Charge_Code Charge Description Charge Amount 11033402 MED/SURG UNIT PRIVATE ROOM $1,028.00 11436002 PSYCH UNIT PRIVATE ROOM $1,638.00 12033401 MED UNIT SEMI PRIVATE $973.00 12133401 MED/SURG SEMI PRIVATE $973.00 12231301 OB LABOR DELIVERY SEMI PRIVATE $1,082.00 12231401 POST PARTUM SEMI PRIVATE $973.00 12436001 PSYCH UNIT SEMI PRIVATE $1,638.00 12437001 SENIOR CARE PSYCH UNIT SEMI PRIVATE $1,638.00 12633402 MEDICAL STABILIZATION SEMI PRIVATE $1,638.00 14133402 MED/SURG PRIVATE ROOM $1,028.00 20032102 ICU ROOM $1,649.00 20633403 MED/SURG TELEMETRY ROOM $1,028.00 25000029 STIFF NECK COLLAR $79.00 25996508 LOCM 300-399MG/ML IODINE 1ML $108.00 25996701 LOCM 300-399MG/ML IODINE,1ML $2.00 26000001 FLU VACCINE $39.00 26000005 FLU VACCINE $39.00 26963600 HYDRATION IV INFUSION, INITIAL $223.00 26963605 INIT HYDRATION 31M-1HOUR $223.00 26963615 HYDRATE IV INFUSION, ADD-ON $39.00 26963616 IV INF; HYD; EA ADD HR UP TO 8 $200.00 26963655 INITIAL INFUSION UP TO ONE HR $378.00 26963665 THER/PRO/DX IV EACH ADDTL HR (+31 $378.00 26963675 TX/PRO/DX ADDL SEQ IV INF NEW SUB $378.00 26963685 CONCURRENT INFUSION (1/VISIT) $33.00 26963720 THER/PROPH/DIAG INJ, SC/IM $39.00 26963725 IM/SQ INJECTION $39.00 26963727 THER/PROPH/DIAG INJ, SC/IM $39.00 26963735 MEDICATION ADMINISTRATION IA $222.00 26963745 THER/PROPH/DIAG INJ IV PUSH $222.00 26963755 TX/PRO/DX INJ NEW DRUG ADDON $222.00 26963765 TX/PRO/DX INJ SAME DRUG ADDON $222.00 27000001 1 1/2 INCH KARAYAD/STOMA $237.00 27000002 1 1/2 INCH STOMA POUCH $210.00 27000003 1 1/2 INCH UROSTOMY $194.00 27000004 1 3/4 INCH KARAYA SEAL $237.00 27000005 1 3/4 INCH UROSTOMY $169.00 27000006 16FR SARATOGA SUMP $67.00 27000007 2 1/2 INCH KARAYA STOMA $237.00 27000008 2 INCH KARAYA STOMA $237.00 27000009 3 INCH KARAYA STOMA $186.00 27000010 3 INCH STARTER SET $143.00 27000011 ABDOMINAL BINDERS $91.00 27000012 ABDUCTION PILLOW MED $108.00 27000013 ADULT GASTRIC LAVAGE KIT $104.00 27000014 ALCOHOL BOTTLE $13.00 27000015 ALUM. FINGER SPLINT $18.00 27000016 ANESTHETIC SPRAY $20.00 27000017 ANKLE BRACE $8.00 27000018 ARM SLING LARGE $32.00 27000019 ARM SLING MEDIUM $32.00 27000020 ARM SLING -SMALL $45.00 27000021 ARROW TWIN CATH $36.00 27000022 ARTERIAL CATH RADIAL $50.00 27000023 BAG 1 3/4 INCH STOMA $189.00 27000024 BAG-KARAYA STOMA $186.00 27000025 BAG-UROSTOMY $169.00 27000026 BAL-PACING KIT $442.00 27000027 BANDAGE - COBAN 3 INCH $12.00 27000028 BANDAGE - COBAN 4 INCH $15.00 27000029 BANDAGE - ELASTIKON 4 INCH $33.00 27000030 BDG-ACE 2IN $7.00 27000031 BDG-ACE 3IN $11.00 27000032 BDG-ACE 4IN $13.00 27000033 BDG-ACE 6IN $19.00 27000034 BDG-ADAPTIC 3X3 $6.00 27000035 BDG-ADAPTIC 3X8 $9.00 27000036 BDG-KLING 2 IN $7.00 27000037 BDG-KLING 3IN $12.00 27000038 BDG-KLING 4IN $18.00 27000039 BDG-KLING 6IN $13.00 27000040 BILE BAG $29.00 27000041 CASSETTE/WARM INJECTION $123.00 27000042 CATH QUAD LUMEN $453.00 27000043 CATH SET ASH SPLIT $575.00 27000044 CATH TROCAR $55.00 27000045 CATH-3 WAY IRRIGATION $41.00 27000046 CATH-FOLEY 30CC $35.00 27000047 CATH-FOLEY 3CC BALL $18.00 27000048 CATH-FOLEY 5CC BAG $18.00 27000049 CATH-LOUDE $28.00 27000050 CATH-MAHURKER $368.00 27000051 CATH-MIDLINE STERILE $87.00 27000052 CATH-SWAN GANZ $47.00 27000053 CATH-THORACIC $32.00 27000054 CATH-THROACIC RT ANGLE $39.00 27000055 CATH-TRAY W/O CATH $49.00 27000056 CATH-TRAY W/O CATH $41.00 27000057 CERVICAL COLLAR $45.00 27000058 CLAVICLE BRACE $66.00 27000059 COUNCILL STYLET 6FR $61.00 27000061 DISP ADULT SENSOR $130.00 27000062 DERMOPLAST SPRAY $20.00 27000063 DISP MONITOR KIT $135.00 27000064 DISP PED OXYGEN SENSOR $22.00 27000065 DISP STETHOSCOPE $4.00 27000066 DOMES TRANSDUCER $33.00 27000067 DRAINS PENROSE $8.00 27000068 DRSD-MICROSPORE 3.5 X 8 $3.00 27000069 DRSG-ADAPTIC 1"" BOTTLE $28.00 27000070 DRSG-ADAPTIC 1/2"" BOTTLE $18.00 27000071 DRSG-ADAPTIC 2"" BOTTLE $28.00 27000072 DRSG-DUO-DERM 4X4 $19.00 27000073 DRSG-DUO-DERM 8X8 $85.00 27000074 DRSG-INSTRUMENT SET DISP $33.00 27000075 DRSG-TRANS LARGE $6.00 27000076 DRSG-TRANS MEDIUM $12.00 27000077 DRSG-TRANS SMALL $16.00 27000078 EAR WICK 12.24 $21.00 27000079 EAR WICK 9.15 $12.00 27000080 EAR WICK 9.24 $15.00 27000081 EPISTAXIS NASAL BALLOON $32.00 27000083 FEED TUBE INFANT $20.00 27000084 FINGER ANCHOR $16.00 27000085 FINGER SPLINT $22.00 27000086 FOOT DROP BOOT $173.00 27000087 GASTROSTOMY TUBE $168.00 27000088 GAUZE VASELINE 1.5""X72"" $35.00 27000089 GELFOAM 100 $110.00 27000090 GELFOAM 50 $74.00 27000091 HEIMLICH VALVE $23.00 27000092 HEMATERIA-CATH $32.00 27000093 IMMOBILIZER KNEE POST OP $16.00 27000094 IMMOBILIZER SHOULDER $58.00 27000095 INTRAOSSEOUS NEEDLE $87.00 27000096 IODOFOAM PACKING 1/4 INCH $22.00 27000097 IRRIG W.W. 3000CC $8.00 27000098 IRRIGATION 3000CC GYLCINE $11.00 27000099 IRRIGATION DRAINAGE BAG $25.00 27000100 IRRIGATION START SET $56.00 27000101 IRRIGATION T.U.R. SET $48.00 27000102 K PAD - LG, MED, SM $63.00 27000103 K THERMIA PAD $119.00 27000104 KNEE BRACE $13.00 27000107 MATTRESS; DISP W/AIR PUMP $82.00 27000108 MINNESITA TUBE $338.00 27000109 MISC-LARYNGOSCOPE $19.00 27000110 MISC-URI-METER $106.00 27000111 MONOMETER SET $80.00 27000112 MULTI LUNEN KIT $35.00 27000113 NASAL TAMPON MED $18.00 27000114 NU GAUZE 1/4IN / 1/2 IN $19.00 27000115 NU GAUZE 1IN / 2 IN $26.00 27000116 NUGAUZE IODO 1 INCH $22.00 27000117 NUGAUZE IODO 1/2 INCH $22.00 27000118 O B PACK $111.00 27000119 ORTHO SHOES $25.00 27000120 PACE TD SWAN-GANZ $877.00 27000121 PASTE/ADAPT HOLLISTER $16.00 27000122 PEDS GASTRIC LAVAGE KIT $12.00 27000123 PENROSE DRAIN $8.00 27000124 PLASTIC SUTURE $25.00 27000125 PLEUR EVAC SET UP $42.00 27000126 PNEUMATIC HOSE $311.00 27000127 PNEUMOTHORAX KIT $135.00 27000128 PORT A CATH HUBERT NEEDLE $29.00 27000129 POSITIVE DISPLACEMENT VALVE $55.00 27000130 PRESSURE MONT KIT $48.00 27000131 PREVENOUS LEAD $71.00 27000132 PUDENAL BLOCK $69.00 27000133 RAPID RHINO LARGE $76.00 27000134 RAPID RHINO MEDIUM $65.00 27000135 RAPID RHINO SMALL $68.00 27000136 RESI BAG PEDS $6.00 27000137 RESSIC BAG DISP ADULT $84.00 27000138 RHINO ROCKETT SM/MED $47.00 27000139 SARATOGA SUMP 20X12 $81.00 27000140 SCROTAL SUPPORT $20.00 27000141 SECURITY POUCH 1 25 INCH $74.00 27000142 SEQ COMPRESSION SLEEVE - LG $77.00 27000143 SEQ. COMPRESSION SLEEVE - MED $65.00 27000144 SET-SUTURE REMOVAL $11.00 27000145 SKIN STAPLER SMALL $19.00 27000146 STAPLE REMOVER $19.00 27000147 STERI-STRIP 1/2 $13.00 27000148 STERI-STRIP 1/4 $13.00 27000149 STOMA BAG 1 25" I6MED $101.00 27000150 T.E.D. HOSE $41.00 27000151 THORACENTESIS/PARACENTESIS $87.00 27000152 THOROCENTHESIS KIT $33.00 27000153 THUMP SPICA $58.00 27000154 TRACTION PELVIC BELT $6.00 27000155 TRANS PACING KIT $406.00 27000156 TRANSDUCER W/MONITOR $193.00 27000157 TRAU-SPINALDISP. $114.00 27000158 TRAY AMNIOCENTESIS $57.00 27000159 TRAY BIOPSY $62.00 27000160 TRAY BONE MARROW BIOPSY $53.00 27000161 TRAY CATHETER SWAN GANZ DISP $47.00 27000162 TRAY CVP $12.00 27000163 TRAY CYSTO CATH $59.00 27000164 TRAY DISP PNEUMOTHORAX $135.00 27000165 TRAY ER SUTURE $62.00 27000166 TRAY FOLEY 16 FR $44.00 27000167 TRAY LACERATION $15.00 27000168 TRAY PERCUTANEOUS $80.00 27000169 TRAY UMBILICAL CATH $104.00 27000170 TRAY/LUMBAR PUNCTURE $108.00 27000171 TRAY-PARACENTESIS $62.00 27000172 TRAY-SIGMOIDSCOPE $57.00 27000173 TRAY-THOROCENTESIS $74.00 27000174 TUBE CONNECTING 18 INCH $3.00 27000175 TUBE CONNECTING 72 INCH $5.00 27000176 TUBE-ENOD TRACH $42.00 27000177 TUBE-ESOPHAGEAL $458.00 27000178 UNNA BOOT $18.00 27000179 UROMETERS $20.00 27000180 UROSTOMY BAG 16 MED $74.00 27000181 V PADS $13.00 27000182 WALL SUCTION CANISTER $99.00 27000183 WRIST SPLINT $75.00 27000184 QUINTON CATHETER-DUAL LUNAM $585.00 27000185 SINGLE LUMEN CATHETER $77.00 27000186 PER SHEATH INTRO KIT $111.00 27000187 TRANSVENOUS PACING $643.00 27000188 CATHETER DIAGNOSTIC BSI CCL $77.00 27000189 CATHETER; THERMODILUTION $427.00 27000190 SHEATH DIAGNOSTIC $30.00 27000192 SUPRAPUBIC CATHETER SET $245.00 27000206 FULL DAY OF OXYGEN $65.00 27000210 PARTIAL DAY OF OXYGEN $40.00 27000235 LOCAL TRAY $104.00 27000236 E.STIM ELECTRODES $33.00 27000237 LEUKOTAPE $46.00 27000238 ORTHO CANE $24.00 27000239 ORTHO CRUTCHES $124.00 27000240 THERABAND/TUBING - YD $14.00 27000241 THERAPUTTY $14.00 27000242 E.STIM ELECTRODES $33.00 27000243 LEUKOTAPE $46.00 270002430 E.STIM ELECTRODES $33.00 27000244 ORTHO CANE $24.00 27000245 ORTHO CRUTCHES $124.00 27000246 THERABAND/TUBING - YD $14.00 27000247 THERAPUTTY $14.00 270002478 THERAPUTTY $14.00 27000248 E.STIM ELECTRODES $33.00 27000249 LEUKOTAPE $46.00 27000250 ORTHO CANE $24.00 27000251 ORTHO CRUTCHES $124.00 27000252 THERABAND/TUBING - YD $14.00 27000253 THERAPUTTY $14.00 27000300 ACCUGRID $49.00 27000301 ADHESION BARRIER (INTERCEED) $714.00 27000302 ARCH BARS $27.00 27000303 ARTHROSCOPY STAPLE $568.00 27000304 AUTOSUTURE CEEA-28 & 31 $1,308.00 27000305 BALANCE SALT SOLUTION $7.00 27000306 BALDE; RECIPROCATING $127.00 27000307 BALDE;DERMATONE;SMAL $55.00 27000308 BARD FOLEY 2 WAY $9.00 27000309 BARD FOLEY 3 WAY $9.00 27000310 BARD IMPLANTABLE MESH $1,566.00 27000311 BARD MALECOTS DRAINS $22.00 27000312 BARD POWER PORT $2,271.00 27000313 BIFURCATED GRAFT $402.00 27000314 BIGLIAN HUMERAL HEAD $2,242.00 27000315 BIGLIAN HUMERAL STEM $4,754.00 27000316 BIOCOAG BIPOLAR FORC $390.00 27000317 BIOMET HUMERAL HEAD $2,271.00 27000318 BIOMET HUMERAL STEM $4,785.00 27000319 BIOPOLAR;CUP;MULITPO $2,996.00 27000320 BLADE; OSCILLATING $179.00 27000321 BLADES;OPTHALMIC;BEA $93.00 27000322 BONE CEMENT $104.00 27000323 BONE PLUG $104.00 27000324 BONE STAPLE $8.00 27000325 BUTTON; NASAL SEPTAL $461.00 27000326 BUTTON; NASAL SINGLE $416.00 27000327 CANCELLOUS BONE $357.00 27000328 CANNULA; VESSEL $9.00 27000329 CAST SPICA; HEAVY $485.00 27000330 CAST;ARM;HV WITHOUT $230.00 27000331 CAST;FIBERGLASS; 4 INCH $156.00 27000332 CAST;LEG;HEAVY;WITH $383.00 27000333 CAST;LEG;HEAVY;WITHO $218.00 27000334 CATARACT PACK $240.00 27000335 CATH: BALLOON DIALATION $364.00 27000336 CATH: PERMA $585.00 27000337 CATH: INFUSION; MIDLINE $2,546.00 27000338 CATH: CHOLANGIOGRAM $291.00 27000339 CATH: HEMATURIA $62.00 27000341 CATH: HICKMAN $585.00 27000342 CATH: MUSHROOM $28.00 27000343 CATH: PICC LINE $298.00 27000344 CATH: TEMP $427.00 27000345 CATH: VASCULAR/CLOT $293.00 27000346 CATH;ARM;HV WITH ELB $327.00 27000347 CATH-STAMEY URETER $7.00 27000348 CAUTERY; EYE $35.00 27000349 CAUTERY; LOOP TIP $88.00 27000350 CEMENT;SURGICAL $318.00 27000351 CLIP: LAPAROSCOPIC $670.00 27000352 CLO TEST $23.00 27000353 COLLOGRAFT; BONE GRA $2,116.00 27000354 COMPERSSION PLATE $487.00 27000355 CONVERTER; SITE STAB $59.00 27000356 CRYO-ABLATION PROBE $14,904.00 27000357 CRYOEXTRACTOR $85.00 27000358 CUTTER;ARTHROSCOPY $293.00 27000359 DAVOL SUMP DRAIN $65.00 27000360 DEMATONE HEAD $46.00 27000361 DILATOR; VESSEL $20.00 27000365 ELECTRO ROLLERBALL $228.00 27000367 MIX SYSTEM; OSTEABON $364.00 27000369 ESMARK STERILE BANDA $85.00 27000371 NAIL; HUMERAL (IMPLANT) $3,547.00 27000373 EXTERNAL FIXATOR $3,530.00 27000375 NAIL; TIB/FIB (IMPLANT) $2,212.00 27000377 FILERT; MONOMER FUME $68.00 27000378 RP 360 FLEXIBLE NEEDLE $596.00 27000379 NEEDLE (SURGI) $26.00 27000381 FORCEP HOT BX $260.00 27000383 NEEDLE CORE BIOPSY 1 $111.00 27000385 GIA 80 $2,373.00 27000387 NEXGEN ARTICULAR SUR $3,249.00 27000389 GIA 80 RELOAD $695.00 27000391 NEXGEN; COMPONET TIB $4,166.00 27000393 GIGLI SAW BLADE $46.00 27000395 NEXGEN; POLY PATELLA $1,684.00 27000397 GLIDE WIRE $75.00 27000399 NEXGENC COMPONET FEM $6,909.00 27000401 GRAFT; BONE CRUSHED $844.00 27000403 PACK LAPAROSCOPY $105.00 27000405 GRAFT; BONE CUBES; C $714.00 27000407 PACK; ARTHROSCOPY $242.00 27000409 GRAFT; IMPRA $1,893.00 27000411 PACK; BASIC $85.00 27000413 GUIDE WIRE $276.00 27000415 PACK; CUSTOM; C-SECT $558.00 27000419 PACK; CUSTOM; EYE $607.00 27000421 HIP PROSTHESIS IMPLANT $737.00 27000423 PACK; CUSTOM; TUBAL $307.00 27000425 HOMOVAC; WOUND $249.00 27000427 PACK; CYSTO $48.00 27000429 HYDOTHERM MACHINE $2,758.00 27000431 PACK; GYN $59.00 27000433 HYDROSET: 10ML $6,790.00 27000435 PACK; LAPAROTOMY $80.00 27000437 HYDROSET: 15ML $9,769.00 27000439 PACK; ORTHOPEDIC $111.00 27000441 HYDROSET: 3ML $2,515.00 27000443 PENILE IMPLANT - INFLATABLE $16,145.00 27000445 HYDROSET: 5ML $3,532.00 27000447 PENILE IMPLANT - NONINFLAT $6,534.00 27000449 I/A SET $237.00 27000451 PHACO EMULSIFIER $506.00 27000453 IM GUIDE PIN $458.00 27000455 PIN ASSEMBLY $172.00 27000457 IM NAIL FEMORAL $3,291.00 27000459 PIN; ALIGNMENT $413.00 27000463 PIN; SMART 1.1MM $341.00 27000465 IMPLANT LENS $1,298.00 27000467 PIN; SMART 1.5MM $406.00 27000469 INSTAT 1X2 $80.00 27000471 PIN; STEINMAN $130.00 27000473 INSTAT 3X4 $280.00 27000475 PIN; STEINMAN (EACH) $71.00 27000477 IRRIGATION; DISPOSAB $364.00 27000479 PLASTIBELL $23.00 27000483 PLATE; COMPRESSION $135.00 27000485 KIT; CHOLECYSTECTOMY $1,104.00 27000487 POLY PLUG $257.00 27000489 KIT; FLEX-FLOW; GAST $545.00 27000491 PORT-A-CATHETER (SPECIAL) $1,725.00 27000493 KIT; INTRODUCER FOR $205.00 27000495 POUCH; ENDOCATH $371.00 27000497 KIT; LTA $54.00 27000499 PROBE: SERFAS ENERGY SUPER 90S $343.00 27000501 KIT; MIC TRANSGAST JEJUN FEED $1,143.00 27000503 RADIAL HEAD (IMPLANT) $3,461.00 27000505 KIT; MYRINGOTOMY $79.00 27000506 16FR SARATOGA SUMP $67.00 27000507 RADIAL STEM (IMPLATN) $2,163.00 27000509 KITNERS; ENDOSCOPIC $56.00 27000511 REG CENTERFLEX GRAFT $1,311.00 27000513 KNIFE;OPTHALMIC;GRIE $194.00 27000515 RESECTOSCOPE LOOP $167.00 27000517 LIGACLIPS $195.00 27000519 RETENTION BOLSTER $17.00 27000521 LIGATING DISSECTING STAPLER $800.00 27000523 SCISSORS (SINGLE USE) LAP 5MM $168.00 27000525 LIGATOR; HEMMORRHOID $536.00 27000527 SCLEROTHERAPY NEEDLE $774.00 27000529 LOOP; VESSEL $6.00 27000531 SCP TUBE/PLATE $1,201.00 27000533 MAJOR BASIN SET $40.00 27000537 MANIPULATOR; UTERINE $118.00 27000539 SCREW; BONE (IMPLANT) $688.00 27000541 MENISCUS REPAIR SET $130.00 27000543 SCREW; CANNULATED (IMPLANT) $688.00 27000545 SCREW; COMPRESSION (IMPLANT) $688.00 27000547 SCREW; CORITCAL (IMPLANT) $688.00 27000549 SCREW; CORTICAL (EACH) $68.00 27000551 SCREW; HERBERT/WIPPL $688.00 27000553 SCREW; INTERLOCKING (IMPLANT) $688.00 27000555 SCREW; LAG $380.00 27000557 SCREW; M/V; 2.0 - 4.0MM $688.00 27000559 SCREW; TI (IMPLANT) $688.00 27000561 SHILED; NASAL $36.00 27000563 SHUNT PERITONEO-VENO $2,859.00 27000565 SILASTIC IMPLANT $29.00 27000567 SKIN STAPLER $79.00 27000569 SNARE; POLYPECTOMY BX $118.00 27000571 SPLINT NASAL $112.00 27000573 SPONGES: SPEAR EYE $13.00 27000575 SPONGES: TONSIL (5) $27.00 27000577 SPONGES; PEANUT $44.00 27000579 SPONGES; RADIOPAQUE $55.00 27000581 STAPLES: EEA $549.00 27000583 STAPLES: FASCIA $260.00 27000585 STAPLES: LDS 15 $692.00 27000587 STAPLES: LDS 6 $516.00 27000589 STAPLES: RELOAD $335.00 27000591 STAPLES; GA $672.00 27000593 STAPLES; SKIN $75.00 27000595 STAPLES; TA-30 $710.00 27000597 STAPLES; TA-55 $710.00 27000599 STAPLES; TA-90 $417.00 27000601 STAPLES; VERSITAK $321.00 27000603 STENT; URETERAL $844.00 27000605 STEPPED CENTERFLEX 45CM $928.00 27000609 STOCKINETTE; BARRIER $27.00 27000611 STRYKER DRILL/SAWS $255.00 27000613 STRYKER SAW BLADES $171.00 27000615 SUCTION CAUTERY $22.00 27000617 SUPER-QUICK ARCHOR $246.00 27000619 SUPRAPUBIC INTRODUCER $141.00 27000621 SURGICAL CLIP APPLIER $86.00 27000623 SURGICEL 2X14 $22.00 27000625 SURGICEL 2X3 $14.00 27000627 SURGICEL 4X8 $20.00 27000629 SURGICLIP $415.00 27000631 SUTURE; MULTI-PACK $90.00 27000633 SUTURE; STATAK $744.00 27000635 SUTURE;EYE;DEXON/SIL $90.00 27000637 SUTURE;PLAIN;SUB-Q-R $41.00 27000639 TAPE: UMBILICAL $13.00 27000641 TESTICULAR IMPL $117.00 27000643 TRAY: EPIDURAL/SPINAL $156.00 27000645 TRAY: SUPRA FOLEY $90.00 27000647 TRICAR; DISP. 10/12 $302.00 27000649 TUBE: ANESTHESIA M $414.00 27000651 TUBE: ARTHROFLOW $85.00 27000653 TUBE: ARTHROSCOPY $307.00 27000655 TUBE: CYSTO $36.00 27000657 TUBE: EXCHANGE $458.00 27000659 TUBE: GASTRO/ENDO (PEG/MOSS) $664.00 27000661 TUBE: HIGH FLOW CO2 $29.00 27000663 TUBE: JUJUNOSTOMY $1,145.00 27000665 TUBE: VENT $36.00 27000667 TUBE; FLEXI FLOW REP $79.00 27000669 VACURETTE $74.00 27000671 VARI-STEM NERVE LOCA $171.00 27000673 VENA CAVA FILTER $3,338.00 27000675 VERSYS ;FEMORAL HEAD $1,756.00 27000677 VERSYS FEMORAL STEM $8,933.00 27000679 VERSYS; CENTRALIZER $260.00 27000681 VITRECTOMY SET $506.00 27000683 WIRE; KIRSCHNER $266.00 27000685 WIRE; TONSIL SNARE $6.00 27000708 2 INCH KARAYA STOMA $237.00 27000809 3 INCH KARAYA STOMA $186.00 27000910 3 INCH STARTER SET $143.00 27001011 ABDOMINAL BINDERS $91.00 27001112 ABDUCTION PILLOW MED $108.00 27001213 ADULT GASTRIC LAVAGE KIT $104.00 27001314 ALCOHOL BOTTLE $13.00 27001415 SPLINT-ALUM FINGER $18.00 27001516 ANESTHETIC SPRAY $20.00 27001617 BRACE ANKLE $8.00 27001718 ARM SLING LARGE $32.00 27001819 ARM SLING MEDIUM $32.00 27001920 ARM SLING SMALL $45.00 27002021 ARROW TWIN CATH $36.00 27002122 ARTERIAL CATH RADIAL $50.00 27002223 BAG 1 3/4 INCH STOMA $189.00 27002324 BAG-KARAYA STOMA $186.00 27002425 BAG-UROSTOMY $169.00 27002526 BAL-PACING KIT $442.00 27002627 BDG-COBAN 3 INCH $12.00 27002728 BDG-COBAN 4 INCH $15.00 27002829 BDG-ELASTIKON 4 INCH $33.00 27002930 BDG-ACE 2 IN $7.00 27003031 BDG-ACE 3 IN $11.00 27003132 BDG-ACE 4 IN $13.00 27003233 BDG-ACE 6 IN $19.00 27003334 BDG-ADAPTIC 3X3 $6.00 27003435 BDG-ADAPTIC 3X8 $9.00 27003536 BDG-KLING 2 IN $7.00 27003637 BDG-KLING 3 IN $12.00 27003738 BDG-KLING 4 IN $18.00 27003839 BDG-KLING 6 IN $13.00 27003940 BILE BAG $29.00 27004041 CASSETTE / WARM INJECTION $123.00 27004142 CATH QUAD LUMEN $453.00 27004243 CATH SET ASH SPLIT $575.00 27004344 CATH TROCAR $55.00 27004445 CATH - 3 WAY IRRIGATION $41.00 27004647 CATH-THERMODILUTION $427.00 27004748 CATH-FOLEY 30CC $35.00 27004849 CATH-FOLEY 3CC BALL $18.00 27004950 CATH-FOLEY 5CC BAG $18.00 27005051 CATH-LOUDE $28.00 27005152 CATH-MAHURKER $368.00 27005253 CATH-MIDLINE STERILE $87.00 27005354 CATH-SWAN GANZ $47.00 27005455 CATH-THORACIC $32.00 27005556 CATH-THORACIC RT ANGLE $39.00 27005657 CATH-TRAY W/ CATH $49.00 27005758 CATH-TRAY W/O CATH $41.00 27005859 CERVICAL COLLAR $45.00 27005960 BRACE CLAVICLE $66.00 27006061 COUNCILL STYLET 6FR $61.00 27006263 DERMOPLAST SPRAY $20.00 27006364 DISP ADULT SENSOR $130.00 27006465 DISP MONITOR KIT $135.00 27006566 DISP PED OXYGEN SENSOR $22.00 27006768 DOMES TRANSDUCER $33.00 27006869 DRAINS PENROSE $8.00 27006970 DRSG-MICROSPORE 3.5X8 $3.00 27007071 DRSG-ADAPTIC 1" BOTTLE $28.00 27007172 DRSG-ADAPTIC 1/2" BOTTLE $18.00 27007273 DRSG-ADAPTIC 2" BOTTLE $28.00 27007374 DRSG-DUO-DERM 4X4 $19.00 27007475 DRSG-DUO-DERM 8X8 $85.00 27007576 DRSG-INSTRUMENT SET DISP $33.00 27007677 DRSG-TRANS LARGE $6.00 27007778 DRSG-TRANS MEDIUM $12.00 27007879 DRSG-TRANS SMALL $16.00 27007980 EAR WICK 12.24 $21.00 27008081 EAR WICK 9.15 $12.00 27008182 EAR WICK 9.24 $15.00 27008283 EPISTAXIS NASAL BALLOON $55.00 27008485 FEED TUBE INFANT $20.00 27008586 FINGER ANCHOR $16.00 27008687 FINGER SPLINT $22.00 27008788 FOOT DROP BOOT $173.00 27008889 GASTROSTOMY TUBE $32.00 27008990 GAUZE VASELINE 1.5"X72" $35.00 27009091 GELFOAM 100 $110.00 27009192 GELFOAM 50 $74.00 27009293 HEIMLICH VALVE $23.00 27009394 HEMATERIA CATH $32.00 27009495 IMMOBILIZER KNEE POST OP $89.00 27009596 IMMOBILIZER SHOULDER $58.00 27009697 INTRAOSSEOUS NEEDLE $87.00 27009798 IODOFOAM PACKING 1/4 INCH $22.00 27009799 OPT FOAM GENTLE 4X4 $8.00 27009800 OPT FOAM GENTLE 6X6 $14.00 27009801 OPIFORM BEARDLESS 4X4 $12.00 27009802 DRESSING MED HONEY HCS 4X4 $24.00 27009803 DRESSING MED HONEYGEL $9.00 27009804 GEL / WOUND SOLOSITE $15.00 27009805 DRESSING ROPE ALGINATE $11.00 27009806 NUTRA SHELD BLUE TOP $11.00 27009807 SKIN REPAIR CREAM PURPLE TOP $8.00 27009899 IRRIG W W 3000CC $8.00 27010001 E.STIM ELECTRODES $33.00 27010002 LEUKOTAPE $46.00 27010003 ORTHO CANE $24.00 27010004 ORTHO CRUTCHES $124.00 27010005 THERABAND/TUBING - YD $14.00 27010006 THERAPUTTY $14.00 27020001 ACCUGRID $49.00 27020002 CONN TISS HUMAN ALLOGRAFT $714.00 27020003 ARCH BARS $27.00 27020004 ARTHROSCOPY STAPLE $568.00 27020005 BSS $7.00 27020006 BSS $7.00 27020007 BLADE;RECIPROCATING $127.00 27020008 BLADE;DERMATONE;SMAL $55.00 27020009 BARD FOLEY 2 WAY $9.00 27020010 BARD FOLEY 3 WAY $9.00 27020011 BARD IMPLANTABLE MESH $1,566.00 27020012 BARD MALECOTS DRAINS $22.00 27020013 BARD POWER PORT $2,271.00 27020014 BIFURCATED GRAFT $402.00 27020015 BIGLIAN HUMERAL HEAD $2,242.00 27020016 BIGLIAN HUMERAL STEM $4,754.00 27020017 BIOCOAG BIPOLAR FORC $390.00 27020018 BIOMET HUMERAL HEAD $2,271.00 27020019 BIOMET HUMERAL STEM $4,785.00 27020020 BIOPOLAR; CUP;MULTIPO $2,996.00 27020021 BLADE;OSCILLATING $179.00 27020022 BLADE;OPTHALMIC;BEA $93.00 27020023 BONE CEMENT $259.00 27020024 BONE PLUG $104.00 27020025 BONE STAPLE $8.00 27020026 BUTTON;NASAL SEPTAL $461.00 27020027 BUTTON;NASAL SINGLE $416.00 27020028 CANCELLOUS BONE $357.00 27020029 CANNULA;VESSEL $9.00 27020030 CAST;SPICA;HEAVY $485.00 27020031 CAST;ARM;HV WITH ELBOW $327.00 27020032 CAST;ARM;HV WITHOUT $230.00 27020033 CAST;FIBERGLASS;4INCH $156.00 27020034 CAST;LEG;HEAVY;WITH $383.00 27020035 CAST;LEG;HEAVY;WITHOUT $218.00 27020036 CATARACT PACK $240.00 27020037 CATH:BALLOON DILATION $638.00 27020038 CATH:PERMA $585.00 27020039 CATH: ACCESS POINT $2,546.00 27020040 CATH: CHOLANGIOGRAM $291.00 27020041 CATH: HEMATURIA $62.00 27020042 CATH:HICKMAN $585.00 27020043 CATH:MUSHROOM $28.00 27020044 CATH:PICC LINE $298.00 27020045 PORT-A-CATHETER (SPECIAL) $1,725.00 27020046 CATH:TEMP $427.00 27020047 CATH:VASCULAR/CLOT $293.00 27020048 CATH-STAMEY URETER $7.00 27020049 CAUTERY;EYE $35.00 27020050 CAUTERY; LOOP TIP $88.00 27020051 CEMENT; SURGICAL $318.00 27020052 CLIP: LAPARSCOPIC OR RESOLUTION $670.00 27020054 COLLOGRAFT; BONE GRA $2,116.00 27020055 COMPRESSION PLATE $541.00 27020056 CONVERTER; SITE STAB $59.00 27020058 CRYOEXTRACTOR $85.00 27020059 CUTTER; ARTHROSCOPY $293.00 27020060 DAVOL SUMP DRAIN $65.00 27020061 DEMATONE HEAD $46.00 27020062 DILATOR; VESSEL $20.00 27020064 ELECTRO ROLLERBALL $228.00 27020065 ESMARK STERILE BANDA $85.00 27020066 EXTERNAL FIXATOR $3,530.00 27020067 FILTER; MONOMER FUME $68.00 27020068 BIOPSY FORCEP $260.00 27020069 GIA GASTRO INTESTINAL STAPLET $2,373.00 27020070 RELOAD GIA $695.00 27020071 GIGLI SAW BLADE $46.00 27020072 GLIDE WIRE $75.00 27020073 GRAFT; BONE CRUSHED $844.00 27020074 GRAFT; BONE CUBES; C $714.00 27020075 GRAFT; IMPRA $1,893.00 27020076 GUIDE WIRE $276.00 27020078 HIP PROSTHESIS IMPLANT $737.00 27020079 HEMOVAC; WOUND $249.00 27020080 HYDOTHERM MACHINE $2,758.00 27020081 HYDROSET:10ML $6,790.00 27020082 HYDROSET: 15ML $9,769.00 27020083 HYDROSET: 3ML $2,515.00 27020084 HYDROSET:5ML $3,532.00 27020085 I/A SET $237.00 27020086 IM GUIDE PIN $458.00 27020087 IM NAIL FEMORAL $3,291.00 27020089 IMPLANT LENS $1,298.00 27020091 INSTAT 1X2 $80.00 27020092 INSTAT 3X4 $280.00 27020093 IRRIGATION;DISPOSAB $364.00 27020095 KIT; CHOLECYSTECTOMY $1,104.00 27020096 KIT; FLEX-FLOW; GAST $545.00 27020097 KIT; INTRODUCER FOR $205.00 27020098 KIT; LTA $54.00 27020099 KIT; MIC TRANSGAST JEJUN FEED $1,143.00 27020100 KIT; MYRINGOTOMY $79.00 27020101 KITNERS; ENDSCOPIC $56.00 27020102 KNIFE; OPTHALMIC; GRIE $194.00 27020103 STAPLES; LIGA CLIP $195.00 27020104 PWRD LIGATING DISSECTING STAPLE $800.00 27020105 LIGATOR; HEMMORRHOID $536.00 27020106 LOOP; VESSLE $6.00 27020107 MAJOR BASIN SET $40.00 27020108 MANIPULATOR; UTERINE $118.00 27020109 MENISCUS REPAIR SET $130.00 27020110 MESH 10X15 CM OBLONG/OVAL $1,015.00 27020111 MESH 11X14CM OBLONG/OVAL $1,055.00 27020112 MESH 12.5X12.5 CM/SQUARE/RN $1,124.00 27020113 MESH 13.5X18CM OBLONG/OVAL $774.00 27020114 MESH 15X20 CM OBLONG/OVAL $815.00 27020115 MESH 15X23CM OBLONG/OVAL $865.00 27020116 MESH 18X23 CM OBLONG/OVAL $2,854.00 27020117 MESH 20.5X30.5 CM OBLONG/OVAL $3,719.00 27020118 MESH 25.5X35.5 CM OBLONG/OVAL $4,854.00 27020119 MESH 30.5X45.5 CM OBLONG/OVAL $7,517.00 27020120 MESH 35.5X35.5 CM OBLONG/OVAL $6,813.00 27020121 MESH 7.5X15CM OBLONG/OVAL $880.00 27020122 MESH 9X9CM SQUARE/ROUND $812.00 27020123 MESH 9CM X 9CM SQUARE/ROUND $812.00 27020124 MESH IMPLANTABLE MARLEXT $983.00 27020125 MESH 10X14 CM $696.00 27020126 MESH 2X12 CM $341.00 27020127 MESH 2X4 CM $323.00 27020128 MESH 3X6 CM $360.00 27020160 REF CENTERFLEXT GRAFT $1,311.00 27020168 SCREW (SURGERY DPT STOCK ITEM) $68.00 27020169 SCREW;BONE (IMPLANT) $688.00 27020170 SCREW; CANNULATED (IMPLANT) $688.00 27020171 SCREW;COMPRESSION (IMPLANT) $688.00 27020172 SCREW;CORTICAL (EACH PER INVOICE) $85.00 27020173 SCREW;CORTICAL (EACH) $85.00 27020174 SCREW;HERBERT/WIPPL $688.00 27020175 SCREW;INTERLOCKING (IMPLANT) $688.00 27020176 SCREW;LAG $1,769.00 27020177 SCREW;M/V;2.4-4.0MM $688.00 27020190 STAPLES, EEA $2,153.00 27020211 SURGICEL 2X14 $22.00 27020236 VENA CAVA FILTER $3,338.00 27020237 10 HOLE PLATE $169.00 27020238 3.5 FULL THREAD CORTEX SCREW 10MM $137.00 27020239 3.5 FULL THREAD CORTEX SCREW 12MM $68.00 27020240 3.5 FULL THREAD CORTEX SCREW 44MM $68.00 27020241 3.5 FULL THREAD CORTEX SCREW 50MM $68.00 27020242 4.0 FULL THREAD CANCELLOUS SCREW $68.00 27020243 4.0 PARTIAL THREAD CANCELLOUS SCREW $58.00 27021700 SIMPULSE SOLO SYSTEM WITH SHOWERHEA $192.00 27021701 ACUCISE SYSTEM STARTER KIT $6,197.00 27021702 THREADED GUIDE WIRE 3.2 X 300MM $14.00 27021703 MESH 3 X 6 CM $360.00 27021704 MESH PERFIX PLUG $856.00 27021705 BIPOLAR GOLD PROBE $784.00 27021706 BLADE TRICUT $439.00 27021707 CALCANEAL PLATE $1,136.00 27021708 FORCEFIBER WITH NEEDLES $74.00 27021709 END CAP $646.00 27021710 TUBULAR PLATE WITH COLLAR $211.00 27021711 TROCHANTERIC NAIL KIT $4,682.00 27021712 BALL TIP GUIDE WIRE $731.00 27021713 SCREW; LOCKING $400.00 27021714 SCREW; FULLY THREADED $400.00 27021715 DRILL BIT $643.00 27021716 DRILL $698.00 27021717 SCREW; SET $643.00 27021718 ACUCISE SYSTEM $4,178.00 27021719 SCREW; CANCELLOUS $114.00 27021720 DRILL; CANNULATED WITH COUPLING $942.00 27021721 DRILL; CANNULATED WITH FITTING $1,388.00 27021722 CLOVERLEAF PLATE $971.00 27021723 CORE FAN BLADE $135.00 27021724 CORPAK 6 TUBE PLACEMENT $168.00 27021725 SCREW; CORTEX $71.00 27021726 SCREW; CORTICAL SELF CUTTING $58.00 27021727 COUNTERSINK WITH FITTING $555.00 27021728 DREAM WIRE $607.00 27021729 DISTAL MEDIAL TIBIA $4,468.00 27021730 PROXIMAL LATERAL TIBIA $4,056.00 27021731 ELECTROHYDRAULIC LITHTRIPSY PROBE $498.00 27021732 BUTTRESS PLATE $1,288.00 27021733 RECONSTRUCTION PLATE $1,296.00 27021734 TB ASPIRATION NEEDLE $270.00 27021735 EZ CLEAN NON STICK TIP FLAT L HOOK $149.00 27021736 SUTURE PASSER $433.00 27021737 INTERPULSE HANDPIECE SET $134.00 27021738 MIXING BOWL $2,565.00 27021739 NUT FOR CORTEX SCREWS $114.00 27021740 HERNIA SYSTEM $1,286.00 27021741 ESOPHAGEAL STENT (TEMPORARY) $7,165.00 27021742 NET POLYP RETRIEVER $242.00 27021743 SIMPULSE SOLO SYSTEM WITH SHOWERHEA $192.00 27021744 REAMER WITH AO FITTING $555.00 27021745 SIMPLEX P WITH TOBRAMYCIN $1,071.00 27021746 SIMPLEX PRO HALF DOSE $197.00 27021747 T5 HOOD WITH PEEL AWAY FACE SHIELD $102.00 27021748 THREADED GUIDE WIRE $114.00 27021749 T-PLATE $920.00 27021750 THREE PRONGED GRASPERS DISPOSIBLE $406.00 27021751 TRANS VAGINAL OBTURATOR TAPE $3,096.00 27021752 TWIST DRILL WITH AO FITTING $627.00 27021753 WASHER $130.00 27021754 ZANGER HEPARIN CANNULA $209.00 27021755 TAP $610.00 27021756 TAPS, AO QUICK COUPLING $463.00 27021801 DOYLE II INTRANASAL AIRWAY SPLINT $130.00 27021802 HEMADERM KIT $349.00 27021803 MYOSURE $4,056.00 27021804 ZIPLINE 24 #0005171 $289.00 27021805 MARYLAND LIGASURE $1,958.00 27021807 KUMAR CATHETER REF# CC-019 $88.00 27021808 SINUS STENT $1,575.00 27123124 PER SHEATH INTRO KIT $111.00 27133134 QUINTON CATHETER-DUAL LUNHAM $585.00 27146147 SHEATH DIAGNOSTIC $30.00 27147148 SINGLE LUMEN CATHETER $77.00 27152153 STIFF NECK COLLAR $79.00 27154155 SUPRAPUBIC CATHETER SET $245.00 27160161 TRANS PACING KIT $406.00 27161162 TRANSDUCER W/MONITOR $193.00 27162163 TRANSVENOUS PACING $643.00 27163164 TRAY-SPINALDISP $114.00 27165166 TRAY BIOPSY $62.00 27166167 TRAY BONE MARROW BIOPSY $53.00 27167168 TRAY CATHETER SWAN GANZ DISP $47.00 27167169 J INFERIOR TURBINALTE BLADE $602.00 27178110 MESH 30.5 X 45.5CM OBLONG/OVAL $7,517.00 27178111 MESH 10 x 15CM OBLONG/OVAL $1,015.00 27178112 MESH 11 x 14CM OBLONG/OVAL $1,055.00 27178113 MESH 12.5 x 12.5CM SQUARE/RND $1,124.00 27178114 MESH 13.5 x 18CM OBLONG/OVAL $774.00 27178115 MESH 15 x 20CM OBLONG/OVAL $815.00 27178116 MESH 15 x 23CM OBLONG/OVAL $865.00 27178117 MESH 18 x 23CM OBLONG/OVAL $2,854.00 27178118 MESH 20.5 x 30.5CM OBLONG/OVAL $3,719.00 27178119 MESH 25.5 x 35.5CM OBLONG/OVAL $4,854.00 27178121 MESH 35.5 x 35.5CM OBLONG/OVAL $6,813.00 27178122 MESH 7.5 x 15CM OBLONG/OVAL $880.00 27178123 MESH 9 X 9CM SQUARE/ROUND $812.00 27178124 MESH 9CM X 9CM SQ/RND $812.00 27178125 MESH IMPLANTABLE MARLEX $983.00 27178128 CARDIOVASCULAR GRAFT $1,172.00 27178129 SEPRAMESH 4X8 REF# 5959480 $1,922.00 27178130 SEPRAMESH 6X8 REF# 5959680 $1,995.00 27178131 VENTRALEX S REF# 5950007 $1,630.00 27178132 VENTRALEX M REF# 5950008 $1,630.00 27178133 VENTRALEX L REF# 5950009 $2,087.00 27178134 3D MAX MEDIUM LEFT REF# 0115310 $840.00 27178135 3D MAX MEDIUM RIGHT REF# 0115320 $840.00 27178136 3D MAX LARGE LEFT REF# 0115311 $893.00 27178137 3D MAX LARGE RIGHT REF# 0115321 $893.00 27178138 3D MAX X-LARGE LEFT REF# 0115312 $985.00 27178139 3D MAX X-LARGE RIGHT REF# 0115322 $985.00 27178140 SORBAFIX REF# 0113116 $407.00 27178141 SORBAFIX REF# 0113115 $263.00 27188189 WALL SUCTION CANISTER $99.00 27189190 WRIST SPLINT $75.00 27190000 SURGICEL SNOW 4X4 $404.00 28965217 REFILL/MAINTAIN PORTABLE PUMP $228.00 28965227 REFILL/MAIN PUMP/RESVR SYSTEM $195.00 28965237 PORT FLUSH $49.00 300000109 RBC DNA HEA 35 AG 11 BLD GRP $1,575.00 30003000 ANTIPROTHROMBIN AB, EA IG CL $55.00 30003009 ANTIPROTHROMBIN AB, EA IG CL $55.00 30003029 RBC MOLECULAR TYPE $735.00 30004819 TOXASSURE SELECT $1,251.00 30004839 TOXASSURE COMPREHENSIVE PROFILE $1,365.00 30010300 PSA; SCREENING $91.00 30010309 PSA; SCREENING $91.00 30036200 NB METABOLIC SCRN PANEL $134.00 30364150 VENIPUNCTURE ROUTINE $28.00 30365140 APHERESIS PLASMA $2,213.00 30800480 BASIC METABOLIC PANEL TOTAL CALCIUM $130.00 30800489 BASIC METABOLIC PANEL TOTAL CALCIUM $130.00 30800510 ELECTROLYTE PANEL $99.00 30800519 ELECTROLYTE PANEL $99.00 30800530 LAB COMPREHENS METABOLIC PANEL $152.00 30800539 LAB COMPREHENS METABOLIC PANEL $152.00 30800610 LIPID PANEL (AUTOMATED) $106.00 30800619 LIPID PANEL (AUTOMATED) $106.00 30800690 RENAL FUNCTION PANEL $104.00 30800699 RENAL FUNCTION PANEL $104.00 30800740 ACUTE HEPATITIS PANEL $320.00 30800749 ACUTE HEPATITIS PANEL $320.00 30800760 HEPATIC FUNCTION PANEL $163.00 30800769 HEPATIC FUNCTION PANEL $163.00 30801010 DRUG SCREEN (EACH) $65.00 30801019 DRUG SCREEN (EACH) $65.00 30801020 DRUG CONFIRMATION (EACH) $108.00 30801029 DRUG CONFIRMATION (EACH) $108.00 30801040 DRUG SCREEN 1+ CLASS NONCHROMO $179.00 30801049 DRUG SCREEN 1+ CLASS NONCHROMO $179.00 30801500 AMIKACIN $49.00 30801509 AMIKACIN $49.00 30801520 AMITRIPTYLINE $114.00 30801529 AMITRIPTYLINE $114.00 30801540 BENZADIAZAPINES $131.00 30801549 BENZADIAZAPINES $131.00 30801560 CARBAMAZEPINE; TOTAL (TEGRETOL $106.00 30801569 CARBAMAZEPINE; TOTAL (TEGRETOL $106.00 30801589 CYCLOSPORINE; A FPIA $48.00 30801599 CLOZAPINE $65.00 30801600 DESIPRAMINE $125.00 30801609 DESIPRAMINE $125.00 30801620 DIGOXIN $104.00 30801629 DIGOXIN $104.00 30801640 ASSAY; DIPROPYLACETIC ACID $106.00 30801649 ASSAY; DIPROPYLACETIC ACID $106.00 30801659 DIPROPYLACETIC ACID FREE $106.00 30801660 DOXEPIN $55.00 30801669 DOXEPIN $55.00 30801680 ETHOSUXIMIDE (ZARATONIN) $33.00 30801689 ETHOSUXIMIDE (ZARATONIN) $33.00 30801700 GENTAMICIN $108.00 30801709 GENTAMICIN $108.00 30801719 DRUG SCREEN QUANT GABAPENTIN #LC R70 $108.00 30801739 HALOPERIDOL (HALDOL) $35.00 30801740 IMIPRAMINE $50.00 30801749 IMIPRAMINE $50.00 30801759 LAMOTRIGINE, SERUM $126.00 30801760 LICOCAINE (XYLOCAINE) $26.00 30801769 LICOCAINE (XYLOCAINE) $26.00 30801779 LEVETIRACETAM, SERUM OR PLASMA $70.00 30801780 LITHIUM $70.00 30801789 LITHIUM $70.00 30801820 NORTRIPTYLINE $131.00 30801829 NORTRIPTYLINE $131.00 30801839 DRUG SCRN QUANT OXCARBAZEPIN $131.00 30801840 PHENOBARBITAL $104.00 30801849 PHENOBARBITAL $104.00 30801850 PHENTYOIN; TOTAL $92.00 30801859 PHENTYOIN; TOTAL $92.00 30801869 PHENYTOIN: FREE $92.00 30801880 PRIMIDONE $42.00 30801889 PRIMIDONE $42.00 30801920 PROCAINAMIDE W/METABOLITES $96.00 30801929 PROCAINAMIDE W/METABOLITES $96.00 30801940 QUINIDINE $105.00 30801949 QUINIDINE $105.00 30801960 SALICYLATE $79.00 30801970 TACROLIMUS $260.00 30801979 TACROLIMUS $260.00 30801980 THEOPHYLLINE $98.00 30801989 THEOPHYLLINE $98.00 30802000 TOBRAMYCIN $149.00 30802009 TOBRAMYCIN $149.00 30802019 TOPIRAMATE $76.00 30802020 VANCOMYCIN $125.00 30802029 VANCOMYCIN $125.00 30802039 DRUG SCREEN QUANT ZONISAMIDE $63.00 30802990 QUANT OF DRUG (EA) NOT ELSE SPEC $49.00 30802999 QUANT OF DRUG (EA) NOT ELSE SPEC $49.00 30803009 DRUG SCREEN NON TLC DEVICES $168.00 30803010 DRUG SCREEN CLASS LIST A $168.00 30803019 DRUG SCREEN CLASS LIST A $168.00 30803029 DRUG SCREEN PRSMPTV 1 CLASS $168.00 30803050 DRUG TEST PRSMV DIR OPT OBS $110.00 30803059 DRUG TEST PRSMV DIR OPT OBS $110.00 30803060 DRUG TEST PRSMV INSTRMNT $110.00 30803069 DRUG TEST PRSMV INSTRMNT $110.00 30803070 DRUG TEST PRSMV CHEM ANLYZR $110.00 30803079 DRUG TEST PRSMV CHEM ANLYZR $110.00 30803200 ETHANOL ALCOHOL $92.00 30803209 ETHANOL ALCOHOL $92.00 30803219 ALCOHOLS BIOMARKERS 1OR 2 $116.00 30803239 NICOTINE AND METABOLITE, QUANTITATIVE $89.00 30803240 AMPHETAMINES $89.00 30803249 AMPHETAMINES $89.00 30803269 OPIOID &OPIATE ANALOG 5/MORE $92.00 30803270 ANABOLIC STEROID 1 OR 2 (DHT) $125.00 30803279 ANABOLIC STEROID 1 OR 2 (DHT) $125.00 30803290 ANALGESICS NON-OPIOD 1 OR 2 $79.00 30803319 ANALGESICS NON-OPIOID 6/MORE $114.00 30803349 ANTIDEPRESSANTS CLASS 6/MORE $114.00 30803350 ANTIDEPRESSANT TRICYCLIC 1/2 $114.00 30803359 ANTIDEPRESSANT TRICYCLIC 1/2 $114.00 30803379 TRICYCLIC & CYCLICALS 6/MORE $137.00 30803389 ANTIDEPRESSANT NOT SPECIFIED $114.00 30803419 ANTIEPILEPTICS NOS 7/MORE $303.00 30803429 QUETIAPINE, SERUM OR PLASMA $105.00 30803449 ANTIPSYCHOTICS NOS 7/MORE $131.00 30803450 BARBITURATES; ASSAY $303.00 30803459 BARBITURATES; ASSAY $303.00 30803460 BENZODIAZEPINES 1-12 $131.00 30803462 CLOZAPINE(CLOZARIL) $131.00 30803464 CLONAZEPAM $131.00 30803466 DIAZEPAM $131.00 30803469 BENZODIAZEPINES 1-12 $131.00 30803479 BENZODIAZEPINES,MS,WB/SP RFX $137.00 30803489 DRUG SCREENING BUPRENORPHINE $84.00 30803499 THC,MS,WB/SP RFX $126.00 30803539 COCAINE $89.00 30803549 DRUG SCREENING FENTANYL $84.00 30803559 GABAPENTIN NON-BLOOD $89.00 30803569 HEROIN METABOLITE $89.00 30803579 KETAMINE AND NORKETAMINE $104.00 30803589 LAB METHADONE $104.00 30803599 METHYLENEDIOXYAMPHETAMINES $84.00 30803609 METHYLPHENIDATE $118.00 30803619 OPIATES 1 OR MORE $118.00 30803629 OPIOIDS & OPIATE ANALOGS 1/2 $221.00 30803649 OPIOID &OPIATE ANALOG 5/MORE $118.00 30803659 DRUG SCREENING OXYCODONE $84.00 30803669 DRUG SCREENING PREGABALIN $118.00 30803679 DRUG SCREENING PROPOXYPHENE $118.00 30803689 SEDATIVE HYPNOTICS $118.00 30803699 SKELETAL MUSCLE RELAXANT 1/2 $118.00 30803709 SKEL MUSC RELAXANT 3 OR MORE $84.00 30803719 STIMULANTS SYNTHETIC $84.00 30803729 DRUG SCREENING TAPENTADOL $84.00 30803739 DRUG SCREENING TRAMADOL $84.00 30803759 HYDROXYZINE, SERUM OR PLASMA $105.00 30803779 DRUG/SUBSTANCE NOS 7/MORE $84.00 30810010 LAB URINALYSIS AUTO W/SCOPE $36.00 30810019 LAB URINALYSIS AUTO W/SCOPE $36.00 30810030 URINALYSIS, AUTO W/O SCOPE $17.00 30810039 URINALYSIS, AUTO W/O SCOPE $17.00 30810050 URINALYSIS MELANIN $17.00 30810059 URINALYSIS MELANIN $17.00 30810150 MICROSCOPIC EXAM OF URINE $27.00 30810250 URINE PREGNANCY TEST $48.00 30810500 URINALYSIS; VOLUME MEASURE $27.00 30812069 BCR/ABL1 GENE MAJOR BP $108.00 30812079 BCR/ABL1 GENE MINOR BP $108.00 30812209 CYST FIBR TRANSMEM GENE ANALYSIS $609.00 30812259 CYP2C19 GENE COM VARIANTS $945.00 30812269 OPIOID CYP2D6 GENOTYPING $751.00 30812279 CYP2C9 GENE COM VARIANTS $189.00 30812409 PROTHROMBIN GENE ANALYSIS #LC511162 $108.00 30812419 FACTOR V LEIDEN MUTATION ANALY #LC5111 $108.00 30812439 FMR1 GENE DETECTION #LC511919 $108.00 30812449 FMR1 GENE CHARACTERIZATION #LC511913 $108.00 30812569 HEREDITARY HEMOCHROMATOSIS DNA #LC5 $105.00 30812709 JAK2 GENE JANUS KINASE 2 #LC489200 $105.00 30812919 MTHFR DNA ANALYSIS #LC511238 $108.00 30813359 TPMT GENE COM VARIANTS $210.00 30813559 VKORC1 GENE ANALYSIS COMMON VARIANT $105.00 30813649 HBB FULL GENE SEQUENCE LC#252823 $420.00 30813749 HLA I TYPING 1 ANTIGEN LR LC#006924 $210.00 30813769 HLA DRB1 INTERMEDIATE RESOLUT LC#1672 $210.00 30813829 HLA DQB1 CWD Resolution# R167095 $39.00 30814019 EPI PROCOLON LC# 481160 $42.00 30814030 RED CELL MOLECULAR TYPE $370.00 30814069 GALACTOSEMIA LC# 252816 $1,220.00 30814209 *MATERNIT21 CHRMOML FETAL#R451927 $760.00 30815009 ONCO (OVAR) TWO PROTEINS LC# $284.00 30820030 ACETAMINOPHEN $117.00 30820090 ACETONE/KEYTONES $33.00 30820099 ACETONE/KEYTONES $33.00 30820100 BETAHYDROXYBUTYRIC ACID, URINE $44.00 30820109 QUANT SERUM ACETONES/KETONES $44.00 30820179 ACYLCARNITINES; QUAN $47.00 30820240 ACTH; ASSAY $195.00 30820249 ACTH; ASSAY $195.00 30820309 CYCLIC ADP OR AMP $74.00 30820400 SERUM ALBUMIN $47.00 30820409 SERUM ALBUMIN $47.00 30820420 URINE ALBUMIN $17.00 30820429 URINE ALBUMIN $17.00 30820430 MICROALBUMIN; URINE QUAN $80.00 30820439 MICROALBUMIN; URINE QUAN $80.00 30820550 ETHANOL $92.00 30820750 BREATH ETHANOL $27.00 30820759 BREATH ETHANOL $27.00 30820850 ALDOLASE $61.00 30820859 ALDOLASE $61.00 30820880 ALDOSTERONE; URINE $111.00 30820889 ALDOSTERONE; URINE $111.00 30821039 ALPHA 1 ANTITRYPSIN; TOTAL $111.00 30821040 ALPHA-1 ANTITRYPSIN PHENOTYPE $92.00 30821049 ALPHA-1 ANTITRYPSIN PHENOTYPE $92.00 30821050 ALPHA FETOPROTEIN $104.00 30821052 ALPHA FETOPROTEIN; MATERNAL $57.00 30821059 ALPHA FETOPROTEIN $104.00 30821079 ALPHA-FETOPROTEIN L3 $131.00 30821080 ALUMINUM $69.00 30821089 ALUMINUM $69.00 30821280 TEST FOR MULTIPLE AMINO ACIDS $39.00 30821289 TEST FOR MULTIPLE AMINO ACIDS $39.00 30821310 SINGLE AMINO ACID $191.00 30821319 SINGLE AMINO ACID $191.00 30821350 AMINOLEVULINIC ACID $40.00 30821359 AMINOLEVULINIC ACID $40.00 30821390 AMINO ACIDS, 6/>, QUAN, EA $541.00 30821399 AMINO ACIDS, 6/>, QUAN, EA $541.00 30821400 AMMONIA $130.00 30821409 AMMONIA, PLASMA LC# 007054 $130.00 30821450 AMPHETAMINES $89.00 30821459 AMPHETAMINES $89.00 30821500 AMYLASE BODY FLUIDS $60.00 30821509 AMYLASE BODY FLUIDS $60.00 30821570 ANDROSTENEDIONE $81.00 30821579 ANDROSTENEDIONE $81.00 30821640 ANGIOTENSIN 1 ENZYME (ACE) $114.00 30821649 ANGIOTENSIN 1 ENZYME (ACE) $114.00 30821720 APOLIPOPROTEIN $124.00 30821729 APOLIPOPROTEIN $124.00 30821750 ARSENIC; ASSAY $194.00 30821759 ARSENIC; ASSAY $194.00 30821800 VITAMIN C (ASCORBIC) $77.00 30821809 VITAMIN C (ASCORBIC) $77.00 30821900 SPECTROSCOPY; ATOMIC ABSORPTIO $194.00 30821909 SPECTROSCOPY; ATOMIC ABSORPTIO $194.00 30822050 BARBITURATES; ASSAY $303.00 30822059 BARBITURATES; ASSAY $303.00 30822320 BETA 2 PROTEIN $118.00 30822329 BETA 2 PROTEIN $118.00 30822470 BILIRUBIN; TOTAL $47.00 30822479 BILIRUBIN; TOTAL #LC001099 $47.00 30822480 BILIRUBIN; DIRECT $47.00 30822489 BILIRUBIN; DIRECT #LC001222 $47.00 30822610 BIOTINIDASE $40.00 30822619 BIOTINIDASE $40.00 30822700 OCCULT BLOOD, FECES SINGLE $35.00 30822710 OCCULT BLOOD, OTHER SOURCES $27.00 30822720 OCCULT BLOOD; FECES, 1-3 TESTS $33.00 30822749 OCCULT BLD FHG QUAL 1-3 $33.00 30823000 CADMIUM $63.00 30823009 CADMIUM $63.00 30823060 VITAMIN D-3 $244.00 30823069 VITAMIN D-3 $244.00 30823080 CALCITONIN $77.00 30823089 CALCITONIN $77.00 30823100 CALCIUM $57.00 30823109 CALCIUM $57.00 30823309 IONIZED CALCIUM $104.00 30823400 URINE CALCIUM $18.00 30823409 URINE CALCIUM $18.00 30823550 STONE ANALYSIS; QUALITATIVE $108.00 30823559 STONE ANALYSIS; QUALITATIVE $108.00 30823600 URINARY CALCULI $120.00 30823609 URINARY CALCULI $120.00 30823659 CALCULUS INFRARED SPECTROSCOPY $27.00 30823740 ASSAY; BLOOD CARBON DIOXIDE $35.00 30823750 ASSAY; BLOOD CARBON MONOXIDE $80.00 30823780 CARCINOEMBRYONIC ANTIGEN (CEA) $133.00 30823789 CARCINOEMBRYONIC ANTIGEN (CEA) $133.00 30823790 CARNITINE $182.00 30823799 CARNITINE $182.00 30823800 CAROTENE $25.00 30823809 CAROTENE $25.00 30823840 FRACTIONATED CATECHOLAMINES;PL $192.00 30823849 FRACTIONATED CATECHOLAMINES;PL $192.00 30823900 CERULOPLASMIN $75.00 30823909 CERULOPLASMIN $75.00 30823970 CHEMILUMINESCENT ASSAY $39.00 30823979 CHEMILUMINESCENT ASSAY $39.00 30824350 BLOOD CHLORIDE $35.00 30824359 BLOOD CHLORIDE $35.00 30824360 URINE CHLORIDE; RANDOM $51.00 30824369 URINE CHLORIDE; RANDOM $51.00 30824380 ASSAY; OTHER FLUID CHLORIDE $39.00 30824389 ASSAY; OTHER FLUID CHLORIDE $39.00 30824419 CHLORINATED HC SCREEN LC# 790890 $23.00 30824650 SERUM CHOLOSTEROL $61.00 30824659 SERUM CHOLOSTEROL $61.00 30824800 SERUM CHOLINESTERASE PCHE(PSEU $22.00 30824809 SERUM CHOLINESTERASE PCHE(PSEU $22.00 30824820 CHOLINESTERASE; RBC $128.00 30824829 RBC CHOLINESTERACE $22.00 30824910 CHROMOTOGRAPHY; QUANT; SING $158.00 30824919 CHROMOTOGRAPHY; QUANT; SING $158.00 30824920 CHROMOTOGRAPHY; QUANT; MULT; P $144.00 30824929 CHROMOTOGRAPHY; QUANT; MULT; P $144.00 30824950 CHROMIUM $78.00 30824959 CHROMIUM $78.00 30825070 CITRATE $35.00 30825079 CITRATE 24 HOUR URINE #LC016865 $35.00 30825200 COCAINE $89.00 30825209 COCAINE $89.00 30825230 COLLAGEN CROSSLINKS $51.00 30825239 COLLAGEN CROSSLINKS $51.00 30825250 COPPER $49.00 30825259 COPPER $49.00 30825300 CORTISOL; FREE $216.00 30825309 CORTISOL; FREE $216.00 30825330 CORTISOL; TOTAL $95.00 30825339 CORTISOL AM LC#R104018 $95.00 30825400 CREATININE $55.00 30825420 LAB THIOPURINE METHYLTRANSFER $173.00 30825429 LAB THIOPURINE METHYLTRANSFER #LC716 $173.00 30825500 CREATINE KINASE ISOENZYMES $64.00 30825509 CREATINE KINASE ISOENZYMES $64.00 30825520 CPK ISOENZYMES $88.00 30825529 CPK ISOENZYMES $88.00 30825530 CPT; MB FRACTION $86.00 30825539 CPT; MB FRACTION $86.00 30825650 BLOOD CREATININE $47.00 30825659 BLOOD CREATININE $47.00 30825700 URINE CREATININE $47.00 30825709 URINE CREATININE $47.00 30825750 CREATININE CLEARANCE TEST $74.00 30825759 CREATININE CLEARANCE TEST $74.00 30825850 CRYOFIBRINOGEN $69.00 30825859 CRYOFIBRINOGEN $34.00 30825950 CRYOGLOBULIN $244.00 30825959 CRYOGLOBULIN $244.00 30826000 CYANIDE (ASSAY OF) $45.00 30826070 VITAMIN B-12 $68.00 30826079 VITAMIN B-12 $68.00 30826080 TEST OF B-12 BINDING CAPACITY $40.00 30826089 TEST OF B-12 BINDING CAPACITY $40.00 30826260 DEHYDROEPIANDROSTERONE (DHEA) $108.00 30826269 DEHYDROEPIANDROSTERONE (DHEA) $108.00 30826270 DEHYDROEPIANDROSTERONE SULFATE $61.00 30826279 DEHYDROEPIANDROSTERONE SULFATE $61.00 30826380 DIBUCAINE NUMBER $35.00 30826389 DIBUCAINE NUMBER $35.00 30826510 DIHYDROTESTOSTERONE (DHT) $125.00 30826519 DIHYDROTESTOSTERONE (DHT) $125.00 30826520 DIHYDROXYVITAMIN D $104.00 30826529 DIHYDROXYVITAMIN D $104.00 30826569 PANCREATIC ELASTASE FECAL LC# R123234 $47.00 30826640 ELECTROPHORESIS NES $108.00 30826649 ELECTROPHORESIS NES $108.00 30826680 ERYTHROPOIETIN $135.00 30826689 ERYTHROPOIETIN $135.00 30826700 ESTRADIOL $33.00 30826709 ESTRADIOL $33.00 30826710 ESTROGENS; FRACTIONATED $278.00 30826719 ESTROGENS; FRACTIONATED $278.00 30826720 ESTROGEN;TOTAL $59.00 30826729 ESTROGEN;TOTAL $59.00 30826770 ESTRIOL $38.00 30826779 ESTRIOL $38.00 30826790 ESTRONE $30.00 30826799 ESTRONE $30.00 30826930 ETHYLENE GLYCOL $42.00 30826939 ETHYLENE GLYCOL $42.00 30827050 FAT/LIPIDS, FECES; QUAL $22.00 30827059 FAT/LIPIDS, FECES; QUAL $22.00 30827100 FAT/LIPIDS, FECES; QUANTITATIVE $70.00 30827109 FAT/LIPIDS, FECES; QUANTITATIVE $70.00 30827250 BLOOD FATTY ACIDS $38.00 30827259 BLOOD FATTY ACIDS $38.00 30827280 FERRITIN $85.00 30827289 FERRITIN $85.00 30827310 FETAL FIBRONECTIN, CV SEMIQUAN $528.00 30827319 FETAL FIBRONECTIN, CV SEMIQUAN $528.00 30827420 FLURAZEPAM $55.00 30827429 FLURAZEPAM $55.00 30827460 FOLIC ACID; SERUM $65.00 30827469 FOLIC ACID; SERUM $65.00 30827470 FOLIC ACID; RBC $142.00 30827479 FOLIC ACID; RBC $142.00 30827590 RBC GLACTOKINASE $142.00 30827599 RBC GLACTOKINASE $142.00 30827840 GAMMAGLOBULIN $90.00 30827849 GAMMAGLOBULIN $90.00 30827850 GAMMAGLOBULIN; IgE $102.00 30827859 GAMMAGLOBULIN; IgE $102.00 30827879 GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLA $90.00 30828030 ARTERIAL BLOOD GAS $180.00 30829410 GASTRIN $48.00 30829419 GASTRIN $48.00 30829450 GLUCOSE; OTHER THAN BLOOD $44.00 30829459 GLUCOSE; OTHER THAN BLOOD $44.00 30829470 BLOOD GLUCOSE; QUANT $44.00 30829479 BLOOD GLUCOSE; QUANT $44.00 30829500 GLUCOSE TEST $70.00 30829509 GLUCOSE TEST $70.00 30829510 GLUCOSE TOL TEST (GTT); 3 SAMP $158.00 30829519 GLUCOSE TOL TEST (GTT) 3 SAMP $158.00 30829520 GLUCOSE TOL TEST (GTT); ADDITI $67.00 30829529 GLUCOSE TOL TEST (GTT) ADDITI $67.00 30829550 ASSAY OF G6PD ENZYME $27.00 30829559 ASSAY OF G6PD ENZYME $27.00 30829600 TEST FOR G6PD ENYZME $82.00 30829609 TEST FOR G6PD ENYZME $82.00 30829620 GLUCOSE; BLD BY MONITOR DEVICE $33.00 30829625 GLUCOSE; BLD BY MONITOR DEVICE $33.00 30829770 GGT (GAMMA GLUTAMYL TRANS.) $46.00 30829779 GGT (GAMMA GLUTAMYL TRANS.) $46.00 30829859 GYCATED PROTEIN $42.00 30830019 GONADOTROPIN; FSH $135.00 30830029 GONADOTROPIN; LH $84.00 30830039 GROWTH HORMONE (HGH) $45.00 30830109 HAPTOGLOBIN; QUANT $93.00 30830139 H PYLORI (C-13) BREATH TEST $201.00 30830189 HEAVY METAL; QUANTITATIVE EACH $82.00 30830219 HEMOGLOBIN CHROMOTOGRAPHY $40.00 30830300 FETAL HEMOBLOBIN; CHEMICAL $108.00 30830309 FETAL HEMOBLOBIN; CHEMICAL $108.00 30830360 LAB GLYCATED HEMOGLOBIN (AIC) $70.00 30830369 LAB GLYCATED HEMOGLOBIN (AIC) $70.00 30830500 BLOOD METHEMOGLOBIN $106.00 30830504 METHEMOGLOBIN $47.00 30830509 BLOOD METHEMOGLOBIN $106.00 30830510 PLASMA HEMOGLOBIN $36.00 30830519 PLASMA HEMOGLOBIN $36.00 30830700 TEST FOR HEMOSIDERIN $55.00 30830909 HOMOCYSTEINE $422.00 30831500 HOMOVALILLIC ACID, 24HR URINE $45.00 30831509 HOMOVALILLIC ACID, 24HR URINE $45.00 30834910 CORTICOSTEROIDS $48.00 30834919 CORTICOSTEROIDS $48.00 30834970 5-HIAA (HYDROXYINDOLACETIC ACI $36.00 30834979 5-HIAA (HYDROXYINDOLACETIC ACI $36.00 30834980 HYDROXYPROGESTERONE; 17-D $75.00 30834989 HYDROXYPROGESTERONE; 17-D $75.00 30835050 TOTAL HYDROXYPROLINE $66.00 30835059 TOTAL HYDROXYPROLINE $66.00 30835160 IMM-ASSY; NNANTBDY $354.00 30835163 ANTI-RIBOSOMAL P PORTEIN AB (RDL)R52012 $37.00 30835169 IMM-ASSY; NNANTBDY $354.00 30835190 IA NOT INFECT AGENT; RIA TECHN $108.00 30835199 IA NOT INFECT AGENT; RIA TECHN $108.00 30835200 IMM-ASSY; NNANTBDY; OTHERC1 ES $318.00 30835209 IMM-ASSY; NNANTBDY; OTHERC1 ES $318.00 30835250 LAB TOTAL INSULIN $82.00 30835259 LAB TOTAL INSULIN $82.00 30835279 LAB FREE INSULIN $95.00 30835400 LAB IRON $60.00 30835409 IRON $85.00 30835500 LAB IRON BINDING CAPACITY $82.00 30835509 LAB IRON BINDING CAPACITY $82.00 30835860 LAB 17 KETOSTERIOIDS, TOTAL $36.00 30835869 LAB 17 KETOSTERIOIDS, TOTAL $36.00 30835930 LAB FRACTION KETOSTEROIDS $71.00 30835939 LAB FRACTION KETOSTEROIDS $71.00 30836050 LACTIC ACID $91.00 30836059 LACTIC ACID $91.00 30836150 LAB LACTIC ENZYME (LDH) $63.00 30836159 LAB LACTIC ENZYME (LDH) $63.00 30836250 LDH ISOENZYMES $86.00 30836259 LDH ISOENZYMES $86.00 30836310 LACTOFERRIN $108.00 30836319 LACTOFERRIN $108.00 30836550 LEAD $62.00 30836559 LEAD $62.00 30836610 L/S RATIO $222.00 30836619 L/S RATIO $222.00 30836700 LAP ENZYME $25.00 30836709 LAP ENZYME $25.00 30836900 LAB LIPASE $45.00 30836909 LAB LIPASE $45.00 30836959 ASSAY OF LIPOPROTEIN $33.00 30836989 LIPOPROTEIN ASSOC PHOSPHOLIPAS $103.00 30837010 LIPOPROTEIN BLD HR FRACTION $95.00 30837040 LIPOPROTEIN PARTICLE NUMBER $163.00 30837049 LIPOPROTEIN PARTICLE NUMBER $163.00 30837180 LAB LIPOPROEIN; HDL $45.00 30837189 LAB LIPOPROEIN HDL $45.00 30837210 BLOOD LIPOPORTEIN; LDL $45.00 30837219 BLOOD LIPOPORTEIN; LDL $45.00 30837270 LUTEINIZING RELEASING FACTOR $324.00 30837279 LUTEINIZING RELEASING FACTOR $324.00 30837350 MAGNESIUM $60.00 30837359 MAGNESIUM $60.00 30837880 QUALLIT MASS SPECT EA SPECIMEN $70.00 30837890 QUALLIT MASS SPECT EA SPECIMEN $70.00 30838250 MERCURY; QUANT $133.00 30838259 MERCURY; QUANT $133.00 30838350 METANEPHRINES, FRACT 24HR URIN $124.00 30838359 METANEPHRINES, FRACT 24HR URIN $124.00 30838400 LAB METHADONE $104.00 30838409 LAB METHADONE $104.00 30838730 CSF MYELIN BASIC $55.00 30838739 CSF MYELIN BASIC PROTEIN $55.00 30838740 MYOGLOBIN $135.00 30838749 MYOGLOBIN #LC010405 $135.00 30838800 NATRIURETIC PEPTIDE $88.00 30838809 NATRIURETIC PEPTIDE $88.00 30838830 OTHER NEPHELOMETRY $39.00 30838839 OTHER NEPHELOMETRY $39.00 30838859 NICKEL #LC071571 $92.00 30838910 MELECULE ISOLATE NUCLEIC $46.00 30838919 MELECULE ISOLATE NUCLEIC $46.00 30838920 MELECULAR ENZYMATIC $51.00 30838929 MELECULAR ENZYMATIC $51.00 30838930 MLCLR DX / SLOT BLOT $39.00 30838939 MLCLR DX / SLOT BLOT $39.00 30838940 MOLECULE GEL ELECTROPHORESIS $49.00 30838949 MOLECULE GEL ELECTROPHORESIS $49.00 30838960 MELECULAR NUCLEIC ACID PROBE $187.00 30838969 MELECULAR NUCLEIC ACID PROBE $187.00 30838980 MOLECULAR NUCLEIC AMPL SINGLE; $57.00 30838989 MOLECULAR NUCLEIC AMPL SINGLE; $57.00 30839000 MOLECULE NUCLEIC AMPLI 2 SEQ $77.00 30839009 MOLECULE NUCLEIC AMPLI 2 SEQ $77.00 30839010 MOLECULE NUCLEIC AMPLI ADDON $50.00 30839019 MOLECULE NUCLEIC AMPLI ADDON $50.00 30839020 MOLECULAR REVERSE TRANS $57.00 30839029 MOLECULAR REVERSE TRANS $57.00 30839030 MOLECULE MUTATION SCAN $49.00 30839039 MOLECULE MUTATION SCAN $49.00 30839080 NUCLEIC ACID, SIGNAL AMPL $40.00 30839089 NUCLEIC ACID, SIGNAL AMPL $40.00 30839090 NUCLEIC ACID, HIGH RESOLUTE $39.00 30839099 NUCLEIC ACID, HIGH RESOLUTE $39.00 30839120 GENETIC EXAMINATION AND REPORT $51.00 30839129 GENETIC EXAMINATION AND REPORT $51.00 30839140 MUTATINO IDENT OLA/SBCE/ASPE $39.00 30839149 MUTATINO IDENT OLA/SBCE/ASPE $39.00 30839150 ASSAY OF NUCLEOTIDASE $26.00 30839159 ASSAY OF NUCLEOTIDASE $26.00 30839160 OLIGOCLONAL BANDS $61.00 30839169 OLIGOCLONAL BANDS $61.00 30839190 QUAL ORGANIC ACIDS EA SPECIMIN $70.00 30839199 QUAL ORGANIC ACIDS EA SPECIMIN $70.00 30839210 SINGLE ORGANIC ACID; QUANE (SE $228.00 30839219 SINGLE ORGANIC ACID; QUANE (SE $228.00 30839250 OPIATES $118.00 30839259 OPIATES $118.00 30839300 BLOOD OSMOLALITY $55.00 30839309 BLOOD OSMOLALITY $55.00 30839350 URINE OSMOLALITY $88.00 30839359 URINE OSMOLALITY $88.00 30839370 OSTEOCALCIN $107.00 30839379 OSTEOCALCIN $107.00 30839450 OXALATE $36.00 30839459 OXALATE $36.00 30839700 PARATHORMONE;PTH C TERMINAL $236.00 30839709 PARATHORMONE;PTH C TERMINAL $236.00 30839860 BODY FLUID ACIDITY; EXCEPT BLO $25.00 30839869 BODY FLUID ACIDITY; EXCEPT BLOOD $25.00 30839920 PHENCYCLIDINE (PCP) $89.00 30839929 PHENCYCLIDINE (PCP) $89.00 30839930 CALPROTECTIN $108.00 30839939 CALPROTECTIN $108.00 30840300 BLOOD PKU $98.00 30840309 BLOOD PKU $98.00 30840600 ACID PHOSPHATASE; TOTAL $74.00 30840609 ACID PHOSPHATASE; TOTAL $74.00 30840660 ACID PHOSPHATASE; PROSTATIC $27.00 30840669 ACID PHOSPHATASE; PROSTATIC $27.00 30840750 ALKALINE PHOSPHATASE $44.00 30840759 ALKALINE PHOSPHATASE $44.00 30840800 ALKALINE PHOSPHATASE ISOS $42.00 30840809 ALKALINE PHOSPHATASE ISOS $42.00 30840810 PHOSPHATIDYLGLYCEROL $39.00 30840819 PHOSPHATIDYLGLYCEROL $39.00 30841000 PHOSPHORUS $44.00 30841009 PHOSPHORUS $44.00 30841050 URINE PHOSPHORUS $82.00 30841059 URINE PHOSPHORUS $82.00 30841100 URINE PORPHOBILINOGEN $28.00 30841109 URINE PORPHOBILINOGEN $28.00 30841120 PLACENTA ALPHA MICRO IG C/V $163.00 30841129 PLACENTA ALPHA MICRO IG C/V $163.00 30841200 URINE PORPHYRINS $41.00 30841209 URINE PORPHYRINS $41.00 30841260 FECAL PORPHYRINS $69.00 30841269 FECAL PORPHYRINS $69.00 30841320 SERUM POTASSIUM $47.00 30841329 SERUM POTASSIUM $47.00 30841330 URINE POTASSIUM $49.00 30841339 URINE POTASSIUM $49.00 30841340 PREALBUMIN $110.00 30841349 PREALBUMIN $110.00 30841409 PREGNENOLONE #LC 140707 $63.00 30841440 PROGESTERONE $57.00 30841449 PROGESTERONE $57.00 30841459 PROCALCITONIN $79.00 30841460 PROLACTIN $82.00 30841469 PROLACTIN $82.00 30841500 PROSTAGLANDIN; EACH $172.00 30841520 PSA - COMPLEXED $87.00 30841529 PSA - COMPLEXED LC#140674 $87.00 30841530 PSA; TOTAL $91.00 30841539 PSA LC 103202 480145 $88.00 30841540 PSA; FREE $62.00 30841549 PSA; FREE LC#480947 $62.00 30841550 PROTEIN;SERUM $47.00 30841559 PROTEIN;SERUM #LC001073 $47.00 30841560 PROTEIN; URINE $20.00 30841569 PROTEIN; URINE $20.00 30841570 PROTEIN; OTHER $20.00 30841630 FIRST TRIMESTER SCREEN $108.00 30841639 FIRST TRIMESTER SCREEN $108.00 30841650 PROTEIN E-PHORESIS;SERUM $87.00 30841659 PROTEIN E-PHORESIS;SERUM $87.00 30841660 PROTEIN E-PHORESIS/URINE/CSF $51.00 30841669 PROTEIN E-PHORESIS/URINE/CSF $51.00 30841810 WESTERN BLOT TEST; PROTEIN $272.00 30841819 WESTERN BLOT TEST; PROTEIN $272.00 30841820 WESTRN BLOT TST;PROTEIN BND ID $143.00 30841829 WESTRN BLOT TST;PROTEIN BND ID $143.00 30842020 RBC PROTOPORPHYRIN $40.00 30842029 RBC PROTOPORPHYRIN $40.00 30842070 VITAMIN B-6 $152.00 30842079 VITAMIN B-6 $152.00 30842100 PYRUVATE $163.00 30842109 PYRUVATE $163.00 30842330 ESTROGEN RECEPTOR $127.00 30842340 PREGESTERONE RECEPTOR $111.00 30842350 ENDROCRINE HORMONE $201.00 30842359 ENDROCRINE HORMONE $201.00 30842380 NONENDROCRINE RECEPTOR $279.00 30842389 NONENDROCRINE RECEPTOR $279.00 30842440 RENIN $60.00 30842449 RENIN $60.00 30842559 SELENIUM LC# 716910 $60.00 30842600 SEROTONIN $48.00 30842609 SEROTONIN $48.00 30842700 SEX HORMONE BINDING GLOBULIN $63.00 30842709 SEX HORMONE BINDING GLOBULIN $63.00 30842950 BLOOD SODIUM $47.00 30842959 BLOOD SODIUM $47.00 30843000 URINE SODIUM $47.00 30843009 URINE SODIUM $47.00 30843020 SODIUM; OTHER $60.00 30843029 ASSAY OF SODIUM OTHER SOURCE $15.00 30843050 SOMATOMEDIN $254.00 30843059 SOMATOMEDIN $254.00 30843110 OTHER SPECTROPHOTOMETER $17.00 30843119 OTHER SPECTROPHOTOMETER $17.00 30843150 SPECIFIC GRAVITY; BODY FLUID $35.00 30843789 SUGARS, SINGLE QUAN EA SPECIMEN $37.00 30843920 LAB URINE SULFATE $65.00 30843929 LAB URINE SULFATE $65.00 30844020 TESTOSTERONE; FREE $213.00 30844029 TESTOSTERONE; FREE $213.00 30844030 TESTOSTERONE, TOTAL $154.00 30844039 TESTOSTERONE, TOTAL $154.00 30844250 VITAMIN B-1 $208.00 30844259 VITAMIN B-1 $208.00 30844300 THIOCYANATE $96.00 30844309 THIOCYANATE #LC811331 $96.00 30844320 THYROGLOBULIN $130.00 30844329 THYROGLOBULIN $130.00 30844360 TOTAL THYROXINE $60.00 30844369 TOTAL THYROXINE $60.00 30844370 NEONATE THYROXINE $19.00 30844379 NEONATE THYROXINE $19.00 30844390 T4 (THYROXINE); FREE $100.00 30844399 T4 (THYROXINE); FREE $100.00 30844420 THYROXINE BINDING GLOBULIN $41.00 30844429 THYROXINE BINDING GLOBULIN $41.00 30844430 THYROID STIMULATING HORMONE TS $118.00 30844439 THYROID STIMULATING HORMONE TS $118.00 30844450 THYROID STIM IMMUNOGLOBULINS $117.00 30844459 THYROID STIM IMMUNOGLOBULINS $117.00 30844460 VITAMIN E $40.00 30844469 VITAMIN E $40.00 30844500 TRANSFERASE (SGOT) (AST) $47.00 30844509 TRANSFERASE (SGOT) (AST) $47.00 30844600 TRANSFERASE (SGPT) (ALT) $47.00 30844609 TRANSFERASE (SGPT) (ALT) $47.00 30844660 TRANSFERRIN $78.00 30844669 TRANSFERRIN $78.00 30844780 TRIGLYCERIDES $44.00 30844789 TRIGLYCERIDES $44.00 30844790 LAB THYROID HORMONE (T3) $55.00 30844799 THYROID HORMONE UPTAKE (T3) #LC001156 $55.00 30844800 TRI-IODOTHYRONINE (T30; TOTAL $41.00 30844809 TRI-IODOTHYRONINE (T30; TOTAL $41.00 30844810 TRI-IODOTHYRONINE (T3); FREE $168.00 30844819 TRI-IODOTHYRONINE (T3); FREE $168.00 30844820 TRI-IODOTHYRONINE; REVERSE (T3 $47.00 30844829 TRI-IODOTHYRONINE; REVERSE (T3 $47.00 30844840 TROPONIN QUANT $138.00 30844849 TROPONIN QUANT $138.00 30845200 BLOOD UREA NITROGEN (BUN) $44.00 30845209 BLOOD UREA NITROGEN (BUN) $44.00 30845500 BLOOD URIC ACID $44.00 30845509 BLOOD URIC ACID $44.00 30845600 OTHER SOURCE URIC ACID $41.00 30845609 OTHER SOURCE URIC ACID $41.00 30845850 URINE VMA (VANILLYMANDELIC ACI $96.00 30845859 URINE VMA (VANILLYMANDELIC ACI $96.00 30845860 VASOACTIVE INTESTINAL PEPTIDE $96.00 30845869 VASOACTIVE INTESTINAL PEPTIDE $96.00 30845880 VASOPRESSIN (ADH) $159.00 30845889 VASOPRESSIN (ADH) $159.00 30845900 VITAMIN A (RETINOL) $33.00 30845909 VITAMIN A (RETINOL) $33.00 30845919 VITAMIN B3 (NIACIN & METABOLITE) R070115 $45.00 30845979 VITAMIN K 1 LC# 121200 $42.00 30846000 VOLATILES; ALCOHOL $106.00 30846002 VOLATILES; ALCOHOL; METHYL (B) $106.00 30846009 VOLATILES; ALCOHOL $106.00 30846300 ZINC $33.00 30846309 ZINC $33.00 30846810 C-PEPTIDE $141.00 30846819 C-PEPTIDE $141.00 30847020 CHORIONIC GONADOTROPIN TEST $43.00 30847029 CHORIONIC GONADOTROPIN TEST $43.00 30847030 CHORIONIC GONADOTROPIN ASSAY $60.00 30847039 HCG SERUM QL W/RFLX HCG QN $60.00 30849990 UNLISTED CHEM $22.00 30849999 UNLISTED CHEM $22.00 30850020 BLEEDING TIME $48.00 30850070 DIFFERENTIAL WBC; MANUAL $33.00 30850140 HEMATOCRIT $24.00 30850149 HEMATOCRIT $24.00 30850180 HEMOGLOBIN $28.00 30850184 HEMOGLOBIN $28.00 30850189 HEMOGLOBIN $28.00 30850250 LAB CBC W/PLAT & AUTO COMPLETE $74.00 30850259 LAB CBC W/PLAT & AUTO COMPLETE $74.00 30850270 AUTO CBC W/ PLATELETS $47.00 30850320 MANUAL CELL COUNT; EACH $39.00 30850410 AUTOMATED RBC COUNT $22.00 30850419 AUTOMATED RBC COUNT $22.00 30850450 AUTOMATED RETICULOCYTE COUNT $60.00 30850459 AUTOMATED RETICULOCYTE COUNT $60.00 30850480 AUTOMATED WBC; EOSINOPHIL COUN $38.00 30850489 AUTOMATED WBC; EOSINOPHIL COUN $38.00 30850490 AUTOMATED PLATELET COUNT $55.00 30850499 AUTOMATED PLATELET COUNT $55.00 30851309 CHROMOGENIC SUBSTRATE ASSAY $36.00 30852109 CLOTTING FACTOR II PROTHROMBIN SPECIF $42.00 30852200 BLOOD CLOT FACTOR V $40.00 30852209 BLOOD CLOT FACTOR V $40.00 30852300 BLOOD CLOT FACTOR VII $42.00 30852309 BLOOD CLOT FACTOR VII $42.00 30852400 BLOOD CLOT FACTOR VIII (1 STG) $143.00 30852409 BLOOD CLOT FACTOR VIII (1 STG) $143.00 30852450 BLOOD CLOT FACOTR VIII; VW FAC $154.00 30852459 BLOOD CLOT FACOTR VIII; VW FAC $154.00 30852460 BLOOD CLOT FACOTR VIII; VW ANT $219.00 30852469 BLOOD CLOT FACOTR VIII; VW ANT $219.00 30852470 BLOOD CLOT FACTOR VIII; VW FAC $234.00 30852479 BLOOD CLOT FACTOR VIII; VW FAC $234.00 30852500 BLOOD CLOT FACTOR IX $39.00 30852509 BLOOD CLOT FACTOR IX $39.00 30852600 BLOOD CLOT FACOTR X $42.00 30852609 BLOOD CLOT FACOTR X $42.00 30852700 BLOOD CLOT FACTOR XI $42.00 30852709 BLOOD CLOT FACTOR XI $42.00 30852800 BLOOD CLOT FACOTR XII $106.00 30852809 BLOOD CLOT FACOTR XII $106.00 30852900 CLOTTING; FACOTR XIII - FS $108.00 30852909 CLOTTING; FACOTR XIII - FS $108.00 30852910 BLOOD CLOT FACTOR XIII SOLUBIL $112.00 30852919 BLOOD CLOT FACTOR XIII SOLUBIL $112.00 30853000 ANTITHROMBIN III; TEST FOR $424.00 30853009 ANTITHROMBIN III; TEST FOR $424.00 30853010 ANTITHROMBIN III; ASSAY OF $55.00 30853019 ANTITHROMBIN III; ASSAY OF $55.00 30853020 PROTEIN C ANTIGEN; TEST FOR $67.00 30853029 PROTEIN C ANTIGEN; TEST FOR $67.00 30853030 PROTEIN C ACTIVITY; ASSAY OF $455.00 30853039 PROTEIN C ACTIVITY; ASSAY OF $455.00 30853050 PROTEIN S; TOTAL; ASSAY OF $63.00 30853059 PROTEIN S; TOTAL; ASSAY OF $63.00 30853060 PROTEIN S; FREE; ASSAY OF $484.00 30853069 PROTEIN S; FREE; ASSAY OF $484.00 30853070 ACTIVATED PROTEIN C RESISTANCE $108.00 30853079 ACTIVATED PROTEIN C RESISTANCE $108.00 30853350 FACTOR INHIBITOR TEST $29.00 30853359 FACTOR INHIBITOR TEST $29.00 30853620 FIBRIN DEGRADATION PRODUCTS $114.00 30853629 FIBRIN DEGRADATION PRODUCTS $114.00 30853790 FIBRIN DEGRADATION; QUANT $116.00 30853799 FIBRIN DEGRADATION; QUANT $116.00 30853840 FIBRINOGEN ACTIVITY $57.00 30853849 FIBRINOGEN ACTIVITY $57.00 30853859 FIBRINOGEN; ANTIGEN $57.00 30853979 CLOTTING FUNCT ACTIVITY R117913 $58.00 30854100 ALPHA-2-ANTIPLASMIN $558.00 30854109 ALPHA-2-ANTIPLASMIN $558.00 30854150 PLASMINOGEN ACTIVATOR $876.00 30854159 PLASMINOGEN ACTIVATOR $876.00 30854200 FIBRINOLYTIC PLASMINOGEN $216.00 30854209 FIBRINOLYTIC PLASMINOGEN $216.00 30854600 FETAL HEMOGLOBIN; ROSETTE $22.00 30854609 FETAL HEMOGLOBIN; ROSETTE $22.00 30854610 FETAL HEMOGLOBIN - ROSETTE $17.00 30855209 HEPARIN ANTI-XA LC#117101 $49.00 30855360 IRON STAIN; PERIPHERAL BLOOD $20.00 30855400 WBC ALKALINE PHOSPHATASE $64.00 30855490 MURAMIDASE- LYSOSME $51.00 30855499 MURAMIDASE- LYSOSME $51.00 30855970 PLATELET NEUTRALIZATION $121.00 30855979 PLATELET NEUTRALIZATION $121.00 30855989 HEXAGONNAL PHASE PHOSPHOLIPID $121.00 30856100 PROTHROMBIN TIME (PT) $41.00 30856109 PROTHROMBIN TIME (PT) $41.00 30856110 PROTHROMBIN TIME MIXING STUDY $103.00 30856119 PROTHROMBIN TIME MIXING STUDY $103.00 30856130 VIPER VENOM; PT; W/DILUTED $121.00 30856139 VIPER VENOM; PT; W/DILUTED $121.00 30856510 MANUAL ASSAY OF RBC SED RATE $41.00 30856529 AUTOM ERYTHROCYTE SED RATE $49.00 30856600 RBC SICKLE CELL $35.00 30856609 RBC SICKLE CELL $35.00 30856700 THROMBIN TIME $44.00 30856705 THROMBIN NEUTRALIZATION $44.00 30856709 THROMBIN TIME $44.00 30857050 THROMBOPLASTIN INHIBITION, TIS $147.00 30857059 THROMBOPLASTIN INHIBITION, TIS $147.00 30857300 PARTIAL THROMBOPLASTIN TIME $51.00 30857309 PARTIAL THROMBOPLASTIN TIME $51.00 30857320 THROMBOPLASTIN; PLASMA FRACTIO $170.00 30857329 THROMBOPLASTIN; PLASMA FRACTIO $170.00 30858100 BLOOD VISCOSITY $40.00 30858109 BLOOD VISCOSITY $40.00 30860030 ALLERGEN SPECIFIC IGE $27.00 30860039 ALLERGEN SPECIFIC IGE $27.00 30860050 ALLERGEN PROFILE, BASIC FOOD $103.00 30860059 ALLERGEN PROFILE, BASIC FOOD $103.00 30860089 ALLG SPEC IGE RECOMB EA LC#60239 & 6043 $42.00 30860210 WBC ANTIBODY I.D $364.00 30860219 WBC ANTIBODY I.D $364.00 30860220 PLATELET ANTIBODY I.D. $227.00 30860229 PLATELET ANTIBODY I.D. $227.00 30860230 IMMUNOGLOBULIN $29.00 30860239 IMMUNOGLOBULIN $29.00 30860380 ANTINUCLEAR ANTIB (ANA) $74.00 30860389 ANTINUCLEAR ANTIB (ANA) $74.00 30860390 ANTINUCLEAR ANTIB TITER (ANA) $61.00 30860399 ANTINUCLEAR ANTIB TITER (ANA) $61.00 30860600 ANTISTREPTOLYSIN O TITER $60.00 30860609 ANTISTREPTOLYSIN O TITER $60.00 30861400 C-REACTIVE PROTEIN $60.00 30861409 C-REACTIVE PROTEIN $60.00 30861410 HS C-REACT PROTEIN; S $79.00 30861419 CARDIAC C-REACTIVE PROTEIN #LC120766 $79.00 30861460 BETA 2 GLYCOPROTEIN I AB $81.00 30861469 BETA 2 GLYCOPROTEIN I AB $81.00 30861470 CARDIOLIPIN ANTIBODY $151.00 30861479 CARDIOLIPIN ANTIBODY $151.00 30861480 ANTI-PHOSPHATIDYLSERINE AB $55.00 30861489 ANTI-PHOSPHATIDYLSERINE AB $55.00 30861570 TITER OF COLD AGGLUTININ $24.00 30861600 ANTIGEN COMPLEMENT $96.00 30861609 ANTIGEN COMPLEMENT $96.00 30861610 COMPLEMENT FUNCTIONAL ACTIVITY $202.00 30861619 COMPLEMENT FUNCTIONAL ACTIVITY $202.00 30861620 TOTAL COMPLEMENT (CH50) $143.00 30861629 TOTAL COMPLEMENT (CH50) $143.00 30862000 LAB CCP ANTIBODY $55.00 30862009 LAB CCP ANTIBODY $55.00 30862150 DEOXYRIBONUCLEASE ANTIBODY $88.00 30862159 DEOXYRIBONUCLEASE ANTIBODY $88.00 30862250 DNA ANITBODY; DOUBLE STRAND $154.00 30862259 DNA ANITBODY; DOUBLE STRAND $154.00 30862260 DNA AB; SS $47.00 30862269 DNA AB; SS $47.00 30862350 ANTICHROMATIN ANTIBODIES $320.00 30862359 *ANTI JO 1 LC#R161455 $320.00 30862550 FLUORESCENT AB; SCREEN $105.00 30862559 FLUORESCENT AB; SCREEN $105.00 30862560 TEST BY FLUORESCENT AB; TITER $35.00 30862569 TEST BY FLUORESCENT AB; TITER $35.00 30863000 IMMUNOASSAY CA 15-3 (27.29) $128.00 30863009 IMMUNOASSAY CA 15-3 (27.29) $128.00 30863010 IMMUNOASSAY CA 19-9 $135.00 30863019 IMMUNOASSAY CA 19-9 $135.00 30863040 IMMUNOASSAY CA 125 $135.00 30863049 IMMUNOASSAY CA 125 $135.00 30863059 HUMAN EPIDIDYMIS PROTEIN 4 $135.00 30863080 HETEROPHILE ANTIBODIES $44.00 30863089 HETEROPHILE ANTIBODIES $44.00 30863160 OTHER TUMOR ANITGEN $135.00 30863169 OTHER TUMOR ANITGEN $135.00 30863170 DIPHTHERIA ANTITOXOID ANTIBODI $38.00 30863179 DIPHTHERIA ANTITOXOID ANTIBODI $38.00 30863200 IMMUNOELECTROPHORESIS; BLOOD $51.00 30863209 IMMUNOELECTROPHORESIS; BLOOD $51.00 30863250 IEP; NOT SERUM $158.00 30863259 IEP; NOT SERUM $158.00 30863310 IMMUNODIFFUSION; OUCTHERLONY $108.00 30863319 IMMUNODIFFUSION; OUCTHERLONY $108.00 30863320 IMMUNE COMPLEX $123.00 30863329 IMMUNE COMPLEX $123.00 30863340 IMMUNOFIXATION ELECTROPH $163.00 30863349 IMMUNOFIXATION ELECTROPH $163.00 30863359 IMMUNFIX E-PHORSIS/URINE/CSF $105.00 30863360 INHIBIN A $260.00 30863369 INHIBIN A R146803 $260.00 30863370 INSULIN ANTIBODIES $59.00 30863379 INSULIN ANTIBODIES $59.00 30863409 INTRINSIC FACTOR ANTIBODIES $114.00 30863410 ISLET CELL ANTIBODY $114.00 30863419 ISLET CELL ANTIBODY $114.00 30863529 CHRONIC URTICARIA #LCR820022 $270.00 30863590 T CELLS; TOTAL COUNT $139.00 30863600 CD4 & CD8 CELLS; ABS COUNT $107.00 30863609 CD4 & CD8 CELLS; ABS COUNT $107.00 30863610 CD4 CELLS; ABS COUNT $130.00 30863619 CD4 CELLS; ABS COUNT $130.00 30863760 MICROSOMAL ANTIBODIES; THYROID $112.00 30863769 MICROSOMAL ANTIBODIES; THYROID $112.00 30864030 PARTICLE AGGLUT $95.00 30864039 PARTICLE AGGLUT $95.00 30864060 PARTICLE AGGLUTINATION TITER $33.00 30864069 PARTICLE AGGLUTINATION TITER $33.00 30864300 RHEUMATOID FACTOR; SCREEN $50.00 30864309 RHEUMATOID FACTOR; SCREEN $50.00 30864310 RHEUMATOID FACTOR; ASSAY $58.00 30864319 RHEUMATOID FACTOR; ASSAY $58.00 30864800 QUANTIFERON - TB GOLD $230.00 30864809 QUANTIFERON - TB GOLD $230.00 30865920 SYPHILIS (VDRL) (RPR) $44.00 30865929 SYPHILIS (VDRL)(RPR) $44.00 30865930 SYPHILIS (ASSAY) TITER $70.00 30865939 SYPHILIS (ASSAY) TITER $70.00 30866020 ACTINOMYCES AB $28.00 30866029 ACTINOMYCES AB $28.00 30866030 ADENOVIRUS ANTIBODY $30.00 30866039 ADENOVIRUS ANTIBODY $30.00 30866060 AB; ASPERGILLUS $91.00 30866069 ASPERGILLUS AB $43.00 30866110 BARTONELLA AB; $44.00 30866119 BARTONELLA AB; $44.00 30866120 BLASTOMYCES ANTIBODY $35.00 30866129 BLASTOMYCES ANTIBODY $35.00 30866150 BORDETELLA ANTIBODY $549.00 30866159 BORDETELLA ANTIBODY $549.00 30866170 LYME DISEASE $66.00 30866179 LYME DISEASE $66.00 30866180 LYME DISEASE;AB;SCREEN $222.00 30866189 LYME DISEASE;AB;SCREEN $222.00 30866220 BRUCELLA; ANTIBODIES $25.00 30866229 BRUCELLA; ANTIBODIES $25.00 30866280 CANDIDA; ANTIBODY $33.00 30866289 CANDIDA; ANTIBODY $33.00 30866310 CHLAMYDIA AB $39.00 30866319 CHLAMYDIA AB $39.00 30866320 CHLAMYDIA IGM $55.00 30866329 CHLAMYDIA IGM $55.00 30866359 COCCIDIODES AB;IGG & IGM $21.00 30866410 AB CRYPOTCOCCUS $120.00 30866419 AB CRYPOTCOCCUS $120.00 30866440 CMV ANTIBODY;IGG ABBY EIA $44.00 30866449 CMV ANTIBODY;IGG ABBY EIA $44.00 30866450 CMV IGM $46.00 30866459 CMV IGM $46.00 30866510 CALIFORNIA ENCEPHALITIS AB $44.00 30866519 CALIFORNIA ENCEPHALITIS AB $44.00 30866520 EASTERN EQUINE ENCEPHALITIS AB $44.00 30866529 EASTERN EQUINE ENCEPHALITIS AB $44.00 30866530 ST LOUIS ENCEPHALITIS AB $36.00 30866539 ST LOUIS ENCEPHALITIS AB $36.00 30866580 ENTEROVIRUS AB $44.00 30866589 ENTEROVIRUS AB $44.00 30866630 EPSTEIN BARR EARLY ANTIGEN $38.00 30866639 EPSTEIN BARR EARLY ANTIGEN $38.00 30866640 EPSTEIN BARR NUCLEAR ANTIGEN $26.00 30866649 EPSTEIN BARR NUCLEAR ANTIGEN $26.00 30866650 EPSTEIN BARR VIRAL CAPSID $50.00 30866659 EPSTEIN BARR AB VIRAL CAPSID $50.00 30866710 OTHER FUNGUS AG $34.00 30866719 OTHER FUNGUS AG $34.00 30866770 H PYLORI AB; IGG $212.00 30866779 H PYLORI AB; IGG $212.00 30866890 HTLV/HIV AB (WESTERN BLOT) $53.00 30866899 HTLV/HIV AB (WESTERN BLOT) $53.00 30866920 AB; HEPATITIS D+ $40.00 30866929 AB; HEPATITIS D+ $40.00 30866940 HSV IGMAB $279.00 30866949 HSV IGMAB #LC164806 $279.00 30866950 HERPES SIMPLEX TYPE 1 AB $30.00 30866959 HERPES SIMPLEX TYPE 1 AB $30.00 30866960 HERPES SIMPLEX TYPE 2 AB $45.00 30866969 HERPES SIMPLEX TYPE 2 AB $45.00 30866980 HISTOPLASMA $35.00 30866989 HISTOPLASMA $35.00 30867010 TEST FOR HIV-1 ANTIBODY $25.00 30867019 TEST FOR HIV-1 ANTIBODY $25.00 30867020 TEST FOR HIV-2 ANTIBODY $25.00 30867029 TEST FOR HIV-2 ANTIBODY $25.00 30867030 HIV RAPID TEST $27.00 30867035 RAPID HIV TEST-LABOR & DEL $27.00 30867039 HIV RAPID TEST $27.00 30867040 HEP B CORE ANTIBODY $69.00 30867049 HEP B CORE ANTIBODY $69.00 30867050 HEP B IGM ANTIBODY $100.00 30867059 HEP B IGM ANTIBODY $100.00 30867060 HEP B SURFACE ANTIBODY $65.00 30867069 HEP B SURFACE ANTIBODY $65.00 30867070 HEP BE ANTIBODY $84.00 30867079 HEP BE ANTIBODY $84.00 30867080 HEP A ANTIBODY $82.00 30867089 HEP A ANTIBODY $82.00 30867090 HEP A IGM ANTIBODY $91.00 30867099 HEP A IGM ANTIBODY $91.00 30867100 INFLUENZA ANTIBODY $121.00 30867102 INFLUENZA ANTIBODY; B $121.00 30867109 INFLUENZA ANTIBODY $121.00 30867130 LEGIONELLA ANTIBODY $121.00 30867139 LEGIONELLA ANTIBODY $121.00 30867200 LEPTOSPIRA IGM ANTIBODIES $108.00 30867209 LEPTOSPIRA IGM ANTIBODIES $108.00 30867350 MUMPS ANTIBODY $110.00 30867359 MUMPS ANTIBODY $110.00 30867380 MYCOPLASMA AB $102.00 30867382 MYCOPLASMA PNEUMONIAE ANTIBODIES, IG $102.00 30867389 MYCOPLASMA AB $102.00 30867440 NOCARDIA AB $33.00 30867449 NOCARDIA AB $33.00 30867470 PARVOVIRUS ANTIBODY $44.00 30867479 PARVOVIRUS ANTIBODY $44.00 30867530 AMEBIASIS ANTIBODIES $77.00 30867539 AMEBIASIS ANTIBODIES $77.00 30867560 RESP SYNCYTIAL VIRUS AB (RSV) $30.00 30867569 RESP SYNCYTIAL VIRUS AB (RSV) $30.00 30867620 RUBELLA $163.00 30867629 RUBELLA $163.00 30867659 RUBEOLA AB $36.00 30867692 SARS-COV-2 COVID-19 ANTIBODY $132.00 30867699 SARS-COV-2 COVID-19 ANTIBODY $132.00 30867770 AB; TOXOPLASMA $154.00 30867779 TOXOPLASMA ANTIBODY; IGG $40.00 30867780 TOXOPLASMA ANTIBODY; IGM $40.00 30867789 TOXOPLASMA ANTIBODY; IGM $40.00 30867800 T PALLIDUM AB (TP-PA) $76.00 30867809 T PALLIDUM AB (TP-PA) $76.00 30867810 FTA-ABS(RPR REFLEX TEST) $76.00 30867840 AB, TRICHINELLA $49.00 30867849 AB, TRICHINELLA $49.00 30867879 VARICELLA-ZOSTER AB $36.00 30867880 WEST NILE VIRUS AB; IGM $55.00 30867889 WEST NILE VIRUS AB; IGM $55.00 30867890 WEST NILE VIRUS AB; IGG $55.00 30867899 WEST NILE VIRUS AB; IGG $55.00 30867900 HEPATITIS E. ANTIBODY $70.00 30867909 HEPATITIS E. ANTIBODY $70.00 30868000 THYROGLOBULIN ANTIBODY $102.00 30868009 THYROGLOBULIN ANTIBODY $102.00 30868030 HEP C ANTIBODY $107.00 30868039 HEP C ANTIBODY $107.00 30868040 HEP C CONFIRMATORY TEST $195.00 30868049 HEP C CONFIRMATORY TEST $195.00 30868050 LYMPHOCYTOTOX VC; W TITRATE $553.00 30868070 PERCENT REACTIVE AB; PRA SCREEN $152.00 30868120 HLA TYPING; A;B; OR C; SINGLE $69.00 30868129 HLA TYPING; A;B; OR C; SINGLE $69.00 30868490 ANTIPROTHROMBIN AB, EA IG CL $55.00 30868499 ANTIPROTHROMBIN AB, EA IG CL $55.00 30868500 RBC ANTIBODY SCREEN $89.00 30868509 RBC ANTIBODY SCREEN $89.00 30868600 RBC ANTIBODY ELUTION $100.00 30868609 RBC ANTIBODY ELUTION $100.00 30868700 RBC ANTIBODY IDENTIFICATION $152.00 30868709 RBC ANTIBODY IDENTIFICATION $152.00 30868800 COOMBS TEST; DIRECT $43.00 30868809 COOMBS TEST; DIRECT $43.00 30868850 COOMBS TEST; INDIRECT; QUAL $46.00 30868860 COOMBS TEST; INDIRECT; TITER $100.00 30868869 COOMBS TEST; INDIRECT; TITER $100.00 30869000 BLOOD TYPING; ABO $40.00 30869009 BLOOD TYPING; ABO $40.00 30869010 BLOOD TYPING; RH (D) $44.00 30869019 BLOOD TYPING; RH (D) $44.00 30869020 BLOOD TYPE ANTIGEN DONOR EA $57.00 30869030 BLOOD TYPING; ANITGEN SCREEN $57.00 30869040 BLOOD TYPING; PATIENT SERUM $36.00 30869050 BLOOD TYPING; RBC ANTIGENS $79.00 30869059 BLOOD TYPING; RBC ANTIGENS $79.00 30869060 BLOOD TYPING; RH PHENOTYPE $38.00 30869200 COMPATIBILITY TEST; SPIN $65.00 30869210 COMPATIBILITY TEST; INCUBATE $38.00 30869220 COMPATIBILITY TEST; ANTIGLOB $53.00 30869270 THAW FFP $53.00 30869700 PRETREAT RBC; CHEMICAL $108.00 30869702 PRETREAT RBC; CHEMICAL $108.00 30869709 PRETREAT RBC; CHEMICAL $108.00 30869710 PRETREAT RBC; ENZYME $108.00 30869719 PRETREAT RBC; ENZYME $108.00 30869720 PRETREAT RBC;DGS $99.00 30869729 PRETREAT RBC;DGS $99.00 30869750 SERUM PRETX; DRUG INCUBATE $87.00 30869759 SERUM PRETX; DRUG INCUBATE $87.00 30869760 PRETREAT RBC: SERUM; DILUTION $23.00 30869770 SERUM PRETX; INHIBITOR INCUBATE $62.00 30869780 PRETREAT RBC; SERUM; PT'S RBC $63.00 30869789 PRETREAT RBC; SERUM; PT'S RBC $63.00 30869850 SPLIT BLOOD OR PRODUCTS $89.00 30869990 UNLISTED TRANSFUSION MED $223.00 30869999 UNLISTED TRANSFUSION MED $223.00 30870150 SPECIMEN CONCENTRATION $19.00 30870159 SPECIMEN CONCENTRATION $19.00 30870400 BLOOD CULTURE FOR BACTERIA $114.00 30870409 BLOOD CULTURE FOR BACTERIA $114.00 30870450 STOOL CULTURE FOR BACTERIA $102.00 30870459 STOOL CULTURE FOR BACTERIA $102.00 30870460 STOOL CULTURE FOR ADD AEROBIC $59.00 30870469 STOOL CULTURE FOR ADD AEROBIC $59.00 30870700 CULTURE BACT $74.00 30870709 CULTURE BACT $74.00 30870750 ANAEROBIC BACT CULTURE $126.00 30870759 ANAEROBIC BACT CULTURE $126.00 30870760 CULTURE ANAEROBIC IDENT; EACH $85.00 30870770 AEROBIC I.D. CULTURE $27.00 30870779 CULT ANAEROBIC ID; EA, WET MNT, STAIN & $85.00 30870810 CULTURE P PATHOG - SCREEN $42.00 30870819 CULTURE P PATHOG - SCREEN #LC R188135 $42.00 30870840 BLOOD CULTURE PP; W ESTIM COUNT $55.00 30870849 BLOOD CULTURE PP; W ESTIM COUNT $55.00 30870860 URINE CULTURE/COLONY COUNT $74.00 30870869 URINE CULTURE/COLONY COUNT $74.00 30870880 URINE BACTERIA CULTURE $22.00 30871010 SKIN FUNGI CULTURE $98.00 30871019 SKIN FUNGI CULTURE $98.00 30871020 FUNGAL ISOLATION CULTURE $24.00 30871029 FUNGAL ISOLATION CULTURE #LC 182493 $24.00 30871030 BLOOD FUNGUS CULTURE $98.00 30871039 BLOOD FUNGUS CULTURE $98.00 30871069 YEAST FUNGI I.D. $55.00 30871070 MOLD FUNGI I.D. $36.00 30871079 MOLD FUNGI I.D. $36.00 30871090 LAB CULTURE, MYCOPLASMA $147.00 30871099 LAB CULTURE, MYCOPLASMA $147.00 30871100 CHLAMYDIA CULTURE $125.00 30871109 CHLAMYDIA CULTURE $125.00 30871160 MYCOBACTERIA CULTURE; ACID FAS $155.00 30871169 MYCOBACTERIA CULTURE; ACID FAS $155.00 30871180 MYCOBACTERIC I.D.;MYCO; DEFINI $30.00 30871189 MYCOBACTERIC I.D.;MYCO; DEFINI $30.00 30871400 CULTURE TYPING; IMMUNOFLUORESC $17.00 30871409 CULTURE TYPING; IMMUNOFLUORESC $17.00 30871470 CULTURE TYPE IMMUNOLOGIC $98.00 30871490 CULTURE; NA PROBE $173.00 30871499 CULTURE; NA PROBE $173.00 30871500 DNA/RNA AMPLIFIED PROBE $130.00 30871539 ORGANISM ID BY SEQUENCING METH EA I $263.00 30871720 PINWORM EXAM $39.00 30871729 PINWORM EXAM $39.00 30871770 OVA AND PARASITES EXAM $130.00 30871779 OVA AND PARASITES EXAM $130.00 30871840 ANTIBIOTIC SENSIVITY; DISK $35.00 30871849 ANTIBIOTIC SENSIVITY; DISK $35.00 30871859 BETA LACTAMASE $105.00 30871860 ANTIBIOTIC SENSIVITY; MIC $105.00 30871869 MIC ORGANISM #1 $105.00 30871970 SERUM BACT TITER (SCHLICHTER) $35.00 30871979 SERUM BACT TITER (SCHLICHTER) $35.00 30872050 GRAM/GIEMSA SMEAR; STAIN & INT $35.00 30872059 GRAM/GIEMSA SMEAR; STAIN & INT $35.00 30872060 ACID FAST STAIN; STAIN & INTER $17.00 30872069 ACID FAST STAIN; STAIN & INTER $17.00 30872079 PARASITE EXAM, WHOLE BLOOD SMEAR STA $35.00 30872090 SMEAR, COMPLEX STAIN $44.00 30872099 SMEAR, COMPLEX STAIN $44.00 30872100 WET MOUNT; STAIN AND INTERPRET $40.00 30872109 INTERPRET $40.00 30872200 TISSUE EXAM FOR FUNGI; KOH PRE $70.00 30872520 VIRUS INNOC TEST; TISSUE CULT $54.00 30872529 VIRUS INNOC TEST; TISSUE CULT $54.00 30872540 VIRUS I.D.; CENTRIFUGE ENHANCE $45.00 30872549 VIRUS I.D.; CENTRIFUGE ENHANCE $45.00 30872550 VIRUS I.D.; OTHER;CULTURE HERP $93.00 30872559 VIRUS I.D.; OTHER;CULTURE HERP $93.00 30872600 ADENOVIRUS ANITGEN; DFA $33.00 30872609 ADENOVIRUS ANTIGEN; DFA $33.00 30872650 BORDATELLA P AG BY DFA $62.00 30872659 BORDATELLA P AG BY DFA $62.00 30872720 CRYPTOSPORIDUM ANTIGEN; DFA $65.00 30872759 INFLUENZA B AG BY IF $42.00 30872769 INFLUENZA A AG BY DFA $42.00 30872780 LEGIONELLA PNEUMOPHILIA ANTIGE $43.00 30872789 LEGIONELLA PNEUMOPHILIA ANTIGE $43.00 30872799 PARAINFLUENZA AG BY DFA $42.00 30872809 RSV AG BY IF $42.00 30872810 PNEUMOCYSTIS CARINII ANTIGEN $33.00 30872819 PNEUMOCYSTIS CARINII ANTIGEN #LC180232 $33.00 30872900 VARCELLA ANTIGEN; DFA $33.00 30872909 VARCELLA ANTIGEN; DFA $33.00 30872999 NOS INFECTIOUS AG BY IF $42.00 30873000 ANTIGEN DETECT; POLYVALENT; IF $167.00 30873009 ANTIGEN DETECT; POLYVALENT; IF $167.00 30873200 CHLAMYDIA TRACHOMATIS; EIA $33.00 30873240 COLSTRIDIUM ANTIGEN; EIA $101.00 30873249 COLSTRIDIUM ANTIGEN; EIA $101.00 30873270 CRYPTCOCCUS NEOFORM AG; EIA $33.00 30873279 CRYPTCOCCUS NEOFORM AG; EIA $33.00 30873289 CRYPTOSPORIDIUM AG EIA $98.00 30873290 LAB - GIARDIA AG, EIA $82.00 30873299 LAB - GIARDIA AG, EIA $82.00 30873380 H PYLORI STOOL ANITGEN; EIA $34.00 30873389 H PYLORI STOOL ANITGEN; EIA $34.00 30873390 H PYLORI ANTIGEN; EIA (CLO) $183.00 30873400 HEP B SURFACE ANTIGEN; EIA $67.00 30873409 HEP B SURFACE ANTIGEN; EIA $67.00 30873500 HEP Be ANTIGEN; EIA $32.00 30873509 HEP Be ANTIGEN; EIA $32.00 30873800 HEPATITIS DELTA AG, EIA $39.00 30873809 HEPATITIS DELTA AG, EIA $39.00 30873850 HISTOPLASM CAPSUL AG BY EIA $163.00 30873859 HISTOPLASM CAPSUL AG BY EIA $163.00 30873890 HIV-1 AG W/HIV-1 & HIV-2 AB $89.00 30873899 HIV-1 AG W/HIV-1 & HIV-2 AB $89.00 30874000 INFLUENZA A/B ANITGEN; EIA; A $28.00 30874002 INFLUENZA A/B ANTIGEN; EIA; B $28.00 30874009 INFLUENZA A/B ANTIGEN; EIA $28.00 30874200 RESP SYNCYTIAL AG; EIA $75.00 30874250 ROTAVIRUS ANTIGEN;EIA $147.00 30874259 ROTAVIRUS , DIRECT DETECTION IMMUNOAS $147.00 30874270 SHIGA-LIKE TOXIN AG, EIA $85.00 30874279 SHIGA-LIKE TOXIN AG, EIA $85.00 30874300 STREP A AG; EIA $57.00 30874490 OTHER AG DET; EIG; MULT;LEGION $149.00 30874499 OTHER AG DET; EIG; MULT;LEGION $149.00 30874500 IA BY EIA - SINGLE STEP $82.00 30874509 IA BY EIA - SINGLE STEP $82.00 30874710 BARTONELLA AMPLIF NAP $135.00 30874760 LYMES, AMPLIFIED NA PROBE $81.00 30874819 CANDIDA NA AMPLIFIED PROBE $87.00 30874869 CHLAMYDIA P AMPLIF NA PROBE $63.00 30874900 CHLAMYDIA T, DIR NA PROBE $101.00 30874909 CHLAMYDIA T, DIR NA PROBE $101.00 30874910 CHLAMYDIA TRACH; DNA;AMP PROBE $164.00 30874919 CHLAMYDIA TRACH; DNA; AMP PROBE $164.00 30874939 C DIFF AMPLIFIED PROBE $108.00 30874960 CMV BY PCR $182.00 30874969 CMV BY PCR $182.00 30874970 CMV DNA PCR, QT $216.00 30874979 CMV DNA PCR, QT $216.00 30875029 INFLUENZA DNA AMP PROBE #LC R186221 $189.00 30875079 IADNA-DNA/RNA PROBE TQ 12-25 $210.00 30875160 HEP-B DNA, QUALITATIVE PCR $179.00 30875169 HEP-B DNA, QUALITATIVE PCR $179.00 30875170 HEP B; DNA; QUANT $275.00 30875179 HEP B; DNA; QUANT $275.00 30875210 HEP C; RNA; AMP PROBE $731.00 30875219 HEP C; RNA; AMP PROBE $731.00 30875220 HEPATITIS C; RNA $433.00 30875229 HEPATITIS C VIRAL RNA, QT BDNA #LC859797 $433.00 30875290 HERPES SIMPLEX; DNA; AMP PROBE $76.00 30875299 HERPES SIMPLEX; DNA; AMP PROBE $76.00 30875350 HIV-1 DNA; AMP PROBE $211.00 30875359 HIV-1 DNA; AMP PROBE $211.00 30875360 HIV-1 DNA; QUANT $365.00 30875369 HIV-1 DNA; QUANT $365.00 30875380 HIV 2 QUALITATIVE PCR $127.00 30875389 HIV 2 QUALITATIVE PCR $127.00 30875410 LEGIONELLA, AMPLIF NA PROBE $184.00 30875419 LEGIONELLA, AMPLIF NA PROBE $184.00 30875520 MYCOBACTERIA NA QUAN (RNA/DNA) $173.00 30875560 PCR TB - MYCOBACTERIA NA PROB $74.00 30875569 PCR TB-MYCOBACTERIA NA PROB $74.00 30875639 IADNA MYCOPLASMA GENITALIUM AMPLIFIED $164.00 30875810 LAB-MYCOPLASMA PNEUMONIA, AMP $216.00 30875819 LAB-MYCOPLASMA PNEUMONIA, AMP $216.00 30875900 NEISSERIA, DIR NA PROBE $103.00 30875909 NEISSERIA, DIR NA PROBE $103.00 30875910 NEISSERIA, AMPLIF NA PROBE $164.00 30875919 NEISSERIA, AMPLIF NA PROBE $164.00 30876210 HPV, AMP PROBE (HIGH OR LOW) $87.00 30876219 HPV, AMP PROBE (HIGH OR LOW) $87.00 30876240 HPV, AMP PROBE (HIGH OR LOW) $87.00 30876249 HPV, AMP PROBE (HIGH OR LOW) $87.00 30876259 HPV TYPES 16 & 18 ONLY $87.00 30876339 RESP VIRUS 12-25 TARGETS $315.00 30876350 IADNA CORONAVIRUS2 $164.00 30876509 STREP A DIR NA PROBE $74.00 30876610 TRICHOMONAS VAGINALIS AMPLIF $87.00 30876619 TRICHOMONAS VAGINALIS AMPLIF $87.00 30877980 AMPLIF NA PROBE, NOS AGENT $215.00 30877989 AMPLIF NA PROBE, NOS AGENT #LC P188052 $215.00 30877999 BK VIRUS QUANT, DNA PCR #LC 138962 $159.00 30878009 OTHER INF AGENT, MULT, DNA;DI $92.00 30878010 DNA/RNA; MULTI ORG - AMP PR $324.00 30878019 DNA/RNA;MULTI ORG-AMP PR $324.00 30878029 STREP B IA W DIRECT OPTICAL OBS $77.00 30878040 INFLUENZA IA W DOO $90.00 30878049 INFLUENZA IA W DOO $90.00 30878070 RSV IA W DIR OBSERV $85.00 30878079 RSV IA W DIR OBSERV $85.00 30878800 STREP GROUP A W DOO $62.00 30878809 STREP GROUP A W DOO $62.00 30878990 INF AGENT NOS BY IA - DOO $65.00 30878999 INF AGENT NOS BY IA - DOO $65.00 30879000 PHENOTYPE, INFECT AGENT DRUG $266.00 30879009 PHENOTYPE, INFECT AGENT DRUG $266.00 30879010 HIV 1 GENOTYPE BY NA $611.00 30879019 HIV 1 GENOTYPE BY NA $611.00 30879020 HEPATITUS C - DNA OR RNA $585.00 30879029 HEPATITUS C - DNA OR RN $585.00 30879030 PHENOTYPE, DNA HIV W/CULTURE $1,109.00 30879039 PHENOTYPE, DNA HIV W/ CULTURE $1,109.00 30879040 PHENOTYPE, DNA HIV W/CLT ADD $160.00 30879049 PHENOTYPE, DNA HIV Q/ CLT ADD $160.00 30879129 HEP B VIRUS (HBV) GENOTYPE $266.00 3088142 CHANGE IG PAP TO LB PA $150.00 30881429 CHANGE IG PAP TO LB PA $150.00 30881559 CYTOPATH; C/V INDEX ADD-ON $17.00 30881759 *CYTOPATH C/V AUTO FLUID LC# R199345 $61.00 30882309 TISSUE CULTURE; LYMPHOCYTE $473.00 30883129 SPECIAL STAINS GROUP 1 $159.00 30887200 BILIRUBIN TOTAL TRANSCUTANEOUS $22.00 30890500 BODY FLUID CELL COUNT $45.00 30890509 BODY FLUID CELL COUNT $45.00 30890510 BODY FLUID DIFFERENTIAL CELL C $60.00 30890519 BODY FLUID DIFFERENTIAL CELL C $60.00 30890550 FECAL LEUKO CNT, QUAL/SEMIQUAN $47.00 30890559 FECAL LEUKO CNT, QUAL/SEMIQUAN $47.00 30890600 EXAM; FLUID CRYSTALS $59.00 30890609 EXAM; FLUID CRYSTALS $59.00 30891250 FAT STAIN; FECES $60.00 30891259 FAT STAIN;FECES $60.00 30891600 EXAM FECES FOR MEAT FIBERS $51.00 30891609 EXAM FECES FOR MEAT FIBERS $51.00 30891900 NASAL SMEAR FOR EOSINOPHILS $17.00 30891909 NASAL SMEAR FOR EOSINOPHILS $17.00 30893210 SEMEN ANALYSIS & MOTILITY $24.00 30893250 SPERM ANTIBODY TEST $114.00 30893259 SPERM ANTIBODY TEST $114.00 30930209 *HGB FRAC. CASCADE#LCR121690 $61.00 318004619 IMMUNOHISTOCHEMISTRY EA ANTBDY $70.00 318004629 IMMUNOHISTOCHEMISTRY EA ADD ANTBDY $70.00 31850609 BLOOD SMEAR INTERPRETATION LC# 005300 $191.00 31850970 BONE MARROW INTERPRETATION $89.00 31850979 BONE MARROW INTERPRETATION $89.00 31860780 PHYS BB SVC (TRANSF REAC INV) $206.00 31860789 PHYS BB SVC (TRANSF REAC INV) $206.00 31860790 PHYS BB SVC (DEVIATION AUTH) $98.00 31860799 PHYS BB SVC (DEVIATION AUTH) $98.00 31881040 CYTOPATHOLOGY; FLUIDS $58.00 31881049 CYTOPATHOLOGY; FLUIDS $58.00 31881080 CYTOPATH; CONCENTRATE TECH $42.00 31881089 CYTOPATH; CONCENTRATE TECH $42.00 31881120 CYTOPATH; CELL ENHANCE $74.00 31881129 CYTOPATH; CELL ENHANCE $74.00 31881250 CYTOPATHOLOGY; FORENSIC $148.00 31881259 CYTOPATHOLOGY; FORENSIC $148.00 31881419 CYTOPATH C/V INTERPRET $150.00 31881420 CYTOPATH; C/V THIN LYR; MAN $47.00 31881429 CP CERV/VAG; ATL; MANUAL SCREEN $108.00 31881500 CYTOPATH; C/V; MANUAL $29.00 31881559 CYTOPATH; C/V INDEX ADD-ON $17.00 31881610 CYTOPATH SMEAR; OTHER SOURCE $180.00 31881619 CYTOPATH SMEAR; OTHER SOURCE $180.00 31881620 CYTOPATH SMEAR; OTHER SOURCE $173.00 31881629 CYTOPATH SMEAR; OTHER SOURCE $173.00 31881640 CYTOPATH BETHESDA; C/V; MANUAL $48.00 31881649 CYTOPATH BETHESDA; C/V; MANUAL $48.00 31881720 CYTOPATHOLOGY EVAL OF FNA $282.00 31881729 CYTOPATHOLOGY EVAL OF FNA $282.00 31881730 CYTOPATH EVA; FNA; REPORT $154.00 31881739 CYTOPATH EVAL; FNA; REPORT $154.00 31881750 CYTOPATH; C/V/ THIN PREP;AUTO $61.00 31881759 CYTOPATH; C/V/ THIN PREP;AUTO $61.00 31881820 CELL MARKER STUDY $195.00 31881829 CELL MARKER STUDY $195.00 31881840 FLOWCYTOMETRY 1 MARKER $26.00 31881850 FLOWCYTOMETRY EA ADDTL MARKER $26.00 31881899 FLOW CYTOMETRY INTERP 16 & > MARKERS $420.00 31882300 TISSUE CULTURE; LYMPHOCYTE $266.00 31882330 TISSUE CUTLURE; SKIN OR SOLID $416.00 31882370 TISSUE CULTURE; BONE MARROW $336.00 31882480 CHROMOSOME ANALYSIS; 50-100 $393.00 31882488 CHROMOSOME ANALYSIS; 50-100 $501.00 31882620 CHROMOSOME ANALYSIS; 15-20 $585.00 31882640 CHROM ANALY; 20-25 CELLS $284.00 31882800 CHROM ANALY; ADDTL KAYOT EA $166.00 31882809 CHROM ANALY; ADDTL KAYOT EA $166.00 31883000 SURGICAL PATH;GROSS LEVEL 1 $77.00 31883009 SURGICAL PATH; GROSS LEV 1 $77.00 31883020 SURGICAL PATH;GROSS;MICRO II $112.00 31883029 SURGICAL PATH; GROSS; MICRO II $112.00 31883040 SURGICAL PATH GROSS;MICRO III $149.00 31883049 SURGICAL PATH GROSS; MICRO III $149.00 31883050 SURGICAL PATH;GROSS;MICRO IV $185.00 31883058 SURGICAL PATH; GROSS; MICRO IV $185.00 31883059 SURGICAL PATH; GROSS; MICRO IV $185.00 31883070 SURGICAL PATH;GROSS;MICRO V $329.00 31883079 SURGICAL PATH; GROSS; MICRO V $329.00 31883090 SURGICAL PATH;GROSS;MICRO VI $473.00 31883099 SURGICAL PATH; GROSS; MICRO VI $473.00 31883110 DECALCIFY TISSUE $78.00 31883119 DECALCIFY TISSUE $78.00 31883120 SPECIAL STAINS;GRP1 $71.00 31883129 SPECIAL STAINS; GRP 1 $71.00 31883130 SPECIAL STAINS;GRP2 $87.00 31883139 SPECIAL STAINS; GRP 2 $87.00 31883140 HISTO CHEMICAL STAIN ADD-ON $195.00 31883149 HISTO CHEMICAL STAIN ADD-ON $195.00 31883180 HISTO CHEM ID OF CHEMICALS $128.00 31883189 HISTO CHEM ID OF CHEMICALS $128.00 31883190 ENZYME HISTO CHEMISTRY $146.00 31883199 ENZYME HISTO CHEMISTRY $146.00 31883210 CONSULTATION & REPORT ON SLIDE $67.00 31883219 CONSULTATION & REPORT ON SLIDE $67.00 31883230 REF CONSULT WITH SLIDE PREP $194.00 31883239 REF CONSULT WITH SLIDE PREP $194.00 31883259 COMPREHENSIVE CONSULT $82.00 31883290 PATH CONSULT DURING SURGERY $294.00 31883310 PATH CONSULT INTRAOP;ADD'L $186.00 31883319 PATH CONSULT INTRAOP; 1 BLOC $222.00 31883329 PATH CONSULT INTRAOP; ADD'L $186.00 31883330 INTRAOP CYTO PATH CONSULT, 1 $82.00 31883339 INTRAOP CYTO PATH CONSULT, 1 $82.00 31883340 INTRAOP CYTO PATH CONSULT, 2 $64.00 31883349 INTRAOP CYTO PATH CONSULT, 2 $64.00 318834109 IMMUNOHISTOCHEMISTRY EA ADD ANTBDY $70.00 31883419 IMMUNOHISTOCHEMISTRY EA ADD ANTBDY $70.00 31883420 IMMUNOHISTOCHEMISTRY EA ANTBDY $70.00 31883429 IMMUNOHISTOCHEMISTRY EA ANTBDY $70.00 31883460 IMMUNOFLUORESCENT DIRECT EA AB $214.00 31883469 IMMUNOFLUORESCENT DIRECT EA AB $214.00 31883480 ELECTRON MICROSCOPY DIAGNOSTIC $471.00 31883489 ELECTRON MICROSCOPY DIAGNOSTIC $471.00 31883600 MANUAL TUMOR IM HISTOCHEM, EA $87.00 31883609 MANUAL TUMOR IM HISTOCHEM, EA $87.00 31883610 MORPHOMETRIC ANLYS EA AB QUANT $163.00 31883619 MORPHOMETRIC ANLYS EA AB QUANT $163.00 31883650 INSITU HYBRIDATION (FISH) EA $60.00 31883659 INSITU HYBRIDATION (FISH) EA $58.00 31883680 MORPHOMETRIC ANALYSIS INSITU $216.00 31883689 MORPHOMETRIC ANALYSIS INSITU $216.00 31883749 M/PHMTRC ALYS ISHQUANT/SEMIQ (FISH) $761.00 32000900 CORONER'S CASE BASIC (1-2) $130.00 32099910 CORONER'S CASE COMPLEX (3-UP) $169.00 32206100 DRAIN/INJ MAJOR JOINT/BURSA W/O US $264.00 32206102 DRAIN/INJ MAJOR JOINT/BURSA W/O US $264.00 32475310 CHOLANGIOGRM BILE/PANCR $363.00 32475440 CHOLANGIOGRM STONE REM $503.00 32516000 INJ FOR CYSTOGRAM $714.00 32701100 MANDIBLE MIN 4-VIEWS $273.00 32701300 MASTOIDS MIN 3-VIEWS $200.00 32701400 ZYGOMATIC ARCHES $132.00 32701500 FACIAL BONES $265.00 32701600 NASAL BONES $142.00 32702000 ORBITS $208.00 32702200 SINUSES $234.00 32702400 SELLA TURCICA $172.00 32702500 SKULL LIMITED $147.00 32702600 SKULL $244.00 32703300 T.M. JOINTS $191.00 32703550 PANOGRAPH (DENTAL) $126.00 32703600 NECK SOFT TISSUE $180.00 32703900 SIALOGRAM $191.00 32710100 CHEST SINGLE VIEW $169.00 32710200 CHEST XRAY - 2 VIEW $211.00 32710210 CHEST XRAY 2 VIEW W OBLIQUE $255.00 32710350 CHEST INS/EXP $135.00 32710351 CHEST SPECIAL STUDY $135.00 32710352 CHEST SPECIAL STUDY $135.00 32710400 BRONCHOGRAM $494.00 32710401 BRONCHOGRAM $494.00 32710402 BRONCHOGRAM $494.00 32710450 CHEST SINGLE VIEW $169.00 32710460 CHEST XRAY - 2 VIEW $211.00 32710470 CHEST XRAY 3 VIEWS $255.00 32710600 BRONCHOGRAM BILAT $541.00 32710900 PACEMAKER INSERTION $1,703.00 32711000 X-RAY EXAM OF RIBS $244.00 32711001 RIBS UNIL - 2 VIEWS LEFT $244.00 32711002 RIBS UNIL - 2 VIEWS RIGHT $244.00 32711010 RIBS 3 VIEWS UNILATERAL $313.00 32711100 RIBS-BILATERAL 3-VIEWS $313.00 32711101 RIBS-LEFT 3-VIEWS $271.00 32711102 RIBS-RIGHT 3-VIEWS $271.00 32711200 STERNUM $148.00 32711300 STERNOCLAVICULAR JOINT(S) $155.00 32720200 SPINE 1 VIEW CC $172.00 32720400 CERVICAL SPINE 2/3V $163.00 32720500 CERVICAL SPINE $268.00 32720520 CERVICAL SPINE $235.00 32720690 SCOLIOSIS SERIES $214.00 32720700 THORACIS SPINE 2-VIEWS $169.00 32720720 THORACIC SPINE 3-VIEWS $200.00 32720810 X-RAY EXAM ENTIRE SPINE 1 VIEW $214.00 32720820 X-RAY ENTIRE SPINE 2/3 VIEWS $214.00 32720830 X-RAY EXAM ENTIRE SPINE 4/5 VIEWS $315.00 32720840 X-RAY EXAM ENTIRE SPINE 6/> VIEWS $315.00 32720900 SPINE/SCOLIOSIS STUDY $138.00 32721000 LUMBAR SPINE 2-3 V $237.00 32721100 LUMBOSACRAL SPINE MN 4VIE $311.00 32721140 LUMBAR SPINE-COMPLETE AND $311.00 32721200 LUMBAR SPINE-BENDING VIEW $163.00 32721700 PELVIS $187.00 32722020 SACROILIAC JOINTS $226.00 32722200 SACRUM AND/OR COCCYX $251.00 32722400 MYELOGRAPHY CERVICAL $1,190.00 32722550 MYELOGRAPHY THORACIC $757.00 32722650 MYELOGRAPHY LUMBOSACRAL $1,514.00 32730000 CLAVICLE - BILAT $210.00 32730001 CLAVICLE - LEFT $152.00 32730002 CLAVICLE - RIGHT $152.00 32730005 CLAVICLE-BILAT $210.00 32730100 SCAPULA - BILAT $228.00 32730101 SCAPULA - LEFT $179.00 32730102 SCAPULA - RIGHT $179.00 32730105 SCAPULA-BILAT $228.00 32730201 SHOULDER - LEFT $123.00 32730202 SHOULDER - RIGHT $123.00 32730205 SHOULDER - BILAT $245.00 32730300 SHOULDER - BILATERAL $265.00 32730301 SHOULDER - LEFT $190.00 32730302 SHOULDER - RIGHT $190.00 32730305 SHOULDER-BILATERAL $265.00 32730400 ARTHROGRAM - SHOULDER BILAT $865.00 32730401 ARTHROGRAM - SHOULDER LEFT $464.00 32730402 ARTHROGRAM - SHOULDER RT $464.00 32730405 ARTHROGRAM-SHOULDER BILAT $920.00 32730500 A C JOINTS $330.00 32730600 HUMERUS - BILAT $228.00 32730601 HUMERUS - LEFT $138.00 32730602 HUMERUS - RIGHT $138.00 32730605 HUMERUS - BILAT $228.00 32730700 ELBOW 2V - BILAT $243.00 32730701 ELBOW 2V - LEFT $152.00 32730702 ELBOW 2V- RIGHT $152.00 32730705 ELBOW 2V- BILAT $243.00 32730800 ELBOW 3V - BILAT $222.00 32730801 ELBOW 3V - LEFT $152.00 32730802 ELBOW 3V - RIGHT $152.00 32730805 ELBOW 3V - BILAT $222.00 32730851 ARTHROGRAM-ELBOW LEFT $649.00 32730852 ARTHROGRAM-ELBOW RIGHT $649.00 32730855 ARTHROGRAM-ELBOW BILATERAL $1,028.00 32730856 ARTHROGRAM-ELBOW $649.00 32730900 FOREARM $195.00 32730901 FOREARM - LEFT $163.00 32730902 FOREARM - RIGHT $163.00 32730905 FOREARM - BILATERAL $195.00 32731001 WRIST 2V - LEFT $122.00 32731002 WRIST 2V - RIGHT $122.00 32731005 WRIST 2V - BILAT $195.00 32731100 WRIST 3V- BILAT $228.00 32731101 WRIST 3V - LEFT $142.00 32731102 WRIST 3V- RIGHT $142.00 32731105 WRIST 3V-BILAT $228.00 32731151 ARTHROGRAM-WRIST LEFT $1,028.00 32731152 ARTHROGRAM-WRIST RIGHT $1,028.00 32731155 ARTHROGRAM-WRIST BILATERAL $1,514.00 32731300 HANDS (BOTH) $216.00 32731301 HAND - LEFT $147.00 32731302 HAND - RIGHT $147.00 32731305 HANDS (BOTH) $195.00 32731400 FINGER LEFT HAND-THUMB $108.00 32731401 FINGER LEFT HAND - 2ND DIGIT $108.00 32731402 FINGER LEFT HAND - 3RD DIGIT $108.00 32731403 FINGER LEFT HAND-4TH DIGIT $108.00 32731404 FINGER LEFT HAND-5TH DIGIT $108.00 32731405 FINGER RIGHT HAND-THUMB $108.00 32731406 FINGER RIGHT HAND-2ND DIGIT $108.00 32731407 FINGER RIGHT HAND - 3RD DIGIT $108.00 32731408 FINGER RIGHT HAND-4TH DIGIT $108.00 32731409 FINGER RIGHT HAND-5TH DIGIT $108.00 32735000 HIP-UNILATERAL ONE VIEW $195.00 32735010 HIP-UNILATERAL ONE VIEW $195.00 32735020 X-RAY HIP UNI 2-3 VIEWS - RIGHT $226.00 32735021 X-RAY HIP UNI 2-3 VIEWS - LEFT $226.00 32735101 HIP 2V- LEFT $226.00 32735102 HIP 2V- RIGHT $226.00 32735200 HIP-BILATERAL $374.00 32735210 X-RAY HIPS BI 2 VIEWS $374.00 32735250 HIP FLUOROSCOPY (NO INJ) RT $757.00 32735251 ARTHROGRAM-HIP LEFT $757.00 32735252 ARTHROGRAM-HIP RIGHT $757.00 32735255 ARTHROGRAM-HIP BILATERAL $1,406.00 32735300 HIP NAILING $877.00 32735301 HIP NAILING OR - LT $439.00 32735302 HIP NAILING OR - RT $439.00 32735305 HIP NAILING OR-BIL $877.00 32735500 FEMUR $255.00 32735501 FEMUR - 2V LEFT $143.00 32735502 FEMUR - 2V RIGHT $143.00 32735505 FEMUR - BILAT $255.00 32735510 X-RAY OF FEMUR 1 VIEW $255.00 32735520 X-RAY OF FEMUR 2 />VIEWS BILATERAL $255.00 32735521 X-RAY OF FEMUR 2 />VIEWS LEFT $255.00 32735522 X-RAY OF FEMUR 2 />VIEWS RIGHT $255.00 32735601 KNEE - 2V LEFT $179.00 32735602 KNEE - 2V RIGHT $179.00 32735605 KNEE - 2V BILAT $286.00 32735620 KNEE 3V - BILAT $316.00 32735621 KNEE 3V - LEFT $184.00 32735622 KNEE 3V - RIGHT $184.00 32735625 KNEE 3V-BILAT $316.00 32735650 KNEES STANDING BILATERAL $281.00 32735800 ARTHROGRAM - KNEE BILAT $792.00 32735801 ARTHROGRAM - KNEE LEFT $396.00 32735802 ARTHROGRAM - KNEE RIGHT $396.00 32735805 ARTHROGRAM -KNEE BILAT $792.00 32735900 TIBIA & FIBULA BILAT $247.00 32735901 TIBIA & FIBULA LEFT $155.00 32735902 TIBIA & FIBULA RIGHT $155.00 32735905 TIBIA & FIBULA BILATERAL $247.00 32736100 ANKLE 3+VIEWS BILAT $251.00 32736101 ANKLE 3+ VIEWS LEFT $158.00 32736102 ANKLE 3+ VIEWS RIGHT $158.00 32736105 ANKLE BILAT $251.00 32736151 ARTHROGRAM-ANKLE LEFT $865.00 32736152 ARTHROGRAM-ANKLE RIGHT $865.00 32736155 ARTHROGRAM-ANKLE BILATERAL $1,514.00 32736200 FOOT 2V BILAT $234.00 32736201 FOOT - LEFT 2 VIEWS $144.00 32736202 FOOT 2V RIGHT $144.00 32736205 FOOT 2V BILAT $234.00 32736300 FOOT 3V BILAT $234.00 32736301 FOOT 3V LEFT $147.00 32736302 FOOT 3V RIGHT $147.00 32736305 FOOT 3V BILAT $234.00 32736500 OSCALSIS BILAT $191.00 32736501 OSCALSIS LEFT $120.00 32736502 OSCALSIS RIGHT $120.00 32736505 OSCALSIS BILAT $191.00 32736600 TOE(S) $135.00 32736601 TOE - LEFT FOOT - 2ND $135.00 32736602 TOE - LEFT FOOT - 3RD $135.00 32736603 TOE-LEFT FOOT-4TH $135.00 32736604 TOE-LEFT FOOT-5TH $135.00 32736605 TOE-RIGHT FOOT-GREAT $135.00 32736606 TOE-RIGHT FOOT-2ND $135.00 32736607 TOE-RIGHT FOOT-3RD $135.00 32736608 TOE-RIGHT FOOT-4TH $135.00 32736609 TOE-RIGHT FOOT-5TH $135.00 32740000 ABDOMEN (KUB) $191.00 32740180 ABDOMEN 1 VIEW (KUB) $191.00 32740190 ABDOMEN 2 VIEWS $284.00 32740200 ABD SUP & UP/OBSTRCT $238.00 32740210 ABDOMEN 3 VIEWS $284.00 32740220 COMP ACUTE ABD (W CHEST) $238.00 32742100 NASOPHARYNX $203.00 32742200 ESOPHOGRAM $263.00 32742300 BARIUM SWALLOW $386.00 32742350 REM FB ESOPH W BALN CATH $55.00 32742400 S.C. U.G.I. $474.00 32742450 S.C. UGI/SM BOWEL $474.00 32742460 UPPER GI SERIES $455.00 32742500 SMALL BOWEL SERIES $379.00 32742700 BARIUM ENEMA $379.00 32742800 BARIUM ENEMA WITH AIR CONTRAST $544.00 32742900 G. B. SERIES $238.00 32743000 CHOLANGIOGRAM-OR $390.00 32743050 CHOLANGIOGRM BILE/PANCR $363.00 32743200 PERC. CHOLANGIOGRAPHY $363.00 32743270 CHOLANGIOGRM STONE REM $503.00 32743280 ERCPB W/BILIARY DUCTS $280.00 32743290 ERCP-PANCREATIC DUCTS $663.00 32743300 ERCP $521.00 32744000 I.V. PYELOGRAM $541.00 32744150 NEPHROTOMOGRAM $757.00 32744200 CYSTO-RETROGRADE $447.00 32744250 NEPHROSTOGRAM $282.00 32744300 CYSTOGRAM $416.00 32744500 URETHROCYSTOGRAPH $343.00 32744550 CYSTOGRAM (VOIDING) $363.00 32747400 HYSTERIOSALPINGOGRAM $494.00 32756250 AORTOGRAM $3,262.00 32757101 ARTERIOGRAM-UPPER LEFT $3,245.00 32757102 ARTERIOGRAM-UPPER RIGHT $3,245.00 32757160 ARTERIOGRAM-UPPER BILAT $3,648.00 32757220 ARTERIO RENAL - LEFT $2,029.00 32757240 ARTERIO RENAL BILAT $3,245.00 32757910 A-V FISTULAGRAM-DIALYSIS $1,825.00 32758200 VENOGRAM EXTREMITY UNILATERAL $823.00 32758201 VENOGRAM LEFT $812.00 32758202 VENOGRAM RIGHT $812.00 32758220 VENOGRAM BILATERAL $760.00 32760000 FLUORO UP TO 1 HR $329.00 32760800 FISTULAGRAM-SINUS TRK STU $321.00 32760980 MAMMOGRAM BIOPSY SPECIMEN $340.00 32760981 MAMMOGRAM BIOPSY SPEC - LEFT $340.00 32760982 MAMMOGRAM BIOPSY SPEC - RIGHT $340.00 32761000 TOMOGRAPHY SNGPLNBDYSC $406.00 32764990 ZYGOMATIC ARCHES $132.00 32770010 FLUOROGUIDE FOR VEIN DEVICE $1,933.00 32770020 NEEDLE BX/ASPIRATION FLUOROSC $331.00 32770021 NEEDLE BX/ASPIRATION FLUOROSC $331.00 32770022 NEEDLE BX/ASPIRATION FLUOROSC $331.00 32770025 NEEDLE BX/ASPIRATION FLUOROSC $492.00 32770030 FLUORO-GUIDANCE(ESI) INJ SPINE $271.00 32770530 SINGLE GALACTOGRAM BILAT $453.00 32770531 SINGLE INJ GALACTOGRAM LEFT $330.00 32770532 SINGLE INJ GALACTOGRAM RIGHT $330.00 32770535 SINGLE GALACTOGRAM BILAT $453.00 32770540 MULT INJ-GALACTOGRAM BILAT $518.00 32770541 MULT INJ GALACTOGRAM LT $412.00 32770542 MULT INJ GALACTOGRAM RIGHT $412.00 32770545 MULT INJ-GALACTOGRAM BILAT $518.00 32770720 BONE AGE STUDIES $164.00 32770730 SCANOGRAM $191.00 32770740 LONG BONES (ADULT) $309.00 32770750 METASTATIC SERIES $357.00 32770760 JOINT SURVEY 1V 1+JOINTS $261.00 32770800 DXA BONE DENSITY AXIAL 1+ SITES $630.00 32770810 DXA BONE DENSITY/PERIPHERAL 1+ SITES $630.00 32770850 DXA BONE DENSITY STUDY $630.00 32939230 UPR/LXTR ART STDY 3+ LVLS $477.00 34000020 I-123 SODIUM IODIDE CAPSULE $48.00 34000040 TECHNETIUM TC 99M MEDRONATE $42.00 34000060 TECHNETIUM TC 99M SESTAMIBI PER DOSE $216.00 34000070 TECHNETIUM TC 99M TETRIFISMON $173.00 34000090 TECHNETIUM TC99M (ULTRATAG) $79.00 34000120 TECHNETIUM TC-99M MACROAG ALBU $173.00 34000140 TECHNETIUM TC-99M MEBROFENIN $173.00 34000160 TECHNETIUM TC99M MERTIATIDE $173.00 34000161 TECHNETIUM TC99M AEROSOL =<75MCI $173.00 34000170 TECHNETIUM TC-99M PER TECHNETA $173.00 34000190 TECHNETIUM TC-99M SULFUR CLLD $173.00 34000200 TECHNETIUM TC99M TETRO $173.00 34000210 TESTICULAR SCAN $495.00 34000230 THALLOUS CHLORIDE TL 201/MCI $85.00 34000300 XENON XE133 10MCI (GAS) $79.00 34780060 THYROID SCAN W UPTK SNGL $453.00 34780120 THYROID SCAN W UPTK SNGL $453.00 34780130 THYROID SCAN TC $372.00 34780140 THYROID IMAGING W/BLOOD FLOW $609.00 34780700 PARATHYROID IMAGING $562.00 34781850 SPLENN SCAN $324.00 34781950 LYMPH NODE SCINTIGRAPHY $888.00 34782010 LIVER IMAGING; STATIC ONLY $496.00 34782050 HEMANGIOMA SCAN/LABLD RBC $628.00 34782150 LIVER AND SPLEEN SCAN (STATIC) $690.00 34782160 LIVER AND SPLEEN SCAN (VFLOW) $690.00 34782230 HEPATOBILIARY SCAN (DUCT) $784.00 34782260 HEPATOBILIARY SCAN W GALLBLADDER $784.00 34782640 GASTRIC EMPTYING STUDY $973.00 34782780 GI BLEEN (TAGGED RBC) $753.00 34783000 BONE IMAGING; LIMITED AREA $413.00 34783060 BONE SCAN; WHOLE BODY $824.00 34783150 THREE PHASE BONE SCAN $1,062.00 34783200 BONE SPECT $657.00 34784510 CARD PERFUS; SPECT SGL $927.00 34784520 HT MUSCLE IMAGE SPECT, MULTIPL $1,902.00 34784660 PYROPHOSPHATE CARDIAC $487.00 34784720 HEART-MUGA $804.00 34784730 CARDIAC GATED BLOOD POOL/MULT $784.00 34784780 CARDIAC PERFUSION W WM $487.00 34784800 MYOCARDIAL PERFUSION EJEC $487.00 34785790 LUNG VENTILATION IMAGING $1,050.00 34785800 LUNG SCAN-PERFUSION $827.00 34785820 LUNG VENT & PERF IMAGING $1,166.00 34785930 LUNG VENT IMAGING; GAS; SINGLE $401.00 34785940 LUNG VENT IMAGING; GAS; MULT $401.00 34787010 KIDNEY IMAGING WITH FLOW $1,082.00 34787070 RENAL SCAN W/VASCULAR FLO $800.00 34787080 LASIX RENAL SCAN $1,082.00 34787090 RENAL SCAN W/CAPTOPRIL-MU $947.00 34787610 TESTICULAR SCAN $495.00 34788000 TUMOR IMAGING; LIMITED AREA $401.00 34788010 GALLIUM MULTIPLE RETURN $494.00 34788030 GALLIUM SCAN - SPECT $870.00 34788050 GALLIUM LIMITED RETURN $1,088.00 34788060 GALLIUM WHOLE BODY $1,088.00 34952101 TECHNETIUM TC-99M EXAMETAZIME $1,338.00 34952102 TC99 TILMANOCEPT DIAGNOSTIC $1,338.00 34996900 NON-HEU TC-99M ADD-ON/DOSE $37.00 34A95580 XENON XE133 10MCI (GAS) $79.00 35002970 LDCT FOR LUNG CA SCREEN $1,313.00 35704500 CT HEAD W/O CONTRAST $914.00 35704600 CT HEAD W/CONTRAST $914.00 35704700 CT HEAD W/O & W/CONTRAST $914.00 35704800 CT - ORBIT SELLA MID/INNER EAR WO CONT $914.00 35704810 CT - ORBIT SELLA MID/INNER EAR W CONTR $1,222.00 35704820 CT - ORBIT SELLA MID/INNER EAR W & WO $1,395.00 35704860 CT FACIAL BONES W/O CNTR $914.00 35704870 CT MAXILLOFACIAL WITH CONTRAST $914.00 35704880 CT MAXILLOFACIAL W&W/O CONTRST $1,466.00 35704900 CT NECK THYROID W/O CONTRAST $914.00 35704910 CT NECK THYROID W/CONTRAST $914.00 35704920 CT NECK THYROID W/O & W $914.00 35704960 CTA-HEAD $1,906.00 35704980 CTA-NECK $1,946.00 35712500 CT CHEST W/O CONTRAST $914.00 35712600 CT CHEST W/CONTRAST $914.00 35712700 CT CHEST W/WO CONTRAST $914.00 35712750 CT ANGIOGRAPHY CHEST $914.00 35721250 CT C-SP W/O CONTRAST $914.00 35721260 CT-C-SPINE WITH CONTRAST $1,947.00 35721270 CT-C-SPINE W AND W/O CONTRAST $2,163.00 35721280 CT T-SP W/O CONTRAST $914.00 35721290 CT T-SP WITH CONTRAST $2,001.00 35721300 CT T-SP W AND W/O CONTRAST $2,163.00 35721310 CT LUMBAR SPINE W/O $914.00 35721320 CT LUMBAR SPINE WITH CONTRAST $2,163.00 35721330 CT-LUMBAR SP W AND W/O CONTRAS $2,163.00 35721920 CT PELVIS W/O C $914.00 35721930 CT PELVIS W C $914.00 35721940 CT PELVIS W/O & W $2,001.00 35732000 CT EXT UPPER W/O BILAT $1,104.00 35732001 CT EXT UPPER W/O LT $914.00 35732002 CT EXT UPPER W/O RT $914.00 35732005 CT EXT UPPER W/O BILAT $1,104.00 35732010 CT ARM WITH CONTRAST - BILAT $1,947.00 35732011 CT ARM WITH CONTRAST - LEFT $914.00 35732012 CT ARM WITH CONTRAST - RIGHT $914.00 35732015 CT ARM WITH CONTRAST BILAT $1,947.00 35732020 CT EXT UPPER WO & W BIL $2,205.00 35732021 CT EXT UPPER WO & W LT $1,214.00 35732022 CT EXT UPPER WO & W RT $1,214.00 35732025 CT EXT UPPER W/O & W BIL $2,205.00 35732060 CT STERNOCLAVICLE $1,622.00 35732061 CTA-UPPER EXT-L $1,528.00 35732062 CTA-UPPER EXT-R $1,528.00 35732065 CTA-UPPER EXT BILAT $2,163.00 35737000 CT EXT LOWER W/O BIL $1,899.00 35737001 CT EXT LOWER W/O LT $914.00 35737002 CT EXT LOWER W/O RT $914.00 35737005 CT EXT LOWER W/O BIL $1,899.00 35737010 CT-LWR EXT W CONTRAST - BILAT $1,622.00 35737011 CT-LWR EXT W CONTRAST - LEFT $914.00 35737012 CT-LWR EXT W CONTRAST - RIGHT $914.00 35737015 CT-LWR EXT W CONTRAST-BILAT $1,622.00 35737020 CT EXT LOWER W/O&W BIL $2,230.00 35737021 CT EXT LOWER W/O&W LT $1,115.00 35737022 CT EXT LOWER W/O & W RT $1,115.00 35737025 CT EXT LOWER W/O & W BIL $2,230.00 35737060 CTA LOWER EXT BILAT $1,220.00 35737061 CTA LOWER EXT LEFT $1,019.00 35737062 CTA LOWER EXT RIGHT $1,019.00 35737065 CTA LOWER EXT BILAT $1,220.00 35741500 CT ABDOMEN W/O CONTRAST $914.00 35741600 CT ABDOMEN W/CONTRAST $914.00 35741700 CT ABD W/O & W $914.00 35741740 CT ANGIO ABD & PELV W/WO DYE $914.00 35741750 CT ANGIO ABDOMEN W/WO DYE $662.00 35741760 CT ABD & PELVIS W/O CONTRAST $1,082.00 35741770 CT ABD & PELVIS W/ CONTRAST $914.00 35741780 CT ABD & PELVIS 1+SECTION/REG $914.00 35742610 CT COLONOSCOPY - W/O DYE $1,298.00 35759890 CT ABSCESS DRAIN KIDNEY $1,019.00 35763760 3D RENDER W/O POSTPROCESS $330.00 35763770 3D RENDER W POSTPROCESS $330.00 35763800 CT LIMITED OR FOLLOW-UP STUDY $541.00 35764970 UNLISTED CT $1,190.00 35770120 CT GUIDED NEEDLE BIOPSY $525.00 35770780 BONE DENSITY $433.00 35770790 SINGLE INJ-GALACTOGRAM LT $379.00 36000000 SURGERY PROC LEVEL 0 CXLD IN OR $131.00 36000001 SURGERY PROCEDURE LEVEL 1 $812.00 36000002 SURGERY PROCEDURE LEVEL 2 $1,622.00 36000003 SURGERY PROCEDURE LEVEL 3 $2,163.00 36000004 SURGERY PROCEDURE LEVEL 4 $3,245.00 36000005 SURGERY PROCEDURE LEVEL 5 $4,326.00 36000006 BREAST BIOPSY DEVICE $163.00 36000007 TISSUE MARKER $189.00 36000030 1 MIN - 30 MINS $324.00 36000034 MINS - EACH ADDTL 30 MIN $324.00 36000060 31 MINS - 60 MINS $1,448.00 36000090 61 MINS - 90 MINS $1,791.00 36000120 91 MINS - 120 MINS $2,067.00 36000150 121 MINS - 150 MINS $2,412.00 36000180 151 MINS - 180 MINS $2,619.00 36000190 181 MINS - 210 MINS $2,894.00 36190830 BX BREAST 1ST LESION U/S IMAGING $1,082.00 36190840 BX BREAST EACH LESION AFTER 1ST ADD-ON $525.00 36191010 OPEN - INCIS BREAST BX $5,566.00 36191030 PERC BRST BX - AUTO VA/DEVICE $1,406.00 36191200 REMOVAL OF BREAST LESION 1+ $5,064.00 36191260 EXC BREAST LES BY N LOC; EA ADDTL $108.00 36192810 PERQ DEVICE BREAST 1ST IMAGE $424.00 36192820 PERQ DEVICE BREAST EACH IMAGE $108.00 36192850 PERQ DEVICE BREAST 1ST US IMAGE $424.00 36192950 PLACE BREAST CLIP PERCUT $324.00 36202060 MUSCLE BX; PERC NDL $2,704.00 36202200 BONE BX TR/NDL; SUPERF $2,123.00 36206000 DRAIN/INJECT, SML JOINT/BURSA $264.00 36206051 US GUIDE DRAIN/INJ WRIST/ELBOW/ANKLE LT $271.00 36206052 US GUIDE DRAIN/INJ WRIST/ELBOW/ANKLE R $271.00 36206100 US GUIDE DRAIN/INJECT, MAJOR JOINT/BURS $264.00 36206101 US GUIDE DRAIN/INJ SHOULDER/HIP/KNEE LT $271.00 36206102 US GUIDE DRAIN/INJ SHOULDER/HIP/KNEE RT $271.00 36206105 US GUIDE DRAIN/INJ SHOULDER/HIP/KNEE BI $541.00 36233500 SHOULDER ARTHROGRAM INJECTION $525.00 36242200 ELBOW ARTHROGRAPHY INJECTION $324.00 36252460 WRIST ARTHROGRAPHY INJECTION $324.00 36270930 HIP ARTHROGRAPHY INJ WO ANES R $324.00 36270931 HIP ARTHROGRAPHY INJ WO ANES L $714.00 36270932 HIP ARTHROGRAPHY INJ WO ANES RT $714.00 36270935 HIP ARTHROGRAPHY INJ WO ANES BILATERA $541.00 36270950 HIP ARTHROGRAPHY INJ W ANES RT $1,082.00 36270951 HIP ARTHROGRAPHY INJ W ANES LT $1,082.00 36270952 HIP ARTHROGRAPHY INJ W ANES RT $1,082.00 36270960 INJECT SACROILIAC JOINT (LT) $865.00 36270961 INJECT SACROILIAC JOINT (LT) $865.00 36270962 INJECT SACROILIAC JOINT (RT) $865.00 36270963 INJECT SACROILIAC JOINT (RT) $865.00 36273700 KNEE ARTHROGRAPHY INJECTION $433.00 36276480 ANKLE ARTHROOGRAPHY INJECTION $324.00 36365690 INSERT PICC CATH (SUMMIT VAS) $1,237.00 36365694 INSERT PICC CATH (SUMMIT VAS) $1,237.00 36365840 REPLACE PICC CATH (SUMMIT VAS) $1,237.00 36365844 REPLACE PICC, AGE 5 YRS/> $1,237.00 36382200 BONE MARROW ASPIRATION ONLY $287.00 36382210 BONE MARROW BIOPSY $287.00 36387920 RA TRACER ID OF SENTINL NODE $368.00 36490834 ADBOMINAL PARACENTESIS W/IMAGING $819.00 36494650 FLUORO EXAM OF G/COLON TUBE $379.00 36505900 LITHOTRIPSY INVOICE - MIDWEST $5,543.00 36505904 LITHOTRIPSY INVOICE-MIDWEST $5,543.00 36526010 GREENLIGHT LASER $2,367.00 36526011 GREENLIGHT FIBER $2,556.00 36583400 CATH & INTRO OF SALINE OR CONTRAST $163.00 36622840 MYLOGRAM INJ $541.00 36963650 INFUSION UP TO 1 HOUR $197.00 36963660 IV INFUSION EACH ADDTL $118.00 36963720 THER/PROPH/DIAG INJ, SC/IM $39.00 36963724 THER/PROPH/DIAG INJ, SC/IM $39.00 36963730 THER/PROPH/DIAG INJ, IA $148.00 36963734 THER/PROHP/DIAG INJ, IA $148.00 37000180 ANESTHESIA UP TO/INC FIRST 15 MINUTES $216.00 37000200 ANESTHESIA EACH MIN AFTER 15 MINUTES $12.00 38364305 BLOOD TRANSFUSION PER DAY $819.00 39364300 BLOOD TRANSFUSION $798.00 39869450 IRRADIATE BLD PRODUCT $133.00 39869990 UNLISTED TRANSFUSION MED $223.00 39901200 CRYOPRECIPITATE EACH UNIT $80.00 39901600 RBC LEUKOCYTES REDUCED $266.00 39901700 PLASMA 1 DONOR FRZ W/IN 8 HR $212.00 39902100 RED BLOOD CELLS 1 UNIT $210.00 39902200 WASHED RED BLOOD CELLS $1,075.00 39903400 PLATELETS; PHERESES $757.00 39903500 PLATELETS PHERESIS LR $1,272.00 39903700 PLATELETS PHERESIS LR IRRAD $1,536.00 39904000 RBC LR IRRADIATED $653.00 39904400 CRYOPR REDUCED PLASMA $133.00 39905400 WSH LR FROZ DW WB/RBC $1,220.00 39905700 RBC FROZ LEUK REDUC IRRAD $1,352.00 39905900 FFP 8-24 HRS OF COLLECTION $133.00 39906000 FFP DONOR RETSTD $134.00 40100050 FNA BX W/US GDN 1ST LES $372.00 40100060 FNA BX W/US GDN EA ADDL $372.00 40100220 FINE NEEDLE ASPIRATION W/IMAGE $1,155.00 40206060 DRAIN/INJ INTER JOINT/BURSA W/US $544.00 40206110 DRAIN/INJ MAJOR JOINT/BURSA W/US $544.00 40765060 HEAD ULTRASOUND $381.00 40765360 NECK - SOFT TISSUE $610.00 40766040 CHEST ULTRASOUND $401.00 40766410 BREAST COMPLETE - BILAT $357.00 40766411 BREAST COMPLETE- LEFT $341.00 40766412 BREAST COMPLETE - RIGHT $341.00 40766421 BREAST LIMITED - LEFT $341.00 40766422 BREAST LIMITED - RIGHT $341.00 40766425 BREAST UNI BILAT $714.00 40766450 BREAST - BILAT $357.00 40766451 BREAST - LEFT $341.00 40766452 BREAST - RIGHT $341.00 40767000 ABDOMEN MULTI ORGAN $477.00 40767050 ABDOMEN LIMITED $477.00 40767700 KIDNEY COMPLETE (ABDO) $491.00 40767750 AORTA DUPLEX SCAN $635.00 40768000 ULTRASOUND SPINAL CANAL (BACK) $595.00 40768010 ULTRASOUND PREG SINGLE <14 WEEKS $309.00 40768020 PREG <14 ADDTL GESTATION $477.00 40768050 PREGNANCY > THAN 14 WKS 1 $426.00 40768100 PREG >= 14 ADDTL GESTATION $674.00 40768110 OB COMPLETE $341.00 40768120 OB COMPLETE ADDTL GESTATION $228.00 40768150 OB LIMITED $323.00 40768160 OB US FOLLOWUP - ABNORMAL PER FETUS $233.00 40768170 TRANSVAGINAL OB $449.00 40768180 BIOPHYSICAL PROFILE $669.00 40768300 TRANSVAGINAL NON-OB ULTRASOUND $359.00 40768310 HYSTEROSONOGRAM $296.00 40768560 PELVIC GENERAL $455.00 40768570 PELVIC LIMITED $294.00 40768700 TESTICULAR US $415.00 40768720 PROSTATE ULTRASOUND $365.00 40768730 PROSTATE VOL STUDY $632.00 40768811 EXTREMITY LEFT NON-VAS COMPLETE $381.00 40768812 EXTREMITY RIGHT NON-VAS COMPLETE $381.00 40768815 EXTREMITY-BILAT NON-VAS COMPLETE $396.00 40768821 EXTREMITY LEFT NON-VAS, LIMITED, SPEC $271.00 40768822 EXTREMITY RIGHT NON-VAS, LIMITED SPEC $271.00 40768825 EXTREMITY NON-VAS, LIMITED $541.00 40769370 US GUIDE, VASCULAR ACCESS PICC $357.00 40769420 US GUIDED NEEDLE PLACEMENT SUP/INT $372.00 40769460 AMNIOCENTESIS $357.00 40769990 GENITALIA $183.00 40770510 CAD DIAGNOSTIC MAMMOGRAPHY $177.00 40770520 CAD SCREENING MAMMOGRAPHY $82.00 40770550 MAMMOGRAM-UNILATERAL-DIGITIAL $173.00 40770551 MAMMOGRAM DIAG LEFT - DIGITAL $173.00 40770552 MAMMOGRAM DIAG - RIGHT - DIGITIAL $173.00 40770560 MAMMOGRAM DIAG-BILATERAL - DIGITAL $255.00 40770570 MAMMOGRAM SCREENING - DIGITIAL $216.00 40770571 MAMMOGRAM SCREENING - LT ONLY - DIGITA $125.00 40770572 MAMMOGRAM SCREENING - RT ONLY - DIGIT $125.00 40770630 BREAST TOMOSYNTHESIS LEFT $167.00 40770631 SCREENING DIGITAL BREAST TOMOSYNTHES $167.00 40770632 BREAST TOMOSYNTHESIS RIGHT $167.00 40770650 DIAG MAMM LEFT INCLUDING CAD $177.00 40770651 DIAG MAMM RIGHT INCLUDING CAD $177.00 40770652 DIAG MAMM UNILATERAL INCLUDING CAD $355.00 40770660 DIAG MAMM BIL INCLUDING CAD $355.00 40770670 SCREENING MAMM BILAT W CAD $355.00 40770671 SCREENING MAMM BILAT W CAD $355.00 40770672 SCR MAMMO BI INCL CAD LEFT $355.00 40770673 SCR MAMMO BI INCL CAD RIGHT $355.00 40G02790 TOMOSYNTHESIS MAMMO LEFT $195.00 40G02791 TOMOSYNTHESIS MAMMO RIGHT $195.00 40G02792 TOMOSYNTHESIS MAMMO BILATERAL $391.00 41366000 ARTERIAL PUNCTURE $28.00 41940020 VENT ASST DAY 1 ADJ & PRESSURE $1,045.00 41940030 VENT ASST SUBSEQUENT DAYS $1,045.00 41946200 PULMONARY STRESS TEST/SIMPLE $270.00 41946201 PULMONARY STRESS TEST/SIMPLE $270.00 41946400 AIRWAY INHALATION TREATMENT $65.00 41946570 VENT ASST SUBSEQUETN DAYS $214.00 41946600 CPAP INITIATION MANAGEMNT $179.00 41946640 AEROSOL TX SPUTUM $47.00 41946670 POSTURAL DRAINAGE $93.00 42909010 BIOFEEDBACK - M $85.00 42909011 BIOFEEDBACK - M $85.00 42909012 BIOFEEDBACK - M $85.00 42909013 BIOFEEDBACK - M $85.00 42909121 BFB TRAINING 1ST 15 MIN $133.00 42909122 BFB TRAINING 1ST 15 MIN $133.00 42909123 BFB TRAINING 1ST 15 MIN $133.00 42909130 BFB TRAINING EA ADDL 15 MIN $81.00 42909131 BFB TRAINING EA ADDL 15 MIN $81.00 42909132 BFB TRAINING EA ADDL 15 MIN $81.00 42909133 BFB TRAINING EA ADDL 15 MIN $81.00 42958310 MANUAL MUSCLE TEST EXTREMITY $87.00 42958311 MANUAL MUSCLE TEST EXTREMITY $87.00 42958320 MUSCLE TST-MAN HAND $87.00 42958321 MUSCLE TST-MAN HAND $87.00 42958510 RANGE OF MOTION TEST EXTREMITY $87.00 42958511 RANGE OF MOTION TEST EXTREMITY $87.00 42958512 RANGE OF MOTION TEST EXTREMITY $87.00 42958513 RANGE OF MOTION TEST EXTREMITY $87.00 42958520 RANGE OF MOTION HAND $87.00 42958521 RANGE OF MOTION HAND $87.00 42958522 RANGE OF MOTION HAND $87.00 42958523 RANGE OF MOTION HAND $87.00 42970010 PT EVALUATION $141.00 42970011 PT EVALUATION $141.00 4297002 TRACTION MECHANICAL $70.00 42970020 PT RE-EVALUATION $87.00 42970021 PT RE-EVALUATION $87.00 4297003 TRACTION MECHANICAL $70.00 4297004 VASOPNEUMATIC DEVICE $70.00 4297005 PARAFIN BATH $70.00 4297006 PARAFIN BATH $70.00 4297007 ELECTRIC STIM MANUAL (15min) $126.00 4297008 ELECTRIC STIM MANUAL (15MIN) $126.00 4297009 IONTOPHORESIS (15MIN) $108.00 4297010 THERAPEUTIC ULTASOUND $108.00 42970100 PHYS THPY HOT/COLD PACKS $56.00 429701001 COLD PACK $56.00 429701002 HOT PACK $56.00 429701003 COLD PACK $56.00 429701004 HOT PACK $56.00 429701005 COLD PACK $56.00 429701006 HOT PACK $56.00 42970101 PHYS THPY HOT/COLD PACKS $56.00 4297011 THERAPEUTIC ULTASOUND $108.00 4297012 PHYS THERAPY EXERCISE (15MIN) $83.00 42970120 TRACTION MECHANICAL $70.00 42970121 TRACTION MECHANICAL $70.00 42970122 TRACTION MECHANICAL $70.00 42970123 TRACTION MECHANICAL $70.00 4297013 NEUROMUSCULAR RE-EDUCATION (15MIN) $77.00 4297014 NEUROMUSCULAR RE-EDUCATION (15MIN) $77.00 42970140 E STIM UNATTENDED WO $82.00 42970141 E STIM UNATTENDED WO $82.00 42970142 E STIM UNATTENDED WO $82.00 42970143 E STIM UNATTENDED WO $82.00 4297015 GAIT TRAINING (15MIN) $77.00 4297016 GAIT TRAINING (15MIN) $77.00 42970160 VASOPNEUMATIC DEVIC $70.00 42970161 VASOPNEUMATIC DEVIC $70.00 42970163 VASOPNEUMATIC DEVIC $70.00 42970180 PARAFFIN BATH $70.00 42970181 PARAFFIN BATH $70.00 42970182 PARAFFIN BATH $70.00 42970183 PARAFFIN BATH $70.00 4297019 PHYS THPY MANUAL THERAPY $98.00 4297020 PT-EVAL-LOW $141.00 4297021 PT EVAL LOW $141.00 4297022 PT EVAL - MOD $141.00 42970220 PHYS THPY WHIRLPOOL $120.00 42970221 PHYS THPY WHIRLPOOL $120.00 42970222 PHYS THPY WHIRLPOOL $120.00 42970223 PHYS THPY WHIRLPOOL $120.00 4297023 PT EVAL - MOD $141.00 4297024 PT EVAL - HIGH $141.00 42970240 DIATHERMY $82.00 42970241 DIATHERMY $82.00 42970242 DIATHERMY $82.00 42970243 DIATHERMY $82.00 4297025 PT EVAL - HIGH $141.00 4297026 PT RE-EVALUATION $87.00 4297027 PT RE-EVALUATION $87.00 4297028 THERAPEUTIC ACTIVITIES (15 MIN $77.00 4297029 PT - UNATTENDED ELECT STIMULTN $82.00 4297030 PT - UNATTENDED ELECT STIMULTN $82.00 4297031 ORTHO FITTING & TRAINING (15MI $85.00 4297032 ORTHO FITTING & TRAINING (15MI $85.00 42970320 ELEC STIMULATION MAN (15MIN) $126.00 42970321 ELEC STIMULATION MAN (15MIN) $126.00 42970322 ELEC STIMULATION MAN (15MIN) $126.00 42970323 ELEC STIMULATION MAN (15MIN) $126.00 4297033 PROSTHETIC TRAINING $75.00 42970330 IONTOPHORESIS 15 MIN $108.00 42970331 IONTOPHORESIS 15 MIN $108.00 42970332 IONTOPHORESIS 15 MIN $108.00 42970333 IONTOPHORESIS 15 MIN $108.00 4297034 PROSTHETIC TRAINING $75.00 42970340 CONTRAST BATH $59.00 42970341 CONTRAST BATH $59.00 42970342 CONTRAST BATH $59.00 42970343 CONTRAST BATH $59.00 4297035 FUNCTIONAL CAPACITY EVALUATION $82.00 42970350 PHONOPHORESIS $108.00 42970351 PHONOPHORESIS $108.00 42970352 PHONOPHORESIS $108.00 42970353 PHONOPHORESIS $108.00 4297036 FUNCTIONAL CAPACITY EVALUATION $82.00 4297037 DAILY LIVING ACTIVITY TRAINING $65.00 4297038 THERAPEUTIC ACTIVITIES (15 MIN $77.00 4297039 IONTOPHORESIS 15 MIN $108.00 42970390 PHYS THPY JOINT TAPING $65.00 42970391 PHYS THPY JOINT TAPING $65.00 42970392 PHYS THPY JOINT TAPING $65.00 42970393 PHYS THPY JOINT TAPING $65.00 4297040 MASSAGE $77.00 4297041 E STIM UNATTENDED WO $82.00 4297107 MASSAGE THERAPY $77.00 4297108 PHYS THPY MANUAL THERAPY $98.00 42971100 PHYS THERAPY EXERCISE THERAPY $83.00 42971101 PHYS THERAPY EXERCISE THERAPY $83.00 42971102 PHYS THERAPY EXERCISE THERAPY $83.00 42971103 PHYSICAL THERAPY EXERCISE (15MIN) $83.00 42971104 PHYS THERAPY EXERCISE THERAPY $83.00 42971120 NEUROMUSCULAR RE-EDU $77.00 42971121 NEUROMUSCULAR REEDUCATION EA 15 MINS $77.00 42971122 NEUROMUSCULAR REEDUCATION EA 15 MINS $77.00 42971123 NEUROMUSCULAR REEDUCATION EA 15 MINS $77.00 42971160 GAIT TRAINING $77.00 42971161 GAIT TRAINING $77.00 42971162 GAIT TRAINING $77.00 42971163 GAIT TRAINING $77.00 42971240 MASSAGE $77.00 42971241 MASSAGE $77.00 42971242 MASSAGE $77.00 42971243 MASSAGE $77.00 42971400 PHYS THPY MANUAL THERAPY $98.00 42971401 PHYS THPY MANUAL THERAPY $98.00 42971402 PHYS THPY MANUAL THERAPY $98.00 42971403 PHYS THPY MANUAL THERAPY $98.00 42971500 THERAPEUTIC REHAB GROUP $98.00 42971501 THERAPEUTIC REHAB GROUP $98.00 42971610 PT EVAL - LOW $141.00 42971611 PT EVAL - LOW $141.00 42971612 PT EVAL - LOW $141.00 429716122 PT EVAL - LOW $141.00 42971613 PT EVAL - LOW $141.00 42971620 PT EVAL - MOD $141.00 42971621 PT EVAL - MOD $141.00 42971622 PT EVAL - MOD $141.00 42971623 PT EVAL - MOD $141.00 42971630 PT EVAL - HIGH $141.00 42971631 PT EVAL - HIGH $141.00 42971632 PT EVAL - HIGH $141.00 42971633 PT EVAL - HIGH $141.00 42971640 PT RE-EVALUATION $87.00 42971641 PT RE-EVALUATION $87.00 42971642 PT RE-EVALUATION $87.00 42971643 PT RE-EVALUATION $87.00 42975300 THERAPEUTIC ACTIVITIES (15 MIN $77.00 42975301 THERAPEUTIC ACTIVITIES (15 MIN $77.00 42975302 THERAPEUTIC ACTIVITIES (15 MIN $77.00 42975303 THERAPEUTIC ACTIVITIES (15 MIN $77.00 42975330 SENSORY INTEGRATION $83.00 42975331 SENSORY INTEGRATION $83.00 42975332 SENSORY INTEGRATION $83.00 42975333 SENSORY INTEGRATION $83.00 42975370 COMMUNITY WORK REINTEGRATION $65.00 42975371 COMMUNITY WORK REINTEGRATION $65.00 42975372 COMMUNITY WORK REINTEGRATION $65.00 42975373 COMMUNITY WORK REINTEGRATION $65.00 42975420 WHEELCHAIR MANAGEMENT $70.00 42975421 WHEELCHAIR MANAGEMENT $70.00 42975422 WHEELCHAIR MANAGEMENT $70.00 42975423 WHEELCHAIR MANAGEMENT $70.00 42975970 DEBRIDE; DEVITAL TIS <20 CM CM $324.00 42975971 DEBRIDE; DEVITAL TIS <20 CM CM $324.00 42975972 DEBRIDE; DEVITAL TIS <20 CM CM $324.00 42975973 DEBRIDE; DEVITAL TIS <20 CM CM $324.00 42975981 DEBRIDE; DEVIT TIS > 20 SQ CM $309.00 42975982 DEBRIDE; DEVIT TIS > 20 SQ CM $309.00 42977500 FUNCTIONAL CAPACITY EVALUATION $82.00 42977501 FUNCTIONAL CAPACITY EVALUATION $82.00 42977502 FUNCTIONAL CAPACITY EVALUATION $82.00 429775022 FUNCTIONAL CAPACITY EVALUATION $82.00 42977503 FUNCTIONAL CAPACITY EVALUATION $82.00 42977600 ORTHO FITTING & TRAINING (15MI $85.00 42977601 ORTHO FITTING & TRAINING (15MI $85.00 42977603 ORTHO FITTING & TRAINING (15MI $85.00 42977610 PROSTHETIC TRAINING $75.00 42977611 PROSTHETIC TRAINING $75.00 42977612 PROSTHETIC TRAINING $75.00 42977613 PROSTHETIC TRAINING $75.00 42977630 C/O FOR ORTHOTIC/PROSTH USE EA 15 MINS $230.00 42977631 ORTHC/PROSTC MGMT SBSQ ENC $230.00 42977632 ORTHC/PROSTC MGMT SBSQ ENC $230.00 42977633 ORTHC/PROSTC MGMT SBSQ ENC $230.00 42G02830 PT - UNATTENDED ELECT STIMULTN $82.00 42G02831 PT - UNATTENDED ELECT STIMULTN $82.00 42G02832 PT - UNATTENDED ELECT STIMULTN $82.00 42G028322 PT - UNATTENDED ELECT STIMULTN $82.00 43410201 OCC MED SPLINT SUPPLY $757.00 43970030 OCCUPATIONAL THERAPY EVALUATIO $278.00 43975350 DAILY LIVING ACTIVITY TRAINING $65.00 43977600 ORTHO FITTING & TRAINING (15MI $85.00 44925060 SPEECH/HEARING EVALUATION $176.00 44925070 SPEECH/HEARING THERAPY $86.00 44925080 SPEECH/HEARING THERAPY (GROUP) $63.00 44925260 SP THPY ORAL FUNCTION THERAPY $89.00 44926050 EVAL FOR NONSPEECH DEVICE RX $63.00 44926060 SP THPY NON-SPEECH DEVICE SVC $63.00 44926070 1 HR EXAM FOR SPEECH DVC RX $63.00 44926090 SPEECH DEVICE SERVICE $63.00 44926100 EVALUATE SWALLOWING FUNCTION $219.00 44926110 SPCH THPY MODIFIED BARIUM SWAL $474.00 44961050 ASSESSMENT OF APHASIA $205.00 44961100 SP THPY DEVELOPMENTAL TEST $200.00 44961110 SP THPY DEVELOPMENTAL TEST EXT $205.00 44975320 COGNITIVE SKILLS DEVELOPMENT $91.00 44975330 SPCH THPY SENSORY INTEGRATION $83.00 44975350 SELF CARE MANAGEMENT TRAINING $65.00 44975370 COMMUNITY/WORK INTEGRATION $63.00 45090013 TREATMENT ROOM $65.00 45100600 DRAINAGE SKIN ABSCESS (SIMPLE) $368.00 45100610 DRAINAGE OF SKIN ABSCESS (MULT $417.00 45100800 I&D PILONIDAL CYST SIMPLE $368.00 45101200 INCISION & REM FB SQ - SIMPLE $368.00 45101210 INC & REM FB, SQ; COMPLICATED $1,883.00 45101400 DRAINAGE & INCISION OF HEMATOMA/FLUID $1,310.00 45101600 PUNCT ASPIR ABSCESS/HEMA/CYST $368.00 45110400 DEBRIDE; SKIN, PARTIAL THICKNS $433.00 45110420 DEBRIDE SKIN/TISSUE $302.00 45110450 DEBRIDE SKIN/TISSUE ADD-ON =<20 SQ CM $197.00 45110550 PARING/CUTTING BENIGN HYPERKERATOTIC $54.00 45110560 TRIM SKIN LESIONS 2 TO 4 $72.00 45110570 TRIM SKIN LESIONS OVER 4 $350.00 45112000 REMOVAL SKIN TAGS $90.00 45113000 SHAVE LES,T/A/L; 0.5CM/< $130.00 45113010 SHAVE LES,T/A/L; 0.6-1.0CM $98.00 45113020 SHAVE LES,T/A/L; 1.1-2.0CM $163.00 45113030 SHAVE LES,T/A/L; > 2.0CM $163.00 45113050 SHAVE LES,S/N/H/F/G; 0.5CM $120.00 45113060 SHAVE LES,S/N/H/F/G;0.6-1.0 $120.00 45113070 SHAVE LES,S/N/H/F/G;1.1-2.0 $173.00 45113080 SHAVE LES,S/N/H/F/G;> 2.0CM $120.00 45113100 SHAVE LES,F/E/N/L; 0.5CM/< $152.00 45113110 SHAVE LES,F/E/N/L;0.6-1.0CM $152.00 45113120 SHAVE LES,F/E/N/L; 1.1-2.0CM $173.00 45113130 SHAVE LES,F/E/N/L;>2.0CM $163.00 45114030 EXC, BEN LES,T/A/L; 2.1-3.0CM $1,006.00 45114040 EXC, BEN LES,T/A/L;3.1-4.0CM $1,298.00 45114060 EXC, BEN LES,T/A/L; >4.0CM $1,622.00 45114200 EXC, BLES,S/N/EX,G;0.5CM/< $973.00 45114210 EXC, BLES,S/N/EX,G;0.6-1.0CM $920.00 45114220 EXC, BLES,S/N/EX,G;1.1-2.0CM $973.00 45114230 EXCISION 2.1-3.0 CM $1,825.00 45114240 EXC, BLES,S/N/EX,G;3.1-4.0CM $1,352.00 45114260 EXC, BLES,S/N/EX,G;> 4.0CM $1,920.00 45114400 EXCISION FACE 0.5 CM OR LESS $488.00 45114410 EXC FACE-MM B9+MARG 0.6-1 CM $649.00 45114420 EXC FACE-MM B9+MARG 1.1-2 CM $865.00 45114430 EXC FACE-MM B9+MARG 2.1-3 CM $920.00 45114440 EXC FACE-MM B9+MARG 3.1-4 CM $920.00 45114460 EXC FACE-MM B9+MARG > 4 CM $1,785.00 45117300 REMOVAL OF NAIL PLATE $108.00 45117400 DRAIN BLOOD FROM UNDER NAIL $34.00 45117500 REMOVAL OF NAIL BED $488.00 45117600 REPAIR NAIL BED $379.00 45117650 EXCISION OF NAIL FOLD, TOE $166.00 45120010 SREP S/N/A/G/TR/E 2.5CM< $236.00 45120020 SREP S/N/A/G/TR/E 2.6-7.5CM $236.00 45120040 SREP S/N/A/G/TR/E 7.6-12.5CM $236.00 45120050 SREP S/N/A/G/TR/E 12.6-20.0CM $236.00 45120060 REPAIR WOUND 20.1-30.0CM $146.00 45120070 REPAIR SUPERFICIAL WOUND > 30C $260.00 45120110 SREP F/E/N/L/MM 2.5CM OR LESS $236.00 45120130 SREP F/E/N/L/MM 2.6-5.0CM $236.00 45120140 SREP F/E/N/L/MM 5.1-7.5CM $236.00 45120150 SREP F/E/N/L/MM 7.6-12.5CM $236.00 45120160 REPAIR FACE WOUNDS 12.6-20.0CM $146.00 45120170 REPAIR FACE WOUNDS 20.1-30.0CM $146.00 45120180 REPAIR FACE WOUNDS >30.0CM $146.00 45120200 TX SUPERF WND DEHISCENCE SMPLE $729.00 45120210 SMPLE TX WOUND DEHIS C PACKING $238.00 45120310 INTMD WND RPR S/A/T/EXT <= 2.5 CM $239.00 45120320 INTMD WND RPR S/A/T/EXT 2.6-7.5CM $239.00 45120340 INTM WND REPR S/TR/EXT 7.6-12.5 CM $609.00 45120350 LAYER CLOSE WOUND(S) 12.6-20.0 $239.00 45120360 LAYER CLOSE WOUND(S) 20.1-30.0 $239.00 45120370 LAYER CLOSE WOUND(S) >30.0CM $239.00 45120410 LAYER CLOSE WOUND(S) 2.5CM>= $239.00 45120420 LAYER CLOSE WOUND(S) 2.6-7.5CM $239.00 45120440 LAYER CLOSE WOUND(S) 7.6-12.5C $239.00 45120450 LAYER CLOSE WOUND(S) 12.6-20.0 $239.00 45120460 LAYER CLOSE WOUND(S) 20.1-30.0 $239.00 45120470 LAYER CLOSE WOUND(S) >30.0CM $239.00 45120510 INTMD WND RPR FACE/MM =< 2.5 CM $239.00 45120520 LAYER CLOSE WOUND(S) 2.6-5.0CM $239.00 45120530 LAYER CLOSE WOUND(S) 5.1-7.5CM $239.00 45120540 LAYER CLOSE WOUND(S) 7.6-12.5C $239.00 45120550 LAYER CLOSE WOUND(S) 12.6-20.0 $239.00 45120560 LAYER CLOSE WOUND(S) 20.1-30.0 $239.00 45120570 LAYER CLOSE WOUND(S) >30.0CM $239.00 45131000 REPAIR CMPLX TRUNK 1.1-2.5CM $741.00 45131010 REPAIR CMPLX TRUNK 2.6-7.5CM $741.00 45131020 REPAIR CMPLX TRUNK EA ADD 0-5C $381.00 45131200 COMPLEX REPAIR 1.1-2.5CM $239.00 45131210 CREP SCALP ARMS LEGS 2.6-7.5CM $513.00 45131220 COMPLEX REPAIR EACH ADDTL <=5C $324.00 45131310 COMPLEX REPAIR 1.1-2.5CM FACE HANDS FE $513.00 45131320 CREP F/G/H/F 2.6-7.5 CM $513.00 45131330 COMPLEX REPAIR EA ADDTL <=5CM $513.00 45131500 COMPLEX REPAIR FACE <=1.0CM $513.00 45131510 COMPLEX REPAIR FACE 1.1-2.5CM $513.00 45131520 COMPLEX REPAIR FACE 2.6-7.5CM $513.00 45131530 CMPLX REPAIR FACE EA ADDTL <=5 $513.00 45160000 INITIAL TREATMENT 1ST DEG BURN $90.00 45160200 DRESS/DEBRID P-THICK BURN, SML $166.00 45160250 DRESS/DEBRID P-THICK BURN, MED $302.00 45160300 DRESS/DEBRID P-THICK BURN, LRG $302.00 45160350 ESCHAROTOMY; INITIAL INCISION $158.00 45171060 DESTR CUT VASC LES; 10 SQ CM/< $1,050.00 45172500 CHEM CAUT GRANULATION TISSUE $190.00 45179990 UNLISTED PROC SKIN MM & SUBQ TISSUE $55.00 45190000 PUNCT ASP OF CYST OF BREAST $490.00 45190010 PUNCT ASP OF CYST BREAST ADDTL $126.00 45190200 EXPLORE BREAST WOUND OR ABSCES $2,076.00 45201020 EXPLORE PENTR WND OF ABD/FLANK $2,611.00 45201030 EXPLORE PENTR WOUND OF EXTREM $1,092.00 45205200 REMOVAL FOREIGN BODY MUSCLE $488.00 45205520 INJ TRIGGER POINT, 1/2 MUSCLE $324.00 45206000 DRAIN/INJECT, SML JOINT/BURSA $264.00 45206050 DRAIN/INJ INTER JOINT/BURSA WO US $264.00 45206100 DRAIN/INJ, MAJOR JOINT/BURSA WO US $264.00 45206110 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BUR $275.00 45206920 APPLY PINS OR WIRES $3,308.00 45209500 MONITOR INTERST FLD PRESSURE $324.00 45213100 CLOSED TX NOSE FRACTURE $284.00 45213200 CL TX OF NASAL BONE FX; W STAB $1,828.00 45213370 CL TX NASAL SEPTAL FX $1,622.00 45214800 CL TX ANKLE DISLOCATION; WO AN $433.00 45235000 CLOSED TX CLAVICAL FRACTURE $201.00 45235050 CLAVICLE FX WITH MANIPULATION $2,038.00 45235200 CLOSED TX STERNOCLAV FRACTURE $487.00 45235250 CL TX SCCLAV DISLOC W MANIPULA $595.00 45235400 CLSD TX ACROMIOCLAV DISLOC W/O $201.00 45235450 CLSD TX ACROMIOCLAV DISLOC W M $487.00 45235700 CLSD TX SCAPULA DISLOC W MANIP $201.00 45235750 CLSD TX SCAPULA DISLOC W MANIP $487.00 45236000 CLSD TX ARM W MANIPULATION $201.00 45236050 CLSD TX ARM W MANIPULATION $1,730.00 45236500 CL TX SHLDR DISL W MANI; WO ANESTH $578.00 45236550 CLSD TX SHOULDER DISLOC $1,674.00 45239310 DRAIN ARM, ELBOW BURSA $2,076.00 45245000 CLSD TX HUMERUS FX WO MANIPULA $427.00 45245050 CL TX HUMERUS FX W MANIPULATE $324.00 45246000 TREAT ELBOW DISLOCATION $201.00 45246050 TX CL ELBOW DISLOC W ANESTHESI $1,298.00 45246200 TREAT ELBOW FRACTURE $1,730.00 45246400 TREAT ELBOW DISLOCATION $1,575.00 45246550 CL TX RADIAL HD/NECK FX; W MANIP $541.00 45246750 TREAT ULNAR FRACTURE $433.00 45255000 CLSD TX RADIAL SHFT FX WO MANI $271.00 45255050 CL TX RADIAL SHFT FX W MANIPUL $757.00 45255300 CLSD TX OF RADIAL SHFT FX WO M $298.00 45255350 CL TX ULNAR SHFT FX W MANIPULA $249.00 45255600 CL TX RADIAL&ULNAR SHFT FX WO $324.00 45255650 CL TX RADIAL & ULNA FX W MANIP $541.00 45256000 CLSD TX ARM FRACTURE $201.00 45256050 CLSD TX ARM FRACTURE $595.00 45256220 CLSD TX WRIST FRACTURE $201.00 45256240 CL TX CARPL SCAPHOID FX W MANI $595.00 45256300 TREAT WRIST BONE FRACTURE W/O $190.00 45256350 TREAT WRIST BONE FRACTURE W MA $595.00 45256500 TREAT WRIST BONE FRACTURE $201.00 45256600 CL TX CARPAL DISLOC W MANIPULA $379.00 45260100 DRAIN FINGER ABSCESS; SIMPLE $368.00 45260110 DRAINAGE OF FINGER ABSCESS $1,310.00 45264100 REPAIR HAND TENDON $1,866.00 45264180 EXTENSOR TENDON REPAIR, EACH $1,622.00 45266000 TREAT METACARPAL FRACTURE $201.00 45266050 CLSD TX METACARPAL FX W MANIP $249.00 45266410 CL TX THUMB WITH MANIPULATION $357.00 45266450 CL TX CMC FX DISLOC THUMB W MA $433.00 45266700 CL TX CARPMETACRPL DISL W M EA $108.00 45267000 TREAT KNUCKLE DISLOCATION $567.00 45267200 CLOSED TX FINGER OR THUMB, EA $201.00 45267250 TREAT FINGER FRACTURE, EACH $567.00 45267420 CL TX ARTFX MCP/IP JNT; W MANIP $1,622.00 45267500 CLOSED TX FINGER OR THUMB, EA $201.00 45267550 TREAT FINGER FRACTURE, EACH $567.00 45267700 TREAT FINGER DISLOCATION $567.00 45267750 CL TX IP JT D, W MANIP; W ANES $1,591.00 45267850 TREAT FINGER DISLOCATION $3,990.00 45270860 REMOVE FOREIGN BODY PELVIS/HIP $985.00 45272300 CL TX PROX FEM FX WO MANIPULAT $249.00 45272500 CL TX TRAUMA HIP DICLOC WO ANE $324.00 45272520 CL TX TRAUMA HIP DISLOC W ANES $1,136.00 45272650 CL TX POST HIP DISLOC WO ANEST $379.00 45275000 CL TX FEMORAL SHAFT FX, WO MAN $460.00 45275020 CL TX FEMORAL SHAFT FX, W MANI $1,514.00 45275080 CL TX DISTAL FEM FX WO MANIP $156.00 45275100 CL TX FEMUR FX OR EPIPHYS SEP $460.00 45275200 CLOSED TX PATELLAR FX, WO MANI $216.00 45275500 CL TX KNEE DISL; WO ANESTHESIA $216.00 45275600 TREAT KNEECAP DISLOCATION $201.00 45275620 CL TX PATELLAR DISLOCATION; W $1,591.00 45277500 TREATMENT TIB FRACTURE $287.00 45277520 CL TX TIB SHAFT FX W MANIPULAT $1,622.00 45277600 CLOSED TX MEDIAL ANKLE FX $201.00 45277800 CL TX PROX FIB/SHAFT FX WO MAN $216.00 45277810 CL TX PROX FIB/SHAFT FX W MANI $1,514.00 45277860 CL TX DSTL FIB FX WO MANIPULAT $309.00 45277880 CL TX DISTL FIB FX W MANIPULAT $641.00 45278080 TREATMENT OF ANKLE FRACTURE $324.00 45278100 TREATMENT OF ANKLE FRACTURE $649.00 45278160 CL TX TRIMALL ANKLE FX; WO MAN $406.00 45278180 TREATMENT OF ANKLE FRACTURE $541.00 45278240 CL TX WT BRG DSTL TIB WO MANIP $120.00 45278250 CL TX WT BRG DSTL TIB W MANIP $1,622.00 45278400 CL TX ANKLE DISLOCATION; WO AN $433.00 45278420 CL TX ANKLE DISLOCATION; W ANESTH $433.00 45281900 REMOVAL OF FOOT FOREIGN BODY $757.00 45284000 CLOSED TX HEEL FX $201.00 45284500 TX TARSAL BONE FX ; WO MANIPU $281.00 45284550 TX TARSAL BONE FX; W MANIP $233.00 45284700 CLOSED TX TOE FRACTURE $201.00 45284750 CL TX METATARSAL FX; WO MANIP $249.00 45284900 CLOSED TX FINGER FRACTURE NO M $201.00 45284950 CL TX FX GT PHALANX(S); W MANI $173.00 45285100 CLOSED TX FINGER FRACTURE W/MA $201.00 45285150 CL TX FX GT PHALANX(S); W MANI $567.00 45285700 CL TX TALOTARSAL JOINT DIS; WO $541.00 45286300 TREAT TOE DISLOCATION $567.00 45286350 CL TX MTP JNT DISLOC; W ANESTH $1,109.00 45286600 CLOSED TX JOINT DISLOC NO ANES $201.00 45290350 APPLICATION OF BODY CAST $260.00 45290490 APPLICATION OF FIGURE EIGHT $125.00 45290650 APPLICATION OF LONG ARM CAST $214.00 45290750 APPLICATION OF SHORT ARM CAST $260.00 45290850 CAST LWR HAND FOREARM GAUNTLET $114.00 45291050 SPLINT APPLICATION - LONG ARM $216.00 45291250 SPLINT APPLICATION - SHORT ARM $125.00 45291260 APPLY FOREARM SPLINT $125.00 45291300 SPLINT APPLICATION - FINGER $147.00 45291310 APPLICATION OF FINGER SPLINT $125.00 45292400 STRAPPING OF SHOULDER $125.00 45292600 STRAPPING; ELBOW OR WRIST $163.00 45292800 STRAPPING OF HAND OR FINGER $125.00 45293450 APPLICATION OF LONG LEG CAST $207.00 45293650 APPLY CYLINDER CAST $190.00 45294050 APPLICATION OF SHORT LEG CAST $260.00 45295050 SPLINT APPLICATION - LONG LEG $150.00 45295150 SPLINT APPLICATION - SHORT LEG $125.00 45295300 STRAPPING - KNEE $125.00 45295400 STRAPPING - ANKLE/FOOT $125.00 45295500 STRAPPING - TOES $125.00 45295800 STRAPPING - UNNA BOOT $120.00 45297000 REM GAUNTLET, BOOT OR BODY CAS $125.00 45297050 REMOVE FULL ARM OR LEG CAST $125.00 45297100 REM SHOULDER OR HIP SPICA $260.00 45297400 WEDGING OF CAST NOT CLUBFOOT C $108.00 45297990 CASTING & STRAPPING (NEC) $271.00 45300000 DR ABSC/HEMATOMA NASAL INT $1,680.00 45300200 DR ABSC/HEMATOMA, NASAL SEPTUM $1,380.00 45303000 REMOVE NASAL FOREIGN BODY $71.00 45309010 CONTROL OF NOSE BLEED $128.00 45309030 CONTROL NASAL HEMORRH, ANT COM $238.00 45309050 INITIAL CONTROL OF NOSE BLEED $128.00 45315000 INSERT EMERGENCY AIRWAY $279.00 45315020 CHANGE OF WINDPIPE AIRWAY $324.00 45315050 LARYNGOSCOPY, IND; DIAGNOSTIC $152.00 45315200 DX LARYNGOSCOPY, NEWBORN $163.00 45315300 LARYNGOSCOPY W/FB REMOVAL $2,575.00 45316030 TRACHEOSTOMY, EMERG; TRANSTRAC $757.00 45316050 TRACHEOSTOMY, EMERG; CRICOTHYR $757.00 45317200 CLEARANCE OF AIRWAYS $45.00 45324210 THORACENTESIS FOR ASPIRATION $433.00 45324220 THORACENTESIS W/TUBE INSERT $548.00 45325510 INSERTION OF CHEST TUBE $819.00 45325540 THORACENTESIS FOR ASPIRATION $433.00 45325550 THORACENTESIS W/TUBE INSERT $548.00 45330100 PERICARDIOCENTESIS; INITIAL $590.00 45332100 INS/REPL TEMP TRANSV SC CARD E $4,110.00 45352010 REPAIR BLOOD VESSEL DIRECT; NECK $5,775.00 45352060 REPAIR BLOOD VESSEL DIRECT; UPR EXTRE $3,624.00 45352070 REPAIR BLOOD VESSEL DIRECT; HAND FINGE $3,624.00 45352260 REPAIR BLOOD VESSEL DIRECT; LWR EXTRE $2,704.00 45352261 RPR BLOOD VESSEL DIRECT LOWER EXTREM $3,011.00 45352361 REPAIR BLOOD VESSEL W/VEIN GRAFT UPPE $3,312.90 45360050 EXTREMITY VENOGRAM INJ $27.00 45361400 NS CATH - EXTREMITY ARTERY $27.00 45364000 BLOOD DRAW < 3 YRS FEM/JUGULAR $20.00 45364050 PHY BL DRAW < 3 YRS SCALP VEIN $17.00 45364060 PHY BL DRAW < 3 YRS OTHER VEIN $17.00 45364100 VENIPUNCTURE AGE 3 YRS/> PHYS $28.00 45364200 VEIN ACCESS CUTDOWN < 1 YR $17.00 45364250 VENIPUNCTURE, CUTDOWN; AGE 1+ $108.00 45364300 BLOOD TRANSFUSION PER DAY $819.00 45365550 INSERT NON-TUNNEL CV CATH $973.00 45365560 INSERT NON-TUNNEL CV CATH $2,310.00 45365690 INSERT PICC CATH $1,237.00 45365890 REMOVE TUNNELED CV CATHETER $757.00 45365900 REM TUNNELED CVAD W PORT/PUMP $1,136.00 45366000 ARTERIAL PUNCTURE, BLOOD FOR D $27.00 45366800 PLACE NEEDLE INTRAOSSEOUS INFU $324.00 45371950 THROMBOLYSIS, CEREBRAL, BY IV $324.00 45377850 LIGATE/DIVIDE/EXCISE VEIN 1 LEG $2,625.00 45383000 DR LN ABSCESS/INFECTION; SIMPL $1,082.00 45406500 REPAIR LIP $844.00 45408000 DRAIN ABSCESS/CYST OF MOUTH $160.00 45408040 REMOVAL, FOREIGN BODY, MOUTH $71.00 45408300 CLSD LACERATION, MOUTH VESTIB $284.00 45408310 CLSD LACERATION, MOUTH > 2.5CM $844.00 45412500 REPAIR TONGUE LACERATION $284.00 45412520 REP LACERAT-TONGUE FLR-MOUTH > 2.6/CP $1,313.00 45418000 DR ABSC, CYST, HEMATOM - DENTO $354.00 45418050 REM EMB FB FROM DENTOALV; SFT $2,163.00 45420000 DRAINAGE OF ABSCESS OF PALATE $293.00 45427000 I&D ABSCESS; PERITONSILLAR $284.00 45428090 REMOVE PHARYNX FOREIGN BODY $71.00 45432470 OPERATIVE UPPER GI ENDOSCOPY $964.00 45432479 OPERATIVE UPPER GI ENDOSCOPY $964.00 45432480 UPPR GI ENDOSCOPY/GUIDE WIRE $964.00 45437530 GASTRIC INTUBATION/ASPIR/LAVAG $163.00 45437600 CHANGE GASTROSTOMY TUBE $368.00 45437610 REPOSITION GASTROSTOMY TUBE $964.00 45437620 PERQ REPLACEMENT GTUBE NOT REQ REVJ $133.00 45437630 PERQ REPLACEMENT GTUBE REQ REVJ GST $293.00 45453070 PROCTOSIG, RIGID; W REM FB $1,839.00 45460400 INCISION OF RECTAL ABSCESS $2,578.00 45460500 INCISION OF ANAL ABSCESS $1,617.00 45460830 INCISE EXTERNAL HEMORRHOID $228.00 45469990 UNLISTED PROCEDURE ANUS $3,675.00 45490800 PERITONEOCENTESIS; INITIAL $649.00 45490810 PERITONEOCENTESIS; SUBSEQUENT $541.00 45490820 PERITONEOCENTESIS; INITIAL $649.00 45511000 DRAIN BLADDER BY NEEDLE $228.00 45511010 DRAIN BLADDER BY TROCAR/CATH $103.00 45511020 DRAIN BL W/CATH INSERTION $2,191.00 45517010 INSERT BLADDER CATHETER $71.00 45517020 INSERT TEMP BLADDER CATH $71.00 45517030 INS BLADDER CATH, COMPLEX $86.00 45517050 CHANGE OF CYSTOSTOMY TUBE; SIM $271.00 45542200 IRRIGATE CORPORA CAVERNOSA FOR $192.00 45544500 FORESKIN MANIPULATION $543.00 45547000 I & D EPIDIDYMIS, TESTIS/SCROT $1,839.00 45551000 DRAINAGE OF SCROTAL WALL ABSCE $1,266.00 45564050 I & D OF VULVA/PERINEUM $313.00 45564200 DRAINAGE OF GLAND ABSCESS $368.00 45583010 REMOVE IUD $1,111.00 45589990 UNLISTED PROC FEMALE GENITAL $163.00 45590250 FETAL NON-STRESS TEST $210.00 45593000 EPISIOTOMY OR VAGINAL REPAIR $1,406.00 45594090 VAGINAL DELIVERY ONLY -IN ER $2,029.00 45594140 DELIVERY OF PLACENTA $2,156.00 45622700 SPINAL FLUID TAP, DIAGNOSTIC $464.00 45622720 DRAIN CEREBRO SPINAL FLUID $464.00 45644000 NERVE BLOCK INJECTION $264.00 45644020 INJ ANESTH; FACIAL NERVE $324.00 45644050 INJ ANESTH ; GREATER OCCIPITAL $433.00 45644170 INJ ANESTH; AXILLARY NERVE $379.00 45644200 INJ ANESTH; INTERCOSTAL NERVE $477.00 45644210 INJ ANESTH; INTERCOST NRV, MUL $649.00 45644500 INJ ANESTH; OTHR PERIPHERAL NR $464.00 45652050 REMOVE FOREIGN BODY FROM EYE $99.00 45652100 REMOVE FOREIGN BODY FROM EYE $99.00 45652200 REMOVE FOREIGN BODY FROM EYE $99.00 45652220 REMOVE FOREIGN BODY FROM EYE $99.00 45677000 DRAIN ABSCESS, EYELID $433.00 45679380 REMOVE EMBEDDED FB EYELID $142.00 45690000 DRAIN EXTERNAL EAR LESION $357.00 45690200 DRAIN EXTERNAL AUDITORY CANAL $160.00 45692000 CLEAR OUTER EAR CANAL $71.00 45692050 REM FB EXT AUDITORY CANAL; W A $1,893.00 45692090 REMOVE IMPACTED EAR WAX UNILATERAL R $139.00 45692100 REMOVE IMPACTED EAR WAX $71.00 45901680 WOUND CLOSURE BY ADHESIVE $152.00 45904710 IMMUNIZATION ADM; 1 VACCINE $49.00 45904713 ADMIN PNEUMONIA VACCINE $39.00 45904720 IMMUNIZATION ADMIN; EA ADDTL $47.00 45907180 TD VACCINE >7, IM $60.00 45907320 ADMIN FLU VAC IN ER $39.00 45911050 GASTRIC INTUBATION/ASPIR/LAVAG $163.00 45924250 APPLY WALKER SHORT LEG CAST $324.00 45929500 CPR-CARDIOPULMONARY RESUSCITAT $487.00 45929530 TEMP TRANSCUTAN PACING $541.00 45929600 CARDIOVERSION $618.00 45929770 THROMBOLYSIS, CORON; IV INFUS $379.00 45963600 HYDRATION IV INFUSION, INITIAL $368.00 45963610 HYDRATE IV INFUSION, ADD-ON $378.00 45963650 INFUSION UP TO 1 HOUR $378.00 45963660 IV INFUSION EACH ADDTL $378.00 45963670 ADDTL SEQ IV INFUSION $378.00 45963680 THER/DIAG CONCURRENT INF $33.00 45963710 SC THER INFUSION, RESET PUMP ADDTL $378.00 45963720 THER/PROPH/DIAG INJ, SC/IM $39.00 45963730 MEDICATION ADMINISTRATION IA $222.00 45963740 IV PUSH INITIAL SUBSTANCE $222.00 45963750 IV PUSH NEW SUBSTANCE $222.00 45963760 TX/PRO/DX INJ NEW DRUG ADD-ON $222.00 45975970 DEBRIDE; DEVITAL TIS <20 CM CM $324.00 45991750 IPECAC ADMINISTRATION $120.00 45992120 O/P VISIT, EST PATIENT - LEV 2 $87.00 45992410 ER TRIAGE ASSESSMENT - OFFICE $77.00 45992810 ER LEVEL 1 $192.00 45992820 ER LEVEL 2 $281.00 45992830 ER LEVEL 3 $352.00 45992840 ER LEVEL 4 $496.00 45992850 ER LEVEL 5 $812.00 45992910 CRITICAL CARE; 30 - 74 MINUTES $973.00 45992920 CRITICAL CARE; EA ADDTL 30 MIN $784.00 46000012 PULSE OXIMETRY; SINGLE - OUTPATIENT ON $27.00 46940100 SPIROMETRY $108.00 46940106 PUL FUNCTION STUDY RD C SVCS $108.00 46940600 SPIROMETRY, PRE & POST MEDICAL $373.00 46940602 SPIROMETRY, PRE & POST MEDICAL (RDC SV $171.00 46941500 TOTAL VITAL CAPACITY $103.00 46942000 MAXIMAL BREATHING CAPACIT $65.00 46942400 FUNCTIONAL RESIDUAL CAPAC $118.00 46943750 FULL FLOW VOL LOOP $131.00 46947200 CD DIFFUSING CAPACITY $201.00 46947270 PULM FUNCTION TEST BY GAS $118.00 46947620 PULSE OXIMETRY; CONTINUOUS $126.00 46947700 CO2 EXPIRED GAS DETER $43.00 47925510 HEARING SCREEN $70.00 47925515 HEARING SCREEN $70.00 48929500 INITIAL RESUS/CODE BLUE/CPR $666.00 48930170 STRESS TEST; TRACING $507.00 48930176 STRESS TEST RDC SVC $507.00 48933030 TTE CONG ABN; COMPLETE $900.00 48933040 TTE CONG ABN; LIMITED/F-UP (BUBBLE) $487.00 48933060 TTE W/DOPPLER, COMPLETE $1,613.00 48933070 ECHO HEART; COMPLETE $900.00 48933071 ECHO HEART; COMPLETE WITH CONTRAST $900.00 48933120 ECHO TRANSESOPHAGEAL (OTH HOSP $1,863.00 48933200 DOPPLER ECHO PULSED $384.00 48933250 DOPPLER ECHO COLOR FLOW $330.00 48934584 L HEART ARTERY/VENTRICLE $11,511.00 48935100 LHC, RETROGR; PERCUTANEOUS $4,770.00 48935390 INJ FOR ART CONDUIT PATENCY $341.00 48935430 LV OR LA ANGIOGRAM DURING $267.00 48935440 INJ AORTOGRAM $165.00 48935450 INJ SEL COR ANGIOGRAPHY $784.00 48935560 SI COR PULM AO BYPASS $1,467.00 48935630 INJ SEL COR ANGIOGRAPHY $784.00 48935650 INJ CARD CATH LFT VENT/ATRIAL $946.00 48935660 INJ CARD CATH RGHT VENT/ATRIAL $946.00 48994400 NEWBORN RESUSCITATION $364.00 48994650 NEWBORN RESUSCITATION $364.00 51000010 BREATH ALCOHOL CONTENT $48.00 51000011 CORNELL BLOOD/URINE COLLECTION $21.00 51000012 DOT-BREATH ALCOHOL TEST $48.00 51000013 DOT-COLLECTION SITE $27.00 51000014 DOT-DRUG & ALCOHOL TEST $108.00 51000015 DOT-DRUG SCREEN $55.00 51000016 DOT-ONSITE WITH URINE DRUG $170.00 51000017 DOT-ONSITE WITHOUT UDT $129.00 51000018 DOT-PHYSICAL ONLY $108.00 51000019 DOT-PRE-EMPLOYMENT PHYS W/DRUG $156.00 51000020 DOT-SPECIMEN COLLECTION $21.00 51000021 DRUG SCREEN ON SITE $68.00 51000022 DRUG SCREEN/ALCOHOL TEST COM $96.00 51000023 FIT FOR WORK EXAM $197.00 51000024 FLU SHOT $21.00 51000025 HEPATITIS A $102.00 51000026 HEPATITIS B ON SITE $89.00 51000027 HEPATITIS B VACCINATION $82.00 51000028 HEPATITIS-A ON SITE $143.00 51000029 LEAD SCREENING $40.00 51000030 NON DOT PHYSICAL W/DRUG SCREEN $156.00 51000031 OFFICE VISIT $62.00 51000032 ON SITE DRUG SCREEN ADDITIONAL $27.00 51000033 POST ACCIDENT W/URING SCREEN $135.00 51000034 POST PLACEMENT PHYSICAL $68.00 51000035 POST PLACEMENT PHYSICAL W/URIN $117.00 51000036 RAPID DRUG SCREEN BATTERY $96.00 51000037 RETURNS TO WORK $48.00 51000038 TB-TEST ON SITE $21.00 51000039 TB-TETANUS SHOT $17.00 51000040 TWINRIX HEP A AND B $68.00 51000041 URINE DRUG SCREEN $48.00 51000042 WORKERS COMP INJURY EXAM $76.00 51000510 BRZ - PRE EMPLOYMENT SCREENING $82.00 51000511 BRZ - TEST DEVELPMNT 1/2 HR EA $55.00 51000512 BRZ - PRE EMPLOYMENT SCREENING $82.00 51000513 BRZ - TEST DEVELPMNT 1/2 HR EA $55.00 51365937 DECLOT VASCULAR DEVICE $324.00 51517200 ANITCARDINOGENIC INTO BLADDER $237.00 51517207 ANTICARCINO GENIC INTO BLADDER $237.00 51963607 IV INFUSION FOR HYDRATION $223.00 51963617 HYDRATE IV INFUSION, ADD-ON $39.00 51963657 INFUSION UP TO 1 HOUR $197.00 51963727 THER/PROPH/DIAG INJECTION $39.00 51992110 OUTPATIENT OFFICE VISIT - LEV1 $65.00 51992117 OUTPATIENT OFFICE VISIT-LEV 1 $65.00 61703360 MRI-TEMPOROMANDIBULAR JAW $1,174.00 61705400 MRI-FACE W/O CONTRAST $920.00 61705420 MRI ORBIT/FACE/NECK W/CONTRAST $883.00 61705430 MRI-FACE W/WO CONTRAST $1,575.00 61705440 MRA-HEAD WITHOUT CONTRAST $1,528.00 61705450 MRA-HEAD W/CONTRAST $1,528.00 61705460 MRA-HEAD W/WO CONTRAST $1,528.00 61705470 MRA-NECK W/O CONTRAST $1,528.00 61705480 MRA-NECK WITH CONTRAST $1,528.00 61705490 MRA-NECK W/WO COSTRAST $2,153.00 61705510 MRI-BRAIN WITHOUT CONTRAST $1,179.00 61705520 MRI-BRAIN WITH CONTRAST $1,131.00 61705530 MRI-BRAIN WITH & W/O CONTRAST $1,575.00 61715500 MRI-CHEST W/O CONTRAST $1,528.00 61715510 MRI-CHEST W/CONTRAST $1,528.00 61715520 MRI-CHEST W/WO CONTRAST $2,017.00 61715550 MRA-CHEST W/O CONTRAST $1,244.00 61715551 MRA-CHEST W/WO CONTRAST $1,244.00 61721410 MRI-CERVICAL SPINE W/O CONTRAST $1,173.00 61721420 MRI-CERVICAL SPINE W/CONTRAST $1,131.00 61721460 MRI-THORACIC SPINE W/O CONTRAST $1,173.00 61721470 MRI-THORACIC SPINE W/CONTRAST $1,131.00 61721480 MRI-LUMBAR SPINE W/O CONTRAST $1,126.00 61721490 MRI-LUMBAR SPINE W/CONTRAST $1,309.00 61721560 MRI-CERVICAL SPINE W&WO CONTRAST $1,575.00 61721570 MRI-THORACIC SPINE W/WO CONTRAST $1,575.00 61721580 MRI-LUMBAR SPINE W/WO CONTRAST $1,575.00 61721950 MRI-PELVIS W/O CONTRAST $1,152.00 61721960 MRI-PELVIS W/CONTRAST $1,104.00 61721970 MRI-PELVIS W/WO CONTRAST $1,575.00 61721980 MRA-PELVIS $736.00 61721981 MRA-PELVIS W/O CONTRAST $736.00 61721982 MRA-PELVIS W/WO CONTRAST $736.00 61721983 MRA-PELVIS WITH CONTRAST $736.00 61732180 MRI-UPR EXT W/O $1,167.00 61732181 MRI-UPPER EXTREMITY LEFT W/O C $1,167.00 61732182 MRI-UPR EXT W/O RIGHT $1,167.00 61732185 MRI-UPR EXT W/O BILATERAL $2,331.00 61732190 MRI-UPPER EXTREMITY $1,687.00 61732191 MRI-UPR EXT W LEFT $844.00 61732192 MRI-UPR EXT W RIGHT $844.00 61732195 MRI-UPPER EXTREMITY BILAT W/CO $1,687.00 61732200 MRI-UPR EXT W/WO $1,583.00 61732201 MRI-UPPER EXTREMITY LEFT W/WO $1,583.00 61732202 MRI-UPR EXT W/WO RIGHT $1,583.00 61732205 MRI-UPR EXT W/WO BILAT $3,167.00 61732210 MRI-JOINT UPR EXT W/O $1,179.00 61732211 MRI-JOINT UPR EXT W/O LT $1,179.00 61732212 MRI-JOINT UPR EXT W/O RT $1,179.00 61732215 MRI-JOINT UPR EXT W/O BILAT $1,883.00 61732220 MRI-JOINT UPR EXT W BILAT $2,207.00 61732221 MRI-JOINT UPR EXT W LT $1,372.00 61732222 MRI-JOINT UPR EXT W RT $1,372.00 61732225 MRI-JOINT UPR EXT W BILAT $2,207.00 61732230 MRI-JOINT UPR EXT W/WO BILAT $1,622.00 61732231 MRI-JOINT UPR EXT W/WO LT $1,575.00 61732232 MRI-JOINT UPR EXT W/WO RT $1,583.00 61732235 MRI-JOINT UPR EXT W/WO BILAT $1,622.00 61732250 MRA-UPR EXT W/WO CNT $1,298.00 61732251 MRA-UPR EXT W/WO CNT - LEFT $649.00 61732252 MRA-UPR EXT W/WO CNT - RIGHT $649.00 61732255 MRA-UPR EXT W/WO CNT-BILAT $1,298.00 61737180 MRI-LWR EXT W/O BILAT $1,883.00 61737181 MRI-LWR EXT W/O LEFT $1,176.00 61737182 MRI-LWR EXT W/O RIGHT $1,176.00 61737185 MRI-LWR EXT W/O BILAT $1,883.00 61737190 MRI-LWR EXT W BILAT $1,765.00 61737191 MRI-LWR EXT W LEFT $883.00 61737192 MRI-LWR EXT W RIGHT $883.00 61737195 MRI-LWR EXT W BILAT $1,765.00 61737200 MRI-LWR EXT W/WO BILAT $3,959.00 61737201 MRI-LOWER LEFT EXTREMITY W/WO $1,575.00 61737202 MRI-LWR EXT W/WO RIGHT $1,575.00 61737205 MRI-LWR EXT W/WO BILAT $3,959.00 61737210 MRI-JOINT LWR EXT W/O BIL $1,701.00 61737211 MRI-JOINT LWR EXT W/O LT $1,176.00 61737212 MRI - LOWER EXTREMITIES JNT W/O CONTRA $1,176.00 61737215 MRI-JOINT LWR EXT W/O BIL $1,701.00 61737220 MRI-JOINT LWR EXT W BILAT $2,654.00 61737221 MRI-JOINT LWR EXT W LT $1,327.00 61737222 MRI-JOINT UPPER EXT W RT $1,327.00 61737225 MRI-JOINT LWR EXT W BILAT $2,654.00 61737230 MRI-JOINT LWR EXT W/WO BILAT $3,167.00 61737231 MRI-JOINT LWR EXT W/WO LT $1,741.00 61737232 MRI-JOINT LWR EXT W/WO RT $1,575.00 61737235 MRI-JOINT LWR EXT W/ WO BILAT $3,167.00 61737250 MRA-LWR EXT W / WO CONTRAST $1,428.00 61737251 MRA-LWR EXT W/CNT - LEFT $1,428.00 61737252 MRA-LWR EXT W/CNT - RIGHT $1,428.00 61737253 MRA-LWR EXT W/O CNT - BILAT $1,428.00 61737254 MRA-LWR EXT W/O CNT - LEFT $1,428.00 61737255 MRA-LWR EXT W/CNT - BILAT $1,428.00 61737256 MRA-LWR EXT W/O CNT - RIGHT $1,428.00 61737257 MRA-LWR EXT W/WO CNT - BILAT $1,428.00 61737258 MRA-LWR EXT W/WO CNT - LEFT $1,428.00 61737259 MRA-LWR EXT W/WO CNT - RIGHT $1,428.00 61741810 MRI-ABDOMEN W/O CONTRAST $1,575.00 61741820 MRI-ABDOMEN W/CONTRAST $2,293.00 61741830 MRI-ABDOMEN W/WO CONTRAST $1,575.00 61741850 MRA-ABDOMEN W/CONTRAST $893.00 61755520 MRI-CARDIAC MORPH W/O CON $753.00 61755530 MRI-CARDIAC MORPH W/CONTR $753.00 61755540 MRI-CARDIAC FUNC COMPLETE $753.00 61755550 MRI-CARDIAC FUNC LIMITED $753.00 61755560 MRI-CARDIAC FLOW MAPPING $753.00 61763900 MRA-SPECTROSCOPY $753.00 61770581 MRI-BREAST LEFT W/CONTRAS $714.00 61770582 MRI-BREAST LEFT W/O CONTR $624.00 61770583 MRI-BREAST LEFT W/WO CONT $851.00 61770584 MRI-BREAST RIGHT W/CONTRA $714.00 61770585 MRI-BREAST RIGHT W/O CONT $624.00 61770586 MRI-BREAST RIGHT W/WO CON $851.00 61770590 MRI-BREAST BIL W/ WO CONTRAST $714.00 61770591 MRI-BREAST BIL W/CONTRAST $714.00 61770592 MRI-BREAST BIL W/CONTRAST $714.00 61770593 MRI-BREAST BIL W/O CONTRA $624.00 61770594 MRI-BREAST BIL W/O CONTRA $624.00 61770595 MRI-BREAST BIL W/WO CONTR $851.00 61770596 MRI-BREAST BIL W/WO CONTR $851.00 61770840 MRI-BM BLOOD SUPPLY $753.00 71000030 LEVEL 2 RECOVERY 1/2 HOUR $195.00 71000040 PEDIATRIC RECOVERY 1-60 MINS $499.00 71000041 PEDIATRIC RECOVERY ADD 30 MIN $69.00 71000060 RECOVERY RM 1 - 60 MINS $228.00 71000070 GI RECOVERY RM 1-30 MINS $195.00 71000080 GI RECOVERY RM 31-60 mins $195.00 71000120 RECOVERY RM 61-120 MINS $390.00 71000150 RECOVERY RM 121-150 MINS $390.00 71000180 RECOVERY RM 151-180 MINS $422.00 71000360 RECOVERY RM 4 TO 6 HOURS $487.00 71000390 EA ADDITOINAL 1/2 HR AFTER 6HR $46.00 72000000 VAGINAL DELIVERY $836.00 72000001 CESSARIAN DELIVERY $1,082.00 72000002 HIGH RISK DELIVERY PRO FEE $135.00 72594120 EXTERNAL CEPHALIC VERSION $2,029.00 72594125 EXTERNAL CEPHALIC VERSION $2,029.00 72994400 NEWBORN RESUSCITATION $364.00 73930050 EKG $135.00 73930056 EKG REPEAT SAME DAY SAME MD $135.00 73930057 EKG REPEAT SAME DAY DIFF MD $135.00 73930410 RHYTHM STRIP $65.00 73932240 ECG MONIT/REPRT UP TO 48 HRS $428.00 73932250 ECG UP TO 48 HRS RECORDING $374.00 73932260 24 HR. ECG W/SCAN;ANALYSIS W/R $395.00 74003990 HOME SLEEP TEST/TYPE 3 PORTABLE $200.00 74946600 POS AIRWAY PRESSURE CPAP $273.00 74957820 POLYSOM < 6 YRS 4> PARAMTRS $1,313.00 74957821 POLYSOM < 6 YRS 4> PARAMTRS $1,155.00 74957830 POLYSOM <6 YRS CPAP/BILVL $1,313.00 74957831 POLYSOM <6 YRS CPAP/BILVL $1,155.00 74958010 SLEEP STUDY UNATT W/ ANALYSIS $152.00 74958050 MSLT/MWT (MULT SLEEP LAT/MTN WAKE) $1,313.00 74958060 HSAT SLEEP STUDY UNAT & RESP EFF $1,313.00 74958070 SLEEP STUDY; ATT < 6 HRS $525.00 74958071 SLEEP STUDY; ATTENDED $630.00 74958080 POLYSOMNOGRAPHY SLEEP 1-3 PARA $1,298.00 74958100 POLYSOM < 6 HOURS $1,155.00 74958101 POLYSOM > 6 HOURS $1,313.00 74958110 POLYSOM CPAP 4 OR MORE < 6 HRS $1,155.00 74958111 POLYSOM CPAP 4 OR MORE < 6 HRS $1,155.00 74958112 POLYSOM CPAP 4 OR MORE PARM >6 HRS $1,313.00 74958160 EEG AWAKE AND DROWSY $378.00 74958190 EEG WHILE AWAKE & IN SLEEP $398.00 74958220 EEG DURING SLEEP ONLY $327.00 74958240 EEG ELECTROCEREBRAL SILENCE EVALUAT $211.00 75432590 EGD ENDO ULTRASOUND (OUTSIDE) $1,889.00 75432599 EGD ENDO ULTRASOUND (OUTSIDE) $1,889.00 75910100 ESOPHAGUS MOTILITY STUDY $630.00 75910340 GASTROESOPH REFLUX W NASAL PH $630.00 76231301 OB OBSERVATION 1ST HOUR $298.00 76231302 OB OBSERVATION ADDTL HOUR $27.00 76231401 POST PARTUM OBSERVATION 1ST HR $298.00 76231402 POST PARTUM OBSERVATION ADDTL HR $27.00 76233401 MED/SURG UNIT OBSERVATION 1ST HOUR $298.00 76233402 MED/SURG UNIT OBSERVATION ADDTL HOUR $27.00 76240701 LABOR & DELIVERY OBSERVATION 1ST HOUR $298.00 76240702 LABOR & DELIVERY OBSERVATION ADDTL HO $27.00 77000090 ADMIN PNEUMONIA VACCINE $39.00 77334001 FLU VACCINE $37.00 77904710 IMMUNIZATION ADM; 1 VACCINE $49.00 77904715 IMMUNIZATION ADM; 1 VACCINE $49.00 77904720 ADDTL IMMUNIZATION ADMINISTRAT $47.00 77904725 IMMUNIZATION ADMIN; EA ADDTL $47.00 77904730 IMMUNE ADMIN ORAL/NASAL $44.00 77G00081 FLU VACCINE (INPATIENT) $39.00 80100001 HEMODIALYSIS $649.00 80100002 DIALYSIS OTHER THAN HEMODIALYSIS $649.00 90907910 BEHAV HEALTH TRX/SVC PSYCH - NON PHYS $213.00 90907917 BEHAV HEALTH TRX/SVC PSYCH - NON PHYS $213.00 90907919 BEHAV HEALTH TRX/SVC PSYCH - NON PHYS $213.00 90907921 BEHAV HEALTH TRX/SVC PSYCH -CAHOKIA $213.00 90907922 BEHAV HEALTH TRX/SVC PSYCH -ALTON $213.00 90907927 BEHAV HEALTH TRX/SVC PSYCH - PHYSICIAN $213.00 90990870 IP ELECTROCONVULSIVE THERAPY $522.00 91907910 DIAG INTERVENTION (INTAKE) $213.00 91907911 DIAG INTERVENTION (INTAKE) - CAHOKIA $213.00 91907912 DIAG INTERVENTION (INTAKE) - ALTON $213.00 91908060 INDIV PSYCHOTHERAPY 45-50 MINS $271.00 91908340 PSYCH TX PATIENT & FAMILY 45 MINS $271.00 91908341 PSYCH TX PATIENT & FAM 45 MINS - CAHOKIA $271.00 91908342 PSYCH TX PATIENT & FAM 45 MINS - ALTON $271.00 91908347 INDIV THERAPY 45 MINS $271.00 91908460 FAMILY TX WITHOUT PATIENT $201.00 91908467 FAMILY TX WITHOUT PATIENT $201.00 91908470 FAMILY TREATMENT WITH PATIENT $201.00 91908477 FAMILY TREATMENT WITH PATIENT $201.00 91908530 GROUP THERAPY $98.00 91908531 GROUP THERAPY - CAHOKIA $98.00 91908532 GROUP THERAPY - ALTON $98.00 91909110 BIOFEEDBACK-U $216.00 91909111 BIOFEEDBACK - U $216.00 91909112 BIOFEEDBACK - U $216.00 91961160 NEUROBEHAVIOR STATUS EXAM $95.00 91990870 OP ELECTROCONVULSIVE THERAPY $522.00 91H00020 ALCOHOL AND/OR DRUG ASSESSEMENT $173.00 91H00040 ALCOHOL/DRUG SERVICES C&T PER 15 MINS $72.00 91H0005 ALCOHOL/DRUG GROUP COUNSELING $98.00 92590205 CONTRACTION STRESS TEST $286.00 92590250 FETAL MONITOR DAILY $324.00 92590255 FETAL NON STRESS TEST $372.00 92590505 FETAL MONITOR DAILY $324.00 9291200 FIBROSCAN-LIVER ELASTOGRAPHY $362.00 92938800 EXTRACRANIAL DUPLEX; BIL $739.00 92939220 EXTREMITY ARTERY SING; BIL $204.00 92939250 DUPLEX; LWR EXT ART; COMP-BIL $540.00 92939261 DUPLEX; LWR EXT ART; LTD-LT $935.00 92939262 DUPLEX; LWR EXT ART; LTD-RT $842.00 92939300 DUPLEX; UPR EXT ART; COMP-BIL $1,164.00 92939311 DUPLEX; UPR EXT ARTERY; LTD-LT $781.00 92939312 DUPLEX; UPR EXT ART; LTD-RT $781.00 92939700 DOPPLER-VENOUS EXT VEINS BILAT $1,399.00 92939710 DUPLEX; UPR EXT VEIN;LTD-LT $926.00 92939711 DUPLEX; LWR EXT VEIN; LTD-LT $926.00 92939712 DUPLEX; LWR EXT VEIN; LTD-RT $926.00 92939715 DUPLEX; LWR EXT VEIN; LTD-BILAT $973.00 92939750 DUPLEX; OTHER; COMP $1,273.00 92939760 DUPLEX ARTERIAL FLOW; LIMITED $195.00 92939780 DUPLEX A IVC IL/BPG; COMPLETE $517.00 92939790 DUPLEX; OTHER; LTD $702.00 92939800 DUPLEX FLOW PENILE V; COMPLETE $541.00 92963720 THER/PROPH/DIAG INJ, SC/IM $39.00 94000002 DIABETES INDIVIDUAL PER 30 MINUTES $87.00 94000004 GROUP NUTRITION THPY; EACH 30M $65.00 94000102 GROUP NUTRITION THPY; EACH 30M $65.00 94000103 DIABETES INDIVIDUAL PER 30 MINUTES $87.00 94021017 NEONATAL AIRWAY SUPPLY $11.00 94021019 PARTIAL DAY OF OXYGEN $40.00 94021027 RESP IPPB FILTER (SUPPLY) $7.00 94021030 RESP PEAK FLOW METER $29.00 94024052 NEBULIZER INITIAL TX $74.00 94024054 NEBULIZER, SUPPLY $14.00 94024077 PULSE OXIMETRY SETUP $33.00 94050003 CRYOPRECIPITATE EACH UNIT $80.00 94051089 UNLISTED CHEM; AMYLAST ISOENZY $16.00 94070014 IV INFUSION THRPY UP TO 1 HR $223.00 94110002 A IND. COUN 22 $104.00 94110071 ACTIVITY THERAPY $98.00 94110072 EDUCATIONAL TRAINING $98.00 94110073 GROUP THERAPY $98.00 94124009 MYOCARD PERSAN TINE W/O SP $681.00 94140001 CATH:HICKMAN $562.00 94140057 CONSCIOUS SEDATION $163.00 94140058 CONSCIOUS SEDATION; $163.00 94140125 INJECTION; INTRAVENE $55.00 94140129 IV PUSH INITIAL SUBSTANCE $222.00 94140141 LITHOTRIPSY $5,235.00 94140222 THER/PROPH/DIAG INJ, IA $148.00 94140223 THER/PROPH/DIAG INJ, SC/IM $39.00 94317200 PF/CATHETER ASPIRATION $170.00 94365110 THERAP APHERESIS; WBC'S $1,956.00 94365120 THERAP APHERESIS; RBC'S $1,956.00 94365130 THERAP APHERESIS; PLATELETS $1,956.00 94402024 BAG-CLAMP $6.00 94402033 BENZOIN SWAB STICK $4.00 94402042 BREAST PADS $6.00 94402055 CATH-DISP A BAG $20.00 94963607 IV INFUSION FOR HYDRATION $223.00 94963617 IV INFUSION FOR HYDRA ADDTL $200.00 94963657 INFUSION UP TO 1 HOUR $197.00 94963667 IV INFUSION EACH ADDTL $118.00 94963677 ADDTL SEQ IV INFUSION $197.00 94963687 CONCURRENT IV INFUSION 1+ HOUR $222.00 94963720 THER/PROPH/DIAG INJ, SC/IM $39.00 94963725 THER/PROPH/DIAG INJECTION $39.00 94963727 THER/PROPH/DIAG INJECTION $39.00 94963737 THER/PROPH/DIAG INJECTION $222.00 94963740 IV PUSH INITIAL SUBSTANCE $222.00 94963744 IV PUSH INITIAL SUBSTANCE $222.00 94963747 IV PUSH INITIAL SUBSTANCE $222.00 94963750 IV PUSH NEW SUBSTANCE $222.00 94963754 IV PUSH NEW SUBSTANCE $222.00 94963757 IV PUSH NEW SUBSTANCE $222.00 94963760 TX/PRO/DX INJ NEW DRUG ADD-ON $222.00 94963764 INJECTION IVP SAME DRUG ADD-ON $222.00 94991950 THERAPEUTIC PHLEBOTOMY $66.00 94991957 THERAPEUTIC PHLEBOTOMY $108.00 96003990 PF/HOME SLEEP TEST/TYPE 3 PORTABLE $131.00 96377850 PF/LIGATE/DIVIDE/EXCISE VEIN 1 LEG $158.00 96910100 PF/ESOPHAGUS MOTILITY STUDY $105.00 96910340 PF/GASTROESOPH REFLUX W NASAL PH $79.00 9691200 P/F LIVER ELASTOGRAPHY $42.00 96946600 PF/POS AIRWAY PRESSURE CPAP $63.00 96957820 PF/POLYSOM < 6 YRS 4> PARAMTRS $197.00 96957821 PF/POLYSOM < 6 YRS 4> PARAMTRS $197.00 96957830 PF/POLYSOM <6 YRS CPAP/BILVL $205.00 96957831 PF/POLYSOM <6 YRS CPAP/BILVL $197.00 96958010 PF/SLEEP STUDY UNATT W/ ANALYSIS $79.00 96958050 PF/MSLT/MWT (MULT SLEEP LAT/MTN WAKE) $95.00 96958060 PF/HSAT SLEEP STUDY UNAT & RESP EFF $158.00 96958070 PF/SLEEP STUDY; ATT < 6 HRS $100.00 96958071 PF/SLEEP STUDY; ATTENDED $100.00 96958100 PF/POLYSOM < 6 HOURS $197.00 96958101 PF/POLYSOM > 6 HOURS $197.00 96958111 PF/POLYSOM CPAP 4 OR MORE $205.00 97002970 PF/ LDCT FOR LUNG CA SCREEN $152.00 97100051 PF/FNA BX W/US GDN 1ST LES $76.00 97100060 PF/FNA BX W/US GDN EA ADDL $76.00 97100220 PF/FINE NEEDLE ASPIRATION W/IMAGE $210.00 97190830 PF/BX BREAST 1ST LESION U/S IMAGING $421.00 97190840 PF/BX BREAST EA LESION AFTER 1ST ADD-O $263.00 97191010 PF/OPEN - INCIS BREAST BX $620.00 97191030 PF/PERC BRST BX - AUTO VA/DEVICE $438.00 97191200 PF/REMOVAL OF BREAST LESION 1+ $915.00 97191250 PF/EXC BREAST LES BY N LOC; SINGLE $1,012.00 97191260 PF/EXC BREAST LES BY N LOC; EA ADDTL $343.00 97192810 PF/PERQ DEVICE BREAST 1ST IMAGE $436.00 97192820 PF/PERQ DEVICE BREAST EACH IMAGE $55.00 97192950 PF/PLACE BREAST CLIP PERCUT $186.00 97202060 PF/MUSCLE BX; PERC NDL $170.00 97202200 PF/BONE BX TR/NDL; SUPERF $209.00 97206000 PF/DRAIN/INJECT, SML JOINT/BURSA $111.00 97206051 PF/DRAIN/INJ WRIST/ELBOW/ANKLE LT $118.00 97206052 PF/DRAIN/INJ WRIST/ELBOW/ANKLE RT $118.00 97206060 PF/DRAIN/INJ INTER JOINT/BURSA W/US $108.00 97206100 PF/DRAIN/INJECT, MAJOR JOINT/BURS $152.00 97206101 PF/DRAIN/INJ SHOULDER/HIP/KNEE LT $152.00 97206102 PF/DRAIN/INJ SHOULDER/HIP/KNEE RT $152.00 97206105 PF/DRAIN/INJ SHOULDER/HIP/KNEE BILAT $152.00 97206110 PF/DRAIN/INJ MAJOR JOINT/BURSA W/US $126.00 97387920 PF/RA TRACER ID OF SENTINL NODE $158.00 97469990 PF/UNLISTED PROCEDURE ANUS $659.00 97475310 PF/CHOLANGIOGRM BILE/PANCR $47.00 97475440 PF/CHOLANGIOGRM STONE REM $315.00 97490834 PF/ADBOMINAL PARACENTESIS W/IMAGING $75.00 97494650 PF/FLUORO EXAM OF G/COLON TUBE $40.00 97516000 PF/INJ FOR CYSTOGRAM $396.00 97583010 PF/REMOVE IUD $163.00 97583400 PF/CATH & INTRO OF CONTRAST $82.00 97701100 PF/MANDIBLE MIN 4-VIEWS $27.00 97701300 PF/MASTOIDS MIN 3-VIEWS $39.00 97701400 PF/ZYGOMATIC ARCHES $21.00 97701500 PF/FACIAL BONES $28.00 97701600 PF/NASAL BONES $20.00 97702000 PF/ORBITS $30.00 97702200 PF/SINUSES $27.00 97702400 PF/SELLA TURCICA $26.00 97702500 PF/SKULL LIMITED $26.00 97702600 PF/SKULL $38.00 97703300 PF/T.M. JOINTS $27.00 97703360 PF/MRI-TEMPOROMANDIBULAR JAW $165.00 97703550 PF/PANOGRAPH (DENTAL) $22.00 97703600 PF/NECK SOFT TISSUE $20.00 97704500 PF/CT HEAD W/O CONTRAST $126.00 97704600 PF/CT HEAD W/CONTRAST $126.00 97704700 PF/CT HEAD W/O & W/CONTRAST $210.00 97704800 PF/CT - ORBIT SELLA MID/INNER EAR WO CO $142.00 97704810 PF/CT - ORBIT SELLA MID/INNER EAR W CONT $83.00 97704820 PF/CT - ORBIT SELLA MID/INNER EAR W & WO $120.00 97704860 PF/CT FACIAL BONES W/O CNTR $127.00 97704870 PF/CT MAXILLOFACIAL WITH CONTRAST $146.00 97704880 PF/CT MAXILLOFACIAL W&W/O CONTRST $158.00 97704900 PF/CT NECK THYROID W/O CONTRAST $143.00 97704910 PF/CT NECK THYROID W/CONTRAST $153.00 97704920 PF/CT NECK THYROID W/O & W $160.00 97704960 PF/CTA-HEAD $269.00 97704980 PF/CTA-NECK $196.00 97705400 PF/MRI-FACE W/O CONTRAST $210.00 97705420 PF/MRI ORBIT/FACE/NECK W/CONTRAST $322.00 97705430 PF/MRI-FACE W/WO CONTRAST $238.00 97705440 PF/MRA-HEAD WITHOUT CONTRAST $132.00 97705450 PF/MRA-HEAD W/CONTRAST $322.00 97705460 PF/MRA-HEAD W/WO CONTRAST $444.00 97705470 PF/MRA-NECK W/O CONTRAST $322.00 97705480 PF/MRA-NECK WITH CONTRAST $322.00 97705490 PF/MRA-NECK W/WO COSTRAST $444.00 97705510 PF/MRI-BRAIN WITHOUT CONTRAST $165.00 97705520 PF/MRI-BRAIN WITH CONTRAST $198.00 97705530 PF/MRI-BRAIN WITH & W/O CONTRAST $261.00 97710100 PF/CHEST SINGLE VIEW $20.00 97710200 PF/CHEST XRAY - 2 VIEW $24.00 97710210 PF/CHEST XRAY 2 VIEW W OBLIQUE $24.00 97710350 PF/CHEST INS/EXP $21.00 97710351 PF/CHEST SPECIAL STUDY $21.00 97710450 PF/CHEST SINGLE VIEW $20.00 97710460 PF/CHEST XRAY - 2 VIEW $24.00 97710470 PF/CHEST XRAY 3 VIEWS $24.00 97711001 PF/RIBS UNIL - 2 VIEWS LEFT $24.00 97711002 PF/RIBS UNIL - 2 VIEWS RIGHT $24.00 97711100 PF/RIBS-BILATERAL 3-VIEWS $29.00 97711101 PF/RIBS-LEFT 3-VIEWS $29.00 97711102 PF/RIBS-RIGHT 3-VIEWS $29.00 97711200 PF/STERNUM $22.00 97711300 PF/STERNOCLAVICULAR JOINT(S) $33.00 97712500 PF/CT CHEST W/O CONTRAST $129.00 97712600 PF/CT CHEST W/CONTRAST $58.00 97712700 PF/CT CHEST W/WO CONTRAST $153.00 97712750 PF/CT ANGIOGRAPHY CHEST $263.00 97715500 PF/MRI-CHEST W/O CONTRAST $161.00 97715510 PF/MRI-CHEST W/CONTRAST $322.00 97715520 PF/MRI-CHEST W/WO CONTRAST $251.00 97715551 PF/MRA-CHEST W/WO CONTRAST $322.00 97720200 PF/SPINE 1 VIEW CC $18.00 97720400 PF/CERVICAL SPINE 2/3V $24.00 97720500 PF/CERVICAL SPINE $34.00 97720520 PF/CERVICAL SPINE $41.00 97720690 PF/SCOLIOSIS SERIES $24.00 97720700 PF/THORACIS SPINE 2-VIEWS $24.00 97720720 PF/THORACIC SPINE 3-VIEWS $24.00 97720810 PF/X-RAY EXAM ENTIRE SPINE 1 VIEW $105.00 97720820 PF/X-RAY ENTIRE SPINE 2/3 VIEWS $158.00 97720830 PF/X-RAY EXAM ENTIRE SPINE 4/5 VIEWS $210.00 97720840 PF/X-RAY EXAM ENTIRE SPINE 6/> VIEWS $210.00 97721000 PF/LUMBAR SPINE 2-3 V $24.00 97721100 PF/LUMBOSACRAL SPINE MN 4VIE $34.00 97721200 PF/LUMBAR SPINE-BENDING VIEW $24.00 97721250 PF/CT C-SP W/O CONTRAST $129.00 97721260 PF/CT-C-SPINE WITH CONTRAST $129.00 97721280 PF/CT T-SP W/O CONTRAST $129.00 97721290 PF/CT T-SP WITH CONTRAST $42.00 97721300 PF/CT T-SP W AND W/O CONTRAST $142.00 97721310 PF/CT LUMBAR SPINE W/O $129.00 97721320 PF/CT LUMBAR SPINE WITH CONTRAST $135.00 97721330 PF/CT-LUMBAR SP W AND W/O CONTRAS $120.00 97721410 PF/MRI-CERVICAL SPINE W/O CONTRAST $176.00 97721420 PF/MRI-CERVICAL SPINE W/CONTRAST $187.00 97721460 PF/MRI-THORACIC SPINE W/O CONTRAST $177.00 97721470 PF/MRI-THORACIC SPINE W/CONTRAST $187.00 97721480 PF/MRI-LUMBAR SPINE W/O CONTRAST $165.00 97721490 PF/MRI-LUMBAR SPINE W/CONTRAST $187.00 97721560 PF/MRI-CERVICAL SPINE W&WO CONTRAST $284.00 97721570 PF/MRI-THORACIC SPINE W/WO CONTRAST $285.00 97721580 PF/MRI-LUMBAR SPINE W/WO CONTRAST $260.00 97721700 PF/PELVIS $20.00 97721920 PF/CT PELVIS W/O C $122.00 97721930 PF/CT PELVIS W C $129.00 97721940 PF/CT PELVIS W/O & W $134.00 97721950 PF/MRI-PELVIS W/O CONTRAST $161.00 97721960 PF/MRI-PELVIS W/CONTRAST $322.00 97721970 PF/MRI-PELVIS W/WO CONTRAST $250.00 97721980 PF/MRA-PELVIS $322.00 97722020 PF/SACROILIAC JOINTS $22.00 97722200 PF/SACRUM AND/OR COCCYX $20.00 97722400 PF/MYELOGRAPHY CERVICAL $95.00 97722550 PF/MYELOGRAPHY THORACIC $95.00 97722650 PF/MYELOGRAPHY LUMBOSACRAL $95.00 97730000 PF/CLAVICLE - BILAT $19.00 97730001 PF/CLAVICLE - LEFT $19.00 97730002 PF/CLAVICLE - RIGHT $19.00 97730100 PF/SCAPULA - BILAT $20.00 97730101 PF/SCAPULA - LEFT $20.00 97730102 PF/SCAPULA - RIGHT $20.00 97730300 PF/SHOULDER - BILATERAL $21.00 97730301 PF/SHOULDER - LEFT $21.00 97730302 PF/SHOULDER - RIGHT $21.00 97730401 PF/ARTHROGRAM - SHOULDER LEFT $60.00 97730402 PF/ARTHROGRAM - SHOULDER RT $60.00 97730405 PF/ARTHROGRAM-SHOULDER BILAT $60.00 97730500 PF/A C JOINTS $23.00 97730600 PF/HUMERUS - BILAT $20.00 97730601 PF/HUMERUS - LEFT $20.00 97730602 PF/HUMERUS - RIGHT $20.00 97730700 PF/ELBOW 2V - BILAT $17.00 97730701 PF/ELBOW 2V - LEFT $17.00 97730702 PF/ELBOW 2V- RIGHT $17.00 97730800 PF/ELBOW 3V - BILAT $20.00 97730801 PF/ELBOW 3V - LEFT $20.00 97730802 PF/ELBOW 3V - RIGHT $20.00 97730855 PF/ARTHROGRAM-ELBOW $50.00 97730900 PF/FOREARM $18.00 97730901 PF/FOREARM - LEFT $18.00 97730902 PF/FOREARM - RIGHT $18.00 97731100 PF/WRIST 3V- BILAT $20.00 97731101 PF/WRIST 3V - LEFT $20.00 97731102 PF/WRIST 3V- RIGHT $20.00 97731151 PF/ARTHROGRAM-WRIST LEFT $60.00 97731152 PF/ARTHROGRAM-WRIST RIGHT $60.00 97731155 PF/ARTHROGRAM-WRIST BILATERAL $60.00 97731300 PF/HANDS (BOTH) $20.00 97731301 PF/HAND - LEFT $20.00 97731302 PF/HAND - RIGHT $20.00 97731400 PF/FINGER LEFT HAND-THUMB $16.00 97731401 PF/FINGER LEFT HAND - 2ND DIGIT $16.00 97731402 PF/FINGER LEFT HAND - 3RD DIGIT $16.00 97731403 PF/FINGER LEFT HAND-4TH DIGIT $16.00 97731404 PF/FINGER LEFT HAND-5TH DIGIT $16.00 97731405 PF/FINGER RIGHT HAND-THUMB $16.00 97731406 PF/FINGER RIGHT HAND-2ND DIGIT $16.00 97731407 PF/FINGER RIGHT HAND - 3RD DIGIT $16.00 97731408 PF/FINGER RIGHT HAND-4TH DIGIT $16.00 97731409 PF/FINGER RIGHT HAND-5TH DIGIT $16.00 97732000 PF/CT EXT UPPER W/O BILAT $122.00 97732001 PF/CT EXT UPPER W/O LT $122.00 97732002 PF/CT EXT UPPER W/O RT $122.00 97732010 PF/CT ARM WITH CONTRAST - BILAT $129.00 97732011 PF/CT ARM WITH CONTRAST - LEFT $129.00 97732012 PF/CT ARM WITH CONTRAST - RIGHT $129.00 97732021 PF/CT EXT UPPER WO & W LT $134.00 97732022 PF/CT EXT UPPER WO & W RT $134.00 97732025 PF/CT EXT UPPER W/O & W BIL $134.00 97732060 PF/CT STERNOCLAVICLE $251.00 97732180 PF/MRI-UPR EXT W/O $149.00 97732181 PF/MRI-UPPER EXTREMITY LEFT W/O C $210.00 97732182 PF/MRI-UPR EXT W/O RIGHT $210.00 97732185 PF/MRI-UPR EXT W/O BILATERAL $149.00 97732190 PF/MRI-UPPER EXTREMITY $322.00 97732200 PF/MRI-UPR EXT W/WO $238.00 97732201 PF/MRI-UPPER EXTREMITY LEFT W/WO $238.00 97732202 PF/MRI-UPR EXT W/WO RIGHT $238.00 97732205 PF/MRI-UPR EXT W/WO BILAT $238.00 97732210 PF/MRI-JOINT UPR EXT W/O $210.00 97732211 PF/MRI-JOINT UPR EXT W/O LT $210.00 97732212 PF/MRI-JOINT UPR EXT W/O RT $210.00 97732215 PF/MRI-JOINT UPR EXT W/O BILAT $150.00 97732220 PF/MRI-JOINT UPR EXT W BILAT $179.00 97732221 PF/MRI-JOINT UPR EXT W LT $179.00 97732222 PF/MRI-JOINT UPR EXT W RT $179.00 97732230 PF/MRI-JOINT UPR EXT W/WO BILAT $238.00 97732231 PF/MRI-JOINT UPR EXT W/WO LT $238.00 97732232 PF/MRI-JOINT UPR EXT W/WO RT $238.00 97732250 PF/MRA-UPR EXT W/WO CNT $322.00 97735010 PF/HIP-UNILATERAL ONE VIEW $152.00 97735020 PF/X-RAY HIP UNI 2-3 VIEWS - RIGHT $105.00 97735021 PF/X-RAY HIP UNI 2-3 VIEWS - LEFT $105.00 97735101 PF/HIP 2V- LEFT $24.00 97735102 PF/HIP 2V- RIGHT $24.00 97735200 PF/HIP-BILATERAL $28.00 97735210 PF/X-RAY HIPS BI 2 VIEWS $28.00 97735251 PF/ARTHROGRAM-HIP LEFT $61.00 97735252 PF/ARTHROGRAM-HIP RIGHT $61.00 97735255 PF/ARTHROGRAM-HIP BILATERAL $20.00 97735300 PF/HIP NAILING $55.00 97735500 PF/FEMUR $24.00 97735501 PF/FEMUR - 2V LEFT $20.00 97735502 PF/FEMUR - 2V RIGHT $20.00 97735505 PF/FEMUR - BILAT $20.00 97735510 PF/X-RAY OF FEMUR 1 VIEW $105.00 97735520 PF/X-RAY OF FEMUR 2 />VIEWS BILAERAL $105.00 97735521 PF/X-RAY OF FEMUR 2 />VIEWS LEFT $105.00 97735522 PF/X-RAY OF FEMUR 2 />VIEWS RIGHT $105.00 97735601 PF/KNEE - 2V LEFT $20.00 97735602 PF/KNEE - 2V RIGHT $20.00 97735605 PF/KNEE - BILAT $20.00 97735620 PF/KNEE 3V - BILAT $21.00 97735621 PF/KNEE 3V - LEFT $21.00 97735622 PF/KNEE 3V - RIGHT $21.00 97735650 PF/KNEES STANDING BILATERAL $23.00 97735800 PF/ARTHROGRAM - KNEE BILAT $61.00 97735801 PF/ARTHROGRAM - KNEE LEFT $61.00 97735802 PF/ARTHROGRAM - KNEE RIGHT $61.00 97735900 PF/TIBIA & FIBULA BILAT $20.00 97735901 PF/TIBIA & FIBULA LEFT $20.00 97735902 PF/TIBIA & FIBULA RIGHT $20.00 97736100 PF/ANKLE 3+VIEWS BILAT $20.00 97736101 PF/ANKLE 3+ VIEWS LEFT $20.00 97736102 PF/ANKLE 3+ VIEWS RIGHT $20.00 97736150 PF/ARTHROGRAM-ANKLE $18.00 97736200 PF/FOOT 2V BILAT $18.00 97736201 PF/FOOT - LEFT 2 VIEWS $18.00 97736202 PF/FOOT 2V RIGHT $18.00 97736300 PF/FOOT 3V BILAT $20.00 97736301 PF/FOOT 3V LEFT $20.00 97736302 PF/FOOT 3V RIGHT $20.00 97736500 PF/OSCALSIS BILAT $18.00 97736501 PF/OSCALSIS LEFT $18.00 97736502 PF/OSCALSIS RIGHT $18.00 97736600 PF/TOE(S) $15.00 97736601 PF/TOE - LEFT FOOT - 2ND $15.00 97736602 PF/TOE - LEFT FOOT - 3RD $15.00 97736603 PF/TOE-LEFT FOOT-4TH $15.00 97736604 PF/TOE-LEFT FOOT-5TH $15.00 97736605 PF/TOE-RIGHT FOOT-GREAT $15.00 97736606 PF/TOE-RIGHT FOOT-2ND $15.00 97736607 PF/TOE-RIGHT FOOT-3RD $15.00 97736608 PF/TOE-RIGHT FOOT-4TH $15.00 97736609 PF/TOE-RIGHT FOOT-5TH $15.00 97737000 PF/CT EXT LOWER W/O BIL $122.00 97737001 PF/CT EXT LOWER W/O LT $122.00 97737002 PF/CT EXT LOWER W/O RT $122.00 97737010 PF/CT-LWR EXT W CONTRAST - BILAT $129.00 97737011 PF/CT-LWR EXT W CONTRAST - LEFT $129.00 97737012 PF/CT-LWR EXT W CONTRAST - RIGHT $129.00 97737020 PF/CT EXT LOWER W/O&W BIL $135.00 97737021 PF/CT EXT LOWER W/O&W LT $135.00 97737022 PF/CT EXT LOWER W/O & W RT $135.00 97737025 PF/CT EXT LOWER W/O & W BIL $135.00 97737065 PF/CTA LOWER EXT LEFT $251.00 97737066 P/F CTA LOWER RIGHT $251.00 97737067 PF/CTA LOWER EXT BI $251.00 97737180 PF/MRI-LWR EXT W/O BILAT $184.00 97737181 PF/MRI-LWR EXT W/O LEFT $184.00 97737182 PF/MRI-LWR EXT W/O RIGHT $184.00 97737191 PF/MRI-LWR EXT W LEFT $322.00 97737192 PF/MRI-LWR EXT W RIGHT $322.00 97737200 PF/MRI-LWR EXT W/WO BILAT $238.00 97737201 PF/MRI-LOWER LEFT EXTREMITY W/WO $238.00 97737202 PF/MRI-LWR EXT W/WO RIGHT $238.00 97737210 PF/MRI-JOINT LWR EXT W/O BIL $273.00 97737211 PF/MRI-JOINT LWR EXT W/O LT $242.00 97737212 PF/MRI-JOINT LWR EXT W/O RT $242.00 97737220 PF/MRI-JOINT LWR EXT W BILAT $180.00 97737221 PF/MRI-JOINT LWR EXT W LT $180.00 97737222 PF/MRI-JOINT UPPER EXT W RT $180.00 97737231 PF/MRI-JOINT LWR EXT W/WO LT $238.00 97737232 PF/MRI-JOINT LWR EXT W/WO RT $238.00 97737235 PF/MRI-JOINT LWR EXT W/ WO BILAT $238.00 97740000 PF/ABDOMEN (KUB) $20.00 97740180 PF/ABDOMEN 1 VIEW (KUB) $20.00 97740190 PF/ABDOMEN 2 VIEWS $50.00 97740200 PF/ABD SUP & UP/OBSTRCT $29.00 97740210 PF/ABDOMEN 3 VIEWS $50.00 97740220 PF/COMP ACUTE ABD (W CHEST) $74.00 97741500 PF/CT ABDOMEN W/O CONTRAST $131.00 97741600 PF/CT ABDOMEN W/CONTRAST $142.00 97741700 PF/CT ABD W/O & W $155.00 97741749 PF/CT ANGIO ABD & PELV W/WO DYE $312.00 97741750 PF/CT ANGIO ABDOMEN W/WO DYE $242.00 97741760 PF/CT ABD & PELVIS W/O CONTRAST $188.00 97741770 PF/CT ABD & PELVIS W/ CONTRAST $196.00 97741780 PF/CT ABD & PELVIS 1+SECTION/REG $218.00 97741810 PF/MRI-ABDOMEN W/O CONTRAST $162.00 97741820 PF/MRI-ABDOMEN W/CONTRAST $193.00 97741830 PF/MRI-ABDOMEN W/WO CONTRAST $250.00 97742200 PF/ESOPHOGRAM $131.00 97742300 PF/BARIUM SWALLOW $59.00 97742460 PF/UPPER GI SERIES $78.00 97742500 PF/SMALL BOWEL SERIES $53.00 97742700 PF/BARIUM ENEMA $78.00 97742800 PF/BARIUM ENEMA WITH AIR CONTRAST $110.00 97743000 PF/CHOLANGIOGRAM-OR $53.00 97743050 PF/CHOLANGIOGRM BILE/PANCR $47.00 97744300 PF/CYSTOGRAM $38.00 97744500 PF/URETHROCYSTOGRAPH $238.00 97744550 PF/CYSTOGRAM (VOIDING) $39.00 97747400 PF/HYSTERIOSALPINGOGRAM $43.00 97759890 PF/CT ABSCESS DRAIN KIDNEY $168.00 97760000 PF/C-ARM (FLUORO UP TO 1 HR) $20.00 97760800 PF/FISTULAGRAM-SINUS TRK STU $63.00 97760980 PF/MAMMOGRAM BIOPSY SPECIMEN $19.00 97760981 PF/MAMMOGRAM BIOPSY SPEC - LEFT $19.00 97760982 PF/MAMMOGRAM BIOPSY SPEC - RIGHT $19.00 97761000 PF/TOMOGRAPHY SNGPLNBDYSC $65.00 97763760 PF/3D RENDER W/O POSTPROCESS $24.00 97763770 PF/3D RENDER W POSTPROCESS $95.00 97763800 PF/CT LIMITED OR FOLLOW-UP STUDY $108.00 97764970 PF/UNLISTED CT $161.00 97765360 PF/NECK - SOFT TISSUE $61.00 97766040 PF/CHEST ULTRASOUND $61.00 97766410 PF/BREAST - BILAT $149.00 97766411 PF/BREAST - LEFT $60.00 97766412 PF/BREAST - RIGHT $60.00 97766420 PF/BREAST - BREAST UNI LIMITED $60.00 97766421 PF/BREAST - LEFT $60.00 97766422 PF/BREAST - RIGHT $60.00 97766425 PF/BREAST - BILAT $120.00 97766450 PF/BREAST - BILAT $60.00 97766451 PF/BREAST - LEFT $60.00 97766452 PF/BREAST - RIGHT $60.00 97767000 PF/ABDOMEN MULTI ORGAN $90.00 97767050 PF/ABDOMEN LIMITED $66.00 97767700 PF/KIDNEY COMPLETE (ABDO) $82.00 97767750 PF/AORTA DUPLEX SCAN $66.00 97768010 PF/ULTRASOUND PREGNANCY <14 WEEKS $108.00 97768050 PF/PREGNANCY > THAN 14 WKS 1 $107.00 97768120 PF/OB COMPLETE ADDTL GESTATION $192.00 97768150 PF/OB LIMITED $70.00 97768160 PF/OB FOLLOWUP - ABNORMAL $92.00 97768170 PF/TRANSVAGINAL OB $82.00 97768180 PF/BIOPHYSICAL PROFILE $114.00 97768300 PF/TRANSVAGINAL NON-OB ULTRASOUND $77.00 97768560 PF/PELVIC GENERAL $77.00 97768570 PF/PELVIC LIMITED $44.00 97768700 PF/TESTICULAR US $71.00 97768720 PF/PROSTATE ULTRASOUND $81.00 97768811 PF/EXTREMITY LEFT NON-VAS COMPLETE $65.00 97768812 PF/EXTREMITY RIGHT NON-VAS COMPLETE $65.00 97768815 PF/EXTREMITY-BILAT NON-VAS COMPLETE $65.00 97768825 PF/EXTREMITY NON-VAS, LIMITED $236.00 97769420 PF/US GUIDED NEEDLE PLACEMENT $76.00 97770010 PF/FLUOROGUIDE FOR VEIN DEVICE $216.00 97770020 PF/NEEDLE BX/ASPIRATION FLUOROSC $61.00 97770030 PF/FLUORO-GUIDANCE(ESI) $66.00 97770120 PF/CT GUIDED NEEDLE BIOPSY $123.00 97770510 PF/CAD DIAGNOSTIC MAMMOGRAPHY $82.00 97770520 PF/CAD SCREENING MAMMOGRAPHY $82.00 97770531 PF/SINGLE INJ GALACTOGRAM LEFT $137.00 97770532 PF/SINGLE INJ GALACTOGRAM RIGHT $137.00 97770535 PF/SINGLE GALACTOGRAM BILAT $137.00 97770550 PF/MAMMOGRAM-UNILATERAL-DIGITIAL $76.00 97770551 PF/MAMMOGRAM DIAG LEFT - DIGITAL $76.00 97770552 PF/MAMMOGRAM DIAG - RIGHT - DIGITIAL $76.00 97770560 PF/MAMMOGRAM DIAG-BILATERAL - DIGITAL $93.00 97770570 PF/MAMMOGRAM SCREENING - DIGITIAL $79.00 97770571 PF/MAMMOGRAM SCREENING - LT ONLY-DIG $79.00 97770572 PF/MAMMOGRAM SCREENING - RT ONLY-DIG $79.00 97770630 P/F BREAST TOMOSYNTHESIS BI $73.00 97770631 P/F BREAST BREAST TOMOSYNTHESIS LEFT $73.00 97770632 P/F BREAST TOMOSYNTHESIS RIGHT $73.00 97770650 PF/DIAGNOSTIC MAMMOGRAPHY LEFT $82.00 97770651 PF/DIAGNOSTIC MAMMOGRAPHY RIGHT $82.00 97770651 PF/DIAGNOSTIC MAMMOGRAPHY RIGHT $82.00 97770652 PF/DIAGNOSTIC MAMMOGRAPHY UNILATERA $164.00 97770660 PF/DIAGNOSTIC MAMMOGRAPHY BILATERAL $164.00 97770670 PF/SCREENING MAMMOGRAPHY BILATERAL $164.00 97770672 P/F SCR MAMMO BI INCL CAD LEFT $73.00 97770673 P/F SCR MAMMO BI INCL CAD LEFT $73.00 97770720 PF/BONE AGE STUDIES $21.00 97770730 PF/SCANOGRAM $29.00 97770750 PF/METASTATIC SERIES $60.00 97770780 PF/BONE DENSITY $27.00 97770800 PF/ DXA BONE DENSITY AXIAL 1+ SITES $284.00 97770810 PF/DXA BONE DENSITY/PERIPHERAL 1+ SITES $284.00 97770850 PF/DXA BONE DENSITY STUDY $284.00 97780120 PF/THYROID SCAN W UPTK SNGL $55.00 97780138 PF/THYROID SCAN TC $55.00 97780140 PF/THYROID IMAGING W/BLOOD FLOW $57.00 97780700 PF/PARATHYROID $92.00 97781950 PF/LYMPH NODE SCINTIGRAPHY $263.00 97782050 PF/HEMANGIOMA SCAN/LABLD RBC $80.00 97782150 PF/LIVER AND SPLEEN SCAN (STATIC) $55.00 97782230 PF/HEPATOBILIARY SCAN (DUCT) $93.00 97782260 PF/HEPATOBILIARY SCAN W GALLBLADDER $79.00 97782640 PF/GASTRIC EMPTYING STUDY $86.00 97783060 PF/BONE SCAN; WHOLE BODY $96.00 97783150 PF/THREE PHASE BONE SCAN $113.00 97784520 PF/HT MUSCLE IMAGE SPECT, MULTIPL $173.00 97784720 PF/HEART-MUGA $112.00 97785790 PF/ LUNG VENTILATION IMAGING $210.00 97785800 PF/LUNG SCAN-PERFUSION $83.00 97785820 PF/LUNG VENT & PERF IMAGING $117.00 97785940 PF/LUNG VENT IMAGING; GAS; MULT $59.00 97787070 PF/RENAL SCAN W/VASCULAR FLO $106.00 97788050 PF/GALLIUM LIMITED RETURN $315.00 97850608 PF/BLOOD SMEAR INTERP LC# 005300 $191.00 97850978 PF/BONE MARROW INTERPRETATION $80.00 97860788 PF/PHYS BB SVC (TRANS REAC) $82.00 97860798 PF/PHYS BB SVC (DEVIAT AUTH) $82.00 97881048 PF/CYTOPATHOLOGY;FLUIDS $60.00 97881088 PF/CYTOPATH; CONCENTRATE TECH $49.00 97881128 PF/CYTOPATH;CELL ENHANCE $87.00 97881129 PF/CYTOPATH; CELL ENHANCE $84.00 97881258 PF/CYTOPATHOLOGY; FORENSIC $92.00 97881419 PF/CYTOPATH C/V INTERPRET $49.00 97881428 PF/CP CERV/VAGINAL ATL; MANUAL SCREEN $49.00 97881618 PF/CYTOPATH SMEAR; OTHER SOURCE $49.00 97881628 PF/CYTOPATH SMEAR;OTHER SOURCE $70.00 97881728 PF/CYTOPATHOLOGY EVAL OF FNA $49.00 97881729 PF/CYTOPATHOLOGY EVAL OF FNA $49.00 97881738 PF/CYTOPATH EVAL;FNA;REPORT $108.00 97881759 PF/CYTOPATH; C/V/ THIN PREP; A $58.00 97881828 PF/CELL MARKER STUDY $60.00 97881899 PF/FLOW CYTOMETRY INTERP 16 & > MARKE $74.00 97882918 PF/CG;MCG;INT & REP $49.00 97883008 PF/SURGICAL PATH;GROSS LEVEL 1 $27.00 97883028 PF/SURGICAL PATH;GR;MICRO II $27.00 97883048 PF/SURGICAL PATH;GR;MICRO III $39.00 97883058 PF/SURGICAL PATH';GR;MIRCRO IV $60.00 97883078 PF/SURGICAL PATH;GR;MICRO V $152.00 97883098 PF/SURGICAL PATH;GR;MICRO VI $190.00 97883118 PF/DECALCIFY TISSUE $27.00 97883128 PF/SPECIAL STAINS;GRP 1 $55.00 97883138 PF/SPECIAL STAINS;GRP 2 $27.00 97883148 PF/HISTO CHEMICAL STAIN $39.00 97883188 PF/CHEMICAL HISTO CHEMISTRY $49.00 97883198 PF/ENZYME HISTO CHEMISTRY $49.00 97883218 PF/CONSULTATION & REPORT ON SLIDE $147.00 97883238 PF/REF CONSULT WITH SLIDE PREP $158.00 97883258 PF/COMPREHENSIVE CONSULT $173.00 97883298 PF/PATH CONSULT DURING SURGERY $147.00 97883318 PF/PATH CONSULT INTRA OP; 1 BLOC $103.00 97883328 PF/PATH CONSULT INTRAOP;ADD'L $60.00 97883338 PF/INTRAOP CYTO PATH CONSULT, 1 $82.00 978834109 PF/IMMUNOHISTOCHEMISTRY EA ADD ANTB $35.00 97883419 PF/IMMUNOHISTOCHEMISTRY EA ADD ANTB $35.00 97883428 PF/IMMUNOHISTOCHEMISTRY $77.00 97883468 PF/IMMUNOFLUORESCENT DIRECT $82.00 97883488 PF/ELECTRON MICROSCOPY $158.00 97883608 PF/MANUAL TUMOR IM HISTOCHEM, EA $87.00 97883618 PF/MORPHOMETRIC ANLYS EA AB QT $87.00 97883658 PF/INSITU HYBRIDATION (FISH) $87.00 97883688 PF/MORPHOMETRIC ANLYSIS INSITU $98.00 97883888 PF/TISS EX MOLECUL STDY ADD-ON $39.00 97938800 PF/EXTRACRANIAL DUPLEX; BIL $216.00 97939220 PF/EXTREMITY ARTERY SING; BIL $135.00 97939250 PF/DUPLEX; LWR EXT ART; COMP-BIL $238.00 97939261 PF/DUPLEX; LWR EXT ART; LTD-LT $347.00 97939262 PF/DUPLEX; LWR EXT ART; LTD-RT $347.00 97939300 PF/DUPLEX; UPR EXT ART; COMP-BIL $487.00 97939311 PF/DUPLEX; UPR EXT ARTERY; LTD-LT $347.00 97939312 PF/DUPLEX; UPR EXT ART; LTD-RT $347.00 97939700 PF/DOPPLER-VENOUS EXT VEINS BILAT $347.00 97939711 PF/DUPLEX; LWR EXT VEIN; LTD-LT $347.00 97939712 PF/DUPLEX; LWR EXT VEIN; LTD-RT $347.00 97939715 PF/DUPLEX; LWR EXT VEIN; LTD-BILAT $347.00 97939750 PF/DUPLEX; OTHER; COMP $487.00 97939760 PF/DUPLEX ARTERIAL FLOW; LIMITED $108.00 97939790 PF/DUPLEX; OTHER; LTD $347.00 97940108 PF/PUL FUNCTIONS STUDIES $65.00 97940608 PF/PUL FUNCTION W/BRONCHO $41.00 97941508 PF/TOTAL VITAL CAPACITY $49.00 97942008 PF/MAXIMA BREATHING CA $41.00 97943758 PF/FUL FLOW VOL LOOP $38.00 97946200 PF/PULMONARY STRESS TEST/SIMPLE $239.00 97946201 PF/PULMONARY STRESS TEST/SIMPLE $239.00 97947208 PF/CO DIFFUSING CAPACITY $201.00 97947278 PF/PULM FUNCTION TEST BY GAS $39.00 97947708 PF/CO2 EXP GAS DETER $33.00 97963720 PF/THER/PROPH/DIAG INJ, SC/IM $44.00 97G02790 PR/TOMOSYNTHESIS MAMMO LEFT $95.00 97G02791 PR/TOMOSYNTHESIS MAMMO RIGHT $95.00 97G02792 PR/TOMOSYNTHESIS MAMMO BILATERAL $95.00 98100608 PF/DRAINAGE SKIN ABSCESS (SIMPLE) $160.00 98100618 PF/DRAINAGE SKIN ABCESS (MULT) $287.00 98100808 PF/DRAINAGE PILONDIDAL CYST $165.00 98101208 PF/REMOVE FOREIGN BOBY; SIMPLE $158.00 98101218 PF/INC & REM FB, SQ; COMPLICATED $284.00 98101408 PF/DRAINAGE OF HEMATOMA/FLUID $209.00 98101608 PF/PUNCTURE ABSCESS/HEMA/CYST $168.00 98110428 PF/DEBRIDE SKIN/TISSUE $90.00 98110458 PF/DEBRIDE SKIN/TISSUE ADD-ON =<20 SQ C $61.00 98112008 PF/REMOVAL SKIN TAGS $112.00 98113008 PF/SHAVE LES, T/A/L; 0.5CM/< $44.00 98113018 PF/SHAVE LES, T/A/L; 0.6-1.0 CM $77.00 98113028 PF/SHAVE LES, T/A/L; 1.1-2.0 CM $92.00 98113038 PF/SHAVE LES, T/A/L; > 2.0 CM $108.00 98113058 PF/SHAVE LES, S/N/H/F/G; 0.5 CM $60.00 98113068 PF/SHAVE LES, S/N/H/F/G; 0.6-1.0 $87.00 98113078 PF/SHAVE LES, S/N/H/F/G; 1.1-2.0 $103.00 98113088 PF/SHAVE LES, S/N/H/F/G; >2.0 CM $125.00 98113108 PF/SHAVE LES, F/E/N/L; 0.5 CM $65.00 98113118 PF/SHAVE LES, F/E/N/L; 0.6-1.0 CM $96.00 98113128 PF/SHAVE LES, F/E/N/L; 1.1-2.0 CM $147.00 98113138 PF/SHAVE LES, F/E/N/L; >2.0 CM $147.00 98114038 PF/EXC, BEN LES, T/A/L; 2.1-3.0 CM $206.00 98114048 PF/EXC, BEN LES, T/A/L; 3.1-4.0 CM $216.00 98114068 PF/EXC, BEN LES, T/A/L; >4.0 CM $324.00 98114208 PF/EXC, BLES, S/N/EX, G; 0.5CM/< $108.00 98114218 PF/EXC, BLES, S/N/EX, G; 0.6-1.0 CM $161.00 98114228 PF/EXC, BLES, S/N/EX, G; 1.1-2.0 CM $185.00 98114238 PF/EXCISION 2.1-3.0 CM $259.00 98114248 PF/EXC, BLES, S/N/EX, G; 3.1-4.0 CM $260.00 98114268 PF/EXC, BLES, S/N/EX, G; >4.0 CM $406.00 98114408 PF/EXCISION FACE 0.5 CM OR LESS $163.00 98114418 PF/EXC FACE - MM B9+MARG 0.6-1 CM $185.00 98114428 PF/EXC FACE-MM B9+MARG 1.1-2 CM $206.00 98114438 PF/EXC FACE-MM B9+MARG 2.1-3 CM $255.00 98114448 PF/EXC FACE-MM B9+MARG 3.1-4 CM $331.00 98114468 PF/EXC FACE-MM B9+MARG > 4 CM $471.00 98117308 PF/REMOVAL OF NAIL PLATE $112.00 98117408 PF/DRAIN BLOOD FROM UNDER NAIL $56.00 98117508 PF/REMOVAL OF NAIL BED $302.00 98117608 PF/REPAIR NAIL BED $195.00 98117658 PF/EXCISION OF NAIL FOLD, TOE $116.00 98120018 PF/REPAIR WOUND 2.5CM OR LESS $179.00 98120028 PF/REPAIR WOUND 2.6-7.5CM $101.00 98120048 PF/REPAIR WOUND 7.6-12.5CM $235.00 98120058 PF/REPAIR WOUND 12.6-20.0CM $294.00 98120068 PF/REPAIR WOUND 20.1-30.0CM $373.00 98120078 PF/REPAIR SUPERFICIAL WOUND > 30C $375.00 98120118 PF/REPAIR FACE WOUNDS 2.5CM OR LS $186.00 98120138 PF/REPAIR FACE WOUNDS 2.6-5.0CM $211.00 98120148 PF/REPAIR FACE WOUNDS 5.1-7.5CM $255.00 98120158 PF/REPAIR FACE WOUNDS 7.6-12.5CM $320.00 98120168 PF/REPAIR FACE WOUNDS 12.6-20.0CM $391.00 98120178 PF/REPAIR FACE WOUNDS 20.1-30.0CM $475.00 98120188 PF/REPAIR FACE WOUNDS >30.0CM $573.00 98120208 PF/TX SUPERF WND DEHISCENCE SMPLE $282.00 98120218 PF/SIMPLE TX WOUND DEHIS C PACKING $238.00 98120318 PF/LAYER CLOSE WOUND(S) 2.5CM>= $251.00 98120328 PF/LAYER CLOSE WOUND(S) 2.6-7.5CM $315.00 98120348 PF/INT REP S/A/T/EX; 7.6-12.5 CM $334.00 98120358 PF/LAYER CLOSE WOUND(S) 12.6-20.0 $412.00 98120368 PF/LAYER CLOSE WOUND(S) 20.1-30.0 $488.00 98120378 PF/LAYER CLOSE WOUND(S) >30.0CM $568.00 98120418 PF/LAYER CLOSE WOUND(S) 2.5CM>= $273.00 98120428 PF/LAYER CLOSE WOUND(S) 2.6-7.5CM $317.00 98120448 PF/LAYER CLOSE WOUND(S) 7.6-12.5C $354.00 98120458 PF/LAYER CLOSE WOUND(S) 12.6-20.0 $428.00 98120468 PF/LAYER CLOSE WOUND(S) 20.1-30.0 $347.00 98120478 PF/LAYER CLOSE WOUND(S) >30.0CM $562.00 98120518 PF/LAYER CLOSE WOUND(S) 2.5CM>= $297.00 98120528 PF/LAYER CLOSE WOUND(S) 2.6-5.0CM $334.00 98120538 PF/LAYER CLOSE WOUND(S) 5.1-7.5CM $352.00 98120548 PF/LAYER CLOSE WOUND(S) 7.6-12.5C $382.00 98120558 PF/LAYER CLOSE WOUND(S) 12.6-20.0 $481.00 98120568 PF/LAYER CLOSE WOUND(S) 20.1-30.0 $597.00 98120578 PF/LAYER CLOSE WOUND(S) >30.0CM $674.00 98131008 PF/REPAIR CMPLX TRUNK 1.1-2.5 CM $599.00 98131018 PF/REPAIR CMPLX TRUNK 2.6-7.5CM $417.00 98131028 PF/REPAIR CMPLX TRUNK EA ADD 0-5C $118.00 98131208 PF/COMPLEX REPAIR 1.1-2.5CM $408.00 98131218 PF/COMPLEX REPAIR 2.6-7.5CM $525.00 98131228 PF/COMPLEX REPAIR EACH ADDTL <=5C $151.00 98131318 PF/COMPLEX REPAIR 1.1-2.5CM $461.00 98131328 PF/COMPLEX REPAIR 2.6-7.5CM $757.00 98131338 PF/COMPLEX REPAIR EA ADDTL <=5CM $230.00 98131508 PF/COMPLEX REPAIR FACE <=1.0CM $468.00 98131518 PF/COMPLEX REPAIR FACE 1.1-2.5CM $468.00 98131528 PF/COMPLEX REPAIR FACE 2.6-7.5CM $719.00 98131538 PF/CMPLX REPAIR FACE EA ADDTL <=5 $255.00 98160008 PF/INITIAL TREATMENT 1ST DEG BURN $84.00 98160208 PF/DRESS/DEBRID P-THICK BURN, SML $99.00 98160258 PF/DRESS/DEBRID P-THICK BURN, MED $203.00 98160308 PF/DRESS/DEBRID P-THICK BURN, LRG $234.00 98160358 PF/ESCHAROTOMY; INITIAL INCISION $341.00 98171060 PF/DESTR CUT VASC LES; 10 SQ CM/< $525.00 98172508 PF/CHEM CAUT GRANULATION TISSUE $55.00 98179998 PF/UNLISTED PROC SKIN MM & SUBQ TISSUE $271.00 98190008 PF/PUNCT ASP OF CYST OF BREAST $84.00 98190018 PF/PUNCT ASP OF CYST BREAST ADDTL $42.00 98190208 PF/EXPLORE BREAST WOUND OR ABSCES $486.00 98201028 PF/EXPLORE PENTR WOUND OF EXTREM $420.00 98201038 PF/EXPLORE PENTR WOUND OF EXTREM $639.00 98205208 PF/REMOVAL FOREIGN BODY MUSCLE $254.00 98205528 PF/INJ TRIGGER POINT, 1/2 MUSCLE $57.00 98206008 PF/DRAIN/INJECT, SML JOINT/BURSA $75.00 98206058 PF/DRAIN/INJECT, MED JOINT/BURSA $77.00 98206108 PF/DRAIN/INJECT, MAJOR JOINT/BURS $92.00 98206928 PF/APPLY PINS OR WIRES $1,604.00 98209508 PF/MONITOR INTERST FLD PRESSURE $141.00 98213108 PF/CLOSED TX NOSE FRACTURE $53.00 98213208 PF/CL TX OF NASAL BONE FX; W STAB $206.00 98213378 PF/CL TX NASAL SEPTAL FX $412.00 98214808 PF/CL TX TMJ DISLOCATION; INITIAL $55.00 98218008 PF/CL TX RIB FX, UNCOMPL, EA $166.00 98235008 PF/CL TX CLAVICULAR FX; WO MANIP $350.00 98235058 PF/CL TX CLAVICULAR FX; W MANIPULA $481.00 98235208 PF/CLOSED TX STERNOCLAV FRACTURE $271.00 98235258 PF/CL TX SCCLAV DISLOC W MANIPULA $455.00 98235408 PF/CLSD TX ACROMIOCLAV DISLOC W/O $353.00 98235458 PF/CLSD TX ACROMIOCLAV DISLOC W M $478.00 98235708 PF/CLSD TX SCAPULA DISLOC W MANIP $385.00 98235758 PF/CLSD TX SCAPULA DISLOC W MANIP $618.00 98236008 PF/CLSD TX ARM W MANIPULATION $492.00 98236058 PF/CLSD TX ARM W MANIPULATION $746.00 98236508 PF/CLSD TX SHOULDER DISLOC $444.00 98236558 PF/CLSD TX SHOULDER DISLOC $662.00 98239318 PF/DRAIN ARM, ELBOW BURSA $281.00 98245008 PF/CLSD TX HUMERUS FX WO MANIPULA $449.00 98245058 PF/CL TX HUMERUS FX W MANIPULATE $649.00 98246008 PF/TREAT ELBOW DISLOCATION $563.00 98246058 PF/TX CL ELBOW DISLOC W ANESTHESI $690.00 98246208 PF/TREAT ELBOW FRACTURE $979.00 98246408 PF/TREAT ELBOW DISLOCATION $979.00 98246558 PF/CL TX RADIAL HD/NECK FX; W MANIP $649.00 98246758 PF/TREAT ULNAR FRACTURE $595.00 98255008 PF/CLSD TX RADIAL SHFT FX WO MANI $336.00 98255058 PF/CL TX RADIAL SHFT FX W MANIPUL $676.00 98255308 PF/CLSD TX OF RADIAL SHFT FX WO M $271.00 98255358 PF/CL TX ULNAR SHFT FX W MANIPULA $649.00 98255608 PF/CL TX RADIAL&ULNAR SHFT FX WO $331.00 98255658 PF/CL TX RADIAL & ULNA FX W MANIP $704.00 98256008 PF/CLSD TX ARM FRACTURE WO MANIPU $429.00 98256058 PF/CLSD TX ARM FRACTURE W MANIPUL $987.00 98256228 PF/CLSD TX WRIST FRACTURE $439.00 98256248 PF/CL TX CARPL SCAPHOID FX W MANI $612.00 98256308 PF/TREAT WRIST BONE FRACTURE W/O $390.00 98256358 PF/TREAT WRIST BONE FRACTURE W MA $570.00 98256508 PF/TREAT WRIST BONE FRACTURE $478.00 98256608 PF/CL TX CARPAL DISLOC W MANIPULA $580.00 98260108 PF/DRAINAGE OF FINGER ABSCESS $228.00 98260118 PF/DRAINAGE OF FINGER ABSCESS $327.00 98264108 PF/REPAIR HAND TENDON $1,045.00 98264188 PF/EXTENSOR TENDON REPAIR, EACH $870.00 98266008 PF/TREAT METACARPAL FRACTURE $402.00 98266058 PF/CLSD TX METACARPAL FX W MANIP $347.00 98266418 PF/CL TX THUMB WITH MANIPULATION $465.00 98266458 PF/CL TX CMC FX DISLOC THUMB W MA $433.00 98267008 PF/TREAT KNUCKLE DISLOCATION $477.00 98267208 PF/CLOSED TX FINGER OR THUMB, EA $245.00 98267258 PF/TREAT FINGER FRACTURE, EACH $516.00 98267420 PF/CL TX ARTFX MCP/IP JNT; W MANIP $315.00 98267508 PF/CLOSED TX FINGER OR THUMB, EA $281.00 98267558 PF/TREAT FINGER FRACTURE, EACH $453.00 98267708 PF/TREAT FINGER DISLOCATION $293.00 98267758 PF/CL TX IP JT D, W MANIP; W ANES $487.00 98267850 PF/TREAT FINGER DISLOCATION $525.00 98270868 PF/REMOVE FOREIGN BODY PELVIS/HIP $263.00 98272308 PF/CL TX PROX FEM FX WO MANIPULAT $698.00 98272508 PF/CL TX TRAUMA HIP DICLOC WO ANE $379.00 98272528 PF/CL TX TRAUMA HIP DISLOC W ANES $1,136.00 98272658 PF/CL TX POST HIP DISLOC WO ANEST $541.00 98275008 PF/CL TX FEMORAL SHAFT FX, WO MAN $726.00 98275028 PF/CL TX FEMORAL SHAFT FX, W MANI $1,234.00 98275088 PF/CL TX DISTAL FEM FX WO MANIP $709.00 98275108 PF/CL TX FEMUR FX OR EPIPHYS SEP $1,082.00 98275208 PF/CLOSED TX PATELLAR FX, WO MANI $406.00 98275508 PF/CL TX KNEE DISL; WO ANESTHESIA $649.00 98275608 PF/TREAT KNEECAP DISLOCATION $528.00 98275628 PF/CL TX PATELLAR DISLOCATION; W $704.00 98277508 PF/TREATMENT TIB FRACTURE $452.00 98277528 PF/CL TX TIB SHAFT FX W MANIPULAT $1,206.00 98277818 PF/CL TX PROX FIB/SHAFT FX W MANI $573.00 98277888 PF/CL TX DISTL FIB FX W MANIPULAT $757.00 98278088 PF/TREATMENT OF ANKLE FRACTURE $401.00 98278108 PF/TREATMENT OF ANKLE FRACTURE $660.00 98278168 PF/CL TX TRIMALL ANKLE FX; WO MAN $395.00 98278188 PF/TREATMENT OF ANKLE FRACTURE $779.00 98278248 PF/CL TX WT BRG DSTL TIB WO MANIP $422.00 98278258 PF/CL TX WT BRG DSTL TIB W MANIP $757.00 98278428 PF/CL TX ANKLE DISLOCATION; W ANESTH $515.00 98281908 PF/REMOVAL OF FOOT FOREIGN BODY $248.00 98284008 PF/CLOSED TX HEEL FX $385.00 98284508 PF/TX TARSAL BONE FX ; WO MANIPU $271.00 98284558 PF/TX TARSAL BONE FX; W MANIP $390.00 98284708 PF/CLOSED TX TOE FRACTURE $324.00 98284758 PF/CL TX METATARSAL FX; WO MANIP $276.00 98284908 PF/CLOSED TX FINGER FRACTURE NO M $201.00 98284958 PF/CL TX FX GT PHALANX(S); W MANI $216.00 98285108 PF/CLOSED TX FINGER FRACTURE W/MA $195.00 98285158 PF/CL TX FX GT PHALANX(S); W MANI $201.00 98285708 PF/CL TX TALOTARSAL JOINT DIS; WO $227.00 98286308 PF/TREAT TOE DISLOCATION $198.00 98286358 PF/CL TX MTP JNT DISLOC; W ANESTH $216.00 98286608 PF/CLOSED TX JOINT DISLOC NO ANES $149.00 98290358 PF/APPLICATION OF BODY CAST $251.00 98290498 PF/APPLICATION OF FIGURE EIGHT $111.00 98290658 PF/APPLIC CAST LONG ARM $214.00 98290758 PF/APPLICATION OF SHORT ARM CAST $111.00 98290858 PF/CAST LWR HAND FOREARM GAUNTLET $103.00 98291058 PF/SPLINT APPLICATION - LONG ARM $106.00 98291258 PF/SPLINT APPLICATION - SHORT ARM $75.00 98291268 PF/APPLY FOREARM SPLINT $90.00 98291308 PF/SPLINT APPLICATION - FINGER $51.00 98291318 PF/APPLICATION OF FINGER SPLINT $55.00 98292408 PF/STRAPPING OF SHOULDER $80.00 98292608 PF/STRAPPING; ELBOW OR WRIST $57.00 98292808 PF/STRAPPING OF HAND OR FINGER $60.00 98293458 PF/APPLIC CASH LONG LEG $207.00 98293658 PF/APPLY CYLINDER CAST $135.00 98294058 PF/APPLICATION OF SHORT LEG CAST $119.00 98294258 PF/APPLY WALKER SHORT LEG CAST $87.00 98295058 PF/SPLINT APPLICATION - LONG LEG $85.00 98295158 PF/SPLINT APPLICATION - SHORT LEG $89.00 98295308 PF/STRAPPING - KNEE $64.00 98295408 PF/STRAPPING - ANKLE/FOOT $61.00 98295508 PF/STRAPPING - TOES $57.00 98295808 PF/STRAPPING UNNA BOOT $91.00 98297008 PF/REM GAUNTLET, BOOT OR BODY CAS $64.00 98297058 PF/REMOVE FULL ARM OR LEG CAST $90.00 98297108 PF/REM SHOULDER OR HIP SPICA $153.00 98297408 PF/WEDGING OF CAST NOT CLUBFOOT $108.00 98297998 PF/CASTING & STRAPPING (NEC) $77.00 98300008 PF/DR ABSC/HEMATOMA NASAL INT $184.00 98300208 PF/DRAIN ABSC/HEMATOMA, NASAL SEPTUM $173.00 98303008 PF/REMOVE NASAL FOREIGN BODY $204.00 98309018 PF/CONTROL OF NOSE BLEED $112.00 98309038 PF/CONTROL NASAL HEMORRH, ANT COM $130.00 98309058 PF/INITIAL CONTROL OF NOSE BLEED $189.00 98315008 PF/INSERT EMERGENCY AIRWAY $202.00 98315028 PF/CHANGE OF WINDPIPE AIRWAY $57.00 98315058 PF/LARYNGOSCOPY, IND; DIAGNOSTIC $75.00 98315208 PF/DX LARYNGOSCOPY, NEWBORN $216.00 98315308 PF/LARYNGOSCOPY W/FB REMOVAL $366.00 98316038 PF/TRACHEOSTOMY, EMERG; TRANSTRAC $363.00 98316058 PF/TRACHEOSTOMY, EMERG; CRICOTHYR $303.00 98317208 PF/CLEARANCE OF AIRWAYS $97.00 98324218 PF/THORACENTESIS FOR ASPIRATION $125.00 98324228 PF/THORACENTESIS W/TUBE INSERT $201.00 98325518 PF/INSERTION OF CHEST TUBE $341.00 98325548 PF/THORACENTESIS FOR ASPIRATION $125.00 98325558 PF/THORACENTESIS W/TUBE INSERT $201.00 98330108 PF/PERICARDIOCENTESIS; INITIAL $222.00 98332108 PF/INS/REPL TEMP TRANSV SC CARD E $303.00 98352010 PF/REPAIR BLOOD VESSEL DIRECT; NECK $1,260.00 98352068 PF/REPAIR BLOOD VESSEL DIRECT; UPR EXT $1,622.00 98352078 PF/REPAIR BLOOD VESSEL DIRECT; HAND FN $1,622.00 98352268 PF/REPAIR BLOOD VESSEL DIRECT; LWR EXT $1,622.00 98360058 PF/EXTREMITY VENOGRAM INJ $77.00 98361408 PF/NS CATH - EXTREMITY ARTERY $163.00 98364008 PF/BLOOD DRAW <3 YRS FEM/JUGULAR $27.00 98364058 PF/PHY BL DRAW < 3 YRS SCALP VEIN $27.00 98364068 PF/PHY BL DRAW < 3 YRS OTHER VEIN $17.00 98364108 PF/VENIPUNCTURE AGE 3 YRS/> PHYS $108.00 98364208 PF/VEIN ACCESS CUTDOWN < 1 YR $77.00 98364258 PF/VENIPUNCTURE, CUTDOWN; AGE 1 + $108.00 98365558 PF/INSERT NON-TUNNEL CV CATH $201.00 98365568 PF/INSERT NON-TUNNEL CV CATH $227.00 98365698 PF/INSERT PICC CATH $182.00 98365898 PF/REMOVE TUNNELED CV CATHETER $233.00 98365908 PF/REM TUNNELED CVAD W PORT/PUMP $324.00 98366008 PF/ARTERIAL PUNCTURE, BLOOD FOR D $27.00 98366808 PF/PLACE NEEDLE INTRAOSSEOUS INFU $100.00 98371958 PF/THROMBOLYSIS, CEREBRAL, BY IV $163.00 98383008 PF/DRAIN ABSCESS/INFECTION; SIMPL $271.00 98406508 PF/REPAIR LIP $499.00 98408008 PF/DRAIN ABSCESS/CYST OF MOUTH $215.00 98408048 PF/REMOVAL, FOREIGN BODY, MOUTH $222.00 98408308 PF/CLSD LACERATION, MOUTH VESTIB $275.00 98408318 PF/CLSD LACERATION, MOUTH > 2.5CM $390.00 98412508 PF/REPAIR TONGUE LACERATION $238.00 98412528 PF/REP LACERAT-TONGUE FLR-MOUTH > 2.6/ $473.00 98418008 PF/DRAIN ABSC, CYST, HEMATOM - DENTO $295.00 98418058 PF/REM EMB FB FROM DENTOALV; SFT $233.00 98420008 PF/DRAINAGE OF ABSCESS OF PALATE $152.00 98427008 PF/I&D ABSCESS; PERITONSILLAR $233.00 98428098 PF/REMOVE PHARYNX FOREIGN BODY $226.00 98432478 PF/OPERATIVE UPPER GI ENDOSCOPY $355.00 98432488 PF/UPPER GI ENDOSCOPY/GUIDE WIRE $333.00 98437538 PF/GASTRIC INTUBATION/ASPIR/LAVAG $33.00 98437608 PF/CHANGE GASTROSTOMY TUBE $95.00 98437618 PF/REPOSITION GASTROSTOMY TUBE $190.00 98437621 P/F PERQ REPLACEMENT GTUBE NOT REQ R $235.00 98437631 P/F PERQ REPLACEMENT GTUBE REQ REVJ G $354.00 98453078 PF/PROCTOSIG, RIGID; W REM FB $141.00 98460408 PF/INCISION OF RECTAL ABSCESS $666.00 98460508 PF/INCISION OF ANAL ABSCESS $156.00 98460838 PF/INCISE EXTERNAL HEMORRHOID $172.00 98490808 PF/PERITONEOCENTESIS; INITIAL $114.00 98490818 PF/PERITONEOCENTESIS; SUBSEQUENT $87.00 98490820 PF/PERITONEOCENTESIS; INITIAL $114.00 98511008 PF/DRAIN BLADDER BY NEEDLE $76.00 98511018 PF/DRAIN BLADDER BY TROCAR/CATH $90.00 98511028 PF/DRAIN BL W/CATH INSERTION $465.00 98517018 PF/INSERT BLADDER CATHETER $53.00 98517028 PF/INSERT TEMP BLADDER CATH $57.00 98517038 PF/INS BLADDER CATH, COMPLEX $135.00 98517058 PF/CHANGE OF CYSTOSTOMY TUBE; SIM $135.00 98542208 PF/IRRIGATE CORPORA CAVERNOSA FOR $215.00 98547008 PF/I & D EPIDIDYMIS, TESTIS/SCROTUM $357.00 98551008 PF/DRAINAGE OF SCROTAL WALL ABSCE $266.00 98564058 PF/I & D OF VULVA/PERINEUM $192.00 98564208 PF/DRAINAGE OF GLAND ABSCESS $171.00 98589998 PF/UNLISTED PROC FEMALE GENITAL $163.00 98590258 PF/FETAL NON-STRESS TEST $63.00 98593008 PF/EPISIOTOMY OR VAGINAL REPAIR $249.00 98594098 PF/VAGINAL DELIVERY ONLY -IN ER $1,352.00 98594148 PF/DELIVERY OF PLACENTA $188.00 98622708 PF/SPINAL FLUID TAP, DIAGNOSTIC $135.00 98622728 PF/DRAIN CEREBRO SPINAL FLUID $153.00 98644008 PF/NERVE BLOCK INJECTION $110.00 98644028 PF/INJ ANESTH; FACIAL NERVE $108.00 98644058 PF/NJ ANESTH ; GREATER OCCIPITAL $108.00 98644178 PF/INJ ANESTH; AXILLARY NERVE $114.00 98644208 PF/INJ ANESTH; INTERCOSTAL NERVE $101.00 98644218 PF/INJ ANESTH; INTERCOST NRV, MUL $135.00 98644508 PF/INJ ANESTH; OTHR PERIPHERAL NR $130.00 98652058 PF/REMOVE FOREIGN BODY FROM EYE $69.00 98652108 PF/REMOVE FOREIGN BODY FROM EYE $85.00 98652208 PF/REMOVE FOREIGN BODY FROM EYE $85.00 98652228 PF/REMOVE FOREIGN BODY FROM EYE $91.00 98677008 PF/DRAIN ABSCESS, EYELID $216.00 98690008 PF/DRAIN EXTERNAL EAR LESION $200.00 98690208 PF/DRAIN EXTERNAL AUDITORY CANAL $244.00 98692008 PF/CLEAR OUTER EAR CANAL $96.00 98692058 PF/REM FB EXT AUDITORY CANAL; W A $147.00 98692090 PF/REMOVE IMPACTED EAR UNILATERAL RIN $26.00 98692108 PF/REMOVE IMPACTED EAR WAX $59.00 98901680 PF/WOUND CLOSURE BY ADHESIVE $53.00 98904738 PF/IMMUNE ADMIN ORAL/NASAL $33.00 98929508 PF/CPR-CARDIOPULMONARY RESUSCITAT $335.00 98929538 PF/TEMP TRANSCUTAN PACING $20.00 98929608 PF/CARDIOVERSION $239.00 98929778 PF/THROMBOLYSIS, CORON; IV INFUS $36.00 98930108 PF/EKG INTERPRETATION $27.00 98930188 PF/INTERPRETATION - STRESS $98.00 98932278 PF/INTERPRETATION HOLTER $111.00 98933038 PF/TTE CONG ABN; COMPLETE $163.00 98933068 PF/TTE W/DOPPLER, COMPLETE $597.00 98933078 PF/INTR M MODE 2D $260.00 98933208 PF/DOPPLER ECHO PULSED $175.00 98933258 PF/DOPPLER ECHO COLOR FLO $163.00 98958168 PF/EEG $210.00 98958190 PF/AWAKE & ASLEEP EEG $204.00 98958198 PF/AWAKE & ASLEEP EEG $210.00 98958220 PF/SLEEP ONLY $204.00 98958228 PF/SLEEP ONLY EEG $210.00 98958248 PF/ELECTRO CEREBRAL SILENCE $91.00 98975970 PF/ DEBRIDE; DEVITAL TIS <20 CM CM $131.00 98991750 PF/IPECAC ADMINISTRATION $120.00 98991758 PF/IPECAC ADMINISTRATION $120.00 98992118 PF/OP VISIT LEVEL 1 PROCEDURE $65.00 98992128 PF/OUTPATIENT EST PT VISIT - LEVEL 2 $87.00 98992410 PF/ER TRIAGE PHYSICIAN ASSESSMENT $69.00 98992418 PF/ER TRIAGE PHYSICIAN ASSESSMENT $69.00 98992810 PF/ER PHYS FEE - BRIEF SERVICE $75.00 98992818 PF/BRIEF SERVICE $75.00 98992820 PF/LIMITED SERVICE $87.00 98992828 PF/LIMITED SERVICE $87.00 98992830 PF/ER PHYS FEE - INTERMEDIATE SVC $152.00 98992838 PF/INTERMEDIATE SVC $152.00 98992840 PF/EXTENDED SERVICE $238.00 98992848 PF/EXTENDED SERVICE $238.00 98992850 PF/ER PHYS FEE COMPREHENSIVE SVC $324.00 98992858 PF/COMPREHENSIVE SVC $324.00 98992910 PF/CRITICAL CARE 1ST HR $433.00 98992918 PF/CRITICAL CARE 1ST HR $433.00 98992920 PF/CRITICAL CARE + 1/2 HR $379.00 98992928 PF/CRITICAL CARE + 1/2 HR $379.00