Fees -As of 6 12 2019.Xls

• Timed charges: Some charges such as anesthesia are based on a units of time, so the charges may vary based on the units charged.

• Drugs and implants: Drugs, implants and supplies are priced individually based on the cost loaded into our information systems at the time of charging, so they do not have individual prices listed. The typical methodology will take the cost in place at the time, multiplied by a markup percentage.

• Estimated Total Charges of Procedure/Stays/Visits etc can be obtained by contacting -AJ Karpinski at 218-546-2507. All charges are then subject to Insurance contract payer reductions. To get any accurate representation of patient final cost, I would strongly encourage contacting us to accurately predict final price -costs of services State Mandated Clinic Price Transparency – Average. Charge Medicare Medicaid Cuyuna Regional Medical Center - Clinic Commecial Reim. Office/outpatient visit new Level 1 $190 $76 $45 $34 Office/outpatient visit new Level 2 $396 $130 $75 $57 Office/outpatient visit new Level 3 $574 $186 $107 $82 Office/outpatient visit new Level 4 $708 $283 $163 $126 Office/outpatient visit est Level 1 $96 $36 $22 $16 Office/outpatient visit est Level 2 $187 $76 $44 $34 Office/outpatient visit est Level 3 $424 $127 $73 $56 Office/outpatient visit est Level 4 $549 $187 $108 $83 Office/outpatient visit est Level 5 $624 $245 $145 $112 Per pm reeval est pat infant $300 $176 Non-cov. $77 Prev visit est age 1-4 $347 $184 Non-cov. $82 Prev visit est age 18-39 $432 $205 Non-cov. $91 Prev visit est age 40-64 $408 $219 Non-cov. $97 Per pm reeval est pat 65+ yr $478 $236 Non-cov. $105 Init pm e/m new pat infant $342 $192 Non-cov. $85 Init pm e/m new pat 1-4 yrs $374 $201 Non-cov. $89 rev visit new age 18-39 $401 $229 Non-cov. $102 Prev visit new age 40-64 $470 $265 Non-cov. $118 Init pm e/m new pat 65+ yrs $514 $287 Non-cov. $128 VENIPUNCTURE/Lab Draw $46 $15 $3 $3 Seasonal Influenza $139 $39 $39 $53 Immunization admin $80 $28 $20 $16 Vaccine Admin $28 $25 $10 $16 PR SUBSEQUENT ANNUAL WELLNESS VISIT $289 $165 $117 $83 Transitional Care Management <14 days post dc. $526 $285 $165 $127

• ATTENTION: The amounts posted above DO NOT reflect the amount(s) each clinic patient will pay for • The Minnesota Legislature passed a law that requires certain clinics to report amounts for their 25 the services listed. For specific information about the amount you will owe for the services you receive, most frequent services that cost more than $25.00. The services listed here do not reflect all the services please contact your insurer. provided at this clinic.

• Patients with government-sponsored health coverage, such as Medicare or Medical Assistance: The For more information, please contact AJ Karpinski, Director Managed Care Contracting, at 218- payment rates listed above reflect amounts set by Medicare or Medical Assistance, not by this clinic. 546-2507 These listed rates do not reflect the amount you might owe as a co-payment. NOTICE: Cuyuna Regional Medical Center - Crosby is a provider based facility. This clinic is a part of a • Patients covered by commercial health insurance or a Medicare Advantage plan: Your health insurance hospital and the patient may receive a separate charge or billing for the facility component of the service. company has likely negotiated a discount or contracted rate for each service. Your health insurance This may result in a higher out of pocket expense. company’s negotiated price might be higher or lower than the average commercial payment amount listed above. To learn more about your health insurance company’s negotiated price or how much you will owe under the term of your specific health policy, please contact your health insurance company. Fee Schedule Procedure Name UNIT_Charge ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID SCIATIC NERVE 1,518.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID SCIATIC NERVE CONT INFUS 32.00 ANES FAC FEE PR ANES SKIN SURG THORAX EXTR 10.00 ANES FAC FEE PR ANES REPAIR UPPER ABD HERNIA NOS 10.00 ANES FAC FEE PR ANES BICEPS TENDON REPAIR 10.00 ANES FAC FEE PR ANES UPPER GI ENDOSCOPY 10.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID BRACHIAL PLEXUS 175.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID INTERCOST NERVE EA ADDL LVL 219.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID FEMORAL NERVE 81.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID FEMORAL NERVE CONT INFUS 174.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID OTH PERIPH NERVE/BRANCH 225.00 ANES FAC FEE PR HEART/LUNG RESUSCITATION (CPR) 342.00 ANES FAC FEE PR ANES CORRECT HEART RHYTHM 10.00 ANES FAC FEE PR ANES CARDIOVERTER DEFIB 10.00 ANES FAC FEE PR ANES EXTERNALCEPHALIC VERSION PRC 10.00 ANES FAC FEE PR INSERT NON TUNNEL CVCATH OVER 5 YRS 395.00 ANES FAC FEE HCHG ANES FACILITY TIMED CUY ONLY 10.00 ANES FAC FEE PR INJ TRIGGER POINTS 3 OR > MUSCLES 58.00 ANES FAC FEE PR INJ LUMBAR EPIDUR BLOOD/CLOT PATCH 204.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID AXILLARY NERVE 181.00 ANES FAC FEE PR ANES DX ARTHROSCOPIC PROC KNEE JOINT 10.00 ANES FAC FEE PR ANES KNEE JOINT CASTING 10.00 ANES FAC FEE PR ANES ACHILLES TENDON SURG 10.00 ANES FAC FEE PR FLUOROSCOPIC GUIDE FOR NEEDLE PLACEMENT 953.00 ANES FAC FEE HCHG NITROUS OXIDE PER 15 MIN 64.00 ANES FAC FEE HCHG MODERATE SED SAME PROVIDER > 5 YRS 1ST 15 MINUTES 210.00 ANES FAC FEE HCHG GENERAL ANESTHESIA 10.00 ANES FAC FEE PR INJ TRIGGER POINT 1 OR 2 MUSCLES 58.00 ANES FAC FEE PR VENIPUNC <3 YEARS FEMORAL JUGULAR MD SKILL 23.00 ANES FAC FEE PR WITHDRAWAL OF ARTERIAL BLOOD 58.00 ANES FAC FEE PR ANES SURG LOWER IP ABDOMEN 10.00 ANES FAC FEE PR ANES SURG LOW ABDEXTRAPERINTONEAL 10.00 ANES FAC FEE PR ANES KNEE AREA SURGERY 10.00 ANES FAC FEE PR ANES TOTAL KNEE ARTHROPLASTY 10.00 ANES FAC FEE PR ANES LOWER ARM SURGERY 10.00 ANES FAC FEE HCHG MODERATE SED DIFF PROVIDER EACH ADDL 15 MINUTES 162.00 ANES FAC FEE PR VENIPUNCTURE > 3 MD SKILL DX OR TX PURP 23.00 ANES FAC FEE PR ANES FOR LENS SURGERY 10.00 ANES FAC FEE PR ANES SKIN SURG HEAD/NECK 10.00 ANES FAC FEE PR ANES REPAIR LO ABD HERNIA NOS 10.00 ANES FAC FEE PR ANES RADICAL REMOVE TESTIS INGUINAL 10.00 ANES FAC FEE PR ANES UPPER LEG SURG 10.00 ANES FAC FEE PR ANES SURGERY OF SHOULDER 10.00 ANES FAC FEE PR ANES OPEN OR ARTHROSCOPIC LOWER ARM SURGERY 10.00 ANES FAC FEE PR NEURAXIAL LABOR ANAL/ANES PLAN VAG DEL 368.00 ANES FAC FEE PR CATH PLCMT INJ/INFUSE EPI OR SUBA LUMB SACRAL WO GUIDE 337.00 ANES FAC FEE PR ULTRASOUND GUIDED NEEDLE PLCMT 509.00 ANES FAC FEE PR ANES LOWER GI ENDOSCOPY SCREENING COLONOSCOPY 10.00 ANES FAC FEE PR SPINAL PUNCTURE THERAPEUTIC DRAINAGE 218.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID BRACHIAL PLEXUS CONTINOUS 175.00 ANES FAC FEE PR ANES BONE MARROW ASP/BX ILIAC CRST 10.00 ANES FAC FEE PR ANES TOTAL HIP ARTHROPLASTY 10.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID LUMBAR PLEXUS CONT INFUS 56.00 ANES FAC FEE HCHG MONITORED ANESTHESIA CARE 10.00 ANES FAC FEE PR INSERT EMERGENCY ENDOTRACH AIRWAY 154.00 ANES FAC FEE PR INJ(S) ANES AGENT AND/OR STEROID INTERCOSTAL NERVE SGL LVL 170.00 ANES FAC FEE PR INJ FORAMEN L/S 1 LEVEL WITH FLUORO OR CT 217.00 ANES FAC FEE PR ANES CES DEL FOL NEURAXIAL ANAL/ANES 10.00 ANES FAC FEE PR ANES NERVE BLOCKS/INJ NOT PRONE 10.00 ANES FAC FEE PR DAILY MGMT EPIDUR/SUBARACH CONT 538.00 ANES FAC FEE PR INSERT NON TUNNEL CVCATH UNDER 5 YRS 357.00 ANES FAC FEE HCHG SEVOFLURANE PER 15 MIN 19.00 ANES FAC FEE HCHG CATH PLCMT INJ/INFUSE EPI OR SUBA LUMB SACRAL WO GUIDE 210.00 ANES FAC FEE HCHG MODERATE SED SAME PROVIDER EACH ADDL 15 MINUTES 162.00 ANES FAC FEE PR ANES LOWER GI ENDOSCOPY 10.00 ANES FAC FEE PR INSERT CATH ART PERCUT SHORT TERM 58.00 ANES FAC FEE PR ANES REPAIR UP HERNIA LUMBAR/VENTR 10.00 ANES FAC FEE PR ANES SURG UPPER IP ABDOMEN 10.00 ANES FAC FEE PR ANES ABD WALL LOWER ANTSURG 10.00 ANES FAC FEE PR ANES ELBOW AREA SURGERY 10.00 ANES FAC FEE PR ANES ELBOW REPLACEMENT 10.00 ANES FAC FEE HCHG MODERATE SED DIFF PROVIDER > 5 YRS 1ST 15 MINUTES 210.00 ANES FAC FEE HCHG ANES US GUIDE 3,464.00 CRNA PR VENIPUNC <3 YEARS FEMORAL JUGULAR MD SKILL 21.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID INTERCOST NERVE EA ADDL LVL 137.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID FEMORAL NERVE 56.00 CRNA PR CRITICAL CARE EA ADDL 30 MIN 404.00 CRNA PR ANES FOR LENS SURGERY 21.00 CRNA PR ANES INTRAORAL PROCEDURE NOS 21.00 CRNA PR ANES REPAIR LO HERNIA VENTR/INCIS 21.00 CRNA PR ANES ANORECTAL SURGERY 21.00 CRNA PR ANES RADICAL REMOVE TESTIS INGUINAL 21.00 CRNA PR ANES VAGINAL PROCEDURES 21.00 CRNA PR ANES HYSTEROSCOPY/VAG BX 21.00 CRNA PR ANES ELBOW REPLACEMENT 21.00 CRNA PR ANES CESAREAN DELIVERY ONLY 21.00 CRNA PR ANES NERVE BLOCKS/INJ NOT PRONE 21.00 CRNA PR DAILY MGMT EPIDUR/SUBARACH CONT 368.00 CRNA PR ANES PERC IMG TX SPINE PROC 21.00 CRNA PR NEWBORN RESUSCITATION 375.00 CRNA PR INSERT EMERGENCY ENDOTRACH AIRWAY 82.00 CRNA PR WITHDRAWAL OF ARTERIAL BLOOD 108.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID INTERCOSTAL NERVE SGL LVL 100.00 CRNA PR ANES NECK VESSEL SURG SIMPL LIGAT 21.00 CRNA PR ANES REPAIR UPPER ABD HERNIA NOS 21.00 CRNA PR ANES GASTRIC RESTRICT MORBID OBESITY 21.00 CRNA PR ANES OPEN PROC UPPER 2/3 FEMUR 21.00 CRNA PR ANES AMPUTATION LEG ABOVE KNEE 21.00 CRNA PR ANES UPPER LEG SURG 21.00 CRNA PR ANES TIB/FIB/PATELLA OPEN PROCEDURE 21.00 CRNA PR ANES TOTAL KNEE ARTHROPLASTY 21.00 CRNA PR ANES ARTHROSCIC OPEN SHOULDER JOINT 21.00 CRNA PR ANES LOWER ARM SURGERY 21.00 CRNA PR INSERT NON TUNNEL CVCATH OVER 5 YRS 395.00 CRNA PR VENT MGMT INPAT SUBQ DAY 194.00 CRNA PR FLUOROSCOPIC GUIDE FOR NEEDLE PLACEMENT 508.00 CRNA HCHG MONITORED ANESTHESIA CARE 21.00 CRNA PR ANES LOWER GI ENDOSCOPY SCREENING COLONOSCOPY 21.00 CRNA PR ANES UPPER/LOWER GI ENDOSCOPY 21.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID SCIATIC NERVE 119.00 CRNA PR HEART/LUNG RESUSCITATION (CPR) 232.00 CRNA PR ANES RADICAL FACIAL BONE SURGERY 21.00 CRNA PR ANES CHEST PROC CLOSED NOS 21.00 CRNA PR ANES CHEST DRAINAGE 21.00 CRNA PR ANES THORACOTOMY PROC W/1 LUNG VENT 21.00 CRNA PR ANES KID STONE DESTRUCT 21.00 CRNA PR ANES URETERAL STONE REMOVAL 21.00 CRNA PR ANES BONE MARROW ASP/BX ILIAC CRST 21.00 CRNA PR ANES CLOSED PROC UPPER 2/3 FEMUR 21.00 CRNA PR ANES KNEE AREA SURGERY 21.00 CRNA PR ANES ARTHROSCOPIC OPEN KNEE JOINT 21.00 CRNA PR INSERT NON TUNNEL CVCATH UNDER 5 YRS 243.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID LUMBAR PLEXUS CONT INFUS 206.00 CRNA PR VENT MGMT INPAT INIT DAY 324.00 CRNA HCHG MODERATE SED SAME PROVIDER EACH ADDL 15 MINUTES 24.00 CRNA HCHG GENERAL ANESTHESIA 21.00 CRNA PR ANES UPPER GI ENDOSCOPY W RETROGRADE 21.00 CRNA PR ANES CRNA TIMED CUY ONLY 21.00 CRNA PR VENIPUNCTURE > 3 MD SKILL DX OR TX PURP 64.00 CRNA PR INSERT CATH ART PERCUT SHORT TERM 131.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID AXILLARY NERVE 188.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID OTH PERIPH NERVE/BRANCH 105.00 CRNA PR INJ FORAMEN L/S 1 LEVEL WITH FLUORO OR CT 314.00 CRNA PR ANES CORRECT HEART RHYTHM 21.00 CRNA PR ANES SURG CLAVICLE SCAPULA 21.00 CRNA PR ANES CENTRL VASCULAR ACCESS 21.00 CRNA PR ANES XURETHRAL REMOVAL OF PROSTATE 21.00 CRNA PR ANES REPAIR OF CERVIX 21.00 CRNA PR ANES UPPER LEG VEINS SURG 21.00 CRNA PR ANES LOWER 1/3 FEMUR OPEN PROC 21.00 CRNA PR ANES RADICAL LEG RESECTION 21.00 CRNA PR ANES OPEN OR ARTHROSCOPIC LOWER ARM SURGERY 21.00 CRNA PR ANES CES DEL FOL NEURAXIAL ANAL/ANES 21.00 CRNA PR ANES EXTERNALCEPHALIC VERSION PRC 21.00 CRNA HCHG MODERATE SED SAME PROVIDER > 5 YRS 1ST 15 MINUTES 210.00 CRNA PR INJ EPIDUR INTERLAM SUBA LUMB SACRAL WO GUIDE 292.00 CRNA PR INJ TRIGGER POINT 1 OR 2 MUSCLES 45.00 CRNA PR INJ LUMBAR EPIDUR BLOOD/CLOT PATCH 578.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID BRACHIAL PLEXUS CONTINOUS 158.00 CRNA PR ANES CORNEAL TRANSPLANT 21.00 CRNA PR ANES NOSE SINUS SURGERY 21.00 CRNA PR ANES PACEMAKER INSERTION 21.00 CRNA PR ANES COLPOVAGINECT COLPORRURETH PROC 21.00 CRNA PR ANES REVISE TOTAL HIP ARTHROPLASTY 21.00 CRNA PR ANES LOWER 1/3 FEMUR CLOSED PROC 21.00 CRNA PR ANES TIB/FIB/PATELLA CLOSED PROCEDURE 21.00 CRNA PR ANES FOR INCOMPLETE OR MISSED ABORTION 21.00 CRNA PR US GUIDED VASCULAR ACCESS 60.00 CRNA PR ULTRASOUND GUIDED NEEDLE PLCMT 67.00 CRNA PR ANES UPPER GI ENDOSCOPY 21.00 CRNA PR INJ TRIGGER POINTS 3 OR > MUSCLES 46.00 CRNA PR LUMBAR PUNCTURE DIAGNOSTIC 407.00 CRNA PR SPINAL PUNCTURE THERAPEUTIC DRAINAGE 149.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID SCIATIC NERVE CONT INFUS 132.00 CRNA PR ECHO HEART TRANSESOPHAGEAL COMPLETE 21.00 CRNA PR ANES RECONSTRUCT EYELID 21.00 CRNA PR ANES TYMPANOTOMY 21.00 CRNA PR ANES PROCEDURES ON EYE 21.00 CRNA PR ANES SKIN SURG HEAD/NECK 21.00 CRNA PR ANES NECK ORG PROC NOS AGE 1 YR/OLD 21.00 CRNA PR ANES TRACHBRONCHI INTRATHOR SURG 21.00 CRNA PR ANES SURG UPPER IP ABDOMEN 21.00 CRNA PR ANES REPAIR LO ABD HERNIA NOS 21.00 CRNA PR ANES TUBAL LIGATION/TRANSECTION 21.00 CRNA PR ANES KNEE JOINT CASTING 21.00 CRNA PR ANES LOWER LEG OPEN PROCEDURE 21.00 CRNA PR ANES BICEPS TENDON REPAIR 21.00 CRNA PR ANES ARTHROSCPIC OPEN ELBOW 21.00 CRNA PR ANES FOREARM BONES CLOSED PROC 21.00 CRNA PR NEURAXIAL LABOR ANAL/ANES PLAN VAG DEL 368.00 CRNA PR CATH PLCMT INJ/INFUSE EPI OR SUBA LUMB SACRAL WO GUIDE 212.00 CRNA PR ANES LOWER GI ENDOSCOPY 21.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID BRACHIAL PLEXUS 219.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID ILIOING/HYPOGAST NERVES 337.00 CRNA PR CRITICAL CARE 30-74 MINUTES 854.00 CRNA PR ANES SURG BREAST RAD MASTEC 21.00 CRNA PR ANES REPAIR UP HERNIA LUMBAR/VENTR 21.00 CRNA PR ANES ABD WALL LOWER ANTSURG 21.00 CRNA PR ANES XURETHRAL BLADDER TUMOR SURG 21.00 CRNA PR ANES MALE GENITALIA SURGERY 21.00 CRNA PR ANES LOWER LEG CLOSED PROCEDURE 21.00 CRNA PR ANES LOWER LEG VEIN SURG NOS 21.00 CRNA PR ANES SURGERY OF SHOULDER 21.00 CRNA PR ANES SHOULDER REPLACEMENT 21.00 CRNA PR ANES ELBOW AREA SURGERY 21.00 CRNA PR TAP BLCK ABD PLN BLCK RECTUS BLCK UNI INJ W IMG GUID 324.00 CRNA PR TAP BLCK ABD PLN BLCK RECTUS BLCK BIL BY INJ W IMG GUID 392.00 CRNA PR INJ(S) ANES AGENT AND/OR STEROID FEMORAL NERVE CONT INFUS 181.00 CRNA PR POS AIRWAY PRESSURE CPAP 305.00 CRNA PR ANES SKIN SURG THORAX EXTR 21.00 CRNA PR ANES CARDIOVERTER DEFIB 21.00 CRNA PR ANES FAT LAYER REMOVAL PANNICULECTOMY 21.00 CRNA PR ANES SURG LOWER IP ABDOMEN 21.00 CRNA PR ANES SURG LOW ABDEXTRAPERINTONEAL 21.00 CRNA PR ANES TRANSURETHRAL SURG NOS 21.00 CRNA PR ANES VAGINAL HYSTERECTOMY 21.00 CRNA PR ANES HIP JOINT SURGERY OPEN 21.00 CRNA PR ANES TOTAL HIP ARTHROPLASTY 21.00 CRNA PR ANES KNEE JOINT CLOSED PROCEDURE 21.00 CRNA PR ANES DX ARTHROSCOPIC PROC KNEE JOINT 21.00 CRNA PR ANES ACHILLES TENDON SURG 21.00 CRNA PR ANES LOWER LEG BONE SURG 21.00 CRNA PR ANES CT/MRI OR RADIATION THERAPY 21.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ TRIGGER POINTS 3 OR > MUSCLES 46.00 CUY ANES MDA FEE SCHEDULE - 4258 PR LUMBAR PUNCTURE DIAGNOSTIC 407.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID INTERCOST NERVE EA ADDL LVL 137.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID OTH PERIPH NERVE/BRANCH 119.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES RECONSTRUCT EYELID 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES FOR LENS SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CHEST PROC CLOSED NOS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SURG LOWER IP ABDOMEN 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SURG LOW ABDEXTRAPERINTONEAL 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES VAGINAL PROCEDURES 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES VAGINAL HYSTERECTOMY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES REPAIR OF CERVIX 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER 1/3 FEMUR CLOSED PROC 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TIB/FIB/PATELLA CLOSED PROCEDURE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ARTHROSCOPIC OPEN KNEE JOINT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER LEG OPEN PROCEDURE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES RADICAL LEG RESECTION 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER LEG BONE REVISION 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER ARM SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CT/MRI OR RADIATION THERAPY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES NERVE BLOCKS/INJ NOT PRONE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR US GUIDED VASCULAR ACCESS 60.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ EPIDUR INTERLAM SUBA LUMB SACRAL WO GUIDE 292.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER GI ENDOSCOPY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID FEMORAL NERVE CONT INFUS 181.00 CUY ANES MDA FEE SCHEDULE - 4258 PR HEART/LUNG RESUSCITATION (CPR) 272.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ECHO HEART XTHORACIC LIMITED 644.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES FAT LAYER REMOVAL PANNICULECTOMY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES REPAIR LO ABD HERNIA NOS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES REPAIR LO HERNIA VENTR/INCIS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES HIP JOINT SURGERY OPEN 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES KNEE JOINT CLOSED PROCEDURE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER LEG CLOSED PROCEDURE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ELBOW AREA SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ARTHROSCPIC OPEN ELBOW 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES NERVE BLOCKS/INJ PRONE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INSERT NON TUNNEL CVCATH UNDER 5 YRS 285.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES FOR INCOMPLETE OR MISSED ABORTION 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES UPPER GI ENDOSCOPY W RETROGRADE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES UPPER/LOWER GI ENDOSCOPY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID ILIOING/HYPOGAST NERVES 337.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID SCIATIC NERVE 138.00 CUY ANES MDA FEE SCHEDULE - 4258 PR REVISE/REMOVE PERIPH/GASTRIC NEUROSTIM/RECEIVER 576.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ECHO HEART TRANSESOPHAGEAL COMPLETE 312.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SKIN SURG HEAD/NECK 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES NECK ORG PROC NOS AGE 1 YR/OLD 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SKIN SURG THORAX EXTR 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SURG BREAST RAD MASTEC 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SURG CLAVICLE SCAPULA 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TRANSURETHRAL SURG NOS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES HYSTEROSCOPY/VAG BX 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES UPPER LEG SURG 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER 1/3 FEMUR OPEN PROC 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TIB/FIB/PATELLA OPEN PROCEDURE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ACHILLES TENDON SURG 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER LEG BONE SURG 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR NEURAXIAL LABOR ANAL/ANES PLAN VAG DEL 368.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INSERT NON TUNNEL CVCATH OVER 5 YRS 395.00 CUY ANES MDA FEE SCHEDULE - 4258 PR FLUOROSCOPIC GUIDE FOR NEEDLE PLACEMENT 508.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES PERC IMG TX SPINE PROC 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR TAP BLCK ABD PLN BLCK RECTUS BLCK UNI INJ W IMG GUID 324.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ULTRASOUND GUIDED NEEDLE PLCMT 67.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INSERT EMERGENCY ENDOTRACH AIRWAY 468.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INSERT CATH ART PERCUT SHORT TERM 131.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID BRACHIAL PLEXUS CONTINOUS 219.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID AXILLARY NERVE 236.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID FEMORAL NERVE 213.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ FORAMEN L/S 1 LEVEL WITH FLUORO OR CT 314.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TYMPANOTOMY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES NOSE SINUS SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES INTRAORAL PROCEDURE NOS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CARDIOVERTER DEFIB 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TRACHBRONCHI INTRATHOR SURG 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SURG UPPER IP ABDOMEN 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES XURETHRAL BLADDER TUMOR SURG 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CLOSED PROC UPPER 2/3 FEMUR 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TOTAL KNEE ARTHROPLASTY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER GI ENDOSCOPY SCREENING COLONOSCOPY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR POS AIRWAY PRESSURE CPAP 305.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES THORACOTOMY PROC W/1 LUNG VENT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ABD WALL LOWER ANTSURG 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES KID STONE DESTRUCT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES MALE GENITALIA SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES RADICAL REMOVE TESTIS INGUINAL 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES REVISE TOTAL HIP ARTHROPLASTY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SHOULDER REPLACEMENT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR TAP BLCK ABD PLN BLCK RECTUS BLCK BIL BY INJ W IMG GUID 392.00 CUY ANES MDA FEE SCHEDULE - 4258 HCHG CATH PLCMT INJ/INFUSE EPI OR SUBA LUMB SACRAL WO GUIDE 294.00 CUY ANES MDA FEE SCHEDULE - 4258 PR VENIPUNC <3 YEARS FEMORAL JUGULAR MD SKILL 83.00 CUY ANES MDA FEE SCHEDULE - 4258 PR VENIPUNCTURE > 3 MD SKILL DX OR TX PURP 68.00 CUY ANES MDA FEE SCHEDULE - 4258 PR CRITICAL CARE 30-74 MINUTES 636.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES GASTRIC RESTRICT MORBID OBESITY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TOTAL HIP ARTHROPLASTY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES OPEN PROC UPPER 2/3 FEMUR 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES AMPUTATION LEG ABOVE KNEE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES KNEE AREA SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES BICEPS TENDON REPAIR 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID LUMBAR PLEXUS CONT INFUS 206.00 CUY ANES MDA FEE SCHEDULE - 4258 HCHG GENERAL ANESTHESIA 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ TRIGGER POINT 1 OR 2 MUSCLES 44.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ LUMBAR EPIDUR BLOOD/CLOT PATCH 651.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID INTERCOSTAL NERVE SGL LVL 100.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CORRECT HEART RHYTHM 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES TUBAL LIGATION/TRANSECTION 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES XURETHRAL REMOVAL OF PROSTATE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES URETERAL STONE REMOVAL 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES BONE MARROW ASP/BX ILIAC CRST 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES UPPER LEG VEINS SURG 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES LOWER LEG VEIN SURG NOS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES SURGERY OF SHOULDER 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ARTHROSCIC OPEN SHOULDER JOINT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ELBOW REPLACEMENT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES FOREARM BONES CLOSED PROC 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CESAREAN DELIVERY ONLY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CES DEL FOL NEURAXIAL ANAL/ANES 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR DAILY MGMT EPIDUR/SUBARACH CONT 538.00 CUY ANES MDA FEE SCHEDULE - 4258 PR VENT MGMT INPAT SUBQ DAY 194.00 CUY ANES MDA FEE SCHEDULE - 4258 PR CATH PLCMT INJ/INFUSE EPI OR SUBA LUMB SACRAL WO GUIDE 352.00 CUY ANES MDA FEE SCHEDULE - 4258 PR MODERATE SED SAME PROVIDER EACH ADDL 15 MINUTES 162.00 CUY ANES MDA FEE SCHEDULE - 4258 HCHG MONITORED ANESTHESIA CARE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR WITHDRAWAL OF ARTERIAL BLOOD 108.00 CUY ANES MDA FEE SCHEDULE - 4258 PR SPINAL PUNCTURE THERAPEUTIC DRAINAGE 174.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID BRACHIAL PLEXUS 219.00 CUY ANES MDA FEE SCHEDULE - 4258 PR INJ(S) ANES AGENT AND/OR STEROID SCIATIC NERVE CONT INFUS 156.00 CUY ANES MDA FEE SCHEDULE - 4258 PR CRITICAL CARE EA ADDL 30 MIN 404.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES PROCEDURES ON EYE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CORNEAL TRANSPLANT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES NECK VESSEL SURG SIMPL LIGAT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CHEST DRAINAGE 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES PACEMAKER INSERTION 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES CENTRL VASCULAR ACCESS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES REPAIR UPPER ABD HERNIA NOS 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES REPAIR UP HERNIA LUMBAR/VENTR 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES ANORECTAL SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES COLPOVAGINECT COLPORRURETH PROC 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES DX ARTHROSCOPIC PROC KNEE JOINT 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES KNEE JOINT CASTING 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES OPEN OR ARTHROSCOPIC LOWER ARM SURGERY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES EXTERNALCEPHALIC VERSION PRC 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR VENT MGMT INPAT INIT DAY 324.00 CUY ANES MDA FEE SCHEDULE - 4258 PR NEWBORN RESUSCITATION 375.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES UPPER GI ENDOSCOPY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR ANES MDA TIMED CUY ONLY 25.00 CUY ANES MDA FEE SCHEDULE - 4258 PR OFFICE OUTPT ESTAB LEVEL 4 474.00 ED PRO FEE PR DRAIN SKIN ABSCESS SIMPLE 386.00 ED PRO FEE PR DRAIN SKIN ABSCESS COMPLIC 649.00 ED PRO FEE PR DEBRIDE TO BONE AT FX SITE 3,105.00 ED PRO FEE PR DEBRIDE SQ TISSUE FIRST 20 SQ CM 629.00 ED PRO FEE PR REPAIR SUPERF WOUND BODY < OR = 2.5 CM 506.00 ED PRO FEE PR REPAIR SUPERF WOUND BODY 7.6-12.5 CM 742.00 ED PRO FEE PR REPAIR SUPERF WOUND FACE EARS EYELIDS 5.1-7.5 CM 661.00 ED PRO FEE PR REPAIR INTERMED LAYER CLOSURE WOUND SCALP TRUNK EXTREM OVER 30 CM 1,437.00 ED PRO FEE PR REPAIR INTERMED WOUND NECK HANDS FEET < OR = 2.5 CM 1,017.00 ED PRO FEE PR REPAIR INTERMED WOUND FACE EARS EYELIDS 20.1-30 CM 1,845.00 ED PRO FEE PR TREAT BURN(S) 1ST DEGREE INITIAL 180.00 ED PRO FEE PR EXPLORE WOUND CHEST 892.00 ED PRO FEE PR INJ CARPAL TUNNEL 566.00 ED PRO FEE PR CLOSED TX NOSE FRACTURE WO STABLIZATION 623.00 ED PRO FEE PR CLOSED TX NOSE FX W STABILIZATN 795.00 ED PRO FEE PR CLOSED TX SCAPULA FX 815.00 ED PRO FEE PR CLOSED TX SHLDR DISLOCATION 849.00 ED PRO FEE PR CLOSED TX SHLDR DISLOC ANESTHESIA 1,148.00 ED PRO FEE PR CLOSED TX ELBOW DISLOCATION 1,296.00 ED PRO FEE PR CLOSED TX RADIAL HEAD DISLOC CHILD 312.00 ED PRO FEE PR CLOSED TX RADIAL SHAFT FX MANIPULATION 1,574.00 ED PRO FEE PR CLOSED TX DIST RAD ULNA FX 1,012.00 ED PRO FEE PR CLOSED TX METACARPAL FX MANIP 1,428.00 ED PRO FEE PR TREAT THUMB DISLOC MANIPULATN 909.00 ED PRO FEE PR CLOSE TX DIST FINGR/THUMB FX 653.00 ED PRO FEE PR CLOSE TX DIST FINGR FX MANIPULATION 1,059.00 ED PRO FEE PR CLOSED TX IP JT DISLOCATION 1,225.00 ED PRO FEE PR CLOSED TX IP JT DISLOCATION ANESTH 1,578.00 ED PRO FEE PR CLOSED TX PATELLA FX 736.00 ED PRO FEE PR CLOSED TX KNEECAP DISLOCATN 953.00 ED PRO FEE PR CLOSED TX MED MALLEOLUS FX MANIP 1,697.00 ED PRO FEE PR CLOSED TX BIMALLEOLAR FX 1,144.00 ED PRO FEE PR CLOSED TX ANKLE DISLOCATN 1,572.00 ED PRO FEE PR CLOSED TX METATARSAL FX 776.00 ED PRO FEE PR CLOSED TX IP JT TOE DISLOC W ANESTH 857.00 ED PRO FEE PR APPLY FOREARM CAST 358.00 ED PRO FEE PR APPLY LONG LEG CAST 522.00 ED PRO FEE PR STRAPPING OF TOES 141.00 ED PRO FEE PR REMOVE NASAL FOREIGN BODY 386.00 ED PRO FEE PR CONTROL NOSEBLEED ANTER COMPLEX 480.00 ED PRO FEE PR INSERT EMERGENCY ENDOTRACH AIRWAY 813.00 ED PRO FEE PR TRACH TUBE CHANGE 112.00 ED PRO FEE PR LARYNGOSCOPY INDIRECT DX 473.00 ED PRO FEE PR VENIPUNC <3 YEARS FEMORAL JUGULAR MD SKILL 55.00 ED PRO FEE PR WITHDRAWAL OF ARTERIAL BLOOD 108.00 ED PRO FEE PR INSERT CATH ART PERCUT SHORT TERM 305.00 ED PRO FEE PR INSERT CATH ART CUTDOWN SHORT TERM 549.00 ED PRO FEE PR REMOVE PHARYNX FOREIGN BODY 291.00 ED PRO FEE PR ANOSCOPY REMOVE FOREIGN BODY 480.00 ED PRO FEE PR I&D BARTHOLIN GLAND ABSCESS 614.00 ED PRO FEE PR COLPORRHAPHY, REPR OF VAGINAL INJURY (NON-OB) 1,910.00 ED PRO FEE PR REMOVE INTRAUTERINE DEVICE 482.00 ED PRO FEE PR INJ(S) ANES AGENT AND/OR STEROID OCCIPITAL NERVE 337.00 ED PRO FEE PR DRAIN EXT AUD CANAL ABSCESS 450.00 ED PRO FEE PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT 267.00 ED PRO FEE PR CRITICAL CARE 30-74 MINUTES 1,290.00 ED PRO FEE PR INSRT PERIPH CV CATH WO PORT WO GUIDANCE UNDER 5 YRS 432.00 ED PRO FEE PR PERC SKELETAL FIXATION DISTAL RADIAL FRACTURE OR EPI SEP 3,184.00 ED PRO FEE HCHG ED US GROIN 1,241.00 ED PRO FEE HCHG MODERATE SED SAME PROVIDER < 5 YRS 1ST 15 MINUTES 173.00 ED PRO FEE TRANS ABD OR VAG US NOT PERFORMED REASON DOCUMENT CLINICIAN 0.01 ED PRO FEE RH-IMMUNOGLOBULIN ORDERED 0.01 ED PRO FEE PR THORACENTESIS W/O GUIDANCE 695.00 ED PRO FEE PR EXCISION OF NAIL FOLD TOE 367.00 ED PRO FEE PR REPAIR SUPERF WOUND BODY 12.6-20 CM 743.00 ED PRO FEE PR REPAIR SUPERF WOUND FACE EARS EYELIDS 2.6-5 CM 561.00 ED PRO FEE PR REPAIR SUPERF WOUND FACE EARS EYELIDS 7.6-12.5 CM 850.00 ED PRO FEE PR REPAIR SUPERF WOUND FACE EARS EYELIDS 12.6-20 CM 1,122.00 ED PRO FEE PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 7.6-12.5 CM 1,227.00 ED PRO FEE PR REPAIR INTERMED WOUND NECK HANDS FEET 2.6-7.5 CM 1,166.00 ED PRO FEE PR DRESS/DEBRID MED BURN 5-10% TBSA 437.00 ED PRO FEE PR REMOVAL OF FB MUSCLE DEEP/COMPLIC 1,902.00 ED PRO FEE PR INJ TENDON SHEATH/LIGAMENT 272.00 ED PRO FEE PR CLOSED TX PROX HUMERUS FX W MANIP 1,941.00 ED PRO FEE PR CLOSED TX GR TUBEROSITY HUM FX 926.00 ED PRO FEE PR CLOSED TX HUMERAL SUPRACONDYLAR FX 1,302.00 ED PRO FEE PR CLOSED TX HUM SUPRACONDYLR FX MANIPU 2,782.00 ED PRO FEE PR CLOSED TX RAD/ULNA SHAFT FX 960.00 ED PRO FEE PR OPEN TX DIST FINGR FX 1,721.00 ED PRO FEE PR CLOSED TX MED MALLEOLUS FX 1,150.00 ED PRO FEE PR CLOSED TX TRIMALLEOLAR FX MANIP 2,498.00 ED PRO FEE PR CLOSED TX HEEL FX 1,012.00 ED PRO FEE PR CLOSED TX BIG TOE FRACTURE 516.00 ED PRO FEE PR CLOSED TX TAR-METATAR DISLOCATION 468.00 ED PRO FEE PR STRAPPING OF SHOULDER 318.00 ED PRO FEE PR APPLY UNNA BOOT 242.00 ED PRO FEE PR CONTROL NOSEBLEED ANTER SIMPLE 487.00 ED PRO FEE PR REPAIR BL VES DIRECT LOW EXTREM 7,935.00 ED PRO FEE PR VENOUS CUTDOWN <1 YEARS 281.00 ED PRO FEE PR DRAIN MOUTH ABSC/CYST/HEMATOMA SIMPL 424.00 ED PRO FEE PR INCISE EXTERNAL HEMORRHOID 607.00 ED PRO FEE PR DRAINAGE SCROTAL WALL ABSCESS 769.00 ED PRO FEE PR INJ LUMBAR EPIDUR BLOOD/CLOT PATCH 651.00 ED PRO FEE PR INJ(S) ANES AGENT AND/OR STEROID INTERCOST NERVE EA ADDL LVL 468.00 ED PRO FEE PR INJ(S) ANES AGENT AND/OR STEROID OTH PERIPH NERVE/BRANCH 332.00 ED PRO FEE PR REMOVE FB EYE SUPERF CONJUNC 343.00 ED PRO FEE PR REMOVE FB EYE CORNEA NO SLIT 295.00 ED PRO FEE PR NASOPHARYNGOSCOPY 248.00 ED PRO FEE PR ECHO HEART TRANSESOPHAGEAL COMPLETE 311.00 ED PRO FEE PR INPATIENT CONSULT LEVL I 250.00 ED PRO FEE PR INPATIENT CONSULT LEVL 5 942.00 ED PRO FEE PR THORACOSCOPIC EVACUATION RIGHT HEMOTHORAX 812.00 ED PRO FEE PR ACTIVE WOUND CARE FIRST 20 SQ CM OR LESS 81.00 ED PRO FEE PR MODERATE SED SAME PROVIDER EACH ADDL 15 MINUTES 171.00 ED PRO FEE PERFORMANCE OF TRANS-ABDOMINAL OR TRANS-VAGINAL ULTRASOUND 0.01 ED PRO FEE PR INCISION AND DRAINAGE OF HEMATOMA/SEROMA OR FLUID 524.00 ED PRO FEE PR REMOVAL OF SKIN TAGS UP TO 15 347.00 ED PRO FEE PR REPAIR SUPERF WOUND BODY 2.6-7.5 CM 638.00 ED PRO FEE PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM < OR = 2.5CM 603.00 ED PRO FEE PR REPAIR INTERMED WOUND NECK HANDS FEET 12.6-20 CM 1,436.00 ED PRO FEE PR REPAIR INTERMED WOUND FACE EARS EYELIDS 2.5-5.0 CM 1,225.00 ED PRO FEE PR REPAIR INTERMED WOUND FACE EARS EYELIDS 5.1-7.5 CM 1,355.00 ED PRO FEE PR REPAIR COMPLEX WOUND TRUNK 2.6-7.5 CM 1,323.00 ED PRO FEE PR REPAIR COMPLEX WOUND SCALP EXTR 1.1-2.5 CM 1,092.00 ED PRO FEE PR REPAIR COMPLEX WOUND EYELID NOSE EAR 1.1-2.5 CM 1,269.00 ED PRO FEE PR CHEMICAL CAUTERY GRANULATION TISSUE 242.00 ED PRO FEE PR EXPLORE WOUND NECK 2,790.00 ED PRO FEE PR INJ TRIGGER POINTS 3 OR > MUSCLES 413.00 ED PRO FEE PR DRAIN/INJ SMALL JOINT/BURSA FINGERS TOES WO US GUIDE 256.00 ED PRO FEE PR DRAIN/INJ MAJOR JOINT/BURSA HIP KNEE WO US GUIDE 549.00 ED PRO FEE PR CLOSED TX NOSE FRACTURE WO MANIP 257.00 ED PRO FEE PR CLOSED TX CLAVICLE FRACTURE 769.00 ED PRO FEE PR CLOSED TX MID HUMERUS FX MANIPULATN 1,531.00 ED PRO FEE PR CLOSED TX PROX ULNA FRACTURE 1,003.00 ED PRO FEE PR CLOSED TX PROX ULNA FX MANIPULATN 1,377.00 ED PRO FEE PR CLOSED TX RAD/ULNA SHAFT FXMANIP 2,124.00 ED PRO FEE PR CLOSED TX CARPOMETACAR DISLOC NON THUMB 938.00 ED PRO FEE PR CLOSED TX POST HIP ARTHRPLAS DISLOC 1,818.00 ED PRO FEE PR CLOSED TX KNEE DISLOC W ANESTH 1,974.00 ED PRO FEE PR CLOSED TX DIST FIBULA FX 1,106.00 ED PRO FEE PR REMOVE FOOT FOREIGN BODY DEEP 1,921.00 ED PRO FEE PR CLOSED TX METATARSAL FX W MANIP 986.00 ED PRO FEE PR CLOSED TX BIG TOE FX W MANIP 580.00 ED PRO FEE PR CLOSED TX TOE FX 454.00 ED PRO FEE PR CLOSED TX IP JT TOE DISLOCATION 343.00 ED PRO FEE PR STRAPPING OF ELBOW OR WRIST 146.00 ED PRO FEE PR APPLY SHORT LEG CAST 475.00 ED PRO FEE PR WINDOWING OF CAST 189.00 ED PRO FEE PR REPEAT CONTROL OF NOSEBLEED 876.00 ED PRO FEE PR LARYNGOSCOPY FLEX DIAGNOSTIC 501.00 ED PRO FEE PR EPISIOTOMY/VAGINAL REPAIR BY OTHR MD 984.00 ED PRO FEE PR CURETTE/TREAT CORNEA 311.00 ED PRO FEE PR PHLEBOTOMY THERAPEUTIC 364.00 ED PRO FEE PR INITIAL OBSERVATION CARE LEVL 3 586.00 ED PRO FEE PR DIRECT ADVANCED LIFE SUPPORT 386.00 ED PRO FEE PR REPLACE G/C TUBE PERC 2,321.00 ED PRO FEE PR RF STRAPPING OF SHOULDER 318.00 ED PRO FEE PR REMOVE IMPACTED CERUMEN USING IRRIGATION LAVAGE UNILATERAL 29.00 ED PRO FEE PR DRAIN PILONIDAL CYST COMPLIC 885.00 ED PRO FEE PR COMPLEX DRAINAGE POSTOP WOUND 3,255.00 ED PRO FEE PR DEBRIDE INFECTED/ECZEMATOUS SKIN 242.00 ED PRO FEE PR SHAV SKIN LESION < 0.5 CM TRUNK ARM LEG 281.00 ED PRO FEE PR EXC SKIN BENIGN 0.6-1 CM TRUNK ARM LEG 474.00 ED PRO FEE PR DEBRIDEMENT OF NAIL(S) 1-5 426.00 ED PRO FEE PR REPAIR SUPERF WOUND FACE EARS EYELIDS OVER 30CM 1,966.00 ED PRO FEE PR CLOSURE SUPERF WND DEHIS SIMPLE 1,080.00 ED PRO FEE PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 20.1-30 CM 1,177.00 ED PRO FEE PR REMOVAL OF FB MUSCLE SIMPLE 460.00 ED PRO FEE PR CLOSED TX STERNUM FRACTURE 567.00 ED PRO FEE PR CLOSED TX A C JT DISLOC 701.00 ED PRO FEE PR CLOSED TX RADIAL HEAD/NECK FX 899.00 ED PRO FEE PR REMOVE FOREARM/WRIST FOREIGN BODY 2,029.00 ED PRO FEE PR CLOSED TX METACARPAL FX 993.00 ED PRO FEE PR OPEN TX METACARPAL FX 2,994.00 ED PRO FEE PR CLOSE TX PROX MID FING OR THUMB SHFT FX MANIP 1,471.00 ED PRO FEE PR CLOSE TX FINGR ARTICULAR FX MANIP 1,293.00 ED PRO FEE PR CLOSED TX TIBIA SHAFT FX MANIPULATN 2,226.00 ED PRO FEE PR CLOSED TX TALUS FX MANIPULATN 1,137.00 ED PRO FEE PR CLOSED TX MT JT DISLOCATION 501.00 ED PRO FEE PR APPLY HAND/WRIST CAST 408.00 ED PRO FEE PR APPLY LONG LEG SPLINT 326.00 ED PRO FEE PR STRAPPING ANKLE AND/OR FOOT 150.00 ED PRO FEE PR CONTROL NOSEBLEED POST W/PACKS AND/OR CAUT 1,143.00 ED PRO FEE PR TRACHEOSTOMY EMERG XTRACH 4,335.00 ED PRO FEE PR BRONCHOSCOPY REMOVE FB 2,020.00 ED PRO FEE PR PLACE NEEDLE IN VEIN 86.00 ED PRO FEE PR VENIPUNC <3 YEARS OTHER MD SKILL 71.00 ED PRO FEE PR BLOOD TRANSFUSION SERVICE 189.00 ED PRO FEE PR REPAIR MOUTH LACERATION>2.5CM 812.00 ED PRO FEE PR CRICOPHAYNGEAL MYOTOMY 2,130.00 ED PRO FEE PR PROCTOSIGMOIDOSCOPY RIGID DIAGNOS 562.00 ED PRO FEE PR CHANGE OF BLADDER TUBE SIMPLE 208.00 ED PRO FEE PR I&D OF VULVA/PERINEUM ABSCESS 535.00 ED PRO FEE PR INJ(S) ANES AND/OR STEROID TRIGEMIN NERVE EACH BRANCH 292.00 ED PRO FEE PR INJ(S) ANES AGENT AND/OR STEROID INTERCOSTAL NERVE SGL LVL 337.00 ED PRO FEE PR REMOVE EXT CANAL FOREIGN BODY 483.00 ED PRO FEE PR REPAIR CONJUNC LACERATN 561.00 ED PRO FEE PR INDUCTION OF VOMITING 529.00 ED PRO FEE PR ULTRASOUND GUIDE NEEDLE PLACEMENT 531.00 ED PRO FEE PR RF WOUND DEBRIDEMNT NON-SELECTIVE EA 310.00 ED PRO FEE PR INJ N BLOCK PLANTAR DIGIT 274.00 ED PRO FEE PR MODERATE SED SAME PROVIDER < 5 YRS 1ST 15 MINUTES 173.00 ED PRO FEE PR MODERATE SED SAME PROVIDER > 5 YRS 1ST 15 MINUTES 114.00 ED PRO FEE PR MODERATE SED DIFF PROVIDER > 5 YRS 1ST 15 MINUTES 210.00 ED PRO FEE PR REMOVE FOREIGN BODY COMPLIC 885.00 ED PRO FEE PR EXC SKIN BENIGN < 0.5 CM SCALP NECK HANDS FEET 397.00 ED PRO FEE PR AVULSION OF NAIL PLATE EA ADDL 205.00 ED PRO FEE PR REMOVAL OF NAIL BED PERMANENT 943.00 ED PRO FEE PR REPAIR SUPERF WOUND FACE EARS EYELIDS < OR = 2.5 CM 543.00 ED PRO FEE PR REPAIR SUPERF WOUND FACE EARS EYELIDS 20.1-30 CM 1,475.00 ED PRO FEE PR REPAIR INTERMED WOUND FACE EARS EYELIDS < 2.5 CM 1,077.00 ED PRO FEE PR INJ TRIGGER POINT 1 OR 2 MUSCLES 575.00 ED PRO FEE PR DRAIN/INJ INTERMEDIATE JOINT/BURSA WO US GUIDE 280.00 ED PRO FEE PR CLOSED TX SHLDR DISLOC W GR TUB FX 812.00 ED PRO FEE PR CLOSED TX MID HUMERUS FRACTURE 1,205.00 ED PRO FEE PR CLOSED TX ULNA STYLOID FX 1,283.00 ED PRO FEE PR CLOSED TX RADIOULNAR DISLOCATION 1,542.00 ED PRO FEE PR REPAIR EXTEN TENDON DORSUM FINGER EA 2,440.00 ED PRO FEE PR CLOSED TX MCP DISLOC 1,369.00 ED PRO FEE PR CLOSED TX POST HIP FIX DISLOC ANESTH 2,840.00 ED PRO FEE PR CLOSED TX PROX/SHAFT FIBULA FX 1,034.00 ED PRO FEE PR CLOSED TX WEIGHT BEAR DIST TIB MANIP 2,591.00 ED PRO FEE PR REMOVE FOOT FOREIGN BODY SUBQ 1,178.00 ED PRO FEE PR CLOSED TX TARSAL DISLOCATION 599.00 ED PRO FEE PR APPLY FOREARM SPLINT STATIC 289.00 ED PRO FEE PR APPLY FINGER SPLINT STATIC 216.00 ED PRO FEE PR REMOVE/REVISN FULL ARM/LEG CAST 610.00 ED PRO FEE PR LARYNGOSCOPY INDIRECT W REMOVE FB 568.00 ED PRO FEE PR VENIPUNCTURE > 3 MD SKILL DX OR TX PURP 80.00 ED PRO FEE PR REPAIR MOUTH LACERATION<2.5CM 445.00 ED PRO FEE PR I&D PERIRECTAL ABSCESS 2,970.00 ED PRO FEE PR I & D PERIANAL ABSCESSSUPERFICIAL 370.00 ED PRO FEE PR CHANGE OF BLADDER TUBE COMPLICATED 2,328.00 ED PRO FEE PR MEASURE POST VOID RESID US NON IMAGING 76.00 ED PRO FEE PR INJ(S) ANES AGENT AND/OR STEROID FEMORAL NERVE 238.00 ED PRO FEE PR DRAIN EXT EAR ABSCESS BLOOD SIMPLE 389.00 ED PRO FEE PR DRAINAGE OF EYELID ABSCESS 431.00 ED PRO FEE PR REMOVE EYELID FOREIGN BODY EMBEDDED 407.00 ED PRO FEE PR TEMPORARY EXTERNAL PACING 48.00 ED PRO FEE PR ECHO HEART XTHORACIC LIMITED 164.00 ED PRO FEE PR PULSE OXIMETRY MULTIPLE 132.00 ED PRO FEE PR INPATIENT CONSULT LEVL 4 699.00 ED PRO FEE PR CRITICAL CARE EA ADDL 30 MIN 612.00 ED PRO FEE PR INSERT TUN CV CATH W/O PORT >5 YRS HOSP 1,461.00 ED PRO FEE PR RMV TUN CV ACCESS DEV W PORT OR PUMP 1,305.00 ED PRO FEE HCHG EP EVAL SGL/DUAL ICD W PROGRAMMING 732.00 ED PRO FEE HCHG SHOE POST-OP DLX 85.00 ED PRO FEE PR PERC REPLACEMENT GTUBE NOT REQ REVISION GASTRO TRACT 100.00 ED PRO FEE PR TRANS ABD OR VAG US NOT PERFORMED REASON NOT GIVEN 0.01 ED PRO FEE RH-IMMUNOGLOBULIN NOT ORDERED REASON DOCUMENT BY CLINICIAN 0.01 ED PRO FEE DOCUMENTATION RH-IMMUNOGLOBULIN NOT ORDERED REASON NOT GIVEN 0.01 ED PRO FEE PR DRAIN SUBUNGUAL HEMATOMA 204.00 ED PRO FEE PR REPAIR SUPERF WOUND BODY 20.1-30 CM 853.00 ED PRO FEE PR REPAIR SUPERF WOUND BODY OVER 30 CM 1,071.00 ED PRO FEE PR REPAIR INTERMED WOUND NECK HANDS FEET 20.1-30 CM 1,086.00 ED PRO FEE PR REPAIR INTERMED WOUND NECK HANDS FEET >30CM 1,615.00 ED PRO FEE PR REPAIR INTERMED WOUND FACE EARS EYELIDS 12.6-20 CM 141.00 ED PRO FEE PR REPAIR COMPLEX WOUND FACE HAND FEET EA ADDL 5CM OR LESS 574.00 ED PRO FEE PR SECD CLOS SURG WND EXTEN/COMPLIC 3,418.00 ED PRO FEE PR DRESS/DEBRID SMALL BURN <5% TBSA 262.00 ED PRO FEE PR EXPLORE WOUND ABDOMEN/FLANK/BACK 1,092.00 ED PRO FEE PR EXPLORE WOUND EXTREMITY 1,223.00 ED PRO FEE PR CLOSED TX CLAVICLE FX MANIPULATN 1,290.00 ED PRO FEE PR INCIS/DRAIN ARM/ELBOW INFECT BURSA 953.00 ED PRO FEE PR CLOSED TX ELBOW DISLOCATN ANESTHESIA 1,935.00 ED PRO FEE PR CLOSED TX ULNA SHAFT FX MANIPULATION 1,749.00 ED PRO FEE PR CLOSED TX DIST RAD ULNA FX MANIPUL 2,416.00 ED PRO FEE PR CLOSED TX CARPAL FX EXCEPT SCAPHOID/NAVICULAR 1,061.00 ED PRO FEE PR DRAIN FINGER ABSCESS COMPLICATED 1,687.00 ED PRO FEE PR CLOSED TX DIST FIBULA FX MANIP 1,810.00 ED PRO FEE PR CLOSED TX ANKLE DISLOCATN ANESTH 1,935.00 ED PRO FEE PR REMOVE FOOT FOREIGN BODY COMPLEX 1,471.00 ED PRO FEE PR APPLY LONG ARM CAST 423.00 ED PRO FEE PR STRAPPING OF HAND OR FINGER 136.00 ED PRO FEE PR REPAIR BL VES DIRECT UP EXTREM 1,872.00 ED PRO FEE PR DRAINAGE OF GUM LESION 463.00 ED PRO FEE PR LUMBAR PUNCTURE DIAGNOSTIC 612.00 ED PRO FEE PR DRAIN EXT EAR ABSCESS BLOOD COMPLIC 599.00 ED PRO FEE PR REMOVE FB EYE EMBED CONJUNC 397.00 ED PRO FEE PR INCISION OF EYELID FOLD 536.00 ED PRO FEE PR RHYTHM ECG REPORT 58.00 ED PRO FEE PR PULSE OXIMETRY SINGLE DETERMINATION 55.00 ED PRO FEE PR WOUND DEBRIDEMNT NON-SELECTIVE EA 82.00 ED PRO FEE PR INPATIENT CONSULT LEVL 2 385.00 ED PRO FEE PR INPATIENT CONSULT LEVL 3 504.00 ED PRO FEE PR INSRT PERIPH CV CATH WO PORT WO GUIDANCE OVER 5 YRS 776.00 ED PRO FEE PR RPR CV CATH WO PORTOR PUMP 518.00 ED PRO FEE HCHG RC CONT INHALATION TREATMENT EA ADDL HR 74.00 ED PRO FEE HCHG CATHETERIZATION UA SPECIMEN COL 56.00 ED PRO FEE PR RF STRAPPING OF ELBOW OR WRIST 146.00 ED PRO FEE PR MODERATE SED SAME PROVIDER EACH ADDL 15 MINUTES 26.00 ED PRO FEE PR DRAIN PILONIDAL CYST SIMPL 570.00 ED PRO FEE PR PUNCTURE DRAINAGE OF CYST/HEMATOMA 423.00 ED PRO FEE PR AVULSION OF NAIL PLATE SINGLE 447.00 ED PRO FEE PR REPAIR COMPLEX WOUND TRUNK 1.1-2.5 CM 1,063.00 ED PRO FEE PR REPAIR COMPLEX WOUND SCALP EXTR 2.6-7.5 CM 1,462.00 ED PRO FEE PR REPAIR COMPLEX WOUND FACE HAND FEET 1.1-2.5 CM 1,204.00 ED PRO FEE PB REPAIR COMPLEX WOUND FACE HAND FEET 2.6-7.5 CM 2,036.00 ED PRO FEE PR CLOSED TX A C JT DISLOC W MANIPULATN 965.00 ED PRO FEE PR REPAIR FOREARM TEND MUSC FLEX PRIM EA 2,358.00 ED PRO FEE PR CLOSED TX ULNA SHAFT FX 890.00 ED PRO FEE PR DRAIN FINGER ABSCESS SIMPLE 1,262.00 ED PRO FEE PR TREAT THUMB FX DISLOC MANIP 1,211.00 ED PRO FEE PR CLOSE TX PROX/MID FING OR THUMB SHFT FX 694.00 ED PRO FEE PR CLOSE TX FINGR ARTICULAR FX 829.00 ED PRO FEE PR CLOSED TX FEMUR SHAFT FX W MANIP 2,370.00 ED PRO FEE PR CLOSED TX KNEE DISLOCATN 1,512.00 ED PRO FEE PR CLOSED TX TALUS FX 912.00 ED PRO FEE PR CLOSED TX TARSAL FX EA 867.00 ED PRO FEE PR APPLY LONG ARM SPLINT 361.00 ED PRO FEE PR APPLY SHORT LEG CAST WALKER 292.00 ED PRO FEE PR REMOVE/REVISN BOOT/BODY CAST 168.00 ED PRO FEE PR OPEN CHEST HEART MASSAGE 4,909.00 ED PRO FEE PR INSER HEART TEMP PACER ONE CHMBR 1,213.00 ED PRO FEE PR VENOUS CUTDOWN >1 YEARS 157.00 ED PRO FEE PR INSERT NEEDLE INTRAOSSEOUS INFUSN 451.00 ED PRO FEE PR I AND D TONGUE/INTRAORAL ABSCESS 420.00 ED PRO FEE PR REPAIR TONGUE LACER 2.6CMOR MORE/COMPLX 731.00 ED PRO FEE PR INC/DRAIN PERITONSIL ABSCESS 413.00 ED PRO FEE PR INTRO LONG GI TUBE 94.00 ED PRO FEE PR STRAIGHT CATHETERIZATION 251.00 ED PRO FEE PR INSERT TEMP INDWELLING CATH SIMPLE 136.00 ED PRO FEE PR INSERT TEMP INDWELLING CATH COMPLICATED 294.00 ED PRO FEE PR IRRIGAT CORPUS CAVERN PRIAPISM 450.00 ED PRO FEE PR HEART/LUNG RESUSCITATION (CPR) 1,373.00 ED PRO FEE PR CARDIOVERSION ELECTIVE EXTERN 1,423.00 ED PRO FEE PR EXTNL ECG CONTINUOUS RHYTHM MD REV AND INTERP UP TO 48 HRS 373.00 ED PRO FEE PR PROLONGED SERVICE WO CONTACT EA ADD 30 MIN 183.00 ED PRO FEE PR INSERT NON TUNNEL CVCATH OVER 5 YRS 936.00 ED PRO FEE PR RF STRAPPING OF HAND OR FINGER 136.00 ED PRO FEE PR ABD PARACENTESIS W IMAGING 2,122.00 ED PRO FEE PR CRITICAL CARE TELEHEALTH INITIAL CONSULT 60 MINUTES 655.00 ED PRO FEE PR MODERATE SED DIFF PROVIDER EACH ADDL 15 MINUTES 36.00 ED PRO FEE PR REMOVE FOREIGN BODY SIMPLE 717.00 ED PRO FEE PR DEBRIDE SKIN/SUBQ AT FX SITE 1,908.00 ED PRO FEE PR DEBRIDE TO MUSC/FASCIA AT FX SITE 2,235.00 ED PRO FEE PR REPAIR OF NAIL BED 967.00 ED PRO FEE PR EXCISION PILONIDAL CYST SIMPLE 1,334.00 ED PRO FEE PR CLOSURE SUPERF WND DEHIS W PACKING 510.00 ED PRO FEE PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 2.6-7.5 CM 1,013.00 ED PRO FEE PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 12.6-20 CM 1,485.00 ED PRO FEE PR REPAIR INTERMED WOUND NECK HANDS FEET 7.6-12.5 CM 1,341.00 ED PRO FEE PR REPAIR INTERMED WOUND FACE EARS EYELIDS 7.6-12.5 CM 813.00 ED PRO FEE PR REPAIR INTERMED WOUND FACE EARS EYELIDS OVER 30 CM 2,117.00 ED PRO FEE PR REPAIR COMPLEX WOUND SCALP EXTR EA ADDL 5CM OR LESS 586.00 ED PRO FEE PR REPAIR COMPLEX WOUND EYELID NOSE EAR 2.5-7.5 CM 2,260.00 ED PRO FEE PR DRESS/DEBRID LARGE BURN >10% TBSA 470.00 ED PRO FEE PR REDUCE TEMPOROMANDIBL DISLOC 266.00 ED PRO FEE PR BIOPSY SOFT TISSUE BACK SUPERF 751.00 ED PRO FEE PR CLOSED TX RADIAL HEAD/NECK FX MANIP 1,546.00 ED PRO FEE PR CLOSED TX RADIAL SHAFT FX 919.00 ED PRO FEE PR CLOSED TX NAVICULAR FX 1,059.00 ED PRO FEE PR CLOSED TREAT WRIST DISLOCATION 1,360.00 ED PRO FEE PR REPAIR EXTEN TENDON DORSUM HAND EA 2,120.00 ED PRO FEE PR CLOSED TX MCP DISLOC W ANESTH 1,408.00 ED PRO FEE PR OPEN TX PROX MID FING OR THUMB SHFT FX 2,380.00 ED PRO FEE PR INJ SACROILIAC JOINT 536.00 ED PRO FEE PR CLOSED TX TRAUMATIC HIP DISLOCATN 1,845.00 ED PRO FEE PR CLOSED TX KNEE CAP DISLOC W ANESTH 1,446.00 ED PRO FEE PR CLOSED TX TIBIA SHAFT FX 1,302.00 ED PRO FEE PR CLOSED TX BIMALLEOLAR FX MANIP 2,305.00 ED PRO FEE PR CLOSED TX TARSAL FX MANIP EA 1,048.00 ED PRO FEE PR CLOSED TX TOE FX MANIPULATN 549.00 ED PRO FEE PR CLOSED TX TALOTARSAL DISLOC 605.00 ED PRO FEE PR APPLY LOWER LEG SPLINT 304.00 ED PRO FEE PR STRAPPING OF KNEE 176.00 ED PRO FEE PR VENIPUNC <3 YEARS SCALP MD SKILL 124.00 ED PRO FEE PR REPAIR LIP FULL THICK VERMILION 1,695.00 ED PRO FEE PR REPAIR TONGUE LACER<2.6CM 547.00 ED PRO FEE PR PLACEMENT NG/OG TUBE BY PHYSICIAN 392.00 ED PRO FEE PR REPOSITION GASTROSTOMY TUBE 411.00 ED PRO FEE PR REMOVAL OF HEMORRHOID CLOT 418.00 ED PRO FEE PR DIAG ANOSCOPY INC COL SPEC BY BRUSH WASH WHEN PERF SEP PROC 349.00 ED PRO FEE PR IRRIGATION OF BLADDER 318.00 ED PRO FEE PR REMOVE FB EYE CORNEA SLIT LAMP 277.00 ED PRO FEE PR OSTEOPATHIC MANIP 1-2 BODY REGN 176.00 ED PRO FEE HCHG ED LEVEL 1 CONV CARE AFFILIATE ONLY 116.00 ED PRO FEE PR PROLONGED SERVICE WO CONTACT 1ST HR 382.00 ED PRO FEE PR INSRT TUN CV ACS DEVW PORT OVER 5 YRS 4,456.00 ED PRO FEE PR CHEST TUBE INSERTION INC DRAIN CONNECT 1,003.00 ED PRO FEE PR MODERATE SED DIFF PROVIDER < 5 YRS 1ST 15 MINUTES 346.00 ED PRO FEE PR EMERGENCY DEPT VISIT LEVEL 2 418.00 ED PRO FEE PR EMERGENCY DEPT VISIT LEVEL 3 542.00 ED PRO FEE PR EMERGENCY DEPT VISIT LEVEL 4 817.00 ED PRO FEE PR EMERGENCY DEPT VISIT LEVEL 5 973.00 ED PRO FEE PR EMERGENCY DEPT VISIT LEVEL I 161.00 ED PRO FEE PR INITIAL OBSERVATION CARE LEVL I 300.00 HOSPITAL BASED ED LVL 1 HCHG 1,012.00 HOSPITAL BASED ED LVL 2 HCHG 1,250.00 HOSPITAL BASED ED LVL 3 HCHG 1,945.00 HOSPITAL BASED ED LVL 4 HCHG 2,771.00 HOSPITAL BASED ED LVL 5 HCHG 4,027.00 HOSPITAL BASED HCHG E/M EST PT LEVEL I 181.00 HOSPITAL BASED HCHG ENDO CANCELLED CASE AFFILIATE ONLY 60.00 HOSPITAL BASED HCHG THER PROC INCR RESP STRNGTH/ENDUR 15MIN 1:1 79.00 HOSPITAL BASED HCHG PT E-STIM UNATTENDED OTHER THAN WOUND 51.00 HOSPITAL BASED HCHG PT FLUIDOTHERAPY 68.00 HOSPITAL BASED HCHG PT GAIT TRAINING 15MIN 71.00 HOSPITAL BASED HCHG PT NONSELECTIVE DEBRIDEMENT/SLOUGH WOUNDS 302.00 HOSPITAL BASED HCHG PT WORK HARDENING INITIAL 2HRS 629.00 HOSPITAL BASED HCHG OT WORK CONDITIONING EA ADDL HR 348.00 HOSPITAL BASED HCHG SLP TX FOR SPCH GEN DEVICE 245.00 HOSPITAL BASED HCHG ED LEVEL 1 CONV CARE AFFILIATE ONLY 116.00 HOSPITAL BASED HCHG ED EMERGENT PROCEDURE MAJOR 2,638.00 HOSPITAL BASED HCHG RC PULSE OXIMETRY OVERNIGHT 320.00 HOSPITAL BASED HCHG SPIROMETRY INCOMPLETE 437.00 HOSPITAL BASED HCHG DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS COMP/DX EVAL 261.00 HOSPITAL BASED HCHG AMBULATORY/BLADDER IRRIGATION, SIMPLE 318.00 HOSPITAL BASED HCHG AMB OWNED BLS AMBULATORY 1,559.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL V 1,431.00 HOSPITAL BASED HCHG EXTNL ECG CONTIN MONIT SCAN AND ANALY UP TO 48 HR 545.00 HOSPITAL BASED HCHG GASTRIC MOTILITY/MANOMETRY 576.00 HOSPITAL BASED HCHG EXTRA ENDO TIME PER MINUTE 52.00 HOSPITAL BASED HCHG BONE MARROW BIOPSY(IES) NEEDLE/TROCAR-TX 177.00 HOSPITAL BASED HCHG NEEDLE EMG 1 EXTREMITY W/WO PARASPINAL 511.00 HOSPITAL BASED HCHG NEEDLE EMG 2 EXTREMITIES W/WO PARASPINAL 511.00 HOSPITAL BASED HCHG DSMT OUTPT INDIV PER 30 MIN 102.00 HOSPITAL BASED HCHG MNT INDIV SUBSEQ EA 15 MIN 80.00 HOSPITAL BASED HCHG RBC LR IRR 790.00 HOSPITAL BASED HCHG LR APHERESIS PLTS 1,640.00 HOSPITAL BASED HCHG PLT LR PHER IRR 1,516.00 HOSPITAL BASED HCHG OT PULSATILE LAVAGE 20 SQ CM OR LESS 256.00 HOSPITAL BASED HCHG SELECTV DEBRIDE EA ADDL 20 SQ CM OR PART THEREOF 220.00 HOSPITAL BASED HCHG OT VAC/NPWT <= 50 SQ CM W DME 448.00 HOSPITAL BASED HCHG KIT CYSTOSCOPY GENERIC 15.00 HOSPITAL BASED HCHG AMB OWNED NON COVERED AMBULANCE MILES 0.00 HOSPITAL BASED HCHG OT PROSTHETIC TRAIN UPR/LWR EXT INITIAL ENC EA 15 MIN 274.00 HOSPITAL BASED HCHG RH IMMUNE GLOBULIN PREP 50 MCG 0.00 HOSPITAL BASED HCHG CHEMO IV PUSH INITIAL 343.00 HOSPITAL BASED HCHG CHEMO IV ADMIN ADDL SEQUENTIAL INFUSION 547.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 ADDL MIN (+ STAFF) 38.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 ADDL MIN (+ STAFF + SETUP) 48.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 (+ STAFF + SETUP) 8,837.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 ADDL MIN 68.00 HOSPITAL BASED HCHG ARC-ANTIBODY ELUTION 188.00 HOSPITAL BASED HCHG RECOVERY PER MINUTE 30.00 HOSPITAL BASED HCHG RC VENTILATION ASSIST FIRST DAY 990.00 HOSPITAL BASED HCHG RC VENTILATION ASSIST, SUBSEQ DAY PT OWN EQUIP 879.00 HOSPITAL BASED HCHG CV STRESS TEST EXERCISE OR PHARM TRACE ONLY 594.00 HOSPITAL BASED HCHG CHEMO INF >8 HRS W PUMP 760.00 HOSPITAL BASED HCHG DEST NEUROLYT W IMAG GUIDE LUMB SACRAL SGL 4,046.00 HOSPITAL BASED HCHG ENDO LEVEL 1 6,571.00 HOSPITAL BASED HCHG ENDO LEVEL 3 7,951.00 HOSPITAL BASED HCHG ENDO LEVEL 6 10,583.00 HOSPITAL BASED HCHG HFO FLEXION GLOVE W ELSTC FNGR CNTRL PREFAB OTS PR10 194.00 HOSPITAL BASED HCHG RN APPL MULTLAY COMPRS LWR LEG 233.00 HOSPITAL BASED HCHG IV INJECTION TX/DX/PROPH INITIAL 224.00 HOSPITAL BASED HCHG FO CUSTOM MOLDED METATARSAL EA 0.00 HOSPITAL BASED PR SUBSQNT OBSERV CARE TO 25 MIN 205.00 HOSPITAL BASED HCHG SLP EVAL SPEECH FLUENCY 514.00 HOSPITAL BASED HCHG SLP BEHAVIORAL QUAL ANLYS VOICE RESONANCE 217.00 HOSPITAL BASED HCHG REMOVE&REPLACE CVD GEN SING LEAD 362.00 HOSPITAL BASED HCHG PT MANUAL THERAPY XE 92.00 HOSPITAL BASED HCHG OT MANUAL THERAPY XU 92.00 HOSPITAL BASED HCHG OT THERAPEUTIC ACTIVITIES XE 261.00 HOSPITAL BASED HCHG OT THERAPEUTIC ACTIVITIES XP 261.00 HOSPITAL BASED HCHG PT SELFCARE/HOME MGMT XS 212.00 HOSPITAL BASED HCHG OT SELFCARE/HOME MGMT XE 212.00 HOSPITAL BASED HCHG OT SELFCARE/HOME MGMT XP 212.00 HOSPITAL BASED HCHG OT THERAPEUTIC EXERCISE XE 101.00 HOSPITAL BASED HCHG PT GAIT TRAINING XU 71.00 HOSPITAL BASED HCHG OT NEUROMUSCULAR RE-ED XP 105.00 HOSPITAL BASED HCHG OT NEUROMUSCULAR RE-ED XU 105.00 HOSPITAL BASED HCHG PT AQUATIC THERAPY XS 130.00 HOSPITAL BASED HCHG PT RE-EVALUATION XE 104.00 HOSPITAL BASED HCHG PT WHIRLPOOL XS 68.00 HOSPITAL BASED HCHG OT WHIRLPOOL XS 68.00 HOSPITAL BASED HCHG OT WHEELCHAIR MGT/PROPUL 15 MIN XU 98.00 HOSPITAL BASED HCHG PT PHY PERF TEST/MEASURE 15 MIN XS 105.00 HOSPITAL BASED HCHG PT COMM/WORK REINTEGRATION 15 MIN XS 94.00 HOSPITAL BASED HCHG OT COMM/WORK REINTEGRATION 15 MIN XP 94.00 HOSPITAL BASED HCHG OT COMM/WORK REINTEGRATION 15 MIN XU 94.00 HOSPITAL BASED HCHG SLP EVAL VIDEO SWALLOW XE 210.00 HOSPITAL BASED HCHG SLP EVAL VIDEO SWALLOW XU 210.00 HOSPITAL BASED HCHG PT E-STIM ATTENDED 15 MIN XS 48.00 HOSPITAL BASED HCHG PT E-STIM ATTENDED 15 MIN XU 48.00 HOSPITAL BASED HCHG OT E-STIM ATTENDED 15 MIN XE 48.00 HOSPITAL BASED HCHG OT E-STIM ATTENDED 15 MIN XS 48.00 HOSPITAL BASED HCHG OT E-STIM ATTENDED 15 MIN XP 48.00 HOSPITAL BASED HCHG SLP EVAL ORAL/PHAR SWALLOWING XS 206.00 HOSPITAL BASED HCHG SLP INDIV TX COMMUNICATION XE 194.00 HOSPITAL BASED HCHG OT SELECTIVE DEBRIDE > 20 SQ CM XU 219.00 HOSPITAL BASED HCHG OT PULSATILE LAVAGE > 20 SQ CM XS 219.00 HOSPITAL BASED HCHG PT SELECTIVE DEBRIDE > 20 SQ CM XE 219.00 HOSPITAL BASED HCHG PT SELECTIVE DEBRIDE > 20 SQ CM XP 219.00 HOSPITAL BASED HCHG OT SELECT DEBRIDE 20 SQ CM OR LESS XS 256.00 HOSPITAL BASED HCHG OT PULSATILE LAV 20 SQ CM OR LESS XS 256.00 HOSPITAL BASED HCHG PT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XU 302.00 HOSPITAL BASED HCHG OT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XU 302.00 HOSPITAL BASED HCHG PT GROUP THERAPY XE 63.00 HOSPITAL BASED HCHG PT GROUP THERAPY XU 63.00 HOSPITAL BASED HCHG SLP ASSESSMENT OF APHASIA W REPORT PER HR XP 254.00 HOSPITAL BASED HCHG XR BLOOD PATCH 656.00 HOSPITAL BASED HCHG PT EVAL LOW COMPLEXITY XS 191.00 HOSPITAL BASED HCHG PT EVAL LOW COMPLEXITY XU 192.00 HOSPITAL BASED HCHG PT EVAL HIGH COMPLEXITY 305.00 HOSPITAL BASED HCHG APPLICATION OF ON BODY INJECTOR TIMED SUBQ INJ 38.00 HOSPITAL BASED HCHG MODERATE SED SAME PROVIDER EACH ADDL 15 MINUTES 171.00 HOSPITAL BASED PR CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH 166.00 HOSPITAL BASED HCHG O/P CARDIAC REHAB EVAL W/CONT MONT KX 318.00 HOSPITAL BASED HCHG PFT C0 MEMBRANE DIFFUSE CAPACITY LIMITED 349.00 HOSPITAL BASED HCHG COMPRESSION STOCKING BK18-30 PR120 AFFILIATE ONLY 54.00 HOSPITAL BASED HCHG CSTM EWHO RIGID WO JOINTS PR820 69.00 HOSPITAL BASED HCHG CSTM L1836 KO RIGID WO JOINTS PREFAB OTS PR110 69.00 HOSPITAL BASED HCHG GRADIENT COMPRESS STOCK THIGH 18-30 PR70 AFFILIATE ONLY 121.00 HOSPITAL BASED HCHG GRADIENT COMPRESS STOCK THIGH 18-30 PR160 AFFILIATE ONLY 233.00 HOSPITAL BASED HCHG SHOE LIFT TAPER METATARSAL PR20 AFFILIATE ONLY 55.00 HOSPITAL BASED HCHG BRACE WRIST WHO CUSTOM PR560 824.00 HOSPITAL BASED HCHG HFO WO JOINTS PREFAB CUSTOM FIT PR80 135.00 HOSPITAL BASED HCHG AFO ANKLE GAUNTLET PREFAB OTS PR80 112.00 HOSPITAL BASED HCHG BRACE WRIST WHO CUSTOM PR527 AFFILIATE ONLY 824.00 HOSPITAL BASED HCHG HFO CUSTOM FABRICATED PR362 AFFILIATE ONLY 576.00 HOSPITAL BASED HCHG CUSTOM L3764 EWHO JOINTS CD PR762 AFFILIATE ONLY 1,162.00 HOSPITAL BASED PR ONLINE DIGITAL E/M SVS EST PATIENT =< 7 DAYS => 21 MIN 101.00 HOSPITAL BASED HCHG NURSERY NO CHARGE 0.00 HOSPITAL BASED HCHG RC AIRWAY INHALATION TX HELIUM 74.00 HOSPITAL BASED HCHG RC CPAP/BI-LEVEL TREATMENT 480.00 HOSPITAL BASED HCHG THER PROC IMPRV RESP FUNC/INCR ENDUR,GROUP 79.00 HOSPITAL BASED HCHG PT E-STIM-ATTENDED 15MIN 48.00 HOSPITAL BASED HCHG PT GROUP THERAPY 63.00 HOSPITAL BASED HCHG PT SELFCARE/HOME MNGMNT 15MIN 212.00 HOSPITAL BASED HCHG PT WHEELCHAIR MGT/PROPUL 15MIN 98.00 HOSPITAL BASED HCHG OT MASSAGE 15MIN 80.00 HOSPITAL BASED HCHG OT RE-EVALUATION 157.00 HOSPITAL BASED HCHG OT SELFCARE/HOME MNGMNT 15MIN 212.00 HOSPITAL BASED HCHG SLP EVAL VIDEO SWALLOW 210.00 HOSPITAL BASED HCHG PFT OSCILLOMETRY 298.00 HOSPITAL BASED HCHG SPIROMETRY BEDSIDE 437.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL V ADDL MIN 45.00 HOSPITAL BASED HCHG EEG AWAKE/ASLEEP 561.00 HOSPITAL BASED HCHG CHEMICAL CAUTERY GRANULATION TISSUE 524.00 HOSPITAL BASED HCHG INSERTION NON-INDWELL/STRGT BLADDER CATH-TX 238.00 HOSPITAL BASED HCHG COMPLEX UROFLOWMETRY(ELECTRONIC) 4,985.00 HOSPITAL BASED HCHG MNT INDIV INITIAL EA 15MIN 95.00 HOSPITAL BASED HCHG ELUTION ABY ID 121.00 HOSPITAL BASED HCHG CRYOPRECIPITATE 609.00 HOSPITAL BASED HCHG IHC SEMIQUANT 130.00 HOSPITAL BASED HCHG PT ULTRAVIOLET 196.00 HOSPITAL BASED HCHG SHOE POST-OP DLX 85.00 HOSPITAL BASED HCHG KIT ACAPELLA GRN VIBRATORY 94.00 HOSPITAL BASED HCHG ARC ANTIGEN TYPE 121.00 HOSPITAL BASED HCHG REFILL/MAINT IMPLANTABLE PUMP 275.00 HOSPITAL BASED HCHG PT PROSTHETIC TRAIN UPR/LWR EXT INITIAL ENC EA 15 MIN 274.00 HOSPITAL BASED HCHG OBSERVATION DIRECT ADMISSION 64.00 HOSPITAL BASED HCHG TX/PROPH/DX ADDL SEQ IV INF 816.00 HOSPITAL BASED HCHG CHEMO IV PUSH EACH ADDL 343.00 HOSPITAL BASED HCHG IV INFUSION TX/DX/PROPHYLAXIS CONCURRENT 368.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 1 (< 2 STAFF) 6,571.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 1 ADDL MIN 30.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 (+ SETUP) 7,275.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 (+ STAFF) 7,262.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 (+ STAFF) 7,996.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 (< 2 STAFF) 8,026.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 ADDL MIN (+ STAFF) 46.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 (+ SETUP) 9,665.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 10,583.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 (+ STAFF) 10,628.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 ADDL MIN (+ STAFF + SETUP) 85.00 HOSPITAL BASED HCHG RC CONT INHALATION TREATMENT EA ADDL HR 74.00 HOSPITAL BASED HCHG HFO WO JOINTS PREFAB CUSTOM FIT PR20 102.00 HOSPITAL BASED HCHG WOUND ULTRASOUND RN 508.00 HOSPITAL BASED PR PHONE E&M EST PATIENT 5-10 MIN 95.00 HOSPITAL BASED HCHG DRSG PR300 33.00 HOSPITAL BASED HCHG OT VASOPNEUMATIC DEVICE 261.00 HOSPITAL BASED HCHG MEAS POST VOID RESID US NON-IMAGING 76.00 HOSPITAL BASED HCHG MISC REHAB SUPPLY AFFILIATE ONLY 17.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP 514.00 HOSPITAL BASED HCHG FETAL MONITORING AFFILIATE ONLY 96.00 HOSPITAL BASED HCHG PT MANUAL THERAPY XP 92.00 HOSPITAL BASED HCHG OT MANUAL THERAPY XE 92.00 HOSPITAL BASED HCHG OT MANUAL THERAPY XP 92.00 HOSPITAL BASED HCHG PT THERAPEUTIC ACTIVITIES XE 261.00 HOSPITAL BASED HCHG OT SELFCARE/HOME MGMT XU 212.00 HOSPITAL BASED HCHG OT THERAPEUTIC EXERCISE XP 101.00 HOSPITAL BASED HCHG OT RE-EVALUATION XS 157.00 HOSPITAL BASED HCHG PT WHIRLPOOL XE 68.00 HOSPITAL BASED HCHG OT WHIRLPOOL XU 68.00 HOSPITAL BASED HCHG OT WHEELCHAIR MGT/PROPUL 15 MIN XP 98.00 HOSPITAL BASED HCHG OT PHY PERF TEST/MEASURE 15 MIN XS 105.00 HOSPITAL BASED HCHG PT PHY PERF TEST/MEASURE 15 MIN XE 105.00 HOSPITAL BASED HCHG PT E-STIM ATTENDED 15 MIN XE 48.00 HOSPITAL BASED HCHG SLP INDIV TX COMMUNICATION XS 194.00 HOSPITAL BASED HCHG OT SELECTIVE DEBRIDE > 20 SQ CM XS 219.00 HOSPITAL BASED HCHG OT PULSATILE LAV 20 SQ CM OR LESS XE 256.00 HOSPITAL BASED HCHG PT SELECT DEBRIDE 20 SQ CM OR LESS XE 256.00 HOSPITAL BASED HCHG PT PULSATILE LAV 20 SQ CM OR LESS XE 256.00 HOSPITAL BASED HCHG OT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XP 302.00 HOSPITAL BASED HCHG PT GROUP THERAPY XS 63.00 HOSPITAL BASED HCHG AMB OWNED ALS NON-EMERG TRANSP LEVEL 1 2,313.00 HOSPITAL BASED HCHG PT EVAL MOD COMPLEXITY XU 248.00 HOSPITAL BASED HCHG PT EVAL HIGH COMPLEXITY XS 305.00 HOSPITAL BASED HCHG OT EVAL LOW COMPLEXITY XU 191.00 HOSPITAL BASED HCHG MODERATE SED SAME PROVIDER > 5 YRS 1ST 15 MINUTES 210.00 HOSPITAL BASED PR BRIEF VIRTUAL CHECK BY MD OR OTHER QHP 5-10 MINUTES 29.00 HOSPITAL BASED HCHG COLD THERAPY PRODUCTS PR100 144.00 HOSPITAL BASED HCHG MNT BEHAVIOR COUNSEL OBESITY EA 15MIN 56.00 HOSPITAL BASED HCHG FACTOR IX ACTIVITY LC 130.00 HOSPITAL BASED HCHG ED BLADDER IRRIGATION SIMPLE AFFILIATE ONLY 318.00 HOSPITAL BASED HCHG ED TRIAGE AFFILIATE ONLY 116.00 HOSPITAL BASED HCHG LO FLEXIBLE L1 <= L5 PREFAB OTS PR100 141.00 HOSPITAL BASED HCHG TRANSFER SHOE CALIPER PLATE EXISTING PR30 AFFILIATE ONLY 108.00 HOSPITAL BASED HCHG PNEUMATIC WALKING BOOT PREFAB CUSTOM FIT PR130 255.00 HOSPITAL BASED HCHG HOLTER COMPLETE UP TO 48 HR AFFILIATE ONLY 224.00 HOSPITAL BASED HCHG BLOOD CULTURE PCR EACH ORGANISM PROBED 101.00 HOSPITAL BASED HCHG PERFUSION SUPPLIES PR192 282.00 HOSPITAL BASED HCHG CAP PR5 58.00 HOSPITAL BASED HCHG WHFO WO JOINTS PREFAB CUSTOM FIT PR362 AFFILIATE ONLY 582.00 HOSPITAL BASED HCHG WOUND SUCTION NEG PRESSURE PR220 47.00 HOSPITAL BASED HCHG NEWBORN NURSE CHECK AFFILIATE ONLY 61.00 HOSPITAL BASED HCHG PT EDUCATION NOC GROUP AFFILIATE ONLY 78.00 HOSPITAL BASED PR QNHP ONLINE E/M SVC EST PATIENT =< 7 DAYS => 21 MIN 78.00 HOSPITAL BASED HCHG SWING BED 4,000.00 HOSPITAL BASED HCHG RC MANIPULATION CHEST WALL INITIAL BASIC 87.00 HOSPITAL BASED HCHG RC MANIPULATION CHEST WALL INITIAL EXTENDED 87.00 HOSPITAL BASED HCHG PT FUNCTIONAL CAPACITY EVAL 15MIN 105.00 HOSPITAL BASED HCHG PT PHONOPHORESIS 15MIN 44.00 HOSPITAL BASED HCHG PT THERAPEUTIC EXERCISE 15MIN 101.00 HOSPITAL BASED HCHG OT E-STIM UNATTENDED OTHER THAN WOUND 51.00 HOSPITAL BASED HCHG OT WORK CONDITIONING INITIAL 2HRS 629.00 HOSPITAL BASED HCHG OT WORK HARDENING EA ADDL HR 348.00 HOSPITAL BASED HCHG SLP EVAL ORAL/PHAR SWALLOWING 206.00 HOSPITAL BASED HCHG NEW PT FAC VISIT LEVEL I AFFILIATE AND CK ONLY 150.00 HOSPITAL BASED HCHG RC METHACHOLINE CHALLENGE 709.00 HOSPITAL BASED HCHG DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LTD 261.00 HOSPITAL BASED HCHG EP EVAL SGL/DUAL ICD W PROGRAMMING 732.00 HOSPITAL BASED HCHG POSTOP PHASE II 199.00 HOSPITAL BASED HCHG BX ABD/RETROP MASS PERCUTANEOUS NEEDLE 2,801.00 HOSPITAL BASED HCHG DEBRIDEMENT OF NAILS ONE TO FIVE 250.00 HOSPITAL BASED HCHG STRAPPING UNNA BOOT 370.00 HOSPITAL BASED HCHG MNT GROUP EA 30 MIN 15.00 HOSPITAL BASED HCHG O/P CARDIAC REHAB WITHOUT CONT MONITOR 92.00 HOSPITAL BASED HCHG RHO D IMMUNE GLOB 625.00 HOSPITAL BASED HCHG ED BLOOD DRAW THROUGH COMPLETELY IMPLANTED VAD 62.00 HOSPITAL BASED HCHG PT PULSATILE LAVAGE 20 SQ CM OR LESS 256.00 HOSPITAL BASED HCHG AMB CONTRACT NON COVERED AMBULANCE MILES 0.00 HOSPITAL BASED HCHG ED INJECTION SQ/IM 40.00 HOSPITAL BASED HCHG IV INFUSION HYDRATION EACH ADDL HOUR 179.00 HOSPITAL BASED HCHG CHEMO IV ADMIN INITIAL HOUR 673.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 ADDL MIN 36.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 (+ STAFF) 8,791.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 ADDL MIN (+ STAFF) 61.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 9,621.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 ADDL MIN (+ SETUP) 68.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 ADDL MIN (+ STAFF + SETUP) 68.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 ADDL MIN (+ STAFF) 68.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 ADDL MIN 81.00 HOSPITAL BASED HCHG RC VENTILATION ASSIST FIRST DAY PT OWN EQUIP 170.00 HOSPITAL BASED HCHG ED IV INJECTION TX/DX/PROPHYLACTIC EACH ADDL PUSH OF SAME DRUG 68.00 HOSPITAL BASED PR PHONE CALL W EST PATIENT 5-10 MIN QUALIFIED HCP 50.00 HOSPITAL BASED HCHG PORTABLE PUMP FILL NON-CHEMO 170.00 HOSPITAL BASED HCHG ELBOW ORTHOTIC PREFAB PR40 73.00 HOSPITAL BASED HCHG IV INJECTION TX/DX/PROPH EACH ADDL PUSH OF SAME DRUG 224.00 HOSPITAL BASED HCHG OT EVAL ORAL/PHAR SWALLOWING 206.00 HOSPITAL BASED HCHG CSTM L3760 EO WITHJOINT, PREFABRICATED 642.00 HOSPITAL BASED HCHG MECHANICAL CHEST WALL OSCILLATION PER SESSION 77.00 HOSPITAL BASED HCHG EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYSIS 119.00 HOSPITAL BASED HCHG PT MANUAL THERAPY XS 92.00 HOSPITAL BASED HCHG OT THERAPEUTIC ACTIVITIES XS 261.00 HOSPITAL BASED HCHG PT SELFCARE/HOME MGMT XU 212.00 HOSPITAL BASED HCHG OT SELFCARE/HOME MGMT XS 212.00 HOSPITAL BASED HCHG PT GAIT TRAINING XE 71.00 HOSPITAL BASED HCHG PT GAIT TRAINING XP 71.00 HOSPITAL BASED HCHG PT NEUROMUSCULAR RE-ED XP 105.00 HOSPITAL BASED HCHG PT RE-EVALUATION XS 104.00 HOSPITAL BASED HCHG PT RE-EVALUATION XP 104.00 HOSPITAL BASED HCHG OT PARAFFIN BATH XE 35.00 HOSPITAL BASED HCHG OT PARAFFIN BATH XS 35.00 HOSPITAL BASED HCHG OT WHIRLPOOL XP 68.00 HOSPITAL BASED HCHG OT PHY PERF TEST/MEASURE 15 MIN XE 105.00 HOSPITAL BASED HCHG SLP EVAL VIDEO SWALLOW XS 210.00 HOSPITAL BASED HCHG SLP EVAL ORAL/PHAR SWALLOWING XU 206.00 HOSPITAL BASED HCHG OT PULSATILE LAVAGE > 20 SQ CM XP 219.00 HOSPITAL BASED HCHG PT PULSATLIE LAVAGE > 20 SQ CM XP 219.00 HOSPITAL BASED HCHG OT SELECT DEBRIDE 20 SQ CM OR LESS XE 256.00 HOSPITAL BASED HCHG PT PULSATILE LAV 20 SQ CM OR LESS XP 256.00 HOSPITAL BASED HCHG PT PULSATILE LAV 20 SQ CM OR LESS XU 256.00 HOSPITAL BASED HCHG PT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XS 302.00 HOSPITAL BASED HCHG IUD MIRENA RMC ONLY 910.00 HOSPITAL BASED HCHG OT GROUP THERAPY XP 63.00 HOSPITAL BASED HCHG PT GROUP THERAPY XP 63.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND PROD XP 514.00 HOSPITAL BASED HCHG PT EVAL LOW COMPLEXITY XP 191.00 HOSPITAL BASED PR MODERATE SED SAME PROVIDER > 5 YRS 1ST 15 MINUTES 114.00 HOSPITAL BASED HCHG THERAPY PRODUCTS PR10 15.00 HOSPITAL BASED HCHG CARDIAC PULM REHAB III MONTHLY COUPLE AFFILIATE ONLY 57.00 HOSPITAL BASED HCHG CARDIAC PULM REHAB III 1 SESSION AFFILIATE ONLY 6.00 HOSPITAL BASED HCHG ED INSERT NEEDLE INTRAOSSEOUS INFUSION AFFILIATE ONLY 451.00 HOSPITAL BASED HCHG AMB OWNED SPECIALTY CARE TRANSPORT 2,313.00 HOSPITAL BASED HCHG CCHD SCREEN 125.00 HOSPITAL BASED HCHG ADMIN HEPAT B VAC 35.00 HOSPITAL BASED HCHG OB NITROUS OXIDE PER 15 MIN 71.00 HOSPITAL BASED PR PERITONEAL BPSY CAUTERIZATION OF ENDOMETRIOSIS PER VAG APPRCH 1,910.00 HOSPITAL BASED HCHG CSTM LMBR ORTHO FLEXIBLE L1 <= L5 OTS PR220 55.00 HOSPITAL BASED HCHG PROTECTOR HEEL ELBOW PR5 AFFILIATE ONLY 20.00 HOSPITAL BASED HCHG CERVICAL COLLAR FLEXIBLE NONADJ FOAM PREFAB OTS PR20 89.00 HOSPITAL BASED HCHG ANKLE CONTROL ORTHOSIS PREFAB OTS PR60 114.00 HOSPITAL BASED HCHG PHYSICAL THERAPY EXERCISE MONTHLY RETAIL AFFILIATE ONLY 63.00 HOSPITAL BASED HCHG COMMUNITY PARAMEDIC CUY ONLY 29.00 HOSPITAL BASED HCHG WHFO RIGID WO JOINTS CUSTOM PR437 AFFILIATE ONLY 673.00 HOSPITAL BASED HCHG PT ORTHO/PROSTHETIC TRAIN UPR/LWR EXT TRUNK SUBQ 15 MIN 114.00 HOSPITAL BASED HCHG PT BIOFEED PERI/URO/ANORECT W EMG MANOMTRY INIT 15 MIN 1:1 213.00 HOSPITAL BASED HCHG PT BIOFEED PERI/URO/ANORECT W EMG MANOMETRY EA ADDL 15 MIN 213.00 HOSPITAL BASED HCHG OT THER INTERVENT COGNITIVE FUNCT 1:1 EA ADDL 15 MIN 73.00 HOSPITAL BASED HCHG SKIN TEST TB INTRADERMAL (PPD) 113.00 HOSPITAL BASED HCHG SEVOFLURANE PER 15 MIN 19.00 HOSPITAL BASED HCHG RC NEBULIZER/INHALER INSTRUCTION 74.00 HOSPITAL BASED HCHG PT AQUATIC THERAPY 15MIN 130.00 HOSPITAL BASED HCHG OT APPLICATION FINGER SPLINT STATIC 260.00 HOSPITAL BASED HCHG OT COMM/WORK REINTEGRATION 15MIN 94.00 HOSPITAL BASED HCHG OT FLUIDOTHERAPY 68.00 HOSPITAL BASED HCHG OT WHEELCHAIR MGT/PROPUL 15MIN 98.00 HOSPITAL BASED HCHG OT WHIRLPOOL 68.00 HOSPITAL BASED HCHG OT WORK HARDENING INITIAL 2HRS 629.00 HOSPITAL BASED HCHG SLP EVAL FOR SPCH GEN COMM DEV ADDL 30 MIN 132.00 HOSPITAL BASED HCHG ED CRITICAL CARE LEVEL VI EA ADDL 30 MIN 1,180.00 HOSPITAL BASED HCHG ED INSERTION NON-INDWELL/STRGT BLADDER CATH 238.00 HOSPITAL BASED HCHG BRONCHOSPASM EVAL-BEDSIDE 349.00 HOSPITAL BASED HCHG TEMPORARY TRANSCUTANEOUS PACING 25.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL I 985.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL IV 1,316.00 HOSPITAL BASED HCHG RHYTHM ECG,1 TO 3 LEADS TRACING ONLY 87.00 HOSPITAL BASED HCHG I&D ABSCESS/CARB/CYST SINGLE SIMPLE 386.00 HOSPITAL BASED HCHG OR CANCELLED CASE AFFILIATE ONLY 60.00 HOSPITAL BASED HCHG FETAL CONTRACTION STRESS TEST 525.00 HOSPITAL BASED HCHG SLEEP STUDY ATTENDED BY TECH 0.00 HOSPITAL BASED HCHG NEUROMUSCULAR JUNCTION TEST, EACH NERVE 511.00 HOSPITAL BASED HCHG INPT CARDIAC REHAB ADL EVAL 204.00 HOSPITAL BASED HCHG FNA INTERP & REPORT 367.00 HOSPITAL BASED HCHG PT SELECTIVE DEBRIDE 20 SQ CM OR LESS 256.00 HOSPITAL BASED HCHG OT SELECTV DEBRIDE EA ADDL 20 SQ CM OR PART THEREOF 220.00 HOSPITAL BASED HCHG PT HOT PACK COLD PACK 145.00 HOSPITAL BASED HCHG IRRIG DRUG DELIVERY DEVICE 560.00 HOSPITAL BASED HCHG DEBRIDEMENT NON-SELECTIVE NON REHAB PROVIDER 302.00 HOSPITAL BASED HCHG VAC/NPWT > 50 SQ CM RN W DME 560.00 HOSPITAL BASED HCHG IV INF THERAPY/DX/PROPH INITIAL HR 499.00 HOSPITAL BASED HCHG ED IV INFUSION HYDRATION EACH ADDL HOUR 179.00 HOSPITAL BASED HCHG ED IV INF THERAPY/DX/PROPH EA ADDL HR 214.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 1 ADDL MIN (< 2 STAFF) 29.00 HOSPITAL BASED HCHG ED IV INJECTION TX/DX/PROPH INITIAL 68.00 HOSPITAL BASED HCHG RC VENTILATION ASSIST SUBSEQ DAY 879.00 HOSPITAL BASED HCHG NITROUS OXIDE PER 15 MIN 973.00 HOSPITAL BASED HCHG CATHETERIZATION UA SPECIMEN COL 56.00 HOSPITAL BASED PR PHONE CALL W EST. PATIENT 21-30 MIN QUALIFIED HCP 137.00 HOSPITAL BASED HCHG KO IMMOB CANVAS LONG PREFAB OTS PR80 116.00 HOSPITAL BASED HCHG LEAD NEUROSTIMULATOR PR5370 7,914.00 HOSPITAL BASED HCHG SLP TEAM CONF >=30 MIN W PT/FAM 628.00 HOSPITAL BASED HCHG BLOOD/BLOOD PRODUCT ADMIN PER UNIT 638.00 HOSPITAL BASED HCHG IV INJECTION TX/DX/PROPH SEQUENTIAL NEW DRUG 225.00 HOSPITAL BASED HCHG INTUBATION ENDOTRACHEAL EMERGENCY 2,003.00 HOSPITAL BASED HCHG ED US GROIN 1,241.00 HOSPITAL BASED HCHG SHOE LIFTS TAPERED =< HALF INCH PR5 21.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND PROD 514.00 HOSPITAL BASED HCHG RC AIRWAY INHALATION TX EZPAP W NEB 74.00 HOSPITAL BASED HCHG POC GLUCOSE AFFILIATE ONLY 76.00 HOSPITAL BASED HCHG OT THERAPEUTIC ACTIVITIES XU 261.00 HOSPITAL BASED HCHG OT THERAPEUTIC EXERCISE XU 101.00 HOSPITAL BASED HCHG OT NEUROMUSCULAR RE-ED XE 105.00 HOSPITAL BASED HCHG OT NEUROMUSCULAR RE-ED XS 105.00 HOSPITAL BASED HCHG PT AQUATIC THERAPY XE 130.00 HOSPITAL BASED HCHG OT RE-EVALUATION XE 157.00 HOSPITAL BASED HCHG PT WHIRLPOOL XP 68.00 HOSPITAL BASED HCHG PT WHEELCHAIR MGT/PROPUL 15 MIN XS 98.00 HOSPITAL BASED HCHG PT COMM/WORK REINTEGRATION 15 MIN XE 94.00 HOSPITAL BASED HCHG PT COMM/WORK REINTEGRATION 15 MIN XU 94.00 HOSPITAL BASED HCHG SLP INDIV TX COMMUNICATION XP 194.00 HOSPITAL BASED HCHG SLP ASSESSMENT OF APHASIA W REPORT PER HR XS 254.00 HOSPITAL BASED HCHG SLP EVAL SPEECH FLUENCY XP 514.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XE 514.00 HOSPITAL BASED HCHG SLP BEHAVIORAL QUAL ANLYS VOICE RESONANCE XE 217.00 HOSPITAL BASED HCHG NOT USED FROZ PLASMA THAWING CHRG 51.00 HOSPITAL BASED HCHG AMB RESPONSE TREATMENT NO TRANSPORT 740.00 HOSPITAL BASED HCHG PT EVAL LOW COMPLEXITY XE 191.00 HOSPITAL BASED HCHG PT EVAL MOD COMPLEXITY XS 248.00 HOSPITAL BASED HCHG OT EVAL LOW COMPLEXITY XS 191.00 HOSPITAL BASED HCHG OT EVAL HIGH COMPLEXITY 305.00 HOSPITAL BASED HCHG OT EVAL HIGH COMPLEXITY XE 305.00 HOSPITAL BASED PR CLSD TX POST PELV RING FX WWO ANTER PELV RING FX WO MANIP 256.00 HOSPITAL BASED HCHG DIAB ED AND TRAIN FOR SELF MGMT 1 PT AFFILIATE ONLY 104.00 HOSPITAL BASED PB ANTISCLERODERMA-70 ANTIBODIES LC 311.00 HOSPITAL BASED HCHG WHO COCKUP NONMOLDED PREFAB OTS PR30 108.00 HOSPITAL BASED HCHG ED THROMBOLYTIC IV THERAPY STROKE AFFILIATE ONLY 472.00 HOSPITAL BASED HCHG CMV NEG IRRAD PLATELETS AFFILIATE ONLY 1,595.00 HOSPITAL BASED HCHG CRUTCH UNDERARM PAIR NO WOOD PR50 AFFILIATE ONLY 52.00 HOSPITAL BASED HCHG EXERCISE EQUIP PR5 AFFILIATE ONLY 12.00 HOSPITAL BASED HCHG GRADIENT COMPRESSION STOCKING NOS PR20 AFFILIATE ONLY 33.00 HOSPITAL BASED HCHG KO ADJST JOINT UNI OR POLY RIGID PREFAB OTS PR580 855.00 HOSPITAL BASED HCHG KO ELAS W CONDYLE PADS JOINTS PR190 187.00 HOSPITAL BASED HCHG FO PIP DIP W JOINT SPRING PREFAB OTS PR80 132.00 HOSPITAL BASED HCHG NONPNEUMATIC WALKING BOOT PREFAB CUSTOM FIT PR180 269.00 HOSPITAL BASED HCHG SLEEVE KNEE PR5 AFFILIATE ONLY 187.00 HOSPITAL BASED HCHG PLT LR PHER CMV NEG 1,500.00 HOSPITAL BASED HCHG NON STERILE SUPPLY PR5 148.00 HOSPITAL BASED HCHG HOLTER MONITOR > 48HR TO 21 DAY RCRD COMPLETE 545.00 HOSPITAL BASED AUC CDS MECHANISM NATIONAL DECISION SUPPORT COMPANY 0.00 HOSPITAL BASED PR ONLINE DIGITAL E/M SVS EST PATIENT =< 7 DAYS 11-20 MIN 59.00 HOSPITAL BASED HCHG SPECIMEN COLLECT SARS-COV-2 AFFILIATE ONLY 60.00 HOSPITAL BASED PR ADMIN FLU VIRUS VAC-(MEDICARE) 35.00 HOSPITAL BASED PR INHALATION TREATMENT AIRWAY OBST 74.00 HOSPITAL BASED PR SUBSEQUENT HOSPITAL CARE LEVL 1 162.00 HOSPITAL BASED HCHG MED/SURG/OB ROOM 3,414.00 HOSPITAL BASED HCHG INFANT CARE LEVEL 1 2,234.00 HOSPITAL BASED HCHG BLOOD DRAW THROUGH COMPLETELY IMPLANTED VAD 60.00 HOSPITAL BASED HCHG LEGAL BLOOD ALCOHOL DRAW 46.00 HOSPITAL BASED HCHG RC AIRWAY INHALATION TX IPPB 74.00 HOSPITAL BASED HCHG RC MANIPULATION CHEST WALL SUBSEQ EXTENDED 87.00 HOSPITAL BASED HCHG PT COMM/WORK REINTEGRATION 15MIN 94.00 HOSPITAL BASED HCHG PT MECHANICAL TRACTION 63.00 HOSPITAL BASED HCHG PT PHYSICAL PERF TEST/MEASUREMENT 15MIN 105.00 HOSPITAL BASED HCHG PT VASOPNEUMATIC DEVICE 261.00 HOSPITAL BASED HCHG PT WHIRLPOOL 68.00 HOSPITAL BASED HCHG OT PARAFFIN BATH 35.00 HOSPITAL BASED HCHG SLP EVAL FOR SPCH GEN COMM DEV 1ST HR 305.00 HOSPITAL BASED HCHG ED CODE BLUE RESUSCITATION 1,112.00 HOSPITAL BASED HCHG PFT C0 MEMBRANE DIFFUSE CAPACITY 349.00 HOSPITAL BASED HCHG RC CO2 EXP GAS DETERMINATION INFRARED SGL READ 161.00 HOSPITAL BASED HCHG POST EXERCISE CHALLENGE TEST 709.00 HOSPITAL BASED HCHG PULSE OXIMETRY MULTIPLE DETERMINATIONS 125.00 HOSPITAL BASED HCHG EVOKED RESPONSE AUDIOMETRY, LIMITED 236.00 HOSPITAL BASED HCHG AMB CONTRACT GROUND MILEAGE PER MILE 36.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL II ADDL MIN 32.00 HOSPITAL BASED HCHG BIRTHING VAGINAL COMPLICATED 7,718.00 HOSPITAL BASED HCHG ARTERIAL PUNCTURE 61.00 HOSPITAL BASED HCHG BLADDER INSTILLATION ANTI-CA AGENT 163.00 HOSPITAL BASED HCHG IMMUN ADMIN IM/SQ EA ADDL (SGL/COMBO) 80.00 HOSPITAL BASED HCHG FETAL NON-STRESS TEST 227.00 HOSPITAL BASED HCHG NEEDLE EMG 4 EXTREMITIES W/WO PARASPINAL 511.00 HOSPITAL BASED HCHG PHLEBOTOMY THERAPEUTIC 364.00 HOSPITAL BASED HCHG MNT REASSESSMENT INDIV 15MIN 71.00 HOSPITAL BASED HCHG INPT CARDIAC REHAB INITIAL EVAL 204.00 HOSPITAL BASED HCHG O/P CARDIAC REHAB EVAL W/CONT MONT 400.00 HOSPITAL BASED HCHG PT SELECTV DEBRIDE EA ADDL 20 SQ CM OR PART THEREOF 220.00 HOSPITAL BASED HCHG OT SELFCARE/HOME MNGMNT 59 212.00 HOSPITAL BASED HCHG CHEMO IV ADMIN ADDL HOUR 673.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 (+ STAFF + SETUP) 8,041.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 ADDL MIN 45.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 ADDL MIN (+ SETUP) 46.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 ADDL MIN (< 2 STAFF) 46.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 8,746.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 ADDL MIN (+ STAFF + SETUP) 61.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 (+ SETUP) 10,628.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 (+ STAFF + SETUP) 10,672.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 ADDL MIN (+ SETUP) 82.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 6 ADDL MIN (+ STAFF) 82.00 HOSPITAL BASED HCHG ARC-PRETREAT RBCS WITH ENZYME 80.00 HOSPITAL BASED HCHG SPLINT FINGER COT PR5 107.00 HOSPITAL BASED PR PHONE CALL W EST PATIENT 11-20 MIN QUALIFIED HCP 93.00 HOSPITAL BASED HCHG TRANSESOPHAG ECHO W PROBE PLMNT COMPLETE WO CONTRAST 1,503.00 HOSPITAL BASED HCHG ED LEVEL IV TRAUMA TEAM ACTIVATION 1,138.00 HOSPITAL BASED HCHG DRSG PR397 586.00 HOSPITAL BASED HCHG REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT 112.00 HOSPITAL BASED HCHG DRSG PR330 33.00 HOSPITAL BASED HCHG WHFO WO JOINTS PREFAB CUSTOM FIT PR50 62.00 HOSPITAL BASED HCHG WHO COCKUP NONMOLDED PREFAB OTS PR70 108.00 HOSPITAL BASED HCHG CSTM L1686 HO POST-OP HIP ABDUCTION 0.00 HOSPITAL BASED HCHG PFT PLETHYSMOGRAP 349.00 HOSPITAL BASED HCHG INF > 8 HRS W ELASTOMERIC INFUSION DEVICE 224.00 HOSPITAL BASED HCHG OT MANUAL THERAPY XS 92.00 HOSPITAL BASED HCHG PT THERAPEUTIC ACTIVITIES XP 261.00 HOSPITAL BASED HCHG PT THERAPEUTIC ACTIVITIES XU 261.00 HOSPITAL BASED HCHG PT THERAPEUTIC EXERCISE XE 101.00 HOSPITAL BASED HCHG PT GAIT TRAINING XS 71.00 HOSPITAL BASED HCHG PT NEUROMUSCULAR RE-ED XS 105.00 HOSPITAL BASED HCHG PT AQUATIC THERAPY XP 130.00 HOSPITAL BASED HCHG PT RE-EVALUATION XU 104.00 HOSPITAL BASED HCHG PT WHIRLPOOL XU 68.00 HOSPITAL BASED HCHG OT WHIRLPOOL XE 68.00 HOSPITAL BASED HCHG OT COMM/WORK REINTEGRATION 15 MIN XE 94.00 HOSPITAL BASED HCHG OT COMM/WORK REINTEGRATION 15 MIN XS 94.00 HOSPITAL BASED HCHG OT E-STIM ATTENDED 15 MIN XU 48.00 HOSPITAL BASED HCHG OT PULSATILE LAVAGE > 20 SQ CM XE 219.00 HOSPITAL BASED HCHG OT PULSATILE LAVAGE > 20 SQ CM XU 219.00 HOSPITAL BASED HCHG OT PULSATILE LAV 20 SQ CM OR LESS XU 256.00 HOSPITAL BASED HCHG PT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XE 302.00 HOSPITAL BASED HCHG PT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XP 302.00 HOSPITAL BASED HCHG OT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XS 302.00 HOSPITAL BASED HCHG OT COGNITIVE TEST PER HR XS 177.00 HOSPITAL BASED HCHG OT COGNITIVE TEST PER HR XU 177.00 HOSPITAL BASED HCHG SLP ASSESSMENT OF APHASIA W REPORT PER HR XE 254.00 HOSPITAL BASED HCHG SLP EVAL SPEECH FLUENCY XU 514.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND PROD XE 514.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND PROD XU 514.00 HOSPITAL BASED HCHG PT EVAL MOD COMPLEXITY 248.00 HOSPITAL BASED HCHG PT EVAL MOD COMPLEXITY XE 248.00 HOSPITAL BASED HCHG OT EVAL LOW COMPLEXITY 191.00 HOSPITAL BASED HCHG OT EVAL MOD COMPLEXITY XP 248.00 HOSPITAL BASED PR CATH PLCMT INJ/INFUSE EPI OR SUBA LUMB SACRAL WO GUIDE 294.00 HOSPITAL BASED HCHG THERAPY PRODUCTS PR20 29.00 HOSPITAL BASED HCHG ED THROMBOLYSIS CORONARY IV INFUSION 94.00 HOSPITAL BASED HCHG WALKING BOOT NONPNEUMATIC WWO JOINTS PREFAB OTS PR60 88.00 HOSPITAL BASED HCHG GAD-65 AUTOANTIBODY LC 92.00 HOSPITAL BASED PB EHRLICHIA AB LC 29.00 HOSPITAL BASED PB GENERAL LAB 8751701 LC 260.00 HOSPITAL BASED HCHG RBC LR IRR CMV NEG 869.00 HOSPITAL BASED HCHG MECHANICAL COUGH ASSIST 68.00 HOSPITAL BASED HCHG O/P CARDIAC REHAB W/CONT MONITOR KX 318.00 HOSPITAL BASED HCHG ED VISUAL ACUITY EXAM AFFILIATE ONLY 179.00 HOSPITAL BASED HCHG ED REMOVE IMPACTED CERUMEN INSTRUMENT UNI AFFILIATE ONLY 279.00 HOSPITAL BASED HCHG ELBOW ORTHOSIS WO JOINTS CUSTOM FAB PR20 74.00 HOSPITAL BASED HCHG UE FX ORTHOSIS SOCK EACH PR30 AFFILIATE ONLY 55.00 HOSPITAL BASED HCHG NON STERILE SUPPLY PR30 124.00 HOSPITAL BASED HCHG PNEUMATIC WALKING BOOT PREFAB CUSTOM FIT PR140 250.00 HOSPITAL BASED HCHG STATIC OR DYNAMIC AFO PREFAB CUSTOM FIT PR80 108.00 HOSPITAL BASED HCHG MINOR PROCEDURE LEVEL III AFFILIATE ONLY 3,375.00 HOSPITAL BASED HCHG SLEEVE COMPRESSION CALF PR10 20.00 HOSPITAL BASED PR COMPLEX CARE MGMT W MLT CHRON COND 60 MINS PER MONTH 187.00 HOSPITAL BASED HCHG SPLINT THUMB SPICA HAND BASED CUSTOM PR330 AFFILIATE ONLY 488.00 HOSPITAL BASED HCHG CUSTOM L3765 EWHFO RIGID WO JNTS CF PR1200 AFFILIATE ONLY 1,772.00 HOSPITAL BASED PR NUTRITION COUNSELING DIETITION VISIT AFFILIATE ONLY 156.00 HOSPITAL BASED PR QNHP ONLINE E/M SVC EST PATIENT =< 7 DAYS 5-10 MIN 28.00 HOSPITAL BASED PR QNHP ONLINE E/M SVC EST PATIENT =< 7 DAYS 11-20 MIN 50.00 HOSPITAL BASED HCHG SPECIMEN COLLECT SNF LAB SARS-COV-2 AFFILIATE ONLY 60.00 HOSPITAL BASED PR VENIPUNCTURE > 3 MD SKILL DX OR TX PURP 63.00 HOSPITAL BASED PR MANUAL THER TECH 1+ REGIONS EA 15 MIN 42.00 HOSPITAL BASED HCHG RC AIRWAY INHALATION TX 74.00 HOSPITAL BASED HCHG RC MANIPULATION CHEST WALL SUBSEQ BASIC 87.00 HOSPITAL BASED HCHG THER PROC IMPROVE RESP FUNC 15MIN 1:1 79.00 HOSPITAL BASED HCHG PT MANUAL THERAPY 15MIN 92.00 HOSPITAL BASED HCHG PT MASSAGE 15 MIN 80.00 HOSPITAL BASED HCHG PT NEUROMUSCULAR RE-ED 15MIN 105.00 HOSPITAL BASED HCHG PT RE-EVALUATION 104.00 HOSPITAL BASED HCHG PT THERAPEUTIC EXERCISE 15MIN 101.00 HOSPITAL BASED HCHG PT WORK CONDITIONING EA ADDL HR 348.00 HOSPITAL BASED HCHG PT WORK HARDENING EA ADDL HR 348.00 HOSPITAL BASED HCHG OT BIOFEEDBACK OTHER THAN PERINEAL/ANO/URET 212.00 HOSPITAL BASED HCHG OT GROUP THERAPY 63.00 HOSPITAL BASED HCHG OT NEUROMUSCULAR RE-ED 15MIN 105.00 HOSPITAL BASED HCHG OT NONSELECTIVE DEBRIDEMENT/SLOUGH WOUNDS 302.00 HOSPITAL BASED HCHG OT PHYSICAL PERF TEST/MEASUREMENT 15MIN 105.00 HOSPITAL BASED HCHG SLP TX SWALLOW DYS/ORAL FUNC FEEDING 331.00 HOSPITAL BASED HCHG ED CRITICAL CARE LEVEL VI 4,514.00 HOSPITAL BASED HCHG ED INSERT INDWELL BLADD CATH SIMPLE 413.00 HOSPITAL BASED HCHG ED EMERGENT PROCEDURE INTERMEDIATE 1,805.00 HOSPITAL BASED HCHG PFT BRONCHOSPASM EVAL-LAB 349.00 HOSPITAL BASED HCHG RC CO2 EXP GAS DETERMINATION INFRARED CONTINUOUS 161.00 HOSPITAL BASED HCHG RC PULSE OXIMETRY SINGLE DETERMINATION 175.00 HOSPITAL BASED HCHG CARDIOVERSION ELECTIVE, EXTERNAL 2,553.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL III ADDL MIN 38.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL II 1,084.00 HOSPITAL BASED HCHG POSTOP PHASE II ADDL TIME 8.00 HOSPITAL BASED HCHG CIRCUMCISION W REGIONAL BLOCK 102.00 HOSPITAL BASED HCHG DECLOT IVAD OR CATH W THROMBOLYTIC 80.00 HOSPITAL BASED HCHG PARING/CURET >4 LESIONS 237.00 HOSPITAL BASED HCHG PARING/CURET 2-4 LESIONS 157.00 HOSPITAL BASED HCHG PROCEDURE MINOR 337.00 HOSPITAL BASED HCHG IMMUN ADMIN IM/SQ ONE VACCINE (SGL/COMBO) 80.00 HOSPITAL BASED HCHG DSMT OUTPT GROUP PER 30 MIN 58.00 HOSPITAL BASED HCHG INPT CARDIAC REHAB SESSION 204.00 HOSPITAL BASED HCHG SYPHILIS CONFIRMATION TPPA 356.00 HOSPITAL BASED HCHG VZ VIRUS BY RAPID PCR 623.00 HOSPITAL BASED HCHG OT PULSATL LAVAGE EA ADDL 20 SQ CM OR PART THEREOF 220.00 HOSPITAL BASED HCHG OT ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITIAL ENC 15 MIN 114.00 HOSPITAL BASED HCHG INJECTION SQ/IM 242.00 HOSPITAL BASED HCHG IV INF THERAPY/DX/PROPH EA ADDL HR 214.00 HOSPITAL BASED HCHG IV INJECTION TX/DX/PROPHYLAXIS INITIAL 911.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 (+ STAFF + SETUP) 7,318.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 ADDL MIN (+ STAFF + SETUP) 40.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 ADDL MIN (+ SETUP) 60.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 (+ STAFF + SETUP) 9,707.00 HOSPITAL BASED PR PHONE E&M EST PATIENT 11-20 MIN 131.00 HOSPITAL BASED HCHG TELEHEALTH ORIGINATING SITE 74.00 HOSPITAL BASED HCHG FO PIP DIP W JOINT SPRING PREFAB OTS PR20 69.00 HOSPITAL BASED PR XR FLUORO 0.00 HOSPITAL BASED HCHG PULMONARY REHAB W EXERCISE 1 HOUR SESSION 249.00 HOSPITAL BASED HCHG OXYGEN PER DAY 277.00 HOSPITAL BASED HCHG OT AQUATIC THERAPY 130.00 HOSPITAL BASED HCHG TRIM DYSTROPHIC NAILS ANY NUMBER 208.00 HOSPITAL BASED PR US BX BREAST INC MARKER EA ADDL LESION W GUIDE RT 1,246.00 HOSPITAL BASED HCHG ED SELECTIVE DEBRIDE 20 SQ CM OR LESS 256.00 HOSPITAL BASED HCHG PT SELFCARE/HOME MGMT XE 212.00 HOSPITAL BASED HCHG PT NEUROMUSCULAR RE-ED XE 105.00 HOSPITAL BASED HCHG OT RE-EVALUATION XU 157.00 HOSPITAL BASED HCHG PT WHEELCHAIR MGT/PROPUL 15 MIN XP 98.00 HOSPITAL BASED HCHG OT PHY PERF TEST/MEASURE 15 MIN XP 105.00 HOSPITAL BASED HCHG PT PHY PERF TEST/MEASURE 15 MIN XU 105.00 HOSPITAL BASED HCHG OT SELECTIVE DEBRIDE > 20 SQ CM XE 219.00 HOSPITAL BASED HCHG PT SELECTIVE DEBRIDE > 20 SQ CM XS 219.00 HOSPITAL BASED HCHG PT PULSATLIE LAVAGE > 20 SQ CM XU 219.00 HOSPITAL BASED HCHG PT SELECT DEBRIDE 20 SQ CM OR LESS XS 256.00 HOSPITAL BASED HCHG PT SELECT DEBRIDE 20 SQ CM OR LESS XP 256.00 HOSPITAL BASED HCHG PT SELECT DEBRIDE 20 SQ CM OR LESS XU 256.00 HOSPITAL BASED HCHG OT COGNITIVE TEST PER HR XE 177.00 HOSPITAL BASED HCHG OT COGNITIVE TEST PER HR XP 177.00 HOSPITAL BASED HCHG SLP EVAL SPEECH FLUENCY XE 514.00 HOSPITAL BASED HCHG SLP EVAL SPEECH FLUENCY XS 514.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND PROD XS 514.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XU 514.00 HOSPITAL BASED HCHG AMB EXTRA AMBULANCE ATTENDANT 146.00 HOSPITAL BASED HCHG PT EVAL LOW COMPLEXITY 191.00 HOSPITAL BASED HCHG CPT OT EVAL MED EVAL COMPLEXITY AFFILIATE ONLY 248.00 HOSPITAL BASED HCHG OT EVAL MOD COMPLEXITY XU 248.00 HOSPITAL BASED HCHG IV START AFFILIATE ONLY 85.00 HOSPITAL BASED PB ANTISTREPTOLYSIN O AB LC 79.00 HOSPITAL BASED HCHG OPTIME IUD 19.5MG KYLEENA KIT 910.00 HOSPITAL BASED HCHG PFT PLETHYSMOGRAP LIMITED 349.00 HOSPITAL BASED HCHG BLOOD DRAW LINE PORT AFFILIATE ONLY 67.00 HOSPITAL BASED HCHG COMPRESSION STOCKING BK18-30 PR100 AFFILIATE ONLY 81.00 HOSPITAL BASED HCHG COMPRESSION STOCKING BK18-30 PR50 AFFILIATE ONLY 76.00 HOSPITAL BASED HCHG GRADIENT COMPRESS STOCK WAIST 18-30 PR90 AFFILIATE ONLY 0.00 HOSPITAL BASED HCHG UE FX ORTHOSIS HUMERAL PR130 225.00 HOSPITAL BASED HCHG UE FX ORTHOSIS RAD UL PREFAB PR350 519.00 HOSPITAL BASED HCHG HFO WO JOINTS PREFAB CUSTOM FIT PR90 201.00 HOSPITAL BASED HCHG BRACE SHOULDER PREFAB PR20 AFFILIATE ONLY 33.00 HOSPITAL BASED HCHG LE ORTHOSIS PR40 60.00 HOSPITAL BASED HCHG MINOR PROCEDURE LEVEL II AFFILIATE ONLY 2,969.00 HOSPITAL BASED HCHG LEAD NEUROSTIMULATOR PR3270 4,591.00 HOSPITAL BASED HCHG RBC LR CMV NEG 750.00 HOSPITAL BASED PR COMPLEX CHRONIC CARE MGMT W MLT CHRON COND EA ADDL 30 MIN 96.00 HOSPITAL BASED HCHG PHYSICAL THERAPY EXERCISE DAILY RETAIL AFFILIATE ONLY 7.00 HOSPITAL BASED HCHG SPLINT FINGER BASED STATIC CUSTOM PR250 AFFILIATE ONLY 385.00 HOSPITAL BASED HCHG NUTRITION COUNSELING DIETITION VISIT AFFILIATE ONLY 156.00 HOSPITAL BASED HCHG OT ORTHO/PROSTHETIC TRAIN UPR/LWR EXT TRUNK SUBQ 15 MIN 92.00 HOSPITAL BASED HCHG OT THER INTERVENT COGNITIVE FUNCT 1:1 INIT 15 MIN 187.00 HOSPITAL BASED RAD CT CHEST WO LOW DOSE 965.00 HOSPITAL BASED PR TRIM DYSTROPHIC NAILS ANY NUMBER 208.00 HOSPITAL BASED PR OPEN TX RADIAL HEAD FX PROSTH IMPLNT 1,399.00 HOSPITAL BASED HCHG RC AIRWAY INHALATION TX MDI VENT 74.00 HOSPITAL BASED HCHG PT BIOFEEDBACK OTHER THAN PERINEAL/ANO/URET 213.00 HOSPITAL BASED HCHG PT THERAPEUTIC ACTIVITY 15MIN 261.00 HOSPITAL BASED HCHG PT WORK CONDITIONING INITIAL 2HRS 629.00 HOSPITAL BASED HCHG OT CONTRAST BATH 15MIN 54.00 HOSPITAL BASED HCHG OT FUNCTIONAL CAPACITY EVAL 15MIN 105.00 HOSPITAL BASED HCHG OT IONTOPHORESIS 15MIN 86.00 HOSPITAL BASED HCHG OT IONTOPHORESIS 15MIN 86.00 HOSPITAL BASED HCHG ED EMERGENT PROCEDURE MINOR 1,216.00 HOSPITAL BASED HCHG EVOKED RESPONSE AUDIOMETRY, COMPREHENSIVE 110.00 HOSPITAL BASED HCHG INTRAVAS DOPPLER PRESSURE COR ADDL VESSEL 162.00 HOSPITAL BASED HCHG AMB OWNED GROUND MILEAGE PER MILE 38.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL IV ADDL MIN 43.00 HOSPITAL BASED HCHG EKG 12LEAD TRACING ONLY WO REPORT/INTERP 219.00 HOSPITAL BASED HCHG PT DEMAND EVENT MONITOR/TRANSMISSION/ANALY 417.00 HOSPITAL BASED HCHG DEBRIDEMENT OF NAILS SIX OR MORE 132.00 HOSPITAL BASED HCHG INSERT INDWELL BLADD CATH SIMPLE TX 413.00 HOSPITAL BASED HCHG INSERTION OF CERVICAL DILATOR 155.00 HOSPITAL BASED HCHG NASOTRACHEAL SUCTIONING 497.00 HOSPITAL BASED HCHG PARING OR CUTTING CORN/CALLUS 156.00 HOSPITAL BASED HCHG CONT GLUC MON HKUP & RECORD > 72 HRS 414.00 HOSPITAL BASED HCHG CONT GLUCOSE MON HKUP & RPT > 72 HRS 80.00 HOSPITAL BASED HCHG NEEDLE EMG 3 EXTREMITIES W/WO PARASPINAL 511.00 HOSPITAL BASED HCHG O/P CARDIAC REHAB EVAL WITHOUT CONT MONITOR 92.00 HOSPITAL BASED HCHG RBC LR UNIT 688.00 HOSPITAL BASED HCHG ESOPHAGEAL MOTILITY STUDY 955.00 HOSPITAL BASED HCHG RC CPAP/BI-LEVEL CONTINUOUS 480.00 HOSPITAL BASED HCHG SELECTIVE DEBRIDE 20 SQ CM OR LESS 256.00 HOSPITAL BASED HCHG PT PULSATL LAVAGE EA ADDL 20 SQ CM OR PART THEREOF 220.00 HOSPITAL BASED HCHG BIOPHYSICAL PROFILE W NST 1,271.00 HOSPITAL BASED HCHG OT HOT PACK COLD PACK 145.00 HOSPITAL BASED HCHG SUPPORT MATERNITY SM XLG 233.00 HOSPITAL BASED HCHG WHFO WO JOINTS PREFAB CUSTOM FIT PR10 129.00 HOSPITAL BASED HCHG SLING PR30 44.00 HOSPITAL BASED HCHG PT ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITIAL ENC 15 MIN 114.00 HOSPITAL BASED HCHG IV INJECTION TX/DX/PROPHYLAXIS ADDL SEQUENTIAL 395.00 HOSPITAL BASED HCHG ED TX/PROPH/DX ADDL SEQ IV INF 816.00 HOSPITAL BASED HCHG ED IV INFUSION HYDRATION INITIAL 31-60 MIN 473.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 7,226.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 (< 2 STAFF) 7,226.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 (+ SETUP) 7,996.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 5 (+ STAFF) 9,665.00 HOSPITAL BASED HCHG ARC-RH PHENOTYPE 92.00 HOSPITAL BASED HCHG ARC-DIFF ADSORPTION 124.00 HOSPITAL BASED HCHG ED IV INJECTION TX/DX/PROPH ADDL SEQUENTIAL 68.00 HOSPITAL BASED HCHG ED IV INFUSION TX/DX/PROPHYLAXIS CONCURRENT 368.00 HOSPITAL BASED HCHG RC CONT INHALATION TREATMENT FIRST HR 107.00 HOSPITAL BASED HCHG DRSG PR5 121.00 HOSPITAL BASED RX-250, NON CHARGEABLE 0.00 HOSPITAL BASED HCHG DRSG PR130 192.00 HOSPITAL BASED HCHG ED BLOOD DRAW THROUGH CENTRAL OR PERIPHERAL VAD 68.00 HOSPITAL BASED HCHG OT COGNITIVE TEST PER HR 177.00 HOSPITAL BASED HCHG ED LEVEL III TRAUMA TEAM ACTIVATION 1,138.00 HOSPITAL BASED HCHG STOCKING PR30 44.00 HOSPITAL BASED HCHG LINGUAL FRENUM INCISION (FRENOTOMY) 838.00 HOSPITAL BASED HCHG DEST NEUROLYTIC W IMAG GUIDE LUMB SACR EA ADDL 3,551.00 HOSPITAL BASED HCHG ENDO LEVEL 2 7,226.00 HOSPITAL BASED HCHG ENDO LEVEL 5 9,621.00 HOSPITAL BASED PR REMOTE TELEMETRY 30 DAY ECG MD INTERP 101.00 HOSPITAL BASED HCHG PT CANALITH REPOSITIONING PER DAY 107.00 HOSPITAL BASED HCHG I&D VULVA/PERINEUM ABSCESS 535.00 HOSPITAL BASED HCHG SLP GROUP TX SWAL DYS/ORAL FUNC FEEDING 331.00 HOSPITAL BASED PR OCH PULMONARY FUNCTION TEST 141.00 HOSPITAL BASED HCHG CSTM L3923 HFO WO JOINTS PREFAB CUSTOM FIT 123.00 HOSPITAL BASED HCHG STRAP KNEE PR30 74.00 HOSPITAL BASED HCHG OPTIME BIOVANCE PER SQ CM 681.00 HOSPITAL BASED HCHG PT MANUAL THERAPY XU 92.00 HOSPITAL BASED HCHG PT SELFCARE/HOME MGMT XP 212.00 HOSPITAL BASED HCHG OT THERAPEUTIC EXERCISE XS 101.00 HOSPITAL BASED HCHG PT THERAPEUTIC EXERCISE XS 101.00 HOSPITAL BASED HCHG PT THERAPEUTIC EXERCISE XP 101.00 HOSPITAL BASED HCHG PT NEUROMUSCULAR RE-ED XU 105.00 HOSPITAL BASED HCHG PT AQUATIC THERAPY XU 130.00 HOSPITAL BASED HCHG OT PARAFFIN BATH XU 35.00 HOSPITAL BASED HCHG PT WHEELCHAIR MGT/PROPUL 15 MIN XE 98.00 HOSPITAL BASED HCHG PT WHEELCHAIR MGT/PROPUL 15 MIN XU 98.00 HOSPITAL BASED HCHG PT COMM/WORK REINTEGRATION 15 MIN XP 94.00 HOSPITAL BASED HCHG PT E-STIM ATTENDED 15 MIN XP 48.00 HOSPITAL BASED HCHG SLP EVAL ORAL/PHAR SWALLOWING XE 206.00 HOSPITAL BASED HCHG SLP INDIV TX COMMUNICATION XU 194.00 HOSPITAL BASED HCHG PT PULSATLIE LAVAGE > 20 SQ CM XS 220.00 HOSPITAL BASED HCHG PT PULSATILE LAV 20 SQ CM OR LESS XS 256.00 HOSPITAL BASED HCHG SLP ASSESSMENT OF APHASIA W REPORT PER HR XU 254.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XS 514.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP XP 514.00 HOSPITAL BASED HCHG XR INJECTION SINGLE TENDON SHEATH LIGAMENT 532.00 HOSPITAL BASED HCHG FRESH FROZEN PLASMA 386.00 HOSPITAL BASED HCHG LABOR EPIDURAL INITIAL 337.00 HOSPITAL BASED HCHG PT EVAL MOD COMPLEXITY XP 248.00 HOSPITAL BASED HCHG PT EVAL HIGH COMPLEXITY XE 305.00 HOSPITAL BASED HCHG PT EVAL HIGH COMPLEXITY XU 305.00 HOSPITAL BASED HCHG OT EVAL LOW COMPLEXITY XP 191.00 HOSPITAL BASED HCHG OT EVAL HIGH COMPLEXITY XP 305.00 HOSPITAL BASED HCHG OT EVAL HIGH COMPLEXITY XU 305.00 HOSPITAL BASED PR OT ULTRASOUND THERAPY EA 15 MIN AFFILIATE ONLY 77.00 HOSPITAL BASED HCHG THERAPY PRODUCTS PR1 0.00 HOSPITAL BASED HCHG DIAB ED AND TRAIN FOR SELF MGMT 5 TO 8 PTS AFFILIATE ONLY 0.00 HOSPITAL BASED HCHG CARDIAC PULM REHAB III MONTHLY AFFILIATE ONLY 68.00 HOSPITAL BASED HCHG NON STERILE SUPPLY PR20 124.00 HOSPITAL BASED HCHG AMB OWNED ALS EMERG TRANSP LEVEL 1 2,313.00 HOSPITAL BASED HCHG ED MEAS POST VOID RESID US NON-IMAGING AFFILIATE ONLY 76.00 HOSPITAL BASED HCHG UE ORTHOSIS PR50 85.00 HOSPITAL BASED PR FLU VACC QUADRIVALENT IIV4 SV PF 0.5 ML IM 33.00 HOSPITAL BASED HCHG IHC STAIN MORPH ANALYSIS TC ONLY 0.00 HOSPITAL BASED PR ASTHMA EDUCATION AFFILIATE ONLY 68.00 HOSPITAL BASED HCHG DME SUPPLY OR ACCESSORY NOS PR20 AFFILIATE ONLY 119.00 HOSPITAL BASED HCHG ELECTROMYOGRAPH BIOFEEDBACK PR50 AFFILIATE ONLY 124.00 HOSPITAL BASED HCHG EXERCISE EQUIP PR30 AFFILIATE ONLY 52.00 HOSPITAL BASED HCHG NON WATERPROOF TAPE PER 18CM IN PR20 AFFILIATE ONLY 233.00 HOSPITAL BASED HCHG POST OP SURGICAL BOOT PR60 225.00 HOSPITAL BASED HCHG SIO FLEXIBLE PELVIC SACROILIAC PREFAB OTS PR100 85.00 HOSPITAL BASED HCHG CONTINUOUS PASSIVE MOTION UNIT AFFILIATE ONLY 223.00 HOSPITAL BASED HCHG AMB ALS PARAMEDIC INTERCEPT 869.00 HOSPITAL BASED HCHG EO WO JOINTS CUSTOM PR330 AFFILIATE ONLY 517.00 HOSPITAL BASED HCHG PACU STEPDOWN ADDL TIME 8.00 HOSPITAL BASED PR PT EDUCATION NOC GROUP AFFILIATE ONLY 78.00 HOSPITAL BASED HCHG INTERFYL PER 1 MG AFFILIATE ONLY 0.00 HOSPITAL BASED PR LARYNGOSCOPY DIRCT INJ VOCAL CORD 740.00 HOSPITAL BASED PR EXT PT & AUTO ACTIVATED ECG DOWNLOAD W R&I <=30 DAYS 101.00 HOSPITAL BASED HCHG LEAVE OF ABSENCE 0.00 HOSPITAL BASED HCHG OBSERVATION 64.00 HOSPITAL BASED HCHG INTENSIVE CARE 6,074.00 HOSPITAL BASED HCHG BLOOD DRAW THROUGH CENTRAL OR PERIPHERAL VAD 68.00 HOSPITAL BASED HCHG RC AIRWAY INHALATION TX MDI/DPI 74.00 HOSPITAL BASED HCHG RC SPUTUM INDUCTION 74.00 HOSPITAL BASED HCHG PT CONTRAST BATH 15MIN 54.00 HOSPITAL BASED HCHG PT IONTOPHORESIS 15MIN 86.00 HOSPITAL BASED HCHG PT ULTRASOUND 15MIN 44.00 HOSPITAL BASED HCHG OT E-STIM ATTENDED 15MIN 48.00 HOSPITAL BASED HCHG OT MANUAL THERAPY 15MIN 92.00 HOSPITAL BASED HCHG OT PHONOPHORESIS 15MIN 44.00 HOSPITAL BASED HCHG OT PREPLACEMENT SCREENING 15MIN 105.00 HOSPITAL BASED HCHG OT THERAPEUTIC ACTIVITY 15MIN 261.00 HOSPITAL BASED HCHG OT THERAPEUTIC EXERCISE 15MIN 101.00 HOSPITAL BASED HCHG OT ULTRASOUND 15MIN 44.00 HOSPITAL BASED HCHG SLP INDIV TX COMMUNICATION 194.00 HOSPITAL BASED HCHG SLP ASSESSMENT OF APHASIA W REPORT PER HR 254.00 HOSPITAL BASED HCHG PFT EXPIRED GAS COLLECTION QUANTITATIVE 44.00 HOSPITAL BASED HCHG PFT SPIROMETRY-LAB 437.00 HOSPITAL BASED HCHG EVOKED POTENTIAL AUDITORY, COMPREHENSIVE 110.00 HOSPITAL BASED HCHG ARTERIAL CATH FOR SAMPL/MONITOR/TRANSF 74.00 HOSPITAL BASED HCHG AMB OWNED BLS NON EMERG TRANSPORT 1,559.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL I ADDL MIN 29.00 HOSPITAL BASED HCHG PHASE I/PACU LEVEL III 1,193.00 HOSPITAL BASED HCHG BIRTHING VAGINAL UNCOMPLICATED 5,468.00 HOSPITAL BASED HCHG EXTNL ECG CONTINUOUS RHYTHM HOOK UP AND REC UP TO 48 HR 980.00 HOSPITAL BASED HCHG PT ACTIVATED EVENT RECORDING ONLY 628.00 HOSPITAL BASED HCHG EEG AWAKE/DROWSY 969.00 HOSPITAL BASED HCHG AMNIOCENTESIS DIAGNOSTIC 255.00 HOSPITAL BASED HCHG BONE MARROW ASPIRATION(S) 513.00 HOSPITAL BASED HCHG INSERT NONTUN CENTR VEN CATH >5 YRS 413.00 HOSPITAL BASED HCHG SPINAL PUNCTURE LUMBAR DIAGNOSTIC 840.00 HOSPITAL BASED HCHG TRIMMING NONDYSTROPHIC NAILS 55.00 HOSPITAL BASED HCHG ADMIN OF PNEUMOCOCCAL VACCINE 35.00 HOSPITAL BASED HCHG O/P CARDIAC REHAB W/CONT MONITOR 318.00 HOSPITAL BASED HCHG MBC-RED CELL PHENOTYPE 80.00 HOSPITAL BASED HCHG ENDO PROCEDURE ADDL NURSE CHARGE 46.00 HOSPITAL BASED HCHG OT SELECTIVE DEBRIDE 20 SQ CM OR LESS 256.00 HOSPITAL BASED HCHG US BIOPHYSICAL PROFILE WO NST 1,271.00 HOSPITAL BASED HCHG O2 SHORT TERM < 4 HRS 31.00 HOSPITAL BASED HCHG CHEMO ADMIN SQ/IM NON-HORMONAL ANTI NEOPL 266.00 HOSPITAL BASED HCHG CHEMO ADMIN SQ/IM HORMON ANTI NEOPL 266.00 HOSPITAL BASED HCHG VAC/NPWT <= 50 SQ CM RN W DME 447.00 HOSPITAL BASED HCHG SPLINT THUMB SPICA FOREARM BASED CUSTOM 673.00 HOSPITAL BASED HCHG IV INFUSION HYDRATION INITIAL 31-60 MIN 473.00 HOSPITAL BASED HCHG ED IV INF THERAPY/DX/PROPH INITIAL HR 499.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 1 6,571.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 ADDL MIN (+ SETUP) 38.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 2 ADDL MIN (< 2 STAFF) 36.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 3 7,951.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 (+ SETUP) 8,791.00 HOSPITAL BASED HCHG PROCEDURE LEVEL 4 ADDL MIN 58.00 HOSPITAL BASED HCHG WHO COCKUP NONMOLDED PREFAB OTS PR20 108.00 HOSPITAL BASED PR PHONE E&M EST PATIENT 21-30 MIN 245.00 HOSPITAL BASED HCHG TRANSESOPHAG ECHO W BUBBLE STUDY COMPLETE WO CONTRAST 1,503.00 HOSPITAL BASED HCHG ED US RETROPERITONEAL LIMITED 1,334.00 HOSPITAL BASED HCHG ENDO LEVEL 4 8,746.00 HOSPITAL BASED HCHG RMT TELEMETRY 30 DAY ECG W/TECH SUPPORT 0.00 HOSPITAL BASED HCHG FO PIP DIP W JOINT SPRING PREFAB OTS PR30 69.00 HOSPITAL BASED PR CHRON CARE MGMT SRVC 20 MIN 102.00 HOSPITAL BASED HCHG IR VERTEBROPLASTY EA ADDL LEVEL INCLUDING GUIDE 2,401.00 HOSPITAL BASED HCHG PT THERAPEUTIC ACTIVITIES XS 261.00 HOSPITAL BASED HCHG PT THERAPEUTIC EXERCISE XU 101.00 HOSPITAL BASED HCHG OT RE-EVALUATION XP 157.00 HOSPITAL BASED HCHG OT PARAFFIN BATH XP 35.00 HOSPITAL BASED HCHG OT WHEELCHAIR MGT/PROPUL 15 MIN XE 98.00 HOSPITAL BASED HCHG OT WHEELCHAIR MGT/PROPUL 15 MIN XS 98.00 HOSPITAL BASED HCHG OT PHY PERF TEST/MEASURE 15 MIN XU 105.00 HOSPITAL BASED HCHG PT PHY PERF TEST/MEASURE 15 MIN XP 105.00 HOSPITAL BASED HCHG SLP EVAL VIDEO SWALLOW XP 210.00 HOSPITAL BASED HCHG SLP EVAL ORAL/PHAR SWALLOWING XP 206.00 HOSPITAL BASED HCHG OT SELECTIVE DEBRIDE > 20 SQ CM XP 219.00 HOSPITAL BASED HCHG PT SELECTIVE DEBRIDE > 20 SQ CM XU 219.00 HOSPITAL BASED HCHG PT PULSATLIE LAVAGE > 20 SQ CM XE 219.00 HOSPITAL BASED HCHG OT SELECT DEBRIDE 20 SQ CM OR LESS XP 256.00 HOSPITAL BASED HCHG OT SELECT DEBRIDE 20 SQ CM OR LESS XU 256.00 HOSPITAL BASED HCHG OT PULSATILE LAV 20 SQ CM OR LESS XP 256.00 HOSPITAL BASED HCHG OT NONSELECTIVE DEBRIDEMENT SLOUGH WOUNDS XE 302.00 HOSPITAL BASED HCHG OT GROUP THERAPY XE 63.00 HOSPITAL BASED HCHG OT GROUP THERAPY XS 63.00 HOSPITAL BASED HCHG OT GROUP THERAPY XU 63.00 HOSPITAL BASED PR SLEEVE KNEE PR5 107.00 HOSPITAL BASED HCHG PT EVAL HIGH COMPLEXITY XP 305.00 HOSPITAL BASED HCHG OT EVAL LOW COMPLEXITY XE 191.00 HOSPITAL BASED HCHG OT EVAL MOD COMPLEXITY 248.00 HOSPITAL BASED HCHG OT EVAL MOD COMPLEXITY XE 248.00 HOSPITAL BASED HCHG OT EVAL MOD COMPLEXITY XS 248.00 HOSPITAL BASED HCHG OT EVAL HIGH COMPLEXITY XS 305.00 HOSPITAL BASED HCHG CATH PLCMT INJ/INFUSE EPI OR SUBA LUMB SACRAL WO GUIDE 294.00 HOSPITAL BASED HCHG MODERATE SED SAME PROVIDER < 5 YRS 1ST 15 MINUTES 173.00 HOSPITAL BASED HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP 52 514.00 HOSPITAL BASED HCHG DIAB ED AND TRAIN FOR SELF MGMT 2 TO 4 PTS AFFILIATE ONLY 58.00 HOSPITAL BASED HCHG PORPHYRINS, QN, 24 HR UR LC 52.00 HOSPITAL BASED HCHG UNLISTED CHEMO PROCEDURE AFFILIATE ONLY 374.00 HOSPITAL BASED HCHG AMB OWNED ALS LEVEL 2 2,313.00 HOSPITAL BASED HCHG ANES BLOOD PATCH 656.00 HOSPITAL BASED HCHG DURABLE MEDICAL EQUIPMENT MISC PR5 AFFILIATE ONLY 0.00 HOSPITAL BASED HCHG EXERCISE EQUIP PR50 AFFILIATE ONLY 276.00 HOSPITAL BASED HCHG FOOT ARCH SUPPORT RMVBL PRMLD EA PR5 150.00 HOSPITAL BASED HCHG SO FIG 8 ABDCT RSTR CAN WEB PREFAB OTS PR150 108.00 HOSPITAL BASED HCHG UE FX ORTHOSIS WRIST PREFAB PR450 668.00 HOSPITAL BASED HCHG WATERPROOF TAPE PER 18CM IN PR20 AFFILIATE ONLY 30.00 HOSPITAL BASED HCHG WHO COCKUP NONMOLDED PREFAB OTS PR170 108.00 HOSPITAL BASED HCHG FO PIP DIP W JOINT SPRING PREFAB OTS PR90 176.00 HOSPITAL BASED HCHG SLING PR5 AFFILIATE ONLY 29.00 HOSPITAL BASED HCHG SLING PR20 AFFILIATE ONLY 263.00 HOSPITAL BASED HCHG MINOR PROCEDURE LEVEL I AFFILIATE ONLY 1,754.00 HOSPITAL BASED HCHG SHOE POST OP AFFILIATE ONLY 85.00 HOSPITAL BASED HCHG OCH CHEST XRAY ONE VIEW AFFILIATE ONLY 45.00 HOSPITAL BASED NM DOSE TECH 99M PENTETATE DX AROSL TO 75 MCI 474.00 HOSPITAL BASED HCHG OT FLUIDOTHERAPY XE 68.00 HOSPITAL BASED HCHG WHFO CUSTOM SPLINT PR482 AFFILIATE ONLY 762.00 HOSPITAL BASED HCHG PULMONARY REHAB W EXERCISE 1 HOUR SESSION >36 KX 249.00 HOSPITAL BASED PR ONLINE DIGITAL E/M SVS EST PATIENT =< 7 DAYS 5-10 MIN 30.00 HOSPITAL BASED HCHG ADMIN OF SEASONAL INFLUENZA VACCINE 35.00 HOSPITAL BASED PR INITIAL OBSERVATION CARE LEVL 2 445.00 LAB/RAD PR PELVIC/BREAST CA SCREEN EXAM 133.00 LAB/RAD SENSITIVITY ANTIBIOTIC,MIC 235.00 LAB/RAD HCHG DOPPLER ECHOCARDIOGRAPHY FU/LTD 54.00 LAB/RAD HCHG BX ABD/RETROP MASS PERCUTANEOUS NEEDLE 2,801.00 LAB/RAD HCHG CONSULT SURGICAL 250.00 LAB/RAD HCHG AMMONIA 268.00 LAB/RAD HCHG AMPHETAMINE URINE 280.00 LAB/RAD HCHG AMYLASE BODY FLUID 392.00 LAB/RAD HCHG ARSENIC, 24HR UR 158.00 LAB/RAD HCHG CHOLESTEROL 125.00 LAB/RAD HCHG CK TOTAL 93.00 LAB/RAD HCHG ISTAT CREATININE 125.00 LAB/RAD HCHG CREATININE CLEARANCE 906.00 LAB/RAD HCHG ERYTHROPOIETIN 416.00 LAB/RAD HCHG BLOOD GAS 223.00 LAB/RAD HCHG LUTEINIZING HORMONE 382.00 LAB/RAD HCHG LD, BODY FLUID 245.00 LAB/RAD HCHG LD, TOTAL 245.00 LAB/RAD HCHG OLIGOCLONAL BANDS 406.00 LAB/RAD HCHG OSMOLALITY,URINE 183.00 LAB/RAD HCHG POTASSIUM URINE 120.00 LAB/RAD HCHG PREALBUMIN 155.00 LAB/RAD HCHG PROGESTERONE BLOOD 99.00 LAB/RAD HCHG PSA-DIAGNOSTIC 232.00 LAB/RAD HCHG PROTEIN, TIMED UR 345.00 LAB/RAD HCHG PSA-SCREEN 232.00 LAB/RAD HCHG T4 (THYROXINE) 212.00 LAB/RAD HCHG BUN 120.00 LAB/RAD HCHG ETHOSUXIMIDE 266.00 LAB/RAD HCHG NORTRIPTYLINE NOR 280.00 LAB/RAD HCHG TOBRAMYCIN PEAK 261.00 LAB/RAD HCHG VENIPUNCTURE 46.00 LAB/RAD HCHG GENERAL LAB 8102500 94.00 LAB/RAD HCHG BLOOD GAS HGB 158.00 LAB/RAD HCHG PROTEIN C ACTIVITY 469.00 LAB/RAD HCHG FIBRINOGEN QUANTITATIVE 211.00 LAB/RAD HCHG PLATELET COUNT 232.00 LAB/RAD HCHG STACLOT LA 216.00 LAB/RAD HCHG PROTHOMBIN TIME 93.00 LAB/RAD HCHG ACT. PROTEIN C RESIST 198.00 LAB/RAD HCHG NATIVE DNA ABY 212.00 LAB/RAD HCHG CA 19-9 538.00 LAB/RAD HCHG RUBEOLA IMMUNITY 32.00 LAB/RAD HCHG SPUTUM CULTURE 256.00 LAB/RAD HCHG VAG CERV CULTURE 256.00 LAB/RAD HCHG VANCO RES ENTERO CULT 132.00 LAB/RAD HCHG PINWORM PREP 210.00 LAB/RAD HCHG BETA LACTAMASE 216.00 LAB/RAD HCHG AFB SMEAR (AFS) 138.00 LAB/RAD HCHG GC PCR 293.00 LAB/RAD HCHG FRZ SECTION 1ST 108.00 LAB/RAD HCHG BASEMENT MEMBRANE ABY IGG 126.00 LAB/RAD HCHG FETAL ABO 210.00 LAB/RAD HCHG ARSENIC HEAVY METAL SCR URINE 149.00 LAB/RAD HCHG GLUCOSE TOLERANCE 1ST ADDL 1,011.00 LAB/RAD HCHG VANCOMYCIN TROUGH 102.00 LAB/RAD HCHG REFERRAL ID & SUSC NONURINE 182.00 LAB/RAD HCHG FLOW MARKER, INTERP 2-8 179.00 LAB/RAD HCHG IHC SEMIQUANT 401.00 LAB/RAD HCHG US PELVIS TRANSVAGINAL NON OB 425.00 LAB/RAD HCHG RBC LR IRR WASH/DEGLYCS 1,023.00 LAB/RAD NM DOSE I 131 DIAG CAP PER MCI 626.00 LAB/RAD NM DOSE TECH 99M PYP 25MCI 391.00 LAB/RAD NM DOSE TECH 99M OXIDRONATE 30MCI 469.00 LAB/RAD NM DOSE IN 111 WBC .5MCI 391.00 LAB/RAD HCHG YEAST SENS CHARGE 235.00 LAB/RAD HCHG MG AD ABY 394.00 LAB/RAD HCHG RAST IN-HOUSE 70.00 LAB/RAD HCHG LEGIONELLA SPECIES BY RAPID PCR 655.00 LAB/RAD HCHG LACOSAMIDE VIMPAT 280.00 LAB/RAD HCHG OXCARBAZEPINE (MEDTOX) TRILEPTAL 37.00 LAB/RAD PB GLUCOSE TOLERANCE FASTING 130.00 LAB/RAD HCHG FELBAMATE MEDTOX 280.00 LAB/RAD HCHG ENTEROVIRUS BY PCR, CSF 232.00 LAB/RAD HCHG H. PYLORI ANTIGEN, STOOL 126.00 LAB/RAD HCHG LAMOTRIGINE LMX 224.00 LAB/RAD HCHG LEVETIRACETAM LVX 264.00 LAB/RAD HCHG US CATH FLUID COLLECTION DRAINAGE SOFT TISSUE INC GUIDE 1,886.00 LAB/RAD PB SCREEN PAP OBTAINING SPECIMEN 68.00 LAB/RAD PB CARDIOLIPIN IGA CRD 177.00 LAB/RAD HCHG CYG-NEOPLASTIC SOLID TISSUE CULTURE 682.00 LAB/RAD HCHG CYG-CELL ENRICHMENT 238.00 LAB/RAD HCHG CYG-CYTOGENETIC INTERP 695.00 LAB/RAD PB TB T-SPOT 216.00 LAB/RAD PB RO60 ANTIBODY 311.00 LAB/RAD PB RO52 ANTIBODY 311.00 LAB/RAD HCHG LAMELLAR BODY COUNT AFFILIATE ONLY 723.00 LAB/RAD HCHG CT ASPIRATION PUNCTURE HEMATOMA BULLA CYST 3,037.00 LAB/RAD HCHG CT DRAIN ABSCESS OR HEMATOMA PELVIS OR HIP 2,511.00 LAB/RAD HCHG CT DRAIN ABSCESS OR HEMATOMA LEG OR ANKLE 2,153.00 LAB/RAD HCHG CT BIOPSY PANCREAS 2,883.00 LAB/RAD HCHG CT BIOPSY ABDOMEN OR RETROPERITONEAL 2,883.00 LAB/RAD HCHG CT BIOPSY ADRENAL BILATERAL 0.00 LAB/RAD HCHG CT PROCEDURE FOR ENDOCRINE SYSTEM 3,457.00 LAB/RAD HCHG CT FACET JOINT INJ CERV/THOR SECOND LEVEL W CT GUIDE 199.00 LAB/RAD HCHG CT SACROPLASTY W GUIDE BILATERAL 13,674.00 LAB/RAD HCHG CT INJ SACROILIAC JOINT 1,533.00 LAB/RAD RAD CT HEAD BRAIN WO 3,869.00 LAB/RAD RAD CT ORBITS OR TEMPORAL BONES WO 4,425.00 LAB/RAD RAD CT ORBITS OR TEMPORAL BONES WWO 4,105.00 LAB/RAD RAD CT FACIAL BONES AND SINUS WO 3,998.00 LAB/RAD RAD CT NECK SOFT TISSUE WO 3,833.00 LAB/RAD RAD CT ANGIO CHEST 6,007.00 LAB/RAD RAD CT SPINE CERVICAL W 4,105.00 LAB/RAD RAD CT ABDOMEN PELVIS WO 6,124.00 LAB/RAD RAD CT ABDOMEN PELVIS COLONOGRAPHY SCREENING WO 4,287.00 LAB/RAD RAD CT 3D RECONSTRUCTION WO POSTPROCESS INDP WKST 1,324.00 LAB/RAD RAD IR FISTULA/SINUS TRACT INJECTION 1,691.00 LAB/RAD RAD IR 3D RECONSTRUCTION W POSTPROCESS INDP WKST 854.00 LAB/RAD RAD MR ANGIO HEAD BRAIN WWO 4,386.00 LAB/RAD RAD MR SPINE LUMBAR WO 4,386.00 LAB/RAD RAD MR SPINE LUMBAR W 4,386.00 LAB/RAD RAD MR PELVIS WO 4,386.00 LAB/RAD RAD MR GUIDED NEEDLE PLACEMENT 4,386.00 LAB/RAD RAD MR BREAST BILATERAL WWO 4,386.00 LAB/RAD RAD NM PARATHYROID PLANAR IMAGING WITH SPECT 782.00 LAB/RAD RAD NM GI BLOOD LOSS 1,926.00 LAB/RAD RAD PET CT SKULL BASE TO MID THIGH SUBSEQUENT TREAT 6,074.00 LAB/RAD RAD PET CT WHOLE BODY SUBSEQUENT TREAT 4,723.00 LAB/RAD HCHG US THORACENTESIS PLEURAL SPACE 2,641.00 LAB/RAD HCHG US BIOPSY LYMPH NODE 528.00 LAB/RAD HCHG US BLADDER WITH POST VOID 180.00 LAB/RAD RAD US GUIDE PERC DRAIN CATH 504.00 LAB/RAD PB AMINO ACIDEMIAS (PKU) MN 187.00 LAB/RAD RAD US PELVIS COMPLETE NONOBSTETRIC 1,386.00 LAB/RAD RAD US GUIDANCE INTRAOPERATIVE 217.00 LAB/RAD RAD US LOWER EXTREMITY BILATERAL COMPLETE 1,346.00 LAB/RAD RAD US DUPLEX SCAN ABDOMEN LTD STUDY 900.00 LAB/RAD HCHG XR ARTHROCENTESIS INTERMEDIATE JOINT OR BURSA 406.00 LAB/RAD HCHG XR INJ ARTHROGRAM KNEE 362.00 LAB/RAD HCHG XR NG TUBE PLACEMENT 1,032.00 LAB/RAD RAD US BREAST LIMITED 2,048.00 LAB/RAD HCHG XR INJ TRANSFORAMINAL LUMBAR OR SACRAL EA ADDL LEV 3,037.00 LAB/RAD HCHG XR INJ NERVE BLOCK LUMBAR SYMPATHETIC 3,139.00 LAB/RAD PB VITAMIN D TOTAL 188.00 LAB/RAD PB VITAMIN B-12 279.00 LAB/RAD PB IRON BINDING CAPACITY (IBC) 86.00 LAB/RAD PB SODIUM 183.00 LAB/RAD PB POTASSIUM 93.00 LAB/RAD PB BASIC METABOLIC PANEL 156.00 LAB/RAD PB TREPONEMA PALLIDUM 355.00 LAB/RAD PB IMAGED THIN PREP PAP DIAGNOSTIC 152.00 LAB/RAD RAD XR PELVIS AND HIPS BILAT INFANT/CHILD 2VIEWS 1,140.00 LAB/RAD RAD XR RIBS BILATERAL AND CHEST MINIMUM 4 VIEWS 1,263.00 LAB/RAD RAD XR STERNOCLAVICULAR JOINT(S) MIN 3 VIEWS 744.00 LAB/RAD RAD XR SPINE CERVICAL FOUR OR FIVE VIEWS 1,174.00 LAB/RAD RAD XR SPINE THORACIC 3 VIEWS 1,270.00 LAB/RAD RAD XR FEMUR 2 VIEWS PORTABLE 520.00 LAB/RAD RAD XR SHOULDER 1 VIEW 831.00 LAB/RAD RAD XR WRIST 2 VIEWS 514.00 LAB/RAD RAD XR WRIST THREE VIEWS OR MORE 716.00 LAB/RAD RAD XR FINGER TWO VIEWS OR MORE 555.00 LAB/RAD HCHG CT BILI CATH PERC WWO CHOLANGIOGRAPHY W GUIDE EXTERNAL S&I 3,156.00 LAB/RAD RAD XR CHOLANGIOGRAM OPERATIVE 2,096.00 LAB/RAD RAD XR UROGRAPHY ANTEGRADE 416.00 LAB/RAD RAD XR CYSTOGRAM 1,237.00 LAB/RAD RAD XR NOSE TO RECTUM OF CHILD FOR FOREIGN BODY 382.00 LAB/RAD RAD XR BONE AGE STUDIES 261.00 LAB/RAD RAD XR BONE SURVEY COMPLETE 3,427.00 LAB/RAD PB BARBITURATE QNT UR 280.00 LAB/RAD HCHG DRUG TESTING INHOUSE 280.00 LAB/RAD HCHG US THORACENTESIS PLEURAL SPACE PORTABLE 2,641.00 LAB/RAD RAD XR SPINE CERVICAL 2 OR 3 VIEWS PORTABLE 664.00 LAB/RAD RAD XR CLAVICLE COMPLETE PORTABLE 903.00 LAB/RAD RAD XR FINGER TWO VIEWS OR MORE PORTABLE 555.00 LAB/RAD HCHG CYG-CONGENTITAL SOLID TISSUE EXTENDED CULTURE MAINTENANCE 625.00 LAB/RAD RAD US ARTERIAL UPPER EXTREMITY BILAT COMPLETE PORTABLE 1,117.00 LAB/RAD RAD US ARTERIAL UPPER EXTREMITY UNI OR LTD STUDY PORTABLE 737.00 LAB/RAD HCHG MICRODISSECTION MANUAL CAPTURE 174.00 LAB/RAD PB MICRO DISSECT MANUAL 176.00 LAB/RAD PB GENERAL LAB 8759104 293.00 LAB/RAD PB ALPHA 1 ANTITRYPSIN A1A 132.00 LAB/RAD PB AMYLASE,TIMED URINE 392.00 LAB/RAD PB OCCULT BLOOD STOOL 94.00 LAB/RAD PB CALCIUM, TIMED URINE 152.00 LAB/RAD PB CK-MB 138.00 LAB/RAD PB GLUCOSE TOLERANCE 1ST ADDL 1,011.00 LAB/RAD PB LD, TOTAL 245.00 LAB/RAD PB MAGNESIUM BLOOD 154.00 LAB/RAD PB PSA-DIAGNOSTIC 232.00 LAB/RAD PB SODIUM, URINE, RANDOM 120.00 LAB/RAD PB CONGENITAL HYPOTHYROIDISM NEWBORN SCR MN 130.00 LAB/RAD PB CBC W/DIFF 120.00 LAB/RAD PB MITOCHONDRIAL ABY 93.00 LAB/RAD PB PATIENT ANTIGEN 81.00 LAB/RAD PB OBSTETRIC PANEL 175.00 LAB/RAD HCHG BABESIA MICROTI ANTIBODY LC 199.00 LAB/RAD HCHG BCR-ABL1, CML/ALL, PCR, MINOR BP LC 485.00 LAB/RAD HCHG BILE ACIDS LC 175.00 LAB/RAD HCHG BLASTOMYCES ABS, QN, DID LC 148.00 LAB/RAD PB VANCOMYCIN TROUGH 102.00 LAB/RAD HCHG CLOZAPINE (CLOZARIL), SERUM LC 78.00 LAB/RAD PB BILIRUBIN URINE 94.00 LAB/RAD HCHG EBV EARLY ANTIGEN AB, IGG LC 42.00 LAB/RAD HCHG ENDOMYSIAL ANTIBODY IGA LC 93.00 LAB/RAD PB CERULOPLASMIN 102.00 LAB/RAD HCHG GENERAL LAB 8751701 LC 260.00 LAB/RAD HCHG HISTOPLASMA CAPSULATUM ABS LC 148.00 LAB/RAD HCHG IGG LC 176.00 LAB/RAD PB FERRITIN 279.00 LAB/RAD PB BLOOD GAS CORD ARTERIAL 223.00 LAB/RAD HCHG LYME (B. BURGDORFERI) PCR LC 339.00 LAB/RAD HCHG ANTIPARIETAL CELL ANTIBODY LC 156.00 LAB/RAD HCHG TOXOPLASMA GONDII AB, IGG, QN LC 52.00 LAB/RAD HCHG VITAMIN B2, WHOLE BLOOD LC 62.00 LAB/RAD HCHG VITAMIN C LC 27.00 LAB/RAD PB PROLACTIN 114.00 LAB/RAD PB ALPHA-1-ANTITRYPSIN, SERUM LC 132.00 LAB/RAD PB ALK PHOS TOTAL LC 295.00 LAB/RAD PB A.FUMIGATUS PRECIPITATING ABS, IGG LC 160.00 LAB/RAD PB HCG BETA QUANT,TUMOR LC 266.00 LAB/RAD PB BLASTOMYCES ABS, QN, DID LC 148.00 LAB/RAD PB RISTOCETIN COFACTOR 460.00 LAB/RAD PB CA 15-3 345.00 LAB/RAD PB TOTAL T CELLS 264.00 LAB/RAD PB GENERAL LAB 8659201 100.00 LAB/RAD PB GENERAL LAB 8670900 243.00 LAB/RAD PB PROINSULIN LC 69.00 LAB/RAD PB SPINAL FLUID CULTURE 256.00 LAB/RAD PB ANAEROBE IDENT 176.00 LAB/RAD PB URINE PRESUMPTIVE ID 32.00 LAB/RAD PB YEAST CULTURE 244.00 LAB/RAD PB TOTAL TESTOSTERONE, LC 294.00 LAB/RAD PB PARASITE DIRECT EXAM 49.00 LAB/RAD PB TISSUE HOMOGENIZATION 210.00 LAB/RAD PB ROTAVIRUS ANTIGEN STOOL 127.00 LAB/RAD PB NON-GYN THIN PREP 155.00 LAB/RAD PB IMMUNOFLUORESCENCE FIRST 312.00 LAB/RAD PB PROSTATE SATURATION BIOPSY 670.00 LAB/RAD PB RBC LR IR PEDS UNIT 300.00 LAB/RAD PB RBC LR CMV NEG PEDS UNIT 300.00 LAB/RAD PB RBC LR IRR CMV NEG WASHED PEDS UNIT 300.00 LAB/RAD HCHG ANCA TITER 93.00 LAB/RAD HCHG EBV VCA IGM 313.00 LAB/RAD PB GLIADIN ABY IGA 156.00 LAB/RAD HCHG FUNGITELL, SERUM LC 62.00 LAB/RAD HCHG TESTOSTERONE FREE LC 294.00 LAB/RAD HCHG US INJ ANES ILIOINGUINAL HYPOGAS 406.00 LAB/RAD HCHG XR INJ INTERCOSTAL NERVES MULT REGIONAL BLOCK 3,139.00 LAB/RAD HCHG XR IVC FILTER REPOSITION 4,079.00 LAB/RAD HCHG XR REPLACE PICC WO SQ PORT W GUIDANCE VIA SAME SITE 400.00 LAB/RAD NM DOSE RADIUM RA 223 DICHLORIDE 5,375.00 LAB/RAD HCHG OPIATE AND OPIOID CONFIRMATION UR 280.00 LAB/RAD HCHG PNEUMOCYSTIS PCR 162.00 LAB/RAD PB MRSA DNA PCR 339.00 LAB/RAD HCHG ENCEPHALOPATHY AUTOIMMUNE FLUORESCENT ABY SCR CSF 93.00 LAB/RAD PB PHENCYCLIDINE PCP QUAL UR 280.00 LAB/RAD RAD XR FEMUR 2 VIEWS LTD 520.00 LAB/RAD PB TB INTRADERMAL TEST 64.00 LAB/RAD PB BILIRUBIN TOTAL TRANSCUTANEOUS POC AFFILIATE ONLY 38.00 LAB/RAD HCHG TROPONIN I QUAL 35.00 LAB/RAD HCHG SP STAIN 2 TECH ONLY 158.00 LAB/RAD PB POST VAS CHECK IN HOUSE NC 166.00 LAB/RAD PB TACROLIMUS AHL 383.00 LAB/RAD RAD US OB BIOPHYSICAL PROFILE W NST PORTABLE 1,271.00 LAB/RAD NM DOSE TECH 99M PENTETATE DX AROSL TO 75 MCI 469.00 LAB/RAD HCHG KRAS MUTATION AFFILIATE ONLY 1,000.00 LAB/RAD HCHG GENERAL LAB G0499 83.00 LAB/RAD PB FLT3 ITD 563.00 LAB/RAD RAD XR CHEST FRONTAL 1 VIEW PORTABLE 470.00 LAB/RAD RAD XR MAMMO BILAT ADDL VIEWS WWO CAD 505.00 LAB/RAD RAD XR MAMMO BILAT SCREENING LTD WWO CAD 505.00 LAB/RAD HCHG NRAS MUTATION ANALYSIS 997.00 LAB/RAD HCHG COVID 19 HIGH THROUGHPUT LC 140.00 LAB/RAD PLATELET FUNCTION TEST 75.00 LAB/RAD TISSUE CULTURE NON-NEOPLASTIC LYMPHOCYTE 406.00 LAB/RAD PR TDAP VACCINE IM OVER 7 YEARS OLD 120.00 LAB/RAD HCHG INJ(S) SGL/MUL TRIG PT(S) 3 OR > MUSC 1,572.00 LAB/RAD HCHG CONSULT MATERIAL 600.00 LAB/RAD HCHG CONSULT EXTENDED 681.00 LAB/RAD HCHG COMPREHENSIVE METABOLIC PANE 173.00 LAB/RAD HCHG LIPID PANEL 181.00 LAB/RAD HCHG AMINO ACID QUANT UR RANDOM 230.00 LAB/RAD HCHG HCO3 94.00 LAB/RAD HCHG CARBOXYHEMOGLOBIN 180.00 LAB/RAD HCHG PROPAFENONE RYTHMOL 280.00 LAB/RAD HCHG IGG (SERUM) 176.00 LAB/RAD HCHG GLUCOSE, CSF 130.00 LAB/RAD HCHG METHEMGLOBIN 26.00 LAB/RAD HCHG CAFFEINE 88.00 LAB/RAD HCHG VALPROIC ACID UNBOUND 308.00 LAB/RAD HCHG CARBAMAZE EPOXIDE 200.00 LAB/RAD HCHG PH BODY FLUID 70.00 LAB/RAD HCHG PROTEIN,BODY FLUID 231.00 LAB/RAD HCHG TESTOSTERONE 146.00 LAB/RAD HCHG T4, FREE 167.00 LAB/RAD HCHG C-PEPTIDE SERUM 139.00 LAB/RAD HCHG SENDOUTS MISC 141.00 LAB/RAD HCHG TOBRAMICIN KINETICS 68.00 LAB/RAD HCHG FACTOR X CHROMOGENIC 152.00 LAB/RAD HCHG HEMATOCRIT 120.00 LAB/RAD HCHG RETIC COUNT 256.00 LAB/RAD HCHG EOSINOPHIL COUNT 139.00 LAB/RAD HCHG DRVVT SCREEN 77.00 LAB/RAD HCHG CELL COUNT & DIFF B.F. ST 339.00 LAB/RAD HCHG GENERAL LAB 8670400 217.00 LAB/RAD HCHG INHIBIN A 99.00 LAB/RAD HCHG THY PEROXIDASE ABY 261.00 LAB/RAD HCHG RPR 100.00 LAB/RAD HCHG HELICOBACTER PYLORI IGG AFFILIATE ONLY 154.00 LAB/RAD HCHG IV CATHETER CULTURE 256.00 LAB/RAD HCHG STERILITY CULTURE 256.00 LAB/RAD HCHG BODY FLUID CULTURE 256.00 LAB/RAD HCHG BRONCH CULTURE 256.00 LAB/RAD HCHG URINE CULTURE 58.00 LAB/RAD HCHG FUNGAL BLOOD CULTURE 127.00 LAB/RAD HCHG MAL/PAR SMEAR 130.00 LAB/RAD HCHG SCABIES/MITE EXAM 152.00 LAB/RAD HCHG TISSUE LEVEL 3 127.00 LAB/RAD HCHG O & P STAIN 174.00 LAB/RAD HCHG FRZ SECTION ADDTL BLK 108.00 LAB/RAD HCHG IHC STAIN FIRST 312.00 LAB/RAD HCHG IMMUNOFLUORESCENCE HCMC FIRST 312.00 LAB/RAD HCHG ANTIBODY TITERED 21.00 LAB/RAD HCHG RH PHEMOTYPE 92.00 LAB/RAD HCHG RBC LR IRR 790.00 LAB/RAD HCHG BLOOD GAS CORD ARTERIAL 223.00 LAB/RAD HCHG HSV 1 IGG ABY 63.00 LAB/RAD HCHG HSV 2 IGG ABY 102.00 LAB/RAD HCHG BLEEDING TIME 152.00 LAB/RAD HCHG US OB TRANSVAGINAL 425.00 LAB/RAD HCHG IMMUNOFLUORESCENCE FIRST 312.00 LAB/RAD NM DOSE TECH 99M MEBROFENIN 15MCI 391.00 LAB/RAD NM DOSE FDG 45MCI 391.00 LAB/RAD HCHG DEFINITY PER ML 207.00 LAB/RAD HCHG MRI BRAIN WO CONTRAST 4,388.00 LAB/RAD HCHG INTRAOP CYTO PATH CONSULT FIRST 166.00 LAB/RAD NM DOSE TECH 99M FILTERED SULFUR COLLOID 20MCI 391.00 LAB/RAD HCHG CYSTO CONRAY II PER ML 497.00 LAB/RAD HCHG GENERAL LAB 8752200 341.00 LAB/RAD HCHG B-HYDROXYBUTYRATE 177.00 LAB/RAD HCHG VON WILLEBRAND ANTIGEN 366.00 LAB/RAD HCHG MG AD IMMUNO 329.00 LAB/RAD HCHG ECHO 2D COMP W CONT-SPECTRAL-COLOR 2,184.00 LAB/RAD HCHG PREGABALIN (LYRICA) 280.00 LAB/RAD HCHG BETA 2 GLYCOPROTEIN 1 IGA 177.00 LAB/RAD HCHG SHIGA TOXIN 1 74.00 LAB/RAD HCHG AEROMONAS PLATE STL 85.00 LAB/RAD HCHG MISC VARIABLE CHARGE 0.00 LAB/RAD NM DOSE TC 99M TILMANOCEPT UP TO 0.5 MCI 614.00 LAB/RAD HCHG TOPIRAMATE TMX 158.00 LAB/RAD HCHG COBALT, SERUM 158.00 LAB/RAD HCHG XR STEREO BREAST LOC PERC MARKER EA ADDL W GUIDE LT 236.00 LAB/RAD HCHG MR BREAST LOC PERC MARKER 1ST LESION W GUIDE 2,103.00 LAB/RAD HCHG MR BREAST LOC PERC MARKER EACH ADDL W GUIDE RT 1,705.00 LAB/RAD HCHG CYTOMEGALOVIRUS (CMV), QUALITATIVE, PCR LC 232.00 LAB/RAD HCHG US INJ PRP INCLUDE US GUIDE/HARVEST/PREP 549.00 LAB/RAD HCHG CYG-ADDL KARYOTYPE 114.00 LAB/RAD HCHG CYG-ADDITIONAL CELLS COUNTED 307.00 LAB/RAD HCHG CYG-FISH ONCOLOGY INTERPHASE PROBE 245.00 LAB/RAD HCHG H HEMACHROMATOSIS 417.00 LAB/RAD PB CYG-FULL CHROMOSOME ANALYSIS 749.00 LAB/RAD HCHG CT BIOPSY MUSCLE 2,883.00 LAB/RAD HCHG CT INJECTION MAJOR JOINT BURSA 1,048.00 LAB/RAD HCHG CT BIOPSY SOFT TISSUE BACK DEEP 1,041.00 LAB/RAD HCHG CT BIOPSY PELVIS SOFT TISSUE SUPERFICIAL 815.00 LAB/RAD HCHG CT CHEST TUBE PLACEMENT 1,174.00 LAB/RAD HCHG CT BIOPSY SALIVARY GLAND 641.00 LAB/RAD HCHG CT ASPIRATION PERC OVARIAN ABSCESS 0.00 LAB/RAD HCHG CT FACET JOINT INJ CERV/THOR SNGL LEVEL W CT GUIDE 5,272.00 LAB/RAD HCHG CT FACET JOINT INJ LUMBAR/SACRAL SNGL LEVEL W CT GUIDE 3,139.00 LAB/RAD HCHG CT ASPIRATION SYNOVIAL CYST FACET JT 1,572.00 LAB/RAD RAD CT ANGIO PELVIS 4,145.00 LAB/RAD RAD CT ANGIO UPPER EXTREMITY 4,286.00 LAB/RAD RAD CT ANGIO ABDOMEN 5,258.00 LAB/RAD RAD CT PELVIS CYSTOGRAM 4,105.00 LAB/RAD RAD CT GUIDED NEEDLE PLACEMENT 1,832.00 LAB/RAD HCHG IR CENTRAL VENOUS CATHETER TUNNEL REMOVAL 730.00 LAB/RAD HCHG POC GLUCOSE AFFILIATE ONLY 130.00 LAB/RAD RAD IR HYSTEROSALPINGOGRAM 2,036.00 LAB/RAD RAD IR FLUORO EQUAL OR LESS 1 HR 574.00 LAB/RAD RAD IR FLUORO GUIDED NEEDLE PLACEMENT 950.00 LAB/RAD RAD MR NECK SOFT TISSUE ORBIT FACE WO 4,386.00 LAB/RAD RAD MR SPINE THORACIC W 4,386.00 LAB/RAD RAD MR SPINE LUMBAR WWO 4,386.00 LAB/RAD RAD MR NON JOINT UPPER EXTREMITY WO 4,386.00 LAB/RAD RAD MR JOINT OF UPPER EXTREMITY WWO 4,386.00 LAB/RAD RAD MR JOINT LOWER EXTREMITY WO 4,386.00 LAB/RAD RAD MR ABDOMEN WO 4,386.00 LAB/RAD RAD NM THYROID IMAGING WITH VASCULAR FLOW 2,373.00 LAB/RAD RAD NM MECKELS 2,501.00 LAB/RAD RAD NM CARDIAC MYOCARD INFARCT SPECT 1,689.00 LAB/RAD RAD NM RENAL MULTI WWO PHARM 899.00 LAB/RAD RAD NM RADIOPHARM ORAL THERAPY 326.00 LAB/RAD RAD PET BRAIN METABOLIC EVALUATION 2,934.00 LAB/RAD RAD PET CT BREAST CANCER INITIAL DX OR SURG PLAN 2,902.00 LAB/RAD HCHG US MUSCULOSKELETAL PROCEDURE 0.00 LAB/RAD HCHG US BIOPSY SOFT TISSUE NECK OR CHEST 2,883.00 LAB/RAD HCHG US BIOPSY LIVER 570.00 LAB/RAD RAD US RETROPERITONEAL LIMITED STUDY 1,081.00 LAB/RAD RAD US SPINAL CANAL AND CONTENTS 773.00 LAB/RAD RAD US OB EQUAL OR GREATER THAN 14 WKS SINGLE GEST 1,304.00 LAB/RAD RAD US PELVIS COMPLETE TV ADD ON 425.00 LAB/RAD HCHG IHC STAIN MULTIPLEX 300.00 LAB/RAD HCHG XR INJ ARTHROGRAM HIP W ANESTHESIA 580.00 LAB/RAD HCHG XR INJ FOR GASTRO TUBE EVAL 423.00 LAB/RAD HCHG XR INJ FOR LOOPOGRAM 235.00 LAB/RAD HCHG XR SPINAL PUNCTURE THERAPEUTIC 1,321.00 LAB/RAD HCHG XR INJECTION FOR MYELOGRAM OR SPINAL CT 437.00 LAB/RAD HCHG XR INJ FACET LUMBAR OR SACRAL SINGLE LEV 3,139.00 LAB/RAD RAD XR SPINE THORACOLUMBAR STANDING SCOLIOSIS 1 VIEW 983.00 LAB/RAD PB DHEA-SULFATE 100.00 LAB/RAD PB GLUCOSE 130.00 LAB/RAD RAD CT CHEST LOW DOSE WO CONTRAST SCREEN 965.00 LAB/RAD RAD XR ELBOW 2 VIEWS 500.00 LAB/RAD RAD XR ELBOW 2 VIEWS LTD 500.00 LAB/RAD RAD XR FOREARM 2 VIEWS 704.00 LAB/RAD RAD XR KNEE COMPLETE 4 VIEWS OR MORE 1,090.00 LAB/RAD RAD XR TIBIA AND FIBULA 2 VIEWS 704.00 LAB/RAD RAD XR FOOT 2 VIEWS LTD 475.00 LAB/RAD RAD XR TOE(S) MINIMUM OF 2 VIEWS 555.00 LAB/RAD RAD XR UPPER GI 1,341.00 LAB/RAD RAD XR SMALL INTESTINE 960.00 LAB/RAD RAD XR COLON WITH CONTRAST ENEMA 1,269.00 LAB/RAD RAD XR ERCP BILIARY ONLY 85.00 LAB/RAD RAD XR IVP FUNCTION 1,489.00 LAB/RAD RAD XR HYSTEROSALPINGOGRAM 2,036.00 LAB/RAD RAD XR FLUOROSCOPY UP TO 1 HOUR 720.00 LAB/RAD RAD XR FLUROSCOPY FOR CENTRAL VENOUS ACCESS DEVICE PLACEMENT 1,534.00 LAB/RAD PB ETHOTOIN ETO 280.00 LAB/RAD PB FELBAMATE FELBATOL MTX 280.00 LAB/RAD RAD XR PELVIS 1 OR 2 VIEWS PORTABLE 525.00 LAB/RAD RAD XR TIBIA AND FIBULA 2 VIEWS PORTABLE 704.00 LAB/RAD RAD US ABDOMEN COMPLETE PORTABLE 1,085.00 LAB/RAD RAD US GUIDED NEEDLE PLACEMENT PORTABLE 3,464.00 LAB/RAD RAD US CAROTID DUPLEX BILATERAL PORTABLE 1,990.00 LAB/RAD RAD US LOWER EXTREMITY BILATERAL COMPLETE PORTABLE 1,346.00 LAB/RAD HCHG BASIC METABOLIC RTR 156.00 LAB/RAD RAD US ABD AORTA SCREENING 815.00 LAB/RAD PB COMPLIANCE DRUG ANALYSIS CDS 312.00 LAB/RAD PB PHENYTOIN 110.00 LAB/RAD PB TOPIRAMATE TMX 158.00 LAB/RAD PB ACTH STIMULATION PANEL 198.00 LAB/RAD PB B-HYDROXYBUTYRATE 177.00 LAB/RAD PB AFP-PRENATAL 100.00 LAB/RAD PB GALACTOSEMIA NEWBORN SCR MN 44.00 LAB/RAD PB PNP RIA 329.00 LAB/RAD PB MYOGLOBIN, SERUM 308.00 LAB/RAD PB PH BODY FLUID 70.00 LAB/RAD PB PROTEIN, TIMED UR 345.00 LAB/RAD PB TRIGLYCERIDE BODY FLUID 212.00 LAB/RAD PB T3 TOTAL 149.00 LAB/RAD PB RAST IN-HOUSE 70.00 LAB/RAD PB SMOOTH MUSCLE ABY 88.00 LAB/RAD PB IMMUNOFIXATION URINE 155.00 LAB/RAD PB HCV RNA RT PCR QUANT 341.00 LAB/RAD PB CELL COUNT & DIFF B.F. ST 339.00 LAB/RAD HCHG ANTISTREPTOLYSIN O AB LC 131.00 LAB/RAD PB VENIPUNCTURE 46.00 LAB/RAD PB RENAL FUNCTION PANEL 170.00 LAB/RAD HCHG BABESIA MICROTI, PCR LC 162.00 LAB/RAD PB HEPATIC FUNCTION PANEL 268.00 LAB/RAD HCHG BARTONELLA ANTIBODY LC 204.00 LAB/RAD PB CARBAMAZEPINE FREE 326.00 LAB/RAD HCHG CORTISOL, URINARY FREE LC 374.00 LAB/RAD PB KETONES URINE 94.00 LAB/RAD PB REDUCING SUBSTANCES URINE 70.00 LAB/RAD PB AMMONIA 268.00 LAB/RAD HCHG EPSTEIN-BARR DNA QUANT, PCR LC 60.00 LAB/RAD HCHG EPSTEIN-BARR VIRUS PCR LC 482.00 LAB/RAD PB CEA 462.00 LAB/RAD HCHG GENERAL LAB 8752902 LC 625.00 LAB/RAD PB CK TOTAL 93.00 LAB/RAD HCHG ANTI-JO-1 LC 65.00 LAB/RAD HCHG LEAD, BLOOD LC 149.00 LAB/RAD PB IGG (CSF) 176.00 LAB/RAD HCHG ASPERGILLUS FUMIGATUS ANTIBODY LC 55.00 LAB/RAD HCHG TOTAL TESTOSTERONE, LC 146.00 LAB/RAD HCHG VANILLYLMANDELIC ACID, 24-HR U LC 139.00 LAB/RAD PB PROTEIN ELP URINE 308.00 LAB/RAD PB RBC 127.00 LAB/RAD PB WBC 139.00 LAB/RAD PB PERIPH BLOOD SMR 191.00 LAB/RAD PB ANTITHROMBIN III 155.00 LAB/RAD PB FIBRINOGEN QUANTITATIVE 211.00 LAB/RAD PB PROTHOMBIN TIME 93.00 LAB/RAD PB INR POCT 93.00 LAB/RAD PB CARDIOLIPIN IGM CRD 177.00 LAB/RAD PB RNP ANTIBODY 311.00 LAB/RAD PB INHIBIN A 99.00 LAB/RAD PB GENERAL LAB 308670701 LC 35.00 LAB/RAD PB GENERAL LAB 8670500 94.00 LAB/RAD PB METANEPHRINES, FRAC, PL FREE LC 196.00 LAB/RAD PB CORD RH TYPE 56.00 LAB/RAD PB NASAL CULTURE 256.00 LAB/RAD PB BRONCH CULTURE 256.00 LAB/RAD PB GC CULTURE 132.00 LAB/RAD PB KB SENS 2 74.00 LAB/RAD PB SCABIES/MITE EXAM 152.00 LAB/RAD PB GIARDIA ANTIGEN 93.00 LAB/RAD PB CYTO FLUID TP 216.00 LAB/RAD PB FNA INTERP & REPORT 294.00 LAB/RAD PB PEDS UNIT RED CELLS 300.00 LAB/RAD PB RBC LR UNIT 688.00 LAB/RAD PB RBC WASHED 731.00 LAB/RAD PB RED BLOOD CELLS IRR 474.00 LAB/RAD HCHG TISSUE TRANSGLUTAMINASE IGG 156.00 LAB/RAD HCHG RA QUAL HHC ONLY 183.00 LAB/RAD HCHG MYD88 MUTATION DETECTION PCR LC 793.00 LAB/RAD HCHG CT INJ PERIPHERAL NERVE BLOCK 1,572.00 LAB/RAD HCHG XR GASTRO TUBE INSERTION 1,693.00 LAB/RAD HCHG LEAD TEST 158.00 LAB/RAD PB ANAEROBE ID 176.00 LAB/RAD PB CHROMIUM BLOOD 162.00 LAB/RAD PB INTERLEUKIN 6 IL 6 SERUM 329.00 LAB/RAD HCHG HLA ABY CLASS I 413.00 LAB/RAD HCHG ANAEROBE ID 176.00 LAB/RAD HCHG CHROMIUM SERUM MEDTOX 162.00 LAB/RAD HCHG MG LES ABY 394.00 LAB/RAD PB CAPILLARY BLOOD SPEC NC 56.00 LAB/RAD PB CYSTIC FIBROSIS MUTATION 370.00 LAB/RAD PB GENERAL LAB 8670304 100.00 LAB/RAD HCHG SUSCEPTIBILITY AEROBIC MAYO 235.00 LAB/RAD HCHG DRUGS OF ABUSE WB 11 312.00 LAB/RAD HCHG PRO-BNP 586.00 LAB/RAD PB TISSUE LEVEL 2 116.00 LAB/RAD PB STREP A PCR 130.00 LAB/RAD HCHG MOLECULAR PHYS INTERP & RPT 304.00 LAB/RAD HCHG IDH1 GENE MUTATION ASSAY 1,200.00 LAB/RAD PB ALK PHOS FRACTIONATED AFFILIATE ONLY 287.00 LAB/RAD RAD ECHO 3D RECON INDEPENDENT WKST 854.00 LAB/RAD PB MYELOPEROXIDASE AB 331.00 LAB/RAD HCHG STOOL PATHOGEN MULTIPLEX PANEL 593.00 LAB/RAD RAD XR CHEST FRONTAL 1 VIEW 470.00 LAB/RAD RAD XR CHEST 2 VIEWS PA AND LATERAL 564.00 LAB/RAD HCHG GENERAL LAB 8759102 293.00 LAB/RAD HCHG SPECIMEN COLLECT SNF LAB SARS-COV-2 AFFILIATE ONLY 60.00 LAB/RAD PB COVID 19 HIGH THROUGHPUT LC 140.00 LAB/RAD PR TB INTRADERMAL TEST 64.00 LAB/RAD HCHG DOPPLER COLORFLOW VELOCITY MAPPING 743.00 LAB/RAD HCHG TRANSFUSION REACTION 1,321.00 LAB/RAD HCHG ALBUMIN SERUM 277.00 LAB/RAD HCHG CERULOPLASMIN 102.00 LAB/RAD HCHG CLOMIPRAMINE 280.00 LAB/RAD HCHG CREATININE URINE 279.00 LAB/RAD HCHG ESTRIOL-PRENATAL 152.00 LAB/RAD HCHG IGM 176.00 LAB/RAD HCHG GLUCOSE 130.00 LAB/RAD HCHG GLUCOSE, GESTATIONAL 130.00 LAB/RAD HCHG GLUCOSE METER TIMED 29.00 LAB/RAD HCHG METHOTREXATE 329.00 LAB/RAD HCHG LACTATE BLOOD 125.00 LAB/RAD HCHG LIPASE 154.00 LAB/RAD HCHG HDL CHOLESTEROL 101.00 LAB/RAD HCHG MAGNESIUM BLOOD 154.00 LAB/RAD HCHG URIC ACID URINE 251.00 LAB/RAD HCHG LORAZEPAM 280.00 LAB/RAD HCHG WBC STOOL 70.00 LAB/RAD HCHG MICROSCOPIC URINE 127.00 LAB/RAD HCHG CBC 99.00 LAB/RAD HCHG ANTITHROMBIN III 155.00 LAB/RAD HCHG DVVT CONFIRM 77.00 LAB/RAD HCHG SICKLE CELL TEST 217.00 LAB/RAD HCHG ACTIVATED PTT 155.00 LAB/RAD HCHG ANA 191.00 LAB/RAD HCHG HIGH SENS CRP 183.00 LAB/RAD HCHG RNP ANTIBODY 311.00 LAB/RAD HCHG CA 125 514.00 LAB/RAD HCHG GENERAL LAB 8734100 30.00 LAB/RAD HCHG GENERAL LAB 8670800 230.00 LAB/RAD HCHG GENERAL LAB 8670900 244.00 LAB/RAD HCHG IMMUNOFIXATION URINE 155.00 LAB/RAD HCHG MISCELLANEOUS BACTERIAL CULT 256.00 LAB/RAD HCHG ANAEROBIC CULTURE 373.00 LAB/RAD HCHG ANAEROBE IDENT 176.00 LAB/RAD HCHG ID AEROBE 182.00 LAB/RAD HCHG O&P CONCENTRATE 210.00 LAB/RAD HCHG KOH PREP OTHER SOURCE 152.00 LAB/RAD HCHG RAPID STREP A THROAT-SAT 208.00 LAB/RAD HCHG CYTO FLUID TP 216.00 LAB/RAD HCHG TISSUE LEVEL 1 100.00 LAB/RAD HCHG TISSUE LEVEL 2 116.00 LAB/RAD HCHG DECALCIFICATION 183.00 LAB/RAD HCHG CAS MORPHOMETRIC 347.00 LAB/RAD HCHG GENERAL LAB 8762400 235.00 LAB/RAD HCHG KB SENS 74.00 LAB/RAD HCHG FLOW MARKER ADDITIONAL 56.00 LAB/RAD HCHG FLOW MARKER INTERP 16 OR MORE 649.00 LAB/RAD NM DOSE TL 201 PER MCI 469.00 LAB/RAD NM DOSE I 131 MIBG PER .5 MCI 469.00 LAB/RAD NM DOSE I 123 DIAG CAP PER 100 UCI UP TO 999 UCI 406.00 LAB/RAD NM DOSE TECH 99M CERETEC 25 MCI 626.00 LAB/RAD NM DOSE TECH 99M RBC 30MCI 391.00 LAB/RAD HCHG PHLEBOTOMY THERAPEUTIC 364.00 LAB/RAD HCHG SP STAIN 1 ORG 88312 TC ONLY 231.00 LAB/RAD HCHG ARC-ABO TYPE 210.00 LAB/RAD HCHG DEXAMETHASONE SUPP 262.00 LAB/RAD HCHG AMNISURE 268.00 LAB/RAD HCHG =E GRADIENT STRIP 266.00 LAB/RAD HCHG WHOLE BLOOD BMP 198.00 LAB/RAD HCHG ECHO 2D F-U OR LTD STUDY W CONT 2,184.00 LAB/RAD HCHG ECHO 2D CONGENITAL ANOMALY COMP WO CONT 2,184.00 LAB/RAD HCHG ECHO ENDOMYOCARDIAL BIOPSY 2,184.00 LAB/RAD HCHG VITAMIN D TOTAL 249.00 LAB/RAD NM DOSE SESTAMIBI PER STUDY DOSE 469.00 LAB/RAD HCHG BETA 2 GLYCOPROTEIN 1 IGG 177.00 LAB/RAD HCHG SHIGA TOXIN 2 74.00 LAB/RAD PB OXCARBAZEPINE MEDTOX 37.00 LAB/RAD PB CRYPTOCOCCAL AGN QUAL 144.00 LAB/RAD HCHG US BREAST LOC PERC MARKER 1ST LESION W GUIDE 300.00 LAB/RAD HCHG CT DRAIN ABSCESS PERITONEAL PERC INC GUIDE 2,785.00 LAB/RAD HCHG CT DRAIN ABSCESS VISCERAL PERC INC GUIDE 2,785.00 LAB/RAD HCHG CYG-FULL CHROMOSOME ANALYSIS 756.00 LAB/RAD HCHG CYG-CONGENITAL SOLID TISSUE CULTURE 625.00 LAB/RAD HCHG CYG-CONGENITAL BLOOD CULTURE 981.00 LAB/RAD HCHG CYG-BONE MARROW/LEUKEMIC BLOOD CULTURE 482.00 LAB/RAD HCHG CYG-FISH GENERAL INTERPHASE ANALYSIS (100-300) 245.00 LAB/RAD HCHG FACTOR 2 GENE MUTATION 711.00 LAB/RAD HCHG MICROSATELLITE INSTABILITY MSI 1,225.00 LAB/RAD HCHG T CELL BETA PCR 967.00 LAB/RAD HCHG B CELL PCR GR 624.00 LAB/RAD HCHG TB T-SPOT 216.00 LAB/RAD HCHG NO BILL LAB CODE 0.00 LAB/RAD PB FACTOR 2 GENE MUTATION 505.00 LAB/RAD PB MICROSATELLITE INSTABILITY MSI 1,225.00 LAB/RAD PB GENERAL LAB 8762400 235.00 LAB/RAD PB CYG-CYTOGENETIC INTERP 106.00 LAB/RAD HCHG RESPIRATORY VIRUS PANEL (RVP) PCR 1,144.00 LAB/RAD HCHG CLOBAZAM 280.00 LAB/RAD HCHG CT THORACENTESIS PLEURAL ASPIRATION 2,641.00 LAB/RAD HCHG CT FACET JOINT INJ LUMBAR SACRAL 208.00 LAB/RAD RAD CT HEAD BRAIN W 3,869.00 LAB/RAD RAD CT NECK SOFT TISSUE WWO 4,105.00 LAB/RAD RAD CT CHEST LTD WO 966.00 LAB/RAD RAD CT SPINE THORACIC WO 4,034.00 LAB/RAD RAD CT PELVIS W 4,105.00 LAB/RAD RAD CT PELVIS WWO 5,709.00 LAB/RAD RAD CT LOWER EXTREMITY WWO 4,105.00 LAB/RAD RAD CT LIMITED OR LOCALIZED FOLLOW UP 2,527.00 LAB/RAD HCHG ALPHA 1 ANTITRYPSIN A1A 132.00 LAB/RAD HCHG OCCULT BLOOD, IFOBT 110.00 LAB/RAD RAD IR FLUORO EQUAL OR LESS 1 HR 574.00 LAB/RAD RAD MR TEMPOROMANDIBULAR JOINT 4,386.00 LAB/RAD RAD MR HEAD BRAIN W 4,386.00 LAB/RAD RAD MR CHEST WWO 5,258.00 LAB/RAD RAD MR SPINE CERVICAL WWO 4,386.00 LAB/RAD RAD MR JOINT OF LOWER EXTREMITY WWO 4,386.00 LAB/RAD HCHG NM INJECTION FOR SENTINEL NODE 469.00 LAB/RAD RAD NM MYOCARD SPECT SINGLE STUDY REST OR STRESS 848.00 LAB/RAD RAD NM LUNG PERFUSION ONLY QUANTITATIVE 2,354.00 LAB/RAD RAD NM RENAL SINGLE W PHARM 1,909.00 LAB/RAD RAD PET CT WHOLE BODY INITIAL TREAT 4,723.00 LAB/RAD HCHG US FINE NEEDLE ASPIRATION BIOPSY W IMAGE GUIDE 1ST LESION 988.00 LAB/RAD HCHG US BREAST ABSCESS INCISION W DRAIN PLCMT 649.00 LAB/RAD HCHG US ASPIRATION FLUID OR CYST 3,049.00 LAB/RAD HCHG US DRAIN SUBCUTANEOUS FLUID COLLECTION 411.00 LAB/RAD HCHG US BREAST CYST ASPIRATION 411.00 LAB/RAD HCHG US INJECT OR ASPIRATE MAJOR JOINT OR BURSA W US GUIDE 2,448.00 LAB/RAD HCHG US BIOPSY SOFT TISSUE THIGH OR KNEE SUPERFICIAL 636.00 LAB/RAD HCHG US PARACENTESIS ABDOMEN WITH IMAGING 3,124.00 LAB/RAD RAD US NECK OR HEAD SOFT TISSUE 1,876.00 LAB/RAD RAD US CHEST 707.00 LAB/RAD RAD US TRANSVAGINAL 425.00 LAB/RAD PB BASEMENT MEMBR ABY IGG 312.00 LAB/RAD RAD US PROCEDURE DIAGNOSTIC OR INTERVENTIONAL 1,368.00 LAB/RAD RAD US DUPLEX AORTA ILIACS INF VENA CAVA COMPLETE 461.00 LAB/RAD HCHG XR INJ SINGLE TENDON ORIGIN INSERT 389.00 LAB/RAD RAD XR SCREENING MAMMO TOMOSYNTHESIS UNILAT 162.00 LAB/RAD HCHG XR INJ NERVE BLOCK OCCIPITAL NERVE 2,176.00 LAB/RAD HCHG XR RF ABLATION LUMBAR OR SACRAL SINGLE LEVEL 4,046.00 LAB/RAD PB AMNISURE 331.00 LAB/RAD PB CREATININE 125.00 LAB/RAD RAD XR FACIAL BONES COMPLETE MINIMUM OF THREE VIEWS 1,237.00 LAB/RAD PB IRON 170.00 LAB/RAD PB ALBUMIN CSF 68.00 LAB/RAD PB IGG (SERUM) 176.00 LAB/RAD PB ELECTROLYTE PANEL 225.00 LAB/RAD PB CO2 TOTAL 94.00 LAB/RAD RAD XR TEMPROMANDIBULAR JOINTS UNILATERAL 362.00 LAB/RAD RAD XR HIP WWO PELVIS UNILATERAL 2 OR 3 VIEWS 564.00 LAB/RAD RAD XR HIP WWO PELVIS UNILATERAL 2 OR 3 VIEWS PORTABLE 564.00 LAB/RAD RAD XR SPINE CERVICAL 2 OR 3 VIEWS 664.00 LAB/RAD RAD XR FEMUR 2 VIEWS 520.00 LAB/RAD RAD XR LUMBOSACRAL MINIMUM OF 4 VIEWS 1,504.00 LAB/RAD RAD XR KNEE 1 OR 2 VIEWS 555.00 LAB/RAD RAD XR CALCANEUS 2 VIEWS 597.00 LAB/RAD RAD XR VIDEO SWALLOW STUDY 1,134.00 LAB/RAD PB PSA-SCREEN 232.00 LAB/RAD RAD XR COLON AIR CONTRAST 2,502.00 LAB/RAD RAD XR ERCP PANCREAS ONLY 85.00 LAB/RAD RAD XR DUCTOGRAM MULTIPLE DUCTS 1,533.00 LAB/RAD RAD XR BONE SURVEY INFANT/CHILD 1,360.00 LAB/RAD RAD XR INJ CHEMOTHERAPY INCLUDING SPINAL PUNCTURE 1,368.00 LAB/RAD PB AMPHETAMINE AND METHAM URINE QT 280.00 LAB/RAD PB ALCOHOL BIOMARKERS QUANT URINE 281.00 LAB/RAD PB METHADONE UR QUANT MUQ 280.00 LAB/RAD PB NORTRIPTYLINE AVENTYL NOR 280.00 LAB/RAD RAD XR DISCOGRAM LUMBAR SPINE 903.00 LAB/RAD RAD XR HAND 2 VIEWS PORTABLE 704.00 LAB/RAD RAD XR KNEE 1 OR 2 VIEWS PORTABLE 555.00 LAB/RAD PR FINE NEEDLE ASPIRATION BIOPSY W US GUIDE EA ADDL 174.00 LAB/RAD HCHG NRAS EXON 4 669.00 LAB/RAD PB ACUTE HEPATITIS PANEL 629.00 LAB/RAD PB ETHOSUXIMIDE 266.00 LAB/RAD PB VANCOMYCIN KINETICS 102.00 LAB/RAD PB ALBUMIN 277.00 LAB/RAD PB AFP TUMOR MARKER SERUM 100.00 LAB/RAD PB AMINO ACID QUANT URINE 230.00 LAB/RAD PB BIOTINIDASE MN NEWBORN SCREEN 68.00 LAB/RAD PB CALCIUM, IONIZED 232.00 LAB/RAD PB ISTAT CREATININE 125.00 LAB/RAD PB CREATININE,RANDOM URINE 279.00 LAB/RAD PB GALACTOSEMIA 44.00 LAB/RAD PB IGM 176.00 LAB/RAD PB IGA 176.00 LAB/RAD PB GASTRIN SERUM 86.00 LAB/RAD PB GLUCOSE, GESTATIONAL 130.00 LAB/RAD PB GLUCOSE METER TIMED 29.00 LAB/RAD PB CONGENITAL ADRENAL HYPERPLAS 125.00 LAB/RAD PB CF SCREEN NEWBORN SCR MN 156.00 LAB/RAD PB PROCALCITONIN 166.00 LAB/RAD PB PROTEIN TOTAL 231.00 LAB/RAD PB T4, FREE 167.00 LAB/RAD PB ALT (SGPT) 101.00 LAB/RAD PB RAST IGE 70.00 LAB/RAD PB CORD ABO GROUP 292.00 LAB/RAD PB AFB CULTURE 21.00 LAB/RAD HCHG 5-HIAA,QUANT,24 HR URINE LC 171.00 LAB/RAD HCHG ALK PHOS ISOENZYME LC 191.00 LAB/RAD HCHG ANGIOTENSIN-CONVERTING ENZYME LC 42.00 LAB/RAD HCHG CMV QUANT DNA PCR (PLASMA) LC 408.00 LAB/RAD HCHG EHRLICHIA AB LC 77.00 LAB/RAD HCHG FREE K+L LT CHAINS,QN,UR LC 95.00 LAB/RAD HCHG LIVER-KIDNEY MICROSOMAL AB LC 261.00 LAB/RAD PB LUTEINIZING HORMONE 382.00 LAB/RAD PB COBALT,SERUM 158.00 LAB/RAD PB HEMOGLOBIN A1C 174.00 LAB/RAD PB INSULIN 102.00 LAB/RAD HCHG THYROID STIM IMMUNOGLOBULIN LC 803.00 LAB/RAD HCHG CELIAC DISEASE HLA DQ ASSOC LC 260.00 LAB/RAD HCHG MPL MUTATION ANALYSIS LC 294.00 LAB/RAD PB T4 (THYROXINE) 212.00 LAB/RAD PB AST (SGOT) 112.00 LAB/RAD PB HCG-PRENATAL 266.00 LAB/RAD PB BARTONELLA ANTIBODY LC 482.00 LAB/RAD PB PROTEIN S FREE 469.00 LAB/RAD PB CATECHOLAMINES,UR,FREE,24 HR LC 189.00 LAB/RAD PB HEPARIN-QUANT 245.00 LAB/RAD PB STACLOT LA 216.00 LAB/RAD PB C-REACTIVE PROTEIN 79.00 LAB/RAD PB C3 COMPLEMENT COMPONENT 131.00 LAB/RAD PB THY PEROXIDASE ABY 261.00 LAB/RAD PB HISTOPLASMA CAPSULATUM ABS LC 148.00 LAB/RAD PB GENERAL LAB 8752902 LC 625.00 LAB/RAD PB HELICOBACTER PYLORI IGG AFFILIATE ONLY 154.00 LAB/RAD PB GENERAL LAB 8159601 LC 224.00 LAB/RAD PB LYME (B. BURGDORFERI) PCR LC 326.00 LAB/RAD PB GENERAL LAB 8670301 100.00 LAB/RAD PB MUMPS IGG 114.00 LAB/RAD PB RUBEOLA IMMUNITY 32.00 LAB/RAD PB BLOOD CULTURE-BACTEC 441.00 LAB/RAD PB TISSUE CULTURE 256.00 LAB/RAD PB VAG CERV CULTURE 256.00 LAB/RAD PB SPUTUM CULTURE 256.00 LAB/RAD PB WATER CULTURE 256.00 LAB/RAD PB GRAM STAIN 170.00 LAB/RAD PB KOH-SKIN, HAIR, NAILS 152.00 LAB/RAD PB VARICELLA-ZOSTER AB, IGM LC 102.00 LAB/RAD PB GENERAL LAB 8734000 120.00 LAB/RAD PB ENTEROVIRUS BY PCR, CSF 232.00 LAB/RAD PB GENERAL LAB 8753601 700.00 LAB/RAD PB FLOW MARKER FIRST 100.00 LAB/RAD PB RESPIRATORY VIRUS PROFILE PCR LC 1,300.00 LAB/RAD PB SP STAIN 1 ORG 231.00 LAB/RAD PB WBC STOOL 70.00 LAB/RAD PB RBC LR IRR WASHED PEDS UNIT 300.00 LAB/RAD HCHG CALRETICULIN EXON 9 ASSAY 1,200.00 LAB/RAD HCHG EBV NA 947.00 LAB/RAD PB EBV VCA IGG 313.00 LAB/RAD PB EBV VCA IGM 313.00 LAB/RAD HCHG XR PICC W PORT => 5 YRS INSERTION 6,340.00 LAB/RAD HCHG XR SACROPLASTY BILATERAL 13,674.00 LAB/RAD RAD CT ABSCESS FISTULA SINUS TRACT 1,691.00 LAB/RAD HCHG MG LES IMMUNO 329.00 LAB/RAD HCHG NICKEL BLOOD 331.00 LAB/RAD PB COLLECTION CAPILLARY BLOOD SPEC 56.00 LAB/RAD PB EMPLOYEE ANTI HCV 230.00 LAB/RAD PB RBC LR CMV NEG 750.00 LAB/RAD PB REFERRAL ID/SUSC, NONURINE 182.00 LAB/RAD PB GENERAL HEALTH PANEL 614.00 LAB/RAD HCHG PDL1 STAIN MORPH ANALYSIS 130.00 LAB/RAD HCHG PRIMIDONE (MYSOLINE) 56.00 LAB/RAD PB MYCOBACTERIAL ID MDH 186.00 LAB/RAD PB TISSUE LEVEL 1 100.00 LAB/RAD HCHG BLOOD CULTURE PCR EACH ORGANISM PROBED 88.00 LAB/RAD PB BLOOD CULTURE PCR EACH ORGANISM PROBED 88.00 LAB/RAD PB PROSTATE CANCER GENE 3 PCA3 261.00 LAB/RAD HCHG MECONIUM DRUG SCREEN HCMC 312.00 LAB/RAD HCHG KRAS MUTATION EXON 4 NEO 669.00 LAB/RAD PB GENERAL LAB G0499 83.00 LAB/RAD RAD XR ABDOMEN COMPLETE 1,173.00 LAB/RAD RAD XR MAMMO BILAT SCREENING 3D WWO CAD 505.00 LAB/RAD HCHG ALLERGEN IGE RECOMBINANT IN HOUSE 52.00 LAB/RAD HCHG BONE MARROW BIOPSY AND ASPIRATE 355.00 LAB/RAD PB STONE ANALYSIS LC 36.00 LAB/RAD HCHG KRAS MUTATION EXON 3 669.00 LAB/RAD HCHG RESPIRATORY PCR AFFILIATE ONLY 1,300.00 LAB/RAD HCHG HEMOGLOBIN 158.00 LAB/RAD HCHG DOPPLER ECHOCARDIOGRAPHY SPECTRAL COMPLETE 425.00 LAB/RAD HCHG INJ(S) SGL/MUL TRIG PT(S) 1 OR 2 MUSC 1,876.00 LAB/RAD HCHG ETHANOLBLOOD 277.00 LAB/RAD HCHG CALCIUM, IONIZED 232.00 LAB/RAD HCHG CALCIUM, TIMED URINE 152.00 LAB/RAD HCHG CHLORIDE 216.00 LAB/RAD HCHG CRYOGLOBULINS QUAL 139.00 LAB/RAD HCHG PH, BLOOD GAS 149.00 LAB/RAD HCHG PHOSPHORUS 183.00 LAB/RAD HCHG PROLACTIN 114.00 LAB/RAD HCHG PROTEIN TOTAL 231.00 LAB/RAD HCHG SODIUM 183.00 LAB/RAD HCHG SODIUM, URINE 120.00 LAB/RAD HCHG METHANOL 280.00 LAB/RAD HCHG VOLATILE SUBSTANCES BLOOD 280.00 LAB/RAD HCHG BASIC METABOLIC PANEL 156.00 LAB/RAD HCHG CARBAMAZEPINE 216.00 LAB/RAD HCHG HCG QUAL BLOOD 266.00 LAB/RAD HCHG PROTEIN S FUNCTIONAL 469.00 LAB/RAD HCHG HEPARIN-QUANT 245.00 LAB/RAD HCHG MITOCHONDRIAL ABY 93.00 LAB/RAD HCHG RUBELLA IMMUNE STATUS 76.00 LAB/RAD HCHG NASAL CULTURE 256.00 LAB/RAD HCHG SPINAL FLUID CULTURE 256.00 LAB/RAD HCHG THROAT STREP A CULT CONF 132.00 LAB/RAD HCHG CLOTEST 132.00 LAB/RAD HCHG YEAST CULTURE 244.00 LAB/RAD HCHG YEAST IDENT 227.00 LAB/RAD HCHG GIARDIA ANTIGEN 74.00 LAB/RAD HCHG CRYTOSPORIDIUM TEST 146.00 LAB/RAD HCHG TISSUE LEVEL 5 350.00 LAB/RAD HCHG CELL SURFACE ABY IGG 168.00 LAB/RAD HCHG ABY SCREEN 425.00 LAB/RAD HCHG CORD ABO GROUP 210.00 LAB/RAD HCHG FETAL RH TYPE 56.00 LAB/RAD HCHG BIG C ANTIGEN TYPE 80.00 LAB/RAD HCHG POOLING CRYO 71.00 LAB/RAD HCHG RED BLOOD CELLS 474.00 LAB/RAD HCHG RBC WASHED 731.00 LAB/RAD HCHG BRAIN NATRIURETIC PEPTIDE 586.00 LAB/RAD HCHG CARBAMAZEPINE TOTAL 216.00 LAB/RAD HCHG SP STAIN ENZYME 88319 304.00 LAB/RAD HCHG ARSENIC,BLOOD 158.00 LAB/RAD HCHG TRIGLYCERIDE BODY FLUID 212.00 LAB/RAD HCHG BLOOD GAS CORD VENOUS 223.00 LAB/RAD HCHG TRANSFUSION REACTION 1,321.00 LAB/RAD HCHG FLOW MARKER FIRST 100.00 LAB/RAD HCHG HEMOGLOBINOPATHIES 43.00 LAB/RAD HCHG H PYLORI BREATH 302.00 LAB/RAD HCHG UA MULTI 94.00 LAB/RAD HCHG INR POCT 93.00 LAB/RAD HCHG TROPONIN I 235.00 LAB/RAD HCHG POST VAS 0.00 LAB/RAD NM DOSE TECH 99M DTPA 25MCI 391.00 LAB/RAD HCHG GAMMA HYDROXYBUTYRIC ACID (GHB), URINE 312.00 LAB/RAD HCHG PAPP A 127.00 LAB/RAD HCHG IMAGED THIN PREP PAP SCREEN 156.00 LAB/RAD HCHG CF SCREEN 370.00 LAB/RAD HCHG FLUNITRAZEPAM SCREEN URINE 312.00 LAB/RAD HCHG CARDIOLIPIN IGM CRD 177.00 LAB/RAD HCHG DHEA-SULFATE 100.00 LAB/RAD CYG-ADD CELLS ANALYSIS 85.00 LAB/RAD HCHG PNP RIA 329.00 LAB/RAD HCHG GROUP B STREP RAPID DNA PCR 345.00 LAB/RAD HCHG ECHO 2D CONGENITAL ANOMALY COMP W CONT 2,184.00 LAB/RAD HCHG ETHYLENE GLYCOL HCMC 329.00 LAB/RAD HCHG ARTHROCENT ASPIR INJ MAJOR JOINT BURSA WO US GUIDE 1,048.00 LAB/RAD HCHG ARTERIAL COLLECTION ART 58.00 LAB/RAD HCHG POLYSPECIFIC HEPARIN ANTIBODIES 343.00 LAB/RAD HCHG IGG SPECIFIC HEPARIN ANTIBODIES 343.00 LAB/RAD PB STAPH A DNA AMP PROBE 266.00 LAB/RAD HCHG XR MAMMO BREAST LOC PERC MARKER 1ST LESION W GUIDE 1,362.00 LAB/RAD HCHG XR STEREO BREAST LOC MARKER 1ST LESION W GUIDE 1,136.00 LAB/RAD HCHG US BREAST LOC PERC MARKER EACH ADDL W GUIDE LT 236.00 LAB/RAD HCHG US DRAIN ABSCESS VISCERAL PERC INC GUIDE 2,785.00 LAB/RAD HCHG CYG-LIMITED/CONFIRMATION CHROMOSOME ANALYSIS 676.00 LAB/RAD HCHG FACTOR V LEIDEN MUTATION 499.00 LAB/RAD HCHG T CELL GAMMA PCR GR 932.00 LAB/RAD HCHG RO52 ANTIBODY 311.00 LAB/RAD PB CYG-BONE MARROW/LEUKEMIC BLOOD CULTURE 749.00 LAB/RAD (IA) PB URINE DRUG SCREEN CDS 312.00 LAB/RAD PB VALPROIC ACID UNB 308.00 LAB/RAD HCHG CT BIOPSY BONE SUPERFICIAL 3,457.00 LAB/RAD HCHG CT BIOPSY BONE DEEP 2,784.00 LAB/RAD HCHG CT MUSCULOSKELETAL SYSTEM 0.00 LAB/RAD HCHG CT BIOPSY LYMPH NODE 528.00 LAB/RAD HCHG CT BIOPSY RENAL 3,457.00 LAB/RAD HCHG CT TRANSFORAMINAL LUMB OR SACRAL SNGL W CT GUIDE 5,442.00 LAB/RAD HCHG CT FACET JOINT INJ LUMBAR/SACRAL SECOND LEVEL W CT GUIDE 251.00 LAB/RAD RAD CT HEAD BRAIN WWO 4,247.00 LAB/RAD RAD CT NECK SOFT TISSUE W 4,044.00 LAB/RAD RAD CT ANGIO NECK 6,007.00 LAB/RAD RAD CT SPINE CERVICAL WWO 648.00 LAB/RAD RAD CT ANGIO LOWER EXTREMITY 6,007.00 LAB/RAD HCHG IR INJ OR ASP INTERMED JT OR BURSA 406.00 LAB/RAD HCHG IR KYPHOPLASTY THORACIC INCLUDING GUIDE 4,255.00 LAB/RAD RAD IR CENTRAL VENOUS CATHETER FLUORO 1,534.00 LAB/RAD RAD MR SPINE CERVICAL W 4,386.00 LAB/RAD RAD MR SPINE THORACIC WO 4,386.00 LAB/RAD RAD MR LOWER EXTREMITY NON JOINT WO 4,386.00 LAB/RAD RAD MR DIAGNOSTIC OR INTERVENTIONAL PROCEDURE 442.00 LAB/RAD RAD MR BREAST W 4,386.00 LAB/RAD RAD MR BREAST BILATERAL W 4,386.00 LAB/RAD RAD NM BONE SCAN 3 PHASE 5,289.00 LAB/RAD RAD NM CARDIAC MYOCARD MULT SPECT WWO EF AND WM 3,426.00 LAB/RAD RAD NM CARDIAC MUGA LEFT VENTRICLE 2,020.00 LAB/RAD HCHG US BIOPSY BACK SOFT TISSUE SUPERFICIAL 1,405.00 LAB/RAD HCHG US BIOPSY SOFT TISSUE BACK DEEP 1,041.00 LAB/RAD HCHG US BIOPSY LUNG OR MEDIASTINUM 3,457.00 LAB/RAD RAD US ABDOMEN COMPLETE 1,085.00 LAB/RAD RAD US RETROPERITONEAL COMPLETE 1,424.00 LAB/RAD RAD US OB BIOPHYSICAL PROFILE W NONSTRESS TESTING 1,281.00 LAB/RAD RAD US PELVIS LIMITED STUDY 236.00 LAB/RAD RAD US INFANT HIPS W MANIPULATION 1,241.00 LAB/RAD RAD US GUIDED VASCULAR ACCESS 1,123.00 LAB/RAD RAD US GUIDANCE AMNIOCENTESIS 1,708.00 LAB/RAD RAD US ARTERIAL UPPER EXTREMITY BILATERAL COMPLETE 1,117.00 LAB/RAD RAD US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY 1,454.00 LAB/RAD HCHG XR INJ TRIGGER POINT EQUAL OR LESS 2 1,876.00 LAB/RAD HCHG XR INJ TRIGGER POINTS MINIMUM 3 1,572.00 LAB/RAD HCHG XR ARTHROCENTESIS SMALL JOINT OR BURSA 441.00 LAB/RAD HCHG XR INJ ARTHROGRAM ANKLE 399.00 LAB/RAD HCHG XR CHEST TUBE INSERTION W WATER SEAL 1,174.00 LAB/RAD RAD XR SCREENING MAMMO TOMOSYNTHESIS BILAT 162.00 LAB/RAD HCHG XR INJ TRANSFORAMINAL CERVICAL OR THORACIC EA ADDL LEV 3,139.00 LAB/RAD HCHG XR INJ FACET JOINT CERVICAL OR THORACIC SECOND LEVEL 199.00 LAB/RAD HCHG XR INJ FACET CERVICAL OR THORACIC THIRD LEVEL OR MORE 4,099.00 LAB/RAD HCHG XR INJ FACET LUMBAR OR SACRAL SECOND LEVEL 251.00 LAB/RAD HCHG XR INJ FACET LUMBAR OR SACRAL THIRD LEVEL OR MORE 208.00 LAB/RAD RAD XR FACIAL BONES TWO VIEWS OR LESS 720.00 LAB/RAD RAD XR ORBITS MINIMUM OF FOUR VIEWS LTD 1,222.00 LAB/RAD RAD XR SINUSES TWO VIEWS OR LESS 362.00 LAB/RAD PB HDL CHOLESTEROL 80.00 LAB/RAD RAD XR NECK SOFT TISSUE 295.00 LAB/RAD RAD XR HIPS BILATERAL 2V WWO PELVIS 1,140.00 LAB/RAD RAD XR HIPS BILATERAL MINIMUM OF 5V WWO PELVIS 1,140.00 LAB/RAD RAD XR FEMUR 1 VIEW UNILATERAL 537.00 LAB/RAD RAD XR LUMBOSACRAL SPINE 2 OR 3 VIEWS 942.00 LAB/RAD RAD XR SACROILIAC JOINTS THREE VIEWS OR MORE 892.00 LAB/RAD RAD XR CLAVICLE COMPLETE 903.00 LAB/RAD RAD XR UPPER EXTREMITY INFANT TWO VIEWS OR MORE 504.00 LAB/RAD RAD XR HAND 2 VIEWS 704.00 LAB/RAD RAD XR KNEE 3 VIEWS 312.00 LAB/RAD RAD XR ANKLE COMPLETE 3 VIEWS OR MORE 762.00 LAB/RAD RAD XR GUIDE PERC DRAIN CATH 504.00 LAB/RAD RAD XR ABSCESS/FISTULA/SINUS TRACT 1,691.00 LAB/RAD RAD XR BONE LENGTH STUDIES 934.00 LAB/RAD PB ACETAMINOPHEN 280.00 LAB/RAD PB OPIATE AND OPIOID CONFIRMATION UR 280.00 LAB/RAD PB MISC LAB CHARGE G0480 385.00 LAB/RAD HCHG RBC LR CMV NEG PEDS UNIT 300.00 LAB/RAD HCHG RBC LR W DEGLYCD 557.00 LAB/RAD RAD XR DISCOGRAM CERVICAL OR THORACIC SPINE 270.00 LAB/RAD RAD CT CHEST WWO CONTRAST ADD ON 4,939.00 LAB/RAD RAD XR SKULL THREE VIEWS OR LESS PORTABLE 720.00 LAB/RAD RAD XR SPINE 1 VIEW PORTABLE 565.00 LAB/RAD RAD XR ANKLE COMPLETE 3 VIEWS OR MORE PORTABLE 762.00 LAB/RAD RAD US OB EQUAL OR GREATER THAN 14 WKS SINGLE GEST PORTABLE 1,304.00 LAB/RAD RAD US PELVIS LIMITED STUDY PORTABLE 236.00 LAB/RAD RAD US ABDOMEN DUPLEX LIMITED PORTABLE 900.00 LAB/RAD PB PSA,FREE 300.00 LAB/RAD HCHG XR INJ EPIDURAL CERVICAL OR THORACIC SPINE W GUIDE 3,139.00 LAB/RAD PB NICOTINE SCR URINE 312.00 LAB/RAD PB COMPREHENSIVE METABOLIC PANE 173.00 LAB/RAD PB CARBAMAZEPINE TOTAL 216.00 LAB/RAD PB AMYLASE BODY FLUID 392.00 LAB/RAD PB ARSENIC,BLOOD 158.00 LAB/RAD PB BILIRUBIN, BODY FLUID,TOTAL 141.00 LAB/RAD PB CALCIUM URINE 152.00 LAB/RAD PB BLOOD GAS CORD VENOUS 223.00 LAB/RAD PB O2 SAT MEASURED 1,328.00 LAB/RAD PB FASTING GLUCOSE 130.00 LAB/RAD PB GLUCOSE 2HPP 130.00 LAB/RAD PB HEMOGLOBINOPATHIES NEWBORN SCR MN 43.00 LAB/RAD PB MG AD ABY (MYASTHENIA GRAVIS ABY) 394.00 LAB/RAD PB PARANEOPLASTIC IA 394.00 LAB/RAD PB LAMBDA FREE LIGHT CHAIN 95.00 LAB/RAD PB METHYLMALONIC ACID SERUM 631.00 LAB/RAD PB PTH INTACT 232.00 LAB/RAD PB ALK PHOSPHATASE 295.00 LAB/RAD PB SODIUM, TIMED URINE 120.00 LAB/RAD PB TESTOSTERONE,TOTAL 146.00 LAB/RAD PB UROBILINOGEN QUAL,UR 251.00 LAB/RAD PB BLEEDING TIME 152.00 LAB/RAD PB NATIVE DNA ABY 212.00 LAB/RAD PB AFB BLOOD CULTURE 21.00 LAB/RAD PB RAPID STREP A THROAT-SAT 208.00 LAB/RAD HCHG APOLIPOPROTEIN A-1 LC 47.00 LAB/RAD HCHG HCG BETA QUANT,TUMOR LC 266.00 LAB/RAD PB PHENOBARBITAL 114.00 LAB/RAD HCHG CALPROTECTIN, FECAL LC 718.00 LAB/RAD HCHG COPPER, SERUM LC 173.00 LAB/RAD PB PH URINE 94.00 LAB/RAD PB GLUCOSE QUAL URINE 94.00 LAB/RAD PB PROTEIN QUAL URINE 94.00 LAB/RAD HCHG EHRLICHIA DETECTION PCR LC 482.00 LAB/RAD RAD NM CARDIAC MYOCARD MULT SPECT W VIABILITY 3,426.00 LAB/RAD HCHG IGG, SUBCLASSES (1-4) LC 266.00 LAB/RAD HCHG ACTINOMYCES ABYS LC 30.00 LAB/RAD HCHG FUNGUS NES ANTIBODY LC 40.00 LAB/RAD HCHG PORPHYRINS, QN, 24 HR UR LC 191.00 LAB/RAD HCHG PTHRP (PTH-RELATED PEPTIDE) LC 100.00 LAB/RAD HCHG STONE ANALYSIS LC 36.00 LAB/RAD HCHG TOXOPLASMA GONDII AB,IGM,QN LC 52.00 LAB/RAD HCHG CALCITRIOL(1,25 DI-OH VIT D) LC 449.00 LAB/RAD PB PHOSPHORUS 183.00 LAB/RAD PB A1A PHENOTYPE (PI) LC 141.00 LAB/RAD PB ALDOSTERONE, SERUM LC 154.00 LAB/RAD PB HEMATOCRIT 120.00 LAB/RAD PB PROTEIN C ACTIVITY 469.00 LAB/RAD PB CCP ANTIBODY IGG 343.00 LAB/RAD PB SM ANTIBODY 311.00 LAB/RAD PB CA 19-9 538.00 LAB/RAD PB CA 125 514.00 LAB/RAD PB CD4/CD8 251.00 LAB/RAD PB GENERAL LAB 8659300 100.00 LAB/RAD PB STOOL CULT 85.00 LAB/RAD PB ENVIRONMENTAL CULTURE 256.00 LAB/RAD PB THROAT CULTURE 256.00 LAB/RAD PB BODY FLUID CULTURE 256.00 LAB/RAD PB MISCELLANEOUS BACTERIAL CULT 256.00 LAB/RAD PB URETHREAL CULTURE 256.00 LAB/RAD PB THROAT STREP A CULT CONF 132.00 LAB/RAD PB CLOTEST 132.00 LAB/RAD PB THYROTROPIN RECEPTOR AB, SERUM LC 329.00 LAB/RAD PB TOXOPLASMA GONDII AB, IGG, QN LC 112.00 LAB/RAD PB KOH PREP OTHER SOURCE 152.00 LAB/RAD PB GENERAL LAB 8734100 30.00 LAB/RAD PB GENERAL LAB 8759100 293.00 LAB/RAD PB FRZ SECTION 1ST 108.00 LAB/RAD PB IHC STAIN FIRST 312.00 LAB/RAD PB CRYSTAL IDENTIFICATION 125.00 LAB/RAD PB RBC-LR W 731.00 LAB/RAD PB TISSUE TRANSGLUT IGA 156.00 LAB/RAD HCHG LACTOFERRIN 289.00 LAB/RAD PB HLA B 27 DISEASE ASSOCIATION LC 210.00 LAB/RAD PB CHROMIUM SERUM MEDTOX 162.00 LAB/RAD HCHG CYSTIC FIBROSIS SCREEN IN HOUSE 370.00 LAB/RAD HCHG MATERNAL CELL CONTAMINATION 597.00 LAB/RAD HCHG TICK BORNE BABESIA EHRLICHIA ANAPL PCR 482.00 LAB/RAD PB CONSULT SLIDES PREP 706.00 LAB/RAD HCHG AP SENDOUTS MISC 0.00 LAB/RAD RAD XR C-ARM EQUAL OR GREATER 4 HR 720.00 LAB/RAD PB TISSUE LEVEL 4 355.00 LAB/RAD PB TISSUE LEVEL 6 413.00 LAB/RAD HCHG BLOOD DRAW LINE PORT AFFILIATE ONLY 67.00 LAB/RAD HCHG THYROGLOB TUMOR MARKER 152.00 LAB/RAD HCHG XR INJ FOR MYELOGRAM THORACIC 807.00 LAB/RAD HCHG STREP A PCR 130.00 LAB/RAD HCHG ALK PHOS FRACTIONATED AFFILIATE ONLY 287.00 LAB/RAD RAD US TRANSVAGINAL FOLLICLE STUDY 425.00 LAB/RAD HCHG ACHR BINDING ABY LC 394.00 LAB/RAD HCHG ACHR MODULATING ABY LC 45.00 LAB/RAD HCHG NPM1 GENE ANALYSIS 837.00 LAB/RAD RAD XR MAMMO BILAT SCREENING WWO CAD 505.00 LAB/RAD HCHG KRAS MUTATION ANALYSIS 1,000.00 LAB/RAD HCHG GI PCR AFFILIATE ONLY 1,300.00 LAB/RAD PB GI PCR AFFILIATE ONLY 1,300.00 LAB/RAD HCHG COVID 19 MML 45.00 LAB/RAD PB COVID 19 MML 140.00 LAB/RAD PR ADMIN PNEUMOCOC VAC-(MEDICARE) 35.00 LAB/RAD HCHG RENAL FUNCTION PANEL 170.00 LAB/RAD HCHG AFP TUMOR MARKER SERUM 100.00 LAB/RAD HCHG BETA-2 MICROGLOBULIN 233.00 LAB/RAD HCHG BILIRUBIN, BODY FLUID,TOTAL 141.00 LAB/RAD HCHG HEMOQUANT FECES 94.00 LAB/RAD HCHG CHLORIDE, RANDOM URINE 81.00 LAB/RAD HCHG RAPAMYCIN 102.00 LAB/RAD HCHG SERTRALINE (ZOLOFT) 280.00 LAB/RAD HCHG ZONISAMIDE 224.00 LAB/RAD HCHG COCAINE QUANT URINE 280.00 LAB/RAD HCHG CORTISOL 262.00 LAB/RAD HCHG CREATININE 125.00 LAB/RAD HCHG FETAL FIBRONECTIN 685.00 LAB/RAD HCHG IGA 176.00 LAB/RAD HCHG IGG (CSF) 176.00 LAB/RAD HCHG IGE 81.00 LAB/RAD HCHG INSULIN 102.00 LAB/RAD HCHG LDL DIRECT CHOLESTEROL 152.00 LAB/RAD HCHG PTH INTACT 232.00 LAB/RAD HCHG ALK PHOSPHATASE 295.00 LAB/RAD HCHG POTASSIUM 93.00 LAB/RAD HCHG PROTEIN URINE RANDOM 345.00 LAB/RAD HCHG PROTEIN ELP,SERUM 245.00 LAB/RAD HCHG TRANSFERRIN (IBC) 125.00 LAB/RAD HCHG TRIGLYCERIDES 212.00 LAB/RAD HCHG T3, FREE 168.00 LAB/RAD HCHG HCG QUANT BLD (PREG) 266.00 LAB/RAD HCHG AMIKACIN KINETICS (AMIKIN) 113.00 LAB/RAD HCHG DIGOXIN 110.00 LAB/RAD HCHG PHENYTOIN 110.00 LAB/RAD HCHG VANCOMYCIN KINETICS 102.00 LAB/RAD HCHG PROTEIN QUAL URINE 94.00 LAB/RAD HCHG KETONES URINE 94.00 LAB/RAD HCHG GLUCOSE QUAL URINE 94.00 LAB/RAD HCHG REDUCING SUBSTANCES-URINE 70.00 LAB/RAD HCHG DIFFERENTIAL 94.00 LAB/RAD HCHG WBC 139.00 LAB/RAD HCHG PROTEIN S FREE 469.00 LAB/RAD HCHG THROMBIN TIME 100.00 LAB/RAD HCHG EOSINOPHIL SMEAR 167.00 LAB/RAD HCHG C-REACTIVE PROTEIN 120.00 LAB/RAD HCHG GENERAL LAB 8734000 120.00 LAB/RAD HCHG GENERAL LAB 8670600 167.00 LAB/RAD HCHG HETEROPHILE 244.00 LAB/RAD HCHG MUMPS IGG 114.00 LAB/RAD HCHG THICK SMEAR 21.00 LAB/RAD HCHG TISSUE CULTURE 256.00 LAB/RAD HCHG WOUND CULTURE 256.00 LAB/RAD HCHG FUNGUS CUL-SKIN, HAIR, NAIL 244.00 LAB/RAD HCHG MOLD IDENT 80.00 LAB/RAD HCHG SEROGROUPING 44.00 LAB/RAD HCHG TISSUE HOMOGENIZATION 210.00 LAB/RAD HCHG MIC MICROTITER 235.00 LAB/RAD HCHG TRICH/YEAST/CLUE 152.00 LAB/RAD HCHG HSV BY RAPID PCR 625.00 LAB/RAD HCHG FNA STAT ADQ X1 PATH 127.00 LAB/RAD HCHG TISSUE LEVEL 6 413.00 LAB/RAD HCHG STAIN SPEC 2 OTHER 158.00 LAB/RAD HCHG THIN PREP PAP DIAGNOSTIC 160.00 LAB/RAD HCHG DNA PLOIDY 732.00 LAB/RAD HCHG FETAL DIRECT COOMBS 183.00 LAB/RAD HCHG RH (D) TYPE 137.00 LAB/RAD HCHG WEAK DU 56.00 LAB/RAD HCHG CORD WEAK D 56.00 LAB/RAD HCHG PEDS UNIT RED CELLS 300.00 LAB/RAD HCHG IGG ANTIHUMAN GLOBULIN 183.00 LAB/RAD HCHG CHOLESTEROL BODY FLUID 125.00 LAB/RAD HCHG GTT 857.00 LAB/RAD HCHG CALCIUM URINE 152.00 LAB/RAD HCHG RISPERIDONE AND METABOLITE 280.00 LAB/RAD HCHG US OB FOLLOW UP PER FETUS 654.00 LAB/RAD NM DOSE TETROFOSMIN OR MYOVIEW 469.00 LAB/RAD NM DOSE TECH 99M PERTECHNETATE PER MCI 391.00 LAB/RAD HCHG NICOTINE SCREEN URINE 312.00 LAB/RAD HCHG BIOTINIDASE 68.00 LAB/RAD NM DOSE TECH CHOLETEC 15MCI 391.00 LAB/RAD NM DOSE TECH 99M HDP 30MCI 469.00 LAB/RAD NM DOSE TECH 99M MERTIATIDE 15MCI 541.00 LAB/RAD NM DOSE TECH 99M MAG 3 15MCI 541.00 LAB/RAD HCHG OMNISCAN 20CC 21.00 LAB/RAD NM DOSE TECH 99M RBC ULTRATAG 30MCI 391.00 LAB/RAD HCHG IV INJECTION TX/DX/PROPHYLAXIS INITIAL 219.00 LAB/RAD HCHG REFERRAL ID ONLY ANAEROBE 0.00 LAB/RAD HCHG CARDIOLIPIN IGA CRD 177.00 LAB/RAD HCHG RISTOCETIN COFACTOR 460.00 LAB/RAD HCHG FLUORO CV DEVICE PL/RPLC/REM 1,534.00 LAB/RAD HCHG QUANTIFERON TB GOLD PLUS 224.00 LAB/RAD HCHG PNP IA 394.00 LAB/RAD HCHG STRESS ECHO 2D EXERCISE WO CONTRAST 2,184.00 LAB/RAD HCHG URIC ACID BODY FLUID 251.00 LAB/RAD CRYPTOCOCCUS AGN 144.00 LAB/RAD HCHG STRESS ECHO 2D PHARMACOLOGIC W STRESS TEST WO CONTRAST 2,184.00 LAB/RAD HCHG STRESS ECHO 2D PHARMACOLOGIC W STRESS TEST W CONTRAST 2,184.00 LAB/RAD HCHG BLOOD GAS MEASURED O2 223.00 LAB/RAD PR US BX BREAST INC MARKER EA ADDL LESION W GUIDE LT 1,645.00 LAB/RAD HH OB BPP 1,271.00 LAB/RAD HCHG MR BREAST LOC PERC MARKER EACH ADDL W GUIDE LT 1,705.00 LAB/RAD HCHG CYG-FISH PANEL INTERPHASE ANALYSIS (100-300) 255.00 LAB/RAD HCHG CYG-FDA APPROVED FISH ANEUPLOIDY PROBE 255.00 LAB/RAD HCHG JAK2 MUTATION DETECTION 921.00 LAB/RAD HCHG RO60 ANTIBODY 311.00 LAB/RAD PB JAK2 MUTATION DETECTION 921.00 LAB/RAD PB CYG-CONGENITAL BLOOD CULTURE 981.00 LAB/RAD HCHG CT BIOPSY SOFT TISSUE LEG OR ANKLE 597.00 LAB/RAD HCHG CT BIOPSY BONE MARROW 2,883.00 LAB/RAD HCHG CT BIOPSY LIVER 570.00 LAB/RAD HCHG CT ASPIRATION SPINE DISK 1,480.00 LAB/RAD RAD CT FACIAL BONES AND SINUS W 3,948.00 LAB/RAD RAD CT ANGIO HEAD 4,547.00 LAB/RAD RAD CT CHEST WO CONTRAST ADD ON 4,287.00 LAB/RAD RAD CT CHEST WWO 4,939.00 LAB/RAD RAD CT SPINE CERVICAL WO 3,982.00 LAB/RAD RAD CT SPINE THORACIC W 4,416.00 LAB/RAD RAD CT UPPER EXTREMITY WO 3,578.00 LAB/RAD RAD CT ABDOMEN WWO 5,928.00 LAB/RAD RAD MR ANGIO HEAD WO 5,258.00 LAB/RAD RAD MR ANGIO NECK W 4,386.00 LAB/RAD RAD MR CHEST W 4,386.00 LAB/RAD RAD MR JOINT OF UPPER EXTREMITY W 4,386.00 LAB/RAD RAD MR NON JOINT LOWER EXTREMITY WWO 5,258.00 LAB/RAD RAD MR ANGIO UPPER EXTREMITY WWO 4,386.00 LAB/RAD RAD NM THYROID UPTAKE SINGLE MULTIPLE QUANT MEASURE 200.00 LAB/RAD RAD NM BONE SCAN LIMITED AREA 987.00 LAB/RAD RAD NM LUNG PERFUSION SCAN 1,836.00 LAB/RAD HCHG US DRAIN SUBCUTANEOUS ABSCESS 386.00 LAB/RAD HCHG US THORACENTESIS W CHEST TUBE PLACEMENT 1,233.00 LAB/RAD HCHG US BIOPSY ABDOMEN OR RETROPERITONEUM MASS 2,883.00 LAB/RAD HCHG US BIOPSY THYROID CORE NEEDLE 570.00 LAB/RAD RAD US OB 1ST TRI EACH ADDL GESTATION TRANSABD 342.00 LAB/RAD RAD US OB EQUAL OR GREATER THAN 14 WKS EA ADDL GEST 342.00 LAB/RAD RAD US GUIDED CHORIONIC VILLUS SAMPLING 80.00 LAB/RAD RAD US CAROTID DUPLEX BILATERAL 1,990.00 LAB/RAD RAD US DUPLEX SCAN EXTREMITY BILATERAL COMPLETE 2,229.00 LAB/RAD HCHG XR ARTHROCENTESIS MAJOR JOINT OR BURSA 1,048.00 LAB/RAD HCHG XR INJECTION FOR CYSTOGRAPHY 443.00 LAB/RAD RAD XR DEXA BONE DENSITY 2 SITE AXIAL SKELETON W VERT FX ASSESS 136.00 LAB/RAD RAD XR DIAGNOSTIC MAMMO TOMOSYNTHESIS BILAT 505.00 LAB/RAD HCHG XR INJECTION FOR DISCOGRAM CERVICAL/THORACIC EA LEVEL 809.00 LAB/RAD RAD XR DIAGNOSTIC MAMMO TOMOSYNTHESIS UNILAT 505.00 LAB/RAD HCHG XR INJ FACET JOINT CERVICAL OR THORACIC SINGLE LEV 5,272.00 LAB/RAD HCHG XR INJ SACROILIAC JOINT 1,533.00 LAB/RAD PB O&P CONCENTRATE 210.00 LAB/RAD RAD XR SKULL THREE VIEWS OR LESS 720.00 LAB/RAD RAD XR HIP UNILATERAL WWO PELVIS1 VIEW PORTABLE 526.00 LAB/RAD RAD XR TEMPROMANDIBULAR JOINTS BILATERAL 1,134.00 LAB/RAD RAD XR PELVIS AND HIPS BILAT INFANT/CHILD 3 OR 4 VIEWS 1,140.00 LAB/RAD RAD XR CERVICAL SPINE SIX OR MORE VIEWS 1,135.00 LAB/RAD RAD NM GASTRIC EMPTYING W SMALL BOWEL 934.00 LAB/RAD RAD XR BENDING LUMBOSACRAL SPINE 2 OR 3 VIEWS 304.00 LAB/RAD RAD XR HUMERUS TWO VIEWS OR MORE 603.00 LAB/RAD RAD XR HAND 2 VIEWS LTD 704.00 LAB/RAD RAD XR FOOT COMPLETE MINIMUM OF 3 VIEWS 755.00 LAB/RAD HCHG IR INJ CHOLANGIOGRAPHY PERC W GUIDE EXISTING ACCESS S&I 878.00 LAB/RAD RAD XR COLON THERAPEUTIC 538.00 LAB/RAD RAD XR FLUORO GUIDANCE FOR NEEDLE PLACEMENT 950.00 LAB/RAD RAD XR DEXA BONE DENSITY 1 SITE AXIAL SKELETON 413.00 LAB/RAD RAD XR DEXA BONE DENSITY PERIPHERAL SKELETON 293.00 LAB/RAD PB ETHANOL ALCOHOL BLOOD 280.00 LAB/RAD PB THC MARIJUANA QUANT UR TCQ 280.00 LAB/RAD RAD CT CHEST W CONTRAST ADD ON 4,960.00 LAB/RAD HCHG US PARACENTESIS ABDOMEN W IMAGING PORTABLE 3,124.00 LAB/RAD RAD XR WRIST 2 VIEWS PORTABLE 514.00 LAB/RAD RAD XR FOOT 2 VIEWS PORTABLE 475.00 LAB/RAD RAD US ARTERIAL LOWER EXTREMITY LTD STUDY PORTABLE 614.00 LAB/RAD PB BRAF V600 MUTATION ASSAY 805.00 LAB/RAD RAD MR HEAD BRAIN WO 4,386.00 LAB/RAD RAD US RENAL TRANSPLANT 1,081.00 LAB/RAD HCHG CREATININE CLEARANCE RTR 906.00 LAB/RAD HCHG URINALYSIS RTR 94.00 LAB/RAD PB GENERAL LAB 8749104 135.00 LAB/RAD HCHG MTB PCR 614.00 LAB/RAD PB CREATININE BODY FLUID 279.00 LAB/RAD PB ESTRIOL-PRENATAL 152.00 LAB/RAD PB BLOOD GAS 223.00 LAB/RAD PB GLUCOSE, CSF 130.00 LAB/RAD PB GLUCOSE, BODY FLUID 130.00 LAB/RAD PB GLUCOSE TOLERANCE TEST 3 SPEC 857.00 LAB/RAD PB FSH-SERUM 168.00 LAB/RAD PB SOLUBLE TRANSFERRIN RECEPTOR 329.00 LAB/RAD PB POTASSIUM,RANDOM URINE 120.00 LAB/RAD PB PROTEIN TOTAL, CSF 231.00 LAB/RAD PB HCG QUANT BLD (PREG) 266.00 LAB/RAD PB HCG QUAL BLOOD 266.00 LAB/RAD PB CBC 111.00 LAB/RAD PB PTT-LA SCREEN 155.00 LAB/RAD PB ANA 191.00 LAB/RAD PB FANA TITER 191.00 LAB/RAD PB RH (D) TYPE 56.00 LAB/RAD PB FETAL RH TYPE 56.00 LAB/RAD PB CELL COUNT & DIFF CSF 339.00 LAB/RAD HCHG ALDOLASE LC 264.00 LAB/RAD HCHG APOLIPOPROTEIN B LC 47.00 LAB/RAD HCHG RBC LC 127.00 LAB/RAD HCHG ARSENIC HEAVY METALS PROFILE II, URINE LC 158.00 LAB/RAD PB HAPTOGLOBIN 102.00 LAB/RAD HCHG METANEPHRINES, FRAC, QN, 24-HR LC 196.00 LAB/RAD HCHG ALLERGEN LC 70.00 LAB/RAD HCHG RENIN ACTIVITY, PLASMA LC 88.00 LAB/RAD PB BRAIN NATRIURETIC PEPTIDE 586.00 LAB/RAD HCHG VITAMIN B1 (THIAMINE), BLOOD LC 99.00 LAB/RAD HCHG VITAMIN E LC 156.00 LAB/RAD HCHG VORICONAZOLE, SERUM/PLASMA LC 78.00 LAB/RAD HCHG ZINC, PLASMA OR SERUM LC 70.00 LAB/RAD PB PREALBUMIN 155.00 LAB/RAD PB PROTEIN ELP,SERUM 245.00 LAB/RAD PB SPECIFIC GRAVITY BF 70.00 LAB/RAD HCHG GROWTH HORMONE, SERUM LC 266.00 LAB/RAD PB TSH 144.00 LAB/RAD PB ALK PHOS ISOENZYME LC 191.00 LAB/RAD PB HCG 266.00 LAB/RAD PB RETIC COUNT 256.00 LAB/RAD PB FACTOR 8 ASSAY 366.00 LAB/RAD PB PROTEIN S FUNCTIONAL 469.00 LAB/RAD PB KLEIHAUER STAIN 825.00 LAB/RAD PB FETAL MATERNAL SCREEN 56.00 LAB/RAD PB HIGH SENS CRP 183.00 LAB/RAD PB SSB ANTIBODY 311.00 LAB/RAD PB GENERAL LAB 8669402 LC 67.00 LAB/RAD PB LYME NO REFLEX 154.00 LAB/RAD PB GENERAL LAB 8669600 102.00 LAB/RAD PB MERCURY, BLOOD LC 262.00 LAB/RAD PB AEROMONAS PLATE STOOL 85.00 LAB/RAD PB E COLI 0157 PLATE STL 85.00 LAB/RAD PB ANAEROBIC CULTURE 373.00 LAB/RAD PB RECTAL/VAG NON-OB STREP CULTURE 132.00 LAB/RAD PB FUNGUS CUL-SKIN, HAIR, NAIL 244.00 LAB/RAD PB FUNGUS CULTURE 244.00 LAB/RAD PB SEROGROUPING 44.00 LAB/RAD PB TOXOPLASMA GONDII AB,IGM,QN LC 112.00 LAB/RAD PB CLOSTRIDIUM DIFF TOXIN PCR 293.00 LAB/RAD PB VZ VIRUS BY RAPID PCR 482.00 LAB/RAD PB THIN PREP PAP DIAGNOSTIC 160.00 LAB/RAD PB RBC LR IRR 790.00 LAB/RAD HCHG TISSUE TRANSGLUT IGA 156.00 LAB/RAD HCHG CT INJ TRANS EPIDURAL CERVICAL OR THORACIC ONE LEVEL 4,045.00 LAB/RAD HCHG CT INJ TRANS EPIDURAL CERVICAL OR THORACIC EA ADDL LEVEL 3,139.00 LAB/RAD HCHG TESTOSTERONE BIOAVAIL LC 148.00 LAB/RAD HCHG US INJ NERVE BLOCK PERIPHERAL 1,572.00 LAB/RAD HCHG CT BIOPSY SOFT TISSUE PELVIS AND HIP DEEP 2,883.00 LAB/RAD HCHG XR IVC FILTER PLACEMENT 16,535.00 LAB/RAD HCHG XR PICC => 5 YRS INSERTION W GUIDANCE S&I 2,470.00 LAB/RAD HCHG XR PICC W PORT < 5 YRS INSERTION 2,896.00 LAB/RAD PB RNA POLYMERASE III IGG ABS LC 156.00 LAB/RAD PB LEAD TEST 149.00 LAB/RAD HCHG RADIOLOGICAL EXAM SURG SPEC 223.00 LAB/RAD HCHG EGFR 1,031.00 LAB/RAD HCHG LYMES WESTERN BLOT 304.00 LAB/RAD HCHG GLIADIN ABY IGA 156.00 LAB/RAD PB GENERAL LAB 8738900 141.00 LAB/RAD HCHG RETIC HGB CONCENTRATE 175.00 LAB/RAD HCHG SUSCEPTIBILITY SLOW GROWER 235.00 LAB/RAD PB TROPONIN I 235.00 LAB/RAD PB SENDOUTS MISC 0.00 LAB/RAD PB EOSINOPHIL SMEAR 167.00 LAB/RAD HCHG ANTIDEPRESSANT DRUG SCR UR QT 280.00 LAB/RAD RAD MR LOWER EXT NON JOINT W CONTRAST 4,386.00 LAB/RAD RAD XR C-ARM EQUAL OR GREATER 2 HR 720.00 LAB/RAD PR FLU VACC QUADRIVALENT IIV4 SV PF 0.25 ML IM 32.00 LAB/RAD PB CMV IGM ABY 199.00 LAB/RAD HCHG CMV IGM ABY 199.00 LAB/RAD HCHG CMV IGG ABY 168.00 LAB/RAD HCHG CYCLOSPORINE AHL 569.00 LAB/RAD HCHG IDH2 GENE MUTATION ASSAY 1,200.00 LAB/RAD HCHG MYELOPEROXIDASE AB 331.00 LAB/RAD RAD IR GUIDED NEEDLE PLACEMENT 3,464.00 LAB/RAD HCHG MYCOBACTERIAL ID MDH 76.00 LAB/RAD HCHG TRICHOMONAS PCR AFFILIATE ONLY 162.00 LAB/RAD RAD XR CHEST 2 VIEWS APICAL LORDOTIC 564.00 LAB/RAD RAD XR MAMMO BILAT DIAGNOSTIC WWO CAD 505.00 LAB/RAD RAD XR MAMMO UNI SCREENING 3D WWO CAD 505.00 LAB/RAD HCHG GLUCOSE TOLERANCE 3RD ADDL 1,011.00 LAB/RAD RAD XR SMALL BOWEL FOLLOW THROUGH 1,341.00 LAB/RAD HCHG COVID 19 NAA LC 110.00 LAB/RAD PR CANDIDA SKIN TEST 199.00 LAB/RAD HCHG ECHO 2D F-U OR LTD STUDY W BUBBLE 643.00 LAB/RAD HCHG CONSULT SLIDES PREP 706.00 LAB/RAD HCHG PERIPH BLOOD SMR 191.00 LAB/RAD HCHG MICROALBUMIN QNI RANDOM UR 171.00 LAB/RAD HCHG AFP-PRENATAL 100.00 LAB/RAD HCHG AFP-MATERNAL (Q) 100.00 LAB/RAD HCHG AMYLASE 392.00 LAB/RAD HCHG LIPOPROTEIN LPA 121.00 LAB/RAD HCHG BILIRUBIN, TOTAL 141.00 LAB/RAD HCHG CALCIUM 171.00 LAB/RAD HCHG CO2 TOTAL 94.00 LAB/RAD HCHG CEA 462.00 LAB/RAD HCHG VITAMIN B-12 251.00 LAB/RAD HCHG GLUCOSE, BODY FLUID 130.00 LAB/RAD HCHG GAMMA GT 132.00 LAB/RAD HCHG HOMOCYSTEINE, CARDIAC 413.00 LAB/RAD HCHG IRON 170.00 LAB/RAD HCHG IRON BINDING CAPACITY (IBC) 86.00 LAB/RAD HCHG MYOGLOBIN, SERUM 308.00 LAB/RAD HCHG METHYLMALONIC ACID SERUM 631.00 LAB/RAD HCHG OSMOLALITY,SERUM 216.00 LAB/RAD HCHG SODIUM URINE 120.00 LAB/RAD HCHG TSH 144.00 LAB/RAD HCHG AST (SGOT) 100.00 LAB/RAD HCHG ALT (SGPT) 82.00 LAB/RAD HCHG URIC ACID 308.00 LAB/RAD HCHG UROBILINOGEN QUAL,UR 251.00 LAB/RAD HCHG HCG-PRENATAL 266.00 LAB/RAD HCHG CLONAZEPAM (KLONOPIN) 280.00 LAB/RAD HCHG BENZODIAZ CONFIRM 280.00 LAB/RAD HCHG VALPROIC ACID 308.00 LAB/RAD HCHG SALICYLATE 280.00 LAB/RAD HCHG CBC W/DIFF 106.00 LAB/RAD HCHG FACTOR 8 ASSAY 366.00 LAB/RAD HCHG D-DIMER QUANT 330.00 LAB/RAD HCHG FETAL MATERNAL SCREEN 56.00 LAB/RAD HCHG CELL COUNT & DIFF CSF-STA 339.00 LAB/RAD HCHG SM ANTIBODY 311.00 LAB/RAD HCHG SMOOTH MUSCLE ABY 93.00 LAB/RAD HCHG GENERAL LAB 8670500 94.00 LAB/RAD HCHG ANTI HCV 230.00 LAB/RAD HCHG IMMUNOFIXATION 155.00 LAB/RAD HCHG RA QUANT 183.00 LAB/RAD HCHG VDRL CSF 100.00 LAB/RAD HCHG LYME (FIA) POLYVALENT 154.00 LAB/RAD HCHG LYME NO REFLEX 154.00 LAB/RAD HCHG VZV IMMUNE ASSAY 102.00 LAB/RAD HCHG GENERAL LAB 8753600 700.00 LAB/RAD HCHG BLOOD CULTURE-BACTEC 441.00 LAB/RAD HCHG RECTAL STREP CULTURE 132.00 LAB/RAD HCHG ADDL DISC SUSCEPT 74.00 LAB/RAD HCHG MIC VITEK 235.00 LAB/RAD HCHG EHRLICHIOSIS 130.00 LAB/RAD HCHG LEGIONELLA ANTIGEN URINE 62.00 LAB/RAD HCHG CD4/CD8 251.00 LAB/RAD HCHG DONOR ANTIGEN 121.00 LAB/RAD HCHG BIG E ANTIGEN TYPE 81.00 LAB/RAD HCHG RBC LR UNIT 688.00 LAB/RAD HCHG METH RES STAPH CULTURE 132.00 LAB/RAD HCHG PHENCYCLIDINE (PCP) QUAL UR 86.00 LAB/RAD HCHG RSV RAPID ANTIGEN 357.00 LAB/RAD HCHG QUETIAPINE (SEROQUEL) 280.00 LAB/RAD HCHG PSA,FREE 300.00 LAB/RAD HCHG COLLAGEN/EPI 75.00 LAB/RAD HCHG IN SITU HYBRIDIZATION FIRST 843.00 LAB/RAD NM DOSE I 131 THERAPY CAP PER MCI 238.00 LAB/RAD NM DOSE TECH 99M PENTETATE 25MCI 391.00 LAB/RAD NM DOSE GALLIUM 67 PER MCI 391.00 LAB/RAD HCHG IMAGED THIN PREP PAP DIAGNOSTIC 152.00 LAB/RAD HCHG ARC-IRRADIATION RBC 100.00 LAB/RAD HCHG NEWBORN DELIVERY PPV 549.00 LAB/RAD HCHG CARDIOLIPIN IGG CRD 177.00 LAB/RAD HCHG CCP ANTIBODY IGG 343.00 LAB/RAD HCHG TOTAL GALACTOSE 44.00 LAB/RAD HCHG FASTING GLUCOSE 155.00 LAB/RAD HCHG TRANSESOPHAG ECHO W BUBBLE STUDY COMPLETE W CONTRAST 1,571.00 LAB/RAD HCHG STRESS ECHO 2D PHARMACOLOGIC W CONTRAST 2,184.00 LAB/RAD HCHG INJ ANES/STER TRANSFORAMINAL LUMB SACR EA ADDL LEVEL WITH FLUORO OR CT 3,037.00 LAB/RAD HCHG INTERROGATION REMOTE PACER/ICD LEAD(S) OR LEADLESS PACER TECH REVIEW UP TO 9058.00 DAYS LAB/RAD HCHG C TRACHOMATIS ORAL BY NAT 135.00 LAB/RAD HCHG CLOSTRIDIUM DIFF TOXIN PCR 293.00 LAB/RAD HCHG STAPH A DNA AMP PROBE 266.00 LAB/RAD PB LAMOTRIGINE 224.00 LAB/RAD PB LEVETIRACETAM 264.00 LAB/RAD PB ZONISAMIDE 224.00 LAB/RAD HCHG US BX BREAST INC MARKER EA ADDL W GUIDE LT 1,645.00 LAB/RAD HCHG XR MAMMO BREAST LOC PERC MARKER EA ADDL W GUIDE RT 236.00 LAB/RAD HCHG CT DRAIN ABSCESS PERITONEAL TRANS VAG/RECTAL INC GUIDE 1,766.00 LAB/RAD HCHG CT CATH FLUID COLLECTION DRAINAGE SOFT TISSUE INC GUIDE 1,886.00 LAB/RAD PB SPECIMEN HANDLING DR OFF >LAB 54.00 LAB/RAD HCHG CYG-CRYOPRESERVE SAMPLE 45.00 LAB/RAD HCHG CYG-FISH METAPHASE ANALYSIS (3-5) 90.00 LAB/RAD HCHG CYG-FISH MORPHOMETRIC PROBE AND ANALYSIS 1,346.00 LAB/RAD PB SUSCEPTIBILITY SLOW GROWER 235.00 LAB/RAD PB FACTOR V LEIDEN MUTATION 505.00 LAB/RAD HCHG CT ASPIRATION FINE NEEDLE BIOPSY W GUIDE 1ST LESION 988.00 LAB/RAD HCHG CT BIOPSY LUNG OR MEDIASTINUM 3,457.00 LAB/RAD HCHG CT ASPIRATION PELVIS BONE MARROW 487.00 LAB/RAD HCHG CT ASPIRATION LIVER 988.00 LAB/RAD HCHG CT PARACENTESIS ABDOMEN PELVIS ASPIRATION 3,124.00 LAB/RAD HCHG CT TRANSFORAMINAL LUMB OR SACRAL EA ADDL W FLUORO GUIDE 3,049.00 LAB/RAD HCHG CT FACET JT INJ CERV/THOR THIRD OR MORE LEVELS W CT GUIDE 4,099.00 LAB/RAD RAD CT ORBITS OR TEMPORAL BONES W 4,678.00 LAB/RAD RAD CT FACIAL BONES AND SINUS WWO 4,655.00 LAB/RAD RAD CT CHEST WO 4,287.00 LAB/RAD RAD CT SPINE LUMBAR OR SACRUM WO 4,772.00 LAB/RAD RAD CT SPINE LUMBAR WWO 4,756.00 LAB/RAD RAD CT ABDOMEN PELVIS W 6,124.00 LAB/RAD RAD CT ABDOMEN PELVIS COLONOGRAPHY DIAGNOSTIC WO 4,287.00 LAB/RAD RAD CT ABDOMEN PELVIS COLONOGRAPHY DIAGNOSTIC W 4,287.00 LAB/RAD HCHG IR CENTRAL VENOUS CATHETER NON TUNNEL =>5Y INSERTION 413.00 LAB/RAD HCHG IR CENTRAL VENOUS CATHETER INJECTION 295.00 LAB/RAD RAD IR FLUORO EQUAL OR LESS 1 HR 154.00 LAB/RAD RAD MR ANGIO HEAD W 4,386.00 LAB/RAD RAD MR HEAD BRAIN WWO 4,386.00 LAB/RAD RAD MR ANGIO ABDOMEN W 4,386.00 LAB/RAD RAD MR ANGIO LOWER EXTREMITY WO 4,386.00 LAB/RAD HCHG NM LYMPHOSCINTIGRAPHY MAPPING 307.00 LAB/RAD RAD NM PARATHYROID SCAN 441.00 LAB/RAD RAD NM HEPATOBILIARY 1,087.00 LAB/RAD RAD NM LUNG VENTILATION AND PERFUSION QUANTITATIVE 762.00 LAB/RAD RAD NM RENAL SCAN 1,909.00 LAB/RAD RAD PET CT LIMITED SUBSEQUENT TREATMENT 2,902.00 LAB/RAD RAD PET CT SKULL BASE TO MID THIGH INITIAL TREAT 6,074.00 LAB/RAD HCHG US INJECT OR ASPIRATE SMALL JOINT OR BURSA W US GUIDE 1,810.00 LAB/RAD HCHG US ASPIRATION ABDOMEN SOFT TISSUE 412.00 LAB/RAD HCHG US DRAIN PLACEMENT EXTRATHORACIC 766.00 LAB/RAD HCHG US BIOPSY SALIVARY GLAND 260.00 LAB/RAD HCHG US DRAIN OVARIAN CYST(S) ABDOMINAL APPROACH 1,193.00 LAB/RAD RAD US ABDOMEN LIMITED 1,334.00 LAB/RAD RAD US OB 1ST TRI SINGLE TRANSABD 1,304.00 LAB/RAD RAD US OB LIMITED ANY TRI 1 OR MORE FETUSES 274.00 LAB/RAD RAD US OB TRANSVAGINAL LTD 425.00 LAB/RAD RAD US FETAL DOPPLER VELOCIMETRY UMBILICAL ARTERY 535.00 LAB/RAD RAD US EXTREMITY NONVASCULAR LTD STUDY 1,241.00 LAB/RAD RAD US ARTERIAL LOWER EXTREMITY LIMITED STUDY 614.00 LAB/RAD HCHG XR INJ DUCTOGRAM 395.00 LAB/RAD HCHG XR INJ FOR ARTHROGRAM SHOULDER 313.00 LAB/RAD HCHG XR INJ FOR ARTHROGRAM WRIST 393.00 LAB/RAD HCHG XR INJ ARTHROGRAM HIP WO ANESTHESIA 406.00 LAB/RAD HCHG XR VENOGRAM INJECTION 811.00 LAB/RAD HCHG XR REPLACEMENT GASTROSTOMY OR CECOSTOMY TUBE 1,693.00 LAB/RAD HCHG XR INJ HYSTEROSALPINGOGRAM 317.00 LAB/RAD HCHG XR INJ TRANSFORAMINAL CERVICAL OR THORACIC SINGLE LEV 4,045.00 LAB/RAD HCHG XR RF ABLATION CERVICAL OR THORACIC SINGLE LEVEL 5,789.00 LAB/RAD HCHG XR RF ABLATION CERVICAL OR THORACIC EA ADDL LEVEL 3,771.00 LAB/RAD HCHG XR NERVOUS SYSTEM PROCEDURE 1,572.00 LAB/RAD HCHG XR GASTRIC BAND ADJUSTMENT 576.00 LAB/RAD RAD XR SPINE THORACOLUMBAR STANDING SCOLIOSIS 2 TO 3 VIEW 1,255.00 LAB/RAD PB BILIRUBIN, TOTAL 141.00 LAB/RAD PB ALBUMIN SERUM 277.00 LAB/RAD RAD XR HIP UNILATERAL WWO PELVIS 1 VIEW 526.00 LAB/RAD PB BUN 120.00 LAB/RAD PB MIC VITEK 235.00 LAB/RAD RAD XR RIBS 2 VIEWS UNILATERAL 70.00 LAB/RAD RAD XR RIBS UNI INCLUDING PA CHEST MINIMUM OF 3 VIEWS 1,021.00 LAB/RAD RAD XR RIBS 3 VIEWS BILATERAL 1,052.00 LAB/RAD RAD XR STERNUM MINIMUM 2 VIEWS 1,242.00 LAB/RAD RAD XR SACRUM AND COCCYX TWO VIEWS OR MORE 1,063.00 LAB/RAD RAD XR HAND 3 VIEWS OR MORE 704.00 LAB/RAD RAD XR ANKLE 2 VIEWS 475.00 LAB/RAD RAD XR ABDOMEN ACUTE W CHEST 1 VIEW 214.00 LAB/RAD RAD XR INTRO GI TUBE 609.00 LAB/RAD RAD XR ESOPHAGEAL DILATION 701.00 LAB/RAD RAD XR SURGICAL SPECIMEN 223.00 LAB/RAD PB LACOSAMIDE VIMPAT LCS 280.00 LAB/RAD HCHG DRUGS OF ABUSE SCREEN RAPID URINE INHOUSE DAS 56.00 LAB/RAD RAD XR NECK SOFT TISSUE PORTABLE 295.00 LAB/RAD RAD XR SPINE THORACIC 2 VIEWS PORTABLE 983.00 LAB/RAD RAD XR LUMBOSACRAL SPINE 2 OR 3 VIEWS PORTABLE 942.00 LAB/RAD RAD XR SHOULDER COMPLETE 2 VIEWS OR MORE PORTABLE 853.00 LAB/RAD RAD XR FOREARM 2 VIEWS PORTABLE 704.00 LAB/RAD RAD XR ANKLE 2 VIEWS PORTABLE 475.00 LAB/RAD RAD XR FOOT COMPLETE MINIMUM OF 3 VIEWS PORTABLE 755.00 LAB/RAD RAD US DUPLEX SCAN EXTREMITY BILAT COMPLETE PORTABLE 2,229.00 LAB/RAD RAD US VENOUS INSUFF OR VEIN MAPPING EXTREMITY UNILATERAL 1,454.00 LAB/RAD RAD US SCROTUM OR OVARY DUPLEX LIMITED STUDY 900.00 LAB/RAD HCHG XR INJ EPIDURAL LUMBAR OR SACRAL W GUIDE 3,771.00 LAB/RAD PB DRUGS OF ABUSE WB 11 327.00 LAB/RAD HCHG INFLUENZA A&B 116.00 LAB/RAD PB CARBAMAZEPINE 216.00 LAB/RAD PB URINALYSIS 94.00 LAB/RAD PB MICROALBUMIN RANDOM URINE 171.00 LAB/RAD PB AFP-MATERNAL (Q) 100.00 LAB/RAD PB CHLORIDE,RANDOM URINE 81.00 LAB/RAD PB CHOLESTEROL BODY FLUID 144.00 LAB/RAD PB ESTRADIOL SERUM 127.00 LAB/RAD PB H PYLORI BREATH 302.00 LAB/RAD PB H PYLORI DRUG ADMINISTRATION 63.00 LAB/RAD PB HOMOCYSTEINE, CARDIAC 413.00 LAB/RAD PB LDL DIRECT CHOLESTEROL 125.00 LAB/RAD PB TRANSFERRIN (IBC) 125.00 LAB/RAD PB URIC ACID URINE 251.00 LAB/RAD PB DIFFERENTIAL 94.00 LAB/RAD PB GENERAL LAB 8680300 230.00 LAB/RAD PB ABY SCREEN 413.00 LAB/RAD PB FETAL DIRECT COOMBS 183.00 LAB/RAD PB WEAK DU 56.00 LAB/RAD PB AFB SMEAR (AFS) 138.00 LAB/RAD HCHG 17-OH PROGESTERONE LC 125.00 LAB/RAD HCHG ALDOSTERONE, SERUM LC 160.00 LAB/RAD HCHG ALK PHOS TOTAL LC 295.00 LAB/RAD HCHG BILIRUBIN, TOTAL BODY FLUID LC 10.00 LAB/RAD PB PHENYTOIN FREE 476.00 LAB/RAD PB VANCOMYCIN PEAK 102.00 LAB/RAD PB SPECIFIC GRAVITY URINE 94.00 LAB/RAD PB UA MULTI 94.00 LAB/RAD PB OCCULT BLOOD GASTRIC 86.00 LAB/RAD HCHG GASTRIN, SERUM LC 86.00 LAB/RAD HCHG EOSINOPHIL SMEAR NASAL 12.00 LAB/RAD HCHG ANTIGLIADIN ABS, IGG LC 156.00 LAB/RAD HCHG G-6-PD, QUANT, BLOOD LC 114.00 LAB/RAD HCHG CADMIUM HEAVY METALS PROFILE II, URINE LC 92.00 LAB/RAD PB CREATININE CLEARANCE 906.00 LAB/RAD HCHG MYCOPLASMA PNEUMONIAE, PCR LC 345.00 LAB/RAD HCHG METHYLMALONIC ACID, SERUM LC 631.00 LAB/RAD HCHG IMMUNODIFFUSION OUCHTERLONY LC 45.00 LAB/RAD HCHG ANTISCLERODERMA-70 ANTIBODIES LC 311.00 LAB/RAD HCHG TESTOSTERONE, FREE, EQUILIBRIUM ULTRAFILTRATION LC 294.00 LAB/RAD HCHG TRYPTASE LC 329.00 LAB/RAD HCHG VZV REAL TIME PCR LC 482.00 LAB/RAD HCHG CELIAC DISEASE HLA DQ ASSOC ALLELE LC 315.00 LAB/RAD PB PROTEIN,BODY FLUID 231.00 LAB/RAD PB PAPP A 127.00 LAB/RAD HCHG JAK2 EXONS 12-15 LC 574.00 LAB/RAD PB URIC ACID 308.00 LAB/RAD PB URIC ACID BODY FLUID 251.00 LAB/RAD PB BABESIA MICROTI, PCR LC 482.00 LAB/RAD PB VON WILLEBRAND ANTIGEN 366.00 LAB/RAD PB SED RATE 139.00 LAB/RAD PB SICKLE CELL TEST 217.00 LAB/RAD PB TRANSFUSION REACTION 1,321.00 LAB/RAD PB BETA 2 GLYCOPROTEIN 1 IGA 177.00 LAB/RAD PB HETEROPHILE 244.00 LAB/RAD PB INTRINSIC FACTOR ABY 114.00 LAB/RAD PB LYME (FIA) POLYVALENT 154.00 LAB/RAD PB GENERAL LAB 8669500 62.00 LAB/RAD PB FETAL WEAK D 56.00 LAB/RAD PB ARC-IRRADIATION RBC 100.00 LAB/RAD PB WOUND CULTURE 256.00 LAB/RAD PB METH RES STAPH CULTURE 132.00 LAB/RAD PB YEAST IDENT 227.00 LAB/RAD PB MOLD IDENT 80.00 LAB/RAD PB CRYPTOSPORIDIUM TEST 146.00 LAB/RAD PB GENERAL LAB 8752900 625.00 LAB/RAD PB WEST NILE VIRUS ANTIBODY IGG SERUM LC 217.00 LAB/RAD PB FLOW MARKER INTERP 16 OR MORE 686.00 LAB/RAD PB DECALCIFICATION 183.00 LAB/RAD PB IHC SEMIQUANT 401.00 LAB/RAD PB THIN PREP PAP ROUTINE 152.00 LAB/RAD PB OCCULT BLOOD, IFOBT 110.00 LAB/RAD PB RBC LR IRR WASH/DEGLYCS 1,023.00 LAB/RAD HCHG ANCA 93.00 LAB/RAD PB EBV NA 947.00 LAB/RAD PB BORDETELLA PCR 482.00 LAB/RAD HCHG CT DRAIN OVARIAN CYST ABD APPROACH 1,609.00 LAB/RAD HCHG XR VERTEBROPLASTY THORACIC 4,255.00 LAB/RAD PB AEROBIC ID BY SEQUENCING 75.00 LAB/RAD HCHG COBALT BLOOD 158.00 LAB/RAD HCHG HLA ABY CLASS II 413.00 LAB/RAD PB PROTEIN ELP URINE RANDOM 345.00 LAB/RAD PB PATIENT SOURCE ANTI HCV 230.00 LAB/RAD PB RBC LR IRR CMV NEG 869.00 LAB/RAD PB NO CHARGE URINALYSIS 94.00 LAB/RAD PB MICROALBUMIN SEMIQUANT CLINIC ONLY 171.00 LAB/RAD PB PRO-BNP 586.00 LAB/RAD HCHG CA15.3 345.00 LAB/RAD HCHG AP MISC VARIABLE CHARGE 0.00 LAB/RAD HCHG TISSUE LEVEL 3 TECH ONLY 127.00 LAB/RAD PR SURGICAL DRESS HOLDER REUSE PR20 AFFILIATE ONLY 29.00 LAB/RAD HCHG COLLECTION CAPILLARY BLOOD SPECIMEN 56.00 LAB/RAD HCHG TACROLIMUS AHL 383.00 LAB/RAD PB KRAS MUTATION AFFILIATE ONLY 1,000.00 LAB/RAD RAD ECHO 3D RECON ACQUISITION WKST 1,324.00 LAB/RAD HCHG FECAL FAT, QUAL LC 18.00 LAB/RAD PB PROTEINASE 3 AB 156.00 LAB/RAD HCHG NRAS MUTATION NEO 997.00 LAB/RAD HCHG FLT3 ITD 563.00 LAB/RAD RAD XR ABDOMEN SINGLE AP VIEW 545.00 LAB/RAD RAD XR ABDOMEN SINGLE AP VIEW PORTABLE 545.00 LAB/RAD RAD XR MAMMO UNI DIAGNOSTIC WWO CAD 505.00 LAB/RAD RAD XR MAMMO BILAT DIAGNOSTIC 3D WWO CAD 505.00 LAB/RAD HCHG GLUCOSE TOLERANCE 2ND ADDL 1,011.00 LAB/RAD HCHG NMR LIPOPROFILE 174.00 LAB/RAD HCHG SPECIMEN COLLECT SARS-COV-2 AFFILIATE ONLY 60.00 LAB/RAD HCHG BONEMRW SMR INTERP 175.00 LAB/RAD HCHG HEPATIC FUNCTION PANEL 370.00 LAB/RAD HCHG ACETAMINOPHEN 281.00 LAB/RAD HCHG ALBUMIN BODY FLUID 68.00 LAB/RAD HCHG AMYLASE URINE 392.00 LAB/RAD HCHG OCCULT BLOOD GASTRIC 86.00 LAB/RAD HCHG THC METABOLITE QUANT URINE 280.00 LAB/RAD HCHG CREATININE BODY FLUID 279.00 LAB/RAD HCHG ESTRADIOL SERUM 155.00 LAB/RAD HCHG FERRITIN 318.00 LAB/RAD HCHG FOLIC ACID 110.00 LAB/RAD HCHG GASTRIN SERUM 86.00 LAB/RAD HCHG FSH-SERUM 223.00 LAB/RAD HCHG HEMOGLOBIN A1C 149.00 LAB/RAD HCHG LACTATE, CSF 125.00 LAB/RAD HCHG NICOTINE CONFIRMATION URINE 274.00 LAB/RAD HCHG OXYCODONE URINE QUANT 280.00 LAB/RAD HCHG POTASSIUM ISTAT 93.00 LAB/RAD HCHG POTASSIUM, URINE 120.00 LAB/RAD HCHG PROTEIN ELP URINE 308.00 LAB/RAD HCHG SPECIFIC GRAVITY BF 70.00 LAB/RAD HCHG ELECTROLYTE PANEL 171.00 LAB/RAD HCHG LITHIUM 155.00 LAB/RAD HCHG PHENYTOIN FREE 476.00 LAB/RAD HCHG URINALYSIS COMPLETE 99.00 LAB/RAD HCHG URINALYSIS 94.00 LAB/RAD HCHG EQUAL MIX, PROTIME 198.00 LAB/RAD HCHG PTT-LA SCREEN 155.00 LAB/RAD HCHG AFB CONCENTRATION 21.00 LAB/RAD HCHG ENVIRONMENTAL CULTURE 256.00 LAB/RAD HCHG URETHREAL CULTURE 256.00 LAB/RAD HCHG WATER CULTURE 256.00 LAB/RAD HCHG FUNGUS CULTURE 244.00 LAB/RAD HCHG AFB CULTURE 21.00 LAB/RAD HCHG GRAM STAIN 170.00 LAB/RAD PB INFLUENZA B AGN 116.00 LAB/RAD HCHG CRYPTOCOCCAL AG-QUAL 144.00 LAB/RAD HCHG TOTAL T CELLS 264.00 LAB/RAD HCHG ANTIBODY ID-HP 125.00 LAB/RAD HCHG DIRECT ANTIGLOBULIN TEST 183.00 LAB/RAD HCHG CORD DAT 183.00 LAB/RAD HCHG PATIENT ANTIGEN 81.00 LAB/RAD HCHG RBC-LR W 731.00 LAB/RAD HCHG RED BLOOD CELLS IRR 474.00 LAB/RAD HCHG O2 SAT MEASURED 1,328.00 LAB/RAD HCHG LEAD HEAVY METAL SCR URINE 149.00 LAB/RAD HCHG MERCURY HEAVY METAL SCR URINE 149.00 LAB/RAD HCHG AFB BLOOD CULTURE 21.00 LAB/RAD HCHG BILIRUBIN URINE 94.00 LAB/RAD HCHG PH URINE 94.00 LAB/RAD HCHG RHO D IMMUNE GLOB 625.00 LAB/RAD HCHG US OB LIMITED 1 OR MORE FETUSES 282.00 LAB/RAD HCHG CONGENITAL HYPOTHYROIDISM 144.00 LAB/RAD HCHG CONGENITAL ADRENAL HYPERPLAS 125.00 LAB/RAD HCHG H PYLORI DRUG ADMINISTRATION 62.00 LAB/RAD NM DOSE TECH 99M MDP UP TO 30 MCI 469.00 LAB/RAD NM DOSE TECH 99M MAA 10MCI 391.00 LAB/RAD NM DOSE TECH 99M SULFUR COLLOID 20MCI 391.00 LAB/RAD HCHG CT MAXILLOFACIAL WO CONTRAST 3,998.00 LAB/RAD HCHG STREP PNEUMONIAE ANTIGEN 62.00 LAB/RAD HCHG SSB ANTIBODY 311.00 LAB/RAD HCHG GLUCOSE 2 HOUR 130.00 LAB/RAD HCHG CHROMOGRANIN A 170.00 LAB/RAD HCHG TRANSESOPHAG ECHO W PROBE PLMNT COMPLETE W CONTRAST 1,571.00 LAB/RAD HCHG TRANSESOPHAG ECHO W PROBE PLMNT COMPLETE WO CONTRAST 2,184.00 LAB/RAD HCHG ECHO 2D F-U OR LTD STUDY WO CONT 2,184.00 LAB/RAD HCHG ECHO 2D COMP WO CONT W BUBBLE-SPECTRAL-COLOR 2,184.00 LAB/RAD HCHG ECHO 2D COMP W CONT-BUBBLE-SPECTRAL-COLOR 2,184.00 LAB/RAD HCHG FETAL WEAK D 56.00 LAB/RAD HCHG STRESS ECHO 2D EXERCISE W STRESS TEST W CONTRAST 2,184.00 LAB/RAD HCHG ACETYLCHOLINE RECEPTOR MOD ABY 394.00 LAB/RAD HCHG PROSTATE SATURATION BIOPSY 670.00 LAB/RAD HCHG BETA 2 GLYCOPROTEIN 1 IGM 177.00 LAB/RAD HCHG PROCALCITONIN 166.00 LAB/RAD HCHG METHADONE URINE QUANT 280.00 LAB/RAD HCHG METHYLPHENIDATE (RITALIN) SERUM 280.00 LAB/RAD HCHG XR BIOPSY BREAST INC MARKER 1ST LESION STEREO GUIDE 9,895.00 LAB/RAD HCHG XR BX BREAST INC MARKER EA ADDL STEREO RT 1,645.00 LAB/RAD HCHG US BX BREAST INC MARKER EA ADDL W GUIDE RT 1,645.00 LAB/RAD HCHG XR MAMMO BREAST LOC PERC MARKER EA ADDL W GUIDE LT 236.00 LAB/RAD HCHG US DRAIN ABSCESS PERITONEAL PERC INC GUIDE 2,785.00 LAB/RAD HCHG CYG-URINE FISH MORPHOMETRIC PROBE AND ANALYSIS 448.00 LAB/RAD HCHG T CELL GAMMA PCR 932.00 LAB/RAD PB H HEMACHROMATOSIS 417.00 LAB/RAD PB T IHC STAIN ADDL 155.00 LAB/RAD HCHG CT BIOPSY SHLDR SOFT TISSUE SUPRFL 506.00 LAB/RAD HCHG CT ASPIRATION PELVIS 0.00 LAB/RAD RAD CT CHEST W 4,960.00 LAB/RAD RAD CT SPINE THORACIC WWO 4,756.00 LAB/RAD RAD CT PELVIS WO 4,678.00 LAB/RAD RAD CT ANGIO ABDOMEN PELVIS 4,145.00 LAB/RAD RAD CT ABDOMEN PELVIS WWO 6,124.00 LAB/RAD RAD CT ANGIO ABDOMEN PELVIS LOWER EXTREMITY RUNOFF 5,786.00 LAB/RAD RAD CT 3D RECONSTRUCTION W POSTPROCESS INDP WKST 854.00 LAB/RAD RAD IR ERCP BILIARY ONLY 85.00 LAB/RAD RAD MR ANGIO NECK WWO 5,258.00 LAB/RAD RAD MR SPINE CERVICAL WO 4,386.00 LAB/RAD RAD MR PELVIS WWO 4,386.00 LAB/RAD RAD MR JOINT OF UPPER EXTREMITY WO 4,386.00 LAB/RAD RAD MR ABDOMEN W 5,258.00 LAB/RAD RAD MR ABDOMEN WWO 5,258.00 LAB/RAD RAD MR ANGIO ABDOMEN WWO 4,386.00 LAB/RAD RAD MR ANGIO CHEST WWO 4,386.00 LAB/RAD RAD MR ANGIO LOWER EXTREMITY W 4,386.00 LAB/RAD RAD NM LYMPHATICS AND LYMPH NODE IMAGING 1,067.00 LAB/RAD RAD NM HEPATOBILIARY W PHARM INTERVENTION 1,472.00 LAB/RAD RAD NM BONE SCAN WHOLE BODY 2,909.00 LAB/RAD RAD NM LUNG VENTILATION AND PERFUSION SCAN 2,354.00 LAB/RAD RAD US OB FOLLOW UP ANY TRI SINGLE TRANSABD 654.00 LAB/RAD RAD US OB BIOPHYSICAL PROFILE WO NONSTRESS TESTING 1,271.00 LAB/RAD RAD US HYSTEROSONOGRAM 1,593.00 LAB/RAD RAD US SCROTUM 1,227.00 LAB/RAD PB CELL SURF ABY IGG 370.00 LAB/RAD RAD US GUIDED NEEDLE PLACEMENT 3,464.00 LAB/RAD HCHG XR INJ SINUS TRACT DIAGNOSTIC 1,879.00 LAB/RAD HCHG XR FOOT OR TOES PROCEDURE 2,039.00 LAB/RAD RAD US BREAST COMPLETE 2,279.00 LAB/RAD HCHG XR LUMBAR PUNCTURE DIAGNOSTIC 1,321.00 LAB/RAD HCHG XR INJ DISCOGRAM LUMBAR EA LEVEL 199.00 LAB/RAD HCHG XR INJ TRANSFORAMINAL LUMBAR OR SACRAL SINGLE LEV 5,442.00 LAB/RAD RAD XR EYE DETECTION OF FOREIGN BODY 242.00 LAB/RAD RAD XR SINUSES COMPLETE MINIMUM OF THREE VIEWS 1,063.00 LAB/RAD PB TRIGLYCERIDES 212.00 LAB/RAD RAD XR HIPS BILATERAL 2V WWO PELVIS PORTABLE 1,140.00 LAB/RAD RAD XR SPINE THORACIC 2 VIEWS 983.00 LAB/RAD RAD XR SPINE LUMBAR INC BENDING MINIMUM 6 VIEWS 645.00 LAB/RAD RAD XR PELVIS 1 OR 2 VIEWS 525.00 LAB/RAD RAD XR SCAPULA COMPLETE 755.00 LAB/RAD RAD XR ACROMIOCLAVICULAR JOINTS BILATERAL WWO WEIGHTS 1,074.00 LAB/RAD RAD XR ELBOW COMPLETE THREE VIEWS OR MORE 804.00 LAB/RAD RAD XR TIBIA AND FIBULA 2 VIEWS LTD 704.00 LAB/RAD RAD XR FOOT 2 VIEWS 475.00 LAB/RAD RAD XR ESOPHAGUS 504.00 LAB/RAD HCHG IR BILI CATH PERC WWO CHOLANGIOGRAPHY W GUIDE EXTERNAL S&I 3,156.00 LAB/RAD RAD XR FLUORO GUIDED SPINAL INJECTION 832.00 LAB/RAD RAD XR BONE SURVEY LIMITED STUDY 651.00 LAB/RAD HCHG FNA IMMED ADEQ PATH ADD 40.00 LAB/RAD HCHG RBC LR IRR CMV NEG WASHED PEDS UNIT 300.00 LAB/RAD HCHG RBC LR IRR WASHED PEDS UNIT 300.00 LAB/RAD RAD XR FOOT 2 VIEWS PORTABLE LIMITED 475.00 LAB/RAD RAD XR TOE(S) MINIMUM OF 2 VIEWS PORTABLE 555.00 LAB/RAD RAD US ABDOMEN LIMITED PORTABLE 1,334.00 LAB/RAD RAD US RETROPERITONEAL COMPLETE PORTABLE 1,424.00 LAB/RAD RAD US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY PORTABLE 1,454.00 LAB/RAD RAD US AORTA ILIACS IVC WITH DUPLEX PORTABLE 461.00 LAB/RAD PB DRUGS OF ABUSE SCR URINE INHOUSE DAS 56.00 LAB/RAD RAD MR BREAST UNILATERAL WO 4,386.00 LAB/RAD PB VALPROIC ACID TOTAL 308.00 LAB/RAD PB URINALYSIS COMPLETE 99.00 LAB/RAD PB ALBUMIN BODY FLUID 68.00 LAB/RAD PB HCO3 94.00 LAB/RAD PB CORTISOL 262.00 LAB/RAD PB IGE 81.00 LAB/RAD PB MYASTHENIA GRAVIS IMMUNO 329.00 LAB/RAD PB LACTATE BLOOD 125.00 LAB/RAD PB LD, BODY FLUID 245.00 LAB/RAD PB OSMOLALITY,URINE 183.00 LAB/RAD PB POTASSIUM ISTAT 93.00 LAB/RAD PB POTASSIUM,TIMED URINE 120.00 LAB/RAD PB T3, FREE 168.00 LAB/RAD PB ARGININE VASOPRESSIN (ADH) 280.00 LAB/RAD PB C-PEPTIDE SERUM 139.00 LAB/RAD PB HEMOGLOBIN,BLOOD GAS 173.00 LAB/RAD PB FACTOR X CHROMOGENIC 152.00 LAB/RAD PB GENERAL LAB 8670300 100.00 LAB/RAD PB GENERAL LAB 8670600 167.00 LAB/RAD PB ANTIBODY ID-HP 54.00 LAB/RAD PB FETAL ABO 210.00 LAB/RAD PB AFB CONCENTRATION 21.00 LAB/RAD PB LITHIUM 155.00 LAB/RAD PB AMYLASE 392.00 LAB/RAD PB CARBOXYHEMOGLOBIN 180.00 LAB/RAD HCHG LEAD HEAVY METALS PROFILE II, URINE LC 149.00 LAB/RAD HCHG HLA B 27 DISEASE ASSOCIATION LC 210.00 LAB/RAD HCHG IGF-1 LC 302.00 LAB/RAD PB GAMMA GT 110.00 LAB/RAD HCHG ACTINOMYCES CULTURE 373.00 LAB/RAD HCHG MYCOPHENOLIC ACID AND METABO LC 224.00 LAB/RAD HCHG PANCREASTATIN LC 394.00 LAB/RAD HCHG BACTERIUM ANTIBODY LC 40.00 LAB/RAD PB LIPASE 154.00 LAB/RAD HCHG SEROTONIN, SERUM LC 193.00 LAB/RAD HCHG REVERSE T3, SERUM LC 110.00 LAB/RAD HCHG THYROTROPIN RECEPTOR AB, SERUM LC 316.00 LAB/RAD HCHG TRIGLYCERIDES, FLUID LC 212.00 LAB/RAD HCHG VARICELLA-ZOSTER AB, IGM LC 102.00 LAB/RAD HCHG VITAMIN A, SERUM LC 95.00 LAB/RAD HCHG VITAMIN B6, PLASMA LC 312.00 LAB/RAD PB PROGESTERONE BLOOD 99.00 LAB/RAD PB ACTH, PLASMA LC 158.00 LAB/RAD PB PANCREATIC AMYLASE, S LC 392.00 LAB/RAD PB BABESIA MICROTI ANTIBODY LC 199.00 LAB/RAD PB PLATELET COUNT 232.00 LAB/RAD PB D-DIMER QUANT 330.00 LAB/RAD PB THROMBIN TIME 100.00 LAB/RAD PB BETA 2 GLYCOPROTEIN 1 IGG 177.00 LAB/RAD PB BETA 2 GLYCOPROTEIN 1 IGM 177.00 LAB/RAD PB CHROMOGRANIN A 170.00 LAB/RAD PB RA QUANT 183.00 LAB/RAD PB QUANTIFERON TB GOLD PLUS 224.00 LAB/RAD PB MYCOPHENOLIC ACID AND METABO LC 224.00 LAB/RAD PB ORGANIC ACID ANALYSIS, URINE LC 156.00 LAB/RAD PB VARICELLA ZOSTER IMMUNE ASSAY 102.00 LAB/RAD PB PTHRP (PTH-RELATED PEPTIDE) LC 100.00 LAB/RAD PB CALCULI, URINARY LC 36.00 LAB/RAD PB STERILITY CULTURE 256.00 LAB/RAD PB URINE CULTURE 58.00 LAB/RAD PB PINWORM PREP 210.00 LAB/RAD PB E TEST 266.00 LAB/RAD PB BETA LACTAMASE 216.00 LAB/RAD PB EHRLICHIOSIS 130.00 LAB/RAD PB TRICH/YEAST/CLUE 152.00 LAB/RAD PB H. PYLORI ANTIGEN, STOOL 126.00 LAB/RAD PB GROUP B STREP RAPID DNA PCR 345.00 LAB/RAD PB WEST NILE VIRUS ANTIBODY IGM, SERUM LC 217.00 LAB/RAD PB RSV RAPID ANTIGEN 357.00 LAB/RAD PB IMAGED THIN PREP PAP SCREEN 152.00 LAB/RAD HCHG RBC LR IRR CMV NEG 869.00 LAB/RAD HCHG MRSA PCR 339.00 LAB/RAD PB ANCA TITER 93.00 LAB/RAD HCHG CT CELIAC PLEXUS ABLATION 806.00 LAB/RAD HCHG CT SINUS TRACT INJECTION DIAGNOSTIC 1,879.00 LAB/RAD HCHG US INJ SINGLE TENDON SHEATH LIGAMENT 406.00 LAB/RAD HCHG US INJ ANES SCIATIC NERVE 475.00 LAB/RAD HCHG XR IVC FILTER REMOVAL 3,873.00 LAB/RAD HCHG XR VERTEBROLPLAST EA ADDL LEVEL 2,401.00 LAB/RAD HCHG XR VERTEBROPLASTY LUMBAR 4,218.00 LAB/RAD HCHG BLASTOMYCES ANTIGEN LC 62.00 LAB/RAD PB MG LES IMMUNO 130.00 LAB/RAD HCHG AEROBIC ID BY SEQUENCING 75.00 LAB/RAD PB BONEMRW SMR INTERP 499.00 LAB/RAD PB CONSULT EXTENDED 506.00 LAB/RAD PB EMPLOYEE ANTI HBS 167.00 LAB/RAD PB GENERAL LAB 8670302 54.00 LAB/RAD HCHG ENCEPHALOPATHY AUTOIMMUNE GAD65 ABY CSF 92.00 LAB/RAD PB INFLUENZA A AGN 116.00 LAB/RAD PB FERN TESTING PROVIDER PERFORMED 23.00 LAB/RAD RAD XR C-ARM EQUAL OR GREATER 3 HR 720.00 LAB/RAD PB TISSUE LEVEL 3 127.00 LAB/RAD PB TISSUE LEVEL 5 350.00 LAB/RAD PB RA QUALITATIVE 183.00 LAB/RAD HCHG THYROGLOB ABY SCREEN 170.00 LAB/RAD PB THYROGLOB ABY SCREEN 170.00 LAB/RAD PB THYROGLOB TUMOR MARKER 154.00 LAB/RAD HCHG XR INJ FOR MYELOGRAM LUMBOSACRAL 886.00 LAB/RAD PB UA COMPLETE RTR 99.00 LAB/RAD PB ERYTHROPOIETIN EPO 416.00 LAB/RAD HCHG MLH1 HYPERMETHYLATION MML 499.00 LAB/RAD HCHG COMPLIANCE DRUG ANALYSIS CDS 331.00 LAB/RAD HCHG KRAS MUTATION NEO 1,000.00 LAB/RAD HCHG STRIATIONAL ABY LC 93.00 LAB/RAD HCHG FLT3 TKD 281.00 LAB/RAD RAD XR MAMMO UNI DIAGNOSTIC 3D WWO CAD 505.00 LAB/RAD RAD XR MAMMO UNI DIAGNOSTIC ADDL VIEWS WWO CAD 505.00 LAB/RAD HCHG PHOSPHOLIPASE A2 RECEPTOR AUTOABY LC 156.00 LAB/RAD PB HERPES SIMPLEX CULTURE AFFILIATE ONLY 224.00 LAB/RAD PB COVID 19 NAA LC 140.00 LAB/RAD PR BUPIVACAINE HCL 30 ML 69.00 LAB/RAD HCHG ROUTINE VENIPUNCTURE 45.00 LAB/RAD PR I-123 SODIUM IODIDE DX PER 100 UCI UP T 406.00 LAB/RAD HCHG ACUTE HEPATITIS PANEL 629.00 LAB/RAD HCHG ALBUMIN 277.00 LAB/RAD HCHG BILIRUBIN NEONATAL TOTAL AFFILIATE ONLY 141.00 LAB/RAD HCHG BILIRUBIN,DIRECT 287.00 LAB/RAD HCHG ETHOTOIN PEGANONE 280.00 LAB/RAD HCHG BARBITURATE CONFIRM UR 250.00 LAB/RAD HCHG CK-MB 138.00 LAB/RAD HCHG CREATININE, URINE 279.00 LAB/RAD HCHG GLUCOSE 2HPP 150.00 LAB/RAD HCHG HAPTOGLOBIN 102.00 LAB/RAD HCHG PROTEIN TOTAL, CSF 231.00 LAB/RAD HCHG T3 TOTAL 149.00 LAB/RAD HCHG UREA NITROGEN-URINE 26.00 LAB/RAD HCHG GENTAMICIN 77.00 LAB/RAD HCHG PHENOBARBITAL 114.00 LAB/RAD HCHG PROCESSING 47.00 LAB/RAD HCHG SPECIFIC GRAVITY URINE 94.00 LAB/RAD HCHG CRYSTAL IDENTIFICATION 125.00 LAB/RAD HCHG HEMOGLOBIN 158.00 LAB/RAD HCHG RBC 127.00 LAB/RAD HCHG KLEIHAUER STAIN 825.00 LAB/RAD HCHG LOW MOL WT HEPARIN 245.00 LAB/RAD HCHG EQUAL MIX APTT 188.00 LAB/RAD HCHG SED RATE 167.00 LAB/RAD HCHG ARC-PALTELET ANTIBODY SCREEN 343.00 LAB/RAD HCHG FANA TITER 191.00 LAB/RAD HCHG C3 COMPLEMENT COMPONENT 131.00 LAB/RAD HCHG C4 COMPLEMENT COMPONENT 131.00 LAB/RAD HCHG GENERAL LAB 8738900 141.00 LAB/RAD HCHG THROAT CULTURE 256.00 LAB/RAD HCHG VAG/RECTAL STREP CULTURE 132.00 LAB/RAD HCHG URINE PRESUMPTIVE ID 32.00 LAB/RAD HCHG PARASITE DIRECT EXAM 49.00 LAB/RAD HCHG VZ VIRUS BY RAPID PCR 378.00 LAB/RAD HCHG GRADIENT STRIP 1 266.00 LAB/RAD HCHG KOH-SKIN, HAIR, NAILS 152.00 LAB/RAD HCHG INFLUENZA A AGN 116.00 LAB/RAD HCHG CHLAMYDIA PCR 135.00 LAB/RAD HCHG FNA INTERP & REPORT 294.00 LAB/RAD HCHG TISSUE LEVEL IV 355.00 LAB/RAD HCHG SP STAIN 1 ORG 231.00 LAB/RAD HCHG ABO GROUP 210.00 LAB/RAD HCHG CORD RH TYPE 56.00 LAB/RAD HCHG RBC LR IR PEDS UNIT 300.00 LAB/RAD HCHG ROTAVIRUS ANTIGEN STOOL 127.00 LAB/RAD HCHG E TEST 266.00 LAB/RAD HCHG VANCOMYCIN PEAK 102.00 LAB/RAD HCHG SOLUBLE TRANSFERRIN RECEPTOR 329.00 LAB/RAD HCHG ALBUMIN CSF 68.00 LAB/RAD HCHG RAPID HIV SCREEN 100.00 LAB/RAD HCHG NON-GYN THIN PREP 155.00 LAB/RAD HCHG FLOW MARKER INTERP 9-15 433.00 LAB/RAD HCHG FLUORO < 1 HOUR 729.00 LAB/RAD HCHG AMINO ACIDEMIAS (PKU) 127.00 LAB/RAD HCHG GALACTOSEMIA 43.00 LAB/RAD HCHG CAPILLARY COLLECTION 56.00 LAB/RAD HCHG ACTH STIMULATION PANEL 198.00 LAB/RAD NM DOSE CARDIOLITE PER STUDY DOSE 469.00 LAB/RAD HCHG HCG 266.00 LAB/RAD HCHG FERN TESTING PROVIDER PERFORMED 152.00 LAB/RAD HCHG TRANSCUTANEOUS BILIRUBIN 38.00 LAB/RAD HCHG GAMMA-HYDROXYBUTYRIC ACID (GHB) 312.00 LAB/RAD HCHG URINALYSIS WO MICRO 94.00 LAB/RAD HCHG KAPPA FREE LIGHT CHAIN 95.00 LAB/RAD HCHG LAMBDA FREE LIGHT CHAIN 95.00 LAB/RAD HCHG PARANEOPLASTIC FLUORESCENT ABY SCR 93.00 LAB/RAD HCHG MRSA DNA PCR 339.00 LAB/RAD HCHG TRANSESOPHAG ECHO W BUBBLE STUDY COMPLETE WO CONTRAST 2,184.00 LAB/RAD PR ALBUTEROL TO 2.5 MG AND IPRATROPIUM BROMIDE TO 0.5 MG 7.00 LAB/RAD HCHG ECHO 2D COMP WO CONT W SPECTRAL-COLOR 2,184.00 LAB/RAD HCHG STRESS ECHO 2D EXERCISE W STRESS TEST WO CONTRAST 2,184.00 LAB/RAD HCHG ISOPROPYL ALCOHOL 280.00 LAB/RAD HCHG TREPONEMA PALLIDUM 355.00 LAB/RAD HCHG STOOL CULT 85.00 LAB/RAD HCHG E COLI 0157 PLATE STL 85.00 LAB/RAD HCHG GLUCOSE TOLERANCE FASTING 130.00 LAB/RAD HCHG CT ARTHROCENTESIS MAJOR JOINT OR BURSA 1,048.00 LAB/RAD PB HEMOGLOBINOPATHY ELECTRO 254.00 LAB/RAD HCHG XR BX BREAST INC MARKER EA ADDL STEREO LT 1,645.00 LAB/RAD HCHG US BIOPSY BREAST INC MARKER 1ST LESION W GUIDE 10,887.00 LAB/RAD HCHG XR STEREO BREAST LOC PERC MARKER EA ADDL W GUIDE RT 236.00 LAB/RAD HCHG US BREAST LOC PERC MARKER EACH ADDL W GUIDE RT 236.00 LAB/RAD HCHG IHC STAIN ADDL 155.00 LAB/RAD HCHG HEMOGLOBINOPATHY ELECTRO 254.00 LAB/RAD PB TOXOPLASMA GONDII PCR LC 463.00 LAB/RAD HCHG CYG-FISH GENERAL INTERPHASE ANALYSIS (25-99) 109.00 LAB/RAD HCHG CYG-FISH MORPHOMETRIC FDA APPROVED PROBE AND ANALYSIS 513.00 LAB/RAD HCHG T CELL BETA PCR GR 967.00 LAB/RAD HCHG SUSCEPTIBILITY NOCARDIA 659.00 LAB/RAD PB CYG-ADDL KARYOTYPE 114.00 LAB/RAD HCHG CT BIOPSY SOFT TISSUE NECK OR CHEST 2,883.00 LAB/RAD HCHG CT SACROPLASTY 0.00 LAB/RAD HCHG CT ASPIRATION RENAL CYST 1,392.00 LAB/RAD HCHG CT NERVE BLOCK CELIAC PLEXUS 458.00 LAB/RAD HCHG CT SACROPLASTY W GUIDE UNILATERAL 13,674.00 LAB/RAD RAD CT SPINE LUMBAR OR SACRUM W 5,303.00 LAB/RAD RAD CT UPPER EXTREMITY W 3,889.00 LAB/RAD RAD CT UPPER EXTREMITY WWO 3,998.00 LAB/RAD RAD CT LOWER EXTREMITY WO 3,744.00 LAB/RAD RAD CT LOWER EXTREMITY W 4,105.00 LAB/RAD RAD CT ABDOMEN WO 3,998.00 LAB/RAD RAD CT ABDOMEN W 4,247.00 LAB/RAD RAD CT GUIDE PERC DRAIN CATH 504.00 LAB/RAD RAD MR NECK SOFT TISSUE ORBIT FACE WWO 4,386.00 LAB/RAD RAD MR ANGIO NECK WO 4,857.00 LAB/RAD RAD MR HEAD BRAIN WO LTD 4,386.00 LAB/RAD RAD MR CHEST WO 4,386.00 LAB/RAD RAD MR SPINE THORACIC WWO 4,386.00 LAB/RAD RAD MR PELVIS W 4,386.00 LAB/RAD RAD MR NON JOINT UPPER EXTREMITY WWO 4,386.00 LAB/RAD RAD MR JOINT OF LOWER EXTREMITY W 4,386.00 LAB/RAD RAD MR BREAST WWO 4,386.00 LAB/RAD RAD MR ANGIO LOWER EXTREMITY WWO 4,386.00 LAB/RAD RAD NM THYROID UPTAKE W FLOW QUANTITATIVE MEASURE 2,889.00 LAB/RAD RAD NM GASTRIC EMPTYING 1,359.00 LAB/RAD RAD NM LUNG VENTILATION SCAN 2,814.00 LAB/RAD RAD NM VOIDING CYSTOGRAM 544.00 LAB/RAD RAD PET CT LIMITED INITIAL TREATMENT 2,902.00 LAB/RAD HCHG US BREAST CYST ASPIRATION EACH ADD'L 137.00 LAB/RAD HCHG US BIOPSY MUSCLE 2,883.00 LAB/RAD HCHG US INJECT OR ASPIRATE INTERMED JOINT OR BURSA W US GUIDE 1,773.00 LAB/RAD HCHG US INJECT OR ASPIRATE GANGLION CYST 274.00 LAB/RAD HCHG US PROCEDURE OF SHOULDER 1,405.00 LAB/RAD RAD US RENAL TRANSPLANT WITH DUPLEX DOPPLER 1,081.00 LAB/RAD RAD US EXTREMITY NONVASCULAR COMPLETE 1,241.00 LAB/RAD RAD US ARTERIAL UPPER EXTREMITY UNLATERAL OR LTD STUDY 737.00 LAB/RAD RAD US DUPLEX SCAN ABDOMEN COMPLETE 681.00 LAB/RAD RAD US OVARY DUPLEX LIMITED 900.00 LAB/RAD HCHG XR INJ FOR ARTHROGRAM ELBOW 383.00 LAB/RAD HCHG XR INJECTION FOR CENTRAL VENOUS CATH EVAL 295.00 LAB/RAD HCHG XR INTRO LONG GI TUBE 88.00 LAB/RAD HCHG XR REPLACEMENT GASTRO JEJUNOSTOMY TUBE 2,190.00 LAB/RAD HCHG XR INJ NERVE BLOCK PERIPHERAL NERVE 1,572.00 LAB/RAD HCHG XR RF ABLATION LUMBAR OR SACRAL EA ADDL LEVEL 3,551.00 LAB/RAD RAD XR MANDIBLE MINIMUM OF FOUR VIEWS 1,063.00 LAB/RAD RAD XR NASAL BONES COMPLETE MINIMUM OF THREE VIEWS 716.00 LAB/RAD PB O & P STAIN 174.00 LAB/RAD RAD XR ORBITS MINIMUM OF FOUR VIEWS 1,222.00 LAB/RAD PB BILIRUBIN,DIRECT 287.00 LAB/RAD PB OLIGOCLONAL BANDS 406.00 LAB/RAD RAD XR SKULL COMPLETE MINIMUM OF FOUR VIEWS 1,050.00 LAB/RAD PB CHLORIDE 216.00 LAB/RAD PB LIPID PANEL 142.00 LAB/RAD PB CHOLESTEROL 125.00 LAB/RAD PB CALCIUM 171.00 LAB/RAD PB GENERAL LAB 8659200 100.00 LAB/RAD PB ID AEROBE, EACH 182.00 LAB/RAD RAD XR HIPS BILATERAL 3 TO 4V WWO PELVIS 1,140.00 LAB/RAD RAD XR SPINE 1 VIEW 565.00 LAB/RAD RAD XR PELVIS THREE VIEWS OR MORE 716.00 LAB/RAD RAD XR SHOULDER COMPLETE 2 VIEWS OR MORE 853.00 LAB/RAD RAD XR KNEES STANDING BILATERAL 406.00 LAB/RAD RAD XR LOWER EXTREMITY INFANT 2 VIEWS OR MORE 504.00 LAB/RAD RAD XR UPPER GI AIR CONTRAST 1,676.00 LAB/RAD RAD XR ERCP BILIARY ONLY 85.00 LAB/RAD RAD XR VOIDING CYSTOURETHROGRAM 1,791.00 LAB/RAD RAD XR RADIOGRAPHIC PROCEDURE 395.00 LAB/RAD RAD XR DUCTOGRAM SINGLE DUCT 1,615.00 LAB/RAD RAD XR STRESS ANY JOINT 181.00 LAB/RAD RAD XR JOINT SURVEY 1 VIEW 2 OR MORE JOINTS 934.00 LAB/RAD PB ANTIDEPRESSANT DRUG SCREEN ADS 280.00 LAB/RAD PB BENZODIAZ CONF UR 280.00 LAB/RAD PB OXYCODONE SER OXY 280.00 LAB/RAD RAD US OB TRANSVAGINAL 512.00 LAB/RAD RAD XR SHOULDER 1 VIEW PORTABLE 831.00 LAB/RAD RAD XR HUMERUS TWO VIEWS OR MORE PORTABLE 603.00 LAB/RAD RAD XR ELBOW 2 VIEWS PORTABLE 500.00 LAB/RAD RAD XR WRIST THREE VIEWS OR MORE PORTABLE 716.00 LAB/RAD HCHG CYG-COMPLEX ADDITIONAL KARYOTYPE 114.00 LAB/RAD RAD US PELVIS COMPLETE NONOBSTETRIC PORTABLE 1,386.00 LAB/RAD RAD US VEIN MAPPING EXTREMITY BILATERAL 2,229.00 LAB/RAD RAD US VENOUS INSUFFICIENCY LOWER EXTREMITY BILATERAL 2,229.00 LAB/RAD HCHG COMP METABOLIC RTR 249.00 LAB/RAD PB MICROSCOPIC URINE 127.00 LAB/RAD PB GENERAL LAB 8102500 94.00 LAB/RAD PB BETA-2 MICROGLOBULIN 232.00 LAB/RAD PB CREATININE,TIMED URINE 279.00 LAB/RAD PB CRYOGLOBULINS QUAL 139.00 LAB/RAD PB PH, BLOOD GAS 149.00 LAB/RAD PB GLUCOSE 2 HOUR 156.00 LAB/RAD PB OSMOLALITY,SERUM 216.00 LAB/RAD PB ACTIVATED PTT 155.00 LAB/RAD PB GENERAL LAB 8670400 217.00 LAB/RAD PB GENERAL LAB 8670800 230.00 LAB/RAD PB RUBELLA IMMUNE STATUS 76.00 LAB/RAD PB IGG ANTIHUMAN GLOBULIN 183.00 LAB/RAD PB ABO GROUP 210.00 LAB/RAD PB EGFR 2,831.00 LAB/RAD HCHG ACTH, PLASMA LC 158.00 LAB/RAD HCHG AMIODARONE (CORDARONE(R)), S LC 224.00 LAB/RAD HCHG ANDROSTENEDIONE LC 94.00 LAB/RAD HCHG ANTI-MULLERIAN HORMONE (AMH) LC 100.00 LAB/RAD PB ISTAT CHEM 8+ 156.00 LAB/RAD HCHG BCR-ABL1, CML/ALL, PCR, MAJOR BP LC 485.00 LAB/RAD HCHG BK QUANT PCR (PLASMA/SERUM) LC 61.00 LAB/RAD PB DIGOXIN 110.00 LAB/RAD PB RAPAMYCIN 102.00 LAB/RAD HCHG CATECHOLAMINES,UR,FREE,24 HR LC 189.00 LAB/RAD HCHG GABAPENTIN (NEURONTIN), SERUM LC 224.00 LAB/RAD HCHG ANTIGLOMERULAR BM AB LC 370.00 LAB/RAD HCHG MERCURY HEAVY METALS PROFILE II, URINE LC 64.00 LAB/RAD HCHG ITRACONAZOLE, SERUM/PLASMA LC 224.00 LAB/RAD PB FETAL FIBRONECTIN 685.00 LAB/RAD PB FOLIC ACID 110.00 LAB/RAD HCHG MUMPS ANTIBODIES, IGM LC 36.00 LAB/RAD HCHG PANCREATIC ELASTASE, FECAL LC 234.00 LAB/RAD PB LIPOPROTEIN LPA 121.00 LAB/RAD HCHG VIRAL CULTURE, GENERAL LC 234.00 LAB/RAD PB HEMOGLOBIN 158.00 LAB/RAD PB DRVVT SCREEN 77.00 LAB/RAD PB CARDIOLIPIN IGG CRD 177.00 LAB/RAD PB C4 COMPLEMENT COMPONENT 131.00 LAB/RAD PB IMMUNOFIXATION 155.00 LAB/RAD PB SYPHILIS CONFIRMATION TPPA 355.00 LAB/RAD PB CORD DAT 183.00 LAB/RAD PB IV CATHETER CULTURE 256.00 LAB/RAD PB VAG RECTAL OB STREP CULT 132.00 LAB/RAD PB TESTOSTERONE, FREE, EQUILIBRIUM ULTRAFILTRATION LC 146.00 LAB/RAD PB SHIGA TOXIN 74.00 LAB/RAD PB GENERAL LAB 8749100 135.00 LAB/RAD PB VZV REAL TIME PCR LC 162.00 LAB/RAD PB FLOW MARKER ADDITIONAL 56.00 LAB/RAD PB STAIN SPEC 2 OTHER 158.00 LAB/RAD PB IMMUNOFLUORESCENCE HCMC FIRST 312.00 LAB/RAD PB RHO D IMMUNE GLOB 625.00 LAB/RAD PB RBC LR W DEGLYCD 557.00 LAB/RAD HCHG STAPH AUREUS PCR 266.00 LAB/RAD HCHG EBV VCA IGG 313.00 LAB/RAD HCHG GENERAL HEALTH PANEL AFFILIATE ONLY 614.00 LAB/RAD PB TISSUE TRANSGLUTAMINASE IGG 156.00 LAB/RAD HCHG BORDETELLA PCR 162.00 LAB/RAD HCHG PNEUMOCOCCAL ABYS (23 SEROTYPE) LC 42.00 LAB/RAD HCHG CT ILIOINGUINAL NERVE INJ 406.00 LAB/RAD HCHG XR PICC < 5 YRS INSERTION W GUIDANCE S&I 408.00 LAB/RAD HCHG XR SACROPLASTY UNILATERAL 13,674.00 LAB/RAD RAD XR DEXA BONE DENSITY 2 SITES AXIAL SKELETON 279.00 LAB/RAD PB LYMES WESTERN BLOT 304.00 LAB/RAD HCHG HISTOPLASMA QUANTITATIVE ANTIGEN LC 141.00 LAB/RAD PB COBALT BLOOD 158.00 LAB/RAD HCHG EXPANDED OPIATE CONFIRM 280.00 LAB/RAD HCHG INTERLEUKIN 6 IL 6 SERUM 329.00 LAB/RAD PB CONSULT MATERIAL 600.00 LAB/RAD PB TRANSFUSION REACTION TRX 1,321.00 LAB/RAD HCHG BRAF V600 MUTATION ASSAY 805.00 LAB/RAD HCHG XR INJ FOR MYELOGRAM CERVICAL 807.00 LAB/RAD HCHG XR INJ FOR MYELOGRAM 2 OR MORE REGIONS 1,712.00 LAB/RAD PR WHO COCKUP NONMOLDED PREFAB OTS PR60 86.00 LAB/RAD PB CMV IGG ABY 168.00 LAB/RAD HCHG US PLCMT SOFT TISSUE DEVICE CLIP AXILLA 1ST LESION INCL GUIDANCE 1,216.00 LAB/RAD HCHG RBC LR CMV NEG 750.00 LAB/RAD PB MISC LAB CHARGE 87507 1,300.00 LAB/RAD RAD XR ESOPHAGEAL MOTILITY STUDY 549.00 LAB/RAD HCHG DRUGS OF ABUSE URINE MATERNITY NEWBORN D33 312.00 LAB/RAD HCHG PROTEINASE 3 AB 156.00 LAB/RAD RAD XR MAMMO BILAT SCREENING W IMPLANT WWO CAD 505.00 LAB/RAD RAD CT CHEST WO LOW DOSE 966.00 LAB/RAD PB INFLUENZA ANTIGEN A OR B IN HOUSE ONLY 116.00 LAB/RAD HCHG INFLUENZA B AGN 116.00 LAB/RAD HCHG INFLUENZA DNA PROBE ADDL 139.00 LAB/RAD HCHG INFLUENZA A/B PCR 345.00 PROF FEES PR INFLUENZA VIRUS VACCINE LIVE QUAD NASAL 0.00 PROF FEES PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION 549.00 PROF FEES PR EMERGENCY DEPT VISIT LEVEL 2 168.00 PROF FEES PR EMERGENCY DEPT VISIT LEVEL 3 285.00 PROF FEES PR REM SUTURES W ANESTH SAME SURGEON 307.00 PROF FEES PR EMERGENCY DEPT VISIT LEVEL 4 451.00 PROF FEES PR INFLUENZA VIRUS VACCINE LIVE QUAD NASAL 42.00 PROF FEES PR COLORECTAL CA SCREEN FLEX SCOPE 385.00 PROF FEES PR PHYSICIAN RECERT FOR HHA PER CERT PERIO 101.00 PROF FEES PR INJ ONABOTULINUMTOXINA 1 UNIT 17.00 PROF FEES PR INJ CLONIDINE HCL 1 MG 219.00 PROF FEES PR METHYLPREDNISOLONE ACETATE-40 MG 32.00 PROF FEES PR REM SUTURES W ANESTH OTHR SURGEON 245.00 PROF FEES PR INJ LEUPROLIDE ACETATE PER 3.75 MG 4,025.00 PROF FEES PR INJ B-12 CYANOCOBALAMIN UP TO 1000MCG 10.00 PROF FEES PR LEUPROLIDE ACET/DEPOT SUSP 7.5 MG CHEMO 4,557.00 PROF FEES PR CAST SUPPLIES SHORT ARM CAST FIBERGLASSADULT (11 YEARS +) 237.00 PROF FEES PR PRENATAL ANTEPART MGMT ENHANC 135.00 PROF FEES PR HEARING AID SUPPLIES ACCESSORIES 0.00 PROF FEES PR DRAIN SKIN ABSCESS SIMPLE 148.00 PROF FEES PR DRAIN PILONIDAL CYST SIMPL 430.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION ONE 146.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION 2-4 64.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION>4 440.00 PROF FEES PR REMOVAL SKIN TAGS EA ADDL 10 93.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM TRUNK ARM LEG 205.00 PROF FEES PR SHAV SKIN LESION 0.6-1.0CM S/N/H/F/GENIT 382.00 PROF FEES PR SHAV SKIN LESION 0.6-1.0CM S/N/H/F/GENIT 244.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM FACE EARS EYELIDS 239.00 PROF FEES PR SHAV SKIN LESION 0.6-1.0CM FACE EARS EYELIDS 431.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM TRUNK ARM LEG 695.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM TRUNK ARM LEG 167.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM TRUNK ARM LEG 419.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM SCALP NECK HANDS FEET 752.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM SCALP NECK HANDS FEET 684.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM FACE EARS EYELIDS 829.00 PROF FEES PR EXC SWEAT GLAND LESN AXILL COMPLX 2,808.00 PROF FEES PR EXC SKIN MALIG 2.1-3 CM TRUNK ARM LEG 382.00 PROF FEES PR EXC SKIN MALIG OVER 4 CM TRUNK ARM LEG 1,608.00 PROF FEES PR EXC SKIN MALIG 0.6-1 CM FACE EARS EYELIDS 1,016.00 PROF FEES PR AVULSION OF NAIL PLATE EA ADDL 205.00 PROF FEES PR EXCISION PILONIDAL CYST EXTENS 2,104.00 PROF FEES PR EXCISION PILONIDAL CYST COMPLIC 2,763.00 PROF FEES PR INJ INTO SKIN LESIONS <=7 224.00 PROF FEES PR REPAIR SUPERF WOUND BODY 7.6-12.5 CM 276.00 PROF FEES PR REPAIR SUPERF WOUND BODY 12.6-20 CM 743.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS 7.6-12.5 CM 528.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS 7.6-12.5 CM 850.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 2.6-7.5 CM 729.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 20.1-30 CM 1,175.00 PROF FEES PR REPAIR INTERMED WOUND NECK HANDS FEET < OR = 2.5 CM 1,017.00 PROF FEES PR REPAIR INTERMED WOUND NECK HANDS FEET 12.6-20 CM 1,436.00 PROF FEES PR REPAIR COMPLEX WOUND SCALP EXTR 1.1-2.5 CM 1,091.00 PROF FEES PR REPAIR COMPLEX WOUND EYELID NOSE EAR 2.5-7.5 CM 2,260.00 PROF FEES PR SPLIT GRAFT TRUNK ARM LEG <100SQ CM 3,457.00 PROF FEES PR FULL THICK GRAFT HEAD FACE HAND <20SQC 3,740.00 PROF FEES PR EXCISE EXCESS SKIN OTHER 3,729.00 PROF FEES PR DRESSING CHANGE ANESTH NOT FOR BURN 700.00 PROF FEES PR DESTROY PREMALIGNANT 1ST LESION 265.00 PROF FEES PR DESTR MALIG FACE NOSE LIP 1.1-2 CM 541.00 PROF FEES PR EXCISE BREAST LESION W XRAY MARK ADDL 1,444.00 PROF FEES PR REMOVAL OF BREAST IMPLANT 988.00 PROF FEES PR INJ CARPAL TUNNEL 322.00 PROF FEES PR DRAIN/INJ INTERMEDIATE JOINT/BURSA WO US GUIDE 280.00 PROF FEES PR DRAIN/INJ MAJOR JOINT/BURSA HIP KNEE WO US GUIDE 254.00 PROF FEES PR RECONSTRUCT PROX HUMERAL IMPLANT 2,772.00 PROF FEES PR CLOSED TX CLAVICLE FRACTURE 491.00 PROF FEES PR OPEN TX A C JT DISLOC FASCIAL GRAFT 2,608.00 PROF FEES PR CLOSED TX SCAPULA FX 814.00 PROF FEES PR CLOSED TX PROX HUMERUS FRACTURE 735.00 PROF FEES PR OPEN TX PROX HUMERUS FX PROSTHESIS 6,768.00 PROF FEES PR REMOVAL OF ELBOW BURSA 1,805.00 PROF FEES PR CLOSED TX HUM SUPRACONDYLR FX MANIPU 2,782.00 PROF FEES PR OPEN TX RADIAL HEAD FX PROSTH IMPLNT 1,399.00 PROF FEES PR DECOMP FOREARM 2 COMPART W O DEBRIDE 3,063.00 PROF FEES PR EXCIS/CURET BENIG BONE LES RAD/ULNA 1,997.00 PROF FEES PR FUSION TENDONS WRIST FINGR EXTENSORS 1,390.00 PROF FEES PR REPAIR NONUNION CARPAL BONE EA 1,716.00 PROF FEES PR REPAIR NONUNION SCAPHOID CARPAL BONE 1,472.00 PROF FEES PR REPAIR INTERCARP/CARP-METACARP JT 4,584.00 PROF FEES PR CLOSED TX ULNA SHAFT FX 890.00 PROF FEES PR OPEN TX ULNA SHAFT FX 3,096.00 PROF FEES PR CLOSED TX DIST RAD ULNA FX 1,012.00 PROF FEES PR CLOSED TX ULNA STYLOID FX 462.00 PROF FEES PR CLOSED TX ULNA STYLOID FX 1,283.00 PROF FEES PR FUSION/GRAFT WRIST JOINT 1,879.00 PROF FEES PR DRAIN HAND TENDON SHEATH 2,625.00 PROF FEES PR RAD EXCIS JT LINING FLEXOR EA 1,208.00 PROF FEES PR PART REMOVE BONE DISTAL PHALANX 1,721.00 PROF FEES PR REALIGNMENT OF TENDONS HAND 3,057.00 PROF FEES PR FIX COLLAT LIG MCP JT IP JT 506.00 PROF FEES PR CLOSED TX METACARPAL FX 642.00 PROF FEES PR CLOSE TX PROX/MID FING OR THUMB SHFT FX 694.00 PROF FEES PR CLOSE TX PROX MID FING OR THUMB SHFT FX MANIP 1,471.00 PROF FEES PR AMPUTATION FINGER OR THUMB W FLAPS 2,641.00 PROF FEES PR PART REMOVE PELV/HIP DEEP 3,191.00 PROF FEES PR FEMORAL FX OPEN TX 6,145.00 PROF FEES PR EXPLOR DRAIN KNEE INFECTN 3,275.00 PROF FEES PR ARTHROTOMY/EXPLORE/TREAT KNEE JOINT 3,467.00 PROF FEES PR FIX INFRAPATELLA TENDON PRIMARY 3,024.00 PROF FEES PR FIX QUAD/HAMSTR MUSC RUPT SECOND 2,607.00 PROF FEES PR CLOSED TX FEMUR SHAFT FX 1,178.00 PROF FEES PR OPEN TX FEMUR DISTAL END 4,205.00 PROF FEES PR CLOSED TX TIBIAL PLATEAU FX 938.00 PROF FEES PR OPEN TX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ 2,527.00 PROF FEES PR OPEN TX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ 4,021.00 PROF FEES PR OPEN TX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ 6,550.00 PROF FEES PR REPAIR ACHILLES TENDON PRIMARY 3,570.00 PROF FEES PR REPAIR EXTEN LEG TENDN PRIM EA 2,179.00 PROF FEES PR XFER SINGLE SUPERFICI LOW LEG TENDON 3,351.00 PROF FEES PR CLOSED TX DIST FIBULA FX MANIP 1,810.00 PROF FEES PR OPEN TX TRIMALLEOLAR FX 3,807.00 PROF FEES PR OPEN TX TRIMALLEOLAR FX FIX POST LIP 5,487.00 PROF FEES PR AMPUTATION LOW LEG+STAT FITTING 4,473.00 PROF FEES PR TARSAL TUNNEL RELEASE 1,622.00 PROF FEES PR FULL EXCIS 1ST METATARSAL HEAD 1,531.00 PROF FEES PR REMOVAL OF HEEL SPUR 2,472.00 PROF FEES PR PART REMOVE OTHR TARSAL/METATARSAL 2,660.00 PROF FEES PR RESEC TOE AT I-P JTSINGLEEA 1,302.00 PROF FEES PR REMOV SESAMOID BONE 1ST TOE 1,821.00 PROF FEES PR APPLY FOREARM CAST 244.00 PROF FEES PR KNEE SCOPE/SURG/INCOND FX AID W FIXAT 3,214.00 PROF FEES PR KNEE SCOPE MED OR LAT MENIS REPAIR 6,467.00 PROF FEES PR ANKLE SCOPE EXTENS DEBRIDEMNT 5,434.00 PROF FEES PR INSERT EMERGENCY ENDOTRACH AIRWAY 719.00 PROF FEES PR LARYNGOSCOPY INDIRECT DX 473.00 PROF FEES PR DX BRONCHOSCOPE/WASH W FLUORO 1,206.00 PROF FEES PR BRONCHOSCOPY W LAVAGE 1,554.00 PROF FEES PR REMOVE ART CLOT ILIAC-POP LEG INCIS 4,559.00 PROF FEES PR BYPASS GRAFT OTHR FEM-POP 7,149.00 PROF FEES PR ANASTOMOSIS AV ANY SITE 4,984.00 PROF FEES PR CREAT AV FISTULA NON-AUTOGENOUS GRAFT 6,670.00 PROF FEES PHLEBECTOMIES LESS THAN 10 SITES 3,701.00 PROF FEES PR TRANS PREP CELLS RED BLOOD CELL REMOVAL 208.00 PROF FEES PR BIOPSY/EXCISION LYMPH NODE(S) 1,310.00 PROF FEES PR REMOVE ARMPIT LYMPH NODES SUPERFIC 3,094.00 PROF FEES PR CRICOPHAYNGEAL MYOTOMY 2,130.00 PROF FEES PR EGD TRANSORAL DIAGNOSTIC 1,137.00 PROF FEES PR EGD TRANSORAL CONTROL BLEEDING ANY METHOD 1,893.00 PROF FEES PR ERCP DX COLLECTION SPECIMEN BRUSHING WASHING 749.00 PROF FEES PR ERCP BIOPSY 1,292.00 PROF FEES PR CLOSURE OF GASTROSTOMY SURGICAL 3,131.00 PROF FEES PR LAP SURG COLECTOMY WANAST 9,605.00 PROF FEES PR PLCMT ENTEROSTOMY/CECOSTOMY TUBE 1,568.00 PROF FEES PR ILEOSCOPY THRU STOMA DIAGNOSTIC 1,253.00 PROF FEES PR CLOSE ENTEROSTOMY 2,971.00 PROF FEES PR LAP APPENDECTOMY 3,356.00 PROF FEES PR PROCTECTOMY AP RESECT W OSTOMY 3,969.00 PROF FEES PR PROCTOSIGMOIDOSCOPY RIGID WDILATION 2,375.00 PROF FEES PR PROCTOSIGMOIDOSCOPY BIOPSY 591.00 PROF FEES PR COLONOSCOPY FLEX W CONTROL BLEEDING ANY METHOD 2,259.00 PROF FEES PR INCISE EXTERNAL HEMORRHOID 433.00 PROF FEES PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP 2,089.00 PROF FEES PR REMOVAL ANAL FISTULA SUBCUTANEOUS 1,545.00 PROF FEES PR ANOSCOPY WDILATION 2,677.00 PROF FEES PR DESTROY PREMALIGNANT LESION EA 2-14 56.00 PROF FEES PR REMOVAL GALLBLADDER 4,086.00 PROF FEES PR LAP DX SURGICAL ABD WBIOPSY 2,872.00 PROF FEES PR UNLISTED LAP PROC ABDOMEN PERITONEUM OMENTUM 4,187.00 PROF FEES PR REPAIR RECURR INGUIN HERN REDUCIBL 3,094.00 PROF FEES PR REPAIR UMBILICAL HERN >5 TRS REDUC 2,314.00 PROF FEES PR LAP INGUINAL HERNIA REPAIR RECUR 3,670.00 PROF FEES PR OMENTAL EXCISION 0.00 PROF FEES PR CHANGE OF BLADDER TUBE SIMPLE 74.00 PROF FEES PR INSTILL ANTICANCER AGENT IN BLADDER 285.00 PROF FEES PR SIMPLE CYSTOMETROGRAM 1,200.00 PROF FEES PR COMPLEX CYSTOMETROGRAM 1,543.00 PROF FEES PR DILATE URETHRA FEMALE INITIAL 528.00 PROF FEES PR DILATE URETHRA FEMALE SUBSEQUENT 133.00 PROF FEES PR DESTROY PREMALIGNANT 15 OR MORE LESIONS 937.00 PROF FEES PR I&D OF VULVA/PERINEUM ABSCESS 288.00 PROF FEES PR I&D OF VULVA/PERINEUM ABSCESS 244.00 PROF FEES PR I&D BARTHOLIN GLAND ABSCESS 373.00 PROF FEES PR BIOPSY VULVA/PERINEUM ONE LESN 491.00 PROF FEES PR COLPOSCOPY VULVA 279.00 PROF FEES PR BIOPSY OF VAGINA EXTENSIVE 1,369.00 PROF FEES PR FITTING OF DIAPHRAGM/CAP 187.00 PROF FEES PR REPAIR ENTEROCELE VAG APPRCH 2,840.00 PROF FEES PR SLING OPER STRES INCONTINENCE 5,599.00 PROF FEES PR COLPOSCOPY ENTIRE VAGINA W/BIOPSY(S) 900.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA 629.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA 313.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA W BX 843.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA W BX 445.00 PROF FEES PR CONIZATION CERVIX LOOP ELECTRD 614.00 PROF FEES PR BIOPSY OF UTERUS LINING 249.00 PROF FEES PR INSERT INTRAUTERINE DEVICE 331.00 PROF FEES PR LAP VAG HYST UTERUS >250GMS SALP-OOPH 8,467.00 PROF FEES PR HYSTEROSCOPY W ABLATION HOSPITAL PERFORMED 7,309.00 PROF FEES PR DRAIN OVARIAN CYST(S)ABD APPRCH 3,180.00 PROF FEES PR REMOVAL OF OVARY(S) 3,526.00 PROF FEES PR D AND C AFTER DELIVERY 1,323.00 PROF FEES PR EPISIOTOMY/VAGINAL REPAIR BY OTHR MD 984.00 PROF FEES PR REMOVE UTERUS AFTER CESAREAN 3,094.00 PROF FEES PR THYR LOBECTOMY W PART REMOV CONTRA 5,185.00 PROF FEES PR EXPLORE PARATHYROID GLANDS 4,874.00 PROF FEES PR ELECT ANALYS INTRATHEC/EPID PUMP W REPROG 130.00 PROF FEES PR PERCUT IMPLNT NEURO ELECTEPIDURAL 3,644.00 PROF FEES PR INJ(S) ANES AND/OR STEROID TRIGEMIN NERVE EACH BRANCH 349.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID PUDENDAL NERVE 316.00 PROF FEES PR INJ NERV BLOCK STELLATE GANGLION 293.00 PROF FEES PR REVISE ULNAR NERVE AT ELBOW 3,914.00 PROF FEES PR REVISE MEDIAN N/CARPAL TUNNEL SURG 3,063.00 PROF FEES PR MICROSURG TECHNIQUES REQ OPER MICROSCOPE 441.00 PROF FEES URINALYSIS NONAUTO W/O MICRO CLINIC IN HOUSE 26.00 PROF FEES PR TB INTRADERMAL TEST 64.00 PROF FEES ARC-AHG PHASE CROSSMATCH 31.00 PROF FEES PR ESOPHAGEAL MOTILITY STUDY 873.00 PROF FEES PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS COMP DX EVAL 256.00 PROF FEES PR DESTRUCTION SKIN LESIONS < 10 SQ CM GRH ONLY 801.00 PROF FEES PR CARDIAC STRESS TST INTERP/REPT ONLY 329.00 PROF FEES PR EXTNL ECG CONTINUOUS RHYTHM HOOKUP & REC UP TO 48 HR 541.00 PROF FEES PR INHALATION TREATMENT AIRWAY OBST 74.00 PROF FEES PR IMMUNOTHERAPY 2+ INJECTIONS 58.00 PROF FEES PR OSTEOPATHIC MANIP 3-4 BODY REGN 99.00 PROF FEES PR HYPERBARIC OXYGEN THERAPY 281.00 PROF FEES PR HYPERBARIC OXYGEN THERAPY 451.00 PROF FEES PR EMERGENCY DEPT VISIT LEVEL 5 685.00 PROF FEES PR EMERGENCY DEPT VISIT LEVEL I 86.00 PROF FEES PR DESTROY BENIGN LESIONS UP TO 14 LESIONS 380.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 1 48.00 PROF FEES PR INITIAL HOSPITAL CARE LEVL I 397.00 PROF FEES PR DESTROY BENIGN LESIONS 15 OR MORE 525.00 PROF FEES PR DESTR MALIG FACE NOSE LIP <0.6 CM 568.00 PROF FEES PR PROLNG E/M OR PSYCHOTHERAPY SVC DIR CONTACT ADDL 30 MIN 554.00 PROF FEES PR HOME HEALTH CARE SUPERV 30+ MIN 401.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 1 48.00 PROF FEES PR PREVENTIVE VISIT NEW INFANT < 1 YR 342.00 PROF FEES PR PREVENTIVE VISIT EST AGE 1-4 174.00 PROF FEES PR PREVENTIVE VISIT EST AGE 1-4 174.00 PROF FEES PR PREVENTIVE VISIT EST 40-64 204.00 PROF FEES PR PREVENT COUNSEL INDIV 15 MIN 62.00 PROF FEES PR PREVENT COUNSEL INDIV 45 MIN 136.00 PROF FEES PR LAPAROSCOPIC LIVER BIOPSY AFFILIATE ONLY 5,025.00 PROF FEES PR LAP VENTRAL INCISIONAL HERNIORRAPHY 4,844.00 PROF FEES PR REMOVAL OF IMPLANTED MESH 0.00 PROF FEES PR FIRST OB VISIT -LEVEL 3 NEW PT 287.00 PROF FEES PR FIRST OB VISIT -LEVEL 3 NEW PT 574.00 PROF FEES PR HEARING AID DIGITAL BI BTE 0.00 PROF FEES PR REPOSITION PREVIOUS PLACED CV CATH 282.00 PROF FEES PR READING OB ULTRASOUND LTD 0.00 PROF FEES PR DESTR MALIG FACE NOSE LIP 1.1-2 CM 828.00 PROF FEES HCHG OT ULTRASOUND 15MIN 44.00 PROF FEES PR REMOVE MESH FROM ABD WALL (SEP) 1,211.00 PROF FEES PR ALLOGRAFT IMPLANT KNEE WITH SCOPE 4,790.00 PROF FEES PR HYSTEROSCOPY STERILIZATION - HOSPITAL PERFORMED 4,232.00 PROF FEES PR GASTROESOPHAGEAL REFLUX TEST 168.00 PROF FEES PR ACTIVE WOUND EACH ADDL 20 SQ CM OR PART THEREOF 104.00 PROF FEES PR ADM EA ADDL VACC ANY AGE ANY ROUTE STATE SERUM 80.00 PROF FEES PR LAP UTEROSCARAL RESUSPENSION PROC 6,884.00 PROF FEES HCHG OT ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITIAL ENC 15 MIN 114.00 PROF FEES PR REMOVE EXTERN BONE FIX DEV W ANESTH 1,884.00 PROF FEES PR I AND D DEEP ABSC/HEMATOMA NECK/CHEST 1,660.00 PROF FEES PR EPIDERM AUTOGRAFT TRUNK ARMS LEGS 1ST 100 SQ CM OR LESS/ONE PERC BODY AREA INFANT/CHILD857.00 PROF FEES PR EXCISE TUMOR NECK/CHEST SUBCUTAN<3CM 1,503.00 PROF FEES PR EXCISE TUMOR NECK/CHEST DEEP<5CM 2,114.00 PROF FEES PR SURGICAL LAPAROSCOPY JEJUNOSTOMY 2,900.00 PROF FEES PR SURG LAPAROSCOPY PROCTOPEXY W SIGMOID RESECT 5,996.00 PROF FEES PR REVISE/REMOV PROSTHETIC VAGINAL GRAFT, VAGINAL APPR 4,276.00 PROF FEES PR AUDITORY REHAB POST-LINGUAL HEARING LOSS 238.00 PROF FEES PR NEURECTOMY FOOT 840.00 PROF FEES PR LSH UTERUS ABOVE 250 G 4,174.00 PROF FEES PR LSH W/T/O UTERUS ABOVE 250 G 4,370.00 PROF FEES PR SPINE FLUORO GUIDE FOR NEEDLE PLACEMENT 275.00 PROF FEES PR ADJ GASTRIC BAND DIAM SUBQ PORT 791.00 PROF FEES HCHG WHO COCKUP NONMOLDED PREFAB OTS PR20 108.00 PROF FEES PR EXCISION EXCESS SKIN ABDOMEN 1,678.00 PROF FEES PR HYALURONAN (EUFLEXXA) INTRA-ARTICULAR 1,179.00 PROF FEES PR HYALURONAN (ORTHOVISC) INTRA-ARTICULAR 1,331.00 PROF FEES PR OPEN TX POST ANKLE FX 2,217.00 PROF FEES PR INSERT PLEURAL CATHETER 1,809.00 PROF FEES PR RADICAL RESEC TUMOR NECK/CHEST<5CM 3,202.00 PROF FEES PR CYSTO W URETEROLITHOTOMY 341.00 PROF FEES PR DISPENSING FEE, BINAURAL 641.00 PROF FEES PR MANIPULATN SHLDR JT W ANESTHESIA 1,098.00 PROF FEES PR LAP INCISIONAL HERNIA REPAIR RECUR 3,175.00 PROF FEES PR PRGM SINGLE LEAD OR LEADLESS PACER EVAL 95.00 PROF FEES PR IV INF HYDRATE EA ADDL HR 174.00 PROF FEES PR IV INF THER/PROPH/DIAG INITIAL HR 494.00 PROF FEES PR PEDS CRTICAL CARE TRANSPORT 30-74 MIN 630.00 PROF FEES PR EKG PREV INTERP AND REPORT MEDICARE 33.00 PROF FEES PR RPR INCARCERATED OBTURATOR HERNIA W/MESH 0.00 PROF FEES PR EXC VAGINAL SCAR W/VAGINOPLASTY 2,700.00 PROF FEES PR RPR HEPATIC BILIARY DUCT LAP 4,139.00 PROF FEES PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM 1,787.00 PROF FEES PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM 2,077.00 PROF FEES PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM 1,210.00 PROF FEES PR RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM 5,883.00 PROF FEES PR RMVL NDWELLG TUN PLEURAL CATH W/CUFF 414.00 PROF FEES PR LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG 2,138.00 PROF FEES PR PNEUMOCOCCAL VACCINE 13 VALENT IM 0.00 PROF FEES PR RESECTION-CLOSURE GASTROCUTANEOUS FISTULA 555.00 PROF FEES PR KNEE ORTHOTIC BRACE CUSTOM FAB PR1 28.00 PROF FEES PR LAP GASTRIC BYPASS ROUX EY BARIATRIC 12,230.00 PROF FEES PR OB FOLLOW UP PER FETUS 654.00 PROF FEES PR OCH URINE DRUG SCREEN COLLECTION 43.00 PROF FEES PR LAP RPR PERFORATED GASTRIC ULCER 13,155.00 PROF FEES PR SCOPE RESECTN LAT OR MED MENISCUS CYST 3,960.00 PROF FEES PR DT VACC IM <7YO 122.00 PROF FEES PR INJ PALIPERIDONE PALMITATE EXTENDED RELEASE 1 MG 35.00 PROF FEES PR HEP A VACC PED/ADOL 2 DOSE 111.00 PROF FEES PR PNEUMOCOCCAL 13-VAL VACC 0.00 PROF FEES PR POLIOMYELITIS VACC INACT SQ/IM 0.00 PROF FEES PR ROTAVIRUS VACC ORAL 2 DOSE 106.00 PROF FEES PR ZOSTER VACC LIVE SQ 0.00 PROF FEES PR ANKLE ARTHRO W/LATERAL STABILIZATION 3,960.00 PROF FEES PR PERC IMPLANT NEUROELEC SACRAL NERVE INC GUIDE CLINIC 5,136.00 PROF FEES PR COMPRESSION STOCKING BK 18-30 MMHG EA PR1 43.00 PROF FEES PR CHEMODENERV MUSC NECK 645.00 PROF FEES PR CLOSED TX ELBOW DISLOCATN ANESTHESIA 1,935.00 PROF FEES PR TRANSILLUMINATED POWERED PHLEBECTOMY AFFILIATE ONLY 3,701.00 PROF FEES PR INJ GANGLION IMPAR BLOCK 433.00 PROF FEES PR ADMIN EA ADDL VACC INTRANASAL/ORAL STATE SERUM 15.00 PROF FEES PR BEHAVIOR COUNSEL OBESITY 15M 56.00 PROF FEES PR US ABDOMEN LIMITED 213.00 PROF FEES PR SKIN SUB GRAFT FACE NK HF G 187.00 PROF FEES PR UNLISTED PROCEDURE FEMALE GENITAL SYSTEM AFFILIATE ONLY 1,910.00 PROF FEES PR CLNSCPY FLX W ABLT OF TUM PLYP LES INC PRE PST DIL GW PSSG 2,366.00 PROF FEES PR PERC KYPHOPLASTY THORACIC 1 LEVEL W GUIDE 19,469.00 PROF FEES PB IGG (SERUM) 176.00 PROF FEES PR RHO D IMMUNE GLOBULIN INJ 625.00 PROF FEES PR INITIAL ANNUAL WELLNESS-NURSE VISIT AFFILIATE ONLY 432.00 PROF FEES PR OT EVAL LOW COMPLEXITY 191.00 PROF FEES PR MODERATE SED SAME PROVIDER < 5 YRS 1ST 15 MINUTES 173.00 PROF FEES PR MODERATE SED DIFF PROVIDER < 5 YRS 1ST 15 MINUTES 346.00 PROF FEES PR ABI LIMITED 282.00 PROF FEES PR TANGENTIAL BIOPSY SKIN SINGLE LESION 174.00 PROF FEES PR OT ORTH FIT/TRAIN UPR/LWR EXT TRUNK INIT 15 MIN AFF ONLY 114.00 PROF FEES PR OT HOT OR COLD PACKS THERAPY AFFILIATE ONLY 145.00 PROF FEES PR OT THERAPEUTIC EXERCISES EA 15 MIN AFFILIATE ONLY 101.00 PROF FEES PR REMOVAL SUBQ CARDIAC RHYTHM MONITOR 414.00 PROF FEES PR BRIEF VIRTUAL CHECK BY MD OR OTHER QHP 5-10 MINUTES 29.00 PROF FEES PR OT ORTHOTIC/PROSTC UPR/LRW EXT TRUNK SUBQ 15 MIN AFF ONLY 94.00 PROF FEES HCHG THERAPY PRODUCTS PR1 0.00 PROF FEES PR PNEUMATIC WALK BOOT PREFAB OTS PR30 248.00 PROF FEES PR PNEUMATIC WALK BOOT PREFAB OTS PR40 245.00 PROF FEES PR FOOT INSERT RMVBLE CUSTOM MOLDED EA 203.00 PROF FEES PR IMMOBILIZER KNEE 20IN SCRMC ONLY 116.00 PROF FEES PB ANTISTREPTOLYSIN O AB LC 79.00 PROF FEES PB HCG BETA QUANT,TUMOR LC 266.00 PROF FEES PB EHRLICHIA DETECTION PCR LC 162.00 PROF FEES PB FACTOR V ACTIVITY LC 198.00 PROF FEES PB GAD 65 ABY ASSAY 93.00 PROF FEES PB CADMIUM HEAVY METALS PROFILE II, BLOOD LC 158.00 PROF FEES PB ASPERGILLUS FUMIGATUS ANTIBODY LC 160.00 PROF FEES PB VITAMIN B1 (THIAMINE), BLOOD LC 99.00 PROF FEES PB TOXOPLASMA GONDII AB,IGM,QN LC 42.00 PROF FEES PB TRYPTASE LC 329.00 PROF FEES PB GROWTH HORMONE, SERUM LC 266.00 PROF FEES PB TISSUE LEVEL 3 TC ONLY 129.00 PROF FEES PB CAS MORPHOMETRIC 347.00 PROF FEES PR WHFO WO JOINTS PREFAB CUSTOM FIT PR90 131.00 PROF FEES PR LAP RIGHT OBTURATOR HERNIA REPAIR W MESH 4,845.00 PROF FEES PR PEDVAX HIB IM 106.00 PROF FEES PR DIPHENHYDRAMINE 25 MG TAB AFFILIATE ONLY 69.00 PROF FEES PR FLU VACC QUADRIVALENT IIV4 SV PF 0.25 ML IM 41.00 PROF FEES PR EXPLORE LAPAROTOMY W DIVISION OF MEDIAN ARCUATE LIGAMENT 0.00 PROF FEES PR ENDOSCOP RELEASE FLX HALLCS LNGS TENDON POSTR SPUR RESECTION 3,960.00 PROF FEES HCHG EXERCISE EQUIP PR5 AFFILIATE ONLY 12.00 PROF FEES PR BRACE ANKLE PR210 AFFILIATE ONLY 305.00 PROF FEES PR XR ESOPHAGEAL DILATION 77.00 PROF FEES HCHG SLEEVE KNEE PR5 AFFILIATE ONLY 187.00 PROF FEES PR PSYCHIATRIC DIAGNOSTIC EVALUATION 211.00 PROF FEES PR PSYCH DIAG EVAL W MED SERV 338.00 PROF FEES PR PSYCHOTHERAPY 45 MIN PATIENT 88.00 PROF FEES PR PHARMACOLOGIC MANAGEMENT W PSYCHOTHERAPY 92.00 PROF FEES PR PHARMACOLOGIC MANAGEMENT W PSYCHOTHERAPY 301.00 PROF FEES PR TRANSITIONAL CARE MANAGEMENT 14 DAYS POST DISCHARGE 186.00 PROF FEES PR TRANSITIONAL CARE MANAGEMENT 14 DAYS POST DISCHARGE 320.00 PROF FEES PR ARTHROPLASTY HUMERAL OR ULNAR 6,158.00 PROF FEES PR RETURN TO WORK EXAM AFFILIATE ONLY 52.00 PROF FEES PR OCH LIMITED PHYSICAL 104.00 PROF FEES PR AFO ANKLE GAUNTLET PREFAB OTS PR30 53.00 PROF FEES PR LAP REVISION RNY AFFILIATE ONLY 13,156.00 PROF FEES PR UNLISTED LAPAROSCOPY PROCEDURE ESOPHAGUS AFFILIATE ONLY 8,206.00 PROF FEES PR REMOVAL OF JEJUNOSTOMY TUBE 1,148.00 PROF FEES PEDS HEAD CT ORDERED BY NON ED PROVIDER AFFILIATE ONLY 0.01 PROF FEES HCHG OT ORTHO/PROSTHETIC TRAIN UPR/LWR EXT TRUNK SUBQ 15 MIN 94.00 PROF FEES PR PNEUMATIC WALKING BOOT PREFAB CUSTOM FIT PR60 94.00 PROF FEES PR CLOSED TX C MC DISLOC W ANESTH 993.00 PROF FEES PR PELVIC/BREAST CA SCREEN EXAM 79.00 PROF FEES PR HOME HA SUPER.W/MONTH30+MIN 237.00 PROF FEES PR INJ KETOROLAC TROMETHAMINE PER 15MG 10.00 PROF FEES PR CAST SUPPLIES LONG ARM CAST FIBERGLASS PEDIATRIC (0-10 YEARS) FIBERGLASS 85.00 PROF FEES PR CAST SUPPLIES SYNTHETIC SHORT ARM CHILD 85.00 PROF FEES PR FINE NEEDLE ASP BX WO IMAGING GUIDANCE 1ST LESION 146.00 PROF FEES PR DRAIN PILONIDAL CYST SIMPL 141.00 PROF FEES PR DRAIN PILONIDAL CYST COMPLIC 593.00 PROF FEES PR DEBRIDE SKIN/SUBQ AT FX SITE 1,336.00 PROF FEES PR DEBRIDE TO MUSC/FASCIA FIRST 20 SQ CM 1,186.00 PROF FEES PR REMOVAL OF SKIN TAGS UP TO 15 119.00 PROF FEES PR REMOVAL OF SKIN TAGS UP TO 15 349.00 PROF FEES PR REMOVAL SKIN TAGS EA ADDL 10 178.00 PROF FEES PR SHAV SKIN LESION 0.6-1.0 CM TRUNK ARM LEG 327.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM TRUNK ARM LEG 144.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM S/N/H/F GENITALI 279.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM S/N/H/F GENITALI 92.00 PROF FEES PR SHAV SKIN LESION 0.6-1.0CM S/N/H/F/GENIT 137.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM FACE EARS EYELIDS 341.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM FACE EARS EYELIDS 102.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM TRUNK ARM LEG 102.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM TRUNK ARM LEG 144.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM TRUNK ARM LEG 553.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM TRUNK ARM LEG 1,122.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM SCALP NECK HANDS FEET 565.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM SCALP NECK HANDS FEET 191.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM SCALP NECK HANDS FEET 996.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM SCALP NECK HANDS FEET 374.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM FACE EARS EYELIDS 124.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM FACE EARS EYELIDS 175.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM FACE EARS EYELIDS 600.00 PROF FEES PR EXC SWEAT GLAND LESN AXILL SIMPL 643.00 PROF FEES PR EXC SWEAT GLAND LESN INGUIN SIMPL 595.00 PROF FEES PR EXC SKIN MALIG OVER 4 CM TRUNK ARM LEG 1,608.00 PROF FEES PR EXC SKIN MALIG 0.6-1 CM SCALP NECK HANDS FEET 776.00 PROF FEES PR EXCISION PILONIDAL CYST SIMPLE 1,334.00 PROF FEES PR REPAIR SUPERF WOUND BODY < OR = 2.5 CM 255.00 PROF FEES PR REPAIR SUPERF WOUND BODY 2.6-7.5 CM 637.00 PROF FEES PR REPAIR SUPERF WOUND BODY 7.6-12.5 CM 742.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS < OR = 2.5 CM 175.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS 2.6-5 CM 561.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM < OR = 2.5CM 694.00 PROF FEES PR REPAIR INTERMED WOUND NECK HANDS FEET 20.1-30 CM 1,086.00 PROF FEES PR REPAIR INTERMED WOUND FACE EARS EYELIDS 5.1-7.5 CM 1,355.00 PROF FEES PR REPAIR COMPLEX WOUND FACE HAND FEET EA ADDL 5CM OR LESS 574.00 PROF FEES PR MUSCLE-SKIN FLAP TRUNK 6,155.00 PROF FEES PR REM SUTURES W ANESTH SAME SURGEON 95.00 PROF FEES PR DESTROY PREMALIGNANT 1ST LESION 76.00 PROF FEES PR BIOPSY OF BREAST NEEDLE CORE 149.00 PROF FEES PR BIOPSY OF BREAST INCISIONAL 1,341.00 PROF FEES PR NIPPLE EXPLORATION 1,052.00 PROF FEES PR SUSPENSION OF BREAST 4,498.00 PROF FEES PR DEEP MUSCLE BIOPSY 965.00 PROF FEES PR INJ TENDON ORIGIN/INSERT 389.00 PROF FEES PR INJ TRIGGER POINT 1 OR 2 MUSCLES 575.00 PROF FEES PR DRAIN/INJ SMALL JOINT/BURSA FINGERS TOES WO US GUIDE 256.00 PROF FEES PR CLOSED TX MCP DISLOC W ANESTH 1,408.00 PROF FEES PR REMOVAL ARM/ELBOW F.B.DEEP 1,233.00 PROF FEES PR RECONSTRUCT ELBOW LAT LIGMNT W GRAFT 4,056.00 PROF FEES PR CLOSED TX HUMERAL SUPRACONDYLAR FX 450.00 PROF FEES PR PERCUT FIX HUM SUPRACONDYLAR FX 3,804.00 PROF FEES PR CLOSED TX HUMER EPICONDYLR FX 367.00 PROF FEES PR OPEN TX PROX ULNA FRACTURE 2,827.00 PROF FEES PR INCIS DRAIN FOREARM INFECTED BURSA 1,107.00 PROF FEES PR CLOSED TX RADIAL SHAFT FX 919.00 PROF FEES PR CLOSED TX RADIAL SHAFT FX W DISLOCATION 1,714.00 PROF FEES PR CLOSED TX ULNA SHAFT FX 613.00 PROF FEES PR RELEASE PALM CONTRACT OPEN PARTIAL 2,579.00 PROF FEES PR EXPLORE & TREAT METACARPO-PHAL JT 641.00 PROF FEES PR EXPLORE/TREAT INTERPHALANGEAL JTEA 1,799.00 PROF FEES PR PART PALMAR FASCIEC OPEN ADDL DIGIT 3,057.00 PROF FEES PR REPAIR FLEX TENDON ZONE 2 HAND 2,428.00 PROF FEES PR REPAIR EXTEN TENDON DORSUM HAND EA 2,120.00 PROF FEES PR REPAIR EXT TENDCENT SLIP SEC 1,086.00 PROF FEES PR FUSION MC P JOINT SINGLE 2,704.00 PROF FEES PR ARTHROPLASTY I P JT IMPLANT 1,591.00 PROF FEES PR CLOSED TX METACARPAL FX 306.00 PROF FEES PR CLOSED TX IP JT DISLOCATION ANESTH 1,578.00 PROF FEES PR CLOSE TX PROX/MID FING OR THUMB SHFT FX 225.00 PROF FEES PR FUSION FINGER JOINT EA ADDL 227.00 PROF FEES PR REMOVAL OF HIP PROSTHESIS 3,439.00 PROF FEES PR PERCUT FIX PROX NECK FEMUR FX 5,328.00 PROF FEES PR CLOSED TX TRAUMA HIP DISLOC ANESTH 3,019.00 PROF FEES PR BX THIGH KNEE SOFT TISSUES DEEP 1,234.00 PROF FEES PR REMOVE SYNOVIUM KNEE ANTER & POST 2,533.00 PROF FEES PR PART/FULL REMOVAL OF KNEECAP 3,230.00 PROF FEES PR FIX UNSTABLE PATELLA EXTEN REALIGN 4,408.00 PROF FEES PR LIGMT REVISION KNEE INTRA-ARTIC 2,411.00 PROF FEES PR REVISE KNEE JOINT REPLACE ALL PARTS 10,671.00 PROF FEES PR OPEN TX FEMUR FX W PLATE SCREW 5,583.00 PROF FEES PR CLOSED TX FEMUR DISTAL 1,837.00 PROF FEES PR OPEN TX CONDYLAR FX FEMUR 5,378.00 PROF FEES PR OPEN TX CONDYLAR FX W EXTENSN 4,291.00 PROF FEES PR OPEN TX UNI TIB PLAT FX 925.00 PROF FEES PR REPAIR LEG FASCIA DEFECT 1,661.00 PROF FEES PR REPAIR FLEX LEG TENDON PRIM EA 2,370.00 PROF FEES PR REPAIR COLLAT ANKLE LIGMNT SECONDARY 4,257.00 PROF FEES PR FIX NON/MALUNION TIBIA 2,713.00 PROF FEES PR CLOSED TX TIBIA SHAFT FX 1,302.00 PROF FEES PR CLOSED TX MED MALLEOLUS FX 393.00 PROF FEES PR CLOSED TX PROX/SHAFT FIBULA FX 1,034.00 PROF FEES PR CLOSED TX DIST FIBULA FX 375.00 PROF FEES PR CLOSED TX BIMALLEOLAR FX 1,144.00 PROF FEES PR CLOSED TX BIMALLEOLAR FX MANIP 2,305.00 PROF FEES PR OPEN TX BIMALLEOLAR FX 3,765.00 PROF FEES PR CLOSED TX TRIMALLEOLAR FX MANIP 2,498.00 PROF FEES PR REMOVE FOOT FOREIGN BODY SUBQ 1,178.00 PROF FEES PR REMOVE FOOT FOREIGN BODY DEEP 1,921.00 PROF FEES PR CLOSED TX HEEL FX 676.00 PROF FEES PR CLOSED TX TARSAL FX EA 292.00 PROF FEES PR OPEN TX METATARSAL FRACTURE 2,257.00 PROF FEES PR CLOSED TX BIG TOE FRACTURE 364.00 PROF FEES PR APPLY LONG ARM SPLINT 231.00 PROF FEES PR APPLY FOREARM SPLINT STATIC 88.00 PROF FEES PR APPLY FINGER SPLINT STATIC 124.00 PROF FEES PR APPLY LONG LEG CAST 189.00 PROF FEES PR APPLY LONG LEG SPLINT 102.00 PROF FEES PR SHLDR ARTHROSCOP SURG CAPSULORRHAPHY 7,125.00 PROF FEES PR SHLDR ARTHROSCOP SURG W/REMOVAL LOOSE/FB 1,935.00 PROF FEES PR SHLDR ARTHROSCOP PART DEBRIDE 4,826.00 PROF FEES PR SCOPE THRU TRACHEOSTOMY 934.00 PROF FEES PR REMOVE LUNG PNEUMONECTOMY 7,509.00 PROF FEES PR THORACOSCOPY RESECT BULLAE 2,070.00 PROF FEES PR INSERT HEART PM ATRIAL & VENT 5,355.00 PROF FEES PR RELOCATION OF SKIN POCKET PACEMAKER 719.00 PROF FEES PR REMOVAL OF PM GENERATOR 2,408.00 PROF FEES PR REMOVE TRANSVEN PACER ELECTRODE1 LEAD 1,078.00 PROF FEES PR REMOVE TRANSVEN PACER ELECTRODE 2 LEAD 1,355.00 PROF FEES PR REPAIR HEART WOUND 8,488.00 PROF FEES PR INJ SPIDER VEINS LIMB/TRUNK 734.00 PROF FEES PR INJ THERAPY VEIN MULT VEINS 768.00 PROF FEES PR REMOVE ARMPITS LYMPH NODES COMPLT 4,649.00 PROF FEES PR EXCIS TONGUE FOLD 960.00 PROF FEES PR ESOPHAGOSCOPY DIAGNOSTIC 629.00 PROF FEES PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL W/REMOVAL FOREIGN BODY(S) 1,661.00 PROF FEES PR PART REMOVAL COLON W END COLOSTOMY 5,623.00 PROF FEES PR LAP SURG ENTERECTOMY RESECT & ANAST 7,644.00 PROF FEES PR LAP SURG EA ADDL RESECT & ANAST 508.00 PROF FEES PR REVISION OF ILEOSTOMY SIMPLE 2,148.00 PROF FEES PR REVISION OF ILEOSTOMY COMPLICATED 2,148.00 PROF FEES PR COLOSTOMY 5,866.00 PROF FEES PR BIOPSY OF RECTUM 1,358.00 PROF FEES PR COLONOSCOPY REMOVE TUM POLYP LESN SNARE 2,677.00 PROF FEES PR COLONOSCOPY FLEX W TRANSENDO BLLN DILAT =>1 STRICTURES 3,494.00 PROF FEES PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS 837.00 PROF FEES PR HEMORRHOIDECTOMY XTRNL 2+ COLUMN/GROUP 1,731.00 PROF FEES PR REMOVAL ANAL FISTULA SECOND STAGE 1,416.00 PROF FEES PR ANOSCOPY REMOVE LESION SNARE 834.00 PROF FEES PR HRHC NTRNL LIG OTH THAN RBBR BAND 1 COL/GRP WO GUIDE 1,172.00 PROF FEES PR NEEDLE BIOPSY LIVER 1,154.00 PROF FEES PR WEDGE BIOPSY OF LIVER 2,831.00 PROF FEES PR RE-EXPLORE LIVER WOUND REMOVE PACKING 4,816.00 PROF FEES PR LAP CHOLECYSTECTOMY/EXPLORE 7,849.00 PROF FEES PR DRAIN ABD ABSCESS OPEN 7,433.00 PROF FEES PR REPAIR ING HERNIA 6MO-5YR STRANG 3,032.00 PROF FEES PR REPAIR RECURR INGUIN HERN STRANG 3,227.00 PROF FEES PR REPAIR INCISIONAL HERNIA REDUCIBLE 3,449.00 PROF FEES PR REPAIR HERNIA W MESH 1,009.00 PROF FEES PR REPAIR UMBILICAL HERN <5 YRS STRANG 1,148.00 PROF FEES PR IRRIGATION OF BLADDER 332.00 PROF FEES PR INSTILL ANTICANCER AGENT IN BLADDER 1,505.00 PROF FEES PR CLOSED TX POST HIP FIX DISLOC ANESTH 2,840.00 PROF FEES PR REPAIR BLADDER WOUND/INJURY COMPLIC 2,229.00 PROF FEES PR DILATE URETHRA FEMALE INITIAL 397.00 PROF FEES PR REMOVAL OF SPERM DUCT(S) 850.00 PROF FEES PR LYSIS OF LABIAL LESION(S) 711.00 PROF FEES PR MANIPULATN KNEE JT W ANESTHESIA 1,564.00 PROF FEES PR REPAIR OF PERINEUM NON OBSTETRICAL 999.00 PROF FEES PR I&D VAGINAL HEMATOMA OBSTET/POSTPART 901.00 PROF FEES PR BIOPSY OF VAGINA SIMPLE 274.00 PROF FEES PR BIOPSY OF VAGINA SIMPLE 231.00 PROF FEES PR CLOSURE OF VAGINA 3,958.00 PROF FEES PR FITTING OF DIAPHRAGM/CAP 205.00 PROF FEES PR TREAT VAGINAL BLEEDING 270.00 PROF FEES PR COLPORRHAPHY, REPR OF VAGINAL INJURY (NON-OB) 1,910.00 PROF FEES PR COMBINED ANT/POST COLPORRHAPHY INCL CYSTURETHROSCOPY 3,430.00 PROF FEES PR MYOMECTOMY 5/>TOT>250 GMSABD APPRCH 4,216.00 PROF FEES PR INSERT INTRAUTERINE DEVICE 364.00 PROF FEES PR REMOVE INTRAUTERINE DEVICE 482.00 PROF FEES PR REMOVE INTRAUTERINE DEVICE 266.00 PROF FEES PR REMOVE INTRAUTERINE DEVICE 216.00 PROF FEES PR HYSTEROSCOPY DX SEP PROC 647.00 PROF FEES PR REMOVAL OF OVARIAN CYST(S) 3,581.00 PROF FEES PR FETAL NON-STRESS TEST 227.00 PROF FEES PB 17-OH PROGESTERONE LC 125.00 PROF FEES PR INSERT CERVICAL DILATOR 563.00 PROF FEES PR FULL ROUT OBSTE CARE VAGINAL DELIV 7,365.00 PROF FEES PR OBSTETRICAL CARE VAG DELIV ONLY 2,946.00 PROF FEES PR ANTEPARTUM CARE ONLY 4-6 VISITS 1,641.00 PROF FEES PR SURG TREATMENT OF MISCARRIAGE 1ST TRI HOSPITAL 1,405.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID OCCIPITAL NERVE 337.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID SUPRACAPULAR NERVE 333.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID INTERCOST NERVE EA ADDL LVL 344.00 PROF FEES PR INJ FORAMEN C/T ADDL LEVELS WITH FLUORO OR CT 261.00 PROF FEES PR INJ NERV BLOCK PARAVERT SYMPATH 432.00 PROF FEES PB LEAD TEST 149.00 PROF FEES PR REPAIR HAND/FOOT NERVE MEDIAN MOTOR 1,739.00 PROF FEES PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT 175.00 PROF FEES PR REMOVE FB EYE CORNEA NO SLIT 295.00 PROF FEES PR HEP A VACCINE ADULT IM 248.00 PROF FEES PR MULTI FAMILY GROUP THERAPY, PER 30 MIN 93.00 PROF FEES PR ESOPHAGEAL MOTILITY STUDY 306.00 PROF FEES PR PURE TONE AUDIOMETRY AIR AND BONE 88.00 PROF FEES PB TESTOSTERONE FREE LC 294.00 PROF FEES PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISSIONS LTD 152.00 PROF FEES PR EXT PT & AUTO ACTIVATED ECG DOWNLOAD W R&I <=30 DAYS 101.00 PROF FEES PR POS AIRWAY PRESSURE CPAP 231.00 PROF FEES PR IMMUNOTHERAPY ONE INJECTION 58.00 PROF FEES PR ANALYZE NEUROSTIM COMPLX/PROG 196.00 PROF FEES PR SELF CARE/HOME MGMT TRAIN EA 15 MIN 212.00 PROF FEES PR OSTEOPATHIC MANIP 5-6 BODY REGN 132.00 PROF FEES PR OSTEOPATHIC MANIP 5-6 BODY REGN 56.00 PROF FEES PR OSTEOPATHIC MANIP 7-8 BODY REGN 181.00 PROF FEES PR OSTEOPATHIC MANIP 7-8 BODY REGN 95.00 PROF FEES PR ANOGENITAL EXAM MAGNIFY CHILD SUSPECT TRAUMA W IMG 216.00 PROF FEES PR FIRST OB VISIT -LEVEL 3 NEW PT 287.00 PROF FEES PB TESTOSTERONE BIOAVAIL LC 148.00 PROF FEES PR FIRST OB VISIT -LEVEL 4 NEW PT 708.00 PROF FEES PR FIRST OB VISIT -LEVEL 4 NEW PT 354.00 PROF FEES PR FIRST OB VISIT -LEVEL 4 NEW PT 354.00 PROF FEES PR INPATIENT CONSULT LEVL I 250.00 PROF FEES PR HOME VISIT NEW PATIENT LEVEL I 225.00 PROF FEES PB C1 ESTERASE INHIBITOR, SERUM LC 225.00 PROF FEES PR PROLNG E/M OR PSYCHOTHERAPY SVC DIR CONTACT 1ST HR 595.00 PROF FEES PR PROLNG E/M OR PSYCHOTHERAPY SVC DIR CONTACT ADDL 30 MIN 428.00 PROF FEES PR HOME HEALTH CARE SUPERV 15-29 MIN 368.00 PROF FEES PR FIRST OB VISIT-LEVEL 2 NEW PT 198.00 PROF FEES PR EXPLORATION OF CHEST 4,626.00 PROF FEES PR PREVENTIVE VISIT EST AGE 5-11 180.00 PROF FEES PR PREVENTIVE VISIT EST 12-17 194.00 PROF FEES PR PREVENTIVE VISIT EST 12-17 194.00 PROF FEES PR PREVENTIVE VISIT EST 18-39 216.00 PROF FEES PR PREVENT COUNSEL INDIV 30 MIN 106.00 PROF FEES PR ARTHRO LBODY+CHRNDRO DIFF COMP SA 331.00 PROF FEES PR LAP VENTRAL INCISIONAL HERNIORRAPHY W MESH 4,844.00 PROF FEES PR FIRST OB VISIT-LEVEL 2 NEW PT 396.00 PROF FEES PR HEARING ACCESSORIES RETAIL 42.00 PROF FEES PR INSRT PERIPH CV CATH WO PORT WO GUIDANCE OVER 5 YRS 649.00 PROF FEES PR LAP COLPOPEXY SURGICAL 3,505.00 PROF FEES PR TDAP VACCINE IM OVER 7 YEARS OLD 121.00 PROF FEES PR READING OB US TRANSVAGINAL 0.00 PROF FEES HCHG OT THERAPEUTIC EXERCISE 15MIN 101.00 PROF FEES HCHG SLP EVAL VIDEO SWALLOW 210.00 PROF FEES PR TINNITUS EVAL PITCHLOUDNESS DISCOM EM105 0.00 PROF FEES PR ADM VACC NO COUNSELING ANY AGE ANY ROUTE STATE SERUM 80.00 PROF FEES PR AV ANASTOMOSIS OPEN 6,679.00 PROF FEES PR OPEN CHEST HEART MASSAGE 4,909.00 PROF FEES PR HEMORRHOIDOPEXY BY STAPLING 1,302.00 PROF FEES PR CHEST TUBE INSERTION INC DRAIN CONNECT 1,003.00 PROF FEES PR GASTROESOPH REFLEX W ELECTROD 1,734.00 PROF FEES PR GASTROESOPH REFLEX W ELECTROD 1,542.00 PROF FEES PR ESOPH IMPED FUNCTION TEST 488.00 PROF FEES PR ESOPH IMPED FUNCT TEST >1 HR 82.00 PROF FEES PR SUBSEQ NURSING FACILITY CARE PER DAY HIGH MDM 329.00 PROF FEES PR LAP GASTR BYPASS INCL SMLL INTEST 13,643.00 PROF FEES PR SURG GASTRIC LAP RESTRIC PLACMNT ADJ GASTRIC DEVICE 12,230.00 PROF FEES PR SURG GASTRIC LAP RESTRIC REVISE ADJ GASTRIC DEVICE 13,186.00 PROF FEES PR LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUS VEIN 1,545.00 PROF FEES PR SURG GASTRIC LAP RESTRIC REM ADJ GASTRIC DEVICE 13,186.00 PROF FEES PR SURG GASTRIC LAP RESTRIC REMVL AND RPLCMNT ADJ GASTRIC DEVICE 13,186.00 PROF FEES PR SURG GASTRIC LAP RESTRIC REMVL OF ADJ GASTRIC DEVICE AND SUB PORT COMP 13,186.00 PROF FEES PR GASTRIC RESTRICTIVE PROCEDURE OPEN REVISION OF SUBCUTANEOUS PORT COMPONENT1,858.00 ONLY PROF FEES PR GASTRIC RESTRIC PROC OPEN REM SUBCUT PORT COMPONENT ONLY 917.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF INDIV PT EA 30 MIN 0.00 PROF FEES PR PESSARY RING W/SPPRT 153.00 PROF FEES PR LAP RESECTION CELIAC LYMPH NODE SG278 464.00 PROF FEES PR HYMENOTOMY SIMPLE INC 324.00 PROF FEES PR ADJ GASTRIC BAND DIAM SUBQ PORT 231.00 PROF FEES PR GASTRIC RESTRIC PROC OPEN REMVL AND RPLCMNT SUBCUT PORT COMPONENT ONLY 1,891.00 PROF FEES PR PHONE E&M EST PATIENT 11-20 MIN 36.00 PROF FEES PR GASTRIC BYPASS (SSUT) 12,230.00 PROF FEES PR LAP EXC OMENTAL NODULE - <5 CM 4,187.00 PROF FEES PR ALCOHOL SUBSTANCE ABUSE SCRNG & SBI 15-30 MN 174.00 PROF FEES PR DISPENSING FEE MONAURAL 0.00 PROF FEES PR LAP INCISIONAL HERNIA REPAIR COMP 3,799.00 PROF FEES PR REMOTE TELEMETRY 30 DAY ECG MD INTERP 101.00 PROF FEES PR PRGM SINGLE LEAD OR LEADLESS PACER EVAL 126.00 PROF FEES PR INIT NEWBORN CARE OTHER PER DAY 316.00 PROF FEES PR PEDS CRITICAL CARE TRANSPORT EA ADDL 30 304.00 PROF FEES PR LAP ROBOT ASSIST EXCCHOLEDOCAL 4,139.00 PROF FEES PR LAPAROSCOPIC GASTROJEJUNOSTOMY 4,932.00 PROF FEES PR EXC NECROTIC ADIPOSE TISSUE LEG 0.00 PROF FEES PR STABILIZER ANKLE ASO 115.00 PROF FEES PR POST OP SURGICAL BOOT PR5 100.00 PROF FEES PR LAP DRAIN OVARIAN CYST 5,963.00 PROF FEES PR SAUCERIZATION MEDIAL/LAT MENISCUS ARTHRO 3,960.00 PROF FEES PR STRAP KNEE PR5 6.00 PROF FEES PR PSYCHOTHERAPY FAMILY WO PATIENT 50 MIN 89.00 PROF FEES PR NERVE CONDUCTION USING ELECTRODE ARRAYS WITH F-WAVE EA LIMB W INTERP/REPORT 10.00 PROF FEES PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM 0.00 PROF FEES PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM 1,355.00 PROF FEES PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM 1,799.00 PROF FEES PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM 1,641.00 PROF FEES PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM 1,354.00 PROF FEES PR REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC 1,088.00 PROF FEES PR REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC 735.00 PROF FEES PR INJ PARAVERTEBRAL FACET JOINT LUMBAR OR SACRAL SECOND LEVEL WITH FLUORO OR CT199.00 PROF FEES HCHG WHO COCKUP NONMOLDED PREFAB OTS PR70 PROF FEES PR GASTROSTOMY JEJUNOSTOMY TUBE 42.00 PROF FEES PR OB EQUAL OR GREATER THAN 14 WKS SINGLE 1,304.00 PROF FEES PR RESECT SMALL INTEST SINGL RESECANAS 5,160.00 PROF FEES PR US GUIDED VASCULAR ACCESS 98.00 PROF FEES PR SCOPE RESECTION COROCOID PROCESS 3,960.00 PROF FEES PR SCOPE STEDMAN CHONDROPLASTY 3,960.00 PROF FEES PR SCOPE GLENOID MICROFRACTION 3,960.00 PROF FEES PR INJ PENICILLIN G BENZATHINE 100000 UNITS 339.00 PROF FEES PR DTAP/HEPB/IPV COMB VACC IM 83.00 PROF FEES PR DTAP-IPV VACC 187.00 PROF FEES PR DTAP VACC IM < 7 YO 188.00 PROF FEES PR DBRDMT TO MUSC/FASCIA EA ADDL 20 SQ CM OR PART THEREOF 224.00 PROF FEES PR SUBSQNT OBSERV CARE TO 25 MIN 205.00 PROF FEES PR FLU VACC TRIVALENT IIV3 SV 0.5 ML IM 42.00 PROF FEES PR HEP B VACC ADOL 2 DOSE IM 0.00 PROF FEES PR HEP B VACC ADULT IM 3 DOSE SCHEDULE 0.00 PROF FEES PR HEP B VACC ADULT IM 3 DOSE SCHEDULE 83.00 PROF FEES PR HEP B VACC PED/ADOL 3 DOSE 0.00 PROF FEES PR HIB VACC PRP-T IM 106.00 PROF FEES PR MMR VARICELLA VACC 413.00 PROF FEES PR LAP GASTRIC WEDGE RESECTION INCLUSIVE TUMOR 13,155.00 PROF FEES PR PNEUMOCOCCAL 23-VAL VACC =>2 YO 0.00 PROF FEES PR PNEUMOCOCCAL 23-VAL VACC =>2 YO 282.00 PROF FEES PR ROTAVIRUS VACC ORAL 3 DOSE 415.00 PROF FEES PR TDAP VACC IM > 7 YO 0.00 PROF FEES PR TYPHOID VACC IM 147.00 PROF FEES PR LAP REVISION LOOP GASTRIC BYPASS TO ROUX ENY 13,155.00 PROF FEES PR FLU VACC 18 YRS AND OLDER FLUBLOK 42.00 PROF FEES PB DRVVT CONFIRM 77.00 PROF FEES PR CHEMODENERV 1 EXTREMITY 1 TO 4 MUSCLES 282.00 PROF FEES PR EGD ENDOSCOPIC STENT PLACEMENT W WIRE AND DILATION 661.00 PROF FEES PR ADMIN EA ADDL VACC 80.00 PROF FEES PR ADMIN EA ADDL VACC STATE SERUM 15.00 PROF FEES PR ADMIN VACC INIT INTRANASAL/ORAL STATE SERUM 28.00 PROF FEES PR ADMIN FLU VACC SEASONAL (MEDICARE) 35.00 PROF FEES PAIN SEVERITY QUANTIFIED PAIN PRESENT 0.01 PROF FEES MEDICATION LIST DOCUMENTED IN MEDICAL RECORD 0.00 PROF FEES PR REMOVE&REPLACE PM GEN DUAL LEAD 1,117.00 PROF FEES PR ELEC ANALYS INTRATHEC/EPID PUMP W REPROG & REFILL REQ MD/QHP 293.00 PROF FEES PR AFO ANKLE GAUNTLET PREFAB OTS PR1 100.00 PROF FEES PR MANIPULAT PALM CORD POST INJ 146.00 PROF FEES PR RESECT SMALL INTEST EA ADDL 1,661.00 PROF FEES PB FRAGILE X SYNDROME 184.00 PROF FEES PR ARTHROCENT ASPIR INJ SMALL JOINT/BURSA W US GUIDE 164.00 PROF FEES HCHG OT MANUAL THERAPY XE 92.00 PROF FEES PR REMOVE IMPACTED CERUMEN USING IRRIGATION LAVAGE UNILATERAL 29.00 PROF FEES PR INJECTION FOR CHOLANGIOGRAM INCLD IMAGE GUID EXISTING ACCESS 878.00 PROF FEES PR SURG TREATMENT MISCARRIAGE 1ST TRI CLINIC 1,405.00 PROF FEES PB CLONAZEPAM CLN 280.00 PROF FEES PB GENERAL LAB 8749104 135.00 PROF FEES HCHG OT EVAL HIGH COMPLEXITY 305.00 PROF FEES PR REPAIR BUNION PROX METATARSAL OSTEOTOMY ANY METHOD 2,134.00 PROF FEES PR LAP EXCISION SPERMATIC CORD 0.00 PROF FEES PR ABI COMPLETE 698.00 PROF FEES PR LAP ESOPHAGEAL LENGTHENING PROC 483.00 PROF FEES PR PUNCH BIOPSY SKIN LESION EA ADDL 142.00 PROF FEES PR FINE NEEDLE ASPIRATION BIOPSY W US GUIDE EA ADDL 174.00 PROF FEES PR REMOVAL SUBQ CARDIAC RHYTHM MONITOR 549.00 PROF FEES PR CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH 166.00 PROF FEES PR OT THERAPEUTIC ACTIVITIES EA 15 MIN AFFILIATE ONLY 261.00 PROF FEES PB IGM 176.00 PROF FEES PR TREPHINATION MENISCAL TEAR 3,960.00 PROF FEES PB VENIPUNCTURE 46.00 PROF FEES PR REPAIR ANASTOMOSIS TENODESIS OF LONGUS TO BREVIS 0.00 PROF FEES PR BRACE WRIST 9IN INDEPENDENCE SCRMC ONLY 73.00 PROF FEES PB ANGIOTENSIN-CONVERTING ENZYME LC 52.00 PROF FEES PB VW CIEP MML 94.00 PROF FEES PB GABAPENTIN (NEURONTIN), SERUM LC 224.00 PROF FEES PB GENERAL LAB 8751701 LC 341.00 PROF FEES PB MERCURY HEAVY METALS PROFILE II, BLOOD LC 158.00 PROF FEES PB GENERAL LAB 8159601 LC 224.00 PROF FEES PB PARVOVIRUS B19, HUMAN, IGG/IGM LC 69.00 PROF FEES PB RENIN ACTIVITY, PLASMA LC 85.00 PROF FEES PB ANTISCLERODERMA-70 ANTIBODIES LC 311.00 PROF FEES PB KB SENSITIVITY 74.00 PROF FEES PR NEG IMPRESSION CASTING EA FOOT 54.00 PROF FEES PB RABIES NEUT ABS TITRAT (RFFIT) LC 73.00 PROF FEES PR SURGICAL LAP CLOSURE OF ENTEROST LG OR SM INTEST W RESECT ANASTOMOSIS 5,808.00 PROF FEES PR BINDER ABD PR5 12.00 PROF FEES PR LAPAROSCOPIC SUTURE LARGE INTESTINE PERFORATION WO COLOSTOMY 7,924.00 PROF FEES PR ULTRASOUND GUIDED NEEDLE PLCMT 139.00 PROF FEES HCHG UE ORTHOSIS PR50 85.00 PROF FEES PB REFERRAL ID/SUSC, URINE 183.00 PROF FEES PR LAP REPAIR OF PERFORATED INTESTINAL ULCER W OMENTAL FLAP 7,924.00 PROF FEES PR ARTHO MICROFX POSTMED HUMERUS 3,960.00 PROF FEES PB ANTIDEPRESSANT DRUG SCR UR QT 281.00 PROF FEES PR XR ERCP BILIARY ONLY CUY ONLY 82.00 PROF FEES PR LAP INTESTINAL HERNIA 7,924.00 PROF FEES PR PREMIUM HA BINAURAL ITE 2U 0.00 PROF FEES PR FIRST OB VISIT-LEVEL 2 NEW PT 198.00 PROF FEES HCHG WHO COCKUP NONMOLDED PREFAB OTS PR170 108.00 PROF FEES PR SURGICAL DRESS HOLDER REUSE PR20 AFFILIATE ONLY 30.00 PROF FEES PR CAST SUP SHT ARM SPLINT PLSTR PR60 88.00 PROF FEES PR TRAPEZIUS SLING PR30 AFFILIATE ONLY 44.00 PROF FEES PR LAP FALLOPIAN TUBAL DYE STUDY 6,884.00 PROF FEES PR HEPATITIS B VACCINE ADULT 2 DOSE IM 270.00 PROF FEES PR PSYCHIATRIC DIAGNOSTIC EVALUATION 572.00 PROF FEES PR PSYCHIATRIC DIAGNOSTIC EVALUATION 784.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 30 MIN 277.00 PROF FEES PR PSYCHOTHERAPY PATIENT 60 MIN 125.00 PROF FEES PR PSYCHOTHERAPY PATIENT 60 MIN 501.00 PROF FEES PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN 245.00 PROF FEES PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN 198.00 PROF FEES PR PHARMACOLOGIC MANAGEMENT W PSYCHOTHERAPY 208.00 PROF FEES PR INJ METHYLNALTREXONE 0.1 MG 1.00 PROF FEES PR COMPLEX CHRONIC CARE MGMT W MLT CHRON COND EA ADDL 30 MIN 96.00 PROF FEES PR COMPLEX CARE MGMT W MLT CHRON COND 60 MINS PER MONTH 187.00 PROF FEES PR EGD FLEX TRANSORAL W OPTICAL ENDOMICROSCOPY 1,061.00 PROF FEES PR INSERT CATH W PLEURAL DRAIN W GUIDANCE 1,152.00 PROF FEES PR THORACENTESIS W/O GUIDANCE 695.00 PROF FEES PR HEARING AID CONSULTATION NO CHARGE 0.00 PROF FEES PR TARSAL TUNNEL INJECTION PERFORMED BILATERALLY 288.00 PROF FEES PR PLCMT ACCESS THRU BILIARY TREE INTO SM BOWEL 3,239.00 PROF FEES PR SUTURE SM INTEST SINGLE PERF 6,601.00 PROF FEES PR SUTURE LRG INTEST 4,501.00 PROF FEES PR ROBOTIC ASSISTED LAPAROSCOPIC PYLOROPLASTY 12,230.00 PROF FEES PR FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT 572.00 PROF FEES PR LOW PECARN PED HEAD TRAUMA AFFILIATE ONLY 0.01 PROF FEES PR NO LOW PECARN PED HEAD TRAUMA AFFILIATE ONLY 0.01 PROF FEES PR OCH FAA FOLLOW UP EXAM 52.00 PROF FEES HCHG NUTRITION COUNSELING DIETITION VISIT AFFILIATE ONLY 78.00 PROF FEES AUC CDS MECHANISM NATIONAL DECISION SUPPORT COMPANY 0.00 PROF FEES PB 25-HYDROXY VITAMIN D (D2+D3 FRACTIONATED) LC 188.00 PROF FEES PR REMOVE RECTAL OBSTR FECES/FB W ANEST 1,278.00 PROF FEES PR TIBIAL METAPHYSIS CORE DECOMPRESSION 0.00 PROF FEES PB SPECIMEN COLLECT SNF LAB SARS-COV-2 AFFILIATE ONLY 60.00 PROF FEES PR FLU VACC TRIVALENT IIV3 SV PF 0.25 ML IM 0.00 PROF FEES PR COLORECTAL CA SCREEN HI RISK COLONOSCOPY 1,716.00 PROF FEES PR DIABETES SELF MGT GROUP 2 OR MORE EA 30 MIN 57.00 PROF FEES PR COLORECTAL CA SCRN NOT HI RISK COLONOSCOPY 1,430.00 PROF FEES PR INJ CEFTRIAXONE SODIUM PER 250 MG 45.00 PROF FEES PR BETAMETHASONE ACETATE-NA PHOS/3 MG 64.00 PROF FEES PR INJ PROMETHAZINE HCL TO 50 MG 4.00 PROF FEES PR INJ TRIAMCINOLONE ACETONIDE PER 10MG 44.00 PROF FEES PR SCREEN PAP OBTAINING SPECIMEN 130.00 PROF FEES PR FIT/ORIENT/CHECKHEARING AID 70.00 PROF FEES PR DISPENSING FEE BINAURAL 642.00 PROF FEES PR FINE NEEDLE ASP BX WO IMAGING GUIDANCE 1ST LESION 338.00 PROF FEES PR ACNE SURGERY OF SKIN ABSCESS 210.00 PROF FEES PR DRAIN PILONIDAL CYST COMPLIC 887.00 PROF FEES PR DEBRIDE SKIN/SUBQ AT FX SITE 572.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION ONE 282.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM TRUNK ARM LEG 449.00 PROF FEES PR SHAV SKIN LESION OVER 2.0 CM S/N/H/F/GENIT 511.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM FACE EARS EYELIDS 131.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM TRUNK ARM LEG 331.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM TRUNK ARM LEG 528.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM TRUNK ARM LEG 223.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM FACE EARS EYELIDS 369.00 PROF FEES PR EXC SWEAT GLAND LESN AXILL COMPLX 929.00 PROF FEES PR EXC SKIN MALIG 3.1-4 CM TRUNK ARM LEG 1,425.00 PROF FEES PR EXC SKIN MALIG OVER 4 CM SCALP NECK HANDS FEET 1,701.00 PROF FEES PR TRIM NONDYSTROPHIC NAIL(S) 87.00 PROF FEES PR REMOVAL OF NAIL BED PERMANENT 943.00 PROF FEES PR EXCISION OF NAIL FOLD TOE 394.00 PROF FEES PR REMOVAL DRUG IMPLANT DEVICE 1,060.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS < OR = 2.5 CM 543.00 PROF FEES PR REPAIR INTERMED WOUND FACE EARS EYELIDS < 2.5 CM 1,077.00 PROF FEES PR REPAIR COMPLEX WOUND SCALP EXTR 2.6-7.5 CM 1,462.00 PROF FEES PR SPLIT GRAFT HEA FACE HAND FEET <100CM 3,819.00 PROF FEES PR EXCISE EXCESS SKIN THIGH 2,111.00 PROF FEES PR REM SUTURES W ANESTH SAME SURGEON 212.00 PROF FEES PR ANORECTAL EXAM SURG REQ ANESTH DIAG 555.00 PROF FEES PR DESTROY ANAL LESN(S)SIMPLE CHEMICAL 586.00 PROF FEES PR DESTROY PREMALIGNANT LESION EA 2-14 36.00 PROF FEES PR DESTR MALIG FACE NOSE LIP <0.6 CM 168.00 PROF FEES PR PUNCTURE ASPIRATION BREAST CYST 102.00 PROF FEES PR PUNCTURE ASPIR BREAST CYST EA ADDL 139.00 PROF FEES PR MASTOTOMY W EXPL/DRAINAGE ABSCESS 1,444.00 PROF FEES PR BIOPSY OF BREAST NEEDLE CORE 342.00 PROF FEES PR BIOPSY OF BREAST NEEDLE CORE 492.00 PROF FEES PR REMOVAL OF BREAST CAPSULE 2,316.00 PROF FEES PR NEEDLE BIOPSY MUSCLE 580.00 PROF FEES PR BONE BIOPSY EXCISIONAL SUPERF 441.00 PROF FEES PR INJ TENDON SHEATH/LIGAMENT 272.00 PROF FEES PR DESTROY ANAL LESN(S) CRYOSURGERY 539.00 PROF FEES PR DESTROY ANAL LESN(S) SURG EXCISION 947.00 PROF FEES PR INCISE TENDON MUSCLE SHLDR SINGLE 3,168.00 PROF FEES PR RECONSTR TOTAL SHOULDER IMPLANT 8,899.00 PROF FEES PR CLOSED TX SCAPULA FX 297.00 PROF FEES PR CLOSED TX MID HUMERUS FRACTURE 414.00 PROF FEES PR CLOSED TX MID HUMERUS FRACTURE 1,205.00 PROF FEES PR CLOSED TX HUMERAL SUPRACONDYLAR FX 849.00 PROF FEES PR OPEN TX HUMERAL SUPRACONDYLAR FX 2,001.00 PROF FEES PR CLOSED TX HUMER CONDYLR FX 1,257.00 PROF FEES PR CLOSED TX PROX ULNA FRACTURE 669.00 PROF FEES PR EXCIS TENDON SHEATH LESN WRIST FOREARM 332.00 PROF FEES PR RELEASE WRIST/FOREARM TENDON 1,137.00 PROF FEES PR RECONSTRUCT ULNA/RADIOULNAR 1,932.00 PROF FEES PR CLOSED TX ULNA SHAFT FX MANIPULATION 1,075.00 PROF FEES PR CLOSED TX RAD/ULNA SHAFT FXMANIP 2,124.00 PROF FEES PR OPEN TX RAD ULNA SHAFT FX W FIX BOTH 4,388.00 PROF FEES PR CLOSED TX DIST RAD ULNA FX 343.00 PROF FEES PR CLOSED TX NAVICULAR FX 1,059.00 PROF FEES PR CLOSED TX CARPAL FX EXCEPT SCAPHOID/NAVICULAR 1,061.00 PROF FEES PR OPEN TX CARPAL BONE FX EA BONE 1,221.00 PROF FEES PR OPEN REPAIR WRIST DISLOCATION 2,099.00 PROF FEES PR CLOSED TX NAVIC/LUNATE FX/DISLOC 1,455.00 PROF FEES PR DRAIN FINGER ABSCESS SIMPLE 1,262.00 PROF FEES PR INCISE FINGER TENDON SHEATH 2,105.00 PROF FEES PR TENOLYSIS EXT TENDON HAND/FINGER EA 1,765.00 PROF FEES PR CORRECT METACARPAL DEFORM 2,600.00 PROF FEES PR CLOSED TX METACARPAL FX MANIP 479.00 PROF FEES PR CLOSED TX METACARPAL FX PERCUT 2,498.00 PROF FEES PR PERCUT FIX CMC DISLOC NON THUMB 1,248.00 PROF FEES PR PERCUT TX PROX MID FING OR THUMB SHFT FX 1,982.00 PROF FEES PR CLOSED TX IP JT DISLOCATION 1,225.00 PROF FEES PR CLOSED TX IP JT DISLOCATION 762.00 PROF FEES PR I&D PELVIS HIP DEEP ABSCESS 2,510.00 PROF FEES PR REMOVE PELV HIP F B SUBCUTANEOUS 641.00 PROF FEES PR DESTROY INTERNAL HEMORRHOIDS 497.00 PROF FEES PR REMOVE THIGH/KNEE TUMOR SUBCUTANEOUS<3CM 1,834.00 PROF FEES PR RMV KNEE SYNOVIUM ANT/POST 1,303.00 PROF FEES PR REMOVE KNEE CYST/GANGLION 1,142.00 PROF FEES PR OPEN TX PATELLA FX 3,806.00 PROF FEES PR CLOSED TX TIB TUBER FX 1,057.00 PROF FEES PR AMPUTATE THIGH THRU FEMUR 4,248.00 PROF FEES PR DRAIN LOWER LEG DEEP ABSC/HEMATOMA 2,153.00 PROF FEES PR RESEC TUMOR LOWER LEG SUBCUT<3CM 2,022.00 PROF FEES PR OPEN TX MED MALLEOLUS FX 3,051.00 PROF FEES PR CLOSED TX PROX/SHAFT FIBULA FX 342.00 PROF FEES PR CLOSED TX TRIMALLEOLAR FX 454.00 PROF FEES PR CLOSED TX WEIGHT BEAR DIST TIBIA 1,499.00 PROF FEES PR CLOSED TX WEIGHT BEAR DIST TIB MANIP 2,591.00 PROF FEES PR PART EXCIS PLANTAR FASCIA 2,018.00 PROF FEES PR EXCIS TENDN/CAPSULE LESN TOES 1,612.00 PROF FEES PR REMOVAL OF SINGLE TOE EA 998.00 PROF FEES PR RELEASE FLEX FOOT TENDON SINGLE 395.00 PROF FEES PR CLOSED TX TOE FX 297.00 PROF FEES PR AMPUTATION FOOT MIDTARSAL CHOPART 3,265.00 PROF FEES PR APPLY FOREARM SPLINT DYNAMIC 312.00 PROF FEES PR APPLY LONG LEG SPLINT 326.00 PROF FEES PR APPLY LOWER LEG SPLINT 110.00 PROF FEES PR REMOVE/REVISN FULL ARM/LEG CAST 243.00 PROF FEES PR KNEE SCOPE REMOVE LOOSE BODY 3,819.00 PROF FEES PR KNEE SCOPE ABRASN ARTHROPLASTY 4,517.00 PROF FEES PR CATHETER ASPIR TRACHEOBRONCH 235.00 PROF FEES PR PARTIAL REMOVAL OF LUNG 7,492.00 PROF FEES PR THORACOSCOPY SURG REMOV FB INTRAPLEU 4,238.00 PROF FEES PR REPAIR BL VES DIRECT LOW EXTREM 7,935.00 PROF FEES PR INJ THERAPY VEIN MULT VEINS 530.00 PROF FEES PR CATH VEIN UMBILICAL NEWBORN 73.00 PROF FEES PR REMOVAL OF LEG VEINS/ULCER 1,224.00 PROF FEES PR REVISE SECONDARY VARICOSITY 2,602.00 PROF FEES PR REMOVAL SPLEEN TOTAL W OTHR PROC 549.00 PROF FEES PR BONE MARROW BIOPSY(IES) 444.00 PROF FEES PR REMOVE GROIN LYMPH NODES 4,029.00 PROF FEES PR EGD DILATION GASTRIC DUODENAL STRICTURE 1,520.00 PROF FEES PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS 1,277.00 PROF FEES PR EGD REMOVAL TUMOR POLYP OTHER LESION SNARE TECH 1,871.00 PROF FEES PR ERCP SPHINCTER PRESS MEASURMT 1,090.00 PROF FEES PR REMOVE STOMACH PART DISTAL FORM POUCH 4,450.00 PROF FEES PR REPOSITION GASTROSTOMY TUBE 225.00 PROF FEES PR REPAIR PERF DUOD GAST ULC/WND/INJURY 6,547.00 PROF FEES PR FREEING BOWEL ADHESION ENTEROLYSIS 4,108.00 PROF FEES PR MOBILIZE SPLENIC FLEXURE 957.00 PROF FEES PR PART REMOVAL COLON W OSTOMY/MUCOFIST 8,179.00 PROF FEES PR LAP SURG COLECTOMY WREMOVAL TERM ILEUM 5,406.00 PROF FEES PR ILEOSTOMY JEJUNOSTOMY NON TUBE 4,166.00 PROF FEES PR COLONOSCOPY THRU STOMA INCLD SPEC COL BRUSH OR WASH SEP PROC 1,346.00 PROF FEES PR INTRAABDOMINAL VOIDING PRESSURE TEST 1,489.00 PROF FEES PR DESTR PENIS LESN SIMPL CRYOSURG 314.00 PROF FEES PR CLOSE ENTEROSTOMY RESEC W COLOREC ANAS 7,545.00 PROF FEES PR SUTURE OF MESENTERY 1,633.00 PROF FEES PR SIGMOIDOSCOPY REMOVE LESN SNARE 1,331.00 PROF FEES PR I&D RECTAL ABSCESS W FISTULECTOMY 3,070.00 PROF FEES PR INCISE EXTERNAL HEMORRHOID 177.00 PROF FEES PR REMOVAL OF HEMORROIDAL TAGS 316.00 PROF FEES PR ANOSCOPY ABLATE LESION 238.00 PROF FEES PR DESTR PENIS LESN EXTENSIVE 495.00 PROF FEES PR LAP DISTAL PANCREATECTOMY 2,211.00 PROF FEES PR LAP ABDOMEN ASPIRATE CYST 3,843.00 PROF FEES PR REPAIR INCISIONAL HERNIA STRANG 3,396.00 PROF FEES PR REPAIR UMBILICAL HERN >5 TRS STRANG 2,907.00 PROF FEES PR INSERT TEMP INDWELLING CATH SIMPLE 439.00 PROF FEES PR CHANGE OF BLADDER TUBE SIMPLE 208.00 PROF FEES PR COMPLEX CYSTOMETROGRAM 293.00 PROF FEES PR URINE FLOW MEASUREMENT SIMPLE 297.00 PROF FEES PR CLOSE CYSTOSTOMY 1,092.00 PROF FEES PR EXCIS TESTIS EXTRAPARENCHYMAL LESION 1,358.00 PROF FEES PR LYSIS/EXCIS PENILE POSTCIRCUM ADHESIONS 581.00 PROF FEES PR REMOVAL TESTIS SIMPLE 1,006.00 PROF FEES PR REMOVAL TESTIS RADICAL 1,185.00 PROF FEES PR REDUCE TESTIS TORSION 3,193.00 PROF FEES PR BIOPSY VULVA/PERINEUM ONE LESN 219.00 PROF FEES PR BIOPSY VULVA/PERINEUM ONE LESN 269.00 PROF FEES PR ORCHIOPEXY ABD APPRCH ABD TESTIS 1,783.00 PROF FEES PR EXCIS VAGINAL CYST/TUMOR 428.00 PROF FEES PR FIT/INSERT INTRAVAG SUPPORT DEVICE 237.00 PROF FEES PR FIT/INSERT INTRAVAG SUPPORT DEVICE 392.00 PROF FEES PR FITTING OF DIAPHRAGM/CAP 393.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA CURETTAG 438.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAG W LOOP BX 1,335.00 PROF FEES PR BIOPSY/EXCISE CERVICAL LESION 624.00 PROF FEES PR BIOPSY/EXCISE CERVICAL LESION 437.00 PROF FEES PR ENDOCERVICAL CURETTAGE 0.00 PROF FEES PR ENDOCERVICAL CURETTAGE 551.00 PROF FEES PR LASER SURGERY OF CERVIX 592.00 PROF FEES PR BIOPSY OF UTERUS LINING 531.00 PROF FEES PR EXCIS UTERINE FIBROIDVAG APPRCH 2,264.00 PROF FEES PR VAG HYST UTERUS >250 GMS REM TUBE/OVARY 4,567.00 PROF FEES PR CATH/INJ HYSTEROSALPINGOGRAM 863.00 PROF FEES PR LAP MYOMECTOMY 1-4TOT WT 250 GMS 3,671.00 PROF FEES PR LAP SALPINGOSTOMY 3,507.00 PROF FEES PR FETAL NON-STRESS TEST 98.00 PROF FEES PR ANTEPARTUM HEAD MANIPULATION 449.00 PROF FEES PR ANTEPARTUM CARE ONLY >=7 VISITS 5,264.00 PROF FEES PR ROUT OB CARE C-SEC PREV C-SEC 5,038.00 PROF FEES PR INDUCED AB BY VAG SUPPOS 2,038.00 PROF FEES PR BIOPSY OF THYROID PERCUT 264.00 PROF FEES PR THYROIDECTOMY 5,067.00 PROF FEES PR BURR HOLE EVAC SUBDUR/EXTRA HEMATOMA 21.00 PROF FEES PR INJ FORAMEN L/S ADDL LEVELS WITH FLUORO OR CT 201.00 PROF FEES PR INSERT/REPLAC PERIP/GASTRIC NEUROSTIM RECEIVE 1,411.00 PROF FEES PR REVISE ULNAR NERVE AT WRIST 3,063.00 PROF FEES PR REMOVE FB EYE SUPERF CONJUNC 292.00 PROF FEES PR HEP B VAC DIAL/IMMUNOSUP 3 DOSE IM 204.00 PROF FEES PR HEPATITIS B VACCINE ADULT IM 3 DOSE SCHEDULE 83.00 PROF FEES PR SPEECH THRESHOLD AUDIOMETRY 48.00 PROF FEES PR INCIS/DRAIN SCROTUM TESTIS EPIDIDYM 987.00 PROF FEES PR CONDITIONING PLAY AUDIOMETRY 152.00 PROF FEES PR SELECT PICTURE AUDIOMETRY 124.00 PROF FEES PR HEARING AID EXAM MONAURAL 155.00 PROF FEES PR GLUCOSE MONITORING 72 HRS SQ SENSOR 411.00 PROF FEES PR CHEMOTHER CNS W LUMBAR PUNCTURE 389.00 PROF FEES PR THERAPEUTIC EXERCISES EA 15 MIN 101.00 PROF FEES PR MANUAL THER TECH 1+ REGIONS EA 15 MIN 92.00 PROF FEES PR THERAPEUTIC ACTIVITIES EA 15 MIN 261.00 PROF FEES PR WORK HARDENING/CONDN EA ADDL HR 260.00 PROF FEES PR DESTRUCTION LESION(S)VULVA SIMPLE 555.00 PROF FEES PR OSTEOPATHIC MANIP 1-2 BODY REGN 176.00 PROF FEES PR OSTEOPATHIC MANIP 9-10 BODY REGN 113.00 PROF FEES PR DESTRUCTION LESION(S)VULVA EXTENSIVE 853.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 2 94.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 2 94.00 PROF FEES PR FIRST OB VISIT-LEVEL 5 NEW PT 888.00 PROF FEES PR SUBSEQUENT HOSPITAL CARE LEVL 1 162.00 PROF FEES PR SUBSEQUENT HOSPITAL CARE LEVL 3 408.00 PROF FEES PR OBSERV/HOSP SAME DATE LEVL 1 538.00 PROF FEES PR CRITICAL CARE EA ADDL 30 MIN 482.00 PROF FEES PR DESTROY VAGINAL LESION(S) SIMPLE 716.00 PROF FEES PR HOME HEALTH CARE SUPERV 30+ MIN 179.00 PROF FEES PR FIRST OB VISIT-LEVEL 5 NEW PT 444.00 PROF FEES PR FIRST OB VISIT-LEVEL 5 NEW PT 444.00 PROF FEES PR DESTROY VAGINAL LESION(S) EXTENSIVE 2,481.00 PROF FEES PR PREVENTIVE VISIT EST 65 AND OVER 239.00 PROF FEES PR PREVENTIVE VISIT EST 65 AND OVER 239.00 PROF FEES PR PREVENT COUNSEL INDIV 15 MIN 138.00 PROF FEES PR PREVENT COUNSEL INDIV 30 MIN 125.00 PROF FEES PR PREVENT COUNSEL INDIV 45 MIN 183.00 PROF FEES PR FOREIGN BODY REMOVAL FROM BLADDER 341.00 PROF FEES PR GROUP THERAPY 180.00 PROF FEES PR FIRST OB VISIT-LEVEL 3 EST PT 212.00 PROF FEES PR BUPIVACAINE HCL 2CC PA NDC:00074161050 69.00 PROF FEES PR INSERT NON TUNNEL CVCATH OVER 5 YRS 936.00 PROF FEES PR MENINGOCOCCAL (MENACTRA) VACCINE IM 479.00 PROF FEES PR GI TRACT IMAGE CAPSULE ENDO W MD I&R 3,033.00 PROF FEES PR POST-PARTUM 6 WK VISIT -$0 0.00 PROF FEES HCHG OT FLUIDOTHERAPY 68.00 PROF FEES HCHG OT THERAPEUTIC ACTIVITY 15MIN 261.00 PROF FEES PR OCH AUDIOGRAM 43.00 PROF FEES PR LAP GASTRIC BYPASS ROUX-EN-Y 12,230.00 PROF FEES PR ESOPH BALLOON DISTENSION W PROVOCATION WHEN PERFORMED 569.00 PROF FEES PR ALBUTEROL UNIT DOSE 15.00 PROF FEES PR HEARING AID MOLD EACH 0.00 PROF FEES PR INITIAL NURSING FAC CARE PER DAY HIGH MDM 423.00 PROF FEES PR SUBSEQ NURSING FAC CARE PER DAY SF MDM 106.00 PROF FEES PR SUBSEQ NURSING FAC CARE PER DAY LOW MDM 164.00 PROF FEES PR SUBSEQ NURSING FACILITY CARE PER DAY MOD MDM 216.00 PROF FEES PR PELVIC EXAMINATION W ANESTH 673.00 PROF FEES PR EPIDERM AUTOGRAFT TRUNK ARMS LEGS 1ST 100 SQ CM OR LESS/ONE PERC BODY AREA INFANT/CHILD1,922.00 PROF FEES PR CHEMODENERVATION OF ECCRINE GLANDS BOTH AXILLAE 79.00 PROF FEES PR ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITIAL ENC 15 MIN 114.00 PROF FEES PR ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITIAL ENC 15 MIN 112.00 PROF FEES PR ULTRASOUND GUIDE NEEDLE PLACEMENT 531.00 PROF FEES PR OPEN TREAT DIST RADIAL FX W INT FIX 3 OR MORE FRAG 4,188.00 PROF FEES PR EXHALED NITRIC OXIDE MEASURE 42.00 PROF FEES PR CYSTO W BLADDER NECK INCISION 341.00 PROF FEES HCHG HFO WO JOINTS PREFAB CUSTOM FIT PR20 102.00 PROF FEES PR INSERT TUN CV CATH W/O PORT >5YRS CLINIC 3,213.00 PROF FEES PR LAP REMOVAL OF IUD 6,884.00 PROF FEES PR EXC ABD TUM 5 CM OR LESS 2,603.00 PROF FEES PR TLH UTERUS 250 G OR LESS 3,302.00 PROF FEES PR PHONE E&M EST PATIENT 5-10 MIN 71.00 PROF FEES PR ADJ GASTRIC BAND DIAM SUBQ PORT 576.00 PROF FEES PR ANKLE CONTROL ORTHOSIS PREFAB OTS 104.00 PROF FEES PR MEDICATION THERAPY MGMT EA ADDL 15 MIN 35.00 PROF FEES PR NEWBORN CARE SUBSEQUENT DAY 116.00 PROF FEES PR INIT NEWBORN CARE HOSP BIRTH CENTER SAME 285.00 PROF FEES PR EKG TRACING FOR INTITAL PREV-MEDICARE 198.00 PROF FEES PR LAP RPR FEMORAL HERNIA 4,845.00 PROF FEES PR WHO COCKUP NONMOLDED PREFAB OTS 42.00 PROF FEES PR PSYCHOTHERAPY FAMILY W PATIENT 50 MIN 413.00 PROF FEES PR PSYCHOTHERAPY FAMILY WO PATIENT 50 MIN 423.00 PROF FEES PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM 850.00 PROF FEES PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM 1,933.00 PROF FEES PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM 1,832.00 PROF FEES PR REMOVAL OF SPINAL NEUROSTIM PERC ARRAYS INC FLUORO 1,328.00 PROF FEES PR INJ PARAVERTEBRAL FACET JOINT CERVICAL OR THORACIC SINGLE LEVEL WITH FLUORO OR438.00 CT PROF FEES PR INJ PARAVERTEBRAL FACET JOINT CERVICAL OR THORACIC SECOND LEVEL WITH FLUORO OR213.00 CT PROF FEES PR LAP ABD EXPLORE DEBRIDE PLACE DRAIN 4,187.00 PROF FEES PR OB LIMITED 1 OR MORE FETUSES 158.00 PROF FEES PR OTOPLASTY EARLOBE PLASTIC 1,077.00 PROF FEES PR SCOPE RPR ROTATOR INTERVAL 3,960.00 PROF FEES PR ADM VACC WITH COUNSELING TO AGE 18 ANY ROUTE 80.00 PROF FEES PR LAP EXCISION PERITONEAL LESION 4,187.00 PROF FEES PR REMOVAL VAGINAL FB W ANESTH 317.00 PROF FEES PR CHICKEN POX VACC LIVE SQ 0.00 PROF FEES PR SUBSQNT OBSERV CARE TO 15 MIN 119.00 PROF FEES PR FLU VACC TRIVALENT IIV3 SV 0.5 ML IM 0.00 PROF FEES PR FLU VACC ENHANC IMMUNOG 132.00 PROF FEES PR HEP A VACC ADULT IM 248.00 PROF FEES PR HIB VACC PRP-T IM 0.00 PROF FEES PR PERORAL ENDOSCOPIC MYOTOMY (POEM) 4,049.00 PROF FEES PR LAP CECECTOMY WO TERMINAL ILEUM AND WO ILEOCOLOSTOMY 7,924.00 PROF FEES PR LAPAROSCOPIC GASTROPEXY 13,156.00 PROF FEES PR US BIOPSY BREAST INC MARKER 1ST LESION W GUIDE 655.00 PROF FEES PR XR STEREO BREAST LOC PERC MARKER EA ADDL W GUIDE LT 414.00 PROF FEES PR CHEMODENERV EACH ADDL EXTREM 1 TO 4 MUSCLES 380.00 PROF FEES PR CHEMODENERV TRUNK 6 OR MORE MUSCLES 541.00 PROF FEES PR ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH 347.00 PROF FEES PR ADMIN VACC W COUNS TO 18 YRS INIT ANY RTE 80.00 PROF FEES PR ADMIN VACC INIT INTRANASAL/ORAL 80.00 PROF FEES PR AIRHEEL PLANTAR FASCIITIS PR20 AFFILIATE ONLY 53.00 PROF FEES PR BRIEF ALCOHOL MISUSE COUNSEL 98.00 PROF FEES PR INJ DENOSUMAB 1 MG 68.00 PROF FEES PR COLONOSCOPY FLEXIBLE W BAND LIGATION(S) (EG HEMORRHOIDS) 1,801.00 PROF FEES PR TAP BLCK ABD PLN BLCK RECTUS BLCK UNI INJ W IMG GUID 357.00 PROF FEES PR PERC KYPHOPLASTY THORACIC/LUMBAR EA ADDL W GUIDE 10,402.00 PROF FEES PR HPV VIRUS VACCINE 9 VAL IM 480.00 PROF FEES PR APP TOPICAL FLUORIDE VARNISH 54.00 PROF FEES PR ADVANCED CARE PLAN EACH ADDL 30 MIN 166.00 PROF FEES PR SURG TREATMENT OF MISCARRIAGE CLINIC 1,461.00 PROF FEES PR HYSTEROSALPINGOGRAM 2,037.00 PROF FEES HCHG OT EVAL LOW COMPLEXITY 191.00 PROF FEES PR OT EVAL MOD COMPLEXITY 248.00 PROF FEES PR INJ EPIDUR INTERLAM SUBA CERV THOR W GUIDE 3,139.00 PROF FEES PR REMOVAL IMPLNT ESPHGL SPHINCTER DEVICE 1,386.00 PROF FEES PR MODERATE SED SAME PROVIDER > 5 YRS 1ST 15 MINUTES 89.00 PROF FEES PR ABI LIMITED 565.00 PROF FEES PR TANGENTIAL BIOPSY SKIN SINGLE LESION 76.00 PROF FEES PR TANGENTIAL BIOPSY SKIN SINGLE LESION 98.00 PROF FEES PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W PROGRAMMING 414.00 PROF FEES PR FETAL NON-STRESS TEST 324.00 PROF FEES ADV CARE PLAN DISCUSSED AND NO ALT DECISION MAKER DOCUMENTED 0.01 PROF FEES PB CBC W/DIFF 120.00 PROF FEES URINALYSIS NO MICROSCOPIC CUY RHH ONLY 95.00 PROF FEES HCHG GENERAL LAB 8751701 LC 260.00 PROF FEES PB FOLIC ACID 110.00 PROF FEES PB BABESIA MICROTI ANTIBODY LC 199.00 PROF FEES PR DESTROY PARAVERTEB W IMAGING GUIDANCE C/T SINGLE 980.00 PROF FEES PB COPPER, SERUM LC 232.00 PROF FEES PB LEAD HEAVY METALS PROFILE II, BLOOD LC 48.00 PROF FEES PB ANTIHISTONE ANTIBODIES LC 311.00 PROF FEES PR DESTROY PARAVERTEB W IMAGING GUIDANCE C/T ADDL JOINT 442.00 PROF FEES PB BLASTOMYCES ANTIGEN LC 62.00 PROF FEES PR KO IMMOB CANVAS LONG PREFAB OTS PR30 47.00 PROF FEES PR LAP VERTICAL BANDED GASTROPLASTY TAKEN DOWN 13,156.00 PROF FEES PR LAP INCISION INFARCTED FAT ABD WALL APPY 4,187.00 PROF FEES PR ARTH REMPLISSAGE HILL SACHS LESION DEFECT PSTR PROX HUMERUS 3,960.00 PROF FEES PR FLU VACC QUADRIVALENT IIV4 SV PF 0.5 ML IM 41.00 PROF FEES PR REVISION OF J G ANASTOMOSIS WITH ENDOSCOPIC APOLLO TECHNIQUE 3,131.00 PROF FEES PR DESTROY PARAVERTEB W IMAGING GUIDANCE L/S SINGLE 968.00 PROF FEES PR DESTROY PARAVERTEB W IMAGING GUIDANCE L/S ADDL JOINT 404.00 PROF FEES PR PREMIUM HA MONO BTE 0.00 PROF FEES PR LAP REMOVAL GASTROSTOMY TUBE 13,156.00 PROF FEES PR TOPICAL FLUORIDE VARNISH APPLICATION 42.00 PROF FEES HCHG PROTECTOR HEEL ELBOW PR5 AFFILIATE ONLY 20.00 PROF FEES HCHG FO PIP DIP W JOINT SPRING PREFAB OTS PR80 133.00 PROF FEES PR SLING PR30 AFFILIATE ONLY 44.00 PROF FEES PR BX LYMPH NODE W DYE ID 2,366.00 PROF FEES PB CYCLOSPORINE AHL 570.00 PROF FEES PR PSYCHOTHERAPY 45 MIN PATIENT 339.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 60 MIN 442.00 PROF FEES PR NERVE CONDUCTION STUDIES 1-2 235.00 PROF FEES PR GI TRANSIT AND PRESSURE WIRELESS CAP MEASURE INTERP REPORT 3,250.00 PROF FEES PB STOOL PATHOGEN MULTIPLEX PANEL 593.00 PROF FEES PB TRICHOMONAS PCR AFFILIATE ONLY 162.00 PROF FEES PR REPAIR NERVE W ALLOGRAFT EACH NERVE FIRST STRAND 1,460.00 PROF FEES PR NUTRITION COUNSELING DIETITION VISIT AFFILIATE ONLY 156.00 PROF FEES PR PT EDUCATION NOC GROUP AFFILIATE ONLY 78.00 PROF FEES RAD CT CHEST WO LOW DOSE 78.00 PROF FEES PR TRIM DYSTROPHIC NAILS ANY NUMBER 137.00 PROF FEES (IA) PR INJ PEN G BENZ/PRO UP TO 600U 298.00 PROF FEES (IA) PR INJ PEN G BENZ/PRO UP TO 1.2 MIU 467.00 PROF FEES PR INJ PROCHLORPERAZINE TO 10 MG 73.00 PROF FEES PR METHYLPREDNISOLONE ACETATE-80 MG 56.00 PROF FEES PR INJ DIPHENHYDRAMINE HCL TO 50 MG 10.00 PROF FEES PR INJ HEPARIN SODIUM PER 1000 UNITS 15.00 PROF FEES PR INJ SUMATRIPTAN SUCCINATE 6 MG/PHYS 200.00 PROF FEES PR DISPENSING FEE MONAURAL HEARING AID 562.00 PROF FEES PR ACNE SURGERY OF SKIN ABSCESS 142.00 PROF FEES PR DRAIN SKIN ABSCESS COMPLIC 350.00 PROF FEES PR DRAIN SKIN ABSCESS COMPLIC 297.00 PROF FEES PR DRAIN PILONIDAL CYST SIMPL 571.00 PROF FEES PR REMOVE FOREIGN BODY SIMPLE 715.00 PROF FEES PR REMOVE FOREIGN BODY COMPLIC 885.00 PROF FEES PR PUNCTURE DRAINAGE OF CYST/HEMATOMA 142.00 PROF FEES PR DEBRIDE TO BONE FIRST 20 SQ CM 1,454.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION 2-4 148.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION>4 285.00 PROF FEES PR REMOVAL SKIN TAGS EA ADDL 10 85.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM TRUNK ARM LEG 280.00 PROF FEES PR SHAV SKIN LESION OVER 2.0 CM S/N/H/F/GENIT 313.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM FACE EARS EYELIDS 483.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM TRUNK ARM LEG 292.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM TRUNK ARM LEG 451.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM SCALP NECK HANDS FEET 396.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM SCALP NECK HANDS FEET 508.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM SCALP NECK HANDS FEET 374.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM FACE EARS EYELIDS 437.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM FACE EARS EYELIDS 525.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM FACE EARS EYELIDS 785.00 PROF FEES PR EXC SWEAT GLAND LESN AXILL SIMPL 1,454.00 PROF FEES PR EXC SWEAT GLAND LESN INGUIN SIMPL 2,039.00 PROF FEES PR EXC SKIN MALIG 2.1-3 CM TRUNK ARM LEG 1,118.00 PROF FEES PR EXC SKIN MALIG 1.1-2 CM FACE EARS EYELIDS 1,198.00 PROF FEES PR DEBRIDEMENT OF NAIL(S) 1-5 404.00 PROF FEES PR AVULSION OF NAIL PLATE EA ADDL 85.00 PROF FEES PR EXCISION OF NAIL FOLD TOE 182.00 PROF FEES PR REMOVAL W/ REINSERT DRUG IMPLANT DEVICE 900.00 PROF FEES PR REPAIR SUPERF WOUND BODY 20.1-30 CM 853.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS < OR = 2.5 CM 368.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS 7.6-12.5 CM 322.00 PROF FEES PR CLOSURE SUPERF WND DEHIS SIMPLE 370.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 20.1-30 CM 761.00 PROF FEES PR REPAIR INTERMED WOUND FACE EARS EYELIDS 7.6-12.5 CM 813.00 PROF FEES PR ADJ TISS XFER LID NOSE EAR <10SQCM 3,488.00 PROF FEES PR DESTROY NERVE OTHER PERIPH NERVE 307.00 PROF FEES PR DESTR MALIG FACE NOSE LIP 1.1-2 CM 287.00 PROF FEES PR PUNCTURE ASPIR BREAST CYST EA ADDL 75.00 PROF FEES PR EXCISE BREAST DUCT FISTULA 1,627.00 PROF FEES PR REMOVAL OF IMPLANT MATERIAL 2,011.00 PROF FEES PR DRAIN/INJ MAJOR JOINT/BURSA HIP KNEE WO US GUIDE 297.00 PROF FEES PR REMOVAL SUPERFICIAL IMPLANT 1,566.00 PROF FEES PR APPLY BONE UNIPLANE EXT FIX DEV 2,373.00 PROF FEES PR REMOVE BONE FOR GRAFT MINOR 2,408.00 PROF FEES PR EXCISION SUBQ SHLDR TUMOR<3CM 1,047.00 PROF FEES PR PARTIAL REMOVAL CLAVICLE 1,263.00 PROF FEES PR PART EXCISION CLAVICLE 1,789.00 PROF FEES PR REPAIR BICEPS LONG TENDON 4,023.00 PROF FEES PR CLOSED TX SCAPULA FX 517.00 PROF FEES PR OPEN TX GR TUBEROSITY FX 3,667.00 PROF FEES PR INCIS/DRAIN ARM/ELBOW INFECT BURSA 1,192.00 PROF FEES PR RADICAL RESECT ELBOW CONTRAC RELEAS 2,540.00 PROF FEES PR REMOVAL ARM/ELBOW F.B.SUPERFICIAL 470.00 PROF FEES PR ARTHROPLASTY ELBOW TOTAL PROSTH REPL 3,134.00 PROF FEES PR CLOSED TX MID HUMERUS FX MANIPULATN 1,531.00 PROF FEES PR OPEN FIXATN MID HUMERUS FRACTURE 4,105.00 PROF FEES PR OPEN TX HUM SUPRACONDY FX INTER EXTN 3,804.00 PROF FEES PR CLOSED TX HUMER EPICONDYLR FX MANIP 1,456.00 PROF FEES PR CLOSED TX ELBOW DISLOCATION 1,296.00 PROF FEES PR EXCIS PRIMARY GANGLION WRIST 2,213.00 PROF FEES PR EXCIS DISTAL ULNA PART/COMPLETE 931.00 PROF FEES PR REMOVE FOREARM/WRIST FOREIGN BODY 2,029.00 PROF FEES PR REPAIR FOREARM EXT TEND SHEATH GRAFT 1,452.00 PROF FEES PR REVISE WRIST JOINTCARPAL INSTABIL 2,696.00 PROF FEES PR ARTHROPLASTY WRIST JT 1,820.00 PROF FEES PR OPEN TX MID RADIAL FX DISLO R U JT 4,737.00 PROF FEES PR OPEN TX RAD SHFT FX & RADIOULN JT W FIX 2,052.00 PROF FEES PR CLOSED TX ULNA SHAFT FX MANIPULATION 674.00 PROF FEES PR CLOSED TX DIST RAD ULNA FX 669.00 PROF FEES PR CLOSED TX NAVICULAR FX 707.00 PROF FEES PR CLOSED TX CARPAL FX EXCEPT SCAPHOID/NAVICULAR 376.00 PROF FEES PR FUSION INTERCARPAL 1,907.00 PROF FEES PR AMPUTATION TRANSMETACARPAL 2,756.00 PROF FEES PR DECOMPRESS FASCIOTOMY FINGR/HAND 2,288.00 PROF FEES PR REPAIR EXTEN TENDON DORSUM FINGER EA 2,453.00 PROF FEES PR TRANSPLANT W GRAFT HAND TENDON 2,831.00 PROF FEES PR OPEN REPAIR THUMB FX DISLOC 3,463.00 PROF FEES PR CLOSED TX MCP DISLOC 1,369.00 PROF FEES PR FUSION FINGER JOINT 1,259.00 PROF FEES PR AMPUTATE METACARPAL W FINGER 3,501.00 PROF FEES PR DRAINAGE OF HIP JOINT 4,579.00 PROF FEES PR CLOSED TX PROX/NECK FEMUR FX 1,453.00 PROF FEES PR CLOSED TX GR TROCHANTERIC FX 1,697.00 PROF FEES PR REMOVE FOREIGN BODY KNEE/THIGH DEEP 2,423.00 PROF FEES PR REPAIR CRUCIATE LIGAMENT KNEE 2,607.00 PROF FEES PR CLOSED TX FEMUR SHAFT FX 2,049.00 PROF FEES PR CLOSED TX CONDYLAR FX 1,336.00 PROF FEES PR CLOSED TX CONDYLAR FX 1,065.00 PROF FEES PR CLOSED TX FEMUR DISTAL 1,080.00 PROF FEES PR CLOSED TX FEMUR DISTAL W MANIP 2,034.00 PROF FEES PR CLOSED TX PATELLA FX 735.00 PROF FEES PR CLOSED TX TIBIAL PLATEAU FX 1,478.00 PROF FEES PR EXCIS BENIGN LESN TIB/FIB 4,198.00 PROF FEES PR CLOSED TX TIBIA SHAFT FX 849.00 PROF FEES PR CLOSED TX TIBIA SHAFT FX MANIPULATN 2,226.00 PROF FEES PR CLOSED TX PROX SHAFT FIB FX MANIP 1,268.00 PROF FEES PR OPEN TX WEIGHTBEAR TIB FIX TIB ONLY 5,758.00 PROF FEES PR AMPUTATION LOW LEG THRU TIB/FIB 4,170.00 PROF FEES PR REPAIR 5TH TOE COCK-UP 1,238.00 PROF FEES PR REPAIR HALLUX RIGIDUS WO IMPLANT 2,890.00 PROF FEES PR CLOSED TX METATARSAL FX 776.00 PROF FEES PR CLOSED TX BIG TOE FRACTURE 516.00 PROF FEES PR CLOSED TX TOE FX 454.00 PROF FEES PR FUSION BIG TOE MTP JT 1,593.00 PROF FEES PR APPLY LONG ARM CAST 137.00 PROF FEES PR APPLY LONG ARM SPLINT 361.00 PROF FEES PR APPLY LONG LEG CAST 332.00 PROF FEES PR APPLY LOWER LEG SPLINT 304.00 PROF FEES PR REMOVE/REVISN FULL ARM/LEG CAST 367.00 PROF FEES PR KNEE SCOPE PART SYNOVECT 4,580.00 PROF FEES PR KNEE SCOPE SHAVE ARTICULAR CART 4,248.00 PROF FEES PR KNEE SCOPE MED W LAT MENISCECT WWO DEBRIDE/SHAVE ANY COMP(S) 5,654.00 PROF FEES PR KNEE SCOPE AID ANT CRUCIATE REPAIR 8,573.00 PROF FEES RAD CT CHEST LOW DOSE WO CONTRAST SCREEN 1,043.00 PROF FEES PR REMOVAL PARIETAL PLEURA 1,980.00 PROF FEES PR EXPLOR POSTOP BLEED INFEC CLOT-EXTR 1,558.00 PROF FEES PR VENIPUNCTURE > 3 MD SKILL DX OR TX PURP 63.00 PROF FEES PR INSERT CATH ART PERCUT SHORT TERM 305.00 PROF FEES PR REVISE AV FISTULA W/O THROMBECTOMY 1,662.00 PROF FEES PR BONE MARROW ASPIRATION(S) 405.00 PROF FEES PR BONE MARROW BIOPSY(IES) 890.00 PROF FEES PR LAP LYMPH NODE BX 2,307.00 PROF FEES PR INCISION OF TONGUE FOLD 824.00 PROF FEES PR REMOVE ESOPHAG DIVERTIC CERV APPRCH 4,692.00 PROF FEES PR EGD SUBMUCOSAL INJECTION 891.00 PROF FEES PR EGD FLEXIBLE FOREIGN BODY REMOVAL(S) 1,499.00 PROF FEES PR EGD BALLOON DILATION ESOPHAGUS LESS THAN 30 MM DIAM 2,610.00 PROF FEES PR REMOVE STOMACH PART DISTAL GASTRO DUOD 2,689.00 PROF FEES PR LAP GASTROSTOMY W O TUBE CONSTR 2,103.00 PROF FEES PR RECONSTRUCTION OF PYLORUS 4,692.00 PROF FEES PR PART REMOVAL COLON W ANASTOMOSIS 5,406.00 PROF FEES PR PART REMOVAL COLON W COLOPROCCOLOST 4,835.00 PROF FEES PR LAP SURG COLECTOMY WEND COLOST & CLOSUR 8,780.00 PROF FEES PR COLONOSCOPY THRU STOMA BIOPSY 1,679.00 PROF FEES PR REPAIR BOWELSKIN FISTULA 4,582.00 PROF FEES PR APPENDECTOMY RUPT APPENDX W ABSCESS 3,874.00 PROF FEES PR COLONOSCOPY REMOVE FOREIGN BODY(S) 2,325.00 PROF FEES PR COLONOSCPY FLEX W DIR SUBMUC INJ ANY SUBSTANCE 2,149.00 PROF FEES PR OB LESS THAN 14 WKS SINGLE GEST 1,304.00 PROF FEES PR I & D PERIANAL ABSCESSSUPERFICIAL 370.00 PROF FEES PR INCISE EXTERNAL HEMORRHOID 607.00 PROF FEES PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS 570.00 PROF FEES PR REMOVAL OF HEMORRHOID CLOT 512.00 PROF FEES PR REMOVE GALLBLADDER W CHOLANGIOGRAM 4,136.00 PROF FEES PR EXPLORATORY RETROPERITONEAL 2,110.00 PROF FEES PR LAP DIAGNOSTIC ABDOMEN 3,197.00 PROF FEES PR REPAIR ING HERNIA >5 TRS REDUCIBL 2,498.00 PROF FEES PR INCISE/DRAIN BLADDER 681.00 PROF FEES PR IRRIGATION OF BLADDER 505.00 PROF FEES PR INSERT TEMP INDWELLING CATH SIMPLE 342.00 PROF FEES PR CHANGE OF BLADDER TUBE SIMPLE 135.00 PROF FEES PR INSTILL ANTICANCER AGENT IN BLADDER 154.00 PROF FEES PR SIMPLE CYSTOMETROGRAM 1,492.00 PROF FEES PR SIMPLE CYSTOMETROGRAM 293.00 PROF FEES PR COMPLEX CYSTOMETROGRAM 1,836.00 PROF FEES PR URINE FLOW MEASUREMENT SIMPLE 345.00 PROF FEES PR ELECTRO-UROFLOWMETRY COMPLEX 431.00 PROF FEES PR DILATE URETHRA FEMALE INITIAL 131.00 PROF FEES PR DILATE URETHRA FEMALE SUBSEQUENT 530.00 PROF FEES PR DILATE URETHRA FEMALE SUBSEQUENT 397.00 PROF FEES PR OB LESS THAN 14 WKS EA ADDL GEST 341.00 PROF FEES PR I&D OF VULVA/PERINEUM ABSCESS 535.00 PROF FEES PR I&D BARTHOLIN GLAND ABSCESS 614.00 PROF FEES PR CONIZATION CERVIX LOOP ELECTRD 312.00 PROF FEES PR VAG HYST UTERUS >250 GMS 4,212.00 PROF FEES PR CATH/INJ HYSTEROSALPINGOGRAM 1,143.00 PROF FEES PR LAP VAG HYST UTERUS 250GMS/< 6,476.00 PROF FEES PR HYSTEROSCOPY DX SEP PROC 1,558.00 PROF FEES PR LAP SUBTOTAL HYSTER W CYSTOTOMIES 6,884.00 PROF FEES PR TREAT ECTOPIC PREG NON REMOVAL 4,174.00 PROF FEES PR CARE AFTER DELIVERY ONLY 576.00 PROF FEES PR SURG TREATMENT OF MISCARRIAGE HOSPITAL 1,461.00 PROF FEES PR INDUCED AB BY VAG SUPP W D&C/EVAC 1,717.00 PROF FEES PR THYROID LOBECTOMY UNILAT 4,071.00 PROF FEES PR INSERT/REPLAC STIM CRANIAL SUBQ 1 ARRAY 1,113.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID PARACERVIC UTERINE NERVE 298.00 PROF FEES PR INJ NERV BLOCK CELIAC PLEXUS 442.00 PROF FEES PR REVISE/REMOVE PERIPHERAL NEUROELECTRODE 1,256.00 PROF FEES PR EXCISE HAND/FOOT NEUROMA 2,641.00 PROF FEES PR REMOVE FB EYE CORNEA NO SLIT 171.00 PROF FEES PR RH IG FULL-DOSE IM 55.00 PROF FEES PR INTERPRETATION OF PSYCH RESULTS 132.00 PROF FEES PR PURE TONE AUDIOMETRY AIR 76.00 PROF FEES PR GASTROESOPHAGEAL REFLUX TEST 974.00 PROF FEES PR RHYTHM ECG WITH REPORT 61.00 PROF FEES PR COMPLETE EXTNL ECG CONTIN RHYTHM MONITOR UP TO 48 HRS 541.00 PROF FEES PR SPIROMETRY W VITAL CAPACITY 184.00 PROF FEES PR BRONCHOSPASM RESP DILATOR PRE/POST ADMIN 207.00 PROF FEES PR POS AIRWAY PRESSURE CPAP 305.00 PROF FEES PR SLEEP STUDY UNATTENDED 220.00 PROF FEES PR SOMATOSENSORY TEST UPPER LIMBS 335.00 PROF FEES PR ULTRASOUND THERAPY EA 15 MIN 77.00 PROF FEES PR WOUND DEBRIDEMNT NON-SELECTIVE EA 225.00 PROF FEES PR OSTEOPATHIC MANIP 1-2 BODY REGN 118.00 PROF FEES PR OSTEOPATHIC MANIP 3-4 BODY REGN 82.00 PROF FEES PR HYPERBARIC OXYGEN THERAPY 735.00 PROF FEES PR FIRST OB VISIT-LEVEL 3 EST PT 212.00 PROF FEES PR ESOPH IMPED FUNCTION TEST 882.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 3 212.00 PROF FEES PR INITIAL HOSPITAL CARE LEVL 2 557.00 PROF FEES PR OBSERV/HOSP SAME DATE LEVL 2 701.00 PROF FEES PR INPATIENT CONSULT LEVL 4 699.00 PROF FEES PR INPATIENT CONSULT LEVL 5 942.00 PROF FEES PR HOME VISIT NEW PATIENT LEVEL III 542.00 PROF FEES PR HOME VISIT NEW PATIENT LEVEL IV 408.00 PROF FEES PR PROLNG E/M OR PSYCHOTHERAPY SVC DIR CONTACT 1ST HR 131.00 PROF FEES PR PROLNG E/M OR PSYCHOTHERAPY SVC DIR CONTACT ADDL 30 MIN 126.00 PROF FEES PR PROLONGED SERV INPATIENT 1ST HR 339.00 PROF FEES PR PROLONGED SERVICE WO CONTACT EA ADD 30 MIN 183.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 3 212.00 PROF FEES PR PREVENTIVE VISIT NEW 65 AND OVER 257.00 PROF FEES PR PREVENTIVE VISIT EST INFANT < 1 YR 150.00 PROF FEES PR ESOPH IMPED FUNCT TEST >1 HR 873.00 PROF FEES PR PREVENT COUNSEL INDIV 30 MIN 231.00 PROF FEES PR PREVENT COUNSEL INDIV 60 MIN 170.00 PROF FEES PR LAP PROC SPLEEN UNLISTED 2,507.00 PROF FEES PR LAP REPAIR ZENKER'S DIVERTICULUM 4,214.00 PROF FEES PR PELVIC EXPLORATN MESH REMOVAL 0.00 PROF FEES PR GROUP THERAPY 250.00 PROF FEES PR PURE TONE SCREENING HEARING TEST AIR 62.00 PROF FEES PR REPLACE COMPLETE CVAD W SQ PORT SAME VENOUS ACCESS 4,591.00 PROF FEES PR RMV TUN CV ACCESS DEV W PORT OR PUMP 1,305.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID LUMBAR PLEXUS CONT INFUS 332.00 PROF FEES HCHG OT MANUAL THERAPY 15MIN 92.00 PROF FEES LOS INCL IN PROCEDURE 0.00 PROF FEES PR OCH DOT & BUS DRIVER PHYSICAL 162.00 PROF FEES PR ESOPH IMPED FUNCTION TEST 124.00 PROF FEES PR NEG PRESS WOUND TX =<50 W DME 447.00 PROF FEES PR INITIAL NURSING FAC CARE PER DAY SF OR LOW MDM 230.00 PROF FEES PR SURGICAL LAPAROSCOPY PROCTOPEXY 3,948.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF 2-4 PTS EA 30 MIN 0.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF, 5-8 PTS EA 30 MIN 0.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF, 5-8 PTS EA 30 MIN 0.00 PROF FEES PR SLING ARM W/ELBOW TAB 37.00 PROF FEES PR SPLINT 120.00 PROF FEES PR WOUND PREP CHILD INFANT TRK ARM LEG FIRST 100SQ CM 757.00 PROF FEES PR PARTIAL MASTECTOMY 2,227.00 PROF FEES PR OPEN TREAT FRACTURE DIST RAD EXTRA-ARTICUL W INT FIX 3,714.00 PROF FEES PR LAP INSERTION TUNNELED IP CATH 848.00 PROF FEES PR LSH UTERUS 250 G OR LESS 3,751.00 PROF FEES PR ARTHROSCOPY BICEPS TENODESIS 2,189.00 PROF FEES PR COMPREHENSIVE HEARING TEST 188.00 PROF FEES PR PHONE E&M EST PATIENT 11-20 MIN 100.00 PROF FEES PR ADJUSTMENT GASTRIC BAND (SSUT) 577.00 PROF FEES PR RNY OPEN REVISION (SSUT) 11,961.00 PROF FEES PR REFRACTIVE POST OP SUBSEQUENT NC 237.00 PROF FEES PR LO FLEXIBLE L1 <= L5 PREFAB OTS 141.00 PROF FEES PR KO IMMOB CANVAS LONG PREFAB OTS PR10 116.00 PROF FEES PR CAST BOOT CLOSED TOE 41.00 PROF FEES PR MEDICATION THERAPY MGMT NEW INITIAL 15 MN 75.00 PROF FEES PR PROG DUAL LEAD PACER IN PERSON W ANLYS, R&R BY MD 295.00 PROF FEES PR ATTENDANCE AT DELIVERY 270.00 PROF FEES PR LAP EXPLORATION W/SIDETOSIDE JEJUNOJEJUNOSTOMY 7,924.00 PROF FEES PR PSYCHOTHERAPY FAMILY WO PATIENT 50 MIN 334.00 PROF FEES PR STENGER TEST PURE TONE 62.00 PROF FEES PR NERVE CONDUCTION USING ELECTRODE ARRAYS WITH F-WAVE EA LIMB W INTERP/REPORT 292.00 PROF FEES PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM 1,710.00 PROF FEES PR EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM 1,772.00 PROF FEES PR LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH 8,425.00 PROF FEES PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES 1,212.00 PROF FEES PR TELEHEALTH INPT/ED CONSULT INITIAL 50 MIN 297.00 PROF FEES PR REVISION OR REPLACEMENT SPINAL NEUROSTIM PERC INC FLUORO 1,739.00 PROF FEES PR ACOUSTIC REFLEX TESTING 33.00 PROF FEES PR OB TRANSVAGINAL 425.00 PROF FEES PR LAP REMVL ADJ GASTRIC DEVICE BARIATRIC 13,186.00 PROF FEES PR DOPPLER VELOCIMETRY UMBILICAL ARTERY 0.00 PROF FEES PR ACOUSTIC IMMITTANCE TESTING W TYMPANOMETRY/ACOUSTIC REFLEX THRESHOLD/DECAY TESTING71.00 PROF FEES PR SMG CARE > DELIV ONLY NC 576.00 PROF FEES PR EXCISE EXCESS SKIN ABDOMEN PLASTIC 4,718.00 PROF FEES PR SCOPE ANT/POST STABILIZATION CAPSULORRHAPHY 3,960.00 PROF FEES PR SCOPE EXCISION CALCIFIC TENDONITIS 3,960.00 PROF FEES PR SCOPE ACL OR PCL DEBRIDEMENT 3,960.00 PROF FEES PR LAP PARTIAL DUODENECTOMY ROBOT ASSIST 7,924.00 PROF FEES PR DTAP/HIB/IPV COMB VACC 0.00 PROF FEES PR HEP A/HEP B VACC ADULT 204.00 PROF FEES PR HEP A VACC ADULT IM 0.00 PROF FEES PR HEP B VACC PED/ADOL 3 DOSE 83.00 PROF FEES PR RABIES VACC ID 1,126.00 PROF FEES PR RABIES VACC IM 1,200.00 PROF FEES PR ROTAVIRUS VACC ORAL 3 DOSE 0.00 PROF FEES PR LAP PLICATION COMMON CHANNEL BILLIOPANCREATIC LIMB 7,924.00 PROF FEES PB CAFFEINE 67.00 PROF FEES PR LAP RPR CYSTIC DUCT STUMP LEAK 4,139.00 PROF FEES PR ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT 436.00 PROF FEES PR ENDOSCOPIC GASTROCNEMIUS RECESSION 3,960.00 PROF FEES PR EGD ABLATE TUMOR POLYP OR LESION W DILATION AND WIRE 2,024.00 PROF FEES PR ERCP BILIARY OR PANC DUCT STENT EXCHANGE W DIL AND WIRE 1,174.00 PROF FEES PR ADMIN VACC INITIAL 80.00 PROF FEES PR POST OP SURGICAL BOOT PR10 12.00 PROF FEES PR FILTERED SPEECH HEARING TEST 121.00 PROF FEES PR STENGER TEST SPEECH 175.00 PROF FEES PR SCREEN STD CHLAMYDIA GONORRHEA SYPHILIS HEP B 135.00 PROF FEES PR SKIN SUB GRAFT TRNK ARM LEG 317.00 PROF FEES PR LAP GASTRIC ACCESS FOR ERCP 13,156.00 PROF FEES PR LAP TRANSGASTRIC ERCP 2,211.00 PROF FEES PR COLNSCPY FLX W ENDO STNT PLCMNT INC PRE PST DIL GW PASS 670.00 PROF FEES PR TAP BLCK ABD PLN BLCK RECTUS BLCK BIL BY INJ W IMG GUID 219.00 PROF FEES PR HPV VIRUS VACCINE 9 VAL IM 0.00 PROF FEES PR ELECTRO HEARING AID TEST MONAURAL 155.00 PROF FEES PB CALRETICULIN EXON 9 1,200.00 PROF FEES PB OPIATE AND OPIOID CONFIRMATION UR 281.00 PROF FEES PR INJ EPIDUR INTERLAM SUBA LUMB SACRAL W GUIDE 541.00 PROF FEES PR REPAIR HALLUX RIGIDUS W IMPLANT 2,122.00 PROF FEES PR LAPAROSCOPIC IMPLNT ESPHGL SPHINCTER DEVICE INC CRUROPLASTY 1,374.00 PROF FEES PR OT ATTENDED ELECTRIC CURRENT THERAPY EACH 15 MIN AFF ONLY 86.00 PROF FEES PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W PROGRAMMING 1,480.00 PROF FEES PR OPEN BIOPSY EXCISION INGUINOFEMORAL NODES 884.00 PROF FEES PR PERC REPLACEMENT GTUBE NOT REQ REVISION GASTRO TRACT 499.00 PROF FEES PR PNEUMATIC WALK BOOT PREFAB OTS PR60 94.00 PROF FEES HCHG 5-HIAA,QUANT,24 HR URINE LC 171.00 PROF FEES HCHG EPSTEIN-BARR DNA QUANT, PCR LC 60.00 PROF FEES PB ALDOLASE LC 264.00 PROF FEES PB ANTI-MULLERIAN HORMONE (AMH) LC 100.00 PROF FEES PB CALCITONIN, SERUM LC 125.00 PROF FEES PB ARSENIC HEAVY METALS PROFILE II, BLOOD LC 158.00 PROF FEES PB IGG, SUBCLASSES (1-4) LC 176.00 PROF FEES PB ANTI-JO-1 LC 26.00 PROF FEES PB RH PHENOTYPE 93.00 PROF FEES PB SEX HORM BINDING GLOB, SERUM LC 68.00 PROF FEES PB REVERSE T3, SERUM LC 110.00 PROF FEES PB MIC MICROTITER 235.00 PROF FEES PB TISSUE LEVEL 5 TC ONLY 352.00 PROF FEES PB ANCA 94.00 PROF FEES PR UNIVERSAL THUMB SUPPORT SCRMC ONLY 116.00 PROF FEES PR ELEC EVAL HEARING AID TEST BINAURAL 155.00 PROF FEES PR CANDIDA 0.00 PROF FEES PR INR NO BILLING TRKG ONLY 0.00 PROF FEES PR LAP NISSEN FUNDOPLICATION TAKEDOWN OF GASTROSTOMY TUBE 13,156.00 PROF FEES PR ARTHO MICROFX HUMERUS HEAD 3,960.00 PROF FEES PR LAPAROSCOPY WITH REDUCTION OF RIGHT FALLOPIAN TUBE TORSION 550.00 PROF FEES PR XR CHOLANGIOGRAM OPERATIVE 83.00 PROF FEES PR WHFO WRIST GAUNTLET THUMB SPICA PR20 30.00 PROF FEES PR SLEEVE KNEE PR5 AFFILIATE ONLY 188.00 PROF FEES PR PREMIUM HA BINAURAL BTE 2U 0.00 PROF FEES PR WALKER PR210 AFFILIATE ONLY 239.00 PROF FEES PR ANKLE CONTROL ORTHOSIS PREFAB OTS PR70 101.00 PROF FEES PR ENDOVENOUS MECHANICAL ABLATION OF BILAT GRTR SAPHENOUS VEIN 5,667.00 PROF FEES PR SPLINT TENNIS ELBOW PR10 509.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 45 MIN 154.00 PROF FEES PR PSYCHOTHERAPY PATIENT 60 MIN 626.00 PROF FEES PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MIN 220.00 PROF FEES PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MIN 100.00 PROF FEES PR GI TRANSIT AND PRESSURE WIRELESS CAP MEASURE INTERP REPORT 2,782.00 PROF FEES PR SMELL ID TEST 0.00 PROF FEES PR LAPAROSCOPY ESOPHAGUS LINX AFFILIATE ONLY 1,362.00 PROF FEES PR DAVINCI TRACKING CODE HP ONLY 0.00 PROF FEES PR BIOVANCE PER SQ CM AFFILIATE ONLY 681.00 PROF FEES HEAD CT ORDERED FOR TRAUMA BY ED PROVIDER AFFILIATE ONLY 0.01 PROF FEES PR BAKRI BALLOON PLACEMENT AFFILIATE ONLY 3,375.00 PROF FEES PR INJ ZOSTER VACCINE RZV RECOMBINANT SUBUNIT ADJUVANTED FOR IM 515.00 PROF FEES PR ORTHOTIC/PROSTHETIC TRAIN UPR/LWR EXT TRUNK SUBQ 15 MIN 94.00 PROF FEES PR CHRONIC CARE MGMT SERVICE EA ADDL 20 MIN 78.00 PROF FEES PR VITAL CAPACITY TEST 369.00 PROF FEES PR NEEDLE INSERT WO INJ 3 OR MORE MUSCLES 42.00 PROF FEES PR LAP RPR SUPERFICIAL LACERATION RECTUM 0.00 PROF FEES PR PELVIC/BREAST CA SCREEN EXAM 133.00 PROF FEES PR DIABETES SELF-MGT INDIV OP EA 30 MIN 121.00 PROF FEES PR PHYSICIAN INITIAL CERTIFICATION FOR HHA 127.00 PROF FEES PR INJ CEPHAPIRIN SODIUM TO 1 GM 75.00 PROF FEES PR DEXAMETHASONE NA PHOSPATE-1 MG 8.00 PROF FEES PR INJ METHYLPRED NA SUCCINATE 40 MG 7.00 PROF FEES PR INJ TRIAMCINOLONE HEXACETONIDE 5 MG 5.00 PROF FEES PR DILTIAZEM IV 10MG 2CC NDC:55390056610 30.00 PROF FEES PR SCREEN PAP OBTAINING SPECIMEN 180.00 PROF FEES PR CAST SUPPLIES SHORT LEG CAST PEDIATRIC (0-10 YEARS) 104.00 PROF FEES PR EAR IMPRESSION EACH 21.00 PROF FEES PR DRAIN SKIN ABSCESS SIMPLE 386.00 PROF FEES PR DRAIN PILONIDAL CYST COMPLIC 294.00 PROF FEES PR INCISION AND DRAINAGE OF HEMATOMA/SEROMA OR FLUID 524.00 PROF FEES PR DEBRIDE INFECTED/ECZEMATOUS SKIN 149.00 PROF FEES PR DEBRIDE SKIN/SUBQ AT FX SITE 1,908.00 PROF FEES PR DEBRIDE TO BONE AT FX SITE 3,105.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION>4 155.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM S/N/H/F/GENI 158.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM TRUNK ARM LEG 391.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM TRUNK ARM LEG 642.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM TRUNK ARM LEG 845.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM TRUNK ARM LEG 669.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM SCALP NECK HANDS FEET 121.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM SCALP NECK HANDS FEET 622.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM SCALP NECK HANDS FEET 1,206.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM FACE EARS EYELIDS 313.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM FACE EARS EYELIDS 208.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM FACE EARS EYELIDS 454.00 PROF FEES PR EXC SWEAT GLAND LESN AXILL SIMPL 2,098.00 PROF FEES PR EXC SKIN MALIG < 0.5 CM SCALP NECK HANDS FEET 604.00 PROF FEES PR EXC SKIN MALIG OVER 4 CM FACE EARS EYELIDS 1,960.00 PROF FEES PR DEBRIDEMENT OF NAILS 6 OR MORE 123.00 PROF FEES PR DEBRIDEMENT OF NAILS 6 OR MORE 107.00 PROF FEES PR REMOVAL OF NAIL BED PERMANENT 511.00 PROF FEES PR REMOVAL OF NAIL BED PERMANENT 432.00 PROF FEES PR INJ INTO SKIN LESIONS <=7 330.00 PROF FEES PR INSERTION DRUG IMPLANT DEVICE 930.00 PROF FEES PR REPAIR SUPERF WOUND BODY 2.6-7.5 CM 414.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS 2.6-5 CM 188.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM < OR = 2.5CM 282.00 PROF FEES PR REPAIR COMPLEX WOUND SCALP EXTR EA ADDL 5CM OR LESS 586.00 PROF FEES PR DESTROY PREMALIGNANT LESION EA 2-14 20.00 PROF FEES PR DESTR MALIG FACE NOSE LIP <0.6 CM 400.00 PROF FEES PR PUNCTURE ASPIRATION BREAST CYST 287.00 PROF FEES PR REMOVAL OF FB MUSCLE SIMPLE 460.00 PROF FEES PR PULM FUNCT TEST PLETHYSMOGRAP 243.00 PROF FEES PR EXCISE TUMOR BACK OR FLANK<3CM 2,735.00 PROF FEES PR RAD RESEC SOFT TISS BACK/FLANK<5CM 4,884.00 PROF FEES PR INCIS/DRAIN SHLDR ABSC/HEMA DEEP 1,857.00 PROF FEES PR EXCISE/CURET BENIGN TUMR PROX HUMERUS 2,160.00 PROF FEES PR OPEN TX PROX HUMERUS FX 3,787.00 PROF FEES PR CLOSED TX GR TUBEROSITY HUM FX 924.00 PROF FEES PR SOMATOSENSORY TEST UPPER LIMBS 380.00 PROF FEES PR EXPLORE/DRAIN ELBOW FOR INFECT 912.00 PROF FEES PR EXCIS BENIGN HUMERUS LESN ALLOGRAFT 2,675.00 PROF FEES PR MUSC/TENDON REPAIR EA ARM/ELBOW 1,483.00 PROF FEES PR COGNITIVE TEST BY HC PRO PER HR 268.00 PROF FEES PR OPEN TX MONTEGGIA FX/DISLOC ELBOW 3,649.00 PROF FEES PR CLOSED TX RADIAL HEAD/NECK FX 899.00 PROF FEES PR CLOSED TX PROX ULNA FRACTURE 333.00 PROF FEES PR INCIS TENDON SHEATH RADIAL STYLOID 2,217.00 PROF FEES PR PART REMOVAL BONE RADIUS 1,260.00 PROF FEES PR REMOVAL OF PROX ROW CARPAL BONES 1,340.00 PROF FEES PR TRANSPLANT FOREARM/WRIST TENDON 3,530.00 PROF FEES PR OSTEOTOMY RADIUS DISTAL THIRD 2,496.00 PROF FEES PR OSTEOPLASTY RADIUS OR ULNA SHORTEN 1,665.00 PROF FEES PR CLOSED TX RADIAL SHAFT FX 599.00 PROF FEES PR CLOSED TX ULNA SHAFT FX 276.00 PROF FEES PR CLOSED TX RAD/ULNA SHAFT FX 960.00 PROF FEES PR PERCUT SKELETAL FIX ULNAR STYLOID FX 1,636.00 PROF FEES PR EXCIS SOFT TISSUE LESION HAND DEEP<1.5CM 1,711.00 PROF FEES PR PALMAR FASCIECTOMY 1,711.00 PROF FEES PR EXCIS FINGER TENDON FLEXOR/EXTENSOR EA 1,291.00 PROF FEES PR EXCIS BENIGN BONE LESN PHALANX 2,159.00 PROF FEES PR MANIPULATE FINGER JT W ANES EA 1,024.00 PROF FEES PR REPAIR EXTEN TENDON DISTAL INSERT OPEN 2,702.00 PROF FEES PR TENOLYSIS FLEX TENDON PALM FINGER EA 1,935.00 PROF FEES PR FIX COLLAT LIG MCP JT IP JT 916.00 PROF FEES PR CLOSED TX METACARPAL FX MANIP 1,428.00 PROF FEES PR OPEN TX METACARPAL FX 2,994.00 PROF FEES PR OPEN TX PROX MID FING OR THUMB SHFT FX 2,380.00 PROF FEES PR CLOSE TX DIST FINGR/THUMB FX 232.00 PROF FEES PR FUSION 1ST CARPOMETACARPAL JT 2,808.00 PROF FEES PR REMOVAL OF HIP PROSTHESIS COMPLEX 9,115.00 PROF FEES PR INJ SACROILIAC JOINT 536.00 PROF FEES PR TOTAL HIP ARTHROPLASTY 9,275.00 PROF FEES PR REVISE ACETABULAR PART OF TOTAL HIP 3,389.00 PROF FEES PR OPEN INTERN FIX ANTER PELV BONE FX UNI 2,126.00 PROF FEES PR CLOSED TX PROX/NECK FEMUR FX 623.00 PROF FEES PR CLOSED TX PROX/NECK FEMUR FX 830.00 PROF FEES PR OPEN FIX INTER SUBTROCH FX IMPLNT 6,032.00 PROF FEES PR FIX QUAD/HAMSTR MUSC RUPT PRIMARY 3,249.00 PROF FEES PR REVISION OF UNSTABLE PATELLA 4,139.00 PROF FEES PR OSTEOTOMY FEMUR SHAFT/SUPRACONDY 5,249.00 PROF FEES PR REVISE KNEE JOINT REPLACE 1 PART 10,663.00 PROF FEES PR REMOVAL OF KNEE PROSTHESIS 5,724.00 PROF FEES PR CLOSED TX FEMUR DISTAL 757.00 PROF FEES PR CLOSED TX PROX/SHAFT FIBULA FX 691.00 PROF FEES PR CLOSED TX BIMALLEOLAR FX 773.00 PROF FEES PR OPEN TX DIST TIB/FIB JT DISRUPT 3,261.00 PROF FEES PR AMPUTATION LOW LEG CIRCULAR 3,748.00 PROF FEES PR PART EXCIS 5TH METATARSAL HEAD 1,899.00 PROF FEES PR RESEC ONE TOE PHALANGEAL BASE EA 926.00 PROF FEES PR REPAIR BUNION ANY METHOD 3,459.00 PROF FEES PR CLOSED TX METATARSAL FX 264.00 PROF FEES PR AMPUTATION TOE MTP JT 1,832.00 PROF FEES PR APPLY LONG ARM CAST 423.00 PROF FEES PR APPLY FOREARM CAST 111.00 PROF FEES PR APPLY LONG ARM SPLINT 130.00 PROF FEES PR APPLY FINGER SPLINT STATIC 93.00 PROF FEES PR STRAPPING OF SHOULDER 304.00 PROF FEES PR APPLY LONG LEG SPLINT 223.00 PROF FEES PR SHLDR ARTHROSCOP SURG REPAIR SLAP LESION 6,460.00 PROF FEES PR SHLDR ARTHROSCOP SURG W/ROTAT CUFF REPAIR 8,088.00 PROF FEES PR WRIST ARTHROSCOP INTERN FIXATN 1,172.00 PROF FEES PR KNEE SCOPE FULL SYNOVECT 4,907.00 PROF FEES PR KNEE SCOPE MED OR LAT MENISCECT WWO DEBRIDE/SHAVE ANY COMP(S) 4,790.00 PROF FEES PR BRONCHOSCOPY DIAGNOSTIC W BRUSH 1,542.00 PROF FEES PR BRONCHOSCOPY BIOPSY 1,387.00 PROF FEES PR BRONCHOSCOPY THERAPEUTIC ASPIR PULM TREE W FLUORO SUBSQ 511.00 PROF FEES PR INSERT PULSE GEN SNGL LEAD 2,564.00 PROF FEES PR INSERT PULSE GEN DUAL LEADS 2,726.00 PROF FEES PR REPAIR OF RUPTURED SPLEEN 4,517.00 PROF FEES PR BONE MARROW ASPIRATION(S) 806.00 PROF FEES PR REPAIR TONGUE LACER 2.6CMOR MORE/COMPLX 731.00 PROF FEES PR DRAINAGE OF GUM LESION 463.00 PROF FEES PR EGD US EXAM SURGICAL ALTER STOM DUODENUM JEJUNUM 443.00 PROF FEES PR ERCP W/REMOVAL STONE BIL/PANCR DUCTS 1,024.00 PROF FEES PR LAP ESOPHAGOGAST FUNDOPLASTY 6,566.00 PROF FEES PR PLACEMENT NG/OG TUBE BY PHYSICIAN 92.00 PROF FEES PR GASTROPLASTY OBESITY OTHER 6,547.00 PROF FEES PR REDUCE VOLVULUS INTUSS INTERN HERNIA 3,963.00 PROF FEES PR BOWEL TO BOWEL ANASTOMOSIS 6,339.00 PROF FEES PR REMOVAL COLON/ILEOSTOMY 7,187.00 PROF FEES PR LAP SURG COLECTOMY WANAST WCOLOSTOMY 8,618.00 PROF FEES PR SMALL BOWEL ENDOSCOPY BIOPSY 374.00 PROF FEES PR APPENDECTOMY 2,644.00 PROF FEES PR SIGMOIDOSCOPY BIOPSY 704.00 PROF FEES PR COLONOSCOPY REMOVE TUM POLYP LESN HOT BPSY FORCEP 2,023.00 PROF FEES PR REMOVAL OF RECTAL MARKER 307.00 PROF FEES PR I&D PERIRECTAL ABSCESS 1,672.00 PROF FEES PR REMOVAL ANAL FISTULA SUBMUSCULAR 2,354.00 PROF FEES PR REMOVAL ANAL FISTULA COMPLEX/MULTI 2,569.00 PROF FEES PR PSYCHOLOGICAL TEST EVAL SVC FIRST HOUR 280.00 PROF FEES PR BILE DUCT ENDOSCOPY INTRAOPERATIVE 1,100.00 PROF FEES PR LAP BILIARY TRACT UNLISTED 4,139.00 PROF FEES PR PART REMOVE PANCREAS DISTAL SUBTOTAL 3,288.00 PROF FEES PR EXCISION OF UMBILICUS 1,687.00 PROF FEES PR REPAIR ING HERNIA 6MO-5YR REDUC 2,260.00 PROF FEES PR REPAIR FEMORAL HERNIA REDUCIBLE 3,002.00 PROF FEES PR SUTURE ABD WALLDEHIS/EVISCER 3,299.00 PROF FEES PR STRAIGHT CATHETERIZATION 105.00 PROF FEES PR INSERT TEMP INDWELLING CATH SIMPLE 98.00 PROF FEES PR ANAL/URINARY MUSCLE STUDY 244.00 PROF FEES PR INTRAABDOMINAL VOIDING PRESSURE TEST 249.00 PROF FEES PR CYSTOURETHROSCOPY 1,103.00 PROF FEES PR CIRCUMC CLAMP/BLOCK HOSPITAL 654.00 PROF FEES PR CIRCUMC OTHR <29 DAYS 505.00 PROF FEES PR DRAINAGE SCROTAL WALL ABSCESS 769.00 PROF FEES PR REMOVAL OF SPERM DUCT(S) 1,174.00 PROF FEES PR MARSUP BARTHOLIN GLAND CYST 1,216.00 PROF FEES PR PHYSICAL PERFORMANCE TEST 15 MIN EA 105.00 PROF FEES PR COLPOSCCERVIX W ADJ VAG W BX AND CURETTAG 391.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA CURETTAG 376.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAG W LOOP CONIZ 566.00 PROF FEES PR CAUTERIZATION CERVIX ELECTRO/THERMAL 629.00 PROF FEES PR REMOVAL OF CERVIX 1,283.00 PROF FEES PR SUPRACERV ABD HYSTERECTOMY 5,029.00 PROF FEES PR INSERT INTRAUTERINE DEVICE 695.00 PROF FEES PR CATH/INJ HYSTEROSALPINGOGRAM 279.00 PROF FEES PR HYSTEROSCOPY RESECT SEPTUM 1,486.00 PROF FEES PR LAP FULGURATE/EXCISE LESIONS 4,580.00 PROF FEES PR REMOVAL OF OVARY/TUBE(S) 3,571.00 PROF FEES PR DRAIN OVARIAN CYST(S)VAG APPRCH 1,252.00 PROF FEES PR TX ECTOP PREG BY SCOPE RMV TUBE OVRY 3,908.00 PROF FEES PR CESAREAN DELIVERY W POSTPARTUM CARE 6,478.00 PROF FEES PR ROUT OB CARE VAG DELIV PREV C-SEC 6,074.00 PROF FEES PR EVACUATE MOLE OF UTERUS 911.00 PROF FEES PR REMOVE BENIGN THYROID LESION 2,731.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID OTH PERIPH NERVE/BRANCH 287.00 PROF FEES PR INCISION IMPLANT NEUROELEC SACRAL NERVE 3,608.00 PROF FEES PR RELIEVE PRESSURE ON NERVE(S) 787.00 PROF FEES PR TRANSECT GREAT OCCIPITAL NERV 1,017.00 PROF FEES PR REMOVE EXT CANAL FOREIGN BODY 483.00 PROF FEES PR REMOVE FB EYE SUPERF CONJUNC 52.00 PROF FEES PR INTERPRETATION OF PSYCH RESULTS 311.00 PROF FEES PR ESOPHAGEAL MOTILITY STUDY 567.00 PROF FEES PR TYMPANOMETRY 82.00 PROF FEES PR OT PHYSICAL PERFORMANCE TEST 15 MIN EA AFFILIATE ONLY 105.00 PROF FEES PR PHONE CALL W EST PATIENT 5-10 MIN QUALIFIED HCP 50.00 PROF FEES PR VISUAL AUDIOMETRY (VRA) 95.00 PROF FEES PR HEARING AID CHECK BINAURAL 52.00 PROF FEES PR EVAL ORAL & PHARYNGEAL SWALLOW FUNCTION 349.00 PROF FEES PR SPIROMETRY W VITAL CAPACITY 20.00 PROF FEES PR BRONCHOSPASM RESP DILATOR PRE/POST ADMIN 168.00 PROF FEES PR VITAL CAPACITY TEST 349.00 PROF FEES PR ANALYZE NEUROSTIM COMPLX/PROG 212.00 PROF FEES PR CHEMOTHER CNS W LUMBAR PUNCTURE 915.00 PROF FEES PR ATTENDED ELECTRICAL STIMULATION EA 15 MIN 46.00 PROF FEES PR WORK HARDENING/CONDN 0-2 HR 584.00 PROF FEES PR WOUND DEBRIDEMNT NON-SELECTIVE EA 56.00 PROF FEES PR OSTEOPATHIC MANIP 9-10 BODY REGN 207.00 PROF FEES PR GLOBAL FOLLOW-UP VISIT NC 0.00 PROF FEES PR VISUAL ACUITY SCREENING 177.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 4 275.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 4 275.00 PROF FEES PR OBSERV/HOSP SAME DATE LEVL 3 874.00 PROF FEES PR HOSPITAL DISCHARGE DAY<= 30 MIN 283.00 PROF FEES PR HOSPITAL DISCHARGE DAY>30 MIN 413.00 PROF FEES PR INPATIENT CONSULT LEVL 2 385.00 PROF FEES PR CRITICAL CARE 30-74 MINUTES 1,072.00 PROF FEES PR NURSING FAC DISCHRGE DAY > 30 MIN 244.00 PROF FEES PR HOME VISIT NEW PATIENT LEVEL II 324.00 PROF FEES PR PROLONGED SERV INPATIENT EA ADDL 30 MIN 322.00 PROF FEES PR PHONE CALL W EST PATIENT 11-20 MIN QUALIFIED HCP 93.00 PROF FEES PR PHONE CALL W EST. PATIENT 21-30 MIN QUALIFIED HCP 137.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 5 312.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 1 96.00 PROF FEES PR PREVENTIVE VISIT EST 18-39 216.00 PROF FEES PR LAB LYSIS & RPR INCAR VENT HERNIA W MESH 4,844.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 5 312.00 PROF FEES PR OBSERVATION CARE DISCHARGE 281.00 PROF FEES PR INITIAL OBSERVATION CARE LEVL I 300.00 PROF FEES PR HEARING AID DIGITAL MONO BTE 0.00 PROF FEES PR INSRT PERIPH CV ACSDEV W PORTOVER 5 YR 6,340.00 PROF FEES PR DEBRIDE ABDOMINAL WALL 3,819.00 PROF FEES PR GASTROESOPHAGEAL REFLUX TEST 805.00 PROF FEES PR INR OFFICE OUTPT ESTAB LEVEL 1 54.00 PROF FEES PR ACTIVE WOUND EACH ADDL 20 SQ CM OR PART THEREOF 70.00 PROF FEES PR LAP SUPRACERVICAL HYSTERECTOMY SG260 6,884.00 PROF FEES PR ANNUAL NURSING FACILITY ASSESSMENT LOW TO MOD MDM 367.00 PROF FEES PR NURSING OV EST PT LEVEL 1 0.00 PROF FEES PR EPIDERM AUTOGRAFT TRUNK ARMS LEGS 1ST 100 SQ CM OR LESS/ONE PERC BODY AREA INFANT/CHILD1,065.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 2 188.00 PROF FEES PR ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITIAL ENC 15 MIN 112.00 PROF FEES PR SHOE POST OP 211.00 PROF FEES PR WHO COCKUP NONMOLDED PREFAB OTS PR10 15.00 PROF FEES PR BRACE ANKLE SWEDE O 120.00 PROF FEES PR ULTRASOUND GUIDE NEEDLE PLACEMENT 597.00 PROF FEES PR ULTRASOUND GUIDE FOR AMNIOCENTESIS 1,708.00 PROF FEES PR ESOPHAGEAL CAPSULE ENDOSCOPY W I&R 1,992.00 PROF FEES PR LAP GASTIC RESECTION 13,155.00 PROF FEES PR VENT MANAGEMENT HOSPITALIST TRKG 191.00 PROF FEES PR REPAIR ELBOW W DEB OPEN 1,706.00 PROF FEES PR CLOSED TX POST ANKLE FX 698.00 PROF FEES PR TLH W TUBES/OVAR 250 G OR LESS 3,607.00 PROF FEES PR TLH UTERUS OVER 250 G 4,081.00 PROF FEES PR FIRST OB VISIT LEVEL 2 EST PT 187.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 3 424.00 PROF FEES PR BEHAV CHNG SMOKING >3-10 MIN 33.00 PROF FEES PR FIRST OB VISIT-LEVEL 3 EST PT 424.00 PROF FEES PR PHONE E&M EST PATIENT 21-30 MIN 144.00 PROF FEES PR UNKNOWN CHARGE 0.00 PROF FEES PR CKI CONSULT NC 504.00 PROF FEES ENDOSCOPIC PANCREATOSCOPY 272.00 PROF FEES PR LAP VENT ABD HERN PROC COMP 3,437.00 PROF FEES PR LAP INCISIONAL HERNIA REPAIR 3,164.00 PROF FEES PR LAP INCISIONAL HERNIA RECUR COMP 4,556.00 PROF FEES PR PROG MULTI LEAD PACER IN PERSON W ANLYS, R&R BY MD 298.00 PROF FEES PR PROG MULTI LEAD PACER IN PERSON W ANLYS, R&R BY MD 173.00 PROF FEES PR MEDICARE WELCOME PREVENTIVE VISIT 269.00 PROF FEES PR INTRADETRUSOR BLADDER BOTOX INJECTIONS 341.00 PROF FEES PR PARTIAL COLECTOMY W/ILEOSTOMY TAKEDOWN 7,924.00 PROF FEES PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM 1,043.00 PROF FEES PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM 1,840.00 PROF FEES PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM 3,153.00 PROF FEES PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 OR MORE CM 1,820.00 PROF FEES PR EXC RCT TUM INCL MUSCULARIS PROPRIA 1,886.00 PROF FEES PR RPR ANORECTAL FISTULA W/ PLUG 912.00 PROF FEES PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES 921.00 PROF FEES PR COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE 1,690.00 PROF FEES PR INJ 1MG HYALURONAN/DERIVATIVE (SYNVISC/SYNVISC ONE) INTRA-ARTICULAR 44.00 PROF FEES PR INJ PARAVERTEBRAL FACET JOINT CERVICAL OR THORACIC THIRD OR ADDL LEVEL WITH FLUORO213.00 OR CT PROF FEES PR LAP GASTRIC BYPASS W SI BARIATRIC 13,643.00 PROF FEES PR BIOPHYSICAL PROFILE W NST 1,271.00 PROF FEES PR OB EQUAL OR GREATER THAN 14 WKS EA ADDL 341.00 PROF FEES PR PELVIS TRANSVAGINAL NON OB 425.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 4 550.00 PROF FEES PR LAP OMENTAL PATCH APPLIED ULCER 4,187.00 PROF FEES PR SCOPE SCAPULOR THORACIC DECOMPRESSION 3,960.00 PROF FEES PR SUBSEQUENT ANNUAL WELLNESS VISIT 289.00 PROF FEES PR INJ ADRENALIN EPINEPHRINE 0.1 MG 784.00 PROF FEES PR INJ PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE 100000 UNITS 7.00 PROF FEES PR SUBSQNT OBSERV CARE TO 35 MIN 258.00 PROF FEES PR HEP B VACC ADOL 2 DOSE IM 83.00 PROF FEES PR HUMAN PAPILLOMA (HPV) VACC 0.00 PROF FEES PR HUMAN PAPILLOMA (HPV) VACC 480.00 PROF FEES PR MENINGOCOCCAL (MENVEO) VACC IM 480.00 PROF FEES PR LAP STRICTUREPLASTY 7,924.00 PROF FEES PR ROTAVIRUS VACC ORAL 2 DOSE 0.00 PROF FEES PR INJECTION TARSAL TUNNEL 288.00 PROF FEES PR SUPPORT TENNIS ELBOW FLOAM PR5 7.00 PROF FEES PR EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER 560.00 PROF FEES PR EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION 661.00 PROF FEES PR ADMIN PNEUMOCOCCAL VACC (MEDICARE) 35.00 PROF FEES ADVNC CARE PLAN OR SIMILAR LEGAL DOC IN MED RECORD 0.00 PROF FEES PR REMOVE&REPLACE PM GEN MULT LEADS 1,154.00 PROF FEES PR ELECT ANLYS IMPLT INTRATHECAL/EPIDURAL PMP W REPRG&REFILL 280.00 PROF FEES PR ONDANSETRON 1 MG ORAL W/CHEMO 2.00 PROF FEES PR SIG FLEX W ENDOSCOPIC MUCOSAL RESECTION 461.00 PROF FEES PR FIRST OB VISIT -LEVEL 4 EST PT 549.00 PROF FEES RAD CT CHEST LOW DOSE WO CONTRAST SCREEN 966.00 PROF FEES PR LAP EXC GASTRIC WALL MASS 13,155.00 PROF FEES HCHG OT EVAL LOW COMPLEXITY XE 191.00 PROF FEES HCHG OT EVAL MOD COMPLEXITY 248.00 PROF FEES PR CLSD TX POST PELV RING FX WWO ANTER PELV RING FX W MANIP 748.00 PROF FEES PR CLSD TX POST PELV RING FX WWO ANTER PELV RING FX W MANIP 186.00 PROF FEES PB DRUG SCREEN BLOOD DSS 313.00 PROF FEES PR WELCOME TO MEDICARE (IPPE) VISIT-NURSE VISIT AFFILIATE ONLY 405.00 PROF FEES PR TANGENTIAL BIOPSY SKIN LESION EA ADDL 76.00 PROF FEES PR PUNCH BIOPSY SKIN SINGLE LESION 285.00 PROF FEES PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W PROGRAMMING 1,065.00 PROF FEES PR REMOVAL SUBQ CARDIAC RHYTHM MONITOR 966.00 PROF FEES PR PERC REPLACEMENT GTUBE NOT REQ REVISION GASTRO TRACT 399.00 PROF FEES PR PERC REPLACEMENT GTUBE NOT REQ REVISION GASTRO TRACT 100.00 PROF FEES ADV CARE PLAN DISCUSSED AND ALT DECISION MAKER DOCUMENTED 0.01 PROF FEES PB METHYLMALONIC ACID SERUM 423.00 PROF FEES PR REDUCTION AND REPAIR FORAMEN MORGAGNI HERNIA 0.00 PROF FEES PR SPLINT WRIST CANVAS SCRMC ONLY 109.00 PROF FEES PB ANDROSTENEDIONE LC 94.00 PROF FEES PB RETIC COUNT 256.00 PROF FEES PB ANTIGLIADIN ABS, IGG LC 156.00 PROF FEES PB IGG LC 176.00 PROF FEES PB MYCOPHENOLIC ACID AND METABO LC 224.00 PROF FEES PB IMMUNODIFFUSION OUCHTERLONY LC 26.00 PROF FEES PB BACTERIUM ANTIBODY LC 262.00 PROF FEES PB VITAMIN B6, PLASMA LC 572.00 PROF FEES PB VITAMIN E LC 312.00 PROF FEES PB COXSACKIE A ABYS IGG & IGM LC 424.00 PROF FEES PB FLOW MARKER INTERP 9-15 434.00 PROF FEES PB RADIOLOGICAL EXAM SURG SPEC 224.00 PROF FEES PB PORPHYRINS, QN, RANDOM U LC 52.00 PROF FEES PR LAPROSCOPY IUD REMOVAL FROM BOWEL AND OMENTUM 4,187.00 PROF FEES PR LIDOCAINE 1% INJ 2 ML AFFILIATE ONLY 72.00 PROF FEES PB HISTOPLASMA QUANTITATIVE ANTIGEN LC 141.00 PROF FEES PB HLA ABY CLASS II 414.00 PROF FEES PR SILICON VAGINAL DILATOR SET PR192 AFFILIATE ONLY 62.00 PROF FEES PR WHFO RIGID WO JOINTS CUSTOM PR20 30.00 PROF FEES PR US NON OB LTD 236.00 PROF FEES PR ARTHROSCOPIC HARDWARE REMOVAL FROM SHOULDER 3,960.00 PROF FEES PR FLU VACC QUADRIVALENT IIV4 SV PF 0.5 ML IM 0.00 PROF FEES PR OFFICE OUTPT ESTAB LEVEL 5 624.00 PROF FEES PR DISPENSING FEE BINAURAL BAHA REPLACEMENT AID 0.00 PROF FEES HCHG HFO WO JOINTS PREFAB CUSTOM FIT PR80 135.00 PROF FEES PR TETRACAINE HCI 0.5% 2 ML AFFILIATE ONLY 35.00 PROF FEES PR FINGER SPLINT STATIC PR30 44.00 PROF FEES PR WHO COCKUP NONMOLDED PREFAB OTS PR60 135.00 PROF FEES PR REMOVE RESHAPE GASTRIC BALLOON CUY ONLY 1,529.00 PROF FEES PR PSYCHOTHERAPY PATIENT 30 MIN 329.00 PROF FEES PR PSYCHOTHERAPY PATIENT 30 MIN 86.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 45 MIN 30.00 PROF FEES PR TRANSITIONAL CARE MANAGEMENT 7 DAYS POST DISCHARGE 263.00 PROF FEES PR TRANSITIONAL CARE MANAGEMENT 14 DAYS POST DISCHARGE 506.00 PROF FEES PR NERVE CONDUCTION STUDIES 1-2 149.00 PROF FEES PR CHEMODENERVATION FACIAL TRIGEM CERVICAL SPINAL NERVES BILAT 382.00 PROF FEES PR GI TRANSIT AND PRESSURE WIRELESS CAP MEASURE INTERP REPORT 468.00 PROF FEES PR FIRST OB VISIT LEVEL 5 EST PT 624.00 PROF FEES PR DOMIC/REST HOME EVAL NEW PT SF MDM 187.00 PROF FEES PB SPECIMEN COLLECT SARS-COV-2 AFFILIATE ONLY 60.00 PROF FEES PR INJ HYDROMORPHONE TO 4 MG 8.00 PROF FEES PR INFUS NORMAL SALINE SOLN 1000 CC 59.00 PROF FEES PR REPAIR/MODIFICATION HEARING AID 0.00 PROF FEES PR FINE NEEDLE ASP BX WO IMAGING GUIDANCE 1ST LESION 484.00 PROF FEES PR DRAIN SKIN ABSCESS SIMPLE 238.00 PROF FEES PR REMOVE FOREIGN BODY SIMPLE 464.00 PROF FEES PR REMOVE FOREIGN BODY SIMPLE 251.00 PROF FEES PR PUNCTURE DRAINAGE OF CYST/HEMATOMA 279.00 PROF FEES PR COMPLEX DRAINAGE POSTOP WOUND 3,255.00 PROF FEES PR DEBRIDE INFECTED/ECZEMATOUS SKIN 93.00 PROF FEES PR DEBRIDE TO MUSC/FASCIA AT FX SITE 2,235.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION ONE 136.00 PROF FEES PR TRIM HYPERKERAT SKIN LESION 2-4 212.00 PROF FEES PR REMOVAL OF SKIN TAGS UP TO 15 230.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM TRUNK ARM LEG 75.00 PROF FEES PR SHAV SKIN LESION 0.6-1.0 CM TRUNK ARM LEG 111.00 PROF FEES PR SHAV SKIN LESION OVER 2.0 CM TRUNK ARM LEG 526.00 PROF FEES PR SHAV SKIN LESION < 0.5 CM S/N/H/F GENITALI 187.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM S/N/H/F/GENI 295.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM TRUNK ARM LEG 287.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM SCALP NECK HANDS FEET 170.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM SCALP NECK HANDS FEET 270.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM SCALP NECK HANDS FEET 522.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM FACE EARS EYELIDS 419.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM FACE EARS EYELIDS 1,147.00 PROF FEES PR EXC SKIN BENIGN OVER 4 CM FACE EARS EYELIDS 1,385.00 PROF FEES PR EXC SKIN MALIG < 0.5 CM TRUNK ARM LEG 593.00 PROF FEES PR EXC SKIN MALIG 2.1-3 CM FACE EARS EYELIDS 1,462.00 PROF FEES PR AVULSION OF NAIL PLATE SINGLE 447.00 PROF FEES PR DRAIN SUBUNGUAL HEMATOMA 204.00 PROF FEES PR EXCISION OF NAIL FOLD TOE 182.00 PROF FEES PR REMOVE TISSUE EXPANDER(S) 1,132.00 PROF FEES PR REPAIR SUPERF WOUND BODY < OR = 2.5 CM 152.00 PROF FEES PR CLOSURE SUPERF WND DEHIS SIMPLE 1,077.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 7.6-12.5 CM 815.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 20.1-30 CM 414.00 PROF FEES PR REPAIR INTERMED WOUND NECK HANDS FEET 7.6-12.5 CM 1,341.00 PROF FEES PR REPAIR COMPLEX WOUND TRUNK 1.1-2.5 CM 1,063.00 PROF FEES PR REPAIR COMPLEX WOUND TRUNK EA ADDL 5CM OR LESS 479.00 PROF FEES PR ADJ TISS XFER TRUNK <10SQCM 2,502.00 PROF FEES PR ADJ TISS XFER SCALP EXTREM 10.1-30 2,985.00 PROF FEES PR DRESSING CHANGE ANESTH NOT FOR BURN 436.00 PROF FEES PR DRESSING CHANGE ANESTH NOT FOR BURN 264.00 PROF FEES PR DESTROY PREMALIGNANT 1ST LESION 189.00 PROF FEES PR DESTROY BENIGN LESIONS UP TO 14 LESIONS 285.00 PROF FEES PR DOMIC/REST HOME VISIT FOR EVAL NEW PT LOW MDM 272.00 PROF FEES PR EXCISE BREAST CYST 1 OR MORE LESION 1,766.00 PROF FEES PR EXPLORE WOUND EXTREMITY 1,223.00 PROF FEES PR MUSCLE BIOPSY 491.00 PROF FEES PR DRAIN/INJ MAJOR JOINT/BURSA HIP KNEE WO US GUIDE 551.00 PROF FEES PR ASPIR/INJ BONE CYST 560.00 PROF FEES PR CLOSED TX CLAVICLE FRACTURE 279.00 PROF FEES PR CLOSED TX CLAVICLE FRACTURE 770.00 PROF FEES PR CLOSED TX PROX HUMERUS FX W MANIP 1,941.00 PROF FEES PR CLOSED TX GR TUBEROSITY HUM FX 610.00 PROF FEES PR EXCIS/CURET BENIGN ELBOW LESN 1,484.00 PROF FEES PR PARTIAL REMOVAL OLECRANNON PROCESS 3,346.00 PROF FEES PR CLOSED TX HUMERAL SUPRACONDYLAR FX 1,299.00 PROF FEES PR PERCUT FIXATN HUMERAL CONDYLAR FX 2,607.00 PROF FEES PR OPEN TX PERIARTIC FX ELBOW IMPLNT 1,177.00 PROF FEES PR OPEN TX ELBOW DISLOCATION 1,543.00 PROF FEES PR CLOSED TX RADIAL HEAD/NECK FX 285.00 PROF FEES PR OSTEOTOMY ULNA 2,392.00 PROF FEES PR REPAIR NONUNION RADIUS AND ULNA W GRAFT 1,325.00 PROF FEES PR OPEN TX RADIAL SHAFT FX 2,985.00 PROF FEES PR CLOSED TX ULNA SHAFT FX MANIPULATION 1,749.00 PROF FEES PR CLOSED TX DIST RAD ULNA FX MANIPUL 2,416.00 PROF FEES PR CLOSED TX CARPAL FX EXCEPT SCAPHOID/NAVICULAR 684.00 PROF FEES PR CLOSED TX ULNA STYLOID FX 822.00 PROF FEES PR OPEN TX ULNAR STYLOID FX 1,347.00 PROF FEES PR OPEN REPAIR LUNATE DISLOCATION 1,360.00 PROF FEES PR DRAIN FINGER ABSCESS COMPLICATED 1,687.00 PROF FEES PR RELEASE MC P JT CONTRACTURE 1,416.00 PROF FEES PR RELEASE I P JT CONTRACTURE 4,231.00 PROF FEES PR FIX COLLAT LIG MCP JT IP JT 1,890.00 PROF FEES PR CLOSED TX METACARPAL FX 948.00 PROF FEES PR CLOSED TX MCP DISLOC 830.00 PROF FEES PR CLOSED TX IP JT DISLOCATION 464.00 PROF FEES PR FUSION MCP JT 2,097.00 PROF FEES PR I&D PELVIS HIP INFECT BURSA 1,604.00 PROF FEES PR INCIS OF HIP/THIGH FASCIA 1,966.00 PROF FEES PR REVISE TOTAL HIP REPLACEMENT 6,703.00 PROF FEES PR CLOSED TX PROX NECK FEMUR FX MANIP 2,271.00 PROF FEES PR INCIS DRAIN THIGH KNEE ABSCESS DEEP 2,654.00 PROF FEES PR REMOVAL PREPATELLA BURSA 2,178.00 PROF FEES PR PART REMOVE FEMUR PROX TIB FIB 1,884.00 PROF FEES PR PLASTY KNEE MED OR LAT COMPARTMT 8,232.00 PROF FEES PR TOTAL KNEE ARTHROPLASTY 9,939.00 PROF FEES PR CLOSED TX FEMUR SHAFT FX 869.00 PROF FEES PR CLOSED TX FEMUR SHAFT FX W MANIP 2,370.00 PROF FEES PR OPEN TX UNI TIB PLAT FX 2,496.00 PROF FEES PR EXCIS LESN TENDON SHEALTH LEG/ANKLE 2,004.00 PROF FEES PR RELEASE TIB/FIB/ANKLE FLEX TENDON EA 2,814.00 PROF FEES PR OPEN TX TIBIA SHAFT FX SCREWS 6,285.00 PROF FEES PR OPEN TX PROX/SHAFT FIBULA FX 2,852.00 PROF FEES PR CLOSED TX TRIMALLEOLAR FX 1,316.00 PROF FEES PR EXCIS FOOT TUMOR SUBCUTANEOUS <1.5CM 1,431.00 PROF FEES PR EXCIS INTERDIGITAL NEUROMA EA 1,192.00 PROF FEES PR REMOVE TARSAL/METATARSAL BENIGN BONE LESN 2,157.00 PROF FEES PR REMOVE TOE BENIGN BONE LESN 1,922.00 PROF FEES PR FULL EXCISION OTHER METATARSAL HEAD 2, 3 OR 4 1,109.00 PROF FEES PR FULL EXCIS 5TH METATARSAL HEAD 1,323.00 PROF FEES PR PART REMOVE PHALANX OF TOE 1,084.00 PROF FEES PR REPAIR EXTEN FOOT TENDON PRIM EA 1,154.00 PROF FEES PR CAPSULOTOMY MTP JT FOOT EA 1,116.00 PROF FEES PR REPAIR BUNION DISTAL METATARSAL OSTEOTOMY ANY METHOD 2,787.00 PROF FEES PR REPAIR BUNION PROX PHALANX OSTEOTOMY ANY METHOD 3,206.00 PROF FEES PR OSTEOTOMY METATARSAL (NOT 1ST) 2,263.00 PROF FEES PR CLOSED TX TALUS FX 912.00 PROF FEES PR CLOSED TX TARSAL FX EA 867.00 PROF FEES PR CLOSED TX METATARSAL FX 512.00 PROF FEES PR AMPUTATION TOE IP JT 1,853.00 PROF FEES PR APPLY FOREARM CAST 358.00 PROF FEES PR APPLY FOREARM SPLINT STATIC 201.00 PROF FEES PR APPLY FOREARM SPLINT STATIC 289.00 PROF FEES PR APPLY FINGER SPLINT STATIC 216.00 PROF FEES PR APPLY LONG LEG CAST 522.00 PROF FEES PR SHLDR ARTHROSCOP PART SYNOVECT 4,566.00 PROF FEES PR SHLDR ARTHROSCOP SURG DIS CLAVICULECTOMY 4,387.00 PROF FEES PR SHOULDER ARTHROSCOPY SURGERY 4,872.00 PROF FEES PR KNEE SCOPE W LATERAL RELEASE 3,718.00 PROF FEES PR ANKLE SCOPE PART SYNOVECTOMY 4,648.00 PROF FEES PR CONTROL NOSEBLEED POST W/PACKS AND/OR CAUT 1,143.00 PROF FEES PR THORACOSCOPY SURG PART PULM DECORT 3,649.00 PROF FEES PR INSERT HEART PM VENTRICULAR 4,011.00 PROF FEES PR REPAIR ART RUPTURE SPLENIC 13,165.00 PROF FEES PR EXPLOR POSTOP BLEED INFEC CLOT-ABD 2,688.00 PROF FEES PR BONE MARROW BIOPSY(IES) 444.00 PROF FEES PR NEEDLE BIOPSY/EXCISION LYMPH NODE(S) 257.00 PROF FEES PR IDENTIFY SENTINEL NODE 1,022.00 PROF FEES PR EGD INTRALUMINAL TUBE CATHETER INSERTION 314.00 PROF FEES PR EGD INTRMURAL NEEDLE ASPIR BIOP ALTERED ANATOMY 930.00 PROF FEES PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE 2,039.00 PROF FEES PR ERCP SPHINCTEROTOMY 1,012.00 PROF FEES PR SURGICAL OPENING OF STOMACH 1,702.00 PROF FEES PR LAP VAGUS NERVES SELECTIVE 1,727.00 PROF FEES PR GASTROSTOMY OPEN W O TUBE CNSTR 3,530.00 PROF FEES PR PART REMOVAL COLON W COLOPROCTOSTOMY 6,300.00 PROF FEES PR REVIS COLOSTOMY REPAIR PARACOLO HERNIA 5,595.00 PROF FEES PR CLOSE ENTEROSTOMY RESEC W ANAST 5,697.00 PROF FEES PR SIGMOIDOSCOPY FLEX W CONTROL BLEEDING ANY METHOD 1,103.00 PROF FEES PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS 270.00 PROF FEES PR REMOVAL OF HEMORROIDAL TAGS 587.00 PROF FEES PR DIAG ANOSCOPY INC COL SPEC BY BRUSH WASH WHEN PERF SEP PROC 268.00 PROF FEES PR ANOSCOPY AND BIOPSY 847.00 PROF FEES PR HRHC NTRNL LIG OTH THAN RBBR BAND 2+ COL/GRP WO GUIDE 780.00 PROF FEES PR LAP CHOLECYSTECTOMY/GRAPH 5,267.00 PROF FEES PR EXPLORATORY OF ABDOMEN 1,779.00 PROF FEES PR REOPEN RECENT ABD EXPLORATORY 5,129.00 PROF FEES PR PERCUT BIOPSY ABDOMINAL MASS 2,831.00 PROF FEES PR REPAIR EPIGASTRIC HERNIA REDUC 2,777.00 PROF FEES PR REPAIR EPIGASTRIC HERNIA STRANG 3,143.00 PROF FEES PR LAP INGUINAL HERNIA REPAIR INITIAL 3,426.00 PROF FEES PR IRRIGATION OF BLADDER 174.00 PROF FEES PR ANAL/URINARY MUSCLE STUDY 1,215.00 PROF FEES PR MEASURE POST VOID RESID US NON IMAGING 160.00 PROF FEES PR CYSTOURETHROSCOPY 1,493.00 PROF FEES PR CYSTOURETHROSCOPY BIOPSY(S) 1,977.00 PROF FEES PR DOMIC/REST HOME VISIT FOR EVAL NEW PT MOD MDM 470.00 PROF FEES PR REMOVAL OF SPERM DUCT(S) 2,024.00 PROF FEES PR REMOVAL OF SPERM CORD LESION 2,072.00 PROF FEES PR DOMIC/REST HOME VISIT FOR EVAL, NEW PT, COMP W MOD MDM 629.00 PROF FEES PR BX VULVA PERINEUM ADDL LESION 125.00 PROF FEES PR EXCIS BARTHOLIN GLAND/CYST 878.00 PROF FEES PR PLASTIC REPAIR OF INTROITUS 1,614.00 PROF FEES PR COMBO ANT/POST COLPORR W ENTEROCELE INCL CYSTURETHROSCOPY 4,071.00 PROF FEES PR REPAIR RECTO-VAG FISTULA 2,172.00 PROF FEES PR DOMIC/REST HOME VISIT FOR EVAL NEW PT COMP W HIGH MDM 840.00 PROF FEES PR COLPOSCOPY ENTIRE VAGINA 255.00 PROF FEES PR COLPOSCCERVIX W ADJ VAG W BX AND CURETTAG 765.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA W BX 397.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA CURETTAG 816.00 PROF FEES PR CRYOCAUTERY OF CERVIX 317.00 PROF FEES PR CONIZATION CERVIX KNIFE/LASER 1,298.00 PROF FEES PR CONIZATION CERVIX LOOP ELECTRD 302.00 PROF FEES PR BIOPSY OF UTERUS LINING 281.00 PROF FEES PR VAGINAL HYSTERECTOMY UTERUS 250 GMS/< 5,186.00 PROF FEES PR LAP VAG HYST UTERUS 250GMS/250GMS 8,556.00 PROF FEES PR CERVICAL SUTURING FOR HEMASTIS 1,910.00 PROF FEES PR AMNIOCENTESIS DIAGNOSTIC 414.00 PROF FEES PR OBSTE CARE VAG DELIV W POSTPARTUM 5,668.00 PROF FEES PR FULL ROUT OBSTE CARE CESAREAN DELIV 7,295.00 PROF FEES PR C-SEC ONLY PREV C-SEC 2,005.00 PROF FEES PR REMOVE CERCLAGE SUTURE 281.00 PROF FEES PR THYROIDECTOMY W RAD NECK SURGERY 10,544.00 PROF FEES PR ELECT ANALYS INTRATHEC/EPID PUMP WO REPROG OR REFILL 94.00 PROF FEES PR REVISE/REMOVE SPINAL NEUROSTIM/RECEIVER 818.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID BRACHIAL PLEXUS 219.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID INTERCOSTAL NERVE SGL LVL 260.00 PROF FEES PR INJ(S) ANES AGENT AND/OR STEROID ILIOING/HYPOGAST NERVES 300.00 PROF FEES PR REVISE/REMOVE PERIPH/GASTRIC NEUROSTIM/RECEIVER 575.00 PROF FEES PR TRANSECT OTHER SPINAL NERVE XTRADURAL 2,228.00 PROF FEES PR REPAIR OF DIGIT NERVE 1,490.00 PROF FEES PR REPAIR EA ADDL DIGIT NERVE 641.00 PROF FEES PR REMOVE EXT CANAL FOREIGN BODY 101.00 PROF FEES PR REMOVE FB EYE CORNEA NO SLIT 125.00 PROF FEES PR ADM VACC NO COUNSELING ANY AGE, ANY ROUTE 80.00 PROF FEES PR AUDITORY EVOKED POTENTIAL LIMITED 241.00 PROF FEES PR DOMIC/REST HOME EVAL EST PT SF MDM 204.00 PROF FEES PR CARDIAC STRESS TST MD SUPERV ONLY 201.00 PROF FEES PR SPIROMETRY W VITAL CAPACITY 164.00 PROF FEES PR VITAL CAPACITY TEST 19.00 PROF FEES PR DOMIC/REST HOME EVAL EST PT LOW MDM 322.00 PROF FEES PR POLYSOMNOGRAPHY => 6YRS =>4 PARAMETERS 220.00 PROF FEES PR DOMIC/REST HOME EVAL EST PT MOD MDM 457.00 PROF FEES PR ANALYZE NEUROSTIM COMPLX/PROG 408.00 PROF FEES PR ATTENDED ELECTRICAL STIMULATION EA 15 MIN 92.00 PROF FEES PR ATTENDED ELECTRICAL STIMULATION EA 15 MIN 44.00 PROF FEES PR ULTRASOUND THERAPY EA 15 MIN 45.00 PROF FEES PR MED NUTR THER SUBSQ INDIV EA 15 MIN 80.00 PROF FEES PR OSTEOPATHIC MANIP 1-2 BODY REGN 57.00 PROF FEES PR OSTEOPATHIC MANIP 3-4 BODY REGN 181.00 PROF FEES PR OSTEOPATHIC MANIP 5-6 BODY REGN 75.00 PROF FEES PR ANOGENITAL EXAM MAGNIFY CHILD SUSPECT TRAUMA W IMG 526.00 PROF FEES PR OFFICE OUTPT NEW LEVEL 1 95.00 PROF FEES PR OFFICE OUTPT NEW LEVEL 1 95.00 PROF FEES PR OFFICE OUTPT NEW LEVEL 1 190.00 PROF FEES PR OFFICE OUTPT NEW LEVEL 2 198.00 PROF FEES PR PROLONGED SERVICE WO CONTACT 1ST HR 382.00 PROF FEES PR PREVENTIVE VISIT NEW 65 AND OVER 257.00 PROF FEES PR PREVENTIVE VISIT NEW AGE 1-4 374.00 PROF FEES PR PREVENTIVE VISIT EST INFANT < 1 YR 150.00 PROF FEES PR DOMIC/REST HOME EVAL EST PT COMP W MOD TO HIGH MDM 653.00 PROF FEES PR HOME VISIT ESTAB PATIENT LEVEL I 224.00 PROF FEES PR SHOULDER ARTHRO CAPSULAR SHRINKAGE 3,960.00 PROF FEES PR HEALING RESPONSE FOR MENISCUS 3,960.00 PROF FEES PR CONTROL POST OP BLEEDING 1,203.00 PROF FEES PR LAP EXC NEUROEND TUMR PANCR 4,187.00 PROF FEES PR HEARING AID CHECK BINAURAL NC AU545 0.00 PROF FEES PR INSRT TUN CV ACS DEVW PORT OVER 5 YRS 4,456.00 PROF FEES PR INSRT TUN CV ACS DEVWITH SUBCU PORT 13,290.00 PROF FEES PR OVARIAN CYSTOTOMY (NU) 5,963.00 PROF FEES PR TRANSABD AMNIOINFUSN W US GUIDE 1,084.00 PROF FEES PR HOME VISIT ESTAB PATIENT LEVEL II 298.00 PROF FEES HCHG OT SELFCARE/HOME MNGMNT 15MIN 212.00 PROF FEES PR OCH FAA EXAM 162.00 PROF FEES PR ESOPH IMPED FUNCT TEST >1 HR 788.00 PROF FEES PR ACTIVE WOUND CARE FIRST 20 SQ CM OR LESS 80.00 PROF FEES PR SURG LAP PROCTECTOMY COMPL COMB ABDPERINEAL W COLOSTOMY 8,669.00 PROF FEES PR HOME VISIT ESTAB PATIENT LEVEL III 436.00 PROF FEES PR ENDOMETRIAL SAMPLING W COLPOSCOPY 111.00 PROF FEES PR AUDITORY REHAB PRE-LINGUAL HEARING LOSS 171.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF INDIV PT EA 30 MIN 0.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF 2-4 PTS EA 30 MIN 0.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF, 5-8 PTS EA 30 MIN 0.00 PROF FEES PR PNEUMATIC WALKING BOOT PREFAB CUSTOM FIT PR70 305.00 PROF FEES PR MASTECTOMY GYNECOMASTIA 1,959.00 PROF FEES PR PERC SKELETAL FIXATION DISTAL RADIAL FRACTURE OR EPI SEP 3,188.00 PROF FEES PR VENT MGMT INPAT INIT DAY 191.00 PROF FEES PR ADJ GASTRIC BAND DIAM SUBQ PORT 560.00 PROF FEES PR CPTR ASST NAVIG MS PROC 312.00 PROF FEES PR BLOOD DRAW THROUGH CENTRAL OR PERIPHERAL VAD 68.00 PROF FEES PR DRAIN BLADDER W CATH INSERTION 503.00 PROF FEES PR BEHAV CHNG SMOKING > 10 MIN 64.00 PROF FEES PR HOME VISIT ESTAB PATIENT LEVEL IV 280.00 PROF FEES PR LAP RPR INCARCERATED FEMORAL HERNIA 4,845.00 PROF FEES PR CERVICAL COLLAR FLEXIBLE NONADJ FOAM PREFAB OTS PR1 90.00 PROF FEES PR DTAP-IPV 186.00 PROF FEES PR PREVENTIVE VISIT EST INFANT < 1 YR 300.00 PROF FEES PR LAP VENT ABD HERNIA REPAIR 3,180.00 PROF FEES PR LAPAROSCOPY TRACHELECTOMY 6,884.00 PROF FEES PR FECAL IMPACTION REMOVAL SEDATION 1,634.00 PROF FEES PR RESECTION PORTION ACL 3,960.00 PROF FEES PR PSYCHOTHERAPY FAMILY W PATIENT 50 MIN 535.00 PROF FEES PR TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS 80.00 PROF FEES PR NERVE CONDUCTION USING ELECTRODE ARRAYS WITH F-WAVE EA LIMB W INTERP/REPORT 280.00 PROF FEES PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM 3,016.00 PROF FEES PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM 1,777.00 PROF FEES PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM 1,926.00 PROF FEES PR RAD RESCJ TUM SOFT TISSUE LEG/ANKLE 5+CM 2,714.00 PROF FEES PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM 1,281.00 PROF FEES PR PNEUMOCOCCAL VACCINE 13 VALENT IM 594.00 PROF FEES PR INJ PARAVERTEBRAL FACET JOINT LUMBAR OR SACRAL THIRD OR ADDL LEVEL WITH FLUORO450.00 OR CT PROF FEES PR LAP GASTRIC RSTRICT BARIATRIC 13,186.00 PROF FEES PR REVISION GASTROPLASTY OBESITY BARIATRIC 11,961.00 PROF FEES PR BIOPHYSICAL PROFILE 1,271.00 PROF FEES PR PREVENTIVE VISIT EST AGE 1-4 347.00 PROF FEES PR OCH DOT EXAM 114.00 PROF FEES PR GASTROSTOMY JEJUNOSTOMY TUBE STANDARD PR30 42.00 PROF FEES PR PARTIAL LEFT URETERECTOMY 341.00 PROF FEES PR MASTOPEXY PLASTIC 4,498.00 PROF FEES PR EXCISION EXCESS SKIN ABD ADD PLASTIC 1,678.00 PROF FEES PR GASTRIC TUBE PLMT W/ASPIR & LAVAGE 60.00 PROF FEES PR LAP I&D PARATUBAL CYST 5,963.00 PROF FEES PR CHICKEN POX VACC LIVE SQ 413.00 PROF FEES PR DBRDMT TO BONE EA ADDL 20 SQ CM OR PART THEREOF 942.00 PROF FEES PR FLU VACC TRIVALENT IIV3 SV PF 0.5 ML IM 42.00 PROF FEES PR HEP A VACC PED/ADOL 2 DOSE 0.00 PROF FEES PR HIB VACC PRP-OM* 0.00 PROF FEES PR MENINGOCOCCAL (MENACTRA) VACC IM 480.00 PROF FEES PR MENINGOCOCCAL (MENVEO) VACC IM 0.00 PROF FEES PR MMR VACC SQ 161.00 PROF FEES PR US GUIDE INTRAOPERATIVE 1,100.00 PROF FEES PR TD VACC PF > 7 YO 122.00 PROF FEES PR TD VACC PF > 7 YO 0.00 PROF FEES PR LOW FREQUENCY NON THERMAL US 479.00 PROF FEES PR CHEMODENERV EACH ADDL EXTREM 5 OR MORE MUSCLES 450.00 PROF FEES PR CHEMODENERV TRUNK 1 TO 5 MUSCLES 416.00 PROF FEES PR ERCP STENT PLACEMENT BILIARY OR PANCREATIC DUCT 1,127.00 PROF FEES PR LAP LIVER PARTIAL RESECTION WITH WEDGE BX 5,027.00 PROF FEES PR ADMIN VACC INITIAL STATE SERUM 28.00 PROF FEES PR ADMIN EA ADDL VACC INTRANASAL/ORAL 80.00 PROF FEES ADVNC CARE PLANNING DISCUSSION DOCD IN MED RECORD 0.00 PROF FEES FUNCTIONAL STATUS ASSESSED 0.00 PROF FEES PR MENB-4C VACC 487.00 PROF FEES PR PREVENTIVE VISIT EST AGE 5-11 360.00 PROF FEES PR SKIN SUB GRAFT TRNK ARM LEG 121.00 PROF FEES PR ENDOSCOPIC RELEASE INTERMETARASAL LIGAMENT 3,960.00 PROF FEES PR PREVENTIVE VISIT EST 12-17 388.00 PROF FEES PR C0 MEMBRANE DIFFUSE CAPACITY 243.00 PROF FEES PB MTHFR MUTATION 203.00 PROF FEES THROMBIN ANTITHROMBIN COMPLEX AML994 329.00 PROF FEES PR ARTHROCENT ASPIR INJ MAJOR JOINT/BURSA W US GUIDE 232.00 PROF FEES PR PERC KYPHOPLASTY LUMBAR 1 LEVEL W GUIDE 1,947.00 PROF FEES PR BRIEF EMOTIONAL BEHAV ASSMT 26.00 PROF FEES PR ADVNCD CARE PLAN 30 MIN 202.00 PROF FEES PR LAP TUBE DIVISION I&D REM ABSCESS PORT 13,156.00 PROF FEES PB COMP METABOLIC RTR 173.00 PROF FEES PR SUPRASCAPULAR NERVE DECOMPRESSION 3,960.00 PROF FEES PR TANGENTIAL BIOPSY SKIN LESION EA ADDL 76.00 PROF FEES PR INCISIONAL BIOPSY SKIN SINGLE LESION 390.00 PROF FEES PR POST-OP SHOE PR1 85.00 PROF FEES PR RHC/FQHC COMM SERVICES 5 MINUTES 40.00 PROF FEES PR OFFICE OUTPT NEW LEVEL 2 198.00 PROF FEES PR OFFICE OUTPT NEW LEVEL 2 396.00 PROF FEES PB LD, TOTAL 245.00 PROF FEES PB KAPPA FREE LIGHT CHAIN 96.00 PROF FEES PR PART REMOVE FEMUR PROX TIB FIB IMPLANTED GRAFT DEEP 3,960.00 PROF FEES HCHG BCR-ABL1, CML/ALL, PCR, MAJOR BP LC 485.00 PROF FEES PR IMMOBILIZER KNEE 24IN SCRMC ONLY 116.00 PROF FEES PB PROTEIN ELP,SERUM 245.00 PROF FEES PB CORTISOL, URINARY FREE LC 374.00 PROF FEES PB ANTI-DNASE B STREP ANTIBODIES LC 42.00 PROF FEES PB EHRLICHIA AB LC 29.00 PROF FEES PB EPSTEIN-BARR VIRUS PCR LC 162.00 PROF FEES PB IMMUNOFIXATION 155.00 PROF FEES PB LEAD, BLOOD LC 149.00 PROF FEES PB THYROID STIM IMMUNOGLOBULIN LC 416.00 PROF FEES PB VANILLYLMANDELIC ACID, 24-HR U LC 139.00 PROF FEES PR REPAIR ANASTOMOSIS TENODESIS OF PERONEUS BREVIS TO LONGUS 0.00 PROF FEES PB REFERRAL ID ONLY, NONURINE 183.00 PROF FEES PR UNLISTED PROCEDURE FEMUR OR KNEE AFFILIATE ONLY 1,424.00 PROF FEES PR XR ERCP PANCREAS ONLY CUY ONLY 82.00 PROF FEES PR REMOVAL OF PROLAPSED ENDOMETRIAL POLYP 198.00 PROF FEES PR OT FLUIDOTHERAPY 68.00 PROF FEES PR LAPAROSCOPIC MESH REMOVAL FROM ABDOMINAL WALL 4,187.00 PROF FEES PR FLU VACC QUADRIVALENT IIV4 SV PF 0.25 ML IM 0.00 PROF FEES PR ADMIN HEP B VACC (MEDICARE) 35.00 PROF FEES HCHG BLOOD DRAW LINE PORT AFFILIATE ONLY 67.00 PROF FEES PR PREVENTIVE VISIT EST 18-39 432.00 PROF FEES PR HEARING AID TUBING CHG MISC RPR AUDIOLOGIST 38.00 PROF FEES PR EXPLOR LAP W REPAIR TRANSECTED RECTUS SHEATH 0.00 PROF FEES PR SLING PR80 AFFILIATE ONLY 116.00 PROF FEES PR PSYCHOTHERAPY 45 MIN PATIENT 430.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 60 MIN 198.00 PROF FEES PR TRANSITIONAL CARE MANAGEMENT 7 DAYS POST DISCHARGE 526.00 PROF FEES PR NERVE CONDUCTION STUDIES 1-2 85.00 PROF FEES PR CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER 707.00 PROF FEES PR THORACENTESIS W GUIDANCE 2,641.00 PROF FEES PR OCH PROVIDER VISIT AFFILIATE ONLY 104.00 PROF FEES PR VAGINAL DILATORS PR30 52.00 PROF FEES PR LAP ENTERORRHAPHY AFFILIATE ONLY 7,924.00 PROF FEES PR LAP REDUCTION INTERNAL HERNIA AFFILIATE ONLY 4,845.00 PROF FEES PR LAP ESOPHAGOJEJUNOSTOMY AFFILIATE ONLY 13,156.00 PROF FEES HCHG SPLINT FINGER BASED STATIC CUSTOM PR250 AFFILIATE ONLY 385.00 PROF FEES PR DOCU OF SHUNT TUMOR COAG OR THROMBOCYT AFFILIATE ONLY 0.01 PROF FEES PB ACHR MODULATING ABY LC 394.00 PROF FEES PR PREVENTIVE VISIT EST 40-64 408.00 PROF FEES PR LAP OMENTAL FLAP INTRA ABDOMINAL 4,187.00 PROF FEES PR FLU VACC TRIVALENT IIV3 SV PF 0.25 ML IM 42.00 PROF FEES PR TRIM DYSTROPHIC NAILS ANY NUMBER 71.00 PROF FEES PR INJ FUROSEMIDE TO 20MG 14.00 PROF FEES PR INJ ONDANSETRON HCL PER 1 MG 2.00 PROF FEES PR PREVENTIVE VISIT EST 65 AND OVER 478.00 PROF FEES PR INJ ROPIVACAINE HCL 1 MG 38.00 PROF FEES PR HEARING AID REPAIR RETAIL 42.00 PROF FEES PR COMPLETED EPSTD SERVICE 402.00 PROF FEES PR ACNE SURGERY OF SKIN ABSCESS 352.00 PROF FEES PR DEBRIDE INFECTED/ECZEMATOUS SKIN 242.00 PROF FEES PR DEBRIDE SQ TISSUE FIRST 20 SQ CM 629.00 PROF FEES PR SHAV SKIN LESION 0.6-1.0 CM TRUNK ARM LEG 216.00 PROF FEES PR SHAV SKIN LESION OVER 2.0 CM S/N/H/F/GENIT 198.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM SCALP NECK HANDS FEET 482.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM FACE EARS EYELIDS 544.00 PROF FEES PR EXC SKIN BENIGN 3.1-4 CM FACE EARS EYELIDS 693.00 PROF FEES PR EXC SWEAT GLAND LESN INGUIN SIMPL 1,446.00 PROF FEES PR EXC SKIN MALIG 0.6-1 CM TRUNK ARM LEG 729.00 PROF FEES PR EXC SKIN MALIG 1.1-2 CM TRUNK ARM LEG 801.00 PROF FEES PR EXC SKIN MALIG 2.1-3 CM TRUNK ARM LEG 736.00 PROF FEES PR EXC SKIN MALIG 2.1-3 CM SCALP NECK HANDS FEET 1,236.00 PROF FEES PR EXC SKIN MALIG < 0.5 CM FACE EARS EYELIDS 804.00 PROF FEES PR EXC SKIN MALIG 3.1-4 CM FACE EARS EYELIDS 1,780.00 PROF FEES PR DEBRIDEMENT OF NAIL(S) 1-5 274.00 PROF FEES PR DEBRIDEMENT OF NAILS 6 OR MORE 216.00 PROF FEES PR AVULSION OF NAIL PLATE SINGLE 135.00 PROF FEES PR INJ INTO SKIN LESIONS <=7 106.00 PROF FEES PR CLOSURE SUPERF WND DEHIS SIMPLE 707.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 2.6-7.5 CM 1,013.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 7.6-12.5 CM 1,227.00 PROF FEES PR REPAIR INTERMED WOUND NECK HANDS FEET 2.6-7.5 CM 1,166.00 PROF FEES PR REPAIR INTERMED WOUND FACE EARS EYELIDS 2.5-5.0 CM 1,225.00 PROF FEES PR REPAIR COMPLEX WOUND TRUNK 2.6-7.5 CM 1,323.00 PROF FEES PR ADJ TISS XFER HEAD FACE HAND <10SQCM 2,098.00 PROF FEES PR DRESS/DEBRID SMALL BURN <5% TBSA 262.00 PROF FEES PR DESTROY PREMALIGNANT 15 OR MORE LESIONS 342.00 PROF FEES PR DESTROY PREMALIGNANT 15 OR MORE LESIONS 597.00 PROF FEES PR DESTROY BENIGN LESIONS UP TO 14 LESIONS 95.00 PROF FEES PR CHEMICAL CAUTERY GRANULATION TISSUE 242.00 PROF FEES PR ONLINE DIGITAL E/M SVS EST PATIENT =< 7 DAYS 5-10 MIN 30.00 PROF FEES PR PUNCTURE ASPIR BREAST CYST EA ADDL 64.00 PROF FEES PR EXCISE BREAST LESION W XRAY MARKER 2,092.00 PROF FEES PR BIOPSY BONE TROCAR OR NEEDLE DEEP 2,733.00 PROF FEES PR INJ CARPAL TUNNEL 242.00 PROF FEES PR INJ TRIGGER POINTS 3 OR > MUSCLES 413.00 PROF FEES PR ASPIRAT/INJ GANGLION CYST(S) 274.00 PROF FEES PR REMOVAL DEEP IMPLANT 2,077.00 PROF FEES PR RAD EXCIS SOFT TISS SHLDR TUMOR<5CM 3,426.00 PROF FEES PR REPAIR ROTATOR CUFF ACUTE 2,121.00 PROF FEES PR CLOSED TX PROX HUMERUS FRACTURE 1,117.00 PROF FEES PR CLOSED TX GR TUBEROSITY HUM FX 314.00 PROF FEES PR OPEN TX SHLDR DISLOCGR TUB FX 1,885.00 PROF FEES PR CLOSED TX SHLDR DISLOC W PROX HUM FX 2,080.00 PROF FEES PR EXCIS TUMOR SOFT TISS UP ARM ELBOW SUB<3CM 1,972.00 PROF FEES PR OPEN FIXATN MID HUMERUS FRACTURE 5,407.00 PROF FEES PR CLOSED TX HUMER EPICONDYLR FX 1,097.00 PROF FEES PR CLOSED TX HUMER CONDYLR FX 407.00 PROF FEES PR CLOSED TX RADIAL HEAD DISLOC CHILD 376.00 PROF FEES PR EXCIS TUMOR SOFT TISS FOREARM/WRIST SUBQ<3CM 2,230.00 PROF FEES PR EXCIS TENDON SHEATH LESN WRIST FOREARM 460.00 PROF FEES PR EXCIS SYNOV WRIST EXTENS TENDON 851.00 PROF FEES PR REPAIR FOREARM TEND MUSC FLEX PRIM EA 2,358.00 PROF FEES PR CLOSED TX RAD/ULNA SHAFT FX 330.00 PROF FEES PR CLOSED TX NAVICULAR FX 349.00 PROF FEES PR OPEN TX NAVICULAR FX 3,006.00 PROF FEES PR CLOSED TX LUNATE DISLOCATION 1,466.00 PROF FEES PR EXCIS SOFT TISSUE LESION HAND SUBCUT<1.5CM 2,540.00 PROF FEES PR PART PALMAR FASCIECOPEN 1 DIGIT 4,553.00 PROF FEES PR REPAIR FLEXOR TENDONHAND WO GRAFT EA 3,617.00 PROF FEES PR REPAIR PROFUNDUS TENDON PRIMARY 1,643.00 PROF FEES PR REPAIR PROFUNDUS TENDON SECONDARY W GRAFT 2,675.00 PROF FEES PR REPAIR EXTEN TENDON DISTAL INSERT CLOSE 961.00 PROF FEES PR FIX COLLAT LIG MCP JT GRAFT 2,434.00 PROF FEES PR FIX COLLAT LIG MCP JT LOCAL TISS 1,349.00 PROF FEES PR CLOSED TX MCP DISLOC 538.00 PROF FEES PR OPEN TX FINGR ARTICULAR FX 3,282.00 PROF FEES PR CLOSE TX DIST FINGR/THUMB FX 653.00 PROF FEES PR OPEN TX DIST FINGR FX 1,721.00 PROF FEES PR OPEN INTERN FIX POST PELV BONE FX UNI 3,128.00 PROF FEES PR TREAT INTER/SUBTROCH FX W PLATE SCREW 5,536.00 PROF FEES PR CLOSED TX PATELLA FX 1,111.00 PROF FEES PR CLOSED TX TIBIAL PLATEAU FX 538.00 PROF FEES PR ONLINE DIGITAL E/M SVS EST PATIENT =< 7 DAYS 11-20 MIN 59.00 PROF FEES PR RAD RESEC SOFT TISS TUMR LOWER LEG<5CM 4,742.00 PROF FEES PR REPAIR ACHILLES TENDON SECONDARY 1,661.00 PROF FEES PR CLOSED TX TIBIA SHAFT FX 450.00 PROF FEES PR CLOSED TX MED MALLEOLUS FX 757.00 PROF FEES PR CLOSED TX MED MALLEOLUS FX 1,150.00 PROF FEES PR CLOSED TX DIST FIBULA FX 729.00 PROF FEES PR CLOSED TX DIST FIBULA FX 1,106.00 PROF FEES PR CLOSED TX BIMALLEOLAR FX 370.00 PROF FEES PR CLOSED TX TRIMALLEOLAR FX 861.00 PROF FEES PR CLOSED TX ANKLE DISLOCATN 1,572.00 PROF FEES PR EXPLOR INTERPHALANGEAL JT 1,149.00 PROF FEES PR REPAIR OF HAMMERTOE ONE 1,815.00 PROF FEES PR CLOSED TX HEEL FX 1,012.00 PROF FEES PR CLOSED TX TALUS FX 604.00 PROF FEES PR CLOSED TX TOE FX 157.00 PROF FEES PR FUSION BIG TOE IP JOINT 1,592.00 PROF FEES PR AMPUTATION METATARSAL W TOE SINGLE 2,024.00 PROF FEES PR APPLY SHORT LEG CAST 311.00 PROF FEES PR APPLY SHORT LEG CAST WALKER 317.00 PROF FEES PR APPLY LOWER LEG SPLINT 192.00 PROF FEES PR APPLY UNNA BOOT 242.00 PROF FEES PR SHLDR ARTHROSCOP EXTEN DEBRIDE 5,144.00 PROF FEES PR WRIST ARTHROSCOP EXCIS TRIANG CART 1,034.00 PROF FEES PR KNEE SCOPE DIAGNOSTIC 1,322.00 PROF FEES PR KNEE SCOPE CLEAN/DRAIN 1,143.00 PROF FEES PR REMOVE NASAL FOREIGN BODY 700.00 PROF FEES PR CONTROL NOSEBLEED ANTER SIMPLE 487.00 PROF FEES PR BRONCHOSCOPY REMOVE FB 2,020.00 PROF FEES PR THORACOSCOPY DIAGNOSTIC 1,817.00 PROF FEES PR THORACOSCOPY SURG W PLEURODESIS 3,700.00 PROF FEES PR REPOSITION TRANSVENOUS ELECTRODE 2,245.00 PROF FEES PR INSERT TWO ELECTRODES PCMKR OR ICD 2,875.00 PROF FEES PR REPAIR BL VES DIRECT ABD 4,610.00 PROF FEES PR REMOVAL OF CLOT IN GRAFT 5,196.00 PROF FEES PR TEMPORAL ARTERY LIGATION OR BX 1,255.00 PROF FEES PR REMOVAL SPLEEN TOTAL 4,367.00 PROF FEES PR LAPSPLENECTOMY 6,263.00 PROF FEES PR BONE MARROW ASPIRATION(S) 414.00 PROF FEES PR NEEDLE BIOPSY/EXCISION LYMPH NODE(S) 830.00 PROF FEES PR LAP LYMPHATIC SYSTEM OTHER PROC 464.00 PROF FEES PR INCISION OF TONGUE FOLD 676.00 PROF FEES PR ESOPHAGOSCOPY BIOPSY 650.00 PROF FEES PR EGD TRANSORAL BIOPSY SINGLE OR MULTIPLE 1,284.00 PROF FEES PR REVISION GASTROPLASTY OBESITY 11,961.00 PROF FEES PR ONLINE DIGITAL E/M SVS EST PATIENT =< 7 DAYS => 21 MIN 101.00 PROF FEES PR PHONE E&M EST PATIENT 5-10 MIN 97.00 PROF FEES PR PART REMOVAL COLON W COLOSTOMY 8,361.00 PROF FEES PR REVISION OF COLOSTOMY COMPLICATED 5,183.00 PROF FEES PR SB SCOPE PLACE PERCUT JEJUN TUBE 557.00 PROF FEES PR SB SCOPE CONVRT GASTRO TO JEJUN 938.00 PROF FEES PR SIGMOIDOSCOPY DIAGNOSTIC 562.00 PROF FEES PR COLONOSCOPY DIAGNOSTIC 1,716.00 PROF FEES PR COLONOSCOPY BIOPSY SINGLE OR MULTIPLE 2,011.00 PROF FEES PR PLACEMENT OF SETON 1,252.00 PROF FEES PR REMOVAL OF ANAL TAG SINGLE 761.00 PROF FEES PR REMOVAL OF HEMORROIDAL TAGS 904.00 PROF FEES PR HEMORRHOIDECTOMY INT & XTRNL 2+ COLUMN/GROUP 2,827.00 PROF FEES PR LAP ABLAT 1> LIVER TUMOR(S) RADIO FREQ 4,816.00 PROF FEES PR LAPAROSCOPY BX LIVER SPEC PURPOSE AFFILIATE ONLY 5,025.00 PROF FEES PR REMOVE GALLBLADDER EXPLOR COMMON DUCT 6,219.00 PROF FEES PR REMOVAL OF OMENTUM 2,913.00 PROF FEES PR REPAIR ING HERNIA >5 TRS STRANG 2,959.00 PROF FEES PR REPAIR RECURR FEMORAL HERNIA STRANG 1,634.00 PROF FEES PR REPAIR UMBILICAL HERN <5 YRS REDUC 2,124.00 PROF FEES PR STRAIGHT CATHETERIZATION 263.00 PROF FEES PR INSERT TEMP INDWELLING CATH COMPLICATED 294.00 PROF FEES PR INTRAABDOMINAL VOIDING PRESSURE TEST 1,241.00 PROF FEES PR CYSTOURETHROSCOPY 392.00 PROF FEES PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH 3,476.00 PROF FEES PR PHONE E&M EST PATIENT 11-20 MIN 136.00 PROF FEES PR REMOVAL OF HYDROCELE TUNICA UNILAT 2,554.00 PROF FEES PR I&D BARTHOLIN GLAND ABSCESS 241.00 PROF FEES PR BX VULVA PERINEUM ADDL LESION 248.00 PROF FEES PR PART SIMPLE REMOVE VULVA 4,580.00 PROF FEES PR PHONE E&M EST PATIENT 21-30 MIN 196.00 PROF FEES PR FIT/INSERT INTRAVAG SUPPORT DEVICE 154.00 PROF FEES PR POST COLPORRHAPHY RECTUM/VAGINA 2,760.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAG W LOOP BX 1,991.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAG W LOOP CONIZ 1,596.00 PROF FEES PR BIOPSY/EXCISE CERVICAL LESION 198.00 PROF FEES PR ENDOCERVICAL CURETTAGE 551.00 PROF FEES PR MYOMECTOMY 1-4W/TOT 250GMS/5 YRS HOSP 3,213.00 PROF FEES PR RPLC CATH ONLY CV ACS DEV W PORT 1,196.00 PROF FEES PR INJ NERV BLOCK HYPOGASTRIC PLEXUS 417.00 PROF FEES PR GI TRACT IMAGE CAPSULE ENDO W MD I&R 374.00 PROF FEES PR ELEC EVAL HEARING AID BINAURAL NC AU546 0.00 PROF FEES PR COLPOPEXY INTRAPERITONEAL 2,523.00 PROF FEES PR GASTROESOPH REFLEX W ELECTROD 191.00 PROF FEES PR ACTIVE WOUND CARE FIRST 20 SQ CM OR LESS 27.00 PROF FEES PR ACTIVE WOUND EACH ADDL 20 SQ CM OR PART THEREOF 33.00 PROF FEES PR LAP BIOPSY LIVER WEDGE SG252 5,025.00 PROF FEES HCHG SLING PR30 44.00 PROF FEES PR EST PT EVAL MGMT FACILITY FEE AFFILIATE ONLY LEVEL 1 106.00 PROF FEES PR LIGATION, DIVISION, STRIPPING, LONG SAPH VEINS FROM SAPH JUNCT TO KNEE OR BELOW1,965.00 PROF FEES PR EST PT EVAL MGMT FACILITY FEE AFFILIATE ONLY LEVEL 2 174.00 PROF FEES PR SURGICAL LAPAROSCOPY ENTEROLYSIS 5,930.00 PROF FEES PR SURGICAL LAPAROSCOPY ILEOSTOMY/JEJUNOSTOMY, NON-TUBE 3,842.00 PROF FEES PR SURG LAPAROSCOPY, COLOSTOMY OR SKIN LEVEL CECOSTOMY 2,617.00 PROF FEES PR AMB CONT GLUCOSE MONITORING TO 72 HRS MD INTERP AND REPORT 146.00 PROF FEES PR REFILL AND MAINT PORTABLE PUMP CHEMO 756.00 PROF FEES PR IRRIG OF IMPLANTED VEN ACCESS DEV FOR DRUG DELIV SYS CHEMO 526.00 PROF FEES PR ZOSTER VACCINE LIVE SQ 1.00 PROF FEES PR EXCISE EXCESSIVE SKIN ABDOMEN 4,718.00 PROF FEES PR P-MASTECTOMY W/LYM REMOVAL 2,995.00 PROF FEES PR MASTECTOMY MOD RAD 3,967.00 PROF FEES PR LSH W/T/O UT 250 G OR LESS 4,118.00 PROF FEES PR FLUOROSCOPIC GUIDE FOR NEEDLE PLACEMENT 572.00 PROF FEES PR HYSTEROSCOPY W ABLATION CLINIC 7,328.00 PROF FEES PR PLACE DUOD/JEJ TUBE PERC 3,115.00 PROF FEES PR REPLACE DUOD/JEJ TUBE PERC 210.00 PROF FEES PR REPAIR PARAVAG DEFECT LAP 1,968.00 PROF FEES PR TLH W TUBES/OVAR UTERUS OVER 250 G 4,595.00 PROF FEES PR EST PT EVAL MGMT FACILITY FEE AFFILIATE ONLY LEVEL 3 219.00 PROF FEES PR PHONE E&M EST PATIENT 5-10 MIN 26.00 PROF FEES PR EST PT EVAL MGMT FACILITY FEE AFFILIATE ONLY LEVEL 4 283.00 PROF FEES PR REMOVAL ABDOMINAL DRAIN 0.00 PROF FEES PR LAP GASTRIC BYPASS RNY (SSUT) 12,230.00 PROF FEES PR LAP REMOVAL STITCH BOWEL OBSTRUCTION 7,924.00 PROF FEES PR PROG DUAL LEAD PACER IN PERSON W ANLYS, R&R BY MD 171.00 PROF FEES PR PROG MULTI LEAD PACER IN PERSON W ANLYS, R&R BY MD 125.00 PROF FEES PR IV INF HYDRATE INITIAL 31-60 MIN 211.00 PROF FEES PR INIT NEWBORN CARE HOSP BIRTH CENTER PER 245.00 PROF FEES PR NEWBORN RESUSCITATION 549.00 PROF FEES PR NEONATE CRITICAL CARE SUBSEQUENT 951.00 PROF FEES PR EKG FOR INTIAL PREVENT INTERP-MEDICARE 81.00 PROF FEES PR PSYCHOTHERAPY FAMILY W PATIENT 50 MIN 122.00 PROF FEES PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM 1,392.00 PROF FEES PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM 1,820.00 PROF FEES PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM 2,154.00 PROF FEES PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA 2,488.00 PROF FEES PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES 291.00 PROF FEES PR REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC 1,824.00 PROF FEES PR INJ PARAVERTEBRAL FACET JOINT LUMBAR OR SACRAL SINGLE LEVEL WITH FLUORO OR CT 400.00 PROF FEES PR APPL MULTLAY COMPRS LWR LEG 220.00 PROF FEES PR LAP REDUCTION INTERNAL HERNIA 7,924.00 PROF FEES PR LAP GASTRIC ADJ DEVICE BARIATRIC 12,230.00 PROF FEES PR OCH URINE DRUG SCREEN PROCESSING GENERAL 43.00 PROF FEES PR CIRCUMC CLAMP/BLOCK CLINIC 654.00 PROF FEES PR LAP PARTIAL GASTRECTOMY W ROUX-EN-Y 13,155.00 PROF FEES PR POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE 293.00 PROF FEES PR IM ADM EA ADD VAC/TOXOID =<18YR COUNSELING 80.00 PROF FEES PR FIRST ANNUAL WELLNESS VISIT 432.00 PROF FEES PR INJ COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 0.01 MG 158.00 PROF FEES PR DTAP/HIB/IPV COMB VACC 187.00 PROF FEES PR DBRDMT SQ TISSUE EA ADDL 20 SQ CM OR PART THEREOF 130.00 PROF FEES PR FLU VACC NASAL 42.00 PROF FEES PR HIB VACC PRP-OM* 106.00 PROF FEES PR MENINGOCOCCAL (MENACTRA) VACC IM 0.00 PROF FEES PR MENINGOCOCCAL (MENOMUNE) VACC SQ 480.00 PROF FEES PR MMR VARICELLA VACC 0.00 PROF FEES PR LAP REDUCTION OF INTUSSUSCEPTION 7,924.00 PROF FEES PR BRACE KNEE ELASTIC PREFAB ADJUST PR20 188.00 PROF FEES PR ERCP REMOVE FB OR STENT BILIARY OR PANC DUCT 921.00 PROF FEES PR ADMIN VACC W COUNS TO 18 YRS INIT ANY RTE STATE SERUM 80.00 PROF FEES PR ADMIN EA ADDL VACC W COUNS TO 18 YRS ANY RTE STATE SERUM 80.00 PROF FEES MED REVIEW BY PRESCRIBING CARE PROVIDER OR CLIN PHARMACIST DOCD 0.00 PROF FEES PR SKIN SUB GRAFT FACE NK HF G 141.00 PROF FEES PR SKIN SUB GRAFT FACE NK HF G 328.00 PROF FEES PR THORACOSCOPY W BX INFILTRATE 1,080.00 PROF FEES PR THORACOSCOPY W BX NODULE 816.00 PROF FEES PB IHC STAIN ADDL 156.00 PROF FEES PR COLONOSCOPY FLEXIBLE WITH ENDOSCOPIC MUCOSAL RESECTION 3,209.00 PROF FEES PR CHRON CARE MGMT SRVC 20 MIN 102.00 PROF FEES HCHG OPTIME BIOVANCE PER SQ CM 425.00 PROF FEES HCHG OT SELFCARE/HOME MGMT XE 212.00 PROF FEES HCHG OT THERAPEUTIC EXERCISE XE 101.00 PROF FEES PR SUBSEQUENT ANNUAL WELLNESS-NURSE VISIT AFFILIATE ONLY 289.00 PROF FEES PB PREGABALIN LYRICA PBL 281.00 PROF FEES PR LAP REDUCTION OF VOLVULUS 7,924.00 PROF FEES PR LYMPHATIC LIGATION 2,366.00 PROF FEES PR LAP LADD W LYSIS OF ADHESIONS 7,924.00 PROF FEES PR LAP REM REPL GASTRIC BAND SQ COMP 13,156.00 PROF FEES PB GENERAL LAB 8759104 293.00 PROF FEES PR CLSD TX POST PELV RING FX WWO ANTER PELV RING FX WO MANIP 256.00 PROF FEES PR EST PT EVAL MGMT FACILITY FEE AFFILIATE ONLY LEVEL 5 400.00 PROF FEES PR OT MANUAL THER TECH 1+ REGIONS EA 15 MIN AFFILIATE ONLY 92.00 PROF FEES PR OT SELF CARE/HOME MGMT TRAIN EA 15 MIN AFFILIATE ONLY 212.00 PROF FEES PB IGA 176.00 PROF FEES PR EXPLORATORY LAPAROSCOPY WITH REPAIR BILE LEAK 4,139.00 PROF FEES PB TSH 144.00 PROF FEES PB BILE ACIDS LC 175.00 PROF FEES PR RECTAL TUBE PLACEMENT 1,634.00 PROF FEES PR QNHP ONLINE E/M SVC EST PATIENT =< 7 DAYS 5-10 MIN 28.00 PROF FEES PB HLA ABY CLASS I 414.00 PROF FEES PR RHOPHYLAC ANTI D IMMUNOGLOBIN 164.00 PROF FEES PR US PELVIC NON OB COMPLETE 1,387.00 PROF FEES PR ARTHROSCOPIC ALLOGRAFT IMPACT OF BONY CYSTS LEFT 3,960.00 PROF FEES PR FO PIP DIP W JOINT SPRING PREFAB OTS PR1 104.00 PROF FEES PR ASSIST LISTEN DEVICE PERSONAL FM DM EAR LEVEL REC CUY ONLY 0.00 PROF FEES PR COUNSELING VISIT FOR LDCT SCREENING 77.00 PROF FEES PR XR CENTRAL VENOUS CATHETER FLUORO 163.00 PROF FEES PR QNHP ONLINE E/M SVC EST PATIENT =< 7 DAYS 11-20 MIN 50.00 PROF FEES PR QNHP ONLINE E/M SVC EST PATIENT =< 7 DAYS => 21 MIN 78.00 PROF FEES HCHG GRADIENT COMPRESS STOCK THIGH 18-30 PR160 AFFILIATE ONLY 233.00 PROF FEES PR XR FLUORO UP TO 1 HR GIH ONLY 155.00 PROF FEES PR LAP ABDOMINAL EXPLORATION WITH RETREIVAL OF FOREIGN OBJECT 1,996.00 PROF FEES PR PSYCHOTHERAPY COMPLEX INTERACTIVE 37.00 PROF FEES PR PSYCH DIAG EVAL W MED SERV 281.00 PROF FEES PR POST OP SURGICAL BOOT PR50 70.00 PROF FEES PR INJ MEDROXYPROGESTERONE ACETATE 1 MG 2.00 PROF FEES PR INJECTION OF PELVIC FLOOR MUSCLE 487.00 PROF FEES PR LAPAROSCOPIC REPAIR STOMACH PERFORATION W OMENTAL FLAP 13,156.00 PROF FEES PR INJ TESTOSTERONE CYPIONATE 1MG 1.00 PROF FEES PR FLU VACC QUADRIVALENT RIV4 PF AF IM 132.00 PROF FEES PR LAP REPAIR STOMACH PERFORMATION 13,156.00 PROF FEES PB COVID 19 MML 110.00 PROF FEES PR DIG RECTAL EXAM PROSTATE CA SCREEN 75.00 PROF FEES PR METHYLPREDNISOLONE ACETATE-20 MG 14.00 PROF FEES PR INJ MORPHINE SULFATE TO 10 MG 7.00 PROF FEES PR INJ METHYLPRED NA SUCCINATE TO 125MG 21.00 PROF FEES PR INJ PHYTONADIONE (VIT K) PER 1 MG 124.00 PROF FEES PR INFUSION NORMAL SALINE SOLN 250 CC 67.00 PROF FEES PR DRAIN SKIN ABSCESS COMPLIC 647.00 PROF FEES PR PUNCTURE DRAINAGE OF CYST/HEMATOMA 421.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM TRUNK ARM LEG 305.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM S/N/H/F/GENI 454.00 PROF FEES PR SHAV SKIN LESION 1.1-2.0 CM FACE EARS EYELIDS 614.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM TRUNK ARM LEG 475.00 PROF FEES PR EXC SKIN BENIGN < 0.5 CM SCALP NECK HANDS FEET 275.00 PROF FEES PR EXC SKIN BENIGN 0.6-1 CM SCALP NECK HANDS FEET 338.00 PROF FEES PR EXC SKIN BENIGN 1.1-2 CM FACE EARS EYELIDS 627.00 PROF FEES PR EXC SKIN BENIGN 2.1-3 CM FACE EARS EYELIDS 304.00 PROF FEES PR EXC SWEAT GLAND LESN AXILL COMPLX 1,879.00 PROF FEES PR EXC SKIN MALIG 1.1-2 CM SCALP NECK HANDS FEET 982.00 PROF FEES PR EXC SKIN MALIG 3.1-4 CM SCALP NECK HANDS FEET 1,398.00 PROF FEES PR DEBRIDEMENT OF NAIL(S) 1-5 130.00 PROF FEES PR AVULSION OF NAIL PLATE SINGLE 312.00 PROF FEES PR AVULSION OF NAIL PLATE EA ADDL 120.00 PROF FEES PR REPAIR OF NAIL BED 966.00 PROF FEES PR REPAIR SUPERF WOUND BODY < OR = 2.5 CM 506.00 PROF FEES PR REPAIR SUPERF WOUND BODY 2.6-7.5 CM 223.00 PROF FEES PR REPAIR SUPERF WOUND BODY 7.6-12.5 CM 466.00 PROF FEES PR REPAIR SUPERF WOUND FACE EARS EYELIDS 2.6-5 CM 370.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM < OR = 2.5CM 978.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 2.6-7.5 CM 283.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 7.6-12.5 CM 412.00 PROF FEES PR REPAIR INTERMED WOUND SCALP TRUNK EXTREM 12.6-20 CM 1,485.00 PROF FEES PR REPAIR COMPLEX WOUND FACE HAND FEET 1.1-2.5 CM 1,204.00 PROF FEES PB REPAIR COMPLEX WOUND FACE HAND FEET 2.6-7.5 CM 2,036.00 PROF FEES PR REPAIR COMPLEX WOUND EYELID NOSE EAR 1.1-2.5 CM 1,293.00 PROF FEES PR SECD CLOS SURG WND EXTEN/COMPLIC 3,418.00 PROF FEES PR INJ ESTRADIOL VALERATE TO 10 MG 304.00 PROF FEES PR INJ PROGESTERONE PER 50 MG 126.00 PROF FEES PR DRESS/DEBRID LARGE BURN >10% TBSA 470.00 PROF FEES PR INJ LEVONORGESTREL RELEASING IUD KYLEENA 19.5 MG 1,618.00 PROF FEES PR PUNCTURE ASPIRATION BREAST CYST 389.00 PROF FEES PR REMOVAL OF FB MUSCLE DEEP/COMPLIC 1,902.00 PROF FEES PR INJ CARPAL TUNNEL 564.00 PROF FEES PR INJ TENDON SHEATH/LIGAMENT 125.00 PROF FEES PR INJ TENDON SHEATH/LIGAMENT 146.00 PROF FEES PR APPLY BONE MULTIPLAN EXT FIX DEV 4,978.00 PROF FEES PR LEVONORGESTREL RELEASE IUD KYLEENA 19.5 MG 1,747.00 PROF FEES PR REPAIR ROTATOR CUFF CHRONIC 6,122.00 PROF FEES PR OPEN REPAIR CLAVICLE FRACTURE 3,465.00 PROF FEES PR CLOSED TX PROX HUMERUS FRACTURE 382.00 PROF FEES PR OPEN TX SHLDR DISLOCGR TUB FX 966.00 PROF FEES PR OPEN TX SHLDR DISLOCGR TUB FX 919.00 PROF FEES PR REINSERT BI/TRICEPS TENDON DISTAL 2,214.00 PROF FEES PR CLOSED TX MID HUMERUS FRACTURE 788.00 PROF FEES PR CLOSED TX HUMER EPICONDYLR FX 730.00 PROF FEES PR CLOSED TX HUMER CONDYLR FX 850.00 PROF FEES PR OPEN TX PERIARTIC FX ELBOW IMPLNT 2,322.00 PROF FEES PR OPEN TX PERIARTIC FX ELBOW IMPLNT 1,147.00 PROF FEES PR CLOSED TX RADIAL HEAD/NECK FX 612.00 PROF FEES PR CLOSED TX PROX ULNA FRACTURE 1,003.00 PROF FEES PR DECOMP FOREARM 1 COMPART W O DEBRIDE 1,618.00 PROF FEES PR EXCIS TENDON SHEATH LESN WRIST FOREARM 790.00 PROF FEES PR PART REMOVAL BONE ULNA 1,687.00 PROF FEES PR REMOVAL OF CARPAL BONE 1,060.00 PROF FEES PR REPAIR FOREARM TEND MUSC EXTEN PRIM EA 2,402.00 PROF FEES PR XPLANT FOREARM TENDON W TENDON GRAFT 1,550.00 PROF FEES PR CLOSED TX RADIAL SHAFT FX 320.00 PROF FEES PR CLOSED TX RADIAL SHAFT FX MANIPULATION 1,574.00 PROF FEES PR CLOSED TX RAD/ULNA SHAFT FX 631.00 PROF FEES PR FUSION OF WRIST JOINT 1,583.00 PROF FEES PR EXCIS TENDON SHEATH LESION HAND/FINGER 2,360.00 PROF FEES PR CLOSED TX METACARPAL FX MANIP 947.00 PROF FEES PR CLOSED TX METACARP FX W MANIP W EXT FIX 1,666.00 PROF FEES PR LEVONORGESTREL IU 52MG 5 YR MIRENA 1,618.00 PROF FEES PR CLOSE TX PROX/MID FING OR THUMB SHFT FX 468.00 PROF FEES PR CLOSE TX DIST FINGR/THUMB FX 419.00 PROF FEES PR PERCUT TX DIST FINGR FX 910.00 PROF FEES PR LEVONORGESTREL IU 13.5 MG SKYLA 1,618.00 PROF FEES PR AMPUTATION FINGER OR THUMB 2,519.00 PROF FEES PR REMOVE HIP PELVIS TUMOR SUBCUT<3CM 2,490.00 PROF FEES PR PARTIAL HIP REPLACEMENT 6,370.00 PROF FEES PR CONV PREV HIP SURG TO TOT HIP ARTHROPLAS 11,066.00 PROF FEES PR REVISE FEM PART OF TOTAL HIP 9,885.00 PROF FEES PR CLOSED TX ACETABULAR FX 2,174.00 PROF FEES PR CLOSED TX POST HIP ARTHRPLAS DISLOC 1,818.00 PROF FEES PR REMOVAL SYNOVIAL CYST KNEE 2,838.00 PROF FEES PR CLOSED TX CONDYLAR FX 2,401.00 PROF FEES PR OPEN TX FEMUR FX W INTRAMED ROD 6,365.00 PROF FEES PR CLOSED TX PATELLA FX 374.00 PROF FEES PR CLOSED TX TIB PLAT FX W MANIP 2,421.00 PROF FEES PR OPEN TX UNI TIB PLAT FX 998.00 PROF FEES PR TREAT TIBIAL SHAFT FX INTRAMED IMPLANT 5,708.00 PROF FEES PR OPEN TX LAT MALLEOLUS FX 3,280.00 PROF FEES PR RE-AMPUTATION LOWER LEG 2,302.00 PROF FEES PR EXCIS TENDN/CAPSULE LESN FOOT 1,922.00 PROF FEES PR PART REMOVE TALUS OR CALCANEUS 3,068.00 PROF FEES PR RELEASE FLEX FOOT TENDON SINGLE 1,093.00 PROF FEES PR RELEASE FLEX FOOT TENDON SINGLE 686.00 PROF FEES PR INCISION EXTEN FOOT/TOE TENDON 1,043.00 PROF FEES PR REPAIR BUNION 1ST METATARSAL JOINT ARTHRODESIS ANY METHOD 3,353.00 PROF FEES PR CLOSED TX HEEL FX 335.00 PROF FEES PR CLOSED TX TALUS FX 307.00 PROF FEES PR CLOSED TX TARSAL FX EA 575.00 PROF FEES PR CLOSED TX BIG TOE FRACTURE 152.00 PROF FEES PR APPLY LONG ARM CAST 283.00 PROF FEES PR APPLY SHORT LEG CAST 164.00 PROF FEES PR APPLY SHORT LEG CAST 475.00 PROF FEES PR REMOVE/REVISN FULL ARM/LEG CAST 610.00 PROF FEES PR ELBOW ARTHROSCOP REMOVE LOOSE BODY 973.00 PROF FEES PR ELBOW ARTHROSCOP PART DEBRIDE 3,951.00 PROF FEES PR WRIST ARTHROSCOP RELEASE XVERS LIG 2,962.00 PROF FEES PR TIBIAL SCOPE SURG FX AID UNICONDYLR 4,890.00 PROF FEES PR TRACHEOSTOMY PLANNED 867.00 PROF FEES PR BRONCHOSCOPY THERAPEUTIC ASPIR PULM TREE W FLUORO INITIAL 1,366.00 PROF FEES PR ETONOGESTREL IMPLANT SYSTEM 1,058.00 PROF FEES PR BILOBECTOMY 9,333.00 PROF FEES PR INSERT HEART PM ATRIAL 4,486.00 PROF FEES PR INSERT SGL ELECTRODE PCMKR OR ICD 2,291.00 PROF FEES PR VEIN BYPASS GRAFT FEM-POP 7,363.00 PROF FEES PR BLOOD TRANSFUSION SERVICE 189.00 PROF FEES PR INJ THERAPY VEIN MULT VEINS 237.00 PROF FEES PR NEEDLE BIOPSY/EXCISION LYMPH NODE(S) 572.00 PROF FEES PR BX/REMOVE LYMPH NODE DEEP CERV 1,803.00 PROF FEES PR BX/REMOVE LYMPH NODE DEEP AXILL 1,849.00 PROF FEES PR INCISION OF TONGUE FOLD 146.00 PROF FEES PR EGD FLEX REM TUM(S) POLYP(S) LESION(S) HOT BX FORCEPS 881.00 PROF FEES PR REVISEGASTROJEJUN ANAST WO VAGOTOMY 8,844.00 PROF FEES PR REMOVAL COLON & TERM ILEUM W/ILEOCOLOSTOMY 5,728.00 PROF FEES PR LAP SURG COLECTOMY PARTIAL WANAST 5,304.00 PROF FEES PR LAP SURG COLECTOMY TOTAL WO PROCTECTOMY 9,022.00 PROF FEES PR SMALL BOWEL ENDOSCOPY PAST 2ND DUOD 1,347.00 PROF FEES PR COLONOSCOPY THRU STOMA LESN RMVL WSNARE 1,179.00 PROF FEES PR APPENDECTOMY W OTHR PROC 380.00 PROF FEES PR I&D RECTAL SUBMUCOSAL ABSCESS 606.00 PROF FEES PR PROCTOSIGMOIDOSCOPY RIGID DIAGNOS 562.00 PROF FEES PR SIGMOIDOSCOPY REMOVE TUM LESN POLY HOT BIOPSPY FORCEPS 1,038.00 PROF FEES PR SIGMOIDSCPY DECOMPR (PATH DISTENT) VOLVULUS INC PLCMNT TUBE 363.00 PROF FEES PR SIGMOIDOSCOPY FLEX W TRANSENDO BLLN DILAT 1 OR >STRICTURES 1,898.00 PROF FEES PR CLOSE RECTUMBLADDER FISTULA 5,236.00 PROF FEES PR ANAL SPHINCTEROTOMY 1,464.00 PROF FEES PR REMOVAL OF ANAL FISSURE 1,554.00 PROF FEES PR DIAG ANOSCOPY INC COL SPEC BY BRUSH WASH WHEN PERF SEP PROC 80.00 PROF FEES PR DIAG ANOSCOPY INC COL SPEC BY BRUSH WASH WHEN PERF SEP PROC 348.00 PROF FEES PR ANOSCOPY WCONTROL BLEEDING 479.00 PROF FEES PR DESTROY ANAL LESN(S) CRYOSURGERY 152.00 PROF FEES PR DESTROY ANAL LESN(S) CRYOSURGERY 386.00 PROF FEES PR NEEDLE BIOPSY LIVERW OTHR PROC 776.00 PROF FEES PR LAP CHOLECYSTECTOMY 5,579.00 PROF FEES PR PANCREATORRHAPHY INJURY 4,618.00 PROF FEES PR REPAIR FEMORAL HERNIA STRANG 3,637.00 PROF FEES PR REPAIR RECURR INCIS HERNIA REDUC 3,574.00 PROF FEES PR REPAIR RECURR INCIS HERNIA STRANG 4,341.00 PROF FEES PR LAP ADHESIOLYSIS VENTRAL HERNIA WMESH 4,844.00 PROF FEES PR STRAIGHT CATHETERIZATION 368.00 PROF FEES PR URINE FLOW MEASUREMENT SIMPLE 49.00 PROF FEES PR ELECTRO-UROFLOWMETRY COMPLEX 60.00 PROF FEES PR ELECTRO-UROFLOWMETRY COMPLEX 492.00 PROF FEES PR ANAL/URINARY MUSCLE STUDY 968.00 PROF FEES PR LAP SLING OPERATION 6,332.00 PROF FEES PR BX VULVA PERINEUM ADDL LESION 123.00 PROF FEES PR PARTIAL REMOVAL OF HYMEN 414.00 PROF FEES PR COLPOSCOPY VULVA WBIOPSY(S) 609.00 PROF FEES PR DESTROY VAGINAL LESION(S) EXTENSIVE 938.00 PROF FEES PR DESTROY VAGINAL LESION(S) EXTENSIVE 1,541.00 PROF FEES PR BIOPSY OF VAGINA SIMPLE 504.00 PROF FEES PR ANTER COLPORRHAPHY BLAD/VAGINA INCL CYSTURETHROSCOPY 2,735.00 PROF FEES PR COLPOPEXY VAG EXTRA-PERITONEAL APPROCH 5,133.00 PROF FEES PR REMOVE/REVS SLING FOR STRES INCONTINENCE 3,930.00 PROF FEES PR COLPOSCOPY ENTIRE VAGINA W/BIOPSY(S) 469.00 PROF FEES PR COLPOSCOPY ENTIRE VAGINA W/BIOPSY(S) 431.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAGINA 313.00 PROF FEES PR COLPOSCCERVIX W ADJ VAG W BX AND CURETTAG 374.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAG W LOOP BX 655.00 PROF FEES PR COLPOSCOPY CERVIX W ADJ VAG W LOOP CONIZ 1,031.00 PROF FEES PR CRYOCAUTERY OF CERVIX 369.00 PROF FEES PR CRYOCAUTERY OF CERVIX 675.00 PROF FEES PR DILATION AND CURETTAGE 1,402.00 PROF FEES PR TOTAL ABDOM HYSTERECTOMY 3,587.00 PROF FEES PR REOPEN FALLOPIAN TUBE CHROMOTUBATION 413.00 PROF FEES PR HYSTEROSCOPY WENDO BX 1,179.00 PROF FEES PR HYSTEROSCOPY RMV MYOMA 2,085.00 PROF FEES PR HYSTEROSCOPY RMV FB 2,036.00 PROF FEES PR REMOVAL OF FALLOPIAN TUBE 3,312.00 PROF FEES PR TREAT ECTOPIC PREG RMV TUBE/OVARY 3,648.00 PROF FEES PR TX ECTOP PREG BY LAPAROSCOPE 3,650.00 PROF FEES PR REVISION CERVIX W PREG VAG APPRCH 631.00 PROF FEES PR DELIVER PLACENTA 728.00 PROF FEES PR CESAREAN DELIVERY ONLY 4,561.00 PROF FEES PR SURG TREATMENT OF MISCARRIAGE 2ND TRI 1,772.00 PROF FEES PR BIOPSY OF THYROID PERCUT 555.00 PROF FEES PR PARTIAL EXCISION THYROID UNILAT 4,453.00 PROF FEES PR PARTIAL EXCISION THYROID BILAT 5,653.00 PROF FEES PR THYROIDECTOMY MALIG LTD NECK SURG 6,403.00 PROF FEES PR LUMBAR PUNCTURE DIAGNOSTIC 753.00 PROF FEES PR INJ LUMBAR EPIDUR BLOOD/CLOT PATCH 651.00 PROF FEES PR INJ FORAMEN C/T 1 LEVEL WITH FLUORO OR CT 543.00 PROF FEES PR INJ FORAMEN L/S 1 LEVEL WITH FLUORO OR CT 508.00 PROF FEES PR PERCUT IMPLANT NEUROELEC PERIPH NERVE 480.00 PROF FEES PR PERC IMPLANT NEUROELEC SACRAL NERVE INC GUIDE HOSPITAL 5,136.00 PROF FEES PR REVISE/REPAIR ARM/LEG NERVE 1,109.00 PROF FEES PR NERVE GRAFT HAND/FOOT MULT=<4CM 2,889.00 PROF FEES PR REMOVE FB EYE SUPERF CONJUNC 343.00 PROF FEES PR MULTI FAMILY GROUP THERAPY, PER 30 MIN 93.00 PROF FEES PR INTERPRETATION OF PSYCH RESULTS 443.00 PROF FEES PR ACID PERFUSION OF ESOPHAGUS 342.00 PROF FEES PR COLOR VISION EXAMINATION 137.00 PROF FEES PR SPEECH AUDIOMETRY COMPLETE 87.00 PROF FEES PR HEARING AID EXAM BINAURAL 155.00 PROF FEES PR ELECTROCARDIOGRAM COMPLETE 205.00 PROF FEES PR ELECTROCARDIOGRAM TRACING 198.00 PROF FEES PR ECG PT ACTIVATED RECORDING 628.00 PROF FEES PR ECHO HEART COMPLETE WO CONTRAST/SPECTRAL/COLOR 293.00 PROF FEES PR POLYSOMNOGRAPHY => 6YRS =>4 PARAMETERS W CPAP OR BILEVEL 456.00 PROF FEES PR SOMATOSENSORY TEST UPPER LIMBS 45.00 PROF FEES PR DEVELOPMENTAL SCREEN 110.00 PROF FEES PR ULTRASOUND THERAPY EA 15 MIN 32.00 PROF FEES PR WOUND DEBRIDEMNT NON-SELECTIVE EA 168.00 PROF FEES PR OSTEOPATHIC MANIP 9-10 BODY REGN 77.00 PROF FEES PR PREVENTIVE VISIT NEW AGE 5-11 372.00 PROF FEES PR PREVENTIVE VISIT NEW 12-17 186.00 PROF FEES PR PREVENTIVE VISIT NEW 18-39 201.00 PROF FEES PR PREVENTIVE VISIT NEW 18-39 201.00 PROF FEES PR INITIAL HOSPITAL CARE LEVL 3 785.00 PROF FEES PR PREVENTIVE VISIT NEW 12-17 372.00 PROF FEES PR PREVENTIVE VISIT NEW AGE 1-4 187.00 PROF FEES PR PREVENTIVE VISIT NEW AGE 1-4 187.00 PROF FEES PR PREVENTIVE VISIT NEW 18-39 401.00 PROF FEES PR HOME HEALTH CARE SUPERV 15-29 MIN 119.00 PROF FEES PR PREVENTIVE VISIT NEW AGE 5-11 186.00 PROF FEES PR PREVENTIVE VISIT NEW 40-64 470.00 PROF FEES PR PREVENTIVE VISIT NEW AGE 5-11 186.00 PROF FEES PR OCH BREATH ALCOHOL TESTING 64.00 PROF FEES PR PREVENTIVE VISIT EST AGE 5-11 180.00 PROF FEES PR PREVENT COUNSEL INDIV 15 MIN 76.00 PROF FEES PR DEBRIDE ACHILLES TENDON 0.00 PROF FEES PR LAP RRP INCAR RECURRINC HERNIA W LYSIS 4,844.00 PROF FEES PR LAP RPR INI INCARC VENT HERNIA W MESH LYSIS 4,844.00 PROF FEES PR GROUP THERAPY 70.00 PROF FEES PR PREVENTIVE VISIT NEW INFANT < 1 YR 171.00 PROF FEES PR PREVENTIVE VISIT NEW 65 AND OVER 514.00 PROF FEES PR PREVENTIVE VISIT NEW INFANT < 1 YR 171.00 PROF FEES PR NEURAXIAL LABOR ANAL/ANES PLAN VAG DEL 368.00 PROF FEES PR TRCK NO CHARGE 0.00 PROF FEES PR TRCK-HEARING AID RECHECK-NC 0.00 PROF FEES PR RMV TUN CV CATH WO PORT OR PUMP 684.00 PROF FEES PR STAB PHLEBTMY VRCS 1 EXTRM 10-20 STAB INC 3,701.00 PROF FEES PR STAB PHLEBTMY VRCS 1 EXTRM 20OR MORE STAB INC 3,701.00 PROF FEES PR GI TRACT IMAGE CAPSULE ENDO W MD I&R 3,407.00 PROF FEES PR OB VISIT - NO CHARGE 0.00 PROF FEES HCHG OT FUNCTIONAL CAPACITY EVAL 15MIN 105.00 PROF FEES HCHG MNT INDIV SUBSEQ EA 15 MIN 80.00 PROF FEES HCHG BETA LACTAMASE 203.00 PROF FEES PR LAP EXCISION MECKELS DIVERTICULUM 2,422.00 PROF FEES PR DEBRIDE GENITALIA AND PERINEUM 2,402.00 PROF FEES PR INSET MESH PELVIC FLR 2,046.00 PROF FEES PR OCH CHEST XRAY 38.00 PROF FEES PR ACTIVE WOUND CARE FIRST 20 SQ CM OR LESS 110.00 PROF FEES PR INITIAL NURSING FAC CARE PER DAY MOD MDM 326.00 PROF FEES PR OCH PREVENTIVE VISIT EST 65 AND OVER 104.00 PROF FEES PR SURGICAL LAP MOBIL SPLENIC FLEX PERF W PART COLECTOMY 876.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF INDIV PT EA 30 MIN 0.00 PROF FEES PR EDUC AND TRNG FOR PT SELF-MGMT BY QUAL PROF 2-4 PTS EA 30 MIN 0.00 PROF FEES PR PARAGARD INTRAUTERINE 2,179.00 PROF FEES PR ULTRASOUND GUIDE NEEDLE PLACEMENT 1,127.00 PROF FEES PR IMPLANT ARTHROPLAST 4TH MET 3,224.00 PROF FEES PR NONPNEUMATIC WALKING BOOT PREFAB CUSTOM FIT PR20 28.00 PROF FEES PR MASTECTOMY SIMPLE COMPLETE 3,426.00 PROF FEES PR OPEN TREAT DIST RADIAL FX INTRA-ARTICUL W INT FIX 2 FRAG 1,907.00 PROF FEES PR LAP OVARIAN DRILLING 5,963.00 PROF FEES PR EXC GASTROGASTRIC FISTULA 1,321.00 PROF FEES PR REPAIR ELBOW DEB/ATTCH OPEN 2,233.00 PROF FEES PR OCH PREVENTIVE VISIT EST 40-64 104.00 PROF FEES PR PHONE E&M EST PATIENT 21-30 MIN 52.00 PROF FEES PR INITIAL DAY HOSPITAL CARE NEONATE 1,275.00 PROF FEES PR SENIORCARE SUBSEQ NURSING FACILITY PER DAY MOD MDM 216.00 PROF FEES PR LAP MYOTOMY HELLER 4,506.00 PROF FEES PR INJ N BLOCK PLANTAR DIGIT 274.00 PROF FEES PR PRGM SINGLE LEAD OR LEADLESS PACER EVAL 223.00 PROF FEES PR PROG DUAL LEAD PACER IN PERSON W ANLYS, R&R BY MD 124.00 PROF FEES PR INJ SQ IM 80.00 PROF FEES PR IV INJ THER/PROPH/DIAG INITIAL 229.00 PROF FEES PR NEONATE CRITICAL CARE INITIAL 3,447.00 PROF FEES PR PEDS CRITICAL CARE INITIAL 1,947.00 PROF FEES PR MEDICARE WELCOME PREVENTIVE VISIT 404.00 PROF FEES PR MEDICARE WELCOME PREVENTIVE VISIT 135.00 PROF FEES PR ARTHROSCOPIC PREPATELLAR BURSECTOMY 3,960.00 PROF FEES PR CONTROL LIVER HEMORRHAGE -LAP 5,025.00 PROF FEES PR XR FLUORO 154.00 PROF FEES PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM 899.00 PROF FEES PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM 1,528.00 PROF FEES PR LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH 7,411.00 PROF FEES PR LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY 13,186.00 PROF FEES PR COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE 344.00 PROF FEES PR COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE 1,344.00 PROF FEES PR OCH HEP B VACCINE 97.00 PROF FEES PR INTRAOP SENTINEL LYMPH ID W/DYE NJX 308.00 PROF FEES PR DTAP/HEPB/IPV COMB VACC IM 0.00 PROF FEES PR DTAP-IPV VACC 0.00 PROF FEES PR DTAP VACC IM < 7 YO 0.00 PROF FEES PR HEP A VACC PED/ADOL 3 DOSE 111.00 PROF FEES PR MENINGOCOCCAL (MENOMUNE) VACC SQ 0.00 PROF FEES PR MMR VACC SQ 0.00 PROF FEES PR PNEUMOCOCCAL 13-VAL VACC 595.00 PROF FEES PR POLIOMYELITIS VACC INACT SQ/IM 1,118.00 PROF FEES PR TDAP VACC IM > 7 YO 122.00 PROF FEES PR ZOSTER VACC LIVE SQ 733.00 PROF FEES PR ARTHRO MICROFX CAPITELLAR OR RADIAL HEAD 3,960.00 PROF FEES PR OMENTAL DIVISION RELIEF 4,187.00 PROF FEES HCHG MISC REHAB SUPPLY AFFILIATE ONLY 17.00 PROF FEES PR US BIOPSY BREAST INC MARKER 1ST LESION W GUIDE 655.00 PROF FEES PR FLU VACC QUADRIVALENT IIV4 SV 0.25 ML 41.00 PROF FEES PR FLU VACC QUADRIVALENT IIV4 SV 0.5 ML IM 41.00 PROF FEES PR ADMIN EA ADDL VACC W COUNS TO 18 YRS ANY ROUTE 80.00 PROF FEES PAIN SEVERITY QUANTIFIED NO PAIN PRESENT 0.01 PROF FEES PR REMOVE&REPLACE PM GEN SINGL 1,111.00 PROF FEES PR DEPRESSION SCREEN ANNUAL 42.00 PROF FEES PR OCH PREVENTIVE VISIT EST 18-39 104.00 PROF FEES PR SKIN SUB GRAFT TRNK ARM LEG 196.00 PROF FEES PR INJ DUPUYTREN CORD W ENZYME 233.00 PROF FEES PR MANIPULAT PALM CORD POST INJ 69.00 PROF FEES PR MANIPULAT PALM CORD POST INJ 214.00 PROF FEES PR THORACOSCOPY W WEDGE RESECT 1,118.00 PROF FEES PR ABD PARACENTESIS WO IMAGING 425.00 PROF FEES PR ABD PARACENTESIS W IMAGING 2,082.00 PROF FEES PR ARTHROCENT ASPIR INJ INTERMED JOINT/BURSA W US GUIDE 180.00 PROF FEES PR CLNSCPY FLX W DECOMP FOR PATHOLOGIC DISTENTION PERFORMED 584.00 PROF FEES PR OCH PREVENTIVE VISIT EST 12-17 104.00 PROF FEES PB TISSUE LEVEL 4 TC ONLY 356.00 PROF FEES PB CBC/DIFF RTR 120.00 PROF FEES PR MODERATE SED SAME PROVIDER EACH ADDL 15 MINUTES 159.00 PROF FEES PR MODERATE SED DIFF PROVIDER > 5 YRS 1ST 15 MINUTES 210.00 PROF FEES PR ABI LIMITED 282.00 PROF FEES PR TANGENTIAL BIOPSY SKIN LESION EA ADDL 142.00 PROF FEES PR OT PARAFFIN BATH THERAPY AFFILIATE ONLY 35.00 PROF FEES PR FINE NEEDLE ASPIRATION BIOPSY W US GUIDE FIRST LESION 239.00 PROF FEES HCHG THERAPY PRODUCTS PR10 15.00 PROF FEES HCHG THERAPY PRODUCTS PR20 29.00 PROF FEES PR READING OB US 1ST TRI SINGLE 1ST GEST 0.00 PROF FEES HCHG CALPROTECTIN, FECAL LC 718.00 PROF FEES PB CERULOPLASMIN 102.00 PROF FEES HCHG FREE K+L LT CHAINS,QN,UR LC 95.00 PROF FEES PR LAPAROSCOPIC REPAIR OF CHOLECYSTODUODENAL FISTULA 4,139.00 PROF FEES HCHG ZINC, PLASMA OR SERUM LC 16.00 PROF FEES PB 17-HYDROXYPREGNENOLONE LC 94.00 PROF FEES PR READING OB US 1ST TRI @ ADD GEST 0.00 PROF FEES PB 5-HIAA,QUANT,24 HR URINE LC 171.00 PROF FEES PB FACTOR IX ACTIVITY LC 130.00 PROF FEES PB METHYLMALONIC ACID, SERUM LC 423.00 PROF FEES PB ACTINOMYCES ABYS LC 26.00 PROF FEES PB FUNGUS NES ANTIBODY LC 262.00 PROF FEES PB VITAMIN C LC 27.00 PROF FEES PB CALCITRIOL(1,25 DI-OH VIT D) LC 449.00 PROF FEES PB ZINC, PLASMA OR SERUM LC 70.00 PROF FEES PB FLOW MARKER, INTERP 2-8 179.00 PROF FEES PB TISSUE LEVEL 2 TC ONLY 80.00 PROF FEES PB COCCIDIOIDAL ABY EACH LC 141.00 PROF FEES PB CYTOCHROME P450 2C19 LC 474.00 PROF FEES PR INTRAUTERINE COPPER CONTRACEPTIVE 910.00 PROF FEES PB RETIC HGB CONC 175.00 PROF FEES PR INJ SQ IM BCBS 80.00 PROF FEES PR LAPAROSCOPIC PARTIAL GASTRECTOMY 13,156.00 PROF FEES PR SO FIG 8 ABD RESTRAINT PREFAB OTS PR5 12.00 PROF FEES PR LAP DRNG OF A MULTILOCATED MESENTERIC ABCESS 4,187.00 PROF FEES PR DISPENSING FEE MONAURAL BAHA REPLACEMENT AID 0.00 PROF FEES PR COLONOSCOPY THRU STOMA W DILATION STRICTURE 1,634.00 PROF FEES PR STOCKING PR80 AFFILIATE ONLY 116.00 PROF FEES PB POST VAS CHECK IN HOUSE NC 0.00 PROF FEES HCHG US PLCMT SOFT TISSUE DEVICE CLIP AXILLA 1ST LESION INCL GUIDANCE 1,216.00 PROF FEES PR COMMUNITY PARAMEDIC CUY ONLY 29.00 PROF FEES PR INSERT RESHAPE GASTRIC BALLOON CUY ONLY 1,529.00 PROF FEES HCHG SLEEVE COMPRESSION CALF PR10 20.00 PROF FEES PR LAPAROSCOPIC TAKEDOWN OF FUNDOPLASTY 6,566.00 PROF FEES PR PSYCH DIAG EVAL W MED SERV 56.00 PROF FEES PR PSYCHOTHERAPY PATIENT 30 MIN 241.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 30 MIN 180.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 30 MIN 461.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 45 MIN 183.00 PROF FEES PR PSYCHOTHERAPY PATIENT W E/M SRVC 60 MIN 244.00 PROF FEES PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN 442.00 PROF FEES PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MIN 121.00 PROF FEES PR TRANSITIONAL CARE MANAGEMENT 7 DAYS POST DISCHARGE 263.00 PROF FEES PR GASTRIC DIVERSION AFFILIATE ONLY 13,156.00 PROF FEES PR DUPLEX SCAN EXTREMITY UNI OR LTD STUDY 282.00 PROF FEES PR OCH FAA EXAM PLUS DOT 208.00 PROF FEES PB THEOPHYLLINE MTX 56.00 PROF FEES PR UNLISTED LAPAROSCOPIC PROCEDURE STOMACH 13,156.00 PROF FEES PR BASIC MEDICAL AVIATION EXAM NON FAA CERTIFIED 208.00 PROF FEES HCHG PT EDUCATION NOC GROUP AFFILIATE ONLY 156.00 PROF FEES PR BALLOON DILATION COLOSTOMY STRICTURE 1,522.00 PROF FEES HCHG INTERFYL PER 1 MG AFFILIATE ONLY PROF FEES PB INFLUENZA A/B PCR 345.00