| Fine needle aspiration of first lesion |
10021 |
$759.00 |
$189.75 |
| Drainage of abscess |
10060 |
$332.00 |
$83.00 |
| Drainage of abscess |
10060 |
$188.00 |
$47.00 |
| Drainage of multiple abscess |
10061 |
$302.00 |
$75.50 |
| Drainage of tailbone cyst |
10080 |
$688.00 |
$172.00 |
| Drainage of tailbone cyst |
10081 |
$688.00 |
$172.00 |
| Removal of foreign body from tissue, accessed beneath the skin |
10120 |
$328.00 |
$82.00 |
| Drainage of blood or fluid accumulation |
10140 |
$4,495.00 |
$1,123.75 |
| Aspiration of abscess, blood accumulation, blister, or cyst |
10160 |
$328.00 |
$82.00 |
| Removal of inflamed or infected skin, up to 10% of body surface |
11000 |
$1,298.00 |
$324.50 |
| Removal of foreign material from skin and tissue at open fracture and/or dislocation |
11010 |
$957.00 |
$239.25 |
| Removal of foreign material from skin, tissue, muscle, and bone at open fracture and/or dislocation |
11012 |
$2,746.00 |
$686.50 |
| Removal of skin and tissue first 20 sq cm or less |
11042 |
$328.00 |
$82.00 |
| Removal of skin and/or muscle first 20 sq cm or less |
11043 |
$566.00 |
$141.50 |
| Removal of skin and bone first 20 sq cm or less |
11044 |
$1,580.00 |
$395.00 |
| Removal of single thickened skin growth |
11055 |
$196.00 |
$49.00 |
| Removal of up to and including 15 skin tags |
11200 |
$443.00 |
$110.75 |
| Shaving of 0.6 centimeters to 1.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth |
11311 |
$298.00 |
$74.50 |
| Removal of growth (0.5 centimeters or less) of the trunk, arms or legs |
11400 |
$634.00 |
$158.50 |
| Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs |
11402 |
$688.00 |
$172.00 |
| Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs |
11403 |
$957.00 |
$239.25 |
| Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth |
11440 |
$634.00 |
$158.50 |
| Removal of tissue from 1 to 5 finger or toe nails |
11720 |
$120.00 |
$30.00 |
| Separation of nail plate from nail bed |
11730 |
$168.00 |
$42.00 |
| Separation of nail plate from nail bed |
11732 |
$77.00 |
$19.25 |
| Removal of blood accumulation between nail and nail bed |
11740 |
$175.00 |
$43.75 |
| Removal of nail |
11750 |
$2,083.00 |
$520.75 |
| Repair of finger or toe nail bed |
11760 |
$531.00 |
$132.75 |
| Removal of skin of finger or toe nail |
11765 |
$443.00 |
$110.75 |
| Removal of drug delivery implant from tissue |
11982 |
$336.00 |
$84.00 |
| Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs |
12001 |
$531.00 |
$132.75 |
| Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs |
12002 |
$531.00 |
$132.75 |
| Repair of wound (7.6 to 12.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs |
12004 |
$531.00 |
$132.75 |
| Repair of wound (12.6 to 20.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs |
12005 |
$531.00 |
$132.75 |
| Repair of wound (20.1 to 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs |
12006 |
$374.00 |
$93.50 |
| Repair of wound (over 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs |
12007 |
$531.00 |
$132.75 |
| Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes |
12011 |
$531.00 |
$132.75 |
| Repair of wound (2.6 to 5.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes |
12013 |
$531.00 |
$132.75 |
| Repair of wound (5.1 to 7.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes |
12014 |
$531.00 |
$132.75 |
| Repair of wound (7.6 to 12.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes |
12015 |
$531.00 |
$132.75 |
| Repair of wound (12.6 to 20.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes |
12016 |
$531.00 |
$132.75 |
| Repair of wound (20.1 to 30.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes |
12017 |
$374.00 |
$93.50 |
| Repair of separation of wound closure |
12020 |
$498.00 |
$124.50 |
| Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs |
12031 |
$1,558.00 |
$389.50 |
| Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs |
12032 |
$1,558.00 |
$389.50 |
| Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs |
12034 |
$1,558.00 |
$389.50 |
| Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs |
12035 |
$498.00 |
$124.50 |
| Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs |
12036 |
$498.00 |
$124.50 |
| Repair of wound (over 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs |
12037 |
$3,077.00 |
$769.25 |
| Repair of wound (2.5 centimeters or less) of neck, hands, feet, and/or genitals |
12041 |
$374.00 |
$93.50 |
| Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals |
12042 |
$1,558.00 |
$389.50 |
| Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals |
12044 |
$1,558.00 |
$389.50 |
| Repair of wound (12.6 to 20.0 centimeters) of neck, hands, feet, and/or genitals |
12045 |
$578.00 |
$144.50 |
| Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth |
12051 |
$1,558.00 |
$389.50 |
| Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth |
12052 |
$1,558.00 |
$389.50 |
| Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth |
12053 |
$1,558.00 |
$389.50 |
| Repair of wound (7.6 to 12.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth |
12054 |
$531.00 |
$132.75 |
| Repair of wound (12.6 to 20.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth |
12055 |
$343.00 |
$85.75 |
| Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs |
13121 |
$498.00 |
$124.50 |
| Repair of wound of scalp, arms, and/or legs |
13122 |
$531.00 |
$132.75 |
| Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet |
13131 |
$1,558.00 |
$389.50 |
| Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet |
13132 |
$2,437.00 |
$609.25 |
| Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet |
13133 |
$1,558.00 |
$389.50 |
| Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips |
13151 |
$2,437.00 |
$609.25 |
| Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips |
13152 |
$2,437.00 |
$609.25 |
| Repair of wound of eyelids, nose, ears, and/or lips |
13153 |
$331.00 |
$82.75 |
| First degree burn treatment |
16000 |
$196.00 |
$49.00 |
| Dressing change and/or removal of burn tissue (less than 5% total body surface) |
16020 |
$168.00 |
$42.00 |
| Dressing change and/or removal of burn tissue (5% to 10% total body surface) |
16025 |
$298.00 |
$74.50 |
| Dressing change and/or removal of burn tissue (greater than 10% total body surface) |
16030 |
$664.00 |
$166.00 |
| Destruction of skin growth (less than 10 sq centimeters) |
17106 |
$1,298.00 |
$324.50 |
| Destruction of up to 14 skin growths |
17110 |
$196.00 |
$49.00 |
| Application of chemical agent to excessive wound tissue |
17250 |
$198.00 |
$49.50 |
| Skin, mucus membrane and beneath the skin procedure |
17999 |
$196.00 |
$49.00 |
| Aspiration of breast cyst |
19000 |
$965.00 |
$241.25 |
| Placement of breast localization devices accessed through the skin with mammographic guidance |
19281 |
$1,143.00 |
$285.75 |
| Placement of breast localization devices accessed through the skin with mammographic guidance |
19282 |
$1,143.00 |
$285.75 |
| Removal of foreign body in muscle or tendon |
20520 |
$1,580.00 |
$395.00 |
| Injections of tendon sheath, ligament, or muscle membrane |
20550 |
$272.00 |
$68.00 |
| Injections of tendon sheath, ligament, or muscle membrane |
20550 |
$561.00 |
$140.25 |
| Injections of trigger points in 1 or 2 muscles |
20552 |
$244.00 |
$61.00 |
| Aspiration and/or injection of small joint or joint capsule |
20600 |
$244.00 |
$61.00 |
| Aspiration and/or injection of medium joint or joint capsule |
20605 |
$244.00 |
$61.00 |
| Aspiration and/or injection of large joint or joint capsule |
20610 |
$435.00 |
$108.75 |
| Aspiration and/or injection of large joint or joint capsule |
20610 |
$244.00 |
$61.00 |
| Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance |
20611 |
$1,544.00 |
$386.00 |
| Aspiration and/or injection of cysts |
20612 |
$244.00 |
$61.00 |
| Insertion of device to monitor muscle compartment fluid pressure |
20950 |
$1,449.00 |
$362.25 |
| Closed treatment of broken nasal bone |
21315 |
$2,054.00 |
$513.50 |
| Closed treatment of jaw temporomandibular joint (TMJ) dislocation |
21480 |
$484.00 |
$121.00 |
| Injection of dye for X-ray imaging of shoulder joint |
23350 |
$362.00 |
$90.50 |
| Closed treatment of collar bone fracture |
23500 |
$197.00 |
$49.25 |
| Closed treatment of collar bone and shoulder joint dislocation with manipulation |
23545 |
$2,470.00 |
$617.50 |
| Closed treatment of broken shoulder blade with manipulation |
23575 |
$1,448.00 |
$362.00 |
| Closed treatment of upper arm fracture |
23600 |
$248.00 |
$62.00 |
| Closed treatment of broken upper arm bone with manipulation |
23605 |
$1,979.00 |
$494.75 |
| Closed treatment of broken upper arm bone at shoulder joint with manipulation |
23625 |
$1,518.00 |
$379.50 |
| Closed treatment of shoulder dislocation with manipulation |
23650 |
$248.00 |
$62.00 |
| Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation |
23665 |
$1,448.00 |
$362.00 |
| Closed treatment of shoulder dislocation and broken upper arm bone with manipulation |
23675 |
$1,448.00 |
$362.00 |
| Removal of foreign body of upper arm or elbow area, accessed beneath the skin |
24200 |
$1,580.00 |
$395.00 |
| Closed treatment of upper arm fracture |
24500 |
$828.00 |
$207.00 |
| Closed treatment of broken upper arm bone with manipulation |
24505 |
$1,448.00 |
$362.00 |
| Closed treatment of growth plate or broken upper arm bone at elbow with manipulation |
24535 |
$2,470.00 |
$617.50 |
| Closed treatment of broken of upper arm bone at shoulder with manipulation |
24577 |
$1,448.00 |
$362.00 |
| Treatment of elbow dislocation |
24600 |
$248.00 |
$62.00 |
| Closed treatment of dislocated forearm bone of elbow, child |
24640 |
$248.00 |
$62.00 |
| Closed treatment of broken forearm bone at elbow with manipulation |
24655 |
$2,470.00 |
$617.50 |
| Closed treatment of broken forearm bone at elbow with manipulation |
24675 |
$1,448.00 |
$362.00 |
| Upper arm and elbow procedure |
24999 |
$196.00 |
$49.00 |
| Closed treatment of broken forearm bone with manipulation |
25505 |
$1,448.00 |
$362.00 |
| Closed treatment of broken forearm bones with manipulation |
25565 |
$2,470.00 |
$617.50 |
| Closed treatment of broken forearm bones |
25600 |
$248.00 |
$62.00 |
| Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation |
25605 |
$1,448.00 |
$362.00 |
| Closed treatment of broken wrist bone with manipulation |
25635 |
$1,448.00 |
$362.00 |
| Closed treatment of dislocated wrist with manipulation |
25660 |
$248.00 |
$62.00 |
| Closed treatment of dislocated wrist with manipulation |
25675 |
$248.00 |
$62.00 |
| Closed treatment of dislocated wrist with manipulation |
25680 |
$227.00 |
$56.75 |
| Drainage of finger abscess |
26010 |
$301.00 |
$75.25 |
| Closed treatment of fracture hand bone |
26600 |
$248.00 |
$62.00 |
| Closed treatment of fracture of bone of hand with manipulation |
26605 |
$248.00 |
$62.00 |
| Closed treatment of thumb dislocation with manipulation |
26641 |
$248.00 |
$62.00 |
| Closed treatment of broken thumb with manipulation |
26645 |
$2,470.00 |
$617.50 |
| Closed treatment of dislocated hand bone with manipulation |
26670 |
$828.00 |
$207.00 |
| Closed treatment of dislocated hand joint with manipulation |
26700 |
$248.00 |
$62.00 |
| Closed treatment of dislocated hand joint with manipulation under anesthesia |
26705 |
$1,448.00 |
$362.00 |
| Closed treatment of broken finger or thumb |
26720 |
$828.00 |
$207.00 |
| Closed treatment of broken finger or thumb with manipulation |
26725 |
$248.00 |
$62.00 |
| Closed treatment of broken hand or finger with manipulation |
26742 |
$1,448.00 |
$362.00 |
| Closed treatment of broken finger or thumb |
26750 |
$828.00 |
$207.00 |
| Closed treatment of broken finger or thumb with manipulation |
26755 |
$248.00 |
$62.00 |
| Closed treatment of dislocated finger joint with manipulation |
26770 |
$828.00 |
$207.00 |
| Amputation of finger or thumb |
26951 |
$3,115.00 |
$778.75 |
| Amputation of finger or thumb |
26952 |
$2,995.00 |
$748.75 |
| Closed treatment of fracture and/or dislocation of pelvis and/or sacrum |
27197 |
$255.00 |
$63.75 |
| Closed treatment of fracture and/or dislocation of pelvis and/or sacrum with manipulation |
27198 |
$255.00 |
$63.75 |
| Closed treatment of hip socket fractures |
27220 |
$227.00 |
$56.75 |
| Treatment of hip dislocation |
27250 |
$248.00 |
$62.00 |
| Closed treatment of dislocated hip prosthesis |
27265 |
$248.00 |
$62.00 |
| Drainage of abscess or blood collection at thigh or knee region |
27301 |
$2,262.00 |
$565.50 |
| Closed treatment of broken thigh bone with manipulation |
27502 |
$1,518.00 |
$379.50 |
| Closed treatment of broken thigh bone |
27508 |
$248.00 |
$62.00 |
| Closed treatment of broken thigh bone with manipulation |
27510 |
$1,448.00 |
$362.00 |
| Closed treatment of knee cap fracture |
27520 |
$248.00 |
$62.00 |
| Closed treatment of fracture of shin bone |
27530 |
$227.00 |
$56.75 |
| Closed treatment of knee dislocation |
27550 |
$248.00 |
$62.00 |
| Closed treatment of knee dislocation under anesthesia |
27552 |
$1,658.00 |
$414.50 |
| Closed treatment of dislocation of knee cap |
27560 |
$197.00 |
$49.25 |
| Closed treatment of broken shin bone |
27750 |
$248.00 |
$62.00 |
| Closed treatment of broken shin bone with manipulation |
27752 |
$1,979.00 |
$494.75 |
| Closed treatment of broken ankle |
27760 |
$248.00 |
$62.00 |
| Closed treatment of broken ankle with manipulation |
27762 |
$1,979.00 |
$494.75 |
| Closed treatment of broken ankle with manipulation |
27768 |
$1,448.00 |
$362.00 |
| Closed treatment of broken ankle with manipulation |
27781 |
$1,448.00 |
$362.00 |
| Closed treatment of broken ankle |
27786 |
$248.00 |
$62.00 |
| Closed treatment of broken ankle with manipulation |
27788 |
$248.00 |
$62.00 |
| Closed treatment of broken ankle with manipulation |
27810 |
$1,448.00 |
$362.00 |
| Closed treatment of broken ankle |
27816 |
$248.00 |
$62.00 |
| Closed treatment of broken ankle with manipulation |
27818 |
$1,448.00 |
$362.00 |
| Closed treatment of fracture of lower weight bearing joint of shin bone with traction and/or manipulation |
27825 |
$1,979.00 |
$494.75 |
| Closed treatment of knee joint dislocation |
27830 |
$196.00 |
$49.00 |
| Closed treatment of ankle dislocation |
27840 |
$613.00 |
$153.25 |
| Leg or ankle procedure |
27899 |
$196.00 |
$49.00 |
| Removal of foreign body of foot tissue, accessed beneath the skin |
28190 |
$957.00 |
$239.25 |
| Closed treatment of broken heel bone with manipulation |
28405 |
$314.00 |
$78.50 |
| Closed treatment of broken ankle joint bone with manipulation |
28435 |
$1,518.00 |
$379.50 |
| Closed treatment of fracture of foot with manipulation |
28475 |
$248.00 |
$62.00 |
| Closed treatment of broken great toe with manipulation |
28495 |
$248.00 |
$62.00 |
| Closed treatment of broken toe with manipulation |
28515 |
$248.00 |
$62.00 |
| Closed treatment of ankle joint bone dislocation |
28540 |
$197.00 |
$49.25 |
| Closed treatment of dislocated foot joint |
28570 |
$613.00 |
$153.25 |
| Closed treatment of dislocated foot joint |
28600 |
$314.00 |
$78.50 |
| Closed treatment of dislocated foot bone |
28630 |
$248.00 |
$62.00 |
| Closed treatment of dislocation of toe joint |
28660 |
$197.00 |
$49.25 |
| Application of cast, elbow to finger (short arm) |
29075 |
$259.00 |
$64.75 |
| Application of long arm splint (shoulder to hand) |
29105 |
$148.00 |
$37.00 |
| Application of long arm splint (shoulder to hand) |
29105 |
$447.00 |
$111.75 |
| Application of non-moveable, short arm splint (forearm to hand) |
29125 |
$171.00 |
$42.75 |
| Application of non-moveable, short arm splint (forearm to hand) |
29125 |
$153.00 |
$38.25 |
| Application of moveable, hinged short arm splint (forearm to hand) |
29126 |
$116.00 |
$29.00 |
| Application of non-moveable, hinged finger splint |
29130 |
$116.00 |
$29.00 |
| Application of moveable, hinged finger splint |
29131 |
$116.00 |
$29.00 |
| Strapping of chest |
29200 |
$172.00 |
$43.00 |
| Strapping of shoulder |
29240 |
$116.00 |
$29.00 |
| Strapping of hand or finger |
29280 |
$116.00 |
$29.00 |
| Application of long leg cast (thigh to toes) |
29345 |
$259.00 |
$64.75 |
| Application of cylinder cast (thigh to ankle) |
29365 |
$279.00 |
$69.75 |
| Application of short leg cast (below knee to toes) |
29405 |
$259.00 |
$64.75 |
| Application of short leg cast (below knee to toes), walking or ambulatory type |
29425 |
$259.00 |
$64.75 |
| Application of long leg splint (thigh to ankle or toes) |
29505 |
$148.00 |
$37.00 |
| Application of short leg splint (calf to foot) |
29515 |
$148.00 |
$37.00 |
| Strapping of knee |
29530 |
$116.00 |
$29.00 |
| Strapping of knee |
29530 |
$223.00 |
$55.75 |
| Strapping of ankle and/or foot |
29540 |
$148.00 |
$37.00 |
| Strapping of toes |
29550 |
$116.00 |
$29.00 |
| Application of vein wound compression system lower leg below knee including ankle and foot |
29581 |
$196.00 |
$49.00 |
| Removal or bivalving of gauntlet, boot, or body cast |
29700 |
$275.00 |
$68.75 |
| Removal or bivalving of full arm or leg cast |
29705 |
$259.00 |
$64.75 |
| Casting or strapping procedure |
29799 |
$148.00 |
$37.00 |
| Drainage of abscess or blood accumulation in nose |
30000 |
$347.00 |
$86.75 |
| Drainage of abscess or blood accumulation in nasal cartilage |
30020 |
$421.00 |
$105.25 |
| Removal of foreign body in nose |
30300 |
$153.00 |
$38.25 |
| Simple control of nose bleed |
30901 |
$153.00 |
$38.25 |
| Control of nose bleed and insertion of packing |
30905 |
$150.00 |
$37.50 |
| Control of nosebleed and insertion of packing |
30906 |
$226.00 |
$56.50 |
| Diagnostic examination of nasal passages using an endoscope |
31231 |
$174.00 |
$43.50 |
| Control of nasal bleeding using an endoscope |
31238 |
$1,713.00 |
$428.25 |
| Emergent insertion of breathing tube into windpipe cartilage using an endoscope |
31500 |
$287.00 |
$71.75 |
| Emergent insertion of breathing tube into windpipe cartilage using an endoscope |
31500 |
$892.00 |
$223.00 |
| Diagnostic examination of voice box using flexible endoscope |
31575 |
$174.00 |
$43.50 |
| Emergent surgical opening of windpipe for insertion of breathing tube |
31605 |
$749.00 |
$187.25 |
| Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope |
31615 |
$1,005.00 |
$251.25 |
| Aspiration of lung secretions from lung airways using an endoscope |
31645 |
$1,353.00 |
$338.25 |
| Needle biopsy of lung or chest tissue, accessed through the skin |
32405 |
$1,442.00 |
$360.50 |
| Removal of fluid from between lung and chest cavity, open procedure |
32551 |
$989.00 |
$247.25 |
| Removal of fluid from between lung and chest cavity, open procedure |
32551 |
$874.00 |
$218.50 |
| Removal of fluid from chest cavity |
32554 |
$2,810.00 |
$702.50 |
| Removal of fluid from chest cavity |
32554 |
$874.00 |
$218.50 |
| Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin |
32556 |
$1,595.00 |
$398.75 |
| Aspiration of fluid from sac that covers the heart |
33010 |
$874.00 |
$218.50 |
| Injection to cause blood clot in a diseased or bulging vessel of arm or leg, accessed through the skin |
36002 |
$874.00 |
$218.50 |
| Insertion of needle into vein, patient 3 years or older |
36410 |
$27.00 |
$6.75 |
| Insertion of needle into vein, patient 3 years or older |
36410 |
$649.00 |
$162.25 |
| Insertion of needle into vein for collection of blood sample |
36415 |
$32.00 |
$8.00 |
| Puncture of skin for collection of blood sample |
36416 |
$32.00 |
$8.00 |
| Transfusion of blood or blood products |
36430 |
$1,774.00 |
$443.50 |
| Insertion of central venous catheter for infusion, patient younger than 5 years |
36555 |
$1,133.00 |
$283.25 |
| Insertion of central venous catheter for infusion, patient 5 years or older |
36556 |
$5,356.00 |
$1,339.00 |
| Insertion of central venous catheter for infusion, patient 5 years or older |
36556 |
$1,049.00 |
$262.25 |
| Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older |
36561 |
$15,181.00 |
$3,795.25 |
| Insertion of central venous catheter for infusion, patient younger than 5 years |
36568 |
$1,090.00 |
$272.50 |
| Insertion of central venous catheter for infusion, patient 5 years or older |
36569 |
$874.00 |
$218.50 |
| Insertion of central venous catheter for infusion, patient 5 years or older |
36569 |
$1,362.00 |
$340.50 |
| Removal of central venous catheter for infusion |
36589 |
$2,724.00 |
$681.00 |
| Collection of blood specimen from central or peripheral venous catheter |
36592 |
$183.00 |
$45.75 |
| Collection of blood specimen from central or peripheral venous catheter |
36592 |
$129.00 |
$32.25 |
| Declotting infusion of implanted central venous access device or catheter |
36593 |
$1,070.00 |
$267.50 |
| Arterial puncture withdrawal of blood for diagnosis |
36600 |
$118.00 |
$29.50 |
| Insertion of arterial catheter for blood sampling or infusion, accessed through the skin |
36620 |
$766.00 |
$191.50 |
| Insertion of needle for infusion into bone |
36680 |
$336.00 |
$84.00 |
| Infusion of drug into a vein to dissolve blood clot obstructing blood flow to brain |
37195 |
$357.00 |
$89.25 |
| Blood vessel procedure |
37799 |
$1,140.00 |
$285.00 |
| Bone marrow biopsy |
38221 |
$1,525.00 |
$381.25 |
| Repair of vertical lip wound extending to half of lip |
40652 |
$543.00 |
$135.75 |
| Repair of vertical lip wound extending to over half of lip |
40654 |
$1,327.00 |
$331.75 |
| Lip procedure |
40799 |
$241.00 |
$60.25 |
| Lip procedure |
40799 |
$226.00 |
$56.50 |
| Incision of abscess, cyst, or blood accumulation in mouth |
40800 |
$688.00 |
$172.00 |
| Removal of embedded foreign body of mouth |
40804 |
$913.00 |
$228.25 |
| Suture of (2.5 centimeter or less) mouth laceration |
40830 |
$421.00 |
$105.25 |
| Suture of (over 2.5 centimeter) mouth laceration |
40831 |
$749.00 |
$187.25 |
| Repair of (2.5 centimeter or less) laceration to floor of mouth and/or tongue |
41250 |
$241.00 |
$60.25 |
| Repair of (2.5 centimeter or less) laceration to floor of mouth or tongue |
41251 |
$211.00 |
$52.75 |
| Repair of (over 2.6 laceration) to floor of mouth or tongue |
41252 |
$749.00 |
$187.25 |
| Tongue or floor of mouth procedure |
41599 |
$226.00 |
$56.50 |
| Drainage of abscess, cyst, or blood accumulation of dental bone |
41800 |
$205.00 |
$51.25 |
| Relocation of mouth tissue to gum surface |
41899 |
$226.00 |
$56.50 |
| Incision and drainage of roof of mouth or its soft tissue projection |
42000 |
$421.00 |
$105.25 |
| Drainage of tonsil abscess |
42700 |
$421.00 |
$105.25 |
| Removal of foreign body from throat |
42809 |
$336.00 |
$84.00 |
| Suture of wound or injury in the throat |
42900 |
$2,253.00 |
$563.25 |
| Control of bleeding of throat |
42960 |
$565.00 |
$141.25 |
| Throat, adenoids, or tonsils procedure |
42999 |
$226.00 |
$56.50 |
| Throat, adenoids, or tonsils procedure |
42999 |
$241.00 |
$60.25 |
| Insertion of stomach tube using an endoscope |
43246 |
$6,316.00 |
$1,579.00 |
| Insertion of stomach tube and aspirations of gastric contents |
43753 |
$291.00 |
$72.75 |
| Biopsy of rectum |
45100 |
$2,662.00 |
$665.50 |
| Control of bleeding in large bowel using an endoscope |
45382 |
$1,021.00 |
$255.25 |
| Rectal procedure |
45999 |
$854.00 |
$213.50 |
| Drainage of rectal abscess |
46050 |
$631.00 |
$157.75 |
| Incision of engorged external hemorrhoid |
46083 |
$457.00 |
$114.25 |
| Anus procedure |
46999 |
$636.00 |
$159.00 |
| Drainage of fluid from abdominal cavity |
49082 |
$2,094.00 |
$523.50 |
| Drainage of fluid from abdominal cavity |
49082 |
$894.00 |
$223.50 |
| Drainage of fluid from abdominal cavity using imaging guidance |
49083 |
$2,810.00 |
$702.50 |
| Drainage of fluid from abdominal cavity using imaging guidance |
49083 |
$631.00 |
$157.75 |
| Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast |
49440 |
$6,316.00 |
$1,579.00 |
| Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin |
49450 |
$691.00 |
$172.75 |
| Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin |
49451 |
$913.00 |
$228.25 |
| Abdominal procedure |
49999 |
$2,864.00 |
$716.00 |
| Needle aspiration of bladder |
51100 |
$765.00 |
$191.25 |
| Injection procedure for X-ray imaging of the bladder or during voiding |
51600 |
$399.00 |
$99.75 |
| Injection procedure through the bladder and bladder canal (urethra) for X-ray imaging |
51610 |
$399.00 |
$99.75 |
| Bladder irrigation and/or instillation |
51700 |
$248.00 |
$62.00 |
| Insertion of temporary bladder catheter |
51701 |
$178.00 |
$44.50 |
| Insertion of temporary bladder catheter |
51701 |
$153.00 |
$38.25 |
| Insertion of indwelling bladder catheter |
51702 |
$153.00 |
$38.25 |
| Insertion of indwelling bladder catheter |
51702 |
$178.00 |
$44.50 |
| Insertion of indwelling bladder catheter |
51703 |
$171.00 |
$42.75 |
| Removal of skin suture with change of bladder tube |
51705 |
$248.00 |
$62.00 |
| Ultrasound measurement of bladder capacity after voiding |
51798 |
$112.00 |
$28.00 |
| Ultrasound measurement of bladder capacity after voiding |
51798 |
$162.00 |
$40.50 |
| Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope |
52000 |
$1,271.00 |
$317.75 |
| Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope |
52000 |
$694.00 |
$173.50 |
| Dilation of bladder canal (urethra) using an endoscope |
52281 |
$2,101.00 |
$525.25 |
| Dilation of narrowing of bladder canal (urethra), male |
53600 |
$287.00 |
$71.75 |
| Dilation of narrowing of bladder canal (urethra), male |
53620 |
$1,861.00 |
$465.25 |
| Incision of penile foreskin |
54001 |
$1,991.00 |
$497.75 |
| Injection of drug into erectile tissue at sides and back of penis |
54220 |
$263.00 |
$65.75 |
| Injection procedure to induce erection |
54235 |
$248.00 |
$62.00 |
| Repositioning of foreskin including scar tissue removal |
54450 |
$282.00 |
$70.50 |
| Incision and drainage of sperm reservoir, testis, and/or scrotal area |
54700 |
$1,914.00 |
$478.50 |
| Aspiration of fluid collection in testicle and sperm reservoir |
55000 |
$542.00 |
$135.50 |
| Incision and drainage of abscess in scrotal sac of testicle |
55100 |
$1,579.00 |
$394.75 |
| Male genital system procedure |
55899 |
$274.00 |
$68.50 |
| Incision and drainage of female genitals abscess |
56405 |
$407.00 |
$101.75 |
| Incision and drainage of female genital gland abscess |
56420 |
$227.00 |
$56.75 |
| Biopsy of uterine lining |
58100 |
$262.00 |
$65.50 |
| Removal of intra-uterine device (IUD) for pregnancy prevention |
58301 |
$262.00 |
$65.50 |
| Female genital system (nonobstetric) procedure |
58999 |
$152.00 |
$38.00 |
| Vaginal delivery of placenta |
59414 |
$2,908.00 |
$727.00 |
| Aspiration or injection of cerebrospinal fluid shunt tubing or reservoir |
61070 |
$647.00 |
$161.75 |
| Spinal tap for diagnosis |
62270 |
$1,056.00 |
$264.00 |
| Spinal tap for diagnosis |
62270 |
$773.00 |
$193.25 |
| Spinal tap with drainage of spinal fluid |
62272 |
$727.00 |
$181.75 |
| Spinal tap with drainage of spinal fluid |
62272 |
$773.00 |
$193.25 |
| Injection of blood or blood clot into spinal canal |
62273 |
$749.00 |
$187.25 |
| Injection of anesthetic agent, trigeminal nerve |
64400 |
$300.00 |
$75.00 |
| Injection of anesthetic agent, facial nerve |
64402 |
$336.00 |
$84.00 |
| Injection of anesthetic agent, greater occipital nerve |
64405 |
$572.00 |
$143.00 |
| Injection of anesthetic agent, neck nerve bundle |
64413 |
$648.00 |
$162.00 |
| Injection of anesthetic agent, other peripheral nerve or branch |
64450 |
$648.00 |
$162.00 |
| Injections of upper or middle spine facet joint using imaging guidance |
64490 |
$1,400.00 |
$350.00 |
| Injections of lower or sacral spine facet joint using imaging guidance |
64493 |
$1,400.00 |
$350.00 |
| Injection of anesthetic agent, middle or lower spine sympathetic nerves |
64520 |
$901.00 |
$225.25 |
| Removal of foreign body in external eye, conjunctiva |
65205 |
$157.00 |
$39.25 |
| Removal of foreign body, external eye, cornea |
65220 |
$336.00 |
$84.00 |
| Removal of foreign body, external eye, cornea with slit lamp examination |
65222 |
$157.00 |
$39.25 |
| Anterior (front) eye procedure |
66999 |
$2,306.00 |
$576.50 |
| Injection of drug into eye |
67028 |
$370.00 |
$92.50 |
| Incision and drainage of eyelid abscess |
67700 |
$345.00 |
$86.25 |
| Removal of embedded foreign body in eyelid |
67938 |
$345.00 |
$86.25 |
| Incision and drainage of external ear abscess or blood accumulation |
69000 |
$688.00 |
$172.00 |
| Incision and drainage of ear canal abscess |
69020 |
$688.00 |
$172.00 |
| Removal of foreign body from ear canal |
69200 |
$153.00 |
$38.25 |
| Removal of impacted ear wax by washing |
69209 |
$75.00 |
$18.75 |
| Removal of impact ear wax, one ear |
69210 |
$66.00 |
$16.50 |
| X-ray of mandible, less than 4 views |
70100 |
$318.00 |
$79.50 |
| X-ray of mandible, minimum of 4 views |
70110 |
$452.00 |
$113.00 |
| X-ray of bones of face, less than 3 views |
70140 |
$406.00 |
$101.50 |
| X-ray of bones of face, minimum of 3 views |
70150 |
$452.00 |
$113.00 |
| X-ray of bones of nose, minimum of 3 views |
70160 |
$452.00 |
$113.00 |
| X-ray of eye bones, minimum of 4 views |
70200 |
$452.00 |
$113.00 |
| X-ray of paranasal sinus, less than 3 views |
70210 |
$318.00 |
$79.50 |
| X-ray of paranasal sinus, complete, minimum of 3 views |
70220 |
$448.00 |
$112.00 |
| X-ray of skull, less than 4 views |
70250 |
$354.00 |
$88.50 |
| X-ray of skull, complete, minimum of 4 views |
70260 |
$448.00 |
$112.00 |
| X-ray of jaw joints on both sides of the face |
70330 |
$452.00 |
$113.00 |
| X-ray of soft tissue of neck |
70360 |
$367.00 |
$91.75 |
| CT scan of the head or brain without contrast or dye |
70450 |
$2,993.00 |
$748.25 |
| CT scan of the head or brain without contrast or dye |
70450 |
$2,993.00 |
$748.25 |
| CT scan head or brain with contrast |
70460 |
$3,077.00 |
$769.25 |
| CT scan head or brain before and after contrast |
70470 |
$3,169.00 |
$792.25 |
| CT scan of cranial cavity |
70480 |
$2,721.00 |
$680.25 |
| CT scan of cranial cavity with contrast |
70481 |
$2,858.00 |
$714.50 |
| CT scan of face |
70486 |
$2,591.00 |
$647.75 |
| CT scan of face |
70486 |
$2,830.00 |
$707.50 |
| CT scan of face with contrast |
70487 |
$2,723.00 |
$680.75 |
| CT scan of face with contrast |
70487 |
$2,972.00 |
$743.00 |
| CT scan of face before and after contrast |
70488 |
$3,597.00 |
$899.25 |
| CT scan of neck |
70490 |
$2,566.00 |
$641.50 |
| CT scan of neck with contrast |
70491 |
$3,031.00 |
$757.75 |
| CT scan of neck before and after contrast |
70492 |
$3,462.00 |
$865.50 |
| CT scan of blood vessel of head with contrast |
70496 |
$3,318.00 |
$829.50 |
| CT scan of neck blood vessels with contrast |
70498 |
$3,318.00 |
$829.50 |
| MRI scan bones of the eye, face, and/or neck |
70540 |
$3,380.00 |
$845.00 |
| MRI scan bones of the eye, face, and/or neck before and after contrast |
70543 |
$5,037.00 |
$1,259.25 |
| MRA scan of head blood vessels |
70544 |
$3,119.00 |
$779.75 |
| MRA scan of head blood vessels before and after contrast |
70546 |
$4,780.00 |
$1,195.00 |
| MRA scan of neck blood vessels |
70547 |
$3,119.00 |
$779.75 |
| MRA scan of neck blood vessels before and after contrast |
70549 |
$5,009.00 |
$1,252.25 |
| MRI scan brain |
70551 |
$3,462.00 |
$865.50 |
| MRI scan of brain with contrast |
70552 |
$3,660.00 |
$915.00 |
| MRI scan of the brain with and without contrast |
70553 |
$4,009.00 |
$1,002.25 |
| MRI scan of the brain with and without contrast |
70553 |
$4,009.00 |
$1,002.25 |
| X-ray of chest, 1 view |
71045 |
$316.00 |
$79.00 |
| X-ray of the chest, 2 views |
71046 |
$364.00 |
$91.00 |
| X-ray of the chest, 2 views |
71046 |
$364.00 |
$91.00 |
| X-ray of chest, minimum of 4 views |
71048 |
$406.00 |
$101.50 |
| X-ray of ribs of one side of body, 2 views |
71100 |
$309.00 |
$77.25 |
| X-ray of ribs on one side of body including the chest, minimum of 3 views |
71101 |
$479.00 |
$119.75 |
| X-ray of both sides of the ribs, 3 views |
71110 |
$479.00 |
$119.75 |
| X-ray of both sides of the ribs including the chest, minimum of 4 views |
71111 |
$495.00 |
$123.75 |
| X-ray of breast bone, minimum of 2 views |
71120 |
$406.00 |
$101.50 |
| X-ray of junction of breast and collar bones, minimum of 2 views |
71130 |
$354.00 |
$88.50 |
| CT scan chest |
71250 |
$2,993.00 |
$748.25 |
| CT scan chest with contrast |
71260 |
$3,077.00 |
$769.25 |
| CT scan chest before and after contrast |
71270 |
$3,169.00 |
$792.25 |
| CT scan of blood vessels in chest with contrast |
71275 |
$3,169.00 |
$792.25 |
| MRI scan of chest |
71550 |
$3,119.00 |
$779.75 |
| X-ray of spine, 1 view |
72020 |
$320.00 |
$80.00 |
| X-ray of spine of neck, 2 or 3 views |
72040 |
$359.00 |
$89.75 |
| X-ray of upper spine, 4 or 5 views |
72050 |
$452.00 |
$113.00 |
| X-ray of upper spine, 6 or more views |
72052 |
$629.00 |
$157.25 |
| X-ray of middle spine, 3 views |
72070 |
$406.00 |
$101.50 |
| X-ray of middle spine, 3 views |
72072 |
$441.00 |
$110.25 |
| X-ray of middle spine, minimum of 4 views |
72074 |
$435.00 |
$108.75 |
| X-ray of middle and lower spine, 2 views |
72080 |
$393.00 |
$98.25 |
| X-ray of spine, 1 view |
72081 |
$313.00 |
$78.25 |
| X-ray of spine, 2 or 3 views |
72082 |
$348.00 |
$87.00 |
| X-ray of spine, 4 or 5 views |
72083 |
$499.00 |
$124.75 |
| X-ray of spine, minimum of 6 views |
72084 |
$575.00 |
$143.75 |
| X-ray of lower and sacral spine, 2 or 3 views |
72100 |
$406.00 |
$101.50 |
| X-ray of the lower spine with 4 or more views |
72110 |
$542.00 |
$135.50 |
| X-ray of the lower spine with 4 or more views |
72110 |
$542.00 |
$135.50 |
| X-ray lower and sacral spine including bending views minimum 6 views |
72114 |
$633.00 |
$158.25 |
| CT scan of upper spine |
72125 |
$2,945.00 |
$736.25 |
| CT scan of upper spine with contrast |
72126 |
$3,009.00 |
$752.25 |
| CT scan of upper spine before and after contrast |
72127 |
$3,303.00 |
$825.75 |
| CT scan of middle spine |
72128 |
$2,931.00 |
$732.75 |
| CT scan of lower spine |
72131 |
$2,931.00 |
$732.75 |
| CT scan of lower spine with contrast |
72132 |
$3,039.00 |
$759.75 |
| CT scan of lower spine before and after contrast |
72133 |
$3,110.00 |
$777.50 |
| MRI scan of upper spinal canal |
72141 |
$3,375.00 |
$843.75 |
| MRI scan of upper spinal canal with contrast |
72142 |
$4,045.00 |
$1,011.25 |
| MRI scan of middle spinal canal |
72146 |
$4,700.00 |
$1,175.00 |
| MRI scan of middle spinal canal with contrast |
72147 |
$4,758.00 |
$1,189.50 |
| MRI scan of lower spinal canal |
72148 |
$3,375.00 |
$843.75 |
| MRI scan of lower spinal canal with contrast |
72149 |
$3,391.00 |
$847.75 |
| MRI scan of upper spinal canal before and after contrast |
72156 |
$4,945.00 |
$1,236.25 |
| MRI scan of middle spinal canal before and after contrast |
72157 |
$4,307.00 |
$1,076.75 |
| MRI scan of lower spinal canal before and after contrast |
72158 |
$4,945.00 |
$1,236.25 |
| X-ray of pelvis, 1 or 2 views |
72170 |
$367.00 |
$91.75 |
| X-ray of pelvis, minimum of 3 views |
72190 |
$452.00 |
$113.00 |
| CT scan of pelvic blood vessels with contrast |
72191 |
$3,318.00 |
$829.50 |
| CT scan pelvis |
72192 |
$2,993.00 |
$748.25 |
| CT scan of the pelvis with contrast or dye |
72193 |
$3,077.00 |
$769.25 |
| CT scan of the pelvis with contrast or dye |
72193 |
$3,077.00 |
$769.25 |
| CT scan of pelvis before and after contrast |
72194 |
$3,169.00 |
$792.25 |
| MRI scan of pelvis |
72195 |
$3,119.00 |
$779.75 |
| MRI scan of pelvis before and after contrast |
72197 |
$5,037.00 |
$1,259.25 |
| X-ray of sacroiliac joints, 3 or more views |
72202 |
$367.00 |
$91.75 |
| X-ray of pelvis, minimum of 2 views |
72220 |
$210.00 |
$52.50 |
| X-ray of collar bone |
73000 |
$367.00 |
$91.75 |
| X-ray of shoulder blade |
73010 |
$367.00 |
$91.75 |
| X-ray of shoulder, 1 view |
73020 |
$320.00 |
$80.00 |
| X-ray of shoulder, minimum of 2 views |
73030 |
$452.00 |
$113.00 |
| Radiological supervision and interpretation X-ray of shoulder joint |
73040 |
$989.00 |
$247.25 |
| X-ray of both collar bones |
73050 |
$367.00 |
$91.75 |
| X-ray of upper arm, minimum of 2 views |
73060 |
$366.00 |
$91.50 |
| X-ray of elbow, 2 views |
73070 |
$320.00 |
$80.00 |
| X-ray of elbow, minimum of 3 views |
73080 |
$366.00 |
$91.50 |
| X-ray of forearm, 2 views |
73090 |
$366.00 |
$91.50 |
| X-ray of arm in infant minimum of 2 views |
73092 |
$367.00 |
$91.75 |
| X-ray of wrist, 2 views |
73100 |
$320.00 |
$80.00 |
| X-ray of wrist, minimum of 3 views |
73110 |
$366.00 |
$91.50 |
| X-ray of hand, 2 views |
73120 |
$320.00 |
$80.00 |
| X-ray of hand, minimum of 3 views |
73130 |
$366.00 |
$91.50 |
| X-ray of fingers, minimum of 2 views |
73140 |
$192.00 |
$48.00 |
| CT scan of arm |
73200 |
$2,342.00 |
$585.50 |
| CT scan of arm with contrast |
73201 |
$2,560.00 |
$640.00 |
| CT scan of arm blood vessels with contrast |
73206 |
$3,318.00 |
$829.50 |
| MRI scan of arm |
73218 |
$2,937.00 |
$734.25 |
| MRI scan of arm before and after contrast |
73220 |
$3,276.00 |
$819.00 |
| MRI scan of arm joint |
73221 |
$3,375.00 |
$843.75 |
| MRI scan of arm joint with contrast |
73222 |
$3,391.00 |
$847.75 |
| MRI scan of arm joint before and after contrast |
73223 |
$3,896.00 |
$974.00 |
| X-ray of hip with pelvis, 1 view |
73501 |
$208.00 |
$52.00 |
| X-ray of hip with pelvis, 2-3 views |
73502 |
$406.00 |
$101.50 |
| X-ray of hip with pelvis, minimum of 4 views |
73503 |
$450.00 |
$112.50 |
| X-ray of both hips with pelvis, 2 views |
73521 |
$394.00 |
$98.50 |
| X-ray of both hips with pelvis, 3-4 views |
73522 |
$450.00 |
$112.50 |
| X-ray of both hips with pelvis, minimum of 5 views |
73523 |
$521.00 |
$130.25 |
| X-ray of femur, 1 view |
73551 |
$187.00 |
$46.75 |
| X-ray of femur, minimum 2 views |
73552 |
$337.00 |
$84.25 |
| X-ray of knee, 1 or 2 views |
73560 |
$318.00 |
$79.50 |
| X-ray of knee, 3 views |
73562 |
$329.00 |
$82.25 |
| X-ray of knee, 4 or more views |
73564 |
$367.00 |
$91.75 |
| X-ray of both knees, standing, front to back view |
73565 |
$318.00 |
$79.50 |
| X-ray of lower leg, 2 views |
73590 |
$366.00 |
$91.50 |
| X-ray of leg in infant minimum of 2 views |
73592 |
$238.00 |
$59.50 |
| X-ray of ankle, 2 views |
73600 |
$367.00 |
$91.75 |
| X-ray of ankle, minimum of 3 views |
73610 |
$406.00 |
$101.50 |
| X-ray of foot, 2 views |
73620 |
$320.00 |
$80.00 |
| X-ray of foot, minimum of 3 views |
73630 |
$366.00 |
$91.50 |
| X-ray of heel, minimum of 2 views |
73650 |
$367.00 |
$91.75 |
| X-ray of toes, minimum of 2 views |
73660 |
$320.00 |
$80.00 |
| CT scan leg |
73700 |
$2,342.00 |
$585.50 |
| CT scan leg with contrast injection |
73701 |
$2,560.00 |
$640.00 |
| CT scan of lower leg blood vessels with contrast |
73706 |
$3,318.00 |
$829.50 |
| MRI scan of leg |
73718 |
$3,119.00 |
$779.75 |
| MRI scan of leg before and after contrast |
73720 |
$3,212.00 |
$803.00 |
| MRI scan of leg joint |
73721 |
$3,485.00 |
$871.25 |
| MRI scan of leg joint before and after contrast |
73723 |
$4,945.00 |
$1,236.25 |
| X-ray of abdomen, 1 view |
74018 |
$316.00 |
$79.00 |
| X-ray of abdomen, 2 views |
74019 |
$541.00 |
$135.25 |
| X-ray of abdomen, minimum of 3 views |
74021 |
$541.00 |
$135.25 |
| Imaging of abdomen and chest |
74022 |
$870.00 |
$217.50 |
| CT scan abdomen |
74150 |
$2,945.00 |
$736.25 |
| CT scan of the abdomen with contrast or dye |
74160 |
$3,077.00 |
$769.25 |
| CT scan of the abdomen with contrast or dye |
74160 |
$3,077.00 |
$769.25 |
| CT scan abdomen before and after contrast |
74170 |
$3,209.00 |
$802.25 |
| CT scan of abdominal and pelvic blood vessels with contrast |
74174 |
$6,632.00 |
$1,658.00 |
| CT scan of abdominal blood vessels with contrast |
74175 |
$3,318.00 |
$829.50 |
| CT scan of abdomen and pelvis |
74176 |
$4,548.00 |
$1,137.00 |
| CT scan of abdomen and pelvis with contrast |
74177 |
$4,872.00 |
$1,218.00 |
| CT scan of abdomen and pelvis before and after contrast |
74178 |
$5,165.00 |
$1,291.25 |
| MRI scan of abdomen |
74181 |
$3,485.00 |
$871.25 |
| MRI scan of abdomen before and after contrast |
74183 |
$4,945.00 |
$1,236.25 |
| X-ray of esophagus |
74220 |
$565.00 |
$141.25 |
| X-ray of upper digestive tract, kidneys, urinary ducts (ureters), and bladder |
74241 |
$1,643.00 |
$410.75 |
| X-ray upper GI series, with small bowel films |
74245 |
$1,876.00 |
$469.00 |
| X-ray of upper digestive tract, kidneys, urinary ducts (ureters), and bladder with contrast |
74247 |
$1,721.00 |
$430.25 |
| X-ray of small intestine |
74250 |
$565.00 |
$141.25 |
| X-ray of large bowel with contrast |
74270 |
$837.00 |
$209.25 |
| X-ray of large bowel with contrast |
74280 |
$965.00 |
$241.25 |
| Imaging of urinary tract with injection of contrast into a vein |
74400 |
$1,428.00 |
$357.00 |
| Imaging of urinary tract using infusion technique with kidney section filming |
74415 |
$1,428.00 |
$357.00 |
| Imaging of urinary tract |
74420 |
$1,428.00 |
$357.00 |
| Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views |
74430 |
$478.00 |
$119.50 |
| Radiological supervision and interpretation X-ray of urinary bladder and urethra |
74450 |
$510.00 |
$127.50 |
| Radiological supervision and interpretation X-ray of urinary bladder and urethra |
74455 |
$589.00 |
$147.25 |
| CT scan of heart with evaluation of blood vessel calcium |
75571 |
$99.00 |
$24.75 |
| CT scan of heart structure with contrast |
75572 |
$3,054.00 |
$763.50 |
| CT scan of heart blood vessels and grafts with contrast dye |
75574 |
$3,054.00 |
$763.50 |
| CT scan of abdominal aorta and both leg arteries with contrast |
75635 |
$3,386.00 |
$846.50 |
| Imaging guidance for procedure, up to 1 hour |
76000 |
$321.00 |
$80.25 |
| Imaging of surgical specimen |
76098 |
$1,197.00 |
$299.25 |
| CT scan limited or follow-up study |
76380 |
$704.00 |
$176.00 |
| CT scan limited or follow-up study |
76380 |
$738.00 |
$184.50 |
| CT scan limited or follow-up study |
76380 |
$1,327.00 |
$331.75 |
| Ultrasound of head and neck |
76536 |
$493.00 |
$123.25 |
| Ultrasound of chest |
76604 |
$409.00 |
$102.25 |
| Ultrasound of one breast |
76641 |
$522.00 |
$130.50 |
| Ultrasound of one breast |
76642 |
$522.00 |
$130.50 |
| Ultrasound of the abdomen |
76700 |
$880.00 |
$220.00 |
| Ultrasound of the abdomen |
76700 |
$880.00 |
$220.00 |
| Ultrasound of abdomen |
76705 |
$549.00 |
$137.25 |
| Ultrasound of abdomen |
76705 |
$704.00 |
$176.00 |
| Ultrasound of abdomen |
76705 |
$669.00 |
$167.25 |
| Ultrasound evaluation of abdominal aorta to detect bulging (aneurysm) |
76706 |
$193.00 |
$48.25 |
| Ultrasound behind abdominal cavity |
76770 |
$669.00 |
$167.25 |
| Ultrasound behind abdominal cavity |
76770 |
$762.00 |
$190.50 |
| Ultrasound behind abdominal cavity, limited |
76775 |
$577.00 |
$144.25 |
| Ultrasound of spinal canal |
76800 |
$387.00 |
$96.75 |
| Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) single or first fetus |
76801 |
$452.00 |
$113.00 |
| Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples |
76805 |
$1,191.00 |
$297.75 |
| Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples |
76805 |
$1,191.00 |
$297.75 |
| Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) |
76810 |
$387.00 |
$96.75 |
| Ultrasound of pregnant uterus, 1 or more fetus(es) |
76815 |
$788.00 |
$197.00 |
| Vaginal ultrasound of pregnant uterus |
76817 |
$289.00 |
$72.25 |
| Ultrasound pelvis through vagina |
76830 |
$677.00 |
$169.25 |
| Ultrasound of pelvis |
76856 |
$702.00 |
$175.50 |
| Ultrasound of pelvis |
76857 |
$503.00 |
$125.75 |
| Ultrasound of scrotum |
76870 |
$430.00 |
$107.50 |
| Complete ultrasound of joint of arm or leg |
76881 |
$609.00 |
$152.25 |
| Partial ultrasound of joint or other non-blood vessel structure of arm or leg |
76882 |
$385.00 |
$96.25 |
| Ultrasonic guidance imaging supervision and interpretation for insertion of needle |
76942 |
$684.00 |
$171.00 |
| Fluoroscopic guidance for injection into spine or muscle next to spine |
77003 |
$679.00 |
$169.75 |
| Radiological supervision and interpretation of CT guidance for needle insertion |
77012 |
$2,701.00 |
$675.25 |
| Mammography of one breast |
77065 |
$499.00 |
$124.75 |
| Mammography of one breast |
77065 |
$126.00 |
$31.50 |
| Mammography of both breasts |
77066 |
$624.00 |
$156.00 |
| Mammogram of both breasts |
77067 |
$430.00 |
$107.50 |
| Mammogram of both breasts |
77067 |
$430.00 |
$107.50 |
| Imaging for bone age assessment |
77072 |
$367.00 |
$91.75 |
| Imaging for bone length assessment |
77073 |
$294.00 |
$73.50 |
| X-ray of bones |
77074 |
$655.00 |
$163.75 |
| Bone density measurement using dedicated X-ray machine |
77080 |
$795.00 |
$198.75 |
| Nuclear medicine imaging for thyroid uptake measurements |
78012 |
$786.00 |
$196.50 |
| Nuclear medicine imaging of thyroid |
78013 |
$1,048.00 |
$262.00 |
| Nuclear medicine imaging for thyroid uptake measurements |
78014 |
$1,587.00 |
$396.75 |
| Imaging of parathyroid |
78070 |
$1,587.00 |
$396.75 |
| Imaging of lymphatic tissue and lymph node |
78195 |
$1,908.00 |
$477.00 |
| Imaging of liver and spleen |
78215 |
$2,141.00 |
$535.25 |
| Imaging of liver and bile duct system |
78226 |
$2,141.00 |
$535.25 |
| Imaging of liver and bile duct system with use of drugs |
78227 |
$2,141.00 |
$535.25 |
| Stomach emptying study |
78264 |
$1,952.00 |
$488.00 |
| Bone and/or joint imaging |
78300 |
$1,783.00 |
$445.75 |
| Bone and/or joint imaging, whole body |
78306 |
$1,891.00 |
$472.75 |
| Bone and/or joint imaging, 3 phase study |
78315 |
$2,000.00 |
$500.00 |
| Nuclear medicine study of vessels of heart using drugs or exercise multiple studies |
78452 |
$2,543.00 |
$635.75 |
| Nuclear medicine study of heart muscle following heart attack |
78466 |
$1,205.00 |
$301.25 |
| Nuclear medicine study of heart muscle following heart attack |
78469 |
$2,214.00 |
$553.50 |
| Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study |
78472 |
$1,312.00 |
$328.00 |
| Nuclear medicine study of lung ventilation |
78579 |
$1,507.00 |
$376.75 |
| Nuclear medicine study of blood circulation in the lungs |
78580 |
$1,507.00 |
$376.75 |
| Nuclear medicine study of lung ventilation and blood circulation in the lungs |
78582 |
$2,291.00 |
$572.75 |
| Nuclear medicine study with measurement of blood circulation in the lungs |
78597 |
$1,654.00 |
$413.50 |
| Nuclear medicine study with measurement of blood circulation in the lungs and ventilation |
78598 |
$2,529.00 |
$632.25 |
| Imaging of kidney |
78700 |
$2,268.00 |
$567.00 |
| Nuclear medicine study of kidney with assessment of blood flow and function |
78708 |
$1,850.00 |
$462.50 |
| Nuclear medicine study of radioactive material distribution at site of inflammation |
78805 |
$3,425.00 |
$856.25 |
| Nuclear medicine study of radioactive material distribution at sites of inflammation in whole body |
78806 |
$1,719.00 |
$429.75 |
| Basic Metabolic Panel |
80048 |
$385.00 |
$96.25 |
| Basic Metabolic Panel |
80048 |
$385.00 |
$96.25 |
| Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) |
80051 |
$367.00 |
$91.75 |
| Comprehensive Metabolic Panel |
80053 |
$526.00 |
$131.50 |
| Comprehensive Metabolic Panel |
80053 |
$526.00 |
$131.50 |
| Lipid Panel |
80061 |
$633.00 |
$158.25 |
| Lipid Panel |
80061 |
$633.00 |
$158.25 |
| Kidney function blood test panel |
80069 |
$445.00 |
$111.25 |
| Acute hepatitis panel |
80074 |
$362.00 |
$90.50 |
| Liver function blood test panel |
80076 |
$447.00 |
$111.75 |
| Amikacin (antibiotic) level |
80150 |
$217.00 |
$54.25 |
| Carbamazepine level |
80156 |
$215.00 |
$53.75 |
| Carbamazepine level |
80157 |
$110.00 |
$27.50 |
| Cyclosporine level |
80158 |
$366.00 |
$91.50 |
| Clozapine level |
80159 |
$223.00 |
$55.75 |
| Digoxin level |
80162 |
$234.00 |
$58.50 |
| Valproic acid level |
80164 |
$185.00 |
$46.25 |
| Ethosuximide level |
80168 |
$178.00 |
$44.50 |
| Everolimus level |
80169 |
$371.00 |
$92.75 |
| Gentamicin (antibiotic) level |
80170 |
$207.00 |
$51.75 |
| Lamotrigine level |
80175 |
$238.00 |
$59.50 |
| Lidocaine level |
80176 |
$47.00 |
$11.75 |
| Levetiracetam level |
80177 |
$367.00 |
$91.75 |
| Levetiracetam level |
80177 |
$335.00 |
$83.75 |
| Lithium level |
80178 |
$98.00 |
$24.50 |
| Mycophenolate (mycophenolic acid) level |
80180 |
$200.00 |
$50.00 |
| Oxcarbazepine level |
80183 |
$270.00 |
$67.50 |
| Phenobarbital level |
80184 |
$173.00 |
$43.25 |
| Phenytoin level |
80185 |
$173.00 |
$43.25 |
| Phenytoin level |
80186 |
$173.00 |
$43.25 |
| Primidone level |
80188 |
$218.00 |
$54.50 |
| Quinidine level |
80194 |
$84.00 |
$21.00 |
| Sirolimus level |
80195 |
$144.00 |
$36.00 |
| Tacrolimus level |
80197 |
$521.00 |
$130.25 |
| Theophylline level |
80198 |
$224.00 |
$56.00 |
| Tiagabine level |
80199 |
$358.00 |
$89.50 |
| Tobramycin (antibiotic) level |
80200 |
$224.00 |
$56.00 |
| Topiramate level |
80201 |
$185.00 |
$46.25 |
| Vancomycin (antibiotic) level |
80202 |
$207.00 |
$51.75 |
| Zonisamide level |
80203 |
$409.00 |
$102.25 |
| Quantitation of therapeutic drug |
80299 |
$38.00 |
$9.50 |
| Quantitation of therapeutic drug |
80299 |
$42.00 |
$10.50 |
| Quantitation of therapeutic drug |
80299 |
$40.00 |
$10.00 |
| Quantitation of therapeutic drug |
80299 |
$163.00 |
$40.75 |
| Quantitation of therapeutic drug |
80299 |
$373.00 |
$93.25 |
| Quantitation of therapeutic drug |
80299 |
$218.00 |
$54.50 |
| Quantitation of therapeutic drug |
80299 |
$321.00 |
$80.25 |
| Quantitation of therapeutic drug |
80299 |
$148.00 |
$37.00 |
| Quantitation of therapeutic drug |
80299 |
$178.00 |
$44.50 |
| Quantitation of therapeutic drug |
80299 |
$445.00 |
$111.25 |
| Quantitation of therapeutic drug |
80299 |
$396.00 |
$99.00 |
| Quantitation of therapeutic drug |
80299 |
$416.00 |
$104.00 |
| Testing for presence of drug |
80305 |
$44.00 |
$11.00 |
| Testing for presence of drug |
80306 |
$58.00 |
$14.50 |
| Testing for presence of drug |
80307 |
$234.00 |
$58.50 |
| Alcohols levels |
80320 |
$254.00 |
$63.50 |
| Alcohols levels |
80320 |
$182.00 |
$45.50 |
| Alcohols levels |
80321 |
$173.00 |
$43.25 |
| Alkaloids levels |
80323 |
$254.00 |
$63.50 |
| Amphetamines levels |
80324 |
$254.00 |
$63.50 |
| Analgesics levels |
80329 |
$244.00 |
$61.00 |
| Antidepressants levels |
80335 |
$254.00 |
$63.50 |
| Antipsychotics levels |
80342 |
$254.00 |
$63.50 |
| Barbiturates levels |
80345 |
$254.00 |
$63.50 |
| Benzodiazepines levels |
80346 |
$254.00 |
$63.50 |
| Buprenorphine level |
80348 |
$254.00 |
$63.50 |
| Cannabinoids levels |
80349 |
$254.00 |
$63.50 |
| Cocaine level |
80353 |
$254.00 |
$63.50 |
| Cocaine level |
80353 |
$141.00 |
$35.25 |
| Fentanyl level |
80354 |
$254.00 |
$63.50 |
| Methadone level |
80358 |
$254.00 |
$63.50 |
| Opiates levels |
80361 |
$254.00 |
$63.50 |
| Opioids levels |
80362 |
$254.00 |
$63.50 |
| Opioids levels |
80363 |
$254.00 |
$63.50 |
| Oxycodone levels |
80365 |
$254.00 |
$63.50 |
| Synthetic stimulants levels |
80371 |
$60.00 |
$15.00 |
| Drugs or substances measurement |
80375 |
$244.00 |
$61.00 |
| Urinalysis, by dipstick or tablet reagent not automated without a microscope |
81001 |
$182.00 |
$45.50 |
| Urinalysis, by dipstick or tablet reagent not automated without a microscope |
81001 |
$182.00 |
$45.50 |
| Urinalysis, by dipstick or tablet reagent non-automated with microscopy |
81002 |
$50.00 |
$12.50 |
| Urinalysis, by dipstick or tablet reagent non-automated with microscopy |
81002 |
$50.00 |
$12.50 |
| Urinalysis, by dipstick or tablet reagent non-automated with microscopy |
81002 |
$58.00 |
$14.50 |
| Urinalysis, by dipstick or tablet reagent non-automated with microscopy |
81002 |
$58.00 |
$14.50 |
| Urinalysis, by dipstick or tablet reagent non-automated with microscopy |
81002 |
$74.00 |
$18.50 |
| Urinalysis, by dipstick or tablet reagent non-automated with microscopy |
81002 |
$74.00 |
$18.50 |
| Automated urinalysis test |
81003 |
$70.00 |
$17.50 |
| Automated urinalysis test |
81003 |
$54.00 |
$13.50 |
| Automated urinalysis test |
81003 |
$49.00 |
$12.25 |
| Urinalysis, 2 or 3 glass test |
81020 |
$16.00 |
$4.00 |
| Urinalysis, 2 or 3 glass test |
81020 |
$12.00 |
$3.00 |
| Urine pregnancy test |
81025 |
$213.00 |
$53.25 |
| Urine volume measurement |
81050 |
$45.00 |
$11.25 |
| Gene analysis (prothrombin, coagulation factor II) A variant |
81240 |
$188.00 |
$47.00 |
| Gene analysis (coagulation factor V) Leiden variant |
81241 |
$424.00 |
$106.00 |
| Gene analysis (hemochromatosis) common variants |
81256 |
$355.00 |
$88.75 |
| Gene analysis (Janus kinase 2) variant |
81270 |
$827.00 |
$206.75 |
| Gene analysis (mutS homolog 6 [E coli]) known familial variants |
81299 |
$362.00 |
$90.50 |
| Molecular pathology procedure |
81479 |
$153.00 |
$38.25 |
| Ketone bodies analysis |
82009 |
$58.00 |
$14.50 |
| Ketone bodies analysis |
82010 |
$57.00 |
$14.25 |
| Adrenocorticotropic hormone (ACTH) level |
82024 |
$672.00 |
$168.00 |
| Albumin (protein) level |
82040 |
$128.00 |
$32.00 |
| Cerebrospinal fluid, or amniotic fluid albumin (protein) level |
82042 |
$17.00 |
$4.25 |
| Urine microalbumin (protein) level |
82043 |
$148.00 |
$37.00 |
| Breath alcohol level |
82075 |
$35.00 |
$8.75 |
| Breath alcohol level |
82075 |
$31.00 |
$7.75 |
| Aldolase (enzyme) level |
82085 |
$159.00 |
$39.75 |
| Aldosterone hormone level |
82088 |
$706.00 |
$176.50 |
| Alpha-1-antitrypsin (protein) blood test |
82103 |
$158.00 |
$39.50 |
| Alpha-fetoprotein (AFP) level, serum |
82105 |
$594.00 |
$148.50 |
| Amino acid level, multiple amino acids |
82139 |
$366.00 |
$91.50 |
| Ammonia level |
82140 |
$255.00 |
$63.75 |
| Amylase (enzyme) level |
82150 |
$159.00 |
$39.75 |
| Amylase (enzyme) level |
82150 |
$20.00 |
$5.00 |
| Androstenedione (hormone) level |
82157 |
$448.00 |
$112.00 |
| Angiotensin l - converting enzyme (ACE) level |
82164 |
$430.00 |
$107.50 |
| Arsenic level |
82175 |
$327.00 |
$81.75 |
| Arsenic level |
82175 |
$254.00 |
$63.50 |
| Ascorbic acid (Vitamin C) level, blood |
82180 |
$307.00 |
$76.75 |
| Bilirubin level |
82247 |
$128.00 |
$32.00 |
| Bilirubin level |
82248 |
$128.00 |
$32.00 |
| Stool analysis for blood to screen for colon tumors |
82270 |
$74.00 |
$18.50 |
| Specimen analysis for blood |
82271 |
$72.00 |
$18.00 |
| Stool analysis for blood |
82272 |
$74.00 |
$18.50 |
| Vitamin D-3 level |
82306 |
$384.00 |
$96.00 |
| Vitamin D-3 level |
82306 |
$90.00 |
$22.50 |
| Calcitonin (hormone) level |
82308 |
$433.00 |
$108.25 |
| Calcium level |
82310 |
$128.00 |
$32.00 |
| Calcium level |
82330 |
$279.00 |
$69.75 |
| Urine calcium level |
82340 |
$128.00 |
$32.00 |
| Infrared analysis of stone |
82365 |
$305.00 |
$76.25 |
| Carbon dioxide (bicarbonate) level |
82374 |
$128.00 |
$32.00 |
| Carboxyhemoglobin (protein) level |
82375 |
$237.00 |
$59.25 |
| Carcinoembryonic antigen (CEA) protein level |
82378 |
$321.00 |
$80.25 |
| Carnitine level |
82379 |
$93.00 |
$23.25 |
| Catecholamines (organic nitrogen) level |
82384 |
$470.00 |
$117.50 |
| Catecholamines (organic nitrogen) level |
82384 |
$369.00 |
$92.25 |
| Ceruloplasmin (protein) level |
82390 |
$114.00 |
$28.50 |
| Analysis using chemiluminescent technique (light and chemical )reaction |
82397 |
$251.00 |
$62.75 |
| Analysis using chemiluminescent technique (light and chemical )reaction |
82397 |
$49.00 |
$12.25 |
| Analysis using chemiluminescent technique (light and chemical )reaction |
82397 |
$88.00 |
$22.00 |
| Blood chloride level |
82435 |
$128.00 |
$32.00 |
| Urine chloride level |
82436 |
$36.00 |
$9.00 |
| Cholesterol level |
82465 |
$128.00 |
$32.00 |
| Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease |
82480 |
$53.00 |
$13.25 |
| Chromium level to test for poisoning or deficiency |
82495 |
$173.00 |
$43.25 |
| Citrate level |
82507 |
$186.00 |
$46.50 |
| Collagen cross links test, (urine test to evaluate bone health) |
82523 |
$165.00 |
$41.25 |
| Copper level |
82525 |
$342.00 |
$85.50 |
| Copper level |
82525 |
$252.00 |
$63.00 |
| Corticosterone (hormone) level |
82528 |
$358.00 |
$89.50 |
| Cortisol (hormone) measurement |
82530 |
$279.00 |
$69.75 |
| Cortisol (hormone) measurement |
82533 |
$261.00 |
$65.25 |
| Chemical analysis using chromatography technique |
82542 |
$50.00 |
$12.50 |
| Chemical analysis using chromatography technique |
82542 |
$330.00 |
$82.50 |
| Chemical analysis using chromatography technique |
82542 |
$287.00 |
$71.75 |
| Chemical analysis using chromatography technique |
82542 |
$189.00 |
$47.25 |
| Chemical analysis using chromatography technique |
82542 |
$363.00 |
$90.75 |
| Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage |
82550 |
$199.00 |
$49.75 |
| Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage |
82550 |
$199.00 |
$49.75 |
| Creatine kinase (cardiac enzyme) level |
82553 |
$282.00 |
$70.50 |
| Blood creatinine level |
82565 |
$167.00 |
$41.75 |
| Creatinine level to test for kidney function or muscle injury |
82570 |
$163.00 |
$40.75 |
| Creatinine level to test for kidney function or muscle injury |
82570 |
$151.00 |
$37.75 |
| Creatinine level to test for kidney function or muscle injury |
82570 |
$86.00 |
$21.50 |
| Creatinine clearance measurement to test for kidney function |
82575 |
$163.00 |
$40.75 |
| Cryoglobulin (protein) measurement |
82595 |
$182.00 |
$45.50 |
| Cyanide measurement |
82600 |
$320.00 |
$80.00 |
| Cyanocobalamin (vitamin B-12) level |
82607 |
$452.00 |
$113.00 |
| Cystine and homocystine (amino acids) analysis |
82615 |
$32.00 |
$8.00 |
| Cystine and homocystine (amino acids) analysis |
82615 |
$30.00 |
$7.50 |
| Dehydroepiandrosterone (DHEA) hormone level |
82626 |
$72.00 |
$18.00 |
| Dehydroepiandrosterone (DHEA-S) hormone level |
82627 |
$470.00 |
$117.50 |
| Dihydroxyvitamin D, 1, 25 level |
82652 |
$291.00 |
$72.75 |
| Enzyme activity measurement |
82657 |
$362.00 |
$90.50 |
| Enzyme activity measurement |
82657 |
$52.00 |
$13.00 |
| Enzyme activity measurement |
82657 |
$10.00 |
$2.50 |
| Electrophoresis, laboratory testing technique |
82664 |
$126.00 |
$31.50 |
| Electrophoresis, laboratory testing technique |
82664 |
$115.00 |
$28.75 |
| Erythropoietin (protein) level |
82668 |
$293.00 |
$73.25 |
| Estradiol (hormone) level |
82670 |
$229.00 |
$57.25 |
| Estrogen analysis |
82672 |
$268.00 |
$67.00 |
| Estrone (hormone) level |
82679 |
$229.00 |
$57.25 |
| Ethylene glycol (antifreeze) measurement |
82693 |
$173.00 |
$43.25 |
| Stool fat analysis |
82705 |
$72.00 |
$18.00 |
| Ferritin (blood protein) level |
82728 |
$255.00 |
$63.75 |
| Folic acid level |
82746 |
$238.00 |
$59.50 |
| Folic acid level |
82747 |
$49.00 |
$12.25 |
| Gammaglobulin (immune system protein) measurement |
82784 |
$112.00 |
$28.00 |
| IgE (immune system protein) level |
82785 |
$254.00 |
$63.50 |
| Blood pH level |
82800 |
$93.00 |
$23.25 |
| Blood gases measurement |
82803 |
$457.00 |
$114.25 |
| Gastrin (GI tract hormone) level |
82941 |
$279.00 |
$69.75 |
| Glucose (sugar) level on body fluid |
82945 |
$158.00 |
$39.50 |
| Blood glucose (sugar) level |
82947 |
$151.00 |
$37.75 |
| Blood glucose (sugar) level after receiving dose of glucose |
82950 |
$128.00 |
$32.00 |
| Blood glucose (sugar) tolerance test |
82951 |
$335.00 |
$83.75 |
| Blood glucose (sugar) tolerance test |
82952 |
$93.00 |
$23.25 |
| Glutamyltransferase (liver enzyme) level |
82977 |
$128.00 |
$32.00 |
| Gonadotropin, follicle stimulating (reproductive hormone) level |
83001 |
$318.00 |
$79.50 |
| Gonadotropin, luteinizing (reproductive hormone) level |
83002 |
$465.00 |
$116.25 |
| Human growth hormone level |
83003 |
$98.00 |
$24.50 |
| Haptoglobin (serum protein) level |
83010 |
$136.00 |
$34.00 |
| Heavy metal screening test |
83015 |
$223.00 |
$55.75 |
| Heavy metal level |
83018 |
$258.00 |
$64.50 |
| Hemoglobin analysis and measurement |
83020 |
$252.00 |
$63.00 |
| Hemoglobin analysis and measurement |
83021 |
$264.00 |
$66.00 |
| Hemoglobin A1C level |
83036 |
$148.00 |
$37.00 |
| Methemoglobin (hemoglobin) analysis |
83050 |
$233.00 |
$58.25 |
| Hemosiderin (hemoglobin breakdown product) analysis |
83070 |
$76.00 |
$19.00 |
| Homocysteine (amino acid) level |
83090 |
$460.00 |
$115.00 |
| Hydroxyindolacetic acid (product of metabolism) level |
83497 |
$215.00 |
$53.75 |
| Hydroxyprogesterone, 17-D (synthetic hormone) level |
83498 |
$433.00 |
$108.25 |
| Analysis of substance using immunoassay technique |
83516 |
$34.00 |
$8.50 |
| Analysis of substance using immunoassay technique |
83516 |
$87.00 |
$21.75 |
| Analysis of substance using immunoassay technique |
83516 |
$369.00 |
$92.25 |
| Analysis of substance using immunoassay technique |
83516 |
$42.00 |
$10.50 |
| Analysis of substance using immunoassay technique |
83516 |
$37.00 |
$9.25 |
| Analysis of substance using immunoassay technique |
83516 |
$470.00 |
$117.50 |
| Analysis of substance using immunoassay technique |
83516 |
$234.00 |
$58.50 |
| Analysis of substance using immunoassay technique |
83516 |
$449.00 |
$112.25 |
| Analysis of substance using immunoassay technique |
83516 |
$192.00 |
$48.00 |
| Analysis of substance using immunoassay technique |
83516 |
$108.00 |
$27.00 |
| Measurement of substance using immunoassay technique |
83519 |
$870.00 |
$217.50 |
| Measurement of substance using immunoassay technique |
83519 |
$88.00 |
$22.00 |
| Measurement of substance using immunoassay technique |
83519 |
$1,876.00 |
$469.00 |
| Measurement of substance using immunoassay technique |
83519 |
$229.00 |
$57.25 |
| Measurement of substance using immunoassay technique |
83519 |
$38.00 |
$9.50 |
| Measurement of substance using immunoassay technique |
83519 |
$139.00 |
$34.75 |
| Measurement of substance using immunoassay technique |
83520 |
$834.00 |
$208.50 |
| Measurement of substance using immunoassay technique |
83520 |
$128.00 |
$32.00 |
| Measurement of substance using immunoassay technique |
83520 |
$36.00 |
$9.00 |
| Measurement of substance using immunoassay technique |
83520 |
$359.00 |
$89.75 |
| Measurement of substance using immunoassay technique |
83520 |
$38.00 |
$9.50 |
| Measurement of substance using immunoassay technique |
83520 |
$437.00 |
$109.25 |
| Measurement of substance using immunoassay technique |
83520 |
$83.00 |
$20.75 |
| Measurement of substance using immunoassay technique |
83520 |
$84.00 |
$21.00 |
| Insulin measurement |
83525 |
$148.00 |
$37.00 |
| Iron level |
83540 |
$128.00 |
$32.00 |
| Iron binding capacity |
83550 |
$158.00 |
$39.50 |
| Lactic acid level |
83605 |
$242.00 |
$60.50 |
| Lactate dehydrogenase (enzyme) level |
83615 |
$163.00 |
$40.75 |
| Lactate dehydrogenase (enzyme) level |
83615 |
$157.00 |
$39.25 |
| Stool lactoferrin (immune system protein) analysis |
83630 |
$50.00 |
$12.50 |
| Lead level |
83655 |
$210.00 |
$52.50 |
| Lipase (fat enzyme) level |
83690 |
$17.00 |
$4.25 |
| Lipase (fat enzyme) level |
83690 |
$77.00 |
$19.25 |
| HDL cholesterol level |
83718 |
$229.00 |
$57.25 |
| LDL cholesterol level |
83721 |
$97.00 |
$24.25 |
| Magnesium level |
83735 |
$151.00 |
$37.75 |
| Magnesium level |
83735 |
$128.00 |
$32.00 |
| Manganese (heavy metal) level |
83785 |
$113.00 |
$28.25 |
| Mass spectrometry (laboratory testing method) |
83789 |
$467.00 |
$116.75 |
| Mass spectrometry (laboratory testing method) |
83789 |
$229.00 |
$57.25 |
| Mercury level |
83825 |
$93.00 |
$23.25 |
| Metanephrines level |
83835 |
$577.00 |
$144.25 |
| Metanephrines level |
83835 |
$261.00 |
$65.25 |
| Metanephrines level |
83835 |
$189.00 |
$47.25 |
| Myelin basic protein (nerve protein) level, spinal fluid |
83873 |
$34.00 |
$8.50 |
| Myoglobin (muscle protein) level |
83874 |
$242.00 |
$60.50 |
| Natriuretic peptide (heart and blood vessel protein) level |
83880 |
$289.00 |
$72.25 |
| Nephelometry, test method using light |
83883 |
$38.00 |
$9.50 |
| Nephelometry, test method using light |
83883 |
$161.00 |
$40.25 |
| Measurement of immune substance (oligoclonal bands) |
83916 |
$354.00 |
$88.50 |
| Organic acids level |
83918 |
$72.00 |
$18.00 |
| Organic acid level |
83921 |
$254.00 |
$63.50 |
| Blood osmolality (concentration) measurement |
83930 |
$114.00 |
$28.50 |
| Urine osmolality (concentration) measurement |
83935 |
$114.00 |
$28.50 |
| Osteocalcin (bone protein) level |
83937 |
$252.00 |
$63.00 |
| Oxalate level |
83945 |
$177.00 |
$44.25 |
| Parathormone (parathyroid hormone) level |
83970 |
$405.00 |
$101.25 |
| Body fluid pH level |
83986 |
$52.00 |
$13.00 |
| PCP drug level |
83992 |
$254.00 |
$63.50 |
| Stool calprotectin (protein) level |
83993 |
$59.00 |
$14.75 |
| Phosphatase (enzyme) measurement |
84060 |
$128.00 |
$32.00 |
| Phosphatase, prostatic (prostate enzyme) level |
84066 |
$173.00 |
$43.25 |
| Phosphatase (enzyme) level |
84075 |
$382.00 |
$95.50 |
| Phosphatase (enzyme) measurement |
84080 |
$161.00 |
$40.25 |
| Phosphate level |
84100 |
$128.00 |
$32.00 |
| Urine phosphate level |
84105 |
$128.00 |
$32.00 |
| Urine porphobilinogen (metabolism substance) level |
84110 |
$38.00 |
$9.50 |
| Urine porphyrins (metabolism substance) measurement |
84120 |
$163.00 |
$40.75 |
| Blood potassium level |
84132 |
$128.00 |
$32.00 |
| Urine potassium level |
84133 |
$136.00 |
$34.00 |
| Prealbumin (protein) level |
84134 |
$289.00 |
$72.25 |
| 17-hydroxypregnenolone (hormone) level |
84143 |
$452.00 |
$113.00 |
| Progesterone (reproductive hormone) level |
84144 |
$310.00 |
$77.50 |
| Procalcitonin (hormone) level |
84145 |
$752.00 |
$188.00 |
| Prolactin (milk producing hormone) level |
84146 |
$197.00 |
$49.25 |
| PSA (prostate specific antigen) measurement |
84153 |
$252.00 |
$63.00 |
| PSA (prostate specific antigen) measurement |
84154 |
$329.00 |
$82.25 |
| Total protein level, blood |
84155 |
$128.00 |
$32.00 |
| Total protein level, urine |
84156 |
$158.00 |
$39.50 |
| Total protein level, urine |
84156 |
$24.00 |
$6.00 |
| Total protein level, body fluid |
84157 |
$187.00 |
$46.75 |
| Protein measurement, serum |
84165 |
$255.00 |
$63.75 |
| Protein measurement, body fluid |
84166 |
$44.00 |
$11.00 |
| Protein measurement |
84181 |
$159.00 |
$39.75 |
| Protein measurement |
84181 |
$568.00 |
$142.00 |
| Proinsulin (pancreatic hormone) level |
84206 |
$308.00 |
$77.00 |
| Vitamin B-6 level |
84207 |
$603.00 |
$150.75 |
| Renin (kidney enzyme) level |
84244 |
$387.00 |
$96.75 |
| Selenium (vitamin) level |
84255 |
$210.00 |
$52.50 |
| Serotonin (hormone) level |
84260 |
$752.00 |
$188.00 |
| Sex hormone binding globulin (protein) level |
84270 |
$64.00 |
$16.00 |
| Blood sodium level |
84295 |
$128.00 |
$32.00 |
| Urine sodium level |
84300 |
$136.00 |
$34.00 |
| Sodium level |
84302 |
$54.00 |
$13.50 |
| Somatostatin (growth hormone inhibitor) level |
84307 |
$112.00 |
$28.00 |
| Carbohydrate (sugar) analysis |
84375 |
$75.00 |
$18.75 |
| Urine sulfate (acid) level |
84392 |
$58.00 |
$14.50 |
| Testosterone (hormone) level |
84402 |
$400.00 |
$100.00 |
| Testosterone (hormone) level |
84403 |
$452.00 |
$113.00 |
| Testosterone (hormone) level |
84403 |
$400.00 |
$100.00 |
| Testosterone level |
84410 |
$157.00 |
$39.25 |
| Vitamin B-1 (thiamine) level |
84425 |
$362.00 |
$90.50 |
| Thyroglobulin (thyroid related hormone) level |
84432 |
$136.00 |
$34.00 |
| Thyroxine (thyroid chemical) measurement |
84436 |
$182.00 |
$45.50 |
| Thyroxine (thyroid chemical) measurement |
84439 |
$192.00 |
$48.00 |
| Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. |
84443 |
$321.00 |
$80.25 |
| Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. |
84443 |
$321.00 |
$80.25 |
| Thyroid stimulating immune globulins (thyroid related protein) level |
84445 |
$270.00 |
$67.50 |
| Vitamin E level |
84446 |
$43.00 |
$10.75 |
| Liver enzyme (SGOT), level |
84450 |
$128.00 |
$32.00 |
| Liver enzyme (SGPT), level |
84460 |
$128.00 |
$32.00 |
| Transferrin (iron binding protein) level |
84466 |
$98.00 |
$24.50 |
| Triglycerides level |
84478 |
$128.00 |
$32.00 |
| Thyroid hormone evaluation |
84479 |
$158.00 |
$39.50 |
| Thyroid hormone, T3 measurement |
84480 |
$261.00 |
$65.25 |
| Thyroid hormone, T3 measurement |
84481 |
$409.00 |
$102.25 |
| Thyroid hormone, T3 measurement |
84482 |
$427.00 |
$106.75 |
| Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks |
84484 |
$293.00 |
$73.25 |
| Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks |
84484 |
$293.00 |
$73.25 |
| Urea nitrogen level to assess kidney function |
84520 |
$151.00 |
$37.75 |
| Urea nitrogen level to assess kidney function |
84545 |
$36.00 |
$9.00 |
| Uric acid level, blood |
84550 |
$128.00 |
$32.00 |
| Uric acid level |
84560 |
$131.00 |
$32.75 |
| Uric acid level |
84560 |
$136.00 |
$34.00 |
| Urine vanillylmandelic acid |
84585 |
$342.00 |
$85.50 |
| Urine vanillylmandelic acid |
84585 |
$229.00 |
$57.25 |
| Vasoactive intestinal peptide (intestinal hormone) level |
84586 |
$93.00 |
$23.25 |
| ADH (antidiuretic hormone) level |
84588 |
$159.00 |
$39.75 |
| Vitamin A level |
84590 |
$215.00 |
$53.75 |
| Vitamin K level |
84597 |
$264.00 |
$66.00 |
| Zinc level |
84630 |
$393.00 |
$98.25 |
| Zinc level |
84630 |
$250.00 |
$62.50 |
| C-peptide (protein) level |
84681 |
$263.00 |
$65.75 |
| Gonadotropin, chorionic (reproductive hormone) level |
84702 |
$385.00 |
$96.25 |
| Gonadotropin (reproductive hormone) analysis |
84703 |
$224.00 |
$56.00 |
| Chemistry procedures |
84999 |
$173.00 |
$43.25 |
| Chemistry procedures |
84999 |
$54.00 |
$13.50 |
| Microscopic examination for white blood cells with manual cell count |
85007 |
$107.00 |
$26.75 |
| Red blood cell concentration measurement |
85014 |
$84.00 |
$21.00 |
| Hemoglobin measurement |
85018 |
$86.00 |
$21.50 |
| Complete blood cell count (red cells, white blood cell, platelets), automated test |
85025 |
$135.00 |
$33.75 |
| Complete blood cell count (red cells, white blood cell, platelets), automated test |
85025 |
$135.00 |
$33.75 |
| Complete blood cell count (red cells, white blood cell, platelets), automated test |
85027 |
$116.00 |
$29.00 |
| Red blood count, manual test |
85044 |
$72.00 |
$18.00 |
| Red blood count, automated test |
85045 |
$187.00 |
$46.75 |
| Automated white blood cell count |
85048 |
$49.00 |
$12.25 |
| Automated white blood cell count |
85048 |
$75.00 |
$18.75 |
| Platelet count, automated test |
85049 |
$72.00 |
$18.00 |
| Clotting factor VII (proconvertin, stable factor) |
85230 |
$396.00 |
$99.00 |
| Clotting factor VIII (AHG) measurement |
85240 |
$77.00 |
$19.25 |
| Clotting factor VIII (VW factor) measurement |
85245 |
$182.00 |
$45.50 |
| Clotting factor VIII (VW factor) antigen |
85246 |
$107.00 |
$26.75 |
| Clotting factor IX (PTC or Christmas) measurement |
85250 |
$49.00 |
$12.25 |
| Clotting factor X (Stuart-Prower) measurement |
85260 |
$113.00 |
$28.25 |
| Clotting factor XI (PTA) measurement |
85270 |
$46.00 |
$11.50 |
| Antithrombin III antigen (clotting inhibitor) activity |
85300 |
$131.00 |
$32.75 |
| Protein C antigen (clotting inhibitor) measurement |
85303 |
$318.00 |
$79.50 |
| Protein S (clotting inhibitor) level |
85305 |
$337.00 |
$84.25 |
| Protein S (clotting inhibitor) measurement |
85306 |
$318.00 |
$79.50 |
| Activated protein resistance assay |
85307 |
$131.00 |
$32.75 |
| Coagulation function analysis |
85362 |
$137.00 |
$34.25 |
| Coagulation function measurement |
85379 |
$234.00 |
$58.50 |
| Fibrinogen (factor 1) activity measurement |
85384 |
$173.00 |
$43.25 |
| Heparin assay |
85520 |
$521.00 |
$130.25 |
| White blood cell enzyme activity measurement |
85549 |
$138.00 |
$34.50 |
| Platelet function test |
85576 |
$307.00 |
$76.75 |
| Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. |
85610 |
$163.00 |
$40.75 |
| Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. |
85610 |
$163.00 |
$40.75 |
| Blood test, clotting time |
85611 |
$34.00 |
$8.50 |
| Clotting factor X assessment test |
85613 |
$164.00 |
$41.00 |
| Red blood cell sedimentation rate, to detect inflammation |
85651 |
$123.00 |
$30.75 |
| Red blood cell sedimentation rate, to detect inflammation |
85652 |
$123.00 |
$30.75 |
| Red blood cell sickling measurement |
85660 |
$61.00 |
$15.25 |
| Red blood cell sickling measurement |
85660 |
$77.00 |
$19.25 |
| Coagulation assessment blood test |
85730 |
$163.00 |
$40.75 |
| Coagulation assessment blood test |
85730 |
$131.00 |
$32.75 |
| Coagulation assessment blood test |
85730 |
$157.00 |
$39.25 |
| Coagulation assessment blood test |
85732 |
$36.00 |
$9.00 |
| Measurement of antibody to infectious organism |
86000 |
$75.00 |
$18.75 |
| Measurement of antibody (IgE) to allergic substance |
86003 |
$20.00 |
$5.00 |
| Measurement of antibody (IgE) to allergic substance |
86008 |
$46.00 |
$11.50 |
| Antibody identification test for white blood cell antibodies |
86021 |
$941.00 |
$235.25 |
| Antibody identification test for platelet antibodies |
86022 |
$706.00 |
$176.50 |
| Screening test for autoimmune disorder |
86038 |
$471.00 |
$117.75 |
| Measurement C-reactive protein for detection of infection or inflammation |
86140 |
$107.00 |
$26.75 |
| Measurement C-reactive protein for detection of infection or inflammation |
86141 |
$167.00 |
$41.75 |
| Beta 2 glycoprotein 1 antibody (autoantibody) measurement |
86146 |
$140.00 |
$35.00 |
| Cardiolipin antibody (tissue antibody) measurement |
86147 |
$275.00 |
$68.75 |
| Cardiolipin antibody (tissue antibody) measurement |
86147 |
$76.00 |
$19.00 |
| Phospholipid antibody (autoimmune antibody) measurement |
86148 |
$398.00 |
$99.50 |
| Measurement of cold agglutinin (protein) to detect infection or disease |
86157 |
$293.00 |
$73.25 |
| Measurement of complement (immune system proteins) |
86160 |
$148.00 |
$37.00 |
| Measurement of complement (immune system proteins) |
86160 |
$201.00 |
$50.25 |
| Measurement of complement (immune system proteins) |
86160 |
$471.00 |
$117.75 |
| Measurement of complement (immune system proteins) |
86160 |
$185.00 |
$46.25 |
| Measurement of antibody for rheumatoid arthritis assessment |
86200 |
$137.00 |
$34.25 |
| Measurement of DNA antibody |
86225 |
$292.00 |
$73.00 |
| Measurement of DNA antibody |
86226 |
$36.00 |
$9.00 |
| Measurement of antibody for assessment of autoimmune disorder |
86235 |
$244.00 |
$61.00 |
| Measurement of antibody for assessment of autoimmune disorder |
86235 |
$275.00 |
$68.75 |
| Measurement of antibody for assessment of autoimmune disorder |
86235 |
$234.00 |
$58.50 |
| Measurement of antibody for assessment of autoimmune disorder |
86235 |
$103.00 |
$25.75 |
| Screening test for antibody to noninfectious agent |
86255 |
$320.00 |
$80.00 |
| Screening test for antibody to noninfectious agent |
86255 |
$238.00 |
$59.50 |
| Screening test for antibody to noninfectious agent |
86255 |
$35.00 |
$8.75 |
| Screening test for antibody to noninfectious agent |
86255 |
$276.00 |
$69.00 |
| Screening test for antibody to noninfectious agent |
86255 |
$104.00 |
$26.00 |
| Screening test for antibody to noninfectious agent |
86255 |
$30.00 |
$7.50 |
| Screening test for antibody to noninfectious agent |
86255 |
$42.00 |
$10.50 |
| Measurement of antibody to noninfectious agent |
86256 |
$138.00 |
$34.50 |
| Measurement of antibody to noninfectious agent |
86256 |
$42.00 |
$10.50 |
| Measurement of antibody to noninfectious agent |
86256 |
$104.00 |
$26.00 |
| Immunologic analysis for detection of tumor antigen |
86300 |
$114.00 |
$28.50 |
| Immunologic analysis for detection of tumor antigen |
86301 |
$279.00 |
$69.75 |
| Immunologic analysis for detection of tumor antigen |
86304 |
$279.00 |
$69.75 |
| Screening test for mononucleosis (mono) |
86308 |
$107.00 |
$26.75 |
| Analysis for detection of tumor marker |
86316 |
$103.00 |
$25.75 |
| Detection of infectious agent antibody |
86317 |
$136.00 |
$34.00 |
| Detection of infectious agent antibody |
86317 |
$148.00 |
$37.00 |
| Immunologic analysis technique on serum |
86320 |
$557.00 |
$139.25 |
| Immunologic analysis technique on body fluid |
86325 |
$557.00 |
$139.25 |
| Immune complex measurement |
86332 |
$291.00 |
$72.75 |
| Immunologic analysis technique on serum |
86334 |
$268.00 |
$67.00 |
| Immunologic analysis technique on body fluid |
86335 |
$457.00 |
$114.25 |
| Immunologic analysis technique on body fluid |
86335 |
$106.00 |
$26.50 |
| Intrinsic factor (stomach protein) antibody measurement |
86340 |
$237.00 |
$59.25 |
| Islet cell (pancreas) antibody measurement |
86341 |
$307.00 |
$76.75 |
| White blood cell function measurement |
86353 |
$279.00 |
$69.75 |
| White blood cell antigen measurement |
86356 |
$210.00 |
$52.50 |
| T cell count and ratio |
86361 |
$137.00 |
$34.25 |
| Microsomal antibodies (autoantibody) measurement |
86376 |
$318.00 |
$79.50 |
| Viral neutralization test to detect viral antibody level |
86382 |
$107.00 |
$26.75 |
| Screening test for presence of antibody |
86403 |
$121.00 |
$30.25 |
| Screening test for presence of antibody |
86403 |
$107.00 |
$26.75 |
| Screening test for presence of antibody |
86403 |
$64.00 |
$16.00 |
| Screening test for presence of antibody |
86403 |
$45.00 |
$11.25 |
| Rheumatoid factor analysis |
86430 |
$107.00 |
$26.75 |
| Rheumatoid factor level |
86431 |
$234.00 |
$58.50 |
| Tuberculosis test |
86480 |
$521.00 |
$130.25 |
| Skin test for tuberculosis |
86580 |
$30.00 |
$7.50 |
| Syphilis detection test |
86592 |
$84.00 |
$21.00 |
| Syphilis detection test |
86592 |
$12.00 |
$3.00 |
| Syphilis test |
86593 |
$12.00 |
$3.00 |
| Analysis for antibody to aspergillus (fungus) |
86606 |
$34.00 |
$8.50 |
| Analysis for antibody to Bartonella (bacteria) |
86611 |
$30.00 |
$7.50 |
| Analysis for antibody to blastomyces (fungus) |
86612 |
$136.00 |
$34.00 |
| Analysis for antibody bordetella (respiratory bacteria) |
86615 |
$58.00 |
$14.50 |
| Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria) |
86617 |
$231.00 |
$57.75 |
| Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) |
86618 |
$238.00 |
$59.50 |
| Analysis for antibody to Brucella (bacteria) |
86622 |
$160.00 |
$40.00 |
| Analysis for antibody to Candida (yeast) |
86628 |
$45.00 |
$11.25 |
| Analysis for antibody to Chlamydia (bacteria) |
86631 |
$229.00 |
$57.25 |
| Analysis for antibody (IgM) to Chlamydia (bacteria) |
86632 |
$103.00 |
$25.75 |
| Analysis for antibody to Coccidioides (bacteria) |
86635 |
$98.00 |
$24.50 |
| Analysis for antibody to Cryptococcus (yeast) |
86641 |
$148.00 |
$37.00 |
| Analysis for antibody to Cytomegalovirus (CMV) |
86644 |
$210.00 |
$52.50 |
| Analysis for antibody (IgM) to Cytomegalovirus (CMV) |
86645 |
$210.00 |
$52.50 |
| Analysis for antibody to St. Louis virus (viral encephalitis) |
86653 |
$192.00 |
$48.00 |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus) |
86663 |
$580.00 |
$145.00 |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus) |
86664 |
$48.00 |
$12.00 |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus) |
86665 |
$234.00 |
$58.50 |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus) |
86665 |
$494.00 |
$123.50 |
| Analysis for antibody to Ehrlichia (bacteria transmitted by ticks) |
86666 |
$541.00 |
$135.25 |
| Analysis for antibody to Ehrlichia (bacteria transmitted by ticks) |
86666 |
$568.00 |
$142.00 |
| Analysis for antibody to Francisella tularensis (bacteria transmitted by rodents) |
86668 |
$151.00 |
$37.75 |
| Analysis for antibody to fungus |
86671 |
$30.00 |
$7.50 |
| Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) |
86677 |
$197.00 |
$49.25 |
| Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) |
86677 |
$187.00 |
$46.75 |
| Analysis for antibody to helminth (intestinal worm) |
86682 |
$77.00 |
$19.25 |
| Analysis for antibody to helminth (intestinal worm) |
86682 |
$161.00 |
$40.25 |
| Analysis for antibody to Herpes simplex virus |
86694 |
$421.00 |
$105.25 |
| Analysis for antibody to Herpes simplex virus, type 1 |
86695 |
$148.00 |
$37.00 |
| Analysis for antibody to Herpes simplex virus, type 2 |
86696 |
$148.00 |
$37.00 |
| Analysis for antibody to histoplasma (fungus) |
86698 |
$107.00 |
$26.75 |
| Analysis for antibody to histoplasma (fungus) |
86698 |
$128.00 |
$32.00 |
| Analysis for antibody to HIV -1 virus |
86701 |
$61.00 |
$15.25 |
| Analysis for antibody to HIV-2 virus |
86702 |
$61.00 |
$15.25 |
| Analysis for antibody to HIV-1 and HIV-2 virus |
86703 |
$447.00 |
$111.75 |
| Analysis for antibody to HIV-1 and HIV-2 virus |
86703 |
$425.00 |
$106.25 |
| Hepatitis B core antibody measurement |
86704 |
$185.00 |
$46.25 |
| Hepatitis B core antibody (IgM) measurement |
86705 |
$140.00 |
$35.00 |
| Hepatitis B surface antibody measurement |
86706 |
$173.00 |
$43.25 |
| Hepatitis B surface antibody measurement |
86706 |
$164.00 |
$41.00 |
| Hepatitis Be antibody measurement |
86707 |
$35.00 |
$8.75 |
| Measurement of Hepatitis A antibody |
86708 |
$182.00 |
$45.50 |
| Measurement of Hepatitis A antibody (IgM) |
86709 |
$136.00 |
$34.00 |
| Analysis for antibody to mumps virus |
86735 |
$97.00 |
$24.25 |
| Analysis for antibody to mumps virus |
86735 |
$104.00 |
$26.00 |
| Analysis for antibody to Mycoplasma (bacteria) |
86738 |
$148.00 |
$37.00 |
| Analysis for antibody to parvovirus |
86747 |
$263.00 |
$65.75 |
| Analysis for antibody to Rickettsia (bacteria) |
86757 |
$104.00 |
$26.00 |
| Analysis for antibody to Rickettsia (bacteria) |
86757 |
$307.00 |
$76.75 |
| Analysis for antibody to Rubella (German measles virus) |
86762 |
$45.00 |
$11.25 |
| Analysis for antibody to Rubella (German measles virus) |
86762 |
$93.00 |
$23.25 |
| Analysis for antibody to Rubeola (measles virus) |
86765 |
$84.00 |
$21.00 |
| Analysis for antibody to Salmonella (intestinal bacteria) |
86768 |
$185.00 |
$46.25 |
| Analysis for antibody to Toxoplasma (parasite) |
86777 |
$125.00 |
$31.25 |
| Analysis for antibody (IgM) to Toxoplasma (parasite) |
86778 |
$140.00 |
$35.00 |
| Analysis for antibody, Treponema pallidum |
86780 |
$151.00 |
$37.75 |
| Analysis for antibody, Treponema pallidum |
86780 |
$46.00 |
$11.50 |
| Analysis for antibody to varicella-zoster virus (chicken pox) |
86787 |
$98.00 |
$24.50 |
| Analysis for antibody to varicella-zoster virus (chicken pox) |
86787 |
$38.00 |
$9.50 |
| Analysis for antibody (IgM) to West Nile virus |
86788 |
$218.00 |
$54.50 |
| Analysis for antibody to West Nile virus |
86789 |
$218.00 |
$54.50 |
| Analysis for antibody to virus |
86790 |
$246.00 |
$61.50 |
| Analysis for antibody to virus |
86790 |
$135.00 |
$33.75 |
| Analysis for antibody to virus |
86790 |
$130.00 |
$32.50 |
| Thyroglobulin (thyroid protein) antibody measurement |
86800 |
$318.00 |
$79.50 |
| Hepatitis C antibody measurement |
86803 |
$129.00 |
$32.25 |
| Immunologic analysis for autoimmune disease |
86812 |
$441.00 |
$110.25 |
| Screening test for red blood cell antibodies |
86850 |
$78.00 |
$19.50 |
| Screening test for red blood cell antibodies |
86850 |
$279.00 |
$69.75 |
| Removal of antibodies from surface of red blood cell |
86860 |
$160.00 |
$40.00 |
| Identification of red blood cell antibodies |
86870 |
$448.00 |
$112.00 |
| Identification of red blood cell antibodies |
86870 |
$434.00 |
$108.50 |
| Identification of red blood cell antibodies |
86870 |
$292.00 |
$73.00 |
| Red blood cell antibody detection test |
86880 |
$137.00 |
$34.25 |
| Red blood cell antibody detection test |
86885 |
$227.00 |
$56.75 |
| Processing and storage of blood unit or component |
86890 |
$809.00 |
$202.25 |
| Blood group typing (ABO) |
86900 |
$178.00 |
$44.50 |
| Blood typing for Rh (D) antigen |
86901 |
$124.00 |
$31.00 |
| Screening test for compatible blood unit |
86902 |
$374.00 |
$93.50 |
| Screening test for compatible blood unit |
86904 |
$34.00 |
$8.50 |
| Blood typing for red blood cell antigens |
86905 |
$378.00 |
$94.50 |
| Blood unit compatibility test |
86920 |
$279.00 |
$69.75 |
| Blood unit compatibility test |
86922 |
$238.00 |
$59.50 |
| Thawing of fresh frozen plasma unit |
86927 |
$395.00 |
$98.75 |
| Concentration of specimen for infectious agents |
87015 |
$207.00 |
$51.75 |
| Bacterial blood culture |
87040 |
$289.00 |
$72.25 |
| Stool culture |
87045 |
$254.00 |
$63.50 |
| Stool culture |
87046 |
$77.00 |
$19.25 |
| Stool culture |
87046 |
$131.00 |
$32.75 |
| Stool culture |
87046 |
$28.00 |
$7.00 |
| Bacterial culture |
87070 |
$254.00 |
$63.50 |
| Bacterial culture |
87075 |
$148.00 |
$37.00 |
| Bacterial culture for aerobic isolates |
87077 |
$167.00 |
$41.75 |
| Bacterial culture for aerobic isolates |
87077 |
$318.00 |
$79.50 |
| Screening test for pathogenic organisms |
87081 |
$20.00 |
$5.00 |
| Screening test for pathogenic organisms |
87081 |
$254.00 |
$63.50 |
| Screening test for pathogenic organisms |
87081 |
$53.00 |
$13.25 |
| Screening test for pathogenic organisms |
87081 |
$218.00 |
$54.50 |
| Screening test for pathogenic organisms |
87081 |
$49.00 |
$12.25 |
| Screening test for pathogenic organisms |
87081 |
$207.00 |
$51.75 |
| Screening test for pathogenic organisms |
87081 |
$126.00 |
$31.50 |
| Screening test for pathogenic organisms |
87081 |
$320.00 |
$80.00 |
| Bacterial colony count, urine |
87086 |
$254.00 |
$63.50 |
| Fungal culture (mold or yeast) of skin, hair, or nail |
87101 |
$23.00 |
$5.75 |
| Fungal culture (mold or yeast) |
87102 |
$292.00 |
$73.00 |
| Fungal blood culture (mold or yeast) |
87103 |
$28.00 |
$7.00 |
| Culture for chlamydia |
87110 |
$546.00 |
$136.50 |
| Culture for acid-fast bacilli |
87116 |
$90.00 |
$22.50 |
| Identification of organisms by immunologic analysis |
87140 |
$77.00 |
$19.25 |
| Identification of organisms by immunologic analysis |
87147 |
$31.00 |
$7.75 |
| Macroscopic examination (visual inspection) of parasite |
87169 |
$85.00 |
$21.25 |
| Pinworm test |
87172 |
$58.00 |
$14.50 |
| Tissue preparation for culture |
87176 |
$18.00 |
$4.50 |
| Smear for parasites |
87177 |
$187.00 |
$46.75 |
| Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) |
87186 |
$175.00 |
$43.75 |
| Special stain for microorganism |
87205 |
$107.00 |
$26.75 |
| Special stain for microorganism |
87205 |
$83.00 |
$20.75 |
| Special stain for microorganism |
87206 |
$107.00 |
$26.75 |
| Special stain for microorganism |
87206 |
$58.00 |
$14.50 |
| Special stain for microorganism |
87207 |
$58.00 |
$14.50 |
| Special stain for parasites |
87209 |
$76.00 |
$19.00 |
| Smear for infectious agents |
87210 |
$75.00 |
$18.75 |
| Microbial toxin or antitoxin assay |
87230 |
$305.00 |
$76.25 |
| Tissue culture inoculation for virus isolation |
87252 |
$275.00 |
$68.75 |
| Tissue culture inoculation for virus isolation |
87252 |
$343.00 |
$85.75 |
| Detection test for bordetella pertussis or parapertussis (respiratory bacteria) |
87265 |
$77.00 |
$19.25 |
| Detection test for giardia (intestinal parasite) |
87269 |
$160.00 |
$40.00 |
| Detection test for cryptosporidium (parasite) |
87272 |
$45.00 |
$11.25 |
| Detection test for herpes simplex virus type 1 |
87274 |
$114.00 |
$28.50 |
| Detection test for pneumocystis carinii (respiratory parasite) |
87281 |
$114.00 |
$28.50 |
| Detection test for clostridium difficile toxins (stool pathogen) |
87324 |
$263.00 |
$65.75 |
| Qualitative or semiquantitative detection test for helicobacter pylori in stool, multiple-step method |
87338 |
$215.00 |
$53.75 |
| Detection test for Hepatitis B surface antigen |
87340 |
$148.00 |
$37.00 |
| Detection test for Hepatitis Be surface antigen |
87350 |
$145.00 |
$36.25 |
| Detection test for histoplasma capsulatum (parasite) |
87385 |
$31.00 |
$7.75 |
| Detection test for HIV-1 and HIV-2 |
87389 |
$82.00 |
$20.50 |
| Detection test for Rotavirus |
87425 |
$416.00 |
$104.00 |
| Detection test for bacteria toxin (shiga-like toxin) |
87427 |
$58.00 |
$14.50 |
| Immunologic analysis for detection of organism |
87449 |
$38.00 |
$9.50 |
| Immunologic analysis for detection of organism |
87449 |
$316.00 |
$79.00 |
| Immunologic analysis for detection of organism |
87449 |
$66.00 |
$16.50 |
| Detection Bartonella henselae and Bartonella quintana (bacteria) |
87471 |
$1,179.00 |
$294.75 |
| Detection test for chlamydia |
87491 |
$81.00 |
$20.25 |
| Detection test for clostridium difficile |
87493 |
$100.00 |
$25.00 |
| Detection test for Cytomegalovirus (CMV) |
87496 |
$545.00 |
$136.25 |
| Detection test for enterovirus (intestinal virus) |
87498 |
$761.00 |
$190.25 |
| Detection test for Hepatitis B virus |
87517 |
$432.00 |
$108.00 |
| Detection test for Hepatitis C virus |
87522 |
$269.00 |
$67.25 |
| Detection test for Hepatitis C virus |
87522 |
$251.00 |
$62.75 |
| Detection test for herpes simplex virus |
87529 |
$197.00 |
$49.25 |
| Detection test for herpes simplex virus |
87530 |
$217.00 |
$54.25 |
| Detection test for HIV-1 virus |
87536 |
$1,063.00 |
$265.75 |
| Detection test for Neisseria gonorrhoeae (gonorrhoeae bacteria) |
87591 |
$135.00 |
$33.75 |
| Detection test for multiple types of respiratory virus |
87633 |
$1,294.00 |
$323.50 |
| Detection test for organism |
87798 |
$119.00 |
$29.75 |
| Detection test for organism |
87798 |
$344.00 |
$86.00 |
| Detection test for organism |
87798 |
$606.00 |
$151.50 |
| Detection test for organism |
87798 |
$108.00 |
$27.00 |
| Detection test for organism |
87799 |
$742.00 |
$185.50 |
| Detection test for organism |
87799 |
$569.00 |
$142.25 |
| Detection test for organism |
87799 |
$655.00 |
$163.75 |
| Detection test for organism |
87799 |
$471.00 |
$117.75 |
| Detection test for organism |
87799 |
$498.00 |
$124.50 |
| Detection test for multiple organisms |
87801 |
$487.00 |
$121.75 |
| Detection test for influenza virus |
87804 |
$229.00 |
$57.25 |
| Detection test for respiratory syncytial virus (RSV) |
87807 |
$129.00 |
$32.25 |
| Strep test (Streptococcus, group A) |
87880 |
$264.00 |
$66.00 |
| Detection test for identification of organism |
87899 |
$72.00 |
$18.00 |
| Detection test for identification of organism |
87899 |
$42.00 |
$10.50 |
| Analysis test for Hepatitis C virus |
87902 |
$794.00 |
$198.50 |
| Cell examination of body fluid |
88104 |
$51.00 |
$12.75 |
| Cell examination of body fluid |
88106 |
$51.00 |
$12.75 |
| Cell examination of specimen |
88108 |
$51.00 |
$12.75 |
| Cell examination of specimen |
88112 |
$151.00 |
$37.75 |
| Cell examination of specimen |
88112 |
$110.00 |
$27.50 |
| Pap test (Pap smear) |
88142 |
$199.00 |
$49.75 |
| Screening examination of specimen cells |
88161 |
$51.00 |
$12.75 |
| Pap test (Pap smear) |
88164 |
$151.00 |
$37.75 |
| Evaluation of fine needle aspirate |
88172 |
$192.00 |
$48.00 |
| Evaluation of fine needle aspirate with interpretation and report |
88173 |
$110.00 |
$27.50 |
| Flow cytometry technique for DNA or cell analysis |
88184 |
$598.00 |
$149.50 |
| Flow cytometry technique for DNA or cell analysis |
88184 |
$395.00 |
$98.75 |
| Flow cytometry technique for DNA or cell analysis |
88185 |
$499.00 |
$124.75 |
| Flow cytometry technique for DNA or cell analysis |
88185 |
$38.00 |
$9.50 |
| Flow cytometry technique for DNA or cell analysis |
88185 |
$114.00 |
$28.50 |
| Flow cytometry technique for DNA or cell analysis |
88189 |
$575.00 |
$143.75 |
| Pathology examination of tissue using a microscope, limited examination |
88300 |
$32.00 |
$8.00 |
| Pathology examination of tissue using a microscope |
88302 |
$51.00 |
$12.75 |
| Pathology examination of tissue using a microscope, moderately low complexity |
88304 |
$110.00 |
$27.50 |
| Pathology examination of tissue using a microscope, intermediate complexity |
88305 |
$110.00 |
$27.50 |
| Pathology examination of tissue using a microscope, moderately high complexity |
88307 |
$395.00 |
$98.75 |
| Pathology examination of tissue using a microscope, high complexity |
88309 |
$832.00 |
$208.00 |
| Preparation of tissue for examination by removing any calcium present |
88311 |
$32.00 |
$8.00 |
| Special stained specimen slides to identify organisms including interpretation and report |
88312 |
$51.00 |
$12.75 |
| Special stained specimen slides to examine tissue including interpretation and report |
88313 |
$51.00 |
$12.75 |
| Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report |
88314 |
$110.00 |
$27.50 |
| Evaluation of specimen enzymes |
88319 |
$832.00 |
$208.00 |
| Pathology examination of tissue during surgery |
88331 |
$227.00 |
$56.75 |
| Pathology examination of specimen during surgery |
88332 |
$32.00 |
$8.00 |
| Pathology examination of tissue specimen during surgery |
88333 |
$832.00 |
$208.00 |
| Pathology examination of specimen during surgery |
88334 |
$51.00 |
$12.75 |
| Special stained specimen slides to examine tissue |
88341 |
$87.00 |
$21.75 |
| Tissue or cell analysis by immunologic technique |
88342 |
$102.00 |
$25.50 |
| Tissue or cell analysis by immunologic technique |
88342 |
$395.00 |
$98.75 |
| Special stained specimen slides to examine tissue |
88344 |
$395.00 |
$98.75 |
| Antibody evaluation |
88346 |
$395.00 |
$98.75 |
| Antibody evaluation |
88350 |
$85.00 |
$21.25 |
| Microscopic genetic analysis of tumor |
88360 |
$359.00 |
$89.75 |
| Microscopic genetic analysis of tumor |
88360 |
$329.00 |
$82.25 |
| Microscopic genetic analysis of tumor |
88361 |
$395.00 |
$98.75 |
| Microscopic genetic analysis of tissue |
88367 |
$395.00 |
$98.75 |
| Microscopic genetic analysis of tissue |
88368 |
$395.00 |
$98.75 |
| Body fluid cell count with cell identification |
89051 |
$128.00 |
$32.00 |
| Body fluid cell count with cell identification |
89051 |
$158.00 |
$39.50 |
| White blood cell measure, stool specimen |
89055 |
$16.00 |
$4.00 |
| Crystal identification from tissue or body fluid |
89060 |
$34.00 |
$8.50 |
| Semen analysis for sperm presence |
89321 |
$84.00 |
$21.00 |
| Administration of 1 vaccine |
90471 |
$100.00 |
$25.00 |
| Administration of 1 vaccine |
90471 |
$109.00 |
$27.25 |
| Administration of vaccine |
90472 |
$100.00 |
$25.00 |
| Treatment of speech, language, voice, communication, and/or hearing processing disorder |
92507 |
$686.00 |
$171.50 |
| Examination of the nose and throat using an endoscope |
92511 |
$174.00 |
$43.50 |
| Evaluation of speech fluency |
92521 |
$282.00 |
$70.50 |
| Evaluation of speech sound production |
92522 |
$231.00 |
$57.75 |
| Evaluation of speech sound production with evaluation of language comprehension and expression |
92523 |
$475.00 |
$118.75 |
| Behavioral and qualitative analysis of voice and resonance |
92524 |
$237.00 |
$59.25 |
| Treatment of swallowing and/or oral feeding function |
92526 |
$580.00 |
$145.00 |
| Evaluation of swallowing function |
92610 |
$445.00 |
$111.25 |
| Attempt to restart heart and lungs |
92950 |
$1,199.00 |
$299.75 |
| Temporary pacemaker to regulate heart beat |
92953 |
$544.00 |
$136.00 |
| External shock to heart to regulate heart beat |
92960 |
$595.00 |
$148.75 |
| External shock to heart to regulate heart beat |
92960 |
$594.00 |
$148.50 |
| External shock to heart to regulate heart beat |
92960 |
$912.00 |
$228.00 |
| Infusion of drug into vein to dissolve coronary blood clot |
92977 |
$271.00 |
$67.75 |
| Routine electrocardiogram (EKG) with tracing using at least 12 leads |
93005 |
$210.00 |
$52.50 |
| Routine electrocardiogram (EKG) with tracing using at least 12 leads |
93005 |
$210.00 |
$52.50 |
| Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report |
93010 |
$86.00 |
$21.50 |
| Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report |
93010 |
$56.00 |
$14.00 |
| Exercise or drug-induced heart and blood vessel stress test with EKG monitoring and physician supervision |
93016 |
$192.00 |
$48.00 |
| Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring |
93017 |
$795.00 |
$198.75 |
| Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report |
93018 |
$126.00 |
$31.50 |
| Heart rhythm tracing of 48-hour EKG |
93225 |
$693.00 |
$173.25 |
| Heart rhythm analysis, interpretation and report of 48-hour EKG |
93226 |
$693.00 |
$173.25 |
| Heart rhythm tracing, analysis, and interpretation of 48-hour EKG |
93227 |
$609.00 |
$152.25 |
| Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function |
93306 |
$3,119.00 |
$779.75 |
| Ultrasound of chest to examine the heart |
93307 |
$1,525.00 |
$381.25 |
| Ultrasound of chest to examine the heart |
93307 |
$1,525.00 |
$381.25 |
| Follow-up or limited ultrasound examination of heart |
93308 |
$854.00 |
$213.50 |
| Doppler ultrasound study of heart blood flow, valves, and chambers |
93320 |
$850.00 |
$212.50 |
| Doppler ultrasound study of color-directed heart blood flow, rate, and valve function |
93325 |
$840.00 |
$210.00 |
| Insertion of catheter into right upper heart chamber and pulmonary (lung) artery for monitoring purposes |
93503 |
$7,880.00 |
$1,970.00 |
| Insertion of catheter into right upper heart chamber and pulmonary (lung) artery for monitoring purposes |
93503 |
$3,908.00 |
$977.00 |
| Measurement of heart blood flow and respiration |
93701 |
$131.00 |
$32.75 |
| Physician services for outpatient heart cardiac rehabilitation per session |
93797 |
$544.00 |
$136.00 |
| Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session |
93798 |
$544.00 |
$136.00 |
| Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session |
93798 |
$245.00 |
$61.25 |
| Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck |
93880 |
$1,282.00 |
$320.50 |
| Ultrasound study of arteries of both arms and legs |
93922 |
$965.00 |
$241.25 |
| Ultrasound study of arteries of both arms and legs |
93923 |
$1,021.00 |
$255.25 |
| Ultrasound study of arteries and arterial grafts of both legs |
93925 |
$1,348.00 |
$337.00 |
| Ultrasound study of arteries and arterial grafts of one leg or limited |
93926 |
$784.00 |
$196.00 |
| Ultrasound study of arteries and arterial grafts of both arms |
93930 |
$965.00 |
$241.25 |
| Ultrasound study of arteries and arterial grafts of one arm or limited |
93931 |
$582.00 |
$145.50 |
| Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers |
93970 |
$1,348.00 |
$337.00 |
| Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers |
93971 |
$901.00 |
$225.25 |
| Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow |
93975 |
$1,250.00 |
$312.50 |
| Ultrasound limited scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow |
93976 |
$522.00 |
$130.50 |
| Ventilation assistance and management, hospital inpatient or observation |
94002 |
$1,586.00 |
$396.50 |
| Ventilation assistance and management, hospital inpatient or observation |
94003 |
$1,109.00 |
$277.25 |
| Measurement and graphic recording of total and timed exhaled air capacity |
94010 |
$50.00 |
$12.50 |
| Measurement and graphic recording of total and timed exhaled air capacity |
94010 |
$665.00 |
$166.25 |
| Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration |
94060 |
$687.00 |
$171.75 |
| Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration |
94060 |
$307.00 |
$76.75 |
| Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration |
94060 |
$146.00 |
$36.50 |
| Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration |
94060 |
$103.00 |
$25.75 |
| Multiple measurements and graphic recordings of the amount and speed of breathed air, before and following medication administration |
94070 |
$840.00 |
$210.00 |
| Diagnostic testing in a pulmonary function lab |
94375 |
$363.00 |
$90.75 |
| Diagnostic testing in a pulmonary function lab |
94375 |
$109.00 |
$27.25 |
| Exercise test for spasm of lung airways |
94617 |
$177.00 |
$44.25 |
| Test for exercise-induced lung stress |
94618 |
$177.00 |
$44.25 |
| Test for exercise-induced heart and lung stress |
94621 |
$1,554.00 |
$388.50 |
| Test for exercise-induced heart and lung stress |
94621 |
$229.00 |
$57.25 |
| Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD |
94640 |
$198.00 |
$49.50 |
| Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD |
94640 |
$198.00 |
$49.50 |
| Respiratory inhaled aerosol treatment to relieve airway obstruction, first hour |
94644 |
$178.00 |
$44.50 |
| Respiratory inhaled aerosol treatment to relieve airway obstruction |
94645 |
$178.00 |
$44.50 |
| Initiation and management of continued pressured respiratory assistance by mask or breathing tube |
94660 |
$704.00 |
$176.00 |
| Demonstration and/or evaluation of manual maneuvers to chest wall to assist movement of lung secretions |
94667 |
$197.00 |
$49.25 |
| Manual maneuvers to chest wall to assist movement of lung secretions |
94668 |
$136.00 |
$34.00 |
| Mechanical chest wall manipulation for improvement in lung function |
94669 |
$246.00 |
$61.50 |
| Determination of lung volumes using plethysmography |
94726 |
$137.00 |
$34.25 |
| Determination of lung volumes using plethysmography |
94726 |
$264.00 |
$66.00 |
| Determination of lung volumes using gas dilution or washout |
94727 |
$450.00 |
$112.50 |
| Determination of lung volumes using gas dilution or washout |
94727 |
$131.00 |
$32.75 |
| Measurement of airway resistance by impulse oscillometry |
94728 |
$97.00 |
$24.25 |
| Measurement of airway resistance by impulse oscillometry |
94728 |
$522.00 |
$130.50 |
| Measurement of lung diffusing capacity |
94729 |
$135.00 |
$33.75 |
| Measurement of lung diffusing capacity |
94729 |
$335.00 |
$83.75 |
| Measurement of oxygen saturation in blood using ear or finger device |
94760 |
$164.00 |
$41.00 |
| Overnight measurement of oxygen saturation in blood using ear or finger device |
94762 |
$289.00 |
$72.25 |
| Measurement of exhaled carbon dioxide gas |
94770 |
$291.00 |
$72.75 |
| Pulmonary service or operation |
94799 |
$147.00 |
$36.75 |
| Sleep monitoring of patient (6 years or older) in sleep lab |
95810 |
$4,023.00 |
$1,005.75 |
| Sleep monitoring of patient (6 years or older) in sleep lab |
95810 |
$514.00 |
$128.50 |
| Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube |
95811 |
$4,640.00 |
$1,160.00 |
| Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube |
95811 |
$551.00 |
$137.75 |
| Measurement of brain wave (EEG) activity, 41-60 minutes |
95812 |
$416.00 |
$104.00 |
| Measurement of brain wave (EEG) activity greater than 1 hour |
95813 |
$1,180.00 |
$295.00 |
| Measurement and recording of brain wave (EEG) activity, awake and asleep |
95819 |
$1,175.00 |
$293.75 |
| Monitoring and localization of seizure activity over 24-hour period using 16-channel electroencephalograph (EEG) |
95951 |
$1,616.00 |
$404.00 |
| Hydration infusion into a vein 31 minutes to 1 hour |
96360 |
$633.00 |
$158.25 |
| Hydration infusion into a vein 31 minutes to 1 hour |
96360 |
$290.00 |
$72.50 |
| Hydration infusion into a vein |
96361 |
$55.00 |
$13.75 |
| Hydration infusion into a vein |
96361 |
$219.00 |
$54.75 |
| Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour |
96365 |
$290.00 |
$72.50 |
| Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour |
96365 |
$996.00 |
$249.00 |
| Infusion into a vein for therapy, prevention, or diagnosis |
96366 |
$55.00 |
$13.75 |
| Infusion into a vein for therapy, prevention, or diagnosis |
96366 |
$219.00 |
$54.75 |
| Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour |
96367 |
$90.00 |
$22.50 |
| Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour |
96367 |
$331.00 |
$82.75 |
| Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion |
96368 |
$207.00 |
$51.75 |
| Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion |
96368 |
$55.00 |
$13.75 |
| Injection beneath the skin or into muscle for therapy, diagnosis, or prevention |
96372 |
$266.00 |
$66.50 |
| Injection beneath the skin or into muscle for therapy, diagnosis, or prevention |
96372 |
$90.00 |
$22.50 |
| Injection into artery for therapy, diagnosis, or prevention |
96373 |
$290.00 |
$72.50 |
| Injection of drug or substance into a vein for therapy, diagnosis, or prevention |
96374 |
$633.00 |
$158.25 |
| Injection of drug or substance into a vein for therapy, diagnosis, or prevention |
96374 |
$290.00 |
$72.50 |
| Injection of different drug or substance into a vein for therapy, diagnosis, or prevention |
96375 |
$100.00 |
$25.00 |
| Injection of different drug or substance into a vein for therapy, diagnosis, or prevention |
96375 |
$55.00 |
$13.75 |
| Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility |
96376 |
$306.00 |
$76.50 |
| Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility |
96376 |
$55.00 |
$13.75 |
| Application of on-body injector for injection under skin |
96377 |
$114.00 |
$28.50 |
| Irrigation of implanted venous access drug delivery device |
96523 |
$151.00 |
$37.75 |
| Application of mechanical traction to 1 or more areas |
97012 |
$124.00 |
$31.00 |
| Application of hot wax bath to 1 or more areas |
97018 |
$124.00 |
$31.00 |
| Application of hot wax bath to 1 or more areas |
97018 |
$163.00 |
$40.75 |
| Application of whirlpool therapy to 1 or more areas |
97022 |
$386.00 |
$96.50 |
| Application of electrical stimulation to 1 or more areas, each 15 minutes |
97032 |
$158.00 |
$39.50 |
| Application of medication through skin using electrical current, each 15 minutes |
97033 |
$192.00 |
$48.00 |
| Application of medication through skin using electrical current, each 15 minutes |
97033 |
$201.00 |
$50.25 |
| Application of ultrasound to 1 or more areas, each 15 minutes |
97035 |
$124.00 |
$31.00 |
| Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes |
97110 |
$131.00 |
$32.75 |
| Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes |
97110 |
$131.00 |
$32.75 |
| Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes |
97112 |
$131.00 |
$32.75 |
| Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes |
97113 |
$87.00 |
$21.75 |
| Training for walking to 1 or more areas for 15 minutes |
97116 |
$131.00 |
$32.75 |
| Training for walking to 1 or more areas for 15 minutes |
97116 |
$164.00 |
$41.00 |
| Training for walking to 1 or more areas for 15 minutes |
97116 |
$131.00 |
$32.75 |
| Training for walking to 1 or more areas for 15 minutes |
97116 |
$164.00 |
$41.00 |
| Therapeutic massage to 1 or more areas, each 15 minutes |
97124 |
$163.00 |
$40.75 |
| Therapeutic massage to 1 or more areas, each 15 minutes |
97124 |
$124.00 |
$31.00 |
| Manual (physical) therapy techniques to 1 or more regions, each 15 minutes |
97140 |
$124.00 |
$31.00 |
| Therapeutic procedures in a group setting |
97150 |
$207.00 |
$51.75 |
| Physical therapy evaluation session for 20 minutes |
97161 |
$673.00 |
$168.25 |
| Physical therapy evaluation session for 20 minutes |
97161 |
$673.00 |
$168.25 |
| Evaluation of physical therapy, typically 30 minutes |
97162 |
$673.00 |
$168.25 |
| Evaluation of physical therapy, typically 45 minutes |
97163 |
$673.00 |
$168.25 |
| Re-evaluation of physical therapy, typically 20 minutes |
97164 |
$342.00 |
$85.50 |
| Evaluation of occupational therapy, typically 30 minutes |
97165 |
$673.00 |
$168.25 |
| Evaluation of occupational therapy, typically 45 minutes |
97166 |
$673.00 |
$168.25 |
| Evaluation of occupational therapy established plan of care, typically 60 minutes |
97167 |
$673.00 |
$168.25 |
| Re-evaluation of occupational therapy established plan of care, typically 30 minutes |
97168 |
$342.00 |
$85.50 |
| Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes |
97530 |
$164.00 |
$41.00 |
| Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes |
97530 |
$131.00 |
$32.75 |
| Self-care or home management training, each 15 minutes |
97535 |
$163.00 |
$40.75 |
| Self-care or home management training, each 15 minutes |
97535 |
$157.00 |
$39.25 |
| Wheelchair management, each 15 minutes |
97542 |
$163.00 |
$40.75 |
| Removal of tissue from wounds per session |
97597 |
$618.00 |
$154.50 |
| Removal of tissue from wounds per session |
97597 |
$298.00 |
$74.50 |
| Removal of tissue from wounds per session |
97598 |
$156.00 |
$39.00 |
| Removal of tissue from wounds per session |
97598 |
$182.00 |
$45.50 |
| Removal of tissue from wounds per session |
97602 |
$168.00 |
$42.00 |
| Negative pressure wound therapy, surface area less than or equal to 50 square centimeters, per session |
97605 |
$252.00 |
$63.00 |
| Negative pressure wound therapy, surface area less than or equal to 50 square centimeters, per session |
97605 |
$196.00 |
$49.00 |
| Negative pressure wound therapy, surface area greater than 50 square centimeters, per session |
97606 |
$318.00 |
$79.50 |
| Physical performance test or measurement with report, each 15 minutes |
97750 |
$107.00 |
$26.75 |
| Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk, per 15 minutes |
97760 |
$163.00 |
$40.75 |
| Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk, per 15 minutes |
97760 |
$157.00 |
$39.25 |
| Training in use of prosthesis for arms and/or legs, per 15 minutes |
97761 |
$163.00 |
$40.75 |
| Handling and/or conveyance of specimen for transfer to a laboratory |
99001 |
$27.00 |
$6.75 |
| Moderate sedation services by physician also performing a procedure, patient younger than 5 years of age, first 15 minutes |
99151 |
$409.00 |
$102.25 |
| Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes |
99152 |
$799.00 |
$199.75 |
| Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes |
99152 |
$409.00 |
$102.25 |
| Moderate sedation services by physician also performing a procedure, additional 15 minutes |
99153 |
$66.00 |
$16.50 |
| Moderate sedation services by physician also performing a procedure, additional 15 minutes |
99153 |
$129.00 |
$32.25 |
| Moderate sedation services by physician not performing a procedure, patient 5 years of age or older, first 15 minutes |
99155 |
$409.00 |
$102.25 |
| Moderate sedation services by physician not performing a procedure, patient 5 years of age or older, first 15 minutes |
99156 |
$409.00 |
$102.25 |
| Moderate sedation services by physician not performing a procedure, each additional 15 minutes |
99157 |
$409.00 |
$102.25 |
| Established patient office or other outpatient visit, typically 5 minutes |
99211 |
$236.00 |
$59.00 |
| Emergency department visit, self limited or minor problem |
99281 |
$227.00 |
$56.75 |
| Emergency department visit, low to moderately severe problem |
99282 |
$342.00 |
$85.50 |
| Emergency department visit facility fees for a visit of moderate severity |
99283 |
$483.00 |
$120.75 |
| Emergency department visit facility fees for a visit of moderate severity |
99283 |
$483.00 |
$120.75 |
| Emergency department visit facility fees for a visit of high to moderate severity |
99284 |
$695.00 |
$173.75 |
| Emergency department visit facility fees for a visit of high to moderate severity |
99284 |
$695.00 |
$173.75 |
| Emergency department visit, problem with significant threat to life or function |
99285 |
$927.00 |
$231.75 |
| Critical care delivery critically ill or injured patient, first 30-74 minutes |
99291 |
$1,336.00 |
$334.00 |
| Critical care delivery critically ill or injured patient |
99292 |
$1,336.00 |
$334.00 |
| Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes |
99406 |
$47.00 |
$11.75 |
| Smoking and tobacco use intensive counseling, greater than 10 minutes |
99407 |
$93.00 |
$23.25 |
