| 2d tee w or w/o fol w/con,in (C8925) |
$3,175.80 |
$5,293 |
4.0× |
| 2d tte w or w/o fol w/con,co (C8923) |
$1,631.40 |
$2,719 |
2.1× |
| 2d tte w or w/o fol w/con,fu (C8924) |
$466.20 |
$777 |
1.3× |
| 3D cntr simula trgt lvr les (0944T) |
$332.40 |
$554 |
1.4× |
| Admin hepatitis b vaccine (G0010) |
$82.20 |
$137 |
1.8× |
| Admin influenza virus vac (G0008) |
$82.20 |
$137 |
1.8× |
| Admin pneumococcal vaccine (G0009) |
$82.20 |
$137 |
1.8× |
| Adrnl Cortcl Tum Bchm Asy 25 (0015M) |
$1,958.40 |
$3,264 |
1.5× |
| Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide Other Diagnostic Radiology FS (0561T) |
$78.60 |
$131 |
0.6× |
| Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic… (0559T) |
$78.60 |
$131 |
0.6× |
| Diab manage trn per indiv (G0108) |
$138.60 |
$231 |
2.5× |
| Diab manage trn ind/group (G0109) |
$49.80 |
$83 |
3.1× |
| Direct refer hospital observ (G0379) |
$570 |
$950 |
1.0× |
| Drug test def 1-7 classes (G0480) |
$127.80 |
$213 |
1.1× |
| Drug test def 15-21 classes (G0482) |
$298.80 |
$498 |
1.5× |
| Drug test def 22+ classes (G0483) |
$370.80 |
$618 |
1.5× |
| Drug test def 8-14 classes (G0481) |
$235.20 |
$392 |
1.5× |
| Eia hiv-1/hiv-2 screen (G0432) |
$69.60 |
$116 |
3.6× |
| Elec stim other than wound (G0283) |
$136.20 |
$227 |
10.7× |
| Fecal blood scrn immunoassay (G0328) |
$56.40 |
$94 |
3.1× |
| Hep c screen high risk/other (G0472) |
$79.80 |
$133 |
1.7× |
| Hiv combination assay (G0475) |
$101.40 |
$169 |
4.2× |
| Home sleep test/type 3 porta (G0399) |
$870 |
$1,450 |
4.0× |
| Hospital outpt clinic visit (G0463) |
$1,950.90 |
$3,251.50 |
14.6× |
| Ig paraprotein qual bld/ur (0077U) |
$66 |
$110 |
1.5× |
| Inj for sacroiliac jt anesth (G0260) |
$6,076.38 |
$10,127.30 |
8.6× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) |
$498.60 |
$831 |
4.1× |
| Mnt subs tx for change dx (G0270) |
$69.60 |
$116 |
2.2× |
| Mra w/cont, abd (C8900) |
$1,897.80 |
$3,163 |
5.4× |
| Mra w/cont, chest (C8909) |
$1,519.80 |
$2,533 |
4.3× |
| Mra w/cont, pelvis (C8918) |
$1,707.60 |
$2,846 |
4.9× |
| Mra w/o cont, abd (C8901) |
$1,586.40 |
$2,644 |
6.6× |
| Mra w/o cont, chest (C8910) |
$1,736.40 |
$2,894 |
7.3× |
| Mra w/o cont, lwr ext (C8913) |
$1,287 |
$2,145 |
5.4× |
| Mra w/o cont, pelvis (C8919) |
$1,590.60 |
$2,651 |
6.7× |
| Mra w/o fol w/cont, abd (C8902) |
$2,157 |
$3,595 |
6.2× |
| Mra w/o fol w/cont, chest (C8911) |
$2,364 |
$3,940 |
6.8× |
| Mra w/o fol w/cont, lwr ext (C8914) |
$1,618.20 |
$2,697 |
4.6× |
| Mra w/o fol w/cont, pelvis (C8920) |
$2,121 |
$3,535 |
6.1× |
| Mra, w/o&w/dye, upper extr (C8936) |
$1,840.20 |
$3,067 |
5.3× |
| Mri w/o fol w/cont, breast, (C8908) |
$3,357 |
$5,595 |
9.6× |
| Mri w/o fol w/cont, brst, un (C8905) |
$1,554.60 |
$2,591 |
4.4× |
| Pathogen test for platelets (P9100) |
$1,287.60 |
$2,146 |
21.8× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) |
$25,148.92 |
$41,914.86 |
2.0× |
| Perq Sacral Augmt Bilat Inj (0201T) |
$6,149.40 |
$10,249 |
0.8× |
| Perq Sacral Augmt Unilat Inj (0200T) |
$14,288.16 |
$23,813.60 |
2.0× |
| Place device/marker, non pro (C9728) |
$2,110.27 |
$3,517.12 |
1.5× |
| Prostate biopsy, any mthd (G0416) |
$742.80 |
$1,238 |
2.1× |
| Psa screening (G0103) |
$166.80 |
$278 |
8.6× |
| Qmrcp w/dx MRI same anatomy (0724T) |
$1,095.60 |
$1,826 |
1.2× |
| Quan CT tiss charac i&r w/cncrnt CT exam (0722T) |
$750 |
$1,250 |
1.2× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) |
$789.60 |
$1,316 |
1.1× |
| Revasc intra lithotrip-ather (C9766) |
$62,195.56 |
$103,659.26 |
3.4× |
| Revasc intra lithotrip-stent (C9765) |
$51,270.48 |
$85,450.80 |
2.8× |
| Revasc intravasc lithotripsy (C9764) |
$51,382.51 |
$85,637.52 |
4.4× |
| Revasc lithotr-ather tib/per (C9774) |
$46,225.62 |
$77,042.70 |
2.5× |
| Revasc lithotr-stent tib/per (C9773) |
$37,628.72 |
$62,714.53 |
2.0× |
| Revasc lithotrip tibi/perone (C9772) |
$33,826.34 |
$56,377.23 |
2.9× |
| Revasc lithotrip-stent-ather (C9767) |
$65,373.12 |
$108,955.20 |
3.6× |
| Scr c/v cyto,thinlayer,rescr (G0145) |
$127.20 |
$212 |
4.8× |
| Tomosynthesis, mammo (G0279) |
$30 |
$50 |
2.4× |
| Tpmt Nudt15 Gene Analysis Common Variants (0034U) |
$640.80 |
$1,068 |
1.4× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) |
$37,582.06 |
$62,636.77 |
3.3× |
| Trluml peripheral atherectomy iliac artery ea (0238T) |
$9,779.40 |
$16,299 |
0.5× |
| Tte w or w/o fol w/cont, com (C8921) |
$1,579.80 |
$2,633 |
2.0× |
| Tte w or wo fol wcon,doppler (C8929) |
$5,880.60 |
$9,801 |
7.5× |
| Unsched dialysis esrd pt hos (G0257) |
$875.40 |
$1,459 |
1.3× |