code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
CDM,PX-26000001,IV Infus Hydration Initial 31 Min-1 Hour - 96360,532.0,399.0,267.94,502.79,5
CDM,PX-26000002,IV Infus Hydration Ea Additional Hour - 96361,242.0,181.5,58.68,230.38,6
CDM,PX-26000003,IV Infus Non-Chemo Initial Up to 1 Hr - 96365,651.0,488.25,267.94,619.75,8
CDM,PX-26000004,IV Infus Non-Chemo Same Drug Ea Hr - 96366,242.0,181.5,58.68,230.38,5
CDM,PX-26000005,IV Infus Non-Chemo Ea Add�L Seq Diff Drug Up to 1 Hr - 96367,319.0,239.25,90.51,301.49,3
CDM,PX-26000006,IV Non-Chemo Concurrent Infus - 96368,214.0,160.5,166.06,166.06,1
CDM,PX-26000010,Therapeutic Prophylactic/Diagnostic Inj Sc/Im - 96372,193.0,144.75,90.51,182.4,9
CDM,PX-26000012,Ivp/ IV < 16 Min Initial Drug - 96374,518.0,388.5,267.94,493.14,9
CDM,PX-26000013,Ivp/ IV <16min Ea Addl Seg Diff Drug - 96375,218.0,163.5,58.68,207.54,7
CDM,PX-26000014,Ivp/ IV <16 Min Ea Add�L Seq Same Drug - 96376,654.0,490.5,507.5,622.61,3
CDM,PX-27000020,Implant Pin/Wire/Peg T1,25.0,18.75,23.21,23.21,1
CDM,PX-27000120,Mesh T2,4063.19,3047.39,3772.67,3772.67,1
CDM,PX-30000003,Venipuncture,16.0,12.0,12.42,15.23,6
CDM,PX-30000004,Collect Finger/Heel/Ear Stick,16.0,12.0,15.12,15.12,1
CDM,PX-30000007,General Health Panel,220.0,165.0,170.72,209.44,5
CDM,PX-30000009,Obstetric Panel,465.0,348.75,425.99,438.4,2
CDM,PX-30000010,Hepatic Function Panel,145.0,108.75,112.52,138.04,6
CDM,PX-30000036,Tacrolimus (Fk-506),157.0,117.75,148.38,148.38,1
CDM,PX-30000038,Therapeutic Drug Assay Other,214.0,160.5,166.06,202.25,2
CDM,PX-30000040,Acth Stimulation Panel Adrenal,377.0,282.75,355.44,355.44,1
CDM,PX-30000067,RBC Antibody Screen,123.0,92.25,95.45,117.1,6
CDM,PX-30000070,Coombs Direct,62.0,46.5,75.54,75.54,1
CDM,PX-30000075,Blood Typing Serologic Abo,55.0,41.25,42.68,163.93,9
CDM,PX-30000076,HC Blood Typing Serologic Rh (D),49.0,36.75,38.02,46.65,6
CDM,PX-30000084,Crossmatch Immediate Spin,248.0,186.0,217.93,230.27,2
CDM,PX-30000113,Crystal ID Light Microscopy,70.0,52.5,54.32,54.32,1
CDM,PX-30000159,Phlebotomy Therapeutic,354.0,265.5,163.93,334.57,4
CDM,PX-30000164,Prostate Cancer Screen Psa,227.0,170.25,198.4,198.4,1
CDM,PX-30000171,Basic Metabolic Panel,143.0,107.25,110.97,136.14,7
CDM,PX-30000172,Comprehensive Metabolic Panel,253.0,189.75,196.33,240.86,7
CDM,PX-30000173,Lipid Panel,140.0,105.0,108.64,133.28,8
CDM,PX-30000175,Renal Function Panel,226.0,169.5,175.38,213.59,2
CDM,PX-30000176,Acute Hepatitis Panel,626.0,469.5,485.78,581.24,3
CDM,PX-30000185,Lithium,71.0,53.25,55.1,67.59,2
CDM,PX-30000192,Vancomycin,135.0,101.25,104.76,104.76,1
CDM,PX-30000227,Analysis Gene Hfe Common Variants,292.0,219.0,255.21,255.21,1
CDM,PX-30000238,Analysis Gene Jak2 V617f Variant,648.0,486.0,610.93,610.93,1
CDM,PX-30000279,Adrenocorticotropic (Acth),282.0,211.5,246.47,246.47,1
CDM,PX-30000281,Albumin Serum/Plasma/Blood,37.0,27.75,28.71,34.35,2
CDM,PX-30000283,Microalbumin Qn Urine,92.0,69.0,71.39,86.95,5
CDM,PX-30000288,Aldolase,85.0,63.75,65.96,80.33,3
CDM,PX-30000289,Aldosterone,290.0,217.5,225.04,225.04,1
CDM,PX-30000291,Alpha-1 Antitrypsin Total,109.0,81.75,95.27,95.27,1
CDM,PX-30000293,Alpha Fetoprotein Serum,138.0,103.5,107.09,107.09,1
CDM,PX-30000296,Aluminum,308.0,231.0,293.22,293.22,1
CDM,PX-30000303,Amino Acids 6 or More Acids Qn,603.0,452.25,574.06,574.06,1
CDM,PX-30000305,Ammonia,104.0,78.0,98.29,98.29,1
CDM,PX-30000309,Amylase,67.0,50.25,51.99,51.99,1
CDM,PX-30000312,Androstenedione,223.0,167.25,173.05,173.05,1
CDM,PX-30000315,Angiotensin I Enzyme (Ace),127.0,95.25,98.55,98.55,1
CDM,PX-30000316,Apolipoprotein,114.0,85.5,99.64,107.74,4
CDM,PX-30000324,Bilirubin Total,43.0,32.25,33.37,40.64,3
CDM,PX-30000325,Bilirubin Direct,42.0,31.5,32.59,39.0,2
CDM,PX-30000328,Occult Blood Feces Cancer Screen,31.0,23.25,27.09,27.09,1
CDM,PX-30000330,Occult Blood Feces Ql Other Single,36.0,27.0,27.94,33.43,2
CDM,PX-30000334,Vitamin D 25 Hydroxy Inc Fraction,227.0,170.25,176.15,216.1,6
CDM,PX-30000336,Calcium Total,38.0,28.5,35.28,36.18,2
CDM,PX-30000337,Calcium Ionized,115.0,86.25,89.24,106.78,2
CDM,PX-30000339,Calcium Qn Timed Urine,69.0,51.75,53.54,64.07,2
CDM,PX-30000348,Carcinoembryonic Antigen (Cea),140.0,105.0,108.64,122.36,2
CDM,PX-30000353,Catecholamines Fraction,178.0,133.5,169.46,169.46,1
CDM,PX-30000355,Ceruloplasmin,109.0,81.75,95.27,95.27,1
CDM,PX-30000365,Cholinesterase Serum,91.0,68.25,86.63,86.63,1
CDM,PX-30000379,Collagen Cross Links,92.0,69.0,86.95,87.58,2
CDM,PX-30000380,Copper,94.0,70.5,82.16,89.49,2
CDM,PX-30000382,Cortisol Free,135.0,101.25,104.76,127.59,3
CDM,PX-30000383,Cortisol Total,151.0,113.25,117.18,143.75,5
CDM,PX-30000389,Creatine Kinase (Cpk) Total,58.0,43.5,45.01,55.22,5
CDM,PX-30000393,Creatinine Blood,38.0,28.5,29.49,29.49,1
CDM,PX-30000394,Creatinine Other Source,55.0,41.25,42.68,52.36,6
CDM,PX-30000398,Cryoglobulin Ql or Sqn,78.0,58.5,73.72,73.72,1
CDM,PX-30000400,Vitamin B-12 (Cyancobalamin),123.0,92.25,95.45,117.1,5
CDM,PX-30000405,Dhea-S,226.0,169.5,175.38,215.15,5
CDM,PX-30000408,Dibucaine Number,151.0,113.25,143.75,143.75,1
CDM,PX-30000422,Assay of Total Estradiol,248.0,186.0,192.45,236.1,6
CDM,PX-30000423,Estrogen Fractionated,401.0,300.75,350.47,378.99,2
CDM,PX-30000424,Estrogen Total,195.0,146.25,181.06,184.29,2
CDM,PX-30000426,Estrone,176.0,132.0,153.82,166.34,2
CDM,PX-30000433,Fatty Acids Nonesterified,93.0,69.75,86.35,86.35,1
CDM,PX-30000435,Ferritin,128.0,96.0,99.33,121.86,7
CDM,PX-30000438,Fluoride,230.0,172.5,218.96,218.96,1
CDM,PX-30000440,Folic Acid Serum,130.0,97.5,100.88,123.76,5
CDM,PX-30000447,Gammaglobulin Igm Iga Igd or Igg,86.0,64.5,66.74,81.87,5
CDM,PX-30000449,Gammaglobulin Ige,158.0,118.5,122.61,149.33,2
CDM,PX-30000454,Blood Gas W/O2 Sat,351.0,263.25,272.38,334.15,5
CDM,PX-30000463,Glucose Blood,123.0,92.25,114.21,117.1,3
CDM,PX-30000465,Glucose Post Dose,248.0,186.0,192.45,234.38,3
CDM,PX-30000470,G6pd Enzyme Qn,176.0,132.0,136.58,136.58,1
CDM,PX-30000472,Glucose by Device,31.0,23.25,24.06,29.3,4
CDM,PX-30000476,Ggt/Ggtp,70.0,52.5,54.32,66.64,4
CDM,PX-30000480,Glycated Protein (Fructosamine),179.0,134.25,166.2,166.2,1
CDM,PX-30000481,Follicle Stimulating Hormone (Fsh),95.0,71.25,73.72,90.44,5
CDM,PX-30000482,Luteinizing Hormone (Lh),128.0,96.0,99.33,121.86,5
CDM,PX-30000486,Haptoglobin Qn,130.0,97.5,120.71,120.71,1
CDM,PX-30000492,Hemoglobin Electrophoresis,158.0,118.5,138.09,138.09,1
CDM,PX-30000493,Hemoglobin Fract Qn,158.0,118.5,138.09,138.09,1
CDM,PX-30000497,Hemoglobin Glycosylated (A1c),86.0,64.5,66.74,81.87,7
CDM,PX-30000511,Histamine,134.0,100.5,103.98,103.98,1
CDM,PX-30000513,Homocystine,142.0,106.5,110.19,135.18,4
CDM,PX-30000516,Hydroxyindolacetic 5-(Hiaa),117.0,87.75,90.79,90.79,1
CDM,PX-30000517,Hydroxyprogesterone 17-D,205.0,153.75,159.08,179.17,2
CDM,PX-30000524,Immuno Qn Ria,184.0,138.0,175.17,175.17,1
CDM,PX-30000526,Immuno Qn Other,201.0,150.75,155.98,186.63,3
CDM,PX-30000528,Insulin Total,105.0,78.75,81.48,99.96,5
CDM,PX-30000531,IRON,67.0,50.25,51.99,63.78,6
CDM,PX-30000532,Iron Binding Capacity,76.0,57.0,58.98,72.35,6
CDM,PX-30000537,Lactate/Lactic Acid,106.0,79.5,82.26,100.91,5
CDM,PX-30000538,Lactate Dehydrogenase (Ldh),46.0,34.5,35.7,43.79,5
CDM,PX-30000541,Lactoferrin Fecal Qn,216.0,162.0,204.14,204.14,1
CDM,PX-30000545,LEAD,97.0,72.75,75.27,92.34,4
CDM,PX-30000551,Lipase,69.0,51.75,53.54,65.69,5
CDM,PX-30000553,Assay of Lipoprotein A,140.0,105.0,108.64,132.31,4
CDM,PX-30000554,Assay Lipoprotein Pla2,237.0,177.75,220.05,220.05,1
CDM,PX-30000555,Lipoprotein Electrophoresis Bld Qn,78.0,58.5,73.72,73.72,1
CDM,PX-30000558,Lipoprotein Blood by Nmr,223.0,167.25,207.06,207.06,1
CDM,PX-30000563,Magnesium,51.0,38.25,39.58,48.55,5
CDM,PX-30000571,Mercury,138.0,103.5,131.38,131.38,1
CDM,PX-30000572,Metanephrines,145.0,108.75,112.52,138.04,2
CDM,PX-30000583,Natriuretic Peptide,243.0,182.25,225.63,231.34,3
CDM,PX-30000592,Organic Acid Single Qn,223.0,167.25,173.05,210.76,3
CDM,PX-30000594,Osmolality Blood,50.0,37.5,38.8,38.8,1
CDM,PX-30000595,Osmolality Urine,59.0,44.25,45.78,45.78,1
CDM,PX-30000596,Osteocalcin,207.0,155.25,197.06,197.06,1
CDM,PX-30000600,Parathormone (Pth),293.0,219.75,227.37,278.94,4
CDM,PX-30000613,Phosphatase Alkaline,46.0,34.5,43.47,43.47,1
CDM,PX-30000615,Phosphatase Alkaline Isoenzyme,131.0,98.25,114.49,124.71,2
CDM,PX-30000619,Phosphorus,38.0,28.5,29.49,36.18,5
CDM,PX-30000620,Phosphorus Urine,62.0,46.5,59.02,59.02,1
CDM,PX-30000623,Eval Cervicovag Pamg-1 Pp12 Alpha-F,740.0,555.0,687.09,699.37,2
CDM,PX-30000628,Potassium Serum/ Plasma/ Blood,34.0,25.5,32.37,32.37,1
CDM,PX-30000630,Prealbumin,104.0,78.0,96.56,96.56,1
CDM,PX-30000633,Pregnenolone,264.0,198.0,245.12,251.33,2
CDM,PX-30000635,Progesterone,175.0,131.25,135.8,166.6,6
CDM,PX-30000637,Prolactin,201.0,150.75,155.98,191.35,5
CDM,PX-30000641,Prostatic Specific Antigen Total,139.0,104.25,107.86,132.33,6
CDM,PX-30000642,Prostatic Specific Antigen Free,137.0,102.75,106.31,129.48,3
CDM,PX-30000643,Protein Total Xcpt Refra Serum Plas,40.0,30.0,31.04,37.8,3
CDM,PX-30000645,Protein Total Urine,59.0,44.25,45.78,56.17,5
CDM,PX-30000650,Protein Electrophoresis,109.0,81.75,84.58,103.02,4
CDM,PX-30000652,Protein Electrophoretic Other Fluid,127.0,95.25,98.55,120.03,3
CDM,PX-30000659,Vitamin B-6 (Pyridoxal Phosphate),194.0,145.5,184.69,184.69,1
CDM,PX-30000671,Sex Hormone Binding Globulin,174.0,130.5,135.02,164.45,4
CDM,PX-30000675,Sodium Urine,42.0,31.5,32.59,32.59,1
CDM,PX-30000689,Testosterone Free,187.0,140.25,145.11,178.02,5
CDM,PX-30000691,Testosterone Total,229.0,171.75,177.7,218.01,5
CDM,PX-30000693,Vitamin B1 (Thiamine),151.0,113.25,140.2,142.71,2
CDM,PX-30000696,Thyroglobulin,208.0,156.0,161.41,161.41,1
CDM,PX-30000697,Thyroxine (T-4) Total,101.0,75.75,78.38,95.46,3
CDM,PX-30000699,Thyroxine (T-4) Free,103.0,77.25,79.93,98.06,6
CDM,PX-30000700,Thyroid Activity (Tbg),129.0,96.75,119.78,119.78,1
CDM,PX-30000701,Thyroid Stimulating Hormone (Tsh),148.0,111.0,114.85,140.9,6
CDM,PX-30000702,Thyroid Stimulating Immun Globulin,390.0,292.5,302.64,362.12,2
CDM,PX-30000705,Ast/Sgot,41.0,30.75,31.82,38.75,3
CDM,PX-30000706,Alt/Sgpt,43.0,32.25,33.37,40.64,3
CDM,PX-30000708,Triglycerides,59.0,44.25,54.78,54.78,1
CDM,PX-30000711,Triiodothyronine (T-3) Total,175.0,131.25,135.8,166.6,6
CDM,PX-30000712,Triiodothyronine (T-3) Free,195.0,146.25,151.32,185.64,5
CDM,PX-30000713,Triiodothyronine (T-3) Reverse,344.0,258.0,300.66,327.49,4
CDM,PX-30000714,Troponin Qn,114.0,85.5,88.46,108.53,5
CDM,PX-30000721,Urea Nitrogen Quantitative,35.0,26.25,27.16,27.16,1
CDM,PX-30000725,Uric Acid Blood,40.0,30.0,31.04,38.08,5
CDM,PX-30000739,ZINC,97.0,72.75,84.78,92.34,3
CDM,PX-30000740,C-Peptide,169.0,126.75,159.72,159.72,1
CDM,PX-30000741,Hcg Qn,150.0,112.5,116.4,142.8,6
CDM,PX-30000743,Hcg Ql,85.0,63.75,65.96,80.92,6
CDM,PX-30000775,Rast Allergen Ige Qn Sq Ea,76.0,57.0,71.83,71.83,1
CDM,PX-30000784,Antinuclear Antibodies (Ana) Titer,85.0,63.75,65.96,80.92,5
CDM,PX-30000785,Antistreptolysin O Titer,93.0,69.75,72.17,72.17,1
CDM,PX-30000787,C-Reactive Protein,70.0,52.5,54.32,66.64,6
CDM,PX-30000788,C-Reactive Protein High Sensitivity,122.0,91.5,94.67,116.14,5
CDM,PX-30000789,Beta 2 Glycoprotein I Antibody Ea,157.0,117.75,121.83,121.83,1
CDM,PX-30000791,Cardiolipin Antibody Ea Ig Class,164.0,123.0,127.26,152.27,3
CDM,PX-30000798,Complement Antigen Ea Component,104.0,78.0,80.7,96.56,3
CDM,PX-30000800,Complement Total (Ch50),202.0,151.5,187.56,187.56,1
CDM,PX-30000804,Cyclic Citrulli Pept (CCP) Antibody,144.0,108.0,111.74,125.86,2
CDM,PX-30000805,Deoxyribonuclease (Dna) Antibody,109.0,81.75,84.58,84.58,1
CDM,PX-30000806,Dna Double Strand Antibody,122.0,91.5,94.67,113.28,3
CDM,PX-30000808,Extract Nuclear Antigen,128.0,96.0,99.33,120.97,4
CDM,PX-30000818,Immunoassay Tumor Antigen Ca 15-3,147.0,110.25,128.48,128.48,1
CDM,PX-30000819,Immunoassay Tumor Antigen Ca 19-9,147.0,110.25,114.07,114.07,1
CDM,PX-30000820,Immunoassay Tumor Antigen Ca 125,182.0,136.5,141.23,173.26,2
CDM,PX-30000822,Heterophile Antibody Screen,94.0,70.5,72.94,89.49,5
CDM,PX-30000827,HC Immunoassay Infectious Agent Antibody Quan,106.0,79.5,100.18,100.18,1
CDM,PX-30000837,Immunofixation Electrophores Serum,160.0,120.0,124.16,151.22,2
CDM,PX-30000841,Insulin Antibody,332.0,249.0,313.77,313.77,1
CDM,PX-30000843,Islet Cell Antibody,209.0,156.75,197.53,197.53,1
CDM,PX-30000853,T Cells Cd4 & Cd8 W/Ratio,165.0,123.75,155.94,155.94,1
CDM,PX-30000856,Microsomal Antibody,145.0,108.75,112.52,138.04,5
CDM,PX-30000867,Rheumatoid Factor Qn,92.0,69.0,71.39,86.95,4
CDM,PX-30000869,TB Test Cell Imm Ag Meas Gam Interf,668.0,501.0,518.37,635.94,6
CDM,PX-30000877,Syphilis Vdrl/Rpr Ql,51.0,38.25,39.58,48.55,5
CDM,PX-30000885,Bartonella Antibody,114.0,85.5,108.53,108.53,1
CDM,PX-30000891,Lyme Disease Antibody Confirm,194.0,145.5,150.54,184.69,6
CDM,PX-30000893,Lyme Disease Antibody,153.0,114.75,118.73,145.66,7
CDM,PX-30000910,Cytomegalovirus (Cmv) Antibody,154.0,115.5,119.5,145.55,2
CDM,PX-30000912,Cytomegalovirus (Cmv) Antibody Igm,168.0,126.0,130.37,130.37,1
CDM,PX-30000925,Epstein-Barr Ebna Ag Antibody,101.0,75.75,78.38,96.15,4
CDM,PX-30000927,Epstein-Barr Vca Ag Antibody,106.0,79.5,82.26,100.91,4
CDM,PX-30000929,Ehrlichia Antibody,139.0,104.25,107.86,132.33,3
CDM,PX-30000931,Francisella Tularensis Antibody,143.0,107.25,110.97,135.15,2
CDM,PX-30000946,Herpes Simplex Type I Antibody,101.0,75.75,78.38,96.15,2
CDM,PX-30000948,Herpes Simplex Type II Antibody,138.0,103.5,107.09,131.38,2
CDM,PX-30000955,Hepatitis B Core Antibody Igm Igg,115.0,86.25,89.24,109.48,5
CDM,PX-30000957,Hepatitis B Surface Antibody,101.0,75.75,78.38,96.15,5
CDM,PX-30000959,HEPATITIS A ANTIBODY (HAAb) TOTAL,112.0,84.0,86.91,86.91,1
CDM,PX-30000973,Mumps Antibody,144.0,108.0,133.7,136.09,2
CDM,PX-30000975,Mycoplasma Antibody,115.0,86.25,108.69,108.69,1
CDM,PX-30000980,Parvovirus Antibody,140.0,105.0,108.64,108.64,1
CDM,PX-30000984,Protozoa Antibody Not Specified,93.0,69.75,72.17,88.54,2
CDM,PX-30000988,Rickettsia Antibody,173.0,129.75,163.5,163.5,1
CDM,PX-30000991,Rubella Antibody,118.0,88.5,91.57,112.34,6
CDM,PX-30000993,Rubeola Antibody,131.0,98.25,101.66,124.71,6
CDM,PX-30001003,Treponema Pallidum Antibody,146.0,109.5,113.3,138.99,5
CDM,PX-30001005,Varicella-Zoster Antibody,133.0,99.75,103.21,126.62,6
CDM,PX-30001009,Virus Not Elsewhere Specified,123.0,92.25,116.25,116.25,1
CDM,PX-30001013,Thyroglobulin Antibody,120.0,90.0,93.12,114.24,4
CDM,PX-30001014,Hepatitis C Antibody,127.0,95.25,98.55,120.9,5
CDM,PX-30001020,Hla Typing Single Antigen a/B/C,250.0,187.5,194.0,232.13,2
CDM,PX-30001031,Blood Smear W/Manual Diff Wbc,55.0,41.25,42.68,52.36,4
CDM,PX-30001035,Blood Count Hematocrit (Hct),26.0,19.5,20.18,24.75,4
CDM,PX-30001036,Blood Count Hemoglobin (Hgb),31.0,23.25,24.06,29.51,4
CDM,PX-30001037,Blood Count Cbc Auto W/Auto Diff,74.0,55.5,57.42,70.45,6
CDM,PX-30001038,Blood Count Cbc Auto W/O Diff,56.0,42.0,43.46,53.31,7
CDM,PX-30001042,Blood Count Reticulocyte Auto,48.0,36.0,44.57,44.57,1
CDM,PX-30001055,Factor VIII Ahg,287.0,215.25,222.71,222.71,1
CDM,PX-30001058,Factor VIII Vw Ristocetin Cofactor,253.0,189.75,196.33,196.33,1
CDM,PX-30001059,Factor VIII Vw Antigen,331.0,248.25,256.86,256.86,1
CDM,PX-30001071,Antithrombin III Activity,238.0,178.5,220.98,220.98,1
CDM,PX-30001074,Protein C Activity,321.0,240.75,298.05,298.05,1
CDM,PX-30001076,Protein S Free,311.0,233.25,288.76,288.76,1
CDM,PX-30001088,Fibrin Degradation D-Dimer Qn,118.0,88.5,91.57,112.34,5
CDM,PX-30001090,Fibrinogen Activity,71.0,53.25,65.92,67.1,2
CDM,PX-30001118,Prothrombin Time (Pt),45.0,33.75,34.92,42.84,5
CDM,PX-30001121,Russell Viper Venom Diluted,153.0,114.75,118.73,118.73,1
CDM,PX-30001123,Sed Rate RBC Non Auto,39.0,29.25,30.26,36.86,4
CDM,PX-30001124,Sed Rate RBC Auto,33.0,24.75,25.61,31.42,6
CDM,PX-30001129,Partial Thromboplastin Time (Ptt),62.0,46.5,48.11,59.02,4
CDM,PX-30001140,Culture Blood Aerobic,130.0,97.5,100.88,122.86,4
CDM,PX-30001141,Culture Stool Salmonella & Shigella,119.0,89.25,92.34,112.47,6
CDM,PX-30001142,Culture Stool Other,68.0,51.0,52.77,64.27,6
CDM,PX-30001144,Culture Bacterial Other Source,109.0,81.75,84.58,103.77,6
CDM,PX-30001150,Culture Aerobic ID,68.0,51.0,52.77,64.74,5
CDM,PX-30001152,Culture Screen Single Organism,80.0,60.0,62.08,74.28,2
CDM,PX-30001154,Culture Urine W/Colony Count,91.0,68.25,70.62,86.63,7
CDM,PX-30001156,Culture Fungus Skin/Hair/Nail,96.0,72.0,90.73,90.73,1
CDM,PX-30001157,Culture Fungus Other,91.0,68.25,86.63,86.63,1
CDM,PX-30001172,Cult Type Amp Prb Cult/Isol Ea,317.0,237.75,245.99,299.6,5
CDM,PX-30001182,Smear Ova & Parasite Concent/Ident,128.0,96.0,99.33,120.97,6
CDM,PX-30001186,Susceptibility Mic per Plate,108.0,81.0,83.81,102.82,5
CDM,PX-30001192,Smear Gram or Geimsa Stain,49.0,36.75,38.02,46.65,5
CDM,PX-30001194,Spec Stain Incls Bodies/Parasites,88.0,66.0,68.29,76.91,2
CDM,PX-30001195,Complex Special Stain O/P Trich/Iro,183.0,137.25,142.01,172.95,6
CDM,PX-30001233,Eia Ql C Difficile Toxin(S) Antigen,160.0,120.0,148.56,148.56,1
CDM,PX-30001235,Eia Ql Cryptosporidium Antigen,92.0,69.0,71.39,71.39,1
CDM,PX-30001236,Eia Ql Giardia Antigen,115.0,86.25,89.24,108.69,3
CDM,PX-30001243,Eia Ql Hepatitis B Ag,118.0,88.5,91.57,112.34,5
CDM,PX-30001255,Eia Ql Multi Shiga-Like Toxin Ag,115.0,86.25,106.78,106.78,1
CDM,PX-30001257,Eia Ql Multi Antigen,113.0,84.75,87.69,104.92,3
CDM,PX-30001275,Nucleic Acid Amp Chlamydia Trach,184.0,138.0,142.78,175.17,7
CDM,PX-30001277,Nucleic Acid Amp Probe Clostridium,276.0,207.0,214.18,260.85,5
CDM,PX-30001281,Nucleic Acid Qn Cmv,310.0,232.5,240.56,292.98,2
CDM,PX-30001292,Nucleic Acid Qn Hepatitis B,306.0,229.5,237.46,284.12,2
CDM,PX-30001295,Nucleic Acid Rev Trans Qn Hepatitis,526.0,394.5,500.75,500.75,1
CDM,PX-30001300,Nucleic Acid Amp Probe Herpes Smpx,601.0,450.75,466.38,572.15,6
CDM,PX-30001305,Nucleic Acid Amp Probe Herpes 6,323.0,242.25,305.27,305.27,1
CDM,PX-30001309,Nucleic Acid Rev Trans Qn Hiv-1,405.0,303.75,376.04,376.04,1
CDM,PX-30001327,Nucleic Acid Amp Myco Pneum,319.0,239.25,301.49,301.49,1
CDM,PX-30001330,Nucleic Acid Amp N Gonorrhoeae,184.0,138.0,142.78,175.17,7
CDM,PX-30001337,Nuc Acid Stph Aureus Amplified,323.0,242.25,250.65,299.91,2
CDM,PX-30001344,Nucleic Acid Amp Infectious,321.0,240.75,249.1,305.59,7
CDM,PX-30001347,Nucleic Acid Amp Multi Org,370.0,277.5,287.12,343.55,3
CDM,PX-30001357,Immunoassay Optical Strep A,91.0,68.25,70.62,86.63,7
CDM,PX-30001367,Microbiology Unlstd Proc,130.0,97.5,123.76,123.76,1
CDM,PX-30001369,Leukocyte Assess Fecal Qn/Semi Qn,78.0,58.5,60.53,73.72,4
CDM,PX-30001374,Urinalysis Auto W/Micro,57.0,42.75,44.23,54.26,8
CDM,PX-30001376,Urinalysis Auto W/O Micro,38.0,28.5,29.49,36.18,6
CDM,PX-30001381,Urine Pregnancy Visual,79.0,59.25,61.3,75.21,6
CDM,PX-30001676,Drug Screen Quan Lamotrigine,141.0,105.75,109.42,109.42,1
CDM,PX-30001852,Iadna Trichomonas Vaginalis Amplified Probe Tech,282.0,211.5,218.83,261.84,2
CDM,PX-30002282,Babesia Microtiter Dna Pcr,321.0,240.75,249.1,305.59,7
CDM,PX-30002297,Her Anaplasma Det Pcr,321.0,240.75,249.1,305.59,7
CDM,PX-30002927,Iaadiadoo Hiv1 Antigen W/Hiv1 & Hiv2 Antibodies,118.0,88.5,91.57,112.34,6
CDM,PX-30002957,Drug Screen Quant Dipropylacetic Acid Total,122.0,91.5,94.67,113.28,2
CDM,PX-30003057,Col-Chr/Ms Nondrug Analyte Nes Qual/Quan Ea Spec,228.0,171.0,176.93,217.06,2
CDM,PX-30003339,Presumptive Drug Test Read by Instrument Assisted Direct Optical Observation,140.0,105.0,108.64,133.28,4
CDM,PX-30003340,Presumptive Drug Test by Instrument Chemistry Analyzer,558.0,418.5,531.22,531.22,1
CDM,PX-30003473,Allergen Spec Ige Recombinant/Purified Compnt Ea,199.0,149.25,154.42,188.07,3
CDM,PX-30003537,Dihydrotestosterone (Dht),289.0,216.75,268.34,268.34,1
CDM,PX-30003547,Tda Nos Eslicarbazepine (Eg. Aptiom),109.0,81.75,84.58,103.02,2
CDM,PX-30003548,"Porphoryns, Total, Plasma",228.0,171.0,176.93,217.06,2
CDM,PX-30003557,"Streptococcus Pneumoniae Igg Antibodies, 23 Serotypes, Serum",106.0,79.5,100.18,100.18,1
CDM,PX-30003578,Tryptase,201.0,150.75,155.98,186.63,3
CDM,PX-30003603,Adalimumab Qn,203.0,152.25,157.53,191.86,2
CDM,PX-30003604,"Adalimumab Ab, S",201.0,150.75,155.98,186.63,3
CDM,PX-30003647,Antibody Sars-Cov-2,200.0,150.0,189.02,189.02,1
CDM,PX-30003691,"Thiopurine Metabolites, Whole Blood",218.0,163.5,169.17,206.03,2
CDM,PX-30003694,Fractionated Catecholamines - 24 Hr Urine,55.0,41.25,42.68,52.36,6
CDM,PX-30003709,"HC Nch Perfluoroalkyl Substances (Pfas), Serum/Plasma",228.0,171.0,176.93,217.06,2
CDM,PX-30003716,Iadna Sarscov2 & Inf a&B & Rsv Mult Amp Probe Tq,519.0,389.25,402.74,494.09,6
CDM,PX-30003718,Nfct Ds Rna 4 Targets Upper Respiratory Specimen,478.0,358.5,370.93,455.06,11
CDM,PX-30003719,Drug Assay Acetaminophen,167.0,125.25,145.96,145.96,1
CDM,PX-30003723,Drug Assay Salicylate,167.0,125.25,145.96,145.96,1
CDM,PX-30003733,Pancreatic Elastase-1,201.0,150.75,155.98,186.63,3
CDM,PX-30003738,Ig Paraprotein Qual Imprcip&Ms Bld/UR W/Isotype,100.0,75.0,92.85,94.28,2
CDM,PX-30003759,Immunoglobulin Light Chains Free Each,153.0,114.75,142.06,144.6,2
CDM,PX-30003761,Actin Smooth Muscle Antibody Each,103.0,77.25,90.02,90.02,1
CDM,PX-30003762,Antineutrophil Cytoplasmic Antb Screen Ea Antb,108.0,81.0,100.28,100.28,1
CDM,PX-30003768,Gliadin Antibody Each Immunoglobulin Class,103.0,77.25,79.93,79.93,1
CDM,PX-30003771,Tissue Transglutaminase Ea Immunoglobulin Class,103.0,77.25,79.93,98.06,5
CDM,PX-30003781,Elastase Pancreatic Fecal Quantitative,207.0,155.25,192.2,195.16,2
CDM,PX-30003805,Iadna Anaplasma Phagocytophilum Amplifed Prb Tq,310.0,232.5,240.56,295.12,6
CDM,PX-30003806,Iadna Babesia Microti Amplified Probe Technique,310.0,232.5,240.56,295.12,6
CDM,PX-30003807,Iadna Borrelia Miyamotoi Amplified Prb Technique,310.0,232.5,287.84,295.12,2
CDM,PX-30003808,Iadna Ehrlichia Chaffeensis Amplified Probe Tq,310.0,232.5,240.56,295.12,6
CDM,PX-30003819,Assay of Anti-Mullerian Hormone,341.0,255.75,264.62,324.63,7
CDM,PX-30003827,Nfct Ds Bct Vaginosis&Vaginitis Mult Amp Probe,921.0,690.75,714.7,876.79,4
CDM,PX-30003831,Quest Anaerobic ID Org,26.0,19.5,24.75,24.75,1
CDM,PX-30003843,Iadna H Pylori Clarithromycin Resist Amp Prb Tq,312.0,234.0,242.11,294.87,4
CDM,PX-31000070,Cyto Urne 3-5 Probe Ea Spec Man,115.0,86.25,217.93,217.93,1
CDM,PX-31000099,Flow Cytometry 1st Marker Tc,157.0,117.75,457.47,457.47,1
CDM,PX-31000867,Vedolizumab Level,357.0,267.75,277.03,337.4,2
CDM,PX-32000012,Xr Facial Bones 3+ Views,1117.0,837.75,866.79,866.79,1
CDM,PX-32000013,Xr Nasal Cmpl 3+ Views,681.0,510.75,528.46,632.31,2
CDM,PX-32000028,Xr Sinuses 3+ Views,681.0,510.75,632.31,632.31,1
CDM,PX-32000030,Xr Skull Ltd <4 Views,851.0,638.25,126.27,126.27,1
CDM,PX-32000036,Xr Tmj Open & Closed Bilat,769.0,576.75,104.55,104.55,1
CDM,PX-32000039,Xr Neck Soft Tissue,696.0,522.0,111.98,111.98,1
CDM,PX-32000049,Xr Ribs W/Cxr 3+ Views Uni,698.0,523.5,135.24,659.68,3
CDM,PX-32000051,Xr Ribs W/Cxr 4+ Views Bilat,843.0,632.25,126.27,126.27,1
CDM,PX-32000056,Xr C-Spine 2 or 3 Views,801.0,600.75,111.98,762.55,6
CDM,PX-32000057,Xr C-Spine 4 or 5 Views,1052.0,789.0,135.24,976.78,4
CDM,PX-32000058,Xr C-Spine 6 or More Views,1199.0,899.25,135.24,135.24,1
CDM,PX-32000060,Xr T-Spine 2 Views,776.0,582.0,135.24,602.18,2
CDM,PX-32000061,Xr T-Spine 3 Views,776.0,582.0,135.24,602.18,2
CDM,PX-32000065,Xr L-Spine 2-3 Views,776.0,582.0,135.24,738.75,8
CDM,PX-32000066,Xr L-Spine 4+ Views,776.0,582.0,135.24,720.52,2
CDM,PX-32000069,Xr Pelvis 1-2 Views,648.0,486.0,135.24,502.85,2
CDM,PX-32000073,Xr Sacrum/Coccyx 2+ Views,710.0,532.5,111.98,671.02,3
CDM,PX-32000090,Xr Shoulder Cmp 2+ Views,682.0,511.5,111.98,111.98,1
CDM,PX-32000103,Xr Elbow Cmpl 3+ Views,646.0,484.5,111.98,111.98,1
CDM,PX-32000119,Xr Wrist Cmpl 3+ Views,668.0,501.0,620.24,620.24,1
CDM,PX-32000154,Xr Knee 1-2 Views,538.0,403.5,111.98,111.98,2
CDM,PX-32000157,Xr Knee 3 Views,702.0,526.5,111.98,111.98,1
CDM,PX-32000160,Xr Knee Cmpl 4+ Views,762.0,571.5,135.24,665.99,2
CDM,PX-32000167,Xr Tibia/Fibula 2 Views,668.0,501.0,620.24,620.24,1
CDM,PX-32000186,Xr Foot Cmpl 3+ Views,599.0,449.25,111.98,111.98,1
CDM,PX-32000198,Xr Esophagus,1733.0,1299.75,226.4,1609.09,3
CDM,PX-32000199,Xr Swallow Cine/Video,1291.0,968.25,226.4,1001.82,3
CDM,PX-32000200,Xr Ugi W/O Kub,1499.0,1124.25,1163.22,1163.22,1
CDM,PX-32000249,Xr Abscess Sinus/Fistula Study,969.0,726.75,651.07,651.07,1
CDM,PX-32000272,Xr Bone Age,648.0,486.0,502.85,601.67,2
CDM,PX-32000278,Xr Bone Density Axial,979.0,734.25,135.24,932.01,8
CDM,PX-32000278,Xr Bone Density Axial|UNUSUAL SEPARATE SERVICE,979.0,734.25,126.27,126.27,1
CDM,PX-32000279,Xr Bone Density Appendicular,676.0,507.0,104.55,104.55,1
CDM,PX-32000364,Xr Fluoro Needle Placement,929.0,696.75,720.9,878.0,3
CDM,PX-32000400,Digital Breast Tomosynthesis Bilateral,316.0,237.0,245.22,300.83,4
CDM,PX-32000401,Screening Digital Breast Tomosynthesis Bi,316.0,237.0,112.35,300.83,8
CDM,PX-32000419,Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 2/3 Vw,694.0,520.5,644.38,644.38,1
CDM,PX-32000423,Radex Hip Unilateral With Pelvis 2-3 Views,450.0,337.5,111.98,393.3,3
CDM,PX-32000425,Radex Hips Bilateral With Pelvis 2 Views,422.0,316.5,126.27,126.27,1
CDM,PX-32000427,Radex Hips Bilateral With Pelvis Minimum 5 Views,607.0,455.25,135.24,135.24,2
CDM,PX-32000436,Radiologic Exam Abdomen 1 View,332.0,249.0,111.98,313.77,3
CDM,PX-32000437,Radiologic Exam Abdomen 2 Views,535.0,401.25,135.24,496.75,3
CDM,PX-32000438,Radiologic Exam Abdomen 3+ Views,540.0,405.0,510.35,510.35,1
CDM,PX-32000439,Radiologic Exam Chest Single View,315.0,236.25,111.98,299.88,4
CDM,PX-32000440,Radiologic Exam Chest 2 Views,419.0,314.25,111.98,398.89,10
CDM,PX-32000448,Radiologic Small Intestine Follow-Through Study,704.0,528.0,546.3,546.3,1
CDM,PX-33000001,Inj Sc/Im Chemo Non-Hormonal Anti-Neoplastic - 96401,292.0,219.0,90.51,90.51,1
CDM,PX-33000002,Inj Sc/Im Chemo Hormonal Anti-Neoplastic � 96402,292.0,219.0,90.51,275.97,6
CDM,PX-33000076,Chem Ivp/ IV <16 Min Initial Single Drug -96409,341.0,255.75,264.62,421.83,2
CDM,PX-33000077,Chemotx Admn Ivp/ IV <16 Min Ea Add�L Seq Diff Drug - 96411,604.0,453.0,90.51,570.84,3
CDM,PX-33000078,Chemo IV Infus Initial Up to 1 Hr - 96413,1415.0,1061.25,421.83,1337.32,5
CDM,PX-33000079,Chemo IV Infus Same Drug Ea Add�L Hr > or = to 31 Min - 96415,221.0,165.75,90.51,208.87,4
CDM,PX-33000080,Chemo IV Infusion Prolong W/Pump,1616.0,1212.0,1254.02,1254.02,1
CDM,PX-33000081,Chem IV Infus Tq Ea Add�L Seq Diff Drug Up to 1 Hr - 96417,697.0,522.75,90.51,658.73,3
CDM,PX-33000129,Chemo Infus > 8 External Pmp,1616.0,1212.0,1254.02,1254.02,1
CDM,PX-35000009,CT Head W/O Contrast,1805.0,1353.75,135.24,1718.36,6
CDM,PX-35000009,CT Head W/O Contrast|UNUSUAL SEPARATE SERVICE,1805.0,1353.75,126.27,126.27,1
CDM,PX-35000011,CT Head W&W/O Contrast,2886.0,2164.5,211.39,2995.87,2
CDM,PX-35000014,CT Orb/Fos/Sel/Ear W/O Contrast,3033.0,2274.75,135.24,135.24,1
CDM,PX-35000017,CT Orb/Fos/Sel/Ear W/Contrast,3545.0,2658.75,2995.87,2995.87,1
CDM,PX-35000021,CT Max/Facial W/O Contrast,2467.0,1850.25,135.24,1914.39,5
CDM,PX-35000022,CT Max/Facial W/Contrast,3015.0,2261.25,2799.43,2799.43,1
CDM,PX-35000024,CT Neck W/O Contrast,2414.0,1810.5,1670.78,1670.78,1
CDM,PX-35000025,CT Neck W/Contrast,2933.0,2199.75,226.4,2995.87,5
CDM,PX-35000027,Cta Head W&W/O Contrast,5935.0,4451.25,226.4,5609.17,5
CDM,PX-35000028,Cta Neck W&W/O Contrast,5968.0,4476.0,226.4,5640.36,5
CDM,PX-35000030,Diagnostic Computed Tomography Thorax W/O Cntrst,2379.0,1784.25,135.24,2248.39,9
CDM,PX-35000031,Diagnostic Computed Tomography Thorax W/Contrast,2895.0,2171.25,226.4,2995.87,11
CDM,PX-35000033,Cta Chest (Noncor) W&W/O Contrast,4259.0,3194.25,226.4,4025.18,8
CDM,PX-35000034,CT C-Spine W/O Contrast,2379.0,1784.25,135.24,2248.39,3
CDM,PX-35000037,CT T-Spine W/O Contrast,2379.0,1784.25,1670.78,1670.78,2
CDM,PX-35000040,CT L-Spine W/O Contrast,2377.0,1782.75,135.24,1670.78,3
CDM,PX-35000044,CT Pelvis W/O Contrast,2228.0,1671.0,126.29,126.29,1
CDM,PX-35000045,CT Pelvis W/Contrast,2729.0,2046.75,226.4,2995.87,2
CDM,PX-35000072,CT Abdomen W/Contrast,3161.0,2370.75,226.4,2995.87,2
CDM,PX-35000073,CT Abdomen W&W/O Contrast,4274.0,3205.5,226.4,2995.87,2
CDM,PX-35000074,CT Abd/Pelvis W/Wocontrast Post,4626.0,3469.5,454.18,5730.46,3
CDM,PX-35000075,Cta Abdomen W&W/O Contrast,4417.0,3312.75,211.39,4174.51,3
CDM,PX-35000076,CT Abdomen & Pelvis W/O Contrast,4486.0,3364.5,307.41,4165.25,7
CDM,PX-35000077,CT Abdomen & Pevis With Contrast,5893.0,4419.75,454.18,5610.14,7
CDM,PX-35000078,CT Abdomen & Pelvis W/O&W Contras,7844.0,5883.0,454.18,7283.15,3
CDM,PX-35000079,CT Hrt W/O Cntrst W/Ca Test,525.0,393.75,925.12,925.12,2
CDM,PX-35000080,CT Hrt W/3d Image,937.0,702.75,454.18,454.18,1
CDM,PX-35000082,CT Angio Hrt W/3d Image,4268.0,3201.0,454.18,4063.14,5
CDM,PX-35000083,Cta Abd Aorta W/&W/O Runoff,4732.0,3549.0,211.39,211.39,1
CDM,PX-35000096,Low Dose CT Lung Screening,1356.0,1017.0,135.24,1259.05,5
CDM,PX-35000100,Whole Body CT Myeloma Survey,3699.0,2774.25,111.98,111.98,1
CDM,PX-35000103,N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp,6807.0,5105.25,1293.86,6480.26,3
CDM,PX-36000099,Excision Single External Papilla or Tag Anus,2234.0,1675.5,1120.45,1120.45,1
CDM,PX-36000168,Abdom Paracentesis Dx/Ther W/Imaging Guidance,564.0,423.0,1192.34,1192.34,2
CDM,PX-39000004,Red Cells L/R Ea,771.0,578.25,194.92,715.87,3
CDM,PX-39000020,Red Cells L/R Irr Ea,1510.0,1132.5,273.96,273.96,1
CDM,PX-39000069,"Platelets, Pheresis, Pathogen-Reduced, Each Unit",3413.0,2559.75,587.28,587.28,1
CDM,PX-39100001,Transfusion Blood/Comp,3527.0,2645.25,555.98,2736.95,2
CDM,PX-40000009,Diagnostic Mammo Bilat 2d Digital (Incl. Cad),721.0,540.75,559.5,686.39,5
CDM,PX-40000029,US Soft Tissue Head/Neck,1311.0,983.25,135.24,1248.07,11
CDM,PX-40000030,US Chest,747.0,560.25,135.24,321.65,2
CDM,PX-40000030,US Chest|REDUCED SERVICES,747.0,560.25,135.24,135.24,1
CDM,PX-40000032,US Abdomen Cmpl,1339.0,1004.25,135.24,1265.49,7
CDM,PX-40000033,US Abdomen Ltd,1332.0,999.0,135.24,1268.06,11
CDM,PX-40000034,US Retroperitioneal Cmpl,1332.0,999.0,135.24,1268.06,10
CDM,PX-40000038,US Pregnancy <14 Weeks Single,1042.0,781.5,135.24,991.98,9
CDM,PX-40000040,US Pregnancy >14 Weeks Single,1220.0,915.0,321.65,1132.77,4
CDM,PX-40000042,US Pregnancy Detailed Single,1542.0,1156.5,659.15,1457.34,5
CDM,PX-40000044,US Pregnancy Nuchal Meas Sgl/1st,880.0,660.0,682.88,837.76,3
CDM,PX-40000046,US Pregnancy Ltd,742.0,556.5,575.79,688.95,2
CDM,PX-40000047,US Pregnancy Followup per Fetus,988.0,741.0,766.69,933.76,3
CDM,PX-40000048,US Pregnancy Transvaginal,832.0,624.0,321.65,786.32,5
CDM,PX-40000050,US Fetal Biophysical Profile W/O,725.0,543.75,562.6,673.16,3
CDM,PX-40000053,US Transvaginal,1050.0,787.5,135.24,999.6,7
CDM,PX-40000054,US Saline Infus Son Incl Color Flow,774.0,580.5,659.15,659.15,1
CDM,PX-40000055,US Pelvis Non OB,1123.0,842.25,135.24,1069.1,7
CDM,PX-40000056,US Pelvis Non OB Ltd,907.0,680.25,135.24,857.21,6
CDM,PX-40000057,US Scrotum,1037.0,777.75,135.24,980.07,6
CDM,PX-40000065,US Lmtd Jt/Fcl Eval Nonvasc Xtr Strux R-T W/Img,212.0,159.0,135.24,135.24,1
CDM,PX-40000097,Mammogram Screen Bilat Digital (Incl. Cad),610.0,457.5,442.83,580.72,8
CDM,PX-40000140,US Breast Uni Real Time With Image Limited,398.0,298.5,347.85,376.15,2
CDM,PX-40000148,US Abdominal Aorta Real Time Screen Study Aaa,398.0,298.5,135.24,321.65,3
CDM,PX-42000009,Pt Traction Mechanical,168.0,126.0,130.37,130.37,1
CDM,PX-42000017,Pt E-Stim Attended 15 Min,168.0,126.0,14.66,130.37,2
CDM,PX-42000020,Pt Ultrasound 15 Min,168.0,126.0,14.37,146.83,3
CDM,PX-42000023,Pt Exercise Therapeutic 15 Min,166.0,124.5,29.82,156.89,6
CDM,PX-42000024,Pt Neuromuscular Re-ED 15 Min,195.0,146.25,33.18,184.29,4
CDM,PX-42000026,Pt Gait Training 15 Min,168.0,126.0,130.37,130.37,1
CDM,PX-42000027,Pt Massage 15 Min,168.0,126.0,30.99,30.99,1
CDM,PX-42000029,Pt Manual Therapy 15 Min,153.0,114.75,28.13,142.06,4
CDM,PX-42000031,Pt Therapeutic Activity 15 Min,195.0,146.25,36.01,184.29,4
CDM,PX-42000034,Pt Home Instruction/Program 15min,279.0,209.25,216.5,216.5,1
CDM,PX-42000090,Bwh Electrical Stim (Unattended) Non Time Based Pt,130.0,97.5,100.88,100.88,1
CDM,PX-42000098,"Physical Therapy Evaluation, Low Complexity",408.0,306.0,101.45,385.6,5
CDM,PX-42000099,"Physical Therapy Evaluation, Moderate Complexity",408.0,306.0,101.45,375.36,4
CDM,PX-42000100,"Physical Therapy Evaluation, High Complexity",408.0,306.0,316.61,316.61,1
CDM,PX-42000103,Physical Therapy Re-Eval Est Plan Care 20 Mins,408.0,306.0,316.61,316.61,1
CDM,PX-43000010,Ot Traction Mechanical,168.0,126.0,130.37,130.37,1
CDM,PX-43000017,Ot E-Stim Attended 15 Min,168.0,126.0,14.66,130.37,2
CDM,PX-43000020,Ot Ultrasound 15 Min,168.0,126.0,14.37,146.83,3
CDM,PX-43000023,Ot Exercise Therapeutic 15 Min,166.0,124.5,29.82,156.89,6
CDM,PX-43000024,Ot Neuromuscular Re-ED 15 Min,195.0,146.25,33.18,184.29,4
CDM,PX-43000027,Ot Massage 15 Min,168.0,126.0,30.99,30.99,1
CDM,PX-43000029,Ot Manual Therapy 15 Min,153.0,114.75,28.13,142.06,4
CDM,PX-43000031,Ot Therapeutic Activity 15 Min,195.0,146.25,36.01,184.29,4
CDM,PX-43000034,Ot Home Instruction/Program 15min,279.0,209.25,216.5,216.5,1
CDM,PX-43000079,"97014 E-Stim, Unattended",130.0,97.5,100.88,100.88,1
CDM,PX-43000108,"Occupational Therapy Evaluation, Low Complexity",408.0,306.0,104.2,316.61,2
CDM,PX-44000005,St Treatment Speech/Lang/Comm Ind,785.0,588.75,609.16,686.09,2
CDM,PX-44000012,St Eval Swallow Video/Fluoro,535.0,401.25,415.16,415.16,1
CDM,PX-44000059,Evaluate Speech Production,457.0,342.75,354.63,354.63,1
CDM,PX-44000060,Speech Sound Lang Comprehen,1045.0,783.75,810.92,810.92,1
CDM,PX-45000004,Emergency Department Visit Moderate Mdm,995.0,746.25,505.69,505.69,1
CDM,PX-45000004,"Emergency Department Visit Moderate Mdm|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE OR OTHER SERVICE",995.0,746.25,505.64,505.64,1
CDM,PX-45000005,Emergency Department Visit High Mdm,1195.0,896.25,779.71,1137.64,10
CDM,PX-45000006,HC Critical Care; First 30-74 Minutes,1564.0,1173.0,1000.55,1488.93,9
CDM,PX-45000007,Critical Care; Ea Add 30 Minutes,431.0,323.25,376.69,407.34,2
CDM,PX-46000001,Nonpressurized Inhalation Treatment,380.0,285.0,258.66,294.88,2
CDM,PX-46000007,Aerosol Neb/Mdi/Ippb Demo/Eval,289.0,216.75,212.49,212.49,1
CDM,PX-46000014,Spirometry/Pft Smp,628.0,471.0,163.46,163.46,1
CDM,PX-46000020,Spirometry/Pft Pre & Post Bronch,1134.0,850.5,396.02,396.02,4
CDM,PX-48000189,Echo Transthoracic W/WO Fol W/Cont|PROFESSIONAL COMPONENT,944.0,708.0,307.41,307.41,2
CDM,PX-48000416,Echo Transthorc R-T 2d W/WO M-Mode Rec F-Up/Lmtd|PROFESSIONAL COMPONENT,944.0,708.0,307.41,307.41,2
CDM,PX-48000419,Echo Tthrc R-T 2d W/Wom-Mode Compl Spec&Colr D,1880.0,1410.0,697.3,1789.76,7
CDM,PX-51000080,"Office Visit, Established Pat",41.0,30.75,31.82,31.82,1
CDM,PX-51000082,"Office Visit, Established Pat",211.0,158.25,163.74,195.91,3
CDM,PX-51000082,"Office Visit, Established Pat|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE OR OTHER SERVICE",211.0,158.25,166.9,166.9,1
CDM,PX-61000015,MRI Orbit/Face/Neck W&W/O Cont,6741.0,5055.75,454.18,5730.46,2
CDM,PX-61000016,MRI Brain W/O Cont,5130.0,3847.5,307.41,4848.36,7
CDM,PX-61000017,MRI Brain W/Cont,5751.0,4313.25,5730.46,5730.46,1
CDM,PX-61000018,MRI Brain W&W/O Cont,6667.0,5000.25,454.18,6346.98,8
CDM,PX-61000024,MRI C-Spine W/O Cont,4538.0,3403.5,307.41,4288.86,7
CDM,PX-61000026,MRI T-Spine W/O Cont,4551.0,3413.25,307.41,4225.6,4
CDM,PX-61000028,MRI L-Spine W/O Cont,4511.0,3383.25,307.41,4263.35,8
CDM,PX-61000030,MRI C-Spine W&W/O Cont,6628.0,4971.0,454.18,5730.46,2
CDM,PX-61000031,MRI T-Spine W&W/O Cont,6113.0,4584.75,454.18,5730.46,2
CDM,PX-61000032,MRI L-Spine W&W/O Cont,6552.0,4914.0,454.18,5730.46,3
CDM,PX-61000035,MRI Chest W/O Cont,5559.0,4169.25,5161.53,5161.53,1
CDM,PX-61000037,MRI Chest W&W/O Cont,7926.0,5944.5,6150.58,6150.58,1
CDM,PX-61000038,MRI Pelvis W/O Cont,5091.0,3818.25,307.41,3950.62,3
CDM,PX-61000040,MRI Pelvis W&W/O Cont,6834.0,5125.5,454.18,6458.81,6
CDM,PX-61000050,MRI Upr Ext Joint W/O Cont,4806.0,3604.5,307.41,307.41,1
CDM,PX-61000062,MRI Lwr Ext Joint W/O Cont,4898.0,3673.5,307.41,307.41,1
CDM,PX-61000065,MRI Abdomen W/O Cont,4446.0,3334.5,307.41,4232.59,3
CDM,PX-61000067,MRI Abdomen W&W/O Cont,6847.0,5135.25,454.18,6518.34,9
CDM,PX-61000083,Mra Head W&W/O Cont|UNUSUAL SEPARATE SERVICE,7510.0,5632.5,454.18,454.18,1
CDM,PX-61000085,Mra Neck W/Cont,5211.0,3908.25,5730.46,5730.46,1
CDM,PX-61000086,Mra Neck W&W/O Cont,7503.0,5627.25,5730.46,7142.86,2
CDM,PX-61000105,Mra Chest W&W/O Contrast,4875.0,3656.25,424.07,4607.36,2
CDM,PX-61000123,Mra Abdomen W&W/O Cont,4897.0,3672.75,424.11,424.11,1
CDM,PX-61000124,MRI Breast Bilat W&W/O Cont,8060.0,6045.0,454.18,454.18,1
CDM,PX-61000158,MRI Breast W/Out&With Contrast W/Cad Unilateral,2029.0,1521.75,1574.5,1574.5,1
CDM,PX-61000159,MRI Breast Without&With Contrast W/Cad Bilateral,2019.0,1514.25,1566.74,6776.35,7
CDM,PX-72000007,Test Non Stress Fetal,1046.0,784.5,811.7,995.79,5
CDM,PX-72000018,Version Cephalic External,800.0,600.0,2700.25,2700.25,1
CDM,PX-72000026,Surg Tx Abortion Incmpl,4210.0,3157.5,2700.25,2700.25,2
CDM,PX-72000027,Surg Tx Abortion Missed 1st Trimest,5095.0,3821.25,2700.25,3953.72,2
CDM,PX-73000001,Ekg Routine Tracing Only,275.0,206.25,75.54,261.8,9
CDM,PX-73000007,Ecg Monitor/Report Up to 48 Hrs Rec,888.0,666.0,824.51,824.51,1
CDM,PX-73000007,Ecg Monitor/Report Up to 48 Hrs Rec|RCRDG/STRG IN SLD ST MEMORY,888.0,666.0,163.93,163.93,2
CDM,PX-73000029,External Ecg Rec>48hr<7d Recording,1082.0,811.5,49.92,1022.6,6
CDM,PX-73000033,External Ecg Rec>7d<15d Recording,1442.0,1081.5,49.92,1362.83,5
CDM,PX-75000006,Drain Absc/Cyst Vestib Mouth Smp,1267.0,950.25,1160.7,1160.7,1
CDM,PX-75000087,Egd Flex Dx W/Brushing/Washing,1913.0,1434.75,870.88,1807.98,7
CDM,PX-75000091,Egd Flex Transoral W/Biopsy,1913.0,1434.75,870.88,1807.98,8
CDM,PX-75000096,Egd W/Band Ligate Varices Esop/Gast,1630.0,1222.5,1513.46,1513.46,1
CDM,PX-75000101,Egd Flex W/Balloon Dilation <30mm,1913.0,1434.75,1696.3,2412.49,3
CDM,PX-75000156,Endo Eval Small Intest Pouch Biopsy,2965.0,2223.75,1082.6,1082.6,1
CDM,PX-75000180,Sigmoidoscopy Flexible,1077.0,807.75,851.82,1159.47,3
CDM,PX-75000181,Sigmoidoscopy W/Biopsy,1913.0,1434.75,1159.47,1776.22,2
CDM,PX-75000193,Colonoscopy Flexible,3451.0,2588.25,851.82,3285.35,8
CDM,PX-75000195,Colonoscopy W/Biopsy Single/Multiple,2524.0,1893.0,1120.45,2385.43,9
CDM,PX-75000200,Colonoscopy Flex W/Rem Tumor Snare,2524.0,1893.0,1120.45,2343.53,6
CDM,PX-75000240,Biopsy Liver Needle Perc,2182.0,1636.5,1572.96,1692.76,2
CDM,PX-75000278,Abdominal Paracentesis W/ Imaging,2778.0,2083.5,870.88,1192.34,3
CDM,PX-75000329,Colon Cancer Scr Colonoscopy,1913.0,1434.75,1159.47,1159.47,1
CDM,PX-75000330,Colon Cancer Scr Non-Hr,1913.0,1434.75,1159.47,1159.47,1
CDM,PX-75000417,Colonoscopy Flx Dx W/Collj Spec When Pfrmd,3451.0,2588.25,851.82,3285.35,8
CDM,PX-75000418,Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq,2524.0,1893.0,1120.45,2343.53,6
CDM,PX-75000452,"Dest Intrnl Hemrrhds, Thermal",698.0,523.5,1120.45,1499.49,2
CDM,PX-76000008,Incision/Remove FB Subq Smp,436.0,327.0,359.17,359.17,1
CDM,PX-76000011,Aspiration Abscess/Hema/Bulla/Cyst,193.0,144.75,359.17,359.17,1
CDM,PX-76000022,Debride Skin/Subq Tissue,200.0,150.0,359.17,474.42,2
CDM,PX-76000033,Remove Tag Skin <15,111.0,83.25,201.78,201.78,1
CDM,PX-76000035,Shave Lesn Trunk/Arm/Leg <0.5cm,131.0,98.25,201.78,201.78,1
CDM,PX-76000047,Exc Lesn Bgn Trunk/Arm/Leg <0.5cm,1077.0,807.75,662.51,835.47,2
CDM,PX-76000048,Exc Lesn Bgn Trunk/Arm/Leg .6-1.0cm,1077.0,807.75,359.17,835.75,4
CDM,PX-76000049,Exc Lesn Bgn Trunk/Arm/Leg 1.1-2.0,1077.0,807.75,662.51,999.99,3
CDM,PX-76000050,Exc Lesn Bgn Trunk/Arm/Leg 2.1-3.0,1077.0,807.75,662.51,894.79,2
CDM,PX-76000053,Exc Lesn Bgn Sclp/Hnd/Gen <0.5cm,1077.0,807.75,999.99,999.99,1
CDM,PX-76000054,Exc Lesn Bgn Sclp/Hnd/Gen 0.6-1.0cm,1077.0,807.75,662.51,894.79,2
CDM,PX-76000060,Exc Lesn Bgn Face/Ear/Lip 0.6-1.0cm,1077.0,807.75,662.51,662.51,1
CDM,PX-76000069,Exc Lesn Mal Trunk/Arm/Leg .6-1.0cm,655.0,491.25,894.79,894.79,1
CDM,PX-76000070,Exc Lesn Mal Trunk/Arm/Leg 1.1-2.0,1077.0,807.75,359.17,359.17,1
CDM,PX-76000073,Exc Lesn Mal Trunk/Arm/Leg >4.0cm,3467.0,2600.25,1923.94,2690.39,3
CDM,PX-76000075,Exc Lesn Mal Sclp/Hnd/Gen 0.6-1.0cm,1077.0,807.75,662.51,894.79,2
CDM,PX-76000080,Exc Lesn Mal Face/Ear/Lip <0.5cm,1077.0,807.75,835.75,835.75,1
CDM,PX-76000081,Exc Lesn Mal Face/Ear/Lip 0.6-1.0cm,724.0,543.0,835.47,835.47,1
CDM,PX-76000121,Rpr Lac Intermd Scalp/Axil <2.5cm,577.0,432.75,359.17,474.42,2
CDM,PX-76000205,Dress/Debride Burn <5% Total Sm,272.0,204.0,211.07,211.07,1
CDM,PX-76000210,Dest Lesn Premalignant 1st Lesion,257.0,192.75,201.78,235.94,2
CDM,PX-76000216,Destruct Benign Lesion Up to 14 Les,297.0,222.75,201.78,201.78,1
CDM,PX-76000227,Dest Lesn Mal Sclp/Hnd/Gen 1.1-2.0,697.0,522.75,252.7,252.7,1
CDM,PX-76000289,Inject Trigger Point 1-2 Muscle(S),723.0,542.25,283.01,671.31,4
CDM,PX-76000290,Inject Trigger Pt 3+ Muscle Groups,698.0,523.5,283.01,283.01,1
CDM,PX-76000341,Exc Tum Tiss Neck/Ant Thx Subq 3+,2138.0,1603.5,3639.81,3639.81,1
CDM,PX-76000352,Exc Tumor Back/Flank <3cm,1888.0,1416.0,1572.96,1572.96,1
CDM,PX-76000353,Exc Tumor Back/Flank Subq 3cm or Gr,2095.0,1571.25,1572.96,1572.96,1
CDM,PX-76001104,Rem Tnld Cv Cath W/O Port/Pump,1913.0,1434.75,709.02,734.15,2
CDM,PX-76001105,Rem Tnld Cv Access W/Port/Pump,2965.0,2223.75,709.02,2802.22,3
CDM,PX-76001106,Collect Blood Port/Access Dvc,138.0,103.5,121.77,163.93,3
CDM,PX-76001108,HC Collect Blood From Catheter Venous,170.0,127.5,121.77,163.93,2
CDM,PX-76001110,Declot Port Thrombolytic Agent,262.0,196.5,329.78,421.83,2
CDM,PX-76001258,Catheter Bladder Smp,316.0,237.0,163.93,163.93,1
CDM,PX-76001276,Cystourethroscopy,2182.0,1636.5,642.96,2025.99,5
CDM,PX-76001320,Vasectomy Semen Exam Postop,1913.0,1434.75,1989.5,1989.5,2
CDM,PX-76001374,Conization Cervix Loop Elect Exc,3467.0,2600.25,2700.25,2700.25,1
CDM,PX-76001382,Insert Intrauterine Device- 58300,1430.0,1072.5,89.94,1327.76,3
CDM,PX-76001383,Remove Device Intrauterine Iud,653.0,489.75,189.75,189.75,1
CDM,PX-76001392,Hysteroscopy Biopsy Endometrium,4466.0,3349.5,2700.25,4146.68,5
CDM,PX-76001396,Hysteroscopy Rem FB Impacted,1440.0,1080.0,1337.04,2700.25,2
CDM,PX-76001397,Hysteroscopy Ablat Endometrial,1698.0,1273.5,4718.12,4718.12,1
CDM,PX-76001462,Lumbar Puncture Diagnostic,716.0,537.0,822.33,822.33,2
CDM,PX-76001973,Image-Guided Catheter Fluid Collection Drainage,798.0,598.5,662.51,835.47,2
CDM,PX-76002270,Tracheotomy Tube Change,45.0,33.75,230.53,230.53,1
CDM,PX-76002357,Tendon Sheath Incision,3141.0,2355.75,2035.32,2035.32,1
CDM,PX-76002392,Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn,2392.0,1794.0,684.77,880.71,3
CDM,PX-76002481,Diagnostic Bone Marrow Biopsies & Aspirations,442.0,331.5,3398.51,3398.51,1
CDM,PX-76002556,Fine Needle Aspiration Bx W/US Gdn 1st Lesion,400.0,300.0,310.4,894.79,4
CDM,PX-76002565,Tangential Biopsy Skin Single Lesion,226.0,169.5,201.78,252.7,2
CDM,PX-76002567,Punch Biopsy Skin Single Lesion,285.0,213.75,508.1,508.1,1
CDM,PX-76200001,Observation 1 Hr,134.0,100.5,103.98,127.57,4
CDM,PX-76200002,Observation 1 Hr,134.0,100.5,103.98,127.57,4
CDM,PX-76200003,Observation 1 Hr,134.0,100.5,103.98,127.57,4
CDM,PX-76200004,Observation 1 Hr,134.0,100.5,103.98,127.57,4
CDM,PX-76200005,Observation 1 Hr,134.0,100.5,103.98,127.57,4
CDM,PX-76200006,Observation 1 Hr,134.0,100.5,103.98,127.57,4
CDM,PX-76200008,Observation Carve Out (10000 - 29999) - Integumentary/Musculoskeletal,134.0,100.5,103.98,127.57,4
CDM,PX-76200009,Observation Carve Out (50000 - 59999) - Urinary/Male/Female/Maternity,134.0,100.5,103.98,127.57,4
CDM,PX-76200010,Observation Carve Out (60000 - 69999) - Endo/Nervous/Eye/Auditory,134.0,100.5,103.98,127.57,4
CDM,PX-76200012,Observation Carve Out (90785 - 98965) - Medicine,134.0,100.5,103.98,127.57,4
CDM,PX-77100003,Immune Admin One Vacc Im/Sub-Q/ID,33.0,24.75,25.61,25.61,1
CDM,PX-77100007,Admin of Influenza Vaccine,33.0,24.75,58.68,58.68,1
CDM,PX-77100020,Vfc Imadm Prq ID Subq/Im Njxs 1 Vaccine,23.0,17.25,17.85,17.85,1
CDM,PX-77100024,Vfc Admin Influenza Virus Vac,23.0,17.25,58.68,58.68,1
CDM,PX-77100027,Imm Admn Sarscov2 30mcg/0.3ml Dil Recon 1st Dose,75.0,56.25,58.2,58.2,1
CDM,PX-77100028,Imm Admn Sarscov2 30mcg/0.3ml Dil Recon 2nd Dose,75.0,56.25,58.2,58.2,1
CDM,PX-77100073,Imm Admn Sarscov2 Vaccine Single Dose,75.0,56.25,52.8,70.71,2
CDM,PX-77100076,Vfc Im Admn Sarscov2 Vaccine Sngl Dose,23.0,17.25,21.68,52.8,2
CDM,PX-90000123,Hospital IP/Obs Discharge Day Mgmt > 30 Min,454.0,340.5,352.3,432.21,5
CDM,PX-90000170,Crisis Intervention Mental Health Services,3211.0,2408.25,2491.74,2491.74,1
CDM,PX-92000023,Duplex Extracranial/Carotid Bilat,2196.0,1647.0,307.41,2075.44,3
CDM,PX-92000039,Duplex Venous Extremity Bilat,2227.0,1670.25,307.41,2104.74,3
CDM,PX-92000042,Duplex Abd/Pel/Retro Cmpl,3256.0,2442.0,3023.2,3023.2,1
CDM,PX-92000044,Duplex Aorta/Ivc/Graft Cmpl,2162.0,1621.5,307.41,2043.31,3
CDM,PX-94000007,Irrigat Implant Ven Access Dvc,255.0,191.25,75.54,222.87,4
CDM,PX-94000018,Nutrition Therapy Eval 15 Min,97.0,72.75,75.27,92.34,5
CDM,PX-94000019,Nutrition Therapy Re-Eval 15 Min,97.0,72.75,75.27,92.34,4
CDM,PX-98300012,Pf Debr Skin/Subq Tissue,223.0,167.25,474.42,474.42,1
CDM,PX-98300035,Pf Exc Lesn Bgn Trnk/Arm <0.5cm,355.0,266.25,835.47,835.47,1
CDM,PX-98300036,Pf Exc Lesn Bgn Trnk/Arm .6-1.0cm,494.0,370.5,383.34,508.1,2
CDM,PX-98300037,Pf Exc Lesn Bgn Trnk/Arm 1.1-2.0cm,542.0,406.5,503.25,894.79,2
CDM,PX-98300038,Pf Exc Lesn Bgn Trnk/Arm 2.1-3.0cm,691.0,518.25,894.79,894.79,1
CDM,PX-98300041,Pf Exc Lesn Bgn Sclp/Hnd <0.5cm,392.0,294.0,363.97,363.97,1
CDM,PX-98300042,Pf Exc Lesn Bgn Sclp/Hnd 0.6-1.0cm,530.0,397.5,894.79,894.79,1
CDM,PX-98300054,Pf Exc Lesn Mal Trnk/Arm .6-1.0cm,714.0,535.5,894.79,894.79,1
CDM,PX-98300058,Pf Exc Lesn Mal Trnk/Arm >4.0cm,1486.0,1114.5,1153.14,1923.94,3
CDM,PX-98300060,Pf Exc Lesn Mal Sclp/Hnd 0.6-1.0cm,721.0,540.75,894.79,894.79,1
CDM,PX-98300065,Pf Exc Lesn Mal Face/Ear <0.5cm,598.0,448.5,464.05,464.05,1
CDM,PX-98300066,Pf Exc Lesn Mal Face/Ear 0.6-1.0cm,760.0,570.0,835.47,835.47,1
CDM,PX-98300100,Pf Rpr Lac Int Sclp/Ax <2.5cm,340.0,255.0,474.42,474.42,1
CDM,PX-98300112,Pf Dress/Debr Burn <5% Sm,157.0,117.75,121.83,121.83,1
CDM,PX-98300115,Pf Dest Lesn Premalig 1st Lesion,274.0,205.5,235.94,235.94,1
CDM,PX-98300127,Pf Dest Lesn Mal Sclp/Hnd 1.1-2.0cm,609.0,456.75,252.7,252.7,1
CDM,PX-98300150,Pf Inject Trigger Point 1-2 Muscle,185.0,138.75,171.77,350.56,3
CDM,PX-98300166,Pf Exc Tum Tiss N/Ant Thx Subq 3+,2175.0,1631.25,3639.81,3639.81,1
CDM,PX-98300171,Pf Exc Tumr Back/Flank Subq 3cm +,2264.0,1698.0,1572.96,1572.96,1
CDM,PX-98300307,Pf Rem Tnl Cv W/O Port/Pump,673.0,504.75,734.15,734.15,1
CDM,PX-98300308,Pf Rem Tnl Cv Acc W/Port/Pump,1279.0,959.25,1208.78,1975.58,2
CDM,PX-98300339,Pf Sigmoidoscopy Flex,656.0,492.0,1159.47,1159.47,1
CDM,PX-98300355,Pf Catheter Bladder Smp,448.0,336.0,163.93,163.93,1
CDM,PX-98300404,Pf Insert Intrauterine Device,250.0,187.5,232.13,232.13,1
CDM,PX-98300407,Pf Hysteroscopy W/Biopsy Sample,2019.0,1514.25,1566.74,3775.5,3
CDM,PX-98300415,Pf Puncture Spinal Lumbar Diag,182.0,136.5,822.33,822.33,2
CDM,PX-98300490,Pf Xr Fluoro Biopsy/Aspiration,133.0,99.75,103.21,125.7,3
CDM,PX-98300496,Pf Spirometry Smp,39.0,29.25,163.46,163.46,1
CDM,PX-98300497,Pf Spirometry/Pft Pre & Post B,69.0,51.75,396.02,396.02,4
CDM,PX-98300520,"Office Visit, Established Pat",40.0,30.0,31.04,31.04,1
CDM,PX-98300522,"Office Visit, Established Pat",212.0,159.0,164.51,196.84,3
CDM,PX-98300522,"Office Visit, Established Pat|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE OR OTHER SERVICE",212.0,159.0,167.69,167.69,1
CDM,PX-98300811,1st Hospital IP/Obs Care Sf/Low Mdm 40 Minutes,440.0,330.0,403.08,418.88,5
CDM,PX-98300812,1st Hospital IP/Obs Care Moderate Mdm 55 Minutes,601.0,450.75,466.38,572.15,5
CDM,PX-98300813,1st Hospital IP/Obs Care High Mdm 75 Minutes,882.0,661.5,684.43,839.66,5
CDM,PX-98300814,Sbsq Hospital IP/Obs Care Sf/Low Mdm 25 Minutes,98.0,73.5,85.65,92.62,3
CDM,PX-98300815,Sbsq Hospital IP/Obs Care Mod Mdm 35 Minutes,321.0,240.75,249.1,305.59,3
CDM,PX-98300816,Hospital IP/Obs Discharge Day Mgmt 30 Min/<,319.0,239.25,247.54,303.69,5
CDM,PX-98300835,Drg Absc Cst Hmtma Vestibule Mouth Smpl,584.0,438.0,535.0,535.0,1
CDM,PX-98301047,Esophagogastroduodenoscopy Transoral Diagnostic,1538.0,1153.5,1192.34,1453.56,5
CDM,PX-98301048,Egd Transoral Biopsy Single/Multiple,1701.0,1275.75,1192.34,1607.62,5
CDM,PX-98301068,Laparoscopic Appendectomy,2611.0,1958.25,2282.01,7419.84,4
CDM,PX-98301070,Sigmoidoscopy Flx W/Biopsy Single/Multiple,850.0,637.5,789.23,1159.47,2
CDM,PX-98301072,Colonoscopy Flx Dx W/Collj Spec When Pfrmd,1221.0,915.75,947.5,1162.39,6
CDM,PX-98301073,Colonoscopy W/Biopsy Single/Multiple,2376.0,1782.0,1499.49,2245.56,7
CDM,PX-98301076,Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq,1434.0,1075.5,1331.47,1499.49,4
CDM,PX-98301083,Hemorrhoidectomy Int & Xtrnl 2/> Column/Gro,2753.0,2064.75,2669.73,2669.73,1
CDM,PX-98301089,Destruction Internal Hemorrhoid Thermal Energy,735.0,551.25,1499.49,1499.49,1
CDM,PX-98301093,Laparoscopy Surg Cholecystectomy,3258.0,2443.5,3025.05,5255.62,3
CDM,PX-98301150,Laparoscopy W/Rmvl Adnexal Structures|BILATERAL PROCEDURE,3544.0,2658.0,7883.43,7883.43,1
CDM,PX-98301158,Fetal Nonstress Test,139.0,104.25,107.86,132.33,5
CDM,PX-98301163,External Cephalic Version W/WO Tocolysis,854.0,640.5,2700.25,2700.25,1
CDM,PX-98301170,Tx Missed Abortion First Trimester Surgical,1708.0,1281.0,1325.41,1325.41,1
CDM,PX-98301180,US Abdominal Real Time W/Image Limited,133.0,99.75,103.21,321.65,11
CDM,PX-98301181,US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat,95.0,71.25,73.72,321.65,9
CDM,PX-98301182,US Preg Uterus W/Detail Fetal Anat 1st Gestation,235.0,176.25,182.36,659.15,5
CDM,PX-98301183,US Pregnant Uterus Limited 1/> Fetuses,95.0,71.25,73.72,88.21,2
CDM,PX-98301184,US Preg Uterus Real Time F/U Trnsabdl per Fetus,95.0,71.25,73.72,89.78,3
CDM,PX-98301185,US Preg Uterus Real Time W/Image Dcmtn Transvag,95.0,71.25,73.72,321.65,5
CDM,PX-98301186,Fetal Biophysical Profile W/O Non-Stress Testing,153.0,114.75,118.73,142.06,3
CDM,PX-98301208,Observation Care Discharge Management,286.0,214.5,221.94,272.27,5
CDM,PX-98301209,Initial Observation Care/Day 50 Minutes,441.0,330.75,404.0,419.83,5
CDM,PX-98301210,Initial Observation Care/Day 70 Minutes,617.0,462.75,565.23,587.38,5
CDM,PX-98301211,Sbsq Observation Care/Day 25 Minutes,219.0,164.25,191.41,206.98,3
CDM,PX-98301212,Sbsq Observation Care/Day 35 Minutes,455.0,341.25,397.67,430.02,3
CDM,PX-98301214,Hospital IP/Obs Care Same Date Mod Mdm 70 Min,759.0,569.25,704.73,704.73,1
CDM,PX-98301216,Hospital IP/Obs Discharge Day Mgmt > 30 Min,467.0,350.25,362.39,444.58,5
CDM,PX-98301224,Emergency Department Visit Moderate Mdm,321.0,240.75,505.69,505.69,1
CDM,PX-98301224,"Emergency Department Visit Moderate Mdm|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE OR OTHER SERVICE",321.0,240.75,505.64,505.64,1
CDM,PX-98301225,Emergency Department Visit High Mdm,504.0,378.0,391.1,779.71,10
CDM,PX-98301226,Critical Care Ill/Injured Patient Init 30-74 Min,556.0,417.0,431.46,1000.55,9
CDM,PX-98301227,Critical Care Ill/Injured Patient Addl 30 Min,276.0,207.0,241.22,260.85,2
CDM,PX-98301238,Colorectal Scrn; Hi Risk Ind,293.0,219.75,1159.47,1159.47,1
CDM,PX-98301239,Colon Ca Scrn Not Hi Rsk Ind,305.0,228.75,1159.47,1159.47,1
CDM,PX-98301285,Initial Observation Care/Day 30 Minutes,434.0,325.5,397.59,413.17,5
CDM,PX-98301307,Sbsq Observation Care/Day 15 Minutes,123.0,92.25,107.5,116.25,3
CDM,PX-98301327,Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn,507.0,380.25,880.71,880.71,2
CDM,PX-98301399,Sono Pelvis Limited,116.0,87.0,90.02,321.65,6
CDM,PX-98301430,"US, OB >/= 14 Wks, Sngl Fetus",154.0,115.5,119.5,321.65,4
CDM,PX-98301432,"US,Preg Uter,Fet & Mat,+ Detl Fet Exm",235.0,176.25,182.36,659.15,5
CDM,PX-98301434,"US,Preg Uter,Nuchal Meas, 1st Trimest, Singleton",271.0,203.25,210.3,257.99,3
CDM,PX-98301672,Diagnostic Bone Marrow Biopsies & Aspirations,400.0,300.0,3398.51,3398.51,1
CDM,PX-98301761,US Cardiac Echo Limited|PROFESSIONAL COMPONENT,115.0,86.25,307.41,307.41,2
CDM,PX-98301808,Fine Needle Aspiration Bx W/US Gdn 1st Lesion,353.0,264.75,273.93,894.79,2
CDM,PX-98301817,Tangential Biopsy Skin Single Lesion,207.0,155.25,252.7,252.7,1
CDM,PX-98301819,Punch Biopsy Skin Single Lesion,258.0,193.5,508.1,508.1,1
CDM,PX-98301857,Image-Guided Catheter Fluid Collection Drainage,731.0,548.25,835.47,835.47,1
CDM,PX-98302041,US Lmtd Jt/Fcl Eval Nonvasc Xtr Strux R-T W/Img,118.0,88.5,135.24,135.24,1
CDM,PX-98302062,US Soft Tissue Head & Neck Real Time Imge Docm,128.0,96.0,99.33,321.65,11
CDM,PX-98302083,"US, Chest, Real Time",137.0,102.75,135.24,321.65,2
CDM,PX-98302083,"US, Chest, Real Time|REDUCED SERVICES",137.0,102.75,135.24,135.24,1
CDM,PX-98302115,Ultrasound Scrotum & Contents,140.0,105.0,108.64,321.65,6
CDM,PX-98302414,US Breast Uni Real Time With Image Limited,147.0,110.25,128.48,138.93,2
CDM,PX-98500002,12 Lead Ecg Interpretation and Report Only,41.0,30.75,31.82,39.03,5
CDM,SUP-ITM-10002679,MESH SYNTHETIC 6.0 XIN ABDOMINAL NON ABSORBABLE SQUARE POLYPROPYLENE BX/6EA,193.42,145.06,179.59,179.59,1
CDM,SUP-ITM-10003305,CATHETER DOVER ROB-NEL 14FR 14IN URETHRAL SMOOTH ROUNDED TIP CS/100EA,1.47,1.1,1.14,1.36,3
CDM,SUP-ITM-10003519,MESH GRAFT 1.6X1.9IN 4.1 4.8CM LG PERFIX POLYPROPYLENE MONOFILAMENT PLUG INGUINAL HERNIA SOFT TISSUE REPAIR CS/2EA,666.86,500.14,619.18,619.18,1
CDM,SUP-ITM-10005093,MESH HERNIA 2.0MMX10 15CM DUAL BIOMATERIAL OVAL,2835.0,2126.25,2632.3,2632.3,1
CDM,SUP-ITM-10013931,GRAFT MESH 8.5CM 13.5CM 3DMAX POLYPROPYLENE MONOFILAMENT PATCH LAPAROSCOPY HERNIA REPAIR LEFT CS/1EA,720.0,540.0,668.52,668.52,1
CDM,SUP-ITM-10014862,WRIST PLATE BONE ACU LOC TITANIUM VOLAR DISTAL RADIUS STANDARD RIGHT,2706.0,2029.5,2512.52,2512.52,1
CDM,SUP-ITM-10016510,SCREW BONE 14X3.5MM CORTICAL ACU LOC 2 TITANIUM,183.0,137.25,169.92,169.92,1
CDM,SUP-ITM-10016514,PEG BONE 2.3MM 14 CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING LOCKING SMOOTH BRONZE,375.0,281.25,348.19,348.19,1
CDM,SUP-ITM-10016518,SCREW BONE 18X2.3MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING LOCKING FULL THREAD GOLD,375.0,281.25,348.19,348.19,1
CDM,SUP-ITM-10017010,SCREW BONE 12X4.0MM CANCELLOUS TITANIUM,237.0,177.75,220.05,220.05,1
CDM,SUP-ITM-10017015,SCREW BONE 14X3.5MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING LOCKING THREAD,390.0,292.5,362.12,362.12,1
CDM,SUP-ITM-10017018,SCREW BONE 16X2.3MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING NONTOGGLING,258.0,193.5,239.55,239.55,1
CDM,SUP-ITM-10017371,RADIUS PLATE ACU LOC 2 TITANIUM STANDARD LEFT,2706.0,2029.5,2512.52,2512.52,1
CDM,SUP-ITM-10017964,HUMERUS PLATE LG BONE HUMERAL PROXIMALIMAL POLARUS ROD SYSTEM RIGHT,3427.5,2570.62,3182.43,3182.43,1
CDM,SUP-ITM-10017967,SCREW BONE 5.0X40MM CANCELLOUS TITANIUM POLARUS,612.0,459.0,568.24,568.24,1
CDM,SUP-ITM-10018259,GRAFT MESH 10.5CM 16CM 3DMAX POLYPROPYLENE MONOFILAMENT PATCH LAPAROSCOPY HERNIA REPAIR RIGHT CS/1EA,780.0,585.0,724.23,724.23,1
CDM,SUP-ITM-10019627,PASSER SUTURE 1.8MM 45DEGREE LEFT NITINOL LF PRELOADED STERILE DISPOSABLE,420.0,315.0,389.97,389.97,1
CDM,SUP-ITM-10024327,SCREW BONE 2.7X10MM CORTICAL TITANIUM FULL THREAD DISTAL ROUNDED HEAD NONLOCKING,201.0,150.75,186.63,186.63,1
CDM,SUP-ITM-10026587,ELBOW PLATE 88MM 8 HOLE MEDIAL TITANIUM LOCKING DISTAL HUMERUS,3522.0,2641.5,3270.18,3270.18,1
CDM,SUP-ITM-10026988,SCREW BONE 26X2.3MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING NONTOGGLING,258.0,193.5,239.55,239.55,1
CDM,SUP-ITM-10030773,KIT PORT 6.0FR INFUSION VASCULAR MRI POWER ISP PLASTIC ATTACHABLE POLYURETHANE CATHETER ATTACHED SUTURE PLUG,1044.0,783.0,810.14,810.14,1
CDM,SUP-ITM-10044452,ULNA PLATE WRIST ACU LOC TITANIUM VOLAR DISTAL STANDARD LEFT,2826.0,2119.5,2623.94,2623.94,1
CDM,SUP-ITM-10044456,WRIST PLATE BONE STD DORSAL PLATING SYSTEM LT ACU LOC,3153.0,2364.75,2927.56,2927.56,1
CDM,SUP-ITM-10044460,ARTICULAR PLATE BONE ACU LOC TITANIUM LOCKING EXTRA STANDARD,2607.0,1955.25,2420.6,2420.6,1
CDM,SUP-ITM-10044466,ULNA PLATE 80MM 6 HOLE ARM TITANIUM MIDHSHAFT,2334.0,1750.5,2167.12,2167.12,1
CDM,SUP-ITM-10045023,RADIUS PLATE XLONG BONE ACU LOC WRIST TITANIUM VOLAR DISTAL RIGHT,3084.0,2313.0,2863.49,2863.49,1
CDM,SUP-ITM-10045050,ELBOW PLATE 14 HOLE BONE LOCKING LATERAL LEFT,3327.5,2495.62,3089.58,3089.58,1
CDM,SUP-ITM-10045067,HUMERAL PLATE EXTRA LONG IMAL LT TITANIUM,4205.0,3153.75,3904.34,3904.34,1
CDM,SUP-ITM-10045069,SCAPULA PLATE ACROMION 6 HOLE LEFT,3965.0,2973.75,3681.5,3681.5,1
CDM,SUP-ITM-10045071,SCAPULA PLATE 4 HOLE BONE GLENOID LOCKING LEFT,3402.0,2551.5,3158.76,3158.76,1
CDM,SUP-ITM-10045072,SCAPULA PLATE 4 HOLE BONE GLENOID LOCKING RIGHT,3402.0,2551.5,3158.76,3158.76,1
CDM,SUP-ITM-10045073,SCAPULA PLATE 10 HOLE BONE R LOCKING LATERAL BORDER LEFT,4068.0,3051.0,3777.14,3777.14,1
CDM,SUP-ITM-10045075,SCAPULA PLATE MEDIAL LOCKING 9 HOLE LEFT,3774.0,2830.5,3504.16,3504.16,1
CDM,SUP-ITM-10049186,CLAVICLE PLATE 3.5X68MM 9 HOLE BONE TITANIUM LOCKING DISTAL LEFT,3603.0,2702.25,3345.39,3345.39,1
CDM,SUP-ITM-10050111,SET BALL 3/8IN 3 3/32 .045 PIN BONE JURGAN SYSTEM W SERIES GENERAL,690.0,517.5,640.67,640.67,1
CDM,SUP-ITM-10050480,CLAVICLE PLATE 101X11 14MM 16 HOLE BONE TITANIUM LOCKING DISTAL RIGHT,3300.0,2475.0,3064.05,3064.05,1
CDM,SUP-ITM-10065022,ANCHOR SUTURE 3.5MM POPLOK ENDOSCOPY KNOTLESS PEEK SUB CORTICAL WING SHOULDER,1521.57,1141.18,1412.78,1412.78,1
CDM,SUP-ITM-10065023,ANCHOR SUTURE 4.5MM POPLOK ENDOSCOPY KNOTLESS PEEK SUB CORTICAL WING SHOULDER,1586.28,1189.71,1472.86,1472.86,1
CDM,SUP-ITM-10065921,MESH SEPARATING 2.4X5.4IN PROLENE TISSUE POLYPROPYLENE NONABSORBABLE PRESHAPED KEYHOLE HERNIA REPAIR BX/6EA,231.6,173.7,215.04,215.04,1
CDM,SUP-ITM-10065922,MESH SURGICAL 1.8X4.0IN SM HERNIA PROLENE POLYPROPYLENE NONABSORBABLE PRESHAPED KEYHOLE REPAIR BX/3EA,403.71,302.78,374.84,374.84,1
CDM,SUP-ITM-10073381,ANTERIOR PLATE 95X11MM 8 HOLE TITANIUM LOCKING,3579.0,2684.25,3323.1,3323.1,1
CDM,SUP-ITM-10073889,BALLOON HERCULES 12MM 5.5CM 240 .035IN GUIDEWIRE 3 STAGE ENDOSCOPIC GASTROINTESTINAL OBLONG FILL WATER,786.0,589.5,609.94,729.8,2
CDM,SUP-ITM-10074026,DILATOR COLONIC 14MM DIA 5.5CM 7FR 240 BALLOON INFLATE CATHETER,975.0,731.25,756.6,905.29,2
CDM,SUP-ITM-10080135,SCREW BONE 3.5X50MM TAP LOC HEXALOBE TITANIUM VARIABLE ANGLE LOCKING FULL THREAD DISTAL,510.0,382.5,473.54,473.54,1
CDM,SUP-ITM-10080139,SCREW BONE 12X3.5MM RADIUS TAP LOC HEXALOBE TITANIUM VOLAR DISTAL PLATING NONLOCKING FULL THREAD,213.0,159.75,197.77,197.77,1
CDM,SUP-ITM-10080156,SCREW BONE 55X3.5MM RADIUS TAP LOC HEXALOBE TITANIUM VOLAR DISTAL PLATING NONLOCKING FULL THREAD,279.0,209.25,259.05,259.05,1
CDM,SUP-ITM-10082333,RADIUS PLATE BONE RADIAL STYLOID DIVERGENT DISTAL FIXATION SYSTEM ACU LOC 2,3132.0,2349.0,2908.06,2908.06,1
CDM,SUP-ITM-10082652,GRAFT MESH 15CMX10 SYNTHETIC ABDOMINAL ABSORBABLE COATED ELLIPSE POLYPROPYLENE SEPRA VENTRALIGHT ST CS/1EA,2220.0,1665.0,2061.27,2061.27,1
CDM,SUP-ITM-10088504,SCREW BONE 12X2.7MM TAP LOC HEXALOBE TITANIUM VARIABLE ANGLE LOCKING FULL THREAD DISTAL,420.0,315.0,389.97,389.97,1
CDM,SUP-ITM-10088527,OLECRANON PLATE 90MM 5 HOLE BONE ELBOW LOCKING MIDSHAFT SUPERIOR TITANIUM LOW PROFILE LEFT,3822.0,2866.5,3548.73,3548.73,1
CDM,SUP-ITM-10088528,OLECRANON PLATE 110MM 7 HOLE ELBOW TITANIUM STANDARD LEFT,3615.0,2711.25,3356.53,3356.53,1
CDM,SUP-ITM-10088539,SCREW BONE 3.5MM TAP SURGICAL LOCKING FOREFOOT PLATING SYSTEM CORTICAL HARD,387.0,290.25,359.33,359.33,1
CDM,SUP-ITM-10090762,SCREW BONE SLEEVE COMPRESSION FRAG LOC,780.0,585.0,724.23,724.23,1
CDM,SUP-ITM-10090763,SCREW BONE COMPRESSION FRAG LOC SS 30-0371,471.0,353.25,437.32,437.32,1
CDM,SUP-ITM-10091971,RADIUS PLATE 63MM LONG BONE ACU LOC 2 ARM TITANIUM VOLAR DISTAL NARROW PROXIMALIMAL LEFT,3475.0,2606.25,3226.54,3226.54,1
CDM,SUP-ITM-10091993,DISTAL PLATE 59MM BONE ARM ACULOC 2 TITANIUM VOLAR RADIUS LT WIDE,3475.0,2606.25,3226.54,3226.54,1
CDM,SUP-ITM-10100469,KIT SET TRACTION FIXATION TIGHTROPE SYNDESMOSIS REPAIR TITANIUM,3525.0,2643.75,3272.96,3272.96,1
CDM,SUP-ITM-10100569,STRAP POCKET 3.2I N LARGE GRAFT MESH VENTRALEX POLYPROPYLENE PGA PATCH HERNIA FIBER HYDROGEL BIORESORBABLE CIRCLE CA/1EA,2610.0,1957.5,2423.39,2423.39,1
CDM,SUP-ITM-10100597,STRAP POCKET 1.7IN SM GRAFT MESH VENTRALEX ST POLYPROPYLENE PGA PATCH HERNIA FIBER HYDROGEL BIORESORBABLE CIRCLE CA/1EA,1695.0,1271.25,1573.81,1573.81,1
CDM,SUP-ITM-10100598,STRAP POCKET 2.5IN MED GRAFT MESH VENTRALEX ST POLYPROPYLENE PGA PATCH HERNIA FIBER HYDROGEL BIORESORBABLE CIRCLE CS/1EA,2040.0,1530.0,1894.14,1894.14,1
CDM,SUP-ITM-10100702,ANTERIOR PLATE 5 HOLE BONE TIBIAL LOW PROFILE LOCKING,2766.0,2074.5,2568.23,2568.23,1
CDM,SUP-ITM-10114047,ANCHOR SUTURE 4.75X19.1MM SWIVELOCK IMPLANT ARTHROSCOPY SPEEDBRIDGE BIOCOMPOSITE,4350.0,3262.5,4038.98,4038.98,1
CDM,SUP-ITM-10114881,SCREW BONE 5.7X38MM HUMERAL TAP LOC HEXALOBE TITANIUM VAIRABLE ANGLE LOCKING FULL THREAD DISTAL,663.0,497.25,615.6,615.6,1
CDM,SUP-ITM-10118253,HUMERUS PLATE 103MM 7 HOLE BONE ARM POST LATERAL DISTAL LT,3437.5,2578.12,3191.72,3191.72,1
CDM,SUP-ITM-10129765,HUMERUS PLATE 203MM 15 HOLE BONE ARM POSTEROLATERAL DISTAL RIGHT,3830.0,2872.5,3556.16,3556.16,1
CDM,SUP-ITM-10132441,ELBOW PLATE SM CORONOID RIGHT,3865.0,2898.75,3588.65,3588.65,1
CDM,SUP-ITM-10135420,KIT LABORATORY PLATE SCREW ACU SINCH,3447.0,2585.25,3200.54,3200.54,1
CDM,SUP-ITM-10137801,PORT POWERPORT CLEARVUE ISP 8FR CATHETER POLYURETHANE IMPLANTABLE SINGLE LUMEN INTERMEDIATE VALVED INTRODUCER,1260.0,945.0,977.76,977.76,1
CDM,SUP-ITM-10139166,SCREW BONE 2.3X18MM ACU LOC HEXALOBE VARIABLE ANGLE TI LOCKING DISTAL,477.0,357.75,442.89,442.89,1
CDM,SUP-ITM-10146052,WIRE BONE 5IN 0.062 CERCLAGE SS SPADE TIP DUAL END,21.01,15.76,19.51,19.51,1
CDM,SUP-ITM-10146053,ANCHOR SUTURE 6.5MM TRIPLE FIT - DISCONTINUED PER SUPPLIER/CONTRACTS,1359.66,1019.74,1262.44,1262.44,1
CDM,SUP-ITM-10146056,ANCHOR SUTURE 2.8MM POPLOK 1 HI-FI,1599.36,1199.52,1485.01,1485.01,1
CDM,SUP-ITM-10146062,ANCHOR SUTURE PRESSFIT HI FI TWO STRAND 3.5 METRIC,907.77,680.83,842.86,842.86,1
CDM,SUP-ITM-10146063,ANCHOR SUTURE 2.6MM PRESSFIT ONE STRAND,821.25,615.94,762.53,762.53,1
CDM,SUP-ITM-10146255,GRAFT MESH 6.0IN VENTRALIGHT ST POLYPROPYLENE HERNIA SEPRA HYDROGEL BIORESORBABLE CIRCLE CS/1EA,3166.8,2375.1,2940.37,2940.37,1
CDM,SUP-ITM-10146923,ANKLE PLATE 9 HOLE BONE TITANIUM LOCKING LATERAL FIBULA,2946.0,2209.5,2735.36,2735.36,1
CDM,SUP-ITM-10146924,FIBULA PLATE LATERAL LOW PROFILE 9 HOLE,2670.0,2002.5,2479.1,2479.1,1
CDM,SUP-ITM-10146927,LATERAL PLATE 7 HOLE BONE FIBULA TITANIUM LOCKING LOW PROFILE,2670.0,2002.5,2479.1,2479.1,1
CDM,SUP-ITM-10146938,SCREW BONE 10X25MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,714.9,536.17,663.78,663.78,1
CDM,SUP-ITM-10146939,SCREW BONE 9X25MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,1067.73,800.8,991.39,991.39,1
CDM,SUP-ITM-10146940,SCREW BONE 11X30MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,714.9,536.17,663.78,663.78,1
CDM,SUP-ITM-10146941,MESH GRAFT 15CMX10 PROGRIP PET PLA LAPAROSCOPY TACK FREE CONTOURED RESORBABLE RIGHT,1033.44,775.08,959.55,959.55,1
CDM,SUP-ITM-10147000,ANCHOR SUTURE SIZE 2 LENGTH2.8MM ARTHROSCOPY Y KNOT RC ALL DOUBLE LOADED HI FI,926.88,695.16,860.61,860.61,1
CDM,SUP-ITM-10151456,MESH GRAFT 15CMX10 PROGRIP PET PLA LAPAROSCOPY TACK FREE RECTANGLE RESORBABLE FLAT SHEET,865.2,648.9,803.34,803.34,1
CDM,SUP-ITM-10159160,ELBOW PLATE CORONOID STANDARD RIGHT,3865.0,2898.75,3588.65,3588.65,1
CDM,SUP-ITM-10168011,LATERAL PLATE 13 HOLE BONE FIBULA LOW PROFILE,2670.0,2002.5,2479.1,2479.1,1
CDM,SUP-ITM-10170928,SCREW BONE 10X30MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,1067.73,800.8,991.39,991.39,1
CDM,SUP-ITM-10171254,KIT SCREW 8X20 3.5MM BONE CANNULATED INTERFERENCE PROPEL PINN ACL GUIDE SYSTEM,426.0,319.5,395.54,395.54,1
CDM,SUP-ITM-10171579,HUMERUS PLATE 75MM 5 HOLE BONE ARM POST LAT DISTAL RT,3639.0,2729.25,3378.81,3378.81,1
CDM,SUP-ITM-10188631,GRAFT MESH 1.7IN VENTRALEX EPTFE PATCH UMBILICAL HERNIA REPR SELF EXPAND STRAP CIRCLE SM CS/2EA,1605.0,1203.75,1490.24,1490.24,1
CDM,SUP-ITM-10189331,FIBULA PLATE LATERAL 9 HOLE RIGHT,2859.0,2144.25,2654.58,2654.58,1
CDM,SUP-ITM-10189339,SCREW BONE 55X2.7MM TAP LOC HEXALOBE TITANIUM VARIABLE ANGLE NONLOCKING FULL THREAD DISTAL,279.0,209.25,259.05,259.05,1
CDM,SUP-ITM-10189441,SCREW BONE 4X60MM CANCELLOUS PARTIAL THREAD HEXALOBE,258.0,193.5,239.55,239.55,1
CDM,SUP-ITM-10189449,SCREW BONE 2.7X44MM LOCKING HEXALOBE TITANIUM FULL THREAD,420.0,315.0,389.97,389.97,1
CDM,SUP-ITM-10189468,SCREW BONE 2.7X38MM NON LOCKING HEXALOBE TITANIUM FULL THREAD,213.0,159.75,197.77,197.77,1
CDM,SUP-ITM-10189483,SCREW BONE 30MM ACUTWIST COMPRESSION,627.0,470.25,582.17,582.17,1
CDM,SUP-ITM-10189492,BONE PLATE 2.7MM FRAGMENT T SHAPE 7010-0108N,1020.0,765.0,947.07,947.07,1
CDM,SUP-ITM-10189501,TIBIA PLATE DISTAL POSTEROLATERAL 3 HOLE RIGHT,2568.0,1926.0,2384.39,2384.39,1
CDM,SUP-ITM-10189503,FIBULA PLATE 4HOLE POSTEROLATERAL DISTAL TIBIA RIGHT,2688.0,2016.0,2495.81,2495.81,1
CDM,SUP-ITM-10189509,FIBULA PLATE POSTEROLATERAL 6 HOLE RIGHT,2814.0,2110.5,2612.8,2612.8,1
CDM,SUP-ITM-10189513,FIBULA PLATE POSTEROLATERAL 4 HOLE RIGHT,2718.0,2038.5,2523.66,2523.66,1
CDM,SUP-ITM-10189519,SCREW BONE 4X45MM CANCELLOUS PARTIAL THREAD HEXALOBE,210.0,157.5,194.99,194.99,1
CDM,SUP-ITM-10189637,PEG CORTICAL 2.3X36MM LOCKING,375.0,281.25,348.19,348.19,1
CDM,SUP-ITM-10189638,ANKLE PLATE LOCKING PEG HOOK 3 HOLE,2085.0,1563.75,1935.92,1935.92,1
CDM,SUP-ITM-10189640,ANKLE PLATE MEDIAL ANTI GLIDE 4 HOLE,1821.0,1365.75,1690.8,1690.8,1
CDM,SUP-ITM-10189945,WASHER SCREW 7MM ODX3.6MM ID CANNULATED,171.0,128.25,158.77,158.77,1
CDM,SUP-ITM-10189949,SCREW BONE 3.5X10MM RADIUS TAP LOC HEXALOBE TI VOLAR DISTAL PLATING LOCKING,510.0,382.5,473.54,473.54,1
CDM,SUP-ITM-10189955,PEG HOOK LOCKING 2 HOLE,1977.0,1482.75,1835.64,1835.64,1
CDM,SUP-ITM-10189986,SCREW BONE 3.5X60MM VARIABLE ANGLE HEXALOBE,477.0,357.75,442.89,442.89,1
CDM,SUP-ITM-10190116,SCREW BONE 48X4MM CANNULATED LONG THREADED,741.0,555.75,688.02,688.02,1
CDM,SUP-ITM-10190291,BONE PLATE 1/3 TUBULAR 12 HOLE,309.0,231.75,286.91,286.91,1
CDM,SUP-ITM-10190292,BONE PLATE 1/3 TUBULAR 10 HOLE,294.0,220.5,272.98,272.98,1
CDM,SUP-ITM-10190293,BONE PLATE 1/3 TUBULAR 8 HOLE 7008-0108,279.0,209.25,259.05,259.05,1
CDM,SUP-ITM-10190294,BONE PLATE 1/3 TUBULAR 7 HOLE,264.0,198.0,245.12,245.12,1
CDM,SUP-ITM-10190295,BONE PLATE 1/3 TUBULAR 6 HOLE,249.0,186.75,231.2,231.2,1
CDM,SUP-ITM-10190296,BONE PLATE 1/3 TUBULAR 5 HOLE,234.0,175.5,217.27,217.27,1
CDM,SUP-ITM-10190297,BONE PLATE 1/3 TUBULAR 4 HOLE,219.0,164.25,203.34,203.34,1
CDM,SUP-ITM-10190298,BONE PLATE 1/3 TUBULAR 3 HOLE,204.0,153.0,189.41,189.41,1
CDM,SUP-ITM-10190755,HUMERUS PLATE 152MM 11 HOLE BONE ARM DISTAL POSTERIOR LATERAL RIGHT,3437.5,2578.12,3191.72,3191.72,1
CDM,SUP-ITM-10191494,PLUG TIBIAL 2.4MM TUNNELER - DISCONTINUED PER NO USAGE,197.88,148.41,183.73,183.73,1
CDM,SUP-ITM-10193285,ANCHOR TISSUE 2.7MM POLYETHER ETHER KETONE NONBIOABSORBABLE,1014.0,760.5,941.5,941.5,1
CDM,SUP-ITM-10207330,PLATE HUMERUS SIZE 0 PROXIMAL STANDARD LEFT,5096.0,3822.0,4731.64,4731.64,1
CDM,SUP-ITM-10207338,SCREW BONE 4.5X20MM LOCKING CORTICAL SELF TAPPING,228.0,171.0,211.7,211.7,1
CDM,SUP-ITM-10240784,SYSTEM KYLEENA 19.5MG LEVONORGESTREL-RELEASING INTRAUTERINE,2915.1,2186.32,2706.67,2706.67,1
CDM,SUP-ITM-10278658,SCREW SPINAL 3.5X80MM ANTHEM TI NONLOCKING,132.0,99.0,122.56,122.56,1
CDM,SUP-ITM-10328718,SUTURE HI-FI 2 36IN POLYESTER CO-BRAIDEDED 1STRAND NO NEEDLE BLUE WHITE BX/12EA,81.78,61.33,75.93,75.93,1
CDM,SUP-ITM-10328720,SUTURE HI-FI 2 HC-5 40IN POLYESTER BRAIDED TAPER 1STRAND 1/2 CIRCLE HIGH STRENGTH WHITE BX/12EA,66.75,50.06,61.98,61.98,1
CPT,0001A,Imm Admn Sarscov2 30mcg/0.3ml Dil Recon 1st Dose,75.0,56.25,58.2,58.2,1
CPT,0002A,Imm Admn Sarscov2 30mcg/0.3ml Dil Recon 2nd Dose,75.0,56.25,58.2,58.2,1
CPT,0077U,Ig Paraprotein Qual Imprcip&Ms Bld/UR W/Isotype,100.0,75.0,92.85,94.28,2
CPT,0241U,Nfct Ds Rna 4 Targets Upper Respiratory Specimen,478.0,358.5,370.93,455.06,11
CPT,10005,Fine Needle Aspiration Bx W/US Gdn 1st Lesion,376.5,282.375,273.93,894.79,6
CPT,10030,Image-Guided Catheter Fluid Collection Drainage,764.5,573.375,662.51,835.47,3
CPT,10120,Incision/Remove FB Subq Smp,436.0,327.0,359.17,359.17,1
CPT,10160,Aspiration Abscess/Hema/Bulla/Cyst,193.0,144.75,359.17,359.17,1
CPT,11042,Debride Skin/Subq Tissue,200.0,150.0,359.17,474.42,2
CPT,11042,Pf Debr Skin/Subq Tissue,223.0,167.25,474.42,474.42,1
CPT,11102,Tangential Biopsy Skin Single Lesion,216.5,162.375,201.78,252.7,3
CPT,11104,Punch Biopsy Skin Single Lesion,271.5,203.625,508.1,508.1,2
CPT,11200,Remove Tag Skin <15,111.0,83.25,201.78,201.78,1
CPT,11300,Shave Lesn Trunk/Arm/Leg <0.5cm,131.0,98.25,201.78,201.78,1
CPT,11400,Exc Lesn Bgn Trunk/Arm/Leg <0.5cm,1077.0,807.75,662.51,835.47,2
CPT,11400,Pf Exc Lesn Bgn Trnk/Arm <0.5cm,355.0,266.25,835.47,835.47,1
CPT,11401,Exc Lesn Bgn Trunk/Arm/Leg .6-1.0cm,1077.0,807.75,359.17,835.75,4
CPT,11401,Pf Exc Lesn Bgn Trnk/Arm .6-1.0cm,494.0,370.5,383.34,508.1,2
CPT,11402,Exc Lesn Bgn Trunk/Arm/Leg 1.1-2.0,1077.0,807.75,662.51,999.99,3
CPT,11402,Pf Exc Lesn Bgn Trnk/Arm 1.1-2.0cm,542.0,406.5,503.25,894.79,2
CPT,11403,Exc Lesn Bgn Trunk/Arm/Leg 2.1-3.0,1077.0,807.75,662.51,894.79,2
CPT,11403,Pf Exc Lesn Bgn Trnk/Arm 2.1-3.0cm,691.0,518.25,894.79,894.79,1
CPT,11420,Exc Lesn Bgn Sclp/Hnd/Gen <0.5cm,1077.0,807.75,999.99,999.99,1
CPT,11420,Pf Exc Lesn Bgn Sclp/Hnd <0.5cm,392.0,294.0,363.97,363.97,1
CPT,11421,Exc Lesn Bgn Sclp/Hnd/Gen 0.6-1.0cm,1077.0,807.75,662.51,894.79,2
CPT,11421,Pf Exc Lesn Bgn Sclp/Hnd 0.6-1.0cm,530.0,397.5,894.79,894.79,1
CPT,11441,Exc Lesn Bgn Face/Ear/Lip 0.6-1.0cm,1077.0,807.75,662.51,662.51,1
CPT,11601,Exc Lesn Mal Trunk/Arm/Leg .6-1.0cm,655.0,491.25,894.79,894.79,1
CPT,11601,Pf Exc Lesn Mal Trnk/Arm .6-1.0cm,714.0,535.5,894.79,894.79,1
CPT,11602,Exc Lesn Mal Trunk/Arm/Leg 1.1-2.0,1077.0,807.75,359.17,359.17,1
CPT,11606,Exc Lesn Mal Trunk/Arm/Leg >4.0cm,3467.0,2600.25,1923.94,2690.39,3
CPT,11606,Pf Exc Lesn Mal Trnk/Arm >4.0cm,1486.0,1114.5,1153.14,1923.94,3
CPT,11621,Exc Lesn Mal Sclp/Hnd/Gen 0.6-1.0cm,1077.0,807.75,662.51,894.79,2
CPT,11621,Pf Exc Lesn Mal Sclp/Hnd 0.6-1.0cm,721.0,540.75,894.79,894.79,1
CPT,11640,Exc Lesn Mal Face/Ear/Lip <0.5cm,1077.0,807.75,835.75,835.75,1
CPT,11640,Pf Exc Lesn Mal Face/Ear <0.5cm,598.0,448.5,464.05,464.05,1
CPT,11641,Exc Lesn Mal Face/Ear/Lip 0.6-1.0cm,724.0,543.0,835.47,835.47,1
CPT,11641,Pf Exc Lesn Mal Face/Ear 0.6-1.0cm,760.0,570.0,835.47,835.47,1
CPT,12031,Pf Rpr Lac Int Sclp/Ax <2.5cm,340.0,255.0,474.42,474.42,1
CPT,12031,Rpr Lac Intermd Scalp/Axil <2.5cm,577.0,432.75,359.17,474.42,2
CPT,16020,Dress/Debride Burn <5% Total Sm,272.0,204.0,211.07,211.07,1
CPT,16020,Pf Dress/Debr Burn <5% Sm,157.0,117.75,121.83,121.83,1
CPT,17000,Dest Lesn Premalignant 1st Lesion,257.0,192.75,201.78,235.94,2
CPT,17000,Pf Dest Lesn Premalig 1st Lesion,274.0,205.5,235.94,235.94,1
CPT,17110,Destruct Benign Lesion Up to 14 Les,297.0,222.75,201.78,201.78,1
CPT,17272,Dest Lesn Mal Sclp/Hnd/Gen 1.1-2.0,697.0,522.75,252.7,252.7,1
CPT,17272,Pf Dest Lesn Mal Sclp/Hnd 1.1-2.0cm,609.0,456.75,252.7,252.7,1
CPT,20552,Inject Trigger Point 1-2 Muscle(S),723.0,542.25,283.01,671.31,4
CPT,20552,Pf Inject Trigger Point 1-2 Muscle,185.0,138.75,171.77,350.56,3
CPT,20553,Inject Trigger Pt 3+ Muscle Groups,698.0,523.5,283.01,283.01,1
CPT,21552,Exc Tum Tiss Neck/Ant Thx Subq 3+,2138.0,1603.5,3639.81,3639.81,1
CPT,21552,Pf Exc Tum Tiss N/Ant Thx Subq 3+,2175.0,1631.25,3639.81,3639.81,1
CPT,21930,Exc Tumor Back/Flank <3cm,1888.0,1416.0,1572.96,1572.96,1
CPT,21931,Exc Tumor Back/Flank Subq 3cm or Gr,2095.0,1571.25,1572.96,1572.96,1
CPT,21931,Pf Exc Tumr Back/Flank Subq 3cm +,2264.0,1698.0,1572.96,1572.96,1
CPT,26055,Tendon Sheath Incision,3141.0,2355.75,2035.32,2035.32,1
CPT,31899,Tracheotomy Tube Change,45.0,33.75,230.53,230.53,1
CPT,36415,Venipuncture,16.0,12.0,12.42,15.23,6
CPT,36416,Collect Finger/Heel/Ear Stick,16.0,12.0,15.12,15.12,1
CPT,36430,Transfusion Blood/Comp,3527.0,2645.25,555.98,2736.95,2
CPT,36589,Pf Rem Tnl Cv W/O Port/Pump,673.0,504.75,734.15,734.15,1
CPT,36589,Rem Tnld Cv Cath W/O Port/Pump,1913.0,1434.75,709.02,734.15,2
CPT,36590,Pf Rem Tnl Cv Acc W/Port/Pump,1279.0,959.25,1208.78,1975.58,2
CPT,36590,Rem Tnld Cv Access W/Port/Pump,2965.0,2223.75,709.02,2802.22,3
CPT,36591,Collect Blood Port/Access Dvc,138.0,103.5,121.77,163.93,3
CPT,36592,HC Collect Blood From Catheter Venous,170.0,127.5,121.77,163.93,2
CPT,36593,Declot Port Thrombolytic Agent,262.0,196.5,329.78,421.83,2
CPT,38222,Diagnostic Bone Marrow Biopsies & Aspirations,421.0,315.75,3398.51,3398.51,2
CPT,40800,Drain Absc/Cyst Vestib Mouth Smp,1267.0,950.25,1160.7,1160.7,1
CPT,40800,Drg Absc Cst Hmtma Vestibule Mouth Smpl,584.0,438.0,535.0,535.0,1
CPT,43235,Egd Flex Dx W/Brushing/Washing,1913.0,1434.75,870.88,1807.98,7
CPT,43235,Esophagogastroduodenoscopy Transoral Diagnostic,1538.0,1153.5,1192.34,1453.56,5
CPT,43239,Egd Flex Transoral W/Biopsy,1913.0,1434.75,870.88,1807.98,8
CPT,43239,Egd Transoral Biopsy Single/Multiple,1701.0,1275.75,1192.34,1607.62,5
CPT,43244,Egd W/Band Ligate Varices Esop/Gast,1630.0,1222.5,1513.46,1513.46,1
CPT,43249,Egd Flex W/Balloon Dilation <30mm,1913.0,1434.75,1696.3,2412.49,3
CPT,44386,Endo Eval Small Intest Pouch Biopsy,2965.0,2223.75,1082.6,1082.6,1
CPT,44970,Laparoscopic Appendectomy,2611.0,1958.25,2282.01,7419.84,4
CPT,45330,Pf Sigmoidoscopy Flex,656.0,492.0,1159.47,1159.47,1
CPT,45330,Sigmoidoscopy Flexible,1077.0,807.75,851.82,1159.47,3
CPT,45331,Sigmoidoscopy Flx W/Biopsy Single/Multiple,850.0,637.5,789.23,1159.47,2
CPT,45331,Sigmoidoscopy W/Biopsy,1913.0,1434.75,1159.47,1776.22,2
CPT,45378,Colonoscopy Flexible,3451.0,2588.25,851.82,3285.35,8
CPT,45378,Colonoscopy Flx Dx W/Collj Spec When Pfrmd,2336.0,1752.0,851.82,3285.35,14
CPT,45380,Colonoscopy W/Biopsy Single/Multiple,2450.0,1837.5,1120.45,2385.43,16
CPT,45385,Colonoscopy Flex W/Rem Tumor Snare,2524.0,1893.0,1120.45,2343.53,6
CPT,45385,Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq,1979.0,1484.25,1120.45,2343.53,10
CPT,46220,Excision Single External Papilla or Tag Anus,2234.0,1675.5,1120.45,1120.45,1
CPT,46260,Hemorrhoidectomy Int & Xtrnl 2/> Column/Gro,2753.0,2064.75,2669.73,2669.73,1
CPT,46930,"Dest Intrnl Hemrrhds, Thermal",698.0,523.5,1120.45,1499.49,2
CPT,46930,Destruction Internal Hemorrhoid Thermal Energy,735.0,551.25,1499.49,1499.49,1
CPT,47000,Biopsy Liver Needle Perc,2182.0,1636.5,1572.96,1692.76,2
CPT,47562,Laparoscopy Surg Cholecystectomy,3258.0,2443.5,3025.05,5255.62,3
CPT,49083,Abdom Paracentesis Dx/Ther W/Imaging Guidance,564.0,423.0,1192.34,1192.34,2
CPT,49083,Abdominal Paracentesis W/ Imaging,2778.0,2083.5,870.88,1192.34,3
CPT,51702,Catheter Bladder Smp,316.0,237.0,163.93,163.93,1
CPT,51702,Pf Catheter Bladder Smp,448.0,336.0,163.93,163.93,1
CPT,52000,Cystourethroscopy,2182.0,1636.5,642.96,2025.99,5
CPT,55250,Vasectomy Semen Exam Postop,1913.0,1434.75,1989.5,1989.5,2
CPT,57522,Conization Cervix Loop Elect Exc,3467.0,2600.25,2700.25,2700.25,1
CPT,58300,Insert Intrauterine Device- 58300,1430.0,1072.5,89.94,1327.76,3
CPT,58300,Pf Insert Intrauterine Device,250.0,187.5,232.13,232.13,1
CPT,58301,Remove Device Intrauterine Iud,653.0,489.75,189.75,189.75,1
CPT,58558,Hysteroscopy Biopsy Endometrium,4466.0,3349.5,2700.25,4146.68,5
CPT,58558,Pf Hysteroscopy W/Biopsy Sample,2019.0,1514.25,1566.74,3775.5,3
CPT,58562,Hysteroscopy Rem FB Impacted,1440.0,1080.0,1337.04,2700.25,2
CPT,58563,Hysteroscopy Ablat Endometrial,1698.0,1273.5,4718.12,4718.12,1
CPT,58661,Laparoscopy W/Rmvl Adnexal Structures|BILATERAL PROCEDURE,3544.0,2658.0,7883.43,7883.43,1
CPT,59025,Fetal Nonstress Test,139.0,104.25,107.86,132.33,5
CPT,59025,Test Non Stress Fetal,1046.0,784.5,811.7,995.79,5
CPT,59412,External Cephalic Version W/WO Tocolysis,854.0,640.5,2700.25,2700.25,1
CPT,59412,Version Cephalic External,800.0,600.0,2700.25,2700.25,1
CPT,59812,Surg Tx Abortion Incmpl,4210.0,3157.5,2700.25,2700.25,2
CPT,59820,Surg Tx Abortion Missed 1st Trimest,5095.0,3821.25,2700.25,3953.72,2
CPT,59820,Tx Missed Abortion First Trimester Surgical,1708.0,1281.0,1325.41,1325.41,1
CPT,62270,Lumbar Puncture Diagnostic,716.0,537.0,822.33,822.33,2
CPT,62270,Pf Puncture Spinal Lumbar Diag,182.0,136.5,822.33,822.33,2
CPT,62323,Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn,1449.5,1087.125,684.77,880.71,5
CPT,70150,Xr Facial Bones 3+ Views,1117.0,837.75,866.79,866.79,1
CPT,70160,Xr Nasal Cmpl 3+ Views,681.0,510.75,528.46,632.31,2
CPT,70220,Xr Sinuses 3+ Views,681.0,510.75,632.31,632.31,1
CPT,70250,Xr Skull Ltd <4 Views,851.0,638.25,126.27,126.27,1
CPT,70330,Xr Tmj Open & Closed Bilat,769.0,576.75,104.55,104.55,1
CPT,70360,Xr Neck Soft Tissue,696.0,522.0,111.98,111.98,1
CPT,70450,CT Head W/O Contrast,1805.0,1353.75,135.24,1718.36,6
CPT,70450,CT Head W/O Contrast|UNUSUAL SEPARATE SERVICE,1805.0,1353.75,126.27,126.27,1
CPT,70470,CT Head W&W/O Contrast,2886.0,2164.5,211.39,2995.87,2
CPT,70480,CT Orb/Fos/Sel/Ear W/O Contrast,3033.0,2274.75,135.24,135.24,1
CPT,70481,CT Orb/Fos/Sel/Ear W/Contrast,3545.0,2658.75,2995.87,2995.87,1
CPT,70486,CT Max/Facial W/O Contrast,2467.0,1850.25,135.24,1914.39,5
CPT,70487,CT Max/Facial W/Contrast,3015.0,2261.25,2799.43,2799.43,1
CPT,70490,CT Neck W/O Contrast,2414.0,1810.5,1670.78,1670.78,1
CPT,70491,CT Neck W/Contrast,2933.0,2199.75,226.4,2995.87,5
CPT,70496,Cta Head W&W/O Contrast,5935.0,4451.25,226.4,5609.17,5
CPT,70498,Cta Neck W&W/O Contrast,5968.0,4476.0,226.4,5640.36,5
CPT,70543,MRI Orbit/Face/Neck W&W/O Cont,6741.0,5055.75,454.18,5730.46,2
CPT,70546,Mra Head W&W/O Cont|UNUSUAL SEPARATE SERVICE,7510.0,5632.5,454.18,454.18,1
CPT,70548,Mra Neck W/Cont,5211.0,3908.25,5730.46,5730.46,1
CPT,70549,Mra Neck W&W/O Cont,7503.0,5627.25,5730.46,7142.86,2
CPT,70551,MRI Brain W/O Cont,5130.0,3847.5,307.41,4848.36,7
CPT,70552,MRI Brain W/Cont,5751.0,4313.25,5730.46,5730.46,1
CPT,70553,MRI Brain W&W/O Cont,6667.0,5000.25,454.18,6346.98,8
CPT,71045,Radiologic Exam Chest Single View,315.0,236.25,111.98,299.88,4
CPT,71046,Radiologic Exam Chest 2 Views,419.0,314.25,111.98,398.89,10
CPT,71101,Xr Ribs W/Cxr 3+ Views Uni,698.0,523.5,135.24,659.68,3
CPT,71111,Xr Ribs W/Cxr 4+ Views Bilat,843.0,632.25,126.27,126.27,1
CPT,71250,Diagnostic Computed Tomography Thorax W/O Cntrst,2379.0,1784.25,135.24,2248.39,9
CPT,71260,Diagnostic Computed Tomography Thorax W/Contrast,2895.0,2171.25,226.4,2995.87,11
CPT,71271,Low Dose CT Lung Screening,1356.0,1017.0,135.24,1259.05,5
CPT,71275,Cta Chest (Noncor) W&W/O Contrast,4259.0,3194.25,226.4,4025.18,8
CPT,71550,MRI Chest W/O Cont,5559.0,4169.25,5161.53,5161.53,1
CPT,71552,MRI Chest W&W/O Cont,7926.0,5944.5,6150.58,6150.58,1
CPT,72040,Xr C-Spine 2 or 3 Views,801.0,600.75,111.98,762.55,6
CPT,72050,Xr C-Spine 4 or 5 Views,1052.0,789.0,135.24,976.78,4
CPT,72052,Xr C-Spine 6 or More Views,1199.0,899.25,135.24,135.24,1
CPT,72070,Xr T-Spine 2 Views,776.0,582.0,135.24,602.18,2
CPT,72072,Xr T-Spine 3 Views,776.0,582.0,135.24,602.18,2
CPT,72082,Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 2/3 Vw,694.0,520.5,644.38,644.38,1
CPT,72100,Xr L-Spine 2-3 Views,776.0,582.0,135.24,738.75,8
CPT,72110,Xr L-Spine 4+ Views,776.0,582.0,135.24,720.52,2
CPT,72125,CT C-Spine W/O Contrast,2379.0,1784.25,135.24,2248.39,3
CPT,72128,CT T-Spine W/O Contrast,2379.0,1784.25,1670.78,1670.78,2
CPT,72131,CT L-Spine W/O Contrast,2377.0,1782.75,135.24,1670.78,3
CPT,72141,MRI C-Spine W/O Cont,4538.0,3403.5,307.41,4288.86,7
CPT,72146,MRI T-Spine W/O Cont,4551.0,3413.25,307.41,4225.6,4
CPT,72148,MRI L-Spine W/O Cont,4511.0,3383.25,307.41,4263.35,8
CPT,72156,MRI C-Spine W&W/O Cont,6628.0,4971.0,454.18,5730.46,2
CPT,72157,MRI T-Spine W&W/O Cont,6113.0,4584.75,454.18,5730.46,2
CPT,72158,MRI L-Spine W&W/O Cont,6552.0,4914.0,454.18,5730.46,3
CPT,72170,Xr Pelvis 1-2 Views,648.0,486.0,135.24,502.85,2
CPT,72192,CT Pelvis W/O Contrast,2228.0,1671.0,126.29,126.29,1
CPT,72193,CT Pelvis W/Contrast,2729.0,2046.75,226.4,2995.87,2
CPT,72195,MRI Pelvis W/O Cont,5091.0,3818.25,307.41,3950.62,3
CPT,72197,MRI Pelvis W&W/O Cont,6834.0,5125.5,454.18,6458.81,6
CPT,72220,Xr Sacrum/Coccyx 2+ Views,710.0,532.5,111.98,671.02,3
CPT,73030,Xr Shoulder Cmp 2+ Views,682.0,511.5,111.98,111.98,1
CPT,73080,Xr Elbow Cmpl 3+ Views,646.0,484.5,111.98,111.98,1
CPT,73110,Xr Wrist Cmpl 3+ Views,668.0,501.0,620.24,620.24,1
CPT,73221,MRI Upr Ext Joint W/O Cont,4806.0,3604.5,307.41,307.41,1
CPT,73502,Radex Hip Unilateral With Pelvis 2-3 Views,450.0,337.5,111.98,393.3,3
CPT,73521,Radex Hips Bilateral With Pelvis 2 Views,422.0,316.5,126.27,126.27,1
CPT,73523,Radex Hips Bilateral With Pelvis Minimum 5 Views,607.0,455.25,135.24,135.24,2
CPT,73560,Xr Knee 1-2 Views,538.0,403.5,111.98,111.98,2
CPT,73562,Xr Knee 3 Views,702.0,526.5,111.98,111.98,1
CPT,73564,Xr Knee Cmpl 4+ Views,762.0,571.5,135.24,665.99,2
CPT,73590,Xr Tibia/Fibula 2 Views,668.0,501.0,620.24,620.24,1
CPT,73630,Xr Foot Cmpl 3+ Views,599.0,449.25,111.98,111.98,1
CPT,73721,MRI Lwr Ext Joint W/O Cont,4898.0,3673.5,307.41,307.41,1
CPT,74018,Radiologic Exam Abdomen 1 View,332.0,249.0,111.98,313.77,3
CPT,74019,Radiologic Exam Abdomen 2 Views,535.0,401.25,135.24,496.75,3
CPT,74021,Radiologic Exam Abdomen 3+ Views,540.0,405.0,510.35,510.35,1
CPT,74160,CT Abdomen W/Contrast,3161.0,2370.75,226.4,2995.87,2
CPT,74170,CT Abdomen W&W/O Contrast,4274.0,3205.5,226.4,2995.87,2
CPT,74174,CT Abd/Pelvis W/Wocontrast Post,4626.0,3469.5,454.18,5730.46,3
CPT,74175,Cta Abdomen W&W/O Contrast,4417.0,3312.75,211.39,4174.51,3
CPT,74176,CT Abdomen & Pelvis W/O Contrast,4486.0,3364.5,307.41,4165.25,7
CPT,74177,CT Abdomen & Pevis With Contrast,5893.0,4419.75,454.18,5610.14,7
CPT,74178,CT Abdomen & Pelvis W/O&W Contras,7844.0,5883.0,454.18,7283.15,3
CPT,74181,MRI Abdomen W/O Cont,4446.0,3334.5,307.41,4232.59,3
CPT,74183,MRI Abdomen W&W/O Cont,6847.0,5135.25,454.18,6518.34,9
CPT,74220,Xr Esophagus,1733.0,1299.75,226.4,1609.09,3
CPT,74230,Xr Swallow Cine/Video,1291.0,968.25,226.4,1001.82,3
CPT,74240,Xr Ugi W/O Kub,1499.0,1124.25,1163.22,1163.22,1
CPT,74248,Radiologic Small Intestine Follow-Through Study,704.0,528.0,546.3,546.3,1
CPT,75571,CT Hrt W/O Cntrst W/Ca Test,525.0,393.75,925.12,925.12,2
CPT,75572,CT Hrt W/3d Image,937.0,702.75,454.18,454.18,1
CPT,75574,CT Angio Hrt W/3d Image,4268.0,3201.0,454.18,4063.14,5
CPT,75580,N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp,6807.0,5105.25,1293.86,6480.26,3
CPT,75635,Cta Abd Aorta W/&W/O Runoff,4732.0,3549.0,211.39,211.39,1
CPT,76080,Xr Abscess Sinus/Fistula Study,969.0,726.75,651.07,651.07,1
CPT,76497,Whole Body CT Myeloma Survey,3699.0,2774.25,111.98,111.98,1
CPT,76536,US Soft Tissue Head & Neck Real Time Imge Docm,128.0,96.0,99.33,321.65,11
CPT,76536,US Soft Tissue Head/Neck,1311.0,983.25,135.24,1248.07,11
CPT,76604,US Chest,747.0,560.25,135.24,321.65,2
CPT,76604,US Chest|REDUCED SERVICES,747.0,560.25,135.24,135.24,1
CPT,76604,"US, Chest, Real Time",137.0,102.75,135.24,321.65,2
CPT,76604,"US, Chest, Real Time|REDUCED SERVICES",137.0,102.75,135.24,135.24,1
CPT,76642,US Breast Uni Real Time With Image Limited,272.5,204.375,128.48,376.15,4
CPT,76700,US Abdomen Cmpl,1339.0,1004.25,135.24,1265.49,7
CPT,76705,US Abdomen Ltd,1332.0,999.0,135.24,1268.06,11
CPT,76705,US Abdominal Real Time W/Image Limited,133.0,99.75,103.21,321.65,11
CPT,76706,US Abdominal Aorta Real Time Screen Study Aaa,398.0,298.5,135.24,321.65,3
CPT,76770,US Retroperitioneal Cmpl,1332.0,999.0,135.24,1268.06,10
CPT,76801,US Pregnancy <14 Weeks Single,1042.0,781.5,135.24,991.98,9
CPT,76801,US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat,95.0,71.25,73.72,321.65,9
CPT,76805,US Pregnancy >14 Weeks Single,1220.0,915.0,321.65,1132.77,4
CPT,76805,"US, OB >/= 14 Wks, Sngl Fetus",154.0,115.5,119.5,321.65,4
CPT,76811,US Preg Uterus W/Detail Fetal Anat 1st Gestation,235.0,176.25,182.36,659.15,5
CPT,76811,US Pregnancy Detailed Single,1542.0,1156.5,659.15,1457.34,5
CPT,76811,"US,Preg Uter,Fet & Mat,+ Detl Fet Exm",235.0,176.25,182.36,659.15,5
CPT,76813,US Pregnancy Nuchal Meas Sgl/1st,880.0,660.0,682.88,837.76,3
CPT,76813,"US,Preg Uter,Nuchal Meas, 1st Trimest, Singleton",271.0,203.25,210.3,257.99,3
CPT,76815,US Pregnancy Ltd,742.0,556.5,575.79,688.95,2
CPT,76815,US Pregnant Uterus Limited 1/> Fetuses,95.0,71.25,73.72,88.21,2
CPT,76816,US Preg Uterus Real Time F/U Trnsabdl per Fetus,95.0,71.25,73.72,89.78,3
CPT,76816,US Pregnancy Followup per Fetus,988.0,741.0,766.69,933.76,3
CPT,76817,US Preg Uterus Real Time W/Image Dcmtn Transvag,95.0,71.25,73.72,321.65,5
CPT,76817,US Pregnancy Transvaginal,832.0,624.0,321.65,786.32,5
CPT,76819,Fetal Biophysical Profile W/O Non-Stress Testing,153.0,114.75,118.73,142.06,3
CPT,76819,US Fetal Biophysical Profile W/O,725.0,543.75,562.6,673.16,3
CPT,76830,US Transvaginal,1050.0,787.5,135.24,999.6,7
CPT,76831,US Saline Infus Son Incl Color Flow,774.0,580.5,659.15,659.15,1
CPT,76856,US Pelvis Non OB,1123.0,842.25,135.24,1069.1,7
CPT,76857,Sono Pelvis Limited,116.0,87.0,90.02,321.65,6
CPT,76857,US Pelvis Non OB Ltd,907.0,680.25,135.24,857.21,6
CPT,76870,US Scrotum,1037.0,777.75,135.24,980.07,6
CPT,76870,Ultrasound Scrotum & Contents,140.0,105.0,108.64,321.65,6
CPT,76882,US Lmtd Jt/Fcl Eval Nonvasc Xtr Strux R-T W/Img,165.0,123.75,135.24,135.24,2
CPT,77002,Pf Xr Fluoro Biopsy/Aspiration,133.0,99.75,103.21,125.7,3
CPT,77002,Xr Fluoro Needle Placement,929.0,696.75,720.9,878.0,3
CPT,77048,MRI Breast W/Out&With Contrast W/Cad Unilateral,2029.0,1521.75,1574.5,1574.5,1
CPT,77049,MRI Breast Without&With Contrast W/Cad Bilateral,2019.0,1514.25,1566.74,6776.35,7
CPT,77062,Digital Breast Tomosynthesis Bilateral,316.0,237.0,245.22,300.83,4
CPT,77063,Screening Digital Breast Tomosynthesis Bi,316.0,237.0,112.35,300.83,8
CPT,77072,Xr Bone Age,648.0,486.0,502.85,601.67,2
CPT,77080,Xr Bone Density Axial,979.0,734.25,135.24,932.01,8
CPT,77080,Xr Bone Density Axial|UNUSUAL SEPARATE SERVICE,979.0,734.25,126.27,126.27,1
CPT,77081,Xr Bone Density Appendicular,676.0,507.0,104.55,104.55,1
CPT,80048,Basic Metabolic Panel,143.0,107.25,110.97,136.14,7
CPT,80050,General Health Panel,220.0,165.0,170.72,209.44,5
CPT,80053,Comprehensive Metabolic Panel,253.0,189.75,196.33,240.86,7
CPT,80055,Obstetric Panel,465.0,348.75,425.99,438.4,2
CPT,80061,Lipid Panel,140.0,105.0,108.64,133.28,8
CPT,80069,Renal Function Panel,226.0,169.5,175.38,213.59,2
CPT,80074,Acute Hepatitis Panel,626.0,469.5,485.78,581.24,3
CPT,80076,Hepatic Function Panel,145.0,108.75,112.52,138.04,6
CPT,80143,Drug Assay Acetaminophen,167.0,125.25,145.96,145.96,1
CPT,80164,Drug Screen Quant Dipropylacetic Acid Total,122.0,91.5,94.67,113.28,2
CPT,80175,Drug Screen Quan Lamotrigine,141.0,105.75,109.42,109.42,1
CPT,80178,Lithium,71.0,53.25,55.1,67.59,2
CPT,80179,Drug Assay Salicylate,167.0,125.25,145.96,145.96,1
CPT,80197,Tacrolimus (Fk-506),157.0,117.75,148.38,148.38,1
CPT,80202,Vancomycin,135.0,101.25,104.76,104.76,1
CPT,80299,Adalimumab Qn,203.0,152.25,157.53,191.86,2
CPT,80299,Tda Nos Eslicarbazepine (Eg. Aptiom),109.0,81.75,84.58,103.02,2
CPT,80299,Therapeutic Drug Assay Other,214.0,160.5,166.06,202.25,2
CPT,80299,"Thiopurine Metabolites, Whole Blood",218.0,163.5,169.17,206.03,2
CPT,80299,Vedolizumab Level,357.0,267.75,277.03,337.4,2
CPT,80306,Presumptive Drug Test Read by Instrument Assisted Direct Optical Observation,140.0,105.0,108.64,133.28,4
CPT,80307,Presumptive Drug Test by Instrument Chemistry Analyzer,558.0,418.5,531.22,531.22,1
CPT,80400,Acth Stimulation Panel Adrenal,377.0,282.75,355.44,355.44,1
CPT,81001,Urinalysis Auto W/Micro,57.0,42.75,44.23,54.26,8
CPT,81003,Urinalysis Auto W/O Micro,38.0,28.5,29.49,36.18,6
CPT,81025,Urine Pregnancy Visual,79.0,59.25,61.3,75.21,6
CPT,81256,Analysis Gene Hfe Common Variants,292.0,219.0,255.21,255.21,1
CPT,81270,Analysis Gene Jak2 V617f Variant,648.0,486.0,610.93,610.93,1
CPT,81515,Nfct Ds Bct Vaginosis&Vaginitis Mult Amp Probe,921.0,690.75,714.7,876.79,4
CPT,82024,Adrenocorticotropic (Acth),282.0,211.5,246.47,246.47,1
CPT,82040,Albumin Serum/Plasma/Blood,37.0,27.75,28.71,34.35,2
CPT,82043,Microalbumin Qn Urine,92.0,69.0,71.39,86.95,5
CPT,82085,Aldolase,85.0,63.75,65.96,80.33,3
CPT,82088,Aldosterone,290.0,217.5,225.04,225.04,1
CPT,82103,Alpha-1 Antitrypsin Total,109.0,81.75,95.27,95.27,1
CPT,82105,Alpha Fetoprotein Serum,138.0,103.5,107.09,107.09,1
CPT,82108,Aluminum,308.0,231.0,293.22,293.22,1
CPT,82139,Amino Acids 6 or More Acids Qn,603.0,452.25,574.06,574.06,1
CPT,82140,Ammonia,104.0,78.0,98.29,98.29,1
CPT,82150,Amylase,67.0,50.25,51.99,51.99,1
CPT,82157,Androstenedione,223.0,167.25,173.05,173.05,1
CPT,82164,Angiotensin I Enzyme (Ace),127.0,95.25,98.55,98.55,1
CPT,82166,Assay of Anti-Mullerian Hormone,341.0,255.75,264.62,324.63,7
CPT,82172,Apolipoprotein,114.0,85.5,99.64,107.74,4
CPT,82247,Bilirubin Total,43.0,32.25,33.37,40.64,3
CPT,82248,Bilirubin Direct,42.0,31.5,32.59,39.0,2
CPT,82270,Occult Blood Feces Cancer Screen,31.0,23.25,27.09,27.09,1
CPT,82272,Occult Blood Feces Ql Other Single,36.0,27.0,27.94,33.43,2
CPT,82306,Vitamin D 25 Hydroxy Inc Fraction,227.0,170.25,176.15,216.1,6
CPT,82310,Calcium Total,38.0,28.5,35.28,36.18,2
CPT,82330,Calcium Ionized,115.0,86.25,89.24,106.78,2
CPT,82340,Calcium Qn Timed Urine,69.0,51.75,53.54,64.07,2
CPT,82378,Carcinoembryonic Antigen (Cea),140.0,105.0,108.64,122.36,2
CPT,82384,Catecholamines Fraction,178.0,133.5,169.46,169.46,1
CPT,82390,Ceruloplasmin,109.0,81.75,95.27,95.27,1
CPT,82480,Cholinesterase Serum,91.0,68.25,86.63,86.63,1
CPT,82523,Collagen Cross Links,92.0,69.0,86.95,87.58,2
CPT,82525,Copper,94.0,70.5,82.16,89.49,2
CPT,82530,Cortisol Free,135.0,101.25,104.76,127.59,3
CPT,82533,Cortisol Total,151.0,113.25,117.18,143.75,5
CPT,82542,Col-Chr/Ms Nondrug Analyte Nes Qual/Quan Ea Spec,228.0,171.0,176.93,217.06,2
CPT,82542,"HC Nch Perfluoroalkyl Substances (Pfas), Serum/Plasma",228.0,171.0,176.93,217.06,2
CPT,82542,"Porphoryns, Total, Plasma",228.0,171.0,176.93,217.06,2
CPT,82550,Creatine Kinase (Cpk) Total,58.0,43.5,45.01,55.22,5
CPT,82565,Creatinine Blood,38.0,28.5,29.49,29.49,1
CPT,82570,Creatinine Other Source,55.0,41.25,42.68,52.36,6
CPT,82570,Fractionated Catecholamines - 24 Hr Urine,55.0,41.25,42.68,52.36,6
CPT,82595,Cryoglobulin Ql or Sqn,78.0,58.5,73.72,73.72,1
CPT,82607,Vitamin B-12 (Cyancobalamin),123.0,92.25,95.45,117.1,5
CPT,82627,Dhea-S,226.0,169.5,175.38,215.15,5
CPT,82638,Dibucaine Number,151.0,113.25,143.75,143.75,1
CPT,82642,Dihydrotestosterone (Dht),289.0,216.75,268.34,268.34,1
CPT,82653,Elastase Pancreatic Fecal Quantitative,207.0,155.25,192.2,195.16,2
CPT,82670,Assay of Total Estradiol,248.0,186.0,192.45,236.1,6
CPT,82671,Estrogen Fractionated,401.0,300.75,350.47,378.99,2
CPT,82672,Estrogen Total,195.0,146.25,181.06,184.29,2
CPT,82679,Estrone,176.0,132.0,153.82,166.34,2
CPT,82725,Fatty Acids Nonesterified,93.0,69.75,86.35,86.35,1
CPT,82728,Ferritin,128.0,96.0,99.33,121.86,7
CPT,82735,Fluoride,230.0,172.5,218.96,218.96,1
CPT,82746,Folic Acid Serum,130.0,97.5,100.88,123.76,5
CPT,82784,Gammaglobulin Igm Iga Igd or Igg,86.0,64.5,66.74,81.87,5
CPT,82785,Gammaglobulin Ige,158.0,118.5,122.61,149.33,2
CPT,82805,Blood Gas W/O2 Sat,351.0,263.25,272.38,334.15,5
CPT,82947,Glucose Blood,123.0,92.25,114.21,117.1,3
CPT,82950,Glucose Post Dose,248.0,186.0,192.45,234.38,3
CPT,82955,G6pd Enzyme Qn,176.0,132.0,136.58,136.58,1
CPT,82962,Glucose by Device,31.0,23.25,24.06,29.3,4
CPT,82977,Ggt/Ggtp,70.0,52.5,54.32,66.64,4
CPT,82985,Glycated Protein (Fructosamine),179.0,134.25,166.2,166.2,1
CPT,83001,Follicle Stimulating Hormone (Fsh),95.0,71.25,73.72,90.44,5
CPT,83002,Luteinizing Hormone (Lh),128.0,96.0,99.33,121.86,5
CPT,83010,Haptoglobin Qn,130.0,97.5,120.71,120.71,1
CPT,83020,Hemoglobin Electrophoresis,158.0,118.5,138.09,138.09,1
CPT,83021,Hemoglobin Fract Qn,158.0,118.5,138.09,138.09,1
CPT,83036,Hemoglobin Glycosylated (A1c),86.0,64.5,66.74,81.87,7
CPT,83088,Histamine,134.0,100.5,103.98,103.98,1
CPT,83090,Homocystine,142.0,106.5,110.19,135.18,4
CPT,83497,Hydroxyindolacetic 5-(Hiaa),117.0,87.75,90.79,90.79,1
CPT,83498,Hydroxyprogesterone 17-D,205.0,153.75,159.08,179.17,2
CPT,83519,Immuno Qn Ria,184.0,138.0,175.17,175.17,1
CPT,83520,"Adalimumab Ab, S",201.0,150.75,155.98,186.63,3
CPT,83520,Immuno Qn Other,201.0,150.75,155.98,186.63,3
CPT,83520,Pancreatic Elastase-1,201.0,150.75,155.98,186.63,3
CPT,83520,Tryptase,201.0,150.75,155.98,186.63,3
CPT,83521,Immunoglobulin Light Chains Free Each,153.0,114.75,142.06,144.6,2
CPT,83525,Insulin Total,105.0,78.75,81.48,99.96,5
CPT,83540,IRON,67.0,50.25,51.99,63.78,6
CPT,83550,Iron Binding Capacity,76.0,57.0,58.98,72.35,6
CPT,83605,Lactate/Lactic Acid,106.0,79.5,82.26,100.91,5
CPT,83615,Lactate Dehydrogenase (Ldh),46.0,34.5,35.7,43.79,5
CPT,83631,Lactoferrin Fecal Qn,216.0,162.0,204.14,204.14,1
CPT,83655,LEAD,97.0,72.75,75.27,92.34,4
CPT,83690,Lipase,69.0,51.75,53.54,65.69,5
CPT,83695,Assay of Lipoprotein A,140.0,105.0,108.64,132.31,4
CPT,83698,Assay Lipoprotein Pla2,237.0,177.75,220.05,220.05,1
CPT,83700,Lipoprotein Electrophoresis Bld Qn,78.0,58.5,73.72,73.72,1
CPT,83704,Lipoprotein Blood by Nmr,223.0,167.25,207.06,207.06,1
CPT,83735,Magnesium,51.0,38.25,39.58,48.55,5
CPT,83825,Mercury,138.0,103.5,131.38,131.38,1
CPT,83835,Metanephrines,145.0,108.75,112.52,138.04,2
CPT,83880,Natriuretic Peptide,243.0,182.25,225.63,231.34,3
CPT,83921,Organic Acid Single Qn,223.0,167.25,173.05,210.76,3
CPT,83930,Osmolality Blood,50.0,37.5,38.8,38.8,1
CPT,83935,Osmolality Urine,59.0,44.25,45.78,45.78,1
CPT,83937,Osteocalcin,207.0,155.25,197.06,197.06,1
CPT,83970,Parathormone (Pth),293.0,219.75,227.37,278.94,4
CPT,84075,Phosphatase Alkaline,46.0,34.5,43.47,43.47,1
CPT,84080,Phosphatase Alkaline Isoenzyme,131.0,98.25,114.49,124.71,2
CPT,84100,Phosphorus,38.0,28.5,29.49,36.18,5
CPT,84105,Phosphorus Urine,62.0,46.5,59.02,59.02,1
CPT,84112,Eval Cervicovag Pamg-1 Pp12 Alpha-F,740.0,555.0,687.09,699.37,2
CPT,84132,Potassium Serum/ Plasma/ Blood,34.0,25.5,32.37,32.37,1
CPT,84134,Prealbumin,104.0,78.0,96.56,96.56,1
CPT,84140,Pregnenolone,264.0,198.0,245.12,251.33,2
CPT,84144,Progesterone,175.0,131.25,135.8,166.6,6
CPT,84146,Prolactin,201.0,150.75,155.98,191.35,5
CPT,84153,Prostatic Specific Antigen Total,139.0,104.25,107.86,132.33,6
CPT,84154,Prostatic Specific Antigen Free,137.0,102.75,106.31,129.48,3
CPT,84155,Protein Total Xcpt Refra Serum Plas,40.0,30.0,31.04,37.8,3
CPT,84156,Protein Total Urine,59.0,44.25,45.78,56.17,5
CPT,84165,Protein Electrophoresis,109.0,81.75,84.58,103.02,4
CPT,84166,Protein Electrophoretic Other Fluid,127.0,95.25,98.55,120.03,3
CPT,84207,Vitamin B-6 (Pyridoxal Phosphate),194.0,145.5,184.69,184.69,1
CPT,84270,Sex Hormone Binding Globulin,174.0,130.5,135.02,164.45,4
CPT,84300,Sodium Urine,42.0,31.5,32.59,32.59,1
CPT,84402,Testosterone Free,187.0,140.25,145.11,178.02,5
CPT,84403,Testosterone Total,229.0,171.75,177.7,218.01,5
CPT,84425,Vitamin B1 (Thiamine),151.0,113.25,140.2,142.71,2
CPT,84432,Thyroglobulin,208.0,156.0,161.41,161.41,1
CPT,84436,Thyroxine (T-4) Total,101.0,75.75,78.38,95.46,3
CPT,84439,Thyroxine (T-4) Free,103.0,77.25,79.93,98.06,6
CPT,84442,Thyroid Activity (Tbg),129.0,96.75,119.78,119.78,1
CPT,84443,Thyroid Stimulating Hormone (Tsh),148.0,111.0,114.85,140.9,6
CPT,84445,Thyroid Stimulating Immun Globulin,390.0,292.5,302.64,362.12,2
CPT,84450,Ast/Sgot,41.0,30.75,31.82,38.75,3
CPT,84460,Alt/Sgpt,43.0,32.25,33.37,40.64,3
CPT,84478,Triglycerides,59.0,44.25,54.78,54.78,1
CPT,84480,Triiodothyronine (T-3) Total,175.0,131.25,135.8,166.6,6
CPT,84481,Triiodothyronine (T-3) Free,195.0,146.25,151.32,185.64,5
CPT,84482,Triiodothyronine (T-3) Reverse,344.0,258.0,300.66,327.49,4
CPT,84484,Troponin Qn,114.0,85.5,88.46,108.53,5
CPT,84520,Urea Nitrogen Quantitative,35.0,26.25,27.16,27.16,1
CPT,84550,Uric Acid Blood,40.0,30.0,31.04,38.08,5
CPT,84630,ZINC,97.0,72.75,84.78,92.34,3
CPT,84681,C-Peptide,169.0,126.75,159.72,159.72,1
CPT,84702,Hcg Qn,150.0,112.5,116.4,142.8,6
CPT,84703,Hcg Ql,85.0,63.75,65.96,80.92,6
CPT,85007,Blood Smear W/Manual Diff Wbc,55.0,41.25,42.68,52.36,4
CPT,85014,Blood Count Hematocrit (Hct),26.0,19.5,20.18,24.75,4
CPT,85018,Blood Count Hemoglobin (Hgb),31.0,23.25,24.06,29.51,4
CPT,85025,Blood Count Cbc Auto W/Auto Diff,74.0,55.5,57.42,70.45,6
CPT,85027,Blood Count Cbc Auto W/O Diff,56.0,42.0,43.46,53.31,7
CPT,85045,Blood Count Reticulocyte Auto,48.0,36.0,44.57,44.57,1
CPT,85240,Factor VIII Ahg,287.0,215.25,222.71,222.71,1
CPT,85245,Factor VIII Vw Ristocetin Cofactor,253.0,189.75,196.33,196.33,1
CPT,85246,Factor VIII Vw Antigen,331.0,248.25,256.86,256.86,1
CPT,85300,Antithrombin III Activity,238.0,178.5,220.98,220.98,1
CPT,85303,Protein C Activity,321.0,240.75,298.05,298.05,1
CPT,85306,Protein S Free,311.0,233.25,288.76,288.76,1
CPT,85379,Fibrin Degradation D-Dimer Qn,118.0,88.5,91.57,112.34,5
CPT,85384,Fibrinogen Activity,71.0,53.25,65.92,67.1,2
CPT,85610,Prothrombin Time (Pt),45.0,33.75,34.92,42.84,5
CPT,85613,Russell Viper Venom Diluted,153.0,114.75,118.73,118.73,1
CPT,85651,Sed Rate RBC Non Auto,39.0,29.25,30.26,36.86,4
CPT,85652,Sed Rate RBC Auto,33.0,24.75,25.61,31.42,6
CPT,85730,Partial Thromboplastin Time (Ptt),62.0,46.5,48.11,59.02,4
CPT,86003,Rast Allergen Ige Qn Sq Ea,76.0,57.0,71.83,71.83,1
CPT,86008,Allergen Spec Ige Recombinant/Purified Compnt Ea,199.0,149.25,154.42,188.07,3
CPT,86015,Actin Smooth Muscle Antibody Each,103.0,77.25,90.02,90.02,1
CPT,86036,Antineutrophil Cytoplasmic Antb Screen Ea Antb,108.0,81.0,100.28,100.28,1
CPT,86039,Antinuclear Antibodies (Ana) Titer,85.0,63.75,65.96,80.92,5
CPT,86060,Antistreptolysin O Titer,93.0,69.75,72.17,72.17,1
CPT,86140,C-Reactive Protein,70.0,52.5,54.32,66.64,6
CPT,86141,C-Reactive Protein High Sensitivity,122.0,91.5,94.67,116.14,5
CPT,86146,Beta 2 Glycoprotein I Antibody Ea,157.0,117.75,121.83,121.83,1
CPT,86147,Cardiolipin Antibody Ea Ig Class,164.0,123.0,127.26,152.27,3
CPT,86160,Complement Antigen Ea Component,104.0,78.0,80.7,96.56,3
CPT,86162,Complement Total (Ch50),202.0,151.5,187.56,187.56,1
CPT,86200,Cyclic Citrulli Pept (CCP) Antibody,144.0,108.0,111.74,125.86,2
CPT,86215,Deoxyribonuclease (Dna) Antibody,109.0,81.75,84.58,84.58,1
CPT,86225,Dna Double Strand Antibody,122.0,91.5,94.67,113.28,3
CPT,86235,Extract Nuclear Antigen,128.0,96.0,99.33,120.97,4
CPT,86258,Gliadin Antibody Each Immunoglobulin Class,103.0,77.25,79.93,79.93,1
CPT,86300,Immunoassay Tumor Antigen Ca 15-3,147.0,110.25,128.48,128.48,1
CPT,86301,Immunoassay Tumor Antigen Ca 19-9,147.0,110.25,114.07,114.07,1
CPT,86304,Immunoassay Tumor Antigen Ca 125,182.0,136.5,141.23,173.26,2
CPT,86308,Heterophile Antibody Screen,94.0,70.5,72.94,89.49,5
CPT,86317,HC Immunoassay Infectious Agent Antibody Quan,106.0,79.5,100.18,100.18,1
CPT,86317,"Streptococcus Pneumoniae Igg Antibodies, 23 Serotypes, Serum",106.0,79.5,100.18,100.18,1
CPT,86334,Immunofixation Electrophores Serum,160.0,120.0,124.16,151.22,2
CPT,86337,Insulin Antibody,332.0,249.0,313.77,313.77,1
CPT,86341,Islet Cell Antibody,209.0,156.75,197.53,197.53,1
CPT,86360,T Cells Cd4 & Cd8 W/Ratio,165.0,123.75,155.94,155.94,1
CPT,86364,Tissue Transglutaminase Ea Immunoglobulin Class,103.0,77.25,79.93,98.06,5
CPT,86376,Microsomal Antibody,145.0,108.75,112.52,138.04,5
CPT,86431,Rheumatoid Factor Qn,92.0,69.0,71.39,86.95,4
CPT,86480,TB Test Cell Imm Ag Meas Gam Interf,668.0,501.0,518.37,635.94,6
CPT,86592,Syphilis Vdrl/Rpr Ql,51.0,38.25,39.58,48.55,5
CPT,86611,Bartonella Antibody,114.0,85.5,108.53,108.53,1
CPT,86617,Lyme Disease Antibody Confirm,194.0,145.5,150.54,184.69,6
CPT,86618,Lyme Disease Antibody,153.0,114.75,118.73,145.66,7
CPT,86644,Cytomegalovirus (Cmv) Antibody,154.0,115.5,119.5,145.55,2
CPT,86645,Cytomegalovirus (Cmv) Antibody Igm,168.0,126.0,130.37,130.37,1
CPT,86664,Epstein-Barr Ebna Ag Antibody,101.0,75.75,78.38,96.15,4
CPT,86665,Epstein-Barr Vca Ag Antibody,106.0,79.5,82.26,100.91,4
CPT,86666,Ehrlichia Antibody,139.0,104.25,107.86,132.33,3
CPT,86668,Francisella Tularensis Antibody,143.0,107.25,110.97,135.15,2
CPT,86695,Herpes Simplex Type I Antibody,101.0,75.75,78.38,96.15,2
CPT,86696,Herpes Simplex Type II Antibody,138.0,103.5,107.09,131.38,2
CPT,86704,Hepatitis B Core Antibody Igm Igg,115.0,86.25,89.24,109.48,5
CPT,86706,Hepatitis B Surface Antibody,101.0,75.75,78.38,96.15,5
CPT,86708,HEPATITIS A ANTIBODY (HAAb) TOTAL,112.0,84.0,86.91,86.91,1
CPT,86735,Mumps Antibody,144.0,108.0,133.7,136.09,2
CPT,86738,Mycoplasma Antibody,115.0,86.25,108.69,108.69,1
CPT,86747,Parvovirus Antibody,140.0,105.0,108.64,108.64,1
CPT,86753,Protozoa Antibody Not Specified,93.0,69.75,72.17,88.54,2
CPT,86757,Rickettsia Antibody,173.0,129.75,163.5,163.5,1
CPT,86762,Rubella Antibody,118.0,88.5,91.57,112.34,6
CPT,86765,Rubeola Antibody,131.0,98.25,101.66,124.71,6
CPT,86769,Antibody Sars-Cov-2,200.0,150.0,189.02,189.02,1
CPT,86780,Treponema Pallidum Antibody,146.0,109.5,113.3,138.99,5
CPT,86787,Varicella-Zoster Antibody,133.0,99.75,103.21,126.62,6
CPT,86790,Virus Not Elsewhere Specified,123.0,92.25,116.25,116.25,1
CPT,86800,Thyroglobulin Antibody,120.0,90.0,93.12,114.24,4
CPT,86803,Hepatitis C Antibody,127.0,95.25,98.55,120.9,5
CPT,86812,Hla Typing Single Antigen a/B/C,250.0,187.5,194.0,232.13,2
CPT,86850,RBC Antibody Screen,123.0,92.25,95.45,117.1,6
CPT,86880,Coombs Direct,62.0,46.5,75.54,75.54,1
CPT,86900,Blood Typing Serologic Abo,55.0,41.25,42.68,163.93,9
CPT,86901,HC Blood Typing Serologic Rh (D),49.0,36.75,38.02,46.65,6
CPT,86920,Crossmatch Immediate Spin,248.0,186.0,217.93,230.27,2
CPT,87040,Culture Blood Aerobic,130.0,97.5,100.88,122.86,4
CPT,87045,Culture Stool Salmonella & Shigella,119.0,89.25,92.34,112.47,6
CPT,87046,Culture Stool Other,68.0,51.0,52.77,64.27,6
CPT,87070,Culture Bacterial Other Source,109.0,81.75,84.58,103.77,6
CPT,87077,Culture Aerobic ID,68.0,51.0,52.77,64.74,5
CPT,87081,Culture Screen Single Organism,80.0,60.0,62.08,74.28,2
CPT,87086,Culture Urine W/Colony Count,91.0,68.25,70.62,86.63,7
CPT,87101,Culture Fungus Skin/Hair/Nail,96.0,72.0,90.73,90.73,1
CPT,87102,Culture Fungus Other,91.0,68.25,86.63,86.63,1
CPT,87150,Cult Type Amp Prb Cult/Isol Ea,317.0,237.75,245.99,299.6,5
CPT,87177,Smear Ova & Parasite Concent/Ident,128.0,96.0,99.33,120.97,6
CPT,87186,Susceptibility Mic per Plate,108.0,81.0,83.81,102.82,5
CPT,87205,Smear Gram or Geimsa Stain,49.0,36.75,38.02,46.65,5
CPT,87207,Spec Stain Incls Bodies/Parasites,88.0,66.0,68.29,76.91,2
CPT,87209,Complex Special Stain O/P Trich/Iro,183.0,137.25,142.01,172.95,6
CPT,87324,Eia Ql C Difficile Toxin(S) Antigen,160.0,120.0,148.56,148.56,1
CPT,87328,Eia Ql Cryptosporidium Antigen,92.0,69.0,71.39,71.39,1
CPT,87329,Eia Ql Giardia Antigen,115.0,86.25,89.24,108.69,3
CPT,87340,Eia Ql Hepatitis B Ag,118.0,88.5,91.57,112.34,5
CPT,87427,Eia Ql Multi Shiga-Like Toxin Ag,115.0,86.25,106.78,106.78,1
CPT,87449,Eia Ql Multi Antigen,113.0,84.75,87.69,104.92,3
CPT,87468,Iadna Anaplasma Phagocytophilum Amplifed Prb Tq,310.0,232.5,240.56,295.12,6
CPT,87469,Iadna Babesia Microti Amplified Probe Technique,310.0,232.5,240.56,295.12,6
CPT,87478,Iadna Borrelia Miyamotoi Amplified Prb Technique,310.0,232.5,287.84,295.12,2
CPT,87484,Iadna Ehrlichia Chaffeensis Amplified Probe Tq,310.0,232.5,240.56,295.12,6
CPT,87491,Nucleic Acid Amp Chlamydia Trach,184.0,138.0,142.78,175.17,7
CPT,87493,Nucleic Acid Amp Probe Clostridium,276.0,207.0,214.18,260.85,5
CPT,87497,Nucleic Acid Qn Cmv,310.0,232.5,240.56,292.98,2
CPT,87513,Iadna H Pylori Clarithromycin Resist Amp Prb Tq,312.0,234.0,242.11,294.87,4
CPT,87517,Nucleic Acid Qn Hepatitis B,306.0,229.5,237.46,284.12,2
CPT,87522,Nucleic Acid Rev Trans Qn Hepatitis,526.0,394.5,500.75,500.75,1
CPT,87529,Nucleic Acid Amp Probe Herpes Smpx,601.0,450.75,466.38,572.15,6
CPT,87532,Nucleic Acid Amp Probe Herpes 6,323.0,242.25,305.27,305.27,1
CPT,87536,Nucleic Acid Rev Trans Qn Hiv-1,405.0,303.75,376.04,376.04,1
CPT,87581,Nucleic Acid Amp Myco Pneum,319.0,239.25,301.49,301.49,1
CPT,87591,Nucleic Acid Amp N Gonorrhoeae,184.0,138.0,142.78,175.17,7
CPT,87637,Iadna Sarscov2 & Inf a&B & Rsv Mult Amp Probe Tq,519.0,389.25,402.74,494.09,6
CPT,87641,Nuc Acid Stph Aureus Amplified,323.0,242.25,250.65,299.91,2
CPT,87661,Iadna Trichomonas Vaginalis Amplified Probe Tech,282.0,211.5,218.83,261.84,2
CPT,87798,Babesia Microtiter Dna Pcr,321.0,240.75,249.1,305.59,7
CPT,87798,Her Anaplasma Det Pcr,321.0,240.75,249.1,305.59,7
CPT,87798,Nucleic Acid Amp Infectious,321.0,240.75,249.1,305.59,7
CPT,87801,Nucleic Acid Amp Multi Org,370.0,277.5,287.12,343.55,3
CPT,87806,Iaadiadoo Hiv1 Antigen W/Hiv1 & Hiv2 Antibodies,118.0,88.5,91.57,112.34,6
CPT,87880,Immunoassay Optical Strep A,91.0,68.25,70.62,86.63,7
CPT,87999,Microbiology Unlstd Proc,130.0,97.5,123.76,123.76,1
CPT,87999,Quest Anaerobic ID Org,26.0,19.5,24.75,24.75,1
CPT,88120,Cyto Urne 3-5 Probe Ea Spec Man,115.0,86.25,217.93,217.93,1
CPT,88184,Flow Cytometry 1st Marker Tc,157.0,117.75,457.47,457.47,1
CPT,89055,Leukocyte Assess Fecal Qn/Semi Qn,78.0,58.5,60.53,73.72,4
CPT,89060,Crystal ID Light Microscopy,70.0,52.5,54.32,54.32,1
CPT,90471,Immune Admin One Vacc Im/Sub-Q/ID,33.0,24.75,25.61,25.61,1
CPT,90471,Vfc Imadm Prq ID Subq/Im Njxs 1 Vaccine,23.0,17.25,17.85,17.85,1
CPT,90480,Imm Admn Sarscov2 Vaccine Single Dose,75.0,56.25,52.8,70.71,2
CPT,90480,Vfc Im Admn Sarscov2 Vaccine Sngl Dose,23.0,17.25,21.68,52.8,2
CPT,92507,St Treatment Speech/Lang/Comm Ind,785.0,588.75,609.16,686.09,2
CPT,92522,Evaluate Speech Production,457.0,342.75,354.63,354.63,1
CPT,92523,Speech Sound Lang Comprehen,1045.0,783.75,810.92,810.92,1
CPT,92611,St Eval Swallow Video/Fluoro,535.0,401.25,415.16,415.16,1
CPT,93005,Ekg Routine Tracing Only,275.0,206.25,75.54,261.8,9
CPT,93010,12 Lead Ecg Interpretation and Report Only,41.0,30.75,31.82,39.03,5
CPT,93225,Ecg Monitor/Report Up to 48 Hrs Rec,888.0,666.0,824.51,824.51,1
CPT,93225,Ecg Monitor/Report Up to 48 Hrs Rec|RCRDG/STRG IN SLD ST MEMORY,888.0,666.0,163.93,163.93,2
CPT,93242,External Ecg Rec>48hr<7d Recording,1082.0,811.5,49.92,1022.6,6
CPT,93246,External Ecg Rec>7d<15d Recording,1442.0,1081.5,49.92,1362.83,5
CPT,93306,Echo Tthrc R-T 2d W/Wom-Mode Compl Spec&Colr D,1880.0,1410.0,697.3,1789.76,7
CPT,93308,Echo Transthoracic W/WO Fol W/Cont|PROFESSIONAL COMPONENT,944.0,708.0,307.41,307.41,2
CPT,93308,Echo Transthorc R-T 2d W/WO M-Mode Rec F-Up/Lmtd|PROFESSIONAL COMPONENT,944.0,708.0,307.41,307.41,2
CPT,93308,US Cardiac Echo Limited|PROFESSIONAL COMPONENT,115.0,86.25,307.41,307.41,2
CPT,93880,Duplex Extracranial/Carotid Bilat,2196.0,1647.0,307.41,2075.44,3
CPT,93970,Duplex Venous Extremity Bilat,2227.0,1670.25,307.41,2104.74,3
CPT,93975,Duplex Abd/Pel/Retro Cmpl,3256.0,2442.0,3023.2,3023.2,1
CPT,93978,Duplex Aorta/Ivc/Graft Cmpl,2162.0,1621.5,307.41,2043.31,3
CPT,94010,Pf Spirometry Smp,39.0,29.25,163.46,163.46,1
CPT,94010,Spirometry/Pft Smp,628.0,471.0,163.46,163.46,1
CPT,94060,Pf Spirometry/Pft Pre & Post B,69.0,51.75,396.02,396.02,4
CPT,94060,Spirometry/Pft Pre & Post Bronch,1134.0,850.5,396.02,396.02,4
CPT,94640,Nonpressurized Inhalation Treatment,380.0,285.0,258.66,294.88,2
CPT,94664,Aerosol Neb/Mdi/Ippb Demo/Eval,289.0,216.75,212.49,212.49,1
CPT,96360,IV Infus Hydration Initial 31 Min-1 Hour - 96360,532.0,399.0,267.94,502.79,5
CPT,96361,IV Infus Hydration Ea Additional Hour - 96361,242.0,181.5,58.68,230.38,6
CPT,96365,IV Infus Non-Chemo Initial Up to 1 Hr - 96365,651.0,488.25,267.94,619.75,8
CPT,96366,IV Infus Non-Chemo Same Drug Ea Hr - 96366,242.0,181.5,58.68,230.38,5
CPT,96367,IV Infus Non-Chemo Ea Add�L Seq Diff Drug Up to 1 Hr - 96367,319.0,239.25,90.51,301.49,3
CPT,96368,IV Non-Chemo Concurrent Infus - 96368,214.0,160.5,166.06,166.06,1
CPT,96372,Therapeutic Prophylactic/Diagnostic Inj Sc/Im - 96372,193.0,144.75,90.51,182.4,9
CPT,96374,Ivp/ IV < 16 Min Initial Drug - 96374,518.0,388.5,267.94,493.14,9
CPT,96375,Ivp/ IV <16min Ea Addl Seg Diff Drug - 96375,218.0,163.5,58.68,207.54,7
CPT,96376,Ivp/ IV <16 Min Ea Add�L Seq Same Drug - 96376,654.0,490.5,507.5,622.61,3
CPT,96401,Inj Sc/Im Chemo Non-Hormonal Anti-Neoplastic - 96401,292.0,219.0,90.51,90.51,1
CPT,96402,Inj Sc/Im Chemo Hormonal Anti-Neoplastic � 96402,292.0,219.0,90.51,275.97,6
CPT,96409,Chem Ivp/ IV <16 Min Initial Single Drug -96409,341.0,255.75,264.62,421.83,2
CPT,96411,Chemotx Admn Ivp/ IV <16 Min Ea Add�L Seq Diff Drug - 96411,604.0,453.0,90.51,570.84,3
CPT,96413,Chemo IV Infus Initial Up to 1 Hr - 96413,1415.0,1061.25,421.83,1337.32,5
CPT,96415,Chemo IV Infus Same Drug Ea Add�L Hr > or = to 31 Min - 96415,221.0,165.75,90.51,208.87,4
CPT,96416,Chemo IV Infusion Prolong W/Pump,1616.0,1212.0,1254.02,1254.02,1
CPT,96416,Chemo Infus > 8 External Pmp,1616.0,1212.0,1254.02,1254.02,1
CPT,96417,Chem IV Infus Tq Ea Add�L Seq Diff Drug Up to 1 Hr - 96417,697.0,522.75,90.51,658.73,3
CPT,96523,Irrigat Implant Ven Access Dvc,255.0,191.25,75.54,222.87,4
CPT,97012,Ot Traction Mechanical,168.0,126.0,130.37,130.37,1
CPT,97012,Pt Traction Mechanical,168.0,126.0,130.37,130.37,1
CPT,97014,"97014 E-Stim, Unattended",130.0,97.5,100.88,100.88,1
CPT,97014,Bwh Electrical Stim (Unattended) Non Time Based Pt,130.0,97.5,100.88,100.88,1
CPT,97032,Ot E-Stim Attended 15 Min,168.0,126.0,14.66,130.37,2
CPT,97032,Pt E-Stim Attended 15 Min,168.0,126.0,14.66,130.37,2
CPT,97035,Ot Ultrasound 15 Min,168.0,126.0,14.37,146.83,3
CPT,97035,Pt Ultrasound 15 Min,168.0,126.0,14.37,146.83,3
CPT,97110,Ot Exercise Therapeutic 15 Min,166.0,124.5,29.82,156.89,6
CPT,97110,Pt Exercise Therapeutic 15 Min,166.0,124.5,29.82,156.89,6
CPT,97112,Ot Neuromuscular Re-ED 15 Min,195.0,146.25,33.18,184.29,4
CPT,97112,Pt Neuromuscular Re-ED 15 Min,195.0,146.25,33.18,184.29,4
CPT,97116,Pt Gait Training 15 Min,168.0,126.0,130.37,130.37,1
CPT,97124,Ot Massage 15 Min,168.0,126.0,30.99,30.99,1
CPT,97124,Pt Massage 15 Min,168.0,126.0,30.99,30.99,1
CPT,97140,Ot Manual Therapy 15 Min,153.0,114.75,28.13,142.06,4
CPT,97140,Pt Manual Therapy 15 Min,153.0,114.75,28.13,142.06,4
CPT,97161,"Physical Therapy Evaluation, Low Complexity",408.0,306.0,101.45,385.6,5
CPT,97162,"Physical Therapy Evaluation, Moderate Complexity",408.0,306.0,101.45,375.36,4
CPT,97163,"Physical Therapy Evaluation, High Complexity",408.0,306.0,316.61,316.61,1
CPT,97164,Physical Therapy Re-Eval Est Plan Care 20 Mins,408.0,306.0,316.61,316.61,1
CPT,97165,"Occupational Therapy Evaluation, Low Complexity",408.0,306.0,104.2,316.61,2
CPT,97530,Ot Therapeutic Activity 15 Min,195.0,146.25,36.01,184.29,4
CPT,97530,Pt Therapeutic Activity 15 Min,195.0,146.25,36.01,184.29,4
CPT,97535,Ot Home Instruction/Program 15min,279.0,209.25,216.5,216.5,1
CPT,97535,Pt Home Instruction/Program 15min,279.0,209.25,216.5,216.5,1
CPT,97802,Nutrition Therapy Eval 15 Min,97.0,72.75,75.27,92.34,5
CPT,97803,Nutrition Therapy Re-Eval 15 Min,97.0,72.75,75.27,92.34,4
CPT,99195,Phlebotomy Therapeutic,354.0,265.5,163.93,334.57,4
CPT,99211,"Office Visit, Established Pat",40.5,30.375,31.04,31.82,2
CPT,99213,"Office Visit, Established Pat",211.5,158.625,163.74,196.84,6
CPT,99213,"Office Visit, Established Pat|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE OR OTHER SERVICE",211.5,158.625,166.9,167.69,2
CPT,99221,1st Hospital IP/Obs Care Sf/Low Mdm 40 Minutes,440.0,330.0,403.08,418.88,5
CPT,99221,Initial Observation Care/Day 30 Minutes,434.0,325.5,397.59,413.17,5
CPT,99221,Initial Observation Care/Day 50 Minutes,441.0,330.75,404.0,419.83,5
CPT,99221,Initial Observation Care/Day 70 Minutes,617.0,462.75,565.23,587.38,5
CPT,99222,1st Hospital IP/Obs Care Moderate Mdm 55 Minutes,601.0,450.75,466.38,572.15,5
CPT,99223,1st Hospital IP/Obs Care High Mdm 75 Minutes,882.0,661.5,684.43,839.66,5
CPT,99231,Sbsq Hospital IP/Obs Care Sf/Low Mdm 25 Minutes,98.0,73.5,85.65,92.62,3
CPT,99231,Sbsq Observation Care/Day 15 Minutes,123.0,92.25,107.5,116.25,3
CPT,99231,Sbsq Observation Care/Day 25 Minutes,219.0,164.25,191.41,206.98,3
CPT,99231,Sbsq Observation Care/Day 35 Minutes,455.0,341.25,397.67,430.02,3
CPT,99232,Sbsq Hospital IP/Obs Care Mod Mdm 35 Minutes,321.0,240.75,249.1,305.59,3
CPT,99235,Hospital IP/Obs Care Same Date Mod Mdm 70 Min,759.0,569.25,704.73,704.73,1
CPT,99238,Hospital IP/Obs Discharge Day Mgmt 30 Min/<,319.0,239.25,247.54,303.69,5
CPT,99238,Observation Care Discharge Management,286.0,214.5,221.94,272.27,5
CPT,99239,Hospital IP/Obs Discharge Day Mgmt > 30 Min,460.5,345.375,352.3,444.58,10
CPT,99284,Emergency Department Visit Moderate Mdm,658.0,493.5,505.69,505.69,2
CPT,99284,"Emergency Department Visit Moderate Mdm|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE OR OTHER SERVICE",658.0,493.5,505.64,505.64,2
CPT,99285,Emergency Department Visit High Mdm,849.5,637.125,391.1,1137.64,20
CPT,99291,Critical Care Ill/Injured Patient Init 30-74 Min,556.0,417.0,431.46,1000.55,9
CPT,99291,HC Critical Care; First 30-74 Minutes,1564.0,1173.0,1000.55,1488.93,9
CPT,99292,Critical Care Ill/Injured Patient Addl 30 Min,276.0,207.0,241.22,260.85,2
CPT,99292,Critical Care; Ea Add 30 Minutes,431.0,323.25,376.69,407.34,2
DRG,133,"Respiratory Failure,MODERATE",14390.94,,6533.19,6533.19,1
DRG,139,"Other Pneumonia,MINOR",12666.8,,3946.87,3946.87,1
DRG,139,"Other Pneumonia,MODERATE",12819.45,,5101.81,5101.81,1
DRG,142,"Interstitial And Alveolar Lung Diseases,EXTREME",45165.67,,16580.3,16580.3,1
DRG,142,"Interstitial And Alveolar Lung Diseases,MODERATE",15904.9,,7962.29,7962.29,1
DRG,194,"Heart Failure,MAJOR",16412.39,,9587.88,9587.88,1
DRG,197,"Peripheral And Other Vascular Disorders,MAJOR",53458.78,,9097.8,9097.8,1
DRG,197,"Peripheral And Other Vascular Disorders,MODERATE",42753.31,,6385.83,6385.83,1
DRG,241,"Peptic Ulcer And Gastritis,MAJOR",21737.01,,10793.07,10793.07,1
DRG,247,"Intestinal Obstruction,MODERATE",14027.38,,5542.76,5542.76,1
DRG,280,"Alcoholic Liver Disease,MAJOR",19138.24,,11172.34,11172.34,1
DRG,282,"Disorders Of Pancreas Except Malignancy,MINOR",20069.24,,4591.17,4591.17,1
DRG,282,"Disorders Of Pancreas Except Malignancy,MODERATE",18456.73,,6488.64,6488.64,1
DRG,383,"Cellulitis And Other Skin Infections,MAJOR",13049.4,,8602.02,8602.02,1
DRG,383,"Cellulitis And Other Skin Infections,MODERATE",20913.74,,5924.31,5924.31,1
DRG,463,"Kidney And Urinary Tract Infections,MODERATE",17447.14,,5227.47,5227.47,1
DRG,469,"Acute Kidney Injury,MODERATE",21013.38,,5403.39,5403.39,1
DRG,539,"Cesarean Section With Sterilization,MINOR",27300.23,,7994.28,7994.28,1
DRG,539,"Cesarean Section With Sterilization,MODERATE",23628.61,,9419.95,9419.95,1
DRG,540,"Cesarean Section Without Sterilization,MINOR",28032.68,,8215.9,8215.9,1
DRG,540,"Cesarean Section Without Sterilization,MODERATE",31175.2,,10490.35,10490.35,1
DRG,542,"Vaginal Delivery With O.R. Procedure Except Sterilization And/Or D&C,MINOR",18100.58,,7158.07,7158.07,1
DRG,542,"Vaginal Delivery With O.R. Procedure Except Sterilization And/Or D&C,MODERATE",13912.16,,8169.06,8169.06,1
DRG,560,"Vaginal Delivery,MINOR",17870.97,,6157.35,6157.35,2
DRG,560,"Vaginal Delivery,MODERATE",19909.3,,6906.74,6906.74,1
DRG,561,"Postpartum And Post Abortion Diagnoses Without Procedure,MODERATE",7272.84,,3635.01,3635.01,1
DRG,566,"Antepartum Without O.R. Procedure,MINOR",16627.87,,3720.69,3720.69,1
DRG,566,"Antepartum Without O.R. Procedure,MODERATE",7208.45,,5398.82,5398.82,1
DRG,581,"Neonate, Transferred < 5 Days Old, Born Here,MODERATE",3000.87,,2171.64,2171.64,1
DRG,626,"Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem,MINOR",6435.18,,2189.92,2189.92,1
DRG,626,"Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem,MODERATE",6426.63,,3504.78,3504.78,1
DRG,633,"Neonate Birth Weight > 2499 Grams With Major Anomaly,MINOR",6288.97,,3143.79,3143.79,1
DRG,639,"Neonate Birth Weight > 2499 Grams With Other Significant Condition,MINOR",3057.63,,4921.31,4921.31,1
DRG,640,"Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem,MINOR",4567.63,,1562.76,1562.76,2
DRG,640,"Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem,MODERATE",4627.63,,1990.0,1990.0,1
DRG,660,"Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagulation,MAJOR",16259.34,,14758.23,14758.23,1
DRG,720,"Septicemia And Disseminated Infections,MAJOR",31518.63,,9871.18,9871.18,1
DRG,720,"Septicemia And Disseminated Infections,MINOR",20305.42,,4604.88,4604.88,1
DRG,720,"Septicemia And Disseminated Infections,MODERATE",25125.27,,6160.78,6160.78,2
DRG,721,"Post-Operative, Post-Traumatic, Other Device Infections,MODERATE",32635.26,,7452.8,7452.8,1
DRG,724,"Other Infectious And Parasitic Diseases,MODERATE",29763.17,,6570.89,6570.89,1
HCPCS,77066,Diagnostic Mammo Bilat 2d Digital (Incl. Cad),721.0,540.75,559.5,686.39,5
HCPCS,77067,Mammogram Screen Bilat Digital (Incl. Cad),610.0,457.5,442.83,580.72,8
HCPCS,C1713,ANCHOR SUTURE 2.6MM PRESSFIT ONE STRAND,821.25,615.94,762.53,762.53,1
HCPCS,C1713,ANCHOR SUTURE 2.8MM POPLOK 1 HI-FI,1599.36,1199.52,1485.01,1485.01,1
HCPCS,C1713,ANCHOR SUTURE 3.5MM POPLOK ENDOSCOPY KNOTLESS PEEK SUB CORTICAL WING SHOULDER,1521.57,1141.18,1412.78,1412.78,1
HCPCS,C1713,ANCHOR SUTURE 4.5MM POPLOK ENDOSCOPY KNOTLESS PEEK SUB CORTICAL WING SHOULDER,1586.28,1189.71,1472.86,1472.86,1
HCPCS,C1713,ANCHOR SUTURE 4.75X19.1MM SWIVELOCK IMPLANT ARTHROSCOPY SPEEDBRIDGE BIOCOMPOSITE,4350.0,3262.5,4038.98,4038.98,1
HCPCS,C1713,ANCHOR SUTURE 6.5MM TRIPLE FIT - DISCONTINUED PER SUPPLIER/CONTRACTS,1359.66,1019.74,1262.44,1262.44,1
HCPCS,C1713,ANCHOR SUTURE PRESSFIT HI FI TWO STRAND 3.5 METRIC,907.77,680.83,842.86,842.86,1
HCPCS,C1713,ANCHOR SUTURE SIZE 2 LENGTH2.8MM ARTHROSCOPY Y KNOT RC ALL DOUBLE LOADED HI FI,926.88,695.16,860.61,860.61,1
HCPCS,C1713,ANCHOR TISSUE 2.7MM POLYETHER ETHER KETONE NONBIOABSORBABLE,1014.0,760.5,941.5,941.5,1
HCPCS,C1713,ANKLE PLATE 9 HOLE BONE TITANIUM LOCKING LATERAL FIBULA,2946.0,2209.5,2735.36,2735.36,1
HCPCS,C1713,ANKLE PLATE LOCKING PEG HOOK 3 HOLE,2085.0,1563.75,1935.92,1935.92,1
HCPCS,C1713,ANKLE PLATE MEDIAL ANTI GLIDE 4 HOLE,1821.0,1365.75,1690.8,1690.8,1
HCPCS,C1713,ANTERIOR PLATE 5 HOLE BONE TIBIAL LOW PROFILE LOCKING,2766.0,2074.5,2568.23,2568.23,1
HCPCS,C1713,ANTERIOR PLATE 95X11MM 8 HOLE TITANIUM LOCKING,3579.0,2684.25,3323.1,3323.1,1
HCPCS,C1713,ARTICULAR PLATE BONE ACU LOC TITANIUM LOCKING EXTRA STANDARD,2607.0,1955.25,2420.6,2420.6,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 10 HOLE,294.0,220.5,272.98,272.98,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 12 HOLE,309.0,231.75,286.91,286.91,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 3 HOLE,204.0,153.0,189.41,189.41,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 4 HOLE,219.0,164.25,203.34,203.34,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 5 HOLE,234.0,175.5,217.27,217.27,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 6 HOLE,249.0,186.75,231.2,231.2,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 7 HOLE,264.0,198.0,245.12,245.12,1
HCPCS,C1713,BONE PLATE 1/3 TUBULAR 8 HOLE 7008-0108,279.0,209.25,259.05,259.05,1
HCPCS,C1713,BONE PLATE 2.7MM FRAGMENT T SHAPE 7010-0108N,1020.0,765.0,947.07,947.07,1
HCPCS,C1713,CLAVICLE PLATE 101X11 14MM 16 HOLE BONE TITANIUM LOCKING DISTAL RIGHT,3300.0,2475.0,3064.05,3064.05,1
HCPCS,C1713,CLAVICLE PLATE 3.5X68MM 9 HOLE BONE TITANIUM LOCKING DISTAL LEFT,3603.0,2702.25,3345.39,3345.39,1
HCPCS,C1713,DISTAL PLATE 59MM BONE ARM ACULOC 2 TITANIUM VOLAR RADIUS LT WIDE,3475.0,2606.25,3226.54,3226.54,1
HCPCS,C1713,ELBOW PLATE 14 HOLE BONE LOCKING LATERAL LEFT,3327.5,2495.62,3089.58,3089.58,1
HCPCS,C1713,ELBOW PLATE 88MM 8 HOLE MEDIAL TITANIUM LOCKING DISTAL HUMERUS,3522.0,2641.5,3270.18,3270.18,1
HCPCS,C1713,ELBOW PLATE CORONOID STANDARD RIGHT,3865.0,2898.75,3588.65,3588.65,1
HCPCS,C1713,ELBOW PLATE SM CORONOID RIGHT,3865.0,2898.75,3588.65,3588.65,1
HCPCS,C1713,FIBULA PLATE 4HOLE POSTEROLATERAL DISTAL TIBIA RIGHT,2688.0,2016.0,2495.81,2495.81,1
HCPCS,C1713,FIBULA PLATE LATERAL 9 HOLE RIGHT,2859.0,2144.25,2654.58,2654.58,1
HCPCS,C1713,FIBULA PLATE LATERAL LOW PROFILE 9 HOLE,2670.0,2002.5,2479.1,2479.1,1
HCPCS,C1713,FIBULA PLATE POSTEROLATERAL 4 HOLE RIGHT,2718.0,2038.5,2523.66,2523.66,1
HCPCS,C1713,FIBULA PLATE POSTEROLATERAL 6 HOLE RIGHT,2814.0,2110.5,2612.8,2612.8,1
HCPCS,C1713,HUMERAL PLATE EXTRA LONG IMAL LT TITANIUM,4205.0,3153.75,3904.34,3904.34,1
HCPCS,C1713,HUMERUS PLATE 103MM 7 HOLE BONE ARM POST LATERAL DISTAL LT,3437.5,2578.12,3191.72,3191.72,1
HCPCS,C1713,HUMERUS PLATE 152MM 11 HOLE BONE ARM DISTAL POSTERIOR LATERAL RIGHT,3437.5,2578.12,3191.72,3191.72,1
HCPCS,C1713,HUMERUS PLATE 203MM 15 HOLE BONE ARM POSTEROLATERAL DISTAL RIGHT,3830.0,2872.5,3556.16,3556.16,1
HCPCS,C1713,HUMERUS PLATE 75MM 5 HOLE BONE ARM POST LAT DISTAL RT,3639.0,2729.25,3378.81,3378.81,1
HCPCS,C1713,HUMERUS PLATE LG BONE HUMERAL PROXIMALIMAL POLARUS ROD SYSTEM RIGHT,3427.5,2570.62,3182.43,3182.43,1
HCPCS,C1713,Implant Pin/Wire/Peg T1,25.0,18.75,23.21,23.21,1
HCPCS,C1713,KIT LABORATORY PLATE SCREW ACU SINCH,3447.0,2585.25,3200.54,3200.54,1
HCPCS,C1713,KIT SCREW 8X20 3.5MM BONE CANNULATED INTERFERENCE PROPEL PINN ACL GUIDE SYSTEM,426.0,319.5,395.54,395.54,1
HCPCS,C1713,KIT SET TRACTION FIXATION TIGHTROPE SYNDESMOSIS REPAIR TITANIUM,3525.0,2643.75,3272.96,3272.96,1
HCPCS,C1713,LATERAL PLATE 13 HOLE BONE FIBULA LOW PROFILE,2670.0,2002.5,2479.1,2479.1,1
HCPCS,C1713,LATERAL PLATE 7 HOLE BONE FIBULA TITANIUM LOCKING LOW PROFILE,2670.0,2002.5,2479.1,2479.1,1
HCPCS,C1713,OLECRANON PLATE 110MM 7 HOLE ELBOW TITANIUM STANDARD LEFT,3615.0,2711.25,3356.53,3356.53,1
HCPCS,C1713,OLECRANON PLATE 90MM 5 HOLE BONE ELBOW LOCKING MIDSHAFT SUPERIOR TITANIUM LOW PROFILE LEFT,3822.0,2866.5,3548.73,3548.73,1
HCPCS,C1713,PASSER SUTURE 1.8MM 45DEGREE LEFT NITINOL LF PRELOADED STERILE DISPOSABLE,420.0,315.0,389.97,389.97,1
HCPCS,C1713,PEG BONE 2.3MM 14 CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING LOCKING SMOOTH BRONZE,375.0,281.25,348.19,348.19,1
HCPCS,C1713,PEG CORTICAL 2.3X36MM LOCKING,375.0,281.25,348.19,348.19,1
HCPCS,C1713,PEG HOOK LOCKING 2 HOLE,1977.0,1482.75,1835.64,1835.64,1
HCPCS,C1713,PLATE HUMERUS SIZE 0 PROXIMAL STANDARD LEFT,5096.0,3822.0,4731.64,4731.64,1
HCPCS,C1713,PLUG TIBIAL 2.4MM TUNNELER - DISCONTINUED PER NO USAGE,197.88,148.41,183.73,183.73,1
HCPCS,C1713,RADIUS PLATE 63MM LONG BONE ACU LOC 2 ARM TITANIUM VOLAR DISTAL NARROW PROXIMALIMAL LEFT,3475.0,2606.25,3226.54,3226.54,1
HCPCS,C1713,RADIUS PLATE ACU LOC 2 TITANIUM STANDARD LEFT,2706.0,2029.5,2512.52,2512.52,1
HCPCS,C1713,RADIUS PLATE BONE RADIAL STYLOID DIVERGENT DISTAL FIXATION SYSTEM ACU LOC 2,3132.0,2349.0,2908.06,2908.06,1
HCPCS,C1713,RADIUS PLATE XLONG BONE ACU LOC WRIST TITANIUM VOLAR DISTAL RIGHT,3084.0,2313.0,2863.49,2863.49,1
HCPCS,C1713,SCAPULA PLATE 10 HOLE BONE R LOCKING LATERAL BORDER LEFT,4068.0,3051.0,3777.14,3777.14,1
HCPCS,C1713,SCAPULA PLATE 4 HOLE BONE GLENOID LOCKING LEFT,3402.0,2551.5,3158.76,3158.76,1
HCPCS,C1713,SCAPULA PLATE 4 HOLE BONE GLENOID LOCKING RIGHT,3402.0,2551.5,3158.76,3158.76,1
HCPCS,C1713,SCAPULA PLATE ACROMION 6 HOLE LEFT,3965.0,2973.75,3681.5,3681.5,1
HCPCS,C1713,SCAPULA PLATE MEDIAL LOCKING 9 HOLE LEFT,3774.0,2830.5,3504.16,3504.16,1
HCPCS,C1713,SCREW BONE 10X25MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,714.9,536.17,663.78,663.78,1
HCPCS,C1713,SCREW BONE 10X30MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,1067.73,800.8,991.39,991.39,1
HCPCS,C1713,SCREW BONE 11X30MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,714.9,536.17,663.78,663.78,1
HCPCS,C1713,SCREW BONE 12X2.7MM TAP LOC HEXALOBE TITANIUM VARIABLE ANGLE LOCKING FULL THREAD DISTAL,420.0,315.0,389.97,389.97,1
HCPCS,C1713,SCREW BONE 12X3.5MM RADIUS TAP LOC HEXALOBE TITANIUM VOLAR DISTAL PLATING NONLOCKING FULL THREAD,213.0,159.75,197.77,197.77,1
HCPCS,C1713,SCREW BONE 12X4.0MM CANCELLOUS TITANIUM,237.0,177.75,220.05,220.05,1
HCPCS,C1713,SCREW BONE 14X3.5MM CORTICAL ACU LOC 2 TITANIUM,183.0,137.25,169.92,169.92,1
HCPCS,C1713,SCREW BONE 14X3.5MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING LOCKING THREAD,390.0,292.5,362.12,362.12,1
HCPCS,C1713,SCREW BONE 16X2.3MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING NONTOGGLING,258.0,193.5,239.55,239.55,1
HCPCS,C1713,SCREW BONE 18X2.3MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING LOCKING FULL THREAD GOLD,375.0,281.25,348.19,348.19,1
HCPCS,C1713,SCREW BONE 2.3X18MM ACU LOC HEXALOBE VARIABLE ANGLE TI LOCKING DISTAL,477.0,357.75,442.89,442.89,1
HCPCS,C1713,SCREW BONE 2.7X10MM CORTICAL TITANIUM FULL THREAD DISTAL ROUNDED HEAD NONLOCKING,201.0,150.75,186.63,186.63,1
HCPCS,C1713,SCREW BONE 2.7X38MM NON LOCKING HEXALOBE TITANIUM FULL THREAD,213.0,159.75,197.77,197.77,1
HCPCS,C1713,SCREW BONE 2.7X44MM LOCKING HEXALOBE TITANIUM FULL THREAD,420.0,315.0,389.97,389.97,1
HCPCS,C1713,SCREW BONE 26X2.3MM CORTICAL ACU LOC 2 TITANIUM VOLAR DISTAL PLATING NONTOGGLING,258.0,193.5,239.55,239.55,1
HCPCS,C1713,SCREW BONE 3.5MM TAP SURGICAL LOCKING FOREFOOT PLATING SYSTEM CORTICAL HARD,387.0,290.25,359.33,359.33,1
HCPCS,C1713,SCREW BONE 3.5X10MM RADIUS TAP LOC HEXALOBE TI VOLAR DISTAL PLATING LOCKING,510.0,382.5,473.54,473.54,1
HCPCS,C1713,SCREW BONE 3.5X50MM TAP LOC HEXALOBE TITANIUM VARIABLE ANGLE LOCKING FULL THREAD DISTAL,510.0,382.5,473.54,473.54,1
HCPCS,C1713,SCREW BONE 3.5X60MM VARIABLE ANGLE HEXALOBE,477.0,357.75,442.89,442.89,1
HCPCS,C1713,SCREW BONE 30MM ACUTWIST COMPRESSION,627.0,470.25,582.17,582.17,1
HCPCS,C1713,SCREW BONE 4.5X20MM LOCKING CORTICAL SELF TAPPING,228.0,171.0,211.7,211.7,1
HCPCS,C1713,SCREW BONE 48X4MM CANNULATED LONG THREADED,741.0,555.75,688.02,688.02,1
HCPCS,C1713,SCREW BONE 4X45MM CANCELLOUS PARTIAL THREAD HEXALOBE,210.0,157.5,194.99,194.99,1
HCPCS,C1713,SCREW BONE 4X60MM CANCELLOUS PARTIAL THREAD HEXALOBE,258.0,193.5,239.55,239.55,1
HCPCS,C1713,SCREW BONE 5.0X40MM CANCELLOUS TITANIUM POLARUS,612.0,459.0,568.24,568.24,1
HCPCS,C1713,SCREW BONE 5.7X38MM HUMERAL TAP LOC HEXALOBE TITANIUM VAIRABLE ANGLE LOCKING FULL THREAD DISTAL,663.0,497.25,615.6,615.6,1
HCPCS,C1713,SCREW BONE 55X2.7MM TAP LOC HEXALOBE TITANIUM VARIABLE ANGLE NONLOCKING FULL THREAD DISTAL,279.0,209.25,259.05,259.05,1
HCPCS,C1713,SCREW BONE 55X3.5MM RADIUS TAP LOC HEXALOBE TITANIUM VOLAR DISTAL PLATING NONLOCKING FULL THREAD,279.0,209.25,259.05,259.05,1
HCPCS,C1713,SCREW BONE 9X25MM INTERFERENCE GENESYS MATRYX BIOCOMPOSITE,1067.73,800.8,991.39,991.39,1
HCPCS,C1713,SCREW BONE COMPRESSION FRAG LOC SS 30-0371,471.0,353.25,437.32,437.32,1
HCPCS,C1713,SCREW BONE SLEEVE COMPRESSION FRAG LOC,780.0,585.0,724.23,724.23,1
HCPCS,C1713,SCREW SPINAL 3.5X80MM ANTHEM TI NONLOCKING,132.0,99.0,122.56,122.56,1
HCPCS,C1713,SET BALL 3/8IN 3 3/32 .045 PIN BONE JURGAN SYSTEM W SERIES GENERAL,690.0,517.5,640.67,640.67,1
HCPCS,C1713,SUTURE HI-FI 2 36IN POLYESTER CO-BRAIDEDED 1STRAND NO NEEDLE BLUE WHITE BX/12EA,81.78,61.33,75.93,75.93,1
HCPCS,C1713,SUTURE HI-FI 2 HC-5 40IN POLYESTER BRAIDED TAPER 1STRAND 1/2 CIRCLE HIGH STRENGTH WHITE BX/12EA,66.75,50.06,61.98,61.98,1
HCPCS,C1713,TIBIA PLATE DISTAL POSTEROLATERAL 3 HOLE RIGHT,2568.0,1926.0,2384.39,2384.39,1
HCPCS,C1713,ULNA PLATE 80MM 6 HOLE ARM TITANIUM MIDHSHAFT,2334.0,1750.5,2167.12,2167.12,1
HCPCS,C1713,ULNA PLATE WRIST ACU LOC TITANIUM VOLAR DISTAL STANDARD LEFT,2826.0,2119.5,2623.94,2623.94,1
HCPCS,C1713,WASHER SCREW 7MM ODX3.6MM ID CANNULATED,171.0,128.25,158.77,158.77,1
HCPCS,C1713,WIRE BONE 5IN 0.062 CERCLAGE SS SPADE TIP DUAL END,21.01,15.76,19.51,19.51,1
HCPCS,C1713,WRIST PLATE BONE ACU LOC TITANIUM VOLAR DISTAL RADIUS STANDARD RIGHT,2706.0,2029.5,2512.52,2512.52,1
HCPCS,C1713,WRIST PLATE BONE STD DORSAL PLATING SYSTEM LT ACU LOC,3153.0,2364.75,2927.56,2927.56,1
HCPCS,C1726,BALLOON HERCULES 12MM 5.5CM 240 .035IN GUIDEWIRE 3 STAGE ENDOSCOPIC GASTROINTESTINAL OBLONG FILL WATER,786.0,589.5,609.94,729.8,2
HCPCS,C1726,DILATOR COLONIC 14MM DIA 5.5CM 7FR 240 BALLOON INFLATE CATHETER,975.0,731.25,756.6,905.29,2
HCPCS,C1758,CATHETER DOVER ROB-NEL 14FR 14IN URETHRAL SMOOTH ROUNDED TIP CS/100EA,1.47,1.1,1.14,1.36,3
HCPCS,C1781,GRAFT MESH 1.7IN VENTRALEX EPTFE PATCH UMBILICAL HERNIA REPR SELF EXPAND STRAP CIRCLE SM CS/2EA,1605.0,1203.75,1490.24,1490.24,1
HCPCS,C1781,GRAFT MESH 10.5CM 16CM 3DMAX POLYPROPYLENE MONOFILAMENT PATCH LAPAROSCOPY HERNIA REPAIR RIGHT CS/1EA,780.0,585.0,724.23,724.23,1
HCPCS,C1781,GRAFT MESH 15CMX10 SYNTHETIC ABDOMINAL ABSORBABLE COATED ELLIPSE POLYPROPYLENE SEPRA VENTRALIGHT ST CS/1EA,2220.0,1665.0,2061.27,2061.27,1
HCPCS,C1781,GRAFT MESH 6.0IN VENTRALIGHT ST POLYPROPYLENE HERNIA SEPRA HYDROGEL BIORESORBABLE CIRCLE CS/1EA,3166.8,2375.1,2940.37,2940.37,1
HCPCS,C1781,GRAFT MESH 8.5CM 13.5CM 3DMAX POLYPROPYLENE MONOFILAMENT PATCH LAPAROSCOPY HERNIA REPAIR LEFT CS/1EA,720.0,540.0,668.52,668.52,1
HCPCS,C1781,MESH GRAFT 1.6X1.9IN 4.1 4.8CM LG PERFIX POLYPROPYLENE MONOFILAMENT PLUG INGUINAL HERNIA SOFT TISSUE REPAIR CS/2EA,666.86,500.14,619.18,619.18,1
HCPCS,C1781,MESH GRAFT 15CMX10 PROGRIP PET PLA LAPAROSCOPY TACK FREE CONTOURED RESORBABLE RIGHT,1033.44,775.08,959.55,959.55,1
HCPCS,C1781,MESH GRAFT 15CMX10 PROGRIP PET PLA LAPAROSCOPY TACK FREE RECTANGLE RESORBABLE FLAT SHEET,865.2,648.9,803.34,803.34,1
HCPCS,C1781,MESH HERNIA 2.0MMX10 15CM DUAL BIOMATERIAL OVAL,2835.0,2126.25,2632.3,2632.3,1
HCPCS,C1781,MESH SEPARATING 2.4X5.4IN PROLENE TISSUE POLYPROPYLENE NONABSORBABLE PRESHAPED KEYHOLE HERNIA REPAIR BX/6EA,231.6,173.7,215.04,215.04,1
HCPCS,C1781,MESH SURGICAL 1.8X4.0IN SM HERNIA PROLENE POLYPROPYLENE NONABSORBABLE PRESHAPED KEYHOLE REPAIR BX/3EA,403.71,302.78,374.84,374.84,1
HCPCS,C1781,MESH SYNTHETIC 6.0 XIN ABDOMINAL NON ABSORBABLE SQUARE POLYPROPYLENE BX/6EA,193.42,145.06,179.59,179.59,1
HCPCS,C1781,Mesh T2,4063.19,3047.39,3772.67,3772.67,1
HCPCS,C1781,STRAP POCKET 1.7IN SM GRAFT MESH VENTRALEX ST POLYPROPYLENE PGA PATCH HERNIA FIBER HYDROGEL BIORESORBABLE CIRCLE CA/1EA,1695.0,1271.25,1573.81,1573.81,1
HCPCS,C1781,STRAP POCKET 2.5IN MED GRAFT MESH VENTRALEX ST POLYPROPYLENE PGA PATCH HERNIA FIBER HYDROGEL BIORESORBABLE CIRCLE CS/1EA,2040.0,1530.0,1894.14,1894.14,1
HCPCS,C1781,STRAP POCKET 3.2I N LARGE GRAFT MESH VENTRALEX POLYPROPYLENE PGA PATCH HERNIA FIBER HYDROGEL BIORESORBABLE CIRCLE CA/1EA,2610.0,1957.5,2423.39,2423.39,1
HCPCS,C1788,KIT PORT 6.0FR INFUSION VASCULAR MRI POWER ISP PLASTIC ATTACHABLE POLYURETHANE CATHETER ATTACHED SUTURE PLUG,1044.0,783.0,810.14,810.14,1
HCPCS,C1788,PORT POWERPORT CLEARVUE ISP 8FR CATHETER POLYURETHANE IMPLANTABLE SINGLE LUMEN INTERMEDIATE VALVED INTRODUCER,1260.0,945.0,977.76,977.76,1
HCPCS,C8902,Mra Abdomen W&W/O Cont,4897.0,3672.75,424.11,424.11,1
HCPCS,C8908,MRI Breast Bilat W&W/O Cont,8060.0,6045.0,454.18,454.18,1
HCPCS,C8911,Mra Chest W&W/O Contrast,4875.0,3656.25,424.07,4607.36,2
HCPCS,G0008,Admin of Influenza Vaccine,33.0,24.75,58.68,58.68,1
HCPCS,G0008,Vfc Admin Influenza Virus Vac,23.0,17.25,58.68,58.68,1
HCPCS,G0103,Prostate Cancer Screen Psa,227.0,170.25,198.4,198.4,1
HCPCS,G0105,Colon Cancer Scr Colonoscopy,1913.0,1434.75,1159.47,1159.47,1
HCPCS,G0105,Colorectal Scrn; Hi Risk Ind,293.0,219.75,1159.47,1159.47,1
HCPCS,G0121,Colon Ca Scrn Not Hi Rsk Ind,305.0,228.75,1159.47,1159.47,1
HCPCS,G0121,Colon Cancer Scr Non-Hr,1913.0,1434.75,1159.47,1159.47,1
HCPCS,G0378,Observation 1 Hr,134.0,100.5,103.98,127.57,24
HCPCS,G0378,Observation Carve Out (10000 - 29999) - Integumentary/Musculoskeletal,134.0,100.5,103.98,127.57,4
HCPCS,G0378,Observation Carve Out (50000 - 59999) - Urinary/Male/Female/Maternity,134.0,100.5,103.98,127.57,4
HCPCS,G0378,Observation Carve Out (60000 - 69999) - Endo/Nervous/Eye/Auditory,134.0,100.5,103.98,127.57,4
HCPCS,G0378,Observation Carve Out (90785 - 98965) - Medicine,134.0,100.5,103.98,127.57,4
HCPCS,J7296,SYSTEM KYLEENA 19.5MG LEVONORGESTREL-RELEASING INTRAUTERINE,2915.1,2186.32,2706.67,2706.67,1
HCPCS,P9016,Red Cells L/R Ea,771.0,578.25,194.92,715.87,3
HCPCS,P9040,Red Cells L/R Irr Ea,1510.0,1132.5,273.96,273.96,1
HCPCS,P9073,"Platelets, Pheresis, Pathogen-Reduced, Each Unit",3413.0,2559.75,587.28,587.28,1
HCPCS,S9485,Crisis Intervention Mental Health Services,3211.0,2408.25,2491.74,2491.74,1
MS-DRG,057,Degenerative Nervous System Disorders Without McC,26081.37,19561.03,13605.98,13605.98,2
MS-DRG,058,Multiple Sclerosis And Cerebellar Ataxia With McC,42014.18,31510.63,17254.99,17254.99,2
MS-DRG,059,Multiple Sclerosis And Cerebellar Ataxia With Cc,31874.46,23905.84,13123.74,13123.74,2
MS-DRG,064,Intracranial Hemorrhage Or Cerebral Infarction With McC,41082.8,30812.1,19913.04,19913.04,2
MS-DRG,065,Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,41101.14,30825.85,11090.75,11090.75,2
MS-DRG,066,Intracranial Hemorrhage Or Cerebral Infarction Without Cc/McC,36596.97,27447.73,8217.57,8217.57,1
MS-DRG,074,Cranial And Peripheral Nerve Disorders Without McC,36147.04,27110.28,11271.48,11271.48,1
MS-DRG,083,Traumatic Stupor And Coma >1 Hour With Cc,15167.72,11375.79,14489.36,14489.36,2
MS-DRG,092,Other Disorders Of Nervous System With Cc,34672.8,26004.6,11202.7,11202.7,2
MS-DRG,100,Seizures With McC,25275.28,18956.46,19258.9,19258.9,2
MS-DRG,101,Seizures Without McC,33348.49,25011.37,10141.24,10141.24,2
MS-DRG,153,Otitis Media And Uri Without McC,9501.99,7126.49,8691.87,8691.87,2
MS-DRG,155,"Other Ear, Nose, Mouth And Throat Diagnoses With Cc",35186.83,26390.12,10263.79,10263.79,2
MS-DRG,177,Respiratory Infections And Inflammations With McC,42076.38,31557.28,15960.77,15960.77,4
MS-DRG,178,Respiratory Infections And Inflammations With Cc,26236.59,19677.44,10788.35,10788.35,2
MS-DRG,184,Major Chest Trauma With Cc,37978.91,28484.18,11565.05,11565.05,2
MS-DRG,189,Pulmonary Edema And Respiratory Failure,21823.03,16367.27,13075.26,13075.26,2
MS-DRG,190,Chronic Obstructive Pulmonary Disease With McC,17862.18,13396.63,11949.43,11949.43,2
MS-DRG,191,Chronic Obstructive Pulmonary Disease With Cc,15613.73,11710.3,9615.8,9615.8,2
MS-DRG,193,Simple Pneumonia And Pleurisy With McC,20091.73,15068.8,13771.73,13771.73,2
MS-DRG,194,Simple Pneumonia And Pleurisy With Cc,17283.01,12962.26,9288.72,9288.72,2
MS-DRG,195,Simple Pneumonia And Pleurisy Without Cc/McC,17546.9,13160.17,7724.73,7724.73,2
MS-DRG,202,Bronchitis And Asthma With Cc/McC,23248.99,17436.74,10746.03,10746.03,2
MS-DRG,281,"Acute Myocardial Infarction, Discharged Alive With Cc",16958.0,12718.5,10286.71,10286.71,2
MS-DRG,291,Heart Failure And Shock With McC,20047.39,15035.54,13501.95,13501.95,3
MS-DRG,292,Heart Failure And Shock With Cc,14260.9,10695.67,9668.69,9668.69,2
MS-DRG,303,Atherosclerosis Without McC,16186.79,12140.09,8118.82,8118.82,2
MS-DRG,305,Hypertension Without McC,14518.79,10889.09,8840.86,8840.86,2
MS-DRG,307,Cardiac Congenital And Valvular Disorders Without McC,18507.51,13880.63,10234.7,10234.7,2
MS-DRG,308,Cardiac Arrhythmia And Conduction Disorders With McC,26944.88,20208.66,12798.43,12798.43,2
MS-DRG,309,Cardiac Arrhythmia And Conduction Disorders With Cc,13886.35,10414.76,8669.83,8669.83,2
MS-DRG,312,Syncope And Collapse,16122.13,12091.6,9867.94,9867.94,2
MS-DRG,378,Gastrointestinal Hemorrhage With Cc,18814.4,14110.8,10829.78,10829.78,2
MS-DRG,379,Gastrointestinal Hemorrhage Without Cc/McC,22699.22,17024.41,7741.5,7741.5,2
MS-DRG,386,Inflammatory Bowel Disease With Cc,54608.74,40956.55,10791.0,10791.0,2
MS-DRG,389,Gastrointestinal Obstruction With Cc,26147.04,19610.28,9146.79,9146.79,2
MS-DRG,391,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With McC",19984.76,14988.57,13365.31,13365.31,2
MS-DRG,392,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without McC",24968.67,18726.5,9056.86,9056.86,3
MS-DRG,399,Appendix Procedures Without Cc/McC,31825.64,23869.23,12275.63,12275.63,1
MS-DRG,440,Disorders Of Pancreas Except Malignancy Without Cc/McC,20069.24,15051.93,7662.15,7662.15,2
MS-DRG,442,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc",18047.23,13535.42,10694.02,10694.02,2
MS-DRG,501,Soft Tissue Procedures With Cc,60758.41,45568.81,17595.28,17595.28,2
MS-DRG,536,Fractures Of Hip And Pelvis Without McC,30195.79,22646.84,9303.71,9303.71,2
MS-DRG,539,Osteomyelitis With McC,13805.41,10354.06,19548.94,19548.94,1
MS-DRG,543,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc,26004.57,19503.43,11246.78,11246.78,2
MS-DRG,547,Connective Tissue Disorders Without Cc/McC,31493.86,23620.39,9555.86,9555.86,3
MS-DRG,551,Medical Back Problems With McC,36590.42,27442.81,16960.52,16960.52,2
MS-DRG,552,Medical Back Problems Without McC,23552.71,17664.53,10658.75,10658.75,2
MS-DRG,558,"Tendonitis, Myositis And Bursitis Without McC",13760.83,10320.62,10058.37,10058.37,2
MS-DRG,560,"Aftercare, Musculoskeletal System And Connective Tissue With Cc",26962.92,20222.19,12111.65,12111.65,1
MS-DRG,563,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without McC",26931.49,20198.62,10078.64,10078.64,2
MS-DRG,564,Other Musculoskeletal System And Connective Tissue Diagnoses With McC,38181.75,28636.31,15792.39,15792.39,2
MS-DRG,565,Other Musculoskeletal System And Connective Tissue Diagnoses With Cc,37641.19,28230.89,10774.24,10774.24,2
MS-DRG,593,Skin Ulcers With Cc,24164.04,18123.03,12642.38,12642.38,2
MS-DRG,594,Skin Ulcers Without Cc/McC,28856.17,21642.13,9825.63,9825.63,2
MS-DRG,602,Cellulitis With McC,27204.17,20403.13,14714.17,14714.17,2
MS-DRG,603,Cellulitis Without McC,15323.15,11492.36,9861.77,9861.77,2
MS-DRG,605,"Trauma To The Skin, Subcutaneous Tissue And Breast Without McC",21656.19,16242.14,10259.37,10259.37,2
MS-DRG,607,Minor Skin Disorders Without McC,22776.91,17082.68,10174.75,10174.75,2
MS-DRG,638,Diabetes With Cc,22550.7,16913.02,10084.82,10084.82,2
MS-DRG,639,Diabetes Without Cc/McC,17730.78,13298.08,7660.38,7660.38,2
MS-DRG,641,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without McC",19672.97,14754.73,9044.52,9044.52,2
MS-DRG,682,Renal Failure With McC,29726.69,22295.02,15240.5,15240.5,3
MS-DRG,683,Renal Failure With Cc,15033.16,11274.87,9904.98,9904.98,2
MS-DRG,689,Kidney And Urinary Tract Infections With McC,27082.29,20311.72,12413.16,12413.16,2
MS-DRG,690,Kidney And Urinary Tract Infections Without McC,19374.04,14530.53,9320.45,9320.45,2
MS-DRG,698,Other Kidney And Urinary Tract Diagnoses With McC,25018.37,18763.78,16769.21,16769.21,2
MS-DRG,699,Other Kidney And Urinary Tract Diagnoses With Cc,13711.4,10283.55,11132.19,11132.19,2
MS-DRG,700,Other Kidney And Urinary Tract Diagnoses Without Cc/McC,12516.3,9387.22,8266.06,8266.06,2
MS-DRG,808,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders With McC,20497.59,15373.19,21648.94,21648.94,1
MS-DRG,811,Red Blood Cell Disorders With McC,24691.91,18518.93,14564.29,14564.29,2
MS-DRG,812,Red Blood Cell Disorders Without McC,26745.16,20058.87,10278.78,10278.78,2
MS-DRG,813,Coagulation Disorders,25812.96,19359.72,15631.05,15631.05,2
MS-DRG,857,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Cc,48344.43,36258.32,21063.55,21063.55,2
MS-DRG,864,Fever And Inflammatory Conditions,70785.62,53089.21,10009.88,10009.88,1
MS-DRG,866,Viral Illness Without McC,45364.49,34023.37,9850.31,9850.31,2
MS-DRG,867,Other Infectious And Parasitic Diseases Diagnoses With McC,41126.22,30844.66,20637.73,20637.73,2
MS-DRG,871,Septicemia Or Severe Sepsis Without Mv >96 Hours With McC,24445.56,18334.17,19309.14,19309.14,3
MS-DRG,872,Septicemia Or Severe Sepsis Without Mv >96 Hours Without McC,25939.7,19454.77,11205.34,11205.34,2
MS-DRG,880,Acute Adjustment Reaction And Psychosocial Dysfunction,27874.92,20906.19,10649.05,10649.05,2
MS-DRG,897,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without McC",18335.17,13751.38,9966.67,9966.67,2
MS-DRG,947,Signs And Symptoms With McC,16698.34,12523.75,13375.01,13375.01,2
MS-DRG,951,Other Factors Influencing Health Status,8277.17,6207.88,7085.57,7085.57,1
MS-DRG,981,Extensive O.R. Procedures Unrelated To Principal Diagnosis With McC,40707.56,30530.67,43547.35,43547.35,2