hospital_name,last_updated_on,version,hospital_location,,hospital_address,license_number | NY ,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
University Hospital of Brooklyn,3/31/2026,1.0.0,"Brooklyn, New York",,"445 Lenox Road, Brooklyn NY 11203",7001037H,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,description,Code | 1,Code | 1 | type,setting,,drug_unit_of_measurement,drug_type_of_measurement,modifiers,standard_charge | gross,standard_charge | discounted_cash ,additional_generic_notes,standard_charge | 1199 | commercial | negotiated_dollar,standard_charge | Aetna | commercial | negotiated_dollar,standard_charge | CIGNA | commercial | negotiated_dollar,standard_charge | EBCBS HMO | commercial | negotiated_dollar,standard_charge | EBCBS PPO | commercial | negotiated_dollar,standard_charge | Emblem GHI | commercial | negotiated_dollar,standard_charge | Emblem HIP | commercial | negotiated_dollar,standard_charge | Healthfirst | commercial | negotiated_dollar,standard_charge | MagnaCare | commercial | negotiated_dollar,standard_charge | UHC AP | commercial | negotiated_dollar,standard_charge | UHC Oxford | commercial | negotiated_dollar,standard_charge | UHC Oxford Narrow | commercial | negotiated_dollar,standard_charge | AETNA - Medicare | commercial | negotiated_dollar,standard_charge | AlphaCare Medicare | commercial | negotiated_dollar,standard_charge | EBCBS Medicare | commercial | negotiated_dollar,standard_charge | ElderPlan Medicare | commercial | negotiated_dollar,standard_charge | Emblem GHI Medicare | commercial | negotiated_dollar,standard_charge | Emblem HIPI Medicare | commercial | negotiated_dollar,standard_charge | Fidelis Medicare | commercial | negotiated_dollar,standard_charge | HAMASPIK Medicare | commercial | negotiated_dollar,standard_charge | Healthfirst Medicare | commercial | negotiated_dollar,standard_charge | Integra Medicare | commercial | negotiated_dollar,standard_charge | Longevity Medicare | commercial | negotiated_dollar,standard_charge | MagnaCare Medicare | commercial | negotiated_dollar,standard_charge | MetroPlus Medicare | commercial | negotiated_dollar,standard_charge | UHC Medicare | commercial | negotiated_dollar,standard_charge | UHC Oxford Medicare | commercial | negotiated_dollar,standard_charge | Village Care Medicare | commercial | negotiated_dollar,standard_charge | VNSNY Medicare | commercial | negotiated_dollar,standard_charge | Affinity Medicaid | commercial | negotiated_dollar,standard_charge | Affinity Medicaid | commercial | negotiated_percentage,standard_charge | AmidaCare Medicaid | commercial | negotiated_dollar,standard_charge | EBCBS Medicaid | commercial | negotiated_dollar,standard_charge | Emblem HIP Medicaid | commercial | negotiated_dollar,standard_charge | Fidelis Medicaid | commercial | negotiated_dollar,standard_charge | Healthfirst Medicaid | commercial | negotiated_dollar,standard_charge | MagnaCare Medicaid | commercial | negotiated_dollar,standard_charge | MetroPlus Medicaid | commercial | negotiated_dollar,standard_charge | UHC Medicaid | commercial | negotiated_dollar,standard_charge | VillageCare Medicaid | commercial | negotiated_dollar,standard_charge | VNSNY Medicaid | commercial | negotiated_dollar,standard_charge | WellCare Medicaid | commercial | negotiated_dollar,standard_charge | Fidelis QHP | commercial | negotiated_dollar,standard_charge | Healthfirst QHP | commercial | negotiated_dollar,standard_charge | MetroPlus QHP | commercial | negotiated_dollar,standard_charge | Fidelis EP | commercial | negotiated_dollar,standard_charge | Healthfirst EP | commercial | negotiated_dollar,standard_charge | MetroPlus EP | commercial | negotiated_dollar,standard_charge | min,standard_charge | max
,,,,,,,,,,,,,OP-Fee Schedule. Not in Fee Schedule 100% of Medicare,"OP Fee Schedule, if no fee 200% MCR",,,"OP- Lab 130%MCR, RAD 125%MCR, Minor Surg 1641",,,,,,,100% Medicare,100% Medicare,100% Medicare,102% Medicare,100% Medicare,100% Medicare,100% Medicare,100% Medicare,95% Medicare,100% Medicare,100% Medicare,100% Medicare,100% Medicare,100% Medicare,100% Medicare,110% Medicare,102% Medicare,107% Medicare,100% Medicaid ,100% Medicaid ,100% Medicaid ,100% Medicaid ,100% Medicaid ,100% Medicaid ,110% Medicaid ,100% Medicaid ,100% Medicaid ,116% Medicaid ,100% Medicaid ,103% Medicaid ,105% Medicaid ,125% Medicaid ,100% Medicaid ,225% Medicaid ,225% Medicaid ,225% Medicaid ,,
,,,,,,,,,,,,15403,16988,10468,16142,19611,24345,24345,1.3,15094,18087,11798,10618,AETNA - Medicare,ALPHACARE-Medicare, EBCBS - Medicare , ELDERPLAN - Medicare , EMBLEM GHI - Medicare , EMBLEM HIP - Medicare , FIDELIS - Medicare , HAMASPIK- Medicare , HEALTHFIRST - Medicare , Integra- Medicare , LONGEVITY- Medicare , MAGNACARE- Medicare ,METROPLUS - Medicare,UHC - Medicare,UHC OXFORD - Medicare,VILLAGECARE - Medicare,VNSNY - Medicare,WELLCARE - Medicare, AFFINITY - Medicaid , AMIDACARE - Medicaid , EBCBS/HEALTHPLUS- Medicaid , EMBLEM HIP - Medicaid , FIDELIS - Medicaid , HEALTHFIRST - Medicaid , MAGNACARE-MEDICAID ,METROPLUS - Medicaid,UHC/COMMUNITY - Medicaid,VILLAGECARE - Medicaid,VNSNY Medicaid,WELLCARE-Medicaid,FIDELIS- QHP,HEALTHFIRST- QHP,METROPLUS-QHP,FIDELIS- EP,HEALTHFIRST- EP,METROPLUS-EP,,
Code,Item/Service Description,,Code Type,,Shoppable,Charges,Medicare,Medicaid EAPG,Medicaid,Medicare Lab, DISCOUNTED CASH PRICES , 1199 - Commercial , AETNA - Commercial , CIGNA - Commercial , EBCBS HMO - Commercial , EBCBS PPO- Commercial , EMBLEM GHI - Commercial , EMBLEM HIP - Commercial , HEALTHFIRST - Commercial , MAGNA CARE - Commercial ,UHC AP - Commercial,UHC OXFORD - Commercial,UHC OXFORD NARROW- Commercial,AETNA - Medicare,ALPHACARE-Medicare, EBCBS - Medicare , ELDERPLAN - Medicare , EMBLEM GHI - Medicare , EMBLEM HIP - Medicare , FIDELIS - Medicare , HAMASPIK- Medicare , HEALTHFIRST - Medicare , Integra- Medicare , LONGEVITY- Medicare , MAGNACARE- Medicare ,METROPLUS - Medicare,UHC - Medicare,UHC OXFORD - Medicare,VILLAGECARE - Medicare,VNSNY - Medicare,WELLCARE - Medicare, AFFINITY - Medicaid , AMIDACARE - Medicaid , EBCBS/HEALTHPLUS- Medicaid , EMBLEM HIP - Medicaid , FIDELIS - Medicaid , HEALTHFIRST - Medicaid , MAGNACARE-MEDICAID ,METROPLUS - Medicaid,UHC/COMMUNITY - Medicaid,VILLAGECARE - Medicaid,VNSNY Medicaid,WELLCARE-Medicaid,FIDELIS- QHP,HEALTHFIRST- QHP,METROPLUS-QHP,FIDELIS- EP,HEALTHFIRST- EP,METROPLUS-EP, DE-IDENTIFIED MINIMUM NEGOTIATED CHARGES , DE-IDENTIFIED MaXIMUM NEGOTIATED CHARGES 
216,216 - CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,216,DRG,Inpatient,YES-CMS,,"$127,581.65 ",9.6511,"$104,942.12 ",#N/A,0,"148,655.89","163,952.89","101,027.71","155,788.06","189,267.72","234,956.03","234,956.03","136,424.76","145,673.70","174,559.45","113,863.68","102,475.38","127,581.65","127,581.65","127,581.65","130,133.29","127,581.65","127,581.65","127,581.65","127,581.65","121,202.57","127,581.65","127,581.65","127,581.65","127,581.65","127,581.65","127,581.65","140,339.82","130,133.29","136,512.37","104,942.12","104,942.12","104,942.12","104,942.12","104,942.12","104,942.12","104,942.12","104,942.12","104,942.12","104,942.12","104,942.12","108,090.39","110,189.23","131,177.65","104,942.12","236,119.77","236,119.77","236,119.77","101,027.71","236,119.77"
291,291 - Heart failure & shock w MCC,291,DRG,Inpatient,,60136.87,"$18,129.28 ",1.3048,"$19,157.14 ",#N/A,"60,136.87","20,097.83","22,165.94","13,658.65","21,062.08","25,588.43","31,765.36","31,765.36","24,904.29","19,694.65","23,599.92","15,394.03","13,854.37","18,129.28","18,129.28","18,129.28","18,491.87","18,129.28","18,129.28","18,129.28","18,129.28","17,222.82","18,129.28","18,129.28","18,129.28","18,129.28","18,129.28","18,129.28","19,942.21","18,491.87","19,398.33","19,157.14","19,157.14","19,157.14","19,157.14","19,157.14","19,157.14","19,157.14","19,157.14","19,157.14","19,157.14","19,157.14","19,731.86","20,115.00","23,946.43","19,157.14","43,103.57","43,103.57","43,103.57","13,658.65","43,103.57"
392,"392 - Esophagitis, gastroent & misc diges",392,DRG,Inpatient,,48108.19,"$11,251.05 ",0.7803,"$13,766.22 ",#N/A,"48,108.19","12,018.96","13,255.74","8,168.18","12,595.60","15,302.46","18,996.40","18,996.40","17,896.09","11,777.85","14,113.29","9,205.98","8,285.23","11,251.05","11,251.05","11,251.05","11,476.07","11,251.05","11,251.05","11,251.05","11,251.05","10,688.50","11,251.05","11,251.05","11,251.05","11,251.05","11,251.05","11,251.05","12,376.16","11,476.07","12,038.62","13,766.22","13,766.22","13,766.22","13,766.22","13,766.22","13,766.22","13,766.22","13,766.22","13,766.22","13,766.22","13,766.22","14,179.21","14,454.54","17,207.78","13,766.22","30,974.01","30,974.01","30,974.01","8,168.18","30,974.01"
460,460 - No longer valid,460,DRG,Inpatient,YES-CMS,264241.78,,1,,#N/A,"264,241.78","15,403.00","16,988.00","10,468.00","16,142.00","19,611.00","24,345.00","24,345.00",0,"15,094.00","18,087.00","11,798.00","10,618.00",0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,"24,345.00"
470,470 - Maj hip/knee joint rplcmnt/reattach,470,DRG,Inpatient,YES-CMS,87584.08,"$25,744.51 ",1.8855,"$25,125.70 ",#N/A,"87,584.08","29,042.36","32,030.87","19,737.41","30,435.74","36,976.54","45,902.50","45,902.50","32,663.41","28,459.74","34,103.04","22,245.13","20,020.24","25,744.51","25,744.51","25,744.51","26,259.40","25,744.51","25,744.51","25,744.51","25,744.51","24,457.28","25,744.51","25,744.51","25,744.51","25,744.51","25,744.51","25,744.51","28,318.96","26,259.40","27,546.63","25,125.70","25,125.70","25,125.70","25,125.70","25,125.70","25,125.70","25,125.70","25,125.70","25,125.70","25,125.70","25,125.70","25,879.47","26,381.98","31,407.12","25,125.70","56,532.82","56,532.82","56,532.82","19,737.41","56,532.82"
473,473 - Cervical spinal fusion w/o CC/MCC,473,DRG,Inpatient,YES-CMS,111776.77,"$32,064.09 ",2.3674,"$30,078.76 ",#N/A,"111,776.77","36,465.06","40,217.39","24,781.94","38,214.57","46,427.08","57,634.35","57,634.35","39,102.39","35,733.54","42,819.16","27,930.59","25,137.05","32,064.09","32,064.09","32,064.09","32,705.37","32,064.09","32,064.09","32,064.09","32,064.09","30,460.88","32,064.09","32,064.09","32,064.09","32,064.09","32,064.09","32,064.09","35,270.50","32,705.37","34,308.57","30,078.76","30,078.76","30,078.76","30,078.76","30,078.76","30,078.76","30,078.76","30,078.76","30,078.76","30,078.76","30,078.76","30,981.13","31,582.70","37,598.45","30,078.76","67,677.22","67,677.22","67,677.22","24,781.94","67,677.22"
743,743 - Uterine & adnexa proc for non-malig,743,DRG,Inpatient,YES-CMS,57321.99,"$16,737.90 ",1.1987,"$18,066.63 ",#N/A,"57,321.99","18,463.58","20,363.52","12,547.99","19,349.42","23,507.71","29,182.35","29,182.35","23,486.61","18,093.18","21,680.89","14,142.26","12,727.80","16,737.90","16,737.90","16,737.90","17,072.66","16,737.90","16,737.90","16,737.90","16,737.90","15,901.00","16,737.90","16,737.90","16,737.90","16,737.90","16,737.90","16,737.90","18,411.69","17,072.66","17,909.55","18,066.63","18,066.63","18,066.63","18,066.63","18,066.63","18,066.63","18,066.63","18,066.63","18,066.63","18,066.63","18,066.63","18,608.62","18,969.96","22,583.28","18,066.63","40,649.91","40,649.91","40,649.91","12,547.99","40,649.91"
787,787 - Cesarean section w/o sterilization,787,CPT,Inpatient,,52723.22,"$14,942.61 ",1.0618,"$16,659.54 ",#N/A,"52,723.22","16,354.91","18,037.86","11,114.92","17,139.58","20,822.96","25,849.52","25,849.52","21,657.40","16,026.81","19,204.78","12,527.12","11,274.19","14,942.61","14,942.61","14,942.61","15,241.46","14,942.61","14,942.61","14,942.61","14,942.61","14,195.48","14,942.61","14,942.61","14,942.61","14,942.61","14,942.61","14,942.61","16,436.87","15,241.46","15,988.59","16,659.54","16,659.54","16,659.54","16,659.54","16,659.54","16,659.54","16,659.54","16,659.54","16,659.54","16,659.54","16,659.54","17,159.33","17,492.52","20,824.42","16,659.54","37,483.96","37,483.96","37,483.96","11,114.92","37,483.96"
794,794 - Neonate w other significant problem,794,CPT,Inpatient,,27805.99,"$20,377.00 ",1.4762,"$20,918.83 ",#N/A,"27,805.99","22,737.91","25,077.69","15,452.86","23,828.82","28,949.76","35,938.09","35,938.09","27,194.48","22,281.76","26,700.03","17,416.21","15,674.29","20,377.00","20,377.00","20,377.00","20,784.54","20,377.00","20,377.00","20,377.00","20,377.00","19,358.15","20,377.00","20,377.00","20,377.00","20,377.00","20,377.00","20,377.00","22,414.70","20,784.54","21,803.39","20,918.83","20,918.83","20,918.83","20,918.83","20,918.83","20,918.83","20,918.83","20,918.83","20,918.83","20,918.83","20,918.83","21,546.39","21,964.77","26,148.53","20,918.83","47,067.36","47,067.36","47,067.36","15,452.86","47,067.36"
795,795 - Normal newborn,795,DRG,Inpatient,,20559.82,"$3,638.44 ",0.1998,"$7,799.73 ",#N/A,"20,559.82","3,077.52","3,394.20","2,091.51","3,225.17","3,918.28","4,864.13","4,864.13","10,139.65","3,015.78","3,613.78","2,357.24","2,121.48","3,638.44","3,638.44","3,638.44","3,711.21","3,638.44","3,638.44","3,638.44","3,638.44","3,456.52","3,638.44","3,638.44","3,638.44","3,638.44","3,638.44","3,638.44","4,002.29","3,711.21","3,893.13","7,799.73","7,799.73","7,799.73","7,799.73","7,799.73","7,799.73","7,799.73","7,799.73","7,799.73","7,799.73","7,799.73","8,033.72","8,189.71","9,749.66","7,799.73","17,549.39","17,549.39","17,549.39","2,091.51","17,549.39"
806,806 - Vaginal delivery w/o sterilization/,806,DRG,Inpatient,,36990.33,"$10,507.49 ",0.7236,"$13,183.45 ",#N/A,"36,990.33","11,145.61","12,292.52","7,574.64","11,680.35","14,190.52","17,616.04","17,616.04","17,138.49","10,922.02","13,087.75","8,537.03","7,683.18","10,507.49","10,507.49","10,507.49","10,717.64","10,507.49","10,507.49","10,507.49","10,507.49","9,982.12","10,507.49","10,507.49","10,507.49","10,507.49","10,507.49","10,507.49","11,558.24","10,717.64","11,243.02","13,183.45","13,183.45","13,183.45","13,183.45","13,183.45","13,183.45","13,183.45","13,183.45","13,183.45","13,183.45","13,183.45","13,578.95","13,842.62","16,479.31","13,183.45","29,662.76","29,662.76","29,662.76","7,574.64","29,662.76"
807,807 - Vaginal delivery w/o sterilization/,807,DRG,Inpatient,,28723.94,"$9,375.77 ",0.6373,"$12,296.44 ",#N/A,"28,723.94","9,816.33","10,826.45","6,671.26","10,287.30","12,498.09","15,515.07","15,515.07","15,985.37","9,619.41","11,526.85","7,518.87","6,766.85","9,375.77","9,375.77","9,375.77","9,563.28","9,375.77","9,375.77","9,375.77","9,375.77","8,906.98","9,375.77","9,375.77","9,375.77","9,375.77","9,375.77","9,375.77","10,313.34","9,563.28","10,032.07","12,296.44","12,296.44","12,296.44","12,296.44","12,296.44","12,296.44","12,296.44","12,296.44","12,296.44","12,296.44","12,296.44","12,665.33","12,911.26","15,370.55","12,296.44","27,666.99","27,666.99","27,666.99","6,671.26","27,666.99"
812,812 - Red blood cell disorders w/o MCC,812,DRG,Inpatient,,41557.01,"$13,121.09 ",0.9229,"$15,231.90 ",#N/A,"41,557.01","14,215.43","15,678.23","9,660.92","14,897.45","18,098.99","22,468.00","22,468.00","19,801.47","13,930.25","16,692.49","10,888.37","9,799.35","13,121.09","13,121.09","13,121.09","13,383.51","13,121.09","13,121.09","13,121.09","13,121.09","12,465.04","13,121.09","13,121.09","13,121.09","13,121.09","13,121.09","13,121.09","14,433.20","13,383.51","14,039.57","15,231.90","15,231.90","15,231.90","15,231.90","15,231.90","15,231.90","15,231.90","15,231.90","15,231.90","15,231.90","15,231.90","15,688.85","15,993.49","19,039.87","15,231.90","34,271.77","34,271.77","34,271.77","9,660.92","34,271.77"
871,871 - Septicemia or severe sepsis without,871,DRG,Inpatient,,101617.51,"$26,749.03 ",1.9621,"$25,913.01 ",#N/A,"101,617.51","30,222.23","33,332.15","20,539.26","31,672.22","38,478.74","47,767.32","47,767.32","33,686.91","29,615.94","35,488.50","23,148.86","20,833.58","26,749.03","26,749.03","26,749.03","27,284.01","26,749.03","26,749.03","26,749.03","26,749.03","25,411.58","26,749.03","26,749.03","26,749.03","26,749.03","26,749.03","26,749.03","29,423.94","27,284.01","28,621.47","25,913.01","25,913.01","25,913.01","25,913.01","25,913.01","25,913.01","25,913.01","25,913.01","25,913.01","25,913.01","25,913.01","26,690.40","27,208.66","32,391.26","25,913.01","58,304.27","58,304.27","58,304.27","20,539.26","58,304.27"
10060,10060 - DRAINAGE OF SKIN ABSCESS,10060,CPT,Both,YES,593,188.1,3,368.36,#N/A,593,80,82.58,178.69,296.78,296.78,"1,641.00","1,641.00",368.36,593,80.12,80.12,80.12,188.1,188.1,188.1,191.86,188.1,188.1,188.1,188.1,178.69,188.1,188.1,188.1,188.1,188.1,188.1,206.91,191.86,201.26,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,379.41,386.77,460.45,368.36,828.8,828.8,828.8,80,"1,641.00"
11056,11056 - PARNG/CUTG B9 HYPRKR LES 2-4,11056,CPT,Both,,399,188.1,3,368.36,#N/A,399,37,,178.69,296.78,296.78,"1,641.00","1,641.00",368.36,399,80.12,80.12,80.12,188.1,188.1,188.1,191.86,188.1,188.1,188.1,188.1,178.69,188.1,188.1,188.1,188.1,188.1,188.1,206.91,191.86,201.26,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,368.36,379.41,386.77,460.45,368.36,828.8,828.8,828.8,37,"1,641.00"
11721,11721 - DEBRIDE NAIL 6 OR MORE,11721,CPT,Both,,243,56.23,5,120.47,#N/A,243,33,,53.42,88.72,88.72,"1,641.00","1,641.00",120.47,243,38.04,38.04,38.04,56.23,56.23,56.23,57.36,56.23,56.23,56.23,56.23,53.42,56.23,56.23,56.23,56.23,56.23,56.23,61.85,57.36,60.17,120.47,120.47,120.47,120.47,120.47,120.47,120.47,120.47,120.47,120.47,120.47,124.09,126.49,150.59,120.47,271.06,271.06,271.06,33,"1,641.00"
19120,19120 - REMOVAL OF BREAST LESION,19120,CPT,Both,YES-CMS,8248.66,3624.94,20,1713.9,#N/A,"8,248.66",387,366.84,"3,535.00","5,719.44","5,719.44","1,641.00","1,641.00","1,713.90","8,248.66","1,487.80","1,487.80","1,487.80","3,624.94","3,624.94","3,624.94","3,697.44","3,624.94","3,624.94","3,624.94","3,624.94","3,443.70","3,624.94","3,624.94","3,624.94","3,624.94","3,624.94","3,624.94","3,987.44","3,697.44","3,878.69","1,713.90","1,713.90","1,713.90","1,713.90","1,713.90","1,713.90","1,713.90","1,713.90","1,713.90","1,713.90","1,713.90","1,765.31","1,799.59","2,142.37","1,713.90","3,856.27","3,856.27","3,856.27",366.84,"8,248.66"
29826,29826 - Sho arthrs srg decompression,29826,CPT,Both,YES-CMS,,0,37,1986.09,#N/A,0,769,,,0,0,"1,641.00","1,641.00","1,986.09",0,123.92,123.92,123.92,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,"1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","2,045.68","2,085.40","2,482.62","1,986.09","4,468.71","4,468.71","4,468.71",0,"4,468.71"
29881,29881 - Knee arthroscopy/surgery,29881,CPT,Both,YES-CMS,,3071.47,37,1986.09,#N/A,0,686,,"2,917.89","4,846.16","4,846.16","1,641.00","1,641.00","1,986.09",0,"1,629.00","1,629.00","1,629.00","3,071.47","3,071.47","3,071.47","3,132.90","3,071.47","3,071.47","3,071.47","3,071.47","2,917.89","3,071.47","3,071.47","3,071.47","3,071.47","3,071.47","3,071.47","3,378.61","3,132.90","3,286.47","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","1,986.09","2,045.68","2,085.40","2,482.62","1,986.09","4,468.71","4,468.71","4,468.71",0,"4,846.16"
31231,31231 - NASAL ENDOSCOPY DX,31231,CPT,Both,YES,549,183.78,249,165.86,#N/A,549,74,68.38,"1,880.00",289.97,289.97,"1,641.00","1,641.00",165.86,549,96.09,96.09,96.09,183.78,183.78,183.78,187.45,183.78,183.78,183.78,183.78,174.59,183.78,183.78,183.78,183.78,183.78,183.78,202.16,187.45,196.64,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,170.84,174.16,207.33,165.86,373.2,373.2,373.2,68.38,"1,880.00"
31575,31575 - DIAGNOSTIC LARYNGOSCOPY,31575,CPT,Both,,489,183.78,249,165.86,#N/A,489,73,,,289.97,289.97,"1,641.00","1,641.00",165.86,489,96.09,96.09,96.09,183.78,183.78,183.78,187.45,183.78,183.78,183.78,183.78,174.59,183.78,183.78,183.78,183.78,183.78,183.78,202.16,187.45,196.64,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,170.84,174.16,207.33,165.86,373.2,373.2,373.2,73,"1,641.00"
36415,36415 - COLL VENOUS BLD VENIPUNCTURE,36415,CPT,Both,,38,8.83,304,64.47,8.83,38,2,,,13.93,13.93,"1,641.00","1,641.00",64.47,38,2.04,2.04,2.04,8.83,8.83,8.83,9.01,8.83,8.83,8.83,8.83,8.39,8.83,8.83,8.83,8.83,8.83,8.83,9.71,9.01,9.45,64.47,64.47,64.47,64.47,64.47,64.47,64.47,64.47,64.47,64.47,64.47,66.4,67.69,80.59,64.47,145.06,145.06,145.06,2,"1,641.00"
36430,36430 - TRANSFUSION BLD/BLD COMPNT,36430,CPT,Both,,954,#N/A,113,605.91,#N/A,954,50,,605.91,#N/A,#N/A,,,605.91,954,8,8,8,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,605.91,605.91,605.91,605.91,605.91,605.91,605.91,605.91,605.91,605.91,605.91,624.09,636.2,757.39,605.91,"1,363.29","1,363.29","1,363.29",#N/A,#N/A
42820,42820 - REMOVE TONSILS AND ADENOIDS,42820,CPT,Both,YES-CMS,12811.99,5599.99,256,1575.58,#N/A,"12,811.99",363,337.7,"3,535.00","8,835.67","8,835.67","5,618.00","5,618.00","1,575.58","12,811.99","2,253.00","2,253.00","2,253.00","5,599.99","5,599.99","5,599.99","5,711.99","5,599.99","5,599.99","5,599.99","5,599.99","5,319.99","5,599.99","5,599.99","5,599.99","5,599.99","5,599.99","5,599.99","6,159.99","5,711.99","5,991.99","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,622.85","1,654.36","1,969.48","1,575.58","3,545.06","3,545.06","3,545.06",337.7,"12,811.99"
42830,42830 - REMOVAL OF ADENOIDS,42830,CPT,Both,YES,6826.35,3070.01,256,1575.58,#N/A,"6,826.35",221,241.3,"2,910.00","4,843.87","4,843.87","5,618.00","5,618.00","1,575.58","6,826.35","2,690.07","2,690.07","2,690.07","3,070.01","3,070.01","3,070.01","3,131.41","3,070.01","3,070.01","3,070.01","3,070.01","2,916.51","3,070.01","3,070.01","3,070.01","3,070.01","3,070.01","3,070.01","3,377.01","3,131.41","3,284.91","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,575.58","1,622.85","1,654.36","1,969.48","1,575.58","3,545.06","3,545.06","3,545.06",221,"6,826.35"
43235,43235 - EGD DIAGNOSTIC BRUSH WASH,43235,CPT,Both,YES-CMS,1980.7,887.52,134,889.36,#N/A,"1,980.70",147,149.2,"1,880.00","1,400.33","1,400.33","5,618.00","5,618.00",889.36,"1,980.70","1,988.00","1,988.00","1,988.00",887.52,887.52,887.52,905.27,887.52,887.52,887.52,887.52,843.15,887.52,887.52,887.52,887.52,887.52,887.52,976.27,905.27,949.65,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,916.04,933.83,"1,111.70",889.36,"2,001.06","2,001.06","2,001.06",147,"5,618.00"
43239,43239 - EGD BIOPSY SINGLE/MULTIPLE,43239,CPT,Both,YES-CMS,1980.7,887.52,134,889.36,#N/A,"1,980.70",174,168.25,"1,965.00","1,400.33","1,400.33","5,618.00","5,618.00",889.36,"1,980.70","1,988.00","1,988.00","1,988.00",887.52,887.52,887.52,905.27,887.52,887.52,887.52,887.52,843.15,887.52,887.52,887.52,887.52,887.52,887.52,976.27,905.27,949.65,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,889.36,916.04,933.83,"1,111.70",889.36,"2,001.06","2,001.06","2,001.06",168.25,"5,618.00"
45378,45378 - DIAGNOSTIC COLONOSCOPY,45378,CPT,Both,YES-CMS,1993.99,863.05,136,855.19,#N/A,"1,993.99",232,222.29,"1,965.00","1,361.72","1,361.72","5,618.00","5,618.00",855.19,"1,993.99","1,988.00","1,988.00","1,988.00",863.05,863.05,863.05,880.31,863.05,863.05,863.05,863.05,819.9,863.05,863.05,863.05,863.05,863.05,863.05,949.36,880.31,923.47,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,880.84,897.95,"1,068.98",855.19,"1,924.17","1,924.17","1,924.17",222.29,"5,618.00"
45380,45380 - COLONOSCOPY AND BIOPSY,45380,CPT,Both,YES-CMS,2598.31,1116.16,136,855.19,#N/A,"2,598.31",274,240.32,"1,965.00","1,761.08","1,761.08","5,618.00","5,618.00",855.19,"2,598.31","1,988.00","1,988.00","1,988.00","1,116.16","1,116.16","1,116.16","1,138.48","1,116.16","1,116.16","1,116.16","1,116.16","1,060.35","1,116.16","1,116.16","1,116.16","1,116.16","1,116.16","1,116.16","1,227.78","1,138.48","1,194.29",855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,880.84,897.95,"1,068.98",855.19,"1,924.17","1,924.17","1,924.17",240.32,"5,618.00"
45385,45385 - COLONOSCOPY W/LESION REMOVAL,45385,CPT,Both,YES-CMS,2598.31,1116.16,136,855.19,#N/A,"2,598.31",325,303.51,"1,965.00","1,761.08","1,761.08","5,618.00","5,618.00",855.19,"2,598.31","1,988.00","1,988.00","1,988.00","1,116.16","1,116.16","1,116.16","1,138.48","1,116.16","1,116.16","1,116.16","1,116.16","1,060.35","1,116.16","1,116.16","1,116.16","1,116.16","1,116.16","1,116.16","1,227.78","1,138.48","1,194.29",855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,880.84,897.95,"1,068.98",855.19,"1,924.17","1,924.17","1,924.17",303.51,"5,618.00"
45391,45391 - COLONOSCOPY W/ENDOSCOPE US,45391,CPT,Both,YES-CMS,2598.31,1116.16,136,855.19,#N/A,"2,598.31",311.94,306.46,"1,965.00","1,761.08","1,761.08","5,618.00","5,618.00",855.19,"2,598.31","1,988.00","1,988.00","1,988.00","1,116.16","1,116.16","1,116.16","1,138.48","1,116.16","1,116.16","1,116.16","1,116.16","1,060.35","1,116.16","1,116.16","1,116.16","1,116.16","1,116.16","1,116.16","1,227.78","1,138.48","1,194.29",855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,855.19,880.84,897.95,"1,068.98",855.19,"1,924.17","1,924.17","1,924.17",306.46,"5,618.00"
47562,47562 - LAPAROSCOPIC CHOLECYSTECTOMY,47562,CPT,Both,YES-CMS,12506.03,5523.03,107,2925.66,#N/A,"12,506.03",719,780.71,"2,910.00","8,714.24","8,714.24","5,618.00","5,618.00","2,925.66","12,506.03","3,843.00","3,843.00","3,843.00","5,523.03","5,523.03","5,523.03","5,633.49","5,523.03","5,523.03","5,523.03","5,523.03","5,246.88","5,523.03","5,523.03","5,523.03","5,523.03","5,523.03","5,523.03","6,075.33","5,633.49","5,909.64","2,925.66","2,925.66","2,925.66","2,925.66","2,925.66","2,925.66","2,925.66","2,925.66","2,925.66","2,925.66","2,925.66","3,013.43","3,071.94","3,657.07","2,925.66","6,582.73","6,582.73","6,582.73",719,"12,506.03"
49505,49505 - PRP I/HERN INIT REDUC >5 YR,49505,CPT,Both,YES-CMS,8498.49,3340.74,3033,2266.37,#N/A,"8,498.49",513,616.88,"2,910.00","5,271.02","5,271.02","5,618.00","5,618.00","2,266.37","8,498.49","2,491.00","2,491.00","2,491.00","3,340.74","3,340.74","3,340.74","3,407.55","3,340.74","3,340.74","3,340.74","3,340.74","3,173.70","3,340.74","3,340.74","3,340.74","3,340.74","3,340.74","3,340.74","3,674.81","3,407.55","3,574.59","2,266.37","2,266.37","2,266.37","2,266.37","2,266.37","2,266.37","2,266.37","2,266.37","2,266.37","2,266.37","2,266.37","2,334.37","2,379.69","2,832.97","2,266.37","5,099.34","5,099.34","5,099.34",513,"8,498.49"
51798,51798 - US URINE CAPACITY MEASURE,51798,CPT,Both,,224,56.23,159,443.26,#N/A,224,26,,,88.72,88.72,"5,618.00","5,618.00",443.26,224,62,62,62,56.23,56.23,56.23,57.36,56.23,56.23,56.23,56.23,53.42,56.23,56.23,56.23,56.23,56.23,56.23,61.85,57.36,60.17,443.26,443.26,443.26,443.26,443.26,443.26,443.26,443.26,443.26,443.26,443.26,456.56,465.42,554.07,443.26,997.33,997.33,997.33,26,"5,618.00"
55700,55700 - BIOPSY OF PROSTATE,55700,CPT,Both,YES-CMS,2485,1939.19,176,2166.87,#N/A,"2,485.00",99,163.98,"1,965.00","3,059.66","3,059.66","5,618.00","5,618.00","2,166.87","2,485.00","1,988.00","1,988.00","1,988.00","1,939.19","1,939.19","1,939.19","1,977.98","1,939.19","1,939.19","1,939.19","1,939.19","1,842.23","1,939.19","1,939.19","1,939.19","1,939.19","1,939.19","1,939.19","2,133.11","1,977.98","2,074.94","2,166.87","2,166.87","2,166.87","2,166.87","2,166.87","2,166.87","2,166.87","2,166.87","2,166.87","2,166.87","2,166.87","2,231.88","2,275.22","2,708.59","2,166.87","4,875.47","4,875.47","4,875.47",99,"5,618.00"
55866,55866 - LAPS SURG PRST8ECT RPBIC RAD,55866,CPT,Both,YES-CMS,21804.07,9855.67,184,2923.49,#N/A,"21,804.07","1,793.00","1,655.42","2,910.00","15,550.28","15,550.28","5,618.00","5,618.00","2,923.49","21,804.07","4,373.00","4,373.00","4,373.00","9,855.67","9,855.67","9,855.67","10,052.78","9,855.67","9,855.67","9,855.67","9,855.67","9,362.89","9,855.67","9,855.67","9,855.67","9,855.67","9,855.67","9,855.67","10,841.24","10,052.78","10,545.57","2,923.49","2,923.49","2,923.49","2,923.49","2,923.49","2,923.49","2,923.49","2,923.49","2,923.49","2,923.49","2,923.49","3,011.20","3,069.67","3,654.36","2,923.49","6,577.85","6,577.85","6,577.85","1,655.42","21,804.07"
59025,59025 - FETAL NON-STRESS TEST,59025,CPT,Both,YES,388,190.43,191,277.62,#N/A,388,12,57.41,65.04,300.46,300.46,194.25,194.25,277.62,388,798,798,798,190.43,190.43,190.43,194.24,190.43,190.43,190.43,190.43,180.91,190.43,190.43,190.43,190.43,190.43,190.43,209.47,194.24,203.76,277.62,277.62,277.62,277.62,277.62,277.62,277.62,277.62,277.62,277.62,277.62,285.95,291.5,347.03,277.62,624.65,624.65,624.65,12,798
59400,59400 - OBSTETRICAL CARE,59400,CPT,Both,YES-CMS,913,0,195,2175.26,#N/A,913,"3,000.00","2,473.00","4,536.26",0,0, NA , NA ,"2,175.26",913,"1,464.95","1,464.95","1,464.95",0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,"2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,240.52","2,284.03","2,719.08","2,175.26","4,894.35","4,894.35","4,894.35",0,"4,894.35"
59510,59510 - Cesarean delivery,59510,CPT,Both,YES-CMS,,0,202,21.59,#N/A,0,"3,000.00",,,0,0,,,21.59,0,"1,626.13","1,626.13","1,626.13",0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,"3,000.00"
59610,59610 - Vbac delivery,59610,CPT,Both,YES-CMS,,0,195,2175.26,#N/A,0,"3,000.00",,,0,0,,,"2,175.26",0,"1,541.40","1,541.40","1,541.40",0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,"2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,175.26","2,240.52","2,284.03","2,719.08","2,175.26","4,894.35","4,894.35","4,894.35",0,"4,894.35"
62323,62323 - NJX INTERLAMINAR LMBR/SAC,62323,CPT,Both,YES-CMS,1546.02,655.56,53,618.65,#N/A,"1,546.02",288,115.24,"1,880.00","1,034.34","1,034.34","4,134.00","4,134.00",618.65,"1,546.02","1,776.00","1,776.00","1,776.00",655.56,655.56,655.56,668.67,655.56,655.56,655.56,655.56,622.78,655.56,655.56,655.56,655.56,655.56,655.56,721.12,668.67,701.45,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,637.21,649.58,773.31,618.65,"1,391.96","1,391.96","1,391.96",115.24,"4,134.00"
64483,64483 - NJX AA&/STRD TFRM EPI L/S 1,64483,CPT,Both,YES-CMS,2044.71,842.78,53,618.65,#N/A,"2,044.71",110,128.81,"1,880.00","1,329.74","1,329.74","4,134.00","4,134.00",618.65,"2,044.71","1,776.00","1,776.00","1,776.00",842.78,842.78,842.78,859.64,842.78,842.78,842.78,842.78,800.64,842.78,842.78,842.78,842.78,842.78,842.78,927.06,859.64,901.78,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,618.65,637.21,649.58,773.31,618.65,"1,391.96","1,391.96","1,391.96",110,"4,134.00"
66821,66821 - AFTER CATARACT LASER SURGERY,66821,CPT,Both,YES-CMS,1342,519.33,247,1757.09,#N/A,"1,342.00",251,371.07,"1,965.00",819.39,819.39,"4,134.00","4,134.00","1,757.09","1,342.00","1,776.00","1,776.00","1,776.00",519.33,519.33,519.33,529.71,519.33,519.33,519.33,519.33,493.36,519.33,519.33,519.33,519.33,519.33,519.33,571.26,529.71,555.68,"1,757.09","1,757.09","1,757.09","1,757.09","1,757.09","1,757.09","1,757.09","1,757.09","1,757.09","1,757.09","1,757.09","1,809.80","1,844.94","2,196.36","1,757.09","3,953.45","3,953.45","3,953.45",251,"4,134.00"
66984,66984 - XCAPSL CTRC RMVL W/O ECP,66984,CPT,Both,YES-CMS,5181.35,2159.03,233,2217.23,#N/A,"5,181.35",766,758.5,"56,020.00","3,406.51","3,406.51","4,134.00","4,134.00","2,217.23","5,181.35","2,253.00","2,253.00","2,253.00","2,159.03","2,159.03","2,159.03","2,202.21","2,159.03","2,159.03","2,159.03","2,159.03","2,051.07","2,159.03","2,159.03","2,159.03","2,159.03","2,159.03","2,159.03","2,374.93","2,202.21","2,310.16","2,217.23","2,217.23","2,217.23","2,217.23","2,217.23","2,217.23","2,217.23","2,217.23","2,217.23","2,217.23","2,217.23","2,283.75","2,328.09","2,771.54","2,217.23","4,988.77","4,988.77","4,988.77",758.5,"56,020.00"
70450,70450 - CT HEAD/BRAIN W/O DYE,70450,CPT,Both,YES-CMS,1339,100.66,300,405.56,#N/A,"1,339.00",241,119.7,"1,171.00",158.83,158.83,101.96,101.96,405.56,"1,339.00",173,173,173,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,417.72,425.83,506.95,405.56,912.5,912.5,912.5,95.63,"1,339.00"
70486,70486 - CT MAXILLOFACIAL W/O DYE,70486,CPT,Both,YES,1759,100.66,299,342.87,#N/A,"1,759.00",241,144.64,"1,171.00",158.83,158.83,134.88,134.88,342.87,"1,759.00",172.8,172.8,172.8,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,353.16,360.01,428.59,342.87,771.46,771.46,771.46,95.63,"1,759.00"
70491,70491 - CT SOFT TISSUE NECK W/DYE,70491,CPT,Both,,2405,168.51,300,405.56,#N/A,"2,405.00",289,,"1,171.00",265.88,265.88,183.79,183.79,405.56,"2,405.00",170,170,170,168.51,168.51,168.51,171.88,168.51,168.51,168.51,168.51,160.09,168.51,168.51,168.51,168.51,168.51,168.51,185.37,171.88,180.31,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,417.72,425.83,506.95,405.56,912.5,912.5,912.5,160.09,"2,405.00"
70496,70496 - CT ANGIOGRAPHY HEAD,70496,CPT,Both,,2699,168.51,302,428.98,#N/A,"2,699.00",393,,"1,171.00",265.88,265.88,263.65,263.65,428.98,"2,699.00",217,217,217,168.51,168.51,168.51,171.88,168.51,168.51,168.51,168.51,160.09,168.51,168.51,168.51,168.51,168.51,168.51,185.37,171.88,180.31,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,441.85,450.43,536.23,428.98,965.21,965.21,965.21,160.09,"2,699.00"
70498,70498 - CT ANGIOGRAPHY NECK,70498,CPT,Both,,2301,168.51,302,428.98,#N/A,"2,301.00",393,,"1,171.00",265.88,265.88,263.65,263.65,428.98,"2,301.00",254,254,254,168.51,168.51,168.51,171.88,168.51,168.51,168.51,168.51,160.09,168.51,168.51,168.51,168.51,168.51,168.51,185.37,171.88,180.31,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,441.85,450.43,536.23,428.98,965.21,965.21,965.21,160.09,"2,301.00"
70551,70551 - MRI BRAIN STEM W/O DYE,70551,CPT,Both,,2104,228.81,293,491.78,#N/A,"2,104.00",571,,"2,143.00",361.02,361.02,195.58,195.58,491.78,"2,104.00",500,500,500,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,506.54,516.37,614.73,491.78,"1,106.51","1,106.51","1,106.51",195.58,"2,143.00"
70553,70553 - MRI BRAIN STEM W/O & W/DYE,70553,CPT,Both,YES-CMS,5954,338.07,295,730.75,#N/A,"5,954.00","1,268.00",370.5,"2,143.00",533.4,533.4,325.54,325.54,730.75,"5,954.00",696,696,696,338.07,338.07,338.07,344.83,338.07,338.07,338.07,338.07,321.17,338.07,338.07,338.07,338.07,338.07,338.07,371.88,344.83,361.73,730.75,730.75,730.75,730.75,730.75,730.75,730.75,730.75,730.75,730.75,730.75,752.67,767.28,913.43,730.75,"1,644.18","1,644.18","1,644.18",321.17,"5,954.00"
71045,71045 - X-RAY EXAM CHEST 1 VIEW,71045,CPT,Both,YES,227,83.35,471,59.03,#N/A,227,13,15.52,17.95,131.51,131.51,25.84,25.84,59.03,227,#N/A,#N/A,#N/A,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,#N/A,#N/A
71046,71046 - X-RAY EXAM CHEST 2 VIEWS,71046,CPT,Both,YES,227,83.35,471,59.03,#N/A,227,24,23.9,21.23,131.51,131.51,34.68,34.68,59.03,227,#N/A,#N/A,#N/A,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,#N/A,#N/A
71250,71250 - CT THORAX DX C-,71250,CPT,Both,YES,1617,100.66,299,342.87,#N/A,"1,617.00",302,168.77,"1,171.00",158.83,158.83,126.53,126.53,342.87,"1,617.00",172.8,172.8,172.8,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,353.16,360.01,428.59,342.87,771.46,771.46,771.46,95.63,"1,617.00"
71260,71260 - CT THORAX DX C+,71260,CPT,Both,YES,1780,168.51,300,405.56,#N/A,"1,780.00",361,237,"1,171.00",265.88,265.88,172.49,172.49,405.56,"1,780.00",346.9,346.9,346.9,168.51,168.51,168.51,171.88,168.51,168.51,168.51,168.51,160.09,168.51,168.51,168.51,168.51,168.51,168.51,185.37,171.88,180.31,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,417.72,425.83,506.95,405.56,912.5,912.5,912.5,160.09,"1,780.00"
71271,71271 - CT THORAX LUNG CANCER SCR C-,71271,CPT,Both,,267,125.83,299,342.87,#N/A,267,112,,"1,171.00",198.54,198.54,133.69,133.69,342.87,267,,,,125.83,125.83,125.83,128.35,125.83,125.83,125.83,125.83,119.54,125.83,125.83,125.83,125.83,125.83,125.83,138.42,128.35,134.64,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,353.16,360.01,428.59,342.87,771.46,771.46,771.46,112,"1,171.00"
71275,71275 - CT ANGIOGRAPHY CHEST,71275,CPT,Both,YES,3150,168.51,302,428.98,#N/A,"3,150.00",475,309.31,"1,171.00",265.88,265.88,263.65,263.65,428.98,"3,150.00",406,406,406,168.51,168.51,168.51,171.88,168.51,168.51,168.51,168.51,160.09,168.51,168.51,168.51,168.51,168.51,168.51,185.37,171.88,180.31,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,441.85,450.43,536.23,428.98,965.21,965.21,965.21,160.09,"3,150.00"
72050,72050 - X-RAY EXAM NECK SPINE 4/5VWS,72050,CPT,Both,,662,100.66,471,59.03,#N/A,662,46,,31.96,158.83,158.83,60.7,60.7,59.03,662,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,31.96,662
72082,72082 - X-RAY EXAM ENTIRE SPI 2/3 VW,72082,CPT,Both,YES,399,100.66,471,59.03,#N/A,399,54,48.38,31.96,158.83,158.83,81.83,81.83,59.03,399,145,145,145,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,31.96,399
72100,72100 - X-RAY EXAM L-S SPINE 2/3 VWS,72100,CPT,Both,,435,100.66,471,59.03,#N/A,435,35,,31.23,158.83,158.83,43.51,43.51,59.03,435,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,31.23,435
72110,72110 - X-RAY EXAM L-2 SPINE 4/>VWS,72110,CPT,Both,YES-CMS,478,100.66,471,59.03,#N/A,478,47,37.78,31.23,158.83,158.83,58.74,58.74,59.03,478,137,137,137,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,31.23,478
72125,72125 - CT NECK SPINE W/O DYE,72125,CPT,Both,,1264,100.66,299,342.87,#N/A,"1,264.00",302,,"1,171.00",158.83,158.83,127.99,127.99,342.87,"1,264.00",,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,342.87,353.16,360.01,428.59,342.87,771.46,771.46,771.46,95.63,"1,264.00"
72141,72141 - MRI NECK SPINE W/O DYE,72141,CPT,Both,,3722,228.81,293,491.78,#N/A,"3,722.00",571,,"2,143.00",361.02,361.02,187.23,187.23,491.78,"3,722.00",,,,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,506.54,516.37,614.73,491.78,"1,106.51","1,106.51","1,106.51",187.23,"3,722.00"
72148,72148 - MRI LUMBAR SPINE W/O DYE,72148,CPT,Both,YES-CMS,3722,228.81,293,491.78,#N/A,"3,722.00",634,370.5,"2,143.00",361.02,361.02,187.71,187.71,491.78,"3,722.00",412,412,412,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,506.54,516.37,614.73,491.78,"1,106.51","1,106.51","1,106.51",187.71,"3,722.00"
72170,72170 - X-RAY EXAM OF PELVIS,72170,CPT,Both,YES,366,100.66,471,59.03,#N/A,366,27,24.64,17.31,158.83,158.83,29.28,29.28,59.03,366,136.8,136.8,136.8,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,17.31,366
72193,72193 - CT PELVIS W/DYE,72193,CPT,Both,YES-CMS,1881,168.51,300,405.56,#N/A,"1,881.00",349,233.95,"1,171.00",265.88,265.88,263.35,263.35,405.56,"1,881.00",347,347,347,168.51,168.51,168.51,171.88,168.51,168.51,168.51,168.51,160.09,168.51,168.51,168.51,168.51,168.51,168.51,185.37,171.88,180.31,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,417.72,425.83,506.95,405.56,912.5,912.5,912.5,160.09,"1,881.00"
73030,73030 - X-RAY EXAM OF SHOULDER,73030,CPT,Both,,257,83.35,471,59.03,#N/A,257,30,24.64,17.31,131.51,131.51,38.6,38.6,59.03,257,15,15,15,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,15,257
73060,73060 - X-RAY EXAM OF HUMERUS,73060,CPT,Both,,332,83.35,471,59.03,#N/A,332,30,24.64,17.31,131.51,131.51,36.15,36.15,59.03,332,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,332
73070,73070 - X-RAY EXAM OF ELBOW,73070,CPT,Both,,197,83.35,471,59.03,#N/A,197,27,24.64,17.31,131.51,131.51,31.73,31.73,59.03,197,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,197
73080,73080 - X-RAY EXAM OF ELBOW,73080,CPT,Both,,197,83.35,471,59.03,#N/A,197,30,24.64,17.31,131.51,131.51,36.64,36.64,59.03,197,12.5,12.5,12.5,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,12.5,197
73090,73090 - X-RAY EXAM OF FOREARM,73090,CPT,Both,,332,83.35,471,59.03,#N/A,332,27,24.64,17.31,131.51,131.51,32.21,32.21,59.03,332,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,332
73100,73100 - X-RAY EXAM OF WRIST,73100,CPT,Both,,206,83.35,471,59.03,#N/A,206,26,24.64,17.31,131.51,131.51,38.6,38.6,59.03,206,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,206
73110,73110 - X-RAY EXAM OF WRIST,73110,CPT,Both,,222,83.35,471,59.03,#N/A,222,28,24.64,17.31,131.51,131.51,48.91,48.91,59.03,222,12.5,12.5,12.5,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,12.5,222
73120,73120 - X-RAY EXAM OF HAND,73120,CPT,Both,,176,100.66,471,59.03,#N/A,176,26,24.64,17.31,158.83,158.83,35.16,35.16,59.03,176,10,10,10,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,176
73130,73130 - X-RAY EXAM OF HAND,73130,CPT,Both,,280,83.35,471,59.03,#N/A,280,28,24.64,17.31,131.51,131.51,43.03,43.03,59.03,280,12.5,12.5,12.5,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,12.5,280
73140,73140 - X-RAY EXAM OF FINGER(S),73140,CPT,Both,,160,83.35,471,59.03,#N/A,160,22,24.64,17.31,131.51,131.51,46.95,46.95,59.03,160,7.5,7.5,7.5,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,7.5,160
73502,73502 - X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CPT,Both,YES,234,83.35,471,59.03,#N/A,234,35,32.03,21.96,131.51,131.51,54.81,54.81,59.03,234,87.6,87.6,87.6,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,21.96,234
73521,73521 - X-RAY EXAM HIPS BI 2 VIEWS,73521,CPT,Both,YES,384,100.66,471,59.03,#N/A,384,33,30.64,21.96,158.83,158.83,45.48,45.48,59.03,384,145,145,145,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,21.96,384
73552,73552 - X-RAY EXAM OF FEMUR 2/>,73552,CPT,Both,YES,234,83.35,471,59.03,#N/A,234,27,25.17,18.68,131.51,131.51,40.08,40.08,59.03,234,87.6,87.6,87.6,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,18.68,234
73560,73560 - X-RAY EXAM OF KNEE 1 OR 2,73560,CPT,Both,,206,83.35,471,59.03,#N/A,206,27,24.64,18.86,131.51,131.51,39.09,39.09,59.03,206,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,206
73562,73562 - X-RAY EXAM OF KNEE 3,73562,CPT,Both,,276,83.35,471,59.03,#N/A,276,30,24.64,21.96,131.51,131.51,47.44,47.44,59.03,276,15,15,15,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,15,276
73564,73564 - X-RAY EXAM KNEE 4 OR MORE,73564,CPT,Both,,331,100.66,471,59.03,#N/A,331,32,24.64,21.96,158.83,158.83,53.83,53.83,59.03,331,20,20,20,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,20,331
73590,73590 - X-RAY EXAM OF LOWER LEG,73590,CPT,Both,,280,83.35,471,59.03,#N/A,280,27,24.64,17.31,131.51,131.51,35.65,35.65,59.03,280,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,280
73600,73600 - X-RAY EXAM OF ANKLE,73600,CPT,Both,,371,83.35,471,59.03,#N/A,371,26,24.64,17.31,131.51,131.51,36.64,36.64,59.03,371,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,371
73610,73610 - X-RAY EXAM OF ANKLE,73610,CPT,Both,,189,83.35,471,59.03,#N/A,189,28,24.64,17.31,131.51,131.51,42.04,42.04,59.03,189,12.5,12.5,12.5,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,12.5,189
73620,73620 - X-RAY EXAM OF FOOT,73620,CPT,Both,,196,83.35,471,59.03,#N/A,196,26,24.64,17.31,131.51,131.51,31.73,31.73,59.03,196,10,10,10,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,10,196
73630,73630 - X-RAY EXAM OF FOOT,73630,CPT,Both,,250,83.35,471,59.03,#N/A,250,28,24.64,17.31,131.51,131.51,39.09,39.09,59.03,250,12.5,12.5,12.5,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,12.5,250
73660,73660 - X-RAY EXAM OF TOE(S),73660,CPT,Both,,228,83.35,471,59.03,#N/A,228,22,24.64,17.31,131.51,131.51,34.19,34.19,59.03,228,7.5,7.5,7.5,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,7.5,228
73721,73721 - MRI JNT OF LWR EXTRE W/O DYE,73721,CPT,Both,YES-CMS,1882,228.81,293,491.78,#N/A,"1,882.00",571,370.5,134.13,361.02,361.02,213.75,213.75,491.78,"1,882.00",412,412,412,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,491.78,506.54,516.37,614.73,491.78,"1,106.51","1,106.51","1,106.51",134.13,"1,882.00"
74018,74018 - X-RAY EXAM ABDOMEN 1 VIEW,74018,CPT,Both,YES,227,83.35,471,59.03,#N/A,227,22,21.47,17.95,131.51,131.51,32.21,32.21,59.03,227,NA,NA,NA,83.35,83.35,83.35,85.02,83.35,83.35,83.35,83.35,79.18,83.35,83.35,83.35,83.35,83.35,83.35,91.69,85.02,89.19,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,59.03,60.8,61.98,73.79,59.03,132.82,132.82,132.82,17.95,227
74174,74174 - CTA ABD&PLVS W/CONTRAST,74174,CPT,Both,,2292,338.07,302,428.98,#N/A,"2,292.00",531,205.57,"1,171.00",533.4,533.4,425.53,425.53,428.98,"2,292.00",,,,338.07,338.07,338.07,344.83,338.07,338.07,338.07,338.07,321.17,338.07,338.07,338.07,338.07,338.07,338.07,371.88,344.83,361.73,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,428.98,441.85,450.43,536.23,428.98,965.21,965.21,965.21,205.57,"2,292.00"
74176,74176 - CT ABD & PELVIS W/O CONTRAST,74176,CPT,Both,YES,1253,228.81,300,405.56,#N/A,"1,253.00",166,205.57,"1,171.00",361.02,361.02,157.26,157.26,405.56,"1,253.00",341.1,341.1,341.1,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,417.72,425.83,506.95,405.56,912.5,912.5,912.5,157.26,"1,253.00"
74177,74177 - CT ABD & PELV W/CONTRAST,74177,CPT,Both,YES-CMS,2901,338.07,300,405.56,#N/A,"2,901.00",318,321.03,"1,171.00",533.4,533.4,334.09,334.09,405.56,"2,901.00",541,541,541,338.07,338.07,338.07,344.83,338.07,338.07,338.07,338.07,321.17,338.07,338.07,338.07,338.07,338.07,338.07,371.88,344.83,361.73,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,417.72,425.83,506.95,405.56,912.5,912.5,912.5,318,"2,901.00"
74178,74178 - CT ABD&PLV WO CNTR FLWD CNTR,74178,CPT,Both,,3192,338.07,300,405.56,#N/A,"3,192.00",420,321.03,"1,171.00",533.4,533.4,377.6,377.6,405.56,"3,192.00",,,,338.07,338.07,338.07,344.83,338.07,338.07,338.07,338.07,321.17,338.07,338.07,338.07,338.07,338.07,338.07,371.88,344.83,361.73,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,405.56,417.72,425.83,506.95,405.56,912.5,912.5,912.5,321.03,"3,192.00"
76000,76000 - FLUOROSCOPY <1 HR PHYS/QHP,76000,CPT,Both,,494,228.81,389,296.6,#N/A,494,74.77,,,361.02,361.02,41.55,41.55,296.6,494,,,,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,296.6,296.6,296.6,296.6,296.6,296.6,296.6,296.6,296.6,296.6,296.6,305.49,311.43,370.75,296.6,667.34,667.34,667.34,41.55,667.34
76536,76536 - US EXAM OF HEAD AND NECK,76536,CPT,Both,YES,477,100.66,288,180.51,#N/A,477,73,90.79,55.11,158.83,158.83,124.06,124.06,180.51,477,194.2,194.2,194.2,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,55.11,477
76641,76641 - ULTRASOUND BREAST COMPLETE,76641,CPT,Both,YES,501,100.66,288,180.51,#N/A,501,84,83.49,71.67,158.83,158.83,100.98,100.98,180.51,501,132,132,132,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,71.67,501
76700,76700 - US EXAM ABDOM COMPLETE,76700,CPT,Both,YES-CMS,965,100.66,289,710.95,#N/A,965,101,95.26,78.98,158.83,158.83,116.5,116.5,710.95,965,194,194,194,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,732.28,746.5,888.69,710.95,"1,599.64","1,599.64","1,599.64",78.98,"1,599.64"
76705,76705 - ECHO EXAM OF ABDOMEN,76705,CPT,Both,,812,100.66,288,180.51,#N/A,812,73,83.49,100.3,158.83,158.83,88.21,88.21,180.51,812,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,73,812
76770,76770 - US EXAM ABDO BACK WALL COMP,76770,CPT,Both,,763,100.66,289,710.95,#N/A,763,101,83.49,71.67,158.83,158.83,108.84,108.84,710.95,763,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,732.28,746.5,888.69,710.95,"1,599.64","1,599.64","1,599.64",71.67,"1,599.64"
76775,76775 - US EXAM ABDO BACK WALL LIM,76775,CPT,Both,,404,100.66,288,180.51,#N/A,404,73,83.49,71.67,158.83,158.83,48.43,48.43,180.51,404,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,48.43,406.15
76801,76801 - OB US < 14 WKS SINGLE FETUS,76801,CPT,Both,YES,400,100.66,470,158.92,#N/A,400,54,95.6,98.24,158.83,158.83,104.91,104.91,158.92,400,194.2,194.2,194.2,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,54,400
76805,76805 - OB US >= 14 WKS SNGL FETUS,76805,CPT,Both,YES-CMS,526,100.66,470,158.92,#N/A,526,108,110.81,100.3,158.83,158.83,131.73,131.73,158.92,526,194,194,194,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,95.63,526
76811,76811 - OB US DETAILED SNGL FETUS,76811,CPT,Both,,918,228.81,470,158.92,#N/A,918,185,110.81,98.24,361.02,361.02,131.03,131.03,158.92,918,,,,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,98.24,918
76816,76816 - OB US FOLLOW-UP PER FETUS,76816,CPT,Both,,682,100.66,470,158.92,#N/A,682,57,110.81,98.24,158.83,158.83,103.44,103.44,158.92,682,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,57,682
76817,76817 - TRANSVAGINAL US OBSTETRIC,76817,CPT,Both,YES,400,100.66,470,158.92,#N/A,400,73,75.76,75,158.83,158.83,84.78,84.78,158.92,400,194.2,194.2,194.2,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,73,400
76818,76818 - FETAL BIOPHYS PROFILE W/NST,76818,CPT,Both,,502,100.66,470,158.92,#N/A,502,83,,,158.83,158.83,103.04,103.04,158.92,502,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,83,502
76819,76819 - FETAL BIOPHYS PROFIL W/O NST,76819,CPT,Both,,471,100.66,470,158.92,#N/A,471,88,,,158.83,158.83,73.76,73.76,158.92,471,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,73.76,471
76820,76820 - UMBILICAL ARTERY ECHO,76820,CPT,Both,,219,100.66,470,158.92,#N/A,219,90,83.49,,158.83,158.83,31.73,31.73,158.92,219,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,31.73,357.58
76825,76825 - ECHO EXAM OF FETAL HEART,76825,CPT,Both,YES,682,519.04,470,158.92,#N/A,682,101,215.77,165.27,818.95,818.95,271.5,271.5,158.92,682,608.8,608.8,608.8,519.04,519.04,519.04,529.42,519.04,519.04,519.04,519.04,493.09,519.04,519.04,519.04,519.04,519.04,519.04,570.95,529.42,555.38,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,101,818.95
76827,76827 - ECHO EXAM OF FETAL HEART,76827,CPT,Both,YES,346,100.66,470,158.92,#N/A,346,90,58.93,56.39,158.83,158.83,63.16,63.16,158.92,346,132,132,132,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,158.92,163.69,166.87,198.66,158.92,357.58,357.58,357.58,56.39,357.58
76830,76830 - TRANSVAGINAL US NON-OB,76830,CPT,Both,YES-CMS,675,100.66,288,180.51,#N/A,675,78,95.31,68.39,158.83,158.83,128.78,128.78,180.51,675,194,194,194,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,68.39,675
76856,76856 - US EXAM PELVIC COMPLETE,76856,CPT,Both,YES,797,100.66,289,710.95,#N/A,797,78,85.55,67.66,158.83,158.83,108.35,108.35,710.95,797,194.2,194.2,194.2,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,732.28,746.5,888.69,710.95,"1,599.64","1,599.64","1,599.64",67.66,"1,599.64"
76857,76857 - US EXAM PELVIC LIMITED,76857,CPT,Both,,477,100.66,288,180.51,#N/A,477,54,83.49,,158.83,158.83,39.09,39.09,180.51,477,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,39.09,477
76870,76870 - US EXAM SCROTUM,76870,CPT,Both,,477,100.66,288,180.51,#N/A,477,78,83.49,,158.83,158.83,103.93,103.93,180.51,477,,,,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,78,477
77063,77063 - BREAST TOMOSYNTHESIS BI,77063,CPT,Both,,62,0,286,153.62,#N/A,62,30.28,,,0,0,35.36,35.36,153.62,62,,,,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,158.23,161.3,192.03,153.62,345.65,345.65,345.65,0,345.65
77065,77065 - DX MAMMO INCL CAD UNI,77065,CPT,Both,YES-CMS,178,0,286,153.62,#N/A,178,112,104.04,80.31,0,0,128.98,128.98,153.62,178,�,�,�,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,158.23,161.3,192.03,153.62,345.65,345.65,345.65,0,345.65
77066,77066 - DX MAMMO INCL CAD BI,77066,CPT,Both,YES-CMS,178,0,286,153.62,#N/A,178,143,132,98.89,0,0,165.61,165.61,153.62,178,�,�,�,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,158.23,161.3,192.03,153.62,345.65,345.65,345.65,0,345.65
77067,77067 - SCR MAMMO BI INCL CAD,77067,CPT,Both,YES-CMS,62,0,286,153.62,#N/A,62,118,106.59,74.32,0,0,136.34,136.34,153.62,62,�,�,�,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,153.62,158.23,161.3,192.03,153.62,345.65,345.65,345.65,0,345.65
77080,77080 - DXA BONE DENSITY AXIAL,77080,CPT,Both,,656,125.83,291,198.99,#N/A,656,126,21.71,,198.54,198.54,44,44,198.99,656,,,,125.83,125.83,125.83,128.35,125.83,125.83,125.83,125.83,119.54,125.83,125.83,125.83,125.83,125.83,125.83,138.42,128.35,134.64,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,204.96,208.94,248.74,198.99,447.73,447.73,447.73,21.71,656
77081,77081 - DXA BONE DENSITY/PERIPHERAL,77081,CPT,Both,YES,277,104.19,291,198.99,#N/A,277,36,21.71,21.23,164.39,164.39,33.2,33.2,198.99,277,85.5,85.5,85.5,104.19,104.19,104.19,106.27,104.19,104.19,104.19,104.19,98.98,104.19,104.19,104.19,104.19,104.19,104.19,114.61,106.27,111.48,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,198.99,204.96,208.94,248.74,198.99,447.73,447.73,447.73,21.23,447.73
80048,80048 - METABOLIC PANEL TOTAL CA,80048,CPT,Both,YES-CMS,85,0,403,53.45,8.46,85,9,4.74,17.1,0,0,25.99,25.99,53.45,85,17,17,17,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,55.06,56.12,66.82,53.45,120.27,120.27,120.27,0,120.27
80053,80053 - COMPREHEN METABOLIC PANEL,80053,CPT,Both,YES-CMS,114,0,403,53.45,10.56,114,12,7.1,26.55,0,0,20.86,20.86,53.45,114,21,21,21,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,55.06,56.12,66.82,53.45,120.27,120.27,120.27,0,120.27
80055,80053 - COMPREHEN METABOLIC PANEL,80055,CPT,Both,YES-CMS,114,0,403,53.45,47.81,114,43,7.1,26.55,0,0,20.86,20.86,53.45,114,21,21,21,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,55.06,56.12,66.82,53.45,120.27,120.27,120.27,0,120.27
80061,80061 - LIPID PANEL,80061,CPT,Both,YES-CMS,167,0,403,53.45,13.39,167,19,9.94,33.92,0,0,9.84,9.84,53.45,167,26,26,26,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,55.06,56.12,66.82,53.45,120.27,120.27,120.27,0,167
80069,80069 - RENAL FUNCTION PANEL,80069,CPT,Both,YES-CMS,104,0,403,53.45,8.68,104,12,5.95,22.12,0,0,1.78,1.78,53.45,104,17,17,17,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,55.06,56.12,66.82,53.45,120.27,120.27,120.27,0,120.27
80074,80074 - ACUTE HEPATITIS PANEL,80074,CPT,Both,,630,0,403,53.45,47.63,630,83,5.95,,0,0,61.92,61.92,53.45,630,,,,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,55.06,56.12,66.82,53.45,120.27,120.27,120.27,0,630
80076,80076 - HEPATIC FUNCTION PANEL,80076,CPT,Both,YES-CMS,146,0,403,53.45,8.17,146,11,4.74,20.66,0,0,10.62,10.62,53.45,146,16,16,16,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,53.45,55.06,56.12,66.82,53.45,120.27,120.27,120.27,0,146
80197,80197 - ASSAY OF TACROLIMUS,80197,CPT,Both,,104,0,405,42.51,13.73,104,19,,,0,0,17.85,17.85,42.51,104,,,,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,42.51,42.51,42.51,42.51,42.51,42.51,42.51,42.51,42.51,42.51,42.51,43.79,44.64,53.14,42.51,95.65,95.65,95.65,0,104
80307,80307 - DRUG TEST PRSMV CHEM ANLYZR,80307,CPT,Both,,214,62.14,2041,21.59,62.14,214,79.81,,,98.04,98.04,80.78,80.78,21.59,214,,,,62.14,62.14,62.14,63.38,62.14,62.14,62.14,62.14,59.03,62.14,62.14,62.14,62.14,62.14,62.14,68.35,63.38,66.49,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,21.59,214
81000,81000 - URINALYSIS NONAUTO W/SCOPE,81000,CPT,Both,YES-CMS,42,4.02,410,34.59,4.02,42,5,2.35,6.49,6.34,6.34,5.23,5.23,34.59,42,6,6,6,4.02,4.02,4.02,4.1,4.02,4.02,4.02,4.02,3.82,4.02,4.02,4.02,4.02,4.02,4.02,4.42,4.1,4.3,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,35.63,36.32,43.24,34.59,77.83,77.83,77.83,2.35,77.83
81001,81001 - URINALYSIS AUTO W/SCOPE,81001,CPT,Both,YES-CMS,68,3.17,410,34.59,3.17,68,5,2.35,6.49,5,5,4.12,4.12,34.59,68,6,6,6,3.17,3.17,3.17,3.23,3.17,3.17,3.17,3.17,3.01,3.17,3.17,3.17,3.17,3.17,3.17,3.49,3.23,3.39,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,35.63,36.32,43.24,34.59,77.83,77.83,77.83,2.35,77.83
81002,81002 - URINALYSIS NONAUTO W/O SCOPE,81002,CPT,Both,YES-CMS,38,3.48,410,34.59,3.48,38,4,1.9,5.9,5.49,5.49,4.52,4.52,34.59,38,�,�,�,3.48,3.48,3.48,3.55,3.48,3.48,3.48,3.48,3.31,3.48,3.48,3.48,3.48,3.48,3.48,3.83,3.55,3.72,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,35.63,36.32,43.24,34.59,77.83,77.83,77.83,1.9,77.83
81003,81003 - URINALYSIS AUTO W/O SCOPE,81003,CPT,Both,YES-CMS,51,2.25,410,34.59,2.25,51,4,1.67,4.73,3.55,3.55,2.93,2.93,34.59,51,4,4,4,2.25,2.25,2.25,2.3,2.25,2.25,2.25,2.25,2.14,2.25,2.25,2.25,2.25,2.25,2.25,2.48,2.3,2.41,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,35.63,36.32,43.24,34.59,77.83,77.83,77.83,1.67,77.83
81370,81370 - HLA I & II TYPING LR,81370,CPT,Both,,1410,402.12,387,21.59,402.12,"1,410.00",402.12,,804.24,634.46,634.46,522.76,522.76,21.59,"1,410.00",372.49,372.49,372.49,402.12,402.12,402.12,410.16,402.12,402.12,402.12,402.12,382.01,402.12,402.12,402.12,402.12,402.12,402.12,442.33,410.16,430.27,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,21.59,"1,410.00"
81371,81371 - HLA I & II TYPE VERIFY LR,81371,CPT,Both,,1046,404.52,387,21.59,404.52,"1,046.00",404.52,,809.04,638.25,638.25,525.88,525.88,21.59,"1,046.00",222.95,222.95,222.95,404.52,404.52,404.52,412.61,404.52,404.52,404.52,404.52,384.29,404.52,404.52,404.52,404.52,404.52,404.52,444.97,412.61,432.84,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,21.59,"1,046.00"
81401,81401 - MOPATH PROCEDURE LEVEL 2,81401,CPT,Both,,1043,137,386,21.59,137,"1,043.00",137,137,274,216.16,216.16,178.1,178.1,21.59,"1,043.00",0,0,0,137,137,137,139.74,137,137,137,137,130.15,137,137,137,137,137,137,150.7,139.74,146.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,"1,043.00"
82010,82010 - KETONE BODYS QUAN,82010,CPT,Both,,34,8.17,402,29.83,8.17,34,12,8.17,16.34,12.89,12.89,10.62,10.62,29.83,34,7.57,7.57,7.57,8.17,8.17,8.17,8.33,8.17,8.17,8.17,8.17,7.76,8.17,8.17,8.17,8.17,8.17,8.17,8.99,8.33,8.74,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,7.57,67.12
82040,82040 - ASSAY OF SERUM ALBUMIN,82040,CPT,Both,,44,4.95,402,29.83,4.95,44,7,4.95,9.9,7.81,7.81,6.44,6.44,29.83,44,5.03,5.03,5.03,4.95,4.95,4.95,5.05,4.95,4.95,4.95,4.95,4.7,4.95,4.95,4.95,4.95,4.95,4.95,5.45,5.05,5.3,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.7,67.12
82043,82043 - UR ALBUMIN QUANTITATIVE,82043,CPT,Both,,44,5.78,410,34.59,5.78,44,8,5.78,11.56,9.12,9.12,7.51,7.51,34.59,44,5.03,5.03,5.03,5.78,5.78,5.78,5.9,5.78,5.78,5.78,5.78,5.49,5.78,5.78,5.78,5.78,5.78,5.78,6.36,5.9,6.18,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,34.59,35.63,36.32,43.24,34.59,77.83,77.83,77.83,5.03,77.83
82088,82088 - ASSAY OF ALDOSTERONE,82088,CPT,Both,,428,40.75,399,65.43,40.75,428,57,40.75,81.5,64.3,64.3,52.98,52.98,65.43,428,48.84,48.84,48.84,40.75,40.75,40.75,41.57,40.75,40.75,40.75,40.75,38.71,40.75,40.75,40.75,40.75,40.75,40.75,44.83,41.57,43.6,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,67.39,68.7,81.79,65.43,147.22,147.22,147.22,38.71,428
82105,82105 - ALPHA-FETOPROTEIN SERUM,82105,CPT,Both,,177,16.77,400,34.85,16.77,177,24,16.77,33.54,26.46,26.46,21.8,21.8,34.85,177,6.5,6.5,6.5,16.77,16.77,16.77,17.11,16.77,16.77,16.77,16.77,15.93,16.77,16.77,16.77,16.77,16.77,16.77,18.45,17.11,17.94,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,6.5,177
82247,82247 - BILIRUBIN TOTAL,82247,CPT,Both,,53,5.02,402,29.83,5.02,53,3,5.02,10.04,7.92,7.92,6.53,6.53,29.83,53,5.03,5.03,5.03,5.02,5.02,5.02,5.12,5.02,5.02,5.02,5.02,4.77,5.02,5.02,5.02,5.02,5.02,5.02,5.52,5.12,5.37,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,3,67.12
82248,82248 - BILIRUBIN DIRECT,82248,CPT,Both,,53,5.02,402,29.83,5.02,53,11,5.02,10.04,7.92,7.92,6.53,6.53,29.83,53,5.03,5.03,5.03,5.02,5.02,5.02,5.12,5.02,5.02,5.02,5.02,4.77,5.02,5.02,5.02,5.02,5.02,5.02,5.52,5.12,5.37,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.77,67.12
82306,82306 - VITAMIN D 25 HYDROXY,82306,CPT,Both,,160,29.6,401,63,29.6,160,41,29.6,59.2,46.7,46.7,38.48,38.48,63,160,36.6,36.6,36.6,29.6,29.6,29.6,30.19,29.6,29.6,29.6,29.6,28.12,29.6,29.6,29.6,29.6,29.6,29.6,32.56,30.19,31.67,63,63,63,63,63,63,63,63,63,63,63,64.89,66.15,78.74,63,141.74,141.74,141.74,28.12,160
82310,82310 - ASSAY OF CALCIUM,82310,CPT,Both,,36,5.16,402,29.83,5.16,36,8,5.16,10.32,8.14,8.14,6.71,6.71,29.83,36,5.03,5.03,5.03,5.16,5.16,5.16,5.26,5.16,5.16,5.16,5.16,4.9,5.16,5.16,5.16,5.16,5.16,5.16,5.68,5.26,5.52,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.9,67.12
82330,82330 - ASSAY OF CALCIUM,82330,CPT,Both,,63,13.68,400,34.85,13.68,63,10,13.68,27.36,21.58,21.58,17.78,17.78,34.85,63,5.03,5.03,5.03,13.68,13.68,13.68,13.95,13.68,13.68,13.68,13.68,13,13.68,13.68,13.68,13.68,13.68,13.68,15.05,13.95,14.64,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,5.03,78.42
82435,82435 - ASSAY OF BLOOD CHLORIDE,82435,CPT,Both,,36,4.6,402,29.83,4.6,36,7,4.6,9.2,7.26,7.26,5.98,5.98,29.83,36,5.03,5.03,5.03,4.6,4.6,4.6,4.69,4.6,4.6,4.6,4.6,4.37,4.6,4.6,4.6,4.6,4.6,4.6,5.06,4.69,4.92,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.37,67.12
82436,82436 - ASSAY OF URINE CHLORIDE,82436,CPT,Both,,19,5.75,402,29.83,5.75,19,4,5.75,11.5,9.07,9.07,7.48,7.48,29.83,19,5.03,5.03,5.03,5.75,5.75,5.75,5.87,5.75,5.75,5.75,5.75,5.46,5.75,5.75,5.75,5.75,5.75,5.75,6.33,5.87,6.15,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4,67.12
82533,82533 - TOTAL CORTISOL,82533,CPT,Both,,172,16.3,398,52.72,16.3,172,23,16.3,32.6,25.72,25.72,21.19,21.19,52.72,172,18.45,18.45,18.45,16.3,16.3,16.3,16.63,16.3,16.3,16.3,16.3,15.49,16.3,16.3,16.3,16.3,16.3,16.3,17.93,16.63,17.44,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,15.49,172
82550,82550 - ASSAY OF CK (CPK),82550,CPT,Both,,50,6.51,402,29.83,6.51,50,10,6.51,13.02,10.27,10.27,8.46,8.46,29.83,50,5.03,5.03,5.03,6.51,6.51,6.51,6.64,6.51,6.51,6.51,6.51,6.18,6.51,6.51,6.51,6.51,6.51,6.51,7.16,6.64,6.97,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,5.03,67.12
82565,82565 - ASSAY OF CREATININE,82565,CPT,Both,,39,5.12,402,29.83,5.12,39,8,5.12,10.24,8.08,8.08,6.66,6.66,29.83,39,5.03,5.03,5.03,5.12,5.12,5.12,5.22,5.12,5.12,5.12,5.12,4.86,5.12,5.12,5.12,5.12,5.12,5.12,5.63,5.22,5.48,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.86,67.12
82570,82570 - ASSAY OF URINE CREATININE,82570,CPT,Both,,14,5.18,402,29.83,5.18,14,8,5.18,10.36,8.17,8.17,6.73,6.73,29.83,14,5.03,5.03,5.03,5.18,5.18,5.18,5.28,5.18,5.18,5.18,5.18,4.92,5.18,5.18,5.18,5.18,5.18,5.18,5.7,5.28,5.54,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.92,67.12
82607,82607 - VITAMIN B-12,82607,CPT,Both,,114,15.08,398,52.72,15.08,114,21,15.08,30.16,23.79,23.79,19.6,19.6,52.72,114,12.5,12.5,12.5,15.08,15.08,15.08,15.38,15.08,15.08,15.08,15.08,14.33,15.08,15.08,15.08,15.08,15.08,15.08,16.59,15.38,16.14,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,12.5,118.63
82652,82652 - VIT D 1 25-DIHYDROXY,82652,CPT,Both,,293,38.5,401,63,38.5,293,54,38.5,77,60.75,60.75,50.05,50.05,63,293,35.66,35.66,35.66,38.5,38.5,38.5,39.27,38.5,38.5,38.5,38.5,36.58,38.5,38.5,38.5,38.5,38.5,38.5,42.35,39.27,41.2,63,63,63,63,63,63,63,63,63,63,63,64.89,66.15,78.74,63,141.74,141.74,141.74,35.66,293
82670,82670 - ASSAY OF TOTAL ESTRADIOL,82670,CPT,Both,,53,27.94,398,52.72,27.94,53,39,27.94,55.88,44.08,44.08,36.32,36.32,52.72,53,34.21,34.21,34.21,27.94,27.94,27.94,28.5,27.94,27.94,27.94,27.94,26.54,27.94,27.94,27.94,27.94,27.94,27.94,30.73,28.5,29.9,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,26.54,118.63
82728,82728 - ASSAY OF FERRITIN,82728,CPT,Both,,103,13.63,400,34.85,13.63,103,19,13.63,27.26,21.51,21.51,17.72,17.72,34.85,103,14.75,14.75,14.75,13.63,13.63,13.63,13.9,13.63,13.63,13.63,13.63,12.95,13.63,13.63,13.63,13.63,13.63,13.63,14.99,13.9,14.58,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,12.95,103
82746,82746 - ASSAY OF FOLIC ACID SERUM,82746,CPT,Both,,111,14.7,400,34.85,14.7,111,21,14.7,29.4,23.19,23.19,19.11,19.11,34.85,111,12.5,12.5,12.5,14.7,14.7,14.7,14.99,14.7,14.7,14.7,14.7,13.97,14.7,14.7,14.7,14.7,14.7,14.7,16.17,14.99,15.73,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,12.5,111
82784,82784 - ASSAY IGA/IGD/IGG/IGM EACH,82784,CPT,Both,,208,9.3,402,29.83,9.3,208,13,9.3,18.6,14.67,14.67,12.09,12.09,29.83,208,10.5,10.5,10.5,9.3,9.3,9.3,9.49,9.3,9.3,9.3,9.3,8.84,9.3,9.3,9.3,9.3,9.3,9.3,10.23,9.49,9.95,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,8.84,208
82785,82785 - ASSAY OF IGE,82785,CPT,Both,,172,16.46,400,34.85,16.46,172,23,16.46,32.92,25.97,25.97,21.4,21.4,34.85,172,12.5,12.5,12.5,16.46,16.46,16.46,16.79,16.46,16.46,16.46,16.46,15.64,16.46,16.46,16.46,16.46,16.46,16.46,18.11,16.79,17.61,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,12.5,172
82803,82803 - BLOOD GASES ANY COMBINATION,82803,CPT,Both,,146,26.07,401,63,26.07,146,27,26.07,52.14,41.13,41.13,33.89,33.89,63,146,16.2,16.2,16.2,26.07,26.07,26.07,26.59,26.07,26.07,26.07,26.07,24.77,26.07,26.07,26.07,26.07,26.07,26.07,28.68,26.59,27.89,63,63,63,63,63,63,63,63,63,63,63,64.89,66.15,78.74,63,141.74,141.74,141.74,16.2,146
82947,82947 - ASSAY GLUCOSE BLOOD QUANT,82947,CPT,Both,,28,3.93,402,29.83,3.93,28,6,3.93,7.86,6.2,6.2,5.11,5.11,29.83,28,5.03,5.03,5.03,3.93,3.93,3.93,4.01,3.93,3.93,3.93,3.93,3.73,3.93,3.93,3.93,3.93,3.93,3.93,4.32,4.01,4.21,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,3.73,67.12
82950,82950 - GLUCOSE TEST,82950,CPT,Both,,51,4.75,402,29.83,4.75,51,7,4.75,9.5,7.49,7.49,6.18,6.18,29.83,51,5.69,5.69,5.69,4.75,4.75,4.75,4.85,4.75,4.75,4.75,4.75,4.51,4.75,4.75,4.75,4.75,4.75,4.75,5.23,4.85,5.08,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.51,67.12
82962,82962 - GLUCOSE BLOOD TEST,82962,CPT,Both,YES,25,3.28,402,29.83,3.28,25,5,1.61,5.3,5.18,5.18,4.26,4.26,29.83,25,2.17,2.17,2.17,3.28,3.28,3.28,3.35,3.28,3.28,3.28,3.28,3.12,3.28,3.28,3.28,3.28,3.28,3.28,3.61,3.35,3.51,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,1.61,67.12
82977,82977 - ASSAY OF GGT,82977,CPT,Both,,78,7.2,402,29.83,7.2,78,10,7.2,14.4,11.36,11.36,9.36,9.36,29.83,78,5.03,5.03,5.03,7.2,7.2,7.2,7.34,7.2,7.2,7.2,7.2,6.84,7.2,7.2,7.2,7.2,7.2,7.2,7.92,7.34,7.7,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,5.03,78
83001,83001 - ASSAY OF GONADOTROPIN (FSH),83001,CPT,Both,,196,18.58,398,52.72,18.58,196,26,18.58,37.16,29.32,29.32,24.15,24.15,52.72,196,22.1,22.1,22.1,18.58,18.58,18.58,18.95,18.58,18.58,18.58,18.58,17.65,18.58,18.58,18.58,18.58,18.58,18.58,20.44,18.95,19.88,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,17.65,196
83002,83002 - ASSAY OF GONADOTROPIN (LH),83002,CPT,Both,,196,18.52,398,52.72,18.52,196,26,18.52,37.04,29.22,29.22,24.08,24.08,52.72,196,20.88,20.88,20.88,18.52,18.52,18.52,18.89,18.52,18.52,18.52,18.52,17.59,18.52,18.52,18.52,18.52,18.52,18.52,20.37,18.89,19.82,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,17.59,196
83010,83010 - ASSAY OF HAPTOGLOBIN QUANT,83010,CPT,Both,,219,12.58,400,34.85,12.58,219,18,12.58,25.16,19.85,19.85,16.35,16.35,34.85,219,13.81,13.81,13.81,12.58,12.58,12.58,12.83,12.58,12.58,12.58,12.58,11.95,12.58,12.58,12.58,12.58,12.58,12.58,13.84,12.83,13.46,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,11.95,219
83020,83020 - HEMOGLOBIN ELECTROPHORESIS,83020,CPT,Both,,34,12.87,400,34.85,12.87,34,18,12.87,25.74,20.31,20.31,16.73,16.73,34.85,34,14.7,14.7,14.7,12.87,12.87,12.87,13.13,12.87,12.87,12.87,12.87,12.23,12.87,12.87,12.87,12.87,12.87,12.87,14.16,13.13,13.77,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,12.23,78.42
83036,83036 - HEMOGLOBIN GLYCOSYLATED A1C,83036,CPT,Both,,72,9.71,402,29.83,9.71,72,14,9.71,19.42,15.32,15.32,12.62,12.62,29.83,72,10.64,10.64,10.64,9.71,9.71,9.71,9.9,9.71,9.71,9.71,9.71,9.22,9.71,9.71,9.71,9.71,9.71,9.71,10.68,9.9,10.39,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,9.22,72
83519,83519 - RIA NONANTIBODY,83519,CPT,Both,,60,18.4,400,34.85,18.4,60,19,18.4,36.8,29.03,29.03,23.92,23.92,34.85,60,12.51,12.51,12.51,18.4,18.4,18.4,18.77,18.4,18.4,18.4,18.4,17.48,18.4,18.4,18.4,18.4,18.4,18.4,20.24,18.77,19.69,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,12.51,78.42
83520,83520 - IMMUNOASSAY QUANT NOS NONAB,83520,CPT,Both,,36,17.27,400,34.85,17.27,36,18,17.27,34.54,27.25,27.25,22.45,22.45,34.85,36,11.99,11.99,11.99,17.27,17.27,17.27,17.62,17.27,17.27,17.27,17.27,16.41,17.27,17.27,17.27,17.27,17.27,17.27,19,17.62,18.48,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,11.99,78.42
83540,83540 - ASSAY OF IRON,83540,CPT,Both,,50,6.47,402,29.83,6.47,50,9,6.47,12.94,10.21,10.21,8.41,8.41,29.83,50,5.03,5.03,5.03,6.47,6.47,6.47,6.6,6.47,6.47,6.47,6.47,6.15,6.47,6.47,6.47,6.47,6.47,6.47,7.12,6.6,6.92,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,5.03,67.12
83550,83550 - IRON BINDING TEST,83550,CPT,Both,,97,8.74,402,29.83,8.74,97,13,8.74,17.48,13.79,13.79,11.36,11.36,29.83,97,5.03,5.03,5.03,8.74,8.74,8.74,8.91,8.74,8.74,8.74,8.74,8.3,8.74,8.74,8.74,8.74,8.74,8.74,9.61,8.91,9.35,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,5.03,97
83605,83605 - ASSAY OF LACTIC ACID,83605,CPT,Both,,66,11.57,400,34.85,11.57,66,12,11.57,23.14,18.26,18.26,15.04,15.04,34.85,66,9.3,9.3,9.3,11.57,11.57,11.57,11.8,11.57,11.57,11.57,11.57,10.99,11.57,11.57,11.57,11.57,11.57,11.57,12.73,11.8,12.38,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,9.3,78.42
83615,83615 - LACTATE (LD) (LDH) ENZYME,83615,CPT,Both,,65,6.04,402,29.83,6.04,65,9,6.04,12.08,9.53,9.53,7.85,7.85,29.83,65,5.03,5.03,5.03,6.04,6.04,6.04,6.16,6.04,6.04,6.04,6.04,5.74,6.04,6.04,6.04,6.04,6.04,6.04,6.64,6.16,6.46,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,5.03,67.12
83655,83655 - ASSAY OF LEAD,83655,CPT,Both,,127,12.11,404,44.92,12.11,127,17,12.11,24.22,19.11,19.11,15.74,15.74,44.92,127,15,15,15,12.11,12.11,12.11,12.35,12.11,12.11,12.11,12.11,11.5,12.11,12.11,12.11,12.11,12.11,12.11,13.32,12.35,12.96,44.92,44.92,44.92,44.92,44.92,44.92,44.92,44.92,44.92,44.92,44.92,46.27,47.17,56.15,44.92,101.07,101.07,101.07,11.5,127
83690,83690 - ASSAY OF LIPASE,83690,CPT,Both,,96,6.89,402,29.83,6.89,96,9,6.89,13.78,10.87,10.87,8.96,8.96,29.83,96,5.75,5.75,5.75,6.89,6.89,6.89,7.03,6.89,6.89,6.89,6.89,6.55,6.89,6.89,6.89,6.89,6.89,6.89,7.58,7.03,7.37,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,5.75,96
83735,83735 - ASSAY OF MAGNESIUM,83735,CPT,Both,,51,6.7,402,29.83,6.7,51,10,6.7,13.4,10.57,10.57,8.71,8.71,29.83,51,5.03,5.03,5.03,6.7,6.7,6.7,6.83,6.7,6.7,6.7,6.7,6.37,6.7,6.7,6.7,6.7,6.7,6.7,7.37,6.83,7.17,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,5.03,67.12
83880,83880 - ASSAY OF NATRIURETIC PEPTIDE,83880,CPT,Both,,145,39.26,401,63,39.26,145,26,39.26,78.52,61.94,61.94,51.04,51.04,63,145,34.07,34.07,34.07,39.26,39.26,39.26,40.05,39.26,39.26,39.26,39.26,37.3,39.26,39.26,39.26,39.26,39.26,39.26,43.19,40.05,42.01,63,63,63,63,63,63,63,63,63,63,63,64.89,66.15,78.74,63,141.74,141.74,141.74,26,145
83883,83883 - ASSAY NEPHELOMETRY NOT SPEC,83883,CPT,Both,,54,13.6,394,34.49,13.6,54,16,13.6,27.2,21.46,21.46,17.68,17.68,34.49,54,12.59,12.59,12.59,13.6,13.6,13.6,13.87,13.6,13.6,13.6,13.6,12.92,13.6,13.6,13.6,13.6,13.6,13.6,14.96,13.87,14.55,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,12.59,77.61
83970,83970 - ASSAY OF PARATHORMONE,83970,CPT,Both,,311,41.28,399,65.43,41.28,311,58,41.28,82.56,65.13,65.13,53.66,53.66,65.43,311,52.32,52.32,52.32,41.28,41.28,41.28,42.11,41.28,41.28,41.28,41.28,39.22,41.28,41.28,41.28,41.28,41.28,41.28,45.41,42.11,44.17,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,65.43,67.39,68.7,81.79,65.43,147.22,147.22,147.22,39.22,311
84100,84100 - ASSAY OF PHOSPHORUS,84100,CPT,Both,,38,4.74,402,29.83,4.74,38,7,4.74,9.48,7.48,7.48,6.16,6.16,29.83,38,5.03,5.03,5.03,4.74,4.74,4.74,4.83,4.74,4.74,4.74,4.74,4.5,4.74,4.74,4.74,4.74,4.74,4.74,5.21,4.83,5.07,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.5,67.12
84132,84132 - ASSAY OF SERUM POTASSIUM,84132,CPT,Both,,57,4.76,402,29.83,4.76,57,7,4.76,9.52,7.51,7.51,6.19,6.19,29.83,57,5.03,5.03,5.03,4.76,4.76,4.76,4.86,4.76,4.76,4.76,4.76,4.52,4.76,4.76,4.76,4.76,4.76,4.76,5.24,4.86,5.09,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.52,67.12
84133,84133 - ASSAY OF URINE POTASSIUM,84133,CPT,Both,,39,4.73,402,29.83,4.73,39,6,4.73,9.46,7.46,7.46,6.15,6.15,29.83,39,5.03,5.03,5.03,4.73,4.73,4.73,4.82,4.73,4.73,4.73,4.73,4.49,4.73,4.73,4.73,4.73,4.73,4.73,5.2,4.82,5.06,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.49,67.12
84134,84134 - ASSAY OF PREALBUMIN,84134,CPT,Both,,42,14.59,400,34.85,14.59,42,8,14.59,29.18,23.02,23.02,18.97,18.97,34.85,42,7.32,7.32,7.32,14.59,14.59,14.59,14.88,14.59,14.59,14.59,14.59,13.86,14.59,14.59,14.59,14.59,14.59,14.59,16.05,14.88,15.61,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,7.32,78.42
84145,84145 - PROCALCITONIN (PCT),84145,CPT,Both,,46,27.22,398,52.72,27.22,46,27.76,27.22,54.44,42.95,42.95,35.39,35.39,52.72,46,24.81,24.81,24.81,27.22,27.22,27.22,27.76,27.22,27.22,27.22,27.22,25.86,27.22,27.22,27.22,27.22,27.22,27.22,29.94,27.76,29.13,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,24.81,118.63
84146,84146 - ASSAY OF PROLACTIN,84146,CPT,Both,,203,19.38,398,52.72,19.38,203,27,19.38,38.76,30.58,30.58,25.19,25.19,52.72,203,25,25,25,19.38,19.38,19.38,19.77,19.38,19.38,19.38,19.38,18.41,19.38,19.38,19.38,19.38,19.38,19.38,21.32,19.77,20.74,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,18.41,203
84153,84153 - ASSAY OF PSA TOTAL,84153,CPT,Both,YES-CMS,140,18.39,400,34.85,18.39,140,26,13.66,46.46,29.02,29.02,23.91,23.91,34.85,140,24.35,24.35,24.35,18.39,18.39,18.39,18.76,18.39,18.39,18.39,18.39,17.47,18.39,18.39,18.39,18.39,18.39,18.39,20.23,18.76,19.68,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,13.66,140
84154,84154 - ASSAY OF PSA FREE,84154,CPT,Both,YES,133,18.39,400,34.85,18.39,133,76,13.66,46.46,29.02,29.02,23.91,23.91,34.85,133,24.35,24.35,24.35,18.39,18.39,18.39,18.76,18.39,18.39,18.39,18.39,17.47,18.39,18.39,18.39,18.39,18.39,18.39,20.23,18.76,19.68,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,13.66,133
84156,84156 - ASSAY OF PROTEIN URINE,84156,CPT,Both,,130,3.67,402,29.83,3.67,130,5,3.67,7.34,5.79,5.79,4.77,4.77,29.83,130,5.03,5.03,5.03,3.67,3.67,3.67,3.74,3.67,3.67,3.67,3.67,3.49,3.67,3.67,3.67,3.67,3.67,3.67,4.04,3.74,3.93,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,3.49,130
84165,84165 - PROTEIN E-PHORESIS SERUM,84165,CPT,Both,,273,10.74,402,29.83,10.74,273,15,10.74,21.48,16.95,16.95,13.96,13.96,29.83,273,8,8,8,10.74,10.74,10.74,10.95,10.74,10.74,10.74,10.74,10.2,10.74,10.74,10.74,10.74,10.74,10.74,11.81,10.95,11.49,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,8,273
84295,84295 - ASSAY OF SERUM SODIUM,84295,CPT,Both,,38,4.81,402,29.83,4.81,38,7,4.81,9.62,7.59,7.59,6.25,6.25,29.83,38,5.03,5.03,5.03,4.81,4.81,4.81,4.91,4.81,4.81,4.81,4.81,4.57,4.81,4.81,4.81,4.81,4.81,4.81,5.29,4.91,5.15,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.57,67.12
84300,84300 - ASSAY OF URINE SODIUM,84300,CPT,Both,,38,5.06,402,29.83,5.06,38,7,5.06,10.12,7.98,7.98,6.58,6.58,29.83,38,5.03,5.03,5.03,5.06,5.06,5.06,5.16,5.06,5.06,5.06,5.06,4.81,5.06,5.06,5.06,5.06,5.06,5.06,5.57,5.16,5.41,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.81,67.12
84403,84403 - ASSAY OF TOTAL TESTOSTERONE,84403,CPT,Both,,196,25.81,398,52.72,25.81,196,36,25.81,51.62,40.72,40.72,33.55,33.55,52.72,196,34.4,34.4,34.4,25.81,25.81,25.81,26.33,25.81,25.81,25.81,25.81,24.52,25.81,25.81,25.81,25.81,25.81,25.81,28.39,26.33,27.62,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,24.52,196
84436,84436 - ASSAY OF TOTAL THYROXINE,84436,CPT,Both,,53,6.87,398,52.72,6.87,53,10,6.87,13.74,10.84,10.84,8.93,8.93,52.72,53,5.7,5.7,5.7,6.87,6.87,6.87,7.01,6.87,6.87,6.87,6.87,6.53,6.87,6.87,6.87,6.87,6.87,6.87,7.56,7.01,7.35,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,5.7,118.63
84439,84439 - ASSAY OF FREE THYROXINE,84439,CPT,Both,,80,9.02,398,52.72,9.02,80,13,9.02,18.04,14.23,14.23,11.73,11.73,52.72,80,9,9,9,9.02,9.02,9.02,9.2,9.02,9.02,9.02,9.02,8.57,9.02,9.02,9.02,9.02,9.02,9.02,9.92,9.2,9.65,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,8.57,118.63
84443,84443 - ASSAY THYROID STIM HORMONE,84443,CPT,Both,YES-CMS,150,16.8,398,52.72,16.8,150,24,12.48,34.22,26.51,26.51,21.84,21.84,52.72,150,9,9,9,16.8,16.8,16.8,17.14,16.8,16.8,16.8,16.8,15.96,16.8,16.8,16.8,16.8,16.8,16.8,18.48,17.14,17.98,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,9,150
84450,84450 - TRANSFERASE (AST) (SGOT),84450,CPT,Both,,46,5.18,402,29.83,5.18,46,8,5.18,,8.17,8.17,6.73,6.73,29.83,46,5.03,5.03,5.03,5.18,5.18,5.18,5.28,5.18,5.18,5.18,5.18,4.92,5.18,5.18,5.18,5.18,5.18,5.18,5.7,5.28,5.54,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,4.92,67.12
84460,84460 - ALANINE AMINO (ALT) (SGPT),84460,CPT,Both,,41,5.3,402,29.83,5.3,41,8,3.98,10.6,8.36,8.36,6.89,6.89,29.83,41,5.03,5.03,5.03,5.3,5.3,5.3,5.41,5.3,5.3,5.3,5.3,5.04,5.3,5.3,5.3,5.3,5.3,5.3,5.83,5.41,5.67,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,3.98,67.12
84466,84466 - ASSAY OF TRANSFERRIN,84466,CPT,Both,,116,12.76,400,34.85,12.76,116,18,9.57,25.52,20.13,20.13,16.59,16.59,34.85,116,12.5,12.5,12.5,12.76,12.76,12.76,13.02,12.76,12.76,12.76,12.76,12.12,12.76,12.76,12.76,12.76,12.76,12.76,14.04,13.02,13.65,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,9.57,116
84480,84480 - ASSAY TRIIODOTHYRONINE (T3),84480,CPT,Both,,259,14.18,398,52.72,14.18,259,20,10.64,28.36,22.37,22.37,18.43,18.43,52.72,259,5.7,5.7,5.7,14.18,14.18,14.18,14.46,14.18,14.18,14.18,14.18,13.47,14.18,14.18,14.18,14.18,14.18,14.18,15.6,14.46,15.17,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,5.7,259
84484,84484 - ASSAY OF TROPONIN QUANT,84484,CPT,Both,,28,12.47,400,34.85,12.47,28,9,9.35,24.94,19.68,19.68,16.21,16.21,34.85,28,8.05,8.05,8.05,12.47,12.47,12.47,12.72,12.47,12.47,12.47,12.47,11.85,12.47,12.47,12.47,12.47,12.47,12.47,13.72,12.72,13.34,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,34.85,35.9,36.6,43.57,34.85,78.42,78.42,78.42,8.05,78.42
84520,84520 - ASSAY OF UREA NITROGEN,84520,CPT,Both,,28,3.95,402,29.83,3.95,28,12.75,2.96,7.9,6.23,6.23,5.14,5.14,29.83,28,5.03,5.03,5.03,3.95,3.95,3.95,4.03,3.95,3.95,3.95,3.95,3.75,3.95,3.95,3.95,3.95,3.95,3.95,4.35,4.03,4.23,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,2.96,67.12
84550,84550 - ASSAY OF BLOOD/URIC ACID,84550,CPT,Both,,50,4.52,402,29.83,4.52,50,7,3.39,9.04,7.13,7.13,5.88,5.88,29.83,50,5.03,5.03,5.03,4.52,4.52,4.52,4.61,4.52,4.52,4.52,4.52,4.29,4.52,4.52,4.52,4.52,4.52,4.52,4.97,4.61,4.84,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,3.39,67.12
84702,84702 - CHORIONIC GONADOTROPIN TEST,84702,CPT,Both,,156,15.05,398,52.72,15.05,156,21,11.29,30.1,23.75,23.75,19.57,19.57,52.72,156,12.37,12.37,12.37,15.05,15.05,15.05,15.35,15.05,15.05,15.05,15.05,14.3,15.05,15.05,15.05,15.05,15.05,15.05,16.56,15.35,16.1,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,52.72,54.31,55.36,65.91,52.72,118.63,118.63,118.63,11.29,156
84703,84703 - CHORIONIC GONADOTROPIN ASSAY,84703,CPT,Both,,103,7.52,402,29.83,7.52,103,11,5.64,15.04,11.87,11.87,9.78,9.78,29.83,103,2,2,2,7.52,7.52,7.52,7.67,7.52,7.52,7.52,7.52,7.14,7.52,7.52,7.52,7.52,7.52,7.52,8.27,7.67,8.05,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,29.83,30.73,31.32,37.29,29.83,67.12,67.12,67.12,2,103
85007,85007 - BL SMEAR W/DIFF WBC COUNT,85007,CPT,Both,,35,3.8,408,35.24,3.8,35,5,2.85,7.6,6,6,4.94,4.94,35.24,35,1.43,1.43,1.43,3.8,3.8,3.8,3.88,3.8,3.8,3.8,3.8,3.61,3.8,3.8,3.8,3.8,3.8,3.8,4.18,3.88,4.07,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,36.29,37,44.04,35.24,79.28,79.28,79.28,1.43,79.28
85008,85008 - BL SMEAR W/O DIFF WBC COUNT,85008,CPT,Both,,14,3.43,408,35.24,3.43,14,5,2.57,6.86,5.41,5.41,4.46,4.46,35.24,14,3.18,3.18,3.18,3.43,3.43,3.43,3.5,3.43,3.43,3.43,3.43,3.26,3.43,3.43,3.43,3.43,3.43,3.43,3.77,3.5,3.67,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,36.29,37,44.04,35.24,79.28,79.28,79.28,2.57,79.28
85014,85014 - HEMATOCRIT,85014,CPT,Both,,60,2.37,408,35.24,2.37,60,4,1.78,4.74,3.74,3.74,3.08,3.08,35.24,60,2,2,2,2.37,2.37,2.37,2.42,2.37,2.37,2.37,2.37,2.25,2.37,2.37,2.37,2.37,2.37,2.37,2.61,2.42,2.54,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,36.29,37,44.04,35.24,79.28,79.28,79.28,1.78,79.28
85025,85025 - COMPLETE CBC W/AUTO DIFF WBC,85025,CPT,Both,YES-CMS,84,7.77,408,35.24,7.77,84,11,5.77,15.93,12.26,12.26,10.1,10.1,35.24,84,3.17,3.17,3.17,7.77,7.77,7.77,7.93,7.77,7.77,7.77,7.77,7.38,7.77,7.77,7.77,7.77,7.77,7.77,8.55,7.93,8.31,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,36.29,37,44.04,35.24,79.28,79.28,79.28,3.17,84
85027,85027 - COMPLETE CBC AUTOMATED,85027,CPT,Both,YES-CMS,44,6.47,408,35.24,6.47,44,9,4.32,12.97,10.21,10.21,8.41,8.41,35.24,44,3.17,3.17,3.17,6.47,6.47,6.47,6.6,6.47,6.47,6.47,6.47,6.15,6.47,6.47,6.47,6.47,6.47,6.47,7.12,6.6,6.92,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,36.29,37,44.04,35.24,79.28,79.28,79.28,3.17,79.28
85046,85046 - RETICYTE/HGB CONCENTRATE,85046,CPT,Both,,44,5.57,408,35.24,5.57,44,9,4.18,11.14,8.79,8.79,7.24,7.24,35.24,44,1.43,1.43,1.43,5.57,5.57,5.57,5.68,5.57,5.57,5.57,5.57,5.29,5.57,5.57,5.57,5.57,5.57,5.57,6.13,5.68,5.96,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,36.29,37,44.04,35.24,79.28,79.28,79.28,1.43,79.28
85379,85379 - FIBRIN DEGRADATION QUANT,85379,CPT,Both,,164,10.18,406,38,10.18,164,12,7.64,20.36,16.06,16.06,13.23,13.23,38,164,10.61,10.61,10.61,10.18,10.18,10.18,10.38,10.18,10.18,10.18,10.18,9.67,10.18,10.18,10.18,10.18,10.18,10.18,11.2,10.38,10.89,38,38,38,38,38,38,38,38,38,38,38,39.14,39.9,47.5,38,85.5,85.5,85.5,7.64,164
85384,85384 - FIBRINOGEN ACTIVITY,85384,CPT,Both,,90,9.72,406,38,9.72,90,12,7.29,19.44,15.34,15.34,12.64,12.64,38,90,6.9,6.9,6.9,9.72,9.72,9.72,9.91,9.72,9.72,9.72,9.72,9.23,9.72,9.72,9.72,9.72,9.72,9.72,10.69,9.91,10.4,38,38,38,38,38,38,38,38,38,38,38,39.14,39.9,47.5,38,85.5,85.5,85.5,6.9,90
85610,85610 - PROTHROMBIN TIME,85610,CPT,Both,YES-CMS,35,4.29,406,38,4.29,35,6,2.92,7.67,6.77,6.77,5.58,5.58,38,35,3.91,3.91,3.91,4.29,4.29,4.29,4.38,4.29,4.29,4.29,4.29,4.08,4.29,4.29,4.29,4.29,4.29,4.29,4.72,4.38,4.59,38,38,38,38,38,38,38,38,38,38,38,39.14,39.9,47.5,38,85.5,85.5,85.5,2.92,85.5
85652,85652 - RBC SED RATE AUTOMATED,85652,CPT,Both,,23,2.7,408,35.24,2.7,23,4,2.03,5.4,4.26,4.26,3.51,3.51,35.24,23,2,2,2,2.7,2.7,2.7,2.75,2.7,2.7,2.7,2.7,2.57,2.7,2.7,2.7,2.7,2.7,2.7,2.97,2.75,2.89,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,35.24,36.29,37,44.04,35.24,79.28,79.28,79.28,2,79.28
85730,85730 - THROMBOPLASTIN TIME PARTIAL,85730,CPT,Both,YES-CMS,54,6.01,406,38,6.01,54,9,4.46,12.02,9.48,9.48,7.81,7.81,38,54,6.19,6.19,6.19,6.01,6.01,6.01,6.13,6.01,6.01,6.01,6.01,5.71,6.01,6.01,6.01,6.01,6.01,6.01,6.61,6.13,6.43,38,38,38,38,38,38,38,38,38,38,38,39.14,39.9,47.5,38,85.5,85.5,85.5,4.46,85.5
86003,86003 - ALLG SPEC IGE CRUDE XTRC EA,86003,CPT,Both,,103,5.22,394,34.49,5.22,103,7,3.92,10.44,8.24,8.24,6.79,6.79,34.49,103,4.83,4.83,4.83,5.22,5.22,5.22,5.32,5.22,5.22,5.22,5.22,4.96,5.22,5.22,5.22,5.22,5.22,5.22,5.74,5.32,5.59,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,3.92,103
86038,86038 - ANTINUCLEAR ANTIBODIES,86038,CPT,Both,,17,12.09,394,34.49,12.09,17,17,9.07,24.18,19.08,19.08,15.72,15.72,34.49,17,5.2,5.2,5.2,12.09,12.09,12.09,12.33,12.09,12.09,12.09,12.09,11.49,12.09,12.09,12.09,12.09,12.09,12.09,13.3,12.33,12.94,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,5.2,77.61
86140,86140 - C-REACTIVE PROTEIN,86140,CPT,Both,,66,5.18,394,34.49,5.18,66,8,3.89,10.36,8.17,8.17,6.73,6.73,34.49,66,4.1,4.1,4.1,5.18,5.18,5.18,5.28,5.18,5.18,5.18,5.18,4.92,5.18,5.18,5.18,5.18,5.18,5.18,5.7,5.28,5.54,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,3.89,77.61
86160,86160 - COMPLEMENT ANTIGEN,86160,CPT,Both,,109,12,394,34.49,12,109,17,9,24,18.93,18.93,15.6,15.6,34.49,109,10.5,10.5,10.5,12,12,12,12.24,12,12,12,12,11.4,12,12,12,12,12,12,13.2,12.24,12.84,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,9,109
86161,86161 - COMPLEMENT/FUNCTION ACTIVITY,86161,CPT,Both,,109,12,394,34.49,12,109,17,9,24,18.93,18.93,15.6,15.6,34.49,109,15.82,15.82,15.82,12,12,12,12.24,12,12,12,12,11.4,12,12,12,12,12,12,13.2,12.24,12.84,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,9,109
86225,86225 - DNA ANTIBODY NATIVE,86225,CPT,Both,,22,13.74,394,34.49,13.74,22,19,10.31,27.48,21.68,21.68,17.86,17.86,34.49,22,5.2,5.2,5.2,13.74,13.74,13.74,14.01,13.74,13.74,13.74,13.74,13.05,13.74,13.74,13.74,13.74,13.74,13.74,15.11,14.01,14.7,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,5.2,77.61
86235,86235 - NUCLEAR ANTIGEN ANTIBODY,86235,CPT,Both,,70,17.93,394,34.49,17.93,70,25,13.45,35.86,28.29,28.29,23.31,23.31,34.49,70,5.2,5.2,5.2,17.93,17.93,17.93,18.29,17.93,17.93,17.93,17.93,17.03,17.93,17.93,17.93,17.93,17.93,17.93,19.72,18.29,19.19,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,5.2,77.61
86355,86355 - B CELLS TOTAL COUNT,86355,CPT,Both,,100,37.73,395,67.75,37.73,100,11,28.3,75.46,59.53,59.53,49.05,49.05,67.75,100,23.17,23.17,23.17,37.73,37.73,37.73,38.48,37.73,37.73,37.73,37.73,35.84,37.73,37.73,37.73,37.73,37.73,37.73,41.5,38.48,40.37,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,69.78,71.13,84.68,67.75,152.43,152.43,152.43,11,152.43
86376,86376 - MICROSOMAL ANTIBODY EACH,86376,CPT,Both,,151,14.55,394,34.49,14.55,151,21,10.91,29.1,22.96,22.96,18.92,18.92,34.49,151,14.91,14.91,14.91,14.55,14.55,14.55,14.84,14.55,14.55,14.55,14.55,13.82,14.55,14.55,14.55,14.55,14.55,14.55,16.01,14.84,15.57,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,10.91,151
86382,86382 - NEUTRALIZATION TEST VIRAL,86382,CPT,Both,,1125,16.91,394,34.49,16.91,"1,125.00",24,12.68,33.82,26.68,26.68,21.98,21.98,34.49,"1,125.00",5,5,5,16.91,16.91,16.91,17.25,16.91,16.91,16.91,16.91,16.06,16.91,16.91,16.91,16.91,16.91,16.91,18.6,17.25,18.09,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,5,"1,125.00"
86430,86430 - RHEUMATOID FACTOR TEST QUAL,86430,CPT,Both,,51,6.14,394,34.49,6.14,51,8,4.61,12.28,9.69,9.69,7.98,7.98,34.49,51,4.88,4.88,4.88,6.14,6.14,6.14,6.26,6.14,6.14,6.14,6.14,5.83,6.14,6.14,6.14,6.14,6.14,6.14,6.75,6.26,6.57,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,4.61,77.61
86480,86480 - TB TEST CELL IMMUN MEASURE,86480,CPT,Both,,503,61.98,395,67.75,61.98,503,86.59,46.49,123.96,97.79,97.79,80.57,80.57,67.75,503,50,50,50,61.98,61.98,61.98,63.22,61.98,61.98,61.98,61.98,58.88,61.98,61.98,61.98,61.98,61.98,61.98,68.18,63.22,66.32,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,67.75,69.78,71.13,84.68,67.75,152.43,152.43,152.43,46.49,503
86592,86592 - SYPHILIS TEST NON-TREP QUAL,86592,CPT,Both,,46,4.27,394,34.49,4.27,46,6,3.2,8.54,6.74,6.74,5.55,5.55,34.49,46,3.27,3.27,3.27,4.27,4.27,4.27,4.36,4.27,4.27,4.27,4.27,4.06,4.27,4.27,4.27,4.27,4.27,4.27,4.7,4.36,4.57,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,3.2,77.61
86644,86644 - CMV ANTIBODY,86644,CPT,Both,,110,14.39,394,34.49,14.39,110,20,10.79,28.78,22.7,22.7,18.71,18.71,34.49,110,15.91,15.91,15.91,14.39,14.39,14.39,14.68,14.39,14.39,14.39,14.39,13.67,14.39,14.39,14.39,14.39,14.39,14.39,15.83,14.68,15.4,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,10.79,110
86664,86664 - EPSTEIN-BARR NUCLEAR ANTIGEN,86664,CPT,Both,,60,15.29,394,34.49,15.29,60,22,11.47,30.58,24.12,24.12,19.88,19.88,34.49,60,16.91,16.91,16.91,15.29,15.29,15.29,15.6,15.29,15.29,15.29,15.29,14.53,15.29,15.29,15.29,15.29,15.29,15.29,16.82,15.6,16.36,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,11.47,77.61
86704,86704 - HEP B CORE ANTIBODY TOTAL,86704,CPT,Both,,91,12.05,394,34.49,12.05,91,17,9.04,24.1,19.01,19.01,15.67,15.67,34.49,91,10.1,10.1,10.1,12.05,12.05,12.05,12.29,12.05,12.05,12.05,12.05,11.45,12.05,12.05,12.05,12.05,12.05,12.05,13.26,12.29,12.89,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,9.04,91
86705,86705 - HEP B CORE ANTIBODY IGM,86705,CPT,Both,,125,11.77,394,34.49,11.77,125,17,8.83,23.54,18.57,18.57,15.3,15.3,34.49,125,10.1,10.1,10.1,11.77,11.77,11.77,12.01,11.77,11.77,11.77,11.77,11.18,11.77,11.77,11.77,11.77,11.77,11.77,12.95,12.01,12.59,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,8.83,125
86706,86706 - HEP B SURFACE ANTIBODY,86706,CPT,Both,,83,10.74,394,34.49,10.74,83,15,8.06,21.48,16.95,16.95,13.96,13.96,34.49,83,10.1,10.1,10.1,10.74,10.74,10.74,10.95,10.74,10.74,10.74,10.74,10.2,10.74,10.74,10.74,10.74,10.74,10.74,11.81,10.95,11.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,8.06,83
86709,86709 - HEPATITIS A IGM ANTIBODY,86709,CPT,Both,,59,11.26,394,34.49,11.26,59,16,8.45,22.52,17.77,17.77,14.64,14.64,34.49,59,10,10,10,11.26,11.26,11.26,11.49,11.26,11.26,11.26,11.26,10.7,11.26,11.26,11.26,11.26,11.26,11.26,12.39,11.49,12.05,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,8.45,77.61
86735,86735 - MUMPS ANTIBODY,86735,CPT,Both,,110,13.05,394,34.49,13.05,110,9,9.79,26.1,20.59,20.59,16.97,16.97,34.49,110,8.03,8.03,8.03,13.05,13.05,13.05,13.31,13.05,13.05,13.05,13.05,12.4,13.05,13.05,13.05,13.05,13.05,13.05,14.36,13.31,13.96,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,8.03,110
86762,86762 - RUBELLA ANTIBODY,86762,CPT,Both,,151,14.39,394,34.49,14.39,151,20,10.79,28.78,22.7,22.7,18.71,18.71,34.49,151,15.91,15.91,15.91,14.39,14.39,14.39,14.68,14.39,14.39,14.39,14.39,13.67,14.39,14.39,14.39,14.39,14.39,14.39,15.83,14.68,15.4,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,10.79,151
86765,86765 - RUBEOLA ANTIBODY,86765,CPT,Both,,97,12.88,394,34.49,12.88,97,18,9.66,25.76,20.32,20.32,16.74,16.74,34.49,97,14.25,14.25,14.25,12.88,12.88,12.88,13.14,12.88,12.88,12.88,12.88,12.24,12.88,12.88,12.88,12.88,12.88,12.88,14.17,13.14,13.78,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,9.66,97
86780,86780 - TREPONEMA PALLIDUM,86780,CPT,Both,,160,13.24,394,34.49,13.24,160,19,9.93,26.48,20.89,20.89,17.21,17.21,34.49,160,12.63,12.63,12.63,13.24,13.24,13.24,13.5,13.24,13.24,13.24,13.24,12.58,13.24,13.24,13.24,13.24,13.24,13.24,14.56,13.5,14.17,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,9.93,160
86787,86787 - VARICELLA-ZOSTER ANTIBODY,86787,CPT,Both,,44,12.88,394,34.49,12.88,44,9,9.66,25.76,20.32,20.32,16.74,16.74,34.49,44,8.03,8.03,8.03,12.88,12.88,12.88,13.14,12.88,12.88,12.88,12.88,12.24,12.88,12.88,12.88,12.88,12.88,12.88,14.17,13.14,13.78,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,8.03,77.61
86790,86790 - VIRUS ANTIBODY NOS,86790,CPT,Both,,254,12.88,394,34.49,12.88,254,9,9.66,25.76,20.32,20.32,16.74,16.74,34.49,254,0,0,0,12.88,12.88,12.88,13.14,12.88,12.88,12.88,12.88,12.24,12.88,12.88,12.88,12.88,12.88,12.88,14.17,13.14,13.78,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,0,254
86803,86803 - HEPATITIS C AB TEST,86803,CPT,Both,,127,14.27,394,34.49,14.27,127,20,10.7,28.54,22.52,22.52,18.55,18.55,34.49,127,10,10,10,14.27,14.27,14.27,14.56,14.27,14.27,14.27,14.27,13.56,14.27,14.27,14.27,14.27,14.27,14.27,15.7,14.56,15.27,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,34.49,35.53,36.22,43.11,34.49,77.61,77.61,77.61,10,127
86813,86813 - HLA TYPING A B OR C,86813,CPT,Both,,139,58,393,72.27,58,139,81,43.5,116,91.51,91.51,75.4,75.4,72.27,139,53.72,53.72,53.72,58,58,58,59.16,58,58,58,58,55.1,58,58,58,58,58,58,63.8,59.16,62.06,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.89,90.34,72.27,162.61,162.61,162.61,43.5,162.61
86828,86828 - HLA CLASS I&II ANTIBODY QUAL,86828,CPT,Both,,102,64.19,393,72.27,64.19,102,54.4,48.14,128.38,101.28,101.28,83.45,83.45,72.27,102,36.66,36.66,36.66,64.19,64.19,64.19,65.47,64.19,64.19,64.19,64.19,60.98,64.19,64.19,64.19,64.19,64.19,64.19,70.61,65.47,68.68,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.89,90.34,72.27,162.61,162.61,162.61,36.66,162.61
86833,86833 - HLA CLASS II HIGH DEFIN QUAL,86833,CPT,Both,,1125,325.8,2043,72.27,325.8,"1,125.00",157.4,244.35,651.6,514.05,514.05,423.54,423.54,72.27,"1,125.00",106.84,106.84,106.84,325.8,325.8,325.8,332.32,325.8,325.8,325.8,325.8,309.51,325.8,325.8,325.8,325.8,325.8,325.8,358.38,332.32,348.61,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.88,90.33,72.27,162.6,162.6,162.6,72.27,"1,125.00"
86850,86850 - RBC ANTIBODY SCREEN,86850,CPT,Both,,269,9.77,486,72.27,9.77,269,18,7.33,19.54,15.42,15.42,12.7,12.7,72.27,269,5.55,5.55,5.55,9.77,9.77,9.77,9.97,9.77,9.77,9.77,9.77,9.28,9.77,9.77,9.77,9.77,9.77,9.77,10.75,9.97,10.45,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.89,90.34,72.27,162.61,162.61,162.61,5.55,269
86870,86870 - RBC ANTIBODY IDENTIFICATION,86870,CPT,Both,,445,#N/A,2043,72.27,#N/A,445,39,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,72.27,445,14.1,14.1,14.1,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.88,90.33,72.27,162.6,162.6,162.6,#N/A,#N/A
86880,86880 - COOMBS TEST DIRECT,86880,CPT,Both,,141,5.39,486,72.27,5.39,141,8,4.04,10.78,8.5,8.5,7.01,7.01,72.27,141,4.69,4.69,4.69,5.39,5.39,5.39,5.5,5.39,5.39,5.39,5.39,5.12,5.39,5.39,5.39,5.39,5.39,5.39,5.93,5.5,5.77,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.89,90.34,72.27,162.61,162.61,162.61,4.04,162.61
86900,86900 - BLOOD TYPING SEROLOGIC ABO,86900,CPT,Both,,197,2.99,486,72.27,2.99,197,5,2.24,5.98,4.72,4.72,3.89,3.89,72.27,197,4.22,4.22,4.22,2.99,2.99,2.99,3.05,2.99,2.99,2.99,2.99,2.84,2.99,2.99,2.99,2.99,2.99,2.99,3.29,3.05,3.2,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.89,90.34,72.27,162.61,162.61,162.61,2.24,197
86906,86906 - BLD TYPING SEROLOGIC RH PHNT,86906,CPT,Both,,306,7.75,486,72.27,7.75,306,11,5.81,15.5,12.23,12.23,10.08,10.08,72.27,306,20.75,20.75,20.75,7.75,7.75,7.75,7.91,7.75,7.75,7.75,7.75,7.36,7.75,7.75,7.75,7.75,7.75,7.75,8.53,7.91,8.29,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,72.27,74.44,75.89,90.34,72.27,162.61,162.61,162.61,5.81,306
87040,87040 - BLOOD CULTURE FOR BACTERIA,87040,CPT,Both,,119,10.32,396,33.52,10.32,119,13,7.74,20.64,16.28,16.28,13.42,13.42,33.52,119,8.15,8.15,8.15,10.32,10.32,10.32,10.53,10.32,10.32,10.32,10.32,9.8,10.32,10.32,10.32,10.32,10.32,10.32,11.35,10.53,11.04,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,7.74,119
87070,87070 - CULTURE OTHR SPECIMN AEROBIC,87070,CPT,Both,,119,8.62,396,33.52,8.62,119,12,6.47,17.24,13.6,13.6,11.21,11.21,33.52,119,8.15,8.15,8.15,8.62,8.62,8.62,8.79,8.62,8.62,8.62,8.62,8.19,8.62,8.62,8.62,8.62,8.62,8.62,9.48,8.79,9.22,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,6.47,119
87081,87081 - CULTURE SCREEN ONLY,87081,CPT,Both,,79,6.63,396,33.52,6.63,79,10,4.97,13.26,10.46,10.46,8.62,8.62,33.52,79,5.2,5.2,5.2,6.63,6.63,6.63,6.76,6.63,6.63,6.63,6.63,6.3,6.63,6.63,6.63,6.63,6.63,6.63,7.29,6.76,7.09,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,4.97,79
87086,87086 - URINE CULTURE/COLONY COUNT,87086,CPT,Both,,128,8.07,396,33.52,8.07,128,12,6.05,16.14,12.73,12.73,10.49,10.49,33.52,128,8.15,8.15,8.15,8.07,8.07,8.07,8.23,8.07,8.07,8.07,8.07,7.67,8.07,8.07,8.07,8.07,8.07,8.07,8.88,8.23,8.63,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,6.05,128
87338,87338 - HPYLORI STOOL AG IA,87338,CPT,Both,,127,14.38,396,33.52,14.38,127,20,10.79,28.76,22.69,22.69,18.69,18.69,33.52,127,8.03,8.03,8.03,14.38,14.38,14.38,14.67,14.38,14.38,14.38,14.38,13.66,14.38,14.38,14.38,14.38,14.38,14.38,15.82,14.67,15.39,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,8.03,127
87340,87340 - HEPATITIS B SURFACE AG IA,87340,CPT,Both,,87,10.33,396,33.52,10.33,87,15,7.75,20.66,16.3,16.3,13.43,13.43,33.52,87,11.1,11.1,11.1,10.33,10.33,10.33,10.54,10.33,10.33,10.33,10.33,9.81,10.33,10.33,10.33,10.33,10.33,10.33,11.36,10.54,11.05,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,7.75,87
87491,87491 - CHLMYD TRACH DNA AMP PROBE,87491,CPT,Both,YES,336,35.09,397,68.83,35.09,336,58,26.32,70.18,55.37,55.37,45.62,45.62,68.83,336,21.43,21.43,21.43,35.09,35.09,35.09,35.79,35.09,35.09,35.09,35.09,33.34,35.09,35.09,35.09,35.09,35.09,35.09,38.6,35.79,37.55,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,21.43,336
87497,87497 - CYTOMEG DNA QUANT,87497,CPT,Both,,378,42.84,397,68.83,42.84,378,71,32.13,85.68,67.59,67.59,55.69,55.69,68.83,378,39.68,39.68,39.68,42.84,42.84,42.84,43.7,42.84,42.84,42.84,42.84,40.7,42.84,42.84,42.84,42.84,42.84,42.84,47.12,43.7,45.84,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,32.13,378
87517,87517 - HEPATITIS B DNA QUANT,87517,CPT,Both,,112,42.84,397,68.83,42.84,112,71,32.13,85.68,67.59,67.59,55.69,55.69,68.83,112,39.68,39.68,39.68,42.84,42.84,42.84,43.7,42.84,42.84,42.84,42.84,40.7,42.84,42.84,42.84,42.84,42.84,42.84,47.12,43.7,45.84,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,32.13,154.87
87522,87522 - HEPATITIS C REVRS TRNSCRPJ,87522,CPT,Both,,450,42.84,397,68.83,42.84,450,71,32.13,85.68,67.59,67.59,55.69,55.69,68.83,450,59.2,59.2,59.2,42.84,42.84,42.84,43.7,42.84,42.84,42.84,42.84,40.7,42.84,42.84,42.84,42.84,42.84,42.84,47.12,43.7,45.84,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,32.13,450
87536,87536 - HIV-1 QUANT&REVRSE TRNSCRPJ,87536,CPT,Both,,717,85.1,397,68.83,85.1,717,69,63.83,170.2,134.27,134.27,110.63,110.63,68.83,717,117.59,117.59,117.59,85.1,85.1,85.1,86.8,85.1,85.1,85.1,85.1,80.85,85.1,85.1,85.1,85.1,85.1,85.1,93.61,86.8,91.06,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,63.83,717
87635,87635 - SARS-COV-2 COVID-19 AMP PRB,87635,CPT,Both,,144,51.31,397,68.83,51.31,144,51.31,38.48,102.62,80.96,80.96,66.7,66.7,68.83,144,#N/A,#N/A,#N/A,51.31,51.31,51.31,52.34,51.31,51.31,51.31,51.31,48.74,51.31,51.31,51.31,51.31,51.31,51.31,56.44,52.34,54.9,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,#N/A,#N/A
87661,87661 - TRICHOMONAS VAGINALIS AMPLIF,87661,CPT,Both,,92,35.09,397,68.83,35.09,92,47.87,26.32,70.18,55.37,55.37,45.62,45.62,68.83,92,21.43,21.43,21.43,35.09,35.09,35.09,35.79,35.09,35.09,35.09,35.09,33.34,35.09,35.09,35.09,35.09,35.09,35.09,38.6,35.79,37.55,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,21.43,154.87
87799,87799 - DETECT AGENT NOS DNA QUANT,87799,CPT,Both,,321,42.84,397,68.83,42.84,321,71,32.13,85.68,67.59,67.59,55.69,55.69,68.83,321,39.68,39.68,39.68,42.84,42.84,42.84,43.7,42.84,42.84,42.84,42.84,40.7,42.84,42.84,42.84,42.84,42.84,42.84,47.12,43.7,45.84,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,32.13,321
87806,87806 - HIV AG W/HIV1&2 ANTB W/OPTIC,87806,CPT,Both,,148,32.77,397,68.83,32.77,148,28.9,24.58,65.54,51.7,51.7,42.6,42.6,68.83,148,18.49,18.49,18.49,32.77,32.77,32.77,33.43,32.77,32.77,32.77,32.77,31.13,32.77,32.77,32.77,32.77,32.77,32.77,36.05,33.43,35.06,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,68.83,70.9,72.27,86.04,68.83,154.87,154.87,154.87,18.49,154.87
87850,87850 - N. GONORRHOEAE ASSAY W/OPTIC,87850,CPT,Both,,340,24.56,396,33.52,24.56,340,13,18.42,49.12,38.75,38.75,31.93,31.93,33.52,340,11.1,11.1,11.1,24.56,24.56,24.56,25.05,24.56,24.56,24.56,24.56,23.33,24.56,24.56,24.56,24.56,24.56,24.56,27.02,25.05,26.28,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,11.1,340
87880,87880 - STREP A ASSAY W/OPTIC,87880,CPT,Both,,111,16.53,396,33.52,16.53,111,13,12.4,33.06,26.08,26.08,21.49,21.49,33.52,111,3.75,3.75,3.75,16.53,16.53,16.53,16.86,16.53,16.53,16.53,16.53,15.7,16.53,16.53,16.53,16.53,16.53,16.53,18.18,16.86,17.69,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,33.52,34.53,35.2,41.9,33.52,75.43,75.43,75.43,3.75,111
88173,88173 - CYTOPATH EVAL FNA REPORT,88173,CPT,Both,,114,#N/A,158,94.22,#N/A,114,23,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,94.22,114,19.12,19.12,19.12,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,94.22,94.22,94.22,94.22,94.22,94.22,94.22,94.22,94.22,94.22,94.22,97.05,98.93,117.78,94.22,212,212,212,#N/A,#N/A
88175,88175 - CYTOPATH C/V AUTO FLUID REDO,88175,CPT,Both,,70,26.61,392,57.27,26.61,70,31.49,19.96,53.22,41.99,41.99,34.59,34.59,57.27,70,37.67,37.67,37.67,26.61,26.61,26.61,27.14,26.61,26.61,26.61,26.61,25.28,26.61,26.61,26.61,26.61,26.61,26.61,29.27,27.14,28.47,57.27,57.27,57.27,57.27,57.27,57.27,57.27,57.27,57.27,57.27,57.27,58.99,60.14,71.59,57.27,128.87,128.87,128.87,19.96,128.87
88248,88248 - CHROMOSOME ANALYSIS 50-100,88248,CPT,Both,,1824,173.17,386,21.59,173.17,"1,824.00",125,129.88,346.34,273.23,273.23,225.12,225.12,21.59,"1,824.00",100,100,100,173.17,173.17,173.17,176.63,173.17,173.17,173.17,173.17,164.51,173.17,173.17,173.17,173.17,173.17,173.17,190.49,176.63,185.29,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,21.59,"1,824.00"
88300,88300 - SURGICAL PATH GROSS,88300,CPT,Both,,91,#N/A,305,82.67,#N/A,91,5,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,91,20.75,20.75,20.75,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,85.15,86.81,103.34,82.67,186.01,186.01,186.01,#N/A,#N/A
88304,88304 - TISSUE EXAM BY PATHOLOGIST,88304,CPT,Both,,164,#N/A,305,82.67,#N/A,164,18,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,164,18.72,18.72,18.72,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,85.15,86.81,103.34,82.67,186.01,186.01,186.01,#N/A,#N/A
88305,88305 - TISSUE EXAM BY PATHOLOGIST,88305,CPT,Both,,420,#N/A,305,82.67,#N/A,420,28,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,420,18.72,18.72,18.72,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,85.15,86.81,103.34,82.67,186.01,186.01,186.01,#N/A,#N/A
88307,88307 - TISSUE EXAM BY PATHOLOGIST,88307,CPT,Both,,424,#N/A,306,107.67,#N/A,424,41,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,107.67,424,18.72,18.72,18.72,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,110.9,113.05,134.58,107.67,242.25,242.25,242.25,#N/A,#N/A
88341,88341 - IMHCHEM/IMCYTCHM EA ADD ANTB,88341,CPT,Both,,167,#N/A,305,82.67,#N/A,167,54,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,167,25.37,25.37,25.37,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,82.67,85.15,86.81,103.34,82.67,186.01,186.01,186.01,#N/A,#N/A
88342,88342 - IMHCHEM/IMCYTCHM 1ST ANTB,88342,CPT,Both,,309,#N/A,306,107.67,#N/A,309,17,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,107.67,309,25.37,25.37,25.37,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,#N/A,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,107.67,110.9,113.05,134.58,107.67,242.25,242.25,242.25,#N/A,#N/A
90471,90471 - IMMUNIZATION ADMIN,90471,CPT,Both,YES,177,67.37,459,37.91,#N/A,177,10,11,41.65,106.29,106.29,#N/A,#N/A,37.91,177,13.23,13.23,13.23,67.37,67.37,67.37,68.71,67.37,67.37,67.37,67.37,64,67.37,67.37,67.37,67.37,67.37,67.37,74.1,68.71,72.08,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,39.05,39.81,47.39,37.91,85.31,85.31,85.31,#N/A,#N/A
90472,90472 - IMMUNIZATION ADMIN EACH ADD,90472,CPT,Both,,98,0,459,37.91,#N/A,98,8,,,0,0,#N/A,,37.91,98,2,2,2,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,37.91,39.05,39.81,47.39,37.91,85.31,85.31,85.31,#N/A,#N/A
90792,90792 - PSYCH DIAG EVAL W/MED SRVCS,90792,CPT,Both,,668,152.09,323,225.8,#N/A,668,165,85.6,,239.97,239.97,188.25,,225.8,668,85.03,85.03,85.03,152.09,152.09,152.09,155.13,152.09,152.09,152.09,152.09,144.49,152.09,152.09,152.09,152.09,152.09,152.09,167.3,155.13,162.74,225.8,225.8,225.8,225.8,225.8,225.8,225.8,225.8,225.8,225.8,225.8,232.58,237.09,282.25,225.8,508.06,508.06,508.06,85.03,668
90832,90832 - PSYTX W PT 30 MINUTES,90832,CPT,Both,YES-CMS,290,152.09,315,144.12,#N/A,290,71,85.6,118.37,239.97,239.97,75.07,55,144.12,290,47.36,47.36,47.36,152.09,152.09,152.09,155.13,152.09,152.09,152.09,152.09,144.49,152.09,152.09,152.09,152.09,152.09,152.09,167.3,155.13,162.74,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,148.44,151.32,180.15,144.12,324.27,324.27,324.27,47.36,324.27
90834,90834 - Psytx w pt 45 minutes,90834,CPT,Both,YES-CMS,290,152.09,316,184.96,#N/A,290,100,85.6,118.37,239.97,239.97,99.11,55,184.96,290,85.03,85.03,85.03,152.09,152.09,152.09,155.13,152.09,152.09,152.09,152.09,144.49,152.09,152.09,152.09,152.09,152.09,152.09,167.3,155.13,162.74,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,190.51,194.21,231.2,184.96,416.16,416.16,416.16,55,416.16
90837,90837 - Psytx w pt 60 minutes,90837,CPT,Both,YES-CMS,290,152.09,316,184.96,#N/A,290,127,85.6,118.37,239.97,239.97,146.32,55,184.96,290,85.03,85.03,85.03,152.09,152.09,152.09,155.13,152.09,152.09,152.09,152.09,144.49,152.09,152.09,152.09,152.09,152.09,152.09,167.3,155.13,162.74,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,190.51,194.21,231.2,184.96,416.16,416.16,416.16,55,416.16
90846,90846 - FAMILY PSYTX W/O PT 50 MIN,90846,CPT,Both,YES-CMS,381,152.09,317,144.12,#N/A,381,75,128.4,192.02,239.97,239.97,107.02,125,144.12,381,85.03,85.03,85.03,152.09,152.09,152.09,155.13,152.09,152.09,152.09,152.09,144.49,152.09,152.09,152.09,152.09,152.09,152.09,167.3,155.13,162.74,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,148.44,151.32,180.15,144.12,324.27,324.27,324.27,75,381
90847,90847 - FAMILY PSYTX W/PT 50 MIN,90847,CPT,Both,YES-CMS,312,152.09,317,144.12,#N/A,312,75,128.4,199.87,239.97,239.97,111.72,125,144.12,312,85.03,85.03,85.03,152.09,152.09,152.09,155.13,152.09,152.09,152.09,152.09,144.49,152.09,152.09,152.09,152.09,152.09,152.09,167.3,155.13,162.74,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,144.12,148.44,151.32,180.15,144.12,324.27,324.27,324.27,75,324.27
90853,90853 - Group psychotherapy,90853,CPT,Both,YES-CMS,,87.56,318,84.9,#N/A,0,35,,,138.16,138.16,26.45,,84.9,0,47.36,47.36,47.36,87.56,87.56,87.56,89.32,87.56,87.56,87.56,87.56,83.19,87.56,87.56,87.56,87.56,87.56,87.56,96.32,89.32,93.69,84.9,84.9,84.9,84.9,84.9,84.9,84.9,84.9,84.9,84.9,84.9,87.44,89.14,106.12,84.9,191.02,191.02,191.02,0,191.02
90935,90935 - HEMODIALYSIS ONE EVALUATION,90935,CPT,Both,YES-CMS,2027,662.38,168,291.1,#N/A,"2,027.00",80,496.78,"1,324.75","1,045.10","1,045.10",#N/A,,291.1,"2,027.00",371.74,371.74,371.74,662.38,662.38,662.38,675.62,662.38,662.38,662.38,662.38,629.26,662.38,662.38,662.38,662.38,662.38,662.38,728.61,675.62,708.74,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,299.83,305.65,363.87,291.1,654.97,654.97,654.97,#N/A,#N/A
90970,90970 - ESRD SVC PR DAY PT 20+,90970,CPT,Both,,1243,0,168,291.1,#N/A,"1,243.00",9,,,0,0,#N/A,,291.1,"1,243.00",5.36,5.36,5.36,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,291.1,299.83,305.65,363.87,291.1,654.97,654.97,654.97,#N/A,#N/A
90989,90989 - DIALYSIS TRAINING COMPLETE,90989,CPT,Both,,1742,0,428,21.59,#N/A,"1,742.00",643,,,0,0,#N/A,,21.59,"1,742.00",251.26,251.26,251.26,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,#N/A,#N/A
92002,92002 - EYE EXAM NEW PATIENT,92002,CPT,Both,YES,372,121.99,491,21.59,#N/A,372,78,35.81,243.97,192.47,192.47,50.05,72,21.59,372,16,16,16,121.99,121.99,121.99,124.43,121.99,121.99,121.99,121.99,115.89,121.99,121.99,121.99,121.99,121.99,121.99,134.19,124.43,130.53,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,16,372
92004,92004 - EYE EXAM NEW PATIENT,92004,CPT,Both,YES,372,121.99,491,21.59,#N/A,372,143,74.95,243.97,192.47,192.47,103.65,51,21.59,372,20,20,20,121.99,121.99,121.99,124.43,121.99,121.99,121.99,121.99,115.89,121.99,121.99,121.99,121.99,121.99,121.99,134.19,124.43,130.53,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,20,372
92020,92020 - SPECIAL EYE EVALUATION,92020,CPT,Both,YES,133,122.02,419,119.36,#N/A,133,58,17.75,244.04,192.53,192.53,22.54,5.61,119.36,133,8,8,8,122.02,122.02,122.02,124.46,122.02,122.02,122.02,122.02,115.92,122.02,122.02,122.02,122.02,122.02,122.02,134.22,124.46,130.56,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,122.94,125.32,149.19,119.36,268.55,268.55,268.55,5.61,268.55
92083,92083 - VISUAL FIELD EXAMINATION(S),92083,CPT,Both,YES,268,122.02,419,119.36,#N/A,268,64,56.27,53.82,192.53,192.53,#N/A,4.2,119.36,268,8,8,8,122.02,122.02,122.02,124.46,122.02,122.02,122.02,122.02,115.92,122.02,122.02,122.02,122.02,122.02,122.02,134.22,124.46,130.56,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,119.36,122.94,125.32,149.19,119.36,268.55,268.55,268.55,#N/A,#N/A
92133,92133 - CMPTR OPHTH IMG OPTIC NERVE,92133,CPT,Both,YES,142,56.23,156,134.32,#N/A,142,19,38.16,NA,88.72,88.72,#N/A,11,134.32,142,16,16,16,56.23,56.23,56.23,57.36,56.23,56.23,56.23,56.23,53.42,56.23,56.23,56.23,56.23,56.23,56.23,61.85,57.36,60.17,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,138.35,141.03,167.9,134.32,302.21,302.21,302.21,#N/A,#N/A
92134,92134 - CPTR OPHTH DX IMG POST SEGMT,92134,CPT,Both,YES,142,56.23,156,134.32,#N/A,142,19,39.11,NA,88.72,88.72,#N/A,11,134.32,142,16,16,16,56.23,56.23,56.23,57.36,56.23,56.23,56.23,56.23,53.42,56.23,56.23,56.23,56.23,56.23,56.23,61.85,57.36,60.17,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,138.35,141.03,167.9,134.32,302.21,302.21,302.21,#N/A,#N/A
92136,92136 - OPHTHALMIC BIOMETRY,92136,CPT,Both,YES,285,122.02,156,134.32,#N/A,285,80,79.35,NA,192.53,192.53,#N/A,49.3,134.32,285,22,22,22,122.02,122.02,122.02,124.46,122.02,122.02,122.02,122.02,115.92,122.02,122.02,122.02,122.02,122.02,122.02,134.22,124.46,130.56,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,138.35,141.03,167.9,134.32,302.21,302.21,302.21,#N/A,#N/A
92250,92250 - EYE EXAM WITH PHOTOS,92250,CPT,Both,YES,188,122.02,156,134.32,#N/A,188,61,69.49,NA,192.53,192.53,#N/A,24,134.32,188,16,16,16,122.02,122.02,122.02,124.46,122.02,122.02,122.02,122.02,115.92,122.02,122.02,122.02,122.02,122.02,122.02,134.22,124.46,130.56,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,138.35,141.03,167.9,134.32,302.21,302.21,302.21,#N/A,#N/A
92285,92285 - EYE PHOTOGRAPHY,92285,CPT,Both,YES,281,37.16,156,134.32,#N/A,281,36,18.6,NA,58.62,58.62,#N/A,21.8,134.32,281,62,62,62,37.16,37.16,37.16,37.9,37.16,37.16,37.16,37.16,35.3,37.16,37.16,37.16,37.16,37.16,37.16,40.87,37.9,39.76,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,134.32,138.35,141.03,167.9,134.32,302.21,302.21,302.21,#N/A,#N/A
92504,92504 - EAR MICROSCOPY EXAMINATION,92504,CPT,Both,YES,319,0,2005,21.59,#N/A,319,31,8.18,18.68,0,0,10.21, NA ,21.59,319,6.58,6.58,6.58,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,319
92511,92511 - NASOPHARYNGOSCOPY,92511,CPT,Both,YES,549,183.78,249,165.86,#N/A,549,98,34.32,"2,910.00",289.97,289.97,43.34,49.5,165.86,549,96.09,96.09,96.09,183.78,183.78,183.78,187.45,183.78,183.78,183.78,183.78,174.59,183.78,183.78,183.78,183.78,183.78,183.78,202.16,187.45,196.64,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,165.86,170.84,174.16,207.33,165.86,373.2,373.2,373.2,34.32,"2,910.00"
92557,92557 - COMPREHENSIVE HEARING TEST,92557,CPT,Both,YES,295,148.1,257,104.72,#N/A,295,61,28.15,64.29,233.68,233.68,35.33,3.1,104.72,295,25,25,25,148.1,148.1,148.1,151.06,148.1,148.1,148.1,148.1,140.7,148.1,148.1,148.1,148.1,148.1,148.1,162.91,151.06,158.47,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,107.86,109.96,130.9,104.72,235.62,235.62,235.62,3.1,295
92567,92567 - TYMPANOMETRY,92567,CPT,Both,YES,155,37.16,229,108.63,#N/A,155,27,9.38,21.44,58.62,58.62,12.12,16.5,108.63,155,10,10,10,37.16,37.16,37.16,37.9,37.16,37.16,37.16,37.16,35.3,37.16,37.16,37.16,37.16,37.16,37.16,40.87,37.9,39.76,108.63,108.63,108.63,108.63,108.63,108.63,108.63,108.63,108.63,108.63,108.63,111.89,114.06,135.79,108.63,244.42,244.42,244.42,9.38,244.42
92579,92579 - VISUAL AUDIOMETRY (VRA),92579,CPT,Both,YES,347,148.1,257,104.72,#N/A,347,37,32.29,75.09,233.68,233.68,40.87,21.8,104.72,347,88.23,88.23,88.23,148.1,148.1,148.1,151.06,148.1,148.1,148.1,148.1,140.7,148.1,148.1,148.1,148.1,148.1,148.1,162.91,151.06,158.47,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,107.86,109.96,130.9,104.72,235.62,235.62,235.62,21.8,347
92587,92587 - EVOKED AUDITORY TEST LIMITED,92587,CPT,Both,YES,390,294.78,257,104.72,#N/A,390,66,18.61,35.41,465.11,465.11,#N/A, NA ,104.72,390,50,50,50,294.78,294.78,294.78,300.68,294.78,294.78,294.78,294.78,280.04,294.78,294.78,294.78,294.78,294.78,294.78,324.26,300.68,315.42,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,107.86,109.96,130.9,104.72,235.62,235.62,235.62,#N/A,#N/A
92588,92588 - EVOKED AUDITORY TST COMPLETE,92588,CPT,Both,,430,294.78,257,104.72,#N/A,430,75,,,465.11,465.11,#N/A,,104.72,430,69,69,69,294.78,294.78,294.78,300.68,294.78,294.78,294.78,294.78,280.04,294.78,294.78,294.78,294.78,294.78,294.78,324.26,300.68,315.42,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,104.72,107.86,109.96,130.9,104.72,235.62,235.62,235.62,#N/A,#N/A
93000,93000 Electrocardiogram complete,93000,CPT,Both,YES-CMS,179,0,413,66.78,#N/A,179,32,7.79,  ,0,0,#N/A,2,66.78,179,15,15,15,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,68.79,70.12,83.48,66.78,150.26,150.26,150.26,#N/A,#N/A
93005,93005 - ELECTROCARDIOGRAM TRACING,93005,CPT,Both,YES,179,56.23,413,66.78,#N/A,179,22,7.79,56.23,88.72,88.72,#N/A,2,66.78,179,7.5,7.5,7.5,56.23,56.23,56.23,57.36,56.23,56.23,56.23,56.23,53.42,56.23,56.23,56.23,56.23,56.23,56.23,61.85,57.36,60.17,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,66.78,68.79,70.12,83.48,66.78,150.26,150.26,150.26,#N/A,#N/A
93017,93017 - CARDIOVASCULAR STRESS TEST,93017,CPT,Both,YES,385,294.78,80,200.96,#N/A,385,83,35.44,294.78,465.11,465.11,#N/A,81.4,200.96,385,30,30,30,294.78,294.78,294.78,300.68,294.78,294.78,294.78,294.78,280.04,294.78,294.78,294.78,294.78,294.78,294.78,324.26,300.68,315.42,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,206.98,211,251.19,200.96,452.15,452.15,452.15,#N/A,#N/A
93306,93306 - TTE W/DOPPLER COMPLETE,93306,CPT,Both,YES,2250,519.04,81,370.77,#N/A,"2,250.00",250,201.39,141.22,818.95,818.95,155.3,155.3,370.77,"2,250.00",206.5,206.5,206.5,519.04,519.04,519.04,529.42,519.04,519.04,519.04,519.04,493.09,519.04,519.04,519.04,519.04,519.04,519.04,570.95,529.42,555.38,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,381.89,389.31,463.46,370.77,834.24,834.24,834.24,141.22,"2,250.00"
93320,93320 - DOPPLER ECHO EXAM HEART,93320,CPT,Both,YES,779,0,81,370.77,#N/A,779,85,47.59,35.11,0,0,40.18,40.18,370.77,779,87,87,87,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,381.89,389.31,463.46,370.77,834.24,834.24,834.24,0,834.24
93325,93325 - DOPPLER COLOR FLOW ADD-ON,93325,CPT,Both,YES,784,0,288,180.51,#N/A,784,145,22.66,5.93,0,0,24.37,24.37,180.51,784,32.8,32.8,32.8,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,0,784
93350,93350 - STRESS TTE ONLY,93350,CPT,Both,YES,1154,519.04,81,370.77,#N/A,"1,154.00",88,212.65,137.21,818.95,818.95,144.8,144.8,370.77,"1,154.00",120,120,120,519.04,519.04,519.04,529.42,519.04,519.04,519.04,519.04,493.09,519.04,519.04,519.04,519.04,519.04,519.04,570.95,529.42,555.38,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,370.77,381.89,389.31,463.46,370.77,834.24,834.24,834.24,88,"1,154.00"
93452,93452 - Left hrt cath w/ventrclgrphy,93452,CPT,Both,YES-CMS,,2783.9,84,1960.34,#N/A,0,741.82,"2,087.93","2,783.90","4,392.44","4,392.44",867.12,867.12,"1,960.34",0,"1,733.40","1,733.40","1,733.40","2,783.90","2,783.90","2,783.90","2,839.58","2,783.90","2,783.90","2,783.90","2,783.90","2,644.71","2,783.90","2,783.90","2,783.90","2,783.90","2,783.90","2,783.90","3,062.29","2,839.58","2,978.78","1,960.34","1,960.34","1,960.34","1,960.34","1,960.34","1,960.34","1,960.34","1,960.34","1,960.34","1,960.34","1,960.34","2,019.15","2,058.35","2,450.42","1,960.34","4,410.76","4,410.76","4,410.76",0,"4,410.76"
93923,93923 - UPR/LXTR ART STDY 3+ LVLS,93923,CPT,Both,,800,148.1,80,200.96,#N/A,800,141,111.08,148.1,233.68,233.68,128.06,128.06,200.96,800,72,72,72,148.1,148.1,148.1,151.06,148.1,148.1,148.1,148.1,140.7,148.1,148.1,148.1,148.1,148.1,148.1,162.91,151.06,158.47,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,200.96,206.98,211,251.19,200.96,452.15,452.15,452.15,72,800
93970,93970 - EXTREMITY STUDY,93970,CPT,Both,,797,228.81,289,710.95,#N/A,797,197,171.61,228.81,361.02,361.02,186.05,186.05,710.95,797,108,108,108,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,732.28,746.5,888.69,710.95,"1,599.64","1,599.64","1,599.64",108,"1,599.64"
93971,93971 - EXTREMITY STUDY,93971,CPT,Both,,554,100.66,288,180.51,#N/A,554,140,75.5,100.66,158.83,158.83,118.31,118.31,180.51,554,93,93,93,100.66,100.66,100.66,102.68,100.66,100.66,100.66,100.66,95.63,100.66,100.66,100.66,100.66,100.66,100.66,110.73,102.68,107.71,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,180.51,185.93,189.54,225.64,180.51,406.15,406.15,406.15,75.5,554
93975,93975 - VASCULAR STUDY,93975,CPT,Both,,709,228.81,289,710.95,#N/A,709,268,171.61,228.81,361.02,361.02,253,253,710.95,709,67.5,67.5,67.5,228.81,228.81,228.81,233.39,228.81,228.81,228.81,228.81,217.37,228.81,228.81,228.81,228.81,228.81,228.81,251.7,233.39,244.83,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,710.95,732.28,746.5,888.69,710.95,"1,599.64","1,599.64","1,599.64",67.5,"1,599.64"
94010,94010 - BREATHING CAPACITY TEST,94010,CPT,Both,,383,148.1,412,101.25,#N/A,383,40,111.08,148.1,233.68,233.68,23.4,23.4,101.25,383,15,15,15,148.1,148.1,148.1,151.06,148.1,148.1,148.1,148.1,140.7,148.1,148.1,148.1,148.1,148.1,148.1,162.91,151.06,158.47,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,104.29,106.31,126.57,101.25,227.82,227.82,227.82,15,383
94060,94060 - EVALUATION OF WHEEZING,94060,CPT,Both,,391,294.78,60,315.99,#N/A,391,69,221.09,294.78,465.11,465.11,34.99,34.99,315.99,391,25,25,25,294.78,294.78,294.78,300.68,294.78,294.78,294.78,294.78,280.04,294.78,294.78,294.78,294.78,294.78,294.78,324.26,300.68,315.42,315.99,315.99,315.99,315.99,315.99,315.99,315.99,315.99,315.99,315.99,315.99,325.47,331.79,394.99,315.99,710.98,710.98,710.98,25,710.98
94640,94640 - AIRWAY INHALATION TREATMENT,94640,CPT,Both,,440,192.53,412,101.25,#N/A,440,34,144.4,192.53,303.78,303.78,,,101.25,440,3,3,3,192.53,192.53,192.53,196.39,192.53,192.53,192.53,192.53,182.91,192.53,192.53,192.53,192.53,192.53,192.53,211.79,196.39,206.01,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,104.29,106.31,126.57,101.25,227.82,227.82,227.82,3,440
94664,94664 - EVALUATE PT USE OF INHALER,94664,CPT,Both,,541,192.53,412,101.25,#N/A,541,26,144.4,192.53,303.78,303.78,,,101.25,541,3,3,3,192.53,192.53,192.53,196.39,192.53,192.53,192.53,192.53,182.91,192.53,192.53,192.53,192.53,192.53,192.53,211.79,196.39,206.01,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,104.29,106.31,126.57,101.25,227.82,227.82,227.82,3,541
94727,94727 - PULM FUNCTION TEST BY GAS,94727,CPT,Both,YES,518,148.1,412,101.25,#N/A,518,35,37.33,23.78,233.68,233.68,29.7,29.7,101.25,518,13.33,13.33,13.33,148.1,148.1,148.1,151.06,148.1,148.1,148.1,148.1,140.7,148.1,148.1,148.1,148.1,148.1,148.1,162.91,151.06,158.47,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,104.29,106.31,126.57,101.25,227.82,227.82,227.82,13.33,518
94729,94729 - CO/MEMBANE DIFFUSE CAPACITY,94729,,Both,,353,0,412,101.25,#N/A,353,53,,,0,0,,,101.25,353,16.88,16.88,16.88,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,101.25,104.29,106.31,126.57,101.25,227.82,227.82,227.82,0,353
95810,95810 - Polysom 6/> yrs 4/> param,95810,CPT,Both,YES-CMS,479,963.1,222,945.3,#N/A,479,772,370.39,114.31,"1,519.58","1,519.58",612.71,612.71,945.3,479,582.38,582.38,582.38,963.1,963.1,963.1,982.36,963.1,963.1,963.1,963.1,914.94,963.1,963.1,963.1,963.1,963.1,963.1,"1,059.41",982.36,"1,030.52",945.3,945.3,945.3,945.3,945.3,945.3,945.3,945.3,945.3,945.3,945.3,973.66,992.57,"1,181.63",945.3,"2,126.94","2,126.94","2,126.94",114.31,"2,126.94"
95819,95819 - EEG AWAKE AND ASLEEP,95819,CPT,Both,YES,479,294.78,211,213.37,#N/A,479,184,370.39,114.31,465.11,465.11,479.96,479.96,213.37,479,35,35,35,294.78,294.78,294.78,300.68,294.78,294.78,294.78,294.78,280.04,294.78,294.78,294.78,294.78,294.78,294.78,324.26,300.68,315.42,213.37,213.37,213.37,213.37,213.37,213.37,213.37,213.37,213.37,213.37,213.37,219.77,224.03,266.71,213.37,480.07,480.07,480.07,35,480.07
96110,96110 - DEVELOPMENTAL SCREEN W/SCORE,96110,CPT,Both,,1051,0,310,184.96,#N/A,"1,051.00",18,,,0,0,,,184.96,"1,051.00",6.09,6.09,6.09,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,184.96,190.51,194.21,231.2,184.96,416.16,416.16,416.16,0,"1,051.00"
96127,96127 - BRIEF EMOTIONAL/BEHAV ASSMT,96127,CPT,Both,YES,44,37.16,324,76.93,#N/A,44,6,4.93,13.86,58.62,58.62,37.16,37.16,76.93,44,8.64,8.64,8.64,37.16,37.16,37.16,37.9,37.16,37.16,37.16,37.16,35.3,37.16,37.16,37.16,37.16,37.16,37.16,40.87,37.9,39.76,76.93,76.93,76.93,76.93,76.93,76.93,76.93,76.93,76.93,76.93,76.93,79.24,80.77,96.16,76.93,173.09,173.09,173.09,4.93,173.09
96360,96360 - HYDRATION IV INFUSION INIT,96360,CPT,Both,YES,501,199.45,111,310.3,#N/A,501,71,51.12,"1,965.00",314.68,314.68,199.45,199.45,310.3,501,35,35,35,199.45,199.45,199.45,203.43,199.45,199.45,199.45,199.45,189.47,199.45,199.45,199.45,199.45,199.45,199.45,219.39,203.43,213.41,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,319.61,325.82,387.88,310.3,698.18,698.18,698.18,35,"1,965.00"
96361,96361 - HYDRATE IV INFUSION ADD-ON,96361,CPT,Both,,156,43.68,110,792.47,#N/A,156,20,,,68.91,68.91,43.68,43.68,792.47,156,5,5,5,43.68,43.68,43.68,44.55,43.68,43.68,43.68,43.68,41.49,43.68,43.68,43.68,43.68,43.68,43.68,48.04,44.55,46.73,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,816.24,832.09,990.59,792.47,"1,783.06","1,783.06","1,783.06",5,"1,783.06"
96365,96365 - THER/PROPH/DIAG IV INF INIT,96365,CPT,Both,YES,568,199.45,111,310.3,#N/A,568,87,61.96,NA,314.68,314.68,199.45,199.45,310.3,568,35,35,35,199.45,199.45,199.45,203.43,199.45,199.45,199.45,199.45,189.47,199.45,199.45,199.45,199.45,199.45,199.45,219.39,203.43,213.41,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,319.61,325.82,387.88,310.3,698.18,698.18,698.18,35,698.18
96366,96366 - THER/PROPH/DIAG IV INF ADDON,96366,CPT,Both,,159,43.68,110,792.47,#N/A,159,27,61.96,,68.91,68.91,43.68,43.68,792.47,159,5,5,5,43.68,43.68,43.68,44.55,43.68,43.68,43.68,43.68,41.49,43.68,43.68,43.68,43.68,43.68,43.68,48.04,44.55,46.73,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,816.24,832.09,990.59,792.47,"1,783.06","1,783.06","1,783.06",5,"1,783.06"
96367,96367 - TX/PROPH/DG ADDL SEQ IV INF,96367,CPT,Both,,159,67.37,111,310.3,#N/A,159,43,61.96,,106.29,106.29,67.37,67.37,310.3,159,5,5,5,67.37,67.37,67.37,68.71,67.37,67.37,67.37,67.37,64,67.37,67.37,67.37,67.37,67.37,67.37,74.1,68.71,72.08,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,319.61,325.82,387.88,310.3,698.18,698.18,698.18,5,698.18
96372,96372 - THER/PROPH/DIAG INJ SC/IM,96372,CPT,Both,YES,121,67.37,109,62.34,#N/A,121,26,22.19,41.65,106.29,106.29,67.37,67.37,62.34,121,13.23,13.23,13.23,67.37,67.37,67.37,68.71,67.37,67.37,67.37,67.37,64,67.37,67.37,67.37,67.37,67.37,67.37,74.1,68.71,72.08,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,64.21,65.45,77.92,62.34,140.26,140.26,140.26,13.23,140.26
96374,96374 - THER/PROPH/DIAG INJ IV PUSH,96374,CPT,Both,YES,347,199.45,109,62.34,#N/A,347,69,50.93,95.95,314.68,314.68,199.45,199.45,62.34,347,62.83,62.83,62.83,199.45,199.45,199.45,203.43,199.45,199.45,199.45,199.45,189.47,199.45,199.45,199.45,199.45,199.45,199.45,219.39,203.43,213.41,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,64.21,65.45,77.92,62.34,140.26,140.26,140.26,50.93,347
96375,96375 - TX/PRO/DX INJ NEW DRUG ADDON,96375,CPT,Both,,226,43.68,109,62.34,#N/A,226,30,50.93,,68.91,68.91,43.68,43.68,62.34,226,28.77,28.77,28.77,43.68,43.68,43.68,44.55,43.68,43.68,43.68,43.68,41.49,43.68,43.68,43.68,43.68,43.68,43.68,48.04,44.55,46.73,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,64.21,65.45,77.92,62.34,140.26,140.26,140.26,28.77,226
96376,96376 - TX/PRO/DX INJ SAME DRUG ADON,96376,CPT,Both,,226,0,109,62.34,#N/A,226,#N/A,,,0,0,0,0,62.34,226,9.98,9.98,9.98,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,64.21,65.45,77.92,62.34,140.26,140.26,140.26,#N/A,#N/A
96401,96401 - CHEMO ANTI-NEOPL SQ/IM,96401,CPT,Both,YES,436,67.37,109,62.34,#N/A,436,76,74.2,874,106.29,106.29,67.37,67.37,62.34,436,783,783,783,67.37,67.37,67.37,68.71,67.37,67.37,67.37,67.37,64,67.37,67.37,67.37,67.37,67.37,67.37,74.1,68.71,72.08,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,64.21,65.45,77.92,62.34,140.26,140.26,140.26,62.34,874
96413,96413 - CHEMO IV INFUSION 1 HR,96413,CPT,Both,YES,776,313.99,111,310.3,#N/A,776,201,134.78,"1,171.00",495.41,495.41,313.99,313.99,310.3,776,783,783,783,313.99,313.99,313.99,320.27,313.99,313.99,313.99,313.99,298.29,313.99,313.99,313.99,313.99,313.99,313.99,345.39,320.27,335.97,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,310.3,319.61,325.82,387.88,310.3,698.18,698.18,698.18,134.78,"1,171.00"
96415,96415 - CHEMO IV INFUSION ADDL HR,96415,CPT,Both,,300,67.37,110,792.47,#N/A,300,44,50.52,,106.29,106.29,67.37,67.37,792.47,300,783,783,783,67.37,67.37,67.37,68.71,67.37,67.37,67.37,67.37,64,67.37,67.37,67.37,67.37,67.37,67.37,74.1,68.71,72.08,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,792.47,816.24,832.09,990.59,792.47,"1,783.06","1,783.06","1,783.06",44,"1,783.06"
96523,96523 - IRRIG DRUG DELIVERY DEVICE,96523,CPT,Both,,214,56.23,109,62.34,#N/A,214,32,42.17,,88.72,88.72,56.23,56.23,62.34,214,38.04,38.04,38.04,56.23,56.23,56.23,57.36,56.23,56.23,56.23,56.23,53.42,56.23,56.23,56.23,56.23,56.23,56.23,61.85,57.36,60.17,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,62.34,64.21,65.45,77.92,62.34,140.26,140.26,140.26,32,214
96900,96900 - ACTINOTHERAPY UV LIGHT,96900,CPT,Both,,146,37.16,493,48.81,#N/A,146,24,27.87,37.16,58.62,58.62,37.16,37.16,48.81,146,20.75,20.75,20.75,37.16,37.16,37.16,37.9,37.16,37.16,37.16,37.16,35.3,37.16,37.16,37.16,37.16,37.16,37.16,40.87,37.9,39.76,48.81,48.81,48.81,48.81,48.81,48.81,48.81,48.81,48.81,48.81,48.81,50.28,51.25,61.02,48.81,109.83,109.83,109.83,20.75,146
97110,97110 - Therapeutic exercises,97110,CPT,Both,YES-CMS,,0,269,98.35,#N/A,0,50.00 per visit,0,,0,0,0,0,98.35,0,22.15,22.15,22.15,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,101.3,103.26,122.93,98.35,221.28,221.28,221.28,0,221.28
97163,97163 - PT EVAL HIGH COMPLEX 45 MIN,97163,CPT,Both,,57,0,271,156.37,#N/A,57,93.00 per visit,0,,0,0,0,0,156.37,57,#N/A,#N/A,#N/A,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,156.37,156.37,156.37,156.37,156.37,156.37,156.37,156.37,156.37,156.37,156.37,161.06,164.19,195.46,156.37,351.83,351.83,351.83,#N/A,#N/A
97166,97166 - OT EVAL MOD COMPLEX 45 MIN,97166,CPT,Both,,109,0,270,164.54,#N/A,109,90.00 per visit,,,0,0,0,0,164.54,109,#N/A,#N/A,#N/A,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,164.54,164.54,164.54,164.54,164.54,164.54,164.54,164.54,164.54,164.54,164.54,169.48,172.77,205.67,164.54,370.21,370.21,370.21,#N/A,#N/A
97530,97530 - THERAPEUTIC ACTIVITIES,97530,CPT,Both,,113,0,269,98.35,#N/A,113,50.00 per visit,,,0,0,0,0,98.35,113,2.35,2.35,2.35,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,98.35,101.3,103.26,122.93,98.35,221.28,221.28,221.28,0,221.28
97802,97802 - MEDICAL NUTRITION INDIV IN,97802,CPT,Both,YES,132,0,118,21.59,#N/A,132,22,27.89,63.68,0,0,0,0,21.59,132,22.4,22.4,22.4,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,132
98960,98960 - EDU&TRN PT SELF-MGMT NQHP 1,98960,CPT,Both,,69,0,428,21.59,#N/A,69,25,,,0,0,0,0,21.59,69,20,20,20,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,69
99173,99173 - VISUAL ACUITY SCREEN,99173,CPT,Both,YES,57,0,2005,21.59,#N/A,57,#N/A,3.02,NA,0,0,0,0,21.59,57,2.19,2.19,2.19,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,#N/A,#N/A
99202,99202 - OFFICE O/P NEW SF 15 MIN,99202,CPT,Both,,591,0,491,21.59,#N/A,591,46,,,0,0,258,258,21.59,591,34.57,34.57,34.57,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,591
99203,99203 - OFFICE O/P NEW LOW 30-44 MIN,99203,CPT,Both,YES-CMS,627,0,491,21.59,#N/A,627,46,57.06,NA,0,0,258,258,21.59,627,52.84,52.84,52.84,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,627
99204,99204 - OFFICE O/P NEW MOD 45-59 MIN,99204,CPT,Both,YES-CMS,704,0,491,21.59,#N/A,704,46,92.04,258.23,0,0,258,258,21.59,704,89.35,89.35,89.35,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,704
99205,99205 - OFFICE O/P NEW HI 60-74 MIN,99205,CPT,Both,YES-CMS,921,0,491,21.59,#N/A,921,46,113.4,337.43,0,0,258,258,21.59,921,116.14,116.14,116.14,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,921
99243,99243 - OFF/OP CNSLTJ NEW/EST LOW 30,99243,CPT,Both,YES-CMS,627,0,491,21.59,#N/A,627,46,70.38,186.59,0,0,258,258,21.59,627,65.74,65.74,65.74,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,627
99244,99244 - OFF/OP CNSLTJ NEW/EST MOD 40,99244,CPT,Both,YES-CMS,704,0,491,21.59,#N/A,704,46,113.18,NA,0,0,258,258,21.59,704,105.67,105.67,105.67,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,704
99381,99381 - INIT PM E/M NEW PAT INFANT,99381,CPT,Both,,627,0,491,21.59,#N/A,627,118,,,0,0,258,258,21.59,627,52.59,52.59,52.59,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,627
99385,99385 - PREV VISIT NEW AGE 18-39,99385,CPT,Both,YES-CMS,627,0,491,21.59,#N/A,627,134,,,0,0,258,258,21.59,627,67.2,67.2,67.2,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,627
99386,99386 - PREV VISIT NEW AGE 40-64,99386,CPT,Both,YES-CMS,627,0,491,21.59,#N/A,627,157,88.46,NA,0,0,258,258,21.59,627,81.8,81.8,81.8,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,0,627
99492,99492 - 1ST PSYC COLLAB CARE MGMT,99492,CPT,Both,,280,87.56,2071,21.59,#N/A,280,184,,,138.16,138.16,258,258,21.59,280,,,,87.56,87.56,87.56,89.32,87.56,87.56,87.56,87.56,83.19,87.56,87.56,87.56,87.56,87.56,87.56,96.32,89.32,93.69,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,21.59,22.24,22.67,26.99,21.59,48.58,48.58,48.58,21.59,280