|
U0002
|
HCPCS
|
Sars-cov 2/2019-any Technique
|
14
|
14
|
$1,500.00
|
$1,500.00
|
$34.48
|
$74.40
|
$50.28
|
2026-07-20
|
|
P9021
|
HCPCS
|
Red Cells Packed Ea
|
1
|
1
|
$1,770.00
|
$1,770.00
|
$141.43
|
$141.43
|
$141.43
|
2026-07-20
|
|
L8679
|
HCPCS
|
Medtronic Neuro Implant 9977006
|
1
|
1
|
$36,000.00
|
$36,000.00
|
$29,801.75
|
$29,801.75
|
$29,801.75
|
2026-07-20
|
|
L4360
|
HCPCS
|
Cam Walker Boot
|
1
|
1
|
$800.00
|
$800.00
|
$311.94
|
$311.94
|
$311.94
|
2026-07-20
|
|
G0463
|
HCPCS
|
Hospital Outpatient Clinic Visit For Assessment And Management Of A Patient
|
16
|
16
|
$520.00
|
$520.00
|
$119.77
|
$525.00
|
$143.34
|
2026-07-20
|
|
G0447
|
HCPCS
|
Face-to-face Behavioral Counseling For Obesity, 15 Minutes
|
15
|
15
|
$392.00
|
$392.00
|
$90.80
|
$392.00
|
$117.60
|
2026-07-20
|
|
G0444
|
HCPCS
|
Annual Depression Screening, 15 Minutes
|
13
|
13
|
$300.00
|
$300.00
|
$26.86
|
$300.00
|
$34.19
|
2026-07-20
|
|
G0378
|
HCPCS
|
Observation Per Hour
|
9
|
9
|
$83.00
|
$83.00
|
$4.15
|
$830.00
|
$83.00
|
2026-07-20
|
|
G0101
|
HCPCS
|
Cervical Or Vaginal Cancer Screening; Pelvic
|
2
|
2
|
$393.20
|
$393.20
|
$90.80
|
$92.70
|
$91.75
|
2026-07-20
|
|
G0008
|
HCPCS
|
Medicare Admin Of Flu Virus Vacc Facility Charge
|
2
|
2
|
$85.00
|
$85.00
|
$45.29
|
$129.08
|
$87.19
|
2026-07-20
|
|
C1820
|
HCPCS
|
Stimulator Spinal Cord
|
1
|
1
|
$120,000.00
|
$120,000.00
|
$20,350.00
|
$20,350.00
|
$20,350.00
|
2026-07-20
|
|
C1781
|
HCPCS
|
Mesh Ventralight Echo 4.5 Circle
|
1
|
1
|
$6,840.00
|
$6,840.00
|
$180.04
|
$180.04
|
$180.04
|
2026-07-20
|
|
C1778
|
HCPCS
|
Kit Trial Neurostimulator Wireless Leads
|
1
|
1
|
$4,200.00
|
$4,200.00
|
$405.94
|
$405.94
|
$405.94
|
2026-07-20
|
|
C1762
|
HCPCS
|
Llium Tricortical Block 25x30x14mm
|
1
|
1
|
$5,600.00
|
$5,600.00
|
$6,300.00
|
$6,300.00
|
$6,300.00
|
2026-07-20
|
|
C1760
|
HCPCS
|
Vascade Vascular Closure System 5f Arterial And Venous Closure
|
1
|
1
|
$1,170.00
|
$1,170.00
|
$2,472.00
|
$2,472.00
|
$2,472.00
|
2026-07-20
|
|
A4301
|
HCPCS
|
Infusion Injectable Port
|
1
|
1
|
$2,590.00
|
$2,590.00
|
$129.50
|
$129.50
|
$129.50
|
2026-07-20
|
|
99406
|
CPT
|
Smoking And Tobacco Use Cessation Counseling
|
6
|
6
|
$300.00
|
$300.00
|
$25.99
|
$300.00
|
$38.26
|
2026-07-20
|
|
99285
|
CPT
|
ER Visit Level 5 High Severity & Threat Funct; Signif, Sep Identifiable Eval & M…
|
23
|
23
|
$7,100.00
|
$7,100.00
|
$355.00
|
$3,845.43
|
$2,010.00
|
2026-07-20
|
|
99284
|
CPT
|
ER Visit Level 4, Problem Of High Severity
|
26
|
26
|
$5,450.00
|
$5,450.00
|
$272.50
|
$2,577.17
|
$558.48
|
2026-07-20
|
|
99283
|
CPT
|
ER Visit Level 3 Facility Fee
|
28
|
28
|
$4,160.00
|
$4,160.00
|
$51.36
|
$4,160.00
|
$598.57
|
2026-07-20
|
|
99282
|
CPT
|
ER Visit Level 2 Facility Fee
|
15
|
15
|
$2,720.00
|
$2,720.00
|
$51.36
|
$773.00
|
$158.62
|
2026-07-20
|
|
99281
|
CPT
|
ER Visit Level 1 Limited/minor Problem Facility
|
11
|
11
|
$1,540.00
|
$1,540.00
|
$51.36
|
$325.60
|
$88.19
|
2026-07-20
|
|
97530
|
CPT
|
Pt Therapeutic Activit 15 Min
|
4
|
4
|
$152.00
|
$152.00
|
$24.72
|
$120.00
|
$33.99
|
2026-07-20
|
|
97166
|
CPT
|
Ot Occupation Therapy Eval Mod Complex 45 Mins
|
1
|
1
|
$960.00
|
$960.00
|
$147.86
|
$147.86
|
$147.86
|
2026-07-20
|
|
97163
|
CPT
|
Pt Physical Therapy Eval High Complex 45 Mins
|
6
|
6
|
$1,780.00
|
$1,780.00
|
$89.44
|
$120.00
|
$96.96
|
2026-07-20
|
|
97110
|
CPT
|
Therapeutic Exercise
|
3
|
3
|
$580.00
|
$580.00
|
$28.63
|
$120.00
|
$40.54
|
2026-07-20
|
|
96375
|
CPT
|
Therapeutic Injection IV Push Each New Drug (list Primary Code Also)
|
14
|
14
|
$140.00
|
$140.00
|
$41.59
|
$140.00
|
$46.16
|
2026-07-20
|
|
96374
|
CPT
|
Therapeutic Prophlx/dx Njx IV Push Single/1st Sbst/drug
|
16
|
16
|
$411.00
|
$411.00
|
$99.01
|
$411.00
|
$210.97
|
2026-07-20
|
|
96372
|
CPT
|
Therapeutic Prophlx/dx Injection Subq/im
|
3
|
3
|
$256.30
|
$256.30
|
$256.30
|
$256.30
|
$256.30
|
2026-07-20
|
|
96366
|
CPT
|
IV Infusion Therapy/prophlx/dx Addl Hr (list Primary Code Also)
|
3
|
3
|
$187.00
|
$187.00
|
$45.29
|
$46.21
|
$45.29
|
2026-07-20
|
|
96365
|
CPT
|
IV Inf Therapy/prp[hylaxis/dx 1st To 1 Hr
|
16
|
16
|
$446.00
|
$446.00
|
$7.40
|
$446.00
|
$209.75
|
2026-07-20
|
|
96361
|
CPT
|
IV Inf Hydration Addl Hour
|
14
|
14
|
$654.00
|
$654.00
|
$42.13
|
$67.00
|
$45.29
|
2026-07-20
|
|
96360
|
CPT
|
IV Inf Hydration 31-60 Min
|
12
|
12
|
$1,015.38
|
$1,015.38
|
$191.36
|
$1,015.38
|
$209.70
|
2026-07-20
|
|
96127
|
CPT
|
Brief Emotional/behavioral Assessment
|
5
|
5
|
$300.00
|
$300.00
|
$42.24
|
$165.00
|
$90.00
|
2026-07-20
|
|
95913
|
CPT
|
Nerve Conduction Studies; 13 Or More Studies
|
15
|
15
|
$7,350.00
|
$7,350.00
|
$288.00
|
$7,350.00
|
$495.30
|
2026-07-20
|
|
95887
|
CPT
|
Needle Electromyography, Non-extremity
|
3
|
3
|
$4,000.00
|
$4,000.00
|
$371.50
|
$4,000.00
|
$743.00
|
2026-07-20
|
|
95886
|
CPT
|
Musc Test Done W/n Test Comp
|
3
|
3
|
$4,000.00
|
$4,000.00
|
$74.25
|
$144.00
|
$144.00
|
2026-07-20
|
|
95819
|
CPT
|
Electroencephalogram (eeg); Including Recording
|
5
|
5
|
$4,000.00
|
$4,000.00
|
$207.30
|
$4,000.00
|
$311.90
|
2026-07-20
|
|
95816
|
CPT
|
Electroencephalogram (eeg); Including Recording
|
12
|
12
|
$4,000.00
|
$4,000.00
|
$197.84
|
$600.00
|
$311.90
|
2026-07-20
|
|
94760
|
CPT
|
Rt Pulse Ox Single Spot Ck
|
8
|
8
|
$80.00
|
$80.00
|
$2.18
|
$80.00
|
$43.66
|
2026-07-20
|
|
94060
|
CPT
|
Pft Pre & Post Bronchodilator
|
5
|
5
|
$3,491.20
|
$3,491.20
|
$306.91
|
$452.26
|
$311.90
|
2026-07-20
|
|
94010
|
CPT
|
Spirometry, Including Graphic Record, Total
|
1
|
1
|
$367.00
|
$367.00
|
$205.20
|
$205.20
|
$205.20
|
2026-07-20
|
|
93971
|
CPT
|
US Ven Dop Uni Ext
|
11
|
11
|
$1,730.00
|
$1,730.00
|
$95.81
|
$365.00
|
$104.78
|
2026-07-20
|
|
93970
|
CPT
|
US Ven Dop Bil Ext
|
12
|
12
|
$2,909.00
|
$2,909.00
|
$217.74
|
$351.06
|
$237.27
|
2026-07-20
|
|
93926
|
CPT
|
US Art Dop Uni Le
|
3
|
3
|
$1,576.49
|
$1,576.49
|
$95.81
|
$104.81
|
$102.48
|
2026-07-20
|
|
93925
|
CPT
|
US Art Dop Bil Le
|
11
|
11
|
$2,499.00
|
$2,499.00
|
$220.70
|
$351.06
|
$237.27
|
2026-07-20
|
|
93923
|
CPT
|
Complete Bilateral Noninvasive Physiologic Studies
|
8
|
8
|
$1,499.00
|
$1,499.00
|
$153.58
|
$1,499.00
|
$191.97
|
2026-07-20
|
|
93880
|
CPT
|
US Carotid Dop Bil
|
10
|
10
|
$2,607.99
|
$2,607.99
|
$189.82
|
$365.00
|
$237.87
|
2026-07-20
|
|
93306
|
CPT
|
US Echo Transthor Real-time 2d W Or Wo M-mode; Compl Spec&colr D
|
11
|
11
|
$1,764.08
|
$1,764.08
|
$148.02
|
$769.00
|
$536.29
|
2026-07-20
|
|
93017
|
CPT
|
Cardiovascular Stress Test Using Maximal
|
12
|
12
|
$2,534.00
|
$2,534.00
|
$45.08
|
$471.00
|
$308.66
|
2026-07-20
|
|
93005
|
CPT
|
Rt EKG 12 Lead Tracking Only
|
18
|
18
|
$720.00
|
$720.00
|
$7.56
|
$720.00
|
$68.70
|
2026-07-20
|
|
93000
|
CPT
|
Electrocardiogram, Routine ECG With At Least 12 Le
|
4
|
4
|
$850.00
|
$850.00
|
$92.65
|
$850.00
|
$471.33
|
2026-07-20
|
|
92950
|
CPT
|
Rt Resuscitation/cpr 1st Event
|
1
|
1
|
$3,351.00
|
$3,351.00
|
$305.66
|
$305.66
|
$305.66
|
2026-07-20
|
|
92507
|
CPT
|
Treatment Of Speech Language, Voice, Communication And/or Auditory Processing
|
1
|
1
|
$950.00
|
$950.00
|
$110.39
|
$110.39
|
$110.39
|
2026-07-20
|
|
90746
|
CPT
|
Hepatitis B Vaccine (hepb), Adult Dosage, 3 Dose
|
1
|
1
|
$266.16
|
$266.16
|
$29.01
|
$29.01
|
$29.01
|
2026-07-20
|
|
90471
|
CPT
|
Vaccine Admin
|
4
|
4
|
$128.15
|
$128.15
|
$29.00
|
$192.50
|
$81.96
|
2026-07-20
|
|
87491
|
CPT
|
Nucleic Acid Chlamydia Trach
|
1
|
1
|
$309.00
|
$309.00
|
$31.58
|
$31.58
|
$31.58
|
2026-07-20
|
|
87340
|
CPT
|
Hbsag (hepatitis B Surface Ag)
|
2
|
2
|
$352.00
|
$352.00
|
$6.94
|
$352.00
|
$179.47
|
2026-07-20
|
|
86923
|
CPT
|
Compatibility Electronic
|
5
|
5
|
$550.00
|
$550.00
|
$85.82
|
$550.00
|
$157.25
|
2026-07-20
|
|
86922
|
CPT
|
Compatibility Antiglobulin
|
1
|
1
|
$572.00
|
$572.00
|
$28.60
|
$28.60
|
$28.60
|
2026-07-20
|
|
86902
|
CPT
|
Rbc Ag Typing Ea (unit)
|
2
|
2
|
$135.00
|
$135.00
|
$5.08
|
$135.00
|
$70.04
|
2026-07-20
|
|
86900
|
CPT
|
Abo/rh Typing
|
6
|
6
|
$143.00
|
$143.00
|
$2.01
|
$143.00
|
$126.78
|
2026-07-20
|
|
86870
|
CPT
|
Antibody Identification
|
1
|
1
|
$639.00
|
$639.00
|
$322.49
|
$322.49
|
$322.49
|
2026-07-20
|
|
86328
|
CPT
|
Sars-cov2/covid19; Immunoassay For Infectious Agent Antibody, Qual Or Semiquan; …
|
3
|
3
|
$1,500.00
|
$1,500.00
|
$30.43
|
$45.28
|
$44.37
|
2026-07-20
|
|
85730
|
CPT
|
Ptt Partial Thromboplastin
|
6
|
6
|
$452.00
|
$452.00
|
$4.81
|
$452.00
|
$127.25
|
2026-07-20
|
|
85610
|
CPT
|
Prothrombin Time (pt)
|
10
|
10
|
$233.00
|
$233.00
|
$2.88
|
$233.00
|
$118.65
|
2026-07-20
|
|
85379
|
CPT
|
D-dimer Quant
|
2
|
2
|
$474.00
|
$474.00
|
$6.84
|
$474.00
|
$240.42
|
2026-07-20
|
|
84484
|
CPT
|
Troponin I
|
3
|
3
|
$563.00
|
$563.00
|
$8.38
|
$563.00
|
$563.00
|
2026-07-20
|
|
84403
|
CPT
|
Testosterone Total
|
1
|
1
|
$802.00
|
$802.00
|
$23.23
|
$23.23
|
$23.23
|
2026-07-20
|
|
84402
|
CPT
|
Testosterone; Free
|
1
|
1
|
$188.70
|
$188.70
|
$22.92
|
$22.92
|
$22.92
|
2026-07-20
|
|
83880
|
CPT
|
Bnp (b-type Peptide)
|
2
|
2
|
$661.00
|
$661.00
|
$26.38
|
$661.00
|
$343.69
|
2026-07-20
|
|
83874
|
CPT
|
Myoglobin
|
3
|
3
|
$442.00
|
$442.00
|
$8.68
|
$442.00
|
$442.00
|
2026-07-20
|
|
83695
|
CPT
|
Lipoprotein
|
1
|
1
|
$95.88
|
$95.88
|
$95.88
|
$95.88
|
$95.88
|
2026-07-20
|
|
83690
|
CPT
|
Lipase
|
2
|
2
|
$487.00
|
$487.00
|
$4.63
|
$63.18
|
$33.91
|
2026-07-20
|
|
82670
|
CPT
|
Estradiol
|
1
|
1
|
$206.94
|
$206.94
|
$25.15
|
$25.15
|
$25.15
|
2026-07-20
|
|
82553
|
CPT
|
Ck-mb
|
3
|
3
|
$465.00
|
$465.00
|
$7.76
|
$465.00
|
$465.00
|
2026-07-20
|
|
82306
|
CPT
|
Vitamin D 25-hydroxy
|
1
|
1
|
$489.00
|
$489.00
|
$26.64
|
$26.64
|
$26.64
|
2026-07-20
|
|
82150
|
CPT
|
Amylase
|
2
|
2
|
$495.00
|
$495.00
|
$4.35
|
$64.21
|
$34.28
|
2026-07-20
|
|
80307
|
CPT
|
Drug Screen, Any Number Of Drug Classes From Drug
|
1
|
1
|
$100.00
|
$100.00
|
$41.76
|
$41.76
|
$41.76
|
2026-07-20
|
|
80053
|
CPT
|
Cmp
|
11
|
11
|
$985.00
|
$985.00
|
$7.10
|
$985.00
|
$127.78
|
2026-07-20
|
|
80047
|
CPT
|
Bmp With Calcium Ionized**chem 8
|
5
|
5
|
$278.00
|
$278.00
|
$9.22
|
$278.00
|
$278.00
|
2026-07-20
|
|
77080
|
CPT
|
Dual-energy X-ray Absorptiometry (dxa), Bone Density
|
14
|
14
|
$1,120.00
|
$1,120.00
|
$23.46
|
$171.01
|
$104.91
|
2026-07-20
|
|
77075
|
CPT
|
Radiologic Examination, Osseous Survey; Complete
|
2
|
2
|
$561.00
|
$561.00
|
$94.06
|
$105.44
|
$99.75
|
2026-07-20
|
|
77067
|
CPT
|
Digital Screening Mammogram With Cad
|
23
|
23
|
$616.26
|
$616.26
|
$72.00
|
$150.19
|
$90.00
|
2026-07-20
|
|
77066
|
CPT
|
Digital Diagnostic Mammogram With Cad, Bilateral
|
10
|
10
|
$1,242.00
|
$1,242.00
|
$87.16
|
$181.09
|
$106.87
|
2026-07-20
|
|
77065
|
CPT
|
Digital Diagnostic Mammogram With Cad, Unilateral
|
9
|
9
|
$972.40
|
$972.40
|
$68.47
|
$142.05
|
$84.08
|
2026-07-20
|
|
77063
|
CPT
|
Screening Digital Breast Tomosynthesis
|
23
|
23
|
$258.70
|
$258.70
|
$18.69
|
$39.04
|
$23.36
|
2026-07-20
|
|
77062
|
CPT
|
Digital Breast Tomosynthesis; Bilateral
|
2
|
2
|
$150.00
|
$150.00
|
$16.35
|
$82.50
|
$49.43
|
2026-07-20
|
|
77061
|
CPT
|
Digital Breast Tomosynthesis; Unilateral
|
5
|
5
|
$150.00
|
$150.00
|
$9.15
|
$142.05
|
$82.50
|
2026-07-20
|
|
77002
|
CPT
|
Fl Fluoroscopic Guidance Needle Placement
|
1
|
1
|
$1,870.00
|
$1,870.00
|
$84.72
|
$84.72
|
$84.72
|
2026-07-20
|
|
76942
|
CPT
|
US Guidance For Needle Placement
|
4
|
4
|
$1,200.00
|
$1,200.00
|
$34.03
|
$1,200.00
|
$1,200.00
|
2026-07-20
|
|
76937
|
CPT
|
US Guidance Vascular Access
|
3
|
3
|
$2,451.00
|
$2,451.00
|
$29.35
|
$2,451.00
|
$122.55
|
2026-07-20
|
|
76882
|
CPT
|
US Extremity Non-vasc Real-time Img Lmtd
|
2
|
2
|
$1,566.00
|
$1,566.00
|
$104.51
|
$106.51
|
$105.51
|
2026-07-20
|
|
76881
|
CPT
|
US Axilla, Unilateral, Complete
|
1
|
1
|
$724.70
|
$724.70
|
$106.51
|
$106.51
|
$106.51
|
2026-07-20
|
|
76872
|
CPT
|
US Transrectal
|
4
|
4
|
$1,778.00
|
$1,778.00
|
$95.86
|
$106.51
|
$102.68
|
2026-07-20
|
|
76870
|
CPT
|
US Scrotum And Contents
|
3
|
3
|
$1,405.00
|
$1,405.00
|
$54.46
|
$139.47
|
$106.51
|
2026-07-20
|
|
76857
|
CPT
|
Ultrasound, Pelvic (nonobstetric), Real Time
|
5
|
5
|
$1,120.00
|
$1,120.00
|
$31.31
|
$106.51
|
$106.51
|
2026-07-20
|
|
76856
|
CPT
|
US Pelvic Nonobstetric Real-time Image Complete
|
12
|
12
|
$1,599.00
|
$1,599.00
|
$57.94
|
$171.01
|
$102.50
|
2026-07-20
|
|
76830
|
CPT
|
US Transvaginal
|
7
|
7
|
$1,192.00
|
$1,192.00
|
$66.39
|
$139.47
|
$102.42
|
2026-07-20
|
|
76817
|
CPT
|
US Pregnant Uterus Real Time W/image Dcmtn Transvag
|
2
|
2
|
$987.00
|
$987.00
|
$74.31
|
$106.51
|
$90.41
|
2026-07-20
|
|
76815
|
CPT
|
US Pregnant Uterus Limited 1/> Fetuses
|
1
|
1
|
$713.00
|
$713.00
|
$64.96
|
$64.96
|
$64.96
|
2026-07-20
|
|
76805
|
CPT
|
US Pregnant Uterus After 1st Trimest 1/1st Gestation
|
1
|
1
|
$2,046.00
|
$2,046.00
|
$83.80
|
$83.80
|
$83.80
|
2026-07-20
|
|
76801
|
CPT
|
US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat
|
1
|
1
|
$1,212.00
|
$1,212.00
|
$106.51
|
$106.51
|
$106.51
|
2026-07-20
|
|
76775
|
CPT
|
US Retroperitoneal Real Time W/image Limited
|
7
|
7
|
$1,764.00
|
$1,764.00
|
$26.06
|
$171.01
|
$105.44
|
2026-07-20
|
|
76770
|
CPT
|
US Retroperitoneal Real Time W/image Complete
|
10
|
10
|
$1,754.00
|
$1,754.00
|
$57.42
|
$106.51
|
$102.92
|
2026-07-20
|
|
76706
|
CPT
|
US Abdominal Aorta Real Time Screen Study Aaa
|
5
|
5
|
$565.00
|
$565.00
|
$104.38
|
$136.64
|
$104.81
|
2026-07-20
|
|
76705
|
CPT
|
US Abdominal Real Time W/image Limited
|
16
|
16
|
$1,406.00
|
$1,406.00
|
$46.80
|
$171.01
|
$104.59
|
2026-07-20
|
|
76700
|
CPT
|
US Abdominal Real Time W/image Complete
|
14
|
14
|
$1,895.00
|
$1,895.00
|
$83.80
|
$304.66
|
$105.55
|
2026-07-20
|
|
76642
|
CPT
|
US Breast, Unilateral, Limited
|
11
|
11
|
$560.80
|
$560.80
|
$43.32
|
$139.01
|
$86.43
|
2026-07-20
|
|
76641
|
CPT
|
US Breast, Unilateral, Complete
|
4
|
4
|
$735.60
|
$735.60
|
$52.54
|
$171.01
|
$78.82
|
2026-07-20
|
|
76604
|
CPT
|
Ultrasound, Chest (includes Mediastinum), Real Tim
|
1
|
1
|
$1,384.00
|
$1,384.00
|
$102.48
|
$102.48
|
$102.48
|
2026-07-20
|
|
76536
|
CPT
|
US Soft Tissue Head & Neck Real Time Imge Docm
|
11
|
11
|
$1,384.00
|
$1,384.00
|
$65.38
|
$1,384.00
|
$106.51
|
2026-07-20
|
|
76000
|
CPT
|
Fl (separate Pdx), Up To 1 Hour Physician/professional Time
|
8
|
8
|
$2,278.40
|
$2,278.40
|
$221.76
|
$242.11
|
$237.27
|
2026-07-20
|
|
75822
|
CPT
|
Venography, Extremity, Bilateral, Radiological Sup
|
1
|
1
|
$2,500.00
|
$2,500.00
|
$50.46
|
$50.46
|
$50.46
|
2026-07-20
|
|
75635
|
CPT
|
CT Abdomen Aorta Angiography & Bilat Iliofemoral W Dye
|
1
|
1
|
$7,187.00
|
$7,187.00
|
$163.31
|
$163.31
|
$163.31
|
2026-07-20
|
|
75574
|
CPT
|
Computed Tomographic Angiography, Heart, Coronary Arteries And Bypass Grafts
|
6
|
6
|
$4,800.00
|
$4,800.00
|
$288.54
|
$625.00
|
$398.97
|
2026-07-20
|
|
74230
|
CPT
|
Xr Barium Swallow W Cine/video
|
1
|
1
|
$1,227.00
|
$1,227.00
|
$171.91
|
$171.91
|
$171.91
|
2026-07-20
|
|
74221
|
CPT
|
Radiologic Exam Esophagus Double Contrast Study (barium)
|
1
|
1
|
$1,283.00
|
$1,283.00
|
$87.94
|
$87.94
|
$87.94
|
2026-07-20
|
|
74183
|
CPT
|
MRI Abdomen W&w/out Contrast
|
4
|
4
|
$4,400.00
|
$4,400.00
|
$321.94
|
$900.00
|
$405.17
|
2026-07-20
|
|
74181
|
CPT
|
MRI Abdomen Without Contrast Material
|
1
|
1
|
$5,000.00
|
$5,000.00
|
$242.11
|
$242.11
|
$242.11
|
2026-07-20
|
|
74178
|
CPT
|
CT Abdomen & Pelvis Wo & W Contrst 1/> Body Regions
|
11
|
11
|
$9,374.00
|
$9,374.00
|
$195.06
|
$625.00
|
$357.71
|
2026-07-20
|
|
74177
|
CPT
|
CT Abdomen & Pelvis; W Dye
|
18
|
18
|
$11,642.00
|
$11,642.00
|
$249.66
|
$11,642.00
|
$357.71
|
2026-07-20
|
|
74176
|
CPT
|
CT Abdomen & Pelvis; Without Contrast
|
17
|
17
|
$10,701.00
|
$10,701.00
|
$150.49
|
$625.00
|
$242.11
|
2026-07-20
|
|
74175
|
CPT
|
CT Angiography, Abdomen Aorta & Bilat Iliofem Lext; With contrast/NONDYE
|
2
|
2
|
$5,643.00
|
$5,643.00
|
$178.31
|
$625.00
|
$401.65
|
2026-07-20
|
|
74022
|
CPT
|
Xr Abdomen; Comp Acute Series; Supine, Erect &/or Decubi Views, W 1 Chest Vw
|
2
|
2
|
$741.00
|
$741.00
|
$40.10
|
$103.02
|
$71.56
|
2026-07-20
|
|
74019
|
CPT
|
Xr, Abdomen; 2 Views
|
2
|
2
|
$1,187.40
|
$1,187.40
|
$105.02
|
$171.01
|
$138.01
|
2026-07-20
|
|
74018
|
CPT
|
Xr, Abdomen; 1 View
|
5
|
5
|
$621.10
|
$621.10
|
$24.32
|
$115.87
|
$86.78
|
2026-07-20
|
|
73722
|
CPT
|
MRI Joint, Any Lower Extrem; W Dye
|
1
|
1
|
$3,227.00
|
$3,227.00
|
$900.00
|
$900.00
|
$900.00
|
2026-07-20
|
|
73721
|
CPT
|
MRI Joint, Any Lower Extrem; Wo Dye
|
11
|
11
|
$6,923.00
|
$6,923.00
|
$111.40
|
$900.00
|
$311.86
|
2026-07-20
|
|
73718
|
CPT
|
MRI Extremity, Lower, No Joint; Wo Dye
|
5
|
5
|
$6,705.00
|
$6,705.00
|
$184.17
|
$373.63
|
$233.87
|
2026-07-20
|
|
73706
|
CPT
|
CT Angiography, Extremity, Lower; With contrast/NONDYE
|
2
|
2
|
$3,685.00
|
$3,685.00
|
$207.16
|
$213.55
|
$210.36
|
2026-07-20
|
|
73702
|
CPT
|
CT Extremity, Lower; W & Wo Dye
|
1
|
1
|
$6,932.00
|
$6,932.00
|
$166.21
|
$166.21
|
$166.21
|
2026-07-20
|
|
73701
|
CPT
|
CT Extremity, Lower; W Dye
|
3
|
3
|
$4,564.00
|
$4,564.00
|
$160.05
|
$431.60
|
$178.31
|
2026-07-20
|
|
73700
|
CPT
|
CT Extremity, Lower; Wo Dye
|
9
|
9
|
$3,975.00
|
$3,975.00
|
$66.70
|
$625.00
|
$106.51
|
2026-07-20
|
|
73660
|
CPT
|
Xr Toe(s); 2+ Vws
|
1
|
1
|
$505.93
|
$505.93
|
$88.19
|
$88.19
|
$88.19
|
2026-07-20
|
|
73650
|
CPT
|
Xr Calcaneus; 2+ Vws
|
1
|
1
|
$536.00
|
$536.00
|
$43.50
|
$43.50
|
$43.50
|
2026-07-20
|
|
73630
|
CPT
|
Xr Foot, Complete; 3+ Vws
|
14
|
14
|
$758.00
|
$758.00
|
$27.53
|
$758.00
|
$86.70
|
2026-07-20
|
|
73610
|
CPT
|
Xr Ankle, Complete, 3+ Vws
|
11
|
11
|
$765.00
|
$765.00
|
$29.40
|
$127.88
|
$83.93
|
2026-07-20
|
|
73590
|
CPT
|
Xr Tibia & Fibula; 2 Vws
|
6
|
6
|
$784.00
|
$784.00
|
$18.94
|
$139.01
|
$86.95
|
2026-07-20
|
|
73565
|
CPT
|
Xr Knee; Bilat, Standing, Anteropost
|
1
|
1
|
$706.75
|
$706.75
|
$88.19
|
$88.19
|
$88.19
|
2026-07-20
|
|
73564
|
CPT
|
Xr Knee, Complete, 4+ Vws
|
3
|
3
|
$758.05
|
$758.05
|
$104.58
|
$106.51
|
$106.51
|
2026-07-20
|
|
73562
|
CPT
|
Xr Knee; 3 Vws
|
15
|
15
|
$615.20
|
$615.20
|
$32.31
|
$615.20
|
$88.19
|
2026-07-20
|
|
73560
|
CPT
|
Xr Knee; 1-2 Vws
|
4
|
4
|
$564.00
|
$564.00
|
$20.35
|
$564.00
|
$65.22
|
2026-07-20
|
|
73552
|
CPT
|
Xr Femur; Minimum 2 Views
|
3
|
3
|
$906.00
|
$906.00
|
$83.78
|
$88.19
|
$83.94
|
2026-07-20
|
|
73523
|
CPT
|
Xr Hips, Bilateral, W Pelvis; Min 5 Views
|
1
|
1
|
$906.00
|
$906.00
|
$106.51
|
$106.51
|
$106.51
|
2026-07-20
|
|
73522
|
CPT
|
Xr Hips, Bilatateral, W Pelvis When Performed; 3-4 Views
|
5
|
5
|
$906.00
|
$906.00
|
$45.29
|
$171.01
|
$106.51
|
2026-07-20
|
|
73502
|
CPT
|
Xr Hip, Unilateral, W Pelvis When Performed; 2-3 Views
|
12
|
12
|
$482.00
|
$482.00
|
$30.35
|
$139.01
|
$86.86
|
2026-07-20
|
|
73221
|
CPT
|
MRI Joint, Any Upper Extremity; Wo Dye
|
9
|
9
|
$7,911.00
|
$7,911.00
|
$111.66
|
$900.00
|
$242.11
|
2026-07-20
|
|
73218
|
CPT
|
MRI Extremity, Upper, No Joint; Wo Dye
|
1
|
1
|
$3,317.00
|
$3,317.00
|
$373.63
|
$373.63
|
$373.63
|
2026-07-20
|
|
73202
|
CPT
|
CT Extremity, Upper; Wo & W Dye
|
1
|
1
|
$4,045.00
|
$4,045.00
|
$178.31
|
$178.31
|
$178.31
|
2026-07-20
|
|
73201
|
CPT
|
CT Extremity, Upper; W Dye
|
1
|
1
|
$4,696.00
|
$4,696.00
|
$341.94
|
$341.94
|
$341.94
|
2026-07-20
|
|
73200
|
CPT
|
CT Extremity, Upper; Wo Dye
|
3
|
3
|
$4,457.00
|
$4,457.00
|
$106.51
|
$112.61
|
$106.51
|
2026-07-20
|
|
73140
|
CPT
|
Xr Finger(s) 2+ Views
|
7
|
7
|
$485.00
|
$485.00
|
$30.74
|
$139.01
|
$88.19
|
2026-07-20
|
|
73130
|
CPT
|
Xr Hand, 3+ Vws
|
6
|
6
|
$653.00
|
$653.00
|
$29.94
|
$139.01
|
$86.78
|
2026-07-20
|
|
73110
|
CPT
|
Xr Wrist, Complete, 3+ Vws
|
8
|
8
|
$673.00
|
$673.00
|
$19.35
|
$115.48
|
$84.06
|
2026-07-20
|
|
73090
|
CPT
|
Xr Forearm, 2 Views
|
2
|
2
|
$571.00
|
$571.00
|
$23.52
|
$139.01
|
$81.27
|
2026-07-20
|
|
73080
|
CPT
|
Xr Elbow Complete Minimum 3 Views
|
6
|
6
|
$709.00
|
$709.00
|
$26.46
|
$139.01
|
$113.60
|
2026-07-20
|
|
73060
|
CPT
|
Xr Humerus, 2+ Vws
|
3
|
3
|
$595.00
|
$595.00
|
$25.66
|
$139.01
|
$85.29
|
2026-07-20
|
|
73030
|
CPT
|
Xr Shoulder, Complete, 2+ Vws
|
15
|
15
|
$801.00
|
$801.00
|
$28.07
|
$139.01
|
$86.93
|
2026-07-20
|
|
73000
|
CPT
|
Xr Clavicle Complete
|
2
|
2
|
$600.00
|
$600.00
|
$85.29
|
$330.00
|
$207.64
|
2026-07-20
|
|
72220
|
CPT
|
Xr Sacrum/coccyx 2+ Views
|
1
|
1
|
$678.00
|
$678.00
|
$88.19
|
$88.19
|
$88.19
|
2026-07-20
|
|
72202
|
CPT
|
Xr Si Joints, 3+ Vws
|
1
|
1
|
$911.00
|
$911.00
|
$22.42
|
$22.42
|
$22.42
|
2026-07-20
|
|
72197
|
CPT
|
MRI Pelvis; Wo & W Dye
|
5
|
5
|
$4,497.00
|
$4,497.00
|
$185.38
|
$357.71
|
$335.10
|
2026-07-20
|
|
72195
|
CPT
|
MRI Pelvis; Wo Dye
|
1
|
1
|
$4,898.00
|
$4,898.00
|
$900.00
|
$900.00
|
$900.00
|
2026-07-20
|
|
72192
|
CPT
|
CT Pelvis; Wo Dye
|
2
|
2
|
$4,589.00
|
$4,589.00
|
$106.51
|
$220.41
|
$163.46
|
2026-07-20
|
|
72170
|
CPT
|
Xr Pelvis 1-2 Views
|
2
|
2
|
$638.00
|
$638.00
|
$102.48
|
$171.01
|
$136.75
|
2026-07-20
|
|
72158
|
CPT
|
MRI Spinal Canal, Lumbar Wo & W Dye
|
5
|
5
|
$9,930.00
|
$9,930.00
|
$263.30
|
$777.61
|
$336.47
|
2026-07-20
|
|
72157
|
CPT
|
MRI Spinal Canal, Thoracic Wo & W Dye
|
2
|
2
|
$9,811.00
|
$9,811.00
|
$264.36
|
$818.53
|
$541.44
|
2026-07-20
|
|
72156
|
CPT
|
MRI Spinal Canal, Cervical; Wo & W Dye
|
3
|
3
|
$10,204.00
|
$10,204.00
|
$263.83
|
$814.79
|
$357.71
|
2026-07-20
|
|
72148
|
CPT
|
MRI Spinal Canal, Lumbar; Wo Dye
|
17
|
17
|
$6,158.00
|
$6,158.00
|
$97.02
|
$900.00
|
$317.03
|
2026-07-20
|
|
72146
|
CPT
|
MRI Spinal Canal, Thoacic Wo Dye
|
2
|
2
|
$5,286.00
|
$5,286.00
|
$311.86
|
$373.63
|
$342.75
|
2026-07-20
|
|
72141
|
CPT
|
MRI Spinal Canal, Cervical; Wo Dye
|
6
|
6
|
$6,334.00
|
$6,334.00
|
$97.58
|
$900.00
|
$307.87
|
2026-07-20
|
|
72131
|
CPT
|
CT Spine, Lumbar; Wo Dye
|
13
|
13
|
$5,758.00
|
$5,758.00
|
$83.80
|
$625.00
|
$104.38
|
2026-07-20
|
|
72128
|
CPT
|
CT Spine, Thoracic; Wo Dye
|
7
|
7
|
$6,920.00
|
$6,920.00
|
$83.80
|
$326.12
|
$220.41
|
2026-07-20
|
|
72125
|
CPT
|
CT Spine, Cervical; Wo Dye
|
14
|
14
|
$6,817.00
|
$6,817.00
|
$83.80
|
$6,817.00
|
$136.64
|
2026-07-20
|
|
72110
|
CPT
|
Xr Spine, Lumbosacral, 4+ Vws
|
5
|
5
|
$1,155.53
|
$1,155.53
|
$41.70
|
$171.01
|
$106.51
|
2026-07-20
|
|
72100
|
CPT
|
Xr Spine, Lumbosacral 2-3 Views
|
12
|
12
|
$1,156.00
|
$1,156.00
|
$23.72
|
$171.01
|
$105.16
|
2026-07-20
|
|
72082
|
CPT
|
Xr Scoliosis Spine, Entire W Skull, 2-3 Vws
|
2
|
2
|
$980.00
|
$980.00
|
$45.21
|
$104.88
|
$75.05
|
2026-07-20
|
|
72081
|
CPT
|
Xr Spine, Entire W Skull, 1 Vw
|
1
|
1
|
$678.00
|
$678.00
|
$86.93
|
$86.93
|
$86.93
|
2026-07-20
|
|
72074
|
CPT
|
Xr Spine, Thoracic 4+ Vws
|
1
|
1
|
$942.00
|
$942.00
|
$102.48
|
$102.48
|
$102.48
|
2026-07-20
|
|
72072
|
CPT
|
Xr Spine, Thoracic 3 Vws
|
4
|
4
|
$942.00
|
$942.00
|
$101.46
|
$139.47
|
$105.69
|
2026-07-20
|
|
72070
|
CPT
|
Xr Spine, Thoracix 2 Vws
|
7
|
7
|
$900.18
|
$900.18
|
$26.46
|
$171.01
|
$104.88
|
2026-07-20
|
|
72050
|
CPT
|
Xr Spine, Cervical Neck 4-5 Vws
|
4
|
4
|
$1,021.91
|
$1,021.91
|
$43.04
|
$106.51
|
$76.43
|
2026-07-20
|
|
72040
|
CPT
|
Xr Spine, Cervical Neck 2-3 Vws
|
11
|
11
|
$701.13
|
$701.13
|
$31.81
|
$139.01
|
$87.31
|
2026-07-20
|
|
71552
|
CPT
|
MRI Chest Without & With Contrast
|
1
|
1
|
$7,164.00
|
$7,164.00
|
$357.71
|
$357.71
|
$357.71
|
2026-07-20
|
|
71550
|
CPT
|
MRI Chest Without Contrast
|
1
|
1
|
$4,462.00
|
$4,462.00
|
$242.11
|
$242.11
|
$242.11
|
2026-07-20
|
|
71275
|
CPT
|
CT Angiography, Chest; With contrast/NONDYE
|
8
|
8
|
$4,580.69
|
$4,580.69
|
$174.74
|
$421.06
|
$205.89
|
2026-07-20
|
|
71271
|
CPT
|
Low Dose CT Scan (ldct) For Lung Cancer Screening
|
8
|
8
|
$6,817.00
|
$6,817.00
|
$69.51
|
$6,817.00
|
$104.91
|
2026-07-20
|
|
71270
|
CPT
|
CT Thorax Wo & W Dye
|
3
|
3
|
$5,305.00
|
$5,305.00
|
$160.70
|
$178.31
|
$175.33
|
2026-07-20
|
|
71260
|
CPT
|
CT Thorax W Dye
|
8
|
8
|
$7,164.00
|
$7,164.00
|
$137.39
|
$625.00
|
$177.22
|
2026-07-20
|
|
71250
|
CPT
|
CT Thorax Wo Dye
|
14
|
14
|
$5,260.00
|
$5,260.00
|
$66.17
|
$5,260.00
|
$106.15
|
2026-07-20
|
|
71120
|
CPT
|
Xr Sternum 2+ Views
|
1
|
1
|
$683.00
|
$683.00
|
$139.01
|
$139.01
|
$139.01
|
2026-07-20
|
|
71111
|
CPT
|
Xr Ribs, Bilat W Posteroant Chest, 4+ Vws
|
2
|
2
|
$788.00
|
$788.00
|
$106.51
|
$171.01
|
$138.76
|
2026-07-20
|
|
71101
|
CPT
|
Xr Ribs, Unilat W Posteroant Chest, 3+ Vws
|
3
|
3
|
$777.00
|
$777.00
|
$33.95
|
$162.10
|
$106.51
|
2026-07-20
|
|
71100
|
CPT
|
Xr Ribs, Unilat, 2 Vws
|
4
|
4
|
$638.00
|
$638.00
|
$29.40
|
$88.19
|
$86.78
|
2026-07-20
|
|
71046
|
CPT
|
Xr Chest, 2 Views
|
21
|
21
|
$621.10
|
$621.10
|
$18.41
|
$139.01
|
$88.19
|
2026-07-20
|
|
71045
|
CPT
|
Xr Chest, Single View
|
20
|
20
|
$621.10
|
$621.10
|
$20.58
|
$621.10
|
$87.59
|
2026-07-20
|
|
70553
|
CPT
|
MRI Brain Brain Stem Wo & W Dye
|
13
|
11
|
$5,141.00
|
$5,141.00
|
$262.49
|
$842.51
|
$357.71
|
2026-07-20
|
|
70552
|
CPT
|
MRI Brain Brain Stem W Dye
|
1
|
1
|
$4,648.00
|
$4,648.00
|
$357.71
|
$357.71
|
$357.71
|
2026-07-20
|
|
70551
|
CPT
|
MRI Brain Brain Stem Wo Dye
|
20
|
20
|
$4,800.00
|
$4,800.00
|
$101.43
|
$900.00
|
$242.11
|
2026-07-20
|
|
70547
|
CPT
|
MRA Neck Wo Dye
|
2
|
2
|
$1,474.00
|
$1,474.00
|
$485.59
|
$532.49
|
$509.04
|
2026-07-20
|
|
70546
|
CPT
|
MRA Head Wo & W Dye
|
1
|
1
|
$8,920.00
|
$8,920.00
|
$348.74
|
$348.74
|
$348.74
|
2026-07-20
|
|
70544
|
CPT
|
MRA Head Without Contrst Material
|
2
|
2
|
$6,159.00
|
$6,159.00
|
$528.85
|
$531.73
|
$530.29
|
2026-07-20
|
|
70543
|
CPT
|
MRI Orbit Face & Neck; Wo & W Dye
|
1
|
1
|
$3,707.00
|
$3,707.00
|
$3,707.00
|
$3,707.00
|
$3,707.00
|
2026-07-20
|
|
70540
|
CPT
|
MRI Orbit Face & Neck; Wo Dye
|
1
|
1
|
$4,290.63
|
$4,290.63
|
$515.99
|
$515.99
|
$515.99
|
2026-07-20
|
|
70498
|
CPT
|
CT Angiography, Neck; With contrast/NONDYE
|
3
|
3
|
$6,557.00
|
$6,557.00
|
$154.74
|
$625.00
|
$414.94
|
2026-07-20
|
|
70496
|
CPT
|
CT Angiography, Head; With contrast/NONDYE
|
6
|
6
|
$6,510.00
|
$6,510.00
|
$155.01
|
$435.82
|
$261.01
|
2026-07-20
|
|
70492
|
CPT
|
CT Neck, Soft Tissue; Wo & W Dye
|
2
|
2
|
$7,745.00
|
$7,745.00
|
$160.05
|
$178.31
|
$169.18
|
2026-07-20
|
|
70491
|
CPT
|
CT Neck, Soft Tissue; W Dye
|
4
|
4
|
$6,002.00
|
$6,002.00
|
$140.05
|
$386.50
|
$205.89
|
2026-07-20
|
|
70490
|
CPT
|
CT Neck, Soft Tissue; Wo Dye
|
3
|
3
|
$5,380.00
|
$5,380.00
|
$210.25
|
$427.10
|
$220.41
|
2026-07-20
|
|
70488
|
CPT
|
CT Face; Wo & W Dye
|
1
|
1
|
$4,837.00
|
$4,837.00
|
$178.31
|
$178.31
|
$178.31
|
2026-07-20
|
|
70487
|
CPT
|
CT Face; W Dye
|
2
|
2
|
$4,853.45
|
$4,853.45
|
$233.48
|
$435.82
|
$334.65
|
2026-07-20
|
|
70486
|
CPT
|
CT Face; Wo Dye
|
8
|
8
|
$4,845.00
|
$4,845.00
|
$83.80
|
$435.82
|
$216.47
|
2026-07-20
|
|
70480
|
CPT
|
CT Orbit/sella/post Fossa/ear Wo Dye
|
5
|
5
|
$4,902.00
|
$4,902.00
|
$83.80
|
$224.91
|
$139.47
|
2026-07-20
|
|
70470
|
CPT
|
CT Head/brain; Wo & W Dye
|
1
|
1
|
$6,140.00
|
$6,140.00
|
$175.46
|
$175.46
|
$175.46
|
2026-07-20
|
|
70450
|
CPT
|
CT Head/brain; Wo Dye
|
18
|
18
|
$4,979.00
|
$4,979.00
|
$83.80
|
$625.00
|
$121.57
|
2026-07-20
|
|
70360
|
CPT
|
Xr Neck & Soft Tissue
|
3
|
3
|
$454.00
|
$454.00
|
$25.13
|
$88.19
|
$81.28
|
2026-07-20
|
|
70260
|
CPT
|
Xr Skull 4+ Views
|
3
|
3
|
$1,133.00
|
$1,133.00
|
$97.40
|
$104.58
|
$104.51
|
2026-07-20
|
|
70250
|
CPT
|
Xr Skull, <4 Vws
|
3
|
3
|
$1,173.00
|
$1,173.00
|
$28.87
|
$106.51
|
$106.51
|
2026-07-20
|
|
70220
|
CPT
|
Xr Sinuses, Paranasal Complete, 3+ Vws
|
1
|
1
|
$904.95
|
$904.95
|
$88.19
|
$88.19
|
$88.19
|
2026-07-20
|
|
70140
|
CPT
|
Xr Facial Bones, <3 Views
|
1
|
1
|
$822.00
|
$822.00
|
$88.19
|
$88.19
|
$88.19
|
2026-07-20
|
|
70110
|
CPT
|
Xr Jaw, Complete, 4+ Vws
|
1
|
1
|
$1,763.00
|
$1,763.00
|
$102.48
|
$102.48
|
$102.48
|
2026-07-20
|
|
69209
|
CPT
|
Removal Impacted Cerumen Using Irrigation/
|
2
|
2
|
$275.00
|
$275.00
|
$41.25
|
$59.50
|
$50.38
|
2026-07-20
|
|
64718
|
CPT
|
Neuroplasty And/or Transposition; Ulnar Nerve Elbow
|
1
|
1
|
$7,898.00
|
$7,898.00
|
$1,924.31
|
$1,924.31
|
$1,924.31
|
2026-07-20
|
|
64636
|
CPT
|
Destruction By Neurolytic Agent, Paravertebral Facet Joint Nerve(s), With Imagin…
|
6
|
5
|
$1,500.00
|
$1,500.00
|
$76.00
|
$528.44
|
$268.25
|
2026-07-20
|
|
64635
|
CPT
|
Destruction By Neurolytic Agent, Paravertebral
|
13
|
12
|
$7,897.00
|
$7,897.00
|
$875.50
|
$8,208.44
|
$1,280.59
|
2026-07-20
|
|
64634
|
CPT
|
Destruction By Neurolytic Agent, Paravertebral Facet Each Add
|
2
|
2
|
$3,948.70
|
$3,948.70
|
$152.00
|
$295.00
|
$223.50
|
2026-07-20
|
|
64633
|
CPT
|
Destruction By Neurolytic Agent, Paravertebral Facet Joint
|
7
|
7
|
$7,897.50
|
$7,897.50
|
$912.99
|
$3,400.00
|
$1,280.59
|
2026-07-20
|
|
64615
|
CPT
|
Chemodenervation Of Muscle(s); Muscle(s) Innervate
|
3
|
3
|
$3,982.00
|
$3,982.00
|
$295.67
|
$296.09
|
$296.04
|
2026-07-20
|
|
64495
|
CPT
|
Injection(s), Diagnostic Or Therapeutic Agent, Par
|
1
|
1
|
$1,648.00
|
$1,648.00
|
$68.50
|
$68.50
|
$68.50
|
2026-07-20
|
|
64494
|
CPT
|
Injection(s), Diagnostic Or Therapeutic Agent, Paravertebral Facet Joint Each Ad…
|
5
|
4
|
$1,648.00
|
$1,648.00
|
$76.00
|
$465.00
|
$116.25
|
2026-07-20
|
|
64493
|
CPT
|
Injection(s), Diagnostic Or Therapeutic Agent, Paravertebral Facet (zygapophysea…
|
16
|
15
|
$3,296.00
|
$3,296.00
|
$275.00
|
$1,167.66
|
$732.27
|
2026-07-20
|
|
64491
|
CPT
|
Injection(s), Diagnostic Or Therapeutic Agent Each Add
|
3
|
2
|
$1,647.95
|
$1,647.95
|
$73.75
|
$465.00
|
$304.00
|
2026-07-20
|
|
64490
|
CPT
|
Injection(s), Diagnostic Or Therapeutic Agent
|
10
|
9
|
$3,295.90
|
$3,295.90
|
$550.00
|
$1,133.00
|
$875.82
|
2026-07-20
|
|
64484
|
CPT
|
Injection(s), Anesthetic Agent And/or Steroid, Transforaminal Epidural, With Ima…
|
5
|
5
|
$1,648.00
|
$1,648.00
|
$152.00
|
$465.00
|
$465.00
|
2026-07-20
|
|
64483
|
CPT
|
Injection(s), Anesthetic Agent And/or Steroid, Transforaminal Epidural, With Ima…
|
3
|
2
|
$3,296.00
|
$3,296.00
|
$658.63
|
$879.80
|
$832.85
|
2026-07-20
|
|
64455
|
CPT
|
Injection(s), Anesthetic Agent(s) And/or Steroid; Plantar Common Digital Nerve(s…
|
1
|
1
|
$3,400.00
|
$3,400.00
|
$296.04
|
$296.04
|
$296.04
|
2026-07-20
|
|
64450
|
CPT
|
Injection Aa&/strd Other Peripheral Nerve/branch - Hospital Fee
|
1
|
1
|
$1,400.00
|
$1,400.00
|
$682.18
|
$682.18
|
$682.18
|
2026-07-20
|
|
64405
|
CPT
|
Injection, Anesthetic Agent; Greater Occipital
|
3
|
3
|
$1,500.00
|
$1,500.00
|
$145.47
|
$321.55
|
$147.38
|
2026-07-20
|
|
63650
|
CPT
|
Percutaneous Implantation Of Neurostimulator Electrode Array, Epidural
|
6
|
6
|
$8,208.44
|
$8,208.44
|
$6,146.25
|
$6,468.35
|
$6,442.06
|
2026-07-20
|
|
63030
|
CPT
|
Laminotomy (hemilaminectomy), With Decompression
|
2
|
2
|
$27,490.00
|
$27,490.00
|
$7,040.82
|
$8,860.80
|
$7,950.81
|
2026-07-20
|
|
62304
|
CPT
|
Myelography Via Lumbar Injection, Including Radiol
|
1
|
1
|
$3,336.60
|
$3,336.60
|
$783.43
|
$783.43
|
$783.43
|
2026-07-20
|
|
51702
|
CPT
|
Insertion Of Temporary Indwelling Bladder Catheter (foley)
|
4
|
4
|
$1,003.00
|
$1,003.00
|
$50.15
|
$1,003.00
|
$123.87
|
2026-07-20
|
|
49450
|
CPT
|
Replace Gastrostomy/cecostomy Tube Percutaneous
|
7
|
7
|
$8,208.44
|
$8,208.44
|
$410.42
|
$939.08
|
$920.30
|
2026-07-20
|
|
49440
|
CPT
|
ER Procedure; Insert Gastrostomy Tube Percutaneous
|
2
|
2
|
$3,085.00
|
$3,085.00
|
$1,862.06
|
$1,862.06
|
$1,862.06
|
2026-07-20
|
|
47000
|
CPT
|
Biopsy Of Liver, Needle; Percutaneou
|
1
|
1
|
$6,610.00
|
$6,610.00
|
$1,596.80
|
$1,596.80
|
$1,596.80
|
2026-07-20
|
|
43762
|
CPT
|
Perq Replacement Gtube Not Req Revj Gstrst Trc
|
2
|
2
|
$1,450.00
|
$1,450.00
|
$232.53
|
$238.73
|
$235.63
|
2026-07-20
|
|
38510
|
CPT
|
Biopsy Or Excision Of Lymph Node(s); Open,
|
3
|
3
|
$13,376.50
|
$13,376.50
|
$3,643.94
|
$3,933.28
|
$3,835.48
|
2026-07-20
|
|
38505
|
CPT
|
Biopsy Or Excision Of Lymph Node(s); By Needle,
|
2
|
2
|
$6,610.00
|
$6,610.00
|
$1,624.57
|
$1,650.99
|
$1,637.78
|
2026-07-20
|
|
37280
|
CPT
|
Revascularization, Endovascular, Open Or Percu
|
3
|
3
|
$35,382.69
|
$35,382.69
|
$10,541.91
|
$35,963.31
|
$10,577.20
|
2026-07-20
|
|
37271
|
CPT
|
Evascularization, Endovascular, Open Or Perc Femoral W/angio & Arthrectomy
|
4
|
4
|
$56,186.07
|
$56,186.07
|
$16,730.14
|
$33,027.52
|
$17,208.48
|
2026-07-20
|
|
37248
|
CPT
|
Transluminal Balloon Angioplasty
|
6
|
6
|
$32,000.00
|
$32,000.00
|
$5,193.63
|
$9,476.00
|
$5,655.05
|
2026-07-20
|
|
36902
|
CPT
|
Introduction Of Needle(s) And/or Catheter(
|
15
|
15
|
$20,000.00
|
$20,000.00
|
$5,296.92
|
$9,476.00
|
$5,596.54
|
2026-07-20
|
|
36592
|
CPT
|
Collection Of Blood Specimen Using Established Central Or Peripheral Catheter, V…
|
1
|
1
|
$550.00
|
$550.00
|
$550.00
|
$550.00
|
$550.00
|
2026-07-20
|
|
36589
|
CPT
|
Removal Of Tunneled Central Venous Catheter
|
18
|
18
|
$3,003.85
|
$3,003.85
|
$572.42
|
$3,003.85
|
$619.26
|
2026-07-20
|
|
36569
|
CPT
|
Insertion Of Peripherally Inserted Central Venous Cath (picc)
|
2
|
2
|
$3,982.00
|
$3,982.00
|
$734.80
|
$1,514.33
|
$1,124.57
|
2026-07-20
|
|
36558
|
CPT
|
Insertion Of Tunneled Centrally Inserted Cvc
|
2
|
2
|
$10,250.00
|
$10,250.00
|
$3,033.87
|
$3,035.47
|
$3,034.67
|
2026-07-20
|
|
31575
|
CPT
|
Laryngoscopy, Flexible; Diagnostic
|
2
|
2
|
$3,982.00
|
$3,982.00
|
$191.34
|
$199.53
|
$195.44
|
2026-07-20
|
|
29882
|
CPT
|
Arthroscopy, Knee, Surgical; With Meniscus Repair
|
1
|
1
|
$12,971.40
|
$12,971.40
|
$2,600.00
|
$2,600.00
|
$2,600.00
|
2026-07-20
|
|
29881
|
CPT
|
Arthroscopy, Knee, Surgical; With Meniscectom
|
2
|
2
|
$12,971.14
|
$12,971.14
|
$3,207.02
|
$5,356.00
|
$4,281.51
|
2026-07-20
|
|
29876
|
CPT
|
Arthroscopy, Knee, Surgical; Synovectomy, Major, 2 Or More Compartments
|
1
|
1
|
$12,974.44
|
$12,974.44
|
$3,197.87
|
$3,197.87
|
$3,197.87
|
2026-07-20
|
|
29873
|
CPT
|
Arthroscopy, Knee, Surgical; With Lateral Release
|
1
|
1
|
$12,971.40
|
$12,971.40
|
$2,600.00
|
$2,600.00
|
$2,600.00
|
2026-07-20
|
|
29827
|
CPT
|
Arthroscopy, Shoulder, Surgical; With Rotator Cuff Repair
|
1
|
1
|
$27,490.00
|
$27,490.00
|
$7,040.82
|
$7,040.82
|
$7,040.82
|
2026-07-20
|
|
29822
|
CPT
|
Arthroscopy, Shoulder, Surgical; Debridement,
|
2
|
2
|
$12,971.40
|
$12,971.40
|
$5,617.36
|
$5,663.64
|
$5,640.50
|
2026-07-20
|
|
29105
|
CPT
|
Application Of Long Arm Splint
|
1
|
1
|
$664.00
|
$664.00
|
$158.05
|
$158.05
|
$158.05
|
2026-07-20
|
|
29075
|
CPT
|
Application, Cast; Elbow To Finger (short Arm)
|
1
|
1
|
$1,595.46
|
$1,595.46
|
$261.75
|
$261.75
|
$261.75
|
2026-07-20
|
|
28190
|
CPT
|
Removal Of Foreign Body, Foot; Subcutaneous
|
1
|
1
|
$7,234.70
|
$7,234.70
|
$2,170.41
|
$2,170.41
|
$2,170.41
|
2026-07-20
|
|
26010
|
CPT
|
Drainage Of Finger Abscess; Simple
|
1
|
1
|
$1,610.00
|
$1,610.00
|
$80.50
|
$80.50
|
$80.50
|
2026-07-20
|
|
20611
|
CPT
|
Arthrocentesis, Aspiration And/or Injection, Major Joint
|
12
|
12
|
$3,982.00
|
$3,982.00
|
$266.10
|
$3,982.00
|
$347.00
|
2026-07-20
|
|
20610
|
CPT
|
Arthrocentesis, Aspiration And/or Injection, Major
|
12
|
12
|
$2,390.00
|
$2,390.00
|
$219.54
|
$387.16
|
$290.35
|
2026-07-20
|
|
20606
|
CPT
|
Arthrocentesis Aspir&/inj Interm Jt/burs W/us
|
1
|
1
|
$1,607.00
|
$1,607.00
|
$627.42
|
$627.42
|
$627.42
|
2026-07-20
|
|
20605
|
CPT
|
Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa
|
2
|
2
|
$2,390.00
|
$2,390.00
|
$717.00
|
$1,314.50
|
$1,015.75
|
2026-07-20
|
|
20600
|
CPT
|
Arthrocentesis, Aspiration And/or Injection, Small Joint
|
1
|
1
|
$1,200.00
|
$1,200.00
|
$276.16
|
$276.16
|
$276.16
|
2026-07-20
|
|
20553
|
CPT
|
Injection(s); Single Or Multiple Trigger Point(s)
|
4
|
4
|
$2,340.00
|
$2,340.00
|
$266.10
|
$293.83
|
$292.11
|
2026-07-20
|
|
20550
|
CPT
|
Injection(s); Single Tendon Sheath, Or Ligament, Aponeurosis (eg, Plantar 'fasci…
|
6
|
6
|
$1,500.00
|
$1,500.00
|
$276.16
|
$930.00
|
$344.00
|
2026-07-20
|
|
19101
|
CPT
|
Biopsy Of Breast; Open, Incisional
|
1
|
1
|
$13,376.50
|
$13,376.50
|
$3,758.77
|
$3,758.77
|
$3,758.77
|
2026-07-20
|
|
19083
|
CPT
|
US Breast Biopsy, First Lesion
|
2
|
2
|
$3,477.35
|
$3,477.35
|
$1,469.39
|
$1,622.86
|
$1,546.12
|
2026-07-20
|
|
19020
|
CPT
|
Mastotomy With Exploration Or Drainage Of Abscess,
|
1
|
1
|
$6,610.35
|
$6,610.35
|
$2,626.50
|
$2,626.50
|
$2,626.50
|
2026-07-20
|
|
15853
|
CPT
|
Removal Sutures/staples Not Requiring Anesthesia
|
1
|
1
|
$120.00
|
$120.00
|
$22.28
|
$22.28
|
$22.28
|
2026-07-20
|
|
1260000005
|
CDM
|
Medical Management Room & Board Private
|
17
|
17
|
$15,000.00
|
$15,000.00
|
$147.14
|
$15,000.00
|
$2,325.00
|
2026-07-20
|
|
1260000004
|
CDM
|
Room & Board Telemetry/imcu
|
4
|
4
|
$7,500.00
|
$7,500.00
|
$1,216.49
|
$5,128.60
|
$2,413.09
|
2026-07-20
|
|
1260000003
|
CDM
|
Room & Board - ICU
|
5
|
5
|
$15,000.00
|
$15,000.00
|
$1,507.44
|
$15,000.00
|
$4,863.56
|
2026-07-20
|
|
1260000002
|
CDM
|
Room & Board Private General
|
17
|
17
|
$5,000.00
|
$5,000.00
|
$147.14
|
$15,000.00
|
$2,325.00
|
2026-07-20
|
|
1260000001
|
CDM
|
Room & Board Isolation
|
1
|
1
|
$10,000.00
|
$10,000.00
|
$3,613.21
|
$3,613.21
|
$3,613.21
|
2026-07-20
|
|
12011
|
CPT
|
Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/or Mu…
|
2
|
2
|
$1,500.00
|
$1,500.00
|
$75.00
|
$1,500.00
|
$787.50
|
2026-07-20
|
|
12001
|
CPT
|
Simple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Genitalia,…
|
1
|
1
|
$1,532.10
|
$1,532.10
|
$76.61
|
$76.61
|
$76.61
|
2026-07-20
|
|
11765
|
CPT
|
Wedge Excision Skin Nail Fold
|
3
|
3
|
$746.00
|
$746.00
|
$223.80
|
$392.18
|
$223.80
|
2026-07-20
|
|
11755
|
CPT
|
Biopsy Nail Unit Separate Procedure
|
1
|
1
|
$3,540.00
|
$3,540.00
|
$697.57
|
$697.57
|
$697.57
|
2026-07-20
|
|
11750
|
CPT
|
Excision Of Nail And Nail Matrix, Partial Or Complete
|
3
|
3
|
$3,460.00
|
$3,460.00
|
$173.00
|
$399.86
|
$365.73
|
2026-07-20
|
|
11730
|
CPT
|
Avulsion Nail Plate Partial/complete Simple 1
|
2
|
2
|
$2,100.00
|
$2,100.00
|
$105.00
|
$630.00
|
$367.50
|
2026-07-20
|
|
11401
|
CPT
|
Excision, Benign Lesion Including Margins, Except
|
1
|
1
|
$1,524.05
|
$1,524.05
|
$1,524.05
|
$1,524.05
|
$1,524.05
|
2026-07-20
|
|
111000001
|
CDM
|
Room & Board Private Medical/surgical
|
1
|
1
|
$10,000.00
|
$10,000.00
|
$515.97
|
$515.97
|
$515.97
|
2026-07-20
|
|
11057
|
CPT
|
Paring/cutting Benign Hyperkeratotic Lesion >4
|
2
|
2
|
$372.00
|
$372.00
|
$111.60
|
$195.04
|
$153.32
|
2026-07-20
|
|
11056
|
CPT
|
Paring Or Cutting Of Benign Hyperkeratotic Lesion
|
3
|
3
|
$1,797.80
|
$1,797.80
|
$89.89
|
$182.04
|
$181.30
|
2026-07-20
|
|
11042
|
CPT
|
Debridement Subcutaneous Tissue 20 Sq Cm Or Less
|
2
|
2
|
$2,583.00
|
$2,583.00
|
$394.38
|
$400.18
|
$397.28
|
2026-07-20
|
|
10120
|
CPT
|
Incision & Removal Foreign Body Subq Tiss Simple
|
1
|
1
|
$3,275.00
|
$3,275.00
|
$400.18
|
$400.18
|
$400.18
|
2026-07-20
|
|
10061
|
CPT
|
Incision & Drainage Abscess Complicated/multiple
|
1
|
1
|
$8,687.00
|
$8,687.00
|
$434.35
|
$434.35
|
$434.35
|
2026-07-20
|
|
10060
|
CPT
|
Incision & Drainage Abscess Simple/single - Hospital ER
|
1
|
1
|
$1,955.00
|
$1,955.00
|
$97.75
|
$97.75
|
$97.75
|
2026-07-20
|
|
0111
|
CDM
|
Utmb Room & Board Private General
|
13
|
13
|
$560.00
|
$560.00
|
$147.14
|
$3,400.00
|
$1,756.40
|
2026-07-20
|
|
0110
|
CDM
|
Room & Board Private General
|
13
|
13
|
$530.00
|
$530.00
|
$147.14
|
$3,400.00
|
$1,756.40
|
2026-07-20
|