| Acne Surgery (10040) |
$151.20 |
$151.20 |
0.8× |
| Amputation of finger/thumb (26952) |
$2,625 |
$2,625 |
0.9× |
| Appl Mlt-Layer Venous Wound Compress Below Knee (29581) |
$312.74 |
$312.74 |
2.1× |
| Application cast elbow finger short arm (29075) |
$149.62 |
$149.62 |
0.6× |
| Application Cast Hand & Lower Forearm Gauntlet (29085) |
$63 |
$63 |
0.4× |
| Application cast shoulder hand long arm (29065) |
$247.80 |
$247.80 |
1.0× |
| Application finger splint static (29130) |
$47.25 |
$47.25 |
0.4× |
| Application long arm splint shoulder hand (29105) |
$178.50 |
$178.50 |
1.2× |
| Application Long Leg Cast Walker/Ambulatory Type (29355) |
$721.88 |
$721.88 |
2.8× |
| Application of long leg cast (29345) |
$364.35 |
$364.35 |
1.4× |
| Application short arm splint forearm-hand static (29125) |
$172.20 |
$172.20 |
1.4× |
| Application short leg splint calf foot (29515) |
$183.75 |
$183.75 |
1.2× |
| Apply multlay comprs arm/hand (29584) |
$289.74 |
$289.74 |
1.9× |
| Apply short leg cast (29405) |
$262.50 |
$262.50 |
1.0× |
| Arterial puncture (36600) |
$78.75 |
$78.75 |
0.6× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$269.85 |
$269.85 |
1.0× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$432.60 |
$432.60 |
1.5× |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
$630 |
$630 |
2.2× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$212.10 |
$212.10 |
0.8× |
| Aspirat/Injection Ganglion Cyst(S) (20612) |
$287.70 |
$287.70 |
1.0× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$239.40 |
$239.40 |
1.3× |
| Biopsy of uterus lining (58100) |
$305.55 |
$305.55 |
1.6× |
| Bladder Irrigation Simple (51700) |
$225.75 |
$225.75 |
1.0× |
| Blood transfusion service (36430) |
$892.50 |
$892.50 |
2.2× |
| Cautery Cervix Cryocautery Initial or Repeat (57511) |
$376.95 |
$376.95 |
1.3× |
| Closed Rx Humeral Supracondylar Fx (24530) |
$105 |
$105 |
0.5× |
| Closed Rx Rad/Ulna Shaft Fx,Manip (25565) |
$892.50 |
$892.50 |
0.6× |
| Closed Rx Radial Shaft Fx (25500) |
$210 |
$210 |
0.9× |
| Closed Rx Tibia Shaft Fx (27750) |
$325.50 |
$325.50 |
1.4× |
| Closed treat wrist dislocation (25660) |
$441 |
$441 |
1.9× |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) |
$346.50 |
$346.50 |
1.5× |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) |
$105 |
$105 |
0.5× |
| Closed tx metatarsal fracture w/o manipulation (28470) |
$241.50 |
$241.50 |
1.1× |
| Closed tx radial head/neck fx w/o manipulation (24650) |
$236.25 |
$236.25 |
1.0× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
$185.85 |
$185.85 |
0.8× |
| Closed tx ulnar shaft fracture w/o manipulation (25530) |
$89.25 |
$89.25 |
0.4× |
| Clsd tx clavicular fracture w/o manipulation (23500) |
$210 |
$210 |
0.9× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$887.25 |
$887.25 |
0.6× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$855.75 |
$855.75 |
3.8× |
| Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) |
$68.25 |
$68.25 |
0.3× |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) |
$409.50 |
$409.50 |
1.8× |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
$105 |
$105 |
0.5× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$945 |
$945 |
4.2× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$498.75 |
$498.75 |
0.3× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
$540.75 |
$540.75 |
2.4× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$636.30 |
$636.30 |
2.8× |
| Cltx metacarpal fx w/manipulation each bone (26605) |
$304.50 |
$304.50 |
1.3× |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
$220.50 |
$220.50 |
1.0× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
$236.25 |
$236.25 |
1.0× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
$333.90 |
$333.90 |
1.5× |
| Colonoscopy flex w/rem forcep (45384) |
$1,373.40 |
$1,373.40 |
1.2× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$246.75 |
$246.75 |
2.0× |
| Debride nail 1-5 (11720) |
$94.50 |
$94.50 |
1.7× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$537.60 |
$537.60 |
1.4× |
| Delivery placenta separate procedure (59414) |
$105 |
$105 |
0.0× |
| Destruc Benign/Premal,15+ Lesions (17004) |
$359.10 |
$359.10 |
1.0× |
| Destruction benign lesions 15 or more (17111) |
$244.65 |
$244.65 |
1.3× |
| Destruction Benign Lesions Up To 14 (17110) |
$233.10 |
$233.10 |
1.3× |
| Destruction mal lesion trunk/arm/leg 1.1-2.0cm (17262) |
$149.48 |
$149.48 |
0.8× |
| Destruction malignant lesion s/n/h/f/g 0.6-1.0cm (17271) |
$247.80 |
$247.80 |
1.3× |
| Destruction malignant lesion t/a/l 0.5 cm/< (17260) |
$196.35 |
$196.35 |
1.1× |
| Destruction premalignant lesion 1st (17000) |
$127.05 |
$127.05 |
0.7× |
| Drainage Finger Abscess Complicated (26011) |
$1,057.35 |
$1,057.35 |
0.7× |
| Drainage Finger Abscess Simple (26010) |
$495.60 |
$495.60 |
2.7× |
| Drainage of hematoma/fluid (10140) |
$317.10 |
$317.10 |
0.2× |
| Draw blood off venous device (36591) |
$136.50 |
$136.50 |
1.1× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
$433.65 |
$433.65 |
1.2× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$147 |
$147 |
0.8× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$110.25 |
$110.25 |
0.6× |
| Egd balloon dilation esophagus <30 mm diam (43249) |
$828.45 |
$828.45 |
0.5× |
| Evacuation of subungual hematoma (11740) |
$117.60 |
$117.60 |
1.0× |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
$505.05 |
$505.05 |
0.3× |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) |
$509.25 |
$509.25 |
0.3× |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) |
$312.90 |
$312.90 |
0.5× |
| Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) |
$338.10 |
$338.10 |
0.5× |
| Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) |
$273 |
$273 |
0.7× |
| Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) |
$326.59 |
$326.59 |
0.5× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
$455.70 |
$455.70 |
0.7× |
| Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) |
$548.10 |
$548.10 |
0.4× |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) |
$764.40 |
$764.40 |
0.5× |
| Exc tr-ext b9+marg 0.5 cm or less (11400) |
$244.65 |
$244.65 |
0.4× |
| Excision mal lesion trunk/arm/leg 0.5 cm/< (11600) |
$386.88 |
$386.88 |
0.6× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) |
$212.46 |
$212.46 |
0.3× |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) |
$472.50 |
$472.50 |
1.3× |
| Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) |
$438.90 |
$438.90 |
0.7× |
| Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) |
$345.45 |
$345.45 |
0.5× |
| Excision malignant lesion f/e/e/n/l 0.6-1.0 cm (11641) |
$486.15 |
$486.15 |
0.7× |
| Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) |
$589.05 |
$589.05 |
0.9× |
| Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) |
$373.80 |
$373.80 |
0.2× |
| Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) |
$525 |
$525 |
0.8× |
| Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) |
$512.40 |
$512.40 |
0.3× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) |
$660.45 |
$660.45 |
0.4× |
| Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) |
$384.30 |
$384.30 |
0.6× |
| Excision of lesion other than skin tag 1.1-2.0 cm (11422) |
$401.10 |
$401.10 |
0.3× |
| Excision of lesion other than skin tag </= 0.5 cm (11420) |
$266.70 |
$266.70 |
0.2× |
| Excision of nail fold toe (11765) |
$288.75 |
$288.75 |
0.8× |
| Expl W/Removal Deep Foreign Body Forearm/Wrist (25248) |
$157.50 |
$157.50 |
0.1× |
| Exploration penetrating wound spx extremity (20103) |
$194.25 |
$194.25 |
0.1× |
| Explore & Treat Metacarpo-Phal Jt (26075) |
$761.25 |
$761.25 |
0.3× |
| Fetal Contraction Stress Test (59020) |
$210 |
$210 |
1.1× |
| Fetal non-stress test (59025) |
$210 |
$210 |
1.1× |
| I&d abscess simple (10060) |
$280.29 |
$280.29 |
1.5× |
| I&d pilonidal cyst simple (10080) |
$1,623.30 |
$1,623.30 |
2.5× |
| Incision & drainage abscess complicated/multiple (10061) |
$509.25 |
$509.25 |
1.4× |
| Incision & drainage pilonidal cyst complicated (10081) |
$591.15 |
$591.15 |
0.9× |
| Incision & removal foreign body subq tiss simple (10120) |
$349.65 |
$349.65 |
0.9× |
| Incision and drainage of bartholin's gland abscess (56420) |
$348.60 |
$348.60 |
1.9× |
| Incision thrombosed hemorrhoid external (46083) |
$168 |
$168 |
0.7× |
| Incisional biopsy skin single lesion (11106) |
$282.11 |
$282.11 |
0.4× |
| Initial tx 1st degree burn local tx (16000) |
$97.65 |
$97.65 |
0.5× |
| Inj paravert f jnt c/t 1 lev (64490) |
$1,173.38 |
$1,173.38 |
1.4× |
| Inj tendon sheath/ligament (20550) |
$146.48 |
$146.48 |
0.5× |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) |
$1,590.75 |
$1,590.75 |
2.0× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$259.09 |
$259.09 |
0.9× |
| Injection single/mlt trigger point 3/> muscles (20553) |
$310.80 |
$310.80 |
1.1× |
| Injection therapeutic carpal tunnel (20526) |
$315 |
$315 |
1.1× |
| Insert Bladder Cath Complex (51703) |
$351.75 |
$351.75 |
3.0× |
| Insert Drug Implant Device (11981) |
$359.93 |
$359.93 |
2.9× |
| Insert Temp Bladder Cath (51702) |
$140.70 |
$140.70 |
1.1× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$158.55 |
$158.55 |
1.3× |
| Late closure of wound (13160) |
$476.70 |
$476.70 |
0.1× |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
$1,281 |
$1,281 |
1.6× |
| Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) |
$2,499 |
$2,499 |
3.8× |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn (62320) |
$1,530.38 |
$1,530.38 |
2.4× |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) |
$1,749.30 |
$1,749.30 |
2.7× |
| Open Tx Distal Phalangeal Fracture Each (26765) |
$1,418.55 |
$1,418.55 |
0.5× |
| Pelvic exam under anesthesia (57410) |
$264.60 |
$264.60 |
0.1× |
| Placement of needle for intraosseous infusion (36680) |
$262.50 |
$262.50 |
0.6× |
| Punch biopsy skin single lesion (11104) |
$233.11 |
$233.11 |
0.6× |
| Puncture Aspiration Cyst Breast (19000) |
$239.40 |
$239.40 |
0.4× |
| Removal fb intranasal (30300) |
$265.65 |
$265.65 |
2.2× |
| Removal Foreign Body Foot Complicated (28193) |
$472.50 |
$472.50 |
0.3× |
| Removal foreign body foot subcutaneous (28190) |
$521.85 |
$521.85 |
0.8× |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
$484.05 |
$484.05 |
0.3× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$49.56 |
$49.56 |
0.9× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$112.35 |
$112.35 |
2.1× |
| Removal Implant Deep (20680) |
$1,358.70 |
$1,358.70 |
0.5× |
| Removal Implant Superficial Separate Procedure (20670) |
$378 |
$378 |
0.2× |
| Removal of intrauterine device (iud) (58301) |
$240.45 |
$240.45 |
0.9× |
| Removal of nail bed (11750) |
$456.75 |
$456.75 |
1.2× |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
$208.42 |
$208.42 |
1.1× |
| Removal/bivalving full arm/full leg cast (29705) |
$162.75 |
$162.75 |
0.6× |
| Removal/bivalving gauntlet boot/body cast (29700) |
$94.50 |
$94.50 |
0.4× |
| Remove drug implant device (11982) |
$350.69 |
$350.69 |
0.9× |
| Remv Ext Canal Foreign Body (69200) |
$273 |
$273 |
2.2× |
| Remv F.B.,Eye,Superf Conjunc (65205) |
$135.45 |
$135.45 |
1.1× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
$334.95 |
$334.95 |
0.5× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
$472.50 |
$472.50 |
0.7× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$717.15 |
$717.15 |
1.9× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$1,005.99 |
$1,005.99 |
2.7× |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
$178.50 |
$178.50 |
0.5× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$1,121.40 |
$1,121.40 |
3.0× |
| Repair complex trunk 1.1-2.5 cm (13100) |
$178.50 |
$178.50 |
0.3× |
| Repair complex trunk 2.6-7.5 cm (13101) |
$252 |
$252 |
0.4× |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
$336 |
$336 |
0.9× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$459.90 |
$459.90 |
1.2× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$525 |
$525 |
1.4× |
| Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) |
$446.25 |
$446.25 |
1.2× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$236.25 |
$236.25 |
0.6× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$288.75 |
$288.75 |
0.8× |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) |
$472.50 |
$472.50 |
1.3× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$262.50 |
$262.50 |
0.4× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$442.05 |
$442.05 |
1.2× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$585.90 |
$585.90 |
1.6× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$660.45 |
$660.45 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) |
$393.75 |
$393.75 |
0.2× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$262.50 |
$262.50 |
0.7× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$328.65 |
$328.65 |
0.9× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$457.80 |
$457.80 |
1.2× |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
$341.25 |
$341.25 |
0.5× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$570.15 |
$570.15 |
1.5× |
| Repair intermediate s/a/t/e >30.0 cm (12037) |
$393.75 |
$393.75 |
0.2× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$183.75 |
$183.75 |
0.4× |
| Rmvl foreign body muscle/tendon sheath deep/comp (20525) |
$367.50 |
$367.50 |
0.1× |
| Rmvl w/rinsj non-biodegradable drug dlvr implt (11983) |
$435.68 |
$435.68 |
1.1× |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
$341.25 |
$341.25 |
0.5× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) |
$162.75 |
$162.75 |
0.9× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) |
$141.75 |
$141.75 |
0.8× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) |
$140.70 |
$140.70 |
0.8× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) |
$190.05 |
$190.05 |
1.0× |
| Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) |
$143.85 |
$143.85 |
0.4× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) |
$163.80 |
$163.80 |
0.9× |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) |
$183.75 |
$183.75 |
1.0× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
$1,127.70 |
$1,127.70 |
3.0× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$351.75 |
$351.75 |
1.9× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$372.75 |
$372.75 |
2.0× |
| Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) |
$325.50 |
$325.50 |
0.9× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$470.40 |
$470.40 |
2.5× |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
$613.20 |
$613.20 |
3.3× |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
$430.50 |
$430.50 |
2.3× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$345.45 |
$345.45 |
1.9× |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
$236.25 |
$236.25 |
1.3× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$395.85 |
$395.85 |
2.1× |
| Skin splt grft trnk/arm/leg (15100) |
$2,130.45 |
$2,130.45 |
1.1× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$364.35 |
$364.35 |
2.0× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$543.90 |
$543.90 |
1.5× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$654.15 |
$654.15 |
1.7× |
| Spinal puncture lumbar diagnostic (62270) |
$458.33 |
$458.33 |
0.7× |
| Strapping ankle (29540) |
$315 |
$315 |
2.1× |
| Strapping knee (29530) |
$205.80 |
$205.80 |
1.7× |
| Strapping shoulder (29240) |
$315 |
$315 |
2.6× |
| Tangential biopsy skin single lesion (11102) |
$211.91 |
$211.91 |
0.6× |
| Treat Fracture Radius & Ulna (25560) |
$236.25 |
$236.25 |
1.0× |
| Treat humerus fracture (23600) |
$262.50 |
$262.50 |
1.2× |
| Treat wrist bone fracture (25622) |
$105 |
$105 |
0.5× |
| Trim skin lesion (11055) |
$90.83 |
$90.83 |
0.5× |
| Trimming Of Nondystrophic Nails, Any Number (11719) |
$64.05 |
$64.05 |
1.2× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
$550.20 |
$550.20 |
0.8× |
| Tx superficial wound dehiscence w/packing (12021) |
$131.25 |
$131.25 |
0.4× |
| Unlisted craniofacial & maxillofacial procedure (21299) |
$399 |
$399 |
1.8× |
| Vaginal delivery only (59409) |
$2,005.50 |
$2,005.50 |
0.7× |
| Venipuncture (36415) |
$21 |
$21 |
2.2× |