ID
|
Description
|
Standard Charge
|
64415AN2
|
N BLOCK, INTERSCALINE
|
$500
|
64415ANS
|
N BLOCK, INFRACLAVICULAR
|
$500
|
64417ANS
|
N BLOCK, AXILLARY
|
$500
|
64418ANS
|
N BLOCK, SUPRASCAPULAR
|
$500
|
64445ANS
|
N BLOCK, POPLITEAL
|
$500
|
64447AN2
|
N BLOCK, SAPHENOUS
|
$500
|
64447ANS
|
N BLOCK, FEMORAL
|
$500
|
64450ANS
|
N BLOCK, ANKLE
|
$500
|
64450ANS2
|
ADDUCTOR CANAL BLOCK
|
$500
|
87015LAB
|
CONCENTRATE (FOR INFECTIOUS AGENTS)
|
$73.44
|
87040LAB
|
CULTURE, BLOOD
|
$113.52
|
87045LAB
|
CULTURE, STOOL
|
$103.76
|
87070L02
|
CULTURE, CATH
|
$94.72
|
87070L03
|
CULTURE, CSF
|
$94.72
|
87070L04
|
CULTURE, EAR
|
$94.72
|
87070L05
|
CULTURE, EYE
|
$94.72
|
87070L06
|
CULTURE, MISC
|
$94.72
|
87070L07
|
CULTURE, NASAL
|
$94.72
|
87070L08
|
CULTURE, SPUTUM
|
$94.72
|
87070L09
|
CULTURE, THROAT
|
$94.72
|
87070L10
|
CULTURE, VAGINAL (CERVIX)
|
$94.72
|
87070L11
|
CULTURE, WOUND
|
$94.72
|
87070LAB
|
CULTURE, BODY FLUID
|
$94.72
|
87073LAB
|
CULTURE, ANAEROBIC
|
$103.76
|
87077LAB
|
ORGANISM ID
|
$88.88
|
87081L03
|
MRSA - SELECT (NASAL)
|
$72.96
|
87086LAB
|
URINE COLONY COUNT
|
$88.8
|
87088LAB
|
CULTURE, URINE
|
$89.04
|
87102LAB
|
CULTURE, FUNGUS
|
$92.4
|
87116LAB
|
CULTURE, AFB
|
$79.92
|
87177LAB
|
OVA & PARASITES IDENTIFICATION (STOOL)
|
$97.84
|
87185L4
|
BETA LACTOMASE
|
$52.24
|
87186LAB
|
SENSITIVITY STUDIES
|
$95.04
|
87205L02
|
GRAM STAIN
|
$25.76
|
87205LAB
|
FECAL WBC
|
$25.76
|
87206LAB
|
AFB STAIN
|
$59.12
|
87209LAB
|
COMPLEX SPECIAL STAIN; TRICHROME
|
$197.68
|
87210L02
|
WET MOUNT
|
$46.96
|
87252LAB
|
CULTURE TISSUE
|
$243.2
|
87255LAB
|
HERPES SIMPLEX VIRUS CULTURE
|
$166.36
|
87272LAB
|
INFECTIOUS AGENT ANTIGEN DETECT; CRYPTOS
|
$131.92
|
87280LAB
|
RESPIRATORY SYNCYTIAL VIRUS RSU Ag
|
$131.92
|
87324LAB
|
C DIFFICILE TOXIN
|
$131.92
|
87328LAB
|
Cryptosporidium Antigen, EIA
|
$130.88
|
87329LAB
|
GIARDIA ANTIGEN
|
$131.92
|
87338LAB
|
H. PYLORI ANTIBODIES (STOOL)
|
$158.16
|
87389LAB
|
HIV 1/2 AG & AB 4TH GEN W REFLEX
|
$197.16
|
87449LAB
|
C DIFF ANTIGEN
|
$131.92
|
87493LAB
|
CLOSTRIDIUM DIFFICILE TOXIN B QUAL PCR
|
$214.16
|
87497LAB
|
CYTOMEGALOVINO QUANT
|
$288
|
87517LAB
|
HEPATITIS B DNA QUANT (PCR)
|
$235.62
|
87522L2
|
HEP C QUANT PCR w/REFLEX GENOTYPE LIPA
|
$233.76
|
87522LAB
|
HEPATITIS C qUANT
|
$235.52
|
87529LAB
|
HSV 1 & 2 DNA REAL TIME PCR
|
$264
|
87536LAB
|
HIV-1 RNA, QN REAL TIME PCR
|
$260
|
87590LAB
|
GONORRHEA DNA PROBE
|
$216.88
|
87660LAB
|
TRRCHOMONAS VAGINALIS
|
$176.88
|
87661LAB
|
TRICHOMONAS, MALES
|
$214.16
|
87799LAB
|
BK VIRUS DNA QUANT
|
$235.52
|
87804LAB
|
INFLUENZA A AND B
|
$131.92
|
87880LAB
|
RAPID STREP (QW)
|
$131.92
|
87902LAB
|
HEP C VIRAL RNA GENOTYPE
|
$479.52
|
36430L2
|
BLOOD ADMINISTRATION LEVEL 2
|
$592.7
|
36430L3
|
BLOOD ADMINISTRATION LEVEL 3
|
$792.7
|
36430L4
|
BLOOD ADMINISTRATION LEVEL 4
|
$992.7
|
36430LAB
|
BLOOD, ADMINISTRATION LEVEL 1
|
$392.7
|
86880LAB
|
COOMBS DIRECT
|
$59.12
|
86885LAB
|
COOMBS INDIRECT
|
$62.96
|
P9016LAB
|
RED BLOOD CELLS, LEUKOCYTES
|
$728
|
P9034LAB
|
PLATELET, PHERESIS
|
$785.4
|
80048LAB
|
BMP
|
$93.04
|
80051LAB
|
ELECTROLYTE PANEL
|
$77.12
|
80053LAB
|
CMP
|
$116.24
|
80061LAB
|
LIPID PROFILE
|
$147.36
|
80069LAB
|
RENAL FUNCTION PANEL
|
$95.52
|
80074LAB
|
HEPATITIS PANEL
|
$523.76
|
80076LAB
|
LIVER PROFILE (LFT)
|
$89.84
|
80100L2
|
URINE DRUG SCREEN
|
$56.95
|
80156LAB
|
TEGRETOL (CARBAMAZEPINE)
|
$160.16
|
80158LAB
|
CYCLOSPORIN
|
$65.44
|
80162LAB
|
DIGOXIN (LANOXIN)
|
$146
|
80164LAB
|
DEPAKENE (DEPAKOTE) (VALPORIC)
|
$149.04
|
80168LAB
|
ETHOSUXIMIDE
|
$179.76
|
80170LAB
|
GENTAMYCIN
|
$180.24
|
80175LAB
|
LAMICTAIL
|
$144.72
|
80178LAB
|
LITHIUM
|
$72.72
|
80184LAB
|
PHENOBARBITAL
|
$125.92
|
80185LAB
|
DILATIN (PHENYTION)
|
$145.76
|
80197LAB
|
TACROLIMUS (PROGRAF)
|
$150.96
|
80198LAB
|
THEOPHYLLINE
|
$155.6
|
80201LAB
|
TOPAMAX TOPIRAMATE
|
$131.12
|
80202LAB
|
VANCOMYCIN
|
$149.04
|
80307L4
|
DRUG SCREEN URINE
|
$303.36
|
80320LAB
|
ETHANOL
|
$118.8
|
80323LAB
|
ALKALOIDS, NOT OTHERWISE SPECIFIED
|
$193.86
|
80327LAB
|
DIHYDROTESTOSTERONE
|
$202.5
|
80329L2
|
ACETAMINOPHEN
|
$222.56
|
80329LAB
|
SALICYLATE
|
$78
|
80375LAB
|
TPMT ACTIVITY
|
$550.06
|
82009L02
|
URINE ACETONE
|
$49.68
|
82010LAB
|
BETA HYDROXYBUTYRATE
|
$89.2
|
82024LAB
|
ACTH
|
$212.4
|
82040LAB
|
ALBUMIN
|
$54.4
|
82043LAB
|
URINE MICRO ALBUMIN
|
$63.6
|
82085LAB
|
ALDOLASE
|
$106.72
|
82088LAB
|
ALDOSTERONE
|
$224.08
|
82103LAB
|
ALPHA-1-ANTITRYPSIN TOTAL
|
$147.76
|
82104LAB
|
ALPHA-1=ANTITRYPSIN PHENOTYPE
|
$157.84
|
82105LAB
|
ALPHA FETAL PROTEIN
|
$184.48
|
82140LAB
|
AMMONIA
|
$160.24
|
82150LAB
|
AMYLASE
|
$71.28
|
82164LAB
|
ANGIOTENSIN 1, (ACE)
|
$160.56
|
82172L2
|
APOLIPOPROTEIN B
|
$169.12
|
82175LAB
|
ARSENIC
|
$128.48
|
82247LAB
|
BILIRUBIN TOTAL
|
$55.2
|
82248LAB
|
BILIRUBIN DIRECT/INDIRECT
|
$55.2
|
82272LAB
|
OCCULT BLOOD (STOOL)
|
$35.84
|
82306L2
|
VITAMIN D 25 HYDOXY D2, D3
|
$242.4
|
82306LAB
|
VITAMIN D-25 HYDROXY
|
$325.6
|
82310LAB
|
CALCIUM
|
$56.72
|
82330LAB
|
CALCIUM, IONIZED
|
$150.32
|
82397LAB
|
ALPHA SUBUNIT
|
$157.48
|
82435LAB
|
CHLORIDE
|
$50.56
|
82436LAB
|
URINE CHLORIDE
|
$55.28
|
82465LAB
|
CHOLESTEROL
|
$47.84
|
82495LAB
|
CHROMIUM
|
$223.04
|
82507LAB
|
CITRIC ACID 24 URINE
|
$229.32
|
82523LAB
|
N-TELOPEPTICLE URINE
|
$205.52
|
82525LAB
|
COPPER
|
$136.48
|
82530L2
|
CORTISOL, FREE
|
$183.76
|
82533LAB
|
CORTISOL LEVEL
|
$179.28
|
82540LAB
|
24 URINE CREATINE
|
$50.96
|
82550LAB
|
CPK
|
$71.6
|
82552LAB
|
CREATINE KINASE ISOENZYME
|
$146.24
|
82553LAB
|
CKMB
|
$126.96
|
82565LAB
|
CREATININE
|
$56.32
|
82570LAB
|
URINE CREATININE
|
$56.88
|
82575LAB
|
24 HOUR CREATININE CLEARANCE
|
$103.92
|
82607LAB
|
VITAMIN B-12
|
$165.76
|
82608LAB
|
VITAMIN B12 BINDING CAPACITY
|
$156.32
|
82627LAB
|
DHEA SULFATE
|
$181.98
|
82652LAB
|
VITAMIN D, 1, 25 DIHYDROXY
|
$423.36
|
82656LAB
|
PANCREATIC ELASTASE
|
$116.64
|
82668LAB
|
ERYTHROPOIETIN
|
$206.72
|
82670LAB
|
ESTRADIOL
|
$307.28
|
82672LAB
|
ESTROGEN
|
$238.56
|
82705LAB
|
FECAL FAT QUAL
|
$55.92
|
82728LAB
|
FERRITIN
|
$149.84
|
82746LAB
|
FOLATE
|
$161.68
|
82747LAB
|
FELATE BBC
|
$190.48
|
82784L02
|
IGG
|
$102.24
|
82784L03
|
IGM
|
$102.24
|
82784LAB
|
IGA
|
$102.24
|
82785LAB
|
IGE
|
$181.12
|
82787L2
|
IgG SUBCLASS 2
|
$66.18
|
82787L3
|
IgG SUBCLASS 3
|
$66.18
|
82787L4
|
IgG SUBCLASS 4
|
$66.18
|
82787LAB
|
IgG SUBCLASS 1
|
$66.18
|
82945L02
|
SYNOVIAL FLUID GLUCOSE
|
$43.12
|
82945LAB
|
GLUCOSE CSF
|
$43.12
|
82947LAB
|
GLUCOSE
|
$43.12
|
82948LAB
|
REAGENT STRIP/BLOOD GLUCOSE
|
$34.8
|
82950LAB
|
GLUCOSE POSTPRANDIAL 1 HOUR
|
$52.24
|
82951LAB
|
GLUCOSE TOLERANCE TEST- 2HR
|
$141.52
|
82952LAB
|
GLUCOSE TOLERANCE TEST- 3HR
|
$43.12
|
82955LAB
|
GLUCOSE-6 PHOSPATE DEHYDROGENASE , QUANT
|
$85.76
|
82977LAB
|
GGT
|
$79.2
|
82985LAB
|
FRUTOSAMINE
|
$148.88
|
83001LAB
|
FOLLICE STIMULATING HORMONE (FSH)
|
$204.32
|
83002LAB
|
LUTEINIZING HORMONE
|
$203.68
|
83009LAB
|
H PYLORI; UREASE
|
$148.72
|
83010LAB
|
HAPTOGLOBIN
|
$40.96
|
83013LAB
|
H PYLORI BREATH TEST
|
$740.72
|
83018LAB
|
COBALT
|
$241.52
|
83021ALAB
|
HEMOGLOBINOPATHY
|
$66
|
83036LAB
|
GLYCOHEMOGLOBIN (A1C)
|
$106.72
|
83090LAB
|
HOMOCYSTEINE LEVEL
|
$185.52
|
83516L2
|
TRONSGLUTAMINASE ANTIBODIES AB(IGA)
|
$117.44
|
83516L3
|
TRANSGLUTAMINOSE AB (IGA)
|
$117.44
|
83516L4
|
ANTIPHOSPHOLIPID Ab IgG
|
$116.64
|
83516LAB
|
CENTROMERE
|
$117.52
|
83519L6
|
PTH RELATED PROTEIN
|
$147.12
|
83519L7
|
TRYPSIN
|
$147.44
|
83519LAB
|
ACETYLCHOLINE RECEPTOR BINDING ANTIBODY
|
$148.56
|
83520L6
|
ANTI IgE ANTIBODY
|
$210
|
83520LAB
|
GLOMERULAR BASEMENT MEMBRANCE
|
$120
|
83525LAB
|
INSULIN
|
$125.68
|
83540LAB
|
IRON
|
$71.2
|
83550LAB
|
IRON BINDING CAPACITY (TIBC)
|
$96.16
|
83605L2
|
LACTIC ACID
|
$80.16
|
83605LAB
|
LACTIC ACID
|
$117.44
|
83615LAB
|
LDH
|
$66.4
|
83655LAB
|
LEAD (BLOOD)
|
$133.12
|
83690LAB
|
LIPASE
|
$75.76
|
83695LAB
|
LIPOPROTEIN A
|
$142.4
|
83704LAB
|
DMR LIPOPROFILE
|
$173.44
|
83721LAB
|
LDL CHOLESTEROL
|
$104.88
|
83735LAB
|
MAGNESIUM (MG)
|
$73.68
|
83789LAB
|
TRILEPTAL (10-HYDROXYCARBAZEPINE)
|
$198.56
|
83825LAB
|
MERCURY
|
$108.8
|
83835LAB
|
24 HOUR METANEPHRINES
|
$186.32
|
83873LAB
|
MYELIN BOSIC PROKIN, CSF
|
$189.2
|
83874L2
|
Myoglobin Serum
|
$140.96
|
83874LAB
|
MYOGLOBIN URINE
|
$142
|
83880LAB
|
BNP B-TYPE NATRIURETIC PEPTIDE
|
$373.28
|
83883L2
|
FREE LAMBDA
|
$151.12
|
83916LAB
|
OLIGOCLONAL BANDS CSF
|
$219.44
|
83921LAB
|
METHYLMALONIC ACID
|
$179.6
|
83935LAB
|
OSMOLALITY URINE
|
$74.96
|
83945LAB
|
OXALIC ACID 24 URINE
|
$141.52
|
83970LAB
|
PARATHYROID HORMONE
|
$226.96
|
83993LAB
|
CALPROTECTIN, STOOL
|
$214.24
|
84080LAB
|
ALKALINE PHOSPHATASE ISOENZYMES
|
$56.48
|
84100LAB
|
PHOSPHORUS (PO4)
|
$52.16
|
84105LAB
|
PHOSPHATE 24 URINE
|
$56.88
|
84120LAB
|
PORPHYNNS URINE
|
$216.56
|
84132LAB
|
POTASSIUM (K+)
|
$50.56
|
84133LAB
|
URINE POTASSIUM (K+)
|
$47.28
|
84134LAB
|
PRE-ALBUMIN
|
$160.4
|
84140LAB
|
PREGNENOLONE
|
$170.52
|
84144LAB
|
PROGESTERONE
|
$224
|
84145LAB
|
PROCALCITONIN
|
$219.24
|
84146LAB
|
PROLACTIN
|
$213.12
|
84154LAB
|
PSA, FREE
|
$202.32
|
84156LAB
|
URINE TOTAL PROTEIN
|
$40.32
|
84157L02
|
SYNOVIAL FLUID PROTEIN
|
$40.32
|
84157LAB
|
CSF TOTAL PROTEIN
|
$40.32
|
84207LAB
|
VITAMIN B6 (pyridoxine)
|
$231.72
|
84244LAB
|
RENIN ACTIVITY PLASMA
|
$241.92
|
84270LAB
|
SEX HORMONE BLOCKING GLOBULIN
|
$179.22
|
84295LAB
|
SODIUM (NA+)
|
$52.96
|
84300L02
|
URINE SODIUM
|
$38
|
84305ALAB
|
INSULIN GROWTH IGF
|
$175.32
|
84311L2
|
CHYMOTRYPSIN
|
$69.04
|
84378LAB
|
GLYCOMARK
|
$126.72
|
84402LAB
|
TESTOSTERONE, FREE & TOTAL
|
$280
|
84403LAB
|
TESTOSTERONE
|
$283.92
|
84425LAB
|
THYAMIN, VITAMIN B1
|
$233.52
|
84432LAB
|
THYROGLOBULIN ANTIBODY
|
$176.64
|
84436LAB
|
T-4, TOTAL
|
$75.52
|
84439LAB
|
T-4, FREE
|
$99.2
|
84443LAB
|
TSH
|
$184.8
|
84446LAB
|
VITAMIN E (TOCOPHEROL)
|
$154.72
|
84450LAB
|
AST (SGOT)
|
$56.88
|
84460LAB
|
ALT (SGPT)
|
$58.16
|
84478LAB
|
TRIGLYCERIDES
|
$63.2
|
84479LAB
|
T-3, UPTAKE
|
$71.12
|
84480LAB
|
T-3, TOTAL
|
$140.24
|
84481LAB
|
T-3, FREE
|
$186.32
|
84482LAB
|
T 3 REVERSE
|
$173.36
|
84512LAB
|
TROPONIN I
|
$81.2
|
84520LAB
|
BUN
|
$43.44
|
84550LAB
|
URIC ACID
|
$49.68
|
84560L2
|
URIC ACID SYNOVIAL FLWD
|
$52.24
|
84630LAB
|
ZINC
|
$125.2
|
84681LAB
|
C-PEPTIDE
|
$174.8
|
84702LAB
|
HCG BETA QUANTATIVE
|
$70.56
|
84703LAB
|
SERUM PREGNANCY
|
$70.56
|
85303LAB
|
PROTEIN C ACTIVITY
|
$152.08
|
85306LAB
|
PROTEIN S ACTIVITY
|
$168.48
|
86300L02
|
CA 27-29
|
$228.88
|
86304LAB
|
CA 125
|
$228.88
|
86334LAB
|
IMMUNOFIXATION (SERUM)
|
$245.68
|
86480LAB
|
QUANTIFERON TB GOLD
|
$340.8
|
86705LAB
|
HEP B CORE IGM ANTIBODY
|
$129.44
|
86812LAB
|
B 27 (HLA)
|
$286.84
|
G0103LAB
|
PSA (TOTAL) SCREENING
|
$202.32
|
77012RAD
|
CT GUIDANCE FOR NEEDLE PLACEMENT
|
$307.75
|
71250RAD
|
CT THORAX W/O CONTRAST MATERIAL
|
$1364.02
|
71260RAD
|
CT THORAX W/CONTRAST MATERIAL
|
$1705.27
|
71270RAD
|
CT THORAX W/O &W/CONTRAST MATERIAL
|
$2063.74
|
71275RAD
|
CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTR
|
$2622.48
|
72125RAD
|
CT CERVICAL SPINE W/O CONTRAST MATERIAL
|
$1395.17
|
72126RAD
|
CT CERVICAL SPINE W/CONTRAST MATERIAL
|
$1702.68
|
72127RAD
|
CT CERVICAL SPINE W/O &W/CONTRAST MATERI
|
$2033.22
|
72128RAD
|
CT THORACIC SPINE W/O CONTRAST MATERIAL
|
$1365.7
|
72129RAD
|
CT THORACIC SPINE W/CONTRAST MATERIAL
|
$1709.05
|
72130RAD
|
CT THORACIC SPINE W/O & W/CONTRAST MATER
|
$2043.93
|
72131RAD
|
CT LUMBAR SPINE W/O CONTRAST MATERIAL
|
$1361.43
|
72132RAD
|
CT LUMBAR SPINE W/CONTRAST MATERIAL
|
$1704.78
|
72133RAD
|
CT LUMBAR SPINE W/O & W/CONTRAST MATERIA
|
$2033.22
|
72192RAD
|
CT PELVIS W/O CONTRAST MATERIAL
|
$1134.77
|
72193RAD
|
CT PELVIS W/CONTRAST MATERIAL
|
$1776.04
|
72194RAD
|
CT PELVIS W/O & W/CONTRAST MATERIAL
|
$1989.26
|
73200RAD
|
CT UPPER EXTREMITY W/O CONTRAST MATERIAL
|
$1357.3
|
73201RAD
|
CT UPPER EXTREMITY WITH CONTRAST
|
$1664.88
|
73202RAD
|
CT UPPER EXTREMITY W/O & W/CONTRAST MATE
|
$2113.3
|
73700RAD
|
CT LOWER EXTREMITY W/O CONTRAST MATERIAL
|
$1361.57
|
73701RAD
|
CT LOWER EXTREMITY W/CONTRAST MATERIAL
|
$1688.4
|
74150RAD
|
CT ABDOMEN W/O CONTRAST MATERIAL
|
$1160.81
|
74160RAD
|
CT ABDOMEN W/CONTRAST MATERIAL
|
$1808.66
|
74170RAD
|
CT ABDOMEN W/O &W/CONTRAST MATERIAL
|
$2081.38
|
74174RAD
|
CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTR
|
$3241.14
|
74175RAD
|
CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCON
|
$2637.04
|
74176RAD
|
CT ABDOMEN & PELVIS W/O CONTRAST MATERIA
|
$1503.81
|
74177RAD
|
CT ABDOEN & PELVIS W/CONTRAST MATERIAL
|
$2243.57
|
74178RAD
|
CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY
|
$2624.72
|
75635RAD
|
CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POS
|
$2923.06
|
76376RAD
|
3D RENDERING W/INTERP CT/MRI/US/OTHER TO
|
$383.53
|
70450RAD
|
CT HEAD/BRAIN W/O CONTRAST MATERIAL
|
$1073.24
|
70460RAD
|
CT HEAD/BRAIN W/CONTRAST MATERIAL
|
$1407.35
|
70470RAD
|
CT HEAD/BRAIN W/O&W/CONTRAST MATERIAL
|
$1425.83
|
70486RAD
|
CT MAXILLOFACIAL W/O CONTRAST MATERIAL
|
$1482.46
|
70487RAD
|
CT MAXILLOFACIAL W/CONTRAST MATERIAL
|
$1783.74
|
70490RAD
|
CT SOFT TISSUE NECK W/O CONTRAST MATERIA
|
$1449.63
|
70491RAD
|
CT SOFT TISSUE NECK W/CONTRAST MATERIAL
|
$1742.93
|
70492RAD
|
CT SOFT TISSUE NECK W/O &W/CONTRAST MATE
|
$2076.2
|
70496RAD
|
CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRA
|
$3238.48
|
70498RAD
|
CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRA
|
$3347.54
|
76010RAD
|
RADEX FROM NOSE RECTUM FOREIGN BODY 1 VI
|
$253.9
|
95941OR
|
NEUROMONITORING INTRAOPERATIVE 8 UNITS
|
$1300
|
J0585OR
|
INJECTION ONABOTULINUMTOXIN, 1 UNIT
|
$303.36
|
20610RAD
|
ARTHROCENTESIS, ASP/INJ JOINT/BURSA (SHO
|
$680
|
70100RAD
|
MANDIBLE, LESS THAN 4 VIEWS
|
$196.38
|
70110RAD
|
MANDIBLE, COMPLETE, MIN 4 VIEWS
|
$225.3
|
70140RAD
|
RADEX FACIAL BONES < 3 VIEWS
|
$170.88
|
70150RAD
|
RADEX FACIAL BONES COMPLETE MINIMUM 3 VI
|
$242.04
|
70160RAD
|
RADEX NASAL BONES COMPLETE MINIMUM 3 VIE
|
$190.62
|
70200RAD
|
RADEX ORBITS COMPLETE MINIMUM 4 VIEWS
|
$247.92
|
70210RAD
|
RADEX SINUSES PARANASAL < 3 VIEWS
|
$126.54
|
70220RAD
|
RADEX SINUSES PARANASAL COMPL MINIMUM 3
|
$221.64
|
70250RAD
|
RADIOLOGIC EXAMINATION SKULL < 4 VIEWS
|
$212.28
|
70260RAD
|
RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4
|
$267.54
|
70360RAD
|
RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
$157.62
|
71010RAD
|
RADIOLOGIC EXAMINATION CHEST SINGLE VIEW
|
$132.18
|
71020RAD
|
RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LA
|
$171.54
|
71021RAD
|
RADEX CH 2 VIEWS FRNT&LAT APICAL LORDOTI
|
$212.88
|
71045RAD
|
RADIOLOGIC EXAM CHEST SINGLE VIEW
|
$132.18
|
71046RAD
|
RADIOLOGIC EXAM CHEST 2 VIEWS FRONT & LA
|
$171.54
|
71047RAD
|
RADEX CHEST 3 VIEWS FRONT LA APIC LORDOT
|
$212.88
|
71100RAD
|
RADEX RIBS UNILATERAL 2 VIEWS
|
$184.38
|
71101RAD
|
RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3
|
$223.92
|
71110RAD
|
RADEX RIBS BILATERAL 3 VIEWS
|
$231.24
|
71111RAD
|
RADEX RIBS BI W/POSTEROANT CH MINIMUM 4
|
$332.46
|
71120RAD
|
RADEX STERNUM MINIMUM 2 VIEWS
|
$178.44
|
72040RAD
|
RADEX SPINE CERVICAL 2/3 VIEWS
|
$202.8
|
72050RAD
|
RADEX SPINE CERVICAL MINIMUM 4 VIEWS
|
$274.32
|
72052RAD
|
RADEX SPINE CRV COMPL W/OBLQ&FLEX&/XTN S
|
$352.38
|
72070RAD
|
RADEX SPINE THORACIC 2 VIEWS
|
$191.7
|
72072RAD
|
RADEX SPINE THORACIC 3 VIEWS
|
$210
|
72074RAD
|
RADEX SPINE THORACIC MINIMUM 4 VIEWS
|
$250.32
|
72080RAD
|
RADEX SPINE THORACOLUMBAR 2 VIEWS
|
$170.88
|
72081RAD
|
RADEX SPINE THORACOLMBR STANDING SCOLIOS
|
$216.18
|
72082RAD
|
RADEX SPINE SCOLIOS STUDY W/SUPINE&EREC
|
$344.76
|
72100RAD
|
RADEX SPINE LUMBOSACRAL 2/3 VIEWS
|
$204.66
|
72110RAD
|
RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS
|
$277.98
|
72114RAD
|
RADEX SPINE LUMBSCRL COMPL W/BENDING VIE
|
$362.58
|
72170RAD
|
RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
$275.2
|
72190RAD
|
RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 V
|
$246.6
|
72200RAD
|
RADIOLOGIC EXAMINATION SACROILIAC JNTS <
|
$168.66
|
72202RAD
|
RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE
|
$196.56
|
72220RAD
|
RADEX SACRUM & COCCYX MINIMUM 2 VIEWS
|
$165
|
72240RAD
|
MYELOGRAPY CERVICAL RS&I
|
$726.9
|
72255RAD
|
MYELOGRAPY THORACIC RS&I
|
$693.84
|
72265RAD
|
MYELOGRAPY LUMBOSACRAL RS&I
|
$712.38
|
72270RAD
|
MYELOGRAPY 2/MORE REGIONS RS&I
|
$1109.76
|
73000RAD
|
RADEX CLAVICLE COMPLETE
|
$164.76
|
73010RAD
|
RADEX SCAPULA COMPLETE
|
$183.42
|
73020RAD
|
RADEX SHOULDER 1 VIEW
|
$135.24
|
73030RAD
|
RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS
|
$176.28
|
73040RAD
|
RADEX SHOULDER ARTHROGRAPHY RS&I
|
$600
|
73050RAD
|
RADEX A-C JOINTS BI W/WO WEIGHTED DISTRC
|
$229.86
|
73060RAD
|
RADEX HUMERUS MINIMUM 2 VIEWS
|
$165
|
73070RAD
|
RADEX ELBOW 2 VIEWS
|
$162.72
|
73080RAD
|
RADEX ELBOW COMPLETE MINIMUM 3 VIEWS
|
$190.62
|
73085RAD
|
RADEX ELBOW ARTHROGRAPHY RS&I
|
$577.92
|
73090RAD
|
RADEX FOREARM 2 VIEWS
|
$159.3
|
73092RAD
|
RADEX UPPER EXTREMITY INFANT MINIMUM 2 V
|
$184.92
|
73100RAD
|
RADEX WRIST 2 VIEWS
|
$183.24
|
73110RAD
|
RADEX WRIST COMPLETE MINIMUM 3 VIEWS
|
$214.5
|
73115RAD
|
RADEX WRIST ARTHROGRAPHY RS&I
|
$631.14
|
73120RAD
|
RADEX HAND 2 VIEWS
|
$157.44
|
73130RAD
|
RADEX HAND MINIMUM 3 VIEWS
|
$185.16
|
73140RAD
|
RADEX FINGR MINIMUM 2 VIEWS
|
$191.64
|
73501RAD
|
RADEX HIP UNILATERAL 1 VIEW
|
$164.22
|
73502RAD
|
RADEX HIP UNILATERAL COMPLETE MIN 2-3 VI
|
$224.58
|
73521RAD
|
RADEX HIPS BILATERAL 2 VIEWS ANTEROPOST
|
$219.18
|
73522RAD
|
RADEX HIPS BILATERAL 3-4V WITH PELVIS
|
$270.9
|
73525RAD
|
RADEX HIP ARTHROGRAPHY RS&I
|
$598.14
|
73551RAD
|
RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
$154.14
|
73552RAD
|
RADIOLOGIC EXAMINATION FEMUR 2 VIEWS
|
$163.26
|
73560RAD
|
RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
$177.96
|
73562RAD
|
RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
$214.8
|
73564RAD
|
RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIE
|
$250.44
|
73565RAD
|
RADIOLOGIC EXAM BOTH KNEES STANDING ANTE
|
$250.44
|
73590RAD
|
RADIOLOGIC EXAMINATION TIBIA & FIBULA 2
|
$157.62
|
73600RAD
|
RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
$164.76
|
73610RAD
|
RADEX ANKLE COMPLETE MINIMUM 3 VIEWS
|
$190.62
|
73620RAD
|
RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
$157.44
|
73630RAD
|
RADEX FOOT COMPLETE MINIMUM 3 VIEWS
|
$179.64
|
73650RAD
|
RADEX CALCANEUS MINIMUM 2 VIEWS
|
$162.96
|
73660RAD
|
RADEX TOE MINIMUM 2 VIEWS
|
$173.34
|
74000RAD
|
RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW
|
$137.7
|
74018RAD
|
RADEX ABDOMEN 1 VIEW
|
$137.7
|
74019RAD
|
RADEX ABDOMEN 2 VIEWS
|
$229.38
|
74020RAD
|
RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS
|
$229.38
|
74022RAD
|
RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1
|
$276.24
|
74220RAD
|
RADEX ESOPHAGUS
|
$515.76
|
74247RAD
|
RADEX UPPER GI W/WO GLUCAGON/DELAY FLMS
|
$748.92
|
74250RAD
|
RADEX SMALL INTESTINE W/MULTIPLE SERIAL
|
$574.2
|
75809RAD
|
SHUNTOGRAM INDWELLING NONVASCULAR
|
$460
|
77001RAD
|
FLUROGUIDE FOR VEIN DEVICE
|
$95.6
|
77002RAD
|
FLUORO GUIDANCE/BIOPSY/ASPIRATION/INJ
|
$529.68
|
77071RAD
|
MANUAL APPL STRESS PFRMD PHYS JOINT RADI
|
$291.3
|
77072RAD
|
BONE AGE STUDIES
|
$132.42
|
77073RAD
|
BONE LENGTH STUDIES
|
$218.58
|
77075RAD
|
RADIOLOGIC EXAMINATION OSSEOUS SURVEY CO
|
$533.94
|
78291RAD
|
SHUNT PATENCY TEST 3V
|
$394.4
|
93306RAD
|
ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&
|
$1048.44
|
93000RES
|
ROUTINE ECG W/LEAST 12 LDS W/I&R
|
$172.5
|
93005RES
|
ELECTROCARDIOGRAM
|
$172.45
|
10060ER
|
INCISION & DRAINAGE ABSCESS SIMPLE/SINGL
|
$441.48
|
10061ER
|
INCISION&DRAINAGE ABSCESS COMPLICATED/MU
|
$783.16
|
10080ER
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
$683.8
|
10120ER
|
INCISION&REMOVAL FOREIGN BODY SUBQ TISS
|
$578.52
|
10121ER
|
INCISION&REMOVAL FOREIGN BODY SUBQ TISS
|
$1054.04
|
10140ER
|
I&D HEMATOMA SEROMA/FLUID COLLECTION
|
$620.36
|
11730ER
|
AVULSION NAIL PLATE PARTIAL/COMPLETE SIM
|
$373.68
|
11740ER
|
EVACUATION SUBUNGUAL HEMATOMA
|
$186.12
|
11750ER
|
EXCISION NAIL MATRIX PERMANENT REMOVAL
|
$849.52
|
11760ER
|
REPAIR NAIL BED
|
$887.72
|
11765ER
|
WEDGE RESECTION TOENAIL
|
$359.24
|
12001ER
|
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK
|
$344.64
|
12002ER
|
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.
|
$418.68
|
12004ER
|
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6
|
$492.72
|
12005ER
|
SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-
|
$638.52
|
12007ER
|
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK
|
$880.68
|
12011ER
|
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
|
$421.36
|
12013ER
|
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0CM
|
$461.36
|
12014ER
|
SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5CM
|
$541.04
|
12015ER
|
SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5CM
|
$660.68
|
12020ER
|
TX SUPERFICIAL WOUND DEHISCENCE SIMPLE C
|
$1073.92
|
12031ER
|
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
$906.56
|
12032ER
|
REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
$1157.2
|
12034ER
|
REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
$1190.84
|
12035ER
|
REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
$1479.88
|
12036ER
|
REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM
|
$1619
|
12041ER
|
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5
|
$921.36
|
12042ER
|
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6
|
$1099.96
|
12045ER
|
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.
|
$985.84
|
12051ER
|
REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 C
|
$1120.68
|
12052ER
|
REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5
|
$784.6
|
12053ER
|
REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7
|
$1320.72
|
12054ER
|
REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-1
|
$1411.2
|
13121ER
|
REPAIR COMPLEX SCALP/ARM/LEG 2.6 CM-7.5
|
$1628.44
|
13122ER
|
REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 C
|
$511.12
|
13131ER
|
REPAIR COMPLEX FOREHEAD 1.1-2.5 CM
|
$975.08
|
13132ER
|
REPAIR COMPLEX FOREHEAD 2.6*--7.5 CM
|
$1225.04
|
16020ER
|
DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SM
|
$309.68
|
16025ER
|
DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ ME
|
$564.28
|
20103ER
|
EXPLORATION PENETRATING WOUND SPX EXTREM
|
$2232.76
|
20520ER
|
REMOVAL FOREIGN BODY MUSCLE/TENDON SHEAT
|
$220.92
|
20552ER
|
INJECTION SINGLE/MLT TRIGGER POINT 1/2 M
|
$209.88
|
20600ER
|
ARTHROCENTESIS ASPIR&/INJECTION SMALL JT
|
$179.32
|
20605ER
|
ARTHROCENTESIS ASPIR&/INJECTION INTERM J
|
$249.96
|
20610ER
|
ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT
|
$229
|
23650ER
|
CLSD TX SHOULDER DISLC W/MANIPULATION W/
|
$1210.04
|
23655ER
|
CLSD TX SHOULDER DISLC W/MANIPULATION RE
|
$1530.08
|
24200ER
|
REMOVE ELBOW/UPPPER ARM FB SIMPLE W/INC
|
$537.04
|
24201ER
|
REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEE
|
$2136.84
|
24605ER
|
TREATMENT CLOSED ELBOW DISLOCATION REQ A
|
$1918.24
|
24640ER
|
CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELB
|
$545
|
25259ER
|
MANIPULATION WRIST UNDER ANESTHESIA
|
$7268
|
25605ER
|
FX CARE DISTAL RADIUS W/MANIPULATION
|
$1977.88
|
25660ER
|
CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W
|
$1569.88
|
26700ER
|
DISLOCATION METACARPOPHALANGEAL EA W/O
|
$1172.52
|
26750ER
|
CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ E
|
$705.84
|
26770ER
|
CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
$1063.96
|
27250ER
|
CLTX HIP DISLOCATION TRAUMATIC W/O ANEST
|
$712.04
|
27252ER
|
CLTX HIP DISLOCATION TRAUMATIC REQ ANEST
|
$2916.48
|
27762ER
|
FX CARE MEDIAL MALLEOLUS W MANIPULATION
|
$1682.76
|
27810ER
|
FX CARE BIMALLEOLAR ANKLE W/MANIPULATION
|
$1488.04
|
27842ER
|
CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL
|
$1903.32
|
28190ER
|
REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
$990.52
|
28515ER
|
CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
$549.12
|
28630ER
|
DISLOCATION RED METASAL PHALANGEALW/OANE
|
$430.36
|
28660ER
|
CLTX INTERPHALANGEAL JOINT DISLOCATION W
|
$451.2
|
29105ER
|
APPLICATION LONG ARM SPLINT SHOULDER HAN
|
$337.72
|
29125ER
|
APPLICATION SHORT ARM SPLINT FOREARM-HAN
|
$249.24
|
29126ER
|
APP OF SHORT ARM CAST; DYNAMIC
|
$295.84
|
29130ER
|
APPLICATION FINGER SPLINT STATIC
|
$157.56
|
29131ER
|
APPL OF FINGER SPLINT; DYNAMIC
|
$199.84
|
29240ER
|
STRAPPING; SHOULDER
|
$220.28
|
29345ER
|
APPLICATION LONG LEG CAST THIGH-TOE
|
$525.28
|
29405ER
|
APPLICATION SHORT LEG CAST BELOW KNEE-TO
|
$313.4
|
29505ER
|
APPLICATION LONG LEG SPLINT THIGH ANKLE/
|
$193.36
|
29515ER
|
APPLICATION SHORT LEG SPLINT CALF FOOT
|
$276.96
|
30300ER
|
REMOVAL FOREIGN BODY FROM NOSE
|
$481.12
|
30901ER
|
CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
|
$369.12
|
30905ER
|
CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY
|
$391.52
|
31500ER
|
INTUBATION ENDOTRACHEAL-ER
|
$460.96
|
32405ER
|
PNEUMOCENTESIS PUNCTURE LUNG ASPIRATION
|
$444.95
|
32551ER
|
TUBE THORACOSTOMY INCLUDES WATER SEAL
|
$687.8
|
36556ER
|
INSJ NON-TUNNELED CENTRAL VENOUS CATH AG
|
$901.24
|
36569ER
|
INSERTION OF PICC LINE
|
$697.14
|
36589ER
|
RMVL TUN CVC W/O SUBW PORT/ PMP
|
$1262.4
|
36680ER
|
EZ I O Intraosseus Venous Access Device
|
$240.72
|
40654ER
|
REPAIR LIP FULL THICKNESS > HALF VERT/HG
|
$1658.2
|
43760ER
|
CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O
|
$1923.22
|
46040ER
|
I & D ISCHORECTAL AND PERIRECTAL ABSCESS
|
$3033.6
|
46050ER
|
I&D PERIANAL ABSCESS SUPERFICIAL
|
$783.24
|
46083ER
|
INCISION THROMBOSED HEMORRHOID EXTERNAL
|
$679.84
|
51701ER
|
INSERT STRAIGHT CATH
|
$109.12
|
51702ER
|
FOLEY CATHETER
|
$118.16
|
51798ER
|
BLADDER SCAN
|
$68.28
|
56405ER
|
I&D VULVA/PERINEAL ABSCESS
|
$425.04
|
56420ER
|
I&D OF BARTHOLINS GLAND ABSCESS
|
$470.72
|
59409ER
|
VAGINAL DELIVERY
|
$3303.76
|
64400ER
|
BLOCK PAIN - DENTAL OR TMJ/PERIPHERAL
|
$271.52
|
64402ER
|
INJECTION ANESTHETIC AGENT FACIAL NERVE
|
$466.6
|
64450ER
|
DIGITAL BLOCK (INJ PERIPHERAL NVE BR)
|
$179.76
|
65205ER
|
REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL
|
$218.04
|
69200ER
|
RMVL FB XTRNL AUDITORY CANAL W/O ANES
|
$476.72
|
69209ER
|
REMOVAL IMPACTED CERUMEN UNILATERAL
|
$28.98
|
69210ER
|
RMVL IMPACTED CERUMEN SPX 1/BOTH EARS
|
$199.4
|
90471ER
|
IMMUNIZATION ADMIINISTRATION (FIRST)
|
$92.64
|
90714ER
|
TETANUS/DIPTHERIA TOXOIDS ABSORBED
|
$167.28
|
90715ER
|
TETANUS/DIPTHERIA/PERTUSSIS TOXOIDS ABSO
|
$296.8
|
92950ER
|
CPR
|
$740.08
|
99151ER
|
MODERATE SEDATION SAME PHY/ QHP INITIAL
|
$214.8
|
99152ER
|
MOD SED SAME PHY/ QHP INITIAL 15 MINS
|
$112.56
|
99195ER
|
PHLEBOTOMY, THERAPEUTIC
|
$369.28
|
99281ER
|
ER LEVEL 1
|
$196.1
|
99282ER
|
ER LEVEL 2
|
$221.1
|
99283ER
|
ER LEVEL 3
|
$319.55
|
99284ER
|
ER LEVEL 4
|
$475.2
|
99285ER
|
ER LEVEL 5
|
$820.6
|
99291ER
|
ER CRITICAL CARE LEVEL 1ST HOUR
|
$1041.52
|
99292ER
|
ER CRITICAL CARE EACH ADD'L 30 MINUTES
|
$465.8
|
97001PT
|
PHYSICAL THERAPY EVALUATION
|
$214.29
|
97161PT
|
PT EVAL LOW COMPLEXITY
|
$156.46
|
97162PT
|
PT EVAL MODERATE COMPLEXITY
|
$156.46
|
97163PT
|
PT EVAL HIGH COMPLEXITY
|
$156.46
|
97164PT
|
PT RE-EVAL CODE 2017
|
$105.9
|
PRIVATE
|
PRIVATE
|
$3000
|
RBPRIVATE
|
PRIVATE
|
$3000
|
85002LAB
|
BLEEDING TIME
|
$49.52
|
85007LAB
|
BLOOD COUNT, DIFFERENTIAL
|
$37.84
|
85014LAB
|
HCT
|
$26.08
|
85018LAB
|
HEMOGLOBIN
|
$26.08
|
85025LAB
|
CBC/AUTO DIFF
|
$85.52
|
85027LAB
|
CBC (NO AUTO DIFF)
|
$71.12
|
85041LAB
|
RBC
|
$48
|
85044LAB
|
Retic
|
$47.28
|
85048LAB
|
WBC
|
$27.92
|
85049LAB
|
PLATELET COUNT
|
$49.2
|
85060LAB
|
PATHOLOGY SMEAR REVIEW
|
$58.3
|
85220LAB
|
FACTOR V
|
$194.08
|
85301LAB
|
ANTITHROMBIN III ANTIGEN
|
$118.88
|
85302LAB
|
PROTEIN C ANTIGEN
|
$132.16
|
85305LAB
|
PROTEIN S ANTIGEN
|
$127.6
|
85307LAB
|
ACT PROTEIN C RESIST W/REFLEX FACTOR C
|
$167.28
|
85379LAB
|
D-DIMER
|
$111.92
|
85384LAB
|
FIBINOGEN
|
$93.44
|
85610LAB
|
PROTIME (PT)
|
$43.2
|
85613L2
|
LUPUS ANTICOAGULANT EVALUATION
|
$105.28
|
85651LAB
|
SED RATE (ESR)
|
$39.04
|
85730LAB
|
PTT (APTT)
|
$66
|
85999LAB
|
EOSINOPHIL COUNT URINE
|
$46.96
|
93225RES
|
HOLTER RECORDING
|
$220.55
|
93226RES
|
HOLTER SCANNING
|
$555.25
|
80177LAB
|
LEVETIRACETAM
|
$150.64
|
80299L02
|
LEVETIRACETAM (KEPPRA)
|
$150.64
|
80299LAB
|
LAMOTRIGINE (LAMICTAIL)
|
$150.64
|
81381LAB
|
HLA B5701 TYPING
|
$339.8
|
82009LAB
|
ACETONE (SERUM)
|
$36.16
|
82271LAB
|
GASTRIC OCCULT
|
$35.84
|
82378LAB
|
CEA
|
$208.64
|
82390LAB
|
CERULOPLASMIN
|
$118.08
|
84300LAB
|
24 HOUR SODIUM (NA+)
|
$53.52
|
85660LAB
|
SICKLE CELL
|
$60.72
|
86003L10
|
LIVE OAK Ige
|
$20.56
|
86003L12
|
DOG Ige
|
$20.56
|
86003L13
|
PECAN TREE IGE
|
$57.36
|
86003L22
|
ASPERGILLUS FUMIGATUS
|
$20.56
|
86003L23
|
BERMUDA GRASS
|
$20.56
|
86003L24
|
BIRCH
|
$20.56
|
86003L25
|
CIADOSPORIUM HERBARUM
|
$20.56
|
86003L26
|
COCROACH
|
$20.56
|
86003L27
|
DERMATOPHOGOIDES FARINAE
|
$20.56
|
86003L28
|
ELM
|
$20.56
|
86003L29
|
MAPLE
|
$20.56
|
86003L30
|
MOUNTAIN CEDAR
|
$20.56
|
86003L31
|
NETTLE
|
$20.56
|
86003L32
|
PENICILLIUM NOTATUM
|
$20.56
|
86003L33
|
SHEEP SORREL
|
$20.56
|
86003L34
|
TIMOTHY GRASS
|
$20.56
|
86003L35
|
ROUGH PIGWEED IgE
|
$56.96
|
86003L36
|
DERMATOPHAGOIDES PTERONYSSINUS IgE
|
$56.96
|
86003L7
|
BAHIA GRASS Ige
|
$20.56
|
86003L8
|
ALTERNARIA Ige
|
$20.56
|
86003L9
|
RAGWEED Ige
|
$20.56
|
86003LAB
|
CAT Ige
|
$20.56
|
86021
|
MYELOPEROXIDASE Ab (Anca-c)
|
$50
|
86038LAB
|
ANA
|
$132.96
|
86039LAB
|
ANA TITER
|
$122.8
|
86060LAB
|
ASO TITER
|
$76.88
|
86140LAB
|
C REACTIVE PROTEIN
|
$56.88
|
86141LAB
|
HS-CRP
|
$140
|
86147LAB
|
CARDIOLIPIN Ab (IgG)
|
$209.82
|
86160L02
|
C4
|
$132
|
86160LAB
|
C3
|
$132
|
86161LAB
|
CI INHIBITOR
|
$32.76
|
86162LAB
|
CH50
|
$223.44
|
86200LAB
|
CYCLIC CITRULLINE PEPTIDE (CCP)
|
$142.4
|
86235L02
|
SMOOTH MUSCLE RNP ANTIBODY
|
$197.2
|
86235L03
|
SJOGREN'S ANTIBODY A; SS-A
|
$197.2
|
86235L04
|
SJOGREN'S ANTIBODY B; SS-B
|
$197.2
|
86235LAB
|
ANTI SMOOTH MUSCLE
|
$218.65
|
86255L02
|
MILOCHONDRIAL Ab
|
$132.56
|
86255L3
|
SMOOTH MUSCLE Ab
|
$131.52
|
86255LAB
|
PARIETAL CELL AB
|
$132.56
|
86301
|
CA19-9
|
$228.88
|
86308LAB
|
MONO TEST
|
$56.88
|
86317L27
|
HEPATITIS B SURFACE AB QUANT
|
$132
|
86335LAB
|
IMMUNOFIXATION URINE
|
$187.36
|
86337LAB
|
GAD-65
|
$235.44
|
86340LAB
|
INTRIOSIC FACTOR BLOCKING AB
|
$165.76
|
86341L2
|
INSULIN AUTOANTIBODY
|
$217.6
|
86341LAB
|
IA-2
|
$217.6
|
86360LAB
|
LYMPHOCYTE SUBSET PANEL 4
|
$258.36
|
86361LAB
|
LYMPHOCYTE SUBSET PANEL 5
|
$215.34
|
86376LAB
|
THYROID PEROXIDOSE ANTIBODY
|
$159.92
|
86403LAB
|
CRYPTOCOCCAL Ag CSF
|
$112.08
|
86430LAB
|
RA LATEX
|
$62.4
|
86431L02
|
QUANTITATIVE TITER
|
$62.4
|
86431LAB
|
RA LATEX (TITER)
|
$62.4
|
86592L2
|
VDRL CSF
|
$46.96
|
86592LAB
|
RPR
|
$46.96
|
86606LAB
|
ASPERGILLUS, FUMIGATUS
|
$41.08
|
86609L2
|
PIGEON SERUM
|
$35.16
|
86609LAB
|
MICROPOLYSPORA FAENI
|
$35.16
|
86611L2
|
BARTONELLA HENSELAE
|
$111.12
|
86617L1
|
LYME DISEASE Ab IgM
|
$170.4
|
86617LAB
|
LYME DISEASE Ab IgG
|
$170.4
|
86618LAB
|
LYME DISEASE Ab WITH REFLEX TO BLOT, EIA
|
$187.28
|
86644LAB
|
CYTOMEGAIOVIRUS Ab IgG
|
$128
|
86664LAB
|
EPSTEIN BARR VIRUS AB
|
$168.24
|
86671L02
|
ASCA (IgA)
|
$134.8
|
86671LAB
|
ASCA (IgG)
|
$134.8
|
86677LAB
|
H. PYLORI ANTIBODIES
|
$170.4
|
86689LAB
|
HIV Ab, WESTERN BLOCK
|
$212.8
|
86695LAB
|
HERPES ANTIBODY 1
|
$145.04
|
86696LAB
|
HERPES ANITBODY 2
|
$212.8
|
86703LAB
|
HIV
|
$150.8
|
86704LAB
|
HEP B CORE TOTAL
|
$132.56
|
86706LAB
|
HEPATITIS B SURF ANTIBODY HBSAB
|
$118.08
|
86708LAB
|
HEP A ANTIBODY
|
$136.24
|
86709LAB
|
HEPATITIS A IgM ANTIBODY
|
$122.88
|
86735L2
|
MUMPS ANTIBODY
|
$142.4
|
86757LAB
|
RICKETTSIA
|
$212.81
|
86762L2
|
RUBELLA IMMUNE STATUS
|
$128
|
86762LAB
|
RUBELLA
|
$128
|
86765LAB
|
MEASLES ANTIBODY
|
$140.64
|
86774LAB
|
TETANUS ANTITOXOID
|
$162.72
|
86777LAB
|
TOXOPLASMA Ab IgG
|
$128
|
86787LAB
|
VARICEIN ZOSTER Ab(IgG)
|
$141.68
|
86800LAB
|
THYROGLUBLIN Ab
|
$174.88
|
86803LAB
|
HEPATITIS C ANTIBODY
|
$156.96
|
86850LAB
|
ANTIBODY SCREEN
|
$140
|
86900LAB
|
ABO
|
$32.8
|
86901LAB
|
RH
|
$32.8
|
86905LAB
|
PATIENT RBC TYPING PER AG
|
$41.76
|
86922LAB
|
CROSSMATCH
|
$121
|
87210LAB
|
KOH
|
$46.96
|
87340LAB
|
HEP B SURGACE ANTIGEN
|
$113.6
|
87380LAB
|
HEP B ANTIGEN
|
$180.48
|
IMP32555
|
ALCON LENS SA6AT4 14.0
|
$576
|
96360ER
|
INTRAVENOUS HYDRATION INIT 31MIN-1 HOUR
|
$212.68
|
96361ER
|
IV INFUS HYDRATION EACH ADDTL HOUR
|
$56.28
|
96365ER
|
IV INFUSION FOR THERAPY; INTL TO 1HR
|
$274.36
|
96366ER
|
IV INFUSION, THERAPY, EACH ADDTL HR
|
$80.76
|
96367ER
|
ADDTL SEQ INFUS OF NEW DRUG TO 1 HR
|
$117.56
|
96368ER
|
CONCURRENT INFUSION
|
$69.6
|
96370ER
|
SUBCUT INFUSION EACH ADDTL HR
|
$64.88
|
96372ER
|
INJECTION; SUBCUT OR INTRAMUSCULAR
|
$95.28
|
96374ER
|
INJECTION INTRAVEN PUSH SNG OR INITIAL
|
$209.16
|
96375ER
|
EH ADDLT PUSH OF NEW DRUG
|
$82.08
|
96376ER
|
IV PUSH EACH ADD'TNAL SEQUENTIAL
|
$61.59
|
36415LAB
|
VENIPUNCTURE
|
$24
|
81256LAB
|
HFE HEREDITARY, HEMOCHROMATOSIS GENE ANA
|
$358.64
|
82340LAB
|
24 HR URINE CALCIUM
|
$66.32
|
82803RES
|
ABG
|
$200
|
83630LAB
|
FECAL LACTOFERRIN
|
$213.68
|
84153LAB
|
PSA (TOTAL) DIAGNOSTIC
|
$202.32
|
84165LAB
|
PROTEIN ELECTROPHORESIS SERUM
|
$118.08
|
84166L2
|
24 HR URINE PROTEN ELECTROPHORESIS
|
$196.16
|
84166LAB
|
URINE PROTEIN ELECTROPHORESES SERUM
|
$196.16
|
84466LAB
|
TRANSFERRIN
|
$140.4
|
85549LAB
|
LYSOZYME, SERUM
|
$185.2
|
86063LAB
|
ASO
|
$63.44
|
86225LAB
|
DNA DS ANTIBODY
|
$151.04
|
86707LAB
|
HEP B ANTIBODY
|
$127.2
|
86870LAB
|
ANTIBODY IDENTIFICATION
|
$246.4
|
86904LAB
|
ANTIGEN SCREEN
|
$104.56
|
87169LAB
|
PARASITE IDENTIFICATION
|
$42.16
|
87185L2
|
CATALASE ENZYME TEST
|
$52.24
|
87491LAB
|
CHLAMYDIA AMPLIFIED PROBE
|
$245.76
|
87521LAB
|
HEPATITIS C VIRAL RNA QUALITATIVE
|
$214.16
|
87591LAB
|
GONORRHOEAE AMPLIFIED PROBE
|
$215.76
|
89051L02
|
SYNOVIAL CELL COUNT WITH DIFF
|
$19.44
|
89051LAB
|
CSF CELL COUNT WITH DIFF
|
$19.44
|
CB00001
|
LEGAL DRUG COLLECTION
|
$27.75
|
CB0004
|
LABCORP VENI
|
$15
|
89220RES
|
SPUTUM COLLECTION
|
$97.9
|
81001LAB
|
URINALYSIS W MICROSOPIC
|
$34.8
|
81003LAB
|
URINALYSIS W/O MICROSCOPIC
|
$24.72
|
81025LAB
|
URINE PREGNANCY
|
$69.6
|
MM2207
|
IS VOLUMETRIC EXCERSISES
|
$97.32
|
MM32652
|
STOCKINGS EMS THIGH HIGH XXL 6PR/BOX
|
$37.02
|
MM32654
|
STOCKING EMS KNEE HIGH XXXL 12PR/BX
|
$29.76
|
RES0001
|
OXYGEN X 1 HOUR
|
$21.2
|
RES0003
|
INCENTIVE SPIROMETRY INSTRUCTION
|
$39.6
|
TELEM-INPT
|
TELEMETRY INPT
|
$3280.88
|
SWINGBED
|
SWINGBED
|
$2105
|
SWINGBEDSC
|
SWINGBED
|
$2105
|
70551MRI
|
MRI BRAIN BRAIN STEM W/O CONTRAST MATERI
|
$2784.81
|
70553MRI
|
MRI BRAIN BRAIN STEM W/O &W/CONTRAST MAT
|
$2878.75
|
23350MRI
|
INJECTION SHOULDER ARTHROGRAPHY/CT/MRI
|
$315.78
|
70543MRI
|
MRI ORBIT FACE & NCK W/O &W/CONTRAST MAT
|
$2949.31
|
70544MRI
|
MRA HEAD W/O CONTRST MATERIAL
|
$2568.65
|
70547MRI
|
MRA NECK W/O CONTRST MATERIAL
|
$2575.23
|
71550MRI
|
MRI CHEST W/O CONTRAST MATERIAL
|
$2562.21
|
72141MRI
|
MRI SPINAL CANAL CERVICAL W/O CONTRAST M
|
$1946.28
|
72146MRI
|
MRI SPINAL CANAL THORACIC W/O CONTRAST M
|
$1950.55
|
72147MRI
|
MRI SPINAL CANAL THORACIC W/CONTRAST MAT
|
$2181.55
|
72148MRI
|
MRI SPINAL CANAL LUMBAR W/O CONTRAST MAT
|
$1948.38
|
72156MRI
|
MRI SPINAL CANAL CERVICAL W/O & W/CONTR
|
$2814.56
|
72157MRI
|
MRI SPINAL CANAL THORACIC W/O & W/CONTR
|
$2560.11
|
72158MRI
|
MRI SPINAL CANAL LUMBAR W/O &W/CONTR MAT
|
$2797.48
|
72195MRI
|
MRI PELVIS W/O CONTRAST MATERIAL
|
$2752.4
|
72197MRI
|
MRI PELVIS W/O & W/CONTRAST MATERIAL
|
$3000.62
|
73218MRI
|
MRI UPPER EXTREMITY OTH THAN JT W/O CONT
|
$2260.65
|
73219MRI
|
MRI UPPER EXTREMITY OTH THAN JT W/CONTR
|
$2470.23
|
73220MRI
|
MRI UPPER EXTREM OTHER THAN JT W/O & W/C
|
$3002.79
|
73221MRI
|
MRI ANY JT UPPER EXTREMITY W/O CONTRAST
|
$1806.56
|
73222MRI
|
MRI ANY JT UPPER EXTREMITY W/CONTRAST MA
|
$2288.44
|
73223MRI
|
MRI ANY JT UPPER EXTREMITY W/O & W/CONTR
|
$2793.21
|
73718MRI
|
MRI LOWER EXTREM OTH/THN JT W/O CONTR MA
|
$2243.57
|
73720MRI
|
MRI LOWER EXTREM OTH/THN JT W/O & W/CONT
|
$3028.48
|
73721MRI
|
MRI ANY JT LOWER EXTREM W/O CONTRAST MAT
|
$1353.87
|
73722MRI
|
MRI ANY JT LOWER EXTREM W/CONTRAST MATER
|
$2324.84
|
73723MRI
|
MRI ANY JT LOWER EXTREM W/O & W/CONTRAST
|
$2791.04
|
74181MRI
|
MRI ABDOMEN W/O CONTRAST MATERIAL
|
$1963.36
|
74183MRI
|
MRI ABDOMEN W/O &W/CONTRAST MATERIAL
|
$3013.5
|
95860EMG
|
NDL EMG 1 XTR W/WO RELATED PARASPINAL AR
|
$500
|
95885EMG
|
NEEDLE EMG EA EXTREMITY W/PARASPINL AREA
|
$500
|
95886EMG
|
NEEDLE EMG EA EXTREMTY W/PARASPINL AREA
|
$500
|
95908EMG
|
NVR CNDJ TST 3-4 STUDIES
|
$79.53
|
95909EMG
|
NVR CNDJ TST 5-6 STUDIES
|
$167.88
|
95910EMG
|
NVR CNDJ TST 7-8 STUDIES
|
$216.51
|
95911EMG
|
NVT CNDJ TST 9-10 STUDIES
|
$251.4
|
95912EMG
|
NVR CODJ TST 11-12 STUDIES
|
$284.43
|
95913EMG
|
NVR CNDJ TST 13- MORE STUDIES
|
$318.39
|
97003OT
|
OCCUPATIONAL THERAPY EVALUATION
|
$266.75
|
97004OT
|
OCCUPATIONAL THERAPY RE-EVALUATION
|
$266.75
|
97014OT
|
APPL MODALITY 1/> AREAS ELEC STIMJ UNATT
|
$106
|
97018OT
|
APPL MODALITY 1/> AREAS PARAFFIN BATH
|
$107
|
97022OT
|
APPLICATION MODALITY 1/> AREAS WHIRLPOOL
|
$129.55
|
97032OT
|
APPL MODALITY 1/> AREAS ELEC STIMJ EA 15
|
$107
|
97033OT
|
APPL MODALITY 1/> AREAS IONTOPHORESIS EA
|
$129.55
|
97035OT
|
APPL MODALITY 1/> AREAS ULTRASOUND EA 15
|
$91.85
|
97110OT
|
THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXE
|
$90.87
|
97112OT
|
THER PX 1/> AREAS EACH 15 MIN NEUROMUSC
|
$129.55
|
97140OT
|
MANUAL THERAPY TQS 1/> REGIONS EACH 15 M
|
$149
|
97161OT
|
OT EVAL LOW COMPLEXITY
|
$156.46
|
97165OT
|
OT EVAL LOW COMPLEXITY
|
$151.96
|
97166OT
|
OT EVAL MODERATE COMPLEXITY
|
$151.96
|
97167OT
|
OT EVAL HIGH COMPLEXITY
|
$151.96
|
97168OT
|
OT RE-EVAL
|
$100.04
|
97530OT
|
THER ACTV DIR PT CONTACT BY PROVIDER EAC
|
$144.65
|
97535OT
|
SELF-CARE/HOME MGMT TRAINING EACH 15 MIN
|
$85.25
|
97545OT
|
work hardening/ conditioning. CA workers
|
$363
|
97597OT
|
DEBRIDEMENT OPEN WOUND 20 SQ CM/<
|
$159.8
|
97598OT
|
REMOVAL DEVITALIZED TISSUE >20 CM
|
$402
|
97750OT
|
PHYSICAL PERFORMANCE TEST/MEAS W/REPRT E
|
$165
|
97760OT
|
ORTHO MGMT&TRAINJ LXTR&/TRNK EA INITIAL
|
$182
|
97763OT
|
ORTHO/PROST MNGMNT- SUBSEQUENT ENC
|
$182
|
G0283OT
|
APPL MODALITY 1/> AREAS ELEC STIMJ UNAT
|
$106
|
L3702OT
|
EO STATIC CUSTOM ELBOW (WRIST NOT INCL)
|
$526
|
L3763OT
|
EWHO STATIC CUSTOM ELBOW WRIST HAND
|
$1446
|
L3806OT
|
WHFO DYNAMIC CUST ORTHOSIS WR,HND,FINGER
|
$828
|
L3808OT
|
WHFO STATIC WRIST HAND FINGER ORTHOSIS
|
$830
|
L3906OT
|
WHO STATIC WRIST HAND ORTHOSIS
|
$769
|
L3913OT
|
HFO STATIC CUSTOM HAND, FINGER ORTHOSIS
|
$494
|
L3919OT
|
HO HAND ORTHOSIS (MC FX OR COLDITZ)
|
$494
|
L3921OT
|
HFO DYNAMIC CUSTOM HAND, FINGER ORTHOSIS
|
$585
|
L3925OT
|
FO DYNAMIC PREFAB FINGER (LMB)
|
$110
|
L3933OT
|
FO STATIC CUSTOM FINGER ORTHOSIS
|
$389
|
81241LAB
|
FACTOR V LEIDEN
|
$160
|
82310L2
|
CALCIUM RANDOM URINE
|
$56.72
|
87807LAB
|
RSV IMMUNOASSAY
|
$131.92
|
88104TC
|
CYTOPATHOLOGY
|
$68
|
88302TC
|
LEVEL II
|
$68
|
88304TC
|
LEVEL I I I
|
$147.28
|
88305TC
|
LEVEL IV
|
$229.08
|
88307TC
|
LEVEL V
|
$229.08
|
88311TC
|
DECALCIFICATION PROCEDURE
|
$20.56
|
88312TC
|
SPECIAL STAIN
|
$68.18
|
89060LAB
|
SYNOVIAL FLUID CRYSTALS
|
$78.64
|
93880RAD
|
US CAROTID
|
$1329
|
93923RAD
|
NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY
|
$797.94
|
93925RAD
|
DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STU
|
$1401.24
|
93926RAD
|
DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STU
|
$806.46
|
93970RAD
|
DUP-SCAN XTR VEINS COMPLETE BILATERAL ST
|
$1058.16
|
93971RAD
|
DUP-SCAN XTR VEINS UNILATERAL/LIMITED ST
|
$640.26
|
97010PT
|
APPLICATION MODALITY 1/> AREAS HOT/COLD
|
$36.3
|
97012PT
|
APPL MODALITY 1/> AREAS TRACTION MECHANI
|
$45.72
|
97014PT
|
APPL MODALITY 1/> AREAS ELEC STIMJ UNATT
|
$106
|
97016PT
|
VASOPNEUMATIC
|
$73.44
|
97018PT
|
APPL MODALITY 1/> AREAS PARAFFIN BATH
|
$107
|
97022PT
|
APPLICATION MODALITY 1/= AREA WHIRLPOOL
|
$129.55
|
97032PT
|
APPL MODALITY 1/> AREAS ELEC STIMJ EA 15
|
$107
|
97033PT
|
APPL MODALITY 1/> AREAS IONTOPHORESIS EA
|
$129.55
|
97035PT
|
APPL MODALITY 1/> AREAS ULTRASOUND EA 15
|
$91.85
|
97110PT
|
THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXE
|
$90.87
|
97112PT
|
THER PX 1/> AREAS EACH 15 MIN NEUROMUSC
|
$129.55
|
97116PT
|
THER PX 1/> AREAS EA 15 MIN GAIT TRAINJ
|
$80.28
|
97140PT
|
MANUAL THERAPY TQS 1/> REGIONS EACH 15 M
|
$149
|
97166PT
|
PT EVAL MODERATE COMPLEXITY
|
$151.96
|
97530PT
|
THER ACTV DIR PT CONTACT BY PROVIDER EAC
|
$144.65
|
97535PT
|
SELF CARE HOME MANAGEMENT
|
$126
|
97545PT
|
work hardening/ conditioning. CA workers
|
$363
|
97750PT
|
PHYSICAL PERFORMANCE TEST/MEAS W/REPRT E
|
$165
|
G0283PT
|
APPL MODALITY 1/> AREAS ELEC STIMJ UNAT
|
$106
|
M243239
|
ENDO, GI w/BIOPSY
|
$870
|
M243246
|
PLACEMENT PERCUTANEOUS G-TUBE
|
$744
|
M245378
|
COLONSCOPY, FLEXIBLE
|
$637
|
M245380
|
COLONOSCOPY, w/BIOPSY
|
$2167
|
94010RES
|
SPIROMETRY W/WO MVV
|
$78.65
|
94060RES
|
BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILA
|
$141.35
|
94640R02
|
AEROSOL SUBSEQUENT
|
$69.72
|
94640R05
|
MDI TREATMENT
|
$47.05
|
94640RES
|
INITIAL AEROSOL
|
$133.16
|
94727RES
|
GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB
|
$218.5
|
94729RES
|
CO DIFFUSING CAPACITY
|
$317.05
|
94762RES
|
NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT
|
$291.5
|
31500RES
|
INTUBATION ENDOTRACHEAL
|
$583.55
|
36600RES
|
PUNCTURE ARTERIAL
|
$118.25
|
92950RES
|
CPR
|
$1014.5
|
94002RES
|
VENTILATION ASSIST & MGMT INPATIENT 1ST
|
$392.7
|
94003RES
|
VENTILATION ASSIST & MGMT INPATIENT EA S
|
$270.68
|
94660RES
|
CPAP VENTILATION CPAP INITIATION & MGMT
|
$188.95
|
94667R02
|
CHEST PERCUSSION/POST DRAIN INIT
|
$78.65
|
94667RES
|
PEP INITIAL DEMONSTRATION AND/OR EVAL
|
$234.05
|
94668R02
|
CHEST PERCUSSION/POST DRAIN SUBSEQUENT
|
$78.65
|
94668RES
|
PEP SUBSEQUENT
|
$47.6
|
94760RES
|
NONINVASIVE EAR/PULSE OXIMETRY SINGLE DE
|
$15.35
|
SEMIPRIV
|
SEMI-PRIVATE
|
$3000
|
97022ST
|
WHIRPOOL
|
$72
|
97110ST
|
THERAPEUTIC EXERCISE
|
$121
|
97140ST
|
MANUAL THERAPY TECH
|
$112
|
97530ST
|
THERAPEUTIC ACTIVITIES
|
$126
|
97750ST
|
PHYSICAL PERF TEST/ MEASUREMEN
|
$124
|
94620RES
|
PULMONARY STRESS TESTING SIMPLE(six min)
|
$288.2
|
99406RES
|
TOBACCO USE CESSATION INTERMEDIATE 3-10
|
$47.72
|
36569PR
|
INSERTION PICC LINE
|
$697.14
|
96360OP
|
INTRAVENOUS HYDRATION INIT 31 MIN-1 HOUR
|
$212.68
|
96361OP
|
IV INFUS HYDRATION EACH ADDITL HOUR
|
$56.28
|
96365OP
|
IV INFUSION FOR THERAPY, INTL TO 1 HR
|
$274.36
|
96366OP
|
IV INFUSION THERAPY, EA ADDTL HR
|
$80.76
|
96367OP
|
ADDTL SEQ INFUS OF NEW DRUG TO 1 HOUR
|
$117.56
|
96372OP
|
INJECTION SUBCUT OR INTRAMUSCULAR
|
$95.28
|
96374OP
|
INJECTION INTRAVEN PUSH SNG OR INITIAL
|
$209.16
|
96376OP
|
IV PUSH EACH ADD'TNAL SEQ
|
$61.59
|
99211ER
|
OFFICE OUTPATIENT VISIT 5 MINUTES
|
$75.88
|
99211OP
|
OUTPATIENT VISIT 5 MINUTES
|
$75.88
|
76536RAD
|
US SOFT TISSUE HEAD & NECK REAL TIME IMG
|
$684.66
|
76604RAD
|
US CHEST REAL TIME W/IMAGE DOCUMENTATION
|
$495.66
|
76700RAD
|
US ABDOMINAL REAL TIME W/IMAGE DOCUMENTA
|
$788.94
|
76705RAD
|
ULTRASOUND ABDOMINAL REAL TIME W/IMAGE L
|
$606.48
|
76770RAD
|
US RETROPERITONEAL REAL TIME W/IMAGE COM
|
$743.46
|
76801RAD
|
US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST
|
$715.62
|
76805RAD
|
US PREG UTERUS AFTER 1ST TRIMEST 1/1ST G
|
$832.92
|
76817RAD
|
US PREG UTERUS REAL TIME W/IMAGE DCMTN T
|
$576.78
|
76830RAD
|
ULTRASOUND TRANSVAGINAL
|
$425.22
|
76856RAD
|
US PELVIC NONOBSTETRIC REAL-TIME IMAGE C
|
$698.4
|
76857RAD
|
US PELVIC NONOBSTETRIC IMAGE DCMTN LIMIT
|
$532.44
|
76870RAD
|
ULTRASOUND SCROTUM & CONTENTS
|
$697.38
|
76881RAD
|
US EXTREMITY NON-VASC REAL-TIME IMG COMP
|
$684.36
|
76882RAD
|
US EXTREMITY NON-VASC REAL-TIME IMG LMTD
|
$201.18
|
76942RAD
|
US GUIDANCE NEEDLE PLACEMENT RS&I
|
$1137.96
|