CT Scan |
CT HEAD/BRAIN W/O DYE | CPT 70450 | 4200001 | Outpatient | $1,155 | $809 | Payer Rates |
CT MAXILLOFACIAL W/O DYE | CPT 70486 | 4200004 | Outpatient | $1,941 | $1,359 | Payer Rates |
CT MAXILLOFACIAL W/O DYE | CPT 70486 | 4200043 | Outpatient | $1,858 | $1,301 | Payer Rates |
CT SOFT TISSUE NECK W/DYE | CPT 70491 | 4200007 | Outpatient | $1,240 | $868 | Payer Rates |
CT THORAX DX C- | CPT 71250 | 4200009 | Outpatient | $2,029 | $1,420 | Payer Rates |
CT THORAX DX C- | CPT 71250 | 4200026 | Outpatient | $1,947 | $1,363 | Payer Rates |
CT THORAX DX C+ | CPT 71260 | 4200010 | Outpatient | $2,453 | $1,717 | Payer Rates |
CT ANGIOGRAPHY CHEST | CPT 71275 | 4200011 | Outpatient | $2,470 | $1,729 | Payer Rates |
CT NECK SPINE W/O DYE | CPT 72125 | 4200029 | Outpatient | $1,290 | $903 | Payer Rates |
CT LUMBAR SPINE W/O DYE | CPT 72131 | 4200031 | Outpatient | $1,290 | $903 | Payer Rates |
CT PELVIS W/O DYE | CPT 72192 | 4200015 | Outpatient | $1,210 | $847 | Payer Rates |
CT PELVIS W/DYE | CPT 72193 | 4200016 | Outpatient | $1,375 | $962 | Payer Rates |
CT LOWER EXTREMITY W/O DYE | CPT 73700 | 4200019 | Outpatient | $1,969 | $1,378 | Payer Rates |
CT ABD & PELVIS W/O CONTRAST | CPT 74176 | 4200024 | Outpatient | $1,350 | $945 | Payer Rates |
CT ABD & PELV W/CONTRAST | CPT 74177 | 4200025 | Outpatient | $1,475 | $1,033 | Payer Rates |
CT ABD & PELV 1/> REGNS | CPT 74178 | 4200023 | Outpatient | $4,900 | $3,430 | Payer Rates |
Cancer Services |
IRRIG DRUG DELIVERY DEVICE | CPT 96523 | 1800004 | Outpatient | $40 | $28 | Payer Rates |
Cardiology |
TTE W/DOPPLER COMPLETE | CPT 93306 | 4100015 | Outpatient | $2,376 | $1,663 | Payer Rates |
Clinic |
INJ TENDON SHEATH/LIGAMENT | CPT 20550 | 5000007 | Outpatient | $440 | $308 | Payer Rates |
INJ TRIGGER POINT 1/2 MUSCL | CPT 20552 | 5000129 | Outpatient | $720 | $504 | Payer Rates |
REMOVE IMPACTED EAR WAX UNI | CPT 69210 | 5000009 | Outpatient | $195 | $137 | Payer Rates |
TB INTRADERMAL TEST | CPT 86580 | 5000015 | Outpatient | $20 | $14 | Payer Rates |
INFLUENZA ASSAY W/OPTIC | CPT 87804 | 5000016 | Outpatient | $94 | $66 | Payer Rates |
CYTOPATH C/V MANUAL | CPT 88150 | 5000017 | Outpatient | $51 | $36 | Payer Rates |
IM ADMIN 1ST/ONLY COMPONENT | CPT 90460 | 5000080 | Outpatient | $15 | $11 | Payer Rates |
IM ADMIN 1ST/ONLY COMPONENT | CPT 90460 | 5000082 | Outpatient | $15 | $11 | Payer Rates |
IM ADMIN EACH ADDL COMPONENT | CPT 90461 | 5000081 | Outpatient | $10 | $7 | Payer Rates |
IM ADMIN EACH ADDL COMPONENT | CPT 90461 | 5000083 | Outpatient | $6 | $4 | Payer Rates |
IMMUNIZATION ADMIN | CPT 90471 | 5000019 | Outpatient | $15 | $11 | Payer Rates |
IMMUNIZATION ADMIN EACH ADD | CPT 90472 | 5000020 | Outpatient | $10 | $7 | Payer Rates |
IMMUNOTHERAPY ONE INJECTION | CPT 95115 | 5000022 | Outpatient | $22 | $15 | Payer Rates |
THER/PROPH/DIAG INJ SC/IM | CPT 96372 | 5000024 | Outpatient | $22 | $15 | Payer Rates |
OFFICE O/P NEW LOW 30-44 MIN | CPT 99203 | 5000004 | Outpatient | $215 | $151 | Payer Rates |
OFFICE O/P NEW LOW 30-44 MIN | CPT 99203 | 5000027 | Outpatient | $143 | $100 | Payer Rates |
OFFICE O/P NEW LOW 30-44 MIN | CPT 99203 | 5000115 | Outpatient | $215 | $151 | Payer Rates |
OFFICE O/P NEW MOD 45-59 MIN | CPT 99204 | 5000028 | Outpatient | $157 | $110 | Payer Rates |
OFFICE O/P NEW HI 60-74 MIN | CPT 99205 | 5000029 | Outpatient | $290 | $203 | Payer Rates |
OFFICE O/P EST SF 10-19 MIN | CPT 99212 | 5000032 | Outpatient | $116 | $81 | Payer Rates |
OFFICE O/P EST SF 10-19 MIN | CPT 99212 | 5000061 | Outpatient | $25 | $18 | Payer Rates |
OFFICE O/P EST SF 10-19 MIN | CPT 99212 | 5000070 | Outpatient | $131 | $92 | Payer Rates |
OFFICE O/P EST LOW 20-29 MIN | CPT 99213 | 5000033 | Outpatient | $143 | $100 | Payer Rates |
OFFICE O/P EST LOW 20-29 MIN | CPT 99213 | 5000067 | Outpatient | $240 | $168 | Payer Rates |
OFFICE O/P EST MOD 30-39 MIN | CPT 99214 | 5000034 | Outpatient | $157 | $110 | Payer Rates |
OFFICE CONSULTATION | CPT 99243 | 5000099 | Outpatient | $215 | $151 | Payer Rates |
OFFICE CONSULTATION | CPT 99244 | 5000037 | Outpatient | $305 | $214 | Payer Rates |
PREV VISIT NEW AGE 18-39 | CPT 99385 | 5000088 | Outpatient | $100 | $70 | Payer Rates |
PREV VISIT NEW AGE 40-64 | CPT 99386 | 5000089 | Outpatient | $100 | $70 | Payer Rates |
PREV VISIT EST AGE 1-4 | CPT 99392 | 5000052 | Outpatient | $121 | $85 | Payer Rates |
PREV VISIT EST AGE 5-11 | CPT 99393 | 5000054 | Outpatient | $121 | $85 | Payer Rates |
PREV VISIT EST AGE 12-17 | CPT 99394 | 5000055 | Outpatient | $121 | $85 | Payer Rates |
WORK RELATED DISABILITY EXAM | CPT 99455 | 5000043 | Outpatient | $100 | $70 | Payer Rates |
PPPS, INITIAL VISIT | HCPCS G0438 | 5000057 | Outpatient | $225 | $158 | Payer Rates |
CLINIC SERVICE | HCPCS T1015 (AM) | 5000059 | Outpatient | $143 | $100 | Payer Rates |
EEG |
(Not Offered) SLEEP STUDY | CPT 95810 | - | - | - | - | - |
EKG |
ELECTROCARDIOGRAM COMPLETE | CPT 93000 | 8200001 | Outpatient | $121 | $85 | Payer Rates |
ELECTROCARDIOGRAM TRACING | CPT 93005 | 8200002 | Outpatient | $211 | $148 | Payer Rates |
ECG MONIT/REPRT UP TO 48 HRS | CPT 93225 | 8000030 | Outpatient | $543 | $380 | Payer Rates |
Emergency Room |
DRAINAGE OF SKIN ABSCESS | CPT 10060 | 3000031 | Outpatient | $492 | $344 | Payer Rates |
RPR S/N/AX/GEN/TRNK 2.5CM/< | CPT 12001 | 3000063 | Outpatient | $204 | $143 | Payer Rates |
RPR S/N/AX/GEN/TRNK2.6-7.5CM | CPT 12002 | 3000048 | Outpatient | $386 | $270 | Payer Rates |
RPR S/N/AX/GEN/TRK7.6-12.5CM | CPT 12004 | 3000049 | Outpatient | $423 | $296 | Payer Rates |
RPR F/E/E/N/L/M 2.5 CM/< | CPT 12011 | 3000050 | Outpatient | $204 | $143 | Payer Rates |
RPR F/E/E/N/L/M 2.6-5.0 CM | CPT 12013 | 3000051 | Outpatient | $230 | $161 | Payer Rates |
TREAT SHOULDER DISLOCATION | CPT 23650 | 3000023 | Outpatient | $466 | $326 | Payer Rates |
APPLY FOREARM SPLINT | CPT 29125 | 3000054 | Outpatient | $287 | $201 | Payer Rates |
INSERT TEMP BLADDER CATH | CPT 51702 | 3000067 | Outpatient | $58 | $41 | Payer Rates |
IMMUNIZATION ADMIN | CPT 90471 | 3000034 | Outpatient | $15 | $11 | Payer Rates |
HYDRATE IV INFUSION ADD-ON | CPT 96361 | 3000085 | Outpatient | $153 | $107 | Payer Rates |
THER/PROPH/DIAG IV INF INIT | CPT 96365 | 3000076 | Outpatient | $546 | $382 | Payer Rates |
THER/PROPH/DIAG INJ SC/IM | CPT 96372 | 3000060 | Outpatient | $56 | $39 | Payer Rates |
THER/PROPH/DIAG INJ IV PUSH | CPT 96374 | 3000059 | Outpatient | $100 | $70 | Payer Rates |
TX/PRO/DX INJ NEW DRUG ADDON | CPT 96375 | 3000071 | Outpatient | $45 | $31 | Payer Rates |
TX/PRO/DX INJ SAME DRUG ADON | CPT 96376 | 3000072 | Outpatient | $150 | $105 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99281 | 3000015 | Outpatient | $156 | $109 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99282 | 3000016 | Outpatient | $215 | $151 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99283 | 3000017 | Outpatient | $274 | $192 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99284 | 3000018 | Outpatient | $470 | $329 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99285 | 3000019 | Outpatient | $780 | $546 | Payer Rates |
CRITICAL CARE FIRST HOUR | CPT 99291 | 3000020 | Outpatient | $850 | $595 | Payer Rates |
Gastro-Intestinal |
EGD DIAGNOSTIC BRUSH WASH | CPT 43235 | 2000040 | Outpatient | $1,450 | $1,015 | Payer Rates |
COLONOSCOPY W/LESION REMOVAL | CPT 45385 | 2000039 | Outpatient | $1,500 | $1,050 | Payer Rates |
IV Therapy |
HYDRATION IV INFUSION INIT | CPT 96360 | 3000068 | Outpatient | $110 | $77 | Payer Rates |
THER/PROPH/DIAG IV INF ADDON | CPT 96366 | 3000069 | Outpatient | $192 | $134 | Payer Rates |
THER/PROPH/DIAG INJ IV PUSH | CPT 96374 | 1800007 | Outpatient | $100 | $70 | Payer Rates |
TX/PRO/DX INJ NEW DRUG ADDON | CPT 96375 | 1800006 | Outpatient | $45 | $31 | Payer Rates |
Imaging |
US EXAM OF HEAD AND NECK | CPT 76536 | 4100028 | Outpatient | $818 | $573 | Payer Rates |
US EXAM ABDOM COMPLETE | CPT 76700 | 4100004 | Outpatient | $1,033 | $723 | Payer Rates |
ECHO EXAM OF ABDOMEN | CPT 76705 | 4100005 | Outpatient | $797 | $558 | Payer Rates |
US EXAM ABDO BACK WALL COMP | CPT 76770 | 4100032 | Outpatient | $869 | $608 | Payer Rates |
OB US >= 14 WKS SNGL FETUS | CPT 76805 | 4100009 | Outpatient | $807 | $565 | Payer Rates |
TRANSVAGINAL US NON-OB | CPT 76830 | 4100011 | Outpatient | $761 | $533 | Payer Rates |
US EXAM PELVIC COMPLETE | CPT 76856 | 4100012 | Outpatient | $888 | $622 | Payer Rates |
US EXAM SCROTUM | CPT 76870 | 4100013 | Outpatient | $818 | $573 | Payer Rates |
(Not Offered) MAMMOGRAPHY OF ONE BREAST | CPT 77065 | - | - | - | - | - |
(Not Offered) MAMMOGRAPHY OF BOTH BREASTS | CPT 77066 | - | - | - | - | - |
(Not Offered) MAMMOGRAPHY, SCREENING, BILATERAL | CPT 77067 | - | - | - | - | - |
LOWER EXTREMITY STUDY | CPT 93925 | 4100031 | Outpatient | $1,361 | $953 | Payer Rates |
VASCULAR STUDY | CPT 93975 | 4100002 | Outpatient | $995 | $697 | Payer Rates |
Inpatient Procedures |
(Not Offered) CARDIAC VALVE OR CARDIOTHORACIC PROCEDURE WI ... | DRG 216 | - | - | - | - | - |
(Not Offered) SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | DRG 460 | - | - | - | - | - |
(Not Offered) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF L ... | DRG 470 | - | - | - | - | - |
(Not Offered) CERVICAL SPINAL FUSION WITHOUT CC OR MCC | DRG 473 | - | - | - | - | - |
(Not Offered) UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGN ... | DRG 743 | - | - | - | - | - |
Laboratory |
RESPIRATORY PANEL, PCR (BIOFIRE) | CPT 0202U | 1000766 | Outpatient | $275 | $193 | Payer Rates |
ROUTINE VENIPUNCTURE | CPT 36415 | 1000115 | Outpatient | $8 | $6 | Payer Rates |
METABOLIC PANEL TOTAL CA | CPT 80048 | 1000121 | Outpatient | $109 | $76 | Payer Rates |
COMPREHEN METABOLIC PANEL | CPT 80053 | 1000120 | Outpatient | $200 | $140 | Payer Rates |
OBSTETRIC PANEL | CPT 80055 | 1000123 | Outpatient | $195 | $137 | Payer Rates |
LIPID PANEL | CPT 80061 | 1000122 | Outpatient | $146 | $102 | Payer Rates |
RENAL FUNCTION PANEL | CPT 80069 | 1000145 | Outpatient | $130 | $91 | Payer Rates |
ACUTE HEPATITIS PANEL | CPT 80074 | 1000133 | Outpatient | $157 | $110 | Payer Rates |
HEPATIC FUNCTION PANEL | CPT 80076 | 1000134 | Outpatient | $152 | $106 | Payer Rates |
ASSAY DIPROPYLACETIC ACD TOT | CPT 80164 | 1000189 | Outpatient | $130 | $91 | Payer Rates |
DRUG SCREEN QUANT GABAPENTIN | CPT 80171 | 1000003 | Outpatient | $194 | $136 | Payer Rates |
ASSAY OF PHENYTOIN TOTAL | CPT 80185 | 1000114 | Outpatient | $128 | $90 | Payer Rates |
ASSAY OF SIROLIMUS | CPT 80195 | 1000228 | Outpatient | $360 | $252 | Payer Rates |
ASSAY OF TACROLIMUS | CPT 80197 | 1000119 | Outpatient | $210 | $147 | Payer Rates |
ASSAY OF VANCOMYCIN | CPT 80202 | 1000194 | Outpatient | $101 | $71 | Payer Rates |
DRUG TEST PRSMV DIR OPT OBS | CPT 80305 | 1000246 | Outpatient | $21 | $15 | Payer Rates |
DRUG SCREEN QUANTALCOHOLS | CPT 80320 | 1000306 | Outpatient | $110 | $77 | Payer Rates |
ANALGESICS NON-OPIOID 1 OR 2 | CPT 80329 | 1000182 | Outpatient | $53 | $37 | Payer Rates |
ANALGESICS NON-OPIOID 1 OR 2 | CPT 80329 | 1000235 | Outpatient | $53 | $37 | Payer Rates |
(Not Offered) URINALYSIS TEST USING MICROSCOPE | CPT 81000 | - | - | - | - | - |
URINALYSIS AUTO W/SCOPE | CPT 81001 | 1000001 | Outpatient | $49 | $34 | Payer Rates |
URINALYSIS NONAUTO W/O SCOPE | CPT 81002 | 5000119 | Outpatient | $25 | $18 | Payer Rates |
(Not Offered) URINALYSIS TEST | CPT 81003 | - | - | - | - | - |
URINE PREGNANCY TEST | CPT 81025 | 1000090 | Outpatient | $61 | $43 | Payer Rates |
URINE PREGNANCY TEST | CPT 81025 | 5000011 | Outpatient | $30 | $21 | Payer Rates |
TEST FOR ACETONE/KETONES | CPT 82009 | 1000098 | Outpatient | $55 | $39 | Payer Rates |
TEST FOR ACETONE/KETONES | CPT 82009 | 1000361 | Outpatient | $109 | $76 | Payer Rates |
UR ALBUMIN QUANTITATIVE | CPT 82043 | 1000154 | Outpatient | $131 | $92 | Payer Rates |
UR ALBUMIN QUANTITATIVE | CPT 82043 | 1000155 | Outpatient | $67 | $47 | Payer Rates |
ALPHA-FETOPROTEIN SERUM | CPT 82105 | 1000264 | Outpatient | $150 | $105 | Payer Rates |
ASSAY OF AMMONIA | CPT 82140 | 1000076 | Outpatient | $94 | $66 | Payer Rates |
ASSAY OF AMYLASE | CPT 82150 | 1000071 | Outpatient | $65 | $46 | Payer Rates |
OCCULT BLOOD FECES | CPT 82270 | 1000236 | Outpatient | $36 | $25 | Payer Rates |
OCCULT BLOOD FECES | CPT 82270 | 1000303 | Outpatient | $36 | $25 | Payer Rates |
VITAMIN D 25 HYDROXY | CPT 82306 | 1000033 | Outpatient | $191 | $134 | Payer Rates |
TOTAL CORTISOL | CPT 82533 | 1000323 | Outpatient | $133 | $93 | Payer Rates |
TOTAL CORTISOL | CPT 82533 | 1000324 | Outpatient | $133 | $93 | Payer Rates |
ASSAY OF CK (CPK) | CPT 82550 | 1000070 | Outpatient | $75 | $53 | Payer Rates |
CREATINE MB FRACTION | CPT 82553 | 1000040 | Outpatient | $70 | $49 | Payer Rates |
ASSAY OF CREATININE | CPT 82565 | 1000072 | Outpatient | $53 | $37 | Payer Rates |
VITAMIN B-12 | CPT 82607 | 1000249 | Outpatient | $132 | $92 | Payer Rates |
VIT D 1 25-DIHYDROXY | CPT 82652 | 1000285 | Outpatient | $121 | $85 | Payer Rates |
ASSAY OF TOTAL ESTRADIOL | CPT 82670 | 1000276 | Outpatient | $190 | $133 | Payer Rates |
ASSAY OF FERRITIN | CPT 82728 | 1000200 | Outpatient | $130 | $91 | Payer Rates |
ASSAY OF FOLIC ACID SERUM | CPT 82746 | 1000158 | Outpatient | $35 | $25 | Payer Rates |
BLOOD GASES ANY COMBINATION | CPT 82803 | 8000023 | Outpatient | $223 | $156 | Payer Rates |
BLOOD GASES W/O2 SATURATION | CPT 82805 | 8000022 | Outpatient | $239 | $167 | Payer Rates |
GLUCOSE BLOOD TEST | CPT 82962 | 5000120 | Outpatient | $20 | $14 | Payer Rates |
ASSAY OF GGT | CPT 82977 | 1000042 | Outpatient | $99 | $69 | Payer Rates |
ASSAY OF GONADOTROPIN (FSH) | CPT 83001 | 1000267 | Outpatient | $152 | $106 | Payer Rates |
H PYLORI (C-13) BREATH | CPT 83013 | 1000351 | Outpatient | $313 | $219 | Payer Rates |
GLYCOSYLATED HEMOGLOBIN TEST | CPT 83036 | 1000165 | Outpatient | $39 | $27 | Payer Rates |
IMMUNOASSAY NONANTIBODY | CPT 83516 | 1000191 | Outpatient | $107 | $75 | Payer Rates |
IRON BINDING TEST | CPT 83550 | 1000149 | Outpatient | $28 | $20 | Payer Rates |
ASSAY OF LACTIC ACID | CPT 83605 | 1000340 | Outpatient | $136 | $95 | Payer Rates |
LACTATE (LD) (LDH) ENZYME | CPT 83615 | 1000057 | Outpatient | $62 | $43 | Payer Rates |
ASSAY OF LEAD | CPT 83655 | 1000166 | Outpatient | $66 | $46 | Payer Rates |
ASSAY OF LIPASE | CPT 83690 | 1000171 | Outpatient | $37 | $26 | Payer Rates |
ASSAY OF BLOOD LIPOPROTEIN | CPT 83721 | 1000245 | Outpatient | $121 | $85 | Payer Rates |
ASSAY OF MAGNESIUM | CPT 83735 | 1000253 | Outpatient | $44 | $31 | Payer Rates |
ASSAY OF NATRIURETIC PEPTIDE | CPT 83880 | 1000322 | Outpatient | $135 | $95 | Payer Rates |
ASSAY OF NATRIURETIC PEPTIDE | CPT 83880 | 1000400 | Outpatient | $228 | $160 | Payer Rates |
ASSAY OF PARATHORMONE | CPT 83970 | 1000205 | Outpatient | $151 | $106 | Payer Rates |
ASSAY OF PARATHORMONE | CPT 83970 | 1000316 | Outpatient | $120 | $84 | Payer Rates |
ASSAY OF PHOSPHORUS | CPT 84100 | 1000077 | Outpatient | $31 | $22 | Payer Rates |
ASSAY OF SERUM POTASSIUM | CPT 84132 | 1000062 | Outpatient | $51 | $36 | Payer Rates |
ASSAY OF PROGESTERONE | CPT 84144 | 1000234 | Outpatient | $108 | $76 | Payer Rates |
ASSAY OF PROLACTIN | CPT 84146 | 1000272 | Outpatient | $115 | $81 | Payer Rates |
ASSAY OF PSA TOTAL | CPT 84153 | 1000175 | Outpatient | $147 | $103 | Payer Rates |
ASSAY OF PSA FREE | CPT 84154 | 1000295 | Outpatient | $73 | $51 | Payer Rates |
ASSAY OF PROTEIN URINE | CPT 84156 | 1000037 | Outpatient | $237 | $166 | Payer Rates |
ASSAY OF FREE TESTOSTERONE | CPT 84402 | 1000011 | Outpatient | $153 | $107 | Payer Rates |
ASSAY OF TOTAL TESTOSTERONE | CPT 84403 | 1000012 | Outpatient | $168 | $118 | Payer Rates |
ASSAY OF VITAMIN B-1 | CPT 84425 | 1000075 | Outpatient | $120 | $84 | Payer Rates |
ASSAY OF TOTAL THYROXINE | CPT 84436 | 1000100 | Outpatient | $84 | $59 | Payer Rates |
ASSAY OF FREE THYROXINE | CPT 84439 | 1000150 | Outpatient | $113 | $79 | Payer Rates |
ASSAY THYROID STIM HORMONE | CPT 84443 | 1000117 | Outpatient | $153 | $107 | Payer Rates |
ASSAY OF THYROID (T3 OR T4) | CPT 84479 | 1000031 | Outpatient | $53 | $37 | Payer Rates |
FREE ASSAY (FT-3) | CPT 84481 | 1000222 | Outpatient | $144 | $101 | Payer Rates |
ASSAY OF TROPONIN QUANT | CPT 84484 | 1000041 | Outpatient | $70 | $49 | Payer Rates |
ASSAY OF TROPONIN QUANT | CPT 84484 | 1000770 | Outpatient | $185 | $130 | Payer Rates |
ASSAY OF UREA NITROGEN | CPT 84520 | 1000048 | Outpatient | $46 | $32 | Payer Rates |
ASSAY OF BLOOD/URIC ACID | CPT 84550 | 1000049 | Outpatient | $51 | $36 | Payer Rates |
CHORIONIC GONADOTROPIN TEST | CPT 84702 | 1000270 | Outpatient | $158 | $111 | Payer Rates |
CHORIONIC GONADOTROPIN ASSAY | CPT 84703 | 1000382 | Outpatient | $61 | $43 | Payer Rates |
HEMATOCRIT | CPT 85014 | 1000064 | Outpatient | $27 | $19 | Payer Rates |
HEMOGLOBIN | CPT 85018 | 1000038 | Outpatient | $28 | $20 | Payer Rates |
HEMOGLOBIN | CPT 85018 | 1000065 | Outpatient | $28 | $20 | Payer Rates |
(Not Offered) COMPLETE BLOOD CELL COUNT (CBC), WITH DIFFER ... | CPT 85025 | - | - | - | - | - |
COMPLETE CBC AUTOMATED | CPT 85027 | 1000067 | Outpatient | $80 | $56 | Payer Rates |
COMPLETE CBC AUTOMATED | CPT 85027 | 1000369 | Outpatient | $80 | $56 | Payer Rates |
FIBRIN DEGRADATION QUANT | CPT 85379 | 1000017 | Outpatient | $158 | $111 | Payer Rates |
PROTHROMBIN TIME | CPT 85610 | 1000018 | Outpatient | $70 | $49 | Payer Rates |
RBC SED RATE NONAUTOMATED | CPT 85651 | 1000080 | Outpatient | $51 | $36 | Payer Rates |
THROMBOPLASTIN TIME PARTIAL | CPT 85730 | 1000079 | Outpatient | $53 | $37 | Payer Rates |
ANTINUCLEAR ANTIBODIES | CPT 86038 | 1000309 | Outpatient | $134 | $94 | Payer Rates |
C-REACTIVE PROTEIN | CPT 86140 | 1000162 | Outpatient | $20 | $14 | Payer Rates |
DNA ANTIBODY NATIVE | CPT 86225 | 1000026 | Outpatient | $95 | $67 | Payer Rates |
NUCLEAR ANTIGEN ANTIBODY | CPT 86235 | 1000022 | Outpatient | $69 | $48 | Payer Rates |
NUCLEAR ANTIGEN ANTIBODY | CPT 86235 | 1000262 | Outpatient | $120 | $84 | Payer Rates |
NUCLEAR ANTIGEN ANTIBODY | CPT 86235 | 1000327 | Outpatient | $60 | $42 | Payer Rates |
NUCLEAR ANTIGEN ANTIBODY | CPT 86235 | 1000416 | Outpatient | $111 | $78 | Payer Rates |
HETEROPHILE ANTIBODY SCREEN | CPT 86308 | 1000081 | Outpatient | $48 | $34 | Payer Rates |
MICROSOMAL ANTIBODY EACH | CPT 86376 | 1000221 | Outpatient | $107 | $75 | Payer Rates |
RHEUMATOID FACTOR TEST QUAL | CPT 86430 | 1000255 | Outpatient | $39 | $27 | Payer Rates |
RHEUMATOID FACTOR QUANT | CPT 86431 | 1000025 | Outpatient | $17 | $12 | Payer Rates |
SYPHILIS TEST NON-TREP QUAL | CPT 86592 | 1000261 | Outpatient | $54 | $38 | Payer Rates |
HELICOBACTER PYLORI ANTIBODY | CPT 86677 | 1000066 | Outpatient | $49 | $34 | Payer Rates |
HEP B SURFACE ANTIBODY | CPT 86706 | 1000212 | Outpatient | $34 | $24 | Payer Rates |
SARS-COV-2 COVID-19 ANTIBODY | CPT 86769 | 1000424 | Outpatient | $50 | $35 | Payer Rates |
RBC ANTIBODY SCREEN | CPT 86850 | 1000307 | Outpatient | $100 | $70 | Payer Rates |
BLOOD TYPING SEROLOGIC ABO | CPT 86900 | 1000136 | Outpatient | $42 | $29 | Payer Rates |
BLOOD TYPING SEROLOGIC RH(D) | CPT 86901 | 1000085 | Outpatient | $77 | $54 | Payer Rates |
COMPATIBILITY TEST SPIN | CPT 86920 | 1100010 | Outpatient | $127 | $89 | Payer Rates |
COMPATIBILITY TEST SPIN | CPT 86920 | 1100012 | Outpatient | $66 | $46 | Payer Rates |
COMPATIBILITY TEST SPIN | CPT 86920 | 1100013 | Outpatient | $127 | $89 | Payer Rates |
COMPATIBILITY TEST SPIN | CPT 86920 | 1100014 | Outpatient | $127 | $89 | Payer Rates |
FECES CULTURE AEROBIC BACT | CPT 87045 | 1000101 | Outpatient | $139 | $97 | Payer Rates |
CULTURE OTHR SPECIMN AEROBIC | CPT 87070 | 1000092 | Outpatient | $111 | $78 | Payer Rates |
CULTR BACTERIA EXCEPT BLOOD | CPT 87075 | 1000201 | Outpatient | $82 | $57 | Payer Rates |
URINE CULTURE/COLONY COUNT | CPT 87086 | 1000108 | Outpatient | $24 | $17 | Payer Rates |
BLOOD FUNGUS CULTURE | CPT 87103 | 1000103 | Outpatient | $81 | $57 | Payer Rates |
BLOOD FUNGUS CULTURE | CPT 87103 | 1000304 | Outpatient | $81 | $57 | Payer Rates |
OVA AND PARASITES SMEARS | CPT 87177 | 1000226 | Outpatient | $41 | $29 | Payer Rates |
MICROBE SUSCEPTIBLE MIC | CPT 87186 | 1000091 | Outpatient | $88 | $62 | Payer Rates |
MICROBE SUSCEPTIBLE MIC | CPT 87186 | 1000358 | Outpatient | $89 | $62 | Payer Rates |
SMEAR GRAM STAIN | CPT 87205 | 1000109 | Outpatient | $34 | $24 | Payer Rates |
SMEAR WET MOUNT SALINE/INK | CPT 87210 | 1000110 | Outpatient | $34 | $24 | Payer Rates |
SMEAR WET MOUNT SALINE/INK | CPT 87210 | 1000311 | Outpatient | $42 | $29 | Payer Rates |
HPYLORI STOOL AG IA | CPT 87338 | 1000225 | Outpatient | $263 | $184 | Payer Rates |
HIV-1 AG W/HIV-1&2 AB AG IA | CPT 87389 | 1000386 | Outpatient | $104 | $73 | Payer Rates |
RESP SYNCYTIAL VIRUS AG IA | CPT 87420 | 1000188 | Outpatient | $44 | $31 | Payer Rates |
SARSCOV CORONAVIRUS AG IA | CPT 87426 | 1000750 | Outpatient | $100 | $70 | Payer Rates |
SARSCOV CORONAVIRUS AG IA | CPT 87426 | 1000772 | Outpatient | $100 | $70 | Payer Rates |
STREP A AG IA | CPT 87430 | 1000132 | Outpatient | $78 | $55 | Payer Rates |
CHYLMD TRACH DNA AMP PROBE | CPT 87491 | 1000298 | Outpatient | $186 | $130 | Payer Rates |
SARS-COV-2 COVID-19 AMP PRB | CPT 87635 | 1000422 | Outpatient | $189 | $132 | Payer Rates |
SARS-COV-2 COVID-19 AMP PRB | CPT 87635 (90) | 1000771 | Outpatient | $141 | $99 | Payer Rates |
CLOSTRIDIUM TOXIN A W/OPTIC | CPT 87803 | 1000089 | Outpatient | $26 | $18 | Payer Rates |
INFLUENZA ASSAY W/OPTIC | CPT 87804 | 1000130 | Outpatient | $94 | $66 | Payer Rates |
STREP A ASSAY W/OPTIC | CPT 87880 | 5000012 | Outpatient | $81 | $57 | Payer Rates |
SPECIMEN HANDLING PT-LAB | CPT 99001 | 1000060 | Outpatient | $20 | $14 | Payer Rates |
PSA SCREENING | HCPCS G0103 | 1000247 | Outpatient | $116 | $81 | Payer Rates |
MRI |
MRI BRAIN STEM W/O DYE | CPT 70551 | 4300003 | Outpatient | $1,500 | $1,050 | Payer Rates |
MRI BRAIN STEM W/O & W/DYE | CPT 70553 | 4300005 | Outpatient | $2,000 | $1,400 | Payer Rates |
MRI NECK SPINE W/O DYE | CPT 72141 | 4300019 | Outpatient | $1,500 | $1,050 | Payer Rates |
MRI LUMBAR SPINE W/O DYE | CPT 72148 | 4300006 | Outpatient | $1,500 | $1,050 | Payer Rates |
MRI LUMBAR SPINE W/O DYE | CPT 72148 | 4300022 | Outpatient | $1,500 | $1,050 | Payer Rates |
MRI JNT OF LWR EXTRE W/O DYE | CPT 73721 | 4300015 | Outpatient | $2,880 | $2,016 | Payer Rates |
MRI JNT OF LWR EXTRE W/O DYE | CPT 73721 | 4300027 | Outpatient | $2,880 | $2,016 | Payer Rates |
Other Diagnostic |
EXTRACRANIAL BILAT STUDY | CPT 93880 | 4100038 | Outpatient | $1,248 | $874 | Payer Rates |
EXTREMITY STUDY | CPT 93970 | 4100018 | Outpatient | $1,381 | $967 | Payer Rates |
EXTREMITY STUDY | CPT 93971 | 4100019 | Outpatient | $937 | $656 | Payer Rates |
Other Procedures and Observation |
IMPLANT HORMONE PELLET(S) | CPT 11980 | 1800049 | Outpatient | $385 | $270 | Payer Rates |
IMPLANT HORMONE PELLET(S) | CPT 11980 | 1800051 | Outpatient | $350 | $245 | Payer Rates |
THER/PROPH/DIAG IV INF INIT | CPT 96365 | 1800053 | Outpatient | $546 | $382 | Payer Rates |
THER/PROPH/DIAG IV INF ADDON | CPT 96366 | 1800054 | Outpatient | $192 | $134 | Payer Rates |
THER/PROPH/DIAG INJ SC/IM | CPT 96372 | 1800047 | Outpatient | $158 | $111 | Payer Rates |
CHEMO ANTI-NEOPL SQ/IM | CPT 96401 | 1800058 | Outpatient | $302 | $211 | Payer Rates |
OFFICE O/P EST MINIMAL PROB | CPT 99211 | 1800059 | Outpatient | $145 | $102 | Payer Rates |
Other Therapeutic |
BLOOD TRANSFUSION SERVICE | CPT 36430 | 1100007 | Outpatient | $100 | $70 | Payer Rates |
CARDIAC REHAB/MONITOR | CPT 93798 | 1700002 | Outpatient | $110 | $77 | Payer Rates |
PHLEBOTOMY | CPT 99195 | 1000137 | Outpatient | $66 | $46 | Payer Rates |
OFFICE O/P NEW LOW 30-44 MIN | CPT 99203 | 1700003 | Outpatient | $148 | $104 | Payer Rates |
RBC LEUKOCYTES REDUCED | HCPCS P9016 | 1100009 | Outpatient | $352 | $246 | Payer Rates |
Psychiatric |
(Not Offered) PSYCHOTHERAPY, 30 MIN | CPT 90832 | - | - | - | - | - |
(Not Offered) PSYCHOTHERAPY, 45 MIN | CPT 90834 | - | - | - | - | - |
(Not Offered) PSYCHOTHERAPY, 60 MIN | CPT 90837 | - | - | - | - | - |
(Not Offered) FAMILY PSYCHOTHERAPY, NOT INCLUDING PATIENT, ... | CPT 90846 | - | - | - | - | - |
(Not Offered) FAMILY PSYCHOTHERAPY, INCLUDING PATIENT, 50 ... | CPT 90847 | - | - | - | - | - |
(Not Offered) GROUP PSYCHOTHERAPY | CPT 90853 | - | - | - | - | - |
Pulmonary Function |
BREATHING CAPACITY TEST | CPT 94010 | 8000014 | Outpatient | $247 | $173 | Payer Rates |
EVALUATION OF WHEEZING | CPT 94060 | 8000015 | Outpatient | $453 | $317 | Payer Rates |
Radiology |
X-RAY EXAM OF FACIAL BONES | CPT 70150 | 4000003 | Outpatient | $212 | $148 | Payer Rates |
X-RAY EXAM CHEST 1 VIEW | CPT 71045 | 4000011 | Outpatient | $88 | $62 | Payer Rates |
X-RAY EXAM CHEST 2 VIEWS | CPT 71046 | 4000012 | Outpatient | $366 | $256 | Payer Rates |
X-RAY EXAM RIBS UNI 2 VIEWS | CPT 71100 | 4000013 | Outpatient | $184 | $129 | Payer Rates |
X-RAY EXAM UNILAT RIBS/CHEST | CPT 71101 | 4000014 | Outpatient | $383 | $268 | Payer Rates |
X-RAY EXAM RIBS BIL 3 VIEWS | CPT 71110 | 4000015 | Outpatient | $132 | $92 | Payer Rates |
X-RAY EXAM RIBS/CHEST4/> VWS | CPT 71111 | 4000016 | Outpatient | $503 | $352 | Payer Rates |
X-RAY EXAM NECK SPINE 2-3 VW | CPT 72040 | 4000018 | Outpatient | $142 | $99 | Payer Rates |
X-RAY EXAM NECK SPINE 6/>VWS | CPT 72052 | 4000019 | Outpatient | $537 | $376 | Payer Rates |
X-RAY EXAM THORAC SPINE 2VWS | CPT 72070 | 4000021 | Outpatient | $121 | $85 | Payer Rates |
X-RAY EXAM THORAC SPINE 3VWS | CPT 72072 | 4000107 | Outpatient | $494 | $346 | Payer Rates |
X-RAY EXAM L-S SPINE 2/3 VWS | CPT 72100 | 4000023 | Outpatient | $165 | $115 | Payer Rates |
X-RAY EXAM L-2 SPINE 4/>VWS | CPT 72110 | 4000024 | Outpatient | $673 | $471 | Payer Rates |
X-RAY EXAM OF PELVIS | CPT 72170 | 4000025 | Outpatient | $135 | $95 | Payer Rates |
X-RAY EXAM SACRUM TAILBONE | CPT 72220 | 4000028 | Outpatient | $210 | $147 | Payer Rates |
X-RAY EXAM OF SHOULDER | CPT 73020 (LT) | 4000031 | Outpatient | $93 | $65 | Payer Rates |
X-RAY EXAM OF SHOULDER | CPT 73030 (LT) | 4000032 | Outpatient | $124 | $87 | Payer Rates |
X-RAY EXAM OF SHOULDER | CPT 73030 (RT) | 4000061 | Outpatient | $125 | $88 | Payer Rates |
X-RAY EXAM OF ELBOW | CPT 73070 (LT) | 4000034 | Outpatient | $120 | $84 | Payer Rates |
X-RAY EXAM OF ELBOW | CPT 73070 (RT) | 4000065 | Outpatient | $120 | $84 | Payer Rates |
X-RAY EXAM OF ELBOW | CPT 73080 | 4000094 | Outpatient | $413 | $289 | Payer Rates |
X-RAY EXAM OF ELBOW | CPT 73080 | 4000095 | Outpatient | $413 | $289 | Payer Rates |
X-RAY EXAM OF FOREARM | CPT 73090 (LT) | 4000035 | Outpatient | $120 | $84 | Payer Rates |
X-RAY EXAM OF FOREARM | CPT 73090 (RT) | 4000067 | Outpatient | $120 | $84 | Payer Rates |
X-RAY EXAM OF WRIST | CPT 73110 (LT) | 4000036 | Outpatient | $125 | $88 | Payer Rates |
X-RAY EXAM OF WRIST | CPT 73110 (RT) | 4000069 | Outpatient | $125 | $88 | Payer Rates |
X-RAY EXAM OF HAND | CPT 73130 (LT) | 4000038 | Outpatient | $313 | $219 | Payer Rates |
X-RAY EXAM OF HAND | CPT 73130 (RT) | 4000072 | Outpatient | $192 | $134 | Payer Rates |
X-RAY EXAM OF HAND | CPT 73130 | 4000073 | Outpatient | $363 | $254 | Payer Rates |
X-RAY EXAM OF FINGER(S) | CPT 73140 | 4000039 | Outpatient | $88 | $62 | Payer Rates |
X-RAY EXAM HIP UNI 2-3 VIEWS | CPT 73502 (RT) | 4000074 | Outpatient | $130 | $91 | Payer Rates |
X-RAY EXAM HIP UNI 2-3 VIEWS | CPT 73502 (LT) | 4000088 | Outpatient | $130 | $91 | Payer Rates |
X-RAY EXAM HIPS BI 2 VIEWS | CPT 73521 | 4000089 | Outpatient | $101 | $71 | Payer Rates |
X-RAY EXAM OF FEMUR 2/> | CPT 73552 (RT) | 4000075 | Outpatient | $145 | $102 | Payer Rates |
X-RAY EXAM OF KNEE 1 OR 2 | CPT 73560 | 4000092 | Outpatient | $360 | $252 | Payer Rates |
X-RAY EXAM OF KNEE 1 OR 2 | CPT 73560 | 4000093 | Outpatient | $360 | $252 | Payer Rates |
X-RAY EXAM OF KNEE 3 | CPT 73562 (LT) | 4000041 | Outpatient | $389 | $272 | Payer Rates |
X-RAY EXAM OF KNEE 3 | CPT 73562 (RT) | 4000077 | Outpatient | $389 | $272 | Payer Rates |
X-RAY EXAM OF KNEE 3 | CPT 73562 | 4000078 | Outpatient | $389 | $272 | Payer Rates |
X-RAY EXAM OF LOWER LEG | CPT 73590 (LT) | 4000045 | Outpatient | $105 | $74 | Payer Rates |
X-RAY EXAM OF LOWER LEG | CPT 73590 (RT) | 4000080 | Outpatient | $105 | $74 | Payer Rates |
X-RAY EXAM OF ANKLE | CPT 73610 (LT) | 4000046 | Outpatient | $110 | $77 | Payer Rates |
X-RAY EXAM OF ANKLE | CPT 73610 (RT) | 4000082 | Outpatient | $110 | $77 | Payer Rates |
X-RAY EXAM OF FOOT | CPT 73620 | 4000101 | Outpatient | $364 | $255 | Payer Rates |
X-RAY EXAM OF FOOT | CPT 73630 (LT) | 4000047 | Outpatient | $153 | $107 | Payer Rates |
X-RAY EXAM OF FOOT | CPT 73630 (RT) | 4000084 | Outpatient | $153 | $107 | Payer Rates |
X-RAY EXAM OF FOOT | CPT 73630 | 4000085 | Outpatient | $306 | $214 | Payer Rates |
X-RAY EXAM OF TOE(S) | CPT 73660 | 4000049 | Outpatient | $115 | $81 | Payer Rates |
X-RAY EXAM ABDOMEN 1 VIEW | CPT 74018 | 4000050 | Outpatient | $185 | $130 | Payer Rates |
X-RAY EXAM ABDOMEN 2 VIEWS | CPT 74019 | 4000051 | Outpatient | $210 | $147 | Payer Rates |
X-RAY EXAM COMPLETE ABDOMEN | CPT 74022 | 4000053 | Outpatient | $315 | $221 | Payer Rates |
DXA BONE DENSITY AXIAL | CPT 77080 | 4000087 | Outpatient | $564 | $395 | Payer Rates |
Respiratory |
WITHDRAWAL OF ARTERIAL BLOOD | CPT 36600 | 8000005 | Outpatient | $32 | $22 | Payer Rates |
VENT MGMT INPAT INIT DAY | CPT 94002 | 8000006 | Outpatient | $1,129 | $790 | Payer Rates |
VENT MGMT INPAT SUBQ DAY | CPT 94003 | 8000009 | Outpatient | $927 | $649 | Payer Rates |
AIRWAY INHALATION TREATMENT | CPT 94640 | 8000003 | Outpatient | $247 | $173 | Payer Rates |
AIRWAY INHALATION TREATMENT | CPT 94640 | 8000025 | Outpatient | $247 | $173 | Payer Rates |
AIRWAY INHALATION TREATMENT | CPT 94640 | 8000027 | Outpatient | $247 | $173 | Payer Rates |
MEASURE BLOOD OXYGEN LEVEL | CPT 94761 | 8000020 | Outpatient | $151 | $106 | Payer Rates |
Surgical Procedures |
(Not Offered) SHAVING OF SHOULDER BONE USING ENDOSCOPE | CPT 29826 | - | - | - | - | - |
(Not Offered) REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOS ... | CPT 29881 | - | - | - | - | - |
(Not Offered) REMOVAL OF TONSILS AND ADENOID GLANDS, PATIE ... | CPT 42820 | - | - | - | - | - |
EGD BIOPSY SINGLE/MULTIPLE | CPT 43239 | 2000042 | Outpatient | $2,155 | $1,509 | Payer Rates |
DIAGNOSTIC COLONOSCOPY | CPT 45378 | 2000037 | Outpatient | $1,500 | $1,050 | Payer Rates |
DIAGNOSTIC COLONOSCOPY | CPT 45378 | 2000082 | Outpatient | $2,466 | $1,726 | Payer Rates |
COLONOSCOPY AND BIOPSY | CPT 45380 | 2000038 | Outpatient | $1,500 | $1,050 | Payer Rates |
(Not Offered) ULTRASOUND EXAMINATION OF LOWER LARGE BOWEL ... | CPT 45391 | - | - | - | - | - |
LAPAROSCOPIC CHOLECYSTECTOMY | CPT 47562 | 2000049 | Outpatient | $8,053 | $5,637 | Payer Rates |
PRP I/HERN INIT REDUC >5 YR | CPT 49505 | 2000028 | Outpatient | $3,200 | $2,240 | Payer Rates |
BIOPSY OF PROSTATE | CPT 55700 | 2000089 | Outpatient | $2,587 | $1,811 | Payer Rates |
(Not Offered) SURGICAL REMOVAL OF PROSTATE AND SURROUNDING ... | CPT 55866 | - | - | - | - | - |
(Not Offered) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY | CPT 59400 | - | - | - | - | - |
(Not Offered) OBSTETRIC CARE, PLANNED CESAREAN DELIVERY | CPT 59510 | - | - | - | - | - |
(Not Offered) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY (PO ... | CPT 59610 | - | - | - | - | - |
(Not Offered) INJECTION(S) OF THERAPEUTIC SUBSTANCE | CPT 62322 | - | - | - | - | - |
(Not Offered) INJECTION(S) OF THERAPEUTIC SUBSTANCE | CPT 62323 | - | - | - | - | - |
(Not Offered) INJECTION(S) OF ANESTHETIC INTO LOWER SPINE ... | CPT 64483 | - | - | - | - | - |
(Not Offered) REMOVAL OF RECURRING CATARACT IN LENS CAPSUL ... | CPT 66821 | - | - | - | - | - |
(Not Offered) REMOVAL OF CATARACT WITH INSERTION OF LENS | CPT 66984 | - | - | - | - | - |
(Not Offered) INSERTION OF CATHETER INTO LEFT HEART FOR DI ... | CPT 93452 | - | - | - | - | - |
Therapy |
THERAPEUTIC EXERCISES | CPT 97110 (GP) | 1500002 | Outpatient | $28 | $20 | Payer Rates |
NEUROMUSCULAR REEDUCATION | CPT 97112 (GP) | 1500008 | Outpatient | $58 | $41 | Payer Rates |
GAIT TRAINING THERAPY | CPT 97116 (GP) | 1500006 | Outpatient | $56 | $39 | Payer Rates |
MANUAL THERAPY 1/> REGIONS | CPT 97140 (GP) | 1500003 | Outpatient | $39 | $27 | Payer Rates |
PT EVAL LOW COMPLEX 20 MIN | CPT 97161 (GP) | 1500010 | Outpatient | $126 | $88 | Payer Rates |
THERAPEUTIC ACTIVITIES | CPT 97530 (GP) | 1500001 | Outpatient | $58 | $41 | Payer Rates |
RMVL DEVITAL TIS 20 CM/< | CPT 97597 (GP) | 1500007 | Outpatient | $92 | $64 | Payer Rates |
Uncategorized |
REMOVAL OF BREAST LESION | CPT 19120 | 2000246 | Outpatient | $6,600 | $4,620 | Payer Rates |
REMOVAL OF BREAST LESION | CPT 19120 | 3100177 | Outpatient | $402 | $281 | Payer Rates |
EGD DIAGNOSTIC BRUSH WASH | CPT 43235 | 3100014 | Outpatient | $700 | $490 | Payer Rates |
EGD BIOPSY SINGLE/MULTIPLE | CPT 43239 | 3100003 | Outpatient | $141 | $99 | Payer Rates |
DIAGNOSTIC COLONOSCOPY | CPT 45378 | 3100091 | Outpatient | $997 | $698 | Payer Rates |
COLONOSCOPY AND BIOPSY | CPT 45380 | 3100002 | Outpatient | $1,102 | $771 | Payer Rates |
COLONOSCOPY W/LESION REMOVAL | CPT 45385 | 3100004 | Outpatient | $1,380 | $966 | Payer Rates |
LAPAROSCOPIC CHOLECYSTECTOMY | CPT 47562 | 3100007 | Outpatient | $651 | $456 | Payer Rates |
PRP I/HERN INIT REDUC >5 YR | CPT 49505 | 3100008 | Outpatient | $1,703 | $1,192 | Payer Rates |
IMMUNIZATION ADMIN | CPT 90471 | 1800002 | Outpatient | $15 | $11 | Payer Rates |
ADMIN INFLUENZA VIRUS VAC | HCPCS G0008 | 1800063 | Outpatient | $15 | $11 | Payer Rates |
ADMIN INFLUENZA VIRUS VAC | HCPCS G0008 | 5000122 | Outpatient | $20 | $14 | Payer Rates |
CASIRIVI AND IMDEVI INFUSION | HCPCS M0243 | 1800061 | Outpatient | $774 | $542 | Payer Rates |
BAMLAN AND ETESEV INFUSION | HCPCS M0245 | 1800065 | Outpatient | $451 | $316 | Payer Rates |
BAMLAN AND ETESEV INFUSION | HCPCS M0245 | 3000110 | Outpatient | $451 | $316 | Payer Rates |
TELEHEALTH FACILITY FEE | HCPCS Q3014 | 1800041 | Outpatient | $58 | $41 | Payer Rates |