CT Scan |
CT HEAD/BRAIN W/O DYE | CPT 70450 | Outpatient | 2100010 | $458 | |
CT MAXILLOFACIAL W/O DYE | CPT 70486 | Outpatient | 2100085 | $607 | |
CT MAXILLOFACIAL W/DYE | CPT 70487 | Outpatient | 2100093 | $758 | |
CT SOFT TISSUE NECK W/O DYE | CPT 70490 | Outpatient | 2100119 | $607 | |
CT SOFT TISSUE NECK W/DYE | CPT 70491 | Outpatient | 2100127 | $758 | |
CT ANGIOGRAPHY HEAD | CPT 70496 | Outpatient | 2100530 | $1,011 | |
CT ANGIOGRAPHY NECK | CPT 70498 | Outpatient | 2100533 | $1,011 | |
CT THORAX DX C- | CPT 71250 | Outpatient | 2100143 | $1,011 | |
CT THORAX DX C+ | CPT 71260 | Outpatient | 2100150 | $1,264 | |
CT THORAX LUNG CANCER SCR C- | CPT 71271 | Outpatient | 2100144 | $248 | |
CT ANGIOGRAPHY CHEST | CPT 71275 | Outpatient | 2100538 | $1,264 | |
CT NECK SPINE W/O DYE | CPT 72125 | Outpatient | 2100176 | $1,460 | |
CT CHEST SPINE W/O DYE | CPT 72128 | Outpatient | 2100200 | $1,460 | |
CT LUMBAR SPINE W/O DYE | CPT 72131 | Outpatient | 2100234 | $1,460 | |
CT PELVIS W/O DYE | CPT 72192 | Outpatient | 2100412 | $809 | |
CT PELVIS W/DYE | CPT 72193 | Outpatient | 2100276 | $1,011 | |
CT UPPER EXTREMITY W/O DYE | CPT 73200 | Outpatient | 2100291 | $809 | |
CT UPPER EXTREMITY W/DYE | CPT 73201 | Outpatient | 2100309 | $1,011 | |
CT LOWER EXTREMITY W/O DYE | CPT 73700 | Outpatient | 2100325 | $809 | |
CT LOWER EXTREMITY W/DYE | CPT 73701 (RT) | Outpatient | 2100333 | $1,011 | |
CT ANGIO ABD&PELV W/O&W/DYE | CPT 74174 | Outpatient | 2100375 | $1,516 | |
CT ABD & PELVIS W/O CONTRAST | CPT 74176 | Outpatient | 2100373 | $2,091 | |
CT ABD & PELV W/CONTRAST | CPT 74177 | Outpatient | 2100372 | $2,718 | |
CT ABD & PELV 1/> REGNS | CPT 74178 | Outpatient | 2100371 | $3,533 | |
Cardiology |
CARDIOVASCULAR STRESS TEST | CPT 93017 | Outpatient | 1000025 | $995 | |
TTE W/DOPPLER COMPLETE | CPT 93306 | Outpatient | 1000700 | $2,531 | |
Clinic |
(N/O) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 30 MIN | CPT 99203 | - | - | - | - |
(N/O) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 45 MIN | CPT 99204 | - | - | - | - |
(N/O) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 60 MIN | CPT 99205 | - | - | - | - |
(N/O) PATIENT OFFICE CONSULTATION, 40 MIN | CPT 99243 | - | - | - | - |
(N/O) PATIENT OFFICE CONSULTATION, 60 MIN | CPT 99244 | - | - | - | - |
(N/O) INITIAL NEW PATIENT PREVENTATIVE MEDICINE EVALUATION ... | CPT 99385 | - | - | - | - |
(N/O) INITIAL NEW PATIENT PREVENTATIVE MEDICINE EVALUATION ... | CPT 99386 | - | - | - | - |
EEG |
(N/O) SLEEP STUDY | CPT 95810 | - | - | - | - |
EEG AWAKE AND ASLEEP | CPT 95819 | Outpatient | 1600035 | $995 | |
EKG |
(N/O) ELECTROCARDIOGRAM, ROUTINE, WITH INTERPRETATION AND ... | CPT 93000 | - | - | - | - |
ELECTROCARDIOGRAM TRACING | CPT 93005 | Outpatient | 1293005 | $168 | |
ECG MONIT/REPRT UP TO 48 HRS | CPT 93225 | Outpatient | 1000028 | $315 | |
ECG MONIT/REPRT UP TO 48 HRS | CPT 93226 | Outpatient | 1000032 | $315 | |
Emergency Room |
DRAINAGE OF SKIN ABSCESS | CPT 10060 | Outpatient | 1210060 | $338 | |
DRAINAGE OF SKIN ABSCESS | CPT 10061 | Outpatient | 1210061 | $622 | |
REMOVE FOREIGN BODY | CPT 10120 | Outpatient | 1210120 | $622 | |
PUNCTURE DRAINAGE OF LESION | CPT 10160 | Outpatient | 1210160 | $622 | |
REMOVAL OF NAIL PLATE | CPT 11730 | Outpatient | 1211730 | $338 | |
RPR S/N/AX/GEN/TRNK 2.5CM/< | CPT 12001 | Outpatient | 1212001 | $338 | |
RPR S/N/AX/GEN/TRNK2.6-7.5CM | CPT 12002 | Outpatient | 1212002 | $338 | |
RPR S/N/AX/GEN/TRK7.6-12.5CM | CPT 12004 | Outpatient | 1212004 | $338 | |
RPR F/E/E/N/L/M 2.5 CM/< | CPT 12011 | Outpatient | 1212011 | $338 | |
RPR F/E/E/N/L/M 2.6-5.0 CM | CPT 12013 | Outpatient | 1212013 | $338 | |
DRESS/DEBRID P-THICK BURN S | CPT 16020 | Outpatient | 1216020 | $338 | |
DRAIN/INJ JOINT/BURSA W/O US | CPT 20610 | Outpatient | 1220610 | $587 | |
TREAT SHOULDER DISLOCATION | CPT 23650 | Outpatient | 1223650 | $430 | |
TREAT ELBOW DISLOCATION | CPT 24640 | Outpatient | 1224640 | $430 | |
TREAT FRACTURE RADIUS/ULNA | CPT 25605 | Outpatient | 1225605 | $1,350 | |
APPLY LONG ARM SPLINT | CPT 29105 (LT) | Outpatient | 1229152 | $271 | |
APPLY FOREARM SPLINT | CPT 29125 (RT) | Outpatient | 1229125 | $210 | |
APPLICATION OF FINGER SPLINT | CPT 29130 | Outpatient | 1229130 | $168 | |
APPLICATION LONG LEG SPLINT | CPT 29505 (LT) | Outpatient | 1229514 | $271 | |
APPLICATION LOWER LEG SPLINT | CPT 29515 (LT) | Outpatient | 1229519 | $271 | |
CONTROL OF NOSEBLEED | CPT 30901 | Outpatient | 1230901 | $210 | |
INSERT EMERGENCY AIRWAY | CPT 31500 | Outpatient | 1231500 | $536 | |
INSERTION OF CHEST TUBE | CPT 32551 | Outpatient | 1232020 | $1,966 | |
INSERT NON-TUNNEL CV CATH | CPT 36556 | Outpatient | 1236556 | $1,966 | |
INSERT TEMP BLADDER CATH | CPT 51702 | Outpatient | 1251702 | $210 | |
DX LMBR SPI PNXR | CPT 62270 | Outpatient | 1262270 | $1,630 | |
NJX AA&/STRD TRIGEMINAL NRV | CPT 64400 | Outpatient | 1264400 | $489 | |
NJX AA&/STRD OTHER PN/BRANCH | CPT 64450 | Outpatient | 1264450 | $1,087 | |
CLEAR OUTER EAR CANAL | CPT 69200 | Outpatient | 1269200 | $210 | |
REMOVE IMPACTED EAR WAX UNI | CPT 69209 | Outpatient | 1269209 | $112 | |
IMMUNIZATION ADMIN | CPT 90471 | Outpatient | 1290471 | $116 | |
HEART/LUNG RESUSCITATION CPR | CPT 92950 | Outpatient | 1292950 | $498 | |
HYDRATION IV INFUSION INIT | CPT 96360 | Outpatient | 1296360 | $382 | |
HYDRATE IV INFUSION ADD-ON | CPT 96361 | Outpatient | 1296361 | $74 | |
MOD SED SAME PHYS/QHP 5/>YRS | CPT 99152 | Outpatient | 1299152 | $95 | |
EMERGENCY DEPT VISIT | CPT 99281 | Outpatient | 1297244 | $309 | |
EMERGENCY DEPT VISIT | CPT 99282 | Outpatient | 1297236 | $561 | |
EMERGENCY DEPT VISIT | CPT 99283 | Outpatient | 1297228 | $986 | |
EMERGENCY DEPT VISIT | CPT 99284 (25) | Outpatient | 1299284 | $1,600 | |
EMERGENCY DEPT VISIT | CPT 99285 (25) | Outpatient | 1299285 | $2,344 | |
CRITICAL CARE FIRST HOUR | CPT 99291 (25) | Outpatient | 1299291 | $3,301 | |
CRITICAL CARE ADDL 30 MIN | CPT 99292 | Outpatient | 1299292 | $260 | |
Imaging |
BX BREAST 1ST LESION US IMAG | CPT 19083 | Outpatient | 2203020 | $2,696 | |
US EXAM OF HEAD AND NECK | CPT 76536 | Outpatient | 2200026 | $343 | |
ULTRASOUND BREAST COMPLETE | CPT 76641 | Outpatient | 2200072 | $229 | |
ULTRASOUND BREAST LIMITED | CPT 76642 | Outpatient | 2200073 | $124 | |
US EXAM ABDOM COMPLETE | CPT 76700 | Outpatient | 2200083 | $572 | |
ECHO EXAM OF ABDOMEN | CPT 76705 | Outpatient | 2200109 | $458 | |
US ABDL AORTA SCREEN AAA | CPT 76706 | Outpatient | 2200166 | $229 | |
US EXAM ABDO BACK WALL COMP | CPT 76770 | Outpatient | 2200174 | $572 | |
US EXAM ABDO BACK WALL LIM | CPT 76775 | Outpatient | 2203016 | $458 | |
OB US < 14 WKS SINGLE FETUS | CPT 76801 | Outpatient | 2200230 | $458 | |
OB US >= 14 WKS SNGL FETUS | CPT 76805 | Outpatient | 2200232 | $344 | |
OB US LIMITED FETUS(S) | CPT 76815 | Outpatient | 1276815 | $229 | |
TRANSVAGINAL US OBSTETRIC | CPT 76817 | Outpatient | 2200229 | $458 | |
TRANSVAGINAL US NON-OB | CPT 76830 | Outpatient | 2203012 | $343 | |
US EXAM PELVIC COMPLETE | CPT 76856 | Outpatient | 2200257 | $343 | |
US EXAM SCROTUM | CPT 76870 | Outpatient | 2200349 | $229 | |
US LMTD JT/NONVASC XTR STRUX | CPT 76882 | Outpatient | 2200316 | $229 | |
US GUIDE VASCULAR ACCESS | CPT 76937 | Outpatient | 2200356 | $245 | |
ECHO GUIDE FOR BIOPSY | CPT 76942 | Outpatient | 2200401 | $852 | |
BREAST TOMOSYNTHESIS UNI | CPT 77061 | Outpatient | 1876087 | $44 | |
BREAST TOMOSYNTHESIS BI | CPT 77062 | Outpatient | 1876085 | $67 | |
BREAST TOMOSYNTHESIS BI | CPT 77063 | Outpatient | 1876084 | $44 | |
DX MAMMO INCL CAD UNI | CPT 77065 | Outpatient | 1800044 | $539 | |
DX MAMMO INCL CAD BI | CPT 77066 | Outpatient | 1800040 | $678 | |
SCR MAMMO BI INCL CAD | CPT 77067 | Outpatient | 1800049 | $583 | |
Inpatient Procedures |
(N/O) CARDIAC VALVE OR CARDIOTHORACIC PROCEDURE WITH CARDI ... | DRG 216 | - | - | - | - |
(N/O) SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | DRG 460 | - | - | - | - |
(N/O) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXT ... | DRG 470 | - | - | - | - |
(N/O) CERVICAL SPINAL FUSION WITHOUT CC OR MCC | DRG 473 | - | - | - | - |
(N/O) UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WIT ... | DRG 743 | - | - | - | - |
Laboratory |
ROUTINE VENIPUNCTURE | CPT 36415 | Outpatient | 1493377 | $24 | |
METABOLIC PANEL TOTAL CA | CPT 80048 | Outpatient | 1420992 | $84 | |
COMPREHEN METABOLIC PANEL | CPT 80053 | Outpatient | 1420950 | $104 | |
(N/O) OBSTETRIC BLOOD TEST PANEL | CPT 80055 | - | - | - | - |
LIPID PANEL | CPT 80061 | Outpatient | 1420976 | $83 | |
RENAL FUNCTION PANEL | CPT 80069 | Outpatient | 1421008 | $54 | |
ACUTE HEPATITIS PANEL | CPT 80074 (90) | Outpatient | 1401801 | $294 | |
HEPATIC FUNCTION PANEL | CPT 80076 | Outpatient | 1420968 | $50 | |
ASSAY OF DIGOXIN TOTAL | CPT 80162 | Outpatient | 1420414 | $82 | |
ASSAY DIPROPYLACETIC ACD TOT | CPT 80164 | Outpatient | 1420106 | $84 | |
DRUG SCRN QUAN LEVETIRACETAM | CPT 80177 (90) | Outpatient | 1405529 | $82 | |
ASSAY OF LITHIUM | CPT 80178 (90) | Outpatient | 1400198 | $41 | |
ASSAY OF PHENYTOIN TOTAL | CPT 80185 | Outpatient | 1420422 | $82 | |
ASSAY OF VANCOMYCIN | CPT 80202 | Outpatient | 1400061 | $84 | |
DRUG SCREEN QUANTALCOHOLS | CPT 80320 | Outpatient | 1420232 | $167 | |
URINALYSIS NONAUTO W/SCOPE | CPT 81000 | Outpatient | 1410019 | $39 | |
(N/O) URINALYSIS TEST USING MICROSCOPE | CPT 81001 | - | - | - | - |
URINALYSIS NONAUTO W/O SCOPE | CPT 81002 | Outpatient | 1492900 | $17 | |
URINALYSIS AUTO W/O SCOPE | CPT 81003 | Outpatient | 1410027 | $14 | |
URINE PREGNANCY TEST | CPT 81025 | Outpatient | 1410084 | $43 | |
ASSAY OF SERUM ALBUMIN | CPT 82040 | Outpatient | 1420224 | $31 | |
OTHER SOURCE ALBUMIN QUAN EA | CPT 82042 | Outpatient | 1420303 | $39 | |
UR ALBUMIN QUANTITATIVE | CPT 82043 (90) | Outpatient | 1400147 | $36 | |
ALPHA-FETOPROTEIN SERUM | CPT 82105 (90) | Outpatient | 1400106 | $104 | |
ASSAY OF AMMONIA | CPT 82140 | Outpatient | 1420258 | $90 | |
ASSAY OF AMYLASE | CPT 82150 | Outpatient | 1420265 | $40 | |
BILIRUBIN TOTAL | CPT 82247 | Outpatient | 1420281 | $31 | |
BILIRUBIN DIRECT | CPT 82248 | Outpatient | 1420299 | $31 | |
OCCULT BLD FECES 1-3 TESTS | CPT 82272 | Outpatient | 1410077 | $21 | |
VITAMIN D 25 HYDROXY | CPT 82306 (90) | Outpatient | 1476556 | $183 | |
CARCINOEMBRYONIC ANTIGEN | CPT 82378 (90) | Outpatient | 1400428 | $117 | |
TOTAL CORTISOL | CPT 82533 (90) | Outpatient | 1400255 | $101 | |
ASSAY OF CK (CPK) | CPT 82550 | Outpatient | 1420365 | $80 | |
CREATINE MB FRACTION | CPT 82553 | Outpatient | 1420372 | $114 | |
ASSAY OF CREATININE | CPT 82565 | Outpatient | 1420380 | $32 | |
ASSAY OF URINE CREATININE | CPT 82570 (90) | Outpatient | 1493416 | $32 | |
VITAMIN B-12 | CPT 82607 (90) | Outpatient | 1400244 | $93 | |
ASSAY OF FERRITIN | CPT 82728 | Outpatient | 1420040 | $84 | |
ASSAY OF FOLIC ACID SERUM | CPT 82746 (90) | Outpatient | 1400269 | $91 | |
BLOOD GASES ANY COMBINATION | CPT 82803 | Outpatient | 1491504 | $130 | |
GLUCOSE OTHER FLUID | CPT 82945 | Outpatient | 1420794 | $24 | |
ASSAY GLUCOSE BLOOD QUANT | CPT 82947 | Outpatient | 1420703 | $24 | |
GLYCOSYLATED HEMOGLOBIN TEST | CPT 83036 | Outpatient | 1493342 | $60 | |
IMMUNOASSAY QUANT NOS NONAB | CPT 83520 (90) | Outpatient | 1400317 | $86 | |
ASSAY OF IRON | CPT 83540 | Outpatient | 1420038 | $40 | |
IRON BINDING TEST | CPT 83550 | Outpatient | 1420039 | $54 | |
ASSAY OF LACTIC ACID | CPT 83605 | Outpatient | 1420464 | $106 | |
LACTATE (LD) (LDH) ENZYME | CPT 83615 | Outpatient | 1420472 | $37 | |
ASSAY OF LIPASE | CPT 83690 | Outpatient | 1420935 | $68 | |
ASSAY OF BLOOD LIPOPROTEIN | CPT 83721 | Outpatient | 1493343 | $59 | |
ASSAY OF MAGNESIUM | CPT 83735 | Outpatient | 1420505 | $66 | |
ASSAY OF BLOOD OSMOLALITY | CPT 83930 (90) | Outpatient | 1400463 | $41 | |
ASSAY OF URINE OSMOLALITY | CPT 83935 (90) | Outpatient | 1400464 | $42 | |
ASSAY PH BODY FLUID NOS | CPT 83986 | Outpatient | 1492710 | $22 | |
ASSAY OF PHOSPHORUS | CPT 84100 | Outpatient | 1420588 | $47 | |
ASSAY OF SERUM POTASSIUM | CPT 84132 | Outpatient | 1420604 | $28 | |
ASSAY OF PREALBUMIN | CPT 84134 (90) | Outpatient | 1404947 | $90 | |
ASSAY OF PSA TOTAL | CPT 84153 (90) | Outpatient | 1400505 | $114 | |
ASSAY OF PSA TOTAL | CPT 84153 | Outpatient | - | $114 | |
(N/O) TOTAL PROSTATE-SPECIFIC ANTIGEN (PSA) TEST | CPT 84154 | - | - | - | - |
ASSAY OF PROTEIN SERUM | CPT 84155 (90) | Outpatient | 1400218 | $23 | |
ASSAY OF PROTEIN URINE | CPT 84156 (90) | Outpatient | 1400216 | $23 | |
ASSAY OF PROTEIN OTHER | CPT 84157 | Outpatient | 1420653 | $23 | |
PROTEIN E-PHORESIS SERUM | CPT 84165 (90) | Outpatient | 1493010 | $66 | |
PROTEIN E-PHORESIS/URINE/CSF | CPT 84166 (90) | Outpatient | 1493011 | $110 | |
ASSAY OF SERUM SODIUM | CPT 84295 | Outpatient | 1420687 | $30 | |
ASSAY OF URINE SODIUM | CPT 84300 | Outpatient | 1492908 | $30 | |
ASSAY OF VITAMIN B-1 | CPT 84425 (90) | Outpatient | 1400330 | $131 | |
ASSAY OF FREE THYROXINE | CPT 84439 | Outpatient | 1420178 | $56 | |
ASSAY THYROID STIM HORMONE | CPT 84443 | Outpatient | 1420094 | $104 | |
ASSAY OF TRIGLYCERIDES | CPT 84478 | Outpatient | 1420836 | $35 | |
ASSAY TRIIODOTHYRONINE (T3) | CPT 84480 (90) | Outpatient | 1400438 | $88 | |
ASSAY OF BLOOD/URIC ACID | CPT 84550 | Outpatient | 1420869 | $28 | |
CHORIONIC GONADOTROPIN TEST | CPT 84702 | Outpatient | 1492761 | $93 | |
CHORIONIC GONADOTROPIN ASSAY | CPT 84703 | Outpatient | 1492751 | $46 | |
HEMATOCRIT | CPT 85014 | Outpatient | 1431252 | $15 | |
HEMOGLOBIN | CPT 85018 | Outpatient | 1431253 | $15 | |
COMPLETE CBC W/AUTO DIFF WBC | CPT 85025 | Outpatient | 1431031 | $96 | |
COMPLETE CBC AUTOMATED | CPT 85027 | Outpatient | 1431049 | $80 | |
MANUAL RETICULOCYTE COUNT | CPT 85044 | Outpatient | 1431163 | $27 | |
AUTOMATED PLATELET COUNT | CPT 85049 | Outpatient | 1431130 | $28 | |
FIBRIN DEGRADATION QUANT | CPT 85379 | Outpatient | 1420121 | $63 | |
PROTHROMBIN TIME | CPT 85610 | Outpatient | 1431148 | $39 | |
RBC SED RATE NONAUTOMATED | CPT 85651 | Outpatient | 1431171 | $22 | |
THROMBOPLASTIN TIME PARTIAL | CPT 85730 | Outpatient | 1431197 | $37 | |
WBC ANTIBODY IDENTIFICATION | CPT 86021 (90) | Outpatient | 1404702 | $74 | |
ANTINUCLEAR ANTIBODIES | CPT 86038 (90) | Outpatient | 1400467 | $75 | |
ANTISTREPTOLYSIN O TITER | CPT 86060 (90) | Outpatient | 1400402 | $45 | |
C-REACTIVE PROTEIN | CPT 86140 (90) | Outpatient | 1400403 | $32 | |
IMMUNOASSAY TUMOR CA 19-9 | CPT 86301 (90) | Outpatient | 1400210 | $129 | |
HETEROPHILE ANTIBODY SCREEN | CPT 86308 (90) | Outpatient | 1400694 | $32 | |
RHEUMATOID FACTOR QUANT | CPT 86431 (90) | Outpatient | 1400426 | $35 | |
SYPHILIS TEST NON-TREP QUAL | CPT 86592 (90) | Outpatient | 1400695 | $26 | |
HEP B SURFACE ANTIBODY | CPT 86706 (90) | Outpatient | 1400500 | $66 | |
MUMPS ANTIBODY | CPT 86735 (90) | Outpatient | 1400723 | $81 | |
RUBELLA ANTIBODY | CPT 86762 (90) | Outpatient | 1400427 | $89 | |
RUBEOLA ANTIBODY | CPT 86765 (90) | Outpatient | 1400722 | $80 | |
VARICELLA-ZOSTER ANTIBODY | CPT 86787 (90) | Outpatient | 1400721 | $80 | |
HEPATITIS C AB TEST | CPT 86803 (90) | Outpatient | 1400542 | $88 | |
RBC ANTIBODY SCREEN | CPT 86850 | Outpatient | 1441311 | $224 | |
BLOOD TYPING SEROLOGIC ABO | CPT 86900 | Outpatient | 1441345 | $525 | |
BLOOD TYPING SEROLOGIC RH(D) | CPT 86901 | Outpatient | 1441352 | $159 | |
BLOOD TYPE ANTIGEN DONOR EA | CPT 86902 (90) | Outpatient | 1500232 | $431 | |
COMPATIBILITY TEST SPIN | CPT 86920 | Outpatient | 1441336 | $646 | |
COMPATIBILITY TEST ANTIGLOB | CPT 86922 | Outpatient | 1441337 | $646 | |
SPECIMEN INFECT AGNT CONCNTJ | CPT 87015 (90) | Outpatient | 1493305 | $41 | |
BLOOD CULTURE FOR BACTERIA | CPT 87040 | Outpatient | 1451740 | $64 | |
FECES CULTURE AEROBIC BACT | CPT 87045 (90) | Outpatient | 1476222 | $58 | |
CULTURE OTHR SPECIMN AEROBIC | CPT 87070 (90) | Outpatient | 1487070 | $53 | |
CULTR BACTERIA EXCEPT BLOOD | CPT 87075 (90) | Outpatient | 1400621 | $58 | |
CULTURE AEROBIC IDENTIFY | CPT 87077 (90) | Outpatient | 1400639 | $50 | |
CULTURE SCREEN ONLY | CPT 87081 (90) | Outpatient | 1400617 | $41 | |
URINE CULTURE/COLONY COUNT | CPT 87086 (90) | Outpatient | 1400626 | $50 | |
URINE BACTERIA CULTURE | CPT 87088 (90) | Outpatient | 1400638 | $50 | |
MYCOBACTERIA CULTURE | CPT 87116 (90) | Outpatient | 1493207 | $67 | |
CULTURE TYPE IMMUNOLOGIC | CPT 87147 (90) | Outpatient | 1400890 | $32 | |
OVA AND PARASITES SMEARS | CPT 87177 (90) | Outpatient | 1420115 | $55 | |
MICROBE SUSCEPTIBLE MIC | CPT 87186 (90) | Outpatient | 1493021 | $53 | |
SMEAR GRAM STAIN | CPT 87205 (90) | Outpatient | 1487205 | $26 | |
SMEAR FLUORESCENT/ACID STAI | CPT 87206 (90) | Outpatient | 1400612 | $33 | |
SMEAR COMPLEX STAIN | CPT 87209 (90) | Outpatient | 1420117 | $111 | |
SMEAR WET MOUNT SALINE/INK | CPT 87210 | Outpatient | 1451724 | $29 | |
HEPATITIS B SURFACE AG IA | CPT 87340 (90) | Outpatient | 1400495 | $64 | |
HIV-1 AG W/HIV-1&2 AB AG IA | CPT 87389 (90) | Outpatient | 1475688 | $149 | |
NOS EACH ORGANISM AG IA | CPT 87449 (90) | Outpatient | 1451010 | $74 | |
CHYLMD TRACH DNA AMP PROBE | CPT 87491 (90) | Outpatient | 1400484 | $217 | |
C DIFF AMPLIFIED PROBE | CPT 87493 | Outpatient | 1487493 | $217 | |
INFLUENZA DNA AMP PROBE | CPT 87502 | Outpatient | 1404991 | $315 | |
HSV DNA AMP PROBE | CPT 87529 | Outpatient | 1406256 | $117 | |
N.GONORRHOEAE DNA AMP PROB | CPT 87591 (90) | Outpatient | 1400479 | $217 | |
STREP A DNA AMP PROBE | CPT 87651 | Outpatient | 1407651 | $117 | |
DETECT AGENT NOS DNA AMP | CPT 87798 | Outpatient | 1407798 | $117 | |
INFLUENZA ASSAY W/OPTIC | CPT 87804 | Outpatient | 1404969 | $83 | |
STREP A ASSAY W/OPTIC | CPT 87880 (QW) | Outpatient | 1451849 | $83 | |
TISSUE EXAM BY PATHOLOGIST | CPT 88304 | Outpatient | 1462135 | $224 | |
TISSUE EXAM BY PATHOLOGIST | CPT 88305 | Outpatient | 1462143 | $224 | |
BODY FLUID CELL COUNT | CPT 89051 | Outpatient | 1492785 | $34 | |
LEUKOCYTE ASSESSMENT FECAL | CPT 89055 | Outpatient | 1451726 | $26 | |
EXAM SYNOVIAL FLUID CRYSTALS | CPT 89060 | Outpatient | 1492868 | $44 | |
Language Pathology |
SPEECH/HEARING THERAPY | CPT 92507 (GN) | Outpatient | 3000020 | $91 | |
SPEECH SOUND LANG COMPREHEN | CPT 92523 (GN) | Outpatient | 3092523 | $367 | |
ORAL FUNCTION THERAPY | CPT 92526 (GN) | Outpatient | 3000040 | $284 | |
EVALUATE SWALLOWING FUNCTION | CPT 92610 (GN) | Outpatient | 3000030 | $586 | |
MOTION FLUOROSCOPY/SWALLOW | CPT 92611 (GN) | Outpatient | 3000066 | $379 | |
MRI |
(N/O) MRI SCAN | CPT 70553 | - | - | - | - |
(N/O) MRI SCAN OF LOWER SPINAL CANAL | CPT 72148 | - | - | - | - |
(N/O) MRI SCAN OF LEG JOINT | CPT 73721 | - | - | - | - |
Medical and Surgical Supplies |
SPECIAL SUPPLIES PHYS/QHP | CPT 99070 | Outpatient | 1341404 | $98 | |
STERILE WATER/SALINE, 500 ML | HCPCS A4217 | Outpatient | 1335019 | $7 | |
INFUSION SUPPLIES WITH PUMP | HCPCS A4222 | Outpatient | 1300202 | $23 | |
CATH IMPL VASC ACCESS PORTAL | HCPCS A4300 | Outpatient | 1342972 | $287 | |
CATH W/DRAINAGE 2-WAY LATEX | HCPCS A4314 | Outpatient | 1340312 | $41 | |
CATH INSERTION TRAY W/BAG | HCPCS A4354 | Outpatient | 1340313 | $27 | |
SURGICAL SUPPLIES | HCPCS A4649 | Outpatient | 1300065 | $25 | |
FOAM DRG <=16 SQ IN W/BORDER | HCPCS A6212 | Outpatient | 1305153 | $20 | |
TRANSPARENT FILM <= 16 SQ IN | HCPCS A6257 | Outpatient | 1300042 | $19 | |
BLANKET BAIR HUGGER LOWER BODY | HCPCS E0215 | Outpatient | 1302091 | $21 | |
Nuclear Medicine |
HEPATOBILIARY SYSTEM IMAGING | CPT 78226 | Outpatient | 2400322 | $1,048 | |
HEPATOBIL SYST IMAGE W/DRUG | CPT 78227 | Outpatient | 2400323 | $1,359 | |
HT MUSCLE IMAGE SPECT MULT | CPT 78452 | Outpatient | 2400943 | $3,608 | |
LUNG VENTILAT&PERFUS IMAGING | CPT 78582 | Outpatient | 2400605 | $1,359 | |
TC99M SESTAMIBI | HCPCS A9500 | Outpatient | 2401640 | $223 | |
TC99M MEDRONATE | HCPCS A9503 | Outpatient | 2401751 | $81 | |
TC99M PERTECHNETATE | HCPCS A9512 | Outpatient | 2401431 | $4 | |
TC99M MEBROFENIN | HCPCS A9537 | Outpatient | 2401763 | $84 | |
TC99M MAA | HCPCS A9540 | Outpatient | 2401758 | $119 | |
TECHNETIUM TC-99M AEROSOL | HCPCS A9567 | Outpatient | 2401761 | $91 | |
Other Diagnostic |
EXTRACRANIAL BILAT STUDY | CPT 93880 | Outpatient | 2200299 | $697 | |
LOWER EXTREMITY STUDY | CPT 93925 | Outpatient | 2200372 | $697 | |
EXTREMITY STUDY | CPT 93970 | Outpatient | 2200373 | $697 | |
EXTREMITY STUDY | CPT 93971 (LT) | Outpatient | 2200377 | $343 | |
VASCULAR STUDY | CPT 93976 | Outpatient | 2200308 | $229 | |
Other Procedures and Observation |
BL DRAW <3 YRS OTHER VEIN | CPT 36406 | Outpatient | 1400001 | $24 | |
WITHDRAWAL OF ARTERIAL BLOOD | CPT 36600 | Outpatient | 1000999 | $210 | |
Other Therapeutic |
BLOOD TRANSFUSION SERVICE | CPT 36430 | Outpatient | 1236430 | $1,126 | |
PLASMA FRESH FROZEN | CPT 86927 | Outpatient | 1441493 | $1,078 | |
THER/PROPH/DIAG IV INF INIT | CPT 96365 | Outpatient | 1296365 | $382 | |
THER/PROPH/DIAG IV INF ADDON | CPT 96366 | Outpatient | 1296366 | $191 | |
TX/PROPH/DG ADDL SEQ IV INF | CPT 96367 | Outpatient | 1296367 | $343 | |
THER/DIAG CONCURRENT INF | CPT 96368 | Outpatient | 1296368 | $343 | |
THER/PROPH/DIAG INJ SC/IM | CPT 96372 | Outpatient | 1296372 | $116 | |
THER/PROPH/DIAG INJ IV PUSH | CPT 96374 | Outpatient | 1296374 | $287 | |
TX/PRO/DX INJ NEW DRUG ADDON | CPT 96375 | Outpatient | 1296375 | $191 | |
TX/PRO/DX INJ SAME DRUG ADON | CPT 96376 | Outpatient | 1296376 | $191 | |
RBC LEUKOCYTES REDUCED | HCPCS P9016 | Outpatient | 1500019 | $294 | |
PLASMA 1 DONOR FRZ W/IN 8 HR | HCPCS P9017 | Outpatient | 1500059 | $121 | |
Psychiatric |
(N/O) PSYCHOTHERAPY, 30 MIN | CPT 90832 | - | - | - | - |
(N/O) PSYCHOTHERAPY, 45 MIN | CPT 90834 | - | - | - | - |
(N/O) PSYCHOTHERAPY, 60 MIN | CPT 90837 | - | - | - | - |
(N/O) FAMILY PSYCHOTHERAPY, NOT INCLUDING PATIENT, 50 MIN | CPT 90846 | - | - | - | - |
(N/O) FAMILY PSYCHOTHERAPY, INCLUDING PATIENT, 50 MIN | CPT 90847 | - | - | - | - |
(N/O) GROUP PSYCHOTHERAPY | CPT 90853 | - | - | - | - |
Pulmonary Function |
EVALUATION OF WHEEZING | CPT 94060 | Outpatient | 1000051 | $747 | |
MEASURE BLOOD OXYGEN LEVEL | CPT 94761 | Outpatient | 1000810 | $444 | |
Radiology |
X-RAY EXAM OF NASAL BONES | CPT 70160 | Outpatient | 1700170 | $186 | |
X-RAY EXAM OF NECK | CPT 70360 | Outpatient | 1700287 | $186 | |
X-RAY EXAM CHEST 1 VIEW | CPT 71045 | Outpatient | 1702109 | $187 | |
X-RAY EXAM CHEST 2 VIEWS | CPT 71046 | Outpatient | 1700345 | $224 | |
X-RAY EXAM RIBS UNI 2 VIEWS | CPT 71100 (RT) | Outpatient | 1700428 | $186 | |
X-RAY EXAM UNILAT RIBS/CHEST | CPT 71101 (LT) | Outpatient | 1700430 | $343 | |
X-RAY EXAM NECK SPINE 2-3 VW | CPT 72040 | Outpatient | 1700485 | $224 | |
X-RAY EXAM NECK SPINE 4/5VWS | CPT 72050 | Outpatient | 1700493 | $343 | |
X-RAY EXAM NECK SPINE 6/>VWS | CPT 72052 | Outpatient | 1700501 | $343 | |
X-RAY EXAM THORAC SPINE 2VWS | CPT 72070 | Outpatient | 1700535 | $343 | |
X-RAY EXAM THORAC SPINE 3VWS | CPT 72072 | Outpatient | 1701970 | $412 | |
X-RAY EXAM L-S SPINE 2/3 VWS | CPT 72100 | Outpatient | 1700550 | $343 | |
X-RAY EXAM L-2 SPINE 4/>VWS | CPT 72110 | Outpatient | 1700568 | $412 | |
X-RAY EXAM L-S SPINE BENDING | CPT 72114 | Outpatient | 1700576 | $412 | |
X-RAY EXAM OF PELVIS | CPT 72170 | Outpatient | 1700592 | $343 | |
X-RAY EXAM OF PELVIS | CPT 72190 | Outpatient | 1700618 | $515 | |
X-RAY EXAM SACRUM TAILBONE | CPT 72220 | Outpatient | 1700634 | $186 | |
X-RAY EXAM OF COLLAR BONE | CPT 73000 | Outpatient | 1700675 | $186 | |
X-RAY EXAM OF SHOULDER | CPT 73030 (LT) | Outpatient | 1700710 | $280 | |
X-RAY EXAM OF HUMERUS | CPT 73060 (LT) | Outpatient | 1700740 | $186 | |
X-RAY EXAM OF ELBOW | CPT 73080 (LT) | Outpatient | 1700767 | $280 | |
X-RAY EXAM OF FOREARM | CPT 73090 (RT) | Outpatient | 1700774 | $186 | |
X-RAY EXAM OF WRIST | CPT 73100 (RT) | Outpatient | 1700782 | $186 | |
X-RAY EXAM OF WRIST | CPT 73110 (LT) | Outpatient | 1700791 | $280 | |
X-RAY EXAM OF HAND | CPT 73120 (RT) | Outpatient | 1700808 | $343 | |
X-RAY EXAM OF HAND | CPT 73130 (RT) | Outpatient | 1700816 | $412 | |
X-RAY EXAM OF FINGER(S) | CPT 73140 (F5) | Outpatient | 1700824 | $186 | |
X-RAY EXAM HIP UNI 1 VIEW | CPT 73501 (RT) | Outpatient | 1700855 | $186 | |
X-RAY EXAM HIP UNI 2-3 VIEWS | CPT 73502 (RT) | Outpatient | 1700863 | $280 | |
X-RAY EXAM HIPS BI 2 VIEWS | CPT 73521 | Outpatient | 1700872 | $343 | |
X-RAY EXAM OF FEMUR 2/> | CPT 73552 (LT) | Outpatient | 1700906 | $186 | |
X-RAY EXAM OF KNEE 1 OR 2 | CPT 73560 (RT) | Outpatient | 1700915 | $186 | |
X-RAY EXAM OF KNEE 3 | CPT 73562 (LT) | Outpatient | 1700927 | $224 | |
X-RAY EXAM KNEE 4 OR MORE | CPT 73564 (RT) | Outpatient | 1700923 | $268 | |
X-RAY EXAM OF LOWER LEG | CPT 73590 (LT) | Outpatient | 1700957 | $186 | |
X-RAY EXAM OF ANKLE | CPT 73600 (RT) | Outpatient | 1700964 | $186 | |
X-RAY EXAM OF ANKLE | CPT 73610 (RT) | Outpatient | 1700972 | $280 | |
X-RAY EXAM OF FOOT | CPT 73620 (LT) | Outpatient | 1700981 | $186 | |
X-RAY EXAM OF FOOT | CPT 73630 (RT) | Outpatient | 1700998 | $280 | |
X-RAY EXAM OF HEEL | CPT 73650 (LT) | Outpatient | 1701011 | $186 | |
X-RAY EXAM OF TOE(S) | CPT 73660 (T5) | Outpatient | 1701020 | $186 | |
X-RAY EXAM ABDOMEN 1 VIEW | CPT 74018 | Outpatient | 1701053 | $186 | |
X-RAY EXAM ABDOMEN 3+ VIEWS | CPT 74021 | Outpatient | 1701079 | $343 | |
X-RAY EXAM COMPLETE ABDOMEN | CPT 74022 | Outpatient | 1702036 | $412 | |
X-RAY XM ESOPHAGUS 1CNTRST | CPT 74220 | Outpatient | 1701095 | $758 | |
X-RAY XM SWLNG FUNCJ C+ | CPT 74230 | Outpatient | 1701103 | $343 | |
X-RAY XM SM INT 1CNTRST STD | CPT 74250 | Outpatient | 1701145 | $458 | |
FLUOROSCOPY <1 HR PHYS/QHP | CPT 76000 | Outpatient | 1701699 | $697 | |
X-RAY NOSE TO RECTUM | CPT 76010 | Outpatient | 1702145 | $186 | |
FLUOROGUIDE FOR VEIN DEVICE | CPT 77001 | Outpatient | 1709991 | $304 | |
DXA BONE DENSITY AXIAL | CPT 77080 | Outpatient | 1702148 | $343 | |
Respiratory |
VENT MGMT INPAT INIT DAY | CPT 94002 | Outpatient | 1000226 | $2,073 | |
VENT MGMT INPAT SUBQ DAY | CPT 94003 | Outpatient | 1000091 | $2,073 | |
AIRWAY INHALATION TREATMENT | CPT 94640 (76) | Outpatient | 1000145 | $373 | |
CBT 1ST HOUR | CPT 94644 | Outpatient | 1000029 | $210 | |
POS AIRWAY PRESSURE CPAP | CPT 94660 | Outpatient | 1000650 | $1,118 | |
CHEST WALL MANIPULATION | CPT 94668 | Outpatient | 1000820 | $210 | |
Surgical Procedures |
(N/O) REMOVAL OF ONE OR MORE BREAST GROWTH, OPEN PROCEDURE | CPT 19120 | - | - | - | - |
(N/O) SHAVING OF SHOULDER BONE USING ENDOSCOPE | CPT 29826 | - | - | - | - |
(N/O) REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE | CPT 29881 | - | - | - | - |
ASPIRATE PLEURA W/ IMAGING | CPT 32555 | Outpatient | 2200358 | $1,225 | |
INSJ PICC RS&I 5 YR+ | CPT 36573 | Outpatient | 1700163 | $2,949 | |
(N/O) REMOVAL OF TONSILS AND ADENOID GLANDS, PATIENT YOUNG ... | CPT 42820 | - | - | - | - |
(N/O) DIAGNOSTIC EXAM OF ESOPHAGUS, STOMACH OR SMALL BOWEL ... | CPT 43235 | - | - | - | - |
EGD BIOPSY SINGLE/MULTIPLE | CPT 43239 | Outpatient | - | $439 | |
DIAGNOSTIC COLONOSCOPY | CPT 45378 | Outpatient | - | $439 | |
(N/O) BIOPSY EXAM OF LARGE BOWEL USING AN ENDOSCOPE | CPT 45380 | - | - | - | - |
COLONOSCOPY W/LESION REMOVAL | CPT 45385 | Outpatient | - | $840 | |
(N/O) ULTRASOUND EXAMINATION OF LOWER LARGE BOWEL USING AN ... | CPT 45391 | - | - | - | - |
(N/O) REMOVAL OF GALLBLADDER USING AN ENDOSCOPE | CPT 47562 | - | - | - | - |
ABD PARACENTESIS W/IMAGING | CPT 49083 | Outpatient | 2200430 | $1,487 | |
(N/O) REPAIR OF GROIN HERNIA PATIENT AGE 5 YEARS OR OLDER | CPT 49505 | - | - | - | - |
(N/O) BIOPSY OF PROSTATE GLAND | CPT 55700 | - | - | - | - |
(N/O) SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH N ... | CPT 55866 | - | - | - | - |
(N/O) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY | CPT 59400 | - | - | - | - |
(N/O) OBSTETRIC CARE, PLANNED CESAREAN DELIVERY | CPT 59510 | - | - | - | - |
(N/O) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY (POST DELIV ... | CPT 59610 | - | - | - | - |
(N/O) INJECTION(S) OF THERAPEUTIC SUBSTANCE | CPT 62322 | - | - | - | - |
(N/O) INJECTION(S) OF THERAPEUTIC SUBSTANCE | CPT 62323 | - | - | - | - |
(N/O) INJECTION(S) OF ANESTHETIC INTO LOWER SPINE USING IM ... | CPT 64483 | - | - | - | - |
(N/O) REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING ... | CPT 66821 | - | - | - | - |
(N/O) REMOVAL OF CATARACT WITH INSERTION OF LENS | CPT 66984 | - | - | - | - |
(N/O) INSERTION OF CATHETER INTO LEFT HEART FOR DIAGNOSIS | CPT 93452 | - | - | - | - |
Therapy |
THERAPEUTIC EXERCISES | CPT 97110 (GP) | Outpatient | 2801219 | $99 | |
THERAPEUTIC EXERCISES | CPT 97110 | Outpatient | - | $99 | |
NEUROMUSCULAR REEDUCATION | CPT 97112 (GP) | Outpatient | 2801227 | $114 | |
GAIT TRAINING THERAPY | CPT 97116 (GP) | Outpatient | 2801243 | $98 | |
MANUAL THERAPY 1/> REGIONS | CPT 97140 (GP) | Outpatient | 2801800 | $90 | |
PT EVAL LOW COMPLEX 20 MIN | CPT 97161 | Outpatient | 2897161 | $401 | |
PT EVAL MOD COMPLEX 30 MIN | CPT 97162 (GP) | Outpatient | 2897162 | $364 | |
PT RE-EVAL EST PLAN CARE | CPT 97164 (GP) | Outpatient | 2897164 | $186 | |
OT EVAL LOW COMPLEX 30 MIN | CPT 97165 (GO) | Outpatient | 2997165 | $296 | |
OT EVAL MOD COMPLEX 45 MIN | CPT 97166 (GO) | Outpatient | 2997166 | $296 | |
THERAPEUTIC ACTIVITIES | CPT 97530 (GP) | Outpatient | 2801235 | $134 | |
SELF CARE MNGMENT TRAINING | CPT 97535 (GO) | Outpatient | 2901010 | $113 | |
WHEELCHAIR MNGMENT TRAINING | CPT 97542 (GP) | Outpatient | 2804210 | $109 | |
ORTHOTIC MGMT&TRAING 1ST ENC | CPT 97760 (GO) | Outpatient | 2902095 | $156 | |
Uncategorized |
ADMIN INFLUENZA VIRUS VAC | HCPCS G0008 | Outpatient | 510001 | $74 | |
ADMIN PNEUMOCOCCAL VACCINE | HCPCS G0009 | Outpatient | 510002 | $74 | |