Supplies, drugs & other prices at Kaiser Foundation Hospital-san Jose

San Jose, CA · every code in this section with a posted price and a Medicare benchmark.

561 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
2019-ncov diagnostic p (U0001) $92.96 $166 2.6×
2d cephal radio image (D0702) $62.16 $111 0.5×
2d cephalometric image (D0340) $50.96 $91 0.4×
2d oral/facial photo image (D0703) $62.16 $111 0.5×
2d tee w or w/o fol w/con,in (C8925) $3,046.40 $5,440 2.6×
2d tte w or w/o fol w/con,co (C8923) $2,122.40 $3,790 1.8×
2d tte w or w/o fol w/con,fu (C8924) $2,749.60 $4,910 5.4×
3d anat seg imaging preop (C8001) $192.08 $343 1.0×
3D contour simulaj trgt lvr les&mrgn micrwv ablt (0944T) $397.60 $710 1.1×
Ablation b9 thyroid nodule perq laser w/img gdn (0673T) $3,175.20 $5,670 1.3×
Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T)
unusually low: confirm this is the full procedure		 $6,792.80 $12,130 0.4×
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T)
unusually low: confirm this is the full procedure		 $2,514.40 $4,490 0.4×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $3,785.60 $6,760 1.3×
Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T)
unusually low: confirm this is the full procedure		 $3,948 $7,050 0.3×
Adapt bhv tx prtcl modificaj ea 15 min tech time (0373T) $537.60 $960 9.8×
Add proc construct new crown (D2971) $108.64 $194 0.1×
Adm tocilizu covid-19 1st (M0249) $1,239.84 $2,214 1.9×
Adm tocilizu covid-19 2nd (M0250) $1,239.84 $2,214 1.9×
Admin hepatitis b vaccine (G0010) $122.64 $219 1.8×
Admin influenza virus vac (G0008) $122.64 $219 1.8×
Admin pneumococcal vaccine (G0009) $122.64 $219 1.8×
Adv prim care mgmt lvl 1 (G0556) $64.96 $116 1.2×
Adv prim care mgmt lvl 2 (G0557) $64.96 $116 1.2×
Adv prim care mgmt lvl 3 (G0558) $202.16 $361 1.4×
Alcohol/sub misuse assess (G2011) $81.76 $146 1.9×
Alcohol/subs interv 15-30mn (G0396) $238.56 $426 4.3×
Alcohol/subs interv >30 min (G0397) $442.40 $790 1.7×
Alveoloplasty w/extract 1-3 (D7311) $912.80 $1,630 0.4×
Alveoplasty w/ extraction (D7310) $912.80 $1,630 0.4×
Alveoplasty w/o extraction (D7320) $912.80 $1,630 0.4×
Amalgam 4 or > surfaces perm (D2161) $2,352 $4,200 2.5×
Amalgam one surface permanen (D2140) $168 $300 0.2×
Amalgam three surfaces perma (D2160) $208.88 $373 0.2×
Amalgam two surfaces permane (D2150) $173.04 $309 0.2×
Anatomic guide 3d printed 1st anatomic guide (0561T) $199.36 $356 1.0×
Anatomic Model 3D Printed 1St Compnt Antmc Strux (0559T) $199.36 $356 1.0×
Annual alcohol screen 15 min (G0442) $214.48 $383 3.9×
Ant resin-based cmpst crown (D2390) $271.04 $484 0.3×
Apexification/recalc final (D3353) $414.40 $740 0.4×
Apicoectomy - anterior (D3410) $1,013.60 $1,810 1.1×
Ascvd rsk mng clin stf pr mo (G0538) $202.16 $361 1.4×
Asstv alg ECG rsk asmt cncrt (0764T) $70 $125 0.4×
Asstv alg ECG rsk asmt prev (0765T) $70 $125 0.4×
Bdy surf activation mapg pm/cvdfb leads tm f/up (0696T) $78.96 $141 1.4×
Behavior counsel obesity 15m (G0447) $256.48 $458 1.7×
Bhv id suprt assmt ea 15 min (0362T) $392 $700 7.1×
Bia whole body composition assessment w/i&r (0358T) $256.48 $458 6.0×
Bitewings four images (D0274) $148.96 $266 0.4×
Blind interatrial shunt ide (C9758) $49,140 $87,750 2.0×
Blood mucoprotein (P2038) $38.64 $69 7.8×
Bone graft peri per tooth (D3428) $248.08 $443 0.3×
Bone replce graft first site (D4263) $4,099.20 $7,320 4.3×
Bone Strength & Fracture Risk Assessment (0556T) $420 $750 1.2×
Bone strength & fracture rsk cncrnt vrt fx assmt (0743T) $735.28 $1,313 2.1×
Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing… (0555T) $203.28 $363 4.8×
Brief alcohol misuse counsel (G0443) $256.48 $458 1.7×
Ca screen;flexi sigmoidscope (G0104) $2,548 $4,550 1.9×
Ca screen;pelvic/breast exam (G0101) $227.92 $407 1.5×
Care manage beh svs 20mins (G0323) $86.80 $155 1.6×
Catheterize for urine spec (P9612) $20.16 $36 2.2×
Cbc without platelet (G0307) $137.20 $245 21.2×
Cbc/diffwbc w/o platelet (G0306) $78.96 $141 10.2×
Chemo extend iv infus w/pump (G0498) $974.40 $1,740 2.0×
Collagen Cross-Linking Cornea&Pachymetry (0402T) $1,607.20 $2,870 0.5×
Colon ca scrn not hi rsk ind (G0121) $3,214.40 $5,740 2.3×
Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter (0736T) $386.40 $690 2.0×
Colorectal scrn; hi risk ind (G0105) $3,225.60 $5,760 2.4×
Complex simulation w/pet-ct (G0562) $4,261.60 $7,610 1.5×
Compre Audiom Threshold Eval & Speech Recog (0212T) $565.60 $1,010 3.0×
Compre ful bdy cptr mrkrls 3d knmtc&kin mtn alys (0693T) $1,024.80 $1,830 2.0×
Comprehensve oral evaluation (D0150) $142.24 $254 0.7×
Computed tomography scan taken for the purpose of biomechanical computed tomography analysis Non-Facility Physician (0558T) $896 $1,600 7.0×
Coms therapy wnd assmt&dr 1st appl <=50 sq cm (0906T) $487.20 $870 1.7×
Cone beam ct capt mandible (D0381) $140.56 $251 0.9×
Cool Quant Sensory Test (0108T) $85.68 $153 1.0×
Coping (D2975) $364 $650 0.4×
Core build-up incl any pins (D2950) $291.20 $520 0.3×
Coronectomy (D7251) $498.40 $890 0.2×
Covid-19 lab test non-cdc (U0002) $89.60 $160 1.7×
Crown 3/4 cast hi noble met (D2780) $980 $1,750 1.0×
Crown 3/4 cast noble metal (D2782) $980 $1,750 1.0×
Crown 3/4 porcelain/ceramic (D2783) $840 $1,500 0.9×
Crown 3/4 resin-based compos (D2712) $980 $1,750 1.0×
Crown full cast base metal (D2791) $980 $1,750 1.0×
Crown porcelain fused base m (D2751) $728 $1,300 0.8×
Crown porcelain w/ h noble m (D2750) $974.40 $1,740 1.0×
Crown porcelain w/ noble met (D2752) $728 $1,300 0.8×
Crown porcelain/ceramic (D2740) $2,850.40 $5,090 3.0×
Crown repair (D2980) $133.28 $238 0.1×
Crown resin-based indirect (D2710) $980 $1,750 1.0×
Crown-titanium (D2794) $812 $1,450 0.9×
Crtj Subq Insj Impltbl Glucose Sensor Sys Train (0446T) $8,019.20 $14,320 1.3×
CT breast w/3d rendering bi with contrast (0637T) $1,125.60 $2,010 2.2×
CT breast w/3d rendering bi without contrast (0636T) $705.60 $1,260 2.0×
CT breast w/3d rendering uni with contrast (0634T) $593.60 $1,060 2.3×
CT breast w/3d rendering uni without contrast (0633T) $554.40 $990 3.6×
CT brst w/3d rendering bi wo cntrst flwd cntrst (0638T) $1,125.60 $2,010 2.2×
CT brst w/3d rendering uni wo cntrst flwd cntrst (0635T) $621.60 $1,110 2.4×
Cysto impl 4 or more (C9740)
unusually low: confirm this is the full procedure		 $5,700.80 $10,180 0.4×
Cystoscopy prostatic imp 1-3 (C9739)
unusually low: confirm this is the full procedure		 $3,220 $5,750 0.4×
Demonstrate use home inr mon (G0248) $464.80 $830 2.4×
Dental bitewing single image (D0270) $59.92 $107 0.5×
Dental bitewings two images (D0272) $3,847.20 $6,870 30.1×
Dental inlay resin 3/mre sur (D2652) $694.40 $1,240 0.7×
Dental onlay porc 3/more sur (D2630) $3,628.80 $6,480 3.8×
Dental onlay porcelin 2 surf (D2642) $649.60 $1,160 0.7×
Dental onlay resin 2 surface (D2662) $560 $1,000 0.6×
Dental onlay resin 3 surface (D2663) $677.60 $1,210 0.7×
Dental onlay resin 4/mre sur (D2664) $722.40 $1,290 0.8×
Dental prophylaxis adult (D1110) $96.88 $173 0.5×
Dental unspec restorative pr (D2999) $4,099.20 $7,320 4.3×
Depression screen annual (G0444) $151.20 $270 2.7×
Device evaluation and interrogation of intraocular retinal electrode array (eg, retinal prosthesis), in person,… (0473T) $91.84 $164 0.7×
Device evaluation, interrogation, and initial programming of intraocular retinal electrode array (eg, retinal… (0472T) $224.56 $401 0.5×
Diab manage trn per indiv (G0108) $142.24 $254 2.6×
Diab manage trn ind/group (G0109) $128.24 $229 8.0×
Direct refer hospital observ (G0379) $1,377.60 $2,460 1.6×
Dist space maint, fixed unil (D1575) $1,400 $2,500 1.5×
Drug test def 1-7 classes (G0480) $364 $650 3.2×
Drug test def 15-21 classes (G0482) $1,383.20 $2,470 7.0×
Drug test def 22+ classes (G0483) $1,780.80 $3,180 7.2×
Drug test def 8-14 classes (G0481) $403.20 $720 2.6×
Dstry eye lesn,fdr vssl tech (G0186) $2,682.40 $4,790 3.3×
Each addtnl prefab post (D2957) $145.60 $260 0.2×
ECG algorithmically gen 12 ld rdcd ld trcg only (0904T) $397.60 $710 4.6×
Ed svc ckd grp per session (G0421) $110.88 $198 4.0×
Ed svc ckd ind per session (G0420) $464.80 $830 4.1×
Egd flexible transnasal dx w/collj spec br/wa (0652T) $1,170.40 $2,090 0.4×
Egd flexible transnasal w/biopsy single/multiple (0653T) $1,747.20 $3,120 0.6×
Egd flexible transnasal w/insj intral tube/cath (0654T) $3,500 $6,250 0.6×
Egd Flx Trnsorl Vol Adjmt Ntrgstr Bariatric Balo (0813T) $2,391.20 $4,270 1.8×
Ekg tracing for initial prev (G0404) $81.76 $146 1.9×
Elec alys cplx prgrmg iins ptn 4+ parameters (0590T) $291.20 $520 2.1×
Elec Alys Cplx Prgrmg Iins Sp/Sac Nrv 4+Param (0789T) $226.24 $404 1.6×
Elec alys int nstimj sys vagus nrv w/o prgrmg (0911T) $397.60 $710 4.6×
Elec alys int nstimj sys vagus nrv w/smpl prgrmg (0912T) $397.60 $710 2.8×
Elec alys smpl prgrmg iins ptn 1-3 parameters (0589T) $291.20 $520 2.1×
Elec Alys Smpl Prgrmg Iins Sp/Sac Nrv 1-3 Param (0788T) $226.24 $404 1.6×
Elec stim other than wound (G0283) $20.16 $36 1.6×
Elec stim unattend for press (G0281) $41.44 $74 3.5×
Electromagntic tx for ulcers (G0329) $31.92 $57 3.0×
Electrophysiologic eval ccm-d leads at 1st impl (0930T) $487.20 $870 0.3×
Electrophysiologic eval ccm-d leads separate (0931T) $487.20 $870 0.3×
Electrophysiologic Eval Icds W/Ss Electrode (0577T) $918.40 $1,640 0.5×
End thxpy, anterior tooth (D3310) $1,153.60 $2,060 1.2×
End thxpy, molar tooth (D3330) $828.80 $1,480 0.9×
End thxpy, premolar tooth (D3320) $901.60 $1,610 0.9×
Endo defect closure gi tract (C9901)
unusually low: confirm this is the full procedure		 $6,423.20 $11,470 0.4×
Endo outlet restrict w/tube (C9785) $16,839.20 $30,070 1.1×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) $56,901.60 $101,610 0.9×
Esd endoscopy or colonoscopy (C9779) $5,269.60 $9,410 0.9×
Esophag muc integ w/eso egd (C9777)
unusually low: confirm this is the full procedure		 $2,475.20 $4,420 0.4×
Esw integumentary wound healing initial wound (0512T) $946.40 $1,690 3.2×
Ev Catheter Dir Chem Abltj Incmptnt Xtr Vein (0524T) $7,884.80 $14,080 1.7×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $11,989.60 $21,410 0.7×
Evac Meibomian Glnds Auto Ht& Intmt Press Uni (0207T) $403.20 $720 2.1×
Evacuation meibomian glands using heat bilateral (0563T) $403.20 $720 4.6×
Excision benign lesion>1.25c (D7411) $912.80 $1,630 0.4×
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie,… (0184T) $13,249.60 $23,660 1.5×
Exposure of unerupted tooth (D7280) $4,099.20 $7,320 4.3×
Extensv oral eval prob focus (D0160) $341.60 $610 1.7×
Extra oral post radio image (D0705) $62.16 $111 0.5×
Extracorporeal shock wave muscskel sys nos (0101T) $6,064.80 $10,830 16.7×
Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral… (0102T) $6,064.80 $10,830 1.3×
Extraction coronal remnants (D7111) $4,099.20 $7,320 4.3×
Extraction erupted tooth/exr (D7140) $4,099.20 $7,320 4.3×
Extraoral 2d project image (D0250) $130.48 $233 1.0×
Extrnl counterpulse, per tx (G0166) $694.40 $1,240 3.5×
Eye mvmt analysis w/o spatial calibration i&r (0615T) $515.20 $920 2.6×
Facility svs dental rehab (G0330) $4,838.40 $8,640 1.0×
Fecal blood scrn immunoassay (G0328) $122.64 $219 6.8×
Fecal microbiota prep instil (G0455) $1,164.80 $2,080 0.9×
Fern test (Q0114) $89.04 $159 9.1×
Fixed bilat space maint, man (D1517) $4,099.20 $7,320 4.3×
Fixed bilat space maint, max (D1516) $4,099.20 $7,320 4.3×
Followup eval of foot pt lop (G0246) $464.80 $830 2.4×
Full mouth debridement (D4355) $4,099.20 $7,320 4.3×
Gi myoelectrical activity study stmch-colon i&r (0779T) $1,036 $1,850 1.9×
Gingivectomy/plasty 4 or mor (D4210) $1,562.40 $2,790 0.3×
Gingivectomy/plasty rest (D4212) $106.96 $191 0.0×
Glaucoma scrn hgh risk direc (G0118) $149.52 $267 2.7×
Glaucoma scrn hgh risk direc (G0117) $206.08 $368 4.8×
Gross pulpal debridement (D3221) $285.60 $510 0.3×
Group behave couns 2-10 (G0473) $230.72 $412 4.2×
Group mnt 2 or more 30 mins (G0271) $43.12 $77 2.5×
Group train w/o patient (G0543) $47.60 $85 1.1×
Guided tiss regen resorble (D4266) $677.60 $1,210 0.3×
Hbot, full body chamber, 30m (G0277) $453.60 $810 2.2×
Hdr electronic brachytherapy ntrstl/intrcav (0395T) $2,105.60 $3,760 2.1×
Heart Symp Image Plnr (0331T) $8,058.40 $14,390 4.2×
Heat Quant Sensory Test (0109T) $85.68 $153 1.6×
High inten beh couns std 30m (G0445) $246.96 $441 1.7×
Histotripsy mal hepatocellular tiss w/img gdn (0686T) $48,468 $86,550 1.9×
Home sleep test/type 2 porta (G0398) $543.20 $970 1.7×
Home sleep test/type 3 porta (G0399) $392 $700 1.2×
Home sleep test/type 4 porta (G0400) $924 $1,650 2.9×
Hopd mntl hlt, 15-29 min (C7900) $86.80 $155 1.6×
Hopd mntl hlt, 30-60 min (C7901) $235.20 $420 1.6×
Hopd mntl hlt, grp (C7903) $73.36 $131 1.3×
Hospital outpt clinic visit (G0463) $255.92 $457 1.3×
Hpv combo assay ca screen (G0476) $96.32 $172 2.7×
Imp extar knee shck absrb (C8003) $32,748.80 $58,480 1.3×
Impact tooth rem bony w/comp (D7241) $4,099.20 $7,320 4.3×
Impact tooth remov comp bony (D7240) $4,099.20 $7,320 4.3×
Impact tooth remov part bony (D7230) $4,099.20 $7,320 4.3×
Impact tooth remov soft tiss (D7220) $4,099.20 $7,320 4.3×
Initial care training 30 m (G0539) $47.60 $85 0.9×
Initial foot exam pt lops (G0245) $464.80 $830 2.4×
Initial preventive exam (G0402) $392 $700 2.0×
Inj for sacroiliac jt anesth (G0260) $4,424 $7,900 4.3×
Injection posterior chamber eye medication (0699T) $4,681.60 $8,360 1.4×
Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image… (0481T) $296.80 $530 0.5×
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) $3,337.60 $5,960 2.6×
Inlay composite/resin one su (D2650) $509.60 $910 0.5×
Inlay composite/resin two su (D2651) $565.60 $1,010 0.6×
Inlay porcelain/ceramic 1 su (D2610) $582.40 $1,040 0.6×
Insert palate implants (C9727) $1,797.60 $3,210 0.8×
Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the… (0253T) $11,289.60 $20,160 1.9×
Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space;… (0449T) $10,264.80 $18,330 1.3×
Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation… (0647T) $1,920.80 $3,430 0.7×
Insertion of sinus tarsi implant (0335T) $9,844.80 $17,580 0.9×
Insertion of substernal implantable defibrillator electrode (0572T) $6,540.80 $11,680 0.5×
Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging… (0786T) $24,074.40 $42,990 1.5×
Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging… (0784T) $24,074.40 $42,990 1.5×
Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system… (0680T)
likely a partial charge, not the full procedure		 $67.76 $121 0.0×
Insertion perm ccm-d system pulse generator only (0916T)
unusually low: confirm this is the full procedure		 $13,843.20 $24,720 0.4×
Insertion wrls car stimulator lv pacg compl sys (0515T) $51,503.20 $91,970 1.6×
Insertion/Replacement Complete Iims (0525T) $22,657.60 $40,460 0.8×
Insertion/Replacement Iims Electrode Only (0526T) $16,979.20 $30,320 1.4×
Insertion/Replacement Iims Implantable Mntr Only (0527T) $16,979.20 $30,320 1.4×
Insj ant sgm drg dev trab mw w/o res&ctrc rmvl1+ (0671T) $4,681.60 $8,360 0.6×
Insj bioprostc vlv fem vn (0744T) $10,858.40 $19,390 1.3×
Insj ocular telescope prosth (0308T) $56,056 $100,100 2.3×
Insj perm ccm-d sys 1 transvns lead only (0917T)
unusually low: confirm this is the full procedure		 $5,101.60 $9,110 0.4×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T)
unusually low: confirm this is the full procedure		 $5,101.60 $9,110 0.4×
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T)
unusually low: confirm this is the full procedure		 $19,773.60 $35,310 0.4×
Insj Wcs Lv Eltrd Only (0516T) $17,337.60 $30,960 1.1×
Insj Wcs Lv Pg Compnt (0517T) $17,337.60 $30,960 1.1×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $26,342.40 $47,040 0.6×
Instlj fecal microbiota ssp (0780T) $336 $600 1.7×
Intens behave ther cardio dx (G0446) $151.20 $270 2.7×
Intens cardiac rehab no exer (G0423) $459.20 $820 2.4×
Intens cardiac rehab w/exerc (G0422) $459.20 $820 2.4×
Interim crown (D2799) $319.20 $570 0.3×
Internal root repair (D3333) $201.60 $360 0.2×
Interrog dev eval iims ip (0529T) $85.12 $152 1.6×
Interrog dev eval impl ccm-d system in person (0927T) $397.60 $710 7.2×
Interrog Dev Eval Wrls Car Stimulator in Person (0521T) $39.20 $70 0.9×
Interrogation Dev Eval Icds W/Ss Eltrd In Person (0576T) $63.28 $113 1.2×
Interrogation device evaluation in person isdss (0685T) $55.44 $99 1.0×
Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg,… (0263T) $12,952.80 $23,130 2.0×
Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg,… (0264T) $12,952.80 $23,130 2.0×
Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg,… (0265T) $12,952.80 $23,130 2.0×
Intraor comprehensive series (D0210) $152.32 $272 0.4×
Intraoral bite radio image (D0708) $62.16 $111 0.5×
Intraoral comp image capture (D0709) $62.16 $111 0.5×
Intraoral occlus radio image (D0706) $62.16 $111 0.5×
Intraoral periap radio image (D0707) $62.16 $111 0.5×
Intraoral periapical first (D0220) $54.88 $98 0.4×
Ire Abltj 1+Tum Organ Perq (0600T)
unusually low: confirm this is the full procedure		 $6,792.80 $12,130 0.4×
Isolation- tooth w rubb dam (D3910) $125.44 $224 0.1×
Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for… (0674T)
likely a partial charge, not the full procedure		 $67.76 $121 0.0×
Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for… (0679T)
likely a partial charge, not the full procedure		 $67.76 $121 0.0×
Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation… (0677T)
likely a partial charge, not the full procedure		 $67.76 $121 0.0×
Laps insj new/rplcmt lead perm isdss 1st lead (0675T)
likely a partial charge, not the full procedure		 $67.76 $121 0.0×
Lev 1 hosp type b ed visit (G0380) $472.08 $843 4.3×
Lev 2 hosp type b ed visit (G0381) $872.48 $1,558 6.4×
Lev 3 hosp type b ed visit (G0382) $1,621.76 $2,896 6.4×
Lev 4 hosp type b ed visit (G0383) $2,712.64 $4,844 7.0×
Lev 5 hosp type b ed visit (G0384) $4,220.16 $7,536 7.0×
Limit oral eval problm focus (D0140) $119.84 $214 0.6×
Low intensity eswt corpus cavernosum low energy (0864T) $599.20 $1,070 1.6×
Magnetically controlled capsule endoscopy w/i&r (0651T) $632.80 $1,130 0.5×
Mnt subs tx for change dx (G0270) $89.60 $160 2.8×
Monthly tx for dmht 20mins (G0553) $280 $500 1.4×
Mra w/cont, abd (C8900) $3,931.20 $7,020 7.7×
Mra w/cont, chest (C8909) $3,931.20 $7,020 7.7×
Mra w/cont, lwr ext (C8912) $5,633.60 $10,060 11.0×
Mra w/cont, pelvis (C8918) $3,931.20 $7,020 7.7×
Mra w/o cont, abd (C8901) $3,029.60 $5,410 8.6×
Mra w/o cont, chest (C8910) $4,138.40 $7,390 11.8×
Mra w/o cont, lwr ext (C8913) $3,029.60 $5,410 8.6×
Mra w/o cont, pelvis (C8919) $3,029.60 $5,410 8.6×
Mra w/o fol w/cont, abd (C8902) $6,624.80 $11,830 12.9×
Mra w/o fol w/cont, chest (C8911) $6,781.60 $12,110 13.2×
Mra w/o fol w/cont, lwr ext (C8914) $5,633.60 $10,060 11.0×
Mra w/o fol w/cont, pelvis (C8920) $6,003.20 $10,720 11.7×
Mri w/cont, breast, bi (C8906) $5,633.60 $10,060 11.0×
Mri w/cont, breast, uni (C8903) $3,931.20 $7,020 15.2×
Mri w/o fol w/cont, breast, (C8908) $4,827.20 $8,620 9.4×
Mri w/o fol w/cont, brst, un (C8905) $5,633.60 $10,060 11.0×
Mrs discogenic pain acquisj single voxel data (0609T) $1,248.80 $2,230 3.6×
Mrs discogenic pain algorthmic alys bmrk data (0611T) $722.40 $1,290 2.1×
Myocardial img by mcg detcj cardiac ischemia (0541T) $1,416.80 $2,530 2.6×
Myocrd Symp Innervaj Img Plnr Qual&Quant W/Spect (0332T) $4,300.80 $7,680 2.3×
N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) $487.20 $870 1.1×
Ncntc R-T Fluor Wnd Img 1st (0598T) $873.60 $1,560 2.8×
Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or… (0507T) $341.60 $610 3.9×
Njx bone sub matrl into subchondral bone defect (0707T) $6,384 $11,400 1.3×
Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) $4,082.40 $7,290 3.1×
Njx platelet plasma (0232T) $593.60 $1,060 0.9×
No pt prsnt train initial 30 (G0541) $47.60 $85 1.1×
Non-auto graft 1st tooth (D4275) $1,008 $1,800 0.4×
Obtaining screen pap smear (Q0091) $113.68 $203 2.7×
Oct middle ear with i&r bilateral (0486T) $254.80 $455 4.6×
Oct middle ear with i&r unilateral (0485T) $108.64 $194 2.0×
Ocular blood flow measure (0198T) $256.48 $458 1.3×
Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm… (0005U) $1,775.20 $3,170 2.3×
Open impltj int neurostimulation sys vagus nerve (0908T)
likely a partial charge, not the full procedure		 $397.60 $710 0.0×
Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg,… (0817T) $38,656.80 $69,030 1.4×
Open insj/rplcmt integrated nstimj sys ptn subq (0816T) $38,656.80 $69,030 1.4×
Opps service,sched team conf (G0175) $1,360.80 $2,430 2.2×
Opto-acoustic img breast uni augmnt alys&reprt (0857T) $262.08 $468 1.7×
Oral antral fistula closure (D7260) $4,099.20 $7,320 4.3×
Oral/facial photo images (D0350) $10.08 $18 0.1×
Ortho impl mvmt alys pair CT (0946T) $392 $700 2.5×
Osseous surg 1 to 3 teeth (D4261) $1,041.60 $1,860 0.2×
Osteotomy, humerus, with insertion of an externally controlled intramedullary lengthening device, including… (0594T)
unusually low: confirm this is the full procedure		 $4,720.80 $8,430 0.4×
Oth resp proc, group (G0239) $164.08 $293 3.0×
Oth resp proc, indiv (G0238)
range across 2 matching MRF lines		 $71.68–$194.88 $128–$348 varies
Other tmj images by report (D0321) $71.68 $128 0.6×
Pano radio image (D0701) $62.16 $111 0.5×
Panoramic image (D0330) $85.68 $153 0.2×
Part pulp for apexogenesis (D3222) $157.36 $281 0.2×
Pathogen test for platelets (P9100) $11.20 $20 0.1×
Pattern erg w/i&r (0509T) $845.60 $1,510 2.7×
Pelvic ring fracture uni/bil (G0413)
unusually low: confirm this is the full procedure		 $5,112.80 $9,130 0.5×
Perc d-e cor revasc chro sin (C9607) $27,361.60 $48,860 1.0×
Perc d-e cor revasc t cabg s (C9604) $24,992.80 $44,630 1.5×
Perc d-e cor stent ather s (C9602) $27,988.80 $49,980 1.0×
Perc drug-el cor stent sing (C9600) $27,361.60 $48,860 1.6×
Percutaneous implantation or replacement of integrated single device neurostimulation system including electrode array… (0587T)
unusually low: confirm this is the full procedure		 $4,636.80 $8,280 0.5×
Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without… (0274T) $17,382.40 $31,040 1.6×
Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart… (0632T)
unusually low: confirm this is the full procedure		 $12,056.80 $21,530 0.4×
Periodic oral evaluation (D0120) $79.52 $142 0.4×
Periodontal maint procedures (D4910) $105.84 $189 0.1×
Periodontal scaling & root (D4341) $800.80 $1,430 0.8×
Periodontal scaling 1-3teeth (D4342) $308 $550 0.3×
Perq njx algc cell &/prdct uni/bi fluor lmbr 1st (0627T)
unusually low: confirm this is the full procedure		 $9,161.60 $16,360 0.5×
Perq njx algc cell&/prdct uni/bi CT lmbr 1st (0629T)
unusually low: confirm this is the full procedure		 $9,161.60 $16,360 0.5×
Perq Sacral Augmt Bilat Inj (0201T) $13,759.20 $24,570 1.3×
Perq Sacral Augmt Unilat Inj (0200T) $11,463.20 $20,470 1.1×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T)
likely a partial charge, not the full procedure		 $487.20 $870 0.0×
Perq Tcat Thrm Abltj Nerves Innervating P-Art (0793T) $31,824.80 $56,830 1.2×
Pinworm examinations (Q0113) $55.44 $99 13.0×
Place device/marker, non pro (C9728) $5,712 $10,200 2.8×
Place direct restoration (D2940) $156.80 $280 0.2×
Place endorectal app (C9725) $5,247.20 $9,370 3.8×
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone… (0221T) $10,035.20 $17,920 0.9×
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone… (0219T)
unusually low: confirm this is the full procedure		 $7,834.40 $13,990 0.4×
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone… (0220T)
unusually low: confirm this is the full procedure		 $7,834.40 $13,990 0.4×
Placement of interstitial device(s) in bone for radiostereometric analysis (RSA) (0347T) $487.20 $870 5.6×
Post 1 srfc resinbased cmpst (D2391) $142.80 $255 0.2×
Post 2 srfc resinbased cmpst (D2392) $186.48 $333 0.2×
Post 3 srfc resinbased cmpst (D2393) $231.28 $413 0.2×
Post >=4srfc resinbase cmpst (D2394) $285.60 $510 0.3×
Post d/c phone follow up (G0544) $202.16 $361 1.4×
Post op service lvrs min 6 (G0305) $1,579.20 $2,820 2.9×
Post-coital mucous exam (Q0115) $100.80 $180 4.0×
Potassium hydroxide preps (Q0112) $22.40 $40 3.8×
Ppps, initial visit (G0438) $420 $750 2.4×
Ppps, subseq visit (G0439) $206.08 $368 1.5×
Pre 3d mdl w/ccta and/or mri (C9793) $2,508.80 $4,480 2.0×
Pre-op service lvrs 1-9 dos (G0304) $1,579.20 $2,820 2.9×
Pre-op service lvrs 10-15dos (G0303) $1,568 $2,800 4.9×
Pre-op service lvrs complete (G0302) $4,127.20 $7,370 7.5×
Prefab porc/cer crown perm (D2928) $44.80 $80 0.0×
Prefab porc/ceram crown pri (D2929) $744.80 $1,330 0.8×
Prefab post/core + crown (D2954) $224 $400 0.2×
Prefab stainless steel crown (D2933) $245.28 $438 0.3×
Prefab steel crown primary (D2934) $319.20 $570 0.3×
Prefab stnlss steel crown pe (D2931) $1,685.60 $3,010 1.8×
Prefab stnlss steel crwn pri (D2930) $845.60 $1,510 0.9×
Prefabricated resin crown (D2932) $537.60 $960 0.6×
Prep skin cell susp, automtd (C8002) $13,652.80 $24,380 1.3×
Prgrmg dev eval iims ip (0528T) $85.12 $152 1.6×
Prgrmg dev eval ldls pm single car chamber ip (0826T) $68.88 $123 1.3×
Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) $67.20 $120 1.2×
Prgrmg device eval wrls car stimulator in person (0522T) $85.12 $152 1.6×
Programming dev eval icds w/ss eltrd in person (0575T) $63.28 $113 1.2×
Programming device eval impl ccm-d sys in person (0926T) $397.60 $710 7.2×
Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of… (0683T) $55.44 $99 1.0×
Prolonged iv inf, req pump (C8957) $1,282.40 $2,290 4.1×
Prostate biopsy, any mthd (G0416) $845.60 $1,510 1.6×
Provide inr test mater/equip (G0249) $392 $700 2.0×
Psa screening (G0103) $73.92 $132 3.8×
Pt spec alg rx-onc tx option (0794T) $146.72 $262 1.7×
Pulm tiss vntj alys prev CT (0807T) $795.20 $1,420 2.5×
Pulm tiss vntj alys w/CT (0808T) $795.20 $1,420 2.5×
Pulp cap direct (D3110) $58.24 $104 0.1×
Pulp cap indirect (D3120) $53.20 $95 0.1×
Pulpal therapy anterior prim (D3230) $526.40 $940 0.6×
Pulpal therapy posterior pri (D3240) $1,780.80 $3,180 1.9×
Pure tone audiometry (threshold), automated; air and bone Non-Facility Physician Technical Component (0209T) $141.12 $252 2.6×
Pure tone audiometry (threshold), automated; air only Non-Facility Physician Technical Component (0208T) $136.64 $244 2.5×
Qmrcp W/Diagnostic MRI Same Anatomy (0724T) $1,008 $1,800 0.7×
Qmrcp W/O Diagnostic MRI Sm Anatomy Drg Sm Sess (0723T) $2,682.40 $4,790 2.0×
Qtc interval augmnt alg alys xtrnl mobile ECG (0902T) $229.60 $410 1.2×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $2,928.80 $5,230 2.1×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $3,399.20 $6,070 2.5×
Quan MRI alys brain w/o diagnostic MRI same sess (0865T) $599.20 $1,070 1.7×
Quan MRI alys brain with diagnostic MRI (0866T) $599.20 $1,070 1.7×
Quant sensory test&interpj/xtr w/vibrj stimuli (0107T) $85.68 $153 1.6×
Quantitative sensory testing (QST), testing and interpretation per extremity; using other stimuli to assess sensation… (0110T) $91.84 $164 0.5×
Quantitative sensory testing (QST), testing and interpretation per extremity; using touch pressure stimuli to assess… (0106T) $85.68 $153 1.6×
Rad exc lesion up to 1.25 cm (D7410) $912.80 $1,630 0.4×
Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee,… (0350T) $610.40 $1,090 4.8×
Radiologic examination, radiostereometric analysis (RSA); spine, (includes cervical, thoracic and lumbosacral, when… (0348T) $1,080.80 $1,930 7.0×
Radiologic examination, radiostereometric analysis (RSA); upper extremity(ies), (includes shoulder, elbow, and wrist,… (0349T) $1,080.80 $1,930 7.0×
Re-cement or re-bond crown (D2920) $198.80 $355 0.2×
Re-eval post-op visit (D0171) $481.60 $860 2.5×
Re-eval,est pt,problem focus (D0170) $515.20 $920 2.6×
Recement space maint - max (D1551) $48.72 $87 0.1×
Recement unilat space maint (D1553) $3,628.80 $6,480 3.8×
Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for… (0681T)
likely a partial charge, not the full procedure		 $67.76 $121 0.0×
Relocation pg wcs lv pacg battery component only (0862T) $4,810.40 $8,590 1.6×
Relocation pg wcs lv pacg transmittr compnt only (0863T) $4,810.40 $8,590 1.6×
Relocation skin pocket implanted ccm-d pg (0925T) $4,513.60 $8,060 1.5×
Rem auton alg nsln cal setup (0740T) $168 $300 1.9×
Rem auton alg nsln data coll (0741T) $101.92 $182 1.9×
Rem imp tooth w mucoper flp (D7210) $912.80 $1,630 0.4×
Rem interrog dev eval ss ld icds < 90d tech (0579T) $63.28 $113 1.2×
Rem multi day cplx uroflowmetry dev sply w/reprt (0812T) $84.56 $151 0.4×
Rem multi day cplx uroflowmetry setup&pt educaj (0811T) $319.20 $570 1.6×
Rem nonodonto cyst > 1.25 cm (D7461) $4,099.20 $7,320 4.3×
Rem odontogen cyst to 1.25cm (D7450) $1,999.20 $3,570 0.4×
Remote interrog dev eval ccm-d sys <90d tech (0929T) $397.60 $710 7.2×
Removal and reinsertion of sinus tarsi implant (0511T) $13,344.80 $23,830 1.3×
Removal complete iims (0530T) $7,179.20 $12,820 1.3×
Removal iims electrode only (0531T) $7,179.20 $12,820 1.3×
Removal iims implt mntr only (0532T) $7,179.20 $12,820 1.3×
Removal int neurostimulation sys vagus nerve (0910T)
likely a partial charge, not the full procedure		 $397.60 $710 0.1×
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision (0447T) $952 $1,700 3.2×
Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation… (0682T)
likely a partial charge, not the full procedure		 $67.76 $121 0.0×
Removal of sinus tarsi implant (0510T) $6,143.20 $10,970 1.3×
Removal perm ccm-d system pulse generator only (0919T)
unusually low: confirm this is the full procedure		 $2,245.60 $4,010 0.4×
Removal pg wcs lv pacing both components (0861T) $6,938.40 $12,390 1.3×
Removal Ss Dfb Electrode (0573T) $2,760.80 $4,930 0.5×
Remove bilat space main, man (D1527) $4,099.20 $7,320 4.3×
Remove bilat space main, max (D1526) $4,099.20 $7,320 4.3×
Remove torus mandibularis (D7473) $4,099.20 $7,320 4.3×
Remove unilat space maintain (D1520) $4,099.20 $7,320 4.3×
Replacement int neurostimulation sys vagus nerve (0909T)
likely a partial charge, not the full procedure		 $397.60 $710 0.0×
Replacment pt electronic sys (G0555) $2,223.20 $3,970 1.8×
Repos prev impl ss impltbl dfb pacing eltrd (0574T) $2,760.80 $4,930 0.5×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $1,523.20 $2,720 1.7×
Resin 4/> surf or w incis an (D2335) $476 $850 0.5×
Resin infiltration of lesion (D2990) $31.92 $57 0.0×
Resin one surface-anterior (D2330) $119.28 $213 0.1×
Resin three surfaces-anterio (D2332) $408.80 $730 0.4×
Resin two surfaces-anterior (D2331) $156.80 $280 0.2×
Retreat root canal anterior (D3346) $599.20 $1,070 0.6×
Retreat root canal molar (D3348) $968.80 $1,730 1.0×
Revasc intra lithotrip-ather (C9766) $27,014.40 $48,240 1.0×
Revasc intra lithotrip-stent (C9765) $35,436.80 $63,280 1.3×
Revasc intravasc lithotripsy (C9764) $13,820.80 $24,680 0.8×
Revasc lith-sten-ath tib/per (C9775) $14,039.20 $25,070 0.5×
Revasc lithotr-ather tib/per (C9774) $14,039.20 $25,070 0.5×
Revasc lithotr-stent tib/per (C9773)
unusually low: confirm this is the full procedure		 $11,076.80 $19,780 0.4×
Revasc lithotrip tibi/perone (C9772)
unusually low: confirm this is the full procedure		 $7,257.60 $12,960 0.4×
Revasc lithotrip-stent-ather (C9767) $47,112.80 $84,130 1.7×
Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body… (0790T)
likely a partial charge, not the full procedure		 $414.40 $740 0.0×
Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and… (0819T) $6,014.40 $10,740 1.2×
Revision or removal of integrated single device neurostimulation system including electrode array and receiver or pulse… (0588T)
unusually low: confirm this is the full procedure		 $2,279.20 $4,070 0.4×
Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator (0787T) $6,014.40 $10,740 1.2×
Revj/rmvl integrated nstimj sys ptn subcutaneous (0818T) $6,014.40 $10,740 1.2×
Revj/Rmvl Nstim Eltrd Ra Spi W/Integrated Nstim (0785T) $6,014.40 $10,740 1.2×
Risk ascvd tst once pr 12 mo (G0537) $64.96 $116 1.2×
Rmvl & Rplcmt Pg Compnt Wcs (0519T) $11,037.60 $19,710 0.7×
Rmvl insj impltbl gluc sensor dif anatomic site (0448T) $8,019.20 $14,320 1.3×
Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T)
unusually low: confirm this is the full procedure		 $2,245.60 $4,010 0.4×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T)
unusually low: confirm this is the full procedure		 $2,245.60 $4,010 0.4×
Rmvl perm ccm-d sys dual transvns leads only (0922T)
unusually low: confirm this is the full procedure		 $2,245.60 $4,010 0.4×
Rmvl Pg Compnt Wcs (0518T) $11,037.60 $19,710 2.0×
Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) $2,760.80 $4,930 0.5×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T)
unusually low: confirm this is the full procedure		 $13,843.20 $24,720 0.4×
Rmvl&Rplcmt Pg Wcs New Eltrd (0520T) $51,503.20 $91,970 3.4×
Rmvl&Rplcmt Substernal Impltbl Defibrillator Pg (0614T)
unusually low: confirm this is the full procedure		 $16,016 $28,600 0.5×
Root surgery molar (D3425) $700 $1,250 0.7×
Root surgery premolar (D3421) $571.20 $1,020 0.6×
Routine footcare pt w lops (G0247) $470.40 $840 1.6×
Rpr intst excl anrect fist (C9796) $1,853.60 $3,310 0.5×
Safety plan interven (G0560) $47.60 $85 1.1×
Sbrt w/positron emission del (G0563) $8,192.80 $14,630 1.8×
Scaling gingiv inflammation (D4346) $1,736 $3,100 1.8×
Scr c/v cyto, automated sys (G0147) $116.48 $208 6.3×
Scr c/v cyto, autosys, rescr (G0148) $153.44 $274 4.8×
Scr c/v cyto,thinlayer,rescr (G0144) $217.84 $389 5.0×
Scr c/v cyto,thinlayer,rescr (G0145) $324.80 $580 12.3×
Scr c/v cyto,thinlayer,rescr (G0143) $205.52 $367 7.6×
Screen cerv/vag thin layer (G0123) $164.08 $293 8.1×
Screen pap by tech w md supv (P3000) $82.88 $148 4.5×
Semen analysis (G0027) $66.08 $118 10.2×
Sialoendoscopy capt & interp (D0371) $498.40 $890 3.9×
Single energy x-ray study (G0130) $610.40 $1,090 4.0×
Smmg cncrnt appl imu snr (0778T) $308 $550 1.6×
Space maintainer fxd unilat (D1510) $4,099.20 $7,320 4.3×
Speech audiometry threshold, automated; Non-Facility Physician Technical Component (0210T) $136.64 $244 2.5×
Speech audiometry threshold, automated; with speech recognition Non-Facility Physician (0211T) $136.64 $244 2.5×
Spine device implant surgery (C9757) $9,878.40 $17,640 0.5×
Supply of digital device (G0552) $280 $500 1.4×
Surg exp root surf anterior (D3501) $4,099.20 $7,320 4.3×
Surg exp root surf molar (D3503) $4,099.20 $7,320 4.3×
Surg exp root surf premolar (D3502) $4,099.20 $7,320 4.3×
Surg rep root res anterior (D3471) $4,099.20 $7,320 4.3×
Surg rep root res molar (D3473) $4,099.20 $7,320 4.3×
Surg rep root res premolar (D3472) $4,099.20 $7,320 4.3×
Tc mag stimj pn 1st tx 1nrv (0766T) $767.20 $1,370 2.4×
Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) $487.20 $870 0.1×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $34,434.40 $61,490 1.2×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $31,824.80 $56,830 1.1×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $5,633.60 $10,060 1.2×
Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) $5,521.60 $9,860 1.2×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $34,434.40 $61,490 1.2×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $31,824.80 $56,830 1.1×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T)
unusually low: confirm this is the full procedure		 $3,768.80 $6,730 0.5×
Tear film imaging unilateral or bilateral w/i&r (0330T) $291.20 $520 5.3×
Tee w or w/o fol w/cont, mon (C8927) $3,046.40 $5,440 2.6×
Tee w or w/o fol w/cont,cong (C8926) $3,046.40 $5,440 2.6×
Temp female intraurethral valve-pump 1st insj (0596T) $795.20 $1,420 0.8×
Temporary female intraurethral valve-pump (ie, voiding prosthesis); replacement (0597T) $795.20 $1,420 0.8×
Therapeutic apheresis with selective HDL delipidation and plasma reinfusion (0342T) $12,952.80 $23,130 2.0×
Therapeutic procd strg endur (G0237) $85.68 $153 2.0×
Therapeutic pulpotomy (D3220) $744.80 $1,330 0.8×
Therapeutic ultrafiltration (0692T) $1,461.60 $2,610 0.6×
Tomosynthesis, mammo (G0279)
range across 3 matching MRF lines		 $130.48–$134.40 $233–$240 varies
Tooth pin retention (D2951) $43.68 $78 0.0×
Tooth reimplantation (D7270) $6,076 $10,850 6.4×
Tooth root removal (D7250) $4,099.20 $7,320 4.3×
Trabeculostomy ab interno by laser (0621T) $3,253.60 $5,810 0.5×
Train for caregiver add 15 (G0540) $47.60 $85 1.8×
Transcatheter Renal Sympath Denervation Bilat (0339T) $11,222.40 $20,040 1.3×
Transcatheter renal sympath denervation unilat (0338T) $11,222.40 $20,040 1.3×
Transperineal laser destruction of benign prostatic enlargement using imaging guidance for prostate volume less than 50… (0714T) $4,144 $7,400 0.5×
Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative… (0582T)
likely a partial charge, not the full procedure		 $62.16 $111 0.0×
Trauma respons w/hosp criti (G0390)
range across 2 matching MRF lines		 $12,485.76–$12,658.80 $22,296–$22,605 varies
Treatment of complications (D9930) $4,099.20 $7,320 4.3×
Trim nail(s) (G0127) $459.20 $820 5.3×
Trluml perip athrc abd aorta (0236T) $31,091.20 $55,520 1.8×
Trluml Perip Athrc Brchiocph (0237T) $31,091.20 $55,520 1.8×
Trluml Perip Athrc Iliac Art (0238T) $51,060.80 $91,180 1.9×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $31,091.20 $55,520 1.8×
Trnscut elect modlation pain reproces ea tx sess (0278T) $397.60 $710 2.1×
Tte w or w/o contr, cont ecg (C8930) $3,158.40 $5,640 2.7×
Tte w or w/o fol w/con,stres (C8928) $2,542.40 $4,540 2.2×
Tte w or w/o fol w/cont, com (C8921) $3,046.40 $5,440 2.6×
Tte w or w/o fol w/cont, f/u (C8922) $2,542.40 $4,540 2.2×
Tte w or wo fol wcon,doppler (C8929) $3,634.40 $6,490 3.2×
Tympanostomy Automated Tube Delivery System (0583T) $1,008 $1,800 0.4×
Unsched dialysis esrd pt hos (G0257) $1,741.60 $3,110 1.7×
Upper GI Blood Detection Sensor Capsule I&R (0977T) $1,946 $3,475 1.5×
Urine specimen collect mult (P9615) $16.80 $30 1.8×
US Ablat Uter Leiomyom <200 (0071T) $7,145.60 $12,760 1.5×
US Ablat Uter Leiomyom >200 (0072T) $7,145.60 $12,760 1.5×
Vasc emb/occ w/prs cath (C9797)
unusually low: confirm this is the full procedure		 $11,569.60 $20,660 0.4×
Ven blood coll snf/hha (G0471) $24.08 $43 2.1×
Visit to determ ldct elig (G0296) $235.20 $420 1.6×
Visual ep test for glaucoma (0464T) $537.60 $960 2.8×
Visual Field Assessment Tech Support W/Instruct (0379T) $150.08 $268 2.7×
Warfarin respon genetic test (G9143) $1,142.40 $2,040 9.5×
Wet mounts/ w preparations (Q0111) $58.24 $104 3.1×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.