Px Code Procedure Description Unit Price 11000001 Room & Board - Private General $1,931.00 11200001 ROOM & BOARD - OB PRIVATE $1,931.00 11300001 Room & Board - Private Pediatric $1,931.00 11400001 ROOM & BOARD - BHU $3,097.00 11600001 ROOM & BOARD - CHEM DEP $4,142.00 11800001 ROOM & BOARD - REHAB $1,931.00 11800002 ROOM & BOARD - IP REHAB $2,301.00 16400001 ROOM & BOARD - ISOLATION $2,225.70 16400002 ROOM & BOARD - PCU ISOLATION $3,390.00 17100001 Nursery Newborn - Level I $1,936.00 17200001 Nursery Newborn - Level II $4,583.00 17300003 Nursery Newborn - Level III $5,941.00 17900001 ROOM & BOARD - SICK BABY LVL 1 $2,382.00 17900002 ROOM & BOARD - HEALTHY BOARDER $2,382.00 18000001 HB LEAVE OF ABSENCE (LOA) $0.01 20000001 Intensive Care General $4,851.00 20600001 Post ICU (AKA Intermediate) $4,123.21 20600004 ROOM & BOARD - TELEMETRY PCU $2,225.70 20600005 ROOM & BOARD - PCU PRIVATE $4,123.00 20600006 ROOM & BOARD - CARDIAC CARE MED SURG $1,931.00 20600007 ROOM & BOARD - CARDIAC CARE TELEMETRY $2,550.00 21000001 HB CORONARY CARE GENERAL $4,851.00 25000001 HB RX 250-PHARMACY $602.48 25000012 HB SOLUTION BAX 5B9896 4.25%2000M $96.66 25000013 HB SOLUTION BAX 5B9866 1.5%2000ML $86.52 25500001 HB RX 255-DRUGS INCIDENT TO RADIOLOGY $5,715.25 25800001 HB RX 343-DX RADIOPHARM $678.82 26000001 HB ADMIN IV HYDRATE; EA ADDTL HR $283.00 26000002 HB ADMIN IV INF TX/DX; 1ST HR $1,045.50 26000003 HB ADMIN IV INF TX/DX; EA ADDTL HR $376.00 26000004 HB ADMIN IV INF TX/DX; EA SEQUENTI $547.50 26000005 HB ADMIN IV INF TX/DX; CONCURRENT $778.50 26000006 HB ADMIN IV PUSH TX/DX; EA NEW MED $440.50 26000007 HB ADMIN IV PUSH; EA ADDTL SAME DRUG SEQ $440.50 26000008 HB ADMIN IV HYDRATE; 1ST HOUR $1,049.00 26000010 HB ADMIN IV PUSH TX/DX; 1ST MED $479.50 26000011 HB ADMIN INJ IM/SUBQ TX/DX MED $329.00 26000013 HB IRRIGATE VAD (FLUSH PORT/PICC) $367.50 26000015 HB APPLICATION OF ON-BODY INJECTOR $128.00 26000017 HB ADMIN SQ INFUSION; 1ST HOUR $1,019.50 26000018 HB ADMIN SQ INFUSION; EA ADDL HR $300.00 26000019 HB ADMIN ADD SQ INF; NEW SITE $412.50 27000004 HB COMPRESSED AIR $170.00 27000484 HB STAPLER ETH PRW35 $200.00 27000641 HB CARTRIDGE VAP PF-DPC-LOW $261.00 27000710 HB PACK C-SEC PB2235659 $2.00 27000727 HB PLEUR-EVAC MAQ 3600-100 CHEST DRAIN $93.75 27000728 HB PACK VAG PB3235659B $2.00 27000740 HB PACK LABOR PB1235659 $2.00 27000751 HB OXYGEN 02/SUPPLEMENTAL $725.00 27040684 HB CATHETER SET RE-ENTRY NEPHROS $286.37 27040765 HB MYOSURE XL $500.00 27040927 HB DAILY OXYGEN CHARGE $725.00 27045040 HB SHUNT MAQ OF-1500L LNG STD 20.25MM 16.25MM $235.00 27140004 HB OXYGEN PER SHIFT $362.50 27200209 HB SUTURE ARX AR-7230-01 $66.00 27200578 HB BUR WRI ALL 57SXXXX $1,770.00 27200754 HB VIPERSLIDE CSI VPR-SLD LUBRICT $252.00 27200772 HB CATH COR 426-2022X SLEEK $858.00 27200947 HB CATH TER 40-5023 $115.50 27200953 HB STAPLER CAR ESPRR35 SKIN $52.94 27200956 HB INTRODUCER GOR DSF2233 DRYSEAL FLEX $420.00 27200975 HB CATH BOS ALL H74939189XXXXX EMERGE PTCA DILATION $560.00 27201339 HB CATH EV3 ALL 410XX-01 CRAGG-MCNAMARA $420.00 27201728 HB SCD SLEEVE THIGH REGULAR $90.00 27201840 HB TROCAR APP CFF03/CFR03 $270.00 27201971 HB INTRODUCER MMD ALL CLS-10XX (31.93) $103.23 27202016 HB LIGASURE COV LF1737 / LS1520 (496.38) $1,489.14 27202093 HB BALLOON ACL BC0724A $750.00 27202200 HB CATH ELS D97120F5 SWANGANZ $352.26 27202396 HB SYRINGE BOS 5060-05 $478.00 27202486 HB TROCAR APM COR47 $99.00 27202560 HB NEW SET-UP ADULT HEMODIALYSIS $160.00 27202622 HB SHEAR ETH ESFC9 HARMONIC $3,032.78 27202675 HB POWDER MHP SM0007-USA $645.00 27202706 HB SYSTEM ADL 301-5400 SMOKE EVAC $236.00 27202759 HB CATH ARR AB-19608K $536.00 27202760 HB SUTURE SUS RA-1065Q $60.10 27202762 HB DRESSING MOL 395790 $70.22 27202780 HB SHEATH TER ALL RSSXXX PINNACLE (8.50) $29.00 27202784 HB GUIDEWIRE ABB 12776-01 PROWATE $510.00 27202870 HB SUTURE ARX AR7200 $55.50 27202921 HB CATH ARR ASK-05501-USC KIT $414.00 27202942 HB CRRT OR SHIFT TX SET-UP $5,606.00 27203172 HB CATH BOS H749391240845 QUANTUM APEX 4.5 X 8MM BALLOON $560.00 27203339 HB STAPLER J&J PSE45A $888.77 27203383 HB CATH ABB ALL 10124XX-XX TREK $900.00 27203409 HB CATH ABB C408646 DRAGONFLY OPTIS KIT $3,584.00 27203515 HB REAMER ARX ALL AR-14XXLP $874.00 27203618 HB SNARE BOS M00562551/M00562531 $96.00 27203798 HB CATH ARR ALL CS-15XX2-VSP $884.94 27203833 HB BALLOON ABB 1012447-06 TREK $750.00 27203901 HB DRILL GUIDE COC 93363 $607.50 27203944 HB CATH MED ALL 2AF2X4 ADVANCE (4500) $13,500.00 27204066 HB DERMABOND ETH DNX12 TOPICAL SKIN ADHESIVE $79.00 27204181 HB CHARGER STJ 3730ANS $4,416.00 27204202 HB INTRODUCER MED KPX153PB-CDS ONE TIME USE $10,350.00 27204245 HB CATH OLY MAJ-1351 BALLOON DILATION $51.55 27204256 HB CATH MED ALL NCEUPXXXXXX (140) $3,075.00 27204321 HB SYRINGE BOS M00566001 RAPID REFIL SYSTEM $246.00 27204544 HB CATH MED ALL ADM0X00XXX3P (1490) ADMIRAL $3,750.00 27204575 HB TROCAR ARX AR-1934-24DS $48.00 27204585 HB TROCAR APP CFF01 $270.00 27204784 HB NEEDLE ARX AR-12990N/AR16991N SCORPION $585.00 27204835 HB ELECTRODE BOS 3501 EMBLEM $12,000.00 27205075 HB SUTURE ARX AR-7276T LABRALTAPE 1.5MM 3IN $210.00 27205167 HB SLEEVE APP CFS02 FIXATION EXTERNAL $24.00 27205188 HB CATH BBM 33540 EPIDURAL $21.11 27205511 HB BASKET BOS M00546550 $1,485.00 27205532 HB CLOSURE ZLM PS1160 $240.00 27205584 HB DRIVER WRI 57S02020 / 57S02025 $815.00 27205585 HB DRILL BIT WRI 57S00022 / 57S00030 $1,030.00 27205604 HB PROSTEP WRI 57S100MT MICA TRANSLATOR $614.00 27205656 HB CATH MED ALL AB35W0XXXX135 $1,008.00 27205756 HB KWIRE WRI DSDS1014S 1.4MM X 150MM L $100.00 27205805 HB SOCKET ARX AR-4505 PORTAL SKID $135.00 27205851 HB POWERBOX WRI 5770POWER NSK $1,770.00 27206004 HB SCOPE AUR MBR-000011 SINGLE USE MONARCH BRONCHOSCOPE $5,959.00 27206005 HB INTRODUCER AUR MBR-000017 BRONCHOSCOPE KIT $282.00 27206006 HB BRUSH AUR MBR-000015 CYTOLOGY $329.00 27206122 HB DRILL ARX AR-8943-112 $400.00 27240005 HB CATH URETERAL 1 $1,557.00 27240006 HB CATH URETERAL 2 $3,440.00 27240043 HB OTH STER SUPP LVL 1 $77.00 27240044 HB OTH STER SUPP LVL 16 $61,715.00 27240045 HB DRILL BIT/BLADE LVL1 $438.00 27240046 HB DRILL BIT/BLADE LVL2 $1,041.50 27240047 HB DRILL BIT/BLADE LVL3 $2,330.00 27240048 HB DRILL BIT/BLADE LVL4 $3,024.50 27240049 HB DRILL BIT/BLADE LVL5 $5,040.00 27240050 HB DRILL BIT/BLADE LVL6 $7,056.50 27240051 HB DRILL BIT/BLADE LVL7 $9,072.50 27240052 HB DRILL BIT/BLADE LVL8 $16,319.00 27240053 HB DRILL BIT/BLADE LVL9 $20,939.00 27240054 HB SUTURE LEVEL 3 $959.00 27240055 HB SUTURE LEVEL 4 $2,051.50 27240056 HB SUTURE LEVEL 5 $4,693.00 27240057 HB SUTURE LEVEL 6 $3,419.00 27240058 HB SUTURE LEVEL 7 $4,786.50 27240059 HB SUTURE LEVEL 9 $15,429.00 27240060 HB STAPLER/RELOAD 1 $685.00 27240061 HB STAPLER/RELOAD 2 $2,051.50 27240062 HB STAPLER/RELOAD 3 $3,529.50 27240063 HB STAPLER/RELOAD 4 $6,553.50 27240064 HB STAPLER/RELOAD 5 $10,080.00 27240065 HB STAPLER/RELOAD 6 $13,587.50 27240066 HB NEEDLES 2 $1,232.50 27240067 HB NEEDLES 3 $4,196.50 27240068 HB NEEDLES 4 $7,864.50 27240069 HB OTH STER SUPP LVL 2 $1,056.00 27240070 HB OTH STER SUPP LVL 3 $1,582.00 27240071 HB OTH STER SUPP LVL 4 $2,110.00 27240072 HB OTH STER SUPP LVL 5 $1,945.00 27240073 HB OTH STER SUPP LVL 6 $2,333.00 27240074 HB OTH STER SUPP LVL 7 $2,723.00 27240075 HB OTH STER SUPP LVL 8 $3,111.00 27240076 HB OTH STER SUPP LVL 9 $4,668.00 27240077 HB OTH STER SUPP LVL 10 $6,223.00 27240078 HB OTH STER SUPP LVL 11 $7,779.00 27240079 HB OTH STER SUPP LVL 12 $15,557.00 27240080 HB OTH STER SUPP LVL 13 $18,279.00 27240081 HB OTH STER SUPP LVL 14 $30,084.00 27240082 HB OTH STER SUPP LVL 15 $50,140.00 27240083 HB TUBE DRAIN CATH 3 $738.00 27240084 HB TUBE DRAIN CATH 4 $1,319.00 27240085 HB TUBE DRAIN CATH 5 $1,847.00 27240086 HB TUBE DRAIN CATH 6 $8,557.00 27241052 HB CATH CAR 8888570549 DRAIN $13.44 27241053 HB DRAIN AUM 2002-000 CHEST $78.63 27241076 HB CATH BOS M004200624S0 $105.00 27241077 HB CATH BOS M0042011010 $1,152.00 27241078 HB CATH BOS H749518050 $1,896.00 27241079 HB CATH JJH D7T20282CT $3,420.00 27241080 HB CATH COV SD300LG NVG EDG $2,596.32 27241081 HB NEEDLE ARG 253030 BRST LOC $60.00 27241082 HB NEEDLE ARG 253125 BRST LOC $66.00 27241083 HB NEEDLE ART 253100 BRST LOC $84.00 27241084 HB MARKER DEV STAR1401 BRST $236.16 27241087 HB CATH BAR LX35130560 $3,600.00 27241088 HB CATH BAR LX351306100 $3,600.00 27241089 HB CATH BAR LX35130660 $3,600.00 27241090 HB CATH BAR LX351304100 BALLOON $3,900.00 27241091 HB CATH BAR LX35130440 BALLOON $3,900.00 27241092 HB CATH BAR LX351305100 BALLOON $3,900.00 27241093 HB CATH BAR LX35130540 BALLOON $3,900.00 27241094 HB CATH BAR LX35130640 BALLOON $3,900.00 27241095 HB CATH BAR LX35130460 BALLOON $4,650.00 27241096 HB CATH BAR LX35130480 BALLOON $4,650.00 27241097 HB CATH BAR LX351304150 BALLOON $4,725.00 27241098 HB CATH BAR LX351306150 BALLOON $4,725.00 27241099 HB CATH BAR LX351305150 BALLOON $4,800.00 27241100 HB CATH BOS M001175000 BALLOON $598.08 27241101 HB NEEDLE ARG 252075 $74.40 27241105 HB PACK MED DYNJCH301A VAGINAL $63.74 27241106 HB PACK MED DYNJCHCS02A C-SECTION $158.11 27241107 HB PACK MED DYNJ41314 D&C $61.91 27241108 HB PACK MED DYNJ41313 ABDOMINAL $119.88 27241109 HB CATHETER COK G14057 70CM 5 FR 14FR $31.55 27241110 HB CATHETER COK G14521 70CM 5FR URETERAL $41.62 27241111 HB CATHETER ALL BOS M005583XX ENDO DILATOR $854.88 27241112 HB TUBE BAR 331 CATH 20FR DRAIN $202.50 27241113 HB SUTURE ETH D9306 RB1 30IN $545.97 27241117 HB SYRINGE BOS M00550601 GAUGE ASSY 60CC $87.60 27241119 HB BLADE STR 2296-003-111 OSC SAW 25MM $92.94 27245015 HB APPLICATOR ETH MS1995 ENDOSCOPIC 34CM SURGIFLO $416.09 27245063 HB SPLINT OWE OG-1L2 ORTHOGLASS COMFORT 1-IN $68.61 27245080 HB BUTTON ARX AR-6592-08-40 CANNULA $96.00 27245098 HB INTRODUCER OSC ALL AP0X016P ADELANTE« PEEL-AWAY SHEATH (35) $105.00 27245099 HB CATH BAR A303316A SURESTEP COMPLETE CARE URINE METER TRAY $53.28 27245151 HB CATH ADY H965460160 4FR BIOFLO SINGLE LUMEN MIDLINE $472.50 27245152 HB CATH ADY H965750310 4FR BIOFLO SINGLE LUMEN PICC $529.20 27245153 HB CATH ADY H965750330 5FR BIOFLO DUAL LUMEN PICC $562.28 27245154 HB CATH ADY H965750350 6FR BIOFLO TRIPLE LUMEN PICC $724.50 27245261 HB INTRODUCER PPI SS9 SAFESHEATH II 9FR 13CM $150.00 27245262 HB BLADE ZIM 506298 SAW CEMENTED OXFORD $5,489.73 27245263 HB INTRODUCER BAR 601110 10 FR PTFE PEEL-APART KIT $180.00 27245264 HB CATH ARR CS-01700 4FR 60CM CHOLANGIOGRAM BALLOON CATHETER KIT $1,008.00 27245273 HB GUIDE ILC 80001 INTEGRA SAFEGUARD $724.00 27245274 HB CATH SMI 4054 18GA 1.75IN J THNWL S $4.65 27245283 HB GUIDE SNE V0100109 VISIONAIRE ADAPTIVE GUIDE KIT LEGION PRIMARY $1,800.00 27245284 HB BOWL SNE 71270068 VACUUM MIXING VORTEX $346.50 27245285 HB GUIDEWIRE ABB 1044592 HIGH TORQUE POWERTURN FLEX GUIDEWIRE $255.00 27245286 HB STENT ABB 1550300-15 XIENCE SIERRA, 3.0 X 15 DRUG ELUTING STENT $6,900.00 27245287 HB BALLOON ARR AI û 07124 5 FR BALLOON WEDGE PRESSURE CATHETER $525.00 27245288 HB CATH BAR SK13514 SEEKER SUPPORT CATHETER $405.00 27245289 HB LEAD BIK 436910 PLEXA PRO MRI S DX 65/17 $11,640.00 27245290 HB GENERATOR BIK 429525 ACTICOR 7 VR-T DX, ICD GENERATOR $42,150.00 27245291 HB CATH BOS 114610-001 ANGIO JET ZELANTE DVT $8,445.00 27245292 HB ASSEMBLY BOS 104834-0020 ANGIO JET ULTRA KIT $102.00 27245293 HB ELECTRODE BOS 3501 EMBLEM S-ICD SUBCUTANEOUS ELECTRODE, MODEL 3501 45 CM $12,000.00 27245294 HB SHEATH BOS 667463-300 SAFE SHEATH II, 9 FR, 13 CM $150.00 27245295 HB DEVICE CAR MX6760 MYNX CONTROL VASCULAR CLOSURE DEVICE 5FR $762.00 27245296 HB GUIDEWIRE CSI 30G-300-014 ZILIENT 30GR .014 WEIGHTED WIRE $510.00 27245297 HB CATH COR 670-192-00 6 FRENCH VISTABRITE ôIM VB1ö GUIDING CATHETER $156.00 27245314 HB SUTURE ARX AR-7253 FIBERLOOP 0SZ 76MM 7MM LOOP $255.00 27245315 HB SEALANT BAX 934071 COSEAL SURGICAL SEALANT 4ML $1,668.39 27245316 HB SHEATH BOS M0062502011 NAVIGATOR 11/13F 28CM URETERAL ACCESS $289.00 27245317 HB SNARE MMD EN2006020-S ENSNARE 6FR $949.00 27245323 HB DRESSING S&N 66022003 WOUND VAC PICO 10CMX30CM $1,980.00 27245325 HB KNIFE ILS 08-0005 SAFEGUARD CUTTING KNIFE $485.00 27245326 HB NEEDLE CLP NB0701400 BONEE BLADDER INJECTION $348.00 27245327 HB DEVICE HIC NS2007US NOVASURE ENDO ABLATION DEVICE $3,260.00 27245332 HB FORCEPS OLY FD-210U ENDO JAW HOT BIOPSY ALLIGATOR CUPS $379.00 27245333 HB GUIDEWIRE BOS M006630205B1 ZIPWIRE STD 150CM 3CM $199.00 27245334 HB GUIDEWIRE BOS M0066703091 SENSOR PTFE NITINOL HYDROPHILIC TIP $191.00 27245335 HB DILATOR OLY ALL BD-400P-XX80 DILATOR EZDILATE BALLOON $775.00 27245336 HB DILATOR OLY BD-400P-1380 DILATOR EZSILATE BALLOON 11-12-13 $775.00 27245337 HB DEVICE OLY MAJ-1740 INFLAION DEVICE EBG $169.00 27245338 HB RETRIEVER OLY ET2000 E-SUCTION ESOPHAGEAL $1,006.00 27245339 HB CATH CSI DBP-145 CLASSIC ROTATIONAL ATHRECTOMY DEVICE $12,244.00 27245340 HB CATHETER IME 21-101 INARI TRIEVER 20 ASPIRATION GUIDE $27,173.00 27400352 HB CAP COC 95083 / 95084 (14.49) $45.99 27440013 HB COLLAR CERV FOAM PRE $19.00 27440014 HB SUPPORT LO FLEX LUMBAR $53.00 27440021 HB IMMOBILIZER KO $7,594.00 27440023 HB SHOE SURGICAL BOOT/SHOE $405.00 27440024 HB SO ACROMIO CLAVICULA $3,076.00 27440026 HB ARTIFICIAL CORNEA $18,574.00 27440027 HB MEMBRANE AMNIOTIC $22,144.00 27440036 HB COLLAR DJO 79-83130 CERVICAL $16.08 27440037 HB COLLAR DJO ALL 79-8302X CERVICAL $19.65 27440040 HB COLLAR DJO ALL 79-8312X CERVICAL $25.08 27440041 HB COLLAR DER TX9916-11 CERVICAL $40.14 27440042 HB COLLAR HPO L0174 $734.61 27440043 HB COLLAR HPO L0190 $1,503.96 27440044 HB BRACE HPO L0486 $5,077.32 27440045 HB SPLINT HPO L0626 LEG $224.16 27440046 HB SPLINT DJO 79-71240 HIP $212.25 27440047 HB LINER HPO L2275 VARUS/VALGUS $351.90 27440048 HB IMMOBILIZER DJO ALL 79-840XX SHOULDER $10.71 27440052 HB SPLINT DJO 79-85008 $10.89 27440053 HB STRAP ALL DJO 79-8501X $16.77 27440055 HB ORTHOSIS HAN L3650 ACROMIO $231.00 27440056 HB BRACE HPO L3760 ELBOW $1,833.00 27440057 HB SPLINT DJO 79-87127 LT FINGER/THUMB $8.97 27440058 HB BRACE DJO 79-87317 LT WRIST/THUMB $40.05 27440059 HB BRACE DJO 79-87315 LT WRIST/THUMB $40.05 27440060 HB BRACE DJO 79-87318 LT WRIST/THUMB $40.05 27440061 HB BRACE DJO 79-87308 RT WRIST/THUMB $40.05 27440062 HB BRACE DJO 79-87307 RT WRIST/THUMB $41.37 27440063 HB BRACE DJO 79-87305 RT WRIST/THUMB $41.37 27440064 HB BRACE DJO 79-87313 LT WRIST/THUMB $41.37 27440065 HB BRACE DJO 79-87303 RT WRIST/THUMB $41.37 27440066 HB SUPPORT DJO 79-87035 RT FOREARM/WRIST $12.30 27440067 HB SUPPORT DJO 79-87050 RT FOREARM/WRIST $12.99 27440068 HB SUPPORT DJO 79-87060 LT FOREARM/WRIST $14.97 27440069 HB SPLINT DJO 79-87040 LT FOREARM/WRIST $17.31 27440070 HB SPLINT DJO 79-87030 RT FOREARM/WRIST $17.31 27440072 HB BRACE DJO 79-97867 ANKLE $28.14 27440073 HB BRACE DJO 79-95328 WALKING $85.29 27440074 HB BOOT DJO 79-90550 $91.11 27440075 HB BOOT HPO L4396 PRAFO $482.64 27440076 HB DRESSING HPO L5450 $1,174.50 27500040 HB ICD GUI E102 TELIGEN VR $1,722.60 27500130 HB ICD STJ ALL CD2357-40X FORTIFY $60,021.00 27500132 HB ICD MED DTBA1D1/DTBA1D4 $60,021.00 27500133 HB ICD MED DVBB1D1/DVBB1D4 EVERA XT VR $44,004.00 27500137 HB ICD MED DTBA1Q1/DTBA1QQ $60,021.00 27500138 HB ICD MED DDMB1D4 EVERA $49,945.00 27500153 HB ICD STJ ALL CD1357-40X FORTIFY (13000) $40,050.00 27500170 HB ICD STJ ALL CD1411-36X ELLIPSE (12430) $40,350.00 27500178 HB ICD BOS ALL D14X INOGEN (13500) $61,920.00 27500188 HB PACER MED W3SR01 AZURE $10,098.00 27500191 HB ICD BOS A219 EM LEM PULSE S $54,000.00 27500197 HB ICD MED DVMB1D4 EVERA MRE XT VR $45,727.68 27500205 HB ICD BOS ALL G14X INOGEN (16700) $62,520.00 27500206 HB PACER STJ PM3242/PM3242 CELL ALLURE QUADRA $21,900.00 27500210 HB ICD MED ALL DDBB1DX EVERA (14385) $52,302.00 27500213 HB PACER BIO 401662 ITREVIA $71,250.00 27500215 HB PACER BOS L321 ACCOLADE EL $20,250.00 27500217 HB ICD STJ ALL CD-3369-40X $60,600.00 27500226 HB PACER MED W1DR01 AZURE $14,256.00 27540006 HB ICD DUAL CHAMBER L5 $99,999.00 27540007 HB ICD DUAL CHAMBER L4 $99,999.00 27540008 HB ICD DUAL CHAMBER L3 $66,122.50 27540009 HB LEAD ICD ENDO SN L5 $50,253.50 27540010 HB LEAD ICD ENDO SN L1 $33,099.00 27540011 HB LEAD ICD ENDO SN L4 $37,605.00 27540017 HB LEAD AICD END DUL L7 $55,350.00 27540018 HB LEAD AICD END DUL L5 $55,102.00 27540019 HB LEAD AICD END DUL L1 $70,765.50 27540020 HB LEAD AICD END DUL L4 $37,605.00 27540021 HB LEAD ICD NO-SING L5 $50,140.00 27540023 HB LEAD PMKR NON-TRN L2 $11,668.00 27540024 HB LEAD PMKR NON-TRN L1 $6,705.00 27540026 HB LEAD LT VENT COR LV3 $17,550.00 27540027 HB LEAD LT VENT COR LV4 $37,605.00 27540028 HB PACER SNGL NON RTE-RE $99,999.00 27540029 HB ADAPTER EXTENSION / PACE NEU LD4 $9,270.00 27540030 HB ICD OHR THN SGL/DU1 $99,999.00 27540031 HB ICD OHR THN SGL/DU3 $99,999.00 27540032 HB ICD OHR THN SGL/DU4 $99,999.00 27540033 HB ICD OHR THN SGL/DU2 $93,492.00 27540048 HB PACE DUAL RATE-RS L2 $30,084.00 27540049 HB PACE DUAL RATE-RS L3 $75,210.00 27540050 HB PACE DUAL RATE-RS L1 $46,507.00 27540059 HB PACE SINGL RATE-RSL1 $67,444.50 27540060 HB PACE SINGL RATE-RSL2 $30,084.00 27540061 HB PACE SINGL RATE-RSL3 $75,210.00 27540080 HB PACER MED C6TR01 VIVA $21,162.00 27540081 HB PACER BIK 394919 ETRINSA $24,285.00 27540082 HB LEAD BIK 379969 PROTEGO $12,765.00 27540083 HB LEAD BIK ALL 3994XX PROTEGO DUAL $12,765.00 27540100 HB ICD MED DDMB1D1 EVERA MRI SURESCAN $51,051.00 27540101 HB ICD BOS D012 $60,420.00 27540102 HB ICD BIO 392423 IPERIA $61,185.00 27540103 HB ICD BOS D022 $64,170.00 27540104 HB ICD MED EVERMRIXTDRMMEE $64,804.80 27540105 HB ICD BOS D152 $65,670.00 27540107 HB ICD BOS D433 $50,700.00 27540108 HB ICD BIO 382565 ILESTO $52,785.00 27540109 HB ICD BIO 393041 ITREVIA $55,485.00 27540110 HB ICD MED DDBB1D4 EVERA $57,969.00 27540111 HB ICD BIO 392412 OTREVOA $59,385.00 27540113 HB ICD G158 $54,750.00 27540114 HB ICD DTMA1QQ CLARIA $58,443.00 27540115 HB ICD BOS N141 $62,520.00 27540116 HB ICD BOS G140 $63,270.00 27540117 HB ICD BIO 393009 IPERIA $68,985.00 27540118 HB ICD MED DTMA1D1 $69,039.00 27540119 HB ICD MED VIVAQUADXTCRTDMMQE $76,860.48 27540120 HB ICD MED AMPLIAMRIQDCRTMMQE $82,673.04 27540121 HB ICD BOS D010 $41,220.00 27540122 HB ICD BOS D432 RESONATE $44,310.00 27540123 HB INTRODUCER MMD PID6F11018NTPD $825.00 27540124 HB ICD MED VISIAAFMRIEMEE $57,167.88 27550001 HB ICD SINGLE CHAMBER 2 $99,999.00 27550002 HB ICD SINGLE CHAMBER 1 $99,999.00 27550003 HB ICD BOS A209 EMBLEM PULSE $74,716.00 27800055 HB STENT BOS 145-150 RETROMAX PLS $1,764.00 27800222 HB PENILE BOS 72404231 PROSTHESIS $24,646.02 27800618 HB STENT MED ALL ETLW16XXC156E EDURNT (6080) $19,200.00 27800919 HB PENILE AMS 72404253 PROSTHESIS $25,110.51 27801010 HB LEAD PACER STJ 1882TC/46 $3,150.00 27801629 HB PATELLA S&N ALL 714205XX $600.00 27801698 HB LEAD ALL MED 5076XX (400) $1,200.00 27801712 HB STENT MED RSINT27530UX INTEGRY $3,675.00 27802064 HB PLATE SYN 241.351 $580.00 27802161 HB GENERATOR LIV 103 VNS DEMIPULSE $67,275.00 27802163 HB LEAD PACER BIK ALL SELOX/SOLIA $1,755.00 27802321 HB STIMULATOR MED 3058 NEURO $35,040.00 27802347 HB OCCLUDER STJ ALL 9-ASD SEPTALL $21,060.00 27802410 HB PROGRAMMER MED 3031A/TH90H01 PATIENT $5,850.00 27802565 HB SURGICEL ETH 1963 HEMOSTAT $333.33 27802855 HB STENT COR ALL CXXXXXXL SMART (600) $2,040.00 27803008 HB EXTENSION BOS ALL SC3138XX(615 $1,950.00 27803458 HB STENT MED ALL RSINT400XXUX INTEGRY (1225) $3,675.00 27803868 HB INTRODUCER BOS ALL 15-9XXB(11. $27.60 27803879 HB EXPANDER MEN ALL 354-9XXX(1550) $4,935.00 27804006 HB STENT MED ALL ETBFXX1XC1XXE (9476.25) $29,925.00 27804053 HB SCREW BIO ALL 18055X $375.00 27804534 HB MESH SPY ALL 330-2X05 $12,000.00 27804539 HB TUBE KIM ALL 0100-XX FEEDING (30.49) $92.34 27804771 HB PIN ARX AR-13303-2.4 $185.00 27804809 HB STENT ABB ALL 1155XXX-XX XIENCE ALPINE $7,500.00 27804885 HB STENT MED ALL ESBFXX14C103E ENDURANT IIS (9476.25) $29,925.00 27804888 HB ENVELOPE ALL MED NMRM61XX (995) $2,985.00 27805011 HB LEAD ICD BIK 379969/379970 PROTEGO $12,765.00 27805096 HB HUMERAL BIO 115375/115370 TRAY $4,800.00 27805316 HB GENERATOR STJ ALL 366X PROCLAIM ELITE $54,000.00 27805402 HB ICD MED DTMB1QQ AMPLIA QUAD $66,339.00 27805469 HB GENERATOR LIV 102 VNS PULSE $59,055.00 27805496 HB PROTECTOR AXO NERVE AXOGUARD $9,097.00 27805563 HB GENERATOR LIV 106 ASPIRE SR VNS THERAPY $84,844.80 27805599 HB SCREW SOR ALL 30-0XXX LOCKING (104) $312.00 27805613 HB LEAD PACER BOS ALL 774X-XXCM INGEVITY (600) $1,800.00 27805644 HB PENILE CLP ES2920 TITAN PUMP $22,500.00 27805730 HB TISSUE AEL MATRISTEM MM1000 PATRICLES 1000MG $7.00 27805731 HB CYTAL AEL WSM1015 MATRIX WOUND 10CMX15CM $36.90 27805769 HB COIL TER ALL 45-75XXXX AZURE $4,412.00 27806370 HB SCREW WRI ALL 57S0X0XX $2,872.00 27806542 HB SUTURE ARX AR-4501 MENISCAL CINCH PEEK $1,770.00 27806646 HB PROSTHESIS CLP 91-9511SC / 91-9513SC (8012) $13,800.00 27806710 HB NAIL SYN ALL 04.037.XXXS $2,616.63 27806771 HB TYRX MED CMRM6122/CMRM6133 ANTIBACTERIAL ABSORBABLE $2,685.00 27807097 HB COMPONENT LBO 16-2823/21 69 MM WIDE (ONE TIME USE) $24,980.00 27807098 HB STEM LBO 15-8522-02 28 X 30 MM (ONE TIME USE) $20,521.00 27807099 HB COMPONENT LBO 16-2849/25 65 MM WIDE (ONE TIME USE) $29,507.00 27807100 HB STEM LBO 15-8522/52 14X 9 X 16 MM (ONE TIME USE) $10,635.00 27807101 HB STEM LBO 15-8523/42 14/10 MM X 130 MM (ONE TIME USE) $7,580.00 27807102 HB STEM LBO 15-8525/42 14/9 X 160 MM (ONE TIME USE) $7,286.00 27807103 HB STAR LBO 15-2975/01 14 MM MEDIUM (ONE TIME USE) $967.00 27807235 HB PLATE ARX AR-13200D-08 $2,330.00 27807236 HB SCREW ARX ALL AR-8835-XX 3.5MM $174.00 27840002 HB CATH ANGIO LEVEL 1 $1,557.00 27840003 HB CATH ANGIO LEVEL 2 $4,930.00 27840004 HB CATH ANGIO LEVEL 3 $9,516.00 27840005 HB CATH ANGIO LEVEL 4 $11,466.00 27840006 HB CATH ANGIO LEVEL 5 $20,644.00 27840008 HB GUIDEWIRE LEVEL 1 $779.00 27840009 HB GUIDEWIRE LEVEL 2 $2,333.00 27840010 HB GUIDEWIRE LEVEL 3 $3,440.00 27840011 HB GUIDEWIRE LEVEL 4 $5,733.00 27840012 HB GUIDEWIRE LEVEL 5 $8,026.00 27840013 HB GUIDEWIRE LEVEL 6 $9,072.50 27840014 HB GUIDEWIRE LEVEL 7 $11,087.50 27840015 HB GUIDEWIRE LEVEL 9 $15,120.00 27840066 HB REP DEV URINRY W/SL1 $9,172.00 27840067 HB REP DEV URINRY W/SL2 $28,084.00 27840068 HB REP DEV URINRY W/SL3 $62,192.00 27840070 HB CATH RETRIEVAL 2 $13,224.50 27840071 HB CATH RETRIEVAL 1 $15,364.00 27840076 HB LEAD NEUROSTIMULAT 1 $20,160.00 27840077 HB LEAD NEUROSTIMULAT 2 $72,024.00 27840078 HB LEAD NEUROSTIMULAT 3 $51,172.00 27840079 HB LEAD NEUROSTIMULAT 4 $52,936.00 27840113 HB MESH IMPLANTABLE 1 $3,111.00 27840114 HB MESH IMPLANTABLE 2 $6,879.00 27840115 HB MESH IMPLANTABLE 3 $11,466.00 27840116 HB MESH IMPLANTABLE 4 $16,051.00 27840117 HB MESH IMPLANTABLE 5 $20,638.00 27840118 HB MESH IMPLANTABLE 6 $26,371.00 27840119 HB MESH IMPLANTABLE 7 $28,188.00 27840120 HB MESH IMPLANTABLE 8 $30,719.00 27840122 HB MESH IMPLANTABLE 12 $12,000.00 27840123 HB MESH IMPLANTABLE 9 $29,238.50 27840124 HB MORCELLATOR 2 $19,446.00 27840141 HB CATH-DRAINAG LEVEL 1 $498.00 27840142 HB CATH-DRAINAG LEVEL 2 $1,962.00 27840143 HB CATH-DRAINAG LEVEL 3 $4,015.00 27840145 HB CATH-DRAINAG LEVEL 7 $17,136.00 27840146 HB CATH-DRAINAG LEVEL 6 $12,601.00 27840147 HB CATH-DRAINAG LEVEL 4 $7,454.00 27840148 HB CATH-DRAINAG LEVEL 5 $10,894.00 27840149 HB CATH-DRAINAG LEVEL 8 $28,664.00 27840150 HB CATH-DRAINAG LEVEL 9 $25,867.00 27840151 HB CATH EP 19 OR FEW 1 $11,588.00 27840152 HB CATH EP 19 OR FEW 2 $22,431.00 27840153 HB CATH EP 19 OR FEW 3 $6,658.00 27840154 HB CATH EP DIG/ABL 3D 1 $4,214.00 27840155 HB CATH EP DIG/ABL 3D 2 $41,604.00 27840156 HB CATH HEMODIAL LT 2 $8,870.00 27840157 HB CATH HEMODIAL LT 1 $4,587.00 27840158 HB CATH INFUS PERIF 1 $498.00 27840159 HB CATH INFUS PERIF 2 $1,166.00 27840160 HB CATH INFUS PERIF 3 $2,333.00 27840161 HB CATH INFUS PERIF 4 $3,624.00 27840162 HB CATH INFUS PERIF 6 $5,160.00 27840163 HB CATH INFUS PERIF 7 $6,307.00 27840164 HB CATH INFUS PERIF 5 $4,015.00 27840165 HB CATH INFUS PERIF 9 $9,747.00 27840166 HB CATH INFUS PERIF 10 $12,095.50 27840167 HB CATH INFUS PERIF 12 $27,627.50 27840172 HB CATH HEMODIAL ST 2 $5,606.00 27840173 HB CATH HEMODIAL ST 1 $1,680.00 27840176 HB LEAD NEUROSTM TST K1 $13,064.50 27840177 HB LEAD NEUROSTM TST K2 $19,121.50 27840178 HB BRACHYTHERAPY SRC YTRIUM90 $761.00 27840181 HB STENT NONCOR TM W/O 2 $4,668.00 27840182 HB STENT NONCOR TM W/O 1 $10,123.00 27840183 HB STENT NONCOR TM W/O 4 $21,169.00 27840187 HB STENT NON-COR TM DL 3 $99,999.00 27840188 HB STENT NON-COR TM DL 1 $2,333.00 27840189 HB STENT NON-COR TM DL 2 $22,015.00 27840208 HB CATHETER SUPRPUBC-CYSTO1 $3,440.00 27840209 HB EMBOLIZ PROTECT SYS1 $15,120.00 27840210 HB EMBOLIZ PROTECT SYS2 $21,292.50 27840211 HB EMBOLIZ PROTECT SYS5 $13,499.50 27840212 HB EMBOLIZ PROTECT SYS4 $15,355.00 27840213 HB CATH TRNSLUM ANG LA1 $20,160.00 27840214 HB CATH ABLATION NONVAS $21,261.00 27840215 HB CATHETER GUIDING 1 $115.50 27840216 HB CATHETER GUIDING 2 $5,733.00 27840217 HB CATHETER GUIDING 3 $12,905.00 27840244 HB CATH ABLTN NOCRD ED1 $3,420.00 27840245 HB CATH ABLTN NOCRD ED2 $22,105.50 27840246 HB CATH ABLTN NOCRD ED4 $10,514.50 27840248 HB DEVICE IMPELLA L1 $60,745.00 27840249 HB SHEATH PEEL-AWAY 1 $1,237.00 27840250 HB SHEATH PEEL-AWAY 2 $3,111.00 27840251 HB SHEATH PEEL-AWAY 3 $4,407.00 27840253 HB INTRODUCER SHTH FIX NO-PL 2 $3,705.00 27840254 HB INTRODUCER SHTH FIX NO-PL 1 $3,393.00 27840259 HB SHEATH NON-LASR 1 $3,111.00 27840260 HB SHEATH NON-LASR 2 $8,026.00 27840261 HB SHEATH NON-LASR 5 $25,201.00 27840262 HB SHEATH NON-LASR 3 $17,198.00 27840264 HB BRACHYTHERAPY NONSTR P-103 $713.00 27840265 HB NERVE NEURAWRAP NV PROT CM $4,201.75 27840285 HB BONE CEMENT 3 $3,644.00 27840286 HB BONE CEMENT 5 $11,683.00 27840287 HB BONE CEMENT 1 $696.00 27840288 HB BONE CEMENT 2 $1,961.00 27840289 HB ANCHOR SCREW LEVEL 1 $561.00 27840290 HB ANCHOR SCREW LEVEL 2 $1,339.00 27840291 HB ANCHOR SCREW LEVEL 3 $2,116.00 27840292 HB ANCHOR SCREW LEVEL 4 $3,267.00 27840293 HB ANCHOR SCREW LEVEL 5 $3,440.00 27840294 HB ANCHOR SCREW LEVEL 6 $5,733.00 27840295 HB ANCHOR SCREW LEVEL 7 $6,879.00 27840296 HB ANCHOR SCREW LEVEL 8 $9,172.00 27840297 HB ANCHOR SCREW LEVEL 9 $13,415.00 27840298 HB ANCHOR SCREW LEVEL 10 $18,345.00 27840299 HB ANCHOR SCREW LEVEL 11 $22,931.00 27840300 HB ANCHOR SCREW LEVEL 12 $32,517.00 27840301 HB ANCHOR SCREW LEVEL 13 $36,759.00 27840302 HB ANCHOR SCREW LEVEL 14 $36,953.00 27840304 HB BONE CEMENT 4 $6,914.00 27840305 HB ANCHOR SCREW LEVEL 21 $99,999.50 27840306 HB ANCHOR SCREW LEVEL 18 $94,214.00 27840307 HB ANCHOR SCREW LEVEL 15 $51,733.00 27840308 HB ANCHOR SCREW LEVEL 16 $66,515.00 27840309 HB ANCHOR SCREW LEVEL 17 $84,991.00 27840311 HB CATH TRNS ARTHR DIR1 $18,986.00 27840312 HB CATH TRNS ARTHR DIR2 $38,982.50 27840313 HB CATH TRNS ARTHR DIR4 $24,088.00 27840320 HB CATH BAL DIL NONVAS1 $5,733.00 27840321 HB CATH BAL DIL NONVAS2 $14,791.00 27840322 HB CATH BAL DIL NONVAS3 $2,521.00 27840323 HB CATH BAL DIL NONVAS5 $14,518.00 27840325 HB ACCESS DIALYSIS SYS1 $3,746.50 27840326 HB FILTER VENA CAVA 1 $10,080.00 27840327 HB FILTER VENA CAVA 2 $25,104.50 27840328 HB FILTER VENA CAVA 3 $6,706.00 27840329 HB FILTER VENA CAVA 4 $15,354.00 27840334 HB MATRL FOR VOCAL CORD $6,075.00 27840341 HB STENT NO COCV W/DEL 3 $32,488.00 27840342 HB STENT NO COCV W/DEL 1 $11,466.00 27840343 HB STENT NO COCV W/DEL 2 $22,172.00 27840350 HB STENT COAT/COV W/DEL1 $4,030.00 27840351 HB STENT MED RONYX30015UX RESOLUTE ONYX DRUG ELUTING 3.0 X 15MM $34,661.00 27840352 HB STENT COAT/COV W/DEL3 $66,442.00 27840353 HB STENT COAT/COV W/DEL4 $99,999.00 27840354 HB STENT COAT/COV W/DEL5 $71,650.00 27840359 HB GENRATOR NEURO RECHR $4,416.00 27840367 HB PORT 1 $2,735.00 27840368 HB PORT 2 $6,879.00 27840369 HB PORT 3 $15,827.00 27840370 HB IMPLANT BREAST 1 $5,040.00 27840371 HB IMPLANT BREAST 3 $20,792.00 27840372 HB IMPLANT BREAST 2 $19,491.00 27840373 HB IMPLANT BREAST 4 $35,475.00 27840375 HB PROGRAMMER PATIENT NEURO3 $39,242.00 27840376 HB PROGRAMMER PATIENT NEURO1 $29,797.00 27840377 HB PROGRAMMER PATIENT NEURO2 $15,042.00 27840379 HB PROSTHESIS PENILE INFL 1 $10,080.00 27840380 HB PROSTHESIS PENILE INFL 2 $29,562.00 27840382 HB PROSTHESIS PENILE INFL 4 $99,999.00 27840383 HB IMPLANT INTERSPINOUS L2 $13,788.00 27840384 HB IMPLANT INTERSPINOUS L3 $41,930.00 27840385 HB PROSTHESIS URINARY SPHB 1 $25,201.00 27840386 HB PROSTHESIS URINARY SPHB 2 $49,347.00 27840387 HB GRAFT VASCULAR 8 $99,999.00 27840388 HB GRAFT VASCULAR 7 $71,473.00 27840389 HB GRAFT VASCULAR 1 $5,733.00 27840390 HB GRAFT VASCULAR 2 $17,198.00 27840391 HB GRAFT VASCULAR 3 $22,172.00 27840392 HB GRAFT VASCULAR 4 $36,953.00 27840393 HB GRAFT VASCULAR 5 $51,733.00 27840394 HB GRAFT VASCULAR 6 $66,515.00 27840411 HB GENERATOR NEUROSTM 2 $99,999.00 27840412 HB GENERATOR NEUROSTM 1 $64,975.00 27840421 HB INTRODUCER SHETH STRBL NP $13,663.00 27840422 HB INTRODUCER SHETH STRBL N3 $8,893.00 27840423 HB INTRODUCER SHETH STRBL N4 $10,205.00 27840425 HB ADHESION BARRIER1 $3,111.00 27840426 HB ADHESION BARRIER2 $13,966.00 27840427 HB ADHESION BARRIER3 $7,832.00 27840429 HB EVENT RECRDR CARDIAC $27,059.00 27840433 HB CATHETER INTRASPINAL $8,079.00 27840435 HB CATH THRMB/EMBOL 1 $1,030.00 27840436 HB CATH THRMB/EMBOL 2 $8,026.00 27840437 HB CATH THRMB/EMBOL 3 $17,198.00 27840438 HB CATH THRMB/EMBOL 4 $22,394.00 27840440 HB CLOSURE DEVIC VASC 2 $16,079.00 27840441 HB CLOSURE DEVIC VASC 1 $5,733.00 27840446 HB TISSUE NON-HUMAN 5 $37,686.00 27840447 HB TISSUE NON-HUMAN 6 $46,781.50 27840448 HB TISSUE NON-HUMAN 1 $5,733.00 27840449 HB TISSUE NON-HUMAN 2 $17,198.00 27840450 HB TISSUE NON-HUMAN 3 $32,103.00 27840451 HB TISSUE NON-HUMAN 4 $32,518.00 27840452 HB TISSUE CONN HUMAN 10 $99,999.00 27840453 HB TISSUE CONN HUMAN 7 $77,970.00 27840454 HB TISSUE CONN HUMAN 1 $4,587.00 27840455 HB TISSUE CONN HUMAN 2 $15,043.00 27840456 HB TISSUE CONN HUMAN 3 $26,238.00 27840457 HB TISSUE CONN HUMAN 4 $35,475.00 27840458 HB TISSUE CONN HUMAN 5 $47,300.00 27840459 HB TISSUE CONN HUMAN 6 $63,559.00 27840461 HB COLLAGEN URIN /2.5ML $616.50 27840462 HB SYNTH IMP URIN1/1ML $9,565.50 27840463 HB SYNTH IMP URIN2/1ML $10,345.00 27840481 HB AUD OSSEO DEV COMP 2 $37,605.00 27840510 HB HAND ASSIST DEVICE $99,999.00 27840511 HB EAR TUBES-DRAINAGE 2 $2,051.50 27840512 HB EMBOLIZATION COIL 1 $836.00 27840513 HB IMPLANT OTHER LVL 1 $1,031.00 27840514 HB IMPLANT OTHER LVL 2 $2,704.00 27840515 HB IMPLANT OTHER LVL 3 $5,795.00 27840516 HB IMPLANT OTHER LVL 4 $11,591.00 27840517 HB IMPLANT OTHER LVL 5 $18,030.00 27840518 HB IMPLANT OTHER LVL 6 $38,636.00 27840519 HB EAR TUBES DRAINAGE 1 $605.00 27840752 HB PIN JUR W332-CR $18.00 27840753 HB PIN JUR W062-GN $18.00 27840754 HB PIN JUR W045-YL $18.50 27841027 HB BUR MED ALL 75BAXX (116.45) $7,980.00 27841028 HB VALVE ELS ALL 3000XX (6895) CRP-ED $20,685.00 27841029 HB CATH JJH SNDSTR10G 3D REPROCESSED $7,980.00 27841032 HB OCCLUDER ABB 9-ASD-009 VASCULAR $22,323.00 27841033 HB MESH ARA 31048 TISSUE $7,710.00 27841034 HB MESH ARA 31049 TISSUE $11,310.00 27841035 HB CAGE SEA 34-5106 HOLLYWOOD CAGE $12,928.50 27841036 HB LEAD PACER ABB 1648T $11,700.00 27841037 HB LEAD PACER ABB 407458 $1,662.00 27841038 HB FILLER SOR 65-0003-S CALLOS $2,985.00 27841039 HB FILLER ILC 05-6010-100 OSSATURA $3,581.55 27841040 HB FILLER ILC CCM10210 INTEGRA MOZAIK $3,581.73 27841041 HB PROCESSOR COC 95204 $10,665.00 27841042 HB TROCAR MED MS101008 DILATOR $394.11 27841043 HB CATH JJH 10439072 SOUNDSTAR $7,980.00 27842001 HB STENT ENX A28-28/C95-O20V GRAFT $15,897.00 27842002 HB STENT ENX A34-34/C100-O20V GRAFT $15,897.00 27842003 HB STENT ENX A28-28/C75-O20V GRAFT $15,897.00 27842004 HB NEUROSTIM BOS SC-1140 SET $48,300.00 27842005 HB NEUROSTIM BOS M365SC1032B0 $51,900.00 27842006 HB NEUROSTIM STJ 3771 $86,985.00 27842007 HB PROSTHESIS CLP 9816-I PENILE $21,615.00 27842008 HB PROSTHESIS CLP ESR818 PENILE $22,260.00 27842009 HB PROSTHESIS CLP ESR820 PENILE $26,694.00 27842010 HB PROSTHESIS AMS ALL 7240145X PENILE $32,980.92 27842011 HB STENT ENX ALL BA-2X-80/IXX-40 GRAFT $34,740.00 27842012 HB STENT TVR TV-2680-J GRAFT $35,997.00 27842013 HB STENT ENX BEA28-120/I20-40 GRAFT $41,997.00 27842014 HB STENT ENX BEA25-70/I16-30 GRAFT $41,997.00 27845067 HB TOTAL HIP DEPUY L98016 CEMENTLESS FEM STEM HA COATED SZ 16 $26,325.00 27845081 HB FILLER BIO A0210-09 BONE VOID FILLER 5ML $1,185.00 27845082 HB FILLER BIO A0210-08 BONE VOID FILLER 10ML $2,085.00 27845098 HB MONITOR BIK 436066 BIOMONITOR III $12,900.00 27845171 HB SLING BOS M0068503000 URETHRAL LYNX SUPRAPUBIC $4,503.69 27845206 HB TISSUE MTF WC2068 SOMAGEN 6CM X 8CM MESHED $9,944.00 27845213 HB CEMENT SNE 71271570 RALLY HV AB BONE CEMENT 40G $173.73 27845214 HB INSERT SNE 7170.4565 FEMORALCOMP/ART INSERT/TIBIAL $13,800.00 27845215 HB STENT MED ALL RONYX2001XUX RESOLUTE ONYX RX DES $2,475.00 27845216 HB SHEATH MED SUL7 SAFESHEATH ULTRA 7 FR, 23 CM $175.20 27845217 HB SHEATH MED 080023 SHEATH INPUT, 8 FR, 23 CM $117.00 27845218 HB INTRODUCER MMD ALL PIDXF11018NTPD PRELUDE IDEAL SHEATH $165.00 27845219 HB INTRODUCER MMD CLS-1007 SPLITTABLE INTRODUCER $95.79 27845220 HB SHEATH TER RSS601 6 FR PINNACLE SHEATH, 10CM $29.70 27845221 HB GUIDEWIRE TER GR3508 ANGLED GLIDEWIRE, .035ö, 180 CM $115.50 27845222 HB INTRODUCER TER 80-160 6 FR GLIDESHEATH SLENDER , RADIAL ACCESS $174.00 27845223 HB SHEATH TER RSS502 5 FR PINNACLE SHEATH, 10 CM $29.10 27845229 HB ANCHOR ART AR-8925SS SYNDESMOSIS TIGHTROPE XP IMPLANT SYSTEM $4,485.00 27845230 HB CATH ARR CS-15422-VFI VECTORFLOW ANTEGRADE HEMODIALYSIS 42CM $893.19 27845231 HB CEMENT ZIM 110035368 BONE CEMENT R 1X40 $225.00 27845232 HB GRAFT AZI CMCV-013-609 VASCURE 1X10C VASULAR REPAIR $1,185.00 27845233 HB STENT ABB ALL 1550XXX-XX XIENCE SIERRA DRUG ELUTING $6,900.00 27845234 HB STENT ABB ALL 1550275-X8 XIENCE SIERRA 2.75 X X8 $6,900.00 27845235 HB BEARING BIO 183660 VANGUARD 79/83X10MM $2,754.00 27845246 HB CATH BOS 109676-001 ANGIOJET SOLENT PROXI $10,152.00 27845247 HB STENT EV3 EVD35-07-150-120 EVERFLEX 7 X 150 CM $3,225.00 27845248 HB SLING BOS M0068502120 ADVANTAGE FIT BLUE $4,728.00 27845249 HB SCREW SYN 872.21 TFNA FENESTRATED 90MM $2,616.63 27845250 HB ROD ATI 62002-20 CP TI 5.5MM X 20CM $873.00 27845251 HB PLATE ARX AR-8943BL-08 LOCKING DISAL FIB PLATE LEFT 8 HOLE $3,562.00 27845252 HB SCREW ARX AR-8827L-16 2.7 X 16 LOCKING SCREW $515.00 27845253 HB SCREW MLN SNAP2012 12MM X 2.0MM SNAP OFF $1,344.00 27845254 HB ANCHOR ARX AR-2600SBS-8 SPEEDBRIDGE IMPLANT SYSTEM W/ MULTIFIRE NEEDLE $5,730.00 27845256 HB SCREW ZIM115395 25MM 6.5MM 3.5MM SHOULDER CENTRAL HEXAGON DRIVER $210.00 27845257 HB SCREW ZIM 180551 20MM 4.75MM 3.5MM SHOULDER FIX ANGLE LOCK $210.00 27845258 HB SCREW ZIM180557 3.5MM 15MM 4.75MM SHOULDER VARIABLE ANGLE NON-LOCK $210.00 27845259 HB COMPONENT ZIM 115310 36MM STANDARD GLENOID GLENOSPHERE COLOR $3,000.00 27845261 HB STENT MED RONYX40022UX RESOLUTE ONYX 4.0 X 22 DRUG ELUTING STENT $4,946.00 27845262 HB STENT MED RONYX27538UX RESOLUTE ONYX 2.75 X 38 DRUG ELUTING STENT $4,946.00 27845269 HB IMPLANT BIO 115396 6.5MM X 30MM CENTRAL SCREW $210.00 27850000 HB NEEDLE BRACHYTHERAPY $3,111.00 27850002 HB CATH TRNS ARTHR ROT 3 $37,369.00 27850003 HB CATH BRACHY SEED AD 1 $2,735.00 27850004 HB PUMP INF PROGRAM LV 4 $89,071.50 27850005 HB PUMP INF PROGRAM LV 6 $60,745.00 27850006 HB JOINT DEVICE IMPLT 1 $11,466.00 27850007 HB JOINT DEVICE IMPLT 2 $22,172.00 27850008 HB JOINT DEVICE IMPLT 3 $33,257.00 27850009 HB JOINT DEVICE IMPLT 4 $48,039.00 27850010 HB JOINT DEVICE IMPLT 5 $66,515.00 27850011 HB JOINT DEVICE IMPLT 6 $84,991.00 29900025 HB SHEAR ETH 5DCS $76.20 30000001 HB VENIPUNCTURE (PROCEDURE) $82.00 30000002 HB CAPILLARY BLOOD STICK (FINGER, HEEL, EAR) $172.00 30000004 HB HEMOCCULT W/OUT SIGNS/SYMPTOMS $130.00 30000007 HB SKIN TEST/TB/INTRADERMAL $56.50 30000008 HB URINE DIP NON AUTO W/O MICRO $84.00 30000009 HB RSV RAPID TEST $111.50 30000010 HB INS CATH FOR SPECIMEN COLLECT $14.00 30000012 HB PH-NITRAZINE $247.50 30000027 HB FUNGAL CULTURE $283.00 30000051 HB SPECIMEN (CHAIN OF CUSTODY) $36.00 30600001 HB RAPID STREP TEST $300.00 30600002 HB RAPID FLU TEST $178.50 30700007 HB URINE PREG TEST-DIAG USE ONLY $118.00 30900022 HB SEMEN ANALYSIS $202.50 32000002 HB XRAY MANDIBLE 4 $1,117.00 32000004 HB XRAY FACIAL < 3 $1,468.00 32000005 HB XRAY FACIAL 3 $1,117.00 32000006 HB XRAY NASAL COMP $712.00 32000007 HB XRAY ORBITS COMP $943.50 32000008 HB XRAY SINUS < 3 $654.00 32000009 HB XRAY SINUS COMP $1,050.50 32000010 HB XRAY SKULL < 4 $814.50 32000011 HB XRAY SKULL COMP $1,066.00 32000017 HB XRAY TMJ BILATERAL $1,059.50 32000019 HB ORTHOPANOGRAM X-RAY $798.50 32000020 HB XRAY NECK SOFT TISSUE $925.50 32000022 HB XRAY SIALOGRAPHY $2,184.50 32000023 HB XRAY RIBS UNILAT 2V $569.00 32000024 HB XRAY X-RAY RIBS/CHEST UNILAT $695.00 32000025 HB XRAY RIBS BILAT 3V $1,019.50 32000026 HB XRAY RIBS BILAT 4 $1,147.50 32000027 HB XRAY STERNUM 2 VIEWS $861.50 32000028 HB XRAY STERNOCLAVICULAR $733.50 32000030 HB XRAY SPINE,SINGLE V $354.00 32000031 HB XRAY SPINE,CERV AP/LT $737.00 32000032 HB XRAY SPINE,CERV 4 V $1,404.50 32000033 HB XRAY SPINE,CERV COMP $1,894.50 32000035 HB XRAY THORACIC SPINE 2 $378.50 32000036 HB XRAY THORACIC SPINE 3 $1,076.50 32000037 HB XRAY THORSPINE CONP 4 $1,475.00 32000038 HB XRAY THORACOLUMBAR 2 $1,036.50 32000040 HB XRAY LUMBOSACRAL SPIN $1,147.50 32000041 HB XRAY LUMBOSACRAL COMP $1,326.00 32000042 HB XRAY LS SP COMP BEND $1,517.00 32000043 HB XRAY LS BENDING ONLY $1,147.50 32000044 HB XRAY PELVIS,AP ONLY $925.50 32000045 HB XRAY PELVIS,COMP 3 V $905.00 32000047 HB XRAY SACROILIAC JTS > 3 $747.50 32000048 HB XRAY SACRUM & COCCYX $745.50 32000056 HB XRAY CLAVICLE,COMP $723.50 32000057 HB XRAY SCAPULA COMP $771.50 32000058 HB XRAY SHOULDER 1 VIEW $524.50 32000059 HB XRAY SHOULDER COMP 2V $1,468.00 32000060 HB XRAY AC JTS BILAT $629.50 32000061 HB XRAY HUMERUS 2 VIEWS $703.50 32000062 HB XRAY ELBOW AP/LAT $629.50 32000063 HB XRAY ELBOW MIN OF 3 V $771.50 32000064 HB XRAY FOREARM AP/LAT $771.50 32000065 HB XRAY UPPER EXTREM/INF $703.50 32000066 HB XRAY WRIST,AP/LAT $612.00 32000067 HB XRAY WRIST COMP 3 V $856.50 32000068 HB XRAY HAND 2 VIEWS $878.50 32000069 HB XRAY HAND,MIN 3 VIEWS $703.50 32000070 HB XRAY FINGER MIN 2 VIE $543.00 32000077 HB XRAY KNEE AP/LAT $703.50 32000078 HB XRAY KNEE,AP,LAT,OBL $1,044.00 32000079 HB XRAY KNEE,COMP $1,488.50 32000080 HB XRAY KNEES,BOTH KNEES, STANDING $524.00 32000081 HB XRAY TIB/FIB AP.LAT $771.50 32000082 HB XRAY LOW EXTREM/INFAN $703.50 32000083 HB XRAY ANKLE,AP/LAT $516.50 32000084 HB XRAY ANKLE,COMP 3 VIEW $771.50 32000085 HB XRAY FOOT,AP/LAT $628.00 32000086 HB XRAY FOOT,COMP,3 VIEW $1,468.00 32000087 HB XRAY HEEL MIN 2 VIEWS $544.50 32000088 HB XRAY TOES MIN 2 VIEWS $543.00 32000092 HB XRAY ABD SERIES COMP $1,582.50 32000094 HB XRAY ESOPHAGUS $1,166.50 32000095 HB XRAY SW FUNCTION $2,138.50 32000097 HB XRAY UGI W/WO FILMS W/O KUB $1,742.00 32000098 HB XRAY UGI W/KUB $2,010.00 32000099 HB XRAY UGI/SMALL BOWEL $3,339.50 32000100 HB XRAY UGI,AIR,W/WO KUB $1,609.00 32000101 HB XRAY UGI,AIR W/KUB $2,348.00 32000102 HB XRAY AIR CONT UP GI W/SM BWL FT $3,338.00 32000103 HB XRAY SMALL BOWEL $1,564.00 32000104 HB XRAY BARIUM ENEMA $2,207.00 32000105 HB XRAY BA ENEMA,AIR CONT $3,313.50 32000107 HB XRAY GALL BLADDER $420.00 32000111 HB XRAY ERCP/BILIARY $3,487.00 32000113 HB XRAY ERCP/COMBINED $4,274.00 32000114 HB INTRO LONG GI TUBE $1,250.00 32000115 HB PERC PLACE ENTEROCLYSIS TUBE $1,424.50 32000116 HB PERC T HEP DIL BIL D $3,059.00 32000118 HB XRAY IVP W/TOMO $1,818.00 32000119 HB XRAY UROGRAPHY RETROGRADE W OR WO KUB $1,960.00 32000120 HB S&I UROGRAPHY ANTEGRADE $1,167.00 32000121 HB S&I CYSTOGRAPHY; MIN 3V $1,226.00 32000122 HB S&I URETHROCYSTROGRAPHY, RETROGRADE $1,167.00 32000123 HB S&I URETHROCYSTROGRAPHY, VOIDING $1,928.00 32000126 HB S&I DILATION URETERS/URETHRA $12,829.50 32000127 HB S&I HYSTEROSALPINGOGRAPHY $1,573.50 32000128 HB XRAY VAGINOGRAM $1,250.00 32000129 HB S&I AORTOGRAPHY, THORACIC BY SERIAL $9,509.85 32000131 HB SHUNTOGRAM, PREV. PLED. SHUNT $524.50 32000132 HB VENOGRAM EXTREMITY UNILAT $5,110.00 32000133 HB VENOGRAM EXTREMITY BILATERAL $6,915.00 32000134 HB VENOGRAM INFERIOR VENACAVA $12,118.50 32000135 HB VENOGRAM SUPERIOR VENACAVA $3,928.50 32000138 HB VENOGRAPHY ADRENAL UNILAT SELECT $21,879.50 32000139 HB VENOGRAPHY ADRENAL BILAT SELECT $21,879.50 32000140 HB VENOGRAPHY VENOUS SINUS/JUGULAR $5,110.50 32000144 HB HEPATIC VENOGRAPHY W/HEMODYNAMIC EVAL $21,879.50 32000145 HB HEPATIC VENOGRAPHY W/O HEMODYNAMIC EVAL $21,879.50 32000147 HB VENOUS SAMPLE W OR WO ANGIO $21,879.50 32000148 HB TRANSCATH EMBOLIZATION THERAPY $3,831.50 32000150 HB ANGIOGRAPHY FOLLOW-UP $2,768.00 32000151 HB MECH REMOVE PERICATH OBSTR MAT $6,101.50 32000166 HB ANG TRANSCATHETER BIOPSY $7,123.00 32000170 HB REPLACE PERC DRAIN CATH $854.50 32000171 HB PERC DRAIN ABSCESS W/CATH PLMT $1,390.50 32000172 HB FLUORO UP TO 1 HOUR $1,397.50 32000174 HB SINUS TRACT ABSCESS S&I $1,669.00 32000175 HB MAMMO SURG SPECIMEN $3,294.00 32000176 HB XRAY SINGLE PLANE BODY TOMOGRAPHY $1,050.50 32000178 HB FLUORO GUIDANCE VAD PLACEMENT $1,420.00 32000179 HB FLUORO GUIDANCE NEEDLE PLACEMENT $596.50 32000180 HB FLUORO GUIDANCE NEEDLE LOC SPINE $1,420.00 32000183 HB BONE AGE STUDIES $452.00 32000184 HB D/P BONE LENGTH $981.00 32000186 HB D/P OSSEOUS SURVEY COMP $3,497.50 32000187 HB D/P OSSEOUS SURVEY INFANT $723.50 32000188 HB DEXA BONE DENSITY STUDY $967.50 32000194 HB DEXA BONE STUDY; APPENDICULAR $585.50 32000198 HB JOINT SURVEY SGL VIEW 2+ JOINTS $519.00 32000202 HB XRAY SPINE ONE VIEW $3,263.00 32000203 HB XRAY SPINE 2 OR 3 VIEWS $3,263.00 32000204 HB XRAY SPINE 4 OR 5 VIEWS $6,526.00 32000205 HB XRAY SPINE MINIMUM 6 VIEWS $6,526.00 32000206 HB XRAY HIP UNILATERAL 1 VIEW $580.50 32000207 HB XRAY HIP UNILATERAL 2-3 VIEWS $935.00 32000208 HB XRAY HIP UNILATERAL MINIMUM 4 VIEWS $1,403.50 32000209 HB XRAY HIP BILATERAL 2 VIEWS $1,244.50 32000210 HB XRAY HIP BILATERAL 3-4 VIEWS $1,244.50 32000211 HB XRAY HIP BILATERAL MINIMUM 5 VIEWS $2,488.00 32000212 HB XRAY FEMUR 1 VIEW $544.50 32000213 HB XRAY FEMUR MINIMUM 2 VIEWS $703.50 32000214 HB RENAL CASE STUDY $3,345.50 32000218 HB X-RAY EXAM ABDOMEN 1 VIEW $618.50 32000219 HB X-RAY EXAM ABDOMEN 2 VIEWS $740.00 32000220 HB X-RAY EXAM ABDOMEN 3+ VIEWS $861.50 32000239 HB CINE/VIDEO SPEECH EVAL $709.00 32000308 HB PERITONEOGRAM AFTER INJECTION $3,345.50 32000309 HB XRAY SMALL BOWEL $1,938.00 32000310 HB CHOLANGIOGRAM -INTRAOPERATIVE $1,202.00 32000311 HB CHOLANGIOGRAM ADD'L INTRAOP $1,202.00 32000312 HB UROGRAPHY INFUSION IVP $1,397.50 32000313 HB XRAY NOSE TO RECTUM -CHILD $685.00 32000315 HB XRAY MAMMARY SINGLE DUCTOGRAM $1,227.50 32000316 HB XRAY MAMMARY MULTI DUCTOGRAM $1,227.50 32200001 HB XRAY SHOULDER ARTHROG $5,884.00 32200002 HB XRAY ELBOW ARTHROGRAP $2,942.00 32200003 HB XRAY WRIST ARTHROGRAP $2,942.00 32200004 HB XRAY HIP ARTHROGRAPHY $2,942.00 32200005 HB XRAY KNEE ARTHROGRAPH $2,942.00 32300001 HB S&I ADBOMINAL AORTA BY SERIAL $9,509.85 32300003 HB S&I AORTOGRAPHY, ABDOMINAL + BILAT LWR EXT $9,509.85 32300006 HB ANGIO EXTREMITY UNILATERAL $9,509.85 32300008 HB ANGIO EXTREMITY BILATERAL $9,509.85 32300010 HB ANGIO VISCERAL SELECT $21,879.50 32300013 HB ANGIO PELVIC SELECT $8,952.39 32300014 HB ANGIO PUL SEL UNI $12,575.00 32300015 HB ANGIO PULM SELECT BILATERAL $17,016.50 32300016 HB ANGIO PUL VEN NONSEL $4,071.65 32300018 HB ANGIO SELECT EA ADDITIONAL VESSEL $4,341.50 32300020 HB IMG SIR ABD AORTA W/HRTCATH $9,509.85 32400008 HB X-RAY EXAM CHEST 1 VIEW $614.00 32400009 HB X-RAY EXAM CHEST 2 VIEWS $629.50 32400010 HB X-RAY EXAM CHEST 3 VIEWS $974.50 32400011 HB X-RAY EXAM CHEST 4+VIEWS $1,050.50 33100001 HB ADMIN IM/SUBQ CHEMO; NON-HORMON $479.50 33100002 HB ADMIN IM/SUBQ CHEMO; HORMONAL $360.50 33100003 HB ADMIN IV PUSH CHEMO $979.00 33100004 HB ADMIN IV PUSH CHEMO; EA ADDTL MED $979.00 33100005 HB CHEMO CNS (INTRATHECAL) W/LP $888.00 33300001 HB SIMULATION SIMPLE $952.00 33300002 HB SIMULATION INTERMEDIATE $1,500.00 33300003 HB SIMULATION COMPLEX $3,286.50 33300004 HB SIMULATION 3-D $9,808.50 33300005 HB BASIC DOSIMETRY CALCULATION $1,188.50 33300006 HB IMRT PLAN $10,803.50 33300010 HB SPEC.PORT PLAN $2,841.50 33300014 HB SPEC.DOS.SPECIF $1,128.00 33300015 HB TX DEVICES SIMP $1,531.00 33300016 HB TX DEVICES INT. $1,589.00 33300017 HB TX DEVICES COMP $2,877.50 33300018 HB CONT PHYSICS/QA $2,401.00 33300019 HB MLC TRMT DEVICE W/IMRT PLAN $7,499.00 33300020 HB SPECIAL PHYSICS $1,749.00 33300022 HB STEREOTACTIC MULTI SESSION $4,475.00 33300030 HB PORT FILM(S) $440.50 33300033 HB SPEC.TREATMENT $5,269.50 33300037 HB INTER.APP.COMP. $37,930.00 33300041 HB SUPERVISE, HANDLE, LOAD RADIATION SOURCE $506.00 33300044 HB RESPIRATORY MOTION MGMT SIMUL $1,749.00 33300045 HB TELETHERAPY ISODOSE PLAN - SIMPLE INCLUDING DOSIMETRY $2,705.50 33300046 HB TELETHERAPY ISODOSE PLAN - COMPLEX INCLUDING DOSIMETRY $3,654.00 33300047 HB BRACHY ISODOSE PLAN - SIMPLE INCLUDING DOSIMETRY $1,072.50 33300048 HB BRACHY ISODOSE PLAN - INTERMEDIATE INCLUDING DOSIMETRY $2,769.50 33300049 HB BRACHY ISODOSE PLAN - COMPLEX INCLUDING DOSIMETRY $4,957.50 33300050 HB IMRT - SIMPLE (INC GUIDE) $2,327.00 33300051 HB IMRT - COMPLEX (INC GUIDE) $2,327.00 33300052 HB GUIDANCE FOR RADIATION TRMT DELIVERY $2,370.50 33300053 HB RAD TREATMENT, > 1MeV; SIMPLE $943.50 33300055 HB RAD TREATMENT, > 1MeV; COMPLEX $1,640.00 33300065 HB RT-RAD TX UNLISTED $685.00 33500001 HB ADMIN INF CHEMO; 1ST HOUR $2,074.50 33500002 HB ADMIN IV INF CHEMO; EA ADDTL HOUR $660.50 33500004 HB ADMIN IV INF CHEMO; EA ADDTL SEQUENTIAL $660.50 33500006 HB ADMIN IN INF CHEMO;CONCURRENT $90.00 34100001 HB THYROID UPTAKE MEASUREMENT $1,858.00 34100002 HB THYROID IMAGING $2,063.50 34100003 HB THYROID IMAGING W/BLOOD FLOW $2,411.00 34100004 HB NM TOTAL BODY 131 SC $3,961.00 34100005 HB NM PARATHYROID $1,863.00 34100006 HB PARATHYROID IMAGING W SPECT $3,345.50 34100007 HB PARATHYROID IMAGING W SPECT&CT $3,345.50 34100011 HB NM LYMPH.IMAGING $3,565.00 34100012 HB NM LIVER/SPLEEN SPCT $6,774.00 34100013 HB LIVER IMAGING WITH VASC FLOW $7,123.00 34100014 HB NM LIVER/SPLEEN; STATIC ONLY $3,135.50 34100015 HB HEPATOBILIARY SYS IMAGING $4,201.00 34100016 HB HEPATOBILIARY IMAGING, W/GAL W/DRUG $4,201.00 34100018 HB GASTRIC EMPTY $2,906.50 34100019 HB NM GI BLEED $4,201.00 34100020 HB NM MECKELS SCAN $4,023.50 34100023 HB NM BONE SCAN WHOLE B $3,702.50 34100024 HB NM BONE 3 PHASE $4,485.50 34100025 HB NM BONE SPECT $4,749.00 34100026 HB MYOCARDIAL PERFUSION SPECT, SGL STUDY $7,043.00 34100027 HB MYOCARDIAL PERFUSION SPECT, MULTIPLE STUDIES $12,478.50 34100029 HB MYOCARDIAL PERF PLANAR MULTIPLE STUDIES $6,037.00 34100030 HB NM CARD.MUGA RESTING $2,276.50 34100032 HB NM PERFUSION LUNG SC $3,160.00 34100033 HB PULMONARY VENT & PERF IMAGE $4,920.00 34100034 HB QUANT DIFF PULM PERF;INC IMAGE $8,364.50 34100035 HB QUANT PULM PERF&VENT; INC IMAG $10,125.50 34100037 HB NM BRAIN SPECT HMPO $9,199.00 34100038 HB NM BRAIN FLOW BR.DEA $2,226.00 34100039 HB NM CISTERNOGRAM $4,671.00 34100041 HB NM RENAL FLOW STUDY $2,888.00 34100042 HB NM RENAL SCAN W/FLOW $2,888.00 34100043 HB NM KIDNEY FLOW/FUNCTION;W/PHAR $4,266.00 34100044 HB NM KIDNEY FL/FUNC;MULT W/WO PH $4,312.50 34100045 HB NM RENAL SPECT $7,067.00 34100046 HB NM VCU $3,341.50 34100047 HB TUMOR LOC MULTI AREA $4,541.50 34100048 HB TUMOR LOC WB $5,859.00 34100050 HB WHOLEBODY TUMOR LOC MULT DAYS $6,312.00 34100051 HB ABSCESS LOC LTD $3,416.00 34100052 HB ABSCESS LOC WB $4,123.50 34100057 HB NUCLEAR DIAG EXAM $1,012.00 34100064 HB URINARY BLADDER RETENTION STUDY $948.50 34100075 HB NM BONE/JOINT SCAN - MULTI AREAS $3,663.00 34100076 HB NM CARDIAC SHUNT DETECT $3,565.00 34100078 HC NM - MYOCARD INFARCT $2,581.50 34100080 HB NM CARDIAC BLOOD POOL IMG - MULTI $4,606.00 34100083 HC NM BRAIN SCAN STATIC W/FLOW $6,434.00 34100084 HB NM KIDNEY FUNCTION W/RI $1,452.50 34100085 HB NM TESTICULAR SCAN W/FLOW $3,342.50 34200001 HB RADIOPHARM THERAPY ORAL $4,205.50 34200002 HB RADIOPHARM THERAPY IV $6,687.00 34300000 HB RX 344-TX RADIOPHARM $8,434.18 34400000 HB RX 343-DX RADIOPHARM $15,034.11 35000005 HB CT HEART W/3D IMAGE $1,382.00 35000006 HB CTA HEART W/3D IMAGE $2,165.00 35000007 HB CT LIMITED OR FOLLOW UP $1,956.00 35000009 HB 3D RENDERING CT/MR/US INDEPEND $1,595.00 35000010 HB CT GUIDANCE PLACE RAD TX FIELDS $2,450.00 35000011 HB CT GUIDANCE NEEDLE PLCMNT $3,002.00 35000012 HB CT GUIDANCE TUMOR ABLATION $2,941.00 35000013 HB 3D RENDERING CT/MR/US NONINDEP $798.50 35100001 HB CT HEAD W/O CONTRAST $3,811.50 35100002 HB CT HEAD W/CONTRAST $5,095.50 35100003 HB CT HEAD WO CONTRAST F-BY CONTRAST $6,401.50 35100004 HB CT PIT, PF W/O CONTRAST (ORB) $4,666.50 35100005 HB CT ORB,PIT,PF W/CONTRAST $4,633.00 35100006 HB CT ORB,PIT,PF WO CONTRAST F-BY CONTRAST $8,036.00 35100007 HB CT FACIAL/SINUS WO CONTRAST $4,001.50 35100008 HB CT MAXILLIOFACIAL W/CONTRAST $4,633.00 35100009 HB CT MAXILLOFACIALWO CONTRAST F-BY CONTRAST $8,036.00 35100010 HB CT SOFT TISSUE NECK W/O CONTRAST $4,112.00 35100011 HB CT SOFT TISSUE NECK W/CONTRAST $4,693.00 35100012 HB CT SOFT TISSUE NECK WO CONTRAST F-BY CONTRAST $8,039.50 35100013 HB CTA HEAD W CONTRAST $7,123.00 35200001 HB CTA NECK W CONTRAST $6,595.50 35200002 HB CT CHEST W/O CONTRAST $5,202.00 35200003 HB CT CHEST W/CONTRAST $5,867.50 35200004 HB CT CHEST W/WO CONTRAST $2,863.50 35200005 HB CTA CHEST $6,595.50 35200006 HB CT CERV SPINE W/O CONTRAST $5,796.50 35200007 HB CT CERV SPINE W/CONTRAST $5,393.50 35200008 HB CT CERV SPINE W/WO CONTRAST $2,681.50 35200009 HB CT THOR SPINE W/O CONTRAST $5,273.50 35200010 HB CT THOR SPINE W/CONTRAST $6,201.50 35200011 HB CT THOR SPINE W/WO CONTRAST $2,681.50 35200012 HB CT LUMBAR SPINE W/O CONTRAST $5,803.50 35200013 HB CT LUM SPINE W/CONTRAST $5,400.50 35200014 HB CT LUM SPINE W/WO CONTRAST $6,822.50 35200015 HB CTA PELVIS $6,595.50 35200016 HB CT PELVIS W/O CONTRAST $3,966.00 35200017 HB CT PELVIS W/CONTRAST $5,647.00 35200018 HB CT PELVIS WO CONTRAST F-BY CONTRAST $5,634.00 35200019 HB CT UPPER EXT W/O CONT $4,090.00 35200020 HB CT UPPER EXT W/CONTR $4,212.50 35200021 HB CT UPPER EXT W/WO CONT $5,305.50 35200022 HB CTA UPPER EXTREMITY $6,595.50 35200023 HB CT LOWER EXT W/O CONT $4,702.00 35200024 HB CT LOWER EXT W/CONT $4,795.00 35200025 HB CT LOWER EXT W/&W/O CONTRAST $2,681.50 35200026 HB CTA LOWER EXTREMITY $6,595.50 35200027 HB CT ABDOMEN W/O CONTRAST $4,612.50 35200028 HB CT ABDOMEN W/CONTRAST $6,239.50 35200029 HB CT ABDOMEN WO CONTRAST F-BY CONTRAST $8,849.50 35200030 HB CTA ABDOMEN & PELVIS W/CONTRAST $15,389.50 35200031 HB CTA ABDOMEN W CONTRAST $8,793.50 35200032 HB CT ABDOMEN & PELVIS WO CONTRAST $8,579.50 35200033 HB CT ABDOMEN & PELVIS W/CONTRAST $11,874.00 35200034 HB CT ABDOMEN & PELVIS WO CONTRAST F-BY CONTRAST $14,484.00 35200035 HB CT HEART W/3D IMAGE, CONGENITA $5,879.50 35200036 HB CTA ADB AORTA W/BILAT ILIO RUN $8,793.50 36000003 HB INSERT VAD;ART ACCESS ONLY $36,952.00 36000005 HB REMOVAL VAD DIFFERENT SESSION $9,338.00 36000006 HB REPOSITION VAD;DIFF SESSION $6,920.00 36000008 HB NS CATH PLACE; THORACIC AORTA $29,149.00 36000009 HB CATH PLACE;CAROTID/INOM W ANG $63,094.50 36000010 HB CATH PLACE;CAROTID/INOM EXTRA $76,761.50 36000011 HB CATH PLACE;INTERNAL CAROTID $77,601.50 36000012 HB CATH PLACE;SUBCLAVIAN ART $19,733.50 36000013 HB CATH PLACE;EXTERNAL CAROTID $50,976.50 36000014 HB CATH PLACE;EXTERNAL CAROTID $30,979.00 36000016 HB TRANSCATH RETRIEVE;FB $25,722.50 36000023 HB OR PER MINUTE $356.00 36000032 HB OR L&D PER MIN $356.00 36000058 HB THERAPEUTIC CELLULAR DEPLETION $6,473.00 36000070 HB VASC EMBOLIZE/OCCLUDE VENOUS $80,071.50 36000071 HB VASC EMBOLIZE/OCCLUDE ARTERY $80,071.50 36000072 HB VASC EMBOLIZE/OCCLUDE ORGAN $80,071.50 36000073 HB VASC EMBOLIZE/OCCLUDE HEMORRHA $80,071.50 36000081 HB ESOPHAGOSCOPY W EMR $3,104.40 36000082 HB ESOPH W BALLOON DILATION INCLUDING FLUORO $5,118.28 36000083 HB ESOPH W OPTICAL ENDOMICROSCOPY $5,118.28 36000084 HB ESOPH PNEUMATIC DILATION FOR ACHALASIA $5,118.28 36000085 HB ESOPH W WIRE GUIDED DILATION $5,118.28 36000086 HB EGD W ULTRASOUND- ALTERED ANATOMY $2,200.11 36000087 HB EGD W ULTRASOUND / FNA - ALTERED ANATOMY $2,200.11 36000088 HB EGD W POLYPECTOMY (SNARE) $2,200.11 36000090 HB EGD W DRAINAGE OF PSEUDOCYST (W EUS) $1,388.00 36000091 HB EGD W INJ OF THERAPEUTIC SUBSTANCE (W EUS) $1,388.00 36000092 HB ERCP W REMOVAL OF STENT OR FOREIGN BODY $1,576.08 36000093 HB ERCP W REMOVAL AND EXCHANGE (EA STENT) $6,829.68 36000094 HB PERCUTANEOUS T-TUBE PLACEMENT $2,212.00 36000096 HB BRONCHIAL VALVE INITIAL INSERT $21,635.28 36000097 HB BRONCHIAL VALVE INS-EA ADDTL $14,125.02 36000108 HB INSERT CANNULA FOR HEMODIALYSIS, OTHER PURPOSE (SEPARATE PROCEDURE); VEIN TO VEIN $8,515.00 36000120 HB PLACE NEPHROURETERAL CATH $30,046.00 36000121 HB PLMT BILE DUCT STENT PRQ EXISTING ACCESS $14,680.00 36000128 HB BRONCH EBUS SAMPLING 1/2 NODE $16,922.96 36000129 HB BRONCH EBUS SAMPLING 3/> NODE $16,922.96 36000130 HB BRONCH EBUS INTERVENTION FOR PERIPH LESION $6,877.44 36000134 HB PLACE BILE DUCT STENT $14,680.00 36000135 HB PLACE BILE DUCT STENT W/SEPBILIARY DRAIN CATH $20,915.50 36000143 HB INTRO CATH DIALYSIS CIRCUIT $11,885.00 36000144 HB INTRO CATH DIALYSIS CIRCUIT W/ANGIO $49,802.50 36000145 HB INTRO CATH DIALYSIS CIRCUIT W/ STENT PLACEMNT $97,475.50 36000146 HB THROM &/OR INFUSION DIALYSIS CIRCUIT $21,447.00 36000147 HB THROM &/OR INFUSION DIALYSIS CIRCUIT W/ANGIO $55,294.50 36000148 HB THROM &/OR INFUSION DIALYSIS CIRCUIT W/STENT PLACEMNT $92,578.50 36000149 HB ANGIO CENTRAL DIALYSIS SEG $37,593.00 36000151 HB DIALYSIS CIRCUIT EMBOLIZATION $67,386.00 36000152 HB TRANS ANGIO; INITIAL ARTERY $62,454.00 36000153 HB TRANS ANGIO; EA ADDTL ARTERY $24,171.00 36000154 HB TRANS ANGIO; INITIAL VEIN $62,454.00 36000155 HB TRANS ANGIO; EA ADDTL VEIN $57,880.00 36000156 HB ENTEROSCOPY W/POLYP REMOVAL BY SNARE $5,652.00 36000159 HB BRONCH W/COMPUTER-ASSIST IMG NAVIGATION $3,450.66 36000160 HB INSERT PERITONEAL-VENOUS SHUNT $1,175.50 36000163 HB LITHOTRIPSY (ESWL) PANCREAS $14,754.00 36000198 HB OR FLAT RATE - TIER 1 $1.00 36000199 HB OR FLAT RATE - TIER 2 $1.00 36000200 HB OR FLAT RATE - TIER 3 $1.00 36000201 HB OR1 PER MINUTE $356.00 36000202 HB OR2 PER MINUTE $356.00 36000203 HB OR3 PER MINUTE $356.00 36000300 HB LITHOTRIPSY $42,165.00 36000303 HB LITHOTRIPSY BILATERAL $63,247.00 36000359 HB OR PERFUSION LEVEL 1 $4,289.50 36000360 HB OR PERFUSION LEVEL 2 $5,362.50 36000361 HB OR PERFUSION LEVEL 3 $6,435.00 36000362 HB OR PERFUSION LEVEL 4 $7,508.00 36100004 HB I&D ABSCESS/SIMPLE/SINGLE $1,786.50 36100005 HB I&D ABSCESS/COMPLEX/MULTI $971.00 36100006 HB I&D PILONIDAL CYST/SIMPLE $1,790.00 36100007 HB INCIS/REM FB/SUBQ/SIMPLE $971.00 36100008 HB REM/FB/SUBQ/COMPLEX $4,250.00 36100010 HB I&D HEMATOMA/FLUID $5,649.50 36100011 HB ASPIRATION/PUNCTURE ABSCESS/HEMATOMA, BULLA/CYST $1,188.50 36100012 HB I&D COMPLEX/POST-OP WOUND INF $7,349.00 36100015 HB DEBRIDE SKIN/TISS $971.00 36100016 HB PAR/CURET/BEN/LES/SINGLE $545.00 36100017 HB PAR/CURET/BEN/LES/2-4 $545.00 36100037 HB EXC/BEN LES/TRK/ARM/LEG/2.1-3. $2,732.00 36100070 HB DEBRIDE NAIL < 6 $173.00 36100071 HB DEBRIDE NAIL >= 6 $173.00 36100072 HB AVULSION NAIL PLATE/PART/COMP/ $545.00 36100073 HB EXC/NAIL & MATRIX PERM REMOVE $971.00 36100084 HB RPR/SIM/SCP/TRK/ETC TO 2.5CM $870.00 36100085 HB RPR/SIM/SCP/TRK/ETC 2.6-7.5CM $1,040.00 36100086 HB RPR/SIM/FCE/EAR/ETC TO 2.5CM $722.00 36100087 HB RPR/SIM/FCE/EAR/ETC 20.1-30 CM $998.00 36100090 HB RPR/INT/SCP/TRK/EXT TO 2.5CM $814.00 36100091 HB RPR/INT/SCP/TRK/EXT 2.6-7.5CM $1,166.00 36100092 HB RPR/INT/SCP/TRK/EXT/7.6-12.5CM $1,404.00 36100095 HB RPR/INT/NCK/HND/FT/ TO 2.5CM $814.00 36100096 HB RPR/INT/NCK/HND/FT/2.6-7.5CM $894.00 36100099 HB RPR/INT/FCE/EAR/ETC TO 2.5CM $814.00 36100100 HB RPR/INT/FCE/EAR/NS/ 2.6-5.0CM $886.00 36100101 HB RPR/INT/FCE/EAR/NS/ 5.1-7.5CM $1,224.00 36100106 HB RPR/COMP/SCLP/ARM/2.6-7.5CM $1,174.00 36100107 HB RPR/COMP/SCLP/ARMS/EA ADD 5CM< $1,016.00 36100109 HB RPR/COMP/FOREHD/NCK/2.6-7.5CM $1,338.00 36100110 HB RPR/COMP/FOREHD/NCK/EA ADD 5CM $1,162.00 36100133 HB SKIN GFT TRK/ARM/LEG - CHILD $9,038.00 36100135 HB SKIN GFT TR/ARM/LEGS-EA ADD $4,519.00 36100151 HB DEBRID/DRESS BURN SM $545.00 36100152 HB DEBRID/DRESS BURN MED $545.00 36100153 HB DEBRID/DRESS BURN LG $971.00 36100160 HB DESTRUCT LESION UP TO 14 LESIO $674.00 36100162 HB CHEMICAL CAUTERIZE GRAN TISSUE $545.00 36100180 HB PUNCTURE/ASP CYST BREAST INITIAL $2,932.50 36100181 HB PUNCTURE/ASP/CYST BREAST/EA AD $737.00 36100192 HB BX/MUSCLE/PERCUTANEOUS NEEDLE $4,527.50 36100193 HB BX/BONE/TROCAR OR NEEDLE; SUPERFICAL $4,527.50 36100194 HB BX/BONE/TROCAROR NEEDLE; DEEP $12,475.50 36100198 HB THORACENTESIS,ASPIRATE W IMG $4,443.00 36100200 HB INSERT CATH PLEURA W IMAGING $4,443.00 36100208 HB INTRO CATH SUP VENA CAVA $5,101.00 36100209 HB INTRO CATH: ARTERIAL, ABDOMINAL/PELVIC/LWR EXT; 1ST ORDER $2,322.00 36100210 HB INTRO CATH: ARTERIAL, ABDOMINAL/PELVIC/LWR EXT: 2ND ORDER $2,578.50 36100211 HB INTRO CATH:ARTERIAL, ABDOMINAL/PELVIC/LWR EXT; 3RD ORDER $2,835.00 36100212 HB INTRO CATH: ARTERIAL, ABDOMINAL/PELVIC/LWR EXT; ADDTL 2ND ORDER & BEYOND $3,229.50 36100213 HB REPLACE TUN CATH W/O PORT $13,967.50 36100214 HB DECLOT BY THROMBOLYTIC AGT $1,231.00 36100224 HB INSERT TUNNEL CATH-COMPLETE $22,590.00 36100225 HB REPLACE GASTRO CECO TUBE PERC $3,825.00 36100226 HB REPLACE DUODENO/J TUBE PERC $4,557.50 36100227 HB REPLACE G TUBE PERC W/FLUORO $4,557.50 36100229 HB FLUORO EXAM OF G/COLON TUBE $1,491.00 36100230 HB BIOPSY RENAL $4,527.50 36100232 HB REMOVE/REPLACE URETERAL STENT $4,671.50 36100233 HB REMOVE NEPHRO TUBE REQ FLUORO $3,825.00 36100234 HB NEPHRO TUBE CHANGE $24,754.00 36100236 HB ASPIRATION BLADDER W/CATH INSERTION $9,063.00 36100237 HB CHANGE OF CYSTOSTOMY TUBE $2,914.50 36100242 HB AMNIOCENTESIS DIAGNOSTIC $2,932.50 36100245 HB PERC ASPIRATION INTERDISCAL,DX $2,614.00 36100248 HB INJECT FACET JT W/IMAGE C/T 1ST L $3,780.50 36100249 HB INJECT FACET JT W/IMAGE L/S 1ST L $3,780.50 36100250 HB REMOVE FB-CORNEAL WO/SLIT LAMP $832.00 36100252 HB FETAL NON-STRESS TEST $975.50 36100253 HB BRONCH THERMOPLASTY-1 LOBE $19,004.50 36100254 HB BRONCH THERMOPLASTY 2+ LOBES $27,692.84 36100255 HB SKIN GFT F/N/HF/GEN -CHILD; 1ST 100SQ CM $2,864.00 36100262 HB ARTHO/ASP/INJ/SMALL JOINT OR BURSA $1,237.50 36100263 HB ARTHO/ASP/INJ/INTERMEDIATE JOINT OR BURSA $965.50 36100264 HB ARTHO/ASP/INJ/MAJOR JOINT OR BURSA $1,326.00 36100273 HB I&D DEEP ABSCESS OR HEMATOMA; SOFT TISSUE NECK/THORAX $9,063.00 36100274 HB BX SOFT TISSUE NECK OR THORAX $12,475.50 36100284 HB INJ/ARTHRO ANES/STEROID; SACROILIAC JT $3,164.50 36100294 HB CNTRL NASAL HEMORR/ANTER/SIMPL $578.00 36100309 HB TUBE THORACOSTOMY; INC WATER SEAL WHEN PERFORMED $3,028.00 36100310 HB REMOVAL TUNNELED PLEURAL CATH $3,825.00 36100326 HB ANG THROMBECTOMY $7,746.00 36100333 HB INJECTION FOR EXTREMITY PSEUDOANEURYSM $1,036.00 36100334 HB INJECTION FOR EXTREMITY VENOGRAPHY $2,792.50 36100335 HB INTRO CATH: RENAL ARTERY; 1ST ORDER-UNILATERAL $11,832.50 36100336 HB INTRO CATH: RENAL ARTERY; 1ST ORDER-BILATERAL $12,869.00 36100337 HB INTRO CATH: RENAL ARTERY; 2ND ORDER-UNILATERAL $16,011.00 36100338 HB INTRO CATH: RENAL ARTERY; 2ND ORDER-BILATERAL $9,866.50 36100343 HB INSERT CENT NON-TUN CATH < 5YR $3,542.00 36100344 HB INSERT CENT NON-TUN CATH > 5YR $5,291.50 36100345 HB INSERT TUN CATH W/O PORT <5YR $22,590.00 36100346 HB INSERT TUN CATH W/O PORT >5YRS $18,540.50 36100347 HB INSERT TUN CATH W/PORT < 5YR $13,967.50 36100350 HB INSERT PICC W/O PORT < 5YRS W/O IMAGING $6,457.50 36100351 HB INSERT PICC W/O PORT >5YRS W/O IMAGING $6,457.50 36100352 HB INSERT PICC W/PORT < 5YRS $18,540.50 36100354 HB REPAIR CV CATH W/O PORT $2,452.00 36100355 HB REPLACE CV CATH ONLY W/PORT $18,540.50 36100356 HB REPLACE NON-TUN CATH W/O PORT $6,457.50 36100357 HB REPLACE TUN CATH W/O PORT $18,540.50 36100358 HB REPLACE PICC W/O PUMP/PORT W/IMAGING $6,457.50 36100359 HB REPLACE PICC W/ PORT/PUMP $18,540.50 36100360 HB REMOVE TUN CATH W/O PORT/PUMP $16,717.00 36100362 HB DECLOT BY MECHANICAL REMOVAL FROM CENT VENOUS DEVICE $5,696.00 36100363 HB REPOS PREV PLACED CATH W/FLUOR $8,133.00 36100364 HB ARTERIAL LINE INSERTION $402.00 36100366 HB CANNULA DECLOT; WITHOUT BALLOON CATHETER $1,297.50 36100371 HB THROMBECTOMY PRIM INITAL ART $16,883.50 36100372 HB THROMBECTOMY PRIM SUBSEQ ART $15,314.00 36100373 HB THROMBECTOMY W/OTHER INTERVEN $15,314.00 36100374 HB THROMBECTOMY VEIN $16,883.50 36100375 HB THROMBECTOMY VEIN SUBSEQ DAY $16,883.50 36100376 HB INSERT IVC FILTER W/IMAGING $17,463.00 36100377 HB REPOSITION IVC FILTER W/IMAGE $16,306.00 36100378 HB REMOVAL IVC FILTER W/IMAGING $16,306.00 36100379 HB THOMBOLYSIS,CEREBRAL BY IVF $630.00 36100380 HB TRANSCATH BIOPSY $22,265.50 36100382 HB PLACE STENT CERV CAR ART W/DEP $18,903.00 36100386 HB BONE MARROW ASPIRATION $2,902.50 36100387 HB BONE MARROW BIOPSY $2,902.50 36100391 HB BX/EXCISION/LYMPH NODE/SUPERFI $4,527.50 36100392 HB BIOPSY/EXCIS LYMPH NODES,NEEDL $2,816.00 36100393 HB INJECTION SENTINEL NODE $1,170.50 36100403 HB BIOPSY SALIVARY GLAND, NEEDLE $2,443.50 36100408 HB I&D ABSCESS/PERITONSILLAR $926.00 36100423 HB REPOS GASTRIC TUBE $6,200.00 36100428 HB COLONOSCOPY REM LESION/SNARE $3,890.70 36100431 HB I&D/PERIANAL ABSCESS/SUPERFICI $1,530.00 36100432 HB INC THROMBOSED HEMORR/EXTERNAL $766.00 36100436 HB BIOPSY LIVER $4,527.50 36100443 HB BILIARY ENDO W/REMOV CALCULUS $21,396.00 36100444 HB BIOPSY,PERC. PANCREAS $4,527.50 36100451 HB PARACENTESIS;ABDOMINAL W/IMAGE $4,535.00 36100452 HB PERITONEAL LAVAGE, INC IMAGING $4,535.00 36100453 HB BIOPSY,ABD\RETROPERITONEAL PER $4,527.50 36100458 HB REM & RPL INT URETERAL STENT $10,413.50 36100459 HB REMOVE URETER STENT, PERCUT $7,576.50 36100460 HB ABLATION RENAL TUMOR(S); UNILATERAL $28,271.00 36100463 HB CHANGE CYSTOSTOMY TUBE COMPL $1,514.00 36100484 HB CIRCUMCISION W/REGIONAL BLOCK $3,222.00 36100488 HB I&D VULVA/PERINEAL ABSCESS $726.00 36100522 HB FETAL CONTRACTION STRESS TEST $913.50 36100523 HB INSERT CERVICAL DILATOR $794.00 36100528 HB BX THYROID PERC $2,932.50 36100536 HB SPINAL TAP LUMBAR DIAGNOSTIC $2,447.00 36100538 HB INJ/LUMBAR EPIDURAL/BLOOD/CLOT $1,712.00 36100547 HB INJECT ANES AGT/OTHR PERIPH NERVE $1,232.00 36100548 HB INJECT TRANSFOR EPI/CERV OR THORA $2,086.00 36100549 HB INJECT TRANSFOR EPI LUMBAR OR SAC $3,033.50 36100550 HB INJECT ANES AGNT/STELLATE GANGLIO $1,855.00 36100573 HB REMOVE FB-CORNEAL W/SLIT LAMP $922.00 36100649 HB DRAIN/ABS/HEMA/EXT EAR/SMP $1,192.00 36100654 HB REM/IMPACTED CERUMEN/ONE/BOTH $173.00 36100673 HB INSERT INDWELLING TUNNEL CATH $22,590.00 36100676 HB COLLECT BLOOD FROM EST PICC $367.50 36100677 HB INJ EXIST CENT VENOUS DEVICE $1,441.00 36100681 HB CHANGE G TUBE TO G-J TUBE PERC $5,445.00 36100682 HB ASPIRATION/INJECT THYROID CYST $2,932.50 36100685 HB INJECT ANES/AGNT/OCCIPITAL NERVE $2,541.00 36100686 HB INJECT ANES AGT/INTERCOSTA/MULTI $2,235.00 36100687 HB BIOPSY LIVER $3,314.00 36100690 HB BRONCH W/ALVEOLAR LAVAGE $10,998.00 36100691 HB BRONCH W/ASP BX ADD LOBE $9,269.42 36100692 HB BRONCH W/ASP BX SNGL LOBE $12,023.58 36100693 HB BRONCH W/BRON STENTS 1ST BRON $23,155.64 36100694 HB BRONCH W/BRON STENTS ADD BRON $9,269.42 36100695 HB BRONCH W/BRUSHING(S) $12,242.48 36100696 HB BRONCH W/ENDOBRONCH BX(S) $14,435.46 36100697 HB BRONCH W/FOREIGN BODY REMOVAL $9,269.42 36100698 HB BRONCH W/NAVIGATION $20,413.42 36100699 HB BRONCH W/STENT REVISION $23,155.64 36100700 HB BRONCH W/TRACH/BRONCH DILATION $23,155.64 36100701 HB BRONCH W/TRACHIAL STENT(S) $23,155.64 36100702 HB BRONCH W/TRANSBR BX ADD LOBE $9,926.12 36100703 HB BRONCH W/TRANSBR BX SNGL LOBE $14,435.46 36100704 HB BRONCH W/TUMOR DESTRUCTION $23,155.64 36100705 HB BRONCH W/TX ASPIRATION INITIAL $9,269.42 36100706 HB BRONCH W/WO CELL WASHINGS $12,023.58 36100707 HB ENDOBRONCHIAL ULTRASOUND $4,450.00 36100717 HB INJ SINUS TRACT DX $724.00 36100770 HB INJ PROCEDURE FOR ATHROGRAPHY SHOULDER $1,796.00 36100771 HB INJ ARTHROGRAM ELBOW $1,432.50 36100772 HB INJ ARTHROGRAM WRIST $1,432.50 36100773 HB INJ ARTHROGRAM HIP W/O ANES $1,170.50 36100776 HB APPLY MULTILAY COMPRESSION $402.00 36100783 HB REM/FB/INTRANASAL $610.00 36100784 HB FLEXIBLE LARYNGOSCOPY;DIAGNOSTIC $1,055.00 36100785 HB BRONCHOSCOPY W/CONTRAST INJ (INCLUDES FLUORO WHEN PERFORMED) $11,362.90 36100787 HB BIOPSY LUNG/MEDIASTINUM PERC $4,527.50 36100789 HB PERICARDIOCENTESIS; INITIAL $5,173.50 36100798 HB PLACE CATH VEIN; 1ST ORDER $3,327.00 36100799 HB PLACE CATH VEIN 2ND ORDER $3,827.50 36100801 HB INTRO CATH LT OR RT PULMONARY ARTERY $10,456.00 36100803 HB INTRO OF CATH CAROTID/VERTEBRA $3,260.00 36100805 HB INTRO NEEDLE/CATH EXTREM ART $3,142.00 36100808 HB INTRO CATH AORTA $2,797.50 36100809 HB CATH ART 1ST ORDER THOR/BRACH $3,142.00 36100810 HB CATH ART INIT 2ND ORD THO\BRAC $3,489.50 36100811 HB INTRO CATH: ARTERIAL, INITIAL 3RD ORDER THOR/BRACHIO BRANCH $3,836.00 36100812 HB INTRO CATH: ARTERIAL, THOR/BRACHIO; EACH ADDTL $4,369.50 36100820 HB CATH PORTAL VEIN $3,799.00 36100821 HB VEN CATH\SEL ORG BLOOD SAMPLE $4,257.00 36100822 HB THERAPEUTIC PLASMA EXCHANGE $6,473.00 36100823 HB LIPOSORBER $25,458.50 36100824 HB COLLECT BLOOD FROM VAD $367.50 36100825 HB ARTERIAL PUNCTURE $442.50 36100835 HB INJECTION SIALOGRAPHY $1,906.00 36100837 HB NASO OR ORO-GASTRIC TUBE PLCMT $684.50 36100841 HB BIOPSY, LIVER W/OTHER PROC $636.00 36100842 HB PERCUT CHOLECYSTOMY $5,131.00 36100846 HB PERC TH INT&EXT B DR $20,915.50 36100848 HB DIL BIL DUCT W/O STE $20,968.00 36100849 HB DIL BIL DUCT W/STENT $31,450.00 36100851 HB EXCHANGE PREV CATH/DRAIN $5,915.00 36100852 HB CONT INJ AS ABSC/CYST V PRV CA $833.00 36100854 HB INSERT GASTROSTOMY TUBE PERC $9,284.00 36100855 HB INSERT DUEDENOSTOMY/J TUBE PER $5,445.00 36100856 HB PYELOGR/RENALCYSTINJ $7,096.00 36100857 HB INTRA CATH INTRO RENAL $30,046.00 36100862 HB RENAL TUMOR ABLATION PERC; UNILATERAL $28,271.00 36100864 HB URETERSTOMY TUBE CHANGE $11,923.50 36100865 HB INJECT ILEAL CONDUIT $1,573.50 36100866 HB INJ VCUG $1,420.00 36100867 HB INJ PROCEDURE RETRO URETH $875.00 36100869 HB NSERT CATH BLADDER IN & OUT $336.00 36100870 HB INSERT CATH BLADDER SIMPLE $336.00 36100889 HB CATH/INJ FOR HYSTEROSONOGRAM $762.50 36100891 HB SHUNT TAP $4,557.50 36100895 HB ANG INJ MYLELOGRAPHY $4,535.00 36100903 HB INJECT ANES AGNT/TRIGEMINAL NERVE $1,040.00 36100906 HB INJECT ANES AGT/INTERCOSTAL/SINGLE $1,855.00 36100913 HB INJECT ANES/TRANS EPI/LUMBAR/ADDL $3,033.50 36100916 HB INJECT FACET JT W/IMAGE L/S 2ND L $1,178.00 36100917 HB INJECT FACET JT W/IMAGE L/S 3RD L $1,178.00 36100923 HB REMOVE FB-EYE $314.00 36100929 HB REM/FB/EXTERNAL AUDITORY CANAL $424.00 36100979 HB CLOSED DISLOCATION TMJ $470.00 36100982 HB APPL/RIGID TOT CONT/LEG CAST $728.00 36100987 HB SIMPL REPR SCLP& TRUNK;12.6-20.0 CM $1,336.00 36100989 HB CLOS TX DIST RADIAL FX; W/O MANIP $728.00 36100997 HB ERYTHROCYTAPHERESIS $6,473.00 36101000 HB IMG GUIDE DRAINAGE;SOFT TISSUE $1,786.50 36101001 HB BRST BX;1ST LESSION/STEREOTACT $18,198.50 36101002 HB BRST BX;EA ADD LESS/STEREOTACT $11,162.50 36101003 HB BRST BX;1ST LESSION/INC U/S $18,198.50 36101004 HB BRST BX;EA ADD LESS/INC U/S $11,162.50 36101005 HB BRST BX;1ST LESSION/INC MRI $13,439.00 36101006 HB BRST BX;EA ADD LESS/INC MRI $13,107.00 36101007 HB PLCMNT BREAST DEVICE/MAMMO-1ST $9,988.00 36101008 HB PLCMNT ADD BREAST DEVICE/MAMMO $1,774.00 36101009 HB PLCMNT BREAST DEVICE/STEREOTAC $16,172.50 36101010 HB PLCMNT ADDTL BREAST DEV/STRT $7,961.50 36101011 HB PLCMNT BREAST DEVICE/US-1ST $3,702.50 36101012 HB PLCMNT ADDTL BREAST DEV; U/S $2,951.50 36101013 HB PLCMNT BREAST DEVICE/MRI-1ST $5,228.50 36101014 HB PLCMNT ADDTL BREAST DEVICE/MRI $4,895.50 36101016 HB IMAGE GUIDE FLUID COLL;VISCER $15,084.00 36101017 HB IMAGE GUIDE FLUID COLL;PER/RET $8,830.00 36101018 HB IMG GUIDE FLUID COLL/TRNS VGNL $10,056.50 36101028 HB APPLY LC SKIN SUB;1ST 25 CM $2,864.00 36101029 HB APPLY LC SKIN SUB;EA ADD 25SCM $1,432.00 36101030 HB APPLY LC SKIN SUB;FA/NK;1ST 25 $2,864.00 36101031 HB APPLY LC SKIN SUB;FA/NK;EA ADD $1,432.00 36101035 HB REM/FB/FINGER/HAND/MUSCLE/SIMP $2,160.00 36101055 HB BRONCH W/CATH PLMNT FOR BRACHY $6,200.84 36101058 HB AVULSION/EA ADD L NAIL PLATE $273.00 36101066 HB CLOSED TX PATELLAR DISLOC W/O ANESTHESIA $642.00 36101069 HB CONTROL NASAL HEMORRHAGE, POSTERIOR INITIAL $502.00 36101070 HB CLOSED TREATMENT POST HIP DISLOCATION $954.00 36101075 HB RPR/SIM/FCE/EAR/ETC TO 7.5CM-12.5CM $770.00 36101076 HB INJECTION ANESTHESIA AGENT/FACIAL NERVE $586.00 36101085 HB CLOSED TREATMENT BIMALLELOAR ANKLE FX; W MANIP $2,688.00 36101090 HB CLOSED TREATMENT OF ANKLE DISLOCATION; W/O ANES $1,034.00 36101097 HB ARTHRO W U/S GUIDE: SMALL JOINT $2,785.00 36101098 HB ARTHRO W U/S GUIDE: INTERMED JOINT $2,785.00 36101099 HB ARTHRO W U/S GUIDE: MAJOR JOINT $2,785.00 36101104 HB VERTEBRAL AUGMENTATION PER VERTEBRAL BODY; THORACIC $55,537.00 36101105 HB VERTEBRAL AUGMENTATION PER VERTEBRAL BODY; LUMBAR $55,537.00 36101111 HB MYELOGRAM VIA LUMBAR INJ - CERVICAL $8,574.50 36101112 HB MYELOGRAM VIA LUMBAR INJ - THORACIC $8,574.50 36101113 HB MYELOGRAM VIA LUMBAR INJ - LUMBAR $8,574.50 36101114 HB MYELOGRAM VIA LUMBAR INJ - TWO OR MORE REGIONS $9,723.50 36101126 HB REPAIR LIP/ FULL THICK; VERMILION ONLY $3,844.00 36101137 HB REPAIR CVA DEVICE W/PORT/PUMP $8,133.00 36101140 HB APPLY SHORT LEG SPLINT (CALF TO FOOT) $460.00 36101145 HB STRAPPING/UNNA BOOT $626.50 36101152 HB VENIPUNCTURE (NON-ROUTINE) REQ DR INTERVENTION $344.00 36101153 HB I&D PILONIDAL CYST; COMPLICATED $1,790.00 36101154 HB CLOSED TREATMENT FX; FINGER/THUMB W/MANIP $1,178.00 36101166 HB UNLISTED VASC PROCEDURE $6,457.50 36101168 HB EPIDERMAL AUTOGRAFT FACE/NCK/HF/GEN 100 SQ CM OR < $4,787.00 36101183 HB DEBRIDE BONE 20 CM OR LESS $4,250.00 36101198 HB PERC IMPLANT NEUROSTIM ELECT, EPIDURAL $37,147.00 36101202 HB CLOSED TREAT METATARSAL FX W MANIP $1,178.00 36101229 HB INJECT NERVE BLOCK PLANTAR DIGIT $1,072.00 36101236 HB DRAIN SCROTAL WALL ABSCESS $4,394.00 36101241 HB URETERAL STENT PLACEMENT; PRE-EXIT NEPH TRACT $30,046.00 36101242 HB URETERAL STENT PLACEMENT; NEW ACCESS $30,046.00 36101243 HB URETERAL STENT PLACEMENT; NEW W/NEPH CATH $30,046.00 36101244 HB INJECT PROC NEPH/URETER COMPLETE: NEW ACCESS $13,520.00 36101245 HB INJECT PROC NEPH/URETER COMP: EXISTING ACCESS $13,520.00 36101246 HB CONVERSION EXTERNAL BILIARY DRAIN CATH $7,760.50 36101247 HB EXCHANGE BILIARY DRAIN CATH $7,760.50 36101248 HB REMOVAL BILIARY DRAIN CATH $2,319.50 36101251 HB IRRIGATE / LAVAGE IMPACTED CERUMEN; UNILAT $173.00 36101252 HB CHOLANGIO / PANCR THROUGH EXIST CATH $3,354.50 36101253 HB PLACE EXTERNAL BILIARY CATH PERC $7,760.50 36101258 HB TRIM SKIN LESIONS OVER 4 $545.00 36101265 HB CIRCUM 28 DAYS OR OLDER $3,222.00 36101272 HB CONVERT NEPHROSTOMY CATH $30,046.00 36101291 HB I&D PERIRECTAL OR ISCHIAL ABSCESS $8,174.00 36101305 HB CLOSED TREAT MTP JOINT W/O ANES $848.00 36101313 HB SCLEROTHERAPY FLUID COLLECT PERQ $6,715.50 36101323 HB CATH ASPIRATION (SEPAR PROC); NASOTRACHEAL $315.50 36101331 HB INJECT DX/TX EPID/SUBAC CERV/THOR W/IMAGING $11,590.50 36101332 HB INJECT DX/TX EPID/SUBAC LUM/SACR W/IMAGING $11,590.50 36101333 HB INJECT CONT DX/TX EPID/SUBAC SERV/THOR W/IMAGING $4,859.00 36101358 HB REPAIR SIMPLE (S,N,G,TR, OR E) 20.1 TO 30CM $1,416.00 36101381 HB INSERT PICC W/O PORT < 5 YRS W/IMAGING $6,457.50 36101382 HB INSERT PICC W/O PORT > 5YRS W/IMAGING $6,457.50 36101383 HB GASTROSTOMY TUBE CHANGE W/O REVISION $880.00 36101386 HB DILAT EXIST TRACT END PX NEW ACCESS $11,122.00 36101387 HB TANGENTIAL BX SKIN; SINGLE LESION $545.00 36101388 HB TANGENTIAL BX SKIN; EA ADD'L LESION $273.00 36101389 HB PUNCH BX SKIN; SINGLE LESION $545.00 36101390 HB PUNCH BX SKIN; EA ADD'L LESION $273.00 36101391 HB INCISIONAL BX SKIN; SINGLE LESION $971.00 36101392 HB INCISIONAL BX SKIN; EA ADD'L LESION $485.00 36101394 HB FNA BX W/US GUIDE; 1ST LESION $5,686.00 36101395 HB FNA BX W/ CT GUIDE; 1ST LESION $5,686.00 36101396 HB INJ CONTRAST KNEE ARTHG/CT/MRI $1,432.50 36101397 HB FNA BX W/FLUORO; 1ST LESION $5,686.00 36101407 HB XR ARTHROGRAM KNEE - LEFT $734.00 36101408 HB XR ARTHROGRAM KNEE - RIGHT $734.00 36101410 HB FNA BX W/US GDN EA ADD $5,686.00 36101422 HB APHERESIS WBC $6,473.00 36101423 HB INJ AIR/CONT PERIT - SEPARATE PROC $1,256.00 36101453 HB DEBRIDE MUSC/FASCIA; 20 SQCM OR LESS $1,492.00 36101454 HB DEBRIDE SKIN/TISS; EA ADDL 20 SQCM $485.00 36101455 HB DEBRIDE MUSC/FASCIA; EA ADDL SQCM $746.00 36101456 HB DEBRIDE BONE; EA ADDL 20 SQCM $2,125.00 36101457 HB EPIDERMAL AUTOGRAFT TRNK/ARM/LEG 100 SQ CM OR < $4,786.00 36101458 HB EPIDERMAL AUTOGRAFT TRNK/ARM/LEG EA ADDL 100 SQ CM $2,711.00 36101459 HB EPIDERMAL AUTOGRAFT FACE/NCK/HF/GEN EA ADDL 100 SQ CM $2,711.00 37000000 HB ANES MAC PER MIN $56.50 37000001 HB ANES GENERAL PER MIN $42.00 37000010 HB ANES MAC NORA PER MIN $56.50 37000011 HB ANES GENERAL NORA PER MIN $56.50 37000013 HB MOD SED (SAME PHYS) PT 5/> YRS; 1ST 15 MIN $1,426.00 37000014 HB MOD SED (SAME PHYS) EA ADDTL 15 MIN $357.00 37000018 HB ANES EPIDURAL/SPINAL $2,903.50 39100001 HB TRANSFUSION BLOOD OR BLOOD COMPONENTS $1,641.00 39100002 HB TRANSFUSION BLOOD OR BLOOD COMPONENTS 0 - 2 HRS $1,797.50 39100003 HB TRANSFUSION BLOOD OR BLOOD COMPONENTS 2 - 4 HRS $2,074.50 39100004 HB TRANSFUSION BLOOD OR BLOOD COMPONENTS 4 - 6 HRS $2,350.00 39100005 HB TRANSFUSION BLOOD OR BLOOD COMPONENTS 6 - 8 HRS $2,628.00 39100006 HB TRANSFUSION BLOOD OR BLOOD COMPONENTS 8 - 10 HRS $2,903.50 39100007 HB TRANSFUSION BLOOD OR BLOOD COMPONENTS 10 - 12 HRS $3,695.50 39100008 HB PUSH BLOOD TRANSFUSION - 2 YRS OR LESS $1,797.50 40100006 HB DX MAMMO INCL CAD UNILAT $723.50 40100007 HB DX MAMMO INCL CAD BILAT $853.50 40200001 HB US GUIDE NEEDLE PLMT-BX/ASP $1,708.00 40200004 HB US SOFT TISSUE HEAD AND NECK $2,024.50 40200005 HB US CHEST $1,553.00 40200007 HB US ABDOMEN COMPLETE $2,102.50 40200008 HB US ABDOMEN LIMITED $1,880.50 40200009 HB US RETROPERITONEAL/COMPLETE $1,880.50 40200010 HB US RETROPERITONEAL LIMITED $1,582.50 40200011 HB US TRANSPLANT KIDNEY REAL TIME $783.00 40200012 HB US SPINAL CANAL $1,920.50 40200013 HB US OB 1ST TRI 1ST GESTATION $1,891.50 40200014 HB US OB 1ST TRI EA ADD GESTATION $656.00 40200015 HB US OB 2-3 TRI 1ST GESTATION $3,217.50 40200016 HB US OB 2-3 TRI EA ADD GESTATION $1,744.00 40200017 HB US OB DETAIL EVAL 1ST GESTATION $1,577.50 40200019 HB US OB 1ST TRI FETAL NUCH 1ST G+ $9,713.00 40200021 HB US OB LIMITED 1 OR MORE FETUS $1,720.00 40200022 HB US OB F/U SUSPECT ABNORMALITY $1,880.50 40200023 HB US OB TRANSVAGINAL $1,313.00 40200024 HB US FETAL BIOPHYS PROF W/NST $2,861.50 40200025 HB US FETAL BIOPHYS PROF W/O NST $2,861.50 40200026 HB US DOPPLER/FETAL UMBIL ARTERY $687.00 40200028 HB ECHO FETAL CARDIAC COMPLETE $1,638.00 40200029 HB ECHO FETAL CARDIAC LTD/FU $1,638.00 40200030 HB ECHO DOPPLER FETAL COMPLETE $301.50 40200031 HB ECHO DOPPLER FETAL LTD/FU $301.50 40200032 HB US NON-OB TRANSVAGINAL $2,305.50 40200033 HB US SONOHYSTEROGRAM $1,319.50 40200034 HB US PELVIC NON-OB COMPLETE $1,609.00 40200035 HB US PELVIC NON-OB LIMITED $1,202.00 40200036 HB US SCROTUM $2,221.00 40200038 HB US EXTREMITY NON-VASC COMPLET $1,373.00 40200039 HB US EXTREMITY NON-VAS LIMITED $687.00 40200040 HB US OF INFANT HIP,REAL TIME,DYN $1,635.50 40200041 HB US GUIDANCE PERICARDIOCENTESIS $374.93 40200043 HB US GUIDANCE VASCULAR ACCESS $1,420.00 40200044 HB ENCEPHALOGRAPHY $1,880.50 40200049 HB US GUIDE NEEDLE PLMT-BX/ASP $2,166.50 40200051 HB US GUIDANCE AMNIOCENTESIS $596.50 40200053 HB US GUIDANCE INTRAOPERATIVE $2,924.00 40200055 HB US GUID COMPRESS REPR PSEUDO-ANEURY $2,157.50 40200056 HB US GUIDANCE VASCULAR ACCESS $1,420.00 40200060 HB U/S BREAST - COMPLETE $1,207.50 40200061 HB U/S BREAST - LIMITED $1,207.50 40200062 HB U/S INFANT HIPS STATIC $502.50 40200064 HB U/S EXAM AAA SCREEN $1,582.50 40200074 HB US GUIDANCE INTERSTITIAL RAD APPL $1,704.50 40200076 HB US FOLLOW UP STUDY $832.50 40300005 HB SCREEN MAMMO INCL CAD BILAT $1,138.00 40300006 HB SCREEN MAMMO INCL CAD UNILATERAL $832.00 40400003 HB PET/CT LIMITED $14,990.50 40400004 HB PET/CT SKULL BASE TO MID-THIGH $14,990.50 41000001 HB RT TIME PATIENT ASSESSMENT $130.00 41000002 HB VENTILATOR MGMT, EA SUBSEQ DAY $2,326.00 41000003 HB AIRWAY TREATMENT/SPUTUM INDUCT $420.00 41000004 HB HHN TREATMENT $420.00 41000005 HB INHALATION TREATMENT BY RN $352.00 41000006 HB IPPB $420.00 41000007 HB MDI TREATMENT $352.00 41000008 HB PENTAMIDINE TREATMENT $782.00 41000009 HB CPAP/BIPAP $601.50 41000012 HB RT TIME MDI INSTRUCT $352.00 41000013 HB INTUBATION $407.50 41000014 HB CONT. NEB. INITIAL HOUR $688.00 41000015 HB CONT NEBULIZE EACH ADD HOUR $688.00 41000016 HB BREATHING EXERCISES $420.00 41000017 HB CHEST PHY THER $420.00 41000018 HB CPT/CHEST WALL MANIPULATION $352.00 41000019 HB PEP THERAPY(POS.EXP.PRESSURE) $420.00 41000020 HB RESP MS THERAPY PER 15 MIN $176.00 41000021 HB RESP FCN/STRNGTH 2+ INDIVID $243.50 41000022 HB INCENTIVE SPIROMETRY $518.00 41000026 HB RT TIME ENDOTRACHEAL TUBE CARE $188.00 41000027 HB RT TIME EXTUBATION $144.00 41000029 HB RT TIME INTUBATION ASSIST $306.00 41000030 HB RT TIME IS INSTRUCT $192.00 41000031 HB RT TIME MANUAL VENTILATION $174.00 41000034 HB RT TIME TRACHEAL SUCTION $242.00 41000035 HB RT TIME TRACHEOSTOMY CARE $266.00 41000037 HB CPT/CHEST WALL MANIP/SUBSEQUNT $310.00 41000038 HB VENTILATOR ASSIST/MGMT;1ST DAY $3,057.00 41000040 HB DELIVERY ROOM RESUSCITATION $1,323.00 41000041 HB PEP THERAPY (POS EXP PRESSURE) - SUBSEQUENT $310.00 41000042 HB RESP FUNCTION THERAPY PER 15 MIN $131.50 41300002 HB HYPERBARIC OXYGEN - PER 30 MIN $354.00 42000002 HB STRAPPING; SHOULDER (EG, VELPEAU) $754.50 42000003 HB STRAPPING; ELBOW OR WRIST $644.00 42000004 HB STRAPPING/ANKLE $400.00 42000006 HB MODALITY-MECH.TRACTION/SUPERVI $563.50 42000007 HB MODALITY-ELECT STIM $172.00 42000008 HB MODALITY-VASOPNEUMTC DEV/SUPER $263.00 42000009 HB MODALITY-WHIRLPOOL/SUPERVISED $506.00 42000010 HB ELECTRICAL STIMULATION MODALITY; CONS ATTEND $547.50 42000013 HB STRAPPING/TOES $178.00 42000017 HB MODALITY-ULTRA SOUND/ATTEND $449.50 42000018 HB THERA PROC/ZUNI UNWEIGHT/SUPER $355.50 42000019 HB THERAPEUTIC EXER/1:1/STRENGTH/ $355.50 42000021 HB NEUROMUSC RE-ED/MOVE/BAL/COORD; EA 15 MIN $710.00 42000022 HB NEUROMUSC/BAL MASTER TRAINING; EA 15 MIN $710.00 42000023 HB NEUROMUSC/RE-ED/PMS TRAINING; EA 15 MIN $172.00 42000024 HB THERAPEUTIC PROC/AQUA/EXERC1:1 $427.00 42000025 HB THERAPEUTIC PROC/GAIT TRAINING $386.50 42000026 HB MASSAGE $516.50 42000027 HB JOINT MOBILIZATION $200.00 42000029 HB MANUAL TRACTION $200.00 42000030 HB MYOFASCL RELEAS/SFT TSS MOBILI $200.00 42000031 HB AQUATIC/GRP/THERA/EXERCISE $168.00 42000032 HB THERAPEUTIC PROC/EXER/GROUP $398.50 42000033 HB THERAPEUTIC ACTIVITY 1:1, EA 15 MIN $412.00 42000035 HB SENSORY INTEGRATION TREATMENT 1:1; EA 15 MIN $463.00 42000036 HB COMMUNITY/WORK RE-ENTRY 1:1; EA 15 MIN $310.00 42000037 HB WHEELCHAIR ,MANAGE/PROPL TRAIN $386.50 42000038 HB DEBRIDE SELECTIVE <= 20 SQ CM $759.50 42000039 HB DEBRIDE SELECTIVE > 20 SQ CM $1,099.50 42000040 HB DEBRIDE NON-SELECTIVE $714.00 42000042 HB PHYSICAL PERFORM TEST/MEAS/BTE EVAL $391.50 42000043 HB PHYSICAL PERFORM TEST/PMS EVAL $391.50 42000044 HB ORTHOTIC FITTING/TRAINING; EA 15 MIN $518.00 42000045 HB PROSTHETIC TRAINING $710.00 42000050 HB WOUND ULTRASOUND-LOW FREQUENCY $610.50 42000058 HB STRAPPING UNNA BOOT $626.50 42000062 HB MANUAL THERAPY 15 MIN $766.00 42000064 HB PARAFFIN TREATMENT $580.50 42000065 HB SELF-CARE/HOME MGMT TRAIN;1:1,EA 15M $310.00 42000067 HB WORK HARDENING EA ADD'L HOUR $1,039.50 42000069 HB APPLY HOT/COLD PACKS; 1+ AREAS $31.00 42000071 HB CONTRAST BATH; EA 15 MIN $427.00 42000072 HB WORK HARDENING INITIAL - 2 HRS $2,076.00 42000076 HB ELECT STIM UNATTEND NON-WOUND $948.50 42400007 HB PT EVAL LOW COMPLEX 20 MIN $1,006.50 42400008 HB PT EVAL MODERATE COMPLEX 30 MIN $1,006.50 42400009 HB PT EVAL HIGH COMPLEX 45 MIN $1,006.50 42400010 HB PT RE-EVAL EST PLAN OF CARE $456.00 42900009 HB SELF CARE, CURRENT STATUS $0.02 43000002 HB APPLY SHORT LEG SPLINT $460.00 43000004 HB PARAFFIN TREATMENT $580.50 43000005 HB APPL/SHRT ARM SPLT/DYNAMIC $999.00 43000006 HB APPL/FINGER SPLT/DYNAMIC $999.00 43000007 HB APPL/STRAPPING HAND/FINGER $1,019.50 43000008 HB FLUIDOTHERAPY MODALITY $506.00 43000009 HB B/FLUIDOTHERAPY MODALITY $506.00 43000010 HB B/IONTOPHORESIS MODALITY $561.00 43000012 HB ULTRASOUND MODALITY $449.50 43000014 HB B/SUPERVISED THERAPEUTIC TRMT. $172.00 43000015 HB SUP.THERAPEUTIC TR. $355.50 43000016 HB THERAPEUTIC-NEUROMUS/REEDUCATE; EA 15 MIN $710.00 43000017 HB MANUAL THERAPY TECHNIQUES $766.00 43000018 HB B/SUPERVISED THERAPEUTIC ACTIVITY $200.00 43000019 HB SUPERVISED THERAPEUTIC ACTIVITY $412.00 43000020 HB B/SUPERVISED FUNCTIONAL TRMT. $172.00 43000021 HB SUP.FUNCTIONAL TRAIN $172.00 43000022 HB WORK HARDENING- EA ADD'L HOUR $1,039.50 43000027 HB ROM MEASUREMENTS-HANDS $676.00 43000028 HB APPL/FINGER SPLT/STATIC $1,130.50 43000029 HB ROM MEASUREMENTS-NO HANDS $501.00 43000030 HB THERAPEUTIC EXERCISES;EA 15MIN $172.00 43000031 HB SELF-CARE/HOME MGMT;1:1,EA 15M $310.00 43000032 HB PHYSICAL PERFORMANCE TEST $391.50 43000033 HB APPLY LONG ARM CAST $1,270.50 43000034 HB APPLY LONG ARM SPLINT (SHOULDER TO HAND) $1,130.50 43000035 HB APPLY SHORT ARM SPLINT (FOREARM TO HAND); STATIC $1,130.50 43000036 HB APPL/STRAPPING SHOULDER $754.50 43000037 HB APPL/STRAPPING ELBOW/WRIST $827.00 43000038 HB WHIRLPOOL/DRESS.CHG. $506.00 43000039 HB ELECTRICAL STIMULATION $547.50 43000040 HB ELECTRICAL STIMULATION $547.50 43000041 HB MASSAGE $516.50 43000043 HB DEVELOP COGNITIVE SKILLS $150.00 43000044 HB SENSORY INTEGRATION TREATMENT $463.00 43000045 HB DEBRIDE SELECTIVE <= 20 SQ CM $759.50 43000046 HB ORTHOTICS FITTING $518.00 43000048 HB WORK HARDENING INITIAL - 2 HRS $2,076.00 43000049 HB THERA INTERVENTION/COGNITIVE; 1 PER DAY $172.00 43000050 HB ORTHO/PROSTH MGMT/TRAIN SUBSEQUENT ENC $355.50 43000051 HB THERA INTERVENTION/COGNITIVE; EA 15 MIN $427.00 43000052 HB THERAPEUTIC PROC/EXER/GROUP $398.50 43000053 HB APPL/SHRT ARM CAST/ELBOW-FINGER $1,130.50 43000054 HB APPLY GAUNTLET CAST $572.00 43000059 HB THERAPEUTIC PROC/AQUA 15 MIN $427.00 43000060 HB THERAPEUTIC PROC/GAIT TRAINING 15 MIN $386.50 43000061 HB APPLY HOT/COLD PACKS; 1+ AREAS $31.00 43000062 HB WHEELCHR MGT/15 MIN $386.50 43000064 HB DEBRIDE NON-SELECTIVE $714.00 43000065 HB CONTRAST BATH; EA 15 MIN $427.00 43000066 HB OT DRIVING EVALUATION $313.50 43000067 HB COMMUNITY/WORK RE-ENTRY 1:1; EA 15 MIN $310.00 43000068 HB MODALITY-ELECT STIM/WOUND CARE $126.50 43000069 HB ELECT STIM UNATD WOUND CARE $93.50 43000070 HB ELECT STIM UNATTEND NON-WOUND $948.50 43000071 HB MODALITY-VASOPNEUMTC DEV $263.00 43000072 HB DEBRIDE SELECTIVE > 20 SQ CM $1,099.50 43000073 HB PROSTHETIC TRAINING INITIAL; EA 15 MIN $710.00 43400009 HB OT EVAL LOW COMPLEX 30 MIN $1,102.00 43400010 HB OT EVAL MOD COMPLEX 45 MIN $1,102.00 43400011 HB OT EVAL HIGH COMPLEX 60 MIN $1,102.00 43400012 HB OT RE-EVAL PLAN OF CARE $456.00 44000001 HB GROUP TREATMENT $427.00 44000002 HB BASIC TX DYSPHAGIA $370.00 44000003 HB STANDARD TX DYSPHAGIA $694.00 44000004 HB BASIC TREATMENT SPCH/LANG/VOIC $370.00 44000006 HB MOD STANDARD VOICE PROSTHESIS $694.00 44000007 HB STANDARD TREATMENT SPCH/LANG/V $618.50 44000010 HB SGD AAC DEVICE TX $830.00 44000011 HB STANDARD COGNITIVE PERF EVAL $542.92 44000013 HB THERA INTERVENTION/COGNITIVE; EA 15 MIN $427.00 44000014 HB ORAL FUNCTION TX $832.50 44000022 HB SENSORY INTEGRATION TREATMENT $463.00 44400001 HB BASIC/EVAL/VOICE PROSTHESIS $1,279.00 44400003 HB BASIC EVAL DYSPHAGIA $452.00 44400004 HB STANDARD EVAL DYSPHAGIA $900.00 44400008 HB SGD AAC DEVICE EVAL 1ST HR $1,279.00 44400009 HB SGD AAC DEVICE EVAL EA ADDL 30 $440.50 44400010 HB RADIOGRAPHIC EVAL OF DYSPHAGIA $1,092.50 44400012 HB ASSESSMENT OF APHASIA; PER HR $1,279.00 44400013 HB LARYNGEAL SENSORY TESTING $899.00 44400016 HB SPEECH SOUND PROD EVAL-STAND $900.00 44400018 HB LANG/SPEECH SOUND PRO EVAL-STD $900.00 44400019 HB LANG/SPEECH SOUND PRO EVAL-BAS $452.00 44400020 HB VOICE/RESONANCE EVAL-STANDARD $1,218.50 44400022 HB FIBEROPTIC ENDO EVAL/SWALLOW $1,005.50 44400023 HB SPEECH FLUENCY EVAL $1,218.50 44400024 HB SPEECH SOUND PRODUCTION EVALUATION $1,218.50 44400025 HB SPEECH/HEARING VISIT EVAL $1,218.50 44400026 HB VOICE/RESONANCE BEHAVIOR EVAL $1,218.50 44400027 HB ORAL SPEECH DEV EVAL $1,279.00 44400028 HB SP EVAL FOR NON-SPEECH DEVICE; 1ST HOUR $1,190.50 44400029 HB EVAL SWALLOW FUNCTION $830.00 44400030 HB NON-SGD AAD DEVICE TX $1,146.00 45000001 HB ER VISIT BRIEF $605.00 45000002 HB ER VISIT LIMITED $1,206.00 45000003 HB ER VISIT INTERMEDIATE $1,900.50 45000004 HB ER VISIT EXTENDED $5,059.50 45000005 HB ER VISIT COMPREHENSIVE $9,483.50 45000006 HB ER VISIT CRITICAL CARE $13,277.50 45000007 HB CRITICAL CARE, EA ADD 30 MI $1,275.00 45000017 HB DRESSING/DEBRIDE OF BURN/SMPLE $545.00 45000023 HB I&D BARTHOLIN'S GLAND ABSCESS $1,254.00 45000030 HB INTUBATION $1,834.00 45000032 HB LP SPINAL/SHUNT TAP $2,447.00 45000040 HB INCIS/REM FB/SUBQ/SIMPLE $971.00 45000043 HB THORACOTOMY OPEN $3,028.00 45000044 HB TRACHEOSTOMY EMERGENT $3,290.00 45000046 HB DRAIN BLOOD FROM UNDER NAIL $228.00 45000047 HB RPR/SIM/SCP/TRK/ETC 7.6-12.5CM $1,190.00 45000048 HB RPR/SIM/FCE/EAR/ETC TO 2.6-5.0CM $738.00 45000049 HB RPR/SIM/FCE/EAR/ETC TO 5.1-7.5CM $748.00 45000051 HB CLOSED TREATMENT SHOULDER DISLOCATION W/MANIPULATION $728.00 45000053 HB CLOSED TREATMENT ELBOW DISLOCATION; W/MANIPULATION $728.00 45000054 HB CLOSED TREATMENT RADIUS & ULNA FX; W/MANIPULATION $2,688.00 45000055 HB CLOSED TREATMENT RADIUS & ULNA FX; W MANIPULATION $2,688.00 45000056 HB DRAINAGE OF FINGER ABSCESS $686.00 45000057 HB CLOSED TREATMENT METACARPAL FX; W/MANIPULATION $728.00 45000060 HB CLOSED TREATMENT FINGER DISLOCATION; W/MANIPULATION $728.00 45000061 HB CLOSED TREATMENT HIP DISLOCATION; TRAUMATIC $728.00 45000063 HB APPLY LONG ARM SPLINT (SHOULDER TO HAND) $1,130.50 45000064 HB APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC $1,130.50 45000066 HB APPLY FINGER SPLINT; STATIC $1,130.50 45000067 HB APPLY FINGER SPLINT; DYNAMIC $999.00 45000069 HB APPLY LONG LEG SPLINT (THIGH TO ANKLE/TOES) $488.00 45000070 HB APPLY SHORT LEG SPLINT (CALF TO FOOT) $460.00 45000071 HB PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION $722.00 45000072 HB DRAINAGE OF ABSCESS/CYST/HEMATOMA FROM HDENTOALVEOLAR STRUCTURES $884.00 45000084 HB CLOSED TX THUMB DISLOCATION; END W/MANIP $1,034.00 45000091 HB APPLY SHORT LEG CAST $826.00 45000098 HC DEBRIDE LE 20 SQ CM $759.50 45000099 HB DEBRIDE SELECTIVE EA ADD 20 SQ CM $1,099.50 46000001 HB SPIROMETRY $566.50 46000002 HB BRONCHIAL PROVOCATION $2,204.92 46000003 HB PRE/POST SPIROMETRY $944.50 46000004 HB BRONCHO EVAL W/ADMIN AGENTS $1,997.00 46000005 HB PULMONARY STRESS TEST COMPLEX $695.00 46000007 HB WEANING PARAMETERS $460.00 46000008 HB MVV (MAXIMAL VOLUNTARY VENT) $447.50 46000012 HB PULM FUNCT TST-PLETHYSMOGRAPH $1,701.00 46000013 HB PULM FUNC TST-WASHOUT LUNG VOL $1,701.00 46000015 HB PULM FUNCT TST-OSCILLOMETRY $1,701.00 46000016 HB DIFFUSING CAPACITY $1,253.50 46000017 HB OXYGEN SATURATION CHECK $120.50 46000018 HB PULSE OXIMETRY (EXERCISE) $362.50 46000019 HB END-TIDAL CO2 MONITORING $1,098.00 46000020 HB PEAK FLOW $136.00 46000033 HB EXERCISE TST BRNCSPSM $582.00 46000034 HB PULMONARY STRESS TESTING $582.00 46000036 HB PULSE OX CONTINUOUS/OVERNIGHT - SEP PROC $1,079.50 46000037 HB PEDIATRIC PNEUMOGRAM; 12-24 HRS - CONTINUOUS $2,315.00 46000038 HB CAR SEAT/ BED TEST (INFANT - 12 MO) - 60 MIN $302.50 46000039 HB CAR SAT/BED TEST (INFANT - 12 M) - EA ADD'L 30 MIN $151.00 47100009 HB AUDITORY EVOKED POT/COMPR $1,888.00 47100036 HB AUD EVOKED POT/LIMITED $518.50 48000001 HB PLACE DRUG-E STENT;SGL ART $41,915.50 48000002 HB PLACE DRUG-E STENT;EA ADD $41,915.50 48000003 HB PLACE DRUG-E STENT/ATHER;SGL $41,915.50 48000004 HB PLACE DRUG-E STENT/ATHER;EA AD $41,915.50 48000005 HB REVASC BYPASS GRFT;DRUG-E;SGL $41,915.50 48000006 HB REVASC BYPASS GRFT;DRUG-E;ADDL $41,915.50 48000007 HB REVASC MI W DRUG-E STENT;SGL $41,915.50 48000008 HB REVASC CHRON OCC W DRUG-E;SGL $41,915.50 48000009 HB REVASC CHRON OCC W DRUG-E;ADDL $41,915.50 48000010 HB EPS W TREATMENT OF SVT $60,113.50 48000011 HB EPS W TRMT OF VENT TACHY $60,113.50 48000013 HB A-FIB ABLATION;PULMONARY VEIN $60,113.50 48000015 HB PTCA,SGL MAJOR CORONARY ARTERY $22,605.00 48000016 HB PTCA,EA ADDTL MJR CORONARY ART $35,799.50 48000019 HB PLACE STENT;SGL MJR COR ART $32,209.00 48000020 HB PLACE STENT;EA ADD COR ARTERY $32,209.00 48000021 HB ANGIO/ATHER/STENT;SGL MJR ART $32,209.00 48000022 HB ANGIO/ATHER/STENT;EA ADD ARTER $32,209.00 48000023 HB REVASC BYPASS GRAFT;SGL VESSEL $32,209.00 48000024 HB REVASC BYPASS GRAFT;EA ADD BRC $32,209.00 48000025 HB REVASC DURING MI;SGL VESSEL $32,209.00 48000026 HB REVASC CHRONIC OCC;SGL VESSEL $32,209.00 48000027 HB REVASC CHRONIC OCC;EA ADD ART $32,209.00 48000028 HB INS/RPL PERM PACER GEN SGL $37,028.00 48000029 HB INS/RPL PERM PACER GEN DUAL $53,546.00 48000030 HB UPGRADE PERM PACER SGL TO DUAL $71,325.50 48000031 HB REPOS RT A/V PACER/ICD LEAD $11,265.50 48000032 HB INSERT PACER/ICD LEAD SGL $24,444.50 48000033 HB INSERT PACER/ICD LEAD DUAL $24,444.50 48000034 HB INSERT PACEMAKER ONLY W/EX LDS $24,444.50 48000035 HB REVISE PACER POCKET $8,689.50 48000036 HB REVISE ICD POCKET $8,689.50 48000037 HB REM/REPLACE PERM PACER;SGL LD $48,812.00 48000038 HB REM/REPLACE PERM PACER;DUAL LD $53,496.50 48000039 HB REM/REPLACE PERM PACER;MULTI $53,496.50 48000040 HB INSERT ICD GEN ONLY W/DUAL LDS $99,999.00 48000041 HB INSERT ICD GEN ONLY;W/MULTI LD $99,999.00 48000042 HB REMOVAL PERM PACER GENERATOR $11,265.50 48000043 HB INS/RPL PERM PACER ATRIAL $45,929.00 48000044 HB INS/RPL PERM PACER VENTRICLE $45,929.00 48000045 HB INS/RPL PERM PACER ATRIAL&VENT $71,325.50 48000046 HB REPAIR PACER/ICD LEAD SGL $11,265.50 48000047 HB REPAIR PACER/ICD LEAD DUAL $11,265.50 48000048 HB INSERT LV LEAD TO EXISTING GEN $71,325.50 48000049 HB INSERT LV LEAD W/INSERT OF GEN $71,325.00 48000050 HB REPOS LV LEAD $11,265.50 48000051 HB REMOVAL PERM PACER LEAD SGL $11,265.50 48000052 HB REMOVAL PERM PACER LEAD DUAL $11,265.50 48000053 HB INS/RPL TEMP SGL CHAMBER LEAD (SEPARATE PROCEDURE) $17,685.00 48000054 HB INSERT ICD GENERATOR ONLY W/EXIST SINGLE LEAD $99,999.00 48000055 HB REMOVAL ICD GENERATOR $11,265.50 48000056 HB REMOVAL ICD LEAD(S) $11,265.50 48000057 HB INS/RPL ICD LEAD(S) & GEN SGL OR DUAL $99,999.00 48000058 HB REM/REPLACE ICD GEN ONLY;SGL L $99,999.00 48000059 HB REM/REPLACE ICD GEN ONLY;MULTI $99,999.00 48000060 HB REM/REPLACE ICD ONLY;MULTI SYS $99,999.00 48000061 HB INSERT PT-ACTIVE HEART RECORDER $13,954.00 48000062 HB CARDIOPULMONARY RESUSCITATION $2,276.50 48000063 HB CARDIOVERSION ELECTIVE $4,270.50 48000064 HB VALVULOPLASTY, AORTIC VALVE $12,248.07 48000077 HB INSERT IABP PERC $14,912.00 48000080 HB THROMBOLYSIS INTRACORONARY $6,354.00 48000081 HB IV INFUSION THROMBOLYSIS $1,297.50 48000082 HB IVUS OR OCT CORONARY INITIAL VESSEL $10,258.00 48000083 HB IVUS OR OCT CORONARY EACH ADD VESSEL $10,258.00 48000095 HB ECHO TTE CONGENITAL COMPLETE $4,489.50 48000096 HB ECHO TTE CONGENITAL LIMITED/FOLLOW-UP $3,043.50 48000097 HB ECHO TTE COMPLETE $2,406.00 48000098 HB ECHO TTE LTD/FU $1,269.50 48000099 HB ECHO TEE $4,157.00 48000101 HB ECHO TEE CONGEN COMPLETE $4,157.00 48000103 HB ECHO DOPPLER FLOW STUDY $759.50 48000104 HB ECHO DOPPLER FLOW LTD/FU $403.00 48000105 HB ECHO DOPPLER COLOR FLOW $825.50 48000106 HB EPS INTRA-ATRIAL PACING $5,147.00 48000107 HB EPS INTRA-VENTRICULAR PACING $5,380.50 48000108 HB EPS ESOPH RECORD A/V ECG W/PAC $5,138.00 48000109 HB ARRHYTHMIA INDUCTION $5,380.50 48000110 HB EPS COMPREHENSIVE W/O INDUCT $27,602.50 48000111 HB EPS COMPREHENSIVE W/ INDUCTION $27,602.50 48000112 HB EPS LT VENT PACING & RECORD $878.50 48000113 HB EPS FOLLOW-UP W/ INDUCTION $27,602.50 48000114 HB INTRA-OP MAP TACHYCARDIA SITE $3,089.00 48000115 HB EP EVAL ICD LEADS AT INSERT $1,470.50 48000116 HB EP EVAL ICD GEN&LEADS AT INSRT $2,483.00 48000117 HB EP ABLATION AV NODE $27,602.50 48000126 HB ART/VEN INF;THROMBO;SUBSEQ $11,968.00 48000127 HB ART/VEN INF;CESS THROMBOLYSIS $11,968.00 48000128 HB PLACE INTRAVAS STENT;INT ART $63,013.50 48000129 HB PLACE INTRAVAS STENT;EA ADDTL $63,013.50 48000130 HB PLACE INTRAVAS STENT;INT VEIN $63,013.50 48000131 HB PLACE INTRA STENT;EA ADD VEIN $63,013.50 48000132 HB EPS TEMP TRANSCUTANEOUS PACING $2,637.00 48000136 HB INSERT/REPLACE SUBQ DEFIB $74,948.00 48000137 HB INSERT SUBQ DEFIB ELECTRODE $13,786.50 48000138 HB REMOEL SUBQ DEFIB ELECTRODE $6,943.00 48000139 HB REPOSITION PREVIOUSLY IMPLANTED SUBQ DEFIB ELECTRODE $6,943.00 48000141 HB EP EVAL SUBQ ICD $923.50 48000142 HB PROG DEVICE EVAL SUBQ DEFIB (IN PERSON) $108.50 48000143 HB INTERROGATE SUBQ DEFIB $108.50 48000145 HB FRACTIONAL FLOW WIRE (SEPERATE PROCEDURE) $6,260.00 48000147 HB COR FFR ALYS GNRJ FFR MDL $5,510.00 48000155 HB INSERT SUBQ CARDIAC RHYTHM MONITOR $28,136.00 48000156 HB REMOVE SUBQ CARDIAC RHYTHM MONITOR $2,550.00 48000157 HB TRANSCATH INS/RPL PERM PM LDLS, VENTR $42,605.22 48100001 HB ARTERIAL INF,THROMBOLYSIS;INIT $10,618.00 48100002 HB VENOUS INF,THROMBILYSIS;INITIA $10,618.00 48100004 HB REVASC;ILIAC UNILAT W/ANGIO $35,851.00 48100005 HB ILIAC REVASC;W/STENT & ANGIO $35,851.00 48100006 HB ILIAC REVASC;EA ADD W/ANGIO $35,851.00 48100007 HB ILIAC REVASC;EA ADD W/STNT&ANG $35,851.00 48100008 HB FEM/POP REVASC;W/ANGIO $35,851.00 48100009 HB FEM/POP REVASC;W/ARTHERECTOMY $76,111.00 48100010 HB FEM/POP REVASC;W/STENT&ANGIO $76,111.00 48100011 HB TIBIAL/PERONEAL REVASC W/ANGIO $35,851.00 48100012 HB TIB/PER REVASC; W/ARTHERECTOMY $76,111.00 48100013 HB TIB/PER REVASC;W/STNT & ANGIO $25,810.50 48100014 HB TIB/PER REVASC;W/STNT & ARTHER $99,999.99 48100015 HB TIB/PER REVASC;EA ADD W/ANGIO $35,851.00 48100016 HB TIB/PER REV EA ADD W/STNT&ANGI $35,851.00 48100017 HB IVUS, INITIAL VESSEL $1,036.00 48100018 HB IVUS, EACH ADDTL VESSEL $9,304.50 48100020 HB ATHERECTOMY; ILIAC, EA VESSEL $60,569.50 48100021 HB FEM/POP REVASC;W/STNT & ARTHER $99,999.99 48100022 HB CATH RT HEART $21,065.50 48100023 HB LHC INCLD INJ/VENT IF PERFORM $18,217.50 48100024 HB RHC/LHC W OR W/O VENTRICLGRPHY $33,004.00 48100025 HB CORONARY ARTERY ANG W/INJ S&I $15,520.50 48100026 HB CORONARY ART/GRFT ANGIO S&I $17,401.50 48100027 HB RHC W/CORONARY ART ANG W/INJ $22,904.00 48100028 HB CORONARY ART ANG W/INJ/GFT/RHC $24,785.00 48100029 HB CORONARY ART ANG W/LHC/INJ $27,490.00 48100030 HB CORONARY ART ANG W/LHC/INJ/GFT $29,363.50 48100031 HB CORONARY ART ANG W/INJ/RHC&LHC $42,269.00 48100032 HB CORONARY ART W/INJ/GFT/RHC/LHC $44,150.00 48100033 HB LHC TRANSEPTAL PUNCTURE $16,708.50 48100036 HB INSERT SWAN GANZ $5,101.00 48100037 HB BIOPSY ENDOMYOCARDIAL $8,184.50 48100044 HB INJ SELECT L VENT/ARTIAL ANGIO $3,831.50 48100045 HB INJ SELECT R VENT/ARTIAL ANGIO $3,248.00 48100046 HB INJ SUPRAVALV AORT W/HRT CATH $5,144.00 48100047 HB INJ PULM ART W/HEART CATH $8,679.50 48100048 HB PRESSURE WIRE INITIAL VESSEL $9,394.00 48100049 HB PRESSURE WIRE EACH ADD VESSEL $9,394.00 48100050 HB TRANSCATH CLOSURE PFO OCCLUDER $39,969.99 48100052 HB EPS BUNDLE OF HIS RECORDING $5,147.00 48100053 HB EPS INTRA-ATRIAL RECORDING $5,380.50 48100054 HB EPS RT VENTRICULAR RECORDING $5,147.00 48100055 HB EPS MAPPING TACH SITES $809.50 48100056 HB EPS MAPPING TACH SITES W/ 3D $7,564.00 48100058 HB EPS COR SINUS PACING & RECORD $878.50 48100059 HB EPS DRUG STIMULATION $591.00 48100060 HB EP EVAL TILT TABLE STUDY $2,547.50 48100061 HB ECHO INTRACARDIAC $1,392.50 48100069 HB TIB/PER REVAS; EA ADD W/ARTHRECTOMY $76,111.00 48100071 HB ATHERECTOMY; RENAL, EA VESSEL $60,569.50 48100072 HB ATHERECTOMY; VISCERAL, EA VESSEL $60,569.50 48100073 HB ATHERECTOMY; ABDOMINAL, EA VESSEL $60,569.50 48100074 HB ATHERECTOMY; BRACHIOCEPHALIC T&B, EA VESSEL $60,569.50 48100118 HB PM CHECK ANTITACH W/WO REPROG $923.50 48200001 HB EKG STRESS TEST TRACING ONLY $1,853.50 48300001 HB ECHO COMPLETE W/DOPPLER&COLOR $2,475.00 48300003 HB TRANSTHO ECHO W/CONTR 2D COMPL $1,813.41 48300005 HB ECHO W/OR WO FOLL W/CON,DOPPLE $2,475.00 48300007 HB TEE FOR MONITORING $4,157.00 48300008 HB TTE W OR WITHOUT F-BY W; FOLLOW-UP OR LIMITED STUDY $1,269.50 48300011 HB STRESS TEE ONLY $2,406.00 49900001 HB PET MYOCARDIAL METABOLIC EVAL $12,354.00 49900002 HB PET BRAIN METABOLIC EVAL $12,354.00 49900003 HB PET/CT WHOLE BODY $14,990.50 51000001 HB MEDICAL VISIT NEW LEVEL 1 $419.00 51000002 HB MEDICAL VISIT NEW LEVEL 4 $1,604.50 51000004 HB ABORTED PROCEDURE $2,904.00 51000005 HB MEDICAL VISIT EST LEVEL 1 $419.00 51000006 HB MEDICAL VISIT EST LEVEL 2 $521.00 51000016 HB MEDICAL VISIT EST LEVEL 4 $934.50 51000020 HB MEDICAL VISIT NEW LEVEL 2 $667.50 51000021 HB MEDICAL VISIT NEW LEVEL 3 $1,378.00 51000022 HB MEDICAL VISIT NEW LEVEL 5 $1,887.00 51000023 HB MEDICAL VISIT EST LEVEL 3 $778.50 51000024 HB MEDICAL VISIT EST LEVEL 5 $1,036.50 61000001 HB CARDIAC MRI W/WO CONT W/STRESS $10,184.50 61000002 HB MRA CHEST W/O CONTRAST $3,111.00 61000003 HB MRA CHEST W/O F/BY W/CONTRAST $9,023.50 61000004 HB MRA CHEST WITH CONTRAST $3,774.00 61000005 HB MRA LWR EXTREMITY W/CONTRAST $6,174.50 61000006 HB MRA LWR EXTREMITY W/O CONTRAST $4,749.00 61000007 HB MRA LWR EXTRMTY W/O F/BY W/CON $9,970.50 61000008 HB MRA ABDOMEN W/CONTRAST $5,460.50 61000009 HB MRA ABDOMEN W/O F/BY W/CONTRST $9,023.50 61000011 HB MRI BREAST W/WO UNILAT $5,699.00 61000014 HB MRI BREAST W/WO BILAT $9,081.50 61000016 HB MRI TEMPORMAN JOINT $11,361.50 61000017 HB MRI ORB,FACE,NECK W/O CONTRAST $9,628.50 61000019 HB MRI ORBIT,FACE,NECK W/O CONTRAST F-BY CONTRAST $10,665.00 61000020 HB MRI CHEST W/O CONTRAST $9,154.00 61000021 HB MRI CHEST W/CONTRAST $9,296.00 61000022 HB MRI CHEST W/O CONT F-BY CONT $9,611.00 61000023 HB MRI PELVIS W/O CONTRAST $10,650.00 61000024 HB MRI PELVIS W/CONTRAST $11,366.00 61000025 HB MRI PELVIS W/O CONT F-BY CONTRAST $12,372.00 61000026 HB MRI UPPER EXT W/O CONTRAST $9,615.00 61000027 HB MRI UPPER EXT W/CONTRAST $3,409.50 61000028 HB MRI UPPER EXT W/O CONT F-BY CONTRAST $10,334.00 61000029 HB MRI UPPER EXT JOINT W/O CONTRAST $10,650.00 61000030 HB MRI JOINT UPPER EXT W/ CONTRAST $10,433.50 61000031 HB MRI JOINT UPPER EXT W/O C F-BY CONTRAST $11,366.00 61000032 HB MRI LOWER EXTRMTY W/O CONTRAST $10,334.00 61000033 HB MRI LOWER EXTRMTY W/CONTRAST $3,409.50 61000034 HB MRI LOWER EXTREMITY W/O CONT F-B CONTRAST $10,334.00 61000035 HB MRI LOWER EXT JOINT W/O CONTRAST $6,542.00 61000036 HB MRI JOINT LOWER EXTRMTY W/CONTRAST $3,409.50 61000037 HB MRI JOINT LOWER EXTRMTY W/O F-BY CONTRAST $10,258.00 61000038 HB MRI ABDOMEN WO CONTRAST $10,334.00 61000039 HB MRI ABDOMEN W/CONTRAST $11,050.00 61000040 HB MRI ABDOMEN W/O CONTRAST F-BY CONTRAST $11,366.00 61000042 HB CARDIAC MRI-MORPH W/FUNCTION $8,246.50 61000043 HB MR GUIDANCE NEEDLE PLACEMENT $3,766.50 61000044 HB MRA ABDOMEN W/O CONTRAST $4,499.50 61000051 MRI BREAST; W/O CONT; BILATERAL $9,081.50 61000053 MRI BREAST; W/WO CONT; INCL CAD; BILATERAL $3,408.00 61100001 HB MRI BRAIN W/O CONTRAST $9,390.00 61100002 HB MRI BRAIN W/CONTRAST $10,108.50 61100003 HB MRI BRAIN W/WO CONTRAST $10,433.50 61200001 HB MRI C-SPINE W/O CONTRAST $9,958.00 61200002 HB MRI C-SPINE W/CONTRAST $10,433.50 61200003 HB MRI T-SPINE W/O CONTRAST $11,965.00 61200004 HB MRI T-SPINE W/CONTRAST $12,688.50 61200005 HB MRI L-SPINE W/O CONTRAST $9,958.00 61200006 HB MRI L-SPINE W/CONTRAST $10,433.50 61200007 HB MRI C-SPINE W/WO CONTRAST $10,747.00 61200008 HB MRI T-SPINE W/WO CONTRAST $13,749.00 61200009 HB MRI L-SPINE W/WO CONTRAST $10,747.00 61400001 HB CARDIAC MRI W/FLOW VELOCITY $315.00 61400002 HB CARDIAC MRI MORPH W/FUNC W/CON $9,162.50 61400003 HB CARDIAC W/STRESS IMG $8,877.00 61500001 HB MRA HEAD W/O CONTRAST $4,499.50 61500004 HB MRA NECK W/O CONTRAST $4,499.50 61500005 HB MRA NECK W/CONTRAST $5,460.50 61500006 HB MRA NECK W/O CONTRAST F-BY CONT $9,023.50 61800001 HB MRA PELVIS W & W/O CONTRAST $9,023.50 61800002 HB MRA PELVIS W/CONTRAST $5,460.50 61800003 HB MRA UPP EXT W/CONTRAST $4,120.00 63600001 HB RX 344-TX RADIOPHARM $5,699.88 63600013 HB RX 636-DRUGS WITH HCPCS $469.86 63600039 HB PNEUMOCOCCAL VACC 13-VAL $233.70 63600045 HB HEPATITIS B 5MCG (RECOMBIVAX) PEDS $130.00 63600045 HB PNEUMOCOCCAL VACC 23-VALPS $54.78 63600047 HB HEPATITIS B 5MCG (RECOMBIVAX) PEDS $101.61 63600057 HB RX 636-HEMOPHILIC FACTOR DRUG $7,834.67 63600077 HB INFLUENZA VACCINE (CCIIV4 $22.00 63600080 HB INJ/INFLUENZA QUAD - FLULAVAL $30.00 63700001 HB RX 637-SELF ADMIN DRUGS $425.08 68100001 HB TRAUMA RESPONSE W/CRITI CARE $13,654.00 68100002 HB TRAUMA RESP <30 MIN CC $10,079.00 68100003 HB TRAUMA RESP A <30 MIN CC $13,654.00 68100004 HB TRAUMA RESP B <30 MIN CC $10,079.00 68100005 HB TRAUMA RESP A W/CC $13,654.00 68100006 HB TRAUMA RESP B W/CC $10,079.00 68300185 HB ELECTRON MICROSCOPY $1,326.00 68300193 HB HISTOCHEMICAL STAIN (FROZEN) $354.00 68500016 HB SPECIAL STAINS GRP. 1 $232.00 68500024 HB SPECIAL STAINS GRP. II $133.00 68500164 HB IF ANTIBODY, FIRST MARKER $287.50 68500222 HB TISSUE IN SITU HYBRIDIZATION $566.00 68500248 HB IMMUNOHIST PER SPEC;1 ANTIBODY $273.50 68500255 HB IMMUNOHIST PER SPEC;EA ADD SPE $273.50 68500256 HB IF ANTIBODY, EA ADDTL MARKER $287.50 68500307 HB TUMOR IHC QT MANUAL $1,346.50 68500309 HB TUMOR IHC QT AUTO $1,346.50 68500310 HB NERVE TEASING PREP $813.50 68500311 HB XM ARCHIVE TISSUE MOLECULAR $166.50 68600014 HB DECALCIFICATION $166.50 68600022 HB FROZEN SECT. W/CONSULT $449.00 68600303 HB FROZ SECTION TOUCH PREP 1ST SP $232.00 68600311 HB FROZ SECTION TOUCH PREP ADD SP $295.50 68600345 HB SURG PATH < 3 BLKS $449.00 68600360 HB SURG PATH < 3 BLKS $694.00 68600428 HB PROSTATE NEEDLE BIOPSY<3BLOCKS $4,933.50 68600500 HB SURG PATH BONE MARROW $287.50 68600501 HB SURG PATH, GROSS & MICRO LVL4 $287.50 68600502 HB SURG PATH GROSS LVL4 $287.50 68600503 HB SURG PATH GROSS & MICRO LEVEL II $232.00 68600505 HB SURG PATH GROSS & MICRO LEVEL III $449.00 68600507 HB SURG PATH GROSS LVL1 $166.50 68600508 HB SURG PATH GROSS LVL5 $679.50 68600510 HB SURG PATH GROSS LEVEL 6 $813.50 68600514 HB PATH CONSULT/INTRADD $197.50 68600515 HB ICC MLTPX AB ST $228.00 68600516 HB ANALYSIS SKELETAL MUSCLE $813.50 68600517 HB ANALYSIS NERVE $679.50 68600518 HB ANALYSIS TUMOR $449.00 69000131 HB N. ASPIRATE INTERP. & REPORT $449.00 69000149 HB TECH FNA ADEQUACY DETERMINATN $232.00 69000222 HB GYN SLIDES MANUAL DIAGNOSTIC $208.50 69000402 HB CYTOPATHOLOGY FLUID NOT V-C $232.00 69000403 HB CYTOPATHOLOGY FLUID FTRW-IN $232.00 69000404 HB CYTOPATHOLOGY CONCENTRATION TECH $232.00 69000406 HB CYTOCELL ENH X CR-VG $449.00 69000407 HB CYTOLOGY UR 3-5 PROBE EA SPEC $679.50 69000408 HB CYTOLOGY UR 3-5 PROBE COMPUTER $813.50 69000409 HB FORENSIC CYTOPATHOLOGY $232.00 69000410 HB SEX CHROMATIN ID BARR $278.00 69000411 HB SEX CHROM ID POLYMOR $168.00 69000412 HB PAP THINLAY LIQ DIAG $360.00 69000413 HB CYTOPATH C-V THIN LAYER $360.00 69000414 HB CYTOPATH C-V AUTOMATED $208.50 69000415 HB CYTOPATH C-V AUTO RESCREEN $264.50 69000416 HB CYTOPATH C-V MANUAL $208.50 69000417 HB CYTOPATH C-V AUTO REDO $208.50 69000418 HB CYTOPATH C-V REDO $208.50 69000419 HB CYTOPATH C-V INDEX ADD-ON $133.50 69000421 HB CYTOPATH SMEAR OTHR SOURCE $232.00 69000424 HB CYTOPATH SMEAR OTH PREP/SCREEN $232.00 69000425 HB CYTOPATH SMEAR OTH > 5 SLIDES $449.00 69000426 HB CYTOPATH TBS, C-V, RESCREEN $208.50 69000427 HB CYTOPATH TBS, C-V AUTORESCREEN $208.50 69000428 HB CYTOPATH TBS, C-C, SELECT $208.50 69000429 HB CYTO-CERVICAL RP CDM $376.50 69000430 HB PAP DIAG AUTO MAN RS $457.00 69000431 HB CYTO EVAL FNA ADD $166.50 69000436 HB CELL MRK STDY CY-DNA $449.00 71000001 HB RECOVERY (GENERAL) - FIRST HOUR $13,447.80 71000002 HB RECOVERY EA ADD HALF HOUR $2,498.10 71000003 HB RECOVERY MAC/MOD SEDATION- FIRST HOUR $4,996.20 71000005 HB RECOVERY (GENERAL) FIRST HR - PHASE 2 $4,996.20 71000006 HB RECOVERY (MAC/MOD) FIRST HR - PHASE 2 $4,996.20 71000007 HB RECOVERY EA ADD HALF HR - PHASE 2 $2,498.10 71000008 HB RECOVERY FIRST 15 MIN (ENDOSCOPY) $3,361.95 71000009 HB RECOVERY EA ADD'L MINUTE (ENDOSCOPY) $224.13 72000001 HB EXTERNAL CEPHALIC VERSION $7,584.50 72000002 HB DELIVERY OF PLACENTA ONLY $1,580.00 72000004 HB L&D LEVEL I UNCOMPLICATED $3,400.14 72000005 HB L&D LEVEL II INTERVENTION $4,956.86 72000006 HB L&D LEVEL III COMPLICATED $6,123.18 73000002 HB EKG SIGNAL AVERAGED $1,074.00 73000003 HB EKG 12-LEAD TRACING ONLY $959.00 73000004 HB ECG 1-3 LEADS TRACING ONLY $187.50 73100001 HB EKG 24HR W/SCAN/RECORDING $1,531.50 73100002 HB EVENT MONITORING, RECORDING PER 30 DAYS $438.00 73100003 HB MEMORY LOOP RECORDER HOOKUP $438.00 73100008 HB EKG 24HR W/SCAN AND ANALYSIS $2,289.00 74000001 HB MULT SLEEP LANTENCY TEST(16) $13,614.00 74000005 HB SLEEP STUDY BASIC $10,442.50 74000006 HB SLEEP STUDY CPAP/BILEVEL VENT $11,398.00 74000007 HB EEG 41-60 MIN $1,783.50 74000008 HB EEG> 60 MIN $1,783.50 74000009 HB EEG AWAKE/DROWSY $1,906.00 74000010 HB EEG AWAKE/ASLEEP $1,999.50 74000011 HB EEG CEREB DEATH EVAL $1,662.50 74000012 HB EEG 24 HOURS W/ VIDEO $7,895.00 74000013 HB EEG <12 HRS WITH VIDEO $3,947.50 74000014 HB EEG 24H AMBULATORY $6,157.00 74000015 HB EEG DURING NON-INTRACRAN SURG $2,909.00 74000017 HB DIGITAL EEG ANALYSIS $2,741.50 74000021 HB SLEEP STUDY-<6YRS;BASIC $10,442.50 74000022 HB SLEEP STUDY-<6YRS W/CPAP $11,398.00 74000024 HB EEG COMA OR SLEEP ONLY $1,318.00 74000028 HB SLEEP STUDY-6YR+ W/CPAP;<6HRS $5,699.00 74000029 HB PORTABLE HOME SLEEP TEST, TYPE 4 $1,072.00 74000030 HB PORTABLE HOME SLEEP TEST, TYPE 3 $543.50 75000001 HB PROLONGED ESOPH 24 PH $4,664.00 75000002 HB ESOPH IMPED FUNC TEST > 1 HOUR $3,832.74 75000003 HB BREATH HYDROGEN TEST $1,620.00 75000004 HB RECTAL SENSATION TEST $522.00 75000005 HB ANAL MANOMETRY $3,022.00 75000006 HB NON ENDO WIRELESS CAPSULE $5,898.36 75000007 HB EGG/DIAGNOSTIC/TRANSCUTANEOUS $3,582.00 75000008 HB ANOSCOPY W/DILATION $4,182.00 75000009 HB ANOSCOPY W/WO SPECIMEN $1,034.80 75000010 HB COLON STOMA W/BIOPSY $1,860.20 75000011 HB COLON STOMA W/POLYPECTOMY $1,731.82 75000012 HB COLON STOMA W/WO SPECEMEN $6,290.62 75000013 HB COLON W/BALLOON DILATION $1,962.38 75000014 HB COLON W/BIOPSY $1,551.04 75000015 HB COLON W/CONTROL OF BLEED $2,811.26 75000016 HB COLON W/DECOMPRESSION $1,226.16 75000017 HB COLON W/HOT BIOPSY $2,090.76 75000018 HB COLON W/POLYPECTOMY(SNARE) $2,090.76 75000019 HB COLON W/REMOVAL FOREIGN BODY $1,024.42 75000020 HB COLON W/STENT PLACEMENT $3,219.98 75000021 HB COLON W/WO SPEC W/DIRECT INJ $5,481.04 75000022 HB COLON W/WO SPEC W/US $5,481.04 75000023 HB COLON W/WO SPEC W/US FNA $5,481.04 75000024 HB COLON W/WO SPECIMEN $8,331.60 75000025 HB EGD W/BAND LIGATION $4,057.83 75000026 HB EGD W/BILIARY/PANC STENT REMOV $2,705.22 75000027 HB EGD W/BIOPSY $2,006.88 75000028 HB EGD W/CELIAC PLEXIS INJ W/EUS $1,772.97 75000029 HB EGD W/CONTROL OF BLEED $2,705.22 75000030 HB EGD W/DILATION/GASTRIC OUTLET $4,444.29 75000031 HB EGD W/EUS & FNA ESOPHAGUS ONLY $14,166.81 75000032 HB EGD W/EUS ESOPHAGUS ONLY $10,593.75 75000033 HB EGD W/GASTRIC/ENTERIC TUBE $3,742.56 75000034 HB EGD W/HOT BIOPSY $3,244.23 75000035 HB EGD W/INJ SCLEROSIS $8,183.46 75000036 HB EGD W/INTRA TUBE/CATHETER PLMT $6,183.36 75000037 HB EGD W/PEG $2,328.93 75000038 HB EGD W/PEG TO PEJ $3,376.44 75000039 HB EGD W/PEJ $4,057.83 75000040 HB EGD W/PEJ CHANGE $3,376.44 75000041 HB EGD W/ALBATION OF LESIONS $2,274.69 75000042 HB EGD W/PSEUDOCYST DRAINAGE $6,183.36 75000043 HB EGD W/REMOVAL OF FOREIGN BODY $3,576.45 75000044 HB EGD W/STENT PLACEMENT $4,837.53 75000045 HB EGD W/ULTRASOUND $13,078.62 75000046 HB EGD W/ULTRASOUND/NEEDLE ASPIRA $18,078.87 75000047 HB EGD W/WIRE GUIDED DILATION $3,247.62 75000048 HB EGD W/WO SPECIMEN $6,512.19 75000049 HB ERCP W/BALLOON DILATION $11,032.56 75000050 HB ERCP W/BIOPSY $5,679.46 75000051 HB ERCP W/INSERTION NB DRAIN $6,093.38 75000052 HB ERCP W/LITHOTRIPSY $15,004.60 75000053 HB ERCP W/MANOMETRY $8,274.42 75000054 HB ERCP W/SPHINCTEROTOMY $9,607.72 75000055 HB ERCP W/STENT CHANGE/REMOVAL $5,679.46 75000056 HB ERCP W/STONE EXTRACTION $10,427.60 75000057 HB ERCP W/ULTRASOUND - MINIPROBE $4,644.66 75000058 HB ERCP W/WO SPECIMEN $19,454.24 75000059 HB ESOPH W/BALLOON DILATION $3,104.40 75000060 HB ESOPH W/BIOPSY $2,356.16 75000061 HB ESOPH W/FOREIGN BODY REMOVAL $1,691.50 75000062 HB ESOPH W/INSERTION OF STENT $3,717.32 75000063 HB ESOPH W/TISSUE ABLATION $3,104.40 75000064 HB ESOPH W/WO SPECIMEN $4,927.24 75000065 HB ESOPHAGEAL 24H PH W/IMPENDANCE $8,103.28 75000066 HB ESOPHAGEAL DILATION NONENDO $4,768.04 75000067 HB ESOPHAGEAL MANOMETRY W/IMPEDAN $3,442.70 75000068 HB FLEX SIG W/BIOPSY $1,266.00 75000069 HB FLEX SIG W/CONTROL OF BLEED $2,132.00 75000070 HB FLEX SIG W/DECOMPRESSION $1,056.00 75000071 HB FLEX SIG W/DILATION BY BALLOON $2,288.00 75000072 HB FLEX SIG W/DIRECT INJECTION $2,772.00 75000073 HB FLEX SIG W/HOT BIOPSY $738.00 75000074 HB FLEX SIG W/POLYPECTOMY $1,436.00 75000075 HB FLEX SIG W/RECTAL EUS $738.00 75000076 HB FLEX SIG W/RECTAL EUS W/FNA $1,520.00 75000077 HB FLEX SIG W/REMOVAL FOREIGN BOD $836.00 75000078 HB FLEX SIG W/STENT PLACEMENT $1,664.00 75000079 HB FLEX SIG W/WO SPECIMEN $4,580.98 75000081 HB ILEOS STOMA W/WO SPECIMEN $2,836.00 75000082 HB ERCP W/INSERTION OF STENT $7,311.26 75000083 HB PEG CHANGE NONENDO $1,052.00 75000086 HB EGD W/BALLOON DILATION ESOPH $4,057.83 75000087 HB ANOSCOPY W/BIOPSY $3,922.00 75000088 HB ANOSCOPY W/CONTROL OF BLEED $1,340.00 75000089 HB COLON STOMA W/ABLATION LESIONS $4,640.02 75000090 HB COLON W/ABLATION OF LESIONS $4,640.02 75000091 HB EGD W DIRECTED INJECTION $1,708.00 75000092 HB EGD W/OPTICAL ENDOMICROSCOPY $6,715.59 75000093 HB EGD W/SMARTPILL $3,095.07 75000094 HB ERCP W/ABLATION OF LESIONS $7,048.58 75000095 HB ERCP W/OPTICAL ENDOMICROSCOPY $7,884.38 75000096 HB ESOPH W/BAND LIGATION $2,491.48 75000097 HB ESOPH W/CONTROL OF BLEED $2,996.94 75000098 HB ESOPH W/INJ SCLEROSIS $2,129.30 75000099 HB ESOPH W/POLYP/LESION BY SNARE $3,008.88 75000102 HB COLON STOMA W/CONTROL OF BLEED $1,755.40 75000103 HB ESOPH W/DIRECT INJECTION $3,176.04 75000104 HB COLON FLEXIBLE W/EMR $5,371.00 75000105 HB COLON FLEXIBLE W/DECOMPRESSION W/TUBE PLCMNT $5,371.00 75000106 HB COLON FLEXIBLE W/BAND LIGATION(S) $5,371.00 75000108 HB COLON STOMA W/EMR $5,371.00 75000109 HB COLON STOMA W/DIRECT SUBMUCOSAL INJECTION $5,371.00 75000110 HB COLON STOMA W/BALLOON DILATION $1,962.38 75000111 HB COLON STOMA W/ U/S OF SIGMOID, DESCND, TRANS OR ASCEND $5,371.00 75000112 HB COLON STOMA W/ U/S GUIDE ASPIRATION/BX $5,481.04 75000113 HB COLON STOMA W/DECOMPRESSION $1,226.16 75000114 HB FLEX SIG W/MUSOCAL RESECTION $322.00 75000115 HB FLEX SIG W/BAND LIGATION(S) $4,598.00 75000116 HB GASTRIC INTUBATION WITH ASPIRATION $724.00 75000117 HB GASTRIC LAVAGE, DX SGL SPECIMEN $1,116.00 75000118 HB COLON MOTILITY (MANOMETRIC) 6 HR STUDY $1,210.44 75000119 HB EGD W/BRAVO PH MONITORING $2,871.33 75000120 HB GASTRIC MOTILITY STUDIES $1,952.00 75000121 HB FUOFRNSL MOTILITY STUDY $4,210.00 75000122 HB ESOPH MOTILITY STUDY $3,530.26 75000124 HB ESOPHAGEAL IMPEDANCE $1,962.14 75000127 HB ESOPH BALLOON DISTN TEST $823.00 76100048 HB DEBRIDEMENT LE 20 SQ CM $759.50 76100049 HB DEBRIDE SELECTIVE EA ADD 20 SQ CM $1,099.50 76200000 HB OBSERVATION ROOM CHG $80.46 76200001 HB OBSERVATION-DIRECT ADMIT $983.50 76200004 HB OBSERVATION ROOM CHG L&D - 1ST HR $701.50 76200005 HB OBSERVATION ROOM CHG L&D - EACH ADDL HR $175.50 77000002 HB LOW DOSE CT FOR LUNG CANCER SCREENING $2,284.00 77100001 HB ADMIN HEPATITIS B $138.50 77100002 HB ADMIN INFLUENZA VIRUS $125.00 77100004 HB ADMIN VACCINE OTHER INITAL $202.50 77100005 HB ADMIN VACCINE OTHER EA ADD $207.00 77100012 HB ADMIN INITIAL (PNEUMO) $125.00 80000001 HB DIALYSIS OTHER THAN HEMODIALYSIS $3,903.00 80100002 HB HEMODIALYSIS CRITICAL CARE $4,243.00 80100003 HB HEMODIALYSIS IP ADULT ESRD PT $4,243.00 80100004 HB HEMODIALYSIS NON-ESRD SCHEDULE $4,243.00 82000001 HB NON SCHEDULED EMERGNT DIALYSIS $4,243.00 82100025 HB ABGS AT $806.00 82100124 HB LAC WB AT $654.00 82100140 HB NA WB AT $204.50 83600130 HB A SODIUM-I STAT $204.50 83600148 HB A POTASSIUM-I STAT $133.00 83600171 HB A GLUCOSE ARTERIAL-I STAT $97.00 83600189 HB A HEMATOCRIT-I STAT $95.50 83600197 HB GLUCOSE $97.00 83600213 HB PH,PC01,P02 BILL $445.00 83600247 HB ARTERIAL IONIZED CALCIUM $120.50 83600270 HB CAPILLARY IONIZED CALCIUM $120.50 83600288 HB ACTIVATED CLOTTING TIME,I-STAT $158.00 83600296 HB GLUCOSE PCx $42.00 83600429 HB HCT I $95.50 83600445 HB CHEM 8 I $502.00 83710111 HB BETA-2 MICROGLOBULIN, SERUM AR $390.00 83710202 HB CITRIC ACID, URINE ARUP $1,071.00 83710665 HB PARIETAL CELL AB, IGG ARUP $200.50 83710962 HB CATECHOLAMINES, PLASM FR ARUP $1,083.50 83711143 HB MITOCHONDRIAL AB, IGG ARUP $200.50 83711192 HB TSH RECEPTOR AB (TRAB) ARUP $191.00 83711317 HB C1 ESTERASE INHIBITOR ARUP $445.00 83711960 HB HSV BY PCR $685.00 83711986 HB LAMOTRIGINE $284.50 83712091 HB HUMAN PARVOVIRUS DNA BY PCR $685.00 83712299 HB VZV BY PCR $685.00 83712307 HB LEGIONELLA PNEUMOPHILIA AB IGG $227.00 83712422 HB TISSUE TRANSGLUTAMINASE AB IGA $200.50 83712497 HB ALDOLASE SERUM $587.50 83712513 HB CORTISOL URINARY, FREE $636.00 83712679 HB EV PCR-AR $545.50 83712935 HB ALLERGEN CAT EPI & DANDER $102.00 83712943 HB ALLERGEN A. FUMIGATUS #2 $102.00 83712968 HB ALLERGEN CORN $102.00 83713032 HB ALLERGEN MILK $102.00 83713040 HB ALLERGEN PEANUT $102.00 83713222 HB PROSTATIC ACID PHOSPHATASE $208.00 83713578 HB DONOR HBsAG $492.00 83713651 HB GLUCOSE-6-PHOSPHATE DEHYDROGEN $189.00 83713677 HB FIBROSURE-APOLIPO $138.00 83713685 HB FIBROSURE-BILIRUBIN $313.50 83713693 HB FIBROSURE-CHOLESTEROL $409.50 83713701 HB FIBROSURE-GLUCOSE $97.00 83713719 HB FIBROSURE-GGT $329.00 83713727 HB FIBROSURE-HAPTOGLOBIN $227.00 83713735 HB FIBROSURE-NEPHELOMETRY $247.50 83713743 HB FIBROSURE-AST $184.50 83713750 HB FIBROSURE-ALT $311.50 83713768 HB FIBROSURE-TRIGLYCERIDE $386.50 83713792 HB MULLERIAN HORMONE AB $200.50 83713836 HB PS - CONCENTRATION - INFECTIOUS AGENT $138.00 83713841 HB MTBRP - SPEC CONC - MA $138.00 83720169 HB ESTRADIOL $785.50 83720201 HB IGF-I/SOMATOMEDIN-C $414.00 83720532 HB COPPER SERUM $334.00 83720953 HB HISTOPLASMA AG $187.00 83721001 HB METHYLMALONIC ACID $291.00 83721007 HB ASO-AR8 $128.00 83721019 HB HOMOCYSTINE URINE $422.50 83721134 HB CREATININE URINE $369.50 83721233 HB PRIMIDONE $320.50 83721308 HB HBELC A2/F-MA $1,092.50 83721314 HB ALK IMMUNOHISTOCHEMISTRY $1,346.50 83721347 HB CULTURE WOUND AEROBIC $476.50 83721350 HB CULTURE STOOL $160.00 83721368 HB PROSTATE SPECIFIC ANTIGEN $507.50 83721370 HB TESTOSTERONE TOTAL $1,537.50 83721371 HB THYROXINE TOTAL $385.00 83721372 HB THYROXINE FREE $374.50 83721385 HB HCG BETA QUANT SERUM $585.50 83721388 HB MICROALBUMIN URINE $698.50 83721391 HB AMMONIA $656.00 83721395 HB CK MB $634.00 83721401 HB COMPREHENSIVE METABOLIC PANEL $783.00 83721406 HB RPR QUAL $334.00 83721409 HB HIV 1 ANTIBODY $156.50 83721410 HB HEPATITIS C ANTIBODY $156.50 83721412 HB SICKLE CELL TEST RBC $267.50 83721414 HB TSH $628.00 83722058 HB COXSACKIE B TYPE 1 $276.50 83722165 HB LEAD WHOLE BLOOD $852.00 83722264 HB EBV AB TO VIRAL CAP IGG $284.50 83722272 HB EBV AB TO VIRAL CAP IGM $284.50 83722280 HB EBV AB TO NUCLEAR IGG $284.50 83722298 HB EBV AB TO EARLY AGS $284.50 83722454 HB INFLUENZA B (LABDAQ DTA FLUB) $254.50 83722454 HB INFLUENZA B (LABDAQ DTA FLUB) $254.50 83722462 HB INFLUENZA A AB $254.50 83722553 HB ROCKY MTN SPOT FEVER $329.00 83722561 HB ROCKY MTN SPOT IGM $329.00 83722694 HB ALPHA 1 ANTITRYPSIN $142.50 83722751 HB CREATININE KINASE TOTAL $378.50 83722793 HB GLIADIN AB IGG $200.50 83723031 HB FREE TESTOSTERONE $507.50 83723098 HB TISSUE CULTURE ADD L STUDIES $429.50 83723106 HB HSV I/II AB IGM $886.00 83723171 HB ANGIOTENSIN CONV ENZ SERUM $821.00 83723213 HB IGG CSF $264.50 83723239 HB ALBUMIN CSF $189.00 83723247 HB OLIGOCLONAL BANDS CSF $1,221.50 83723254 HB VITAMIN B6 $358.50 83723346 HB OXYCARBAZINE $62.00 83723379 HB CALCIUM-STONE $398.50 83723387 HB OXALATE-STONE $705.50 83723395 HB URIC ACID-STONE $287.50 83723403 HB CITRATE-STONE $1,071.00 83723437 HB SODIUM-STONE $209.50 83723445 HB PHOSPHORUS-STONE $211.50 83723452 HB MAGNESIUM-STONE $298.00 83723460 HB POTASSIUM-STONE $147.00 83723478 HB CREATNINE-STONE $369.50 83723486 HB SULFATE-STONE $60.00 83723494 HB AMMONIA-STONE $656.00 83723734 HB HEP B SURFACE AB TITER $363.00 83723965 HB H PYLORI IGG AB $665.50 83723973 HB H PYLORI IGA AB $665.50 83723981 HB H PYLORI IGM AB $665.50 83724161 HB KEPPRA (LEVETIRACETAM) $284.50 83724344 HB B PERTUSSIS IGG $256.00 83724351 HB B PERTUSSIS IGM $256.00 83724369 HB B PERTUSSIS IGA $256.00 83724641 HB FACTOR VIII ACTIVITY $1,459.50 83724716 HB APTT 1:1 NP $305.00 83724724 HB APTT 1:1 SALINE $305.00 83724781 HB F-ACTIN AB, TGG $200.50 83724807 HB SOLUBLE LIVER AG AB, IGG $200.50 83724914 HB WEST NILE IGG $268.00 83724922 HB WEST NILE IGM $306.00 83725127 HB METANEPHRINES, PLASMA $1,301.50 83725390 HB TMT $401.00 83725531 HB Q FEVER ABS $239.50 83725556 HB HHV-6 BY PCR $305.00 83725606 HB INSULIN, FREE $248.00 83725614 HB INSULIN, TOTAL $580.50 83725630 HB STREPT AG, U $694.00 83725630 HB STREPT AG, U $694.00 83725655 HB TOXO GONDII PCR $685.00 83725788 HB KAPPA/LAMBDA FREE $247.50 83725804 HB FREE CORTISOL $636.00 83725812 HB PTH RELATED PEPTIDE $180.50 83726174 HB TTG IGG $200.50 83726471 HB VON WILLEBRAND ANTIGEN $261.50 83726539 HB JC VIRUS $685.00 83726802 HB PROTEIN S FUNC/ACT $917.00 83726810 HB PROTEIN S, TOTAL $1,482.00 83726844 HB PROTEIN C AG $1,159.00 83727297 HB PNEUMOCOCCAL ANTIBODY $311.50 83727354 HB BCR ABL1 MAJOR $1,013.00 83727363 HB HSV 1/2 QPCR $728.00 83727365 HB FUNGITELL B-D-GLUCAN $336.00 83727410 HB PDL-1 KEYTRUDA $1,346.50 83784678 HB T3 UPTAKE $269.00 83784694 HB ACETYCHOLINE RECEPTOR BINDG Ab $1,468.00 83784801 HB CHROMOGRANIN A $454.00 83784819 HB ZINC SERUM $432.00 83784835 HB HSV TYPE 1 IgG AB $100.50 83784843 HB HSV TYPE 2 IgG AB $220.00 83784850 HB ALDOSTERONE $465.00 83784892 HB SOLUBLE TRANSFERRIN RECEPTOR $180.50 83784900 HB ASPERGILLUS ANTIGEN $259.00 83784918 HB MYCOPLASMA IgM $244.00 83795195 HB DHEA-S $1,297.50 83795203 HB CMV TOTAL AB $390.00 83800011 HB VENIPUNCTURE (LAB VENIPUNCTURE) $82.00 83800110 HB VENIPUNCTURE CAPILLARY $172.00 83800144 HB VENIPUNCTURE ART - VP A $82.00 85100139 HB C BLOOD $429.50 85100170 HB C UR $162.50 85100188 HB C CSF $476.50 85100204 HB C EX $476.50 85100238 HB C EX BHS $476.50 85100246 HB C EX IVLT $476.50 85100287 HB C RESP $540.00 85100303 HB C ST $160.00 85100428 HB GRAM ST $169.00 85100600 HB WGSC $169.00 85100667 HB WLTG $44.00 85100980 HB SENSITIVITY DISK METH (KB) $170.00 85101095 HB SCREEN FOR ONE ORGANISM $164.50 85101194 HB STOOL CULT FOR AERO/PLEISOMONA $160.00 85101384 HB ANAEROBR CULTURE $343.00 85101533 HB ENTEROVIRUS BY PCR $545.50 85101574 HB EIA FOR SHIGA-LIKE TOXIN $246.50 85104702 HB WET PREP/KOH $242.50 85104703 HB TISSUE CULTURE INOCULATION $823.00 85104704 HB CULTURE VIRUS $823.00 85110013 HB CRYTOCOCCAL ANTIGEN $156.50 85110047 HB CULT. FUNGUS $556.50 85110104 HB CALCAFLOUR STAIN $298.00 85110302 HB FUNGAL CULTURE, SKIN/HAIR $283.00 85120145 HB WBC, FE $26.50 85120152 HB WET PREP $242.50 85120320 HB BORDETELLA PERTUSSIS PCR $685.00 85130193 HB CYTOMEGALOVIRUS CULTURE $823.00 85130219 HB CHLAMYDIA TRACHOMATIS CULTURE $217.50 85130300 HB ROTAVIRUS ANTIGEN $418.00 85130359 HB VARICELLA-ZOSTER BY DFA $244.50 85130368 HB GI PANEL INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA) $1,376.00 85140135 HB AFB SMEAR ACID FAST STAIN $298.00 85140143 HB AFB SMEAR FLUORESCENT STAIN $298.00 85140390 HB AFB CULTURE $582.50 85140624 HB MBT ID-IDENTIFICATION BY MALDI $100.50 85140654 HB MYCOPLASMA PNEUMONIAE $660.50 85140655 HB CHLAMYDIA PNEUMONIAE $629.00 85140656 HB BORDETELLA PERTUSSIS $685.00 85140662 HB ANAEROBE ID $149.00 85140664 HB YEAST ID $200.50 85140665 HB FUNGAL ID $230.50 85140666 HB URINE PRESUMPTIVE ID $296.00 85140667 HB C DIFF PCR $626.50 85140668 HB STOOL FOR OCCULT BLOOD - SINGLE $164.50 85140669 HB STOOL FOR OCCULT BLOOD - MULTIPLE $20.50 85140670 HB H. PYLORI ANTIGEN, STOOL $268.00 85140672 HB QUANT AERO $418.00 85140674 HB FECAL LACTOFERRIN $358.50 85140675 HB CRYPTOCOCCAL ANTIGEN TEST,SERUM $156.50 85140676 HB CRYPTOCOCCAL ANTIGEN TITER,SERUM $156.50 85140677 HB CRYPTOCCOCAL ANTIGEN,CSF $156.50 85140679 HB BORDETELLA PARAPERTUSSIS $685.00 85140680 HB FECAL LACTOFERRIN - QUANT $77.50 85140683 HB MICROBE SUSCEPTIBILITY - MIC $100.50 85140685 HB MICROBE SUSCEPTIBILITY - MLC $235.50 85140686 HB MICROBE SUSCEPTIBILITY - MACROBROTH $46.00 85140687 HB MICROBE SUSCEPTIBILITY - MYCOBACTERIA $235.50 85140690 HB GRAM STAIN - SMEAR $169.00 85140696 HB SMEAR, SPECIAL STAIN $133.50 85140697 HB TRICHROME COMPLEX STAIN $133.50 85140698 HB SMEAR COMPLEX STAIN $133.50 85140701 HB TOXIN/ANTITOXIN ASSAY $66.00 85140702 HB H. PYLORI AG EIA $259.00 85140703 HB HBSAG NEUTRALIZATION $122.50 85140704 HB HEPATITIS BE AG $190.00 85140705 HB HEPATITIS DELTA AGENT $514.00 85140706 HB HISTOPLASMA CAPSULATUM $187.00 85140710 HB RSV RAPID TEST $371.00 85140711 HB CULTURE IMMUNOFLUORESCENT - EACH $71.50 85140713 HB BACTERIAL AEROBIC CULTURE IDENTIFICATION $100.50 85140716 HB AG DETEC NOS, EIA MUL $336.00 85140722 HB BARTONELLA DNA AMP PROBE $605.00 85140724 HB CANDIDA DNA DIRECT PROBE $95.00 85140725 HB CANDIDA DNA AMPLIFIED PROBE $85.50 85140726 HB CHLAMYDIA TRACHOMATIS DIRECT PROBE $621.00 85140729 HB CYTOMEGALOVIRUS BY PCR $660.50 85140730 HB CYTOMEGALOVIRUS DNA AMP PROBE $660.50 85140732 HB CMV DNA QUANT $795.50 85140733 HB CMV QUANT PCR $795.50 85140734 HB ENTEROVIRUS DNA AMP PROBE $545.50 85140735 HB INFLU DNA AMP PRO 1+ $1,022.50 85140736 HB INFLU DNA AMP PROBE $1,695.50 85140737 HB INFLU DNA AMP PRO AD $413.50 85140738 HB GARDNERELLA VAG DNA DIRECT PROBE $111.00 85140745 HB INFECTIOUS AGENT NOS DNA AMP $685.00 85140747 HB EPSTEIN BARR BY PCR $685.00 85140749 HB CULTURE PRESUMPTIVE PATH SCREEN $164.50 85140766 HB CULTURE THROAT $476.50 85140768 HB CULTURE BACTERIA OTH $476.50 85140777 HB AFB CULTURE & SMEAR $138.00 85140779 HB SPECIMEN CONCENTRATION FOR IA $138.00 85140780 HB DETECT AGT MULT - DNAD $684.50 85140782 HB DETECT AGT MULT,DNAA $875.50 85140783 HB STREP B ASSAY W/OPTICAL OBS $156.50 85140784 HB INFLUENZA ASSAY W/OP $178.50 85140786 HB STREP A ASSAY W/OPTI $274.00 85140788 HB BACT ANTIGEN SCREEN $156.50 85140789 HB AGENT NOS ASSAY W/OP $156.50 85140790 HB PHENOTYPE INFECT DRUG $2,201.00 85140791 HB LEUKOCYTE ASSMT STOOL QL/SQN $26.50 85140792 HB EXAM FECES - MEAT FIBER $104.50 85140793 HB NASAL SMEAR - EOSINOPHILIS $133.00 85140795 HB CULT TYPE NUCLEIC ACID $162.00 85140796 HB DNA/RNA SEQUENCING $310.00 85140797 HB OVA AND PARASITE EXAM $291.00 85140799 HB CULTURE FUNGUS - BLOOD $283.00 85140800 HB MYCOBACTERIA IDENTIFCATION $200.50 85140803 HB STREP GROUP A ANTIGEN $184.87 85140806 HB RSV AG, EI $371.00 85140810 HB HEPATITIS B DNA AMP PROBE $626.50 85140812 HB TISSUE HOMOGENIZ CULTURE $44.00 85140813 HB MICROBIAL SUSCEP DIFFUS $89.00 85140814 HB MYCOPLASMA CULTURE $318.50 85140815 HB MICROB SUSCEP ENZYME $102.00 85140817 HB STOOL CULTURE $160.00 85140818 HB STOOL CULTURE BACTER EA $160.00 85140823 HB M TUBERCULO DNA AMPP $447.50 85140825 HB M AVIUM-INTR DNA DIRECT $255.50 85140826 HB M AVIUM-INTR DNA AMP $660.50 85140828 HB NEISSERIA GONORRHOEAE BY DNA PROBE $418.00 85140829 HB RESPIRATORY VIRUS 6-11 TARGETS $2,830.00 85140830 HB RESPIRATORY VIRUS 12-25 TARGETS $1,038.00 85140831 HB TRICHOMONAS VAG DIRECT PROBE $95.00 85140832 HB VIRUS ISOLATION SHELL VIAL (CENTRIFUGE ENHANCED) $429.50 85140834 HB VIRUS ISOLATION GEN $280.50 85140835 HB ADENOVIRUS AG, IF $234.00 85140838 HB CRYPTOSPORIDIUM AG BY IFA $259.00 85140840 HB INFLUENZA B AG BY IF $231.00 85140841 HB INFLUENZA A AG BY DFA $231.00 85140842 HB LEGIONELLA P AG BY DFA $237.50 85140843 HB PARAINFLUENZA AG BY DFA $237.50 85140844 HB RSV BY IF $237.50 85140845 HB PNEUMOCYSTIS C AG BY IF $259.00 85140846 HB NOS INFECTIOUS AG BY IF $244.50 85140849 HB AG DETECT POLYVAL IF $282.00 85150002 HB C DIFFICILE TOXIN ANTIGEN TEST $398.50 85200269 HB HIV1 RNA $3,237.50 85200384 HB HCV RNA VIRAL LOAD $2,547.50 85200434 HB HCV GENOTYPE $4,923.00 85200640 HB BKDNA URINE VIRAL LOAD $795.50 85210177 HB AMPLIFIED DNA PROBE GC $447.50 85210185 HB AMPLIFIED DNA PROBE CT $447.50 85210193 HB HPV HIGH RISK $80.00 85212363 HB T VAGINALIS NA AMPLIFIED TEST $85.50 85212421 HB PROTHROMBIN G20210A $306.50 85212422 HB HBVDNA VIRAL LOAD $544.50 85212425 HB PROTHROMBIN G20210A DNA $306.50 85212426 HB FACTOR V LEIDEN $380.00 85212429 HB HIV-1 GENOTYPE $4,526.00 85212434 HB BK VIRUS DNA QUAN PCR $156.50 85212435 HB INFECTIOUS AGENT NOS DNA $795.50 85212437 HB HIV GEN DNA REV OTH $2,565.50 85212438 HB AUTOPSY GROSS/MICRO W/O CNS $6,110.00 85212439 HB HCV RNA BY PCR $2,547.50 85212442 HB HSV DNA/PCR $685.00 85212444 HB HSV DNA QUAN $728.00 85212446 HB HIV-1, DNA,AMP PROBE $509.00 85212450 HB HIV-1 RNA BY PCR QUANT $3,237.50 85212452 HB HIV-2 DNA AMP PROBE $115.00 85212454 HB MYCOBACTERIA DNA AMP $498.50 85212455 HB MYOBACTERIA TUBERCULOSIS DNA DIRECT PROBE $255.50 85212456 HB LEGIONELLA DNA AMPP $590.50 85212459 HB HEPATITS C RNA PCR QUAL $590.50 85212461 HB HEPATITIS C RNA AMPP $590.50 85212463 HB FMR1 GENE ANALY AB $252.50 85212464 HB HFE HEREDITARY HEMOCHROMATOSIS DNA $407.50 85212465 HB HBA1-HBA2 GENE CDV $1,260.00 85212468 HB IGH GENE REARRANGE AMP METH $3,219.50 85212469 HB IGK GENE REARRANGE CLONAL POP $392.50 85310019 HB ACETAMINOPHEN $278.00 85310035 HB ALBUMIN $164.50 85310043 HB ALCOHOL, ETHYL $244.00 85310050 HB ALKALINE PHOSPHATASE $225.00 85310068 HB ALT (SGPT) $311.50 85310076 HB AMMONIA $656.00 85310084 HB AMYLASE, URINE $310.00 85310092 HB AMYLASE $310.00 85310100 HB AMYLASE, FLUID $310.00 85310118 HB AST (SGOT) $184.50 85310134 HB BILIRUBIN, TOTAL $313.50 85310159 HB BILIRUBIN, DIRECT $313.50 85310167 HB CALCIUM $220.00 85310175 HB CALCIUM, URINE $220.00 85310183 HB 24 HR URINE CALCIUM $398.50 85310266 HB CHLORIDE, FLUID $200.50 85310274 HB CHLORIDE $67.00 85310282 HB CHLORIDE, URINE $220.00 85310290 HB 24 HR URINE CHLORIDE $220.00 85310324 HB CHOLESTEROL $409.50 85310332 HB CREATINE KINASE $378.50 85310340 HB CO2 CONTENT $44.50 85310365 HB CREATININE, FLUID $369.50 85310373 HB CREATININE $138.00 85310381 HB CREATININE, URINE $369.50 85310399 HB 24 HR URINE CREATININE $369.50 85310415 HB GAMMA GLUTAMYL TRANSFERASE $329.00 85310423 HB CSF GLUCOSE $222.50 85310431 HB GLUCOSE, FLUID $222.50 85310456 HB GLUCOSE $97.00 85310563 HB 24 HR URINE GLUCOSE $222.50 85310605 HB CSF LACTIC ACID $654.00 85310613 HB LACTIC ACID $654.00 85310621 HB LACTATE DEHYDOGENASE, FLUID $209.50 85310647 HB LACTATE DEHYDROGENASE $209.50 85310654 HB LIPASE $402.00 85310662 HB LITHIUM $681.00 85310688 HB MAGNESIUM URINE $298.00 85310696 HB MAGNESIUM $298.00 85310720 HB OSMOLALITY, SERUM $298.00 85310738 HB OSMOLALITY, URINE $298.00 85310746 HB PHOSPHOROUS $149.00 85310753 HB PHOSPHOROUS, URINE $211.50 85310787 HB POTASSIUM $147.00 85310795 HB POTASSIUM, URINE $147.00 85310803 HB 24 HR URINE POTASSIUM $147.00 85310811 HB CSF PROTEIN $445.00 85310829 HB PROTEIN, FLUID $445.00 85310837 HB TOTAL PROTEIN $275.50 85310860 HB SALICYLATES $106.00 85310878 HB SODIUM $204.50 85310894 HB SODIUM, URINE $209.50 85310902 HB 24 HR URINE SODIUM $209.50 85310910 HB TRIGYLCERIDES $386.50 85310944 HB BLOOD UREA NITROGEN $138.00 85310951 HB UREA NITROGEN, URINE $376.00 85310969 HB 24 HR URINE UREA NITROGEN $376.00 85310985 HB URIC ACID $240.00 85310993 HB URIC ACID, URINE $287.50 85311058 HB TRIGLYCERIDES $386.50 85311066 HB GLUCOSE, URINE $222.50 85311082 HB 24 HR URINE MAGNESIUM $298.00 85311090 HB LIPID PROFILE $523.00 85311108 HB CHOLESTEROL FLUID $409.50 85311116 HB MASS CKMB $634.00 85311157 HB HUMAN CHORIONIC GONADOTROPIN $585.50 85311181 HB FETAL LUNG MATURITY $1,568.50 85311199 HB DIGOXIN $295.00 85311207 HB THEOPHYLLINE $376.00 85311215 HB LUTEINIZING HORMONE $1,010.00 85311231 HB PROLACTIN $972.50 85311256 HB THYROID STIMULATING HORMONE $628.00 85311272 HB FOLLICLE STIM HORMONE $797.00 85311314 HB TRIIODOTHYRONINE $189.00 85311348 HB THYROXINE $385.00 85311355 HB CARBAMAZEPINE $376.00 85311363 HB DILANTIN $376.00 85311371 HB PHENOBARBITAL $376.00 85311389 HB VALPROIC ACID $381.50 85311397 HB GENTAMYCIN $394.00 85311405 HB VANCOMYCIN $487.00 85311413 HB TOTAL TRICYCLIC LEVEL $331.50 85311421 HB TOBRAMYCIN $574.00 85311439 HB RIA ASSAY, FREE THYROXINE $374.50 85311611 HB URINE CREATININE CLEARANCE $603.00 85311629 HB METABOLIC PANEL $783.00 85311637 HB HEPATIC FUNCTION PANEL A $912.50 85311645 HB BASIC METABOLIC PANEL $572.00 85311850 HB CANCER ANTIGEN 125 $894.00 85311892 HB ALPHA-FETOPROTEIN TUMOR MARKER $701.00 85311900 HB UA DIPSTICK $365.00 85311967 HB HDL CHOLESTEROL $209.50 85311968 HB CA15-3 (CANCER ANTIGEN 15-3) $385.00 85311969 HB HAVAB IGG $266.00 85311971 HB HE 4 (OVARIAN CANCER MARKER $411.00 85311972 HB HIV AG/AB COMBO (HIV-1/HIV-2) $222.00 85312007 HB FREE T3 $470.00 85312015 HB FETAL FIBRONECTIN $1,293.00 85313070 HB URINE PROTEIN $354.00 85313088 HB 24 HR URINE PROTEIN $354.00 85313104 HB LDL CHOLESTEROL $274.00 85313138 HB LIDOCAINE $376.00 85313153 HB IRON $298.00 85313195 HB BRAIN NATRIURETIC PEPTIDE $501.00 85313211 HB TESTOSTERONE $1,537.50 85313237 HB CARCINOEMBTYONIC ANTIGEN $476.50 85313245 HB PROGESTERONE $470.00 85313252 HB ESTRADIOL $785.50 85313260 HB CORTISOL $507.50 85313278 HB INSULIN $580.50 85313286 HB VITAMIN B-12 $429.50 85313294 HB FOLATE $386.50 85313302 HB FERRITIN $429.50 85313310 HB IMMUNOGLOBULINE E $795.00 85313336 HB PSA SCREEN $632.50 85313351 HB PSA TOTAL $507.50 85313369 HB PTH(IRMA) $1,110.50 85313385 HB HOMOCYSTEINE TOTAL $556.50 85313401 HB AHP-ACUTE HEPATITIS PANEL $1,689.00 85313419 HB LYTES (ELECTROLYTE PANEL) $490.50 85313427 HB RENAL (RENAL PANEL) $881.50 85313451 HB CA19-9 (CANCER ANTIGEN 19-9) $894.00 85313452 HB METHADONE $66.00 85320034 HB CSF CELL COUNT $291.00 85320042 HB BODY FLUID CELL COUNT $291.00 85320075 HB WESTERGREN SEDIMENTION RATE $258.50 85320091 HB HEMATOCRIT $95.50 85320117 HB HEMOGLOBIN $95.50 85320141 HB BLOOD COUNT; PLATELET, AUTO $175.50 85320208 HB URATE CRYSTALS $269.00 85320216 HB WHITE BLOOD CELL COUNT $240.00 85320331 HB FETAL STAIN $418.00 85320349 HB PH FLUID $247.50 85320364 HB HEMOGRAM & AUTODIFF $394.00 85320372 HB HEMOGRAM $296.00 85320398 HB GASTROCULT $164.50 85320455 HB RETICULOCYTE COUNT $136.00 85320463 HB PLASMA FREE HEMOGLOBIN $101.50 85320471 HB ALBUMIN FLUID (ALB F) $189.00 85330017 HB ANTITHROMBIN III TEST % $1,386.00 85330025 HB CRYOFIBRINOGEN $234.50 85330058 HB FACTOR V ASSAY $643.50 85330066 HB FACTOR VII ASSAY $259.50 85330074 HB FACTOR VIII ASSAY $1,459.50 85330082 HB FAXTOR IX ASSAY $1,624.50 85330090 HB FACTOR X ASSAY $233.50 85330116 HB FACTOR XIII SCREEN SOLUBILITY $188.00 85330140 HB FIBRINOGEN $570.00 85330165 HB HEPARIN $534.00 85330181 HB MIXING STUDY $305.00 85330199 HB PLASMINOGEN $128.50 85330215 HB PROTHROMBIN TIME $200.50 85330223 HB ACTIVTD PARTL THROMBOPLASTITIM $269.00 85330231 HB THROMBIN TIME $133.00 85330256 HB D-DIMER $565.00 85330272 HB FREE PROTEIN S ANTIGEN $917.00 85330280 HB PROTEIN C FUNCTIONAL $881.50 85330298 HB INHIBITOR ASSAY $153.50 85340073 HB HEMOSIDERIN URINE $138.00 85340123 HB PH URINE $365.00 85340131 HB PREGNANCY-QUALITATIVE URINE $541.00 85340180 HB URINALYSIS $402.00 85340363 HB C-PEPTIDE,SERUM $1,484.50 85340367 HB PROCALCITONIN $354.50 85340368 HB VITAMIN D 25 HYDROXY $1,299.50 85340396 HB AMIKACIN $592.50 85340404 HB PREALBUMIN $175.50 85360295 HB C3 COMPLEMENT $445.00 85360311 HB C4 $445.00 85360337 HB CRP HIGH SENSITIVITY $311.50 85360345 HB HAPTOGLOBIN $227.00 85360352 HB IMMUNOGLOBULIN A QUANTITATION $264.50 85360360 HB IMMUNOGLOBULIN G QUANTITATION $264.50 85360378 HB IMMUNOGLOBULIN M QUANTITATION $264.50 85360386 HB MICROALBUMIN URINE $698.50 85360394 HB RHEUMATOID FACTOR QUANT $409.50 85360402 HB TRANSFERRIN $652.50 85360410 HB ETHANOL URINE $244.00 85360428 HB HEMOGLOBIN A1C $418.00 85360436 HB GLUCOSE TOLERANCE 1 $1,297.50 85360444 HB GLUCOSE TOLERANCE 4 $260.00 85360469 HB HEPATITIS A ANTIBODY IgM N $418.00 85360477 HB HEPATITIS B CORE ANTIBODY $363.00 85360485 HB HEPATITIS B CORE ANTIBODY IGM N $255.50 85360493 HB HEPATITIS B SURFACE ANTIBODY N $363.00 85360501 HB HEPATITIS B SURFACE ANTIGEN N $492.00 85360527 HB TROPONIN I ULTRA (TPiU) $340.00 85360535 HB CRP $416.00 85360543 HB HETEROPHILE ANTIBODY SCREEN $334.00 85360584 HB DIL FREE-DILANTIN FREE $458.00 85360594 HB URINALYSIS NONAUTO W/SCOPE $104.50 85360595 HB UA NONAUTO W/O SCOPE $33.50 85360596 HB PH STOOL $247.50 85360604 HB OBSTETRIC PANEL $797.00 85360605 HB FREE CARBAMEZEPINE $169.00 85360606 HB CLOZAPINE $284.50 85360607 HB DIGOXIN FREE $295.00 85360608 HB VALPROIC ACID FREE $381.50 85360609 HB ETHOSUXIMIDE (ZARONTIN) $527.50 85360610 HB GABAPENTIN $284.50 85360611 HB AMIKACIN - TROUGH $592.50 85360615 HB HALOPERIDOL (HALDOL) $113.00 85360616 HB LAMOTRIGINE $284.50 85360617 HB KEPPRA (LEVETIRACETAM) $284.50 85360618 HB PRIMIDONE (MYSOLINE) $320.50 85360619 HB PROCAINAMIDE W/METABOLITES $596.50 85360622 HB TOPIRAMATE (TOPAMAX) $175.50 85360625 HB HELICOBACFER PYLORI - BREATH TEST $135.00 85360627 HB HGB ELECTROPHORESIS $147.00 85360628 HB HGB ELECTROPHORESIS - NBS $147.00 85360630 HB FRUCTOSAMINE (GYLCATED PROTEIN) $390.00 85360631 HB OBSTETRIC PANEL W/HIV $943.00 85360632 HB QUINIDINE $580.50 85360638 HB ALCOHOLS MS $44.00 85360642 HB ALKALOIDS NOS MS $108.00 85360647 HB ANTIDPRS TRIC MS 3-5 $365.00 85360648 HB ANTIDPRS TRIC MS 6PL $437.50 85360651 HB TRAZODONE $444.00 85360653 HB ANTIEPILP NOS MS 1-3 $58.00 85360654 HB ANTIEPILP NOS MS 4-6 $64.00 85360655 HB ANTIEPILP NOS MS 7PL $77.50 85360662 HB ANTIPSYCH NOS MS 1-3 $82.00 85360663 HB ANTIPSYCH NOS MS 4-6 $90.50 85360664 HB ANTIPSYCH NOS MS 7PL $108.00 85360669 HB HISTAMINE $380.00 85360670 HB HOMOVANILLIC ACID (HVA) $264.50 85360672 HB CORTICOSTEROIDS $698.50 85360673 HB 17 - HYDROXYPROGESTERONE $529.00 85360674 HB 17-D HYDROXYPROGESTERONE - NBS $529.00 85360679 HB 17-KETOGENIC STERIODS FRACTIONATION $180.50 85360680 HB 17-KETOSTEROIDS TOTAL $452.00 85360681 HB 17-KETOSTEROIDS FRACTIONATION $336.00 85360683 HB LDH ISOENZYMES $267.50 85360684 HB FETAL LUNG, L-S RATIO $461.00 85360685 HB LIPOPROTEIN A $238.00 85360688 HB LIPOPROTEIN - HIGH RESOLUTION $458.00 85360691 HB NMR LIPOPROTEIN BLD $599.50 85360693 HB LEUTENIZING RELEASING FACTOR $207.00 85360695 HB MASS SPECTROMETRY QT $351.00 85360698 HB MERCURY $852.00 85360702 HB METANEPHRINES $1,301.50 85360703 HB METANEPHRINES 24 HR URINE $1,301.50 85360704 HB METANEPHRINE PLASMA $1,301.50 85360705 HB METANEPHRINE FRAC. U $1,301.50 85360706 HB MYELIN BASIC PROTEIN $1,297.50 85360708 HB MYOGLOBIN $283.00 85360709 HB MYELOPEROXIDASE $432.00 85360710 HB 5-NUCLEOTIDASE $216.50 85360711 HB OLIGOCLONAL BANDS $1,221.50 85360713 HB ORGANIC ACIDS, TOTAL, QUALITATIVE $1,186.50 85360715 HB ORGANIC ACID QUALITATIVE - EACH $191.00 85360716 HB ORGANIC ACID SINGLE QT $291.00 85360719 HB OSTEOCALCIN $380.00 85360720 HB OXALATE 24 HR URINE $705.50 85360721 HB OXALATE $705.50 85360722 HB PARATHORMONE PTH $1,110.50 85360726 HB PHENCYCLIDINE PCP MS $187.00 85360727 HB CALPROTECTIN FECAL $358.50 85360729 HB PHENYLKETONURIA (PKU) $60.00 85360730 HB PHENYLALANINE (PKU) BLOOD $60.00 85360731 HB PHOSPHATASE ACID TOTAL $93.50 85360732 HB PROSTATIC ACID PHOSPHATASE $208.00 85360734 HB AKLALINE PHOSPHATASE HEAT $132.00 85360735 HB BONE ALKALINE PHOSPHATASE ISO $225.00 85360736 HB PHOSPHATIDYLGLYCEROL $1,173.00 85360738 HB PORPHOBILINOGEN QUAN $291.00 85360739 HB PAMG-1, AMNISURE $1,187.50 85360740 HB PAMG-1 QUALITATIVE $1,187.50 85360742 HB POTASSIUM SER PL WB $133.00 85360746 HB 17-OH HYDROXYPREGNENOLONE $291.00 85360747 HB PROSTAGLANDIN $370.50 85360750 HB 5-HIAA $771.50 85360751 HB MUCOPOLYSAC QT $296.00 85360752 HB PORPHOBILINOGEN, QUAL $56.00 85360753 HB IGA SUBCLASSES $102.00 85360754 HB IGG SUBCLASSES 1,2,3 OR 4 $102.00 85360758 HB BLOOD GAS PH $109.50 85360759 HB BLOOD GAS/PH,PO2,PCO2 $445.00 85360760 HB ABG ANALYSIS $445.00 85360761 HB BLD GAS W-O2 SAT DIR $442.50 85360762 HB BLD GAS, O2 SAT ONLY $111.00 85360763 HB HEMOGLOBIN-O2 AFFIN $839.00 85360764 HB GASTRIC ANAL W-PH EA $109.00 85360765 HB GASTRIN $603.00 85360768 HB GLUCAGON TOLERANCE $224.00 85360771 HB GLUCOSE, POST DOSE $556.50 85360775 HB GTT, 3 SPECIMEN $1,297.50 85360781 HB GLUCOSE-6-PHOSPHATE DEHYDROGEN $189.00 85360783 HB CELL COUNT BODY FLUID $310.00 85360784 HB CRYSTAL ID TISSUE OR FLUID $269.00 85360786 HB SEMEN ANALYSIS MOTILITY COUNT $313.50 85360787 HB SEMEN ANYALYSIS VOL/COUNT/MOT - W/DIF $594.50 85360788 HB SEMEN ANALYSIS SPERM DETECTION $202.50 85360791 HB BLOOD SMEAR SCAN $51.50 85360792 HB CBC W/PLT AUTO COMP $394.00 85360795 HB RBC COUNT AUTO $120.50 85360796 HB RETICULOCYTE COUNT MANUAL $242.50 85360797 HB RETICULATED PLT ASSY $340.00 85360799 HB CHROMOGENIC SUBSTRATE ASSAY $156.50 85360800 HB CLOT RETRACTION $100.50 85360801 HB FACTOR II PROTHROMBIN $193.50 85360803 HB FACTOR VIII (ANTIGEN) $231.00 85360808 HB FACTOR XI $153.50 85360809 HB FACTOR XII $153.50 85360810 HB FACTOR XIII $259.50 85360811 HB PREKALLIKREIN FACTOR $339.00 85360812 HB KININOGEN FITZGERALD $339.00 85360813 HB ANTITHROMBIN III, ANTIGEN $212.00 85360814 HB PROTEIN S, TOTAL $1,482.00 85360816 HB PROTEIN S FREE $917.00 85360817 HB ACTIVATED PROTEIN C-RESISTANCE $194.00 85360818 HB COAGULATION TIME - LEE WHITE $110.50 85360819 HB COAG TIME ACTIVATED $158.00 85360820 HB COAG TIME OTHER $81.00 85360821 HB EUGLOBULIN LYSIS $174.50 85360823 HB FDP/FSP AGG SLIDE $303.00 85360824 HB FDP-FSP PARACOAG $109.00 85360825 HB FDP-FSP QUANT $220.50 85360826 HB D-DIMER SEMIQUANTITATIVE $118.00 85360828 HB CLOTTING FUNCT ACTIVITY $196.00 85360829 HB ALPHA-2 ANTIPLASMIN $115.00 85360830 HB PLASMINOGEN ACTIVATOR $220.00 85360831 HB PLASMIN EXCEPT AG AS $41.00 85360833 HB LYSOZYME (MURAMIDASE) $856.50 85360836 HB SED RATE AUTOMATED $258.50 85360838 HB THROMBOPLASTIN INHIBITION TISSUE $122.50 85360840 HB MIXING STUDIES; PTT $269.00 85360842 HB VISCOSITY EXAM $360.50 85360843 HB HEME-COAG PROC, NOS $90.50 85360844 HB WBC DIFFERENTIAL $172.00 85360845 HB AUTO DIFF WBC COUNT $120.50 85360846 HB PORPHYRINS URINE $1,260.00 85360850 HB PORPHYRINS FECAL QT $325.00 85360851 HB PSA FREE $209.50 85360862 HB VITAMIN B6 $358.50 85360863 HB PYRUVATE $116.00 85360864 HB PYRUVATE KINASE $116.00 85360865 HB QUININE $149.00 85360869 HB ACETYLCHOLINE RECEPTOR AB $467.00 85360871 HB ACETYLCHOLINE RECEPT BLOCKING $467.00 85360872 HB ACETYLCHOLINE RECEPTOR MOD $467.00 85360873 HB RENIN $596.50 85360875 HB VITAMIN B2 $300.00 85360876 HB SELENIUM $325.00 85360877 HB SEROTONIN $1,232.50 85360878 HB SEX HORMONE BINGING GLOBULIN $278.00 85360879 HB SILICA $300.00 85360881 HB SODIUM, OTHER SOURCES $135.50 85360882 HB SOMATOMEDIN $414.00 85360886 HB SPECTROPHOTOMETRY ANALYTE $233.50 85360891 HB PHOSPHOLIPIDS SERUM $233.50 85360893 HB SPECIFIC GRAVITY $164.50 85360894 HB SUGARS, SINGLE, QUAL $133.50 85360895 HB SUGARS, MULTI, QUAL $43.50 85360897 HB SUGARS, SING, QUANT $231.00 85360898 HB SULFATE URINE $60.00 85360899 HB TESTOSTERONE, FREE $507.50 85360900 HB TESTOSTERONE, BIOAVL $2,045.00 85360901 HB THYROXINE T4, NEO $60.00 85360902 HB THYROXINE (T4), FREE $374.50 85360904 HB THYROXINE BINDING GLOBULIN $162.50 85360905 HB THYROID STIMULATING HORMONE - NBS $628.00 85360906 HB THYROID STIMULATING IMMUNOGLOBULINS $175.00 85360907 HB VITAMIN E $180.50 85360908 HB TRANSFERASE (AST) $184.50 85360909 HB T3-T4 UPTAKE $269.00 85360910 HB T3 REVERSE $422.50 85360912 HB TROPONIN QUANTITATIVE $340.00 85360913 HB TYROSINE $154.50 85360919 HB UROBILINOGEN, FECES $158.00 85360920 HB UROBILINOGEN, UR, SEMI $64.50 85360922 HB VMA URINE $463.00 85360923 HB VASOINTESTINAL PEP $297.50 85360924 HB VASOPRESSIN (ANTIDIURETIC HORMONE) $432.00 85360925 HB VITAMIN A $142.50 85360927 HB VITAMIN ASSAY, NOS $142.50 85360928 HB VITAMIN K $175.50 85360929 HB VOLATILES $235.50 85360932 HB XYLOSE ABSORPTION $327.50 85360933 HB ZINC SERUM $432.00 85360935 HB HUMAN CHORIONIC GONADOTROPIN QUAL $541.00 85360943 HB CHEMISTRY TEST NOS $244.50 85360948 HB THROMBOMODULIN $206.00 85360950 HB ACETONE/KETONE SERUM QL $91.50 85360952 HB BETA-HYDROXYBUTERATE $167.00 85360953 HB ACETON-KETON SERM QT $167.00 85360956 HB ACETYLCHOLINESTERASE BI $142.50 85360957 HB ACYLCARITINE $250.50 85360958 HB ACYLCARNITINE NBS $250.50 85360962 HB ALBUMIN FLUID $189.00 85360965 HB ALDOLASE $587.50 85360966 HB ALDOSTERONE, SERUM $465.00 85360968 HB ALDOSTERONE $465.00 85360969 HB ALPHA-1-ANTITRYPSIN TOTAL $199.00 85360971 HB ALPHA-1-ANTI-TRYPSIN PHENOTYPE $184.50 85360972 HB ALUMINUM $213.00 85360975 HB AMINO ACID MULT QUAL $416.00 85360977 HB CYSTINE 24 HR URINE $422.50 85360978 HB AMINO ACID SINGLE QUAN $422.50 85360979 HB DELTA AMINOLEVULNIC ACID $309.00 85360980 HB AMINO ACID QUAN 2-5 $250.50 85360981 HB AMINO ACID QT 6P - NBS $376.00 85360982 HB AMINO ACID QUAN 6+ $376.00 85360988 HB ANDROSTENEDIONE $1,190.50 85360989 HB ANDROSTERONE $318.50 85360990 HB ANGIOTENSIN II $263.00 85360992 HB ANGIOTENSIN CONVERTING ENZYME $821.00 85360994 HB APOLIPOPROTEIN A $138.00 85360996 HB APOLIPOPROTEIN EACH $138.00 85360999 HB ARSENIC $852.00 85361000 HB VITAMIN C (ABSORBIC ACID) $147.00 85361006 HB BILE ACIDS TOTAL $218.00 85361007 HB BILE ACIDS CHOLYLGLYCINE $338.50 85361008 HB BIOTINIDASE $250.50 85361009 HB BIOTINIDASE NBS $250.50 85361010 HB BLOOD OCCULT OTHER SRC $164.50 85361013 HB CADMIUM $296.00 85361014 HB CALCIUM, IONIZED $120.50 85361015 HB CALCIUM, URINE QN TIMED $398.50 85361017 HB CALCULUS ANAL QUANT $828.00 85361019 HB CARBON MONOXIDE (CARBOXYHEMOGLOBIN) QN $183.00 85361020 HB CARBON MONOXIDE (CARBOXYHEMOGLOBIN) QL $75.50 85361023 HB CARNITINE $378.00 85361024 HB CAROTENE $184.50 85361025 HB CATECHOLAMINES, TOTAL URINE $200.50 85361026 HB CATECHOLAMINES, BLOOD $320.50 85361027 HB CATECHOLAMINES, FRACTIONATED $1,083.50 85361028 HB CATECHOLAMINES FRACTIONATED URINE $1,083.50 85361029 HB CATECHOLAMINES FRACTIONATED RANDOM URINE $1,083.50 85361033 HB CHEMILUM ASSAY NOS $180.50 85361038 HB CHOLINESTERASE SERUM $247.50 85361040 HB CHROMIUM $301.50 85361041 HB CITRATE $1,071.00 85361042 HB CITRATE 24 HR URINE $1,071.00 85361044 HB COLLAGEN CROSSLINKS $281.50 85361046 HB COPPER $334.00 85361047 HB COPPER SERUM $334.00 85361048 HB CORTICOSTERONE $112.00 85361049 HB CORTISOL FREE $636.00 85361054 HB CREATINE $60.00 85361059 HB COL CHROMATOG QT - NBS $73.50 85361060 HB COL CHRM NODRG EA $73.50 85361063 HB CPK ISOENZYMES $225.00 85361067 HB CRYOGLOBULINS $300.00 85361068 HB CYANIDE $378.50 85361070 HB CYSTINE-HOMOCYSTINE $104.50 85361071 HB DHEA, SERUM $1,014.50 85361074 HB DHEA-S $1,297.50 85361077 HB VITAMIN D 1, 25 DIHDROXY $492.00 85361078 HB PANCREATIC ELASTASE, FECAL $230.00 85361079 HB ENZYME ACTIVITY IN CELLS $401.00 85361082 HB ELECTROPHORETIC TECH $510.00 85361085 HB ESTROGEN, TOTAL $1,793.50 85361086 HB ESTRIOL $471.50 85361091 HB FAT-LIPID FECES QUAL $133.00 85361092 HB FECAL FAT QUANTITATIVE $249.50 85361093 HB FAT-LIPID FECES QUAN $249.50 85361097 HB FLUORIDE $235.50 85361098 HB FOLIC ACID, RBC $338.50 85361099 HB GALACTOSE NBS $178.50 85361100 HB GALACTOSE $178.50 85361101 HB GALACTOSE TRN QT - NBS $178.50 85361102 HB GALACTOSE QUANTITATIVE $178.50 85361104 HB GAMMAGLOBULIN $264.50 85361111 HB IGA $264.50 85361112 HB IGG $264.50 85361113 HB IGM $264.50 85361115 HB IGM CSF $264.50 85361117 HB IGE $795.00 85361118 HB CALCITONIN $1,186.50 85361120 HB IMMUNOASSAY BY RIA $1,468.00 85361123 HB THYROTROPIN RECEPTOR AB $1,468.00 85361137 HB IMMUNOASSAY INFECTIOUS AGENT $191.00 85361138 HB SOLUBLE TRANSFERRIN RECEPTOR $191.00 85361244 HB ETHANOL BREATH ANAL $153.50 85361245 HB ZONISAMIDE QT $62.00 85361251 HB ACTH STIM PANEL $416.00 85361252 HB ALDOSTERONE SUP EVAL $1,571.50 85361253 HB CALCITONIN STIM PAN $1,024.00 85361254 HB CRH STIM PANEL $3,901.00 85361255 HB RENIN STIM REN VEIN $1,683.00 85361256 HB RENIN STIM PERI VEIN $561.00 85361257 HB MICROSCOPIC EX OF UR $67.00 85361259 HB URINE SCREEN FOR BACTERIA $33.50 85361260 HB PROINSULIN $73.00 85361265 HB COMPLEMENT AG, EA $445.00 85361269 HB COMPLEMENT FUNC ACT $153.50 85361270 HB COMPLEMENT TOTAL (CH5O) $762.50 85361277 HB CA 27-29 $385.00 85361281 HB HETEROPHILE TIT, P-AB $32.50 85361283 HB TUMOR AG, OTHER $454.00 85361285 HB IMMUNOASSAY, QUAN, NOS $311.50 85361288 HB INF AGENT IMMUNO QUA $311.50 85361296 HB IMMUNODIFF, OUCHTER $256.00 85361298 HB CELLULAR FUNCTION ASSAY $1,712.00 85361304 HB LYMPH TRANSFORM $883.50 85361308 HB RHEUMATOID FACT,QUAL $502.50 85361309 HB HEP B CORE AB $363.00 85361310 HB HEP B SURFACE AB $156.50 85361311 HB HEPATITIS BE ANTIBODY $217.50 85361312 HB HEP A AB $266.00 85361313 HB INFLUENZA A $254.50 85361314 HB INFLUENZA B $254.50 85361315 HB INFLUENZA VIRUS AB $254.50 85361318 HB JOHN CUNNINGHAM AB $170.00 85361319 HB LEGIONELLA ANTIBODY $227.00 85361320 HB LEPTOSPIRA AB $81.00 85361321 HB LYMPH CHORIOMENINGIT $208.00 85361322 HB HEPATITUS C VIRUS AB $629.50 85361323 HB HEP C AB TEST CONFIR (RIBA) $197.50 85361325 HB UR VOLUME MEASUREMENT - TIMED COLLECTION $82.00 85361327 HB BRCA1 2 SEQ FULL DD $4,460.50 85361331 HB ALCOHOLS MS $44.00 85361346 HB DRUG SCREEN, URINE $1,358.00 85361358 HB PRS DRG IA ANAZ $1,358.00 85361359 HB DARVON (PROPOXYPHENE) SERUM $200.50 85361366 HB QUAN OF DRUG, NOS $284.50 85361381 HB HIV-1 AB EIA $121.00 85361382 HB HIV-1 AB ELISA $754.50 85361383 HB HIV1 AG HIV1 HIV2 AB $146.50 85361384 HB HIV1-HIV2 AB SNG RES $175.50 85361385 HB HIV1 AG W HIV 1 2 AB $146.50 85500015 HB TISSUE CULTURE $2,344.50 85500023 HB TISSUE/LEU/TUM ANALYSIS $2,383.50 85500031 HB BONE MARROW CULTURE $2,171.50 85500064 HB AMNIOTIC FLUID CULTURE $2,340.00 85500098 HB ADDITIONAL KARYOTYPING $480.00 85500197 HB ADDITONAL HIGH $1,312.00 85500205 HB ADDITIONAL BANDING $1,114.00 85500486 HB FISH PROBE $423.00 85500536 HB ADD I HYBRIDIZATION $748.50 85500619 HB MOLECULAR INTERPHASE HYBRIDIZA $748.50 85500684 HB HYBRID INTERPHASE 25-99 CELLS $586.50 85500809 HB ARRAY-CANCER $2,501.00 85500866 HB UNLISTED MOLECULAR PATHOLOGY PROCEDURE $186.50 85500867 HB ADDITIONAL SINGLE PROBE $565.50 85500868 HB MULTIPLEX PROBE $565.50 85501005 HB Molecular Path Procedure - Level 4 $1,429.00 85501013 HB Molecular Path Procedure - Level 5 $1,786.00 85501021 HB BRAF V600E Variant $1,743.00 85501021 HB BRAF V600E Variant $1,743.00 85501039 HB KRAS Variants - Codons 12 and 13 $1,437.50 85501047 HB EGFR Common Varients $2,382.50 85501054 HB HEMATOLYMPHOID GENOMIC PANEL $5,776.00 85501059 HB JAK2 V617F VARIANT $795.00 85501063 HB MOL PATH PROCEDURE LEVEL 2 $714.00 85501064 HB MOL PATH PROCEDURE LEVEL 6 $2,143.00 85501067 HB - BCR/ABL1 - MAJOR $1,013.00 85501068 HB- BCR/ABL1 - MINOR $894.50 85501073 HB TISSUE CULTURE $2,272.00 85501074 HB CHROMOSOME ANAYLSIS $2,272.00 85501075 HB TISSUE CULTURE SKIN & OTHER $2,238.50 85501077 HB CELL CRYOPRESERVATION EA CELL LINE $171.00 85501078 HB FROZEN CELL PREP $171.00 85501079 HB CHROMOSOME ANALYSIS 20-25 $2,383.50 85501080 HB CHROMOSOM ANALYSIS 50-100 $2,744.50 85501081 HB CHROMOSOME ANALYSIS 100 $2,744.50 85501082 HB CHROMOSOME ANALYSIS 5 CELL $2,670.50 85501083 HB CHROMOSOME ANALYSIS - 15-20 CELLS $2,430.00 85501085 HB CHROMOSOME ANALYSIS - 45 CELLS $2,387.00 85501086 HB CHROMOSOME ANALYSIS 20-25 $2,383.50 85501087 HB CHROMOSOME ANALYSIS - AMNIO $2,638.00 85501088 HB CHROMOSOME ANALYSIS - PLACENTA $2,847.00 85501089 HB MCG DNA PROBE $423.00 85501090 HB MCG 3-5 CELLS $461.50 85501091 HB MCG HROMOSOME IN SITU HYBRIDZATION 10-30 CELLS $544.50 85501092 HB CHROMOSOME COUNT ADDITIONAL $282.00 85501094 HB CYTOGENETIC STUDY $166.50 85501095 HB CYTO & MCG INT/REP $345.76 85501098 HB INS HYBRD MAN SP INI $565.50 85501099 HB PROTEIN-WEST BLOTTIS $390.50 85501100 HB PROTEIN ANALYSW/PROB $398.50 85501102 HB MICRODISSECTION MANUAL $1,452.50 85501103 HB SURGICAL PATH PROCED $166.50 85501104 HB MOL PATH PROCEDURE LEVEL 1 $559.00 85501106 HB SCID NBS $186.50 85501107 HB MOLEC PATH LEV 7 $2,501.00 85501109 HB FET ANEUP GSA PN $3,113.50 85501111 HB CYSTIC FIBROSIS GENE ANALYSIS $214.50 85501116 HB MTHFR GENE ANALY CV $269.50 85501117 HB MLH1 GENE ANALY FULL $1,184.50 85501118 HB MLH1 DUP-DEL VARIANT $339.00 85501119 HB MSH2 GENE ANALY FULL $269.50 85501120 HB MSH2 DUP-DEL VARIANT $269.50 85501121 HB MSH6 GENE ANALY FULL $511.50 85501122 HB MSH6 DUP-DEL VARIANT $287.50 85501124 HB PML-RAR TRANS QL-QN $2,046.00 85501125 HB PMS2 GENE ANALY FULL $1,389.00 85501126 HB PMS2 DUP-DEL VARIANT $394.00 85501127 HB PTEN GENE FULL SEQ $2,165.50 85501128 HB PTEN GENE DUPDEL VAR $341.50 85501130 HB TRB GENE REARRANGE AMP $1,237.50 85501131 HB TRG GENE REARRANGE ANALYSIS $1,194.00 85501132 HB JAK2 $795.00 85600807 HB ADD MARKER $243.50 85610012 HB BONE MARROW DIFFERENTIAL $408.50 85620037 HB LEUKOCYTE ALKALINE PHOSPHATASE $367.50 85620136 HB PLATELET AGGREGATION $298.00 85620151 HB PROTEIN C ANTIGEN $1,159.00 85620177 HB VON WILLEBRAND FACTOR ACTIVITY $341.50 85620185 HB LUPUS $267.50 85650675 HB CYTOPATHOLOGY PROCEDURE $166.50 85650679 HB LGL PANEL $813.50 85650680 HB OUTSIDE SLIDE INTERPRETATION $232.00 85650681 HB MICROSLID CONSULT W/PREP $449.00 85650682 HB COMPRE REVIEW OF DATA $679.50 85650683 HB PATH CONSULT INTROP $232.00 85650684 HB VON WILLEBRAND FACTOR ANTIGEN $261.50 85650685 HB VW FACTOR MULITIMERS $189.50 85650689 HB PLATELET NEUTRALIZATION $218.00 85650691 HB RUSSELL VIPER VENON TIME DILUTED $502.50 85650692 HB LUPUS ANTICOAGULANT PANEL I $502.50 85650693 HB REPTILASE TEST $90.50 85650694 HB SED RATE NONAUTOMATE $44.50 85650695 HB B CELL TOTAL COUNT $655.50 85650696 HB MONONUC CELL AG QT $472.00 85650697 HB NK CELLS TOTAL COUNT $706.50 85650698 HB TOTAL T CELLS $655.50 85650699 HB T4 & T8 COUNT WITH RATIO $493.50 85650870 HB T CD#4 $472.00 85650871 HB FLOW CYTOMETRY - FIRST MARKER $165.50 85900108 HB CL-4C $67.00 85900132 HB GLUC-4C $97.00 85900199 HB K-4C $133.00 85900207 HB METHGB-4C $84.00 85900439 HB PH FLUID $247.50 86200128 HB RSV RAPID $111.50 86200129 HB INFLUENZA A - RAPID $178.50 86200133 HB PROTEIN U CAC $354.00 88500001 HB PARATHYROID HORMONE (INTRA-OP) $1,110.50 89200018 HB ABO W/RH $208.00 89200067 HB DIRECT COOMBS $211.50 89200075 HB FETAL SCREEN COMMENT $278.00 89200083 HB XM $642.00 89200109 HB NEWBORN ABO $208.00 89200158 HB NEWBORN RH $164.00 89200174 HB D(RHO)TYPE $128.50 89210017 HB AB ID (0-2 HRS) $1,030.00 89210058 HB ANTIGEN TYPE $303.50 89210082 HB DC C3D $211.50 89210090 HB DC IGG $211.50 89210124 HB ELUTION $396.50 89210132 HB ISO OR IGG TITER $454.00 89210199 HB PHENOTYPE $151.50 89220099 HB POOLED PRODUCT HANDLING $274.00 89220115 HB DIV PROD FEE $274.00 89220149 HB PLASMA THAW FEE $477.50 89220222 HB IRRADIATION $347.00 89220230 HB PATIENT ANTIGEN TYPE $518.00 89220248 HB ELECTRONIC CROSSMATCH $143.00 89220289 HB ANTIBODY SCREEN 3 CELL SP $408.00 89220313 HB ANTIBODY SCREEN RBC $323.00 89220315 HB ANTIBODY ID,EA PANEL $558.50 89220316 HB COOMBS TEST INDIRECT QUAL $189.00 89220317 HB COOMBS TEST INDIRECT TITER $194.00 89220319 HB BLOOD TYPING RBC $162.50 89220321 HB BLOOD TYPING PAT EA ADD'L AG $836.50 89220323 HB COMPATABILITY TEST IMMEDIATE SPIN $184.50 89220324 HB COMPATIBILITY TEST INCUBATE $107.00 89220326 HB COMPATIBILITY TEST ANTIGLOB $213.00 89220327 HB HEMOLYS-AGGLUT AUTO $116.00 89220328 HB HEMOLYS-AGGLUT INCUBATE $169.00 89220329 HB RBC PRETREATMENT CHEM/DRUG $298.00 89220330 HB RBC PRETREAT ENZYMES $298.00 89220332 HB RBC PRETREAT DENSITY GRADIENT SEPARATION $331.50 89220333 HB RBC PRETREAT SERUM, INCUBATE W/DRUG $189.00 89220336 HB RBC PRETREAT, SERUM DILUTION $274.00 89220337 HB LEUKOCYTE TRANSFUSION $117.50 89415327 HB HLA CLASS 1 FLOW HDID $2,516.00 89415335 HB HLA CLASS 2 FLOW HDID $2,516.00 89415475 HB HLA CS-CLASS 1 SL $206.00 89415541 HB HLA CS-CLASS II ML $680.00 89415574 HB HLA CS-CLASS II SL $326.50 89416200 HB HLA A, B , OR C - SINGLE ANTIGENS $1,035.00 89416206 HB HLA2 TYP LR 1 AG EA $572.00 89416207 HB HLA1 TYP HR 1 AL EA $259.00 89416208 HB HLA2 TYP HR 1 LOC EA $1,030.00 89500086 HB CRYO $867.50 89500128 HB FFP $516.50 89500177 HB PLATELETPHERESIS IRR/LKP $4,764.50 89500219 HB RED BLOOD CELLS LKP $1,144.00 89500243 HB RBCS THAWED/FROZEN $1,720.00 89500375 HB LEUKOPOOR PLATELETS $826.00 89500581 HB ARC PRETREATMENT WITH ENZYMES $298.00 89500672 HB RED BLOOD CELLS UNIT $923.50 89500722 HB PLATELETS APHERESED UNIT $5,644.50 89500730 HB BLOOD IRRADIATED/LEUKOREDUCED $1,406.00 89500805 HB PLATELETPHERESIS IRRADIATED $5,812.50 89500847 HB PLATELET PHERESIS HLA LKPR $5,923.00 89501078 HB RBC PRETREAT DIFF EA $409.50 89501080 HB RBC PRETREAT W/INHIB $493.50 89501083 HB BLOOD TYPING RH D $128.50 89501085 HB BLOOD TYPE ABO $128.50 89501088 HB RBC SICKLE CELL TEST $267.50 89501089 HB AUTOLOGOUS COMPONENT PROCESSING $941.50 89501090 HB S & H ONE DONOR FRESH FROZEN PLASMA $612.00 89501095 HB S-H PLT A-P L-R CMV- $3,371.00 89800098 HB CAFFEINE $284.50 89800296 HB LEAD, B $852.00 89800411 HB THIOCYANATE $157.00 89800627 HB TISSUE TRANSGLUTAMINASE AB,IgA $200.50 89800650 HB GLYCOL $376.00 89810030 HB IMMUNOFIX ELECTROPHORESIS $1,313.00 89810048 HB IMMUNOFIX ELECTROPHORESIS URIN $1,313.00 89810089 HB PROTEIN ELECTROPHORESIS $538.50 89810097 HB PROTEIN ELECTROPHORESIS URINE $269.00 89810105 HB HEMOGLOBIN VARIANTS $1,092.50 89810154 HB VITAMIN D25 $1,299.50 89810155 HB TTG IGG $200.50 89810157 HB QUANTIFERON $1,128.00 89811129 HB ASPERGILLUS AG $259.00 89811130 HB HIV-1 $170.00 89811131 HB HIV-2 $256.00 89811132 HB VITAMIN B1 $271.50 89840078 HB GROWTH HORMONE $283.00 89850135 HB CYCLOSPORINE $343.00 89850143 HB TACROLIMUS $267.50 89850150 HB SIROLIMUS $175.50 89860373 HB THYROID PEROXIDASE AB $1,435.50 89860407 HB ERYTHROPOIETIN $759.50 89860431 HB ACTH $1,288.50 89860472 HB THROGLOBULIN $238.50 89860480 HB THROYOBLOBULIN AB $202.50 89860506 HB INHIBIN A RESULT $305.00 89860514 HB MYCOPHENOLIC ACID $205.00 89860571 HB TOXOPLASMA 1GM $660.50 89860621 HB CMV AB IgM $390.00 89860639 HB EBV AB (TOTAL) $284.50 89860670 HB RUBELLA AB $347.00 89860696 HB SYPH AB SCREEN (RPR) $334.00 89860712 HB SYPH AB CSF (VDRL) $334.00 89860720 HB SYPH AB QNT (RPR) $376.00 89860738 HB TOXOPLASMA AB $650.00 89860746 HB VZV AB-IgG $480.50 89860845 HB ANA SCREEN $894.00 89860852 HB ANA QUANTITATIVE $676.00 89860860 HB ANTI-DNA AB $994.50 89860878 HB ALLERGEN TESTING MULTIPLES $102.00 89860886 HB ANTI-CYCLIC CITRULINATE PEPTID $252.00 89860902 HB GMB, QN $200.50 89860910 HB ANTI-MPO $200.50 89861033 HB ANTI-SSA ANTIBODY $770.00 89861041 HB ANTI-SSB ANTIBODY $770.00 89861058 HB ANTI-SCL 70 ANTIBODY $770.00 89861074 HB Antiplatelet Antibody $650.00 89861108 HB CARDIOLIPIN ABS $544.50 89861116 HB B2 GLYCOPROTEIN ABS $496.00 89861181 HB BETA-2 MICROGLOBULIN $390.00 89861207 HB SYPHILIS AB IGG $529.00 89861249 HB EBV NA IGG $284.50 89861256 HB MEASLES IGG $311.50 89861280 HB CYSTATIN C $256.00 89861306 HB LAMBDA FLC $247.50 89861314 HB CERULOPLASMIN $532.00 89861317 HB OXCARBAZEPINE $62.00 89861318 HB TIAGABINE (GABITRIL) $284.50 89861320 HB HEAVY METALS QUAL $240.00 89861323 HB HEAVY METALS QUANT $326.50 89861333 HB BARBITURATES MS $147.00 89861340 HB BENZODIAZ MS 1-12 $400.50 89861341 HB BENZODIAZ MS 13PL $480.00 89861342 HB CANNABINOID QUANT GCMS $62.00 89861343 HB CANNABINDS NATUR MS $62.00 89861346 HB COCAINE MS $122.50 89861348 HB METHADONE MS $209.50 89861353 HB NEPHELOMETRY, NOS $247.50 89861355 HB FREE KAPPA LIGHT CHAIN $247.50 89861356 HB FREE LAMBDA LIGHT CHAIN $247.50 89861357 HB NICKEL $311.50 89861359 HB IMMUNOASSAY-QUALITATIVE $200.50 89861360 HB IMMUNOASSAY-SEMIQUANITATIVE $200.50 89861361 HB NBS CYSTIC FIB IRT $200.50 89861362 HB IMMUNOASSAY, OTHER $200.50 89861366 HB ANTIHISTONE AB QUAL/SEMIQUANT $200.50 89861368 HB FEBRILE AGGLUTININS $371.00 89861372 HB ALLERGEN IGG QT $67.00 89861442 HB RAST ALLERGEN PANEL 1-12 $102.00 89861487 HB ANTIBODY ID LEUKOCYTES AB $452.00 89861490 HB P-ANCA (MYELOPEROXIDASE AB) $452.00 89861497 HB PROTEIN ELECTROPHORESIS CSF $269.00 89861499 HB WESTERN BLOT $262.00 89861503 HB PROTOPORPHYRIN RBC QUAN $182.50 89861504 HB PROTOPORPHYRIN RBC SCREEN $91.50 89861505 HB VITAMIN B1 PLASMA $271.50 89861507 HB CLOSTRIDIUM DIFFICILE TOXINS $398.50 89861511 HB CRYPTOSPORIUM ANTIGEN EIA $59.00 89861512 HB GIARDIA AG IA $233.50 89861514 HB ALPHA-FETOPROTEIN, SERUM $701.00 89861516 HB AFP-L3 AND TOTL AFP $174.00 89861523 HB OXYCODONE MS $124.00 89861527 HB SKEL MSCL RLX MS 1-2 $112.50 89861528 HB BRAMADOL MS $94.00 89861534 HB PLT ASSOC IMMUNOGLOB $1,384.50 89861535 HB ANTINUCLEAR ANTIBODIES $894.00 89861538 HB ASO,TITER $336.00 89861539 HB ASO SCREEN $541.00 89861543 HB ANTI CARDIOLIPID AB, IGG, IGM $544.50 89861544 HB ANTICARDIOLIPIN AB-IGA $544.50 89861545 HB ANTICARDIOLIPIN AB IGG $544.50 89861546 HB ANTICARDIOLIPIN AB IGM $544.50 89861550 HB ANTIPHOSPHOLIPID AB (PHOSPHOLIPID) $313.50 89861551 HB COLD AGGLUTININ SCREEN $391.50 89861554 HB COLD AGGLUTININ TITER $478.50 89861555 HB DNA AB SINGLE STRAND $258.00 89861556 HB DNA AB, NATIVE-DOUBLE $994.50 89861557 HB DNA DOUBLE STRAND EIA $994.50 89861561 HB ANTI ENA ANTIBODIES $770.00 89861563 HB EXTRACTIBLE NUCLEAR AG $770.00 89861564 HB ANTI SJOGREN'S $770.00 89861571 HB FLUORESCENT NONINFECTIOUS AGENT AB $801.00 89861575 HB FLUORESCENT AB 1 $801.00 89861577 HB FLUORESCENT AB SCREEN $801.00 89861578 HB FLUORESCENT AB NONINFECTIOUS TITER $445.00 89861581 HB ANTI MITOCHONDRIAL AB $445.00 89861592 HB ANTI NEUTROPH CYTOPLAS AB $445.00 89861596 HB PROTEIN ELECTROPHORESIS CSF $1,313.00 89861597 HB 24 HR URINE IMMUNOFIXATION $1,313.00 89861598 HB IMMUNOFIX ELECTROPHORESIS URINE/CSF $1,313.00 89861599 HB INSULIN ANTIBODY $422.50 89861602 HB INTRINSIC FACTOR BLOCKING AB $527.50 89861603 HB ISLET CELL AB $225.50 89861607 HB MICROSOMAL AB $1,435.50 89861608 HB PARTICLE AGGLUTINATION SCREEN $412.00 89861616 HB PARTICLE AGGLUTINATION TEST $235.50 89861618 HB TB TEST CELL IM MEAS $1,128.00 89861620 HB ENUMERAT TCELL SUSP $1,235.50 89861622 HB ACTINOMYCES AB $44.50 89861623 HB ADENOVIRUS AB $259.00 89861627 HB DEOXYRIBONUCLEASE AB $225.00 89861628 HB ASPERGILLUS ANTIBODIES $312.50 89861630 HB BACTERIUM AB $252.00 89861635 HB BARTONELLA AB $194.00 89861637 HB BLASTOMYCES AB $252.00 89861639 HB BORDETELLA $256.00 89861644 HB BORRELIA BURGDORFERI CONFIRM $197.50 89861645 HB LYME DISEASE ANTIBODIES $1,124.00 89861646 HB BRUCELLA $86.50 89861647 HB CAMPYLOBACTER AB $248.50 89861648 HB CANDIDA AB $259.50 89861649 HB CHLAMYDIA AB $877.00 89861652 HB CHLAMYDIA IGM $258.50 89861654 HB COCCIDIODES AB $178.50 89861656 HB COXIELLA $239.50 89861657 HB CRYPTOCOCCUS AB $100.00 89861661 HB CMV AB $390.00 89861667 HB DIPTHERIA AB $315.00 89861669 HB ENCEPHALITIS CALIF $169.00 89861670 HB ENCEPH EAST EQUINE $169.00 89861671 HB ENCEPH ST LOUIS $169.00 89861673 HB W EQUINE ENCEPH $169.00 89861676 HB COXSACKIE - GP A2 $156.50 89861677 HB COXSACKIE - GP A4 $156.50 89861678 HB COXSACKIE - GP B2 $156.50 89861679 HB COXSACKIE - GP B3 $156.50 89861680 HB COXSACKIE - GP B4 $156.50 89861681 HB COXSACKIE - GP B5 $156.50 89861682 HB COXSACKIE - GP B6 $156.50 89861683 HB COXSACKIE - GP B1 $156.50 89861686 HB ENTEROVIRUS AB $276.50 89861687 HB EPSTEIN BARR AB $284.50 89861689 HB EBV NUCLEAR ANTIGEN $156.50 89861690 HB EBV-NUCLEAR AG $284.50 89861694 HB EPSTEIN-BARR VCA $284.50 89861695 HB EBV VCA CSF IGM $156.50 89861697 HB AB (EBV) TO VCA; IGM $156.50 89861699 HB EHRLICHIA CHAFFEENIS $197.50 89861701 HB FRANCISELLA TULAREMIA AB $205.50 89861703 HB FUNGUS AB NOS $238.00 89861710 HB GIARDIA LAMBLIA AB $660.50 89861712 HB H PYLORI AB QL $665.50 89861716 HB HELMINTH AB, NOS $263.50 89861719 HB H. INFLUENZA AB $68.50 89861725 HB HTLV-HIV AB CONFIRM $355.50 89861728 HB HERPES SIMPLEX AB NON-SPECIFIC $886.00 89861729 HB HERPES SIMPLEX 1 AB IGM $100.50 89861730 HB HERPES SIMP TYPE 1 $100.50 89861731 HB HERPES SIMPLEX AB IGM TYPE 2 $220.00 89861732 HB HERPES SIMPLEX AB TYPE 2 $220.00 89861734 HB HISTOPLASMA AB $253.00 89861736 HB MUMPS AB $320.50 89861737 HB MYCOPLASMA AB $320.50 89861739 HB MYCOPLASMA PNEUMONIAE IGG $320.50 89861742 HB NEISSERIA MENING AB $65.00 89861743 HB NOCARDIA AB $280.00 89861747 HB PARVOVIRUS AB $312.00 89861750 HB PROTOZOA AB, NOS $347.00 89861754 HB RICKETTSIA AB $329.00 89861758 HB ROCKY MOUNTAIN SPOT FEVER IGG $156.50 89861761 HB RUBELLA IGG ANTIBODY $156.50 89861764 HB RUBEOLA AB $311.50 89861765 HB SALMONELLA AB $196.00 89861766 HB TETANUS AB $307.50 89861770 HB TREPONEMA PALLIDUM CONFI $529.00 89861771 HB FTA-ABS $529.00 89861772 HB TRICHINELLA AB $269.00 89861773 HB VARICELLA ZOSTER $480.50 89861776 HB WEST NILE VIRUS IGM $156.50 89861777 HB WEST NILE VIRUS IGG $156.50 89861778 HB WEST NILE VIRUS ANTIBODY $268.00 89861781 HB VIRUS AB NOS $164.50 89861785 HB ZIKA VIRUS IGM AB $150.00 89861786 HB THYROID AUTOANTIBODIES $202.50 89861791 HB ANCA INFLAMMATORY BOWEL DISEAS $801.00 89861797 HB DEF DRUG NOS MS 1-3 $150.00 89940000 HB AMNIOBAND MTF WC3014 AMNIOBAND MEMBRANE 18MM DISC $840.00 89940001 HB AMNIOBAND MTF WC3018 AMNIOBAND MEMBRANE 18MM DISC $1,680.00 89940002 HB AMNIOBAND MTF WC3023 AMNIOBAND MEMBRANE 2X3CM SHEET $450.00 89940003 HB AMNIOBAND MTF WC3034 WC3034- AMNIOBAND MEMBRANE 3X4CM SHEET $3,240.00 89940004 HB THERASKIN LHN 102TSL SIZE: 2IN X 3IN $3,885.00 89940005 HB THERASKIN LHN 101TSS SIZE: 1IN X 2IN $3,240.00 89940006 HB THERASKIN LHN 100TSXS 1IN X 1IN $2,850.00 89940007 HB NEOCORE ATI 70-6005 OSTEOCONDUCTIVE MATRIX STRIP 50X25X4MM $2,308.00 89940008 HB TISSUE FOC FBF-200 FLOWER-FLO ACELLULAR LIQ 2.0CC $398.11 89940009 HB TISSUE FOC FBP 404 4X4CM AMNIOTIC MEMBRANE ALLOGRAFT $483.00 89940010 HB TISSUE FOC FBP 204 2X4CM AMNIOTIC MEMBRANE ALLOGRAFT $6,142.50 89940011 HB TISSUE MMX AF-1000 AMNIOFILL 1000.0MG $6,300.00 89940012 HB DONATED TISSUE MTMF WC3014 AMNIOBAND 18MM DISC $1.00 89940013 HB TISSUE FOC FBP-408 FLOWERPATCH ALLOGRAFT 4 X 8CM $316.97 89940014 HB TISSUE FOC FBF 100 FLOWERFLO ACELLULAR LIQ AMNION 1.0ML $9,817.00 89940015 HB TISSUE FOC FBP-406 FLOWERPATCH ALLOGRAFT 4 X 6CM (ONE TIME USE) $386.95 89940016 HB TISSUE MTF WC3022 AMNIOBAND MEMBRANE 2 X 2CM $963.20 89940017 HB TISSUE MTF WC3044 AMNIOBAND MEMBRANE 4 X 4CM $595.65 89960001 HB APLIGRAF PER 1 SQ CM $108.00 89960002 HB OASIS WND MATRIX PER 1 SQ CM $40.00 89960003 HB ALLODERM SQ CM $291.50 89960005 HB THERASKIN PER 1 SQ CM $160.00 89960011 HB GRAFIX CORE PER SQ CM $1,761.25 89960017 HB GRAFIX PRIME PER SQ CM $461.00 89960020 HB BIOVANCE SQ CM $6,025.00 89960021 HB AFFINITY 1 SQ CM $1,751.00 89960022 HB NUSHIELD SQ CM $636.50 89960023 HB INTERFYL 1MG $86.50 89960024 HB EPIFIX PER SQ CM $560.00 89960027 HB AMNIOFIX SQ CM $401.00 89960028 HB EXTRACELL WND COVER $1,750.00 89960031 HB OASIS BURN MATRIX PER SQ CM $40.00 89960032 HB INTEGRA DRT PER SQ CM $109.50 89960033 HB DERMAGRAFT PER SQ CM $116.00 89960034 HB GRAFTJACKET PER SQ CM $306.00 89960035 HB INTEGRA MATRIX PER SQ CM $147.00 89960036 HB PRIMATRIX PER SQ CM $183.00 89960037 HB INTEGRA BMWD PER SQ CM $223.50 89960038 HB OASIS ULTRA TRI LAYER WND MATRIX PER SQ CM $50.00 89960039 HB MATRISTEM MICRO MATRIX PER 1 MG $11.00 89960040 HB PURAPLY PER SQ CM $249.00 89960041 HB TISSUE ABS-4100-044 4X4CM ARTHREX AMNION MATRIX $6,675.00 91400001 HB PSYCHIATRIC DIAGNOSTIC EVAL $988.00 91400012 HB HEALTH/BEHAVIOR ASSESS EA 15 MIN, INITIAL $325.00 91400013 HB HEALTH/BEHAVIOR INTERVENTION EA 15 MIN, INDIV $325.00 91400014 HB HEALTH/BEHAVIOR RE-ASSESS 15 MIN $325.00 91500002 HB IOP-GROUP TX/ADULT $3,089.00 91500004 HB HEALTH/BEHAVIOR INTERVENTION EA 15 MIN, GROUP $325.00 91600001 HB FAM PSYCHOTHERAPY-W/O PATIENT $965.50 91600002 HB FAM PSYCHOTHERAPY W/PATIENT $716.50 91600003 HB HEALTH/BEHAVIOR INTERVENTION EA 15 MIN, INDIV W/FAMILY $325.00 91600004 HB HEALTH/BEHAVIOR INTERVENTION EA 15 MIN, FAMILY ONLY $147.00 92000002 HB INTRAOP NEURO MONITOR:EA 15MIN $303.50 92000003 HB INTRAOP NM-REMOTE;PER HOUR $1,213.50 92000004 HB INTRAOP NM-NON OR; EA 15 PER PT $303.50 92000009 HB CONT GLUC MONITOR-UP TO 72 HRS $204.50 92000010 HB EVOKED POT CENT LOWER LIMBS $1,086.00 92000011 HB EVOKED POT CNS VISUAL $1,685.50 92000034 HB EVOKED POT SOMATOSENSORY UPPER LIMBS $1,386.50 92000035 HB EVOKED POT SOMATOSENSORY LOWER LIMBS $1,570.50 92000036 HB EVOKED POT CENT UPPER LIMBS $725.50 92000037 HB SOMATOSENSORY UPPER & LOWER $2,957.00 92000054 HB TENSILON/MYASTHENIA GRAVIS TEST $701.50 92100001 HB CAROTID DUPLEX SCAN-BILAT $2,789.00 92100002 HB CAROTID DUPLEX SCAN-UNILAT $1,999.50 92100003 HB DOPPLER TRANSCRANIAL COMPLETE $2,547.50 92100004 HB DOPPLER TRANSCRANIAL LIMITED $1,782.50 92100007 HB SCAN EXT ART BILAT SNGL LEVEL+ $656.00 92100008 HB SCAN ARM ART BILAT MULT LEVELS $1,166.00 92100009 HB SCAN LEG ART BILAT REST/STRESS $2,568.50 92100010 HB DUPLEX LEG ART BILAT COMPLETE $3,473.00 92100011 HB DUPLEX LEG ART UNILAT/LIMITED $1,509.50 92100012 HB DUPLEX ARM ART BILAT COMPLETE $2,016.00 92100013 HB DUPLEX ARM ART UNILAT/LIMITED $1,772.50 92100015 HB DUPLEX EXT VEIN BILAT COMPLETE $3,568.50 92100016 HB DUPLEX VEINS LOWER BILAT EXTREM $3,568.50 92100017 HB DUPLEX VEINS UPPER BILAT EXTREM $3,568.50 92100018 HB DUPLEX EXT VEIN UNILAT/LIMITED $2,011.00 92100019 HB DUPLEX ABD/PELVIC/SCROTAL COMPLETE STUDY $2,455.00 92100020 HB DUPLEX ABD/PELVIC/SCROTAL LIMITED STUDY $2,431.50 92100021 HB DUPLEX AORTA/IVC/ILIAC COMPLETE STUDY $2,463.50 92100022 HB DUPLEX AORTA/IVC/ILIAC. UNILAT OR LIMITED $1,184.00 92100023 HB DUPLEX HEMODIALYSIS ACCESS $1,212.00 92100028 HB VESSEL MAPPING FOR HEMODIALYSIS ACCESS $1,264.50 92100029 HB DUPLEX LEG ART UNILAT/LIMITED - LEFT $1,509.50 92100030 HB DUPLEX LEG ART UNILAT/LIMITED - RIGHT $1,509.50 92100031 HB SCAN EXT ART UNILAT SNGL LEVEL+ $656.00 92100032 HB DUPLEX ARM ART UNILAT/LIMITED - LEFT $1,772.50 92100033 HB DUPLEX ARM ART UNILAT/LIMITED - RIGHT $1,772.50 92100034 HB DUPLEX EXT VEIN UNILAT/LIMITED - LEFT UPPER $2,011.00 92100035 HB DUPLEX EXT VEIN UNILAT/LIMITED - RIGHT UPPER $2,011.00 92100036 HB DUPLEX EXT VEIN UNILAT/LIMITED - LEFT LOWER $2,011.00 92100037 HB DUPLEX EXT VEIN UNILAT/LIMITED - RIGHT LOWER $2,011.00 92200001 HB NERVE CONDUCTION: 1-2 STUDIES $678.50 92200002 HB NERVE CONDUTION; 3-4 STUDIES $725.50 92200003 HB NERVE CONDUTION; 5-6 STUDIES $725.50 92200004 HB NERVE CONDUCTION; 7-8 STUDIES $725.50 92200005 HB NERVE CONDUCTION; 9-10 STUDIES $725.50 92200006 HB NERVE CONDUCTION; 11-12 STUDIE $1,256.00 92200007 HB NERVE CONDUCTION;13+ STUDIES $1,256.00 92200008 HB EMG ONE EXTREMITY $1,026.00 92200009 HB EMG TWO EXTREMITIES $1,463.50 92200010 HB EMG THREE EXTREMITIES $1,945.50 92200011 HB EMG FOUR EXTREMITIES $1,906.00 92200022 HB EMG LIMITED;EA EXTR W/NRV TST $973.57 92200023 HB EMG COMPLETE;EA EXTREM/5+ MUSC $1,504.00 92200025 HB N/M JUNCTION EACH NERVE $493.50 92200026 HB EVOKED POT CENT UPPR/LWR LIMBS $1,559.50 92900055 HB CT HEART W/O CONT W/EVAL COR C $363.00 92900058 HB EP EVAL AICD CHECK W/ DEFIB $3,866.00 92900064 HB INJ/MAMMARY DUCTOGRM/GALACTOGM $1,005.50 94000002 HB THERAPEUTIC PHLEBOTOMY $747.50 94000010 HB WOUND TX/NEG PRESS <= 50 SQ CM $723.00 94000011 HB WOUND TX/NEG PRESS > 50 SQ CM $912.50 94000017 HB DISCHARGE PREPARAT./PER 30MIN $192.00 94000019 HB FOLLOW-UP ASMNT/30 MIN $220.00 94000022 HB POUCH APPL./MANAGEMENT/ 30MIN $406.00 94000023 HB SKIN CARE MANAGEMENT/ 30MIN $132.00 94000024 HB SPECIALTY BED CONSULT/ 30MIN $378.00 94000025 HB TEACHING SESSION/ 30MIN $348.00 94000026 HB WOUND CARE (COMPLEX)/ 30MIN $592.00 94000027 HB WOUND CARE SIMPLE/ 30MIN $220.00 94000030 HB DEBRIDE NON-SELECTIVE $714.00 94000031 HB TRIM/NONDYSTROPHIC NAILS/ANY # $173.00 94000032 HB NEG PRESS WOUND TX <=50 SQ CM NON DME UTIL $2,118.00 94000033 HB NEG PRESS WOUND TX >50 SQCM - UTIL NON DME $2,118.00 94000037 HB DEBRIDE SELECTIVE <= 20 SQ CM $545.00 94000042 HB DEBRIDE SELECTIVE EA ADD 20 SQ CM $1,099.50 94000043 HB DEBRIDE NON-SELECTIVE $714.00 94000044 HB WOUND TX/NEG PRESS <= 50 SQ CM $723.00 94200003 HB SMOKING CESS/ASYMPTON;>3-10MIN $79.00 94200005 HB MNT/1ST ASSESS; PER 15 MIN $45.50 94200006 HB MNT/REASSESS; INDIVIDUAL; PER 15 MIN $38.50 94200007 HB MNT/ASSESS; GROUP; EA 30 MIN $21.00 94200008 HB INDIV TRAINING/SELF MGMT; PER 30 MIN $72.50 94200010 HB PHP-TRAINING AND EDUCATION; PER SESSION (45MIN+) $667.50 94300001 HB CARDIAC REHAB W/OUT CONT ECG $411.50 94300002 HB CARDIAC REHAB/CONT ECG MONITOR $445.50 94800001 HB PULMONARY REHAB W/EXERCISE;1HR $291.00 95100056 HB PANEL-DUPLEX VEINS UPPER EXTRE $3,568.50 95100057 HB PANEL-DUPLEX VEINS LOWER EXTRE $3,568.50 99000001 HB SPE-CARDIAC REHAB PHASE III $5.50 99000039 HB SPE MAINTENANCE WELLNESS $52.00 99000040 HB SPE BUDDY WELLNESS $27.50