| 2d tee w or w/o fol w/con,in (C8925) |
— |
$3,646.25 |
— |
| 2d tte w or w/o fol w/con,co (C8923) |
— |
$2,856.50 |
— |
| 2d tte w or w/o fol w/con,fu (C8924) |
— |
$3,021 |
— |
| Admin influenza virus vac (G0008) |
— |
$76 |
— |
| Admin pneumococcal vaccine (G0009) |
— |
$56.70 |
— |
| Ca screen;pelvic/breast exam (G0101) |
— |
$14,090.19 |
— |
| Colon ca scrn not hi rsk ind (G0121) |
— |
$5,431.86 |
— |
| Colorectal scrn; hi risk ind (G0105) |
— |
$4,700.86 |
— |
| Covid-19 lab test non-cdc (U0002) |
— |
$155.50 |
— |
| Direct refer hospital observ (G0379) |
— |
$1,841 |
— |
| Drug test def 1-7 classes (G0480) |
— |
$278.25 |
— |
| Elec stim other than wound (G0283) |
— |
$78.50 |
— |
| Facility svs dental rehab (G0330) |
— |
$15,503.72 |
— |
| Hbot, full body chamber, 30m (G0277) |
— |
$710 |
— |
| Hiv combination assay (G0475) |
— |
$129.75 |
— |
| Hospital outpt clinic visit (G0463) |
— |
$1,084.50 |
— |
| Inj for sacroiliac jt anesth (G0260) |
— |
$4,356 |
— |
| Mra w/o cont, abd (C8901) |
— |
$3,489.75 |
— |
| Mra w/o cont, pelvis (C8919) |
— |
$4,315.50 |
— |
| Mra w/o fol w/cont, abd (C8902) |
— |
$4,221.75 |
— |
| Mra w/o fol w/cont, chest (C8911) |
— |
$4,510 |
— |
| Mra w/o fol w/cont, lwr ext (C8914) |
— |
$4,217.50 |
— |
| Mra, w/o&w/dye, upper extr (C8936) |
— |
$4,685 |
— |
| Mri w/cont, breast, uni (C8903) |
— |
$3,841.50 |
— |
| Mri w/o fol w/cont, breast, (C8908) |
— |
$5,742.75 |
— |
| Oth resp proc, group (G0239) |
— |
$111.25 |
— |
| Perc d-e cor revasc t cabg s (C9604) |
— |
$86,598.41 |
— |
| Perc drug-el cor stent sing (C9600) |
— |
$84,250.77 |
— |
| Posterior vertebral joint(s) arthroplasty (e.g., facet joint(s) replacement) including facetectomy, laminectomy,… (0202T) |
— |
$106,921.96 |
— |
| Psa screening (G0103) |
— |
$150.50 |
— |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) |
— |
$613 |
— |
Revasc intra lithotrip-ather (C9766)
range across 2 matching MRF lines |
— |
$63,415.29–$211,586.76 |
— |
Revasc intra lithotrip-stent (C9765)
range across 4 matching MRF lines |
— |
$119,056.72–$127,004.20 |
— |
Revasc intravasc lithotripsy (C9764)
range across 3 matching MRF lines |
— |
$63,455.62–$142,260.85 |
— |
| Revasc lithotr-stent tib/per (C9773) |
— |
$103,074.48 |
— |
| Revasc lithotrip tibi/perone (C9772) |
— |
$86,092.15 |
— |
Revasc lithotrip-stent-ather (C9767)
range across 2 matching MRF lines |
— |
$157,442.99–$172,247.94 |
— |
| Tee w or w/o fol w/cont,cong (C8926) |
— |
$3,646.25 |
— |
| Tomosynthesis, mammo (G0279) |
— |
$220 |
— |
| Trauma respons w/hosp criti (G0390) |
— |
$4,283 |
— |
| Tte w or w/o fol w/con,stres (C8928) |
— |
$3,021 |
— |
| Tte w or w/o fol w/cont, f/u (C8922) |
— |
$3,021 |
— |
| Tte w or wo fol wcon,doppler (C8929) |
— |
$2,236.50 |
— |
| Unsched dialysis esrd pt hos (G0257) |
— |
$2,173 |
— |