得克萨斯大学MD安德森中心医院收费表SARS-COV-2诊断测试定值到2020年5月Med Anderson提供此信息时,即用辅助基础向用户提供与医疗护理无关的潜在特性总体判断,而不警告获取信息时的认知性、完整性或使用性信息无关 北考虑金融或医疗咨询MDDERSON不保护信息 提供到此 weblite集合信息严格地算法 和驱动安卓无法保证 服务改编为教程 和他们的科5因 教程决策, 强制编译编译,辅助测试或服务 和个体需求IN ADDITION, ESTIMATES MAY CHANGE BASED ON YOUR CONTRACTED INSURANCE BENEFITS, INSURANCE POLICY EXCLUSIONS, MAXIMUM BENEFITS, PENDING FINANCIAL ASSISTANCE, OR PENDING STATE/FEDERAL PROGRAM OR OTHER AID.",,,,, List ID,Revenue Code,Revenue Code Description,CPT Code,Procedure Name,Unit Charge 1,110,ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION,BLANK,HC PRIVATE ROOM,"$1,945" 2,200,INTENSIVE CARE UNIT - GENERAL CLASSIFICATION,BLANK,HC RECOVERY ROOM - OVERNIGHT,"$5,559" 3,202,INTENSIVE CARE UNIT - MEDICAL,BLANK,HC INTENSIVE CARE,"$5,559" 4,203,INTENSIVE CARE UNIT - PEDIATRIC,BLANK,HC INTENSIVE CARE PEDI,"$5,493" 5,206,INTENSIVE CARE UNIT - INTERMEDIATE ICU,BLANK,HC INTERMEDIATE CARE,"$2,518" 6,260,IV THERAPY - GENERAL CLASSIFICATION,96360,HC IV INF HYDRA INIT 1 HR,$643 7,260,IV THERAPY - GENERAL CLASSIFICATION,96361,HC IV HYDRA EA ADD HR,$85 8,260,IV THERAPY - GENERAL CLASSIFICATION,96365,HC IV INF THER INIT 1 HR,$643 9,260,IV THERAPY - GENERAL CLASSIFICATION,96366,HC IV THER EA ADD HR,$85 10,260,IV THERAPY - GENERAL CLASSIFICATION,96367,HC IV THER ADD SEQ INF 1HR,$339 11,260,IV THERAPY - GENERAL CLASSIFICATION,96368,HC IV THER CONCURR INF,$623 12,260,IV THERAPY - GENERAL CLASSIFICATION,96372,HC THER INJ SUBCU/IM,$212 13,260,IV THERAPY - GENERAL CLASSIFICATION,96374,HC THER INJ IVP INIT DRUG,$280 14,260,IV THERAPY - GENERAL CLASSIFICATION,96375,HC THER INJ EA ADD SQ IVP,$280 15,260,IV THERAPY - GENERAL CLASSIFICATION,96376,HC THER IVP SAME DRUG EA,$280 16,260,IV THERAPY - GENERAL CLASSIFICATION,96377,HC APPLICATON ON-BODY INJECTOR (NEULASTA),$247 17,260,IV THERAPY - GENERAL CLASSIFICATION,C8957,HC IV INF THERAPY INIT PUMP,$643 18,300,LABORATORY - GENERAL CLASSIFICATION,36415,HC ROUTINE VENIPUNCTURE,$48 19,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,62284,HC INJ PROCEDURE MYELOGRAPHY/CT LUMBAR,"$2,052" 20,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70100,"HC MAND, COMP 3VIEWS",$206 21,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70110,"HC X-RAY MANDIBLE, COMPLETE MIN 4 VIEWS",$296 22,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70150,"HC FACIAL BONES, COMP",$263 23,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70160,"HC NASAL BONES, COM",$192 24,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70200,"HC ORBITS, COMPLETE",$255 25,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70220,"HC SINUSES, PARANASAL",$202 26,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70250,"HC SKULL,LESS THAN4 VWS",$219 27,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70260,HC SKULL COMPLETE,$357 28,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70300,HC RAD EXM TEETH SNGL VIEW,$54 29,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70330,HC RAD EX TMJ OP&CLO MO BIL,$304 30,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70355,HC ORTHOPANTOGRAM,$227 31,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,70360,"HC NECK, LAT SOFT TISS",$247 32,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,71045,HC X-RAY EXAM CHEST SINGLE VIEW,$458 33,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,71046,X-RAY EXAM CHEST 2 VIEWS,$480 34,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,71048,HC X-RAY EXAM CHEST >= 4 VIEWS,$501 35,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,71110,"HC RIBS, BILATERAL",$349 36,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,71120,HC STERNUM,$252 37,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72020,"HC SPINE,SINGLE VIEW",$188 38,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72040,HC SPINE CERV 2 OR 3 VIEWS,$284 39,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72050,HC SPINE CERVICAL 4 OR 5 VWS,$386 40,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72070,HC SPINE THORACIC 2 VIEWS,$271 41,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72072,HC SPINE THORACIC 3 VIEWS,$325 42,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72074,HC SPINE THORACIC 4 VIEWS,$406 43,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72080,"HC SPINE,THORACOLUMBAR 2 VIEWS",$222 44,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72081,HC RADIOLOGIC EXAM SPINE ENTIRE THORACIC&LUMBAR INCL SKULL/CERVICAL/SACRALSPINE 1 VIEW,$468 45,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72100,"HC SPINE,LUMBOSACRAL,2 OR 3 VIEWS",$245 46,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72110,"HC SPINE,LUMBOSACRAL,MINIMUM4VIEW",$461 47,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72170,"HC PELVIS,ONE OR TWO VIEWS",$270 48,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72190,"HC X-RAY PELVIS COMPLETE, MIN 3 VIEWS",$406 49,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72200,HC RAD EXAM SACROIL JOINT<3,$162 50,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72202,HC SACROILIAC JOINTS,$296 51,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72220,HC SACRUM AND COCCYX,$271 52,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72240,HC MYELOGRAPHY CERVICAL,"$1,975" 53,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72255,HC MYELOGRAPHY THORACI,"$2,401" 54,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72265,HC MYELOGRAPHY LUMBAR,"$1,951" 55,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,72270,HC MYLEOGRAPHY 2OR>REG,"$1,019" 56,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73000,HC CLAVICLE,$236 57,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73010,HC SCAPULA,$247 58,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73020,HC SHOULDER 1 VIEW,$206 59,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73030,HC SHOULDER COMPLET MIN 2VWS,$257 60,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73060,HC HUMERUS,$236 61,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73070,HC ELBOW TWO VIEWS,$231 62,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73090,HC FOREARM TWO VIEWS,$393 63,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73110,HC WRIST,$243 64,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73130,HC HAND,$218 65,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73140,HC FINGER(S),$171 66,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73501,HC RADIOLOGIC EXAM HIP UNILATERAL WITH PELVIS 1 VIEW,$308 67,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73502,HC RADIOLOGIC EXAM HIP UNILATERAL WITH PELVIS 2 OR 3 VIEWS,$342 68,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73503,HC RADIOLOGIC EXAM HIP UNILATERAL WITH PELVIS MIN 4 VIEWS,$376 69,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73521,HC RADIOLOGIC EXAM HIP BILATERAL WITH PELVIS 2 VIEWS,$369 70,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73522,HC RADIOLOGIC EXAM HIP BILATERAL WITH PELVIS 3-4 VIEWS,$417 71,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73523,HC RADIOLOGIC EXAM HIP BILATERAL WITH PELVIS MIN 5 VIEWS,$462 72,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73551,HC RADIOLOGIC EXAM FEMUR 1 VIEW,$316 73,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73552,HC RADIOLOGIC EXAM FEMUR MIN 2 VIEWS,$350 74,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73560,HC KNEE ONE OR TWO VIEWS,$216 75,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73562,"HC KNEE, 3 VIEWS",$268 76,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73565,"HC RADIOLOGIC EXAM, KNEE, BOTH KNEES, STANDING ANTEROPOSTERIOR",$300 77,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73590,HC TIBIA & FIBULA TWO VIEWS,$250 78,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73600,HC RAD EXAM ANKLE 2 VIEWS,$176 79,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73610,HC ANKLE COMPLETE MIN 3 VWS,$227 80,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73620,HC RAD EXAM FOOT 2 VIEWS,$171 81,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73630,HC FOOT 3VWS MIN,$248 82,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73650,HC OS CALCIS (HEEL),$209 83,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,73660,HC TOE,$162 84,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74018,HC X-RAY EXAM ABDOMEN 1 VIEW,$459 85,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74019,HC X-RAY EXAM ABDOMEN 2 VIEWS,$477 86,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74021,HC X-RAY EXAM ABDOMEN >= 3 VIEWS,$501 87,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74022,HC ACUTE ABD COMP&1 VW CHEST,$419 88,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74220,HC ESOPHAGUS,$462 89,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74230,"HC ESOPH, CINE OR VIDE",$411 90,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74240,HC UPPER GI SERIES,$483 91,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74246,HC UGI-DOUBLE CONT,$633 92,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74249,HC UPPER GIW/SML BWL,$958 93,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74250,HC SMALL BOWEL SERIES,$571 94,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74270,HC BARIUM ENEMA COLON,$635 95,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74300,HC CHOLANGIOGR/PANCR IO RS&I,"$1,575" 96,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74328,HC END CTH-BIL DUCT S&I,$125 97,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74329,HC ENDO CATH PANCR DUCT S&I,$284 98,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74330,"HC FLUORO MON,ENDO CATH",$132 99,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74340,HC LONG GI TUBE INSERT RS&I,$424 100,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74355,HC PERC PLACE ENTEROCL RS&I,$723 101,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74360,HC ILUM DIL STRCT/OBSTR RS&I,$880 102,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74363,HC PERCUTAN TRANSHEP DI,"$1,537" 103,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74420,HC RETROGRAD URETEROPYELOGRM,$889 104,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74425,HC URETEROPYELO/CONDUIT S&I,$889 105,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74430,HC CYSTOGRAPHY S&I,$719 106,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74450,HC RETROGRAD URETHROGRAM S&I,$137 107,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74455,"HC URETHROCYSTOG,VOIDING S&I",$572 108,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,74485,HC DILATION NEPHROSTOMY/URETER/URETHRA RAD S&I,$903 109,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75605,HC AORTOGRAPHY THOR RS&I,"$2,629" 110,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75625,HC S/I ABDOMIN AORTOGRAM,"$2,629" 111,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75630,HC S/I ABD AORTOGRAM W/LLRO,"$6,109" 112,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75705,HC ANGIOSPINAL SEL RS&I,"$4,253" 113,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75710,HC ANGIOEXTUNILAT RS&I,"$2,629" 114,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75716,HC ANGIOEXTBILAT RS&I,"$2,629" 115,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75726,HC VISC ANGIO SELEC RS&I,"$5,469" 116,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75731,HC ADREN ANGIO UNI SEL RS&I,"$2,629" 117,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75736,HC PELVIC ANGIO SELEC RS&I,"$2,629" 118,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75741,HC PULM ANGIO UNISEL RS&I,"$2,629" 119,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75743,HC PULM ANGIO BILSEL RS&I,$218 120,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75756,HC ANGIO INT MAMMARY RS&I,"$2,332" 121,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75774,HC ANGIO SELECTIVE EA ADD'L,"$2,184" 122,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75803,HC LYMPHANGIOEXTBIL RS&I,$108 123,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75805,HC LYMPH UNILAT PEL/ABD RS&I,$756 124,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75807,HC LYMPHBILATPEL/ABD RS&I,"$1,227" 125,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75820,HC VENOG EXT UNI RS&I,$850 126,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75822,HC VENOG EXT BILAT RS&I,$835 127,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75825,HC S/I VENOG INFER VENACAVA,"$2,629" 128,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75827,HC VENOG CAVAL SUP RS&I,$850 129,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75831,HC S/I VENOG RENAL UNIATERAL,"$2,629" 130,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75860,HC JUGULAR OR SINUS VENOGRAM,$190 131,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75885,HC PERC TRANS PORTW/HEM S&I,"$2,709" 132,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75887,HC PERC TRAN PORT W/OHEMS&I,"$3,497" 133,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75889,HC VENOGHEPATW/HEMO RS&I,"$2,629" 134,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75891,HC VENOHEPATW/O HEMO RS&I,"$2,629" 135,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75893,HC VENOUS SAMP THRU CAT RS&I,"$2,629" 136,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75894,HC TRANS THERAPYEMBOLI RS&I,$139 137,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75898,HC F/UP ANGIO INFUS/EMBOL,$850 138,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75970,HC TRANSCATH BIOPSY RS&I,"$2,553" 139,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75984,HC PERC TUBE/DRAIN CATH RS&I,"$1,032" 140,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,75989,HC RAD GUIDEPERC DRAIN/SPEC,"$1,352" 141,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,76000,HC FLUOROS (SEP) UP TO 1 HR,$349 142,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,76080,"SINOGRAM,FISTULA S&I",$702 143,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,76376,HC 3D RNDR WO POPRC INDWKSTA,$137 144,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,76377,HC 3D RNDR RQ POPRC INDWKSTA,"$1,019" 145,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,76536,HC U/S SOFT TISS HEAD &NECK,$620 146,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,76604,HC ULTRASOUND CHEST,$464 147,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,76815,HC U/S PEL LMTD (FETAL),$94 148,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77001,HC FLUORO GUI CVC PLACE/REM,"$1,017" 149,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77002,HC FLUORO GUIDED NDL PLACE,"$1,037" 150,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77003,HC FLURO GUID/NDL LOC SPINE,$774 151,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77053,HC MAMMOGRAPHY DUCT/GA,$482 152,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77054,HC MAMMOGRAPHY DUCT/GA MULT,$570 153,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77072,HC WRIST BONE AGE,$273 154,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77073,HC BONE LENGTH STUDY,$418 155,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77074,HC BONE SURVEY LMTD,$588 156,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77075,HC BONE SURVEY COMPL,$927 157,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77076,HC BONE SURVEY INF,$289 158,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77080,HC BONE DENSITY (DEXA),$441 159,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,77081,HC DXA APPENDICULAR,$226 160,320,RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION,G0278,HC L HRT CATH W/ILIAC ARTER,"$4,702" 161,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96401,HC CHEMADM SUBCU/IM NONHORM,$409 162,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96401,HC VELCADE INJ SUBCU/IM,$409 163,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96402,HC CHEM ADM SUBCU HORM,$391 164,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96405,HC CHEM-INTRALES-UP TO 7 LESIONS,$431 165,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96406,HC CHEM-INTRALES > 7 LESIONS,$452 166,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96409,HC CHEM ADM IVP-INIT,$409 167,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96411,HC CHEM ADM-IVP-EA ADD,$409 168,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96420,HC CHEMO INTRA-ART-PUSH,$431 169,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96440,HC CHEMO INTRACAV-THORACENTESIS,"$1,164" 170,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96446,HC CHEMO ADMIN VIA PORT/CATH,$634 171,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96450,HC CHEMO INTO CNS W/SPIN PUNC,"$1,223" 172,331,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - INJECTED,96542,HC CHEMO INJ VIA SUBCU RESV,"$1,164" 173,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77014,HC CT BASED IGRT,$680 174,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77014,HC CT XRT FIELD PLACEMNT 4D,$616 175,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77280,HC XRT-SIM SIMPLE,$972 176,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77285,HC XRT-SIM INTERMED,"$1,503" 177,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77290,HC XRT- SIM COMPLEX,"$1,981" 178,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77293,HC 4D CT MOTION MGMT SMULATN,$956 179,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77295,HC 3D RECON TUMOR VOL,"$4,770" 180,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77295,HC FUSION RECONSTRUCTION,"$4,770" 181,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77295,HC STEREO RECNSTR TUMR VOLUM,"$4,770" 182,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77300,HC XRT-DOSIM CALC,$708 183,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77301,HC XRT-IMRT TX PLAN,"$7,689" 184,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77306,HC TELTHRPY ISODOS PLAN SMPL,"$3,304" 185,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77307,HC TELTHRPY ISODOS PLAN CMPLX,"$3,075" 186,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77316,HC BRACHY ISODOSE PLAN SIMPL,"$1,920" 187,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77317,HC BRACHY ISODOS PLAN INTRMD,"$2,667" 188,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77321,HC SPECIAL TELE PORT PLAN,"$1,227" 189,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77331,HC SPECIAL DOSIMETRY,$818 190,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77332,HC XRT-DEVICE SIMPLE,$510 191,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77333,HC XRT-DEVICE INTERME,$771 192,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77334,HC APERTURE DEVICE COMPLEX,$990 193,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77334,HC AQUAPLAST TX DEV,$990 194,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77334,HC COMPENSATOR DEVICE COMPLEX,$990 195,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77334,HC VACLOCK TX DEV,$990 196,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77334,HC XRT-DEVICE COMPLEX,$990 197,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77336,HC XRT-MED PHYSICS QA,$744 198,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77338,HC MLC FOR IMRT/PLAN,"$4,053" 199,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77370,HC XRT - PHYSICS CONSLT,"$1,162" 200,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77371,HC SRS GAMMA KNIFE,"$57,049" 201,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77373,HC SBRT STEREO BDY RAD TXDEL,"$14,779" 202,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77385,HC XRT-IMRT DLV BRST/PROSTAT,"$2,462" 203,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77386,HC XRT-IMRT DELVRY FOR OTHRS,"$2,515" 204,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77387,HC T* CT BASED IGRT GUIDANCE,$388 205,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77387,HC T* KV BASED IGRT GUIDANCE,$388 206,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77387,HC T*MR BASED IGRT GUIDANCE,$388 207,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77401,HC XRT-SUPER/ORTHO,$491 208,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77402,HC XRT-SMP SGL TX AREA>= 1MV,$664 209,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77407,HC XRT-INTRMD 2 TX AREA>=1MV,$707 210,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77412,HC XRT-CMPLX 3+ TX AREA>=1MV,"$1,004" 211,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77417,HC PORT FILMS,$238 212,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77470,HC SPCL TMT PROCD,"$2,716" 213,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77520,HC PROTON TX DEL SIMPLE W/O COMPENSATION,"$3,489" 214,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77522,HC PROTON TX DEL SIMPLE W/ COMPENSATION,"$3,684" 215,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77523,HC PROTON TX DEL INTERMEDIATE,"$4,912" 216,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77525,HC PROTON TX DEL COMPLEX,"$5,208" 217,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77762,HC XRT-INTRACAV APP INTERM,"$1,819" 218,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77770,HC XRT-DR REMOTE INTER 1CH,"$5,194" 219,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77771,HC XRT-DR REMOTE INTER2-12CH,"$6,618" 220,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77772,HC XRT-DR REMOTE INTER 12+CH,"$7,432" 221,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77778,HC INTERSTIT RAD APPLC CMPLX,"$1,819" 222,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77778,HC XRT-INTER11+COM SUP/RADIO,"$1,819" 223,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77789,HC XRT-SURFACE APP,$89 224,333,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - RADIATION THERAPY,77790,HC SPVS/HAND/LOAD RAD SOURC,$84 225,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,96413,HC CHEM ADM-IV-1HR-INIT,$985 226,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,96415,HC CHEM ADM-IV EA ADD HR,$85 227,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,96416,HC CHEM ADM IV PUMP >8HRS,$707 228,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,96417,HC CHEMADM IV EA ADD SQ 1HR,$323 229,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,96521,HC REFILL MAINT PORT PUMP-CHEMO,$441 230,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,96523,HC IRRIGATION OF IMPLANT VAD,$148 231,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,G0498,HC CHEMO EXTEND IV INFUS W/PUMP,$993 232,335,RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY - IV,G0498,HC CHEMO EXTEND IV INFUS W/PUMP NO F/U,$993 233,341,NUCLEAR MEDICINE - DIAGNOSTIC,38792,HC INDENT SENTINEL NODE INJ,$577 234,341,NUCLEAR MEDICINE - DIAGNOSTIC,78013,HC THYROID IMAG INC VASC FLW,"$1,086" 235,341,NUCLEAR MEDICINE - DIAGNOSTIC,78014,HC THYROID IMAG SGL/MLT UPTK,"$1,795" 236,341,NUCLEAR MEDICINE - DIAGNOSTIC,78018,HC THY WB DIAGNOSTIC,"$1,261" 237,341,NUCLEAR MEDICINE - DIAGNOSTIC,78020,HC THYROID CA METS UPTAKE,$479 238,341,NUCLEAR MEDICINE - DIAGNOSTIC,78072,HC PARTHY PLNR IMG WSPECT&CT,"$2,746" 239,341,NUCLEAR MEDICINE - DIAGNOSTIC,78075,HC ADRENAL MEDULLARY IMAGING,"$3,466" 240,341,NUCLEAR MEDICINE - DIAGNOSTIC,78195,HC LYMPHOSCINTIGRA,"$1,603" 241,341,NUCLEAR MEDICINE - DIAGNOSTIC,78201,HC LIVER IMAGING STATIC ONLY,$975 242,341,NUCLEAR MEDICINE - DIAGNOSTIC,78205,HC SPECT LIVER IMAGING,"$1,559" 243,341,NUCLEAR MEDICINE - DIAGNOSTIC,78206,HC LIVER SPECT W/FLOW,"$1,883" 244,341,NUCLEAR MEDICINE - DIAGNOSTIC,78216,HC LIVER/SPLEEN IMAG W/VASC.FLOW,$879 245,341,NUCLEAR MEDICINE - DIAGNOSTIC,78226,HC HEPATOBLARY IMG IC GLBLDR,"$1,068" 246,341,NUCLEAR MEDICINE - DIAGNOSTIC,78227,HC HEPATOBLARY W/PHARM&QUANT,"$1,068" 247,341,NUCLEAR MEDICINE - DIAGNOSTIC,78264,HC GASTRIC EMPTYING,"$1,564" 248,341,NUCLEAR MEDICINE - DIAGNOSTIC,78267,HC BREATH TEST ACQUISITION,$340 249,341,NUCLEAR MEDICINE - DIAGNOSTIC,78268,HC BREATH TEST ANALYSIS,$176 250,341,NUCLEAR MEDICINE - DIAGNOSTIC,78278,HC GI BLOOD LOSS IMAGING,$753 251,341,NUCLEAR MEDICINE - DIAGNOSTIC,78290,HC MECKELS,$775 252,341,NUCLEAR MEDICINE - DIAGNOSTIC,78305,"HC BONE &OR JT.IMAGING,MULT",$272 253,341,NUCLEAR MEDICINE - DIAGNOSTIC,78306,HC WB BONE SCAN,"$1,345" 254,341,NUCLEAR MEDICINE - DIAGNOSTIC,78315,"HC BONE&OR JT.IMAGING,3PHASE","$1,071" 255,341,NUCLEAR MEDICINE - DIAGNOSTIC,78320,HC SPECT BONE IMAGING,"$1,701" 256,341,NUCLEAR MEDICINE - DIAGNOSTIC,78445,HC NON CARDIAC VASC FLOW IMAGING,"$1,090" 257,341,NUCLEAR MEDICINE - DIAGNOSTIC,78451,HC MYOPERF SPECT SGL RST/STR,"$2,606" 258,341,NUCLEAR MEDICINE - DIAGNOSTIC,78452,HC MYOPERF SPECT MLT RST/STR,"$2,606" 259,341,NUCLEAR MEDICINE - DIAGNOSTIC,78457,"HC VENOUSTHROMBOSIS,VENOGRAMUNILA",$400 260,341,NUCLEAR MEDICINE - DIAGNOSTIC,78458,"HC VENOGRAM,BILATERAL","$1,079" 261,341,NUCLEAR MEDICINE - DIAGNOSTIC,78472,HC GATED CARDIAC,"$1,490" 262,341,NUCLEAR MEDICINE - DIAGNOSTIC,78580,HC LUNG PERFUSION SCAN,$761 263,341,NUCLEAR MEDICINE - DIAGNOSTIC,78582,HC PULMONARY VENT & PERF IMG,"$2,542" 264,341,NUCLEAR MEDICINE - DIAGNOSTIC,78597,HC QUANT DIFF PULM PERF IMAG,$656 265,341,NUCLEAR MEDICINE - DIAGNOSTIC,78598,HC QUANT DIFF PULM PERF &VNT,"$2,542" 266,341,NUCLEAR MEDICINE - DIAGNOSTIC,78606,HC BRAIN IMAGING W/VASC FLOW,"$1,054" 267,341,NUCLEAR MEDICINE - DIAGNOSTIC,78630,HC CISTERNOGRAM,"$1,644" 268,341,NUCLEAR MEDICINE - DIAGNOSTIC,78645,HC CSF SHUNT EVALUATION,"$1,541" 269,341,NUCLEAR MEDICINE - DIAGNOSTIC,78647,HC CSF IMAGING TOMO (SPECT),"$1,897" 270,341,NUCLEAR MEDICINE - DIAGNOSTIC,78707,HC RENALFL/SCAN/FNC WOINTRVN,"$1,178" 271,341,NUCLEAR MEDICINE - DIAGNOSTIC,78708,HC KIDNEY SGL W/INTERVEN,"$1,482" 272,341,NUCLEAR MEDICINE - DIAGNOSTIC,78725,HC NON-IMAG KIDNEY FUNCTION,$147 273,341,NUCLEAR MEDICINE - DIAGNOSTIC,78800,HC TUMOR LOCL LTD AREA,"$1,031" 274,341,NUCLEAR MEDICINE - DIAGNOSTIC,78802,"HC TUMOR LOC,WHOLE BDY SGL DAY","$1,096" 275,341,NUCLEAR MEDICINE - DIAGNOSTIC,78803,HC SPECT TUMOR LOC,"$2,260" 276,341,NUCLEAR MEDICINE - DIAGNOSTIC,78804,HC TUMOR LOC WB MULTI DAYS,"$2,778" 277,341,NUCLEAR MEDICINE - DIAGNOSTIC,78806,HC WB ABSCESS LOCALIZATION,"$1,488" 278,341,NUCLEAR MEDICINE - DIAGNOSTIC,78808,HC PARATHYROID INJ PRE-SURG,$585 279,342,NUCLEAR MEDICINE - THERAPEUTIC,79005,HC RADIOPHARM TX-ORAL ADMIN,"$1,396" 280,342,NUCLEAR MEDICINE - THERAPEUTIC,79101,HC RADIOPHARM TX-IV ADMIN,$946 281,350,CT SCAN - GENERAL CLASSIFICATION,71275,HC CTA CHEST(NONCOR)W&WO CNT,"$3,492" 282,350,CT SCAN - GENERAL CLASSIFICATION,72127,HC CT C-SPINE W&W/O CON,"$3,320" 283,350,CT SCAN - GENERAL CLASSIFICATION,72191,HC CT ANGIO PELVIS W&WO CON,"$3,557" 284,350,CT SCAN - GENERAL CLASSIFICATION,74174,HC CT ANGIO AB&PLVS W&WO CON,"$6,728" 285,350,CT SCAN - GENERAL CLASSIFICATION,74175,HC CT ANGIO ABD W&WO CON,"$3,658" 286,350,CT SCAN - GENERAL CLASSIFICATION,75574,HC CTA HRT W/EVL CRDSTRMRP3D,"$3,156" 287,350,CT SCAN - GENERAL CLASSIFICATION,76380,HC CT LIMITED STUDY,$861 288,350,CT SCAN - GENERAL CLASSIFICATION,77011,HC INTRAOP CT LOCAL STEREOTACTIC GUIDANCE,"$2,241" 289,350,CT SCAN - GENERAL CLASSIFICATION,77012,HC CT GUID FOR NDLE PLC RS&I,"$1,870" 290,350,CT SCAN - GENERAL CLASSIFICATION,77013,HC CT GUIDE&MON VIS TISS ABL,"$1,633" 291,350,CT SCAN - GENERAL CLASSIFICATION,G0297,HC LDCT SCAN LUNG CA SCREENING,"$1,393" 292,351,CT SCAN - HEAD SCAN,70450,HC CT HEAD OR BRAIN W/O,"$1,968" 293,351,CT SCAN - HEAD SCAN,70460,HC CT HEAD OR BRAIN WITH,"$2,884" 294,351,CT SCAN - HEAD SCAN,70470,HC CT HEAD OR BRAIN W/O&W,"$2,923" 295,351,CT SCAN - HEAD SCAN,70480,HC CT ORB SEL POST W/0,"$2,611" 296,351,CT SCAN - HEAD SCAN,70481,HC CT ORB SEL POST WITH,"$2,774" 297,351,CT SCAN - HEAD SCAN,70486,HC CT MAXILLOFAC W/O,"$2,475" 298,351,CT SCAN - HEAD SCAN,70487,HC CT MAXILLOFAC W/CON,"$3,007" 299,351,CT SCAN - HEAD SCAN,70488,HC CT MAXILLOFAC W&W/O,"$3,308" 300,351,CT SCAN - HEAD SCAN,70490,HC CT SOFT TIS NCK W/O CONTR,"$2,553" 301,351,CT SCAN - HEAD SCAN,70491,HC CT SOFT TIS NCK W/ CONTR,"$3,134" 302,351,CT SCAN - HEAD SCAN,70492,HC CT SFT TIS NCK W&WO CONTR,"$3,198" 303,351,CT SCAN - HEAD SCAN,70496,HC CTA HEAD W&W/O CONTRAST,"$3,444" 304,351,CT SCAN - HEAD SCAN,70498,HC CTA NECK W&W/O CONTRAST,"$3,328" 305,352,CT SCAN - BODY SCAN,71250,HC CT THORAX W/O CONTRAST,"$2,647" 306,352,CT SCAN - BODY SCAN,71260,HC CT THORAX W/CONTRAST,"$3,344" 307,352,CT SCAN - BODY SCAN,71270,HC CT THORAX W&W/O CONTRAST,"$3,552" 308,352,CT SCAN - BODY SCAN,72125,HC CT C-SPINE W/O CONTR,"$2,768" 309,352,CT SCAN - BODY SCAN,72125,HC INTRAOP CT C-SPINE W/O CONTRAST,"$2,768" 310,352,CT SCAN - BODY SCAN,72126,HC CT C-SPINE W/CONTRAST,"$3,045" 311,352,CT SCAN - BODY SCAN,72128,HC CT T-SPINE W/O,"$2,769" 312,352,CT SCAN - BODY SCAN,72128,HC INTRAOP CT T-SPINE W/O CONTRAST,"$2,769" 313,352,CT SCAN - BODY SCAN,72129,HC CT T-SPINE W/CON,"$3,156" 314,352,CT SCAN - BODY SCAN,72130,HC CT T-SPINE W&W/O,"$3,320" 315,352,CT SCAN - BODY SCAN,72131,HC CT L-SPINE W/O,"$2,769" 316,352,CT SCAN - BODY SCAN,72131,HC INTRAOP CT L-SPINE W/O CONTRAST,"$2,769" 317,352,CT SCAN - BODY SCAN,72132,HC CT L-SPINE W/CON,"$3,156" 318,352,CT SCAN - BODY SCAN,72192,HC CT PELVIS W/O CONTRAST,"$2,466" 319,352,CT SCAN - BODY SCAN,72192,HC INTRAOP CT PELVIS W/O CONTRAST,"$2,466" 320,352,CT SCAN - BODY SCAN,72193,HC CT PELVIS W/CONTRAST,"$2,930" 321,352,CT SCAN - BODY SCAN,72194,HC CT PELVIS W&W/O CONT,"$3,027" 322,352,CT SCAN - BODY SCAN,73200,HC CT SCAN EXTREM W/O,"$2,385" 323,352,CT SCAN - BODY SCAN,73201,HC CT EXTREMITY W/CONTRAST,"$2,538" 324,352,CT SCAN - BODY SCAN,73202,HC CT SCAN EXT W&WO,"$2,662" 325,352,CT SCAN - BODY SCAN,73206,HC CTA UPR EXTREMITY W&W/O,"$2,414" 326,352,CT SCAN - BODY SCAN,73700,HC CT LOWER EXT W/O,"$2,238" 327,352,CT SCAN - BODY SCAN,73701,HC CT LOWER EXT W/CON,"$2,578" 328,352,CT SCAN - BODY SCAN,73702,HC CT LOWER EXT W&W/O,"$2,693" 329,352,CT SCAN - BODY SCAN,73706,HC CTA LOWER EXTRMITY W&W/O,"$2,754" 330,352,CT SCAN - BODY SCAN,74150,HC CT ABDOMEN W/O CONTRAST,"$2,322" 331,352,CT SCAN - BODY SCAN,74160,HC CT ABDOMEN W/CONTRAST,"$3,419" 332,352,CT SCAN - BODY SCAN,74170,HC CT ABDOMEN W&W/O CNTRAST,"$3,760" 333,352,CT SCAN - BODY SCAN,74176,HC CT ABD & PELVIS W/O CNTRST,"$4,554" 334,352,CT SCAN - BODY SCAN,74177,HC CT ABD & PELVIS W/CONTRST,"$6,043" 335,352,CT SCAN - BODY SCAN,74178,HC CT ABD &PELVIS WO&WCNTRST,"$6,728" 336,352,CT SCAN - BODY SCAN,74261,HC CT COLONOGRAPHYDIAG WOCON,"$2,175" 337,352,CT SCAN - BODY SCAN,74262,HC CT COLONOGRAPHYDIAG W/CON,"$2,352" 338,352,CT SCAN - BODY SCAN,74263,HC CT COLONOGRAPHY SCREENING,"$2,175" 339,352,CT SCAN - BODY SCAN,75635,HC CTA ABDOMNAL AORTA W&W/O,"$5,835" 340,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR 1 HR,"$5,133" 341,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR EACH 1/2 HR 1.5-8,"$1,715" 342,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR EACH 1/2 HR 8.5-24,"$1,020" 343,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR INTRAOP BRAIN STE 1 HR,"$36,567" 344,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR INTRAOP BRAIN STE EACH 1/2 HR 1.5-8,"$1,763" 345,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR INTRAOP BRAIN STE EACH 1/2 HR 8.5-24,$987 346,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR IOCT 1 HR,"$28,833" 347,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR IOCT EACH 1/2 HR 1.5-8,"$1,763" 348,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR IOCT EACH 1/2 HR 8.5-24,$987 349,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR ROBOTIC ROOM STE 1 HR,"$10,998" 350,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR ROBOTIC ROOM STE EACH 1/2 HR 1.5-8,"$1,763" 351,360,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,BLANK,HC OR ROBOTIC ROOM STE EACH 1/2 HR 8.5-24,$987 352,361,OPERATING ROOM SERVICES - MINOR SURGERY,10005,HC FINE NEEDLE ASPIRATION BX W/US GUIDANCE 1ST LESION,"$2,461" 353,361,OPERATING ROOM SERVICES - MINOR SURGERY,10006,HC FINE NEEDLE ASPIRATION BX W/US GUIDANCE EA ADDL,$615 354,361,OPERATING ROOM SERVICES - MINOR SURGERY,10009,HC FINE NEEDLE ASPIRATION BX W/CT GUIDANCE 1ST LESION,"$3,321" 355,361,OPERATING ROOM SERVICES - MINOR SURGERY,10035,HC PLCMT SOFT TISSUE LOCALIZATION DEVICE(S) PERCUTANEOUS INCL IMAGING GUIDANCE 1ST LESION,"$5,471" 356,361,OPERATING ROOM SERVICES - MINOR SURGERY,10036,HC PLCMT SOFT TISSUE LOCALIZATION DEVICE(S) PERCUTANEOUS INCL IMAGING GUIDANCE EA ADD LESION,"$2,675" 357,361,OPERATING ROOM SERVICES - MINOR SURGERY,20615,HC ASPIRAT &INJ TX BONE CYST,"$2,445" 358,361,OPERATING ROOM SERVICES - MINOR SURGERY,20982,HC BONE RFA PERC W/CT GUIDNC,"$6,477" 359,361,OPERATING ROOM SERVICES - MINOR SURGERY,24201,HC REMOVAL FOREIGN BODY DEEP,$769 360,361,OPERATING ROOM SERVICES - MINOR SURGERY,27096,HC INJ SACROILIAC JOINT ARTHRGRPHY&/ANES/STEROID W/ IMG GUIDANCE FLUR/CT,"$2,001" 361,361,OPERATING ROOM SERVICES - MINOR SURGERY,27216,"HC PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC BONE FRACTURE/ DISLOCATION, UNILATERAL","$11,383" 362,361,OPERATING ROOM SERVICES - MINOR SURGERY,28190,HC REMOV FOREIGN BODY&FT SQ,"$1,819" 363,361,OPERATING ROOM SERVICES - MINOR SURGERY,31231,"HC ENDOSCOPY,DIAGNOSTIC",$532 364,361,OPERATING ROOM SERVICES - MINOR SURGERY,31237,HC ENDOSCOPY BIOPSY,"$4,639" 365,361,OPERATING ROOM SERVICES - MINOR SURGERY,31500,HC ENDOTRACHEAL INTUBATION,$738 366,361,OPERATING ROOM SERVICES - MINOR SURGERY,31502,HC TRACHSTMY-TUBE CHG,$804 367,361,OPERATING ROOM SERVICES - MINOR SURGERY,31570,HC LARYNGOSCOPY DIR INJ VOCALCORD TX,"$3,435" 368,361,OPERATING ROOM SERVICES - MINOR SURGERY,31575,HC LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,$543 369,361,OPERATING ROOM SERVICES - MINOR SURGERY,31579,HC LARYNGSCPY STRBSCPY,"$1,588" 370,361,OPERATING ROOM SERVICES - MINOR SURGERY,31611,HC TRACHEOESPH PROSTH (TEP),"$4,148" 371,361,OPERATING ROOM SERVICES - MINOR SURGERY,31622,HC BRONCH DIAGNOS,"$2,678" 372,361,OPERATING ROOM SERVICES - MINOR SURGERY,31623,HC BRONCH W/BRUSHING,"$2,678" 373,361,OPERATING ROOM SERVICES - MINOR SURGERY,31624,HC BRONCH W/LAVAGE,"$2,678" 374,361,OPERATING ROOM SERVICES - MINOR SURGERY,31625,HC BRONCHOSCOPY W/BX,"$2,678" 375,361,OPERATING ROOM SERVICES - MINOR SURGERY,31628,HC BRONCH W/TRANS BIO,"$3,081" 376,361,OPERATING ROOM SERVICES - MINOR SURGERY,31629,HC BRONC W/TRAN NDL ASP,"$3,338" 377,361,OPERATING ROOM SERVICES - MINOR SURGERY,31630,HC BRONCH W/TRACH,"$7,587" 378,361,OPERATING ROOM SERVICES - MINOR SURGERY,31631,HC BRONCHOSCOPY W/STENT,"$5,341" 379,361,OPERATING ROOM SERVICES - MINOR SURGERY,31632,HC BRONCH W/TNSBRNC LUNG BXS,"$2,578" 380,361,OPERATING ROOM SERVICES - MINOR SURGERY,31634,HC BRONCH W/BALLOON AIR LEAK,"$2,836" 381,361,OPERATING ROOM SERVICES - MINOR SURGERY,31635,HC BRONCH W/REM FOREIGN,"$2,678" 382,361,OPERATING ROOM SERVICES - MINOR SURGERY,31636,HC BRONCH W/PLAC BRNCH STENT,"$7,243" 383,361,OPERATING ROOM SERVICES - MINOR SURGERY,31637,HC BRONCH EAADD BRNCUS STNTD,"$1,932" 384,361,OPERATING ROOM SERVICES - MINOR SURGERY,31638,HC BRONC RVS TR/BRNC PRVSTNT,"$4,680" 385,361,OPERATING ROOM SERVICES - MINOR SURGERY,31640,HC BRONCH W/EXC TUMOR,"$3,672" 386,361,OPERATING ROOM SERVICES - MINOR SURGERY,31641,HC BRONCH W/DESTRUCT,"$3,672" 387,361,OPERATING ROOM SERVICES - MINOR SURGERY,31643,HC BRONCH W/CATH PLACE,"$2,436" 388,361,OPERATING ROOM SERVICES - MINOR SURGERY,31645,HC THERAPEUTIC BRONCHOSCOPY INITIAL,"$3,012" 389,361,OPERATING ROOM SERVICES - MINOR SURGERY,31647,HC PLMNT BRONCHIAL INIT LOBE,"$2,860" 390,361,OPERATING ROOM SERVICES - MINOR SURGERY,31648,HC BRONCH REMOV INIT LOBE,"$5,334" 391,361,OPERATING ROOM SERVICES - MINOR SURGERY,31648,HC RMOVL BRONCHIAL INIT LOBE,"$2,678" 392,361,OPERATING ROOM SERVICES - MINOR SURGERY,31649,HC BRONCH REMOV EA ADD LOBE,"$1,932" 393,361,OPERATING ROOM SERVICES - MINOR SURGERY,31651,HC BRONCH INSERT EA ADD LOBE,"$1,932" 394,361,OPERATING ROOM SERVICES - MINOR SURGERY,31785,HC EXCIS BEN LES TRACH CRVCL,"$5,308" 395,361,OPERATING ROOM SERVICES - MINOR SURGERY,32400,"HC BIOPSY, PLEURA","$2,659" 396,361,OPERATING ROOM SERVICES - MINOR SURGERY,32405,"HC BIOPSY, LUNG","$3,198" 397,361,OPERATING ROOM SERVICES - MINOR SURGERY,32552,HC REM TUNN PLEUR CAT W/CUFF,$363 398,361,OPERATING ROOM SERVICES - MINOR SURGERY,32556,HC PLEURAL DRAINAGE W/O IMAG,"$3,277" 399,361,OPERATING ROOM SERVICES - MINOR SURGERY,32557,HC PLEURAL DRAINAGE W/IMAGE,"$4,086" 400,361,OPERATING ROOM SERVICES - MINOR SURGERY,32560,HC CHEMICAL PLEURODESIS,$701 401,361,OPERATING ROOM SERVICES - MINOR SURGERY,32601,"HC THORACOS, DIAGW/OBIOPSY","$6,402" 402,361,OPERATING ROOM SERVICES - MINOR SURGERY,32609,HC THORAW/BIOPSY LUNG PLEURA,"$7,963" 403,361,OPERATING ROOM SERVICES - MINOR SURGERY,32650,HC THORACOS W/PLEURODESIS,"$8,028" 404,361,OPERATING ROOM SERVICES - MINOR SURGERY,32994,"HC ABLATION THERAPY REDUCT OR ERAD >= 1 PULM TUMOR(S) W/IMG, UNI!CRYOABLATION","$14,230" 405,361,OPERATING ROOM SERVICES - MINOR SURGERY,32998,"HC ABLATION PULMONARY TUMOR PERQ INCLU IMG RADIOFREQUENCY, UNI","$14,647" 406,361,OPERATING ROOM SERVICES - MINOR SURGERY,33010,HC PERICARDIOCENTESIS INT,"$2,443" 407,361,OPERATING ROOM SERVICES - MINOR SURGERY,33011,HC PERICARDIOCENTESIS SUBSQ,$614 408,361,OPERATING ROOM SERVICES - MINOR SURGERY,33015,HC TUBE PERICARDIOSTOMY,"$2,327" 409,361,OPERATING ROOM SERVICES - MINOR SURGERY,33206,HC INS/RPL PM S/LD ART W/GEN,"$21,280" 410,361,OPERATING ROOM SERVICES - MINOR SURGERY,33207,HC INS/RPL PM S/LD VEN W/GEN,"$13,179" 411,361,OPERATING ROOM SERVICES - MINOR SURGERY,33208,HC INS/RPL PM D/LD A&V W/GEN,"$17,539" 412,361,OPERATING ROOM SERVICES - MINOR SURGERY,33210,HC TEMPORARY PM SINGLE,"$6,955" 413,361,OPERATING ROOM SERVICES - MINOR SURGERY,33211,HC TEMPORARY PACEMAKER DUAL,"$14,087" 414,361,OPERATING ROOM SERVICES - MINOR SURGERY,33215,HC PM/AICD LEAD REVISION,"$5,469" 415,361,OPERATING ROOM SERVICES - MINOR SURGERY,33223,HC AICD POCKET REVISION,"$4,490" 416,361,OPERATING ROOM SERVICES - MINOR SURGERY,33225,HC LV LEAD PLACEM W/NW GENRT,"$22,467" 417,361,OPERATING ROOM SERVICES - MINOR SURGERY,33227,HC REM/REPL PM GEN SGL,"$15,473" 418,361,OPERATING ROOM SERVICES - MINOR SURGERY,33228,HC REM/REPL PM GEN DUAL,"$22,362" 419,361,OPERATING ROOM SERVICES - MINOR SURGERY,33241,HC AICD GENERATOR REMOVAL,"$5,949" 420,361,OPERATING ROOM SERVICES - MINOR SURGERY,33244,HC AICD LEADS REMOVAL,"$5,153" 421,361,OPERATING ROOM SERVICES - MINOR SURGERY,33249,HC AICD INS/REP LD GENERATOR,"$16,914" 422,361,OPERATING ROOM SERVICES - MINOR SURGERY,33264,HC REMV&REPL CVD MULTI LEAD,"$19,827" 423,361,OPERATING ROOM SERVICES - MINOR SURGERY,34201,"HC EMBOLECTOMY OR THROMBECTOMY W/WO CATH FEMOROPOPLITEAL, AORTOILLIAC ARTERY, LEG INCISION","$9,239" 424,361,OPERATING ROOM SERVICES - MINOR SURGERY,34203,"HC EMBOLECTOMY OR THROMBECTOMY, W/WO CATH!POPLITEAL-TIBIO-PERONEAL ARTERY, LEG INCISION","$9,118" 425,361,OPERATING ROOM SERVICES - MINOR SURGERY,34705,"HC EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT, S & I","$23,905" 426,361,OPERATING ROOM SERVICES - MINOR SURGERY,34709,HC PLACEMENT XTN PROSTH FOR ENDOVASCULAR REPAIR S & I,"$11,729" 427,361,OPERATING ROOM SERVICES - MINOR SURGERY,34713,HC PERQ ACCESS & CLOSURE FEML ART FOR DELIVERY NDGFT THRU LARGE SHEATH =>12 FRENCH,"$8,726" 428,361,OPERATING ROOM SERVICES - MINOR SURGERY,34812,HC OP FMA EXP DL EVP GRN UNI,"$7,127" 429,361,OPERATING ROOM SERVICES - MINOR SURGERY,35371,HC THRMBENDARTRCTRMY PGF CFM,"$10,695" 430,361,OPERATING ROOM SERVICES - MINOR SURGERY,35372,HC THRMBENDARTRCTRMY PGF DFM,"$13,015" 431,361,OPERATING ROOM SERVICES - MINOR SURGERY,35661,HC BYPASS GRAFT OTH/THN VEIN FEMORAL-FEMORAL,"$7,607" 432,361,OPERATING ROOM SERVICES - MINOR SURGERY,36002,HC INJ PRC TX EXT PSDOANEURY,"$1,602" 433,361,OPERATING ROOM SERVICES - MINOR SURGERY,36005,HC VENOGRAM,"$2,843" 434,361,OPERATING ROOM SERVICES - MINOR SURGERY,36010,HC INTRO CATH SUP VENA CAVA,"$2,773" 435,361,OPERATING ROOM SERVICES - MINOR SURGERY,36011,HC SEL VENOUS 1ST ORDER,"$3,125" 436,361,OPERATING ROOM SERVICES - MINOR SURGERY,36012,HC SEL VENOUS 2ND ORDER,"$3,732" 437,361,OPERATING ROOM SERVICES - MINOR SURGERY,36013,HC INTRO CTH RTHRT/MN PULART,"$7,819" 438,361,OPERATING ROOM SERVICES - MINOR SURGERY,36014,HC SELCTHPLC LT/RT PULM ART,"$4,276" 439,361,OPERATING ROOM SERVICES - MINOR SURGERY,36140,HC INTRO NEEDLE OR INTRACATHER UPPER/LOWER EXTREMITY ARTERY,"$2,456" 440,361,OPERATING ROOM SERVICES - MINOR SURGERY,36200,HC INTRO CATH AORTA,"$4,031" 441,361,OPERATING ROOM SERVICES - MINOR SURGERY,36215,HC CATH PLAC EA1ST THOR/BRAC,"$3,256" 442,361,OPERATING ROOM SERVICES - MINOR SURGERY,36216,HC SEL THORAC BRACH/CEP 2ND,"$5,110" 443,361,OPERATING ROOM SERVICES - MINOR SURGERY,36217,HC SEL THORAC BRACH/CEP 3RD,"$5,291" 444,361,OPERATING ROOM SERVICES - MINOR SURGERY,36218,HC SEL THORAC BRACH/CEP >3,"$3,106" 445,361,OPERATING ROOM SERVICES - MINOR SURGERY,36221,HC NSCP TA ANGECC/V/ICV RS&I,"$6,109" 446,361,OPERATING ROOM SERVICES - MINOR SURGERY,36245,HC SEL ABD PEL EXTREM RENALS,"$3,611" 447,361,OPERATING ROOM SERVICES - MINOR SURGERY,36246,HC SEL ABD PEL EXTR RENAL 2,"$4,277" 448,361,OPERATING ROOM SERVICES - MINOR SURGERY,36247,HC SCP AR IN3RD+ A/PV/LXTABR,"$5,008" 449,361,OPERATING ROOM SERVICES - MINOR SURGERY,36248,HC SEL ABD PEL EXTR REN >3,"$2,916" 450,361,OPERATING ROOM SERVICES - MINOR SURGERY,36251,HC S/I 1ST RENAL UNILATERAL,"$6,284" 451,361,OPERATING ROOM SERVICES - MINOR SURGERY,36253,HC S/I 1-2+ RENAL UNILATERAL,"$6,284" 452,361,OPERATING ROOM SERVICES - MINOR SURGERY,36470,HC INJECTION SCLEROSANT SINGLE INCOMPETENT VEIN,"$2,445" 453,361,OPERATING ROOM SERVICES - MINOR SURGERY,36471,"HC INJECT SCLEROSANT, MULT INCOMPETENT VEIN","$2,445" 454,361,OPERATING ROOM SERVICES - MINOR SURGERY,36481,HC PRC PRTL VN CATH ANY MTHD,"$6,061" 455,361,OPERATING ROOM SERVICES - MINOR SURGERY,36500,HC VNS CTH SL ORGAN BLD SMPL,"$3,732" 456,361,OPERATING ROOM SERVICES - MINOR SURGERY,36557,HC INS TN CVC WO PRT/PMP<5YR,"$3,943" 457,361,OPERATING ROOM SERVICES - MINOR SURGERY,36558,HC INS TN CVC WO PRT/PM 5YR+,"$3,943" 458,361,OPERATING ROOM SERVICES - MINOR SURGERY,36561,HC INS TN CVAD W SCPRT 5YRS+,"$7,127" 459,361,OPERATING ROOM SERVICES - MINOR SURGERY,36563,HC INS TN CVAD W SUBCU PUMP,"$7,127" 460,361,OPERATING ROOM SERVICES - MINOR SURGERY,36573,"HC INSERT PICC W/O SUBQ PORT/PMP & IMG GUIDANCE, RS&I = OR > 5YRS","$3,486" 461,361,OPERATING ROOM SERVICES - MINOR SURGERY,36598,HC CONTRAST INJ EXISTING CVC,$493 462,361,OPERATING ROOM SERVICES - MINOR SURGERY,36821,"HC ARTERIOVENOUS ANASTOMOSIS, OPEN!DIRECT, ANY SITE","$10,943" 463,361,OPERATING ROOM SERVICES - MINOR SURGERY,36832,HC AV FISTULA REV OPEN W/O THROMBECT AUTOGENOUS OR NONAUTOGEN DIALYS GRFT,"$9,665" 464,361,OPERATING ROOM SERVICES - MINOR SURGERY,36833,HC AV FISTULA REV OPEN W/ THROMBECT AUTOGENOUS OR NONAUTOGEN DIALYS GRFT,"$10,046" 465,361,OPERATING ROOM SERVICES - MINOR SURGERY,36902,"HC INTRO CATH DIALYSIS CIRCUIT DX ANGIOP FLUOR GUID S&I W/ IMG DOC, TRLUML BALO","$8,837" 466,361,OPERATING ROOM SERVICES - MINOR SURGERY,36905,"HC PERQ THRMBC/NFS THROMB DIALYSIS CIRCUIT IMG, S&I, DX ANGRPH, FLUOR GUID W/TRLUML BALO ANGIOP","$9,320" 467,361,OPERATING ROOM SERVICES - MINOR SURGERY,37182,HC INSERTION OF TIPS,"$18,569" 468,361,OPERATING ROOM SERVICES - MINOR SURGERY,37184,HC PRC TRNS MCH THROMBECTOMY,"$8,555" 469,361,OPERATING ROOM SERVICES - MINOR SURGERY,37185,HC SUBSQ VESSLS THROMBECTOMY,"$8,481" 470,361,OPERATING ROOM SERVICES - MINOR SURGERY,37186,HC SECND THROMBART THRMBCTMY,"$8,555" 471,361,OPERATING ROOM SERVICES - MINOR SURGERY,37187,HC MCH VEN THROMBECT W/FLUOR,"$8,556" 472,361,OPERATING ROOM SERVICES - MINOR SURGERY,37188,HC SUB TX VEN THROMB W/FLUOR,"$8,483" 473,361,OPERATING ROOM SERVICES - MINOR SURGERY,37191,HC INSERTION IVC FILTR RS&I,"$9,351" 474,361,OPERATING ROOM SERVICES - MINOR SURGERY,37193,HC RETRVL(RMV) IVC FLTR RS&I,"$6,417" 475,361,OPERATING ROOM SERVICES - MINOR SURGERY,37197,HC TC RTR PC IVSC FBD W RS&I,"$6,131" 476,361,OPERATING ROOM SERVICES - MINOR SURGERY,37200,HC TRANSCATHETER BIOPSY,"$6,131" 477,361,OPERATING ROOM SERVICES - MINOR SURGERY,37211,HC TCTX AI-THR OCR WRS&I IND,"$7,819" 478,361,OPERATING ROOM SERVICES - MINOR SURGERY,37212,HC TCTX VI-THR ANY WRS&I IND,"$7,819" 479,361,OPERATING ROOM SERVICES - MINOR SURGERY,37213,HC TCTX AVI-TB OCR WRS&I CNT,"$7,127" 480,361,OPERATING ROOM SERVICES - MINOR SURGERY,37214,HC TCT AVI-TR OC RSI CD SESS,"$7,127" 481,361,OPERATING ROOM SERVICES - MINOR SURGERY,37220,HC ILIAC REVASC UNI INIT VSL,"$11,954" 482,361,OPERATING ROOM SERVICES - MINOR SURGERY,37221,HC ILIAC REVSC UNI INIW/STNT,"$11,954" 483,361,OPERATING ROOM SERVICES - MINOR SURGERY,37222,HC ILIAC REVASC UNI ADD VESL,"$11,954" 484,361,OPERATING ROOM SERVICES - MINOR SURGERY,37223,HC ILIAC REVSC UNI ADD WSTNT,"$11,954" 485,361,OPERATING ROOM SERVICES - MINOR SURGERY,37224,HC FEM/POP REVSC UNI INI VSL,"$11,954" 486,361,OPERATING ROOM SERVICES - MINOR SURGERY,37226,HC FM/POP RVSC UNI VSL WSTNT,"$25,377" 487,361,OPERATING ROOM SERVICES - MINOR SURGERY,37228,HC TIB/PER RVSC UNI INIT VSL,"$11,954" 488,361,OPERATING ROOM SERVICES - MINOR SURGERY,37232,HC TIB/PER RVSC UNI ADDL VSL,"$11,954" 489,361,OPERATING ROOM SERVICES - MINOR SURGERY,37236,HC TRNSCTH ARTERY STENT INIT,"$28,480" 490,361,OPERATING ROOM SERVICES - MINOR SURGERY,37237,HC TRNSCTH ARTERY STENT ADDL,"$14,105" 491,361,OPERATING ROOM SERVICES - MINOR SURGERY,37238,HC TRNSCTH VENOUS STENT INIT,"$28,480" 492,361,OPERATING ROOM SERVICES - MINOR SURGERY,37239,HC TRNSCTH VENOUS STENT ADDL,"$14,105" 493,361,OPERATING ROOM SERVICES - MINOR SURGERY,37241,HC EMB VEIN WIMG NOTUMR/HEMR,"$26,639" 494,361,OPERATING ROOM SERVICES - MINOR SURGERY,37242,HC EMB ARTRY WIMG NOTUMR/HMR,"$26,639" 495,361,OPERATING ROOM SERVICES - MINOR SURGERY,37243,HC EMB ORGAN/TUMORHAE/TACE,"$26,639" 496,361,OPERATING ROOM SERVICES - MINOR SURGERY,37244,HC EMB VASCGI BLEED/LYMEXT,"$26,639" 497,361,OPERATING ROOM SERVICES - MINOR SURGERY,37246,"HC TRLUML BALO ANGIOP OPEN OR PERCT, S&I PERFORM ANGIOP W/SAME ARTERY, INITIAL ARTERY","$9,258" 498,361,OPERATING ROOM SERVICES - MINOR SURGERY,37248,"HC TRLUML BALO ANGIOP OPEN OR PERCT, S&I PERFORM ANGIOP W/SAME VEIN, INITIAL VEIN","$9,258" 499,361,OPERATING ROOM SERVICES - MINOR SURGERY,37249,"HC TRLUML BALO ANGIOP OPEN OR PERCT, S&I PERFORM ANGIOP W/SAME VEIN, EA ADDL VEIN","$8,483" 500,361,OPERATING ROOM SERVICES - MINOR SURGERY,37607,HC LIGATN ANGIOACCESS AV FISTULA,"$6,650" 501,361,OPERATING ROOM SERVICES - MINOR SURGERY,38999,HC CRYOBLATION HEMIC OR LYMPHATIC SYSTEM,"$6,634" 502,361,OPERATING ROOM SERVICES - MINOR SURGERY,38999,HC LYMPHNOD IRRV ELCTRPR ABL,"$11,136" 503,361,OPERATING ROOM SERVICES - MINOR SURGERY,43752,HC NASOGASTRIC TUBE PLACMNT,$618 504,361,OPERATING ROOM SERVICES - MINOR SURGERY,43761,HC GAST FEED TUBE REPOS DUOD,"$1,717" 505,361,OPERATING ROOM SERVICES - MINOR SURGERY,44370,HC SM INTES ENDO W/O ILEUM,"$5,661" 506,361,OPERATING ROOM SERVICES - MINOR SURGERY,44500,HC INTRODUCT LONG GI TUBE,"$1,210" 507,361,OPERATING ROOM SERVICES - MINOR SURGERY,47000,"HC BIOPSY, LIVER","$3,303" 508,361,OPERATING ROOM SERVICES - MINOR SURGERY,47120,HC HEPATECTOMY RESECTION OF LIVER!PARTIAL LOPECTOMY,"$51,883" 509,361,OPERATING ROOM SERVICES - MINOR SURGERY,47382,HC ABLAT 1+ LIVR TUMR PRC RF,"$13,015" 510,361,OPERATING ROOM SERVICES - MINOR SURGERY,47490,HC CHOLECYSTOSTMY PC CPWRS&I,"$5,582" 511,361,OPERATING ROOM SERVICES - MINOR SURGERY,47531,"HC INJ CHOLANGIOGRAPHY,PERCUTANEOUS,COMPLETE DIA PX IMG GUIDANCE S&I, EXISTING ACCESS","$1,452" 512,361,OPERATING ROOM SERVICES - MINOR SURGERY,47531,HC INJ CHOLANGIOGRAPHYPERCUTANEOUSCOMPLETE DIA PX IMG GUIDANCE S&I EXISTING ACCESS,"$1,452" 513,361,OPERATING ROOM SERVICES - MINOR SURGERY,47532,"HC INJ CHOLANGIOGRAPHY,PERCUTANEOUS,COMPLETE DIA PX IMG GUIDANCE S&I, NEW ACCESS","$2,346" 514,361,OPERATING ROOM SERVICES - MINOR SURGERY,47532,HC INJ CHOLANGIOGRAPHYPERCUTANEOUSCOMPLETE DIA PX IMG GUIDANCE S&I NEW ACCESS,"$2,346" 515,361,OPERATING ROOM SERVICES - MINOR SURGERY,47533,HC PLACEMENT BILIARY DRAINAGE CATHPERCT INCL DIA CHOLANGIOGR IMG GUID S&I EXTERNAL,"$8,338" 516,361,OPERATING ROOM SERVICES - MINOR SURGERY,47534,HC PLACEMENT BILIARY DRAINAGE CATHPERCT INCL DIA CHOLANGIOGR IMG GUID S&I INTERNAL-EXTERNAL,"$8,675" 517,361,OPERATING ROOM SERVICES - MINOR SURGERY,47535,HC CONVERSION EXT BILI DRAIN CATH TO IN-EXTERNAL BILI DRAIN CATHPERCUTDIA CHOLANG IMG GUID S&I,"$7,575" 518,361,OPERATING ROOM SERVICES - MINOR SURGERY,47536,HC EXCHANGE BILIARY DRAINGE CATHPERCUTINCL DIA CHOLANGIOGRAPHY IMG GUID S&I,"$7,213" 519,361,OPERATING ROOM SERVICES - MINOR SURGERY,47537,HC REMOVAL BILIARY DRAINGE CATHPERCUTREQ FLUOROSCOPIC GUIDINCL DIA CHOLANG IMG GUID S&I,"$7,320" 520,361,OPERATING ROOM SERVICES - MINOR SURGERY,47538,HC PLCMT STENT BILE DUCTPERCUT DIA CHOLIMG GUID BALL DIALCATH EXCH/REM S&I EA STE EXIST ACCE,"$7,575" 521,361,OPERATING ROOM SERVICES - MINOR SURGERY,47541,"HC PLMT ACCESS THRU BILIARY TREE & SMALL BOWEL INCL CHOLANGIO, IMAGING, S & I, NEW ACCESS","$8,180" 522,361,OPERATING ROOM SERVICES - MINOR SURGERY,47542,"HC BALLON DILATION BILIARY DUCT(S), AMPULLA, PERCUTANEOUS, INCL IMG GUIDANCE S & I, EA DUCT","$5,496" 523,361,OPERATING ROOM SERVICES - MINOR SURGERY,47543,"HC ENDOLUMINAL BIOPSY BILIARY TREE, PERCUT, ANY METH INCL IMG GUIDANCE, S & I SINGLE OR MULT","$5,750" 524,361,OPERATING ROOM SERVICES - MINOR SURGERY,47552,HC BILENDO VIA T-TUBE DX SPC,"$3,090" 525,361,OPERATING ROOM SERVICES - MINOR SURGERY,47555,HC BILENDO V T-TB DIL WO STN,"$8,666" 526,361,OPERATING ROOM SERVICES - MINOR SURGERY,47556,HC BILENDO V T-TB DIL W/ STN,"$11,739" 527,361,OPERATING ROOM SERVICES - MINOR SURGERY,47801,HC PLACMNT CHOLEDOCHAL STENT,"$4,457" 528,361,OPERATING ROOM SERVICES - MINOR SURGERY,48102,HC BIOPSY PANCREAS PRCU NDL,"$3,303" 529,361,OPERATING ROOM SERVICES - MINOR SURGERY,49180,HC BX ABD/RTPRITNL MASS PCND,"$2,659" 530,361,OPERATING ROOM SERVICES - MINOR SURGERY,49185,"HC SCLEROTHERAPY FLUID COLLECTION, PERCUTANEOUS INCL CONTRAST INJ, DX, IMAG GUID, RAD S & I","$5,994" 531,361,OPERATING ROOM SERVICES - MINOR SURGERY,49405,HC DRAIN VISCRAL/ORG W IMG,"$4,696" 532,361,OPERATING ROOM SERVICES - MINOR SURGERY,49406,HC DRAIN IP PERIT/RTRO W IMG,"$4,314" 533,361,OPERATING ROOM SERVICES - MINOR SURGERY,49407,HC DRAIN TRNSVAG/RECTL W IMG,"$4,696" 534,361,OPERATING ROOM SERVICES - MINOR SURGERY,49411,HC INS MRK RTX IA/IP/RTP S/M,"$2,709" 535,361,OPERATING ROOM SERVICES - MINOR SURGERY,49418,HC IP CATH PLCMNT INC IMAGNG,"$6,751" 536,361,OPERATING ROOM SERVICES - MINOR SURGERY,49419,HC INSRT TUNNEL IP CATH PORT,"$5,724" 537,361,OPERATING ROOM SERVICES - MINOR SURGERY,49422,HC IP CATH REMOVL INC IMAGNG,"$5,767" 538,361,OPERATING ROOM SERVICES - MINOR SURGERY,49423,HC XCHG PRV AB/CYS DRNCTH GD,"$2,519" 539,361,OPERATING ROOM SERVICES - MINOR SURGERY,49424,HC CNTR INJ AB/CYS VIA PPCTH,$995 540,361,OPERATING ROOM SERVICES - MINOR SURGERY,49440,HC PLACE GASTROSTOMY TUB PRC,"$2,797" 541,361,OPERATING ROOM SERVICES - MINOR SURGERY,49441,HC PLACE DUOD/JEJ TUBE PERC,"$2,022" 542,361,OPERATING ROOM SERVICES - MINOR SURGERY,49442,HC PLACE CECOSTOMY TUBE PERC,"$3,512" 543,361,OPERATING ROOM SERVICES - MINOR SURGERY,49446,HC CHANGE G-TUBE TO G-J PERC,"$3,153" 544,361,OPERATING ROOM SERVICES - MINOR SURGERY,49450,HC REPLACE G/C TUBE PERC,"$1,177" 545,361,OPERATING ROOM SERVICES - MINOR SURGERY,49451,HC REPLACE DUOD/JEJ TUBE PRC,"$1,177" 546,361,OPERATING ROOM SERVICES - MINOR SURGERY,49452,HC REPLACE G-J TUBE PERC,"$1,177" 547,361,OPERATING ROOM SERVICES - MINOR SURGERY,49465,HC FLUORO EXAM G/COLON TUBE,$434 548,361,OPERATING ROOM SERVICES - MINOR SURGERY,50200,HC RENAL BX PRC TROCAR/NEEDL,"$3,303" 549,361,OPERATING ROOM SERVICES - MINOR SURGERY,50382,HC RMV/RPLC INT URETERL STNT,"$5,122" 550,361,OPERATING ROOM SERVICES - MINOR SURGERY,50384,HC INT URETERAL STENT REMOVL,"$4,094" 551,361,OPERATING ROOM SERVICES - MINOR SURGERY,50386,HC REMOV STNT VIA TRANSURETH,"$1,635" 552,361,OPERATING ROOM SERVICES - MINOR SURGERY,50387,HC RMV/RPLC EXT URETERL STNT,"$3,392" 553,361,OPERATING ROOM SERVICES - MINOR SURGERY,50389,HC NPHRSTMY TUBE RMV W/FLURO,"$1,234" 554,361,OPERATING ROOM SERVICES - MINOR SURGERY,50396,HC MANOMTRY NPHR IDW URTRCTH,"$1,069" 555,361,OPERATING ROOM SERVICES - MINOR SURGERY,50430,HC INJ ANTEGRADE NEPHROSTOGRAM &OR URETEROGRAMCOMPL DIA PX IMG GUID S&I NEW ACCESS,"$2,356" 556,361,OPERATING ROOM SERVICES - MINOR SURGERY,50431,HC INJ ANTEGRADE NEPHROSTOGRAM &OR URETEROGRAMCOMPL DIA PX IMG GUID S&I EXIST ACCESS,"$1,885" 557,361,OPERATING ROOM SERVICES - MINOR SURGERY,50432,HC PLCMT NEPHROSTOMY CATH PERCUT INCL DIA NEPHROSTOGRAM/URETEROGRAM IMG GUID S&I,"$7,575" 558,361,OPERATING ROOM SERVICES - MINOR SURGERY,50433,HC PLCMT NEPHROSTOMY CATH PERCUT INCL DIA NEPHROSTOGRAM/URETEROGRAM IMG GUID S&I NEW ACCESS,"$8,212" 559,361,OPERATING ROOM SERVICES - MINOR SURGERY,50434,HC CONVERT NEPHR CATHPERCUT INCL DIA NEPHRGRAM/UREGRAM IMG GUID S&I PRE-EXST NEPHR TRACT,"$7,701" 560,361,OPERATING ROOM SERVICES - MINOR SURGERY,50435,HC EXCHANGE NEPHROSTOMY CATH PERCUT INCL DIA NEPHROSTOGRAM/URETEROGRAM IMG GUID S&I.,"$7,211" 561,361,OPERATING ROOM SERVICES - MINOR SURGERY,50592,HC ABLAT 1+ RNLTMR PC UNI RF,"$13,015" 562,361,OPERATING ROOM SERVICES - MINOR SURGERY,50593,HC ABLAT 1+ RNLTMR P/UNI CRY,"$13,015" 563,361,OPERATING ROOM SERVICES - MINOR SURGERY,50688,HC CHG URTROS TB/EXT USTN IL,"$3,308" 564,361,OPERATING ROOM SERVICES - MINOR SURGERY,50693,HC PLCMT URETER STENTPERCUT INCL DIA NEPHRGRAM/UREGRAM IMG GUID S&I PRE-EXST NEPHR TRACT,"$7,701" 565,361,OPERATING ROOM SERVICES - MINOR SURGERY,50694,HC PLCMT URET STENTPERCUT INCL DIA NEPHRGRAM/UREGRAM IMG GUID S&I NEW ACCESS WO SEP NEPHR CATH,"$8,338" 566,361,OPERATING ROOM SERVICES - MINOR SURGERY,50695,HC PLCMT URET STENTPERCUT INCL DIA NEPHRGRAM/UREGRAM IMG GUID S&I NEW ACCESS W SEP NEPHR CATH,"$8,465" 567,361,OPERATING ROOM SERVICES - MINOR SURGERY,50705,HC URETERAL EMBOLIZATION OR OCCLUSION INCL IMAGING GUIDANCE S&I,"$8,335" 568,361,OPERATING ROOM SERVICES - MINOR SURGERY,50706,HC BALLOON DILATION URETERAL STRICTURE INCL IMAGING GUIDANCE S&I,"$8,209" 569,361,OPERATING ROOM SERVICES - MINOR SURGERY,58900,HC BIOPSY OVARY UNILT/BILAT,"$2,659" 570,361,OPERATING ROOM SERVICES - MINOR SURGERY,61624,HC TC PERM OCCLU/EMBOL P CNS,"$21,109" 571,361,OPERATING ROOM SERVICES - MINOR SURGERY,61626,HC TC PRM OCLU/EMBL P NCNSHN,"$21,109" 572,361,OPERATING ROOM SERVICES - MINOR SURGERY,61650,"HC EVASC PRLNG ADMN RX AGNT ART, IMG GUIDANCE, 1ST VAS TERRITORY","$3,868" 573,361,OPERATING ROOM SERVICES - MINOR SURGERY,62267,HC ASP NUCLP IVTDSC/PVTIS DX,"$5,026" 574,361,OPERATING ROOM SERVICES - MINOR SURGERY,64561,HC IMP NEUROSTM SACRAL NRV,"$14,006" 575,361,OPERATING ROOM SERVICES - MINOR SURGERY,66761,HC IRIDOTOMY/ECTMY LASR1+SSN,"$1,136" 576,361,OPERATING ROOM SERVICES - MINOR SURGERY,67028,HC INTRAVITRL INJ PHARM AGNT,$714 577,361,OPERATING ROOM SERVICES - MINOR SURGERY,67345,HC CHEMODNV EXTRAOCUL MUSCL,$570 578,361,OPERATING ROOM SERVICES - MINOR SURGERY,67515,HC INJ TX AGNT TENON'S CAPSL,$665 579,361,OPERATING ROOM SERVICES - MINOR SURGERY,67710,HC SEVERING OF TARSORRHAPHY,"$1,688" 580,361,OPERATING ROOM SERVICES - MINOR SURGERY,67810,HC BIOPSY EYELID,$887 581,361,OPERATING ROOM SERVICES - MINOR SURGERY,67820,HC COR TRICH EPIL FORCP,$881 582,361,OPERATING ROOM SERVICES - MINOR SURGERY,67840,HC EXC LES EYELID,"$1,595" 583,361,OPERATING ROOM SERVICES - MINOR SURGERY,67875,HC TEMP CLOS EYELID SUTURE,"$1,420" 584,361,OPERATING ROOM SERVICES - MINOR SURGERY,67880,HC TARSORRHAPHY CONSTRUCT,"$3,093" 585,361,OPERATING ROOM SERVICES - MINOR SURGERY,68100,HC BIOPSY OF CONJUNCTIVA,"$1,138" 586,361,OPERATING ROOM SERVICES - MINOR SURGERY,68760,HC CLO LACR PUNC CAUT/LASER,$978 587,361,OPERATING ROOM SERVICES - MINOR SURGERY,68761,HC CLOSE LACR PUNCT PLUG,$824 588,361,OPERATING ROOM SERVICES - MINOR SURGERY,68810,HC PROBE NASOLACR DUCT,$916 589,361,OPERATING ROOM SERVICES - MINOR SURGERY,73525,HC RAD EXAM HIP ARTHROGRAPHY R S& I,"$1,345" 590,361,OPERATING ROOM SERVICES - MINOR SURGERY,92950,HC CARDIOPULMONARY RESUSCITATION,$955 591,361,OPERATING ROOM SERVICES - MINOR SURGERY,0200T,HC SACRL AUG PC UNI NJ 1+NDL,"$7,162" 592,361,OPERATING ROOM SERVICES - MINOR SURGERY,0230T,"HC INJ ANESTHETIC/STEROID TRANSFORAMINAL EPIDURAL W/US LUM/SAC, 1 LEVEL","$3,697" 593,361,OPERATING ROOM SERVICES - MINOR SURGERY,0231T,"HC INJ ANESTHETIC/STEROID TRANSFORAMINAL EPIDURAL W/US LUM/SAC, EA ADD'L LEVEL","$1,314" 594,361,OPERATING ROOM SERVICES - MINOR SURGERY,G0269,HC PLACMNT CLOSE VEIN/ARTERY,$539 595,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38206,"HC BLD DERIVED HARVEST, AUTO","$3,642" 596,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38207,HC TXPREP CRO/STOR,"$8,364" 597,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38208,HC TXPREP THAWING,"$3,238" 598,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38209,HC TXPREP WASHING,"$6,092" 599,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38212,HC TXPREP RBC REMOVAL,"$5,228" 600,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38214,HC TXPREP PLASMA DEPL,"$5,573" 601,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38215,HC TXPREP CELL CONCEN,"$6,205" 602,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38240,HC BONE MARROW TRANSPL ALLO PER DONOR,"$5,284" 603,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38241,HC BONE MARR STEM CELL AUTO,"$4,135" 604,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38242,HC PERIPH STEM CELL ALLO DLI,"$4,312" 605,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38243,HC HPC BOOST,"$4,494" 606,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38999,"HC ADMINISTRATION, OTHER CELLULAR THERAPY","$4,135" 607,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38999,HC AUTO CAR-T CELLS MANIP HANDLING,"$1,371" 608,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38999,HC AUTOLOGOUS DLI,"$4,350" 609,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38999,HC MNC THERAPEUTIC T CELL COLLECTION AUTO,"$3,479" 610,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,38999,HC NON-THERAP LEUKAPHERSIS,"$3,479" 611,362,OPERATING ROOM SERVICES - ORGAN TRANSPLANT - OTHER THAN KIDNEY,99199,HC TXPREP MANIP HANDLG,"$1,371" 612,370,ANESTHESIA - GENERAL CLASSIFICATION,99152,"HC MOD SEDATION SAME PHYS/QHP 5/>YRS, INITIAL 15MIN",$427 613,370,ANESTHESIA - GENERAL CLASSIFICATION,99153,"HC MOD SEDATION SAME PHYS/QHP EA, EACH ADD'L 15MIN",$245 614,370,ANESTHESIA - GENERAL CLASSIFICATION,99156,HC MOD SEDATION OTHER PHYS/QHP 5/>YRS!INITIAL 15MIN,$427 615,370,ANESTHESIA - GENERAL CLASSIFICATION,99157,HC MOD SEDATION OTHER PHYS/QHP EA ADD'L 15 MIN,$253 616,370,ANESTHESIA - GENERAL CLASSIFICATION,BLANK,HC ANESTHESIA BUNDLE 1 30 MIN EA,$202 617,370,ANESTHESIA - GENERAL CLASSIFICATION,BLANK,HC ANESTHESIA BUNDLE 1 BASE,"$1,726" 618,370,ANESTHESIA - GENERAL CLASSIFICATION,BLANK,HC ANESTHESIA BUNDLE 2 30 MIN EA,$176 619,370,ANESTHESIA - GENERAL CLASSIFICATION,BLANK,HC ANESTHESIA BUNDLE 2 BASE,"$1,373" 620,370,ANESTHESIA - GENERAL CLASSIFICATION,G0500,"HC MOD SED GI ENDO SAME PHYS 5/>YRS, INITIAL 15MIN",$427 621,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9012,HC CRYOPRECIP PROC,$100 622,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9017,HC PLASMA FROZEN PROC,$145 623,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9017,HC PLASMA SGL DONOR,$145 624,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9022,HC RED BLD CELLS FROZ,$718 625,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9032,HC PLATELETS IRRADIATED,$263 626,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9036,HC PLATELETS PHER IRR EA,"$1,096" 627,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9037,HC PLATEL PHERESIS LEUK IRR,"$1,393" 628,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9038,HC RED CELLS IRRAD,$430 629,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9040,HC RED CELLS LEUKOR IRRAD,$473 630,390,"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION",P9050,HC GRANULOCYTE PHERESIS EACH UNIT,"$6,070" 631,391,"ADMINISTRATION, PROCESSING, & STORAGE FOR BLOOD AND BLOOD COMPONENTS-ADMINISTRATION(E.G.TRANSFUSION)",36430,HC BLOOD ADMIN OUTPATIENT,"$1,213" 632,391,"ADMINISTRATION, PROCESSING, & STORAGE FOR BLOOD AND BLOOD COMPONENTS-ADMINISTRATION(E.G.TRANSFUSION)",36430,HC TRANSFUSE BLD/BLD COMP (ANESTH),"$1,213" 633,391,"ADMINISTRATION, PROCESSING, & STORAGE FOR BLOOD AND BLOOD COMPONENTS-ADMINISTRATION(E.G.TRANSFUSION)",36455,HC EXCHG TRANSFS BLD NOT NB,"$1,191" 634,401,OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY,19281,HC MAMMO BRST LCDV PLC 1STLS,"$3,252" 635,401,OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY,19282,HC MAMMO BRST LCDV PLC ADDLS,"$1,301" 636,401,OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY,77065,"HC DIAGNOSTIC MAMMOGRAPHY INCL CAD, UNILATERAL",$494 637,401,OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY,77066,"HC DIAGNOSTIC MAMMOGRAPHY INCL CAD, BILATERAL",$647 638,401,OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY,G0279,HC DIAGNST BREAST TOMOSYNTHS,$150 639,402,OTHER IMAGING SERVICES - ULTRASOUND,19285,HC U/S BRST LCDV PLC 1ST LES,"$3,115" 640,402,OTHER IMAGING SERVICES - ULTRASOUND,19286,HC U/S BRST LCDV PLC ADD LES,"$1,246" 641,402,OTHER IMAGING SERVICES - ULTRASOUND,37252,HC US INTRAVASCULAR NONCORONARY VESSEL S&I INITIAL,"$1,608" 642,402,OTHER IMAGING SERVICES - ULTRASOUND,76511,HC OPHTH US ECHO DX A-SCAN,$434 643,402,OTHER IMAGING SERVICES - ULTRASOUND,76512,HC OPHTH US DX CONT B-SCAN,$516 644,402,OTHER IMAGING SERVICES - ULTRASOUND,76513,HC OPHTH US-DX ANT SEG,$334 645,402,OTHER IMAGING SERVICES - ULTRASOUND,76514,HC OPHTH US CORNEAL PACYMTRY,$48 646,402,OTHER IMAGING SERVICES - ULTRASOUND,76519,HC OPHTH BIOMETRY A-SCAN,$408 647,402,OTHER IMAGING SERVICES - ULTRASOUND,76641,HC U/S BREAST UNILATCOMPLET,"$1,176" 648,402,OTHER IMAGING SERVICES - ULTRASOUND,76642,HC U/S BREAST UNILAT LIMITED,"$1,021" 649,402,OTHER IMAGING SERVICES - ULTRASOUND,76700,HC U/S ABD COMPL,$941 650,402,OTHER IMAGING SERVICES - ULTRASOUND,76705,HC U/S ABDOMEN LIMITED,$585 651,402,OTHER IMAGING SERVICES - ULTRASOUND,76770,HC US RETROPERITONEAL COMPLETE,$494 652,402,OTHER IMAGING SERVICES - ULTRASOUND,76775,HC US RETROPERITONEAL LTD,$450 653,402,OTHER IMAGING SERVICES - ULTRASOUND,76801,"HC U/S PREG 1ST TRI,SGI",$394 654,402,OTHER IMAGING SERVICES - ULTRASOUND,76805,"HC U/S PREG AFTER 1ST TRI,SGL",$394 655,402,OTHER IMAGING SERVICES - ULTRASOUND,76817,HC TRANSVAGINAL US OBSTETRIC,$507 656,402,OTHER IMAGING SERVICES - ULTRASOUND,76830,HC U/S TRANSVAGINAL,$682 657,402,OTHER IMAGING SERVICES - ULTRASOUND,76856,HC U/S PELVIC,$727 658,402,OTHER IMAGING SERVICES - ULTRASOUND,76857,HC U/S PELVIS LIMITED,$393 659,402,OTHER IMAGING SERVICES - ULTRASOUND,76870,HC U/S TESTICULAR,$561 660,402,OTHER IMAGING SERVICES - ULTRASOUND,76872,HC PROSTATES STAG U/S,$562 661,402,OTHER IMAGING SERVICES - ULTRASOUND,76873,HC PLANNING ULTRASOUND,$441 662,402,OTHER IMAGING SERVICES - ULTRASOUND,76881,HC US COMPETE JOINT REAL-TIME W/ IMG DOCUMENT,$587 663,402,OTHER IMAGING SERVICES - ULTRASOUND,76882,HC US LIMITED JOINT/OTHER NONVAS EXTREMITY STRUCTURE(S) REAL-TIME W/ IMG DOCUMENT,$482 664,402,OTHER IMAGING SERVICES - ULTRASOUND,76930,HC S/I PERICARDIOCENTIS,$864 665,402,OTHER IMAGING SERVICES - ULTRASOUND,76937,HC U/S GUID FOR VASC ACCESS,$845 666,402,OTHER IMAGING SERVICES - ULTRASOUND,76940,HC US GUID&MN PRNCML TIS ABL,$643 667,402,OTHER IMAGING SERVICES - ULTRASOUND,76942,HC ULTRASOUND GUIDANCE NEEDLE PLACMNT,"$1,193" 668,402,OTHER IMAGING SERVICES - ULTRASOUND,76965,HC U/S GD INTRST RADLMNT APP,"$1,575" 669,402,OTHER IMAGING SERVICES - ULTRASOUND,76978,HC ULTRASOUND TARGET DYNAMIC MICROBUBBLE 1ST LESION,"$1,504" 670,402,OTHER IMAGING SERVICES - ULTRASOUND,76981,HC ULTRASOUND ELASTOGRAPHY PARENCHYMA,"$1,178" 671,402,OTHER IMAGING SERVICES - ULTRASOUND,76998,HC US GUIDANCE INTRAOPERATIV,"$1,017" 672,402,OTHER IMAGING SERVICES - ULTRASOUND,G0365,HC MAP VESSEL FOR ACCESS,"$1,132" 673,403,OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY,77063,HC SCREEN BREAST TOMOSYNTHS,$150 674,403,OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY,77067,"HC SCREENING MAMMOGRAPHY INCL CAD, BILATERAL",$531 675,404,OTHER IMAGING SERVICES - POSITRON EMISSION TOMOGRAPHY,78608,HC PET BRAIN METABOLIC EVAL,"$7,162" 676,404,OTHER IMAGING SERVICES - POSITRON EMISSION TOMOGRAPHY,78812,HC PET SKULL BAS TO MIDTHIGH,"$7,548" 677,404,OTHER IMAGING SERVICES - POSITRON EMISSION TOMOGRAPHY,78814,HC PET/CT LIMITED AREA,"$7,484" 678,404,OTHER IMAGING SERVICES - POSITRON EMISSION TOMOGRAPHY,78815,HC PET CT SKUL BAS TOMDTHIGH,"$7,548" 679,404,OTHER IMAGING SERVICES - POSITRON EMISSION TOMOGRAPHY,78816,HC PET CT WHOLE BODY,"$7,548" 680,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94002,HC HIGH FREQ VENT INITIAL,"$2,650" 681,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94002,HC MECHANICAL VENT INITIAL,"$2,650" 682,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94003,HC HIGH FREQ VENTILATION,"$2,260" 683,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94003,HC MECHANICAL VENT SUBSEQ,"$2,260" 684,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94640,HC BREATHING EX SUBSEQUENT,$201 685,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94640,HC OSCILLATORY PEP INITIAL,$277 686,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94640,HC OSCILLATORY PEP SUBSEQUENT,$201 687,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94640,HC POS.PRESS BREATHING SUB,$201 688,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94640,HC SPAG AEROSOL SUBSEQUENT,$201 689,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94640,HC UPDRAFT NEB/SPUTUM IND,$186 690,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94640,HC UPDRAFT NEBULIZER SUBSEQU,$201 691,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94642,HC PENTAMIDINE AERSL INHALATION PNEUM/PROPH,$365 692,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94660,HC CPAP/BIPAP THERAPY,$990 693,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94664,HC POS PRESS BREATHING INITIAL,$289 694,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94664,HC SPAG AEROSOL INITIAL,$289 695,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94664,HC UPDRAFT NEBULIZER INITIAL,$289 696,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94667,HC PPD TREATMENT INITIAL,$283 697,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94668,HC PPD TREATMENT SUBSEQUENT,$95 698,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC 02 THERAPY INITIAL,$313 699,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC AEROSOL THERAPY INITIAL,$344 700,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC AEROSOL THERAPY SUBSEQ,$296 701,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC CONT MEDIC AEROSOL,$473 702,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC HIGH FLOW OXYGEN INITIAL,$548 703,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC HIGH FLOW OXYGEN SUBSEQUENT,$319 704,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC MIXED GASES INIT,$506 705,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC MIXED GASES SUBSEQ,$409 706,410,RESPIRATORY SERVICES - GENERAL CLASSIFICATION,94799,HC O2 THERAPY SUBSEQUENT,$182 707,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97012,HC MECHANICAL TRACTION,$51 708,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97032,HC ELEC STIM(MANUAL) 15MIN,$77 709,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97034,HC CONTRAST BATH 15MIN,$59 710,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97035,HC ULTRASOUND 15MIN,$76 711,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97036,HC HUBBARD TANK 15MIN,$132 712,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97110,HC THER EXER 15MIN,$99 713,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97112,HC NEUROMS REEDUC EX 15MIN,$95 714,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97116,HC GAIT TRAINING 15MIN,$91 715,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97124,HC THERAPEU MASSAGE 15MIN,$111 716,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97140,HC MANUAL THERAPY 15MIN,$160 717,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97150,HC GROUP THERAPY,$68 718,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97161,HC PT EVAL LOW COMPLEX 20 MIN,$272 719,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97162,HC PT EVAL MOD COMPLEX 30 MIN,$374 720,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97163,HC PT EVAL HIGH COMPLEX 45 MIN,$529 721,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97164,HC PT RE-EVAL EST PLAN CARE,$146 722,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97530,HC THERAP ACTIVITIES 15MIN,$120 723,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97533,HC SENSORY INTEG 15MIN,$114 724,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97535,HC SELF CARE HOME TRN 15 MIN,$120 725,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97537,HC COMM/WK REINTEGR 15MIN,$91 726,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97542,HC W/C MGT/PROP TRAIN 15MIN,$89 727,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97750,HC PHYSICAL PERF TEST 15MIN,$105 728,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97755,HC ASSIS TECH ASSESS 15MIN,$161 729,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97760,HC ORTH MGMT & TRAIN INITIAL ENCTR 15 MIN,$100 730,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97761,HC PROST TRAINING INITIAL ENCTR 15 MIN,$130 731,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,97763,HC ORTH/PROST MGMT & TRAIN SBSQ ENCTR 15 MIN,$99 732,420,PHYSICAL THERAPY - GENERAL CLASSIFICATION,G0283,HC ELEC STIMULATION(UNATT'D),$77 733,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,29085,HC APPL HAND/FOREARM CAST,$437 734,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97032,HC ELEC STIM(MANUAL) 15MIN,$77 735,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97110,HC THER EXER 15MIN,$99 736,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97112,HC NEUROMS REEDUC EX 15MIN,$95 737,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97127,HC COGNITIVE SKILLS DEVELOPMENT DIRECT/DAY (MC15MIN) - OT,$115 738,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97140,HC MANUAL THERAPY 15MIN,$160 739,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97150,HC GROUP THERAPY,$68 740,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97165,HC OT EVAL LOW COMPLEX 30 MIN,$272 741,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97166,HC OT EVAL MOD COMPLEX 45 MIN,$374 742,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97167,HC OT EVAL HIGH COMPLEX 60 MIN,$477 743,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97168,HC OT RE-EVAL EST PLAN CARE,$146 744,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97530,HC THERAP ACTIVITIES 15MIN,$120 745,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97533,HC SENSORY INTEG 15MIN,$114 746,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97535,HC SELF CARE HOME TRN 15 MIN,$120 747,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97537,HC COMM/WK REINTEGR 15MIN,$59 748,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97542,HC W/C MGT/PROP TRAIN 15MIN,$89 749,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97750,HC PHYSICAL PERF TEST 15MIN,$105 750,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97760,HC ORTH MGMT & TRAIN INITIAL ENCTR 15 MIN,$100 751,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97761,HC PROST TRAINING INITIAL ENCTR 15 MIN,$130 752,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,97763,HC ORTH/PROST MGMT & TRAIN SBSQ ENCTR 15 MIN,$99 753,430,OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION,G0283,HC ELEC STIMULATION(UNATT'D),$77 754,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92507,HC TX SPEECH/LANG/VOICE/COMMUN/AU,$397 755,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92508,HC TX SPCH/LNG/VOC/CM/AU-MOD-GP2+,$359 756,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92522,HC EVAL SPEECH SOUND PRODUC,$658 757,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92523,HC EVAL SND PR LNG CMPRH/XPR,$700 758,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92524,HC BEHV&QUAL ANLY VOIC/RESON,$563 759,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92526,HC TREATMENT DYSPHAGIA,$421 760,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92597,HC EVAL OF PATIENT FOR PRESCRIPTI,$710 761,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,92609,HC ADAPT & TRAIN SPCH GEN DEVICES,$526 762,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,96110,HC DVLOPMNTL TST LNG MTR LTD,$489 763,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,96125,HC STND COGNITIV TESTING/HR,$397 764,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,97127,HC COGNITIVE SKILLS DEVELOPMENT DIRECT/DAY (MC15MIN) - SPEECH,$132 765,440,SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION,97140,HC MANUAL THERAPY 15MIN,$160 766,444,SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION,92607,HC EVAL VOICE PROSTHESIS FIT,$859 767,444,SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION,92610,HC EVAL ORAL & PHARYN SWALLOW,$700 768,444,SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION,92611,HC MOTION FLUORO EVAL SWALLOW,$791 769,444,SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION,92612,HC FLEX ENDO EVAL SWALLOWING BY CINE OR VIDEO RECORDING,$843 770,444,SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION,92616,HC FLEX ENDO EVAL SWALLOW & LARYNGEAL SENSORY TEST BY CINE/VIDEO RECORD,$691 771,444,SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION,96105,HC AST APHASIA W/I&R PER HR,$602 772,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,16000,"HC INIT TMT,1ST DEGREE BURN",$326 773,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29065,HC APPL SHOUL/HAND CAST,$417 774,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29075,HC APPL ELBOW/FINGER CAST,$437 775,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29105,HC APPL LONG ARM SPLINT,$434 776,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29125,HC APPL SHORT ARM SPL STA,$479 777,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29126,HC APPL SHORT ARM SPL DYN,$479 778,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29130,HC APPL FINGER SPL STA,$500 779,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29405,HC APPL SHORT LEG CAST,$387 780,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29505,HC APPL LONG LEG SPLINT,$265 781,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,29515,HC APPL SHORT LEG SPLINT,$319 782,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,30905,"HC NASAL HEMORHAGE,POST,INIT",$466 783,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,69200,"HC REMOVE FB,AUDIT CANAL",$218 784,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,99281,"HC LEVEL I VISIT, EC",$278 785,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,99282,"HC LEVEL II VISIT, EC",$336 786,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,99283,"HC LEVEL III VISIT, EC",$833 787,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,99284,"HC LEVEL IV VISIT, EC",$932 788,450,EMERGENCY ROOM - GENERAL CLASSIFICATION,99285,"HC LEVEL V VISIT, EC","$1,031" 789,456,EMERGENCY ROOM - URGENT CARE,G0381,HC ED VISIT TYPE B LEV 2,$305 790,456,EMERGENCY ROOM - URGENT CARE,G0382,HC ED VISIT TYPE B LEV 3,$688 791,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94060,HC SPIROMETRY W/DILATORS,$627 792,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94070,HC BRONCHOPROVOCATION,"$1,015" 793,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94150,HC BREATHING EXERCISES,$113 794,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94618,HC PULMONARY STRESS TESTING,$604 795,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94621,HC PULMONARY STRESS COMPLEX,$805 796,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94681,HC INDIRECT CALORIM,$602 797,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94726,HC PLETHSMOGRAP LUNG VOLUMES,$524 798,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94729,HC SINGLE BRTH DIFFUS,$541 799,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94760,HC PULSE OXIMETRY,$105 800,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94761,HC PULSE OXIMETRY MULT DETER,$115 801,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94762,HC PULSE OXIMETRY OVERNITE,$367 802,460,PULMONARY FUNCTION - GENERAL CLASSIFICATION,94770,HC TRANSCUTAN MONITOR,$328 803,471,AUDIOLOGY - DIAGNOSTIC,92504,HC BINOCULAR MICROSCOPY,$237 804,471,AUDIOLOGY - DIAGNOSTIC,92537,HC CALORIC VESTIBULAR TEST BITHERMAL-4 IRRIG,$688 805,471,AUDIOLOGY - DIAGNOSTIC,92538,HC CALORIC VESTIBULAR TEST MONOTHERMAL-2 IRRIG,$572 806,471,AUDIOLOGY - DIAGNOSTIC,92540,HC BASIC VESTIBULAR EVALUAT,$769 807,471,AUDIOLOGY - DIAGNOSTIC,92546,HC SINUSOIDAL VERTI AXIS ROTAT,$623 808,471,AUDIOLOGY - DIAGNOSTIC,92550,HC TYMPNOMTRY RFLX THRSH MES,$431 809,471,AUDIOLOGY - DIAGNOSTIC,92551,HC SCREEN TEST PURE TONE AIR,$79 810,471,AUDIOLOGY - DIAGNOSTIC,92552,HC PUR TONE THRESHOLD AIR ONLY,$168 811,471,AUDIOLOGY - DIAGNOSTIC,92553,HC PURE TON AUDIOMTRY AIR&BN,$263 812,471,AUDIOLOGY - DIAGNOSTIC,92555,HC SPEECH RECOGNITN THRSHOLD(SRT),$113 813,471,AUDIOLOGY - DIAGNOSTIC,92556,HC SRT/SPEECH DISCRIMINATION,$168 814,471,AUDIOLOGY - DIAGNOSTIC,92557,HC COMP AUD THR EVL& SPCHRCG,$422 815,471,AUDIOLOGY - DIAGNOSTIC,92567,HC TYMPANOMETRY,$148 816,471,AUDIOLOGY - DIAGNOSTIC,92579,HC VISUL REINFRCMT AUDIOMETR,$331 817,471,AUDIOLOGY - DIAGNOSTIC,92582,HC CNDITIONING PLAY AUDIOMTR,$391 818,471,AUDIOLOGY - DIAGNOSTIC,92584,HC ELECTROCOCHLEOGRAPHY (ECOG),$620 819,471,AUDIOLOGY - DIAGNOSTIC,92585,HC AUDITORY EVOKED RESPONSE,$889 820,471,AUDIOLOGY - DIAGNOSTIC,92587,HC EVOK OTOACOUST EMISS EOA,$521 821,471,AUDIOLOGY - DIAGNOSTIC,92588,HC DX OTOACOUST EMISS COMPRE,$601 822,479,AUDIOLOGY - OTHER AUDIOLOGY,V5011,HC HEARAID FIT/ORIENT/CHECK,$152 823,480,CARDIOLOGY - GENERAL CLASSIFICATION,92960,HC EXTERNAL CARDIOVERSION,"$1,307" 824,480,CARDIOLOGY - GENERAL CLASSIFICATION,92961,HC INTERNAL CARDIOVERSION,"$1,166" 825,480,CARDIOLOGY - GENERAL CLASSIFICATION,93260,HC PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,$201 826,480,CARDIOLOGY - GENERAL CLASSIFICATION,93279,HC PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,$81 827,480,CARDIOLOGY - GENERAL CLASSIFICATION,93280,HC PROG DV EV IMP DV DL PM,$81 828,480,CARDIOLOGY - GENERAL CLASSIFICATION,93281,HC PROG DV EV IMP DV ML PM,$201 829,480,CARDIOLOGY - GENERAL CLASSIFICATION,93282,HC PROG DV EV IMP DV SL IPCD,$141 830,480,CARDIOLOGY - GENERAL CLASSIFICATION,93283,HC PROG DV EV IMP DV DL IPCD,$141 831,480,CARDIOLOGY - GENERAL CLASSIFICATION,93284,HC PROG DV EV IMP DV ML IPCD,$141 832,480,CARDIOLOGY - GENERAL CLASSIFICATION,93285,HC PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,$203 833,480,CARDIOLOGY - GENERAL CLASSIFICATION,93286,HC PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,$349 834,480,CARDIOLOGY - GENERAL CLASSIFICATION,93287,HC PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,$388 835,480,CARDIOLOGY - GENERAL CLASSIFICATION,93288,HC INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,$81 836,480,CARDIOLOGY - GENERAL CLASSIFICATION,93289,HC INT DV EV S-D-M LPM CD,$141 837,480,CARDIOLOGY - GENERAL CLASSIFICATION,93291,HC INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,$81 838,480,CARDIOLOGY - GENERAL CLASSIFICATION,93296,HC REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,$203 839,480,CARDIOLOGY - GENERAL CLASSIFICATION,93299,HC REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW,$203 840,481,CARDIOLOGY - CARDIAC CATH LAB,33229,HC REMOV/REPL PULSE MULTLEAD,"$26,321" 841,481,CARDIOLOGY - CARDIAC CATH LAB,33233,HC REMOVE PM GENERATOR,"$4,701" 842,481,CARDIOLOGY - CARDIAC CATH LAB,33263,HC REMV&REPL CVD DUAL LEAD,"$19,827" 843,481,CARDIOLOGY - CARDIAC CATH LAB,33285,HC INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,"$15,779" 844,481,CARDIOLOGY - CARDIAC CATH LAB,33286,HC REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,"$1,860" 845,481,CARDIOLOGY - CARDIAC CATH LAB,92978,HC ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,"$4,198" 846,481,CARDIOLOGY - CARDIAC CATH LAB,92979,HC ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,"$4,025" 847,481,CARDIOLOGY - CARDIAC CATH LAB,93451,HC RHC O2 SAT CARDIAC OUTPUT,"$8,877" 848,481,CARDIOLOGY - CARDIAC CATH LAB,93453,HC R/LHC INCLUDE INTRAP INJ,"$14,923" 849,481,CARDIOLOGY - CARDIAC CATH LAB,93454,HC CORONARY ANGIO (ONLY),"$12,026" 850,481,CARDIOLOGY - CARDIAC CATH LAB,93455,HC CORONARY ANGIO GRAFTS,"$15,123" 851,481,CARDIOLOGY - CARDIAC CATH LAB,93456,HC RHC CORONARY ANGIO,"$18,590" 852,481,CARDIOLOGY - CARDIAC CATH LAB,93457,HC RHC CORONARY ANGIO GRAFTS,"$20,669" 853,481,CARDIOLOGY - CARDIAC CATH LAB,93458,HC LHC WITH CORONARIES LV,"$18,406" 854,481,CARDIOLOGY - CARDIAC CATH LAB,93459,HC LHC CORONAR CATH GRAFT LV,"$19,186" 855,481,CARDIOLOGY - CARDIAC CATH LAB,93460,HC R/L CATH CORONARY ANGIO LV,"$22,108" 856,481,CARDIOLOGY - CARDIAC CATH LAB,93461,HC R/L CAT CORON ANG GRAF LV,"$22,312" 857,481,CARDIOLOGY - CARDIAC CATH LAB,93463,HC MEDICATION ADMIN & HEMODYNAMIC MEASURMENT (INOMAX),"$5,427" 858,481,CARDIOLOGY - CARDIAC CATH LAB,93463,HC PHARMACOLOGIC ADM HEMOD,"$1,775" 859,481,CARDIOLOGY - CARDIAC CATH LAB,93505,HC ENDOMYOCARDIAL BIOPSY,"$6,855" 860,481,CARDIOLOGY - CARDIAC CATH LAB,93567,HC AORTIC ROOT ANGIOGRAM,"$2,813" 861,481,CARDIOLOGY - CARDIAC CATH LAB,93568,HC PULMONARY ANGIOGRAM,"$4,632" 862,481,CARDIOLOGY - CARDIAC CATH LAB,93571,HC INTRA DOPP'R VES/COR INIT,"$2,375" 863,481,CARDIOLOGY - CARDIAC CATH LAB,93572,HC INTRA DOPP'RVES/COR ADD,"$1,854" 864,481,CARDIOLOGY - CARDIAC CATH LAB,93580,HC ASD CLOSURE,"$26,835" 865,481,CARDIOLOGY - CARDIAC CATH LAB,93620,HC EP W/ATTEM IND RA/RV/HIS,"$11,869" 866,482,CARDIOLOGY - STRESS TEST,93017,HC EKG-STRESS TEST,$640 867,483,CARDIOLOGY - ECHOCARDIOLOGY,93306,HC ECHO 2D MODE W/M-MODE,"$2,291" 868,483,CARDIOLOGY - ECHOCARDIOLOGY,93307,HC ECHO 2D MODE,"$1,306" 869,483,CARDIOLOGY - ECHOCARDIOLOGY,93308,HC ECHO TRANS REAL-TIME FOLLUP,$435 870,483,CARDIOLOGY - ECHOCARDIOLOGY,93312,HC TRANSEOPHAGEAL ECHO,"$1,363" 871,483,CARDIOLOGY - ECHOCARDIOLOGY,93320,HC DOPPLER ECHOCARDIOGRAPHY,$966 872,483,CARDIOLOGY - ECHOCARDIOLOGY,93321,HC DOPPLER ECHO FOLLUP/LIM STUDY,$345 873,483,CARDIOLOGY - ECHOCARDIOLOGY,93325,HC COLOR FLOW DOPPLER STUDY,$879 874,483,CARDIOLOGY - ECHOCARDIOLOGY,93350,HC ECHO STRESS,"$1,107" 875,510,CLINIC - GENERAL CLASSIFICATION,99201,HC CLINIC VISIT NEW LEVEL 1,$115 876,510,CLINIC - GENERAL CLASSIFICATION,99202,HC CLINIC VISIT NEW LEVEL 2,$161 877,510,CLINIC - GENERAL CLASSIFICATION,99203,HC CLINIC VISIT NEW LEVEL 3,$240 878,510,CLINIC - GENERAL CLASSIFICATION,99204,HC CLINIC VISIT NEW LEVEL 4,$323 879,510,CLINIC - GENERAL CLASSIFICATION,99205,HC CLINIC VISIT NEW LEVEL 5,$401 880,510,CLINIC - GENERAL CLASSIFICATION,99211,HC CLINIC VISIT ESTAB LVL 1,$115 881,510,CLINIC - GENERAL CLASSIFICATION,99212,HC CLINIC VISIT ESTAB LVL 2,$161 882,510,CLINIC - GENERAL CLASSIFICATION,99213,HC CLINIC VISIT ESTAB LVL 3,$240 883,510,CLINIC - GENERAL CLASSIFICATION,99214,HC CLINIC VISIT ESTAB LVL 4,$323 884,510,CLINIC - GENERAL CLASSIFICATION,99215,HC CLINIC VISIT ESTAB LVL 5,$401 885,510,CLINIC - GENERAL CLASSIFICATION,99241,HC CLINIC VISIT CONS LVL 1,$115 886,510,CLINIC - GENERAL CLASSIFICATION,99242,HC CLINIC VISIT CONS LVL 2,$161 887,510,CLINIC - GENERAL CLASSIFICATION,99243,HC CLINIC VISIT CONS LVL 3,$240 888,510,CLINIC - GENERAL CLASSIFICATION,99244,HC CLINIC VISIT CONS LVL 4,$323 889,510,CLINIC - GENERAL CLASSIFICATION,99245,HC CLINIC VISIT CONS LVL 5,$401 890,510,CLINIC - GENERAL CLASSIFICATION,99386,HC NEW PT PREVENT 40-64 YR,$168 891,510,CLINIC - GENERAL CLASSIFICATION,99395,HC ESTAB PT PREVEN 18-39 YR,$168 892,510,CLINIC - GENERAL CLASSIFICATION,99396,HC ESTAB PT PREVEN 40-64 YR,$168 893,510,CLINIC - GENERAL CLASSIFICATION,99397,HC ESTAB PT PREVEN 65+ YR,$168 894,519,CLINIC - OTHER CLINIC,99091,HC PHARMACOKINETIC BUSULFAN,$790 895,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,19287,HC MRI BRST LCDV PLC 1STLS,"$5,510" 896,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,19288,HC MRI BRST LCDV PLC ADDLS,"$3,689" 897,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,70336,HC MRI TEMPOROMANDIBULAR JOINT,"$3,637" 898,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,70540,HC MRI ORB FAC&/OR NK WOCNTR,"$4,182" 899,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,70542,HC MRI ORB FAC&/OR NK WCNTRS,"$4,560" 900,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,70543,HC MRI ORB FC&/OR NK WWO CNT,"$5,506" 901,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,71550,HC MRI CHEST W/O CONTRAST,"$4,043" 902,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,71552,HC MRI CHEST W&W/O CONRAST,"$5,324" 903,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,72195,HC MRI PELVIS W/O CONTRAST,"$4,284" 904,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,72196,HC MRI PELVIS WITH CONTRAST,"$4,701" 905,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,72197,HC MRI PELVIS W&W/O CON,"$5,427" 906,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73218,HC MRI UPPER EXT W/O CONTR,"$3,563" 907,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73220,HC MRI UP EXT W&W/O CON,"$5,220" 908,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73221,HC MRI ANY JNT UP EXT W/O,"$3,657" 909,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73223,HC MRI ANY JNT UP EXT W&W/O,"$5,416" 910,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73718,HC MRI LOW EXT W/O CON,"$4,258" 911,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73719,HC MRI LOW EXT W/CON,"$4,365" 912,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73720,HC MRI LOW EXT W&W/O CON,"$5,401" 913,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73721,HC MRI ANY JNT LOW EXT W/O,"$3,943" 914,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73722,HC MRI ANY JNT LOW EXT W,"$4,237" 915,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,73723,HC MRI ANY JNT LOW EXTW&W/O,"$5,222" 916,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,74181,HC MRI ABDOMEN W/O CONTRAST,"$3,997" 917,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,74182,HC MRI ABDOMEN W CON,"$4,718" 918,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,74183,HC MRI ABD W&W/O CONTRAST,"$6,423" 919,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,76390,HC MR SPECTROSCOPY,"$3,396" 920,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,77021,HC MRI IMG GUIDANCE NEEDLE REPLACE RS&I,"$3,740" 921,610,MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION,77022,HC MR IMG GUIDANCE & MONITORING PARENCHYMAL TISSUE ABLATION,"$3,517" 922,611,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM,70551,HC MRI BRAIN W/O CONT,"$4,360" 923,611,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM,70552,HC MRI BRAIN W/CONT,"$4,535" 924,611,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM,70553,HC MRI BRAIN W&W/O CON,"$6,515" 925,611,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM,70554,HC FUNCTIONAL MRI BRAIN-TECH,"$4,357" 926,611,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM,70555,HC FNCTNL MRI BRAIN-PHYS/PSY,"$4,320" 927,611,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM,70557,HC MRI BRAIN INTRAOP W/O CNT,"$4,272" 928,611,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM,70559,HC MRI BRAIN INTRAOP W&W/O,"$6,116" 929,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72141,HC MRI C-SPINE,"$4,709" 930,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72142,HC MRI C-SPINE W/CON,"$4,793" 931,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72146,HC MRI TSPINE W/O,"$4,224" 932,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72147,HC MRI T-SPINE W/CON,"$4,632" 933,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72148,HC MRI LSPINE W/O,"$4,375" 934,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72149,HC MRI L-SPINE W/CON,"$4,811" 935,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72156,HC MRI C-SPINE W&W/O,"$6,634" 936,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72157,HC MRI T-SPINE W&W/O CO,"$6,432" 937,612,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE,72158,HC MRI L-SPINE W&W/O CO,"$6,515" 938,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,75557,HC CARDIAC IMAGNG WO CNTRAST,"$1,282" 939,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,75561,HC CARDIAC IMAG W&WO CNTRST,"$1,962" 940,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,76391,HC MR ELASTOGRAPHY,"$6,423" 941,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,77046,"HC MRI BREAST WO CONTRAST, UNILATERAL","$3,579" 942,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,77047,"HC MRI BREAST WO CONTRAST, BILATERAL","$3,945" 943,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,77048,HC MRI BREAST W/WO CONTRAST W/CAD UNILATERAL,"$4,759" 944,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,77049,HC MRI BREAST W/WO CONTRAST W/CAD BILATERAL,"$4,957" 945,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,C8903,"HC MRI BREAST W/CONTRAST, UNILATERAL","$3,988" 946,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,C8905,"HC MRI BREAST W/WO CONTRAST, UNILATERAL","$4,611" 947,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,C8906,"HC MRI BREAST W/CONTRAST, BILATERAL","$4,367" 948,614,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - OTHER,C8908,"HC MRI BREAST W/WO CONTRAST, BILATERAL","$4,809" 949,615,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK,70544,HC MRA HEAD W/O CON,"$1,725" 950,615,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK,70546,HC MRA HEAD W&W/O CON,"$2,181" 951,615,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK,70547,HC MRA NECK W/O CON,"$1,725" 952,615,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK,70548,HC MRA NECK W/CONTRAST,"$1,927" 953,615,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK,70549,HC MRA NECK W&W/O CON,"$2,162" 954,616,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - LOWER EXTREMITIES,73725,HC MRA LOWER EXTREMITY W& W/O CONTRAST,"$2,068" 955,618,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - OTHER,C8900,HC MRA ABDOMEN WITH CONTRAST,"$1,918" 956,618,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - OTHER,C8902,HC MRA ABDOMEN W&W/O CONTRAST,"$2,354" 957,618,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - OTHER,C8909,HC MRA CHEST WITH CONTRAST,"$1,936" 958,618,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - OTHER,C8910,HC MRA CHEST W/O CONTRAST,"$1,692" 959,618,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - OTHER,C8911,HC MRA CHEST W&W/O CONTRAST,"$2,068" 960,618,MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - OTHER,C8919,HC MRA PELVIS W/O CONTRAST,"$2,808" 961,710,RECOVERY ROOM - GENERAL CLASSIFICATION,BLANK,HC RECOVERY ROOM TIER1 EACH ADDL � HR 1 � 8,$178 962,710,RECOVERY ROOM - GENERAL CLASSIFICATION,BLANK,HC RECOVERY ROOM TIER1 INITIAL 1/2 HR,$368 963,710,RECOVERY ROOM - GENERAL CLASSIFICATION,BLANK,HC RECOVERY ROOM TIER2 1 HR,"$1,339" 964,710,RECOVERY ROOM - GENERAL CLASSIFICATION,BLANK,HC RECOVERY ROOM TIER2 EACH � HR 1.5 � 3,$387 965,710,RECOVERY ROOM - GENERAL CLASSIFICATION,BLANK,HC RECOVERY ROOM TIER2 EACH � HR 3.5 - 12,$139 966,730,ELECTROCARDIOGRAM (EKG/ECG) - GENERAL CLASSIFICATION,93005,HC ELECTROCARDIOGRAM-RESTING,$296 967,731,ELECTROCARDIOGRAM (EKG/ECG) - HOLTER MONITOR,93225,HC WEARABLE HOLTER MONITOR RECORDING 12-48 HRS,$224 968,731,ELECTROCARDIOGRAM (EKG/ECG) - HOLTER MONITOR,93226,HC WEARABLE HOLTER MONITOR SCANNING ANALYSIS W/REPORT 12 - 48 HRS,"$1,212" 969,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95805,HC MULTIPLE SLEEP LATENCY TEST,"$3,080" 970,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95806,HC SLEEP STUDY UNATT&RESP,$723 971,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95810,HC POLYSOMNOGRAPHY 4 OR MORE,"$4,159" 972,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95811,HC POLYSOMNOGRAPHY W/CPAP,"$4,498" 973,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95812,HC EEG EXT MONIT 41-60MIN,"$1,860" 974,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95813,HC EEG> THAN 1 HOUR,"$1,957" 975,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95816,HC EEG AWAKE AND DROWSY,$634 976,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95819,HC EEG AWAKE AND ASLEEP,"$1,114" 977,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95822,HC EEG COMA OR SLEEP ONLY,"$1,204" 978,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95829,HC ELECTROCORTICOGRAM,"$1,741" 979,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95933,HC BLINK REFLEX,$313 980,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95953,HC MNTR SEIZ FOCPRT EEG 24HR,"$2,448" 981,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95953,HC MNTR SEIZ FOCPRT EEG 6-12HR,"$2,448" 982,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95955,HC EEG NONINTRACRANIAL SURG,$584 983,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95961,HC SUB/CORTICAL MAP 1ST HR,$637 984,740,ELECTROENCEPHALOGRAM (EEG) - GENERAL CLASSIFICATION,95962,HC SUB/CORTICAL MAP ADD HR,$676 985,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43200,HC ESOPHAGOSCOPY,"$2,149" 986,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43202,HC ESOPH W/ BIOP,"$2,260" 987,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43212,HC ESOPH W/ STENT PLACEMENT,"$6,321" 988,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43215,HC ESOPH W/ FOR BOD REMV,"$2,615" 989,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43220,HC ESOPH W/BALLN DIL<30MM,"$3,034" 990,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43229,HC ESOPH W/ABLATION OF TUMOR,"$4,944" 991,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43231,HC ESOPHAGO W/US EXAM,"$3,212" 992,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43232,HC ESOPHAGO W/US GUIDE BX,"$4,902" 993,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43233,HC EGD W/DILAT BALLOON>30MM,"$3,220" 994,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43235,HC EGD,"$2,329" 995,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43236,"HC EGD,W/DIREC SUB INJECT","$2,022" 996,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43237,HC UPPER GI ENDO W/ULTRAS ESOPH,"$3,835" 997,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43238,HC UPP GI ENDO W/FNA/BIOP,"$3,104" 998,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43239,HC EGD W/ BX OR POLYPCT COLD,"$2,787" 999,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43240,HC EGD W/DRAIN PSEUDOCYST,"$2,819" 1000,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43241,HC UGI ENDO W/ILUM TB/CTHPLC,"$1,792" 1001,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43242,HC UP GAST ENDO W/TRANS US,"$4,179" 1002,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43244,HC EGD W/ BAND LIGAT VAR,"$2,868" 1003,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43245,HC EGD W/DIL GASTRIC OUTLET,"$2,924" 1004,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43246,HC EGD W/PEG,"$3,109" 1005,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43247,HC EGD W/ FOR BOD REMOVAL,"$2,921" 1006,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43248,HC EGD W/DILATE,"$2,543" 1007,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43249,HC EGD W/BALLN DILATE<30MM,"$3,753" 1008,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43251,HC EGD W/ POLYPECT-SNARE,"$2,913" 1009,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43252,HC EGD W/OPTC ENDMC CELLVSIO,"$10,986" 1010,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43253,HC EGD W/US GUIDED TRANSMURAL INJ/FIDUCIAL MARKER,"$6,114" 1011,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43254,HC EGD W/ENDO MUCOSL RESEC,"$7,481" 1012,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43255,HC EGD W/ CONTROL BLEEDING,"$2,753" 1013,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43259,HC EGD W/EUS EXAM,"$4,114" 1014,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43260,HC ERCP,"$5,325" 1015,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43261,HC ERCP W/ BIOPSY,"$4,463" 1016,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43262,HC ERCP W/SPHINCTOMY/PAPILLO,"$5,283" 1017,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43264,HC ERCP W/REMOV OF STONES,"$4,999" 1018,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43265,HC ERCP W/LITHOTRIPSY,"$5,521" 1019,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43266,HC EGD W/ STENT PLACEMENT,"$7,651" 1020,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43270,HC EGD W/ABLATION OF TUMOR,"$7,079" 1021,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43273,HC ENDOS CANN PAP W/D VISUAL,"$5,089" 1022,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43274,HC ERCP W/STENT PLACEMENT,"$10,360" 1023,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43275,HC ERCP W/RMV FORGN BDY/STNT,"$8,148" 1024,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43276,HC ERCP W/STENT RMV & EXCHG,"$10,418" 1025,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43277,HC ERCP W/BALN DIL+SPHINCTRO,"$10,001" 1026,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43278,HC ERCP W/ABLAT TUMR + DILAT,"$10,310" 1027,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,43762,HC PERCU REPLACEMENT GASTRO TUBE NOT REQ REVISION GASTRO TRACT WO IMGGUID,$911 1028,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44360,HC SMALL BOWEL THROUGH STOMA,"$1,775" 1029,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44361,HC SMBWL WO ILUM WBX/PLYPCLD,"$2,715" 1030,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44363,HC SM BOWEL ENDO W/FB REM,"$2,961" 1031,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44364,HC SM BWL ENDO W/SNARE REM,"$3,239" 1032,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44366,HC SM BWL W/BLEED CONTR,"$2,683" 1033,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44376,HC DX SM BOWEL W/ILEUM,"$1,649" 1034,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44377,HC SMBOWL ENDO W/BX/PLYPCCLD,"$1,862" 1035,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44380,HC SM BWL ILEOSCPY THR STOMA,"$2,149" 1036,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44381,HC ILEOSCP STOMA W/TE BLN DL,"$4,735" 1037,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44382,HC SM BWL THRU STOMA W/BX,"$2,149" 1038,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44385,HC SM BWL ENDO W/POUCH EVAL,"$1,955" 1039,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44386,HC SM BWL ENDO W/EVAL &BX,"$1,955" 1040,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44388,HC COLONOSCOPY THRU STOMA,"$2,304" 1041,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44389,HC COLNSC STOMA W/BX/PLYPCLD,"$2,662" 1042,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44392,HC CLNSC STMA WPLYP HBX/BPCT,"$2,700" 1043,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44394,HC COLON STOMA SNARE POLYP,"$2,900" 1044,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44401,HC COLONOSC STOMA W/ABL TUMR,"$3,300" 1045,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44403,HC COLONOSCOPY STOMA W/ EMR,"$4,632" 1046,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44404,HC COLNSC STOMAW/DR SBMUCINJ,"$3,235" 1047,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,44405,HC COLONOSC STOMA W/BALN DIL,"$3,437" 1048,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45300,HC RIGID PROCTOSIGMOIDOSCOPY,"$1,469" 1049,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45305,HC PROCTOSIGMOIDOSCOPY W/BX,"$1,522" 1050,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45330,HC FLEXIBLE SIGMOIDOSCOPY,$953 1051,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45331,HC FLEX SIG W/ BIOPSY,"$1,468" 1052,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45333,HC FLEX SIGMOID W/POLYP,"$1,689" 1053,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45334,HC SIGMOID W/BLEED CONT,"$2,033" 1054,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45335,HC FLEX SIGMOID W/SUBMUC INJ,"$1,155" 1055,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45337,HC SIGMOID W/DCMP VOLVULUS,"$2,644" 1056,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45338,HC SIGMOID W/SNARE POLYP,"$2,339" 1057,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45340,HC SIGMOID FLEX DILAT BY BLN,"$1,948" 1058,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45341,HC SIGMOID W/US EXAM,"$2,032" 1059,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45342,HC SIGMOID W/US GUID BX,"$2,165" 1060,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45346,HC SIGMOIDOSCOPY W/ABL TUMOR,"$4,071" 1061,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45347,HC SIGMOIDOSCOPY W/STENT PLC,"$4,449" 1062,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45349,HC SIGMOIDOSCOPY WITH EMR,"$4,285" 1063,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45378,HC COLONOSCOPY,"$2,615" 1064,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45379,HC COLONOSC W/ FOR BDY REM,"$2,527" 1065,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45380,HC COLON W/BX OR POLYPC COLD,"$2,793" 1066,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45381,HC COLONOSFLEXW/SUBMUC INJ,"$2,515" 1067,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45382,HC COLONOSCOPY W/BLEED CONT,"$2,662" 1068,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45384,HC COLN W/PLYP HOTBX/BIPCAUT,"$2,965" 1069,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45385,HC COLONOSC W/ POLYP SNARE,"$3,115" 1070,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45386,HC COLONOS FLEX W/DILAT BLN,"$3,082" 1071,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45388,HC COLONOSCOPY W/ABLT TUMOR,"$4,683" 1072,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45389,HC COLONOSCOPY W/STENT PLCMT,"$4,539" 1073,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45390,HC COLONOSCOPY WITH EMR,"$5,445" 1074,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45391,HC CLNSCPY SPFLX W/EN US EXM,"$2,094" 1075,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45392,HC CLNSCPY W/EN US FNA BX(S),"$1,902" 1076,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45393,HC COLONOSCOPY W/DECOMPRESSN,"$4,178" 1077,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,46600,HC ANOSCOPY W/WO BRUSH/WASH,$606 1078,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,46601,HC ANOSCOPY HIGH RESOLUTION,$666 1079,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,46606,HC ANOSCOPY W BIOPSY,"$1,818" 1080,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,46615,HC ANOSCOPY ABLATION LESION,"$1,369" 1081,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,91010,HC ESOPHAGEAL MOTILITY STUDY W/INTERP&REPORT (MANOSCAN HIGH RES),"$1,483" 1082,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,91034,HC GASTROESOPHAGEAL REFLUX TEST W/NASAL CATH PH ELECTROD/DIGITRAPPER,"$1,422" 1083,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,91035,HC GASTROESOPHAGEAL REFLUX TEST-BRAVO PILL W/TELEMTRY PH ELECTRODE,"$1,422" 1084,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,91040,HC ESOPHAGEAL BALLOON DISTENTION TEST (ENDO FLIP),"$1,210" 1085,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,91110,HC GI TRACT IMG ESOPH-ILEUM W/I&R,"$2,989" 1086,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,91112,HC GI SMARTPILL TRNS&PR MSMT,"$10,943" 1087,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,G0104,HC CANCER SCREEN SIGMOID,$953 1088,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,G0105,HC COLONOS SCRN HIGH RISK,"$2,687" 1089,750,GASTRO-INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,G0121,HC COLONOS SCRN NOT H RISK,"$2,414" 1090,760,SPECIALTY SERVICES - GENERAL CLASSIFICATION,0539T,HC AUTO CAR-T CELLS THAWING,"$3,238" 1091,761,SPECIALTY SERVICES - TREATMENT ROOM,10021,HC FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,$363 1092,761,SPECIALTY SERVICES - TREATMENT ROOM,10030,HC DRAIN SFT TISS CATH W IMG,"$4,314" 1093,761,SPECIALTY SERVICES - TREATMENT ROOM,10040,HC ACNE SURGERY,$401 1094,761,SPECIALTY SERVICES - TREATMENT ROOM,10060,HC INCISE/DRAIN ABSCESS,$570 1095,761,SPECIALTY SERVICES - TREATMENT ROOM,10061,HC I&D ABSCESS COMP,$634 1096,761,SPECIALTY SERVICES - TREATMENT ROOM,10120,HC REMOV SUBCUT FOREIGN BODY,$318 1097,761,SPECIALTY SERVICES - TREATMENT ROOM,10140,HC INCISE/DRAIN HEMATOMA,"$1,281" 1098,761,SPECIALTY SERVICES - TREATMENT ROOM,10160,HC ASPIRATION OF SUBCU FLUID/CYST,$501 1099,761,SPECIALTY SERVICES - TREATMENT ROOM,11000,HC DEBRIDE SKIN <10%,$310 1100,761,SPECIALTY SERVICES - TREATMENT ROOM,11042,HC DEBRIDE TISS 1< 20SQ CM,$852 1101,761,SPECIALTY SERVICES - TREATMENT ROOM,11045,HC DEBRIDE TISS EA 20SQ CM,$845 1102,761,SPECIALTY SERVICES - TREATMENT ROOM,11055,HC TRIM SKIN LESION SINGLE,$385 1103,761,SPECIALTY SERVICES - TREATMENT ROOM,11056,HC TRIM SKIN LESION 2-4,$421 1104,761,SPECIALTY SERVICES - TREATMENT ROOM,11057,HC TRIM SKIN LESIONS >4,$480 1105,761,SPECIALTY SERVICES - TREATMENT ROOM,11102,HC TANGENTIAL BIOPSY SKIN SINGLE LESION,$584 1106,761,SPECIALTY SERVICES - TREATMENT ROOM,11103,HC TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,$292 1107,761,SPECIALTY SERVICES - TREATMENT ROOM,11104,HC PUNCH BIOPSY SKIN SINGLE LESION,$584 1108,761,SPECIALTY SERVICES - TREATMENT ROOM,11105,HC PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,$292 1109,761,SPECIALTY SERVICES - TREATMENT ROOM,11106,HC INCISIONAL BIOPSY SKIN SINGLE LESION,$844 1110,761,SPECIALTY SERVICES - TREATMENT ROOM,11107,HC INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,$422 1111,761,SPECIALTY SERVICES - TREATMENT ROOM,11200,HC REMOVE SKIN TAGS UPTO 15,$460 1112,761,SPECIALTY SERVICES - TREATMENT ROOM,11201,HC REM SKIN TAGS EA ADD 10,$228 1113,761,SPECIALTY SERVICES - TREATMENT ROOM,11300,HC SHAVE SKIN LESION <.5CM,$280 1114,761,SPECIALTY SERVICES - TREATMENT ROOM,11301,HC SHAVE SKIN LESION .6-1CM,$333 1115,761,SPECIALTY SERVICES - TREATMENT ROOM,11302,HC SHAVE SKIN LESION 1.1-2CM,$342 1116,761,SPECIALTY SERVICES - TREATMENT ROOM,11303,HC SHAVE SKIN LES OVER 2CM,$363 1117,761,SPECIALTY SERVICES - TREATMENT ROOM,11307,HC SHAVE SKIN LESION1.1-2CM,$317 1118,761,SPECIALTY SERVICES - TREATMENT ROOM,11400,HC REM BEN SKN LESION <.5CM,"$1,142" 1119,761,SPECIALTY SERVICES - TREATMENT ROOM,11401,HC REM BEN SKN LES .6-1CM,"$1,233" 1120,761,SPECIALTY SERVICES - TREATMENT ROOM,11402,HC REM BEN SKN LES 1.1-2CM,"$1,422" 1121,761,SPECIALTY SERVICES - TREATMENT ROOM,11403,HC RM BEN SKN LES 2.1-3CM,"$1,566" 1122,761,SPECIALTY SERVICES - TREATMENT ROOM,11404,HC REM BEN SKN LES 3.1-4CM,"$1,646" 1123,761,SPECIALTY SERVICES - TREATMENT ROOM,11406,HC EXC BEN SKIN LES > 4CM,"$1,892" 1124,761,SPECIALTY SERVICES - TREATMENT ROOM,11421,HC REM BEN SKIN LES .6-1CM,"$1,713" 1125,761,SPECIALTY SERVICES - TREATMENT ROOM,11422,HC REM BEN SKIN LES 1.1-2CM,"$2,125" 1126,761,SPECIALTY SERVICES - TREATMENT ROOM,11423,HC REM BEN SKIN LES 2.1-3CM,"$1,717" 1127,761,SPECIALTY SERVICES - TREATMENT ROOM,11424,HC REM BEN SKIN LES 3.1-4CM,"$1,722" 1128,761,SPECIALTY SERVICES - TREATMENT ROOM,11426,HC REM BEN SKIN LESION >4CM,"$3,182" 1129,761,SPECIALTY SERVICES - TREATMENT ROOM,11600,HC REM MAL SKN LESION <.5CM,"$1,059" 1130,761,SPECIALTY SERVICES - TREATMENT ROOM,11601,HC REM MAL SKIN LES .6-1CM,"$1,270" 1131,761,SPECIALTY SERVICES - TREATMENT ROOM,11602,HC REM MAL SKN LES 1.1-2.CM,"$1,332" 1132,761,SPECIALTY SERVICES - TREATMENT ROOM,11603,HC EXC MAL SKIN LES 2.1-3CM,"$1,538" 1133,761,SPECIALTY SERVICES - TREATMENT ROOM,11604,HC EXC MAL SKIN LES 3.1-4CM,"$1,690" 1134,761,SPECIALTY SERVICES - TREATMENT ROOM,11606,HC REM MAL SKIN LESION >4CM,"$3,496" 1135,761,SPECIALTY SERVICES - TREATMENT ROOM,11623,HC REM MAL SKIN LES 2.1-3CM,"$1,611" 1136,761,SPECIALTY SERVICES - TREATMENT ROOM,11624,HC REM MAL SKIN LES 3.1-4CM,"$1,947" 1137,761,SPECIALTY SERVICES - TREATMENT ROOM,11640,HC REM MAL SKIN LES <0.5CM,"$1,099" 1138,761,SPECIALTY SERVICES - TREATMENT ROOM,11642,HC REM MAL SKN LES 1.1-2CM,"$1,356" 1139,761,SPECIALTY SERVICES - TREATMENT ROOM,11719,HC TRIM NAILS,$186 1140,761,SPECIALTY SERVICES - TREATMENT ROOM,11720,HC DEBRIDE NAILS 1-5,$280 1141,761,SPECIALTY SERVICES - TREATMENT ROOM,11721,HC DEBRIDE NAIL >6,$308 1142,761,SPECIALTY SERVICES - TREATMENT ROOM,11730,HC REMOVE NAIL PLATE,$386 1143,761,SPECIALTY SERVICES - TREATMENT ROOM,11750,HC EXC NAIL PERM REM,"$1,019" 1144,761,SPECIALTY SERVICES - TREATMENT ROOM,11755,HC BIOPSY NAIL,"$1,019" 1145,761,SPECIALTY SERVICES - TREATMENT ROOM,11765,HC WEDGE EXC NAIL FOLD,$388 1146,761,SPECIALTY SERVICES - TREATMENT ROOM,11900,HC INJ SKN LES UPTO & INC 7,$319 1147,761,SPECIALTY SERVICES - TREATMENT ROOM,11901,HC INJ SKN LES MORE THAN 7,$360 1148,761,SPECIALTY SERVICES - TREATMENT ROOM,11920,HC TATTOOING SKIN <6CM,"$2,031" 1149,761,SPECIALTY SERVICES - TREATMENT ROOM,11921,HC TATTOOING SKIN 6.1-20CM,"$2,387" 1150,761,SPECIALTY SERVICES - TREATMENT ROOM,11922,HC TATTOO SKIN EA ADD 20CM,"$2,149" 1151,761,SPECIALTY SERVICES - TREATMENT ROOM,11950,HC SUBCUT INJ FILL MTL:1CC OR LES,$668 1152,761,SPECIALTY SERVICES - TREATMENT ROOM,11951,HC SUBC INJ FILL:1.1 TO 5.0,$736 1153,761,SPECIALTY SERVICES - TREATMENT ROOM,12001,HC SIMPLE REPAIR <2.5 CM,$515 1154,761,SPECIALTY SERVICES - TREATMENT ROOM,12002,HC SIMPLE REPAIR 2.6-7.5 CM,$584 1155,761,SPECIALTY SERVICES - TREATMENT ROOM,12004,HC SIMPLE REPAIR 7.6-12.5CM,$738 1156,761,SPECIALTY SERVICES - TREATMENT ROOM,12013,HC SIMPLE REPAIR 2.6-5.0CM,$619 1157,761,SPECIALTY SERVICES - TREATMENT ROOM,12020,HC CLOSURE OF SPLIT WOUND,$538 1158,761,SPECIALTY SERVICES - TREATMENT ROOM,12021,HC SIMPLE CLOSURE W/PACKING,$538 1159,761,SPECIALTY SERVICES - TREATMENT ROOM,12031,HC RP INT LYR CL WD<2.5CM,$673 1160,761,SPECIALTY SERVICES - TREATMENT ROOM,12032,HC RP INT LY CL WD 2.6-7.5CM,$707 1161,761,SPECIALTY SERVICES - TREATMENT ROOM,12034,HC RP INT LY CL WD7.6-12.5CM,$741 1162,761,SPECIALTY SERVICES - TREATMENT ROOM,12035,HC RP INT LY CL WD12.6-20CM,$781 1163,761,SPECIALTY SERVICES - TREATMENT ROOM,12036,HC RP INT LYR CL WD20.1-30CM,$781 1164,761,SPECIALTY SERVICES - TREATMENT ROOM,12041,HC RP INT LY CL WD< 2.5CM,$646 1165,761,SPECIALTY SERVICES - TREATMENT ROOM,12044,HC RP IN N H GN LS7.6-12.5-I,$646 1166,761,SPECIALTY SERVICES - TREATMENT ROOM,12045,HC RP IN N H GN LES12.6-20-I,$704 1167,761,SPECIALTY SERVICES - TREATMENT ROOM,12052,HC RP INT LY CL WD 2.6-5.0CM,$831 1168,761,SPECIALTY SERVICES - TREATMENT ROOM,12053,HC RP INT LY CL WD5.1-7.5CM,$881 1169,761,SPECIALTY SERVICES - TREATMENT ROOM,12054,HC RP FC ER MU LES7.6-12.5-I,$929 1170,761,SPECIALTY SERVICES - TREATMENT ROOM,13100,HC RPR WND/LESION<2.5CM,"$1,188" 1171,761,SPECIALTY SERVICES - TREATMENT ROOM,13101,HC RPR WND/LESION 2.6-7.5CM,"$1,314" 1172,761,SPECIALTY SERVICES - TREATMENT ROOM,13102,HC RPR WND/LES EA ADD<5CM,$791 1173,761,SPECIALTY SERVICES - TREATMENT ROOM,13120,HC RPR WND/LESION 1.1-2.5CM,"$1,003" 1174,761,SPECIALTY SERVICES - TREATMENT ROOM,13122,HC RPR WND/LES EA ADD <5CM,$837 1175,761,SPECIALTY SERVICES - TREATMENT ROOM,13133,HC RP WND/LESION EA ADD 5CM,$752 1176,761,SPECIALTY SERVICES - TREATMENT ROOM,13153,HC RP WND/LESION EA AD <5CM,$831 1177,761,SPECIALTY SERVICES - TREATMENT ROOM,13160,HC SEC CLOSURE EXTENSIVE,"$2,925" 1178,761,SPECIALTY SERVICES - TREATMENT ROOM,14000,HC ADJ TX TNK <10 CM,"$2,212" 1179,761,SPECIALTY SERVICES - TREATMENT ROOM,14001,HC ADJ TX TRNK 10.1-30 CM,"$3,682" 1180,761,SPECIALTY SERVICES - TREATMENT ROOM,14020,HC ADJ TX SC/EXT <10CM,"$3,066" 1181,761,SPECIALTY SERVICES - TREATMENT ROOM,14021,HC ADJ TX SC/EXT 10.1-30CM,"$3,508" 1182,761,SPECIALTY SERVICES - TREATMENT ROOM,14040,HC ADJ TX FC/NK/AX/FT <10CM,"$3,529" 1183,761,SPECIALTY SERVICES - TREATMENT ROOM,14041,HC ADJ TX F/N/A/FT 10-30CM,"$3,682" 1184,761,SPECIALTY SERVICES - TREATMENT ROOM,14060,HC ADJ TX LID/NS/LIP <10 CM,"$3,633" 1185,761,SPECIALTY SERVICES - TREATMENT ROOM,14061,HC ADJ TX LD/NS/LP 10-30 CM,"$4,085" 1186,761,SPECIALTY SERVICES - TREATMENT ROOM,14301,HC ADJ TX 30.1-60.SQ CM COMP,"$3,887" 1187,761,SPECIALTY SERVICES - TREATMENT ROOM,14302,HC ADJ TX EA AD30.SQ CM COMP,"$3,887" 1188,761,SPECIALTY SERVICES - TREATMENT ROOM,15100,HC AUTOGFT TK/AR/LG 100SQCM<,"$4,049" 1189,761,SPECIALTY SERVICES - TREATMENT ROOM,15120,HC SPLIT AUTOGRAFT <100CM2,"$4,430" 1190,761,SPECIALTY SERVICES - TREATMENT ROOM,15200,HC GRFT TNK <20CM,"$2,925" 1191,761,SPECIALTY SERVICES - TREATMENT ROOM,15220,HC GRFT SC/EXT <20 CM,"$2,925" 1192,761,SPECIALTY SERVICES - TREATMENT ROOM,15240,HC GRFT FC/NK/HD/FT <20 CM,"$3,365" 1193,761,SPECIALTY SERVICES - TREATMENT ROOM,15241,HC GRFT FC/NK/FT ADD 20 CM,"$3,337" 1194,761,SPECIALTY SERVICES - TREATMENT ROOM,15260,HC GRFT NS/ER/LP <20 CM,"$3,702" 1195,761,SPECIALTY SERVICES - TREATMENT ROOM,15271,HC GRFT TRNK/ARM/LEG 25SQCM<,$686 1196,761,SPECIALTY SERVICES - TREATMENT ROOM,15272,HC GRFT TRNK/ARM/LEG +25SQCM,$253 1197,761,SPECIALTY SERVICES - TREATMENT ROOM,15275,HC GRFT SCLP/HD/FT/GN25SQCM<,$754 1198,761,SPECIALTY SERVICES - TREATMENT ROOM,15276,HC GRFT SCLP/HD/FT/GN+25SQCM,$280 1199,761,SPECIALTY SERVICES - TREATMENT ROOM,15576,HC FORMAT DIREC PEDICLE,"$3,056" 1200,761,SPECIALTY SERVICES - TREATMENT ROOM,15630,HC DELAY SECTN FLAP FACIAL,"$3,392" 1201,761,SPECIALTY SERVICES - TREATMENT ROOM,15731,HC FLAP W/PRES VASCUL PEDICL,"$3,056" 1202,761,SPECIALTY SERVICES - TREATMENT ROOM,15760,HC GRAFT INCLUDE CLOSURE,"$4,430" 1203,761,SPECIALTY SERVICES - TREATMENT ROOM,15788,HC CHEM PEEL FACIAL EPIDERM,$190 1204,761,SPECIALTY SERVICES - TREATMENT ROOM,15792,HC CHEM PEEL NONFACE EPIDER,$741 1205,761,SPECIALTY SERVICES - TREATMENT ROOM,15793,HC CHEM PEEL NONFACE DERM,$741 1206,761,SPECIALTY SERVICES - TREATMENT ROOM,17000,HC DES BEN/PREMAL LES SING,$161 1207,761,SPECIALTY SERVICES - TREATMENT ROOM,17003,HC DES PREMAL LES 2-14 EACH,$85 1208,761,SPECIALTY SERVICES - TREATMENT ROOM,17004,HC DESTR PREMAL LESION 15+,$805 1209,761,SPECIALTY SERVICES - TREATMENT ROOM,17110,HC DESTRUCT BENIGN <14 LES,$213 1210,761,SPECIALTY SERVICES - TREATMENT ROOM,17111,HC DESTRUCT BENIGN >15 LES,$582 1211,761,SPECIALTY SERVICES - TREATMENT ROOM,17250,HC CHEM CAUTERIZ GRANUL TISS,$329 1212,761,SPECIALTY SERVICES - TREATMENT ROOM,17260,HC DES MAL LESION < 0.5CM,$310 1213,761,SPECIALTY SERVICES - TREATMENT ROOM,17261,HC DES MAL LESION 0.6-1.0CM,$351 1214,761,SPECIALTY SERVICES - TREATMENT ROOM,17262,HC DES MAL LESION 1.1-2.0CM,$357 1215,761,SPECIALTY SERVICES - TREATMENT ROOM,17263,HC DES OF LES 2.1-3 TNK,$386 1216,761,SPECIALTY SERVICES - TREATMENT ROOM,17264,HC DES MAL LESION 3.1-4CM,$425 1217,761,SPECIALTY SERVICES - TREATMENT ROOM,17266,HC DES OF LES 4.0+ TNK,$428 1218,761,SPECIALTY SERVICES - TREATMENT ROOM,17270,HC DES MAL LESION <0.5CM,$318 1219,761,SPECIALTY SERVICES - TREATMENT ROOM,17273,HC DEST MAL LES 2.1 -3CM,$338 1220,761,SPECIALTY SERVICES - TREATMENT ROOM,17274,HC DES OF LES 3.1-4 S N H F,$367 1221,761,SPECIALTY SERVICES - TREATMENT ROOM,17276,HC DES OF LES 4+ S N H F,$402 1222,761,SPECIALTY SERVICES - TREATMENT ROOM,17283,HC DEST MAL LES 2.1-3CM,$399 1223,761,SPECIALTY SERVICES - TREATMENT ROOM,17284,HC DES OF LES 3.1-4 FC,$445 1224,761,SPECIALTY SERVICES - TREATMENT ROOM,17286,HC DES OF LES 4+ FC,$493 1225,761,SPECIALTY SERVICES - TREATMENT ROOM,17311,HC MOHS 1-5 TISS HD/MUS/NER,"$1,703" 1226,761,SPECIALTY SERVICES - TREATMENT ROOM,17312,HC MOHS 6-10 TISS HD/MUS/NER,"$1,466" 1227,761,SPECIALTY SERVICES - TREATMENT ROOM,17313,HC MOHS 1-5 TISS TRK/ARM/LEG,"$1,703" 1228,761,SPECIALTY SERVICES - TREATMENT ROOM,17314,HC MOHS 6-10TISS TRK/ARM/LEG,"$1,466" 1229,761,SPECIALTY SERVICES - TREATMENT ROOM,17315,HC MOHS >5 SPECIMENS,$368 1230,761,SPECIALTY SERVICES - TREATMENT ROOM,17380,HC LASER HAIR REMOVAL,$189 1231,761,SPECIALTY SERVICES - TREATMENT ROOM,19000,HC ASPIRATE BREAST CYST,$468 1232,761,SPECIALTY SERVICES - TREATMENT ROOM,19001,HC ASPIR BREAST CYST EA ADD,$465 1233,761,SPECIALTY SERVICES - TREATMENT ROOM,19081,HC STEREO BRST BX+IMG 1ST LS,"$3,424" 1234,761,SPECIALTY SERVICES - TREATMENT ROOM,19082,HC STEREO BRST BX+IMG ADD LS,"$1,369" 1235,761,SPECIALTY SERVICES - TREATMENT ROOM,19083,HC BX BREAST W U/S INIT LES,"$3,184" 1236,761,SPECIALTY SERVICES - TREATMENT ROOM,19084,HC BX BREAST W US ADD LESION,"$1,577" 1237,761,SPECIALTY SERVICES - TREATMENT ROOM,19085,HC MRI BRST BX+IMG 1ST LS,"$7,616" 1238,761,SPECIALTY SERVICES - TREATMENT ROOM,19086,HC MRI BRST BX+IMG ADD LS,"$3,971" 1239,761,SPECIALTY SERVICES - TREATMENT ROOM,19100,HC BIOPSY CORE BREAST,$938 1240,761,SPECIALTY SERVICES - TREATMENT ROOM,19350,HC NIPPLE/AREOLA RECONSTRUC,"$3,682" 1241,761,SPECIALTY SERVICES - TREATMENT ROOM,20206,HC BIOPSY MUSCLE PERCU NDL,"$2,445" 1242,761,SPECIALTY SERVICES - TREATMENT ROOM,20220,HC BX BONE TROC/NDL SUPERFCL,"$2,445" 1243,761,SPECIALTY SERVICES - TREATMENT ROOM,20225,HC BX BONE TROC/NDL DEEP,"$2,659" 1244,761,SPECIALTY SERVICES - TREATMENT ROOM,20500,HC SINUS TRACT INJECT THERP,"$1,605" 1245,761,SPECIALTY SERVICES - TREATMENT ROOM,20501,HC DIAGN SINOGRAM INJ SINUST,"$1,605" 1246,761,SPECIALTY SERVICES - TREATMENT ROOM,20526,HC INJ THERAP CARPAL TUNNEL,$470 1247,761,SPECIALTY SERVICES - TREATMENT ROOM,20550,HC INJ TEND SH/LIG/TRG/GANG,$498 1248,761,SPECIALTY SERVICES - TREATMENT ROOM,20551,HC INJ TENDON ORIGIN/INSRTN,$501 1249,761,SPECIALTY SERVICES - TREATMENT ROOM,20552,HC INJ SGL/MLT 1-2 MUSCLE(S),$508 1250,761,SPECIALTY SERVICES - TREATMENT ROOM,20553,HC INJ SGL/MLT TRGGR PT3+MSC,$561 1251,761,SPECIALTY SERVICES - TREATMENT ROOM,20600,HC ARTHO/ASPR/INJ SM JT/CYT WO U/S,$556 1252,761,SPECIALTY SERVICES - TREATMENT ROOM,20604,HC ARTH/ASPNJ SMJT/BR W/ U/S,"$1,749" 1253,761,SPECIALTY SERVICES - TREATMENT ROOM,20605,HC ARTH/ASPNJ IMJT/BR W/ U/S,$591 1254,761,SPECIALTY SERVICES - TREATMENT ROOM,20605,HC ARTHA/ASP/INJ INT JT/CYST W/O U/S,$591 1255,761,SPECIALTY SERVICES - TREATMENT ROOM,20610,HC ARTHR/ASP/INJ MJ JT/BRSA W/O US,$598 1256,761,SPECIALTY SERVICES - TREATMENT ROOM,20611,HC ARTH/ASPNJ MJR JT/BR WU/S,"$1,791" 1257,761,SPECIALTY SERVICES - TREATMENT ROOM,20680,HC REMOVAL IMPLANT DEEP,"$4,510" 1258,761,SPECIALTY SERVICES - TREATMENT ROOM,20694,HC REMOVE BONE PLATE,"$3,958" 1259,761,SPECIALTY SERVICES - TREATMENT ROOM,21077,HC PREP PROSTHS ORBIT PROS,"$14,704" 1260,761,SPECIALTY SERVICES - TREATMENT ROOM,21079,HC PREP INTERIM OBTURATR,"$11,836" 1261,761,SPECIALTY SERVICES - TREATMENT ROOM,21080,HC PREP DEFINIT OBTURATR,"$13,289" 1262,761,SPECIALTY SERVICES - TREATMENT ROOM,21081,HC PREP PROS MANDIB RESECT,"$9,071" 1263,761,SPECIALTY SERVICES - TREATMENT ROOM,21082,HC PREP PROS PALATAL AUGMEN,"$11,055" 1264,761,SPECIALTY SERVICES - TREATMENT ROOM,21086,HC PREP AURICULAR PROSTH,"$12,518" 1265,761,SPECIALTY SERVICES - TREATMENT ROOM,21087,HC CUSTOM PREP NASAL PROSTH,"$11,358" 1266,761,SPECIALTY SERVICES - TREATMENT ROOM,21235,HC GRAFT EAR CARTILAGE NOSE,"$4,779" 1267,761,SPECIALTY SERVICES - TREATMENT ROOM,22510,HC PC VRTBRPLSTY CVTR+BX+IMG,"$7,490" 1268,761,SPECIALTY SERVICES - TREATMENT ROOM,22511,HC PC VRTBRPLSTY LBSC+BX+IMG,"$7,490" 1269,761,SPECIALTY SERVICES - TREATMENT ROOM,22512,HC VRTBPLST EAAD CTLS+BX+IMG,"$4,696" 1270,761,SPECIALTY SERVICES - TREATMENT ROOM,22513,HC VTB AUG+BX 1VTB CN&IMG TH,"$16,359" 1271,761,SPECIALTY SERVICES - TREATMENT ROOM,22514,HC VT AUG+BX 1VTB CAN+IMG LB,"$16,359" 1272,761,SPECIALTY SERVICES - TREATMENT ROOM,22515,HC VTAUG+BX VT CN+IM EAAD TL,"$11,195" 1273,761,SPECIALTY SERVICES - TREATMENT ROOM,27093,HC INJ HIP ARTHRO W/O ANES,"$1,365" 1274,761,SPECIALTY SERVICES - TREATMENT ROOM,30100,HC BIOPSY INTRANASAL,"$1,732" 1275,761,SPECIALTY SERVICES - TREATMENT ROOM,30120,HC EXSN RHINOPHYMA NOSE,"$3,635" 1276,761,SPECIALTY SERVICES - TREATMENT ROOM,30901,HC COAGULATION-SMPLE,$629 1277,761,SPECIALTY SERVICES - TREATMENT ROOM,31600,HC INCISION OF WINDPIPE,"$2,764" 1278,761,SPECIALTY SERVICES - TREATMENT ROOM,31615,HC TRACHEOBRONCHOSCOPY,"$2,593" 1279,761,SPECIALTY SERVICES - TREATMENT ROOM,31652,HC BRONCH EBUS SAMPLNG 1OR2,"$8,682" 1280,761,SPECIALTY SERVICES - TREATMENT ROOM,31653,HC BRONCH EBUS SAMPLNG 3OR>,"$12,801" 1281,761,SPECIALTY SERVICES - TREATMENT ROOM,31654,HC BRONCH EBUS IVNTJ PERPH,"$3,048" 1282,761,SPECIALTY SERVICES - TREATMENT ROOM,32550,HC INS NDW TN PLRL CTH W/CUF,"$4,692" 1283,761,SPECIALTY SERVICES - TREATMENT ROOM,32551,HC CHEST TUBE PLACEMENT,"$3,168" 1284,761,SPECIALTY SERVICES - TREATMENT ROOM,32553,HC INSMRK RTX GD PC IT S/MLT,"$3,277" 1285,761,SPECIALTY SERVICES - TREATMENT ROOM,32554,HC THORACENTESIS W/O IMAGE,"$2,096" 1286,761,SPECIALTY SERVICES - TREATMENT ROOM,32555,HC THORACENTESIS W/IMAGE,"$3,133" 1287,761,SPECIALTY SERVICES - TREATMENT ROOM,32561,HC INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,$942 1288,761,SPECIALTY SERVICES - TREATMENT ROOM,36222,HC S/I COM EXTR CAROT W/ANG,"$7,231" 1289,761,SPECIALTY SERVICES - TREATMENT ROOM,36223,HC S/I INTR CAROT W/ANG EXTR,"$7,231" 1290,761,SPECIALTY SERVICES - TREATMENT ROOM,36224,HC S/I INIT INTR CAROTID,"$4,623" 1291,761,SPECIALTY SERVICES - TREATMENT ROOM,36225,HC S/I SUBCLAVIAN VERTABRAL,"$5,862" 1292,761,SPECIALTY SERVICES - TREATMENT ROOM,36226,HC S/I VERTABRAL,"$5,862" 1293,761,SPECIALTY SERVICES - TREATMENT ROOM,36227,HC S/I EXTR CAROTID W/ANGIO,"$6,197" 1294,761,SPECIALTY SERVICES - TREATMENT ROOM,36228,HC S/I INTRA BRANCH W/ANGIO,"$1,550" 1295,761,SPECIALTY SERVICES - TREATMENT ROOM,36511,HC THERAP APHERESIS FOR WBC,"$3,584" 1296,761,SPECIALTY SERVICES - TREATMENT ROOM,36513,HC THERAP APHERESIS FR PLATE,"$3,584" 1297,761,SPECIALTY SERVICES - TREATMENT ROOM,36514,HC THERAP APHER FR PLAS PHER,"$3,584" 1298,761,SPECIALTY SERVICES - TREATMENT ROOM,36522,HC PHOTOPHER-LEUK W/UV,"$10,325" 1299,761,SPECIALTY SERVICES - TREATMENT ROOM,36555,HC INSERT NON-TUN CVC <5YRS,"$2,923" 1300,761,SPECIALTY SERVICES - TREATMENT ROOM,36556,HC INS NON-TUN CVC 5 YRS/>,"$3,070" 1301,761,SPECIALTY SERVICES - TREATMENT ROOM,36568,"HC INSERT PICC W/O SUBQ PORT/PMP & IMG GUIDANCE, < 5YRS","$2,773" 1302,761,SPECIALTY SERVICES - TREATMENT ROOM,36569,"HC INSERT PICC W/O SUBQ PORT/PMP & IMG GUIDANCE, = OR > 5YRS","$2,641" 1303,761,SPECIALTY SERVICES - TREATMENT ROOM,36575,HC RPR TUN/NON CVAD W/O PORT,"$1,364" 1304,761,SPECIALTY SERVICES - TREATMENT ROOM,36580,HC REPL NON-TUN CVC W/O PT,"$2,406" 1305,761,SPECIALTY SERVICES - TREATMENT ROOM,36581,HC REPL TUN CVC W/O PORT,"$4,827" 1306,761,SPECIALTY SERVICES - TREATMENT ROOM,36582,HC REPL TUN CVC W/PORT,"$5,177" 1307,761,SPECIALTY SERVICES - TREATMENT ROOM,36584,"HC RPLCMT COMPL PRPH CVC W/O SUBQ PORT/PMP, INCL IMG GUI, RS & I","$2,641" 1308,761,SPECIALTY SERVICES - TREATMENT ROOM,36589,HC REM TUNN CVC W/O PORT,"$1,364" 1309,761,SPECIALTY SERVICES - TREATMENT ROOM,36590,HC REM TUNN CVAD W/PORT,"$2,040" 1310,761,SPECIALTY SERVICES - TREATMENT ROOM,36591,HC CENTRAL VENOUS ACCESS - MAIN LEUKEMIA LAB,$70 1311,761,SPECIALTY SERVICES - TREATMENT ROOM,36592,HC CENT/PERI CATH VENOUS COL,$70 1312,761,SPECIALTY SERVICES - TREATMENT ROOM,36593,HC DECLOT VENOUS ACC DEV,$620 1313,761,SPECIALTY SERVICES - TREATMENT ROOM,36597,HC REPO VENOUS CATH GUIDE,"$2,711" 1314,761,SPECIALTY SERVICES - TREATMENT ROOM,36600,HC ARTERIAL PUNCTURE - MAIN LEUKEMIA LAB,$59 1315,761,SPECIALTY SERVICES - TREATMENT ROOM,38220,HC DIAGNOSTIC BONE MARROW ASPIRATION,$755 1316,761,SPECIALTY SERVICES - TREATMENT ROOM,38221,HC DIAGNOSTIC BONE MARROW BIOPSY,$999 1317,761,SPECIALTY SERVICES - TREATMENT ROOM,38222,HC DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,"$1,740" 1318,761,SPECIALTY SERVICES - TREATMENT ROOM,38500,HC BIOPSY: LYMPH NODE,"$3,987" 1319,761,SPECIALTY SERVICES - TREATMENT ROOM,38505,HC BX/EX LYMPH NODES NDL SFC,"$2,445" 1320,761,SPECIALTY SERVICES - TREATMENT ROOM,38790,HC INJ PRC LYMPHANGIOGRAPHY,"$1,605" 1321,761,SPECIALTY SERVICES - TREATMENT ROOM,40490,HC BIOPSY LIP,$991 1322,761,SPECIALTY SERVICES - TREATMENT ROOM,40654,HC REPAIR LIP OVER 1/2VERTIC,"$2,334" 1323,761,SPECIALTY SERVICES - TREATMENT ROOM,40808,HC ORAL BIOPSY,$787 1324,761,SPECIALTY SERVICES - TREATMENT ROOM,40810,HC EXLES-VEST MOUTH WO REP,"$3,306" 1325,761,SPECIALTY SERVICES - TREATMENT ROOM,41100,HC BIOPSY TONGUE,"$1,632" 1326,761,SPECIALTY SERVICES - TREATMENT ROOM,41108,HC BX FLOOR OF MOUTH,"$1,632" 1327,761,SPECIALTY SERVICES - TREATMENT ROOM,41116,HC EXC LES FLOOR MOUTH,"$2,996" 1328,761,SPECIALTY SERVICES - TREATMENT ROOM,42100,HC PALATE UVULA BIOPSY,"$1,107" 1329,761,SPECIALTY SERVICES - TREATMENT ROOM,42400,HC BIOPSY NDL SALIVRY GLAND,"$2,445" 1330,761,SPECIALTY SERVICES - TREATMENT ROOM,42800,HC BIOPSY:OROPHARYNX,"$1,632" 1331,761,SPECIALTY SERVICES - TREATMENT ROOM,42804,HC BX NASOPHARYNX VISIBLE LES SI,"$3,302" 1332,761,SPECIALTY SERVICES - TREATMENT ROOM,46910,HC DES LESION ANAL ELEC,$922 1333,761,SPECIALTY SERVICES - TREATMENT ROOM,49082,HC PARACNTESIS AB WO IMGGUID,"$1,447" 1334,761,SPECIALTY SERVICES - TREATMENT ROOM,49083,HC PARACNTESIS AB W IMG GUID,"$2,854" 1335,761,SPECIALTY SERVICES - TREATMENT ROOM,49084,HC PERITONEAL LAVAG W IMG GD,"$1,447" 1336,761,SPECIALTY SERVICES - TREATMENT ROOM,50391,HC NPHROSTMY INSTL ANTICARCN,$536 1337,761,SPECIALTY SERVICES - TREATMENT ROOM,50690,HC RTROGRD ILEAL CNDUIT STDY,$445 1338,761,SPECIALTY SERVICES - TREATMENT ROOM,51102,HC INSERT SUPRAPUBIC CATH,"$4,532" 1339,761,SPECIALTY SERVICES - TREATMENT ROOM,51600,HC INJ PROC FOR CYSTOG/VCUG,$482 1340,761,SPECIALTY SERVICES - TREATMENT ROOM,51610,HC INJ RETROGRAD URETHROGRAM,$443 1341,761,SPECIALTY SERVICES - TREATMENT ROOM,51700,HC BLADDER IRRIGATION,$474 1342,761,SPECIALTY SERVICES - TREATMENT ROOM,51701,HC CATHETER NON-INDWELLING,$160 1343,761,SPECIALTY SERVICES - TREATMENT ROOM,51702,HC BLADDER CATH TEMP INDWELL,$185 1344,761,SPECIALTY SERVICES - TREATMENT ROOM,51703,HC CATHETERIZATION COMPLEX,$549 1345,761,SPECIALTY SERVICES - TREATMENT ROOM,51705,HC CHANGE CYSTOSTOMY,"$3,133" 1346,761,SPECIALTY SERVICES - TREATMENT ROOM,51715,HC COLLAGN INJ SUBMUCOS TISS,"$5,080" 1347,761,SPECIALTY SERVICES - TREATMENT ROOM,51720,HC BLADDER INST I11,$854 1348,761,SPECIALTY SERVICES - TREATMENT ROOM,51725,HC SIMPLE CYSTOMETROGRAM,$668 1349,761,SPECIALTY SERVICES - TREATMENT ROOM,51726,HC COMPLEX CYSTOMETROGRAM,"$1,219" 1350,761,SPECIALTY SERVICES - TREATMENT ROOM,51797,HC INTRAABDOMINAL PRESSURE TEST,$485 1351,761,SPECIALTY SERVICES - TREATMENT ROOM,51798,HC US MS POSTVOID URIN/BLADD,$147 1352,761,SPECIALTY SERVICES - TREATMENT ROOM,52000,HC CYSTOURETHROSCOPY,"$1,480" 1353,761,SPECIALTY SERVICES - TREATMENT ROOM,52005,HC CYSTOURETHRSCOPY - CATH,"$3,460" 1354,761,SPECIALTY SERVICES - TREATMENT ROOM,52204,HC CYSTO W/BIOPSYM,"$2,448" 1355,761,SPECIALTY SERVICES - TREATMENT ROOM,52214,HC CYSTO W/FULG DIAG,"$3,272" 1356,761,SPECIALTY SERVICES - TREATMENT ROOM,52224,HC CYSTO W/ FULGURATION,"$2,817" 1357,761,SPECIALTY SERVICES - TREATMENT ROOM,52234,HC CYSTO W/FULG OF TUMOR,"$3,954" 1358,761,SPECIALTY SERVICES - TREATMENT ROOM,52281,HC CYSTO W/DILAT URETH STRIC,"$3,044" 1359,761,SPECIALTY SERVICES - TREATMENT ROOM,52310,HC CYSO W/ REMOVAL,"$3,044" 1360,761,SPECIALTY SERVICES - TREATMENT ROOM,52315,HC CYSTOSCOPY W/COMPLEX REMOVAL STONE & STENT,"$5,880" 1361,761,SPECIALTY SERVICES - TREATMENT ROOM,52317,HC CYSTOLITHOLAPAXY SMPL/SML,"$5,483" 1362,761,SPECIALTY SERVICES - TREATMENT ROOM,52332,HC CYSTOURETHRSCOPY - STENT,"$4,862" 1363,761,SPECIALTY SERVICES - TREATMENT ROOM,52351,HC CYSTOURETHROSCOPY RETRO,"$2,619" 1364,761,SPECIALTY SERVICES - TREATMENT ROOM,53600,HC DILATE URET STRICT BY FIL/FLWR,$684 1365,761,SPECIALTY SERVICES - TREATMENT ROOM,54056,HC DES LESION PENIS CRYO,$770 1366,761,SPECIALTY SERVICES - TREATMENT ROOM,54100,HC BIOPSY PENIS,"$1,810" 1367,761,SPECIALTY SERVICES - TREATMENT ROOM,54235,HC PENILE INJECTION,$704 1368,761,SPECIALTY SERVICES - TREATMENT ROOM,54700,HC INCIS/DRAIN OF EPIDIDYMIS,"$3,740" 1369,761,SPECIALTY SERVICES - TREATMENT ROOM,55000,HC PUNC ASP HYDRO W/WO INJ,$403 1370,761,SPECIALTY SERVICES - TREATMENT ROOM,55700,HC PROSTATE BIOPSY,"$2,659" 1371,761,SPECIALTY SERVICES - TREATMENT ROOM,55876,HC PLC INRST DVC-RT GD PROST,"$1,230" 1372,761,SPECIALTY SERVICES - TREATMENT ROOM,56515,HC VULVA LEEP DEST LESION,"$3,771" 1373,761,SPECIALTY SERVICES - TREATMENT ROOM,56605,HC BIOPSY-VULVA,"$1,244" 1374,761,SPECIALTY SERVICES - TREATMENT ROOM,56606,HC BX VULVA/PERIN ADD LES,"$1,008" 1375,761,SPECIALTY SERVICES - TREATMENT ROOM,56620,HC VULVECTOMY SIMPLE,"$4,508" 1376,761,SPECIALTY SERVICES - TREATMENT ROOM,56820,HC COLPO OF VULVA,$443 1377,761,SPECIALTY SERVICES - TREATMENT ROOM,56821,HC COLPO W/BX(S) OF VULVA,$561 1378,761,SPECIALTY SERVICES - TREATMENT ROOM,57065,HC VAG LEEPDEST OF LESION,"$4,543" 1379,761,SPECIALTY SERVICES - TREATMENT ROOM,57100,HC BIOPSY VAGINA,$713 1380,761,SPECIALTY SERVICES - TREATMENT ROOM,57160,HC PESSARY FIT/INSERT,$309 1381,761,SPECIALTY SERVICES - TREATMENT ROOM,57180,HC VAGINAL PACKING,$493 1382,761,SPECIALTY SERVICES - TREATMENT ROOM,57420,HC COLPO OF ENTIRE VAGINA,$935 1383,761,SPECIALTY SERVICES - TREATMENT ROOM,57421,HC COLPO W/BX OF VAGINA,"$1,096" 1384,761,SPECIALTY SERVICES - TREATMENT ROOM,57452,HC COLPOSCOPY OF CERVIX,$413 1385,761,SPECIALTY SERVICES - TREATMENT ROOM,57454,HC COLPOSCOPY W/BX & EEC,$953 1386,761,SPECIALTY SERVICES - TREATMENT ROOM,57455,HC COLPO W/BX OF CERVIX,$985 1387,761,SPECIALTY SERVICES - TREATMENT ROOM,57456,HC COLPO W/ENDOCRV CURETTAGE,$994 1388,761,SPECIALTY SERVICES - TREATMENT ROOM,57460,HC COLPOSCOPY W/LEEP,"$3,108" 1389,761,SPECIALTY SERVICES - TREATMENT ROOM,57461,HC COLPO W/LEEP CONE,"$6,092" 1390,761,SPECIALTY SERVICES - TREATMENT ROOM,57500,HC CERVICAL BIOPSY,"$1,281" 1391,761,SPECIALTY SERVICES - TREATMENT ROOM,57505,HC ENDOCERVICAL CURETTAGE,$831 1392,761,SPECIALTY SERVICES - TREATMENT ROOM,57522,HC LEEP CONE,"$5,717" 1393,761,SPECIALTY SERVICES - TREATMENT ROOM,57800,HC DILATION OF CERVIX,"$2,590" 1394,761,SPECIALTY SERVICES - TREATMENT ROOM,58100,HC BIOPSY ENDOMETRIAL,$426 1395,761,SPECIALTY SERVICES - TREATMENT ROOM,58110,HC ENDOMETRIAL BX CNJ WCOLPO,$413 1396,761,SPECIALTY SERVICES - TREATMENT ROOM,58300,HC INSERTION INTRAUTERIN DVC,$763 1397,761,SPECIALTY SERVICES - TREATMENT ROOM,58301,HC REMOVE INTRAUTER DEVICE,$339 1398,761,SPECIALTY SERVICES - TREATMENT ROOM,60100,HC THYROID BX PERC CORE NDL,"$2,681" 1399,761,SPECIALTY SERVICES - TREATMENT ROOM,61020,HC OMMAYA TAP,"$1,087" 1400,761,SPECIALTY SERVICES - TREATMENT ROOM,61026,HC OMMAYA PUNCT:W/INJ-DX/TX,"$1,149" 1401,761,SPECIALTY SERVICES - TREATMENT ROOM,62270,HC LUMBAR PUNCTURE,"$1,062" 1402,761,SPECIALTY SERVICES - TREATMENT ROOM,62272,HC SPINAL PUNCTURE THERA,"$1,171" 1403,761,SPECIALTY SERVICES - TREATMENT ROOM,62273,HC INJ EPIDRL-BLD/CLOT PATCH,"$1,556" 1404,761,SPECIALTY SERVICES - TREATMENT ROOM,62320,HC INJ INTERLAMINAR CRV/THRC NON-NEUROLYTIC W/O IMG GUID,"$1,763" 1405,761,SPECIALTY SERVICES - TREATMENT ROOM,62321,HC INJ INTERLAMINAR CRV/THRC NON-NEUROLYTIC W/ IMG GUID,"$2,802" 1406,761,SPECIALTY SERVICES - TREATMENT ROOM,62322,HC INJ INTERLAMINAR LMBR/SAC NON-NEUROLYTIC W/O IMG GUID,"$1,763" 1407,761,SPECIALTY SERVICES - TREATMENT ROOM,62323,HC INJ INTERLAMINAR LMBR/SAC NON-NEUROLYTIC W/ IMG GUID,"$2,802" 1408,761,SPECIALTY SERVICES - TREATMENT ROOM,62324,HC INJ INTERLAMINAR CRV/THRC CONTINU/INTERMIT NON-NEUROLYTIC W/O IMG GUID,"$1,966" 1409,761,SPECIALTY SERVICES - TREATMENT ROOM,62325,HC INJ INTERLAMINAR CRV/THRC CONTINU/INTERMIT NON-NEUROLYTIC W/ IMG GUID,"$3,006" 1410,761,SPECIALTY SERVICES - TREATMENT ROOM,62326,HC INJ INTERLAMINAR LMBR/SAC CONTINU/INTERMIT NON-NEUROLYTIC W/O IMG GUID,"$1,966" 1411,761,SPECIALTY SERVICES - TREATMENT ROOM,62327,HC INJ INTERLAMINAR LMBR/SAC CONTINU/INTERMIT NON-NEUROLYTIC W/ IMG GUID,"$3,006" 1412,761,SPECIALTY SERVICES - TREATMENT ROOM,62350,HC IMPL EPI CATH MEDS WO LAM,"$8,589" 1413,761,SPECIALTY SERVICES - TREATMENT ROOM,62365,HC REMV IMPLT SUB RESV/PUMP,"$2,283" 1414,761,SPECIALTY SERVICES - TREATMENT ROOM,62367,HC ELC ANLY PRO PMP WO REPG,$704 1415,761,SPECIALTY SERVICES - TREATMENT ROOM,62369,HC ANALYSIS PMP W/REPRG REFL,$775 1416,761,SPECIALTY SERVICES - TREATMENT ROOM,62370,HC ANALY PMP W/REPG RFL RQMD,$816 1417,761,SPECIALTY SERVICES - TREATMENT ROOM,64400,HC INJEC ANESTH TRIGEM NERV,$792 1418,761,SPECIALTY SERVICES - TREATMENT ROOM,64402,HC INJEC ANESTH FACIAL NERVE,$518 1419,761,SPECIALTY SERVICES - TREATMENT ROOM,64405,HC INJEC ANESTH >OCCIP NERV,$792 1420,761,SPECIALTY SERVICES - TREATMENT ROOM,64418,HC INJ ANS AGT SUPRASCAP NER,$430 1421,761,SPECIALTY SERVICES - TREATMENT ROOM,64420,HC INJ ANS AGT INTRCST NV1,$792 1422,761,SPECIALTY SERVICES - TREATMENT ROOM,64421,HC INJ ANS AG INTRCST NEV MX,$845 1423,761,SPECIALTY SERVICES - TREATMENT ROOM,64425,HC INJ ANS AGT ILIOING NRV,$792 1424,761,SPECIALTY SERVICES - TREATMENT ROOM,64430,HC INJECTION PUDENDAL BLOCK,"$1,627" 1425,761,SPECIALTY SERVICES - TREATMENT ROOM,64445,HC INJ ANS AGT SCIATIC NERV,$792 1426,761,SPECIALTY SERVICES - TREATMENT ROOM,64450,HC INJ ANS AG OTR PERIP NEV,$875 1427,761,SPECIALTY SERVICES - TREATMENT ROOM,64455,HC INJ ANS AG PLANTAR DIGIT,$721 1428,761,SPECIALTY SERVICES - TREATMENT ROOM,64461,HC PARAVERTEBRAL BLOCK (PVB) THORACIC SINGLE INJ ST INCL IMG,"$1,805" 1429,761,SPECIALTY SERVICES - TREATMENT ROOM,64462,HC PARAVERTEBRAL BLOCK (PVB) THORACIC 2ND INJ & ANY ADD'L INC IMG,$890 1430,761,SPECIALTY SERVICES - TREATMENT ROOM,64479,HC INJ ANS EPI CER/TH 1LVL,$792 1431,761,SPECIALTY SERVICES - TREATMENT ROOM,64480,HC INJ AN EPI CV/TH-EA ADD,$792 1432,761,SPECIALTY SERVICES - TREATMENT ROOM,64483,HC INJ ANS EPI LUM/SAC 1LVL,$875 1433,761,SPECIALTY SERVICES - TREATMENT ROOM,64484,HC INJ AN EPI LU/SAC-EA ADD,$792 1434,761,SPECIALTY SERVICES - TREATMENT ROOM,64488,HC TAP BLOCK BILAT-INJECTNS,"$1,072" 1435,761,SPECIALTY SERVICES - TREATMENT ROOM,64490,HC INJ AN FACET CV/THR 1LVL,"$1,520" 1436,761,SPECIALTY SERVICES - TREATMENT ROOM,64491,HC INJ AN FACET CV/THR 2LVL,$792 1437,761,SPECIALTY SERVICES - TREATMENT ROOM,64492,HC INJ AN FACET CV/TH >3LVL,$792 1438,761,SPECIALTY SERVICES - TREATMENT ROOM,64493,HC INJ AN FACET LU/SC 1LVL,"$1,520" 1439,761,SPECIALTY SERVICES - TREATMENT ROOM,64494,HC INJ AN FACET LU/SC 2LVL,$792 1440,761,SPECIALTY SERVICES - TREATMENT ROOM,64495,HC INJ AN FACET LU/SC >3LVL,$792 1441,761,SPECIALTY SERVICES - TREATMENT ROOM,64505,HC INJEC ANESTH SPENO GANG,$518 1442,761,SPECIALTY SERVICES - TREATMENT ROOM,64510,HC INJ ANS AGT STELLT GANG,$792 1443,761,SPECIALTY SERVICES - TREATMENT ROOM,64517,HC INJEC ANES SUP HYPO PLEX,$756 1444,761,SPECIALTY SERVICES - TREATMENT ROOM,64520,HC INJ ANES AGENT LUM/THOR,$756 1445,761,SPECIALTY SERVICES - TREATMENT ROOM,64530,HC INJ ANES CELIAC PLEX,$792 1446,761,SPECIALTY SERVICES - TREATMENT ROOM,64600,HC DEST NEU TRIG NERV SUPAOR,"$2,794" 1447,761,SPECIALTY SERVICES - TREATMENT ROOM,64610,HC 2ND&3RD DIV OVAL W/RAD,"$2,794" 1448,761,SPECIALTY SERVICES - TREATMENT ROOM,64611,HC CHEMODENRV SALVI GLANDS,$544 1449,761,SPECIALTY SERVICES - TREATMENT ROOM,64612,HC CHEMODENRV MUS INNRV FAC,$599 1450,761,SPECIALTY SERVICES - TREATMENT ROOM,64615,HC CHMDNRVTN MUSC SPNL BLAT,$897 1451,761,SPECIALTY SERVICES - TREATMENT ROOM,64616,HC CHEMODNRV NCK WO LRYN UNI,$927 1452,761,SPECIALTY SERVICES - TREATMENT ROOM,64617,HC CHEMODENRV MUS LRYN EMG,$976 1453,761,SPECIALTY SERVICES - TREATMENT ROOM,64620,HC DESTR-NEUROL INTRCST NRV,"$2,283" 1454,761,SPECIALTY SERVICES - TREATMENT ROOM,64633,HC DES FCT NRV C/T 1LVL W GD,"$3,670" 1455,761,SPECIALTY SERVICES - TREATMENT ROOM,64634,HC DES FCT NRV C/T EA AD WGD,"$2,263" 1456,761,SPECIALTY SERVICES - TREATMENT ROOM,64635,HC DEST FCT JTNV L/S-1LV WGD,"$4,215" 1457,761,SPECIALTY SERVICES - TREATMENT ROOM,64636,HC DES FC JTNV L/S-EA ADLVGD,"$2,263" 1458,761,SPECIALTY SERVICES - TREATMENT ROOM,64640,HC DEST OTH PERIPH NERV,"$1,314" 1459,761,SPECIALTY SERVICES - TREATMENT ROOM,64642,HC CHEMODNRV 1EXTRM 1-4MUSCS,$927 1460,761,SPECIALTY SERVICES - TREATMENT ROOM,64643,HC CHEMODNRV ADD EXTR1-4MSCS,$927 1461,761,SPECIALTY SERVICES - TREATMENT ROOM,64644,HC CHEMODNRV 1EXTRM 5+ MUSCS,$927 1462,761,SPECIALTY SERVICES - TREATMENT ROOM,64646,HC CHEMODNRV TRNK 1-5 MUSCLS,$927 1463,761,SPECIALTY SERVICES - TREATMENT ROOM,64653,HC CHEMODENRV ECC GLAND OTH,$567 1464,761,SPECIALTY SERVICES - TREATMENT ROOM,64680,HC DEST CELIAC PLX W/WO RAD,"$2,283" 1465,761,SPECIALTY SERVICES - TREATMENT ROOM,64681,HC SUPERIOR HYPOGAST PLEX,"$2,794" 1466,761,SPECIALTY SERVICES - TREATMENT ROOM,69100,HC BIOPSY-EXTERNAL EAR,"$1,008" 1467,761,SPECIALTY SERVICES - TREATMENT ROOM,69105,HC BX EXTRNL AUDITORY CANAL,"$3,850" 1468,761,SPECIALTY SERVICES - TREATMENT ROOM,69210,HC CERUMEN REMOVAL,$432 1469,761,SPECIALTY SERVICES - TREATMENT ROOM,69420,HC MYRINGOTOMY,"$1,187" 1470,761,SPECIALTY SERVICES - TREATMENT ROOM,69433,HC TYMPANOSTOMY,"$1,603" 1471,761,SPECIALTY SERVICES - TREATMENT ROOM,91122,HC ANORECTAL MANOMETRY,"$1,960" 1472,761,SPECIALTY SERVICES - TREATMENT ROOM,92025,HC COMPUTERIZD CORNEAL TOPOGRAPHY,$265 1473,761,SPECIALTY SERVICES - TREATMENT ROOM,92511,HC NASOPHRYNGOSCOPE W/ENDOSCOPE,$504 1474,761,SPECIALTY SERVICES - TREATMENT ROOM,94640,HC AIRWAY INHALATION TREAT,$188 1475,761,SPECIALTY SERVICES - TREATMENT ROOM,97597,HC DEBRIDEMENT <20 SQ CM,$202 1476,761,SPECIALTY SERVICES - TREATMENT ROOM,97598,HC DEBRIDEMENT EA 20 SQ CM,$237 1477,761,SPECIALTY SERVICES - TREATMENT ROOM,97602,HC WOUND CARE NON-SELECT,$121 1478,761,SPECIALTY SERVICES - TREATMENT ROOM,97605,HC WOUND VAC < 50 SQ CM,$178 1479,761,SPECIALTY SERVICES - TREATMENT ROOM,97605,HC WOUND VAC <50 SQ CM,$178 1480,761,SPECIALTY SERVICES - TREATMENT ROOM,97606,HC WOUND VAC >50 SQ CM,$332 1481,761,SPECIALTY SERVICES - TREATMENT ROOM,97610,HC WOUND US MIST THERPY,$498 1482,761,SPECIALTY SERVICES - TREATMENT ROOM,99291,HC CRITICAL CARE 1ST 30-74 MIN,"$1,415" 1483,761,SPECIALTY SERVICES - TREATMENT ROOM,99292,HC CRITICAL CARE-1/2HR,$535 1484,761,SPECIALTY SERVICES - TREATMENT ROOM,D7140,HC DENT EXT/PRE-RAD MED,$214 1485,761,SPECIALTY SERVICES - TREATMENT ROOM,G0260,HC INJ-SI JT ARTH &/ANS/STD,"$1,575" 1486,762,SPECIALTY SERVICES - OBSERVATION HOURS,BLANK,HC OBSERVATION CARVE-OUT > 1 HOUR,$52 1487,769,SPECIALTY SERVICES - OTHER SPECIALTY SERVICES,20983,HC CRYOABLTX BONETUMRS+IMCRY,"$12,352" 1488,769,SPECIALTY SERVICES - OTHER SPECIALTY SERVICES,37218,HC IVSC STNTPLC IT CCAR+PLST,"$7,231" 1489,769,SPECIALTY SERVICES - OTHER SPECIALTY SERVICES,47383,HC CRYOABLTX LIVRTUMRS+IMCRY,"$12,352" 1490,769,SPECIALTY SERVICES - OTHER SPECIALTY SERVICES,62302,HC MYELOGRAPHY CERV INJ+S&,"$2,530" 1491,769,SPECIALTY SERVICES - OTHER SPECIALTY SERVICES,62303,HC MYELOGRAPHY THOR INJ+S&I,"$2,599" 1492,769,SPECIALTY SERVICES - OTHER SPECIALTY SERVICES,62304,HC MYELOGRAPHY LSAC INJ+S&I,"$2,543" 1493,769,SPECIALTY SERVICES - OTHER SPECIALTY SERVICES,62305,HC MYELOGRAPHY 2+REG INJ+S&I,"$2,988" 1494,770,PREVENTATIVE CARE SERVICES - GENERAL CLASSIFICATION,G0101,HC PELVIC BREAST SCREENING,$222 1495,770,PREVENTATIVE CARE SERVICES - GENERAL CLASSIFICATION,G0102,HC PROST SCREEN DIGIT EXAM,$58 1496,770,PREVENTATIVE CARE SERVICES - GENERAL CLASSIFICATION,G0296,HC COUNSELING TO DISCUSS LOW DOSE CT SCAN ELIGIBILITY,$114 1497,771,PREVENTATIVE CARE SERVICES - VACCINE ADMINISTRATION,90471,HC VAC ADM SGL W/PRFSVC,$62 1498,771,PREVENTATIVE CARE SERVICES - VACCINE ADMINISTRATION,90472,HC VAC ADM EA ADDL W/PRFSVC,$62 1499,771,PREVENTATIVE CARE SERVICES - VACCINE ADMINISTRATION,90473,HC VACC ADM INTRANAS/ORAL SGL/CMB,$56 1500,771,PREVENTATIVE CARE SERVICES - VACCINE ADMINISTRATION,G0008,HC INFLUENZA VACCINE-ADMIN,$56 1501,771,PREVENTATIVE CARE SERVICES - VACCINE ADMINISTRATION,G0009,HC PNEUMOCOCAL VACCINE-ADMIN,$56 1502,771,PREVENTATIVE CARE SERVICES - VACCINE ADMINISTRATION,G0010,HC HEPATITIS B VACCINE ADMIN,$56 1503,800,INPATIENT RENAL DIALYSIS - GENERAL CLASSIFICATION,90947,HC DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,"$1,476" 1504,801,INPATIENT RENAL DIALYSIS - INPATIENT HEMODIALYSIS,90937,"HC RENAL DIALYSIS, ACUTE","$1,476" 1505,809,INPATIENT RENAL DIALYSIS - OTHER INPATIENT DIALYSIS,90997,HC HEMOPERFUS DIALYSIS,"$3,649" 1506,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,36415,HC CONFIRM TYPE-BLOOD SAMPLE,"$1,113" 1507,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,36415,HC PRECOLL/ADDL BLOOD SAMPLE,"$1,080" 1508,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38204,HC FORMAL SEARCH-NMDP,"$3,333" 1509,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38205,HC DONOR BLD DERV HARVSTALLO,"$4,234" 1510,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38205,HC PRIMARY PBSC COLLECTION,"$66,609" 1511,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38205,HC SECONDARY PBSC COLLECTION,"$66,609" 1512,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38210,HC ALLO TXPREP TCELL DEP,"$31,235" 1513,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38230,HC MARROW COLLECTION,"$73,152" 1514,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38999,HC CORD SAMPLE SHIP,$438 1515,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38999,HC DONOR MNC COLLECTION ALLO,"$3,479" 1516,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38999,HC MARROW-WORKUP CANCEL,"$4,923" 1517,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38999,HC PBSC-WORKUP CANCELLATION,"$5,827" 1518,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,38999,HC T-CELLS WORKUP CANCELL,"$3,050" 1519,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81372,HC HLA-IR ABC STD,"$1,148" 1520,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81376,HC CORD HLA-IR DRB3-4-5 STD,$723 1521,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81376,HC CORD HLA-IR DRB3-4-5URG,$784 1522,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81380,HC HLA-HR A STD,"$1,098" 1523,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81380,HC HLA-HR B STD,"$1,264" 1524,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81380,HC HLA-HR C STD,"$1,264" 1525,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81382,HC HLA-HR DPB1 STD,"$1,191" 1526,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81382,HC HLA-HR DQB1 STD,"$1,161" 1527,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81382,HC HLA-HR DRB1 STD,"$1,089" 1528,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,81403,HC HLA-KIR TESTING,$483 1529,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,86890,HC MARROW-AUTOLGOUS BLD UNIT,"$1,575" 1530,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,87905,HC CONFIRM TYPE-INF DIS MRK,$933 1531,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,99212,HC MARROW-DONOR INFO SESSION,"$1,512" 1532,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,99212,HC PBSC-DONOR INFO SESSION,"$1,449" 1533,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,99215,HC MARROW-DONOR PHYSICAL EXM,"$4,950" 1534,815,ALLOGENEIC STEM CELL ACQUISITION/DONOR SERVICES,99215,HC PBSC-DONOR PHYSICAL EXAM,"$4,968" 1535,819,ACQUISITION OF BODY COMPONENTS - OTHER ORGAN DONOR,J1442,HC PBSC-FILGRASTIM INJECT,"$7,341" 1536,829,HEMODIALYSIS - OUTPATIENT OR HOME DIALYSIS - OTHER HEMODIALYSIS OUTPATIENT,G0257,HC RENAL DIALYSIS-UNSCHEDULED,"$1,476" 1537,871,CELL COLLECTION,0537T,HC AUTO CAR-T CELLS HARVESTING PER COLLECTION,"$3,642" 1538,872,SPECILIZED BIOLOGIC PROCESSING AND STORAGE-PRIOR TO TRANSPORT,0538T,HC AUTO CAR-T CELLS PREP - FRESH TRANSFER,"$1,371" 1539,872,SPECILIZED BIOLOGIC PROCESSING AND STORAGE-PRIOR TO TRANSPORT,0538T,HC AUTO CAR-T CELLS PREP & CRYO,"$8,364" 1540,873,STORAGE AND PROCESSING AFTER RECIPT OF CELLS FROM MANUFACTURER,0539T,HC AUTO CAR-T CELLS THAWING & MANIP HANDLING,"$4,609" 1541,874,INFUSION OF MODIFIED CELLS,0540T,HC AUTO CAR-T CELLS IV ADMINSTRATION,"$4,135" 1542,900,BEHAVIOR HEALTH TREATMENTS/SERVICES (ALSO SEE 091X) - GENERAL CLASSIFICATION,90785,HC INTERACTIVE COMPLEXITY,$488 1543,900,BEHAVIOR HEALTH TREATMENTS/SERVICES (ALSO SEE 091X) - GENERAL CLASSIFICATION,90791,HC PSYC DX INTRVW NO MEDSVC,$480 1544,900,BEHAVIOR HEALTH TREATMENTS/SERVICES (ALSO SEE 091X) - GENERAL CLASSIFICATION,90792,HC PSYC DX INTRVW W/ MEDSVC,$575 1545,900,BEHAVIOR HEALTH TREATMENTS/SERVICES (ALSO SEE 091X) - GENERAL CLASSIFICATION,90853,HC GROUP PSYCHOTHERAPY,$245 1546,914,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - INDIVIDUAL THERAPY,90832,HC PSYCTX 30MIN W/ PT NO E&M,$293 1547,914,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - INDIVIDUAL THERAPY,90833,HC PSYCTX 30MIN W/ PT + E&M,$293 1548,914,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - INDIVIDUAL THERAPY,90834,HC PSYCTX 45MIN W/ PT NO E&M,$426 1549,914,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - INDIVIDUAL THERAPY,90836,HC PSYCTX 45MIN W/ PT + E&M,$426 1550,914,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - INDIVIDUAL THERAPY,90837,HC PSYCTX 60MIN W/ PT NO E&M,$515 1551,914,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - INDIVIDUAL THERAPY,90838,HC PSYCTX 60MIN W/ PT + E&M,$515 1552,916,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - FAMILY THERAPY,90839,HC PSYCTX CRISIS 1ST 60MIN FM,$619 1553,916,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - FAMILY THERAPY,90846,"HC FAMILY PSYCHOTX W/O PAT, 50MIN",$371 1554,916,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - FAMILY THERAPY,90847,"HC FAMILY PSYCHOTX W/PAT, 50MIN",$374 1555,918,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - TESTING,96116,"HC NEUROBEHAVIORAL STATUS EXAM PHYS W/PT, INTERPJ & PREPJ 1ST HR",$566 1556,918,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - TESTING,96121,"HC NEUROBEHAVIORAL STATUS EXAM PHYS W/PT, INTERPJ & PREPJ EA ADD'L HR",$566 1557,918,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - TESTING,96132,HC NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HR,$483 1558,918,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - TESTING,96133,HC NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,$483 1559,918,BEHAVIORAL HEALTH TREATMENT/SERVICES-EXTENSION OF 090X - TESTING,96136,HC PSYL/NEUROPSYCL TEST PHYS/QHP = OR >2 TESTS ANY METHOD!242 1560 918BEHAVIES扩展090X-测试96137HCPSYL/NEUROSCL测试HYS/QHP=OR2TES24215618BEHAVORATS/SERVES扩展090X-Tests,96138HCPSYCL/NEUROSYTECH=或>2TES任何方法242 1562 918BEHAVIES扩展090X-测试96139HCPSYCL/NEUROSESTTECH=或>2测试方法EA ADDL 30 MIN,$242 1563,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,51728,HC VOIDING PRESSURE STUDY,$991 1564,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,51741,HC COMPLEX UROFLOWMETRY,$570 1565,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,62368,HC ELEC ANALY PRO PUM W REP,$741 1566,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92020,HC GONIOSCOPY,$280 1567,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92060,HC SENSORIMOTOR EXAM,$261 1568,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92081,HC VISUAL FIELD EXAM LTD,$205 1569,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92082,HC VISUAL FIELD EXAM MED,$257 1570,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92083,HC VISUAL FIELD EXAM EXTEN,$296 1571,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92132,HC SCN OPH IMG ANTSG UNI/BI,$190 1572,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92133,HC SCN OPHIMG P UNI/BI OPNRV,$190 1573,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92134,HC SCN OPHIMG P UNI/BIL RTNA,$190 1574,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92235,HC FLUORESCEIN ANGIO,$719 1575,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92250,HC FUNDUS PHOTO,$284 1576,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,92285,HC EXT OCU PHOTO MED PROG,$246 1577,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95249,HC CONTINUE GLUCOSE MONITORING MINIMUM 72 HRS!PATIENT PROVIDE EQUIPMENT,$362 1578,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95873,HC ELECTRIC GUIDANCE W/CHEMODENER,$130 1579,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95928,HC CNTRL MOTR EVK POT UPRLMB,$222 1580,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95929,HC CNTRL MOTR EVK POT LWRLMB,$237 1581,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95930,HC VISUAL EVOKED POTENTIAL (VEP) EXCEPT GLAUCOMA WITH I & R,"$1,000" 1582,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95937,HC NEUROMUSCULAR JUNCTION,$339 1583,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95938,HC SHRTLATENCY STUDY U&LLIMB,"$1,482" 1584,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95939,HC CENTRL MOTOR STUDYU&LLIMB,"$1,313" 1585,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95940,HC ITROP NEUMNTR 1:1OR/15MIN,$181 1586,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95941,HC ITROP NEUMNTR RMT/>1PT/HR,$697 1587,920,OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION,95972,HC ANLY NEUR CMPLX SPINLCRD/PERIPH+PROG,"$1,504" 1588,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93880,HC DUPLX SCAN CAROTID ARTERY BIL,"$1,035" 1589,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93882,HC DUPLEX SCAN UNILATERAL/LIM STU,$468 1590,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93886,HC TCD INTRACRANIAL ARTERIES COMP,$568 1591,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93888,HC TCD INTRACRANIAL ARTERIES LMTD,$352 1592,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93922,HC UP/LWR EXTRM STDY SGLLVL BILAT,$430 1593,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93923,HC UP/LWR EXTRM STDY MLTLVL BILAT,$430 1594,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93925,HC DUPLEX DOPPLER LWR EXTRM BILAT,"$1,005" 1595,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93926,HC DUPLEX DOPLR LWREXT UNILAT/LTD,$605 1596,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93930,HC DUPLEX DOPPLR UPPR EXTRM BILAT,"$1,005" 1597,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93931,HC DUPLEX DOPLR UPREXT UNILAT/LTD,$605 1598,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93970,HC DUPLX SCAN EXTRMTY VEINS BILAT,$994 1599,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93971,HC DUPLX SCAN EXT VNS UNI OR LTD,$591 1600,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93975,"HC DUPLX DOPP ABD,PEL/RETROPERIT",$978 1601,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93976,"HC DUPLX DOP ABD,PEL/RETROPER.F/U",$444 1602,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93978,HC DUPLX DOP AORT IVC CMPLT,"$1,132" 1603,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93979,HC DPLX DOP AORT IVC LIMITD,$533 1604,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93980,HC DUPLX SCN PENIL VESL COMP,$554 1605,921,OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB,93990,HC DUPLEX HEMODIALYSIS,$605 1606,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,51784,HC EMG ANAL URETH SPHINCT,$295 1607,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,51785,HC NEEDLE EMG ANAL/URETHRAL,$427 1608,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95860,HC EMG 1 EXTREM,$597 1609,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95861,HC EMG 2 EXTREM,$667 1610,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95867,HC EMG CRANL NERV SUP MUSCL,$713 1611,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95868,HC EMG CRAN NERV SUP MUS BI,$787 1612,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95869,HC EMG THORACIC PARASPIN MUS,$261 1613,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95870,HC EMG LIMITED,$313 1614,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95874,HC NEEDLE ELECT GUIDE W/CHEMODENE,$131 1615,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95885,HC EMG EA EXTRM W/NERV LIMIT,$310 1616,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95886,HC EMG EA EXTRM W/NERV 5/3/4,$597 1617,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95887,HC EMG NONEXTRM W/NERV LIMIT,$706 1618,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95907,HC 1-2 NERVE CONDCT STUDIES,$368 1619,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95908,HC 3-4 NERVE CONDCT STUDIES,$738 1620,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95909,HC 5-6 NERVE CONDCT STUDIES,"$1,219" 1621,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95910,HC 7-8 NERVE CONDCT STUDIES,"$1,623" 1622,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95911,HC 9-10 NERVE CONDCT STUDIES,"$1,844" 1623,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95912,HC 11-12 NERVE CONDCT STUDIES,"$2,436" 1624,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95913,HC 13+ NERVE CONDCT STUDIES,"$2,842" 1625,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95925,HC SOMATOSENS RESP UP EXTR,$784 1626,922,OTHER DIAGNOSTIC SERVICES - ELECTROMYELOGRAM,95926,HC SOMATOSENS RESP LOW EXTR,$784 1627,923,OTHER DIAGNOSTIC SERVICES - PAP SMEAR,Q0091,HC PAP SMEAR SCREENING,$40 1628,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",92071,HC FIT CONTACT LENS OCSF DIS,$423 1629,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96521,HC REFILL MAINT PORT PUMP - NONCHEMO,$426 1630,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96567,HC PDT TX/ EXPOSURE SESSION,$553 1631,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96570,"HC PDT THER,LIGHT 1ST 30MIN","$1,160" 1632,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96900,HC ACTINOTHERAPY UV,$200 1633,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96910,HC PHOTO/CHEMO THERAPY UV-B,$94 1634,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96912,HC PHOTCHEMOTHERAPY UV-A,$261 1635,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96999,HC PHOTO 10-12 VIEW,$108 1636,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96999,HC PHOTO 1-3 VIEWS,$51 1637,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96999,HC PHOTO 13-15 VIEW,$129 1638,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96999,HC PHOTO 4-6 VIEWS,$64 1639,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96999,HC PHOTO 7-9 VIEW,$87 1640,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96999,HC PHOTO OVER 15 VIEW,$179 1641,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",96999,HC WHOLE BODY PHOTO,$287 1642,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",97810,HC ACUPUNCTURE,$225 1643,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",97813,HC ACUPUNCTURE WITH ESTIM,$288 1644,940,"OTHER THERAPEUTIC SERVICES (ALSO SEE 095X, AN EXTENSION OF 094X) - GENERAL CLASSIFICATION",99195,HC THERAPEUT PHLEB,$154 1645,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,97810,HC ACUPUNCTURE,$65 1646,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,97813,HC ACUPUNCTURE WITH ESTIM,$75 1647,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,99199,HC SCALP COOLING INITIATION & FITTING,$25 1648,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,99199,HC SCALP COOLING PER SESSION,$50 1649,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,BLANK,HC MEDITATION CONSULT,$50 1650,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,BLANK,HC MUSIC CONSULT,$50 1651,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,BLANK,HC MUSIC FOLLOW UP 30 MIN,$15 1652,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,BLANK,HC MUSIC FOLLOW UP 45 MIN,$12 1653,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,BLANK,HC MUSIC FOLLOW UP 60 MIN,$15 1654,998,PATIENT CONVENIENCE ITEMS - BEAUTY SHOP/BARBER,BLANK,HC ONCOLOGY MASSAGE,$55 Certain lab codes can be applicable to multiple tests performed to obtain different results.Please note that the amounts listed below represent the minimum and maximum charge as of December 2019 and are subject to change.,,,,, List ID,Revenue Code,Revenue Code Description,CPT Code,Procedure Name,Min and Max Charge 1655,300,LABORATORY - GENERAL CLASSIFICATION,80061,"Blood test, lipids (cholesterol and triglycerides)",$234 1656,300,LABORATORY - GENERAL CLASSIFICATION,80150,Amikacin (antibiotic) level,$268 1657,300,LABORATORY - GENERAL CLASSIFICATION,80156,Carbamazepine level,$186 1658,300,LABORATORY - GENERAL CLASSIFICATION,80162,Digoxin level,$59 1659,300,LABORATORY - GENERAL CLASSIFICATION,80164,Valproic acid level,$111 1660,300,LABORATORY - GENERAL CLASSIFICATION,80170,Gentamicin (antibiotic) level,$85 1661,300,LABORATORY - GENERAL CLASSIFICATION,80185,Phenytoin level,$178 1662,300,LABORATORY - GENERAL CLASSIFICATION,80197,Tacrolimus level,$207 1663,300,LABORATORY - GENERAL CLASSIFICATION,80200,Tobramycin (antibiotic) level,$101 1664,300,LABORATORY - GENERAL CLASSIFICATION,80202,Vancomycin (antibiotic) level,$129 1665,300,LABORATORY - GENERAL CLASSIFICATION,80299,Quantitation of therapeutic drug,$144 1666,300,LABORATORY - GENERAL CLASSIFICATION,81001,Manual urinalysis test with examination using microscope,$96 1667,300,LABORATORY - GENERAL CLASSIFICATION,81002,"Urinalysis, manual test",$69- $212 1668,300,LABORATORY - GENERAL CLASSIFICATION,81003,Automated urinalysis test,$77 1669,300,LABORATORY - GENERAL CLASSIFICATION,81050,Urine volume measurement,$55 1670,300,LABORATORY - GENERAL CLASSIFICATION,82248,Bilirubin level,$81 1671,300,LABORATORY - GENERAL CLASSIFICATION,83036,Hemoglobin A1C level,$206 1672,300,LABORATORY - GENERAL CLASSIFICATION,85396,"Coagulation or fibrinolysis (clot dissolving) function measurement with interpretation and written report, per day",$531 1673,300,LABORATORY - GENERAL CLASSIFICATION,86832,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I","$1,036" 1674,300,LABORATORY - GENERAL CLASSIFICATION,86833,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",$905 1675,300,LABORATORY - GENERAL CLASSIFICATION,86860,Removal of antibodies from surface of red blood cell,$121 1676,300,LABORATORY - GENERAL CLASSIFICATION,86870,Identification of red blood cell antibodies,$292 1677,300,LABORATORY - GENERAL CLASSIFICATION,86880,Red blood cell antibody detection test,$72 1678,300,LABORATORY - GENERAL CLASSIFICATION,86885,Red blood cell antibody detection test,$32- $41 1679,300,LABORATORY - GENERAL CLASSIFICATION,86890,Processing and storage of blood unit or component,$373 1680,300,LABORATORY - GENERAL CLASSIFICATION,86900,Blood group typing (ABO),$77- $83 1681,300,LABORATORY - GENERAL CLASSIFICATION,86901,Blood typing for Rh (D) antigen,$40- $43 1682,300,LABORATORY - GENERAL CLASSIFICATION,86905,Blood typing for red blood cell antigens,$43- $48 1683,300,LABORATORY - GENERAL CLASSIFICATION,86920,Blood unit compatibility test,$81 1684,300,LABORATORY - GENERAL CLASSIFICATION,86922,Blood unit compatibility test,$76 1685,300,LABORATORY - GENERAL CLASSIFICATION,86927,Thawing of fresh frozen plasma unit,$27 1686,300,LABORATORY - GENERAL CLASSIFICATION,86945,"Irradiation of blood product, each unit",$30 1687,300,LABORATORY - GENERAL CLASSIFICATION,86960,Volume reduction of blood unit or blood product,$137 1688,300,LABORATORY - GENERAL CLASSIFICATION,86965,Pooling of platelets or other blood products,$32 1689,300,LABORATORY - GENERAL CLASSIFICATION,87254,Virus isolation,$76 1690,300,LABORATORY - GENERAL CLASSIFICATION,87497,"Detection test for cytomegalovirus, quantification",$351 1691,300,LABORATORY - GENERAL CLASSIFICATION,87507,Detection test for digestive tract pathogen,"$1,341" 1692,300,LABORATORY - GENERAL CLASSIFICATION,87529,Detection test for herpes simplex virus,$140 1693,300,LABORATORY - GENERAL CLASSIFICATION,87798,Detection test for organism,$140 1694,300,LABORATORY - GENERAL CLASSIFICATION,89050,Body fluid cell count,$28- $31 1695,300,LABORATORY - GENERAL CLASSIFICATION,89051,Body fluid cell count with cell identification,$43 1696,300,LABORATORY - GENERAL CLASSIFICATION,89060,Crystal identification from tissue or body fluid,$32 1697,301,LABORATORY - CHEMISTRY,80180,Mycophenolate (mycophenolic acid) level,$221 1698,301,LABORATORY - CHEMISTRY,80195,Sirolimus level,$278 1699,301,LABORATORY - CHEMISTRY,80200,Tobramycin (antibiotic) level,$101 1700,301,LABORATORY - CHEMISTRY,81025,Urine pregnancy test,$77 1701,301,LABORATORY - CHEMISTRY,82024,Adrenocorticotropic hormone (ACTH) level,$474 1702,301,LABORATORY - CHEMISTRY,82040,Albumin (protein) level,$40 1703,301,LABORATORY - CHEMISTRY,82042,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",$40 1704,301,LABORATORY - CHEMISTRY,82043,Urine microalbumin (protein) level,$154 1705,301,LABORATORY - CHEMISTRY,82105,"Alpha-fetoprotein (AFP) level, serum",$175 1706,301,LABORATORY - CHEMISTRY,82140,Ammonia level,$190 1707,301,LABORATORY - CHEMISTRY,82150,Amylase (enzyme) level,$63 1708,301,LABORATORY - CHEMISTRY,82232,Beta-2 microglobulin (protein) level,$181 1709,301,LABORATORY - CHEMISTRY,82247,Bilirubin level,$43 1710,301,LABORATORY - CHEMISTRY,82270,Stool analysis for blood to screen for colon tumors,$25 1711,301,LABORATORY - CHEMISTRY,82271,Specimen analysis for blood,$7 1712,301,LABORATORY - CHEMISTRY,82274,Stool analysis for blood,$365 1713,301,LABORATORY - CHEMISTRY,82306,Vitamin D-3 level,$226 1714,301,LABORATORY - CHEMISTRY,82308,Calcitonin (hormone) level,$322 1715,301,LABORATORY - CHEMISTRY,82310,Calcium level,$40 1716,301,LABORATORY - CHEMISTRY,82330,Calcium level,$93 1717,301,LABORATORY - CHEMISTRY,82340,Urine calcium level,$81 1718,301,LABORATORY - CHEMISTRY,82374,Carbon dioxide (bicarbonate) level,$47- $51 1719,301,LABORATORY - CHEMISTRY,82378,Carcinoembryonic antigen (CEA) protein level,$139 1720,301,LABORATORY - CHEMISTRY,82397,Analysis using chemiluminescent technique (light and chemical )reaction,$575 1721,301,LABORATORY - CHEMISTRY,82435,Blood chloride level,$51- $59 1722,301,LABORATORY - CHEMISTRY,82436,Urine chloride level,$32 1723,301,LABORATORY - CHEMISTRY,82438,Chloride level,$52 1724,301,LABORATORY - CHEMISTRY,82465,Cholesterol level,$72 1725,301,LABORATORY - CHEMISTRY,82523,"Collagen cross links test, (urine test to evaluate bone health)",$134 1726,301,LABORATORY - CHEMISTRY,82533,Cortisol (hormone) measurement,$211 1727,301,LABORATORY - CHEMISTRY,82550,Creatine kinase (cardiac enzyme) level,$63 1728,301,LABORATORY - CHEMISTRY,82553,Creatine kinase (cardiac enzyme) level,$100 1729,301,LABORATORY - CHEMISTRY,82565,Blood creatinine level,$30- $55 1730,301,LABORATORY - CHEMISTRY,82570,Creatinine level to test for kidney function or muscle injury,$66- $70 1731,301,LABORATORY - CHEMISTRY,82575,Creatinine clearance measurement to test for kidney function,$113 1732,301,LABORATORY - CHEMISTRY,82595,Cryoglobulin (protein) measurement,$66 1733,301,LABORATORY - CHEMISTRY,82607,Cyanocobalamin (vitamin B-12) level,$95 1734,301,LABORATORY - CHEMISTRY,82668,Erythropoietin (protein) level,$121 1735,301,LABORATORY - CHEMISTRY,82670,Estradiol (hormone) level,$136 1736,301,LABORATORY - CHEMISTRY,82728,Ferritin (blood protein) level,$181 1737,301,LABORATORY - CHEMISTRY,82746,Folic acid level,$180 1738,301,LABORATORY - CHEMISTRY,82784,Gammaglobulin (immune system protein) measurement,$115- $122 1739,301,LABORATORY - CHEMISTRY,82785,IgE (immune system protein) level,$175 1740,301,LABORATORY - CHEMISTRY,82800,Blood pH level,$63 1741,301,LABORATORY - CHEMISTRY,82803,Blood gases measurement,$99- $157 1742,301,LABORATORY - CHEMISTRY,82810,"Blood gas, oxygen saturation measurement",$31 1743,301,LABORATORY - CHEMISTRY,82945,Glucose (sugar) level on body fluid,$43 1744,301,LABORATORY - CHEMISTRY,82947,Blood glucose (sugar) level,$35 1745,301,LABORATORY - CHEMISTRY,82951,Blood glucose (sugar) tolerance test,$170 1746,301,LABORATORY - CHEMISTRY,82952,Blood glucose (sugar) tolerance test,$41 1747,301,LABORATORY - CHEMISTRY,82962,Blood glucose (sugar) test performed by hand-held instrument,$62- $64 1748,301,LABORATORY - CHEMISTRY,82977,Glutamyltransferase (liver enzyme) level,$108 1749,301,LABORATORY - CHEMISTRY,83001,"Gonadotropin, follicle stimulating (reproductive hormone) level",$175 1750,301,LABORATORY - CHEMISTRY,83002,"Gonadotropin, luteinizing (reproductive hormone) level",$185 1751,301,LABORATORY - CHEMISTRY,83010,Haptoglobin (serum protein) level,$131 1752,301,LABORATORY - CHEMISTRY,83036,Hemoglobin A1C level,$93 1753,301,LABORATORY - CHEMISTRY,83090,Homocysteine (amino acid) level,$246 1754,301,LABORATORY - CHEMISTRY,83520,Measurement of substance using immunoassay technique,$426 1755,301,LABORATORY - CHEMISTRY,83525,Insulin measurement,$151 1756,301,LABORATORY - CHEMISTRY,83540,Iron level,$73 1757,301,LABORATORY - CHEMISTRY,83605,Lactic acid level,$52- $76 1758,301,LABORATORY - CHEMISTRY,83615,Lactate dehydrogenase (enzyme) level,$40 1759,301,LABORATORY - CHEMISTRY,83630,Stool lactoferrin (immune system protein) analysis,$192 1760,301,LABORATORY - CHEMISTRY,83690,Lipase (fat enzyme) level,$96 1761,301,LABORATORY - CHEMISTRY,83718,HDL cholesterol level,$79 1762,301,LABORATORY - CHEMISTRY,83735,Magnesium level,$91 1763,301,LABORATORY - CHEMISTRY,83789,Mass spectrometry (laboratory testing method),$436 1764,301,LABORATORY - CHEMISTRY,83880,Natriuretic peptide (heart and blood vessel protein) level,$146- $236 1765,301,LABORATORY - CHEMISTRY,83883,"Nephelometry, test method using light",$254 1766,301,LABORATORY - CHEMISTRY,83930,Blood osmolality (concentration) measurement,$70 1767,301,LABORATORY - CHEMISTRY,83935,Urine osmolality (concentration) measurement,$56 1768,301,LABORATORY - CHEMISTRY,83937,Osteocalcin (bone protein) level,$288 1769,301,LABORATORY - CHEMISTRY,83970,Parathormone (parathyroid hormone) level,$415- $484 1770,301,LABORATORY - CHEMISTRY,83986,Body fluid pH level,$7- $63 1771,301,LABORATORY - CHEMISTRY,84075,Phosphatase (enzyme) level,$40 1772,301,LABORATORY - CHEMISTRY,84100,Phosphate level,$32 1773,301,LABORATORY - CHEMISTRY,84105,Urine phosphate level,$60- $93 1774,301,LABORATORY - CHEMISTRY,84132,Blood potassium level,$51- $59 1775,301,LABORATORY - CHEMISTRY,84133,Urine potassium level,$35 1776,301,LABORATORY - CHEMISTRY,84134,Prealbumin (protein) level,$81 1777,301,LABORATORY - CHEMISTRY,84145,Procalcitonin (hormone) level,$345 1778,301,LABORATORY - CHEMISTRY,84146,Prolactin (milk producing hormone) level,$105 1779,301,LABORATORY - CHEMISTRY,84153,PSA (prostate specific antigen) measurement,$181 1780,301,LABORATORY - CHEMISTRY,84154,PSA (prostate specific antigen) measurement,$213 1781,301,LABORATORY - CHEMISTRY,84155,"Total protein level, blood",$40 1782,301,LABORATORY - CHEMISTRY,84156,"Total protein level, urine",$52 1783,301,LABORATORY - CHEMISTRY,84160,Total protein level,$29 1784,301,LABORATORY - CHEMISTRY,84165,"Protein measurement, serum",$130 1785,301,LABORATORY - CHEMISTRY,84166,"Protein measurement, body fluid",$197 1786,301,LABORATORY - CHEMISTRY,84295,Blood sodium level,$51- $59 1787,301,LABORATORY - CHEMISTRY,84300,Urine sodium level,$40 1788,301,LABORATORY - CHEMISTRY,84302,Sodium level,$35 1789,301,LABORATORY - CHEMISTRY,84315,Specific gravity (liquid weight) measurement,$32 1790,301,LABORATORY - CHEMISTRY,84403,Testosterone (hormone) level,$116 1791,301,LABORATORY - CHEMISTRY,84432,Thyroglobulin (thyroid related hormone) level,$202 1792,301,LABORATORY - CHEMISTRY,84436,Thyroxine (thyroid chemical) measurement,$101 1793,301,LABORATORY - CHEMISTRY,84439,Thyroxine (thyroid chemical) measurement,$137 1794,301,LABORATORY - CHEMISTRY,84443,"Blood test, thyroid stimulating hormone (TSH)",$251 1795,301,LABORATORY - CHEMISTRY,84450,"Liver enzyme (SGOT), level",$91 1796,301,LABORATORY - CHEMISTRY,84460,"Liver enzyme (SGPT), level",$43 1797,301,LABORATORY - CHEMISTRY,84466,Transferrin (iron binding protein) level,$95 1798,301,LABORATORY - CHEMISTRY,84478,Triglycerides level,$63- $83 1799,301,LABORATORY - CHEMISTRY,84480,"Thyroid hormone, T3 measurement",$134 1800,301,LABORATORY - CHEMISTRY,84481,"Thyroid hormone, T3 measurement",$131 1801,301,LABORATORY - CHEMISTRY,84484,Troponin (protein) analysis,$141- $200 1802,301,LABORATORY - CHEMISTRY,84520,Urea nitrogen level to assess kidney function,$32- $55 1803,301,LABORATORY - CHEMISTRY,84540,Urea nitrogen level to assess kidney function,$32- $66 1804,301,LABORATORY - CHEMISTRY,84550,"Uric acid level, blood",$29- $43 1805,301,LABORATORY - CHEMISTRY,84681,C-peptide (protein) level,$219 1806,301,LABORATORY - CHEMISTRY,84702,"Gonadotropin, chorionic (reproductive hormone) level",$146- $178 1807,301,LABORATORY - CHEMISTRY,86152,Cell enumeration using immunologic selection and identification in fluid specimen,"$1,761" 1808,301,LABORATORY - CHEMISTRY,86300,Immunologic analysis for detection of tumor antigen,$252 1809,301,LABORATORY - CHEMISTRY,86305,Analysis of female reproductive genetic marker,"$3,346" 1810,301,LABORATORY - CHEMISTRY,86316,Analysis for detection of tumor marker,$175 1811,301,LABORATORY - CHEMISTRY,86386,Protein test for diagnosis and monitoring of bladder cancer,$125 1812,301,LABORATORY - CHEMISTRY,86886,Red blood cell antibody level,$60 1813,301,LABORATORY - CHEMISTRY,G0103,Psa screening,$190 1814,302,LABORATORY - IMMUNOLOGY,86023,Antibody identification test for platelet antibodies,$504 1815,302,LABORATORY - IMMUNOLOGY,86039,Measurement of antibody for assessment of autoimmune disorder,$251 1816,302,LABORATORY - IMMUNOLOGY,86140,Measurement C-reactive protein for detection of infection or inflammation,$119 1817,302,LABORATORY - IMMUNOLOGY,86301,Immunologic analysis for detection of tumor antigen,$156 1818,302,LABORATORY - IMMUNOLOGY,86304,Immunologic analysis for detection of tumor antigen,$238 1819,302,LABORATORY - IMMUNOLOGY,86317,Detection of infectious agent antibody,$224 1820,302,LABORATORY - IMMUNOLOGY,86334,Immunologic analysis technique on serum,$256 1821,302,LABORATORY - IMMUNOLOGY,86335,Immunologic analysis technique on body fluid,$256 1822,302,LABORATORY - IMMUNOLOGY,86355,Total cell count for B cells (white blood cells),$285 1823,302,LABORATORY - IMMUNOLOGY,86357,Total cell count for natural killer cells (white blood cell),$285 1824,302,LABORATORY - IMMUNOLOGY,86359,"T cells count, total",$285 1825,302,LABORATORY - IMMUNOLOGY,86360,T cell count and ratio,$573 1826,302,LABORATORY - IMMUNOLOGY,86367,"Stem cells count, total",$257 1827,302,LABORATORY - IMMUNOLOGY,86376,Microsomal antibodies (autoantibody) measurement,$148 1828,302,LABORATORY - IMMUNOLOGY,86592,Syphilis detection test,$96 1829,302,LABORATORY - IMMUNOLOGY,86644,Analysis for antibody to Cytomegalovirus (CMV),$89- $111 1830,302,LABORATORY - IMMUNOLOGY,86645,Analysis for antibody (IgM) to Cytomegalovirus (CMV),$151 1831,302,LABORATORY - IMMUNOLOGY,86664,Analysis for antibody to Epstein-Barr virus (mononucleosis virus),$203 1832,302,LABORATORY - IMMUNOLOGY,86665,Analysis for antibody to Epstein-Barr virus (mononucleosis virus),$206- $287 1833,302,LABORATORY - IMMUNOLOGY,86694,Analysis for antibody to Herpes simplex virus,$293 1834,302,LABORATORY - IMMUNOLOGY,86703,Analysis for antibody to HIV-1 and HIV-2 virus,$238 1835,302,LABORATORY - IMMUNOLOGY,86704,Hepatitis B core antibody measurement,$170 1836,302,LABORATORY - IMMUNOLOGY,86759,Analysis for antibody to Rotavirus (intestinal virus),$131 1837,302,LABORATORY - IMMUNOLOGY,86790,Analysis for antibody to virus,$124 1838,302,LABORATORY - IMMUNOLOGY,86800,Thyroglobulin (thyroid protein) antibody measurement,$180 1839,302,LABORATORY - IMMUNOLOGY,86803,Hepatitis C antibody measurement,$222- $278 1840,302,LABORATORY - IMMUNOLOGY,86830,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class I",$443 1841,302,LABORATORY - IMMUNOLOGY,86831,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class II",$394 1842,302,LABORATORY - IMMUNOLOGY,86832,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",$692 1843,302,LABORATORY - IMMUNOLOGY,86833,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",$595 1844,302,LABORATORY - IMMUNOLOGY,87389,Detection test for HIV-1 and HIV-2,$85 1845,302,LABORATORY - IMMUNOLOGY,87899,Detection test for identification of organism,$239- $305 1846,302,LABORATORY - IMMUNOLOGY,P9100,Pathogen(s) test for platelets,$127 1847,305,LABORATORY - HEMATOLOGY,85013,Red blood cell hemoglobin concentration,$23 1848,305,LABORATORY - HEMATOLOGY,85014,Red blood cell concentration measurement,$22- $31 1849,305,LABORATORY - HEMATOLOGY,85018,Hemoglobin measurement,$22 1850,305,LABORATORY - HEMATOLOGY,85025,"Complete blood cell count (red cells, white blood cell, platelets), automated test",$107 1851,305,LABORATORY - HEMATOLOGY,85027,"Complete blood cell count (red cells, white blood cell, platelets), automated test",$85 1852,305,LABORATORY - HEMATOLOGY,85041,"Red blood cell count, automated test",$23 1853,305,LABORATORY - HEMATOLOGY,85044,"Red blood count, manual test",$36 1854,305,LABORATORY - HEMATOLOGY,85045,"Red blood count, automated test",$85 1855,305,LABORATORY - HEMATOLOGY,85048,Automated white blood cell count,$23 1856,305,LABORATORY - HEMATOLOGY,85049,"Platelet count, automated test",$77 1857,305,LABORATORY - HEMATOLOGY,85055,Reticulated (young) platelet measurement,$90 1858,305,LABORATORY - HEMATOLOGY,85300,Antithrombin III antigen (clotting inhibitor) activity,$226 1859,305,LABORATORY - HEMATOLOGY,85303,Protein C antigen (clotting inhibitor) measurement,$227 1860,305,LABORATORY - HEMATOLOGY,85307,Activated protein resistance assay,$195 1861,305,LABORATORY - HEMATOLOGY,85347,Coagulation time measurement,$68- $76 1862,305,LABORATORY - HEMATOLOGY,85362,Coagulation function analysis,$93 1863,305,LABORATORY - HEMATOLOGY,85379,Coagulation function measurement,$77 1864,305,LABORATORY - HEMATOLOGY,85384,Fibrinogen (factor 1) activity measurement,$41- $829 1865,305,LABORATORY - HEMATOLOGY,85396,"Coagulation or fibrinolysis (clot dissolving) function measurement with interpretation and written report, per day",$548 1866,305,LABORATORY - HEMATOLOGY,85520,Heparin assay,$283 1867,305,LABORATORY - HEMATOLOGY,85610,"Blood test, clotting time",$85 1868,305,LABORATORY - HEMATOLOGY,85611,"Blood test, clotting time",$40- $63 1869,305,LABORATORY - HEMATOLOGY,85612,Clotting factor X assessment test,$59 1870,305,LABORATORY - HEMATOLOGY,85613,Clotting factor X assessment test,$161 1871,305,LABORATORY - HEMATOLOGY,85651,"Red blood cell sedimentation rate, to detect inflammation",$51 1872,305,LABORATORY - HEMATOLOGY,85660,Red blood cell sickling measurement,$119 1873,305,LABORATORY - HEMATOLOGY,85670,"Thrombin time, fibrinogen screening test",$48 1874,305,LABORATORY - HEMATOLOGY,85730,Coagulation assessment blood test,$72 1875,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87040,Bacterial blood culture,$66- $263 1876,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87046,Stool culture,$55 1877,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87070,Bacterial culture,$77 1878,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87075,Bacterial culture,$67 1879,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87076,Bacterial culture for anaerobic isolates,$134 1880,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87077,Bacterial culture for aerobic isolates,$122- $219 1881,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87081,Screening test for pathogenic organisms,$67- $107 1882,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87086,"Bacterial colony count, urine",$68 1883,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87101,"Fungal culture (mold or yeast) of skin, hair, or nail",$97 1884,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87102,Fungal culture (mold or yeast),$66- $68 1885,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87106,"Fungal culture, yeast",$68- $219 1886,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87107,Culture for identification of yeast,$68 1887,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87118,Identification of mycobacteria (TB or TB like organism),$192- $202 1888,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87153,Identification of organisms by genetic analysis,$357- $444 1889,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87177,Smear for parasites,$111 1890,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87181,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",$59 1891,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87186,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",$122- $367 1892,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87205,Special stain for microorganism,$48 1893,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87206,Special stain for microorganism,$32- $132 1894,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87210,Smear for infectious agents,$81 1895,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87220,Tissue fungi or parasites,$193 1896,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87252,Tissue culture inoculation for virus isolation,$85 1897,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87254,Virus isolation,$85 1898,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87274,Detection test for herpes simplex virus type 1,$134 1899,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87305,Detection test for aspergillus (fungus),$369 1900,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87324,Detection test for clostridium difficile toxins (stool pathogen),$130 1901,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87327,Detection test for cryptococcus neoformans (yeast),$131 1902,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87338,"Qualitative or semiquantitative detection test for helicobacter pylori in stool, multiple-step method",$176 1903,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87340,Detection test for Hepatitis B surface antigen,$124 1904,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87450,Immunologic analysis for detection of organism,$71 1905,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87471,Detection Bartonella henselae and Bartonella quintana (bacteria),$349 1906,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87483,Test for detecting nucleic acid of organism causing infection of central nervous system,"$1,258" 1907,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87486,Detection test for Chlamydia pneumoniae,$60 1908,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87491,Detection test for chlamydia,$62 1909,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87493,Detection test for clostridium difficile,$237 1910,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87496,Detection test for Cytomegalovirus (CMV),$287 1911,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87497,"Detection test for cytomegalovirus, quantification",$445 1912,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87529,Detection test for herpes simplex virus,$330 1913,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87533,Detection test for herpes virus-6,$425 1914,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87556,Detection test for Mycobacteria tuberculosis (TB bacteria),$333 1915,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87581,Detection test for Mycoplasma pneumoniae (bacteria),$60 1916,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87591,Detection test for Neisseria gonorrhoeae (gonorrhoeae bacteria),$62 1917,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87624,Detection test for human papillomavirus (hpv),$212 1918,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87633,Detection test for multiple types of respiratory virus,"$1,051" 1919,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87798,Detection test for organism,$60- $550 1920,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87799,Detection test for organism,$376- $445 1921,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87801,Detection test for multiple organisms,$147- $332 1922,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87910,Analysis test for cytomegalovirus,"$1,062" 1923,309,LABORATORY - OTHER LABORATORY,81120,"Gene analysis (isocitrate dehydrogenase 1 [NADP+], soluble) for common variants","$2,189" 1924,309,LABORATORY - OTHER LABORATORY,81121,"Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants","$2,189" 1925,309,LABORATORY - OTHER LABORATORY,81170,"Gene analysis (ABL proto-oncogene 1, non-receptor tyrosine kinase)","$2,694" 1926,309,LABORATORY - OTHER LABORATORY,81206,Translocation analysis (BCR/ABL1) minor breakpoint,$579- $1861 1927,309,LABORATORY - OTHER LABORATORY,81207,Translocation analysis (BCR/ABL1) major breakpoint,$579- $1861 1928,309,LABORATORY - OTHER LABORATORY,81208,Translocation analysis (BCR/ABL1) other breakpoint,"$1,694" 1929,309,LABORATORY - OTHER LABORATORY,81210,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),$1638- $1799 1930,309,LABORATORY - OTHER LABORATORY,81218,"Gene analysis (ccaat/enhancer binding protein [c/ebp], alpha) full gene sequence","$2,694" 1931,309,LABORATORY - OTHER LABORATORY,81219,"Gene analysis (calreticulin), common variants",$1438- $2662 1932,309,LABORATORY - OTHER LABORATORY,81235,"Gene analysis (epidermal growth factor receptor), common variants",$1799- $3315 1933,309,LABORATORY - OTHER LABORATORY,81245,Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants,$571 1934,309,LABORATORY - OTHER LABORATORY,81246,Test for detecting genes associated with blood cancer,$571 1935,309,LABORATORY - OTHER LABORATORY,81261,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population amplified methodology,"$1,114" 1936,309,LABORATORY - OTHER LABORATORY,81263,"Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region somatic mutation analysis","$3,415" 1937,309,LABORATORY - OTHER LABORATORY,81267,Chimerism analysis post transplantation,"$1,472" 1938,309,LABORATORY - OTHER LABORATORY,81268,Chimerism analysis post transplantation,$928- $1290 1939,309,LABORATORY - OTHER LABORATORY,81270,Gene analysis (Janus kinase 2) variant,"$1,795" 1940,309,LABORATORY - OTHER LABORATORY,81272,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence",$2189- $3315 1941,309,LABORATORY - OTHER LABORATORY,81273,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), D816 variants","$1,628" 1942,309,LABORATORY - OTHER LABORATORY,81275,Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13,$1035- $1093 1943,309,LABORATORY - OTHER LABORATORY,81276,"Gene analysis (Kirsten rat sarcoma viral oncogene homolog), additional variants",$1035- $1093 1944,309,LABORATORY - OTHER LABORATORY,81287,Gene analysis (O-6-methylguanine-DNA methyltransferase) for promoter methylation,"$2,504" 1945,309,LABORATORY - OTHER LABORATORY,81288,Test for detecting genes associated with colon cancer,"$1,544" 1946,309,LABORATORY - OTHER LABORATORY,81301,Microsatellite instability analysis,"$1,060" 1947,309,LABORATORY - OTHER LABORATORY,81305,Gene analysis (myeloid differentiation primary response 88) for p.Leu265 Pro variant,"$2,042" 1948,309,LABORATORY - OTHER LABORATORY,81310,Gene analysis (nucleophosmin) exon 12 variants,"$1,072" 1949,309,LABORATORY - OTHER LABORATORY,81311,Gene analysis for cancer (neuroblastoma),$2071- $2185 1950,309,LABORATORY - OTHER LABORATORY,81315,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,$579- $1693 1951,309,LABORATORY - OTHER LABORATORY,81340,Gene analysis (T cell antigen receptor beta) amplification methodology,"$1,093" 1952,309,LABORATORY - OTHER LABORATORY,81342,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),"$1,093" 1953,309,LABORATORY - OTHER LABORATORY,81370,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1","$2,251" 1954,309,LABORATORY - OTHER LABORATORY,81371,"HLA class I and II typing, low resolution HLA-A, -B, and -DRB1","$2,008" 1955,309,LABORATORY - OTHER LABORATORY,81372,HLA class I typing low resolution,"$1,741" 1956,309,LABORATORY - OTHER LABORATORY,81373,HLA class I typing low resolution one locus,"$1,202" 1957,309,LABORATORY - OTHER LABORATORY,81375,HLA class II typing low resolution HLA-DRB1/3/4/5 and -DQB1,"$1,741" 1958,309,LABORATORY - OTHER LABORATORY,81376,HLA class II typing low resolution one locus,"$1,202" 1959,309,LABORATORY - OTHER LABORATORY,81378,"HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1","$2,251" 1960,309,LABORATORY - OTHER LABORATORY,81380,HLA class I typing high resolution one locus,"$1,279" 1961,309,LABORATORY - OTHER LABORATORY,81382,HLA class II typing high resolution one locus,"$1,276" 1962,309,LABORATORY - OTHER LABORATORY,81401,Molecular pathology procedure level 2,$579- $1694 1963,309,LABORATORY - OTHER LABORATORY,81402,Molecular pathology procedure level 3,$1084- $2378 1964,309,LABORATORY - OTHER LABORATORY,81403,Molecular pathology procedure level 4,$1231- $2189 1965,309,LABORATORY - OTHER LABORATORY,81404,Molecular pathology procedure level 5,$1488- $2189 1966,309,LABORATORY - OTHER LABORATORY,81405,Molecular pathology procedure level 6,$2746- $4252 1967,309,LABORATORY - OTHER LABORATORY,81406,Molecular pathology procedure level 7,"$5,782" 1968,309,LABORATORY - OTHER LABORATORY,81479,Molecular pathology procedure,$579- $2365 1969,309,LABORATORY - OTHER LABORATORY,BLANK,HC SOLID TUMOR GENOMIC ASSAY - FUSIONS 2018,"$3,539" 1970,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,85097,"Bone marrow, smear interpretation",$364 1971,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,87040,Bacterial blood culture,$156 1972,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,87798,Detection test for organism,$334 1973,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88120,Cell examination of urine,"$2,437" 1974,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88184,Flow cytometry technique for DNA or cell analysis,$287 1975,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88185,Flow cytometry technique for DNA or cell analysis,$238 1976,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88237,Tissue culture for tumor disorders of bone marrow and blood cells,$800 1977,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88271,DNA testing for genetic defects,$420- $614 1978,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88272,Chromosome analysis for genetic defects,$611 1979,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88274,Genetic testing,$329 1980,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88275,Genetic testing,$186 1981,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88291,Interpretation and report of genetic testing,$420 1982,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88300,"Pathology examination of tissue using a microscope, limited examination",$81 1983,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88302,Pathology examination of tissue using a microscope,$129 1984,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88304,"Pathology examination of tissue using a microscope, moderately low complexity",$153 1985,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88305,"Pathology examination of tissue using a microscope, intermediate complexity",$317 1986,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88307,"Pathology examination of tissue using a microscope, moderately high complexity",$436 1987,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88309,"Pathology examination of tissue using a microscope, high complexity",$568 1988,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88311,Preparation of tissue for examination by removing any calcium present,$81 1989,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88312,Special stained specimen slides to identify organisms including interpretation and report,$112- $430 1990,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88313,Special stained specimen slides to examine tissue including interpretation and report,$52- $1144 1991,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88319,Evaluation of specimen enzymes,$66- $147 1992,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88331,Pathology examination of tissue during surgery,$94- $112 1993,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88332,Pathology examination of specimen during surgery,$40- $94 1994,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88333,Pathology examination of tissue specimen during surgery,$209 1995,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88334,Pathology examination of specimen during surgery,$190 1996,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88341,Special stained specimen slides to examine tissue,$202- $395 1997,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88342,Tissue or cell analysis by immunologic technique,$202- $395 1998,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88344,Special stained specimen slides to examine tissue,$386 1999,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88346,Antibody evaluation,$426- $1912 2000,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88360,Microscopic genetic analysis of tumor,$190- $551 2001,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88361,Microscopic genetic analysis of tumor,$255 2002,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88363,Microscopic genetic analysis of tissue,$202 2003,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88365,Analysis of genetic material,$410 2004,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88367,Microscopic genetic analysis of tissue,"$1,643" 2005,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88368,Microscopic genetic analysis of tissue,"$1,359" 2006,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88381,"Preparation of specimen, manual",$290 2007,310,LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION,88387,"Pathologist examination, dissection, and preparation of tissue",$165 2008,311,LABORATORY PATHOLOGICAL - CYTOLOGY,87625,Detection test for human papillomavirus (hpv),$213 2009,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88104,Cell examination of body fluid,$197 2010,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88108,Cell examination of specimen,$168 2011,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88121,Cell examination of urine,"$2,181" 2012,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88142,Pap test (Pap smear),$120 2013,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88162,Screening examination of specimen cells,$145 2014,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88164,Pap test (Pap smear),$127 2015,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88172,Evaluation of fine needle aspirate,$261 2016,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88173,Evaluation of fine needle aspirate with interpretation and report,$165 2017,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88177,Pap test,$102 2018,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88184,Flow cytometry technique for DNA or cell analysis,$287 2019,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88239,Tissue culture for tumor disorders,$843 2020,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88262,Chromosome analysis for genetic defects,"$1,426" 2021,311,LABORATORY PATHOLOGICAL - CYTOLOGY,88333,Pathology examination of tissue specimen during surgery,$209 2022,312,LABORATORY PATHOLOGICAL - HISTOLOGY,88313,Special stained specimen slides to examine tissue including interpretation and report,$154 2023,312,LABORATORY PATHOLOGICAL - HISTOLOGY,88323,Surgical pathology consultation and report,$218 2024,314,LABORATORY PATHOLOGICAL - BIOPSY,88305,"Pathology examination of tissue using a microscope, intermediate complexity","$3,798" 2025,319,LABORATORY PATHOLOGICAL - OTHER LABORATORY PATHOLOGICAL,BLANK,HC CLL29 PANEL,"$5,196" 2026,319,LABORATORY PATHOLOGICAL - OTHER LABORATORY PATHOLOGICAL,BLANK,HC CM50 ST MUT ANALYSIS PANEL,"$8,620" 2027,319,LABORATORY PATHOLOGICAL - OTHER LABORATORY PATHOLOGICAL,BLANK,HC LBP V1,"$6,391" 2028,319,LABORATORY PATHOLOGICAL - OTHER LABORATORY PATHOLOGICAL,BLANK,HC LEUKEMIA MUTATION PANEL V1,"$6,803" 2029,319,LABORATORY PATHOLOGICAL - OTHER LABORATORY PATHOLOGICAL,BLANK,HC SARCOMA GENE FUSION ASSAY (SGF),"$4,444" 2030,319,LABORATORY PATHOLOGICAL - OTHER LABORATORY PATHOLOGICAL,BLANK,HC SOLID TUMOR GENOMIC ASSAY - DNA 2018,"$7,363" SARS-COV-2 diagnostic test pricing are below and subject to change.,,,,, List ID,Revenue Code,Revenue Code Description,CPT Code,Procedure Name,Unit Charge 2031,302,LABORATORY - GENERAL CLASSIFICATION,86769,HC SARS COV-2 IGG ,$86 2032,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,86769,HC REF COVID 19 IGM VIRACOR,$114 2033,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,86769,HC REF COVID 19 IGG VIRACOR,$114 2034,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87635,HC REF COVID19 PCR VIRACOR,$739 2035,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,87635,HC 2019-NCOV COVID-19,$382 2036,306,LABORATORY - BACTERIOLOGY & MICROBIOLOGY,U0004,HC COVID19 AUTOMATED PCR,$382