| 2d tee w or w/o fol w/con,in (C8925) |
$1,453.50 |
$2,850 |
1.3× |
| 2d tte w or w/o fol w/con,fu (C8924) |
$1,069.98 |
$2,098 |
2.2× |
| Catheterize for urine spec (P9612) |
$46.92 |
$92 |
5.0× |
| Chemo extend iv infus w/pump (G0498) |
$355.47 |
$697 |
0.8× |
| Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater… (0419T) |
$1,266.33 |
$2,483 |
1.2× |
| Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities,… (0420T) |
$1,266.33 |
$2,483 |
1.2× |
| Diab manage trn per indiv (G0108) |
$201.96 |
$396 |
3.6× |
| Direct refer hospital observ (G0379) |
$706.86 |
$1,386 |
0.8× |
| Home sleep test/type 3 porta (G0399) |
$828.75 |
$1,625 |
2.7× |
| Home sleep test/type 4 porta (G0400) |
$828.75 |
$1,625 |
2.7× |
| Hospital outpt clinic visit (G0463) |
$135.66 |
$266 |
0.7× |
| Lev 1 hosp type b ed visit (G0380) |
$131.07 |
$257 |
1.2× |
| Lev 2 hosp type b ed visit (G0381) |
$238.17 |
$467 |
1.8× |
| Lev 3 hosp type b ed visit (G0382) |
$416.67 |
$817 |
1.7× |
| Lev 4 hosp type b ed visit (G0383) |
$598.74 |
$1,174 |
1.6× |
| Lev 5 hosp type b ed visit (G0384) |
$738.99 |
$1,449 |
1.3× |
| Pathogen test for platelets (P9100) |
$62.22 |
$122 |
0.7× |
| Perc d-e cor revasc chro sin (C9607) |
$22,111.05 |
$43,355 |
0.8× |
| Perc d-e cor revasc t cabg s (C9604) |
$22,111.05 |
$43,355 |
1.3× |
| Perc d-e cor stent ather s (C9602) |
$22,111.05 |
$43,355 |
0.8× |
| Perc drug-el cor stent sing (C9600) |
$22,528.74 |
$44,174 |
1.4× |
| Perq Sacral Augmt Unilat Inj (0200T) |
$22,738.86 |
$44,586 |
2.2× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) |
$8,384.91 |
$16,441 |
0.5× |
| Place device/marker, non pro (C9728) |
$2,366.91 |
$4,641 |
1.2× |
| Prolonged iv inf, req pump (C8957) |
$576.30 |
$1,130 |
1.9× |
| Revasc intra lithotrip-stent (C9765) |
$17,905.08 |
$35,108 |
0.7× |
| Revasc intravasc lithotripsy (C9764) |
$16,479.12 |
$32,312 |
1.0× |
| Revasc lithotrip tibi/perone (C9772) |
$14,931.27 |
$29,277 |
0.9× |
| Tomosynthesis, mammo (G0279) |
$61.20 |
$120 |
4.8× |
Trauma respons w/hosp criti (G0390)
range across 3 matching MRF lines |
$12,245.61–$44,829.51 |
$24,011–$87,901 |
varies |
| Tte w or wo fol wcon,doppler (C8929) |
$4,803.69 |
$9,419 |
4.3× |
| Unsched dialysis esrd pt hos (G0257) |
$8,272.71 |
$16,221 |
8.5× |