| 2d tee w or w/o fol w/con,in (C8925) |
$1,003 |
$3,683.40 |
1.0× |
| Admin hepatitis b vaccine (G0010) |
$59 |
$173.90 |
1.0× |
Admin influenza virus vac (G0008)
range across 2 matching MRF lines |
$59 |
$173.90–$174.60 |
1.0× |
| Admin pneumococcal vaccine (G0009) |
$59 |
$264.47 |
1.0× |
| Colon ca scrn not hi rsk ind (G0121) |
$1,190 |
$3,763.80 |
1.0× |
| Colorectal scrn; hi risk ind (G0105) |
$1,190 |
$3,763.80 |
1.0× |
| Compre Audiom Threshold Eval & Speech Recog (0212T) |
$164 |
$408.96 |
1.0× |
| Cysto impl 4 or more (C9740) |
$12,115 |
$22,788.80 |
1.0× |
| Direct refer hospital observ (G0379) |
$762 |
$3,514.50 |
1.0× |
Drug test def 1-7 classes (G0480)
range across 3 matching MRF lines |
$114 |
$377.62–$629.37 |
1.0× |
| Drug test def 15-21 classes (G0482) |
$198 |
$993.70 |
1.0× |
| Drug test def 22+ classes (G0483) |
$246 |
$1,234.60 |
1.0× |
| Drug test def 8-14 classes (G0481) |
$156 |
$782.95 |
1.0× |
| Extrnl counterpulse, per tx (G0166) |
$170 |
$1,318.05 |
1.0× |
| Fecal blood scrn immunoassay (G0328) |
$18 |
$155.54 |
1.0× |
| Fern test (Q0114) |
$9 |
$48.70 |
0.9× |
| Hospital outpt clinic visit (G0463) |
$170 |
$738.68 |
1.0× |
| Inj for sacroiliac jt anesth (G0260) |
$903 |
$3,172.95 |
1.0× |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) |
$1,132 |
$2,929.15 |
1.0× |
| Insertion of sinus tarsi implant (0335T) |
$9,286 |
$2,729.25 |
1.0× |
| Njx bone sub matrl into subchondral bone defect (0707T) |
$4,187 |
$6,618.70 |
1.0× |
| Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) |
$1,132 |
$2,929.15 |
1.0× |
| Njx platelet plasma (0232T) |
$571 |
$990.03 |
1.0× |
| Perc d-e cor revasc chro sin (C9607) |
$23,462 |
$48,061.20 |
1.0× |
| Perc d-e cor revasc t cabg s (C9604) |
$14,775 |
$31,531.40 |
1.0× |
| Perc d-e cor stent ather s (C9602) |
$23,462 |
$102,928 |
1.0× |
| Perc drug-el cor stent sing (C9600) |
$14,775 |
$65,004 |
1.0× |
| Potassium hydroxide preps (Q0112) |
$5 |
$41.72 |
0.9× |
| Psa screening (G0103) |
$19 |
$200.62 |
1.0× |
| Pure tone audiometry (threshold), automated; air and bone Non-Facility Physician Technical Component (0209T) |
$47 |
$103.25 |
1.0× |
| Pure tone audiometry (threshold), automated; air only Non-Facility Physician Technical Component (0208T) |
$47 |
$103.25 |
1.0× |
| Revasc intra lithotrip-ather (C9766) |
$23,462 |
$61,756.60 |
1.0× |
| Revasc intra lithotrip-stent (C9765) |
$23,462 |
$61,756.60 |
1.0× |
| Revasc intravasc lithotripsy (C9764) |
$14,775 |
$39,002.40 |
1.0× |
| Revasc lith-sten-ath tib/per (C9775) |
$23,462 |
$50,320 |
1.0× |
| Revasc lithotr-ather tib/per (C9774) |
$23,462 |
$61,756.60 |
1.0× |
| Revasc lithotr-stent tib/per (C9773) |
$23,462 |
$61,756.60 |
1.0× |
| Revasc lithotrip tibi/perone (C9772) |
$14,775 |
$50,214.70 |
1.0× |
| Revasc lithotrip-stent-ather (C9767) |
$23,462 |
$50,320 |
1.0× |
| Speech audiometry threshold, automated; Non-Facility Physician Technical Component (0210T) |
$47 |
$103.25 |
1.0× |
| Speech audiometry threshold, automated; with speech recognition Non-Facility Physician (0211T) |
$47 |
$103.25 |
1.0× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) |
$24,652 |
$95,335.80 |
1.0× |
| Trluml perip athrc abd aorta (0236T) |
$14,775 |
$35,791.40 |
1.0× |
| Trluml Perip Athrc Brchiocph (0237T) |
$14,775 |
$35,791.40 |
1.0× |
| Trluml Perip Athrc Iliac Art (0238T) |
$23,462 |
$48,061.20 |
1.0× |
Trluml Peripheral Atherectomy Renal Artery Ea (0234T)
range across 2 matching MRF lines |
$14,775 |
$31,531.40–$35,791.40 |
1.0× |
| Tte w or w/o contr, cont ecg (C8930) |
$1,003 |
$2,646.50 |
1.0× |
| Tte w or w/o fol w/con,stres (C8928) |
$1,003 |
$324.45 |
1.0× |
| Tte w or wo fol wcon,doppler (C8929) |
$1,003 |
$3,142.85 |
1.0× |
| Unsched dialysis esrd pt hos (G0257) |
$878 |
$2,990.15 |
1.0× |
| Wet mounts/ w preparations (Q0111) |
$18 |
$109 |
1.0× |