| 2d cephalometric image (D0340) |
$43.55 |
$67 |
0.4× |
| 2d tte w or w/o fol w/con,fu (C8924) |
$5,697.13 |
$8,764.82 |
14.5× |
| Ablation b9 thyroid nodule perq laser w/img gdn (0673T) |
$4,007.90 |
$6,166 |
2.2× |
| Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T) |
$23,621.65 |
$36,341 |
2.0× |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) |
$4,898.40 |
$7,536 |
2.2× |
| Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) |
$11,778 |
$18,120 |
1.2× |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) |
$3,946.80 |
$6,072 |
1.8× |
| Admin hepatitis b vaccine (G0010) |
$37.70 |
$58 |
0.7× |
| Admin influenza virus vac (G0008) |
$37.70 |
$58 |
0.7× |
| Admin pneumococcal vaccine (G0009) |
$37.70 |
$58 |
0.7× |
| Alcohol/sub misuse assess (G2011) |
$64.35 |
$99 |
2.0× |
| Amalgam 4 or > surfaces perm (D2161) |
$113.10 |
$174 |
0.2× |
| Amalgam one surface permanen (D2140) |
$63.70 |
$98 |
0.1× |
| Amalgam three surfaces perma (D2160) |
$99.45 |
$153 |
0.1× |
| Amalgam two surfaces permane (D2150) |
$79.30 |
$122 |
0.1× |
| Annual alcohol screen 15 min (G0442) |
$78.65 |
$121 |
1.9× |
| Auto tissue graft 1st tooth (D4273) |
$434.20 |
$668 |
0.2× |
| Bitewings four images (D0274) |
$27.30 |
$42 |
0.1× |
| Ca screen;flexi sigmoidscope (G0104) |
$2,284.10 |
$3,514 |
2.2× |
| Ca screen;pelvic/breast exam (G0101) |
$75.40 |
$116 |
0.7× |
| Catheterize for urine spec (P9612) |
$17.55 |
$27 |
1.9× |
| Chemo extend iv infus w/pump (G0498) |
$57.85 |
$89 |
0.2× |
| Collagen Cross-Linking Cornea&Pachymetry (0402T) |
$3,705 |
$5,700 |
1.4× |
| Comp periodontal evaluation (D0180) |
$318.50 |
$490 |
2.1× |
| Complete occlusal adjustment (D9952) |
$187.20 |
$288 |
0.3× |
| Comprehensve oral evaluation (D0150) |
$35.10 |
$54 |
0.2× |
| Cone beam ct capt & interp (D0364) |
$67.60 |
$104 |
0.6× |
| Cone beam ct interp both jaw (D0367) |
$406.90 |
$626 |
3.5× |
| Cone beam ct interprete man (D0365) |
$94.25 |
$145 |
0.8× |
| Cone beam ct interprete max (D0366) |
$406.90 |
$626 |
3.5× |
| Coronectomy (D7251) |
$170.30 |
$262 |
0.1× |
| Crown porcelain w/ h noble m (D2750) |
$438.10 |
$674 |
0.6× |
| Crown porcelain/ceramic (D2740) |
$438.10 |
$674 |
0.6× |
| Dental bitewing single image (D0270) |
$10.40 |
$16 |
0.1× |
| Dental bitewings two images (D0272) |
$18.20 |
$28 |
0.2× |
| Dental prophylaxis adult (D1110) |
$39 |
$60 |
0.3× |
| Depression screen annual (G0444) |
$78.65 |
$121 |
1.9× |
| Dermal filler injection(s) (G0429) |
$2,766.40 |
$4,256 |
1.2× |
| Diab manage trn per indiv (G0108) |
$129.35 |
$199 |
2.3× |
| Diab manage trn ind/group (G0109) |
$57.20 |
$88 |
3.6× |
Drug test def 1-7 classes (G0480)
range across 5 matching MRF lines |
$16.65–$8,730.54 |
$25.62–$13,431.60 |
varies |
| Egd flexible transnasal w/insj intral tube/cath (0654T) |
$7,598.50 |
$11,690 |
1.8× |
| End thxpy, anterior tooth (D3310) |
$282.10 |
$434 |
0.4× |
| End thxpy, molar tooth (D3330) |
$423.15 |
$651 |
0.6× |
| End thxpy, premolar tooth (D3320) |
$325.65 |
$501 |
0.4× |
| Endo outlet restrict w/tube (C9785) |
$19,516.25 |
$30,025 |
1.6× |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) |
$76,148.80 |
$117,152 |
1.5× |
| Ev Catheter Dir Chem Abltj Incmptnt Xtr Vein (0524T) |
$6,490.25 |
$9,985 |
1.8× |
| Exposure of unerupted tooth (D7280) |
$214.50 |
$330 |
0.3× |
| Extensv oral eval prob focus (D0160) |
$50.70 |
$78 |
0.3× |
| Extraction erupted tooth/exr (D7140) |
$65 |
$100 |
0.1× |
| Fecal microbiota prep instil (G0455) |
$2,284.10 |
$3,514 |
2.2× |
| Flt3 gene int tandem dupl variants quantitative (0046U) |
$2,263.95 |
$3,483 |
5.6× |
| Full mouth debridement (D4355) |
$69.55 |
$107 |
0.1× |
| Gingivectomy/plasty 1 to 3 (D4211) |
$85.15 |
$131 |
0.0× |
| Gross pulpal debridement (D3221) |
$79.95 |
$123 |
0.1× |
| Hbot, full body chamber, 30m (G0277) |
$363.35 |
$559 |
2.4× |
| Hopd mntl hlt, 15-29 min (C7900) |
$78.65 |
$121 |
1.9× |
| Hopd mntl hlt, 30-60 min (C7901) |
$243.75 |
$375 |
2.1× |
Hospital outpt clinic visit (G0463)
range across 5 matching MRF lines |
$59.15–$169.65 |
$91–$261 |
varies |
| Hpv combo assay ca screen (G0476) |
$149.50 |
$230 |
4.3× |
| I&d absc intraoral soft tiss (D7510) |
$1,654.90 |
$2,546 |
2.1× |
| Impact tooth rem bony w/comp (D7241) |
$238.55 |
$367 |
0.3× |
| Impact tooth remov comp bony (D7240) |
$195 |
$300 |
0.3× |
| Impact tooth remov part bony (D7230) |
$171.60 |
$264 |
0.2× |
| Impact tooth remov soft tiss (D7220) |
$139.10 |
$214 |
0.2× |
| Incision/drain abscess intra (D7511) |
$183.95 |
$283 |
0.2× |
| Initial preventive exam (G0402) |
$104.65 |
$161 |
0.7× |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) |
$1,844.05 |
$2,837 |
1.9× |
| Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation… (0647T) |
$4,258.80 |
$6,552 |
2.0× |
| Instill pharm renal pelvis (C9789) |
$1,821.95 |
$2,803 |
1.3× |
| Intraor comprehensive series (D0210) |
$48.10 |
$74 |
0.2× |
| Intraoral occlusal film (D0240) |
$16.90 |
$26 |
0.2× |
| Intraoral periapical first (D0220) |
$10.40 |
$16 |
0.1× |
| Ire Abltj 1+Tum Organ Perq (0600T) |
$14,941.55 |
$22,987 |
1.3× |
| Limit oral eval problm focus (D0140) |
$31.20 |
$48 |
0.2× |
| Limited occlusal adjustment (D9951) |
$39.65 |
$61 |
0.1× |
| Mra w/o fol w/cont, lwr ext (C8914) |
$57.08 |
$87.81 |
0.1× |
| Mri w/cont, breast, bi (C8906) |
$3,954.60 |
$6,084 |
10.1× |
| Mri w/cont, breast, uni (C8903) |
$3,404.05 |
$5,237 |
17.3× |
| Myocrd Symp Innervaj Img Plnr Qual&Quant W/Spect (0332T) |
$2,694.25 |
$4,145 |
1.9× |
| Neuro csf prion prtn qual (0035U) |
$682.50 |
$1,050 |
1.3× |
| Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) |
$1,844.05 |
$2,837 |
1.9× |
| Njx platelet plasma (0232T) |
$323.70 |
$498 |
0.6× |
| Non-blind interatrial shunt (C9760) |
$32,903.65 |
$50,621 |
1.1× |
| Non-ophthalmic fva (C9733) |
$731.90 |
$1,126 |
1.9× |
| Obtaining screen pap smear (Q0091) |
$20.15 |
$31 |
0.6× |
| Occ guard, hard, full arch (D9944) |
$180.05 |
$277 |
0.2× |
| Occ guard, soft, full arch (D9945) |
$144.30 |
$222 |
0.2× |
| Onc cns alys 30000 DNA methylation loci tum tiss (0020M) |
$1,950 |
$3,000 |
0.8× |
| Onc Merkel Cll Carc Srm Quan (0058U) |
$645.45 |
$993 |
2.0× |
| Panoramic image (D0330) |
$42.90 |
$66 |
0.2× |
| Pathogen test for platelets (P9100) |
$174.20 |
$268 |
2.6× |
| Pattern erg w/i&r (0509T) |
$726.70 |
$1,118 |
3.0× |
| Periodic oral evaluation (D0120) |
$24.05 |
$37 |
0.2× |
| Periodontal maint procedures (D4910) |
$63.05 |
$97 |
0.1× |
| Periodontal scaling & root (D4341) |
$109.85 |
$169 |
0.2× |
| Periodontal scaling 1-3teeth (D4342) |
$78.65 |
$121 |
0.1× |
| Perq Sacral Augmt Bilat Inj (0201T) |
$10,840.70 |
$16,678 |
1.3× |
| Place direct restoration (D2940) |
$41.60 |
$64 |
0.1× |
| Post 1 srfc resinbased cmpst (D2391) |
$66.95 |
$103 |
0.1× |
| Post 2 srfc resinbased cmpst (D2392) |
$87.10 |
$134 |
0.1× |
| Post 3 srfc resinbased cmpst (D2393) |
$104 |
$160 |
0.1× |
| Post >=4srfc resinbase cmpst (D2394) |
$119.60 |
$184 |
0.2× |
| Prefab stnlss steel crown pe (D2931) |
$131.30 |
$202 |
0.2× |
| Prolonged iv inf, req pump (C8957) |
$840.45 |
$1,293 |
3.5× |
| Pulp cap indirect (D3120) |
$26 |
$40 |
0.0× |
| Pulp vitality test (D0460) |
$22.10 |
$34 |
0.0× |
| Pure tone audiometry (threshold), automated; air and bone Non-Facility Physician Technical Component (0209T) |
$103.35 |
$159 |
2.5× |
| Quan mr alys tiss composition w/MRI 1orgn (0649T) |
$2,295.80 |
$3,532 |
2.2× |
| Quan mr alys tiss composition w/MRI mlt organs (0698T) |
$3,838.25 |
$5,905 |
3.7× |
| Quan us tiss charac i&r w/o dx us same anat (0689T) |
$230.10 |
$354 |
2.4× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) |
$378.95 |
$583 |
0.5× |
| Re-cement or re-bond crown (D2920) |
$37.70 |
$58 |
0.1× |
| Re-eval,est pt,problem focus (D0170) |
$27.95 |
$43 |
0.2× |
| Rem imp tooth w mucoper flp (D7210) |
$113.10 |
$174 |
0.1× |
| Removal of sloughed off bone (D7550) |
$165.75 |
$255 |
0.2× |
| Resin 4/> surf or w incis an (D2335) |
$110.50 |
$170 |
0.2× |
| Resin one surface-anterior (D2330) |
$61.75 |
$95 |
0.1× |
| Resin three surfaces-anterio (D2332) |
$91 |
$140 |
0.1× |
| Resin two surfaces-anterior (D2331) |
$78.65 |
$121 |
0.1× |
| Revasc intra lithotrip-stent (C9765) |
$21,562.45 |
$33,173 |
1.0× |
| Revasc intravasc lithotripsy (C9764) |
$17,984.20 |
$27,668 |
1.4× |
| Revasc lithotrip tibi/perone (C9772) |
$17,984.20 |
$27,668 |
1.4× |
| Revasc lithotrip-stent-ather (C9767) |
$19,602.05 |
$30,157 |
1.0× |
| Splint extra-coronal (D4323) |
$149.50 |
$230 |
0.2× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) |
$18,586.75 |
$28,595 |
0.9× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) |
$18,586.75 |
$28,595 |
0.9× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) |
$10,097.10 |
$15,534 |
1.6× |
| Therapeutic procd strg endur (G0237) |
$208 |
$320 |
6.4× |
| Tooth reimplantation (D7270) |
$195 |
$300 |
0.3× |
| Tooth root removal (D7250) |
$121.55 |
$187 |
0.2× |
| Transcatheter implantation of coronary sinus reduction device including vascular access and closure, right heart… (0645T) |
$21,562.45 |
$33,173 |
1.0× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) |
$10,097.10 |
$15,534 |
1.6× |
Trauma respons w/hosp criti (G0390)
range across 2 matching MRF lines |
$10,672.35–$14,294.80 |
$16,419–$21,992 |
varies |
| Treatment of complications (D9930) |
$35.10 |
$54 |
0.0× |
| Trim nail(s) (G0127) |
$48.10 |
$74 |
0.7× |
| Trluml Perip Athrc Iliac Art (0238T) |
$21,562.45 |
$33,173 |
1.0× |
| Tte w or w/o fol w/cont, f/u (C8922) |
$28,521.81 |
$43,879.71 |
32.4× |
Tympanostomy Automated Tube Delivery System (0583T)
range across 2 matching MRF lines |
$3,681.60–$6,626.88 |
$5,664–$10,195.20 |
varies |
| US Ablat Uter Leiomyom <200 (0071T) |
$6,638.45 |
$10,213 |
1.8× |
| US Ablat Uter Leiomyom >200 (0072T) |
$6,638.45 |
$10,213 |
1.8× |
| Visit to determ ldct elig (G0296) |
$243.75 |
$375 |
2.1× |
| Wet mounts/ w preparations (Q0111) |
$40.30 |
$62 |
2.2× |