracture $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat humerus fracture $12,866.82 $12,866.82 $12,866.82 $6,347.40
Treat humerus fracture $1,600.41 $1,600.41 $1,600.41 $2,552.40
Treat humerus fracture $12,866.82 $12,866.82 $12,866.82 $6,347.40
Treat humerus fracture $12,866.82 $12,866.82 $12,866.82 $12,866.82
Treat humerus fracture $12,866.82 $12,866.82 $12,866.82 $6,347.40
Treat knee dislocation $1,600.41 $1,600.41 $1,600.41 $2,630.40
Treat knee fracture 27530 $239.88 $239.88 $239.88 $759.00
Treat knee fracture(s) $239.88 $239.88 $239.88 $642.00
Treat kneecap dislocation $239.88 $239.88 $239.88 $2,336.00
Treat kneecap dislocation $7,143.73 $7,143.73 $7,143.73 $4,493.40
Treat kneecap fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treat knuckle dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat knuckle dislocation $1,600.41 $1,600.41 $1,600.41 $3,448.20
Treat lower jaw fracture 21462 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Treat lower leg bone lesion $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat lower leg dislocation $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat lower leg dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat lower leg dislocation $239.88 $239.88 $239.88 $2,812.80
Treat lower leg fracture $12,866.82 $12,866.82 $12,866.82 $5,152.80
Treat lower leg fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treat lower leg fracture $12,866.82 $12,866.82 $12,866.82 $6,347.40
Treat lower leg joint $7,143.73 $7,143.73 $7,143.73 $4,493.40
Treat metacarpal fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat metacarpal fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat metatarsal fracture $7,143.73 $7,143.73 $7,143.73 $6,347.40
Treat metatarsal fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat midfoot fracture each $1,600.41 $1,600.41 $1,600.41 $5,502.00
Treat midfoot fracture each $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat penis lesion graft $9,247.15 $9,247.15 $9,247.15 $9,247.15
Treat penis lesion graft $5,083.62 $5,083.62 $5,083.62 $5,083.62
Treat radius fracture $12,866.82 $12,866.82 $12,866.82 $12,866.82
Treat radius fracture $7,143.73 $7,143.73 $7,143.73 $6,347.40
Treat sesamoid bone fracture $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat skull fracture $3,243.07 $3,243.07 $3,243.07 $3,243.07
Treat spinal cord lesion $890.29 $890.29 $890.29 $890.29
Treat spinal cord lesion $890.29 $890.29 $890.29 $890.29
Treat sternum fracture $239.88 $239.88 $239.88 $390.75
Treat tail bone fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat thigh fracture $1,600.41 $1,600.41 $1,600.41 $3,355.20
Treat thigh fracture $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treat thigh fracture $239.88 $239.88 $239.88 $261.75
Treat thigh fracture $239.88 $239.88 $239.88 $647.20
Treat thigh fx growth plate $1,600.41 $1,600.41 $1,600.41 $1,678.50
Treat thigh fx growth plate $239.88 $239.88 $239.88 $239.88
Treat thumb fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat thumb fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat toe dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat toe dislocation $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat toe dislocation $265.58 $265.58 $265.58 $3,197.40
Treat toe fracture $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treat trigeminal nerve $1,952.77 $1,952.77 $1,952.77 $1,952.77
Treat trigeminal tract $1,952.77 $1,952.77 $1,952.77 $1,952.77
Treat ulnar fracture $1,600.41 $1,600.41 $1,600.41 $2,874.60
Treat ulnar fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treat vaginal bleeding $201.17 $201.17 $201.17 $235.50
Treat wrist bone fracture $1,600.41 $1,600.41 $1,600.41 $1,815.75
Treat wrist dislocation $239.88 $239.88 $239.88 $825.60
Treat/graft heel fracture $12,866.82 $12,866.82 $12,866.82 $12,866.82
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) $7,143.73 $7,143.73 $7,143.73 $7,747.20
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) $7,143.73 $7,143.73 $7,143.73 $7,747.20
Treatment fx radial distal open w/internal fixation left (restricted method ii cah) $7,143.73 $7,143.73 $7,143.73 $7,747.20
Treatment incomplete abortion completed surgically any trimester $3,179.53 $3,179.53 $3,179.53 $5,405.40
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour $128.90 $128.90 $128.90 $246.60
Treatment inhalation pressurized/nonpressurized acute airway obstruction $203.39 $203.39 $203.39 $286.80
Treatment missed abortion completed surgically 1st trimester $3,179.53 $3,179.53 $3,179.53 $5,405.40
Treatment mouth roof lesion $3,243.07 $3,243.07 $3,243.07 $3,243.07
Treatment of anal fissure $911.71 $911.71 $911.71 $911.71
Treatment of anal fissure w/dilat 46940 $2,742.39 $2,742.39 $2,742.39 $2,742.39
Treatment of ankle fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treatment of ankle fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treatment of ankle fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treatment of ankle fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treatment of ankle fracture 27786 $239.88 $239.88 $239.88 $825.60
Treatment of choroid lesion $548.60 $548.60 $548.60 $548.60
Treatment of corneal lesion $298.93 $298.93 $298.93 $298.93
Treatment of eyelid lesions $298.93 $298.93 $298.93 $298.93
Treatment of fibula fracture $7,143.73 $7,143.73 $7,143.73 $5,152.80
Treatment of fibula fracture 27780 $239.88 $239.88 $239.88 $769.80
Treatment of foot infection $1,600.41 $1,600.41 $1,600.41 $1,560.75
Treatment of foot infection $3,244.61 $3,244.61 $3,244.61 $3,244.61
Treatment of gum lesion $1,481.28 $1,481.28 $1,481.28 $1,481.28
Treatment of heel fracture 28400 $239.88 $239.88 $239.88 $759.00
Treatment of miscarriage $3,179.53 $3,179.53 $3,179.53 $3,179.53
Treatment of mouth lesion physical 40820 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Treatment of penis lesion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Treatment of penis lesion $2,862.05 $2,862.05 $2,862.05 $2,862.05
Treatment of rectal prolapse $911.71 $911.71 $911.71 $911.71
Treatment of retinal lesion $548.60 $548.60 $548.60 $548.60
Treatment of retinal lesion $298.93 $298.93 $298.93 $298.93
Treatment of retinal lesion $3,771.00 $3,771.00 $3,771.00 $3,771.00
Treatment of thigh fracture $1,600.41 $1,600.41 $1,600.41 $2,093.25
Treatment of thigh fracture $239.88 $239.88 $239.88 $677.25
Treatment of thigh fracture $239.88 $239.88 $239.88 $759.00
Treatment of thigh fracture $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treatment of thigh fracture $1,600.41 $1,600.41 $1,600.41 $2,068.50
Treatment of tibia fracture $12,866.82 $12,866.82 $12,866.82 $6,347.40
Treatment of tibia fracture $7,143.73 $7,143.73 $7,143.73 $7,143.73
Treatment of tibia fracture $12,866.82 $12,866.82 $12,866.82 $6,347.40
Treatment of toe fracture 28510 $239.88 $239.88 $239.88 $371.40
Treatment of urethra lesion $2,048.51 $2,048.51 $2,048.51 $2,048.51
Treatment of urethra lesion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Treatment of urethra lesion $3,448.97 $3,448.97 $3,448.97 $3,448.97
Treatment radiation delivery level 2 $262.98 $262.98 $262.98 $787.80
Treatment x10sv retinopathy $548.60 $548.60 $548.60 $548.60
Tremelimumab-actl 20 mg/ml intravenous solution $141.17 $141.17 $141.17 $258.60
Treponema pallidum antibody $13.24 $13.24 $13.24 $146.40
Treprostinil injection $55.48 $55.48 $55.48 $1,570.80
Trg gene rearrangement anal $201.50 $201.50 $201.50 $732.00
Triamcinolone a inj prs-free $24.51 $24.51 $24.51 $696.00
Trichinella antibody $12.56 $12.56 $12.56 $140.25
Trichomonas assay w/optic $15.29 $15.29 $15.29 $123.60
Triglycerides $5.74 $5.74 $5.74 $80.40
Trilaciclib 300 mg intravenous solution $5.39 $5.39 $5.39 $5.39
Trim nail(s) $59.40 $59.40 $59.40 $105.60
Trim nondyst nails $59.40 $59.40 $59.40 $138.60
Triptorelin pamoate $491.90 $491.90 $491.90 $3,103.20
Trluml dil aq o/f can w/st $5,159.71 $5,159.71 $5,159.71 $5,159.71
Trluml dil aq o/f can without st $4,022.86 $4,022.86 $4,022.86 $4,022.86
Trml dstrj ios bvn 1st 2 l/s $12,866.82 $12,866.82 $12,866.82 $12,715.50
Trmt of fracture (femoral shaft) 27500 $239.88 $239.88 $239.88 $729.60
Trnscath plc vas stent w/s&i ini vein $11,340.57 $11,340.57 $11,340.57 $13,370.25
Trnscath retrv pq vasc fb w/guide $3,147.50 $3,147.50 $3,147.50 $6,120.00
Trnscath tx thromblytc art/ven sbsq day $3,147.50 $3,147.50 $3,147.50 $4,949.25
Trnscath tx thromblytc artery non-intracrn ini day $5,405.70 $5,405.70 $5,405.70 $6,966.60
Trnscath tx thromblytc cath rmv sbsq day $3,147.50 $3,147.50 $3,147.50 $5,324.40
Trnscath tx thromblytc vein ini day $3,147.50 $3,147.50 $3,147.50 $5,236.20
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm $3,660.97 $3,660.97 $3,660.97 $8,968.80
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< $1,829.23 $1,829.23 $1,829.23 $3,955.80
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm $1,829.23 $1,829.23 $1,829.23 $1,829.23
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm $1,829.23 $1,829.23 $1,829.23 $3,955.80
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm $1,829.23 $1,829.23 $1,829.23 $3,955.80
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< $1,829.23 $1,829.23 $1,829.23 $4,080.00
Troponin quantitative $12.47 $12.47 $12.47 $114.60
Trurl dstrj prst8 tiss rf wv $3,448.97 $3,448.97 $3,448.97 $3,448.97
Tte w or without contr, cont ecg $790.06 $790.06 $790.06 $2,577.00
Tte w or without fol w/con,stres $790.06 $790.06 $790.06 $1,171.20
Tte w or without fol w/cont, com $790.06 $790.06 $790.06 $1,098.00
Tte w or without fol w/cont, f/u $790.06 $790.06 $790.06 $693.75
Tubal Ligation (Laparoscopic) $5,834.36 $5,834.36 $5,834.36 $1,536.60
Tumor cell deplete of harvst $437.18 $437.18 $437.18 $437.18
Tvh >250 gms 58290 $7,394.81 $7,394.81 $7,394.81 $7,394.81
Tx atrial fib pulm vein isol $24,532.30 $24,532.30 $24,532.30 $29,199.75
Tx closed distal humerus fx $239.88 $239.88 $239.88 $134.40
Tx closed hip disl traumatic without anes $239.88 $239.88 $239.88 $998.40
Tx closed tib fx proximal w/w/o manip w/skel trac $3,244.61 $3,244.61 $3,244.61 $3,483.00
Tx closed tib shaft fx without manip $239.88 $239.88 $239.88 $718.20
Tx contour defects 1.1-5.0cc 11951 $612.13 $612.13 $612.13 $612.13
Tx contour defects >10.0 cc $612.13 $612.13 $612.13 $612.13
Tx open art fx mcp/iphlngl jnt incl int fixtn ea $3,244.61 $3,244.61 $3,244.61 $5,134.20
Tx open dstl phlngl fx f/t internal fixation ea $3,244.61 $3,244.61 $3,244.61 $5,728.20
Tx open iphlngl jt disl internal fixation sngl $3,244.61 $3,244.61 $3,244.61 $4,281.00
Tx open nsl fx uncomp $3,243.07 $3,243.07 $3,243.07 $5,368.20
Tx open nsl sptl fx $3,244.61 $3,244.61 $3,244.61 $3,244.61
Tx phalangeal shaft fx open prox/middle ea $3,244.61 $3,244.61 $3,244.61 $5,854.20
Tx tarsal bone fx without manip 28450 $239.88 $239.88 $239.88 $509.40
Tympanic membrane repair $1,481.28 $1,481.28 $1,481.28 $1,481.28
Tympanolysis transcanal 69450 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Tympanometry & reflex thresh $156.46 $156.46 $156.46 $156.46
Tympanostomy/ven tube/loc/top anes 69433 $509.25 $509.25 $509.25 $2,048.25
Tympp antrt/mastoid without ossic chain recnst 69635 $5,915.66 $5,915.66 $5,915.66 $5,915.66
Tympp antrt/mastoidotomy prosthesis torp 69637 $5,915.66 $5,915.66 $5,915.66 $5,915.66
U/s trtmt, not leiomyomata $12,866.82 $12,866.82 $12,866.82 $12,866.82
Ua w/micro/comp poc $4.02 $4.02 $4.02 $25.80
Ublituximab-xiiy 25 mg/ml intravenous solution $71.90 $71.90 $71.90 $133.20
Ugt1a1 gene analy common variants $234.00 $234.00 $234.00 $438.75
Ultrasound abdomen aorta screening study aaa $106.34 $106.34 $106.34 $288.00
Ultrasound bone density measure $106.34 $106.34 $106.34 $106.34
Ultrasound breast complete $106.34 $106.34 $106.34 $546.60
Ultrasound breast unilateral limited (both sides) $88.05 $88.05 $88.05 $423.00
Ultrasound chest $106.34 $106.34 $106.34 $461.40
Ultrasound doppler velocimetry fetal umbilical artery $106.34 $106.34 $106.34 $257.40
Ultrasound dx ophth b-scan $106.34 $106.34 $106.34 $438.00
Ultrasound elastography parenchyma $106.34 $106.34 $106.34 $202.20
Ultrasound encephalogram $106.34 $106.34 $106.34 $463.50
Ultrasound exam k transpl w/doppler $106.34 $106.34 $106.34 $718.80
Ultrasound fetal biophysical profile without non-stress testing $106.34 $106.34 $106.34 $540.00
Ultrasound hips infant dynamic $88.05 $88.05 $88.05 $382.50
Ultrasound infant hips ltd without stress $88.05 $88.05 $88.05 $295.50
Ultrasound joint complete left $106.34 $106.34 $106.34 $785.40
Ultrasound joint/nonvascular extremity limited left $106.34 $106.34 $106.34 $571.80
Ultrasound nrv&acc strux 1xtr compre $106.34 $106.34 $106.34 $106.34
Ultrasound pregnant uterus detailed fetal exam single/1st gestation $241.72 $241.72 $241.72 $915.75
Ultrasound pregnant uterus follow up per fetus $106.34 $106.34 $106.34 $450.75
Ultrasound pregnant uterus limited >= 1 fetuses $106.34 $106.34 $106.34 $548.25
Ultrasound pregnant uterus transvaginal $106.34 $106.34 $106.34 $678.60
Ultrasound prostate/transrectal $106.34 $106.34 $106.34 $695.40
Ultrasound retroperitoneal limited $106.34 $106.34 $106.34 $543.00
Ultrasound scrotum and contents $106.34 $106.34 $106.34 $693.75
Ultrasound spinal canal and contents $106.34 $106.34 $106.34 $411.00
Ultrasound transvaginal non obstetric $106.34 $106.34 $106.34 $704.25
Ultrasound trgt dyn mbubb 1st les $178.02 $178.02 $178.02 $303.00
Ultraviolet therapy $10.45 $10.45 $10.45 $10.45
Umbilical cord occlud w/us $304.19 $304.19 $304.19 $304.19
Unlistd noninvas vasc dx std $24.49 $24.49 $24.49 $24.49
Unlisted CT procedure $88.05 $88.05 $88.05 $758.40
Unlisted all/immlg svc/px $24.49 $24.49 $24.49 $24.49
Unlisted chemotherapy px $46.14 $46.14 $46.14 $44.25
Unlisted cranfcl&maxlfcl px $232.22 $232.22 $232.22 $232.22
Unlisted cv px dx nuc med $401.83 $401.83 $401.83 $1,864.20
Unlisted cytogenetic study $53.43 $53.43 $53.43 $53.43
Unlisted cytopathology px $53.43 $53.43 $53.43 $53.43
Unlisted dx gi procedure $156.46 $156.46 $156.46 $247.20
Unlisted endocrine px dx nuc $401.83 $401.83 $401.83 $401.83
Unlisted fetal invas px w/us $201.17 $201.17 $201.17 $201.17
Unlisted fluoroscopic px $88.05 $88.05 $88.05 $88.05
Unlisted gi px dx nuc med $401.83 $401.83 $401.83 $780.60
Unlisted gu px dx nuc med $401.83 $401.83 $401.83 $401.83
Unlisted hystsc px uterus $201.17 $201.17 $201.17 $201.17
Unlisted laparoscopic liver biopy 47379 $5,834.36 $5,834.36 $5,834.36 $3,289.80
Unlisted laparoscopic procedure 49659 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laparoscopic reduction intestine 44238 $5,834.36 $5,834.36 $5,834.36 $3,467.40
Unlisted laparoscopy procedure biliary tract 47579 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px appendix $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px bladder $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px endoc sys $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px esoph $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px lymphtc sys $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px ovidct ovry $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px renal $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px spleen $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px testis $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px ureter $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted laps px uterus $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlisted maxlfcl prosth px $232.22 $232.22 $232.22 $232.22
Unlisted misc path test $53.43 $53.43 $53.43 $299.40
Unlisted mr procedure $88.05 $88.05 $88.05 $1,037.40
Unlisted muscskel px dx nuc $401.83 $401.83 $401.83 $545.40
Unlisted muscskel px head $232.22 $232.22 $232.22 $232.22
Unlisted neurological dx px $156.46 $156.46 $156.46 $156.46
Unlisted nrvs sys px dx nuc $401.83 $401.83 $401.83 $401.83
Unlisted oph svc/procedure $24.49 $24.49 $24.49 $24.49
Unlisted orl service/px $24.49 $24.49 $24.49 $117.00
Unlisted procedure colon $911.71 $911.71 $911.71 $2,595.60
Unlisted procedure esophagus $937.56 $937.56 $937.56 $152.40
Unlisted procedure eyelids $298.93 $298.93 $298.93 $298.93
Unlisted procedure larynx $232.22 $232.22 $232.22 $232.22
Unlisted procedure liver $703.59 $703.59 $703.59 $2,694.00
Unlisted procedure orbit $298.93 $298.93 $298.93 $298.93
Unlisted procedure pancreas $703.59 $703.59 $703.59 $152.40
Unlisted procedure rectum $911.71 $911.71 $911.71 $882.75
Unlisted procedure spine $239.88 $239.88 $239.88 $239.88
Unlisted psychiatric service/proc 90899 $29.79 $29.79 $29.79 $29.79
Unlisted px abdomen muscskel $239.88 $239.88 $239.88 $1,461.75
Unlisted px accessory sinus $232.22 $232.22 $232.22 $232.22
Unlisted px ant segment eye $2,280.73 $2,280.73 $2,280.73 $761.40
Unlisted px arthroscopy $239.88 $239.88 $239.88 $239.88
Unlisted px biliary tract $937.56 $937.56 $937.56 $1,788.00
Unlisted px casting/strpg $157.79 $157.79 $157.79 $152.00
Unlisted px conjunctiva $298.93 $298.93 $298.93 $298.93
Unlisted px exc pressure ulc $703.59 $703.59 $703.59 $703.59
Unlisted px external ear $232.22 $232.22 $232.22 $126.00
Unlisted px extraocular musc $298.93 $298.93 $298.93 $298.93
Unlisted px foot/toes $239.88 $239.88 $239.88 $3,556.50
Unlisted px forearm/wrist $239.88 $239.88 $239.88 $109.20
Unlisted px hands/fingers $239.88 $239.88 $239.88 $4,387.20
Unlisted px inner ear $232.22 $232.22 $232.22 $232.22
Unlisted px lacrimal system $298.93 $298.93 $298.93 $298.93
Unlisted px leg/ankle $239.88 $239.88 $239.88 $118.20
Unlisted px male genital sys $243.21 $243.21 $243.21 $90.60
Unlisted px med radj physics $132.77 $132.77 $132.77 $132.77
Unlisted px middle ear $232.22 $232.22 $232.22 $232.22
Unlisted px neck/thorax $232.22 $232.22 $232.22 $1,989.00
Unlisted px palate uvula $232.22 $232.22 $232.22 $232.22
Unlisted px pelvis/hip joint $239.88 $239.88 $239.88 $239.88
Unlisted px posterior segmnt $2,280.73 $2,280.73 $2,280.73 $4,036.20
Unlisted px salivry glnd/dux $232.22 $232.22 $232.22 $93.60
Unlisted px small intestine $937.56 $937.56 $937.56 $2,744.40
Unlisted px temporal bone $232.22 $232.22 $232.22 $232.22
Unlisted px ther rad tx plng $132.77 $132.77 $132.77 $132.77
Unlisted px tongue flr mouth $232.22 $232.22 $232.22 $286.80
Unlisted px vestibule mouth $232.22 $232.22 $232.22 $232.22
Unlisted reprod med lab proc $53.43 $53.43 $53.43 $53.43
Unlisted resp px dx nuc med $401.83 $401.83 $401.83 $401.83
Unlisted spec derm svc/px $198.70 $198.70 $198.70 $198.70
Unlisted surgical path px $53.43 $53.43 $53.43 $53.43
Unlisted transfusion med px $24.49 $24.49 $24.49 $306.00
Unlisted ultrasound procedure $88.05 $88.05 $88.05 $306.00
Unlisted vasc endoscopy px $618.26 $618.26 $618.26 $618.26
Unlstd hematop ret/endo lymp $401.83 $401.83 $401.83 $607.20
Unlstd laps px mat care&dlvr $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unlstd laps px sprmatic cord $5,834.36 $5,834.36 $5,834.36 $5,834.36
Unsched dialysis esrd pt hos $699.72 $699.72 $699.72 $1,560.60
Upgrade pm system $10,465.33 $10,465.33 $10,465.33 $7,818.75
Upper Back (Thoracic Spine) MRI (with and without contrast) $357.13 $357.13 $357.13 $2,713.80
Upper Back (Thoracic Spine) MRI (with contrast) $357.13 $357.13 $357.13 $2,039.85
Upper Back (Thoracic Spine) MRI (without contrast) $241.72 $241.72 $241.72 $2,013.08
Upper Endoscopy (EGD, diagnostic) $937.56 $937.56 $937.56 $1,751.66
Upper Endoscopy (EGD, with biopsy) $937.56 $937.56 $937.56 $1,675.80
Uppr gi scope w/submuc inj $937.56 $937.56 $937.56 $2,262.00
Urachal cyst/sinus excision 51500 $5,834.36 $5,834.36 $5,834.36 $5,834.36
Urea nitrogen $3.95 $3.95 $3.95 $39.60
Urea nitrogen 24 hour urine $5.56 $5.56 $5.56 $49.50
Urea nitrogen clearance $7.20 $7.20 $7.20 $57.00
Ureter endoscopy $3,448.97 $3,448.97 $3,448.97 $3,448.97
Ureter endoscopy & biopsy $5,083.62 $5,083.62 $5,083.62 $5,083.62
Ureter endoscopy & biopsy $5,083.62 $5,083.62 $5,083.62 $5,083.62
Ureter endoscopy & catheter $3,448.97 $3,448.97 $3,448.97 $3,448.97
Ureter endoscopy & treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Ureter endoscopy & treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Ureter endoscopy & treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Ureter endoscopy & treatment $5,083.62 $5,083.62 $5,083.62 $5,083.62
Ureteral reflux study $401.83 $401.83 $401.83 $1,251.75
Urethrcystgrphy rtrgrde s&i $241.72 $241.72 $241.72 $642.60
Urethrlys transvag with scope $3,448.97 $3,448.97 $3,448.97 $3,448.97
Urethrocystography void s&i $241.72 $241.72 $241.72 $707.25
Uric acid blood $4.52 $4.52 $4.52 $48.60
Uric acid urine $5.08 $5.08 $5.08 $52.20
Urinalysis (with microscopy) $3.17 $3.17 $3.17 $36.52
Urinalysis (without microscopy) $2.25 $2.25 $2.25 $32.50
Urinalysis microscopic only $3.05 $3.05 $3.05 $13.80
Urinalysis qual/semiquant excpt ia $2.17 $2.17 $2.17 $14.40
Urinary reflex study $59.40 $59.40 $59.40 $59.40
Urine Culture Test $8.07 $8.07 $8.07 $65.15
Urine flow measurement 51736 $128.90 $128.90 $128.90 $128.90
Urine pregnancy test $8.61 $8.61 $8.61 $63.00
Urography inf drip &/or bolus $178.02 $178.02 $178.02 $178.02
Urography, antegrade $357.13 $357.13 $357.13 $1,132.80
Use 1st target lesion $106.34 $106.34 $106.34 $189.00
Ustekinumab 130 mg/26 ml intravenous solution $13.29 $13.29 $13.29 $55.80
Ustekinumab 45 mg/0.5 ml subcutaneous solution $157.68 $157.68 $157.68 $746.40
V-exc/lip/w/pri linear closure 40520 $3,243.07 $3,243.07 $3,243.07 $3,243.07
Vaccine rabies im $312.03 $312.03 $312.03 $800.00
Vaccinia vrs vac 0.3 ml perq $0.01 $0.01 $0.01 $0.01
Vag hys/<250g/rmv tube/rpr entero 58263 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Vag hyst incl t/o complex $4,936.45 $4,936.45 $4,936.45 $4,936.45
Vag hyst including t/o $4,936.45 $4,936.45 $4,936.45 $4,936.45
Vag hyst t/o & repair compl $7,394.81 $7,394.81 $7,394.81 $7,394.81
Vag hyst w/enterocele compl 58294 $4,936.45 $4,936.45 $4,936.45 $4,936.45
Vag hyst w/enterocele repair $4,936.45 $4,936.45 $4,936.45 $4,936.45
Vaginal bx $201.17 $201.17 $201.17 $184.50
Vaginal delivery after cesarean delivery 59612 $3,179.53 $3,179.53 $3,179.53 $3,179.53
Vaginal hysterectomy $4,936.45 $4,936.45 $4,936.45 $4,936.45
Vaginectomy partial w/nodes $3,179.53 $3,179.53 $3,179.53 $3,179.53
Valproic acid total therapeutic drug level $13.54 $13.54 $13.54 $153.75
Valrubicin injection $1,376.79 $1,376.79 $1,376.79 $6,841.31
Valvuloplasty aortic $5,701.52 $5,701.52 $5,701.52 $6,420.60
Valvuloplasty mitral $11,340.57 $11,340.57 $11,340.57 $11,340.57
Valvuloplasty pulmonary $11,340.57 $11,340.57 $11,340.57 $12,754.50
Vancomycin peak therapeutic drug level $13.54 $13.54 $13.54 $147.00
Vanomycin dna amp probe $35.09 $35.09 $35.09 $35.09
Varicella zoster antibody igg $12.88 $12.88 $12.88 $117.00
Varicella-zoster immue globin im $2,359.90 $2,359.90 $2,359.90 $2,359.90
Vasc emb/occ w/prs cath $17,956.72 $17,956.72 $17,956.72 $17,508.00
Vasc graft into carpal bone $3,244.61 $3,244.61 $3,244.61 $3,244.61
Vasectomy $2,048.51 $2,048.51 $2,048.51 $2,361.00
Vedolizumab 300 mg intravenous solution $22.06 $22.06 $22.06 $27,154.80
Veeg cont 2-12 hrs $530.60 $530.60 $530.60 $1,194.00
Veeg ea 12-26hr cont mntr $1,017.39 $1,017.39 $1,017.39 $2,109.60
Veeg intrmnt 2-12 hrs $311.40 $311.40 $311.40 $783.60
Veeg unmon 12-26 hrs $530.60 $530.60 $530.60 $530.60
Veeg unmon 2-12 hrs $311.40 $311.40 $311.40 $586.80
Vein x-ray adrenal gland $3,147.50 $3,147.50 $3,147.50 $3,147.50
Vein x-ray adrenal glands $5,405.70 $5,405.70 $5,405.70 $2,962.20
Vein x-ray eye socket $618.26 $618.26 $618.26 $1,141.50
Vein x-ray kidney $3,147.50 $3,147.50 $3,147.50 $2,750.25
Vein x-ray liver $3,147.50 $3,147.50 $3,147.50 $3,147.50
Vein x-ray liver w/hemodynam $3,147.50 $3,147.50 $3,147.50 $3,413.25
Vein x-ray liver w/hemodynam $3,147.50 $3,147.50 $3,147.50 $3,147.50
Vein x-ray liver without hemodyn $3,147.50 $3,147.50 $3,147.50 $3,476.40
Vein x-ray skull $3,147.50 $3,147.50 $3,147.50 $2,489.25
Vein x-ray skull epidural $618.26 $618.26 $618.26 $797.25
Vein x-ray spleen/liver $3,147.50 $3,147.50 $3,147.50 $3,324.60
Velaglucerase alfa 400 unit intravenous solution $380.18 $380.18 $380.18 $5,564.78
Vemp test i&r cervical $156.46 $156.46 $156.46 $336.60
Vemp test i&r ocular $156.46 $156.46 $156.46 $336.60
Vemp tst i&r cervical&ocular $311.40 $311.40 $311.40 $636.60
Ven thrombosis images bilat $401.83 $401.83 $401.83 $1,103.25
Venogram ext bil s&i $1,553.44 $1,553.44 $1,553.44 $2,472.00
Venogram extremity supervision & interpretation unilateral $1,553.44 $1,553.44 $1,553.44 $1,553.44
Venous m-thrombectomy add-on $3,147.50 $3,147.50 $3,147.50 $6,159.75
Venous mech thrombectomy $11,340.57 $11,340.57 $11,340.57 $12,268.80
Venous sampling s&i $5,405.70 $5,405.70 $5,405.70 $4,294.50
Venous thrombosis imaging $538.27 $538.27 $538.27 $1,172.40
Ventilator each subsequent day $661.10 $661.10 $661.10 $1,138.50
Ventilator initial day $661.10 $661.10 $661.10 $1,387.50
Ventricular puncture prev burr hole without inj 61020 $890.29 $890.29 $890.29 $693.75
Version cephalic external $3,179.53 $3,179.53 $3,179.53 $1,444.80
Verteporfin injection $11.55 $11.55 $11.55 $11.55
Very long chain fatty acids $19.75 $19.75 $19.75 $342.75
Viper venom prothrombin time $17.49 $17.49 $17.49 $17.49
Virus isolation addl studies ea $20.20 $20.20 $20.20 $186.60
Visit established high 40-54 minutes/level 5 $128.87 $128.87 $128.87 $128.87
Visual audiometry (vra) $156.46 $156.46 $156.46 $156.46
Vit for macular hole $4,022.86 $4,022.86 $4,022.86 $4,022.86
Vit for macular pucker $4,022.86 $4,022.86 $4,022.86 $4,022.86
Vit for membrane dissect $4,022.86 $4,022.86 $4,022.86 $4,022.86
Vital capacity test $156.46 $156.46 $156.46 $156.46
Vitamin D Test $29.60 $29.60 $29.60 $142.35
Vitamin b-12 $15.08 $15.08 $15.08 $111.00
Vkorc1 gene $88.20 $88.20 $88.20 $88.20
Vol reduction of blood/prod $171.36 $171.36 $171.36 $131.25
Volume deplete of harvest $437.18 $437.18 $437.18 $437.18
Volume measurement urine timed $3.64 $3.64 $3.64 $25.80
Vonvendi inj 1 iu vwf:rco $1.85 $1.85 $1.85 $10.80
Vulvectomy simple partial $3,179.53 $3,179.53 $3,179.53 $3,179.53
Vutrisiran 25 mg/0.5 ml subcutaneous syringe $4,983.86 $4,983.86 $4,983.86 $13,248.60
Vyjuvek 5x10^9pfu/ml, 0.1 ml $1,037.12 $1,037.12 $1,037.12 $1,037.12
Warde 1003990 aldosterone $40.75 $40.75 $40.75 $244.50
Warde 1005020 citrate 24 hour urine $27.80 $27.80 $27.80 $182.25
Warde 1005055 5-hiaa 24 hour urine $12.90 $12.90 $12.90 $138.00
Warde 1006955 catecholamines fractionated 24 hour urine $25.25 $25.25 $25.25 $225.60
Warde 1007138 vanillymandelic acid 24 hour urine $15.50 $15.50 $15.50 $133.50
Warde 1015200 kappa light chain free $17.27 $17.27 $17.27 $130.80
Warde 3004000 immunoglobulin subclass 1 $8.02 $8.02 $8.02 $128.40
Warde 3008005 oligoclonal bands $27.39 $27.39 $27.39 $138.60
Warde 3016000 west nile virus antibody $16.85 $16.85 $16.85 $111.20
Warde 3016000 west nile virus antibody igg $14.39 $14.39 $14.39 $111.20
Warde 3016300 saccharomyces cerevisiae iga antibody $12.25 $12.25 $12.25 $100.80
Warde 3400652 ova & parasites direct smear concentration and id $8.90 $8.90 $8.90 $49.20
Warde 3400652 smear complex special stain ova/parasites $17.98 $17.98 $17.98 $100.20
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis $142.63 $142.63 $142.63 $447.60
Warde 3400852 arsenic $18.97 $18.97 $18.97 $142.20
Warde 3708165 mercury urine $16.26 $16.26 $16.26 $109.20
Warde acetylcholine receptor blocking antibody $18.40 $18.40 $18.40 $355.80
Warde actin (smooth muscle) antibody each $12.05 $12.05 $12.05 $132.60
Warde adenosine deaminase pleural fluid $8.10 $8.10 $8.10 $87.60
Warde adrenocorticotropic hormone (acth) $38.62 $38.62 $38.62 $195.00
Warde aldolase $9.71 $9.71 $9.71 $79.50
Warde amino acids 6 or more quantitative each specimen $16.87 $16.87 $16.87 $552.75
Warde amiodarone therapeutic drug level $18.64 $18.64 $18.64 $141.00
Warde analysis gene hfe common variants $65.36 $65.36 $65.36 $1,048.20
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative $163.96 $163.96 $163.96 $718.20
Warde anti-mullerian hormone $38.62 $38.62 $38.62 $198.75
Warde apolipoprotein b $21.09 $21.09 $21.09 $117.00
Warde bile acids $17.12 $17.12 $17.12 $143.25
Warde cadmium blood $23.64 $23.64 $23.64 $111.60
Warde calcitonin $26.79 $26.79 $26.79 $136.20
Warde calculus (stone) infrared $12.90 $12.90 $12.90 $97.20
Warde clozapine therapeutic drug level $20.15 $20.15 $20.15 $94.50
Warde cobalt heavy metal quantitative each nes $21.96 $21.96 $21.96 $248.25
Warde collagen cross links c-telopeptide $18.68 $18.68 $18.68 $148.50
Warde complement total hemolytic $20.32 $20.32 $20.32 $171.75
Warde copper $12.41 $12.41 $12.41 $159.00
Warde cryoglobulin $6.47 $6.47 $6.47 $75.60
Warde erythropoietin $18.79 $18.79 $18.79 $127.50
Warde estrogen fractionated $32.30 $32.30 $32.30 $298.80
Warde fluorescent antibody screen endomysial iga $12.09 $12.09 $12.09 $102.00
Warde folic acid rbc $17.65 $17.65 $17.65 $90.60
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative $9.70 $9.70 $9.70 $252.75
Warde gastrin $17.63 $17.63 $17.63 $146.40
Warde growth hormone (hgh) $16.67 $16.67 $16.67 $114.00
Warde haloperidol therapeutic drug level $15.78 $15.78 $15.78 $72.75
Warde helminth antibody strongyloides igg $13.01 $13.01 $13.01 $139.80
Warde hemoglobin fractionation/quantitation electrophoresis $12.87 $12.87 $12.87 $102.60
Warde hepatitis a antibody $12.39 $12.39 $12.39 $111.75
Warde hepatitis be antibody $11.57 $11.57 $11.57 $94.50
Warde hepatitis delta agent antibody $17.16 $17.16 $17.16 $142.20
Warde immunofixation electrophoresis urine $29.35 $29.35 $29.35 $241.20
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn $11.53 $11.53 $11.53 $93.75
Warde infectious agent nucleic acid genotype hepatitis c $257.45 $257.45 $257.45 $1,579.80
Warde islet cell antibody zinc transporter 8 $23.57 $23.57 $23.57 $202.80
Warde lipoprotein (a) $14.32 $14.32 $14.32 $93.00
Warde lipoprotein-associated phospholipase a2 $46.31 $46.31 $46.31 $234.60
Warde mitochondrial antibody each $25.45 $25.45 $25.45 $114.00
Warde neutralization rabies $16.91 $16.91 $16.91 $105.00
Warde oxcarbazepine therapeutic drug level $13.25 $13.25 $13.25 $129.60
Warde pancreatic elastase fecal quantitative $22.97 $22.97 $22.97 $129.00
Warde protein c antigen $12.01 $12.01 $12.01 $110.40
Warde sex hormone binding globulin $21.73 $21.73 $21.73 $141.00
Warde somatomedin $21.26 $21.26 $21.26 $119.25
Warde sugars single qualitative each specimen stool $5.50 $5.50 $5.50 $28.80
Warde t3 (triiodothyronine) reverse $15.76 $15.76 $15.76 $133.20
Warde thyroid stimulating immunoglobulins $50.86 $50.86 $50.86 $407.25
Warde topiramate therapeutic drug level $11.92 $11.92 $11.92 $130.20
Warde virus isolation tissue culture innoculation presumptive id herpes simplex $26.07 $26.07 $26.07 $162.00
Warde viscosity $11.67 $11.67 $11.67 $119.40
Warde vitamin a $11.61 $11.61 $11.61 $97.20
Warde vitamin b-1 (thiamine) $21.23 $21.23 $21.23 $147.60
Warde vitamin b6 (pyridoxine) $28.10 $28.10 $28.10 $198.00
Warde vitamin c (ascorbic acid) $9.89 $9.89 $9.89 $72.00
Warde vitamin d (1 25 dihydroxy) $38.50 $38.50 $38.50 $205.50
Warde vitamin e (alpha-tocopherol) $14.18 $14.18 $14.18 $102.00
Warde zinc $11.39 $11.39 $11.39 $95.25
Wash harvest stem cells $437.18 $437.18 $437.18 $437.18
Wbc automated $2.54 $2.54 $2.54 $36.60
Wedge rescj/bisctj ovary uni/bi 58920 $7,394.81 $7,394.81 $7,394.81 $7,394.81
Wedging of cast $265.58 $265.58 $265.58 $265.58
Wedging of clubfoot cast $265.58 $265.58 $265.58 $265.58
Western blot test $17.03 $17.03 $17.03 $181.20
Wet mounts/ w preparations $18.19 $18.19 $18.19 $40.80
Whole blood for transfusion $225.12 $225.12 $225.12 $603.00
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit $242.44 $242.44 $242.44 $242.44
Whole blood/red blood cells leukocytes reduced cmv negative each unit $172.20 $172.20 $172.20 $267.60
Whole mitochondrial genome $1,287.00 $1,287.00 $1,287.00 $1,287.00
Wilate injection $1.27 $1.27 $1.27 $1.27
Wound therapy negative pressure per session <= 50 sq cm $399.53 $399.53 $399.53 $230.40
Wound therapy negative pressure per session <= 50 sq cm dme $198.70 $198.70 $198.70 $204.00
Wound therapy negative pressure per session > 50 sq cm $399.53 $399.53 $399.53 $230.40
Wound therapy negative pressure per session > 50 sq cm dme $399.53 $399.53 $399.53 $348.60
Wrist X-ray $88.05 $88.05 $88.05 $311.17
Wrist arthroscopy $3,244.61 $3,244.61 $3,244.61 $3,244.61
Wrist arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Wrist arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Wrist arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Wrist arthroscopy/surgery $3,244.61 $3,244.61 $3,244.61 $3,244.61
Wrist arthroscopy/surgery $7,143.73 $7,143.73 $7,143.73 $7,143.73
Wrist endoscopy/surgery $1,600.41 $1,600.41 $1,600.41 $1,600.41
X-ray abdomen 1 view $88.05 $88.05 $88.05 $284.25
X-ray abdomen 2 views $106.34 $106.34 $106.34 $327.00
X-ray abdomen >=3 views $106.34 $106.34 $106.34 $336.00
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest $106.34 $106.34 $106.34 $504.00
X-ray acromioclavicular joints without or w/weighted distraction bilateral $88.05 $88.05 $88.05 $397.80
X-ray ankle 2 views (both sides) $88.05 $88.05 $88.05 $398.25
X-ray arthrogram shoulder supervision & interpretation (both sides) $357.13 $357.13 $357.13 $814.20
X-ray bone age studies $106.34 $106.34 $106.34 $289.80
X-ray bone length studies $106.34 $106.34 $106.34 $366.00
X-ray bone survey complete $106.34 $106.34 $106.34 $682.20
X-ray bone survey infant $106.34 $106.34 $106.34 $292.80
X-ray cervical spine 2-3 views $88.05 $88.05 $88.05 $405.00
X-ray cervical spine 4-5 views $106.34 $106.34 $106.34 $526.20
X-ray cervical spine >= 6 views $106.34 $106.34 $106.34 $666.60
X-ray clavicle complete (both sides) $88.05 $88.05 $88.05 $267.75
X-ray colon abdominal radiograph(s) & delayed images single contrast study $178.02 $178.02 $178.02 $690.75
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study $178.02 $178.02 $178.02 $1,107.00
X-ray elbow 2 views (both sides) $88.05 $88.05 $88.05 $379.50
X-ray elbow >= 3 views (both sides) $88.05 $88.05 $88.05 $373.80
X-ray esophogram chest radiograph(s) & delayed images single contrast study $178.02 $178.02 $178.02 $713.40
X-ray exam entire spi 4/5 vw $106.34 $106.34 $106.34 $381.75
X-ray exam entire spi 6/> vw $106.34 $106.34 $106.34 $341.25
X-ray exam of arm infant $106.34 $106.34 $106.34 $299.25
X-ray exam of eye sockets $106.34 $106.34 $106.34 $399.00
X-ray exam of femur 1 $88.05 $88.05 $88.05 $237.60
X-ray exam of jaw joint $241.72 $241.72 $241.72 $542.40
X-ray exam of jaw joint $88.05 $88.05 $88.05 $331.50
X-ray exam of mastoids $106.34 $106.34 $106.34 $310.80
X-ray exam of middle ear $548.30 $548.30 $548.30 $475.20
X-ray exam of penis $106.34 $106.34 $106.34 $106.34
X-ray exam of perineum $241.72 $241.72 $241.72 $284.25
X-ray exam of salivary gland $88.05 $88.05 $88.05 $501.60
X-ray exam of sinuses $88.05 $88.05 $88.05 $318.60
X-ray exam of tear duct $241.72 $241.72 $241.72 $241.72
X-ray exam of teeth $241.72 $241.72 $241.72 $241.72
X-ray exam of teeth $88.05 $88.05 $88.05 $88.05
X-ray exam si joints $106.34 $106.34 $106.34 $218.40
X-ray exam thorac spine4/>vw $106.34 $106.34 $106.34 $405.00
X-ray eye detection foreign body (both sides) $88.05 $88.05 $88.05 $419.40
X-ray facial bones complete > 3 views $106.34 $106.34 $106.34 $444.00
X-ray femur >=2 views (both sides) $88.05 $88.05 $88.05 $405.00
X-ray finger(s) >= 2 views (both sides) $88.05 $88.05 $88.05 $294.60
X-ray foot 2 views (both sides) $88.05 $88.05 $88.05 $398.25
X-ray forearm 2 views (both sides) $88.05 $88.05 $88.05 $394.50
X-ray hand 2 views (both sides) $106.34 $106.34 $106.34 $405.00
X-ray head for orthodontia $88.05 $88.05 $88.05 $88.05
X-ray heel/calcaneus > 2 views (both sides) $88.05 $88.05 $88.05 $292.80
X-ray hip uni w/wo pelvis min 4 views $106.34 $106.34 $106.34 $414.00
X-ray hip with pelvis when performed bilateral 2 views $106.34 $106.34 $106.34 $374.40
X-ray hip with pelvis when performed bilateral 3-4 views $106.34 $106.34 $106.34 $414.00
X-ray hip with pelvis when performed bilateral >= 5 views $106.34 $106.34 $106.34 $456.60
X-ray hip with pelvis when performed unilateral 1 view left $88.05 $88.05 $88.05 $270.75
X-ray humerus >= 2 views left $88.05 $88.05 $88.05 $363.75
X-ray joint survey 1 view $106.34 $106.34 $106.34 $343.50
X-ray knee 1-2 views (both sides) $88.05 $88.05 $88.05 $283.50
X-ray knee 3 views (both sides) $88.05 $88.05 $88.05 $399.00
X-ray knee ap standing bilateral $88.05 $88.05 $88.05 $237.60
X-ray l/s-spine bend vw only 2-3 vw $106.34 $106.34 $106.34 $405.00
X-ray lower extremities infant > 2 views (both sides) $88.05 $88.05 $88.05 $375.75
X-ray lumbosacral spine >= 4 views $106.34 $106.34 $106.34 $577.50
X-ray lumbosacral spine complete including bending views >= 6 views $106.34 $106.34 $106.34 $666.60
X-ray male genital tract $241.72 $241.72 $241.72 $241.72
X-ray mandible complete > 4 views $106.34 $106.34 $106.34 $412.80
X-ray mandible ltd <4 views $88.05 $88.05 $88.05 $326.25
X-ray nasal bones complete > 3 views $88.05 $88.05 $88.05 $283.50
X-ray neck soft tissue $88.05 $88.05 $88.05 $285.60
X-ray nose to rectum for foreign body child $88.05 $88.05 $88.05 $246.00
X-ray of mammary ducts $241.72 $241.72 $241.72 $438.00
X-ray optic foramina $88.05 $88.05 $88.05 $292.80
X-ray pelvis 1-2 views $106.34 $106.34 $106.34 $300.00
X-ray pelvis complete > 3 views $106.34 $106.34 $106.34 $405.00
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation $357.13 $357.13 $357.13 $839.25
X-ray ribs 2 views left $88.05 $88.05 $88.05 $304.80
X-ray ribs 3 views bilateral $106.34 $106.34 $106.34 $419.40
X-ray ribs w/posterior anterior chest 3 views left $106.34 $106.34 $106.34 $399.00
X-ray ribs w/posterior anterior chest > 4 views bilateral $106.34 $106.34 $106.34 $600.75
X-ray sacroiliac joints >= 3 views $106.34 $106.34 $106.34 $397.80
X-ray sacrum/coccyx >= 2 views $88.05 $88.05 $88.05 $297.00
X-ray scapula complete (both sides) $106.34 $106.34 $106.34 $304.20
X-ray sella turcica $88.05 $88.05 $88.05 $405.00
X-ray shoulder 1 view (both sides) $88.05 $88.05 $88.05 $263.25
X-ray sinus tract/fistula/abscess $548.30 $548.30 $548.30 $1,129.80
X-ray sinuses paranasal complete > 3 views $88.05 $88.05 $88.05 $405.00
X-ray skull < 4 views $106.34 $106.34 $106.34 $364.20
X-ray skull > 4 views complete $106.34 $106.34 $106.34 $440.40
X-ray slg plne bdy sect without urogr $106.34 $106.34 $106.34 $945.00
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study $178.02 $178.02 $178.02 $669.60
X-ray spine single view $88.05 $88.05 $88.05 $309.60
X-ray sternoclavicular joint(s) > 3 views $88.05 $88.05 $88.05 $385.80
X-ray sternum > 2 views $88.05 $88.05 $88.05 $331.80
X-ray surgical specimen $548.30 $548.30 $548.30 $400.50
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study $178.02 $178.02 $178.02 $719.25
X-ray temporomandibular joint open/closed mouth bilateral $88.05 $88.05 $88.05 $419.40
X-ray thoracic spine 2 views $106.34 $106.34 $106.34 $388.50
X-ray thoracic spine 3 views $106.34 $106.34 $106.34 $419.40
X-ray thoracolumbar spine >=2 views $88.05 $88.05 $88.05 $348.00
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view $88.05 $88.05 $88.05 $396.00
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views $106.34 $106.34 $106.34 $378.00
X-ray tibia/fibula 2 views (both sides) $88.05 $88.05 $88.05 $405.00
X-ray toe(s) > 2 views (both sides) $88.05 $88.05 $88.05 $364.80
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast $178.02 $178.02 $178.02 $589.50
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study $178.02 $178.02 $178.02 $580.20
X-ray wrist 2 views (both sides) $88.05 $88.05 $88.05 $355.50
X-ray xm phrnx&/crv esoph c+ $178.02 $178.02 $178.02 $178.02
Xcapsl ctrc rmvl cplx w/ecp $4,022.86 $4,022.86 $4,022.86 $4,022.86
Xcapsl ctrc rmvl cplx wo ecp $2,280.73 $2,280.73 $2,280.73 $2,280.73
Xcapsl ctrc rmvl insj 1+ $5,159.71 $5,159.71 $5,159.71 $5,159.71
Xcapsl ctrc rmvl w/ecp $4,022.86 $4,022.86 $4,022.86 $4,022.86
Xcpsl ctrc rmvl cplx insj 1+ $5,159.71 $5,159.71 $5,159.71 $5,159.71
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< $1,829.23 $1,829.23 $1,829.23 $3,321.00
Xfer tis s/a/l 10 sq cm/< $1,829.23 $1,829.23 $1,829.23 $3,955.80
Xm archive tissue molec anal $24.49 $24.49 $24.49 $40.50
Xylose absorption test blood &/or urine $12.91 $12.91 $12.91 $46.80
Xyntha inj $1.54 $1.54 $1.54 $1.54
Yersinia antibody $13.19 $13.19 $13.19 $13.19
Yttrium y-90 ibritumomab ther $56,824.55 $56,824.55 $56,824.55 $94,667.40
Ziconotide injection $10.13 $10.13 $10.13 $4,530.00
Zika virus dna/rna amp probe $51.31 $51.31 $51.31 $197.25
Zika virus igm antibody $16.85 $16.85 $16.85 $114.75
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) $7.98 $7.98 $7.98 $74.40
Zolbetuximab-clzb 100 mg intravenous solution $33.56 $33.56 $33.56 $46.20
_afb id by dna probe rflx ast $20.05 $20.05 $20.05 $141.00
_afb org id by sequencing rflx ast-sendout $115.36 $115.36 $115.36 $1,266.00
_fragile x methylation-sendout $44.89 $44.89 $44.89 $162.00