UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $115.80 | $193.00 | $11.87 – $154.40 | 17 |
| #acylcarnitineprfl CPT 82017 | $222.60 | $371.00 | $13.17 – $296.80 | 17 |
| #aptt mix-1:1 incubated CPT 87532 | $466.20 | $777.00 | $27.39 – $621.60 | 17 |
| #bac vag cand-c. albicans naa CPT 87481 | $183.00 | $305.00 | $34.68 – $244.00 | 17 |
| #cbg+cort-cbg CPT 84449 | $246.00 | $410.00 | $17.79 – $328.00 | 17 |
| #celiac hla-dq8 CPT 81383 | $1,687.80 | $2,813.00 | $107.86 – $2,250.40 | 17 |
| #cf-97variants CPT 81220 | $3,263.40 | $5,439.00 | $119.61 – $601.13 | 17 |
| #cmvcul-virus inoculation shell CPT 87254 | $8.40 | $14.00 | $3.98 – $19.33 | 17 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $93.00 | $155.00 | $10.18 – $124.00 | 17 |
| #creutz-prot.,western blot CPT 84182 | $146.40 | $244.00 | $27.00 – $195.20 | 17 |
| #fecal-sodium CPT 84302 | $83.40 | $139.00 | $4.80 – $111.20 | 17 |
| #flow interp 9 - 15 markers CPT 88188 | $287.40 | $479.00 | $74.04 – $383.20 | 17 |
| #pnh-flow cytometry interp CPT 88187 | $656.40 | $1,094.00 | $59.38 – $875.20 | 17 |
| #resp virpnl dfa-adenovirus CPT 87260 | $162.00 | $270.00 | $11.26 – $216.00 | 15 |
| (both sides) smear without diff wbc count CPT 85008 | $121.80 | $203.00 | $3.40 – $162.40 | 17 |
| 11-desoxycortisol - sendout CPT 82634 | $493.80 | $823.00 | $19.25 – $658.40 | 17 |
| 17-hydroxypregnenolone CPT 84143 | $307.20 | $512.00 | $22.55 – $409.60 | 17 |
| 17-ketosteroids CPT 83586 | $343.20 | $572.00 | $12.65 – $457.60 | 17 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $848.40 | $1,414.00 | $562.63 – $1,272.60 | 16 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $848.40 | $1,414.00 | $381.78 – $1,272.60 | 16 |
| 2nd order venous cath CPT 36012 | $438.00 | $730.00 | $125.95 – $630.70 | 17 |
| 3-d radiotherapy plan CPT 77295 | $4,344.00 | $7,240.00 | $411.47 – $5,792.00 | 17 |
| 3d ech img cgen car anomal CPT 93319 | $1,419.60 | $2,366.00 | $21.73 – $1,892.80 | 17 |
| 3d recon without postprocess indpndt CPT 76376 | $697.20 | $1,162.00 | $11.65 – $929.60 | 15 |
| 5' nucleotidase - sendout CPT 83915 | $243.00 | $405.00 | $11.02 – $324.00 | 17 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $91.20 | $152.00 | $12.52 – $121.60 | 17 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $117.00 | $195.00 | $25.60 – $175.50 | 14 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $97.20 | $162.00 | $25.60 – $145.80 | 14 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $82.80 | $138.00 | $25.60 – $124.20 | 14 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $98.40 | $164.00 | $25.60 – $147.60 | 14 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $82.80 | $138.00 | $25.60 – $124.20 | 14 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $86.40 | $144.00 | $25.60 – $129.60 | 14 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $103.20 | $172.00 | $25.60 – $154.80 | 14 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $258.40 | $323.00 | $44.11 – $290.70 | 17 |
| Abd aorta w/runoff s&i CPT 75630 | $4,443.00 | $7,405.00 | $198.37 – $5,924.00 | 17 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $971.40 | $1,619.00 | $59.98 – $1,295.20 | 17 |
| Abd/low ext cath 1st CPT 36245 | $1,138.20 | $1,897.00 | $512.19 – $1,517.60 | 15 |
| Abd/low ext cath 2nd CPT 36246 | $948.00 | $1,580.00 | $426.60 – $1,264.00 | 15 |
| Abd/low ext cath 3rd CPT 36247 | $1,129.20 | $1,882.00 | $508.14 – $1,505.60 | 15 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $3,476.40 | $5,794.00 | $142.72 – $4,635.20 | 17 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,772.60 | $4,621.00 | $115.20 – $3,696.80 | 17 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,175.00 | $3,625.00 | $99.20 – $2,900.00 | 17 |
| Abdominal MRI (with and without contrast) CPT 74183 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| Abdominal MRI (with contrast) CPT 74182 | $3,051.00 | $5,085.00 | $343.82 – $4,068.00 | 17 |
| Abdominal MRI (without contrast) CPT 74181 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| Abdominal Ultrasound (complete) CPT 76700 | $916.80 | $1,528.00 | $73.60 – $1,222.40 | 17 |
| Abdominal Ultrasound (limited) CPT 76705 | $690.60 | $1,151.00 | $48.00 – $920.80 | 17 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,689.00 | $2,815.00 | $92.76 – $2,252.00 | 17 |
| Abl1 gene CPT 81170 | $3,217.80 | $5,363.00 | $289.97 – $812.00 | 17 |
| Ablate arrhythmia add on CPT 93655 | $5,650.20 | $9,417.00 | $419.23 – $7,533.60 | 15 |
| Ablate heart dysrhythm focus CPT 93650 | $4,569.60 | $7,616.00 | $993.28 – $7,812.36 | 17 |
| Ablate pulm tumor perq crybl CPT 32994 | $24,227.40 | $40,379.00 | $4,069.64 – $32,303.20 | 17 |
| Ablation cryo abd perit om CPT 49999 | $122.40 | $204.00 | $81.17 – $965.27 | 16 |
| Ablation of upper extremity nerves rf CPT 64999 | $825.60 | $1,376.00 | $212.29 – $1,238.40 | 16 |
| Abobotulinumtoxina HCPCS J0586 | $61.20 | $76.50 | $8.75 – $68.40 | 17 |
| Abscess drain retroperitoneal surg code CPT 49406 | $4,627.80 | $7,713.00 | $190.99 – $6,170.40 | 17 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $2.40 | $3.00 | $0.06 – $0.90 | 16 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $256.80 | $321.00 | $19.84 – $288.90 | 16 |
| Acetone qualitative CPT 82009 | $59.40 | $99.00 | $4.47 – $79.20 | 17 |
| Acetylcholine receptor modulating antibody CPT 86043 | $274.80 | $458.00 | $10.60 – $366.40 | 16 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $1,044.60 | $1,741.00 | $0.39 – $26.10 | 16 |
| Acetylcysteine non-comp unit HCPCS J7608 | $92.80 | $116.00 | $3.44 – $11.47 | 16 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $417.00 | $695.00 | $96.41 – $556.00 | 17 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $20.40 | $34.00 | $9.18 – $30.60 | 14 |
| Acute hepatitis panel CPT 80074 | $762.60 | $1,271.00 | $47.07 – $1,016.80 | 17 |
| Acyclovir 400 mg tablet HCPCS J8499 | $13.20 | $22.00 | $5.94 – $19.80 | 15 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $74.40 | $124.00 | $0.04 – $0.90 | 16 |
| Adapter b 8 channel 10cm HCPCS C1883 | $496.20 | $827.00 | $165.40 – $744.30 | 14 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $382.20 | $637.00 | $0.56 – $5.40 | 16 |
| Adenovirus antibody,serum - quest CPT 86603 | $91.80 | $153.00 | $12.72 – $122.40 | 17 |
| Adh-sendout CPT 84588 | $311.40 | $519.00 | $33.54 – $415.20 | 17 |
| Adj gastric band via subq port CPT 43999 | $3,526.20 | $5,877.00 | $644.56 – $5,289.30 | 16 |
| Adjmt/revj ext fixj sys anes CPT 20693 | $4,493.40 | $7,489.00 | $173.80 – $5,991.20 | 17 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $120.00 | $150.00 | $0.54 – $1.80 | 14 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $223.20 | $372.00 | $31.11 – $297.60 | 17 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $223.20 | $372.00 | $67.85 – $297.60 | 17 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $808.20 | $1,347.00 | $137.28 – $1,077.60 | 17 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $508.20 | $847.00 | $101.42 – $677.60 | 17 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $223.20 | $372.00 | $34.94 – $297.60 | 17 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $223.20 | $372.00 | $32.23 – $101.67 | 17 |
| Administration immunization 1 vaccine CPT 90471 | $12.00 | $20.00 | $5.40 – $73.27 | 16 |
| Administration immunization each additional component CPT 90461 | $48.60 | $81.00 | $7.94 – $64.80 | 15 |
| Administration immunization each additional vaccine CPT 90472 | $12.00 | $20.00 | $5.40 – $18.00 | 14 |
| Administration immunization first component each vaccine CPT 90460 | $234.60 | $391.00 | $17.73 – $312.80 | 15 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $12.00 | $20.00 | $7.96 – $73.27 | 16 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $24.00 | $40.00 | $10.80 – $32.00 | 14 |
| Administration vaccine hepatitis b HCPCS G0010 | $12.00 | $20.00 | $7.96 – $47.50 | 16 |
| Administration vaccine influenza virus HCPCS G0008 | $12.00 | $20.00 | $7.96 – $18.00 | 16 |
| Administration vaccine pneumococcal HCPCS G0009 | $12.00 | $20.00 | $7.96 – $18.00 | 16 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $24.00 | $40.00 | $10.80 – $32.00 | 14 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $139.20 | $232.00 | $42.16 – $208.80 | 17 |
| Adrenal cortex & medulla img CPT 78075 | $1,703.40 | $2,839.00 | $46.72 – $2,271.20 | 17 |
| Aep neurodiagnostic i&r CPT 92653 | $243.60 | $406.00 | $74.26 – $324.80 | 17 |
| Afamelanotide implant, 1 mg HCPCS J7352 | $6,227.40 | $10,379.00 | $2,814.78 – $9,341.10 | 17 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $27,295.80 | $45,493.00 | $230.15 – $1,169.10 | 17 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $304.00 | $380.00 | $53.08 – $319.50 | 15 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $682.40 | $853.00 | $53.08 – $359.10 | 17 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $349.20 | $582.00 | $5.71 – $465.60 | 17 |
| Albumin body fluid quantitative each specimen CPT 82042 | $63.60 | $106.00 | $6.08 – $84.80 | 17 |
| Albumin serum plasma or whole blood CPT 82040 | $66.60 | $111.00 | $4.01 – $88.80 | 17 |
| Albuterol ipratrop non-comp HCPCS J7620 | $13.80 | $17.25 | $0.20 – $15.53 | 16 |
| Albuterol non-comp con HCPCS J7611 | $5.00 | $6.25 | $0.17 – $5.62 | 16 |
| Albuterol non-comp unit HCPCS J7613 | $10.00 | $12.50 | $0.08 – $0.90 | 16 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $364.80 | $456.00 | $123.67 – $2,429.89 | 17 |
| Alkaline phosphatase CPT 84075 | $114.00 | $190.00 | $5.12 – $152.00 | 17 |
| Allergen alpha lactalbumin ige CPT 86008 | $25.80 | $43.00 | $11.61 – $34.40 | 17 |
| Allergen egg white ige CPT 86003 | $25.80 | $43.00 | $5.16 – $34.40 | 17 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $2,982.60 | $4,971.00 | $265.00 – $1,192.50 | 14 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $9,287.40 | $15,479.00 | $613.00 – $2,758.50 | 14 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $4,721.40 | $7,869.00 | $151.16 – $891.90 | 15 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $3,954.00 | $6,590.00 | $121.29 – $5,931.00 | 15 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $29.80 | $37.25 | $5.46 – $31.50 | 17 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $147.00 | $245.00 | $63.66 – $196.00 | 17 |
| Alpha-fetoprotein amniotic CPT 82106 | $160.20 | $267.00 | $16.80 – $213.60 | 17 |
| Alpha-fetoprotein tumor marker CPT 82105 | $139.20 | $232.00 | $16.57 – $185.60 | 17 |
| Alprostadil for injection HCPCS J0270 | $550.20 | $917.00 | $0.27 – $0.90 | 14 |
| Alt/sgpt CPT 84460 | $133.80 | $223.00 | $5.24 – $178.40 | 17 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $543.20 | $679.00 | $94.45 – $531.90 | 17 |
| Aluminum - quest CPT 82108 | $319.20 | $532.00 | $25.18 – $425.60 | 17 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $1,389.60 | $2,316.00 | $71.24 – $1,852.80 | 17 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $26.80 | $33.50 | $0.63 – $5.40 | 16 |
| Amino acids quant 2-5 CPT 82136 | $220.80 | $368.00 | $19.38 – $294.40 | 17 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $8.00 | $12.00 | $1.71 – $9.00 | 16 |
| Aminolevulinic acid delta CPT 82135 | $178.80 | $298.00 | $13.20 – $238.40 | 17 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $70.20 | $87.75 | $7.29 – $24.30 | 16 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $42.80 | $53.50 | $0.43 – $2.70 | 16 |
| Ammonia CPT 82140 | $126.00 | $210.00 | $5.50 – $168.00 | 17 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $321.20 – $3,309.88 | 12 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $4,707.00 | $7,845.00 | $252.45 – $6,276.00 | 17 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $136.80 | $171.00 | $43.41 – $153.90 | 16 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $1,050.00 | $1,750.00 | $21.48 – $315.00 | 17 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $27.40 | $34.25 | $0.55 – $28.80 | 16 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $45.20 | $56.50 | $1.39 – $24.30 | 16 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $280.20 | $467.00 | $142.90 – $373.60 | 16 |
| Amputation toe interphalangeal joint CPT 28825 | $2,733.00 | $4,555.00 | $591.83 – $3,644.00 | 17 |
| Amylase CPT 82150 | $113.40 | $189.00 | $5.50 – $151.20 | 17 |
| An cholangiogram percutaneous compl CPT 47531 | $2,636.40 | $4,394.00 | $85.71 – $3,515.20 | 17 |
| An fluoro guide for cvp CPT 77001 | $1,275.00 | $2,125.00 | $59.21 – $1,700.00 | 17 |
| Ana ds-dna CPT 86226 | $178.80 | $298.00 | $11.96 – $238.40 | 17 |
| Anal/urinary muscle study CPT 51785 | $1,258.20 | $2,097.00 | $61.44 – $1,677.60 | 17 |
| Analysis gene f2 20210g>a variant CPT 81240 | $2,479.80 | $4,133.00 | $59.07 – $316.80 | 17 |
| Analysis gene f5 leiden variant CPT 81241 | $1,217.40 | $2,029.00 | $72.52 – $1,184.80 | 17 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $744.60 | $1,241.00 | $39.13 – $992.80 | 17 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $290.40 | $484.00 | $30.88 – $387.20 | 17 |
| Anca screen with reflex to titer -quest CPT 86021 | $103.20 | $172.00 | $5.50 – $137.60 | 17 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $2,525.40 | $4,209.00 | $112.62 – $3,367.20 | 17 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $4,394.40 | $7,324.00 | $993.28 – $11,675.74 | 17 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | $4,126.80 | $6,878.00 | $159.14 – $5,502.40 | 17 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $4,416.60 | $7,361.00 | $320.94 – $5,888.80 | 17 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | $4,126.80 | $6,878.00 | $135.41 – $5,502.40 | 17 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $4,416.60 | $7,361.00 | $275.98 – $5,888.80 | 17 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $4,394.40 | $7,324.00 | $993.28 – $5,994.27 | 17 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | $4,394.40 | $7,324.00 | $218.24 – $5,859.20 | 15 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $3,734.40 | $6,224.00 | $385.15 – $4,992.28 | 17 |
| Angiotensin ii CPT 82163 | $276.60 | $461.00 | $15.95 – $368.80 | 17 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $21,829.80 | $36,383.00 | $0.27 – $0.90 | 14 |
| Anidulafungin injection HCPCS J0348 | $8.40 | $14.00 | $0.52 – $12.60 | 16 |
| Ankle X-ray CPT 73610 | $307.20 | $512.00 | $23.97 – $409.60 | 17 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | $1,135.80 | $1,893.00 | $40.46 – $1,514.40 | 17 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $97.20 | $162.00 | $25.60 – $145.80 | 14 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $96.60 | $161.00 | $25.60 – $144.90 | 14 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $115.20 | $192.00 | $25.60 – $172.80 | 14 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $121.20 | $202.00 | $25.60 – $181.80 | 14 |
| Anoscopy control bleeding 46614 CPT 46614 | $991.20 | $1,652.00 | $70.63 – $1,321.60 | 17 |
| Anoscopy remove fb 46608 CPT 46608 | not published | not published | $77.41 – $993.28 | 12 |
| Anti mog serum - sendout CPT 86362 | $132.60 | $221.00 | $10.60 – $176.80 | 17 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $36.60 | $61.00 | $10.06 – $48.80 | 17 |
| Antibody htlv-i CPT 86687 | $79.20 | $132.00 | $8.98 – $105.60 | 17 |
| Antibody htlv/hiv confirm test CPT 86689 | $246.60 | $411.00 | $19.13 – $328.80 | 17 |
| Antibody id rbc panel CPT 86870 | $205.80 | $343.00 | $9.29 – $274.40 | 17 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $527.40 | $879.00 | $5.50 – $703.20 | 17 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $91.80 | $153.00 | $12.72 – $122.40 | 17 |
| Antibody screen rbc CPT 86850 | $113.40 | $189.00 | $9.29 – $151.20 | 17 |
| Antibody tetanus CPT 86774 | $332.40 | $554.00 | $11.56 – $443.20 | 17 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $11.40 | $14.25 | $1.49 – $12.60 | 17 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $103.20 | $172.00 | $10.60 – $137.60 | 17 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $156.00 | $260.00 | $10.60 – $208.00 | 17 |
| Antinuclear antibodies CPT 86038 | $71.40 | $119.00 | $11.95 – $95.20 | 17 |
| Antinuclear antibodies titer CPT 86039 | $91.20 | $152.00 | $11.03 – $121.60 | 17 |
| Antiphosphatidylserine antibody CPT 86148 | $394.20 | $657.00 | $12.54 – $525.60 | 17 |
| Antistreptolysin o screen CPT 86063 | $56.40 | $94.00 | $5.70 – $75.20 | 17 |
| Antithrombin iii activity CPT 85300 | $157.80 | $263.00 | $10.34 – $210.40 | 17 |
| Aortic dysfunction/dilation CPT 81410 | $7,223.40 | $12,039.00 | $393.52 – $9,631.20 | 17 |
| Apl(pml-rara) quant - sendout CPT 81315 | $741.00 | $1,235.00 | $204.89 – $560.00 | 17 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $261.00 | $435.00 | $17.52 – $348.00 | 15 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $5,034.60 | $8,391.00 | $420.87 – $6,712.80 | 17 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $3,682.80 | $6,138.00 | $44.52 – $4,910.40 | 15 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $993.28 – $6,007.35 | 11 |
| Appl mltpln uni ext fixj sys CPT 20692 | $6,347.40 | $10,579.00 | $993.28 – $13,247.10 | 17 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $76.80 | $128.00 | $6.60 – $102.40 | 17 |
| Appl multlay comprs arm/hand CPT 29584 | $508.20 | $847.00 | $15.45 – $677.60 | 17 |
| Appl unipln uni ext fixj sys CPT 20690 | $4,493.40 | $7,489.00 | $750.18 – $7,354.86 | 17 |
| Application finger splntstatic 29130 CPT 29130 | $471.00 | $785.00 | $66.50 – $628.00 | 17 |
| Application long leg splint 29505 CPT 29505 | $471.00 | $785.00 | $40.70 – $628.00 | 17 |
| Application lower leg splint 29515 CPT 29515 | $471.00 | $785.00 | $38.50 – $628.00 | 17 |
| Application multi layer compression below knee (both sides) CPT 29581 | $274.20 | $457.00 | $27.80 – $365.60 | 17 |
| Application of forearm cast 29075 CPT 29075 | $825.60 | $1,376.00 | $50.05 – $1,100.80 | 17 |
| Application of long arm cast 29065 CPT 29065 | $1,258.80 | $2,098.00 | $46.75 – $1,678.40 | 17 |
| Application of long leg cast 29345 CPT 29345 | $73.20 | $122.00 | $48.54 – $993.28 | 17 |
| Application of paste boot 29580 CPT 29580 | $307.20 | $512.00 | $71.62 – $162.45 | 17 |
| Application short leg cast 29405 CPT 29405 | $62.40 | $104.00 | $41.38 – $993.28 | 17 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $1,242.60 | $2,071.00 | $219.71 – $1,883.29 | 17 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $1,242.60 | $2,071.00 | $203.45 – $1,883.29 | 17 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $843.00 | $1,405.00 | $379.35 – $1,264.50 | 13 |
| Apply forearm splintdynamic 29126 CPT 29126 | $471.00 | $785.00 | $28.60 – $628.00 | 17 |
| Apply hand/wrist cast 29085 CPT 29085 | $839.40 | $1,399.00 | $30.25 – $1,119.20 | 17 |
| Apply rigid leg cast 29445 CPT 29445 | $631.20 | $1,052.00 | $111.62 – $841.60 | 17 |
| Apply short leg castambul type 29425 CPT 29425 | $807.60 | $1,346.00 | $57.75 – $1,076.80 | 17 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | $4.20 | $7.00 | $1.64 – $6.30 | 17 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | $137.40 | $229.00 | $10.56 – $183.20 | 17 |
| Aquaporin-4 antibody cba each CPT 86052 | $132.60 | $221.00 | $10.60 – $176.80 | 17 |
| Aquaporin-4 antibody elisa CPT 86051 | $132.60 | $221.00 | $10.14 – $176.80 | 17 |
| Aquatic exercise - group charge CPT 97150 | $93.00 | $155.00 | $9.06 – $124.00 | 15 |
| Argatroban nonesrd use 1mg HCPCS J0883 | $41.60 | $52.00 | $0.80 – $46.80 | 17 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | $367.20 | $459.00 | $8.15 – $413.10 | 17 |
| Arterial blood draw/perc 36620 CPT 36620 | $1,175.40 | $1,959.00 | $52.34 – $1,567.20 | 17 |
| Artery x-rays adrenal gland CPT 75731 | $2,556.60 | $4,261.00 | $28.80 – $3,408.80 | 17 |
| Artery x-rays adrenals CPT 75733 | $2,190.00 | $3,650.00 | $28.80 – $2,920.00 | 17 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $2,556.60 | $4,261.00 | $28.80 – $3,408.80 | 17 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $2,446.20 | $4,077.00 | $28.80 – $3,261.60 | 17 |
| Artery x-rays lung CPT 75741 | $1,094.40 | $1,824.00 | $28.80 – $1,459.20 | 17 |
| Artery x-rays lung CPT 75746 | $1,885.80 | $3,143.00 | $19.20 – $2,514.40 | 17 |
| Artery x-rays lungs CPT 75743 | $3,831.60 | $6,386.00 | $28.80 – $5,108.80 | 17 |
| Artery xray of abdomen 75726-26 CPT 75726 | $2,556.60 | $4,261.00 | $28.80 – $3,408.80 | 17 |
| Artery xrays of pelvis 75736 26 CPT 75736 | $2,556.60 | $4,261.00 | $28.80 – $3,408.80 | 17 |
| Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah) CPT 29826 | not published | not published | $695.68 – $2,719.83 | 4 |
| Arthrd ant ntrbdy cervical CPT 22551 | not published | not published | $993.28 – $13,248.33 | 11 |
| Arthrd si jt perq/min nvas CPT 27279 | $2,428.20 | $4,047.00 | $769.03 – $18,933.57 | 17 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $922.20 | $1,537.00 | $40.76 – $1,229.60 | 17 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $1,473.60 | $2,456.00 | $25.85 – $993.28 | 17 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | $943.20 | $1,572.00 | $46.59 – $1,257.60 | 17 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $825.60 | $1,376.00 | $23.65 – $1,400.32 | 17 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | $1,194.60 | $1,991.00 | $54.80 – $1,592.80 | 17 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $825.60 | $1,376.00 | $19.80 – $993.28 | 17 |
| Arthrodes/ant/cerv below c2 ea add 22552 CPT 22552 | not published | not published | $415.65 – $684.24 | 4 |
| Arthrodesis subtalar CPT 28725 | $6,347.40 | $10,579.00 | $803.41 – $8,463.20 | 17 |
| Arthrotomy/elbow/exp/drain/rmv fb 24000 CPT 24000 | $6,347.40 | $10,579.00 | $308.55 – $8,463.20 | 17 |
| Artiss fibrin sealant HCPCS C9250 | $3,076.20 | $5,127.00 | $141.89 – $4,614.30 | 17 |
| Ascenda two piece catheter HCPCS C1772 | $25,665.60 | $42,776.00 | $8,555.20 – $38,498.40 | 14 |
| Asp core fat pad CPT 17999 | $174.00 | $290.00 | $78.30 – $261.00 | 16 |
| Aspir/inj thyroid cyst 60300 CPT 60300 | $971.40 | $1,619.00 | $40.49 – $1,295.20 | 17 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $3,936.60 | $6,561.00 | $169.77 – $5,248.80 | 17 |
| Aspirate pleura without imaging 32554 CPT 32554 | $1,076.40 | $1,794.00 | $595.22 – $1,435.20 | 17 |
| Aspirate/inj ganglion cyst 20612 CPT 20612 | $616.80 | $1,028.00 | $42.76 – $993.28 | 17 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $971.40 | $1,619.00 | $65.76 – $1,295.20 | 17 |
| Aspiration peritonsillar abscess CPT 42999 | $120.00 | $200.00 | $79.58 – $239.08 | 16 |
| Assay dir meas fr estradiol CPT 82681 | $103.20 | $172.00 | $21.81 – $137.60 | 17 |
| Assay free hydroxyproline CPT 83500 | $216.00 | $360.00 | $22.39 – $288.00 | 17 |
| Assay myeloperoxidase CPT 83876 | $177.00 | $295.00 | $39.71 – $236.00 | 17 |
| Assay neurflmnt light chain CPT 83884 | $259.80 | $433.00 | $116.91 – $389.70 | 13 |
| Assay of feces porphyrins CPT 84126 | $227.40 | $379.00 | $30.54 – $303.20 | 17 |
| Assay of fluoride CPT 82735 | $227.40 | $379.00 | $8.80 – $303.20 | 17 |
| Assay of glutathione CPT 82978 | $77.40 | $129.00 | $7.42 – $103.20 | 17 |
| Assay of interleukin-6 (il-6) CPT 83529 | $259.80 | $433.00 | $13.48 – $346.40 | 17 |
| Assay of lrh hormone CPT 83727 | $247.80 | $413.00 | $16.98 – $330.40 | 17 |
| Assay of procainamide w/metab CPT 80192 | $280.80 | $468.00 | $16.55 – $374.40 | 17 |
| Assay of prostaglandin CPT 84150 | $796.80 | $1,328.00 | $12.10 – $1,062.40 | 17 |
| Assay of sialic acid CPT 84275 | $188.40 | $314.00 | $13.29 – $251.20 | 17 |
| Assay of somatostatin CPT 84307 | $235.20 | $392.00 | $18.07 – $313.60 | 17 |
| Assay of tyrosine CPT 84510 | $148.20 | $247.00 | $2.20 – $197.60 | 17 |
| Assay of urine sulfate CPT 84392 | $52.20 | $87.00 | $4.29 – $69.60 | 17 |
| Assay toxin or antitoxin CPT 87230 | $154.20 | $257.00 | $19.51 – $205.60 | 17 |
| Assess cyst contrast inject CPT 49424 | $708.00 | $1,180.00 | $34.32 – $993.28 | 17 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $39.00 | $65.00 | $4.22 – $52.00 | 17 |
| Ast/sgot CPT 84450 | $39.60 | $66.00 | $5.12 – $52.80 | 17 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | $450.40 | $570.00 | $91.34 – $506.70 | 17 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $11,535.60 | $19,226.00 | $993.28 – $18,487.43 | 17 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $11,535.60 | $19,226.00 | $993.28 – $18,487.43 | 17 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $40.20 | $67.00 | $0.10 – $0.90 | 16 |
| Augment injectable kit 3.0cc HCPCS C1734 | $7,646.40 | $12,744.00 | $2,548.80 – $11,469.60 | 14 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $17,598.60 | $29,331.00 | $237.06 – $23,464.80 | 15 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $29,186.40 | $48,644.00 | $993.28 – $38,915.20 | 17 |
| Autologous blood op salvage CPT 86891 | $222.60 | $371.00 | $113.53 – $841.05 | 16 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $172.80 | $288.00 | $78.11 – $259.20 | 17 |
| Avul nail plate addl CPT 11732 | $114.00 | $190.00 | $28.32 – $152.00 | 17 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $471.00 | $785.00 | $28.32 – $993.28 | 17 |
| Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial HCPCS J9038 | $99.60 | $166.00 | $45.02 – $149.40 | 17 |
| Azacitidine injection HCPCS J9025 | $2,860.20 | $4,767.00 | $0.57 – $42.30 | 16 |
| Azathioprine 50 mg tablet HCPCS J7500 | $14.40 | $18.00 | $0.06 – $16.20 | 16 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $186.40 | $233.00 | $2.04 – $209.70 | 16 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $16.80 | $21.00 | $2.53 – $18.90 | 16 |
| B cells total count CPT 86355 | $112.80 | $188.00 | $37.28 – $150.40 | 17 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | $1,459.20 | $1,824.00 | $181.22 – $1,641.60 | 17 |
| Baclofen eval charges CPT 97750 | $103.20 | $172.00 | $18.43 – $137.60 | 17 |
| Bacterial meningitis antigen CPT 86403 | $100.80 | $168.00 | $11.40 – $134.40 | 17 |
| Bacterial vaginosis pcr CPT 87801 | $336.00 | $560.00 | $42.68 – $448.00 | 17 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | $18.60 | $31.00 | $2.36 – $24.80 | 15 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | $3.60 | $6.00 | $1.08 – $12.04 | 15 |
| Bartonella dna pcr-sendout CPT 87471 | $671.40 | $1,119.00 | $34.68 – $895.20 | 17 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | $4,381.80 | $7,303.00 | $3.89 – $26.10 | 17 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | $7,506.00 | $12,510.00 | $56.07 – $296.10 | 17 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | $114.00 | $190.00 | $13.49 – $171.00 | 17 |
| Benign lesion paring 2-4 CPT 11056 | $230.40 | $384.00 | $32.65 – $993.28 | 17 |
| Benign lesion paring 4+ CPT 11057 | $671.40 | $1,119.00 | $42.83 – $993.28 | 17 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $186.40 | $233.00 | $15.32 – $144.00 | 16 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $61.80 | $103.00 | $25.16 – $82.40 | 17 |
| Beta-2 microglobulin CPT 82232 | $262.80 | $438.00 | $15.99 – $350.40 | 17 |
| Beta-amyloid 1-40 CPT 82233 | $1,404.00 | $2,340.00 | $631.80 – $2,106.00 | 13 |
| Beta-amyloid 1-42 CPT 82234 | $1,404.00 | $2,340.00 | $631.80 – $2,106.00 | 13 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $76.00 | $95.00 | $6.96 – $85.50 | 16 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $480.80 | $615.00 | $73.20 – $540.90 | 17 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $320.40 | $534.00 | $27.86 – $480.60 | 17 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $162.60 | $271.00 | $25.77 – $243.90 | 17 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $3,548.40 | $5,914.00 | $38.50 – $4,731.20 | 17 |
| Bilateral n block inj occipital 64405 CPT 64405 | $568.20 | $947.00 | $38.50 – $993.28 | 17 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $825.60 | $1,376.00 | $14.30 – $1,100.80 | 17 |
| Biliary endoscopy thru skin CPT 47556 | $1,036.20 | $1,727.00 | $247.50 – $1,381.60 | 17 |
| Bilicheck CPT 88720 | $3.00 | $5.00 | $1.89 – $7.36 | 17 |
| Bilirubin direct CPT 82248 | $82.80 | $138.00 | $4.96 – $110.40 | 17 |
| Bilirubin total CPT 82247 | $75.60 | $126.00 | $4.96 – $100.80 | 17 |
| Biofeedback, pt CPT 90901 | $504.00 | $840.00 | $14.82 – $672.00 | 15 |
| Biopsy abdominal mass CPT 49180 | $1,119.00 | $1,865.00 | $89.07 – $1,492.00 | 17 |
| Biopsy bone trocar/needle superficial CPT 20220 | $1,119.00 | $1,865.00 | $69.30 – $1,492.00 | 17 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | $424.20 | $707.00 | $72.73 – $997.12 | 17 |
| Biopsy muscle percutaneous needle CPT 20206 | $1,119.00 | $1,865.00 | $62.03 – $1,492.00 | 17 |
| Biopsy needle liver percutaneous CPT 47000 | $1,062.60 | $1,771.00 | $98.61 – $1,416.80 | 17 |
| Biopsy needle lymph node superficial CPT 38505 | $1,119.00 | $1,865.00 | $74.17 – $1,492.00 | 17 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,119.00 | $1,865.00 | $150.82 – $1,492.00 | 17 |
| Biopsy skin incisional single lesion CPT 11106 | $529.80 | $883.00 | $54.13 – $993.28 | 17 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $1,712.40 | $2,854.00 | $69.65 – $2,283.20 | 17 |
| Biopsy, bone open deep CPT 20245 | not published | not published | $248.05 – $2,919.62 | 12 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $1,822.80 | $3,038.00 | $37.95 – $2,430.40 | 17 |
| Biospy of bladder CPT 53899 | not published | not published | $167.77 – $250.42 | 8 |
| Bivalirudin HCPCS J0583 | $5,267.40 | $8,779.00 | $0.17 – $31.50 | 16 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $825.60 | $1,376.00 | $31.57 – $1,100.80 | 17 |
| Bld prd mix CPT 86965 | $29.40 | $49.00 | $14.99 – $176.42 | 16 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $306.40 | $383.00 | $21.52 – $344.70 | 16 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $3,807.00 | $6,345.00 | $75.87 – $252.90 | 14 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $4,790.40 | $7,984.00 | $19.00 – $85.50 | 14 |
| Bln dil 900ml preperitnl HCPCS C1727 | $646.20 | $1,077.00 | $290.79 – $969.30 | 13 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $4,915.80 | $8,193.00 | $1,638.60 – $7,373.70 | 14 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $1,989.60 | $3,316.00 | $663.20 – $2,984.40 | 14 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | $43.20 | $72.00 | $2.97 – $25.26 | 15 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | $2,011.80 | $3,353.00 | $89.17 – $2,682.40 | 17 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | $1,747.20 | $2,912.00 | $80.54 – $2,329.60 | 17 |
| Block plantar digital nerve CPT 64455 | $580.20 | $967.00 | $29.63 – $773.60 | 17 |
| Block tap inj(s) w/wo img bi CPT 64488 | $655.80 | $1,093.00 | $81.63 – $874.40 | 15 |
| Block tap inj(s) w/wo img uni CPT 64486 | $530.40 | $884.00 | $65.08 – $707.20 | 15 |
| Blood Clotting (PT/INR) Test CPT 85610 | $77.40 | $129.00 | $4.24 – $103.20 | 17 |
| Blood Clotting (PTT) Test CPT 85730 | $105.60 | $176.00 | $5.94 – $134.40 | 17 |
| Blood Count (CBC) Test CPT 85025 | $95.40 | $159.00 | $6.60 – $127.20 | 17 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $80.40 | $134.00 | $6.39 – $107.20 | 17 |
| Blood Culture Test CPT 87040 | $399.60 | $666.00 | $10.20 – $532.80 | 17 |
| Blood draw capillary 36416 CPT 36416 | $27.60 | $46.00 | $12.42 – $41.40 | 13 |
| Blood gases o2 saturation direct measurement CPT 82805 | $121.80 | $203.00 | $42.75 – $162.40 | 17 |
| Blood gases ph venous CPT 82800 | $114.00 | $190.00 | $10.87 – $152.00 | 17 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $27.00 | $45.00 | $3.08 – $36.00 | 17 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $20.40 | $34.00 | $3.99 – $27.20 | 17 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $20.40 | $34.00 | $1.22 – $4.73 | 17 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $50.40 | $84.00 | $3.99 – $67.20 | 17 |
| Blood split unit HCPCS P9011 | $247.80 | $413.00 | $69.44 – $330.40 | 17 |
| Blood typing abo CPT 86900 | $8.40 | $14.00 | $2.96 – $11.20 | 17 |
| Blood typing ag donor ea ag CPT 86902 | $64.80 | $108.00 | $3.10 – $86.40 | 17 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $81.00 | $135.00 | $3.61 – $108.00 | 17 |
| Blood typing rh (d) CPT 86901 | $40.20 | $67.00 | $2.96 – $53.60 | 17 |
| Bone Density Scan (DEXA) CPT 77080 | $240.00 | $400.00 | $66.12 – $320.00 | 17 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $861.60 | $1,436.00 | $76.80 – $1,148.80 | 17 |
| Bone marrow imaging body CPT 78104 | $2,315.40 | $3,859.00 | $70.40 – $3,087.20 | 17 |
| Bone marrow interpretation CPT 85097 | $251.40 | $419.00 | $21.12 – $335.20 | 17 |
| Bone marrow;aspiration only 38220 CPT 38220 | $758.40 | $1,264.00 | $60.15 – $1,011.20 | 17 |
| Bone survey-lead poisoning CPT 77074 | $697.80 | $1,163.00 | $38.68 – $930.40 | 17 |
| Bone/joint imaging ltd area CPT 78300 | $857.40 | $1,429.00 | $53.12 – $1,143.20 | 17 |
| Boot j walker l HCPCS L4386 | $1,417.80 | $2,363.00 | $159.46 – $1,890.40 | 16 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $805.80 | $1,343.00 | $33.40 – $532.07 | 16 |
| Borrelia antibody CPT 86619 | $176.40 | $294.00 | $10.44 – $235.20 | 17 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $70.80 | $118.00 | $16.83 – $94.40 | 17 |
| Borrelia miyamotoi amp prb CPT 87478 | $290.40 | $484.00 | $30.88 – $387.20 | 17 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $283.20 | $354.00 | $2.79 – $318.60 | 16 |
| Bowel imaging CPT 78290 | $1,447.80 | $2,413.00 | $57.60 – $1,930.40 | 17 |
| Bra surgical elizabeth pink sm HCPCS L8000 | $55.20 | $92.00 | $18.40 – $73.60 | 16 |
| Brace ank air stirrup univ HCPCS L4350 | $272.40 | $454.00 | $77.16 – $363.20 | 16 |
| Brace ankle stablizing lg HCPCS L1902 | $286.80 | $478.00 | $78.11 – $382.40 | 16 |
| Brace knee extender plus 22-30in HCPCS L1832 | $351.60 | $586.00 | $117.20 – $1,223.04 | 16 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $170.40 | $284.00 | $56.80 – $255.60 | 15 |
| Brace wrist classic lft sm HCPCS L3908 | $132.60 | $221.00 | $13.60 – $113.83 | 16 |
| Brach/thor cath 1st CPT 36215 | $1,107.60 | $1,846.00 | $189.20 – $1,476.80 | 17 |
| Brach/thor cath 2nd CPT 36216 | $947.40 | $1,579.00 | $125.95 – $1,263.20 | 17 |
| Brach/thor cath 3rd CPT 36217 | $1,133.40 | $1,889.00 | $332.28 – $1,511.20 | 17 |
| Brach/thor cath addl CPT 36218 | $97.20 | $162.00 | $43.74 – $151.12 | 17 |
| Brachy source yttrium-90 HCPCS C2616 | $37,851.00 | $63,085.00 | $10,939.80 – $49,229.10 | 16 |
| Brachy src nonstrand hdr ir-192 HCPCS C1717 | $1,164.60 | $1,941.00 | $262.12 – $1,746.90 | 16 |
| Brachytx isodose complex CPT 77318 | $1,950.00 | $3,250.00 | $192.63 – $2,600.00 | 17 |
| Brachytx isodose intermed CPT 77317 | $1,418.40 | $2,364.00 | $141.91 – $1,891.20 | 17 |
| Brachytx isodose plan simple CPT 77316 | $1,241.40 | $2,069.00 | $108.90 – $1,655.20 | 17 |
| Braf gene CPT 81210 | $349.20 | $582.00 | $157.50 – $465.60 | 17 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $3,826.20 | $6,377.00 | $343.82 – $5,101.60 | 17 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $3,207.00 | $5,345.00 | $342.28 – $4,276.00 | 17 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,366.40 | $3,944.00 | $232.71 – $3,155.20 | 17 |
| Brain MRI (with and without contrast) CPT 70553 | $3,804.00 | $6,340.00 | $343.82 – $5,072.00 | 17 |
| Brain MRI (with contrast) CPT 70552 | $2,910.60 | $4,851.00 | $343.82 – $3,880.80 | 17 |
| Brain MRI (without contrast) CPT 70551 | $2,398.20 | $3,997.00 | $232.71 – $3,197.60 | 17 |
| Brain flow imaging only CPT 78610 | $1,557.00 | $2,595.00 | $43.52 – $2,076.00 | 17 |
| Brain image w/flow 4 + views CPT 78606 | $1,873.80 | $3,123.00 | $75.52 – $2,498.40 | 17 |
| Brca1&2 gen ful dup/del alys CPT 81164 | $2,222.40 | $3,704.00 | $514.12 – $2,963.20 | 17 |
| Brcassure comprehensive panel-sendout CPT 81162 | $1,920.00 | $3,200.00 | $864.00 – $2,560.00 | 17 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $3,828.00 | $6,380.00 | $152.78 – $5,104.00 | 17 |
| Breast punct aspir cyst, bil CPT 19000 | $845.40 | $1,409.00 | $40.15 – $1,127.20 | 17 |
| Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 | $843.20 | $1,096.00 | $258.64 – $948.60 | 17 |
| Bronch ebus ivntj perph les 31654 CPT 31654 | $2,053.20 | $3,422.00 | $60.45 – $2,737.60 | 17 |
| Bronch ebus samplng 1/2 node CPT 31652 | $3,484.80 | $5,808.00 | $208.90 – $4,646.40 | 17 |
| Bronch w/debrdmt subgltc & uppr trach CPT 31899 | $2,203.80 | $3,673.00 | $139.57 – $3,305.70 | 16 |
| Bronchial challenge CPT 94070 | $761.40 | $1,269.00 | $14.59 – $1,015.20 | 17 |
| Bronchoscopy clear airways 31645 CPT 31645 | $3,515.40 | $5,859.00 | $162.58 – $4,687.20 | 17 |
| Bronchoscopy w/biopsy(s) 31625 CPT 31625 | $2,926.80 | $4,878.00 | $173.59 – $3,902.40 | 17 |
| Bronchoscopy w/fb removal 31635 CPT 31635 | $2,926.80 | $4,878.00 | $193.76 – $3,902.40 | 17 |
| Bronchoscopy/lung bx each 31628 CPT 31628 | $3,484.80 | $5,808.00 | $193.38 – $4,646.40 | 17 |
| Bronchoscopy/needle bx each 31629 CPT 31629 | $3,484.80 | $5,808.00 | $206.13 – $4,646.40 | 17 |
| Budesonide non-comp unit HCPCS J7626 | $463.20 | $579.00 | $1.35 – $521.10 | 16 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $8.20 | $10.25 | $0.37 – $3.60 | 17 |
| Bundled special stain group 1 microorganisms CPT 88312 | $161.40 | $269.00 | $50.94 – $215.20 | 17 |
| Bundled special stain group 2 CPT 88313 | $237.60 | $396.00 | $41.44 – $316.80 | 17 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $0.40 | $0.50 | $0.01 – $0.05 | 16 |
| Buprenorph X-ray 100 mg or less HCPCS Q9991 | $5,427.00 | $9,045.00 | $2,016.42 – $8,140.50 | 17 |
| Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet HCPCS J0572 | $27.00 | $45.00 | $4.52 – $15.07 | 14 |
| Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 | $64.40 | $80.50 | $21.73 – $72.45 | 14 |
| Buprenorphine X-ray over 100 mg HCPCS Q9992 | $7,236.00 | $9,045.00 | $2,016.42 – $8,140.50 | 17 |
| Buprenorphine hydrochloride HCPCS J0592 | $14.20 | $17.75 | $4.17 – $15.30 | 16 |
| Bur rotalink 2.15mm HCPCS C1724 | $8,485.20 | $14,142.00 | $1,772.55 – $5,908.50 | 13 |
| Burr hole implant ventricular cath/other device CPT 61210 | $4,290.60 | $7,151.00 | $431.42 – $5,720.80 | 15 |
| Butorphanol tartrate 1 mg HCPCS J0595 | $90.60 | $151.00 | $6.43 – $135.90 | 16 |
| Bx bone trocar/ndl deep CPT 20225 | $1,119.00 | $1,865.00 | $107.80 – $1,492.00 | 17 |
| Bx breast 1st lesion strtctc CPT 19081 | $3,700.20 | $6,167.00 | $163.13 – $4,933.60 | 17 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $1,914.60 | $3,191.00 | $72.73 – $2,552.80 | 17 |
| Bx breast add lesion strtctc CPT 19082 | $2,079.60 | $3,466.00 | $77.42 – $2,772.80 | 17 |
| Bx pancreas pq ndl CPT 48102 | $971.40 | $1,619.00 | $639.06 – $1,668.12 | 17 |
| Bx pleura pq ndl CPT 32400 | $971.40 | $1,619.00 | $89.14 – $1,295.20 | 17 |
| Bx skin punch ea sep/ addl les CPT 11105 | $148.80 | $248.00 | $24.25 – $85.60 | 17 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $148.80 | $248.00 | $20.52 – $88.00 | 17 |
| Bx soft tiss pelvis/hip deep 27041 CPT 27041 | $1,119.00 | $1,865.00 | $37.95 – $1,492.00 | 17 |
| Bx vulva or perineum/1 lesion 56605 CPT 56605 | $489.60 | $816.00 | $61.06 – $993.28 | 17 |
| Bx/curett of cervix w/scope 57454 CPT 57454 | $218.40 | $364.00 | $116.53 – $993.28 | 17 |
| Bypass temp external fem-fem CPT 37799 | $1,473.00 | $2,455.00 | $451.70 – $2,209.50 | 16 |
| C motor evoked lwr limbs CPT 95929 | $486.60 | $811.00 | $91.93 – $648.80 | 17 |
| C motor evoked uppr limbs CPT 95928 | $429.00 | $715.00 | $85.12 – $572.00 | 17 |
| C motor evoked upr&lwr limbs CPT 95939 | $2,816.40 | $4,694.00 | $325.84 – $3,755.20 | 17 |
| C-1 esterase, berinert HCPCS J0597 | $156.00 | $195.00 | $52.88 – $175.50 | 17 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $3,941.40 | $6,569.00 | $289.97 – $5,255.20 | 17 |
| C-peptide CPT 84681 | $189.00 | $315.00 | $20.57 – $252.00 | 17 |
| C-reactive protein CPT 86140 | $238.20 | $397.00 | $3.30 – $317.60 | 17 |
| C-reactive protein high sensitivity CPT 86141 | $452.40 | $754.00 | $11.58 – $603.20 | 17 |
| C-reactive protein, quantitative CPT 86406 | $441.00 | $735.00 | $10.51 – $588.00 | 17 |
| C-section delivery incl p/p care 59515 CPT 59515 | $1,012.80 | $1,688.00 | $455.76 – $3,060.29 | 15 |
| C1 esterase inhibitor func - sendout CPT 86161 | $118.20 | $197.00 | $11.86 – $157.60 | 17 |
| CT 3d report other modality w/workstation CPT 76377 | $697.20 | $1,162.00 | $30.43 – $929.60 | 15 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $7,318.20 | $12,197.00 | $343.82 – $9,757.60 | 17 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,384.00 | $5,640.00 | $171.38 – $4,512.00 | 17 |
| CT Angiogram of the Head CPT 70496 | $4,092.00 | $6,820.00 | $171.38 – $5,456.00 | 17 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $5,723.40 | $9,539.00 | $326.02 – $7,631.20 | 17 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $4,453.20 | $7,422.00 | $246.69 – $5,937.60 | 17 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,320.40 | $5,534.00 | $129.37 – $4,427.20 | 17 |
| CT angio hrt w/3d image CPT 75574 | $2,133.00 | $3,555.00 | $265.05 – $2,844.00 | 17 |
| CT angio pelvis CPT 72191 | $2,494.20 | $4,157.00 | $171.38 – $3,325.60 | 17 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $161.64 – $247.00 | 8 |
| CT guid parench tis ablat CPT 77013 | $3,177.00 | $5,295.00 | $1,429.65 – $4,765.50 | 13 |
| CT guidance for needle placement CPT 77012 | $2,904.60 | $4,841.00 | $130.88 – $3,872.80 | 17 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $2,921.40 | $4,869.00 | $12.80 – $3,895.20 | 17 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $120.00 | $200.00 | $44.52 – $160.00 | 17 |
| CT hrt w/3d image CPT 75572 | $3,384.00 | $5,640.00 | $216.36 – $4,512.00 | 17 |
| CT limited or localized follow-up study CPT 76380 | $541.20 | $902.00 | $67.84 – $721.60 | 17 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,680.20 | $4,467.00 | $105.60 – $3,573.60 | 17 |
| CT lower extremity without contrast (both sides) CPT 73700 | $2,358.60 | $3,931.00 | $101.17 – $3,144.80 | 17 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,819.40 | $4,699.00 | $118.40 – $3,759.20 | 17 |
| CT neck soft tissue w/contrast CPT 70491 | $2,511.00 | $4,185.00 | $105.60 – $3,348.00 | 17 |
| CT neck soft tissue without & w/contrast CPT 70492 | $3,145.80 | $5,243.00 | $118.40 – $4,194.40 | 17 |
| CT neck soft tissue without contrast CPT 70490 | $2,061.60 | $3,436.00 | $101.12 – $2,748.80 | 17 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $2,151.00 | $3,585.00 | $165.12 – $2,868.00 | 17 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,623.00 | $2,705.00 | $102.37 – $2,164.00 | 17 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $2,712.60 | $4,521.00 | $171.38 – $3,616.80 | 17 |
| CT scan for therapy guide CPT 77014 | $592.80 | $988.00 | $86.87 – $790.40 | 17 |
| CT t-spine w /wo contrast CPT 72130 | $2,602.20 | $4,337.00 | $171.38 – $3,469.60 | 17 |
| CT thoracic spine w/contrast CPT 72129 | $2,555.40 | $4,259.00 | $112.00 – $3,407.20 | 17 |
| CT thoracic spine without contrast CPT 72128 | $2,074.20 | $3,457.00 | $102.37 – $2,765.60 | 17 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $253.20 | $422.00 | $93.93 – $337.60 | 17 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $2,358.60 | $3,931.00 | $105.60 – $3,144.80 | 17 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,943.40 | $3,239.00 | $101.17 – $2,591.20 | 17 |
| CT uppr extremity w/o&w/dye CPT 73202 | $3,574.80 | $5,958.00 | $118.40 – $4,766.40 | 17 |
| Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 | $808.20 | $1,347.00 | $227.28 – $1,212.30 | 17 |
| Cable cath 22-pin diag HCPCS C1730 | $2,604.00 | $4,340.00 | $232.47 – $774.90 | 13 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | $109.80 | $183.00 | $4.05 – $13.50 | 14 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $20,030.40 | $25,038.00 | $484.97 – $22,534.20 | 17 |
| Calcium 24 hour urine CPT 82340 | $78.60 | $131.00 | $5.96 – $104.80 | 17 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $0.80 | $1.00 | $0.04 – $0.90 | 16 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $0.80 | $1.00 | $0.09 – $0.90 | 16 |
| Calcium ionized CPT 82330 | $107.40 | $179.00 | $9.73 – $143.20 | 17 |
| Calcium total CPT 82310 | $39.60 | $66.00 | $5.10 – $52.80 | 17 |
| Calprotectin fecal CPT 83993 | $290.40 | $484.00 | $19.40 – $387.20 | 17 |
| Campylobacter antibody CPT 86625 | $80.40 | $134.00 | $12.97 – $107.20 | 17 |
| Candida dna CPT 87480 | $255.60 | $426.00 | $19.82 – $340.80 | 17 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $11,907.00 | $19,845.00 | $4.60 – $20.70 | 14 |
| Canthotomy 67715 CPT 67715 | $3,355.20 | $5,592.00 | $322.00 – $4,473.60 | 17 |
| Cap nerve 2x15mm HCPCS C1763 | $3,405.60 | $5,676.00 | $72.00 – $324.00 | 14 |
| Cap trach decann 15mm HCPCS C1750 | $1,842.60 | $3,071.00 | $141.80 – $600.30 | 14 |
| Carbamazepine free CPT 80157 | $235.20 | $392.00 | $12.09 – $313.60 | 17 |
| Carbamazepine free -sendout CPT 80161 | $197.40 | $329.00 | $14.55 – $263.20 | 17 |
| Carbamazepine total therapeutic drug level CPT 80156 | $197.40 | $329.00 | $14.40 – $263.20 | 17 |
| Carbohydrate deficient transf - sendout CPT 82373 | $71.40 | $119.00 | $8.76 – $95.20 | 17 |
| Carbohydrate urine - sendout CPT 84377 | $30.60 | $51.00 | $5.44 – $40.80 | 17 |
| Carbon dioxide CPT 82374 | $39.60 | $66.00 | $4.82 – $52.80 | 17 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | $420.80 | $526.00 | $2.47 – $47.70 | 16 |
| Carboxyhemoglobin quantitative CPT 82375 | $226.80 | $378.00 | $6.16 – $302.40 | 17 |
| Carcinoembryonic ag (cea) CPT 82378 | $334.20 | $557.00 | $18.70 – $444.00 | 17 |
| Cardiac MRI w/stress img CPT 75559 | $2,657.40 | $4,429.00 | $321.97 – $3,543.20 | 17 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $3,772.20 | $6,287.00 | $243.44 – $5,029.60 | 17 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $180.60 | $301.00 | $72.81 – $240.80 | 17 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $176.40 | $294.00 | $51.81 – $235.20 | 17 |
| Cardiolipin antibody iga CPT 86147 | $89.40 | $149.00 | $25.16 – $119.20 | 17 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $1,245.00 | $2,075.00 | $95.70 – $1,660.00 | 17 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $103.20 | $172.00 | $43.32 – $137.60 | 14 |
| Carfilzomib 10 mg intravenous solution HCPCS J9047 | $232.00 | $290.00 | $55.65 – $261.00 | 17 |
| Carotene CPT 82380 | $209.40 | $349.00 | $9.12 – $279.20 | 17 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,433.40 | $2,389.00 | $152.76 – $1,911.20 | 17 |
| Carpal Tunnel Release Surgery CPT 64721 | $4,530.60 | $7,551.00 | $330.00 – $6,040.80 | 17 |
| Caspofungin acetate HCPCS J0637 | $1,752.00 | $2,920.00 | $3.54 – $189.00 | 16 |
| Catecholamines,fractionated, urine CPT 82382 | $234.00 | $390.00 | $21.45 – $312.00 | 17 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $403.80 | $673.00 | $118.80 – $396.00 | 14 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $3,024.00 | $5,040.00 | $620.19 – $2,067.30 | 13 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $6,022.80 | $10,038.00 | $2,710.26 – $9,034.20 | 13 |
| Cath access del ds spyscop 2.0 HCPCS C1748 | $6,411.60 | $10,686.00 | $2,885.22 – $9,617.40 | 13 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $5,743.20 | $9,572.00 | $5.94 – $85.60 | 14 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $3,905.40 | $6,509.00 | $1,757.43 – $5,858.10 | 13 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $15,737.40 | $26,229.00 | $5.94 – $19.80 | 13 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $3,581.40 | $5,969.00 | $123.39 – $411.30 | 14 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $219.00 | $365.00 | $73.00 – $328.50 | 14 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $4,239.00 | $7,065.00 | $993.28 – $5,652.00 | 17 |
| Cath council tip 16fr 5cc HCPCS A4344 | $42.00 | $70.00 | $2.70 – $31.77 | 16 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $1,059.00 | $1,765.00 | $7.02 – $64.40 | 14 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $2,232.00 | $3,720.00 | $51.03 – $170.10 | 13 |
| Cath entrl fd nutri 5fr 40cm HCPCS B4082 | $8.40 | $14.00 | $3.78 – $18.85 | 14 |
| Cath epdrl brevi-stf 12in .043 HCPCS C1755 | $1,297.80 | $2,163.00 | $584.01 – $1,946.70 | 13 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $1,672.20 | $2,787.00 | $281.60 – $1,267.20 | 14 |
| Cath hawkone s directional HCPCS C1714 | $14,437.80 | $24,063.00 | $6,497.01 – $21,656.70 | 13 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $3,262.80 | $5,438.00 | $29.16 – $1,087.60 | 14 |
| Cath infuse micro 150cm rapidtransit HCPCS A4351 | $114.00 | $190.00 | $0.54 – $4.02 | 15 |
| Cath left heart transseptal punc CPT 93462 | $4,045.80 | $6,743.00 | $209.42 – $5,394.40 | 15 |
| Cath left heart/lv gram CPT 93452 | $3,955.80 | $6,593.00 | $993.28 – $5,274.40 | 17 |
| Cath lt/rt pulm art CPT 36014 | $369.00 | $615.00 | $125.95 – $539.52 | 17 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $3,807.00 | $6,345.00 | $3.51 – $28.80 | 14 |
| Cath pezzer 34fr drain bardex propor head mushrm ltx HCPCS A4340 | $179.40 | $299.00 | $2.70 – $48.31 | 15 |
| Cath place 1st order venous 36011 CPT 36011 | $307.20 | $512.00 | $125.95 – $993.28 | 17 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $6,051.00 | $10,085.00 | $993.28 – $8,068.00 | 17 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $7,321.20 | $12,202.00 | $993.28 – $9,761.60 | 17 |
| Cath plc art/grft/angio right hrt CPT 93457 | $4,763.40 | $7,939.00 | $993.28 – $6,351.20 | 17 |
| Cath ptca pcltxl agent 3x20mm HCPCS C9610 | $10,678.80 | $17,798.00 | $4,805.46 – $16,018.20 | 13 |
| Cath right heart w/o2 sat & card CPT 93451 | $3,429.60 | $5,716.00 | $993.28 – $4,572.80 | 17 |
| Cath right hrt mnpul art CPT 36013 | $358.20 | $597.00 | $125.95 – $537.30 | 17 |
| Cath segmntl pulm art CPT 36015 | $512.40 | $854.00 | $125.95 – $683.20 | 17 |
| Cath steerable flex adv 12f HCPCS C1766 | $3,718.20 | $6,197.00 | $1,445.85 – $4,819.50 | 13 |
| Cath suction replogle 8fr neonatal esophageal HCPCS A4624 | $2.40 | $4.00 | $0.27 – $5.46 | 15 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $977.40 | $1,629.00 | $2.20 – $9.90 | 14 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $380.40 | $634.00 | $57.20 – $993.28 | 17 |
| Catheter declot mechanical CPT 36596 | $4,740.60 | $7,901.00 | $47.30 – $6,320.80 | 17 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $42.60 | $71.00 | $6.69 – $56.80 | 17 |
| Cauterization chemical granulation tissue CPT 17250 | $408.60 | $681.00 | $28.40 – $544.80 | 17 |
| Cdna analysis for variants CPT 81403 | $1,934.40 | $3,224.00 | $144.60 – $633.60 | 17 |
| Cebpa gene full sequence CPT 81218 | $2,101.20 | $3,502.00 | $239.08 – $2,801.60 | 17 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $33.60 | $56.00 | $0.80 – $3.60 | 16 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $62.80 | $78.50 | $1.22 – $69.30 | 16 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $70.00 | $87.50 | $4.78 – $78.30 | 16 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $814.20 | $1,357.00 | $2.44 – $8.10 | 17 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $13.80 | $17.25 | $1.57 – $14.40 | 16 |
| Ceftazidime and avibactam HCPCS J0714 | $1,516.80 | $2,528.00 | $104.73 – $569.70 | 17 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $50.20 | $62.75 | $0.43 – $1.80 | 16 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $12.40 | $15.50 | $1.85 – $13.50 | 16 |
| Cell count w differential body fluid CPT 89051 | $158.40 | $264.00 | $5.54 – $105.60 | 17 |
| Cell cryopreserve/storage CPT 88240 | $133.80 | $223.00 | $10.20 – $178.40 | 17 |
| Cell function assay w/stim CPT 86352 | $898.80 | $1,498.00 | $85.62 – $1,198.40 | 17 |
| Cell marker study CPT 88182 | $137.40 | $229.00 | $8.79 – $194.38 | 17 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | $843.60 | $1,406.00 | $29.29 – $180.00 | 17 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | $34.60 | $43.25 | $3.91 – $38.70 | 17 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $280.20 | $467.00 | $78.37 – $419.40 | 17 |
| Cftr gene intron poly t CPT 81224 | $276.00 | $460.00 | $131.76 – $368.00 | 17 |
| Cftr gene known fam variants CPT 81221 | $327.60 | $546.00 | $85.56 – $436.80 | 17 |
| Change cystostomy tube simple CPT 51705 | $825.60 | $1,376.00 | $30.80 – $1,100.80 | 17 |
| Change cystostomy tube; complex 51710 CPT 51710 | $3,355.20 | $5,592.00 | $30.80 – $4,473.60 | 17 |
| Change g-tube to g-j perc CPT 49446 | $2,179.80 | $3,633.00 | $138.42 – $2,906.40 | 17 |
| Change of windpipe airway 31502 CPT 31502 | $472.80 | $788.00 | $126.57 – $630.40 | 17 |
| Chemo extend IV infus w/pump HCPCS G0498 | $696.00 | $1,160.00 | $259.71 – $1,044.00 | 16 |
| Chemo ia infuse each addl hr CPT 96423 | $184.80 | $308.00 | $44.42 – $246.40 | 17 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | $723.00 | $1,205.00 | $102.89 – $993.28 | 17 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | $647.40 | $1,079.00 | $94.27 – $993.28 | 17 |
| Chemodenerv musc migraine 64615 CPT 64615 | $783.00 | $1,305.00 | $112.74 – $1,044.00 | 17 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | $2,170.20 | $3,617.00 | $170.29 – $2,893.60 | 17 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | $697.20 | $1,162.00 | $101.97 – $993.28 | 17 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | $772.20 | $1,287.00 | $117.77 – $1,029.60 | 17 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | $1,877.40 | $3,129.00 | $284.19 – $2,503.20 | 17 |
| Chest 2 vws w oblique CPT 71048 | $499.20 | $832.00 | $24.87 – $665.60 | 17 |
| Chest CT scan (with and without contrast) CPT 71270 | $3,152.40 | $5,254.00 | $132.48 – $4,203.20 | 17 |
| Chest CT scan (with contrast) CPT 71260 | $2,664.00 | $4,440.00 | $112.00 – $3,552.00 | 17 |
| Chest CT scan (without contrast) CPT 71250 | $2,244.60 | $3,741.00 | $102.37 – $2,992.80 | 17 |
| Chest X-ray CPT 71046 | $580.20 | $967.00 | $19.01 – $773.60 | 17 |
| Chest X-ray (single view) CPT 71045 | $175.20 | $292.00 | $10.38 – $233.60 | 17 |
| Chest apical lordotic proj CPT 71047 | $499.20 | $832.00 | $24.19 – $665.60 | 17 |
| Chg pr pul rehab for copd patients CPT 94626 | $330.60 | $551.00 | $44.88 – $440.80 | 17 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $712.20 | $1,187.00 | $71.69 – $949.60 | 17 |
| Chlamydia culture CPT 87110 | $730.20 | $1,217.00 | $19.38 – $973.60 | 17 |
| Chlamydia trachomatis ag if CPT 87270 | $66.60 | $111.00 | $9.36 – $88.80 | 17 |
| Chloride CPT 82435 | $39.60 | $66.00 | $4.55 – $52.80 | 17 |
| Chloride 24 hour urine CPT 82436 | $66.60 | $111.00 | $5.68 – $88.80 | 17 |
| Chloroprocaine hcl injection HCPCS J2401 | $68.40 | $114.00 | $0.04 – $0.90 | 16 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $1,236.80 | $1,546.00 | $39.45 – $1,391.40 | 16 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $177.60 | $222.00 | $25.27 – $199.80 | 16 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | $0.80 | $1.00 | $0.27 – $0.90 | 14 |
| Cholangiogram percutaneous compl CPT 47532 | $3,863.40 | $6,439.00 | $193.84 – $5,151.20 | 17 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $982.80 | $1,638.00 | $121.79 – $1,310.40 | 14 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $3,933.00 | $6,555.00 | $241.92 – $5,244.00 | 17 |
| Cholesterol CPT 82465 | $39.60 | $66.00 | $4.30 – $52.80 | 17 |
| Cholesterol (Lipid) Test CPT 80061 | $228.00 | $380.00 | $13.24 – $304.00 | 17 |
| Cholesterol body fluid CPT 84999 | $9,473.40 | $15,789.00 | $5.13 – $17.10 | 13 |
| Cholinesterase CPT 82480 | $103.20 | $172.00 | $6.60 – $137.60 | 17 |
| Chromatography CPT 83021 | $18.60 | $31.00 | $8.37 – $25.56 | 17 |
| Chromo high res and frag x - sendout CPT 81243 | $3,704.40 | $6,174.00 | $50.19 – $860.00 | 17 |
| Chromogenic substrate assay CPT 85130 | $158.40 | $264.00 | $9.28 – $211.20 | 17 |
| Chromosome analysis 15-20 cell count CPT 88262 | $1,017.00 | $1,695.00 | $124.02 – $1,356.00 | 17 |
| Chromosome analysis 45 CPT 88263 | $943.80 | $1,573.00 | $148.54 – $1,258.40 | 17 |
| Chromosome karyotype study CPT 88280 | $140.40 | $234.00 | $33.08 – $187.20 | 17 |
| Chronic urticaria - sendout CPT 86343 | $133.80 | $223.00 | $9.73 – $178.40 | 17 |
| Chylomicron screen, bf - sendout CPT 82664 | $334.80 | $558.00 | $48.03 – $446.40 | 17 |
| Ciliary transsleral therapy CPT 66710 | $4,695.00 | $7,825.00 | $993.28 – $6,260.00 | 17 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $9.00 | $11.25 | $1.89 – $6.30 | 16 |
| Circumcision (newborn) CPT 54150 | $1,425.60 | $2,376.00 | $86.90 – $945.90 | 16 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $16.20 | $27.00 | $2.29 – $24.30 | 16 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $268.80 | $337.00 | $10.68 – $302.40 | 17 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $4,416.60 | $7,361.00 | $781.38 – $2,604.60 | 13 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $45.80 | $57.25 | $1.83 – $9.90 | 16 |
| Clip ligating vesolock lg HCPCS C1760 | $925.20 | $1,542.00 | $18.09 – $172.60 | 14 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $729.60 | $1,216.00 | $18.17 – $135.90 | 16 |
| Clos txnose fx without stablz 21315 CPT 21315 | $825.60 | $1,376.00 | $131.45 – $1,100.80 | 17 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $825.60 | $1,376.00 | $34.65 – $1,100.80 | 17 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | $3,001.80 | $5,003.00 | $439.68 – $4,002.40 | 15 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $825.60 | $1,376.00 | $179.30 – $1,100.80 | 17 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $3,135.00 | $5,225.00 | $203.50 – $4,180.00 | 17 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $3,355.20 | $5,592.00 | $128.15 – $4,473.60 | 17 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $825.60 | $1,376.00 | $59.95 – $1,100.80 | 17 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $4,522.80 | $7,538.00 | $260.70 – $6,030.40 | 17 |
| Closed tx sesamoid fx 28530 CPT 28530 | $1,258.80 | $2,098.00 | $114.50 – $1,678.40 | 17 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | $5,312.40 | $8,854.00 | $230.94 – $7,083.20 | 17 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | $825.60 | $1,376.00 | $122.10 – $1,100.80 | 17 |
| Closure paravalvlr leak pq CPT 33999 | $1,123.80 | $1,873.00 | $451.70 – $1,685.70 | 16 |
| Clot factor fletcher fact CPT 85292 | $260.40 | $434.00 | $18.70 – $347.20 | 17 |
| Clot factor viii reltd antgn CPT 85244 | $288.00 | $480.00 | $20.18 – $384.00 | 17 |
| Clot factor xii hageman CPT 85280 | $163.20 | $272.00 | $14.30 – $217.60 | 17 |
| Clot factor xiii fibrin stab CPT 85290 | $106.20 | $177.00 | $8.80 – $141.60 | 17 |
| Clozapine, 25 mg HCPCS S0136 | $8.40 | $10.50 | $1.75 – $5.85 | 14 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $3,355.20 | $5,592.00 | $230.94 – $4,473.60 | 17 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $825.60 | $1,376.00 | $53.35 – $1,100.80 | 17 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $3,355.20 | $5,592.00 | $103.95 – $4,473.60 | 17 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $718.20 | $1,197.00 | $174.90 – $993.28 | 17 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $825.60 | $1,376.00 | $58.30 – $1,100.80 | 17 |
| Clsd tx fracture of radius 25500 CPT 25500 | $825.60 | $1,376.00 | $86.35 – $1,100.80 | 17 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $825.60 | $1,376.00 | $182.60 – $1,272.32 | 17 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $825.60 | $1,376.00 | $125.95 – $1,100.80 | 17 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $825.60 | $1,376.00 | $220.55 – $1,179.75 | 17 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $1,427.40 | $2,379.00 | $125.95 – $1,903.20 | 17 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $718.20 | $1,197.00 | $230.94 – $1,107.39 | 17 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $3,355.20 | $5,592.00 | $135.85 – $4,473.60 | 17 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $3,355.20 | $5,592.00 | $123.20 – $4,473.60 | 17 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $3,349.80 | $5,583.00 | $255.68 – $4,466.40 | 17 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | $4,493.40 | $7,489.00 | $176.00 – $5,991.20 | 17 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $534.60 | $891.00 | $129.80 – $993.28 | 17 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $4,530.60 | $7,551.00 | $159.50 – $6,040.80 | 17 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $825.60 | $1,376.00 | $112.20 – $1,100.80 | 17 |
| Clsd tx pelvic ring fx CPT 27197 | $465.00 | $775.00 | $102.45 – $993.28 | 17 |
| Clsd tx pelvic ring fx CPT 27198 | $1,195.80 | $1,993.00 | $230.94 – $1,594.40 | 17 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $825.60 | $1,376.00 | $216.70 – $1,100.80 | 17 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $3,365.40 | $5,609.00 | $130.35 – $4,487.20 | 17 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $3,135.00 | $5,225.00 | $172.70 – $4,180.00 | 17 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $4,493.40 | $7,489.00 | $165.55 – $5,991.20 | 17 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $825.60 | $1,376.00 | $31.88 – $1,100.80 | 17 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $613.80 | $1,023.00 | $53.35 – $818.40 | 17 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $718.20 | $1,197.00 | $262.90 – $1,421.13 | 17 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $825.60 | $1,376.00 | $230.94 – $1,100.80 | 17 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $3,355.20 | $5,592.00 | $216.70 – $4,473.60 | 17 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $825.60 | $1,376.00 | $230.94 – $1,100.80 | 17 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $825.60 | $1,376.00 | $134.20 – $1,100.80 | 17 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $801.60 | $1,336.00 | $160.60 – $1,068.80 | 17 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $3,355.20 | $5,592.00 | $77.55 – $4,473.60 | 17 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $825.60 | $1,376.00 | $52.80 – $1,100.80 | 17 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $3,355.20 | $5,592.00 | $230.94 – $4,473.60 | 17 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,926.80 | $4,878.00 | $434.50 – $3,902.40 | 17 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $825.60 | $1,376.00 | $60.50 – $1,100.80 | 17 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $825.60 | $1,376.00 | $73.15 – $1,100.80 | 17 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $3,355.20 | $5,592.00 | $172.70 – $4,473.60 | 17 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $825.60 | $1,376.00 | $76.45 – $1,100.80 | 17 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $825.60 | $1,376.00 | $116.60 – $1,100.80 | 17 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $825.60 | $1,376.00 | $92.95 – $1,100.80 | 17 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $3,355.20 | $5,592.00 | $144.10 – $4,473.60 | 17 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $825.60 | $1,376.00 | $61.60 – $1,100.80 | 17 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $825.60 | $1,376.00 | $113.30 – $1,100.80 | 17 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $3,435.60 | $5,726.00 | $80.30 – $4,580.80 | 17 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $3,135.00 | $5,225.00 | $152.90 – $4,180.00 | 17 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $825.60 | $1,376.00 | $118.80 – $1,100.80 | 17 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $825.60 | $1,376.00 | $108.90 – $1,100.80 | 17 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $825.60 | $1,376.00 | $110.00 – $1,100.80 | 17 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $4,493.40 | $7,489.00 | $170.50 – $5,991.20 | 17 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $729.60 | $1,216.00 | $172.70 – $993.28 | 17 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $3,355.20 | $5,592.00 | $122.10 – $4,473.60 | 17 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $3,355.20 | $5,592.00 | $122.10 – $4,473.60 | 17 |
| Cltx post ankle fx CPT 27767 | $2,523.60 | $4,206.00 | $226.89 – $3,364.80 | 17 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $3,435.60 | $5,726.00 | $123.20 – $4,580.80 | 17 |
| Cmv pcr-sendout CPT 87496 | $860.40 | $1,434.00 | $34.68 – $1,147.20 | 17 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $9.00 | $11.25 | $2.65 – $9.90 | 17 |
| Coagulation time activated teg CPT 85347 | $25.20 | $42.00 | $4.23 – $33.60 | 17 |
| Coagulation time otr method CPT 85348 | $33.00 | $55.00 | $4.44 – $44.00 | 17 |
| Cold agglutinin titer CPT 86157 | $100.20 | $167.00 | $7.96 – $133.60 | 17 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $62.40 | $104.00 | $3.40 – $48.29 | 16 |
| Collar cerv ascend 172 reg HCPCS L0172 | $135.00 | $225.00 | $45.00 – $241.85 | 16 |
| Collar cerv patriot adlt HCPCS L0150 | $60.60 | $101.00 | $27.27 – $207.45 | 15 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $162.00 | $270.00 | $31.08 – $216.00 | 17 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $162.00 | $270.00 | $38.42 – $216.00 | 17 |
| Collection of venous blood by venipuncture CPT 36415 | $27.60 | $46.00 | $3.06 – $9.82 | 17 |
| Colonoscopy (diagnostic) CPT 45378 | $1,500.00 | $2,500.00 | $198.55 – $2,000.00 | 17 |
| Colonoscopy (with biopsy) CPT 45380 | $3,252.60 | $5,421.00 | $247.96 – $4,336.80 | 17 |
| Colonoscopy (with polyp removal) CPT 45385 | $3,252.60 | $5,421.00 | $294.89 – $4,336.80 | 17 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $3,252.60 | $5,421.00 | $261.22 – $4,336.80 | 17 |
| Colonoscopy for bleeding 44391 CPT 44391 | $3,252.60 | $5,421.00 | $241.94 – $4,336.80 | 17 |
| Colonoscopy stoma w/snare 44394 CPT 44394 | $3,252.60 | $5,421.00 | $993.28 – $4,336.80 | 17 |
| Colonoscopy submucous njx CPT 45381 | $3,252.60 | $5,421.00 | $234.53 – $4,336.80 | 17 |
| Colonoscopy thru stoma spx CPT 44388 | $3,156.60 | $5,261.00 | $160.08 – $4,208.80 | 17 |
| Colonoscopy w/ablation CPT 45388 | $3,252.60 | $5,421.00 | $993.28 – $4,878.90 | 16 |
| Colonoscopy w/balloon dilat CPT 45386 | $3,252.60 | $5,421.00 | $255.45 – $4,336.80 | 17 |
| Colonoscopy w/band ligation CPT 45398 | $3,252.60 | $5,421.00 | $993.28 – $4,878.90 | 16 |
| Colonoscopy w/control bleed CPT 45382 | $3,252.60 | $5,421.00 | $279.40 – $4,336.80 | 17 |
| Colonoscopy w/decompression CPT 44408 | $3,156.60 | $5,261.00 | $877.73 – $4,734.90 | 16 |
| Colonoscopy w/endoscope Ultrasound CPT 45391 | $3,252.60 | $5,421.00 | $241.22 – $4,336.80 | 17 |
| Colonoscopy w/endoscopic fnb CPT 45392 | $3,252.60 | $5,421.00 | $305.16 – $4,336.80 | 17 |
| Colonoscopy w/fb removal CPT 45379 | $2,010.60 | $3,351.00 | $260.75 – $2,680.80 | 17 |
| Colonoscopy w/injection CPT 44404 | $3,252.60 | $5,421.00 | $993.28 – $4,878.90 | 16 |
| Colonoscopy w/resection CPT 45390 | $3,252.60 | $5,421.00 | $993.28 – $4,878.90 | 16 |
| Colonoscopy with biopsy CPT 44389 | $3,252.60 | $5,421.00 | $177.36 – $4,336.80 | 17 |
| Colonoscopy/w endoscopic stent 45389 CPT 45389 | $6,529.80 | $10,883.00 | $993.28 – $9,794.70 | 16 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $3,435.60 | $5,726.00 | $144.65 – $4,580.80 | 17 |
| Colposcopy w/biopsy of cervix 57455 CPT 57455 | $218.40 | $364.00 | $111.85 – $993.28 | 17 |
| Colposcopy/cervix/bx vagina/cervix 57421 CPT 57421 | $425.40 | $709.00 | $124.06 – $993.28 | 17 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $133.80 | $223.00 | $43.45 – $747.52 | 17 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $433.20 | $722.00 | $23.10 – $577.60 | 17 |
| Compatibility test each unit electronic CPT 86923 | $82.80 | $138.00 | $23.10 – $124.20 | 16 |
| Compatibility test each unit immediate spin technique CPT 86920 | $220.80 | $368.00 | $23.10 – $294.40 | 17 |
| Complement antigen each component c3 CPT 86160 | $88.80 | $148.00 | $11.86 – $118.40 | 17 |
| Complement fixation each CPT 86171 | $100.20 | $167.00 | $7.70 – $133.60 | 17 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $825.60 | $1,376.00 | $66.00 – $1,100.80 | 17 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $2,172.00 | $3,620.00 | $511.97 – $2,896.00 | 17 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $2,172.00 | $3,620.00 | $194.70 – $2,896.00 | 17 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $2,172.00 | $3,620.00 | $589.31 – $2,896.00 | 17 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $2,172.00 | $3,620.00 | $78.10 – $2,896.00 | 17 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $2,172.00 | $3,620.00 | $589.31 – $2,896.00 | 17 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $2,172.00 | $3,620.00 | $137.87 – $2,896.00 | 15 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $825.60 | $1,376.00 | $93.25 – $1,100.80 | 15 |
| Concentration infection agents any type CPT 87015 | $76.80 | $128.00 | $6.60 – $102.40 | 17 |
| Condylomata destruction 56420 CPT 56420 | $589.80 | $983.00 | $55.55 – $864.00 | 17 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $762.40 | $953.00 | $258.45 – $857.70 | 17 |
| Connect omega .5mm HCPCS L8613 | $728.40 | $1,214.00 | $12.00 – $54.00 | 14 |
| Consultation pathology during surgery CPT 88329 | $159.00 | $265.00 | $32.75 – $212.00 | 17 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $176.40 | $294.00 | $20.49 – $235.20 | 17 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $211.80 | $353.00 | $9.97 – $282.40 | 17 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $276.00 | $460.00 | $9.60 – $368.00 | 17 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $737.40 | $1,229.00 | $13.26 – $983.20 | 17 |
| Contrast baths charges CPT 97034 | $103.20 | $172.00 | $16.61 – $137.60 | 15 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $4,797.60 | $7,996.00 | $35.20 – $6,396.80 | 17 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $2,557.80 | $4,263.00 | $35.20 – $3,410.40 | 17 |
| Control nosebleed pack+caut 30905 CPT 30905 | $471.00 | $785.00 | $87.45 – $993.28 | 17 |
| Control of nosebleed ant comp 30903 CPT 30903 | $471.00 | $785.00 | $44.55 – $628.00 | 17 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $471.00 | $785.00 | $29.70 – $993.28 | 17 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $2,883.00 | $4,805.00 | $87.45 – $3,844.00 | 17 |
| Control throat bleeding CPT 42962 | not published | not published | $87.45 – $3,308.31 | 12 |
| Controller infinity pt dbs HCPCS C1787 | $4,347.00 | $7,245.00 | $584.00 – $2,628.00 | 14 |
| Conversion ext bil drg cath CPT 47535 | $2,475.00 | $4,125.00 | $209.58 – $3,300.00 | 17 |
| Convert nephrostomy catheter CPT 50434 | $3,489.60 | $5,816.00 | $993.28 – $4,652.80 | 17 |
| Coombs direct CPT 86880 | $70.20 | $117.00 | $5.32 – $93.60 | 17 |
| Coombs indirect titer reference CPT 86886 | $306.00 | $510.00 | $5.12 – $408.00 | 17 |
| Copper cu 64 dotatate diag HCPCS A9592 | $2,125.80 | $3,543.00 | $600.93 – $3,188.70 | 15 |
| Copper intrauterine device HCPCS J7300 | $2,606.40 | $3,258.00 | $879.66 – $2,932.20 | 15 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | $5,397.60 | $8,996.00 | $1,388.80 – $7,196.80 | 15 |
| Core ndl bx lng/med perq CPT 32408 | $2,911.80 | $4,853.00 | $133.56 – $3,882.40 | 17 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $5,770.20 | $9,617.00 | $993.28 – $7,693.60 | 17 |
| Coronary angio/lv gram/lt heart CPT 93458 | $4,899.60 | $8,166.00 | $993.28 – $6,532.80 | 17 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $5,181.00 | $8,635.00 | $993.28 – $6,908.00 | 17 |
| Coronary art/grft angio s&i CPT 93455 | $4,763.40 | $7,939.00 | $993.28 – $6,351.20 | 17 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $3,891.00 | $6,485.00 | $993.28 – $5,188.00 | 17 |
| Correct rectal prolapse CPT 45541 | $8,777.40 | $14,629.00 | $993.28 – $11,703.20 | 17 |
| Corrj halux rigdus w/implt CPT 28291 | $3,042.00 | $5,070.00 | $959.70 – $4,056.00 | 15 |
| Cortisol total am CPT 82533 | $130.80 | $218.00 | $13.20 – $174.40 | 17 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $594.40 | $743.00 | $25.37 – $668.70 | 16 |
| Counseling smoke cess interm >10mins CPT 99407 | $48.00 | $80.00 | $10.74 – $37.93 | 17 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $7,683.00 | $12,805.00 | $27.80 – $125.10 | 14 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $1,020.00 | $1,700.00 | $351.76 – $1,360.00 | 17 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 | $1,020.00 | $1,700.00 | $351.76 – $1,360.00 | 17 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $24.00 | $40.00 | $15.92 – $42.74 | 15 |
| Crbrospnl fld flw imag cistern CPT 78630 | $3,014.40 | $5,024.00 | $104.32 – $4,019.20 | 17 |
| Creatine - sendout CPT 82540 | $45.60 | $76.00 | $3.62 – $60.80 | 17 |
| Creatine kinase CPT 82550 | $127.20 | $212.00 | $6.44 – $169.60 | 17 |
| Creatine kinase isoenzymes CPT 82552 | $37.80 | $63.00 | $13.24 – $50.40 | 17 |
| Creatine kinase mb CPT 82553 | $146.40 | $244.00 | $11.09 – $195.20 | 17 |
| Creatinine CPT 82565 | $39.60 | $66.00 | $5.07 – $52.80 | 17 |
| Creatinine 24 hour urine CPT 82570 | $75.00 | $125.00 | $5.12 – $100.00 | 17 |
| Creatinine clearance urine CPT 82575 | $146.40 | $244.00 | $9.35 – $195.20 | 17 |
| Critical care 30-74 minutes CPT 99291 | $1,796.40 | $2,994.00 | $166.79 – $2,395.20 | 17 |
| Critical care each additional 30 minutes CPT 99292 | $504.00 | $840.00 | $81.84 – $672.00 | 17 |
| Crotalidae poly immune fab HCPCS J0840 | $6,069.00 | $10,115.00 | $1,828.71 – $9,103.50 | 17 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $55.80 | $93.00 | $5.50 – $74.40 | 17 |
| Cryoprecipitate each unit HCPCS P9012 | $235.20 | $392.00 | $58.09 – $313.60 | 17 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | $118.80 | $198.00 | $30.80 – $993.28 | 17 |
| Cryptococcus abs qn - sendout CPT 86641 | $216.00 | $360.00 | $14.24 – $288.00 | 17 |
| Cryptosporidium antigen CPT 87272 | $162.60 | $271.00 | $9.36 – $216.80 | 17 |
| Crystal identification light microscopy CPT 89060 | $93.00 | $155.00 | $7.24 – $118.40 | 17 |
| Cta abdomen without & /or w/contrast CPT 74175 | $3,739.20 | $6,232.00 | $171.38 – $4,985.60 | 17 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $4,764.00 | $7,940.00 | $171.38 – $6,352.00 | 17 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $3,098.40 | $5,164.00 | $171.38 – $4,131.20 | 17 |
| Cta neck without &/or w/contrast CPT 70498 | $2,598.60 | $4,331.00 | $171.38 – $3,464.80 | 17 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $3,739.20 | $6,232.00 | $171.38 – $4,985.60 | 17 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $3,691.20 | $6,152.00 | $87.45 – $4,921.60 | 17 |
| Culture aerobic additional method definitive id each CPT 87077 | $67.80 | $113.00 | $7.81 – $90.40 | 17 |
| Culture afb any source CPT 87116 | $76.80 | $128.00 | $8.25 – $102.40 | 17 |
| Culture anaerobic additional method definitive id each CPT 87076 | $127.80 | $213.00 | $7.99 – $170.40 | 17 |
| Culture anaerobic except blood CPT 87075 | $147.00 | $245.00 | $9.36 – $196.00 | 17 |
| Culture bact stool aero addl path ea CPT 87046 | $86.40 | $144.00 | $2.87 – $109.60 | 17 |
| Culture body fluid CPT 87070 | $232.20 | $387.00 | $7.59 – $309.60 | 17 |
| Culture fungi definitive id mold CPT 87107 | $137.40 | $229.00 | $10.20 – $183.20 | 17 |
| Culture fungi definitive id yeast CPT 87106 | $75.00 | $125.00 | $10.20 – $100.00 | 17 |
| Culture fungi other (except blood) CPT 87102 | $170.40 | $284.00 | $8.31 – $227.20 | 17 |
| Culture fungi skin/hair/nail CPT 87101 | $70.80 | $118.00 | $7.62 – $94.40 | 17 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $154.20 | $257.00 | $14.44 – $205.60 | 17 |
| Culture mycoplasma any source CPT 87109 | $289.80 | $483.00 | $15.21 – $386.40 | 17 |
| Culture screening strep group a CPT 87081 | $75.00 | $125.00 | $5.72 – $86.40 | 17 |
| Culture typing immunologic CPT 87147 | $14.40 | $24.00 | $3.30 – $19.20 | 17 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $481.20 | $802.00 | $34.68 – $641.60 | 17 |
| Cutter lead HCPCS C1773 | $3,079.80 | $5,133.00 | $31.86 – $228.20 | 14 |
| Cv line/pic reposition CPT 36597 | $2,403.00 | $4,005.00 | $63.95 – $3,204.00 | 17 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $54.00 | $67.50 | $1.00 – $3.60 | 16 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $108.60 | $181.00 | $14.16 – $144.80 | 17 |
| Cyclic citrullinated peptide antibody CPT 86200 | $251.40 | $419.00 | $12.80 – $335.20 | 17 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $13.20 | $22.00 | $0.48 – $19.80 | 17 |
| Cyclosporine 2 hour CPT 80158 | $448.80 | $748.00 | $17.84 – $569.60 | 17 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $29.00 | $36.25 | $9.72 – $72.58 | 16 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $8.80 | $11.00 | $0.80 – $9.90 | 16 |
| Cyclosporine oral 100 mg HCPCS J7502 | $34.00 | $42.50 | $2.04 – $37.80 | 16 |
| Cyp2c19 gene com variants CPT 81225 | $916.20 | $1,527.00 | $227.49 – $1,221.60 | 17 |
| Cyp2c9 gene com variants CPT 81227 | $1,852.80 | $3,088.00 | $136.49 – $2,066.40 | 17 |
| Cyp2d6 gene com variants CPT 81226 | $258.60 | $431.00 | $162.92 – $486.94 | 17 |
| Cystatin c CPT 82610 | $275.40 | $459.00 | $16.72 – $367.20 | 17 |
| Cystic fibrosis cftr CPT 81223 | $3,831.00 | $6,385.00 | $439.12 – $3,854.40 | 17 |
| Cystine urine quantitative CPT 82131 | $116.40 | $194.00 | $22.71 – $155.20 | 17 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $838.81 – $3,551.23 | 11 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $585.08 – $5,234.35 | 11 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $795.00 | $1,325.00 | $27.52 – $1,060.00 | 17 |
| Cystoscopy & ureter catheter CPT 52005 | not published | not published | $127.60 – $2,089.72 | 12 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,287.60 | $2,146.00 | $82.50 – $1,716.80 | 17 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $199.65 – $3,518.35 | 12 |
| Cystoscopy and treatment CPT 52310 | $4,493.40 | $7,489.00 | $141.90 – $5,991.20 | 17 |
| Cystoscopy implant stent CPT 52282 | not published | not published | $888.36 – $3,551.23 | 11 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $6,497.40 | $10,829.00 | $289.60 – $8,663.20 | 17 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $667.07 – $3,551.23 | 11 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $954.79 – $5,234.35 | 11 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $824.16 – $3,551.23 | 11 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $4,732.80 | $7,888.00 | $118.25 – $6,310.40 | 17 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $135.85 – $2,089.72 | 12 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $28.80 | $48.00 | $0.83 – $20.70 | 16 |
| Cyto/molecular report CPT 88291 | $269.40 | $449.00 | $12.37 – $359.20 | 15 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $146.40 | $244.00 | $14.22 – $195.20 | 17 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $146.40 | $244.00 | $16.65 – $195.20 | 17 |
| Cytopath smear other source CPT 88160 | $54.60 | $91.00 | $3.20 – $81.90 | 17 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $142.20 | $237.00 | $50.94 – $218.54 | 17 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $78.00 | $130.00 | $26.30 – $104.00 | 17 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $61.20 | $102.00 | $17.60 – $81.60 | 17 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $51.00 | $85.00 | $5.12 – $80.77 | 17 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $232.20 | $387.00 | $8.32 – $309.60 | 17 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $70.80 | $118.00 | $44.60 – $176.42 | 17 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $372.60 | $621.00 | $39.16 – $496.80 | 17 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $598.25 – $3,273.80 | 11 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $51.20 | $64.00 | $3.45 – $57.60 | 16 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $7,113.00 | $11,855.00 | $15.61 – $106.20 | 17 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $2,063.40 | $3,439.00 | $0.03 – $5.40 | 16 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $104.40 | $174.00 | $47.19 – $156.60 | 17 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $5,376.60 | $8,961.00 | $2.93 – $53.10 | 17 |
| Darbepoetin alfa, esrd use HCPCS J0882 | $2,171.40 | $3,619.00 | $2.93 – $53.10 | 17 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $413.60 | $517.00 | $21.70 – $465.30 | 17 |
| Dch glucoscan CPT 82948 | $12.00 | $20.00 | $2.20 – $16.00 | 17 |
| Dch pulmonary stress test CPT 94621 | $660.60 | $1,101.00 | $81.36 – $880.80 | 17 |
| Dch validity tests CPT 81002 | $51.00 | $85.00 | $3.44 – $9.60 | 17 |
| Deamidated gliadin antibody iga CPT 86258 | $80.40 | $134.00 | $9.41 – $107.20 | 17 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $728.40 | $1,214.00 | $36.30 – $971.20 | 17 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $1,317.00 | $2,195.00 | $32.23 – $1,756.00 | 17 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $1,470.60 | $2,451.00 | $677.36 – $1,960.80 | 17 |
| Debride nail1-5 11720 CPT 11720 | $471.00 | $785.00 | $17.13 – $628.00 | 17 |
| Debride nail6 or more 11721 CPT 11721 | $202.20 | $337.00 | $22.00 – $269.60 | 17 |
| Debride skin bone at fx site CPT 11012 | $4,947.60 | $8,246.00 | $993.28 – $6,596.80 | 17 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $4,833.60 | $8,056.00 | $677.36 – $6,444.80 | 17 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $728.40 | $1,214.00 | $18.50 – $971.20 | 15 |
| Debridement (>20 cm) charge pt CPT 97598 | $429.00 | $715.00 | $12.72 – $572.00 | 17 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,738.80 | $2,898.00 | $36.30 – $2,318.40 | 17 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $825.60 | $1,376.00 | $36.30 – $1,100.80 | 17 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $728.40 | $1,214.00 | $38.95 – $971.20 | 15 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,023.60 | $1,706.00 | $67.84 – $1,364.80 | 15 |
| Decalcification CPT 88311 | $388.20 | $647.00 | $7.92 – $517.60 | 17 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $141.60 | $177.00 | $1.22 – $159.30 | 16 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $653.40 | $1,089.00 | $27.57 – $871.20 | 17 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $78.60 | $98.25 | $4.45 – $42.30 | 17 |
| Delivery of placenta 59414 CPT 59414 | $3,276.00 | $5,460.00 | $93.96 – $4,368.00 | 17 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $419.40 | $699.00 | $13.00 – $86.40 | 17 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $10,269.00 | $17,115.00 | $6.78 – $29.38 | 17 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $589.80 | $983.00 | $25.85 – $884.70 | 16 |
| Design mlc device for imrt CPT 77338 | $5,968.20 | $9,947.00 | $280.09 – $7,957.60 | 17 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $2,755.80 | $4,593.00 | $2.98 – $9.90 | 17 |
| Desoxycorticosterone CPT 82633 | $398.40 | $664.00 | $30.62 – $531.20 | 17 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | $258.60 | $431.00 | $102.30 – $444.81 | 17 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | $246.00 | $410.00 | $129.13 – $523.06 | 17 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | $134.40 | $224.00 | $89.13 – $443.77 | 17 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $3,434.40 | $5,724.00 | $629.15 – $4,579.20 | 17 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $3,434.40 | $5,724.00 | $60.74 – $4,579.20 | 17 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $141.00 | $235.00 | $22.00 – $1,181.44 | 17 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $120.60 | $201.00 | $56.51 – $993.28 | 17 |
| Destruction 2-14 lesions 17003 CPT 17003 | $64.20 | $107.00 | $4.67 – $85.60 | 17 |
| Destruction anal lesion(s) CPT 46924 | $1,638.00 | $2,730.00 | $126.50 – $2,184.00 | 17 |
| Destruction benign lesions < 14 lesions CPT 17110 | $141.00 | $235.00 | $53.90 – $825.60 | 17 |
| Destruction by injection tx of nerve 64630 CPT 64630 | $4,695.00 | $7,825.00 | $80.85 – $6,260.00 | 17 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $3,434.40 | $5,724.00 | $618.25 – $4,579.20 | 17 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $3,434.40 | $5,724.00 | $52.82 – $4,579.20 | 17 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | $118.80 | $198.00 | $78.78 – $318.65 | 17 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | $229.20 | $382.00 | $22.55 – $993.28 | 17 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $258.60 | $431.00 | $128.03 – $407.64 | 17 |
| Device ablt adv novasure HCPCS C1886 | $9,649.20 | $16,082.00 | $1,279.26 – $4,264.20 | 13 |
| Device intraute mirena HCPCS J7298 | $4,133.60 | $5,167.00 | $983.88 – $3,279.60 | 15 |
| Device sut capio slim opn HCPCS C2631 | $1,350.00 | $2,250.00 | $607.50 – $2,025.00 | 13 |
| Device tiss remov myosure reach HCPCS C1782 | $2,707.20 | $4,512.00 | $645.57 – $2,151.90 | 13 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $121.20 | $202.00 | $22.63 – $161.60 | 17 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | $477.60 | $597.00 | $98.14 – $537.30 | 17 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $5.40 | $9.00 | $0.02 – $0.90 | 16 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $1.80 | $2.25 | $0.09 – $0.90 | 16 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,087.80 | $1,813.00 | $63.06 – $898.20 | 17 |
| Dextran 40 infusion HCPCS J7100 | $645.60 | $807.00 | $217.89 – $726.30 | 14 |
| Dextrose 5 % IV bolus HCPCS J7070 | $26.80 | $33.50 | $3.11 – $29.70 | 16 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $37.20 | $62.00 | $1.41 – $15.30 | 16 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $29.00 | $36.25 | $9.72 – $32.40 | 14 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $60.40 | $75.50 | $1.81 – $13.50 | 16 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $184.20 | $307.00 | $21.97 – $245.60 | 17 |
| Diab manage trn ind/group HCPCS G0109 | $93.00 | $155.00 | $13.28 – $139.50 | 16 |
| Diabetes (HbA1c) Test CPT 83036 | $165.60 | $276.00 | $3.06 – $10.49 | 17 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $701.79 – $6,007.35 | 11 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $483.00 | $805.00 | $116.26 – $724.50 | 16 |
| Diagnostic Mammogram (one breast) CPT 77065 | $316.80 | $528.00 | $90.89 – $475.20 | 16 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $87.60 | $146.00 | $22.00 – $116.80 | 17 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $256.80 | $428.00 | $75.90 – $993.28 | 17 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $3,309.60 | $5,516.00 | $160.23 – $4,412.80 | 17 |
| Dialysis one evaluation CPT 90945 | $1,270.20 | $2,117.00 | $44.80 – $1,693.60 | 17 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.80 | $1.00 | $0.08 – $0.90 | 15 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $127.20 | $212.00 | $7.35 – $95.40 | 16 |
| Dicyclomine injection HCPCS J0500 | $494.40 | $618.00 | $11.36 – $556.20 | 16 |
| Diffusing capacity CPT 94729 | $412.20 | $687.00 | $42.39 – $549.60 | 17 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $34.00 | $42.50 | $9.05 – $37.80 | 16 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $16,441.80 | $27,403.00 | $3,442.07 – $11,422.80 | 17 |
| Digoxin total therapeutic drug level CPT 80162 | $126.00 | $210.00 | $12.10 – $168.00 | 17 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $924.80 | $1,156.00 | $60.00 – $1,040.40 | 16 |
| Dilate esophagus 1/mult pass CPT 43450 | $3,526.20 | $5,877.00 | $64.90 – $4,701.60 | 17 |
| Dilator fascial 10fx20cm HCPCS C2627 | $127.80 | $213.00 | $57.51 – $191.70 | 13 |
| Dimenhydrinate injection HCPCS J1240 | $13.20 | $16.50 | $4.32 – $14.40 | 16 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $9.60 | $16.00 | $0.27 – $0.90 | 14 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $16.80 | $21.00 | $0.76 – $18.90 | 16 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $24.60 | $41.00 | $11.00 – $36.90 | 17 |
| Disability dlco CPT 94727 | $234.00 | $390.00 | $28.08 – $312.00 | 17 |
| Disaccharidases CPT 82657 | $88.80 | $148.00 | $17.31 – $118.40 | 17 |
| Dna antibody native/double stranded CPT 86225 | $249.60 | $416.00 | $13.58 – $316.80 | 17 |
| Dna gardnerella CPT 87510 | $255.60 | $426.00 | $17.64 – $340.80 | 17 |
| Dna trichomonas CPT 87660 | $266.40 | $444.00 | $19.82 – $355.20 | 17 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $81.00 | $135.00 | $7.08 – $26.10 | 16 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $88.20 | $147.00 | $0.63 – $65.70 | 16 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $56.40 | $94.00 | $0.27 – $0.90 | 16 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $1,881.00 | $3,135.00 | $541.32 – $2,508.00 | 14 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,081.80 | $1,803.00 | $89.66 – $1,442.40 | 17 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $759.60 | $1,266.00 | $47.50 – $1,012.80 | 17 |
| Dornase alfa non-comp unit HCPCS J7639 | $236.00 | $295.00 | $55.16 – $265.50 | 16 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $544.20 | $907.00 | $243.71 – $816.30 | 17 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $364.20 | $607.00 | $3.02 – $47.70 | 16 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,245.20 | $3,742.00 | $108.47 – $3,366.90 | 17 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $1.20 | $1.50 | $0.11 – $0.90 | 16 |
| Dpyd gene common variants CPT 81232 | $2,476.80 | $4,128.00 | $136.49 – $2,028.00 | 17 |
| Drain blood from under nail 11740 CPT 11740 | $247.20 | $412.00 | $26.40 – $993.28 | 17 |
| Drain cath image guided visceral pq CPT 49405 | $4,627.80 | $7,713.00 | $190.71 – $6,170.40 | 17 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,260.60 | $2,101.00 | $40.70 – $1,680.80 | 17 |
| Drain finger abscess;simple 26010 CPT 26010 | $589.80 | $983.00 | $29.15 – $993.28 | 17 |
| Drain thigh/knee lesion 27301 CPT 27301 | $5,397.60 | $8,996.00 | $97.35 – $7,196.80 | 17 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,440.00 | $2,400.00 | $29.15 – $1,920.00 | 17 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $1,440.00 | $2,400.00 | $38.50 – $1,920.00 | 17 |
| Drainage external ear complex 69005 CPT 69005 | $7,126.80 | $11,878.00 | $151.23 – $9,502.40 | 17 |
| Drainage external ear simple 69000 CPT 69000 | $591.60 | $986.00 | $47.30 – $993.28 | 17 |
| Drainage mouth roof lesion CPT 42000 | $4,695.00 | $7,825.00 | $22.00 – $6,260.00 | 17 |
| Drainage of kidney lesion CPT 50390 | $1,119.00 | $1,865.00 | $100.70 – $1,492.00 | 17 |
| Drainage of mouth lesion CPT 41008 | $3,435.60 | $5,726.00 | $25.85 – $4,580.80 | 17 |
| Drainage of nose lesion int 30000 CPT 30000 | $10,044.00 | $16,740.00 | $56.10 – $13,392.00 | 17 |
| Drainage of pelvis lesion 26990 CPT 26990 | $3,355.20 | $5,592.00 | $97.35 – $4,473.60 | 17 |
| Drainage of rectal abscess 45020 CPT 45020 | $5,376.00 | $8,960.00 | $165.55 – $7,168.00 | 17 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $825.60 | $1,376.00 | $126.59 – $1,100.80 | 17 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $825.60 | $1,376.00 | $110.61 – $1,100.80 | 17 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $589.80 | $983.00 | $22.00 – $786.40 | 17 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,875.00 | $3,125.00 | $88.00 – $2,500.00 | 17 |
| Drng of scrotum abscess 55100 CPT 55100 | $2,892.60 | $4,821.00 | $38.50 – $3,856.80 | 17 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $39.60 | $49.50 | $7.63 – $44.10 | 16 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,778.40 | $2,964.00 | $117.18 – $390.60 | 13 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $696.00 | $1,160.00 | $2.49 – $1,044.00 | 14 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | $10,017.00 | $16,695.00 | $4,507.65 – $15,025.50 | 14 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $28,128.00 | $46,880.00 | $51.00 – $8,371.80 | 14 |
| Drug assay rufinamide CPT 80210 | $205.80 | $343.00 | $21.17 – $274.40 | 15 |
| Drug assay vedolizumab CPT 80280 | $431.40 | $719.00 | $30.12 – $575.20 | 17 |
| Drug screen quant tiagabine CPT 80199 | $188.40 | $314.00 | $21.67 – $251.20 | 17 |
| Drug test def 1-7 classes HCPCS G0480 | $437.40 | $729.00 | $70.34 – $475.20 | 16 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $316.80 | $528.00 | $24.30 – $81.73 | 17 |
| Drvvt confirm - quest CPT 85597 | $169.20 | $282.00 | $17.78 – $225.60 | 17 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $1,429.20 | $2,382.00 | $480.33 – $2,010.48 | 17 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $878.40 | $1,464.00 | $101.74 – $1,171.20 | 17 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $914.40 | $1,524.00 | $98.04 – $1,219.20 | 17 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $974.40 | $1,624.00 | $152.76 – $1,299.20 | 17 |
| Duplex scan bilateral study 93985 CPT 93985 | $1,429.20 | $2,382.00 | $222.68 – $1,905.60 | 17 |
| Duplex scan unilateral study 93986 CPT 93986 | $714.60 | $1,191.00 | $102.37 – $952.80 | 17 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $324.60 | $541.00 | $85.12 – $486.90 | 17 |
| Dx bronchoscope/brush 31623 CPT 31623 | $5,050.20 | $8,417.00 | $148.66 – $6,733.60 | 17 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $2,926.80 | $4,878.00 | $148.66 – $3,902.40 | 17 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,322.60 | $3,871.00 | $147.25 – $3,096.80 | 17 |
| Dxa bone density axl vrt fx CPT 77085 | $672.60 | $1,121.00 | $73.47 – $896.80 | 17 |
| E equine encephalitis igg CPT 86652 | $91.80 | $153.00 | $13.03 – $122.40 | 17 |
| ER Visit (level 1, minor) CPT 99281 | $252.60 | $421.00 | $51.60 – $336.80 | 17 |
| ER Visit (level 2) CPT 99282 | $406.80 | $678.00 | $36.28 – $542.40 | 17 |
| ER Visit (level 3) CPT 99283 | $744.00 | $1,240.00 | $62.31 – $992.00 | 17 |
| ER Visit (level 4) CPT 99284 | $1,243.80 | $2,073.00 | $104.86 – $1,658.40 | 17 |
| ER Visit (level 5, high severity) CPT 99285 | $1,287.60 | $2,146.00 | $152.61 – $1,716.80 | 17 |
| Ear canal biopsy 69105 CPT 69105 | $1,353.00 | $2,255.00 | $61.89 – $1,804.00 | 17 |
| Ear irrigation 69209 CPT 69209 | $117.00 | $195.00 | $16.06 – $993.28 | 17 |
| Ecg 12 lead tracing only CPT 93005 | $271.80 | $453.00 | $11.51 – $65.70 | 17 |
| Ecg external < 48 hours recording CPT 93225 | $551.40 | $919.00 | $20.07 – $735.20 | 17 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $671.40 | $1,119.00 | $43.74 – $895.20 | 17 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $75.00 | $125.00 | $10.01 – $100.00 | 17 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $75.00 | $125.00 | $9.61 – $100.00 | 17 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $128.40 | $214.00 | $5.57 – $54.90 | 17 |
| Echo guide for artery repair CPT 76936 | $1,009.20 | $1,682.00 | $112.96 – $1,345.60 | 17 |
| Echo stress CPT 93350 | $816.00 | $1,360.00 | $59.52 – $1,088.00 | 17 |
| Echo tee guidance CPT 93355 | $1,054.80 | $1,758.00 | $231.50 – $1,406.40 | 15 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $860.40 | $1,434.00 | $170.15 – $1,147.20 | 17 |
| Echo transesophageal intraop CPT 93318 | $2,142.60 | $3,571.00 | $392.84 – $3,213.90 | 16 |
| Echo transthoracic CPT 93303 | $904.80 | $1,508.00 | $121.60 – $1,206.40 | 17 |
| Echo transthoracic CPT 93304 | $534.60 | $891.00 | $27.52 – $712.80 | 17 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,265.00 | $3,775.00 | $125.62 – $3,020.00 | 17 |
| Echocardiography doppler color flow mapping CPT 93325 | $480.00 | $800.00 | $20.44 – $640.00 | 17 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,265.00 | $3,775.00 | $578.38 – $3,397.50 | 16 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $399.60 | $666.00 | $27.52 – $532.80 | 17 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $364.20 | $607.00 | $163.89 – $546.30 | 16 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $763.20 | $1,272.00 | $26.30 – $1,017.60 | 17 |
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | $268.80 | $336.00 | $44.82 – $302.40 | 17 |
| Edu/train/pt/nonmd/in person/30 min98960 CPT 98960 | $670.20 | $1,117.00 | $23.01 – $1,005.30 | 14 |
| Eeg during surgery CPT 95955 | $546.60 | $911.00 | $92.84 – $728.80 | 17 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $1,189.80 | $1,983.00 | $17.28 – $1,586.40 | 17 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $470.40 | $784.00 | $56.90 – $627.20 | 17 |
| Eeg recording awake and asleep CPT 95819 | $1,189.80 | $1,983.00 | $17.28 – $1,586.40 | 17 |
| Eeg without vid ea 12-26hr intmt CPT 95709 | $1,065.60 | $1,776.00 | $510.82 – $1,598.40 | 16 |
| Eeg wo vid ea 12-26hr unmntr CPT 95708 | $1,014.60 | $1,691.00 | $132.00 – $1,521.90 | 16 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $1,133.40 | $1,889.00 | $377.46 – $1,700.10 | 16 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | $1,189.80 | $1,983.00 | $24.32 – $1,586.40 | 17 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | $79.20 | $99.00 | $26.85 – $89.10 | 17 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | $3,414.00 | $5,690.00 | $993.28 – $5,121.00 | 16 |
| Egd Ultrasound fine needle bx/aspir CPT 43242 | $3,414.00 | $5,690.00 | $277.43 – $4,552.00 | 17 |
| Egd balloon dil esoph30 mm/> CPT 43233 | $3,414.00 | $5,690.00 | $332.32 – $4,552.00 | 17 |
| Egd control bleeding any CPT 43255 | $3,414.00 | $5,690.00 | $255.75 – $4,552.00 | 17 |
| Egd dilate stricture CPT 43245 | $3,414.00 | $5,690.00 | $180.20 – $4,552.00 | 17 |
| Egd endo mucosal resection CPT 43254 | $3,414.00 | $5,690.00 | $400.54 – $4,552.00 | 17 |
| Egd endoscopic stent place CPT 43266 | $6,529.80 | $10,883.00 | $331.59 – $8,706.40 | 17 |
| Egd guide wire insertion CPT 43248 | $3,526.20 | $5,877.00 | $686.69 – $4,701.60 | 17 |
| Egd lesion ablation CPT 43270 | $3,414.00 | $5,690.00 | $973.70 – $4,552.00 | 17 |
| Egd remove foreign body CPT 43247 | $3,526.20 | $5,877.00 | $191.43 – $4,701.60 | 17 |
| Egd remove lesion snare CPT 43251 | $3,414.00 | $5,690.00 | $208.28 – $4,552.00 | 17 |
| Egd varices ligation CPT 43244 | $3,414.00 | $5,690.00 | $720.64 – $4,552.00 | 17 |
| Egd w/thrml txmnt gerd CPT 43257 | $6,529.80 | $10,883.00 | $541.08 – $8,706.40 | 17 |
| Egd w/transmural drain cyst CPT 43240 | $6,103.80 | $10,173.00 | $814.39 – $8,138.40 | 17 |
| Egd/insert intraluminal tube/cath 43241 CPT 43241 | $3,414.00 | $5,690.00 | $148.54 – $4,552.00 | 17 |
| Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 | $3,414.00 | $5,690.00 | $993.28 – $4,552.00 | 17 |
| Egfr gene com variants CPT 81235 | $134.40 | $224.00 | $84.67 – $350.55 | 17 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $290.40 | $484.00 | $30.88 – $387.20 | 17 |
| Elect anlys sp inf pmp w/reprg&fill 62369 CPT 62369 | $1,044.00 | $1,740.00 | $30.16 – $1,392.00 | 17 |
| Electroconvulsive therapy 90870 CPT 90870 | $2,124.00 | $3,540.00 | $49.50 – $2,832.00 | 16 |
| Electrocorticography durng sx CPT 95829 | $955.80 | $1,593.00 | $417.90 – $1,274.40 | 15 |
| Electrolyte panel CPT 80051 | $130.80 | $218.00 | $6.92 – $174.40 | 17 |
| Electron microscopy diagnostic CPT 88348 | $1,084.80 | $1,808.00 | $22.40 – $1,446.40 | 17 |
| Electrophys map 3d add-on CPT 93613 | $4,986.00 | $8,310.00 | $227.55 – $7,479.00 | 14 |
| Electrophysiologic study CPT 93624 | $4,569.60 | $7,616.00 | $902.75 – $7,812.36 | 17 |
| Electrophysiology evaluation CPT 93619 | $4,569.60 | $7,616.00 | $993.28 – $7,812.36 | 17 |
| Electrophysiology evaluation CPT 93620 | $4,555.20 | $7,592.00 | $993.28 – $7,812.36 | 17 |
| Electrophysiology evaluation CPT 93621 | $4,123.20 | $6,872.00 | $890.56 – $6,184.80 | 14 |
| Emb w/colposcopy 58110 CPT 58110 | $189.60 | $316.00 | $35.26 – $252.80 | 17 |
| Emb without cervical dilation 58100 CPT 58100 | $2,178.00 | $3,630.00 | $56.10 – $934.40 | 17 |
| Embo or occlude vascular arterial s&i CPT 37242 | $6,596.40 | $10,994.00 | $449.83 – $10,146.49 | 17 |
| Embo or occlude vascular hemorrhage s&i CPT 37244 | $6,596.40 | $10,994.00 | $625.66 – $9,620.13 | 17 |
| Embo or occlude vascular tumor/organ/infarct s&i CPT 37243 | $6,596.40 | $10,994.00 | $536.36 – $12,805.40 | 17 |
| Embo or occlude vascular venous s&i CPT 37241 | $6,596.40 | $10,994.00 | $402.84 – $8,795.20 | 17 |
| Embolization s&i CPT 75894 | $3,495.60 | $5,826.00 | $120.37 – $4,660.80 | 17 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | $462.60 | $771.00 | $28.80 – $616.80 | 17 |
| Emg cranial nerve bilateral CPT 95868 | $444.00 | $740.00 | $32.59 – $592.00 | 17 |
| Encephalitis, california igg/igm CPT 86651 | $91.80 | $153.00 | $13.03 – $122.40 | 17 |
| Encephalitis, st louis igg/igm CPT 86653 | $91.80 | $153.00 | $13.03 – $122.40 | 17 |
| Encephalitis, western equine igg/igm CPT 86654 | $91.80 | $153.00 | $13.03 – $122.40 | 17 |
| Endo abl/incom vein/ext/laser/#1 36478 CPT 36478 | $3,715.20 | $6,192.00 | $993.28 – $4,953.60 | 17 |
| Endo abl/incom vein/ext/rad fre/#1 36475 CPT 36475 | $3,715.20 | $6,192.00 | $993.28 – $4,953.60 | 17 |
| Endo cath bile duct s&i CPT 74328 | $1,216.80 | $2,028.00 | $385.46 – $1,622.40 | 14 |
| Endo cholangiopancreatograph CPT 43261 | $6,529.80 | $10,883.00 | $993.28 – $8,706.40 | 17 |
| Endo cholangiopancreatograph CPT 43262 | $6,529.80 | $10,883.00 | $184.32 – $8,706.40 | 17 |
| Endocerv curettage w/scope 57456 CPT 57456 | $218.40 | $364.00 | $104.51 – $993.28 | 17 |
| Endocervical curettage 57505 CPT 57505 | $513.60 | $856.00 | $24.20 – $993.28 | 17 |
| Endoluminl ivus oct c 1st CPT 92978 | $806.40 | $1,344.00 | $192.17 – $1,075.20 | 17 |
| Endoluminl ivus oct c ea CPT 92979 | $578.40 | $964.00 | $260.28 – $771.20 | 14 |
| Endoscopic Ultrasound exam esoph CPT 43237 | not published | not published | $186.92 – $1,935.15 | 12 |
| Endoscopic pancreatoscopy CPT 43273 | $6,529.80 | $10,883.00 | $96.90 – $8,706.40 | 15 |
| Endoscopy bowel pouch/biop CPT 44386 | $3,156.60 | $5,261.00 | $121.29 – $4,208.80 | 17 |
| Endoscopy swallow (fees) vid CPT 92612 | $162.00 | $270.00 | $69.17 – $316.31 | 17 |
| Endoscpy nsl/sns w/cntrl nsl hmrrgh CPT 31238 | $2,287.20 | $3,812.00 | $494.88 – $3,049.60 | 17 |
| Endovasc rpr a-biiliac endogft 34705 CPT 34705 | $6,193.80 | $10,323.00 | $1,621.89 – $8,258.40 | 15 |
| Endovenous laser vein addon 36479 CPT 36479 | $3,715.20 | $6,192.00 | $181.40 – $4,953.60 | 15 |
| Endovenous rf abl vein addl CPT 36476 | $3,715.20 | $6,192.00 | $182.34 – $4,953.60 | 15 |
| Enfortumab vedotin-ejfv 20 mg intravenous solution HCPCS J9177 | $64.20 | $107.00 | $29.02 – $96.30 | 17 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $7.60 | $9.50 | $0.59 – $6.30 | 16 |
| Enzyme histochemistry CPT 88319 | $471.60 | $786.00 | $9.48 – $628.80 | 17 |
| Ep & ablate supravent arrhyt CPT 93653 | $14,329.20 | $23,882.00 | $993.28 – $25,257.35 | 17 |
| Ep & ablate ventric tachy CPT 93654 | $27,777.00 | $46,295.00 | $993.28 – $37,036.00 | 17 |
| Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution HCPCS J9321 | $100.80 | $168.00 | $45.56 – $151.20 | 17 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $1,461.00 | $2,435.00 | $65.56 – $1,948.00 | 17 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $441.60 | $552.00 | $0.27 – $0.90 | 16 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | $8.40 | $14.00 | $2.11 – $12.60 | 16 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $160.00 | $200.00 | $8.54 – $178.20 | 17 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $874.20 | $1,457.00 | $7.85 – $32.40 | 17 |
| Epstein barr early antigen antibody CPT 86663 | $213.60 | $356.00 | $12.97 – $284.80 | 17 |
| Epstein barr nuclear antigen antibody CPT 86664 | $292.20 | $487.00 | $15.11 – $389.60 | 17 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $292.20 | $487.00 | $17.93 – $389.60 | 17 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $268.80 | $336.00 | $75.60 – $252.00 | 14 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $3,469.20 | $5,782.00 | $15.73 – $52.20 | 17 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | $6,529.80 | $10,883.00 | $686.48 – $8,706.40 | 17 |
| Ercp biliary & pancreas CPT 74330 | $1,070.40 | $1,784.00 | $385.46 – $1,427.20 | 14 |
| Ercp ea duct/ampulla dilate CPT 43277 | $6,529.80 | $10,883.00 | $569.35 – $8,706.40 | 17 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | $6,529.80 | $10,883.00 | $647.45 – $8,706.40 | 17 |
| Ercp lithotripsy calculi CPT 43265 | $6,529.80 | $10,883.00 | $993.28 – $8,706.40 | 17 |
| Ercp remove duct calculi 43264 CPT 43264 | $6,529.80 | $10,883.00 | $993.28 – $8,706.40 | 17 |
| Ercp remove forgn body duct 43275 CPT 43275 | $6,529.80 | $10,883.00 | $565.94 – $8,706.40 | 17 |
| Ercp stent exchange w/dilate CPT 43276 | $6,529.80 | $10,883.00 | $714.16 – $8,706.40 | 17 |
| Ercp w/specimen collection CPT 43260 | $6,529.80 | $10,883.00 | $524.80 – $8,706.40 | 17 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $509.40 | $849.00 | $89.34 – $764.10 | 17 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $396.00 | $495.00 | $9.86 – $445.50 | 16 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $460.00 | $575.00 | $64.62 – $517.50 | 16 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $11.80 | $14.75 | $0.22 – $12.60 | 16 |
| Esoph egd dilation <30 mm CPT 43249 | $3,414.00 | $5,690.00 | $666.36 – $4,552.00 | 17 |
| Esophageal dilat s&i CPT 74360 | $556.20 | $927.00 | $105.43 – $741.60 | 17 |
| Esophagoscop ultrasound exam CPT 43231 | $3,414.00 | $5,690.00 | $180.76 – $4,552.00 | 17 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $111.63 – $1,935.15 | 12 |
| Esophagoscopy flex remove fb CPT 43215 | $3,414.00 | $5,690.00 | $577.28 – $4,552.00 | 17 |
| Esophagoscopy w/us needle bx CPT 43232 | $3,414.00 | $5,690.00 | $535.78 – $4,552.00 | 17 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $3,526.20 | $5,877.00 | $102.82 – $4,701.60 | 17 |
| Esophagus motility study CPT 91010 | $2,006.40 | $3,344.00 | $21.12 – $2,675.20 | 17 |
| Established Patient Office Visit (level 1) CPT 99211 | $199.80 | $333.00 | $22.00 – $124.00 | 17 |
| Established Patient Office Visit (level 2) CPT 99212 | $250.80 | $418.00 | $28.60 – $124.00 | 17 |
| Established Patient Office Visit (level 3) CPT 99213 | $250.80 | $418.00 | $38.50 – $124.00 | 17 |
| Established Patient Office Visit (level 4) CPT 99214 | $327.00 | $545.00 | $41.85 – $139.50 | 17 |
| Established Patient Office Visit (level 5) CPT 99215 | $421.20 | $702.00 | $41.85 – $211.32 | 17 |
| Estradiol total CPT 82670 | $373.20 | $622.00 | $23.65 – $497.60 | 17 |
| Estrogens total-sendout CPT 82672 | $310.20 | $517.00 | $15.31 – $413.60 | 17 |
| Ethylene glycol -sendout CPT 82693 | $202.80 | $338.00 | $11.64 – $270.40 | 17 |
| Etonogestrel implant system HCPCS J7307 | $5,044.00 | $6,305.00 | $980.91 – $3,269.70 | 15 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $261.60 | $436.00 | $0.94 – $7.20 | 16 |
| Etoposide 50 mg cap HCPCS J8560 | $271.80 | $453.00 | $77.46 – $407.70 | 16 |
| Euflexxa inj per dose HCPCS J7323 | $752.40 | $1,254.00 | $112.45 – $1,128.60 | 17 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $310.20 | $517.00 | $97.63 – $413.60 | 15 |
| Evaluation of speech fluency 92521 CPT 92521 | $457.20 | $762.00 | $113.04 – $609.60 | 15 |
| Evaluation psychiatric diagnostic CPT 90791 | $105.60 | $176.00 | $33.60 – $209.34 | 17 |
| Event monitor CPT 93270 | $462.00 | $770.00 | $16.17 – $616.00 | 17 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $127.80 | $213.00 | $24.36 – $191.70 | 16 |
| Evoked potentials upper limbs CPT 95925 | $491.40 | $819.00 | $21.12 – $655.20 | 17 |
| Exam of vagina w/scope 57420 CPT 57420 | $189.60 | $316.00 | $89.90 – $993.28 | 17 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $483.60 | $806.00 | $86.35 – $966.40 | 17 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $501.00 | $835.00 | $97.90 – $1,177.60 | 17 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $490.80 | $818.00 | $59.95 – $993.28 | 17 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $490.80 | $818.00 | $46.75 – $867.84 | 17 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $1,052.40 | $1,754.00 | $39.60 – $1,403.20 | 17 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $258.60 | $431.00 | $51.15 – $737.28 | 17 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $526.20 | $877.00 | $71.50 – $750.08 | 17 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | $1,105.20 | $1,842.00 | $128.70 – $1,473.60 | 17 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $490.80 | $818.00 | $41.25 – $993.28 | 17 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $490.80 | $818.00 | $102.30 – $993.28 | 17 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | $940.20 | $1,567.00 | $210.28 – $1,253.60 | 17 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | $1,965.60 | $3,276.00 | $59.95 – $2,620.80 | 17 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $258.60 | $431.00 | $89.10 – $993.28 | 17 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $483.60 | $806.00 | $94.05 – $993.28 | 17 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $491.40 | $819.00 | $138.05 – $993.28 | 17 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $490.80 | $818.00 | $148.50 – $993.28 | 17 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | $955.80 | $1,593.00 | $243.10 – $1,274.40 | 17 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | $490.80 | $818.00 | $84.70 – $993.28 | 17 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | $1,105.20 | $1,842.00 | $100.65 – $1,473.60 | 17 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $1,052.40 | $1,754.00 | $124.85 – $1,403.20 | 17 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $490.80 | $818.00 | $108.90 – $993.28 | 17 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $491.40 | $819.00 | $123.20 – $993.28 | 17 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $1,105.20 | $1,842.00 | $270.60 – $1,473.60 | 17 |
| Exchange biliary drg cath CPT 47536 | $2,475.00 | $4,125.00 | $132.20 – $3,300.00 | 17 |
| Exchange drainage catheter CPT 49423 | $971.40 | $1,619.00 | $64.68 – $1,295.20 | 17 |
| Exchange nephrostomy cath CPT 50435 | $5,026.20 | $8,377.00 | $604.53 – $6,701.60 | 17 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $490.80 | $818.00 | $72.05 – $674.56 | 17 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $1,105.20 | $1,842.00 | $41.25 – $1,473.60 | 17 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $490.80 | $818.00 | $59.40 – $872.96 | 17 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $940.20 | $1,567.00 | $129.25 – $1,253.60 | 17 |
| Excision of gum lesion 41825 CPT 41825 | not published | not published | $121.65 – $3,308.31 | 12 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $2,967.60 | $4,946.00 | $116.00 – $522.00 | 14 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $2,872.20 | $4,787.00 | $156.20 – $702.90 | 14 |
| Expl lap celiotomy w/wo bx 49000 CPT 49000 | $6,630.60 | $11,051.00 | $426.24 – $8,840.80 | 15 |
| Exploration of knee joint CPT 27310 | $6,400.80 | $10,668.00 | $419.10 – $8,534.40 | 17 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $3,349.80 | $5,583.00 | $824.80 – $4,466.40 | 17 |
| Explore/treat finger joint CPT 26080 | $6,347.40 | $10,579.00 | $172.70 – $8,463.20 | 17 |
| Explore/treat wrist joint CPT 25101 | $5,383.80 | $8,973.00 | $306.35 – $7,178.40 | 17 |
| External chromosome analysis 20-25 cells CPT 88264 | $354.60 | $591.00 | $142.92 – $472.80 | 17 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $354.60 | $591.00 | $142.07 – $472.80 | 17 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $132.60 | $221.00 | $17.72 – $176.80 | 17 |
| F-18 fdg pet diag HCPCS A9552 | $2,058.00 | $3,430.00 | $926.10 – $3,087.00 | 13 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $7,344.60 | $12,241.00 | $2,216.13 – $11,016.90 | 15 |
| F-18 fluciclovine per mci HCPCS A9588 | $710.40 | $1,184.00 | $271.05 – $1,065.60 | 15 |
| Facial bones <3 CPT 70140 | $320.40 | $534.00 | $23.18 – $427.20 | 17 |
| Factor ix CPT 85250 | $82.20 | $137.00 | $5.50 – $109.60 | 17 |
| Factor viii CPT 85240 | $239.40 | $399.00 | $14.30 – $304.00 | 17 |
| Factor viii recomb novoeight HCPCS J7182 | $3.40 | $4.25 | $1.08 – $3.60 | 17 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $52.80 | $88.00 | $23.87 – $79.20 | 17 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $0.40 | $0.50 | $0.01 – $0.45 | 16 |
| Fat/lipids feces qualitative CPT 82705 | $199.80 | $333.00 | $5.04 – $266.40 | 17 |
| Fatty acids nonesterified CPT 82725 | $153.60 | $256.00 | $14.50 – $204.80 | 17 |
| Feeding tube reposition CPT 74355 | $1,011.00 | $1,685.00 | $347.19 – $1,348.00 | 14 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $226.20 | $377.00 | $14.55 – $301.60 | 17 |
| Fem/popl revasc w/stent CPT 37226 | $7,915.20 | $13,192.00 | $993.28 – $13,195.02 | 17 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $82.80 | $138.00 | $1.08 – $3.60 | 16 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $5,580.60 | $9,301.00 | $1.11 – $10.80 | 17 |
| Ferritin CPT 82728 | $212.40 | $354.00 | $13.20 – $283.20 | 17 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $3,963.60 | $6,606.00 | $0.32 – $10.80 | 17 |
| Fetal fibronectin CPT 82731 | $851.40 | $1,419.00 | $22.00 – $1,135.20 | 17 |
| Fetal non stress test CPT 59025 | $373.20 | $622.00 | $6.04 – $497.60 | 17 |
| Fibrin degradation d dimer quantitative CPT 85379 | $148.20 | $247.00 | $10.06 – $197.60 | 17 |
| Fibrin degradation products CPT 85362 | $91.80 | $153.00 | $6.81 – $122.40 | 17 |
| Fibrinogen activity CPT 85384 | $133.20 | $222.00 | $9.61 – $177.60 | 17 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $61.80 | $103.00 | $3.30 – $82.40 | 17 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $66.60 | $111.00 | $5.50 – $88.80 | 17 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $2,461.20 | $4,102.00 | $1.00 – $5.40 | 17 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $347.40 | $579.00 | $0.27 – $0.90 | 17 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $2,032.80 | $3,388.00 | $0.46 – $5.40 | 17 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $5,677.80 | $9,463.00 | $1,892.60 – $8,516.70 | 14 |
| Filter vena cava fem denali HCPCS C1880 | $4,242.60 | $7,071.00 | $1,054.62 – $3,515.40 | 14 |
| Finasteride, 5 mg HCPCS S0138 | $20.60 | $25.75 | $6.95 – $23.18 | 14 |
| Fine needle asp without image guide 10021 CPT 10021 | $722.40 | $1,204.00 | $68.46 – $993.28 | 17 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,092.00 | $1,820.00 | $84.41 – $1,456.00 | 17 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $726.00 | $1,210.00 | $44.78 – $968.00 | 17 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $1,917.00 | $3,195.00 | $639.00 – $2,875.50 | 14 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $5,510.40 | $9,184.00 | $957.59 – $7,347.20 | 17 |
| Fl exam g/colon tube w contrast CPT 49465 | $1,778.40 | $2,964.00 | $26.11 – $2,371.20 | 17 |
| Flecainide (tambocor)-sendout CPT 80181 | $205.80 | $343.00 | $14.55 – $274.40 | 17 |
| Flexible Sigmoidoscopy CPT 45330 | $598.20 | $997.00 | $58.47 – $797.60 | 17 |
| Flow cytometry interp 16 or more CPT 88189 | $374.40 | $624.00 | $97.55 – $499.20 | 17 |
| Flow cytometry marker each additional CPT 88185 | $276.60 | $461.00 | $20.09 – $368.80 | 17 |
| Flow cytometry one marker technical component CPT 88184 | $276.60 | $461.00 | $40.85 – $368.80 | 17 |
| Flt3 gene CPT 81245 | $277.80 | $463.00 | $146.01 – $370.40 | 17 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $42.00 | $70.00 | $2.26 – $15.36 | 17 |
| Fluid pressure muscle 20950 CPT 20950 | $801.60 | $1,336.00 | $82.50 – $1,068.80 | 17 |
| Fluorescent antibody titer dna CPT 86256 | $202.20 | $337.00 | $10.02 – $269.60 | 17 |
| Fluoroestradiol f 18 HCPCS A9591 | $1,413.00 | $2,355.00 | $503.56 – $2,119.50 | 15 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $1,275.00 | $2,125.00 | $36.08 – $1,700.00 | 17 |
| Fluoroguide needle placement CPT 77002 | $1,275.00 | $2,125.00 | $45.66 – $1,700.00 | 17 |
| Fluoroscopy up to 1 hour CPT 76000 | $534.60 | $891.00 | $14.72 – $712.80 | 17 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $31.80 | $53.00 | $1.99 – $20.70 | 16 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $276.00 | $460.00 | $7.30 – $215.10 | 16 |
| Fna bx w/ct gdn 1st les CPT 10009 | $971.40 | $1,619.00 | $102.33 – $1,295.20 | 17 |
| Fna bx w/ct gdn ea addl CPT 10010 | $726.00 | $1,210.00 | $74.79 – $968.00 | 17 |
| Fna bx w/mr gdn 1st les CPT 10011 | $587.40 | $979.00 | $147.66 – $881.10 | 16 |
| Folic acid CPT 82746 | $130.80 | $218.00 | $13.20 – $174.40 | 17 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $0.80 | $1.00 | $0.06 – $0.23 | 16 |
| Follow-up angiography CPT 75898 | $1,141.80 | $1,903.00 | $343.22 – $3,240.52 | 17 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $5,244.60 | $8,741.00 | $6.28 – $78.30 | 17 |
| Fondaparinux sodium HCPCS J1652 | $595.80 | $993.00 | $0.72 – $45.00 | 16 |
| Foot X-ray CPT 73630 | $364.80 | $608.00 | $14.72 – $486.40 | 17 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $3,435.60 | $5,726.00 | $167.77 – $4,580.80 | 17 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,173.00 | $1,955.00 | $0.10 – $15.30 | 16 |
| Foscarnet sodium injection HCPCS J1455 | $526.40 | $658.00 | $16.08 – $592.20 | 17 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $366.60 | $611.00 | $7.29 – $24.30 | 14 |
| Frenectomy 41115 CPT 41115 | $3,435.60 | $5,726.00 | $351.82 – $4,580.80 | 17 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $243.00 | $405.00 | $33.00 – $364.50 | 16 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $303.00 | $505.00 | $33.00 – $404.00 | 17 |
| Fresh frozen plasma thawing ea un CPT 86927 | $75.60 | $126.00 | $38.56 – $176.42 | 16 |
| Fructosamine glycated protein CPT 82985 | $209.40 | $349.00 | $16.56 – $279.20 | 17 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $0.60 | $1.00 | $0.02 – $0.45 | 16 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $6.60 | $11.00 | $2.43 – $8.10 | 14 |
| Fusion of finger joint CPT 26860 | not published | not published | $925.94 – $3,340.82 | 11 |
| Fusion of foot bones CPT 28730 | not published | not published | $366.30 – $13,125.66 | 12 |
| G-esoph reflx tst w/electrod CPT 91035 | $4,449.00 | $7,415.00 | $365.89 – $5,932.00 | 17 |
| G-tube reposition CPT 43761 | $721.20 | $1,202.00 | $103.87 – $961.60 | 17 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $2.40 | $4.00 | $0.28 – $3.60 | 15 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $14.40 | $24.00 | $1.48 – $8.80 | 15 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $0.60 | $1.00 | $0.11 – $0.90 | 15 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $22.20 | $37.00 | $9.99 – $29.60 | 15 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $34.20 | $57.00 | $2.20 – $45.60 | 17 |
| Galectin-3 CPT 82777 | $78.00 | $130.00 | $15.66 – $104.00 | 17 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $993.28 – $6,007.35 | 11 |
| Gamma globulin 1 cc inj HCPCS J1460 | $189.60 | $316.00 | $49.03 – $284.40 | 17 |
| Gamma glutamyltransferase CPT 82977 | $111.00 | $185.00 | $7.12 – $148.00 | 17 |
| Gammaglobulin iga CPT 82784 | $280.80 | $468.00 | $9.19 – $165.60 | 17 |
| Gammaglobulin ige CPT 82785 | $226.80 | $378.00 | $16.27 – $302.40 | 17 |
| Gamunex-c/gammaked HCPCS J1561 | $338.40 | $423.00 | $48.96 – $345.60 | 17 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $735.20 | $919.00 | $39.54 – $827.10 | 16 |
| Gardner vag dna quant CPT 87512 | $290.40 | $484.00 | $32.60 – $387.20 | 17 |
| Gastric motility studies CPT 91020 | $1,578.60 | $2,631.00 | $207.90 – $2,104.80 | 17 |
| Gel-one HCPCS J7326 | $2,173.80 | $3,623.00 | $529.26 – $3,260.70 | 17 |
| Gel-syn injection 0.1 mg HCPCS J7328 | $3.00 | $5.00 | $0.70 – $4.50 | 16 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $364.20 | $607.00 | $3.13 – $26.10 | 16 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $844.20 | $1,407.00 | $236.62 – $1,139.40 | 17 |
| Generator barostim neo2 2014 HCPCS C1767 | $54,031.20 | $90,052.00 | $405.40 – $1,824.30 | 14 |
| Generator emblem MRI sicd subq HCPCS C1722 | $62,886.00 | $104,810.00 | $0.20 – $0.90 | 14 |
| Genetic tstg severe inh cond CPT 81443 | $11,622.60 | $19,371.00 | $852.01 – $2,644.20 | 17 |
| Genome sequence analysis CPT 81425 | $4,397.40 | $7,329.00 | $2,770.36 – $5,863.20 | 17 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $49.60 | $62.00 | $1.62 – $5.40 | 16 |
| Gentamicin peak therapeutic drug level CPT 80170 | $351.60 | $586.00 | $13.20 – $468.80 | 17 |
| Ghs HIV antibody CPT 86703 | $200.40 | $334.00 | $13.54 – $267.20 | 17 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $147.00 | $245.00 | $19.79 – $220.50 | 16 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $1,020.00 | $1,700.00 | $338.72 – $1,360.00 | 17 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $1,020.00 | $1,700.00 | $338.72 – $1,360.00 | 17 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $1,020.00 | $1,700.00 | $396.00 – $1,360.00 | 17 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $513.60 | $856.00 | $259.71 – $687.18 | 17 |
| Ghs abscess perianal iandd CPT 46050 | $1,512.60 | $2,521.00 | $83.23 – $2,016.80 | 17 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $110.40 | $184.00 | $13.36 – $147.20 | 17 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $1,593.00 | $2,655.00 | $101.06 – $2,124.00 | 17 |
| Ghs antibodies (torch) igm CPT 86694 | $455.40 | $759.00 | $14.22 – $607.20 | 17 |
| Ghs bladder cath - complex-foley CPT 51703 | $471.00 | $785.00 | $82.07 – $993.28 | 17 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,332.00 | $2,220.00 | $38.50 – $1,776.00 | 17 |
| Ghs change cysto/gastrost CPT 43762 | $1,759.80 | $2,933.00 | $34.21 – $2,346.40 | 17 |
| Ghs chemo >8 hrs CPT 96416 | $696.00 | $1,160.00 | $148.68 – $928.00 | 17 |
| Ghs chemo IV push, ea addtl CPT 96411 | $446.40 | $744.00 | $58.18 – $595.20 | 17 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $54.00 | $90.00 | $27.54 – $72.00 | 17 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $2,389.20 | $3,982.00 | $172.70 – $3,185.60 | 17 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $825.60 | $1,376.00 | $42.90 – $1,100.80 | 17 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $825.60 | $1,376.00 | $40.15 – $1,100.80 | 17 |
| Ghs closed reduction ankle dislocation CPT 27840 | $825.60 | $1,376.00 | $98.45 – $1,100.80 | 17 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $718.20 | $1,197.00 | $323.19 – $1,647.71 | 17 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $718.20 | $1,197.00 | $256.85 – $1,082.07 | 17 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $4,530.60 | $7,551.00 | $268.40 – $6,040.80 | 17 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $2,926.80 | $4,878.00 | $877.63 – $3,902.40 | 17 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $825.60 | $1,376.00 | $230.94 – $1,100.80 | 17 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $2,827.20 | $4,712.00 | $993.28 – $3,769.60 | 17 |
| Ghs community re-entry 15 minutes CPT 97537 | $72.00 | $120.00 | $32.40 – $96.00 | 14 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $408.60 | $681.00 | $119.83 – $993.28 | 17 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $408.60 | $681.00 | $28.60 – $810.24 | 17 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $408.60 | $681.00 | $29.15 – $988.16 | 17 |
| Ghs cutdown placement age 1 and over CPT 36425 | $120.00 | $200.00 | $15.40 – $160.00 | 17 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $304.20 | $507.00 | $15.03 – $405.60 | 17 |
| Ghs dislocation elbow closed treatment CPT 24600 | $825.60 | $1,376.00 | $112.75 – $1,100.80 | 17 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $5,277.60 | $8,796.00 | $85.38 – $7,036.80 | 17 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $471.00 | $785.00 | $187.33 – $706.50 | 16 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,360.20 | $2,267.00 | $101.39 – $1,813.60 | 17 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $547.20 | $912.00 | $150.63 – $820.80 | 16 |
| Ghs excision ingrown nail CPT 11765 | $589.80 | $983.00 | $55.00 – $344.80 | 17 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $718.20 | $1,197.00 | $174.87 – $994.56 | 17 |
| Ghs fb removal - incisional CPT 10121 | $7,126.80 | $11,878.00 | $71.50 – $9,502.40 | 17 |
| Ghs fb removal - non-incisional CPT 20520 | $3,129.60 | $5,216.00 | $68.75 – $4,172.80 | 17 |
| Ghs fb removal foot - deep - left CPT 28192 | $7,126.80 | $11,878.00 | $71.50 – $9,502.40 | 17 |
| Ghs fish cytogen CPT 88271 | $354.60 | $591.00 | $16.73 – $472.80 | 17 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $354.60 | $591.00 | $39.97 – $472.80 | 17 |
| Ghs flow volume loop CPT 94375 | $163.80 | $273.00 | $23.09 – $218.40 | 17 |
| Ghs gastric intub aspiration lavage CPT 43753 | $304.80 | $508.00 | $18.16 – $993.28 | 17 |
| Ghs histoplasma antigen CPT 87385 | $674.40 | $1,124.00 | $10.34 – $899.20 | 17 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | $458.40 | $764.00 | $97.88 – $611.20 | 17 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $7,126.80 | $11,878.00 | $42.35 – $9,502.40 | 17 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $2,172.00 | $3,620.00 | $119.35 – $2,896.00 | 17 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $589.80 | $983.00 | $39.60 – $993.28 | 17 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $825.60 | $1,376.00 | $45.10 – $1,100.80 | 17 |
| Ghs inf midline insertion CPT 36140 | $327.00 | $545.00 | $105.24 – $993.28 | 17 |
| Ghs inhibitor screen CPT 85335 | $345.00 | $575.00 | $8.30 – $460.00 | 17 |
| Ghs init tx 1st degree burn CPT 16000 | $471.00 | $785.00 | $19.80 – $628.00 | 17 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $1,332.00 | $2,220.00 | $80.85 – $1,776.00 | 17 |
| Ghs inj tendon origin/insertion CPT 20551 | $616.20 | $1,027.00 | $42.64 – $280.80 | 17 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $3,816.00 | $6,360.00 | $118.55 – $5,088.00 | 17 |
| Ghs insertion of needle - bone CPT 36680 | $471.00 | $785.00 | $54.45 – $628.00 | 17 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $825.60 | $1,376.00 | $101.20 – $1,100.80 | 17 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $4,494.00 | $7,490.00 | $101.20 – $5,992.00 | 17 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $2,619.00 | $4,365.00 | $234.14 – $3,492.00 | 17 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $471.00 | $785.00 | $34.65 – $631.04 | 17 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $825.60 | $1,376.00 | $26.95 – $673.28 | 17 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $825.60 | $1,376.00 | $26.95 – $1,100.80 | 17 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $825.60 | $1,376.00 | $34.65 – $1,100.80 | 17 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $825.60 | $1,376.00 | $52.25 – $1,100.80 | 17 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $825.60 | $1,376.00 | $39.05 – $1,100.80 | 17 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $825.60 | $1,376.00 | $52.25 – $1,100.80 | 17 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $825.60 | $1,376.00 | $51.15 – $1,100.80 | 17 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $825.60 | $1,376.00 | $53.35 – $1,100.80 | 17 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $825.60 | $1,376.00 | $67.65 – $1,100.80 | 17 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $825.60 | $1,376.00 | $101.20 – $1,100.80 | 17 |
| Ghs mbp CPT 83873 | $209.40 | $349.00 | $16.50 – $279.20 | 17 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $147.00 | $245.00 | $20.92 – $196.00 | 17 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $154.20 | $257.00 | $9.16 – $205.60 | 17 |
| Ghs myocardial strain img spckl track CPT 93356 | $792.60 | $1,321.00 | $9.00 – $1,056.80 | 15 |
| Ghs nailbed repair/nail removal CPT 11760 | $825.60 | $1,376.00 | $25.30 – $1,100.80 | 17 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $2,249.40 | $3,749.00 | $47.85 – $2,999.20 | 17 |
| Ghs nerve blk intercostal, single level CPT 64420 | $3,217.20 | $5,362.00 | $47.85 – $4,289.60 | 17 |
| Ghs nerve block axillary nerve CPT 64417 | $2,285.40 | $3,809.00 | $23.10 – $3,047.20 | 17 |
| Ghs nerve block brachial plexus CPT 64415 | $2,285.40 | $3,809.00 | $38.50 – $3,047.20 | 17 |
| Ghs nerve block celiac plexus CPT 64530 | $2,569.20 | $4,282.00 | $59.40 – $3,425.60 | 17 |
| Ghs nerve block interscaline CPT 64510 | $3,548.40 | $5,914.00 | $59.95 – $4,731.20 | 17 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $1,499.40 | $2,499.00 | $59.40 – $1,999.20 | 17 |
| Ghs nerve block sciatic nerve CPT 64445 | $2,399.40 | $3,999.00 | $25.85 – $3,199.20 | 17 |
| Ghs nerve block suprascapular CPT 64418 | $2,285.40 | $3,809.00 | $38.50 – $3,047.20 | 17 |
| Ghs ng placement w fluoro guidance CPT 43752 | $2,568.60 | $4,281.00 | $294.81 – $3,852.90 | 16 |
| Ghs o2 saturation CPT 82810 | $54.00 | $90.00 | $9.66 – $72.00 | 17 |
| Ghs opcc repair cvp w subq port CPT 36576 | $5,034.60 | $8,391.00 | $191.51 – $6,712.80 | 17 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $39.60 | $66.00 | $12.73 – $58.70 | 17 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $19.20 | $32.00 | $12.73 – $76.57 | 17 |
| Ghs ot group caregiver training CPT 97552 | $43.20 | $72.00 | $19.44 – $57.60 | 14 |
| Ghs ot prosthetic training/15 min CPT 97761 | $124.20 | $207.00 | $33.08 – $165.60 | 15 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $130.20 | $217.00 | $48.34 – $173.60 | 15 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $2,157.60 | $3,596.00 | $63.49 – $2,876.80 | 15 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $2,481.60 | $4,136.00 | $54.28 – $3,308.80 | 15 |
| Ghs peritonsillar abscess i andd CPT 42700 | $825.60 | $1,376.00 | $68.20 – $1,100.80 | 17 |
| Ghs plngl fx pm cl CPT 26725 | $825.60 | $1,376.00 | $84.70 – $1,100.80 | 17 |
| Ghs ppd (tb intradermal) CPT 86580 | $18.60 | $31.00 | $6.05 – $25.19 | 17 |
| Ghs pr without cont pulse ox CPT 94625 | $347.40 | $579.00 | $44.88 – $463.20 | 17 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $237.60 | $396.00 | $9.55 – $316.80 | 17 |
| Ghs protoporphyrins fract CPT 84202 | $139.80 | $233.00 | $14.19 – $186.40 | 17 |
| Ghs removal intranasal foreign body CPT 30300 | $247.20 | $412.00 | $24.75 – $993.28 | 17 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $6,497.40 | $10,829.00 | $935.47 – $8,663.20 | 17 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $286.20 | $477.00 | $10.87 – $381.60 | 17 |
| Ghs sedimentation rate CPT 85651 | $62.40 | $104.00 | $3.30 – $83.20 | 17 |
| Ghs semen analysis fert CPT 89320 | $195.60 | $326.00 | $9.61 – $260.80 | 17 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $589.80 | $983.00 | $101.20 – $993.28 | 17 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $589.80 | $983.00 | $101.20 – $993.28 | 17 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $781.80 | $1,303.00 | $101.20 – $1,042.40 | 17 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $589.80 | $983.00 | $52.25 – $993.28 | 17 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $589.80 | $983.00 | $53.35 – $944.64 | 17 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $589.80 | $983.00 | $67.65 – $786.40 | 17 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $589.80 | $983.00 | $101.20 – $993.28 | 17 |
| Ghs sleep study unattended CPT 95800 | $90.00 | $150.00 | $59.69 – $303.16 | 17 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $687.00 | $1,145.00 | $236.02 – $916.00 | 17 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $366.60 | $611.00 | $81.50 – $488.80 | 15 |
| Ghs sphenopalatine ganglion block CPT 64505 | $568.20 | $947.00 | $59.95 – $757.60 | 17 |
| Ghs st - eval for alt comm CPT 92567 | $27.00 | $45.00 | $13.20 – $62.38 | 17 |
| Ghs st - re-eval for alt comm CPT 92597 | $249.60 | $416.00 | $56.63 – $332.80 | 15 |
| Ghs strapping shoulder - 29240 CPT 29240 | $471.00 | $785.00 | $21.45 – $628.00 | 17 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $3,384.00 | $5,640.00 | $103.40 – $4,512.00 | 17 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $825.60 | $1,376.00 | $80.30 – $1,100.80 | 17 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $499.80 | $833.00 | $230.94 – $993.28 | 17 |
| Ghs urine, porphyrins quant CPT 84120 | $518.40 | $864.00 | $8.25 – $691.20 | 17 |
| Ghs vaginal delivery only CPT 59409 | $9,063.60 | $15,106.00 | $1,536.00 – $12,084.80 | 17 |
| Gi inhouse confirmation CPT 87045 | $86.40 | $144.00 | $7.59 – $115.20 | 17 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,353.00 | $2,255.00 | $608.85 – $1,804.00 | 17 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $1,053.60 | $1,317.00 | $182.45 – $1,185.30 | 17 |
| Glucagon plasma - sendout CPT 82943 | $202.20 | $337.00 | $14.12 – $269.60 | 17 |
| Glucose 1 hr post dose CPT 82950 | $37.20 | $62.00 | $4.70 – $49.60 | 17 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $29.40 | $49.00 | $2.20 – $39.20 | 17 |
| Glucose blood quantitative CPT 82947 | $52.20 | $87.00 | $3.89 – $69.60 | 17 |
| Glucose body fluid CPT 82945 | $52.20 | $87.00 | $3.89 – $69.60 | 17 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $95.40 | $159.00 | $46.35 – $127.20 | 17 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $199.80 | $333.00 | $12.72 – $266.40 | 17 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $42.60 | $71.00 | $3.60 – $56.80 | 17 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $35.40 | $44.25 | $0.46 – $39.60 | 17 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $104.80 | $131.00 | $11.04 – $117.90 | 17 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $280.80 | $468.00 | $18.37 – $374.40 | 17 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $255.60 | $426.00 | $18.31 – $340.80 | 17 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $2,802.00 | $4,670.00 | $681.53 – $2,261.70 | 17 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $62.40 | $104.00 | $20.80 – $93.60 | 15 |
| Graft axiofill 1000mg HCPCS J3590 | $15,289.20 | $25,482.00 | $1,491.75 – $4,972.50 | 14 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $256.80 | $428.00 | $67.27 – $385.20 | 14 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $28,077.00 | $46,795.00 | $2,995.60 – $13,480.20 | 14 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $28,969.20 | $48,282.00 | $160.00 – $720.00 | 14 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $16,977.00 | $28,295.00 | $80.20 – $360.90 | 14 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $1,233.60 | $2,056.00 | $101.03 – $478.80 | 14 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $410.40 | $684.00 | $136.80 – $615.60 | 14 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $6,183.00 | $10,305.00 | $52.75 – $9,274.50 | 14 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $25,379.40 | $42,299.00 | $15.20 – $68.40 | 14 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $2,112.60 | $3,521.00 | $49.40 – $222.30 | 14 |
| Granisetron hcl injection HCPCS J1626 | $27.00 | $45.00 | $0.19 – $0.90 | 16 |
| Great toe with reduction 28495 CPT 28495 | $825.60 | $1,376.00 | $83.05 – $1,100.80 | 17 |
| Growth stimulation gene 2 CPT 83006 | $234.00 | $390.00 | $26.33 – $312.00 | 17 |
| Guid loc target vol rad tx CPT 77387 | $292.20 | $487.00 | $81.68 – $438.30 | 16 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $9,511.20 | $15,852.00 | $37.20 – $167.40 | 14 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $2,825.40 | $4,709.00 | $4.86 – $16.20 | 14 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,083.60 | $1,806.00 | $46.71 – $155.70 | 13 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,183.40 | $3,639.00 | $137.81 – $2,911.20 | 17 |
| Gw stiffened micro access kit HCPCS C1894 | $3,307.80 | $5,513.00 | $1.08 – $38.80 | 14 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $160.00 | $200.00 | $4.40 – $180.00 | 16 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $9.00 | $11.25 | $0.80 – $9.90 | 16 |
| Hand X-ray CPT 73130 | $294.60 | $491.00 | $14.72 – $392.80 | 17 |
| Hand-held pefr meter a4614 HCPCS A4614 | $25.20 | $42.00 | $11.34 – $48.63 | 15 |
| Haptoglobin quantitative CPT 83010 | $155.40 | $259.00 | $12.44 – $207.20 | 17 |
| Hbot, full body chamber, 30m HCPCS G0277 | $873.60 | $1,456.00 | $48.28 – $1,310.40 | 16 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $190.20 | $317.00 | $85.59 – $285.30 | 13 |
| Hc nm fusion spect CT unlisted CPT 78999 | $717.60 | $1,196.00 | $303.48 – $1,076.40 | 16 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $5,647.20 | $9,412.00 | $1,256.82 – $8,470.80 | 16 |
| Hcg qualitative CPT 84703 | $102.60 | $171.00 | $7.43 – $136.80 | 17 |
| Hcg quantitative CPT 84702 | $301.80 | $503.00 | $14.88 – $402.40 | 17 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $3,516.00 | $5,860.00 | $211.60 – $4,688.00 | 17 |
| Hdr rdncl skn surf brachytx CPT 77768 | $1,093.20 | $1,822.00 | $205.30 – $1,457.60 | 17 |
| Head CT scan (with and without contrast) CPT 70470 | $2,704.20 | $4,507.00 | $128.00 – $3,605.60 | 17 |
| Head CT scan (with contrast) CPT 70460 | $2,371.20 | $3,952.00 | $102.40 – $3,161.60 | 17 |
| Head CT scan (without contrast) CPT 70450 | $1,602.60 | $2,671.00 | $99.20 – $2,136.80 | 17 |
| Hematocrit CPT 85014 | $48.00 | $80.00 | $2.35 – $64.00 | 17 |
| Hemodialysis one evaluation CPT 90935 | $1,935.60 | $3,226.00 | $211.20 – $2,580.80 | 17 |
| Hemoglobin CPT 85018 | $27.60 | $46.00 | $2.35 – $23.20 | 17 |
| Hemoglobin f (fetal) chemical CPT 83030 | $228.00 | $380.00 | $5.50 – $304.00 | 17 |
| Hemoglobin fetal qualitative CPT 83033 | $72.00 | $120.00 | $7.18 – $96.00 | 17 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $226.80 | $378.00 | $3.30 – $302.40 | 17 |
| Hemoglobin plasma CPT 83051 | $61.20 | $102.00 | $3.85 – $81.60 | 17 |
| Hemoglobin urine CPT 83069 | $52.20 | $87.00 | $3.08 – $69.60 | 17 |
| Hemolysins and agglutinins incubated CPT 86941 | $129.60 | $216.00 | $11.96 – $172.80 | 17 |
| Hemophilus influenza antibdy CPT 86684 | $139.20 | $232.00 | $15.65 – $185.60 | 17 |
| Heparin assay CPT 85520 | $335.40 | $559.00 | $7.18 – $447.20 | 17 |
| Heparin bolus from bag HCPCS J1644 | $6.00 | $10.00 | $0.21 – $0.90 | 16 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $4.40 | $5.50 | $0.02 – $1.80 | 17 |
| Hepatitis a antibody igm CPT 86709 | $168.00 | $280.00 | $11.13 – $224.00 | 17 |
| Hepatitis b core antibody igm CPT 86705 | $168.00 | $280.00 | $11.64 – $224.00 | 17 |
| Hepatitis b core antibody total CPT 86704 | $455.40 | $759.00 | $11.91 – $607.20 | 17 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,109.60 | $1,387.00 | $11.00 – $401.40 | 17 |
| Hepatitis b surface antibody CPT 86706 | $137.40 | $229.00 | $10.62 – $183.20 | 17 |
| Hepatitis c antibody CPT 86803 | $279.60 | $466.00 | $14.10 – $372.80 | 17 |
| Hepatobiliary system imaging CPT 78226 | $1,608.00 | $2,680.00 | $266.27 – $2,144.00 | 17 |
| Hereditary colon ca dsordrs CPT 81435 | $13,579.80 | $22,633.00 | $495.41 – $1,918.40 | 17 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $349.25 – $3,600.06 | 12 |
| Herpes simplex 1 ag if CPT 87274 | $158.40 | $264.00 | $9.36 – $211.20 | 17 |
| Herpes simplex 2 ag if CPT 87273 | $143.40 | $239.00 | $11.84 – $191.20 | 17 |
| Herpes simplex type 1 antibody igg CPT 86695 | $271.80 | $453.00 | $13.03 – $328.00 | 17 |
| Herpes simplex type 2 antibody igg CPT 86696 | $91.80 | $153.00 | $19.13 – $111.20 | 17 |
| Herpes simplex virus isolation CPT 87255 | $447.60 | $746.00 | $33.46 – $596.80 | 17 |
| Heterophile antibodies screening CPT 86308 | $56.40 | $94.00 | $5.12 – $75.20 | 17 |
| Hexa gene CPT 81255 | $1,336.80 | $2,228.00 | $50.85 – $1,782.40 | 17 |
| Hhv-6 dna quant CPT 87533 | $551.40 | $919.00 | $32.60 – $735.20 | 17 |
| Hip X-ray CPT 73502 | $653.40 | $1,089.00 | $28.62 – $871.20 | 17 |
| Histamine CPT 83088 | $351.60 | $586.00 | $14.30 – $468.80 | 17 |
| Histochemical stains add-on CPT 88314 | $193.20 | $322.00 | $11.00 – $257.60 | 17 |
| Hiv-1 ag ia CPT 87390 | $223.20 | $372.00 | $11.55 – $297.60 | 17 |
| Hla class i high defin qual CPT 86832 | $556.80 | $928.00 | $146.45 – $742.40 | 17 |
| Hla class i phenotype qual CPT 86830 | $230.40 | $384.00 | $93.20 – $307.20 | 17 |
| Hla class i&ii antibody qual CPT 86828 | $234.60 | $391.00 | $47.87 – $312.80 | 17 |
| Hla class ii high defin qual CPT 86833 | $507.00 | $845.00 | $133.14 – $676.00 | 17 |
| Hla class ii phenotype qual CPT 86831 | $402.00 | $670.00 | $79.88 – $536.00 | 17 |
| Hla i & ii typing hr CPT 81378 | $2,407.80 | $4,013.00 | $341.53 – $3,210.40 | 17 |
| Hla i & ii typing lr CPT 81370 | $3,220.20 | $5,367.00 | $397.42 – $4,212.00 | 17 |
| Hla i low res one antigen equiv ea CPT 81374 | $791.40 | $1,319.00 | $73.46 – $1,055.20 | 17 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $1,183.20 | $1,972.00 | $113.54 – $621.60 | 17 |
| Hla ii typing 1 loc hr CPT 81382 | $1,843.80 | $3,073.00 | $122.24 – $2,246.40 | 17 |
| Hla typing a b or c CPT 86813 | $799.20 | $1,332.00 | $57.32 – $1,065.60 | 17 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $0.60 | $1.00 | $0.22 – $0.90 | 15 |
| Home sleep test/type 2 porta HCPCS G0398 | $1,572.00 | $2,620.00 | $113.55 – $2,358.00 | 16 |
| Homocysteine CPT 83090 | $301.80 | $503.00 | $17.71 – $402.40 | 17 |
| Homogenization tissue CPT 87176 | $96.00 | $160.00 | $5.80 – $128.00 | 17 |
| Homovanillic acid (hva) CPT 83150 | $105.60 | $176.00 | $8.25 – $140.80 | 17 |
| Hpa-5 genotyping CPT 81109 | $166.20 | $277.00 | $95.42 – $221.60 | 17 |
| Hpv types 16 & 18 only CPT 87625 | $188.40 | $314.00 | $40.08 – $251.20 | 17 |
| Hrdtry cardmypy gene panel CPT 81439 | $9,382.20 | $15,637.00 | $456.69 – $12,509.60 | 17 |
| Htt gene detc abnor alleles CPT 81271 | $1,271.40 | $2,119.00 | $106.97 – $1,695.20 | 17 |
| Human epididymis protein 4 (he4) CPT 86305 | $166.20 | $277.00 | $20.57 – $221.60 | 17 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $259.20 | $432.00 | $0.36 – $2.70 | 16 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $92.80 | $116.00 | $5.60 – $104.40 | 16 |
| Hydration IV infusion each additional hour CPT 96361 | $322.20 | $537.00 | $9.90 – $429.60 | 17 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $1,143.00 | $1,905.00 | $34.79 – $1,524.00 | 17 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $83.20 | $104.00 | $21.31 – $87.30 | 16 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $8.00 | $10.00 | $0.02 – $0.10 | 16 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $850.80 | $1,418.00 | $0.27 – $0.90 | 14 |
| Hysterosalpingography s&i CPT 74740 | $1,358.40 | $2,264.00 | $33.92 – $1,811.20 | 17 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $577.87 – $3,273.80 | 11 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $150.00 | $250.00 | $11.00 – $225.00 | 17 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $3,355.20 | $5,592.00 | $448.71 – $4,473.60 | 17 |
| I-123 iobenguane diag HCPCS A9582 | $7,549.20 | $12,582.00 | $2,095.14 – $11,323.80 | 15 |
| I-123 ioflupane diag HCPCS A9584 | $5,594.40 | $9,324.00 | $1,401.62 – $8,391.60 | 15 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $103.20 | $172.00 | $46.44 – $154.80 | 13 |
| I131 iodide cap, rx HCPCS A9517 | $106.20 | $177.00 | $23.36 – $159.30 | 15 |
| I131 iodide sol, rx HCPCS A9530 | $78.60 | $131.00 | $21.08 – $117.90 | 15 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $285.60 | $476.00 | $21.16 – $380.80 | 17 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $285.60 | $476.00 | $12.57 – $380.80 | 17 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $285.60 | $476.00 | $13.52 – $380.80 | 17 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $1,143.00 | $1,905.00 | $43.23 – $1,524.00 | 17 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $290.40 | $484.00 | $27.39 – $387.20 | 17 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $2,792.80 | $3,491.00 | $172.31 – $3,141.90 | 17 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $61,359.00 | $102,265.00 | $0.20 – $0.90 | 14 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $64,147.20 | $106,912.00 | $9,211.20 – $41,450.40 | 14 |
| Icd crtp serena MRI HCPCS C2621 | $15,633.60 | $26,056.00 | $5,211.20 – $23,450.40 | 14 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $14,973.00 | $24,955.00 | $4,991.00 – $22,459.50 | 14 |
| Idarubicin hcl injection HCPCS J9211 | $462.00 | $770.00 | $36.67 – $693.00 | 16 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $268.20 | $447.00 | $25.20 – $402.30 | 16 |
| Igh@ var region somatic mutation analy CPT 81263 | $2,169.00 | $3,615.00 | $291.08 – $1,653.60 | 17 |
| Igk rearrangeabn clonal pop CPT 81264 | $930.00 | $1,550.00 | $170.71 – $1,240.00 | 17 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $293.40 | $489.00 | $43.56 – $391.20 | 17 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $273.00 | $455.00 | $73.15 – $364.00 | 17 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $556.80 | $928.00 | $51.38 – $742.40 | 17 |
| Iliac revasc add-on 37222 CPT 37222 | $4,394.40 | $7,324.00 | $203.55 – $5,859.20 | 15 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | $98.40 | $164.00 | $44.48 – $147.60 | 17 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $362.40 | $604.00 | $6.00 – $229.76 | 16 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $198.00 | $330.00 | $7.20 – $160.53 | 16 |
| Immune complex assay CPT 86332 | $168.00 | $280.00 | $24.09 – $224.00 | 17 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $623.20 | $779.00 | $45.31 – $208.80 | 17 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $174.00 | $290.00 | $20.57 – $232.00 | 17 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $174.60 | $291.00 | $20.57 – $232.80 | 17 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $232.20 | $387.00 | $8.80 – $309.60 | 17 |
| Immunodiffusion nes CPT 86329 | $123.00 | $205.00 | $13.89 – $164.00 | 17 |
| Immunofixation electrophoresis serum CPT 86334 | $219.60 | $366.00 | $22.08 – $292.80 | 17 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $84.60 | $141.00 | $15.40 – $112.80 | 17 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $84.60 | $141.00 | $19.58 – $122.14 | 17 |
| Immunoglobulin assay CPT 86023 | $108.00 | $180.00 | $12.32 – $144.00 | 17 |
| Immunology procedure CPT 86849 | $43.20 | $72.00 | $19.44 – $64.80 | 13 |
| Impl neurostim electr perc CPT 63650 | $4,750.20 | $7,917.00 | $410.25 – $6,333.60 | 17 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $12,413.40 | $20,689.00 | $28.89 – $96.30 | 14 |
| Implant neuroelectrodes CPT 64555 | $3,355.80 | $5,593.00 | $662.09 – $6,756.87 | 17 |
| Implant ureth bulk agent HCPCS L8606 | $1,032.60 | $1,721.00 | $344.20 – $1,548.90 | 14 |
| Imported lipodox inj HCPCS Q2049 | $2,244.60 | $3,741.00 | $528.86 – $3,366.90 | 17 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $219.00 | $365.00 | $66.68 – $292.00 | 17 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $275.40 | $459.00 | $14.77 – $367.20 | 17 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $1,305.60 | $2,176.00 | $780.21 – $1,958.40 | 15 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $544.20 | $907.00 | $360.90 – $816.30 | 15 |
| In-111 pentetreotide HCPCS A9572 | $3,477.00 | $5,795.00 | $1,933.37 – $5,215.50 | 15 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $3,349.80 | $5,583.00 | $25.85 – $1,302.40 | 17 |
| Incision of breast lesion CPT 19020 | $4,599.00 | $7,665.00 | $80.30 – $6,132.00 | 17 |
| Incision of foot fascia CPT 28008 | $5,397.60 | $8,996.00 | $150.15 – $7,196.80 | 17 |
| Incision of metatarsal CPT 28308 | $204.00 | $340.00 | $91.80 – $1,326.08 | 15 |
| Incisn of toe tndn CPT 28010 | $1,520.40 | $2,534.00 | $144.10 – $2,027.20 | 17 |
| Incisn windpipe CPT 31600 | $2,216.40 | $3,694.00 | $813.99 – $3,338.92 | 17 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | $133.80 | $223.00 | $60.21 – $200.76 | 14 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | $145.80 | $243.00 | $65.61 – $308.59 | 14 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | $138.60 | $231.00 | $62.37 – $207.90 | 14 |
| Infect ag drug suscept pheno predict CPT 87900 | $1,390.80 | $2,318.00 | $128.83 – $1,854.40 | 17 |
| Infect ag eia influenza a or b ea CPT 87400 | $141.60 | $236.00 | $6.70 – $188.80 | 17 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $1,484.40 | $2,474.00 | $254.45 – $1,979.20 | 17 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $368.40 | $614.00 | $165.78 – $491.20 | 17 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $1,390.80 | $2,318.00 | $127.22 – $1,854.40 | 17 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $1,404.00 | $2,340.00 | $254.45 – $1,872.00 | 17 |
| Infect ag ia optc obs influenza CPT 87804 | $13.20 | $22.00 | $6.73 – $17.87 | 17 |
| Infect ag if hep delta agent CPT 87380 | $199.20 | $332.00 | $18.15 – $265.60 | 17 |
| Infect ag if influenza a CPT 87276 | $150.60 | $251.00 | $12.54 – $200.80 | 17 |
| Infect ag if influenza b CPT 87275 | $150.60 | $251.00 | $12.11 – $200.80 | 17 |
| Infect ag if pneumocystis carinii CPT 87281 | $143.40 | $239.00 | $11.84 – $191.20 | 17 |
| Infect ag na herpes simplex quant CPT 87530 | $440.40 | $734.00 | $33.45 – $587.20 | 17 |
| Infect ag na hpv high-risk types CPT 87624 | $312.00 | $520.00 | $34.68 – $416.00 | 17 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $1,147.80 | $1,913.00 | $94.68 – $1,530.40 | 17 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $624.00 | $1,040.00 | $280.80 – $832.00 | 17 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | $26.40 | $44.00 | $12.66 – $40.89 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $103.20 | $172.00 | $9.36 – $137.60 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $118.80 | $198.00 | $11.84 – $158.40 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $166.80 | $278.00 | $11.23 – $222.40 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $723.60 | $1,206.00 | $10.21 – $964.80 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $67.80 | $113.00 | $10.21 – $90.40 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $197.40 | $329.00 | $23.80 – $263.20 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $407.40 | $679.00 | $9.36 – $543.20 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $144.00 | $240.00 | $9.36 – $192.00 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $115.80 | $193.00 | $11.84 – $154.40 | 17 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $145.80 | $243.00 | $74.36 – $194.40 | 16 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $292.80 | $488.00 | $25.51 – $387.20 | 17 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $276.00 | $460.00 | $25.51 – $368.00 | 17 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $286.80 | $478.00 | $36.84 – $382.40 | 17 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $582.60 | $971.00 | $297.13 – $776.80 | 17 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $253.80 | $423.00 | $27.39 – $338.40 | 17 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $453.60 | $756.00 | $34.68 – $604.80 | 17 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $253.80 | $423.00 | $32.54 – $338.40 | 17 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $276.00 | $460.00 | $25.51 – $368.00 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $75.00 | $125.00 | $33.75 – $100.00 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $210.00 | $350.00 | $94.50 – $280.00 | 17 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $381.00 | $635.00 | $34.68 – $508.00 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $438.00 | $730.00 | $197.10 – $584.00 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $581.40 | $969.00 | $44.06 – $138.54 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $968.40 | $1,614.00 | $205.34 – $1,291.20 | 17 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $517.80 | $863.00 | $33.45 – $690.40 | 17 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $513.60 | $856.00 | $42.34 – $684.80 | 17 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $778.80 | $1,298.00 | $42.34 – $1,038.40 | 17 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $1,066.20 | $1,777.00 | $84.10 – $1,421.60 | 17 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $776.40 | $1,294.00 | $140.96 – $1,035.20 | 17 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $720.80 | $947.00 | $31.09 – $810.90 | 17 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,012.80 | $1,688.00 | $20.41 – $152.10 | 17 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $4,383.60 | $7,306.00 | $19.99 – $315.90 | 17 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | $40.00 | $50.00 | $11.00 – $98.16 | 16 |
| Initiation & management bipap/cpap initial day CPT 94660 | $172.20 | $287.00 | $43.85 – $229.60 | 17 |
| Inj andexxa, 10 mg HCPCS J7169 | $13,400.40 | $22,334.00 | $131.38 – $669.60 | 17 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $10,166.40 | $16,944.00 | $15.19 – $50.40 | 17 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | $5,052.80 | $6,316.00 | $68.34 – $226.80 | 17 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $26.40 | $44.00 | $1.35 – $4.50 | 14 |
| Inj ceftolozane tazobactam HCPCS J0695 | $487.80 | $813.00 | $9.07 – $36.00 | 17 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $969.00 | $1,615.00 | $42.56 – $1,292.00 | 15 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | $13.20 | $22.00 | $0.78 – $19.80 | 17 |
| Inj dx for sinogram CPT 20501 | $1,942.20 | $3,237.00 | $38.50 – $2,589.60 | 17 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,627.80 | $2,713.00 | $90.97 – $2,170.40 | 17 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,260.60 | $2,101.00 | $78.27 – $1,680.80 | 17 |
| Inj for ext venography CPT 36005 | $438.00 | $730.00 | $48.02 – $584.00 | 17 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $943.20 | $1,572.00 | $57.11 – $1,257.60 | 15 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $871.20 | $1,452.00 | $43.98 – $1,161.60 | 15 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $7.20 | $9.00 | $2.44 – $8.10 | 17 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $387.00 | $645.00 | $75.89 – $204.58 | 17 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $205.60 | $257.00 | $23.61 – $231.30 | 16 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $107.40 | $179.00 | $48.33 – $143.20 | 14 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $8.60 | $10.75 | $2.70 – $9.00 | 16 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | $558.40 | $806.00 | $189.30 – $628.20 | 17 |
| Inj multihance HCPCS A9577 | $40.80 | $51.00 | $1.74 – $40.80 | 15 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $845.40 | $1,409.00 | $209.24 – $1,127.20 | 17 |
| Inj ogivri 10 mg HCPCS Q5114 | $234.00 | $390.00 | $40.29 – $351.00 | 17 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $1,264.80 | $2,108.00 | $30.32 – $1,897.20 | 17 |
| Inj peritoneal venous shunt CPT 49427 | $553.80 | $923.00 | $54.22 – $738.40 | 15 |
| Inj proc elbow arthro CPT 24220 | $969.00 | $1,615.00 | $44.80 – $1,292.00 | 15 |
| Inj proc for lymphang CPT 38790 | $475.20 | $792.00 | $80.92 – $993.28 | 17 |
| Inj retro urethrocysto CPT 51610 | $3,691.20 | $6,152.00 | $37.95 – $4,921.60 | 17 |
| Inj secukinumab intrav 1mg HCPCS J3247 | $31.80 | $53.00 | $14.37 – $47.70 | 17 |
| Inj teclistamab cqyv 0.5 mg HCPCS J9380 | $58.20 | $97.00 | $26.31 – $87.30 | 17 |
| Inj tedizolid phosphate HCPCS J3090 | $1,282.20 | $2,137.00 | $1.96 – $9.00 | 17 |
| Inj testosterone cypionate HCPCS J1071 | $0.80 | $1.00 | $0.03 – $0.90 | 16 |
| Inj thrc fascial pln blk bi w/wo image CPT 64468 | $133.80 | $223.00 | $60.21 – $178.40 | 14 |
| Inj thrc fascial pln blk uni w/wo image CPT 64466 | $118.80 | $198.00 | $53.46 – $158.40 | 14 |
| Inj w/fluor eval cv device CPT 36598 | $1,012.20 | $1,687.00 | $74.24 – $1,349.60 | 17 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $7,107.60 | $11,846.00 | $7.28 – $26.10 | 17 |
| Inj, aponvie, 1 mg HCPCS C9145 | $3.00 | $5.00 | $1.36 – $4.50 | 17 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | $96.60 | $161.00 | $43.66 – $144.90 | 17 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $11,130.60 | $18,551.00 | $39.83 – $264.60 | 17 |
| Inj, bupivacaine liposome HCPCS J0666 | $7.60 | $9.50 | $1.08 – $3.60 | 17 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $5.80 | $7.25 | $1.90 – $6.30 | 17 |
| Inj, clevidipine butyrate HCPCS C9248 | $839.40 | $1,399.00 | $15.12 – $50.40 | 14 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | $7.20 | $12.00 | $3.25 – $10.80 | 17 |
| Inj, durolane 1 mg HCPCS J7318 | $22.80 | $38.00 | $6.77 – $34.20 | 17 |
| Inj, factor x, (human), 1iu HCPCS J7175 | $32.40 | $54.00 | $9.78 – $48.60 | 17 |
| Inj, focinvez, 1mg HCPCS J1434 | $5.40 | $9.00 | $2.44 – $8.10 | 17 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $3.60 | $6.00 | $1.63 – $5.40 | 17 |
| Inj, tislelizumab-jsgr HCPCS J9329 | $102.00 | $170.00 | $46.10 – $153.00 | 17 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $12.60 | $15.75 | $4.07 – $13.50 | 17 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $141.60 | $177.00 | $22.02 – $159.30 | 17 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | $413.40 | $689.00 | $61.44 – $620.10 | 17 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | $864.00 | $1,440.00 | $390.53 – $1,296.00 | 17 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | $152.40 | $254.00 | $46.32 – $228.60 | 17 |
| Inj. tagraxofusp-erzs 10 mcg HCPCS J9269 | $540.00 | $900.00 | $244.08 – $810.00 | 17 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | $726.00 | $1,210.00 | $328.15 – $1,089.00 | 17 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $568.00 | $710.00 | $164.59 – $639.00 | 17 |
| Inj., evomela, 1 mg HCPCS J9246 | $105.60 | $176.00 | $18.50 – $158.40 | 17 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $991.20 | $1,652.00 | $2.18 – $14.40 | 17 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | $424.00 | $530.00 | $127.45 – $477.00 | 17 |
| Inject sacroiliac joint CPT 27096 | $2,370.00 | $3,950.00 | $78.32 – $3,160.00 | 15 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $750.00 | $1,250.00 | $251.70 – $1,000.00 | 17 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $969.00 | $1,615.00 | $61.44 – $1,292.00 | 15 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $293.40 | $489.00 | $54.76 – $280.80 | 17 |
| Injection during cath supravalvular aortography CPT 93567 | $436.80 | $728.00 | $49.48 – $582.40 | 15 |
| Injection epidural blood patch or clot CPT 62273 | $1,470.60 | $2,451.00 | $52.80 – $1,960.80 | 17 |
| Injection for arthrography wrist (both sides) CPT 25246 | $969.00 | $1,615.00 | $44.80 – $1,292.00 | 15 |
| Injection for bladder x-ray CPT 51600 | $2,905.80 | $4,843.00 | $35.20 – $3,874.40 | 17 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $969.00 | $1,615.00 | $141.55 – $1,292.00 | 15 |
| Injection of sinus tract CPT 20500 | $343.20 | $572.00 | $38.50 – $457.60 | 17 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $1,242.00 | $2,070.00 | $503.10 – $1,863.00 | 16 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $165.60 | $276.00 | $34.12 – $220.80 | 17 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $147.00 | $245.00 | $14.31 – $196.00 | 17 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $147.00 | $245.00 | $66.15 – $220.50 | 13 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $147.00 | $245.00 | $13.97 – $196.00 | 17 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $871.80 | $1,453.00 | $67.10 – $1,162.40 | 17 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,470.60 | $2,451.00 | $23.10 – $1,960.80 | 17 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,461.00 | $2,435.00 | $104.54 – $1,948.00 | 17 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $2,481.60 | $4,136.00 | $62.41 – $3,308.80 | 15 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,481.60 | $4,136.00 | $268.69 – $3,308.80 | 17 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $2,481.60 | $4,136.00 | $53.22 – $3,308.80 | 15 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,481.60 | $4,136.00 | $239.89 – $3,308.80 | 17 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,020.00 | $1,700.00 | $98.12 – $1,360.00 | 17 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,094.60 | $3,491.00 | $89.45 – $2,792.80 | 17 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $616.20 | $1,027.00 | $35.20 – $280.80 | 17 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $825.60 | $1,376.00 | $34.17 – $280.80 | 17 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $654.00 | $1,090.00 | $37.92 – $872.00 | 17 |
| Injection, cangrelor HCPCS C9460 | $41,627.40 | $69,379.00 | $19.98 – $124.20 | 17 |
| Injection, daratumumab 10 mg HCPCS J9145 | $314.40 | $394.00 | $71.37 – $353.70 | 17 |
| Injection, fulvestrant HCPCS J9395 | $589.60 | $737.00 | $6.73 – $663.30 | 17 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $39.20 | $49.00 | $10.31 – $34.20 | 17 |
| Injection, isavuconazonium HCPCS J1833 | $4.80 | $6.00 | $1.01 – $5.40 | 17 |
| Injection, renflexis HCPCS Q5104 | $1,624.80 | $2,708.00 | $27.00 – $243.90 | 17 |
| Injection,onabotulinumtoxina HCPCS J0585 | $2,783.40 | $4,639.00 | $6.50 – $41.40 | 17 |
| Ins cath ren art 1st bi CPT 36252 | $4,600.80 | $7,668.00 | $322.01 – $6,134.40 | 17 |
| Ins cath ren art 1st uni CPT 36251 | $2,781.00 | $4,635.00 | $247.21 – $3,708.00 | 17 |
| Ins cath ren art 2nd+ bi CPT 36254 | $4,097.40 | $6,829.00 | $371.55 – $5,463.20 | 17 |
| Ins cath ren art 2nd+ uni CPT 36253 | $3,054.00 | $5,090.00 | $344.41 – $4,072.00 | 17 |
| Ins cerv dilator (sep proc) CPT 59200 | $2,562.00 | $4,270.00 | $227.97 – $3,843.00 | 16 |
| Ins icd gen exist sgl lead CPT 33240 | $4,971.60 | $8,286.00 | $993.28 – $23,109.59 | 17 |
| Ins lv lead exist pm/icd CPT 33224 | $4,608.60 | $7,681.00 | $918.74 – $10,774.64 | 17 |
| Ins picad w subq port 5yr> CPT 36571 | $1,624.80 | $2,708.00 | $993.28 – $3,240.52 | 17 |
| Ins pm gen w/exist mlt leads CPT 33221 | $3,785.40 | $6,309.00 | $520.93 – $19,634.81 | 17 |
| Ins pq tunnld ip cath w/img CPT 49418 | $7,670.40 | $12,784.00 | $993.28 – $10,227.20 | 17 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $2,739.00 | $4,565.00 | $993.28 – $3,652.00 | 17 |
| Ins tun cvad 2 cath w/subq port(s) CPT 36566 | $5,640.60 | $9,401.00 | $993.28 – $7,520.80 | 17 |
| Ins tun intraperit dia cath CPT 49421 | $3,691.20 | $6,152.00 | $975.10 – $4,921.60 | 17 |
| Ins vag brachytx device CPT 57156 | $561.60 | $936.00 | $224.29 – $993.28 | 17 |
| Ins/rpl ldless pm right vent w img & eval CPT 33274 | $14,857.20 | $24,762.00 | $610.14 – $19,809.60 | 17 |
| Ins/rpl pm gen exist dual lead CPT 33213 | $3,922.80 | $6,538.00 | $993.28 – $10,774.64 | 17 |
| Ins/rpl pm gen exist sgl lead CPT 33212 | $3,785.40 | $6,309.00 | $331.10 – $5,047.20 | 17 |
| Insert and remove bone pin CPT 20650 | $5,275.20 | $8,792.00 | $152.49 – $7,033.60 | 17 |
| Insert cath pleura with image CPT 32557 | $2,040.00 | $3,400.00 | $993.28 – $2,720.00 | 17 |
| Insert cath pleura without image CPT 32556 | $2,977.80 | $4,963.00 | $791.18 – $3,970.40 | 17 |
| Insert drug delivery implant CPT 11981 | $255.60 | $426.00 | $58.09 – $993.28 | 17 |
| Insert hepatic shunt (tips) CPT 37182 | $9,621.60 | $16,036.00 | $1,033.93 – $12,828.80 | 15 |
| Insert intrauterine device iud CPT 58300 | $280.80 | $468.00 | $18.98 – $421.20 | 16 |
| Insert pessary/other device CPT 57160 | $859.20 | $1,432.00 | $16.66 – $1,145.60 | 17 |
| Insert pm/icd lead dual CPT 33217 | $5,231.40 | $8,719.00 | $993.28 – $8,520.57 | 17 |
| Insert vad art access left hrt arterial access CPT 33990 | $48,647.40 | $81,079.00 | $278.87 – $64,863.20 | 15 |
| Insert/repl sq defib w/eltrd CPT 33270 | $6,004.80 | $10,008.00 | $881.95 – $33,009.16 | 17 |
| Insertion catheter bladder non indwelling CPT 51701 | $247.20 | $412.00 | $28.00 – $116.80 | 17 |
| Insertion catheter bladder temporary simple CPT 51702 | $247.20 | $412.00 | $30.26 – $313.60 | 17 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $2,846.40 | $4,744.00 | $993.28 – $3,795.20 | 17 |
| Insertion intra aortic balloon assist device percutaneous CPT 33967 | $2,809.20 | $4,682.00 | $312.18 – $3,745.60 | 15 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $8,073.60 | $13,456.00 | $993.28 – $10,764.80 | 17 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $3,349.80 | $5,583.00 | $124.53 – $4,466.40 | 17 |
| Insertion of catheter vein CPT 36481 | $512.40 | $854.00 | $230.58 – $1,248.86 | 17 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $5,231.40 | $8,719.00 | $509.38 – $6,975.20 | 17 |
| Insertion of new/replacement ppm w/transvenous electrode(s) ventricular CPT 33207 | $4,956.60 | $8,261.00 | $507.30 – $6,608.80 | 17 |
| Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator CPT 33225 | $5,125.80 | $8,543.00 | $430.03 – $6,834.40 | 15 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $1,823.40 | $3,039.00 | $96.13 – $2,431.20 | 17 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,267.20 | $2,112.00 | $76.74 – $1,689.60 | 17 |
| Insertion single tranvenous electrode/ppm/implantable defibrillator CPT 33216 | $5,097.00 | $8,495.00 | $392.35 – $6,796.00 | 17 |
| Insertion subcutaneous cardiac rhythm monitor CPT 33285 | $2,804.40 | $4,674.00 | $993.28 – $8,520.57 | 17 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $2,205.60 | $3,676.00 | $993.28 – $3,240.52 | 17 |
| Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber CPT 33249 | $6,004.80 | $10,008.00 | $993.28 – $33,009.16 | 17 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $3,844.20 | $6,407.00 | $181.39 – $5,125.60 | 17 |
| Insitu hybridization (fish) CPT 88366 | $255.60 | $426.00 | $82.33 – $340.80 | 17 |
| Insitu hybridization manual CPT 88368 | $512.40 | $854.00 | $81.10 – $683.20 | 17 |
| Insj biomechanical device 22853 CPT 22853 | not published | not published | $275.38 – $392.23 | 4 |
| Insulin total CPT 83525 | $165.60 | $276.00 | $11.30 – $220.80 | 17 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $7,989.60 | $13,316.00 | $1,494.41 – $11,984.40 | 14 |
| Integra meshed bil wound mat HCPCS C9363 | $35,932.20 | $59,887.00 | $16,169.49 – $53,898.30 | 14 |
| Interdental fixation CPT 21110 | $4,494.00 | $7,490.00 | $1,063.94 – $5,992.00 | 17 |
| Interferon alfa-2b inj HCPCS J9214 | $111.00 | $185.00 | $49.95 – $166.50 | 14 |
| Interrog dev eval scrms ip CPT 93291 | $234.00 | $390.00 | $15.33 – $312.00 | 17 |
| Interrog device eval heart CPT 93289 | $234.00 | $390.00 | $15.64 – $312.00 | 17 |
| Interrog evl pm/ldls pm ip CPT 93288 | $234.00 | $390.00 | $12.68 – $312.00 | 17 |
| Interrogate subq defib CPT 93261 | $117.00 | $195.00 | $27.33 – $156.00 | 17 |
| Intracard echo interv w/s&i CPT 93662 | $4,616.40 | $7,694.00 | $598.57 – $6,155.20 | 14 |
| Intrapul surf admin endo tube CPT 94610 | $60.60 | $101.00 | $40.19 – $209.40 | 17 |
| Intraventricular pacing CPT 93612 | $2,392.80 | $3,988.00 | $206.25 – $3,190.40 | 17 |
| Intrinsic factor antibody CPT 86340 | $203.40 | $339.00 | $14.90 – $271.20 | 17 |
| Intro cath dialysis circuit CPT 36901 | $2,582.40 | $4,304.00 | $131.16 – $3,443.20 | 17 |
| Intro cath dialysis circuit w/pta CPT 36902 | $2,851.80 | $4,753.00 | $195.43 – $3,802.40 | 17 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $3,122.40 | $5,204.00 | $267.53 – $6,975.66 | 17 |
| Intro cath svc/ivc CPT 36010 | $2,478.60 | $4,131.00 | $125.95 – $3,304.80 | 17 |
| Intro catheter aorta CPT 36200 | $580.80 | $968.00 | $122.10 – $993.28 | 17 |
| Intro long gi tube CPT 44500 | $559.20 | $932.00 | $21.64 – $745.60 | 17 |
| Intro long gi tube w/mult fluo CPT 74340 | $384.60 | $641.00 | $173.07 – $512.80 | 14 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $4,370.40 | $7,284.00 | $68.80 – $5,827.20 | 15 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $4,237.80 | $7,063.00 | $54.50 – $5,650.40 | 15 |
| Intubation endotracheal emergency procedure CPT 31500 | $718.20 | $1,197.00 | $79.20 – $993.28 | 17 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $1,636.80 | $2,728.00 | $736.56 – $2,455.20 | 13 |
| Ionm in operatng room 15 min CPT 95940 | $177.60 | $296.00 | $25.14 – $236.80 | 15 |
| Ionm remote/>1 pt or per hr CPT 95941 | $1,008.00 | $1,680.00 | $453.60 – $1,512.00 | 13 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $121.20 | $202.00 | $0.27 – $0.90 | 15 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $6.80 | $8.50 | $0.15 – $0.90 | 15 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $664.80 | $1,108.00 | $183.48 – $996.30 | 17 |
| Ipratropium bromide non-comp HCPCS J7644 | $4.40 | $5.50 | $0.39 – $4.95 | 16 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $1,091.20 | $1,364.00 | $1.75 – $42.30 | 16 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $210.60 | $351.00 | $66.00 – $315.90 | 17 |
| Iron CPT 83540 | $48.00 | $80.00 | $6.39 – $64.00 | 17 |
| Iron binding capacity CPT 83550 | $100.80 | $168.00 | $5.50 – $134.40 | 17 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $72.00 | $120.00 | $18.11 – $108.00 | 17 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $555.60 | $926.00 | $0.23 – $3.60 | 16 |
| Irradiation of blood product each unit reference CPT 86945 | $98.40 | $164.00 | $26.52 – $147.60 | 16 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $142.20 | $237.00 | $21.43 – $189.60 | 17 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $149.40 | $249.00 | $67.53 – $224.10 | 17 |
| Ivc venogram s&i CPT 75825 | $1,510.20 | $2,517.00 | $28.80 – $2,013.60 | 17 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,283.40 | $2,139.00 | $35.20 – $1,711.20 | 17 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $361.20 | $602.00 | $139.21 – $541.80 | 17 |
| Jak2 targeted sequence analysis CPT 81279 | $1,170.00 | $1,950.00 | $162.98 – $671.20 | 17 |
| John cunningham antibody CPT 86711 | $3,164.40 | $5,274.00 | $16.69 – $4,219.20 | 17 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $174.60 | $291.00 | $5.50 – $232.80 | 17 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $24.60 | $30.75 | $0.29 – $27.00 | 17 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $732.60 | $1,221.00 | $62.72 – $976.80 | 17 |
| Kidney imag w/bld flow multi CPT 78709 | $1,161.00 | $1,935.00 | $237.62 – $1,548.00 | 17 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,552.20 | $2,587.00 | $88.32 – $2,069.60 | 17 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $382.20 | $637.00 | $171.99 – $573.30 | 13 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $10,797.00 | $17,995.00 | $4,858.65 – $16,195.50 | 13 |
| Kit gene analys d816 variant CPT 81273 | $1,111.20 | $1,852.00 | $109.89 – $1,461.60 | 17 |
| Kit lead specify 5-6-5 HCPCS C1778 | $12,081.00 | $20,135.00 | $160.40 – $721.80 | 14 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $597.85 – $3,309.88 | 12 |
| Knee MRI (with and without contrast) CPT 73723 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| Knee MRI (with contrast) CPT 73722 | $3,051.00 | $5,085.00 | $393.92 – $4,068.00 | 17 |
| Knee MRI (without contrast) CPT 73721 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| Knee X-ray CPT 73564 | $477.00 | $795.00 | $28.70 – $636.00 | 17 |
| Knee arthroscopy/surgery CPT 29882 | $5,152.80 | $8,588.00 | $597.85 – $6,870.40 | 17 |
| Kras gene addl variants CPT 81276 | $429.00 | $715.00 | $173.53 – $572.00 | 17 |
| Kras gene variants exon 2 CPT 81275 | $325.80 | $543.00 | $173.78 – $434.40 | 17 |
| Kyleena, 19.5 mg HCPCS J7296 | $3,100.20 | $5,167.00 | $840.24 – $2,800.80 | 15 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $327.00 | $545.00 | $0.54 – $1.80 | 14 |
| Lactate dehydrogenase (ldh) CPT 83615 | $42.60 | $71.00 | $5.98 – $56.80 | 17 |
| Lactated ringers intravenous solution HCPCS J7120 | $32.40 | $40.50 | $1.62 – $5.40 | 16 |
| Lactic acid CPT 83605 | $121.80 | $203.00 | $8.80 – $162.40 | 17 |
| Lactoferrin fecal qualitative CPT 83630 | $351.60 | $586.00 | $13.54 – $468.80 | 17 |
| Lactoferrin fecal quant CPT 83631 | $175.20 | $292.00 | $19.40 – $233.60 | 17 |
| Lam facetec & foramot lumbar CPT 63047 | not published | not published | $993.28 – $7,355.55 | 11 |
| Laminotomy single lumbar CPT 63042 | not published | not published | $993.28 – $7,355.55 | 11 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $372.00 | $465.00 | $34.05 – $418.50 | 17 |
| Lap ing hernia repair init CPT 49650 | not published | not published | $818.32 – $6,007.35 | 11 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | $993.28 – $6,007.35 | 11 |
| Laparoscopy remove adnexa CPT 58661 | $7,589.40 | $12,649.00 | $993.28 – $10,119.20 | 17 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $4,599.00 | $7,665.00 | $373.84 – $6,132.00 | 17 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $4,228.80 | $7,048.00 | $129.80 – $5,638.40 | 17 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $270.89 – $3,761.11 | 12 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $4,649.40 | $7,749.00 | $1,549.80 – $6,974.10 | 14 |
| Lead capillary CPT 83655 | $165.60 | $276.00 | $11.00 – $220.80 | 17 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $5,084.40 | $8,474.00 | $67.60 – $304.20 | 14 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,227.60 | $2,046.00 | $146.18 – $1,636.80 | 17 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $16.60 | $20.75 | $3.22 – $18.00 | 16 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $1,045.80 | $1,743.00 | $472.70 – $1,730.32 | 17 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $2,789.60 | $3,487.00 | $176.45 – $3,138.30 | 17 |
| Levalbuterol non-comp unit HCPCS J7614 | $12.00 | $20.00 | $0.09 – $18.00 | 16 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $276.00 | $460.00 | $0.04 – $0.90 | 16 |
| Levetiracetam therapeutic drug level CPT 80177 | $330.60 | $551.00 | $13.09 – $440.80 | 17 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $37.00 | $46.25 | $2.54 – $13.50 | 16 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $24.60 | $41.00 | $6.87 – $27.00 | 16 |
| Liberta rc ipg HCPCS C1820 | $39,513.60 | $65,856.00 | $2,003.80 – $9,017.10 | 14 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $0.16 | $0.20 | $0.00 – $0.09 | 16 |
| Lidocaine therapeutic drug level CPT 80176 | $164.40 | $274.00 | $14.30 – $219.20 | 17 |
| Ligation/major artery/extremity 37618 CPT 37618 | $3,848.40 | $6,414.00 | $418.88 – $5,131.20 | 15 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $164.00 | $205.00 | $3.57 – $184.50 | 16 |
| Lip surgery procedure CPT 40799 | $114.60 | $191.00 | $76.00 – $239.08 | 16 |
| Lipase CPT 83690 | $139.80 | $233.00 | $5.50 – $186.40 | 17 |
| Lipoprotein blood high res frac & quant CPT 83701 | $325.20 | $542.00 | $30.51 – $433.60 | 17 |
| Lipoprotein blood quant CPT 83704 | $375.60 | $626.00 | $26.70 – $500.80 | 17 |
| Lipoprotein direct measurement hdl CPT 83718 | $60.60 | $101.00 | $7.70 – $80.80 | 17 |
| Lipoprotein direct measurement ldl CPT 83721 | $164.40 | $274.00 | $10.37 – $219.20 | 17 |
| Lithium therapeutic drug level CPT 80178 | $82.80 | $138.00 | $6.54 – $110.40 | 17 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $315.00 | $525.00 | $134.25 – $420.00 | 14 |
| Liver Function Test CPT 80076 | $232.20 | $387.00 | $8.08 – $309.60 | 17 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $944.40 | $1,574.00 | $155.04 – $1,259.20 | 16 |
| Liver elastography 91200 CPT 91200 | $480.60 | $801.00 | $24.22 – $640.80 | 17 |
| Liver imag w/vasclr flow CPT 78202 | $1,510.20 | $2,517.00 | $64.00 – $2,013.60 | 17 |
| Liver/spleen imag static only CPT 78215 | $1,308.60 | $2,181.00 | $59.52 – $1,744.80 | 17 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $394.80 | $658.00 | $178.45 – $592.20 | 17 |
| Loop ostmy bridg ster HCPCS A4421 | $64.80 | $108.00 | $1.54 – $97.20 | 14 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $31.20 | $52.00 | $0.27 – $1.38 | 16 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,574.80 | $5,958.00 | $171.38 – $4,766.40 | 17 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,555.40 | $4,259.00 | $120.32 – $3,407.20 | 17 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,051.40 | $3,419.00 | $102.37 – $2,735.20 | 17 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,051.00 | $5,085.00 | $343.82 – $4,068.00 | 17 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $417.00 | $695.00 | $28.80 – $556.00 | 17 |
| Lung Function Test (Spirometry) CPT 94010 | $228.00 | $380.00 | $11.52 – $148.00 | 17 |
| Lung function test (mbc/mvv) CPT 94200 | $133.20 | $222.00 | $6.91 – $177.60 | 17 |
| Lung perfusion imaging CPT 78580 | $479.40 | $799.00 | $60.80 – $639.20 | 17 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $380.40 | $634.00 | $171.94 – $570.60 | 17 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $83.40 | $139.00 | $37.70 – $125.10 | 17 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $607.20 | $1,012.00 | $320.10 – $910.80 | 15 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $600.00 | $1,000.00 | $258.35 – $900.00 | 15 |
| Lymph vessel x-ray trunk CPT 75807 | $2,704.20 | $4,507.00 | $72.32 – $3,605.60 | 17 |
| Lymphatics/lymph node imaging CPT 78195 | $1,172.40 | $1,954.00 | $166.40 – $1,563.20 | 17 |
| Lymphocyte transformation mitogen CPT 86353 | $630.00 | $1,050.00 | $48.45 – $840.00 | 17 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $404.40 | $674.00 | $141.17 – $539.20 | 17 |
| MRA chest wwo IV cont HCPCS C8911 | $2,479.80 | $4,133.00 | $287.67 – $3,719.70 | 16 |
| MRA without fol w/cont, abd HCPCS C8902 | $2,734.20 | $4,557.00 | $287.67 – $4,101.30 | 16 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,954.80 | $3,258.00 | $287.67 – $2,932.20 | 16 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $2,734.20 | $4,557.00 | $287.67 – $4,101.30 | 14 |
| MRI breast without cont bi CPT 77047 | $3,482.40 | $5,804.00 | $170.33 – $4,643.20 | 17 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $2,562.00 | $4,270.00 | $232.71 – $3,416.00 | 17 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $3,051.00 | $5,085.00 | $343.82 – $4,068.00 | 17 |
| MRI chest w IV cont CPT 71551 | $3,051.00 | $5,085.00 | $399.62 – $4,068.00 | 17 |
| MRI chest without & w/contrast CPT 71552 | $3,985.80 | $6,643.00 | $343.82 – $5,314.40 | 17 |
| MRI chest without contrast CPT 71550 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| MRI loex nonjt w IV cont CPT 73719 | $3,051.00 | $5,085.00 | $343.82 – $4,068.00 | 17 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $3,804.00 | $6,340.00 | $343.82 – $5,072.00 | 17 |
| MRI orbit/face/neck without contrast CPT 70540 | $2,398.20 | $3,997.00 | $232.71 – $3,197.60 | 17 |
| MRI tmj CPT 70336 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| MRI upper extremity w/dye CPT 73219 | $3,051.00 | $5,085.00 | $343.82 – $4,068.00 | 17 |
| MRI without fol w/cont, breast HCPCS C8908 | $3,543.00 | $5,905.00 | $287.67 – $5,314.50 | 16 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $4,459.80 | $7,433.00 | $287.67 – $6,689.70 | 16 |
| Macroscopic exam arthropod CPT 87168 | $75.00 | $125.00 | $3.33 – $100.00 | 17 |
| Macroscopic exam parasite CPT 87169 | $51.60 | $86.00 | $3.37 – $68.80 | 17 |
| Magnesium CPT 83735 | $54.00 | $90.00 | $6.62 – $72.00 | 17 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $74.40 | $124.00 | $0.27 – $0.90 | 16 |
| Manipulat palm cord post inj CPT 26341 | $735.60 | $1,226.00 | $138.33 – $993.28 | 17 |
| Manipulate wrist w/anesthes CPT 25259 | $4,104.60 | $6,841.00 | $296.78 – $5,472.80 | 17 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $193.20 | $322.00 | $33.52 – $257.60 | 17 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $237.60 | $396.00 | $58.32 – $316.80 | 17 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $88.80 | $148.00 | $4.59 – $15.30 | 14 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $499.80 | $833.00 | $50.42 – $749.70 | 16 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $91.20 | $152.00 | $41.22 – $136.80 | 17 |
| Marker biop eviva buckle ss HCPCS A4648 | $2,182.80 | $3,638.00 | $97.47 – $324.90 | 14 |
| Mastoids complete CPT 70130 | $479.40 | $799.00 | $35.20 – $639.20 | 17 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $316.80 | $528.00 | $14.29 – $422.40 | 17 |
| Mayo aathr protein s free CPT 85306 | $149.40 | $249.00 | $15.14 – $199.20 | 17 |
| Mayo activated protein c resistance assay CPT 85307 | $253.20 | $422.00 | $15.14 – $337.60 | 17 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $205.80 | $343.00 | $30.12 – $274.40 | 17 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $130.80 | $218.00 | $11.55 – $174.40 | 17 |
| Mayo alpha 1 antitrypsin CPT 82103 | $197.40 | $329.00 | $13.29 – $263.20 | 17 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $113.40 | $189.00 | $12.10 – $151.20 | 17 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,160.40 | $1,934.00 | $94.96 – $671.20 | 17 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $1,608.60 | $2,681.00 | $90.59 – $671.20 | 17 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $1,192.80 | $1,988.00 | $120.56 – $964.00 | 17 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $12,834.00 | $21,390.00 | $905.73 – $17,112.00 | 17 |
| Mayo androstenedione CPT 82157 | $154.20 | $257.00 | $27.50 – $205.60 | 17 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $139.20 | $232.00 | $14.43 – $185.60 | 17 |
| Mayo antithrombin iii antigen CPT 85301 | $582.60 | $971.00 | $10.69 – $776.80 | 17 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $118.80 | $198.00 | $14.88 – $158.40 | 17 |
| Mayo avwpr vw factor activity CPT 85397 | $322.80 | $538.00 | $28.93 – $430.40 | 17 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $290.40 | $484.00 | $30.88 – $387.20 | 17 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $16.80 | $28.00 | $7.56 – $22.40 | 17 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $364.20 | $607.00 | $113.09 – $485.60 | 17 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $843.00 | $1,405.00 | $167.58 – $1,124.00 | 17 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $175.20 | $292.00 | $12.75 – $233.60 | 17 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $100.80 | $168.00 | $13.03 – $134.40 | 17 |
| Mayo brcmg brucella antibody igm CPT 86622 | $118.80 | $198.00 | $8.82 – $158.40 | 17 |
| Mayo c1 esterase inhibitor CPT 83883 | $130.80 | $218.00 | $10.62 – $174.40 | 17 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $331.20 | $552.00 | $13.17 – $441.60 | 17 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $351.00 | $585.00 | $26.46 – $468.00 | 17 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $1,609.80 | $2,683.00 | $120.80 – $591.20 | 17 |
| Mayo ceruloplasmin CPT 82390 | $97.80 | $163.00 | $10.62 – $130.40 | 17 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $158.40 | $264.00 | $11.02 – $211.20 | 17 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $360.60 | $601.00 | $10.06 – $480.80 | 17 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $166.80 | $278.00 | $10.87 – $222.40 | 17 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $38.40 | $64.00 | $12.53 – $51.20 | 17 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $1,097.40 | $1,829.00 | $115.13 – $1,463.20 | 17 |
| Mayo chromium CPT 82495 | $232.20 | $387.00 | $6.60 – $309.60 | 17 |
| Mayo coccidioides antibody CPT 86635 | $229.80 | $383.00 | $11.33 – $306.40 | 17 |
| Mayo cocou cortisone urine CPT 82542 | $305.40 | $509.00 | $21.20 – $301.60 | 17 |
| Mayo cortisol free CPT 82530 | $166.80 | $278.00 | $16.51 – $222.40 | 17 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $123.00 | $205.00 | $12.28 – $164.00 | 17 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $171.00 | $285.00 | $11.98 – $228.00 | 17 |
| Mayo cyanide CPT 82600 | $265.80 | $443.00 | $18.70 – $354.40 | 17 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $102.60 | $171.00 | $13.09 – $136.80 | 17 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $479.40 | $799.00 | $23.10 – $639.20 | 17 |
| Mayo dihydrotestosterone CPT 82642 | $301.80 | $503.00 | $22.86 – $402.40 | 17 |
| Mayo efpo chloride stool CPT 82438 | $267.60 | $446.00 | $3.30 – $356.80 | 17 |
| Mayo estriol CPT 82677 | $123.00 | $205.00 | $19.25 – $164.00 | 17 |
| Mayo estrone CPT 82679 | $177.60 | $296.00 | $14.30 – $236.80 | 17 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $318.60 | $531.00 | $14.30 – $424.80 | 17 |
| Mayo everolimus therapeutic drug level CPT 80169 | $359.40 | $599.00 | $13.56 – $479.20 | 17 |
| Mayo factor ii CPT 85210 | $54.00 | $90.00 | $4.40 – $72.00 | 17 |
| Mayo factor vii CPT 85230 | $185.40 | $309.00 | $5.50 – $247.20 | 17 |
| Mayo factor viii vw factor antigen CPT 85246 | $239.40 | $399.00 | $22.67 – $304.00 | 17 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $239.40 | $399.00 | $22.67 – $304.00 | 17 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $239.40 | $399.00 | $22.67 – $304.00 | 17 |
| Mayo factor x CPT 85260 | $356.40 | $594.00 | $13.20 – $475.20 | 17 |
| Mayo factor xi CPT 85270 | $162.60 | $271.00 | $13.20 – $216.80 | 17 |
| Mayo fat/lipids feces quantitative CPT 82710 | $198.00 | $330.00 | $4.42 – $264.00 | 17 |
| Mayo fbl culture fungi blood CPT 87103 | $471.60 | $786.00 | $13.71 – $628.80 | 17 |
| Mayo ffspg allergen clam igg CPT 86001 | $147.00 | $245.00 | $6.36 – $192.00 | 17 |
| Mayo fibrinogen antigen CPT 85385 | $120.00 | $200.00 | $10.90 – $160.00 | 17 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $432.00 | $720.00 | $15.92 – $576.00 | 17 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $8,576.40 | $14,294.00 | $62.64 – $208.80 | 13 |
| Mayo hemosiderin qualitative urine CPT 83070 | $92.40 | $154.00 | $3.30 – $123.20 | 17 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $357.60 | $596.00 | $27.39 – $476.80 | 17 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $508.20 | $847.00 | $27.39 – $677.60 | 17 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $205.80 | $343.00 | $13.62 – $274.40 | 17 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $293.40 | $489.00 | $13.20 – $391.20 | 17 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $149.40 | $249.00 | $8.79 – $199.20 | 17 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $149.40 | $249.00 | $13.36 – $199.20 | 17 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $466.20 | $777.00 | $22.55 – $621.60 | 17 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $259.80 | $433.00 | $13.48 – $329.60 | 17 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $491.40 | $819.00 | $14.82 – $655.20 | 17 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $197.40 | $329.00 | $20.57 – $263.20 | 17 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $364.20 | $607.00 | $20.57 – $485.60 | 17 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | $978.60 | $1,631.00 | $34.10 – $1,304.80 | 16 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $187.80 | $313.00 | $12.54 – $250.40 | 17 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $427.20 | $712.00 | $11.84 – $569.60 | 17 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $660.60 | $1,101.00 | $34.68 – $880.80 | 17 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $457.20 | $762.00 | $30.88 – $609.60 | 17 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $54.00 | $90.00 | $27.39 – $72.00 | 17 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $290.40 | $484.00 | $34.10 – $387.20 | 16 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $505.20 | $842.00 | $42.34 – $673.60 | 17 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $669.00 | $1,115.00 | $63.52 – $892.00 | 17 |
| Mayo infliximab therapeutic drug level CPT 80230 | $196.20 | $327.00 | $30.12 – $261.60 | 17 |
| Mayo inhab inhibin a CPT 86336 | $127.80 | $213.00 | $12.17 – $170.40 | 17 |
| Mayo insft insulin free CPT 83527 | $117.00 | $195.00 | $12.80 – $156.00 | 17 |
| Mayo insulin antibodies CPT 86337 | $197.40 | $329.00 | $12.10 – $263.20 | 17 |
| Mayo iodine CPT 83789 | $202.20 | $337.00 | $18.83 – $256.80 | 17 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $208.20 | $347.00 | $23.86 – $277.60 | 17 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $205.80 | $343.00 | $21.17 – $274.40 | 17 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $330.60 | $551.00 | $13.09 – $440.80 | 17 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $37.20 | $62.00 | $12.10 – $49.60 | 17 |
| Mayo legionella antibody CPT 86713 | $394.20 | $657.00 | $15.12 – $525.60 | 17 |
| Mayo lipoprotein electrophoresis CPT 83700 | $261.00 | $435.00 | $11.13 – $348.00 | 17 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $234.00 | $390.00 | $15.31 – $312.00 | 17 |
| Mayo manganese CPT 83785 | $83.40 | $139.00 | $20.81 – $111.20 | 17 |
| Mayo metanephrines plasma CPT 83835 | $316.80 | $528.00 | $14.30 – $422.40 | 17 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $235.20 | $392.00 | $11.91 – $313.60 | 17 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $235.20 | $392.00 | $16.19 – $313.60 | 16 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $219.60 | $366.00 | $8.70 – $292.80 | 17 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $205.80 | $343.00 | $16.83 – $274.40 | 17 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $3,829.20 | $6,382.00 | $106.97 – $390.40 | 17 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $710.40 | $1,184.00 | $144.60 – $671.20 | 17 |
| Mayo muramidase CPT 85549 | $248.40 | $414.00 | $18.08 – $331.20 | 17 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $235.20 | $392.00 | $18.18 – $313.60 | 16 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $202.20 | $337.00 | $17.84 – $269.60 | 17 |
| Mayo myoglobin CPT 83874 | $364.20 | $607.00 | $12.77 – $485.60 | 17 |
| Mayo nickel CPT 83885 | $269.40 | $449.00 | $12.10 – $359.20 | 17 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $606.00 | $1,010.00 | $20.02 – $808.00 | 17 |
| Mayo oxalate 24 hour urine CPT 83945 | $52.20 | $87.00 | $14.28 – $66.40 | 17 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $130.80 | $218.00 | $11.39 – $174.40 | 17 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $365.40 | $609.00 | $14.85 – $487.20 | 17 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $132.60 | $221.00 | $11.91 – $176.80 | 17 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $177.60 | $296.00 | $34.68 – $236.80 | 17 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $232.20 | $387.00 | $17.78 – $309.60 | 17 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $77.40 | $129.00 | $13.60 – $103.20 | 17 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $250.20 | $417.00 | $2.20 – $333.60 | 17 |
| Mayo pregnenolone CPT 84140 | $352.20 | $587.00 | $20.43 – $469.60 | 17 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $107.40 | $179.00 | $16.40 – $136.00 | 17 |
| Mayo proinsulin CPT 84206 | $435.60 | $726.00 | $8.80 – $580.80 | 17 |
| Mayo psaft prostate specific antigen free CPT 84154 | $421.20 | $702.00 | $18.17 – $561.60 | 17 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $323.40 | $539.00 | $14.36 – $313.60 | 17 |
| Mayo receptor assay transferrin soluble CPT 84238 | $579.00 | $965.00 | $24.20 – $772.00 | 17 |
| Mayo renin CPT 84244 | $184.20 | $307.00 | $13.20 – $245.60 | 17 |
| Mayo repu protein electrophoresis urine CPT 84166 | $219.60 | $366.00 | $17.62 – $292.80 | 17 |
| Mayo selenium CPT 84255 | $150.60 | $251.00 | $19.93 – $200.80 | 17 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | $168.00 | $280.00 | $12.11 – $224.00 | 17 |
| Mayo serotonin CPT 84260 | $631.20 | $1,052.00 | $30.62 – $841.60 | 17 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $85.20 | $142.00 | $19.13 – $113.60 | 17 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $280.80 | $468.00 | $13.56 – $374.40 | 17 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $491.40 | $819.00 | $221.13 – $737.10 | 13 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $40.80 | $68.00 | $4.22 – $51.20 | 17 |
| Mayo tau phosphorylated 217 each CPT 84393 | $259.80 | $433.00 | $116.91 – $389.70 | 13 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $1,216.80 | $2,028.00 | $163.12 – $1,108.00 | 17 |
| Mayo tgrp testosterone free CPT 84402 | $72.00 | $120.00 | $25.17 – $96.00 | 17 |
| Mayo tgrp testosterone total CPT 84403 | $184.20 | $307.00 | $25.52 – $245.60 | 17 |
| Mayo thyroglobulin CPT 84432 | $184.20 | $307.00 | $15.88 – $245.60 | 17 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $97.80 | $163.00 | $10.06 – $130.40 | 17 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $121.80 | $203.00 | $9.68 – $162.40 | 17 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $147.60 | $246.00 | $13.99 – $196.80 | 17 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $183.60 | $306.00 | $13.38 – $244.80 | 17 |
| Mayo vasoactive intestinal peptide CPT 84586 | $375.60 | $626.00 | $34.92 – $500.80 | 17 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $251.40 | $419.00 | $8.80 – $335.20 | 17 |
| Mayo vitamin b3 (niacin) CPT 84591 | $234.00 | $390.00 | $13.32 – $312.00 | 17 |
| Mayo vitamin k CPT 84597 | $320.40 | $534.00 | $10.71 – $427.20 | 17 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $307.80 | $513.00 | $13.09 – $410.40 | 17 |
| Measurement post void urine by ultrasound CPT 51798 | $130.20 | $217.00 | $15.48 – $173.60 | 17 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $3,637.80 | $6,063.00 | $1.62 – $5.40 | 14 |
| Megestrol 20 mg tabs 100 each bottle HCPCS S0179 | $4.20 | $5.25 | $0.41 – $1.35 | 14 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | $114,657.00 | $191,095.00 | $17,198.46 – $57,328.20 | 14 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $28.20 | $47.00 | $3.24 – $15.69 | 16 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $102.40 | $128.00 | $31.27 – $115.20 | 17 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $27.40 | $34.25 | $0.42 – $8.10 | 16 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $40.80 | $51.00 | $1.86 – $45.90 | 16 |
| Metabolic Blood Panel (Basic) CPT 80048 | $186.60 | $311.00 | $8.36 – $248.80 | 17 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $215.40 | $359.00 | $10.43 – $287.20 | 17 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $230.40 | $384.00 | $1.75 – $6.08 | 16 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $78.20 | $97.75 | $4.79 – $87.30 | 16 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $332.00 | $415.00 | $2.82 – $26.10 | 16 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $38.60 | $48.25 | $0.19 – $43.20 | 16 |
| Methotrexate therapeutic drug level CPT 80204 | $438.60 | $731.00 | $30.12 – $584.80 | 17 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $12.00 | $15.00 | $4.07 – $13.50 | 17 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $53.00 | $66.25 | $17.82 – $59.40 | 16 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $504.60 | $841.00 | $1.62 – $5.40 | 14 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $9.00 | $11.25 | $0.11 – $9.90 | 16 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $1.60 | $2.00 | $0.12 – $0.90 | 17 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $4.60 | $5.75 | $0.14 – $0.45 | 17 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $5.40 | $6.75 | $1.08 – $5.40 | 16 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $1.20 | $2.00 | $0.12 – $1.80 | 16 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $0.20 | $0.25 | $0.03 – $0.23 | 16 |
| Mgmt promoter methylation analysis CPT 81287 | $980.40 | $1,634.00 | $91.31 – $292.80 | 17 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $5.80 | $7.25 | $0.26 – $6.30 | 16 |
| Microdissection manual CPT 88381 | $1,058.40 | $1,764.00 | $141.03 – $1,411.20 | 15 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | $1,822.80 | $3,038.00 | $171.72 – $2,430.40 | 15 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $11.00 | $13.75 | $0.15 – $0.90 | 16 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $15.20 | $19.00 | $1.45 – $17.10 | 16 |
| Minocycline hydrochloride HCPCS J2265 | $403.80 | $673.00 | $1.63 – $5.40 | 17 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | $129.00 | $215.00 | $58.31 – $193.50 | 17 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $1,680.80 | $2,101.00 | $20.35 – $241.20 | 17 |
| Mitomycin instillation HCPCS J9281 | $818.40 | $1,023.00 | $277.44 – $920.70 | 17 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $390.40 | $488.00 | $23.88 – $438.30 | 17 |
| Mlh1 gene CPT 81288 | $1,549.80 | $2,583.00 | $150.17 – $1,400.00 | 17 |
| Mlh1 gene dup/delete variant CPT 81294 | $1,438.80 | $2,398.00 | $167.79 – $1,918.40 | 17 |
| Mlh1 gene full seq CPT 81292 | $399.00 | $665.00 | $251.37 – $729.43 | 17 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $140.80 – $1,632.61 | 12 |
| Mnpj elbow under anes CPT 24300 | $4,107.00 | $6,845.00 | $298.64 – $5,476.00 | 17 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $25.20 | $42.00 | $10.60 – $37.80 | 17 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $12,083.40 | $20,139.00 | $2,406.80 – $10,830.60 | 14 |
| Monovisc inj per dose HCPCS J7327 | $2,835.00 | $4,725.00 | $636.59 – $4,252.50 | 17 |
| Mopath procedure level 1 CPT 81400 | $1,434.60 | $2,391.00 | $49.95 – $393.60 | 17 |
| Mopath procedure level 3 CPT 81402 | $1,314.60 | $2,191.00 | $117.38 – $535.20 | 17 |
| Mopath procedure level 5 CPT 81404 | $3,033.60 | $5,056.00 | $214.59 – $633.60 | 17 |
| Mopath procedure level 6 CPT 81405 | $5,054.40 | $8,424.00 | $177.28 – $375.20 | 17 |
| Mopath procedure level 7 CPT 81406 | $8,008.80 | $13,348.00 | $60.48 – $305.48 | 17 |
| Mopath procedure level 8 CPT 81407 | $1,672.20 | $2,787.00 | $377.24 – $913.89 | 17 |
| Mopath procedure level 9 CPT 81408 | $4,017.00 | $6,695.00 | $1,203.55 – $2,547.20 | 17 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $61.40 | $76.75 | $5.40 – $18.00 | 16 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $41.60 | $52.00 | $1.62 – $5.40 | 16 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $322.80 | $538.00 | $151.72 – $430.40 | 17 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $599.40 | $999.00 | $79.54 – $799.20 | 17 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $868.80 | $1,448.00 | $45.41 – $1,158.40 | 17 |
| Mpl gene analysis common variants CPT 81338 | $1,170.00 | $1,950.00 | $117.38 – $1,560.00 | 17 |
| Mr safety determination physician/other qhp CPT 76016 | $160.20 | $267.00 | $65.26 – $213.60 | 16 |
| Mr safety implant elec prepj CPT 76018 | $166.80 | $278.00 | $75.06 – $222.40 | 16 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $44.40 | $74.00 | $9.61 – $59.20 | 16 |
| Mr sfty med physics xm cstmz CPT 76017 | $439.80 | $733.00 | $197.91 – $586.40 | 16 |
| Msh2 gene dup/delete variant CPT 81297 | $1,824.00 | $3,040.00 | $133.51 – $1,918.40 | 17 |
| Msh2 gene full seq CPT 81295 | $1,824.00 | $3,040.00 | $133.51 – $532.00 | 17 |
| Msh6 gene dup/delete variant CPT 81300 | $1,971.00 | $3,285.00 | $142.27 – $1,918.40 | 17 |
| Msh6 gene full seq CPT 81298 | $1,971.00 | $3,285.00 | $251.37 – $634.35 | 17 |
| Msh6 gene known variants CPT 81299 | $235.80 | $393.00 | $141.89 – $325.64 | 17 |
| Mthfr gene analy common variants CPT 81291 | $334.80 | $558.00 | $51.02 – $446.40 | 17 |
| Mucopolysaccharides CPT 83864 | $280.80 | $468.00 | $19.80 – $374.40 | 17 |
| Multiple sleep latency test CPT 95805 | $4,393.20 | $7,322.00 | $257.69 – $5,857.60 | 17 |
| Mumps antibody igg CPT 86735 | $285.60 | $476.00 | $10.19 – $380.80 | 17 |
| Muscle test cran nerv unilat CPT 95867 | $235.20 | $392.00 | $19.20 – $313.60 | 17 |
| Muscle test larynx CPT 95865 | $324.60 | $541.00 | $22.86 – $432.80 | 17 |
| Mycobacteria dna amp probe CPT 87551 | $468.00 | $780.00 | $37.67 – $624.00 | 17 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $79.60 | $99.50 | $0.16 – $6.30 | 16 |
| Mycoplasma antibody igm CPT 86738 | $581.40 | $969.00 | $13.08 – $775.20 | 17 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $888.60 | $1,481.00 | $136.95 – $436.00 | 17 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $4,064.40 | $6,774.00 | $114.50 – $5,419.20 | 17 |
| Myelography via inj w/s&i cervical CPT 62302 | $3,476.40 | $5,794.00 | $111.12 – $4,635.20 | 17 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $3,447.00 | $5,745.00 | $109.28 – $4,596.00 | 17 |
| Myelography via inj w/s&i thoracic CPT 62303 | $2,874.60 | $4,791.00 | $112.58 – $3,832.80 | 17 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $126.00 | $210.00 | $9.00 – $168.00 | 17 |
| N block inj hypogas plxs CPT 64517 | $2,191.80 | $3,653.00 | $115.47 – $2,922.40 | 17 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $1.80 | $2.25 | $0.05 – $1.80 | 16 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $14.40 | $18.00 | $3.70 – $16.20 | 16 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $1.20 | $2.00 | $0.08 – $1.80 | 16 |
| Naltrexone, depot form HCPCS J2315 | $7,275.00 | $12,125.00 | $4.24 – $28.80 | 17 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $3,435.60 | $5,726.00 | $64.75 – $4,580.80 | 17 |
| Nasal endoscopy with removal of nasal foreign body CPT 30999 | $135.00 | $225.00 | $89.53 – $239.08 | 16 |
| Nasopharyngoscopy w/endoscope CPT 92511 | $365.40 | $609.00 | $133.62 – $487.20 | 17 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | $28,621.80 | $47,703.00 | $24.00 – $144.00 | 17 |
| Natriuretic peptide CPT 83880 | $342.00 | $570.00 | $38.79 – $456.00 | 17 |
| Natural killer cells total count CPT 86357 | $112.80 | $188.00 | $37.28 – $150.40 | 17 |
| Navigational bronchoscopy 31627 CPT 31627 | $5,596.80 | $9,328.00 | $74.09 – $7,462.40 | 15 |
| Ndl emg musc 1 xtr/non-limb CPT 95870 | $359.40 | $599.00 | $22.09 – $479.20 | 17 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $3,574.80 | $5,958.00 | $171.38 – $4,766.40 | 17 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $3,176.40 | $5,294.00 | $120.32 – $4,235.20 | 17 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $2,108.40 | $3,514.00 | $102.37 – $2,811.20 | 17 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $3,867.60 | $6,446.00 | $343.82 – $5,156.80 | 17 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $2,941.20 | $4,902.00 | $343.82 – $3,921.60 | 17 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $2,424.00 | $4,040.00 | $232.71 – $3,232.00 | 17 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $3,826.20 | $6,377.00 | $343.82 – $5,101.60 | 17 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $3,207.00 | $5,345.00 | $342.28 – $4,276.00 | 17 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,366.40 | $3,944.00 | $232.71 – $3,155.20 | 17 |
| Neisseria meningitidis CPT 86741 | $139.80 | $233.00 | $10.30 – $186.40 | 17 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $213.00 | $355.00 | $4.59 – $15.30 | 14 |
| Neurolysis celiac plexus CPT 64680 | $4,170.00 | $6,950.00 | $80.85 – $5,560.00 | 17 |
| New Patient Office Visit (level 2) CPT 99202 | $250.80 | $418.00 | $38.86 – $334.40 | 17 |
| New Patient Office Visit (level 3) CPT 99203 | $327.00 | $545.00 | $41.85 – $139.50 | 17 |
| New Patient Office Visit (level 4) CPT 99204 | $421.20 | $702.00 | $41.85 – $219.29 | 17 |
| New Patient Office Visit (level 5) CPT 99205 | $589.80 | $983.00 | $41.85 – $264.44 | 17 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $3.00 | $3.75 | $0.07 – $2.70 | 16 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $4.00 | $5.00 | $1.35 – $4.50 | 16 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $162.40 | $203.00 | $32.96 – $182.70 | 17 |
| Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 | $375.60 | $626.00 | $169.77 – $563.40 | 17 |
| Njx aa&/strd lmbr plex nfs CPT 64449 | $1,816.80 | $3,028.00 | $107.08 – $2,422.40 | 17 |
| Njx aa&/strd nrv nrvtg si jt CPT 64451 | $727.20 | $1,212.00 | $249.25 – $969.60 | 17 |
| Njx aa&/strd sc nrv nfs img CPT 64446 | $1,963.80 | $3,273.00 | $90.60 – $2,618.40 | 17 |
| Njx interlaminar crv/thrc CPT 62324 | $3,015.60 | $5,026.00 | $83.56 – $4,020.80 | 17 |
| Njx interlaminar lmbr/sac CPT 62326 | $637.80 | $1,063.00 | $81.77 – $993.28 | 17 |
| Njx interlaminar lmbr/sac CPT 62327 | $913.80 | $1,523.00 | $87.09 – $1,218.40 | 17 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $845.40 | $1,409.00 | $560.64 – $1,127.20 | 17 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,684.80 | $2,808.00 | $152.32 – $2,246.40 | 17 |
| Nm imaging bone/joint whole body CPT 78306 | $1,474.20 | $2,457.00 | $78.72 – $1,965.60 | 17 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $1,651.20 | $2,752.00 | $78.08 – $2,201.60 | 17 |
| Nm imaging gastric emptying study CPT 78264 | $1,510.20 | $2,517.00 | $126.72 – $2,013.60 | 17 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,691.40 | $2,819.00 | $49.92 – $2,255.20 | 17 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,956.60 | $3,261.00 | $364.11 – $2,608.80 | 17 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,658.40 | $2,764.00 | $88.32 – $2,211.20 | 17 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $2,217.00 | $3,695.00 | $254.48 – $2,956.00 | 17 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $1,494.00 | $2,490.00 | $196.58 – $1,992.00 | 17 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $944.40 | $1,574.00 | $48.37 – $1,259.20 | 17 |
| Npm1 gene CPT 81310 | $2,101.20 | $3,502.00 | $216.94 – $1,235.20 | 17 |
| Nr lnr acclrtr tx max 5 sessions CPT 77373 | $6,205.80 | $10,343.00 | $1,100.00 – $8,274.40 | 17 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $2,570.40 | $4,284.00 | $312.94 – $3,855.60 | 16 |
| Ntsty modul rad tx dlvr smpl CPT 77385 | $2,393.40 | $3,989.00 | $295.68 – $3,590.10 | 16 |
| Nuclear Stress Test (Heart) CPT 78452 | $4,206.60 | $7,011.00 | $356.28 – $5,608.80 | 17 |
| Nuclear rx IV admin CPT 79101 | $2,610.00 | $4,350.00 | $47.65 – $3,480.00 | 17 |
| Nuclear rx intra-arterial CPT 79445 | $666.00 | $1,110.00 | $195.00 – $888.00 | 17 |
| Nudt15 gene common variants CPT 81306 | $472.80 | $788.00 | $227.49 – $630.40 | 17 |
| Nushield 1 square cm HCPCS Q4160 | $312.00 | $520.00 | $104.00 – $468.00 | 14 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $300.60 | $501.00 | $79.00 – $450.90 | 17 |
| Observation direct referral from physician office for admission HCPCS G0379 | $117.00 | $195.00 | $77.59 – $631.28 | 15 |
| Observation per hour HCPCS G0378 | $176.40 | $294.00 | $79.38 – $1,372.04 | 13 |
| Obstetrical care 59410 CPT 59410 | $1,012.80 | $1,688.00 | $455.76 – $2,671.44 | 15 |
| Obtaining screen pap smear HCPCS Q0091 | $13.80 | $23.00 | $8.69 – $25.22 | 16 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $220.80 | $368.00 | $0.61 – $16.20 | 16 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $1,886.40 | $2,405.00 | $203.58 – $1,417.50 | 17 |
| Oil silicone ophth 8.5ml silikon 1000 HCPCS C1814 | $1,824.80 | $2,281.00 | $615.87 – $2,052.90 | 13 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $12.80 | $16.00 | $0.87 – $14.40 | 16 |
| Oncoprotein dcp CPT 83951 | $861.60 | $1,436.00 | $63.66 – $1,148.80 | 17 |
| Ondansetron 4 mg s0119 HCPCS S0119 | $136.80 | $171.00 | $46.17 – $153.90 | 14 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $25.20 | $42.00 | $0.01 – $37.80 | 15 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $27.40 | $34.25 | $0.09 – $30.60 | 16 |
| Opn tx orbit fx w/implant CPT 21407 | not published | not published | $993.28 – $6,091.06 | 11 |
| Optx clavicular fx w/int fix CPT 23515 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | $7,589.40 | $12,649.00 | $440.00 – $10,119.20 | 17 |
| Optx medial ankle fx CPT 27766 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Optx palatal/max fracture CPT 21422 | not published | not published | $581.76 – $6,091.06 | 11 |
| Optx post ankle fx CPT 27769 | $6,855.00 | $11,425.00 | $971.71 – $9,140.00 | 17 |
| Optx prox humrl fx w/int fix CPT 23615 | $6,347.40 | $10,579.00 | $520.30 – $8,463.20 | 17 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | $4,493.40 | $7,489.00 | $331.10 – $5,991.20 | 17 |
| Optx radial shaft fracture CPT 25515 | $5,152.80 | $8,588.00 | $396.00 – $6,870.40 | 17 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | $6,347.40 | $10,579.00 | $993.28 – $8,463.20 | 17 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | $5,152.80 | $8,588.00 | $474.10 – $6,870.40 | 17 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Optx scapular fx w/int fixj CPT 23585 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Optx ulnar shft fx int fixj CPT 25545 | $5,152.80 | $8,588.00 | $374.00 – $6,870.40 | 17 |
| Optx ulnar styloid fracture CPT 25652 | $6,492.00 | $10,820.00 | $993.28 – $8,656.00 | 17 |
| Oral aprepitant HCPCS J8501 | $1,012.80 | $1,688.00 | $2.73 – $95.40 | 16 |
| Oral everolimus HCPCS J7527 | $1,152.00 | $1,920.00 | $1.37 – $1,728.00 | 16 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $897.28 – $3,633.70 | 11 |
| Organic acids total quant ea spec CPT 83918 | $277.20 | $462.00 | $23.32 – $369.60 | 17 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $447.20 | $559.00 | $28.68 – $503.10 | 17 |
| Oropharyngeal biopsy 42800 CPT 42800 | $836.40 | $1,394.00 | $59.95 – $1,115.20 | 17 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $61.00 | $76.25 | $11.19 – $68.40 | 16 |
| Orthovisc inj per dose HCPCS J7324 | $903.60 | $1,506.00 | $114.54 – $1,355.40 | 17 |
| Oscillation chest wall mechanical per session CPT 94669 | $128.40 | $214.00 | $45.93 – $209.40 | 17 |
| Osmolality blood CPT 83930 | $111.00 | $185.00 | $3.30 – $148.00 | 17 |
| Osmolality urine CPT 83935 | $108.00 | $180.00 | $3.30 – $144.00 | 17 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | $19.20 | $32.00 | $12.73 – $94.06 | 17 |
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | $19.20 | $32.00 | $12.73 – $116.19 | 17 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | $19.20 | $32.00 | $12.73 – $134.04 | 17 |
| Ot evaluation high complexity patient/family CPT 97167 | $197.40 | $329.00 | $79.01 – $263.20 | 15 |
| Ot evaluation low complexity patient/family CPT 97165 | $197.40 | $329.00 | $79.01 – $263.20 | 15 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $197.40 | $329.00 | $32.42 – $263.20 | 15 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $150.60 | $251.00 | $42.07 – $200.80 | 15 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $103.20 | $172.00 | $38.37 – $137.60 | 15 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $130.20 | $217.00 | $23.13 – $173.60 | 17 |
| Ot re-evaluation patient/family CPT 97168 | $97.20 | $162.00 | $43.74 – $129.60 | 17 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $130.20 | $217.00 | $14.30 – $173.60 | 17 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $106.20 | $177.00 | $20.32 – $141.60 | 17 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $106.20 | $177.00 | $20.95 – $141.60 | 17 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $130.20 | $217.00 | $9.22 – $173.60 | 17 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $130.20 | $217.00 | $18.43 – $173.60 | 17 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $103.20 | $172.00 | $25.93 – $137.60 | 15 |
| Oth resp proc, group HCPCS G0239 | $391.80 | $653.00 | $26.52 – $587.70 | 16 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $13.20 | $16.50 | $0.08 – $14.40 | 16 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $29.00 | $36.25 | $9.72 – $32.40 | 14 |
| PSA (Prostate) Test CPT 84153 | $198.00 | $330.00 | $18.17 – $264.00 | 17 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $2.40 | $4.00 | $0.14 – $0.90 | 16 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $61.80 | $103.00 | $10.54 – $92.70 | 17 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $54.40 | $68.00 | $14.37 – $47.70 | 17 |
| Palonosetron hcl HCPCS J2469 | $378.60 | $631.00 | $0.36 – $56.70 | 16 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $450.00 | $750.00 | $9.64 – $225.00 | 16 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $550.80 | $918.00 | $173.03 – $826.20 | 17 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $30.80 | $38.50 | $8.37 – $27.90 | 14 |
| Papaverin hcl injection HCPCS J2440 | $264.80 | $331.00 | $89.37 – $297.90 | 14 |
| Parathormone (pth) intact CPT 83970 | $188.40 | $314.00 | $40.80 – $251.20 | 17 |
| Parathyrd planar w/spect&ct CPT 78072 | $2,233.80 | $3,723.00 | $330.43 – $3,350.70 | 16 |
| Parathyroid planar imaging CPT 78070 | $1,859.40 | $3,099.00 | $80.00 – $2,479.20 | 17 |
| Paricalcitol HCPCS J2501 | $26.40 | $44.00 | $0.95 – $20.70 | 16 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $230.40 | $384.00 | $22.00 – $993.28 | 17 |
| Part removal of metatarsal CPT 28110 | $5,397.60 | $8,996.00 | $293.11 – $7,196.80 | 17 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | $5,397.60 | $8,996.00 | $288.75 – $7,196.80 | 17 |
| Partial removal finger bone CPT 26236 | $5,465.40 | $9,109.00 | $302.50 – $7,287.20 | 17 |
| Partial removal of foot bone CPT 28288 | $5,397.60 | $8,996.00 | $271.15 – $7,196.80 | 17 |
| Partial removal of toe CPT 28160 | $5,397.60 | $8,996.00 | $781.95 – $7,196.80 | 15 |
| Passy muir valve metal trach HCPCS L8501 | $289.80 | $483.00 | $96.00 – $386.40 | 16 |
| Path clin consltj mod 21-40 CPT 80504 | $431.40 | $719.00 | $54.71 – $575.20 | 17 |
| Path clin consltj sf 5-20 CPT 80503 | $190.20 | $317.00 | $27.31 – $253.60 | 17 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $12,717.60 | $21,196.00 | $89.34 – $1,589.40 | 17 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $2,015.20 | $2,519.00 | $106.33 – $2,267.10 | 17 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $645.60 | $1,076.00 | $184.91 – $968.40 | 17 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $2,014.80 | $3,358.00 | $99.13 – $1,164.60 | 17 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $11,823.60 | $19,706.00 | $3,660.83 – $17,735.40 | 17 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | $548.00 | $685.00 | $185.77 – $616.50 | 17 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,533.80 | $4,223.00 | $131.20 – $3,378.40 | 17 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,902.00 | $3,170.00 | $110.72 – $2,536.00 | 17 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,313.40 | $2,189.00 | $86.40 – $1,751.20 | 17 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| Pelvic MRI (with contrast) CPT 72196 | $3,051.00 | $5,085.00 | $260.35 – $4,068.00 | 17 |
| Pelvic MRI (without contrast) CPT 72195 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| Pelvic Ultrasound (complete) CPT 76856 | $732.00 | $1,220.00 | $59.52 – $976.00 | 17 |
| Pelvic Ultrasound (limited) CPT 76857 | $718.80 | $1,198.00 | $24.32 – $958.40 | 17 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $287.20 | $359.00 | $60.29 – $323.10 | 17 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $3,134.40 | $5,224.00 | $4.36 – $469.80 | 17 |
| Peng benzathine/procaine inj HCPCS J0558 | $48.00 | $80.00 | $19.52 – $72.00 | 17 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,422.60 | $2,371.00 | $21.70 – $72.00 | 17 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $222.60 | $371.00 | $0.79 – $9.00 | 16 |
| Pentobarbital sodium inj HCPCS J2515 | $8.00 | $10.00 | $2.70 – $9.00 | 14 |
| Perc cryo ablate renal tum CPT 50593 | $51,594.60 | $85,991.00 | $7,000.76 – $68,792.80 | 17 |
| Perc d-e cor revasc chro add HCPCS C9608 | $2,265.60 | $3,776.00 | $1,019.52 – $3,398.40 | 13 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $12,224.40 | $20,374.00 | $5,500.98 – $18,336.60 | 14 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $2,265.60 | $3,776.00 | $1,019.52 – $3,398.40 | 13 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $12,224.40 | $20,374.00 | $5,500.98 – $18,336.60 | 14 |
| Perc d-e cor stent ather br HCPCS C9603 | $2,265.60 | $3,776.00 | $1,019.52 – $3,398.40 | 13 |
| Perc d-e cor stent ather s HCPCS C9602 | $12,224.40 | $20,374.00 | $5,500.98 – $18,336.60 | 14 |
| Perc drug-el cor stent bran HCPCS C9601 | $1,388.40 | $2,314.00 | $624.78 – $2,082.60 | 13 |
| Perc drug-el cor stent sing HCPCS C9600 | $7,905.00 | $13,175.00 | $3,557.25 – $11,857.50 | 14 |
| Perc rf ablate renal tumor CPT 50592 | $64,293.00 | $107,155.00 | $993.28 – $85,724.00 | 17 |
| Percut ablate liver rf CPT 47382 | $9,892.80 | $16,488.00 | $702.83 – $13,190.40 | 17 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $1,066.20 | $1,777.00 | $40.65 – $799.20 | 15 |
| Peri-proc device eval pm CPT 93286 | $243.60 | $406.00 | $25.14 – $324.80 | 15 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,461.80 | $4,103.00 | $213.32 – $3,282.40 | 17 |
| Perq dev breast 1st strtctc CPT 19283 | $1,793.40 | $2,989.00 | $91.72 – $2,391.20 | 17 |
| Perq plmt bile duct stent CPT 47538 | $20,625.60 | $34,376.00 | $295.36 – $27,500.80 | 17 |
| Perq plmt bile duct stent CPT 47540 | $24,524.40 | $40,874.00 | $476.83 – $32,699.20 | 17 |
| Perq skel fix rad/uln dislc CPT 25671 | $3,519.00 | $5,865.00 | $867.45 – $4,692.00 | 17 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | $4,493.40 | $7,489.00 | $443.77 – $5,991.20 | 17 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | $324.60 | $541.00 | $62.10 – $350.10 | 17 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $55.20 | $92.00 | $17.02 – $80.10 | 17 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $87.00 | $145.00 | $39.15 – $130.50 | 14 |
| Pet CT skull-mid thgh initial CPT 78815 | $6,981.60 | $11,636.00 | $1,404.22 – $10,472.40 | 16 |
| Pet CT whole body initial CPT 78816 | $6,981.60 | $11,636.00 | $1,404.22 – $10,472.40 | 16 |
| Pet image skull-thigh CPT 78812 | $7,438.80 | $12,398.00 | $1,404.22 – $11,158.20 | 16 |
| Pet image w/ct lmtd CPT 78814 | $6,981.60 | $11,636.00 | $1,404.22 – $10,472.40 | 16 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $23,848.80 | $39,748.00 | $19.00 – $85.50 | 14 |
| Ph body fluid CPT 83986 | $39.60 | $66.00 | $2.20 – $52.80 | 17 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $193.20 | $322.00 | $22.95 – $76.50 | 16 |
| Phenobarbital therapeutic drug level CPT 80184 | $163.80 | $273.00 | $15.12 – $208.00 | 17 |
| Phentolaine mesylate inj HCPCS J2760 | $1,124.00 | $1,405.00 | $381.04 – $1,264.50 | 17 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $0.05 | $0.06 | $0.00 – $0.01 | 16 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $300.00 | $500.00 | $0.45 – $4.50 | 16 |
| Phenytoin total therapeutic drug level CPT 80185 | $114.00 | $190.00 | $13.09 – $152.00 | 17 |
| Phlebotomy therapeutic CPT 99195 | $193.20 | $322.00 | $11.00 – $257.60 | 17 |
| Phosphorus CPT 84100 | $70.80 | $118.00 | $4.69 – $94.40 | 17 |
| Phosphorus 24 hour urine CPT 84105 | $75.00 | $125.00 | $5.71 – $100.00 | 17 |
| Phys blood bank serv reactj CPT 86078 | $398.40 | $664.00 | $45.72 – $531.20 | 17 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $111.20 | $139.00 | $2.73 – $22.50 | 16 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $1,119.00 | $1,865.00 | $335.70 – $1,678.50 | 15 |
| Pin caspar distraction 12mm HCPCS C1821 | $33,127.20 | $55,212.00 | $1,786.00 – $8,037.00 | 14 |
| Pin finger fracture each CPT 26756 | not published | not published | $156.20 – $3,309.88 | 12 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $108.60 | $181.00 | $1.07 – $40.50 | 16 |
| Place cecostomy tube perc CPT 49442 | $11,644.80 | $19,408.00 | $993.28 – $15,526.40 | 17 |
| Place gastrostomy tube perc CPT 49440 | $402.60 | $671.00 | $194.19 – $1,670.96 | 17 |
| Place slctv cath carotd art uni CPT 36224 | $8,365.80 | $13,943.00 | $993.28 – $11,154.40 | 17 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $7,552.20 | $12,587.00 | $993.28 – $10,069.60 | 17 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $8,367.00 | $13,945.00 | $277.61 – $11,156.00 | 17 |
| Place slctv cath subclavian art CPT 36225 | $7,476.00 | $12,460.00 | $276.45 – $4,984.00 | 17 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,141.20 | $1,902.00 | $90.85 – $1,521.60 | 17 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $1,141.20 | $1,902.00 | $43.26 – $1,521.60 | 17 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $946.80 | $1,578.00 | $77.78 – $1,262.40 | 17 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $4,370.40 | $7,284.00 | $993.28 – $5,827.20 | 17 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $2,893.80 | $4,823.00 | $993.28 – $4,340.70 | 14 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $4,478.40 | $7,464.00 | $420.05 – $5,971.20 | 17 |
| Platelet aggregation each agent teg CPT 85576 | $385.80 | $643.00 | $24.62 – $514.40 | 17 |
| Platelet automated CPT 85049 | $35.40 | $59.00 | $3.30 – $47.20 | 17 |
| Platelet pheresis each unit HCPCS P9034 | $1,141.20 | $1,902.00 | $260.76 – $1,711.80 | 16 |
| Platelets each unit HCPCS P9019 | $110.40 | $184.00 | $33.00 – $165.60 | 17 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $2,713.80 | $4,523.00 | $379.20 – $4,070.70 | 16 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $2,893.20 | $4,822.00 | $498.30 – $4,339.80 | 16 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $1,791.00 | $2,985.00 | $451.21 – $2,686.50 | 16 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $946.80 | $1,578.00 | $37.38 – $1,262.40 | 17 |
| Plc pq device breast ea addl lesion stereo guide CPT 19284 | $1,619.40 | $2,699.00 | $43.55 – $2,159.20 | 17 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $2,475.00 | $4,125.00 | $274.65 – $3,300.00 | 17 |
| Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 | $2,525.40 | $4,209.00 | $168.81 – $3,590.19 | 17 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $4,370.40 | $7,284.00 | $993.28 – $5,827.20 | 17 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $4,370.40 | $7,284.00 | $993.28 – $5,827.20 | 17 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $234.00 | $390.00 | $38.96 – $312.00 | 17 |
| Plmt access bil tree sm bwl CPT 47541 | $6,321.60 | $10,536.00 | $253.59 – $8,428.80 | 17 |
| Plmt biliary drainage cath CPT 47534 | $2,475.00 | $4,125.00 | $364.49 – $3,300.00 | 17 |
| Plmt nephroureteral catheter CPT 50433 | $4,370.40 | $7,284.00 | $993.28 – $5,827.20 | 17 |
| Pm device progr eval dual CPT 93280 | $176.40 | $294.00 | $15.64 – $235.20 | 17 |
| Pm device progr eval multi CPT 93281 | $176.40 | $294.00 | $18.06 – $235.20 | 17 |
| Pm phone r-strip device eval CPT 93293 | $229.80 | $383.00 | $28.54 – $306.40 | 17 |
| Pms2 gene dup/delet variants CPT 81319 | $1,452.60 | $2,421.00 | $195.06 – $1,918.40 | 17 |
| Pms2 gene full seq analysis CPT 81317 | $3,158.40 | $5,264.00 | $251.37 – $800.04 | 17 |
| Pms2 known familial variants CPT 81318 | $235.80 | $393.00 | $148.55 – $349.96 | 17 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $268.20 | $447.00 | $25.77 – $357.60 | 17 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $348.80 | $436.00 | $117.43 – $389.70 | 17 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $6,491.40 | $10,819.00 | $662.62 – $8,655.20 | 17 |
| Positioner proc acufex leg acs HCPCS E0190 | $42.60 | $71.00 | $13.23 – $44.10 | 13 |
| Postpartum Care Only CPT 59430 | $67.80 | $113.00 | $30.51 – $235.78 | 15 |
| Potassium 24 hour urine CPT 84133 | $52.20 | $87.00 | $4.67 – $69.60 | 17 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $11.40 | $19.00 | $0.11 – $0.90 | 16 |
| Potassium serum/plasma/whole blood CPT 84132 | $39.60 | $66.00 | $4.70 – $52.80 | 17 |
| Pouch high output 2pc 50mm red HCPCS A4413 | $2.40 | $4.00 | $1.08 – $10.70 | 15 |
| Pq biliary strict dil s&i CPT 74363 | $3,042.00 | $5,070.00 | $119.97 – $4,056.00 | 17 |
| Pq dr cath chg w cont s&i CPT 75984 | $1,347.00 | $2,245.00 | $12.80 – $1,796.00 | 17 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $29,025.00 | $48,375.00 | $993.28 – $38,700.00 | 17 |
| Pq thr inj ext pse CPT 36002 | $730.80 | $1,218.00 | $113.66 – $974.40 | 17 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $7,009.80 | $11,683.00 | $993.28 – $9,346.40 | 17 |
| Pr application of long arm splint CPT 29105 | $471.00 | $785.00 | $36.85 – $993.28 | 17 |
| Pr application splint static short arm CPT 29125 | $471.00 | $785.00 | $28.60 – $628.00 | 17 |
| Pr biopsy skin punch single lesion CPT 11104 | $300.00 | $500.00 | $44.47 – $993.28 | 17 |
| Pr correction hammertoe CPT 28285 | $205.20 | $342.00 | $92.34 – $1,212.16 | 17 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $30.00 | $50.00 | $19.22 – $40.00 | 17 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $4,764.60 | $7,941.00 | $158.09 – $6,352.80 | 17 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $429.00 | $715.00 | $34.69 – $572.00 | 17 |
| Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 | $103.20 | $172.00 | $25.60 – $154.80 | 14 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $3,414.00 | $5,690.00 | $993.28 – $4,552.00 | 17 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $1,105.20 | $1,842.00 | $44.00 – $1,473.60 | 17 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $3,505.20 | $5,842.00 | $88.55 – $2,024.96 | 17 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $1,470.60 | $2,451.00 | $171.49 – $993.28 | 17 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $589.80 | $983.00 | $57.75 – $768.00 | 17 |
| Pr incision & drainage abscess simple/single CPT 10060 | $589.80 | $983.00 | $25.85 – $792.32 | 17 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $825.60 | $1,376.00 | $103.19 – $993.28 | 17 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $589.80 | $983.00 | $33.55 – $994.56 | 17 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | $93.00 | $155.00 | $61.67 – $224.03 | 17 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $164.40 | $274.00 | $10.89 – $219.20 | 17 |
| Pr removal drug delivery implant CPT 11982 | $1,602.00 | $2,670.00 | $101.56 – $993.28 | 17 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $247.20 | $412.00 | $33.00 – $622.08 | 17 |
| Pr removal intrauterine device CPT 58301 | $589.80 | $983.00 | $18.98 – $993.28 | 16 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $825.60 | $1,376.00 | $36.30 – $1,100.80 | 17 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $589.80 | $983.00 | $52.25 – $993.28 | 17 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $589.80 | $983.00 | $34.65 – $631.04 | 17 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $589.80 | $983.00 | $26.95 – $673.28 | 17 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $589.80 | $983.00 | $39.05 – $993.28 | 17 |
| Pr robotic surgical system HCPCS S2900 | not published | not published | not published | 0 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $2,172.00 | $3,620.00 | $269.64 – $2,896.00 | 17 |
| Prealbumin CPT 84134 | $114.00 | $190.00 | $14.42 – $152.00 | 17 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $13.80 | $23.00 | $0.23 – $6.30 | 16 |
| Prednisone 1 mg tablet HCPCS J7512 | $14.80 | $18.50 | $0.01 – $0.90 | 16 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $690.60 | $1,151.00 | $59.52 – $920.80 | 17 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $690.60 | $1,151.00 | $49.14 – $920.80 | 17 |
| Pregnancy associated plasma protein-a CPT 84163 | $158.40 | $264.00 | $14.88 – $211.20 | 17 |
| Prenatal Care Only (4-6 visits) CPT 59425 | $528.60 | $881.00 | $237.87 – $801.28 | 15 |
| Prenatal Care Only (7+ visits) CPT 59426 | $528.60 | $881.00 | $237.87 – $1,277.89 | 15 |
| Prep skin to 100cm2 other CPT 15004 | $5,034.60 | $8,391.00 | $537.67 – $6,712.80 | 17 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $5,034.60 | $8,391.00 | $445.52 – $6,712.80 | 17 |
| Pressure max expiratory/inspiratory CPT 94799 | $154.20 | $257.00 | $47.79 – $161.09 | 16 |
| Pressure velocity wire add ves CPT 93572 | $1,746.00 | $2,910.00 | $498.48 – $2,328.00 | 14 |
| Pretreat rbc absorption reference CPT 86978 | $98.40 | $164.00 | $26.52 – $147.60 | 16 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $187.80 | $313.00 | $95.78 – $281.70 | 16 |
| Prgr stim/pace a/iv drug CPT 93623 | $3,905.40 | $6,509.00 | $241.92 – $5,858.10 | 14 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $176.40 | $294.00 | $13.49 – $235.20 | 17 |
| Prgrmg dev eval scrms ip CPT 93285 | $225.00 | $375.00 | $12.42 – $300.00 | 17 |
| Prgrmg eval implantable dfb CPT 93282 | $176.40 | $294.00 | $16.18 – $235.20 | 17 |
| Prgrmg eval implantable dfb CPT 93283 | $225.00 | $375.00 | $18.60 – $300.00 | 17 |
| Prgrmg eval implantable dfb CPT 93284 | $225.00 | $375.00 | $21.29 – $300.00 | 17 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $5,352.00 | $8,920.00 | $993.28 – $18,487.43 | 17 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $5,352.00 | $8,920.00 | $172.71 – $7,136.00 | 15 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $5,730.60 | $9,551.00 | $1,137.24 – $3,790.80 | 13 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $533.60 | $667.00 | $180.89 – $600.30 | 17 |
| Procalcitonin CPT 84145 | $133.80 | $223.00 | $24.43 – $178.40 | 17 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $115.20 | $144.00 | $1.81 – $129.60 | 16 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | $3.00 | $5.00 | $1.35 – $4.50 | 14 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $3,156.60 | $5,261.00 | $26.81 – $4,208.80 | 17 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | $3,355.80 | $5,593.00 | $57.54 – $4,474.40 | 17 |
| Progesterone CPT 84144 | $268.20 | $447.00 | $18.70 – $357.60 | 17 |
| Prolactin CPT 84146 | $307.20 | $512.00 | $19.15 – $409.60 | 17 |
| Promethazine hcl injection HCPCS J2550 | $8.40 | $10.50 | $0.27 – $2.95 | 16 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $1.80 | $2.25 | $0.09 – $0.90 | 16 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $4.80 | $6.00 | $1.62 – $5.40 | 14 |
| Prostate biopsy, any mthd HCPCS G0416 | $97.80 | $163.00 | $61.61 – $370.35 | 16 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $115.20 | $192.00 | $1.75 – $6.30 | 16 |
| Protein c activity CPT 85303 | $262.20 | $437.00 | $13.68 – $349.60 | 17 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $171.60 | $286.00 | $10.62 – $228.80 | 17 |
| Protein s total CPT 85305 | $551.40 | $919.00 | $11.47 – $735.20 | 17 |
| Protein total 24 hour urine CPT 84156 | $37.20 | $62.00 | $3.63 – $49.60 | 17 |
| Protein total body fluid CPT 84157 | $82.80 | $138.00 | $3.96 – $110.40 | 17 |
| Protein total serum plasma whole blood CPT 84155 | $86.40 | $144.00 | $3.63 – $115.20 | 17 |
| Prothrombin complex kcentra HCPCS J7168 | $13.80 | $17.25 | $2.14 – $15.30 | 17 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $190.20 | $317.00 | $3.90 – $253.60 | 17 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $993.28 – $3,633.70 | 11 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $12,955.20 | $21,592.00 | $5,829.84 – $19,432.80 | 13 |
| Prq card stent w/angio addl CPT 92929 | $1,388.40 | $2,314.00 | $164.70 – $2,082.60 | 14 |
| Prq cardiac angio addl art CPT 92921 | $693.60 | $1,156.00 | $148.25 – $1,040.40 | 14 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $12,224.40 | $20,374.00 | $858.79 – $16,299.20 | 17 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $226.60 – $7,287.44 | 12 |
| Prq skel fix talus fx w/mnpj CPT 28436 | $4,493.40 | $7,489.00 | $907.20 – $7,354.86 | 17 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $7,905.00 | $13,175.00 | $859.73 – $10,540.00 | 15 |
| Prq trluml c angiop 1art&/br CPT 92920 | $3,954.00 | $6,590.00 | $773.91 – $5,272.00 | 15 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $203.40 | $339.00 | $21.96 – $271.20 | 17 |
| Psychotherapy group therapy CPT 90853 | $742.80 | $1,238.00 | $38.40 – $990.40 | 16 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $105.60 | $176.00 | $42.90 – $140.80 | 16 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $103.20 | $172.00 | $16.20 – $137.60 | 15 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $38.40 | $64.00 | $17.28 – $51.20 | 15 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $103.20 | $172.00 | $16.97 – $137.60 | 15 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $101.40 | $169.00 | $13.38 – $135.20 | 15 |
| Pt application of modality traction mechanical CPT 97012 | $103.20 | $172.00 | $16.76 – $137.60 | 15 |
| Pt evaluation high complexity patient/family CPT 97163 | $197.40 | $329.00 | $81.42 – $263.20 | 15 |
| Pt evaluation low complexity patient/family CPT 97161 | $197.40 | $329.00 | $81.42 – $263.20 | 15 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $197.40 | $329.00 | $32.42 – $263.20 | 15 |
| Pt re-evaluation patient/family CPT 97164 | $97.20 | $162.00 | $43.74 – $129.60 | 17 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $223.20 | $372.00 | $28.31 – $334.80 | 14 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $114.00 | $190.00 | $9.52 – $171.00 | 14 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $130.20 | $217.00 | $9.22 – $173.60 | 17 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $130.20 | $217.00 | $18.43 – $173.60 | 17 |
| Pt wheelchair management each 15 minutes CPT 97542 | $165.60 | $276.00 | $25.14 – $220.80 | 15 |
| Pten gene dup/delet variant CPT 81323 | $564.60 | $941.00 | $234.24 – $752.80 | 17 |
| Pten gene full sequence CPT 81321 | $564.60 | $941.00 | $355.70 – $752.80 | 17 |
| Pten gene known fam variant CPT 81322 | $42.00 | $70.00 | $26.46 – $56.00 | 17 |
| Pulse ox continuous overnight monitoring CPT 94762 | $302.40 | $504.00 | $94.09 – $403.20 | 17 |
| Pulse ox multiple CPT 94761 | $388.20 | $647.00 | $4.25 – $517.60 | 17 |
| Pulse ox single CPT 94760 | $62.40 | $104.00 | $2.18 – $24.80 | 17 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $87.60 | $146.00 | $14.30 – $116.80 | 17 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $1,119.00 | $1,865.00 | $26.40 – $993.28 | 17 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,470.60 | $2,451.00 | $46.20 – $1,960.80 | 17 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $357.60 | $596.00 | $48.60 – $476.80 | 17 |
| Pvb thoracic single inj site CPT 64461 | $660.60 | $1,101.00 | $77.09 – $993.28 | 17 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $18.40 | $23.00 | $6.05 – $20.70 | 16 |
| Pyruvate CPT 84210 | $271.80 | $453.00 | $8.80 – $362.40 | 17 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $3,089.40 | $5,149.00 | $245.43 – $4,119.20 | 17 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,126.20 | $1,877.00 | $151.94 – $1,501.60 | 17 |
| Quest t3 uptake CPT 84479 | $295.20 | $492.00 | $6.39 – $393.60 | 17 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $871.20 | $1,089.00 | $11.00 – $961.20 | 17 |
| Radiation physics consult CPT 77336 | $568.80 | $948.00 | $53.90 – $758.40 | 17 |
| Radiation therapy dose plan CPT 77300 | $571.20 | $952.00 | $27.52 – $761.60 | 17 |
| Radiation treatment aid(s) CPT 77332 | $642.60 | $1,071.00 | $41.60 – $856.80 | 17 |
| Radiation treatment aid(s) CPT 77334 | $1,244.40 | $2,074.00 | $70.40 – $1,659.20 | 17 |
| Radiation treatment delivery CPT 77402 | $698.40 | $1,164.00 | $23.65 – $931.20 | 17 |
| Radiation treatment delivery CPT 77412 | $1,321.20 | $2,202.00 | $48.40 – $1,761.60 | 17 |
| Radiology port images(s) CPT 77417 | $215.40 | $359.00 | $14.21 – $287.20 | 17 |
| Radiotherapy dose plan imrt CPT 77301 | $6,649.20 | $11,082.00 | $906.02 – $8,865.60 | 17 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $384.60 | $641.00 | $173.91 – $576.90 | 15 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,360.80 | $2,268.00 | $89.60 – $1,814.40 | 17 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,386.20 | $3,977.00 | $394.09 – $3,181.60 | 17 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,767.80 | $4,613.00 | $284.40 – $3,690.40 | 17 |
| Radphm lcl tumor plr sgl day CPT 78800 | $769.20 | $1,282.00 | $70.40 – $1,025.60 | 17 |
| Radphm quant measure sgl area add-on CPT 78835 | $2,767.80 | $4,613.00 | $80.00 – $3,690.40 | 17 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $258.60 | $431.00 | $74.36 – $387.90 | 17 |
| Rapid Strep Test CPT 87880 | $13.20 | $22.00 | $6.73 – $17.60 | 17 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $3,833.40 | $6,389.00 | $377.52 – $1,916.10 | 17 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $660.00 | $825.00 | $223.74 – $742.50 | 17 |
| Rbc count only automated CPT 85041 | $17.40 | $29.00 | $2.98 – $23.20 | 17 |
| Red blood cells each unit HCPCS P9021 | $759.60 | $1,266.00 | $33.00 – $1,012.80 | 17 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $1,027.80 | $1,713.00 | $147.74 – $1,370.40 | 17 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $1,189.20 | $1,982.00 | $202.32 – $1,783.80 | 16 |
| Reduce testis torsion CPT 54600 | not published | not published | $993.28 – $3,551.23 | 11 |
| Reinforce thigh CPT 27495 | $12,198.00 | $20,330.00 | $958.72 – $16,264.00 | 15 |
| Relocation skin pocket aicd CPT 33223 | $3,513.00 | $5,855.00 | $993.28 – $4,684.00 | 17 |
| Relocation skin pocket pm CPT 33222 | $3,513.00 | $5,855.00 | $364.32 – $4,684.00 | 17 |
| Rem endovas vena cava filter CPT 37193 | $7,915.20 | $13,192.00 | $993.28 – $10,553.60 | 17 |
| Rem interrog dev eval icpms CPT 93297 | $103.20 | $172.00 | $26.42 – $137.60 | 17 |
| Rem interrog dev eval scrms CPT 93298 | $103.20 | $172.00 | $29.26 – $137.60 | 17 |
| Rem interrog evl pm/ids CPT 93296 | $229.80 | $383.00 | $21.99 – $306.40 | 17 |
| Rem/biv cast full arm/leg CPT 29705 | $571.80 | $953.00 | $187.33 – $857.70 | 16 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $16.00 | $20.00 | $5.42 – $18.00 | 17 |
| Removal biliary drg cath CPT 47537 | $1,703.40 | $2,839.00 | $89.12 – $2,271.20 | 17 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $2,172.00 | $3,620.00 | $319.83 – $2,896.00 | 17 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $3,081.00 | $5,135.00 | $202.50 – $4,108.00 | 17 |
| Removal cerclage without anes CPT 59899 | $3,022.20 | $5,037.00 | $139.08 – $4,533.30 | 16 |
| Removal cerumen impacted (both sides) CPT 69210 | $247.20 | $412.00 | $29.05 – $993.28 | 17 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $589.80 | $983.00 | $29.70 – $884.70 | 16 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | $1,767.60 | $2,946.00 | $33.55 – $2,356.80 | 17 |
| Removal foreign body foot subcutaneous right CPT 28190 | $1,470.60 | $2,451.00 | $33.55 – $1,960.80 | 17 |
| Removal implant superficial separate procedure CPT 20670 | $3,355.20 | $5,592.00 | $102.85 – $4,473.60 | 17 |
| Removal mamma implant mat 19330 CPT 19330 | $3,355.20 | $5,592.00 | $993.28 – $4,473.60 | 17 |
| Removal of artery clot 34101 CPT 34101 | not published | not published | $993.28 – $5,565.99 | 11 |
| Removal of foot lesion CPT 28080 | $199.20 | $332.00 | $89.64 – $997.12 | 17 |
| Removal of heel spur CPT 28119 | $6,648.60 | $11,081.00 | $317.90 – $8,864.80 | 17 |
| Removal of hip foreign body 27087 CPT 27087 | $5,152.80 | $8,588.00 | $71.50 – $6,870.40 | 17 |
| Removal of implant deep CPT 20680 | $5,152.80 | $8,588.00 | $188.65 – $6,870.40 | 17 |
| Removal of knee cartilage CPT 27332 | $6,347.40 | $10,579.00 | $1,287.68 – $8,463.20 | 17 |
| Removal of skin tags each add'l 10 CPT 11201 | $64.20 | $107.00 | $16.03 – $85.60 | 17 |
| Removal of testis CPT 54520 | not published | not published | $228.80 – $3,518.35 | 12 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $471.00 | $785.00 | $34.10 – $993.28 | 17 |
| Removal sutr and stapl no anes CPT 15854 | $39.00 | $65.00 | $5.40 – $16.67 | 15 |
| Removal sutr or stapl no anes CPT 15853 | $27.60 | $46.00 | $4.05 – $12.00 | 15 |
| Removal tunnled intprtnl cath CPT 49422 | $1,119.00 | $1,865.00 | $368.41 – $1,492.00 | 17 |
| Removal w/reinsrt nonbiogrdble CPT 11983 | $278.40 | $464.00 | $182.58 – $417.60 | 17 |
| Removal/replacement ppm generator dual lead system CPT 33228 | $5,997.00 | $9,995.00 | $518.50 – $10,774.64 | 17 |
| Remove cva lumen obstruct CPT 75902 | $1,428.00 | $2,380.00 | $57.42 – $1,904.00 | 15 |
| Remove epididymis lesion CPT 54830 | not published | not published | $866.42 – $3,551.23 | 11 |
| Remove foreign body from eye CPT 65235 | not published | not published | $993.28 – $2,348.35 | 11 |
| Remove renal tube w/fluoro CPT 50389 | $621.60 | $1,036.00 | $412.22 – $993.28 | 17 |
| Remove spinal lamina add-on 63048 CPT 63048 | not published | not published | $248.33 – $4,166.32 | 4 |
| Renal function panel CPT 80069 | $156.00 | $260.00 | $8.58 – $208.00 | 17 |
| Renal venogram bil s&i CPT 75833 | $2,600.40 | $4,334.00 | $28.80 – $3,467.20 | 17 |
| Repair blood vessel dir lower extr CPT 35226 | $1,582.20 | $2,637.00 | $677.36 – $2,839.30 | 17 |
| Repair blood vessel dir upper extr CPT 35206 | $5,738.40 | $9,564.00 | $993.28 – $7,651.20 | 17 |
| Repair blood vessel direct hand finger CPT 35207 | $7,133.40 | $11,889.00 | $726.32 – $9,511.20 | 17 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $2,172.00 | $3,620.00 | $589.31 – $2,896.00 | 17 |
| Repair dental ellis ii fx CPT 41899 | $229.80 | $383.00 | $103.41 – $344.70 | 16 |
| Repair extns tendon finger without grft ea CPT 26418 | not published | not published | $254.65 – $1,632.61 | 12 |
| Repair finger/hand tendon CPT 26350 | $3,505.20 | $5,842.00 | $404.25 – $4,673.60 | 17 |
| Repair foot dislocation CPT 28585 | $5,152.80 | $8,588.00 | $411.95 – $6,870.40 | 17 |
| Repair foot dislocation CPT 28615 | $5,152.80 | $8,588.00 | $246.40 – $6,870.40 | 17 |
| Repair humerus with graft CPT 24435 | $6,347.40 | $10,579.00 | $993.28 – $13,247.10 | 17 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $3,487.80 | $5,813.00 | $405.09 – $4,650.40 | 17 |
| Repair of ankle ligament CPT 27695 | $4,493.40 | $7,489.00 | $993.28 – $7,354.86 | 17 |
| Repair of foot tendon CPT 28200 | not published | not published | $260.70 – $3,309.88 | 12 |
| Repair of humerus CPT 24430 | $5,152.80 | $8,588.00 | $993.28 – $13,247.10 | 17 |
| Repair of tibia CPT 27720 | $9,541.80 | $15,903.00 | $993.28 – $12,722.40 | 17 |
| Repair pm/icd lead sgl CPT 33218 | $3,316.20 | $5,527.00 | $400.86 – $4,421.60 | 17 |
| Repair radius or ulna CPT 25400 | $5,667.60 | $9,446.00 | $577.50 – $7,556.80 | 17 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $4,530.60 | $7,551.00 | $95.15 – $6,040.80 | 17 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $3,349.80 | $5,583.00 | $273.82 – $4,466.40 | 17 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | not published | not published | $261.80 – $3,309.88 | 12 |
| Repair upper arm/elbow tendon/muscle ea CPT 24341 | $5,527.80 | $9,213.00 | $993.28 – $7,370.40 | 17 |
| Repair/graft of thigh CPT 27472 | $13,765.80 | $22,943.00 | $1,000.96 – $18,354.40 | 15 |
| Repair/graft of tibia CPT 27724 | $13,881.60 | $23,136.00 | $1,155.84 – $18,508.80 | 15 |
| Replace duod/jej tube perc CPT 49451 | $3,105.00 | $5,175.00 | $77.36 – $4,140.00 | 17 |
| Replace g-j tube perc CPT 49452 | $3,105.00 | $5,175.00 | $120.76 – $4,140.00 | 17 |
| Replace g/c tube perc CPT 49450 | $3,105.00 | $5,175.00 | $56.21 – $4,140.00 | 17 |
| Repos lv lead pm/icd CPT 33226 | $4,350.00 | $7,250.00 | $884.67 – $5,800.00 | 17 |
| Reposition pm/icd lead CPT 33215 | $4,818.00 | $8,030.00 | $564.80 – $6,424.00 | 17 |
| Reptilase test CPT 85635 | $87.60 | $146.00 | $6.60 – $116.80 | 17 |
| Resp virus 6-11 targets CPT 87632 | $1,237.80 | $2,063.00 | $215.52 – $1,650.40 | 17 |
| Respirator motion mgmt simul CPT 77293 | $367.20 | $612.00 | $165.24 – $568.09 | 17 |
| Resuscitation cardiopulmonary CPT 92950 | $603.60 | $1,006.00 | $218.68 – $905.40 | 16 |
| Reticulocyte automated CPT 85045 | $75.60 | $126.00 | $3.95 – $100.80 | 17 |
| Revasc intra lithotrip-ather HCPCS C9766 | $20,533.20 | $34,222.00 | $13,412.28 – $30,799.80 | 16 |
| Revasc intra lithotrip-stent HCPCS C9765 | $20,533.20 | $34,222.00 | $13,412.28 – $30,799.80 | 16 |
| Revasc intravasc lithotripsy HCPCS C9764 | $10,266.00 | $17,110.00 | $6,808.07 – $15,399.00 | 16 |
| Revasc lithotrip-stent-ather HCPCS C9767 | $33,032.40 | $55,054.00 | $13,412.28 – $49,548.60 | 16 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $2,295.42 – $13,248.33 | 10 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $1,780.51 – $2,741.37 | 4 |
| Revision tips CPT 37183 | $23,630.40 | $39,384.00 | $795.42 – $31,507.20 | 17 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $3,768.60 | $6,281.00 | $587.87 – $5,024.80 | 17 |
| Rheumatoid factor qualitative CPT 86430 | $75.00 | $125.00 | $6.07 – $100.00 | 17 |
| Rheumatoid factor quantitative CPT 86431 | $98.40 | $164.00 | $5.61 – $131.20 | 17 |
| Rho d immune globulin inj HCPCS J2790 | $728.80 | $911.00 | $28.89 – $96.30 | 16 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $163.20 | $204.00 | $4.86 – $183.60 | 16 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $0.20 | $0.25 | $0.07 – $0.23 | 16 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $26.40 | $33.00 | $8.95 – $29.70 | 17 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $4,199.40 | $6,999.00 | $10.98 – $63.00 | 17 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $218.40 | $364.00 | $36.69 – $327.60 | 17 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $580.00 | $725.00 | $75.22 – $652.50 | 17 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $265.80 | $443.00 | $29.38 – $398.70 | 17 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $196.20 | $327.00 | $26.51 – $294.30 | 17 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $7,463.40 | $12,439.00 | $27.84 – $224.10 | 17 |
| Rmvl ext fixj sys under anes CPT 20694 | $3,355.20 | $5,592.00 | $662.79 – $4,473.60 | 17 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $3,435.60 | $5,726.00 | $42.35 – $4,580.80 | 17 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $1,470.60 | $2,451.00 | $33.55 – $1,960.80 | 17 |
| Rmvl icd by tv extr CPT 33244 | $4,125.60 | $6,876.00 | $993.28 – $5,500.80 | 17 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $6,921.60 | $11,536.00 | $562.05 – $23,109.59 | 17 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $6,921.60 | $11,536.00 | $583.58 – $33,009.16 | 17 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $6,921.60 | $11,536.00 | $540.55 – $23,109.59 | 17 |
| Rmvl icd pulse gen only CPT 33241 | $1,950.60 | $3,251.00 | $515.11 – $3,746.86 | 17 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $1,119.00 | $1,865.00 | $272.28 – $1,492.00 | 17 |
| Rmvl perm pm pulse gen CPT 33233 | $2,074.20 | $3,457.00 | $857.94 – $8,520.57 | 17 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $5,997.00 | $9,995.00 | $540.01 – $19,634.81 | 17 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $5,859.60 | $9,766.00 | $496.99 – $8,520.57 | 17 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $64,606.80 | $107,678.00 | $144.73 – $86,142.40 | 15 |
| Rmvl subq card rhythm mntr CPT 33286 | $2,436.00 | $4,060.00 | $160.97 – $3,248.00 | 17 |
| Rmvl tv pm lead dual CPT 33235 | $4,986.00 | $8,310.00 | $916.22 – $6,648.00 | 17 |
| Rmvl tv pm lead sgl CPT 33234 | $4,620.60 | $7,701.00 | $961.02 – $6,160.80 | 17 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $197.60 | $247.00 | $30.78 – $222.30 | 17 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $44.60 | $55.75 | $7.05 – $23.40 | 17 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $178.80 | $298.00 | $0.05 – $0.90 | 16 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $2,767.80 | $4,613.00 | $416.61 – $3,690.40 | 17 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $3,139.20 | $5,232.00 | $792.37 – $4,185.60 | 17 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $2,866.80 | $4,778.00 | $547.03 – $3,822.40 | 17 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $2,106.00 | $3,510.00 | $71.65 – $2,808.00 | 17 |
| Rpl tun cvc wo subq port CPT 36581 | $2,739.00 | $4,565.00 | $204.48 – $3,652.00 | 17 |
| Rpl tun-cvad w subq port CPT 36582 | $5,510.40 | $9,184.00 | $301.63 – $7,347.20 | 17 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | $1,793.40 | $2,989.00 | $751.37 – $6,006.79 | 17 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $821.40 | $1,369.00 | $344.03 – $3,633.37 | 17 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $478.93 – $6,007.35 | 11 |
| Rsv assay w/optic CPT 87807 | $10.80 | $18.00 | $5.51 – $15.76 | 17 |
| Rubella antibody igg CPT 86762 | $130.20 | $217.00 | $14.22 – $173.60 | 17 |
| Rubeola antibody igg CPT 86765 | $219.60 | $366.00 | $12.73 – $292.80 | 17 |
| Russell viper venom diluted CPT 85613 | $424.20 | $707.00 | $9.47 – $565.60 | 17 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $4,810.20 | $8,017.00 | $30.37 – $100.80 | 17 |
| Salmonella antibody CPT 86768 | $25.20 | $42.00 | $10.30 – $33.60 | 17 |
| Sarscov coronavirus ag ia CPT 87426 | $34.80 | $58.00 | $17.75 – $46.40 | 17 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,265.40 | $2,109.00 | $152.76 – $1,687.20 | 17 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $1,044.00 | $1,740.00 | $100.61 – $1,392.00 | 17 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $1,054.80 | $1,758.00 | $116.01 – $1,406.40 | 17 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $931.80 | $1,553.00 | $100.61 – $1,242.40 | 17 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $861.00 | $1,435.00 | $102.37 – $1,148.00 | 17 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $829.20 | $1,382.00 | $100.61 – $1,105.60 | 17 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,678.20 | $2,797.00 | $152.76 – $2,237.60 | 17 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $986.40 | $1,644.00 | $100.61 – $1,315.20 | 17 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $931.80 | $1,553.00 | $100.61 – $1,242.40 | 17 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $78.00 | $130.00 | $20.68 – $117.00 | 16 |
| Screen cerv/vag thin layer HCPCS G0123 | $61.20 | $102.00 | $15.82 – $91.80 | 16 |
| Screening Mammogram CPT 77067 | $205.20 | $342.00 | $92.34 – $307.80 | 16 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $142.20 | $237.00 | $20.90 – $213.30 | 16 |
| Screening prostate cancer PSA HCPCS G0103 | $96.00 | $160.00 | $15.08 – $144.00 | 16 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $9,834.60 | $16,391.00 | $0.40 – $1.80 | 14 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $5,352.00 | $8,920.00 | $259.05 – $7,136.00 | 15 |
| Sedimentation rate erythrocyte automated CPT 85652 | $57.00 | $95.00 | $2.67 – $76.00 | 17 |
| Semen analysis presence/motility CPT 89321 | $118.20 | $197.00 | $9.41 – $157.60 | 17 |
| Serpina1 gene CPT 81332 | $332.40 | $554.00 | $43.14 – $426.40 | 17 |
| Set radiation therapy field CPT 77280 | $945.00 | $1,575.00 | $46.72 – $1,260.00 | 17 |
| Set radiation therapy field CPT 77285 | $1,137.60 | $1,896.00 | $65.28 – $1,516.80 | 17 |
| Set radiation therapy field CPT 77290 | $1,653.00 | $2,755.00 | $92.80 – $2,204.00 | 17 |
| Sgmdsc w/band ligation CPT 45350 | $3,252.60 | $5,421.00 | $993.28 – $4,878.90 | 16 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $141.00 | $235.00 | $35.20 – $855.04 | 17 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $243.00 | $405.00 | $55.00 – $855.04 | 17 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $229.20 | $382.00 | $69.30 – $855.04 | 17 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $141.00 | $235.00 | $30.80 – $855.04 | 17 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $120.60 | $201.00 | $45.10 – $855.04 | 17 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $141.00 | $235.00 | $27.50 – $855.04 | 17 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $141.00 | $235.00 | $35.20 – $855.04 | 17 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $120.60 | $201.00 | $41.80 – $855.04 | 17 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $993.28 – $7,355.55 | 11 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $597.85 – $3,309.88 | 12 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $993.28 – $7,355.55 | 11 |
| Shoulder MRI (with and without contrast) CPT 73223 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| Shoulder MRI (with contrast) CPT 73222 | $3,051.00 | $5,085.00 | $393.92 – $4,068.00 | 17 |
| Shoulder MRI (without contrast) CPT 73221 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| Shoulder X-ray CPT 73030 | $307.20 | $512.00 | $21.12 – $409.60 | 17 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $382.20 | $637.00 | $36.08 – $509.60 | 17 |
| Sickling rbc CPT 85660 | $81.00 | $135.00 | $3.30 – $108.00 | 17 |
| Sig w/tndsc balloon dilation CPT 45340 | $3,097.80 | $5,163.00 | $109.36 – $4,130.40 | 17 |
| Sigmoidoscopy and biopsy CPT 45331 | $3,156.60 | $5,261.00 | $70.04 – $4,208.80 | 17 |
| Sigmoidoscopy for bleeding CPT 45334 | $3,252.60 | $5,421.00 | $123.20 – $4,336.80 | 17 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $3,252.60 | $5,421.00 | $134.15 – $4,336.80 | 17 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $3,156.60 | $5,261.00 | $86.52 – $4,208.80 | 17 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $448.20 | $747.00 | $27.56 – $672.30 | 16 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $516.00 | $645.00 | $123.36 – $580.50 | 16 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,712.60 | $4,521.00 | $128.00 – $3,616.80 | 17 |
| Sinus CT scan (with contrast) CPT 70487 | $2,160.00 | $3,600.00 | $102.40 – $2,880.00 | 17 |
| Sinus CT scan (without contrast) CPT 70486 | $1,590.60 | $2,651.00 | $99.20 – $2,120.80 | 17 |
| Sinus/juglr venogram s&i CPT 75860 | $1,438.80 | $2,398.00 | $19.20 – $1,918.40 | 17 |
| Sirolimus, oral HCPCS J7520 | $180.00 | $225.00 | $0.87 – $202.50 | 16 |
| Skin Biopsy CPT 11102 | $300.00 | $500.00 | $35.45 – $993.28 | 17 |
| Skyla, 13.5 mg HCPCS J7301 | $532.80 | $888.00 | $239.76 – $944.09 | 15 |
| Sleep Study (Polysomnography) CPT 95810 | $5,466.60 | $9,111.00 | $346.01 – $7,288.80 | 17 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $201.60 | $336.00 | $2.97 – $9.90 | 14 |
| Sling suprapubic suburetheral HCPCS C1771 | $3,847.20 | $6,412.00 | $921.60 – $4,147.20 | 14 |
| Slitting of prepuce CPT 54001 | $4,530.60 | $7,551.00 | $52.80 – $6,040.80 | 17 |
| Slp pure tone screening CPT 92551 | $70.20 | $117.00 | $8.80 – $105.30 | 16 |
| Small bowel endoscopy CPT 44360 | $3,414.00 | $5,690.00 | $149.01 – $4,552.00 | 17 |
| Small bowel endoscopy CPT 44366 | $3,414.00 | $5,690.00 | $228.25 – $4,552.00 | 17 |
| Small bowel endoscopy CPT 44369 | $3,414.00 | $5,690.00 | $228.25 – $4,552.00 | 17 |
| Small bowel endoscopy CPT 44382 | $3,526.20 | $5,877.00 | $76.74 – $4,701.60 | 17 |
| Small bowel endoscopy br/wa CPT 44380 | $3,526.20 | $5,877.00 | $64.44 – $4,701.60 | 17 |
| Small bowel endoscopy/biopsy CPT 44361 | $3,414.00 | $5,690.00 | $164.24 – $4,552.00 | 17 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $91.80 | $153.00 | $3.30 – $122.40 | 17 |
| Smear gram stain CPT 87205 | $60.60 | $101.00 | $4.22 – $80.80 | 17 |
| Smear nasal eosinophil CPT 89190 | $101.40 | $169.00 | $5.72 – $135.20 | 17 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $194.40 | $324.00 | $4.95 – $259.20 | 17 |
| Smear wet mount CPT 87210 | $111.60 | $186.00 | $2.14 – $7.45 | 17 |
| Sodium 24 hour urine CPT 84300 | $52.20 | $87.00 | $5.01 – $69.60 | 17 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $22.20 | $27.75 | $1.26 – $13.50 | 16 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $32.40 | $40.50 | $0.65 – $13.50 | 16 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $26.00 | $38.00 | $1.95 – $28.80 | 16 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $26.40 | $44.00 | $0.27 – $0.90 | 14 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $39.40 | $49.25 | $2.02 – $44.10 | 16 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $480.00 | $800.00 | $71.52 – $720.00 | 16 |
| Sodium serum/plasma/whole blood CPT 84295 | $39.60 | $66.00 | $4.76 – $52.80 | 17 |
| Somatropin injection HCPCS J2941 | $1,512.00 | $2,520.00 | $48.92 – $2,268.00 | 17 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | not published | 0 |
| Special physics consult CPT 77370 | $732.00 | $1,220.00 | $106.15 – $976.00 | 17 |
| Special radiation dosimetry CPT 77331 | $471.00 | $785.00 | $22.35 – $628.00 | 17 |
| Special radiation treatment CPT 77470 | $1,801.80 | $3,003.00 | $27.52 – $2,402.40 | 17 |
| Special teletx port plan CPT 77321 | $975.60 | $1,626.00 | $40.32 – $1,300.80 | 17 |
| Specific gravity body fluid CPT 84315 | $42.60 | $71.00 | $2.56 – $56.80 | 17 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $87.05 – $427.32 | 4 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | not published | 0 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,360.20 | $2,267.00 | $80.72 – $1,813.60 | 17 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $526.80 | $878.00 | $14.59 – $702.40 | 17 |
| Splint finger 4 prong foam sm HCPCS A4570 | $2.40 | $4.00 | $0.81 – $2.70 | 13 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $106.20 | $177.00 | $26.61 – $159.30 | 15 |
| Srs linear based CPT 77372 | $19,502.40 | $32,504.00 | $694.74 – $26,003.20 | 17 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $310.20 | $517.00 | $95.96 – $413.60 | 15 |
| St evaluate speech sound production CPT 92522 | $310.20 | $517.00 | $91.99 – $413.60 | 15 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $310.20 | $517.00 | $139.59 – $413.60 | 15 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $249.60 | $416.00 | $46.55 – $332.80 | 17 |
| St evaluation swallow function CPT 92610 | $249.60 | $416.00 | $42.79 – $332.80 | 17 |
| St treatment speech individual CPT 92507 | $180.00 | $300.00 | $23.87 – $240.00 | 17 |
| St treatment swallow dysfunction/oral CPT 92526 | $179.40 | $299.00 | $61.11 – $239.20 | 15 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $32,602.80 | $54,338.00 | $258.00 – $1,161.00 | 14 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $1,894.80 | $3,158.00 | $22.20 – $99.90 | 14 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $33,391.20 | $55,652.00 | $437.60 – $1,969.20 | 14 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $5,938.80 | $9,898.00 | $1,138.20 – $5,121.90 | 14 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $6,724.80 | $11,208.00 | $993.28 – $11,675.74 | 17 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $7,915.20 | $13,192.00 | $231.04 – $10,553.60 | 15 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $15,054.60 | $25,091.00 | $993.28 – $22,581.90 | 17 |
| Str markers specimen anal CPT 81265 | $258.60 | $431.00 | $162.92 – $344.80 | 17 |
| Strapping of knee CPT 29530 | $243.60 | $406.00 | $28.05 – $324.80 | 17 |
| Strep a ag ia CPT 87430 | $76.80 | $128.00 | $6.93 – $102.40 | 17 |
| Strep b dna amp probe CPT 87653 | $107.40 | $179.00 | $34.68 – $143.20 | 17 |
| Streptozocin injection HCPCS J9320 | $1,285.80 | $2,143.00 | $578.61 – $1,928.70 | 14 |
| Stress test pulmonary CPT 94618 | $652.80 | $1,088.00 | $11.08 – $870.40 | 17 |
| Stress tte complete CPT 93351 | $1,989.60 | $3,316.00 | $152.59 – $2,652.80 | 17 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $16.20 | $27.00 | $3.78 – $12.60 | 14 |
| Sugars single quant CPT 84378 | $150.00 | $250.00 | $11.39 – $200.00 | 17 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $0.40 | $0.50 | $0.05 – $0.45 | 16 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $148.00 | $185.00 | $49.95 – $166.50 | 14 |
| Support clav 29.6-40.5in med HCPCS L3650 | $180.60 | $301.00 | $60.20 – $240.80 | 16 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $562.56 – $1,792.78 | 4 |
| Surgical pathology level 1 gross examination only CPT 88300 | $48.00 | $80.00 | $1.92 – $64.00 | 17 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $189.00 | $315.00 | $6.40 – $252.00 | 17 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $212.40 | $354.00 | $8.32 – $283.20 | 17 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $250.20 | $417.00 | $11.52 – $333.60 | 17 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $408.00 | $680.00 | $14.72 – $544.00 | 17 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $619.20 | $1,032.00 | $22.40 – $825.60 | 17 |
| Suscept studies macrobroth dilution ea CPT 87188 | $87.00 | $145.00 | $6.56 – $116.00 | 17 |
| Susceptibility agar dilution per agent CPT 87181 | $91.80 | $153.00 | $4.70 – $122.40 | 17 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $16.80 | $28.00 | $4.70 – $22.40 | 17 |
| Susceptibility mic per plate CPT 87186 | $186.00 | $310.00 | $8.55 – $248.00 | 17 |
| Svc venogram s&i CPT 75827 | $1,510.20 | $2,517.00 | $28.80 – $2,013.60 | 17 |
| Sweat collection by iontophoresis CPT 89230 | $73.80 | $123.00 | $3.28 – $110.70 | 16 |
| Synvisc or synvisc-one HCPCS J7325 | $73.20 | $122.00 | $7.95 – $109.80 | 17 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $76.80 | $128.00 | $4.34 – $54.40 | 17 |
| System pacing micra av HCPCS C1786 | $22,146.00 | $36,910.00 | $0.20 – $0.90 | 14 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $24,240.00 | $40,400.00 | $0.20 – $0.90 | 14 |
| T cells absolute cd 4 count CPT 86361 | $144.00 | $240.00 | $26.46 – $192.00 | 17 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $112.80 | $188.00 | $46.43 – $150.40 | 17 |
| T cells total count CPT 86359 | $112.80 | $188.00 | $37.28 – $150.40 | 17 |
| T3 (triiodothyronine) free CPT 84481 | $137.40 | $229.00 | $16.74 – $183.20 | 17 |
| T3 (triiodothyronine) total CPT 84480 | $222.60 | $371.00 | $8.80 – $296.80 | 17 |
| T4 (thyroxine) free CPT 84439 | $103.20 | $172.00 | $8.80 – $137.60 | 17 |
| T4 (thyroxine) total CPT 84436 | $82.80 | $138.00 | $6.79 – $110.40 | 17 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $3.40 | $4.25 | $1.08 – $3.60 | 16 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $27.60 | $34.50 | $0.17 – $15.30 | 16 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $1,588.00 | $1,985.00 | $263.15 – $1,786.50 | 17 |
| Tacrolimus therapeutic drug level CPT 80197 | $276.00 | $460.00 | $13.56 – $368.00 | 17 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $27.60 | $46.00 | $12.48 – $41.40 | 17 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | $101.40 | $169.00 | $45.83 – $152.10 | 17 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | $14.80 | $18.50 | $5.00 – $16.65 | 14 |
| Tap block bilat cont infusion 64489 CPT 64489 | $891.60 | $1,486.00 | $91.72 – $1,188.80 | 15 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,302.00 | $2,170.00 | $270.00 – $820.29 | 17 |
| Target gsa panel organ neop CPT 81445 | $3,073.80 | $5,123.00 | $526.16 – $4,098.40 | 17 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $5,526.00 | $9,210.00 | $2,569.25 – $7,368.00 | 17 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $2,801.40 | $4,669.00 | $1,266.23 – $4,202.10 | 17 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $797.40 | $1,329.00 | $76.76 – $1,063.20 | 17 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $209.40 | $349.00 | $61.26 – $279.20 | 17 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $3.60 | $6.00 | $0.28 – $5.40 | 17 |
| Tc-99m bicisate HCPCS A9557 | $697.80 | $1,163.00 | $462.76 – $1,046.70 | 15 |
| Tc-99m depreotide HCPCS A9536 | $209.40 | $349.00 | $94.23 – $314.10 | 13 |
| Tc-99m exametazime diag HCPCS A9521 | $717.00 | $1,195.00 | $475.49 – $1,075.50 | 15 |
| Tc-99m labeled rbc HCPCS A9560 | $147.00 | $245.00 | $66.15 – $220.50 | 13 |
| Tc-99m maa HCPCS A9540 | $133.80 | $223.00 | $60.21 – $200.70 | 13 |
| Tc-99m mebrofenin HCPCS A9537 | $292.20 | $487.00 | $131.49 – $438.30 | 13 |
| Tc-99m mertiatide HCPCS A9562 | $709.20 | $1,182.00 | $319.14 – $1,063.80 | 13 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $15.00 | $25.00 | $6.75 – $22.50 | 15 |
| Tc-99m oxidronate HCPCS A9561 | $44.40 | $74.00 | $19.98 – $66.60 | 13 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $196.20 | $327.00 | $88.29 – $294.30 | 13 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $59.40 | $99.00 | $26.73 – $89.10 | 13 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $126.00 | $210.00 | $56.70 – $189.00 | 13 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $237.60 | $396.00 | $106.92 – $356.40 | 13 |
| Tc-99m sulfur colloid HCPCS A9541 | $158.40 | $264.00 | $71.28 – $237.60 | 13 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | $418.80 | $698.00 | $189.30 – $628.20 | 17 |
| Telethx isodose plan cplx CPT 77307 | $3,457.20 | $5,762.00 | $127.95 – $4,609.60 | 17 |
| Telethx isodose plan simple CPT 77306 | $2,039.40 | $3,399.00 | $69.75 – $2,719.20 | 17 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $436.80 | $546.00 | $26.71 – $491.40 | 17 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $27,148.20 | $45,247.00 | $172.22 – $813.60 | 17 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $111.20 | $139.00 | $7.39 – $125.10 | 16 |
| Test stress cardiovascular tracing only CPT 93017 | $1,618.20 | $2,697.00 | $51.15 – $2,157.60 | 17 |
| Tetanus immune globulin inj HCPCS J1670 | $1,304.80 | $1,631.00 | $442.33 – $1,467.90 | 17 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $48.80 | $61.00 | $16.54 – $54.90 | 17 |
| Tgsap so/hl 51/< rna alys CPT 81456 | $2,116.80 | $3,528.00 | $1,333.58 – $3,153.17 | 17 |
| Theophylline therapeutic drug level CPT 80198 | $163.80 | $273.00 | $12.10 – $218.40 | 17 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $27.00 | $45.00 | $12.15 – $40.50 | 14 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $20.40 | $34.00 | $9.18 – $30.60 | 14 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $42.60 | $53.25 | $1.82 – $23.40 | 16 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,275.00 | $2,125.00 | $595.22 – $1,700.00 | 17 |
| Thrombectmy crnry perq mechanical CPT 92973 | $730.80 | $1,218.00 | $184.10 – $974.40 | 17 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $3,631.80 | $6,053.00 | $308.07 – $4,842.40 | 17 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $3,903.00 | $6,505.00 | $386.68 – $5,204.00 | 17 |
| Thrombectomy/inf pq dialysis circuit w/stent plcmnt CPT 36906 | $4,168.80 | $6,948.00 | $451.26 – $8,469.31 | 17 |
| Thrombin time CPT 85670 | $81.00 | $135.00 | $5.70 – $108.00 | 17 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $105.60 | $176.00 | $6.39 – $140.80 | 17 |
| Thyroglobulin antibody CPT 86800 | $210.00 | $350.00 | $15.73 – $280.00 | 17 |
| Thyroid (TSH) Test CPT 84443 | $226.80 | $378.00 | $16.60 – $302.40 | 17 |
| Thyroid Ultrasound CPT 76536 | $646.20 | $1,077.00 | $65.25 – $861.60 | 17 |
| Thyroid mets imag whole body CPT 78018 | $3,225.60 | $5,376.00 | $72.32 – $4,300.80 | 17 |
| Thyroxine binding globulin (tbg) CPT 84442 | $208.20 | $347.00 | $11.00 – $277.60 | 17 |
| Tigecycline injection HCPCS J3243 | $19.40 | $24.25 | $0.39 – $21.60 | 16 |
| Tilt table study CPT 93660 | $2,985.00 | $4,975.00 | $137.11 – $4,477.50 | 16 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $322.20 | $537.00 | $145.63 – $483.30 | 17 |
| Tissue culture skin/biopsy CPT 88233 | $1,299.00 | $2,165.00 | $139.08 – $1,732.00 | 17 |
| Tissue exam koh skin/hair/nails CPT 87220 | $70.80 | $118.00 | $1.53 – $4.99 | 17 |
| Tissue transglutaminase iga CPT 86364 | $273.00 | $455.00 | $9.00 – $364.00 | 17 |
| Tl-201 thallium diag per mci HCPCS A9505 | $50.40 | $84.00 | $22.68 – $75.60 | 13 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $97.60 | $122.00 | $2.37 – $109.80 | 16 |
| Tobramycin peak therapeutic drug level CPT 80200 | $180.00 | $300.00 | $15.94 – $240.00 | 17 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $9,652.20 | $16,087.00 | $5.71 – $36.00 | 17 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $123.00 | $205.00 | $24.64 – $139.50 | 16 |
| Tomosynthesis breast screen bilateral CPT 77063 | $45.00 | $75.00 | $20.25 – $75.04 | 17 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $17.40 | $29.00 | $2.54 – $26.10 | 16 |
| Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 | $70.20 | $117.00 | $31.73 – $105.30 | 17 |
| Total Knee Replacement CPT 27447 | not published | not published | $993.28 – $13,248.33 | 11 |
| Total tau CPT 84394 | $259.80 | $433.00 | $116.91 – $389.70 | 13 |
| Toxoplasma antibody igg CPT 86777 | $241.20 | $402.00 | $14.22 – $321.60 | 17 |
| Toxoplasma antibody igm CPT 86778 | $241.20 | $402.00 | $14.24 – $321.60 | 17 |
| Tp53 gene trgt sequence alys CPT 81352 | $2,041.20 | $3,402.00 | $257.28 – $2,721.60 | 17 |
| Tpmt gene com vrnts CPT 81335 | $472.80 | $788.00 | $136.49 – $630.40 | 17 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $1,769.60 | $2,212.00 | $391.07 – $1,990.80 | 17 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $121.20 | $202.00 | $23.55 – $181.80 | 16 |
| Transcath biopsy CPT 37200 | $816.60 | $1,361.00 | $125.40 – $1,088.80 | 17 |
| Transcath rmvl perm ldss pmkr rv CPT 33275 | $2,428.20 | $4,047.00 | $649.67 – $3,240.52 | 17 |
| Transcatheter bx s&i CPT 75970 | $2,803.80 | $4,673.00 | $12.80 – $3,738.40 | 17 |
| Transferrin CPT 84466 | $108.00 | $180.00 | $12.62 – $144.00 | 17 |
| Transfusion blood/blood component(s) CPT 36430 | $1,821.00 | $3,035.00 | $30.62 – $2,428.00 | 17 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $480.60 | $801.00 | $75.03 – $701.10 | 17 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $448.80 | $748.00 | $47.55 – $673.20 | 17 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $194.40 | $324.00 | $27.99 – $211.50 | 17 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $6,448.80 | $10,748.00 | $899.12 – $9,673.20 | 16 |
| Treat ankle dislocation CPT 27842 | $3,135.00 | $5,225.00 | $130.35 – $4,180.00 | 17 |
| Treat ankle dislocation CPT 27848 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Treat ankle fracture CPT 28445 | $5,152.80 | $8,588.00 | $295.90 – $6,870.40 | 17 |
| Treat big toe fracture CPT 28505 | not published | not published | $183.15 – $3,309.88 | 12 |
| Treat ectopic pregnancy CPT 59150 | not published | not published | $993.28 – $6,007.35 | 11 |
| Treat ectopic pregnancy CPT 59151 | not published | not published | $993.28 – $6,007.35 | 11 |
| Treat elbow dislocation CPT 24605 | $3,135.00 | $5,225.00 | $173.25 – $4,180.00 | 17 |
| Treat elbow fracture CPT 24586 | $6,347.40 | $10,579.00 | $715.00 – $8,463.20 | 17 |
| Treat elbow fracture CPT 24620 | $3,135.00 | $5,225.00 | $154.55 – $4,180.00 | 17 |
| Treat elbow fracture CPT 24635 | $5,152.80 | $8,588.00 | $492.80 – $6,870.40 | 17 |
| Treat finger fracture each CPT 26727 | not published | not published | $246.40 – $3,309.88 | 12 |
| Treat finger fracture each CPT 26742 | $3,135.00 | $5,225.00 | $80.85 – $4,180.00 | 17 |
| Treat foot dislocation CPT 28570 | $801.60 | $1,336.00 | $123.20 – $1,068.80 | 17 |
| Treat foot dislocation CPT 28606 | $4,493.40 | $7,489.00 | $309.10 – $5,991.20 | 17 |
| Treat fracture of radius CPT 25505 | $825.60 | $1,376.00 | $159.50 – $1,100.80 | 17 |
| Treat fracture of ulna CPT 25535 | $499.80 | $833.00 | $176.55 – $993.28 | 17 |
| Treat heel fracture CPT 28415 | $5,152.80 | $8,588.00 | $331.65 – $6,870.40 | 17 |
| Treat hip dislocation CPT 27252 | $4,493.40 | $7,489.00 | $309.65 – $5,991.20 | 17 |
| Treat hip dislocation CPT 27257 | $3,349.80 | $5,583.00 | $260.70 – $4,466.40 | 17 |
| Treat hip socket fracture CPT 27222 | $7,571.40 | $12,619.00 | $385.28 – $10,095.20 | 15 |
| Treat humerus fracture CPT 24515 | $6,347.40 | $10,579.00 | $431.20 – $8,463.20 | 17 |
| Treat humerus fracture CPT 24516 | $6,347.40 | $10,579.00 | $993.28 – $13,247.10 | 17 |
| Treat humerus fracture CPT 24535 | $3,250.80 | $5,418.00 | $226.60 – $4,334.40 | 17 |
| Treat humerus fracture CPT 24545 | $6,347.40 | $10,579.00 | $465.85 – $8,463.20 | 17 |
| Treat humerus fracture CPT 24546 | $7,589.40 | $12,649.00 | $993.28 – $13,247.10 | 17 |
| Treat knee dislocation CPT 27552 | $3,135.00 | $5,225.00 | $172.70 – $4,180.00 | 17 |
| Treat knee fracture CPT 27535 | $5,152.80 | $8,588.00 | $839.68 – $6,870.40 | 15 |
| Treat knee fracture CPT 27536 | $6,347.40 | $10,579.00 | $696.32 – $8,463.20 | 15 |
| Treat knee fracture CPT 27540 | $4,493.40 | $7,489.00 | $672.00 – $5,991.20 | 15 |
| Treat knee fracture 27530 CPT 27530 | $3,355.20 | $5,592.00 | $141.35 – $4,473.60 | 17 |
| Treat knee fracture(s) CPT 27538 | $3,355.20 | $5,592.00 | $123.20 – $4,473.60 | 17 |
| Treat kneecap dislocation CPT 27562 | $1,931.40 | $3,219.00 | $147.95 – $2,575.20 | 17 |
| Treat kneecap dislocation CPT 27566 | $4,493.40 | $7,489.00 | $492.80 – $5,991.20 | 17 |
| Treat kneecap fracture CPT 27524 | $5,152.80 | $8,588.00 | $446.60 – $6,870.40 | 17 |
| Treat knuckle dislocation CPT 26705 | $4,695.00 | $7,825.00 | $80.85 – $6,260.00 | 17 |
| Treat knuckle dislocation CPT 26715 | $6,497.40 | $10,829.00 | $246.40 – $8,663.20 | 17 |
| Treat lower leg fracture CPT 27826 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Treat lower leg fracture CPT 27827 | $5,152.80 | $8,588.00 | $993.28 – $13,247.10 | 17 |
| Treat lower leg fracture CPT 27828 | $6,347.40 | $10,579.00 | $993.28 – $13,247.10 | 17 |
| Treat lower leg joint CPT 27829 | $4,493.40 | $7,489.00 | $993.28 – $7,354.86 | 17 |
| Treat metacarpal fracture CPT 26615 | not published | not published | $255.20 – $3,309.88 | 12 |
| Treat metatarsal fracture CPT 28476 | $4,493.40 | $7,489.00 | $304.70 – $5,991.20 | 17 |
| Treat metatarsal fracture CPT 28485 | $6,347.40 | $10,579.00 | $168.85 – $8,463.20 | 17 |
| Treat pelvic ring fracture CPT 27216 | $11,319.00 | $18,865.00 | $993.28 – $15,092.00 | 15 |
| Treat pelvic ring fracture CPT 27217 | $10,960.80 | $18,268.00 | $960.00 – $14,614.40 | 15 |
| Treat radius fracture CPT 24665 | $6,347.40 | $10,579.00 | $345.95 – $8,463.20 | 17 |
| Treat thigh fracture CPT 27230 | $3,355.20 | $5,592.00 | $230.94 – $4,473.60 | 17 |
| Treat thigh fracture CPT 27236 | $12,076.20 | $20,127.00 | $965.12 – $16,101.60 | 15 |
| Treat thigh fracture CPT 27238 | $3,355.20 | $5,592.00 | $267.30 – $4,473.60 | 17 |
| Treat thigh fracture CPT 27245 | $15,467.40 | $25,779.00 | $993.28 – $20,623.20 | 15 |
| Treat thigh fracture CPT 27246 | $3,355.20 | $5,592.00 | $123.20 – $4,473.60 | 17 |
| Treat thigh fracture CPT 27248 | $8,407.20 | $14,012.00 | $336.00 – $11,209.60 | 15 |
| Treat toe dislocation CPT 28665 | $3,505.20 | $5,842.00 | $255.68 – $4,673.60 | 17 |
| Treat toe fracture CPT 28525 | not published | not published | $525.62 – $3,340.82 | 11 |
| Treat ulnar fracture CPT 24675 | $3,365.40 | $5,609.00 | $200.75 – $4,487.20 | 17 |
| Treat ulnar fracture CPT 24685 | $5,152.80 | $8,588.00 | $460.90 – $6,870.40 | 17 |
| Treat vaginal bleeding CPT 57180 | $3,505.20 | $5,842.00 | $38.50 – $4,673.60 | 17 |
| Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 | $7,747.20 | $12,912.00 | $993.28 – $10,329.60 | 17 |
| Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) CPT 25609 | $7,747.20 | $12,912.00 | $993.28 – $10,329.60 | 17 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | $7,747.20 | $12,912.00 | $966.67 – $10,329.60 | 17 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | not published | not published | $199.65 – $3,243.49 | 12 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $246.60 | $411.00 | $28.27 – $328.80 | 17 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $234.00 | $390.00 | $10.78 – $312.00 | 17 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $286.80 | $478.00 | $37.90 – $209.40 | 17 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | not published | not published | $748.80 – $3,273.80 | 11 |
| Treatment of ankle fracture CPT 27792 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Treatment of ankle fracture CPT 27814 | $5,152.80 | $8,588.00 | $495.00 – $6,870.40 | 17 |
| Treatment of ankle fracture CPT 27822 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Treatment of ankle fracture CPT 27823 | $5,152.80 | $8,588.00 | $547.25 – $6,870.40 | 17 |
| Treatment of ankle fracture 27786 CPT 27786 | $825.60 | $1,376.00 | $130.35 – $1,100.80 | 17 |
| Treatment of fibula fracture CPT 27784 | $5,152.80 | $8,588.00 | $993.28 – $7,354.86 | 17 |
| Treatment of fibula fracture 27780 CPT 27780 | $825.60 | $1,376.00 | $230.94 – $1,100.80 | 17 |
| Treatment of heel fracture 28400 CPT 28400 | $3,355.20 | $5,592.00 | $154.00 – $4,473.60 | 17 |
| Treatment of thigh fracture CPT 27506 | $13,663.20 | $22,772.00 | $844.80 – $18,217.60 | 15 |
| Treatment of thigh fracture CPT 27508 | $3,355.20 | $5,592.00 | $230.94 – $4,473.60 | 17 |
| Treatment of thigh fracture CPT 27510 | $3,135.00 | $5,225.00 | $348.70 – $4,180.00 | 17 |
| Treatment of thigh fracture CPT 27511 | $6,347.40 | $10,579.00 | $967.68 – $8,463.20 | 15 |
| Treatment of tibia fracture CPT 27758 | $6,347.40 | $10,579.00 | $556.05 – $8,463.20 | 17 |
| Treatment of tibia fracture CPT 27759 | $6,347.40 | $10,579.00 | $993.28 – $13,247.10 | 17 |
| Treatment of toe fracture 28510 CPT 28510 | $825.60 | $1,376.00 | $198.03 – $1,100.80 | 17 |
| Treatment radiation delivery level 2 CPT 77407 | $787.80 | $1,313.00 | $35.75 – $1,050.40 | 17 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | $258.60 | $431.00 | $116.89 – $387.90 | 17 |
| Treponema pallidum antibody CPT 86780 | $36.60 | $61.00 | $13.08 – $46.40 | 17 |
| Trg gene rearrangement anal CPT 81342 | $781.20 | $1,302.00 | $157.34 – $944.80 | 17 |
| Triamcinolone a inj prs-free HCPCS J3300 | $351.00 | $585.00 | $7.86 – $26.10 | 17 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $15.00 | $18.75 | $0.81 – $2.70 | 16 |
| Trichinella antibody CPT 86784 | $316.80 | $528.00 | $12.41 – $422.40 | 17 |
| Triglycerides CPT 84478 | $121.80 | $203.00 | $5.68 – $162.40 | 17 |
| Trim nail(s) HCPCS G0127 | $117.60 | $196.00 | $44.88 – $176.40 | 16 |
| Trim nondyst nails CPT 11719 | $129.00 | $215.00 | $28.21 – $172.00 | 17 |
| Trimethobenzamide hcl inj HCPCS J3250 | $94.40 | $118.00 | $31.86 – $106.20 | 16 |
| Trnscath plc stent crv crtd w/prtct CPT 37215 | $5,782.20 | $9,637.00 | $1,083.30 – $7,709.60 | 15 |
| Trnscath plc stent crv crtd without prtct CPT 37216 | $5,782.20 | $9,637.00 | $1,043.46 – $7,709.60 | 15 |
| Trnscath plc vas stent w/s&i ea addl vein CPT 37239 | $2,719.80 | $4,533.00 | $137.21 – $3,626.40 | 17 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | $4,478.40 | $7,464.00 | $294.23 – $5,971.20 | 17 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $2,325.60 | $3,876.00 | $255.95 – $3,240.52 | 17 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $6,156.00 | $10,260.00 | $356.24 – $8,208.00 | 17 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $4,843.20 | $8,072.00 | $149.54 – $6,457.60 | 17 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $5,236.20 | $8,727.00 | $314.51 – $6,981.60 | 17 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | $11,606.40 | $19,344.00 | $993.28 – $15,475.20 | 17 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $5,275.20 | $8,792.00 | $268.40 – $7,033.60 | 17 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | $4,493.40 | $7,489.00 | $128.70 – $5,991.20 | 17 |
| Troponin quantitative CPT 84484 | $91.20 | $152.00 | $10.86 – $121.60 | 17 |
| Tte w or without fol w/con,stres HCPCS C8928 | $968.40 | $1,614.00 | $578.38 – $1,452.60 | 16 |
| Tte w or without fol w/cont, com HCPCS C8921 | $904.80 | $1,508.00 | $578.38 – $1,357.20 | 16 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $534.60 | $891.00 | $354.53 – $813.41 | 16 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $220.80 | $368.00 | $35.10 – $104.00 | 15 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | $77.40 | $129.00 | $7.04 – $103.20 | 15 |
| Tx atrial fib pulm vein isol CPT 93656 | $19,314.00 | $32,190.00 | $993.28 – $25,752.00 | 17 |
| Tx closed distal humerus fx CPT 24999 | not published | not published | $161.64 – $247.00 | 8 |
| Tx closed hip disl traumatic without anes CPT 27250 | $825.60 | $1,376.00 | $225.12 – $1,198.63 | 17 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $3,355.20 | $5,592.00 | $250.25 – $4,473.60 | 17 |
| Tx closed tib shaft fx without manip CPT 27750 | $3,355.20 | $5,592.00 | $156.75 – $4,473.60 | 17 |
| Tx l/r atrial fib addl CPT 93657 | $5,650.20 | $9,417.00 | $419.61 – $7,533.60 | 15 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $6,510.60 | $10,851.00 | $195.80 – $8,680.80 | 17 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $6,348.00 | $10,580.00 | $246.40 – $8,464.00 | 17 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $825.60 | $1,376.00 | $125.40 – $1,100.80 | 17 |
| Ua w/micro/comp poc CPT 81000 | $4.80 | $8.00 | $2.45 – $6.40 | 17 |
| Ugt1a1 gene analy common variants CPT 81350 | $1,194.60 | $1,991.00 | $182.71 – $1,592.80 | 17 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $248.40 | $414.00 | $64.14 – $331.20 | 17 |
| Ultrasound breast complete CPT 76641 | $546.60 | $911.00 | $68.39 – $728.80 | 17 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $479.40 | $799.00 | $52.40 – $639.20 | 17 |
| Ultrasound chest CPT 76604 | $461.40 | $769.00 | $60.06 – $615.20 | 17 |
| Ultrasound dx ophth b-scan CPT 76512 | $634.20 | $1,057.00 | $46.75 – $845.60 | 17 |
| Ultrasound encephalogram CPT 76506 | $610.20 | $1,017.00 | $60.80 – $813.60 | 17 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $718.80 | $1,198.00 | $81.27 – $958.40 | 17 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $540.00 | $900.00 | $62.31 – $720.00 | 17 |
| Ultrasound guidance for vascular access CPT 76937 | $400.20 | $667.00 | $16.15 – $533.60 | 17 |
| Ultrasound guide intraoperative CPT 76998 | $628.80 | $1,048.00 | $282.96 – $943.20 | 13 |
| Ultrasound guide tissue ablation CPT 76940 | $1,161.00 | $1,935.00 | $308.19 – $1,548.00 | 14 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $1,009.80 | $1,683.00 | $55.30 – $1,346.40 | 17 |
| Ultrasound hips infant dynamic CPT 76885 | $1,000.20 | $1,667.00 | $84.77 – $1,333.60 | 17 |
| Ultrasound joint complete left CPT 76881 | $847.80 | $1,413.00 | $84.71 – $1,130.40 | 17 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $571.80 | $953.00 | $10.05 – $762.40 | 17 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $309.00 | $515.00 | $54.54 – $653.91 | 17 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $309.00 | $515.00 | $28.13 – $412.00 | 17 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $690.60 | $1,151.00 | $50.92 – $920.80 | 17 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $658.80 | $1,098.00 | $49.92 – $878.40 | 17 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $678.60 | $1,131.00 | $67.88 – $904.80 | 17 |
| Ultrasound prostate/transrectal CPT 76872 | $695.40 | $1,159.00 | $69.31 – $927.20 | 17 |
| Ultrasound retroperitoneal limited CPT 76775 | $697.80 | $1,163.00 | $62.72 – $930.40 | 17 |
| Ultrasound scrotum and contents CPT 76870 | $646.20 | $1,077.00 | $56.32 – $861.60 | 17 |
| Ultrasound spinal canal and contents CPT 76800 | $571.80 | $953.00 | $65.25 – $762.40 | 17 |
| Ultrasound transvaginal non obstetric CPT 76830 | $678.60 | $1,131.00 | $59.52 – $904.80 | 17 |
| Unlisted CT procedure CPT 76497 | $624.00 | $1,040.00 | $67.84 – $936.00 | 16 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $162.28 – $239.10 | 8 |
| Unlisted cv px dx nuc med CPT 78499 | $1,864.20 | $3,107.00 | $303.48 – $2,796.30 | 16 |
| Unlisted misc path test CPT 89240 | $93.00 | $155.00 | $39.16 – $139.50 | 16 |
| Unlisted procedure colon CPT 45399 | $1,566.60 | $2,611.00 | $648.87 – $2,349.90 | 16 |
| Unlisted procedure microbiology CPT 87999 | $124.80 | $208.00 | $56.16 – $187.20 | 13 |
| Unlisted procedure rectum CPT 45999 | $3,156.60 | $5,261.00 | $648.87 – $4,734.90 | 16 |
| Unlisted px casting/strpg CPT 29799 | $126.00 | $210.00 | $83.56 – $189.00 | 16 |
| Unlisted px external ear CPT 69399 | $126.00 | $210.00 | $83.56 – $239.08 | 16 |
| Unlisted px hands/fingers CPT 26989 | not published | not published | $161.64 – $247.00 | 8 |
| Unlisted px leg/ankle CPT 27899 | $114.60 | $191.00 | $76.00 – $246.97 | 16 |
| Unlisted px posterior segmnt CPT 67299 | $3,997.80 | $6,663.00 | $1,686.09 – $5,996.70 | 16 |
| Unlisted px small intestine CPT 44799 | not published | not published | $644.56 – $965.36 | 8 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,665.00 | $2,775.00 | $492.31 – $2,497.50 | 16 |
| Upgrade pm system CPT 33214 | $5,231.40 | $8,719.00 | $993.28 – $10,774.64 | 17 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $4,010.40 | $6,684.00 | $343.82 – $5,347.20 | 17 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $3,051.00 | $5,085.00 | $343.82 – $4,068.00 | 17 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,514.00 | $4,190.00 | $232.71 – $3,352.00 | 17 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $3,526.20 | $5,877.00 | $137.74 – $4,701.60 | 17 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $3,526.20 | $5,877.00 | $163.44 – $4,701.60 | 17 |
| Uppr gi scope w/submuc inj CPT 43236 | $3,526.20 | $5,877.00 | $166.71 – $4,701.60 | 17 |
| Urea nitrogen CPT 84520 | $39.60 | $66.00 | $3.90 – $52.80 | 17 |
| Urea nitrogen 24 hour urine CPT 84540 | $63.00 | $105.00 | $4.34 – $84.00 | 17 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $642.60 | $1,071.00 | $28.80 – $856.80 | 17 |
| Uric acid blood CPT 84550 | $48.60 | $81.00 | $4.47 – $64.80 | 17 |
| Uric acid urine CPT 84560 | $52.20 | $87.00 | $4.95 – $69.60 | 17 |
| Urinalysis (with microscopy) CPT 81001 | $102.60 | $171.00 | $3.13 – $93.60 | 17 |
| Urinalysis (without microscopy) CPT 81003 | $37.80 | $63.00 | $2.22 – $50.40 | 17 |
| Urine Culture Test CPT 87086 | $218.40 | $364.00 | $7.98 – $291.20 | 17 |
| Urine pregnancy test CPT 81025 | $93.00 | $155.00 | $3.37 – $9.11 | 17 |
| Urography, antegrade CPT 74425 | $1,132.80 | $1,888.00 | $28.80 – $1,510.40 | 17 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $76.00 | $95.00 | $12.99 – $85.50 | 17 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $199.20 | $332.00 | $44.00 – $298.80 | 17 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $340.00 | $425.00 | $44.00 – $298.80 | 17 |
| Vaccine dtap < 7 years im CPT 90700 | $32.40 | $54.00 | $9.99 – $33.30 | 17 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $37.80 | $63.00 | $11.00 – $56.70 | 17 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $36.60 | $61.00 | $11.00 – $54.90 | 17 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $31.20 | $52.00 | $7.02 – $23.40 | 17 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $31.20 | $52.00 | $2.70 – $17.04 | 17 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $108.00 | $135.00 | $11.00 – $121.50 | 17 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $39.60 | $66.00 | $11.00 – $59.40 | 17 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $86.40 | $108.00 | $11.00 – $97.20 | 17 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $168.80 | $222.00 | $11.00 – $189.90 | 17 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $63.20 | $79.00 | $6.75 – $31.67 | 17 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $186.00 | $310.00 | $83.70 – $279.00 | 14 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $186.00 | $310.00 | $11.00 – $279.00 | 17 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $12.00 | $20.00 | $5.40 – $22.07 | 16 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $13.20 | $22.00 | $5.94 – $19.80 | 17 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $12.00 | $20.00 | $5.40 – $18.00 | 17 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $24.00 | $30.00 | $8.10 – $49.49 | 16 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $109.60 | $137.00 | $11.00 – $123.30 | 17 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $108.80 | $136.00 | $11.00 – $71.10 | 17 |
| Vaccine mmr live subcutaneous CPT 90707 | $90.60 | $151.00 | $11.00 – $72.90 | 17 |
| Vaccine mmrv live subcutaneous CPT 90710 | $136.80 | $228.00 | $11.00 – $205.20 | 17 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $75.00 | $125.00 | $11.00 – $133.47 | 17 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $144.00 | $240.00 | $11.00 – $257.99 | 17 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $192.00 | $240.00 | $11.00 – $312.90 | 17 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $38.40 | $64.00 | $11.00 – $57.60 | 17 |
| Vaccine rabies im CPT 90675 | $800.00 | $1,000.00 | $11.00 – $900.00 | 17 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $672.00 | $840.00 | $11.00 – $756.00 | 17 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $1,184.80 | $1,481.00 | $11.00 – $1,269.00 | 17 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $846.00 | $1,410.00 | $11.00 – $1,269.00 | 17 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $63.00 | $105.00 | $11.00 – $94.50 | 17 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $74.40 | $93.00 | $5.94 – $37.37 | 17 |
| Vaccine tdap >=7 years im CPT 90715 | $42.40 | $53.00 | $11.00 – $45.00 | 17 |
| Vaccine varicella live subcutaneous CPT 90716 | $748.80 | $936.00 | $11.00 – $842.40 | 17 |
| Vaginal bx CPT 58999 | $114.60 | $191.00 | $76.00 – $207.11 | 16 |
| Valproic acid total therapeutic drug level CPT 80164 | $181.20 | $302.00 | $13.38 – $241.60 | 17 |
| Valvuloplasty aortic CPT 92986 | $3,814.80 | $6,358.00 | $993.28 – $5,870.03 | 16 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $0.60 | $1.00 | $0.03 – $0.90 | 16 |
| Vancomycin hcl injection HCPCS J3370 | $37.20 | $62.00 | $16.74 – $55.80 | 14 |
| Vancomycin peak therapeutic drug level CPT 80202 | $213.00 | $355.00 | $13.38 – $284.00 | 17 |
| Varicella zoster antibody igg CPT 86787 | $146.40 | $244.00 | $12.73 – $122.40 | 17 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $42.00 | $52.50 | $0.93 – $46.80 | 16 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $27,154.80 | $45,258.00 | $21.31 – $135.90 | 17 |
| Vein x-ray kidney CPT 75831 | $1,510.20 | $2,517.00 | $28.80 – $2,013.60 | 17 |
| Vein x-ray liver CPT 75891 | $3,328.80 | $5,548.00 | $155.52 – $4,438.40 | 17 |
| Vein x-ray liver w/hemodynam CPT 75885 | $4,614.60 | $7,691.00 | $161.92 – $6,152.80 | 17 |
| Vein x-ray liver w/hemodynam CPT 75889 | $3,298.20 | $5,497.00 | $168.32 – $4,397.60 | 17 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $511.20 | $852.00 | $7.14 – $681.60 | 15 |
| Venogram ext bil s&i CPT 75822 | $3,953.40 | $6,589.00 | $28.80 – $5,271.20 | 17 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $3,303.00 | $5,505.00 | $28.80 – $4,404.00 | 17 |
| Venous m-thrombectomy add-on CPT 37188 | $5,352.00 | $8,920.00 | $993.28 – $7,136.00 | 17 |
| Venous mech thrombectomy CPT 37187 | $5,352.00 | $8,920.00 | $993.28 – $11,675.74 | 17 |
| Ventilator each subsequent day CPT 94003 | $1,718.40 | $2,864.00 | $61.16 – $2,291.20 | 17 |
| Ventilator initial day CPT 94002 | $1,735.20 | $2,892.00 | $84.16 – $2,313.60 | 17 |
| Version cephalic external CPT 59412 | $91.80 | $153.00 | $60.88 – $3,273.50 | 16 |
| Vinblastine 1 mg/ml intravenous solution HCPCS J9360 | $19.80 | $33.00 | $5.30 – $29.70 | 16 |
| Vincristine 1 mg/ml intravenous solution HCPCS J9370 | $48.60 | $81.00 | $8.22 – $36.00 | 16 |
| Vinorelbine 10 mg/ml intravenous solution (wrapper) HCPCS J9390 | $115.80 | $193.00 | $7.68 – $125.10 | 16 |
| Vitamin D Test CPT 82306 | $226.80 | $378.00 | $29.26 – $302.40 | 17 |
| Vitamin b-12 CPT 82607 | $133.80 | $223.00 | $14.30 – $178.40 | 17 |
| Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 | $690.60 | $1,151.00 | $0.77 – $51.30 | 16 |
| Warde 1003990 aldosterone CPT 82088 | $569.40 | $949.00 | $28.60 – $759.20 | 17 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $52.20 | $87.00 | $21.71 – $66.40 | 17 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $373.20 | $622.00 | $12.75 – $497.60 | 17 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $246.00 | $410.00 | $24.20 – $328.00 | 17 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $209.40 | $349.00 | $13.20 – $279.20 | 17 |
| Warde 1015200 kappa light chain free CPT 83521 | $130.80 | $218.00 | $15.20 – $174.40 | 17 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $45.60 | $76.00 | $7.92 – $60.80 | 17 |
| Warde 3008005 oligoclonal bands CPT 83916 | $237.60 | $396.00 | $16.50 – $316.80 | 17 |
| Warde 3016000 west nile virus antibody CPT 86788 | $91.80 | $153.00 | $16.65 – $122.40 | 17 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $92.40 | $154.00 | $14.22 – $123.20 | 17 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $100.80 | $168.00 | $9.56 – $134.40 | 17 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $41.40 | $69.00 | $8.25 – $55.20 | 17 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $88.80 | $148.00 | $17.78 – $118.40 | 17 |
| Warde 3400683 amplification rna markers infectious disease bacterial vaginosis CPT 81513 | $538.20 | $897.00 | $111.36 – $717.60 | 17 |
| Warde 3400852 arsenic CPT 82175 | $209.40 | $349.00 | $14.81 – $279.20 | 17 |
| Warde 3708165 mercury urine CPT 83825 | $334.80 | $558.00 | $13.20 – $446.40 | 17 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $274.80 | $458.00 | $16.19 – $366.40 | 16 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $132.60 | $221.00 | $10.14 – $176.80 | 17 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $87.60 | $146.00 | $6.32 – $116.80 | 17 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $616.80 | $1,028.00 | $38.17 – $822.40 | 17 |
| Warde aldolase CPT 82085 | $139.20 | $232.00 | $9.60 – $185.60 | 17 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $721.20 | $1,202.00 | $16.67 – $961.60 | 17 |
| Warde amiodarone therapeutic drug level CPT 80151 | $175.20 | $292.00 | $14.55 – $233.60 | 17 |
| Warde analysis gene hfe common variants CPT 81256 | $324.60 | $541.00 | $64.60 – $228.80 | 17 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $718.20 | $1,197.00 | $128.03 – $584.00 | 17 |
| Warde anti-mullerian hormone CPT 82166 | $294.60 | $491.00 | $38.17 – $392.80 | 16 |
| Warde apolipoprotein b CPT 82172 | $133.80 | $223.00 | $20.85 – $178.40 | 17 |
| Warde bile acids CPT 82239 | $243.00 | $405.00 | $16.50 – $324.00 | 17 |
| Warde cadmium blood CPT 82300 | $247.20 | $412.00 | $20.90 – $329.60 | 17 |
| Warde calcitonin CPT 82308 | $484.20 | $807.00 | $23.02 – $645.60 | 17 |
| Warde calculus (stone) infrared CPT 82365 | $349.20 | $582.00 | $11.00 – $465.60 | 17 |
| Warde clozapine therapeutic drug level CPT 80159 | $345.00 | $575.00 | $19.92 – $460.00 | 17 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $309.60 | $516.00 | $21.70 – $412.80 | 17 |
| Warde collagen cross links c-telopeptide CPT 82523 | $479.40 | $799.00 | $14.58 – $639.20 | 17 |
| Warde complement total hemolytic CPT 86162 | $164.40 | $274.00 | $20.08 – $219.20 | 17 |
| Warde copper CPT 82525 | $271.80 | $453.00 | $12.26 – $362.40 | 17 |
| Warde cryoglobulin CPT 82595 | $54.00 | $90.00 | $6.39 – $72.00 | 17 |
| Warde erythropoietin CPT 82668 | $178.80 | $298.00 | $16.50 – $238.40 | 17 |
| Warde estrogen fractionated CPT 82671 | $292.20 | $487.00 | $24.20 – $389.60 | 17 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $83.40 | $139.00 | $10.64 – $111.20 | 17 |
| Warde folic acid rbc CPT 82747 | $190.20 | $317.00 | $17.44 – $253.60 | 17 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $258.60 | $431.00 | $8.80 – $344.80 | 17 |
| Warde gastrin CPT 82941 | $209.40 | $349.00 | $15.40 – $279.20 | 17 |
| Warde growth hormone (hgh) CPT 83003 | $280.80 | $468.00 | $8.80 – $374.40 | 17 |
| Warde helminth antibody strongyloides igg CPT 86682 | $150.60 | $251.00 | $10.16 – $200.80 | 17 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $112.80 | $188.00 | $12.10 – $150.40 | 17 |
| Warde hepatitis a antibody CPT 86708 | $249.60 | $416.00 | $12.25 – $332.80 | 17 |
| Warde hepatitis be antibody CPT 86707 | $100.20 | $167.00 | $11.43 – $133.60 | 17 |
| Warde hepatitis delta agent antibody CPT 86692 | $142.20 | $237.00 | $16.96 – $189.60 | 17 |
| Warde immunofixation electrophoresis urine CPT 86335 | $230.40 | $384.00 | $29.01 – $307.20 | 17 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $103.20 | $172.00 | $11.00 – $137.60 | 17 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $1,579.80 | $2,633.00 | $201.01 – $2,106.40 | 17 |
| Warde islet cell antibody zinc transporter 8 CPT 86341 | $133.20 | $222.00 | $23.29 – $177.60 | 17 |
| Warde lipoprotein (a) CPT 83695 | $93.00 | $155.00 | $14.16 – $124.00 | 17 |
| Warde lipoprotein-associated phospholipase a2 CPT 83698 | $266.40 | $444.00 | $41.73 – $355.20 | 17 |
| Warde mitochondrial antibody each CPT 86381 | $75.60 | $126.00 | $19.87 – $100.80 | 17 |
| Warde oxcarbazepine therapeutic drug level CPT 80183 | $199.80 | $333.00 | $13.09 – $266.40 | 17 |
| Warde pancreatic elastase fecal quantitative CPT 82653 | $456.60 | $761.00 | $20.22 – $608.80 | 17 |
| Warde protein c antigen CPT 85302 | $190.20 | $317.00 | $11.87 – $253.60 | 17 |
| Warde sex hormone binding globulin CPT 84270 | $171.00 | $285.00 | $21.47 – $228.00 | 17 |
| Warde somatomedin CPT 84305 | $511.20 | $852.00 | $21.01 – $681.60 | 17 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $733.20 | $1,222.00 | $15.57 – $977.60 | 17 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $869.40 | $1,449.00 | $22.00 – $1,159.20 | 17 |
| Warde topiramate therapeutic drug level CPT 80201 | $130.20 | $217.00 | $11.78 – $173.60 | 17 |
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | $739.80 | $1,233.00 | $25.77 – $986.40 | 17 |
| Warde viscosity CPT 85810 | $207.00 | $345.00 | $4.40 – $276.00 | 17 |
| Warde vitamin a CPT 84590 | $421.20 | $702.00 | $11.47 – $561.60 | 17 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $194.40 | $324.00 | $7.70 – $259.20 | 17 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $226.80 | $378.00 | $27.77 – $302.40 | 17 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $309.60 | $516.00 | $7.70 – $412.80 | 17 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $579.00 | $965.00 | $38.05 – $772.00 | 17 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $373.20 | $622.00 | $11.00 – $497.60 | 17 |
| Warde zinc CPT 84630 | $258.60 | $431.00 | $11.26 – $344.80 | 17 |
| Wbc automated CPT 85048 | $35.40 | $59.00 | $2.51 – $47.20 | 17 |
| Western blot test CPT 84181 | $181.20 | $302.00 | $16.83 – $241.60 | 17 |
| Wet mounts/ w preparations HCPCS Q0111 | $12.00 | $20.00 | $6.12 – $18.00 | 16 |
| Whole blood for transfusion HCPCS P9010 | $759.60 | $1,266.00 | $33.00 – $1,012.80 | 17 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $230.40 | $384.00 | $152.79 – $411.33 | 16 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $230.40 | $384.00 | $31.88 – $345.60 | 16 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $230.40 | $384.00 | $152.79 – $411.33 | 16 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $240.60 | $401.00 | $34.56 – $411.33 | 16 |
| Wrist X-ray CPT 73110 | $309.60 | $516.00 | $14.72 – $412.80 | 17 |
| X-ray abdomen 1 view CPT 74018 | $538.20 | $897.00 | $17.63 – $717.60 | 17 |
| X-ray abdomen 2 views CPT 74019 | $327.00 | $545.00 | $21.09 – $436.00 | 17 |
| X-ray abdomen >=3 views CPT 74021 | $336.00 | $560.00 | $24.54 – $448.00 | 17 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $504.00 | $840.00 | $30.72 – $672.00 | 17 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $397.80 | $663.00 | $24.32 – $530.40 | 17 |
| X-ray ankle 2 views (both sides) CPT 73600 | $577.20 | $962.00 | $14.72 – $769.60 | 17 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $718.20 | $1,197.00 | $21.12 – $957.60 | 17 |
| X-ray bone age studies CPT 77072 | $289.80 | $483.00 | $12.54 – $386.40 | 17 |
| X-ray bone length studies CPT 77073 | $483.00 | $805.00 | $26.80 – $644.00 | 17 |
| X-ray bone survey complete CPT 77075 | $1,675.20 | $2,792.00 | $57.88 – $2,233.60 | 17 |
| X-ray bone survey infant CPT 77076 | $697.20 | $1,162.00 | $35.92 – $929.60 | 17 |
| X-ray cervical spine 2-3 views CPT 72040 | $637.20 | $1,062.00 | $21.12 – $849.60 | 17 |
| X-ray cervical spine 4-5 views CPT 72050 | $526.20 | $877.00 | $33.92 – $701.60 | 17 |
| X-ray cervical spine >= 6 views CPT 72052 | $679.20 | $1,132.00 | $41.60 – $905.60 | 17 |
| X-ray clavicle complete (both sides) CPT 73000 | $258.60 | $431.00 | $14.72 – $344.80 | 17 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $647.40 | $1,079.00 | $28.80 – $863.20 | 17 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $1,107.00 | $1,845.00 | $49.92 – $1,476.00 | 17 |
| X-ray elbow 2 views (both sides) CPT 73070 | $544.80 | $908.00 | $14.72 – $726.40 | 17 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $373.80 | $623.00 | $14.72 – $498.40 | 17 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $713.40 | $1,189.00 | $28.80 – $951.20 | 17 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $718.20 | $1,197.00 | $47.71 – $957.60 | 17 |
| X-ray exam entire spi 6/> vw CPT 72084 | $970.80 | $1,618.00 | $57.57 – $1,294.40 | 17 |
| X-ray exam of arm infant CPT 73092 | $511.20 | $852.00 | $14.08 – $681.60 | 17 |
| X-ray exam of eye sockets CPT 70200 | $399.00 | $665.00 | $26.88 – $532.00 | 17 |
| X-ray exam of femur 1 CPT 73551 | $237.60 | $396.00 | $18.41 – $316.80 | 17 |
| X-ray exam of jaw joint CPT 70328 | $665.40 | $1,109.00 | $21.12 – $887.20 | 17 |
| X-ray exam of sinuses CPT 70210 | $318.60 | $531.00 | $21.12 – $424.80 | 17 |
| X-ray exam si joints CPT 72200 | $213.00 | $355.00 | $21.12 – $284.00 | 17 |
| X-ray exam thorac spine4/>vw CPT 72074 | $679.20 | $1,132.00 | $27.52 – $905.60 | 17 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $540.00 | $900.00 | $19.16 – $720.00 | 17 |
| X-ray facial bones complete > 3 views CPT 70150 | $444.00 | $740.00 | $28.80 – $592.00 | 17 |
| X-ray femur >=2 views (both sides) CPT 73552 | $599.40 | $999.00 | $21.82 – $799.20 | 17 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $294.60 | $491.00 | $11.52 – $392.80 | 17 |
| X-ray foot 2 views (both sides) CPT 73620 | $627.60 | $1,046.00 | $12.80 – $836.80 | 17 |
| X-ray forearm 2 views (both sides) CPT 73090 | $545.40 | $909.00 | $14.72 – $727.20 | 17 |
| X-ray hand 2 views (both sides) CPT 73120 | $564.60 | $941.00 | $12.80 – $752.80 | 17 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $292.80 | $488.00 | $14.72 – $390.40 | 17 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $414.00 | $690.00 | $35.43 – $552.00 | 17 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $374.40 | $624.00 | $26.59 – $499.20 | 17 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $414.00 | $690.00 | $32.04 – $552.00 | 17 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $786.00 | $1,310.00 | $38.52 – $1,048.00 | 17 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $621.00 | $1,035.00 | $19.10 – $828.00 | 17 |
| X-ray humerus >= 2 views left CPT 73060 | $567.00 | $945.00 | $14.72 – $756.00 | 17 |
| X-ray joint survey 1 view CPT 77077 | $345.00 | $575.00 | $29.85 – $460.00 | 17 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $608.40 | $1,014.00 | $21.12 – $811.20 | 17 |
| X-ray knee 3 views (both sides) CPT 73562 | $399.00 | $665.00 | $21.12 – $532.00 | 17 |
| X-ray knee ap standing bilateral CPT 73565 | $237.60 | $396.00 | $22.22 – $316.80 | 17 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $417.00 | $695.00 | $26.88 – $556.00 | 17 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $511.20 | $852.00 | $21.12 – $681.60 | 17 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $710.40 | $1,184.00 | $28.80 – $947.20 | 17 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $828.00 | $1,380.00 | $26.88 – $1,104.00 | 17 |
| X-ray mandible complete > 4 views CPT 70110 | $412.80 | $688.00 | $21.12 – $550.40 | 17 |
| X-ray mandible ltd <4 views CPT 70100 | $375.60 | $626.00 | $21.12 – $500.80 | 17 |
| X-ray nasal bones complete > 3 views CPT 70160 | $262.20 | $437.00 | $14.72 – $349.60 | 17 |
| X-ray neck soft tissue CPT 70360 | $285.60 | $476.00 | $12.80 – $380.80 | 17 |
| X-ray nose to rectum for foreign body child CPT 76010 | $243.00 | $405.00 | $11.14 – $324.00 | 17 |
| X-ray pelvis 1-2 views CPT 72170 | $511.20 | $852.00 | $12.80 – $681.60 | 17 |
| X-ray pelvis complete > 3 views CPT 72190 | $509.40 | $849.00 | $26.88 – $679.20 | 17 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $723.60 | $1,206.00 | $28.80 – $964.80 | 17 |
| X-ray ribs 2 views left CPT 71100 | $304.80 | $508.00 | $21.12 – $406.40 | 17 |
| X-ray ribs 3 views bilateral CPT 71110 | $464.40 | $774.00 | $21.12 – $619.20 | 17 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $399.00 | $665.00 | $21.12 – $532.00 | 17 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $644.40 | $1,074.00 | $21.12 – $859.20 | 17 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $397.80 | $663.00 | $21.12 – $530.40 | 17 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $387.60 | $646.00 | $21.12 – $516.80 | 17 |
| X-ray scapula complete (both sides) CPT 73010 | $304.20 | $507.00 | $21.12 – $405.60 | 17 |
| X-ray sella turcica CPT 70240 | $494.40 | $824.00 | $14.72 – $659.20 | 17 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $582.60 | $971.00 | $18.57 – $776.80 | 17 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,167.00 | $1,945.00 | $21.12 – $1,556.00 | 17 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $448.80 | $748.00 | $28.80 – $598.40 | 17 |
| X-ray skull < 4 views CPT 70250 | $364.20 | $607.00 | $26.88 – $485.60 | 17 |
| X-ray skull > 4 views complete CPT 70260 | $440.40 | $734.00 | $35.19 – $587.20 | 17 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $945.00 | $1,575.00 | $35.20 – $1,260.00 | 17 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $669.60 | $1,116.00 | $28.80 – $892.80 | 17 |
| X-ray small intestine follow-through study CPT 74248 | $397.20 | $662.00 | $46.07 – $529.60 | 17 |
| X-ray spine single view CPT 72020 | $309.60 | $516.00 | $18.51 – $412.80 | 17 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $385.80 | $643.00 | $14.72 – $514.40 | 17 |
| X-ray sternum > 2 views CPT 71120 | $331.80 | $553.00 | $14.72 – $442.40 | 17 |
| X-ray surgical specimen CPT 76098 | $178.80 | $298.00 | $13.59 – $238.40 | 17 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $828.00 | $1,380.00 | $35.84 – $1,104.00 | 17 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $675.60 | $1,126.00 | $21.12 – $900.80 | 17 |
| X-ray thoracic spine 2 views CPT 72070 | $642.00 | $1,070.00 | $25.84 – $856.00 | 17 |
| X-ray thoracic spine 3 views CPT 72072 | $551.40 | $919.00 | $27.52 – $735.20 | 17 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $335.40 | $559.00 | $21.12 – $447.20 | 17 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $396.00 | $660.00 | $24.20 – $528.00 | 17 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $718.20 | $1,197.00 | $43.96 – $957.60 | 17 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $646.80 | $1,078.00 | $21.12 – $862.40 | 17 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $364.80 | $608.00 | $11.52 – $486.40 | 17 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $580.20 | $967.00 | $51.20 – $773.60 | 17 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $580.20 | $967.00 | $49.92 – $773.60 | 17 |
| X-ray wrist 2 views (both sides) CPT 73100 | $587.40 | $979.00 | $14.72 – $783.20 | 17 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $6.60 | $11.00 | $1.51 – $9.90 | 16 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $229.80 | $383.00 | $6.83 – $172.80 | 16 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | $45.60 | $76.00 | $20.61 – $68.40 | 17 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $4,651.80 | $7,753.00 | $5.06 – $927.90 | 16 |
| _afb id by dna probe rflx ast CPT 87149 | $141.00 | $235.00 | $19.82 – $188.00 | 17 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $1,507.80 | $2,513.00 | $114.02 – $2,010.40 | 17 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.