| 2d tee w or w/o fol w/con,in (C8925) |
— |
$2,990 |
— |
| 2d tte w or w/o fol w/con,co (C8923) |
— |
$1,273 |
— |
| 2d tte w or w/o fol w/con,fu (C8924) |
— |
$965 |
— |
| Adm tocilizu covid-19 1st (M0249) |
— |
$450 |
— |
| Adm tocilizu covid-19 2nd (M0250) |
— |
$450 |
— |
| Admin hepatitis b vaccine (G0010) |
— |
$88 |
— |
| Admin influenza virus vac (G0008) |
— |
$88 |
— |
| Admin pneumococcal vaccine (G0009) |
— |
$88 |
— |
| Ca screen;flexi sigmoidscope (G0104) |
— |
$700 |
— |
| Catheterize for urine spec (P9612) |
— |
$99 |
— |
| Colon ca scrn not hi rsk ind (G0121) |
— |
$3,750 |
— |
| Colorectal scrn; hi risk ind (G0105) |
— |
$3,750 |
— |
| Covid-19 lab test non-cdc (U0002) |
— |
$143 |
— |
| Diab manage trn per indiv (G0108) |
— |
$100 |
— |
Diab manage trn ind/group (G0109)
range across 3 matching MRF lines |
— |
$17–$300 |
— |
| Direct refer hospital observ (G0379) |
— |
$447 |
— |
Drug test def 1-7 classes (G0480)
range across 111 matching MRF lines |
— |
$309–$828 |
— |
| Drug test def 22+ classes (G0483) |
— |
$1,227 |
— |
| Drug test def 8-14 classes (G0481) |
— |
$940 |
— |
| Elec stim other than wound (G0283) |
— |
$54 |
— |
| Fecal microbiota prep instil (G0455) |
— |
$3,794 |
— |
| Fern test (Q0114) |
— |
$48 |
— |
| Group mnt 2 or more 30 mins (G0271) |
— |
$38 |
— |
| Hbot, full body chamber, 30m (G0277) |
— |
$1,754 |
— |
| Hopd mntl hlt, 15-29 min (C7900) |
— |
$27 |
— |
| Hospital outpt clinic visit (G0463) |
— |
$281 |
— |
| Mnt subs tx for change dx (G0270) |
— |
$68 |
— |
| Mra w/cont, abd (C8900) |
— |
$3,187 |
— |
| Mra w/cont, chest (C8909) |
— |
$3,187 |
— |
| Mra w/cont, lwr ext (C8912) |
— |
$3,187 |
— |
| Mra w/cont, pelvis (C8918) |
— |
$3,187 |
— |
| Mra w/o cont, abd (C8901) |
— |
$1,904 |
— |
| Mra w/o cont, chest (C8910) |
— |
$1,904 |
— |
| Mra w/o cont, lwr ext (C8913) |
— |
$1,904 |
— |
| Mra w/o cont, pelvis (C8919) |
— |
$1,904 |
— |
| Mra w/o fol w/cont, abd (C8902) |
— |
$3,187 |
— |
| Mra w/o fol w/cont, chest (C8911) |
— |
$3,187 |
— |
| Mra w/o fol w/cont, lwr ext (C8914) |
— |
$3,187 |
— |
| Mra w/o fol w/cont, pelvis (C8920) |
— |
$3,187 |
— |
| Mra, w/dye, upper extremity (C8934) |
— |
$3,187 |
— |
| Mra, w/o dye, upper extr (C8935) |
— |
$1,904 |
— |
| Mra, w/o&w/dye, upper extr (C8936) |
— |
$3,187 |
— |
| Prolonged iv inf, req pump (C8957) |
— |
$1,197 |
— |
| Prostate biopsy, any mthd (G0416) |
— |
$359 |
— |
| Psa screening (G0103) |
— |
$96 |
— |
Tomosynthesis, mammo (G0279)
range across 4 matching MRF lines |
— |
$116–$414 |
— |
| Tte w or w/o fol w/con,stres (C8928) |
— |
$2,352 |
— |
| Tte w or wo fol wcon,doppler (C8929) |
— |
$1,112 |
— |