Top 40 services provided by BAPTIST MEMORIAL HOSPITAL BOONEVILLE
Services CPT Price Est. Cash Price
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