| Abd paracentesis w/imaging (49083) |
$2,533.50 |
$5,067 |
2.9× |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
$1,656 |
$3,312 |
1.9× |
Ablation 1/> liver tumor perq cryoablation (47383)
likely a partial charge, not the full procedure |
$3,045 |
$6,090 |
0.3× |
Ablation Bone Tumor Rf Perq W/Img Gdn When Done (20982)
likely a partial charge, not the full procedure |
$5,056.50 |
$10,113 |
0.3× |
| Amniocentesis diagnostic (59000) |
$745 |
$1,490 |
0.8× |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) |
$2,388.50 |
$4,777 |
0.8× |
| Anoscopy diagnostic (46600) |
$215.50 |
$431 |
1.7× |
| Appl Mltlayr Compres Sys Uparm Lwarm Hand&Fing (29584) |
$169.50 |
$339 |
1.1× |
| Application cast elbow finger short arm (29075) |
$540.50 |
$1,081 |
2.0× |
| Application Finger Splint Dynamic (29131) |
$473 |
$946 |
8.3× |
| Application finger splint static (29130) |
$403.50 |
$807 |
3.1× |
| Application long arm splint shoulder hand (29105) |
$370.50 |
$741 |
2.3× |
| Application Long Leg Splint (29505) |
$325.50 |
$651 |
2.1× |
| Application of long leg cast (29345) |
$363 |
$726 |
1.3× |
| Application of rigid total contact leg cast (29445) |
$1,965.50 |
$3,931 |
7.2× |
| Application Short Arm Splint Dynamic (29126) |
$537 |
$1,074 |
4.2× |
| Application short arm splint forearm-hand static (29125) |
$424 |
$848 |
3.3× |
| Application short leg splint calf foot (29515) |
$307.50 |
$615 |
1.9× |
| Apply hand/wrist cast (29085) |
$150 |
$300 |
0.9× |
| Apply Multlay Comprs Lwr Leg (29581) |
$543 |
$1,086 |
3.4× |
| Arterial puncture (36600) |
$48 |
$96 |
0.4× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$2,466 |
$4,932 |
8.3× |
| Arthrocentesis aspir&/inj interm jt/burs w/us (20606) |
$2,466 |
$4,932 |
3.6× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$2,466 |
$4,932 |
8.3× |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
$2,466 |
$4,932 |
8.3× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$2,466 |
$4,932 |
8.3× |
| Aspirate pleura w/ imaging (32555) |
$3,359.50 |
$6,719 |
5.5× |
| Aspirate Pleura W/O Imaging (32554) |
$2,119.50 |
$4,239 |
3.5× |
| Aspiration and/or injection thyroid cyst (60300) |
$839.50 |
$1,679 |
1.2× |
| Aspiration bladder insert suprapubic catheter (51102) |
$1,321.50 |
$2,643 |
0.7× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$543 |
$1,086 |
2.8× |
| Biopsy Abdominal Mass (49180) |
$1,046 |
$2,092 |
0.7× |
| Biopsy bone trocar/needle deep (20225) |
$6,760.50 |
$13,521 |
4.2× |
| Biopsy Bone Trocar/Needle Superficial (20220) |
$1,046 |
$2,092 |
0.7× |
| Biopsy muscle percutaneous needle (20206) |
$1,685.50 |
$3,371 |
1.1× |
| Biopsy Muscle Superficial (20200) |
$6,760.50 |
$13,521 |
4.2× |
| Biopsy of liver, needle; percutaneous (47000) |
$7,407.50 |
$14,815 |
4.6× |
| Biopsy Pleura Percutaneous Needle (32400) |
$1,164.50 |
$2,329 |
0.7× |
| Biopsy Salivary Gland Needle (42400) |
$1,063.50 |
$2,127 |
1.5× |
| Biopsy Soft Tissue Back/Flank Superficial (21920) |
$1,504 |
$3,008 |
0.9× |
| Bladder Irrigation (51700) |
$318.50 |
$637 |
1.3× |
| Bladder Scan (51798) |
$115 |
$230 |
2.0× |
| Blood Transfusion Service (36430) |
$3,060.50 |
$6,121 |
7.1× |
| Bone Marrow Biopsy (38221) |
$1,046 |
$2,092 |
0.7× |
| Brnchsc Ebus Guided Sampl 1/2 Node Station/Strux (31652) |
$3,425 |
$6,850 |
0.9× |
| Brnchsc Ebus Guided Sampl 3/> Node Station/Strux (31653) |
$3,425 |
$6,850 |
0.9× |
Bronch Thermoplsty 1 Lobe (31660)
unusually low: confirm this is the full procedure |
$3,182.50 |
$6,365 |
0.5× |
| Bronchoscopic Thermoplasty 2/> Lobes (31661) |
$4,637.50 |
$9,275 |
0.7× |
| Bx breast 1st lesion strtctc (19081) |
$1,485.50 |
$2,971 |
0.9× |
| Bx breast 1st lesion us imag (19083) |
$2,793.50 |
$5,587 |
1.7× |
| Catheter aspiration nasotracheal spx (31720) |
$467.50 |
$935 |
2.2× |
| Cessj Therapy Cath Removal (37214) |
$2,723 |
$5,446 |
0.9× |
| Change Cystostomy Tube Complicated (51710) |
$964 |
$1,928 |
1.4× |
| Change Cystostomy Tube Simple (51705) |
$384 |
$768 |
1.6× |
| Change of Windpipe Airway (31502) |
$265 |
$530 |
1.2× |
| Chemical Cautery Tissue (17250) |
$726.50 |
$1,453 |
3.7× |
| Chest tube placement (32551) |
$2,001.50 |
$4,003 |
1.3× |
| Chng Urtrost Tube/Xtrnlly Accessible Stent Ileal (50688) |
$1,480.50 |
$2,961 |
0.7× |
| Cholecystostomy Prq W/Imaging & Catheter Plmt (47490) |
$1,790.50 |
$3,581 |
0.5× |
| Circumcision 28 days or older (54161) |
$4,776 |
$9,552 |
2.4× |
| Circumcision w/clamp/oth dev w/block (54150) |
$2,169 |
$4,338 |
1.1× |
| Cl Tx Scapular Fx; W Manip (23575) |
$999 |
$1,998 |
0.6× |
| Cl Tx Tib Shft Fx W Manip (27752) |
$2,087 |
$4,174 |
1.3× |
| Clear outer ear canal (69200) |
$269.50 |
$539 |
2.1× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$658 |
$1,316 |
2.7× |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
$1,779 |
$3,558 |
1.1× |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) |
$463.50 |
$927 |
1.9× |
| Closed tx knee dislocation w/o anesthesia (27550) |
$436 |
$872 |
1.8× |
| Closed tx patellar dislocation w/o anesthesia (27560) |
$408 |
$816 |
1.7× |
| Closed tx radial head/neck fx w/manipulation (24655) |
$220.50 |
$441 |
0.1× |
| Closed tx radial head/neck fx w/o manipulation (24650) |
$220.50 |
$441 |
0.9× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
$1,796 |
$3,592 |
1.1× |
| Closed tx radial&ulnar shaft fractures w/o man (25560) |
$605 |
$1,210 |
2.5× |
| Closed tx septal&nose fx (21337) |
$2,705 |
$5,410 |
0.8× |
| Closed tx talotarsal joint dislc w/o anes (28570) |
$222.50 |
$445 |
0.9× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
$299 |
$598 |
1.2× |
| Closure Laceration Vestibule Mouth 2.5 Cm/< (40830) |
$771 |
$1,542 |
3.3× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$3,432 |
$6,864 |
2.2× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$486 |
$972 |
2.0× |
| Cltx ankle dislc req anes w/wo prq skel fixj (27842) |
$2,857 |
$5,714 |
1.8× |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
$1,668.50 |
$3,337 |
1.1× |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) |
$386.50 |
$773 |
1.6× |
| Cltx dstl fibular fx lat malls w/manj (27788) |
$607 |
$1,214 |
2.5× |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
$271 |
$542 |
1.1× |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) |
$749.50 |
$1,499 |
3.1× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$463.50 |
$927 |
1.9× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$1,796 |
$3,592 |
1.1× |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) |
$2,611.50 |
$5,223 |
1.7× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
$271 |
$542 |
1.1× |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
$2,937 |
$5,874 |
1.9× |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
$396 |
$792 |
1.7× |
| Cltx hip dislocation traumatic req anesthesia (27252) |
$3,323 |
$6,646 |
2.1× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
$463.50 |
$927 |
1.9× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
$590.50 |
$1,181 |
2.5× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$486 |
$972 |
2.0× |
| Cltx Med Ankle Fx W/Mnpj (27762) |
$2,265 |
$4,530 |
1.4× |
| Cltx metacarpal fx w/manipulation each bone (26605) |
$486 |
$972 |
2.0× |
| Cltx Metatarsophlngl Jt Dislc Req Anes (28635) |
$1,739 |
$3,478 |
1.1× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
$486 |
$972 |
2.0× |
| Cltx post hip arthrp dislc req anes (27266) |
$4,193.50 |
$8,387 |
2.7× |
| Cltx post hip arthrp dislc w/o anes (27265) |
$631 |
$1,262 |
2.6× |
| Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) |
$1,581 |
$3,162 |
1.0× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
$486 |
$972 |
2.0× |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) |
$1,710.50 |
$3,421 |
1.1× |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
$1,779 |
$3,558 |
1.1× |
| Collect Blood From Catheter Venous Nos (36592) |
$95.50 |
$191 |
0.7× |
| Collection of venous blood by venipuncture (36415) |
$38 |
$76 |
4.1× |
| Control Nasal Hemorrhage Anterior Complex (30903) |
$257 |
$514 |
2.0× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$368 |
$736 |
2.8× |
| Convert gastrostomy-gastro-jejunostomy tube percutaneous (49446) |
$1,649.50 |
$3,299 |
0.9× |
| Convert Nephrostomy Catheter (50434) |
$1,058.50 |
$2,117 |
0.5× |
| Core Needle Bx Lung/Mediastinum Perq W/Img (32408) |
$7,704 |
$15,408 |
4.8× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$319.50 |
$639 |
2.5× |
| Cysto W/Simple Removal Stone & Stent (52310) |
$1,505.50 |
$3,011 |
0.7× |
| Cysto/uretero w/lithotripsy (52356) |
$5,386 |
$10,772 |
1.0× |
| Deb Musc/Fascia 20 Sq Cm/< (11043) |
$1,965.50 |
$3,931 |
2.7× |
| Debride nail 1-5 (11720) |
$543 |
$1,086 |
9.5× |
| Debride nail 6 or more (11721) |
$543 |
$1,086 |
9.5× |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
$1,965.50 |
$3,931 |
1.2× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$726.50 |
$1,453 |
1.8× |
| Declot vascular device (36593) |
$735.50 |
$1,471 |
2.3× |
| Deep Muscle Biopsy (20205) |
$10,547 |
$21,094 |
3.7× |
| Destroy cerv/thor facet jnt (64633) |
$2,101 |
$4,202 |
1.1× |
| Destroy lumb/sac facet jnt (64635) |
$3,091.50 |
$6,183 |
1.6× |
| Destruct B9 Lesion 1-14 (17110) |
$428.50 |
$857 |
2.2× |
| Dilat Xst Trc New Access Rcs (50437) |
$6,728.50 |
$13,457 |
2.0× |
| Dise Dyn Eval Sleep Disordered Breathing Flx Dx (42975) |
$1,600.50 |
$3,201 |
0.9× |
| Drain/inj small joint/bursa w/us (20604) |
$1,479.50 |
$2,959 |
5.0× |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
$759 |
$1,518 |
1.1× |
| Drainage Finger Abscess Complicated (26011) |
$3,197 |
$6,394 |
2.0× |
| Drainage Mouth Roof Lesion (42000) |
$1,374.50 |
$2,749 |
6.0× |
| Drainage of finger abscess simple (26010) |
$458.50 |
$917 |
2.4× |
| Drainage of gum lesion (41800) |
$590.50 |
$1,181 |
4.6× |
| Drainage of hematoma/fluid (10140) |
$726.50 |
$1,453 |
0.5× |
| Drainage of scrotal wall abscess (55100) |
$2,796 |
$5,592 |
1.7× |
| Drainage of scrotum (54700) |
$2,640.50 |
$5,281 |
1.3× |
| Draw Blood Off Venous Device (36591) |
$169.50 |
$339 |
1.3× |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) |
$206 |
$412 |
0.3× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
$737.50 |
$1,475 |
1.9× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$672 |
$1,344 |
3.4× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$543 |
$1,086 |
2.8× |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) |
$1,327 |
$2,654 |
1.5× |
| Dx Bone Marrow Bx & Aspir (38222) |
$2,424.50 |
$4,849 |
0.9× |
| Dx Bronchoscope/Wash (31622) |
$2,050.50 |
$4,101 |
1.2× |
| Dx lmbr spi pnxr w/fluor/CT (62328) |
$855.50 |
$1,711 |
1.2× |
| Egd Flexible Foreign Body Removal (43247) |
$1,082 |
$2,164 |
1.2× |
| Egd place gastrostomy tube (43246) |
$1,762 |
$3,524 |
0.9× |
| Endoven abltj incmptnt vein xtr rf 1st vein (36475) |
$4,866.50 |
$9,733 |
1.6× |
| Endoven ther chem adhes 1st (36482) |
$5,861.50 |
$11,723 |
1.1× |
| Epidural Blood Patch (62273) |
$1,813 |
$3,626 |
2.6× |
| Evacuation of subungual hematoma (11740) |
$152 |
$304 |
1.2× |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) |
$2,083 |
$4,166 |
1.3× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
$1,738.50 |
$3,477 |
2.5× |
| Exchange Biliary Drg Catheter Prq W/Img Gid Rs&I (47536) |
$3,224.50 |
$6,449 |
0.9× |
| Exchange Nephrostomy Catheter Prq W/Img Gid Rs&I (50435) |
$1,321.50 |
$2,643 |
0.7× |
| Exchng Absc/Cst Drg Cath Rad Gid Spx (49423) |
$1,970 |
$3,940 |
1.1× |
| Excision Excessive Skin & Subq Tissue Other Area (15839) |
$2,454.50 |
$4,909 |
0.9× |
| Excision soft tissue lesion, external auditory canal (69145) |
$2,456 |
$4,912 |
0.9× |
| Explo/Drain Breast Abscess (19020) |
$4,718 |
$9,436 |
2.9× |
| Fetal Contraction Stress Test (59020) |
$298 |
$596 |
1.5× |
| Fetal non-stress test (59025) |
$767 |
$1,534 |
3.9× |
| Fine needle aspiration bx w/CT gdn 1st lesion (10009) |
$2,026.50 |
$4,053 |
2.9× |
| Fine needle aspiration without imaging guidance (10021) |
$490.50 |
$981 |
1.2× |
| Fluoro exam of g/colon tube (49465) |
$239.50 |
$479 |
1.0× |
| Fna Bx W/Fluor Gdn 1St Les (10007) |
$2,026.50 |
$4,053 |
2.9× |
| Fna bx w/us gdn 1st les (10005) |
$2,026.50 |
$4,053 |
2.9× |
| Guide Cathet Fluid Drainage (10030) |
$1,402.50 |
$2,805 |
2.0× |
| Hysteroscopy Biopsy (58558) |
$3,401 |
$6,802 |
1.1× |
| I&d abscess peritonsillar (42700) |
$589 |
$1,178 |
2.6× |
| I&d abscess simple (10060) |
$726.50 |
$1,453 |
3.7× |
| I&d perianal abscess superficial (46050) |
$974 |
$1,948 |
1.1× |
| I&d pilonidal cyst complicated (10081) |
$3,027.50 |
$6,055 |
4.4× |
| I&d pilonidal cyst simple (10080) |
$759 |
$1,518 |
1.1× |
| Icd Pocket Revision (33223) |
$2,811 |
$5,622 |
1.4× |
| Image Cath Fluid Colxn Visc (49405) |
$2,962.50 |
$5,925 |
1.8× |
| Image Cath Fluid Peri/Retro (49406) |
$2,962.50 |
$5,925 |
1.8× |
| Image Cath Fluid Trns/Vgnl (49407) |
$2,962.50 |
$5,925 |
1.8× |
| Implant neuroelectrodes (63650) |
$9,331 |
$18,662 |
1.5× |
| Incise external hemorrhoid (46083) |
$487.50 |
$975 |
2.0× |
| Incision & drainage abscess complicated/multiple (10061) |
$3,296 |
$6,592 |
8.3× |
| Incision & drainage leg/ankle abscess/hematoma (27603) |
$2,456 |
$4,912 |
0.9× |
| Incision & removal foreign body subq tiss compl (10121) |
$2,173 |
$4,346 |
1.4× |
| Incision & removal foreign body subq tiss simple (10120) |
$583 |
$1,166 |
1.5× |
| Incision and drainage of bartholin's gland abscess (56420) |
$838 |
$1,676 |
4.3× |
| Incision and drainage of vulva or perineal abscess (56405) |
$462 |
$924 |
1.6× |
| Incision of rectal abscess (46040) |
$5,201.50 |
$10,403 |
4.5× |
| Incisional biopsy skin single lesion (11106) |
$726.50 |
$1,453 |
1.0× |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) |
$1,749.50 |
$3,499 |
2.0× |
| Inj W/Fluor Eval Cv Device (36598) |
$761.50 |
$1,523 |
3.7× |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) |
$2,202 |
$4,404 |
2.6× |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
$1,089.50 |
$2,179 |
1.3× |
| Injection aa&/strd nerves nrvtg si joint w/img (64451) |
$898 |
$1,796 |
1.3× |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
$1,089.50 |
$2,179 |
1.6× |
| Injection Anes Agent Sphenopalatine Ganglion (64505) |
$374.50 |
$749 |
1.3× |
| Injection anesthetic agent suprascapular nerve (64418) |
$1,524.50 |
$3,049 |
2.2× |
| Injection for identification of sentinel node (38792) |
$316.50 |
$633 |
0.8× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$248 |
$496 |
0.8× |
| Injection, anesthetic agent; brachial plexus, single (64415) |
$999 |
$1,998 |
1.2× |
| Injection, anesthetic agent; femoral nerve, single (64447) |
$512.50 |
$1,025 |
0.7× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
$557.50 |
$1,115 |
0.8× |
| Ins cath ren art 1st bilat (36252) |
$4,222 |
$8,444 |
1.4× |
| Ins cath ren art 1st unilat (36251) |
$4,222 |
$8,444 |
1.4× |
Ins cath ren art 2nd+ unilat (36253)
unusually low: confirm this is the full procedure |
$2,595 |
$5,190 |
0.5× |
Ins endovas vena cava filtr (37191)
likely a partial charge, not the full procedure |
$886.50 |
$1,773 |
0.2× |
| Ins/Rep Subq Defibrillator (33270) |
$70,629 |
$141,258 |
2.3× |
| Insert 1 Electrode Pm-Defib (33216) |
$8,150.50 |
$16,301 |
1.0× |
| Insert Bladder Cath Complex (51703) |
$181 |
$362 |
1.4× |
| Insert cath pleura w/ image (32557) |
$775.50 |
$1,551 |
0.5× |
| Insert cervical dilator (59200) |
$505.50 |
$1,011 |
1.7× |
| Insert Gastrostomy Tube Percutaneous (49440) |
$1,473 |
$2,946 |
0.8× |
| Insert Heart Pm Atrial (33206) |
$16,872 |
$33,744 |
1.7× |
| Insert Heart Pm Ventricular (33207) |
$16,872 |
$33,744 |
1.7× |
| Insert non-tunnel cv cath (36556) |
$2,254 |
$4,508 |
0.7× |
| Insert Pacing Lead & Connect (33224) |
$34,040.50 |
$68,081 |
3.4× |
| Insert Temp Bladder Cath (51702) |
$214 |
$428 |
1.7× |
| Insert tun ip cath perc (49418) |
$4,511 |
$9,022 |
1.3× |
| Insert tunneled cv cath (36561) |
$3,249.50 |
$6,499 |
1.1× |
| Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) |
$3,716.50 |
$7,433 |
0.7× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$214 |
$428 |
1.7× |
| Insertion indwelling tunneled pleural catheter (32550) |
$5,313.50 |
$10,627 |
1.5× |
| Insertion Picc W/Rs&I 5 Yr/> (36573) |
$1,170.50 |
$2,341 |
0.8× |
| Insertion subq cardiac rhythm monitor w/prgrmg (33285) |
$16,573.50 |
$33,147 |
2.1× |
Insj 2 Transvns Eltrd Perm Pacemaker/Impltbl Dfb (33217)
unusually low: confirm this is the full procedure |
$2,440 |
$4,880 |
0.3× |
| Insj Non-Tunneled Central Venous Cath Age < 5 Y (36555) |
$2,254 |
$4,508 |
0.7× |
| Insj Picc Rs&I <5 Yr (36572) |
$835 |
$1,670 |
1.4× |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
$2,143.50 |
$4,287 |
0.7× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) |
$3,249.50 |
$6,499 |
2.1× |
| Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) |
$2,116.50 |
$4,233 |
0.7× |
| Insj/Rplcmt Defib W/Lead(S) (33249) |
$70,629 |
$141,258 |
2.3× |
Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210)
likely a partial charge, not the full procedure |
$1,315.50 |
$2,631 |
0.2× |
| Insrt heart pm atrial & vent (33208) |
$20,706.50 |
$41,413 |
2.0× |
Insrt Pulse Gen W/Singl Lead (33240)
likely a partial charge, not the full procedure |
$5,545 |
$11,090 |
0.3× |
| Intraoral i&d tongue/floor lingual (41000) |
$1,208 |
$2,416 |
2.3× |
| Intro cath dialysis circuit (36901) |
$2,193.50 |
$4,387 |
1.4× |
| Intro Cath Dialysis Circuit W/Trluml Balo Angiop (36902) |
$8,155 |
$16,310 |
1.5× |
| Intubation endotracheal emergency procedure (31500) |
$2,617 |
$5,234 |
11.4× |
| Irrigation of corpora cavernosa for priapism (54220) |
$798 |
$1,596 |
3.3× |
| Laryngoscopy flexible diagnostic (31575) |
$184.50 |
$369 |
1.0× |
| Laryngoscopy Flx/Rgd Telescopic W/Stroboscopy (31579) |
$369.50 |
$739 |
1.0× |
| Lithotripsy, extracorporeal shock wave (50590) |
$12,555.50 |
$25,111 |
3.7× |
| Lyse chest fibrin init day (32561) |
$619.50 |
$1,239 |
1.0× |
| Manometric stds thru tube/ndwellg urtrl cath (50396) |
$482 |
$964 |
0.7× |
| Mech remov tunneled cv cath (36595) |
$3,624.50 |
$7,249 |
1.2× |
| Myelography Lumbar Injection (62305) |
$6,761.50 |
$13,523 |
8.9× |
| Myelography Lumbar Injection (62304) |
$3,270.50 |
$6,541 |
4.3× |
| Myelography via lumbar injection rs&i cervical (62302) |
$3,748.50 |
$7,497 |
4.9× |
| Myelography Via Lumbar Injection Rs&I Thoracic (62303) |
$3,748.50 |
$7,497 |
4.9× |
| N Block Inj Ilio-Ing/Hypogi (64425) |
$784 |
$1,568 |
1.1× |
| N block inj intercost sng (64420) |
$892.50 |
$1,785 |
1.3× |
| N Block Inj Plantar Digit (64455) |
$682 |
$1,364 |
2.3× |
| N Block Lumbar/Thoracic (64520) |
$1,089.50 |
$2,179 |
1.3× |
| Nasal Endoscopy Dx (31231) |
$206 |
$412 |
1.1× |
| Nasal/Orogastric W/Tube Plmt (43752) |
$459.50 |
$919 |
1.1× |
| Needle Biopsy Lymph Nodes (38505) |
$6,575.50 |
$13,151 |
4.1× |
| Needle Biopsy Pancreas (48102) |
$837.50 |
$1,675 |
0.5× |
| Needle insertion w/o injection 1 or 2 muscles (20560) |
$37 |
$74 |
1.3× |
| Needle insertion w/o injection 3 or more muscles (20561) |
$37 |
$74 |
1.3× |
| Nfct agent HIV trgt viral next-gnrj seq alys alg (0219U) |
$493.50 |
$987 |
0.7× |
| Njx anes stellate ganglion crv sympathetic (64510) |
$567 |
$1,134 |
0.7× |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) |
$661.50 |
$1,323 |
2.2× |
| Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) |
$2,235 |
$4,470 |
0.6× |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
$1,749.50 |
$3,499 |
2.0× |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62325) |
$2,014.50 |
$4,029 |
2.3× |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) |
$2,014.50 |
$4,029 |
2.9× |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62327) |
$2,014.50 |
$4,029 |
2.3× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
$2,014.50 |
$4,029 |
2.9× |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn (62326) |
$2,014.50 |
$4,029 |
2.3× |
| Njx Noncmpnd Sclrsnt 1 Vein (36465) |
$2,821 |
$5,642 |
1.4× |
| Njx Px Antegrde Nfrosgrm &/Urtrgrm Exstng Acess (50431) |
$676.50 |
$1,353 |
1.0× |
| Njx Px Antegrde Nfrosgrm &/Urtrgrm New Access (50430) |
$670 |
$1,340 |
1.0× |
| Ob preeclampsia biochem asy sflt-1&plgf serum (0482U) |
$840 |
$1,680 |
6.5× |
| Occipital Nerve Block (64405) |
$1,703.50 |
$3,407 |
5.7× |
| Onc Sld Org Neo Trgt Gen Seq Dna Alys 505 Genes (0250U) |
$3,650 |
$7,300 |
1.3× |
| Open/Perq Place Stent 1St (37236) |
$7,840 |
$15,680 |
0.7× |
| Open/Perq Place Stent Same (37238) |
$7,840 |
$15,680 |
0.7× |
| Penile Injection (54235) |
$286 |
$572 |
1.2× |
| Perc Cryo Ablate Renal Tum (50593) |
$7,442.50 |
$14,885 |
0.7× |
| Pericardiocentesis W/Imaging (33016) |
$1,507.50 |
$3,015 |
1.0× |
| Perq Cervicothoracic Inject (22510) |
$4,758.50 |
$9,517 |
1.5× |
| Perq dev breast 1st strtctc (19283) |
$506 |
$1,012 |
0.7× |
| Perq dev breast 1st us imag (19285) |
$1,111.50 |
$2,223 |
1.6× |
| Perq device breast 1st imag (19281) |
$2,499 |
$4,998 |
1.6× |
| Perq Lumbosacral Injection (22511) |
$7,856 |
$15,712 |
2.5× |
| Perq thrmbc/nfs dial circuit trluml balo angiop (36905) |
$16,483.50 |
$32,967 |
1.5× |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
$10,325 |
$20,650 |
1.5× |
| Perq Vertebral Augmentation (22513) |
$11,564 |
$23,128 |
1.6× |
| Place Cath Subclavian Art (36225) |
$8,009.50 |
$16,019 |
2.6× |
| Place Cath Thoracic Aorta (36221) |
$8,096.50 |
$16,193 |
2.6× |
| Place Cath Vertebral Art (36226) |
$8,009.50 |
$16,019 |
1.5× |
| Place Duod/Jej Tube Perc (49441) |
$1,649.50 |
$3,299 |
0.9× |
| Placement of needle for intraosseous infusion (36680) |
$1,010.50 |
$2,021 |
2.3× |
Plmt Bile Duct Stent Prq Existing Access (47538)
unusually low: confirm this is the full procedure |
$2,222.50 |
$4,445 |
0.4× |
| Plmt Nephrostomy Cath Prq New Access Rs&I (50432) |
$1,058.50 |
$2,117 |
0.5× |
| Plmt Nephroureteral Catheter (50433) |
$2,230.50 |
$4,461 |
0.7× |
| Plmt Urtrl Stent Prq New Access W/Sep Nfros Cath (50695) |
$4,151.50 |
$8,303 |
1.2× |
| Plmt Urtrl Stent Prq Pre-Existing Nfros Tract (50693) |
$4,151.50 |
$8,303 |
1.2× |
Prim art mech thrombectomy (37184)
unusually low: confirm this is the full procedure |
$6,522 |
$13,044 |
0.4× |
| Prq Aspir Pulposus/Intervertebral Disc/Pvrt Tiss (62267) |
$620 |
$1,240 |
0.9× |
| Prq Plmt Biliary Drg Cath W/Img Gid Rs&I Externl (47533) |
$3,721.50 |
$7,443 |
1.1× |
| Prq Plmt Biliary Drg Cath W/Img Gid Rs&I Int-Ext (47534) |
$3,721.50 |
$7,443 |
1.1× |
| Pseudoaneurysm Injection Trt (36002) |
$470 |
$940 |
0.8× |
| Punch biopsy skin single lesion (11104) |
$726.50 |
$1,453 |
1.8× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
$802 |
$1,604 |
2.0× |
| Puncture Aspiration Cyst Breast (19000) |
$460.50 |
$921 |
0.7× |
| Push Transfusion Blood 2 Yr/Under (36440) |
$3,076 |
$6,152 |
7.2× |
| Relocation Pocket Pacemaker (33222) |
$2,781 |
$5,562 |
1.4× |
| Rem Endovas Vena Cava Filter (37193) |
$1,898.50 |
$3,797 |
0.6× |
| Removal Biliary Drg Catheter Req Fluor Gid Rs&I (47537) |
$715 |
$1,430 |
0.8× |
| Removal Foreign Body Foot Subcutaneous (28190) |
$1,499 |
$2,998 |
2.2× |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
$2,251.50 |
$4,503 |
1.4× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$189 |
$378 |
3.3× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$103 |
$206 |
1.8× |
| Removal Implant Deep (20680) |
$4,511.50 |
$9,023 |
1.6× |
| Removal of foreign body from pharynx (42809) |
$364 |
$728 |
0.8× |
| Removal of intranasal lesion (30118) |
$2,705 |
$5,410 |
0.8× |
| Removal of nail bed (11750) |
$1,953 |
$3,906 |
4.9× |
| Removal of tunneled intraperitoneal catheter (49422) |
$3,854 |
$7,708 |
1.3× |
| Removal Pacemaker Electrode (33235) |
$2,948 |
$5,896 |
0.8× |
Removal ppm generator only (33233)
unusually low: confirm this is the full procedure |
$3,418.50 |
$6,837 |
0.4× |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) |
$252.50 |
$505 |
1.3× |
| Removal subcutaneous cardiac rhythm monitor (33286) |
$2,609.50 |
$5,219 |
3.8× |
| Remove Elctrd Transvenously (33244) |
$2,781 |
$5,562 |
0.8× |
| Remove foreign body from eye (65205) |
$165.50 |
$331 |
1.3× |
| Remove intrvas foreign body (37197) |
$2,195 |
$4,390 |
0.7× |
| Remove Nasal Foreign Body (30300) |
$388.50 |
$777 |
3.0× |
| Remove Pulse Generator (33241) |
$3,382 |
$6,764 |
0.9× |
| Remove renal tube w/fluoro (50389) |
$408 |
$816 |
0.6× |
| Remove&replace pm gen singl (33227) |
$10,062 |
$20,124 |
1.3× |
Remv&replc cvd gen dual lead (33263)
unusually low: confirm this is the full procedure |
$10,745.50 |
$21,491 |
0.5× |
Remv&replc cvd gen mult lead (33264)
unusually low: confirm this is the full procedure |
$11,771 |
$23,542 |
0.4× |
Remv&replc cvd gen sing lead (33262)
unusually low: confirm this is the full procedure |
$9,954.50 |
$19,909 |
0.5× |
| Remv&replc pm gen dual lead (33228) |
$10,745.50 |
$21,491 |
1.1× |
| Remv&replc pm gen mult leads (33229) |
$11,645 |
$23,290 |
0.6× |
| Renal Biopsy Perq (50200) |
$7,407.50 |
$14,815 |
4.6× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
$1,124 |
$2,248 |
1.6× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$775 |
$1,550 |
2.0× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$851 |
$1,702 |
2.2× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$747 |
$1,494 |
1.9× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$518 |
$1,036 |
1.3× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$564 |
$1,128 |
1.4× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$779 |
$1,558 |
2.0× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$879.50 |
$1,759 |
2.2× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$687.50 |
$1,375 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$518 |
$1,036 |
1.3× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$569 |
$1,138 |
1.4× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$632.50 |
$1,265 |
0.9× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$1,071.50 |
$2,143 |
2.7× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$518 |
$1,036 |
1.3× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$741.50 |
$1,483 |
1.9× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$893.50 |
$1,787 |
2.3× |
| Repair lead pace-defib dual (33220) |
$6,240 |
$12,480 |
1.7× |
| Repair Lead Pace-Defib One (33218) |
$3,390.50 |
$6,781 |
0.9× |
| Repair of nail bed (11760) |
$558 |
$1,116 |
0.8× |
| Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) |
$7,037 |
$14,074 |
1.0× |
| Repair tongue laceration (41250) |
$319.50 |
$639 |
0.7× |
| Replace duodenostomy/jejunostomy tube perq (49451) |
$651 |
$1,302 |
0.7× |
| Replace G-J Tube Perc (49452) |
$581.50 |
$1,163 |
0.7× |
| Replace g/c tube perc (49450) |
$774.50 |
$1,549 |
0.9× |
| Reposition Gastrostomy Tube (43761) |
$704.50 |
$1,409 |
2.9× |
| Reposition L Ventric Lead (33226) |
$3,390.50 |
$6,781 |
1.1× |
| Reposition Pacing-Defib Lead (33215) |
$5,637.50 |
$11,275 |
1.8× |
| Revise Abdomen-Venous Shunt (49426) |
$3,596.50 |
$7,193 |
1.0× |
| Revj Transvns Intrahepatic Portosystemic Shunt (37183) |
$7,497.50 |
$14,995 |
1.4× |
| Rmvl & rplcmt xtrnl accessible nephrourtrl cath (50387) |
$2,165.50 |
$4,331 |
1.1× |
| Rmvl embedded fb from dentalvlr struxs soft tiss (41805) |
$1,588 |
$3,176 |
1.1× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$440.50 |
$881 |
1.0× |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
$488 |
$976 |
3.8× |
| Rmvl of subq implantable defibrillator electrode (33272) |
$49,400 |
$98,800 |
13.6× |
| Rmvl transvns pm eltrd 1 lead sys atr/ventr (33234) |
$2,948 |
$5,896 |
0.8× |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
$1,918 |
$3,836 |
1.3× |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
$1,120 |
$2,240 |
1.8× |
| Rplc Gtube No Revj Trc (43762) |
$774.50 |
$1,549 |
3.2× |
| Rplc gtube revj gstrst trc (43763) |
$887.50 |
$1,775 |
3.7× |
| Rplcmt compl non-tun cvc w/o subq port/pmp (36580) |
$1,254 |
$2,508 |
0.8× |
| Rplcmt Compl Prph Ctr Vad W/Subq Port (36585) |
$2,116.50 |
$4,233 |
0.7× |
| Rplcmt Compl Prph Cvc W/O Subq Port/Pmp (36584) |
$1,262 |
$2,524 |
0.8× |
| Rplcmt compl tun cvc w/o subq port/pmp (36581) |
$3,249.50 |
$6,499 |
1.1× |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) |
$897.50 |
$1,795 |
4.6× |
| Rpr Lac Appl Tissue Glue Wound Cornea&/Sclera (65286) |
$795.50 |
$1,591 |
0.4× |
| Rpr Lip Full Thickness Vermilion Only (40650) |
$2,446 |
$4,892 |
4.7× |
| Sclerotx Fluid Collection (49185) |
$1,927 |
$3,854 |
1.2× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$878 |
$1,756 |
4.5× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$884.50 |
$1,769 |
4.5× |
| Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) |
$904 |
$1,808 |
2.3× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$890.50 |
$1,781 |
4.6× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$160 |
$320 |
0.8× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$795.50 |
$1,591 |
4.1× |
| Skin sub graft face/nk/hf/g (15275) |
$1,688 |
$3,376 |
2.4× |
| Skin sub graft trnk/arm/leg (15271) |
$1,943.50 |
$3,887 |
2.7× |
| Skin sub grft t/arm/lg child (15273) |
$1,943.50 |
$3,887 |
1.0× |
| Skn sub grft f/n/hf/g child (15277) |
$1,755 |
$3,510 |
0.9× |
| Slctv Cath Carotid/Innom Art Angio Intrcranl Art (36223) |
$3,854 |
$7,708 |
0.7× |
| Slctv cath carotid/innom art angio xtrcranl art (36222) |
$7,784.50 |
$15,569 |
2.5× |
| Slctv Cath Intrnl Carotid Art Angio Intrcrnl Art (36224) |
$8,009.50 |
$16,019 |
1.5× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$343 |
$686 |
1.8× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$850 |
$1,700 |
2.2× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$901 |
$1,802 |
2.3× |
| Spinal puncture lumbar diagnostic (62270) |
$778 |
$1,556 |
1.1× |
| Split Agrft T/a/L 1st 100 Cm/&/1% Bdy Inft/Chld (15100) |
$4,177 |
$8,354 |
2.1× |
| Strapping ankle (29540) |
$254.50 |
$509 |
1.6× |
| Strapping Hip (29520) |
$127 |
$254 |
1.0× |
| Strapping knee (29530) |
$127 |
$254 |
1.0× |
| Strapping toes (29550) |
$113.50 |
$227 |
2.0× |
| Strapping Unna Boot (29580) |
$543 |
$1,086 |
3.4× |
| Tangential biopsy skin single lesion (11102) |
$278.50 |
$557 |
0.7× |
| Ther Spi Pnxr Csf Fluor/Ct (62329) |
$735 |
$1,470 |
1.1× |
| Thrmbc Artl/Ven Grf Oth/Thn Hemo Grf/Fstl (35875) |
$3,286 |
$6,572 |
0.6× |
| Thrmbc/Nfs Dialysis Circuit (36906) |
$24,983.50 |
$49,967 |
1.4× |
| Thromblytic art/ven therapy (37213) |
$2,723 |
$5,446 |
0.9× |
| Thrombolytic Art Therapy (37211) |
$2,723 |
$5,446 |
0.5× |
| Thrombolytic Therapy Stroke (37195) |
$315 |
$630 |
1.0× |
| Thrombolytic Venous Therapy (37212) |
$2,723 |
$5,446 |
0.9× |
| Thyroid biopsy (60100) |
$3,108.50 |
$6,217 |
4.5× |
| Tracheobrnchsc Thru Est Trachs Inc (31615) |
$1,095.50 |
$2,191 |
2.1× |
| Tracheostomy Emergency Cricothyroid Membrane (31605) |
$1,975.50 |
$3,951 |
8.6× |
Transcatheter biopsy (37200)
unusually low: confirm this is the full procedure |
$1,871 |
$3,742 |
0.3× |
| Treat knee fracture (27532) |
$2,004 |
$4,008 |
0.6× |
| Treat Metatarsal Fracture (28475) |
$749.50 |
$1,499 |
3.1× |
| Treat Thumb Dislocation (26641) |
$691 |
$1,382 |
2.9× |
| Treat toe dislocation (28630) |
$539.50 |
$1,079 |
2.3× |
| Treatment closed elbow dislocation w/o anes (24600) |
$486 |
$972 |
2.0× |
| Trim skin lesion (11055) |
$1,965.50 |
$3,931 |
10.1× |
| Trim skin lesions 2 to 4 (11056) |
$1,972.50 |
$3,945 |
10.1× |
| Trim skin lesions over 4 (11057) |
$2,036 |
$4,072 |
10.4× |
| Trimming Nondystrophic Nails Any Number (11719) |
$543 |
$1,086 |
9.5× |
| Trluml Balo Angiop 1St Art (37246) |
$3,901.50 |
$7,803 |
0.7× |
Trluml Balo Angiop 1St Vein (37248)
unusually low: confirm this is the full procedure |
$2,372 |
$4,744 |
0.4× |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
$3,070 |
$6,140 |
1.0× |
| Tx Missed Abortion First Trimester Surgical (59820) |
$2,979 |
$5,958 |
0.9× |
| Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) |
$1,575 |
$3,150 |
1.0× |
| Unlisted procedure lungs and pleura (32999) |
$1,518 |
$3,036 |
2.5× |
Unlisted procedure nervous system (64999)
range across 3 matching MRF lines |
$327.50–$1,740 |
$655–$3,480 |
varies |
| Unlisted Procedure Trachea Bronchi (31899) |
$2,220.50 |
$4,441 |
11.4× |
| Unlisted Procedure Vascular Surgery (37799) |
$776.50 |
$1,553 |
1.3× |
| Upgrade of pacemaker system (33214) |
$21,136.50 |
$42,273 |
2.1× |
| Vasc embolize/occlude artery (37242) |
$16,510 |
$33,020 |
0.9× |
| Vasc Embolize/Occlude Bleed (37244) |
$14,741 |
$29,482 |
1.3× |
| Vasc Embolize/Occlude Organ (37243) |
$14,741 |
$29,482 |
1.3× |
| Vasc embolize/occlude venous (37241) |
$14,741 |
$29,482 |
1.3× |
Venous Mech Thrombectomy (37187)
unusually low: confirm this is the full procedure |
$5,492.50 |
$10,985 |
0.5× |
| Wedge excision skin nail fold (11765) |
$415 |
$830 |
1.1× |