Pricing

CPT M1 Description Prices
0042T CT PERFUSION W/CONTRAST CBF 183.00
0159T 26 CAD BREAST MRI 13.00
0200T PERQ SACRAL AUGMT UNILAT INJ 1,654.00
0201T PERQ SACRAL AUGMT BILAT INJ 2,069.00
0346T ULTRASOUND ELASTOGRAPHY 93.00
0346T 26 ULTRASOUND ELASTOGRAPHY 93.00
10021 FNA W/O IMAGE 205.00
10022 FNA W/IMAGE 193.00
10022 76 FNA W/IMAGE 193.00
10030 GUIDE CATHET FLUID DRAINAGE 501.00
10030 50 GUIDE CATHET FLUID DRAINAGE 1,002.00
10035 PERQ DEV SOFT TISS 1ST IMAG 257.00
10036 PERQ DEV SOFT TISS ADD IMAG 130.00
10060 DRAINAGE OF SKIN ABSCESS 278.00
10061 DRAINAGE OF SKIN ABSCESS 517.00
10120 REMOVE FOREIGN BODY 296.00
10121 REMOVE FOREIGN BODY 539.00
10140 DRAINAGE OF HEMATOMA/FLUID 341.00
10160 PUNCTURE DRAINAGE OF LESION 276.00
10160 76 PUNCTURE DRAINAGE OF LESION 276.00
11100 BIOPSY SKIN LESION 143.00
11976 REMOVE CONTRACEPTIVE CAPSULE 276.00
11982 REMOVE DRUG IMPLANT DEVICE 295.00
12020 CLOSURE OF SPLIT WOUND 566.00
19000 DRAINAGE OF BREAST LESION 130.00
19001 DRAIN BREAST LESION ADD-ON 65.00
19001 76 DRAIN BREAST LESION ADD-ON 65.00
19020 INCISION OF BREAST LESION 885.00
19030 INJECTION FOR BREAST X-RAY 230.00
19081 BX BREAST 1ST LESION STRTCTC 504.00
19081 50 BX BREAST 1ST LESION STRTCTC 1,008.00
19082 BX BREAST ADD LESION STRTCTC 252.00
19083 BX BREAST 1ST LESION US IMAG 472.00
19083 50 BX BREAST 1ST LESION US IMAG 944.00
19084 BX BREAST ADD LESION US IMAG 236.00
19084 76 BX BREAST ADD LESION US IMAG 236.00
19085 BX BREAST 1ST LESION MR IMAG 554.00
19086 BX BREAST ADD LESION MR IMAG 274.00
19100 BX BREAST PERCUT W/O IMAGE 208.00
19102 BX BREAST PERCUT W/IMAGE 294.00
19103 BX BREAST PERCUT W/DEVICE 695.00
19103 50 BX BREAST PERCUT W/DEVICE 1,390.00
19103 52 BX BREAST PERCUT W/DEVICE 695.00
19103 76 BX BREAST PERCUT W/DEVICE 695.00
19105 CRYOSURG ABLATE FA EACH 576.00
19281 PERQ DEVICE BREAST 1ST IMAG 301.00
19282 PERQ DEVICE BREAST EA IMAG 151.00
19283 PERQ DEV BREAST 1ST STRTCTC 303.00
19284 PERQ DEV BREAST ADD STRTCTC 153.00
19285 PERQ DEV BREAST 1ST US IMAG 257.00
19285 50 PERQ DEV BREAST 1ST US IMAG 514.00
19286 PERQ DEV BREAST ADD US IMAG 130.00
19287 PERQ DEV BREAST 1ST MR GUIDE 385.00
19288 PERQ DEV BREAST ADD MR GUIDE 192.00
19290 PLACE NEEDLE WIRE BREAST 192.00
19291 PLACE NEEDLE WIRE BREAST 101.00
19295 PLACE BREAST CLIP PERCUT 101.00
19295 76 PLACE BREAST CLIP PERCUT 101.00
20000 INCISION OF ABSCESS 432.00
20200 MUSCLE BIOPSY 282.00
20205 DEEP MUSCLE BIOPSY 460.00
20206 NEEDLE BIOPSY MUSCLE 174.00
20206 76 NEEDLE BIOPSY MUSCLE 174.00
20220 BONE BIOPSY TROCAR/NEEDLE 214.00
20225 BONE BIOPSY TROCAR/NEEDLE 320.00
20500 INJECTION OF SINUS TRACT 245.00
20500 76 INJECTION OF SINUS TRACT 245.00
20501 INJECT SINUS TRACT FOR X-RAY 113.00
20520 REMOVAL OF FOREIGN BODY 422.00
20550 INJ TENDON SHEATH/LIGAMENT 123.00
20551 INJ TENDON ORIGIN/INSERTION 125.00
20600 DRAIN/INJ JOINT/BURSA W/O US 105.00
20604 DRAIN/INJ JOINT/BURSA W/US 136.00
20605 DRAIN/INJ JOINT/BURSA W/O US 110.00
20605 50 DRAIN/INJ JOINT/BURSA W/O US 220.00
20606 DRAIN/INJ JOINT/BURSA W/US 155.00
20610 DRAIN/INJ JOINT/BURSA W/O US 135.00
20610 50 DRAIN/INJ JOINT/BURSA W/O US 270.00
20610 52 DRAIN/INJ JOINT/BURSA W/O US 135.00
20611 DRAIN/INJ JOINT/BURSA W/US 181.00
20611 50 DRAIN/INJ JOINT/BURSA W/US 362.00
20612 ASPIRATE/INJ GANGLION CYST 122.00
20982 ABLATE BONE TUMOR(S) PERQ 1,133.00
20983 ABLATE BONE TUMOR(S) PERQ 1,204.00
21116 INJECTION JAW JOINT X-RAY 130.00
21501 DRAIN NECK/CHEST LESION 934.00
21550 BIOPSY OF NECK/CHEST 459.00
21925 BIOPSY SOFT TISSUE OF BACK 1,031.00
22510 PERQ CERVICOTHORACIC INJECT 1,340.00
22511 PERQ LUMBOSACRAL INJECTION 1,258.00
22512 VERTEBROPLASTY ADDL INJECT 626.00
22513 PERQ VERTEBRAL AUGMENTATION 1,595.00
22514 PERQ VERTEBRAL AUGMENTATION 1,486.00
22515 PERQ VERTEBRAL AUGMENTATION 676.00
22520 PERCUT VERTEBROPLASTY THOR 1,445.00
22521 PERCUT VERTEBROPLASTY LUMB 1,355.00
22522 PERCUT VERTEBROPLASTY ADDL 471.00
22523 PERCUT KYPHOPLASTY THOR 1,710.00
22524 PERCUT KYPHOPLASTY LUMBAR 1,639.00
22525 PERCUT KYPHOPLASTY ADD-ON 784.00
22526 IDET SINGLE LEVEL 978.00
22527 IDET 1 OR MORE LEVELS 453.00
23330 REMOVE SHOULDER FOREIGN BODY 435.00
23350 INJECTION FOR SHOULDER X-RAY 151.00
23550 TREAT CLAVICLE DISLOCATION 1,636.00
24220 INJECTION FOR ELBOW X-RAY 204.00
25246 INJECTION FOR WRIST X-RAY 223.00
27086 REMOVE HIP FOREIGN BODY 479.00
27093 INJECTION FOR HIP X-RAY 207.00
27093 50 INJECTION FOR HIP X-RAY 414.00
27093 76 INJECTION FOR HIP X-RAY 207.00
27095 INJECTION FOR HIP X-RAY 244.00
27096 INJECT SACROILIAC JOINT 248.00
27096 50 INJECT SACROILIAC JOINT 496.00
27370 INJECTION FOR KNEE X-RAY 150.00
27603 DRAIN LOWER LEG LESION 1,132.00
27648 INJECTION FOR ANKLE X-RAY 156.00
32201 DRAIN PERCUT LUNG LESION 775.00
32400 NEEDLE BIOPSY CHEST LINING 259.00
32405 PERCUT BX LUNG/MEDIASTINUM 307.00
32405 52 PERCUT BX LUNG/MEDIASTINUM 307.00
32420 PUNCTURE/CLEAR LUNG 345.00
32421 THORACENTESIS FOR ASPIRATION 219.00
32421 52 THORACENTESIS FOR ASPIRATION 219.00
32550 INSERT PLEURAL CATH 661.00
32550 50 INSERT PLEURAL CATH 1,322.00
32550 76 INSERT PLEURAL CATH 661.00
32551 INSERTION OF CHEST TUBE 507.00
32552 REMOVE LUNG CATHETER 469.00
32553 INS MARK THOR FOR RT PERQ 577.00
32555 ASPIRATE PLEURA W/ IMAGING 334.00
32555 50 ASPIRATE PLEURA W/ IMAGING 668.00
32555 52 ASPIRATE PLEURA W/ IMAGING 334.00
32555 76 ASPIRATE PLEURA W/ IMAGING 334.00
32556 INSERT CATH PLEURA W/O IMAGE 368.00
32557 INSERT CATH PLEURA W/ IMAGE 458.00
32557 50 INSERT CATH PLEURA W/ IMAGE 916.00
32557 50 INSERT CATH PLEURA W/ IMAGE 916.00
32557 52 INSERT CATH PLEURA W/ IMAGE 458.00
32557 76 INSERT CATH PLEURA W/ IMAGE 458.00
32560 TREAT PLEURODESIS W/AGENT 233.00
32561 LYSE CHEST FIBRIN INIT DAY 204.00
32998 PERQ RF ABLATE TX PUL TUMOR 847.00
33015 INCISION OF HEART SAC 1,511.00
34401 REMOVAL OF VEIN CLOT 4,384.00
34421 REMOVAL OF VEIN CLOT 2,218.00
34471 REMOVAL OF VEIN CLOT 3,299.00
34825 ENDOVASC EXTEND PROSTH INIT 2,113.00
34826 ENDOVASC EXTEN PROSTH ADDL 628.00
35286 REPAIR BLOOD VESSEL LESION 2,846.00
35471 REPAIR ARTERIAL BLOCKAGE 1,581.00
35471 50 REPAIR ARTERIAL BLOCKAGE 3,162.00
35472 REPAIR ARTERIAL BLOCKAGE 1,077.00
35475 REPAIR ARTERIAL BLOCKAGE 1,004.00
35476 REPAIR VENOUS BLOCKAGE 808.00
35476 50 REPAIR VENOUS BLOCKAGE 1,616.00
35476 50 REPAIR VENOUS BLOCKAGE 1,616.00
35476 76 REPAIR VENOUS BLOCKAGE 808.00
35875 REMOVAL OF CLOT IN GRAFT 1,811.00
36000 PLACE NEEDLE IN VEIN 126.00
36002 PSEUDOANEURYSM INJECTION TRT 318.00
36005 INJECTION EXT VENOGRAPHY 145.00
36005 50 INJECTION EXT VENOGRAPHY 290.00
36005 76 INJECTION EXT VENOGRAPHY 145.00
36010 PLACE CATHETER IN VEIN 368.00
36010 50 PLACE CATHETER IN VEIN 736.00
36011 PLACE CATHETER IN VEIN 472.00
36011 50 PLACE CATHETER IN VEIN 944.00
36011 76 PLACE CATHETER IN VEIN 472.00
36012 PLACE CATHETER IN VEIN 524.00
36012 50 PLACE CATHETER IN VEIN 1,048.00
36012 50 PLACE CATHETER IN VEIN 1,048.00
36012 76 PLACE CATHETER IN VEIN 524.00
36013 PLACE CATHETER IN ARTERY 376.00
36014 PLACE CATHETER IN ARTERY 450.00
36014 50 PLACE CATHETER IN ARTERY 900.00
36015 PLACE CATHETER IN ARTERY 515.00
36015 50 PLACE CATHETER IN ARTERY 1,030.00
36100 ESTABLISH ACCESS TO ARTERY 467.00
36120 ESTABLISH ACCESS TO ARTERY 303.00
36120 50 ESTABLISH ACCESS TO ARTERY 606.00
36140 ESTABLISH ACCESS TO ARTERY 311.00
36140 50 ESTABLISH ACCESS TO ARTERY 622.00
36140 76 ESTABLISH ACCESS TO ARTERY 311.00
36147 ACCESS AV DIAL GRFT FOR EVAL 560.00
36147 52 ACCESS AV DIAL GRFT FOR EVAL 560.00
36148 ACCESS AV DIAL GRFT FOR PROC 147.00
36148 76 ACCESS AV DIAL GRFT FOR PROC 147.00
36160 ESTABLISH ACCESS TO AORTA 371.00
36200 PLACE CATHETER IN AORTA 463.00
36215 PLACE CATHETER IN ARTERY 706.00
36215 76 PLACE CATHETER IN ARTERY 706.00
36216 PLACE CATHETER IN ARTERY 829.00
36216 76 PLACE CATHETER IN ARTERY 829.00
36217 PLACE CATHETER IN ARTERY 985.00
36217 76 PLACE CATHETER IN ARTERY 985.00
36218 PLACE CATHETER IN ARTERY 160.00
36218 76 PLACE CATHETER IN ARTERY 160.00
36221 PLACE CATH THORACIC AORTA 649.00
36223 PLACE CATH CAROTID/INOM ART 970.00
36223 50 PLACE CATH CAROTID/INOM ART 1,940.00
36223 76 PLACE CATH CAROTID/INOM ART 970.00
36224 PLACE CATH CAROTD ART 1,079.00
36224 50 PLACE CATH CAROTD ART 2,158.00
36225 PLACE CATH SUBCLAVIAN ART 956.00
36225 50 PLACE CATH SUBCLAVIAN ART 1,912.00
36226 PLACE CATH VERTEBRAL ART 1,082.00
36226 50 PLACE CATH VERTEBRAL ART 2,164.00
36227 PLACE CATH XTRNL CAROTID 342.00
36245 INS CATH ABD/L-EXT ART 1ST 760.00
36245 76 INS CATH ABD/L-EXT ART 1ST 760.00
36246 INS CATH ABD/L-EXT ART 2ND 811.00
36246 50 INS CATH ABD/L-EXT ART 2ND 1,622.00
36247 INS CATH ABD/L-EXT ART 3RD 959.00
36247 50 INS CATH ABD/L-EXT ART 3RD 1,918.00
36247 76 INS CATH ABD/L-EXT ART 3RD 959.00
36248 INS CATH ABD/L-EXT ART ADDL 149.00
36248 76 INS CATH ABD/L-EXT ART ADDL 149.00
36251 INS CATH REN ART 1ST UNILAT 847.00
36252 INS CATH REN ART 1ST BILAT 1,128.00
36253 INS CATH REN ART 2ND+ UNILAT 1,134.00
36410 NON-ROUTINE BL DRAW 3/> YRS 28.00
36473 ENDOVENOUS MCHNCHEM 1ST VEIN 518.00
36474 ENDOVENOUS MCHNCHEM ADD-ON 260.00
36476 76 ENDOVENOUS RF VEIN ADD-ON 411.00
36478 ENDOVENOUS LASER 1ST VEIN 841.00
36481 INSERTION OF CATHETER VEIN 1,043.00
36500 INSERTION OF CATHETER VEIN 546.00
36500 50 INSERTION OF CATHETER VEIN 1,092.00
36500 76 INSERTION OF CATHETER VEIN 546.00
36555 INSERT NON-TUNNEL CV CATH 354.00
36556 INSERT NON-TUNNEL CV CATH 360.00
36556 52 INSERT NON-TUNNEL CV CATH 360.00
36556 76 INSERT NON-TUNNEL CV CATH 360.00
36557 INSERT TUNNELED CV CATH 974.00
36558 INSERT TUNNELED CV CATH 822.00
36558 52 INSERT TUNNELED CV CATH 822.00
36560 INSERT TUNNELED CV CATH 1,157.00
36561 INSERT TUNNELED CV CATH 1,052.00
36561 52 INSERT TUNNELED CV CATH 1,052.00
36565 INSERT TUNNELED CV CATH 1,044.00
36566 INSERT TUNNELED CV CATH 1,146.00
36568 INSERT PICC CATH 289.00
36569 INSERT PICC CATH 272.00
36569 52 INSERT PICC CATH 272.00
36570 INSERT PICVAD CATH 920.00
36571 INSERT PICVAD CATH 959.00
36575 REPAIR TUNNELED CV CATH 105.00
36576 REPAIR TUNNELED CV CATH 587.00
36578 REPLACE TUNNELED CV CATH 640.00
36580 REPLACE CVAD CATH 199.00
36580 76 REPLACE CVAD CATH 199.00
36581 REPLACE TUNNELED CV CATH 583.00
36582 REPLACE TUNNELED CV CATH 910.00
36584 REPLACE PICC CATH 197.00
36584 52 REPLACE PICC CATH 197.00
36585 REPLACE PICVAD CATH 844.00
36589 REMOVAL TUNNELED CV CATH 407.00
36590 REMOVAL TUNNELED CV CATH 607.00
36593 DECLOT VASCULAR DEVICE 85.00
36595 MECH REMOV TUNNELED CV CATH 550.00
36595 52 MECH REMOV TUNNELED CV CATH 550.00
36596 MECH REMOV TUNNELED CV CATH 133.00
36596 52 MECH REMOV TUNNELED CV CATH 133.00
36597 REPOSITION VENOUS CATHETER 183.00
36598 INJ W/FLUOR EVAL CV DEVICE 110.00
36620 INSERTION CATHETER ARTERY 152.00
36860 EXTERNAL CANNULA DECLOTTING 326.00
36861 CANNULA DECLOTTING 397.00
36870 PERCUT THROMBECT AV FISTULA 892.00
36870 52 PERCUT THROMBECT AV FISTULA 892.00
36901 INTRO CATH DIALYSIS CIRCUIT 435.00
36902 INTRO CATH DIALYSIS CIRCUIT 647.00
36903 INTRO CATH DIALYSIS CIRCUIT 886.00
36904 THRMBC/NFS DIALYSIS CIRCUIT 1,020.00
36905 THRMBC/NFS DIALYSIS CIRCUIT 1,281.00
36906 THRMBC/NFS DIALYSIS CIRCUIT 1,495.00
36907 BALO ANGIOP CTR DIALYSIS SEG 373.00
36908 STENT PLMT CTR DIALYSIS SEG 559.00
36909 DIALYSIS CIRCUIT EMBOLJ 531.00
37182 INSERT HEPATIC SHUNT (TIPS) 2,496.00
37183 REMOVE HEPATIC SHUNT (TIPS) 1,178.00
37184 PRIM ART M-THRMBC 1ST VSL 1,388.00
37185 PRIM ART M-THRMBC SBSQ VSL 508.00
37186 SEC ART THROMBECTOMY ADD-ON 755.00
37187 VENOUS MECH THROMBECTOMY 1,229.00
37187 50 VENOUS MECH THROMBECTOMY 2,458.00
37188 VENOUS M-THROMBECTOMY ADD-ON 882.00
37188 50 VENOUS M-THROMBECTOMY ADD-ON 1,764.00
37191 INS ENDOVAS VENA CAVA FILTR 718.00
37192 REDO ENDOVAS VENA CAVA FILTR 1,109.00
37193 REM ENDOVAS VENA CAVA FILTER 1,102.00
37193 22 REM ENDOVAS VENA CAVA FILTER 1,102.00
37193 52 REM ENDOVAS VENA CAVA FILTER 1,102.00
37197 REMOVE INTRVAS FOREIGN BODY 953.00
37200 TRANSCATHETER BIOPSY 659.00
37201 TRANSCATHETER THERAPY INFUSE 1,445.00
37202 TRANSCATHETER THERAPY INFUSE 1,131.00
37203 TRANSCATHETER RETRIEVAL 1,006.00
37203 52 TRANSCATHETER RETRIEVAL 1,006.00
37204 TRANSCATHETER OCCLUSION 3,613.00
37204 76 TRANSCATHETER OCCLUSION 3,613.00
37205 TRANSCATH IV STENT PERCUT 1,495.00
37206 TRANSCATH IV STENT/PERC ADDL 747.00
37206 76 TRANSCATH IV STENT/PERC ADDL 747.00
37207 TRANSCATH IV STENT OPEN 1,377.00
37209 CHANGE IV CATH AT THROMB TX 397.00
37210 EMBOLIZATION UTERINE FIBROID 2,625.00
37211 THROMBOLYTIC ART THERAPY 1,207.00
37211 50 THROMBOLYTIC ART THERAPY 2,414.00
37211 76 THROMBOLYTIC ART THERAPY 1,207.00
37212 THROMBOLYTIC VENOUS THERAPY 1,061.00
37212 50 THROMBOLYTIC VENOUS THERAPY 2,122.00
37212 76 THROMBOLYTIC VENOUS THERAPY 1,061.00
37213 THROMBLYTIC ART/VEN THERAPY 745.00
37213 50 THROMBLYTIC ART/VEN THERAPY 1,490.00
37213 76 THROMBLYTIC ART/VEN THERAPY 745.00
37214 CESSJ THERAPY CATH REMOVAL 409.00
37214 50 CESSJ THERAPY CATH REMOVAL 818.00
37214 76 CESSJ THERAPY CATH REMOVAL 409.00
37215 TRANSCATH STENT CCA W/EPS 3,024.00
37216 TRANSCATH STENT CCA W/O EPS 3,214.00
37218 STENT PLACEMT ANTE CAROTID 2,473.00
37220 ILIAC REVASC 1,262.00
37221 ILIAC REVASC W/STENT 1,551.00
37222 ILIAC REVASC ADD-ON 570.00
37223 ILIAC REVASC W/STENT ADD-ON 653.00
37224 FEM/POPL REVAS W/TLA 1,389.00
37225 FEM/POPL REVAS W/ATHER 1,882.00
37226 FEM/POPL REVASC W/STENT 1,632.00
37227 FEM/POPL REVASC STNT & ATHER 2,264.00
37228 TIB/PER REVASC W/TLA 1,697.00
37229 TIB/PER REVASC W/ATHER 2,196.00
37230 TIB/PER REVASC W/STENT 2,162.00
37231 TIB/PER REVASC STENT & ATHER 2,352.00
37232 TIB/PER REVASC ADD-ON 617.00
37233 TIBPER REVASC W/ATHER ADD-ON 1,004.00
37234 REVSC OPN/PRQ TIB/PERO STENT 864.00
37235 TIB/PER REVASC STNT & ATHER 1,228.00
37236 OPEN/PERQ PLACE STENT 1ST 1,372.00
37237 OPEN/PERQ PLACE STENT EA ADD 648.00
37238 OPEN/PERQ PLACE STENT SAME 950.00
37238 50 OPEN/PERQ PLACE STENT SAME 1,900.00
37239 OPEN/PERQ PLACE STENT EA ADD 453.00
37241 VASC EMBOLIZE/OCCLUDE VENOUS 1,361.00
37242 VASC EMBOLIZE/OCCLUDE ARTERY 1,488.00
37243 VASC EMBOLIZE/OCCLUDE ORGAN 1,756.00
37244 VASC EMBOLIZE/OCCLUDE BLEED 2,055.00
37246 TRLUML BALO ANGIOP 1ST ART 1,063.00
37247 TRLUML BALO ANGIOP ADDL ART 527.00
37248 TRLUML BALO ANGIOP 1ST VEIN 914.00
37249 TRLUML BALO ANGIOP ADDL VEIN 449.00
37250 IV US FIRST VESSEL ADD-ON 354.00
37251 IV US EACH ADD VESSEL ADD-ON 270.00
37252 INTRVASC US NONCORONARY 1ST 279.00
37253 INTRVASC US NONCORONARY ADDL 223.00
37620 REVISION OF MAJOR VEIN 2,109.00
38200 INJECTION FOR SPLEEN X-RAY 349.00
38220 BONE MARROW ASPIRATION 181.00
38221 BONE MARROW BIOPSY 220.00
38221 50 BONE MARROW BIOPSY 440.00
38505 NEEDLE BIOPSY LYMPH NODES 209.00
38505 50 NEEDLE BIOPSY LYMPH NODES 418.00
38505 76 NEEDLE BIOPSY LYMPH NODES 209.00
38790 INJECT FOR LYMPHATIC X-RAY 244.00
38792 RA TRACER ID OF SENTINL NODE 116.00
38792 50 RA TRACER ID OF SENTINL NODE 232.00
40800 DRAINAGE OF MOUTH LESION 385.00
41019 PLACE NEEDLES H&N FOR RT 1,386.00
42400 BIOPSY OF SALIVARY GLAND 162.00
42550 INJECTION FOR SALIVARY X-RAY 188.00
42660 DILATION OF SALIVARY DUCT 264.00
42806 BIOPSY OF UPPER NOSE/THROAT 387.00
43456 DILATE ESOPHAGUS 438.00
43752 NASAL/OROGASTRIC W/TUBE PLMT 121.00
43752 52 NASAL/OROGASTRIC W/TUBE PLMT 121.00
43760 CHANGE GASTROSTOMY TUBE 140.00
43761 REPOSITION GASTROSTOMY TUBE 305.00
44015 INSERT NEEDLE CATH BOWEL 427.00
44373 SMALL BOWEL ENDOSCOPY 593.00
44500 INTRO GASTROINTESTINAL TUBE 73.00
44901 DRAIN APP ABSCESS PERCUT 516.00
45100 BIOPSY OF RECTUM 874.00
45303 PROCTOSIGMOIDOSCOPY DILATE 273.00
47000 NEEDLE BIOPSY OF LIVER 305.00
47000 52 NEEDLE BIOPSY OF LIVER 305.00
47000 76 NEEDLE BIOPSY OF LIVER 305.00
47001 NEEDLE BIOPSY LIVER ADD-ON 311.00
47011 PERCUT DRAIN LIVER LESION 718.00
47011 52 PERCUT DRAIN LIVER LESION 718.00
47015 INJECT/ASPIRATE LIVER CYST 3,391.00
47382 PERCUT ABLATE LIVER RF 2,296.00
47383 PERQ ABLTJ LVR CRYOABLATION 1,459.00
47490 INCISION OF GALLBLADDER 970.00
47500 INJECTION FOR LIVER X-RAYS 391.00
47500 76 INJECTION FOR LIVER X-RAYS 391.00
47505 INJECTION FOR LIVER X-RAYS 261.00
47505 52 INJECTION FOR LIVER X-RAYS 261.00
47510 INSERT CATHETER BILE DUCT 1,132.00
47511 INSERT BILE DUCT DRAIN 1,405.00
47511 76 INSERT BILE DUCT DRAIN 1,405.00
47525 CHANGE BILE DUCT CATHETER 772.00
47530 REVISE/REINSERT BILE TUBE 768.00
47531 INJECTION FOR CHOLANGIOGRAM 285.00
47532 INJECTION FOR CHOLANGIOGRAM 645.00
47533 PLMT BILIARY DRAINAGE CATH 913.00
47534 PLMT BILIARY DRAINAGE CATH 1,212.00
47535 CONVERSION EXT BIL DRG CATH 697.00
47536 EXCHANGE BILIARY DRG CATH 439.00
47537 REMOVAL BILIARY DRG CATH 296.00
47538 PERQ PLMT BILE DUCT STENT 982.00
47539 PERQ PLMT BILE DUCT STENT 1,328.00
47540 PERQ PLMT BILE DUCT STENT 1,586.00
47541 PLMT ACCESS BIL TREE SM BWL 844.00
47542 DILATE BILIARY DUCT/AMPULLA 400.00
47543 ENDOLUMINAL BX BILIARY TREE 503.00
47544 REMOVAL DUCT GLBLDR CALCULI 644.00
47552 BILIARY ENDO PERQ DX W/SPECI 928.00
47553 BILIARY ENDOSCOPY THRU SKIN 919.00
47555 BILIARY ENDOSCOPY THRU SKIN 1,100.00
47555 76 BILIARY ENDOSCOPY THRU SKIN 1,100.00
47556 BILIARY ENDOSCOPY THRU SKIN 1,251.00
47630 REMOVE BILE DUCT STONE 1,344.00
47801 PLACEMENT BILE DUCT SUPPORT 2,958.00
48102 NEEDLE BIOPSY PANCREAS 722.00
48511 DRAIN PANCREATIC PSEUDOCYST 775.00
49021 DRAIN ABDOMINAL ABSCESS 841.00
49021 76 DRAIN ABDOMINAL ABSCESS 841.00
49041 DRAIN PERCUT ABDOM ABSCESS 775.00
49061 DRAIN PERCUT RETROPER ABSC 718.00
49080 PUNCTURE PERITONEAL CAVITY 246.00
49081 REMOVAL OF ABDOMINAL FLUID 225.00
49082 ABD PARACENTESIS 219.00
49083 ABD PARACENTESIS W/IMAGING 322.00
49083 76 ABD PARACENTESIS W/IMAGING 322.00
49180 BIOPSY ABDOMINAL MASS 255.00
49185 SCLEROTX FLUID COLLECTION 366.00
49400 AIR INJECTION INTO ABDOMEN 280.00
49405 IMAGE CATH FLUID COLXN VISC 631.00
49406 IMAGE CATH FLUID PERI/RETRO 631.00
49407 IMAGE CATH FLUID TRNS/VGNL 678.00
49411 INS MARK ABD/PEL FOR RT PERQ 588.00
49418 INSERT TUN IP CATH PERC 651.00
49419 INSERT TUN IP CATH W/PORT 1,313.00
49422 REMOVE TUNNELED IP CATH 1,129.00
49423 EXCHANGE DRAINAGE CATHETER 215.00
49424 ASSESS CYST CONTRAST INJECT 114.00
49424 76 ASSESS CYST CONTRAST INJECT 114.00
49427 INJECTION ABDOMINAL SHUNT 138.00
49440 PLACE GASTROSTOMY TUBE PERC 659.00
49441 PLACE DUOD/JEJ TUBE PERC 764.00
49446 CHANGE G-TUBE TO G-J PERC 486.00
49450 REPLACE G/C TUBE PERC 201.00
49451 REPLACE DUOD/JEJ TUBE PERC 272.00
49452 REPLACE G-J TUBE PERC 418.00
49460 FIX G/COLON TUBE W/DEVICE 144.00
49465 FLUORO EXAM OF G/COLON TUBE 93.00
50021 RENAL ABSCESS PERCUT DRAIN 1,362.00
50200 RENAL BIOPSY PERQ 421.00
50200 50 RENAL BIOPSY PERQ 842.00
50200 76 RENAL BIOPSY PERQ 421.00
50382 CHANGE URETER STENT PERCUT 807.00
50384 REMOVE URETER STENT PERCUT 733.00
50385 CHANGE STENT VIA TRANSURETH 689.00
50386 REMOVE STENT VIA TRANSURETH 523.00
50387 CHANGE NEPHROURETERAL CATH 290.00
50389 REMOVE RENAL TUBE W/FLUORO 162.00
50389 50 REMOVE RENAL TUBE W/FLUORO 324.00
50390 DRAINAGE OF KIDNEY LESION 288.00
50390 50 DRAINAGE OF KIDNEY LESION 576.00
50392 INSERT KIDNEY DRAIN 1,758.00
50392 50 INSERT KIDNEY DRAIN 3,516.00
50392 52 INSERT KIDNEY DRAIN 1,758.00
50393 INSERT URETERAL TUBE 2,188.00
50393 50 INSERT URETERAL TUBE 4,376.00
50394 INJECTION FOR KIDNEY X-RAY 424.00
50394 50 INJECTION FOR KIDNEY X-RAY 848.00
50395 CREATE PASSAGE TO KIDNEY 530.00
50398 CHANGE KIDNEY TUBE 466.00
50398 50 CHANGE KIDNEY TUBE 932.00
50430 NJX PX NFROSGRM &/URTRGRM 496.00
50431 NJX PX NFROSGRM &/URTRGRM 195.00
50431 50 NJX PX NFROSGRM &/URTRGRM 390.00
50432 PLMT NEPHROSTOMY CATHETER 657.00
50432 50 PLMT NEPHROSTOMY CATHETER 1,314.00
50433 PLMT NEPHROURETERAL CATHETER 810.00
50434 CONVERT NEPHROSTOMY CATHETER 621.00
50435 EXCHANGE NEPHROSTOMY CATH 300.00
50435 50 EXCHANGE NEPHROSTOMY CATH 600.00
50592 PERC RF ABLATE RENAL TUMOR 1,072.00
50593 PERC CRYO ABLATE RENAL TUM 1,422.00
50606 ENDOLUMINAL BX URTR RNL PLVS 470.00
50684 INJECTION FOR URETER X-RAY 147.00
50688 CHANGE OF URETER TUBE/STENT 233.00
50690 INJECTION FOR URETER X-RAY 207.00
50690 52 INJECTION FOR URETER X-RAY 207.00
50693 PLMT URETERAL STENT PRQ 649.00
50693 50 PLMT URETERAL STENT PRQ 1,298.00
50694 PLMT URETERAL STENT PRQ 840.00
50695 PLMT URETERAL STENT PRQ 1,066.00
50695 50 PLMT URETERAL STENT PRQ 2,132.00
50705 URETERAL EMBOLIZATION/OCCL 601.00
50706 BALLOON DILATE URTRL STRIX 559.00
51100 DRAIN BLADDER BY NEEDLE 116.00
51101 DRAIN BLADDER BY TROCAR/CATH 154.00
51102 DRAIN BL W/CATH INSERTION 428.00
51600 INJECTION FOR BLADDER X-RAY 132.00
51600 52 INJECTION FOR BLADDER X-RAY 132.00
51610 INJECTION FOR BLADDER X-RAY 188.00
51701 INSERT BLADDER CATHETER 82.00
51702 INSERT TEMP BLADDER CATH 89.00
51705 CHANGE OF BLADDER TUBE 152.00
51710 CHANGE OF BLADDER TUBE 235.00
54235 PENILE INJECTION 215.00
55000 DRAINAGE OF HYDROCELE 250.00
55700 BIOPSY OF PROSTATE 411.00
55876 PLACE RT DEVICE/MARKER PROS 295.00
58340 CATHETER FOR HYSTEROGRAPHY 168.00
58340 52 CATHETER FOR HYSTEROGRAPHY 168.00
58345 REOPEN FALLOPIAN TUBE 788.00
60100 BIOPSY OF THYROID 234.00
60100 76 BIOPSY OF THYROID 234.00
60300 ASPIR/INJ THYROID CYST 148.00
61055 INJECTION INTO BRAIN CANAL 357.00
61070 BRAIN CANAL SHUNT PROCEDURE 170.00
61623 ENDOVASC TEMPORY VESSEL OCCL 1,702.00
61624 TRANSCATH OCCLUSION CNS 3,421.00
61626 TRANSCATH OCCLUSION NON-CNS 2,573.00
61645 PERQ ART M-THROMBECT &/NFS 2,331.00
61650 EVASC PRLNG ADMN RX AGNT 1ST 1,553.00
61651 EVASC PRLNG ADMN RX AGNT ADD 660.00
62267 INTERDISCAL PERQ ASPIR DX 472.00
62267 76 INTERDISCAL PERQ ASPIR DX 472.00
62270 SPINAL FLUID TAP DIAGNOSTIC 230.00
62272 DRAIN CEREBRO SPINAL FLUID 247.00
62284 INJECTION FOR MYELOGRAM 254.00
62287 PERCUTANEOUS DISKECTOMY 1,664.00
62290 INJECT FOR SPINE DISK X-RAY 508.00
62290 76 INJECT FOR SPINE DISK X-RAY 508.00
62291 INJECT FOR SPINE DISK X-RAY 502.00
62302 MYELOGRAPHY LUMBAR INJECTION 363.00
62303 MYELOGRAPHY LUMBAR INJECTION 368.00
62304 MYELOGRAPHY LUMBAR INJECTION 357.00
62305 MYELOGRAPHY LUMBAR INJECTION 373.00
62310 INJECT SPINE CERV/THORACIC 319.00
62311 INJECT SPINE LUMBAR/SACRAL 263.00
62311 76 INJECT SPINE LUMBAR/SACRAL 263.00
62320 NJX INTERLAMINAR CRV/THRC 301.00
62321 NJX INTERLAMINAR CRV/THRC 325.00
62322 NJX INTERLAMINAR LMBR/SAC 259.00
62323 NJX INTERLAMINAR LMBR/SAC 296.00
62324 NJX INTERLAMINAR CRV/THRC 277.00
62325 NJX INTERLAMINAR CRV/THRC 319.00
62326 NJX INTERLAMINAR LMBR/SAC 271.00
62327 NJX INTERLAMINAR LMBR/SAC 289.00
63600 REMOVE SPINAL CORD LESION 2,667.00
64400 N BLOCK INJ TRIGEMINAL 208.00
64461 PVB THORACIC SINGLE INJ SITE 256.00
64462 PVB THORACIC 2ND+ INJ SITE 162.00
64463 PVB THORACIC CONT INFUSION 249.00
64483 INJ FORAMEN EPIDURAL L/S 331.00
64483 50 INJ FORAMEN EPIDURAL L/S 662.00
64490 INJ PARAVERT F JNT C/T 1 LEV 313.00
64493 INJ PARAVERT F JNT L/S 1 LEV 268.00
64493 50 INJ PARAVERT F JNT L/S 1 LEV 536.00
68850 INJECTION FOR TEAR SAC X-RAY 161.00
70010 26 CONTRAST X-RAY OF BRAIN 180.00
70030 26 X-RAY EYE FOR FOREIGN BODY 25.00
70030 26 X-RAY EYE FOR FOREIGN BODY 25.00
70100 26 X-RAY EXAM OF JAW <4VIEWS 27.00
70110 26 X-RAY EXAM OF JAW 4/> VIEWS 37.00
70110 26 X-RAY EXAM OF JAW 4/> VIEWS 37.00
70120 26 X-RAY EXAM OF MASTOIDS 27.00
70130 26 X-RAY EXAM OF MASTOIDS 50.00
70134 26 X-RAY EXAM OF MIDDLE EAR 51.00
70140 26 X-RAY EXAM OF FACIAL BONES 31.00
70150 26 X-RAY EXAM OF FACIAL BONES 39.00
70160 26 X-RAY EXAM OF NASAL BONES 26.00
70160 26 X-RAY EXAM OF NASAL BONES 26.00
70170 26 X-RAY EXAM OF TEAR DUCT 44.00
70190 26 X-RAY EXAM OF EYE SOCKETS 33.00
70200 26 X-RAY EXAM OF EYE SOCKETS 41.00
70200 26 X-RAY EXAM OF EYE SOCKETS 41.00
70210 26 X-RAY EXAM OF SINUSES 26.00
70220 26 X-RAY EXAM OF SINUSES 37.00
70240 26 X-RAY EXAM PITUITARY SADDLE 29.00
70250 26 X-RAY EXAM OF SKULL 37.00
70250 26 X-RAY EXAM OF SKULL 37.00
70260 26 X-RAY EXAM OF SKULL 51.00
70328 26 X-RAY EXAM OF JAW JOINT 27.00
70330 26 X-RAY EXAM OF JAW JOINTS 37.00
70332 26 X-RAY EXAM OF JAW JOINT 91.00
70336 26 MAGNETIC IMAGE JAW JOINT 216.00
70355 26 PANORAMIC X-RAY OF JAWS 33.00
70360 26 X-RAY EXAM OF NECK 25.00
70370 26 THROAT X-RAY & FLUOROSCOPY 47.00
70371 26 SPEECH EVALUATION COMPLEX 125.00
70380 26 X-RAY EXAM OF SALIVARY GLAND 27.00
70390 26 X-RAY EXAM OF SALIVARY DUCT 55.00
70450 26 CT HEAD/BRAIN W/O DYE 125.00
70450 26 CT HEAD/BRAIN W/O DYE 125.00
70460 26 CT HEAD/BRAIN W/DYE 165.00
70470 26 CT HEAD/BRAIN W/O & W/DYE 187.00
70480 26 CT ORBIT/EAR/FOSSA W/O DYE 188.00
70481 26 CT ORBIT/EAR/FOSSA W/DYE 202.00
70482 26 CT ORBIT/EAR/FOSSA W/O&W/DYE 212.00
70486 26 CT MAXILLOFACIAL W/O DYE 125.00
70486 26 CT MAXILLOFACIAL W/O DYE 125.00
70487 26 CT MAXILLOFACIAL W/DYE 165.00
70488 26 CT MAXILLOFACIAL W/O & W/DYE 186.00
70490 26 CT SOFT TISSUE NECK W/O DYE 188.00
70491 26 CT SOFT TISSUE NECK W/DYE 203.00
70492 26 CT SFT TSUE NCK W/O & W/DYE 213.00
70496 26 CT ANGIOGRAPHY HEAD 256.00
70498 26 CT ANGIOGRAPHY NECK 256.00
70540 26 MRI ORBIT/FACE/NECK W/O DYE 197.00
70542 26 MRI ORBIT/FACE/NECK W/DYE 237.00
70543 26 MRI ORBT/FAC/NCK W/O & W/DYE 314.00
70543 26 MRI ORBT/FAC/NCK W/O & W/DYE 314.00
70544 26 MR ANGIOGRAPHY HEAD W/O DYE 177.00
70544 26 MR ANGIOGRAPHY HEAD W/O DYE 177.00
70545 26 MR ANGIOGRAPHY HEAD W/DYE 176.00
70546 26 MR ANGIOGRAPH HEAD W/O&W/DYE 264.00
70547 26 MR ANGIOGRAPHY NECK W/O DYE 177.00
70548 26 MR ANGIOGRAPHY NECK W/DYE 177.00
70549 26 MR ANGIOGRAPH NECK W/O&W/DYE 264.00
70551 26 MRI BRAIN STEM W/O DYE 217.00
70552 26 MRI BRAIN STEM W/DYE 261.00
70553 26 MRI BRAIN STEM W/O & W/DYE 336.00
70554 26 FMRI BRAIN BY TECH 311.00
70555 26 FMRI BRAIN BY PHYS/PSYCH 370.00
71010 26 CHEST X-RAY 1 VIEW FRONTAL 27.00
71010 26 CHEST X-RAY 1 VIEW FRONTAL 27.00
71010 26 CHEST X-RAY 1 VIEW FRONTAL 27.00
71020 26 CHEST X-RAY 2VW FRONTAL&LATL 32.00
71020 26 CHEST X-RAY 2VW FRONTAL&LATL 32.00
71020 26 CHEST X-RAY 2VW FRONTAL&LATL 32.00
71021 26 CHEST X-RAY FRNT LAT LORDOTC 40.00
71022 26 CHEST X-RAY FRNT LAT OBLIQUE 48.00
71022 26 CHEST X-RAY FRNT LAT OBLIQUE 48.00
71023 26 CHEST X-RAY AND FLUOROSCOPY 55.00
71030 26 CHEST X-RAY 4/> VIEWS 46.00
71030 26 CHEST X-RAY 4/> VIEWS 46.00
71034 26 CHEST X-RAY&FLUORO 4/> VIEWS 69.00
71035 26 CHEST X-RAY SPECIAL VIEWS 27.00
71035 26 CHEST X-RAY SPECIAL VIEWS 27.00
71040 26 CONTRAST X-RAY OF BRONCHI 96.00
71060 26 CONTRAST X-RAY OF BRONCHI 120.00
71090 26 X-RAY & PACEMAKER INSERTION 88.00
71090 26 X-RAY & PACEMAKER INSERTION 88.00
71100 26 X-RAY EXAM RIBS UNI 2 VIEWS 33.00
71101 26 X-RAY EXAM UNILAT RIBS/CHEST 40.00
71110 26 X-RAY EXAM RIBS BIL 3 VIEWS 40.00
71111 26 X-RAY EXAM RIBS/CHEST4/> VWS 48.00
71120 26 X-RAY EXAM BREASTBONE 2/>VWS 30.00
71130 26 X-RAY STRENOCLAVIC JT 3/>VWS 33.00
71250 26 CT THORAX W/O DYE 150.00
71260 26 CT THORAX W/DYE 183.00
71270 26 CT THORAX W/O & W/DYE 202.00
71275 26 CT ANGIOGRAPHY CHEST 266.00
71275 26 CT ANGIOGRAPHY CHEST 266.00
71550 26 MRI CHEST W/O DYE 214.00
71551 26 MRI CHEST W/DYE 253.00
71552 26 MRI CHEST W/O & W/DYE 332.00
71555 26 MRI ANGIO CHEST W OR W/O DYE 262.00
72010 26 X-RAY EXAM SPINE AP&LAT 71.00
72020 26 X-RAY EXAM OF SPINE 1 VIEW 23.00
72020 26 X-RAY EXAM OF SPINE 1 VIEW 23.00
72040 26 X-RAY EXAM NECK SPINE 2-3 VW 33.00
72040 26 X-RAY EXAM NECK SPINE 2-3 VW 33.00
72050 26 X-RAY EXAM NECK SPINE 4/5VWS 46.00
72052 26 X-RAY EXAM NECK SPINE 6/>VWS 53.00
72069 26 X-RAY EXAM TRUNK SPINE STAND 36.00
72069 26 X-RAY EXAM TRUNK SPINE STAND 36.00
72070 26 X-RAY EXAM THORAC SPINE 2VWS 33.00
72072 26 X-RAY EXAM THORAC SPINE 3VWS 32.00
72074 26 X-RAY EXAM THORAC SPINE4/>VW 32.00
72080 26 X-RAY EXAM THORACOLMB 2/> VW 32.00
72080 26 X-RAY EXAM THORACOLMB 2/> VW 32.00
72081 26 X-RAY EXAM ENTIRE SPI 1 VW 39.00
72082 26 X-RAY EXAM ENTIRE SPI 2/3 VW 47.00
72083 26 X-RAY EXAM ENTIRE SPI 4/5 VW 51.00
72084 26 X-RAY EXAM ENTIRE SPI 6/> VW 60.00
72090 26 X-RAY EXAM SCLOIOSIS ERECT 46.00
72090 26 X-RAY EXAM SCLOIOSIS ERECT 46.00
72100 26 X-RAY EXAM L-S SPINE 2/3 VWS 33.00
72100 26 X-RAY EXAM L-S SPINE 2/3 VWS 33.00
72110 26 X-RAY EXAM L-2 SPINE 4/>VWS 46.00
72114 26 X-RAY EXAM L-S SPINE BENDING 48.00
72120 26 X-RAY BEND ONLY L-S SPINE 33.00
72125 26 CT NECK SPINE W/O DYE 157.00
72125 26 CT NECK SPINE W/O DYE 157.00
72125 26 CT NECK SPINE W/O DYE 157.00
72126 26 CT NECK SPINE W/DYE 179.00
72127 26 CT NECK SPINE W/O & W/DYE 186.00
72128 26 CT CHEST SPINE W/O DYE 147.00
72128 26 CT CHEST SPINE W/O DYE 147.00
72129 26 CT CHEST SPINE W/DYE 179.00
72130 26 CT CHEST SPINE W/O & W/DYE 186.00
72131 26 CT LUMBAR SPINE W/O DYE 147.00
72131 26 CT LUMBAR SPINE W/O DYE 147.00
72132 26 CT LUMBAR SPINE W/DYE 179.00
72132 26 CT LUMBAR SPINE W/DYE 179.00
72133 26 CT LUMBAR SPINE W/O & W/DYE 186.00
72141 26 MRI NECK SPINE W/O DYE 218.00
72142 26 MRI NECK SPINE W/DYE 263.00
72146 26 MRI CHEST SPINE W/O DYE 218.00
72147 26 MRI CHEST SPINE W/DYE 261.00
72148 26 MRI LUMBAR SPINE W/O DYE 218.00
72149 26 MRI LUMBAR SPINE W/DYE 263.00
72156 26 MRI NECK SPINE W/O & W/DYE 336.00
72157 26 MRI CHEST SPINE W/O & W/DYE 336.00
72158 26 MRI LUMBAR SPINE W/O & W/DYE 336.00
72159 26 MR ANGIO SPINE W/O&W/DYE 265.00
72170 26 X-RAY EXAM OF PELVIS 26.00
72170 26 X-RAY EXAM OF PELVIS 26.00
72190 26 X-RAY EXAM OF PELVIS 32.00
72190 26 X-RAY EXAM OF PELVIS 32.00
72191 26 CT ANGIOGRAPH PELV W/O&W/DYE 265.00
72192 26 CT PELVIS W/O DYE 160.00
72192 26 CT PELVIS W/O DYE 160.00
72193 26 CT PELVIS W/DYE 171.00
72194 26 CT PELVIS W/O & W/DYE 179.00
72195 26 MRI PELVIS W/O DYE 215.00
72196 26 MRI PELVIS W/DYE 255.00
72197 26 MRI PELVIS W/O & W/DYE 332.00
72198 26 MR ANGIO PELVIS W/O & W/DYE 262.00
72200 26 X-RAY EXAM SI JOINTS 26.00
72202 26 X-RAY EXAM SI JOINTS 3/> VWS 28.00
72220 26 X-RAY EXAM SACRUM TAILBONE 26.00
72220 26 X-RAY EXAM SACRUM TAILBONE 26.00
72240 26 MYELOGRAPHY NECK SPINE 134.00
72240 26 MYELOGRAPHY NECK SPINE 134.00
72240 26 MYELOGRAPHY NECK SPINE 134.00
72255 26 MYELOGRAPHY THORACIC SPINE 136.00
72255 26 MYELOGRAPHY THORACIC SPINE 136.00
72265 26 MYELOGRAPHY L-S SPINE 122.00
72265 26 MYELOGRAPHY L-S SPINE 122.00
72270 26 MYELOGPHY 2/> SPINE REGIONS 196.00
72270 26 MYELOGPHY 2/> SPINE REGIONS 196.00
72285 26 DISCOGRAPHY CERV/THOR SPINE 177.00
72291 26 PERQ VERTE/SACROPLSTY FLUOR 196.00
72291 26 PERQ VERTE/SACROPLSTY FLUOR 196.00
72291 26 PERQ VERTE/SACROPLSTY FLUOR 196.00
72292 26 PERQ VERTE/SACROPLSTY CT 201.00
72295 26 X-RAY OF LOWER SPINE DISK 127.00
72295 26 X-RAY OF LOWER SPINE DISK 127.00
72295 26 X-RAY OF LOWER SPINE DISK 127.00
73000 26 X-RAY EXAM OF COLLAR BONE 25.00
73000 26 X-RAY EXAM OF COLLAR BONE 25.00
73010 26 X-RAY EXAM OF SHOULDER BLADE 27.00
73020 26 X-RAY EXAM OF SHOULDER 23.00
73020 26 X-RAY EXAM OF SHOULDER 23.00
73030 26 X-RAY EXAM OF SHOULDER 28.00
73030 26 X-RAY EXAM OF SHOULDER 28.00
73040 26 CONTRAST X-RAY OF SHOULDER 80.00
73040 26 CONTRAST X-RAY OF SHOULDER 80.00
73050 26 X-RAY EXAM OF SHOULDERS 31.00
73060 26 X-RAY EXAM OF HUMERUS 25.00
73060 26 X-RAY EXAM OF HUMERUS 25.00
73060 26 X-RAY EXAM OF HUMERUS 25.00
73070 26 X-RAY EXAM OF ELBOW 24.00
73070 26 X-RAY EXAM OF ELBOW 24.00
73070 26 X-RAY EXAM OF ELBOW 24.00
73070 26 X-RAY EXAM OF ELBOW 24.00
73080 26 X-RAY EXAM OF ELBOW 26.00
73080 26 X-RAY EXAM OF ELBOW 26.00
73085 26 CONTRAST X-RAY OF ELBOW 84.00
73085 26 CONTRAST X-RAY OF ELBOW 84.00
73090 26 X-RAY EXAM OF FOREARM 25.00
73090 26 X-RAY EXAM OF FOREARM 25.00
73090 26 X-RAY EXAM OF FOREARM 25.00
73092 26 X-RAY EXAM OF ARM INFANT 24.00
73100 26 X-RAY EXAM OF WRIST 25.00
73100 26 X-RAY EXAM OF WRIST 25.00
73100 26 X-RAY EXAM OF WRIST 25.00
73110 26 X-RAY EXAM OF WRIST 26.00
73110 26 X-RAY EXAM OF WRIST 26.00
73115 26 CONTRAST X-RAY OF WRIST 83.00
73120 26 X-RAY EXAM OF HAND 25.00
73120 26 X-RAY EXAM OF HAND 25.00
73120 26 X-RAY EXAM OF HAND 25.00
73120 26 X-RAY EXAM OF HAND 25.00
73130 26 X-RAY EXAM OF HAND 26.00
73130 26 X-RAY EXAM OF HAND 26.00
73130 26 X-RAY EXAM OF HAND 26.00
73140 26 X-RAY EXAM OF FINGER(S) 20.00
73140 26 X-RAY EXAM OF FINGER(S) 20.00
73140 26 X-RAY EXAM OF FINGER(S) 20.00
73200 26 CT UPPER EXTREMITY W/O DYE 147.00
73201 26 CT UPPER EXTREMITY W/DYE 171.00
73201 26 CT UPPER EXTREMITY W/DYE 171.00
73202 26 CT UPPR EXTREMITY W/O&W/DYE 179.00
73206 26 CT ANGIO UPR EXTRM W/O&W/DYE 263.00
73218 26 MRI UPPER EXTREMITY W/O DYE 198.00
73218 26 MRI UPPER EXTREMITY W/O DYE 198.00
73218 26 MRI UPPER EXTREMITY W/O DYE 198.00
73219 26 MRI UPPER EXTREMITY W/DYE 238.00
73220 26 MRI UPPR EXTREMITY W/O&W/DYE 315.00
73220 26 MRI UPPR EXTREMITY W/O&W/DYE 315.00
73221 26 MRI JOINT UPR EXTREM W/O DYE 199.00
73221 26 MRI JOINT UPR EXTREM W/O DYE 199.00
73222 26 MRI JOINT UPR EXTREM W/DYE 238.00
73223 26 MRI JOINT UPR EXTR W/O&W/DYE 315.00
73225 26 MR ANGIO UPR EXTR W/O&W/DYE 251.00
73500 26 X-RAY EXAM OF HIP 26.00
73500 26 X-RAY EXAM OF HIP 26.00
73501 26 X-RAY EXAM HIP UNI 1 VIEW 28.00
73502 26 X-RAY EXAM HIP UNI 2-3 VIEWS 33.00
73503 26 X-RAY EXAM HIP UNI 4/> VIEWS 42.00
73510 26 X-RAY EXAM OF HIP 35.00
73510 26 X-RAY EXAM OF HIP 35.00
73520 26 X-RAY EXAM OF HIPS 43.00
73520 26 X-RAY EXAM OF HIPS 43.00
73520 26 X-RAY EXAM OF HIPS 43.00
73521 26 X-RAY EXAM HIPS BI 2 VIEWS 34.00
73522 26 X-RAY EXAM HIPS BI 3-4 VIEWS 44.00
73523 26 X-RAY EXAM HIPS BI 5/> VIEWS 47.00
73525 26 CONTRAST X-RAY OF HIP 84.00
73525 26 CONTRAST X-RAY OF HIP 84.00
73525 26 CONTRAST X-RAY OF HIP 84.00
73530 26 X-RAY EXAM OF HIP 47.00
73540 26 X-RAY EXAM OF PELVIS & HIPS 34.00
73540 26 X-RAY EXAM OF PELVIS & HIPS 34.00
73542 26 X-RAY EXAM SACROILIAC JOINT 76.00
73550 26 X-RAY EXAM OF THIGH 26.00
73550 26 X-RAY EXAM OF THIGH 26.00
73550 26 X-RAY EXAM OF THIGH 26.00
73551 26 X-RAY EXAM OF FEMUR 1 25.00
73552 26 X-RAY EXAM OF FEMUR 2/> 28.00
73560 26 X-RAY EXAM OF KNEE 1 OR 2 25.00
73560 26 X-RAY EXAM OF KNEE 1 OR 2 25.00
73562 26 X-RAY EXAM OF KNEE 3 28.00
73562 26 X-RAY EXAM OF KNEE 3 28.00
73564 26 X-RAY EXAM KNEE 4 OR MORE 33.00
73564 26 X-RAY EXAM KNEE 4 OR MORE 33.00
73565 26 X-RAY EXAM OF KNEES 26.00
73580 26 CONTRAST X-RAY OF KNEE JOINT 83.00
73590 26 X-RAY EXAM OF LOWER LEG 25.00
73590 26 X-RAY EXAM OF LOWER LEG 25.00
73590 26 X-RAY EXAM OF LOWER LEG 25.00
73592 26 X-RAY EXAM OF LEG INFANT 24.00
73600 26 X-RAY EXAM OF ANKLE 25.00
73600 26 X-RAY EXAM OF ANKLE 25.00
73600 26 X-RAY EXAM OF ANKLE 25.00
73610 26 X-RAY EXAM OF ANKLE 26.00
73610 26 X-RAY EXAM OF ANKLE 26.00
73615 26 CONTRAST X-RAY OF ANKLE 84.00
73620 26 X-RAY EXAM OF FOOT 23.00
73620 26 X-RAY EXAM OF FOOT 23.00
73620 26 X-RAY EXAM OF FOOT 23.00
73630 26 X-RAY EXAM OF FOOT 25.00
73630 26 X-RAY EXAM OF FOOT 25.00
73630 26 X-RAY EXAM OF FOOT 25.00
73650 26 X-RAY EXAM OF HEEL 24.00
73650 26 X-RAY EXAM OF HEEL 24.00
73650 26 X-RAY EXAM OF HEEL 24.00
73660 26 X-RAY EXAM OF TOE(S) 20.00
73660 26 X-RAY EXAM OF TOE(S) 20.00
73660 26 X-RAY EXAM OF TOE(S) 20.00
73700 26 CT LOWER EXTREMITY W/O DYE 147.00
73700 26 CT LOWER EXTREMITY W/O DYE 147.00
73701 26 CT LOWER EXTREMITY W/DYE 171.00
73701 26 CT LOWER EXTREMITY W/DYE 171.00
73702 26 CT LWR EXTREMITY W/O&W/DYE 178.00
73706 26 CT ANGIO LWR EXTR W/O&W/DYE 278.00
73718 26 MRI LOWER EXTREMITY W/O DYE 198.00
73719 26 MRI LOWER EXTREMITY W/DYE 237.00
73720 26 MRI LWR EXTREMITY W/O&W/DYE 315.00
73721 26 MRI JNT OF LWR EXTRE W/O DYE 199.00
73721 26 MRI JNT OF LWR EXTRE W/O DYE 199.00
73722 26 MRI JOINT OF LWR EXTR W/DYE 238.00
73723 26 MRI JOINT LWR EXTR W/O&W/DYE 315.00
73723 26 MRI JOINT LWR EXTR W/O&W/DYE 315.00
73725 26 MR ANG LWR EXT W OR W/O DYE 264.00
74000 26 X-RAY EXAM OF ABDOMEN 27.00
74000 26 X-RAY EXAM OF ABDOMEN 27.00
74010 26 X-RAY EXAM OF ABDOMEN 34.00
74020 26 X-RAY EXAM OF ABDOMEN 40.00
74020 26 X-RAY EXAM OF ABDOMEN 40.00
74020 26 X-RAY EXAM OF ABDOMEN 40.00
74022 26 X-RAY EXAM SERIES ABDOMEN 47.00
74022 26 X-RAY EXAM SERIES ABDOMEN 47.00
74150 26 CT ABDOMEN W/O DYE 175.00
74160 26 CT ABDOMEN W/DYE 187.00
74170 26 CT ABDOMEN W/O & W/DYE 206.00
74174 26 CT ANGIO ABD&PELV W/O&W/DYE 321.00
74175 26 CT ANGIO ABDOM W/O & W/DYE 265.00
74176 26 CT ABD & PELVIS W/O CONTRAST 256.00
74177 26 CT ABD & PELV W/CONTRAST 267.00
74177 26 CT ABD & PELV W/CONTRAST 267.00
74178 26 CT ABD & PELV 1/> REGNS 295.00
74181 26 MRI ABDOMEN W/O DYE 214.00
74181 26 MRI ABDOMEN W/O DYE 214.00
74182 26 MRI ABDOMEN W/DYE 254.00
74183 26 MRI ABDOMEN W/O & W/DYE 332.00
74183 26 MRI ABDOMEN W/O & W/DYE 332.00
74185 26 MRI ANGIO ABDOM W ORW/O DYE 262.00
74190 26 X-RAY EXAM OF PERITONEUM 69.00
74210 26 CONTRST X-RAY EXAM OF THROAT 52.00
74220 26 CONTRAST X-RAY ESOPHAGUS 68.00
74230 26 CINE/VID X-RAY THROAT/ESOPH 78.00
74230 26 CINE/VID X-RAY THROAT/ESOPH 78.00
74240 26 X-RAY UPPER GI DELAY W/O KUB 102.00
74240 26 X-RAY UPPER GI DELAY W/O KUB 102.00
74241 26 X-RAYUPPER GI DELAY W/KUB 102.00
74245 26 X-RAY UPPER GI&SMALL INTEST 134.00
74246 26 CONTRST X-RAY UPPR GI TRACT 102.00
74247 26 CONTRST X-RAY UPPR GI TRACT 102.00
74249 26 CONTRST X-RAY UPPR GI TRACT 134.00
74250 26 X-RAY EXAM OF SMALL BOWEL 69.00
74251 26 X-RAY EXAM OF SMALL BOWEL 102.00
74260 26 X-RAY EXAM OF SMALL BOWEL 74.00
74261 26 CT COLONOGRAPHY DX 353.00
74262 26 CT COLONOGRAPHY DX W/DYE 367.00
74263 26 CT COLONOGRAPHY SCREENING 336.00
74270 26 CONTRAST X-RAY EXAM OF COLON 102.00
74280 26 CONTRAST X-RAY EXAM OF COLON 146.00
74283 26 CONTRAST X-RAY EXAM OF COLON 299.00
74290 26 CONTRAST X-RAY GALLBLADDER 47.00
74300 26 X-RAY BILE DUCTS/PANCREAS 53.00
74300 26 X-RAY BILE DUCTS/PANCREAS 53.00
74301 26 X-RAYS AT SURGERY ADD-ON 31.00
74301 26 X-RAYS AT SURGERY ADD-ON 31.00
74305 26 X-RAY BILE DUCTS/PANCREAS 69.00
74305 26 X-RAY BILE DUCTS/PANCREAS 69.00
74305 26 X-RAY BILE DUCTS/PANCREAS 69.00
74320 26 CONTRAST X-RAY OF BILE DUCTS 90.00
74320 26 CONTRAST X-RAY OF BILE DUCTS 90.00
74320 26 CONTRAST X-RAY OF BILE DUCTS 90.00
74327 26 X-RAY BILE STONE REMOVAL 114.00
74327 26 X-RAY BILE STONE REMOVAL 114.00
74328 26 X-RAY BILE DUCT ENDOSCOPY 104.00
74328 26 X-RAY BILE DUCT ENDOSCOPY 104.00
74329 26 X-RAY FOR PANCREAS ENDOSCOPY 105.00
74329 26 X-RAY FOR PANCREAS ENDOSCOPY 105.00
74330 26 X-RAY BILE/PANC ENDOSCOPY 133.00
74330 26 X-RAY BILE/PANC ENDOSCOPY 133.00
74340 26 X-RAY GUIDE FOR GI TUBE 79.00
74355 26 X-RAY GUIDE INTESTINAL TUBE 113.00
74360 26 X-RAY GUIDE GI DILATION 82.00
74363 26 X-RAY BILE DUCT DILATION 126.00
74363 26 X-RAY BILE DUCT DILATION 126.00
74400 26 CONTRST X-RAY URINARY TRACT 72.00
74400 26 CONTRST X-RAY URINARY TRACT 72.00
74410 26 CONTRST X-RAY URINARY TRACT 71.00
74415 26 CONTRST X-RAY URINARY TRACT 72.00
74420 26 CONTRST X-RAY URINARY TRACT 51.00
74420 26 CONTRST X-RAY URINARY TRACT 51.00
74425 26 CONTRST X-RAY URINARY TRACT 51.00
74425 26 CONTRST X-RAY URINARY TRACT 51.00
74425 26 CONTRST X-RAY URINARY TRACT 51.00
74430 26 CONTRAST X-RAY BLADDER 47.00
74430 26 CONTRAST X-RAY BLADDER 47.00
74445 26 X-RAY EXAM OF PENIS 159.00
74450 26 X-RAY URETHRA/BLADDER 48.00
74450 26 X-RAY URETHRA/BLADDER 48.00
74455 26 X-RAY URETHRA/BLADDER 48.00
74455 26 X-RAY URETHRA/BLADDER 48.00
74470 26 X-RAY EXAM OF KIDNEY LESION 77.00
74475 26 X-RAY CONTROL CATH INSERT 90.00
74475 26 X-RAY CONTROL CATH INSERT 90.00
74475 26 X-RAY CONTROL CATH INSERT 90.00
74480 26 X-RAY CONTROL CATH INSERT 90.00
74480 26 X-RAY CONTROL CATH INSERT 90.00
74480 26 X-RAY CONTROL CATH INSERT 90.00
74485 26 X-RAY GUIDE GU DILATION 76.00
74485 26 X-RAY GUIDE GU DILATION 76.00
74710 26 X-RAY MEASUREMENT OF PELVIS 50.00
74712 26 MRI FETAL SNGL/1ST GESTATION 441.00
74713 26 MRI FETAL EA ADDL GESTATION 262.00
74740 26 X-RAY FEMALE GENITAL TRACT 55.00
74740 26 X-RAY FEMALE GENITAL TRACT 55.00
74742 26 X-RAY FALLOPIAN TUBE 87.00
75557 26 CARDIAC MRI FOR MORPH 338.00
75561 26 CARDIAC MRI FOR MORPH W/DYE 374.00
75565 26 CARD MRI VELOC FLOW MAPPING 36.00
75571 26 CT HRT W/O DYE W/CA TEST 84.00
75572 26 CT HRT W/3D IMAGE 254.00
75573 26 CT HRT W/3D IMAGE CONGEN 369.00
75574 26 CT ANGIO HRT W/3D IMAGE 347.00
75600 26 CONTRAST EXAM THORACIC AORTA 71.00
75605 26 CONTRAST EXAM THORACIC AORTA 164.00
75625 26 CONTRAST EXAM ABDOMINL AORTA 164.00
75625 26 CONTRAST EXAM ABDOMINL AORTA 164.00
75630 26 X-RAY AORTA LEG ARTERIES 259.00
75635 26 CT ANGIO ABDOMINAL ARTERIES 350.00
75658 26 ARTERY X-RAYS ARM 188.00
75660 26 ARTERY X-RAYS HEAD & NECK 216.00
75662 26 ARTERY X-RAYS HEAD & NECK 271.00
75676 26 ARTERY X-RAYS NECK 216.00
75676 26 ARTERY X-RAYS NECK 216.00
75705 26 ARTERY X-RAYS SPINE 335.00
75705 26 ARTERY X-RAYS SPINE 335.00
75710 26 ARTERY X-RAYS ARM/LEG 166.00
75710 26 ARTERY X-RAYS ARM/LEG 166.00
75710 26 ARTERY X-RAYS ARM/LEG 166.00
75716 26 ARTERY X-RAYS ARMS/LEGS 190.00
75716 26 ARTERY X-RAYS ARMS/LEGS 190.00
75716 26 ARTERY X-RAYS ARMS/LEGS 190.00
75722 26 ARTERY X-RAYS KIDNEY 188.00
75724 26 ARTERY X-RAYS KIDNEYS 243.00
75726 26 ARTERY X-RAYS ABDOMEN 163.00
75726 26 ARTERY X-RAYS ABDOMEN 163.00
75731 26 ARTERY X-RAYS ADRENAL GLAND 167.00
75733 26 ARTERY X-RAYS ADRENALS 186.00
75736 26 ARTERY X-RAYS PELVIS 163.00
75736 26 ARTERY X-RAYS PELVIS 163.00
75741 26 ARTERY X-RAYS LUNG 186.00
75743 26 ARTERY X-RAYS LUNGS 237.00
75746 26 ARTERY X-RAYS LUNG 165.00
75756 26 ARTERY X-RAYS CHEST 165.00
75774 26 ARTERY X-RAY EACH VESSEL 52.00
75774 26 ARTERY X-RAY EACH VESSEL 52.00
75791 26 AV DIALYSIS SHUNT IMAGING 254.00
75801 26 LYMPH VESSEL X-RAY ARM/LEG 131.00
75803 26 LYMPH VESSEL X-RAY ARMS/LEGS 172.00
75805 26 LYMPH VESSEL X-RAY TRUNK 119.00
75807 26 LYMPH VESSEL X-RAY TRUNK 173.00
75809 26 NONVASCULAR SHUNT X-RAY 70.00
75810 26 VEIN X-RAY SPLEEN/LIVER 168.00
75820 26 VEIN X-RAY ARM/LEG 102.00
75820 26 VEIN X-RAY ARM/LEG 102.00
75822 26 VEIN X-RAY ARMS/LEGS 153.00
75825 26 VEIN X-RAY TRUNK 166.00
75825 26 VEIN X-RAY TRUNK 166.00
75827 26 VEIN X-RAY CHEST 166.00
75831 26 VEIN X-RAY KIDNEY 163.00
75833 26 VEIN X-RAY KIDNEYS 213.00
75840 26 VEIN X-RAY ADRENAL GLAND 167.00
75842 26 VEIN X-RAY ADRENAL GLANDS 218.00
75860 26 VEIN X-RAY NECK 164.00
75885 26 VEIN X-RAY LIVER W/HEMODYNAM 204.00
75887 26 VEIN X-RAY LIVER W/O HEMODYN 205.00
75889 26 VEIN X-RAY LIVER W/HEMODYNAM 162.00
75891 26 VEIN X-RAY LIVER 164.00
75893 26 VENOUS SAMPLING BY CATHETER 79.00
75893 26 VENOUS SAMPLING BY CATHETER 79.00
75894 26 X-RAYS TRANSCATH THERAPY 195.00
75896 26 X-RAYS TRANSCATH THERAPY 216.00
75896 26 X-RAYS TRANSCATH THERAPY 216.00
75896 26 X-RAYS TRANSCATH THERAPY 216.00
75898 26 FOLLOW-UP ANGIOGRAPHY 247.00
75898 26 FOLLOW-UP ANGIOGRAPHY 247.00
75901 26 REMOVE CVA DEVICE OBSTRUCT 70.00
75901 26 REMOVE CVA DEVICE OBSTRUCT 70.00
75902 26 REMOVE CVA LUMEN OBSTRUCT 56.00
75940 26 X-RAY PLACEMENT VEIN FILTER 90.00
75940 26 X-RAY PLACEMENT VEIN FILTER 90.00
75945 26 INTRAVASCULAR US 68.00
75946 26 INTRAVASCULAR US ADD-ON 68.00
75952 26 ENDOVASC REPAIR ABDOM AORTA 662.00
75953 26 ABDOM ANEURYSM ENDOVAS RPR 201.00
75954 26 ILIAC ANEURYSM ENDOVAS RPR 335.00
75960 26 TRANSCATH IV STENT RS&I 131.00
75960 26 TRANSCATH IV STENT RS&I 131.00
75962 26 REPAIR ARTERIAL BLOCKAGE 78.00
75962 26 REPAIR ARTERIAL BLOCKAGE 78.00
75964 26 REPAIR ARTERY BLOCKAGE EACH 53.00
75966 26 REPAIR ARTERIAL BLOCKAGE 189.00
75966 26 REPAIR ARTERIAL BLOCKAGE 189.00
75968 26 REPAIR ARTERY BLOCKAGE EACH 53.00
75970 26 VASCULAR BIOPSY 118.00
75978 26 REPAIR VENOUS BLOCKAGE 78.00
75978 26 REPAIR VENOUS BLOCKAGE 78.00
75980 26 CONTRAST XRAY EXAM BILE DUCT 236.00
75982 26 CONTRAST XRAY EXAM BILE DUCT 236.00
75982 26 CONTRAST XRAY EXAM BILE DUCT 236.00
75984 26 XRAY CONTROL CATHETER CHANGE 103.00
75984 26 XRAY CONTROL CATHETER CHANGE 103.00
75989 26 ABSCESS DRAINAGE UNDER X-RAY 172.00
75989 26 ABSCESS DRAINAGE UNDER X-RAY 172.00
76000 26 FLUOROSCOPE EXAMINATION 26.00
76001 26 FLUOROSCOPE EXAM EXTENSIVE 105.00
76010 26 X-RAY NOSE TO RECTUM 27.00
76080 26 X-RAY EXAM OF FISTULA 77.00
76080 26 X-RAY EXAM OF FISTULA 77.00
76098 26 X-RAY EXAM BREAST SPECIMEN 24.00
76098 26 X-RAY EXAM BREAST SPECIMEN 24.00
76100 26 X-RAY EXAM OF BODY SECTION 92.00
76101 26 COMPLEX BODY SECTION X-RAY 98.00
76102 26 COMPLEX BODY SECTION X-RAYS 99.00
76376 26 3D RENDER W/INTRP POSTPROCES 29.00
76377 26 3D RENDER W/INTRP POSTPROCES 116.00
76380 26 CAT SCAN FOLLOW-UP STUDY 144.00
76390 26 MR SPECTROSCOPY 204.00
76496 26 FLUOROSCOPIC PROCEDURE 58.00
76506 26 ECHO EXAM OF HEAD 95.00
76506 26 ECHO EXAM OF HEAD 95.00
76536 26 US EXAM OF HEAD AND NECK 82.00
76604 26 US EXAM CHEST 79.00
76604 26 US EXAM CHEST 79.00
76604 26 US EXAM CHEST 79.00
76641 26 ULTRASOUND BREAST COMPLETE 107.00
76642 26 ULTRASOUND BREAST LIMITED 100.00
76645 26 US EXAM BREAST(S) 92.00
76645 26 US EXAM BREAST(S) 92.00
76700 26 US EXAM ABDOM COMPLETE 118.00
76705 26 ECHO EXAM OF ABDOMEN 86.00
76705 26 ECHO EXAM OF ABDOMEN 86.00
76706 26 US ABDL AORTA SCREEN AAA 82.00
76770 26 US EXAM ABDO BACK WALL COMP 108.00
76775 26 US EXAM ABDO BACK WALL LIM 84.00
76776 26 US EXAM K TRANSPL W/DOPPLER 111.00
76800 26 US EXAM SPINAL CANAL 177.00
76801 26 OB US < 14 WKS SINGLE FETUS 147.00
76802 26 OB US < 14 WKS ADDL FETUS 124.00
76805 26 OB US >/= 14 WKS SNGL FETUS 148.00
76810 26 OB US >/= 14 WKS ADDL FETUS 147.00
76811 26 OB US DETAILED SNGL FETUS 288.00
76812 26 OB US DETAILED ADDL FETUS 270.00
76813 26 OB US NUCHAL MEAS 1 GEST 179.00
76814 26 OB US NUCHAL MEAS ADD-ON 151.00
76815 26 OB US LIMITED FETUS(S) 96.00
76816 26 OB US FOLLOW-UP PER FETUS 128.00
76817 26 TRANSVAGINAL US OBSTETRIC 112.00
76818 26 FETAL BIOPHYS PROFILE W/NST 159.00
76819 26 FETAL BIOPHYS PROFIL W/O NST 116.00
76825 26 ECHO EXAM OF FETAL HEART 246.00
76830 26 TRANSVAGINAL US NON-OB 102.00
76830 26 TRANSVAGINAL US NON-OB 102.00
76831 26 ECHO EXAM UTERUS 108.00
76856 26 US EXAM PELVIC COMPLETE 101.00
76857 26 US EXAM PELVIC LIMITED 73.00
76870 26 US EXAM SCROTUM 94.00
76872 26 US TRANSRECTAL 98.00
76872 26 US TRANSRECTAL 98.00
76881 26 US XTR NON-VASC COMPLETE 91.00
76882 26 US XTR NON-VASC LMTD 72.00
76885 26 US EXAM INFANT HIPS DYNAMIC 109.00
76886 26 US EXAM INFANT HIPS STATIC 89.00
76936 26 ECHO GUIDE FOR ARTERY REPAIR 290.00
76937 26 US GUIDE VASCULAR ACCESS 42.00
76937 26 US GUIDE VASCULAR ACCESS 42.00
76940 26 US GUIDE TISSUE ABLATION 303.00
76942 26 ECHO GUIDE FOR BIOPSY 98.00
76942 26 ECHO GUIDE FOR BIOPSY 98.00
76942 26 ECHO GUIDE FOR BIOPSY 98.00
76946 26 ECHO GUIDE FOR AMNIOCENTESIS 57.00
76998 26 US GUIDE INTRAOP 187.00
77001 26 FLUOROGUIDE FOR VEIN DEVICE 56.00
77001 26 FLUOROGUIDE FOR VEIN DEVICE 56.00
77002 26 NEEDLE LOCALIZATION BY XRAY 82.00
77003 26 FLUOROGUIDE FOR SPINE INJECT 88.00
77003 26 FLUOROGUIDE FOR SPINE INJECT 88.00
77011 26 CT SCAN FOR LOCALIZATION 183.00
77012 26 CT SCAN FOR NEEDLE BIOPSY 169.00
77012 26 CT SCAN FOR NEEDLE BIOPSY 169.00
77013 26 CT GUIDE FOR TISSUE ABLATION 572.00
77014 26 CT SCAN FOR THERAPY GUIDE 127.00
77021 MR GUIDANCE FOR NEEDLE PLACE 220.00
77021 26 MR GUIDANCE FOR NEEDLE PLACE 220.00
77022 26 MRI FOR TISSUE ABLATION 621.00
77031 26 STEREOTACT GUIDE FOR BRST BX 257.00
77031 26 STEREOTACT GUIDE FOR BRST BX 257.00
77032 26 GUIDANCE FOR NEEDLE BREAST 92.00
77032 26 GUIDANCE FOR NEEDLE BREAST 92.00
77051 COMPUTER DX MAMMOGRAM ADD-ON 8.00
77051 26 COMPUTER DX MAMMOGRAM ADD-ON 8.00
77052 26 COMP SCREEN MAMMOGRAM ADD-ON 8.00
77052 26 COMP SCREEN MAMMOGRAM ADD-ON 8.00
77053 26 X-RAY OF MAMMARY DUCT 52.00
77054 26 X-RAY OF MAMMARY DUCTS 67.00
77055 26 MAMMOGRAM ONE BREAST 103.00
77056 26 MAMMOGRAM BOTH BREASTS 127.00
77057 26 MAMMOGRAM SCREENING 103.00
77058 26 MRI ONE BREAST 238.00
77059 26 MRI BOTH BREASTS 238.00
77061 26 BREAST TOMOSYNTHESIS UNI 158.00
77062 26 BREAST TOMOSYNTHESIS BI 158.00
77063 26 BREAST TOMOSYNTHESIS BI 87.00
77063 26 BREAST TOMOSYNTHESIS BI 87.00
77065 26 DX MAMMO INCL CAD UNI 105.00
77066 26 DX MAMMO INCL CAD BI 129.00
77067 26 SCR MAMMO BI INCL CAD 66.00
77071 26 X-RAY STRESS VIEW 135.00
77072 26 X-RAYS FOR BONE AGE 28.00
77073 26 X-RAYS BONE LENGTH STUDIES 42.00
77074 26 X-RAYS BONE SURVEY LIMITED 67.00
77074 26 X-RAYS BONE SURVEY LIMITED 67.00
77075 26 X-RAYS BONE SURVEY COMPLETE 79.00
77076 26 X-RAYS BONE SURVEY INFANT 103.00
77077 26 JOINT SURVEY SINGLE VIEW 47.00
77077 26 JOINT SURVEY SINGLE VIEW 47.00
77078 26 CT BONE DENSITY AXIAL 36.00
77079 26 CT BONE DENSITY PERIPHERAL 32.00
77080 26 DXA BONE DENSITY AXIAL 30.00
77081 26 DXA BONE DENSITY/PERIPHERAL 32.00
77082 26 DXA BONE DENSITY VERT FX 25.00
77083 26 RADIOGRAPHIC ABSORPTIOMETRY 35.00
77084 26 MAGNETIC IMAGE BONE MARROW 235.00
77085 26 DXA BONE DENSITY STUDY 45.00
77086 26 FRACTURE ASSESSMENT VIA DXA 26.00
77263 RADIATION THERAPY PLANNING 480.00
77290 26 SET RADIATION THERAPY FIELD 235.00
78012 26 THYROID UPTAKE MEASUREMENT 28.00
78013 26 THYROID IMAGING W/BLOOD FLOW 53.00
78014 26 THYROID IMAGING W/BLOOD FLOW 72.00
78015 26 THYROID MET IMAGING 96.00
78018 26 THYROID MET IMAGING BODY 121.00
78020 26 THYROID MET UPTAKE 81.00
78070 26 PARATHYROID PLANAR IMAGING 114.00
78071 26 PARATHYRD PLANAR W/WO SUBTRJ 172.00
78072 26 PARATHYRD PLANAR W/SPECT&CT 225.00
78075 26 ADRENAL CORTEX & MEDULLA IMG 103.00
78102 26 BONE MARROW IMAGING LTD 78.00
78103 26 BONE MARROW IMAGING MULT 106.00
78104 26 BONE MARROW IMAGING BODY 112.00
78110 26 PLASMA VOLUME SINGLE 28.00
78111 26 PLASMA VOLUME MULTIPLE 32.00
78120 26 RED CELL MASS SINGLE 34.00
78122 26 BLOOD VOLUME 63.00
78135 26 RED CELL SURVIVAL KINETICS 93.00
78185 26 SPLEEN IMAGING 59.00
78195 26 LYMPH SYSTEM IMAGING 173.00
78201 26 LIVER IMAGING 62.00
78202 26 LIVER IMAGING WITH FLOW 70.00
78205 26 LIVER IMAGING (3D) 99.00
78206 26 LIVER IMAGE (3D) WITH FLOW 137.00
78215 26 LIVER AND SPLEEN IMAGING 71.00
78216 26 LIVER & SPLEEN IMAGE/FLOW 80.00
78220 26 LIVER FUNCTION STUDY 91.00
78223 26 HEPATOBILIARY IMAGING 137.00
78223 26 HEPATOBILIARY IMAGING 137.00
78226 26 HEPATOBILIARY SYSTEM IMAGING 107.00
78227 26 HEPATOBIL SYST IMAGE W/DRUG 131.00
78230 26 SALIVARY GLAND IMAGING 56.00
78231 26 SERIAL SALIVARY IMAGING 77.00
78232 26 SALIVARY GLAND FUNCTION EXAM 58.00
78258 26 ESOPHAGEAL MOTILITY STUDY 107.00
78261 26 GASTRIC MUCOSA IMAGING 100.00
78262 26 GASTROESOPHAGEAL REFLUX EXAM 97.00
78264 26 GASTRIC EMPTYING IMAG STUDY 107.00
78265 26 GASTRIC EMPTYING IMAG STUDY 141.00
78266 26 GASTRIC EMPTYING IMAG STUDY 156.00
78270 26 VIT B-12 ABSORPTION EXAM 31.00
78271 26 VIT B-12 ABSRP EXAM INT FAC 30.00
78278 26 ACUTE GI BLOOD LOSS IMAGING 143.00
78290 26 MECKELS DIVERT EXAM 99.00
78291 26 LEVEEN/SHUNT PATENCY EXAM 124.00
78300 26 BONE IMAGING LIMITED AREA 91.00
78305 26 BONE IMAGING MULTIPLE AREAS 120.00
78306 26 BONE IMAGING WHOLE BODY 124.00
78315 26 BONE IMAGING 3 PHASE 147.00
78320 26 BONE IMAGING (3D) 147.00
78351 26 BONE MINERAL DUAL PHOTON 96.00
78428 26 CARDIAC SHUNT IMAGING 110.00
78445 26 VASCULAR FLOW IMAGING 68.00
78451 26 HT MUSCLE IMAGE SPECT SING 196.00
78452 26 HT MUSCLE IMAGE SPECT MULT 230.00
78453 26 HT MUSCLE IMAGE PLANAR SING 144.00
78454 26 HT MUSC IMAGE PLANAR MULT 195.00
78456 26 ACUTE VENOUS THROMBUS IMAGE 142.00
78457 26 VENOUS THROMBOSIS IMAGING 112.00
78458 26 VEN THROMBOSIS IMAGES BILAT 112.00
78459 26 HEART MUSCLE IMAGING (PET) 207.00
78466 26 HEART INFARCT IMAGE 102.00
78469 26 HEART INFARCT IMAGE (3D) 133.00
78472 26 GATED HEART PLANAR SINGLE 140.00
78473 26 GATED HEART MULTIPLE 208.00
78481 26 HEART FIRST PASS SINGLE 139.00
78483 26 HEART FIRST PASS MULTIPLE 208.00
78491 26 HEART IMAGE (PET) SINGLE 209.00
78492 26 HEART IMAGE (PET) MULTIPLE 262.00
78494 26 HEART IMAGE SPECT 170.00
78496 26 HEART FIRST PASS ADD-ON 71.00
78579 26 LUNG VENTILATION IMAGING 69.00
78580 26 LUNG PERFUSION IMAGING 107.00
78582 26 LUNG VENTILAT&PERFUS IMAGING 154.00
78584 26 LUNG V/Q IMAGE SINGLE BREATH 152.00
78585 26 LUNG V/Q IMAGING 166.00
78586 26 AEROSOL LUNG IMAGE SINGLE 91.00
78587 26 AEROSOL LUNG IMAGE MULTIPLE 137.00
78588 26 PERFUSION LUNG IMAGE 162.00
78594 26 VENT IMAGE MULT PROJ GAS 90.00
78596 26 LUNG DIFFERENTIAL FUNCTION 205.00
78597 26 LUNG PERFUSION DIFFERENTIAL 104.00
78598 26 LUNG PERF&VENTILAT DIFERENTL 121.00
78600 26 BRAIN IMAGE < 4 VIEWS 66.00
78601 26 BRAIN IMAGE W/FLOW < 4 VIEWS 73.00
78605 26 BRAIN IMAGE 4+ VIEWS 78.00
78606 26 BRAIN IMAGE W/FLOW 4 + VIEWS 92.00
78607 26 BRAIN IMAGING (3D) 173.00
78608 26 BRAIN IMAGING (PET) 210.00
78609 26 BRAIN IMAGING (PET) 238.00
78610 26 BRAIN FLOW IMAGING ONLY 44.00
78630 26 CEREBROSPINAL FLUID SCAN 99.00
78645 26 CSF SHUNT EVALUATION 81.00
78647 26 CEREBROSPINAL FLUID SCAN 132.00
78650 26 CSF LEAKAGE IMAGING 87.00
78700 26 KIDNEY IMAGING MORPHOL 65.00
78701 26 KIDNEY IMAGING WITH FLOW 69.00
78707 26 K FLOW/FUNCT IMAGE W/O DRUG 137.00
78708 26 K FLOW/FUNCT IMAGE W/DRUG 173.00
78709 26 K FLOW/FUNCT IMAGE MULTIPLE 201.00
78710 26 KIDNEY IMAGING (3D) 90.00
78725 26 KIDNEY FUNCTION STUDY 54.00
78740 26 URETERAL REFLUX STUDY 80.00
78740 26 URETERAL REFLUX STUDY 80.00
78761 26 TESTICULAR IMAGING W/FLOW 105.00
78800 26 TUMOR IMAGING LIMITED AREA 99.00
78801 26 TUMOR IMAGING MULT AREAS 117.00
78802 26 TUMOR IMAGING WHOLE BODY 122.00
78803 26 TUMOR IMAGING (3D) 152.00
78804 26 TUMOR IMAGING WHOLE BODY 152.00
78805 26 ABSCESS IMAGING LTD AREA 105.00
78806 26 ABSCESS IMAGING WHOLE BODY 122.00
78807 26 NUCLEAR LOCALIZATION/ABSCESS 152.00
78808 26 IV INJ RA DRUG DX STUDY 128.00
78811 26 PET IMAGE LTD AREA 226.00
78812 26 PET IMAGE SKULL-THIGH 275.00
78813 26 PET IMAGE FULL BODY 287.00
78814 26 PET IMAGE W/CT LMTD 317.00
78815 26 PET IMAGE W/CT SKULL-THIGH 350.00
78816 26 PET IMAGE W/CT FULL BODY 353.00
79005 26 NUCLEAR RX ORAL ADMIN 257.00
79101 26 NUCLEAR RX IV ADMIN 279.00
79200 26 NUCLEAR RX INTRACAV ADMIN 296.00
79300 26 NUCLR RX INTERSTIT COLLOID 232.00
79403 26 HEMATOPOIETIC NUCLEAR TX 324.00
79440 26 NUCLEAR RX INTRA-ARTICULAR 278.00
79445 26 NUCLEAR RX INTRA-ARTERIAL 338.00
90772 26 THER/PROPH/DIAG INJ, SC/IM 54.00
93010 ELECTROCARDIOGRAM REPORT 25.00
93015 CARDIOVASCULAR STRESS TEST 214.00
93503 26 INSERT/PLACE HEART CATHETER 384.00
93875 26 EXTRACRANIAL STUDY 79.00
93880 26 EXTRACRANIAL BILAT STUDY 117.00
93882 26 EXTRACRANIAL UNI/LTD STUDY 74.00
93886 26 INTRACRANIAL COMPLETE STUDY 139.00
93888 26 INTRACRANIAL LIMITED STUDY 75.00
93888 26 INTRACRANIAL LIMITED STUDY 75.00
93922 26 UPR/L XTREMITY ART 2 LEVELS 37.00
93923 26 UPR/LXTR ART STDY 3+ LVLS 66.00
93924 26 LWR XTR VASC STDY BILAT 73.00
93925 26 LOWER EXTREMITY STUDY 115.00
93926 26 LOWER EXTREMITY STUDY 71.00
93930 26 UPPER EXTREMITY STUDY 117.00
93931 26 UPPER EXTREMITY STUDY 73.00
93965 26 EXTREMITY STUDY 51.00
93970 26 EXTREMITY STUDY 102.00
93971 26 EXTREMITY STUDY 66.00
93975 26 VASCULAR STUDY 170.00
93975 26 VASCULAR STUDY 170.00
93976 26 VASCULAR STUDY 117.00
93976 26 VASCULAR STUDY 117.00
93976 26 VASCULAR STUDY 117.00
93978 26 VASCULAR STUDY 118.00
93979 26 VASCULAR STUDY 73.00
93980 26 PENILE VASCULAR STUDY 179.00
93981 26 PENILE VASCULAR STUDY 65.00
93990 26 DOPPLER FLOW TESTING 73.00
94060 EVALUATION OF WHEEZING 160.00
94060 26 EVALUATION OF WHEEZING 36.00
96450 CHEMOTHERAPY INTO CNS 236.00
96450 26 CHEMOTHERAPY INTO CNS 236.00
99024 POSTOP FOLLOW-UP VISIT
99144 MOD SEDAT PHYS/QHP 5YRS/> 58.00
99145 MOD SEDAT PHYS/QHP EA 15 MIN 22.00
99145 76 MOD SEDAT PHYS/QHP EA 15 MIN 22.00
99151 MOD SED SAME PHYS/QHP <5 YRS 70.00
99152 MOD SED SAME PHYS/QHP 5/>YRS 37.00
99153 MOD SED SAME PHYS/QHP EA 30.00
99155 MOD SED OTH PHYS/QHP <5 YRS 272.00
99156 MOD SED OTH PHYS/QHP 5/>YRS 223.00
99157 MOD SED OTHER PHYS/QHP EA 169.00
99201 OFFICE/OUTPATIENT VISIT NEW 77.00
99202 OFFICE/OUTPATIENT VISIT NEW 146.00
99203 OFFICE/OUTPATIENT VISIT NEW 223.00
99204 OFFICE/OUTPATIENT VISIT NEW 376.00
99205 OFFICE/OUTPATIENT VISIT NEW 489.00
99211 OFFICE/OUTPATIENT VISIT EST 27.00
99212 OFFICE/OUTPATIENT VISIT EST 73.00
99213 OFFICE/OUTPATIENT VISIT EST 148.00
99214 OFFICE/OUTPATIENT VISIT EST 227.00
99215 OFFICE/OUTPATIENT VISIT EST 321.00
99217 OBSERVATION CARE DISCHARGE 209.00
99218 INITIAL OBSERVATION CARE 289.00
99221 INITIAL HOSPITAL CARE 294.00
99222 INITIAL HOSPITAL CARE 396.00
99224 SUBSEQUENT OBSERVATION CARE 115.00
99225 SUBSEQUENT OBSERVATION CARE 210.00
99226 SUBSEQUENT OBSERVATION CARE 304.00
99231 SUBSEQUENT HOSPITAL CARE 114.00
99232 SUBSEQUENT HOSPITAL CARE 208.00
99233 SUBSEQUENT HOSPITAL CARE 301.00
99238 HOSPITAL DISCHARGE DAY 208.00
99241 OFFICE CONSULTATION 131.00
99242 OFFICE CONSULTATION 208.00
99243 OFFICE CONSULTATION 261.00
99244 OFFICE CONSULTATION 387.00
99245 OFFICE CONSULTATION 492.00
99251 INPATIENT CONSULTATION 137.00
99252 INPATIENT CONSULTATION 210.00
99253 INPATIENT CONSULTATION 263.00
99281 EMERGENCY DEPT VISIT 62.00
G0202 26 SCR MAMMO BI INCL CAD 102.00
G0202 26 SCR MAMMO BI INCL CAD 102.00
G0202 26 SCR MAMMO BI INCL CAD 102.00
G0204 26 DX MAMMO INCL CAD BI 127.00
G0204 26 DX MAMMO INCL CAD BI 127.00
G0206 26 DX MAMMO INCL CAD UNI 102.00
G0206 26 DX MAMMO INCL CAD UNI 102.00
G0219 26 PET IMG WHOLBOD MELANO NONCO 236.00
G0235 26 PET NOT OTHERWISE SPECIFIED 214.00
G0279 TOMOSYNTHESIS, MAMMO 87.00
G0279 26 TOMOSYNTHESIS, MAMMO 87.00
G0297 26 LDCT FOR LUNG CA SCREEN 148.00
G0364 BONE MARROW ASPIRATE &BIOPSY 26.00
G0365 VESSEL MAPPING HEMO ACCESS 36.00
G0365 26 VESSEL MAPPING HEMO ACCESS 36.00
G0389 26 ULTRASOUND EXAM AAA SCREEN 85.00
G9500 RAD EXPOS IND/EXP TM DOC
G9637 DOC >1 DOSE REDUC TECH
NON S NON SUFFICIENT FUNDS 26.00
Q0083 CHEMO BY OTHER THAN INFUSION 79.00
S8032 LOW DOSE CT LUNG SCREENING 152.00
S8032 26 LOW DOSE CT LUNG SCREENING 152.00