| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
$364.20 |
$607 |
0.4× |
| Ablate inf turbinate submuc (30802) |
$577.20 |
$962 |
0.4× |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) |
$1,220.40 |
$2,034 |
0.4× |
| Application finger splint static (29130) |
$82.20 |
$137 |
0.6× |
| Application long arm splint shoulder hand (29105) |
$174 |
$290 |
1.1× |
| Application Long Leg Splint (29505) |
$168.60 |
$281 |
1.0× |
| Application short arm splint forearm-hand static (29125) |
$128.40 |
$214 |
1.0× |
| Application short leg splint calf foot (29515) |
$142.20 |
$237 |
0.9× |
| Apply long arm cast (29065) |
$190.20 |
$317 |
0.7× |
| Apply Short Leg Cast (29405) |
$160.80 |
$268 |
0.6× |
| Arterial puncture (36600) |
$39.60 |
$66 |
0.3× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$95.40 |
$159 |
0.3× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$118.80 |
$198 |
0.4× |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
$172.20 |
$287 |
0.6× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$91.80 |
$153 |
0.3× |
Arthroplasty glenohumeral joint total shoulder (23472)
likely a partial charge, not the full procedure |
$2,500.80 |
$4,168 |
0.1× |
| Arthroscopy Knee Synovectomy 2/>Compartments (29876) |
$1,131.60 |
$1,886 |
0.3× |
| Arthroscopy shoulder distal claviculectomy (29824) |
$1,175.40 |
$1,959 |
0.4× |
Arthroscopy, shoulder, surgical; biceps tenodesis (29828)
likely a partial charge, not the full procedure |
$1,584.60 |
$2,641 |
0.2× |
| Arthroscopy, shoulder, surgical; debridement, extensive (29823) |
$1,155.60 |
$1,926 |
0.4× |
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827)
unusually low: confirm this is the full procedure |
$2,168.40 |
$3,614 |
0.3× |
| Arthrs knee debridement/shaving artclr crtlg (29877) |
$1,077.60 |
$1,796 |
0.3× |
Aspirate pleura w/ imaging (32555)
range across 2 matching MRF lines |
$718.80–$1,225.80 |
$1,198–$2,043 |
varies |
| Aspirate Pleura W/O Imaging (32554) |
$403.80 |
$673 |
0.6× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$233.40 |
$389 |
1.2× |
| Biopsy of breast; open, incisional (19101) |
$570.60 |
$951 |
0.1× |
| Biopsy/removal lymph nodes (38510) |
$915 |
$1,525 |
0.2× |
| Bladder Scan (51798) |
$130.20 |
$217 |
2.2× |
| Blood Transfusion Service (36430) |
$564.60 |
$941 |
1.3× |
| Bx breast 1st lesion us imag (19083) |
$2,688 |
$4,480 |
1.6× |
| Canthotomy Separate Procedure (67715) |
$456.60 |
$761 |
0.2× |
| Carpal Tunnel Surgery (64721) |
$771.60 |
$1,286 |
0.4× |
| Cataract surgery complex (66982) |
$1,659.60 |
$2,766 |
0.7× |
| Catheter aspiration nasotracheal spx (31720) |
$75 |
$125 |
0.3× |
| Change of Windpipe Airway (31502) |
$512.40 |
$854 |
2.2× |
| Chest tube placement (32551) |
$329.40 |
$549 |
0.2× |
| Circumcision w/clamp/oth dev w/block (54150) |
$109.20 |
$182 |
0.1× |
| Clear outer ear canal (69200) |
$160.80 |
$268 |
1.2× |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
$833.40 |
$1,389 |
0.5× |
| Closed Tx Calcaneal Fracture W/O Manipulation (28400) |
$493.20 |
$822 |
2.0× |
| Closed tx metatarsal fracture w/o manipulation (28470) |
$434.40 |
$724 |
1.8× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
$916.20 |
$1,527 |
0.6× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$585 |
$975 |
2.4× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$597.60 |
$996 |
2.4× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$949.80 |
$1,583 |
0.6× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
$216 |
$360 |
0.9× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$509.40 |
$849 |
2.1× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
$606.60 |
$1,011 |
2.5× |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
$391.20 |
$652 |
1.6× |
| Cltx post hip arthrp dislc w/o anes (27265) |
$727.80 |
$1,213 |
3.0× |
| Cltx prox fibula/shft fx w/o manj (27780) |
$604.20 |
$1,007 |
2.5× |
| Collect Blood From Catheter Venous Nos (36592) |
$67.80 |
$113 |
0.5× |
Collection of venous blood by venipuncture (36415)
range across 2 matching MRF lines |
$13.20–$16.20 |
$22–$27 |
varies |
| Colonoscopy w/submucosal inj (45381) |
$886.20 |
$1,477 |
0.7× |
| Colsc flx w/removal lesion by hot bx forceps (45384) |
$842.40 |
$1,404 |
0.7× |
| Control Nasal Hemorrhage Anterior Complex (30903) |
$424.80 |
$708 |
3.2× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$271.80 |
$453 |
2.1× |
| Crnl Relaxing Inc Corrj Induced Astigmatism (65772) |
$941.40 |
$1,569 |
0.9× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$672 |
$1,120 |
5.1× |
| Cysto calibration dilat urtl strix/stenosis (52281) |
$562.20 |
$937 |
0.3× |
| Cysto w/insert ureteral stent (52332) |
$940.80 |
$1,568 |
0.3× |
| Cysto W/Urtroscopy&/Pyeloscopy Dx (52351) |
$621 |
$1,035 |
0.2× |
Cysto/pyeloscopy bx&/fulguration pelivc lesion (52354)
likely a partial charge, not the full procedure |
$857.40 |
$1,429 |
0.2× |
Cysto/uretero w/lithotripsy (52356)
likely a partial charge, not the full procedure |
$855.60 |
$1,426 |
0.2× |
| Cystourethroscopy with biopsy (52204) |
$753 |
$1,255 |
0.4× |
| Deb Musc/Fascia 20 Sq Cm/< (11043) |
$399.60 |
$666 |
0.5× |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
$534.60 |
$891 |
0.3× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$259.80 |
$433 |
0.6× |
| Diagnostic sigmoidoscopy (45330) |
$319.20 |
$532 |
0.3× |
| Dise Dyn Eval Sleep Disordered Breathing Flx Dx (42975) |
$234 |
$390 |
0.1× |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
$365.40 |
$609 |
0.5× |
| Drainage Finger Abscess Complicated (26011) |
$830.40 |
$1,384 |
0.5× |
| Drainage of finger abscess simple (26010) |
$594 |
$990 |
3.0× |
| Drainage of gum lesion (41800) |
$574.80 |
$958 |
4.3× |
| Drainage of hematoma/fluid (10140) |
$324 |
$540 |
0.2× |
| Drainage of scrotum (54700) |
$370.80 |
$618 |
0.2× |
| Draw Blood Off Venous Device (36591) |
$79.80 |
$133 |
0.6× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$162 |
$270 |
0.8× |
| Dstrj lesion anus simple surg excision (46922) |
$541.20 |
$902 |
0.2× |
| Dstrj Lesion Anus Smpl Eltrdsiccation (46910) |
$513.60 |
$856 |
0.3× |
| Dstrj lesion penis simple surg excision (54060) |
$335.40 |
$559 |
0.2× |
| Dx Laryngoscopy Excl Nb (31525) |
$514.20 |
$857 |
0.3× |
| Dx lmbr spi pnxr w/fluor/CT (62328) |
$1,111.80 |
$1,853 |
1.6× |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) |
$1,903.80 |
$3,173 |
1.0× |
| Egd cautery tumor polyp (43250) |
$777 |
$1,295 |
0.4× |
| Egd Flexible Foreign Body Removal (43247) |
$661.80 |
$1,103 |
0.7× |
| Egd remove lesion snare (43251) |
$854.40 |
$1,424 |
0.4× |
| Endometrial Biopsy (58100) |
$213.60 |
$356 |
1.1× |
| Evacuation of subungual hematoma (11740) |
$98.40 |
$164 |
0.7× |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) |
$246.60 |
$411 |
0.3× |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) |
$221.40 |
$369 |
0.1× |
| Exc Rct Tum Not Incl Muscularis Propria (45171) |
$1,214.40 |
$2,024 |
0.4× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
$341.40 |
$569 |
0.5× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
$548.40 |
$914 |
0.3× |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
$296.40 |
$494 |
0.4× |
| Exc tumor soft tis neck/ant thorax subq 3 cm/> (21552) |
$772.20 |
$1,287 |
0.3× |
| Exc Tumor Soft Tissue Neck/Ant Thorax Subfascial 5+Cm (21554) |
$1,264.20 |
$2,107 |
0.4× |
| Exc tumor soft tissue neck/ant thorax subq <3cm (21555) |
$750 |
$1,250 |
0.5× |
| Exchange Intraocular Lens (66986) |
$1,897.20 |
$3,162 |
0.8× |
| Excision lesion mouth roof (42104) |
$431.40 |
$719 |
0.1× |
| Excision of ganglion, wrist (dorsal or volar); primary (25111) |
$567.60 |
$946 |
0.4× |
| Excision of hydrocele; unilateral (55040) |
$584.40 |
$974 |
0.2× |
Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve Facility (42415)
unusually low: confirm this is the full procedure |
$2,131.20 |
$3,552 |
0.4× |
| Excision olecranon bursa (24105) |
$628.20 |
$1,047 |
0.2× |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
$925.80 |
$1,543 |
0.6× |
| Excision tumor soft tissue shoulder subq 3 cm/> (23071) |
$827.40 |
$1,379 |
0.5× |
| Excision/destruction intranasal lesion int appr (30117) |
$1,679.40 |
$2,799 |
0.5× |
| Fetal non-stress test (59025) |
$267.60 |
$446 |
1.3× |
| Fluoro exam of g/colon tube (49465) |
$168 |
$280 |
0.7× |
| Goniotomy (65820) |
$1,412.40 |
$2,354 |
0.3× |
| Hysteroscopy Biopsy (58558) |
$2,543.40 |
$4,239 |
0.8× |
| I&d abscess simple (10060) |
$254.40 |
$424 |
1.3× |
| I&d perianal abscess superficial (46050) |
$407.40 |
$679 |
0.4× |
| Incise finger tendon sheath (26055) |
$1,020.60 |
$1,701 |
0.6× |
| Incision & drainage abscess complicated/multiple (10061) |
$406.20 |
$677 |
1.0× |
| Incision & removal foreign body subq tiss simple (10120) |
$302.40 |
$504 |
0.7× |
| Incision and drainage of vulva or perineal abscess (56405) |
$256.20 |
$427 |
0.8× |
| Incision of lingual frenum (frenotomy) (41010) |
$497.40 |
$829 |
0.3× |
| Incision of rectal abscess (46040) |
$1,075.80 |
$1,793 |
0.9× |
| Initial Tx 1st Degree Burn Local Tx (16000) |
$135.60 |
$226 |
0.7× |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
$277.20 |
$462 |
0.4× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$109.20 |
$182 |
0.4× |
| Injection single/mlt trigger point 3/> muscles (20553) |
$125.40 |
$209 |
0.4× |
| Injection, anesthetic agent; brachial plexus, single (64415) |
$233.40 |
$389 |
0.3× |
| Injection, anesthetic agent; femoral nerve, single (64447) |
$240.60 |
$401 |
0.3× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
$157.80 |
$263 |
0.2× |
| Insert Bladder Cath Complex (51703) |
$286.20 |
$477 |
2.2× |
| Insert Drug Implant Device (11981) |
$90.60 |
$151 |
0.7× |
| Insert non-tunnel cv cath (36556) |
$440.40 |
$734 |
0.1× |
Insert Picc W/O Sub-Q Port <5 Y/O (36568)
range across 3 matching MRF lines |
$2,965.20–$3,138.60 |
$4,942–$5,231 |
varies |
Insert Temp Bladder Cath (51702)
range across 2 matching MRF lines |
$125.40–$126.60 |
$209–$211 |
varies |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$305.40 |
$509 |
2.3× |
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569)
range across 3 matching MRF lines |
$649.80–$729.60 |
$1,083–$1,216 |
varies |
Intubation endotracheal emergency procedure (31500)
range across 2 matching MRF lines |
$299.40–$425.40 |
$499–$709 |
varies |
Laparoscopy aspiration (49322)
likely a partial charge, not the full procedure |
$747 |
$1,245 |
0.1× |
Laparoscopy, surgical, appendectomy (44970)
likely a partial charge, not the full procedure |
$1,208.40 |
$2,014 |
0.2× |
Laps abd prtm&omentum dx w/wo spec br/wa spx (49320)
likely a partial charge, not the full procedure |
$657.60 |
$1,096 |
0.1× |
| Largsc W/Njx Vocal Cord Ther W/Micro/Telescope (31571) |
$519.60 |
$866 |
0.1× |
| Laryngoscopy w/biopsy microscope/telescope (31536) |
$439.80 |
$733 |
0.1× |
| Larynscop w/tumr exc + scope (31541) |
$549.60 |
$916 |
0.1× |
| Laser vaporization of prostate (52648) |
$3,327 |
$5,545 |
0.6× |
| Ligation or biopsy temporal artery (37609) |
$649.20 |
$1,082 |
0.4× |
| Nasal/Orogastric W/Tube Plmt (43752) |
$83.40 |
$139 |
0.2× |
| Nasal/Sinus Ndsc Surg W/Dilation Frnt&Sphn Sinus (31298) |
$7,599.60 |
$12,666 |
1.1× |
| Needle Biopsy Lymph Nodes (38505) |
$903.60 |
$1,506 |
0.5× |
| Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) |
$449.40 |
$749 |
1.1× |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) |
$256.20 |
$427 |
0.8× |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
$337.80 |
$563 |
0.4× |
Nsl/sinus ndsc max antrost w/rmvl tiss max sinus (31267)
likely a partial charge, not the full procedure |
$557.40 |
$929 |
0.1× |
| Occipital Nerve Block (64405) |
$201 |
$335 |
0.7× |
Open Treatment Bimalleolar Ankle Fracture (27814)
likely a partial charge, not the full procedure |
$1,326.60 |
$2,211 |
0.2× |
Open Treatment Humeral Condylar Fracture (24579)
likely a partial charge, not the full procedure |
$1,448.40 |
$2,414 |
0.1× |
Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal… (25526)
likely a partial charge, not the full procedure |
$1,656.60 |
$2,761 |
0.2× |
Open Tx Distal Fibular Fracture Lat Malleolus (27792)
likely a partial charge, not the full procedure |
$1,120.80 |
$1,868 |
0.2× |
Open Tx Humeral Epicondylar Fracture (24575)
likely a partial charge, not the full procedure |
$1,272 |
$2,120 |
0.1× |
| Open tx interphalangeal joint dislocation (26785) |
$955.80 |
$1,593 |
0.3× |
Partial removal of thyroid (60220)
likely a partial charge, not the full procedure |
$1,225.20 |
$2,042 |
0.2× |
| Placement of needle for intraosseous infusion (36680) |
$126 |
$210 |
0.3× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
$256.20 |
$427 |
0.6× |
| Puncture Aspiration Cyst Breast (19000) |
$629.40 |
$1,049 |
0.9× |
| Push Transfusion Blood 2 Yr/Under (36440) |
$444 |
$740 |
1.0× |
| Removal Foreign Body Foot Subcutaneous (28190) |
$516 |
$860 |
0.7× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$26.40 |
$44 |
0.4× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$96 |
$160 |
1.6× |
| Removal, under anesthesia, of external fixation system (20694) |
$744.60 |
$1,241 |
0.5× |
| Remove foreign body from eye (65205) |
$112.80 |
$188 |
0.9× |
| Remove Nasal Foreign Body (30300) |
$363.60 |
$606 |
2.7× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$816 |
$1,360 |
2.0× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$735.60 |
$1,226 |
1.8× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$490.20 |
$817 |
1.2× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$546 |
$910 |
1.3× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$456 |
$760 |
1.1× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$535.80 |
$893 |
1.3× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$745.80 |
$1,243 |
1.8× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$454.20 |
$757 |
1.1× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$592.80 |
$988 |
1.5× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$577.20 |
$962 |
1.4× |
| Repair of nail bed (11760) |
$369.60 |
$616 |
0.5× |
| Repair tongue laceration (41250) |
$545.40 |
$909 |
1.2× |
| Rmvl Lens Material Phacofragmentation Aspir (66850) |
$1,654.80 |
$2,758 |
0.7× |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
$467.40 |
$779 |
0.3× |
Rplcmt Compl Prph Cvc W/O Subq Port/Pmp (36584)
range across 2 matching MRF lines |
$907.80–$944.40 |
$1,513–$1,574 |
varies |
| Rpr Aa Hernia 1st < 3 Cm Reducible (49591) |
$708 |
$1,180 |
0.2× |
Rpr aa hrn 1st 3-10 rdc (49593)
likely a partial charge, not the full procedure |
$1,186.20 |
$1,977 |
0.2× |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) |
$297.60 |
$496 |
1.5× |
| Rpr Lip Full Thickness Half/< Vertical Height (40652) |
$993.60 |
$1,656 |
1.9× |
| Rpr Lip Full Thickness Vermilion Only (40650) |
$829.80 |
$1,383 |
1.5× |
| Rpr Nsl Vlv Collapse W/Implt (30468) |
$6,352.20 |
$10,587 |
1.1× |
| Septoplasty/Submucous Resecj W/WO Cartilage Grf (30520) |
$1,302.60 |
$2,171 |
0.4× |
| Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) |
$515.40 |
$859 |
0.4× |
| Shoulder Arthroscopy/Surgery (29825) |
$1,018.80 |
$1,698 |
0.3× |
| Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) |
$640.20 |
$1,067 |
0.7× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$218.40 |
$364 |
1.1× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$228.60 |
$381 |
1.1× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$247.20 |
$412 |
1.2× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$178.80 |
$298 |
0.9× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$254.40 |
$424 |
1.3× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$217.80 |
$363 |
1.1× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$305.40 |
$509 |
0.8× |
Spinal puncture lumbar diagnostic (62270)
range across 2 matching MRF lines |
$280.20–$442.80 |
$467–$738 |
varies |
| Submucous Rescj Inferior Turbinate Prtl/Compl (30140) |
$572.40 |
$954 |
0.2× |
| Surg nasopharyngoscopy dilat eustachian tube bi (69706) |
$6,198.60 |
$10,331 |
1.1× |
Suture of quadriceps or hamstring muscle rupture primary (27385)
likely a partial charge, not the full procedure |
$1,056 |
$1,760 |
0.1× |
Tenodesis long tendon biceps (23430)
likely a partial charge, not the full procedure |
$1,291.80 |
$2,153 |
0.2× |
| Ther Spi Pnxr Csf Fluor/Ct (62329) |
$1,111.80 |
$1,853 |
1.6× |
| Tonsillectomy and adenoidectomy; age 12 or over (42821) |
$691.80 |
$1,153 |
0.2× |
Treat Fx Rad Extra-Articul (25607)
likely a partial charge, not the full procedure |
$1,287 |
$2,145 |
0.2× |
| Treat Knuckle Dislocation (26700) |
$601.20 |
$1,002 |
2.4× |
| Tx Gastro Intub W/Asp (43753) |
$183 |
$305 |
0.9× |
Tx Superficial Wound Dehiscence Simple Closure (12020)
range across 2 matching MRF lines |
$421.20–$517.80 |
$702–$863 |
varies |
| Tx superficial wound dehiscence w/packing (12021) |
$306 |
$510 |
0.8× |
| Tympanostomy general anesthesia (69436) |
$277.80 |
$463 |
0.2× |
| Uvulectomy excision of uvula (42140) |
$538.80 |
$898 |
0.2× |
| Vulvectomy simple partial (56620) |
$1,017.60 |
$1,696 |
0.3× |
Xcapsl ctrc rmvl insj io lens prosth insj 1+ (66991)
likely a partial charge, not the full procedure |
$1,411.20 |
$2,352 |
0.3× |