| 2d tee w or w/o fol w/con,in (C8925) |
$832 |
$1,280 |
0.9× |
| 2d tte w or w/o fol w/con,fu (C8924) |
$510.25 |
$785 |
1.2× |
| Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) |
$3,660.15 |
$5,631 |
0.8× |
| Admin influenza virus vac (G0008) |
$66.95 |
$103 |
1.2× |
| Admin pneumococcal vaccine (G0009) |
$44.20 |
$68 |
0.8× |
| Ca screen;flexi sigmoidscope (G0104) |
$1,045.30 |
— |
0.9× |
| Chemo extend iv infus w/pump (G0498) |
$258.70 |
$398 |
0.7× |
| Colon ca scrn not hi rsk ind (G0121) |
$1,053.10 |
— |
0.9× |
| Colorectal scrn; hi risk ind (G0105) |
$1,060.99 |
— |
1.0× |
| Cysto impl 4 or more (C9740) |
$12,224.26 |
— |
1.1× |
| Diab manage trn per indiv (G0108) |
$68.90 |
$106 |
1.2× |
| Diab manage trn ind/group (G0109) |
$46.80 |
$72 |
2.9× |
| Direct refer hospital observ (G0379) |
$2,570.75 |
— |
3.6× |
| Elec stim other than wound (G0283) |
$68.90 |
$106 |
5.4× |
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T)
likely a partial charge, not the full procedure |
$12,896.65 |
$19,841 |
0.2× |
| Facility svs dental rehab (G0330) |
$8,094.12 |
— |
2.0× |
| Fecal blood scrn immunoassay (G0328) |
$43.55 |
$67 |
2.4× |
| Hbot, full body chamber, 30m (G0277) |
$891.80 |
— |
5.4× |
| Hep c screen high risk/other (G0472) |
$124.15 |
$191 |
2.7× |
| Hepb screen high risk indiv (G0499) |
$66.95 |
$103 |
2.4× |
| Hiv combination assay (G0475) |
$57.20 |
$88 |
2.4× |
| Hospital outpt clinic visit (G0463) |
$122.20 |
— |
0.8× |
| Iliac Atherectomy (0238T) |
$16,632.85 |
$25,589 |
0.8× |
| Inj for sacroiliac jt anesth (G0260) |
$916.14 |
— |
1.1× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) |
$28,847.65 |
$44,381 |
0.8× |
| Mra w/o fol w/cont, abd (C8902) |
$815.10 |
$1,254 |
1.9× |
| Mra w/o fol w/cont, chest (C8911) |
$975 |
$1,500 |
2.3× |
| Mri w/o fol w/cont, breast, (C8908) |
$562.25 |
$865 |
1.3× |
| Neuro csf prion prtn qual (0035U) |
$422.50 |
$650 |
0.8× |
| Pathogen test for platelets (P9100) |
$53.30 |
$82 |
0.8× |
| Perq Sacral Augmt Bilat Inj (0201T) |
$6,617 |
$10,180 |
0.8× |
| Psa screening (G0103) |
$69.55 |
$107 |
3.6× |
| Revasc intra lithotrip-ather (C9766) |
$17,132.05 |
$26,357 |
0.8× |
| Revasc intra lithotrip-stent (C9765) |
$15,375.75 |
$23,655 |
0.7× |
| Revasc intravasc lithotripsy (C9764) |
$10,820.55 |
$16,647 |
0.8× |
| Revasc lithotrip-stent-ather (C9767) |
$17,132.70 |
$26,358 |
0.8× |
| Smmg cncrnt appl imu snr (0778T) |
$122.20 |
$188 |
0.8× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) |
$17,665.70 |
$27,178 |
0.8× |
| Tomosynthesis, mammo (G0279) |
$171.60 |
$264 |
13.5× |
| Trim nail(s) (G0127) |
$55.25 |
$85 |
0.8× |
| Tte w or w/o contr, cont ecg (C8930) |
$772.20 |
$1,188 |
0.8× |
| Tte w or w/o fol w/cont, com (C8921) |
$781.30 |
$1,202 |
0.8× |
| Tte w or wo fol wcon,doppler (C8929) |
$1,205.10 |
$1,854 |
1.3× |
| Unsched dialysis esrd pt hos (G0257) |
$852.15 |
$1,311 |
1.0× |
| Xenograft implantation into the articular surface Non-Facility (0737T) |
$18,285.53 |
— |
1.2× |