code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
,,Bilateral Procedures,,,,,0
,,Bilateral Services,,,,,0
,,CT services furnished with equipment that don't meet NEMA standard,,,,,0
,,Computed radiography x-ray,,,,,0
,,Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (NEMA) XR-29-2013 standard,,,,,0
,,Discontinued Procedure,,,,,0
,,Excepted off-campus service,,,,,0
,,Non-excepted off-campus service,,,,,0
,,X-ray taken using film,,,,,0
,,X-ray was performed using film,,,,,0
,,X-ray was taken using computed radiography technology/cassette-based imaging,,,,,0
CDM,12013,R&B ICU INTERMEDIATE,5841.0,3318.56,2512.0,5665.77,17
CDM,12476,R&B ICU INTERMEDIATE,5841.0,3318.56,2512.0,5665.77,17
CDM,13011,R&B ICU INTERMEDIATE,5841.0,3318.56,2512.0,5665.77,17
CDM,22012,R&B MEDICAL/SURGICAL SEMI-PVT,2781.0,1580.03,2502.9,3111.1,17
CDM,22475,R&B MEDICAL/SURGICAL SEMI-PVT,2781.0,1580.03,2502.9,3111.1,17
CDM,23010,R&B MEDICAL/SURGICAL SEMI-PVT,2781.0,1580.03,2502.9,3111.1,17
CDM,24075,R&B MEDICAL/SURGICAL SEMI-PVT,2781.0,1580.03,2502.9,3111.1,17
CDM,2601359,INF IV HYDRATION 31-60MIN,504.0,261.07,131.04,488.88,29
CDM,2601367,INF IV HYDRATION ADDL HR,98.0,50.76,25.48,95.06,29
CDM,2601375,INF IV THRPY 1ST HR,608.0,314.94,158.08,589.76,29
CDM,2601383,INF IV THRPY ADDL HR,114.0,59.05,29.64,110.58,29
CDM,2601409,INF IV THRPY CONCURRENT,187.0,96.87,48.62,181.39,29
CDM,2770006,IMP ADPT/EXT LD PACING/NEURO LVL 02,4397.0,2528.27,1143.22,4265.09,29
CDM,2770055,CLIP APPLIER LVL 01,594.0,286.9,154.44,576.18,29
CDM,2770063,CLIP APPLIER LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2770170,BIT LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2770287,BLADE LVL 07,2157.0,1041.83,560.82,2092.29,29
CDM,2770329,HYPO-HYPER THERMAL LVL 01,166.0,106.07,43.16,161.02,29
CDM,2770337,IMP BOLT LVL 01,709.0,407.67,184.34,687.73,29
CDM,2770345,IMP BOLT LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,2770352,IMP BONE HUMAN/SYNTHETIC LVL 01,594.0,341.55,154.44,576.18,29
CDM,2770360,IMP BONE HUMAN/SYNTHETIC LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,2770378,IMP BONE HUMAN/SYNTHETIC LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,2770386,IMP BONE HUMAN/SYNTHETIC LVL 04,3083.0,1772.72,801.58,2990.51,29
CDM,2770394,IMP BONE HUMAN/SYNTHETIC LVL 09,17524.0,10076.3,4556.24,16998.28,29
CDM,2770402,IMP BONE HUMAN/SYNTHETIC LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,2770410,IMP BONE HUMAN/SYNTHETIC LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,2770428,IMP BONE HUMAN/SYNTHETIC LVL 07,9265.0,5327.38,2408.9,8987.05,29
CDM,2770436,IMP BONE HUMAN/SYNTHETIC LVL 08,13895.0,7989.62,3612.7,13478.15,29
CDM,2770444,IMP BONE HUMAN/SYNTHETIC LVL 10,21904.0,12594.8,5695.04,21246.88,29
CDM,2770451,BOWL CELL SAVER LVL 01,1132.0,546.76,294.32,1098.04,29
CDM,2770469,BRA SURG POSTOP LVL 02,447.0,285.63,116.22,433.59,29
CDM,2770477,BRUSH LVL 02,447.0,215.9,116.22,433.59,29
CDM,2770485,BRUSH LVL 01,166.0,80.18,43.16,161.02,29
CDM,2770493,IMP AGENT COLLAGN BULK 2.5ML LVL 06,20152.0,11587.4,5239.52,19547.44,29
CDM,2770501,IMP AGENT SYNTHETIC BULK 1ML LVL 01,166.0,95.45,43.16,161.02,29
CDM,2770519,BURR LVL 01,166.0,80.18,43.16,161.02,29
CDM,2770527,BURR LVL 02,313.0,151.18,81.38,303.61,29
CDM,2770535,BURR LVL 03,447.0,215.9,116.22,433.59,29
CDM,2770543,BURR LVL 04,594.0,286.9,154.44,576.18,29
CDM,2770550,BURR LVL 05,1132.0,546.76,294.32,1098.04,29
CDM,2770568,BURR LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,2770576,BUTTON SEPTAL LVL 01,594.0,286.9,154.44,576.18,29
CDM,2770584,IMP CABLE LVL 01,313.0,179.98,81.38,303.61,29
CDM,2770592,IMP CABLE LVL 02,844.0,485.3,219.44,818.68,29
CDM,2770600,IMP CABLE LVL 03,1413.0,812.47,367.38,1370.61,29
CDM,2770618,IMP CABLE LVL 04,2157.0,1240.27,560.82,2092.29,29
CDM,2770626,IMP CABLE LVL 05,3596.0,2067.7,934.96,3488.12,29
CDM,2770634,CANNULA LVL 01,166.0,80.18,43.16,161.02,29
CDM,2770642,CANNULA LVL 02,313.0,151.18,81.38,303.61,29
CDM,2770659,CANNULA LVL 03,594.0,286.9,154.44,576.18,29
CDM,2770667,CANNULA LVL 04,850.0,410.55,221.0,824.5,29
CDM,2770675,IMP PROSTH OPHTHALMIC LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,2770683,CANNULA LVL 05,1132.0,546.76,294.32,1098.04,29
CDM,2770691,IMP VALVE LVL 08,35044.0,20150.3,9111.44,33992.68,29
CDM,2770709,IMP VALVE LVL 09,39424.0,22668.8,10250.24,38241.28,29
CDM,2770725,IMP VALVE LVL 10,43804.0,25187.3,11389.04,42489.88,29
CDM,2770733,IMP PROSTH OPHTHALMIC LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,2770741,CATH ABL COOL-TIP LVL 05,5861.0,2830.86,1523.86,5685.17,29
CDM,2770758,CATH ABL EP 3D/VECTOR LVL 01,2157.0,1041.83,560.82,2092.29,29
CDM,2770766,CATH ABL EP NON 3D/VECTOR LVL 01,1619.0,781.98,420.94,1570.43,29
CDM,2770774,CATH ANGIO TRANSL LASER LVL 01,2695.0,1301.68,700.7,2614.15,29
CDM,2770782,CATH ANGIO TRANSL NONLASER LVL 01,850.0,410.55,221.0,824.5,29
CDM,2770790,CATH ATHERECT TRANSL DIRECT LVL 01,4885.0,2359.46,1270.1,4738.45,29
CDM,2770808,CATH ATHERECT TRANSL ROTAT LVL 01,4885.0,2359.46,1270.1,4738.45,29
CDM,2770816,CATH BALLOON LVL 01,166.0,80.18,43.16,161.02,29
CDM,2770824,CATH BALLOON DILAT NONVASC LVL 01,1413.0,682.48,367.38,1370.61,29
CDM,2770857,CATH DIAGNOSTIC LVL 01,102.0,49.27,26.52,98.94,29
CDM,2770865,CATH CHOLANGIOGRAM LVL 01,313.0,151.18,81.38,303.61,29
CDM,2770873,CATH EP NON 3D 1-19 LVL 01,594.0,286.9,154.44,576.18,29
CDM,2770881,CATH EP NON 3D 20+ LVL 01,3083.0,1489.09,801.58,2990.51,29
CDM,2770899,CATH ENDOBRONCHIAL LVL 01,594.0,286.9,154.44,576.18,29
CDM,2770907,CATH FEEDING LVL 01,594.0,286.9,154.44,576.18,29
CDM,2770915,CATH GUIDE LVL 01,166.0,80.18,43.16,161.02,29
CDM,2770923,CATH HEM/PER SHORT TERM LVL 01,313.0,151.18,81.38,303.61,29
CDM,2770931,IMP CATH HEM/PER LONG TERM LVL 01,313.0,179.98,81.38,303.61,29
CDM,2770949,CATH HYDROPHYLIC LVL 01,2695.0,1301.68,700.7,2614.15,29
CDM,2770956,CATH INF NON HEMODIALYSIS LVL 01,313.0,151.18,81.38,303.61,29
CDM,2770964,CATH INTRACARDIAC ECHO LVL 02,3596.0,1736.87,934.96,3488.12,29
CDM,2770980,CATH INTRASPINAL LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,2770998,CATH INTRAVASCULAR US LVL 01,850.0,410.55,221.0,824.5,29
CDM,2771012,CATH OCCLUSION LVL 01,594.0,286.9,154.44,576.18,29
CDM,2771020,CATH BALLOON PACING LVL 01,594.0,286.9,154.44,576.18,29
CDM,2771046,CATH SPINAL/NEURO LVL 01,850.0,410.55,221.0,824.5,29
CDM,2771053,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 01,251.0,121.23,65.26,243.47,29
CDM,2771061,CATH THROMBECTOMY/EMBOLECTMY LVL 01,313.0,151.18,81.38,303.61,29
CDM,2771079,CATH URETERAL LVL 01,313.0,151.18,81.38,303.61,29
CDM,2771087,CATH URETHRAL LVL 02,166.0,80.18,43.16,161.02,29
CDM,2771095,ELECTRODE ELECTROSURGICAL LVL 01,166.0,80.18,43.16,161.02,29
CDM,2771103,ELECTRODE ELECTROSURGICAL LVL 02,313.0,151.18,81.38,303.61,29
CDM,2771111,ELECTRODE ELECTROSURGICAL LVL 03,447.0,215.9,116.22,433.59,29
CDM,2771129,ELECTRODE ELECTROSURGICAL LVL 04,594.0,286.9,154.44,576.18,29
CDM,2771137,IMP VALVE LVL 11,52564.0,30224.3,13666.64,50987.08,29
CDM,2771145,ELECTRODE ELECTROSURGICAL LVL 05,850.0,410.55,221.0,824.5,29
CDM,2771152,ELECTRODE ELECTROSURGICAL LVL 06,1413.0,682.48,367.38,1370.61,29
CDM,2771160,ELECTRODE ELECTROSURGICAL LVL 07,1888.0,911.9,490.88,1831.36,29
CDM,2771178,ELECTRODE ELECTROSURGICAL LVL 08,2695.0,1301.68,700.7,2614.15,29
CDM,2771186,IMP PROSTH ENT LVL 04,2695.0,1549.62,700.7,2614.15,29
CDM,2771194,IMP CEMENT LVL 01,313.0,179.98,81.38,303.61,29
CDM,2771202,CEMENT ACCESSORIES LVL 01,313.0,151.18,81.38,303.61,29
CDM,2771210,IMP CEMENT ACCESSORY LVL 01,313.0,179.98,81.38,303.61,29
CDM,2771228,IMP CEMENT LVL 02,594.0,341.55,154.44,576.18,29
CDM,2771236,IMP CEMENT LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,2771277,CLIP LVL 01,166.0,80.18,43.16,161.02,29
CDM,2771285,IMP CLIP ANEURYSM LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2771301,IMP DEV CLOSURE VASCULAR LVL 01,313.0,179.98,81.38,303.61,29
CDM,2771319,IMP COIL EMBOLIZATION LVL 01,313.0,179.98,81.38,303.61,29
CDM,2771327,COIL IMAGING MAGNETIC RESON LVL 01,313.0,151.18,81.38,303.61,29
CDM,2771335,THERAPY COLD LVL 02,850.0,410.55,221.0,824.5,29
CDM,2771343,IMP COVER BURR HOLE LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2771350,CATH ABL EP NON 3D/VECTOR LVL 02,3083.0,1489.09,801.58,2990.51,29
CDM,2771368,CATH ABL EP NON 3D/VECTOR LVL 03,4885.0,2359.46,1270.1,4738.45,29
CDM,2771376,CATH ABL EP NON 3D/VECTOR LVL 04,9265.0,4475.0,2408.9,8987.05,29
CDM,2771384,CATH ANGIO TRANSL LASER LVL 02,4885.0,2359.46,1270.1,4738.45,29
CDM,2771400,IMP ACCESS SYSTEM DIALYS LVL 01,594.0,341.55,154.44,576.18,29
CDM,2771418,DIALYSIS ACCESSORIES LVL 01,166.0,80.18,43.16,161.02,29
CDM,2771426,DILATOR LVL 01,166.0,80.18,43.16,161.02,29
CDM,2771434,DILATOR LVL 02,313.0,151.18,81.38,303.61,29
CDM,2771442,DILATOR LVL 03,850.0,410.55,221.0,824.5,29
CDM,2771459,DILATOR LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,2771467,DILATOR LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,2771475,DRAIN LVL 02,134.0,64.72,34.84,129.98,29
CDM,2771483,DRAIN LVL 03,313.0,151.18,81.38,303.61,29
CDM,2771491,DRAIN LVL 04,594.0,286.9,154.44,576.18,29
CDM,2771509,DRAIN LVL 05,1132.0,546.76,294.32,1098.04,29
CDM,2771517,PUNCH LVL 02,594.0,286.9,154.44,576.18,29
CDM,2771525,RESERVOIR NEURO LVL 02,1619.0,781.98,420.94,1570.43,29
CDM,2771533,DRAIN REINFUSION LVL 01,594.0,286.9,154.44,576.18,29
CDM,2771558,DRAIN W ACCESSORIES LVL 01,190.0,91.77,49.4,184.3,29
CDM,2771566,DRESSING SPECIALTY LVL 02,166.0,80.18,43.16,161.02,29
CDM,2771574,DRESSING SPECIALTY LVL 03,313.0,151.18,81.38,303.61,29
CDM,2771582,DRESSING SPECIALTY LVL 04,594.0,286.9,154.44,576.18,29
CDM,2771590,DRESSING SPECIALTY LVL 05,1132.0,546.76,294.32,1098.04,29
CDM,2771608,DRESSING SPECIALTY LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,2771616,IMP DEV JT KNEE TOTAL LVL 19,87604.0,50372.3,22777.04,84975.88,29
CDM,2771624,CATH BALLOON PACING LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2771632,IMP EXPANDER TISSUE LVL 01,2426.0,1394.95,630.76,2353.22,29
CDM,2771640,IMP EXPANDER TISSUE LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,2771657,IMP EXPANDER TISSUE LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,2771673,CATH ANGIO TRANSL NONLASER LVL 02,1413.0,682.48,367.38,1370.61,29
CDM,2771681,CATH ANGIO TRANSL NONLASER LVL 03,1888.0,911.9,490.88,1831.36,29
CDM,2771699,CATH ANGIO TRANSL NONLASER LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,2771707,CATH ANGIO TRANSL NONLASER LVL 05,3083.0,1489.09,801.58,2990.51,29
CDM,2771715,CATH EP NON 3D 20+ LVL 02,5861.0,2830.86,1523.86,5685.17,29
CDM,2771723,CATH ANGIO TRANSL NONLASER LVL 06,4397.0,2123.75,1143.22,4265.09,29
CDM,2771731,CATH ANGIO TRANSL NONLASER LVL 07,5861.0,2830.86,1523.86,5685.17,29
CDM,2771749,CATH ANGIO TRANSL NONLASER LVL 08,7413.0,3580.48,1927.38,7190.61,29
CDM,2771756,CATH ANGIO TRANSL NONLASER LVL 09,9265.0,4475.0,2408.9,8987.05,29
CDM,2771764,CATH FEEDING LVL 02,850.0,410.55,221.0,824.5,29
CDM,2771772,CATH INF NON HEMODIALYSIS LVL 02,594.0,286.9,154.44,576.18,29
CDM,2771780,CATH INF NON HEMODIALYSIS LVL 03,850.0,410.55,221.0,824.5,29
CDM,2771798,CATH INF NON HEMODIALYSIS LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,2771806,CATH INF NON HEMODIALYSIS LVL 05,1619.0,781.98,420.94,1570.43,29
CDM,2771814,CATH INF NON HEMODIALYSIS LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,2771822,CATH INF NON HEMODIALYSIS LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,2771830,CATH INF NON HEMODIALYSIS LVL 08,6950.0,3356.85,1807.0,6741.5,29
CDM,2771848,CATH INF NON HEMODIALYSIS LVL 09,9265.0,4475.0,2408.9,8987.05,29
CDM,2771855,CATH INTRAUTERN/HYST LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2771863,CATH INTRAVASCULAR US LVL 03,3853.0,1861.0,1001.78,3737.41,29
CDM,2771871,CATH INTRAUTERN/HYST LVL 03,1619.0,781.98,420.94,1570.43,29
CDM,2771889,CATH INTRAUTERN/HYST LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,2771897,CATH INTRAUTERN/HYST LVL 05,4885.0,2359.46,1270.1,4738.45,29
CDM,2771905,CATH INTRAVASCULAR US LVL 02,2426.0,1171.76,630.76,2353.22,29
CDM,2771921,CATH OCCLUSION LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2771939,CATH OCCLUSION LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2771947,CATH OCCLUSION LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,2771954,CATH OCCLUSION LVL 05,9265.0,4475.0,2408.9,8987.05,29
CDM,2771962,CATH OCCLUSION LVL 06,13895.0,6711.28,3612.7,13478.15,29
CDM,2771970,CATH BALLOON PACING LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2771988,CATH BALLOON PACING LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,2771996,CATH SPINAL/NEURO LVL 02,1888.0,911.9,490.88,1831.36,29
CDM,2772002,IMP EMBOLIZATION AGENT LVL 01,1132.0,650.9,294.32,1098.04,29
CDM,2772010,CATH SPINAL/NEURO LVL 03,2827.0,1365.44,735.02,2742.19,29
CDM,2772028,CATH SPINAL/NEURO LVL 04,3853.0,1861.0,1001.78,3737.41,29
CDM,2772044,IMP VALVE LVL 07,30664.0,17631.8,7972.64,29744.08,29
CDM,2772119,IMP FILTER VENA CAVA LVL 03,4885.0,2808.88,1270.1,4738.45,29
CDM,2772143,IMP GRAFT VASCULAR LVL 01,594.0,341.55,154.44,576.18,29
CDM,2772150,IMP GRAFT VASCULAR LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2772168,IMP GRAFT VASCULAR LVL 03,1619.0,930.92,420.94,1570.43,29
CDM,2772176,IMP GRAFT VASCULAR LVL 04,2157.0,1240.27,560.82,2092.29,29
CDM,2772184,IMP GRAFT VASCULAR LVL 09,6950.0,3996.25,1807.0,6741.5,29
CDM,2772192,IMP GRAFT VASCULAR LVL 05,2695.0,1549.62,700.7,2614.15,29
CDM,2772200,IMP GRAFT VASCULAR LVL 06,3083.0,1772.72,801.58,2990.51,29
CDM,2772218,IMP GRAFT VASCULAR LVL 07,3909.0,2247.67,1016.34,3791.73,29
CDM,2772226,IMP GRAFT VASCULAR LVL 08,4885.0,2808.88,1270.1,4738.45,29
CDM,2772234,IMP GRAFT VASCULAR LVL 10,9265.0,5327.38,2408.9,8987.05,29
CDM,2772242,PIN GUIDE LVL 01,313.0,151.18,81.38,303.61,29
CDM,2772259,PIN GUIDE LVL 02,594.0,286.9,154.44,576.18,29
CDM,2772267,PIN GUIDE LVL 03,850.0,410.55,221.0,824.5,29
CDM,2772275,WIRE GUIDE LVL 01,166.0,80.18,43.16,161.02,29
CDM,2772283,WIRE GUIDE LVL 02,313.0,151.18,81.38,303.61,29
CDM,2772291,WIRE GUIDE LVL 03,594.0,286.9,154.44,576.18,29
CDM,2772309,HANDPIECE LVL 01,594.0,286.9,154.44,576.18,29
CDM,2772317,HANDPIECE LVL 02,1619.0,781.98,420.94,1570.43,29
CDM,2772325,HANDPIECE LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2772333,HARVESTER LVL 01,1132.0,546.76,294.32,1098.04,29
CDM,2772341,HEMOSTATIC AGENT LVL 01,313.0,151.18,81.38,303.61,29
CDM,2772358,HEMOSTATIC AGENT LVL 02,594.0,286.9,154.44,576.18,29
CDM,2772366,HEMOSTATIC AGENT LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2772374,IMP ICD CHAMBER NON SGL/DUAL LVL 04,96364.0,55409.3,25054.64,93473.08,29
CDM,2772382,IMP ICD CHAMBER DUAL LVL 02,65704.0,37329.73,17083.04,63732.88,29
CDM,2772390,IMP ICD CHAMBER SGL LVL 02,65704.0,37329.73,17083.04,63732.88,29
CDM,2772408,IMMOBILIZER LVL 01,166.0,106.07,43.16,161.02,29
CDM,2772416,IMMOBILIZER LVL 02,313.0,200.01,81.38,303.61,29
CDM,2772424,IMMOBILIZER LVL 03,594.0,379.57,154.44,576.18,29
CDM,2772432,IMMOBILIZER LVL 04,1132.0,723.35,294.32,1098.04,29
CDM,2772440,RESERVOIR THORACIC LVL 02,850.0,410.55,221.0,824.5,29
CDM,2772457,IMP NEURO LVL 01,594.0,341.55,154.44,576.18,29
CDM,2772465,INSERTER LVL 01,166.0,80.18,43.16,161.02,29
CDM,2772473,INSERTER LVL 02,313.0,151.18,81.38,303.61,29
CDM,2772481,INSERTER LVL 03,594.0,286.9,154.44,576.18,29
CDM,2772499,IMP DEV URINARY W SLING LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,2772507,IMP DEV URINARY WO SLNG LVL 02,3853.0,2215.48,1001.78,3737.41,29
CDM,2772515,INSTRUMENT DISP MULTIPLE LVL 02,594.0,286.9,154.44,576.18,29
CDM,2772523,INSTRUMENT DISP MULTIPLE LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2772531,INSTRUMENT DISP MULTIPLE LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,2772549,INSTRUMENT DISP MULTIPLE LVL 05,3083.0,1489.09,801.58,2990.51,29
CDM,2772556,INSTRUMENT DISP MULTIPLE LVL 01,313.0,151.18,81.38,303.61,29
CDM,2772564,INSTRUMENT DISP SINGLE LVL 01,190.0,91.77,49.4,184.3,29
CDM,2772572,INSTRUMENT DISP SINGLE LVL 02,594.0,286.9,154.44,576.18,29
CDM,2772580,INSTRUMENT DISP SINGLE LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2772598,INSTRUMENT DISP SINGLE LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2772606,INSTRUMENT DISP SINGLE LVL 05,2157.0,1041.83,560.82,2092.29,29
CDM,2772622,IMP FIX SPINE LVL 01,594.0,341.55,154.44,576.18,29
CDM,2772630,IMP FIX SPINE LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2772648,IMP FIX SPINE LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,2772655,IMP FIX SPINE LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,2772663,IMP STENT NONCOR TEMP WO DEL LVL 02,594.0,341.55,154.44,576.18,29
CDM,2772671,IMP FIX SPINE LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,2772689,IMP FIX SPINE LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,2772697,IMP FIX SPINE LVL 07,17524.0,10076.3,4556.24,16998.28,29
CDM,2772705,IMP FIX SPINE LVL 08,21904.0,12594.8,5695.04,21246.88,29
CDM,2772713,IMP STENT NONCOR TEMP WO DEL LVL 03,850.0,488.75,221.0,824.5,29
CDM,2772721,IMP STENT NONCOR TEMP WO DEL LVL 04,1132.0,650.9,294.32,1098.04,29
CDM,2772739,IMP STENT NONCOR TEMP WO DEL LVL 05,1619.0,930.92,420.94,1570.43,29
CDM,2772770,INTRO EP FIX CRV NONPEEL LVL 01,594.0,286.9,154.44,576.18,29
CDM,2772788,INTRO EP FIX CRV PEEL LVL 01,313.0,151.18,81.38,303.61,29
CDM,2772804,INTRO LVL 01,166.0,80.18,43.16,161.02,29
CDM,2772812,INTRO LVL 02,313.0,151.18,81.38,303.61,29
CDM,2772820,INTRO LVL 03,594.0,286.9,154.44,576.18,29
CDM,2772846,INTRO EP STEER NONPEEL LVL 03,4885.0,2359.46,1270.1,4738.45,29
CDM,2772853,TAPS LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2772861,TAPS LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2772879,IRRIGATOR/ACCESSORY LVL 01,313.0,151.18,81.38,303.61,29
CDM,2772887,IRRIGATOR/ACCESSORY LVL 02,594.0,286.9,154.44,576.18,29
CDM,2772895,IRRIGATOR/ACCESSORY LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2772903,KNOT PUSHER LVL 01,594.0,286.9,154.44,576.18,29
CDM,2772911,LASER FIBER LVL 01,594.0,286.9,154.44,576.18,29
CDM,2772929,LASER FIBER LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2772937,LASER FIBER LVL 03,1619.0,781.98,420.94,1570.43,29
CDM,2772945,LASER FIBER LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,2772952,LASER FIBER LVL 05,3083.0,1489.09,801.58,2990.51,29
CDM,2772960,LASER PROBE LVL 01,1413.0,682.48,367.38,1370.61,29
CDM,2772978,LASER PROBE LVL 02,2695.0,1301.68,700.7,2614.15,29
CDM,2772986,LASER PROBE LVL 03,3853.0,1861.0,1001.78,3737.41,29
CDM,2772994,LASER PROBE LVL 04,6105.0,2948.71,1587.3,5921.85,29
CDM,2773000,LASER PROBE LVL 05,13895.0,6711.28,3612.7,13478.15,29
CDM,2773018,IMP LD ICD COIL DUAL LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2773026,IMP LD ICD NON SGL/DUAL LVL 04,6950.0,3996.25,1807.0,6741.5,29
CDM,2773034,IMP LD ICD COIL SGL LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2773042,IMP LD NEUROSTIM LVL 01,6950.0,3996.25,1807.0,6741.5,29
CDM,2773059,IMP LD NEUROSTIM TEST KIT LVL 06,2695.0,1549.62,700.7,2614.15,29
CDM,2773067,IMP LD PCMKR/ICD COMBO LVL 01,594.0,341.55,154.44,576.18,29
CDM,2773075,IMP LD PCMKR NON VDD LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2773083,IMP LD PCMKR VDD LVL 02,6950.0,3996.25,1807.0,6741.5,29
CDM,2773141,MAMMOTOME LVL 01,313.0,151.18,81.38,303.61,29
CDM,2773158,IMP MARKER TISSUE LVL 01,313.0,179.98,81.38,303.61,29
CDM,2773166,IMP MESH LVL 01,313.0,179.98,81.38,303.61,29
CDM,2773174,IMP MESH LVL 02,594.0,341.55,154.44,576.18,29
CDM,2773182,IMP MESH LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,2773190,IMP MESH LVL 04,2157.0,1240.27,560.82,2092.29,29
CDM,2773208,IMP MESH LVL 09,11580.0,6658.5,3010.8,11232.6,29
CDM,2773216,IMP MESH LVL 05,3596.0,2067.7,934.96,3488.12,29
CDM,2773224,IMP MESH LVL 06,4885.0,2808.88,1270.1,4738.45,29
CDM,2773232,IMP MESH LVL 07,6950.0,3996.25,1807.0,6741.5,29
CDM,2773240,IMP MESH LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,2773257,IMP MESH LVL 10,15334.0,8817.05,3986.84,14873.98,29
CDM,2773315,MORCELLATOR LVL 04,13895.0,6711.28,3612.7,13478.15,29
CDM,2773331,NEEDLE BIOPSY LVL 01,166.0,80.18,43.16,161.02,29
CDM,2773349,NEEDLE BIOPSY LVL 02,313.0,151.18,81.38,303.61,29
CDM,2773356,NEEDLE BIOPSY LVL 03,594.0,286.9,154.44,576.18,29
CDM,2773364,NEEDLE BRACHYTHERAPY LVL 01,166.0,80.18,43.16,161.02,29
CDM,2773380,NEEDLE INSUFFLATION LVL 01,166.0,80.18,43.16,161.02,29
CDM,2773398,NEEDLE INSUFFLATION LVL 02,313.0,151.18,81.38,303.61,29
CDM,2773406,NEEDLE SPECIALTY LVL 01,166.0,80.18,43.16,161.02,29
CDM,2773414,NEEDLE SPECIALTY LVL 02,313.0,151.18,81.38,303.61,29
CDM,2773422,NEEDLE SPECIALTY LVL 03,850.0,410.55,221.0,824.5,29
CDM,2773430,NEEDLE SPECIALTY LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,2773448,NEEDLE SPECIALTY LVL 05,1888.0,911.9,490.88,1831.36,29
CDM,2773455,SUPPLY NEURO LVL 01,166.0,80.18,43.16,161.02,29
CDM,2773463,SUPPLY NEURO LVL 02,313.0,151.18,81.38,303.61,29
CDM,2773471,SUPPLY NEURO LVL 03,850.0,410.55,221.0,824.5,29
CDM,2773505,OBTURATOR DISPOSABLE LVL 01,313.0,151.18,81.38,303.61,29
CDM,2773513,OCCLUDER LVL 01,594.0,286.9,154.44,576.18,29
CDM,2773521,OCCLUDER LVL 02,4885.0,2359.46,1270.1,4738.45,29
CDM,2773539,ERASER OPHTHALMIC LVL 01,166.0,80.18,43.16,161.02,29
CDM,2773570,SUPPLY OSTOMY LVL 02,134.0,85.63,34.84,129.98,29
CDM,2773588,SUPPLY OSTOMY LVL 03,359.0,229.4,93.34,348.23,29
CDM,2773596,SUPPLY OSTOMY LVL 04,709.0,453.05,184.34,687.73,29
CDM,2773604,PACER ACCESSORY LVL 01,313.0,151.18,81.38,303.61,29
CDM,2773620,IMP PCMKR DUAL NON RR LVL 03,28474.0,16177.5,7403.24,27619.78,29
CDM,2773638,IMP PCMKR DUAL RR LVL 02,21904.0,12444.76,5695.04,21246.88,29
CDM,2773646,IMP PCMKR NONSGL OR DUAL LVL 05,43804.0,24887.24,11389.04,42489.88,29
CDM,2773653,IMP PCMKR SGL NON RR LVL 04,28474.0,16177.5,7403.24,27619.78,29
CDM,2773661,IMP PCMKR SGL RR LVL 03,21904.0,12444.76,5695.04,21246.88,29
CDM,2773679,CATH/WIRE/SUTURE PASSER LVL 01,313.0,151.18,81.38,303.61,29
CDM,2773687,SUPPLY PERFUSION/ECMO LVL 01,102.0,49.27,26.52,98.94,29
CDM,2773695,SUPPLY PERFUSION/ECMO LVL 02,221.0,106.74,57.46,214.37,29
CDM,2773703,SUPPLY PERFUSION/ECMO LVL 03,447.0,215.9,116.22,433.59,29
CDM,2773711,SUPPLY PERFUSION/ECMO LVL 04,850.0,410.55,221.0,824.5,29
CDM,2773729,SUPPLY PERFUSION/ECMO LVL 05,1413.0,682.48,367.38,1370.61,29
CDM,2773737,IMP PIN/WIRE LVL 01,313.0,179.98,81.38,303.61,29
CDM,2773745,IMP PIN/WIRE LVL 02,594.0,341.55,154.44,576.18,29
CDM,2773752,IMP PIN/WIRE LVL 03,850.0,488.75,221.0,824.5,29
CDM,2773778,RETRIEVER BASKET LVL 02,594.0,286.9,154.44,576.18,29
CDM,2773786,IMP PLATE LVL 01,313.0,179.98,81.38,303.61,29
CDM,2773794,IMP PLATE LVL 02,594.0,341.55,154.44,576.18,29
CDM,2773802,IMP PLATE LVL 03,850.0,488.75,221.0,824.5,29
CDM,2773810,IMP PLATE LVL 04,1132.0,650.9,294.32,1098.04,29
CDM,2773828,IMP PLATE LVL 09,6105.0,3510.37,1587.3,5921.85,29
CDM,2773836,IMP PLATE LVL 05,1619.0,930.92,420.94,1570.43,29
CDM,2773844,IMP PLATE LVL 06,2695.0,1549.62,700.7,2614.15,29
CDM,2773851,IMP PLATE LVL 07,3596.0,2067.7,934.96,3488.12,29
CDM,2773869,IMP PLATE LVL 08,4885.0,2808.88,1270.1,4738.45,29
CDM,2773877,IMP PLATE LVL 10,6950.0,3996.25,1807.0,6741.5,29
CDM,2773885,IMP CATH PORT INDWELLING LVL 01,166.0,95.45,43.16,161.02,29
CDM,2773893,PROBE LVL 01,166.0,80.18,43.16,161.02,29
CDM,2773901,PROBE LVL 02,594.0,286.9,154.44,576.18,29
CDM,2773919,PROBE LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2773927,RETRIEVER BASKET LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2773935,PROGRAMMER PT NEUROSTIM LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,2773943,IMP PROSTH ANKLE LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,2773950,IMP PROSTH ANKLE LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2773968,IMP PROSTH ANKLE LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,2773976,IMP PROSTH ANKLE LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,2773984,RETRIEVER BASKET LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2773992,IMP PROSTH ANKLE LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,2774008,RETRIEVER BASKET LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,2774016,RETRIEVER SUTURE LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2774024,IMP RING CARDIAC LVL 01,9265.0,5327.38,2408.9,8987.05,29
CDM,2774032,IMP RING CARDIAC LVL 02,13895.0,7989.62,3612.7,13478.15,29
CDM,2774040,IMP ROD/NAIL LVL 07,6487.0,3730.02,1686.62,6292.39,29
CDM,2774099,IMP PROSTH BREAST LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2774107,IMP PROSTH BREAST LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,2774115,IMP PROSTH BREAST LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,2774123,IMP VALVE LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,2774131,IMP VALVE LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2774149,IMP VALVE LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,2774156,IMP VALVE LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,2774164,IMP VALVE LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,2774172,IMP DEV COCHLEAR INT&EXT CMP LVL 05,109504.0,62964.8,28471.04,106218.88,29
CDM,2774180,IMP DEV JT ELBOW TOTAL LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,2774198,IMP DEV JT ELBOW TOTAL LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2774206,IMP DEV JT ELBOW TOTAL LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,2774214,IMP DEV JT ELBOW TOTAL LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,2774230,IMP DEV JT ELBOW TOTAL LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,2774248,IMP SHUNT LVL 06,3909.0,2247.67,1016.34,3791.73,29
CDM,2774255,IMP SHUNT LVL 07,6487.0,3730.02,1686.62,6292.39,29
CDM,2774263,IMP SHUNT LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,2774271,IMP SHUNT LVL 09,13895.0,7989.62,3612.7,13478.15,29
CDM,2774289,IMP STENT NONCOAT WO DEL LVL 07,9265.0,5327.38,2408.9,8987.05,29
CDM,2774297,IMP STENT NONCOAT WO DEL LVL 08,11580.0,6658.5,3010.8,11232.6,29
CDM,2774305,SNARE LVL 04,3596.0,1736.87,934.96,3488.12,29
CDM,2774313,IMP EMBOLIZATION SPHERE LVL 02,3596.0,2067.7,934.96,3488.12,29
CDM,2774321,IMP EMBOLIZATION SPHERE LVL 03,4885.0,2808.88,1270.1,4738.45,29
CDM,2774339,IMP PROSTH ENT LVL 01,594.0,341.55,154.44,576.18,29
CDM,2774347,IMP PROSTH ENT LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2774354,IMP PROSTH ENT LVL 03,1619.0,930.92,420.94,1570.43,29
CDM,2774362,IMP DEV JT FINGER LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,2774370,IMP DEV JT FINGER LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2774388,IMP DEV JT FINGER LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,2774404,IMP DEV JT FINGER LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,2774412,TUBE CHEST LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2774420,TUBE SPECIALTY LVL 11,3596.0,1736.87,934.96,3488.12,29
CDM,2774446,IMP TISSUE CONNECT NONHUMAN LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,2774453,IMP TISSUE CONNECT NONHUMAN LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,2774461,TRANSDUCER LVL 02,850.0,410.55,221.0,824.5,29
CDM,2774479,TRANSDUCER LVL 03,1413.0,682.48,367.38,1370.61,29
CDM,2774487,TUBE CHEST LVL 02,313.0,151.18,81.38,303.61,29
CDM,2774495,TUBE CHEST LVL 03,594.0,286.9,154.44,576.18,29
CDM,2774503,IMP DEV JT FINGER LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,2774511,IMP DEV JT HIP TOTAL LVL 01,594.0,341.55,154.44,576.18,29
CDM,2774529,IMP DEV JT HIP TOTAL LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2774537,IMP DEV JT HIP TOTAL LVL 03,1619.0,930.92,420.94,1570.43,29
CDM,2774545,IMP DEV JT HIP TOTAL LVL 04,2695.0,1549.62,700.7,2614.15,29
CDM,2774552,IMP DEV JT HIP TOTAL LVL 09,21904.0,12594.8,5695.04,21246.88,29
CDM,2774560,IMP DEV JT HIP TOTAL LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,2774578,IMP DEV JT HIP TOTAL LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,2774586,IMP DEV JT HIP TOTAL LVL 07,13895.0,7989.62,3612.7,13478.15,29
CDM,2774594,IMP DEV JT HIP TOTAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
CDM,2774602,IMP DEV JT HIP TOTAL LVL 10,26284.0,15113.3,6833.84,25495.48,29
CDM,2774610,IMP DEV JT HIP TOTAL LVL 11,30664.0,17631.8,7972.64,29744.08,29
CDM,2774628,IMP DEV JT HIP TOTAL LVL 12,35044.0,20150.3,9111.44,33992.68,29
CDM,2774636,IMP DEV JT HIP TOTAL LVL 13,43804.0,25187.3,11389.04,42489.88,29
CDM,2774644,IMP DEV JT HIP TOTAL LVL 14,52564.0,30224.3,13666.64,50987.08,29
CDM,2774651,IMP EMBOLIZATION SPHERE LVL 04,6950.0,3996.25,1807.0,6741.5,29
CDM,2774669,IMP DEV JT HIP TOTAL LVL 15,65704.0,37779.8,17083.04,63732.88,29
CDM,2774677,IMP DEV JT HIP TOTAL LVL 16,87604.0,50372.3,22777.04,84975.88,29
CDM,2774685,IMP STAPLE BONE LVL 04,991.0,569.82,257.66,961.27,29
CDM,2774693,STAPLE RELOAD LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2774701,STAPLE RELOAD LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,2774719,IMP DEV JT KNEE TOTAL LVL 15,56944.0,32742.8,14805.44,55235.68,29
CDM,2774727,IMP DEV JT KNEE TOTAL LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,2774735,IMP DEV JT KNEE TOTAL LVL 05,13895.0,7989.62,3612.7,13478.15,29
CDM,2774743,IMP DEV JT KNEE TOTAL LVL 06,17524.0,10076.3,4556.24,16998.28,29
CDM,2774750,IMP DEV JT KNEE TOTAL LVL 07,21904.0,12594.8,5695.04,21246.88,29
CDM,2774768,IMP DEV JT KNEE TOTAL LVL 12,43804.0,25187.3,11389.04,42489.88,29
CDM,2774776,IMP DEV JT KNEE TOTAL LVL 08,26284.0,15113.3,6833.84,25495.48,29
CDM,2774784,IMP DEV JT KNEE TOTAL LVL 09,30664.0,17631.8,7972.64,29744.08,29
CDM,2774792,IMP DEV JT KNEE TOTAL LVL 10,35044.0,20150.3,9111.44,33992.68,29
CDM,2774800,IMP DEV JT KNEE TOTAL LVL 11,39424.0,22668.8,10250.24,38241.28,29
CDM,2774818,IMP DEV JT KNEE TOTAL LVL 13,48184.0,27705.8,12527.84,46738.48,29
CDM,2774826,IMP DEV JT KNEE TOTAL LVL 14,52564.0,30224.3,13666.64,50987.08,29
CDM,2774834,IMP DEV JT KNEE TOTAL LVL 16,61324.0,35261.3,15944.24,59484.28,29
CDM,2774842,IMP DEV JT KNEE TOTAL LVL 17,70084.0,40298.3,18221.84,67981.48,29
CDM,2774859,IMP DEV JT KNEE TOTAL LVL 18,78844.0,45335.3,20499.44,76478.68,29
CDM,2774867,RESERVOIR OTHER LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2774875,IMP PROSTH MAXILLOFACIAL LVL 01,594.0,341.55,154.44,576.18,29
CDM,2774883,IMP PROSTH MAXILLOFACIAL LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,2774891,IMP PROSTH MAXILLOFACIAL LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,2774909,IMP PROSTH MAXILLOFACIAL LVL 04,3853.0,2215.48,1001.78,3737.41,29
CDM,2774917,IMP PUMP INF NONPRG TMP LVL 05,43804.0,25187.3,11389.04,42489.88,29
CDM,2774925,IMP PROSTH MAXILLOFACIAL LVL 05,6105.0,3510.37,1587.3,5921.85,29
CDM,2774933,IMP PUMP INF NONPRG TMP LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,2774941,IMP PUMP INF NONPRG TMP LVL 03,4885.0,2808.88,1270.1,4738.45,29
CDM,2774958,IMP PUMP INF NONPRG TMP LVL 04,21904.0,12594.8,5695.04,21246.88,29
CDM,2774982,RESERVOIR OTHER LVL 02,1619.0,781.98,420.94,1570.43,29
CDM,2774990,RESERVOIR OTHER LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,2775005,RESERVOIR OTHER LVL 05,6950.0,3356.85,1807.0,6741.5,29
CDM,2775054,CATH URETHRAL LVL 06,1619.0,781.98,420.94,1570.43,29
CDM,2775070,CATH URETHRAL LVL 03,313.0,151.18,81.38,303.61,29
CDM,2775088,CATH URETHRAL LVL 04,594.0,286.9,154.44,576.18,29
CDM,2775096,CATH URETHRAL LVL 05,850.0,410.55,221.0,824.5,29
CDM,2775104,IMP PROSTH BREAST LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,2775112,PROGRAMMER PT NEUROSTIM LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2775120,LASER FIBER LVL 06,4397.0,2123.75,1143.22,4265.09,29
CDM,2775153,IMP CEMENT ACCESSORY LVL 02,850.0,488.75,221.0,824.5,29
CDM,2775161,IMP PROSTH OPHTHALMIC LVL 01,313.0,179.98,81.38,303.61,29
CDM,2775179,IMP PROSTH OPHTHALMIC LVL 02,594.0,341.55,154.44,576.18,29
CDM,2775187,IMP PROSTH OPHTHALMIC LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,2775195,IMP PROSTH PENILE INFLT LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,2775203,IMP PROSTH PENILE INFLT LVL 03,9265.0,5327.38,2408.9,8987.05,29
CDM,2775211,IMP PROSTH PENILE INFLT LVL 04,21904.0,12594.8,5695.04,21246.88,29
CDM,2775229,IMP PROSTH PENILE NONINF LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,2775237,IMP PROSTH PENILE NONINF LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2775245,IMP PROSTH PENILE NONINF LVL 03,21904.0,12594.8,5695.04,21246.88,29
CDM,2775252,IMP PROSTH PLASTIC SURG LVL 01,594.0,341.55,154.44,576.18,29
CDM,2775260,IMP PROSTH PLASTIC SURG LVL 02,1619.0,930.92,420.94,1570.43,29
CDM,2775278,IMP PROSTH PLASTIC SURG LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,2775286,IMP DEV JT SHDR TOTAL LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,2775294,IMP DEV JT SHDR TOTAL LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,2775302,IMP DEV JT SHDR TOTAL LVL 07,13895.0,7989.62,3612.7,13478.15,29
CDM,2775310,IMP DEV JT SHDR TOTAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
CDM,2775328,STAPLE RELOAD LVL 06,3596.0,1736.87,934.96,3488.12,29
CDM,2775336,IMP DEV JT SHDR TOTAL LVL 09,21904.0,12594.8,5695.04,21246.88,29
CDM,2775344,IMP DEV JT SHDR TOTAL LVL 10,26284.0,15113.3,6833.84,25495.48,29
CDM,2775351,STAPLER LVL 06,3596.0,1736.87,934.96,3488.12,29
CDM,2775369,IMP STENT COAT W DEL LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,2775377,IMP STENT COAT W DEL LVL 03,4885.0,2808.88,1270.1,4738.45,29
CDM,2775385,IMP STENT COAT W DEL LVL 04,6950.0,3996.25,1807.0,6741.5,29
CDM,2775393,IMP STENT COAT W DEL LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,2775401,IMP STENT COAT W DEL LVL 06,11580.0,6658.5,3010.8,11232.6,29
CDM,2775419,IMP STENT COAT W DEL LVL 07,13895.0,7989.62,3612.7,13478.15,29
CDM,2775427,IMP STENT COAT W DEL LVL 08,15334.0,8817.05,3986.84,14873.98,29
CDM,2775435,IMP PROSTH TESTICULAR LVL 01,6105.0,3510.37,1587.3,5921.85,29
CDM,2775443,IMP PROSTH TESTICULAR LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2775450,IMP PROSTH TESTICULAR LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,2775468,IMP DEV JT TOE LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,2775476,IMP DEV JT TOE LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,2775484,IMP DEV JT TOE LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,2775492,IMP DEV JT TOE LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,2775518,IMP DEV JT TOE LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,2775526,CATH THROMBECTOMY/EMBOLECTMY LVL 05,3083.0,1489.09,801.58,2990.51,29
CDM,2775534,CATH THROMBECTOMY/EMBOLECTMY LVL 06,4885.0,2359.46,1270.1,4738.45,29
CDM,2775542,CATH THROMBECTOMY/EMBOLECTMY LVL 07,6950.0,3356.85,1807.0,6741.5,29
CDM,2775559,CATH URETERAL LVL 02,850.0,410.55,221.0,824.5,29
CDM,2775567,CATH URETERAL LVL 03,1888.0,911.9,490.88,1831.36,29
CDM,2775575,CATH URETERAL LVL 04,2827.0,1365.44,735.02,2742.19,29
CDM,2775583,CATH THROMBECTOMY/EMBOLECTMY LVL 02,594.0,286.9,154.44,576.18,29
CDM,2775591,CATH THROMBECTOMY/EMBOLECTMY LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2775609,CATH THROMBECTOMY/EMBOLECTMY LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,2775617,IMP PROSTH SPHINCTR URIN LVL 01,11580.0,6658.5,3010.8,11232.6,29
CDM,2775641,IMP PUMP INF NONPRG PERM LVL 01,26284.0,15113.3,6833.84,25495.48,29
CDM,2775658,IMP PUMP INF NONPRG TMP LVL 01,594.0,341.55,154.44,576.18,29
CDM,2775666,IMP PUMP INF PRG LVL 01,6105.0,3510.37,1587.3,5921.85,29
CDM,2775674,PUNCH LVL 01,313.0,151.18,81.38,303.61,29
CDM,2775682,REAMER LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2775690,IMP STENT COAT W DEL LVL 09,17524.0,10076.3,4556.24,16998.28,29
CDM,2775708,IMP STENT NONCOAT W DEL LVL 02,1619.0,930.92,420.94,1570.43,29
CDM,2775716,IMP NEUROSTIM RECVR&/TRANS LVL 01,21904.0,12594.8,5695.04,21246.88,29
CDM,2775724,IMP CARDIAC EVENT REC LVL 04,24970.0,14357.75,6492.2,24220.9,29
CDM,2775732,RESERVOIR OTHER LVL 01,594.0,286.9,154.44,576.18,29
CDM,2775740,RESERVOIR THORACIC LVL 01,313.0,151.18,81.38,303.61,29
CDM,2775757,RESERVOIR THORACIC REINFUSN LVL 01,594.0,286.9,154.44,576.18,29
CDM,2775781,DEVICE INSERT RETRV LVL 01,1132.0,546.76,294.32,1098.04,29
CDM,2775799,RETRIEVER BASKET LVL 01,313.0,151.18,81.38,303.61,29
CDM,2775807,RETRIEVER SUTURE LVL 01,594.0,286.9,154.44,576.18,29
CDM,2775815,RETRIEVER VASCULAR LVL 01,1132.0,546.76,294.32,1098.04,29
CDM,2775823,RETRIEVER VASCULAR LVL 02,2157.0,1041.83,560.82,2092.29,29
CDM,2775831,IMP RING FALLOPE LVL 03,1619.0,930.92,420.94,1570.43,29
CDM,2775849,IMP RING LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2775856,IMP STENT NONCOAT W DEL LVL 03,3083.0,1772.72,801.58,2990.51,29
CDM,2775864,IMP STENT NONCOAT W DEL LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,2775872,IMP ROD/NAIL LVL 01,313.0,179.98,81.38,303.61,29
CDM,2775880,IMP ROD/NAIL LVL 02,850.0,488.75,221.0,824.5,29
CDM,2775898,IMP ROD/NAIL LVL 03,1413.0,812.47,367.38,1370.61,29
CDM,2775906,IMP ROD/NAIL LVL 04,2695.0,1549.62,700.7,2614.15,29
CDM,2775914,IMP ROD/NAIL LVL 05,3909.0,2247.67,1016.34,3791.73,29
CDM,2775922,IMP ROD/NAIL LVL 06,5373.0,3089.48,1396.98,5211.81,29
CDM,2775930,SCALPEL HARMONIC LVL 02,2426.0,1171.76,630.76,2353.22,29
CDM,2776094,IMP STENT NONCOAT W DEL LVL 05,6950.0,3996.25,1807.0,6741.5,29
CDM,2776102,IMP STENT NONCOAT W DEL LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,2776110,IMP STENT NONCOAT W DEL LVL 07,11580.0,6658.5,3010.8,11232.6,29
CDM,2776136,SEAL PROXIMAL SYS LVL 01,2695.0,1301.68,700.7,2614.15,29
CDM,2776144,IMP SEALANT PULMONARY LIQUID LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2776151,IMP SEPTAL DEFECT INTRACARD LVL 01,15334.0,8817.05,3986.84,14873.98,29
CDM,2776169,IMP SHUNT LVL 01,313.0,179.98,81.38,303.61,29
CDM,2776177,IMP SHUNT LVL 02,594.0,341.55,154.44,576.18,29
CDM,2776185,IMP SHUNT LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,2776193,IMP SHUNT LVL 04,1619.0,930.92,420.94,1570.43,29
CDM,2776201,IMP SHUNT LVL 05,2695.0,1549.62,700.7,2614.15,29
CDM,2776250,SLEEVE SCD LVL 01,166.0,106.07,43.16,161.02,29
CDM,2776268,SLEEVE SCD LVL 02,535.0,341.86,139.1,518.95,29
CDM,2776276,SLEEVE SCD LVL 03,850.0,543.15,221.0,824.5,29
CDM,2776284,IMP STENT NONCOAT W DEL LVL 08,13895.0,7989.62,3612.7,13478.15,29
CDM,2776292,IMP STENT NONCOAT WO DEL LVL 02,850.0,488.75,221.0,824.5,29
CDM,2776300,SNARE LVL 01,313.0,151.18,81.38,303.61,29
CDM,2776318,SNARE LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2776326,SNARE LVL 03,2157.0,1041.83,560.82,2092.29,29
CDM,2776334,IMP EMBOLIZATION SPHERE LVL 01,1619.0,930.92,420.94,1570.43,29
CDM,2776342,IMP STAPLE BONE LVL 01,166.0,95.45,43.16,161.02,29
CDM,2776359,IMP STAPLE BONE LVL 02,447.0,257.02,116.22,433.59,29
CDM,2776367,IMP STAPLE BONE LVL 03,709.0,407.67,184.34,687.73,29
CDM,2776375,STAPLE RELOAD LVL 01,166.0,80.18,43.16,161.02,29
CDM,2776383,STAPLE RELOAD LVL 02,447.0,215.9,116.22,433.59,29
CDM,2776391,STAPLE RELOAD LVL 03,850.0,410.55,221.0,824.5,29
CDM,2776409,STAPLER LVL 01,313.0,151.18,81.38,303.61,29
CDM,2776417,STAPLER LVL 02,594.0,286.9,154.44,576.18,29
CDM,2776425,STAPLER LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2776433,STAPLER LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2776441,STAPLER LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,2776458,IMP STENT COAT W DEL LVL 01,594.0,341.55,154.44,576.18,29
CDM,2776466,IMP STENT COAT WO DEL LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,2776474,IMP STENT NOS LVL 01,594.0,341.55,154.44,576.18,29
CDM,2776482,IMP STENT NOS LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2776490,IMP STENT NOS LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,2776508,IMP STENT NOS LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,2776516,IMP STENT NONCOAT WO DEL LVL 03,1619.0,930.92,420.94,1570.43,29
CDM,2776524,IMP STENT NOS LVL 05,6950.0,3996.25,1807.0,6741.5,29
CDM,2776532,IMP STENT NOS LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,2776540,IMP STENT NOS LVL 07,11580.0,6658.5,3010.8,11232.6,29
CDM,2776557,IMP STENT NOS LVL 08,13895.0,7989.62,3612.7,13478.15,29
CDM,2776565,IMP STENT NONCOAT WO DEL LVL 04,2695.0,1549.62,700.7,2614.15,29
CDM,2776573,IMP STENT NONCOAT W DEL LVL 01,594.0,341.55,154.44,576.18,29
CDM,2776581,IMP STENT NONCOAT WO DEL LVL 01,447.0,257.02,116.22,433.59,29
CDM,2776599,IMP STENT NONCOR TEMP W DEL LVL 01,850.0,488.75,221.0,824.5,29
CDM,2776607,IMP STENT NONCOR TEMP WO DEL LVL 01,166.0,95.45,43.16,161.02,29
CDM,2776623,STYLET LVL 01,313.0,151.18,81.38,303.61,29
CDM,2776631,STYLET LVL 02,594.0,286.9,154.44,576.18,29
CDM,2776649,STYLET LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2776763,TIPS LVL 01,313.0,151.18,81.38,303.61,29
CDM,2776771,TIPS LVL 02,594.0,286.9,154.44,576.18,29
CDM,2776789,TIPS LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2776797,IMP TISSUE CONNECT HUMAN LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,2776805,IMP TISSUE CONNECT HUMAN LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,2776813,IMP STENT NONCOAT WO DEL LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,2776821,IMP STENT NONCOAT WO DEL LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,2776854,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 02,594.0,286.9,154.44,576.18,29
CDM,2776862,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2776870,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,2776888,IMP TISSUE CONNECT NONHUMAN LVL 01,850.0,488.75,221.0,824.5,29
CDM,2776896,IMP TISSUE CONNECT NONHUMAN LVL 02,2157.0,1240.27,560.82,2092.29,29
CDM,2776904,IMP TISSUE CONNECT NONHUMAN LVL 03,3083.0,1772.72,801.58,2990.51,29
CDM,2776912,IMP TISSUE CONNECT NONHUMAN LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,2776979,TRANSDUCER LVL 01,313.0,151.18,81.38,303.61,29
CDM,2776987,TREPHINE LVL 01,594.0,286.9,154.44,576.18,29
CDM,2776995,TREPHINE LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2777001,TROCAR LVL 01,313.0,151.18,81.38,303.61,29
CDM,2777019,TROCAR LVL 02,594.0,286.9,154.44,576.18,29
CDM,2777027,TROCAR LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2777035,TROCAR LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,2777043,TROCAR LVL 05,4885.0,2359.46,1270.1,4738.45,29
CDM,2777050,TUBE CHEST LVL 01,102.0,49.27,26.52,98.94,29
CDM,2777068,IMP TUBE EAR LVL 01,166.0,95.45,43.16,161.02,29
CDM,2777076,TUBE ENDOBRONCHIAL LVL 01,594.0,286.9,154.44,576.18,29
CDM,2777084,TUBE SPECIALTY LVL 01,32.0,15.46,8.32,31.04,29
CDM,2777092,TUBE SPECIALTY LVL 03,313.0,151.18,81.38,303.61,29
CDM,2777100,TUBE SPECIALTY LVL 02,166.0,80.18,43.16,161.02,29
CDM,2777118,TUBE SPECIALTY LVL 04,447.0,215.9,116.22,433.59,29
CDM,2777126,TUBE SPECIALTY LVL 09,1619.0,781.98,420.94,1570.43,29
CDM,2777134,TUBE SPECIALTY LVL 05,594.0,286.9,154.44,576.18,29
CDM,2777142,TUBE SPECIALTY LVL 06,709.0,342.45,184.34,687.73,29
CDM,2777159,TUBE SPECIALTY LVL 07,850.0,410.55,221.0,824.5,29
CDM,2777167,TUBE SPECIALTY LVL 08,1132.0,546.76,294.32,1098.04,29
CDM,2777175,TUBE SPECIALTY LVL 10,2695.0,1301.68,700.7,2614.15,29
CDM,2777266,BIT LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2777274,BIT LVL 05,2157.0,1041.83,560.82,2092.29,29
CDM,2777282,BIT LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,2777290,BLADE LVL 01,166.0,80.18,43.16,161.02,29
CDM,2777308,BLADE LVL 02,313.0,151.18,81.38,303.61,29
CDM,2777316,BLADE LVL 03,447.0,215.9,116.22,433.59,29
CDM,2777324,BLADE LVL 04,594.0,286.9,154.44,576.18,29
CDM,2777332,BLADE LVL 09,4397.0,2123.75,1143.22,4265.09,29
CDM,2777340,BLADE LVL 05,850.0,410.55,221.0,824.5,29
CDM,2777357,BLADE LVL 06,1132.0,546.76,294.32,1098.04,29
CDM,2777365,BLADE LVL 08,3083.0,1489.09,801.58,2990.51,29
CDM,2777373,BLADE LVL 10,5861.0,2830.86,1523.86,5685.17,29
CDM,2777381,MASK AIRWAY LARYNGEAL LVL 01,166.0,80.18,43.16,161.02,29
CDM,2777399,CLIP APPLIER LVL 03,2157.0,1041.83,560.82,2092.29,29
CDM,2777407,BAG DRAINAGE LVL 02,190.0,121.41,49.4,184.3,29
CDM,2777415,BAG DRAINAGE LVL 03,359.0,229.4,93.34,348.23,29
CDM,2777449,BIT LVL 01,313.0,151.18,81.38,303.61,29
CDM,2777456,BIT LVL 02,594.0,286.9,154.44,576.18,29
CDM,2777464,BAG DRAINAGE LVL 01,102.0,65.18,26.52,98.94,29
CDM,2777639,CATH INTRAUTERN/HYST LVL 01,594.0,286.9,154.44,576.18,29
CDM,2777647,RESERVOIR NEURO LVL 01,1132.0,546.76,294.32,1098.04,29
CDM,2777654,KIT/SET NON ROUTINE SURG LVL 01,166.0,80.18,43.16,161.02,29
CDM,2777662,INSERTS LVL 01,166.0,80.18,43.16,161.02,29
CDM,2777670,KIT/SET NON ROUTINE CARDIAC LVL 01,313.0,151.18,81.38,303.61,29
CDM,2777688,KIT/SET NON ROUTINE ORTH LVL 01,594.0,286.9,154.44,576.18,29
CDM,2777696,KIT/SET NON ROUTINE GI LVL 01,594.0,286.9,154.44,576.18,29
CDM,2777738,TAPS LVL 01,594.0,286.9,154.44,576.18,29
CDM,2777886,MASK AIRWAY LARYNGEAL LVL 02,594.0,286.9,154.44,576.18,29
CDM,2777894,MASK AIRWAY LARYNGEAL LVL 03,1619.0,781.98,420.94,1570.43,29
CDM,2777944,BLADE LVL 11,7413.0,3580.48,1927.38,7190.61,29
CDM,2777951,MASK AIRWAY LARYNGEAL LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,2777969,BLADE LVL 12,9265.0,4475.0,2408.9,8987.05,29
CDM,2778009,HYPO-HYPER THERMAL LVL 02,594.0,379.57,154.44,576.18,29
CDM,2778017,CATH ERCP LVL 01,594.0,286.9,154.44,576.18,29
CDM,2778025,CEMENT ACCESSORIES LVL 02,594.0,286.9,154.44,576.18,29
CDM,2778041,CLIP LVL 02,313.0,151.18,81.38,303.61,29
CDM,2778058,IMP COIL EMBOLIZATION LVL 02,594.0,341.55,154.44,576.18,29
CDM,2778066,IMP COIL EMBOLIZATION LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,2778074,IMP COIL EMBOLIZATION LVL 04,3083.0,1772.72,801.58,2990.51,29
CDM,2778082,IMP COIL EMBOLIZATION LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,2778090,IMP COIL EMBOLIZATION LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,2778108,IMP COIL EMBOLIZATION LVL 07,9265.0,5327.38,2408.9,8987.05,29
CDM,2778116,IMP COIL EMBOLIZATION LVL 08,11580.0,6658.5,3010.8,11232.6,29
CDM,2778124,IMP COIL EMBOLIZATION LVL 09,13895.0,7989.62,3612.7,13478.15,29
CDM,2778132,DRAIN REINFUSION LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2778140,DRAIN REINFUSION LVL 03,2157.0,1041.83,560.82,2092.29,29
CDM,2778157,DRAIN W ACCESSORIES LVL 02,476.0,229.91,123.76,461.72,29
CDM,2778165,DRAIN W ACCESSORIES LVL 03,850.0,410.55,221.0,824.5,29
CDM,2778173,DRAIN W ACCESSORIES LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,2778181,IMP FILTER VENA CAVA LVL 04,6950.0,3996.25,1807.0,6741.5,29
CDM,2778199,IMP FILTER VENA CAVA LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,2778249,IMP GRAFT VASCULAR LVL 11,11580.0,6658.5,3010.8,11232.6,29
CDM,2778256,IMP GRAFT VASCULAR LVL 12,21904.0,12594.8,5695.04,21246.88,29
CDM,2778264,IMP GRAFT VASCULAR LVL 13,32854.0,18891.05,8542.04,31868.38,29
CDM,2778272,IMP GRAFT VASCULAR LVL 14,43804.0,25187.3,11389.04,42489.88,29
CDM,2778280,WIRE GUIDE LVL 04,850.0,410.55,221.0,824.5,29
CDM,2778298,WIRE GUIDE LVL 05,1413.0,682.48,367.38,1370.61,29
CDM,2778306,WIRE GUIDE LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,2778314,IMP ICD CHAMBER DUAL LVL 03,87604.0,49772.21,22777.04,84975.88,29
CDM,2778322,IMP ICD CHAMBER SGL LVL 03,87604.0,49772.21,22777.04,84975.88,29
CDM,2778330,INSERTS LVL 02,313.0,151.18,81.38,303.61,29
CDM,2778348,INSTRUMENT DISP SINGLE LVL 06,3083.0,1489.09,801.58,2990.51,29
CDM,2778355,INSTRUMENT DISP MULTIPLE LVL 06,3909.0,1888.05,1016.34,3791.73,29
CDM,2778363,INSTRUMENT DISP MULTIPLE LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,2778371,IRRIGATOR/ACCESSORY LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,2778389,IRRIGATOR/ACCESSORY LVL 05,3596.0,1736.87,934.96,3488.12,29
CDM,2778397,KIT/SET NON ROUTINE CARDIAC LVL 02,594.0,286.9,154.44,576.18,29
CDM,2778405,KIT/SET NON ROUTINE CARDIAC LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2778413,KIT/SET NON ROUTINE CARDIAC LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,2778421,KIT/SET NON ROUTINE CARDIAC LVL 05,3909.0,1888.05,1016.34,3791.73,29
CDM,2778439,KIT/SET NON ROUTINE CARDIAC LVL 06,5373.0,2595.16,1396.98,5211.81,29
CDM,2778447,KNOT PUSHER LVL 02,1413.0,682.48,367.38,1370.61,29
CDM,2778454,KNOT PUSHER LVL 03,2157.0,1041.83,560.82,2092.29,29
CDM,2778462,TIPS LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,2778470,IMP MARKER TISSUE LVL 02,594.0,341.55,154.44,576.18,29
CDM,2778488,NEEDLE BIOPSY LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,2778496,NEEDLE BIOPSY LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,2778504,NEEDLE BIOPSY LVL 06,5861.0,2830.86,1523.86,5685.17,29
CDM,2778512,CEMENT ACCESSORIES LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2778520,SUPPLY NEURO LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,2778538,IMP CEMENT LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,2778546,IMP CEMENT LVL 05,6950.0,3996.25,1807.0,6741.5,29
CDM,2778561,OBTURATOR DISPOSABLE LVL 02,850.0,410.55,221.0,824.5,29
CDM,2778579,OCCLUDER LVL 03,13895.0,6711.28,3612.7,13478.15,29
CDM,2778587,OCCLUDER LVL 04,21904.0,10579.63,5695.04,21246.88,29
CDM,2778611,IMP DEV CLOSURE VASCULAR LVL 02,594.0,341.55,154.44,576.18,29
CDM,2778629,WIRE GUIDE LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,2778637,WIRE GUIDE LVL 08,6950.0,3356.85,1807.0,6741.5,29
CDM,2778645,HEMOSTATIC AGENT LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2778652,IMP DEV CLOSURE VASCULAR LVL 04,1619.0,930.92,420.94,1570.43,29
CDM,2778660,INSTRUMENT DISP MULTIPLE LVL 08,6950.0,3356.85,1807.0,6741.5,29
CDM,2778678,INTRO LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,2778686,INTRO LVL 05,1888.0,911.9,490.88,1831.36,29
CDM,2778694,IMP DEV CLOSURE VASCULAR LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,2778702,KIT/SET NON ROUTINE SURG LVL 02,313.0,151.18,81.38,303.61,29
CDM,2778710,KIT/SET NON ROUTINE SURG LVL 03,594.0,286.9,154.44,576.18,29
CDM,2778728,KIT/SET NON ROUTINE SURG LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,2778736,KIT/SET NON ROUTINE SURG LVL 05,1619.0,781.98,420.94,1570.43,29
CDM,2778744,KIT/SET NON ROUTINE SURG LVL 06,2157.0,1041.83,560.82,2092.29,29
CDM,2778751,KIT/SET NON ROUTINE SURG LVL 07,2695.0,1301.68,700.7,2614.15,29
CDM,2778769,KIT/SET NON ROUTINE SURG LVL 08,3853.0,1861.0,1001.78,3737.41,29
CDM,2778777,KIT/SET NON ROUTINE SURG LVL 09,4885.0,2359.46,1270.1,4738.45,29
CDM,2778785,IMP DEV CLOSURE VASCULAR LVL 05,2157.0,1240.27,560.82,2092.29,29
CDM,2778793,IMP LD PCMKR/ICD COMBO LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2778801,IMP LD PCMKR/ICD COMBO LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,2778819,IMP LD PCMKR/ICD COMBO LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,2778827,IMP LD PCMKR/ICD COMBO LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,2778835,IMP LD PCMKR/ICD COMBO LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,2778843,IMP LD PCMKR/ICD COMBO LVL 07,17524.0,10076.3,4556.24,16998.28,29
CDM,2778850,IMP LD PCMKR/ICD COMBO LVL 08,21904.0,12594.8,5695.04,21246.88,29
CDM,2778868,IMP LD PCMKR/ICD COMBO LVL 09,26284.0,15113.3,6833.84,25495.48,29
CDM,2778876,SUPPLY NEURO LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,2778884,SUPPLY NEURO LVL 06,4885.0,2359.46,1270.1,4738.45,29
CDM,2778892,SUPPLY NEURO LVL 07,9265.0,4475.0,2408.9,8987.05,29
CDM,2778900,SUPPLY NEURO LVL 08,13895.0,6711.28,3612.7,13478.15,29
CDM,2778918,BRUSH LVL 03,850.0,410.55,221.0,824.5,29
CDM,2778926,BURR LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,2778934,IMP CABLE LVL 06,4885.0,2808.88,1270.1,4738.45,29
CDM,2778942,IMP DEV CLOSURE VASCULAR LVL 06,2695.0,1549.62,700.7,2614.15,29
CDM,2778959,IMP COIL EMBOLIZATION LVL 10,15334.0,8817.05,3986.84,14873.98,29
CDM,2778967,COIL IMAGING MAGNETIC RESON LVL 02,594.0,286.9,154.44,576.18,29
CDM,2778975,THERAPY COLD LVL 03,1413.0,682.48,367.38,1370.61,29
CDM,2778983,IMP ACCESS SYSTEM DIALYS LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,2778991,IMP ACCESS SYSTEM DIALYS LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,2779007,DIALYSIS ACCESSORIES LVL 02,313.0,151.18,81.38,303.61,29
CDM,2779015,DIALYSIS ACCESSORIES LVL 03,594.0,286.9,154.44,576.18,29
CDM,2779023,DIALYSIS ACCESSORIES LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,2779031,DRAIN REINFUSION LVL 04,3596.0,1736.87,934.96,3488.12,29
CDM,2779049,DRAIN REINFUSION LVL 05,4885.0,2359.46,1270.1,4738.45,29
CDM,2779056,CATH ABL EP 3D/VECTOR LVL 02,3083.0,1489.09,801.58,2990.51,29
CDM,2779064,CATH ABL EP 3D/VECTOR LVL 03,4885.0,2359.46,1270.1,4738.45,29
CDM,2779072,CATH ABL EP 3D/VECTOR LVL 04,11580.0,5593.14,3010.8,11232.6,29
CDM,2779080,CATH ABL EP 3D/VECTOR LVL 05,17524.0,8464.09,4556.24,16998.28,29
CDM,2779098,CATH ABL EP 3D/VECTOR LVL 06,21904.0,10579.63,5695.04,21246.88,29
CDM,2779106,CATH ATHERECT TRANSL DIRECT LVL 02,9265.0,4475.0,2408.9,8987.05,29
CDM,2779114,CATH ATHERECT TRANSL ROTAT LVL 02,9265.0,4475.0,2408.9,8987.05,29
CDM,2779122,CATH BALLOON LVL 02,313.0,151.18,81.38,303.61,29
CDM,2779130,CATH BALLOON LVL 03,594.0,286.9,154.44,576.18,29
CDM,2779148,CATH BALLOON LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,2779155,CATH BALLOON LVL 05,1619.0,781.98,420.94,1570.43,29
CDM,2779163,CATH BALLOON LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,2779171,CATH BALLOON LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,2779189,CATH BALLOON DILAT NONVASC LVL 02,2695.0,1301.68,700.7,2614.15,29
CDM,2779197,CATH BALLOON DILAT NONVASC LVL 03,4885.0,2359.46,1270.1,4738.45,29
CDM,2779205,CATH BALLOON DILAT NONVASC LVL 04,6950.0,3356.85,1807.0,6741.5,29
CDM,2779213,CATH BALLOON DILAT NONVASC LVL 05,9265.0,4475.0,2408.9,8987.05,29
CDM,2779239,IMP CATH BRACHY SEED ADM LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,2779247,CATH CHOLANGIOGRAM LVL 02,850.0,410.55,221.0,824.5,29
CDM,2779254,CATH CHOLANGIOGRAM LVL 03,1413.0,682.48,367.38,1370.61,29
CDM,2779262,CATH CHOLANGIOGRAM LVL 04,1888.0,911.9,490.88,1831.36,29
CDM,2779270,CATH DIAGNOSTIC LVL 02,134.0,64.72,34.84,129.98,29
CDM,2779288,CATH DIAGNOSTIC LVL 03,251.0,121.23,65.26,243.47,29
CDM,2779296,CATH DIAGNOSTIC LVL 04,313.0,151.18,81.38,303.61,29
CDM,2779304,CATH DIAGNOSTIC LVL 05,594.0,286.9,154.44,576.18,29
CDM,2779312,CATH DIAGNOSTIC LVL 06,1132.0,546.76,294.32,1098.04,29
CDM,2779320,CATH DIAGNOSTIC LVL 07,2157.0,1041.83,560.82,2092.29,29
CDM,2779338,CATH DIAGNOSTIC LVL 08,3596.0,1736.87,934.96,3488.12,29
CDM,2779346,CATH DIAGNOSTIC LVL 09,5861.0,2830.86,1523.86,5685.17,29
CDM,2779353,CATH EP NON 3D 1-19 LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,2779361,CATH EP NON 3D 1-19 LVL 03,2157.0,1041.83,560.82,2092.29,29
CDM,2779379,CATH EP NON 3D 1-19 LVL 04,3083.0,1489.09,801.58,2990.51,29
CDM,2779387,CATH EP NON 3D 1-19 LVL 05,4885.0,2359.46,1270.1,4738.45,29
CDM,2779395,CATH EP NON 3D 1-19 LVL 06,9265.0,4475.0,2408.9,8987.05,29
CDM,2779403,CATH GUIDE LVL 02,313.0,151.18,81.38,303.61,29
CDM,2779411,CATH GUIDE LVL 03,447.0,215.9,116.22,433.59,29
CDM,2779429,CATH GUIDE LVL 04,594.0,286.9,154.44,576.18,29
CDM,2779437,CATH GUIDE LVL 05,850.0,410.55,221.0,824.5,29
CDM,2779445,CATH GUIDE LVL 06,1413.0,682.48,367.38,1370.61,29
CDM,2779452,CATH GUIDE LVL 07,2827.0,1365.44,735.02,2742.19,29
CDM,2779460,CATH HEM/PER SHORT TERM LVL 02,594.0,286.9,154.44,576.18,29
CDM,2779478,CATH HEM/PER SHORT TERM LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,2779486,CATH HEM/PER SHORT TERM LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2779494,IMP CATH HEM/PER LONG TERM LVL 02,594.0,341.55,154.44,576.18,29
CDM,2779502,IMP CATH HEM/PER LONG TERM LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,2779510,IMP CATH HEM/PER LONG TERM LVL 04,1619.0,930.92,420.94,1570.43,29
CDM,2779528,IMP CATH HEM/PER LONG TERM LVL 05,2695.0,1549.62,700.7,2614.15,29
CDM,2779536,IMP CATH HEM/PER LONG TERM LVL 06,3596.0,2067.7,934.96,3488.12,29
CDM,2779544,IMP CATH HEM/PER LONG TERM LVL 07,4885.0,2808.88,1270.1,4738.45,29
CDM,2779551,IMP CATH HEM/PER LONG TERM LVL 08,6950.0,3996.25,1807.0,6741.5,29
CDM,2779569,DRESSING SPECIALTY LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,2779577,IMP GRAFT VASCULAR LVL 15,54754.0,31483.55,14236.04,53111.38,29
CDM,2779585,HANDPIECE LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,2779593,HANDPIECE LVL 05,9265.0,4475.0,2408.9,8987.05,29
CDM,2779601,HANDPIECE LVL 06,13895.0,6711.28,3612.7,13478.15,29
CDM,2779619,HARVESTER LVL 02,2695.0,1301.68,700.7,2614.15,29
CDM,2779627,HARVESTER LVL 03,4885.0,2359.46,1270.1,4738.45,29
CDM,2779635,IMP NEURO LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,2779643,IMP NEURO LVL 03,4885.0,2808.88,1270.1,4738.45,29
CDM,2779650,IMP NEURO LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,2779668,IMP NEURO LVL 05,13895.0,7989.62,3612.7,13478.15,29
CDM,2779676,IMP NEURO LVL 06,21904.0,12594.8,5695.04,21246.88,29
CDM,2779684,IMP NEURO LVL 07,43804.0,25187.3,11389.04,42489.88,29
CDM,2779692,KIT/SET NON ROUTINE GI LVL 02,1619.0,781.98,420.94,1570.43,29
CDM,2779700,KIT/SET NON ROUTINE GI LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2779718,KIT/SET NON ROUTINE GI LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,2779726,KIT/SET NON ROUTINE GI LVL 05,9265.0,4475.0,2408.9,8987.05,29
CDM,2779734,KIT/SET NON ROUTINE ORTH LVL 02,1619.0,781.98,420.94,1570.43,29
CDM,2779742,KIT/SET NON ROUTINE ORTH LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,2779759,KIT/SET NON ROUTINE ORTH LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,2779767,KIT/SET NON ROUTINE ORTH LVL 05,9265.0,4475.0,2408.9,8987.05,29
CDM,2779775,KIT/SET NON ROUTINE ORTH LVL 06,13895.0,6711.28,3612.7,13478.15,29
CDM,2779783,MAMMOTOME LVL 02,594.0,286.9,154.44,576.18,29
CDM,2779791,MAMMOTOME LVL 03,1126.0,543.86,292.76,1092.22,29
CDM,2779809,MAMMOTOME LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,2779817,IMP PCMKR DUAL RR LVL 03,26284.0,14933.25,6833.84,25495.48,29
CDM,2779825,IMP PCMKR DUAL RR LVL 04,43804.0,24887.24,11389.04,42489.88,29
CDM,2779833,SUPPLY PERFUSION/ECMO LVL 06,2426.0,1171.76,630.76,2353.22,29
CDM,2779841,SUPPLY PERFUSION/ECMO LVL 07,3340.0,1613.22,868.4,3239.8,29
CDM,2779858,SUPPLY PERFUSION/ECMO LVL 08,4153.0,2005.9,1079.78,4028.41,29
CDM,2779866,IMP CATH PORT INDWELLING LVL 02,447.0,257.02,116.22,433.59,29
CDM,2779874,IMP CATH PORT INDWELLING LVL 03,850.0,488.75,221.0,824.5,29
CDM,2779882,IMP PCMKR SGL RR LVL 04,26284.0,14933.25,6833.84,25495.48,29
CDM,2779890,CATH/WIRE/SUTURE PASSER LVL 02,594.0,286.9,154.44,576.18,29
CDM,2779908,IMP CATH PORT INDWELLING LVL 04,1413.0,812.47,367.38,1370.61,29
CDM,2779916,IMP CATH PORT INDWELLING LVL 05,1888.0,1085.6,490.88,1831.36,29
CDM,2779924,IMP CATH PORT INDWELLING LVL 06,2695.0,1549.62,700.7,2614.15,29
CDM,2779932,IMP CATH PORT INDWELLING LVL 07,3340.0,1920.5,868.4,3239.8,29
CDM,2779940,PROBE LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,2779957,PROBE LVL 05,3083.0,1489.09,801.58,2990.51,29
CDM,2779965,PROBE LVL 06,3909.0,1888.05,1016.34,3791.73,29
CDM,2779973,PROBE LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,2779981,IMP VALVE LVL 06,26284.0,15113.3,6833.84,25495.48,29
CDM,2783801,CATH CHOLANGIOGRAM LVL 05,2426.0,1171.76,630.76,2353.22,29
CDM,2783819,CATH CHOLANGIOGRAM LVL 06,2827.0,1365.44,735.02,2742.19,29
CDM,2793552,FIX EXTRNL LW/UP/PELVIC LVL 01,102.0,49.27,26.52,98.94,29
CDM,2793560,FIX EXTRNL LW/UP/PELVIC LVL 02,190.0,91.77,49.4,184.3,29
CDM,2793578,FIX EXTRNL LW/UP/PELVIC LVL 03,313.0,151.18,81.38,303.61,29
CDM,2793586,FIX EXTRNL LW/UP/PELVIC LVL 04,594.0,286.9,154.44,576.18,29
CDM,2793594,FIX EXTRNL LW/UP/PELVIC LVL 05,1413.0,682.48,367.38,1370.61,29
CDM,2793602,FIX EXTRNL LW/UP/PELVIC LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,2793610,FIX EXTRNL LW/UP/PELVIC LVL 07,3853.0,1861.0,1001.78,3737.41,29
CDM,2793628,FIX EXTRNL LW/UP/PELVIC LVL 08,4885.0,2359.46,1270.1,4738.45,29
CDM,2793636,FIX EXTRNL LW/UP/PELVIC LVL 09,6950.0,3356.85,1807.0,6741.5,29
CDM,2793644,FIX EXTRNL LW/UP/PELVIC LVL 10,9265.0,4475.0,2408.9,8987.05,29
CDM,2793651,FIX EXTRNL LW/UP/PELVIC LVL 11,11580.0,5593.14,3010.8,11232.6,29
CDM,2793669,FIX EXTRNL LW/UP/PELVIC LVL 12,13895.0,6711.28,3612.7,13478.15,29
CDM,2793677,FIX EXTRNL LW/UP/PELVIC LVL 13,17524.0,8464.09,4556.24,16998.28,29
CDM,2793685,FIX EXTRNL LW/UP/PELVIC LVL 14,21904.0,10579.63,5695.04,21246.88,29
CDM,2793693,FIX EXTRNL LW/UP/PELVIC LVL 15,26284.0,12695.17,6833.84,25495.48,29
CDM,2793701,FIX EXTRNL LW/UP/PELVIC LVL 16,30664.0,14810.71,7972.64,29744.08,29
CDM,2793719,FIX EXTRNL LW/UP/PELVIC LVL 17,35044.0,16926.25,9111.44,33992.68,29
CDM,2793727,FIX EXTRNL LW/UP/PELVIC LVL 18,43804.0,21157.33,11389.04,42489.88,29
CDM,2793735,FIX EXTRNL LW/UP/PELVIC LVL 19,52564.0,25388.41,13666.64,50987.08,29
CDM,2793743,FIX EXTRNL LW/UP/PELVIC LVL 20,61324.0,29619.49,15944.24,59484.28,29
CDM,2793750,FIX EXTRNL LW/UP/PELVIC LVL 21,70084.0,33850.57,18221.84,67981.48,29
CDM,2793768,FIX EXTRNL LW/UP/PELVIC LVL 22,78844.0,38081.65,20499.44,76478.68,29
CDM,2793776,FIX EXTRNL LW/UP/PELVIC LVL 23,87604.0,42312.73,22777.04,84975.88,29
CDM,2793784,FIX EXTRNL LW/UP/PELVIC LVL 24,96364.0,46543.81,25054.64,93473.08,29
CDM,3000007,LAB IG FREE LIGHT CHAIN SERUM EA,61.0,29.4,15.86,59.17,29
CDM,3000015,LAB IG FREE LIGHT CHAIN URINE EA,69.0,33.26,17.94,66.93,29
CDM,3012,R&B OBSTETRICS PVT,2781.0,1580.03,2502.9,3111.1,17
CDM,3020112,LAB SUSCPT ETEST AGENT EA NS,66.0,35.05,17.16,64.02,29
CDM,3020120,LAB SUGARS SINGLE QL STOOL NS,64.0,30.85,16.64,62.08,29
CDM,3020922,LAB LEUKOCYTE HISTAMINE RELEASE,64.0,36.86,16.64,62.08,29
CDM,3021243,LAB SCR AB SYPHILIS,53.0,30.53,13.78,51.41,29
CDM,3022373,LAB CHOLINESTERASE SERUM NS,61.0,29.4,15.86,59.17,29
CDM,3022381,LAB DIBUCAINE NUMBER NS,67.0,32.29,17.42,64.99,29
CDM,3022472,LAB EVEROLIMUS,60.0,28.92,15.6,58.2,29
CDM,3022720,LAB HORMONE ANTIMULLERIAN,116.0,55.91,30.16,112.52,29
CDM,3022886,LAB MCG IN SITU INT 25-99 CELL NS,128.0,27.65,33.28,124.16,29
CDM,3023199,LAB DET IA HIV-1 PRB AMP NS,108.0,57.35,28.08,104.76,29
CDM,3023355,LAB DET IA ENTEROVRS PRB AMP NS,139.0,73.81,36.14,134.83,29
CDM,3023462,LAB FETAL CONGENITAL ABNORMALITIES,260.0,126.36,67.6,252.2,29
CDM,3023488,LAB DET IA HSV PRB AMP PCR CSF,106.0,56.29,27.56,102.82,29
CDM,3024007,LAB GENOTYPE IA HEPATITIS B,773.0,410.46,200.98,749.81,29
CDM,3024049,LAB DET IA RESP MLTPLX 12-25 TGT NS,1251.0,664.28,325.26,1213.47,29
CDM,3024114,LAB DET IA FLU REV T&PRB AMP 1-2,288.0,152.93,74.88,279.36,29
CDM,3024270,LAB SCR AG BLD TYPE SERUM PT U NS,153.0,115.82,39.78,148.41,29
CDM,3024387,LAB DET IA HEP C PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3024395,LAB DET IA HEP C QN,129.0,68.5,33.54,125.13,29
CDM,3024403,LAB DET IA HIV-1 QN,256.0,135.94,66.56,248.32,29
CDM,3024411,LAB DET IA HEP C QN NS,147.0,78.06,38.22,142.59,29
CDM,3025087,LAB GENOTYPE IA CYTOMEGALOVIRUS,773.0,410.46,200.98,749.81,29
CDM,3025111,LAB GENE F2 VAR 20210G>A,198.0,96.23,51.48,192.06,29
CDM,3025426,LAB DET IA RESP MLTPLX 6-11 TGT,655.0,347.8,170.3,635.35,29
CDM,3025889,LAB DET IA RESP MLTPLX 3-5 TGT,428.0,227.27,111.28,415.16,29
CDM,3026051,LAB AB HISTOPLASMA COMP FIXATION,63.0,36.29,16.38,61.11,29
CDM,3026077,LAB SCR AB CHAGAS,62.0,35.71,16.12,60.14,29
CDM,3026184,LAB BACLOFEN,132.0,63.62,34.32,128.04,29
CDM,3026234,LAB GENE ANLYS MUT C-KIT,989.0,480.65,257.14,959.33,29
CDM,3026663,LAB GENE BCR/ABL1 REFLEX P210 NS,492.0,239.11,127.92,477.24,29
CDM,3026689,LAB IBD SGI DIAGNOSTIC,292.0,141.91,75.92,283.24,29
CDM,3027018,LAB RNA NOROVIRUS AMP PROBE,109.0,57.88,28.34,105.73,29
CDM,3027588,LAB DET IA RESP MLTPLX 3-5 TGT NS,428.0,227.27,111.28,415.16,29
CDM,3027612,LAB DET IA HIV-2 REV T&PRB AMP,122.0,64.78,31.72,118.34,29
CDM,3027778,LAB DET IA MYCOPLAS PNEU PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3028024,LAB OXCARBAZEPINE,69.0,33.26,17.94,66.93,29
CDM,3028065,LAB BIOTIN,160.0,77.12,41.6,155.2,29
CDM,3028164,LAB COPPER SERUM,63.0,30.37,16.38,61.11,29
CDM,3028172,LAB ZINC,61.0,29.4,15.86,59.17,29
CDM,3028206,LAB IMM RIA BETAPROTEIN,360.0,173.52,93.6,349.2,29
CDM,3028230,LAB ITRACONAZOLE,131.0,63.14,34.06,127.07,29
CDM,3028347,LAB DET IA MUCORALES PCR PRB AMP,275.0,146.02,71.5,266.75,29
CDM,3028354,LAB DET IA NORCARDIA PCR PRB AMP,362.0,192.22,94.12,351.14,29
CDM,3028388,LAB DET IA COV19&FLU A&B PRB AMP,96.0,50.98,24.96,93.12,29
CDM,3028461,LAB THIOPURINE,160.0,77.12,41.6,155.2,29
CDM,3028669,LAB ESTRADIOL TOTAL,84.0,40.49,21.84,81.48,29
CDM,3028677,LAB ESTRADIOL TOTAL NS,84.0,40.49,21.84,81.48,29
CDM,3028701,LAB CARBAMAZEPINE -10 11-EPOXIDE,58.0,27.96,15.08,56.26,29
CDM,3028719,LAB CARBAMAZEPINE -10 11-EPOXIDE NS,90.0,43.38,23.4,87.3,29
CDM,3028727,LAB IMM AB QL/SEMI QN SGL COVID-19,136.0,78.34,35.36,131.92,29
CDM,3028735,LAB GENE NUDT15&TPMT VAR COMMON,1399.0,679.91,363.74,1357.03,29
CDM,3028768,LAB IMM AB BP180 QN,73.0,35.19,18.98,70.81,29
CDM,3028842,LAB DRG DF ETOH BIOMRK TIS CORD 1-2,110.0,53.02,28.6,106.7,29
CDM,3028859,LAB IMM ELASTASE PANCREATIC QN,100.0,48.2,26.0,97.0,29
CDM,3029121,LAB SCR AB PHOSPHOLIPAS A2 RECPT FL,190.0,109.44,49.4,184.3,29
CDM,3029139,LAB AB FL TITER PHOSPHOLPS A2 RECPT,285.0,164.16,74.1,276.45,29
CDM,3029147,LAB DIS INFCT DNA PLASMA NGS UNTGT,6379.0,3100.19,1658.54,6187.63,29
CDM,3029162,LAB CROSS LINKS DEOXYPYRIDINOLINE,113.0,54.47,29.38,109.61,29
CDM,3029170,LAB AB ECHINOCOCCUS,71.0,40.9,18.46,68.87,29
CDM,3029188,LAB DRG DF SULFONAMIDES DAY 1-3,147.0,70.85,38.22,142.59,29
CDM,3029196,LAB ACID PHOSPHATASE TOTAL NS,63.0,30.37,16.38,61.11,29
CDM,3029204,LAB ACID URIC OTHER SOURCE NS,58.0,27.96,15.08,56.26,29
CDM,3029253,LAB CHROMAT MS METHOXYTYRAMINE,392.0,188.94,101.92,380.24,29
CDM,3029295,LAB DET IA VARICELLA-ZOSTER PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3029360,LAB AB FL TITER AQUAPORIN 4,219.0,126.14,56.94,212.43,29
CDM,3029394,LAB GENE SEQ RET DUP/DEL,224.0,108.86,58.24,217.28,29
CDM,3029402,LAB DET IA ASPERGILLUS PCR PRB AMP,115.0,61.07,29.9,111.55,29
CDM,3029451,LAB TRNSPL DNA DNR DRV CELL-FREE QN,8260.0,4014.36,2147.6,8012.2,29
CDM,3029493,LAB AB ENA FIBRILLARIN,130.0,74.88,33.8,126.1,29
CDM,3029519,LAB BLOOD OCCULT FECES 1-3 IMM NS,62.0,29.88,16.12,60.14,29
CDM,3029527,LAB AB FL TITER NMDA,194.0,111.74,50.44,188.18,29
CDM,3029626,LAB IMMUNOFIXATION EP IGD IGE,142.0,81.79,36.92,137.74,29
CDM,3029642,LAB PROT FRCTN ELECTRO&QN SERUM NS,56.0,26.99,14.56,54.32,29
CDM,3029709,LAB IMMUNOFIXATION EP SERUM NS,74.0,42.62,19.24,71.78,29
CDM,3029725,LAB ESTRADIOL FREE MEASURE DIRECT,84.0,40.49,21.84,81.48,29
CDM,3029733,LAB DET AG IA IMM ENZ SEMI QN,147.0,78.06,38.22,142.59,29
CDM,3029865,LAB AB ENA MYOSITIS,77.0,44.35,20.02,74.69,29
CDM,3029873,LAB PROT WB W INTRP ID MYOSITIS,88.0,42.42,22.88,85.36,29
CDM,3029923,LAB IMMUNOFIXATION EP TRANSFRN BETA,89.0,51.26,23.14,86.33,29
CDM,3029949,LAB GENE TYPING HLA 1 LR AG 1 EA NS,223.0,108.38,57.98,216.31,29
CDM,3029964,LAB IMM AB LDL OXIDIZED,100.0,48.2,26.0,97.0,29
CDM,3029980,LAB SCR CULT ORGANISMS SGL NS,66.0,35.05,17.16,64.02,29
CDM,3029998,LAB AB CHAGAS IGG,72.0,41.47,18.72,69.84,29
CDM,3030004,LAB DET IA RESP MLTPLX 6-11 TGT NS,655.0,347.8,170.3,635.35,29
CDM,3030111,LAB IMM MS PHOSPHAT/PROTHROMBIN NS,59.0,28.44,15.34,57.23,29
CDM,3030145,LAB GENE MPL VAR COMMON,451.0,341.41,117.26,437.47,29
CDM,3030152,LAB HORMONE ANTIMULLERIAN NS,116.0,55.91,30.16,112.52,29
CDM,3030285,LAB IMM NEURO AMYLD 1-42&1-40 CSF,785.0,381.51,204.1,761.45,29
CDM,3030301,LAB DRG DF BENZ DAY 1-12 NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030319,LAB DRG DF BUPRENORPHINE DAY NON UR,56.0,26.99,14.56,54.32,29
CDM,3030327,LAB DRG DF COCAINE DAY NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030335,LAB DRG DF OPIATE DAY 1+ NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030350,LAB DRG DF OXYCODONE DAY NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030368,LAB DRG DF TRAMADOL NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030376,LAB DRG DF FENTANYL DAY NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030384,LAB DRG DF METHYLENEDIOXYAMP NON UR,56.0,26.99,14.56,54.32,29
CDM,3030400,LAB DRG DF AMPH/METH DAY 1-2 NON UR,56.0,26.99,14.56,54.32,29
CDM,3030418,LAB DRG DF BARB PHENOBARB NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030434,LAB DRG DF METHADONE DAY NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030442,LAB DRG DF PHENCYCLDN NON URINE,56.0,26.99,14.56,54.32,29
CDM,3030459,LAB DRG DF CANNABINOIDS DAY NON UR,56.0,26.99,14.56,54.32,29
CDM,3030491,LAB AG CARCINOEMBRYONIC ARUP NS,68.0,32.78,17.68,65.96,29
CDM,3030509,LAB AG CARCINOEMBRYONIC MAYO NS,329.0,158.58,85.54,319.13,29
CDM,3030517,LAB MOPATH LVL2 CARDIO IQ APOE GENO,411.0,199.75,106.86,398.67,29
CDM,3030533,LAB MOPATH LVL2 EML4-ALK,411.0,199.75,106.86,398.67,29
CDM,3030608,LAB DET IA ORGANISMS FNGL MULT PRB,638.0,338.78,165.88,618.86,29
CDM,3030632,LAB DET IA FUNGAL MULT PRB AMP,1372.0,728.53,356.72,1330.84,29
CDM,3030657,LAB DET IA PNEUM JIROVECII RFLX PRB,421.0,223.55,109.46,408.37,29
CDM,3030665,LAB DET IA TOXOPLASMA RFLX PCR PRB,421.0,223.55,109.46,408.37,29
CDM,3030715,LAB SYPHILIS VDRL/RPR QL DNR TESTNG,134.0,77.18,34.84,129.98,29
CDM,3030830,LAB DET IA MALARIA PCR PRB AMP,518.0,275.06,134.68,502.46,29
CDM,3031754,LAB BIOTINIDASE SPEC EA,112.0,53.98,29.12,108.64,29
CDM,3032208,LAB DRG DF PHENCYCLIDINE,123.0,59.29,31.98,119.31,29
CDM,3032232,LAB DRG DF BRIVARACETAM DAY 1-3,189.0,91.1,49.14,183.33,29
CDM,3032281,LAB DRG DF ANLG OPIOID&OPIAT UR 5+,97.0,46.75,25.22,94.09,29
CDM,3060001,LAB ALDOSTERONE,270.0,130.14,70.2,261.9,29
CDM,3062015,LAB COUNT CELL W DIFF FLUID BODY,17.0,12.87,4.42,16.49,29
CDM,3062023,LAB COUNT CELL FLUID BODY,15.0,11.36,3.9,14.55,29
CDM,3062031,LAB COUNT CELL CSF,15.0,11.36,3.9,14.55,29
CDM,3062049,LAB COUNT CELL W DIFF CSF,17.0,12.87,4.42,16.49,29
CDM,3062056,LAB ID CRYSTAL MICROSCOPY LIGHT,294.0,222.56,76.44,285.18,29
CDM,3062080,LAB ASSESSMENT LEUKOCYTE FECAL,13.0,9.84,3.38,12.61,29
CDM,3062106,LAB FIBERS MEAT FECES,155.0,117.34,40.3,150.35,29
CDM,3062130,LAB SEMEN MOTILITY&CT WO HUHNER,26.0,19.68,6.76,25.22,29
CDM,3062288,LAB KETONES ACETONE QN,25.0,12.05,6.5,24.25,29
CDM,3062312,LAB PANEL HEPATITIS ACUTE,226.0,108.93,58.76,219.22,29
CDM,3062338,LAB HORMONE ADRENOCORTICOTROPIC,116.0,55.91,30.16,112.52,29
CDM,3062346,LAB ALBUMIN SRM/PLASMA/BLD WHL,30.0,14.46,7.8,29.1,29
CDM,3062387,LAB ALDOLASE,53.0,25.55,13.78,51.41,29
CDM,3062395,LAB ALDOSTERONE NS,123.0,59.29,31.98,119.31,29
CDM,3062403,LAB ALDOSTERONE URINE,123.0,59.29,31.98,119.31,29
CDM,3062411,LAB AFP AMNIOTIC FLUID,51.0,24.58,13.26,49.47,29
CDM,3062429,LAB AFP SERUM,51.0,24.58,13.26,49.47,29
CDM,3062445,LAB ALPHA-1-ANTITRYPSIN TOTAL NS,59.0,28.44,15.34,57.23,29
CDM,3062452,LAB ALPHA-1-ANTITRYPSIN PHENOTYPE,63.0,30.37,16.38,61.11,29
CDM,3062460,LAB TRANSFERASE AMINO ALANINE,38.0,18.32,9.88,36.86,29
CDM,3062478,LAB ALUMINUM,77.0,37.11,20.02,74.69,29
CDM,3062536,LAB ACIDS AMINO SGL QN SPEC EA,91.0,43.86,23.66,88.27,29
CDM,3062551,LAB ACIDS AMINO 6+ QN SPEC EA,141.0,67.96,36.66,136.77,29
CDM,3062569,LAB ACIDS AMINO 6+ QN URINE SPEC EA,141.0,67.96,36.66,136.77,29
CDM,3062585,LAB ACID AMINOLEVULINIC DELTA URINE,75.0,36.15,19.5,72.75,29
CDM,3062593,LAB AMIODARONE,90.0,43.38,23.4,87.3,29
CDM,3062619,LAB AMMONIA,44.0,21.21,11.44,42.68,29
CDM,3062650,LAB AMYLASE,20.0,9.64,5.2,19.4,29
CDM,3062668,LAB AMYLASE FLUID BODY,52.0,25.06,13.52,50.44,29
CDM,3062676,LAB AMYLASE TOTAL,54.0,26.03,14.04,52.38,29
CDM,3062684,LAB AMYLASE URINE,53.0,25.55,13.78,51.41,29
CDM,3062718,LAB ANDROSTENEDIONE,88.0,42.42,22.88,85.36,29
CDM,3062734,LAB ANGIOTENSIN I CONVERTING ENZYME,61.0,29.4,15.86,59.17,29
CDM,3062742,LAB ANGIOTENSIN 2,89.0,42.9,23.14,86.33,29
CDM,3062759,LAB APOLIPOPROTEIN EA,64.0,30.85,16.64,62.08,29
CDM,3062767,LAB APOLIPOPROTEIN A1 EA,77.0,37.11,20.02,74.69,29
CDM,3062775,LAB APOLIPOPROTEIN B EA,64.0,30.85,16.64,62.08,29
CDM,3062783,LAB ARSENIC BLOOD NS,63.0,30.37,16.38,61.11,29
CDM,3062791,LAB ARSENIC NON BLOOD,95.0,45.79,24.7,92.15,29
CDM,3062809,LAB TRANSFERASE AMINO ASPARTATE,38.0,18.32,9.88,36.86,29
CDM,3062866,LAB PANEL METAB BASIC W CA TOTAL,100.0,48.2,26.0,97.0,29
CDM,3062882,LAB MICROGLOBULIN BETA-2,58.0,27.96,15.08,56.26,29
CDM,3062932,LAB ACIDS BILE TOTAL,63.0,30.37,16.38,61.11,29
CDM,3062957,LAB BILIRUBIN DIRECT,31.0,14.94,8.06,30.07,29
CDM,3062973,LAB BILIRUBIN TOTAL,36.0,17.35,9.36,34.92,29
CDM,3063005,LAB GASES BLD ANY COMBO ARTERIAL,79.0,38.08,20.54,76.63,29
CDM,3063021,LAB GASES BLD ANY COMBO W SAT O2,237.0,114.23,61.62,229.89,29
CDM,3063047,LAB GASES BLD ANY COMBO VENOUS,79.0,38.08,20.54,76.63,29
CDM,3063070,LAB CADMIUM,71.0,34.22,18.46,68.87,29
CDM,3063088,LAB CAFFEINE,116.0,55.91,30.16,112.52,29
CDM,3063096,LAB CALCITONIN,81.0,39.04,21.06,78.57,29
CDM,3063104,LAB CALCIUM IONIZED,97.0,46.75,25.22,94.09,29
CDM,3063112,LAB CALCIUM TOTAL,35.0,16.87,9.1,33.95,29
CDM,3063120,LAB CALCIUM TOTAL URINE,56.0,26.99,14.56,54.32,29
CDM,3063138,LAB CALCIUM URINE QN TIMED,56.0,26.99,14.56,54.32,29
CDM,3063146,LAB CALCULUS SPECTROSCOPY INFRARED,74.0,35.67,19.24,71.78,29
CDM,3063179,LAB CARBAMAZEPINE TOTAL,52.0,25.06,13.52,50.44,29
CDM,3063187,LAB CARBON DIOXIDE HCO3,36.0,17.35,9.36,34.92,29
CDM,3063203,LAB AG CARCINOEMBRYONIC,57.0,27.47,14.82,55.29,29
CDM,3063229,LAB CARNITINE TOTAL&FREE QN URINE,115.0,55.43,29.9,111.55,29
CDM,3063237,LAB CARNITINE TOTAL&FREE QN,78.0,37.6,20.28,75.66,29
CDM,3063252,LAB CAROTENE,67.0,32.29,17.42,64.99,29
CDM,3063278,LAB CATECHOLAMINES FRACTIONATED,76.0,36.63,19.76,73.72,29
CDM,3063302,LAB CERULOPLASMIN,53.0,25.55,13.78,51.41,29
CDM,3063328,LAB CHEMILUMINESCENT,70.0,33.74,18.2,67.9,29
CDM,3063351,LAB CHLORIDE BLOOD,28.0,13.5,7.28,27.16,29
CDM,3063369,LAB CHLORIDE FLUID BODY,51.0,24.58,13.26,49.47,29
CDM,3063385,LAB CHLORIDE OTHER SOURCE,15.0,7.23,3.9,14.55,29
CDM,3063401,LAB CHLORIDE URINE,18.0,8.68,4.68,17.46,29
CDM,3063419,LAB CHOLESTEROL SRM/BLD WHL TTL,55.0,26.51,14.3,53.35,29
CDM,3063427,LAB LIPOPROTEIN CHOLESTEROL HDL,60.0,28.92,15.6,58.2,29
CDM,3063450,LAB CHOLINESTERASE RBC,59.0,28.44,15.34,57.23,29
CDM,3063559,LAB CITRATE,84.0,40.49,21.84,81.48,29
CDM,3063641,LAB PANEL METAB COMP,124.0,59.77,32.24,120.28,29
CDM,3063674,LAB COPPER TISSUE NS,211.0,101.7,54.86,204.67,29
CDM,3063682,LAB COPPER URINE,65.0,31.33,16.9,63.05,29
CDM,3063690,LAB CORTICOSTERONE,83.0,40.01,21.58,80.51,29
CDM,3063708,LAB CORTISOL FREE,55.0,26.51,14.3,53.35,29
CDM,3063716,LAB CORTISOL TOTAL,58.0,27.96,15.08,56.26,29
CDM,3063724,LAB CORTISOL TOTAL NS,323.0,155.69,83.98,313.31,29
CDM,3063732,LAB C-PEPTIDE,63.0,30.37,16.38,61.11,29
CDM,3063740,LAB CREATINE KINASE ISOENZYMES,59.0,28.44,15.34,57.23,29
CDM,3063765,LAB CREATINE KINASE MB ONLY QN,35.0,16.87,9.1,33.95,29
CDM,3063773,LAB CREATINE SERUM,60.0,28.92,15.6,58.2,29
CDM,3063781,LAB CREATINE URINE,60.0,28.92,15.6,58.2,29
CDM,3063799,LAB CREATININE BLOOD,34.0,16.39,8.84,32.98,29
CDM,3063815,LAB CREATININE CLEARANCE,29.0,13.98,7.54,28.13,29
CDM,3063823,LAB CREATINE KINASE TOTAL,20.0,9.64,5.2,19.4,29
CDM,3063831,LAB CREATININE OTHER SOURCE,80.0,38.56,20.8,77.6,29
CDM,3063849,LAB CREATININE URINE,16.0,7.71,4.16,15.52,29
CDM,3063864,LAB CRYOGLOBULIN QL/SEMI QN,63.0,30.37,16.38,61.11,29
CDM,3063872,LAB CYANIDE,78.0,37.6,20.28,75.66,29
CDM,3063898,LAB CYCLOSPORINE A,58.0,27.96,15.08,56.26,29
CDM,3063922,LAB DEOXYCORTISOL 11-,88.0,42.42,22.88,85.36,29
CDM,3063955,LAB DEHYDROEPIANDROSTERONE,76.0,36.63,19.76,73.72,29
CDM,3063963,LAB DEHYDROEPIANDROSTERONE-SULFATE,67.0,32.29,17.42,64.99,29
CDM,3064482,LAB PANEL ELECTROLYTE,71.0,34.22,18.46,68.87,29
CDM,3064490,LAB PROT FRCTN ELECTRO&QN SERUM,57.0,27.47,14.82,55.29,29
CDM,3064516,LAB ELECTRO,185.0,89.17,48.1,179.45,29
CDM,3064532,LAB ACTIVITY ENZYME NONRADIOACTIVE,121.0,58.32,31.46,117.37,29
CDM,3064540,LAB ERYTHROPOIETIN,57.0,27.47,14.82,55.29,29
CDM,3064565,LAB ESTRIOL SERUM NS,73.0,35.19,18.98,70.81,29
CDM,3064581,LAB ESTROGEN TOTAL,66.0,31.81,17.16,64.02,29
CDM,3064599,LAB ESTROGENS FRACTIONATED,98.0,47.24,25.48,95.06,29
CDM,3064607,LAB ESTRONE,75.0,36.15,19.5,72.75,29
CDM,3064631,LAB ETHOSUXIMIDE,107.0,51.57,27.82,103.79,29
CDM,3064649,LAB ETHYLENE GLYCOL,81.0,39.04,21.06,78.57,29
CDM,3064763,LAB FAT/LIPIDS FECES QN,51.0,24.58,13.26,49.47,29
CDM,3064771,LAB ACIDS FATTY NONESTERIFIED,69.0,33.26,17.94,66.93,29
CDM,3064789,LAB FELBAMATE,74.0,35.67,19.24,71.78,29
CDM,3064797,LAB FERRITIN,60.0,28.92,15.6,58.2,29
CDM,3064805,LAB FIBRONECTIN FETAL SEMI QL,194.0,93.51,50.44,188.18,29
CDM,3064888,LAB ACID FOLIC RBC,55.0,26.51,14.3,53.35,29
CDM,3064896,LAB ACID FOLIC SERUM,45.0,21.69,11.7,43.65,29
CDM,3064904,LAB GONADOTROPIN FSH SERUM,56.0,26.99,14.56,54.32,29
CDM,3064946,LAB GABAPENTIN SRM/PLASMA/BLD WHL,77.0,37.11,20.02,74.69,29
CDM,3064979,LAB IG IGE,58.0,27.96,15.08,56.26,29
CDM,3065000,LAB SCR AB ANCA FL EA AB,54.0,31.1,14.04,52.38,29
CDM,3065018,LAB AB CHANNEL CA VOLTAGE-GATED,444.0,255.74,115.44,430.68,29
CDM,3065448,LAB IMM AB ADALIMUMAB ANTIDRUG,286.0,137.85,74.36,277.42,29
CDM,3065455,LAB AMYLASE FLUID CYST PANCREATIC,341.0,164.36,88.66,330.77,29
CDM,3071321,LAB AFP SERUM MATERNAL,51.0,24.58,13.26,49.47,29
CDM,3071370,LAB PROTHROMBIN TIME NS,63.0,30.37,16.38,61.11,29
CDM,3071560,LAB GONADOTROPIN FSH SERUM NS,58.0,27.96,15.08,56.26,29
CDM,3072196,LAB DET IA HEP B PRB AMP,135.0,71.68,35.1,130.95,29
CDM,3072360,LAB IMM MS TRANSGLUTAMINASE NS,35.0,20.16,9.1,33.95,29
CDM,3072808,LAB GENOTYPE IA HIV-1 REV T NS,773.0,410.46,200.98,749.81,29
CDM,3073004,LAB GASTRIN,58.0,27.96,15.08,56.26,29
CDM,3073038,LAB GENTAMICIN PEAK,82.0,39.52,21.32,79.54,29
CDM,3073053,LAB GENTAMICIN TROUGH,82.0,39.52,21.32,79.54,29
CDM,3073061,LAB TRANSFERASE GAMMA-GLUTAMYL,22.0,10.6,5.72,21.34,29
CDM,3073079,LAB GLUCAGON,67.0,32.29,17.42,64.99,29
CDM,3073137,LAB GLUCOSE FLUID BODY,56.0,26.99,14.56,54.32,29
CDM,3073152,LAB GLUCOSE CSF,55.0,26.51,14.3,53.35,29
CDM,3073160,LAB GLUCOSE POST DOSE,15.0,7.23,3.9,14.55,29
CDM,3073186,LAB GLUCOSE TOLERANCE SPEC 1ST 3,39.0,18.8,10.14,37.83,29
CDM,3073194,LAB GLUCOSE TOLERANCE SPEC EA ADDL,12.0,5.78,3.12,11.64,29
CDM,3073202,LAB GLUCOSE URINE RANDOM,55.0,26.51,14.3,53.35,29
CDM,3073210,LAB GLUCOSE URINE TIMED,56.0,26.99,14.56,54.32,29
CDM,3073236,LAB PROT GLYCATED,53.0,25.55,13.78,51.41,29
CDM,3073251,LAB HORMONE HUMAN GROWTH,51.0,24.58,13.26,49.47,29
CDM,3073269,LAB H PYLORI UREASE NONRADIOACT,203.0,97.85,52.78,196.91,29
CDM,3073277,LAB HALOPERIDOL,99.0,47.72,25.74,96.03,29
CDM,3073285,LAB HAPTOGLOBIN QN,53.0,25.55,13.78,51.41,29
CDM,3073293,LAB HCG QL,23.0,11.09,5.98,22.31,29
CDM,3073301,LAB HCG QN,46.0,22.17,11.96,44.62,29
CDM,3073319,LAB HCG TUMOR MARKER QN,57.0,27.47,14.82,55.29,29
CDM,3073400,LAB HEAVY METAL QN EA,106.0,51.09,27.56,102.82,29
CDM,3073558,LAB HEMOGLOBIN PLASMA,59.0,28.44,15.34,57.23,29
CDM,3073574,LAB HEMOSIDERIN QL,67.0,32.29,17.42,64.99,29
CDM,3073582,LAB PANEL FUNCTION HEPATIC,98.0,47.24,25.48,95.06,29
CDM,3073624,LAB HEMOGLOBIN A1C,30.0,14.46,7.8,29.1,29
CDM,3073632,LAB HISTAMINE,89.0,42.9,23.14,86.33,29
CDM,3073657,LAB HOMOCYSTEINE SERUM,58.0,27.96,15.08,56.26,29
CDM,3073665,LAB ACID HOMOVANILLIC,68.0,32.78,17.68,65.96,29
CDM,3073681,LAB ACID HYDROXYINDOLACETIC 5-,61.0,29.4,15.86,59.17,29
CDM,3073699,LAB HYDROXYPROGESTERONE 17-D NS,82.0,39.52,21.32,79.54,29
CDM,3073707,LAB HYDROXYPROLINE FREE,112.0,53.98,29.12,108.64,29
CDM,3073749,LAB IG IGA IGD IGG IGM SERUM EA,52.0,25.06,13.52,50.44,29
CDM,3073764,LAB IMM MS QL/SEMI QN NS,57.0,27.47,14.82,55.29,29
CDM,3073780,LAB IMM MS GLIADIN IGA QL,37.0,21.31,9.62,35.89,29
CDM,3073798,LAB IMM MS GLIADIN IGG QL,37.0,21.31,9.62,35.89,29
CDM,3073830,LAB IMM ANALYTE OTHER QN,80.0,38.56,20.8,77.6,29
CDM,3073848,LAB IMM POLY PANCREATIC QN,91.0,43.86,23.66,88.27,29
CDM,3073855,LAB IMM RIA PB3 IGF QN,106.0,51.09,27.56,102.82,29
CDM,3073863,LAB IMM RIA QN,94.0,45.31,24.44,91.18,29
CDM,3073871,LAB IMM RIA TRYPSIN QN,82.0,39.52,21.32,79.54,29
CDM,3073897,LAB IG SUBCLASSES EA,59.0,28.44,15.34,57.23,29
CDM,3073905,LAB INSULIN FREE,79.0,38.08,20.54,76.63,29
CDM,3073913,LAB INSULIN TOTAL,57.0,27.47,14.82,55.29,29
CDM,3073921,LAB IRON,20.0,9.64,5.2,19.4,29
CDM,3074010,LAB KETOSTEROIDS 17- TOTAL,80.0,38.56,20.8,77.6,29
CDM,3074036,LAB LACTATE/LACTIC ACID,35.0,16.87,9.1,33.95,29
CDM,3074044,LAB LACTATE/LACTIC ACID CSF,88.0,42.42,22.88,85.36,29
CDM,3074077,LAB LAMOTRIGINE,61.0,29.4,15.86,59.17,29
CDM,3074085,LAB LDH,19.0,9.16,4.94,18.43,29
CDM,3074093,LAB LDH FLUID BODY,57.0,27.47,14.82,55.29,29
CDM,3074101,LAB LDH CSF,56.0,26.99,14.56,54.32,29
CDM,3074119,LAB LDH ISOENZYMES,59.0,28.44,15.34,57.23,29
CDM,3074127,LAB LEAD BLOOD,59.0,28.44,15.34,57.23,29
CDM,3074135,LAB LEAD NON BLOOD,79.0,38.08,20.54,76.63,29
CDM,3074176,LAB LIPASE,21.0,10.12,5.46,20.37,29
CDM,3074184,LAB LIPASE FLUID BODY,52.0,25.06,13.52,50.44,29
CDM,3074192,LAB PANEL LIPID,92.0,44.34,23.92,89.24,29
CDM,3074200,LAB LIPOPROTEIN A,57.0,27.47,14.82,55.29,29
CDM,3074218,LAB LIPOPROTEIN ELECTRO,64.0,30.85,16.64,62.08,29
CDM,3074226,LAB LIPOPROTEIN FRCTN HR,102.0,49.16,26.52,98.94,29
CDM,3074234,LAB LITHIUM,52.0,25.06,13.52,50.44,29
CDM,3074259,LAB GONADOTROPIN LH,58.0,27.96,15.08,56.26,29
CDM,3074283,LAB MAGNESIUM,21.0,10.12,5.46,20.37,29
CDM,3074291,LAB MAGNESIUM STOOL,21.0,10.12,5.46,20.37,29
CDM,3074309,LAB MAGNESIUM URINE,52.0,25.06,13.52,50.44,29
CDM,3074325,LAB MANGANESE,80.0,38.56,20.8,77.6,29
CDM,3074390,LAB MERCURY BLOOD QN,49.0,23.62,12.74,47.53,29
CDM,3074408,LAB MERCURY NON BLOOD QN,88.0,42.42,22.88,85.36,29
CDM,3074416,LAB METANEPHRINES,66.0,31.81,17.16,64.02,29
CDM,3074515,LAB MICROALBUMIN URINE QN,56.0,26.99,14.56,54.32,29
CDM,3074770,LAB PROT MYELIN BASIC CSF,63.0,30.37,16.38,61.11,29
CDM,3074788,LAB MYOGLOBIN,59.0,28.44,15.34,57.23,29
CDM,3074796,LAB MYOGLOBIN URINE,59.0,28.44,15.34,57.23,29
CDM,3074820,LAB NEPHELOMETRY ANALYTE EA,41.0,19.76,10.66,39.77,29
CDM,3074861,LAB NUCLEOTIDASE 5-,99.0,47.72,25.74,96.03,29
CDM,3074887,LAB BLOOD OCCULT FECES SINGLE QL,14.0,6.75,3.64,13.58,29
CDM,3074903,LAB BLOOD OCCULT OTHER SOURCE QL,16.0,7.71,4.16,15.52,29
CDM,3074937,LAB BANDS OLIGOCLONAL CSF,83.0,40.01,21.58,80.51,29
CDM,3074952,LAB ACID ORGANIC SINGLE QN,195.0,93.99,50.7,189.15,29
CDM,3074960,LAB ACID ORGANIC SINGLE METHY QN NS,64.0,30.85,16.64,62.08,29
CDM,3074978,LAB ACIDS ORGANIC EA QL,50.0,24.1,13.0,48.5,29
CDM,3074994,LAB ACIDS ORGANIC TOTAL EA QN,406.0,195.69,105.56,393.82,29
CDM,3075009,LAB ACIDS ORGANIC TOTAL URINE EA QN,101.0,48.68,26.26,97.97,29
CDM,3075017,LAB OSMOLALITY BLOOD,56.0,26.99,14.56,54.32,29
CDM,3075033,LAB OSMOLALITY STOOL,68.0,32.78,17.68,65.96,29
CDM,3075041,LAB OSMOLALITY URINE,56.0,26.99,14.56,54.32,29
CDM,3075058,LAB OSTEOCALCIN,90.0,43.38,23.4,87.3,29
CDM,3075066,LAB OXALATE,109.0,52.54,28.34,105.73,29
CDM,3075074,LAB OXALATE URINE,67.0,32.29,17.42,64.99,29
CDM,3075132,LAB PH FLUID BODY NOS,51.0,24.58,13.26,49.47,29
CDM,3075165,LAB PHENOBARBITAL,54.0,26.03,14.04,52.38,29
CDM,3075181,LAB PHENYLALANINE BLOOD,17.0,8.19,4.42,16.49,29
CDM,3075215,LAB PHENYTOIN FREE,63.0,30.37,16.38,61.11,29
CDM,3075223,LAB PHENYTOIN TOTAL,59.0,28.44,15.34,57.23,29
CDM,3075249,LAB ACID PHOSPHATASE PROSTATIC,60.0,28.92,15.6,58.2,29
CDM,3075264,LAB ALKALINE PHOSPHATASE ISOENZYMES,57.0,27.47,14.82,55.29,29
CDM,3075272,LAB ALKALINE PHOSPHATASE,37.0,17.83,9.62,35.89,29
CDM,3075298,LAB PHOSPHORUS INORGANIC,36.0,17.35,9.36,34.92,29
CDM,3075306,LAB PHOSPHORUS INORGANIC URINE,52.0,25.06,13.52,50.44,29
CDM,3075322,LAB PORPHOBILINOGEN URINE QN,62.0,29.88,16.12,60.14,29
CDM,3075330,LAB PORPHYRINS URINE QN&FRCTN,62.0,29.88,16.12,60.14,29
CDM,3075355,LAB POTASS SRM/PLASMA/BLD WHL,30.0,14.46,7.8,29.1,29
CDM,3075363,LAB POTASS FLUID BODY,56.0,26.99,14.56,54.32,29
CDM,3075389,LAB POTASS URINE,55.0,26.51,14.3,53.35,29
CDM,3075397,LAB PREALBUMIN,54.0,26.03,14.04,52.38,29
CDM,3075421,LAB PREGNENOLONE,63.0,30.37,16.38,61.11,29
CDM,3075439,LAB 17-HYDROXYPREGNENOLONE,69.0,33.26,17.94,66.93,29
CDM,3075454,LAB PEPTIDE NATRIURETIC PB,118.0,56.88,30.68,114.46,29
CDM,3075462,LAB PROCAINAMIDE W NAPA,51.0,24.58,13.26,49.47,29
CDM,3075470,LAB PROGESTERONE,63.0,30.37,16.38,61.11,29
CDM,3075488,LAB PROINSULIN,81.0,39.04,21.06,78.57,29
CDM,3075496,LAB PROLACTIN,59.0,28.44,15.34,57.23,29
CDM,3075553,LAB PROT FLUID BODY,56.0,26.99,14.56,54.32,29
CDM,3075561,LAB PROT FLUID CEREBROSPINAL,56.0,26.99,14.56,54.32,29
CDM,3075579,LAB PROT TTL SRM/PLASMA/BLD WHL,56.0,26.99,14.56,54.32,29
CDM,3075587,LAB PROT URINE,56.0,26.99,14.56,54.32,29
CDM,3075595,LAB PROT URINE TIMED,12.0,5.78,3.12,11.64,29
CDM,3075603,LAB PROTOPORPHYRIN RBC QN,111.0,53.5,28.86,107.67,29
CDM,3075645,LAB PSA FREE,56.0,26.99,14.56,54.32,29
CDM,3075652,LAB PSA TOTAL,56.0,26.99,14.56,54.32,29
CDM,3075660,LAB PARATHORMONE,124.0,59.77,32.24,120.28,29
CDM,3075678,LAB PARATHORMONE C-TERMINAL,124.0,59.77,32.24,120.28,29
CDM,3075769,LAB QUINIDINE,60.0,28.92,15.6,58.2,29
CDM,3075819,LAB RECEPTOR ACETYLCHOLINE NON-ENDO,110.0,53.02,28.6,106.7,29
CDM,3075843,LAB PANEL FUNCTION RENAL,141.0,67.96,36.66,136.77,29
CDM,3075850,LAB RENIN,140.0,67.48,36.4,135.8,29
CDM,3075884,LAB SELENIUM,77.0,37.11,20.02,74.69,29
CDM,3075892,LAB SEROTONIN,93.0,44.83,24.18,90.21,29
CDM,3075900,LAB HORMONE SEX BINDING GLOBULIN,66.0,31.81,17.16,64.02,29
CDM,3075934,LAB SODIUM SRM/PLASMA/BLD WHL,24.0,11.57,6.24,23.28,29
CDM,3075975,LAB SODIUM URINE,16.0,7.71,4.16,15.52,29
CDM,3075983,LAB SODIUM URINE TIMED,16.0,7.71,4.16,15.52,29
CDM,3075991,LAB SODIUM OTHER SOURCE,15.0,7.23,3.9,14.55,29
CDM,3076015,LAB SOMATOSTATIN,82.0,39.52,21.32,79.54,29
CDM,3076056,LAB SPCTPHOT ANALYTE NS,58.0,27.96,15.08,56.26,29
CDM,3076072,LAB SUGARS MULTIPLE QL EA,229.0,110.38,59.54,222.13,29
CDM,3076080,LAB SULFATE URINE,17.0,8.19,4.42,16.49,29
CDM,3076114,LAB UPTAKE HORMONE T3,56.0,26.99,14.56,54.32,29
CDM,3076122,LAB TACROLIMUS FK-506,57.0,27.47,14.82,55.29,29
CDM,3076148,LAB TESTOSTERONE TOTAL,78.0,37.6,20.28,75.66,29
CDM,3076155,LAB TESTOSTERONE FREE,77.0,37.11,20.02,74.69,29
CDM,3076189,LAB THEOPHYLLINE,43.0,20.73,11.18,41.71,29
CDM,3076221,LAB THYROGLOBULIN,58.0,27.96,15.08,56.26,29
CDM,3076239,LAB THYROXINE BINDING GLOBULIN,45.0,21.69,11.7,43.65,29
CDM,3076247,LAB THYROID STIMULATING IMMUN GLOB,153.0,73.75,39.78,148.41,29
CDM,3076254,LAB THYROXINE T4 FREE,28.0,13.5,7.28,27.16,29
CDM,3076262,LAB THYROXINE T4 TOTAL,56.0,26.99,14.56,54.32,29
CDM,3076288,LAB TOBRAMYCIN PEAK,49.0,23.62,12.74,47.53,29
CDM,3076296,LAB TOBRAMYCIN RANDOM,49.0,23.62,12.74,47.53,29
CDM,3076304,LAB TOBRAMYCIN TROUGH,49.0,23.62,12.74,47.53,29
CDM,3076338,LAB TOPIRAMATE,36.0,17.35,9.36,34.92,29
CDM,3076353,LAB TRANSFERRIN,39.0,18.8,10.14,37.83,29
CDM,3076361,LAB DRG DF TRAZODONE DAY,70.0,33.74,18.2,67.9,29
CDM,3076395,LAB TRIGLYCERIDES,41.0,19.76,10.66,39.77,29
CDM,3076411,LAB TRIIODOTHYRONINE T3 FREE,54.0,26.03,14.04,52.38,29
CDM,3076429,LAB TRIIODOTHYRONINE T3 REVERSE,59.0,28.44,15.34,57.23,29
CDM,3076437,LAB TRIIODOTHYRONINE T3 TOTAL,43.0,20.73,11.18,41.71,29
CDM,3076460,LAB TROPONIN QN,38.0,18.32,9.88,36.86,29
CDM,3076486,LAB THYROID STIMULATING HORMONE,54.0,26.03,14.04,52.38,29
CDM,3076510,LAB NITROGEN UREA QN,33.0,15.91,8.58,32.01,29
CDM,3076528,LAB NITROGEN UREA CLEARANCE,71.0,34.22,18.46,68.87,29
CDM,3076536,LAB NITROGEN UREA URINE,52.0,25.06,13.52,50.44,29
CDM,3076544,LAB ACID URIC BLOOD,14.0,6.75,3.64,13.58,29
CDM,3076551,LAB ACID URIC FLUID BODY,56.0,26.99,14.56,54.32,29
CDM,3076577,LAB ACID URIC URINE,56.0,26.99,14.56,54.32,29
CDM,3076619,LAB VANCOMYCIN PEAK,41.0,19.76,10.66,39.77,29
CDM,3076627,LAB VANCOMYCIN RANDOM,41.0,19.76,10.66,39.77,29
CDM,3076635,LAB VANCOMYCIN TROUGH,41.0,19.76,10.66,39.77,29
CDM,3076643,LAB ACID VANILLYLMANDELIC URINE,82.0,39.52,21.32,79.54,29
CDM,3076650,LAB VASOACTIVE INTS PEPTIDE NS,160.0,77.12,41.6,155.2,29
CDM,3076668,LAB VASOPRESSIN,102.0,49.16,26.52,98.94,29
CDM,3076700,LAB RIBOFLAVIN,74.0,35.67,19.24,71.78,29
CDM,3076718,LAB PYRIDOXAL PHOSPHATE,85.0,40.97,22.1,82.45,29
CDM,3076726,LAB ACID ASCORBIC BLOOD,59.0,28.44,15.34,57.23,29
CDM,3076734,LAB VITAMIN D 1 25 DIHYDROXY FRAC,116.0,55.91,30.16,112.52,29
CDM,3076759,LAB VITAMIN D 25 HYDROXY W FRAC NS,89.0,42.9,23.14,86.33,29
CDM,3076767,LAB TOCOPHEROL ALPHA,62.0,29.88,16.12,60.14,29
CDM,3076775,LAB VITAMIN A,62.0,29.88,16.12,60.14,29
CDM,3076783,LAB THIAMINE,64.0,30.85,16.64,62.08,29
CDM,3076791,LAB CYANOCOBALAMIN,54.0,26.03,14.04,52.38,29
CDM,3076809,LAB VITAMIN K,85.0,40.97,22.1,82.45,29
CDM,3076833,LAB PROT WB W INTRP ID BAND,139.0,67.0,36.14,134.83,29
CDM,3076841,LAB PROT WB W INTRP,104.0,50.13,27.04,100.88,29
CDM,3076874,LAB ZINC NS,35.0,16.87,9.1,33.95,29
CDM,3076924,LAB AB ADENOVIRUS,61.0,35.14,15.86,59.17,29
CDM,3076940,LAB AGGLUTININS FEBRILE AG EA,21.0,12.1,5.46,20.37,29
CDM,3076965,LAB AB AMOEBIC,65.0,37.44,16.9,63.05,29
CDM,3076973,LAB SCR ANA,53.0,30.53,13.78,51.41,29
CDM,3076981,LAB ANA TITER,59.0,33.98,15.34,57.23,29
CDM,3077005,LAB ANTISTREPTOLYSIN O TITER,57.0,32.83,14.82,55.29,29
CDM,3077013,LAB AB ASPERGILLUS,55.0,31.68,14.3,53.35,29
CDM,3077039,LAB AB BARTONELLA,62.0,35.71,16.12,60.14,29
CDM,3077047,LAB AB BETA 2 GLYCOPROTEIN I,77.0,44.35,20.02,74.69,29
CDM,3077054,LAB DET AB BLASTOMYCES NS,78.0,44.93,20.28,75.66,29
CDM,3077070,LAB BLOOD TYPE ABO,281.0,212.72,73.06,272.57,29
CDM,3077088,LAB BLOOD TYPE RHD,79.0,59.8,20.54,76.63,29
CDM,3077104,LAB AB BORDETELLA,70.0,40.32,18.2,67.9,29
CDM,3077112,LAB AB BRUCELLA,67.0,38.59,17.42,64.99,29
CDM,3077138,LAB AB CANDIDA,71.0,40.9,18.46,68.87,29
CDM,3077146,LAB AB CARDIOLIPIN IG EA,80.0,46.08,20.8,77.6,29
CDM,3077153,LAB AB CHLAMYDIA,81.0,46.66,21.06,78.57,29
CDM,3077179,LAB AB CHLAMYDIA PNEU IGG IGA,61.0,35.14,15.86,59.17,29
CDM,3077187,LAB AB CHLAMYDIA PNEUM IGM,61.0,35.14,15.86,59.17,29
CDM,3077195,LAB AB CHLAMYDIA PSITTACI IGG IGA,61.0,35.14,15.86,59.17,29
CDM,3077203,LAB AB CHLAMYDIA PSITTACI IGM,61.0,35.14,15.86,59.17,29
CDM,3077211,LAB AB CHLAMYDIA TRAC IGM,61.0,35.14,15.86,59.17,29
CDM,3077229,LAB AB CYTOMEGALOVIRUS,60.0,34.56,15.6,58.2,29
CDM,3077237,LAB AB CYTOMEGALOVIRUS IGM,61.0,35.14,15.86,59.17,29
CDM,3077252,LAB AB COCCIDIOIDES,55.0,31.68,14.3,53.35,29
CDM,3077260,LAB AB COCCIDIOIDES IGG,63.0,36.29,16.38,61.11,29
CDM,3077278,LAB AB COCCIDIOIDES IGM,63.0,36.29,16.38,61.11,29
CDM,3077286,LAB SCR AGGLUTININ COLD,25.0,14.4,6.5,24.25,29
CDM,3077294,LAB AGGLUTININ COLD TITER,58.0,33.41,15.08,56.26,29
CDM,3077377,LAB COMPLEMENT ACT FUNC C1 ESTER,66.0,38.02,17.16,64.02,29
CDM,3077385,LAB COMPLEMENT AG C1Q COMP EA,76.0,43.78,19.76,73.72,29
CDM,3077393,LAB COMPLEMENT AG C2 COMP EA,36.0,20.74,9.36,34.92,29
CDM,3077401,LAB COMPLEMENT AG C3 COMP EA,36.0,20.74,9.36,34.92,29
CDM,3077419,LAB COMPLEMENT AG C4 COMP EA,53.0,30.53,13.78,51.41,29
CDM,3077427,LAB COMPLEMENT AG C5 COMP EA,77.0,44.35,20.02,74.69,29
CDM,3077443,LAB COMPLEMENT AG C1 ESTER NONFUNC,36.0,20.74,9.36,34.92,29
CDM,3077468,LAB COMPLEMENT ACT FUNC,66.0,38.02,17.16,64.02,29
CDM,3077484,LAB COMPLEMENT TOTAL HEMOLYTIC,61.0,35.14,15.86,59.17,29
CDM,3077492,LAB COOMBS INDIRECT TITER AB EA NS,359.0,206.78,93.34,348.23,29
CDM,3077526,LAB AB COXIELLA BRUNETII,57.0,32.83,14.82,55.29,29
CDM,3077534,LAB AB COXSACKIE,53.0,30.53,13.78,51.41,29
CDM,3077542,LAB PROT C-REACTIVE SENS HIGH,57.0,32.83,14.82,55.29,29
CDM,3077559,LAB PROT C-REACTIVE,16.0,9.22,4.16,15.52,29
CDM,3077567,LAB CROSSMATCH ANTIGLOBULIN,359.0,271.76,93.34,348.23,29
CDM,3077575,LAB CROSSMATCH SPIN IMMEDIATE,359.0,271.76,93.34,348.23,29
CDM,3077617,LAB AB DEOXYRIBONUCLEASE,40.0,23.04,10.4,38.8,29
CDM,3077625,LAB AB DIPTHERIA,63.0,36.29,16.38,61.11,29
CDM,3077633,LAB AB DNA STRANDED NATVE/DOUBLE,42.0,24.19,10.92,40.74,29
CDM,3077658,LAB AB EBV EARLY AG,55.0,31.68,14.3,53.35,29
CDM,3077666,LAB AB EBV EBNA,46.0,26.5,11.96,44.62,29
CDM,3077674,LAB AB EBV VCA IGG,55.0,31.68,14.3,53.35,29
CDM,3077682,LAB AB EBV VCA IGM,62.0,35.71,16.12,60.14,29
CDM,3077708,LAB AB ECHOVIRUS,54.0,31.1,14.04,52.38,29
CDM,3077716,LAB AB EHRLICHIA,80.0,46.08,20.8,77.6,29
CDM,3077732,LAB AB ENA RNP,55.0,31.68,14.3,53.35,29
CDM,3077757,LAB AB ENA SCLERODERMA,123.0,70.85,31.98,119.31,29
CDM,3077765,LAB AB ENA SMITH,55.0,31.68,14.3,53.35,29
CDM,3077773,LAB AB ENA SS-A/RO,55.0,31.68,14.3,53.35,29
CDM,3077781,LAB AB ENA SS-B/LA,55.0,31.68,14.3,53.35,29
CDM,3077799,LAB AB ENCEPHALITIS CALIFORNIA,65.0,37.44,16.9,63.05,29
CDM,3077807,LAB AB ENCEPHALITIS EQUINE EASTERN,65.0,37.44,16.9,63.05,29
CDM,3077815,LAB AB ENCEPHALITIS SAINT LOUIS NS,65.0,37.44,16.9,63.05,29
CDM,3077823,LAB AB ENCEPHALITIS EQUINE WEST NS,65.0,37.44,16.9,63.05,29
CDM,3077849,LAB THAWING PLASMA FRESH FROZEN,359.0,271.76,93.34,348.23,29
CDM,3077856,LAB SCR AB FL NS,55.0,31.68,14.3,53.35,29
CDM,3077872,LAB SCR AB ADRENAL FL,37.0,21.31,9.62,35.89,29
CDM,3077906,LAB SCR AB ENDOMYSIAL FL,61.0,35.14,15.86,59.17,29
CDM,3077948,LAB SCR AB PARIETAL FL,55.0,31.68,14.3,53.35,29
CDM,3077955,LAB SCR AB RETICULUM FL,54.0,31.1,14.04,52.38,29
CDM,3077963,LAB SCR AB MUSCLE SMOOTH FL,60.0,34.56,15.6,58.2,29
CDM,3077971,LAB SCR AB MUSCLE STRIATED FL,56.0,32.26,14.56,54.32,29
CDM,3078011,LAB AB FL TITER HU,55.0,31.68,14.3,53.35,29
CDM,3078029,LAB AB FL TITER MITOCHONDRIA,60.0,34.56,15.6,58.2,29
CDM,3078045,LAB AB FL TITER PARIETAL,55.0,31.68,14.3,53.35,29
CDM,3078052,LAB AB FL TITER PURKINJE,190.0,109.44,49.4,184.3,29
CDM,3078060,LAB AB FL TITER MUSCLE SMOOTH,65.0,37.44,16.9,63.05,29
CDM,3078078,LAB AB FL TITER MUSCLE STRIATED,65.0,37.44,16.9,63.05,29
CDM,3078086,LAB SCR AB FL,128.0,73.73,33.28,124.16,29
CDM,3078094,LAB AB FRANCISELLA TULARENSIS,100.0,57.6,26.0,97.0,29
CDM,3078110,LAB AB FUNGUS NOT SPECIFIED,55.0,31.68,14.3,53.35,29
CDM,3078128,LAB AB GIARDIA LAMBLIA,67.0,38.59,17.42,64.99,29
CDM,3078136,LAB AB HELICOBACTER PYLORI,78.0,44.93,20.28,75.66,29
CDM,3078144,LAB AB HELMINTH NONSPECIFIED,65.0,37.44,16.9,63.05,29
CDM,3078169,LAB AB HAEMOPHILUS INFLUENZA IGG,62.0,35.71,16.12,60.14,29
CDM,3078185,LAB AB HEPATITIS A IGM,65.0,37.44,16.9,63.05,29
CDM,3078201,LAB AB HEPATITIS B CORE IGM,72.0,41.47,18.72,69.84,29
CDM,3078219,LAB AB HEPATITIS B CORE TOTAL,55.0,31.68,14.3,53.35,29
CDM,3078227,LAB AB HEPATITIS B SURFACE,55.0,31.68,14.3,53.35,29
CDM,3078235,LAB AB HEPATITIS BE,59.0,33.98,15.34,57.23,29
CDM,3078243,LAB AB HEPATITIS C,72.0,41.47,18.72,69.84,29
CDM,3078250,LAB AB HEPATITIS C CONFIRMATORY,239.0,137.66,62.14,231.83,29
CDM,3078268,LAB AB HEPATITIS DELTA AGENT,85.0,48.96,22.1,82.45,29
CDM,3078276,LAB AB HERPES SIMPLEX NONSPECIFIC,44.0,25.34,11.44,42.68,29
CDM,3078284,LAB AB HERPES SIMPLEX TYPE 1,40.0,23.04,10.4,38.8,29
CDM,3078292,LAB AB HERPES SIMPLEX TYPE 2,59.0,33.98,15.34,57.23,29
CDM,3078300,LAB SCR AB HETEROPHILE,16.0,9.22,4.16,15.52,29
CDM,3078326,LAB AB HISTOPLASMA IMMUNODIFFUSION,68.0,39.17,17.68,65.96,29
CDM,3078334,LAB AB HIV-1,76.0,43.78,19.76,73.72,29
CDM,3078342,LAB AB HIV-1&HIV-2 RESULT SGL,42.0,24.19,10.92,40.74,29
CDM,3078359,LAB AB HIV-2,87.0,50.11,22.62,84.39,29
CDM,3078375,LAB BLOOD TYPE HLA B-27 AG SINGLE,78.0,44.93,20.28,75.66,29
CDM,3078417,LAB BLOOD TYPE HLA DR/DQ AG SGL,91.0,52.42,23.66,88.27,29
CDM,3078425,LAB AB HTLV-I,28.0,16.13,7.28,27.16,29
CDM,3078466,LAB IMMUNE COMPLEX C1Q BINDING,74.0,42.62,19.24,71.78,29
CDM,3078508,LAB IMM AG TUMOR CA 125,63.0,36.29,16.38,61.11,29
CDM,3078516,LAB IMM AG TUMOR CA 15-3,63.0,36.29,16.38,61.11,29
CDM,3078524,LAB IMM AG TUMOR CA 19-9,63.0,36.29,16.38,61.11,29
CDM,3078532,LAB IMM AG TUMOR CA 27-29,63.0,36.29,16.38,61.11,29
CDM,3078540,LAB IMM AG TUMOR OTHER QN NS,75.0,43.2,19.5,72.75,29
CDM,3078565,LAB IMDF,55.0,31.68,14.3,53.35,29
CDM,3078573,LAB IMDF GEL AB/AG QL,56.0,32.26,14.56,54.32,29
CDM,3078599,LAB IMMUNOELECTROPHORESIS SERUM,90.0,51.84,23.4,87.3,29
CDM,3078615,LAB IMMUNOFIXATION EP URINE/CSF,89.0,51.26,23.14,86.33,29
CDM,3078631,LAB AB INFLUENZA A,68.0,39.17,17.68,65.96,29
CDM,3078656,LAB AB INFLUENZA B,68.0,39.17,17.68,65.96,29
CDM,3078664,LAB INHIBIN A NS,77.0,44.35,20.02,74.69,29
CDM,3078672,LAB AB INSULIN,66.0,38.02,17.16,64.02,29
CDM,3078680,LAB AB INTRINSIC FACTOR,59.0,33.98,15.34,57.23,29
CDM,3078698,LAB AB ISLET CELL NS,71.0,40.9,18.46,68.87,29
CDM,3078714,LAB AB LEGIONELLA,72.0,41.47,18.72,69.84,29
CDM,3078748,LAB AB ID LEUKOCYTE,55.0,31.68,14.3,53.35,29
CDM,3078755,LAB AB ID LEUKOCYTE NS,54.0,31.1,14.04,52.38,29
CDM,3078813,LAB TRANSFORM LYMPHOCYTE MITOGEN,205.0,118.08,53.3,198.85,29
CDM,3078839,LAB AB CHORIOMENINGITIS LYMPHOCYTIC,62.0,35.71,16.12,60.14,29
CDM,3078854,LAB AB MICROSOMAL EA,44.0,25.34,11.44,42.68,29
CDM,3078862,LAB AB MICROSOMAL LIVER-KIDNEY EA,63.0,36.29,16.38,61.11,29
CDM,3078888,LAB AB MUMPS,61.0,35.14,15.86,59.17,29
CDM,3078896,LAB AB MUMPS IGG,56.0,32.26,14.56,54.32,29
CDM,3078904,LAB AB MUMPS IGM,62.0,35.71,16.12,60.14,29
CDM,3078938,LAB AB MYCOPLASMA IGM,55.0,31.68,14.3,53.35,29
CDM,3078953,LAB NEUTRALIZATION VIRAL,69.0,39.74,17.94,66.93,29
CDM,3078995,LAB SCR AB CRYPTO AGG PARTICLE,59.0,33.98,15.34,57.23,29
CDM,3079019,LAB SCR AB NEISS AGG PARTICLE,74.0,42.62,19.24,71.78,29
CDM,3079027,LAB SCR AB NEISS GRP A AGG PARTICLE,53.0,30.53,13.78,51.41,29
CDM,3079043,LAB SCR AB NEISS GRP C AGG PARTICLE,53.0,30.53,13.78,51.41,29
CDM,3079050,LAB SCR AB STREP PNEUMO AGGPARTICLE,53.0,30.53,13.78,51.41,29
CDM,3079076,LAB AGG PARTICLE TITER,59.0,33.98,15.34,57.23,29
CDM,3079092,LAB AB PARVOVIRUS B19 IGG,62.0,35.71,16.12,60.14,29
CDM,3079100,LAB AB PARVOVIRUS B19 IGM,62.0,35.71,16.12,60.14,29
CDM,3079118,LAB AB ANTIPHOSPHATIDYLSERINE,57.0,32.83,14.82,55.29,29
CDM,3079175,LAB SCR ALLG IGE QL MULTI,56.0,32.26,14.56,54.32,29
CDM,3079183,LAB ELUTION AB RBC EA,359.0,206.78,93.34,348.23,29
CDM,3079209,LAB FACTOR RHEUMATOID QL,70.0,40.32,18.2,67.9,29
CDM,3079217,LAB FACTOR RHEUMATOID QN,18.0,10.37,4.68,17.46,29
CDM,3079225,LAB AB RICKETTSIA,71.0,40.9,18.46,68.87,29
CDM,3079258,LAB AB RSV,72.0,41.47,18.72,69.84,29
CDM,3079274,LAB AB RUBELLA IGG,56.0,32.26,14.56,54.32,29
CDM,3079282,LAB AB RUBELLA IGM NS,56.0,32.26,14.56,54.32,29
CDM,3079308,LAB AB RUBEOLA IGG,60.0,34.56,15.6,58.2,29
CDM,3079316,LAB AB RUBEOLA IGM,56.0,32.26,14.56,54.32,29
CDM,3079324,LAB AB RUBEOLA TITER NS,39.0,22.46,10.14,37.83,29
CDM,3079340,LAB AB SALMONELLA,73.0,42.05,18.98,70.81,29
CDM,3079373,LAB SYPHILIS VDRL/RPR QL,52.0,29.95,13.52,50.44,29
CDM,3079381,LAB SYPHILIS VDRL/RPR QL CSF,62.0,35.71,16.12,60.14,29
CDM,3079399,LAB SYPHILIS VDRL/RPR QN,52.0,29.95,13.52,50.44,29
CDM,3079407,LAB COUNT CELLS T CD4&CD8 RATIO,141.0,81.22,36.66,136.77,29
CDM,3079415,LAB COUNT TOTAL CELLS T,114.0,65.66,29.64,110.58,29
CDM,3079431,LAB AB TETANUS,63.0,36.29,16.38,61.11,29
CDM,3079449,LAB AB THYROGLOBULIN,57.0,32.83,14.82,55.29,29
CDM,3079456,LAB AB TOXOPLASMA,44.0,25.34,11.44,42.68,29
CDM,3079464,LAB AB TOXOPLASMA IGG NS,63.0,36.29,16.38,61.11,29
CDM,3079472,LAB AB TOXOPLASMA IGM NS,63.0,36.29,16.38,61.11,29
CDM,3079498,LAB AB TRICHINELLA,69.0,39.74,17.94,66.93,29
CDM,3079514,LAB AB VARICELLA-ZOSTER IGG,39.0,22.46,10.14,37.83,29
CDM,3079522,LAB AB VARICELLA-ZOSTER IGM,39.0,22.46,10.14,37.83,29
CDM,3079530,LAB AB VIRUS NONSPECIFIED,65.0,37.44,16.9,63.05,29
CDM,3079548,LAB PROT C ACT RESISTANCE,66.0,31.81,17.16,64.02,29
CDM,3079563,LAB CLOTTING ACT ANTITHROM 3,63.0,30.37,16.38,61.11,29
CDM,3079589,LAB COUNT BLD LEUKO AUTO,8.0,3.86,2.08,7.76,29
CDM,3079605,LAB COUNT BLD PLATELET AUTOMATED,14.0,6.75,3.64,13.58,29
CDM,3079613,LAB COUNT BLD RBC AUTO,62.0,29.88,16.12,60.14,29
CDM,3079639,LAB COUNT BLD RETIC MANUAL,13.0,6.27,3.38,12.61,29
CDM,3079654,LAB COUNT BLD DIFF MANUAL WBC,54.0,26.03,14.04,52.38,29
CDM,3079688,LAB CBC AUTO W AUTO DIFF,24.0,11.57,6.24,23.28,29
CDM,3079696,LAB CBC AUTO WO DIFF,20.0,9.64,5.2,19.4,29
CDM,3079720,LAB CLOTTING FACTOR 2 PROTHROM,64.0,30.85,16.64,62.08,29
CDM,3079746,LAB CLOTTING FACTOR 8 1-STG,66.0,31.81,17.16,64.02,29
CDM,3079779,LAB INHIBITOR FACTOR 8,97.0,46.75,25.22,94.09,29
CDM,3079787,LAB CLOTTING FACTOR 9 PTC/XMAS,79.0,38.08,20.54,76.63,29
CDM,3079795,LAB CLOTTING FACTOR 5 LABILE,75.0,36.15,19.5,72.75,29
CDM,3079803,LAB CLOTTING FACTOR 7,76.0,36.63,19.76,73.72,29
CDM,3079829,LAB CLOTTING FACTOR 8 VWF AG,74.0,35.67,19.24,71.78,29
CDM,3079837,LAB CLOTTING FACTOR 8 VWF MULTI,69.0,33.26,17.94,66.93,29
CDM,3079845,LAB CLOTTING FACTOR 8 VWF RIST,74.0,35.67,19.24,71.78,29
CDM,3079852,LAB CLOTTING FACTOR 10 STUART-PROWR,76.0,36.63,19.76,73.72,29
CDM,3079878,LAB CLOTTING FACTOR 12 HAGEMAN,76.0,36.63,19.76,73.72,29
CDM,3079894,LAB CLOTTING FACTOR 13 SCR SOL,28.0,13.5,7.28,27.16,29
CDM,3079928,LAB TRIIODOTHYRONINE T3 FREE TR DIA,71.0,34.22,18.46,68.87,29
CDM,3079944,LAB SCR ALLG IGE QL MULTI NS,59.0,33.98,15.34,57.23,29
CDM,3079951,LAB SCR AB MOG FL,86.0,49.54,22.36,83.42,29
CDM,3079969,LAB AB FL TITER MOG,837.0,482.11,217.62,811.89,29
CDM,3079977,LAB IG IGA SERUM NS,56.0,26.99,14.56,54.32,29
CDM,3079993,LAB PARATHORMONE INTRAOP BASELINE 3,124.0,59.77,32.24,120.28,29
CDM,3080041,LAB SCR AB LRP4 AUTO FL,850.0,489.6,221.0,824.5,29
CDM,3080074,LAB RECEPTOR INTERLEUK 2 SOL N-END,500.0,241.0,130.0,485.0,29
CDM,3080082,LAB NEUTRALIZATION VIRAL IFNB-1,1178.0,678.53,306.28,1142.66,29
CDM,3080124,LAB POTASS BLD WHL RBC,82.0,39.52,21.32,79.54,29
CDM,3080132,LAB POTASS PLASMA,59.0,28.44,15.34,57.23,29
CDM,3086014,LAB HGB FETAL KLEIHAUER-BETKE,59.0,28.44,15.34,57.23,29
CDM,3086022,LAB HGB FETAL ROSETTE,29.0,13.98,7.54,28.13,29
CDM,3086055,LAB FDP D-DIMER QN,31.0,14.94,8.06,30.07,29
CDM,3086063,LAB FIBRINOGEN ACTIVITY,30.0,14.46,7.8,29.1,29
CDM,3086097,LAB COUNT BLD HEMATOCRIT,8.0,3.86,2.08,7.76,29
CDM,3086113,LAB HEMO PLT AUTO W AUTO SCAN,24.0,11.57,6.24,23.28,29
CDM,3086121,LAB COUNT BLD HEMOGLOBIN,8.0,3.86,2.08,7.76,29
CDM,3086147,LAB ASSAY HEPARIN,65.0,31.33,16.9,63.05,29
CDM,3086188,LAB MURAMIDASE,57.0,27.47,14.82,55.29,29
CDM,3086196,LAB FRAGILITY OSMOTIC RBC INCUB,57.0,27.47,14.82,55.29,29
CDM,3086238,LAB PLASMINOGEN NON-ANTIGENIC,57.0,27.47,14.82,55.29,29
CDM,3086261,LAB CLOTTING ACT PROTEIN C,42.0,20.24,10.92,40.74,29
CDM,3086279,LAB CLOTTING AG PROTEIN C,65.0,31.33,16.9,63.05,29
CDM,3086287,LAB CLOTTING PROTEIN S FREE,66.0,31.81,17.16,64.02,29
CDM,3086295,LAB CLOTTING PROTEIN S TOTAL,64.0,30.85,16.64,62.08,29
CDM,3086303,LAB PROTHROMBIN TIME,51.0,24.58,13.26,49.47,29
CDM,3086311,LAB PROTHROMBIN TIME SUB,58.0,27.96,15.08,56.26,29
CDM,3086329,LAB PTT SUBSTITUTION FRAC PLASMA,103.0,49.65,26.78,99.91,29
CDM,3086337,LAB REPTILASE,80.0,38.56,20.8,77.6,29
CDM,3086345,LAB VENOM TIME RUSSELL VIPER DLT,60.0,28.92,15.6,58.2,29
CDM,3086360,LAB RATE SEDIMENTATION RBC AUTO,9.0,4.34,2.34,8.73,29
CDM,3086378,LAB RATE SEDIMENTATION RBC NONAUTO,13.0,6.27,3.38,12.61,29
CDM,3086402,LAB THROMBIN TIME PLASMA,56.0,26.99,14.56,54.32,29
CDM,3086428,LAB PTT PLASMA/BLD WHL,19.0,9.16,4.94,18.43,29
CDM,3086444,LAB VISCOSITY,57.0,27.47,14.82,55.29,29
CDM,3086493,LAB DET IA CHLAMYD TRAC PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3086519,LAB DET IA CMV PRB AMP NS,106.0,56.29,27.56,102.82,29
CDM,3086527,LAB DET IA CMV QN NS,129.0,68.5,33.54,125.13,29
CDM,3086535,LAB CONCENTRATION AFB IA,21.0,11.15,5.46,20.37,29
CDM,3086543,LAB CONCENTRATION ANY TYPE IA,21.0,11.15,5.46,20.37,29
CDM,3086550,LAB CULT BACT AEROBIC ID DF,25.0,13.28,6.5,24.25,29
CDM,3086568,LAB CULT BACT AEROBIC OTHER QN,61.0,32.39,15.86,59.17,29
CDM,3086592,LAB CULT BACT ANAEROBIC OTHER,29.0,15.4,7.54,28.13,29
CDM,3086600,LAB CULT BACT ANAEROBIC ID DF,25.0,13.28,6.5,24.25,29
CDM,3086618,LAB CULT BACT AEROBIC BLOOD,31.0,16.46,8.06,30.07,29
CDM,3086626,LAB CULT BACT AEROBIC CATHETER TIP,26.0,13.81,6.76,25.22,29
CDM,3086634,LAB CULT CHLAMYDIA,71.0,37.7,18.46,68.87,29
CDM,3086642,LAB CULT BACT AEROBIC CSF,26.0,13.81,6.76,25.22,29
CDM,3086659,LAB ISO VIRUS SHELL VIAL ID W IF,64.0,33.98,16.64,62.08,29
CDM,3086667,LAB CULT BACT AEROBIC EAR,26.0,13.81,6.76,25.22,29
CDM,3086683,LAB CULT BACT AEROBIC EYE,61.0,32.39,15.86,59.17,29
CDM,3086691,LAB CULT FUNGI ID ISOLATES BLOOD,69.0,36.64,17.94,66.93,29
CDM,3086709,LAB CULT FUNGI ID DERMATOPHYTE,59.0,31.33,15.34,57.23,29
CDM,3086717,LAB CULT FUNGI ID DF MOLD,62.0,32.92,16.12,60.14,29
CDM,3086725,LAB CULT FUNGI ID DF YEAST,62.0,32.92,16.12,60.14,29
CDM,3086733,LAB CULT FUNGI ID ISOLATES,78.0,41.42,20.28,75.66,29
CDM,3086741,LAB CULT BACT AEROBIC GENITAL,26.0,13.81,6.76,25.22,29
CDM,3086758,LAB CULT BACT AEROBIC RESP LOWER,26.0,13.81,6.76,25.22,29
CDM,3086766,LAB CULT MYCOPLASMA/UREAPLASMA,63.0,33.45,16.38,61.11,29
CDM,3086774,LAB CULT MYCOBACTERIAL ID DF,64.0,33.98,16.64,62.08,29
CDM,3086808,LAB CULT BACT AEROBIC OTHER,75.0,39.83,19.5,72.75,29
CDM,3086840,LAB SCR CULT GONORRHEA,58.0,30.8,15.08,56.26,29
CDM,3086873,LAB SCR CULT STAPH MRSA,20.0,10.62,5.2,19.4,29
CDM,3086881,LAB SCR CULT STREP GROUP B,20.0,10.62,5.2,19.4,29
CDM,3086915,LAB CULT BACT FLUID BODY STERILE,26.0,13.81,6.76,25.22,29
CDM,3086931,LAB CULT BACT AEROBIC STOOL CAMPY,29.0,15.4,7.54,28.13,29
CDM,3086949,LAB CULT BACT AEROBIC STOOL E COLI,29.0,15.4,7.54,28.13,29
CDM,3086956,LAB CULT BACT AEROBIC STOOL PATH,79.0,41.95,20.54,76.63,29
CDM,3086964,LAB CULT BACT AEROBIC STOOL,29.0,15.4,7.54,28.13,29
CDM,3086980,LAB CULT BACT AEROBIC STOOL YERSNIA,29.0,15.4,7.54,28.13,29
CDM,3086998,LAB CULT BACT AEROBIC TISSUE,112.0,59.47,29.12,108.64,29
CDM,3087020,LAB CULT TYPING IF ANTISERUM EA,57.0,30.27,14.82,55.29,29
CDM,3087046,LAB CULT TYPING SEROLOGICAL,16.0,8.5,4.16,15.52,29
CDM,3087053,LAB CULT BACT AEROBIC RESP UPPER,26.0,13.81,6.76,25.22,29
CDM,3087061,LAB CULT BACT ID ISOLATE URINE,25.0,13.28,6.5,24.25,29
CDM,3087079,LAB CULT BACT COLONY COUNT URINE,25.0,13.28,6.5,24.25,29
CDM,3087087,LAB ISO VIRUS ID ACT ENZYMATIC,102.0,54.16,26.52,98.94,29
CDM,3087095,LAB ISO VIRUS INOC TISSUE ADDL,65.0,34.52,16.9,63.05,29
CDM,3087103,LAB ISO VIRUS INOC TISSUE,79.0,41.95,20.54,76.63,29
CDM,3087129,LAB CULT BACT AEROBIC WOUND,26.0,13.81,6.76,25.22,29
CDM,3087137,LAB CULT FUNGI YEAST ID ISOLATES,60.0,31.86,15.6,58.2,29
CDM,3087160,LAB DET AG IA IMM ENZ TOXIN C DIFF,60.0,31.86,15.6,58.2,29
CDM,3087194,LAB DET AG IA IMM ENZ CRYPTOSPOR,42.0,22.3,10.92,40.74,29
CDM,3087210,LAB DET AG IA IMM H PYLORI STOOL,75.0,39.83,19.5,72.75,29
CDM,3087228,LAB DET AG IA HBSAG QL/SEMI QN,34.0,18.05,8.84,32.98,29
CDM,3087236,LAB DET AG IA IMM ENZ HEP BE,59.0,31.33,15.34,57.23,29
CDM,3087244,LAB DET AG IA IMM ENZ HISTOPLASMA,152.0,80.71,39.52,147.44,29
CDM,3087301,LAB DET AG IA IMM ENZ ROTAVIRUS,36.0,19.12,9.36,34.92,29
CDM,3087319,LAB DET AG IA IMM ENZ RSV,42.0,22.3,10.92,40.74,29
CDM,3087327,LAB DET AG IA IMM ENZ TOX SHIGA,64.0,33.98,16.64,62.08,29
CDM,3087350,LAB DET AG IA IMM ENZ QL,36.0,19.12,9.36,34.92,29
CDM,3087368,LAB DET IA GC PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3087459,LAB DET IA HERPES 6 PRB AMP,120.0,63.72,31.2,116.4,29
CDM,3087467,LAB DET IA HSV PRB AMP NS,106.0,56.29,27.56,102.82,29
CDM,3087491,LAB HOMOGENIZATION TISSUE,52.0,27.61,13.52,50.44,29
CDM,3087533,LAB DET AG IA IF BORDETELLA,36.0,19.12,9.36,34.92,29
CDM,3087566,LAB DET AG IA IF CRYPTOSPORIDIUM,61.0,32.39,15.86,59.17,29
CDM,3087582,LAB DET AG IA IF HSV TYPE 1,60.0,31.86,15.6,58.2,29
CDM,3087590,LAB DET AG IA IF HSV TYPE 2,60.0,31.86,15.6,58.2,29
CDM,3087608,LAB DET AG IA IF INFLUENZA A VIRUS,60.0,31.86,15.6,58.2,29
CDM,3087616,LAB DET AG IA IF INFLUENZA B VIRUS,60.0,31.86,15.6,58.2,29
CDM,3087640,LAB DET AG IA IF PNEUMOCYSTIS,36.0,19.12,9.36,34.92,29
CDM,3087657,LAB DET AG IA IF PLYVLT ORG MULT,60.0,31.86,15.6,58.2,29
CDM,3087665,LAB DET AG IA IF RSV,60.0,31.86,15.6,58.2,29
CDM,3087673,LAB DET AG IA IF VARICELLA-ZOSTER,60.0,31.86,15.6,58.2,29
CDM,3087681,LAB DET AG IA IMM OPTICAL,65.0,34.52,16.9,63.05,29
CDM,3087715,LAB DET AG IA INFLUENZA IMM OPT,50.0,26.55,13.0,48.5,29
CDM,3087749,LAB DET IA MYCOBCT TB PRB AMP NS,126.0,66.91,32.76,122.22,29
CDM,3087764,LAB EXAM MACROSCOPIC ARTHROPOD,13.0,6.9,3.38,12.61,29
CDM,3087772,LAB EXAM MACROSCOPIC PARASITE,58.0,30.8,15.08,56.26,29
CDM,3087798,LAB DET IA ORGANISMS MULT PRB AMP,211.0,112.04,54.86,204.67,29
CDM,3087806,LAB DET IA MYCOPLAS PNEU PRB AMP NS,106.0,56.29,27.56,102.82,29
CDM,3087822,LAB EXAM PINWORM,13.0,6.9,3.38,12.61,29
CDM,3087830,LAB SMEAR INCL BODIES/PARASITE,18.0,9.56,4.68,17.46,29
CDM,3087848,LAB SMEAR STAIN ACID FAST AFB,17.0,9.03,4.42,16.49,29
CDM,3087863,LAB SMEAR STAIN FL AFB,57.0,30.27,14.82,55.29,29
CDM,3087889,LAB SMEAR STAIN FL FUNGI,58.0,30.8,15.08,56.26,29
CDM,3087897,LAB SMEAR GRAM/GIEMSA,13.0,6.9,3.38,12.61,29
CDM,3087913,LAB SMEARS DIRECT OVA&PARASITES,27.0,14.34,7.02,26.19,29
CDM,3087947,LAB SUSCPT DISK KIRBY BAUER,23.0,12.21,5.98,22.31,29
CDM,3087954,LAB SUSCPT DETECTION ENZYME EA,56.0,29.74,14.56,54.32,29
CDM,3087962,LAB SUSCPT ETEST AGENT EA,255.0,135.4,66.3,247.35,29
CDM,3087970,LAB SUSCPT DILUTION MACROBROTH,58.0,30.8,15.08,56.26,29
CDM,3087988,LAB SUSCPT MIC PLATE EA,26.0,13.81,6.76,25.22,29
CDM,3088002,LAB TISSUE KOH SKIN/HAIR/NAIL FUNGI,64.0,33.98,16.64,62.08,29
CDM,3088010,LAB TOXIN CULT TISSUE C DIFF NS,79.0,41.95,20.54,76.63,29
CDM,3088036,LAB SMEAR IA WET MOUNT,53.0,28.14,13.78,51.41,29
CDM,3088069,LAB UA REDUCING SUBSTANCE,11.0,5.29,2.86,10.67,29
CDM,3088101,LAB UA GRAVITY SPCFC AUTO WO MICRO,53.0,25.49,13.78,51.41,29
CDM,3088119,LAB UA AUTO W MICRO,10.0,4.81,2.6,9.7,29
CDM,3088127,LAB UA AUTO WO MICRO,7.0,3.37,1.82,6.79,29
CDM,3088135,LAB UA MICROSCOPIC ONLY,10.0,4.81,2.6,9.7,29
CDM,3088143,LAB UA NONAUTO WO MICRO,11.0,5.29,2.86,10.67,29
CDM,3088168,LAB UA QL/SEMI QN,7.0,3.37,1.82,6.79,29
CDM,3088192,LAB PREGNANCY URINE,58.0,27.9,15.08,56.26,29
CDM,3088200,LAB MEASUREMENT VOL COLL TIMED EA,11.0,5.29,2.86,10.67,29
CDM,3088283,LAB PROT FRCTN ELECTRO&QN URINE,54.0,26.03,14.04,52.38,29
CDM,3088861,LAB ALPHA-1-ANTITRYPSIN TOTAL,41.0,19.76,10.66,39.77,29
CDM,3088937,LAB STAIN SPECIAL 2 NS,281.0,123.64,73.06,272.57,29
CDM,3088978,LAB MICROSCOPY ELECTRON DIAG NS,1665.0,732.6,432.9,1615.05,29
CDM,3089000,LAB SCR AB AGG PARTICLE EA,74.0,42.62,19.24,71.78,29
CDM,3089018,LAB ASSAY HEPARIN NS,92.0,44.34,23.92,89.24,29
CDM,3090016,LAB CYTOP SLD LIQ NONGYN SMT/QNI NS,110.0,23.76,28.6,106.7,29
CDM,3094034,LAB DET AG IA IF GIARDIA,61.0,32.39,15.86,59.17,29
CDM,3094042,LAB DET AG IA IMM ENZ GIARDIA NS,66.0,35.05,17.16,64.02,29
CDM,3094059,POC COLLECT SPEC SPUTUM AEROSOL,359.0,271.76,93.34,348.23,29
CDM,3094091,LAB SMEAR STAIN CMPLX OVA&PARASITES,71.0,37.7,18.46,68.87,29
CDM,3094125,LAB SCR CULT STREP GROUP A,20.0,10.62,5.2,19.4,29
CDM,3094182,LAB AGGREGATION PLT EA AGENT,75.0,36.15,19.5,72.75,29
CDM,3094638,POC GASES BLD ANY COMBO,79.0,38.08,20.54,76.63,29
CDM,3094646,LAB LEVETIRACETAM NS,63.0,30.37,16.38,61.11,29
CDM,3094661,LAB DET IA STREP GROUP A PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3094976,LAB CYTOP SLD LIQ NONGYN,110.0,23.76,28.6,106.7,29
CDM,3095015,LAB ALKALINE PHOSPHATASE NS,57.0,27.47,14.82,55.29,29
CDM,3095049,LAB COUNT TOTAL CELLS CD56 NK,114.0,65.66,29.64,110.58,29
CDM,3095056,LAB B CELLS CD19 COUNT TOTAL,114.0,65.66,29.64,110.58,29
CDM,3095064,LAB CYTOM FLOW TECH MARKER 1ST,751.0,162.22,195.26,728.47,29
CDM,3095114,LAB PROT FRCTN ELECTRO&QN OTHER,54.0,26.03,14.04,52.38,29
CDM,3095122,LAB COUNT CELLS T CD4 ABSOLUTE,111.0,63.94,28.86,107.67,29
CDM,3095130,LAB CYTOM FLOW TECH MARKER ADDL,119.0,25.7,30.94,115.43,29
CDM,3102811,LAB DET AG IA IMM ENZ HEP B SURF NS,85.0,45.14,22.1,82.45,29
CDM,3102852,LAB NEUTRALIZATION VIRAL RABIES,127.0,73.15,33.02,123.19,29
CDM,3102894,LAB CHROM W BND 15-20 CLL 2 KRTY NS,532.0,114.91,138.32,516.04,29
CDM,3102902,LAB CHROM W BND 15-20 CLL 2 KRTY,377.0,81.43,98.02,365.69,29
CDM,3102928,LAB CHROM W BND AF 6-12 COL 1 K,521.0,112.54,135.46,505.37,29
CDM,3102936,LAB MCG IN SITU CHROM 10-30 CELL,335.0,72.36,87.1,324.95,29
CDM,3102977,LAB MCG IN SITU INT 100-300 CELL,154.0,33.26,40.04,149.38,29
CDM,3102985,LAB CULT TISS NON-NEO AF/CELL CV,451.0,97.42,117.26,437.47,29
CDM,3102993,LAB CHROM STUDY CELLS COUNTED ADDL,81.0,17.5,21.06,78.57,29
CDM,3103009,LAB CHROM STUDY RES HIGH ADDL,104.0,22.46,27.04,100.88,29
CDM,3103017,LAB CHROM KARYOTYPES ADDL EA,101.0,21.82,26.26,97.97,29
CDM,3103090,LAB CYTOPATH CONCENTRATION,79.0,17.06,20.54,76.63,29
CDM,3103108,LAB CYTOPATH FLUIDS SMEARS,79.0,17.06,20.54,76.63,29
CDM,3103157,LAB CYTOPATH EVAL FNA INTRP&RPT,110.0,23.76,28.6,106.7,29
CDM,3103199,LAB MCG PROBE DNA PROBE EA,65.0,14.04,16.9,63.05,29
CDM,3103371,LAB DECALCIFICATION,26.0,11.44,6.76,25.22,29
CDM,3103397,LAB PATH GROSS&MICRO LVL 2,79.0,34.76,20.54,76.63,29
CDM,3103405,LAB PATH GROSS&MICRO LVL 3,110.0,48.4,28.6,106.7,29
CDM,3103439,LAB PATH GROSS&MICRO LVL 6,1665.0,732.6,432.9,1615.05,29
CDM,3103447,LAB PATH GROSS ONLY LVL 1,62.0,27.28,16.12,60.14,29
CDM,3103595,LAB AB MYCOPLASMA IGG NS,55.0,31.68,14.3,53.35,29
CDM,3103637,LAB CLOZAPINE/NORCLOZAPINE,68.0,32.78,17.68,65.96,29
CDM,3103652,LAB CARBAMAZEPINE FREE,90.0,43.38,23.4,87.3,29
CDM,3103686,LAB TACROLIMUS FK-506 NS,64.0,30.85,16.64,62.08,29
CDM,3103728,LAB CALCIUM TOTAL NS,65.0,31.33,16.9,63.05,29
CDM,3103736,LAB CHLORIDE STOOL NS,58.0,27.96,15.08,56.26,29
CDM,3103744,LAB CHOLESTEROL SRM/BLD WHL TTL NS,56.0,26.99,14.56,54.32,29
CDM,3103777,LAB CREATINE KINASE TOTAL NS,55.0,26.51,14.3,53.35,29
CDM,3103785,LAB CREATININE URINE NS,52.0,25.06,13.52,50.44,29
CDM,3103793,LAB CRYOGLOBULIN QL/SEMI QN NS,63.0,30.37,16.38,61.11,29
CDM,3103801,LAB TRANSFERASE GALACTOSE-1 QN,173.0,83.39,44.98,167.81,29
CDM,3103819,LAB IG IGA IGD IGG IGM CSF EA,63.0,30.37,16.38,61.11,29
CDM,3103827,LAB IG IGA IGD IGG IGM SERUM EA NS,59.0,28.44,15.34,57.23,29
CDM,3103850,LAB IMM ACHR BINDING QN,70.0,40.32,18.2,67.9,29
CDM,3103884,LAB IMM GANGLIOSIDE GM TRIPLE QN,70.0,33.74,18.2,67.9,29
CDM,3103918,LAB IMM GLYCPROT MYELIN ASSC IGM,69.0,33.26,17.94,66.93,29
CDM,3103942,LAB LDH NS,55.0,26.51,14.3,53.35,29
CDM,3103967,LAB LIPASE FLUID BODY NS,58.0,27.96,15.08,56.26,29
CDM,3104122,LAB SODIUM STOOL NS,58.0,27.96,15.08,56.26,29
CDM,3104130,LAB SPCTPHOT PORPHYRINS SERUM,70.0,33.74,18.2,67.9,29
CDM,3104148,LAB TESTOSTERONE TOTAL NS,78.0,37.6,20.28,75.66,29
CDM,3104155,LAB THYROXINE T4 FREE NS,66.0,31.81,17.16,64.02,29
CDM,3104163,LAB TRIGLYCERIDES NS,57.0,27.47,14.82,55.29,29
CDM,3104213,LAB CLOTTING AG ANTITHROMBIN 3 NS,69.0,33.26,17.94,66.93,29
CDM,3104221,LAB FIBRINOGEN ACTIVITY NS,30.0,14.46,7.8,29.1,29
CDM,3104239,LAB AB ID PLATELET PATIENT SERUM NS,145.0,83.52,37.7,140.65,29
CDM,3104262,LAB COMPLEMENT AG C6 COMP EA,36.0,20.74,9.36,34.92,29
CDM,3104304,LAB SCR AB ANTIMYOCARDIAL FL,76.0,43.78,19.76,73.72,29
CDM,3104338,LAB SCR AB H INFLUENZA AGG PARTICLE,53.0,30.53,13.78,51.41,29
CDM,3104353,LAB AB CHLAMYDIA TRAC IGG IGA,61.0,35.14,15.86,59.17,29
CDM,3104361,LAB SCR AB RBC SERUM EA NS,158.0,119.61,41.08,153.26,29
CDM,3104379,LAB ELUTION AB RBC EA NS,359.0,206.78,93.34,348.23,29
CDM,3104395,LAB PANEL AB RBC EA TECH SERUM NS,751.0,568.51,195.26,728.47,29
CDM,3104403,LAB COOMBS DIR ANTISERUM EA NS,125.0,72.0,32.5,121.25,29
CDM,3104411,LAB BLOOD TYPE ABO NS,281.0,212.72,73.06,272.57,29
CDM,3104429,LAB BLOOD TYPE ABO DISCREPANCY,281.0,212.72,73.06,272.57,29
CDM,3104437,LAB BLOOD TYPE RHD NS,79.0,59.8,20.54,76.63,29
CDM,3104452,LAB BLOOD TYPE AG RBC PT EA,751.0,568.51,195.26,728.47,29
CDM,3104460,LAB BLOOD TYPE PHENOTYPING RH COMP,122.0,92.35,31.72,118.34,29
CDM,3104486,LAB PRETREAT RBC AB CHEMICAL NS,150.0,113.55,39.0,145.5,29
CDM,3104494,LAB PRETREAT SERUM ABSORP NS,277.0,159.55,72.02,268.69,29
CDM,3104536,LAB CULT BACT AEROBIC BARTONELLA,26.0,13.81,6.76,25.22,29
CDM,3104544,LAB ISO VIRUS SHELL VIAL ID W IF NS,106.0,56.29,27.56,102.82,29
CDM,3104551,LAB DET AG IA IMM ENZ LEGN URINE NS,66.0,35.05,17.16,64.02,29
CDM,3104569,LAB DET IA HSV QN,129.0,68.5,33.54,125.13,29
CDM,3104577,LAB DET IA PRB AMP NS,106.0,56.29,27.56,102.82,29
CDM,3104585,LAB GENOTYPE IA HEPATITIS C NS,773.0,410.46,200.98,749.81,29
CDM,3104593,LAB CULT TISS NON-NEO LYMPHOCYTE NS,350.0,75.6,91.0,339.5,29
CDM,3104619,LAB INHIBIN A,57.0,32.83,14.82,55.29,29
CDM,3104643,LAB ESTRIOL SERUM,73.0,35.19,18.98,70.81,29
CDM,3104650,LAB SIROLIMUS,57.0,27.47,14.82,55.29,29
CDM,3104692,LAB DET AG IA RSV IMM OPT,40.0,21.24,10.4,38.8,29
CDM,3105129,LAB SICKLING RBC REDUCTION,56.0,26.99,14.56,54.32,29
CDM,3105194,POC CARBOXYHEMOGLOBIN QN,37.0,17.83,9.62,35.89,29
CDM,3105210,POC GASES BLD ANY COMBO W SAT O2,237.0,114.23,61.62,229.89,29
CDM,3105244,LAB DET AG IA IMM ENZ HEP B SURF,58.0,30.8,15.08,56.26,29
CDM,3105343,LAB AMIKACIN PEAK,59.0,28.44,15.34,57.23,29
CDM,3105350,LAB AMIKACIN RANDOM,62.0,29.88,16.12,60.14,29
CDM,3105368,LAB AMIKACIN TROUGH,62.0,29.88,16.12,60.14,29
CDM,3105392,LAB IMM AB GBM QN NS,52.0,25.06,13.52,50.44,29
CDM,3105400,LAB IMM AG ANTI-SOLUBLE LIVER QN,71.0,34.22,18.46,68.87,29
CDM,3105434,LAB ACIDS FATTY VERY LONG CHAIN,205.0,98.81,53.3,198.85,29
CDM,3105467,LAB IMM AB QN NS,142.0,81.79,36.92,137.74,29
CDM,3105475,LAB DET IA PARVOVIRUS PCR PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3105509,LAB ALBUMIN SRM/PLASMA/BLD WHL NS,63.0,30.37,16.38,61.11,29
CDM,3105525,LAB HEMOGLOBIN FRCTN&QN ELECTRO NS,71.0,34.22,18.46,68.87,29
CDM,3105533,LAB ISO VIRUS INOC TISSUE NS,100.0,53.1,26.0,97.0,29
CDM,3105566,POC BILIRUBIN TOTAL TRANSQ,16.0,7.71,4.16,15.52,29
CDM,3105608,LAB ACYLCARNITINES QN EA,115.0,55.43,29.9,111.55,29
CDM,3105616,LAB AB ENA CENTROMERE B,60.0,34.56,15.6,58.2,29
CDM,3105681,LAB DET AG IA STREP GROUP A IMM OPT,50.0,26.55,13.0,48.5,29
CDM,3105756,POC GASES BLD PH ONLY,33.0,15.91,8.58,32.01,29
CDM,3105772,LAB CROSS LINKS N-TELOPEPTIDE,68.0,32.78,17.68,65.96,29
CDM,3105855,LAB LEAD BLOOD NS,37.0,17.83,9.62,35.89,29
CDM,3105871,LAB SCR METABOLIC NEWBORN,157.0,118.85,40.82,152.29,29
CDM,3106036,LAB AB LYME DISEASE CONFIRMATORY,61.0,35.14,15.86,59.17,29
CDM,3106051,LAB CULT TISS NON-NEO SKIN/BX NS,423.0,91.37,109.98,410.31,29
CDM,3106069,LAB CULT BACT AEROBIC ID DF ADDL,25.0,13.28,6.5,24.25,29
CDM,3106168,LAB CROSSMATCH ELECTRONIC,359.0,271.76,93.34,348.23,29
CDM,3106176,LAB AB PEPTIDE CYCLIC CITRUL,60.0,34.56,15.6,58.2,29
CDM,3106390,LAB NIACIN,94.0,45.31,24.44,91.18,29
CDM,3106440,LAB ALLG IGG QN/SEMI QN EA,109.0,62.78,28.34,105.73,29
CDM,3106531,LAB RENIN NS,66.0,31.81,17.16,64.02,29
CDM,3106572,LAB CULT BACT AEROBIC OTHER NS,68.0,36.11,17.68,65.96,29
CDM,3106622,LAB DET AG IA IMM ENZ GIARDIA,36.0,19.12,9.36,34.92,29
CDM,3106648,LAB AB FTA CONFIRM,40.0,23.04,10.4,38.8,29
CDM,3106689,LAB IMM TRYPTASE QN,77.0,37.11,20.02,74.69,29
CDM,3106721,LAB IMMUNOFIXATION EP SERUM,68.0,39.17,17.68,65.96,29
CDM,3106911,LAB TRANSFERASE AMINO ALANINE NS,59.0,28.44,15.34,57.23,29
CDM,3106929,LAB TRANSFERASE AMINO ASPARTATE NS,76.0,36.63,19.76,73.72,29
CDM,3106994,LAB AB YERSINIA,76.0,43.78,19.76,73.72,29
CDM,3107026,LAB VITAMIN D 25 HYDROXY W FRAC,89.0,42.9,23.14,86.33,29
CDM,3107067,LAB TEST SKIN TB INTRADERMAL,62.0,35.71,16.12,60.14,29
CDM,3107133,LAB AB BACTERIUM NONSPECIFIED NS,153.0,88.13,39.78,148.41,29
CDM,3107141,LAB AB ENA NS,65.0,37.44,16.9,63.05,29
CDM,3107166,LAB DET AG IA IMM ENZ INFLUENZA A/B,43.0,22.83,11.18,41.71,29
CDM,3107265,LAB IMM RIA PTH REL PROT QN,72.0,34.7,18.72,69.84,29
CDM,3107356,LAB AFP-L3 ISOFORM FRAC&AFP TOTAL,194.0,93.51,50.44,188.18,29
CDM,3107364,LAB LIPOPROTEIN PHOSPHOLIPASE A2,139.0,67.0,36.14,134.83,29
CDM,3107422,LAB DET IA MRSA PRB AMP NS,106.0,56.29,27.56,102.82,29
CDM,3107430,LAB DET IA STREP GROUP B PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3107489,LAB AB WEST NILE VIRUS IGM NS,72.0,41.47,18.72,69.84,29
CDM,3107497,LAB AB WEST NILE VIRUS NS,72.0,41.47,18.72,69.84,29
CDM,3107505,LAB DET AG IA IMM ENZ ASPRGLS NS,152.0,80.71,39.52,147.44,29
CDM,3107539,COLLECT SPEC BLD VENIPNCTR LEGAL,34.0,25.74,8.84,32.98,29
CDM,3107596,LAB LIPOPROTEIN CHOLESTEROL LDL,32.0,15.42,8.32,31.04,29
CDM,3107612,LAB HCG QN NS,67.0,32.29,17.42,64.99,29
CDM,3107620,LAB MICROALBUMIN URINE QN NS,68.0,32.78,17.68,65.96,29
CDM,3107638,LAB PROT TTL SRM/PLASMA/BLD WHL NS,53.0,25.55,13.78,51.41,29
CDM,3107646,LAB PROT URINE NS,59.0,28.44,15.34,57.23,29
CDM,3107653,LAB PSA TOTAL NS,70.0,33.74,18.2,67.9,29
CDM,3107661,LAB PTT PLASMA/BLD WHL NS,54.0,26.03,14.04,52.38,29
CDM,3107679,LAB SMEAR GRAM/GIEMSA NS,91.0,68.89,23.66,88.27,29
CDM,3107687,LAB SUSCPT MIC PLATE EA NS,152.0,115.06,39.52,147.44,29
CDM,3107703,LAB CORTISOL BINDING GLOBULIN,54.0,26.03,14.04,52.38,29
CDM,3107745,LAB SCR PSA,56.0,26.99,14.56,54.32,29
CDM,3107828,LAB DET IA EBV PCR QN,129.0,68.5,33.54,125.13,29
CDM,3107836,LAB IRON TISSUE LIVER,208.0,100.26,54.08,201.76,29
CDM,3107877,LAB SMEAR STAIN FL AFB NS,68.0,36.11,17.68,65.96,29
CDM,3107893,LAB INHIBITOR VWF PROTEASE,225.0,108.45,58.5,218.25,29
CDM,3107919,LAB COUNT BLD RETIC AUTO W PARAM,112.0,53.98,29.12,108.64,29
CDM,3108032,LAB CLOTTING PROTEIN S TOTAL NS,58.0,27.96,15.08,56.26,29
CDM,3108040,LAB CLOTTING PROTEIN S FREE NS,60.0,28.92,15.6,58.2,29
CDM,3108057,LAB PROT FLUID BODY NS,52.0,25.06,13.52,50.44,29
CDM,3108123,LAB LACTOFERRIN FECAL QL NS,98.0,47.24,25.48,95.06,29
CDM,3108180,LAB PATH GROSS&MICRO LVL 5 NS,751.0,330.44,195.26,728.47,29
CDM,3108198,LAB STAIN SPECIAL 1 NS,110.0,48.4,28.6,106.7,29
CDM,3108271,LAB PATH GROSS&MICRO LVL 4 NS,110.0,48.4,28.6,106.7,29
CDM,3108305,LAB CYTOM FLOW TECH MARKER 1ST NS,751.0,162.22,195.26,728.47,29
CDM,3108313,LAB CYTOM FLOW TECH MARKER ADDL NS,126.0,27.22,32.76,122.22,29
CDM,3108404,LAB LIPOPROTEIN PART NO/S&SBCLS QN,103.0,49.65,26.78,99.91,29
CDM,3108545,LAB IMM IL-2 RECPT SOLUBLE QN,368.0,177.38,95.68,356.96,29
CDM,3108552,LAB SEMEN SPERM PRESENCE MOTILITY,37.0,28.01,9.62,35.89,29
CDM,3108628,POC HEMOGLOBIN METHEMOGLOBIN QN,25.0,12.05,6.5,24.25,29
CDM,3108651,LAB CALPROTECTIN FECAL,250.0,120.5,65.0,242.5,29
CDM,3108735,LAB IMM ACHR BLOCKING QN,99.0,57.02,25.74,96.03,29
CDM,3108768,LAB AB PROTOZOA BABESIA,58.0,33.41,15.08,56.26,29
CDM,3108792,LAB ACID MYCOPHENOLIC NS,55.0,26.51,14.3,53.35,29
CDM,3108891,LAB DET IA HERPES 6 PCR QN,126.0,66.91,32.76,122.22,29
CDM,3108909,LAB DET IA JC VIRUS PCR PRB AMP,123.0,65.31,31.98,119.31,29
CDM,3108917,LAB DET IA JC VIRUS PCR QN,129.0,68.5,33.54,125.13,29
CDM,3108925,LAB DET IA BK VIRUS PCR QN NS,129.0,68.5,33.54,125.13,29
CDM,3108933,LAB VORICONAZOLE,127.0,61.21,33.02,123.19,29
CDM,3109022,LAB CYSTATIN C,56.0,26.99,14.56,54.32,29
CDM,3109097,LAB SCR CULT H PYLORI SGL,20.0,10.62,5.2,19.4,29
CDM,3109212,LAB AB DNA STRANDED NATVE/DOUBLE NS,62.0,35.71,16.12,60.14,29
CDM,3109287,LAB IG IGE NS,58.0,27.96,15.08,56.26,29
CDM,3109303,LAB GONADOTROPIN LH NS,57.0,27.47,14.82,55.29,29
CDM,3109311,LAB DEHYDROGENASE G6PD QN NS,56.0,26.99,14.56,54.32,29
CDM,3109352,LAB ANA TITER NS,115.0,66.24,29.9,111.55,29
CDM,3109378,LAB AB COCCIDIOIDES NS,66.0,38.02,17.16,64.02,29
CDM,3109428,LAB SOMATOMEDIN NS,64.0,30.85,16.64,62.08,29
CDM,3109436,LAB PROT GLYCATED NS,56.0,26.99,14.56,54.32,29
CDM,3109444,LAB AB HERPES SIMPLEX TYPE 1 NS,53.0,30.53,13.78,51.41,29
CDM,3109485,LAB FAT/LIPIDS FECES QL NS,68.0,32.78,17.68,65.96,29
CDM,3109501,LAB DET AG IA IMM ENZ HEP DELTA AGT,175.0,92.93,45.5,169.75,29
CDM,3109576,LAB CLOTTING FACTOR 8 1-STG NS,114.0,54.95,29.64,110.58,29
CDM,3109584,LAB CLOTTING FACTOR 9 PTC/XMAS NS,75.0,36.15,19.5,72.75,29
CDM,3109600,LAB CLOTTING FACTOR 11 PTA NS,89.0,42.9,23.14,86.33,29
CDM,3109626,LAB AB EBV EBNA NS,54.0,31.1,14.04,52.38,29
CDM,3109642,LAB AB EBV VCA IGM NS,55.0,31.68,14.3,53.35,29
CDM,3109659,LAB AB VARICELLA-ZOSTER IGM NS,39.0,22.46,10.14,37.83,29
CDM,3109667,LAB AB VARICELLA-ZOSTER IGG NS,53.0,30.53,13.78,51.41,29
CDM,3109675,LAB CLOTTING FACTOR 8 VWF RIST NS,87.0,41.93,22.62,84.39,29
CDM,3109709,LAB PHOSPHORUS INORGANIC URINE NS,18.0,8.68,4.68,17.46,29
CDM,3109725,LAB SICKLING RBC REDUCTION NS,91.0,43.86,23.66,88.27,29
CDM,3109758,LAB FACTOR RHEUMATOID QN NS,55.0,31.68,14.3,53.35,29
CDM,3109766,LAB LIPOPROTEIN A NS,58.0,27.96,15.08,56.26,29
CDM,3109840,LAB AB MICROSOMAL THYROID EA NS,55.0,31.68,14.3,53.35,29
CDM,3109915,LAB MICROGLOBULIN BETA-2 NS,93.0,44.83,24.18,90.21,29
CDM,3109956,LAB ESTROGEN TOTAL NS,66.0,31.81,17.16,64.02,29
CDM,3109980,LAB THYROGLOBULIN NS,57.0,27.47,14.82,55.29,29
CDM,3110038,LAB CLOTTING FACTOR 13 STB FBR NS,98.0,47.24,25.48,95.06,29
CDM,3110053,LAB PRIMIDONE NS,59.0,28.44,15.34,57.23,29
CDM,3110137,LAB AB THYROGLOBULIN NS,96.0,55.3,24.96,93.12,29
CDM,3110152,LAB PROT C-REACTIVE SENS HIGH NS,131.0,75.46,34.06,127.07,29
CDM,3110160,LAB DET AG IA IMM H PYLORI STOOL NS,44.0,23.36,11.44,42.68,29
CDM,3110301,LAB IMM MUSK QN,56.0,32.26,14.56,54.32,29
CDM,3110319,LAB SCR AB MUSCLE SMOOTH FL NS,56.0,32.26,14.56,54.32,29
CDM,3110517,LAB CHROMIUM,61.0,29.4,15.86,59.17,29
CDM,3110582,LAB ALPHA2-MACROGLOBULIN QN,72.0,34.7,18.72,69.84,29
CDM,3110590,LAB IMM ACHR MODULATING QN,78.0,44.93,20.28,75.66,29
CDM,3110608,LAB ACID MYCOPHENOLIC,55.0,26.51,14.3,53.35,29
CDM,3110715,LAB SUSCPT DILUTION MACROBROTH NS,115.0,61.07,29.9,111.55,29
CDM,3110731,LAB CULT FUNGI ID DF MOLD NS,138.0,73.28,35.88,133.86,29
CDM,3110764,LAB ELASTASE PANCREATIC FECAL,104.0,50.13,27.04,100.88,29
CDM,3110772,LAB DET IA EBV PCR QN NS,129.0,68.5,33.54,125.13,29
CDM,3110798,LAB DET IA ADENOVIRUS PCR QN,129.0,68.5,33.54,125.13,29
CDM,3110806,LAB DET IA HHV NON 6 PCR QN,129.0,68.5,33.54,125.13,29
CDM,3110814,LAB DET IA HHV-8 PCR PRB AMP,124.0,65.84,32.24,120.28,29
CDM,3110822,LAB DET IA EBV PCR PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3110830,LAB AB HERPES SIMPLEX TYPE 2 NS,59.0,33.98,15.34,57.23,29
CDM,3110863,LAB COAGULATION&FIBRINOLYSIS,164.0,79.05,42.64,159.08,29
CDM,3110871,LAB AB ENA JO1,123.0,70.85,31.98,119.31,29
CDM,3110889,LAB IMM MS RIBO P PROTEIN QL,35.0,16.87,9.1,33.95,29
CDM,3110897,LAB AB ENA CHROMATIN,124.0,71.42,32.24,120.28,29
CDM,3110905,LAB AB ENA SM/RNP,124.0,71.42,32.24,120.28,29
CDM,3110921,LAB AB LYME DISEASE IGG IGM,66.0,38.02,17.16,64.02,29
CDM,3110996,LAB KAPPA/LAMBDA LIGHT NS,55.0,26.51,14.3,53.35,29
CDM,3111002,LAB DET IA BK VIRUS PCR PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3111028,LAB DET IA CHLAMYD TRAC PRB AMP NS,115.0,61.07,29.9,111.55,29
CDM,3111036,LAB DET IA GC PRB AMP NS,106.0,56.29,27.56,102.82,29
CDM,3111069,LAB AB TOXOPLASMA IGM,60.0,34.56,15.6,58.2,29
CDM,3111077,LAB AB TOXOPLASMA IGG,60.0,34.56,15.6,58.2,29
CDM,3111093,LAB AB PARAINFLUENZA,66.0,38.02,17.16,64.02,29
CDM,3111101,LAB IMM RIA POLY PANCREATIC QN,78.0,37.6,20.28,75.66,29
CDM,3111119,LAB AB STRONGYLOIDES,69.0,39.74,17.94,66.93,29
CDM,3111168,LAB TRIIODOTHYRONINE T3 TOTAL NS,43.0,20.73,11.18,41.71,29
CDM,3111176,LAB HEMOGLOBIN FRCTN&QN CHROMAT NS,55.0,26.51,14.3,53.35,29
CDM,3111234,LAB DET IA MYCOBCT AV-INTRA PRB AMP,270.0,143.37,70.2,261.9,29
CDM,3111283,LAB IMM RIA RECEPTOR TSH QN,101.0,48.68,26.26,97.97,29
CDM,3111341,LAB IMM MS HISTONE QL,62.0,29.88,16.12,60.14,29
CDM,3111390,LAB SCR AB PURKINJE FL,64.0,36.86,16.64,62.08,29
CDM,3111416,LAB AGG PARTICLE TITER STREPTOZYME,81.0,46.66,21.06,78.57,29
CDM,3111432,LAB DET IA VZV PCR QN,129.0,68.5,33.54,125.13,29
CDM,3111457,LAB NICKEL,124.0,59.77,32.24,120.28,29
CDM,3111473,LAB ONCOPROTEIN DCP,194.0,93.51,50.44,188.18,29
CDM,3111630,LAB PROCALCITONIN,141.0,67.96,36.66,136.77,29
CDM,3111648,LAB FNCT CELL W STIM&DET BIOMARK,408.0,235.01,106.08,395.76,29
CDM,3111655,LAB AG CELL MONONUC QN EA AG,93.0,53.57,24.18,90.21,29
CDM,3111671,LAB AB ID IG PLATELET ASSOCIATED,236.0,135.94,61.36,228.92,29
CDM,3111713,LAB LACTOFERRIN FECAL QN,204.0,98.33,53.04,197.88,29
CDM,3111804,LAB MCG PROBE DNA PROBE EA NS,272.0,58.75,70.72,263.84,29
CDM,3111812,LAB MCG IN SITU INT 100-300 CELL NS,154.0,33.26,40.04,149.38,29
CDM,3111820,LAB CONCENTRATION AFB IA NS,71.0,37.7,18.46,68.87,29
CDM,3111838,LAB CULT AFB ID ISOLATES NS,65.0,34.52,16.9,63.05,29
CDM,3111895,LAB DET IA TOXIN C DIFF PRB AMP NS,112.0,59.47,29.12,108.64,29
CDM,3111911,LAB BLOOD OCCULT FECES 1-3 IMM QL,62.0,29.88,16.12,60.14,29
CDM,3111929,LAB IMM RECEPTOR TSH QN,52.0,25.06,13.52,50.44,29
CDM,3112026,LAB AB LEPTOSPIRA TITER,154.0,88.7,40.04,149.38,29
CDM,3112059,LAB AB CAMPYLOBACTER NS,40.0,23.04,10.4,38.8,29
CDM,3112075,LAB COUNT TOTAL CELLS CD56 NK NS,114.0,65.66,29.64,110.58,29
CDM,3112182,LAB IMM AB QN PNEUMOCOCCAL,51.0,29.38,13.26,49.47,29
CDM,3112224,LAB TB MEAS IMMUNITY GAMMA INTERFRN,186.0,107.14,48.36,180.42,29
CDM,3112232,LAB VITAMIN B-12 CAPACITY BNDG NS,66.0,31.81,17.16,64.02,29
CDM,3112240,LAB DET IA HEP B QN,129.0,68.5,33.54,125.13,29
CDM,3112331,LAB CARBOXYHEMOGLOBIN QN,56.0,26.99,14.56,54.32,29
CDM,3112372,LAB DET IA CHLAMYD PNEU PRB AMP NS,328.0,174.17,85.28,318.16,29
CDM,3112570,LAB NEUTRAL PHOSPHO HEXAGONAL,71.0,34.22,18.46,68.87,29
CDM,3112646,LAB TRANSFERASE GAMMA-GLUTAMYL NS,62.0,29.88,16.12,60.14,29
CDM,3112661,LAB PROT 4 HUMAN EPIDIDYMIS,97.0,55.87,25.22,94.09,29
CDM,3112679,POC PAMG-1 CERVICOVAGINAL QL,295.0,142.19,76.7,286.15,29
CDM,3112695,LAB IMM AB GBM QN,60.0,28.92,15.6,58.2,29
CDM,3112703,LAB GENOTYPE IA HIV-1 TROPISM CORCP,387.0,205.5,100.62,375.39,29
CDM,3112711,LAB ZONISAMIDE,79.0,38.08,20.54,76.63,29
CDM,3112737,LAB PH FLUID BODY NOS NS,104.0,50.13,27.04,100.88,29
CDM,3112786,LAB HEAVY METAL QN COBALT,288.0,138.82,74.88,279.36,29
CDM,3112950,LAB SEPARATION RED CELL,268.0,202.88,69.68,259.96,29
CDM,3113032,LAB PHENOBARBITAL NS,59.0,28.44,15.34,57.23,29
CDM,3113065,LAB FDP D-DIMER QN NS,92.0,44.34,23.92,89.24,29
CDM,3113073,LAB CULT BACT AEROBIC STOOL PATH NS,63.0,33.45,16.38,61.11,29
CDM,3113081,LAB CULT TYPING ID NUC ACID PRB AMP,137.0,72.75,35.62,132.89,29
CDM,3113115,LAB DET IA BK VIRUS PCR QN URINE,129.0,68.5,33.54,125.13,29
CDM,3113131,LAB PROT WB W INTRP ID CREUTZ-JAKOB,89.0,42.9,23.14,86.33,29
CDM,3113149,LAB IMM AB QN CREUTZFELDT-JAKOB,83.0,47.81,21.58,80.51,29
CDM,3113156,LAB SPCTPHOT 1-3-BETA-D-GLUCAN,157.0,75.67,40.82,152.29,29
CDM,3113206,LAB ELECTRO NS,185.0,89.17,48.1,179.45,29
CDM,3113222,LAB DET IA TOXOPLASMA PCR QN,130.0,69.03,33.8,126.1,29
CDM,3113230,LAB DET IA PNEUMOCYSTIS PCR QN,275.0,146.02,71.5,266.75,29
CDM,3113255,LAB DET AG IA IMM ENZ ENTAM HIST NS,73.0,38.76,18.98,70.81,29
CDM,3113362,LAB TB MEAS IMMUNITY T-CELL SUSP,300.0,172.8,78.0,291.0,29
CDM,3113420,LAB DET IA PARVOVIRUS PCR QN,141.0,74.87,36.66,136.77,29
CDM,3113461,LAB DET IA TOXIN C DIFF PRB AMP,112.0,59.47,29.12,108.64,29
CDM,3113479,LAB IMM MS GLIADIN QL,59.0,33.98,15.34,57.23,29
CDM,3113487,LAB IMM MS TRANSGLUTAMINASE QL,59.0,33.98,15.34,57.23,29
CDM,3113495,LAB AB FL TITER NS,78.0,44.93,20.28,75.66,29
CDM,3113545,LAB COUNT TOTAL CELLS T NS,114.0,65.66,29.64,110.58,29
CDM,3113552,LAB COUNT CELLS T CD4&CD8 RATIO NS,141.0,81.22,36.66,136.77,29
CDM,3113636,LAB SCR FIBRINOLYSINS/COAG NS,47.0,22.65,12.22,45.59,29
CDM,3113685,LAB PLATELET RETICULATED,108.0,52.06,28.08,104.76,29
CDM,3113727,LAB PRETREAT SERUM INCUB W DRUGS,940.0,541.44,244.4,911.8,29
CDM,3113750,LAB KAPPA/LAMBDA LIGHT,69.0,33.26,17.94,66.93,29
CDM,3113784,LAB GENE BCR/ABL1 BREAKPOINT MAJOR,492.0,239.11,127.92,477.24,29
CDM,3113792,LAB GENE BCR/ABL1 BREAKPOINT MIN NS,435.0,211.41,113.1,421.95,29
CDM,3113800,LAB GENE BCR/ABL1 BREAKPOINT OTHER,644.0,312.98,167.44,624.68,29
CDM,3113826,LAB GENE BRAF VAR V600E NS,527.0,256.12,137.02,511.19,29
CDM,3113909,LAB GENE CFTR VAR COMMON,1670.0,811.62,434.2,1619.9,29
CDM,3113941,LAB GENE CFTR INTRON 8 POLY-T,507.0,246.4,131.82,491.79,29
CDM,3114006,LAB GENE F2 VAR 20210G>A NS,198.0,96.23,51.48,192.06,29
CDM,3114014,LAB GENE F5 VAR LEIDEN,221.0,107.41,57.46,214.37,29
CDM,3114030,LAB GENE FMR1 DET ALLELES ABNORMAL,172.0,83.59,44.72,166.84,29
CDM,3114048,LAB GENE FMR1 CHARACTER ALLELES,135.0,65.61,35.1,130.95,29
CDM,3114055,LAB GENE FLT3 VAR ITD,497.0,241.54,129.22,482.09,29
CDM,3114097,LAB GENE HFE VAR COMMON NS,197.0,95.74,51.22,191.09,29
CDM,3114105,LAB GENE HBA1/HBA2 DEL/VAR COMMON,307.0,149.2,79.82,297.79,29
CDM,3114121,LAB GENE IGH REARRANGEMENT AMP,594.0,288.68,154.44,576.18,29
CDM,3114147,LAB GENE IGH MUT VARIABLE REGION,884.0,429.62,229.84,857.48,29
CDM,3114154,LAB GENE IGK REARRANGEMENT CLONAL,519.0,252.23,134.94,503.43,29
CDM,3114162,LAB GENE MARKERS STR SPEC PT&CMP,700.0,340.2,182.0,679.0,29
CDM,3114188,LAB GENE CHIMERISM WO CELL SLCT NS,1139.0,553.55,296.14,1104.83,29
CDM,3114204,LAB GENE JAK2 VAR V617F NS,275.0,133.65,71.5,266.75,29
CDM,3114212,LAB GENE KRAS VAR CODONS 12&13 NS,580.0,281.88,150.8,562.6,29
CDM,3114261,LAB GENE MTHFR VAR COMMON NS,197.0,95.74,51.22,191.09,29
CDM,3114279,LAB GENE MLH1 SEQ FULL,2027.0,985.12,527.02,1966.19,29
CDM,3114303,LAB GENE MSH2 SEQ FULL,1146.0,556.96,297.96,1111.62,29
CDM,3114360,LAB GENE INSTABILITY MICROSATELLITE,1046.0,508.36,271.96,1014.62,29
CDM,3114402,LAB GENE NPM1 VAR EXON 12,740.0,359.64,192.4,717.8,29
CDM,3114485,LAB GENE SERPINA1 VAR COMMON,346.0,168.16,89.96,335.62,29
CDM,3114493,LAB GENE TRB REARRANGEMENT AMP,627.0,304.72,163.02,608.19,29
CDM,3114519,LAB GENE TRG REARRANGEMENT CLONAL,605.0,294.03,157.3,586.85,29
CDM,3114527,LAB GENE UGT1A1 VAR COMMON NS,702.0,341.17,182.52,680.94,29
CDM,3114568,LAB GENE TYPING HLA 1 LR CMP,1211.0,588.55,314.86,1174.67,29
CDM,3114600,LAB GENE TYPING HLA 2 LR LOCUS EA,367.0,178.36,95.42,355.99,29
CDM,3114618,LAB GENE TYPING HLA 2 LR AG 1 EA,285.0,138.51,74.1,276.45,29
CDM,3114659,LAB GENE TYPING HLA 1 HR ALLE 1/GRP,510.0,247.86,132.6,494.7,29
CDM,3114675,LAB GENE TYPING HLA 2 HR ALLE 1/GRP,328.0,159.41,85.28,318.16,29
CDM,3114683,LAB PROC PATHOLOGY MOLEC LEVEL 1,192.0,93.31,49.92,186.24,29
CDM,3114709,LAB PROC PATHOLOGY MOLEC LEVEL 3,451.0,219.19,117.26,437.47,29
CDM,3114717,LAB PROC PATHOLOGY MOLEC LEVEL 4 NS,617.0,299.86,160.42,598.49,29
CDM,3114725,LAB PROC PATHOLOGY MOLEC LEVEL 5,825.0,400.95,214.5,800.25,29
CDM,3114733,LAB PROC PATHOLOGY MOLEC LEVEL 6,905.0,439.83,235.3,877.85,29
CDM,3114741,LAB PROC PATHOLOGY MOLEC LEVEL 7,849.0,412.61,220.74,823.53,29
CDM,3114758,LAB PROC PATHOLOGY MOLEC LEVEL 8,2539.0,1233.95,660.14,2462.83,29
CDM,3114766,LAB PROC PATHOLOGY MOLEC LEVEL 9,6000.0,2916.0,1560.0,5820.0,29
CDM,3114824,LAB SCR AB NMDA RECEPTOR FL,167.0,96.19,43.42,161.99,29
CDM,3114840,LAB THROMBIN TIME PLASMA NS,18.0,8.68,4.68,17.46,29
CDM,3114931,LAB GENE MA CYTO COPY NO&SNP BLD NS,3480.0,1691.28,904.8,3375.6,29
CDM,3114949,LAB GENE MA CYTO COPY NO&SNP POC,3480.0,1691.28,904.8,3375.6,29
CDM,3114956,LAB COUNT BLD RBC AUTO NS,63.0,30.37,16.38,61.11,29
CDM,3114964,LAB COUNT BLD HEMATOCRIT NS,69.0,33.26,17.94,66.93,29
CDM,3114972,LAB COUNT BLD HEMOGLOBIN NS,60.0,28.92,15.6,58.2,29
CDM,3114998,LAB DEXAMETHASONE,60.0,28.92,15.6,58.2,29
CDM,3115003,LAB FLUCONAZOLE,111.0,53.5,28.86,107.67,29
CDM,3115011,LAB SCR AB SYPHILIS NS,40.0,23.04,10.4,38.8,29
CDM,3115060,LAB DET IA TRICHOMONAS VAG PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3115151,LAB OLANZAPINE,197.0,94.95,51.22,191.09,29
CDM,3115169,LAB DET IA B PERTUSSIS PCR PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3115193,LAB B CELLS CD19 COUNT TOTAL NS,114.0,65.66,29.64,110.58,29
CDM,3115649,LAB DET IA LEGIONELL PNEUM PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3115664,LAB POSACONAZOLE,118.0,56.88,30.68,114.46,29
CDM,3115672,LAB DIGOXIN TOTAL,53.0,25.55,13.78,51.41,29
CDM,3115698,LAB ACID VALPROIC TOTAL,53.0,25.55,13.78,51.41,29
CDM,3115748,LAB MORPHO HER2 MANUAL PER SPEC NS,374.0,164.56,97.24,362.78,29
CDM,3115755,LAB MORPHO HER2 COMP PER SPEC,751.0,330.44,195.26,728.47,29
CDM,3115904,LAB IMHST/IMCYT AB 1ST PER SPEC NS,359.0,157.96,93.34,348.23,29
CDM,3115912,LAB IMHST/IMCYT AB PER SPEC NS ADDL,137.0,60.28,35.62,132.89,29
CDM,3115979,LAB KETONES NS,61.0,29.4,15.86,59.17,29
CDM,3116001,LAB MORPHO ISH COMP MULT SPEC NS,553.0,243.32,143.78,536.41,29
CDM,3116035,LAB FDP FSP AGG SEMI QN NS,80.0,38.56,20.8,77.6,29
CDM,3116043,LAB MORPHO ISH MAN MULT PER SPEC NS,359.0,157.96,93.34,348.23,29
CDM,3116126,LAB ACID VALPROIC TOTAL NS,66.0,31.81,17.16,64.02,29
CDM,3116134,LAB ACID VALPROIC FREE,66.0,31.81,17.16,64.02,29
CDM,3116142,LAB GENE TPMT NS,525.0,255.15,136.5,509.25,29
CDM,3116316,LAB DET AG IA IMM HIV1 W HIV 1&2,87.0,46.2,22.62,84.39,29
CDM,3116332,LAB DET IA HIV-1 QN NS,256.0,135.94,66.56,248.32,29
CDM,3116357,LAB PH STOOL NS,72.0,34.7,18.72,69.84,29
CDM,3116365,LAB SCR AB PARANEOPLASTIC FL,93.0,53.57,24.18,90.21,29
CDM,3116381,LAB HSP 70 WB W INTRP,174.0,83.87,45.24,168.78,29
CDM,3116399,LAB GENE BCR/ABL1 BREAKPOINT MIN,435.0,211.41,113.1,421.95,29
CDM,3116407,LAB GENE BCR/ABL1 REFLEX P210,492.0,239.11,127.92,477.24,29
CDM,3116423,LAB CONCENTRATION ANY TYPE IA NS,128.0,67.97,33.28,124.16,29
CDM,3116431,LAB DET AG IA IF PNEUMOCYSTIS NS,76.0,40.36,19.76,73.72,29
CDM,3116464,LAB AB MITOCHONDRIA EA,150.0,86.4,39.0,145.5,29
CDM,3116472,LAB GENE ANLYS MUT CALRETICULIN,365.0,177.39,94.9,354.05,29
CDM,3116506,LAB GENE MLH1 METHYLATION,614.0,298.4,159.64,595.58,29
CDM,3116514,LAB CHROMAT MS NON-DRUG QL/QN NS,73.0,35.19,18.98,70.81,29
CDM,3116522,LAB MS&MS TNDM NON-DRUG QL/QN,73.0,35.19,18.98,70.81,29
CDM,3116530,LAB AB HEPATITIS A,55.0,31.68,14.3,53.35,29
CDM,3116571,LAB CLOMIPRAMINE,62.0,29.88,16.12,60.14,29
CDM,3116589,LAB GENE KRAS VAR ADDL NS,580.0,281.88,150.8,562.6,29
CDM,3116597,LAB GENE ABL1 VAR KD,900.0,437.4,234.0,873.0,29
CDM,3116605,LAB GENE CEBPA SEQ FULL,726.0,352.84,188.76,704.22,29
CDM,3116662,LAB GENE FLT3 VAR TKD,249.0,121.01,64.74,241.53,29
CDM,3116670,LAB DRG DF ANTD CYCL AMIT DAY 1-2,62.0,29.88,16.12,60.14,29
CDM,3116704,LAB DRG DF BENZ DAY 1-12,84.0,40.49,21.84,81.48,29
CDM,3116720,LAB DRG DF BENZ CLONAZEPM DAY 1-12,67.0,32.29,17.42,64.99,29
CDM,3116837,LAB DRG DF ANTD CYCL DESI DAY 1-2NS,62.0,29.88,16.12,60.14,29
CDM,3116860,LAB DRG DF ANTD CYCL DOXE DAY 1-2,62.0,29.88,16.12,60.14,29
CDM,3116928,LAB DRG DF ANTD CYCL IMIPRM DAY 1-2,62.0,29.88,16.12,60.14,29
CDM,3116951,LAB DRG DF ANTD CYCL NORT DAY 1-2,68.0,32.78,17.68,65.96,29
CDM,3117017,LAB DRG DF ANLG SALICYLATE DAY 1-2,154.0,74.23,40.04,149.38,29
CDM,3117041,LAB DRG DF ANLG ACETAMINPHN DAY 1-2,154.0,74.23,40.04,149.38,29
CDM,3117074,LAB DRG DF ETOH EXCEPT BR DAY,117.0,56.39,30.42,113.49,29
CDM,3117082,LAB DRG DF ETOH EXCEPT BR DAY NS,61.0,29.4,15.86,59.17,29
CDM,3117108,LAB DRG DF AMPH/METH DAY 1-2 NS,73.0,35.19,18.98,70.81,29
CDM,3117181,LAB DRG DF BARB URINE DAY,67.0,32.29,17.42,64.99,29
CDM,3117199,LAB DRG DF COCAINE DAY,67.0,32.29,17.42,64.99,29
CDM,3117256,LAB DRG DF MSCL RELAX DAY 1-2,154.0,74.23,40.04,149.38,29
CDM,3117272,LAB DRG DF METHADONE DAY,58.0,27.96,15.08,56.26,29
CDM,3117280,LAB DRG DF METHADONE DAY NS,67.0,32.29,17.42,64.99,29
CDM,3117298,LAB DRG DF ALKALOIDS NICOTINE DAY,105.0,50.61,27.3,101.85,29
CDM,3117306,LAB DRG DF OPIATE DAY 1+,104.0,50.13,27.04,100.88,29
CDM,3117314,LAB DRG DF OXYCODONE DAY,104.0,50.13,27.04,100.88,29
CDM,3117405,LAB DRG DF CNFRM AMPH DAY 1-2,73.0,35.19,18.98,70.81,29
CDM,3117462,LAB DRG DF CNFRM PHENCYCLDN/PCP DAY,67.0,32.29,17.42,64.99,29
CDM,3117512,LAB DRG DF SULFONYLUREAS DAY 7+,178.0,85.8,46.28,172.66,29
CDM,3117538,LAB DRG DF CANNABINOIDS DAY,84.0,40.49,21.84,81.48,29
CDM,3117611,LAB COMPLEMENT AG COMP EA NS,222.0,127.87,57.72,215.34,29
CDM,3117645,LAB DRG DF ANTIEPILEPTICS DAY 1-3,176.0,84.83,45.76,170.72,29
CDM,3117652,LAB IMM MS MYOSITIS,67.0,32.29,17.42,64.99,29
CDM,3117660,LAB DET IA GI MULT PRB 12-25TGT NS,1251.0,664.28,325.26,1213.47,29
CDM,3117686,LAB GENE MTHFR VAR COMMON,197.0,95.74,51.22,191.09,29
CDM,3117694,LAB IF AB STAIN PER SPEC ADDL NS,189.0,83.16,49.14,183.33,29
CDM,3117702,LAB IF AB STAIN INITIAL PER SPEC NS,359.0,157.96,93.34,348.23,29
CDM,3117710,LAB INTERLEUKIN 2 RECEPTOR,144.0,69.41,37.44,139.68,29
CDM,3117728,LAB DRG DF FENTANYL DAY,67.0,32.29,17.42,64.99,29
CDM,3117744,LAB GENE BRCA1&2 SEQ&DUP/DEL FULL,5475.0,2660.85,1423.5,5310.75,29
CDM,3117769,LAB IMM INTERLEUKIN 6 QN,109.0,52.54,28.34,105.73,29
CDM,3117785,LAB AB JOHN CUNNINGHAM VIRUS,1448.0,834.05,376.48,1404.56,29
CDM,3117819,LAB DRG DF METHYLENEDIOXYAMPH NS,70.0,33.74,18.2,67.9,29
CDM,3117835,LAB GENOMIC ANLY SEQ SO/HL 51+ NS,8759.0,4256.87,2277.34,8496.23,29
CDM,3117868,LAB DET IA HSV PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3117884,LAB DRG DF ANLG NON-OPIOID DAY 1-2,57.0,27.47,14.82,55.29,29
CDM,3117900,LAB DRG DF ANTD SEROTONERG DAY 1-2,51.0,24.58,13.26,49.47,29
CDM,3117918,LAB DRG DF ANTD SEROTONERG DAY 3-5,97.0,46.75,25.22,94.09,29
CDM,3117926,LAB DRG DF ANTD CYCL DAY 6+,87.0,41.93,22.62,84.39,29
CDM,3118031,LAB FETAL CHROMOSOMAL ANEUPLOIDY,2278.0,1107.11,592.28,2209.66,29
CDM,3118064,LAB GENOMIC ANLY SEQ HL 5-50 NS,2395.0,1163.97,622.7,2323.15,29
CDM,3118106,LAB DET IA MYCOBCT PRB AMP,450.0,238.95,117.0,436.5,29
CDM,3118239,LAB DRG DF ANTPSY DAY 1-3,57.0,27.47,14.82,55.29,29
CDM,3118270,LAB IMM PHOS TAU/TTL TAU/BETA42,650.0,313.3,169.0,630.5,29
CDM,3118320,LAB GENE EGFR VAR COMMON,974.0,473.36,253.24,944.78,29
CDM,3118379,LAB IMM IGFBP 3 QN,64.0,30.85,16.64,62.08,29
CDM,3118387,LAB DRG DF HEROIN METABOLITE DAY,56.0,26.99,14.56,54.32,29
CDM,3118502,LAB DET AG IA HBSAG QL/SEMI QN NS,231.0,122.66,60.06,224.07,29
CDM,3118601,LAB DRG DF ETOH BIOMRK URINE 1-2,158.0,76.16,41.08,153.26,29
CDM,3118619,LAB DRG DF METHYLPHENIDATE DAY,67.0,32.29,17.42,64.99,29
CDM,3118684,LAB GLUCOSE FLUID BODY NS,131.0,63.14,34.06,127.07,29
CDM,3118767,LAB DRG DF TRAMADOL,67.0,32.29,17.42,64.99,29
CDM,3118775,LAB DET IA CNS PRB AMP 12-25 TGT,1251.0,664.28,325.26,1213.47,29
CDM,3118791,LAB DET IA CMV QN,129.0,68.5,33.54,125.13,29
CDM,3118833,LAB AB HEPATITIS A NS,57.0,32.83,14.82,55.29,29
CDM,3118957,LAB PANTOTHENIC ACID B5,69.0,33.26,17.94,66.93,29
CDM,3119047,LAB ALBUMIN OTHER SOURCE QN EA,58.0,27.96,15.08,56.26,29
CDM,3119054,LAB ALBUMIN OTHER SOURCE QN EA NS,24.0,11.57,6.24,23.28,29
CDM,3119062,LAB ALLG IGE QN/SEMI QN CRUDE EA,56.0,32.26,14.56,54.32,29
CDM,3119070,LAB ALLG IGE QN/SEMI QN CRUDE EA NS,55.0,31.68,14.3,53.35,29
CDM,3119120,LAB DRG DF PREGABALIN,95.0,45.79,24.7,92.15,29
CDM,3119146,LAB CHROMAT/MS METHYLTETRAHYDOFOLAT,266.0,128.21,69.16,258.02,29
CDM,3119153,LAB CHROMAT/MS NEOPTERIN,275.0,132.55,71.5,266.75,29
CDM,3119179,LAB SCR AB LG1 FL,565.0,325.44,146.9,548.05,29
CDM,3119187,LAB SCR AB CASPR2 FL,606.0,349.06,157.56,587.82,29
CDM,3119211,LAB DET IA TRICHOMON VAG PRB AMP NS,111.0,58.94,28.86,107.67,29
CDM,3119252,LAB DRG DF ANTD NOT SRTNRG/CYCL DAY,52.0,25.06,13.52,50.44,29
CDM,3119260,LAB DRG DF BUPRENORPHINE DAY NS,109.0,52.54,28.34,105.73,29
CDM,3119286,LAB DRG DF GABAPENTN NON BLD DAY,56.0,26.99,14.56,54.32,29
CDM,3119294,LAB DRG DF KETAMN&NORKETMN DAY,145.0,69.89,37.7,140.65,29
CDM,3119302,LAB DRG DF HYPNOTICS SED DAY,56.0,26.99,14.56,54.32,29
CDM,3119310,LAB DRG DF STIMULANTS SYN DAY,160.0,77.12,41.6,155.2,29
CDM,3119328,LAB DRG DF TAPENTADOL DAY,56.0,26.99,14.56,54.32,29
CDM,3119377,LAB ALLG IGE QN/SEMI QN EA,64.0,36.86,16.64,62.08,29
CDM,3119385,LAB USTEKINUMAB,226.0,108.93,58.76,219.22,29
CDM,3119393,LAB AB VIRUS ZIKA IGM,325.0,187.2,84.5,315.25,29
CDM,3119526,LAB IG IGD SERUM EA,63.0,30.37,16.38,61.11,29
CDM,3119534,LAB IMMUNOFIXATION EP CRYOGLOBULIN,68.0,39.17,17.68,65.96,29
CDM,3119542,LAB IG IGG SERUM EA,56.0,26.99,14.56,54.32,29
CDM,3119575,LAB HANTAVIRUS,102.0,58.75,26.52,98.94,29
CDM,3119583,LAB THYROGLOBULIN FNA,82.0,39.52,21.32,79.54,29
CDM,3119591,LAB THYROID CASCADING REFLEX,55.0,26.51,14.3,53.35,29
CDM,3119666,LAB AB TREPONEMA PALLIDUM CONF,74.0,42.62,19.24,71.78,29
CDM,3119674,LAB DRG DF THIOPURINE DAY 1-3,160.0,77.12,41.6,155.2,29
CDM,3119682,LAB DET IA VIRUS ZIKA PRB AMP,200.0,106.2,52.0,194.0,29
CDM,3119716,LAB PANEL LIPID NS,69.0,33.26,17.94,66.93,29
CDM,3119732,LAB IMM RBA AB 21 HYDROXYLASE QN,114.0,54.95,29.64,110.58,29
CDM,3119773,LAB DET IA LEGIONELL PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3119799,LAB CULT TYPING IF ANTISERUM EA NS,56.0,29.74,14.56,54.32,29
CDM,3119807,LAB HAPTOGLOBIN QN NS,59.0,28.44,15.34,57.23,29
CDM,3119815,LAB APOLIPOPROTEIN A1 EA NS,77.0,37.11,20.02,74.69,29
CDM,3119823,LAB BILIRUBIN TOTAL NS,58.0,27.96,15.08,56.26,29
CDM,3119849,LAB AB ZINC TRANSPORTER,240.0,138.24,62.4,232.8,29
CDM,3119864,LAB GENOMIC ANLY SEQ SO/HL 51+,8759.0,4256.87,2277.34,8496.23,29
CDM,3119872,LAB GENOMIC ANLY SEQ HL 5-50,2279.0,1107.59,592.54,2210.63,29
CDM,3119880,LAB VEDOLIZUMAB,317.0,152.79,82.42,307.49,29
CDM,3119898,LAB DET AG IA IMM ENZ FUNGITELL NS,157.0,83.37,40.82,152.29,29
CDM,3119930,LAB CULT TYPING ID SEQ NUC ACID NS,347.0,184.26,90.22,336.59,29
CDM,3120300,LAB CHROMAT MS IODINE QL/QN,73.0,35.19,18.98,70.81,29
CDM,3120318,LAB GENE HBA1/HBA2 SEQ FULL,1800.0,874.8,468.0,1746.0,29
CDM,3120326,LAB GENE DPYD VAR COMMON NS,525.0,255.15,136.5,509.25,29
CDM,3120342,LAB GENE HBB SEQ FULL,974.0,473.36,253.24,944.78,29
CDM,3120375,LAB GENE BRCA1&2 ANLY SEQ FULL,1404.0,682.34,365.04,1361.88,29
CDM,3120391,LAB AB VIRUS HEPATITIS E IGG,71.0,40.9,18.46,68.87,29
CDM,3120409,LAB IMM FIBRO GROWTH FACTOR,305.0,147.01,79.3,295.85,29
CDM,3120417,LAB DRG DF AMPH/METH MCNIUM DAY 1-2,83.0,40.01,21.58,80.51,29
CDM,3120425,LAB DRG DF COCAINE MECONIUM,149.0,71.82,38.74,144.53,29
CDM,3120433,LAB DRG DF METHADONE MECONIUM DAY,165.0,79.53,42.9,160.05,29
CDM,3120441,LAB DRG DF OPIATE MECONIUM DAY 1+,70.0,33.74,18.2,67.9,29
CDM,3120458,LAB DRG DF OXYCODONE MECONIUM DAY,70.0,33.74,18.2,67.9,29
CDM,3120490,LAB GENE DMPK DET ALLELES ABNRM MYO,825.0,400.95,214.5,800.25,29
CDM,3120516,LAB GENE NUDT15 VAR COMMON NS,875.0,425.25,227.5,848.75,29
CDM,3120524,LAB GENE SMN1 ANALYSIS DOSAGE/DEL,525.0,255.15,136.5,509.25,29
CDM,3120573,LAB HCV INFCT DIS CHRNC 6 ASSAYS,217.0,105.46,56.42,210.49,29
CDM,3120607,LAB INFLIXIMAB,266.0,128.21,69.16,258.02,29
CDM,3120656,LAB DIHYDROTESTOSTERONE,88.0,42.42,22.88,85.36,29
CDM,3120664,LAB GENE MYD88 VAR L265P,527.0,256.12,137.02,511.19,29
CDM,3120714,LAB COMPLEMENT ACT FUNC NS,185.0,106.56,48.1,179.45,29
CDM,3120755,LAB SCR AB PARANEOPLASTIC CSF FL,200.0,115.2,52.0,194.0,29
CDM,3120763,LAB CSF3R MUTATION EXONS 14&17,300.0,145.8,78.0,291.0,29
CDM,3120839,LAB NEURO CSF PRION PROT QUAL,1623.0,788.78,421.98,1574.31,29
CDM,3120847,LAB SCR AB COPEPTIN FL,300.0,172.8,78.0,291.0,29
CDM,3120854,LAB CHROMAT MS ORGANIC ACIDS,153.0,73.75,39.78,148.41,29
CDM,3120888,LAB DET AG IA IMM ENZ CAMPY,78.0,41.42,20.28,75.66,29
CDM,3120896,LAB GENE CYP2C19 VAR COMMON,875.0,425.25,227.5,848.75,29
CDM,3120904,LAB GENE CYP2D6 VAR COMMON,1353.0,657.56,351.78,1312.41,29
CDM,3120912,LAB GENE CYP2C9 VAR COMMON,525.0,255.15,136.5,509.25,29
CDM,3120920,LAB GENE CYP3A4 VAR COMMON,525.0,255.15,136.5,509.25,29
CDM,3120938,LAB GENE CYP3A5 VAR COMMON,525.0,255.15,136.5,509.25,29
CDM,3120946,LAB GENE DPYD VAR COMMON,525.0,255.15,136.5,509.25,29
CDM,3120953,LAB GENE IFNL3,221.0,107.41,57.46,214.37,29
CDM,3120961,LAB GENE NUDT15 VAR COMMON,875.0,425.25,227.5,848.75,29
CDM,3120979,LAB GENE SLCO1B1 VAR COMMON,525.0,255.15,136.5,509.25,29
CDM,3120987,LAB GENE TPMT,525.0,255.15,136.5,509.25,29
CDM,3120995,LAB GENE UGT1A1 VAR COMMON,702.0,341.17,182.52,680.94,29
CDM,3121001,LAB GENE VKORC1 VAR COMMON,265.0,128.79,68.9,257.05,29
CDM,3121019,LAB GENE PHARMOCOGENOMICS PANEL,51.0,24.79,13.26,49.47,29
CDM,3121027,LAB LIPOPROTEIN CHOLESTEROL LDL NS,94.0,45.31,24.44,91.18,29
CDM,3121035,LAB ACTIVITY ENZYME ALPHA GALACTOS,375.0,180.75,97.5,363.75,29
CDM,3121050,LAB AMMONIA STONE RISK,115.0,55.43,29.9,111.55,29
CDM,3121068,LAB CALCIUM STONE RISK,77.0,37.11,20.02,74.69,29
CDM,3121076,LAB CITRATE STONE RISK,174.0,83.87,45.24,168.78,29
CDM,3121084,LAB CREATININE STONE RISK,73.0,35.19,18.98,70.81,29
CDM,3121092,LAB MAGNESIUM NS,88.0,42.42,22.88,85.36,29
CDM,3121100,LAB OXALATE STONE RISK,108.0,52.06,28.08,104.76,29
CDM,3121118,LAB PH STONE RISK,66.0,31.81,17.16,64.02,29
CDM,3121126,LAB PHOSPHORUS STONE RISK,74.0,35.67,19.24,71.78,29
CDM,3121134,LAB POTASSIUM STONE RISK,70.0,33.74,18.2,67.9,29
CDM,3121142,LAB SODIUM STONE RISK,72.0,34.7,18.72,69.84,29
CDM,3121159,LAB SULFATE STONE RISK,72.0,34.7,18.72,69.84,29
CDM,3121167,LAB URIC ACID STONE RISK,72.0,34.7,18.72,69.84,29
CDM,3121183,LAB IMM AB HMGCR IGG,315.0,151.83,81.9,305.55,29
CDM,3121209,LAB LIVER DISEASE 10 ASSAYS,1511.0,1143.83,392.86,1465.67,29
CDM,3121225,LAB DET IA IGM PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3121258,LAB AB FL TITER ENDOMYSIAL,103.0,59.33,26.78,99.91,29
CDM,3121274,LAB DET AG IA IMM OPTICAL NS,75.0,39.83,19.5,72.75,29
CDM,3121308,LAB GENE TYPING HLA 1 LR LOCUS NS,383.0,186.14,99.58,371.51,29
CDM,3121365,LAB HLA CLASS I&II AB QL NS,330.0,190.08,85.8,320.1,29
CDM,3121399,LAB CULT BACT ANAEROBIC ID DF NS,118.0,62.66,30.68,114.46,29
CDM,3121456,LAB ADALIMUMAB,300.0,144.6,78.0,291.0,29
CDM,3121464,LAB LACOSAMIDE,82.0,39.52,21.32,79.54,29
CDM,3121480,LAB GENE HTT DET ALLELES ABNORMAL,411.0,199.75,106.86,398.67,29
CDM,3121498,LAB DRG DF CONF PROPOXYPHENE DAY NS,56.0,26.99,14.56,54.32,29
CDM,3121563,LAB GENE TYPING HLA 2 HR LOCUS NS,372.0,180.79,96.72,360.84,29
CDM,3121571,LAB DRG DF BARB PHENOBARB DAY NS,158.0,76.16,41.08,153.26,29
CDM,3121589,LAB IMM MS 21-HYDROXYLASE QL,114.0,54.95,29.64,110.58,29
CDM,3121597,LAB GENE FLT3 VAR ITD QN,2340.0,1137.24,608.4,2269.8,29
CDM,3121621,LAB DET IA MYCOPLAS GEN PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3121647,LAB SCR AB ENCEPHALITIS FL,98.0,56.45,25.48,95.06,29
CDM,3121654,LAB NPM1 GENE ANALYSIS QUAN,2275.0,1105.65,591.5,2206.75,29
CDM,3121696,LAB LIPOPROTEIN CHOLESTEROL LDL SD,103.0,49.65,26.78,99.91,29
CDM,3121712,LAB VOLATILE NS,184.0,88.69,47.84,178.48,29
CDM,3121779,LAB CULT FUNGI ID ISOLATES NS,88.0,46.73,22.88,85.36,29
CDM,3121811,LAB DET IA COV19 PRB AMP NS,154.0,81.77,40.04,149.38,29
CDM,3121829,LAB DET IA COV19 PRB AMP,154.0,81.77,40.04,149.38,29
CDM,3121902,LAB DET AG IA IF CRYPTOSPORIDIUM NS,111.0,58.94,28.86,107.67,29
CDM,3121910,LAB AB SARS-COV-2 COVID-19,127.0,73.15,33.02,123.19,29
CDM,3121928,LAB AB SARS-COV-2 COVID-19 NS,127.0,73.15,33.02,123.19,29
CDM,3122058,LAB CHROMAT MS OMEGA FATTY ACIDS,100.0,48.2,26.0,97.0,29
CDM,3122108,LAB GENE F5 VAR LEIDEN NS,221.0,107.41,57.46,214.37,29
CDM,3122165,LAB GENE TYPING HLA 1&2 LR VERIF NS,1214.0,590.0,315.64,1177.58,29
CDM,3122173,LAB GENE PIK3CA ANLYS SEQ TARGETED,825.0,400.95,214.5,800.25,29
CDM,3122199,LAB GENE MPL MUTATION EXON 10 ANLYS,556.0,270.22,144.56,539.32,29
CDM,3122207,LAB GENE JAK2 EXON TGT SEQ 12,556.0,270.22,144.56,539.32,29
CDM,3122215,LAB IMM MS SP100 IGG,104.0,50.13,27.04,100.88,29
CDM,3122249,LAB DRG SC INST ALYZ URINE DAY,187.0,90.13,48.62,181.39,29
CDM,3122256,LAB DRG SC INST ALYZ SERUM DAY,187.0,90.13,48.62,181.39,29
CDM,3122264,LAB DRG SC INST ALYZ URINE ETOH DAY,187.0,90.13,48.62,181.39,29
CDM,3122272,LAB DRG SC INST ALYZ URINE DAY NS,187.0,90.13,48.62,181.39,29
CDM,3122280,LAB DRG SC INST ALYZ SERUM DAY NS,187.0,90.13,48.62,181.39,29
CDM,3122298,LAB DRG SC INST ALYZ URINE PMGT DAY,449.0,216.42,116.74,435.53,29
CDM,3122306,LAB DRG SC INST ALYZ MECON DAY NS,187.0,90.13,48.62,181.39,29
CDM,3122322,LAB DRG DF BUPRENORPHINE MECON DAY,129.0,62.18,33.54,125.13,29
CDM,3122330,LAB DRG SC INST ALYZ CORD TIS DAYNS,187.0,90.13,48.62,181.39,29
CDM,3122389,LAB CULT BACT AEROBIC ID DF NS,96.0,50.98,24.96,93.12,29
CDM,3122397,LAB ISO VIRUS ID ACT ENZYMATIC NS,102.0,54.16,26.52,98.94,29
CDM,3122413,LAB CULT BACT AEROBIC STOOL NS,63.0,33.45,16.38,61.11,29
CDM,3122421,LAB CULT BACT AEROBIC ID DF ADDL NS,103.0,54.69,26.78,99.91,29
CDM,3122439,LAB CULT TYPING SEROLOGICAL NS,85.0,45.14,22.1,82.45,29
CDM,3122496,LAB AB ISLET ENCEPHALITIS,144.0,82.94,37.44,139.68,29
CDM,3122504,LAB SCR AB REFLEX ENCEPHALITIS FL,525.0,302.4,136.5,509.25,29
CDM,3122512,LAB AB FL TITER ENCEPHALITIS,194.0,111.74,50.44,188.18,29
CDM,3122520,LAB PROT WB W INTRP ENCEPHALITIS,155.0,74.71,40.3,150.35,29
CDM,3122652,LAB H PYLORI UREASE NONRADIOACT NS,203.0,97.85,52.78,196.91,29
CDM,3122710,LAB DIS INFCT ID BAC&FNG GRM+ RXRST,471.0,228.91,122.46,456.87,29
CDM,3122728,LAB DIS INFCT ID BAC&FNG GRM- RXRST,471.0,228.91,122.46,456.87,29
CDM,3122744,LAB SCR AB MITOCHONDRIAL,77.0,44.35,20.02,74.69,29
CDM,3122751,LAB SCR AQUAPORIN 4 AB IGG CSF,350.0,201.6,91.0,339.5,29
CDM,3122769,LAB SCR AQUAPORIN 4 AB IGG SERUM,225.0,129.6,58.5,218.25,29
CDM,3122777,LAB AQUAPORIN AB,268.0,154.37,69.68,259.96,29
CDM,3122785,LAB ISAVUCONAZOLE,135.0,65.07,35.1,130.95,29
CDM,3122793,LAB AQUAPORIN 4 AB FLOW CYTOMETRY,118.0,67.97,30.68,114.46,29
CDM,3122827,LAB DRG DF ANTD CLOM DAY 1-2,62.0,29.88,16.12,60.14,29
CDM,3122926,LAB IMM MS GP210 IGG,148.0,71.34,38.48,143.56,29
CDM,3122983,LAB IMM AB ADAMTS 13,300.0,144.6,78.0,291.0,29
CDM,3123007,LAB TISSUE KOH SKN/HAR/NAL FUNGI NS,215.0,114.16,55.9,208.55,29
CDM,3123072,LAB AB ENA PM/SC1-100,115.0,66.24,29.9,111.55,29
CDM,3123080,LAB IMM MS POLYMERASE III AB,107.0,51.57,27.82,103.79,29
CDM,3123122,LAB DET IA ORTHOPOXVIRUS PRB AMP,154.0,81.77,40.04,149.38,29
CDM,3123148,LAB ALLG IGE QN/SEMI QN EA NS,80.0,46.08,20.8,77.6,29
CDM,3123155,LAB IMM VWF BINDING ASSAY,145.0,69.89,37.7,140.65,29
CDM,3123171,LAB CHLORDIAZEPOXIDE,169.0,81.46,43.94,163.93,29
CDM,3123247,LAB AB HTLV/HIV CONFIRM DONOR NS,503.0,289.73,130.78,487.91,29
CDM,3123254,LAB PLASMINOGEN NON-ANTIGENIC NS,71.0,34.22,18.46,68.87,29
CDM,3123288,LAB TB MEAS IMMUNITY T-CELL SUSP NS,300.0,172.8,78.0,291.0,29
CDM,3123296,LAB IMM ANALYTE CYTOKINES QN,135.0,65.07,35.1,130.95,29
CDM,3123320,LAB COMPLEMENT AG SC5B-9 COMP EA,292.0,168.19,75.92,283.24,29
CDM,3123395,LAB AB M FAENI,153.0,88.13,39.78,148.41,29
CDM,3123403,LAB AB S VIRIDIS,153.0,88.13,39.78,148.41,29
CDM,3123411,LAB AB T CANDIDUS,153.0,88.13,39.78,148.41,29
CDM,3123429,LAB AB T VULGARIS,153.0,88.13,39.78,148.41,29
CDM,3123437,LAB AB LISTERIA,153.0,88.13,39.78,148.41,29
CDM,3123445,LAB AB CYSTICERCUS CSF,65.0,37.44,16.9,63.05,29
CDM,3123452,LAB AB CYSTICERCUS SERUM,65.0,37.44,16.9,63.05,29
CDM,3123460,LAB AB SCHISTOSOMA SERUM,65.0,37.44,16.9,63.05,29
CDM,3123478,LAB DRG DF FUROSEMIDE DAY 1-3,187.0,90.13,48.62,181.39,29
CDM,3123486,LAB DRG DF MITOTANE DAY 1-3,187.0,90.13,48.62,181.39,29
CDM,3123494,LAB DRG DF TPMT ACTIVITY DAY 1-3,187.0,90.13,48.62,181.39,29
CDM,3123502,LAB COUNT BLD PLATELET AUTOMATED NS,58.0,27.96,15.08,56.26,29
CDM,3123569,LAB THIOPURINE S-METHYLTRANSFERASE,112.0,53.98,29.12,108.64,29
CDM,3123577,LAB COMPLEMENT ACT FUNC C3NEF,300.0,172.8,78.0,291.0,29
CDM,3123767,LAB GSAP METAB RX >=6,2752.0,1337.47,715.52,2669.44,29
CDM,3123817,LAB DET AG IA IMM ENZ FUNGITELL,97.0,51.51,25.22,94.09,29
CDM,3123825,LAB SUSCPT MIC PLATE EA LSI NS,200.0,151.4,52.0,194.0,29
CDM,3123874,LAB DIS INFCT SARS-COV-2 TGT 21,1251.0,607.99,325.26,1213.47,29
CDM,3123882,POC FERN,66.0,31.81,17.16,64.02,29
CDM,3123981,LAB IMM AB BP230 QN,90.0,43.38,23.4,87.3,29
CDM,3124021,LAB DET IA LEPTOSPIRA PCR PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3124047,LAB DRG DF OPIOID DAY 1-2 TISSUE,56.0,26.99,14.56,54.32,29
CDM,3124138,LAB IMM MS CARBAMYLATED PROTEIN AB,105.0,50.61,27.3,101.85,29
CDM,3124229,LAB HCV INFCT DIS CHRNC 6 ASSAYS NS,217.0,105.46,56.42,210.49,29
CDM,3124245,LAB LIVER DIS ANYL 3BIOMARK ALG SRM,529.0,257.09,137.54,513.13,29
CDM,3124252,LAB NORTRIPTYLINE,68.0,32.78,17.68,65.96,29
CDM,3124286,LAB IMM INHIBIN B QN,104.0,50.13,27.04,100.88,29
CDM,3124294,LAB SCR AB MOG TITER,837.0,482.11,217.62,811.89,29
CDM,3124302,LAB SCR ANCA TITER AB EA,62.0,35.71,16.12,60.14,29
CDM,3124476,LAB CHROMAT MS APOE ISOFORM,550.0,265.1,143.0,533.5,29
CDM,3124492,LAB DET IA RUBELLA PCR PRB AMP,106.0,56.29,27.56,102.82,29
CDM,3124518,LAB RBC DNA HEA 35 AG 11 BLD GRP NS,2160.0,1244.16,561.6,2095.2,29
CDM,3124542,LAB DET IA ENTEROBACTR MULT PRB AMP,411.0,218.24,106.86,398.67,29
CDM,3124559,LAB DET IA BACTERIAL MULT PRB AMP,1309.0,695.08,340.34,1269.73,29
CDM,3124567,LAB CLONAZEPAM,67.0,32.29,17.42,64.99,29
CDM,3124583,LAB GENE B-CELL CLONALITY PCR,51.0,24.58,13.26,49.47,29
CDM,3124625,LAB GENE HFE VAR COMMON,197.0,95.74,51.22,191.09,29
CDM,3124690,LAB DET IA HPV TYPE RISK HIGH POOL,106.0,56.29,27.56,102.82,29
CDM,3124716,LAB GENE 5+ COLON CA DIS HRDTRY,3912.0,1901.23,1017.12,3794.64,29
CDM,3124781,LAB GENE MARKERS STR SPEC PT&CMP NS,1427.0,693.52,371.02,1384.19,29
CDM,3124864,LAB BETA AMYLOID 1-42,387.0,186.53,100.62,375.39,29
CDM,3124872,LAB TAU TOTAL,387.0,186.53,100.62,375.39,29
CDM,3124906,LAB GENE SEPT9 ANLYS METHYLATION,576.0,279.94,149.76,558.72,29
CDM,3124914,LAB AB STREP PNEU SEROT IA,372.0,214.27,96.72,360.84,29
CDM,3124930,LAB AB ID PLATELET BLOOD PRODUCT,238.0,137.09,61.88,230.86,29
CDM,3124971,LAB CYTOPATH EVAL FNA INTRP&RPT NS,110.0,23.76,28.6,106.7,29
CDM,3125010,LAB ONC SEQ NEXT GEN DNA&RNA FFPE,25365.0,12327.39,6594.9,24604.05,29
CDM,3125044,LAB BETA AMYLOID 1-40,387.0,186.53,100.62,375.39,29
CDM,3125051,LAB MOPATH LVL2 CBFB/MYH11 DET QN,411.0,199.75,106.86,398.67,29
CDM,3125101,LAB TAU217 PHOSPHORYLATED EA,387.0,186.53,100.62,375.39,29
CDM,3125119,LAB TAU181 PHOSPHORYLATED EA,387.0,186.53,100.62,375.39,29
CDM,3125168,LAB ONC SEQ NEXT GEN DNA&MRNA 74,10800.0,5248.8,2808.0,10476.0,29
CDM,3125176,LAB DET IA NOROVIRUS PCR PRB AMP,109.0,57.88,28.34,105.73,29
CDM,3125309,LAB AB HTLV/HIV CONFIRM SRM/PLASMA,472.0,271.87,122.72,457.84,29
CDM,3125341,LAB ACTIVITY ENZYME CHITOTRIOSIDASE,362.0,174.48,94.12,351.14,29
CDM,3125358,LAB IMM MS ANTI TH/TO AB,135.0,65.07,35.1,130.95,29
CDM,3125721,LAB IMM ANALYTE SFIT-1,72.0,34.7,18.72,69.84,29
CDM,3125739,LAB IMM ANALYTE PIGF,72.0,34.7,18.72,69.84,29
CDM,3125796,LAB CHROMAT MS PFAS 9 CMPD SRM/PLSM,597.0,290.14,155.22,579.09,29
CDM,3125911,LAB DRG SC INST ALYZ CORD TIS DAY,187.0,90.13,48.62,181.39,29
CDM,3125945,LAB SUSCPT CARBAPENEMASE DET ENZ,56.0,29.74,14.56,54.32,29
CDM,3126034,LAB DET IA CT&NG PRB AMP MULTIPLEX,211.0,112.04,54.86,204.67,29
CDM,3126109,LAB IMM MS CYTOSOLC 5 NUCLEOTDAS 1A,315.0,151.83,81.9,305.55,29
CDM,3126117,LAB DET IA PATH JT&GENE RXRST 26+,2040.0,1083.24,530.4,1978.8,29
CDM,3126331,LAB AB LEPTOSPIRA IGM DOT BLOT,102.0,58.75,26.52,98.94,29
CDM,3126372,LAB PROSTAGLANDIN EA ARP,335.0,161.47,87.1,324.95,29
CDM,3126448,LAB CULT TISS NON-NEO LYMPHOCYT MYO,1148.0,247.97,298.48,1113.56,29
CDM,32011,R&B ICU,8761.0,4977.56,2512.0,8498.17,17
CDM,3204583,XR SPINE ENTIRE THOR&LUMB 2-3 VW,589.0,315.7,153.14,571.33,29
CDM,3204617,XR HIP W PELVIS 1 VW RT,209.0,112.02,54.34,202.73,29
CDM,3204625,XR HIP W PELVIS 1 VW LT,209.0,112.02,54.34,202.73,29
CDM,3204633,INJ CHOLANGIOGRAM ACCESS EXIST S&I,462.0,149.23,120.12,448.14,28
CDM,3204641,XR HIP W PELVIS 2-3 VW RT,566.0,303.38,147.16,549.02,29
CDM,3204658,XR HIP W PELVIS 2-3 VW LT,566.0,303.38,147.16,549.02,29
CDM,3204716,XR HIPS W PELVIS 3-4 VW BI,598.0,320.53,155.48,580.06,29
CDM,3204765,XR FEMUR 2+ VW RT,483.0,258.89,125.58,468.51,29
CDM,3204773,XR FEMUR 2+ VW LT,483.0,258.89,125.58,468.51,29
CDM,3204823,INJ/S EPID/SUB C/T WO IMG,903.0,291.67,234.78,875.91,28
CDM,3204831,INJ/S EPID/SUB C/T W IMG,2613.0,844.0,679.38,2534.61,28
CDM,3204849,INJ/S EPID/SUB L/S WO IMG,677.0,218.67,176.02,656.69,28
CDM,3204856,INJ/S EPID/SUB L/S W IMG,1156.0,373.39,300.56,1121.32,28
CDM,3205564,PLC DEV/S LOC TIS SOFT PERC LSN 1ST,1015.0,327.84,263.9,984.55,28
CDM,3205572,PLC DEV/S LOC TIS SOFT PERC LSN ADD,591.0,190.89,153.66,573.27,28
CDM,3206505,MAMMO DX W/WO CAD LT,211.0,132.3,54.86,204.67,29
CDM,3206513,MAMMO DX W/WO CAD RT,211.0,132.3,54.86,204.67,29
CDM,3206521,MAMMO DX W/WO CAD BI,271.0,169.92,70.46,262.87,29
CDM,3206539,MAMMO SCRN W/WO CAD 2 VW BI,336.0,219.74,87.36,325.92,29
CDM,3206976,MAMMO SCRN W/WO CAD 2 VW BI RDC,224.0,146.5,58.24,217.28,29
CDM,3220001,XR ABSCESS/SINUS/FISTULA S&I,593.0,317.85,154.18,575.21,29
CDM,3220019,XR ABDOMEN CMP 2+VW W CHEST 1 VW,409.0,219.22,106.34,396.73,29
CDM,3220050,XR JTS ACROMIOCLAVICULAR BI,210.0,112.56,54.6,203.7,29
CDM,3220092,XR ANKLE CMP 3+ VW LT,330.0,176.88,85.8,320.1,29
CDM,3220100,XR ANKLE CMP 3+ VW RT,330.0,176.88,85.8,320.1,29
CDM,3220126,XR ANKLE 2 VW LT,307.0,164.55,79.82,297.79,29
CDM,3220134,XR ANKLE 2 VW RT,307.0,164.55,79.82,297.79,29
CDM,3220357,STUDIES AGE BONE,325.0,174.2,84.5,315.25,29
CDM,3220365,STUDIES LENGTH BONE,609.0,326.42,158.34,590.73,29
CDM,3220373,XR SURVEY OSSEOUS CMP,388.0,207.97,100.88,376.36,29
CDM,3220381,XR SURVEY OSSEOUS INFANT,456.0,244.42,118.56,442.32,29
CDM,3220399,XR SURVEY OSSEOUS LTD,267.0,143.11,69.42,258.99,29
CDM,3220555,XR CALCANEUS 2+ VW LT,303.0,162.41,78.78,293.91,29
CDM,3220563,XR CALCANEUS 2+ VW RT,303.0,162.41,78.78,293.91,29
CDM,3220696,CHOLANGIO&/PANCREATOGRAM OR ADD S&I,296.0,158.66,76.96,287.12,29
CDM,3220704,CHOLANGIO&/PANCREATOGRAM OR S&I,723.0,387.53,187.98,701.31,29
CDM,3220738,CHOLECYSTOGRAPHY CNT ORAL,326.0,174.74,84.76,316.22,29
CDM,3220803,XR CLAVICLE CMP LT,445.0,238.52,115.7,431.65,29
CDM,3220811,XR CLAVICLE CMP RT,445.0,238.52,115.7,431.65,29
CDM,3220951,CYSTOGRAM 3+ VW S&I,532.0,285.15,138.32,516.04,29
CDM,3221231,XR ELBOW CMP 3+ VW LT,323.0,173.13,83.98,313.31,29
CDM,3221249,XR ELBOW CMP 3+ VW RT,323.0,173.13,83.98,313.31,29
CDM,3221264,XR ELBOW 2 VW LT,287.0,153.83,74.62,278.39,29
CDM,3221272,XR ELBOW 2 VW RT,287.0,153.83,74.62,278.39,29
CDM,3221330,ENEMA THERAPEUTIC,635.0,340.36,165.1,615.95,29
CDM,3221371,CATH ENDO DUCT BILIARY&PANCREAS S&I,497.0,266.39,129.22,482.09,29
CDM,3221470,XR BONES FACIAL 0-2 VW,195.0,104.52,50.7,189.15,29
CDM,3221488,XR BONES FACIAL CMP 3+ VW,578.0,309.81,150.28,560.66,29
CDM,3221496,XR FB NOSE TO RECTUM CHILD 1 VW,173.0,92.73,44.98,167.81,29
CDM,3221538,XR FINGER/S 2+ VW LT,191.0,102.38,49.66,185.27,29
CDM,3221546,XR FINGER/S 2+ VW RT,191.0,102.38,49.66,185.27,29
CDM,3221579,FLUORO GD&LOC NEEDLE SPINE,585.0,313.56,152.1,567.45,29
CDM,3221603,FLUORO GD PLCMT NEEDLE,731.0,391.82,190.06,709.07,29
CDM,3221611,FLUORO 0-1HR TIME PHYS/QHCP,780.0,418.08,202.8,756.6,29
CDM,3221645,XR FOOT CMP 3+ VW LT,481.0,257.82,125.06,466.57,29
CDM,3221652,XR FOOT CMP 3+ VW RT,481.0,257.82,125.06,466.57,29
CDM,3221678,XR FOOT 2 VW LT,148.0,79.33,38.48,143.56,29
CDM,3221686,XR FOOT 2 VW RT,148.0,79.33,38.48,143.56,29
CDM,3221702,XR FOREARM 2 VW LT,275.0,147.4,71.5,266.75,29
CDM,3221710,XR FOREARM 2 VW RT,275.0,147.4,71.5,266.75,29
CDM,3221744,XR HAND 3+ VW LT,503.0,269.61,130.78,487.91,29
CDM,3221751,XR HAND 3+ VW RT,503.0,269.61,130.78,487.91,29
CDM,3221777,XR HAND 2 VW LT,455.0,243.88,118.3,441.35,29
CDM,3221785,XR HAND 2 VW RT,455.0,243.88,118.3,441.35,29
CDM,3221876,XR HUMERUS 2+ VW LT,455.0,243.88,118.3,441.35,29
CDM,3221884,XR HUMERUS 2+ VW RT,455.0,243.88,118.3,441.35,29
CDM,3221892,HYSTEROSALPINGOGRAM S&I,1086.0,582.1,282.36,1053.42,29
CDM,3222023,INJ ARTHRO ANKLE LT,164.0,52.97,42.64,159.08,28
CDM,3222031,INJ ARTHRO ANKLE RT,164.0,52.97,42.64,159.08,28
CDM,3222049,INJ ARTHRO ELBOW LT,206.0,66.54,53.56,199.82,28
CDM,3222056,INJ ARTHRO ELBOW RT,206.0,66.54,53.56,199.82,28
CDM,3222080,INJ ARTHRO HIP WO ANES LT,314.0,101.42,81.64,304.58,28
CDM,3222098,INJ ARTHRO HIP WO ANES RT,314.0,101.42,81.64,304.58,28
CDM,3222122,INJ ARTHRO SHOULDER LT,372.0,120.16,96.72,360.84,28
CDM,3222130,INJ ARTHRO SHOULDER RT,372.0,120.16,96.72,360.84,28
CDM,3222163,INJ ARTHRO WRIST LT,275.0,88.82,71.5,266.75,28
CDM,3222171,INJ ARTHRO WRIST RT,275.0,88.82,71.5,266.75,28
CDM,3222338,INJ VENOGRAPHY EXTREMITY BI,234.0,75.58,60.84,226.98,28
CDM,3222346,INJ VENOGRAPHY EXTREMITY LT,156.0,50.39,40.56,151.32,28
CDM,3222353,INJ VENOGRAPHY EXTREMITY RT,156.0,50.39,40.56,151.32,28
CDM,3222841,INTRO TUBE GI LONG W FLUORO S&I,197.0,105.59,51.22,191.09,29
CDM,3223047,UROGRAPHY IV W/WO KUB,612.0,328.03,159.12,593.64,29
CDM,3223096,APPLY MANUAL STRESS JOINT UNI/BI,211.0,113.1,54.86,204.67,29
CDM,3223120,XR KNEE CMP 4+ VW LT,618.0,331.25,160.68,599.46,29
CDM,3223138,XR KNEE CMP 4+ VW RT,618.0,331.25,160.68,599.46,29
CDM,3223153,XR KNEE 1-2 VW LT,345.0,184.92,89.7,334.65,29
CDM,3223161,XR KNEE 1-2 VW RT,345.0,184.92,89.7,334.65,29
CDM,3223187,XR KNEE 3 VW LT,419.0,224.58,108.94,406.43,29
CDM,3223195,XR KNEE 3 VW RT,419.0,224.58,108.94,406.43,29
CDM,3223203,XR KNEES STANDING AP BI,463.0,248.17,120.38,449.11,29
CDM,3223229,XR EXT LOWER INFANT 2+ VW LT,276.0,147.94,71.76,267.72,29
CDM,3223237,XR EXT LOWER INFANT 2+ VW RT,276.0,147.94,71.76,267.72,29
CDM,3223336,XR MANDIBLE CMP 4+ VW,511.0,273.9,132.86,495.67,29
CDM,3223344,XR MANDIBLE PARTIAL 1-3 VW,132.0,70.75,34.32,128.04,29
CDM,3223377,MYELOGRAPHY CERVICAL S&I,1456.0,780.42,378.56,1412.32,29
CDM,3223385,MYELOGRAPHY LUMBOSACRAL S&I,2647.0,1418.79,688.22,2567.59,29
CDM,3223401,MYELOGRAPHY THORACIC S&I,1359.0,728.42,353.34,1318.23,29
CDM,3223419,MYELOGRAPHY 2+ REGIONS S&I,2774.0,1486.86,721.24,2690.78,29
CDM,3223427,XR BONES NASAL CMP 3+ VW,384.0,205.82,99.84,372.48,29
CDM,3223435,XR TISSUE SOFT NECK,456.0,244.42,118.56,442.32,29
CDM,3223534,XR FORAMINA OPTIC LT,215.0,115.24,55.9,208.55,29
CDM,3223542,XR FORAMINA OPTIC RT,215.0,115.24,55.9,208.55,29
CDM,3223567,XR ORBITS CMP 4+ VW,273.0,146.33,70.98,264.81,29
CDM,3223591,XR PELVIS CMP 3+ VW,561.0,300.7,145.86,544.17,29
CDM,3223609,XR PELVIS 1-2 VW,503.0,269.61,130.78,487.91,29
CDM,3223773,PLC G-TUBE NASO/ORO PHYS W FL GD,272.0,87.86,70.72,263.84,28
CDM,3224227,XR RIBS 2 VW LT,450.0,241.2,117.0,436.5,29
CDM,3224235,XR RIBS 2 VW RT,450.0,241.2,117.0,436.5,29
CDM,3224243,XR RIBS 3+ VW BI,650.0,348.4,169.0,630.5,29
CDM,3224276,XR RIBS W CXR 4+ VW BI,777.0,416.47,202.02,753.69,29
CDM,3224359,XR SACRUM&COCCYX 2+ VW,381.0,204.22,99.06,369.57,29
CDM,3224383,XR SCAPULA CMP LT,374.0,200.46,97.24,362.78,29
CDM,3224391,XR SCAPULA CMP RT,374.0,200.46,97.24,362.78,29
CDM,3224565,XR SHOULDER CMP 2+ VW LT,499.0,267.46,129.74,484.03,29
CDM,3224573,XR SHOULDER CMP 2+ VW RT,499.0,267.46,129.74,484.03,29
CDM,3224599,XR SHOULDER 1 VW LT,161.0,86.3,41.86,156.17,29
CDM,3224607,XR SHOULDER 1 VW RT,161.0,86.3,41.86,156.17,29
CDM,3224623,SHUNTOGRAM NONVASCULAR S&I,273.0,146.33,70.98,264.81,29
CDM,3224631,XR JTS SACROILIAC 1-2 VW,495.0,265.32,128.7,480.15,29
CDM,3224649,XR JTS SACROILIAC 3+ VW,541.0,289.98,140.66,524.77,29
CDM,3224672,XR SINUSES PARANASAL 0-2 VW,214.0,114.7,55.64,207.58,29
CDM,3224680,XR SINUSES PARANASAL CMP 3+ VW,329.0,176.34,85.54,319.13,29
CDM,3224698,XR SKULL 0-3 VW,197.0,105.59,51.22,191.09,29
CDM,3224706,XR SKULL CMP 4+ VW,263.0,140.97,68.38,255.11,29
CDM,3224730,EVAL SPEECH COMPLEX CINE/VIDEO,639.0,342.5,166.14,619.83,29
CDM,3224748,XR SPINE 1 VW,401.0,214.94,104.26,388.97,29
CDM,3224771,XR SPINE CERVICAL 2-3 VW,515.0,276.04,133.9,499.55,29
CDM,3224797,XR SPINE LS 4+ VW,806.0,432.02,209.56,781.82,29
CDM,3224805,XR SPINE LS 2-3 VW,613.0,328.57,159.38,594.61,29
CDM,3224862,XR SPINE THORACIC 2 VW,515.0,276.04,133.9,499.55,29
CDM,3224870,XR SPINE THORACIC 3 VW,616.0,330.18,160.16,597.52,29
CDM,3224888,XR SPINE THORACOLUMBAR => 2 VW,377.0,202.07,98.02,365.69,29
CDM,3224920,XR JT/S STERNOCLAVICULAR 3+ VW,425.0,227.8,110.5,412.25,29
CDM,3224938,XR STERNUM 2+ VW,340.0,182.24,88.4,329.8,29
CDM,3225091,XR TIBIA&FIBULA 2 VW LT,306.0,164.02,79.56,296.82,29
CDM,3225109,XR TIBIA&FIBULA 2 VW RT,306.0,164.02,79.56,296.82,29
CDM,3225125,XR TMJ MOUTH OPEN&CLOSE BI,381.0,204.22,99.06,369.57,29
CDM,3225133,XR TMJ MOUTH OPEN&CLOSE LT,143.0,76.65,37.18,138.71,29
CDM,3225141,XR TMJ MOUTH OPEN&CLOSE RT,143.0,76.65,37.18,138.71,29
CDM,3225299,XR EXT UPPER INFANT 2+ VW LT,254.0,136.14,66.04,246.38,29
CDM,3225307,XR EXT UPPER INFANT 2+ VW RT,254.0,136.14,66.04,246.38,29
CDM,3225323,URETHROCYSTOGRAM RETROGRADE S&I,491.0,263.18,127.66,476.27,29
CDM,3225331,URETHROCYSTOGRAM VOIDING S&I,561.0,300.7,145.86,544.17,29
CDM,3225349,UROGRAPHY ANTEGRADE S&I,845.0,452.92,219.7,819.65,29
CDM,3225364,UROGRAPHY RETROGRADE W/WO KUB,536.0,287.3,139.36,519.92,29
CDM,3225422,VENOGRAM EXTREMITY LT S&I,816.0,437.38,212.16,791.52,29
CDM,3225430,VENOGRAM EXTREMITY RT S&I,816.0,437.38,212.16,791.52,29
CDM,3225448,VENOGRAM EXTREMITY BI S&I,1225.0,656.6,318.5,1188.25,29
CDM,3225620,XR WRIST CMP 3+ VW LT,511.0,273.9,132.86,495.67,29
CDM,3225638,XR WRIST CMP 3+ VW RT,511.0,273.9,132.86,495.67,29
CDM,3225653,XR WRIST 2 VW LT,256.0,137.22,66.56,248.32,29
CDM,3225661,XR WRIST 2 VW RT,256.0,137.22,66.56,248.32,29
CDM,3225687,XR ARTHRO SHOULDER LT S&I,730.0,414.75,189.8,708.1,29
CDM,3225695,XR ARTHRO SHOULDER RT S&I,730.0,414.75,189.8,708.1,29
CDM,3225703,XR ARTHRO ANKLE LT S&I,553.0,314.19,143.78,536.41,29
CDM,3225711,XR ARTHRO ANKLE RT S&I,553.0,314.19,143.78,536.41,29
CDM,3225729,XR ARTHRO ELBOW LT S&I,1076.0,611.33,279.76,1043.72,29
CDM,3225737,XR ARTHRO ELBOW RT S&I,1076.0,611.33,279.76,1043.72,29
CDM,3225745,XR ARTHRO HIP LT S&I,865.0,491.45,224.9,839.05,29
CDM,3225752,XR ARTHRO HIP RT S&I,865.0,491.45,224.9,839.05,29
CDM,3225760,XR ARTHRO KNEE LT S&I,734.0,417.02,190.84,711.98,29
CDM,3225778,XR ARTHRO KNEE RT S&I,734.0,417.02,190.84,711.98,29
CDM,3225802,XR ARTHRO WRIST LT S&I,260.0,147.72,67.6,252.2,29
CDM,3225810,XR ARTHRO WRIST RT S&I,260.0,147.72,67.6,252.2,29
CDM,3226479,XR TOE/S 2+ VW LT,331.0,177.42,86.06,321.07,29
CDM,3226487,XR TOE/S 2+ VW RT,331.0,177.42,86.06,321.07,29
CDM,3227907,INJ TRACT SINOGRAM,161.0,52.0,41.86,156.17,28
CDM,3228020,BX LIVER NDL PERC,1389.0,448.65,361.14,1347.33,28
CDM,3228087,INJ CNT ABSC/CYST VIA PREV CATH/TB,170.0,54.91,44.2,164.9,28
CDM,3228103,INJ CYSTOGRAM,562.0,181.53,146.12,545.14,28
CDM,3228145,INJ SIS/HYSTEROSALPINGOGRAPHY,758.0,244.83,197.08,735.26,28
CDM,3228160,PUNCT C1-C2 W INJ,1268.0,409.56,329.68,1229.96,28
CDM,3228186,PUNCT LUMBAR DIAGNOSTIC,896.0,289.41,232.96,869.12,28
CDM,3229028,FLUORO GD PLC/REPL/REM CVAD,390.0,209.04,101.4,378.3,29
CDM,3234994,INJ CNT TUBE G/COLON PERC S&I,281.0,90.76,73.06,272.57,28
CDM,3241734,INJ/S JT FCT C/T IMG 1 LVL BI,1928.0,622.74,501.28,1870.16,28
CDM,3241742,INJ/S JT FCT C/T IMG 1 LVL LT,1285.0,415.06,334.1,1246.45,28
CDM,3241759,INJ/S JT FCT C/T IMG 1 LVL RT,1285.0,415.06,334.1,1246.45,28
CDM,3241767,INJ/S JT FCT C/T IMG 2 LVL BI,812.0,262.28,211.12,787.64,28
CDM,3241775,INJ/S JT FCT C/T IMG 2 LVL LT,541.0,174.74,140.66,524.77,28
CDM,3241783,INJ/S JT FCT C/T IMG 2 LVL RT,541.0,174.74,140.66,524.77,28
CDM,3241791,INJ/S JT FCT C/T IMG 3+ LVL BI,825.0,266.48,214.5,800.25,28
CDM,3241809,INJ/S JT FCT C/T IMG 3+ LVL LT,550.0,177.65,143.0,533.5,28
CDM,3241817,INJ/S JT FCT C/T IMG 3+ LVL RT,550.0,177.65,143.0,533.5,28
CDM,3241825,INJ/S JT FCT L/S IMG 1 LVL BI,3494.0,1128.56,908.44,3389.18,28
CDM,3241833,INJ/S JT FCT L/S IMG 1 LVL LT,2329.0,752.27,605.54,2259.13,28
CDM,3241841,INJ/S JT FCT L/S IMG 1 LVL RT,2329.0,752.27,605.54,2259.13,28
CDM,3241858,INJ/S JT FCT L/S IMG 2 LVL BI,840.0,271.32,218.4,814.8,28
CDM,3241866,INJ/S JT FCT L/S IMG 2 LVL LT,560.0,180.88,145.6,543.2,28
CDM,3241874,INJ/S JT FCT L/S IMG 2 LVL RT,560.0,180.88,145.6,543.2,28
CDM,3241882,INJ/S JT FCT L/S IMG 3+ LVL BI,792.0,255.82,205.92,768.24,28
CDM,3241890,INJ/S JT FCT L/S IMG 3+ LVL LT,528.0,170.54,137.28,512.16,28
CDM,3241908,INJ/S JT FCT L/S IMG 3+ LVL RT,528.0,170.54,137.28,512.16,28
CDM,3241973,XR SPECIMEN SURGICAL,234.0,125.42,60.84,226.98,29
CDM,3242237,XR EYE FOREIGN BODY LT,275.0,147.4,71.5,266.75,29
CDM,3242245,XR EYE FOREIGN BODY RT,275.0,147.4,71.5,266.75,29
CDM,3242351,INJ ARTHRO SHOULDER BI,558.0,180.23,145.08,541.26,28
CDM,3243326,XR RIBS W CXR 3+ VW,642.0,344.11,166.92,622.74,29
CDM,3243979,XR MASTOIDS CMP 3+ VW PER SIDE LT,353.0,189.21,91.78,342.41,29
CDM,3243987,XR MASTOIDS CMP 3+ VW PER SIDE RT,353.0,189.21,91.78,342.41,29
CDM,3244993,XR CHEST 1 VW,428.0,203.73,111.28,415.16,29
CDM,3245016,XR CHEST 2 VW,492.0,234.19,127.92,477.24,29
CDM,3245032,XR CHEST 3 VW,607.0,288.93,157.82,588.79,29
CDM,3245057,XR CHEST 4+ VW,649.0,308.92,168.74,629.53,29
CDM,3245479,XR ABDOMEN 1 VW,250.0,134.0,65.0,242.5,29
CDM,3245495,XR ABDOMEN 2 VW,302.0,161.87,78.52,292.94,29
CDM,3245511,XR ABDOMEN 3+ VW,354.0,189.74,92.04,343.38,29
CDM,3245800,INJ ARTHRO KNEE CNT/CNT ENHANCE BI,239.0,77.2,62.14,231.83,28
CDM,3245818,INJ ARTHRO KNEE CNT/CNT ENHANCE LT,159.0,51.36,41.34,154.23,28
CDM,3245826,INJ ARTHRO KNEE CNT/CNT ENHANCE RT,159.0,51.36,41.34,154.23,28
CDM,3247087,INJ ARTHRO ANKLE BI,246.0,79.46,63.96,238.62,28
CDM,3247103,INJ ARTHRO ELBOW BI,309.0,99.81,80.34,299.73,28
CDM,3247111,INJ ARTHRO WRIST BI,413.0,133.4,107.38,400.61,28
CDM,3247129,INJ ARTHRO HIP WO ANES BI,471.0,152.13,122.46,456.87,28
CDM,32474,R&B ICU,8761.0,4977.56,2512.0,8498.17,17
CDM,3249000,INJ JT SI ANES/STRD FL/CT GD BI,2076.0,670.55,539.76,2013.72,28
CDM,3249018,INJ JT SI ANES/STRD FL/CT GD LT,1384.0,447.03,359.84,1342.48,28
CDM,3249026,INJ JT SI ANES/STRD FL/CT GD RT,1384.0,447.03,359.84,1342.48,28
CDM,3249182,DST NRV CERV/THOR FL/CT GD SGL BI,2102.0,678.95,546.52,2038.94,28
CDM,3249190,DST NRV CERV/THOR FL/CT GD SGL LT,1401.0,452.52,364.26,1358.97,28
CDM,3249208,DST NRV CERV/THOR FL/CT GD SGL RT,1401.0,452.52,364.26,1358.97,28
CDM,3249216,DST NRV CERV/THOR FL/CT GD ADDL BI,345.0,111.44,89.7,334.65,28
CDM,3249224,DST NRV CERV/THOR FL/CT GD ADDL LT,230.0,74.29,59.8,223.1,28
CDM,3249232,DST NRV CERV/THOR FL/CT GD ADDL RT,230.0,74.29,59.8,223.1,28
CDM,3249240,DST NRV LUMB/SAC FL/CT GD SGL BI,2082.0,672.49,541.32,2019.54,28
CDM,3249257,DST NRV LUMB/SAC FL/CT GD SGL LT,1388.0,448.32,360.88,1346.36,28
CDM,3249265,DST NRV LUMB/SAC FL/CT GD SGL RT,1388.0,448.32,360.88,1346.36,28
CDM,3249273,DST NRV LUMB/SAC FL/CT GD ADDL BI,357.0,115.31,92.82,346.29,28
CDM,3249281,DST NRV LUMB/SAC FL/CT GD ADDL LT,238.0,76.87,61.88,230.86,28
CDM,3249299,DST NRV LUMB/SAC FL/CT GD ADDL RT,238.0,76.87,61.88,230.86,28
CDM,3249307,XR SPINE LS CMP W BEND 6+ VW,939.0,503.3,244.14,910.83,29
CDM,3249315,XR SPINE LS BEND 2-3 VW,529.0,283.54,137.54,513.13,29
CDM,3252293,XR SPINE CERVICAL 4-5 VW,747.0,400.39,194.22,724.59,29
CDM,3252301,XR SPINE CERVICAL 6+ VW,854.0,457.74,222.04,828.38,29
CDM,3254117,ASP&/INJ JT/BUR INTR WO US GD RT,251.0,81.07,65.26,243.47,28
CDM,3254125,ASP&/INJ JT/BUR INTR WO US GD BI,377.0,121.77,98.02,365.69,28
CDM,3254158,ASP&/INJ JT/BUR INTR WO US GD LT,251.0,81.07,65.26,243.47,28
CDM,3254174,ASP&/INJ JT/BUR MAJ WO US GD RT,780.0,251.94,202.8,756.6,28
CDM,3254182,ASP&/INJ JT/BUR MAJ WO US GD BI,1170.0,377.91,304.2,1134.9,28
CDM,3254190,ASP&/INJ JT/BUR MAJ WO US GD LT,780.0,251.94,202.8,756.6,28
CDM,3254257,INJ MYELOGRAM&/CT LUMBAR,762.0,246.13,198.12,739.14,28
CDM,3262227,DXA VERTEBRAL FRACTURE ASSESSMENT,176.0,94.34,45.76,170.72,29
CDM,3262235,TOMOSYNTHESIS DX DIG BRST UNI/BI,59.0,36.99,15.34,57.23,29
CDM,3263373,TOMOSYNTHESIS SCRN DIG BRST BI,63.0,41.2,16.38,61.11,29
CDM,3263415,INJ LUMB MYELOGRPHY CERVICAL S&I,842.0,271.97,218.92,816.74,28
CDM,3263431,INJ LUMB MYELOGRPHY THORACIC S&I,971.0,313.63,252.46,941.87,28
CDM,3263456,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,846.0,273.26,219.96,820.62,28
CDM,3263464,INJ LUMB MYELOGRPHY 2+ S&I,934.0,301.68,242.84,905.98,28
CDM,3264363,DXA STUDY DENSITY 1+SKEL AX FX VERT,667.0,357.51,173.42,646.99,29
CDM,3265337,XR HUMERUS 2 VW RT RDC,455.0,243.88,118.3,441.35,29
CDM,3265345,XR HUMERUS 2 VW LT RDC,455.0,243.88,118.3,441.35,29
CDM,3265352,XR ELBOW 2 VW RT RDC,287.0,153.83,74.62,278.39,29
CDM,3265360,XR ELBOW 2 VW LT RDC,287.0,153.83,74.62,278.39,29
CDM,3265386,XR FOREARM 2 VW RT RDC,275.0,147.4,71.5,266.75,29
CDM,3265394,XR FOREARM 2 VW LT RDC,275.0,147.4,71.5,266.75,29
CDM,3265410,XR WRIST 2 VW RT RDC,256.0,137.22,66.56,248.32,29
CDM,3265428,XR WRIST 2 VW LT RDC,256.0,137.22,66.56,248.32,29
CDM,3265444,XR HAND 2 VW RT RDC,455.0,243.88,118.3,441.35,29
CDM,3265451,XR HAND 2 VW LT RDC,455.0,243.88,118.3,441.35,29
CDM,3265477,XR TIBIA&FIBULA 2 VW RT RDC,306.0,164.02,79.56,296.82,29
CDM,3265485,XR TIBIA&FIBULA 2 VW LT RDC,306.0,164.02,79.56,296.82,29
CDM,3265501,XR ANKLE 2 VW RT RDC,307.0,164.55,79.82,297.79,29
CDM,3265519,XR ANKLE 2 VW LT RDC,307.0,164.55,79.82,297.79,29
CDM,3265535,XR FOOT 2 VW RT RDC,148.0,79.33,38.48,143.56,29
CDM,3265543,XR FOOT 2 VW LT RDC,148.0,79.33,38.48,143.56,29
CDM,3266020,XR ESOPHAGUS STUDY CNT SINGLE,694.0,371.98,180.44,673.18,29
CDM,3266038,FNCT SWALLOW W CINE/VIDEO STUDY CNT,365.0,195.64,94.9,354.05,29
CDM,3266046,XR UGI STUDY CNT SINGLE,1043.0,559.05,271.18,1011.71,29
CDM,3266053,XR UGI STUDY CNT DOUBLE,1113.0,596.57,289.38,1079.61,29
CDM,3266061,XR INTESTINE SM STUDY FOLLOW THRU,327.0,175.27,85.02,317.19,29
CDM,3266079,XR INTESTINE SM STUDY CNT SINGLE,312.0,167.23,81.12,302.64,29
CDM,3266087,XR INTESTINE SM STUDY CNT DOUBLE,1913.0,1025.37,497.38,1855.61,29
CDM,3266095,XR COLON STUDY CNT SINGLE,615.0,329.64,159.9,596.55,29
CDM,3266103,XR COLON STUDY CNT DOUBLE,937.0,502.23,243.62,908.89,29
CDM,3266319,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,884.0,285.53,229.84,857.48,28
CDM,3266848,INJ/S ANES NRV ILIOING ILIOHYGAS LT,548.0,177.0,142.48,531.56,28
CDM,3266855,INJ/S ANES NRV ILIOING ILIOHYGAS RT,548.0,177.0,142.48,531.56,28
CDM,3266863,INJ/S ANES NRV ILIOING ILIOHYGAS BI,822.0,265.51,213.72,797.34,28
CDM,3266970,INJ/S ANES NRV GENICULAR INCL IMGBI,1517.0,489.99,394.42,1471.49,28
CDM,3266988,INJ/S ANES NRV GENICULAR INCL IMGLT,1011.0,326.55,262.86,980.67,28
CDM,3266996,INJ/S ANES NRV GENICULAR INCL IMGRT,1011.0,326.55,262.86,980.67,28
CDM,33019,R&B ICU,8761.0,4977.56,2512.0,8498.17,17
CDM,3305372,CHEMO SUBQ/IM NONHORMONAL,558.0,201.44,145.08,541.26,29
CDM,3305380,CHEMO SUBQ/IM HORMONAL,438.0,158.12,113.88,424.86,29
CDM,3305398,CHEMO IVP DRUG INITIAL,458.0,165.34,119.08,444.26,29
CDM,3305406,CHEMO IVP DRUG ADDL,284.0,102.52,73.84,275.48,29
CDM,3305414,CHEMO INF IV 1ST HR,482.0,135.44,125.32,467.54,29
CDM,3305422,CHEMO INF IV ADDL HR,106.0,29.79,27.56,102.82,29
CDM,3305430,CHEMO INF IV SEQ 1ST HR,237.0,66.6,61.62,229.89,29
CDM,3305570,CHEMO INTRALESIONAL LSN 1-7,175.0,63.18,45.5,169.75,29
CDM,3305588,CHEMO INTRALESIONAL LSN 8+,304.0,109.74,79.04,294.88,29
CDM,3305927,CHEMO IV HOME PMP EXT VNDR SUPPLIED,504.0,141.62,131.04,488.88,29
CDM,3305935,CHEMO IV HOME PMP EXT BH SPLD W FU,504.0,141.62,131.04,488.88,29
CDM,3305943,CHEMO IV HOME PMP EXT BH SPLD WO FU,504.0,141.62,131.04,488.88,29
CDM,3305950,CHEMO IV HOSP PMP EXT/IMP 8+ HR,504.0,141.62,131.04,488.88,29
CDM,3411238,NM BONE&/JOINT PHASE 3,2984.0,1611.36,775.84,2894.48,29
CDM,3411246,NM BONE&/JOINT LTD,1918.0,1035.72,498.68,1860.46,29
CDM,3411287,NM BONE&/JOINT MULTIPLE,2292.0,1237.68,595.92,2223.24,29
CDM,3411303,NM BONE&/JOINT BODY WHOLE,2915.0,1574.1,757.9,2827.55,29
CDM,3411345,NM FLOW VASCULAR BRAIN,576.0,311.04,149.76,558.72,29
CDM,3411360,NM POOL BLOOD CARDIAC 1ST PASS SGL,848.0,457.92,220.48,822.56,29
CDM,3411394,NM FLOW CSF CISTERNOGRAM,844.0,455.76,219.44,818.68,29
CDM,3411410,NM DETECTION&LOC LEAK CSF,1878.0,1014.12,488.28,1821.66,29
CDM,3411428,NM FLOW CSF EVAL SHUNT,1305.0,704.7,339.3,1265.85,29
CDM,3411436,NM REFLEX URETERAL,1071.0,578.34,278.46,1038.87,29
CDM,3411451,NM MOTILITY ESOPHAGEAL,970.0,523.8,252.2,940.9,29
CDM,3411469,NM EMPTYING GASTRIC,2196.0,1185.84,570.96,2130.12,29
CDM,3411485,NM REFLUX GASTROESOPHAGEAL,1792.0,967.68,465.92,1738.24,29
CDM,3411493,NM LOSS BLOOD GI ACUTE,1226.0,662.04,318.76,1189.22,29
CDM,3411576,NM LIVER STATIC,795.0,429.3,206.7,771.15,29
CDM,3411584,NM LIVER W FLOW VASCULAR,1124.0,606.96,292.24,1090.28,29
CDM,3411592,NM LIVER&SPLEEN STATIC,736.0,397.44,191.36,713.92,29
CDM,3411600,NM LIVER&SPLEEN W FLOW VASCULAR,700.0,378.0,182.0,679.0,29
CDM,3411626,NM PERF PULMONARY,1360.0,734.4,353.6,1319.2,29
CDM,3411683,NM LYMPH SYSTEM,1048.0,565.92,272.48,1016.56,29
CDM,3411691,NM INTESTINE,1102.0,595.08,286.52,1068.94,29
CDM,3411717,NM MUGA REST/STRESS PLANAR SGL,2457.0,1326.78,638.82,2383.29,29
CDM,3411725,NM MUGA REST W SPECT,1803.0,973.62,468.78,1748.91,29
CDM,3411733,NM MUGA REST&STRESS MULTI,2504.0,1352.16,651.04,2428.88,29
CDM,3411881,NM KIDNEY FUNCTION&FLOW,1407.0,759.78,365.82,1364.79,29
CDM,3411899,NM KIDNEY FUNCTION&FLOW PHARM MULTI,1980.0,1069.2,514.8,1920.6,29
CDM,3411907,NM KIDNEY FUNCTION&FLOW PHARM SGL,964.0,520.56,250.64,935.08,29
CDM,3411931,NM KIDNEY,812.0,438.48,211.12,787.64,29
CDM,3411949,NM KIDNEY W FLOW VASCULAR,1040.0,561.6,270.4,1008.8,29
CDM,3411998,NM PATENCY SHUNT PERITONEAL VENOUS,923.0,498.42,239.98,895.31,29
CDM,3412020,NM TESTICULAR W FLOW VASCULAR,1012.0,546.48,263.12,981.64,29
CDM,3412160,NM LOC RRX TMR PLNR WHL BODY 2D IMG,1261.0,680.94,327.86,1223.17,29
CDM,3412178,NM LOC RRX TMR PLNR WHL BODY 1D IMG,958.0,517.32,249.08,929.26,29
CDM,3412186,NM TEST BREATH UREA C14 ACQ,35.0,18.9,9.1,33.95,29
CDM,3412194,NM TEST BREATH UREA C14 ANALYSIS,285.0,153.9,74.1,276.45,29
CDM,3412434,RRX TC99 MEDRONATE/0-30MCI DOSE,354.3,187.07,92.12,343.67,28
CDM,3412608,RRX INDIUM 111 PENTETATE DX/0.5MCI,2018.0,1065.5,524.68,1957.46,29
CDM,3412624,RRX INDIUM 111 OXYQ DX/0.5MCI,98.0,51.74,25.48,1662.92,29
CDM,3412657,RRX TETROFOSMIN DX/DOSE,200.0,105.6,52.0,194.0,28
CDM,3412707,RRX TC-99 SESTAMIBI DX/DOSE,277.9,146.73,72.25,269.56,28
CDM,3412814,RRX PERTECHNETATE DX/MCI,116.0,61.25,30.16,112.52,28
CDM,3412863,RRX EXAMETAZIME DX/0-25MCI DOSE,725.0,382.8,188.5,1855.42,29
CDM,3412921,INJ EVAL SHUNT PERITONEAL-VENOUS,197.0,63.63,51.22,191.09,28
CDM,3412962,NM FLOW VASCULAR NON-CARDIAC,809.0,436.86,210.34,784.73,29
CDM,3413101,RRX MERTIATIDE DX/0-15MCI DOSE,413.0,218.06,107.38,400.61,28
CDM,3413143,RRX PYROPHOSPHATE DX/0-25MCI DOSE,463.2,244.57,120.43,449.3,28
CDM,3413168,RRX MEBROFENIN DX/0-15MCI DOSE,942.0,497.38,244.92,913.74,28
CDM,3413184,RRX PENTETATE DX/0-25MCI DOSE,257.0,135.7,66.82,249.29,28
CDM,3413200,RRX MAA DX/0-10MCI DOSE,172.0,90.82,44.72,166.84,28
CDM,3413218,RRX BICISATE DX/0-25MCI DOSE,1683.0,888.62,437.58,1632.51,29
CDM,3413226,RRX SULFUR COLLOID DX/0-20MCI DOSE,172.0,90.82,44.72,166.84,28
CDM,3413234,RRX RBC LABELED DX/0-30MCI DOSE,804.0,424.51,209.04,779.88,28
CDM,3413408,NM BRAIN 4+ VW STATIC,769.0,415.26,199.94,745.93,29
CDM,3413416,NM BRAIN 4+ VW STATIC W FLOW,1280.0,691.2,332.8,1241.6,29
CDM,3413457,RRX I-123 IOD NA DX/100UCI <1MCI,110.0,58.08,28.6,106.7,28
CDM,3413465,RRX INDIUM-111 PENTET DX/0-6MCI,4325.0,2283.6,1124.5,4195.25,29
CDM,3413473,RRX EXAMETAZIME WBC LABELED DX/DOSE,1852.0,977.86,481.52,1868.26,29
CDM,3413572,NM PERF MYOC SPECT WM/EF SGL,4551.0,2457.54,1183.26,4414.47,29
CDM,3413580,NM PERF MYOC SPEC WM/EF MULT,5478.0,2958.12,1424.28,5313.66,29
CDM,3413721,INJ IVP DRUG INITIAL INCMP TEST,453.0,212.0,117.78,439.41,29
CDM,3413762,INJ RRX NODE SENTINEL ID BI,468.0,151.16,121.68,453.96,28
CDM,3413770,INJ RRX NODE SENTINEL ID LT,312.0,100.78,81.12,302.64,28
CDM,3413788,INJ RRX NODE SENTINEL ID RT,312.0,100.78,81.12,302.64,28
CDM,3413796,NM HEPATOBILIARY W/WO GB,918.0,495.72,238.68,890.46,29
CDM,3413804,NM HEPATOBILIARY W PHARM W/WO GB,2462.0,1329.48,640.12,2388.14,29
CDM,3413820,NM VENT&PERF PULMONARY,1467.0,792.18,381.42,1422.99,29
CDM,3413960,NM THYROID UPTAKE MEAS QN SGL/MULT,492.0,265.68,127.92,477.24,29
CDM,3413978,NM THYROID W/WO FLOW VASCULAR,515.0,278.1,133.9,499.55,29
CDM,3413986,NM THYROID UPTAKE MEAS W/WO FLW STM,739.0,399.06,192.14,716.83,29
CDM,3413994,NM PLANAR PARATHYROID,1209.0,652.86,314.34,1172.73,29
CDM,3414067,RRX DTPA AEROSOL DOSE 0-75MCI,426.3,225.09,110.84,413.51,28
CDM,3414356,NM LOC RRX TMR PLNR 1 AREA 1D IMG,821.0,443.34,213.46,796.37,29
CDM,3414364,NM LOC RRX TMR PLNR 2+AREA 1+D IMG,846.0,456.84,219.96,820.62,29
CDM,3414372,NM LOC RRX TMR SPECT 1AREA 1ACQ 1D,971.0,524.34,252.46,941.87,29
CDM,3414380,NM LOC RRX TMR SPECT CT 1AREA 1ACQ,1099.0,593.46,285.74,1066.03,29
CDM,3414398,NM LOC RRX TMR SPECT 2+AREA 2ACQ,1837.0,991.98,477.62,1781.89,29
CDM,3414406,NM LOC RRX TMR SPECT CT 2+AREA 2ACQ,2178.0,1176.12,566.28,2112.66,29
CDM,3522182,CT LTD/FOLLOWUP,872.0,346.18,226.72,845.84,29
CDM,3522216,CT GD PLCMT NEEDLE S&I,966.0,383.5,251.16,937.02,29
CDM,3522307,CTA AORTA ABD RUNOFF W CNT,5215.0,2070.36,1355.9,5058.55,29
CDM,3522687,CT HEAD W CNT,1878.0,788.76,488.28,1821.66,29
CDM,3522695,CT HEAD WO CNT,1502.0,630.84,390.52,1456.94,29
CDM,3522703,CT HEAD W&WO CNT,2253.0,946.26,585.78,2185.41,29
CDM,3522711,CT MAXFACIAL WO CNT,1619.0,679.98,420.94,1570.43,29
CDM,3522729,CT MAXFACIAL W CNT,2024.0,850.08,526.24,1963.28,29
CDM,3522737,CT MAXFACIAL W&WO CNT,2429.0,1020.18,631.54,2356.13,29
CDM,3522745,CT NECK ST W CNT,2425.0,1018.5,630.5,2352.25,29
CDM,3522752,CT NECK ST WO CNT,1940.0,814.8,504.4,1881.8,29
CDM,3522760,CT NECK ST W&WO CNT,2910.0,1222.2,756.6,2822.7,29
CDM,3522778,CT ORB/PF/SEL/IAC W CNT,2317.0,973.14,602.42,2247.49,29
CDM,3522786,CT ORB/PF/SEL/IAC WO CNT,1853.0,778.26,481.78,1797.41,29
CDM,3522794,CT ORB/PF/SEL/IAC W&WO CNT,2780.0,1167.6,722.8,2696.6,29
CDM,3522810,CTA HEAD W CNT&PP,2366.0,993.72,615.16,2295.02,29
CDM,3522836,CTA NECK W CNT&PP,3056.0,1283.52,794.56,2964.32,29
CDM,3522844,CT ABDOMEN W CNT,2829.0,1386.21,735.54,2744.13,29
CDM,3522851,CT ABDOMEN WO CNT,2263.0,1108.87,588.38,2195.11,29
CDM,3522869,CT ABDOMEN W&WO CNT,3395.0,1663.55,882.7,3293.15,29
CDM,3522877,CT DENSITY BONE AXIAL 1+ SITE,278.0,136.22,72.28,269.66,29
CDM,3522893,CT CHEST DX W CNT,2619.0,1283.31,680.94,2540.43,29
CDM,3522901,CT CHEST DX WO CNT,2095.0,1026.55,544.7,2032.15,29
CDM,3522919,CT CHEST DX W&WO CNT,3143.0,1540.07,817.18,3048.71,29
CDM,3522927,CT SPINE CERVICAL W CNT,2728.0,1336.72,709.28,2646.16,29
CDM,3522935,CT SPINE CERVICAL WO CNT,2182.0,1069.18,567.32,2116.54,29
CDM,3522943,CT SPINE CERVICAL W&WO CNT,3273.0,1603.77,850.98,3174.81,29
CDM,3522950,CT EXT LOWER W CNT LT,2110.0,1033.9,548.6,2046.7,29
CDM,3522968,CT EXT LOWER W CNT RT,2110.0,1033.9,548.6,2046.7,29
CDM,3522976,CT EXT LOWER WO CNT LT,1688.0,827.12,438.88,1637.36,29
CDM,3522984,CT EXT LOWER WO CNT RT,1688.0,827.12,438.88,1637.36,29
CDM,3523024,CT EXT LOWER W&WO CNT LT,2532.0,1240.68,658.32,2456.04,29
CDM,3523032,CT EXT LOWER W&WO CNT RT,2532.0,1240.68,658.32,2456.04,29
CDM,3523040,CT SPINE LUMBAR W CNT,3133.0,1535.17,814.58,3039.01,29
CDM,3523057,CT SPINE LUMBAR WO CNT,2506.0,1227.94,651.56,2430.82,29
CDM,3523065,CT SPINE LUMBAR W&WO CNT,3759.0,1841.91,977.34,3646.23,29
CDM,3523073,CT PELVIS W CNT,3020.0,1479.8,785.2,2929.4,29
CDM,3523081,CT PELVIS WO CNT,2416.0,1183.84,628.16,2343.52,29
CDM,3523099,CT PELVIS W&WO CNT,3624.0,1775.76,942.24,3515.28,29
CDM,3523107,CT SPINE THORACIC W CNT,2857.0,1399.93,742.82,2771.29,29
CDM,3523115,CT SPINE THORACIC WO CNT,2285.0,1119.65,594.1,2216.45,29
CDM,3523123,CT SPINE THORACIC W&WO CNT,3428.0,1679.72,891.28,3325.16,29
CDM,3523156,CT EXT UPPER W CNT LT,2024.0,991.76,526.24,1963.28,29
CDM,3523164,CT EXT UPPER W CNT RT,2024.0,991.76,526.24,1963.28,29
CDM,3523180,CT EXT UPPER WO CNT LT,1619.0,793.31,420.94,1570.43,29
CDM,3523198,CT EXT UPPER WO CNT RT,1619.0,793.31,420.94,1570.43,29
CDM,3523206,CT EXT UPPER W&WO CNT LT,2429.0,1190.21,631.54,2356.13,29
CDM,3523214,CT EXT UPPER W&WO CNT RT,2429.0,1190.21,631.54,2356.13,29
CDM,3523230,CTA ABDOMEN W CNT&PP,3565.0,1746.85,926.9,3458.05,29
CDM,3523255,CTA CHEST W CNT&PP,3301.0,1617.49,858.26,3201.97,29
CDM,3523289,CTA EXT LOWER W CNT&PP LT,2659.0,1302.91,691.34,2579.23,29
CDM,3523297,CTA EXT LOWER W CNT&PP RT,2659.0,1302.91,691.34,2579.23,29
CDM,3523313,CTA PELVIS W CNT&PP,3806.0,1864.94,989.56,3691.82,29
CDM,3523321,CTA EXT UPPER W CNT&PP LT,2551.0,1249.99,663.26,2474.47,29
CDM,3523339,CTA EXT UPPER W CNT&PP RT,2551.0,1249.99,663.26,2474.47,29
CDM,3525375,STUDIES LENGTH BONE,609.0,326.42,158.34,590.73,29
CDM,3528957,CT ABDOMEN&PELVIS WO CNT,3757.0,1840.93,976.82,3644.29,29
CDM,3528965,CT ABDOMEN&PELVIS W CNT,4697.0,2301.53,1221.22,4556.09,29
CDM,3528973,CT ABDOMEN&PELVIS W&WO CNT,5636.0,2761.64,1465.36,5466.92,29
CDM,3529542,CTA ABDOMEN&PELVIS W CNT&PP,5918.0,2899.82,1538.68,5740.46,29
CDM,3530078,CT REND 3D W I&R W PP SAME WRKST,331.0,131.41,86.06,321.07,29
CDM,3530086,CT REND 3D W I&R W PP DIFF WRKST,492.0,195.32,127.92,477.24,29
CDM,3530185,DRN PLEURA INS CATH INDWL W IMG LT,1189.0,384.05,309.14,1153.33,28
CDM,3530193,DRN PLEURA INS CATH INDWL W IMG RT,1189.0,384.05,309.14,1153.33,28
CDM,3530201,DRN PLEURA INS CATH INDWL W IMG BI,1784.0,576.23,463.84,1730.48,28
CDM,3530581,DRN CATH FLUID PERI PERC IMG GD,1973.0,637.28,512.98,1913.81,28
CDM,3532322,BX NEEDLE CORE LUNG/MEDSTRNM PERC,2149.0,694.13,558.74,2084.53,28
CDM,3532397,CT LOW DOSE SCRN CA LUNG WO CNT,1224.0,599.76,318.24,1187.28,29
CDM,3534328,CTA HEAD&NECK W&WO CNT&PP,5422.0,2152.53,1409.72,5259.34,29
CDM,3602000,OR LEVEL 1 FIRST 30MIN,3680.0,2127.04,956.8,3569.6,28
CDM,3602018,OR LEVEL 1 ADDL 15MIN,1350.0,780.3,351.0,1309.5,28
CDM,3602026,OR LEVEL 2 FIRST 30MIN,4680.0,2705.04,1216.8,4539.6,28
CDM,3602034,OR LEVEL 2 ADDL 15MIN,1600.0,924.8,416.0,1552.0,28
CDM,3602042,OR LEVEL 3 FIRST 30MIN,5680.0,3283.04,1476.8,5509.6,28
CDM,3602059,OR LEVEL 3 ADDL 15MIN,2100.0,1213.8,546.0,2037.0,28
CDM,3602067,OR LEVEL 4 FIRST 30MIN,6415.0,3707.87,1667.9,6222.55,28
CDM,3602075,OR LEVEL 4 ADDL 15MIN,2420.0,1398.76,629.2,2347.4,28
CDM,3602083,OR LEVEL 5 FIRST 30MIN,8915.0,5152.87,2317.9,8647.55,28
CDM,3602091,OR LEVEL 5 ADDL 15MIN,2920.0,1687.76,759.2,2832.4,28
CDM,3602109,OR LEVEL 6 FIRST 30MIN,11415.0,6597.87,2967.9,11072.55,28
CDM,3602117,OR LEVEL 6 ADDL 15MIN,3420.0,1976.76,889.2,3317.4,28
CDM,3604659,MONITOR NEURO 1:1 IN OR 15MIN,142.0,154.35,36.92,137.74,29
CDM,3701075,SED MOD SAME 0-4Y INIT 15MN,490.0,329.77,127.4,475.3,29
CDM,3701083,SED MOD SAME 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CDM,3701091,SED MOD ENDO SAME 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CDM,3701109,SED MOD SAME ADDL 15MN,245.0,164.89,63.7,237.65,29
CDM,3702107,ANESTHESIA LEVEL 1 FIRST 30MIN,670.0,450.91,174.2,649.9,29
CDM,3702115,ANESTHESIA LEVEL 2 FIRST 30MIN,1170.0,787.41,304.2,1134.9,29
CDM,3702123,ANESTHESIA LEVEL 3 FIRST 30MIN,1670.0,1123.91,434.2,1619.9,29
CDM,3702131,ANESTHESIA LEVEL 4 FIRST 30MIN,2170.0,1460.41,564.2,2104.9,29
CDM,3705100,ANESTHESIA LEVEL 1 ADDL 15MIN,340.0,228.82,88.4,329.8,29
CDM,3705118,ANESTHESIA LEVEL 2 ADDL 15MIN,390.0,262.47,101.4,378.3,29
CDM,3705126,ANESTHESIA LEVEL 3 ADDL 15MIN,440.0,296.12,114.4,426.8,29
CDM,3705134,ANESTHESIA LEVEL 4 ADDL 15MIN,640.0,430.72,166.4,620.8,29
CDM,3900040,PLATELETS PATHOGEN RDC VOL RDC EA,1752.0,527.35,455.52,1699.44,29
CDM,3902038,LAB COOMBS DIR ANTISERUM EA,125.0,72.0,32.5,121.25,29
CDM,3902053,CRYOPRECIPITATE EA UNIT,89.0,26.79,23.14,86.33,29
CDM,3902087,FFP FRZ WITHIN 8 HRS COLL EA UNIT,93.0,27.99,24.18,90.21,29
CDM,3902129,FFP FRZ 8-24 HRS AFTER COLL EA UNIT,93.0,27.99,24.18,90.21,29
CDM,3902277,PLATELETS PHER LR EA UNIT,731.0,220.03,190.06,709.07,29
CDM,3902285,PLATELETS PHER LR IRRD EA UNIT,787.0,236.89,204.62,763.39,29
CDM,3902319,LAB BLOOD TYPE AG RBC EA,751.0,568.51,195.26,728.47,29
CDM,3902327,LAB PANEL AB RBC EA TECH SERUM,751.0,568.51,195.26,728.47,29
CDM,3902335,LAB SCR AB RBC SERUM EA,110.0,83.27,28.6,106.7,29
CDM,3902384,RBC LR AUTO EA UNIT,714.0,214.91,185.64,692.58,29
CDM,3902418,RBC LR IRRD EA UNIT,350.0,105.35,91.0,339.5,29
CDM,3902525,TRANSFUSION BLOOD/COMP 1 UNIT,842.0,266.07,218.92,816.74,29
CDM,3902533,TRANSFUSION BLOOD/COMP 2 UNITS,1053.0,332.75,273.78,1021.41,29
CDM,3902541,TRANSFUSION BLOOD/COMP 3+ UNITS,1263.0,399.11,328.38,1225.11,29
CDM,3902558,LAB BLOOD TYPE AG RBC EA NS,751.0,568.51,195.26,728.47,29
CDM,3902632,RBC LR EA UNIT,294.0,88.49,76.44,285.18,29
CDM,3903614,PLATELETS PATHOGEN RDC WASHED EA,1752.0,527.35,455.52,1699.44,29
CDM,3903630,LAB DET IA RSV PRB AMP,211.0,112.04,54.86,204.67,29
CDM,3903689,LAB CHROMAT MS NON-DRUG QL/QN,75.0,36.15,19.5,72.75,29
CDM,3903713,LAB STAIN SPECIAL 2 PROT AMYLOID,281.0,123.64,73.06,272.57,29
CDM,3903721,LAB MICRODISSECTION LASER PROT AMYL,202.0,88.88,52.52,195.94,29
CDM,3903739,LAB CHROMAT MS PROT AMYLOID QN,909.0,438.14,236.34,881.73,29
CDM,3903788,LAB IMM MS ALPHA 2 MACROGLOBULIN,59.0,28.44,15.34,57.23,29
CDM,3903838,LAB SCR AB THSD7A W REFLEX FL,453.0,260.93,117.78,439.41,29
CDM,3903978,LAB DRG DF ETOH BIOMRK 1-2,130.0,62.66,33.8,126.1,29
CDM,3904109,LAB DET IA DENGUE TYPES 1-4 PRB AMP,290.0,153.99,75.4,281.3,29
CDM,3904117,LAB AB VIRUS DENGUE,70.0,40.32,18.2,67.9,29
CDM,3904166,LAB AB ID PLATELET IGG FLOW CYTO,236.0,135.94,61.36,228.92,29
CDM,3904216,LAB EOSINOPHILS URINE/OTHER,57.0,27.47,14.82,55.29,29
CDM,3904281,LAB IMM AB MUT CITRULLINAT VIMENTIN,89.0,42.9,23.14,86.33,29
CDM,3904422,LAB CHOLESTEROL FLUID BODY,55.0,26.51,14.3,53.35,29
CDM,3904430,LAB IMM AB QN HAEMOPHILUS INFLU B,63.0,36.29,16.38,61.11,29
CDM,3904471,LAB AB ISLET ANTIGEN 2 AUTOAB,158.0,91.01,41.08,153.26,29
CDM,3904513,LAB ACTIVITY ENZYME L-ASPARAGNSE,325.0,156.65,84.5,315.25,29
CDM,3904539,LAB AB FILARIA IGG4,102.0,58.75,26.52,98.94,29
CDM,3904562,LAB PROT WB AB RYR W INTRP,710.0,342.22,184.6,688.7,29
CDM,3904661,LAB AB ENA SCLERODERMA PANEL,161.0,92.74,41.86,156.17,29
CDM,3904729,PLATELETS PATHOGEN RDC LOW YIELD EA,1875.0,564.38,487.5,1818.75,29
CDM,3904737,PLATELETS PATHOGEN PHER LOW YIELDEA,1875.0,564.38,487.5,1818.75,29
CDM,3904745,PLATELETS PHER LR IRRD LOW YIELD EA,2042.0,614.64,530.92,1980.74,29
CDM,3904760,PLATELETS PHER LR LOW YIELD EA,1875.0,564.38,487.5,1818.75,29
CDM,4002069,US BREAST CMP LT,681.0,475.34,177.06,660.57,29
CDM,4002077,US BREAST CMP RT,681.0,475.34,177.06,660.57,29
CDM,4002085,US BREAST LTD LT,630.0,439.74,163.8,611.1,29
CDM,4002093,US BREAST LTD RT,630.0,439.74,163.8,611.1,29
CDM,4002226,ASP&/INJ JT/BUR MAJ W US GD BI,1248.0,403.1,324.48,1210.56,28
CDM,4002234,ASP&/INJ JT/BUR MAJ W US GD LT,832.0,268.74,216.32,807.04,28
CDM,4002242,ASP&/INJ JT/BUR MAJ W US GD RT,832.0,268.74,216.32,807.04,28
CDM,4002382,US BREAST LTD BI,945.0,659.61,245.7,916.65,29
CDM,4002416,US BREAST CMP BI,1022.0,713.36,265.72,991.34,29
CDM,4030029,AMNIOCENTESIS DIAGNOSTIC,609.0,196.71,158.34,590.73,28
CDM,4030409,BX MUSCLE NDL PERC,1943.0,627.59,505.18,1884.71,28
CDM,4030474,BX THYROID NDL CORE PERC,1426.0,460.6,370.76,1383.22,28
CDM,4030847,US UTERUS PREG DETAIL GEST ADDL,959.0,669.38,249.34,930.23,29
CDM,4030854,US ABDOMEN CMP,1001.0,698.7,260.26,970.97,29
CDM,4030862,US ABDOMEN LTD,887.0,619.13,230.62,860.39,29
CDM,4030870,US PROFILE BIO FETAL W NST ADDL,620.0,432.76,161.2,601.4,29
CDM,4030888,US PROFILE BIO FETAL WO NST,435.0,303.63,113.1,421.95,29
CDM,4030896,US PROFILE BIO FETAL WO NST ADDL,435.0,303.63,113.1,421.95,29
CDM,4030904,US PROFILE BIO FETAL W NST,620.0,432.76,161.2,601.4,29
CDM,4030953,US CHEST,577.0,402.75,150.02,559.69,29
CDM,4031084,US GD VA EVAL SITE W REC PERM,182.0,127.04,47.32,176.54,29
CDM,4031092,US GD INTRAOPERATIVE,331.0,231.04,86.06,321.07,29
CDM,4031100,US GD AMNIOCENTESIS S&I,433.0,302.23,112.58,420.01,29
CDM,4031142,US GD PLCMT NEEDLE S&I,662.0,462.08,172.12,642.14,29
CDM,4031175,US HIPS INFANT DYNAMIC,253.0,176.59,65.78,245.41,29
CDM,4031183,US HIPS INFANT STATIC,168.0,117.26,43.68,162.96,29
CDM,4031191,SONOHYSTEROGRAPHY INF SALINE,510.0,355.98,132.6,494.7,29
CDM,4031225,US HEAD NEONATAL,420.0,293.16,109.2,407.4,29
CDM,4031241,US UTERUS PREG 0-13WK GEST ADDL,253.0,176.59,65.78,245.41,29
CDM,4031258,US UTERUS PREG 0-13WK GEST SGL,901.0,628.9,234.26,873.97,29
CDM,4031266,US UTERUS PREG 14+WK GEST ADDL,460.0,321.08,119.6,446.2,29
CDM,4031274,US UTERUS PREG 14+WK GEST SGL,1029.0,718.24,267.54,998.13,29
CDM,4031282,US UTERUS PREG DETAIL GEST SGL,558.0,389.48,145.08,541.26,29
CDM,4031290,US UTERUS PREG RE-EVAL FETUS,737.0,514.43,191.62,714.89,29
CDM,4031308,US UTERUS PREG RE-EVAL FETUS ADDL,737.0,514.43,191.62,714.89,29
CDM,4031316,US UTERUS PREG LTD 1+ FETUS,705.0,492.09,183.3,683.85,29
CDM,4031324,US UTERUS PREG TRANSVAGINAL,809.0,564.68,210.34,784.73,29
CDM,4031332,US PELVIS NON OB CMP,930.0,649.14,241.8,902.1,29
CDM,4031340,US PELVIS NON OB LTD,786.0,548.63,204.36,762.42,29
CDM,4031399,US GD RPR PSEUDOAN ART/FISTULA AV,752.0,524.9,195.52,729.44,29
CDM,4031407,US RETROPERITONEAL LTD,688.0,480.22,178.88,667.36,29
CDM,4031415,US RETROPERITONEAL CMP,875.0,610.75,227.5,848.75,29
CDM,4031423,US SCROTUM&CONTENTS,846.0,590.51,219.96,820.62,29
CDM,4031431,US TISSUE SOFT HEAD&NECK,926.0,646.35,240.76,898.22,29
CDM,4031449,US SPINAL CANAL&CONTENTS,482.0,336.44,125.32,467.54,29
CDM,4031464,US TRANSRECTAL,292.0,203.82,75.92,283.24,29
CDM,4031472,US TRANSVAGINAL,827.0,577.25,215.02,802.19,29
CDM,4031597,ASP PUNCT CYST BREAST ADDL LT,92.0,29.72,23.92,89.24,28
CDM,4031605,ASP PUNCT CYST BREAST ADDL RT,92.0,29.72,23.92,89.24,28
CDM,4031621,ASP PUNCT CYST BREAST INIT LT,366.0,118.22,95.16,355.02,28
CDM,4031639,ASP PUNCT CYST BREAST INIT RT,366.0,118.22,95.16,355.02,28
CDM,4031860,INJ DUCTO/GALACTOGRAM MAMMARY BI,252.0,81.4,65.52,244.44,28
CDM,4031878,INJ DUCTO/GALACTOGRAM MAMMARY LT,168.0,54.26,43.68,162.96,28
CDM,4031886,INJ DUCTO/GALACTOGRAM MAMMARY RT,168.0,54.26,43.68,162.96,28
CDM,4032116,DXA STUDY DENSITY 1+SKEL AX,604.0,323.74,157.04,585.88,29
CDM,4032124,DXA STUDY DENSITY 1+SKEL APPEND,388.0,207.97,100.88,376.36,29
CDM,4032132,DUCTO/GALACTOGRAM MAMMARY MULTI S&I,433.0,232.09,112.58,420.01,29
CDM,4032140,DUCTO/GALACTOGRAM MAMMARY SGL LTS&I,388.0,207.97,100.88,376.36,29
CDM,4032157,DUCTO/GALACTOGRAM MAMMARY SGL RTS&I,388.0,207.97,100.88,376.36,29
CDM,4032405,US DUPLEX ART EXT UPR UNI/LTD LT,980.0,471.38,254.8,950.6,29
CDM,4032413,US DUPLEX ART EXT LWR UNI/LTD RT,990.0,476.19,257.4,960.3,29
CDM,4032421,US DUPLEX ART EXT LWR UNI/LTD LT,990.0,476.19,257.4,960.3,29
CDM,4032439,US DUPLEX ART EXT UPR UNI/LTD RT,980.0,471.38,254.8,950.6,29
CDM,4032447,US DUPLEX ART EXT LWR BI,1550.0,745.55,403.0,1503.5,29
CDM,4032454,US DUPLEX ART EXT UPR CMP BI,1402.0,674.36,364.52,1359.94,29
CDM,4032488,US ART PHYS EXT LWR TREADMILL BI,469.0,225.59,121.94,454.93,29
CDM,4032496,US DUPLEX EXTRACRANIAL CMP BI,1661.0,798.94,431.86,1611.17,29
CDM,4032504,US DUPLEX EXTRACRANIAL UNI/LTD,980.0,471.38,254.8,950.6,29
CDM,4032520,US DUPLEX ABD/PEL/SCR&/RETRO CMP,1762.0,847.52,458.12,1709.14,29
CDM,4032538,US DUPLEX ABD/PEL/SCR&/RETRO LTD,627.0,301.59,163.02,608.19,29
CDM,4032553,US DUPLEX AO/IVC/ILIAC/GRFT CMP,590.0,283.79,153.4,572.3,29
CDM,4032587,US DUPLEX VEIN EXT CMP BI,1740.0,836.94,452.4,1687.8,29
CDM,4032595,US DUPLEX VEIN EXT LTD/UNI,1168.0,561.81,303.68,1132.96,29
CDM,4033445,VELOCIMETRY DOPPLER ART UMB FETAL,319.0,222.66,82.94,309.43,29
CDM,4033452,VELOCIMETRY DOPPLER ART CERE FETAL,525.0,366.45,136.5,509.25,29
CDM,4033759,ECHO 2D CMP WO CNT,1437.0,678.26,373.62,1393.89,29
CDM,4033767,ECHO 2D LTD WO CNT,755.0,356.36,196.3,732.35,29
CDM,4033775,ECHO DOPP MAP VELOCITY COLOR FLOW,344.0,162.37,89.44,333.68,29
CDM,4033783,ECHO DOPP CMP,436.0,205.79,113.36,422.92,29
CDM,4033791,ECHO DOPP LTD,220.0,103.84,57.2,213.4,29
CDM,4033809,ECHO 2D REST&STRESS WO CNT W I&R,979.0,462.09,254.54,949.63,29
CDM,4035002,US KIDNEY TRANSPLANTED W DOPPLER,474.0,330.85,123.24,459.78,29
CDM,4035010,US SCREEN AAA,465.0,324.57,120.9,451.05,29
CDM,4035028,US UTERUS PREG MEAS NUCHAL GEST SGL,427.0,298.05,111.02,414.19,29
CDM,4035036,US UTERUS PREG MEAS NUCHAL GEST ADD,249.0,173.8,64.74,241.53,29
CDM,4036356,ECHO 2D DOPP&CLR FLW CMP WO CNT,2143.0,1011.5,557.18,2078.71,29
CDM,4036596,US GD VA EVAL SITE W REC PERM,182.0,127.04,47.32,176.54,29
CDM,4037222,BX/EXCISE NODE NDL SUPERFICIAL BI,4202.0,1357.25,1092.52,4075.94,28
CDM,4037230,BX/EXCISE NODE NDL SUPERFICIAL LT,2801.0,904.72,728.26,2716.97,28
CDM,4037248,BX/EXCISE NODE NDL SUPERFICIAL RT,2801.0,904.72,728.26,2716.97,28
CDM,4037792,ART PHYS 1-2 LEVEL LTD BI,818.0,393.46,212.68,793.46,29
CDM,4037800,ART PHYS 3+ LEVEL CMP BI,1347.0,647.91,350.22,1306.59,29
CDM,4037990,ART PHYS 1-2 LEVEL LTD UNI,545.0,262.14,141.7,528.65,29
CDM,4038006,ART PHYS 3+ LEVEL CMP UNI,898.0,431.94,233.48,871.06,29
CDM,4038618,PARACENTESIS ABDOMINAL W IMG,832.0,268.74,216.32,807.04,28
CDM,4038832,THORACENTESIS ASP W IMG LT,909.0,293.61,236.34,881.73,28
CDM,4038840,THORACENTESIS ASP W IMG RT,909.0,293.61,236.34,881.73,28
CDM,4038857,THORACENTESIS ASP W IMG BI,1364.0,440.57,354.64,1323.08,28
CDM,4038865,US REND 3D W I&R W PP SAME WRKST,331.0,231.04,86.06,321.07,29
CDM,4038873,US REND 3D W I&R W PP DIFF WRKST,492.0,343.42,127.92,477.24,29
CDM,4039319,BX BRST W/WO DEV/IMG US LSN ADD,2119.0,684.44,550.94,2055.43,28
CDM,4039350,PLC DEV/S BRST US GD LSN ADD,232.0,74.94,60.32,225.04,28
CDM,4039459,BX BRST W/WO DEV/IMG SG LSN ADD,559.0,180.56,145.34,542.23,28
CDM,4039491,PLC DEV/S BRST MAMMO GD LSN ADD,379.0,122.42,98.54,367.63,28
CDM,4039582,PLC DEV/S BRST MAMMO GD LSN 1ST LT,1148.0,370.8,298.48,1113.56,28
CDM,4039590,PLC DEV/S BRST MAMMO GD LSN 1ST RT,1148.0,370.8,298.48,1113.56,28
CDM,4039624,PLC DEV/S BRST US GD LSN 1ST LT,743.0,239.99,193.18,720.71,28
CDM,4039632,PLC DEV/S BRST US GD LSN 1ST RT,743.0,239.99,193.18,720.71,28
CDM,4039681,BX BRST W/WO DEV/IMG SG LSN 1ST LT,1117.0,360.79,290.42,1083.49,28
CDM,4039699,BX BRST W/WO DEV/IMG SG LSN 1ST RT,1117.0,360.79,290.42,1083.49,28
CDM,4039707,BX BRST W/WO DEV/IMG US LSN 1ST LT,4235.0,1367.9,1101.1,4107.95,28
CDM,4039715,BX BRST W/WO DEV/IMG US LSN 1ST RT,4235.0,1367.9,1101.1,4107.95,28
CDM,4040069,US JT/EVAL FOCAL EXT NONVASC LTD,695.0,485.11,180.7,674.15,29
CDM,4040556,PERICARDIOCENTESIS INCL IMG GD,1457.0,470.61,378.82,1413.29,28
CDM,4109245,CPR,763.0,291.47,198.38,740.11,29
CDM,4109351,DEMO&/EVAL PT AEROSOL/NEB/MDI/IPPB,199.0,76.02,51.74,193.03,29
CDM,4109385,BIPAP INITIAL DAY,882.0,336.92,229.32,855.54,29
CDM,4109393,BIPAP SUBSQ DAY,882.0,336.92,229.32,855.54,29
CDM,4109401,PHYSIOTHERAPY CHEST INITIAL,98.0,37.44,25.48,95.06,29
CDM,4109419,PHYSIOTHERAPY CHEST SUBSQ,96.0,36.67,24.96,93.12,29
CDM,4109435,CPAP INITIAL DAY,882.0,336.92,229.32,855.54,29
CDM,4109443,CPAP SUBSQ DAY,882.0,336.92,229.32,855.54,29
CDM,4109468,CLEARANCE AIRWAY INITIAL,98.0,37.44,25.48,95.06,29
CDM,4109476,CLEARANCE AIRWAY SUBSQ,96.0,36.67,24.96,93.12,29
CDM,4109583,VENT INITIAL DAY,1265.0,483.23,328.9,1227.05,29
CDM,4109591,VENT SUBSQ DAY,924.0,352.97,240.24,896.28,29
CDM,4109823,PUNCT ARTERIAL FOR DIAGNOSIS,95.0,71.92,24.7,92.15,29
CDM,4109963,SPIROMETRY W VITAL CAP W/WO VENT,404.0,150.29,105.04,391.88,29
CDM,4110094,BRONCHDLTN PRE&POST SPIROMETRY W VC,580.0,215.76,150.8,562.6,29
CDM,4110151,EVAL BRONCHSPSM SPIRO W AGENTS,784.0,291.65,203.84,760.48,29
CDM,4110169,CAPACITY BREATHING MAX VENT VOL MAX,110.0,40.92,28.6,106.7,29
CDM,4110193,LOOP VOLUME FLOW RESP,341.0,126.85,88.66,330.77,29
CDM,4110458,DECLOT CATH/VAD W AGENT THROMB,497.0,160.53,129.22,482.09,28
CDM,4110615,PLETHYSMOGRAPHY VOLUMES LUNG,252.0,93.74,65.52,244.44,29
CDM,4110623,DILUT GAS/WASHOUT VOLUMES LUNG,337.0,125.36,87.62,326.89,29
CDM,4110649,CAPACITY DIFFUSING,373.0,138.76,96.98,361.81,29
CDM,4110961,RESIST AIRWAY OSCILLOMETRY,282.0,104.9,73.32,273.54,29
CDM,4200515,PT EVAL THERAPY LOW,310.0,182.9,80.6,300.7,29
CDM,4200564,PT EVAL THERAPY MOD,393.0,231.87,102.18,381.21,29
CDM,4200614,PT EVAL THERAPY HIGH,445.0,262.55,115.7,431.65,29
CDM,4200663,PT RE-EVAL THERAPY,310.0,182.9,80.6,300.7,29
CDM,4201794,PT STRAPPING BOOT UNNA BI,413.0,251.1,107.38,400.61,29
CDM,4201802,PT STRAPPING BOOT UNNA LT,275.0,167.2,71.5,266.75,29
CDM,4201810,PT STRAPPING BOOT UNNA RT,275.0,167.2,71.5,266.75,29
CDM,4209094,PT MODALITY APPL HOT/COLD,34.0,20.67,8.84,32.98,29
CDM,4209102,PT MODALITY APPL TRACTION MECHANIC,80.0,48.64,20.8,77.6,29
CDM,4209128,PT MODALITY APPL E-STIM UNATND OTH,74.0,44.99,19.24,71.78,29
CDM,4209136,PT MODALITY APPL E-STIM UNATND ULC,74.0,44.99,19.24,71.78,29
CDM,4209169,PT MODALITY APPL BATH PARAFFIN,41.0,24.93,10.66,39.77,29
CDM,4209185,PT MODALITY APPL WHIRLPOOL,73.0,44.38,18.98,70.81,29
CDM,4209250,PT MODALITY APPL E-STIM MAN 15MN,79.0,48.03,20.54,76.63,29
CDM,4209268,PT MODALITY APPL IONTOPHORES 15MN,65.0,39.52,16.9,63.05,29
CDM,4209276,PT MODALITY APPL BATH CNT 15MN,43.0,26.14,11.18,41.71,29
CDM,4209284,PT MODALITY APPL ULTRASOUND 15MN,84.0,51.07,21.84,81.48,29
CDM,4209318,PT THER EXERCISE 15MN,139.0,84.51,36.14,134.83,29
CDM,4209334,PT THER NEUROMUS REEDUCATE 15MN,154.0,93.63,40.04,149.38,29
CDM,4209342,PT THER AQUATIC 15MN,146.0,88.77,37.96,141.62,29
CDM,4209359,PT THER TRAIN GAIT 15MN,73.0,44.38,18.98,70.81,29
CDM,4209375,PT THER MASSAGE 15MN,75.0,45.6,19.5,72.75,29
CDM,4209391,PT THERAPY MANUAL 15MN,160.0,97.28,41.6,155.2,29
CDM,4209433,PT THER ACTIVITIES 15MN,95.0,57.76,24.7,92.15,29
CDM,4209474,PT MANAGEMENT SELF-CARE/HOME 15MN,86.0,52.29,22.36,83.42,29
CDM,4209490,PT MANAGEMENT WHEELCHAIR 15MN,82.0,49.86,21.32,79.54,29
CDM,4209524,PT DEBRIDE NONSELECT WO ANES SESSN,147.0,89.38,38.22,142.59,29
CDM,4209557,PT MEAS/TEST PERFORMANCE 15MIN,85.0,51.68,22.1,82.45,29
CDM,4209698,PT THERAPY MIST,325.0,197.6,84.5,315.25,29
CDM,4211975,PT DEBRIDE SLCT WND OPEN 1ST 20CM,270.0,164.16,70.2,261.9,29
CDM,4211983,PT DEBRIDE SLCT WND OPEN ADDL 20CM,84.0,51.07,21.84,81.48,29
CDM,4212056,PT REPOSITIONING CANALITH PER DAY,167.0,101.54,43.42,161.99,29
CDM,4214144,PT TRAIN ORTHO UE/LE INIT 15MN,74.0,44.99,19.24,71.78,29
CDM,4214177,PT TRAIN PROSTH UE&/LE INIT 15MN,72.0,43.78,18.72,69.84,29
CDM,4214227,PT TRAIN ORTHO/PROS EXT SUBSQ 15MN,79.0,48.03,20.54,76.63,29
CDM,4214722,PTA MODALITY APPL HOT/COLD,34.0,20.67,8.84,32.98,29
CDM,4214730,PTA MODALITY APPL TRACTION MECHANIC,80.0,48.64,20.8,77.6,29
CDM,4214755,PTA MODALITY APPL BATH PARAFFIN,41.0,24.93,10.66,39.77,29
CDM,4214763,PTA MODALITY APPL WHIRLPOOL,73.0,44.38,18.98,70.81,29
CDM,4214789,PTA MODALITY APPL E-STIM MAN 15MN,79.0,48.03,20.54,76.63,29
CDM,4214797,PTA MODALITY APPL IONTOPHORES 15MN,65.0,39.52,16.9,63.05,29
CDM,4214805,PTA MODALITY APPL BATH CNT 15MN,43.0,26.14,11.18,41.71,29
CDM,4214813,PTA MODALITY APPL ULTRASOUND 15MN,84.0,51.07,21.84,81.48,29
CDM,4214821,PTA THER EXERCISE 15MN,139.0,84.51,36.14,134.83,29
CDM,4214839,PTA THER NEUROMUS REEDUCATE 15MN,154.0,93.63,40.04,149.38,29
CDM,4214847,PTA THER AQUATIC 15MN,146.0,88.77,37.96,141.62,29
CDM,4214854,PTA THER TRAIN GAIT 15MN,73.0,44.38,18.98,70.81,29
CDM,4214862,PTA THER MASSAGE 15MN,75.0,45.6,19.5,72.75,29
CDM,4214870,PTA THERAPY MANUAL 15MN,160.0,97.28,41.6,155.2,29
CDM,4214896,PTA THER ACTIVITIES 15MN,95.0,57.76,24.7,92.15,29
CDM,4214912,PTA MANAGEMENT SELF-CARE/HOME 15MN,86.0,52.29,22.36,83.42,29
CDM,4214938,PTA MANAGEMENT WHEELCHAIR 15MN,82.0,49.86,21.32,79.54,29
CDM,4214961,PTA DEBRIDE SLCT WND OPEN 1ST 20CM,270.0,164.16,70.2,261.9,29
CDM,4214979,PTA DEBRIDE SLCT WND OPEN ADDL 20CM,84.0,51.07,21.84,81.48,29
CDM,4214987,PTA DEBRIDE NONSELECT WO ANES SESSN,147.0,89.38,38.22,142.59,29
CDM,4215034,PTA THERAPY MIST,325.0,197.6,84.5,315.25,29
CDM,4215059,PTA MEAS/TEST PERFORMANCE 15MIN,85.0,51.68,22.1,82.45,29
CDM,4215067,PTA TRAIN ORTHO UE/LE INIT 15MN,74.0,44.99,19.24,71.78,29
CDM,4215075,PTA TRAIN PROSTH UE&/LE INIT 15MN,72.0,43.78,18.72,69.84,29
CDM,4215083,PTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,79.0,48.03,20.54,76.63,29
CDM,4218731,PTA STRAPPING BOOT UNNA BI,413.0,251.1,107.38,400.61,29
CDM,4218749,PTA STRAPPING BOOT UNNA LT,275.0,167.2,71.5,266.75,29
CDM,4218756,PTA STRAPPING BOOT UNNA RT,275.0,167.2,71.5,266.75,29
CDM,4219556,PTA MODALITY APPL E-STIM UNATND OTH,74.0,44.99,19.24,71.78,29
CDM,4219564,PTA MODALITY APPL E-STIM UNATND ULC,74.0,44.99,19.24,71.78,29
CDM,4219853,PT MODALITY APPL THPY LASER LOW LVL,113.0,68.7,29.38,109.61,29
CDM,4219861,PT TRAIN CAREGIVER WO PT 1ST 30MIN,303.0,184.22,78.78,293.91,29
CDM,4219879,PT TRAIN CAREGIVER WO PT ADD 15MIN,115.0,69.92,29.9,111.55,29
CDM,4219887,PT TRAIN CAREGIVER GROUP,98.0,59.58,25.48,95.06,29
CDM,4219895,PT MOTOR COG VRF TRAIN GAIT 15MN,100.0,60.8,26.0,97.0,29
CDM,42473,R&B OBSTETRICS SEMI-PVT,2781.0,1580.03,2502.9,3111.1,17
CDM,4307781,OT MODALITY APPL TRACTION MECHANIC,80.0,30.96,20.8,77.6,29
CDM,4307955,OT MODALITY APPL ULTRASOUND 15MN,84.0,32.51,21.84,81.48,29
CDM,4307989,OT THER EXERCISE 15MN,139.0,53.79,36.14,134.83,29
CDM,4307997,OT THER NEUROMUS REEDUCATE 15MN,154.0,59.6,40.04,149.38,29
CDM,4308003,OT THER AQUATIC 15MN,146.0,56.5,37.96,141.62,29
CDM,4308011,OT THER TRAIN GAIT 15MN,73.0,28.25,18.98,70.81,29
CDM,4308029,OT THER MASSAGE 15MN,75.0,29.02,19.5,72.75,29
CDM,4308045,OT THERAPY MANUAL 15MN,160.0,61.92,41.6,155.2,29
CDM,4308052,OT THER GROUP,47.0,26.7,12.22,45.59,29
CDM,4308086,OT THER ACTIVITIES 15MN,95.0,36.76,24.7,92.15,29
CDM,4308110,OT TECHNIQUES SENSORY 15MN,90.0,34.83,23.4,87.3,29
CDM,4308136,OT REINTEGRATION COMM/WORK 15MN,126.0,48.76,32.76,122.22,29
CDM,4312401,OT EVAL THERAPY LOW,175.0,99.43,45.5,169.75,29
CDM,4312427,OT EVAL THERAPY MOD,233.0,132.38,60.58,226.01,29
CDM,4312443,OT EVAL THERAPY HIGH,250.0,142.04,65.0,242.5,29
CDM,4312468,OT RE-EVAL THERAPY,175.0,99.43,45.5,169.75,29
CDM,4313011,OT TRAIN ORTHO UE/LE INIT 15MN,74.0,28.64,19.24,71.78,29
CDM,4313052,OT TRAIN PROSTH UE&/LE INIT 15MN,72.0,27.86,18.72,69.84,29
CDM,4313326,OT SKILLS DEVLPMT COGNITIVE 15MN,66.0,25.54,17.16,64.02,29
CDM,4313334,OT SKILLS DEVLPMT COGNITIVE AD 15MN,62.0,23.99,16.12,60.14,29
CDM,4313714,OTA MODALITY APPL TRACTION MECHANIC,80.0,30.96,20.8,77.6,29
CDM,4313797,OTA MODALITY APPL ULTRASOUND 15MN,84.0,32.51,21.84,81.48,29
CDM,4313805,OTA THER EXERCISE 15MN,139.0,53.79,36.14,134.83,29
CDM,4313813,OTA THER NEUROMUS REEDUCATE 15MN,154.0,59.6,40.04,149.38,29
CDM,4313821,OTA THER AQUATIC 15MN,146.0,56.5,37.96,141.62,29
CDM,4313839,OTA THER TRAIN GAIT 15MN,73.0,28.25,18.98,70.81,29
CDM,4313847,OTA THER MASSAGE 15MN,75.0,29.02,19.5,72.75,29
CDM,4313862,OTA THERAPY MANUAL 15MN,160.0,61.92,41.6,155.2,29
CDM,4313870,OTA THER GROUP,47.0,26.7,12.22,45.59,29
CDM,4313888,OTA THER ACTIVITIES 15MN,95.0,36.76,24.7,92.15,29
CDM,4313896,OTA TECHNIQUES SENSORY 15MN,90.0,34.83,23.4,87.3,29
CDM,4313912,OTA REINTEGRATION COMM/WORK 15MN,126.0,48.76,32.76,122.22,29
CDM,4314035,OTA TRAIN ORTHO UE/LE INIT 15MN,74.0,28.64,19.24,71.78,29
CDM,4314043,OTA TRAIN PROSTH UE&/LE INIT 15MN,72.0,27.86,18.72,69.84,29
CDM,4315677,OTA SKILLS DEVLPMT COGNITIVE 15MN,66.0,25.54,17.16,64.02,29
CDM,4315685,OTA SKILL DEVLPMT COGNITIVE AD 15MN,62.0,23.99,16.12,60.14,29
CDM,4318135,OT TRAIN CAREGIVER WO PT 1ST 30MIN,303.0,117.26,78.78,293.91,29
CDM,4318143,OT TRAIN CAREGIVER WO PT ADD 15MIN,115.0,44.5,29.9,111.55,29
CDM,4318150,OT TRAIN CAREGIVER GROUP,98.0,37.93,25.48,95.06,29
CDM,4400057,ST SCRN DVLPMNTL W S&D INST STD,128.0,72.72,33.28,124.16,29
CDM,4403283,ST LARYNGOSCOPY DIAGNOSTIC FLEX,291.0,93.99,75.66,282.27,28
CDM,4405924,ST TX SPEECH/LANG/VOICE/COM IND,250.0,142.04,65.0,242.5,29
CDM,4405932,ST TX SPEECH/LANG/VOICE/COM GROUP,78.0,44.32,20.28,75.66,29
CDM,4405940,ST TX DYSFNCT SWALLOW FNCT FEED,210.0,119.31,54.6,203.7,29
CDM,4405965,ST EVAL DEVICE NON SP W PT 1ST HR,322.0,182.94,83.72,312.34,29
CDM,4405973,ST THER DEVICE NON SP W PRG,153.0,86.93,39.78,148.41,29
CDM,4406013,ST EVAL FNCT SWALLOW ORAL&PHARYNGEL,245.0,139.2,63.7,237.65,29
CDM,4406021,ST EVAL FNCT SWALLOW FLUOROSCOPIC,309.0,175.56,80.34,299.73,29
CDM,4406062,ST EVAL/EXAM APHASIA W RPT PER HR,242.0,137.49,62.92,234.74,29
CDM,4406278,ST TEST COGNITIVE HC PRO PER HR,269.0,152.83,69.94,260.93,29
CDM,44073,R&B OBSTETRICS SEMI-PVT,2781.0,1580.03,2502.9,3111.1,17
CDM,4409140,ST EVAL PROD SOUND SP,279.0,158.51,72.54,270.63,29
CDM,4409157,ST EVAL PROD SOUND SP W LANG&EXPRSN,426.0,242.03,110.76,413.22,29
CDM,4409165,ST ANALYSIS VOICE&RESON BEH&QUAL,273.0,155.1,70.98,264.81,29
CDM,4409645,ST SKILLS DEVLPMT COGNITIVE 15MN,66.0,37.5,17.16,64.02,29
CDM,4409652,ST SKILLS DEVLPMT COGNITIVE AD 15MN,62.0,35.23,16.12,60.14,29
CDM,4409793,ST TRAIN CAREGIVER WO PT 1ST 30MIN,303.0,172.15,78.78,293.91,29
CDM,4409801,ST TRAIN CAREGIVER WO PT ADD 15MIN,115.0,65.34,29.9,111.55,29
CDM,4409819,ST TRAIN CAREGIVER GROUP,98.0,55.68,25.48,95.06,29
CDM,4504502,ED AMPUTATION DIGIT,2466.0,986.4,641.16,2392.02,29
CDM,4504510,ED ANOSCOPY,260.0,104.0,67.6,252.2,29
CDM,4504528,ED ASP/INJECT JOINT/BURSA,375.0,150.0,97.5,363.75,29
CDM,4504544,ED TREATMENT BURN LVL 01 SMALL,295.0,118.0,76.7,286.15,29
CDM,4504551,ED CARDIOVERSION ELECTIVE EXTERNAL,1178.0,471.2,306.28,1142.66,29
CDM,4504569,ED CASTING EXTREMITY LOWER,245.0,98.0,63.7,237.65,29
CDM,4504577,ED CASTING EXTREMITY UPPER,280.0,112.0,72.8,271.6,29
CDM,4504585,ED ASP BLADDER CATH SUPRAPUB,2041.0,816.4,530.66,1979.77,29
CDM,4504593,ED INS CATH BLADDER INDWL CMPLX,357.0,142.8,92.82,346.29,29
CDM,4504650,ED CPR,763.0,305.2,198.38,740.11,29
CDM,4504668,ED VISIT CRITICAL CARE ADDL 30MIN,956.0,382.4,248.56,927.32,29
CDM,4504676,ED VISIT CRITICAL CARE 1ST 30-74MIN,1911.0,764.4,496.86,1853.67,29
CDM,4504684,ED CHG TUBE CYSTO,380.0,152.0,98.8,368.6,29
CDM,4504692,ED DEBRIDE TISSUE SKIN/SUBQ,672.0,268.8,174.72,651.84,29
CDM,4504700,ED DELIVERY PLACENTA,1940.0,776.0,504.4,1881.8,29
CDM,4504718,ED DELIVERY VAGINAL ONLY,3875.0,1550.0,1007.5,3758.75,29
CDM,4504726,ED INTUBATION ENDOTRACHEAL,608.0,243.2,158.08,589.76,29
CDM,4504734,ED INJ EPID PATCH BLOOD/CLOT,863.0,345.2,224.38,837.11,29
CDM,4504742,ED EXPLORATION WOUND/TRAUMA,505.0,202.0,131.3,489.85,29
CDM,4504775,ED I&D HEMATOMA/SEROMA/FLUID,697.0,278.8,181.22,676.09,29
CDM,4504783,ED I&R FB SUBCUTANEOUS,270.0,108.0,70.2,261.9,29
CDM,4504809,ED IMMUNIZATION 1ST VACCINE,81.0,44.14,21.06,78.57,29
CDM,4504817,ED IMMUNIZATION ADDL VACCINE,41.0,22.35,10.66,39.77,29
CDM,4504833,ED INJ SUBQ/IM,144.0,57.6,37.44,139.68,29
CDM,4504841,ED INJ SHTH TNDN SGL/LIG/AP,403.0,161.2,104.78,390.91,29
CDM,4504858,ED INJ TRIGGER PT/S MUSCLE,370.0,148.0,96.2,358.9,29
CDM,4504866,ED PROCEDURE IRRG BLADDER,492.0,196.8,127.92,477.24,29
CDM,4504890,ED LARYNGOSCOPY,343.0,137.2,89.18,332.71,29
CDM,4504908,ED VISIT LEVEL 1,189.0,123.2,49.14,183.33,29
CDM,4504916,ED VISIT LEVEL 2,352.0,256.87,91.52,341.44,29
CDM,4504924,ED VISIT LEVEL 3,625.0,738.4,162.5,606.25,29
CDM,4504932,ED VISIT LEVEL 4,1024.0,2097.47,266.24,993.28,29
CDM,4504940,ED VISIT LEVEL 5,1455.0,2469.72,378.3,1411.35,29
CDM,4504965,ED PUNCT LUMBAR,896.0,358.4,232.96,869.12,29
CDM,4504973,ED MONITOR PRESS SYND COMPART MUSC,630.0,252.0,163.8,611.1,29
CDM,4504981,ED PROCEDURE NAIL,305.0,122.0,79.3,295.85,29
CDM,4504999,ED PLC NEEDLE INF INTRAOSSEOUS,532.0,212.8,138.32,516.04,29
CDM,4505038,ED LAVAGE PERITONEAL/PARACENTESIS,457.0,182.8,118.82,443.29,29
CDM,4505046,ED PLC CATHETER CENTRAL VENOUS,890.0,356.0,231.4,863.3,29
CDM,4505053,ED REDUCTION FX/DISLOCATION OTHER,470.0,188.0,122.2,455.9,29
CDM,4505061,ED REDUCTION FX/DISLOCATION DIGIT,385.0,154.0,100.1,373.45,29
CDM,4505087,ED REM/BIVALVE CAST,216.0,86.4,56.16,209.52,29
CDM,4505095,ED REM IUD,456.0,182.4,118.56,442.32,29
CDM,4505103,ED REM FB NASAL,391.0,156.4,101.66,379.27,29
CDM,4505129,ED REM FB EYE EMBEDDED,344.0,137.6,89.44,333.68,29
CDM,4505137,ED REM FB EYE RUSTRING (METAL),321.0,128.4,83.46,311.37,29
CDM,4505145,ED REM FB EYE SUPERFICIAL,155.0,62.0,40.3,150.35,29
CDM,4505152,ED REM FB PHARYNX,671.0,268.4,174.46,650.87,29
CDM,4505194,ED SPLINT/STRAP EXTREMITY LOWER,215.0,86.0,55.9,208.55,29
CDM,4505202,ED SPLINT/STRAP EXTREMITY UPPER,240.0,96.0,62.4,232.8,29
CDM,4505210,ED PACING TRANSCUTANEOUS TEMP,623.0,249.2,161.98,604.31,29
CDM,4505228,ED THORACENT/TUBE CHEST/DRN PLEURAL,1241.0,496.4,322.66,1203.77,29
CDM,4505236,ED THORACOTOMY MASSAGE CARDIAC,850.0,340.0,221.0,824.5,29
CDM,4505244,ED TRACH/CRICOTHYROID,1085.0,434.0,282.1,1052.45,29
CDM,4505335,ED TREATMENT INCOMPLETE ABORTION,1612.0,644.8,419.12,1563.64,29
CDM,4505343,ED VENIPUNCTURE CUTDOWN,1366.0,546.4,355.16,1325.02,29
CDM,4505350,ED CLOSURE WOUND W TISSUE ADHESIVE,264.0,105.6,68.64,256.08,29
CDM,4505368,ED RPR WOUND LVL 03 COMPLEX,720.0,288.0,187.2,698.4,29
CDM,4505392,ED EKG TRACING ROUTINE 12+ LEADS,488.0,254.25,126.88,473.36,29
CDM,4505400,ED EKG TRACING RHYTHM 1-3 LEADS,145.0,75.54,37.7,140.65,29
CDM,4505491,ED INS CATH BLADDER INDWL SMPL,334.0,133.6,86.84,323.98,29
CDM,4505590,ED INF IV HYDRATION 31-60MIN,504.0,201.6,131.04,488.88,29
CDM,4505608,ED INF IV HYDRATION ADDL HR,98.0,39.2,25.48,95.06,29
CDM,4505616,ED INF IV THRPY 1ST HR,608.0,243.2,158.08,589.76,29
CDM,4505624,ED INF IV THRPY ADDL HR,114.0,45.6,29.64,110.58,29
CDM,4505640,ED INF IV THRPY CONCURRENT,187.0,74.8,48.62,181.39,29
CDM,4505657,ED INJ IVP DRUG INITIAL,453.0,181.2,117.78,439.41,29
CDM,4505665,ED INJ IVP SEQ DRUG ADDL NEW,144.0,57.6,37.44,139.68,29
CDM,4505681,ED CHEMO SUBQ/IM NONHORMONAL,558.0,201.44,145.08,541.26,29
CDM,4505715,ED CHEMO INF IV ADDL HR,106.0,29.79,27.56,102.82,29
CDM,4505723,ED CHEMO INF IV 1ST HR,482.0,135.44,125.32,467.54,29
CDM,4505731,ED CHEMO IVP DRUG INITIAL,458.0,165.34,119.08,444.26,29
CDM,4505749,ED CHEMO IVP DRUG ADDL,284.0,102.52,73.84,275.48,29
CDM,4505756,ED CHEMO INF IV SEQ 1ST HR,237.0,66.6,61.62,229.89,29
CDM,4505871,ED INJ IVP SEQ DRUG ADDL SAME,107.0,42.8,27.82,103.79,29
CDM,4505889,ED CHG TUBE GASTRO WO GD IMG/ENDO,530.0,212.0,137.8,514.1,29
CDM,4505913,ED PROCEDURE IRRG NOT BLADDER,550.0,220.0,143.0,533.5,29
CDM,4505954,ED INJ/S ANES NRV BLOCK OTHER,334.0,133.6,86.84,323.98,29
CDM,4506135,ED PROCEDURE UNLIST LVL 01 SMPL,780.0,312.0,202.8,756.6,29
CDM,4506143,ED PROCEDURE UNLIST LVL 02 INTRM,1165.0,466.0,302.9,1130.05,29
CDM,4506150,ED PROCEDURE UNLIST LVL 03 CMPLX,2350.0,940.0,611.0,2279.5,29
CDM,4506168,ED TRANSFUSION BLOOD/COMP 1 UNIT,842.0,266.07,218.92,816.74,29
CDM,4506176,ED TRANSFUSION BLOOD/COMP 2 UNITS,1053.0,332.75,273.78,1021.41,29
CDM,4506184,ED TRANSFUSION BLOOD/COMP 3+ UNITS,1263.0,399.11,328.38,1225.11,29
CDM,4506192,ED I&D/ASP PUNCT LVL 01 SIMPLE,435.0,174.0,113.1,421.95,29
CDM,4506200,ED I&D LVL 02 INTRM,530.0,212.0,137.8,514.1,29
CDM,4506218,ED I&D LVL 03 COMPLEX,580.0,232.0,150.8,562.6,29
CDM,4506226,ED REM FB CANL AUD EXT LVL 01 SMPL,269.0,107.6,69.94,260.93,29
CDM,4506234,ED REM FB CANL AUD EXT LVL 02 CMPLX,388.0,155.2,100.88,376.36,29
CDM,4506242,ED REM FB MUSCLE/TNDN LVL 01 SIMPLE,817.0,326.8,212.42,792.49,29
CDM,4506259,ED REM FB MUSCLE/TNDN LVL 02 CMPLX,1255.0,502.0,326.3,1217.35,29
CDM,4506267,ED RPR TENDON FOOT LVL 01 SIMPLE,2660.0,1064.0,691.6,2580.2,29
CDM,4506275,ED RPR TENDON FOOT LVL 02 CMPLX,2960.0,1184.0,769.6,2871.2,29
CDM,4506283,ED RPR TENDON HAND/FNG LVL 01 SMPL,3225.0,1290.0,838.5,3128.25,29
CDM,4506291,ED RPR TENDON HAND/FNG LVL 02 CMPLX,3395.0,1358.0,882.7,3293.15,29
CDM,4506317,ED INTUBATION/ASPIRATION GASTRIC,257.0,102.8,66.82,249.29,29
CDM,4506325,ED CATH COLLECT SPEC URINE,84.0,63.59,21.84,81.48,29
CDM,4506333,ED INS CATH BLADDER NONINDWL,194.0,77.6,50.44,188.18,29
CDM,4506341,ED PROCEDURE UNLIST ADD-ON,220.0,88.0,57.2,213.4,29
CDM,4506408,ED INF IV THRPY SEQ DRUG NEW 1ST HR,214.0,85.6,55.64,207.58,29
CDM,4506424,ED TREATMENT BURN LVL 02 MEDIUM,492.0,196.8,127.92,477.24,29
CDM,4506432,ED TREATMENT BURN LVL 03 LARGE,563.0,225.2,146.38,546.11,29
CDM,4506440,ED RPR WOUND LVL 02 INTERMEDIATE,520.0,208.0,135.2,504.4,29
CDM,4506457,ED RPR WOUND LVL 01 SIMPLE,490.0,196.0,127.4,475.3,29
CDM,4506572,ED HEM NASAL CNTRL ANT LVL 02 BI,585.0,234.0,152.1,567.45,29
CDM,4506580,ED HEM NASAL CNTRL POST LVL 02 BI,575.0,230.0,149.5,557.75,29
CDM,4506598,ED HEM NASAL CNTRL ANT LVL 01 UNI,295.0,118.0,76.7,286.15,29
CDM,4506606,ED HEM NASAL CNTRL POST LVL 01 UNI,285.0,114.0,74.1,276.45,29
CDM,4506697,ED REM CERUMEN IMPACTED W INST UNI,100.0,40.0,26.0,97.0,29
CDM,4506705,ED REM CERUMEN IMPACTED W INST BI,150.0,60.0,39.0,145.5,29
CDM,4506721,ED REM CERUMEN IMPACTED W IRRG UNI,95.0,38.0,24.7,92.15,29
CDM,4506739,ED REM CERUMEN IMPACTED W IRRG BI,143.0,57.2,37.18,138.71,29
CDM,4506804,ED SED MOD SAME 0-4Y INIT 15MN,490.0,329.77,127.4,475.3,29
CDM,4506812,ED SED MOD SAME 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CDM,4506820,ED SED MOD SAME ADDL 15MN,245.0,164.89,63.7,237.65,29
CDM,4506838,ED SED MOD DIFF 0-4Y INIT 15MN,490.0,329.77,127.4,475.3,29
CDM,4506846,ED SED MOD DIFF 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CDM,4506853,ED SED MOD DIFF ADDL 15MN,245.0,164.89,63.7,237.65,29
CDM,4506929,ED PERICARDIOCENTESIS INCL IMG GD,1457.0,582.8,378.82,1413.29,29
CDM,4506960,ED INJ/S ANES NRV TRIGEMINAL BR BI,683.0,273.2,177.58,662.51,29
CDM,4506978,ED INJ/S ANES NRV TRIGEMINAL BR LT,455.0,182.0,118.3,441.35,29
CDM,4506986,ED INJ/S ANES NRV TRIGEMINAL BR RT,455.0,182.0,118.3,441.35,29
CDM,4507026,ED CATH/CANN ART SMP/MNTR/TRNS PERC,336.0,134.4,87.36,325.92,29
CDM,4507034,ED REM SUTURE/STAPLE NO ANESTH,84.0,33.6,21.84,81.48,29
CDM,4507042,ED REM SUTURE&STAPLE NO ANESTH,112.0,44.8,29.12,108.64,29
CDM,4507091,ED INJ/S ANES NRV INTRCST LVL SGLBI,572.0,228.8,148.72,554.84,29
CDM,4507109,ED INJ/S ANES NRV INTRCST LVL SGLRT,381.0,152.4,99.06,369.57,29
CDM,4507117,ED INJ/S ANES NRV INTRCST LVL SGLLT,381.0,152.4,99.06,369.57,29
CDM,4507125,ED INJ/S ANES NRV INTRCST LVL ADDBI,1188.0,475.2,308.88,1152.36,29
CDM,4507133,ED INJ/S ANES NRV INTRCST LVL ADDRT,792.0,316.8,205.92,768.24,29
CDM,4507141,ED INJ/S ANES NRV INTRCST LVL ADDLT,792.0,316.8,205.92,768.24,29
CDM,4601753,REHAB PULM OP WO CONT OX SESSN,158.0,89.77,41.08,153.26,29
CDM,4601761,REHAB PULM OP W CONT OX SESSN,306.0,173.85,79.56,296.82,29
CDM,4701306,EVOK EMISSIONS OTOACOUSTIC 3-6 FREQ,210.0,119.31,54.6,203.7,29
CDM,4701504,EVOK EMISSIONS OTOACOUSTIC 3-6 FREQ,210.0,119.31,54.6,203.7,29
CDM,4803359,TEST CV STRESS TREAD/BIKE&/RX TRACE,1250.0,632.5,325.0,1212.5,29
CDM,4818589,TEST STRESS PULMONARY,313.0,116.44,81.38,303.61,29
CDM,4819264,EKG EXT REC >48HR<=7 DAYS REC,206.0,101.76,53.56,199.82,29
CDM,4819272,EKG EXT REC >7 DAYS-15 DAYS REC,195.0,96.33,50.7,189.15,29
CDM,5405469,TRNSPRT NONEMR AMB ALS LEVEL 1,2153.0,936.56,559.78,2088.41,29
CDM,5405543,TRNSPRT EMERG AMB ALS LEVEL 1,2492.0,1084.02,647.92,2417.24,29
CDM,5405550,TRNSPRT EMERG AMB BLS,1814.0,789.09,471.64,1759.58,29
CDM,5405568,TRNSPRT NONEMR AMB BLS,1525.0,663.38,396.5,1479.25,29
CDM,5405576,MILEAGE GROUND MILE 1.00,27.0,11.74,7.02,26.19,29
CDM,5405592,TRNSPRT SPECIALTY CARE,2716.0,1181.46,706.16,2634.52,29
CDM,5405600,TRNSPRT AMB ALS LEVEL 2,3322.0,1445.07,863.72,3222.34,29
CDM,5405618,RESPONSE/TREATMENT AMB WO TRNSPRT,222.0,32.41,57.72,215.34,29
CDM,5405626,MILEAGE GROUND MILE 0.10,2.7,1.17,0.702,2.62,29
CDM,5405642,MILEAGE NONCOVERED MILE 0.10,2.7,0.39,0.702,2.62,29
CDM,5405725,TRNSPRT AIR FIXED WING,20440.0,8891.4,5314.4,19826.8,29
CDM,5405733,MILEAGE AIR FIXED WING MILE 1.00,170.0,73.95,44.2,164.9,29
CDM,55160,R&B NURSERY LEVEL 1,3477.0,1975.46,2512.0,3372.69,17
CDM,6104087,MRI GD PLC NDL S&I,870.0,436.74,226.2,843.9,29
CDM,6104137,MRI ABDOMEN W CNT,4057.0,2036.61,1054.82,3935.29,29
CDM,6104145,MRI ABDOMEN WO CNT,3245.0,1628.99,843.7,3147.65,29
CDM,6104152,MRI ABDOMEN W&WO CNT,4868.0,2443.74,1265.68,4721.96,29
CDM,6104160,MRI BONE MARROW,1725.0,865.95,448.5,1673.25,29
CDM,6104319,MRI CHEST W CNT,3183.0,1597.87,827.58,3087.51,29
CDM,6104327,MRI CHEST WO CNT,2546.0,1278.09,661.96,2469.62,29
CDM,6104335,MRI CHEST W&WO CNT,3819.0,1917.14,992.94,3704.43,29
CDM,6104376,MRI EXT LOWER JT W CNT LT,3858.0,1936.72,1003.08,3742.26,29
CDM,6104384,MRI EXT LOWER JT W CNT RT,3858.0,1936.72,1003.08,3742.26,29
CDM,6104400,MRI EXT LOWER JT WO CNT LT,3086.0,1549.17,802.36,2993.42,29
CDM,6104418,MRI EXT LOWER JT WO CNT RT,3086.0,1549.17,802.36,2993.42,29
CDM,6104434,MRI EXT LOWER JT W&WO CNT LT,4629.0,2323.76,1203.54,4490.13,29
CDM,6104442,MRI EXT LOWER JT W&WO CNT RT,4629.0,2323.76,1203.54,4490.13,29
CDM,6104467,MRI EXT LOWER NONJT W CNT LT,2505.0,1257.51,651.3,2429.85,29
CDM,6104475,MRI EXT LOWER NONJT W CNT RT,2505.0,1257.51,651.3,2429.85,29
CDM,6104491,MRI EXT LOWER NONJT WO CNT LT,2004.0,1006.01,521.04,1943.88,29
CDM,6104509,MRI EXT LOWER NONJT WO CNT RT,2004.0,1006.01,521.04,1943.88,29
CDM,6104525,MRI EXT LOWER NONJT W&WO CNT LT,3006.0,1509.01,781.56,2915.82,29
CDM,6104533,MRI EXT LOWER NONJT W&WO CNT RT,3006.0,1509.01,781.56,2915.82,29
CDM,6104574,MRI JOINT TEMPOROMANDIBULAR BI,1353.0,679.21,351.78,1312.41,29
CDM,6104582,MRI JOINT TEMPOROMANDIBULAR LT,902.0,452.8,234.52,874.94,29
CDM,6104590,MRI JOINT TEMPOROMANDIBULAR RT,902.0,452.8,234.52,874.94,29
CDM,6104616,MRI EXT UPPER JT W CNT LT,3137.0,1574.77,815.62,3042.89,29
CDM,6104624,MRI EXT UPPER JT W CNT RT,3137.0,1574.77,815.62,3042.89,29
CDM,6104640,MRI EXT UPPER JT WO CNT LT,2509.0,1259.52,652.34,2433.73,29
CDM,6104657,MRI EXT UPPER JT WO CNT RT,2509.0,1259.52,652.34,2433.73,29
CDM,6104673,MRI EXT UPPER JT W&WO CNT LT,3764.0,1889.53,978.64,3651.08,29
CDM,6104681,MRI EXT UPPER JT W&WO CNT RT,3764.0,1889.53,978.64,3651.08,29
CDM,6104707,MRI EXT UPPER NONJT W&WO CNT LT,3627.0,1820.75,943.02,3518.19,29
CDM,6104715,MRI EXT UPPER NONJT W&WO CNT RT,3627.0,1820.75,943.02,3518.19,29
CDM,6104731,MRI EXT UPPER NONJT W CNT LT,3023.0,1517.55,785.98,2932.31,29
CDM,6104749,MRI EXT UPPER NONJT W CNT RT,3023.0,1517.55,785.98,2932.31,29
CDM,6104764,MRI EXT UPPER NONJT WO CNT LT,2418.0,1213.84,628.68,2345.46,29
CDM,6104848,MRI BRAIN W CNT,4440.0,2357.64,1154.4,4306.8,29
CDM,6104855,MRI BRAIN WO CNT,3552.0,1886.11,923.52,3445.44,29
CDM,6104863,MRI BRAIN W&WO CNT,5328.0,2829.17,1385.28,5168.16,29
CDM,6104871,MRI ORBIT FACE&/NECK W&WO CNT,3033.0,1610.52,788.58,2942.01,29
CDM,6104889,MRI ORBIT FACE&/NECK W CNT,2528.0,1342.37,657.28,2452.16,29
CDM,6104897,MRI ORBIT FACE&/NECK WO CNT,2022.0,1073.68,525.72,1961.34,29
CDM,6104905,MRI SPINE CERVICAL W CNT,3610.0,1909.69,938.6,3501.7,29
CDM,6104913,MRI SPINE CERVICAL WO CNT,2888.0,1527.75,750.88,2801.36,29
CDM,6104921,MRI SPINE CERVICAL W&WO CNT,4332.0,2291.63,1126.32,4202.04,29
CDM,6104939,MRI SPINE LUMBAR W CNT,4532.0,2397.43,1178.32,4396.04,29
CDM,6104947,MRI SPINE LUMBAR WO CNT,3625.0,1917.62,942.5,3516.25,29
CDM,6104954,MRI SPINE LUMBAR W&WO CNT,5438.0,2876.7,1413.88,5274.86,29
CDM,6104962,MRI PELVIS W CNT,3489.0,1751.48,907.14,3384.33,29
CDM,6104970,MRI PELVIS WO CNT,2791.0,1401.08,725.66,2707.27,29
CDM,6104988,MRI PELVIS W&WO CNT,4187.0,2101.87,1088.62,4061.39,29
CDM,6104996,MRI SPINE THORACIC W CNT,3639.0,1925.03,946.14,3529.83,29
CDM,6105001,MRI SPINE THORACIC WO CNT,2911.0,1539.92,756.86,2823.67,29
CDM,6105019,MRI SPINE THORACIC W&WO CNT,4367.0,2310.14,1135.42,4235.99,29
CDM,6105555,MRI EXT UPPER NONJT WO CNT RT,2418.0,1213.84,628.68,2345.46,29
CDM,6105662,MRI BREAST WO CNT LT,983.0,493.47,255.58,953.51,29
CDM,6105670,MRI BREAST WO CNT RT,983.0,493.47,255.58,953.51,29
CDM,6105688,MRI BREAST WO CNT BI,1162.0,583.32,302.12,1127.14,29
CDM,6105696,MRI BREAST W&WO CNT LT,1475.0,740.45,383.5,1430.75,29
CDM,6105704,MRI BREAST W&WO CNT RT,1475.0,740.45,383.5,1430.75,29
CDM,6105712,MRI BREAST W&WO CNT BI,1743.0,874.99,453.18,1690.71,29
CDM,6111827,MRCP WO CNT,3245.0,1628.99,843.7,3147.65,29
CDM,6111835,MRCP W CNT,4057.0,2036.61,1054.82,3935.29,29
CDM,6111843,MRCP W&WO CNT,4868.0,2443.74,1265.68,4721.96,29
CDM,6113682,MR ASSESS IMP&/FB CLIN INIT 15MIN,44.0,23.58,11.44,42.68,29
CDM,6113690,MR ASSESS IMP&/FB CLIN EA ADD 30MIN,130.0,69.68,33.8,126.1,29
CDM,6113708,MR DETERMIN SAFETY PHYS/QHCP,108.0,57.89,28.08,104.76,29
CDM,6113716,MR CUST EXAM MED PHYSICS SAFETY PLN,456.0,244.42,118.56,442.32,29
CDM,6113724,MR PREP ELECT IMP SAFETY PHYS/QHCP,257.0,137.75,66.82,249.29,29
CDM,6113732,MR POS IMP SAFETY&/IMMOB PHYS/QHCP,306.0,164.02,79.56,296.82,29
CDM,6114029,MRI REND 3D W I&R W PP SAME WRKST,331.0,166.16,86.06,321.07,29
CDM,6114037,MRI REND 3D W I&R W PP DIFF WRKST,492.0,246.98,127.92,477.24,29
CDM,6152003,MRA HEAD W CNT,3494.0,1719.05,908.44,3389.18,29
CDM,6152011,MRA HEAD WO CNT,2795.0,1375.14,726.7,2711.15,29
CDM,6152029,MRA HEAD W&WO CNT,4193.0,2062.96,1090.18,4067.21,29
CDM,6152037,MRA EXT LOWER W CNT LT,4051.0,2301.58,1053.26,3929.47,29
CDM,6152045,MRA EXT LOWER W CNT RT,4051.0,2301.58,1053.26,3929.47,29
CDM,6152052,MRA EXT LOWER WO CNT LT,3241.0,1841.37,842.66,3143.77,29
CDM,6152060,MRA EXT LOWER WO CNT RT,3241.0,1841.37,842.66,3143.77,29
CDM,6152078,MRA EXT LOWER W/WO CNT LT,4861.0,2761.78,1263.86,4715.17,29
CDM,6152086,MRA EXT LOWER W/WO CNT RT,4861.0,2761.78,1263.86,4715.17,29
CDM,6152094,MRA ABDOMEN W CNT,4260.0,2420.32,1107.6,4132.2,29
CDM,6152102,MRA ABDOMEN WO CNT,3408.0,1936.26,886.08,3305.76,29
CDM,6152110,MRA ABDOMEN W/WO CNT,5112.0,2904.38,1329.12,4958.64,29
CDM,6152128,MRA CHEST W CNT,3343.0,1899.33,869.18,3242.71,29
CDM,6152136,MRA CHEST WO CNT,2674.0,1519.23,695.24,2593.78,29
CDM,6152144,MRA CHEST W/WO CNT,4010.0,2278.28,1042.6,3889.7,29
CDM,6152151,MRA PELVIS W CNT,3664.0,2081.7,952.64,3554.08,29
CDM,6152169,MRA PELVIS WO CNT,2931.0,1665.25,762.06,2843.07,29
CDM,6152177,MRA PELVIS W/WO CNT,4397.0,2498.16,1143.22,4265.09,29
CDM,6152185,MRA SPINE W CNT,4759.0,2703.83,1237.34,4616.23,29
CDM,6152193,MRA SPINE WO CNT,3807.0,2162.95,989.82,3692.79,29
CDM,6152201,MRA SPINE W/WO CNT,5710.0,3244.14,1484.6,5538.7,29
CDM,6152219,MRA EXT UPPER W CNT LT,3294.0,1871.49,856.44,3195.18,29
CDM,6152227,MRA EXT UPPER W CNT RT,3294.0,1871.49,856.44,3195.18,29
CDM,6152235,MRA EXT UPPER WO CNT LT,2635.0,1497.08,685.1,2555.95,29
CDM,6152243,MRA EXT UPPER WO CNT RT,2635.0,1497.08,685.1,2555.95,29
CDM,6152250,MRA EXT UPPER W/WO CNT LT,3953.0,2245.9,1027.78,3834.41,29
CDM,6152268,MRA EXT UPPER W/WO CNT RT,3953.0,2245.9,1027.78,3834.41,29
CDM,6152276,MRA NECK W CNT,2717.0,1336.76,706.42,2635.49,29
CDM,6152284,MRA NECK WO CNT,2173.0,1069.12,564.98,2107.81,29
CDM,6152292,MRA NECK W&WO CNT,3260.0,1603.92,847.6,3162.2,29
CDM,62018,R&B SWING BED SKILLED,2781.0,1580.03,2502.9,3111.1,17
CDM,6271142,BIT LVL 07,3596.0,1736.87,934.96,3488.12,29
CDM,6271159,BIT LVL 08,4880.0,2357.04,1268.8,4733.6,29
CDM,6271167,IMP BOLT LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,6271175,IMP BOLT LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,6271183,IMP BOLT LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,6271191,IMP BONE HUMAN/SYNTHETIC LVL 11,26284.0,15113.3,6833.84,25495.48,29
CDM,6271217,CANNULA LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,6271225,CANNULA LVL 07,3596.0,1736.87,934.96,3488.12,29
CDM,6271233,CANNULA LVL 08,4397.0,2123.75,1143.22,4265.09,29
CDM,6271241,CATH ANGIO TRANSL NONLASER LVL 10,12969.0,6264.03,3371.94,12579.93,29
CDM,6271258,CATH EP NON 3D 1-19 LVL 07,13895.0,6711.28,3612.7,13478.15,29
CDM,6271266,CATH EP NON 3D 1-19 LVL 08,17524.0,8464.09,4556.24,16998.28,29
CDM,6271274,CATH GUIDE LVL 08,3596.0,1736.87,934.96,3488.12,29
CDM,6271282,CATH GUIDE LVL 09,4885.0,2359.46,1270.1,4738.45,29
CDM,6271290,ELECTRODE ELECTROSURGICAL LVL 10,5861.0,2830.86,1523.86,5685.17,29
CDM,6271308,ELECTRODE ELECTROSURGICAL LVL 11,9265.0,4475.0,2408.9,8987.05,29
CDM,6271316,ELECTRODE ELECTROSURGICAL LVL 12,12506.0,6040.4,3251.56,12130.82,29
CDM,6271324,ELECTRODE ELECTROSURGICAL LVL 09,3596.0,1736.87,934.96,3488.12,29
CDM,6271332,CEMENT ACCESSORIES LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,6271340,CEMENT ACCESSORIES LVL 05,4885.0,2359.46,1270.1,4738.45,29
CDM,6271357,CEMENT ACCESSORIES LVL 06,6950.0,3356.85,1807.0,6741.5,29
CDM,6271365,CLIP LVL 03,594.0,286.9,154.44,576.18,29
CDM,6271373,EMBOLIZATION SYS PROTECT LVL 02,6950.0,3996.25,1807.0,6741.5,29
CDM,6271381,IMP GENERATOR NEUROSTIM LVL 02,43800.0,25185.0,11388.0,42486.0,29
CDM,6271399,IMP GENERATOR NEUROSTIM LVL 03,65704.0,37779.8,17083.04,63732.88,29
CDM,6271407,IMP GENERATOR NEUROSTIM LVL 04,87604.0,50372.3,22777.04,84975.88,29
CDM,6271415,WIRE GUIDE LVL 09,9265.0,4475.0,2408.9,8987.05,29
CDM,6271423,IMP ICD CHAMBER DUAL LVL 04,109504.0,62214.7,28471.04,106218.88,29
CDM,6271431,IMP ICD CHAMBER DUAL LVL 05,131404.0,74657.18,34165.04,127461.88,29
CDM,6271449,INSTRUMENT DISP SINGLE LVL 07,3596.0,1736.87,934.96,3488.12,29
CDM,6271456,INTRO LVL 06,3596.0,1736.87,934.96,3488.12,29
CDM,6271464,INTRO LVL 07,5861.0,2830.86,1523.86,5685.17,29
CDM,6271472,INTRO NON GD/EP/LASER LVL 02,313.0,151.18,81.38,303.61,29
CDM,6271480,INTRO NON GD/EP/LASER LVL 03,594.0,286.9,154.44,576.18,29
CDM,6271498,INTRO NON GD/EP/LASER LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,6271506,INTRO NON GD/EP/LASER LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,6271514,INTRO NON GD/EP/LASER LVL 06,3596.0,1736.87,934.96,3488.12,29
CDM,6271522,INTRO NON GD/EP/LASER LVL 07,5861.0,2830.86,1523.86,5685.17,29
CDM,6271530,INTRO NON GD/EP/LASER LVL 08,7876.0,3804.11,2047.76,7639.72,29
CDM,6271548,KIT/SET NON ROUTINE SURG LVL 10,6950.0,3356.85,1807.0,6741.5,29
CDM,6271555,KIT/SET NON ROUTINE SURG LVL 11,9265.0,4475.0,2408.9,8987.05,29
CDM,6271563,KIT/SET NON ROUTINE SURG LVL 12,11580.0,5593.14,3010.8,11232.6,29
CDM,6271571,KIT/SET NON ROUTINE SURG LVL 13,13895.0,6711.28,3612.7,13478.15,29
CDM,6271589,MANIPULATOR LVL 01,313.0,151.18,81.38,303.61,29
CDM,6271597,MANIPULATOR LVL 02,594.0,286.9,154.44,576.18,29
CDM,6271605,IMP MESH LVL 11,19714.0,11335.55,5125.64,19122.58,29
CDM,6271613,IMP MESH LVL 12,24094.0,13854.05,6264.44,23371.18,29
CDM,6271621,IMP MESH LVL 13,28474.0,16372.55,7403.24,27619.78,29
CDM,6271639,NEEDLE SPECIALTY LVL 06,2157.0,1041.83,560.82,2092.29,29
CDM,6271647,NEEDLE SPECIALTY LVL 07,2426.0,1171.76,630.76,2353.22,29
CDM,6271662,IMP PCMKR SGL RR LVL 05,30664.0,17421.75,7972.64,29744.08,29
CDM,6271670,IMP PCMKR SGL RR LVL 06,35044.0,19910.25,9111.44,33992.68,29
CDM,6271688,SUPPLY PERFUSION/ECMO LVL 10,6105.0,2948.71,1587.3,5921.85,29
CDM,6271696,SUPPLY PERFUSION/ECMO LVL 09,5129.0,2477.31,1333.54,4975.13,29
CDM,6271704,IMP PIN/WIRE LVL 04,1132.0,650.9,294.32,1098.04,29
CDM,6271712,IMP PIN/WIRE LVL 05,1413.0,812.47,367.38,1370.61,29
CDM,6271720,IMP PIN/WIRE LVL 06,1619.0,930.92,420.94,1570.43,29
CDM,6271738,IMP PIN/WIRE LVL 07,1888.0,1085.6,490.88,1831.36,29
CDM,6271746,IMP PLATE LVL 11,9265.0,5327.38,2408.9,8987.05,29
CDM,6271753,IMP PLATE LVL 12,11580.0,6658.5,3010.8,11232.6,29
CDM,6271761,IMP PLATE LVL 13,13895.0,7989.62,3612.7,13478.15,29
CDM,6271779,IMP PLATE LVL 14,15334.0,8817.05,3986.84,14873.98,29
CDM,6271787,POUCH LVL 01,166.0,80.18,43.16,161.02,29
CDM,6271795,POUCH LVL 02,447.0,215.9,116.22,433.59,29
CDM,6271803,POUCH LVL 03,850.0,410.55,221.0,824.5,29
CDM,6271811,PROBE LVL 10,13895.0,6711.28,3612.7,13478.15,29
CDM,6271829,PROBE LVL 08,5861.0,2830.86,1523.86,5685.17,29
CDM,6271837,PROBE LVL 09,9265.0,4475.0,2408.9,8987.05,29
CDM,6271845,IMP DEV JT KNEE TOTAL LVL 20,96364.0,55409.3,25054.64,93473.08,29
CDM,6271852,REAMER LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,6271860,REAMER LVL 05,3083.0,1489.09,801.58,2990.51,29
CDM,6271878,IMP RING LVL 02,3596.0,2067.7,934.96,3488.12,29
CDM,6271886,IMP RING LVL 03,4397.0,2528.27,1143.22,4265.09,29
CDM,6271894,IMP ROD/NAIL LVL 08,7876.0,4528.7,2047.76,7639.72,29
CDM,6271902,IMP ROD/NAIL LVL 09,9265.0,5327.38,2408.9,8987.05,29
CDM,6271910,IMP STAPLE BONE LVL 05,1490.0,856.75,387.4,1445.3,29
CDM,6271928,IMP STAPLE BONE LVL 06,2157.0,1240.27,560.82,2092.29,29
CDM,6271936,IMP STAPLE BONE LVL 07,3083.0,1772.72,801.58,2990.51,29
CDM,6271944,IMP STAPLE BONE LVL 08,3909.0,2247.67,1016.34,3791.73,29
CDM,6271951,IMP STAPLE BONE LVL 09,4885.0,2808.88,1270.1,4738.45,29
CDM,6271969,IMP STAPLE BONE LVL 10,5861.0,3370.08,1523.86,5685.17,29
CDM,6271977,IMP STAPLE BONE LVL 11,6487.0,3730.02,1686.62,6292.39,29
CDM,6271985,STAPLER LVL 07,5861.0,2830.86,1523.86,5685.17,29
CDM,6271993,IMP STENT NOS LVL 10,21904.0,12594.8,5695.04,21246.88,29
CDM,6272009,IMP STENT NOS LVL 11,26284.0,15113.3,6833.84,25495.48,29
CDM,6272017,IMP STENT NOS LVL 12,30664.0,17631.8,7972.64,29744.08,29
CDM,6272025,IMP STENT NOS LVL 13,35044.0,20150.3,9111.44,33992.68,29
CDM,6272033,IMP STENT NOS LVL 14,39424.0,22668.8,10250.24,38241.28,29
CDM,6272041,IMP STENT NOS LVL 09,17524.0,10076.3,4556.24,16998.28,29
CDM,6272058,IMP STENT NONCOAT W DEL LVL 09,21904.0,12594.8,5695.04,21246.88,29
CDM,6272066,IMP STENT NONCOAT W DEL LVL 10,26284.0,15113.3,6833.84,25495.48,29
CDM,6272074,IMP STENT NONCOAT W DEL LVL 11,30664.0,17631.8,7972.64,29744.08,29
CDM,6272082,IMP STENT NONCOAT W DEL LVL 12,35044.0,20150.3,9111.44,33992.68,29
CDM,6272090,IMP STENT NONCOAT WO DEL LVL 10,17524.0,10076.3,4556.24,16998.28,29
CDM,6272108,IMP STENT NONCOAT WO DEL LVL 11,21904.0,12594.8,5695.04,21246.88,29
CDM,6272116,IMP STENT NONCOAT WO DEL LVL 12,26284.0,15113.3,6833.84,25495.48,29
CDM,6272124,IMP STENT NONCOAT WO DEL LVL 13,30664.0,17631.8,7972.64,29744.08,29
CDM,6272132,IMP STENT NONCOAT WO DEL LVL 14,35044.0,20150.3,9111.44,33992.68,29
CDM,6272140,IMP STENT NONCOAT WO DEL LVL 09,13895.0,7989.62,3612.7,13478.15,29
CDM,6272165,IMP TISSUE CONNECT HUMAN LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,6272173,IMP TISSUE CONNECT HUMAN LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6272181,IMP TISSUE CONNECT HUMAN LVL 05,11580.0,6658.5,3010.8,11232.6,29
CDM,6272199,IMP TISSUE CONNECT HUMAN LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,6272207,IMP TISSUE CONNECT HUMAN LVL 07,15334.0,8817.05,3986.84,14873.98,29
CDM,6272215,IMP TISSUE CONNECT HUMAN LVL 08,17524.0,10076.3,4556.24,16998.28,29
CDM,6272231,WIRE PACING TEMP LVL 01,313.0,151.18,81.38,303.61,29
CDM,6272249,WIRE PACING TEMP LVL 02,594.0,286.9,154.44,576.18,29
CDM,6272256,PACER ACCESSORY LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,6272389,IMP CEMENT ACCESSORY LVL 03,1619.0,930.92,420.94,1570.43,29
CDM,6272397,IMP CEMENT ACCESSORY LVL 04,2695.0,1549.62,700.7,2614.15,29
CDM,6272405,CATH BALLOON LVL 08,6950.0,3356.85,1807.0,6741.5,29
CDM,6272413,CATH BALLOON LVL 09,9265.0,4475.0,2408.9,8987.05,29
CDM,6272421,CATH BALLOON LVL 10,11580.0,5593.14,3010.8,11232.6,29
CDM,6272439,CATH BALLOON LVL 11,13895.0,6711.28,3612.7,13478.15,29
CDM,6272462,INSTRUMENT DISP SINGLE LVL 08,5861.0,2830.86,1523.86,5685.17,29
CDM,6272470,INSTRUMENT DISP SINGLE LVL 09,6950.0,3356.85,1807.0,6741.5,29
CDM,6272488,IMP PROSTH ANKLE LVL 06,26284.0,15113.3,6833.84,25495.48,29
CDM,6272496,IMP PROSTH ANKLE LVL 07,30664.0,17631.8,7972.64,29744.08,29
CDM,6272504,IMP PROSTH ANKLE LVL 08,35044.0,20150.3,9111.44,33992.68,29
CDM,6272512,IMP CONNECTOR SPINAL LVL 01,313.0,179.98,81.38,303.61,29
CDM,6272520,IMP CONNECTOR SPINAL LVL 02,594.0,341.55,154.44,576.18,29
CDM,6272538,IMP CONNECTOR SPINAL LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,6272546,IMP CONNECTOR SPINAL LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,6272553,IMP CONNECTOR SPINAL LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,6272561,IMP CONNECTOR SPINAL LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,6272579,IMP CONNECTOR SPINAL LVL 07,9265.0,5327.38,2408.9,8987.05,29
CDM,6272587,IMP STENT COAT W DEL LVL 10,21904.0,12594.8,5695.04,21246.88,29
CDM,6272595,IMP STENT COAT W DEL LVL 11,26284.0,15113.3,6833.84,25495.48,29
CDM,6272603,IMP STENT COAT W DEL LVL 12,30664.0,17631.8,7972.64,29744.08,29
CDM,6272611,IMP STENT COAT W DEL LVL 13,35044.0,20150.3,9111.44,33992.68,29
CDM,6272629,PUNCH LVL 03,1619.0,781.98,420.94,1570.43,29
CDM,6272637,PUNCH LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,6272645,PROBE LVL 11,17524.0,8464.09,4556.24,16998.28,29
CDM,6272678,IMP MESH LVL 14,32854.0,18891.05,8542.04,31868.38,29
CDM,6272686,INSTRUMENT DISP SINGLE LVL 10,9265.0,4475.0,2408.9,8987.05,29
CDM,6272694,INSTRUMENT DISP SINGLE LVL 11,11580.0,5593.14,3010.8,11232.6,29
CDM,6272702,INSTRUMENT DISP SINGLE LVL 12,13895.0,6711.28,3612.7,13478.15,29
CDM,6272710,IMP DEV JT ELBOW TOTAL LVL 06,26284.0,15113.3,6833.84,25495.48,29
CDM,6272728,IMP DEV JT ELBOW TOTAL LVL 07,30664.0,17631.8,7972.64,29744.08,29
CDM,6272736,IMP DEV JT ELBOW TOTAL LVL 08,35044.0,20150.3,9111.44,33992.68,29
CDM,6272744,IMP DEV JT ELBOW TOTAL LVL 09,39424.0,22668.8,10250.24,38241.28,29
CDM,6272751,IMP DEV JT ELBOW TOTAL LVL 10,43804.0,25187.3,11389.04,42489.88,29
CDM,6272769,IMP DEV JT ELBOW TOTAL LVL 11,48184.0,27705.8,12527.84,46738.48,29
CDM,6272777,IMP DEV JT ELBOW TOTAL LVL 12,52564.0,30224.3,13666.64,50987.08,29
CDM,6272785,IMP DEV JT ELBOW TOTAL LVL 13,56944.0,32742.8,14805.44,55235.68,29
CDM,6272793,IMP DEV JT ELBOW TOTAL LVL 14,61324.0,35261.3,15944.24,59484.28,29
CDM,6272801,IMP DEV JT ELBOW TOTAL LVL 15,65704.0,37779.8,17083.04,63732.88,29
CDM,6272819,IMP TISSUE CONNECT HUMAN LVL 09,21904.0,12594.8,5695.04,21246.88,29
CDM,6272827,IMP TISSUE CONNECT HUMAN LVL 10,26284.0,15113.3,6833.84,25495.48,29
CDM,6272835,IMP TISSUE CONNECT HUMAN LVL 11,30664.0,17631.8,7972.64,29744.08,29
CDM,6272926,PAIN MGMT ACCESSORY LVL 01,313.0,151.18,81.38,303.61,29
CDM,6272934,PAIN MGMT ACCESSORY LVL 02,594.0,286.9,154.44,576.18,29
CDM,6272942,PAIN MGMT ACCESSORY LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,6273171,IMP ACCESS SYSTEM DIALYS LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,6273189,IMP ACCESS SYSTEM DIALYS LVL 05,5861.0,3370.08,1523.86,5685.17,29
CDM,6273197,IMP ACCESS SYSTEM DIALYS LVL 06,8107.0,4661.52,2107.82,7863.79,29
CDM,6273205,INTRO EP FIX CRV PEEL LVL 02,594.0,286.9,154.44,576.18,29
CDM,6273213,INTRO EP LASER LVL 01,313.0,151.18,81.38,303.61,29
CDM,6273221,INTRO EP LASER LVL 02,594.0,286.9,154.44,576.18,29
CDM,6273247,IMP DEV URINARY W SLING LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,6273254,IMP DEV URINARY W SLING LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6273288,IMP ORTHOPEDIC CAGE LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,6273296,IMP ORTHOPEDIC CAGE LVL 03,9265.0,5327.38,2408.9,8987.05,29
CDM,6273304,IMP ORTHOPEDIC CAGE LVL 04,13895.0,7989.62,3612.7,13478.15,29
CDM,6273312,IMP ORTHOPEDIC CAGE LVL 05,17524.0,10076.3,4556.24,16998.28,29
CDM,6273320,IMP ORTHOPEDIC CAGE LVL 06,21904.0,12594.8,5695.04,21246.88,29
CDM,6273338,IMP ORTHOPEDIC CAGE LVL 07,26284.0,15113.3,6833.84,25495.48,29
CDM,6273346,IMP ORTHOPEDIC CAGE LVL 08,30664.0,17631.8,7972.64,29744.08,29
CDM,6273353,IMP ORTHOPEDIC CAGE LVL 09,35044.0,20150.3,9111.44,33992.68,29
CDM,6273361,IMP LD PCMKR NON VDD LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,6273379,IMP STENT NONCOR TEMP WO DEL LVL 06,2695.0,1549.62,700.7,2614.15,29
CDM,6273387,IMP STENT NONCOR TEMP WO DEL LVL 07,4885.0,2808.88,1270.1,4738.45,29
CDM,6273395,IMP STENT NONCOR TEMP WO DEL LVL 08,6950.0,3996.25,1807.0,6741.5,29
CDM,6273403,IMP STENT NONCOR TEMP WO DEL LVL 09,9265.0,5327.38,2408.9,8987.05,29
CDM,6273494,CEMENT ACCESSORIES LVL 07,9265.0,4475.0,2408.9,8987.05,29
CDM,6273502,CEMENT ACCESSORIES LVL 08,15334.0,7406.32,3986.84,14873.98,29
CDM,6273510,PROGRAMMER PT NEUROSTIM LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,6273528,IMP PROSTH PENILE INFLT LVL 05,30664.0,17631.8,7972.64,29744.08,29
CDM,6273585,CLIP APPLIER LVL 04,3083.0,1489.09,801.58,2990.51,29
CDM,6273627,IMP DEV JT KNEE TOTAL LVL 21,109504.0,62964.8,28471.04,106218.88,29
CDM,6273635,IMP DEV JT KNEE TOTAL LVL 22,122644.0,70520.3,31887.44,118964.68,29
CDM,6273643,IMP DEV JT KNEE TOTAL LVL 23,135784.0,78075.8,35303.84,131710.48,29
CDM,6273668,KIT/SET NON ROUTINE ORTH LVL 07,17524.0,8464.09,4556.24,16998.28,29
CDM,6273676,KIT/SET NON ROUTINE SURG LVL 14,17524.0,8464.09,4556.24,16998.28,29
CDM,6273684,KIT/SET NON ROUTINE SURG LVL 15,21904.0,10579.63,5695.04,21246.88,29
CDM,6273692,IMP CLIP ANEURYSM LVL 02,3596.0,2067.7,934.96,3488.12,29
CDM,6273700,IMP LD NEUROSTIM LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,6273718,IMP LD NEUROSTIM LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,6273726,IMP LD NEUROSTIM LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,6273734,IMP RING CARDIAC LVL 03,17524.0,10076.3,4556.24,16998.28,29
CDM,6273742,IMP LD ICD COIL SGL LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,6273759,IMP LD ICD COIL SGL LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,6273767,IMP LD ICD COIL SGL LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6273775,IMP LD ICD COIL SGL LVL 05,11580.0,6658.5,3010.8,11232.6,29
CDM,6273783,IMP LD ICD COIL SGL LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,6273791,IMP LD ICD COIL SGL LVL 07,15334.0,8817.05,3986.84,14873.98,29
CDM,6273809,IMP LD ICD COIL SGL LVL 08,17524.0,10076.3,4556.24,16998.28,29
CDM,6273817,IMP LD ICD COIL SGL LVL 09,19714.0,11335.55,5125.64,19122.58,29
CDM,6273825,IMP LD ICD COIL DUAL LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,6273833,IMP LD ICD COIL DUAL LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,6273841,IMP LD ICD COIL DUAL LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6273858,IMP LD ICD COIL DUAL LVL 05,11580.0,6658.5,3010.8,11232.6,29
CDM,6273866,IMP LD ICD COIL DUAL LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,6273874,IMP LD ICD COIL DUAL LVL 07,15334.0,8817.05,3986.84,14873.98,29
CDM,6273882,IMP LD ICD COIL DUAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
CDM,6273890,IMP LD ICD COIL DUAL LVL 09,19714.0,11335.55,5125.64,19122.58,29
CDM,6273908,INTRO EP FIX CRV PEEL LVL 03,1413.0,682.48,367.38,1370.61,29
CDM,6273916,INTRO EP FIX CRV PEEL LVL 04,2023.0,977.11,525.98,1962.31,29
CDM,6273924,IMP DEV JT SHDR TOTAL LVL 11,30664.0,17631.8,7972.64,29744.08,29
CDM,6273932,IMP DEV JT SHDR TOTAL LVL 12,35044.0,20150.3,9111.44,33992.68,29
CDM,6273940,IMP PROSTH ENT LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,6273957,IMP PROSTH ENT LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,6273965,IMP PROSTH ENT LVL 07,9265.0,5327.38,2408.9,8987.05,29
CDM,6273973,IMP PROSTH ENT LVL 08,11580.0,6658.5,3010.8,11232.6,29
CDM,6274005,IMP PROSTH SPHINCTR ANAL LVL 02,11580.0,6658.5,3010.8,11232.6,29
CDM,6274013,CLIP LVL 04,850.0,410.55,221.0,824.5,29
CDM,6274021,IMP FIX SPINE LVL 09,27160.0,15617.0,7061.6,26345.2,29
CDM,6274039,CATH EP NON 3D 20+ LVL 03,9265.0,4475.0,2408.9,8987.05,29
CDM,6274047,CATH EP NON 3D 20+ LVL 04,13895.0,6711.28,3612.7,13478.15,29
CDM,6274054,CATH EP NON 3D 20+ LVL 05,17524.0,8464.09,4556.24,16998.28,29
CDM,6274062,IMP LD VENOUS COR LV LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6274070,IMP LD VENOUS COR LV LVL 05,13895.0,7989.62,3612.7,13478.15,29
CDM,6274088,IMP LD VENOUS COR LV LVL 06,17524.0,10076.3,4556.24,16998.28,29
CDM,6274096,IMP LD VENOUS COR LV LVL 07,21904.0,12594.8,5695.04,21246.88,29
CDM,6274104,IMP LD VENOUS COR LV LVL 08,26284.0,15113.3,6833.84,25495.48,29
CDM,6274112,IMP LD VENOUS COR LV LVL 09,30664.0,17631.8,7972.64,29744.08,29
CDM,6274260,IMP PCMKR DUAL RR LVL 05,65704.0,37329.73,17083.04,63732.88,29
CDM,6274278,IMP PCMKR DUAL RR LVL 06,87604.0,49772.21,22777.04,84975.88,29
CDM,6274286,IMP PCMKR DUAL RR LVL 07,109504.0,62214.7,28471.04,106218.88,29
CDM,6274294,IMP LD PCMKR NON VDD LVL 03,9265.0,5327.38,2408.9,8987.05,29
CDM,6274302,IMP LD PCMKR NON VDD LVL 04,13895.0,7989.62,3612.7,13478.15,29
CDM,6274310,IMP LD PCMKR NON VDD LVL 05,17524.0,10076.3,4556.24,16998.28,29
CDM,6274328,IMP LD PCMKR NON VDD LVL 06,21904.0,12594.8,5695.04,21246.88,29
CDM,6274336,IMP LD PCMKR NON VDD LVL 07,26284.0,15113.3,6833.84,25495.48,29
CDM,6274344,IMP LD PCMKR NON VDD LVL 08,30664.0,17631.8,7972.64,29744.08,29
CDM,6274351,IMP ICD CHAMBER NON SGL/DUAL LVL 05,109504.0,62964.8,28471.04,106218.88,29
CDM,6274369,IMP DEV CLOSURE VASCULAR LVL 07,4885.0,2808.88,1270.1,4738.45,29
CDM,6274377,IMP PLATE LVL 15,18400.0,10580.0,4784.0,17848.0,29
CDM,6274393,TAPE MARKING RADIOPAQUE LVL 01,166.0,80.18,43.16,161.02,29
CDM,6274401,DEVICE INSERT RETRV LVL 02,2157.0,1041.83,560.82,2092.29,29
CDM,6274419,DEVICE INSERT RETRV LVL 03,3596.0,1736.87,934.96,3488.12,29
CDM,6274427,IMP LD ICD COIL DUAL LVL 10,24094.0,13854.05,6264.44,23371.18,29
CDM,6274435,IMP PCMKR NONSGL OR DUAL LVL 04,35040.0,19907.98,9110.4,33988.8,29
CDM,6274468,CATH ANGIO TRANSL LASER LVL 03,6950.0,3356.85,1807.0,6741.5,29
CDM,6274476,IMP PROSTH ENT LVL 09,13895.0,7989.62,3612.7,13478.15,29
CDM,6274484,IMP PROSTH ENT LVL 10,17524.0,10076.3,4556.24,16998.28,29
CDM,6274492,IMP PROSTH ENT LVL 11,21904.0,12594.8,5695.04,21246.88,29
CDM,6274500,IMP PROSTH ENT LVL 12,26284.0,15113.3,6833.84,25495.48,29
CDM,6274518,CATH ATHERECT TRANSL ROTAT LVL 03,13895.0,6711.28,3612.7,13478.15,29
CDM,6274526,IMP FILTER VENA CAVA LVL 02,2690.0,1546.75,699.4,2609.3,29
CDM,6274575,DIALYSIS ACCESSORIES LVL 05,1888.0,911.9,490.88,1831.36,29
CDM,6274617,IMP LD PCMKR VDD LVL 03,9265.0,5327.38,2408.9,8987.05,29
CDM,6274625,IMP LD PCMKR VDD LVL 04,11580.0,6658.5,3010.8,11232.6,29
CDM,6274633,IMP LD PCMKR VDD LVL 05,13895.0,7989.62,3612.7,13478.15,29
CDM,6274641,IMP LD PCMKR VDD LVL 06,15334.0,8817.05,3986.84,14873.98,29
CDM,6274658,IMP LD PCMKR VDD LVL 07,17524.0,10076.3,4556.24,16998.28,29
CDM,6274666,IMP LD PCMKR VDD LVL 08,19714.0,11335.55,5125.64,19122.58,29
CDM,6274682,CATH DIAGNOSTIC LVL 10,6950.0,3356.85,1807.0,6741.5,29
CDM,6274690,REAMER LVL 06,3853.0,1861.0,1001.78,3737.41,29
CDM,6274708,IMP PUMP INF PRG LVL 02,8112.0,4664.4,2109.12,7868.64,29
CDM,6274716,IMP PUMP INF PRG LVL 03,10431.0,5997.82,2712.06,10118.07,29
CDM,6274724,IMP PUMP INF PRG LVL 04,13895.0,7989.62,3612.7,13478.15,29
CDM,6274732,IMP PUMP INF PRG LVL 05,19714.0,11335.55,5125.64,19122.58,29
CDM,6274740,IMP PUMP INF PRG LVL 06,26284.0,15113.3,6833.84,25495.48,29
CDM,6274757,IMP PUMP INF PRG LVL 07,32854.0,18891.05,8542.04,31868.38,29
CDM,6274765,IMP PUMP INF PRG LVL 08,39424.0,22668.8,10250.24,38241.28,29
CDM,6274773,IMP PUMP INF PRG LVL 09,46870.0,26950.25,12186.2,45463.9,29
CDM,6274781,IMP PROSTH TESTICULAR LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,6274799,IMP PROSTH TESTICULAR LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,6274807,IMP PROSTH TESTICULAR LVL 06,26284.0,15113.3,6833.84,25495.48,29
CDM,6274815,IMP PROSTH TESTICULAR LVL 07,30664.0,17631.8,7972.64,29744.08,29
CDM,6274823,IMP PROSTH TESTICULAR LVL 08,35044.0,20150.3,9111.44,33992.68,29
CDM,6274864,IMP PLATE LVL 16,21904.0,12594.8,5695.04,21246.88,29
CDM,6274872,IMP PLATE LVL 17,24094.0,13854.05,6264.44,23371.18,29
CDM,6275028,CATH INTRASPINAL LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,6275036,CATH INTRASPINAL LVL 06,3853.0,1861.0,1001.78,3737.41,29
CDM,6275044,IMP DEV URINARY WO SLNG LVL 03,6105.0,3510.37,1587.3,5921.85,29
CDM,6275051,IMP DEV URINARY WO SLNG LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6275077,IMP ICD CHAMBER NON SGL/DUAL LVL 06,122644.0,70520.3,31887.44,118964.68,29
CDM,6275085,CATH INTRAVASCULAR US LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,6275101,SUPPLY OSTOMY LVL 01,32.0,20.45,8.32,31.04,29
CDM,6275135,CANNULA LVL 09,6105.0,2948.71,1587.3,5921.85,29
CDM,6275143,IMP PUMP VALVE BLOOD LVL 06,87604.0,50372.3,22777.04,84975.88,29
CDM,6275184,IMP BONE HUMAN/SYNTHETIC LVL 12,30664.0,17631.8,7972.64,29744.08,29
CDM,6275192,IMP BONE HUMAN/SYNTHETIC LVL 13,35482.0,20402.15,9225.32,34417.54,29
CDM,6275200,IMP PROSTH ORTHOPEDIC LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6275218,IMP PROSTH ORTHOPEDIC LVL 03,4885.0,2808.88,1270.1,4738.45,29
CDM,6275226,DILATOR LVL 06,3340.0,1613.22,868.4,3239.8,29
CDM,6275259,INTRO EP FIX CRV NONPEEL LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,6275275,VEST AIRWAY DISPOSABLE LVL 01,594.0,379.57,154.44,576.18,29
CDM,6275291,PAIN MGMT ACCESSORY LVL 04,2157.0,1041.83,560.82,2092.29,29
CDM,6275309,PAIN MGMT ACCESSORY LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,6275317,IMP FIX SPINE LVL 10,32854.0,18891.05,8542.04,31868.38,29
CDM,6275325,CATH ANGIO TRANSL LASER LVL 04,9265.0,4475.0,2408.9,8987.05,29
CDM,6275374,IMP DEV COCHLEAR INT&EXT CMP LVL 04,96364.0,55409.3,25054.64,93473.08,29
CDM,6275390,IMP PROSTH ANKLE LVL 09,39424.0,22668.8,10250.24,38241.28,29
CDM,6275408,KIT/SET NON ROUTINE CARDIAC LVL 07,6487.0,3133.22,1686.62,6292.39,29
CDM,6275416,KIT/SET NON ROUTINE CARDIAC LVL 08,7876.0,3804.11,2047.76,7639.72,29
CDM,6275531,CATH INTRACARDIAC ECHO LVL 03,6487.0,3133.22,1686.62,6292.39,29
CDM,6275580,IMP DEV URINARY W SLING LVL 01,2690.0,1546.75,699.4,2609.3,29
CDM,6275622,IMP STAPLE BONE LVL 12,7413.0,4262.47,1927.38,7190.61,29
CDM,6275671,IMP PROSTH MAXILLOFACIAL LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,6275689,IMP PROSTH MAXILLOFACIAL LVL 07,13895.0,7989.62,3612.7,13478.15,29
CDM,6275697,IMP PROSTH MAXILLOFACIAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
CDM,6275705,IMP PROSTH MAXILLOFACIAL LVL 09,21904.0,12594.8,5695.04,21246.88,29
CDM,6275762,CATH ABL COOL-TIP LVL 06,6487.0,3133.22,1686.62,6292.39,29
CDM,6275770,CATH ABL COOL-TIP LVL 07,7413.0,3580.48,1927.38,7190.61,29
CDM,6275820,INTRO EP FIX CRV PEEL LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,6275853,HEMOSTATIC AGENT LVL 05,3083.0,1489.09,801.58,2990.51,29
CDM,6275861,IMP PUMP INF PRG LVL 10,51250.0,29468.75,13325.0,49712.5,29
CDM,6275879,IMP MATERIAL CORD VOCAL LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6275895,STYLET LVL 04,1888.0,911.9,490.88,1831.36,29
CDM,6275903,EMBOLIZATION SYS PROTECT LVL 03,8339.0,4794.92,2168.14,8088.83,29
CDM,6275911,CATH ABL NONCARDIAC LVL 01,1619.0,781.98,420.94,1570.43,29
CDM,6275929,CATH ABL NONCARDIAC LVL 02,3083.0,1489.09,801.58,2990.51,29
CDM,6275937,IMP DEV JT KNEE TOTAL LVL 01,1132.0,650.9,294.32,1098.04,29
CDM,6275945,IMP DEV JT KNEE TOTAL LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6275952,IMP DEV JT KNEE TOTAL LVL 03,4880.0,2806.0,1268.8,4733.6,29
CDM,6275986,IMP TISSUE CONNECT HUMAN LVL 12,35044.0,20150.3,9111.44,33992.68,29
CDM,6276034,BIT LVL 09,6024.0,2909.59,1566.24,5843.28,29
CDM,6276042,IMP DEV URINARY WO SLNG LVL 01,2421.0,1392.07,629.46,2348.37,29
CDM,6276083,CATH ATHERECT TRANSL DIRECT LVL 03,13895.0,6711.28,3612.7,13478.15,29
CDM,6276117,IMP EMBOLIZATION AGENT LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6276125,IMP EMBOLIZATION AGENT LVL 03,3596.0,2067.7,934.96,3488.12,29
CDM,6276133,IMP EMBOLIZATION AGENT LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,6276141,IMP EMBOLIZATION AGENT LVL 05,6950.0,3996.25,1807.0,6741.5,29
CDM,6276158,IMP EMBOLIZATION AGENT LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,6276166,IMP EMBOLIZATION AGENT LVL 07,11580.0,6658.5,3010.8,11232.6,29
CDM,6276174,IMP EMBOLIZATION AGENT LVL 08,13895.0,7989.62,3612.7,13478.15,29
CDM,6276182,IMP EMBOLIZATION AGENT LVL 09,15334.0,8817.05,3986.84,14873.98,29
CDM,6276190,IMP PROSTH ORTHOPEDIC LVL 01,1614.0,928.05,419.64,1565.58,29
CDM,6276208,IMP PROSTH ORTHOPEDIC LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6276216,IMP TISSUE CONNECT HUMAN LVL 13,39424.0,22668.8,10250.24,38241.28,29
CDM,6276224,IMP TISSUE CONNECT HUMAN LVL 14,43804.0,25187.3,11389.04,42489.88,29
CDM,6276232,IMP BOLT LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,6276240,IMP LD PCMKR VDD LVL 01,2690.0,1546.75,699.4,2609.3,29
CDM,6276257,HYPO-HYPER THERMAL LVL 03,1413.0,902.91,367.38,1370.61,29
CDM,6276273,IMP DEV JT SHDR TOTAL LVL 13,39424.0,22668.8,10250.24,38241.28,29
CDM,6276281,IMP DEV JT SHDR TOTAL LVL 14,43804.0,25187.3,11389.04,42489.88,29
CDM,6276299,IMP DEV JT SHDR TOTAL LVL 15,48184.0,27705.8,12527.84,46738.48,29
CDM,6276315,PIN GUIDE LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,6276323,IMP LD NEUROSTIM LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,6276331,IMP LD NEUROSTIM LVL 06,26284.0,15113.3,6833.84,25495.48,29
CDM,6276356,RETRIEVER SUTURE LVL 03,2157.0,1041.83,560.82,2092.29,29
CDM,6276364,RETRIEVER SUTURE LVL 04,3083.0,1489.09,801.58,2990.51,29
CDM,6276372,RETRIEVER SUTURE LVL 05,3853.0,1861.0,1001.78,3737.41,29
CDM,6276398,INTRO EP LASER LVL 03,1888.0,911.9,490.88,1831.36,29
CDM,6276406,INTRO EP LASER LVL 04,3083.0,1489.09,801.58,2990.51,29
CDM,6276414,INTRO EP LASER LVL 05,4885.0,2359.46,1270.1,4738.45,29
CDM,6276422,INTRO EP LASER LVL 06,9265.0,4475.0,2408.9,8987.05,29
CDM,6276430,INTRO EP LASER LVL 07,13895.0,6711.28,3612.7,13478.15,29
CDM,6276455,IMP AGENT SYNTHETIC BULK 1ML LVL 02,447.0,257.02,116.22,433.59,29
CDM,6276463,IMP AGENT SYNTHETIC BULK 1ML LVL 03,709.0,407.67,184.34,687.73,29
CDM,6276471,IMP AGENT SYNTHETIC BULK 1ML LVL 04,1272.0,731.4,330.72,1233.84,29
CDM,6276497,IMP SEPTAL DEFECT INTRACARD LVL 02,19714.0,11335.55,5125.64,19122.58,29
CDM,6276505,IMP SEPTAL DEFECT INTRACARD LVL 03,24094.0,13854.05,6264.44,23371.18,29
CDM,6276513,IMP DEV URINARY W SLING LVL 05,11580.0,6658.5,3010.8,11232.6,29
CDM,6276521,IMP DEV URINARY WO SLNG LVL 05,11580.0,6658.5,3010.8,11232.6,29
CDM,6276604,MORCELLATOR LVL 01,2690.0,1299.27,699.4,2609.3,29
CDM,6276612,MORCELLATOR LVL 02,4880.0,2357.04,1268.8,4733.6,29
CDM,6276620,MORCELLATOR LVL 03,9260.0,4472.58,2407.6,8982.2,29
CDM,6276638,CATH THROMBECTOMY/EMBOLECTMY LVL 08,9265.0,4475.0,2408.9,8987.05,29
CDM,6276646,INTRO LVL 08,7876.0,3804.11,2047.76,7639.72,29
CDM,6276653,INTRO LVL 09,10191.0,4922.25,2649.66,9885.27,29
CDM,6276661,CATH INTRACARDIAC ECHO LVL 01,2690.0,1299.27,699.4,2609.3,29
CDM,6276679,IMP TISSUE CONNECT NONHUMAN LVL 07,21904.0,12594.8,5695.04,21246.88,29
CDM,6276687,IMP LD ICD COIL DUAL LVL 11,32854.0,18891.05,8542.04,31868.38,29
CDM,6276711,PATCH EP REFSTAR LVL 03,2695.0,1722.1,700.7,2614.15,29
CDM,6276729,IMP AGENT SYNTHETIC BULK 1ML LVL 05,2690.0,1546.75,699.4,2609.3,29
CDM,6276737,IMP AGENT SYNTHETIC BULK 1ML LVL 06,3078.0,1769.85,800.28,2985.66,29
CDM,6276794,IMP ROD/NAIL LVL 10,11580.0,6658.5,3010.8,11232.6,29
CDM,6276802,HANDPIECE LVL 07,17524.0,8464.09,4556.24,16998.28,29
CDM,6276810,HANDPIECE LVL 08,21904.0,10579.63,5695.04,21246.88,29
CDM,6276828,HANDPIECE LVL 09,26284.0,12695.17,6833.84,25495.48,29
CDM,6276836,HANDPIECE LVL 10,30664.0,14810.71,7972.64,29744.08,29
CDM,6276844,HANDPIECE LVL 11,35044.0,16926.25,9111.44,33992.68,29
CDM,6276851,HANDPIECE LVL 12,39424.0,19041.79,10250.24,38241.28,29
CDM,6276885,SUPPLY PERFUSION/ECMO LVL 11,7181.0,3468.42,1867.06,6965.57,29
CDM,6276893,INTRO NON GD/EP/LASER LVL 01,96.0,46.37,24.96,93.12,29
CDM,6276927,CATH INTRACARDIAC ECHO LVL 04,9265.0,4475.0,2408.9,8987.05,29
CDM,6276935,CATH INTRACARDIAC ECHO LVL 05,11580.0,5593.14,3010.8,11232.6,29
CDM,6276943,IMP PCMKR SGL RR LVL 02,17520.0,9953.99,4555.2,16994.4,29
CDM,6276968,IMP DEV CLOSURE VASCULAR LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,6276976,IMP DEV CLOSURE VASCULAR LVL 09,13895.0,7989.62,3612.7,13478.15,29
CDM,6276984,IMP DEV CLOSURE VASCULAR LVL 10,17524.0,10076.3,4556.24,16998.28,29
CDM,6276992,IMP DEV CLOSURE VASCULAR LVL 11,21904.0,12594.8,5695.04,21246.88,29
CDM,6277008,DILATOR LVL 07,5861.0,2830.86,1523.86,5685.17,29
CDM,6277016,IMP DEV JT HIP TOTAL LVL 17,109504.0,62964.8,28471.04,106218.88,29
CDM,6277024,IMP MEMBRANE AMNIO OCULAR LVL 01,2695.0,1549.62,700.7,2614.15,29
CDM,6277032,IMP MEMBRANE AMNIO OCULAR LVL 02,3853.0,2215.48,1001.78,3737.41,29
CDM,6277057,IMP CEMENT LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,6277065,IMP CEMENT LVL 07,11580.0,6658.5,3010.8,11232.6,29
CDM,6277099,IMP PLATE CUST LVL 01,65704.0,37779.8,17083.04,63732.88,29
CDM,6277107,IMP PLATE CUST LVL 02,87604.0,50372.3,22777.04,84975.88,29
CDM,6277115,IMP PLATE CUST LVL 03,109504.0,62964.8,28471.04,106218.88,29
CDM,6277123,IMP PLATE CUST LVL 04,131404.0,75557.3,34165.04,127461.88,29
CDM,6277131,IMP BONE HUMAN/SYNTHETIC LVL 14,39862.0,22920.65,10364.12,38666.14,29
CDM,6277149,IMP BONE HUMAN/SYNTHETIC LVL 15,44242.0,25439.15,11502.92,42914.74,29
CDM,6277156,IMP BONE HUMAN/SYNTHETIC LVL 16,48622.0,27957.65,12641.72,47163.34,29
CDM,6277164,IMP BONE HUMAN/SYNTHETIC LVL 17,53002.0,30476.15,13780.52,51411.94,29
CDM,6277172,IMP SPINE KYPHX LVL 01,594.0,341.55,154.44,576.18,29
CDM,6277180,IMP SPINE KYPHX LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,6277198,IMP SPINE KYPHX LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6277206,IMP SPINE KYPHX LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,6277214,IMP SPINE KYPHX LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,6277222,IMP SPINE KYPHX LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,6277230,IMP SPINE KYPHX LVL 07,17524.0,10076.3,4556.24,16998.28,29
CDM,6277248,IMP SPINE KYPHX LVL 08,21904.0,12594.8,5695.04,21246.88,29
CDM,6277545,NEEDLE SPECIALTY LVL 08,2827.0,1365.44,735.02,2742.19,29
CDM,6277552,NEEDLE SPECIALTY LVL 09,3340.0,1613.22,868.4,3239.8,29
CDM,6277560,NEEDLE SPECIALTY LVL 10,3853.0,1861.0,1001.78,3737.41,29
CDM,6277578,LASER FIBER LVL 07,5861.0,2830.86,1523.86,5685.17,29
CDM,6277669,IMP PROSTH SPHINCTR URIN LVL 02,14020.0,8061.5,3645.2,13599.4,29
CDM,6277818,IMP TISSUE CONNECT NONHUMAN LVL 08,30664.0,17631.8,7972.64,29744.08,29
CDM,6277842,IMP PROSTH SPHINCTR URIN LVL 03,19714.0,11335.55,5125.64,19122.58,29
CDM,6277859,IMP PROSTH SPHINCTR URIN LVL 04,25408.0,14609.6,6606.08,24645.76,29
CDM,6277875,SENSOR ENDOSURE AAA LVL 01,13895.0,6711.28,3612.7,13478.15,29
CDM,6277917,DRESSING SPECIALTY LVL 08,6950.0,3356.85,1807.0,6741.5,29
CDM,6277925,IMP MARKER TISSUE LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,6277933,INTRO EP FIX CRV NONPEEL LVL 03,1888.0,911.9,490.88,1831.36,29
CDM,6277941,INTRO EP FIX CRV NONPEEL LVL 04,2695.0,1301.68,700.7,2614.15,29
CDM,6277958,INTRO EP FIX CRV NONPEEL LVL 05,3853.0,1861.0,1001.78,3737.41,29
CDM,6277982,IMP PCMKR DUAL RR LVL 01,17520.0,9953.99,4555.2,16994.4,29
CDM,6278014,IMP DEV URINARY W SLING LVL 06,14020.0,8061.5,3645.2,13599.4,29
CDM,6278113,CATH INTRAVASCULAR US LVL 05,6950.0,3356.85,1807.0,6741.5,29
CDM,6278121,CATH INTRAVASCULAR US LVL 06,9265.0,4475.0,2408.9,8987.05,29
CDM,6278139,CATH INTRAVASCULAR US LVL 07,11580.0,5593.14,3010.8,11232.6,29
CDM,6278147,IMP PIN/WIRE LVL 08,2426.0,1394.95,630.76,2353.22,29
CDM,6278154,IMP PIN/WIRE LVL 09,2827.0,1625.52,735.02,2742.19,29
CDM,6278162,IMP PIN/WIRE LVL 10,3340.0,1920.5,868.4,3239.8,29
CDM,6278170,IMP PIN/WIRE LVL 11,3853.0,2215.48,1001.78,3737.41,29
CDM,6278188,CATH GUIDE LVL 10,6105.0,2948.71,1587.3,5921.85,29
CDM,6278196,CATH GUIDE LVL 11,9265.0,4475.0,2408.9,8987.05,29
CDM,6278204,CATH GUIDE LVL 12,11580.0,5593.14,3010.8,11232.6,29
CDM,6278220,IMP SHUNT LVL 10,17524.0,10076.3,4556.24,16998.28,29
CDM,6278238,IMP ICD CHAMBER NON SGL/DUAL LVL 03,78840.0,45333.0,20498.4,76474.8,29
CDM,6278246,CATH INTRACARDIAC ECHO LVL 06,13895.0,6711.28,3612.7,13478.15,29
CDM,6278253,IMP ROD/NAIL LVL 11,15334.0,8817.05,3986.84,14873.98,29
CDM,6278261,IMP ROD/NAIL LVL 12,19714.0,11335.55,5125.64,19122.58,29
CDM,6278279,IMP ROD/NAIL LVL 13,24094.0,13854.05,6264.44,23371.18,29
CDM,6278329,IMP PIN/WIRE LVL 12,6105.0,3510.37,1587.3,5921.85,29
CDM,6278337,IMP CABLE LVL 07,6950.0,3996.25,1807.0,6741.5,29
CDM,6278345,IMP CABLE LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,6278352,IMP CABLE LVL 09,11580.0,6658.5,3010.8,11232.6,29
CDM,6278360,IMP PCMKR DUAL NON RR LVL 01,19714.0,11200.51,5125.64,19122.58,29
CDM,6278378,IMP PCMKR DUAL NON RR LVL 02,24090.0,13686.73,6263.4,23367.3,29
CDM,6278386,IMP PCMKR SGL NON RR LVL 02,19714.0,11200.51,5125.64,19122.58,29
CDM,6278394,IMP PCMKR SGL NON RR LVL 03,22776.0,12940.18,5921.76,22092.72,29
CDM,6278410,IMP CARDIAC EVENT REC LVL 03,14892.0,8562.9,3871.92,14445.24,29
CDM,6278444,CANNULA LVL 10,7181.0,3468.42,1867.06,6965.57,29
CDM,6278451,CANNULA LVL 11,10654.0,5145.88,2770.04,10334.38,29
CDM,6278469,IMP PROSTH SPHINCTR ANAL LVL 01,5368.0,3086.6,1395.68,5206.96,29
CDM,6278519,IMP CEMENT LVL 08,13895.0,7989.62,3612.7,13478.15,29
CDM,6278584,STAPLE RELOAD LVL 07,6105.0,2948.71,1587.3,5921.85,29
CDM,6278600,STAPLE RELOAD LVL 08,8107.0,3915.68,2107.82,7863.79,29
CDM,6278634,IMP DEV COCHLEAR INT&EXT CMP LVL 06,131404.0,75557.3,34165.04,127461.88,29
CDM,6278642,IMP DEV COCHLEAR INT&EXT CMP LVL 07,153304.0,88149.8,39859.04,148704.88,29
CDM,6278659,IMP DEV COCHLEAR INT&EXT CMP LVL 08,175204.0,100742.3,45553.04,169947.88,29
CDM,6278667,IMP DEV COCHLEAR INT&EXT CMP LVL 09,197104.0,113334.8,51247.04,191190.88,29
CDM,6278675,IMP DEV COCHLEAR INT&EXT CMP LVL 10,219004.0,125927.3,56941.04,212433.88,29
CDM,6278683,DEVICE INSERT RETRV LVL 04,4397.0,2123.75,1143.22,4265.09,29
CDM,6278709,IMP DEV JT SHDR TOTAL LVL 16,55630.0,31987.25,14463.8,53961.1,29
CDM,6278717,CATH ABL EP NON 3D/VECTOR LVL 05,13895.0,6711.28,3612.7,13478.15,29
CDM,6278741,SUPPLY NEURO LVL 09,17524.0,8464.09,4556.24,16998.28,29
CDM,6278758,IMP MESH LVL 15,37234.0,21409.55,9680.84,36116.98,29
CDM,6278766,BAG DRAINAGE LVL 04,535.0,341.86,139.1,518.95,29
CDM,6278774,BAG DRAINAGE LVL 05,766.0,489.47,199.16,743.02,29
CDM,6278857,LENS INTRAOCULAR CHAM POST LVL 01,594.0,238.19,154.44,576.18,29
CDM,6278865,LENS INTRAOCULAR CHAM POST LVL 02,1132.0,453.93,294.32,1098.04,29
CDM,6278873,LENS INTRAOCULAR CHAM POST LVL 03,2157.0,864.96,560.82,2092.29,29
CDM,6278881,LENS INTRAOCULAR CHAM ANT LVL 01,594.0,238.19,154.44,576.18,29
CDM,6278899,LENS INTRAOCULAR CHAM ANT LVL 02,1132.0,453.93,294.32,1098.04,29
CDM,6278907,LENS INTRAOCULAR CHAM ANT LVL 03,2157.0,864.96,560.82,2092.29,29
CDM,6278915,INTRO EP FIX CRV PEEL LVL 06,3596.0,1736.87,934.96,3488.12,29
CDM,6278931,IMP PIN/WIRE LVL 13,8107.0,4661.52,2107.82,7863.79,29
CDM,6278949,IMP LD ICD NON SGL/DUAL LVL 05,11580.0,6658.5,3010.8,11232.6,29
CDM,6278956,IMP STENT NOS LVL 15,43804.0,25187.3,11389.04,42489.88,29
CDM,6278972,IMP ADPT/EXT LD PACING/NEURO LVL 03,7413.0,4262.47,1927.38,7190.61,29
CDM,6279004,IMP LD NEUROSTIM LVL 07,30664.0,17631.8,7972.64,29744.08,29
CDM,6279046,PAIN MGMT ACCESSORY LVL 06,3340.0,1613.22,868.4,3239.8,29
CDM,6279111,REAMER LVL 02,588.0,284.0,152.88,570.36,29
CDM,6279152,IMP FIX SPINE LVL 11,39424.0,22668.8,10250.24,38241.28,29
CDM,6279160,RETRIEVER BASKET LVL 06,3853.0,1861.0,1001.78,3737.41,29
CDM,6279178,REAMER LVL 01,159.0,76.8,41.34,154.23,29
CDM,6279194,IMP ICD CHAMBER SGL LVL 01,43800.0,24884.97,11388.0,42486.0,29
CDM,6279202,CATH ABL COOL-TIP LVL 08,9265.0,4475.0,2408.9,8987.05,29
CDM,6279210,CATH ABL COOL-TIP LVL 09,11575.0,5590.72,3009.5,11227.75,29
CDM,6279228,CATH ABL COOL-TIP LVL 10,13432.0,6487.66,3492.32,13029.04,29
CDM,6279236,IMP PROSTH ORTHOPEDIC LVL 05,13895.0,7989.62,3612.7,13478.15,29
CDM,6279269,IMP DEV INTERSPINOUS LVL 01,4885.0,2808.88,1270.1,4738.45,29
CDM,6279277,IMP DEV INTERSPINOUS LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,6279285,IMP DEV INTERSPINOUS LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,6279293,IMP DEV INTERSPINOUS LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,6279301,IMP DEV INTERSPINOUS LVL 05,21904.0,12594.8,5695.04,21246.88,29
CDM,6279319,IMP DEV INTERSPINOUS LVL 06,26284.0,15113.3,6833.84,25495.48,29
CDM,6279327,IMP DEV INTERSPINOUS LVL 07,30664.0,17631.8,7972.64,29744.08,29
CDM,6279335,IMP DEV INTERSPINOUS LVL 08,35044.0,20150.3,9111.44,33992.68,29
CDM,6279343,HYPO-HYPER THERMAL LVL 04,3853.0,2462.07,1001.78,3737.41,29
CDM,6279376,IMP ORTHOPEDIC CAGE LVL 10,39424.0,22668.8,10250.24,38241.28,29
CDM,6279384,IMP STAPLE BONE LVL 13,8339.0,4794.92,2168.14,8088.83,29
CDM,6279392,IMP BONE HUMAN/SYNTHETIC LVL 18,61324.0,35261.3,15944.24,59484.28,29
CDM,6279400,IMP BONE HUMAN/SYNTHETIC LVL 19,70084.0,40298.3,18221.84,67981.48,29
CDM,6279418,IMP BONE HUMAN/SYNTHETIC LVL 20,78844.0,45335.3,20499.44,76478.68,29
CDM,6279426,IMP BONE HUMAN/SYNTHETIC LVL 21,87604.0,50372.3,22777.04,84975.88,29
CDM,6279434,IMP ORTHOPEDIC CAGE LVL 11,52564.0,30224.3,13666.64,50987.08,29
CDM,6279442,IMP ORTHOPEDIC CAGE LVL 12,65704.0,37779.8,17083.04,63732.88,29
CDM,6279459,IMP FIX SPINE LVL 12,52564.0,30224.3,13666.64,50987.08,29
CDM,6279467,IMP FIX SPINE LVL 13,65704.0,37779.8,17083.04,63732.88,29
CDM,6279475,IMP ORTHOPEDIC CAGE LVL 13,78844.0,45335.3,20499.44,76478.68,29
CDM,6279483,IMP FIX SPINE LVL 14,78844.0,45335.3,20499.44,76478.68,29
CDM,6279491,IMP BONE HUMAN/SYNTHETIC LVL 22,96364.0,55409.3,25054.64,93473.08,29
CDM,6279509,IMP GENERATOR NEUROSTIM LVL 05,109504.0,62964.8,28471.04,106218.88,29
CDM,6279525,IMP TUBE EAR LVL 02,447.0,257.02,116.22,433.59,29
CDM,6279533,IMP TUBE EAR LVL 03,709.0,407.67,184.34,687.73,29
CDM,6279541,IMP ORTHOTIC CAP END LVL 01,159.0,91.42,41.34,154.23,29
CDM,6279558,IMP ORTHOTIC CAP END LVL 02,313.0,179.98,81.38,303.61,29
CDM,6279566,IMP ORTHOTIC CAP END LVL 03,850.0,488.75,221.0,824.5,29
CDM,6279574,IMP ORTHOTIC CAP END LVL 04,1413.0,812.47,367.38,1370.61,29
CDM,6279582,IMP ORTHOTIC CAP END LVL 05,1888.0,1085.6,490.88,1831.36,29
CDM,6279590,IMP ORTHOTIC CAP END LVL 06,2695.0,1549.62,700.7,2614.15,29
CDM,6279608,IMP STENT NONCOR TEMP W DEL LVL 02,1132.0,650.9,294.32,1098.04,29
CDM,6279624,INSERTS LVL 03,594.0,286.9,154.44,576.18,29
CDM,6279632,INSERTS LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,6279640,IMP DEV URINARY W SLING LVL 07,17962.0,10328.15,4670.12,17423.14,29
CDM,6279665,CATH INTRAVASCULAR US LVL 08,13895.0,6711.28,3612.7,13478.15,29
CDM,6279673,CATH INTRAVASCULAR US LVL 09,15334.0,7406.32,3986.84,14873.98,29
CDM,6279699,DRESSING SPECIALTY LVL 09,9265.0,4475.0,2408.9,8987.05,29
CDM,6279707,DRESSING SPECIALTY LVL 10,11580.0,5593.14,3010.8,11232.6,29
CDM,6279715,IMP SPINE FUSION LVL 03,7413.0,4262.47,1927.38,7190.61,29
CDM,6279723,IMP SPINE FUSION LVL 04,8339.0,4794.92,2168.14,8088.83,29
CDM,6279731,IMP SPINE FUSION LVL 05,9728.0,5593.6,2529.28,9436.16,29
CDM,6279749,IMP SPINE FUSION LVL 06,11117.0,6392.28,2890.42,10783.49,29
CDM,6279756,IMP SPINE FUSION LVL 07,13895.0,7989.62,3612.7,13478.15,29
CDM,6279764,IMP SPINE FUSION LVL 08,17524.0,10076.3,4556.24,16998.28,29
CDM,6279772,IMP SPINE FUSION LVL 09,21904.0,12594.8,5695.04,21246.88,29
CDM,6279780,IMP SPINE FUSION LVL 10,26284.0,15113.3,6833.84,25495.48,29
CDM,6279798,IMP SPINE FUSION LVL 11,30664.0,17631.8,7972.64,29744.08,29
CDM,6279806,IMP SPINE FUSION LVL 12,35044.0,20150.3,9111.44,33992.68,29
CDM,6279814,IMP SPINE FUSION LVL 13,39424.0,22668.8,10250.24,38241.28,29
CDM,6279830,IMP CEMENT ACCESSORY LVL 05,3853.0,2215.48,1001.78,3737.41,29
CDM,6279848,IMP CEMENT ACCESSORY LVL 06,4880.0,2806.0,1268.8,4733.6,29
CDM,6279855,IMP PLATE LVL 18,26284.0,15113.3,6833.84,25495.48,29
CDM,6279863,IMP PLATE LVL 19,28474.0,16372.55,7403.24,27619.78,29
CDM,6279871,IMP PLATE LVL 20,30664.0,17631.8,7972.64,29744.08,29
CDM,6279889,IMP PLATE LVL 21,32854.0,18891.05,8542.04,31868.38,29
CDM,6279897,IMP PLATE LVL 22,35044.0,20150.3,9111.44,33992.68,29
CDM,6279996,IMP SPINE FUSION LVL 14,43804.0,25187.3,11389.04,42489.88,29
CDM,6280002,IMP SPINE FUSION LVL 15,48184.0,27705.8,12527.84,46738.48,29
CDM,6280010,IMP SPINE FUSION LVL 16,52564.0,30224.3,13666.64,50987.08,29
CDM,6280028,IMP SPINE FUSION LVL 17,56944.0,32742.8,14805.44,55235.68,29
CDM,6280036,IMP SPINE FUSION LVL 18,61324.0,35261.3,15944.24,59484.28,29
CDM,6280044,IMP PROSTH ANKLE LVL 10,43804.0,25187.3,11389.04,42489.88,29
CDM,6280051,STAPLE RELOAD LVL 09,10422.0,5033.83,2709.72,10109.34,29
CDM,6280101,IMP TISSUE CONNECT NONHUMAN LVL 09,39424.0,22668.8,10250.24,38241.28,29
CDM,6280119,IMP TISSUE CONNECT NONHUMAN LVL 10,43804.0,25187.3,11389.04,42489.88,29
CDM,6280200,INSTRUMENT DISP SINGLE LVL 13,15334.0,7406.32,3986.84,14873.98,29
CDM,6280234,IMP SPINE FUSION LVL 19,65704.0,37779.8,17083.04,63732.88,29
CDM,6280242,IMP SPINE FUSION LVL 20,70084.0,40298.3,18221.84,67981.48,29
CDM,6280259,IMP SPINE FUSION LVL 21,74464.0,42816.8,19360.64,72230.08,29
CDM,6280267,IMP SPINE FUSION LVL 22,78844.0,45335.3,20499.44,76478.68,29
CDM,6280275,IMP SPINE FUSION LVL 23,83224.0,47853.8,21638.24,80727.28,29
CDM,6280283,CATH/WIRE/SUTURE PASSER LVL 03,850.0,410.55,221.0,824.5,29
CDM,6280291,BRA SURG POSTOP LVL 01,159.0,101.6,41.34,154.23,29
CDM,6280309,IMP SPINE FUSION LVL 24,111694.0,64224.05,29040.44,108343.18,29
CDM,6280317,SENSOR CEREBRAL OXIMETER LVL 02,1619.0,1034.54,420.94,1570.43,29
CDM,6280325,IMP BOLT LVL 07,9265.0,5327.38,2408.9,8987.05,29
CDM,6280333,IMP BOLT LVL 08,12506.0,7190.95,3251.56,12130.82,29
CDM,6280341,CLIP LVL 05,1485.0,717.26,386.1,1440.45,29
CDM,6280358,CLIP LVL 06,2028.0,979.52,527.28,1967.16,29
CDM,6280366,NEEDLE BRACHYTHERAPY LVL 02,588.0,284.0,152.88,570.36,29
CDM,6280374,IMP PROSTH PENILE INFLT LVL 06,43804.0,25187.3,11389.04,42489.88,29
CDM,6280382,IMP PROSTH PENILE INFLT LVL 07,56944.0,32742.8,14805.44,55235.68,29
CDM,6280390,IMP PROSTH PENILE INFLT LVL 08,65704.0,37779.8,17083.04,63732.88,29
CDM,6280408,EMBOLIZATION SYS PROTECT LVL 04,11580.0,6658.5,3010.8,11232.6,29
CDM,6280416,TAPS LVL 04,3596.0,1736.87,934.96,3488.12,29
CDM,6280424,THERAPY COLD LVL 04,2426.0,1171.76,630.76,2353.22,29
CDM,6280432,THERAPY COLD LVL 05,3909.0,1888.05,1016.34,3791.73,29
CDM,6280440,IMP TISSUE CONNECT NONHUMAN LVL 11,48184.0,27705.8,12527.84,46738.48,29
CDM,6280523,IMP ADPT/EXT LD PACING/NEURO LVL 01,1126.0,647.45,292.76,1092.22,29
CDM,6280572,IMP STAPLE REINFORCEMENT LVL 01,313.0,179.98,81.38,303.61,29
CDM,6280580,IMP STAPLE REINFORCEMENT LVL 02,594.0,341.55,154.44,576.18,29
CDM,6280598,IMP STAPLE REINFORCEMENT LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,6280606,IMP STAPLE REINFORCEMENT LVL 04,1619.0,930.92,420.94,1570.43,29
CDM,6280614,IMP STAPLE REINFORCEMENT LVL 05,2157.0,1240.27,560.82,2092.29,29
CDM,6280655,IMP LD NEUROSTIM TEST KIT LVL 07,3909.0,2247.67,1016.34,3791.73,29
CDM,6280671,IMP PROSTH SPHINCTR ANAL LVL 03,15334.0,8817.05,3986.84,14873.98,29
CDM,6280689,IMP PROSTH SPHINCTR ANAL LVL 04,19714.0,11335.55,5125.64,19122.58,29
CDM,6280721,IMP NEURO LVL 08,65704.0,37779.8,17083.04,63732.88,29
CDM,6280739,IMP STENT NONCOR TEMP W DEL LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6280747,IMP STENT NONCOR TEMP W DEL LVL 04,3909.0,2247.67,1016.34,3791.73,29
CDM,6280754,IMP STENT NONCOR TEMP W DEL LVL 05,5373.0,3089.48,1396.98,5211.81,29
CDM,6280762,WIRE PACING TEMP LVL 03,850.0,410.55,221.0,824.5,29
CDM,6280770,WIRE PACING TEMP LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,6280788,WIRE PACING TEMP LVL 05,1413.0,682.48,367.38,1370.61,29
CDM,6280796,MANIPULATOR LVL 03,850.0,410.55,221.0,824.5,29
CDM,6280804,IMP MATERIAL CORD VOCAL LVL 02,1614.0,928.05,419.64,1565.58,29
CDM,6280812,IMP LD NEUROSTIM TEST KIT LVL 08,6105.0,3510.37,1587.3,5921.85,29
CDM,6280820,IMP LD NEUROSTIM TEST KIT LVL 09,7644.0,4395.3,1987.44,7414.68,29
CDM,6280838,DEVICE CLOSURE TISSUE LVL 01,313.0,151.18,81.38,303.61,29
CDM,6280846,DEVICE CLOSURE TISSUE LVL 02,594.0,286.9,154.44,576.18,29
CDM,6280853,DEVICE CLOSURE TISSUE LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,6280861,DEVICE CLOSURE TISSUE LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,6280879,DEVICE CLOSURE TISSUE LVL 05,2157.0,1041.83,560.82,2092.29,29
CDM,6280887,DEVICE CLOSURE TISSUE LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,6280895,DEVICE CLOSURE TISSUE LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,6280903,DEVICE CLOSURE TISSUE LVL 08,9265.0,4475.0,2408.9,8987.05,29
CDM,6280911,DEVICE CLOSURE TISSUE LVL 09,13895.0,6711.28,3612.7,13478.15,29
CDM,6280929,DEVICE CLOSURE TISSUE LVL 10,17524.0,8464.09,4556.24,16998.28,29
CDM,6280937,DEVICE CLOSURE TISSUE LVL 11,21904.0,10579.63,5695.04,21246.88,29
CDM,6280945,IMP HOOK LVL 01,2690.0,1546.75,699.4,2609.3,29
CDM,6280952,IMP HOOK LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,6280960,IMP HOOK LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,6280978,IMP HOOK LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6280986,WIRE GUIDE LVL 10,11580.0,5593.14,3010.8,11232.6,29
CDM,6280994,WIRE GUIDE LVL 11,13895.0,6711.28,3612.7,13478.15,29
CDM,6281000,IMP STENT COAT W DEL LVL 14,39424.0,22668.8,10250.24,38241.28,29
CDM,6281018,IMP STENT COAT W DEL LVL 15,43804.0,25187.3,11389.04,42489.88,29
CDM,6281026,IMP SPINAL BAR/RG/CLR LVL 01,594.0,341.55,154.44,576.18,29
CDM,6281034,IMP SPINAL BAR/RG/CLR LVL 02,850.0,488.75,221.0,824.5,29
CDM,6281042,IMP SPINAL BAR/RG/CLR LVL 03,1132.0,650.9,294.32,1098.04,29
CDM,6281059,IMP SPINAL BAR/RG/CLR LVL 04,1413.0,812.47,367.38,1370.61,29
CDM,6281067,IMP SPINAL BAR/RG/CLR LVL 05,1619.0,930.92,420.94,1570.43,29
CDM,6281075,IMP SPINAL BAR/RG/CLR LVL 06,1888.0,1085.6,490.88,1831.36,29
CDM,6281083,IMP SPINAL BAR/RG/CLR LVL 07,2426.0,1394.95,630.76,2353.22,29
CDM,6281091,IMP SPINAL BAR/RG/CLR LVL 08,2827.0,1625.52,735.02,2742.19,29
CDM,6281109,IMP SPINAL BAR/RG/CLR LVL 09,3340.0,1920.5,868.4,3239.8,29
CDM,6281117,DEVICE INFLATION DISP LVL 01,313.0,151.18,81.38,303.61,29
CDM,6281125,DEVICE INFLATION DISP LVL 02,594.0,286.9,154.44,576.18,29
CDM,6281133,DEVICE INFLATION DISP LVL 03,850.0,410.55,221.0,824.5,29
CDM,6281141,DEVICE INFLATION DISP LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,6281158,DEVICE INFLATION DISP LVL 05,1619.0,781.98,420.94,1570.43,29
CDM,6281166,DEVICE INFLATION DISP LVL 06,2157.0,1041.83,560.82,2092.29,29
CDM,6281174,DEVICE INFLATION DISP LVL 07,2695.0,1301.68,700.7,2614.15,29
CDM,6281182,IMP TISSUE CONNECT HUMAN LVL 15,48184.0,27705.8,12527.84,46738.48,29
CDM,6281208,DEVICE FIXATION DISP LVL 01,313.0,151.18,81.38,303.61,29
CDM,6281216,DEVICE FIXATION DISP LVL 02,594.0,286.9,154.44,576.18,29
CDM,6281224,DEVICE FIXATION DISP LVL 03,1132.0,546.76,294.32,1098.04,29
CDM,6281232,DEVICE FIXATION DISP LVL 04,1619.0,781.98,420.94,1570.43,29
CDM,6281240,DEVICE FIXATION DISP LVL 05,2157.0,1041.83,560.82,2092.29,29
CDM,6281257,DEVICE FIXATION DISP LVL 06,2695.0,1301.68,700.7,2614.15,29
CDM,6281265,DEVICE FIXATION DISP LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,6281273,IMP SPINAL BAR/RG/CLR LVL 10,3853.0,2215.48,1001.78,3737.41,29
CDM,6281281,IMP SPINAL BAR/RG/CLR LVL 11,4153.0,2387.98,1079.78,4028.41,29
CDM,6281299,IMP CATH PORT INDWELLING LVL 08,4153.0,2387.98,1079.78,4028.41,29
CDM,6281307,IMP CATH PORT INDWELLING LVL 09,4641.0,2668.58,1206.66,4501.77,29
CDM,6281323,DEVICE FIXATION DISP LVL 08,6950.0,3356.85,1807.0,6741.5,29
CDM,6281349,IMP STENT NOS LVL 16,50374.0,28965.05,13097.24,48862.78,29
CDM,6281372,EMBOLIZATION SYS PROTECT LVL 01,5861.0,3370.08,1523.86,5685.17,29
CDM,6281380,DEVICE ABLATION LVL 02,1132.0,546.76,294.32,1098.04,29
CDM,6281398,DEVICE ABLATION LVL 03,3083.0,1489.09,801.58,2990.51,29
CDM,6281406,DEVICE ABLATION LVL 04,4885.0,2359.46,1270.1,4738.45,29
CDM,6281414,DEVICE ABLATION LVL 05,6950.0,3356.85,1807.0,6741.5,29
CDM,6281422,DEVICE ABLATION LVL 06,9265.0,4475.0,2408.9,8987.05,29
CDM,6281430,DEVICE ABLATION LVL 07,11580.0,5593.14,3010.8,11232.6,29
CDM,6281448,DEVICE ABLATION LVL 08,13895.0,6711.28,3612.7,13478.15,29
CDM,6281489,DEVICE INSERT RETRV LVL 05,6105.0,2948.71,1587.3,5921.85,29
CDM,6281497,DEVICE INSERT RETRV LVL 06,8107.0,3915.68,2107.82,7863.79,29
CDM,6281505,DEVICE INSERT RETRV LVL 07,10422.0,5033.83,2709.72,10109.34,29
CDM,6281513,DEVICE INSERT RETRV LVL 08,12737.0,6151.97,3311.62,12354.89,29
CDM,6281521,DEVICE INSERT RETRV LVL 09,14239.0,6877.44,3702.14,13811.83,29
CDM,6281539,DEVICE INSERT RETRV LVL 10,16429.0,7935.21,4271.54,15936.13,29
CDM,6281547,DEVICE INSERT RETRV LVL 11,18619.0,8992.98,4840.94,18060.43,29
CDM,6281554,DEVICE INSERT RETRV LVL 12,20809.0,10050.75,5410.34,20184.73,29
CDM,6281562,DEVICE INSERT RETRV LVL 13,22999.0,11108.52,5979.74,22309.03,29
CDM,6281570,DEVICE INSERT RETRV LVL 14,25189.0,12166.29,6549.14,24433.33,29
CDM,6281588,DEVICE INSERT RETRV LVL 15,27379.0,13224.06,7118.54,26557.63,29
CDM,6281596,DEVICE INSERT RETRV LVL 16,29569.0,14281.83,7687.94,28681.93,29
CDM,6281604,DEVICE INSERT RETRV LVL 17,31759.0,15339.6,8257.34,30806.23,29
CDM,6281646,CATH/WIRE/SUTURE PASSER LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,6281653,CATH/WIRE/SUTURE PASSER LVL 05,1888.0,911.9,490.88,1831.36,29
CDM,6281778,IMP TISSUE CONNECT NONHUMAN LVL 12,52564.0,30224.3,13666.64,50987.08,29
CDM,6281786,IMP TISSUE CONNECT NONHUMAN LVL 13,56944.0,32742.8,14805.44,55235.68,29
CDM,6282198,IMP PUMP VALVE BLOOD LVL 05,78844.0,45335.3,20499.44,76478.68,29
CDM,6282289,IMP GENERATOR NEUROSTIM LVL 01,28470.0,16370.25,7402.2,27615.9,29
CDM,6282859,IMP RV/AD/RP HIP FEMORAL HD LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6282867,IMP RV/AD/RP HIP FEMORAL HD LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,6282875,IMP RV/AD/RP HIP FEMORAL HD LVL 05,4397.0,2528.27,1143.22,4265.09,29
CDM,6282883,IMP RV/AD/RP HIP FEMORAL HD LVL 06,5373.0,3089.48,1396.98,5211.81,29
CDM,6282891,IMP RV/AD/RP HIP STEM LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,6282909,IMP RV/AD/RP HIP STEM LVL 04,21904.0,12594.8,5695.04,21246.88,29
CDM,6282917,IMP RV/AD/RP HIP STEM LVL 05,30664.0,17631.8,7972.64,29744.08,29
CDM,6282925,IMP RV/AD/RP HIP SHELL LVL 03,4397.0,2528.27,1143.22,4265.09,29
CDM,6282933,IMP RV/AD/RP HIP SHELL LVL 04,5373.0,3089.48,1396.98,5211.81,29
CDM,6282941,IMP RV/AD/RP HIP SHELL LVL 05,6487.0,3730.02,1686.62,6292.39,29
CDM,6282958,IMP RV/AD/RP HIP SHELL LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,6282966,IMP RV/AD/RP HIP LINER LVL 04,5373.0,3089.48,1396.98,5211.81,29
CDM,6282974,IMP RV/AD/RP HIP LINER LVL 05,6487.0,3730.02,1686.62,6292.39,29
CDM,6282982,IMP RV/AD/RP HIP LINER LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,6282990,IMP RV/AD/RP HIP CUP LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,6283006,IMP RV/AD/RP HIP CUP LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,6283014,IMP RV/AD/RP HIP CUP LVL 07,17524.0,10076.3,4556.24,16998.28,29
CDM,6283022,IMP RV/AD/RP HIP CUP LVL 08,21904.0,12594.8,5695.04,21246.88,29
CDM,6283030,IMP RV/AD/RP KN FEMORAL LVL 01,3596.0,2067.7,934.96,3488.12,29
CDM,6283048,IMP RV/AD/RP KN FEMORAL LVL 02,4885.0,2808.88,1270.1,4738.45,29
CDM,6283055,IMP RV/AD/RP KN FEMORAL LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,6283063,IMP RV/AD/RP KN FEMORAL LVL 04,26284.0,15113.3,6833.84,25495.48,29
CDM,6283071,IMP RV/AD/RP KN TIBIAL LVL 01,3596.0,2067.7,934.96,3488.12,29
CDM,6283089,IMP RV/AD/RP KN TIBIAL LVL 02,5373.0,3089.48,1396.98,5211.81,29
CDM,6283097,IMP RV/AD/RP KN TIBIAL LVL 03,6950.0,3996.25,1807.0,6741.5,29
CDM,6283105,IMP RV/AD/RP KN TIBIAL LVL 04,8802.0,5061.15,2288.52,8537.94,29
CDM,6283113,IMP RV/AD/RP KN TIBIAL LVL 05,10654.0,6126.05,2770.04,10334.38,29
CDM,6283121,IMP RV/AD/RP KN TIBIAL LVL 06,12506.0,7190.95,3251.56,12130.82,29
CDM,6283139,IMP RV/AD/RP KN TIBIAL LVL 07,13582.0,7809.65,3531.32,13174.54,29
CDM,6283147,IMP RV/AD/RP KN TIBIAL LVL 08,15334.0,8817.05,3986.84,14873.98,29
CDM,6283154,IMP RV/AD/RP KN TIBIAL LVL 09,17086.0,9824.45,4442.36,16573.42,29
CDM,6283162,IMP RV/AD/RP KN STEM LVL 02,3596.0,2067.7,934.96,3488.12,29
CDM,6283170,IMP RV/AD/RP KN STEM LVL 03,4397.0,2528.27,1143.22,4265.09,29
CDM,6283188,IMP RV/AD/RP KN STEM LVL 04,5373.0,3089.48,1396.98,5211.81,29
CDM,6283196,IMP RV/AD/RP KN STEM LVL 05,6024.0,3463.8,1566.24,5843.28,29
CDM,6283204,IMP RV/AD/RP KN INSR/SLV/LN LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,6283212,IMP RV/AD/RP KN INSR/SLV/LN LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,6283220,IMP RV/AD/RP KN INSR/SLV/LN LVL 07,17524.0,10076.3,4556.24,16998.28,29
CDM,6283238,IMP RV/AD/RP KN PATELLA LVL 03,3083.0,1772.72,801.58,2990.51,29
CDM,6283246,IMP RV/AD/RP KN PATELLA LVL 04,3909.0,2247.67,1016.34,3791.73,29
CDM,6283253,IMP RV/AD/RP KN PATELLA LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,6283261,IMP RV/AD/RP KN PATELLA LVL 06,5861.0,3370.08,1523.86,5685.17,29
CDM,6283279,IMP RV/AD/RP KN PATELLA LVL 07,6024.0,3463.8,1566.24,5843.28,29
CDM,6283287,IMP RV/AD/RP SHDR HEAD LVL 05,6487.0,3730.02,1686.62,6292.39,29
CDM,6283295,IMP RV/AD/RP SHDR HEAD LVL 06,7413.0,4262.47,1927.38,7190.61,29
CDM,6283303,IMP RV/AD/RP SHDR HEAD LVL 07,8339.0,4794.92,2168.14,8088.83,29
CDM,6283311,IMP RV/AD/RP SHDR STEM LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,6283329,IMP RV/AD/RP SHDR STEM LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,6283337,IMP RV/AD/RP SHDR STEM LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,6283345,IMP RV/AD/RP SHDR GLEN CMP LVL 02,9265.0,5327.38,2408.9,8987.05,29
CDM,6283352,IMP RV/AD/RP SHDR GLEN CMP LVL 03,13895.0,7989.62,3612.7,13478.15,29
CDM,6283360,IMP RV/AD/RP SHDR GLEN CMP LVL 04,17524.0,10076.3,4556.24,16998.28,29
CDM,6283402,IMP RV/AD/RP SHDR SHELL LVL 01,9265.0,5327.38,2408.9,8987.05,29
CDM,6283410,IMP RV/AD/RP SHDR SHELL LVL 02,13895.0,7989.62,3612.7,13478.15,29
CDM,6283428,IMP RV/AD/RP SHDR SHELL LVL 03,17524.0,10076.3,4556.24,16998.28,29
CDM,6283436,IMP RV/AD/RP SHDR INSERT LVL 03,9265.0,5327.38,2408.9,8987.05,29
CDM,6283444,IMP RV/AD/RP SHDR INSERT LVL 04,13895.0,7989.62,3612.7,13478.15,29
CDM,6283451,IMP RV/AD/RP SHDR INSERT LVL 05,17524.0,10076.3,4556.24,16998.28,29
CDM,6283501,IMP RV/AD/RP HIP FEMORAL HD LVL 07,6024.0,3463.8,1566.24,5843.28,29
CDM,6283519,IMP RV/AD/RP HIP FEMORAL HD LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,6283527,IMP RV/AD/RP HIP FEMORAL HD LVL 09,12506.0,7190.95,3251.56,12130.82,29
CDM,6283725,IMP RING FALLOPE LVL 01,166.0,95.45,43.16,161.02,29
CDM,6283733,IMP RING FALLOPE LVL 02,588.0,338.1,152.88,570.36,29
CDM,6283840,IMP RV/AD/RP KN INSR/SLV/LN LVL 04,4880.0,2806.0,1268.8,4733.6,29
CDM,6283881,THERAPY COLD LVL 06,4885.0,2359.46,1270.1,4738.45,29
CDM,6283949,BRUSH LVL 04,1132.0,546.76,294.32,1098.04,29
CDM,6284228,IMP RV/AD/RP HIP INSR/EX/RNG LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6284236,IMP RV/AD/RP HIP INSR/EX/RNG LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,6284244,IMP RV/AD/RP HIP INSR/EX/RNG LVL 05,4397.0,2528.27,1143.22,4265.09,29
CDM,6284251,IMP RV/AD/RP HIP INSR/EX/RNG LVL 06,5373.0,3089.48,1396.98,5211.81,29
CDM,6284269,IMP RV/AD/RP HIP INSR/EX/RNG LVL 07,6024.0,3463.8,1566.24,5843.28,29
CDM,6284277,IMP RV/AD/RP HIP INSR/EX/RNG LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,6284285,IMP RV/AD/RP HIP INSR/EX/RNG LVL 09,12506.0,7190.95,3251.56,12130.82,29
CDM,6284483,IMP RV/AD/RP KN DIS/POS AUG LVL 02,1619.0,930.92,420.94,1570.43,29
CDM,6284491,IMP RV/AD/RP KN DIS/POS AUG LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,6284509,IMP RV/AD/RP KN DIS/POS AUG LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,6284517,IMP RV/AD/RP KN DIS/POS AUG LVL 05,4397.0,2528.27,1143.22,4265.09,29
CDM,6284525,IMP RV/AD/RP KN DIS/POS AUG LVL 06,5373.0,3089.48,1396.98,5211.81,29
CDM,6284533,IMP RV/AD/RP KN DIS/POS AUG LVL 07,6024.0,3463.8,1566.24,5843.28,29
CDM,6284541,IMP RV/AD/RP KN DIS/POS AUG LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,6284558,IMP RV/AD/RP KN DIS/POS AUG LVL 09,12506.0,7190.95,3251.56,12130.82,29
CDM,6284566,IMP RV/AD/RP KN DIS/POS AUG LVL 10,13582.0,7809.65,3531.32,13174.54,29
CDM,6284574,IMP RV/AD/RP KN DIS/POS AUG LVL 11,15334.0,8817.05,3986.84,14873.98,29
CDM,6284582,IMP RV/AD/RP KN DIS/POS AUG LVL 12,17524.0,10076.3,4556.24,16998.28,29
CDM,6284590,IMP RV/AD/RP KN DIS/POS AUG LVL 13,19714.0,11335.55,5125.64,19122.58,29
CDM,6284608,IMP RV/AD/RP KN TIB/FM TRIAL LVL 02,1619.0,930.92,420.94,1570.43,29
CDM,6284616,IMP RV/AD/RP KN TIB/FM TRIAL LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,6284624,IMP RV/AD/RP KN TIB/FM TRIAL LVL 04,3596.0,2067.7,934.96,3488.12,29
CDM,6284632,IMP RV/AD/RP KN TIB/FM TRIAL LVL 05,4397.0,2528.27,1143.22,4265.09,29
CDM,6284640,IMP RV/AD/RP KN TIB/FM TRIAL LVL 06,5373.0,3089.48,1396.98,5211.81,29
CDM,6284657,IMP RV/AD/RP KN TIB/FM TRIAL LVL 07,6024.0,3463.8,1566.24,5843.28,29
CDM,6284665,IMP RV/AD/RP KN TIB/FM TRIAL LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,6284673,IMP RV/AD/RP KN TIB/FM TRIAL LVL 09,12506.0,7190.95,3251.56,12130.82,29
CDM,6284681,IMP RV/AD/RP KN TIB/FM TRIAL LVL 10,13582.0,7809.65,3531.32,13174.54,29
CDM,6284699,IMP RV/AD/RP KN TIB/FM TRIAL LVL 11,15334.0,8817.05,3986.84,14873.98,29
CDM,6284707,IMP RV/AD/RP KN TIB/FM TRIAL LVL 12,17524.0,10076.3,4556.24,16998.28,29
CDM,6284715,IMP RV/AD/RP KN TIB/FM TRIAL LVL 13,19714.0,11335.55,5125.64,19122.58,29
CDM,6284806,IMP RV/AD/RP HIP INSR/EX/RNG LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,6284830,IMP RV/AD/RP KN DIS/POS AUG LVL 01,1126.0,647.45,292.76,1092.22,29
CDM,6284848,IMP RV/AD/RP KN TIB/FM TRIAL LVL 01,1126.0,647.45,292.76,1092.22,29
CDM,6284863,DRESSING SPECIALTY LVL 01,32.0,15.46,8.32,31.04,29
CDM,6284996,CATH URETHRAL LVL 01,32.0,15.46,8.32,31.04,29
CDM,6285001,DRAIN LVL 01,32.0,15.46,8.32,31.04,29
CDM,6285233,IMP RV/AD/RP SHDR INSERT LVL 02,4880.0,2806.0,1268.8,4733.6,29
CDM,6285399,IMP RV/AD/RP KN STEM LVL 06,13895.0,7989.62,3612.7,13478.15,29
CDM,6285407,IMP RV/AD/RP KN STEM LVL 07,17524.0,10076.3,4556.24,16998.28,29
CDM,6285415,IMP RV/AD/RP HIP INSR/EX/RNG LVL 01,594.0,341.55,154.44,576.18,29
CDM,6285423,IMP RV/AD/RP HIP SYS MODULAR LVL 02,13895.0,7989.62,3612.7,13478.15,29
CDM,6285431,IMP RV/AD/RP HIP SYS MODULAR LVL 03,17524.0,10076.3,4556.24,16998.28,29
CDM,6285449,IMP RV/AD/RP HIP SYS MODULAR LVL 04,21904.0,12594.8,5695.04,21246.88,29
CDM,6285456,IMP RV/AD/RP HIP SYS MODULAR LVL 05,26284.0,15113.3,6833.84,25495.48,29
CDM,6285464,IMP RV/AD/RP HIP SYS MODULAR LVL 06,30664.0,17631.8,7972.64,29744.08,29
CDM,6285472,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 01,594.0,341.55,154.44,576.18,29
CDM,6285480,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,6285498,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6285506,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 04,3853.0,2215.48,1001.78,3737.41,29
CDM,6285514,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 05,6105.0,3510.37,1587.3,5921.85,29
CDM,6285522,IMP RV/AD/RP KN ROTATING HNG LVL 01,1413.0,812.47,367.38,1370.61,29
CDM,6285530,IMP RV/AD/RP KN ROTATING HNG LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6285548,IMP RV/AD/RP KN ROTATING HNG LVL 03,3853.0,2215.48,1001.78,3737.41,29
CDM,6285555,IMP RV/AD/RP KN ROTATING HNG LVL 04,6105.0,3510.37,1587.3,5921.85,29
CDM,6285563,IMP RV/AD/RP KN ROTATING HNG LVL 05,13895.0,7989.62,3612.7,13478.15,29
CDM,6285571,IMP RV/AD/RP KN ROTATING HNG LVL 06,19714.0,11335.55,5125.64,19122.58,29
CDM,6285589,IMP RV/AD/RP KN EX/CONNECT LVL 05,13895.0,7989.62,3612.7,13478.15,29
CDM,6285597,IMP RV/AD/RP KN EX/CONNECT LVL 06,17524.0,10076.3,4556.24,16998.28,29
CDM,6285605,IMP RV/AD/RP KN EX/CONNECT LVL 07,21904.0,12594.8,5695.04,21246.88,29
CDM,6285654,IMP TISSUE CONNECT NONHUMAN LVL 14,65704.0,37779.8,17083.04,63732.88,29
CDM,6285662,IMP TISSUE CONNECT NONHUMAN LVL 15,74464.0,42816.8,19360.64,72230.08,29
CDM,6285670,IMP TISSUE CONNECT NONHUMAN LVL 16,83224.0,47853.8,21638.24,80727.28,29
CDM,6285712,IMP RV/AD/RP KN BR/AX/YK/BH LVL 01,594.0,341.55,154.44,576.18,29
CDM,6285720,IMP RV/AD/RP KN BR/AX/YK/BH LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,6285738,IMP RV/AD/RP KN BR/AX/YK/BH LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6285746,IMP RV/AD/RP KN BR/AX/YK/BH LVL 04,3853.0,2215.48,1001.78,3737.41,29
CDM,6285753,IMP RV/AD/RP KN BR/AX/YK/BH LVL 05,6105.0,3510.37,1587.3,5921.85,29
CDM,6286538,IMP ICD CHAMBER NON SGL/DUAL LVL 02,70080.0,40296.0,18220.8,67977.6,29
CDM,6286678,DEVICE INSERT RETRV LVL 18,36139.0,17455.14,9396.14,35054.83,29
CDM,6286918,IMP RV/AD/RP ELBOW HEAD LVL 03,3853.0,2215.48,1001.78,3737.41,29
CDM,6286926,IMP RV/AD/RP ELBOW HEAD LVL 04,5856.0,3367.2,1522.56,5680.32,29
CDM,6286934,IMP RV/AD/RP ELBOW HEAD LVL 05,6487.0,3730.02,1686.62,6292.39,29
CDM,6286942,IMP RV/AD/RP ELBOW HEAD LVL 06,7413.0,4262.47,1927.38,7190.61,29
CDM,6286959,IMP RV/AD/RP ELBOW HEAD LVL 07,8339.0,4794.92,2168.14,8088.83,29
CDM,6286967,IMP RV/AD/RP ELBOW HEAD LVL 08,9265.0,5327.38,2408.9,8987.05,29
CDM,6287015,IMP RV/AD/RP ELBOW STEM LVL 01,9265.0,5327.38,2408.9,8987.05,29
CDM,6287023,IMP RV/AD/RP ELBOW STEM LVL 02,13895.0,7989.62,3612.7,13478.15,29
CDM,6287031,IMP RV/AD/RP ELBOW STEM LVL 03,17524.0,10076.3,4556.24,16998.28,29
CDM,6287551,IMP RV/AD/RP ELBOW HEAD LVL 09,11580.0,6658.5,3010.8,11232.6,29
CDM,6287569,IMP RV/AD/RP KN BR/AX/YK/BH LVL 06,9265.0,5327.38,2408.9,8987.05,29
CDM,6287577,IMP RV/AD/RP HIP FEMORAL HD LVL 02,1619.0,930.92,420.94,1570.43,29
CDM,6287692,IMP RV/AD/RP SHDR INSERT LVL 01,3853.0,2215.48,1001.78,3737.41,29
CDM,6287916,IMP TISSUE CONNECT NONHUMAN LVL 17,91984.0,52890.8,23915.84,89224.48,29
CDM,6287924,IMP TISSUE CONNECT NONHUMAN LVL 18,100744.0,57927.8,26193.44,97721.68,29
CDM,6287932,IMP RV/AD/RP HIP LINER LVL 03,4392.0,2525.4,1141.92,4260.24,29
CDM,6287940,IMP RV/AD/RP HIP STEM LVL 01,3853.0,2215.48,1001.78,3737.41,29
CDM,6287957,IMP RV/AD/RP HIP STEM LVL 02,4880.0,2806.0,1268.8,4733.6,29
CDM,6288088,IMP DEV JT SHDR TOTAL LVL 01,594.0,341.55,154.44,576.18,29
CDM,6288096,IMP DEV JT SHDR TOTAL LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,6288104,IMP DEV JT SHDR TOTAL LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6288112,IMP DEV JT SHDR TOTAL LVL 04,3853.0,2215.48,1001.78,3737.41,29
CDM,6288203,IMP RV/AD/RP KN INSR/SLV/LN LVL 01,594.0,341.55,154.44,576.18,29
CDM,6288211,IMP RV/AD/RP KN INSR/SLV/LN LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,6288229,IMP RV/AD/RP KN INSR/SLV/LN LVL 03,2152.0,1237.4,559.52,2087.44,29
CDM,6288260,IMP RV/AD/RP ELBOW HEAD LVL 10,13895.0,7989.62,3612.7,13478.15,29
CDM,6288468,CATH INTRASPINAL LVL 01,166.0,80.18,43.16,161.02,29
CDM,6288476,CATH INTRASPINAL LVL 02,313.0,151.18,81.38,303.61,29
CDM,6288484,CATH INTRASPINAL LVL 03,594.0,286.9,154.44,576.18,29
CDM,6288609,IMP RV/AD/RP HIP LINER LVL 02,3853.0,2215.48,1001.78,3737.41,29
CDM,6288633,LENS INTRAOCULAR CHAM POST LVL 04,2695.0,1080.7,700.7,2614.15,29
CDM,6288690,DEVICE ABLATION LVL 01,594.0,286.9,154.44,576.18,29
CDM,6288948,POUCH LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,6289227,INTRO EP STEER NONPEEL LVL 04,6105.0,2948.71,1587.3,5921.85,29
CDM,6289540,SCALPEL HARMONIC LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,6289615,ADHESIVE LVL 01,166.0,80.18,43.16,161.02,29
CDM,6289623,ADHESIVE LVL 02,313.0,151.18,81.38,303.61,29
CDM,6289631,ADHESIVE LVL 03,594.0,286.9,154.44,576.18,29
CDM,6289649,ADHESIVE LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,6289656,ADHESIVE LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,6289664,ADHESIVE LVL 06,3853.0,1861.0,1001.78,3737.41,29
CDM,6289672,ADHESIVE LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,6289680,ADHESIVE LVL 08,6105.0,2948.71,1587.3,5921.85,29
CDM,6289953,IMP RV/AD/RP SHDR GLEN CMP LVL 01,4880.0,2806.0,1268.8,4733.6,29
CDM,6289961,SCALPEL HARMONIC LVL 01,1413.0,682.48,367.38,1370.61,29
CDM,6289979,CATH URETHRAL LVL 07,2695.0,1301.68,700.7,2614.15,29
CDM,6290308,SCALPEL HARMONIC LVL 04,3853.0,1861.0,1001.78,3737.41,29
CDM,6292106,INTRO EP STEER NONPEEL LVL 05,9265.0,4475.0,2408.9,8987.05,29
CDM,6292395,LENS INTRAOCULAR NEW TECH LVL 01,1413.0,566.61,367.38,1370.61,29
CDM,6292460,IMP ICD CHAMBER NON SGL/DUAL LVL 01,61320.0,35259.0,15943.2,59480.4,29
CDM,6292502,IMP CATH BRACHY SEED ADM LVL 01,1413.0,812.47,367.38,1370.61,29
CDM,6292510,IMP CATH BRACHY SEED ADM LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6292528,IMP CATH BRACHY SEED ADM LVL 03,3853.0,2215.48,1001.78,3737.41,29
CDM,6292536,IMP CATH BRACHY SEED ADM LVL 04,6105.0,3510.37,1587.3,5921.85,29
CDM,6292544,IMP CATH BRACHY SEED ADM LVL 05,9265.0,5327.38,2408.9,8987.05,29
CDM,6293385,IMP STIMULATOR BONE LVL 02,19714.0,11335.55,5125.64,19122.58,29
CDM,6293393,IMP STIMULATOR BONE LVL 03,24094.0,13854.05,6264.44,23371.18,29
CDM,6293401,IMP STIMULATOR BONE LVL 04,28474.0,16372.55,7403.24,27619.78,29
CDM,6295281,IMP BLADE LVL 01,1413.0,812.47,367.38,1370.61,29
CDM,6295299,IMP BLADE LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6295307,IMP BLADE LVL 03,3853.0,2215.48,1001.78,3737.41,29
CDM,6295919,INSTRUMENT DISP SINGLE LVL 14,17524.0,8464.09,4556.24,16998.28,29
CDM,6297006,IMP RV/AD/RP SHDR STEM LVL 01,4880.0,2806.0,1268.8,4733.6,29
CDM,6297576,LENS INTRAOCULAR PRESBYOPIA LVL 01,594.0,238.19,154.44,576.18,29
CDM,6297584,LENS INTRAOCULAR PRESBYOPIA LVL 02,1132.0,453.93,294.32,1098.04,29
CDM,6297758,LENS INTRAOCULAR CHAM POST LVL 05,3853.0,1545.05,1001.78,3737.41,29
CDM,6298475,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 01,594.0,341.55,154.44,576.18,29
CDM,6298483,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 02,1413.0,812.47,367.38,1370.61,29
CDM,6298491,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 03,2157.0,1240.27,560.82,2092.29,29
CDM,6298509,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 04,3083.0,1772.72,801.58,2990.51,29
CDM,6298517,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 05,4885.0,2808.88,1270.1,4738.45,29
CDM,6298525,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 06,6950.0,3996.25,1807.0,6741.5,29
CDM,6298533,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 07,9265.0,5327.38,2408.9,8987.05,29
CDM,6298939,IMP CARDIAC EVENT REC LVL 01,6105.0,3510.37,1587.3,5921.85,29
CDM,6298947,IMP CARDIAC EVENT REC LVL 02,11575.0,6655.62,3009.5,11227.75,29
CDM,6298954,IMP PCMKR NONSGL OR DUAL LVL 01,6105.0,3468.56,1587.3,5921.85,29
CDM,6298962,IMP PCMKR NONSGL OR DUAL LVL 02,13895.0,7894.44,3612.7,13478.15,29
CDM,6298970,IMP PCMKR NONSGL OR DUAL LVL 03,21900.0,12442.48,5694.0,21243.0,29
CDM,6301071,IMP RV/AD/RP HIP FEMORAL HD LVL 01,1132.0,650.9,294.32,1098.04,29
CDM,6301287,IMP RING FALLOPE LVL 04,2695.0,1549.62,700.7,2614.15,29
CDM,6301337,INTRO EP STEER NONPEEL LVL 01,1413.0,682.48,367.38,1370.61,29
CDM,6301345,INTRO EP STEER NONPEEL LVL 02,2695.0,1301.68,700.7,2614.15,29
CDM,6301493,IMP LD NEUROSTIM TEST KIT LVL 01,166.0,95.45,43.16,161.02,29
CDM,6301501,IMP LD NEUROSTIM TEST KIT LVL 02,313.0,179.98,81.38,303.61,29
CDM,6301519,IMP LD NEUROSTIM TEST KIT LVL 03,594.0,341.55,154.44,576.18,29
CDM,6301527,IMP LD NEUROSTIM TEST KIT LVL 04,1413.0,812.47,367.38,1370.61,29
CDM,6301535,IMP LD NEUROSTIM TEST KIT LVL 05,1883.0,1082.72,489.58,1826.51,29
CDM,6306948,IMP ANCHOR/SCREW/WASHER/NUT LVL 01,70.0,40.25,18.2,67.9,29
CDM,6306955,IMP ANCHOR/SCREW/WASHER/NUT LVL 02,102.0,58.65,26.52,98.94,29
CDM,6306963,IMP ANCHOR/SCREW/WASHER/NUT LVL 03,166.0,95.45,43.16,161.02,29
CDM,6306971,IMP ANCHOR/SCREW/WASHER/NUT LVL 04,221.0,127.07,57.46,214.37,29
CDM,6306989,IMP ANCHOR/SCREW/WASHER/NUT LVL 05,313.0,179.98,81.38,303.61,29
CDM,6306997,IMP ANCHOR/SCREW/WASHER/NUT LVL 06,447.0,257.02,116.22,433.59,29
CDM,6307003,IMP ANCHOR/SCREW/WASHER/NUT LVL 07,594.0,341.55,154.44,576.18,29
CDM,6307011,IMP ANCHOR/SCREW/WASHER/NUT LVL 08,850.0,488.75,221.0,824.5,29
CDM,6307029,IMP ANCHOR/SCREW/WASHER/NUT LVL 09,1132.0,650.9,294.32,1098.04,29
CDM,6307037,IMP ANCHOR/SCREW/WASHER/NUT LVL 10,1413.0,812.47,367.38,1370.61,29
CDM,6307045,IMP ANCHOR/SCREW/WASHER/NUT LVL 11,1619.0,930.92,420.94,1570.43,29
CDM,6307052,IMP ANCHOR/SCREW/WASHER/NUT LVL 12,2695.0,1549.62,700.7,2614.15,29
CDM,6307060,IMP ANCHOR/SCREW/WASHER/NUT LVL 13,3853.0,2215.48,1001.78,3737.41,29
CDM,6307078,IMP ANCHOR/SCREW/WASHER/NUT LVL 14,4885.0,2808.88,1270.1,4738.45,29
CDM,6307086,IMP ANCHOR/SCREW/WASHER/NUT LVL 15,6105.0,3510.37,1587.3,5921.85,29
CDM,6307094,IMP ANCHOR/SCREW/WASHER/NUT LVL 16,6950.0,3996.25,1807.0,6741.5,29
CDM,6307102,IMP ANCHOR/SCREW/WASHER/NUT LVL 17,9265.0,5327.38,2408.9,8987.05,29
CDM,6307110,IMP ANCHOR/SCREW/WASHER/NUT LVL 18,11580.0,6658.5,3010.8,11232.6,29
CDM,6307128,IMP ANCHOR/SCREW/WASHER/NUT LVL 19,13895.0,7989.62,3612.7,13478.15,29
CDM,6307136,IMP ANCHOR/SCREW/WASHER/NUT LVL 20,17524.0,10076.3,4556.24,16998.28,29
CDM,6307144,IMP ANCHOR/SCREW/WASHER/NUT LVL 21,21904.0,12594.8,5695.04,21246.88,29
CDM,6307425,DURAL SLNT ADHERUS AUTOSPRAY,4621.8,2657.54,1201.67,4483.15,29
CDM,6307433,DURAL SLNT ADHERUS AUTOSPRAY ET,2592.5,1490.69,674.05,2514.72,29
CDM,6307565,SURGICAL SLNT COSEAL ADH VASC 4ML,1880.6,1081.34,488.96,1824.18,29
CDM,6307581,SURGICAL SLNT COSEAL PREMIX 8ML,2908.7,1672.5,756.26,2821.44,29
CDM,6307821,SEALANT SYS DURASEAL 5ML,2180.2,1253.61,566.85,2114.79,29
CDM,6307953,FBR SLNT TISSEEL W DPLJECT SYS 10ML,2404.8,1161.52,625.25,2332.66,29
CDM,6307979,FBR SLNT TISSEEL W DPLJECT SYS 4ML,969.0,468.03,251.94,939.93,29
CDM,6307987,FBR SLNT TISSEEL W PRIMA 10ML SYR,2256.9,1090.08,586.79,2189.19,29
CDM,6307995,FBR SLNT TISSEEL W PRIMA 4ML SYR,644.3,311.2,167.52,624.97,29
CDM,6309256,IMP SEALANT PULMONARY LIQUID LVL 02,3596.0,2067.7,934.96,3488.12,29
CDM,6309264,IMP SEALANT PULMONARY LIQUID LVL 03,4397.0,2528.27,1143.22,4265.09,29
CDM,6309272,IMP SEALANT PULMONARY LIQUID LVL 04,6105.0,3510.37,1587.3,5921.85,29
CDM,6310056,IMP PUMP VALVE BLOOD LVL 01,30664.0,17631.8,7972.64,29744.08,29
CDM,6310064,IMP PUMP VALVE BLOOD LVL 02,39424.0,22668.8,10250.24,38241.28,29
CDM,6310072,IMP PUMP VALVE BLOOD LVL 03,52564.0,30224.3,13666.64,50987.08,29
CDM,6310080,IMP PUMP VALVE BLOOD LVL 04,65704.0,37779.8,17083.04,63732.88,29
CDM,6310890,IMP STENT COAT WO DEL LVL 01,1413.0,812.47,367.38,1370.61,29
CDM,6310908,IMP STENT COAT WO DEL LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6310916,IMP STENT COAT WO DEL LVL 03,3853.0,2215.48,1001.78,3737.41,29
CDM,6310924,IMP STENT COAT WO DEL LVL 04,4885.0,2808.88,1270.1,4738.45,29
CDM,6310932,IMP STENT COAT WO DEL LVL 05,6945.0,3993.37,1805.7,6736.65,29
CDM,6310981,IMP RV/AD/RP ELBOW HEAD LVL 01,1413.0,812.47,367.38,1370.61,29
CDM,6310999,IMP RV/AD/RP ELBOW HEAD LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6312359,IMP ADHSN BARRIER 30+ DAYS LVL 01,850.0,488.75,221.0,824.5,29
CDM,6312367,IMP ADHSN BARRIER 30+ DAYS LVL 02,2695.0,1549.62,700.7,2614.15,29
CDM,6312375,IMP ADHSN BARRIER 30+ DAYS LVL 03,4885.0,2808.88,1270.1,4738.45,29
CDM,6312383,IMP ADHSN BARRIER 30+ DAYS LVL 04,9265.0,5327.38,2408.9,8987.05,29
CDM,6312417,IMP CATH DRAINAGE 30+ DAYS LVL 01,594.0,341.55,154.44,576.18,29
CDM,6312425,IMP CATH DRAINAGE 30+ DAYS LVL 02,1888.0,1085.6,490.88,1831.36,29
CDM,6312433,IMP CATH DRAINAGE 30+ DAYS LVL 03,2695.0,1549.62,700.7,2614.15,29
CDM,6312441,IMP CATH DRAINAGE 30+ DAYS LVL 04,3853.0,2215.48,1001.78,3737.41,29
CDM,6312540,ADHSN BARRIER IMP <30DAYS LVL 01,850.0,410.55,221.0,824.5,29
CDM,6312557,ADHSN BARRIER IMP <30DAYS LVL 02,2695.0,1301.68,700.7,2614.15,29
CDM,6312565,ADHSN BARRIER IMP <30DAYS LVL 03,4885.0,2359.46,1270.1,4738.45,29
CDM,6312573,ADHSN BARRIER IMP <30DAYS LVL 04,9265.0,4475.0,2408.9,8987.05,29
CDM,6312607,CATH DRAINAGE IMP <30DAYS LVL 01,594.0,286.9,154.44,576.18,29
CDM,6312615,CATH DRAINAGE IMP <30DAYS LVL 02,1888.0,911.9,490.88,1831.36,29
CDM,6312623,CATH DRAINAGE IMP <30DAYS LVL 03,2695.0,1301.68,700.7,2614.15,29
CDM,6312631,CATH DRAINAGE IMP <30DAYS LVL 04,3853.0,1861.0,1001.78,3737.41,29
CDM,6313001,DEVICE SYS HEM CNTRL UTR VAC LVL 01,166.0,80.18,43.16,161.02,29
CDM,6313019,DEVICE SYS HEM CNTRL UTR VAC LVL 02,313.0,151.18,81.38,303.61,29
CDM,6313027,DEVICE SYS HEM CNTRL UTR VAC LVL 03,594.0,286.9,154.44,576.18,29
CDM,6313035,DEVICE SYS HEM CNTRL UTR VAC LVL 04,1413.0,682.48,367.38,1370.61,29
CDM,6313043,DEVICE SYS HEM CNTRL UTR VAC LVL 05,2695.0,1301.68,700.7,2614.15,29
CDM,6313050,DEVICE SYS HEM CNTRL UTR VAC LVL 06,3853.0,1861.0,1001.78,3737.41,29
CDM,6313068,DEVICE SYS HEM CNTRL UTR VAC LVL 07,4885.0,2359.46,1270.1,4738.45,29
CDM,6313076,DEVICE SYS HEM CNTRL UTR VAC LVL 08,6105.0,2948.71,1587.3,5921.85,29
CDM,6313084,DEVICE SYS HEM CNTRL UTR VAC LVL 09,9265.0,4475.0,2408.9,8987.05,29
CDM,6316434,DURAGEN PL 2.5X2.5/SH,841.0,483.58,218.66,815.77,29
CDM,6316772,DURAGEN PL 2.5X7.5/SH,1366.2,785.56,355.21,1325.21,29
CDM,6316780,DURAGEN PL 5X5/SH,1384.0,795.8,359.84,1342.48,29
CDM,6316798,DURAGEN PL 7.5X7.5/SH,2458.7,1413.75,639.26,2384.94,29
CDM,6316806,DURAGEN PL 7.5X7.5/SH 5/PKG,2393.5,1376.26,622.31,2321.7,29
CDM,6316814,DURAGEN SU 2.5X7.5/SH,1369.5,787.46,356.07,1328.41,29
CDM,6316822,DURAGEN SU 7.5X7.5/SH,2697.4,1551.0,701.32,2616.48,29
CDM,6317010,DURAGEN CL 10X12.5/SH,3229.8,1857.14,839.75,3132.91,29
CDM,6317028,DURAGEN CL 2.5X2.5/SH 5/PKG,854.4,491.28,222.14,828.77,29
CDM,6317036,DURAGEN CL 2.5X7.5/SH,1200.5,690.29,312.13,1164.48,29
CDM,6317051,DURAGEN CL 5X5/SH,1011.0,581.32,262.86,980.67,29
CDM,6317077,DURAGEN CL 7.5X7.5/SH,1823.8,1048.68,474.19,1769.09,29
CDM,6317085,DURAGEN CL 7.5X7.5/SH 5/PKG,2028.5,1166.39,527.41,1967.64,29
CDM,6318026,TACHOSIL 9.5X4.8CM PATCH,50.4,24.34,13.1,48.89,29
CDM,6318034,TACHOSIL 4.8X4.8CM PATCH,52.5,25.36,13.65,50.92,29
CDM,6761159,AMANTADINE/100MG 100MG CP,7.4,0.65,1.92,7.18,29
CDM,6780704,LIDO 2%-EPI/1.8ML 1.8ML SNIJ,5.8,1.25,1.51,5.63,29
CDM,6785851,NICOTINE RESIN COMPLEX/2MG 2MG GU,3.1,0.27,0.806,3.01,29
CDM,6796304,TIMOLOL MALEATE 0.25%/5ML 5ML SNOP,28.6,2.52,7.44,27.74,29
CDM,6824361,ADMIN FEE PNEUMOCOCCAL,81.0,44.14,21.06,78.57,29
CDM,6824379,ADMIN FEE INFLUENZA,81.0,44.14,21.06,78.57,29
CDM,6824478,ADMIN FEE HEPATITIS B,81.0,44.14,21.06,78.57,29
CDM,6828685,LEVOFLOXACN/750MG 750MG TB,6.2,0.55,1.61,6.01,29
CDM,6856868,PANCRELIPASE/25000U 25000U CP,44.4,3.91,11.54,43.07,29
CDM,6869291,EPO ALFA ESRD/100U 2KU SNIJ,4.9,2.78,1.27,4.75,29
CDM,6869317,EPO ALFA ESRD/100U 3KU SNIJ,7.9,4.49,2.05,7.66,29
CDM,6869325,EPO ALFA ESRD/100U 4KU SNIJ,4.9,2.78,1.27,4.75,29
CDM,6871586,EPO ALFA/1000U 4000U SNIJ,82.1,28.9,15.48,79.64,29
CDM,6872626,EPO ALFA EPBX ESRD/100U 2KU SNIJ,3.4,1.93,0.884,3.3,29
CDM,6872634,EPO ALFA EPBX ESRD/100U 3KU SNIJ,3.4,1.93,0.884,3.3,29
CDM,6872642,EPO ALFA EPBX ESRD/100U 4KU SNIJ,3.4,1.93,0.884,3.3,29
CDM,6883060,LIFILEUCEL TIL/DOSE 7.5B-72B SNIJ,3141500.0,1784843.22,816790.0,3047255.0,28
CDM,7140817,RECOVERY LEVEL 1 FIRST 1MIN,535.0,345.08,139.1,518.95,29
CDM,7140825,RECOVERY LEVEL 1 ADDL 1MIN,17.0,10.96,4.42,16.49,29
CDM,7140833,RECOVERY LEVEL 2 FIRST 1MIN,635.0,409.58,165.1,615.95,29
CDM,7140841,RECOVERY LEVEL 2 ADDL 1MIN,23.0,14.84,5.98,22.31,29
CDM,7140858,RECOVERY LEVEL 3 FIRST 1MIN,735.0,474.08,191.1,712.95,29
CDM,7140866,RECOVERY LEVEL 3 ADDL 1MIN,30.0,19.35,7.8,29.1,29
CDM,7140874,RECOVERY LEVEL 4 FIRST 1MIN,835.0,538.58,217.1,809.95,29
CDM,7140882,RECOVERY LEVEL 4 ADDL 1MIN,33.0,21.28,8.58,32.01,29
CDM,7201056,AMNIOCENTESIS DIAGNOSTIC,609.0,196.71,158.34,590.73,28
CDM,7201072,INS DILATOR CERVICAL,422.0,239.76,109.72,409.34,29
CDM,7201080,VERSION CEPHALIC EXTERNAL,745.0,423.27,193.7,722.65,29
CDM,7201098,INJ EPID PATCH BLOOD/CLOT,863.0,278.75,224.38,837.11,28
CDM,7201221,EPIDURAL LABOR,900.0,605.7,234.0,873.0,29
CDM,7201429,LABOR LEVEL 1 0-12HRS,2655.0,2487.74,690.3,2575.35,29
CDM,7201437,LABOR LEVEL 2 12+HRS,3990.0,3738.63,1037.4,3870.3,29
CDM,7201445,DELIVERY VAGINAL SINGLE,3875.0,2201.58,1007.5,3758.75,29
CDM,7201452,DELIVERY VAGINAL MULTI,5730.0,3255.5,1489.8,5558.1,29
CDM,7201528,TEST STRESS CONTRACTION FETAL,536.0,582.63,139.36,519.92,29
CDM,7201536,TEST NONSTRESS FETAL,519.0,564.15,134.94,503.43,29
CDM,7201544,INJ SUBQ/IM,144.0,67.39,37.44,139.68,29
CDM,7201601,RECOVERY WO DELIVERY VAGINAL,1430.0,812.45,371.8,1387.1,29
CDM,7201676,CIRCUMCISION W BLOCK REGIONAL,380.0,215.9,98.8,368.6,29
CDM,72017,R&B ADMIN DAY INTERMEDIATE,1176.0,668.14,1058.4,3111.1,17
CDM,7202328,DELIVERY OF PLACENTA,1940.0,1102.21,504.4,1881.8,29
CDM,7202427,VISIT OB TRIAGE NEW LEVEL 1,770.0,721.49,200.2,746.9,29
CDM,7202435,VISIT OB TRIAGE NEW LEVEL 2,1475.0,1382.08,383.5,1430.75,29
CDM,7202443,VISIT OB TRIAGE NEW LEVEL 3,2210.0,2070.77,574.6,2143.7,29
CDM,7202450,VISIT OB TRIAGE NEW LEVEL 4,2660.0,2492.42,691.6,2580.2,29
CDM,7202468,VISIT OB TRIAGE NEW LEVEL 5,3560.0,3335.72,925.6,3453.2,29
CDM,7202476,VISIT OB TRIAGE ESTABLISHED LEVEL 1,290.0,271.73,75.4,281.3,29
CDM,7202484,VISIT OB TRIAGE ESTABLISHED LEVEL 2,735.0,688.7,191.1,712.95,29
CDM,7202492,VISIT OB TRIAGE ESTABLISHED LEVEL 3,1475.0,1382.08,383.5,1430.75,29
CDM,7202500,VISIT OB TRIAGE ESTABLISHED LEVEL 4,2275.0,2131.68,591.5,2206.75,29
CDM,7202518,VISIT OB TRIAGE ESTABLISHED LEVEL 5,3205.0,3003.08,833.3,3108.85,29
CDM,7202526,INF IV HYDRATION 31-60MIN,504.0,261.07,131.04,488.88,29
CDM,7202534,INF IV HYDRATION ADDL HR,98.0,50.76,25.48,95.06,29
CDM,7202542,INF IV THRPY 1ST HR,608.0,314.94,158.08,589.76,29
CDM,7202559,INF IV THRPY ADDL HR,114.0,59.05,29.64,110.58,29
CDM,7202567,INF IV THRPY SEQ DRUG NEW 1ST HR,214.0,110.85,55.64,207.58,29
CDM,7202575,INF IV THRPY CONCURRENT,187.0,96.87,48.62,181.39,29
CDM,7202583,INJ IVP DRUG INITIAL,453.0,212.0,117.78,439.41,29
CDM,7202591,INJ IVP SEQ DRUG ADDL NEW,144.0,67.39,37.44,139.68,29
CDM,7202609,INJ IVP SEQ DRUG ADDL SAME,107.0,50.08,27.82,103.79,29
CDM,7301013,EKG TRACING RHYTHM 1-3 LEADS,145.0,75.54,37.7,140.65,29
CDM,7301021,EKG TRACING ROUTINE 12+ LEADS,488.0,254.25,126.88,473.36,29
CDM,7301385,EKG RECORD EXTERNAL 0-48HR,429.0,211.93,111.54,416.13,29
CDM,7301393,EKG ANALYSIS EXTERNAL 0-48HR,684.0,337.9,177.84,663.48,29
CDM,7301401,EKG RECORD EVENT REMOTE 0-30DAY,375.0,185.25,97.5,363.75,29
CDM,7400518,TEST LATENCY SLEEP MULT,4709.0,5118.68,1224.34,4567.73,29
CDM,7401003,PSG W 4+ PARAM 6+YRS,6000.0,4188.0,1560.0,5820.0,29
CDM,7401011,PSG W 4+ PARAM 6+YRS W CPAP,6917.0,4828.07,1798.42,6709.49,29
CDM,7401037,PSG W 4+PARAM 6+YR RDC<6HRS,6000.0,4188.0,1560.0,5820.0,29
CDM,7401052,PSG W 4+ PARAM 0-5YRS,8391.0,5856.92,2181.66,8139.27,29
CDM,7401060,PSG W 4+ PARAM 0-5YRS W CPAP,8855.0,9625.38,2302.3,8589.35,29
CDM,7401078,PSG W 4+ PARAM 6+YR W CPAP RDC<6HR,6917.0,4828.07,1798.42,6709.49,29
CDM,7401110,TEST LATENCY SLEEP MULT RDC<4 NAPS,4709.0,5118.68,1224.34,4567.73,29
CDM,7401185,SLP UNATND HOM RT/SAT/FLW&EFF,785.0,853.3,204.1,761.45,29
CDM,7401193,SLP UNATND HOM RT/SAT/FLW&EFF<6HR,785.0,853.3,204.1,761.45,29
CDM,7401508,SLP UNATND HOM RT/SAT/ANLY&TIME,844.0,917.43,219.44,818.68,29
CDM,7401516,SLP UNATND HOM RT/SAT/ANLY&TIME<6HR,844.0,917.43,219.44,818.68,29
CDM,7501240,CARDIOVERSION ELECTIVE EXTERNAL,1178.0,669.28,306.28,1142.66,29
CDM,7501984,TEST ESOPHAGUS PH CAP,1391.0,1016.82,361.66,1349.27,29
CDM,7502784,ENDO GI LEVEL 1 FIRST 15MIN,275.0,201.02,71.5,266.75,29
CDM,7502792,ENDO GI LEVEL 1 ADDL 15MIN,140.0,102.34,36.4,135.8,29
CDM,7502800,ENDO GI LEVEL 2 FIRST 15MIN,590.0,431.29,153.4,572.3,29
CDM,7502818,ENDO GI LEVEL 2 ADDL 15MIN,295.0,215.64,76.7,286.15,29
CDM,7502826,ENDO GI LEVEL 3 FIRST 15MIN,1375.0,1005.12,357.5,1333.75,29
CDM,7502834,ENDO GI LEVEL 3 ADDL 15MIN,690.0,504.39,179.4,669.3,29
CDM,7502842,ENDO GI LEVEL 4 FIRST 15MIN,1900.0,1388.9,494.0,1843.0,29
CDM,7502859,ENDO GI LEVEL 4 ADDL 15MIN,950.0,694.45,247.0,921.5,29
CDM,7502941,ENDO OTHER LEVEL 1 FIRST 15MIN,275.0,88.82,71.5,266.75,28
CDM,7502958,ENDO OTHER LEVEL 1 ADDL 15MIN,140.0,45.22,36.4,135.8,28
CDM,7502966,ENDO OTHER LEVEL 2 FIRST 15MIN,590.0,190.57,153.4,572.3,28
CDM,7502974,ENDO OTHER LEVEL 2 ADDL 15MIN,295.0,95.28,76.7,286.15,28
CDM,7502982,ENDO OTHER LEVEL 3 FIRST 15MIN,1375.0,444.12,357.5,1333.75,28
CDM,7502990,ENDO OTHER LEVEL 3 ADDL 15MIN,690.0,222.87,179.4,669.3,28
CDM,7503006,ENDO OTHER LEVEL 4 FIRST 15MIN,1900.0,613.7,494.0,1843.0,28
CDM,7503014,ENDO OTHER LEVEL 4 ADDL 15MIN,950.0,306.85,247.0,921.5,28
CDM,7503030,ENDO ANES MAC/GEN FIRST 15MIN,670.0,450.91,174.2,649.9,29
CDM,7503048,ENDO ANES MAC/GEN ADDL 15MIN,340.0,228.82,88.4,329.8,29
CDM,7503055,TRANSFUSION BLOOD/COMP 1 UNIT,842.0,266.07,218.92,816.74,29
CDM,7503063,TRANSFUSION BLOOD/COMP 2 UNITS,1053.0,332.75,273.78,1021.41,29
CDM,7503071,TRANSFUSION BLOOD/COMP 3+ UNITS,1263.0,399.11,328.38,1225.11,29
CDM,7503089,ENDO OR LEVEL 1 FIRST 15MIN,275.0,158.95,71.5,266.75,28
CDM,7503097,ENDO OR LEVEL 1 ADDL 15MIN,140.0,80.92,36.4,135.8,28
CDM,7503105,ENDO OR LEVEL 2 FIRST 15MIN,590.0,341.02,153.4,572.3,28
CDM,7503113,ENDO OR LEVEL 2 ADDL 15MIN,295.0,170.51,76.7,286.15,28
CDM,7503121,ENDO OR LEVEL 3 FIRST 15MIN,1375.0,794.75,357.5,1333.75,28
CDM,7503139,ENDO OR LEVEL 3 ADDL 15MIN,690.0,398.82,179.4,669.3,28
CDM,7503147,ENDO OR LEVEL 4 FIRST 15MIN,1900.0,1098.2,494.0,1843.0,28
CDM,7503154,ENDO OR LEVEL 4 ADDL 15MIN,950.0,549.1,247.0,921.5,28
CDM,7503360,INSTILL FECAL MICROB LGI EN RECT SP,584.0,426.9,151.84,566.48,29
CDM,7611379,TELEMED ORIGINATING SITE FAC FEE,35.0,19.89,9.1,33.95,29
CDM,7616030,COLLECT SPEC BLD VAD IMPLNT,245.0,95.06,63.7,237.65,29
CDM,7616048,INS CATH BLADDER NONINDWL,194.0,75.27,50.44,188.18,29
CDM,7616055,INS CATH BLADDER INDWL SMPL,334.0,129.59,86.84,323.98,29
CDM,7616329,DECLOT CATH/VAD W AGENT THROMB,497.0,192.84,129.22,482.09,29
CDM,7616675,VISIT NEW LEVEL 1,150.0,85.22,39.0,145.5,29
CDM,7616683,VISIT NEW LEVEL 2,200.0,113.63,52.0,194.0,29
CDM,7616691,VISIT NEW LEVEL 3,270.0,153.4,70.2,261.9,29
CDM,7616709,VISIT NEW LEVEL 4,370.0,210.22,96.2,358.9,29
CDM,7616717,VISIT NEW LEVEL 5,470.0,267.03,122.2,455.9,29
CDM,7616725,VISIT ESTABLISHED LEVEL 1,140.0,79.54,36.4,135.8,29
CDM,7616733,VISIT ESTABLISHED LEVEL 2,190.0,107.95,49.4,184.3,29
CDM,7616741,VISIT ESTABLISHED LEVEL 3,240.0,136.36,62.4,232.8,29
CDM,7616758,VISIT ESTABLISHED LEVEL 4,290.0,164.76,75.4,281.3,29
CDM,7616766,VISIT ESTABLISHED LEVEL 5,340.0,193.17,88.4,329.8,29
CDM,7616881,PHLEBOTOMY THERAPEUTIC,192.0,89.86,49.92,186.24,29
CDM,7616899,IMMUNIZATION 1ST VACCINE,81.0,44.14,21.06,78.57,29
CDM,7618416,INS CATH BLADDER INDWL CMP,357.0,138.52,92.82,346.29,29
CDM,7618515,IMMUNIZATION ADDL VACCINE,41.0,22.35,10.66,39.77,29
CDM,7619984,COLLECT SPEC BLD PICC NOS,248.0,96.22,64.48,240.56,29
CDM,7620529,OBSRV MEDICAL/SURGICAL PER HOUR,116.0,36.66,30.16,112.52,29
CDM,7620594,OBSRV MEDICAL/SURGICAL PER HOUR,116.0,36.66,30.16,112.52,29
CDM,7621147,OBSRV OB PER HOUR,116.0,36.66,30.16,112.52,29
CDM,7622244,OBSRV ICU PER HOUR,244.0,77.1,63.44,236.68,29
CDM,7623077,INJ/S ANES NRV INTRCST LVL SGL BI,572.0,184.76,148.72,554.84,28
CDM,7623085,INJ/S ANES NRV INTRCST LVL SGL RT,381.0,123.06,99.06,369.57,28
CDM,7623093,INJ/S ANES NRV INTRCST LVL SGL LT,381.0,123.06,99.06,369.57,28
CDM,7623101,INJ/S ANES NRV INTRCST LVL ADD BI,1188.0,383.72,308.88,1152.36,28
CDM,7623119,INJ/S ANES NRV INTRCST LVL ADD RT,792.0,255.82,205.92,768.24,28
CDM,7623127,INJ/S ANES NRV INTRCST LVL ADD LT,792.0,255.82,205.92,768.24,28
CDM,7630148,INF IV THRPY SEQ DRUG NEW 1ST HR,214.0,110.85,55.64,207.58,29
CDM,7632409,WOUND NEG PRESS W DME 0-50 SC,176.0,68.29,45.76,170.72,29
CDM,7632417,WOUND NEG PRESS W DME 51+ SC,283.0,109.8,73.58,274.51,29
CDM,7636574,INS PICC WO P/P W IMG 0-4YRS,1035.0,401.58,269.1,1003.95,29
CDM,7636582,INS PICC WO P/P W IMG 5+YRS,1137.0,441.16,295.62,1102.89,29
CDM,7636590,INS PICC WO P/P WO IMG 0-4YRS,963.0,373.64,250.38,934.11,29
CDM,7636608,INS PICC WO P/P WO IMG 5+YRS,990.0,384.12,257.4,960.3,29
CDM,7639446,REM SUTURE/STAPLE NO ANESTH,84.0,32.59,21.84,81.48,29
CDM,7639453,REM SUTURE&STAPLE NO ANESTH,112.0,43.46,29.12,108.64,29
CDM,7690001,CHEMO INF IV 1ST HR,482.0,135.44,125.32,467.54,29
CDM,7690019,CHEMO INF IV ADDL HR,106.0,29.79,27.56,102.82,29
CDM,7690027,CHEMO INF IV SEQ 1ST HR,237.0,66.6,61.62,229.89,29
CDM,7690035,CHEMO IVP DRUG INITIAL,458.0,165.34,119.08,444.26,29
CDM,7690043,CHEMO IVP DRUG ADDL,284.0,102.52,73.84,275.48,29
CDM,7690050,INF IV THRPY 1ST HR,608.0,314.94,158.08,589.76,29
CDM,7690068,INF IV THRPY ADDL HR,114.0,59.05,29.64,110.58,29
CDM,7690076,INF IV THRPY CONCURRENT,187.0,96.87,48.62,181.39,29
CDM,7690084,INF IV THRPY SEQ DRUG NEW 1ST HR,214.0,110.85,55.64,207.58,29
CDM,7690092,INJ IVP DRUG INITIAL,453.0,212.0,117.78,439.41,29
CDM,7690100,INJ IVP SEQ DRUG ADDL SAME,107.0,50.08,27.82,103.79,29
CDM,7690118,INJ IVP SEQ DRUG ADDL NEW,144.0,67.39,37.44,139.68,29
CDM,7690126,INF IV HYDRATION 31-60MIN,504.0,261.07,131.04,488.88,29
CDM,7690134,INF IV HYDRATION ADDL HR,98.0,50.76,25.48,95.06,29
CDM,7690142,ASP BLADDER CATH SUPRAPUB,2041.0,659.24,530.66,1979.77,28
CDM,7690159,INS CATH BLADDER INDWL SMPL,334.0,107.88,86.84,323.98,28
CDM,7690167,INS CATH BLADDER INDWL CMP,357.0,115.31,92.82,346.29,28
CDM,7690175,INS CATH BLADDER NONINDWL,194.0,62.66,50.44,188.18,28
CDM,7690183,CATH COLLECT SPEC URINE,84.0,63.59,21.84,81.48,29
CDM,7690217,INJ EPID PATCH BLOOD/CLOT,863.0,278.75,224.38,837.11,28
CDM,7690225,IMMUNIZATION 1ST VACCINE,81.0,44.14,21.06,78.57,29
CDM,7690233,IMMUNIZATION ADDL VACCINE,41.0,22.35,10.66,39.77,29
CDM,7690258,CHEMO SUBQ/IM NONHORMONAL,558.0,201.44,145.08,541.26,29
CDM,7690274,INJ/S ANES NRV BLOCK OTHER,334.0,107.88,86.84,323.98,28
CDM,7690282,INJ SUBQ/IM,144.0,67.39,37.44,139.68,29
CDM,7690290,INJ/S SHTH TNDN SGL/LIG/AP,403.0,130.17,104.78,390.91,28
CDM,7690308,INJ/S TRIGGER PT/S MUSC/S,370.0,119.51,96.2,358.9,28
CDM,7690316,PROCEDURE IRRG BLADDER,492.0,158.92,127.92,477.24,28
CDM,7690324,PUNCT LUMBAR,896.0,289.41,232.96,869.12,28
CDM,7690340,LAVAGE PERITONEAL/PARACENTESIS,457.0,147.61,118.82,443.29,28
CDM,7690357,SPLINT/STRAP EXTREMITY LOWER,215.0,69.45,55.9,208.55,28
CDM,7690365,SPLINT/STRAP EXTREMITY UPPER,240.0,77.52,62.4,232.8,28
CDM,7690373,THORACENT/TUBE CHEST/DRN PLEURAL,1241.0,400.84,322.66,1203.77,28
CDM,7690381,TRANSFUSION BLOOD/COMP 1 UNIT,842.0,266.07,218.92,816.74,29
CDM,7690399,TRANSFUSION BLOOD/COMP 2 UNITS,1053.0,332.75,273.78,1021.41,29
CDM,7690407,TRANSFUSION BLOOD/COMP 3+ UNITS,1263.0,399.11,328.38,1225.11,29
CDM,7690415,ADMISSION DIRECT OBSERVATION HOSP,668.0,559.78,173.68,647.96,29
CDM,7690423,PROCEDURE UNLIST LVL 01 SMPL,780.0,251.94,202.8,756.6,28
CDM,7690431,PROCEDURE UNLIST LVL 02 INTRM,1165.0,376.3,302.9,1130.05,28
CDM,7690449,PROCEDURE UNLIST LVL 03 CMPLX,2350.0,759.05,611.0,2279.5,28
CDM,7690464,I&D/ASP PUNCT LVL 01 SIMPLE,435.0,140.5,113.1,421.95,28
CDM,7690472,I&D LVL 02 INTRM,530.0,171.19,137.8,514.1,28
CDM,7690480,I&D LVL 03 COMPLEX,580.0,187.34,150.8,562.6,28
CDM,7690555,INJ/S ANES NRV TRIGEMINAL BR EA,455.0,146.96,118.3,441.35,28
CDM,7690621,CHG TUBE CYSTO SIMPLE,259.0,83.66,67.34,251.23,28
CDM,7690647,DEBRIDE TISSUE SKIN/SUBQ,672.0,217.06,174.72,651.84,28
CDM,7690654,RPR WOUND LVL 01 SIMPLE,490.0,158.27,127.4,475.3,28
CDM,7690662,RPR WOUND LVL 02 INTERMEDIATE,520.0,167.96,135.2,504.4,28
CDM,7690670,RPR WOUND LVL 03 COMPLEX,720.0,232.56,187.2,698.4,28
CDM,82016,R&B ADMIN DAY SKILLED,1923.0,1092.55,1730.7,3111.1,17
CDM,8401333,HYDROCOD-ACET/7.5-325MG TB,0.05,,0.013,0.0485,29
CDM,8415457,LEVOTHYROXN/112MCG 112MCG TB,0.12,0.01,0.0312,0.1164,29
CDM,8421026,FENOFIBRATE/54MG 54MG TB,0.04,,0.0104,0.0388,29
CDM,8462483,DANTROLENE SOD/20MG 20MG PWIJ,56.08,12.11,14.58,54.4,29
CDM,8467862,RIMANTADINE/100MG 100MG TB,2.19,0.19,0.5694,2.12,29
CDM,8480139,EPO ALFA ESRD/100U 2KU SNIJ,0.22,0.12,0.0572,0.2134,29
CDM,8480154,EPO ALFA ESRD/100U 3KU SNIJ,0.85,0.48,0.221,0.8245,29
CDM,8480162,EPO ALFA ESRD/100U 4KU SNIJ,0.22,0.12,0.0572,0.2134,29
CDM,8481079,CEFTAZIDIME/500MG 500MG PWIJ,6.6,1.43,1.72,6.4,29
CDM,8483315,EPO ALFA EPBX ESRD/100U 2KU SNIJ,0.22,0.12,0.0572,0.2134,29
CDM,8483323,EPO ALFA EPBX ESRD/100U 3KU SNIJ,0.52,0.3,0.1352,0.5044,29
CDM,8483331,EPO ALFA EPBX ESRD/100U 4KU SNIJ,0.56,0.32,0.1456,0.5432,29
CDM,8489155,D5-NACL 0.9%/500ML 1000ML SNIV,2.95,0.64,0.767,2.86,29
CDM,8489650,VANCO MYL/500MG 1.5GM PWIJ,2.58,0.91,0.6708,2.5,29
CDM,8489767,PROGESTERONE/90MG 90MG/1.125G GLVG,8.26,0.73,2.15,8.01,29
CDM,9400029,INJ SUBQ/IM,144.0,67.39,37.44,139.68,29
CDM,9400094,DSMT IND 30MIN,120.0,99.6,31.2,116.4,29
CDM,9400177,MNT INITIAL ASSESS INDIVIDUAL 15MIN,60.0,49.8,15.6,58.2,29
CDM,9400185,MNT GROUP 30MIN,32.0,26.56,8.32,31.04,29
CDM,9400193,MNT RE-ASSESS INDIVIDUAL 15MIN,57.0,47.31,14.82,55.29,29
CDM,9400771,REFILL&MAINT PUMP PORTABLE,365.0,170.82,94.9,354.05,29
CDM,9400987,INJ IVP DRUG INITIAL,453.0,212.0,117.78,439.41,29
CDM,9400995,INJ IVP SEQ DRUG ADDL NEW,144.0,67.39,37.44,139.68,29
CDM,9401019,IRRG VAD IMP DELIVERY DRUG,281.0,131.51,73.06,272.57,29
CDM,9401159,INJ INTRA-ARTERIAL,191.0,89.39,49.66,185.27,29
CDM,9401662,INJ IVP SEQ DRUG ADDL SAME,107.0,50.08,27.82,103.79,29
CDM,9402058,OXYGN UPTAKE REST CALORMTRY INDIRCT,345.0,128.34,89.7,334.65,29
CDM,9402124,EDUC&TRAIN SELFMGMT IND 30MIN,106.0,87.98,27.56,102.82,29
CPT,0001U,LAB RBC DNA HEA 35 AG 11 BLD GRP NS,2160.0,1244.16,561.6,2095.2,29
CPT,0003M,LAB LIVER DISEASE 10 ASSAYS,1511.0,1143.83,392.86,1465.67,29
CPT,0035U,LAB NEURO CSF PRION PROT QUAL,1623.0,788.78,421.98,1574.31,29
CPT,0046U,LAB GENE FLT3 VAR ITD QN,2340.0,1137.24,608.4,2269.8,29
CPT,0049U,LAB NPM1 GENE ANALYSIS QUAN,2275.0,1105.65,591.5,2206.75,29
CPT,0118U,LAB TRNSPL DNA DNR DRV CELL-FREE QN,8260.0,4014.36,2147.6,8012.2,29
CPT,0141U,LAB DIS INFCT ID BAC&FNG GRM+ RXRST,471.0,228.91,122.46,456.87,29
CPT,0142U,LAB DIS INFCT ID BAC&FNG GRM- RXRST,471.0,228.91,122.46,456.87,29
CPT,0152U,LAB DIS INFCT DNA PLASMA NGS UNTGT,6379.0,3100.19,1658.54,6187.63,29
CPT,0169U,LAB GENE NUDT15&TPMT VAR COMMON,1399.0,679.91,363.74,1357.03,29
CPT,0211U,LAB ONC SEQ NEXT GEN DNA&RNA FFPE,25365.0,12327.39,6594.9,24604.05,29
CPT,0225U,LAB DIS INFCT SARS-COV-2 TGT 21,1251.0,607.99,325.26,1213.47,29
CPT,0313U,LAB ONC SEQ NEXT GEN DNA&MRNA 74,10800.0,5248.8,2808.0,10476.0,29
CPT,0358U,LAB IMM NEURO AMYLD 1-42&1-40 CSF,785.0,381.51,204.1,761.45,29
CPT,0457U,LAB CHROMAT MS PFAS 9 CMPD SRM/PLSM,597.0,290.14,155.22,579.09,29
CPT,0780T,INSTILL FECAL MICROB LGI EN RECT SP,584.0,426.9,151.84,566.48,29
CPT,0791T,PT MOTOR COG VRF TRAIN GAIT 15MN,100.0,60.8,26.0,97.0,29
CPT,10035,PLC DEV/S LOC TIS SOFT PERC LSN 1ST,1015.0,327.84,263.9,984.55,28
CPT,10036,PLC DEV/S LOC TIS SOFT PERC LSN ADD,591.0,190.89,153.66,573.27,28
CPT,10061,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",,,,,0
CPT,11012,"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (e.g., excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone",,,,,0
CPT,11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",,,,,0
CPT,11403,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm",,,,,0
CPT,11421,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm",,,,,0
CPT,11422,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm",,,,,0
CPT,11442,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm",,,,,0
CPT,11602,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm",,,,,0
CPT,11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",,,,,0
CPT,11770,Excision of pilonidal cyst or sinus; simple,,,,,0
CPT,11771,Excision of pilonidal cyst or sinus; extensive,,,,,0
CPT,14021,"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm",,,,,0
CPT,15853,ED REM SUTURE/STAPLE NO ANESTH,84.0,33.6,21.84,81.48,29
CPT,15853,REM SUTURE/STAPLE NO ANESTH,84.0,32.59,21.84,81.48,29
CPT,15854,ED REM SUTURE&STAPLE NO ANESTH,112.0,44.8,29.12,108.64,29
CPT,15854,REM SUTURE&STAPLE NO ANESTH,112.0,43.46,29.12,108.64,29
CPT,19000,ASP PUNCT CYST BREAST INIT LT,366.0,118.22,95.16,355.02,28
CPT,19000,ASP PUNCT CYST BREAST INIT RT,366.0,118.22,95.16,355.02,28
CPT,19001,ASP PUNCT CYST BREAST ADDL LT,92.0,29.72,23.92,89.24,28
CPT,19001,ASP PUNCT CYST BREAST ADDL RT,92.0,29.72,23.92,89.24,28
CPT,19020,"MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP",,,,,0
CPT,19030,INJ DUCTO/GALACTOGRAM MAMMARY BI,252.0,81.4,65.52,244.44,28
CPT,19030,INJ DUCTO/GALACTOGRAM MAMMARY LT,168.0,54.26,43.68,162.96,28
CPT,19030,INJ DUCTO/GALACTOGRAM MAMMARY RT,168.0,54.26,43.68,162.96,28
CPT,19081,BX BRST W/WO DEV/IMG SG LSN 1ST LT,1117.0,360.79,290.42,1083.49,28
CPT,19081,BX BRST W/WO DEV/IMG SG LSN 1ST RT,1117.0,360.79,290.42,1083.49,28
CPT,19082,BX BRST W/WO DEV/IMG SG LSN ADD,559.0,180.56,145.34,542.23,28
CPT,19083,BX BRST W/WO DEV/IMG US LSN 1ST LT,4235.0,1367.9,1101.1,4107.95,28
CPT,19083,BX BRST W/WO DEV/IMG US LSN 1ST RT,4235.0,1367.9,1101.1,4107.95,28
CPT,19084,BX BRST W/WO DEV/IMG US LSN ADD,2119.0,684.44,550.94,2055.43,28
CPT,19120,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions",,,,,0
CPT,19281,PLC DEV/S BRST MAMMO GD LSN 1ST LT,1148.0,370.8,298.48,1113.56,28
CPT,19281,PLC DEV/S BRST MAMMO GD LSN 1ST RT,1148.0,370.8,298.48,1113.56,28
CPT,19282,PLC DEV/S BRST MAMMO GD LSN ADD,379.0,122.42,98.54,367.63,28
CPT,19285,PLC DEV/S BRST US GD LSN 1ST LT,743.0,239.99,193.18,720.71,28
CPT,19285,PLC DEV/S BRST US GD LSN 1ST RT,743.0,239.99,193.18,720.71,28
CPT,19286,PLC DEV/S BRST US GD LSN ADD,232.0,74.94,60.32,225.04,28
CPT,19301,"Mastectomy, partial (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy);",,,,,0
CPT,19303,"Mastectomy, simple, complete",,,,,0
CPT,19307,"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle",,,,,0
CPT,19380,"Revision of reconstructed breast (e.g., significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue e",,,,,0
CPT,20206,BX MUSCLE NDL PERC,1943.0,627.59,505.18,1884.71,28
CPT,20501,INJ TRACT SINOGRAM,161.0,52.0,41.86,156.17,28
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD BI,377.0,121.77,98.02,365.69,28
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD LT,251.0,81.07,65.26,243.47,28
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD RT,251.0,81.07,65.26,243.47,28
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD BI,1170.0,377.91,304.2,1134.9,28
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD LT,780.0,251.94,202.8,756.6,28
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD RT,780.0,251.94,202.8,756.6,28
CPT,20610,"Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance",,,,,0
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD BI,1248.0,403.1,324.48,1210.56,28
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD LT,832.0,268.74,216.32,807.04,28
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD RT,832.0,268.74,216.32,807.04,28
CPT,20670,"REMOVAL OF IMPLANT; SUPERFICIAL (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE)",,,,,0
CPT,20950,ED MONITOR PRESS SYND COMPART MUSC,630.0,252.0,163.8,611.1,29
CPT,21552,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; 3 CM OR GREATER",,,,,0
CPT,21554,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); 5 cm or greater",,,,,0
CPT,21556,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM",,,,,0
CPT,21931,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",,,,,0
CPT,22902,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm",,,,,0
CPT,23071,"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater",,,,,0
CPT,23350,INJ ARTHRO SHOULDER BI,558.0,180.23,145.08,541.26,28
CPT,23350,INJ ARTHRO SHOULDER LT,372.0,120.16,96.72,360.84,28
CPT,23350,INJ ARTHRO SHOULDER RT,372.0,120.16,96.72,360.84,28
CPT,23515,"OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,,,0
CPT,24220,INJ ARTHRO ELBOW BI,309.0,99.81,80.34,299.73,28
CPT,24220,INJ ARTHRO ELBOW LT,206.0,66.54,53.56,199.82,28
CPT,24220,INJ ARTHRO ELBOW RT,206.0,66.54,53.56,199.82,28
CPT,25246,INJ ARTHRO WRIST BI,413.0,133.4,107.38,400.61,28
CPT,25246,INJ ARTHRO WRIST LT,275.0,88.82,71.5,266.75,28
CPT,25246,INJ ARTHRO WRIST RT,275.0,88.82,71.5,266.75,28
CPT,26765,"OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,,,0
CPT,27093,INJ ARTHRO HIP WO ANES BI,471.0,152.13,122.46,456.87,28
CPT,27093,INJ ARTHRO HIP WO ANES LT,314.0,101.42,81.64,304.58,28
CPT,27093,INJ ARTHRO HIP WO ANES RT,314.0,101.42,81.64,304.58,28
CPT,27096,INJ JT SI ANES/STRD FL/CT GD BI,2076.0,670.55,539.76,2013.72,28
CPT,27096,INJ JT SI ANES/STRD FL/CT GD LT,1384.0,447.03,359.84,1342.48,28
CPT,27096,INJ JT SI ANES/STRD FL/CT GD RT,1384.0,447.03,359.84,1342.48,28
CPT,27130,"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft",,,,,0
CPT,27327,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm",,,,,0
CPT,27369,INJ ARTHRO KNEE CNT/CNT ENHANCE BI,239.0,77.2,62.14,231.83,28
CPT,27369,INJ ARTHRO KNEE CNT/CNT ENHANCE LT,159.0,51.36,41.34,154.23,28
CPT,27369,INJ ARTHRO KNEE CNT/CNT ENHANCE RT,159.0,51.36,41.34,154.23,28
CPT,27535,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,,,0
CPT,27648,INJ ARTHRO ANKLE BI,246.0,79.46,63.96,238.62,28
CPT,27648,INJ ARTHRO ANKLE LT,164.0,52.97,42.64,159.08,28
CPT,27648,INJ ARTHRO ANKLE RT,164.0,52.97,42.64,159.08,28
CPT,27695,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL",,,,,0
CPT,27792,"OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,,,0
CPT,29580,PT STRAPPING BOOT UNNA BI,413.0,251.1,107.38,400.61,29
CPT,29580,PT STRAPPING BOOT UNNA LT,275.0,167.2,71.5,266.75,29
CPT,29580,PT STRAPPING BOOT UNNA RT,275.0,167.2,71.5,266.75,29
CPT,29580,PTA STRAPPING BOOT UNNA BI,413.0,251.1,107.38,400.61,29
CPT,29580,PTA STRAPPING BOOT UNNA LT,275.0,167.2,71.5,266.75,29
CPT,29580,PTA STRAPPING BOOT UNNA RT,275.0,167.2,71.5,266.75,29
CPT,29807,"Arthroscopy, shoulder, surgical; repair of SLAP lesion",,,,,0
CPT,29822,"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anc",,,,,0
CPT,29824,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)",,,,,0
CPT,29826,"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) release, when performed (list separately in addition to code f",,,,,0
CPT,29828,"Arthroscopy, shoulder, surgical; biceps tenodesis",,,,,0
CPT,29897,"ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, LIMITED",,,,,0
CPT,31575,ST LARYNGOSCOPY DIAGNOSTIC FLEX,291.0,93.99,75.66,282.27,28
CPT,31625,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites",,,,,0
CPT,32408,BX NEEDLE CORE LUNG/MEDSTRNM PERC,2149.0,694.13,558.74,2084.53,28
CPT,32555,THORACENTESIS ASP W IMG BI,1364.0,440.57,354.64,1323.08,28
CPT,32555,THORACENTESIS ASP W IMG LT,909.0,293.61,236.34,881.73,28
CPT,32555,THORACENTESIS ASP W IMG RT,909.0,293.61,236.34,881.73,28
CPT,32557,DRN PLEURA INS CATH INDWL W IMG BI,1784.0,576.23,463.84,1730.48,28
CPT,32557,DRN PLEURA INS CATH INDWL W IMG LT,1189.0,384.05,309.14,1153.33,28
CPT,32557,DRN PLEURA INS CATH INDWL W IMG RT,1189.0,384.05,309.14,1153.33,28
CPT,33016,ED PERICARDIOCENTESIS INCL IMG GD,1457.0,582.8,378.82,1413.29,29
CPT,33016,PERICARDIOCENTESIS INCL IMG GD,1457.0,470.61,378.82,1413.29,28
CPT,36005,INJ VENOGRAPHY EXTREMITY BI,234.0,75.58,60.84,226.98,28
CPT,36005,INJ VENOGRAPHY EXTREMITY LT,156.0,50.39,40.56,151.32,28
CPT,36005,INJ VENOGRAPHY EXTREMITY RT,156.0,50.39,40.56,151.32,28
CPT,36415,COLLECT SPEC BLD VENIPNCTR LEGAL,34.0,25.74,8.84,32.98,29
CPT,36430,ED TRANSFUSION BLOOD/COMP 1 UNIT,842.0,266.07,218.92,816.74,29
CPT,36430,ED TRANSFUSION BLOOD/COMP 2 UNITS,1053.0,332.75,273.78,1021.41,29
CPT,36430,ED TRANSFUSION BLOOD/COMP 3+ UNITS,1263.0,399.11,328.38,1225.11,29
CPT,36430,TRANSFUSION BLOOD/COMP 1 UNIT,842.0,266.07,218.92,816.74,87
CPT,36430,TRANSFUSION BLOOD/COMP 2 UNITS,1053.0,332.75,273.78,1021.41,87
CPT,36430,TRANSFUSION BLOOD/COMP 3+ UNITS,1263.0,399.11,328.38,1225.11,87
CPT,36561,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older",,,,,0
CPT,36568,INS PICC WO P/P WO IMG 0-4YRS,963.0,373.64,250.38,934.11,29
CPT,36569,INS PICC WO P/P WO IMG 5+YRS,990.0,384.12,257.4,960.3,29
CPT,36572,INS PICC WO P/P W IMG 0-4YRS,1035.0,401.58,269.1,1003.95,29
CPT,36573,INS PICC WO P/P W IMG 5+YRS,1137.0,441.16,295.62,1102.89,29
CPT,36590,"REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION",,,,,0
CPT,36591,COLLECT SPEC BLD VAD IMPLNT,245.0,95.06,63.7,237.65,29
CPT,36592,COLLECT SPEC BLD PICC NOS,248.0,96.22,64.48,240.56,29
CPT,36593,DECLOT CATH/VAD W AGENT THROMB,497.0,176.685,129.22,482.09,57
CPT,36600,PUNCT ARTERIAL FOR DIAGNOSIS,95.0,71.92,24.7,92.15,29
CPT,36620,ED CATH/CANN ART SMP/MNTR/TRNS PERC,336.0,134.4,87.36,325.92,29
CPT,36680,ED PLC NEEDLE INF INTRAOSSEOUS,532.0,212.8,138.32,516.04,29
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL BI,4202.0,1357.25,1092.52,4075.94,28
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL LT,2801.0,904.72,728.26,2716.97,28
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL RT,2801.0,904.72,728.26,2716.97,28
CPT,38525,"Biopsy or excision of lymph node(s); open, deep axillary node(s)",,,,,0
CPT,38792,INJ RRX NODE SENTINEL ID BI,468.0,151.16,121.68,453.96,28
CPT,38792,INJ RRX NODE SENTINEL ID LT,312.0,100.78,81.12,302.64,28
CPT,38792,INJ RRX NODE SENTINEL ID RT,312.0,100.78,81.12,302.64,28
CPT,38900,"Intraoperative identification (e.g., mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)",,,,,0
CPT,43752,PLC G-TUBE NASO/ORO PHYS W FL GD,272.0,87.86,70.72,263.84,28
CPT,44139,MOBILIZATION (TAKE-DOWN) OF SPLENIC FLEXURE PERFORMED IN CONJUNCTION WITH PARTIAL COLECTOMY (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE),,,,,0
CPT,44141,"COLECTOMY, PARTIAL; WITH SKIN LEVEL CECOSTOMY OR COLOSTOMY",,,,,0
CPT,44970,"Laparoscopy, surgical, appendectomy",,,,,0
CPT,45378,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,,,0
CPT,45380,"Colonoscopy, flexible; with biopsy, single or multiple",,,,,0
CPT,46221,"HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S)",,,,,0
CPT,46260,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;",,,,,0
CPT,47000,BX LIVER NDL PERC,1389.0,448.65,361.14,1347.33,28
CPT,47531,INJ CHOLANGIOGRAM ACCESS EXIST S&I,462.0,149.23,120.12,448.14,28
CPT,47562,"Laparoscopy, surgical; cholecystectomy",,,,,0
CPT,49083,PARACENTESIS ABDOMINAL W IMG,832.0,268.74,216.32,807.04,28
CPT,49320,"LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,,,0
CPT,49321,"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)",,,,,0
CPT,49322,"Laparoscopy, surgical; with aspiration of cavity or cyst (e.g., ovarian cyst) (single or multiple)",,,,,0
CPT,49329,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,,,0
CPT,49406,DRN CATH FLUID PERI PERC IMG GD,1973.0,637.28,512.98,1913.81,28
CPT,49424,INJ CNT ABSC/CYST VIA PREV CATH/TB,170.0,54.91,44.2,164.9,28
CPT,49427,INJ EVAL SHUNT PERITONEAL-VENOUS,197.0,63.63,51.22,191.09,28
CPT,49465,INJ CNT TUBE G/COLON PERC S&I,281.0,90.76,73.06,272.57,28
CPT,49505,"Repair initial inguinal hernia, age 5 years or older; reducible",,,,,0
CPT,49507,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated",,,,,0
CPT,49521,"REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED",,,,,0
CPT,49553,"Repair initial femoral hernia, any age; incarcerated or strangulated",,,,,0
CPT,49591,"Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, Spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other",,,,,0
CPT,49592,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL, INCLUDING IMPLANTATION OF MESH OR OTHER PRO",,,,,0
CPT,49593,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL, INCLUDING IMPLANTATION OF MESH OR OTHER PRO",,,,,0
CPT,49594,"Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, Spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other",,,,,0
CPT,49614,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,,,0
CPT,49651,"Laparoscopy, surgical; repair recurrent inguinal hernia",,,,,0
CPT,51600,INJ CYSTOGRAM,562.0,181.53,146.12,545.14,28
CPT,51700,ED PROCEDURE IRRG BLADDER,492.0,196.8,127.92,477.24,29
CPT,51700,PROCEDURE IRRG BLADDER,492.0,158.92,127.92,477.24,28
CPT,51701,ED INS CATH BLADDER NONINDWL,194.0,77.6,50.44,188.18,29
CPT,51701,INS CATH BLADDER NONINDWL,194.0,68.965,50.44,188.18,57
CPT,51702,ED INS CATH BLADDER INDWL SMPL,334.0,133.6,86.84,323.98,29
CPT,51702,INS CATH BLADDER INDWL SMPL,334.0,118.735,86.84,323.98,57
CPT,51703,INS CATH BLADDER INDWL CMP,357.0,126.915,92.82,346.29,57
CPT,51705,CHG TUBE CYSTO SIMPLE,259.0,83.66,67.34,251.23,28
CPT,52000,Cystourethroscopy (separate procedure),,,,,0
CPT,54150,CIRCUMCISION W BLOCK REGIONAL,380.0,215.9,98.8,368.6,29
CPT,55520,EXCISION OF LESION OF SPERMATIC CORD (SEPARATE PROCEDURE),,,,,0
CPT,56405,Incision and drainage of vulva or perineal abscess,,,,,0
CPT,56605,BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION,,,,,0
CPT,56740,EXCISION OF BARTHOLIN'S GLAND OR CYST,,,,,0
CPT,57240,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed",,,,,0
CPT,57410,PELVIC EXAMINATION UNDER ANESTHESIA (OTHER THAN LOCAL),,,,,0
CPT,57522,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision",,,,,0
CPT,58120,"DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)",,,,,0
CPT,58150,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);",,,,,0
CPT,58300,INSERTION OF INTRAUTERINE DEVICE (IUD),,,,,0
CPT,58301,ED REM IUD,456.0,182.4,118.56,442.32,29
CPT,58301,REMOVAL OF INTRAUTERINE DEVICE (IUD),,,,,0
CPT,58340,INJ SIS/HYSTEROSALPINGOGRAPHY,758.0,244.83,197.08,735.26,28
CPT,58353,"ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE",,,,,0
CPT,58550,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;",,,,,0
CPT,58552,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,,,0
CPT,58554,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)",,,,,0
CPT,58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",,,,,0
CPT,58570,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;",,,,,0
CPT,58571,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,,,0
CPT,58579,"UNLISTED HYSTEROSCOPY PROCEDURE, UTERUS",,,,,0
CPT,58611,Ligation or transection of Fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure,,,,,0
CPT,58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",,,,,0
CPT,58662,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",,,,,0
CPT,58999,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL)",,,,,0
CPT,59000,AMNIOCENTESIS DIAGNOSTIC,609.0,196.71,158.34,590.73,56
CPT,59020,TEST STRESS CONTRACTION FETAL,536.0,582.63,139.36,519.92,29
CPT,59025,TEST NONSTRESS FETAL,519.0,564.15,134.94,503.43,29
CPT,59160,"Curettage, postpartum",,,,,0
CPT,59200,INS DILATOR CERVICAL,422.0,239.76,109.72,409.34,29
CPT,59409,Vaginal delivery only (with or without episiotomy and/or forceps);,,,,,0
CPT,59412,VERSION CEPHALIC EXTERNAL,745.0,423.27,193.7,722.65,29
CPT,59414,DELIVERY OF PLACENTA,1940.0,1102.21,504.4,1881.8,29
CPT,59414,ED DELIVERY PLACENTA,1940.0,776.0,504.4,1881.8,29
CPT,59514,Cesarean delivery only;,,,,,0
CPT,59812,"Treatment of incomplete abortion, any trimester, completed surgically",,,,,0
CPT,59820,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER",,,,,0
CPT,60100,BX THYROID NDL CORE PERC,1426.0,460.6,370.76,1383.22,28
CPT,61055,PUNCT C1-C2 W INJ,1268.0,409.56,329.68,1229.96,28
CPT,62270,PUNCT LUMBAR DIAGNOSTIC,896.0,289.41,232.96,869.12,28
CPT,62273,ED INJ EPID PATCH BLOOD/CLOT,863.0,345.2,224.38,837.11,29
CPT,62273,INJ EPID PATCH BLOOD/CLOT,863.0,278.75,224.38,837.11,56
CPT,62284,INJ MYELOGRAM&/CT LUMBAR,762.0,246.13,198.12,739.14,28
CPT,62302,INJ LUMB MYELOGRPHY CERVICAL S&I,842.0,271.97,218.92,816.74,28
CPT,62303,INJ LUMB MYELOGRPHY THORACIC S&I,971.0,313.63,252.46,941.87,28
CPT,62304,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,846.0,273.26,219.96,820.62,28
CPT,62305,INJ LUMB MYELOGRPHY 2+ S&I,934.0,301.68,242.84,905.98,28
CPT,62320,INJ/S EPID/SUB C/T WO IMG,903.0,291.67,234.78,875.91,28
CPT,62321,INJ/S EPID/SUB C/T W IMG,2613.0,844.0,679.38,2534.61,28
CPT,62322,INJ/S EPID/SUB L/S WO IMG,677.0,218.67,176.02,656.69,28
CPT,62323,INJ/S EPID/SUB L/S W IMG,1156.0,373.39,300.56,1121.32,28
CPT,62328,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,884.0,285.53,229.84,857.48,28
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR BI,683.0,273.2,177.58,662.51,29
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR LT,455.0,182.0,118.3,441.35,29
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR RT,455.0,182.0,118.3,441.35,29
CPT,64400,INJ/S ANES NRV TRIGEMINAL BR EA,455.0,146.96,118.3,441.35,28
CPT,64420,ED INJ/S ANES NRV INTRCST LVL SGLBI,572.0,228.8,148.72,554.84,29
CPT,64420,ED INJ/S ANES NRV INTRCST LVL SGLLT,381.0,152.4,99.06,369.57,29
CPT,64420,ED INJ/S ANES NRV INTRCST LVL SGLRT,381.0,152.4,99.06,369.57,29
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL BI,572.0,184.76,148.72,554.84,28
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL LT,381.0,123.06,99.06,369.57,28
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL RT,381.0,123.06,99.06,369.57,28
CPT,64421,ED INJ/S ANES NRV INTRCST LVL ADDBI,1188.0,475.2,308.88,1152.36,29
CPT,64421,ED INJ/S ANES NRV INTRCST LVL ADDLT,792.0,316.8,205.92,768.24,29
CPT,64421,ED INJ/S ANES NRV INTRCST LVL ADDRT,792.0,316.8,205.92,768.24,29
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD BI,1188.0,383.72,308.88,1152.36,28
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD LT,792.0,255.82,205.92,768.24,28
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD RT,792.0,255.82,205.92,768.24,28
CPT,64425,INJ/S ANES NRV ILIOING ILIOHYGAS BI,822.0,265.51,213.72,797.34,28
CPT,64425,INJ/S ANES NRV ILIOING ILIOHYGAS LT,548.0,177.0,142.48,531.56,28
CPT,64425,INJ/S ANES NRV ILIOING ILIOHYGAS RT,548.0,177.0,142.48,531.56,28
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGBI,1517.0,489.99,394.42,1471.49,28
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGLT,1011.0,326.55,262.86,980.67,28
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGRT,1011.0,326.55,262.86,980.67,28
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL BI,1928.0,622.74,501.28,1870.16,28
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL LT,1285.0,415.06,334.1,1246.45,28
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL RT,1285.0,415.06,334.1,1246.45,28
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL BI,812.0,262.28,211.12,787.64,28
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL LT,541.0,174.74,140.66,524.77,28
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL RT,541.0,174.74,140.66,524.77,28
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL BI,825.0,266.48,214.5,800.25,28
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL LT,550.0,177.65,143.0,533.5,28
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL RT,550.0,177.65,143.0,533.5,28
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL BI,3494.0,1128.56,908.44,3389.18,28
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL LT,2329.0,752.27,605.54,2259.13,28
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL RT,2329.0,752.27,605.54,2259.13,28
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL BI,840.0,271.32,218.4,814.8,28
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL LT,560.0,180.88,145.6,543.2,28
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL RT,560.0,180.88,145.6,543.2,28
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL BI,792.0,255.82,205.92,768.24,28
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL LT,528.0,170.54,137.28,512.16,28
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL RT,528.0,170.54,137.28,512.16,28
CPT,64633,DST NRV CERV/THOR FL/CT GD SGL BI,2102.0,678.95,546.52,2038.94,28
CPT,64633,DST NRV CERV/THOR FL/CT GD SGL LT,1401.0,452.52,364.26,1358.97,28
CPT,64633,DST NRV CERV/THOR FL/CT GD SGL RT,1401.0,452.52,364.26,1358.97,28
CPT,64634,DST NRV CERV/THOR FL/CT GD ADDL BI,345.0,111.44,89.7,334.65,28
CPT,64634,DST NRV CERV/THOR FL/CT GD ADDL LT,230.0,74.29,59.8,223.1,28
CPT,64634,DST NRV CERV/THOR FL/CT GD ADDL RT,230.0,74.29,59.8,223.1,28
CPT,64635,DST NRV LUMB/SAC FL/CT GD SGL BI,2082.0,672.49,541.32,2019.54,28
CPT,64635,DST NRV LUMB/SAC FL/CT GD SGL LT,1388.0,448.32,360.88,1346.36,28
CPT,64635,DST NRV LUMB/SAC FL/CT GD SGL RT,1388.0,448.32,360.88,1346.36,28
CPT,64636,DST NRV LUMB/SAC FL/CT GD ADDL BI,357.0,115.31,92.82,346.29,28
CPT,64636,DST NRV LUMB/SAC FL/CT GD ADDL LT,238.0,76.87,61.88,230.86,28
CPT,64636,DST NRV LUMB/SAC FL/CT GD ADDL RT,238.0,76.87,61.88,230.86,28
CPT,64831,"SUTURE OF DIGITAL NERVE, HAND OR FOOT; 1 NERVE",,,,,0
CPT,66984,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification); without endos",,,,,0
CPT,70030,XR EYE FOREIGN BODY LT,275.0,147.4,71.5,266.75,29
CPT,70030,XR EYE FOREIGN BODY RT,275.0,147.4,71.5,266.75,29
CPT,70100,XR MANDIBLE PARTIAL 1-3 VW,132.0,70.75,34.32,128.04,29
CPT,70110,XR MANDIBLE CMP 4+ VW,511.0,273.9,132.86,495.67,29
CPT,70130,XR MASTOIDS CMP 3+ VW PER SIDE LT,353.0,189.21,91.78,342.41,29
CPT,70130,XR MASTOIDS CMP 3+ VW PER SIDE RT,353.0,189.21,91.78,342.41,29
CPT,70140,XR BONES FACIAL 0-2 VW,195.0,104.52,50.7,189.15,29
CPT,70150,XR BONES FACIAL CMP 3+ VW,578.0,309.81,150.28,560.66,29
CPT,70160,XR BONES NASAL CMP 3+ VW,384.0,205.82,99.84,372.48,29
CPT,70190,XR FORAMINA OPTIC LT,215.0,115.24,55.9,208.55,29
CPT,70190,XR FORAMINA OPTIC RT,215.0,115.24,55.9,208.55,29
CPT,70200,XR ORBITS CMP 4+ VW,273.0,146.33,70.98,264.81,29
CPT,70210,XR SINUSES PARANASAL 0-2 VW,214.0,114.7,55.64,207.58,29
CPT,70220,XR SINUSES PARANASAL CMP 3+ VW,329.0,176.34,85.54,319.13,29
CPT,70250,XR SKULL 0-3 VW,197.0,105.59,51.22,191.09,29
CPT,70260,XR SKULL CMP 4+ VW,263.0,140.97,68.38,255.11,29
CPT,70328,XR TMJ MOUTH OPEN&CLOSE LT,143.0,76.65,37.18,138.71,29
CPT,70328,XR TMJ MOUTH OPEN&CLOSE RT,143.0,76.65,37.18,138.71,29
CPT,70330,XR TMJ MOUTH OPEN&CLOSE BI,381.0,204.22,99.06,369.57,29
CPT,70336,MRI JOINT TEMPOROMANDIBULAR BI,1353.0,679.21,351.78,1312.41,29
CPT,70336,MRI JOINT TEMPOROMANDIBULAR LT,902.0,452.8,234.52,874.94,29
CPT,70336,MRI JOINT TEMPOROMANDIBULAR RT,902.0,452.8,234.52,874.94,29
CPT,70360,XR TISSUE SOFT NECK,456.0,244.42,118.56,442.32,29
CPT,70371,EVAL SPEECH COMPLEX CINE/VIDEO,639.0,342.5,166.14,619.83,29
CPT,70450,CT HEAD WO CNT,1502.0,630.84,390.52,1456.94,29
CPT,70460,CT HEAD W CNT,1878.0,788.76,488.28,1821.66,29
CPT,70470,CT HEAD W&WO CNT,2253.0,946.26,585.78,2185.41,29
CPT,70471,CTA HEAD&NECK W&WO CNT&PP,5422.0,2152.53,1409.72,5259.34,29
CPT,70480,CT ORB/PF/SEL/IAC WO CNT,1853.0,778.26,481.78,1797.41,29
CPT,70481,CT ORB/PF/SEL/IAC W CNT,2317.0,973.14,602.42,2247.49,29
CPT,70482,CT ORB/PF/SEL/IAC W&WO CNT,2780.0,1167.6,722.8,2696.6,29
CPT,70486,CT MAXFACIAL WO CNT,1619.0,679.98,420.94,1570.43,29
CPT,70487,CT MAXFACIAL W CNT,2024.0,850.08,526.24,1963.28,29
CPT,70488,CT MAXFACIAL W&WO CNT,2429.0,1020.18,631.54,2356.13,29
CPT,70490,CT NECK ST WO CNT,1940.0,814.8,504.4,1881.8,29
CPT,70491,CT NECK ST W CNT,2425.0,1018.5,630.5,2352.25,29
CPT,70492,CT NECK ST W&WO CNT,2910.0,1222.2,756.6,2822.7,29
CPT,70496,CTA HEAD W CNT&PP,2366.0,993.72,615.16,2295.02,29
CPT,70498,CTA NECK W CNT&PP,3056.0,1283.52,794.56,2964.32,29
CPT,70540,MRI ORBIT FACE&/NECK WO CNT,2022.0,1073.68,525.72,1961.34,29
CPT,70542,MRI ORBIT FACE&/NECK W CNT,2528.0,1342.37,657.28,2452.16,29
CPT,70543,MRI ORBIT FACE&/NECK W&WO CNT,3033.0,1610.52,788.58,2942.01,29
CPT,70544,MRA HEAD WO CNT,2795.0,1375.14,726.7,2711.15,29
CPT,70545,MRA HEAD W CNT,3494.0,1719.05,908.44,3389.18,29
CPT,70546,MRA HEAD W&WO CNT,4193.0,2062.96,1090.18,4067.21,29
CPT,70547,MRA NECK WO CNT,2173.0,1069.12,564.98,2107.81,29
CPT,70548,MRA NECK W CNT,2717.0,1336.76,706.42,2635.49,29
CPT,70549,MRA NECK W&WO CNT,3260.0,1603.92,847.6,3162.2,29
CPT,70551,MRI BRAIN WO CNT,3552.0,1886.11,923.52,3445.44,29
CPT,70552,MRI BRAIN W CNT,4440.0,2357.64,1154.4,4306.8,29
CPT,70553,MRI BRAIN W&WO CNT,5328.0,2829.17,1385.28,5168.16,29
CPT,71045,XR CHEST 1 VW,428.0,203.73,111.28,415.16,29
CPT,71046,XR CHEST 2 VW,492.0,234.19,127.92,477.24,29
CPT,71047,XR CHEST 3 VW,607.0,288.93,157.82,588.79,29
CPT,71048,XR CHEST 4+ VW,649.0,308.92,168.74,629.53,29
CPT,71100,XR RIBS 2 VW LT,450.0,241.2,117.0,436.5,29
CPT,71100,XR RIBS 2 VW RT,450.0,241.2,117.0,436.5,29
CPT,71101,XR RIBS W CXR 3+ VW,642.0,344.11,166.92,622.74,29
CPT,71110,XR RIBS 3+ VW BI,650.0,348.4,169.0,630.5,29
CPT,71111,XR RIBS W CXR 4+ VW BI,777.0,416.47,202.02,753.69,29
CPT,71120,XR STERNUM 2+ VW,340.0,182.24,88.4,329.8,29
CPT,71130,XR JT/S STERNOCLAVICULAR 3+ VW,425.0,227.8,110.5,412.25,29
CPT,71250,CT CHEST DX WO CNT,2095.0,1026.55,544.7,2032.15,29
CPT,71260,CT CHEST DX W CNT,2619.0,1283.31,680.94,2540.43,29
CPT,71270,CT CHEST DX W&WO CNT,3143.0,1540.07,817.18,3048.71,29
CPT,71271,CT LOW DOSE SCRN CA LUNG WO CNT,1224.0,599.76,318.24,1187.28,29
CPT,71275,CTA CHEST W CNT&PP,3301.0,1617.49,858.26,3201.97,29
CPT,71550,MRI CHEST WO CNT,2546.0,1278.09,661.96,2469.62,29
CPT,71551,MRI CHEST W CNT,3183.0,1597.87,827.58,3087.51,29
CPT,71552,MRI CHEST W&WO CNT,3819.0,1917.14,992.94,3704.43,29
CPT,71555,MRA CHEST W CNT,3343.0,1899.33,869.18,3242.71,29
CPT,71555,MRA CHEST W/WO CNT,4010.0,2278.28,1042.6,3889.7,29
CPT,71555,MRA CHEST WO CNT,2674.0,1519.23,695.24,2593.78,29
CPT,72020,XR SPINE 1 VW,401.0,214.94,104.26,388.97,29
CPT,72040,XR SPINE CERVICAL 2-3 VW,515.0,276.04,133.9,499.55,29
CPT,72050,XR SPINE CERVICAL 4-5 VW,747.0,400.39,194.22,724.59,29
CPT,72052,XR SPINE CERVICAL 6+ VW,854.0,457.74,222.04,828.38,29
CPT,72070,XR SPINE THORACIC 2 VW,515.0,276.04,133.9,499.55,29
CPT,72072,XR SPINE THORACIC 3 VW,616.0,330.18,160.16,597.52,29
CPT,72080,XR SPINE THORACOLUMBAR => 2 VW,377.0,202.07,98.02,365.69,29
CPT,72082,XR SPINE ENTIRE THOR&LUMB 2-3 VW,589.0,315.7,153.14,571.33,29
CPT,72100,XR SPINE LS 2-3 VW,613.0,328.57,159.38,594.61,29
CPT,72110,XR SPINE LS 4+ VW,806.0,432.02,209.56,781.82,29
CPT,72114,XR SPINE LS CMP W BEND 6+ VW,939.0,503.3,244.14,910.83,29
CPT,72120,XR SPINE LS BEND 2-3 VW,529.0,283.54,137.54,513.13,29
CPT,72125,CT SPINE CERVICAL WO CNT,2182.0,1069.18,567.32,2116.54,29
CPT,72126,CT SPINE CERVICAL W CNT,2728.0,1336.72,709.28,2646.16,29
CPT,72127,CT SPINE CERVICAL W&WO CNT,3273.0,1603.77,850.98,3174.81,29
CPT,72128,CT SPINE THORACIC WO CNT,2285.0,1119.65,594.1,2216.45,29
CPT,72129,CT SPINE THORACIC W CNT,2857.0,1399.93,742.82,2771.29,29
CPT,72130,CT SPINE THORACIC W&WO CNT,3428.0,1679.72,891.28,3325.16,29
CPT,72131,CT SPINE LUMBAR WO CNT,2506.0,1227.94,651.56,2430.82,29
CPT,72132,CT SPINE LUMBAR W CNT,3133.0,1535.17,814.58,3039.01,29
CPT,72133,CT SPINE LUMBAR W&WO CNT,3759.0,1841.91,977.34,3646.23,29
CPT,72141,MRI SPINE CERVICAL WO CNT,2888.0,1527.75,750.88,2801.36,29
CPT,72142,MRI SPINE CERVICAL W CNT,3610.0,1909.69,938.6,3501.7,29
CPT,72146,MRI SPINE THORACIC WO CNT,2911.0,1539.92,756.86,2823.67,29
CPT,72147,MRI SPINE THORACIC W CNT,3639.0,1925.03,946.14,3529.83,29
CPT,72148,MRI SPINE LUMBAR WO CNT,3625.0,1917.62,942.5,3516.25,29
CPT,72149,MRI SPINE LUMBAR W CNT,4532.0,2397.43,1178.32,4396.04,29
CPT,72156,MRI SPINE CERVICAL W&WO CNT,4332.0,2291.63,1126.32,4202.04,29
CPT,72157,MRI SPINE THORACIC W&WO CNT,4367.0,2310.14,1135.42,4235.99,29
CPT,72158,MRI SPINE LUMBAR W&WO CNT,5438.0,2876.7,1413.88,5274.86,29
CPT,72159,MRA SPINE W CNT,4759.0,2703.83,1237.34,4616.23,29
CPT,72159,MRA SPINE W/WO CNT,5710.0,3244.14,1484.6,5538.7,29
CPT,72159,MRA SPINE WO CNT,3807.0,2162.95,989.82,3692.79,29
CPT,72170,XR PELVIS 1-2 VW,503.0,269.61,130.78,487.91,29
CPT,72190,XR PELVIS CMP 3+ VW,561.0,300.7,145.86,544.17,29
CPT,72191,CTA PELVIS W CNT&PP,3806.0,1864.94,989.56,3691.82,29
CPT,72192,CT PELVIS WO CNT,2416.0,1183.84,628.16,2343.52,29
CPT,72193,CT PELVIS W CNT,3020.0,1479.8,785.2,2929.4,29
CPT,72194,CT PELVIS W&WO CNT,3624.0,1775.76,942.24,3515.28,29
CPT,72195,MRI PELVIS WO CNT,2791.0,1401.08,725.66,2707.27,29
CPT,72196,MRI PELVIS W CNT,3489.0,1751.48,907.14,3384.33,29
CPT,72197,MRI PELVIS W&WO CNT,4187.0,2101.87,1088.62,4061.39,29
CPT,72198,MRA PELVIS W CNT,3664.0,2081.7,952.64,3554.08,29
CPT,72198,MRA PELVIS W/WO CNT,4397.0,2498.16,1143.22,4265.09,29
CPT,72198,MRA PELVIS WO CNT,2931.0,1665.25,762.06,2843.07,29
CPT,72200,XR JTS SACROILIAC 1-2 VW,495.0,265.32,128.7,480.15,29
CPT,72202,XR JTS SACROILIAC 3+ VW,541.0,289.98,140.66,524.77,29
CPT,72220,XR SACRUM&COCCYX 2+ VW,381.0,204.22,99.06,369.57,29
CPT,72240,MYELOGRAPHY CERVICAL S&I,1456.0,780.42,378.56,1412.32,29
CPT,72255,MYELOGRAPHY THORACIC S&I,1359.0,728.42,353.34,1318.23,29
CPT,72265,MYELOGRAPHY LUMBOSACRAL S&I,2647.0,1418.79,688.22,2567.59,29
CPT,72270,MYELOGRAPHY 2+ REGIONS S&I,2774.0,1486.86,721.24,2690.78,29
CPT,73000,XR CLAVICLE CMP LT,445.0,238.52,115.7,431.65,29
CPT,73000,XR CLAVICLE CMP RT,445.0,238.52,115.7,431.65,29
CPT,73010,XR SCAPULA CMP LT,374.0,200.46,97.24,362.78,29
CPT,73010,XR SCAPULA CMP RT,374.0,200.46,97.24,362.78,29
CPT,73020,XR SHOULDER 1 VW LT,161.0,86.3,41.86,156.17,29
CPT,73020,XR SHOULDER 1 VW RT,161.0,86.3,41.86,156.17,29
CPT,73030,XR SHOULDER CMP 2+ VW LT,499.0,267.46,129.74,484.03,29
CPT,73030,XR SHOULDER CMP 2+ VW RT,499.0,267.46,129.74,484.03,29
CPT,73040,XR ARTHRO SHOULDER LT S&I,730.0,414.75,189.8,708.1,29
CPT,73040,XR ARTHRO SHOULDER RT S&I,730.0,414.75,189.8,708.1,29
CPT,73050,XR JTS ACROMIOCLAVICULAR BI,210.0,112.56,54.6,203.7,29
CPT,73060,XR HUMERUS 2 VW LT RDC,455.0,243.88,118.3,441.35,29
CPT,73060,XR HUMERUS 2 VW RT RDC,455.0,243.88,118.3,441.35,29
CPT,73060,XR HUMERUS 2+ VW LT,455.0,243.88,118.3,441.35,29
CPT,73060,XR HUMERUS 2+ VW RT,455.0,243.88,118.3,441.35,29
CPT,73070,XR ELBOW 2 VW LT,287.0,153.83,74.62,278.39,29
CPT,73070,XR ELBOW 2 VW LT RDC,287.0,153.83,74.62,278.39,29
CPT,73070,XR ELBOW 2 VW RT,287.0,153.83,74.62,278.39,29
CPT,73070,XR ELBOW 2 VW RT RDC,287.0,153.83,74.62,278.39,29
CPT,73080,XR ELBOW CMP 3+ VW LT,323.0,173.13,83.98,313.31,29
CPT,73080,XR ELBOW CMP 3+ VW RT,323.0,173.13,83.98,313.31,29
CPT,73085,XR ARTHRO ELBOW LT S&I,1076.0,611.33,279.76,1043.72,29
CPT,73085,XR ARTHRO ELBOW RT S&I,1076.0,611.33,279.76,1043.72,29
CPT,73090,XR FOREARM 2 VW LT,275.0,147.4,71.5,266.75,29
CPT,73090,XR FOREARM 2 VW LT RDC,275.0,147.4,71.5,266.75,29
CPT,73090,XR FOREARM 2 VW RT,275.0,147.4,71.5,266.75,29
CPT,73090,XR FOREARM 2 VW RT RDC,275.0,147.4,71.5,266.75,29
CPT,73092,XR EXT UPPER INFANT 2+ VW LT,254.0,136.14,66.04,246.38,29
CPT,73092,XR EXT UPPER INFANT 2+ VW RT,254.0,136.14,66.04,246.38,29
CPT,73100,XR WRIST 2 VW LT,256.0,137.22,66.56,248.32,29
CPT,73100,XR WRIST 2 VW LT RDC,256.0,137.22,66.56,248.32,29
CPT,73100,XR WRIST 2 VW RT,256.0,137.22,66.56,248.32,29
CPT,73100,XR WRIST 2 VW RT RDC,256.0,137.22,66.56,248.32,29
CPT,73110,XR WRIST CMP 3+ VW LT,511.0,273.9,132.86,495.67,29
CPT,73110,XR WRIST CMP 3+ VW RT,511.0,273.9,132.86,495.67,29
CPT,73115,XR ARTHRO WRIST LT S&I,260.0,147.72,67.6,252.2,29
CPT,73115,XR ARTHRO WRIST RT S&I,260.0,147.72,67.6,252.2,29
CPT,73120,XR HAND 2 VW LT,455.0,243.88,118.3,441.35,29
CPT,73120,XR HAND 2 VW LT RDC,455.0,243.88,118.3,441.35,29
CPT,73120,XR HAND 2 VW RT,455.0,243.88,118.3,441.35,29
CPT,73120,XR HAND 2 VW RT RDC,455.0,243.88,118.3,441.35,29
CPT,73130,XR HAND 3+ VW LT,503.0,269.61,130.78,487.91,29
CPT,73130,XR HAND 3+ VW RT,503.0,269.61,130.78,487.91,29
CPT,73140,XR FINGER/S 2+ VW LT,191.0,102.38,49.66,185.27,29
CPT,73140,XR FINGER/S 2+ VW RT,191.0,102.38,49.66,185.27,29
CPT,73200,CT EXT UPPER WO CNT LT,1619.0,793.31,420.94,1570.43,29
CPT,73200,CT EXT UPPER WO CNT RT,1619.0,793.31,420.94,1570.43,29
CPT,73201,CT EXT UPPER W CNT LT,2024.0,991.76,526.24,1963.28,29
CPT,73201,CT EXT UPPER W CNT RT,2024.0,991.76,526.24,1963.28,29
CPT,73202,CT EXT UPPER W&WO CNT LT,2429.0,1190.21,631.54,2356.13,29
CPT,73202,CT EXT UPPER W&WO CNT RT,2429.0,1190.21,631.54,2356.13,29
CPT,73206,CTA EXT UPPER W CNT&PP LT,2551.0,1249.99,663.26,2474.47,29
CPT,73206,CTA EXT UPPER W CNT&PP RT,2551.0,1249.99,663.26,2474.47,29
CPT,73218,MRI EXT UPPER NONJT WO CNT LT,2418.0,1213.84,628.68,2345.46,29
CPT,73218,MRI EXT UPPER NONJT WO CNT RT,2418.0,1213.84,628.68,2345.46,29
CPT,73219,MRI EXT UPPER NONJT W CNT LT,3023.0,1517.55,785.98,2932.31,29
CPT,73219,MRI EXT UPPER NONJT W CNT RT,3023.0,1517.55,785.98,2932.31,29
CPT,73220,MRI EXT UPPER NONJT W&WO CNT LT,3627.0,1820.75,943.02,3518.19,29
CPT,73220,MRI EXT UPPER NONJT W&WO CNT RT,3627.0,1820.75,943.02,3518.19,29
CPT,73221,MRI EXT UPPER JT WO CNT LT,2509.0,1259.52,652.34,2433.73,29
CPT,73221,MRI EXT UPPER JT WO CNT RT,2509.0,1259.52,652.34,2433.73,29
CPT,73222,MRI EXT UPPER JT W CNT LT,3137.0,1574.77,815.62,3042.89,29
CPT,73222,MRI EXT UPPER JT W CNT RT,3137.0,1574.77,815.62,3042.89,29
CPT,73223,MRI EXT UPPER JT W&WO CNT LT,3764.0,1889.53,978.64,3651.08,29
CPT,73223,MRI EXT UPPER JT W&WO CNT RT,3764.0,1889.53,978.64,3651.08,29
CPT,73225,MRA EXT UPPER W CNT LT,3294.0,1871.49,856.44,3195.18,29
CPT,73225,MRA EXT UPPER W CNT RT,3294.0,1871.49,856.44,3195.18,29
CPT,73225,MRA EXT UPPER W/WO CNT LT,3953.0,2245.9,1027.78,3834.41,29
CPT,73225,MRA EXT UPPER W/WO CNT RT,3953.0,2245.9,1027.78,3834.41,29
CPT,73225,MRA EXT UPPER WO CNT LT,2635.0,1497.08,685.1,2555.95,29
CPT,73225,MRA EXT UPPER WO CNT RT,2635.0,1497.08,685.1,2555.95,29
CPT,73501,XR HIP W PELVIS 1 VW LT,209.0,112.02,54.34,202.73,29
CPT,73501,XR HIP W PELVIS 1 VW RT,209.0,112.02,54.34,202.73,29
CPT,73502,XR HIP W PELVIS 2-3 VW LT,566.0,303.38,147.16,549.02,29
CPT,73502,XR HIP W PELVIS 2-3 VW RT,566.0,303.38,147.16,549.02,29
CPT,73522,XR HIPS W PELVIS 3-4 VW BI,598.0,320.53,155.48,580.06,29
CPT,73525,XR ARTHRO HIP LT S&I,865.0,491.45,224.9,839.05,29
CPT,73525,XR ARTHRO HIP RT S&I,865.0,491.45,224.9,839.05,29
CPT,73552,XR FEMUR 2+ VW LT,483.0,258.89,125.58,468.51,29
CPT,73552,XR FEMUR 2+ VW RT,483.0,258.89,125.58,468.51,29
CPT,73560,XR KNEE 1-2 VW LT,345.0,184.92,89.7,334.65,29
CPT,73560,XR KNEE 1-2 VW RT,345.0,184.92,89.7,334.65,29
CPT,73562,XR KNEE 3 VW LT,419.0,224.58,108.94,406.43,29
CPT,73562,XR KNEE 3 VW RT,419.0,224.58,108.94,406.43,29
CPT,73564,XR KNEE CMP 4+ VW LT,618.0,331.25,160.68,599.46,29
CPT,73564,XR KNEE CMP 4+ VW RT,618.0,331.25,160.68,599.46,29
CPT,73565,XR KNEES STANDING AP BI,463.0,248.17,120.38,449.11,29
CPT,73580,XR ARTHRO KNEE LT S&I,734.0,417.02,190.84,711.98,29
CPT,73580,XR ARTHRO KNEE RT S&I,734.0,417.02,190.84,711.98,29
CPT,73590,XR TIBIA&FIBULA 2 VW LT,306.0,164.02,79.56,296.82,29
CPT,73590,XR TIBIA&FIBULA 2 VW LT RDC,306.0,164.02,79.56,296.82,29
CPT,73590,XR TIBIA&FIBULA 2 VW RT,306.0,164.02,79.56,296.82,29
CPT,73590,XR TIBIA&FIBULA 2 VW RT RDC,306.0,164.02,79.56,296.82,29
CPT,73592,XR EXT LOWER INFANT 2+ VW LT,276.0,147.94,71.76,267.72,29
CPT,73592,XR EXT LOWER INFANT 2+ VW RT,276.0,147.94,71.76,267.72,29
CPT,73600,XR ANKLE 2 VW LT,307.0,164.55,79.82,297.79,29
CPT,73600,XR ANKLE 2 VW LT RDC,307.0,164.55,79.82,297.79,29
CPT,73600,XR ANKLE 2 VW RT,307.0,164.55,79.82,297.79,29
CPT,73600,XR ANKLE 2 VW RT RDC,307.0,164.55,79.82,297.79,29
CPT,73610,XR ANKLE CMP 3+ VW LT,330.0,176.88,85.8,320.1,29
CPT,73610,XR ANKLE CMP 3+ VW RT,330.0,176.88,85.8,320.1,29
CPT,73615,XR ARTHRO ANKLE LT S&I,553.0,314.19,143.78,536.41,29
CPT,73615,XR ARTHRO ANKLE RT S&I,553.0,314.19,143.78,536.41,29
CPT,73620,XR FOOT 2 VW LT,148.0,79.33,38.48,143.56,29
CPT,73620,XR FOOT 2 VW LT RDC,148.0,79.33,38.48,143.56,29
CPT,73620,XR FOOT 2 VW RT,148.0,79.33,38.48,143.56,29
CPT,73620,XR FOOT 2 VW RT RDC,148.0,79.33,38.48,143.56,29
CPT,73630,XR FOOT CMP 3+ VW LT,481.0,257.82,125.06,466.57,29
CPT,73630,XR FOOT CMP 3+ VW RT,481.0,257.82,125.06,466.57,29
CPT,73650,XR CALCANEUS 2+ VW LT,303.0,162.41,78.78,293.91,29
CPT,73650,XR CALCANEUS 2+ VW RT,303.0,162.41,78.78,293.91,29
CPT,73660,XR TOE/S 2+ VW LT,331.0,177.42,86.06,321.07,29
CPT,73660,XR TOE/S 2+ VW RT,331.0,177.42,86.06,321.07,29
CPT,73700,CT EXT LOWER WO CNT LT,1688.0,827.12,438.88,1637.36,29
CPT,73700,CT EXT LOWER WO CNT RT,1688.0,827.12,438.88,1637.36,29
CPT,73701,CT EXT LOWER W CNT LT,2110.0,1033.9,548.6,2046.7,29
CPT,73701,CT EXT LOWER W CNT RT,2110.0,1033.9,548.6,2046.7,29
CPT,73702,CT EXT LOWER W&WO CNT LT,2532.0,1240.68,658.32,2456.04,29
CPT,73702,CT EXT LOWER W&WO CNT RT,2532.0,1240.68,658.32,2456.04,29
CPT,73706,CTA EXT LOWER W CNT&PP LT,2659.0,1302.91,691.34,2579.23,29
CPT,73706,CTA EXT LOWER W CNT&PP RT,2659.0,1302.91,691.34,2579.23,29
CPT,73718,MRI EXT LOWER NONJT WO CNT LT,2004.0,1006.01,521.04,1943.88,29
CPT,73718,MRI EXT LOWER NONJT WO CNT RT,2004.0,1006.01,521.04,1943.88,29
CPT,73719,MRI EXT LOWER NONJT W CNT LT,2505.0,1257.51,651.3,2429.85,29
CPT,73719,MRI EXT LOWER NONJT W CNT RT,2505.0,1257.51,651.3,2429.85,29
CPT,73720,MRI EXT LOWER NONJT W&WO CNT LT,3006.0,1509.01,781.56,2915.82,29
CPT,73720,MRI EXT LOWER NONJT W&WO CNT RT,3006.0,1509.01,781.56,2915.82,29
CPT,73721,MRI EXT LOWER JT WO CNT LT,3086.0,1549.17,802.36,2993.42,29
CPT,73721,MRI EXT LOWER JT WO CNT RT,3086.0,1549.17,802.36,2993.42,29
CPT,73722,MRI EXT LOWER JT W CNT LT,3858.0,1936.72,1003.08,3742.26,29
CPT,73722,MRI EXT LOWER JT W CNT RT,3858.0,1936.72,1003.08,3742.26,29
CPT,73723,MRI EXT LOWER JT W&WO CNT LT,4629.0,2323.76,1203.54,4490.13,29
CPT,73723,MRI EXT LOWER JT W&WO CNT RT,4629.0,2323.76,1203.54,4490.13,29
CPT,73725,MRA EXT LOWER W CNT LT,4051.0,2301.58,1053.26,3929.47,29
CPT,73725,MRA EXT LOWER W CNT RT,4051.0,2301.58,1053.26,3929.47,29
CPT,73725,MRA EXT LOWER W/WO CNT LT,4861.0,2761.78,1263.86,4715.17,29
CPT,73725,MRA EXT LOWER W/WO CNT RT,4861.0,2761.78,1263.86,4715.17,29
CPT,73725,MRA EXT LOWER WO CNT LT,3241.0,1841.37,842.66,3143.77,29
CPT,73725,MRA EXT LOWER WO CNT RT,3241.0,1841.37,842.66,3143.77,29
CPT,74018,XR ABDOMEN 1 VW,250.0,134.0,65.0,242.5,29
CPT,74019,XR ABDOMEN 2 VW,302.0,161.87,78.52,292.94,29
CPT,74021,XR ABDOMEN 3+ VW,354.0,189.74,92.04,343.38,29
CPT,74022,XR ABDOMEN CMP 2+VW W CHEST 1 VW,409.0,219.22,106.34,396.73,29
CPT,74150,CT ABDOMEN WO CNT,2263.0,1108.87,588.38,2195.11,29
CPT,74160,CT ABDOMEN W CNT,2829.0,1386.21,735.54,2744.13,29
CPT,74170,CT ABDOMEN W&WO CNT,3395.0,1663.55,882.7,3293.15,29
CPT,74174,CTA ABDOMEN&PELVIS W CNT&PP,5918.0,2899.82,1538.68,5740.46,29
CPT,74175,CTA ABDOMEN W CNT&PP,3565.0,1746.85,926.9,3458.05,29
CPT,74176,CT ABDOMEN&PELVIS WO CNT,3757.0,1840.93,976.82,3644.29,29
CPT,74177,CT ABDOMEN&PELVIS W CNT,4697.0,2301.53,1221.22,4556.09,29
CPT,74178,CT ABDOMEN&PELVIS W&WO CNT,5636.0,2761.64,1465.36,5466.92,29
CPT,74181,MRCP WO CNT,3245.0,1628.99,843.7,3147.65,29
CPT,74181,MRI ABDOMEN WO CNT,3245.0,1628.99,843.7,3147.65,29
CPT,74182,MRCP W CNT,4057.0,2036.61,1054.82,3935.29,29
CPT,74182,MRI ABDOMEN W CNT,4057.0,2036.61,1054.82,3935.29,29
CPT,74183,MRCP W&WO CNT,4868.0,2443.74,1265.68,4721.96,29
CPT,74183,MRI ABDOMEN W&WO CNT,4868.0,2443.74,1265.68,4721.96,29
CPT,74185,MRA ABDOMEN W CNT,4260.0,2420.32,1107.6,4132.2,29
CPT,74185,MRA ABDOMEN W/WO CNT,5112.0,2904.38,1329.12,4958.64,29
CPT,74185,MRA ABDOMEN WO CNT,3408.0,1936.26,886.08,3305.76,29
CPT,74220,XR ESOPHAGUS STUDY CNT SINGLE,694.0,371.98,180.44,673.18,29
CPT,74230,FNCT SWALLOW W CINE/VIDEO STUDY CNT,365.0,195.64,94.9,354.05,29
CPT,74240,XR UGI STUDY CNT SINGLE,1043.0,559.05,271.18,1011.71,29
CPT,74246,XR UGI STUDY CNT DOUBLE,1113.0,596.57,289.38,1079.61,29
CPT,74248,XR INTESTINE SM STUDY FOLLOW THRU,327.0,175.27,85.02,317.19,29
CPT,74250,XR INTESTINE SM STUDY CNT SINGLE,312.0,167.23,81.12,302.64,29
CPT,74251,XR INTESTINE SM STUDY CNT DOUBLE,1913.0,1025.37,497.38,1855.61,29
CPT,74270,XR COLON STUDY CNT SINGLE,615.0,329.64,159.9,596.55,29
CPT,74280,XR COLON STUDY CNT DOUBLE,937.0,502.23,243.62,908.89,29
CPT,74283,ENEMA THERAPEUTIC,635.0,340.36,165.1,615.95,29
CPT,74290,CHOLECYSTOGRAPHY CNT ORAL,326.0,174.74,84.76,316.22,29
CPT,74300,CHOLANGIO&/PANCREATOGRAM OR S&I,723.0,387.53,187.98,701.31,29
CPT,74301,CHOLANGIO&/PANCREATOGRAM OR ADD S&I,296.0,158.66,76.96,287.12,29
CPT,74330,CATH ENDO DUCT BILIARY&PANCREAS S&I,497.0,266.39,129.22,482.09,29
CPT,74340,INTRO TUBE GI LONG W FLUORO S&I,197.0,105.59,51.22,191.09,29
CPT,74400,UROGRAPHY IV W/WO KUB,612.0,328.03,159.12,593.64,29
CPT,74420,UROGRAPHY RETROGRADE W/WO KUB,536.0,287.3,139.36,519.92,29
CPT,74425,UROGRAPHY ANTEGRADE S&I,845.0,452.92,219.7,819.65,29
CPT,74430,CYSTOGRAM 3+ VW S&I,532.0,285.15,138.32,516.04,29
CPT,74450,URETHROCYSTOGRAM RETROGRADE S&I,491.0,263.18,127.66,476.27,29
CPT,74455,URETHROCYSTOGRAM VOIDING S&I,561.0,300.7,145.86,544.17,29
CPT,74740,HYSTEROSALPINGOGRAM S&I,1086.0,582.1,282.36,1053.42,29
CPT,75635,CTA AORTA ABD RUNOFF W CNT,5215.0,2070.36,1355.9,5058.55,29
CPT,75809,SHUNTOGRAM NONVASCULAR S&I,273.0,146.33,70.98,264.81,29
CPT,75820,VENOGRAM EXTREMITY LT S&I,816.0,437.38,212.16,791.52,29
CPT,75820,VENOGRAM EXTREMITY RT S&I,816.0,437.38,212.16,791.52,29
CPT,75822,VENOGRAM EXTREMITY BI S&I,1225.0,656.6,318.5,1188.25,29
CPT,76000,FLUORO 0-1HR TIME PHYS/QHCP,780.0,418.08,202.8,756.6,29
CPT,76010,XR FB NOSE TO RECTUM CHILD 1 VW,173.0,92.73,44.98,167.81,29
CPT,76014,MR ASSESS IMP&/FB CLIN INIT 15MIN,44.0,23.58,11.44,42.68,29
CPT,76015,MR ASSESS IMP&/FB CLIN EA ADD 30MIN,130.0,69.68,33.8,126.1,29
CPT,76016,MR DETERMIN SAFETY PHYS/QHCP,108.0,57.89,28.08,104.76,29
CPT,76017,MR CUST EXAM MED PHYSICS SAFETY PLN,456.0,244.42,118.56,442.32,29
CPT,76018,MR PREP ELECT IMP SAFETY PHYS/QHCP,257.0,137.75,66.82,249.29,29
CPT,76019,MR POS IMP SAFETY&/IMMOB PHYS/QHCP,306.0,164.02,79.56,296.82,29
CPT,76080,XR ABSCESS/SINUS/FISTULA S&I,593.0,317.85,154.18,575.21,29
CPT,76098,XR SPECIMEN SURGICAL,234.0,125.42,60.84,226.98,29
CPT,76376,CT REND 3D W I&R W PP SAME WRKST,331.0,131.41,86.06,321.07,29
CPT,76376,MRI REND 3D W I&R W PP SAME WRKST,331.0,166.16,86.06,321.07,29
CPT,76376,US REND 3D W I&R W PP SAME WRKST,331.0,231.04,86.06,321.07,29
CPT,76377,CT REND 3D W I&R W PP DIFF WRKST,492.0,195.32,127.92,477.24,29
CPT,76377,MRI REND 3D W I&R W PP DIFF WRKST,492.0,246.98,127.92,477.24,29
CPT,76377,US REND 3D W I&R W PP DIFF WRKST,492.0,343.42,127.92,477.24,29
CPT,76380,CT LTD/FOLLOWUP,872.0,346.18,226.72,845.84,29
CPT,76506,US HEAD NEONATAL,420.0,293.16,109.2,407.4,29
CPT,76536,US TISSUE SOFT HEAD&NECK,926.0,646.35,240.76,898.22,29
CPT,76604,US CHEST,577.0,402.75,150.02,559.69,29
CPT,76641,US BREAST CMP BI,1022.0,713.36,265.72,991.34,29
CPT,76641,US BREAST CMP LT,681.0,475.34,177.06,660.57,29
CPT,76641,US BREAST CMP RT,681.0,475.34,177.06,660.57,29
CPT,76642,US BREAST LTD BI,945.0,659.61,245.7,916.65,29
CPT,76642,US BREAST LTD LT,630.0,439.74,163.8,611.1,29
CPT,76642,US BREAST LTD RT,630.0,439.74,163.8,611.1,29
CPT,76700,US ABDOMEN CMP,1001.0,698.7,260.26,970.97,29
CPT,76705,US ABDOMEN LTD,887.0,619.13,230.62,860.39,29
CPT,76706,US SCREEN AAA,465.0,324.57,120.9,451.05,29
CPT,76770,US RETROPERITONEAL CMP,875.0,610.75,227.5,848.75,29
CPT,76775,US RETROPERITONEAL LTD,688.0,480.22,178.88,667.36,29
CPT,76776,US KIDNEY TRANSPLANTED W DOPPLER,474.0,330.85,123.24,459.78,29
CPT,76800,US SPINAL CANAL&CONTENTS,482.0,336.44,125.32,467.54,29
CPT,76801,US UTERUS PREG 0-13WK GEST SGL,901.0,628.9,234.26,873.97,29
CPT,76802,US UTERUS PREG 0-13WK GEST ADDL,253.0,176.59,65.78,245.41,29
CPT,76805,US UTERUS PREG 14+WK GEST SGL,1029.0,718.24,267.54,998.13,29
CPT,76810,US UTERUS PREG 14+WK GEST ADDL,460.0,321.08,119.6,446.2,29
CPT,76811,US UTERUS PREG DETAIL GEST SGL,558.0,389.48,145.08,541.26,29
CPT,76812,US UTERUS PREG DETAIL GEST ADDL,959.0,669.38,249.34,930.23,29
CPT,76813,US UTERUS PREG MEAS NUCHAL GEST SGL,427.0,298.05,111.02,414.19,29
CPT,76814,US UTERUS PREG MEAS NUCHAL GEST ADD,249.0,173.8,64.74,241.53,29
CPT,76815,US UTERUS PREG LTD 1+ FETUS,705.0,492.09,183.3,683.85,29
CPT,76816,US UTERUS PREG RE-EVAL FETUS,737.0,514.43,191.62,714.89,29
CPT,76816,US UTERUS PREG RE-EVAL FETUS ADDL,737.0,514.43,191.62,714.89,29
CPT,76817,US UTERUS PREG TRANSVAGINAL,809.0,564.68,210.34,784.73,29
CPT,76818,US PROFILE BIO FETAL W NST,620.0,432.76,161.2,601.4,29
CPT,76818,US PROFILE BIO FETAL W NST ADDL,620.0,432.76,161.2,601.4,29
CPT,76819,US PROFILE BIO FETAL WO NST,435.0,303.63,113.1,421.95,29
CPT,76819,US PROFILE BIO FETAL WO NST ADDL,435.0,303.63,113.1,421.95,29
CPT,76820,VELOCIMETRY DOPPLER ART UMB FETAL,319.0,222.66,82.94,309.43,29
CPT,76821,VELOCIMETRY DOPPLER ART CERE FETAL,525.0,366.45,136.5,509.25,29
CPT,76830,US TRANSVAGINAL,827.0,577.25,215.02,802.19,29
CPT,76831,SONOHYSTEROGRAPHY INF SALINE,510.0,355.98,132.6,494.7,29
CPT,76856,US PELVIS NON OB CMP,930.0,649.14,241.8,902.1,29
CPT,76857,US PELVIS NON OB LTD,786.0,548.63,204.36,762.42,29
CPT,76870,US SCROTUM&CONTENTS,846.0,590.51,219.96,820.62,29
CPT,76872,US TRANSRECTAL,292.0,203.82,75.92,283.24,29
CPT,76882,US JT/EVAL FOCAL EXT NONVASC LTD,695.0,485.11,180.7,674.15,29
CPT,76885,US HIPS INFANT DYNAMIC,253.0,176.59,65.78,245.41,29
CPT,76886,US HIPS INFANT STATIC,168.0,117.26,43.68,162.96,29
CPT,76936,US GD RPR PSEUDOAN ART/FISTULA AV,752.0,524.9,195.52,729.44,29
CPT,76937,US GD VA EVAL SITE W REC PERM,182.0,127.04,47.32,176.54,58
CPT,76942,US GD PLCMT NEEDLE S&I,662.0,462.08,172.12,642.14,29
CPT,76946,US GD AMNIOCENTESIS S&I,433.0,302.23,112.58,420.01,29
CPT,76998,US GD INTRAOPERATIVE,331.0,231.04,86.06,321.07,29
CPT,77001,FLUORO GD PLC/REPL/REM CVAD,390.0,209.04,101.4,378.3,29
CPT,77002,FLUORO GD PLCMT NEEDLE,731.0,391.82,190.06,709.07,29
CPT,77003,FLUORO GD&LOC NEEDLE SPINE,585.0,313.56,152.1,567.45,29
CPT,77012,CT GD PLCMT NEEDLE S&I,966.0,383.5,251.16,937.02,29
CPT,77021,MRI GD PLC NDL S&I,870.0,436.74,226.2,843.9,29
CPT,77046,MRI BREAST WO CNT LT,983.0,493.47,255.58,953.51,29
CPT,77046,MRI BREAST WO CNT RT,983.0,493.47,255.58,953.51,29
CPT,77047,MRI BREAST WO CNT BI,1162.0,583.32,302.12,1127.14,29
CPT,77048,MRI BREAST W&WO CNT LT,1475.0,740.45,383.5,1430.75,29
CPT,77048,MRI BREAST W&WO CNT RT,1475.0,740.45,383.5,1430.75,29
CPT,77049,MRI BREAST W&WO CNT BI,1743.0,874.99,453.18,1690.71,29
CPT,77053,DUCTO/GALACTOGRAM MAMMARY SGL LTS&I,388.0,207.97,100.88,376.36,29
CPT,77053,DUCTO/GALACTOGRAM MAMMARY SGL RTS&I,388.0,207.97,100.88,376.36,29
CPT,77054,DUCTO/GALACTOGRAM MAMMARY MULTI S&I,433.0,232.09,112.58,420.01,29
CPT,77063,TOMOSYNTHESIS SCRN DIG BRST BI,63.0,41.2,16.38,61.11,29
CPT,77065,MAMMO DX W/WO CAD LT,211.0,132.3,54.86,204.67,29
CPT,77065,MAMMO DX W/WO CAD RT,211.0,132.3,54.86,204.67,29
CPT,77066,MAMMO DX W/WO CAD BI,271.0,169.92,70.46,262.87,29
CPT,77067,MAMMO SCRN W/WO CAD 2 VW BI,336.0,219.74,87.36,325.92,29
CPT,77067,MAMMO SCRN W/WO CAD 2 VW BI RDC,224.0,146.5,58.24,217.28,29
CPT,77071,APPLY MANUAL STRESS JOINT UNI/BI,211.0,113.1,54.86,204.67,29
CPT,77072,STUDIES AGE BONE,325.0,174.2,84.5,315.25,29
CPT,77073,STUDIES LENGTH BONE,609.0,326.42,158.34,590.73,58
CPT,77074,XR SURVEY OSSEOUS LTD,267.0,143.11,69.42,258.99,29
CPT,77075,XR SURVEY OSSEOUS CMP,388.0,207.97,100.88,376.36,29
CPT,77076,XR SURVEY OSSEOUS INFANT,456.0,244.42,118.56,442.32,29
CPT,77078,CT DENSITY BONE AXIAL 1+ SITE,278.0,136.22,72.28,269.66,29
CPT,77080,DXA STUDY DENSITY 1+SKEL AX,604.0,323.74,157.04,585.88,29
CPT,77081,DXA STUDY DENSITY 1+SKEL APPEND,388.0,207.97,100.88,376.36,29
CPT,77084,MRI BONE MARROW,1725.0,865.95,448.5,1673.25,29
CPT,77085,DXA STUDY DENSITY 1+SKEL AX FX VERT,667.0,357.51,173.42,646.99,29
CPT,77086,DXA VERTEBRAL FRACTURE ASSESSMENT,176.0,94.34,45.76,170.72,29
CPT,78012,NM THYROID UPTAKE MEAS QN SGL/MULT,492.0,265.68,127.92,477.24,29
CPT,78013,NM THYROID W/WO FLOW VASCULAR,515.0,278.1,133.9,499.55,29
CPT,78014,NM THYROID UPTAKE MEAS W/WO FLW STM,739.0,399.06,192.14,716.83,29
CPT,78070,NM PLANAR PARATHYROID,1209.0,652.86,314.34,1172.73,29
CPT,78195,NM LYMPH SYSTEM,1048.0,565.92,272.48,1016.56,29
CPT,78201,NM LIVER STATIC,795.0,429.3,206.7,771.15,29
CPT,78202,NM LIVER W FLOW VASCULAR,1124.0,606.96,292.24,1090.28,29
CPT,78215,NM LIVER&SPLEEN STATIC,736.0,397.44,191.36,713.92,29
CPT,78216,NM LIVER&SPLEEN W FLOW VASCULAR,700.0,378.0,182.0,679.0,29
CPT,78226,NM HEPATOBILIARY W/WO GB,918.0,495.72,238.68,890.46,29
CPT,78227,NM HEPATOBILIARY W PHARM W/WO GB,2462.0,1329.48,640.12,2388.14,29
CPT,78258,NM MOTILITY ESOPHAGEAL,970.0,523.8,252.2,940.9,29
CPT,78262,NM REFLUX GASTROESOPHAGEAL,1792.0,967.68,465.92,1738.24,29
CPT,78264,NM EMPTYING GASTRIC,2196.0,1185.84,570.96,2130.12,29
CPT,78267,NM TEST BREATH UREA C14 ACQ,35.0,18.9,9.1,33.95,29
CPT,78268,NM TEST BREATH UREA C14 ANALYSIS,285.0,153.9,74.1,276.45,29
CPT,78278,NM LOSS BLOOD GI ACUTE,1226.0,662.04,318.76,1189.22,29
CPT,78290,NM INTESTINE,1102.0,595.08,286.52,1068.94,29
CPT,78291,NM PATENCY SHUNT PERITONEAL VENOUS,923.0,498.42,239.98,895.31,29
CPT,78300,NM BONE&/JOINT LTD,1918.0,1035.72,498.68,1860.46,29
CPT,78305,NM BONE&/JOINT MULTIPLE,2292.0,1237.68,595.92,2223.24,29
CPT,78306,NM BONE&/JOINT BODY WHOLE,2915.0,1574.1,757.9,2827.55,29
CPT,78315,NM BONE&/JOINT PHASE 3,2984.0,1611.36,775.84,2894.48,29
CPT,78445,NM FLOW VASCULAR NON-CARDIAC,809.0,436.86,210.34,784.73,29
CPT,78451,NM PERF MYOC SPECT WM/EF SGL,4551.0,2457.54,1183.26,4414.47,29
CPT,78452,NM PERF MYOC SPEC WM/EF MULT,5478.0,2958.12,1424.28,5313.66,29
CPT,78472,NM MUGA REST/STRESS PLANAR SGL,2457.0,1326.78,638.82,2383.29,29
CPT,78473,NM MUGA REST&STRESS MULTI,2504.0,1352.16,651.04,2428.88,29
CPT,78481,NM POOL BLOOD CARDIAC 1ST PASS SGL,848.0,457.92,220.48,822.56,29
CPT,78494,NM MUGA REST W SPECT,1803.0,973.62,468.78,1748.91,29
CPT,78580,NM PERF PULMONARY,1360.0,734.4,353.6,1319.2,29
CPT,78582,NM VENT&PERF PULMONARY,1467.0,792.18,381.42,1422.99,29
CPT,78605,NM BRAIN 4+ VW STATIC,769.0,415.26,199.94,745.93,29
CPT,78606,NM BRAIN 4+ VW STATIC W FLOW,1280.0,691.2,332.8,1241.6,29
CPT,78610,NM FLOW VASCULAR BRAIN,576.0,311.04,149.76,558.72,29
CPT,78630,NM FLOW CSF CISTERNOGRAM,844.0,455.76,219.44,818.68,29
CPT,78645,NM FLOW CSF EVAL SHUNT,1305.0,704.7,339.3,1265.85,29
CPT,78650,NM DETECTION&LOC LEAK CSF,1878.0,1014.12,488.28,1821.66,29
CPT,78700,NM KIDNEY,812.0,438.48,211.12,787.64,29
CPT,78701,NM KIDNEY W FLOW VASCULAR,1040.0,561.6,270.4,1008.8,29
CPT,78707,NM KIDNEY FUNCTION&FLOW,1407.0,759.78,365.82,1364.79,29
CPT,78708,NM KIDNEY FUNCTION&FLOW PHARM SGL,964.0,520.56,250.64,935.08,29
CPT,78709,NM KIDNEY FUNCTION&FLOW PHARM MULTI,1980.0,1069.2,514.8,1920.6,29
CPT,78740,NM REFLEX URETERAL,1071.0,578.34,278.46,1038.87,29
CPT,78761,NM TESTICULAR W FLOW VASCULAR,1012.0,546.48,263.12,981.64,29
CPT,78800,NM LOC RRX TMR PLNR 1 AREA 1D IMG,821.0,443.34,213.46,796.37,29
CPT,78801,NM LOC RRX TMR PLNR 2+AREA 1+D IMG,846.0,456.84,219.96,820.62,29
CPT,78802,NM LOC RRX TMR PLNR WHL BODY 1D IMG,958.0,517.32,249.08,929.26,29
CPT,78803,NM LOC RRX TMR SPECT 1AREA 1ACQ 1D,971.0,524.34,252.46,941.87,29
CPT,78804,NM LOC RRX TMR PLNR WHL BODY 2D IMG,1261.0,680.94,327.86,1223.17,29
CPT,78830,NM LOC RRX TMR SPECT CT 1AREA 1ACQ,1099.0,593.46,285.74,1066.03,29
CPT,78831,NM LOC RRX TMR SPECT 2+AREA 2ACQ,1837.0,991.98,477.62,1781.89,29
CPT,78832,NM LOC RRX TMR SPECT CT 2+AREA 2ACQ,2178.0,1176.12,566.28,2112.66,29
CPT,80048,LAB PANEL METAB BASIC W CA TOTAL,100.0,48.2,26.0,97.0,29
CPT,80051,LAB PANEL ELECTROLYTE,71.0,34.22,18.46,68.87,29
CPT,80053,LAB PANEL METAB COMP,124.0,59.77,32.24,120.28,29
CPT,80061,LAB PANEL LIPID,92.0,44.34,23.92,89.24,29
CPT,80061,LAB PANEL LIPID NS,69.0,33.26,17.94,66.93,29
CPT,80069,LAB PANEL FUNCTION RENAL,141.0,67.96,36.66,136.77,29
CPT,80074,LAB PANEL HEPATITIS ACUTE,226.0,108.93,58.76,219.22,29
CPT,80076,LAB PANEL FUNCTION HEPATIC,98.0,47.24,25.48,95.06,29
CPT,80145,LAB ADALIMUMAB,300.0,144.6,78.0,291.0,29
CPT,80150,LAB AMIKACIN PEAK,59.0,28.44,15.34,57.23,29
CPT,80150,LAB AMIKACIN RANDOM,62.0,29.88,16.12,60.14,29
CPT,80150,LAB AMIKACIN TROUGH,62.0,29.88,16.12,60.14,29
CPT,80151,LAB AMIODARONE,90.0,43.38,23.4,87.3,29
CPT,80155,LAB CAFFEINE,116.0,55.91,30.16,112.52,29
CPT,80156,LAB CARBAMAZEPINE TOTAL,52.0,25.06,13.52,50.44,29
CPT,80157,LAB CARBAMAZEPINE FREE,90.0,43.38,23.4,87.3,29
CPT,80158,LAB CYCLOSPORINE A,58.0,27.96,15.08,56.26,29
CPT,80159,LAB CLOZAPINE/NORCLOZAPINE,68.0,32.78,17.68,65.96,29
CPT,80161,LAB CARBAMAZEPINE -10 11-EPOXIDE,58.0,27.96,15.08,56.26,29
CPT,80161,LAB CARBAMAZEPINE -10 11-EPOXIDE NS,90.0,43.38,23.4,87.3,29
CPT,80162,LAB DIGOXIN TOTAL,53.0,25.55,13.78,51.41,29
CPT,80164,LAB ACID VALPROIC TOTAL,53.0,25.55,13.78,51.41,29
CPT,80164,LAB ACID VALPROIC TOTAL NS,66.0,31.81,17.16,64.02,29
CPT,80165,LAB ACID VALPROIC FREE,66.0,31.81,17.16,64.02,29
CPT,80167,LAB FELBAMATE,74.0,35.67,19.24,71.78,29
CPT,80168,LAB ETHOSUXIMIDE,107.0,51.57,27.82,103.79,29
CPT,80169,LAB EVEROLIMUS,60.0,28.92,15.6,58.2,29
CPT,80170,LAB GENTAMICIN PEAK,82.0,39.52,21.32,79.54,29
CPT,80170,LAB GENTAMICIN TROUGH,82.0,39.52,21.32,79.54,29
CPT,80171,LAB GABAPENTIN SRM/PLASMA/BLD WHL,77.0,37.11,20.02,74.69,29
CPT,80173,LAB HALOPERIDOL,99.0,47.72,25.74,96.03,29
CPT,80175,LAB LAMOTRIGINE,61.0,29.4,15.86,59.17,29
CPT,80177,LAB LEVETIRACETAM NS,63.0,30.37,16.38,61.11,29
CPT,80178,LAB LITHIUM,52.0,25.06,13.52,50.44,29
CPT,80180,LAB ACID MYCOPHENOLIC,55.0,26.51,14.3,53.35,29
CPT,80180,LAB ACID MYCOPHENOLIC NS,55.0,26.51,14.3,53.35,29
CPT,80183,LAB OXCARBAZEPINE,69.0,33.26,17.94,66.93,29
CPT,80184,LAB PHENOBARBITAL,54.0,26.03,14.04,52.38,29
CPT,80184,LAB PHENOBARBITAL NS,59.0,28.44,15.34,57.23,29
CPT,80185,LAB PHENYTOIN TOTAL,59.0,28.44,15.34,57.23,29
CPT,80186,LAB PHENYTOIN FREE,63.0,30.37,16.38,61.11,29
CPT,80187,LAB POSACONAZOLE,118.0,56.88,30.68,114.46,29
CPT,80188,LAB PRIMIDONE NS,59.0,28.44,15.34,57.23,29
CPT,80189,LAB ITRACONAZOLE,131.0,63.14,34.06,127.07,29
CPT,80192,LAB PROCAINAMIDE W NAPA,51.0,24.58,13.26,49.47,29
CPT,80194,LAB QUINIDINE,60.0,28.92,15.6,58.2,29
CPT,80195,LAB SIROLIMUS,57.0,27.47,14.82,55.29,29
CPT,80197,LAB TACROLIMUS FK-506,57.0,27.47,14.82,55.29,29
CPT,80197,LAB TACROLIMUS FK-506 NS,64.0,30.85,16.64,62.08,29
CPT,80198,LAB THEOPHYLLINE,43.0,20.73,11.18,41.71,29
CPT,80200,LAB TOBRAMYCIN PEAK,49.0,23.62,12.74,47.53,29
CPT,80200,LAB TOBRAMYCIN RANDOM,49.0,23.62,12.74,47.53,29
CPT,80200,LAB TOBRAMYCIN TROUGH,49.0,23.62,12.74,47.53,29
CPT,80201,LAB TOPIRAMATE,36.0,17.35,9.36,34.92,29
CPT,80202,LAB VANCOMYCIN PEAK,41.0,19.76,10.66,39.77,29
CPT,80202,LAB VANCOMYCIN RANDOM,41.0,19.76,10.66,39.77,29
CPT,80202,LAB VANCOMYCIN TROUGH,41.0,19.76,10.66,39.77,29
CPT,80203,LAB ZONISAMIDE,79.0,38.08,20.54,76.63,29
CPT,80230,LAB INFLIXIMAB,266.0,128.21,69.16,258.02,29
CPT,80235,LAB LACOSAMIDE,82.0,39.52,21.32,79.54,29
CPT,80280,LAB VEDOLIZUMAB,317.0,152.79,82.42,307.49,29
CPT,80285,LAB VORICONAZOLE,127.0,61.21,33.02,123.19,29
CPT,80299,LAB BACLOFEN,132.0,63.62,34.32,128.04,29
CPT,80299,LAB CHLORDIAZEPOXIDE,169.0,81.46,43.94,163.93,29
CPT,80299,LAB CLOMIPRAMINE,62.0,29.88,16.12,60.14,29
CPT,80299,LAB CLONAZEPAM,67.0,32.29,17.42,64.99,29
CPT,80299,LAB DEXAMETHASONE,60.0,28.92,15.6,58.2,29
CPT,80299,LAB FLUCONAZOLE,111.0,53.5,28.86,107.67,29
CPT,80299,LAB ISAVUCONAZOLE,135.0,65.07,35.1,130.95,29
CPT,80299,LAB NORTRIPTYLINE,68.0,32.78,17.68,65.96,29
CPT,80299,LAB OLANZAPINE,197.0,94.95,51.22,191.09,29
CPT,80299,LAB THIOPURINE,160.0,77.12,41.6,155.2,29
CPT,80299,LAB USTEKINUMAB,226.0,108.93,58.76,219.22,29
CPT,80307,LAB DRG SC INST ALYZ CORD TIS DAY,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ CORD TIS DAYNS,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ MECON DAY NS,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ SERUM DAY,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ SERUM DAY NS,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ URINE DAY,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ URINE DAY NS,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ URINE ETOH DAY,187.0,90.13,48.62,181.39,29
CPT,80307,LAB DRG SC INST ALYZ URINE PMGT DAY,449.0,216.42,116.74,435.53,29
CPT,80320,LAB DRG DF ETOH EXCEPT BR DAY,117.0,56.39,30.42,113.49,29
CPT,80320,LAB DRG DF ETOH EXCEPT BR DAY NS,61.0,29.4,15.86,59.17,29
CPT,80321,LAB DRG DF ETOH BIOMRK 1-2,130.0,62.66,33.8,126.1,29
CPT,80321,LAB DRG DF ETOH BIOMRK TIS CORD 1-2,110.0,53.02,28.6,106.7,29
CPT,80321,LAB DRG DF ETOH BIOMRK URINE 1-2,158.0,76.16,41.08,153.26,29
CPT,80323,LAB DRG DF ALKALOIDS NICOTINE DAY,105.0,50.61,27.3,101.85,29
CPT,80324,LAB DRG DF AMPH/METH DAY 1-2 NON UR,56.0,26.99,14.56,54.32,29
CPT,80324,LAB DRG DF AMPH/METH DAY 1-2 NS,73.0,35.19,18.98,70.81,29
CPT,80324,LAB DRG DF AMPH/METH MCNIUM DAY 1-2,83.0,40.01,21.58,80.51,29
CPT,80324,LAB DRG DF CNFRM AMPH DAY 1-2,73.0,35.19,18.98,70.81,29
CPT,80329,LAB DRG DF ANLG ACETAMINPHN DAY 1-2,154.0,74.23,40.04,149.38,29
CPT,80329,LAB DRG DF ANLG NON-OPIOID DAY 1-2,57.0,27.47,14.82,55.29,29
CPT,80329,LAB DRG DF ANLG SALICYLATE DAY 1-2,154.0,74.23,40.04,149.38,29
CPT,80332,LAB DRG DF ANTD SEROTONERG DAY 1-2,51.0,24.58,13.26,49.47,29
CPT,80333,LAB DRG DF ANTD SEROTONERG DAY 3-5,97.0,46.75,25.22,94.09,29
CPT,80335,LAB DRG DF ANTD CLOM DAY 1-2,62.0,29.88,16.12,60.14,29
CPT,80335,LAB DRG DF ANTD CYCL AMIT DAY 1-2,62.0,29.88,16.12,60.14,29
CPT,80335,LAB DRG DF ANTD CYCL DESI DAY 1-2NS,62.0,29.88,16.12,60.14,29
CPT,80335,LAB DRG DF ANTD CYCL DOXE DAY 1-2,62.0,29.88,16.12,60.14,29
CPT,80335,LAB DRG DF ANTD CYCL IMIPRM DAY 1-2,62.0,29.88,16.12,60.14,29
CPT,80335,LAB DRG DF ANTD CYCL NORT DAY 1-2,68.0,32.78,17.68,65.96,29
CPT,80337,LAB DRG DF ANTD CYCL DAY 6+,87.0,41.93,22.62,84.39,29
CPT,80338,LAB DRG DF ANTD NOT SRTNRG/CYCL DAY,52.0,25.06,13.52,50.44,29
CPT,80338,LAB DRG DF TRAZODONE DAY,70.0,33.74,18.2,67.9,29
CPT,80339,LAB DRG DF ANTIEPILEPTICS DAY 1-3,176.0,84.83,45.76,170.72,29
CPT,80342,LAB DRG DF ANTPSY DAY 1-3,57.0,27.47,14.82,55.29,29
CPT,80345,LAB DRG DF BARB PHENOBARB DAY NS,158.0,76.16,41.08,153.26,29
CPT,80345,LAB DRG DF BARB PHENOBARB NON URINE,56.0,26.99,14.56,54.32,29
CPT,80345,LAB DRG DF BARB URINE DAY,67.0,32.29,17.42,64.99,29
CPT,80346,LAB DRG DF BENZ CLONAZEPM DAY 1-12,67.0,32.29,17.42,64.99,29
CPT,80346,LAB DRG DF BENZ DAY 1-12,84.0,40.49,21.84,81.48,29
CPT,80346,LAB DRG DF BENZ DAY 1-12 NON URINE,56.0,26.99,14.56,54.32,29
CPT,80348,LAB DRG DF BUPRENORPHINE DAY NON UR,56.0,26.99,14.56,54.32,29
CPT,80348,LAB DRG DF BUPRENORPHINE DAY NS,109.0,52.54,28.34,105.73,29
CPT,80348,LAB DRG DF BUPRENORPHINE MECON DAY,129.0,62.18,33.54,125.13,29
CPT,80349,LAB DRG DF CANNABINOIDS DAY,84.0,40.49,21.84,81.48,29
CPT,80349,LAB DRG DF CANNABINOIDS DAY NON UR,56.0,26.99,14.56,54.32,29
CPT,80353,LAB DRG DF COCAINE DAY,67.0,32.29,17.42,64.99,29
CPT,80353,LAB DRG DF COCAINE DAY NON URINE,56.0,26.99,14.56,54.32,29
CPT,80353,LAB DRG DF COCAINE MECONIUM,149.0,71.82,38.74,144.53,29
CPT,80354,LAB DRG DF FENTANYL DAY,67.0,32.29,17.42,64.99,29
CPT,80354,LAB DRG DF FENTANYL DAY NON URINE,56.0,26.99,14.56,54.32,29
CPT,80355,LAB DRG DF GABAPENTN NON BLD DAY,56.0,26.99,14.56,54.32,29
CPT,80356,LAB DRG DF HEROIN METABOLITE DAY,56.0,26.99,14.56,54.32,29
CPT,80357,LAB DRG DF KETAMN&NORKETMN DAY,145.0,69.89,37.7,140.65,29
CPT,80358,LAB DRG DF METHADONE DAY,58.0,27.96,15.08,56.26,29
CPT,80358,LAB DRG DF METHADONE DAY NON URINE,56.0,26.99,14.56,54.32,29
CPT,80358,LAB DRG DF METHADONE DAY NS,67.0,32.29,17.42,64.99,29
CPT,80358,LAB DRG DF METHADONE MECONIUM DAY,165.0,79.53,42.9,160.05,29
CPT,80359,LAB DRG DF METHYLENEDIOXYAMP NON UR,56.0,26.99,14.56,54.32,29
CPT,80359,LAB DRG DF METHYLENEDIOXYAMPH NS,70.0,33.74,18.2,67.9,29
CPT,80360,LAB DRG DF METHYLPHENIDATE DAY,67.0,32.29,17.42,64.99,29
CPT,80361,LAB DRG DF OPIATE DAY 1+,104.0,50.13,27.04,100.88,29
CPT,80361,LAB DRG DF OPIATE DAY 1+ NON URINE,56.0,26.99,14.56,54.32,29
CPT,80361,LAB DRG DF OPIATE MECONIUM DAY 1+,70.0,33.74,18.2,67.9,29
CPT,80362,LAB DRG DF OPIOID DAY 1-2 TISSUE,56.0,26.99,14.56,54.32,29
CPT,80364,LAB DRG DF ANLG OPIOID&OPIAT UR 5+,97.0,46.75,25.22,94.09,29
CPT,80365,LAB DRG DF OXYCODONE DAY,104.0,50.13,27.04,100.88,29
CPT,80365,LAB DRG DF OXYCODONE DAY NON URINE,56.0,26.99,14.56,54.32,29
CPT,80365,LAB DRG DF OXYCODONE MECONIUM DAY,70.0,33.74,18.2,67.9,29
CPT,80366,LAB DRG DF PREGABALIN,95.0,45.79,24.7,92.15,29
CPT,80367,LAB DRG DF CONF PROPOXYPHENE DAY NS,56.0,26.99,14.56,54.32,29
CPT,80368,LAB DRG DF HYPNOTICS SED DAY,56.0,26.99,14.56,54.32,29
CPT,80369,LAB DRG DF MSCL RELAX DAY 1-2,154.0,74.23,40.04,149.38,29
CPT,80371,LAB DRG DF STIMULANTS SYN DAY,160.0,77.12,41.6,155.2,29
CPT,80372,LAB DRG DF TAPENTADOL DAY,56.0,26.99,14.56,54.32,29
CPT,80373,LAB DRG DF TRAMADOL,67.0,32.29,17.42,64.99,29
CPT,80373,LAB DRG DF TRAMADOL NON URINE,56.0,26.99,14.56,54.32,29
CPT,80375,LAB DRG DF BRIVARACETAM DAY 1-3,189.0,91.1,49.14,183.33,29
CPT,80375,LAB DRG DF FUROSEMIDE DAY 1-3,187.0,90.13,48.62,181.39,29
CPT,80375,LAB DRG DF MITOTANE DAY 1-3,187.0,90.13,48.62,181.39,29
CPT,80375,LAB DRG DF SULFONAMIDES DAY 1-3,147.0,70.85,38.22,142.59,29
CPT,80375,LAB DRG DF THIOPURINE DAY 1-3,160.0,77.12,41.6,155.2,29
CPT,80375,LAB DRG DF TPMT ACTIVITY DAY 1-3,187.0,90.13,48.62,181.39,29
CPT,80377,LAB DRG DF SULFONYLUREAS DAY 7+,178.0,85.8,46.28,172.66,29
CPT,81001,LAB UA AUTO W MICRO,10.0,4.81,2.6,9.7,29
CPT,81002,LAB UA NONAUTO WO MICRO,11.0,5.29,2.86,10.67,29
CPT,81002,LAB UA REDUCING SUBSTANCE,11.0,5.29,2.86,10.67,29
CPT,81003,LAB UA AUTO WO MICRO,7.0,3.37,1.82,6.79,29
CPT,81003,LAB UA GRAVITY SPCFC AUTO WO MICRO,53.0,25.49,13.78,51.41,29
CPT,81005,LAB UA QL/SEMI QN,7.0,3.37,1.82,6.79,29
CPT,81015,LAB UA MICROSCOPIC ONLY,10.0,4.81,2.6,9.7,29
CPT,81025,LAB PREGNANCY URINE,58.0,27.9,15.08,56.26,29
CPT,81050,LAB MEASUREMENT VOL COLL TIMED EA,11.0,5.29,2.86,10.67,29
CPT,81162,LAB GENE BRCA1&2 SEQ&DUP/DEL FULL,5475.0,2660.85,1423.5,5310.75,29
CPT,81163,LAB GENE BRCA1&2 ANLY SEQ FULL,1404.0,682.34,365.04,1361.88,29
CPT,81170,LAB GENE ABL1 VAR KD,900.0,437.4,234.0,873.0,29
CPT,81206,LAB GENE BCR/ABL1 BREAKPOINT MAJOR,492.0,239.11,127.92,477.24,29
CPT,81206,LAB GENE BCR/ABL1 REFLEX P210,492.0,239.11,127.92,477.24,29
CPT,81206,LAB GENE BCR/ABL1 REFLEX P210 NS,492.0,239.11,127.92,477.24,29
CPT,81207,LAB GENE BCR/ABL1 BREAKPOINT MIN,435.0,211.41,113.1,421.95,29
CPT,81207,LAB GENE BCR/ABL1 BREAKPOINT MIN NS,435.0,211.41,113.1,421.95,29
CPT,81208,LAB GENE BCR/ABL1 BREAKPOINT OTHER,644.0,312.98,167.44,624.68,29
CPT,81210,LAB GENE BRAF VAR V600E NS,527.0,256.12,137.02,511.19,29
CPT,81218,LAB GENE CEBPA SEQ FULL,726.0,352.84,188.76,704.22,29
CPT,81219,LAB GENE ANLYS MUT CALRETICULIN,365.0,177.39,94.9,354.05,29
CPT,81220,LAB GENE CFTR VAR COMMON,1670.0,811.62,434.2,1619.9,29
CPT,81224,LAB GENE CFTR INTRON 8 POLY-T,507.0,246.4,131.82,491.79,29
CPT,81225,LAB GENE CYP2C19 VAR COMMON,875.0,425.25,227.5,848.75,29
CPT,81226,LAB GENE CYP2D6 VAR COMMON,1353.0,657.56,351.78,1312.41,29
CPT,81227,LAB GENE CYP2C9 VAR COMMON,525.0,255.15,136.5,509.25,29
CPT,81229,LAB GENE MA CYTO COPY NO&SNP BLD NS,3480.0,1691.28,904.8,3375.6,29
CPT,81229,LAB GENE MA CYTO COPY NO&SNP POC,3480.0,1691.28,904.8,3375.6,29
CPT,81230,LAB GENE CYP3A4 VAR COMMON,525.0,255.15,136.5,509.25,29
CPT,81231,LAB GENE CYP3A5 VAR COMMON,525.0,255.15,136.5,509.25,29
CPT,81232,LAB GENE DPYD VAR COMMON,525.0,255.15,136.5,509.25,29
CPT,81232,LAB GENE DPYD VAR COMMON NS,525.0,255.15,136.5,509.25,29
CPT,81234,LAB GENE DMPK DET ALLELES ABNRM MYO,825.0,400.95,214.5,800.25,29
CPT,81235,LAB GENE EGFR VAR COMMON,974.0,473.36,253.24,944.78,29
CPT,81240,LAB GENE F2 VAR 20210G>A,198.0,96.23,51.48,192.06,29
CPT,81240,LAB GENE F2 VAR 20210G>A NS,198.0,96.23,51.48,192.06,29
CPT,81241,LAB GENE F5 VAR LEIDEN,221.0,107.41,57.46,214.37,29
CPT,81241,LAB GENE F5 VAR LEIDEN NS,221.0,107.41,57.46,214.37,29
CPT,81243,LAB GENE FMR1 DET ALLELES ABNORMAL,172.0,83.59,44.72,166.84,29
CPT,81244,LAB GENE FMR1 CHARACTER ALLELES,135.0,65.61,35.1,130.95,29
CPT,81245,LAB GENE FLT3 VAR ITD,497.0,241.54,129.22,482.09,29
CPT,81246,LAB GENE FLT3 VAR TKD,249.0,121.01,64.74,241.53,29
CPT,81256,LAB GENE HFE VAR COMMON,197.0,95.74,51.22,191.09,29
CPT,81256,LAB GENE HFE VAR COMMON NS,197.0,95.74,51.22,191.09,29
CPT,81257,LAB GENE HBA1/HBA2 DEL/VAR COMMON,307.0,149.2,79.82,297.79,29
CPT,81259,LAB GENE HBA1/HBA2 SEQ FULL,1800.0,874.8,468.0,1746.0,29
CPT,81261,LAB GENE IGH REARRANGEMENT AMP,594.0,288.68,154.44,576.18,29
CPT,81263,LAB GENE IGH MUT VARIABLE REGION,884.0,429.62,229.84,857.48,29
CPT,81264,LAB GENE IGK REARRANGEMENT CLONAL,519.0,252.23,134.94,503.43,29
CPT,81265,LAB GENE MARKERS STR SPEC PT&CMP,700.0,340.2,182.0,679.0,29
CPT,81265,LAB GENE MARKERS STR SPEC PT&CMP NS,1427.0,693.52,371.02,1384.19,29
CPT,81267,LAB GENE CHIMERISM WO CELL SLCT NS,1139.0,553.55,296.14,1104.83,29
CPT,81270,LAB GENE JAK2 VAR V617F NS,275.0,133.65,71.5,266.75,29
CPT,81271,LAB GENE HTT DET ALLELES ABNORMAL,411.0,199.75,106.86,398.67,29
CPT,81272,LAB GENE ANLYS MUT C-KIT,989.0,480.65,257.14,959.33,29
CPT,81275,LAB GENE KRAS VAR CODONS 12&13 NS,580.0,281.88,150.8,562.6,29
CPT,81276,LAB GENE KRAS VAR ADDL NS,580.0,281.88,150.8,562.6,29
CPT,81279,LAB GENE JAK2 EXON TGT SEQ 12,556.0,270.22,144.56,539.32,29
CPT,81283,LAB GENE IFNL3,221.0,107.41,57.46,214.37,29
CPT,81288,LAB GENE MLH1 METHYLATION,614.0,298.4,159.64,595.58,29
CPT,81291,LAB GENE MTHFR VAR COMMON,197.0,95.74,51.22,191.09,29
CPT,81291,LAB GENE MTHFR VAR COMMON NS,197.0,95.74,51.22,191.09,29
CPT,81292,LAB GENE MLH1 SEQ FULL,2027.0,985.12,527.02,1966.19,29
CPT,81295,LAB GENE MSH2 SEQ FULL,1146.0,556.96,297.96,1111.62,29
CPT,81301,LAB GENE INSTABILITY MICROSATELLITE,1046.0,508.36,271.96,1014.62,29
CPT,81305,LAB GENE MYD88 VAR L265P,527.0,256.12,137.02,511.19,29
CPT,81306,LAB GENE NUDT15 VAR COMMON,875.0,425.25,227.5,848.75,29
CPT,81306,LAB GENE NUDT15 VAR COMMON NS,875.0,425.25,227.5,848.75,29
CPT,81309,LAB GENE PIK3CA ANLYS SEQ TARGETED,825.0,400.95,214.5,800.25,29
CPT,81310,LAB GENE NPM1 VAR EXON 12,740.0,359.64,192.4,717.8,29
CPT,81327,LAB GENE SEPT9 ANLYS METHYLATION,576.0,279.94,149.76,558.72,29
CPT,81328,LAB GENE SLCO1B1 VAR COMMON,525.0,255.15,136.5,509.25,29
CPT,81329,LAB GENE SMN1 ANALYSIS DOSAGE/DEL,525.0,255.15,136.5,509.25,29
CPT,81332,LAB GENE SERPINA1 VAR COMMON,346.0,168.16,89.96,335.62,29
CPT,81335,LAB GENE TPMT,525.0,255.15,136.5,509.25,29
CPT,81335,LAB GENE TPMT NS,525.0,255.15,136.5,509.25,29
CPT,81338,LAB GENE MPL VAR COMMON,451.0,341.41,117.26,437.47,29
CPT,81339,LAB GENE MPL MUTATION EXON 10 ANLYS,556.0,270.22,144.56,539.32,29
CPT,81340,LAB GENE TRB REARRANGEMENT AMP,627.0,304.72,163.02,608.19,29
CPT,81342,LAB GENE TRG REARRANGEMENT CLONAL,605.0,294.03,157.3,586.85,29
CPT,81350,LAB GENE UGT1A1 VAR COMMON,702.0,341.17,182.52,680.94,29
CPT,81350,LAB GENE UGT1A1 VAR COMMON NS,702.0,341.17,182.52,680.94,29
CPT,81355,LAB GENE VKORC1 VAR COMMON,265.0,128.79,68.9,257.05,29
CPT,81364,LAB GENE HBB SEQ FULL,974.0,473.36,253.24,944.78,29
CPT,81371,LAB GENE TYPING HLA 1&2 LR VERIF NS,1214.0,590.0,315.64,1177.58,29
CPT,81372,LAB GENE TYPING HLA 1 LR CMP,1211.0,588.55,314.86,1174.67,29
CPT,81373,LAB GENE TYPING HLA 1 LR LOCUS NS,383.0,186.14,99.58,371.51,29
CPT,81374,LAB GENE TYPING HLA 1 LR AG 1 EA NS,223.0,108.38,57.98,216.31,29
CPT,81376,LAB GENE TYPING HLA 2 LR LOCUS EA,367.0,178.36,95.42,355.99,29
CPT,81377,LAB GENE TYPING HLA 2 LR AG 1 EA,285.0,138.51,74.1,276.45,29
CPT,81381,LAB GENE TYPING HLA 1 HR ALLE 1/GRP,510.0,247.86,132.6,494.7,29
CPT,81382,LAB GENE TYPING HLA 2 HR LOCUS NS,372.0,180.79,96.72,360.84,29
CPT,81383,LAB GENE TYPING HLA 2 HR ALLE 1/GRP,328.0,159.41,85.28,318.16,29
CPT,81400,LAB PROC PATHOLOGY MOLEC LEVEL 1,192.0,93.31,49.92,186.24,29
CPT,81401,LAB MOPATH LVL2 CARDIO IQ APOE GENO,411.0,199.75,106.86,398.67,29
CPT,81401,LAB MOPATH LVL2 CBFB/MYH11 DET QN,411.0,199.75,106.86,398.67,29
CPT,81401,LAB MOPATH LVL2 EML4-ALK,411.0,199.75,106.86,398.67,29
CPT,81402,LAB PROC PATHOLOGY MOLEC LEVEL 3,451.0,219.19,117.26,437.47,29
CPT,81403,LAB PROC PATHOLOGY MOLEC LEVEL 4 NS,617.0,299.86,160.42,598.49,29
CPT,81404,LAB PROC PATHOLOGY MOLEC LEVEL 5,825.0,400.95,214.5,800.25,29
CPT,81405,LAB PROC PATHOLOGY MOLEC LEVEL 6,905.0,439.83,235.3,877.85,29
CPT,81406,LAB PROC PATHOLOGY MOLEC LEVEL 7,849.0,412.61,220.74,823.53,29
CPT,81407,LAB PROC PATHOLOGY MOLEC LEVEL 8,2539.0,1233.95,660.14,2462.83,29
CPT,81408,LAB PROC PATHOLOGY MOLEC LEVEL 9,6000.0,2916.0,1560.0,5820.0,29
CPT,81418,LAB GSAP METAB RX >=6,2752.0,1337.47,715.52,2669.44,29
CPT,81420,LAB FETAL CHROMOSOMAL ANEUPLOIDY,2278.0,1107.11,592.28,2209.66,29
CPT,81435,LAB GENE 5+ COLON CA DIS HRDTRY,3912.0,1901.23,1017.12,3794.64,29
CPT,81450,LAB GENOMIC ANLY SEQ HL 5-50,2279.0,1107.59,592.54,2210.63,29
CPT,81450,LAB GENOMIC ANLY SEQ HL 5-50 NS,2395.0,1163.97,622.7,2323.15,29
CPT,81455,LAB GENOMIC ANLY SEQ SO/HL 51+,8759.0,4256.87,2277.34,8496.23,29
CPT,81455,LAB GENOMIC ANLY SEQ SO/HL 51+ NS,8759.0,4256.87,2277.34,8496.23,29
CPT,81479,LAB CSF3R MUTATION EXONS 14&17,300.0,145.8,78.0,291.0,29
CPT,81479,LAB GENE PHARMOCOGENOMICS PANEL,51.0,24.79,13.26,49.47,29
CPT,81479,LAB GENE SEQ RET DUP/DEL,224.0,108.86,58.24,217.28,29
CPT,81479,LAB IBD SGI DIAGNOSTIC,292.0,141.91,75.92,283.24,29
CPT,81508,LAB FETAL CONGENITAL ABNORMALITIES,260.0,126.36,67.6,252.2,29
CPT,81517,LAB LIVER DIS ANYL 3BIOMARK ALG SRM,529.0,257.09,137.54,513.13,29
CPT,81596,LAB HCV INFCT DIS CHRNC 6 ASSAYS,217.0,105.46,56.42,210.49,29
CPT,81596,LAB HCV INFCT DIS CHRNC 6 ASSAYS NS,217.0,105.46,56.42,210.49,29
CPT,82010,LAB KETONES ACETONE QN,25.0,12.05,6.5,24.25,29
CPT,82010,LAB KETONES NS,61.0,29.4,15.86,59.17,29
CPT,82017,LAB ACYLCARNITINES QN EA,115.0,55.43,29.9,111.55,29
CPT,82024,LAB HORMONE ADRENOCORTICOTROPIC,116.0,55.91,30.16,112.52,29
CPT,82040,LAB ALBUMIN SRM/PLASMA/BLD WHL,30.0,14.46,7.8,29.1,29
CPT,82040,LAB ALBUMIN SRM/PLASMA/BLD WHL NS,63.0,30.37,16.38,61.11,29
CPT,82042,LAB ALBUMIN OTHER SOURCE QN EA,58.0,27.96,15.08,56.26,29
CPT,82042,LAB ALBUMIN OTHER SOURCE QN EA NS,24.0,11.57,6.24,23.28,29
CPT,82043,LAB MICROALBUMIN URINE QN,56.0,26.99,14.56,54.32,29
CPT,82043,LAB MICROALBUMIN URINE QN NS,68.0,32.78,17.68,65.96,29
CPT,82085,LAB ALDOLASE,53.0,25.55,13.78,51.41,29
CPT,82088,LAB ALDOSTERONE,270.0,130.14,70.2,261.9,29
CPT,82088,LAB ALDOSTERONE NS,123.0,59.29,31.98,119.31,29
CPT,82088,LAB ALDOSTERONE URINE,123.0,59.29,31.98,119.31,29
CPT,82103,LAB ALPHA-1-ANTITRYPSIN TOTAL,41.0,19.76,10.66,39.77,29
CPT,82103,LAB ALPHA-1-ANTITRYPSIN TOTAL NS,59.0,28.44,15.34,57.23,29
CPT,82104,LAB ALPHA-1-ANTITRYPSIN PHENOTYPE,63.0,30.37,16.38,61.11,29
CPT,82105,LAB AFP SERUM,51.0,24.58,13.26,49.47,29
CPT,82105,LAB AFP SERUM MATERNAL,51.0,24.58,13.26,49.47,29
CPT,82106,LAB AFP AMNIOTIC FLUID,51.0,24.58,13.26,49.47,29
CPT,82107,LAB AFP-L3 ISOFORM FRAC&AFP TOTAL,194.0,93.51,50.44,188.18,29
CPT,82108,LAB ALUMINUM,77.0,37.11,20.02,74.69,29
CPT,82131,LAB ACIDS AMINO SGL QN SPEC EA,91.0,43.86,23.66,88.27,29
CPT,82135,LAB ACID AMINOLEVULINIC DELTA URINE,75.0,36.15,19.5,72.75,29
CPT,82139,LAB ACIDS AMINO 6+ QN SPEC EA,141.0,67.96,36.66,136.77,29
CPT,82139,LAB ACIDS AMINO 6+ QN URINE SPEC EA,141.0,67.96,36.66,136.77,29
CPT,82140,LAB AMMONIA,44.0,21.21,11.44,42.68,29
CPT,82140,LAB AMMONIA STONE RISK,115.0,55.43,29.9,111.55,29
CPT,82150,LAB AMYLASE,20.0,9.64,5.2,19.4,29
CPT,82150,LAB AMYLASE FLUID BODY,52.0,25.06,13.52,50.44,29
CPT,82150,LAB AMYLASE FLUID CYST PANCREATIC,341.0,164.36,88.66,330.77,29
CPT,82150,LAB AMYLASE TOTAL,54.0,26.03,14.04,52.38,29
CPT,82150,LAB AMYLASE URINE,53.0,25.55,13.78,51.41,29
CPT,82157,LAB ANDROSTENEDIONE,88.0,42.42,22.88,85.36,29
CPT,82163,LAB ANGIOTENSIN 2,89.0,42.9,23.14,86.33,29
CPT,82164,LAB ANGIOTENSIN I CONVERTING ENZYME,61.0,29.4,15.86,59.17,29
CPT,82166,LAB HORMONE ANTIMULLERIAN,116.0,55.91,30.16,112.52,29
CPT,82166,LAB HORMONE ANTIMULLERIAN NS,116.0,55.91,30.16,112.52,29
CPT,82172,LAB APOLIPOPROTEIN A1 EA,77.0,37.11,20.02,74.69,29
CPT,82172,LAB APOLIPOPROTEIN A1 EA NS,77.0,37.11,20.02,74.69,29
CPT,82172,LAB APOLIPOPROTEIN B EA,64.0,30.85,16.64,62.08,29
CPT,82172,LAB APOLIPOPROTEIN EA,64.0,30.85,16.64,62.08,29
CPT,82175,LAB ARSENIC BLOOD NS,63.0,30.37,16.38,61.11,29
CPT,82175,LAB ARSENIC NON BLOOD,95.0,45.79,24.7,92.15,29
CPT,82180,LAB ACID ASCORBIC BLOOD,59.0,28.44,15.34,57.23,29
CPT,82232,LAB MICROGLOBULIN BETA-2,58.0,27.96,15.08,56.26,29
CPT,82232,LAB MICROGLOBULIN BETA-2 NS,93.0,44.83,24.18,90.21,29
CPT,82233,LAB BETA AMYLOID 1-40,387.0,186.53,100.62,375.39,29
CPT,82234,LAB BETA AMYLOID 1-42,387.0,186.53,100.62,375.39,29
CPT,82239,LAB ACIDS BILE TOTAL,63.0,30.37,16.38,61.11,29
CPT,82247,LAB BILIRUBIN TOTAL,36.0,17.35,9.36,34.92,29
CPT,82247,LAB BILIRUBIN TOTAL NS,58.0,27.96,15.08,56.26,29
CPT,82248,LAB BILIRUBIN DIRECT,31.0,14.94,8.06,30.07,29
CPT,82261,LAB BIOTINIDASE SPEC EA,112.0,53.98,29.12,108.64,29
CPT,82270,LAB BLOOD OCCULT FECES SINGLE QL,14.0,6.75,3.64,13.58,29
CPT,82271,LAB BLOOD OCCULT OTHER SOURCE QL,16.0,7.71,4.16,15.52,29
CPT,82274,LAB BLOOD OCCULT FECES 1-3 IMM NS,62.0,29.88,16.12,60.14,29
CPT,82274,LAB BLOOD OCCULT FECES 1-3 IMM QL,62.0,29.88,16.12,60.14,29
CPT,82300,LAB CADMIUM,71.0,34.22,18.46,68.87,29
CPT,82306,LAB VITAMIN D 25 HYDROXY W FRAC,89.0,42.9,23.14,86.33,29
CPT,82306,LAB VITAMIN D 25 HYDROXY W FRAC NS,89.0,42.9,23.14,86.33,29
CPT,82308,LAB CALCITONIN,81.0,39.04,21.06,78.57,29
CPT,82310,LAB CALCIUM TOTAL,35.0,16.87,9.1,33.95,29
CPT,82310,LAB CALCIUM TOTAL NS,65.0,31.33,16.9,63.05,29
CPT,82310,LAB CALCIUM TOTAL URINE,56.0,26.99,14.56,54.32,29
CPT,82330,LAB CALCIUM IONIZED,97.0,46.75,25.22,94.09,29
CPT,82340,LAB CALCIUM STONE RISK,77.0,37.11,20.02,74.69,29
CPT,82340,LAB CALCIUM URINE QN TIMED,56.0,26.99,14.56,54.32,29
CPT,82365,LAB CALCULUS SPECTROSCOPY INFRARED,74.0,35.67,19.24,71.78,29
CPT,82374,LAB CARBON DIOXIDE HCO3,36.0,17.35,9.36,34.92,29
CPT,82375,LAB CARBOXYHEMOGLOBIN QN,56.0,26.99,14.56,54.32,29
CPT,82375,POC CARBOXYHEMOGLOBIN QN,37.0,17.83,9.62,35.89,29
CPT,82378,LAB AG CARCINOEMBRYONIC,57.0,27.47,14.82,55.29,29
CPT,82378,LAB AG CARCINOEMBRYONIC ARUP NS,68.0,32.78,17.68,65.96,29
CPT,82378,LAB AG CARCINOEMBRYONIC MAYO NS,329.0,158.58,85.54,319.13,29
CPT,82379,LAB CARNITINE TOTAL&FREE QN,78.0,37.6,20.28,75.66,29
CPT,82379,LAB CARNITINE TOTAL&FREE QN URINE,115.0,55.43,29.9,111.55,29
CPT,82380,LAB CAROTENE,67.0,32.29,17.42,64.99,29
CPT,82384,LAB CATECHOLAMINES FRACTIONATED,76.0,36.63,19.76,73.72,29
CPT,82390,LAB CERULOPLASMIN,53.0,25.55,13.78,51.41,29
CPT,82397,LAB CHEMILUMINESCENT,70.0,33.74,18.2,67.9,29
CPT,82435,LAB CHLORIDE BLOOD,28.0,13.5,7.28,27.16,29
CPT,82436,LAB CHLORIDE URINE,18.0,8.68,4.68,17.46,29
CPT,82438,LAB CHLORIDE FLUID BODY,51.0,24.58,13.26,49.47,29
CPT,82438,LAB CHLORIDE OTHER SOURCE,15.0,7.23,3.9,14.55,29
CPT,82438,LAB CHLORIDE STOOL NS,58.0,27.96,15.08,56.26,29
CPT,82465,LAB CHOLESTEROL SRM/BLD WHL TTL,55.0,26.51,14.3,53.35,29
CPT,82465,LAB CHOLESTEROL SRM/BLD WHL TTL NS,56.0,26.99,14.56,54.32,29
CPT,82480,LAB CHOLINESTERASE SERUM NS,61.0,29.4,15.86,59.17,29
CPT,82482,LAB CHOLINESTERASE RBC,59.0,28.44,15.34,57.23,29
CPT,82495,LAB CHROMIUM,61.0,29.4,15.86,59.17,29
CPT,82507,LAB CITRATE,84.0,40.49,21.84,81.48,29
CPT,82507,LAB CITRATE STONE RISK,174.0,83.87,45.24,168.78,29
CPT,82523,LAB CROSS LINKS DEOXYPYRIDINOLINE,113.0,54.47,29.38,109.61,29
CPT,82523,LAB CROSS LINKS N-TELOPEPTIDE,68.0,32.78,17.68,65.96,29
CPT,82525,LAB COPPER SERUM,63.0,30.37,16.38,61.11,29
CPT,82525,LAB COPPER TISSUE NS,211.0,101.7,54.86,204.67,29
CPT,82525,LAB COPPER URINE,65.0,31.33,16.9,63.05,29
CPT,82528,LAB CORTICOSTERONE,83.0,40.01,21.58,80.51,29
CPT,82530,LAB CORTISOL FREE,55.0,26.51,14.3,53.35,29
CPT,82533,LAB CORTISOL TOTAL,58.0,27.96,15.08,56.26,29
CPT,82533,LAB CORTISOL TOTAL NS,323.0,155.69,83.98,313.31,29
CPT,82540,LAB CREATINE SERUM,60.0,28.92,15.6,58.2,29
CPT,82540,LAB CREATINE URINE,60.0,28.92,15.6,58.2,29
CPT,82542,LAB CHROMAT MS APOE ISOFORM,550.0,265.1,143.0,533.5,29
CPT,82542,LAB CHROMAT MS IODINE QL/QN,73.0,35.19,18.98,70.81,29
CPT,82542,LAB CHROMAT MS METHOXYTYRAMINE,392.0,188.94,101.92,380.24,29
CPT,82542,LAB CHROMAT MS NON-DRUG QL/QN,75.0,36.15,19.5,72.75,29
CPT,82542,LAB CHROMAT MS NON-DRUG QL/QN NS,73.0,35.19,18.98,70.81,29
CPT,82542,LAB CHROMAT MS OMEGA FATTY ACIDS,100.0,48.2,26.0,97.0,29
CPT,82542,LAB CHROMAT MS ORGANIC ACIDS,153.0,73.75,39.78,148.41,29
CPT,82542,LAB CHROMAT MS PROT AMYLOID QN,909.0,438.14,236.34,881.73,29
CPT,82542,LAB CHROMAT/MS METHYLTETRAHYDOFOLAT,266.0,128.21,69.16,258.02,29
CPT,82542,LAB CHROMAT/MS NEOPTERIN,275.0,132.55,71.5,266.75,29
CPT,82550,LAB CREATINE KINASE TOTAL,20.0,9.64,5.2,19.4,29
CPT,82550,LAB CREATINE KINASE TOTAL NS,55.0,26.51,14.3,53.35,29
CPT,82552,LAB CREATINE KINASE ISOENZYMES,59.0,28.44,15.34,57.23,29
CPT,82553,LAB CREATINE KINASE MB ONLY QN,35.0,16.87,9.1,33.95,29
CPT,82565,LAB CREATININE BLOOD,34.0,16.39,8.84,32.98,29
CPT,82570,LAB CREATININE OTHER SOURCE,80.0,38.56,20.8,77.6,29
CPT,82570,LAB CREATININE STONE RISK,73.0,35.19,18.98,70.81,29
CPT,82570,LAB CREATININE URINE,16.0,7.71,4.16,15.52,29
CPT,82570,LAB CREATININE URINE NS,52.0,25.06,13.52,50.44,29
CPT,82575,LAB CREATININE CLEARANCE,29.0,13.98,7.54,28.13,29
CPT,82595,LAB CRYOGLOBULIN QL/SEMI QN,63.0,30.37,16.38,61.11,29
CPT,82595,LAB CRYOGLOBULIN QL/SEMI QN NS,63.0,30.37,16.38,61.11,29
CPT,82600,LAB CYANIDE,78.0,37.6,20.28,75.66,29
CPT,82607,LAB CYANOCOBALAMIN,54.0,26.03,14.04,52.38,29
CPT,82608,LAB VITAMIN B-12 CAPACITY BNDG NS,66.0,31.81,17.16,64.02,29
CPT,82610,LAB CYSTATIN C,56.0,26.99,14.56,54.32,29
CPT,82626,LAB DEHYDROEPIANDROSTERONE,76.0,36.63,19.76,73.72,29
CPT,82627,LAB DEHYDROEPIANDROSTERONE-SULFATE,67.0,32.29,17.42,64.99,29
CPT,82634,LAB DEOXYCORTISOL 11-,88.0,42.42,22.88,85.36,29
CPT,82638,LAB DIBUCAINE NUMBER NS,67.0,32.29,17.42,64.99,29
CPT,82642,LAB DIHYDROTESTOSTERONE,88.0,42.42,22.88,85.36,29
CPT,82652,LAB VITAMIN D 1 25 DIHYDROXY FRAC,116.0,55.91,30.16,112.52,29
CPT,82653,LAB IMM ELASTASE PANCREATIC QN,100.0,48.2,26.0,97.0,29
CPT,82656,LAB ELASTASE PANCREATIC FECAL,104.0,50.13,27.04,100.88,29
CPT,82657,LAB ACTIVITY ENZYME ALPHA GALACTOS,375.0,180.75,97.5,363.75,29
CPT,82657,LAB ACTIVITY ENZYME CHITOTRIOSIDASE,362.0,174.48,94.12,351.14,29
CPT,82657,LAB ACTIVITY ENZYME L-ASPARAGNSE,325.0,156.65,84.5,315.25,29
CPT,82657,LAB ACTIVITY ENZYME NONRADIOACTIVE,121.0,58.32,31.46,117.37,29
CPT,82664,LAB ELECTRO,185.0,89.17,48.1,179.45,29
CPT,82664,LAB ELECTRO NS,185.0,89.17,48.1,179.45,29
CPT,82668,LAB ERYTHROPOIETIN,57.0,27.47,14.82,55.29,29
CPT,82670,LAB ESTRADIOL TOTAL,84.0,40.49,21.84,81.48,29
CPT,82670,LAB ESTRADIOL TOTAL NS,84.0,40.49,21.84,81.48,29
CPT,82671,LAB ESTROGENS FRACTIONATED,98.0,47.24,25.48,95.06,29
CPT,82672,LAB ESTROGEN TOTAL,66.0,31.81,17.16,64.02,29
CPT,82672,LAB ESTROGEN TOTAL NS,66.0,31.81,17.16,64.02,29
CPT,82677,LAB ESTRIOL SERUM,73.0,35.19,18.98,70.81,29
CPT,82677,LAB ESTRIOL SERUM NS,73.0,35.19,18.98,70.81,29
CPT,82679,LAB ESTRONE,75.0,36.15,19.5,72.75,29
CPT,82681,LAB ESTRADIOL FREE MEASURE DIRECT,84.0,40.49,21.84,81.48,29
CPT,82693,LAB ETHYLENE GLYCOL,81.0,39.04,21.06,78.57,29
CPT,82705,LAB FAT/LIPIDS FECES QL NS,68.0,32.78,17.68,65.96,29
CPT,82710,LAB FAT/LIPIDS FECES QN,51.0,24.58,13.26,49.47,29
CPT,82725,LAB ACIDS FATTY NONESTERIFIED,69.0,33.26,17.94,66.93,29
CPT,82726,LAB ACIDS FATTY VERY LONG CHAIN,205.0,98.81,53.3,198.85,29
CPT,82728,LAB FERRITIN,60.0,28.92,15.6,58.2,29
CPT,82731,LAB FIBRONECTIN FETAL SEMI QL,194.0,93.51,50.44,188.18,29
CPT,82746,LAB ACID FOLIC SERUM,45.0,21.69,11.7,43.65,29
CPT,82747,LAB ACID FOLIC RBC,55.0,26.51,14.3,53.35,29
CPT,82775,LAB TRANSFERASE GALACTOSE-1 QN,173.0,83.39,44.98,167.81,29
CPT,82784,LAB IG IGA IGD IGG IGM CSF EA,63.0,30.37,16.38,61.11,29
CPT,82784,LAB IG IGA IGD IGG IGM SERUM EA,52.0,25.06,13.52,50.44,29
CPT,82784,LAB IG IGA IGD IGG IGM SERUM EA NS,59.0,28.44,15.34,57.23,29
CPT,82784,LAB IG IGA SERUM NS,56.0,26.99,14.56,54.32,29
CPT,82784,LAB IG IGD SERUM EA,63.0,30.37,16.38,61.11,29
CPT,82784,LAB IG IGG SERUM EA,56.0,26.99,14.56,54.32,29
CPT,82785,LAB IG IGE,58.0,27.96,15.08,56.26,29
CPT,82785,LAB IG IGE NS,58.0,27.96,15.08,56.26,29
CPT,82787,LAB IG SUBCLASSES EA,59.0,28.44,15.34,57.23,29
CPT,82800,POC GASES BLD PH ONLY,33.0,15.91,8.58,32.01,29
CPT,82803,LAB GASES BLD ANY COMBO ARTERIAL,79.0,38.08,20.54,76.63,29
CPT,82803,LAB GASES BLD ANY COMBO VENOUS,79.0,38.08,20.54,76.63,29
CPT,82803,POC GASES BLD ANY COMBO,79.0,38.08,20.54,76.63,29
CPT,82805,LAB GASES BLD ANY COMBO W SAT O2,237.0,114.23,61.62,229.89,29
CPT,82805,POC GASES BLD ANY COMBO W SAT O2,237.0,114.23,61.62,229.89,29
CPT,82941,LAB GASTRIN,58.0,27.96,15.08,56.26,29
CPT,82943,LAB GLUCAGON,67.0,32.29,17.42,64.99,29
CPT,82945,LAB GLUCOSE CSF,55.0,26.51,14.3,53.35,29
CPT,82945,LAB GLUCOSE FLUID BODY,56.0,26.99,14.56,54.32,29
CPT,82945,LAB GLUCOSE FLUID BODY NS,131.0,63.14,34.06,127.07,29
CPT,82945,LAB GLUCOSE URINE RANDOM,55.0,26.51,14.3,53.35,29
CPT,82945,LAB GLUCOSE URINE TIMED,56.0,26.99,14.56,54.32,29
CPT,82950,LAB GLUCOSE POST DOSE,15.0,7.23,3.9,14.55,29
CPT,82951,LAB GLUCOSE TOLERANCE SPEC 1ST 3,39.0,18.8,10.14,37.83,29
CPT,82952,LAB GLUCOSE TOLERANCE SPEC EA ADDL,12.0,5.78,3.12,11.64,29
CPT,82955,LAB DEHYDROGENASE G6PD QN NS,56.0,26.99,14.56,54.32,29
CPT,82977,LAB TRANSFERASE GAMMA-GLUTAMYL,22.0,10.6,5.72,21.34,29
CPT,82977,LAB TRANSFERASE GAMMA-GLUTAMYL NS,62.0,29.88,16.12,60.14,29
CPT,82985,LAB PROT GLYCATED,53.0,25.55,13.78,51.41,29
CPT,82985,LAB PROT GLYCATED NS,56.0,26.99,14.56,54.32,29
CPT,83001,LAB GONADOTROPIN FSH SERUM,56.0,26.99,14.56,54.32,29
CPT,83001,LAB GONADOTROPIN FSH SERUM NS,58.0,27.96,15.08,56.26,29
CPT,83002,LAB GONADOTROPIN LH,58.0,27.96,15.08,56.26,29
CPT,83002,LAB GONADOTROPIN LH NS,57.0,27.47,14.82,55.29,29
CPT,83003,LAB HORMONE HUMAN GROWTH,51.0,24.58,13.26,49.47,29
CPT,83010,LAB HAPTOGLOBIN QN,53.0,25.55,13.78,51.41,29
CPT,83010,LAB HAPTOGLOBIN QN NS,59.0,28.44,15.34,57.23,29
CPT,83013,LAB H PYLORI UREASE NONRADIOACT,203.0,97.85,52.78,196.91,29
CPT,83013,LAB H PYLORI UREASE NONRADIOACT NS,203.0,97.85,52.78,196.91,29
CPT,83018,LAB HEAVY METAL QN COBALT,288.0,138.82,74.88,279.36,29
CPT,83018,LAB HEAVY METAL QN EA,106.0,51.09,27.56,102.82,29
CPT,83020,LAB HEMOGLOBIN FRCTN&QN ELECTRO NS,71.0,34.22,18.46,68.87,29
CPT,83021,LAB HEMOGLOBIN FRCTN&QN CHROMAT NS,55.0,26.51,14.3,53.35,29
CPT,83036,LAB HEMOGLOBIN A1C,30.0,14.46,7.8,29.1,29
CPT,83050,POC HEMOGLOBIN METHEMOGLOBIN QN,25.0,12.05,6.5,24.25,29
CPT,83051,LAB HEMOGLOBIN PLASMA,59.0,28.44,15.34,57.23,29
CPT,83070,LAB HEMOSIDERIN QL,67.0,32.29,17.42,64.99,29
CPT,83088,LAB HISTAMINE,89.0,42.9,23.14,86.33,29
CPT,83090,LAB HOMOCYSTEINE SERUM,58.0,27.96,15.08,56.26,29
CPT,83150,LAB ACID HOMOVANILLIC,68.0,32.78,17.68,65.96,29
CPT,83497,LAB ACID HYDROXYINDOLACETIC 5-,61.0,29.4,15.86,59.17,29
CPT,83498,LAB HYDROXYPROGESTERONE 17-D NS,82.0,39.52,21.32,79.54,29
CPT,83500,LAB HYDROXYPROLINE FREE,112.0,53.98,29.12,108.64,29
CPT,83516,LAB IMM MS 21-HYDROXYLASE QL,114.0,54.95,29.64,110.58,29
CPT,83516,LAB IMM MS ALPHA 2 MACROGLOBULIN,59.0,28.44,15.34,57.23,29
CPT,83516,LAB IMM MS ANTI TH/TO AB,135.0,65.07,35.1,130.95,29
CPT,83516,LAB IMM MS CARBAMYLATED PROTEIN AB,105.0,50.61,27.3,101.85,29
CPT,83516,LAB IMM MS CYTOSOLC 5 NUCLEOTDAS 1A,315.0,151.83,81.9,305.55,29
CPT,83516,LAB IMM MS GP210 IGG,148.0,71.34,38.48,143.56,29
CPT,83516,LAB IMM MS HISTONE QL,62.0,29.88,16.12,60.14,29
CPT,83516,LAB IMM MS MYOSITIS,67.0,32.29,17.42,64.99,29
CPT,83516,LAB IMM MS PHOSPHAT/PROTHROMBIN NS,59.0,28.44,15.34,57.23,29
CPT,83516,LAB IMM MS POLYMERASE III AB,107.0,51.57,27.82,103.79,29
CPT,83516,LAB IMM MS QL/SEMI QN NS,57.0,27.47,14.82,55.29,29
CPT,83516,LAB IMM MS RIBO P PROTEIN QL,35.0,16.87,9.1,33.95,29
CPT,83516,LAB IMM MS SP100 IGG,104.0,50.13,27.04,100.88,29
CPT,83519,LAB IMM RBA AB 21 HYDROXYLASE QN,114.0,54.95,29.64,110.58,29
CPT,83519,LAB IMM RIA BETAPROTEIN,360.0,173.52,93.6,349.2,29
CPT,83519,LAB IMM RIA PB3 IGF QN,106.0,51.09,27.56,102.82,29
CPT,83519,LAB IMM RIA POLY PANCREATIC QN,78.0,37.6,20.28,75.66,29
CPT,83519,LAB IMM RIA PTH REL PROT QN,72.0,34.7,18.72,69.84,29
CPT,83519,LAB IMM RIA QN,94.0,45.31,24.44,91.18,29
CPT,83519,LAB IMM RIA RECEPTOR TSH QN,101.0,48.68,26.26,97.97,29
CPT,83519,LAB IMM RIA TRYPSIN QN,82.0,39.52,21.32,79.54,29
CPT,83520,LAB IMM AB ADALIMUMAB ANTIDRUG,286.0,137.85,74.36,277.42,29
CPT,83520,LAB IMM AB ADAMTS 13,300.0,144.6,78.0,291.0,29
CPT,83520,LAB IMM AB BP180 QN,73.0,35.19,18.98,70.81,29
CPT,83520,LAB IMM AB BP230 QN,90.0,43.38,23.4,87.3,29
CPT,83520,LAB IMM AB GBM QN,60.0,28.92,15.6,58.2,29
CPT,83520,LAB IMM AB GBM QN NS,52.0,25.06,13.52,50.44,29
CPT,83520,LAB IMM AB HMGCR IGG,315.0,151.83,81.9,305.55,29
CPT,83520,LAB IMM AB LDL OXIDIZED,100.0,48.2,26.0,97.0,29
CPT,83520,LAB IMM AB MUT CITRULLINAT VIMENTIN,89.0,42.9,23.14,86.33,29
CPT,83520,LAB IMM AG ANTI-SOLUBLE LIVER QN,71.0,34.22,18.46,68.87,29
CPT,83520,LAB IMM ANALYTE CYTOKINES QN,135.0,65.07,35.1,130.95,29
CPT,83520,LAB IMM ANALYTE OTHER QN,80.0,38.56,20.8,77.6,29
CPT,83520,LAB IMM ANALYTE PIGF,72.0,34.7,18.72,69.84,29
CPT,83520,LAB IMM ANALYTE SFIT-1,72.0,34.7,18.72,69.84,29
CPT,83520,LAB IMM FIBRO GROWTH FACTOR,305.0,147.01,79.3,295.85,29
CPT,83520,LAB IMM GANGLIOSIDE GM TRIPLE QN,70.0,33.74,18.2,67.9,29
CPT,83520,LAB IMM GLYCPROT MYELIN ASSC IGM,69.0,33.26,17.94,66.93,29
CPT,83520,LAB IMM IGFBP 3 QN,64.0,30.85,16.64,62.08,29
CPT,83520,LAB IMM IL-2 RECPT SOLUBLE QN,368.0,177.38,95.68,356.96,29
CPT,83520,LAB IMM INHIBIN B QN,104.0,50.13,27.04,100.88,29
CPT,83520,LAB IMM PHOS TAU/TTL TAU/BETA42,650.0,313.3,169.0,630.5,29
CPT,83520,LAB IMM POLY PANCREATIC QN,91.0,43.86,23.66,88.27,29
CPT,83520,LAB IMM RECEPTOR TSH QN,52.0,25.06,13.52,50.44,29
CPT,83520,LAB IMM TRYPTASE QN,77.0,37.11,20.02,74.69,29
CPT,83520,LAB IMM VWF BINDING ASSAY,145.0,69.89,37.7,140.65,29
CPT,83521,LAB IG FREE LIGHT CHAIN SERUM EA,61.0,29.4,15.86,59.17,29
CPT,83521,LAB IG FREE LIGHT CHAIN URINE EA,69.0,33.26,17.94,66.93,29
CPT,83525,LAB INSULIN TOTAL,57.0,27.47,14.82,55.29,29
CPT,83527,LAB INSULIN FREE,79.0,38.08,20.54,76.63,29
CPT,83529,LAB IMM INTERLEUKIN 6 QN,109.0,52.54,28.34,105.73,29
CPT,83540,LAB IRON,20.0,9.64,5.2,19.4,29
CPT,83540,LAB IRON TISSUE LIVER,208.0,100.26,54.08,201.76,29
CPT,83586,LAB KETOSTEROIDS 17- TOTAL,80.0,38.56,20.8,77.6,29
CPT,83605,LAB LACTATE/LACTIC ACID,35.0,16.87,9.1,33.95,29
CPT,83605,LAB LACTATE/LACTIC ACID CSF,88.0,42.42,22.88,85.36,29
CPT,83615,LAB LDH,19.0,9.16,4.94,18.43,29
CPT,83615,LAB LDH CSF,56.0,26.99,14.56,54.32,29
CPT,83615,LAB LDH FLUID BODY,57.0,27.47,14.82,55.29,29
CPT,83615,LAB LDH NS,55.0,26.51,14.3,53.35,29
CPT,83625,LAB LDH ISOENZYMES,59.0,28.44,15.34,57.23,29
CPT,83630,LAB LACTOFERRIN FECAL QL NS,98.0,47.24,25.48,95.06,29
CPT,83631,LAB LACTOFERRIN FECAL QN,204.0,98.33,53.04,197.88,29
CPT,83655,LAB LEAD BLOOD,59.0,28.44,15.34,57.23,29
CPT,83655,LAB LEAD BLOOD NS,37.0,17.83,9.62,35.89,29
CPT,83655,LAB LEAD NON BLOOD,79.0,38.08,20.54,76.63,29
CPT,83690,LAB LIPASE,21.0,10.12,5.46,20.37,29
CPT,83690,LAB LIPASE FLUID BODY,52.0,25.06,13.52,50.44,29
CPT,83690,LAB LIPASE FLUID BODY NS,58.0,27.96,15.08,56.26,29
CPT,83695,LAB LIPOPROTEIN A,57.0,27.47,14.82,55.29,29
CPT,83695,LAB LIPOPROTEIN A NS,58.0,27.96,15.08,56.26,29
CPT,83698,LAB LIPOPROTEIN PHOSPHOLIPASE A2,139.0,67.0,36.14,134.83,29
CPT,83700,LAB LIPOPROTEIN ELECTRO,64.0,30.85,16.64,62.08,29
CPT,83701,LAB LIPOPROTEIN FRCTN HR,102.0,49.16,26.52,98.94,29
CPT,83704,LAB LIPOPROTEIN PART NO/S&SBCLS QN,103.0,49.65,26.78,99.91,29
CPT,83718,LAB LIPOPROTEIN CHOLESTEROL HDL,60.0,28.92,15.6,58.2,29
CPT,83721,LAB LIPOPROTEIN CHOLESTEROL LDL,32.0,15.42,8.32,31.04,29
CPT,83721,LAB LIPOPROTEIN CHOLESTEROL LDL NS,94.0,45.31,24.44,91.18,29
CPT,83722,LAB LIPOPROTEIN CHOLESTEROL LDL SD,103.0,49.65,26.78,99.91,29
CPT,83735,LAB MAGNESIUM,21.0,10.12,5.46,20.37,29
CPT,83735,LAB MAGNESIUM NS,88.0,42.42,22.88,85.36,29
CPT,83735,LAB MAGNESIUM STOOL,21.0,10.12,5.46,20.37,29
CPT,83735,LAB MAGNESIUM URINE,52.0,25.06,13.52,50.44,29
CPT,83785,LAB MANGANESE,80.0,38.56,20.8,77.6,29
CPT,83789,LAB MS&MS TNDM NON-DRUG QL/QN,73.0,35.19,18.98,70.81,29
CPT,83825,LAB MERCURY BLOOD QN,49.0,23.62,12.74,47.53,29
CPT,83825,LAB MERCURY NON BLOOD QN,88.0,42.42,22.88,85.36,29
CPT,83835,LAB METANEPHRINES,66.0,31.81,17.16,64.02,29
CPT,83873,LAB PROT MYELIN BASIC CSF,63.0,30.37,16.38,61.11,29
CPT,83874,LAB MYOGLOBIN,59.0,28.44,15.34,57.23,29
CPT,83874,LAB MYOGLOBIN URINE,59.0,28.44,15.34,57.23,29
CPT,83880,LAB PEPTIDE NATRIURETIC PB,118.0,56.88,30.68,114.46,29
CPT,83883,LAB ALPHA2-MACROGLOBULIN QN,72.0,34.7,18.72,69.84,29
CPT,83883,LAB KAPPA/LAMBDA LIGHT,69.0,33.26,17.94,66.93,29
CPT,83883,LAB KAPPA/LAMBDA LIGHT NS,55.0,26.51,14.3,53.35,29
CPT,83883,LAB NEPHELOMETRY ANALYTE EA,41.0,19.76,10.66,39.77,29
CPT,83885,LAB NICKEL,124.0,59.77,32.24,120.28,29
CPT,83915,LAB NUCLEOTIDASE 5-,99.0,47.72,25.74,96.03,29
CPT,83916,LAB BANDS OLIGOCLONAL CSF,83.0,40.01,21.58,80.51,29
CPT,83918,LAB ACIDS ORGANIC TOTAL EA QN,406.0,195.69,105.56,393.82,29
CPT,83918,LAB ACIDS ORGANIC TOTAL URINE EA QN,101.0,48.68,26.26,97.97,29
CPT,83919,LAB ACIDS ORGANIC EA QL,50.0,24.1,13.0,48.5,29
CPT,83921,LAB ACID ORGANIC SINGLE METHY QN NS,64.0,30.85,16.64,62.08,29
CPT,83921,LAB ACID ORGANIC SINGLE QN,195.0,93.99,50.7,189.15,29
CPT,83930,LAB OSMOLALITY BLOOD,56.0,26.99,14.56,54.32,29
CPT,83935,LAB OSMOLALITY URINE,56.0,26.99,14.56,54.32,29
CPT,83937,LAB OSTEOCALCIN,90.0,43.38,23.4,87.3,29
CPT,83945,LAB OXALATE,109.0,52.54,28.34,105.73,29
CPT,83945,LAB OXALATE STONE RISK,108.0,52.06,28.08,104.76,29
CPT,83945,LAB OXALATE URINE,67.0,32.29,17.42,64.99,29
CPT,83951,LAB ONCOPROTEIN DCP,194.0,93.51,50.44,188.18,29
CPT,83970,LAB PARATHORMONE,124.0,59.77,32.24,120.28,29
CPT,83970,LAB PARATHORMONE C-TERMINAL,124.0,59.77,32.24,120.28,29
CPT,83970,LAB PARATHORMONE INTRAOP BASELINE 3,124.0,59.77,32.24,120.28,29
CPT,83986,LAB PH FLUID BODY NOS,51.0,24.58,13.26,49.47,29
CPT,83986,LAB PH FLUID BODY NOS NS,104.0,50.13,27.04,100.88,29
CPT,83986,LAB PH STONE RISK,66.0,31.81,17.16,64.02,29
CPT,83986,LAB PH STOOL NS,72.0,34.7,18.72,69.84,29
CPT,83992,LAB DRG DF CNFRM PHENCYCLDN/PCP DAY,67.0,32.29,17.42,64.99,29
CPT,83992,LAB DRG DF PHENCYCLDN NON URINE,56.0,26.99,14.56,54.32,29
CPT,83992,LAB DRG DF PHENCYCLIDINE,123.0,59.29,31.98,119.31,29
CPT,83993,LAB CALPROTECTIN FECAL,250.0,120.5,65.0,242.5,29
CPT,84030,LAB PHENYLALANINE BLOOD,17.0,8.19,4.42,16.49,29
CPT,84060,LAB ACID PHOSPHATASE TOTAL NS,63.0,30.37,16.38,61.11,29
CPT,84066,LAB ACID PHOSPHATASE PROSTATIC,60.0,28.92,15.6,58.2,29
CPT,84075,LAB ALKALINE PHOSPHATASE,37.0,17.83,9.62,35.89,29
CPT,84075,LAB ALKALINE PHOSPHATASE NS,57.0,27.47,14.82,55.29,29
CPT,84080,LAB ALKALINE PHOSPHATASE ISOENZYMES,57.0,27.47,14.82,55.29,29
CPT,84100,LAB PHOSPHORUS INORGANIC,36.0,17.35,9.36,34.92,29
CPT,84105,LAB PHOSPHORUS INORGANIC URINE,52.0,25.06,13.52,50.44,29
CPT,84105,LAB PHOSPHORUS INORGANIC URINE NS,18.0,8.68,4.68,17.46,29
CPT,84105,LAB PHOSPHORUS STONE RISK,74.0,35.67,19.24,71.78,29
CPT,84110,LAB PORPHOBILINOGEN URINE QN,62.0,29.88,16.12,60.14,29
CPT,84112,POC PAMG-1 CERVICOVAGINAL QL,295.0,142.19,76.7,286.15,29
CPT,84120,LAB PORPHYRINS URINE QN&FRCTN,62.0,29.88,16.12,60.14,29
CPT,84132,LAB POTASS BLD WHL RBC,82.0,39.52,21.32,79.54,29
CPT,84132,LAB POTASS PLASMA,59.0,28.44,15.34,57.23,29
CPT,84132,LAB POTASS SRM/PLASMA/BLD WHL,30.0,14.46,7.8,29.1,29
CPT,84133,LAB POTASS URINE,55.0,26.51,14.3,53.35,29
CPT,84133,LAB POTASSIUM STONE RISK,70.0,33.74,18.2,67.9,29
CPT,84134,LAB PREALBUMIN,54.0,26.03,14.04,52.38,29
CPT,84140,LAB PREGNENOLONE,63.0,30.37,16.38,61.11,29
CPT,84143,LAB 17-HYDROXYPREGNENOLONE,69.0,33.26,17.94,66.93,29
CPT,84144,LAB PROGESTERONE,63.0,30.37,16.38,61.11,29
CPT,84145,LAB PROCALCITONIN,141.0,67.96,36.66,136.77,29
CPT,84146,LAB PROLACTIN,59.0,28.44,15.34,57.23,29
CPT,84150,LAB PROSTAGLANDIN EA ARP,335.0,161.47,87.1,324.95,29
CPT,84153,LAB PSA TOTAL,56.0,26.99,14.56,54.32,29
CPT,84153,LAB PSA TOTAL NS,70.0,33.74,18.2,67.9,29
CPT,84153,LAB SCR PSA,56.0,26.99,14.56,54.32,29
CPT,84154,LAB PSA FREE,56.0,26.99,14.56,54.32,29
CPT,84155,LAB PROT TTL SRM/PLASMA/BLD WHL,56.0,26.99,14.56,54.32,29
CPT,84155,LAB PROT TTL SRM/PLASMA/BLD WHL NS,53.0,25.55,13.78,51.41,29
CPT,84156,LAB PROT URINE,56.0,26.99,14.56,54.32,29
CPT,84156,LAB PROT URINE NS,59.0,28.44,15.34,57.23,29
CPT,84156,LAB PROT URINE TIMED,12.0,5.78,3.12,11.64,29
CPT,84157,LAB PROT FLUID BODY,56.0,26.99,14.56,54.32,29
CPT,84157,LAB PROT FLUID BODY NS,52.0,25.06,13.52,50.44,29
CPT,84157,LAB PROT FLUID CEREBROSPINAL,56.0,26.99,14.56,54.32,29
CPT,84165,LAB PROT FRCTN ELECTRO&QN SERUM,57.0,27.47,14.82,55.29,29
CPT,84165,LAB PROT FRCTN ELECTRO&QN SERUM NS,56.0,26.99,14.56,54.32,29
CPT,84166,LAB PROT FRCTN ELECTRO&QN OTHER,54.0,26.03,14.04,52.38,29
CPT,84166,LAB PROT FRCTN ELECTRO&QN URINE,54.0,26.03,14.04,52.38,29
CPT,84181,LAB HSP 70 WB W INTRP,174.0,83.87,45.24,168.78,29
CPT,84181,LAB PROT WB AB RYR W INTRP,710.0,342.22,184.6,688.7,29
CPT,84181,LAB PROT WB W INTRP,104.0,50.13,27.04,100.88,29
CPT,84182,LAB PROT WB W INTRP ENCEPHALITIS,155.0,74.71,40.3,150.35,29
CPT,84182,LAB PROT WB W INTRP ID BAND,139.0,67.0,36.14,134.83,29
CPT,84182,LAB PROT WB W INTRP ID CREUTZ-JAKOB,89.0,42.9,23.14,86.33,29
CPT,84182,LAB PROT WB W INTRP ID MYOSITIS,88.0,42.42,22.88,85.36,29
CPT,84202,LAB PROTOPORPHYRIN RBC QN,111.0,53.5,28.86,107.67,29
CPT,84206,LAB PROINSULIN,81.0,39.04,21.06,78.57,29
CPT,84207,LAB PYRIDOXAL PHOSPHATE,85.0,40.97,22.1,82.45,29
CPT,84238,LAB INTERLEUKIN 2 RECEPTOR,144.0,69.41,37.44,139.68,29
CPT,84238,LAB RECEPTOR ACETYLCHOLINE NON-ENDO,110.0,53.02,28.6,106.7,29
CPT,84238,LAB RECEPTOR INTERLEUK 2 SOL N-END,500.0,241.0,130.0,485.0,29
CPT,84244,LAB RENIN,140.0,67.48,36.4,135.8,29
CPT,84244,LAB RENIN NS,66.0,31.81,17.16,64.02,29
CPT,84252,LAB RIBOFLAVIN,74.0,35.67,19.24,71.78,29
CPT,84255,LAB SELENIUM,77.0,37.11,20.02,74.69,29
CPT,84260,LAB SEROTONIN,93.0,44.83,24.18,90.21,29
CPT,84270,LAB HORMONE SEX BINDING GLOBULIN,66.0,31.81,17.16,64.02,29
CPT,84295,LAB SODIUM SRM/PLASMA/BLD WHL,24.0,11.57,6.24,23.28,29
CPT,84300,LAB SODIUM STONE RISK,72.0,34.7,18.72,69.84,29
CPT,84300,LAB SODIUM URINE,16.0,7.71,4.16,15.52,29
CPT,84300,LAB SODIUM URINE TIMED,16.0,7.71,4.16,15.52,29
CPT,84302,LAB SODIUM OTHER SOURCE,15.0,7.23,3.9,14.55,29
CPT,84302,LAB SODIUM STOOL NS,58.0,27.96,15.08,56.26,29
CPT,84305,LAB SOMATOMEDIN NS,64.0,30.85,16.64,62.08,29
CPT,84307,LAB SOMATOSTATIN,82.0,39.52,21.32,79.54,29
CPT,84311,LAB SPCTPHOT 1-3-BETA-D-GLUCAN,157.0,75.67,40.82,152.29,29
CPT,84311,LAB SPCTPHOT ANALYTE NS,58.0,27.96,15.08,56.26,29
CPT,84311,LAB SPCTPHOT PORPHYRINS SERUM,70.0,33.74,18.2,67.9,29
CPT,84376,LAB SUGARS SINGLE QL STOOL NS,64.0,30.85,16.64,62.08,29
CPT,84377,LAB SUGARS MULTIPLE QL EA,229.0,110.38,59.54,222.13,29
CPT,84392,LAB SULFATE STONE RISK,72.0,34.7,18.72,69.84,29
CPT,84392,LAB SULFATE URINE,17.0,8.19,4.42,16.49,29
CPT,84393,LAB TAU181 PHOSPHORYLATED EA,387.0,186.53,100.62,375.39,29
CPT,84393,LAB TAU217 PHOSPHORYLATED EA,387.0,186.53,100.62,375.39,29
CPT,84394,LAB TAU TOTAL,387.0,186.53,100.62,375.39,29
CPT,84402,LAB TESTOSTERONE FREE,77.0,37.11,20.02,74.69,29
CPT,84403,LAB TESTOSTERONE TOTAL,78.0,37.6,20.28,75.66,29
CPT,84403,LAB TESTOSTERONE TOTAL NS,78.0,37.6,20.28,75.66,29
CPT,84425,LAB THIAMINE,64.0,30.85,16.64,62.08,29
CPT,84432,LAB THYROGLOBULIN,58.0,27.96,15.08,56.26,29
CPT,84432,LAB THYROGLOBULIN FNA,82.0,39.52,21.32,79.54,29
CPT,84432,LAB THYROGLOBULIN NS,57.0,27.47,14.82,55.29,29
CPT,84433,LAB THIOPURINE S-METHYLTRANSFERASE,112.0,53.98,29.12,108.64,29
CPT,84436,LAB THYROXINE T4 TOTAL,56.0,26.99,14.56,54.32,29
CPT,84439,LAB THYROXINE T4 FREE,28.0,13.5,7.28,27.16,29
CPT,84439,LAB THYROXINE T4 FREE NS,66.0,31.81,17.16,64.02,29
CPT,84442,LAB THYROXINE BINDING GLOBULIN,45.0,21.69,11.7,43.65,29
CPT,84443,LAB THYROID CASCADING REFLEX,55.0,26.51,14.3,53.35,29
CPT,84443,LAB THYROID STIMULATING HORMONE,54.0,26.03,14.04,52.38,29
CPT,84445,LAB THYROID STIMULATING IMMUN GLOB,153.0,73.75,39.78,148.41,29
CPT,84446,LAB TOCOPHEROL ALPHA,62.0,29.88,16.12,60.14,29
CPT,84449,LAB CORTISOL BINDING GLOBULIN,54.0,26.03,14.04,52.38,29
CPT,84450,LAB TRANSFERASE AMINO ASPARTATE,38.0,18.32,9.88,36.86,29
CPT,84450,LAB TRANSFERASE AMINO ASPARTATE NS,76.0,36.63,19.76,73.72,29
CPT,84460,LAB TRANSFERASE AMINO ALANINE,38.0,18.32,9.88,36.86,29
CPT,84460,LAB TRANSFERASE AMINO ALANINE NS,59.0,28.44,15.34,57.23,29
CPT,84466,LAB TRANSFERRIN,39.0,18.8,10.14,37.83,29
CPT,84478,LAB TRIGLYCERIDES,41.0,19.76,10.66,39.77,29
CPT,84478,LAB TRIGLYCERIDES NS,57.0,27.47,14.82,55.29,29
CPT,84479,LAB UPTAKE HORMONE T3,56.0,26.99,14.56,54.32,29
CPT,84480,LAB TRIIODOTHYRONINE T3 TOTAL,43.0,20.73,11.18,41.71,29
CPT,84480,LAB TRIIODOTHYRONINE T3 TOTAL NS,43.0,20.73,11.18,41.71,29
CPT,84481,LAB TRIIODOTHYRONINE T3 FREE,54.0,26.03,14.04,52.38,29
CPT,84481,LAB TRIIODOTHYRONINE T3 FREE TR DIA,71.0,34.22,18.46,68.87,29
CPT,84482,LAB TRIIODOTHYRONINE T3 REVERSE,59.0,28.44,15.34,57.23,29
CPT,84484,LAB TROPONIN QN,38.0,18.32,9.88,36.86,29
CPT,84520,LAB NITROGEN UREA QN,33.0,15.91,8.58,32.01,29
CPT,84540,LAB NITROGEN UREA URINE,52.0,25.06,13.52,50.44,29
CPT,84545,LAB NITROGEN UREA CLEARANCE,71.0,34.22,18.46,68.87,29
CPT,84550,LAB ACID URIC BLOOD,14.0,6.75,3.64,13.58,29
CPT,84560,LAB ACID URIC FLUID BODY,56.0,26.99,14.56,54.32,29
CPT,84560,LAB ACID URIC OTHER SOURCE NS,58.0,27.96,15.08,56.26,29
CPT,84560,LAB ACID URIC URINE,56.0,26.99,14.56,54.32,29
CPT,84560,LAB URIC ACID STONE RISK,72.0,34.7,18.72,69.84,29
CPT,84585,LAB ACID VANILLYLMANDELIC URINE,82.0,39.52,21.32,79.54,29
CPT,84586,LAB VASOACTIVE INTS PEPTIDE NS,160.0,77.12,41.6,155.2,29
CPT,84588,LAB VASOPRESSIN,102.0,49.16,26.52,98.94,29
CPT,84590,LAB VITAMIN A,62.0,29.88,16.12,60.14,29
CPT,84591,LAB BIOTIN,160.0,77.12,41.6,155.2,29
CPT,84591,LAB NIACIN,94.0,45.31,24.44,91.18,29
CPT,84591,LAB PANTOTHENIC ACID B5,69.0,33.26,17.94,66.93,29
CPT,84597,LAB VITAMIN K,85.0,40.97,22.1,82.45,29
CPT,84600,LAB VOLATILE NS,184.0,88.69,47.84,178.48,29
CPT,84630,LAB ZINC,61.0,29.4,15.86,59.17,29
CPT,84630,LAB ZINC NS,35.0,16.87,9.1,33.95,29
CPT,84681,LAB C-PEPTIDE,63.0,30.37,16.38,61.11,29
CPT,84702,LAB HCG QN,46.0,22.17,11.96,44.62,29
CPT,84702,LAB HCG QN NS,67.0,32.29,17.42,64.99,29
CPT,84702,LAB HCG TUMOR MARKER QN,57.0,27.47,14.82,55.29,29
CPT,84703,LAB HCG QL,23.0,11.09,5.98,22.31,29
CPT,84999,LAB CHOLESTEROL FLUID BODY,55.0,26.51,14.3,53.35,29
CPT,84999,LAB GENE B-CELL CLONALITY PCR,51.0,24.58,13.26,49.47,29
CPT,84999,LAB OSMOLALITY STOOL,68.0,32.78,17.68,65.96,29
CPT,84999,LAB POTASS FLUID BODY,56.0,26.99,14.56,54.32,29
CPT,85007,LAB COUNT BLD DIFF MANUAL WBC,54.0,26.03,14.04,52.38,29
CPT,85014,LAB COUNT BLD HEMATOCRIT,8.0,3.86,2.08,7.76,29
CPT,85014,LAB COUNT BLD HEMATOCRIT NS,69.0,33.26,17.94,66.93,29
CPT,85018,LAB COUNT BLD HEMOGLOBIN,8.0,3.86,2.08,7.76,29
CPT,85018,LAB COUNT BLD HEMOGLOBIN NS,60.0,28.92,15.6,58.2,29
CPT,85025,LAB CBC AUTO W AUTO DIFF,24.0,11.57,6.24,23.28,29
CPT,85025,LAB HEMO PLT AUTO W AUTO SCAN,24.0,11.57,6.24,23.28,29
CPT,85027,LAB CBC AUTO WO DIFF,20.0,9.64,5.2,19.4,29
CPT,85041,LAB COUNT BLD RBC AUTO,62.0,29.88,16.12,60.14,29
CPT,85041,LAB COUNT BLD RBC AUTO NS,63.0,30.37,16.38,61.11,29
CPT,85044,LAB COUNT BLD RETIC MANUAL,13.0,6.27,3.38,12.61,29
CPT,85046,LAB COUNT BLD RETIC AUTO W PARAM,112.0,53.98,29.12,108.64,29
CPT,85048,LAB COUNT BLD LEUKO AUTO,8.0,3.86,2.08,7.76,29
CPT,85049,LAB COUNT BLD PLATELET AUTOMATED,14.0,6.75,3.64,13.58,29
CPT,85049,LAB COUNT BLD PLATELET AUTOMATED NS,58.0,27.96,15.08,56.26,29
CPT,85055,LAB PLATELET RETICULATED,108.0,52.06,28.08,104.76,29
CPT,85210,LAB CLOTTING FACTOR 2 PROTHROM,64.0,30.85,16.64,62.08,29
CPT,85220,LAB CLOTTING FACTOR 5 LABILE,75.0,36.15,19.5,72.75,29
CPT,85230,LAB CLOTTING FACTOR 7,76.0,36.63,19.76,73.72,29
CPT,85240,LAB CLOTTING FACTOR 8 1-STG,66.0,31.81,17.16,64.02,29
CPT,85240,LAB CLOTTING FACTOR 8 1-STG NS,114.0,54.95,29.64,110.58,29
CPT,85245,LAB CLOTTING FACTOR 8 VWF RIST,74.0,35.67,19.24,71.78,29
CPT,85245,LAB CLOTTING FACTOR 8 VWF RIST NS,87.0,41.93,22.62,84.39,29
CPT,85246,LAB CLOTTING FACTOR 8 VWF AG,74.0,35.67,19.24,71.78,29
CPT,85247,LAB CLOTTING FACTOR 8 VWF MULTI,69.0,33.26,17.94,66.93,29
CPT,85250,LAB CLOTTING FACTOR 9 PTC/XMAS,79.0,38.08,20.54,76.63,29
CPT,85250,LAB CLOTTING FACTOR 9 PTC/XMAS NS,75.0,36.15,19.5,72.75,29
CPT,85260,LAB CLOTTING FACTOR 10 STUART-PROWR,76.0,36.63,19.76,73.72,29
CPT,85270,LAB CLOTTING FACTOR 11 PTA NS,89.0,42.9,23.14,86.33,29
CPT,85280,LAB CLOTTING FACTOR 12 HAGEMAN,76.0,36.63,19.76,73.72,29
CPT,85290,LAB CLOTTING FACTOR 13 STB FBR NS,98.0,47.24,25.48,95.06,29
CPT,85291,LAB CLOTTING FACTOR 13 SCR SOL,28.0,13.5,7.28,27.16,29
CPT,85300,LAB CLOTTING ACT ANTITHROM 3,63.0,30.37,16.38,61.11,29
CPT,85301,LAB CLOTTING AG ANTITHROMBIN 3 NS,69.0,33.26,17.94,66.93,29
CPT,85302,LAB CLOTTING AG PROTEIN C,65.0,31.33,16.9,63.05,29
CPT,85303,LAB CLOTTING ACT PROTEIN C,42.0,20.24,10.92,40.74,29
CPT,85305,LAB CLOTTING PROTEIN S TOTAL,64.0,30.85,16.64,62.08,29
CPT,85305,LAB CLOTTING PROTEIN S TOTAL NS,58.0,27.96,15.08,56.26,29
CPT,85306,LAB CLOTTING PROTEIN S FREE,66.0,31.81,17.16,64.02,29
CPT,85306,LAB CLOTTING PROTEIN S FREE NS,60.0,28.92,15.6,58.2,29
CPT,85307,LAB PROT C ACT RESISTANCE,66.0,31.81,17.16,64.02,29
CPT,85335,LAB INHIBITOR FACTOR 8,97.0,46.75,25.22,94.09,29
CPT,85335,LAB INHIBITOR VWF PROTEASE,225.0,108.45,58.5,218.25,29
CPT,85362,LAB FDP FSP AGG SEMI QN NS,80.0,38.56,20.8,77.6,29
CPT,85379,LAB FDP D-DIMER QN,31.0,14.94,8.06,30.07,29
CPT,85379,LAB FDP D-DIMER QN NS,92.0,44.34,23.92,89.24,29
CPT,85384,LAB FIBRINOGEN ACTIVITY,30.0,14.46,7.8,29.1,29
CPT,85384,LAB FIBRINOGEN ACTIVITY NS,30.0,14.46,7.8,29.1,29
CPT,85390,LAB SCR FIBRINOLYSINS/COAG NS,47.0,22.65,12.22,45.59,29
CPT,85397,LAB COAGULATION&FIBRINOLYSIS,164.0,79.05,42.64,159.08,29
CPT,85420,LAB PLASMINOGEN NON-ANTIGENIC,57.0,27.47,14.82,55.29,29
CPT,85420,LAB PLASMINOGEN NON-ANTIGENIC NS,71.0,34.22,18.46,68.87,29
CPT,85460,LAB HGB FETAL KLEIHAUER-BETKE,59.0,28.44,15.34,57.23,29
CPT,85461,LAB HGB FETAL ROSETTE,29.0,13.98,7.54,28.13,29
CPT,85520,LAB ASSAY HEPARIN,65.0,31.33,16.9,63.05,29
CPT,85520,LAB ASSAY HEPARIN NS,92.0,44.34,23.92,89.24,29
CPT,85549,LAB MURAMIDASE,57.0,27.47,14.82,55.29,29
CPT,85557,LAB FRAGILITY OSMOTIC RBC INCUB,57.0,27.47,14.82,55.29,29
CPT,85576,LAB AGGREGATION PLT EA AGENT,75.0,36.15,19.5,72.75,29
CPT,85598,LAB NEUTRAL PHOSPHO HEXAGONAL,71.0,34.22,18.46,68.87,29
CPT,85610,LAB PROTHROMBIN TIME,51.0,24.58,13.26,49.47,29
CPT,85610,LAB PROTHROMBIN TIME NS,63.0,30.37,16.38,61.11,29
CPT,85611,LAB PROTHROMBIN TIME SUB,58.0,27.96,15.08,56.26,29
CPT,85613,LAB VENOM TIME RUSSELL VIPER DLT,60.0,28.92,15.6,58.2,29
CPT,85635,LAB REPTILASE,80.0,38.56,20.8,77.6,29
CPT,85651,LAB RATE SEDIMENTATION RBC NONAUTO,13.0,6.27,3.38,12.61,29
CPT,85652,LAB RATE SEDIMENTATION RBC AUTO,9.0,4.34,2.34,8.73,29
CPT,85660,LAB SICKLING RBC REDUCTION,56.0,26.99,14.56,54.32,29
CPT,85660,LAB SICKLING RBC REDUCTION NS,91.0,43.86,23.66,88.27,29
CPT,85670,LAB THROMBIN TIME PLASMA,56.0,26.99,14.56,54.32,29
CPT,85670,LAB THROMBIN TIME PLASMA NS,18.0,8.68,4.68,17.46,29
CPT,85730,LAB PTT PLASMA/BLD WHL,19.0,9.16,4.94,18.43,29
CPT,85730,LAB PTT PLASMA/BLD WHL NS,54.0,26.03,14.04,52.38,29
CPT,85732,LAB PTT SUBSTITUTION FRAC PLASMA,103.0,49.65,26.78,99.91,29
CPT,85810,LAB VISCOSITY,57.0,27.47,14.82,55.29,29
CPT,85999,LAB EOSINOPHILS URINE/OTHER,57.0,27.47,14.82,55.29,29
CPT,86000,LAB AGGLUTININS FEBRILE AG EA,21.0,12.1,5.46,20.37,29
CPT,86001,LAB ALLG IGG QN/SEMI QN EA,109.0,62.78,28.34,105.73,29
CPT,86003,LAB ALLG IGE QN/SEMI QN CRUDE EA,56.0,32.26,14.56,54.32,29
CPT,86003,LAB ALLG IGE QN/SEMI QN CRUDE EA NS,55.0,31.68,14.3,53.35,29
CPT,86005,LAB SCR ALLG IGE QL MULTI,56.0,32.26,14.56,54.32,29
CPT,86005,LAB SCR ALLG IGE QL MULTI NS,59.0,33.98,15.34,57.23,29
CPT,86008,LAB ALLG IGE QN/SEMI QN EA,64.0,36.86,16.64,62.08,29
CPT,86008,LAB ALLG IGE QN/SEMI QN EA NS,80.0,46.08,20.8,77.6,29
CPT,86015,LAB SCR AB MUSCLE SMOOTH FL,60.0,34.56,15.6,58.2,29
CPT,86015,LAB SCR AB MUSCLE SMOOTH FL NS,56.0,32.26,14.56,54.32,29
CPT,86021,LAB AB ID LEUKOCYTE,55.0,31.68,14.3,53.35,29
CPT,86021,LAB AB ID LEUKOCYTE NS,54.0,31.1,14.04,52.38,29
CPT,86022,LAB AB ID PLATELET BLOOD PRODUCT,238.0,137.09,61.88,230.86,29
CPT,86022,LAB AB ID PLATELET IGG FLOW CYTO,236.0,135.94,61.36,228.92,29
CPT,86022,LAB AB ID PLATELET PATIENT SERUM NS,145.0,83.52,37.7,140.65,29
CPT,86023,LAB AB ID IG PLATELET ASSOCIATED,236.0,135.94,61.36,228.92,29
CPT,86036,LAB SCR AB ANCA FL EA AB,54.0,31.1,14.04,52.38,29
CPT,86037,LAB SCR ANCA TITER AB EA,62.0,35.71,16.12,60.14,29
CPT,86038,LAB SCR ANA,53.0,30.53,13.78,51.41,29
CPT,86039,LAB ANA TITER,59.0,33.98,15.34,57.23,29
CPT,86039,LAB ANA TITER NS,115.0,66.24,29.9,111.55,29
CPT,86041,LAB IMM ACHR BINDING QN,70.0,40.32,18.2,67.9,29
CPT,86042,LAB IMM ACHR BLOCKING QN,99.0,57.02,25.74,96.03,29
CPT,86043,LAB IMM ACHR MODULATING QN,78.0,44.93,20.28,75.66,29
CPT,86051,LAB AQUAPORIN AB,268.0,154.37,69.68,259.96,29
CPT,86052,LAB SCR AQUAPORIN 4 AB IGG CSF,350.0,201.6,91.0,339.5,29
CPT,86052,LAB SCR AQUAPORIN 4 AB IGG SERUM,225.0,129.6,58.5,218.25,29
CPT,86053,LAB AQUAPORIN 4 AB FLOW CYTOMETRY,118.0,67.97,30.68,114.46,29
CPT,86060,LAB ANTISTREPTOLYSIN O TITER,57.0,32.83,14.82,55.29,29
CPT,86140,LAB PROT C-REACTIVE,16.0,9.22,4.16,15.52,29
CPT,86141,LAB PROT C-REACTIVE SENS HIGH,57.0,32.83,14.82,55.29,29
CPT,86141,LAB PROT C-REACTIVE SENS HIGH NS,131.0,75.46,34.06,127.07,29
CPT,86146,LAB AB BETA 2 GLYCOPROTEIN I,77.0,44.35,20.02,74.69,29
CPT,86147,LAB AB CARDIOLIPIN IG EA,80.0,46.08,20.8,77.6,29
CPT,86148,LAB AB ANTIPHOSPHATIDYLSERINE,57.0,32.83,14.82,55.29,29
CPT,86156,LAB SCR AGGLUTININ COLD,25.0,14.4,6.5,24.25,29
CPT,86157,LAB AGGLUTININ COLD TITER,58.0,33.41,15.08,56.26,29
CPT,86160,LAB COMPLEMENT AG C1 ESTER NONFUNC,36.0,20.74,9.36,34.92,29
CPT,86160,LAB COMPLEMENT AG C1Q COMP EA,76.0,43.78,19.76,73.72,29
CPT,86160,LAB COMPLEMENT AG C2 COMP EA,36.0,20.74,9.36,34.92,29
CPT,86160,LAB COMPLEMENT AG C3 COMP EA,36.0,20.74,9.36,34.92,29
CPT,86160,LAB COMPLEMENT AG C4 COMP EA,53.0,30.53,13.78,51.41,29
CPT,86160,LAB COMPLEMENT AG C5 COMP EA,77.0,44.35,20.02,74.69,29
CPT,86160,LAB COMPLEMENT AG C6 COMP EA,36.0,20.74,9.36,34.92,29
CPT,86160,LAB COMPLEMENT AG COMP EA NS,222.0,127.87,57.72,215.34,29
CPT,86160,LAB COMPLEMENT AG SC5B-9 COMP EA,292.0,168.19,75.92,283.24,29
CPT,86161,LAB COMPLEMENT ACT FUNC,66.0,38.02,17.16,64.02,29
CPT,86161,LAB COMPLEMENT ACT FUNC C1 ESTER,66.0,38.02,17.16,64.02,29
CPT,86161,LAB COMPLEMENT ACT FUNC C3NEF,300.0,172.8,78.0,291.0,29
CPT,86161,LAB COMPLEMENT ACT FUNC NS,185.0,106.56,48.1,179.45,29
CPT,86162,LAB COMPLEMENT TOTAL HEMOLYTIC,61.0,35.14,15.86,59.17,29
CPT,86200,LAB AB PEPTIDE CYCLIC CITRUL,60.0,34.56,15.6,58.2,29
CPT,86215,LAB AB DEOXYRIBONUCLEASE,40.0,23.04,10.4,38.8,29
CPT,86225,LAB AB DNA STRANDED NATVE/DOUBLE,42.0,24.19,10.92,40.74,29
CPT,86225,LAB AB DNA STRANDED NATVE/DOUBLE NS,62.0,35.71,16.12,60.14,29
CPT,86231,LAB SCR AB ENDOMYSIAL FL,61.0,35.14,15.86,59.17,29
CPT,86235,LAB AB ENA CENTROMERE B,60.0,34.56,15.6,58.2,29
CPT,86235,LAB AB ENA CHROMATIN,124.0,71.42,32.24,120.28,29
CPT,86235,LAB AB ENA FIBRILLARIN,130.0,74.88,33.8,126.1,29
CPT,86235,LAB AB ENA JO1,123.0,70.85,31.98,119.31,29
CPT,86235,LAB AB ENA MYOSITIS,77.0,44.35,20.02,74.69,29
CPT,86235,LAB AB ENA NS,65.0,37.44,16.9,63.05,29
CPT,86235,LAB AB ENA PM/SC1-100,115.0,66.24,29.9,111.55,29
CPT,86235,LAB AB ENA RNP,55.0,31.68,14.3,53.35,29
CPT,86235,LAB AB ENA SCLERODERMA,123.0,70.85,31.98,119.31,29
CPT,86235,LAB AB ENA SCLERODERMA PANEL,161.0,92.74,41.86,156.17,29
CPT,86235,LAB AB ENA SM/RNP,124.0,71.42,32.24,120.28,29
CPT,86235,LAB AB ENA SMITH,55.0,31.68,14.3,53.35,29
CPT,86235,LAB AB ENA SS-A/RO,55.0,31.68,14.3,53.35,29
CPT,86235,LAB AB ENA SS-B/LA,55.0,31.68,14.3,53.35,29
CPT,86255,LAB SCR AB ADRENAL FL,37.0,21.31,9.62,35.89,29
CPT,86255,LAB SCR AB ANTIMYOCARDIAL FL,76.0,43.78,19.76,73.72,29
CPT,86255,LAB SCR AB CASPR2 FL,606.0,349.06,157.56,587.82,29
CPT,86255,LAB SCR AB COPEPTIN FL,300.0,172.8,78.0,291.0,29
CPT,86255,LAB SCR AB ENCEPHALITIS FL,98.0,56.45,25.48,95.06,29
CPT,86255,LAB SCR AB FL,128.0,73.73,33.28,124.16,29
CPT,86255,LAB SCR AB FL NS,55.0,31.68,14.3,53.35,29
CPT,86255,LAB SCR AB LG1 FL,565.0,325.44,146.9,548.05,29
CPT,86255,LAB SCR AB LRP4 AUTO FL,850.0,489.6,221.0,824.5,29
CPT,86255,LAB SCR AB MUSCLE STRIATED FL,56.0,32.26,14.56,54.32,29
CPT,86255,LAB SCR AB NMDA RECEPTOR FL,167.0,96.19,43.42,161.99,29
CPT,86255,LAB SCR AB PARANEOPLASTIC CSF FL,200.0,115.2,52.0,194.0,29
CPT,86255,LAB SCR AB PARANEOPLASTIC FL,93.0,53.57,24.18,90.21,29
CPT,86255,LAB SCR AB PARIETAL FL,55.0,31.68,14.3,53.35,29
CPT,86255,LAB SCR AB PHOSPHOLIPAS A2 RECPT FL,190.0,109.44,49.4,184.3,29
CPT,86255,LAB SCR AB PURKINJE FL,64.0,36.86,16.64,62.08,29
CPT,86255,LAB SCR AB REFLEX ENCEPHALITIS FL,525.0,302.4,136.5,509.25,29
CPT,86255,LAB SCR AB RETICULUM FL,54.0,31.1,14.04,52.38,29
CPT,86255,LAB SCR AB THSD7A W REFLEX FL,453.0,260.93,117.78,439.41,29
CPT,86256,LAB AB FL TITER AQUAPORIN 4,219.0,126.14,56.94,212.43,29
CPT,86256,LAB AB FL TITER ENCEPHALITIS,194.0,111.74,50.44,188.18,29
CPT,86256,LAB AB FL TITER ENDOMYSIAL,103.0,59.33,26.78,99.91,29
CPT,86256,LAB AB FL TITER HU,55.0,31.68,14.3,53.35,29
CPT,86256,LAB AB FL TITER MITOCHONDRIA,60.0,34.56,15.6,58.2,29
CPT,86256,LAB AB FL TITER MOG,837.0,482.11,217.62,811.89,29
CPT,86256,LAB AB FL TITER MUSCLE SMOOTH,65.0,37.44,16.9,63.05,29
CPT,86256,LAB AB FL TITER MUSCLE STRIATED,65.0,37.44,16.9,63.05,29
CPT,86256,LAB AB FL TITER NMDA,194.0,111.74,50.44,188.18,29
CPT,86256,LAB AB FL TITER NS,78.0,44.93,20.28,75.66,29
CPT,86256,LAB AB FL TITER PARIETAL,55.0,31.68,14.3,53.35,29
CPT,86256,LAB AB FL TITER PHOSPHOLPS A2 RECPT,285.0,164.16,74.1,276.45,29
CPT,86256,LAB AB FL TITER PURKINJE,190.0,109.44,49.4,184.3,29
CPT,86258,LAB IMM MS GLIADIN IGA QL,37.0,21.31,9.62,35.89,29
CPT,86258,LAB IMM MS GLIADIN IGG QL,37.0,21.31,9.62,35.89,29
CPT,86258,LAB IMM MS GLIADIN QL,59.0,33.98,15.34,57.23,29
CPT,86300,LAB IMM AG TUMOR CA 15-3,63.0,36.29,16.38,61.11,29
CPT,86300,LAB IMM AG TUMOR CA 27-29,63.0,36.29,16.38,61.11,29
CPT,86301,LAB IMM AG TUMOR CA 19-9,63.0,36.29,16.38,61.11,29
CPT,86304,LAB IMM AG TUMOR CA 125,63.0,36.29,16.38,61.11,29
CPT,86305,LAB PROT 4 HUMAN EPIDIDYMIS,97.0,55.87,25.22,94.09,29
CPT,86308,LAB SCR AB HETEROPHILE,16.0,9.22,4.16,15.52,29
CPT,86316,LAB IMM AG TUMOR OTHER QN NS,75.0,43.2,19.5,72.75,29
CPT,86317,LAB IMM AB QN CREUTZFELDT-JAKOB,83.0,47.81,21.58,80.51,29
CPT,86317,LAB IMM AB QN HAEMOPHILUS INFLU B,63.0,36.29,16.38,61.11,29
CPT,86317,LAB IMM AB QN NS,142.0,81.79,36.92,137.74,29
CPT,86317,LAB IMM AB QN PNEUMOCOCCAL,51.0,29.38,13.26,49.47,29
CPT,86320,LAB IMMUNOELECTROPHORESIS SERUM,90.0,51.84,23.4,87.3,29
CPT,86328,LAB IMM AB QL/SEMI QN SGL COVID-19,136.0,78.34,35.36,131.92,29
CPT,86329,LAB IMDF,55.0,31.68,14.3,53.35,29
CPT,86331,LAB IMDF GEL AB/AG QL,56.0,32.26,14.56,54.32,29
CPT,86332,LAB IMMUNE COMPLEX C1Q BINDING,74.0,42.62,19.24,71.78,29
CPT,86334,LAB IMMUNOFIXATION EP CRYOGLOBULIN,68.0,39.17,17.68,65.96,29
CPT,86334,LAB IMMUNOFIXATION EP IGD IGE,142.0,81.79,36.92,137.74,29
CPT,86334,LAB IMMUNOFIXATION EP SERUM,68.0,39.17,17.68,65.96,29
CPT,86334,LAB IMMUNOFIXATION EP SERUM NS,74.0,42.62,19.24,71.78,29
CPT,86335,LAB IMMUNOFIXATION EP TRANSFRN BETA,89.0,51.26,23.14,86.33,29
CPT,86335,LAB IMMUNOFIXATION EP URINE/CSF,89.0,51.26,23.14,86.33,29
CPT,86336,LAB INHIBIN A,57.0,32.83,14.82,55.29,29
CPT,86336,LAB INHIBIN A NS,77.0,44.35,20.02,74.69,29
CPT,86337,LAB AB INSULIN,66.0,38.02,17.16,64.02,29
CPT,86340,LAB AB INTRINSIC FACTOR,59.0,33.98,15.34,57.23,29
CPT,86341,LAB AB ISLET ANTIGEN 2 AUTOAB,158.0,91.01,41.08,153.26,29
CPT,86341,LAB AB ISLET CELL NS,71.0,40.9,18.46,68.87,29
CPT,86341,LAB AB ISLET ENCEPHALITIS,144.0,82.94,37.44,139.68,29
CPT,86341,LAB AB ZINC TRANSPORTER,240.0,138.24,62.4,232.8,29
CPT,86343,LAB LEUKOCYTE HISTAMINE RELEASE,64.0,36.86,16.64,62.08,29
CPT,86352,LAB FNCT CELL W STIM&DET BIOMARK,408.0,235.01,106.08,395.76,29
CPT,86353,LAB TRANSFORM LYMPHOCYTE MITOGEN,205.0,118.08,53.3,198.85,29
CPT,86355,LAB B CELLS CD19 COUNT TOTAL,114.0,65.66,29.64,110.58,29
CPT,86355,LAB B CELLS CD19 COUNT TOTAL NS,114.0,65.66,29.64,110.58,29
CPT,86356,LAB AG CELL MONONUC QN EA AG,93.0,53.57,24.18,90.21,29
CPT,86357,LAB COUNT TOTAL CELLS CD56 NK,114.0,65.66,29.64,110.58,29
CPT,86357,LAB COUNT TOTAL CELLS CD56 NK NS,114.0,65.66,29.64,110.58,29
CPT,86359,LAB COUNT TOTAL CELLS T,114.0,65.66,29.64,110.58,29
CPT,86359,LAB COUNT TOTAL CELLS T NS,114.0,65.66,29.64,110.58,29
CPT,86360,LAB COUNT CELLS T CD4&CD8 RATIO,141.0,81.22,36.66,136.77,29
CPT,86360,LAB COUNT CELLS T CD4&CD8 RATIO NS,141.0,81.22,36.66,136.77,29
CPT,86361,LAB COUNT CELLS T CD4 ABSOLUTE,111.0,63.94,28.86,107.67,29
CPT,86362,LAB SCR AB MOG FL,86.0,49.54,22.36,83.42,29
CPT,86362,LAB SCR AB MOG TITER,837.0,482.11,217.62,811.89,29
CPT,86364,LAB IMM MS TRANSGLUTAMINASE NS,35.0,20.16,9.1,33.95,29
CPT,86364,LAB IMM MS TRANSGLUTAMINASE QL,59.0,33.98,15.34,57.23,29
CPT,86366,LAB IMM MUSK QN,56.0,32.26,14.56,54.32,29
CPT,86376,LAB AB MICROSOMAL EA,44.0,25.34,11.44,42.68,29
CPT,86376,LAB AB MICROSOMAL LIVER-KIDNEY EA,63.0,36.29,16.38,61.11,29
CPT,86376,LAB AB MICROSOMAL THYROID EA NS,55.0,31.68,14.3,53.35,29
CPT,86381,LAB AB MITOCHONDRIA EA,150.0,86.4,39.0,145.5,29
CPT,86381,LAB SCR AB MITOCHONDRIAL,77.0,44.35,20.02,74.69,29
CPT,86382,LAB NEUTRALIZATION VIRAL,69.0,39.74,17.94,66.93,29
CPT,86382,LAB NEUTRALIZATION VIRAL IFNB-1,1178.0,678.53,306.28,1142.66,29
CPT,86382,LAB NEUTRALIZATION VIRAL RABIES,127.0,73.15,33.02,123.19,29
CPT,86403,LAB SCR AB AGG PARTICLE EA,74.0,42.62,19.24,71.78,29
CPT,86403,LAB SCR AB CRYPTO AGG PARTICLE,59.0,33.98,15.34,57.23,29
CPT,86403,LAB SCR AB H INFLUENZA AGG PARTICLE,53.0,30.53,13.78,51.41,29
CPT,86403,LAB SCR AB NEISS AGG PARTICLE,74.0,42.62,19.24,71.78,29
CPT,86403,LAB SCR AB NEISS GRP A AGG PARTICLE,53.0,30.53,13.78,51.41,29
CPT,86403,LAB SCR AB NEISS GRP C AGG PARTICLE,53.0,30.53,13.78,51.41,29
CPT,86403,LAB SCR AB STREP PNEUMO AGGPARTICLE,53.0,30.53,13.78,51.41,29
CPT,86406,LAB AGG PARTICLE TITER,59.0,33.98,15.34,57.23,29
CPT,86406,LAB AGG PARTICLE TITER STREPTOZYME,81.0,46.66,21.06,78.57,29
CPT,86430,LAB FACTOR RHEUMATOID QL,70.0,40.32,18.2,67.9,29
CPT,86431,LAB FACTOR RHEUMATOID QN,18.0,10.37,4.68,17.46,29
CPT,86431,LAB FACTOR RHEUMATOID QN NS,55.0,31.68,14.3,53.35,29
CPT,86480,LAB TB MEAS IMMUNITY GAMMA INTERFRN,186.0,107.14,48.36,180.42,29
CPT,86481,LAB TB MEAS IMMUNITY T-CELL SUSP,300.0,172.8,78.0,291.0,29
CPT,86481,LAB TB MEAS IMMUNITY T-CELL SUSP NS,300.0,172.8,78.0,291.0,29
CPT,86580,LAB TEST SKIN TB INTRADERMAL,62.0,35.71,16.12,60.14,29
CPT,86581,LAB AB STREP PNEU SEROT IA,372.0,214.27,96.72,360.84,29
CPT,86592,LAB SYPHILIS VDRL/RPR QL,52.0,29.95,13.52,50.44,29
CPT,86592,LAB SYPHILIS VDRL/RPR QL CSF,62.0,35.71,16.12,60.14,29
CPT,86592,LAB SYPHILIS VDRL/RPR QL DNR TESTNG,134.0,77.18,34.84,129.98,29
CPT,86593,LAB SYPHILIS VDRL/RPR QN,52.0,29.95,13.52,50.44,29
CPT,86596,LAB AB CHANNEL CA VOLTAGE-GATED,444.0,255.74,115.44,430.68,29
CPT,86603,LAB AB ADENOVIRUS,61.0,35.14,15.86,59.17,29
CPT,86606,LAB AB ASPERGILLUS,55.0,31.68,14.3,53.35,29
CPT,86609,LAB AB BACTERIUM NONSPECIFIED NS,153.0,88.13,39.78,148.41,29
CPT,86609,LAB AB LISTERIA,153.0,88.13,39.78,148.41,29
CPT,86609,LAB AB M FAENI,153.0,88.13,39.78,148.41,29
CPT,86609,LAB AB S VIRIDIS,153.0,88.13,39.78,148.41,29
CPT,86609,LAB AB T CANDIDUS,153.0,88.13,39.78,148.41,29
CPT,86609,LAB AB T VULGARIS,153.0,88.13,39.78,148.41,29
CPT,86611,LAB AB BARTONELLA,62.0,35.71,16.12,60.14,29
CPT,86612,LAB DET AB BLASTOMYCES NS,78.0,44.93,20.28,75.66,29
CPT,86615,LAB AB BORDETELLA,70.0,40.32,18.2,67.9,29
CPT,86617,LAB AB LYME DISEASE CONFIRMATORY,61.0,35.14,15.86,59.17,29
CPT,86618,LAB AB LYME DISEASE IGG IGM,66.0,38.02,17.16,64.02,29
CPT,86622,LAB AB BRUCELLA,67.0,38.59,17.42,64.99,29
CPT,86625,LAB AB CAMPYLOBACTER NS,40.0,23.04,10.4,38.8,29
CPT,86628,LAB AB CANDIDA,71.0,40.9,18.46,68.87,29
CPT,86631,LAB AB CHLAMYDIA,81.0,46.66,21.06,78.57,29
CPT,86631,LAB AB CHLAMYDIA PNEU IGG IGA,61.0,35.14,15.86,59.17,29
CPT,86631,LAB AB CHLAMYDIA PSITTACI IGG IGA,61.0,35.14,15.86,59.17,29
CPT,86631,LAB AB CHLAMYDIA TRAC IGG IGA,61.0,35.14,15.86,59.17,29
CPT,86632,LAB AB CHLAMYDIA PNEUM IGM,61.0,35.14,15.86,59.17,29
CPT,86632,LAB AB CHLAMYDIA PSITTACI IGM,61.0,35.14,15.86,59.17,29
CPT,86632,LAB AB CHLAMYDIA TRAC IGM,61.0,35.14,15.86,59.17,29
CPT,86635,LAB AB COCCIDIOIDES,55.0,31.68,14.3,53.35,29
CPT,86635,LAB AB COCCIDIOIDES IGG,63.0,36.29,16.38,61.11,29
CPT,86635,LAB AB COCCIDIOIDES IGM,63.0,36.29,16.38,61.11,29
CPT,86635,LAB AB COCCIDIOIDES NS,66.0,38.02,17.16,64.02,29
CPT,86638,LAB AB COXIELLA BRUNETII,57.0,32.83,14.82,55.29,29
CPT,86644,LAB AB CYTOMEGALOVIRUS,60.0,34.56,15.6,58.2,29
CPT,86645,LAB AB CYTOMEGALOVIRUS IGM,61.0,35.14,15.86,59.17,29
CPT,86648,LAB AB DIPTHERIA,63.0,36.29,16.38,61.11,29
CPT,86651,LAB AB ENCEPHALITIS CALIFORNIA,65.0,37.44,16.9,63.05,29
CPT,86652,LAB AB ENCEPHALITIS EQUINE EASTERN,65.0,37.44,16.9,63.05,29
CPT,86653,LAB AB ENCEPHALITIS SAINT LOUIS NS,65.0,37.44,16.9,63.05,29
CPT,86654,LAB AB ENCEPHALITIS EQUINE WEST NS,65.0,37.44,16.9,63.05,29
CPT,86658,LAB AB COXSACKIE,53.0,30.53,13.78,51.41,29
CPT,86658,LAB AB ECHOVIRUS,54.0,31.1,14.04,52.38,29
CPT,86663,LAB AB EBV EARLY AG,55.0,31.68,14.3,53.35,29
CPT,86664,LAB AB EBV EBNA,46.0,26.5,11.96,44.62,29
CPT,86664,LAB AB EBV EBNA NS,54.0,31.1,14.04,52.38,29
CPT,86665,LAB AB EBV VCA IGG,55.0,31.68,14.3,53.35,29
CPT,86665,LAB AB EBV VCA IGM,62.0,35.71,16.12,60.14,29
CPT,86665,LAB AB EBV VCA IGM NS,55.0,31.68,14.3,53.35,29
CPT,86666,LAB AB EHRLICHIA,80.0,46.08,20.8,77.6,29
CPT,86668,LAB AB FRANCISELLA TULARENSIS,100.0,57.6,26.0,97.0,29
CPT,86671,LAB AB FUNGUS NOT SPECIFIED,55.0,31.68,14.3,53.35,29
CPT,86674,LAB AB GIARDIA LAMBLIA,67.0,38.59,17.42,64.99,29
CPT,86677,LAB AB HELICOBACTER PYLORI,78.0,44.93,20.28,75.66,29
CPT,86682,LAB AB CYSTICERCUS CSF,65.0,37.44,16.9,63.05,29
CPT,86682,LAB AB CYSTICERCUS SERUM,65.0,37.44,16.9,63.05,29
CPT,86682,LAB AB ECHINOCOCCUS,71.0,40.9,18.46,68.87,29
CPT,86682,LAB AB FILARIA IGG4,102.0,58.75,26.52,98.94,29
CPT,86682,LAB AB HELMINTH NONSPECIFIED,65.0,37.44,16.9,63.05,29
CPT,86682,LAB AB SCHISTOSOMA SERUM,65.0,37.44,16.9,63.05,29
CPT,86682,LAB AB STRONGYLOIDES,69.0,39.74,17.94,66.93,29
CPT,86684,LAB AB HAEMOPHILUS INFLUENZA IGG,62.0,35.71,16.12,60.14,29
CPT,86687,LAB AB HTLV-I,28.0,16.13,7.28,27.16,29
CPT,86689,LAB AB HTLV/HIV CONFIRM DONOR NS,503.0,289.73,130.78,487.91,29
CPT,86689,LAB AB HTLV/HIV CONFIRM SRM/PLASMA,472.0,271.87,122.72,457.84,29
CPT,86692,LAB AB HEPATITIS DELTA AGENT,85.0,48.96,22.1,82.45,29
CPT,86694,LAB AB HERPES SIMPLEX NONSPECIFIC,44.0,25.34,11.44,42.68,29
CPT,86695,LAB AB HERPES SIMPLEX TYPE 1,40.0,23.04,10.4,38.8,29
CPT,86695,LAB AB HERPES SIMPLEX TYPE 1 NS,53.0,30.53,13.78,51.41,29
CPT,86696,LAB AB HERPES SIMPLEX TYPE 2,59.0,33.98,15.34,57.23,29
CPT,86696,LAB AB HERPES SIMPLEX TYPE 2 NS,59.0,33.98,15.34,57.23,29
CPT,86698,LAB AB HISTOPLASMA COMP FIXATION,63.0,36.29,16.38,61.11,29
CPT,86698,LAB AB HISTOPLASMA IMMUNODIFFUSION,68.0,39.17,17.68,65.96,29
CPT,86701,LAB AB HIV-1,76.0,43.78,19.76,73.72,29
CPT,86702,LAB AB HIV-2,87.0,50.11,22.62,84.39,29
CPT,86703,LAB AB HIV-1&HIV-2 RESULT SGL,42.0,24.19,10.92,40.74,29
CPT,86704,LAB AB HEPATITIS B CORE TOTAL,55.0,31.68,14.3,53.35,29
CPT,86705,LAB AB HEPATITIS B CORE IGM,72.0,41.47,18.72,69.84,29
CPT,86706,LAB AB HEPATITIS B SURFACE,55.0,31.68,14.3,53.35,29
CPT,86707,LAB AB HEPATITIS BE,59.0,33.98,15.34,57.23,29
CPT,86708,LAB AB HEPATITIS A,55.0,31.68,14.3,53.35,29
CPT,86708,LAB AB HEPATITIS A NS,57.0,32.83,14.82,55.29,29
CPT,86709,LAB AB HEPATITIS A IGM,65.0,37.44,16.9,63.05,29
CPT,86710,LAB AB INFLUENZA A,68.0,39.17,17.68,65.96,29
CPT,86710,LAB AB INFLUENZA B,68.0,39.17,17.68,65.96,29
CPT,86711,LAB AB JOHN CUNNINGHAM VIRUS,1448.0,834.05,376.48,1404.56,29
CPT,86713,LAB AB LEGIONELLA,72.0,41.47,18.72,69.84,29
CPT,86720,LAB AB LEPTOSPIRA IGM DOT BLOT,102.0,58.75,26.52,98.94,29
CPT,86720,LAB AB LEPTOSPIRA TITER,154.0,88.7,40.04,149.38,29
CPT,86727,LAB AB CHORIOMENINGITIS LYMPHOCYTIC,62.0,35.71,16.12,60.14,29
CPT,86735,LAB AB MUMPS,61.0,35.14,15.86,59.17,29
CPT,86735,LAB AB MUMPS IGG,56.0,32.26,14.56,54.32,29
CPT,86735,LAB AB MUMPS IGM,62.0,35.71,16.12,60.14,29
CPT,86738,LAB AB MYCOPLASMA IGG NS,55.0,31.68,14.3,53.35,29
CPT,86738,LAB AB MYCOPLASMA IGM,55.0,31.68,14.3,53.35,29
CPT,86747,LAB AB PARVOVIRUS B19 IGG,62.0,35.71,16.12,60.14,29
CPT,86747,LAB AB PARVOVIRUS B19 IGM,62.0,35.71,16.12,60.14,29
CPT,86753,LAB AB AMOEBIC,65.0,37.44,16.9,63.05,29
CPT,86753,LAB AB CHAGAS IGG,72.0,41.47,18.72,69.84,29
CPT,86753,LAB AB PROTOZOA BABESIA,58.0,33.41,15.08,56.26,29
CPT,86753,LAB SCR AB CHAGAS,62.0,35.71,16.12,60.14,29
CPT,86756,LAB AB RSV,72.0,41.47,18.72,69.84,29
CPT,86757,LAB AB RICKETTSIA,71.0,40.9,18.46,68.87,29
CPT,86762,LAB AB RUBELLA IGG,56.0,32.26,14.56,54.32,29
CPT,86762,LAB AB RUBELLA IGM NS,56.0,32.26,14.56,54.32,29
CPT,86765,LAB AB RUBEOLA IGG,60.0,34.56,15.6,58.2,29
CPT,86765,LAB AB RUBEOLA IGM,56.0,32.26,14.56,54.32,29
CPT,86765,LAB AB RUBEOLA TITER NS,39.0,22.46,10.14,37.83,29
CPT,86768,LAB AB SALMONELLA,73.0,42.05,18.98,70.81,29
CPT,86769,LAB AB SARS-COV-2 COVID-19,127.0,73.15,33.02,123.19,29
CPT,86769,LAB AB SARS-COV-2 COVID-19 NS,127.0,73.15,33.02,123.19,29
CPT,86774,LAB AB TETANUS,63.0,36.29,16.38,61.11,29
CPT,86777,LAB AB TOXOPLASMA,44.0,25.34,11.44,42.68,29
CPT,86777,LAB AB TOXOPLASMA IGG,60.0,34.56,15.6,58.2,29
CPT,86777,LAB AB TOXOPLASMA IGG NS,63.0,36.29,16.38,61.11,29
CPT,86778,LAB AB TOXOPLASMA IGM,60.0,34.56,15.6,58.2,29
CPT,86778,LAB AB TOXOPLASMA IGM NS,63.0,36.29,16.38,61.11,29
CPT,86780,LAB AB FTA CONFIRM,40.0,23.04,10.4,38.8,29
CPT,86780,LAB AB TREPONEMA PALLIDUM CONF,74.0,42.62,19.24,71.78,29
CPT,86780,LAB SCR AB SYPHILIS,53.0,30.53,13.78,51.41,29
CPT,86780,LAB SCR AB SYPHILIS NS,40.0,23.04,10.4,38.8,29
CPT,86784,LAB AB TRICHINELLA,69.0,39.74,17.94,66.93,29
CPT,86787,LAB AB VARICELLA-ZOSTER IGG,39.0,22.46,10.14,37.83,29
CPT,86787,LAB AB VARICELLA-ZOSTER IGG NS,53.0,30.53,13.78,51.41,29
CPT,86787,LAB AB VARICELLA-ZOSTER IGM,39.0,22.46,10.14,37.83,29
CPT,86787,LAB AB VARICELLA-ZOSTER IGM NS,39.0,22.46,10.14,37.83,29
CPT,86788,LAB AB WEST NILE VIRUS IGM NS,72.0,41.47,18.72,69.84,29
CPT,86789,LAB AB WEST NILE VIRUS NS,72.0,41.47,18.72,69.84,29
CPT,86790,LAB AB PARAINFLUENZA,66.0,38.02,17.16,64.02,29
CPT,86790,LAB AB VIRUS DENGUE,70.0,40.32,18.2,67.9,29
CPT,86790,LAB AB VIRUS HEPATITIS E IGG,71.0,40.9,18.46,68.87,29
CPT,86790,LAB AB VIRUS NONSPECIFIED,65.0,37.44,16.9,63.05,29
CPT,86790,LAB HANTAVIRUS,102.0,58.75,26.52,98.94,29
CPT,86793,LAB AB YERSINIA,76.0,43.78,19.76,73.72,29
CPT,86794,LAB AB VIRUS ZIKA IGM,325.0,187.2,84.5,315.25,29
CPT,86800,LAB AB THYROGLOBULIN,57.0,32.83,14.82,55.29,29
CPT,86800,LAB AB THYROGLOBULIN NS,96.0,55.3,24.96,93.12,29
CPT,86803,LAB AB HEPATITIS C,72.0,41.47,18.72,69.84,29
CPT,86804,LAB AB HEPATITIS C CONFIRMATORY,239.0,137.66,62.14,231.83,29
CPT,86812,LAB BLOOD TYPE HLA B-27 AG SINGLE,78.0,44.93,20.28,75.66,29
CPT,86816,LAB BLOOD TYPE HLA DR/DQ AG SGL,91.0,52.42,23.66,88.27,29
CPT,86828,LAB HLA CLASS I&II AB QL NS,330.0,190.08,85.8,320.1,29
CPT,86850,LAB SCR AB RBC SERUM EA,110.0,83.27,28.6,106.7,29
CPT,86850,LAB SCR AB RBC SERUM EA NS,158.0,119.61,41.08,153.26,29
CPT,86860,LAB ELUTION AB RBC EA,359.0,206.78,93.34,348.23,29
CPT,86860,LAB ELUTION AB RBC EA NS,359.0,206.78,93.34,348.23,29
CPT,86870,LAB PANEL AB RBC EA TECH SERUM,751.0,568.51,195.26,728.47,29
CPT,86870,LAB PANEL AB RBC EA TECH SERUM NS,751.0,568.51,195.26,728.47,29
CPT,86880,LAB COOMBS DIR ANTISERUM EA,125.0,72.0,32.5,121.25,29
CPT,86880,LAB COOMBS DIR ANTISERUM EA NS,125.0,72.0,32.5,121.25,29
CPT,86886,LAB COOMBS INDIRECT TITER AB EA NS,359.0,206.78,93.34,348.23,29
CPT,86900,LAB BLOOD TYPE ABO,281.0,212.72,73.06,272.57,29
CPT,86900,LAB BLOOD TYPE ABO DISCREPANCY,281.0,212.72,73.06,272.57,29
CPT,86900,LAB BLOOD TYPE ABO NS,281.0,212.72,73.06,272.57,29
CPT,86901,LAB BLOOD TYPE RHD,79.0,59.8,20.54,76.63,29
CPT,86901,LAB BLOOD TYPE RHD NS,79.0,59.8,20.54,76.63,29
CPT,86904,LAB SCR AG BLD TYPE SERUM PT U NS,153.0,115.82,39.78,148.41,29
CPT,86905,LAB BLOOD TYPE AG RBC EA,751.0,568.51,195.26,728.47,29
CPT,86905,LAB BLOOD TYPE AG RBC EA NS,751.0,568.51,195.26,728.47,29
CPT,86905,LAB BLOOD TYPE AG RBC PT EA,751.0,568.51,195.26,728.47,29
CPT,86906,LAB BLOOD TYPE PHENOTYPING RH COMP,122.0,92.35,31.72,118.34,29
CPT,86920,LAB CROSSMATCH SPIN IMMEDIATE,359.0,271.76,93.34,348.23,29
CPT,86922,LAB CROSSMATCH ANTIGLOBULIN,359.0,271.76,93.34,348.23,29
CPT,86923,LAB CROSSMATCH ELECTRONIC,359.0,271.76,93.34,348.23,29
CPT,86927,LAB THAWING PLASMA FRESH FROZEN,359.0,271.76,93.34,348.23,29
CPT,86970,LAB PRETREAT RBC AB CHEMICAL NS,150.0,113.55,39.0,145.5,29
CPT,86975,LAB PRETREAT SERUM INCUB W DRUGS,940.0,541.44,244.4,911.8,29
CPT,86978,LAB PRETREAT SERUM ABSORP NS,277.0,159.55,72.02,268.69,29
CPT,86999,LAB SEPARATION RED CELL,268.0,202.88,69.68,259.96,29
CPT,87015,LAB CONCENTRATION AFB IA,21.0,11.15,5.46,20.37,29
CPT,87015,LAB CONCENTRATION AFB IA NS,71.0,37.7,18.46,68.87,29
CPT,87015,LAB CONCENTRATION ANY TYPE IA,21.0,11.15,5.46,20.37,29
CPT,87015,LAB CONCENTRATION ANY TYPE IA NS,128.0,67.97,33.28,124.16,29
CPT,87040,LAB CULT BACT AEROBIC BLOOD,31.0,16.46,8.06,30.07,29
CPT,87045,LAB CULT BACT AEROBIC STOOL,29.0,15.4,7.54,28.13,29
CPT,87045,LAB CULT BACT AEROBIC STOOL NS,63.0,33.45,16.38,61.11,29
CPT,87046,LAB CULT BACT AEROBIC STOOL CAMPY,29.0,15.4,7.54,28.13,29
CPT,87046,LAB CULT BACT AEROBIC STOOL E COLI,29.0,15.4,7.54,28.13,29
CPT,87046,LAB CULT BACT AEROBIC STOOL PATH,79.0,41.95,20.54,76.63,29
CPT,87046,LAB CULT BACT AEROBIC STOOL PATH NS,63.0,33.45,16.38,61.11,29
CPT,87046,LAB CULT BACT AEROBIC STOOL YERSNIA,29.0,15.4,7.54,28.13,29
CPT,87070,LAB CULT BACT AEROBIC BARTONELLA,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT AEROBIC CATHETER TIP,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT AEROBIC CSF,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT AEROBIC EAR,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT AEROBIC EYE,61.0,32.39,15.86,59.17,29
CPT,87070,LAB CULT BACT AEROBIC GENITAL,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT AEROBIC OTHER,75.0,39.83,19.5,72.75,29
CPT,87070,LAB CULT BACT AEROBIC OTHER NS,68.0,36.11,17.68,65.96,29
CPT,87070,LAB CULT BACT AEROBIC RESP LOWER,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT AEROBIC RESP UPPER,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT AEROBIC TISSUE,112.0,59.47,29.12,108.64,29
CPT,87070,LAB CULT BACT AEROBIC WOUND,26.0,13.81,6.76,25.22,29
CPT,87070,LAB CULT BACT FLUID BODY STERILE,26.0,13.81,6.76,25.22,29
CPT,87071,LAB CULT BACT AEROBIC OTHER QN,61.0,32.39,15.86,59.17,29
CPT,87075,LAB CULT BACT ANAEROBIC OTHER,29.0,15.4,7.54,28.13,29
CPT,87076,LAB CULT BACT ANAEROBIC ID DF,25.0,13.28,6.5,24.25,29
CPT,87076,LAB CULT BACT ANAEROBIC ID DF NS,118.0,62.66,30.68,114.46,29
CPT,87077,LAB CULT BACT AEROBIC ID DF,25.0,13.28,6.5,24.25,29
CPT,87077,LAB CULT BACT AEROBIC ID DF ADDL,25.0,13.28,6.5,24.25,29
CPT,87077,LAB CULT BACT AEROBIC ID DF ADDL NS,103.0,54.69,26.78,99.91,29
CPT,87077,LAB CULT BACT AEROBIC ID DF NS,96.0,50.98,24.96,93.12,29
CPT,87081,LAB SCR CULT GONORRHEA,58.0,30.8,15.08,56.26,29
CPT,87081,LAB SCR CULT H PYLORI SGL,20.0,10.62,5.2,19.4,29
CPT,87081,LAB SCR CULT ORGANISMS SGL NS,66.0,35.05,17.16,64.02,29
CPT,87081,LAB SCR CULT STAPH MRSA,20.0,10.62,5.2,19.4,29
CPT,87081,LAB SCR CULT STREP GROUP A,20.0,10.62,5.2,19.4,29
CPT,87081,LAB SCR CULT STREP GROUP B,20.0,10.62,5.2,19.4,29
CPT,87086,LAB CULT BACT COLONY COUNT URINE,25.0,13.28,6.5,24.25,29
CPT,87088,LAB CULT BACT ID ISOLATE URINE,25.0,13.28,6.5,24.25,29
CPT,87101,LAB CULT FUNGI ID DERMATOPHYTE,59.0,31.33,15.34,57.23,29
CPT,87102,LAB CULT FUNGI ID ISOLATES,78.0,41.42,20.28,75.66,29
CPT,87102,LAB CULT FUNGI ID ISOLATES NS,88.0,46.73,22.88,85.36,29
CPT,87102,LAB CULT FUNGI YEAST ID ISOLATES,60.0,31.86,15.6,58.2,29
CPT,87103,LAB CULT FUNGI ID ISOLATES BLOOD,69.0,36.64,17.94,66.93,29
CPT,87106,LAB CULT FUNGI ID DF YEAST,62.0,32.92,16.12,60.14,29
CPT,87107,LAB CULT FUNGI ID DF MOLD,62.0,32.92,16.12,60.14,29
CPT,87107,LAB CULT FUNGI ID DF MOLD NS,138.0,73.28,35.88,133.86,29
CPT,87109,LAB CULT MYCOPLASMA/UREAPLASMA,63.0,33.45,16.38,61.11,29
CPT,87110,LAB CULT CHLAMYDIA,71.0,37.7,18.46,68.87,29
CPT,87116,LAB CULT AFB ID ISOLATES NS,65.0,34.52,16.9,63.05,29
CPT,87118,LAB CULT MYCOBACTERIAL ID DF,64.0,33.98,16.64,62.08,29
CPT,87140,LAB CULT TYPING IF ANTISERUM EA,57.0,30.27,14.82,55.29,29
CPT,87140,LAB CULT TYPING IF ANTISERUM EA NS,56.0,29.74,14.56,54.32,29
CPT,87147,LAB CULT TYPING SEROLOGICAL,16.0,8.5,4.16,15.52,29
CPT,87147,LAB CULT TYPING SEROLOGICAL NS,85.0,45.14,22.1,82.45,29
CPT,87150,LAB CULT TYPING ID NUC ACID PRB AMP,137.0,72.75,35.62,132.89,29
CPT,87153,LAB CULT TYPING ID SEQ NUC ACID NS,347.0,184.26,90.22,336.59,29
CPT,87168,LAB EXAM MACROSCOPIC ARTHROPOD,13.0,6.9,3.38,12.61,29
CPT,87169,LAB EXAM MACROSCOPIC PARASITE,58.0,30.8,15.08,56.26,29
CPT,87172,LAB EXAM PINWORM,13.0,6.9,3.38,12.61,29
CPT,87176,LAB HOMOGENIZATION TISSUE,52.0,27.61,13.52,50.44,29
CPT,87177,LAB SMEARS DIRECT OVA&PARASITES,27.0,14.34,7.02,26.19,29
CPT,87181,LAB SUSCPT ETEST AGENT EA,255.0,135.4,66.3,247.35,29
CPT,87181,LAB SUSCPT ETEST AGENT EA NS,66.0,35.05,17.16,64.02,29
CPT,87182,LAB SUSCPT CARBAPENEMASE DET ENZ,56.0,29.74,14.56,54.32,29
CPT,87184,LAB SUSCPT DISK KIRBY BAUER,23.0,12.21,5.98,22.31,29
CPT,87185,LAB SUSCPT DETECTION ENZYME EA,56.0,29.74,14.56,54.32,29
CPT,87186,LAB SUSCPT MIC PLATE EA,26.0,13.81,6.76,25.22,29
CPT,87186,LAB SUSCPT MIC PLATE EA LSI NS,200.0,151.4,52.0,194.0,29
CPT,87186,LAB SUSCPT MIC PLATE EA NS,152.0,115.06,39.52,147.44,29
CPT,87188,LAB SUSCPT DILUTION MACROBROTH,58.0,30.8,15.08,56.26,29
CPT,87188,LAB SUSCPT DILUTION MACROBROTH NS,115.0,61.07,29.9,111.55,29
CPT,87205,LAB SMEAR GRAM/GIEMSA,13.0,6.9,3.38,12.61,29
CPT,87205,LAB SMEAR GRAM/GIEMSA NS,91.0,68.89,23.66,88.27,29
CPT,87206,LAB SMEAR STAIN ACID FAST AFB,17.0,9.03,4.42,16.49,29
CPT,87206,LAB SMEAR STAIN FL AFB,57.0,30.27,14.82,55.29,29
CPT,87206,LAB SMEAR STAIN FL AFB NS,68.0,36.11,17.68,65.96,29
CPT,87206,LAB SMEAR STAIN FL FUNGI,58.0,30.8,15.08,56.26,29
CPT,87207,LAB SMEAR INCL BODIES/PARASITE,18.0,9.56,4.68,17.46,29
CPT,87209,LAB SMEAR STAIN CMPLX OVA&PARASITES,71.0,37.7,18.46,68.87,29
CPT,87210,LAB SMEAR IA WET MOUNT,53.0,28.14,13.78,51.41,29
CPT,87220,LAB TISSUE KOH SKIN/HAIR/NAIL FUNGI,64.0,33.98,16.64,62.08,29
CPT,87220,LAB TISSUE KOH SKN/HAR/NAL FUNGI NS,215.0,114.16,55.9,208.55,29
CPT,87230,LAB TOXIN CULT TISSUE C DIFF NS,79.0,41.95,20.54,76.63,29
CPT,87252,LAB ISO VIRUS INOC TISSUE,79.0,41.95,20.54,76.63,29
CPT,87252,LAB ISO VIRUS INOC TISSUE NS,100.0,53.1,26.0,97.0,29
CPT,87253,LAB ISO VIRUS INOC TISSUE ADDL,65.0,34.52,16.9,63.05,29
CPT,87254,LAB ISO VIRUS SHELL VIAL ID W IF,64.0,33.98,16.64,62.08,29
CPT,87254,LAB ISO VIRUS SHELL VIAL ID W IF NS,106.0,56.29,27.56,102.82,29
CPT,87255,LAB ISO VIRUS ID ACT ENZYMATIC,102.0,54.16,26.52,98.94,29
CPT,87255,LAB ISO VIRUS ID ACT ENZYMATIC NS,102.0,54.16,26.52,98.94,29
CPT,87265,LAB DET AG IA IF BORDETELLA,36.0,19.12,9.36,34.92,29
CPT,87269,LAB DET AG IA IF GIARDIA,61.0,32.39,15.86,59.17,29
CPT,87272,LAB DET AG IA IF CRYPTOSPORIDIUM,61.0,32.39,15.86,59.17,29
CPT,87272,LAB DET AG IA IF CRYPTOSPORIDIUM NS,111.0,58.94,28.86,107.67,29
CPT,87273,LAB DET AG IA IF HSV TYPE 2,60.0,31.86,15.6,58.2,29
CPT,87274,LAB DET AG IA IF HSV TYPE 1,60.0,31.86,15.6,58.2,29
CPT,87275,LAB DET AG IA IF INFLUENZA B VIRUS,60.0,31.86,15.6,58.2,29
CPT,87276,LAB DET AG IA IF INFLUENZA A VIRUS,60.0,31.86,15.6,58.2,29
CPT,87280,LAB DET AG IA IF RSV,60.0,31.86,15.6,58.2,29
CPT,87281,LAB DET AG IA IF PNEUMOCYSTIS,36.0,19.12,9.36,34.92,29
CPT,87281,LAB DET AG IA IF PNEUMOCYSTIS NS,76.0,40.36,19.76,73.72,29
CPT,87290,LAB DET AG IA IF VARICELLA-ZOSTER,60.0,31.86,15.6,58.2,29
CPT,87300,LAB DET AG IA IF PLYVLT ORG MULT,60.0,31.86,15.6,58.2,29
CPT,87305,LAB DET AG IA IMM ENZ ASPRGLS NS,152.0,80.71,39.52,147.44,29
CPT,87324,LAB DET AG IA IMM ENZ TOXIN C DIFF,60.0,31.86,15.6,58.2,29
CPT,87328,LAB DET AG IA IMM ENZ CRYPTOSPOR,42.0,22.3,10.92,40.74,29
CPT,87329,LAB DET AG IA IMM ENZ GIARDIA,36.0,19.12,9.36,34.92,29
CPT,87329,LAB DET AG IA IMM ENZ GIARDIA NS,66.0,35.05,17.16,64.02,29
CPT,87337,LAB DET AG IA IMM ENZ ENTAM HIST NS,73.0,38.76,18.98,70.81,29
CPT,87338,LAB DET AG IA IMM H PYLORI STOOL,75.0,39.83,19.5,72.75,29
CPT,87338,LAB DET AG IA IMM H PYLORI STOOL NS,44.0,23.36,11.44,42.68,29
CPT,87340,LAB DET AG IA HBSAG QL/SEMI QN,34.0,18.05,8.84,32.98,29
CPT,87340,LAB DET AG IA HBSAG QL/SEMI QN NS,231.0,122.66,60.06,224.07,29
CPT,87341,LAB DET AG IA IMM ENZ HEP B SURF,58.0,30.8,15.08,56.26,29
CPT,87341,LAB DET AG IA IMM ENZ HEP B SURF NS,85.0,45.14,22.1,82.45,29
CPT,87350,LAB DET AG IA IMM ENZ HEP BE,59.0,31.33,15.34,57.23,29
CPT,87380,LAB DET AG IA IMM ENZ HEP DELTA AGT,175.0,92.93,45.5,169.75,29
CPT,87385,LAB DET AG IA IMM ENZ HISTOPLASMA,152.0,80.71,39.52,147.44,29
CPT,87389,LAB DET AG IA IMM HIV1 W HIV 1&2,87.0,46.2,22.62,84.39,29
CPT,87400,LAB DET AG IA IMM ENZ INFLUENZA A/B,43.0,22.83,11.18,41.71,29
CPT,87420,LAB DET AG IA IMM ENZ RSV,42.0,22.3,10.92,40.74,29
CPT,87425,LAB DET AG IA IMM ENZ ROTAVIRUS,36.0,19.12,9.36,34.92,29
CPT,87427,LAB DET AG IA IMM ENZ TOX SHIGA,64.0,33.98,16.64,62.08,29
CPT,87449,LAB DET AG IA IMM ENZ CAMPY,78.0,41.42,20.28,75.66,29
CPT,87449,LAB DET AG IA IMM ENZ FUNGITELL,97.0,51.51,25.22,94.09,29
CPT,87449,LAB DET AG IA IMM ENZ FUNGITELL NS,157.0,83.37,40.82,152.29,29
CPT,87449,LAB DET AG IA IMM ENZ LEGN URINE NS,66.0,35.05,17.16,64.02,29
CPT,87449,LAB DET AG IA IMM ENZ QL,36.0,19.12,9.36,34.92,29
CPT,87449,LAB DET AG IA IMM ENZ SEMI QN,147.0,78.06,38.22,142.59,29
CPT,87483,LAB DET IA CNS PRB AMP 12-25 TGT,1251.0,664.28,325.26,1213.47,29
CPT,87486,LAB DET IA CHLAMYD PNEU PRB AMP NS,328.0,174.17,85.28,318.16,29
CPT,87491,LAB DET IA CHLAMYD TRAC PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87491,LAB DET IA CHLAMYD TRAC PRB AMP NS,115.0,61.07,29.9,111.55,29
CPT,87493,LAB DET IA TOXIN C DIFF PRB AMP,112.0,59.47,29.12,108.64,29
CPT,87493,LAB DET IA TOXIN C DIFF PRB AMP NS,112.0,59.47,29.12,108.64,29
CPT,87494,LAB DET IA CT&NG PRB AMP MULTIPLEX,211.0,112.04,54.86,204.67,29
CPT,87496,LAB DET IA CMV PRB AMP NS,106.0,56.29,27.56,102.82,29
CPT,87497,LAB DET IA CMV QN,129.0,68.5,33.54,125.13,29
CPT,87497,LAB DET IA CMV QN NS,129.0,68.5,33.54,125.13,29
CPT,87498,LAB DET IA ENTEROVRS PRB AMP NS,139.0,73.81,36.14,134.83,29
CPT,87502,LAB DET IA FLU REV T&PRB AMP 1-2,288.0,152.93,74.88,279.36,29
CPT,87507,LAB DET IA GI MULT PRB 12-25TGT NS,1251.0,664.28,325.26,1213.47,29
CPT,87516,LAB DET IA HEP B PRB AMP,135.0,71.68,35.1,130.95,29
CPT,87517,LAB DET IA HEP B QN,129.0,68.5,33.54,125.13,29
CPT,87521,LAB DET IA HEP C PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87522,LAB DET IA HEP C QN,129.0,68.5,33.54,125.13,29
CPT,87522,LAB DET IA HEP C QN NS,147.0,78.06,38.22,142.59,29
CPT,87529,LAB DET IA HSV PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87529,LAB DET IA HSV PRB AMP NS,106.0,56.29,27.56,102.82,29
CPT,87529,LAB DET IA HSV PRB AMP PCR CSF,106.0,56.29,27.56,102.82,29
CPT,87530,LAB DET IA HSV QN,129.0,68.5,33.54,125.13,29
CPT,87532,LAB DET IA HERPES 6 PRB AMP,120.0,63.72,31.2,116.4,29
CPT,87533,LAB DET IA HERPES 6 PCR QN,126.0,66.91,32.76,122.22,29
CPT,87535,LAB DET IA HIV-1 PRB AMP NS,108.0,57.35,28.08,104.76,29
CPT,87536,LAB DET IA HIV-1 QN,256.0,135.94,66.56,248.32,29
CPT,87536,LAB DET IA HIV-1 QN NS,256.0,135.94,66.56,248.32,29
CPT,87538,LAB DET IA HIV-2 REV T&PRB AMP,122.0,64.78,31.72,118.34,29
CPT,87541,LAB DET IA LEGIONELL PNEUM PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87551,LAB DET IA MYCOBCT PRB AMP,450.0,238.95,117.0,436.5,29
CPT,87556,LAB DET IA MYCOBCT TB PRB AMP NS,126.0,66.91,32.76,122.22,29
CPT,87561,LAB DET IA MYCOBCT AV-INTRA PRB AMP,270.0,143.37,70.2,261.9,29
CPT,87563,LAB DET IA MYCOPLAS GEN PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87581,LAB DET IA MYCOPLAS PNEU PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87581,LAB DET IA MYCOPLAS PNEU PRB AMP NS,106.0,56.29,27.56,102.82,29
CPT,87591,LAB DET IA GC PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87591,LAB DET IA GC PRB AMP NS,106.0,56.29,27.56,102.82,29
CPT,87593,LAB DET IA ORTHOPOXVIRUS PRB AMP,154.0,81.77,40.04,149.38,29
CPT,87594,LAB DET IA PNEUM JIROVECII RFLX PRB,421.0,223.55,109.46,408.37,29
CPT,87624,LAB DET IA HPV TYPE RISK HIGH POOL,106.0,56.29,27.56,102.82,29
CPT,87627,LAB DET IA PATH JT&GENE RXRST 26+,2040.0,1083.24,530.4,1978.8,29
CPT,87631,LAB DET IA RESP MLTPLX 3-5 TGT,428.0,227.27,111.28,415.16,29
CPT,87631,LAB DET IA RESP MLTPLX 3-5 TGT NS,428.0,227.27,111.28,415.16,29
CPT,87632,LAB DET IA RESP MLTPLX 6-11 TGT,655.0,347.8,170.3,635.35,29
CPT,87632,LAB DET IA RESP MLTPLX 6-11 TGT NS,655.0,347.8,170.3,635.35,29
CPT,87633,LAB DET IA RESP MLTPLX 12-25 TGT NS,1251.0,664.28,325.26,1213.47,29
CPT,87634,LAB DET IA RSV PRB AMP,211.0,112.04,54.86,204.67,29
CPT,87635,LAB DET IA COV19 PRB AMP,154.0,81.77,40.04,149.38,29
CPT,87635,LAB DET IA COV19 PRB AMP NS,154.0,81.77,40.04,149.38,29
CPT,87636,LAB DET IA COV19&FLU A&B PRB AMP,96.0,50.98,24.96,93.12,29
CPT,87641,LAB DET IA MRSA PRB AMP NS,106.0,56.29,27.56,102.82,29
CPT,87651,LAB DET IA STREP GROUP A PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87653,LAB DET IA STREP GROUP B PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87661,LAB DET IA TRICHOMON VAG PRB AMP NS,111.0,58.94,28.86,107.67,29
CPT,87661,LAB DET IA TRICHOMONAS VAG PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87662,LAB DET IA VIRUS ZIKA PRB AMP,200.0,106.2,52.0,194.0,29
CPT,87798,LAB DET IA ASPERGILLUS PCR PRB AMP,115.0,61.07,29.9,111.55,29
CPT,87798,LAB DET IA B PERTUSSIS PCR PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA BK VIRUS PCR PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA DENGUE TYPES 1-4 PRB AMP,290.0,153.99,75.4,281.3,29
CPT,87798,LAB DET IA EBV PCR PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA HHV-8 PCR PRB AMP,124.0,65.84,32.24,120.28,29
CPT,87798,LAB DET IA IGM PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA JC VIRUS PCR PRB AMP,123.0,65.31,31.98,119.31,29
CPT,87798,LAB DET IA LEGIONELL PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA LEPTOSPIRA PCR PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA MALARIA PCR PRB AMP,518.0,275.06,134.68,502.46,29
CPT,87798,LAB DET IA MUCORALES PCR PRB AMP,275.0,146.02,71.5,266.75,29
CPT,87798,LAB DET IA NORCARDIA PCR PRB AMP,362.0,192.22,94.12,351.14,29
CPT,87798,LAB DET IA NOROVIRUS PCR PRB AMP,109.0,57.88,28.34,105.73,29
CPT,87798,LAB DET IA PARVOVIRUS PCR PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA PRB AMP NS,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA RUBELLA PCR PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB DET IA TOXOPLASMA RFLX PCR PRB,421.0,223.55,109.46,408.37,29
CPT,87798,LAB DET IA VARICELLA-ZOSTER PRB AMP,106.0,56.29,27.56,102.82,29
CPT,87798,LAB RNA NOROVIRUS AMP PROBE,109.0,57.88,28.34,105.73,29
CPT,87799,LAB DET IA ADENOVIRUS PCR QN,129.0,68.5,33.54,125.13,29
CPT,87799,LAB DET IA BK VIRUS PCR QN NS,129.0,68.5,33.54,125.13,29
CPT,87799,LAB DET IA BK VIRUS PCR QN URINE,129.0,68.5,33.54,125.13,29
CPT,87799,LAB DET IA EBV PCR QN,129.0,68.5,33.54,125.13,29
CPT,87799,LAB DET IA EBV PCR QN NS,129.0,68.5,33.54,125.13,29
CPT,87799,LAB DET IA HHV NON 6 PCR QN,129.0,68.5,33.54,125.13,29
CPT,87799,LAB DET IA JC VIRUS PCR QN,129.0,68.5,33.54,125.13,29
CPT,87799,LAB DET IA PARVOVIRUS PCR QN,141.0,74.87,36.66,136.77,29
CPT,87799,LAB DET IA PNEUMOCYSTIS PCR QN,275.0,146.02,71.5,266.75,29
CPT,87799,LAB DET IA TOXOPLASMA PCR QN,130.0,69.03,33.8,126.1,29
CPT,87799,LAB DET IA VZV PCR QN,129.0,68.5,33.54,125.13,29
CPT,87801,LAB DET IA BACTERIAL MULT PRB AMP,1309.0,695.08,340.34,1269.73,29
CPT,87801,LAB DET IA ENTEROBACTR MULT PRB AMP,411.0,218.24,106.86,398.67,29
CPT,87801,LAB DET IA FUNGAL MULT PRB AMP,1372.0,728.53,356.72,1330.84,29
CPT,87801,LAB DET IA ORGANISMS FNGL MULT PRB,638.0,338.78,165.88,618.86,29
CPT,87801,LAB DET IA ORGANISMS MULT PRB AMP,211.0,112.04,54.86,204.67,29
CPT,87804,LAB DET AG IA INFLUENZA IMM OPT,50.0,26.55,13.0,48.5,29
CPT,87807,LAB DET AG IA RSV IMM OPT,40.0,21.24,10.4,38.8,29
CPT,87880,LAB DET AG IA STREP GROUP A IMM OPT,50.0,26.55,13.0,48.5,29
CPT,87899,LAB DET AG IA IMM OPTICAL,65.0,34.52,16.9,63.05,29
CPT,87899,LAB DET AG IA IMM OPTICAL NS,75.0,39.83,19.5,72.75,29
CPT,87901,LAB GENOTYPE IA HIV-1 REV T NS,773.0,410.46,200.98,749.81,29
CPT,87902,LAB GENOTYPE IA HEPATITIS C NS,773.0,410.46,200.98,749.81,29
CPT,87906,LAB GENOTYPE IA HIV-1 TROPISM CORCP,387.0,205.5,100.62,375.39,29
CPT,87910,LAB GENOTYPE IA CYTOMEGALOVIRUS,773.0,410.46,200.98,749.81,29
CPT,87912,LAB GENOTYPE IA HEPATITIS B,773.0,410.46,200.98,749.81,29
CPT,88104,LAB CYTOPATH FLUIDS SMEARS,79.0,17.06,20.54,76.63,29
CPT,88108,LAB CYTOPATH CONCENTRATION,79.0,17.06,20.54,76.63,29
CPT,88112,LAB CYTOP SLD LIQ NONGYN,110.0,23.76,28.6,106.7,29
CPT,88112,LAB CYTOP SLD LIQ NONGYN SMT/QNI NS,110.0,23.76,28.6,106.7,29
CPT,88173,LAB CYTOPATH EVAL FNA INTRP&RPT,110.0,23.76,28.6,106.7,29
CPT,88173,LAB CYTOPATH EVAL FNA INTRP&RPT NS,110.0,23.76,28.6,106.7,29
CPT,88184,LAB CYTOM FLOW TECH MARKER 1ST,751.0,162.22,195.26,728.47,29
CPT,88184,LAB CYTOM FLOW TECH MARKER 1ST NS,751.0,162.22,195.26,728.47,29
CPT,88185,LAB CYTOM FLOW TECH MARKER ADDL,119.0,25.7,30.94,115.43,29
CPT,88185,LAB CYTOM FLOW TECH MARKER ADDL NS,126.0,27.22,32.76,122.22,29
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYT MYO,1148.0,247.97,298.48,1113.56,29
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYTE NS,350.0,75.6,91.0,339.5,29
CPT,88233,LAB CULT TISS NON-NEO SKIN/BX NS,423.0,91.37,109.98,410.31,29
CPT,88235,LAB CULT TISS NON-NEO AF/CELL CV,451.0,97.42,117.26,437.47,29
CPT,88262,LAB CHROM W BND 15-20 CLL 2 KRTY,377.0,81.43,98.02,365.69,29
CPT,88262,LAB CHROM W BND 15-20 CLL 2 KRTY NS,532.0,114.91,138.32,516.04,29
CPT,88269,LAB CHROM W BND AF 6-12 COL 1 K,521.0,112.54,135.46,505.37,29
CPT,88271,LAB MCG PROBE DNA PROBE EA,65.0,14.04,16.9,63.05,29
CPT,88271,LAB MCG PROBE DNA PROBE EA NS,272.0,58.75,70.72,263.84,29
CPT,88273,LAB MCG IN SITU CHROM 10-30 CELL,335.0,72.36,87.1,324.95,29
CPT,88274,LAB MCG IN SITU INT 25-99 CELL NS,128.0,27.65,33.28,124.16,29
CPT,88275,LAB MCG IN SITU INT 100-300 CELL,154.0,33.26,40.04,149.38,29
CPT,88275,LAB MCG IN SITU INT 100-300 CELL NS,154.0,33.26,40.04,149.38,29
CPT,88280,LAB CHROM KARYOTYPES ADDL EA,101.0,21.82,26.26,97.97,29
CPT,88285,LAB CHROM STUDY CELLS COUNTED ADDL,81.0,17.5,21.06,78.57,29
CPT,88289,LAB CHROM STUDY RES HIGH ADDL,104.0,22.46,27.04,100.88,29
CPT,88300,LAB PATH GROSS ONLY LVL 1,62.0,27.28,16.12,60.14,29
CPT,88302,LAB PATH GROSS&MICRO LVL 2,79.0,34.76,20.54,76.63,29
CPT,88304,LAB PATH GROSS&MICRO LVL 3,110.0,48.4,28.6,106.7,29
CPT,88305,LAB PATH GROSS&MICRO LVL 4 NS,110.0,48.4,28.6,106.7,29
CPT,88307,LAB PATH GROSS&MICRO LVL 5 NS,751.0,330.44,195.26,728.47,29
CPT,88309,LAB PATH GROSS&MICRO LVL 6,1665.0,732.6,432.9,1615.05,29
CPT,88311,LAB DECALCIFICATION,26.0,11.44,6.76,25.22,29
CPT,88312,LAB STAIN SPECIAL 1 NS,110.0,48.4,28.6,106.7,29
CPT,88313,LAB STAIN SPECIAL 2 NS,281.0,123.64,73.06,272.57,29
CPT,88313,LAB STAIN SPECIAL 2 PROT AMYLOID,281.0,123.64,73.06,272.57,29
CPT,88341,LAB IMHST/IMCYT AB PER SPEC NS ADDL,137.0,60.28,35.62,132.89,29
CPT,88342,LAB IMHST/IMCYT AB 1ST PER SPEC NS,359.0,157.96,93.34,348.23,29
CPT,88346,LAB IF AB STAIN INITIAL PER SPEC NS,359.0,157.96,93.34,348.23,29
CPT,88348,LAB MICROSCOPY ELECTRON DIAG NS,1665.0,732.6,432.9,1615.05,29
CPT,88350,LAB IF AB STAIN PER SPEC ADDL NS,189.0,83.16,49.14,183.33,29
CPT,88360,LAB MORPHO HER2 MANUAL PER SPEC NS,374.0,164.56,97.24,362.78,29
CPT,88361,LAB MORPHO HER2 COMP PER SPEC,751.0,330.44,195.26,728.47,29
CPT,88374,LAB MORPHO ISH COMP MULT SPEC NS,553.0,243.32,143.78,536.41,29
CPT,88377,LAB MORPHO ISH MAN MULT PER SPEC NS,359.0,157.96,93.34,348.23,29
CPT,88380,LAB MICRODISSECTION LASER PROT AMYL,202.0,88.88,52.52,195.94,29
CPT,88720,POC BILIRUBIN TOTAL TRANSQ,16.0,7.71,4.16,15.52,29
CPT,89050,LAB COUNT CELL CSF,15.0,11.36,3.9,14.55,29
CPT,89050,LAB COUNT CELL FLUID BODY,15.0,11.36,3.9,14.55,29
CPT,89051,LAB COUNT CELL W DIFF CSF,17.0,12.87,4.42,16.49,29
CPT,89051,LAB COUNT CELL W DIFF FLUID BODY,17.0,12.87,4.42,16.49,29
CPT,89055,LAB ASSESSMENT LEUKOCYTE FECAL,13.0,9.84,3.38,12.61,29
CPT,89060,LAB ID CRYSTAL MICROSCOPY LIGHT,294.0,222.56,76.44,285.18,29
CPT,89160,LAB FIBERS MEAT FECES,155.0,117.34,40.3,150.35,29
CPT,89220,POC COLLECT SPEC SPUTUM AEROSOL,359.0,271.76,93.34,348.23,29
CPT,89310,LAB SEMEN MOTILITY&CT WO HUHNER,26.0,19.68,6.76,25.22,29
CPT,89321,LAB SEMEN SPERM PRESENCE MOTILITY,37.0,28.01,9.62,35.89,29
CPT,90471,ED IMMUNIZATION 1ST VACCINE,81.0,44.14,21.06,78.57,29
CPT,90471,IMMUNIZATION 1ST VACCINE,81.0,44.14,21.06,78.57,58
CPT,90472,ED IMMUNIZATION ADDL VACCINE,41.0,22.35,10.66,39.77,29
CPT,90472,IMMUNIZATION ADDL VACCINE,41.0,22.35,10.66,39.77,58
CPT,91035,TEST ESOPHAGUS PH CAP,1391.0,1016.82,361.66,1349.27,29
CPT,92507,ST TX SPEECH/LANG/VOICE/COM IND,250.0,142.04,65.0,242.5,29
CPT,92508,ST TX SPEECH/LANG/VOICE/COM GROUP,78.0,44.32,20.28,75.66,29
CPT,92522,ST EVAL PROD SOUND SP,279.0,158.51,72.54,270.63,29
CPT,92523,ST EVAL PROD SOUND SP W LANG&EXPRSN,426.0,242.03,110.76,413.22,29
CPT,92524,ST ANALYSIS VOICE&RESON BEH&QUAL,273.0,155.1,70.98,264.81,29
CPT,92526,ST TX DYSFNCT SWALLOW FNCT FEED,210.0,119.31,54.6,203.7,29
CPT,92587,EVOK EMISSIONS OTOACOUSTIC 3-6 FREQ,210.0,119.31,54.6,203.7,58
CPT,92605,ST EVAL DEVICE NON SP W PT 1ST HR,322.0,182.94,83.72,312.34,29
CPT,92606,ST THER DEVICE NON SP W PRG,153.0,86.93,39.78,148.41,29
CPT,92610,ST EVAL FNCT SWALLOW ORAL&PHARYNGEL,245.0,139.2,63.7,237.65,29
CPT,92611,ST EVAL FNCT SWALLOW FLUOROSCOPIC,309.0,175.56,80.34,299.73,29
CPT,92950,CPR,763.0,291.47,198.38,740.11,29
CPT,92950,ED CPR,763.0,305.2,198.38,740.11,29
CPT,92953,ED PACING TRANSCUTANEOUS TEMP,623.0,249.2,161.98,604.31,29
CPT,92960,CARDIOVERSION ELECTIVE EXTERNAL,1178.0,669.28,306.28,1142.66,29
CPT,92960,ED CARDIOVERSION ELECTIVE EXTERNAL,1178.0,471.2,306.28,1142.66,29
CPT,93005,ED EKG TRACING ROUTINE 12+ LEADS,488.0,254.25,126.88,473.36,29
CPT,93005,EKG TRACING ROUTINE 12+ LEADS,488.0,254.25,126.88,473.36,29
CPT,93017,TEST CV STRESS TREAD/BIKE&/RX TRACE,1250.0,632.5,325.0,1212.5,29
CPT,93041,ED EKG TRACING RHYTHM 1-3 LEADS,145.0,75.54,37.7,140.65,29
CPT,93041,EKG TRACING RHYTHM 1-3 LEADS,145.0,75.54,37.7,140.65,29
CPT,93225,EKG RECORD EXTERNAL 0-48HR,429.0,211.93,111.54,416.13,29
CPT,93226,EKG ANALYSIS EXTERNAL 0-48HR,684.0,337.9,177.84,663.48,29
CPT,93242,EKG EXT REC >48HR<=7 DAYS REC,206.0,101.76,53.56,199.82,29
CPT,93246,EKG EXT REC >7 DAYS-15 DAYS REC,195.0,96.33,50.7,189.15,29
CPT,93270,EKG RECORD EVENT REMOTE 0-30DAY,375.0,185.25,97.5,363.75,29
CPT,93306,ECHO 2D DOPP&CLR FLW CMP WO CNT,2143.0,1011.5,557.18,2078.71,29
CPT,93307,ECHO 2D CMP WO CNT,1437.0,678.26,373.62,1393.89,29
CPT,93308,ECHO 2D LTD WO CNT,755.0,356.36,196.3,732.35,29
CPT,93320,ECHO DOPP CMP,436.0,205.79,113.36,422.92,29
CPT,93321,ECHO DOPP LTD,220.0,103.84,57.2,213.4,29
CPT,93325,ECHO DOPP MAP VELOCITY COLOR FLOW,344.0,162.37,89.44,333.68,29
CPT,93350,ECHO 2D REST&STRESS WO CNT W I&R,979.0,462.09,254.54,949.63,29
CPT,93880,US DUPLEX EXTRACRANIAL CMP BI,1661.0,798.94,431.86,1611.17,29
CPT,93882,US DUPLEX EXTRACRANIAL UNI/LTD,980.0,471.38,254.8,950.6,29
CPT,93922,ART PHYS 1-2 LEVEL LTD BI,818.0,393.46,212.68,793.46,29
CPT,93922,ART PHYS 1-2 LEVEL LTD UNI,545.0,262.14,141.7,528.65,29
CPT,93923,ART PHYS 3+ LEVEL CMP BI,1347.0,647.91,350.22,1306.59,29
CPT,93923,ART PHYS 3+ LEVEL CMP UNI,898.0,431.94,233.48,871.06,29
CPT,93924,US ART PHYS EXT LWR TREADMILL BI,469.0,225.59,121.94,454.93,29
CPT,93925,US DUPLEX ART EXT LWR BI,1550.0,745.55,403.0,1503.5,29
CPT,93926,US DUPLEX ART EXT LWR UNI/LTD LT,990.0,476.19,257.4,960.3,29
CPT,93926,US DUPLEX ART EXT LWR UNI/LTD RT,990.0,476.19,257.4,960.3,29
CPT,93930,US DUPLEX ART EXT UPR CMP BI,1402.0,674.36,364.52,1359.94,29
CPT,93931,US DUPLEX ART EXT UPR UNI/LTD LT,980.0,471.38,254.8,950.6,29
CPT,93931,US DUPLEX ART EXT UPR UNI/LTD RT,980.0,471.38,254.8,950.6,29
CPT,93970,US DUPLEX VEIN EXT CMP BI,1740.0,836.94,452.4,1687.8,29
CPT,93971,US DUPLEX VEIN EXT LTD/UNI,1168.0,561.81,303.68,1132.96,29
CPT,93975,US DUPLEX ABD/PEL/SCR&/RETRO CMP,1762.0,847.52,458.12,1709.14,29
CPT,93976,US DUPLEX ABD/PEL/SCR&/RETRO LTD,627.0,301.59,163.02,608.19,29
CPT,93978,US DUPLEX AO/IVC/ILIAC/GRFT CMP,590.0,283.79,153.4,572.3,29
CPT,94002,VENT INITIAL DAY,1265.0,483.23,328.9,1227.05,29
CPT,94003,VENT SUBSQ DAY,924.0,352.97,240.24,896.28,29
CPT,94010,SPIROMETRY W VITAL CAP W/WO VENT,404.0,150.29,105.04,391.88,29
CPT,94060,BRONCHDLTN PRE&POST SPIROMETRY W VC,580.0,215.76,150.8,562.6,29
CPT,94070,EVAL BRONCHSPSM SPIRO W AGENTS,784.0,291.65,203.84,760.48,29
CPT,94200,CAPACITY BREATHING MAX VENT VOL MAX,110.0,40.92,28.6,106.7,29
CPT,94375,LOOP VOLUME FLOW RESP,341.0,126.85,88.66,330.77,29
CPT,94618,TEST STRESS PULMONARY,313.0,116.44,81.38,303.61,29
CPT,94625,REHAB PULM OP WO CONT OX SESSN,158.0,89.77,41.08,153.26,29
CPT,94626,REHAB PULM OP W CONT OX SESSN,306.0,173.85,79.56,296.82,29
CPT,94660,BIPAP INITIAL DAY,882.0,336.92,229.32,855.54,29
CPT,94660,BIPAP SUBSQ DAY,882.0,336.92,229.32,855.54,29
CPT,94660,CPAP INITIAL DAY,882.0,336.92,229.32,855.54,29
CPT,94660,CPAP SUBSQ DAY,882.0,336.92,229.32,855.54,29
CPT,94664,DEMO&/EVAL PT AEROSOL/NEB/MDI/IPPB,199.0,76.02,51.74,193.03,29
CPT,94667,CLEARANCE AIRWAY INITIAL,98.0,37.44,25.48,95.06,29
CPT,94667,PHYSIOTHERAPY CHEST INITIAL,98.0,37.44,25.48,95.06,29
CPT,94668,CLEARANCE AIRWAY SUBSQ,96.0,36.67,24.96,93.12,29
CPT,94668,PHYSIOTHERAPY CHEST SUBSQ,96.0,36.67,24.96,93.12,29
CPT,94690,OXYGN UPTAKE REST CALORMTRY INDIRCT,345.0,128.34,89.7,334.65,29
CPT,94726,PLETHYSMOGRAPHY VOLUMES LUNG,252.0,93.74,65.52,244.44,29
CPT,94727,DILUT GAS/WASHOUT VOLUMES LUNG,337.0,125.36,87.62,326.89,29
CPT,94728,RESIST AIRWAY OSCILLOMETRY,282.0,104.9,73.32,273.54,29
CPT,94729,CAPACITY DIFFUSING,373.0,138.76,96.98,361.81,29
CPT,95782,PSG W 4+ PARAM 0-5YRS,8391.0,5856.92,2181.66,8139.27,29
CPT,95783,PSG W 4+ PARAM 0-5YRS W CPAP,8855.0,9625.38,2302.3,8589.35,29
CPT,95800,SLP UNATND HOM RT/SAT/ANLY&TIME,844.0,917.43,219.44,818.68,29
CPT,95800,SLP UNATND HOM RT/SAT/ANLY&TIME<6HR,844.0,917.43,219.44,818.68,29
CPT,95805,TEST LATENCY SLEEP MULT,4709.0,5118.68,1224.34,4567.73,29
CPT,95805,TEST LATENCY SLEEP MULT RDC<4 NAPS,4709.0,5118.68,1224.34,4567.73,29
CPT,95806,SLP UNATND HOM RT/SAT/FLW&EFF,785.0,853.3,204.1,761.45,29
CPT,95806,SLP UNATND HOM RT/SAT/FLW&EFF<6HR,785.0,853.3,204.1,761.45,29
CPT,95810,PSG W 4+ PARAM 6+YRS,6000.0,4188.0,1560.0,5820.0,29
CPT,95810,PSG W 4+PARAM 6+YR RDC<6HRS,6000.0,4188.0,1560.0,5820.0,29
CPT,95811,PSG W 4+ PARAM 6+YR W CPAP RDC<6HR,6917.0,4828.07,1798.42,6709.49,29
CPT,95811,PSG W 4+ PARAM 6+YRS W CPAP,6917.0,4828.07,1798.42,6709.49,29
CPT,95940,MONITOR NEURO 1:1 IN OR 15MIN,142.0,154.35,36.92,137.74,29
CPT,95992,PT REPOSITIONING CANALITH PER DAY,167.0,101.54,43.42,161.99,29
CPT,96105,ST EVAL/EXAM APHASIA W RPT PER HR,242.0,137.49,62.92,234.74,29
CPT,96110,ST SCRN DVLPMNTL W S&D INST STD,128.0,72.72,33.28,124.16,29
CPT,96125,ST TEST COGNITIVE HC PRO PER HR,269.0,152.83,69.94,260.93,29
CPT,96360,ED INF IV HYDRATION 31-60MIN,504.0,201.6,131.04,488.88,29
CPT,96360,INF IV HYDRATION 31-60MIN,504.0,261.07,131.04,488.88,87
CPT,96361,ED INF IV HYDRATION ADDL HR,98.0,39.2,25.48,95.06,29
CPT,96361,INF IV HYDRATION ADDL HR,98.0,50.76,25.48,95.06,87
CPT,96365,ED INF IV THRPY 1ST HR,608.0,243.2,158.08,589.76,29
CPT,96365,INF IV THRPY 1ST HR,608.0,314.94,158.08,589.76,87
CPT,96366,ED INF IV THRPY ADDL HR,114.0,45.6,29.64,110.58,29
CPT,96366,INF IV THRPY ADDL HR,114.0,59.05,29.64,110.58,87
CPT,96367,ED INF IV THRPY SEQ DRUG NEW 1ST HR,214.0,85.6,55.64,207.58,29
CPT,96367,INF IV THRPY SEQ DRUG NEW 1ST HR,214.0,110.85,55.64,207.58,87
CPT,96368,ED INF IV THRPY CONCURRENT,187.0,74.8,48.62,181.39,29
CPT,96368,INF IV THRPY CONCURRENT,187.0,96.87,48.62,181.39,87
CPT,96372,ED INJ SUBQ/IM,144.0,57.6,37.44,139.68,29
CPT,96372,INJ SUBQ/IM,144.0,67.39,37.44,139.68,87
CPT,96373,INJ INTRA-ARTERIAL,191.0,89.39,49.66,185.27,29
CPT,96374,ED INJ IVP DRUG INITIAL,453.0,181.2,117.78,439.41,29
CPT,96374,INJ IVP DRUG INITIAL,453.0,212.0,117.78,439.41,87
CPT,96374,INJ IVP DRUG INITIAL INCMP TEST,453.0,212.0,117.78,439.41,29
CPT,96375,ED INJ IVP SEQ DRUG ADDL NEW,144.0,57.6,37.44,139.68,29
CPT,96375,INJ IVP SEQ DRUG ADDL NEW,144.0,67.39,37.44,139.68,87
CPT,96376,ED INJ IVP SEQ DRUG ADDL SAME,107.0,42.8,27.82,103.79,29
CPT,96376,INJ IVP SEQ DRUG ADDL SAME,107.0,50.08,27.82,103.79,87
CPT,96401,CHEMO SUBQ/IM NONHORMONAL,558.0,201.44,145.08,541.26,58
CPT,96401,ED CHEMO SUBQ/IM NONHORMONAL,558.0,201.44,145.08,541.26,29
CPT,96402,CHEMO SUBQ/IM HORMONAL,438.0,158.12,113.88,424.86,29
CPT,96405,CHEMO INTRALESIONAL LSN 1-7,175.0,63.18,45.5,169.75,29
CPT,96406,CHEMO INTRALESIONAL LSN 8+,304.0,109.74,79.04,294.88,29
CPT,96409,CHEMO IVP DRUG INITIAL,458.0,165.34,119.08,444.26,58
CPT,96409,ED CHEMO IVP DRUG INITIAL,458.0,165.34,119.08,444.26,29
CPT,96411,CHEMO IVP DRUG ADDL,284.0,102.52,73.84,275.48,58
CPT,96411,ED CHEMO IVP DRUG ADDL,284.0,102.52,73.84,275.48,29
CPT,96413,CHEMO INF IV 1ST HR,482.0,135.44,125.32,467.54,58
CPT,96413,ED CHEMO INF IV 1ST HR,482.0,135.44,125.32,467.54,29
CPT,96415,CHEMO INF IV ADDL HR,106.0,29.79,27.56,102.82,58
CPT,96415,ED CHEMO INF IV ADDL HR,106.0,29.79,27.56,102.82,29
CPT,96416,CHEMO IV HOME PMP EXT BH SPLD W FU,504.0,141.62,131.04,488.88,29
CPT,96416,CHEMO IV HOME PMP EXT BH SPLD WO FU,504.0,141.62,131.04,488.88,29
CPT,96416,CHEMO IV HOME PMP EXT VNDR SUPPLIED,504.0,141.62,131.04,488.88,29
CPT,96416,CHEMO IV HOSP PMP EXT/IMP 8+ HR,504.0,141.62,131.04,488.88,29
CPT,96417,CHEMO INF IV SEQ 1ST HR,237.0,66.6,61.62,229.89,58
CPT,96417,ED CHEMO INF IV SEQ 1ST HR,237.0,66.6,61.62,229.89,29
CPT,96521,REFILL&MAINT PUMP PORTABLE,365.0,170.82,94.9,354.05,29
CPT,96523,IRRG VAD IMP DELIVERY DRUG,281.0,131.51,73.06,272.57,29
CPT,97010,PT MODALITY APPL HOT/COLD,34.0,20.67,8.84,32.98,29
CPT,97010,PTA MODALITY APPL HOT/COLD,34.0,20.67,8.84,32.98,29
CPT,97012,OT MODALITY APPL TRACTION MECHANIC,80.0,30.96,20.8,77.6,29
CPT,97012,OTA MODALITY APPL TRACTION MECHANIC,80.0,30.96,20.8,77.6,29
CPT,97012,PT MODALITY APPL TRACTION MECHANIC,80.0,48.64,20.8,77.6,29
CPT,97012,PTA MODALITY APPL TRACTION MECHANIC,80.0,48.64,20.8,77.6,29
CPT,97014,PT MODALITY APPL E-STIM UNATND OTH,74.0,44.99,19.24,71.78,29
CPT,97014,PT MODALITY APPL E-STIM UNATND ULC,74.0,44.99,19.24,71.78,29
CPT,97014,PTA MODALITY APPL E-STIM UNATND OTH,74.0,44.99,19.24,71.78,29
CPT,97014,PTA MODALITY APPL E-STIM UNATND ULC,74.0,44.99,19.24,71.78,29
CPT,97018,PT MODALITY APPL BATH PARAFFIN,41.0,24.93,10.66,39.77,29
CPT,97018,PTA MODALITY APPL BATH PARAFFIN,41.0,24.93,10.66,39.77,29
CPT,97022,PT MODALITY APPL WHIRLPOOL,73.0,44.38,18.98,70.81,29
CPT,97022,PTA MODALITY APPL WHIRLPOOL,73.0,44.38,18.98,70.81,29
CPT,97032,PT MODALITY APPL E-STIM MAN 15MN,79.0,48.03,20.54,76.63,29
CPT,97032,PTA MODALITY APPL E-STIM MAN 15MN,79.0,48.03,20.54,76.63,29
CPT,97033,PT MODALITY APPL IONTOPHORES 15MN,65.0,39.52,16.9,63.05,29
CPT,97033,PTA MODALITY APPL IONTOPHORES 15MN,65.0,39.52,16.9,63.05,29
CPT,97034,PT MODALITY APPL BATH CNT 15MN,43.0,26.14,11.18,41.71,29
CPT,97034,PTA MODALITY APPL BATH CNT 15MN,43.0,26.14,11.18,41.71,29
CPT,97035,OT MODALITY APPL ULTRASOUND 15MN,84.0,32.51,21.84,81.48,29
CPT,97035,OTA MODALITY APPL ULTRASOUND 15MN,84.0,32.51,21.84,81.48,29
CPT,97035,PT MODALITY APPL ULTRASOUND 15MN,84.0,51.07,21.84,81.48,29
CPT,97035,PTA MODALITY APPL ULTRASOUND 15MN,84.0,51.07,21.84,81.48,29
CPT,97037,PT MODALITY APPL THPY LASER LOW LVL,113.0,68.7,29.38,109.61,29
CPT,97110,OT THER EXERCISE 15MN,139.0,53.79,36.14,134.83,29
CPT,97110,OTA THER EXERCISE 15MN,139.0,53.79,36.14,134.83,29
CPT,97110,PT THER EXERCISE 15MN,139.0,84.51,36.14,134.83,29
CPT,97110,PTA THER EXERCISE 15MN,139.0,84.51,36.14,134.83,29
CPT,97112,OT THER NEUROMUS REEDUCATE 15MN,154.0,59.6,40.04,149.38,29
CPT,97112,OTA THER NEUROMUS REEDUCATE 15MN,154.0,59.6,40.04,149.38,29
CPT,97112,PT THER NEUROMUS REEDUCATE 15MN,154.0,93.63,40.04,149.38,29
CPT,97112,PTA THER NEUROMUS REEDUCATE 15MN,154.0,93.63,40.04,149.38,29
CPT,97113,OT THER AQUATIC 15MN,146.0,56.5,37.96,141.62,29
CPT,97113,OTA THER AQUATIC 15MN,146.0,56.5,37.96,141.62,29
CPT,97113,PT THER AQUATIC 15MN,146.0,88.77,37.96,141.62,29
CPT,97113,PTA THER AQUATIC 15MN,146.0,88.77,37.96,141.62,29
CPT,97116,OT THER TRAIN GAIT 15MN,73.0,28.25,18.98,70.81,29
CPT,97116,OTA THER TRAIN GAIT 15MN,73.0,28.25,18.98,70.81,29
CPT,97116,PT THER TRAIN GAIT 15MN,73.0,44.38,18.98,70.81,29
CPT,97116,PTA THER TRAIN GAIT 15MN,73.0,44.38,18.98,70.81,29
CPT,97124,OT THER MASSAGE 15MN,75.0,29.02,19.5,72.75,29
CPT,97124,OTA THER MASSAGE 15MN,75.0,29.02,19.5,72.75,29
CPT,97124,PT THER MASSAGE 15MN,75.0,45.6,19.5,72.75,29
CPT,97124,PTA THER MASSAGE 15MN,75.0,45.6,19.5,72.75,29
CPT,97129,OT SKILLS DEVLPMT COGNITIVE 15MN,66.0,25.54,17.16,64.02,29
CPT,97129,OTA SKILLS DEVLPMT COGNITIVE 15MN,66.0,25.54,17.16,64.02,29
CPT,97129,ST SKILLS DEVLPMT COGNITIVE 15MN,66.0,37.5,17.16,64.02,29
CPT,97130,OT SKILLS DEVLPMT COGNITIVE AD 15MN,62.0,23.99,16.12,60.14,29
CPT,97130,OTA SKILL DEVLPMT COGNITIVE AD 15MN,62.0,23.99,16.12,60.14,29
CPT,97130,ST SKILLS DEVLPMT COGNITIVE AD 15MN,62.0,35.23,16.12,60.14,29
CPT,97140,OT THERAPY MANUAL 15MN,160.0,61.92,41.6,155.2,29
CPT,97140,OTA THERAPY MANUAL 15MN,160.0,61.92,41.6,155.2,29
CPT,97140,PT THERAPY MANUAL 15MN,160.0,97.28,41.6,155.2,29
CPT,97140,PTA THERAPY MANUAL 15MN,160.0,97.28,41.6,155.2,29
CPT,97150,OT THER GROUP,47.0,26.7,12.22,45.59,29
CPT,97150,OTA THER GROUP,47.0,26.7,12.22,45.59,29
CPT,97161,PT EVAL THERAPY LOW,310.0,182.9,80.6,300.7,29
CPT,97162,PT EVAL THERAPY MOD,393.0,231.87,102.18,381.21,29
CPT,97163,PT EVAL THERAPY HIGH,445.0,262.55,115.7,431.65,29
CPT,97164,PT RE-EVAL THERAPY,310.0,182.9,80.6,300.7,29
CPT,97165,OT EVAL THERAPY LOW,175.0,99.43,45.5,169.75,29
CPT,97166,OT EVAL THERAPY MOD,233.0,132.38,60.58,226.01,29
CPT,97167,OT EVAL THERAPY HIGH,250.0,142.04,65.0,242.5,29
CPT,97168,OT RE-EVAL THERAPY,175.0,99.43,45.5,169.75,29
CPT,97530,OT THER ACTIVITIES 15MN,95.0,36.76,24.7,92.15,29
CPT,97530,OTA THER ACTIVITIES 15MN,95.0,36.76,24.7,92.15,29
CPT,97530,PT THER ACTIVITIES 15MN,95.0,57.76,24.7,92.15,29
CPT,97530,PTA THER ACTIVITIES 15MN,95.0,57.76,24.7,92.15,29
CPT,97533,OT TECHNIQUES SENSORY 15MN,90.0,34.83,23.4,87.3,29
CPT,97533,OTA TECHNIQUES SENSORY 15MN,90.0,34.83,23.4,87.3,29
CPT,97535,PT MANAGEMENT SELF-CARE/HOME 15MN,86.0,52.29,22.36,83.42,29
CPT,97535,PTA MANAGEMENT SELF-CARE/HOME 15MN,86.0,52.29,22.36,83.42,29
CPT,97537,OT REINTEGRATION COMM/WORK 15MN,126.0,48.76,32.76,122.22,29
CPT,97537,OTA REINTEGRATION COMM/WORK 15MN,126.0,48.76,32.76,122.22,29
CPT,97542,PT MANAGEMENT WHEELCHAIR 15MN,82.0,49.86,21.32,79.54,29
CPT,97542,PTA MANAGEMENT WHEELCHAIR 15MN,82.0,49.86,21.32,79.54,29
CPT,97550,OT TRAIN CAREGIVER WO PT 1ST 30MIN,303.0,117.26,78.78,293.91,29
CPT,97550,PT TRAIN CAREGIVER WO PT 1ST 30MIN,303.0,184.22,78.78,293.91,29
CPT,97550,ST TRAIN CAREGIVER WO PT 1ST 30MIN,303.0,172.15,78.78,293.91,29
CPT,97551,OT TRAIN CAREGIVER WO PT ADD 15MIN,115.0,44.5,29.9,111.55,29
CPT,97551,PT TRAIN CAREGIVER WO PT ADD 15MIN,115.0,69.92,29.9,111.55,29
CPT,97551,ST TRAIN CAREGIVER WO PT ADD 15MIN,115.0,65.34,29.9,111.55,29
CPT,97552,OT TRAIN CAREGIVER GROUP,98.0,37.93,25.48,95.06,29
CPT,97552,PT TRAIN CAREGIVER GROUP,98.0,59.58,25.48,95.06,29
CPT,97552,ST TRAIN CAREGIVER GROUP,98.0,55.68,25.48,95.06,29
CPT,97597,PT DEBRIDE SLCT WND OPEN 1ST 20CM,270.0,164.16,70.2,261.9,29
CPT,97597,PTA DEBRIDE SLCT WND OPEN 1ST 20CM,270.0,164.16,70.2,261.9,29
CPT,97598,PT DEBRIDE SLCT WND OPEN ADDL 20CM,84.0,51.07,21.84,81.48,29
CPT,97598,PTA DEBRIDE SLCT WND OPEN ADDL 20CM,84.0,51.07,21.84,81.48,29
CPT,97602,PT DEBRIDE NONSELECT WO ANES SESSN,147.0,89.38,38.22,142.59,29
CPT,97602,PTA DEBRIDE NONSELECT WO ANES SESSN,147.0,89.38,38.22,142.59,29
CPT,97605,WOUND NEG PRESS W DME 0-50 SC,176.0,68.29,45.76,170.72,29
CPT,97606,WOUND NEG PRESS W DME 51+ SC,283.0,109.8,73.58,274.51,29
CPT,97610,PT THERAPY MIST,325.0,197.6,84.5,315.25,29
CPT,97610,PTA THERAPY MIST,325.0,197.6,84.5,315.25,29
CPT,97750,PT MEAS/TEST PERFORMANCE 15MIN,85.0,51.68,22.1,82.45,29
CPT,97750,PTA MEAS/TEST PERFORMANCE 15MIN,85.0,51.68,22.1,82.45,29
CPT,97760,OT TRAIN ORTHO UE/LE INIT 15MN,74.0,28.64,19.24,71.78,29
CPT,97760,OTA TRAIN ORTHO UE/LE INIT 15MN,74.0,28.64,19.24,71.78,29
CPT,97760,PT TRAIN ORTHO UE/LE INIT 15MN,74.0,44.99,19.24,71.78,29
CPT,97760,PTA TRAIN ORTHO UE/LE INIT 15MN,74.0,44.99,19.24,71.78,29
CPT,97761,OT TRAIN PROSTH UE&/LE INIT 15MN,72.0,27.86,18.72,69.84,29
CPT,97761,OTA TRAIN PROSTH UE&/LE INIT 15MN,72.0,27.86,18.72,69.84,29
CPT,97761,PT TRAIN PROSTH UE&/LE INIT 15MN,72.0,43.78,18.72,69.84,29
CPT,97761,PTA TRAIN PROSTH UE&/LE INIT 15MN,72.0,43.78,18.72,69.84,29
CPT,97763,PT TRAIN ORTHO/PROS EXT SUBSQ 15MN,79.0,48.03,20.54,76.63,29
CPT,97763,PTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,79.0,48.03,20.54,76.63,29
CPT,97802,MNT INITIAL ASSESS INDIVIDUAL 15MIN,60.0,49.8,15.6,58.2,29
CPT,97803,MNT RE-ASSESS INDIVIDUAL 15MIN,57.0,47.31,14.82,55.29,29
CPT,97804,MNT GROUP 30MIN,32.0,26.56,8.32,31.04,29
CPT,98960,EDUC&TRAIN SELFMGMT IND 30MIN,106.0,87.98,27.56,102.82,29
CPT,99151,ED SED MOD SAME 0-4Y INIT 15MN,490.0,329.77,127.4,475.3,29
CPT,99151,SED MOD SAME 0-4Y INIT 15MN,490.0,329.77,127.4,475.3,29
CPT,99152,ED SED MOD SAME 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CPT,99152,SED MOD ENDO SAME 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CPT,99152,SED MOD SAME 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CPT,99153,ED SED MOD SAME ADDL 15MN,245.0,164.89,63.7,237.65,29
CPT,99153,SED MOD SAME ADDL 15MN,245.0,164.89,63.7,237.65,29
CPT,99155,ED SED MOD DIFF 0-4Y INIT 15MN,490.0,329.77,127.4,475.3,29
CPT,99156,ED SED MOD DIFF 5+Y INIT 15MN,490.0,329.77,127.4,475.3,29
CPT,99157,ED SED MOD DIFF ADDL 15MN,245.0,164.89,63.7,237.65,29
CPT,99195,PHLEBOTOMY THERAPEUTIC,192.0,89.86,49.92,186.24,29
CPT,99202,VISIT NEW LEVEL 1,150.0,85.22,39.0,145.5,29
CPT,99202,VISIT NEW LEVEL 2,200.0,113.63,52.0,194.0,29
CPT,99202,VISIT OB TRIAGE NEW LEVEL 1,770.0,721.49,200.2,746.9,29
CPT,99202,VISIT OB TRIAGE NEW LEVEL 2,1475.0,1382.08,383.5,1430.75,29
CPT,99203,VISIT NEW LEVEL 3,270.0,153.4,70.2,261.9,29
CPT,99203,VISIT OB TRIAGE NEW LEVEL 3,2210.0,2070.77,574.6,2143.7,29
CPT,99204,VISIT NEW LEVEL 4,370.0,210.22,96.2,358.9,29
CPT,99204,VISIT OB TRIAGE NEW LEVEL 4,2660.0,2492.42,691.6,2580.2,29
CPT,99205,VISIT NEW LEVEL 5,470.0,267.03,122.2,455.9,29
CPT,99205,VISIT OB TRIAGE NEW LEVEL 5,3560.0,3335.72,925.6,3453.2,29
CPT,99211,VISIT ESTABLISHED LEVEL 1,140.0,79.54,36.4,135.8,29
CPT,99211,VISIT OB TRIAGE ESTABLISHED LEVEL 1,290.0,271.73,75.4,281.3,29
CPT,99212,VISIT ESTABLISHED LEVEL 2,190.0,107.95,49.4,184.3,29
CPT,99212,VISIT OB TRIAGE ESTABLISHED LEVEL 2,735.0,688.7,191.1,712.95,29
CPT,99213,VISIT ESTABLISHED LEVEL 3,240.0,136.36,62.4,232.8,29
CPT,99213,VISIT OB TRIAGE ESTABLISHED LEVEL 3,1475.0,1382.08,383.5,1430.75,29
CPT,99214,VISIT ESTABLISHED LEVEL 4,290.0,164.76,75.4,281.3,29
CPT,99214,VISIT OB TRIAGE ESTABLISHED LEVEL 4,2275.0,2131.68,591.5,2206.75,29
CPT,99215,VISIT ESTABLISHED LEVEL 5,340.0,193.17,88.4,329.8,29
CPT,99215,VISIT OB TRIAGE ESTABLISHED LEVEL 5,3205.0,3003.08,833.3,3108.85,29
CPT,99281,ED VISIT LEVEL 1,189.0,123.2,49.14,183.33,29
CPT,99282,ED VISIT LEVEL 2,352.0,256.87,91.52,341.44,29
CPT,99283,ED VISIT LEVEL 3,625.0,738.4,162.5,606.25,29
CPT,99284,ED VISIT LEVEL 4,1024.0,2097.47,266.24,993.28,29
CPT,99285,ED VISIT LEVEL 5,1455.0,2469.72,378.3,1411.35,29
CPT,99291,ED VISIT CRITICAL CARE 1ST 30-74MIN,1911.0,764.4,496.86,1853.67,29
CPT,99292,ED VISIT CRITICAL CARE ADDL 30MIN,956.0,382.4,248.56,927.32,29
CPT,G0105,Colorectal cancer screening; colonoscopy on individual at high risk,,,,,0
CPT,G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,,,,,0
HCPCS,A0425,MILEAGE GROUND MILE 0.10,2.7,1.17,0.702,2.62,29
HCPCS,A0425,MILEAGE GROUND MILE 1.00,27.0,11.74,7.02,26.19,29
HCPCS,A0426,TRNSPRT NONEMR AMB ALS LEVEL 1,2153.0,936.56,559.78,2088.41,29
HCPCS,A0427,TRNSPRT EMERG AMB ALS LEVEL 1,2492.0,1084.02,647.92,2417.24,29
HCPCS,A0428,TRNSPRT NONEMR AMB BLS,1525.0,663.38,396.5,1479.25,29
HCPCS,A0429,TRNSPRT EMERG AMB BLS,1814.0,789.09,471.64,1759.58,29
HCPCS,A0430,TRNSPRT AIR FIXED WING,20440.0,8891.4,5314.4,19826.8,29
HCPCS,A0433,TRNSPRT AMB ALS LEVEL 2,3322.0,1445.07,863.72,3222.34,29
HCPCS,A0434,TRNSPRT SPECIALTY CARE,2716.0,1181.46,706.16,2634.52,29
HCPCS,A0435,MILEAGE AIR FIXED WING MILE 1.00,170.0,73.95,44.2,164.9,29
HCPCS,A0888,MILEAGE NONCOVERED MILE 0.10,2.7,0.39,0.702,2.62,29
HCPCS,A0998,RESPONSE/TREATMENT AMB WO TRNSPRT,222.0,32.41,57.72,215.34,29
HCPCS,A4648,IMP MARKER TISSUE LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,A4648,IMP MARKER TISSUE LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,A4648,IMP MARKER TISSUE LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,A9500,RRX TC-99 SESTAMIBI DX/DOSE,277.9,146.73,72.25,269.56,28
HCPCS,A9502,RRX TETROFOSMIN DX/DOSE,200.0,105.6,52.0,194.0,28
HCPCS,A9503,RRX TC99 MEDRONATE/0-30MCI DOSE,354.3,187.07,92.12,343.67,28
HCPCS,A9512,RRX PERTECHNETATE DX/MCI,116.0,61.25,30.16,112.52,28
HCPCS,A9516,RRX I-123 IOD NA DX/100UCI <1MCI,110.0,58.08,28.6,106.7,28
HCPCS,A9521,RRX EXAMETAZIME DX/0-25MCI DOSE,725.0,382.8,188.5,1855.42,29
HCPCS,A9537,RRX MEBROFENIN DX/0-15MCI DOSE,942.0,497.38,244.92,913.74,28
HCPCS,A9538,RRX PYROPHOSPHATE DX/0-25MCI DOSE,463.2,244.57,120.43,449.3,28
HCPCS,A9539,RRX PENTETATE DX/0-25MCI DOSE,257.0,135.7,66.82,249.29,28
HCPCS,A9540,RRX MAA DX/0-10MCI DOSE,172.0,90.82,44.72,166.84,28
HCPCS,A9541,RRX SULFUR COLLOID DX/0-20MCI DOSE,172.0,90.82,44.72,166.84,28
HCPCS,A9547,RRX INDIUM 111 OXYQ DX/0.5MCI,98.0,51.74,25.48,1662.92,29
HCPCS,A9548,RRX INDIUM 111 PENTETATE DX/0.5MCI,2018.0,1065.5,524.68,1957.46,29
HCPCS,A9557,RRX BICISATE DX/0-25MCI DOSE,1683.0,888.62,437.58,1632.51,29
HCPCS,A9560,RRX RBC LABELED DX/0-30MCI DOSE,804.0,424.51,209.04,779.88,28
HCPCS,A9562,RRX MERTIATIDE DX/0-15MCI DOSE,413.0,218.06,107.38,400.61,28
HCPCS,A9567,RRX DTPA AEROSOL DOSE 0-75MCI,426.3,225.09,110.84,413.51,28
HCPCS,A9569,RRX EXAMETAZIME WBC LABELED DX/DOSE,1852.0,977.86,481.52,1868.26,29
HCPCS,A9572,RRX INDIUM-111 PENTET DX/0-6MCI,4325.0,2283.6,1124.5,4195.25,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 01,70.0,40.25,18.2,67.9,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 02,102.0,58.65,26.52,98.94,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 03,166.0,95.45,43.16,161.02,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 04,221.0,127.07,57.46,214.37,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 05,313.0,179.98,81.38,303.61,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 06,447.0,257.02,116.22,433.59,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 07,594.0,341.55,154.44,576.18,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 08,850.0,488.75,221.0,824.5,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 09,1132.0,650.9,294.32,1098.04,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 10,1413.0,812.47,367.38,1370.61,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 11,1619.0,930.92,420.94,1570.43,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 12,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 13,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 14,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 15,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 16,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 17,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 18,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 19,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 20,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 21,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1713,IMP BLADE LVL 01,1413.0,812.47,367.38,1370.61,29
HCPCS,C1713,IMP BLADE LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1713,IMP BLADE LVL 03,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1713,IMP BOLT LVL 01,709.0,407.67,184.34,687.73,29
HCPCS,C1713,IMP BOLT LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,C1713,IMP BOLT LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1713,IMP BOLT LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1713,IMP BOLT LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1713,IMP BOLT LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1713,IMP BOLT LVL 07,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1713,IMP BOLT LVL 08,12506.0,7190.95,3251.56,12130.82,29
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 02,850.0,488.75,221.0,824.5,29
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 03,1619.0,930.92,420.94,1570.43,29
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 04,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 05,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 06,4880.0,2806.0,1268.8,4733.6,29
HCPCS,C1713,IMP CEMENT LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1713,IMP CEMENT LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C1713,IMP CEMENT LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1713,IMP CEMENT LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1713,IMP CEMENT LVL 05,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1713,IMP CEMENT LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1713,IMP CEMENT LVL 07,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1713,IMP CEMENT LVL 08,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1713,IMP PIN/WIRE LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1713,IMP PIN/WIRE LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C1713,IMP PIN/WIRE LVL 03,850.0,488.75,221.0,824.5,29
HCPCS,C1713,IMP PIN/WIRE LVL 04,1132.0,650.9,294.32,1098.04,29
HCPCS,C1713,IMP PIN/WIRE LVL 05,1413.0,812.47,367.38,1370.61,29
HCPCS,C1713,IMP PIN/WIRE LVL 06,1619.0,930.92,420.94,1570.43,29
HCPCS,C1713,IMP PIN/WIRE LVL 07,1888.0,1085.6,490.88,1831.36,29
HCPCS,C1713,IMP PIN/WIRE LVL 08,2426.0,1394.95,630.76,2353.22,29
HCPCS,C1713,IMP PIN/WIRE LVL 09,2827.0,1625.52,735.02,2742.19,29
HCPCS,C1713,IMP PIN/WIRE LVL 10,3340.0,1920.5,868.4,3239.8,29
HCPCS,C1713,IMP PIN/WIRE LVL 11,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1713,IMP PIN/WIRE LVL 12,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1713,IMP PIN/WIRE LVL 13,8107.0,4661.52,2107.82,7863.79,29
HCPCS,C1713,IMP PLATE CUST LVL 01,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1713,IMP PLATE CUST LVL 02,87604.0,50372.3,22777.04,84975.88,29
HCPCS,C1713,IMP PLATE CUST LVL 03,109504.0,62964.8,28471.04,106218.88,29
HCPCS,C1713,IMP PLATE CUST LVL 04,131404.0,75557.3,34165.04,127461.88,29
HCPCS,C1713,IMP PLATE LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1713,IMP PLATE LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C1713,IMP PLATE LVL 03,850.0,488.75,221.0,824.5,29
HCPCS,C1713,IMP PLATE LVL 04,1132.0,650.9,294.32,1098.04,29
HCPCS,C1713,IMP PLATE LVL 05,1619.0,930.92,420.94,1570.43,29
HCPCS,C1713,IMP PLATE LVL 06,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1713,IMP PLATE LVL 07,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1713,IMP PLATE LVL 08,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1713,IMP PLATE LVL 09,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1713,IMP PLATE LVL 10,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1713,IMP PLATE LVL 11,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1713,IMP PLATE LVL 12,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1713,IMP PLATE LVL 13,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1713,IMP PLATE LVL 14,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1713,IMP PLATE LVL 15,18400.0,10580.0,4784.0,17848.0,29
HCPCS,C1713,IMP PLATE LVL 16,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1713,IMP PLATE LVL 17,24094.0,13854.05,6264.44,23371.18,29
HCPCS,C1713,IMP PLATE LVL 18,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1713,IMP PLATE LVL 19,28474.0,16372.55,7403.24,27619.78,29
HCPCS,C1713,IMP PLATE LVL 20,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1713,IMP PLATE LVL 21,32854.0,18891.05,8542.04,31868.38,29
HCPCS,C1713,IMP PLATE LVL 22,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1713,IMP RING LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1713,IMP RING LVL 02,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1713,IMP RING LVL 03,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1713,IMP ROD/NAIL LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1713,IMP ROD/NAIL LVL 02,850.0,488.75,221.0,824.5,29
HCPCS,C1713,IMP ROD/NAIL LVL 03,1413.0,812.47,367.38,1370.61,29
HCPCS,C1713,IMP ROD/NAIL LVL 04,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1713,IMP ROD/NAIL LVL 05,3909.0,2247.67,1016.34,3791.73,29
HCPCS,C1713,IMP ROD/NAIL LVL 06,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1713,IMP ROD/NAIL LVL 07,6487.0,3730.02,1686.62,6292.39,29
HCPCS,C1713,IMP ROD/NAIL LVL 08,7876.0,4528.7,2047.76,7639.72,29
HCPCS,C1713,IMP ROD/NAIL LVL 09,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1713,IMP ROD/NAIL LVL 10,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1713,IMP ROD/NAIL LVL 11,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1713,IMP ROD/NAIL LVL 12,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1713,IMP ROD/NAIL LVL 13,24094.0,13854.05,6264.44,23371.18,29
HCPCS,C1713,IMP STAPLE BONE LVL 01,166.0,95.45,43.16,161.02,29
HCPCS,C1713,IMP STAPLE BONE LVL 02,447.0,257.02,116.22,433.59,29
HCPCS,C1713,IMP STAPLE BONE LVL 03,709.0,407.67,184.34,687.73,29
HCPCS,C1713,IMP STAPLE BONE LVL 04,991.0,569.82,257.66,961.27,29
HCPCS,C1713,IMP STAPLE BONE LVL 05,1490.0,856.75,387.4,1445.3,29
HCPCS,C1713,IMP STAPLE BONE LVL 06,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1713,IMP STAPLE BONE LVL 07,3083.0,1772.72,801.58,2990.51,29
HCPCS,C1713,IMP STAPLE BONE LVL 08,3909.0,2247.67,1016.34,3791.73,29
HCPCS,C1713,IMP STAPLE BONE LVL 09,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1713,IMP STAPLE BONE LVL 10,5861.0,3370.08,1523.86,5685.17,29
HCPCS,C1713,IMP STAPLE BONE LVL 11,6487.0,3730.02,1686.62,6292.39,29
HCPCS,C1713,IMP STAPLE BONE LVL 12,7413.0,4262.47,1927.38,7190.61,29
HCPCS,C1713,IMP STAPLE BONE LVL 13,8339.0,4794.92,2168.14,8088.83,29
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 01,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 02,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 03,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1715,NEEDLE BRACHYTHERAPY LVL 01,166.0,80.18,43.16,161.02,29
HCPCS,C1715,NEEDLE BRACHYTHERAPY LVL 02,588.0,284.0,152.88,570.36,29
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 02,65704.0,37329.73,17083.04,63732.88,29
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 03,87604.0,49772.21,22777.04,84975.88,29
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 04,109504.0,62214.7,28471.04,106218.88,29
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 05,131404.0,74657.18,34165.04,127461.88,29
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 01,43800.0,24884.97,11388.0,42486.0,29
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 02,65704.0,37329.73,17083.04,63732.88,29
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 03,87604.0,49772.21,22777.04,84975.88,29
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 01,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 02,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 03,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 01,850.0,410.55,221.0,824.5,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 02,1413.0,682.48,367.38,1370.61,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 03,1888.0,911.9,490.88,1831.36,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 04,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 05,3083.0,1489.09,801.58,2990.51,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 06,4397.0,2123.75,1143.22,4265.09,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 07,5861.0,2830.86,1523.86,5685.17,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 08,7413.0,3580.48,1927.38,7190.61,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 09,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 10,12969.0,6264.03,3371.94,12579.93,29
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 01,1413.0,682.48,367.38,1370.61,29
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 02,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 03,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 04,6950.0,3356.85,1807.0,6741.5,29
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 05,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 01,1413.0,812.47,367.38,1370.61,29
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 03,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 04,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 01,594.0,286.9,154.44,576.18,29
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 02,1888.0,911.9,490.88,1831.36,29
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 03,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 04,3853.0,1861.0,1001.78,3737.41,29
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 02,1888.0,1085.6,490.88,1831.36,29
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 04,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 01,594.0,286.9,154.44,576.18,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 02,1132.0,546.76,294.32,1098.04,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 03,2157.0,1041.83,560.82,2092.29,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 04,3083.0,1489.09,801.58,2990.51,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 05,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 06,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 07,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 08,17524.0,8464.09,4556.24,16998.28,29
HCPCS,C1731,CATH EP NON 3D 20+ LVL 01,3083.0,1489.09,801.58,2990.51,29
HCPCS,C1731,CATH EP NON 3D 20+ LVL 02,5861.0,2830.86,1523.86,5685.17,29
HCPCS,C1731,CATH EP NON 3D 20+ LVL 03,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1731,CATH EP NON 3D 20+ LVL 04,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1731,CATH EP NON 3D 20+ LVL 05,17524.0,8464.09,4556.24,16998.28,29
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 01,2157.0,1041.83,560.82,2092.29,29
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 02,3083.0,1489.09,801.58,2990.51,29
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 03,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 04,11580.0,5593.14,3010.8,11232.6,29
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 05,17524.0,8464.09,4556.24,16998.28,29
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 06,21904.0,10579.63,5695.04,21246.88,29
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 01,1619.0,781.98,420.94,1570.43,29
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 02,3083.0,1489.09,801.58,2990.51,29
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 03,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 04,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 05,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 04,1619.0,930.92,420.94,1570.43,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 05,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 06,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 07,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 08,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 01,313.0,151.18,81.38,303.61,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 02,594.0,286.9,154.44,576.18,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 03,850.0,410.55,221.0,824.5,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 04,1132.0,546.76,294.32,1098.04,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 05,1619.0,781.98,420.94,1570.43,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 06,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 07,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 08,6950.0,3356.85,1807.0,6741.5,29
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 09,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 01,313.0,151.18,81.38,303.61,29
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 02,594.0,286.9,154.44,576.18,29
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 03,1132.0,546.76,294.32,1098.04,29
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 04,1619.0,781.98,420.94,1570.43,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 01,850.0,410.55,221.0,824.5,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 02,2426.0,1171.76,630.76,2353.22,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 03,3853.0,1861.0,1001.78,3737.41,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 04,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 05,6950.0,3356.85,1807.0,6741.5,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 06,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 07,11580.0,5593.14,3010.8,11232.6,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 08,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1753,CATH INTRAVASCULAR US LVL 09,15334.0,7406.32,3986.84,14873.98,29
HCPCS,C1755,CATH INTRASPINAL LVL 01,166.0,80.18,43.16,161.02,29
HCPCS,C1755,CATH INTRASPINAL LVL 02,313.0,151.18,81.38,303.61,29
HCPCS,C1755,CATH INTRASPINAL LVL 03,594.0,286.9,154.44,576.18,29
HCPCS,C1755,CATH INTRASPINAL LVL 04,1413.0,682.48,367.38,1370.61,29
HCPCS,C1755,CATH INTRASPINAL LVL 05,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1755,CATH INTRASPINAL LVL 06,3853.0,1861.0,1001.78,3737.41,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 01,313.0,151.18,81.38,303.61,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 02,594.0,286.9,154.44,576.18,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 03,1132.0,546.76,294.32,1098.04,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 04,2157.0,1041.83,560.82,2092.29,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 05,3083.0,1489.09,801.58,2990.51,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 06,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 07,6950.0,3356.85,1807.0,6741.5,29
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 08,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1758,CATH URETERAL LVL 01,313.0,151.18,81.38,303.61,29
HCPCS,C1758,CATH URETERAL LVL 02,850.0,410.55,221.0,824.5,29
HCPCS,C1758,CATH URETERAL LVL 03,1888.0,911.9,490.88,1831.36,29
HCPCS,C1758,CATH URETERAL LVL 04,2827.0,1365.44,735.02,2742.19,29
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 01,2690.0,1299.27,699.4,2609.3,29
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 02,3596.0,1736.87,934.96,3488.12,29
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 03,6487.0,3133.22,1686.62,6292.39,29
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 04,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 05,11580.0,5593.14,3010.8,11232.6,29
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 06,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 04,1619.0,930.92,420.94,1570.43,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 05,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 06,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 07,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 09,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 10,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 11,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 05,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 07,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 08,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 09,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 10,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 11,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 12,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 13,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 14,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 15,48184.0,27705.8,12527.84,46738.48,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 01,850.0,488.75,221.0,824.5,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 02,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 03,3083.0,1772.72,801.58,2990.51,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 07,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 08,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 09,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 10,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 11,48184.0,27705.8,12527.84,46738.48,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 12,52564.0,30224.3,13666.64,50987.08,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 13,56944.0,32742.8,14805.44,55235.68,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 14,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 15,74464.0,42816.8,19360.64,72230.08,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 16,83224.0,47853.8,21638.24,80727.28,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 17,91984.0,52890.8,23915.84,89224.48,29
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 18,100744.0,57927.8,26193.44,97721.68,29
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 01,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 02,11575.0,6655.62,3009.5,11227.75,29
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 03,14892.0,8562.9,3871.92,14445.24,29
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 04,24970.0,14357.75,6492.2,24220.9,29
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 01,850.0,410.55,221.0,824.5,29
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 02,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 03,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 04,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 01,850.0,488.75,221.0,824.5,29
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 03,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 01,1413.0,682.48,367.38,1370.61,29
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 02,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 03,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 04,6105.0,2948.71,1587.3,5921.85,29
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 05,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 01,28470.0,16370.25,7402.2,27615.9,29
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 02,43800.0,25185.0,11388.0,42486.0,29
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 03,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 04,87604.0,50372.3,22777.04,84975.88,29
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 05,109504.0,62964.8,28471.04,106218.88,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 03,1619.0,930.92,420.94,1570.43,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 04,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 05,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 06,3083.0,1772.72,801.58,2990.51,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 07,3909.0,2247.67,1016.34,3791.73,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 08,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 09,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 10,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 11,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 12,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 13,32854.0,18891.05,8542.04,31868.38,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 14,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1768,IMP GRAFT VASCULAR LVL 15,54754.0,31483.55,14236.04,53111.38,29
HCPCS,C1769,WIRE GUIDE LVL 01,166.0,80.18,43.16,161.02,29
HCPCS,C1769,WIRE GUIDE LVL 02,313.0,151.18,81.38,303.61,29
HCPCS,C1769,WIRE GUIDE LVL 03,594.0,286.9,154.44,576.18,29
HCPCS,C1769,WIRE GUIDE LVL 04,850.0,410.55,221.0,824.5,29
HCPCS,C1769,WIRE GUIDE LVL 05,1413.0,682.48,367.38,1370.61,29
HCPCS,C1769,WIRE GUIDE LVL 06,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1769,WIRE GUIDE LVL 07,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1769,WIRE GUIDE LVL 08,6950.0,3356.85,1807.0,6741.5,29
HCPCS,C1769,WIRE GUIDE LVL 09,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1769,WIRE GUIDE LVL 10,11580.0,5593.14,3010.8,11232.6,29
HCPCS,C1769,WIRE GUIDE LVL 11,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1770,COIL IMAGING MAGNETIC RESON LVL 01,313.0,151.18,81.38,303.61,29
HCPCS,C1770,COIL IMAGING MAGNETIC RESON LVL 02,594.0,286.9,154.44,576.18,29
HCPCS,C1771,IMP DEV URINARY W SLING LVL 01,2690.0,1546.75,699.4,2609.3,29
HCPCS,C1771,IMP DEV URINARY W SLING LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1771,IMP DEV URINARY W SLING LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1771,IMP DEV URINARY W SLING LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1771,IMP DEV URINARY W SLING LVL 05,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1771,IMP DEV URINARY W SLING LVL 06,14020.0,8061.5,3645.2,13599.4,29
HCPCS,C1771,IMP DEV URINARY W SLING LVL 07,17962.0,10328.15,4670.12,17423.14,29
HCPCS,C1772,IMP PUMP INF PRG LVL 01,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1772,IMP PUMP INF PRG LVL 02,8112.0,4664.4,2109.12,7868.64,29
HCPCS,C1772,IMP PUMP INF PRG LVL 03,10431.0,5997.82,2712.06,10118.07,29
HCPCS,C1772,IMP PUMP INF PRG LVL 04,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1772,IMP PUMP INF PRG LVL 05,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1772,IMP PUMP INF PRG LVL 06,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1772,IMP PUMP INF PRG LVL 07,32854.0,18891.05,8542.04,31868.38,29
HCPCS,C1772,IMP PUMP INF PRG LVL 08,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1772,IMP PUMP INF PRG LVL 09,46870.0,26950.25,12186.2,45463.9,29
HCPCS,C1772,IMP PUMP INF PRG LVL 10,51250.0,29468.75,13325.0,49712.5,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 01,1132.0,546.76,294.32,1098.04,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 02,2157.0,1041.83,560.82,2092.29,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 03,3596.0,1736.87,934.96,3488.12,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 04,4397.0,2123.75,1143.22,4265.09,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 05,6105.0,2948.71,1587.3,5921.85,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 06,8107.0,3915.68,2107.82,7863.79,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 07,10422.0,5033.83,2709.72,10109.34,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 08,12737.0,6151.97,3311.62,12354.89,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 09,14239.0,6877.44,3702.14,13811.83,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 10,16429.0,7935.21,4271.54,15936.13,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 11,18619.0,8992.98,4840.94,18060.43,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 12,20809.0,10050.75,5410.34,20184.73,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 13,22999.0,11108.52,5979.74,22309.03,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 14,25189.0,12166.29,6549.14,24433.33,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 15,27379.0,13224.06,7118.54,26557.63,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 16,29569.0,14281.83,7687.94,28681.93,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 17,31759.0,15339.6,8257.34,30806.23,29
HCPCS,C1773,DEVICE INSERT RETRV LVL 18,36139.0,17455.14,9396.14,35054.83,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 06,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 07,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 08,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 09,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 10,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 11,48184.0,27705.8,12527.84,46738.48,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 12,52564.0,30224.3,13666.64,50987.08,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 13,56944.0,32742.8,14805.44,55235.68,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 14,61324.0,35261.3,15944.24,59484.28,29
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 15,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1776,IMP DEV JT FINGER LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1776,IMP DEV JT FINGER LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP DEV JT FINGER LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP DEV JT FINGER LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP DEV JT FINGER LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 03,1619.0,930.92,420.94,1570.43,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 04,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 07,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 09,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 10,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 11,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 12,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 13,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 14,52564.0,30224.3,13666.64,50987.08,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 15,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 16,87604.0,50372.3,22777.04,84975.88,29
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 17,109504.0,62964.8,28471.04,106218.88,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 01,1132.0,650.9,294.32,1098.04,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 03,4880.0,2806.0,1268.8,4733.6,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 05,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 06,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 07,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 08,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 09,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 10,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 11,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 12,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 13,48184.0,27705.8,12527.84,46738.48,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 14,52564.0,30224.3,13666.64,50987.08,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 15,56944.0,32742.8,14805.44,55235.68,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 16,61324.0,35261.3,15944.24,59484.28,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 17,70084.0,40298.3,18221.84,67981.48,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 18,78844.0,45335.3,20499.44,76478.68,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 19,87604.0,50372.3,22777.04,84975.88,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 20,96364.0,55409.3,25054.64,93473.08,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 21,109504.0,62964.8,28471.04,106218.88,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 22,122644.0,70520.3,31887.44,118964.68,29
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 23,135784.0,78075.8,35303.84,131710.48,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 04,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 07,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 09,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 10,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 11,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 12,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 13,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 14,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 15,48184.0,27705.8,12527.84,46738.48,29
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 16,55630.0,31987.25,14463.8,53961.1,29
HCPCS,C1776,IMP DEV JT TOE LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1776,IMP DEV JT TOE LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP DEV JT TOE LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP DEV JT TOE LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP DEV JT TOE LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 01,1413.0,812.47,367.38,1370.61,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 03,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 04,5856.0,3367.2,1522.56,5680.32,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 05,6487.0,3730.02,1686.62,6292.39,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 06,7413.0,4262.47,1927.38,7190.61,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 07,8339.0,4794.92,2168.14,8088.83,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 09,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 10,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 01,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 02,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 03,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 04,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 05,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 07,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 08,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 01,1132.0,650.9,294.32,1098.04,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 02,1619.0,930.92,420.94,1570.43,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 05,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 06,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 07,6024.0,3463.8,1566.24,5843.28,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 09,12506.0,7190.95,3251.56,12130.82,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 05,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 06,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 07,6024.0,3463.8,1566.24,5843.28,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 09,12506.0,7190.95,3251.56,12130.82,29
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 02,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 03,4392.0,2525.4,1141.92,4260.24,29
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 04,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 05,6487.0,3730.02,1686.62,6292.39,29
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 03,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 04,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 05,6487.0,3730.02,1686.62,6292.39,29
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 01,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 02,4880.0,2806.0,1268.8,4733.6,29
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 04,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 05,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 02,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 03,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 04,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 05,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 06,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 04,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 05,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 01,1126.0,647.45,292.76,1092.22,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 02,1619.0,930.92,420.94,1570.43,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 05,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 06,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 07,6024.0,3463.8,1566.24,5843.28,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 09,12506.0,7190.95,3251.56,12130.82,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 10,13582.0,7809.65,3531.32,13174.54,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 11,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 12,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 13,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 05,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 06,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 07,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 01,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 04,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 03,2152.0,1237.4,559.52,2087.44,29
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 04,4880.0,2806.0,1268.8,4733.6,29
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 07,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 03,3083.0,1772.72,801.58,2990.51,29
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 04,3909.0,2247.67,1016.34,3791.73,29
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 06,5861.0,3370.08,1523.86,5685.17,29
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 07,6024.0,3463.8,1566.24,5843.28,29
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 01,1413.0,812.47,367.38,1370.61,29
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 03,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 04,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 05,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 06,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 02,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 03,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 04,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 05,6024.0,3463.8,1566.24,5843.28,29
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 07,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 01,1126.0,647.45,292.76,1092.22,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 02,1619.0,930.92,420.94,1570.43,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 05,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 06,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 07,6024.0,3463.8,1566.24,5843.28,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 09,12506.0,7190.95,3251.56,12130.82,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 10,13582.0,7809.65,3531.32,13174.54,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 11,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 12,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 13,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 01,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 02,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 04,8802.0,5061.15,2288.52,8537.94,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 05,10654.0,6126.05,2770.04,10334.38,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 06,12506.0,7190.95,3251.56,12130.82,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 07,13582.0,7809.65,3531.32,13174.54,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 08,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 09,17086.0,9824.45,4442.36,16573.42,29
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 01,4880.0,2806.0,1268.8,4733.6,29
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 05,6487.0,3730.02,1686.62,6292.39,29
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 06,7413.0,4262.47,1927.38,7190.61,29
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 07,8339.0,4794.92,2168.14,8088.83,29
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 01,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 02,4880.0,2806.0,1268.8,4733.6,29
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 03,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 04,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 05,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 01,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 02,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 03,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 01,4880.0,2806.0,1268.8,4733.6,29
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 05,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 07,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 08,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1777,IMP LD ICD COIL SGL LVL 09,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1778,IMP LD NEUROSTIM LVL 01,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1778,IMP LD NEUROSTIM LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1778,IMP LD NEUROSTIM LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1778,IMP LD NEUROSTIM LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1778,IMP LD NEUROSTIM LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1778,IMP LD NEUROSTIM LVL 06,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1778,IMP LD NEUROSTIM LVL 07,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 01,2690.0,1546.75,699.4,2609.3,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 02,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 03,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 04,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 05,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 06,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 07,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1779,IMP LD PCMKR VDD LVL 08,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 01,1413.0,566.61,367.38,1370.61,29
HCPCS,C1781,IMP MESH LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1781,IMP MESH LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C1781,IMP MESH LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,C1781,IMP MESH LVL 04,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1781,IMP MESH LVL 05,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1781,IMP MESH LVL 06,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1781,IMP MESH LVL 07,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1781,IMP MESH LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1781,IMP MESH LVL 09,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1781,IMP MESH LVL 10,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1781,IMP MESH LVL 11,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1781,IMP MESH LVL 12,24094.0,13854.05,6264.44,23371.18,29
HCPCS,C1781,IMP MESH LVL 13,28474.0,16372.55,7403.24,27619.78,29
HCPCS,C1781,IMP MESH LVL 14,32854.0,18891.05,8542.04,31868.38,29
HCPCS,C1781,IMP MESH LVL 15,37234.0,21409.55,9680.84,36116.98,29
HCPCS,C1782,MORCELLATOR LVL 01,2690.0,1299.27,699.4,2609.3,29
HCPCS,C1782,MORCELLATOR LVL 02,4880.0,2357.04,1268.8,4733.6,29
HCPCS,C1782,MORCELLATOR LVL 03,9260.0,4472.58,2407.6,8982.2,29
HCPCS,C1782,MORCELLATOR LVL 04,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C1785,IMP PCMKR DUAL RR LVL 01,17520.0,9953.99,4555.2,16994.4,29
HCPCS,C1785,IMP PCMKR DUAL RR LVL 02,21904.0,12444.76,5695.04,21246.88,29
HCPCS,C1785,IMP PCMKR DUAL RR LVL 03,26284.0,14933.25,6833.84,25495.48,29
HCPCS,C1785,IMP PCMKR DUAL RR LVL 04,43804.0,24887.24,11389.04,42489.88,29
HCPCS,C1785,IMP PCMKR DUAL RR LVL 05,65704.0,37329.73,17083.04,63732.88,29
HCPCS,C1785,IMP PCMKR DUAL RR LVL 06,87604.0,49772.21,22777.04,84975.88,29
HCPCS,C1785,IMP PCMKR DUAL RR LVL 07,109504.0,62214.7,28471.04,106218.88,29
HCPCS,C1786,IMP PCMKR SGL RR LVL 02,17520.0,9953.99,4555.2,16994.4,29
HCPCS,C1786,IMP PCMKR SGL RR LVL 03,21904.0,12444.76,5695.04,21246.88,29
HCPCS,C1786,IMP PCMKR SGL RR LVL 04,26284.0,14933.25,6833.84,25495.48,29
HCPCS,C1786,IMP PCMKR SGL RR LVL 05,30664.0,17421.75,7972.64,29744.08,29
HCPCS,C1786,IMP PCMKR SGL RR LVL 06,35044.0,19910.25,9111.44,33992.68,29
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 01,166.0,95.45,43.16,161.02,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 02,447.0,257.02,116.22,433.59,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 03,850.0,488.75,221.0,824.5,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 04,1413.0,812.47,367.38,1370.61,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 05,1888.0,1085.6,490.88,1831.36,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 06,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 07,3340.0,1920.5,868.4,3239.8,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 08,4153.0,2387.98,1079.78,4028.41,29
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 09,4641.0,2668.58,1206.66,4501.77,29
HCPCS,C1789,IMP PROSTH BREAST LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1789,IMP PROSTH BREAST LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1789,IMP PROSTH BREAST LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1789,IMP PROSTH BREAST LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 03,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 04,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 05,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 06,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 07,56944.0,32742.8,14805.44,55235.68,29
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 08,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 01,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 02,14020.0,8061.5,3645.2,13599.4,29
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 03,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 04,25408.0,14609.6,6606.08,24645.76,29
HCPCS,C1816,IMP NEUROSTIM RECVR&/TRANS LVL 01,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 01,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 02,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 03,24094.0,13854.05,6264.44,23371.18,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 06,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 07,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 08,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 03,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 04,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 06,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 07,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 08,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 09,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 10,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 11,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 12,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 13,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 14,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1874,IMP STENT COAT W DEL LVL 15,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1875,IMP STENT COAT WO DEL LVL 01,1413.0,812.47,367.38,1370.61,29
HCPCS,C1875,IMP STENT COAT WO DEL LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1875,IMP STENT COAT WO DEL LVL 03,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1875,IMP STENT COAT WO DEL LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1875,IMP STENT COAT WO DEL LVL 05,6945.0,3993.37,1805.7,6736.65,29
HCPCS,C1875,IMP STENT COAT WO DEL LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 02,1619.0,930.92,420.94,1570.43,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 03,3083.0,1772.72,801.58,2990.51,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 05,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 07,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 08,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 09,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 10,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 11,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 12,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 01,447.0,257.02,116.22,433.59,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 02,850.0,488.75,221.0,824.5,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 03,1619.0,930.92,420.94,1570.43,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 04,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 07,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 08,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 09,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 10,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 11,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 12,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 13,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 14,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 02,1614.0,928.05,419.64,1565.58,29
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1880,IMP FILTER VENA CAVA LVL 02,2690.0,1546.75,699.4,2609.3,29
HCPCS,C1880,IMP FILTER VENA CAVA LVL 03,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1880,IMP FILTER VENA CAVA LVL 04,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1880,IMP FILTER VENA CAVA LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 05,5861.0,3370.08,1523.86,5685.17,29
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 06,8107.0,4661.52,2107.82,7863.79,29
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 01,61320.0,35259.0,15943.2,59480.4,29
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 02,70080.0,40296.0,18220.8,67977.6,29
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 03,78840.0,45333.0,20498.4,76474.8,29
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 04,96364.0,55409.3,25054.64,93473.08,29
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 05,109504.0,62964.8,28471.04,106218.88,29
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 06,122644.0,70520.3,31887.44,118964.68,29
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 01,1126.0,647.45,292.76,1092.22,29
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 02,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 03,7413.0,4262.47,1927.38,7190.61,29
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 01,5861.0,3370.08,1523.86,5685.17,29
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 02,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 03,8339.0,4794.92,2168.14,8088.83,29
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 04,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 01,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 02,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 03,6950.0,3356.85,1807.0,6741.5,29
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 04,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1887,CATH GUIDE LVL 01,166.0,80.18,43.16,161.02,29
HCPCS,C1887,CATH GUIDE LVL 02,313.0,151.18,81.38,303.61,29
HCPCS,C1887,CATH GUIDE LVL 03,447.0,215.9,116.22,433.59,29
HCPCS,C1887,CATH GUIDE LVL 04,594.0,286.9,154.44,576.18,29
HCPCS,C1887,CATH GUIDE LVL 05,850.0,410.55,221.0,824.5,29
HCPCS,C1887,CATH GUIDE LVL 06,1413.0,682.48,367.38,1370.61,29
HCPCS,C1887,CATH GUIDE LVL 07,2827.0,1365.44,735.02,2742.19,29
HCPCS,C1887,CATH GUIDE LVL 08,3596.0,1736.87,934.96,3488.12,29
HCPCS,C1887,CATH GUIDE LVL 09,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C1887,CATH GUIDE LVL 10,6105.0,2948.71,1587.3,5921.85,29
HCPCS,C1887,CATH GUIDE LVL 11,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C1887,CATH GUIDE LVL 12,11580.0,5593.14,3010.8,11232.6,29
HCPCS,C1888,CATH ABL NONCARDIAC LVL 01,1619.0,781.98,420.94,1570.43,29
HCPCS,C1888,CATH ABL NONCARDIAC LVL 02,3083.0,1489.09,801.58,2990.51,29
HCPCS,C1889,DURAL SLNT ADHERUS AUTOSPRAY,4621.8,2657.54,1201.67,4483.15,29
HCPCS,C1889,DURAL SLNT ADHERUS AUTOSPRAY ET,2592.5,1490.69,674.05,2514.72,29
HCPCS,C1889,IMP CABLE LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1889,IMP CABLE LVL 02,844.0,485.3,219.44,818.68,29
HCPCS,C1889,IMP CABLE LVL 03,1413.0,812.47,367.38,1370.61,29
HCPCS,C1889,IMP CABLE LVL 04,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1889,IMP CABLE LVL 05,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1889,IMP CABLE LVL 06,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1889,IMP CABLE LVL 07,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1889,IMP CABLE LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1889,IMP CABLE LVL 09,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1889,IMP CLIP ANEURYSM LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1889,IMP CLIP ANEURYSM LVL 02,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1889,IMP COVER BURR HOLE LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 01,1132.0,650.9,294.32,1098.04,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 03,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 05,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 07,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 08,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 09,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 01,1619.0,930.92,420.94,1570.43,29
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 02,3596.0,2067.7,934.96,3488.12,29
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 03,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 04,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1889,IMP FIX SPINE LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1889,IMP FIX SPINE LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C1889,IMP FIX SPINE LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1889,IMP FIX SPINE LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1889,IMP FIX SPINE LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1889,IMP FIX SPINE LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1889,IMP FIX SPINE LVL 07,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1889,IMP FIX SPINE LVL 08,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1889,IMP FIX SPINE LVL 09,27160.0,15617.0,7061.6,26345.2,29
HCPCS,C1889,IMP FIX SPINE LVL 10,32854.0,18891.05,8542.04,31868.38,29
HCPCS,C1889,IMP FIX SPINE LVL 11,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1889,IMP FIX SPINE LVL 12,52564.0,30224.3,13666.64,50987.08,29
HCPCS,C1889,IMP FIX SPINE LVL 13,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1889,IMP FIX SPINE LVL 14,78844.0,45335.3,20499.44,76478.68,29
HCPCS,C1889,IMP HOOK LVL 01,2690.0,1546.75,699.4,2609.3,29
HCPCS,C1889,IMP HOOK LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1889,IMP HOOK LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1889,IMP HOOK LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1889,IMP NEURO LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1889,IMP NEURO LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1889,IMP NEURO LVL 03,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1889,IMP NEURO LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1889,IMP NEURO LVL 05,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1889,IMP NEURO LVL 06,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1889,IMP NEURO LVL 07,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1889,IMP NEURO LVL 08,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1889,IMP RING FALLOPE LVL 01,166.0,95.45,43.16,161.02,29
HCPCS,C1889,IMP RING FALLOPE LVL 02,588.0,338.1,152.88,570.36,29
HCPCS,C1889,IMP RING FALLOPE LVL 03,1619.0,930.92,420.94,1570.43,29
HCPCS,C1889,IMP RING FALLOPE LVL 04,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 02,850.0,488.75,221.0,824.5,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 04,1413.0,812.47,367.38,1370.61,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 05,1619.0,930.92,420.94,1570.43,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 06,1888.0,1085.6,490.88,1831.36,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 07,2426.0,1394.95,630.76,2353.22,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 08,2827.0,1625.52,735.02,2742.19,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 09,3340.0,1920.5,868.4,3239.8,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 10,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 11,4153.0,2387.98,1079.78,4028.41,29
HCPCS,C1889,IMP SPINE FUSION LVL 03,7413.0,4262.47,1927.38,7190.61,29
HCPCS,C1889,IMP SPINE FUSION LVL 04,8339.0,4794.92,2168.14,8088.83,29
HCPCS,C1889,IMP SPINE FUSION LVL 05,9728.0,5593.6,2529.28,9436.16,29
HCPCS,C1889,IMP SPINE FUSION LVL 06,11117.0,6392.28,2890.42,10783.49,29
HCPCS,C1889,IMP SPINE FUSION LVL 07,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1889,IMP SPINE FUSION LVL 08,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1889,IMP SPINE FUSION LVL 09,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1889,IMP SPINE FUSION LVL 10,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1889,IMP SPINE FUSION LVL 11,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1889,IMP SPINE FUSION LVL 12,35044.0,20150.3,9111.44,33992.68,29
HCPCS,C1889,IMP SPINE FUSION LVL 13,39424.0,22668.8,10250.24,38241.28,29
HCPCS,C1889,IMP SPINE FUSION LVL 14,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C1889,IMP SPINE FUSION LVL 15,48184.0,27705.8,12527.84,46738.48,29
HCPCS,C1889,IMP SPINE FUSION LVL 16,52564.0,30224.3,13666.64,50987.08,29
HCPCS,C1889,IMP SPINE FUSION LVL 17,56944.0,32742.8,14805.44,55235.68,29
HCPCS,C1889,IMP SPINE FUSION LVL 18,61324.0,35261.3,15944.24,59484.28,29
HCPCS,C1889,IMP SPINE FUSION LVL 19,65704.0,37779.8,17083.04,63732.88,29
HCPCS,C1889,IMP SPINE FUSION LVL 20,70084.0,40298.3,18221.84,67981.48,29
HCPCS,C1889,IMP SPINE FUSION LVL 21,74464.0,42816.8,19360.64,72230.08,29
HCPCS,C1889,IMP SPINE FUSION LVL 22,78844.0,45335.3,20499.44,76478.68,29
HCPCS,C1889,IMP SPINE FUSION LVL 23,83224.0,47853.8,21638.24,80727.28,29
HCPCS,C1889,IMP SPINE FUSION LVL 24,111694.0,64224.05,29040.44,108343.18,29
HCPCS,C1889,IMP SPINE KYPHX LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1889,IMP SPINE KYPHX LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C1889,IMP SPINE KYPHX LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1889,IMP SPINE KYPHX LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1889,IMP SPINE KYPHX LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1889,IMP SPINE KYPHX LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1889,IMP SPINE KYPHX LVL 07,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1889,IMP SPINE KYPHX LVL 08,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 04,1619.0,930.92,420.94,1570.43,29
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 05,2157.0,1240.27,560.82,2092.29,29
HCPCS,C1889,IMP STIMULATOR BONE LVL 02,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1889,IMP STIMULATOR BONE LVL 03,24094.0,13854.05,6264.44,23371.18,29
HCPCS,C1889,IMP STIMULATOR BONE LVL 04,28474.0,16372.55,7403.24,27619.78,29
HCPCS,C1889,SEALANT SYS DURASEAL 5ML,2180.2,1253.61,566.85,2114.79,29
HCPCS,C1889,SURGICAL SLNT COSEAL ADH VASC 4ML,1880.6,1081.34,488.96,1824.18,29
HCPCS,C1889,SURGICAL SLNT COSEAL PREMIX 8ML,2908.7,1672.5,756.26,2821.44,29
HCPCS,C1891,IMP PUMP INF NONPRG PERM LVL 01,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 01,313.0,151.18,81.38,303.61,29
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 02,594.0,286.9,154.44,576.18,29
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 03,1413.0,682.48,367.38,1370.61,29
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 04,2023.0,977.11,525.98,1962.31,29
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 05,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 06,3596.0,1736.87,934.96,3488.12,29
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 01,594.0,286.9,154.44,576.18,29
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 02,1132.0,546.76,294.32,1098.04,29
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 03,1888.0,911.9,490.88,1831.36,29
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 04,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 05,3853.0,1861.0,1001.78,3737.41,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 01,96.0,46.37,24.96,93.12,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 02,313.0,151.18,81.38,303.61,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 03,594.0,286.9,154.44,576.18,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 04,1619.0,781.98,420.94,1570.43,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 05,2695.0,1301.68,700.7,2614.15,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 06,3596.0,1736.87,934.96,3488.12,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 07,5861.0,2830.86,1523.86,5685.17,29
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 08,7876.0,3804.11,2047.76,7639.72,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 05,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 07,15334.0,8817.05,3986.84,14873.98,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 09,19714.0,11335.55,5125.64,19122.58,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 10,24094.0,13854.05,6264.44,23371.18,29
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 11,32854.0,18891.05,8542.04,31868.38,29
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 04,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 05,11580.0,6658.5,3010.8,11232.6,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 01,166.0,95.45,43.16,161.02,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 02,313.0,179.98,81.38,303.61,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 03,594.0,341.55,154.44,576.18,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 04,1413.0,812.47,367.38,1370.61,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 05,1883.0,1082.72,489.58,1826.51,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 06,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 07,3909.0,2247.67,1016.34,3791.73,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 08,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 09,7644.0,4395.3,1987.44,7414.68,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 03,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 04,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 05,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 06,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 07,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 08,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 05,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 06,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 07,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 08,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 09,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1900,IMP LD VENOUS COR LV LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C1900,IMP LD VENOUS COR LV LVL 05,13895.0,7989.62,3612.7,13478.15,29
HCPCS,C1900,IMP LD VENOUS COR LV LVL 06,17524.0,10076.3,4556.24,16998.28,29
HCPCS,C1900,IMP LD VENOUS COR LV LVL 07,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C1900,IMP LD VENOUS COR LV LVL 08,26284.0,15113.3,6833.84,25495.48,29
HCPCS,C1900,IMP LD VENOUS COR LV LVL 09,30664.0,17631.8,7972.64,29744.08,29
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 02,3596.0,2067.7,934.96,3488.12,29
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 03,4397.0,2528.27,1143.22,4265.09,29
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 04,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 01,166.0,95.45,43.16,161.02,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 03,850.0,488.75,221.0,824.5,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 04,1132.0,650.9,294.32,1098.04,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 05,1619.0,930.92,420.94,1570.43,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 06,2695.0,1549.62,700.7,2614.15,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 07,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 08,6950.0,3996.25,1807.0,6741.5,29
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 09,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 01,19714.0,11200.51,5125.64,19122.58,29
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 02,24090.0,13686.73,6263.4,23367.3,29
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 03,28474.0,16177.5,7403.24,27619.78,29
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 02,19714.0,11200.51,5125.64,19122.58,29
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 03,22776.0,12940.18,5921.76,22092.72,29
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 04,28474.0,16177.5,7403.24,27619.78,29
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 01,6105.0,3468.56,1587.3,5921.85,29
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 02,13895.0,7894.44,3612.7,13478.15,29
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 03,21900.0,12442.48,5694.0,21243.0,29
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 04,35040.0,19907.98,9110.4,33988.8,29
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 05,43804.0,24887.24,11389.04,42489.88,29
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 03,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 01,850.0,488.75,221.0,824.5,29
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 04,3909.0,2247.67,1016.34,3791.73,29
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 05,5373.0,3089.48,1396.98,5211.81,29
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 03,4885.0,2808.88,1270.1,4738.45,29
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 04,21904.0,12594.8,5695.04,21246.88,29
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 05,43804.0,25187.3,11389.04,42489.88,29
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 01,251.0,121.23,65.26,243.47,29
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 02,594.0,286.9,154.44,576.18,29
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 03,1132.0,546.76,294.32,1098.04,29
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 04,2157.0,1041.83,560.82,2092.29,29
HCPCS,C2628,CATH OCCLUSION LVL 01,594.0,286.9,154.44,576.18,29
HCPCS,C2628,CATH OCCLUSION LVL 02,1132.0,546.76,294.32,1098.04,29
HCPCS,C2628,CATH OCCLUSION LVL 03,2695.0,1301.68,700.7,2614.15,29
HCPCS,C2628,CATH OCCLUSION LVL 04,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C2628,CATH OCCLUSION LVL 05,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C2628,CATH OCCLUSION LVL 06,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C2629,INTRO EP LASER LVL 01,313.0,151.18,81.38,303.61,29
HCPCS,C2629,INTRO EP LASER LVL 02,594.0,286.9,154.44,576.18,29
HCPCS,C2629,INTRO EP LASER LVL 03,1888.0,911.9,490.88,1831.36,29
HCPCS,C2629,INTRO EP LASER LVL 04,3083.0,1489.09,801.58,2990.51,29
HCPCS,C2629,INTRO EP LASER LVL 05,4885.0,2359.46,1270.1,4738.45,29
HCPCS,C2629,INTRO EP LASER LVL 06,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C2629,INTRO EP LASER LVL 07,13895.0,6711.28,3612.7,13478.15,29
HCPCS,C2630,CATH ABL COOL-TIP LVL 05,5861.0,2830.86,1523.86,5685.17,29
HCPCS,C2630,CATH ABL COOL-TIP LVL 06,6487.0,3133.22,1686.62,6292.39,29
HCPCS,C2630,CATH ABL COOL-TIP LVL 07,7413.0,3580.48,1927.38,7190.61,29
HCPCS,C2630,CATH ABL COOL-TIP LVL 08,9265.0,4475.0,2408.9,8987.05,29
HCPCS,C2630,CATH ABL COOL-TIP LVL 09,11575.0,5590.72,3009.5,11227.75,29
HCPCS,C2630,CATH ABL COOL-TIP LVL 10,13432.0,6487.66,3492.32,13029.04,29
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 01,2421.0,1392.07,629.46,2348.37,29
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 02,3853.0,2215.48,1001.78,3737.41,29
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 03,6105.0,3510.37,1587.3,5921.85,29
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 05,11580.0,6658.5,3010.8,11232.6,29
HCPCS,G0008,ADMIN FEE INFLUENZA,81.0,44.14,21.06,78.57,29
HCPCS,G0009,ADMIN FEE PNEUMOCOCCAL,81.0,44.14,21.06,78.57,29
HCPCS,G0010,ADMIN FEE HEPATITIS B,81.0,44.14,21.06,78.57,29
HCPCS,G0108,DSMT IND 30MIN,120.0,99.6,31.2,116.4,29
HCPCS,G0279,TOMOSYNTHESIS DX DIG BRST UNI/BI,59.0,36.99,15.34,57.23,29
HCPCS,G0378,OBSRV ICU PER HOUR,244.0,77.1,63.44,236.68,29
HCPCS,G0378,OBSRV MEDICAL/SURGICAL PER HOUR,116.0,36.66,30.16,112.52,58
HCPCS,G0378,OBSRV OB PER HOUR,116.0,36.66,30.16,112.52,29
HCPCS,G0379,ADMISSION DIRECT OBSERVATION HOSP,668.0,559.78,173.68,647.96,29
HCPCS,J0713,CEFTAZIDIME/500MG 500MG PWIJ,6.6,1.43,1.72,6.4,29
HCPCS,J0885,EPO ALFA/1000U 4000U SNIJ,82.1,28.9,15.48,79.64,29
HCPCS,J3371,VANCO MYL/500MG 1.5GM PWIJ,2.58,0.91,0.6708,2.5,29
HCPCS,J3490,DANTROLENE SOD/20MG 20MG PWIJ,56.08,12.11,14.58,54.4,29
HCPCS,J3490,LIDO 2%-EPI/1.8ML 1.8ML SNIJ,5.8,1.25,1.51,5.63,29
HCPCS,J3490,NICOTINE RESIN COMPLEX/2MG 2MG GU,3.1,0.27,0.806,3.01,29
HCPCS,J3490,PROGESTERONE/90MG 90MG/1.125G GLVG,8.26,0.73,2.15,8.01,29
HCPCS,J3490,TIMOLOL MALEATE 0.25%/5ML 5ML SNOP,28.6,2.52,7.44,27.74,29
HCPCS,J7042,D5-NACL 0.9%/500ML 1000ML SNIV,2.95,0.64,0.767,2.86,29
HCPCS,J8499,AMANTADINE/100MG 100MG CP,7.4,0.65,1.92,7.18,29
HCPCS,J8499,FENOFIBRATE/54MG 54MG TB,0.04,,0.0104,0.0388,29
HCPCS,J8499,HYDROCOD-ACET/7.5-325MG TB,0.05,,0.013,0.0485,29
HCPCS,J8499,LEVOFLOXACN/750MG 750MG TB,6.2,0.55,1.61,6.01,29
HCPCS,J8499,LEVOTHYROXN/112MCG 112MCG TB,0.12,0.01,0.0312,0.1164,29
HCPCS,J8499,PANCRELIPASE/25000U 25000U CP,44.4,3.91,11.54,43.07,29
HCPCS,J8499,RIMANTADINE/100MG 100MG TB,2.19,0.19,0.5694,2.12,29
HCPCS,J9999,LIFILEUCEL TIL/DOSE 7.5B-72B SNIJ,3141500.0,1784843.22,816790.0,3047255.0,28
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 06,20152.0,11587.4,5239.52,19547.44,29
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 01,166.0,95.45,43.16,161.02,29
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 02,447.0,257.02,116.22,433.59,29
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 03,709.0,407.67,184.34,687.73,29
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 04,1272.0,731.4,330.72,1233.84,29
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 05,2690.0,1546.75,699.4,2609.3,29
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 06,3078.0,1769.85,800.28,2985.66,29
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 04,96364.0,55409.3,25054.64,93473.08,29
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 05,109504.0,62964.8,28471.04,106218.88,29
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 06,131404.0,75557.3,34165.04,127461.88,29
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 07,153304.0,88149.8,39859.04,148704.88,29
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 08,175204.0,100742.3,45553.04,169947.88,29
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 09,197104.0,113334.8,51247.04,191190.88,29
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 10,219004.0,125927.3,56941.04,212433.88,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 04,3083.0,1772.72,801.58,2990.51,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 07,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 08,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 09,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 10,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 11,26284.0,15113.3,6833.84,25495.48,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 12,30664.0,17631.8,7972.64,29744.08,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 13,35482.0,20402.15,9225.32,34417.54,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 14,39862.0,22920.65,10364.12,38666.14,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 15,44242.0,25439.15,11502.92,42914.74,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 16,48622.0,27957.65,12641.72,47163.34,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 17,53002.0,30476.15,13780.52,51411.94,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 18,61324.0,35261.3,15944.24,59484.28,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 19,70084.0,40298.3,18221.84,67981.48,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 20,78844.0,45335.3,20499.44,76478.68,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 21,87604.0,50372.3,22777.04,84975.88,29
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 22,96364.0,55409.3,25054.64,93473.08,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 04,3083.0,1772.72,801.58,2990.51,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 07,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 08,11580.0,6658.5,3010.8,11232.6,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 09,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 10,15334.0,8817.05,3986.84,14873.98,29
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 07,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP EXPANDER TISSUE LVL 01,2426.0,1394.95,630.76,2353.22,29
HCPCS,L8699,IMP EXPANDER TISSUE LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP EXPANDER TISSUE LVL 03,6950.0,3996.25,1807.0,6741.5,29
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 04,3083.0,1772.72,801.58,2990.51,29
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 07,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 02,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 03,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 04,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 05,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 06,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 07,26284.0,15113.3,6833.84,25495.48,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 08,30664.0,17631.8,7972.64,29744.08,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 09,35044.0,20150.3,9111.44,33992.68,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 10,39424.0,22668.8,10250.24,38241.28,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 11,52564.0,30224.3,13666.64,50987.08,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 12,65704.0,37779.8,17083.04,63732.88,29
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 13,78844.0,45335.3,20499.44,76478.68,29
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 01,159.0,91.42,41.34,154.23,29
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 02,313.0,179.98,81.38,303.61,29
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 03,850.0,488.75,221.0,824.5,29
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 04,1413.0,812.47,367.38,1370.61,29
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 05,1888.0,1085.6,490.88,1831.36,29
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 06,2695.0,1549.62,700.7,2614.15,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 06,26284.0,15113.3,6833.84,25495.48,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 07,30664.0,17631.8,7972.64,29744.08,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 08,35044.0,20150.3,9111.44,33992.68,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 09,39424.0,22668.8,10250.24,38241.28,29
HCPCS,L8699,IMP PROSTH ANKLE LVL 10,43804.0,25187.3,11389.04,42489.88,29
HCPCS,L8699,IMP PROSTH ENT LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP PROSTH ENT LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,L8699,IMP PROSTH ENT LVL 03,1619.0,930.92,420.94,1570.43,29
HCPCS,L8699,IMP PROSTH ENT LVL 04,2695.0,1549.62,700.7,2614.15,29
HCPCS,L8699,IMP PROSTH ENT LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP PROSTH ENT LVL 06,6950.0,3996.25,1807.0,6741.5,29
HCPCS,L8699,IMP PROSTH ENT LVL 07,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP PROSTH ENT LVL 08,11580.0,6658.5,3010.8,11232.6,29
HCPCS,L8699,IMP PROSTH ENT LVL 09,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP PROSTH ENT LVL 10,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP PROSTH ENT LVL 11,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP PROSTH ENT LVL 12,26284.0,15113.3,6833.84,25495.48,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 02,1413.0,812.47,367.38,1370.61,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 04,3853.0,2215.48,1001.78,3737.41,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 05,6105.0,3510.37,1587.3,5921.85,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 07,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 08,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 09,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 03,2157.0,1240.27,560.82,2092.29,29
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 04,3596.0,2067.7,934.96,3488.12,29
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 05,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 01,1614.0,928.05,419.64,1565.58,29
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 02,2695.0,1549.62,700.7,2614.15,29
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 03,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 04,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 05,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 02,1619.0,930.92,420.94,1570.43,29
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 01,5368.0,3086.6,1395.68,5206.96,29
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 02,11580.0,6658.5,3010.8,11232.6,29
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 03,15334.0,8817.05,3986.84,14873.98,29
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 04,19714.0,11335.55,5125.64,19122.58,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 01,6105.0,3510.37,1587.3,5921.85,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 06,26284.0,15113.3,6833.84,25495.48,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 07,30664.0,17631.8,7972.64,29744.08,29
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 08,35044.0,20150.3,9111.44,33992.68,29
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 01,30664.0,17631.8,7972.64,29744.08,29
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 02,39424.0,22668.8,10250.24,38241.28,29
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 03,52564.0,30224.3,13666.64,50987.08,29
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 04,65704.0,37779.8,17083.04,63732.88,29
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 05,78844.0,45335.3,20499.44,76478.68,29
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 06,87604.0,50372.3,22777.04,84975.88,29
HCPCS,L8699,IMP RING CARDIAC LVL 01,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP RING CARDIAC LVL 02,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP RING CARDIAC LVL 03,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP SHUNT LVL 01,313.0,179.98,81.38,303.61,29
HCPCS,L8699,IMP SHUNT LVL 02,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP SHUNT LVL 03,1132.0,650.9,294.32,1098.04,29
HCPCS,L8699,IMP SHUNT LVL 04,1619.0,930.92,420.94,1570.43,29
HCPCS,L8699,IMP SHUNT LVL 05,2695.0,1549.62,700.7,2614.15,29
HCPCS,L8699,IMP SHUNT LVL 06,3909.0,2247.67,1016.34,3791.73,29
HCPCS,L8699,IMP SHUNT LVL 07,6487.0,3730.02,1686.62,6292.39,29
HCPCS,L8699,IMP SHUNT LVL 08,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP SHUNT LVL 09,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP SHUNT LVL 10,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP STENT NOS LVL 01,594.0,341.55,154.44,576.18,29
HCPCS,L8699,IMP STENT NOS LVL 02,1132.0,650.9,294.32,1098.04,29
HCPCS,L8699,IMP STENT NOS LVL 03,2695.0,1549.62,700.7,2614.15,29
HCPCS,L8699,IMP STENT NOS LVL 04,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP STENT NOS LVL 05,6950.0,3996.25,1807.0,6741.5,29
HCPCS,L8699,IMP STENT NOS LVL 06,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP STENT NOS LVL 07,11580.0,6658.5,3010.8,11232.6,29
HCPCS,L8699,IMP STENT NOS LVL 08,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP STENT NOS LVL 09,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP STENT NOS LVL 10,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP STENT NOS LVL 11,26284.0,15113.3,6833.84,25495.48,29
HCPCS,L8699,IMP STENT NOS LVL 12,30664.0,17631.8,7972.64,29744.08,29
HCPCS,L8699,IMP STENT NOS LVL 13,35044.0,20150.3,9111.44,33992.68,29
HCPCS,L8699,IMP STENT NOS LVL 14,39424.0,22668.8,10250.24,38241.28,29
HCPCS,L8699,IMP STENT NOS LVL 15,43804.0,25187.3,11389.04,42489.88,29
HCPCS,L8699,IMP STENT NOS LVL 16,50374.0,28965.05,13097.24,48862.78,29
HCPCS,L8699,IMP TUBE EAR LVL 01,166.0,95.45,43.16,161.02,29
HCPCS,L8699,IMP TUBE EAR LVL 02,447.0,257.02,116.22,433.59,29
HCPCS,L8699,IMP TUBE EAR LVL 03,709.0,407.67,184.34,687.73,29
HCPCS,L8699,IMP VALVE LVL 01,4885.0,2808.88,1270.1,4738.45,29
HCPCS,L8699,IMP VALVE LVL 02,9265.0,5327.38,2408.9,8987.05,29
HCPCS,L8699,IMP VALVE LVL 03,13895.0,7989.62,3612.7,13478.15,29
HCPCS,L8699,IMP VALVE LVL 04,17524.0,10076.3,4556.24,16998.28,29
HCPCS,L8699,IMP VALVE LVL 05,21904.0,12594.8,5695.04,21246.88,29
HCPCS,L8699,IMP VALVE LVL 06,26284.0,15113.3,6833.84,25495.48,29
HCPCS,L8699,IMP VALVE LVL 07,30664.0,17631.8,7972.64,29744.08,29
HCPCS,L8699,IMP VALVE LVL 08,35044.0,20150.3,9111.44,33992.68,29
HCPCS,L8699,IMP VALVE LVL 09,39424.0,22668.8,10250.24,38241.28,29
HCPCS,L8699,IMP VALVE LVL 10,43804.0,25187.3,11389.04,42489.88,29
HCPCS,L8699,IMP VALVE LVL 11,52564.0,30224.3,13666.64,50987.08,29
HCPCS,P9012,CRYOPRECIPITATE EA UNIT,89.0,26.79,23.14,86.33,29
HCPCS,P9016,RBC LR AUTO EA UNIT,714.0,214.91,185.64,692.58,29
HCPCS,P9016,RBC LR EA UNIT,294.0,88.49,76.44,285.18,29
HCPCS,P9017,FFP FRZ WITHIN 8 HRS COLL EA UNIT,93.0,27.99,24.18,90.21,29
HCPCS,P9035,PLATELETS PHER LR EA UNIT,731.0,220.03,190.06,709.07,29
HCPCS,P9035,PLATELETS PHER LR LOW YIELD EA,1875.0,564.38,487.5,1818.75,29
HCPCS,P9037,PLATELETS PHER LR IRRD EA UNIT,787.0,236.89,204.62,763.39,29
HCPCS,P9037,PLATELETS PHER LR IRRD LOW YIELD EA,2042.0,614.64,530.92,1980.74,29
HCPCS,P9040,RBC LR IRRD EA UNIT,350.0,105.35,91.0,339.5,29
HCPCS,P9059,FFP FRZ 8-24 HRS AFTER COLL EA UNIT,93.0,27.99,24.18,90.21,29
HCPCS,P9073,PLATELETS PATHOGEN PHER LOW YIELDEA,1875.0,564.38,487.5,1818.75,29
HCPCS,P9073,PLATELETS PATHOGEN RDC LOW YIELD EA,1875.0,564.38,487.5,1818.75,29
HCPCS,P9073,PLATELETS PATHOGEN RDC VOL RDC EA,1752.0,527.35,455.52,1699.44,29
HCPCS,P9073,PLATELETS PATHOGEN RDC WASHED EA,1752.0,527.35,455.52,1699.44,29
HCPCS,P9612,CATH COLLECT SPEC URINE,84.0,63.59,21.84,81.48,29
HCPCS,P9612,ED CATH COLLECT SPEC URINE,84.0,63.59,21.84,81.48,29
HCPCS,Q0114,POC FERN,66.0,31.81,17.16,64.02,29
HCPCS,Q3014,TELEMED ORIGINATING SITE FAC FEE,35.0,19.89,9.1,33.95,29
HCPCS,Q4081,EPO ALFA ESRD/100U 2KU SNIJ,2.56,1.45,0.0572,4.75,58
HCPCS,Q4081,EPO ALFA ESRD/100U 3KU SNIJ,4.375,2.4850000000000003,0.221,7.66,58
HCPCS,Q4081,EPO ALFA ESRD/100U 4KU SNIJ,2.56,1.45,0.0572,4.75,58
HCPCS,Q4432,DURAGEN CL 10X12.5/SH,3229.8,1857.14,839.75,3132.91,29
HCPCS,Q4432,DURAGEN CL 2.5X2.5/SH 5/PKG,854.4,491.28,222.14,828.77,29
HCPCS,Q4432,DURAGEN CL 2.5X7.5/SH,1200.5,690.29,312.13,1164.48,29
HCPCS,Q4432,DURAGEN CL 5X5/SH,1011.0,581.32,262.86,980.67,29
HCPCS,Q4432,DURAGEN CL 7.5X7.5/SH,1823.8,1048.68,474.19,1769.09,29
HCPCS,Q4432,DURAGEN CL 7.5X7.5/SH 5/PKG,2028.5,1166.39,527.41,1967.64,29
HCPCS,Q4432,DURAGEN PL 2.5X2.5/SH,841.0,483.58,218.66,815.77,29
HCPCS,Q4432,DURAGEN PL 2.5X7.5/SH,1366.2,785.56,355.21,1325.21,29
HCPCS,Q4432,DURAGEN PL 5X5/SH,1384.0,795.8,359.84,1342.48,29
HCPCS,Q4432,DURAGEN PL 7.5X7.5/SH,2458.7,1413.75,639.26,2384.94,29
HCPCS,Q4432,DURAGEN PL 7.5X7.5/SH 5/PKG,2393.5,1376.26,622.31,2321.7,29
HCPCS,Q4432,DURAGEN SU 2.5X7.5/SH,1369.5,787.46,356.07,1328.41,29
HCPCS,Q4432,DURAGEN SU 7.5X7.5/SH,2697.4,1551.0,701.32,2616.48,29
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 2KU SNIJ,1.81,1.025,0.0572,3.3,58
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 3KU SNIJ,1.96,1.115,0.1352,3.3,58
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 4KU SNIJ,1.98,1.125,0.1456,3.3,58
HCPCS,S3620,LAB SCR METABOLIC NEWBORN,157.0,118.85,40.82,152.29,29
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 01,594.0,238.19,154.44,576.18,29
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 02,1132.0,453.93,294.32,1098.04,29
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 03,2157.0,864.96,560.82,2092.29,29
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 01,594.0,238.19,154.44,576.18,29
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 02,1132.0,453.93,294.32,1098.04,29
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 03,2157.0,864.96,560.82,2092.29,29
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 04,2695.0,1080.7,700.7,2614.15,29
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 05,3853.0,1545.05,1001.78,3737.41,29
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 01,594.0,238.19,154.44,576.18,29
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 02,1132.0,453.93,294.32,1098.04,29
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 01,2695.0,1549.62,700.7,2614.15,29
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 02,3853.0,2215.48,1001.78,3737.41,29
NDC,00536136223,NICOTINE RESIN COMPLEX/2MG 2MG GU,3.1,0.27,0.806,3.01,29
NDC,00904635361,LEVOFLOXACN/750MG 750MG TB,6.2,0.55,1.61,6.01,29
NDC,00904704261,AMANTADINE/100MG 100MG CP,7.4,0.65,1.92,7.18,29
NDC,59676030401,EPO ALFA/1000U 4000U SNIJ,82.1,28.9,15.48,79.64,29
NDC,61314022605,TIMOLOL MALEATE 0.25%/5ML 5ML SNOP,28.6,2.52,7.44,27.74,29
NDC,66312017616,LIDO 2%-EPI/1.8ML 1.8ML SNIJ,5.8,1.25,1.51,5.63,29
NDC,73562011601,PANCRELIPASE/25000U 25000U CP,44.4,3.91,11.54,43.07,29
RC,360,"ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, LIMITED",,,,,0
RC,360,"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm",,,,,0
RC,360,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed",,,,,0
RC,360,"Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance",,,,,0
RC,360,"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft",,,,,0
RC,360,"Arthroscopy, shoulder, surgical; biceps tenodesis",,,,,0
RC,360,"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anc",,,,,0
RC,360,"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) release, when performed (list separately in addition to code f",,,,,0
RC,360,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)",,,,,0
RC,360,"Arthroscopy, shoulder, surgical; repair of SLAP lesion",,,,,0
RC,360,BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION,,,,,0
RC,360,"Biopsy or excision of lymph node(s); open, deep axillary node(s)",,,,,0
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites",,,,,0
RC,360,"COLECTOMY, PARTIAL; WITH SKIN LEVEL CECOSTOMY OR COLOSTOMY",,,,,0
RC,360,Cesarean delivery only;,,,,,0
RC,360,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,,,0
RC,360,"Colonoscopy, flexible; with biopsy, single or multiple",,,,,0
RC,360,Colorectal cancer screening; colonoscopy on individual at high risk,,,,,0
RC,360,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,,,,,0
RC,360,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision",,,,,0
RC,360,"Curettage, postpartum",,,,,0
RC,360,Cystourethroscopy (separate procedure),,,,,0
RC,360,"DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)",,,,,0
RC,360,"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (e.g., excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone",,,,,0
RC,360,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",,,,,0
RC,360,"ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE",,,,,0
RC,360,EXCISION OF BARTHOLIN'S GLAND OR CYST,,,,,0
RC,360,EXCISION OF LESION OF SPERMATIC CORD (SEPARATE PROCEDURE),,,,,0
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; 3 CM OR GREATER",,,,,0
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM",,,,,0
RC,360,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions",,,,,0
RC,360,Excision of pilonidal cyst or sinus; extensive,,,,,0
RC,360,Excision of pilonidal cyst or sinus; simple,,,,,0
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm",,,,,0
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm",,,,,0
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm",,,,,0
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm",,,,,0
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",,,,,0
RC,360,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm",,,,,0
RC,360,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm",,,,,0
RC,360,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",,,,,0
RC,360,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); 5 cm or greater",,,,,0
RC,360,"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater",,,,,0
RC,360,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm",,,,,0
RC,360,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification); without endos",,,,,0
RC,360,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;",,,,,0
RC,360,"HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S)",,,,,0
RC,360,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",,,,,0
RC,360,INSERTION OF INTRAUTERINE DEVICE (IUD),,,,,0
RC,360,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",,,,,0
RC,360,Incision and drainage of vulva or perineal abscess,,,,,0
RC,360,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older",,,,,0
RC,360,"Intraoperative identification (e.g., mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)",,,,,0
RC,360,"LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,,,0
RC,360,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;",,,,,0
RC,360,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)",,,,,0
RC,360,"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)",,,,,0
RC,360,"Laparoscopy, surgical, appendectomy",,,,,0
RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;",,,,,0
RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,,,0
RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,,,0
RC,360,"Laparoscopy, surgical; cholecystectomy",,,,,0
RC,360,"Laparoscopy, surgical; repair recurrent inguinal hernia",,,,,0
RC,360,"Laparoscopy, surgical; with aspiration of cavity or cyst (e.g., ovarian cyst) (single or multiple)",,,,,0
RC,360,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",,,,,0
RC,360,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",,,,,0
RC,360,Ligation or transection of Fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure,,,,,0
RC,360,"MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP",,,,,0
RC,360,MOBILIZATION (TAKE-DOWN) OF SPLENIC FLEXURE PERFORMED IN CONJUNCTION WITH PARTIAL COLECTOMY (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE),,,,,0
RC,360,"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle",,,,,0
RC,360,"Mastectomy, partial (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy);",,,,,0
RC,360,"Mastectomy, simple, complete",,,,,0
RC,360,"OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,,,0
RC,360,"OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,,,0
RC,360,"OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,,,0
RC,360,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,,,0
RC,360,PELVIC EXAMINATION UNDER ANESTHESIA (OTHER THAN LOCAL),,,,,0
RC,360,"REMOVAL OF IMPLANT; SUPERFICIAL (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE)",,,,,0
RC,360,REMOVAL OF INTRAUTERINE DEVICE (IUD),,,,,0
RC,360,"REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION",,,,,0
RC,360,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL, INCLUDING IMPLANTATION OF MESH OR OTHER PRO",,,,,0
RC,360,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,,,0
RC,360,"REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED",,,,,0
RC,360,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL",,,,,0
RC,360,"Repair initial femoral hernia, any age; incarcerated or strangulated",,,,,0
RC,360,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated",,,,,0
RC,360,"Repair initial inguinal hernia, age 5 years or older; reducible",,,,,0
RC,360,"Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, Spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other",,,,,0
RC,360,"Revision of reconstructed breast (e.g., significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue e",,,,,0
RC,360,"SUTURE OF DIGITAL NERVE, HAND OR FOOT; 1 NERVE",,,,,0
RC,360,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER",,,,,0
RC,360,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);",,,,,0
RC,360,"Treatment of incomplete abortion, any trimester, completed surgically",,,,,0
RC,360,"UNLISTED HYSTEROSCOPY PROCEDURE, UTERUS",,,,,0
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,,,0
RC,360,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL)",,,,,0
RC,360,Vaginal delivery only (with or without episiotomy and/or forceps);,,,,,0