Cardiology |
HEART/LUNG RESUSCITATION CPR | CPT 92950 | 30031192 | Outpatient | $625 | $156 | Payer Rates |
CARDIOVASCULAR STRESS TEST | CPT 93017 | 30031213 | Outpatient | $625 | $156 | Payer Rates |
ECHO 2D COMP/COLOR/DOP W/ CON | HCPCS C8929 | 30306465 | Outpatient | $2,136 | $534 | Payer Rates |
Clinic |
(Not Offered) PATIENT OFFICE CONSULTATION, 40 MIN | CPT 99243 | - | - | - | - | - |
EKG |
ELECTROCARDIOGRAM TRACING | CPT 93005 | 30031036 | Outpatient | $310 | $78 | Payer Rates |
Emergency Room |
DRAINAGE OF SKIN ABSCESS | CPT 10060 | 30111109 | Outpatient | $425 | $106 | Payer Rates |
DRESS/DEBRID P-THICK BURN S | CPT 16020 | 30112095 | Outpatient | $387 | $97 | Payer Rates |
REMOVE NASAL FOREIGN BODY | CPT 30300 | 30112182 | Outpatient | $346 | $87 | Payer Rates |
CONTROL OF NOSEBLEED | CPT 30901 | 30112188 | Outpatient | $346 | $87 | Payer Rates |
INSERT EMERGENCY AIRWAY | CPT 31500 | 30111500 | Outpatient | $400 | $100 | Payer Rates |
INSERT BLADDER CATHETER | CPT 51701 | 30111108 | Outpatient | $346 | $87 | Payer Rates |
INSERT TEMP BLADDER CATH | CPT 51702 | 30111702 | Outpatient | $346 | $87 | Payer Rates |
INJECT ANES AGENT FACIAL NERVE | CPT 64402 | 30112401 | Outpatient | $634 | $159 | Payer Rates |
NERVOUS SYSTEM SURGERY | CPT 64999 | 30112401 | Outpatient | $634 | $159 | Payer Rates |
REMOVE FOREIGN BODY FROM EYE | CPT 65205 | 30112422 | Outpatient | $265 | $66 | Payer Rates |
CLEAR OUTER EAR CANAL | CPT 69200 | 30112437 | Outpatient | $346 | $87 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99281 | 30117225 | Outpatient | $263 | $66 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99282 | 30117250 | Outpatient | $541 | $135 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99283 | 30117330 | Outpatient | $811 | $203 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99284 | 30117335 | Outpatient | $1,073 | $268 | Payer Rates |
EMERGENCY DEPT VISIT | CPT 99285 | 30117340 | Outpatient | $1,329 | $332 | Payer Rates |
CRITICAL CARE FIRST HOUR | CPT 99291 | 30119291 | Outpatient | $3,150 | $788 | Payer Rates |
CRITICAL CARE ADDL 30 MIN | CPT 99292 | 30119292 | Outpatient | $788 | $197 | Payer Rates |
CATHETERIZE FOR URINE SPEC | HCPCS P9612 | 30111108 | Outpatient | $346 | $87 | Payer Rates |
IV Therapy |
HYDRATION IV INFUSION INIT | CPT 96360 | 30111158 | Outpatient | $325 | $81 | Payer Rates |
HYDRATE IV INFUSION ADD-ON | CPT 96361 | 30111164 | Outpatient | $155 | $39 | Payer Rates |
THER/PROPH/DIAG IV INF INIT | CPT 96365 | 30111176 | Outpatient | $456 | $114 | Payer Rates |
THER/PROPH/DIAG IV INF ADDON | CPT 96366 | 30041516 | Outpatient | $87 | $22 | Payer Rates |
TX/PROPH/DG ADDL SEQ IV INF | CPT 96367 | 30111173 | Outpatient | $141 | $35 | Payer Rates |
THER/DIAG CONCURRENT INF | CPT 96368 | 30111179 | Outpatient | $63 | $16 | Payer Rates |
THER/PROPH/DIAG INJ SC/IM | CPT 96372 | 30111190 | Outpatient | $176 | $44 | Payer Rates |
THER/PROPH/DIAG INJ IV PUSH | CPT 96374 | 30116374 | Outpatient | $449 | $112 | Payer Rates |
TX/PRO/DX INJ NEW DRUG ADDON | CPT 96375 | 30111182 | Outpatient | $152 | $38 | Payer Rates |
TX/PRO/DX INJ SAME DRUG ADON | CPT 96376 | 30041416 | Outpatient | $142 | $36 | Payer Rates |
Imaging |
PERQ DEVICE BREAST 1ST IMAG | CPT 19281 | 30306283 | Outpatient | $881 | $220 | Payer Rates |
ULTRASOUND BREAST COMPLETE | CPT 76641 | 30306178 | Outpatient | $475 | $119 | Payer Rates |
US BRST UNILAT REAL TIME COMP | CPT 76645 | 30306178 | Outpatient | $475 | $119 | Payer Rates |
FETAL BIOPHYS PROFILE W/NST | CPT 76818 | 30306226 | Outpatient | $656 | $164 | Payer Rates |
FETAL BIOPHYS PROFIL W/O NST | CPT 76819 | 30306226 | Outpatient | $656 | $164 | Payer Rates |
UMBILICAL ARTERY ECHO | CPT 76820 | 30096820 | Outpatient | $241 | $60 | 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 | - | - | - | - | - |
Labor and Delivery |
CIRCUMCISION W/REGIONL BLOCK | CPT 54150 | 30084150 | Outpatient | $2,686 | $672 | Payer Rates |
FETAL NON-STRESS TEST | CPT 59025 | 30091849 | Outpatient | $664 | $166 | Payer Rates |
OBSTETRICAL CARE | CPT 59410 | 30091852 | Outpatient | $4,725 | $1,181 | Payer Rates |
Laboratory |
ROUTINE VENIPUNCTURE | CPT 36415 | 30272497 | Outpatient | $42 | $11 | Payer Rates |
CAPILLARY BLOOD DRAW | CPT 36416 | 30081838 | Outpatient | $22 | $6 | Payer Rates |
METABOLIC PANEL IONIZED CA | CPT 80047 | 30272503 | Outpatient | $151 | $38 | Payer Rates |
METABOLIC PANEL TOTAL CA | CPT 80048 | 30272506 | Outpatient | $151 | $38 | Payer Rates |
ELECTROLYTE PANEL | CPT 80051 | 30272512 | Outpatient | $93 | $23 | Payer Rates |
COMPREHEN METABOLIC PANEL | CPT 80053 | 30272515 | Outpatient | $320 | $80 | Payer Rates |
OBSTETRIC PANEL | CPT 80055 | 30272518 | Outpatient | $364 | $91 | Payer Rates |
LIPID PANEL | CPT 80061 | 30272521 | Outpatient | $179 | $45 | Payer Rates |
RENAL FUNCTION PANEL | CPT 80069 | 30272524 | Outpatient | $158 | $40 | Payer Rates |
ACUTE HEPATITIS PANEL | CPT 80074 | 30272527 | Outpatient | $343 | $86 | Payer Rates |
HEPATIC FUNCTION PANEL | CPT 80076 | 30272530 | Outpatient | $138 | $35 | Payer Rates |
URINE DRUG SCREEN | CPT 80104 | 30275242 | Outpatient | $184 | $46 | Payer Rates |
ASSAY CARBAMAZEPINE TOTAL | CPT 80156 | 30272551 | Outpatient | $139 | $35 | Payer Rates |
ASSAY OF DIGOXIN TOTAL | CPT 80162 | 30272560 | Outpatient | $108 | $27 | Payer Rates |
ASSAY DIPROPYLACETIC ACD TOT | CPT 80164 | 30272563 | Outpatient | $139 | $35 | Payer Rates |
DRUG SCRN QUAN LEVETIRACETAM | CPT 80177 | 30272590 | Outpatient | $105 | $26 | Payer Rates |
ASSAY OF LITHIUM | CPT 80178 | 30272593 | Outpatient | $135 | $34 | Payer Rates |
ASSAY OF PHENYTOIN TOTAL | CPT 80185 | 30272611 | Outpatient | $108 | $27 | Payer Rates |
ASSAY OF TACROLIMUS | CPT 80197 | 30272629 | Outpatient | $105 | $26 | Payer Rates |
ASSAY OF TOBRAMYCIN | CPT 80200 | 30272638 | Outpatient | $116 | $29 | Payer Rates |
ASSAY OF VANCOMYCIN | CPT 80202 | 30273438 | Outpatient | $173 | $43 | Payer Rates |
URINE DRUG SCREEN | CPT 80300 | 30275242 | Outpatient | $184 | $46 | Payer Rates |
DRUG TEST PRSMV DIR OPT OBS | CPT 80305 | 30275242 | Outpatient | $184 | $46 | Payer Rates |
DRUG TEST PRSMV CHEM ANLYZR | CPT 80307 | 30275242 | Outpatient | $184 | $46 | Payer Rates |
URINALYSIS AUTO W/SCOPE | CPT 81001 | 30272680 | Outpatient | $81 | $20 | Payer Rates |
(Not Offered) URINALYSIS TEST | CPT 81002 | - | - | - | - | - |
URINALYSIS AUTO W/O SCOPE | CPT 81003 | 30272683 | Outpatient | $61 | $15 | Payer Rates |
URINE PREGNANCY TEST | CPT 81025 | 30272689 | Outpatient | $131 | $33 | Payer Rates |
F5 GENE | CPT 81241 | 30272704 | Outpatient | $439 | $110 | Payer Rates |
TEST FOR ACETONE/KETONES | CPT 82009 | 30272722 | Outpatient | $54 | $14 | Payer Rates |
ASSAY OF SERUM ALBUMIN | CPT 82040 | 30272731 | Outpatient | $79 | $20 | Payer Rates |
OTHER SOURCE ALBUMIN QUAN EA | CPT 82042 | 30272734 | Outpatient | $79 | $20 | Payer Rates |
UR ALBUMIN QUANTITATIVE | CPT 82043 | 30272737 | Outpatient | $80 | $20 | Payer Rates |
ASSAY OF AMMONIA | CPT 82140 | 30272788 | Outpatient | $139 | $35 | Payer Rates |
ASSAY OF AMYLASE | CPT 82150 | 30272797 | Outpatient | $122 | $31 | Payer Rates |
BILE ACIDS TOTAL | CPT 82239 | 30272827 | Outpatient | $124 | $31 | Payer Rates |
BILIRUBIN TOTAL | CPT 82247 | 30272830 | Outpatient | $122 | $31 | Payer Rates |
BILIRUBIN DIRECT | CPT 82248 | 30272839 | Outpatient | $122 | $31 | Payer Rates |
OCCULT BLOOD FECES | CPT 82270 | 30110003 | Outpatient | $108 | $27 | Payer Rates |
ASSAY TEST FOR BLOOD FECAL | CPT 82274 | 30272851 | Outpatient | $226 | $57 | Payer Rates |
VITAMIN D 25 HYDROXY | CPT 82306 | 30272857 | Outpatient | $250 | $63 | Payer Rates |
ASSAY OF CALCIUM | CPT 82310 | 30272494 | Outpatient | $105 | $26 | Payer Rates |
ASSAY OF CALCIUM | CPT 82330 | 30272866 | Outpatient | $99 | $25 | Payer Rates |
CARCINOEMBRYONIC ANTIGEN | CPT 82378 | 30272884 | Outpatient | $153 | $38 | Payer Rates |
ASSAY OF COPPER | CPT 82525 | 30272947 | Outpatient | $73 | $18 | Payer Rates |
TOTAL CORTISOL | CPT 82533 | 30272956 | Outpatient | $175 | $44 | Payer Rates |
ASSAY OF CK (CPK) | CPT 82550 | 30272968 | Outpatient | $139 | $35 | Payer Rates |
CREATINE MB FRACTION | CPT 82553 | 30272974 | Outpatient | $173 | $43 | Payer Rates |
ASSAY OF CREATININE | CPT 82565 | 30272977 | Outpatient | $79 | $20 | Payer Rates |
ASSAY OF URINE CREATININE | CPT 82570 | 30272983 | Outpatient | $105 | $26 | Payer Rates |
CREATININE CLEARANCE TEST | CPT 82575 | 30272989 | Outpatient | $241 | $60 | Payer Rates |
VITAMIN B-12 | CPT 82607 | 30272995 | Outpatient | $150 | $38 | Payer Rates |
DEHYDROEPIANDROSTERONE | CPT 82627 | 30273004 | Outpatient | $176 | $44 | Payer Rates |
VIT D 1 25-DIHYDROXY | CPT 82652 | 30273010 | Outpatient | $306 | $77 | Payer Rates |
ASSAY OF TOTAL ESTRADIOL | CPT 82670 | 30273019 | Outpatient | $202 | $51 | Payer Rates |
ASSAY OF FERRITIN | CPT 82728 | 30273046 | Outpatient | $99 | $25 | Payer Rates |
ASSAY OF FETAL FIBRONECTIN | CPT 82731 | 30273049 | Outpatient | $462 | $116 | Payer Rates |
ASSAY OF FOLIC ACID SERUM | CPT 82746 | 30273052 | Outpatient | $160 | $40 | Payer Rates |
ASSAY IGA/IGD/IGG/IGM EACH | CPT 82784 | 30273061 | Outpatient | $130 | $33 | Payer Rates |
ASSAY OF IGE | CPT 82785 | 30273094 | Outpatient | $130 | $33 | Payer Rates |
IGG 1 2 3 OR 4 EACH | CPT 82787 | 30273097 | Outpatient | $145 | $36 | Payer Rates |
BLOOD PH | CPT 82800 | 30031198 | Outpatient | $263 | $66 | Payer Rates |
BLOOD GASES ANY COMBINATION | CPT 82803 | 30031195 | Outpatient | $296 | $74 | Payer Rates |
GLUCOSE OTHER FLUID | CPT 82945 | 30273121 | Outpatient | $105 | $26 | Payer Rates |
ASSAY GLUCOSE BLOOD QUANT | CPT 82947 | 30273127 | Outpatient | $63 | $16 | Payer Rates |
GLUCOSE TEST | CPT 82950 | 30273130 | Outpatient | $122 | $31 | Payer Rates |
GLUCOSE TOLERANCE TEST (GTT) | CPT 82951 | 30273136 | Outpatient | $209 | $52 | Payer Rates |
GLUCOSE BLOOD TEST | CPT 82962 | 30041107 | Outpatient | $15 | $4 | Payer Rates |
ASSAY OF GGT | CPT 82977 | 30273157 | Outpatient | $89 | $22 | Payer Rates |
ASSAY OF GONADOTROPIN (FSH) | CPT 83001 | 30273163 | Outpatient | $135 | $34 | Payer Rates |
ASSAY OF GONADOTROPIN (LH) | CPT 83002 | 30273166 | Outpatient | $213 | $53 | Payer Rates |
ASSAY OF HAPTOGLOBIN QUANT | CPT 83010 | 30273172 | Outpatient | $74 | $19 | Payer Rates |
H PYLORI (C-13) BREATH | CPT 83013 | 30375812 | Outpatient | $188 | $47 | Payer Rates |
GLYCOSYLATED HEMOGLOBIN TEST | CPT 83036 | 30273190 | Outpatient | $158 | $40 | Payer Rates |
ASSAY OF HOMOCYSTINE | CPT 83090 | 30273205 | Outpatient | $122 | $31 | Payer Rates |
IMMUNOASSAY NONANTIBODY | CPT 83516 | 30273515 | Outpatient | $67 | $17 | Payer Rates |
RIA NONANTIBODY | CPT 83519 | 30273265 | Outpatient | $189 | $47 | Payer Rates |
ASSAY OF INSULIN | CPT 83525 | 30273286 | Outpatient | $99 | $25 | Payer Rates |
ASSAY OF IRON | CPT 83540 | 30273307 | Outpatient | $50 | $13 | Payer Rates |
IRON BINDING TEST | CPT 83550 | 30271200 | Outpatient | $63 | $16 | Payer Rates |
ASSAY OF LACTIC ACID | CPT 83605 | 30273316 | Outpatient | $166 | $42 | Payer Rates |
LACTATE (LD) (LDH) ENZYME | CPT 83615 | 30273322 | Outpatient | $168 | $42 | Payer Rates |
LACTOFERRIN FECAL (QUAL) | CPT 83630 | 30273328 | Outpatient | $141 | $35 | Payer Rates |
ASSAY OF LIPASE | CPT 83690 | 30273340 | Outpatient | $122 | $31 | Payer Rates |
ASSAY OF MAGNESIUM | CPT 83735 | 30273355 | Outpatient | $115 | $29 | Payer Rates |
SECOND NEWBORN SCREENING | CPT 83788 | 30273364 | Outpatient | $131 | $33 | Payer Rates |
MASS SPECTROMETRY QUAL/QUAN | CPT 83789 | 30273364 | Outpatient | $131 | $33 | Payer Rates |
ASSAY OF MYOGLOBIN | CPT 83874 | 30273385 | Outpatient | $182 | $46 | Payer Rates |
ASSAY OF NATRIURETIC PEPTIDE | CPT 83880 | 30273391 | Outpatient | $296 | $74 | Payer Rates |
ASSAY OF BLOOD OSMOLALITY | CPT 83930 | 30273418 | Outpatient | $83 | $21 | Payer Rates |
ASSAY OF URINE OSMOLALITY | CPT 83935 | 30273421 | Outpatient | $99 | $25 | Payer Rates |
ASSAY OF PARATHORMONE | CPT 83970 | 30273427 | Outpatient | $297 | $74 | Payer Rates |
ASSAY OF BLOOD PKU | CPT 84030 | 30273364 | Outpatient | $131 | $33 | Payer Rates |
ASSAY OF PHOSPHORUS | CPT 84100 | 30273460 | Outpatient | $121 | $30 | Payer Rates |
ASSAY OF SERUM POTASSIUM | CPT 84132 | 30273469 | Outpatient | $79 | $20 | Payer Rates |
ASSAY OF PREALBUMIN | CPT 84134 | 30273478 | Outpatient | $91 | $23 | Payer Rates |
ASSAY OF PROLACTIN | CPT 84146 | 30273490 | Outpatient | $270 | $68 | Payer Rates |
ASSAY OF PSA TOTAL | CPT 84153 | 30273493 | Outpatient | $150 | $38 | Payer Rates |
ASSAY OF PSA FREE | CPT 84154 | 30273496 | Outpatient | $107 | $27 | Payer Rates |
ASSAY OF PROTEIN URINE | CPT 84156 | 30273505 | Outpatient | $90 | $23 | Payer Rates |
ASSAY OF PROTEIN OTHER | CPT 84157 | 30273514 | Outpatient | $197 | $49 | Payer Rates |
PROTEIN E-PHORESIS SERUM | CPT 84165 | 30273523 | Outpatient | $138 | $35 | Payer Rates |
ASSAY OF VITAMIN B-6 | CPT 84207 | 30273532 | Outpatient | $164 | $41 | Payer Rates |
ASSAY OF SEX HORMONE GLOBUL | CPT 84270 | 30273553 | Outpatient | $158 | $40 | Payer Rates |
ASSAY OF URINE SODIUM | CPT 84300 | 30273562 | Outpatient | $29 | $7 | Payer Rates |
ASSAY OF FREE TESTOSTERONE | CPT 84402 | 30270001 | Outpatient | $140 | $35 | Payer Rates |
ASSAY OF TOTAL TESTOSTERONE | CPT 84403 | 30273586 | Outpatient | $187 | $47 | Payer Rates |
ASSAY OF VITAMIN B-1 | CPT 84425 | 30273595 | Outpatient | $124 | $31 | Payer Rates |
ASSAY OF TOTAL THYROXINE | CPT 84436 | 30273601 | Outpatient | $58 | $15 | Payer Rates |
ASSAY OF FREE THYROXINE | CPT 84439 | 30273604 | Outpatient | $175 | $44 | Payer Rates |
ASSAY THYROID STIM HORMONE | CPT 84443 | 30273613 | Outpatient | $275 | $69 | Payer Rates |
ASSAY OF VITAMIN E | CPT 84446 | 30273619 | Outpatient | $150 | $38 | Payer Rates |
ASSAY OF TRIGLYCERIDES | CPT 84478 | 30273634 | Outpatient | $150 | $38 | Payer Rates |
ASSAY TRIIODOTHYRONINE (T3) | CPT 84480 | 30273643 | Outpatient | $161 | $40 | Payer Rates |
FREE ASSAY (FT-3) | CPT 84481 | 30273646 | Outpatient | $208 | $52 | Payer Rates |
ASSAY OF UREA NITROGEN | CPT 84520 | 30273655 | Outpatient | $79 | $20 | Payer Rates |
ASSAY OF BLOOD/URIC ACID | CPT 84550 | 30273664 | Outpatient | $150 | $38 | Payer Rates |
ASSAY OF VITAMIN A | CPT 84590 | 30273685 | Outpatient | $150 | $38 | Payer Rates |
ASSAY OF VITAMIN K | CPT 84597 | 30273688 | Outpatient | $205 | $51 | Payer Rates |
ASSAY OF ZINC | CPT 84630 | 30273697 | Outpatient | $67 | $17 | Payer Rates |
CHORIONIC GONADOTROPIN TEST | CPT 84702 | 30273706 | Outpatient | $254 | $64 | Payer Rates |
CHORIONIC GONADOTROPIN ASSAY | CPT 84703 | 30273709 | Outpatient | $114 | $29 | Payer Rates |
BL SMEAR W/DIFF WBC COUNT | CPT 85007 | 30271202 | Outpatient | $43 | $11 | Payer Rates |
HEMATOCRIT | CPT 85014 | 30273724 | Outpatient | $55 | $14 | Payer Rates |
HEMOGLOBIN | CPT 85018 | 30273727 | Outpatient | $55 | $14 | Payer Rates |
COMPLETE CBC W/AUTO DIFF WBC | CPT 85025 | 30273730 | Outpatient | $109 | $27 | Payer Rates |
COMPLETE CBC AUTOMATED | CPT 85027 | 30273440 | Outpatient | $134 | $34 | Payer Rates |
AUTOMATED PLATELET COUNT | CPT 85049 | 30273748 | Outpatient | $42 | $11 | Payer Rates |
FIBRIN DEGRADE SEMIQUANT | CPT 85378 | 30273808 | Outpatient | $205 | $51 | Payer Rates |
FIBRIN DEGRADATION QUANT | CPT 85379 | 30273808 | Outpatient | $205 | $51 | Payer Rates |
FIBRINOGEN ACTIVITY | CPT 85384 | 30273811 | Outpatient | $90 | $23 | Payer Rates |
PROTHROMBIN TIME | CPT 85610 | 30273835 | Outpatient | $87 | $22 | Payer Rates |
RBC SED RATE AUTOMATED | CPT 85652 | 30273856 | Outpatient | $94 | $24 | Payer Rates |
THROMBOPLASTIN TIME PARTIAL | CPT 85730 | 30273868 | Outpatient | $115 | $29 | Payer Rates |
ALLG SPEC IGE CRUDE XTRC EA | CPT 86003 | 30273907 | Outpatient | $40 | $10 | Payer Rates |
ANTINUCLEAR ANTIBODIES | CPT 86038 | 30273937 | Outpatient | $155 | $39 | Payer Rates |
C-REACTIVE PROTEIN | CPT 86140 | 30273946 | Outpatient | $139 | $35 | Payer Rates |
C-REACTIVE PROTEIN HS | CPT 86141 | 30273949 | Outpatient | $150 | $38 | Payer Rates |
CCP ANTIBODY | CPT 86200 | 30274015 | Outpatient | $130 | $33 | Payer Rates |
NUCLEAR ANTIGEN ANTIBODY | CPT 86235 | 30274024 | Outpatient | $137 | $34 | Payer Rates |
IMMUNOASSAY TUMOR CA 19-9 | CPT 86301 | 30274105 | Outpatient | $150 | $38 | Payer Rates |
IMMUNOASSAY TUMOR CA 125 | CPT 86304 | 30274108 | Outpatient | $150 | $38 | Payer Rates |
IMMUNOASSAY INFECTIOUS AGENT | CPT 86317 | 30274114 | Outpatient | $152 | $38 | Payer Rates |
IMMUNOASSAY INFECTIOUS AGENT | CPT 86317 | 30274135 | Outpatient | $110 | $28 | Payer Rates |
IMMUNOFIX E-PHORESIS SERUM | CPT 86334 | 30274144 | Outpatient | $162 | $41 | Payer Rates |
IMMUNFIX E-PHORSIS/URINE/CSF | CPT 86335 | 30274150 | Outpatient | $227 | $57 | Payer Rates |
MICROSOMAL ANTIBODY EACH | CPT 86376 | 30274195 | Outpatient | $105 | $26 | Payer Rates |
PARTICLE AGGLUT ANTBDY SCRN | CPT 86403 | 30274204 | Outpatient | $81 | $20 | Payer Rates |
RHEUMATOID FACTOR QUANT | CPT 86431 | 30274210 | Outpatient | $105 | $26 | Payer Rates |
SYPHILIS TEST NON-TREP QUAL | CPT 86592 | 30274216 | Outpatient | $115 | $29 | Payer Rates |
BARTONELLA ANTIBODY | CPT 86611 | 30274243 | Outpatient | $131 | $33 | Payer Rates |
COCCIDIOIDES ANTIBODY | CPT 86635 | 30274294 | Outpatient | $67 | $17 | Payer Rates |
CMV ANTIBODY | CPT 86644 | 30274303 | Outpatient | $160 | $40 | Payer Rates |
CMV ANTIBODY IGM | CPT 86645 | 30274309 | Outpatient | $160 | $40 | Payer Rates |
EPSTEIN-BARR CAPSID VCA | CPT 86665 | 30274339 | Outpatient | $152 | $38 | Payer Rates |
HERPES SIMPLEX NES ANTBDY | CPT 86694 | 30274381 | Outpatient | $147 | $37 | Payer Rates |
HISTOPLASMA ANTIBODY | CPT 86698 | 30274396 | Outpatient | $73 | $18 | Payer Rates |
HIV-1/HIV-2 1 RESULT ANTBDY | CPT 86703 | 30274402 | Outpatient | $105 | $26 | Payer Rates |
HEP B CORE ANTIBODY TOTAL | CPT 86704 | 30274405 | Outpatient | $89 | $22 | Payer Rates |
MUMPS ANTIBODY | CPT 86735 | 30274435 | Outpatient | $95 | $24 | Payer Rates |
RUBELLA ANTIBODY | CPT 86762 | 30274135 | Outpatient | $110 | $28 | Payer Rates |
RUBEOLA ANTIBODY | CPT 86765 | 30274474 | Outpatient | $93 | $23 | Payer Rates |
VARICELLA-ZOSTER ANTIBODY | CPT 86787 | 30274492 | Outpatient | $75 | $19 | Payer Rates |
WEST NILE VIRUS AB IGM | CPT 86788 | 30274498 | Outpatient | $144 | $36 | Payer Rates |
WEST NILE VIRUS ANTIBODY | CPT 86789 | 30274504 | Outpatient | $144 | $36 | Payer Rates |
HEPATITIS C AB TEST | CPT 86803 | 30274522 | Outpatient | $150 | $38 | Payer Rates |
HLA TYPING A B OR C | CPT 86812 | 30274528 | Outpatient | $187 | $47 | Payer Rates |
RBC ANTIBODY SCREEN | CPT 86850 | 30274531 | Outpatient | $125 | $31 | Payer Rates |
RBC ANTIBODY IDENTIFICATION | CPT 86870 | 30274537 | Outpatient | $301 | $75 | Payer Rates |
COOMBS TEST DIRECT | CPT 86880 | 30274558 | Outpatient | $90 | $23 | Payer Rates |
BLOOD TYPING SEROLOGIC ABO | CPT 86900 | 30274573 | Outpatient | $65 | $16 | Payer Rates |
BLOOD TYPING SEROLOGIC RH(D) | CPT 86901 | 30274579 | Outpatient | $65 | $16 | Payer Rates |
BLOOD TYPING RBC ANTIGENS | CPT 86905 | 30274597 | Outpatient | $301 | $75 | Payer Rates |
COMPATIBILITY TEST SPIN | CPT 86920 | 30274606 | Outpatient | $114 | $29 | Payer Rates |
COMPATIBILITY TEST INCUBATE | CPT 86921 | 30274609 | Outpatient | $170 | $43 | Payer Rates |
COMPATIBILITY TEST ANTIGLOB | CPT 86922 | 30274612 | Outpatient | $114 | $29 | Payer Rates |
SPECIMEN INFECT AGNT CONCNTJ | CPT 87015 | 30274627 | Outpatient | $63 | $16 | Payer Rates |
BLOOD CULTURE FOR BACTERIA | CPT 87040 | 30274630 | Outpatient | $144 | $36 | Payer Rates |
FECES CULTURE AEROBIC BACT | CPT 87045 | 30274633 | Outpatient | $161 | $40 | Payer Rates |
CULTURE OTHR SPECIMN AEROBIC | CPT 87070 | 30274651 | Outpatient | $150 | $38 | Payer Rates |
CULTR BACTERIA EXCEPT BLOOD | CPT 87075 | 30274687 | Outpatient | $138 | $35 | Payer Rates |
CULTURE AEROBIC IDENTIFY | CPT 87077 | 30274699 | Outpatient | $95 | $24 | Payer Rates |
CULTURE SCREEN ONLY | CPT 87081 | 30274978 | Outpatient | $158 | $40 | Payer Rates |
URINE CULTURE/COLONY COUNT | CPT 87086 | 30274711 | Outpatient | $150 | $38 | Payer Rates |
MYCOBACTERIA CULTURE | CPT 87116 | 30274744 | Outpatient | $218 | $55 | Payer Rates |
MACROSCOPIC EXAM PARASITE | CPT 87169 | 30278330 | Outpatient | $53 | $13 | Payer Rates |
MICROBE SUSCEPTIBLE ENZYME | CPT 87185 | 30274777 | Outpatient | $48 | $12 | Payer Rates |
MICROBE SUSCEPTIBLE MIC | CPT 87186 | 30274780 | Outpatient | $155 | $39 | Payer Rates |
SMEAR GRAM STAIN | CPT 87205 | 30274804 | Outpatient | $98 | $25 | Payer Rates |
SMEAR FLUORESCENT/ACID STAI | CPT 87206 | 30274816 | Outpatient | $103 | $26 | Payer Rates |
SMEAR WET MOUNT SALINE/INK | CPT 87210 | 30274828 | Outpatient | $53 | $13 | Payer Rates |
GIARDIA AG IA | CPT 87329 | 30274876 | Outpatient | $87 | $22 | Payer Rates |
HPYLORI STOOL AG IA | CPT 87338 | 30274882 | Outpatient | $133 | $33 | Payer Rates |
HEPATITIS B SURFACE AG IA | CPT 87340 | 30274885 | Outpatient | $120 | $30 | Payer Rates |
HISTOPLASMA CAPSUL AG IA | CPT 87385 | 30274894 | Outpatient | $67 | $17 | Payer Rates |
STREP A AG IA | CPT 87430 | 30274912 | Outpatient | $120 | $30 | Payer Rates |
CHYLMD TRACH DNA AMP PROBE | CPT 87491 | 30274924 | Outpatient | $252 | $63 | Payer Rates |
C DIFF AMPLIFIED PROBE | CPT 87493 | 30274927 | Outpatient | $252 | $63 | Payer Rates |
HEPATITIS C REVRS TRNSCRPJ | CPT 87522 | 30274948 | Outpatient | $368 | $92 | Payer Rates |
N.GONORRHOEAE DNA AMP PROB | CPT 87591 | 30274975 | Outpatient | $252 | $63 | Payer Rates |
DETECT AGENT NOS DNA AMP | CPT 87798 | 30274984 | Outpatient | $252 | $63 | Payer Rates |
INFLUENZA ASSAY W/OPTIC | CPT 87804 | 30274999 | Outpatient | $149 | $37 | Payer Rates |
RSV ASSAY W/OPTIC | CPT 87807 | 30275002 | Outpatient | $116 | $29 | Payer Rates |
AGENT NOS ASSAY W/OPTIC | CPT 87899 | 30275011 | Outpatient | $158 | $40 | Payer Rates |
BILIRUBIN TOTAL TRANSCUT | CPT 88720 | 30081846 | Outpatient | $52 | $13 | Payer Rates |
BODY FLUID CELL COUNT | CPT 89050 | 30275068 | Outpatient | $72 | $18 | Payer Rates |
BODY FLUID CELL COUNT | CPT 89051 | 30275074 | Outpatient | $127 | $32 | Payer Rates |
Language Pathology |
SPEECH SOUND LANG COMPREHEN | CPT 92523 (GN) | 30461746 | Outpatient | $508 | $127 | Payer Rates |
EVALUATE SWALLOWING FUNCTION | CPT 92610 | 30467255 | Outpatient | $234 | $59 | Payer Rates |
EVALUATE SWALLOWING FUNCTION | CPT 92610 (GN) | 30467255 | Outpatient | $234 | $59 | Payer Rates |
MOTION FLUOROSCOPY/SWALLOW | CPT 92611 (GN) | 30467258 | Outpatient | $387 | $97 | Payer Rates |
Medical and Surgical Supplies |
SCREW LOCKING 3.5X16MM | HCPCS C1713 | 30109617 | Outpatient | $451 | $113 | Payer Rates |
CATHETER INTRATHECAL | HCPCS C1755 | 3010010012 | Outpatient | $915 | $229 | Payer Rates |
BARRIER ADHESION 3X4 SM | HCPCS C1765 | 30100085 | Outpatient | $1,114 | $279 | Payer Rates |
PUMP PAIN PROMETRA II | HCPCS C1772 | 3010010008 | Outpatient | $28,365 | $7,091 | Payer Rates |
AUTOPLEX W/HV CEMENT KIT | HCPCS C1776 | 30100203 | Outpatient | $2,900 | $725 | Payer Rates |
LENS BASE CHARGE | HCPCS C1780 | 30109999 | Outpatient | $504 | $126 | Payer Rates |
MESH MACROPOROUS 11X6CM | HCPCS C1781 | 30100112 | Outpatient | $480 | $120 | Payer Rates |
PORT LOW PROFILE 8FR TITANIUM | HCPCS C1788 | 30107712 | Outpatient | $1,890 | $473 | Payer Rates |
CAPPED VERTIFLEX INTERSPINOUS | HCPCS C1821 | 30100077 | Outpatient | $36,000 | $9,000 | Payer Rates |
IPG KIT (NIPG1500) | HCPCS C1822 | 30100246 | Outpatient | $74,000 | $18,500 | Payer Rates |
KIT LEAD TRIAL (TLEAD1058-50B) | HCPCS C1897 | 30100256 | Outpatient | $3,100 | $775 | Payer Rates |
POST CHMBR INTRAOCULAR LENS | HCPCS V2632 | 30107933 | Outpatient | $504 | $126 | Payer Rates |
LENS ADD ON 1155.00 ASTIGMATIS | HCPCS V2787GY (GY) | 30109996 | Outpatient | $1,155 | $289 | Payer Rates |
LENS ADD ON 630.00 ASTIGMATISM | HCPCS V2787GY (GY) | 30109998 | Outpatient | $600 | $150 | Payer Rates |
LENS ADD ON 1050.00 PRESBYOPIA | HCPCS V2788GY (GY) | 30109997 | Outpatient | $1,100 | $275 | Payer Rates |
Other Diagnostic |
AEP SCR AUDITORY POTENTIAL | CPT 92650 | 30081831 | Outpatient | $417 | $104 | Payer Rates |
POLYSOM <6 YRS 4/> PARAMTRS | CPT 95782 | 30375782 | Outpatient | $9,850 | $2,463 | Payer Rates |
POLYSOM 6/> YRS 4/> PARAM | CPT 95810 | 30375810 | Outpatient | $9,850 | $2,463 | Payer Rates |
POLYSOM 6/>YRS CPAP 4/> PARM | CPT 95811 | 30375811 | Outpatient | $9,850 | $2,463 | Payer Rates |
Other Procedures and Observation |
INSJ PICC 5 YR+ W/O IMAGING | CPT 36569 | 30041255 | Outpatient | $2,214 | $554 | Payer Rates |
COLLECT BLOOD FROM PICC | CPT 36592 | 30041238 | Outpatient | $250 | $63 | Payer Rates |
WITHDRAWAL OF ARTERIAL BLOOD | CPT 36600 | 30031126 | Outpatient | $90 | $23 | Payer Rates |
EPIDURAL STERIOD INJECTION | CPT 62311 | 30041188 | Outpatient | $829 | $207 | Payer Rates |
EPIDURAL STERIOD INJECTION | CPT 62311 | 30041188 | Outpatient | $829 | $207 | Payer Rates |
NJX INTERLAMINAR LMBR/SAC | CPT 62322 | 30041188 | Outpatient | $829 | $207 | Payer Rates |
IRRIG DRUG DELIVERY DEVICE | CPT 96523 | 30071777 | Outpatient | $207 | $52 | Payer Rates |
OFFICE O/P EST SF 10-19 MIN | CPT 99212 | 30099212 | Outpatient | $190 | $48 | Payer Rates |
OFFICE O/P EST LOW 20-29 MIN | CPT 99213 | 30099213 | Outpatient | $235 | $59 | Payer Rates |
OFFICE O/P EST MOD 30-39 MIN | CPT 99214 | 30099214 | Outpatient | $280 | $70 | Payer Rates |
HOSPITAL OBSERVATION PER HR | HCPCS G0378 | 30061291 | Outpatient | $114 | $29 | Payer Rates |
DIRECT REFER HOSPITAL OBSERV | HCPCS G0379 | 30061294 | Outpatient | $533 | $133 | Payer Rates |
Other Therapeutic |
BLOOD TRANSFUSION SERVICE | CPT 36430 | 30041789 | Outpatient | $1,477 | $369 | Payer Rates |
CARDIAC REHAB/MONITOR | CPT 93798 | 30436991 | Outpatient | $303 | $76 | Payer Rates |
ULTRAVIOLET LIGHT THERAPY | CPT 96900 | 30081855 | Outpatient | $134 | $34 | Payer Rates |
MEDICAL NUTRITION INDIV IN | CPT 97802 | 30700001 | Outpatient | $200 | $50 | Payer Rates |
MED NUTRITION INDIV SUBSEQ | CPT 97803 | 30700002 | Outpatient | $150 | $38 | Payer Rates |
BEHAV CHNG SMOKING 3-10 MIN | CPT 99406 | 30031069 | Outpatient | $51 | $13 | Payer Rates |
PULMONARY REHAB W EXER | HCPCS G0424 | 30436916 | Outpatient | $212 | $53 | Payer Rates |
RBC LEUKOCYTES REDUCED | HCPCS P9016 | 30275221 | Outpatient | $686 | $172 | Payer Rates |
PLASMA 1 DONOR FRZ W/IN 8 HR | HCPCS P9017 | 30275227 | Outpatient | $188 | $47 | Payer Rates |
PLATELET PHERES LEUKOREDUCED | HCPCS P9035 | 30275230 | Outpatient | $1,494 | $374 | Payer Rates |
RBC LEUKOREDUCED IRRADIATED | HCPCS P9040 | 30275233 | Outpatient | $1,040 | $260 | 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 |
EVALUATION OF WHEEZING | CPT 94060 | 30031114 | Outpatient | $622 | $156 | Payer Rates |
MEASURE BLOOD OXYGEN LEVEL | CPT 94760 | 30031066 | Outpatient | $164 | $41 | Payer Rates |
MEASURE BLOOD OXYGEN LEVEL | CPT 94761 | 30031067 | Outpatient | $656 | $164 | Payer Rates |
MEASURE BLOOD OXYGEN LEVEL | CPT 94762 | 30031063 | Outpatient | $296 | $74 | Payer Rates |
CO2 BY INFRARED ANALYZER | CPT 94770 | 30031033 | Outpatient | $622 | $156 | Payer Rates |
Radiology |
X-RAY CHEST 1 VIEW | CPT 71010 | 30305668 | Outpatient | $218 | $55 | Payer Rates |
X-RAY CHEST 2 VIEWS | CPT 71020 | 30305674 | Outpatient | $291 | $73 | Payer Rates |
X-RAY EXAM CHEST 1 VIEW | CPT 71045 | 30305668 | Outpatient | $218 | $55 | Payer Rates |
X-RAY EXAM CHEST 2 VIEWS | CPT 71046 | 30305674 | Outpatient | $291 | $73 | Payer Rates |
X-RAY EXAM OF HAND | CPT 73120 (RT) | 30306616 | Outpatient | $235 | $59 | Payer Rates |
X-RAY EXAM OF HAND | CPT 73120 (RT) | 30306616 | Outpatient | $235 | $59 | Payer Rates |
X-RAY EXAM HIP UNI 1 VIEW | CPT 73501 (RT) | 30306616 | Outpatient | $235 | $59 | Payer Rates |
X-RAY EXAM HIP UNI 1 VIEW | CPT 73501 (LT) | 30306643 | Outpatient | $160 | $40 | Payer Rates |
X-RAY EXAM HIP UNI 2-3 VIEWS | CPT 73502 (RT) | 30306640 | Outpatient | $277 | $69 | Payer Rates |
HIP 2 VIEWS - RIGHT | CPT 73510 (RT) | 30306640 | Outpatient | $277 | $69 | Payer Rates |
HIP LT INTRAOPERATIVE | CPT 73530 (LT) | 30306643 | Outpatient | $160 | $40 | Payer Rates |
FEMUR LEFT 2 VIEWS | CPT 73550 (LT) | 30306649 | Outpatient | $191 | $48 | Payer Rates |
X-RAY EXAM OF FEMUR 2/> | CPT 73552 (LT) | 30306649 | Outpatient | $191 | $48 | Payer Rates |
X-RAY KUB KIDNEY-URIN BLADDER | CPT 74000 | 30305941 | Outpatient | $220 | $55 | Payer Rates |
X-RAY EXAM ABDOMEN 1 VIEW | CPT 74018 | 30305941 | Outpatient | $220 | $55 | Payer Rates |
X-RAY EXAM ABDOMEN 2 VIEWS | CPT 74019 | 30305944 | Outpatient | $324 | $81 | Payer Rates |
ABDOMEN 2 VIEWS | CPT 74020 | 30305944 | Outpatient | $324 | $81 | Payer Rates |
Respiratory |
VENT MGMT INPAT INIT DAY | CPT 94002 | 30031108 | Outpatient | $982 | $246 | Payer Rates |
VENT MGMT INPAT SUBQ DAY | CPT 94003 | 30031111 | Outpatient | $982 | $246 | Payer Rates |
AIRWAY INHALATION TREATMENT | CPT 94640 | 30031150 | Outpatient | $432 | $108 | Payer Rates |
AIRWAY INHALATION TREATMENT | CPT 94640 (76) | 30031150 | Outpatient | $432 | $108 | Payer Rates |
CBT 1ST HOUR | CPT 94644 | 30031138 | Outpatient | $346 | $87 | Payer Rates |
POS AIRWAY PRESSURE CPAP | CPT 94660 | 30031087 | Outpatient | $432 | $108 | Payer Rates |
POS AIRWAY PRESSURE CPAP | CPT 94660 (76) | 30031087 | Outpatient | $432 | $108 | Payer Rates |
EVALUATE PT USE OF INHALER | CPT 94664 | 30031135 | Outpatient | $177 | $44 | Payer Rates |
CHEST WALL MANIPULATION | CPT 94667 | 30031096 | Outpatient | $432 | $108 | Payer Rates |
CHEST WALL MANIPULATION | CPT 94668 | 30031093 | Outpatient | $138 | $35 | Payer Rates |
CHEST WALL MANIPULATION | CPT 94668 (76) | 30031093 | Outpatient | $138 | $35 | Payer Rates |
CHEST WALL MANIPULATION | CPT 94668 | 30031093 | Outpatient | $138 | $35 | Payer Rates |
THERAPEUTIC PROCD STRG ENDUR | HCPCS G0237 | 30031117 | Outpatient | $138 | $35 | Payer Rates |
Surgical Procedures |
FNA BX W/US GDN 1ST LES | CPT 10005 | 30300001 | Outpatient | $1,347 | $337 | Payer Rates |
DRAIN/INJ JOINT/BURSA W/O US | CPT 20610 | 30305359 | Outpatient | $378 | $95 | Payer Rates |
INJECTION FOR SHOULDER X-RAY | CPT 23350 | 30305371 | Outpatient | $648 | $162 | Payer Rates |
(Not Offered) REMOVAL OF TONSILS AND ADENOID GLANDS, PATIE ... | CPT 42820 | - | - | - | - | - |
(Not Offered) ULTRASOUND EXAMINATION OF LOWER LARGE BOWEL ... | CPT 45391 | - | - | - | - | - |
(Not Offered) BIOPSY OF PROSTATE GLAND | CPT 55700 | - | - | - | - | - |
(Not Offered) SURGICAL REMOVAL OF PROSTATE AND SURROUNDING ... | CPT 55866 | - | - | - | - | - |
(Not Offered) OBSTETRIC CARE, PLANNED CESAREAN DELIVERY | CPT 59510 | - | - | - | - | - |
(Not Offered) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY (PO ... | CPT 59610 | - | - | - | - | - |
INJ ANES AGNT/CATH INFUS INTER | CPT 62310 | 30181642 | Outpatient | $829 | $207 | Payer Rates |
NJX INTERLAMINAR CRV/THRC | CPT 62320 | 30181642 | Outpatient | $829 | $207 | Payer Rates |
NJX INTERLAMINAR LMBR/SAC | CPT 62323 | 30305346 | Outpatient | $1,198 | $300 | Payer Rates |
(Not Offered) REMOVAL OF RECURRING CATARACT IN LENS CAPSUL ... | CPT 66821 | - | - | - | - | - |
(Not Offered) INSERTION OF CATHETER INTO LEFT HEART FOR DI ... | CPT 93452 | - | - | - | - | - |
MOD SED SAME PHYS/QHP <5 YRS | CPT 99151 | 30113021 | Outpatient | $199 | $50 | Payer Rates |
MOD SED SAME PHYS/QHP 5/>YRS | CPT 99152 | 30113022 | Outpatient | $199 | $50 | Payer Rates |
MOD SED SAME PHYS/QHP EA | CPT 99153 | 30111021 | Outpatient | $107 | $27 | Payer Rates |
Therapy |
ELECTRIC STIMULATION THERAPY | CPT 97014 | 30467060 | Outpatient | $80 | $20 | Payer Rates |
ELECTRIC STIMULATION THERAPY | CPT 97014 | 30467060 | Outpatient | $80 | $20 | Payer Rates |
ELECTRICAL STIMULATION | CPT 97032 (GP) | 30467060 | Outpatient | $80 | $20 | Payer Rates |
ELECTRICAL STIMULATION | CPT 97032 (GP) | 30467060 | Outpatient | $80 | $20 | Payer Rates |
NEUROMUSCULAR REEDUCATION | CPT 97112 (GP) | 30467120 | Outpatient | $92 | $23 | Payer Rates |
GAIT TRAINING THERAPY | CPT 97116 (GP) | 30467123 | Outpatient | $84 | $21 | Payer Rates |
MANUAL THERAPY 1/> REGIONS | CPT 97140 (GO) | 30467444 | Outpatient | $141 | $35 | Payer Rates |
PT EVAL LOW COMPLEX 20 MIN | CPT 97161 (GP) | 30467049 | Outpatient | $202 | $51 | Payer Rates |
PT EVAL MOD COMPLEX 30 MIN | CPT 97162 (GP) | 30467052 | Outpatient | $224 | $56 | Payer Rates |
PT EVAL HIGH COMPLEX 45 MIN | CPT 97163 (GP) | 30467053 | Outpatient | $247 | $62 | Payer Rates |
OT EVAL LOW COMPLEX 30 MIN | CPT 97165 (GO) | 30467347 | Outpatient | $279 | $70 | Payer Rates |
OT EVAL MOD COMPLEX 45 MIN | CPT 97166 (GO) | 30467349 | Outpatient | $279 | $70 | Payer Rates |
OT EVAL HIGH COMPLEX 60 MIN | CPT 97167 (GO) | 30467350 | Outpatient | $279 | $70 | Payer Rates |
PT ESTIM UNATTENDED NON WOUND | HCPCS G0283GP (GP) | 30467060 | Outpatient | $80 | $20 | Payer Rates |
PT ESTIM UNATTENDED NON WOUND | HCPCS G0283GP (GP) | 30467060 | Outpatient | $80 | $20 | Payer Rates |
Uncategorized |
REMOVAL OF BREAST LESION | CPT 19120 | - | Outpatient | $2,744 | $686 | Payer Rates |
SHO ARTHRS SRG DECOMPRESSION | CPT 29826 | - | Outpatient | $4,219 | $1,055 | Payer Rates |
KNEE ARTHROSCOPY/SURGERY | CPT 29881 | - | Outpatient | $8,385 | $2,096 | Payer Rates |
EGD DIAGNOSTIC BRUSH WASH | CPT 43235 | - | Outpatient | $4,434 | $1,109 | Payer Rates |
EGD BIOPSY SINGLE/MULTIPLE | CPT 43239 | - | Outpatient | $4,087 | $1,022 | Payer Rates |
DIAGNOSTIC COLONOSCOPY | CPT 45378 | - | Outpatient | $3,811 | $953 | Payer Rates |
COLONOSCOPY AND BIOPSY | CPT 45380 | - | Outpatient | $4,087 | $1,022 | Payer Rates |
COLONOSCOPY W/LESION REMOVAL | CPT 45385 | - | Outpatient | $1,773 | $443 | Payer Rates |
LAPAROSCOPIC CHOLECYSTECTOMY | CPT 47562 | - | Outpatient | $8,259 | $2,065 | Payer Rates |
PRP I/HERN INIT REDUC >5 YR | CPT 49505 | - | Outpatient | $8,625 | $2,156 | Payer Rates |
OBSTETRICAL CARE | CPT 59400 | - | Outpatient | $5,189 | $1,297 | Payer Rates |
NJX AA&/STRD TFRM EPI L/S 1 | CPT 64483 | - | Outpatient | $2,400 | $600 | Payer Rates |
XCAPSL CTRC RMVL W/O ECP | CPT 66984 | - | Outpatient | $2,625 | $656 | Payer Rates |
CT HEAD/BRAIN W/O DYE | CPT 70450 | - | Outpatient | $2,002 | $501 | Payer Rates |
MRI BRAIN STEM W/O & W/DYE | CPT 70553 | - | Outpatient | $4,311 | $1,078 | Payer Rates |
X-RAY EXAM L-2 SPINE 4/>VWS | CPT 72110 | - | Outpatient | $600 | $150 | Payer Rates |
MRI LUMBAR SPINE W/O DYE | CPT 72148 | - | Outpatient | $2,665 | $666 | Payer Rates |
CT PELVIS W/DYE | CPT 72193 | - | Outpatient | $252 | $63 | Payer Rates |
MRI JNT OF LWR EXTRE W/O DYE | CPT 73721 | - | Outpatient | $2,583 | $646 | Payer Rates |
CT ABD & PELV W/CONTRAST | CPT 74177 | - | Outpatient | $2,525 | $631 | Payer Rates |
US EXAM ABDOM COMPLETE | CPT 76700 | - | Outpatient | $950 | $238 | Payer Rates |
OB US >= 14 WKS SNGL FETUS | CPT 76805 | - | Outpatient | $686 | $172 | Payer Rates |
TRANSVAGINAL US NON-OB | CPT 76830 | - | Outpatient | $747 | $187 | Payer Rates |
DX MAMMO INCL CAD UNI | CPT 77065 | - | Outpatient | $175 | $44 | Payer Rates |
DX MAMMO INCL CAD BI | CPT 77066 | - | Outpatient | $223 | $56 | Payer Rates |
SCR MAMMO BI INCL CAD | CPT 77067 | - | Outpatient | $134 | $34 | Payer Rates |
URINALYSIS NONAUTO W/SCOPE | CPT 81000 | - | Outpatient | $109 | $27 | Payer Rates |
IMMUNIZATION ADMIN | CPT 90471 | 30110471 | Outpatient | $141 | $35 | Payer Rates |
ELECTROCARDIOGRAM COMPLETE | CPT 93000 | - | Outpatient | $40 | $10 | Payer Rates |
THERAPEUTIC EXERCISES | CPT 97110 | - | Outpatient | $186 | $47 | Payer Rates |
OFFICE O/P NEW LOW 30-44 MIN | CPT 99203 | - | Outpatient | $282 | $71 | Payer Rates |
OFFICE O/P NEW MOD 45-59 MIN | CPT 99204 | - | Outpatient | $336 | $84 | Payer Rates |
OFFICE O/P NEW HI 60-74 MIN | CPT 99205 | - | Outpatient | $390 | $98 | Payer Rates |
OFFICE CONSULTATION | CPT 99244 | - | Outpatient | $462 | $116 | Payer Rates |
PREV VISIT NEW AGE 18-39 | CPT 99385 | - | Outpatient | $250 | $63 | Payer Rates |
PREV VISIT NEW AGE 40-64 | CPT 99386 | - | Outpatient | $250 | $63 | Payer Rates |
TRAUMA RESPONS W/HOSP CRITI | HCPCS G0390 | 30117302 | Outpatient | $2,334 | $584 | Payer Rates |
TRAUMA RESPONS W/HOSP CRITI | HCPCS G0390 | 30117302 | Outpatient | $2,334 | $584 | Payer Rates |