| Colon ca scrn not hi rsk ind (G0121) |
— |
$7,500 |
— |
| Colorectal scrn; hi risk ind (G0105) |
— |
$7,500 |
— |
| Direct refer hospital observ (G0379) |
— |
$500 |
— |
| Drug test def 1-7 classes (G0480) |
— |
$915.44 |
— |
| Drug test def 15-21 classes (G0482) |
— |
$1,589.92 |
— |
Drug test def 22+ classes (G0483)
range across 2 matching MRF lines |
— |
$750–$1,975.36 |
— |
| Drug test def 8-14 classes (G0481) |
— |
$1,252.72 |
— |
| Hospital outpt clinic visit (G0463) |
— |
$185 |
— |
| Inj for sacroiliac jt anesth (G0260) |
— |
$9,500 |
— |
| Mra w/cont, abd (C8900) |
— |
$5,100 |
— |
| Mra w/cont, chest (C8909) |
— |
$5,100 |
— |
| Mra w/cont, lwr ext (C8912) |
— |
$5,100 |
— |
| Mra w/cont, pelvis (C8918) |
— |
$5,100 |
— |
| Mra w/o cont, abd (C8901) |
— |
$4,800 |
— |
| Mra w/o cont, chest (C8910) |
— |
$4,800 |
— |
| Mra w/o cont, lwr ext (C8913) |
— |
$4,800 |
— |
| Mra w/o cont, pelvis (C8919) |
— |
$4,800 |
— |
| Mra w/o fol w/cont, abd (C8902) |
— |
$5,300 |
— |
| Mra w/o fol w/cont, chest (C8911) |
— |
$5,300 |
— |
| Mra w/o fol w/cont, lwr ext (C8914) |
— |
$5,300 |
— |
| Mra w/o fol w/cont, pelvis (C8920) |
— |
$5,300 |
— |
| Mra, w/dye, spinal canal (C8931) |
— |
$5,100 |
— |
| Mra, w/dye, upper extremity (C8934) |
— |
$5,100 |
— |
| Mra, w/o dye, spinal canal (C8932) |
— |
$4,800 |
— |
| Mra, w/o dye, upper extr (C8935) |
— |
$4,800 |
— |
| Mra, w/o&w/dye, spinal canal (C8933) |
— |
$5,300 |
— |
| Mra, w/o&w/dye, upper extr (C8936) |
— |
$5,300 |
— |
| Mri w/cont, breast, bi (C8906) |
$1,600 |
$5,100 |
4.8× |
| Mri w/cont, breast, uni (C8903) |
$800 |
$5,100 |
4.8× |
| Mri w/o fol w/cont, breast, (C8908) |
$1,600 |
$5,300 |
4.8× |
| Mri w/o fol w/cont, brst, un (C8905) |
$800 |
$5,300 |
2.4× |