Supplies, drugs & other prices at East Cooper Medical Center
Mount Pleasant, SC · every code in this section with a posted price and a Medicare benchmark.
407 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) | $141 | $282 | 3.9× |
| 2d cephalometric image (D0340) | $124.01 | — | 1.5× |
| 2d tee w or w/o fol w/con,in (C8925) | $1,824.41 | — | 2.5× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,824.41 | — | 2.5× |
| 2d tte w or w/o fol w/con,fu (C8924) | $664.42 | — | 2.0× |
| 3d bn img algor drvd fr mri (G0566) | $293.36 | — | 2.5× |
| Add proc construct new crown (D2971) | $1,071.79 | — | 1.8× |
| Adm of soc dtr assess 5-15 m (G0136) | $38.49 | — | 1.1× |
| Adm tocilizu covid-19 1st (M0249) | $495.15 | $2,698 | 1.2× |
| Adm tocilizu covid-19 2nd (M0250) | $495.15 | $2,698 | 1.2× |
| Admin hepatitis b vaccine (G0010) | $57.60 | $221 | 1.3× |
| Admin influenza virus vac (G0008) | $79.76 | $210 | 1.8× |
| Admin pneumococcal vaccine (G0009) | $79.76 | $215 | 1.8× |
| Adv prim care mgmt lvl 1 (G0556) | $55.86 | — | 1.6× |
| Adv prim care mgmt lvl 2 (G0557) | $55.86 | — | 1.6× |
| Adv prim care mgmt lvl 3 (G0558) | $173.44 | — | 1.8× |
| Alcohol/sub misuse assess (G2011) | $35.45 | — | 1.3× |
| Alcohol/subs interv 15-30mn (G0396) | $86.40 | — | 2.5× |
| Alcohol/subs interv >30 min (G0397) | $86.40 | — | 0.5× |
| Alveoloplasty not w/extracts (D7321) | $2,777.40 | — | 1.9× |
| Alveoloplasty w/extract 1-3 (D7311) | $2,071.07 | — | 1.4× |
| Alveolus clsd reduc stblz te (D7771) | $4,373.05 | — | 1.4× |
| Alveolus open reduction (D7671) | $7,953.59 | — | 1.4× |
| Alveoplasty w/ extraction (D7310) | $2,071.07 | — | 1.4× |
| Alveoplasty w/o extraction (D7320) | $2,777.40 | — | 1.9× |
| Amalgam 4 or > surfaces perm (D2161) | $1,071.79 | — | 1.8× |
| Amalgam one surface permanen (D2140) | $1,071.79 | — | 1.8× |
| Amalgam three surfaces perma (D2160) | $1,071.79 | — | 1.8× |
| Amalgam two surfaces permane (D2150) | $1,071.79 | — | 1.8× |
| Ana crown exp 1-3 per quad (D4231) | $2,071.07 | — | 1.4× |
| Ana crown exp 4 or> per quad (D4230) | $4,373.05 | — | 1.4× |
| Annual alcohol screen 15 min (G0442) | $86.40 | — | 2.5× |
| Ant resin-based cmpst crown (D2390) | $1,071.79 | — | 1.8× |
| Apexification/recalc final (D3353) | $1,071.79 | — | 1.8× |
| Apexification/recalc initial (D3351) | $1,071.79 | — | 1.8× |
| Apexification/recalc interim (D3352) | $1,071.79 | — | 1.8× |
| Apically positioned flap (D4245) | $2,071.07 | — | 1.4× |
| Apicoectomy - anterior (D3410) | $1,071.79 | — | 1.8× |
| Arthro/shoul surg; w/spacer (C9781) | $17,874.20 | — | 1.5× |
| Ascvd rsk mng clin stf pr mo (G0538) | $173.44 | — | 1.8× |
| Auto tissue graft 1st tooth (D4273) | $1,629.46 | — | 1.1× |
| Autolog prp not diab ulcer (G0460) | $2,202.95 | — | 1.1× |
| Behavior counsel obesity 15m (G0447) | $86.40 | — | 0.9× |
| Bio mtrls to aid soft/os reg (D4265) | $1,071.79 | — | 1.8× |
| Bitewings - three images (D0273) | $332.11 | — | 1.5× |
| Bitewings four images (D0274) | $1,629.46 | — | 7.3× |
| Blind cor sinus reducer impl (C9783) | $14,940.79 | — | 1.4× |
| Blind interatrial shunt ide (C9758) | $22,478.21 | — | 1.4× |
| Blind myocar trpl bon marrow (C9782) | $22,356.76 | — | 1.4× |
| Blind/nonblind trans atrial (C9792) | $13,898.83 | — | 1.6× |
| Bone replce graft first site (D4263) | $1,460.36 | — | 2.4× |
| Brief alcohol misuse counsel (G0443) | $86.40 | — | 0.9× |
| Ca screen;flexi sigmoidscope (G0104) | $968.94 | — | 1.1× |
| Ca screen;pelvic/breast exam (G0101) | $176.13 | — | 1.9× |
| Canal prep/fitting of dowel (D3950) | $1,071.79 | — | 1.8× |
| Cardiac mri seg dys strain (C9762) | $692.33 | — | 1.4× |
| Cardiac mri seg dys stress (C9763) | $692.33 | — | 1.4× |
| Cardiokymography (Q0035) | $550.54 | — | 15.8× |
| Care manage beh svs 20mins (G0323) | $37.66 | — | 1.1× |
| Chemo extend iv infus w/pump (G0498) | $112.99 | — | 0.4× |
| Closd rductn splint alveolus (D7670) | $4,373.05 | — | 1.4× |
| Colon ca scrn not hi rsk ind (G0121) | $1,127.78 | — | 1.3× |
| Colorectal scrn; hi risk ind (G0105) | $832.93 | — | 1.0× |
| Colpopexy, min/inv, ex-perit (C9778) | $3,759.60 | — | 0.8× |
| Comm hlth intg svs sdoh 60mn (G0019) | $121.15 | — | 1.3× |
| Commissure splint (D5987) | $1,460.36 | — | 2.4× |
| Comp periodontal evaluation (D0180) | $179.60 | — | 1.5× |
| Complete occlusal adjustment (D9952) | $1,460.36 | — | 2.4× |
| Complex simulation w/pet-ct (G0562) | $2,780.91 | — | 1.6× |
| Comprehensve oral evaluation (D0150) | $1,629.46 | — | 13.2× |
| Con tissue w pedicle graft (D4276) | $2,071.07 | — | 1.4× |
| Coping (D2975) | $1,071.79 | — | 1.8× |
| Core build-up incl any pins (D2950) | $1,071.79 | — | 1.8× |
| Coronectomy (D7251) | $2,071.07 | — | 1.4× |
| Covid-19 lab test non-cdc (U0002) | $60.50 | $202 | 1.2× |
| Crown 3/4 cast base metal (D2781) | $1,071.79 | — | 1.8× |
| Crown 3/4 cast hi noble met (D2780) | $1,071.79 | — | 1.8× |
| Crown 3/4 cast noble metal (D2782) | $1,071.79 | — | 1.8× |
| Crown 3/4 porcelain/ceramic (D2783) | $1,071.79 | — | 1.8× |
| Crown 3/4 resin-based compos (D2712) | $1,071.79 | — | 1.8× |
| Crown full cast base metal (D2791) | $1,071.79 | — | 1.8× |
| Crown full cast high noble m (D2790) | $1,071.79 | — | 1.8× |
| Crown full cast noble metal (D2792) | $1,071.79 | — | 1.8× |
| Crown lengthen hard tissue (D4249) | $1,071.79 | — | 1.8× |
| Crown porcelain fused base m (D2751) | $1,071.79 | — | 1.8× |
| Crown porcelain w/ h noble m (D2750) | $1,071.79 | — | 1.8× |
| Crown porcelain w/ noble met (D2752) | $1,071.79 | — | 1.8× |
| Crown porcelain/ceramic (D2740) | $1,071.79 | — | 1.8× |
| Crown repair (D2980) | $1,071.79 | — | 1.8× |
| Crown resin w/ base metal (D2721) | $1,071.79 | — | 1.8× |
| Crown resin w/ high noble me (D2720) | $1,071.79 | — | 1.8× |
| Crown resin w/ noble metal (D2722) | $1,071.79 | — | 1.8× |
| Crown resin-based indirect (D2710) | $1,071.79 | — | 1.8× |
| Crown-titanium (D2794) | $1,071.79 | — | 1.8× |
| Cysto impl 4 or more (C9740) | $6,899.93 | — | 0.8× |
| Cysto, litho, vacuum kidney (C9761) | $6,326.19 | — | 0.7× |
| Cystoscopy prostatic imp 1-3 (C9739) | $6,326.19 | — | 1.3× |
| Demonstrate use home inr mon (G0248) | $365.55 | — | 3.0× |
| Dental bitewing single image (D0270) | $1,629.46 | — | 20.1× |
| Dental bitewings two images (D0272) | $1,629.46 | — | 20.1× |
| Dental connector bar (D6920) | $1,460.36 | — | 2.4× |
| Dental gold foil one surface (D2410) | $1,071.79 | — | 1.8× |
| Dental gold foil three surfa (D2430) | $1,071.79 | — | 1.8× |
| Dental gold foil two surface (D2420) | $1,071.79 | — | 1.8× |
| Dental inlay metalic 1 surf (D2510) | $1,071.79 | — | 1.8× |
| Dental inlay metallic 2 surf (D2520) | $1,071.79 | — | 1.8× |
| Dental inlay metl 3/more sur (D2530) | $1,071.79 | — | 1.8× |
| Dental inlay resin 3/mre sur (D2652) | $1,071.79 | — | 1.8× |
| Dental onlay metallic 2 surf (D2542) | $1,071.79 | — | 1.8× |
| Dental onlay metallic 3 surf (D2543) | $1,071.79 | — | 1.8× |
| Dental onlay metl 4/more sur (D2544) | $1,071.79 | — | 1.8× |
| Dental onlay porc 3/more sur (D2630) | $1,071.79 | — | 1.8× |
| Dental onlay porc 4/more sur (D2644) | $1,071.79 | — | 1.8× |
| Dental onlay porcelin 2 surf (D2642) | $1,071.79 | — | 1.8× |
| Dental onlay porcelin 3 surf (D2643) | $1,071.79 | — | 1.8× |
| Dental onlay resin 2 surface (D2662) | $1,071.79 | — | 1.8× |
| Dental onlay resin 3 surface (D2663) | $1,071.79 | — | 1.8× |
| Dental onlay resin 4/mre sur (D2664) | $1,071.79 | — | 1.8× |
| Dental prophylaxis adult (D1110) | $179.60 | — | 1.5× |
| Dental saliography (D0310) | $332.11 | — | 1.5× |
| Dental tmj arthrogram incl i (D0320) | $332.11 | — | 1.5× |
| Dental tomographic survey (D0322) | $149.66 | — | 1.5× |
| Dental unspec restorative pr (D2999) | $1,460.36 | — | 2.4× |
| Depression screen annual (G0444) | $86.40 | — | 2.5× |
| Dermal filler injection(s) (G0429) | $2,202.95 | — | 1.1× |
| Devlopment test interpt&rep (G0451) | $86.40 | — | 0.9× |
| Diab manage trn ind/group (G0109) | $19.94 | — | 1.2× |
| Direct refer hospital observ (G0379) | $176.13 | $332 | 0.3× |
| Dstry eye lesn,fdr vssl tech (G0186) | $1,111.90 | — | 2.2× |
| Each addtnl prefab post (D2957) | $1,071.79 | — | 1.8× |
| Ekg tracing for initial prev (G0404) | $84.19 | — | 3.1× |
| Elec stim other than wound (G0283) | $11 | — | 0.9× |
| Elec stim unattend for press (G0281) | $11 | — | 0.9× |
| End thxpy, anterior tooth (D3310) | $1,071.79 | — | 1.8× |
| End thxpy, molar tooth (D3330) | $1,071.79 | — | 1.8× |
| End thxpy, premolar tooth (D3320) | $1,071.79 | — | 1.8× |
| Endo outlet restrict w/tube (C9785) | $13,980.08 | — | 1.4× |
| Endodontic endosseous implan (D3460) | $1,460.36 | — | 2.4× |
| Endodontic procedure (D3999) | $1,460.36 | — | 2.4× |
| Esd endoscopy or colonoscopy (C9779) | $5,201.19 | — | 1.5× |
| Excision benign lesion compl (D7412) | $2,071.07 | — | 1.4× |
| Excision benign lesion>1.25c (D7411) | $2,071.07 | — | 1.4× |
| Excision malig les complicat (D7415) | $2,071.07 | — | 1.4× |
| Excision malig lesion<=1.25c (D7413) | $2,071.07 | — | 1.4× |
| Excision malig lesion>1.25cm (D7414) | $2,071.07 | — | 1.4× |
| Exposure of unerupted tooth (D7280) | $1,071.79 | — | 1.8× |
| Extensv oral eval prob focus (D0160) | $179.60 | — | 1.5× |
| Extraction coronal remnants (D7111) | $1,460.36 | — | 2.4× |
| Extraction erupted tooth/exr (D7140) | $1,460.36 | — | 2.4× |
| Extraoral 2d project image (D0250) | $1,629.46 | — | 20.1× |
| Extrnl counterpulse, per tx (G0166) | $328.99 | — | 2.7× |
| Facial moulage complete (D5912) | $1,460.36 | — | 2.4× |
| Facial moulage sectional (D5911) | $1,460.36 | — | 2.4× |
| Facility svs dental rehab (G0330) | $4,373.05 | — | 1.4× |
| Fecal microbiota prep instil (G0455) | $123.10 | — | 0.1× |
| Fern test (Q0114) | $11.08 | — | 1.1× |
| Followup eval of foot pt lop (G0246) | $222.65 | — | 1.8× |
| Full mouth debridement (D4355) | $1,460.36 | — | 2.4× |
| Gingival flap proc w/ planin (D4240) | $4,373.05 | — | 1.4× |
| Gingivectomy/plasty 1 to 3 (D4211) | $4,373.05 | — | 1.4× |
| Gingivectomy/plasty 4 or mor (D4210) | $4,373.05 | — | 1.4× |
| Glaucoma scrn hgh risk direc (G0118) | $137.36 | — | 4.0× |
| Glaucoma scrn hgh risk direc (G0117) | $198.28 | — | 7.4× |
| Gngvl flap w rootplan 1-3 th (D4241) | $2,071.07 | — | 1.4× |
| Gross pulpal debridement (D3221) | $1,071.79 | — | 1.8× |
| Group behave couns 2-10 (G0473) | $37.66 | — | 1.1× |
| Guided tiss regen nonresorb (D4267) | $2,071.07 | — | 1.4× |
| Guided tiss regen resorble (D4266) | $2,071.07 | — | 1.4× |
| Hbot, full body chamber, 30m (G0277) | $333.42 | $1,002 | 2.6× |
| High inten beh couns std 30m (G0445) | $86.40 | — | 0.9× |
| Hiv prep counsel, clin staff (G0013) | $121.15 | — | 3.5× |
| Home sleep test/type 2 porta (G0398) | $492.94 | — | 2.5× |
| Home sleep test/type 3 porta (G0399) | $492.94 | — | 2.5× |
| Home sleep test/type 4 porta (G0400) | $492.94 | — | 2.5× |
| Hopd mntl hlt, 15-29 min (C7900) | $38.49 | — | 1.1× |
| Hopd mntl hlt, 30-60 min (C7901) | $121.15 | — | 1.3× |
| Hopd mntl hlt, grp (C7903) | $38.49 | — | 1.1× |
| I&d absc intraoral soft tiss (D7510) | $855.90 | — | 1.3× |
| I&d abscess extraoral (D7520) | $855.90 | — | 1.3× |
| Impact tooth rem bony w/comp (D7241) | $1,460.36 | — | 2.4× |
| Impact tooth remov comp bony (D7240) | $1,460.36 | — | 2.4× |
| Impact tooth remov part bony (D7230) | $1,460.36 | — | 2.4× |
| Impact tooth remov soft tiss (D7220) | $1,460.36 | — | 2.4× |
| Incision/drain abscess extra (D7521) | $855.90 | — | 1.3× |
| Incision/drain abscess intra (D7511) | $855.90 | — | 1.3× |
| Incomplete endodontic tx (D3332) | $1,071.79 | — | 1.8× |
| Init/sub psych care m 1st 30 (G2214) | $107.45 | — | 1.1× |
| Initial foot exam pt lops (G0245) | $176.13 | — | 1.4× |
| Initial preventive exam (G0402) | $222.65 | — | 1.8× |
| Inj for sacroiliac jt anesth (G0260) | $795.91 | — | 1.2× |
| Injection of hiv prep drug (G0012) | $64.14 | — | 1.0× |
| Inlay composite/resin one su (D2650) | $1,071.79 | — | 1.8× |
| Inlay composite/resin two su (D2651) | $1,071.79 | — | 1.8× |
| Inlay porcelain/ceramic 1 su (D2610) | $1,071.79 | — | 1.8× |
| Inlay porcelain/ceramic 2 su (D2620) | $1,071.79 | — | 1.8× |
| Insert cv cath inf & sup app (C9780) | $11,760.77 | — | 1.6× |
| Insert drug del implant, >=4 (G0516) | $137.36 | — | 0.3× |
| Insert palate implants (C9727) | $1,602.87 | — | 1.1× |
| Instill pharm renal pelvis (C9789) | $2,875.56 | — | 2.5× |
| Intens behave ther cardio dx (G0446) | $86.40 | — | 2.5× |
| Intens cardiac rehab no exer (G0423) | $120.74 | — | 1.0× |
| Intens cardiac rehab w/exerc (G0422) | $120.74 | — | 1.0× |
| Intentional replantation (D3470) | $1,071.79 | — | 1.8× |
| Interim crown (D2799) | $1,071.79 | — | 1.8× |
| Internal root repair (D3333) | $1,071.79 | — | 1.8× |
| Intraor comprehensive series (D0210) | $332.11 | — | 1.5× |
| Intraoral occlusal film (D0240) | $1,629.46 | — | 20.1× |
| Intraoral periapical first (D0220) | $124.01 | — | 1.5× |
| Isolation- tooth w rubb dam (D3910) | $1,071.79 | — | 1.8× |
| Iv cipaglucosidase alfa-atga (G0138) | $1,219.69 | — | 2.1× |
| Labial veneer porc indirect (D2962) | $1,071.79 | — | 1.8× |
| Labial veneer resin direct (D2960) | $1,071.79 | — | 1.8× |
| Labial veneer resin indirect (D2961) | $1,071.79 | — | 1.8× |
| Lev 1 hosp type b ed visit (G0380) | $145.11 | — | 2.1× |
| Lev 2 hosp type b ed visit (G0381) | $198.28 | — | 2.3× |
| Lev 3 hosp type b ed visit (G0382) | $285.79 | — | 1.8× |
| Lev 4 hosp type b ed visit (G0383) | $512.87 | — | 2.1× |
| Lev 5 hosp type b ed visit (G0384) | $1,043.47 | — | 2.7× |
| Limit oral eval problm focus (D0140) | $179.60 | — | 1.5× |
| Limited occlusal adjustment (D9951) | $1,460.36 | — | 2.4× |
| Localized delivery antimicro (D4381) | $1,460.36 | — | 2.4× |
| Malig tumor > 1.25 cm (D7441) | $4,373.05 | — | 1.4× |
| Malig tumor exc to 1.25 cm (D7440) | $4,373.05 | — | 1.4× |
| Mandible graft (D7950) | $7,953.59 | — | 1.4× |
| Mesial/distal wedge proc (D4274) | $1,071.79 | — | 1.8× |
| Monthly tx for dmht 20mins (G0553) | $241.63 | — | 2.0× |
| Mra w/cont, abd (C8900) | $1,376.90 | — | 4.2× |
| Mra w/cont, chest (C8909) | $1,376.90 | — | 4.2× |
| Mra w/cont, lwr ext (C8912) | $1,376.90 | — | 4.2× |
| Mra w/cont, pelvis (C8918) | $1,376.90 | — | 4.2× |
| Mra w/o cont, abd (C8901) | $1,121.01 | — | 5.1× |
| Mra w/o cont, chest (C8910) | $1,121.01 | — | 5.1× |
| Mra w/o cont, lwr ext (C8913) | $1,121.01 | — | 5.1× |
| Mra w/o cont, pelvis (C8919) | $1,121.01 | — | 5.1× |
| Mra w/o fol w/cont, abd (C8902) | $1,735.80 | — | 5.3× |
| Mra w/o fol w/cont, chest (C8911) | $1,456.55 | — | 4.5× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,735.80 | — | 5.3× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,735.80 | — | 5.3× |
| Mra, w/dye, spinal canal (C8931) | $1,376.90 | — | 4.2× |
| Mra, w/dye, upper extremity (C8934) | $1,376.90 | — | 4.2× |
| Mra, w/o dye, spinal canal (C8932) | $1,121.01 | — | 5.1× |
| Mra, w/o dye, upper extr (C8935) | $1,121.01 | — | 5.1× |
| Mra, w/o&w/dye, spinal canal (C8933) | $1,735.80 | — | 5.3× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,735.80 | — | 5.3× |
| Mri hyperpolarized xenon129 (C9791) | $1,598.10 | — | 1.4× |
| Mri w/cont, breast, bi (C8906) | $2,094.50 | — | 6.5× |
| Mri w/cont, breast, uni (C8903) | $1,376.90 | $4,663 | 8.4× |
| Mri w/o fol w/cont, breast, (C8908) | $2,964.53 | — | 9.1× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,735.80 | — | 5.3× |
| Nav srv peer sup 60 min pr m (G0140) | $121.15 | — | 1.3× |
| Non-auto graft 1st tooth (D4275) | $2,071.07 | — | 1.4× |
| Non-blind interatrial shunt (C9760) | $35,323.61 | — | 1.4× |
| Non-cov proc, clinical trial (G0294) | $137.36 | — | 4.0× |
| Non-cov surg proc,clin trial (G0293) | $137.36 | — | 4.0× |
| Non-ophthalmic fva (C9733) | $602.60 | — | 1.9× |
| Non-surg tx root canal obs (D3331) | $1,071.79 | — | 1.8× |
| Obtaining screen pap smear (Q0091) | $32.12 | — | 1.2× |
| Occlusion analysis (D9950) | $1,460.36 | — | 2.4× |
| Off base opioid tx 70min (G2086) | $191.64 | — | 1.2× |
| Off base opioid tx, 60 m (G2087) | $191.64 | — | 1.2× |
| Open reduc compd alveolus fx (D7770) | $7,953.59 | — | 1.4× |
| Open tx iliac spine uni/bil (G0412) | $8,979.18 | — | 1.3× |
| Open tx post pelvic fxcture (G0415) | $17,649.30 | — | 5.8× |
| Opps service,sched team conf (G0175) | $289.11 | — | 0.7× |
| Oral antral fistula closure (D7260) | $1,460.36 | — | 2.4× |
| Oral/facial photo images (D0350) | $124.01 | — | 1.5× |
| Osseous surg 1 to 3 teeth (D4261) | $4,373.05 | — | 1.4× |
| Osseous surgery 4 or more (D4260) likely a partial charge, not the full procedure |
$1,629.46 | — | 0.3× |
| Oth resp proc, group (G0239) | $85.29 | — | 2.5× |
| Oth resp proc, indiv (G0238) | $85.29 | — | 3.2× |
| Other tmj images by report (D0321) | $124.01 | — | 1.5× |
| Panoramic image (D0330) | $332.11 | — | 1.5× |
| Part pulp for apexogenesis (D3222) | $1,071.79 | — | 1.8× |
| Pathogen test for platelets (P9100) | $48.74 | — | 0.9× |
| Pedicle soft tissue graft pr (D4270) | $1,629.46 | — | 1.1× |
| Pelvic ring fracture uni/bil (G0413) | $6,360.53 | — | 0.9× |
| Pelvic ring fx treat int fix (G0414) | $17,649.30 | — | 2.6× |
| Pemivibart infusion (M0224) | $495.15 | — | 1.2× |
| Perc d-e cor revasc chro sin (C9607) | $24,709.91 | — | 1.4× |
| Perc d-e cor revasc t cabg s (C9604) | $15,374.28 | — | 1.4× |
| Perc d-e cor stent ather s (C9602) | $24,709.91 | — | 1.4× |
| Perc drug-el cor stent sing (C9600) | $20,828.21 | — | 1.9× |
| Periodic oral evaluation (D0120) | $179.60 | — | 1.5× |
| Periodontal maint procedures (D4910) | $1,071.79 | — | 1.8× |
| Periodontal scaling & root (D4341) | $1,071.79 | — | 1.8× |
| Periodontal scaling 1-3teeth (D4342) | $1,071.79 | — | 1.8× |
| Pet not otherwise specified (G0235) | $540.57 | — | 1.5× |
| Pild/placebo control clin tr (G0276) | $8,979.18 | — | 1.3× |
| Pin service 60m per month (G0023) | $121.15 | — | 1.3× |
| Place device/marker, non pro (C9728) | $2,876.75 | — | 2.2× |
| Place direct restoration (D2940) | $1,071.79 | — | 1.8× |
| Place endorectal app (C9725) | $1,116.86 | — | 1.3× |
| Pne flu hepb cov home admin (M0201) | $39.88 | — | 1.2× |
| Post 1 srfc resinbased cmpst (D2391) | $1,071.79 | — | 1.8× |
| Post 2 srfc resinbased cmpst (D2392) | $1,071.79 | — | 1.8× |
| Post 3 srfc resinbased cmpst (D2393) | $1,071.79 | — | 1.8× |
| Post >=4srfc resinbase cmpst (D2394) | $1,071.79 | — | 1.8× |
| Post and core cast + crown (D2952) | $1,071.79 | — | 1.8× |
| Post d/c phone follow up (G0544) | $173.44 | — | 1.8× |
| Post op service lvrs min 6 (G0305) | $492.94 | — | 1.4× |
| Potassium hydroxide preps (Q0112) | $12.18 | — | 2.1× |
| Pre 3d mdl w/ccta and/or mri (C9793) | $1,419.67 | — | 1.8× |
| Pre-op service lvrs 1-9 dos (G0304) | $492.94 | — | 1.4× |
| Pre-op service lvrs 10-15dos (G0303) | $2,430.34 | — | 12.1× |
| Pre-op service lvrs complete (G0302) | $2,430.34 | — | 7.0× |
| Prefab post/core + crown (D2954) | $1,071.79 | — | 1.8× |
| Prefab stainless steel crown (D2933) | $1,071.79 | — | 1.8× |
| Prefab steel crown primary (D2934) | $1,071.79 | — | 1.8× |
| Prefab stnlss steel crown pe (D2931) | $1,071.79 | — | 1.8× |
| Prefab stnlss steel crwn pri (D2930) | $1,071.79 | — | 1.8× |
| Prefabricated resin crown (D2932) | $1,071.79 | — | 1.8× |
| Primary closure sinus perf (D7261) | $1,460.36 | — | 2.4× |
| Prolonged iv inf, req pump (C8957) | $378 | — | 1.9× |
| Prostate biopsy, any mthd (G0416) | $417.61 | — | 1.3× |
| Provide inr test mater/equip (G0249) | $365.55 | — | 3.0× |
| Psa screening (G0103) | $50.96 | $175 | 2.6× |
| Pulp cap direct (D3110) | $1,195.89 | — | 2.0× |
| Pulp cap indirect (D3120) | $1,195.89 | — | 2.0× |
| Pulp vitality test (D0460) | $1,460.36 | — | 2.4× |
| Pulpal therapy anterior prim (D3230) | $1,071.79 | — | 1.8× |
| Pulpal therapy posterior pri (D3240) | $1,071.79 | — | 1.8× |
| Rad exc lesion up to 1.25 cm (D7410) | $2,071.07 | — | 1.4× |
| Radiation applicator (D5983) | $1,460.36 | — | 2.4× |
| Radiation cone locator (D5985) | $1,460.36 | — | 2.4× |
| Radiation shield (D5984) | $1,460.36 | — | 2.4× |
| Re-cement or re-bond crown (D2920) | $1,071.79 | — | 1.8× |
| Re-eval,est pt,problem focus (D0170) | $179.60 | — | 1.5× |
| Recement cast or prefab post (D2915) | $1,071.79 | — | 1.8× |
| Recement inlay onlay or part (D2910) | $1,071.79 | — | 1.8× |
| Rem exostosis any site (D7471) | $6,080.76 | — | 2.0× |
| Rem imp tooth w mucoper flp (D7210) | $1,629.46 | — | 1.1× |
| Rem nonodonto cyst > 1.25 cm (D7461) | $1,071.79 | — | 1.8× |
| Rem nonodonto cyst to 1.25cm (D7460) | $1,071.79 | — | 1.8× |
| Rem odontogen cyst > 1.25 cm (D7451) | $4,373.05 | — | 1.4× |
| Rem odontogen cyst to 1.25cm (D7450) | $4,373.05 | — | 1.4× |
| Removal fb skin/areolar tiss (D7530) | $1,071.79 | — | 1.8× |
| Removal of fb reaction (D7540) | $1,071.79 | — | 1.8× |
| Removal of sloughed off bone (D7550) | $1,071.79 | — | 1.8× |
| Removal of torus palatinus (D7472) | $1,071.79 | — | 1.8× |
| Remove drug implant (G0517) | $137.36 | — | 0.3× |
| Remove torus mandibularis (D7473) | $1,071.79 | — | 1.8× |
| Remove unilat space maintain (D1520) | $1,460.36 | — | 2.4× |
| Remove w insert drug implant (G0518) | $137.36 | — | 0.3× |
| Reshaping bone orthognathic (D7940) | $1,460.36 | — | 2.4× |
| Resin 4/> surf or w incis an (D2335) | $1,071.79 | — | 1.8× |
| Resin one surface-anterior (D2330) | $1,071.79 | — | 1.8× |
| Resin three surfaces-anterio (D2332) | $1,071.79 | — | 1.8× |
| Resin two surfaces-anterior (D2331) | $1,071.79 | — | 1.8× |
| Retreat root canal anterior (D3346) | $1,071.79 | — | 1.8× |
| Retreat root canal molar (D3348) | $1,071.79 | — | 1.8× |
| Retreat root canal premolar (D3347) | $1,071.79 | — | 1.8× |
| Retrograde filling (D3430) | $1,071.79 | — | 1.8× |
| Revasc intra lithotrip-ather (C9766) | $14,393.71 | — | 0.8× |
| Revasc intra lithotrip-stent (C9765) | $14,393.71 | — | 0.8× |
| Revasc intravasc lithotripsy (C9764) | $7,103.81 | — | 0.7× |
| Revasc lith-sten-ath tib/per (C9775) | $23,022.85 | — | 1.4× |
| Revasc lithotr-ather tib/per (C9774) | $23,022.85 | — | 1.4× |
| Revasc lithotr-stent tib/per (C9773) | $23,022.85 | — | 1.4× |
| Revasc lithotrip tibi/perone (C9772) | $14,393.71 | — | 1.3× |
| Revasc lithotrip-stent-ather (C9767) | $23,022.85 | — | 1.4× |
| Risk ascvd tst once pr 12 mo (G0537) | $55.86 | — | 1.6× |
| Root amputation (D3450) | $1,071.79 | — | 1.8× |
| Root surgery molar (D3425) | $1,071.79 | — | 1.8× |
| Root surgery premolar (D3421) | $1,071.79 | — | 1.8× |
| Routine footcare pt w lops (G0247) | $176.13 | — | 0.9× |
| Sbrt w/positron emission del (G0563) | $5,346.58 | — | 1.8× |
| Scr c/v cyto,thinlayer,rescr (G0144) | $49.10 | — | 1.1× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $32.12 | — | 1.2× |
| Screen cerv/vag thin layer (G0123) | $22.81 | — | 1.1× |
| Single energy x-ray study (G0130) | $58.98 | — | 0.6× |
| Software meas of cardiac vol (G0183) | $165.09 | — | 2.0× |
| Space maintainer fxd unilat (D1510) | $1,460.36 | — | 2.4× |
| Spine device implant surgery (C9757) | $17,649.30 | — | 1.5× |
| Supply of digital device (G0552) | $241.63 | — | 2.0× |
| Surg reduct osseoustuberosit (D7485) | $7,953.59 | — | 1.4× |
| Surgical revision procedure (D4268) | $1,460.36 | — | 2.4× |
| Surgical splint (D5988) | $1,071.79 | — | 1.8× |
| Tee w or w/o fol w/cont, mon (C8927) | $1,824.41 | — | 2.5× |
| Tee w or w/o fol w/cont,cong (C8926) | $1,824.41 | — | 2.5× |
| Therapeutic procd strg endur (G0237) | $85.29 | — | 3.2× |
| Therapeutic pulpotomy (D3220) | $1,071.79 | — | 1.8× |
| Tmj arthroscopy disc reposit (D7874) | $4,395.86 | — | 1.4× |
| Tooth pin retention (D2951) | $1,071.79 | — | 1.8× |
| Tooth reimplantation (D7270) | $1,071.79 | — | 1.8× |
| Tooth root removal (D7250) | $1,460.36 | — | 2.4× |
| Tooth splitting (D3920) | $1,071.79 | — | 1.8× |
| Tooth transplantation (D7272) | $1,071.79 | — | 1.8× |
| Transseptal fiberotomy (D7291) | $1,460.36 | — | 2.4× |
| Trauma respons w/hosp criti (G0390) | $3,013 | $7,498 | 2.4× |
| Treatment of complications (D9930) | $1,460.36 | — | 2.4× |
| Trim nail(s) (G0127) | $176.13 | — | 3.2× |
| Tte w or w/o contr, cont ecg (C8930) | $1,824.41 | — | 2.5× |
| Tte w or w/o fol w/con,stres (C8928) | $1,361.06 | — | 1.9× |
| Tte w or w/o fol w/cont, com (C8921) | $1,824.41 | — | 2.5× |
| Tte w or w/o fol w/cont, f/u (C8922) | $1,824.41 | — | 2.5× |
| Tte w or wo fol wcon,doppler (C8929) | $1,582.63 | $6,194 | 2.2× |
| U/s trtmt, not leiomyomata (C9734) | $12,254.71 | — | 1.0× |
| Unsched dialysis esrd pt hos (G0257) | $1,395.73 | $3,391 | 2.2× |
| Unscheduled dressing change (D4920) | $1,195.89 | — | 2.0× |
| Unspecified periodontal proc (D4999) | $297.64 | — | 1.4× |
| Vert bitewings 7 to 8 images (D0277) | $1,629.46 | — | 7.3× |
| Vestibuloplasty exten graft (D7350) | $7,953.59 | — | 1.4× |
| Vestibuloplasty ridge extens (D7340) | $7,953.59 | — | 1.4× |
| Visit esketamine 56m or less (G2082) | $873.99 | — | 0.9× |
| Visit esketamine, > 56m (G2083) | $1,277.20 | — | 0.9× |
| Visit to determ ldct elig (G0296) | $107.45 | — | 1.1× |
| Wet mounts/ w preparations (Q0111) | $11.08 | — | 0.6× |