| Admin influenza virus vac (G0008) |
— |
$361 |
— |
| Admin pneumococcal vaccine (G0009) |
— |
$361 |
— |
| Catheterize for urine spec (P9612) |
— |
$27 |
— |
| Colon ca scrn not hi rsk ind (G0121) |
— |
$10,713.42 |
— |
| Colorectal scrn; hi risk ind (G0105) |
— |
$11,278.76 |
— |
| Covid-19 lab test non-cdc (U0002) |
— |
$389 |
— |
| Cysto impl 4 or more (C9740) |
— |
$66,732.36 |
— |
| Cystoscopy prostatic imp 1-3 (C9739) |
— |
$69,797 |
— |
| Direct refer hospital observ (G0379) |
— |
$2,340 |
— |
| Elec stim other than wound (G0283) |
— |
$297 |
— |
| Elec stim unattend for press (G0281) |
— |
$211 |
— |
| Fecal blood scrn immunoassay (G0328) |
— |
$131 |
— |
| Fern test (Q0114) |
— |
$115 |
— |
| Hbot, full body chamber, 30m (G0277) |
— |
$635 |
— |
| Insertion of sinus tarsi implant (0335T) |
— |
$73,792.42 |
— |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) |
— |
$342,421.60 |
— |
| Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) |
— |
$38,147 |
— |
| Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) |
— |
$38,147 |
— |
| Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) |
— |
$124,753 |
— |
| Interro Device Evaluation Cardiac Modulj System (0418T) |
— |
$198 |
— |
| Mnt subs tx for change dx (G0270) |
— |
$109 |
— |
| Mri w/cont, breast, bi (C8906) |
— |
$7,037 |
— |
| Perc d-e cor revasc chro sin (C9607) |
— |
$81,750 |
— |
| Perc d-e cor revasc t cabg s (C9604) |
— |
$59,370.60 |
— |
| Perc d-e cor stent ather s (C9602) |
— |
$81,750 |
— |
Perc drug-el cor stent sing (C9600)
range across 3 matching MRF lines |
— |
$85,548.55–$92,024.82 |
— |
| Prgrmg Device Evaluation Cardiac Modulj System (0417T) |
— |
$198 |
— |
| Prostate biopsy, any mthd (G0416) |
— |
$273 |
— |
| Psa screening (G0103) |
— |
$326 |
— |
| Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) |
— |
$8,045 |
— |
Revasc intra lithotrip-ather (C9766)
range across 2 matching MRF lines |
— |
$98,734.24–$113,887.61 |
— |
Revasc intra lithotrip-stent (C9765)
range across 2 matching MRF lines |
— |
$91,752.44–$100,922.24 |
— |
Revasc intravasc lithotripsy (C9764)
range across 3 matching MRF lines |
— |
$62,589.75–$95,593.26 |
— |
| Revasc lith-sten-ath tib/per (C9775) |
— |
$123,501 |
— |
| Revasc lithotr-ather tib/per (C9774) |
— |
$123,501 |
— |
| Revasc lithotr-stent tib/per (C9773) |
— |
$123,501 |
— |
| Revasc lithotrip tibi/perone (C9772) |
— |
$159,336.73 |
— |
| Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) |
— |
$124,753 |
— |
| Rmvl Car Modulj Tranvns Elt (0413T) |
— |
$14,185 |
— |
| Rmvl Cardiac Modulj Pls Gen (0412T) |
— |
$14,185 |
— |
| Tomosynthesis, mammo (G0279) |
— |
$271 |
— |
| Trauma respons w/hosp criti (G0390) |
— |
$8,227 |
— |
| Trluml Perip Athrc Brchiocph (0237T) |
— |
$46,338 |
— |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) |
— |
$46,338 |
— |
| Unsched dialysis esrd pt hos (G0257) |
— |
$1,262 |
— |