Frio Regional Hospital

Price List for Shoppable Services. Effective 07-13-2022.

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Billing DescriptionBilling CodeCDM CodeDepartmentGross ChargeCash PricePNR
Billing DescriptionBilling CodeCDM CodeDepartmentGross ChargeCash PricePNR
CT Scan
CT HEAD/BRAIN W/O DYECPT 704506207182Outpatient$1,092$764Payer Rates
CT MAXILLOFACIAL W/O DYECPT 704866207185Outpatient$1,092$764Payer Rates
CT MAXILLOFACIAL W/DYECPT 704876207186Outpatient$1,713$1,199Payer Rates
CT SOFT TISSUE NECK W/O DYECPT 704906207189Outpatient$1,092$764Payer Rates
CT SOFT TISSUE NECK W/DYECPT 704916207188Outpatient$1,713$1,199Payer Rates
CT ANGIOGRAPHY HEADCPT 704966207225Outpatient$1,070$749Payer Rates
CT ANGIOGRAPHY NECKCPT 704986207226Outpatient$3,425$2,398Payer Rates
CT THORAX DX C-CPT 712506207174Outpatient$1,092$764Payer Rates
CT THORAX DX C+CPT 712606207175Outpatient$1,713$1,199Payer Rates
CT THORAX DX C-/C+CPT 712706207173Outpatient$1,902$1,331Payer Rates
CT ANGIOGRAPHY CHESTCPT 712756207228Outpatient$3,400$2,380Payer Rates
CT ANGIOGRAPHY CHESTCPT 712756207239Outpatient$1,926$1,348Payer Rates
CT NECK SPINE W/O DYECPT 721256207198Outpatient$1,092$764Payer Rates
CT CHEST SPINE W/O DYECPT 721286207202Outpatient$1,092$764Payer Rates
CT LUMBAR SPINE W/O DYECPT 721316207204Outpatient$1,092$764Payer Rates
CT PELVIS W/O DYECPT 721926207194Outpatient$1,092$764Payer Rates
CT PELVIS W/DYECPT 721936207195Outpatient$1,713$1,199Payer Rates
CT UPPER EXTREMITY W/O DYECPT 732006207176Outpatient$1,092$764Payer Rates
CT LOWER EXTREMITY W/O DYECPT 737006207179Outpatient$1,092$764Payer Rates
CT LOWER EXTREMITY W/DYECPT 737016207180Outpatient$1,713$1,199Payer Rates
CT ABDOMEN W/O DYECPT 741506207171Outpatient$1,092$764Payer Rates
CT ABDOMEN W/O & W/DYECPT 741706207170Outpatient$1,902$1,331Payer Rates
CT ABD & PELV W/CONTRASTCPT 741776207235Outpatient$3,977$2,784Payer Rates
CT ABD & PELV 1/> REGNSCPT 741786207244Outpatient$3,400$2,380Payer Rates
3D RENDER W/INTRP POSTPROCESCPT 763766207197Outpatient$351$246Payer Rates
Clinic
(Not Offered) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT ...CPT 99203-----
(Not Offered) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT ...CPT 99204-----
(Not Offered) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT ...CPT 99205-----
(Not Offered) PATIENT OFFICE CONSULTATION, 40 MINCPT 99243-----
(Not Offered) PATIENT OFFICE CONSULTATION, 60 MINCPT 99244-----
(Not Offered) INITIAL NEW PATIENT PREVENTATIVE MEDICINE EV ...CPT 99385-----
(Not Offered) INITIAL NEW PATIENT PREVENTATIVE MEDICINE EV ...CPT 99386-----
EEG
(Not Offered) SLEEP STUDYCPT 95810-----
EKG
(Not Offered) ELECTROCARDIOGRAM, ROUTINE, WITH INTERPRETAT ...CPT 93000-----
ELECTROCARDIOGRAM TRACINGCPT 930057102007Outpatient$151$106Payer Rates
Emergency Room
DRAINAGE OF SKIN ABSCESSCPT 100602900388Outpatient$700$490Payer Rates
RPR S/N/AX/GEN/TRNK 2.5CM/<CPT 120012900291Outpatient$479$335Payer Rates
RPR S/N/AX/GEN/TRNK2.6-7.5CMCPT 120022900292Outpatient$452$316Payer Rates
RPR F/E/E/N/L/M 2.5 CM/<CPT 120112900286Outpatient$479$335Payer Rates
RPR F/E/E/N/L/M 2.6-5.0 CMCPT 120132900287Outpatient$452$316Payer Rates
APPLY LONG ARM SPLINTCPT 291052900297Outpatient$528$370Payer Rates
APPLY FOREARM SPLINTCPT 291252900299Outpatient$528$370Payer Rates
APPLICATION OF FINGER SPLINTCPT 291302900251Outpatient$301$211Payer Rates
APPLICATION LONG LEG SPLINTCPT 295052900255Outpatient$528$370Payer Rates
APPLICATION LOWER LEG SPLINTCPT 295152900256Outpatient$528$370Payer Rates
INSERT EMERGENCY AIRWAYCPT 315002900394Outpatient$898$629Payer Rates
INSERT TEMP BLADDER CATHCPT 517022900433Outpatient$278$195Payer Rates
CLEAR OUTER EAR CANALCPT 692002901270Outpatient$452$316Payer Rates
HEART/LUNG RESUSCITATION CPRCPT 929502900442Outpatient$898$629Payer Rates
EMERGENCY DEPT VISITCPT 992822900427Outpatient$488$342Payer Rates
EMERGENCY DEPT VISITCPT 992832900428Outpatient$768$538Payer Rates
EMERGENCY DEPT VISITCPT 992842900429Outpatient$1,234$864Payer Rates
EMERGENCY DEPT VISITCPT 99285 (25)2900430Outpatient$1,822$1,275Payer Rates
CRITICAL CARE FIRST HOURCPT 992912900443Outpatient$2,987$2,091Payer Rates
Gastro-Intestinal
EGD DIAGNOSTIC BRUSH WASHCPT 432352000016Outpatient$3,441$2,409Payer Rates
EGD BIOPSY SINGLE/MULTIPLECPT 43239 (59)2010017Outpatient$3,441$2,409Payer Rates
DIAGNOSTIC COLONOSCOPYCPT 453782000006Outpatient$3,855$2,699Payer Rates
DIAGNOSTIC COLONOSCOPYCPT 45378 (59)2010006Outpatient$3,855$2,699Payer Rates
COLONOSCOPY AND BIOPSYCPT 45380 (59)2010010Outpatient$3,855$2,699Payer Rates
COLONOSCOPY W/LESION REMOVALCPT 453852000013Outpatient$3,816$2,671Payer Rates
IV Therapy
D5W INFUSIONHCPCS J70704104508Outpatient$14$10Payer Rates
Imaging
US EXAM OF HEAD AND NECKCPT 765366808385Outpatient$555$389Payer Rates
ULTRASOUND BREAST COMPLETECPT 766416808942Outpatient$808$566Payer Rates
ULTRASOUND BREAST COMPLETECPT 76641 (LT)6808943Outpatient$405$284Payer Rates
ULTRASOUND BREAST COMPLETECPT 76641 (RT)6808944Outpatient$405$284Payer Rates
US EXAM ABDOM COMPLETECPT 767006808370Outpatient$555$389Payer Rates
ECHO EXAM OF ABDOMENCPT 767056808371Outpatient$555$389Payer Rates
ECHO EXAM OF ABDOMENCPT 767056808377Outpatient$555$389Payer Rates
ECHO EXAM OF ABDOMENCPT 767056808378Outpatient$555$389Payer Rates
US EXAM K TRANSPL W/DOPPLERCPT 767766808382Outpatient$611$428Payer Rates
OB US < 14 WKS SINGLE FETUSCPT 768016808406Outpatient$555$389Payer Rates
OB US >= 14 WKS SNGL FETUSCPT 768056807362Outpatient$555$389Payer Rates
OB US >= 14 WKS SNGL FETUSCPT 768056808375Outpatient$555$389Payer Rates
OB US FOLLOW-UP PER FETUSCPT 768166808405Outpatient$361$253Payer Rates
TRANSVAGINAL US NON-OBCPT 768306808391Outpatient$555$389Payer Rates
US EXAM PELVIC COMPLETECPT 768566808380Outpatient$555$389Payer Rates
US EXAM SCROTUMCPT 768706808384Outpatient$555$389Payer Rates
ECHO EXAMINATION PROCEDURECPT 769996808392Outpatient$361$253Payer Rates
(Not Offered) MAMMOGRAPHY OF ONE BREASTCPT 77065-----
(Not Offered) MAMMOGRAPHY OF BOTH BREASTSCPT 77066-----
(Not Offered) MAMMOGRAPHY, SCREENING, BILATERALCPT 77067-----
Inpatient Procedures
(Not Offered) CARDIAC VALVE OR CARDIOTHORACIC PROCEDURE WI ...DRG 216-----
(Not Offered) SPINAL FUSION EXCEPT CERVICAL WITHOUT MCCDRG 460-----
(Not Offered) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF L ...DRG 470-----
(Not Offered) CERVICAL SPINAL FUSION WITHOUT CC OR MCCDRG 473-----
(Not Offered) UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGN ...DRG 743-----
Labor and Delivery
FETAL NON-STRESS TESTCPT 590253508554Outpatient$655$458Payer Rates
Laboratory
ROUTINE VENIPUNCTURECPT 364154409070Outpatient$19$13Payer Rates
METABOLIC PANEL TOTAL CACPT 800484406958Outpatient$124$87Payer Rates
GENERAL HEALTH PANELCPT 800504403349Outpatient$270$189Payer Rates
COMPREHEN METABOLIC PANELCPT 800534406043Outpatient$124$87Payer Rates
OBSTETRIC PANELCPT 800554406248Outpatient$89$62Payer Rates
LIPID PANELCPT 800614406106Outpatient$109$76Payer Rates
RENAL FUNCTION PANELCPT 800694406355Outpatient$112$78Payer Rates
HEPATIC FUNCTION PANELCPT 800764406127Outpatient$190$133Payer Rates
ASSAY OF DIGOXIN TOTALCPT 801624406067Outpatient$108$76Payer Rates
ASSAY DIPROPYLACETIC ACD TOTCPT 801644406246Outpatient$110$77Payer Rates
ASSAY OF GENTAMICINCPT 801704403433Outpatient$134$94Payer Rates
ASSAY OF LITHIUMCPT 801784406109Outpatient$58$41Payer Rates
ASSAY OF PHENYTOIN TOTALCPT 801854406068Outpatient$108$76Payer Rates
ASSAY OF TACROLIMUSCPT 801974409092Outpatient$278$195Payer Rates
ASSAY OF VANCOMYCINCPT 802024409011Outpatient$110$77Payer Rates
DRUG TEST PRSMV CHEM ANLYZRCPT 803074406069Outpatient$91$64Payer Rates
ANALGESICS NON-OPIOID 1 OR 2CPT 803294406151Outpatient$66$46Payer Rates
BENZODIAZEPINES1-12CPT 803464403315Outpatient$227$159Payer Rates
METHYLENEDIOXYAMPHETAMINESCPT 803594403324Outpatient$227$159Payer Rates
OPIATES 1 OR MORECPT 803614403322Outpatient$227$159Payer Rates
URINALYSIS NONAUTO W/SCOPECPT 81000 (91)4416169Outpatient$32$22Payer Rates
URINALYSIS AUTO W/SCOPECPT 810014403539Outpatient$37$26Payer Rates
URINALYSIS AUTO W/SCOPECPT 810014406169Outpatient$37$26Payer Rates
URINALYSIS NONAUTO W/O SCOPECPT 810024406202Outpatient$23$16Payer Rates
URINALYSIS AUTO W/O SCOPECPT 810034403560Outpatient$19$13Payer Rates
TEST FOR ACETONE/KETONESCPT 820094406974Outpatient$39$27Payer Rates
UR ALBUMIN SEMIQUANTITATIVECPT 820444409098Outpatient$112$78Payer Rates
ALPHA-FETOPROTEIN SERUMCPT 821054406233Outpatient$137$96Payer Rates
ASSAY OF AMMONIACPT 821404406014Outpatient$120$84Payer Rates
ASSAY OF AMYLASECPT 821504406015Outpatient$67$47Payer Rates
BILIRUBIN TOTALCPT 822474409200Outpatient$57$40Payer Rates
BILIRUBIN DIRECTCPT 822484409201Outpatient$57$40Payer Rates
OCCULT BLOOD FECESCPT 822704406116Outpatient$31$22Payer Rates
CARCINOEMBRYONIC ANTIGENCPT 823784406038Outpatient$152$106Payer Rates
TOTAL CORTISOLCPT 825334406300Outpatient$133$93Payer Rates
ASSAY OF CK (CPK)CPT 825504406059Outpatient$67$47Payer Rates
CREATINE MB FRACTIONCPT 825534406060Outpatient$112$78Payer Rates
ASSAY OF CREATININECPT 825654406057Outpatient$56$39Payer Rates
ASSAY OF URINE CREATININECPT 825704406061Outpatient$44$31Payer Rates
VITAMIN B-12CPT 826074409080Outpatient$124$87Payer Rates
ASSAY OF TOTAL ESTRADIOLCPT 826704409101Outpatient$227$159Payer Rates
ASSAY OF FERRITINCPT 827284406940Outpatient$111$78Payer Rates
ASSAY OF FOLIC ACID SERUMCPT 827464406917Outpatient$121$85Payer Rates
BLOOD GASES ANY COMBINATIONCPT 828034403444Outpatient$162$113Payer Rates
BLOOD GASES ANY COMBINATIONCPT 828034406312Outpatient$162$113Payer Rates
ASSAY GLUCOSE BLOOD QUANTCPT 829474406160Outpatient$44$31Payer Rates
REAGENT STRIP/BLOOD GLUCOSECPT 829484403725Outpatient$29$20Payer Rates
GTT-ADDED SAMPLESCPT 829524406255Outpatient$40$28Payer Rates
ASSAY OF GGTCPT 829774406911Outpatient$61$43Payer Rates
ASSAY OF GONADOTROPIN (FSH)CPT 830014406825Outpatient$150$105Payer Rates
ASSAY OF GONADOTROPIN (LH)CPT 830024406984Outpatient$150$105Payer Rates
H PYLORI (C-13) BREATHCPT 830134403640Outpatient$522$365Payer Rates
GLYCOSYLATED HEMOGLOBIN TESTCPT 830364406088Outpatient$80$56Payer Rates
ASSAY OF INSULINCPT 835254406232Outpatient$94$66Payer Rates
ASSAY OF IRONCPT 835404406101Outpatient$64$45Payer Rates
ASSAY OF IRONCPT 835404409030Outpatient$54$38Payer Rates
IRON BINDING TESTCPT 835504409076Outpatient$73$51Payer Rates
ASSAY OF LACTIC ACIDCPT 836054403722Outpatient$100$70Payer Rates
ASSAY OF LACTIC ACIDCPT 836054403723Outpatient$100$70Payer Rates
ASSAY OF LACTIC ACIDCPT 836054403724Outpatient$100$70Payer Rates
ASSAY OF LACTIC ACIDCPT 836054406185Outpatient$100$70Payer Rates
LACTATE (LD) (LDH) ENZYMECPT 836154406103Outpatient$64$45Payer Rates
ASSAY OF LIPASECPT 836904406105Outpatient$58$41Payer Rates
ASSAY OF MAGNESIUMCPT 837354406241Outpatient$57$40Payer Rates
ASSAY OF MYOGLOBINCPT 838744409171Outpatient$105$74Payer Rates
ASSAY OF NATRIURETIC PEPTIDECPT 838804406506Outpatient$417$292Payer Rates
ASSAY NEPHELOMETRY NOT SPECCPT 838834403284Outpatient$114$80Payer Rates
ASSAY OF PARATHORMONECPT 839704406228Outpatient$333$233Payer Rates
ASSAY OF PHOSPHORUSCPT 841004406122Outpatient$46$32Payer Rates
ASSAY OF SERUM POTASSIUMCPT 841324406130Outpatient$41$29Payer Rates
ASSAY OF PREALBUMINCPT 841344403311Outpatient$158$111Payer Rates
ASSAY OF PROLACTINCPT 841464406929Outpatient$157$110Payer Rates
(Not Offered) TOTAL PROSTATE-SPECIFIC ANTIGEN (PSA) TESTCPT 84153-----
(Not Offered) TOTAL PROSTATE-SPECIFIC ANTIGEN (PSA) TESTCPT 84154-----
ASSAY OF PROTEIN SERUMCPT 841554406137Outpatient$34$24Payer Rates
ASSAY OF PROTEIN URINECPT 841564403285Outpatient$53$37Payer Rates
ASSAY OF PROTEIN URINECPT 841564406139Outpatient$53$37Payer Rates
ASSAY OF PROTEIN URINECPT 841564406163Outpatient$50$35Payer Rates
PROTEIN E-PHORESIS SERUMCPT 841654406134Outpatient$89$62Payer Rates
ASSAY OF SERUM SODIUMCPT 842954406158Outpatient$42$29Payer Rates
ASSAY OF FREE TESTOSTERONECPT 844024409009Outpatient$261$183Payer Rates
ASSAY OF VITAMIN B-1CPT 844254409073Outpatient$222$155Payer Rates
ASSAY OF TOTAL THYROXINECPT 844364406209Outpatient$58$41Payer Rates
ASSAY OF FREE THYROXINECPT 844394406162Outpatient$128$90Payer Rates
ASSAY THYROID STIM HORMONECPT 844434406217Outpatient$137$96Payer Rates
ASSAY OF TRIGLYCERIDESCPT 844784406166Outpatient$70$49Payer Rates
ASSAY OF THYROID (T3 OR T4)CPT 844794406227Outpatient$108$76Payer Rates
FREE ASSAY (FT-3)CPT 844814403297Outpatient$251$176Payer Rates
ASSAY OF TROPONIN QUANTCPT 844844409173Outpatient$82$57Payer Rates
ASSAY OF TROPONIN QUANTCPT 844844409179Outpatient$82$57Payer Rates
ASSAY OF UREA NITROGENCPT 845204406167Outpatient$43$30Payer Rates
ASSAY OF BLOOD/URIC ACIDCPT 845504406168Outpatient$42$29Payer Rates
CHORIONIC GONADOTROPIN TESTCPT 847024406928Outpatient$176$123Payer Rates
CHORIONIC GONADOTROPIN ASSAYCPT 847034406131Outpatient$63$44Payer Rates
CHORIONIC GONADOTROPIN ASSAYCPT 847034406208Outpatient$63$44Payer Rates
HEMATOCRITCPT 850144406093Outpatient$27$19Payer Rates
HEMOGLOBINCPT 850184406094Outpatient$27$19Payer Rates
COMPLETE CBC W/AUTO DIFF WBCCPT 850254406051Outpatient$66$46Payer Rates
(Not Offered) COMPLETE BLOOD CELL COUNT (CBC), AUTOMATEDCPT 85027-----
MANUAL RETICULOCYTE COUNTCPT 850444406147Outpatient$39$27Payer Rates
BLOOD SMEAR INTERPRETATIONCPT 850604403415Outpatient$80$56Payer Rates
FIBRIN DEGRADATION QUANTCPT 853794409192Outpatient$106$74Payer Rates
PROTHROMBIN TIMECPT 856104406141Outpatient$44$31Payer Rates
PROTHROMBIN TIMECPT 856104416141Outpatient$43$30Payer Rates
RBC SED RATE AUTOMATEDCPT 856524406152Outpatient$39$27Payer Rates
THROMBOPLASTIN TIME PARTIALCPT 857304406120Outpatient$52$36Payer Rates
THROMBOPLASTIN TIME PARTIALCPT 857304416120Outpatient$49$34Payer Rates
ANTINUCLEAR ANTIBODIESCPT 860384406019Outpatient$99$69Payer Rates
C-REACTIVE PROTEINCPT 861404406056Outpatient$49$34Payer Rates
COMPLEMENT ANTIGENCPT 861604409060Outpatient$106$74Payer Rates
FLUORESCENT ANTIBODY TITERCPT 862564409058Outpatient$110$77Payer Rates
HETEROPHILE ANTIBODY SCREENCPT 863084406115Outpatient$44$31Payer Rates
RHEUMATOID FACTOR TEST QUALCPT 864304406149Outpatient$47$33Payer Rates
TB TEST CELL IMMUN MEASURECPT 864804403485Outpatient$502$351Payer Rates
SYPHILIS TEST NON-TREP QUALCPT 865924406144Outpatient$39$27Payer Rates
HELICOBACTER PYLORI ANTIBODYCPT 866774409036Outpatient$184$129Payer Rates
HEP B SURFACE ANTIBODYCPT 867064409096Outpatient$120$84Payer Rates
HEPATITIS A ANTIBODYCPT 867084408520Outpatient$127$89Payer Rates
MUMPS ANTIBODYCPT 867354406998Outpatient$106$74Payer Rates
RUBELLA ANTIBODYCPT 867624406150Outpatient$119$83Payer Rates
SARS-COV-2 COVID-19 ANTIBODYCPT 867694403693Outpatient$230$161Payer Rates
SARS-COV-2 COVID-19 ANTIBODYCPT 867694403694Outpatient$230$161Payer Rates
VARICELLA-ZOSTER ANTIBODYCPT 867874409067Outpatient$139$97Payer Rates
HEPATITIS C AB TESTCPT 868034406969Outpatient$124$87Payer Rates
COOMBS TEST DIRECTCPT 868804406052Outpatient$46$32Payer Rates
COOMBS TEST INDIRECT QUALCPT 868854406053Outpatient$57$40Payer Rates
COOMBS TEST INDIRECT QUALCPT 868855008027Outpatient$53$37Payer Rates
BLOOD TYPING SEROLOGIC ABOCPT 869004406031Outpatient$44$31Payer Rates
BLOOD TYPING SEROLOGIC RH(D)CPT 869014406032Outpatient$30$21Payer Rates
COMPATIBILITY TEST SPINCPT 869205008014Outpatient$151$106Payer Rates
COMPATIBILITY TEST INCUBATECPT 869215008016Outpatient$148$104Payer Rates
COMPATIBILITY TEST ANTIGLOBCPT 869225008015Outpatient$257$180Payer Rates
BLOOD CULTURE FOR BACTERIACPT 870404406029Outpatient$86$60Payer Rates
FECES CULTURE AEROBIC BACTCPT 870454409082Outpatient$78$55Payer Rates
CULTURE SCREEN ONLYCPT 870814403501Outpatient$162$113Payer Rates
URINE CULTURE/COLONY COUNTCPT 870864406063Outpatient$72$50Payer Rates
OVA AND PARASITES SMEARSCPT 871774406118Outpatient$73$51Payer Rates
MICROBE SUSCEPTIBLE MICCPT 871864409079Outpatient$73$51Payer Rates
SMEAR GRAM STAINCPT 872054406922Outpatient$42$29Payer Rates
SMEAR WET MOUNT SALINE/INKCPT 872104406175Outpatient$39$27Payer Rates
CLOSTRIDIUM AG IACPT 873244409150Outpatient$155$109Payer Rates
HPYLORI STOOL AG IACPT 873384406078Outpatient$273$191Payer Rates
HEPATITIS B SURFACE AG IACPT 873404406970Outpatient$86$60Payer Rates
CHYLMD TRACH DNA AMP PROBECPT 874914406111Outpatient$306$214Payer Rates
HEPATITIS C REVRS TRNSCRPJCPT 875224409142Outpatient$677$474Payer Rates
RESP VIRUS 12-25 TARGETSCPT 876334403742Outpatient$1,389$972Payer Rates
TRICHOMONAS VAGINALIS AMPLIFCPT 876614403404Outpatient$267$187Payer Rates
INFLUENZA ASSAY W/OPTICCPT 878044403447Outpatient$94$66Payer Rates
INFLUENZA ASSAY W/OPTICCPT 878044403448Outpatient$94$66Payer Rates
HIV W/HIV1&2 ANTB W/OPTICCPT 878064406963Outpatient$153$107Payer Rates
RSV ASSAY W/OPTICCPT 878074406991Outpatient$99$69Payer Rates
STREP A ASSAY W/OPTICCPT 878804406199Outpatient$62$43Payer Rates
CYTOPATH C/V AUTO FLUID REDOCPT 881754403641Outpatient$205$144Payer Rates
TISSUE EXAM BY PATHOLOGISTCPT 883024403450Outpatient$77$54Payer Rates
TISSUE EXAM BY PATHOLOGISTCPT 883054403409Outpatient$152$106Payer Rates
TISSUE EXAM BY PATHOLOGISTCPT 883074403410Outpatient$892$624Payer Rates
SPECIAL STAINS GROUP 1CPT 883124403571Outpatient$152$106Payer Rates
IMMUNOHISTO ANTB ADDL SLIDECPT 883414403625Outpatient$333$233Payer Rates
IMMUNOHISTO ANTB 1ST STAINCPT 883424406951Outpatient$457$320Payer Rates
COVID-19 SPECIMEN COLLECTION FEEHCPCS C98034403698Outpatient$123$86Payer Rates
Language Pathology
SPEECH/HEARING THERAPYCPT 92507 (GN)8909710Outpatient$411$288Payer Rates
SPEECH SOUND LANG COMPREHENCPT 92523 (GN)8907711Outpatient$1,034$724Payer Rates
ORAL FUNCTION THERAPYCPT 92526 (GN)8909713Outpatient$452$316Payer Rates
EVALUATE SWALLOWING FUNCTIONCPT 92610 (GN)8909712Outpatient$372$260Payer Rates
MRI
(Not Offered) MRI SCANCPT 70553-----
(Not Offered) MRI SCAN OF LOWER SPINAL CANALCPT 72148-----
(Not Offered) MRI SCAN OF LEG JOINTCPT 73721-----
Other Diagnostic
EXTRACRANIAL BILAT STUDYCPT 938807710009Outpatient$864$605Payer Rates
EXTREMITY STUDYCPT 939707710010Outpatient$1,130$791Payer Rates
EXTREMITY STUDYCPT 939707710017Outpatient$1,130$791Payer Rates
EXTREMITY STUDYCPT 939717710011Outpatient$797$558Payer Rates
EXTREMITY STUDYCPT 939717710014Outpatient$797$558Payer Rates
Other Procedures and Observation
OFFICE O/P EST MINIMAL PROBCPT 992113508452Outpatient$314$220Payer Rates
Other Therapeutic
BLOOD TRANSFUSION SERVICECPT 364302901252Outpatient$1,453$1,017Payer Rates
BLOOD TRANSFUSION SERVICECPT 364303508465Outpatient$1,437$1,006Payer Rates
RED BLOOD CELLS UNITHCPCS P90215006955Outpatient$847$593Payer Rates
RED BLOOD CELLS UNITHCPCS P90215008017Outpatient$847$593Payer Rates
Psychiatric
(Not Offered) PSYCHOTHERAPY, 30 MINCPT 90832-----
(Not Offered) PSYCHOTHERAPY, 45 MINCPT 90834-----
(Not Offered) PSYCHOTHERAPY, 60 MINCPT 90837-----
(Not Offered) FAMILY PSYCHOTHERAPY, NOT INCLUDING PATIENT, ...CPT 90846-----
(Not Offered) FAMILY PSYCHOTHERAPY, INCLUDING PATIENT, 50 ...CPT 90847-----
(Not Offered) GROUP PSYCHOTHERAPYCPT 90853-----
Pulmonary Function
MEASURE BLOOD OXYGEN LEVELCPT 947608001569Outpatient$114$80Payer Rates
MEASURE BLOOD OXYGEN LEVELCPT 9476080000760Outpatient$114$80Payer Rates
MEASURE BLOOD OXYGEN LEVELCPT 9476080008154Outpatient$114$80Payer Rates
Radiology
X-RAY EXAM CHEST 1 VIEWCPT 710455607042Outpatient$257$180Payer Rates
X-RAY EXAM CHEST 1 VIEWCPT 710455607058Outpatient$257$180Payer Rates
X-RAY EXAM CHEST 2 VIEWSCPT 710465607059Outpatient$257$180Payer Rates
X-RAY EXAM NECK SPINE 2-3 VWCPT 720405607100Outpatient$257$180Payer Rates
X-RAY EXAM NECK SPINE 4/5VWSCPT 720505607101Outpatient$430$301Payer Rates
X-RAY EXAM THORAC SPINE 2VWSCPT 720705607103Outpatient$257$180Payer Rates
X-RAY EXAM L-S SPINE 2/3 VWSCPT 721005607105Outpatient$257$180Payer Rates
X-RAY EXAM L-2 SPINE 4/>VWSCPT 721105607125Outpatient$430$301Payer Rates
X-RAY EXAM OF PELVISCPT 721705607088Outpatient$257$180Payer Rates
X-RAY EXAM SACRUM TAILBONECPT 722205607066Outpatient$257$180Payer Rates
X-RAY EXAM SACRUM TAILBONECPT 722205607159Outpatient$257$180Payer Rates
X-RAY EXAM OF COLLAR BONECPT 73000 (LT)5617064Outpatient$257$180Payer Rates
X-RAY EXAM OF SHOULDERCPT 73030 (RT)5607095Outpatient$257$180Payer Rates
X-RAY EXAM OF SHOULDERCPT 73030 (LT)5617095Outpatient$257$180Payer Rates
X-RAY EXAM OF HUMERUSCPT 73060 (RT)5607117Outpatient$257$180Payer Rates
X-RAY EXAM OF HUMERUSCPT 73060 (LT)5617117Outpatient$257$180Payer Rates
X-RAY EXAM OF ELBOWCPT 73070 (RT)5607068Outpatient$257$180Payer Rates
X-RAY EXAM OF ELBOWCPT 73070 (LT)5617068Outpatient$257$180Payer Rates
X-RAY EXAM OF ELBOWCPT 73080 (RT)5607146Outpatient$257$180Payer Rates
X-RAY EXAM OF ELBOWCPT 73080 (LT)5617146Outpatient$257$180Payer Rates
X-RAY EXAM OF FOREARMCPT 73090 (RT)5607076Outpatient$257$180Payer Rates
X-RAY EXAM OF FOREARMCPT 73090 (LT)5617076Outpatient$257$180Payer Rates
X-RAY EXAM OF WRISTCPT 73100 (RT)5607112Outpatient$257$180Payer Rates
X-RAY EXAM OF WRISTCPT 73100 (LT)5617151Outpatient$257$180Payer Rates
X-RAY EXAM OF WRISTCPT 73110 (RT)5607149Outpatient$257$180Payer Rates
X-RAY EXAM OF WRISTCPT 73110 (LT)5617149Outpatient$257$180Payer Rates
X-RAY EXAM OF HANDCPT 73120 (RT)5607080Outpatient$257$180Payer Rates
X-RAY EXAM OF HANDCPT 73120 (LT)5617080Outpatient$254$178Payer Rates
X-RAY EXAM OF HANDCPT 73130 (RT)5607144Outpatient$257$180Payer Rates
X-RAY EXAM OF HANDCPT 73130 (LT)5617144Outpatient$257$180Payer Rates
X-RAY EXAM HIP UNI 2-3 VIEWSCPT 735025607083Outpatient$257$180Payer Rates
X-RAY EXAM HIP UNI 2-3 VIEWSCPT 73502 (LT)5617083Outpatient$257$180Payer Rates
X-RAY EXAM HIPS BI 2 VIEWSCPT 735215607043Outpatient$514$360Payer Rates
X-RAY EXAM OF FEMUR 2/>CPT 73552 (RT)5607072Outpatient$257$180Payer Rates
X-RAY EXAM OF FEMUR 2/>CPT 73552 (LT)5617072Outpatient$257$180Payer Rates
X-RAY EXAM OF KNEE 1 OR 2CPT 73560 (RT)5607084Outpatient$257$180Payer Rates
X-RAY EXAM OF KNEE 1 OR 2CPT 73560 (LT)5617084Outpatient$257$180Payer Rates
X-RAY EXAM OF KNEE 3CPT 73562 (RT)5607147Outpatient$257$180Payer Rates
X-RAY EXAM OF KNEE 3CPT 73562 (LT)5617147Outpatient$257$180Payer Rates
X-RAY EXAM KNEE 4 OR MORECPT 73564 (RT)5607163Outpatient$396$277Payer Rates
X-RAY EXAM KNEE 4 OR MORECPT 73564 (LT)5617163Outpatient$396$277Payer Rates
X-RAY EXAM OF LOWER LEGCPT 73590 (RT)5607085Outpatient$257$180Payer Rates
X-RAY EXAM OF LOWER LEGCPT 73590 (LT)5617085Outpatient$257$180Payer Rates
X-RAY EXAM OF ANKLECPT 73600 (RT)5607054Outpatient$257$180Payer Rates
X-RAY EXAM OF ANKLECPT 73600 (LT)5617054Outpatient$257$180Payer Rates
X-RAY EXAM OF ANKLECPT 73610 (RT)5607145Outpatient$257$180Payer Rates
X-RAY EXAM OF ANKLECPT 73610 (LT)5617145Outpatient$257$180Payer Rates
X-RAY EXAM OF FOOTCPT 73620 (RT)5607075Outpatient$257$180Payer Rates
X-RAY EXAM OF FOOTCPT 73620 (LT)5617075Outpatient$257$180Payer Rates
X-RAY EXAM OF FOOTCPT 73630 (RT)5607153Outpatient$257$180Payer Rates
X-RAY EXAM OF FOOTCPT 73630 (LT)5617153Outpatient$257$180Payer Rates
X-RAY EXAM OF TOE(S)CPT 73660 (RT)5607106Outpatient$257$180Payer Rates
X-RAY EXAM OF TOE(S)CPT 73660 (LT)5617106Outpatient$257$180Payer Rates
X-RAY EXAM ABDOMEN 1 VIEWCPT 740185607051Outpatient$257$180Payer Rates
X-RAY EXAM ABDOMEN 2 VIEWSCPT 740195607053Outpatient$257$180Payer Rates
X-RAY EXAM COMPLETE ABDOMENCPT 740225607400Outpatient$430$301Payer Rates
Respiratory
AIRWAY INHALATION TREATMENTCPT 94640808102Outpatient$94$66Payer Rates
Surgical Procedures
(Not Offered) REMOVAL OF ONE OR MORE BREAST GROWTH, OPEN P ...CPT 19120-----
(Not Offered) SHAVING OF SHOULDER BONE USING ENDOSCOPECPT 29826-----
(Not Offered) REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOS ...CPT 29881-----
(Not Offered) REMOVAL OF TONSILS AND ADENOID GLANDS, PATIE ...CPT 42820-----
(Not Offered) ULTRASOUND EXAMINATION OF LOWER LARGE BOWEL ...CPT 45391-----
(Not Offered) REMOVAL OF GALLBLADDER USING AN ENDOSCOPECPT 47562-----
PRP I/HERN INIT REDUC >5 YRCPT 495052000119Outpatient$9,748$6,824Payer Rates
(Not Offered) BIOPSY OF PROSTATE GLANDCPT 55700-----
(Not Offered) SURGICAL REMOVAL OF PROSTATE AND SURROUNDING ...CPT 55866-----
(Not Offered) OBSTETRIC CARE, PLANNED VAGINAL DELIVERYCPT 59400-----
(Not Offered) OBSTETRIC CARE, PLANNED CESAREAN DELIVERYCPT 59510-----
(Not Offered) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY (PO ...CPT 59610-----
NJX INTERLAMINAR LMBR/SACCPT 623222000096Outpatient$3,154$2,208Payer Rates
(Not Offered) INJECTION(S) OF THERAPEUTIC SUBSTANCECPT 62323-----
(Not Offered) INJECTION(S) OF ANESTHETIC INTO LOWER SPINE ...CPT 64483-----
AFTER CATARACT LASER SURGERYCPT 66821 (RT)2000048Outpatient$2,291$1,604Payer Rates
XCAPSL CTRC RMVL W/O ECPCPT 66984 (RT)2000070Outpatient$9,645$6,752Payer Rates
XCAPSL CTRC RMVL W/O ECPCPT 66984 (LT)2010070Outpatient$9,645$6,752Payer Rates
(Not Offered) INSERTION OF CATHETER INTO LEFT HEART FOR DI ...CPT 93452-----
INJECTION, BUPIVICAINE HYDROHCPCS S00203803684Outpatient$23$16Payer Rates
Therapy
HOT OR COLD PACKS THERAPYCPT 97010 (GP)8907708Outpatient$41$29Payer Rates
HOT OR COLD PACKS THERAPYCPT 97010 (GO)8908828Outpatient$41$29Payer Rates
ELECTRIC STIMULATION THERAPYCPT 97014 (GO)8908802Outpatient$85$59Payer Rates
PARAFFIN BATH THERAPYCPT 97018 (GO)8908805Outpatient$60$42Payer Rates
ELECTRICAL STIMULATIONCPT 97032 (GO)8908804Outpatient$102$71Payer Rates
ULTRASOUND THERAPYCPT 97035 (GO)8908808Outpatient$69$48Payer Rates
THERAPEUTIC EXERCISESCPT 97110 (GP)8907790Outpatient$171$120Payer Rates
THERAPEUTIC EXERCISESCPT 97110 (95)8908760Outpatient$171$120Payer Rates
THERAPEUTIC EXERCISESCPT 97110 (GO)8908770Outpatient$171$120Payer Rates
NEUROMUSCULAR REEDUCATIONCPT 97112 (GP)8907791Outpatient$179$125Payer Rates
NEUROMUSCULAR REEDUCATIONCPT 97112 (GO)8908771Outpatient$179$125Payer Rates
GAIT TRAINING THERAPYCPT 97116 (GP)8907792Outpatient$151$106Payer Rates
THER IVNTJ 1ST 15 MINCPT 971298907860Outpatient$25$18Payer Rates
THER IVNTJ EA ADDL 15 MINCPT 971308907861Outpatient$24$17Payer Rates
MANUAL THERAPY 1/> REGIONSCPT 97140 (GP)8907842Outpatient$160$112Payer Rates
MANUAL THERAPY 1/> REGIONSCPT 97140 (GO)8908792Outpatient$160$112Payer Rates
PT EVAL LOW COMPLEX 20 MINCPT 97161 (GP)8907770Outpatient$400$280Payer Rates
PT EVAL MOD COMPLEX 30 MINCPT 97162 (GP)8907771Outpatient$400$280Payer Rates
PT EVAL HIGH COMPLEX 45 MINCPT 97163 (GP)8907772Outpatient$400$280Payer Rates
PT RE-EVAL EST PLAN CARECPT 97164 (GP)8907774Outpatient$226$158Payer Rates
OT EVAL LOW COMPLEX 30 MINCPT 97165 (95)8908811Outpatient$451$316Payer Rates
OT EVAL MOD COMPLEX 45 MINCPT 97166 (GO)8908810Outpatient$451$316Payer Rates
OT EVAL HIGH COMPLEX 60 MINCPT 97167 (GO)8908813Outpatient$451$316Payer Rates
OT RE-EVAL EST PLAN CARECPT 97168 (GO)8908814Outpatient$282$197Payer Rates
OT RE-EVAL EST PLAN CARECPT 97168 (95)8908815Outpatient$282$197Payer Rates
THERAPEUTIC ACTIVITIESCPT 97530 (GP)8907812Outpatient$186$130Payer Rates
THERAPEUTIC ACTIVITIESCPT 97530 (GO)8908830Outpatient$186$130Payer Rates
THERAPEUTIC ACTIVITIESCPT 97530 (95)89008860Outpatient$429$300Payer Rates
SELF CARE MNGMENT TRAININGCPT 97535 (GP)8907813Outpatient$185$130Payer Rates
SELF CARE MNGMENT TRAININGCPT 97535 (GO)8908773Outpatient$185$130Payer Rates
ELEC STIM OTHER THAN WOUNDHCPCS G0283 (GP)8907779Outpatient$76$53Payer Rates