| 2019-ncov diagnostic p (U0001) |
— |
$107.76 |
— |
| 2d tee w or w/o fol w/con,in (C8925) |
— |
$2,004.54 |
— |
| Admin hepatitis b vaccine (G0010) |
— |
$118.92 |
— |
| Admin influenza virus vac (G0008) |
— |
$176.37 |
— |
| Admin pneumococcal vaccine (G0009) |
— |
$176.37 |
— |
| Ca screen;flexi sigmoidscope (G0104) |
— |
$10,500.59 |
— |
| Colon ca scrn not hi rsk ind (G0121) |
— |
$10,500.59 |
— |
| Colorectal scrn; hi risk ind (G0105) |
— |
$10,500.59 |
— |
| Covid-19 lab test non-cdc (U0002) |
— |
$153.93 |
— |
| Direct refer hospital observ (G0379) |
— |
$1,608.06 |
— |
Drug test def 1-7 classes (G0480)
range across 35 matching MRF lines |
— |
$51.81–$343.29 |
— |
| Drug test def 8-14 classes (G0481) |
— |
$469.77 |
— |
| Egd flexible transnasal dx w/collj spec br/wa (0652T) |
— |
$17,353.52 |
— |
| Egd flexible transnasal w/biopsy single/multiple (0653T) |
— |
$17,353.52 |
— |
| Elec stim other than wound (G0283) |
— |
$129 |
— |
| Extraction erupted tooth/exr (D7140) |
— |
$12,009.47 |
— |
| Facility svs dental rehab (G0330) |
— |
$12,901.13 |
— |
| Hbot, full body chamber, 30m (G0277) |
— |
$347.40 |
— |
| Hospital outpt clinic visit (G0463) |
— |
$330.93 |
— |
| Mra w/cont, abd (C8900) |
— |
$962.79 |
— |
| Mra w/cont, chest (C8909) |
— |
$962.79 |
— |
| Mra w/cont, lwr ext (C8912) |
— |
$962.79 |
— |
| Mra w/cont, pelvis (C8918) |
— |
$962.79 |
— |
| Mra w/o cont, abd (C8901) |
— |
$613.49 |
— |
| Mra w/o cont, chest (C8910) |
— |
$613.49 |
— |
Mra w/o cont, lwr ext (C8913)
range across 2 matching MRF lines |
— |
$613.47–$613.49 |
— |
| Mra w/o cont, pelvis (C8919) |
— |
$613.47 |
— |
| Mra w/o fol w/cont, abd (C8902) |
— |
$962.79 |
— |
| Mra w/o fol w/cont, lwr ext (C8914) |
— |
$962.79 |
— |
| Mra w/o fol w/cont, pelvis (C8920) |
— |
$962.79 |
— |
| Mra, w/o&w/dye, upper extr (C8936) |
— |
$962.79 |
— |
| Mri w/o fol w/cont, breast, (C8908) |
— |
$962.79 |
— |
| Neuro csf prion prtn qual (0035U) |
— |
$1,622.97 |
— |
| Oth resp proc, group (G0239) |
— |
$100.41 |
— |
| Oth resp proc, indiv (G0238) |
— |
$74.55 |
— |
| Perc d-e cor revasc chro sin (C9607) |
— |
$43,899.81 |
— |
| Perc d-e cor revasc t cabg s (C9604) |
— |
$27,541.80 |
— |
| Perc d-e cor stent ather s (C9602) |
— |
$43,899.81 |
— |
| Perc drug-el cor stent sing (C9600) |
— |
$27,541.80 |
— |
| Prostate biopsy, any mthd (G0416) |
— |
$899.88 |
— |
| Psa screening (G0103) |
— |
$57.93 |
— |
| Quan mr alys tiss compj w/o MRI same sess 1orgn (0648T) |
— |
$2,539.95 |
— |
| Quan mr alys tiss composition w/MRI 1orgn (0649T) |
— |
$14.70 |
— |
| Revasc intra lithotrip-ather (C9766) |
— |
$43,899.81 |
— |
| Revasc intra lithotrip-stent (C9765) |
— |
$43,899.81 |
— |
| Revasc intravasc lithotripsy (C9764) |
— |
$27,541.80 |
— |
| Revasc lith-sten-ath tib/per (C9775) |
— |
$43,899.81 |
— |
| Revasc lithotr-ather tib/per (C9774) |
— |
$43,899.81 |
— |
| Revasc lithotr-stent tib/per (C9773) |
— |
$43,899.81 |
— |
| Revasc lithotrip tibi/perone (C9772) |
— |
$27,541.80 |
— |
| Revasc lithotrip-stent-ather (C9767) |
— |
$43,899.81 |
— |
| Scr c/v cyto,thinlayer,rescr (G0144) |
— |
$131.91 |
— |
| Scr c/v cyto,thinlayer,rescr (G0145) |
— |
$79.83 |
— |
| Tomosynthesis, mammo (G0279) |
— |
$62 |
— |
| Trauma respons w/hosp criti (G0390) |
— |
$3,427.59 |
— |
| Trluml Perip Athrc Iliac Art (0238T) |
— |
$49,807.83 |
— |
| Tte w or wo fol wcon,doppler (C8929) |
— |
$2,004.54 |
— |
| Unsched dialysis esrd pt hos (G0257) |
— |
$1,749.48 |
— |