| 2d tee w or w/o fol w/con,in (C8925) |
$502.80 |
$838 |
0.6× |
| 2d tte w or w/o fol w/con,fu (C8924) |
$907.20 |
$1,512 |
2.6× |
| Admin hepatitis b vaccine (G0010) |
$65.40 |
$109 |
1.4× |
| Admin influenza virus vac (G0008) |
$66.60 |
$111 |
1.4× |
| Admin pneumococcal vaccine (G0009) |
$97.20 |
$162 |
2.1× |
| Alcohol/subs interv 15-30mn (G0396) |
$161.70 |
$269.50 |
4.3× |
| Alcohol/subs interv >30 min (G0397) |
$218.40 |
$364 |
1.2× |
| Annual alcohol screen 15 min (G0442) |
$106.80 |
$178 |
2.8× |
| Brief alcohol misuse counsel (G0443) |
$106.80 |
$178 |
1.0× |
| Ca screen;pelvic/breast exam (G0101) |
$202.80 |
$338 |
2.0× |
| Catheterize for urine spec (P9612) |
$44.40 |
$74 |
4.8× |
| Depression screen annual (G0444) |
$43.20 |
$72 |
1.1× |
| Drug test def 1-7 classes (G0480) |
$179.40 |
$299 |
1.6× |
| Drug test def 15-21 classes (G0482) |
$370.80 |
$618 |
1.9× |
| Drug test def 8-14 classes (G0481) |
$301.20 |
$502 |
1.9× |
| Elec stim other than wound (G0283) |
$156 |
$260 |
12.3× |
| Electrophysiologic eval icds w/ss electrode (0577T) |
$1,050.60 |
$1,751 |
0.9× |
| Elisa hiv-1/hiv-2 screen (G0433) |
$162.60 |
$271 |
8.9× |
| Facility svs dental rehab (G0330) |
$1,962 |
$3,270 |
0.6× |
| Fecal blood scrn immunoassay (G0328) |
$54.60 |
$91 |
3.0× |
| Fern test (Q0114) |
$6.60 |
$11 |
0.7× |
| Hepb screen high risk indiv (G0499) |
$275.40 |
$459 |
9.7× |
| Init/sub psych care m 1st 30 (G2214) |
$147 |
$245 |
1.4× |
| Initial preventive exam (G0402) |
$279 |
$465 |
2.1× |
| Insertion of substernal implantable defibrillator electrode (0572T) |
$7,163.40 |
$11,939 |
0.9× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) |
$27,750.60 |
$46,251 |
0.9× |
| Interrogation dev eval icds w/ss eltrd in person (0576T) |
$32.40 |
$54 |
0.9× |
| Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg,… (0263T) |
$7,289.40 |
$12,149 |
1.7× |
| Mra w/cont, abd (C8900) |
$908.40 |
$1,514 |
2.6× |
| Mra w/cont, chest (C8909) |
$986.40 |
$1,644 |
2.8× |
| Mra w/cont, lwr ext (C8912) |
$1,031.40 |
$1,719 |
2.9× |
| Mra w/cont, pelvis (C8918) |
$986.40 |
$1,644 |
2.8× |
| Mra w/o cont, abd (C8901) |
$986.40 |
$1,644 |
4.1× |
| Mra w/o cont, chest (C8910) |
$986.40 |
$1,644 |
4.1× |
| Mra w/o cont, lwr ext (C8913) |
$1,031.40 |
$1,719 |
4.3× |
| Mra w/o cont, pelvis (C8919) |
$986.40 |
$1,644 |
4.1× |
| Mra w/o fol w/cont, abd (C8902) |
$1,042.20 |
$1,737 |
3.0× |
| Mra w/o fol w/cont, chest (C8911) |
$1,042.20 |
$1,737 |
3.0× |
| Mra w/o fol w/cont, lwr ext (C8914) |
$1,042.20 |
$1,737 |
3.0× |
| Mra w/o fol w/cont, pelvis (C8920) |
$1,042.20 |
$1,737 |
3.0× |
| Mra, w/dye, spinal canal (C8931) |
$939 |
$1,565 |
2.7× |
| Mra, w/dye, upper extremity (C8934) |
$1,031.40 |
$1,719 |
2.9× |
| Mra, w/o dye, spinal canal (C8932) |
$939 |
$1,565 |
3.9× |
| Mra, w/o dye, upper extr (C8935) |
$1,031.40 |
$1,719 |
4.3× |
| Mra, w/o&w/dye, spinal canal (C8933) |
$1,005.60 |
$1,676 |
2.9× |
| Mri w/cont, breast, bi (C8906) |
$279 |
$465 |
0.8× |
| Mri w/cont, breast, uni (C8903) |
$259.80 |
$433 |
1.5× |
| Mri w/o fol w/cont, breast, (C8908) |
$529.80 |
$883 |
1.5× |
| Mri w/o fol w/cont, brst, un (C8905) |
$327.60 |
$546 |
0.9× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) |
$324 |
$540 |
0.6× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$1,380.60 |
$2,301 |
3.1× |
| Obtaining screen pap smear (Q0091) |
$98.40 |
$164 |
3.4× |
| Perc d-e cor revasc chro sin (C9607) |
$32,400.60 |
$54,001 |
1.8× |
| Perc d-e cor revasc t cabg s (C9604) |
$12,925.80 |
$21,543 |
1.1× |
| Perc d-e cor stent ather s (C9602) |
$19,930.80 |
$33,218 |
1.1× |
| Perc drug-el cor stent sing (C9600) |
$12,804 |
$21,340 |
1.1× |
| Perq Sacral Augmt Bilat Inj (0201T) |
$11,013.60 |
$18,356 |
1.5× |
| Perq Sacral Augmt Unilat Inj (0200T) |
$11,013.60 |
$18,356 |
1.5× |
| Place device/marker, non pro (C9728) |
$2,368.80 |
$3,948 |
1.7× |
| Ppps, initial visit (G0438) |
$330.60 |
$551 |
1.9× |
| Ppps, subseq visit (G0439) |
$211.20 |
$352 |
1.5× |
| Prgrmg dev eval icds ss ip (0575T) |
$32.40 |
$54 |
0.9× |
| Prostate biopsy, any mthd (G0416) |
$385.80 |
$643 |
1.1× |
| Psa screening (G0103) |
$92.40 |
$154 |
4.8× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) |
$3,150 |
$5,250 |
0.8× |
| Revasc intra lithotrip-ather (C9766) |
$25,929.60 |
$43,216 |
1.4× |
| Revasc intra lithotrip-stent (C9765) |
$25,929.60 |
$43,216 |
1.4× |
| Revasc intravasc lithotripsy (C9764) |
$16,216.80 |
$27,028 |
1.4× |
| Revasc lith-sten-ath tib/per (C9775) |
$25,929.60 |
$43,216 |
1.4× |
| Revasc lithotr-ather tib/per (C9774) |
$25,929.60 |
$43,216 |
1.4× |
| Revasc lithotr-stent tib/per (C9773) |
$25,929.60 |
$43,216 |
1.4× |
| Revasc lithotrip tibi/perone (C9772) |
$16,216.80 |
$27,028 |
1.4× |
| Revasc lithotrip-stent-ather (C9767) |
$25,929.60 |
$43,216 |
1.4× |
| Rmvl substernal implantable defibrillator eltrd (0573T) |
$3,150 |
$5,250 |
0.8× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) |
$3,150 |
$5,250 |
0.8× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) |
$33,013.80 |
$55,023 |
1.7× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) |
$8,001.60 |
$13,336 |
1.4× |
| Tomosynthesis, mammo (G0279) |
$63.30 |
$105.50 |
5.0× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) |
$17,775.60 |
$29,626 |
1.5× |
| Trauma respons w/hosp criti (G0390) |
$8,569.80 |
$14,283 |
6.4× |
| Trim nail(s) (G0127) |
$239.40 |
$399 |
4.0× |
| Trluml Perip Athrc Renal Art (0234T) |
$22,956 |
$38,260 |
2.0× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) |
$14,668.80 |
$24,448 |
1.3× |
| Trluml peripheral atherectomy iliac artery ea (0238T) |
$38,447.40 |
$64,079 |
2.1× |
| Tte w or w/o fol w/con,stres (C8928) |
$2,199 |
$3,665 |
2.8× |
| Tte w or w/o fol w/cont, com (C8921) |
$1,772.40 |
$2,954 |
2.3× |
| Tte w or w/o fol w/cont, f/u (C8922) |
$1,772.40 |
$2,954 |
2.3× |
| Tte w or wo fol wcon,doppler (C8929) |
$2,214.60 |
$3,691 |
2.8× |
| Unsched dialysis esrd pt hos (G0257) |
$4,114.20 |
$6,857 |
6.0× |