Version 3.19 Update - Outpatient Facility,,,,,,,,,,,,, ,,,,,,,,,,,,, Item Code,Code Type,Description,Modifier,Service Category Code,Multiple Surgery Indicator,Primary/Pass-Through Indicator,Unit Charge,Base Charge,Unit Type,Inpatient Indicator,Skilled Nursing Facility Indicator,Start Date,End Date 10021,CPT,FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 10022,CPT,FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 10030,CPT,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 10035,CPT,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,,30,,,"$3,025.36",$0.00,1,0,1,20161001, 10040,CPT,ACNE SURGERY,,30,,,$398.75,$0.00,1,0,1,20161001, 10060,CPT,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,,30,,,$465.39,$0.00,1,0,1,20161001, 10061,CPT,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 10080,CPT,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 10081,CPT,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 10120,CPT,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 10121,CPT,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 10140,CPT,I&D HEMATOMA SEROMA/FLUID COLLECTION,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 10160,CPT,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 10180,CPT,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11000,CPT,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 11001,CPT,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,,30,,,$436.25,$0.00,1,0,1,20161001, 11010,CPT,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11011,CPT,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 11012,CPT,DBRDMT FX&/DISLC SUBQ T/M/F BONE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11042,CPT,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11043,CPT,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 11044,CPT,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11045,CPT,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,,30,,,"$1,090.62",$0.00,1,0,1,20161001, 11046,CPT,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,,30,,,"$1,744.99",$0.00,1,0,1,20161001, 11047,CPT,DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM,,30,,,"$2,617.49",$0.00,1,0,1,20161001, 11055,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,,30,,,$398.75,$0.00,1,0,1,20161001, 11056,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,,30,,,$398.75,$0.00,1,0,1,20161001, 11057,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11100,CPT,BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11101,CPT,BIOPSY SKIN SUBQ&/MUCOUS MEMBRANE EA ADDL LESN,,30,,,$305.37,$0.00,1,0,1,20161001, 11200,CPT,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,,30,,,$398.75,$0.00,1,0,1,20161001, 11201,CPT,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,,30,,,"$1,013.79",$0.00,1,0,1,20161001, 11300,CPT,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,,30,,,$398.75,$0.00,1,0,1,20161001, 11301,CPT,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 11302,CPT,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 11303,CPT,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 11305,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,,30,,,$398.75,$0.00,1,0,1,20161001, 11306,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 11307,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11308,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 11310,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11311,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11312,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11313,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11400,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11401,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11402,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11403,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM/<,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11404,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11406,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11420,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11421,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11422,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11423,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11424,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11426,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11440,CPT,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11441,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11442,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11443,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11444,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11446,CPT,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11450,CPT,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11451,CPT,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11462,CPT,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11463,CPT,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11470,CPT,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11471,CPT,EXCISION H/P/P/U COMPLEX REPAIR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11600,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11601,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11602,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11603,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM/<,,30,,,"$5,733.20",$0.00,1,0,1,20161001, 11604,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11606,CPT,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11620,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11621,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11622,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11623,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM/<,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11624,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11626,CPT,EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11640,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11641,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11642,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11643,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11644,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 11646,CPT,EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11719,CPT,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,,30,,,$306.21,$0.00,1,0,1,20161001, 11720,CPT,DEBRIDEMENT NAIL ANY METHOD 1-5,,30,,,$425.53,$0.00,1,0,1,20161001, 11721,CPT,DEBRIDEMENT NAIL ANY METHOD 6/>,,30,,,$306.21,$0.00,1,0,1,20161001, 11730,CPT,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,,30,,,$398.75,$0.00,1,0,1,20161001, 11732,CPT,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,,30,,,$398.75,$0.00,1,0,1,20161001, 11740,CPT,EVACUATION SUBUNGUAL HEMATOMA,,30,,,$306.21,$0.00,1,0,1,20161001, 11750,CPT,EXCISION NAIL MATRIX PERMANENT REMOVAL,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 11752,CPT,EXC NAIL MATRIX PRM RMVL W/AMP TUFT DSTL PHALANX,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11755,CPT,BIOPSY NAIL UNIT SEPARATE PROCEDURE,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 11760,CPT,REPAIR NAIL BED,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 11762,CPT,RECONSTRUCTION NAIL BED W/GRAFT,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 11765,CPT,WEDGE EXCISION SKIN NAIL FOLD,,30,,,$398.75,$0.00,1,0,1,20161001, 11770,CPT,EXCISION PILONIDAL CYST/SINUS SIMPLE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11771,CPT,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11772,CPT,EXCISION PILONIDAL CYST/SINUS COMPLICATED,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11900,CPT,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,,30,,,$398.75,$0.00,1,0,1,20161001, 11901,CPT,INJECTION INTRALESIONAL >7 LESIONS,,30,,,$398.75,$0.00,1,0,1,20161001, 11920,CPT,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 11921,CPT,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 11922,CPT,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,,30,,,"$2,066.99",$0.00,1,0,1,20161001, 11950,CPT,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11951,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 11952,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 11954,CPT,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 11960,CPT,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 11970,CPT,REPLACEMENT TISS EXPANDER PERMANENT PROSTHESIS,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 11971,CPT,REMOVAL TISS EXPANDER W/O INSERTION PROSTHESIS,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 11976,CPT,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 11980,CPT,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,,30,,,$425.53,$0.00,1,0,1,20161001, 11981,CPT,INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,30,,,$425.53,$0.00,1,0,1,20161001, 11982,CPT,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,30,,,$425.53,$0.00,1,0,1,20161001, 11983,CPT,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,,30,,,$425.53,$0.00,1,0,1,20161001, 12001,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,,30,,,$398.75,$0.00,1,0,1,20161001, 12002,CPT,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12004,CPT,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12005,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12006,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12007,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12011,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,,30,,,$398.75,$0.00,1,0,1,20161001, 12013,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12014,CPT,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12015,CPT,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12016,CPT,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12017,CPT,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12018,CPT,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12020,CPT,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 12021,CPT,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 12031,CPT,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12032,CPT,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12034,CPT,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12035,CPT,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12036,CPT,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 12037,CPT,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 12041,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,,30,,,$398.75,$0.00,1,0,1,20161001, 12042,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12044,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12045,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12046,CPT,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12047,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 12051,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12052,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12053,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12054,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12055,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 12056,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,,30,,,$398.75,$0.00,1,0,1,20161001, 12057,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 13100,CPT,REPAIR COMPLEX TRUNK 1.1-2.5 CM,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 13101,CPT,REPAIR COMPLEX TRUNK 2.6-7.5 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 13102,CPT,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,,30,,,"$1,702.90",$0.00,1,0,1,20161001, 13120,CPT,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 13121,CPT,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 13122,CPT,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,,30,,,"$1,702.90",$0.00,1,0,1,20161001, 13131,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 13132,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 13133,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,,30,,,"$2,231.39",$0.00,1,0,1,20161001, 13151,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 13152,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 13153,CPT,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,,30,,,"$2,231.39",$0.00,1,0,1,20161001, 13160,CPT,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 14000,CPT,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14001,CPT,ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14020,CPT,ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14021,CPT,ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14040,CPT,ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14041,CPT,ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14060,CPT,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14061,CPT,ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 14301,CPT,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 14302,CPT,ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM/<,,30,,,"$7,046.49",$0.00,1,0,1,20161001, 14350,CPT,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15002,CPT,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15003,CPT,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,,30,,,"$4,227.89",$0.00,1,0,1,20161001, 15004,CPT,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 15005,CPT,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,,30,,,"$4,227.89",$0.00,1,0,1,20161001, 15040,CPT,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 15050,CPT,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 15100,CPT,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15101,CPT,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,30,,,"$4,932.54",$0.00,1,0,1,20161001, 15110,CPT,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15111,CPT,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,30,,,"$5,872.07",$0.00,1,0,1,20161001, 15115,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15116,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM,,30,,,"$6,106.95",$0.00,1,0,1,20161001, 15120,CPT,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM//=100SCM ADL 100SQCM,,30,,,$503.82,$0.00,1,0,1,20161001, 15275,CPT,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15276,CPT,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,,30,,,$258.37,$0.00,1,0,1,20161001, 15277,CPT,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM 1ST 100SQ CM,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15278,CPT,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM ADL 100SQ CM,,30,,,$604.82,$0.00,1,0,1,20161001, 15570,CPT,FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15572,CPT,FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15574,CPT,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15576,CPT,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15600,CPT,DELAY FLAP/SECTIONING FLAP TRUNK,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15610,CPT,DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15620,CPT,DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15630,CPT,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15650,CPT,TRANSFER ANY PEDICLE FLAP ANY LOCATION,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15731,CPT,FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15732,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NC,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15734,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15736,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15738,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15740,CPT,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15750,CPT,FLAP NEUROVASCULAR PEDICLE,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15760,CPT,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15770,CPT,GRAFT DERMA-FAT-FASCIA,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15775,CPT,PUNCH GRAFT HAIR TRANSPLANT 1-15 PUNCH GRAFTS,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 15776,CPT,PUNCH GRAFT HAIR TRANSPLANT >15 PUNCH GRAFTS,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 15777,CPT,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,,30,,,"$3,125.12",$0.00,1,0,1,20161001, 15780,CPT,DERMABRASION TOTAL FACE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15781,CPT,DERMABRASION SEGMENTAL FACE,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 15782,CPT,DERMABRASION REGIONAL OTHER THAN FACE,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 15783,CPT,DERMABRASION SUPERFICIAL ANY SITE,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 15786,CPT,ABRASION 1 LESION,,30,,,$398.75,$0.00,1,0,1,20161001, 15787,CPT,ABRASION EACH ADDITIONAL 4 LESIONS OR LESS,,30,,,$294.31,$0.00,1,0,1,20161001, 15788,CPT,CHEMICAL PEEL FACIAL EPIDERMAL,,30,,,$398.75,$0.00,1,0,1,20161001, 15789,CPT,CHEMICAL PEEL FACIAL DERMAL,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 15792,CPT,CHEMICAL PEEL NONFACIAL EPIDERMAL,,30,,,$398.75,$0.00,1,0,1,20161001, 15793,CPT,CHEMICAL PEEL NONFACIAL DERMAL,,30,,,$398.75,$0.00,1,0,1,20161001, 15819,CPT,CERVICOPLASTY,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15820,CPT,BLEPHAROPLASTY LOWER EYELID,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15821,CPT,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15822,CPT,BLEPHAROPLASTY UPPER EYELID,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15823,CPT,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15824,CPT,RHYTIDECTOMY FOREHEAD,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15825,CPT,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15826,CPT,RHYTIDECTOMY GLABELLAR FROWN LINES,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15828,CPT,RHYTIDECTOMY CHEEK CHIN & NECK,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15829,CPT,RHYTIDECTOMY SMAS FLAP,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15830,CPT,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 15832,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15833,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15834,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15835,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15836,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15837,CPT,EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15838,CPT,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15839,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15840,CPT,GRAFT FACIAL NERVE PARALYSIS FREE FASCIAL GRAFT,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15841,CPT,GRAFT FACIAL NERVE PARALYSIS FREE MUSCLE GRAFT,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15842,CPT,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15845,CPT,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15847,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN,,30,,,"$5,486.10",$0.00,1,0,1,20161001, 15850,CPT,REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15851,CPT,REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 15852,CPT,DRESSING CHANGE UNDER ANESTHESIA,,30,,,$425.53,$0.00,1,0,1,20161001, 15860,CPT,IV INJECTION TEST VASCULAR FLOW FLAP/GRAFT,,30,,,$425.53,$0.00,1,0,1,20161001, 15876,CPT,SUCTION ASSISTED LIPECTOMY HEAD & NECK,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15877,CPT,SUCTION ASSISTED LIPECTOMY TRUNK,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15878,CPT,SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15879,CPT,SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY,,30,,,"$11,856.65",$0.00,1,0,1,20161001, 15920,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15922,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15931,CPT,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15933,CPT,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15934,CPT,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15935,CPT,EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15936,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15937,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15940,CPT,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15941,CPT,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15944,CPT,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15945,CPT,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15946,CPT,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,,30,,,"$11,856.65",$0.00,1,0,1,20161001, 15950,CPT,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15951,CPT,EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 15952,CPT,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15953,CPT,EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 15956,CPT,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15958,CPT,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 15999,CPT,UNLISTED PROCEDURE EXCISION PRESSURE ULCER,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 16000,CPT,INITIAL TX 1ST DEGREE BURN LOCAL TX,,30,,,$398.75,$0.00,1,0,1,20161001, 16020,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,,30,,,$398.75,$0.00,1,0,1,20161001, 16025,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 16030,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 16035,CPT,ESCHAROTOMY FIRST INCISION,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17000,CPT,DESTRUCTION PREMALIGNANT LESION 1ST,,30,,,$398.75,$0.00,1,0,1,20161001, 17003,CPT,DESTRUCTION PREMALIGNANT LESION 2-14 EA,,30,,,$132.20,$0.00,1,0,1,20161001, 17004,CPT,DESTRUCTION PREMALIGNANT LESION 15/>,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17106,CPT,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17107,CPT,DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17108,CPT,DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM,,30,,,"$6,908.09",$0.00,1,0,1,20161001, 17110,CPT,DESTRUCTION BENIGN LESIONS UP TO 14,,30,,,$398.75,$0.00,1,0,1,20161001, 17111,CPT,DESTRUCTION BENIGN LESIONS 15/>,,30,,,$398.75,$0.00,1,0,1,20161001, 17250,CPT,CHEMICAL CAUTERIZATION GRANULATION TISSUE,,30,,,$398.75,$0.00,1,0,1,20161001, 17260,CPT,DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<,,30,,,$398.75,$0.00,1,0,1,20161001, 17261,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,30,,,$398.75,$0.00,1,0,1,20161001, 17262,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,,30,,,$398.75,$0.00,1,0,1,20161001, 17263,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,,30,,,$398.75,$0.00,1,0,1,20161001, 17264,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17266,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17270,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17271,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17272,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,,30,,,$398.75,$0.00,1,0,1,20161001, 17273,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17274,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17276,CPT,DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17280,CPT,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,,30,,,$398.75,$0.00,1,0,1,20161001, 17281,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17282,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17283,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17284,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17286,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 17311,CPT,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17312,CPT,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,,30,,,"$1,335.51",$0.00,1,0,1,20161001, 17313,CPT,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17314,CPT,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,,30,,,"$2,391.97",$0.00,1,0,1,20161001, 17315,CPT,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,,30,,,"$1,129.96",$0.00,1,0,1,20161001, 17340,CPT,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,,30,,,$156.54,$0.00,1,0,1,20161001, 17360,CPT,CHEMICAL EXFOLIATION ACNE,,30,,,$398.75,$0.00,1,0,1,20161001, 17380,CPT,ELECTROLYSIS EPILATION EACH 30 MINUTES,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 17999,CPT,UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE,,30,,,$398.75,$0.00,1,0,1,20161001, 19000,CPT,PUNCTURE ASPIRATION CYST BREAST,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 19001,CPT,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,,30,,,$739.90,$0.00,1,0,1,20161001, 19020,CPT,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 19030,CPT,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,,30,,,$807.71,$0.00,1,0,1,20161001, 19081,CPT,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 19083,CPT,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 19085,CPT,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 19100,CPT,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 19101,CPT,BIOPSY BREAST OPEN INCISIONAL,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19105,CPT,ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19110,CPT,NIPPLE EXPLORATION,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19112,CPT,EXCISION LACTIFEROUS DUCT FISTULA,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19120,CPT,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19125,CPT,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19126,CPT,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,,30,,,"$4,307.81",$0.00,1,0,1,20161001, 19260,CPT,EXCISION CHEST WALL TUMOR INCLUDING RIBS,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 19281,CPT,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 19283,CPT,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 19285,CPT,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 19287,CPT,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 19296,CPT,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,,30,,,"$23,463.49",$0.00,1,0,1,20161001, 19297,CPT,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,,30,,,"$5,384.76",$0.00,1,0,1,20161001, 19298,CPT,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,,30,,,"$23,463.49",$0.00,1,0,1,20161001, 19300,CPT,MASTECTOMY GYNECOMASTIA,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19301,CPT,MASTECTOMY PARTIAL,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19302,CPT,MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19303,CPT,MASTECTOMY SIMPLE COMPLETE,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19304,CPT,MASTECTOMY SUBCUTANEOUS,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19307,CPT,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19316,CPT,MASTOPEXY,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19318,CPT,REDUCTION MAMMAPLASTY,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19324,CPT,MAMMAPLASTY AUGMENTATION W/O PROSTHETIC IMPLANT,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19325,CPT,MAMMAPLASTY AUGMENTATION W/PROSTHETIC IMPLANT,,30,,,"$23,463.49",$0.00,1,0,1,20161001, 19328,CPT,REMOVAL INTACT MAMMARY IMPLANT,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19330,CPT,REMOVAL MAMMARY IMPLANT MATERIAL,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19340,CPT,IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19342,CPT,DLYD INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,30,,,"$23,463.49",$0.00,1,0,1,20161001, 19350,CPT,NIPPLE/AREOLA RECONSTRUCTION,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19355,CPT,CORRECTION INVERTED NIPPLES,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19357,CPT,BRST RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ,,30,,,"$23,463.49",$0.00,1,0,1,20161001, 19366,CPT,BREAST RECONSTRUCTION OTHER TECHNIQUE,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19370,CPT,OPEN PERIPROSTHETIC CAPSULOTOMY BREAST,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19371,CPT,PERIPROSTHETIC CAPSULECTOMY BREAST,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19380,CPT,REVISION RECONSTRUCTED BREAST,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 19396,CPT,PREPARATION MOULAGE CUSTOM BREAST IMPLANT,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 19499,CPT,UNLISTED PROCEDURE BREAST,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 20005,CPT,I&D SOFT TISSUE ABSCESS SUBFASC,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20100,CPT,EXPLORATION PENETRATING WOUND SPX NECK,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 20101,CPT,EXPLORATION PENETRATING WOUND SPX CHEST,,30,,,"$11,856.65",$0.00,1,0,1,20161001, 20102,CPT,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 20103,CPT,EXPLORATION PENETRATING WOUND SPX EXTREMITY,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 20150,CPT,EXCISION EPIPHYSEAL BAR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20200,CPT,BIOPSY MUSCLE SUPERFICIAL,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20205,CPT,BIOPSY MUSCLE DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20206,CPT,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 20220,CPT,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 20225,CPT,BIOPSY BONE TROCAR/NEEDLE DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20240,CPT,BIOPSY BONE OPEN SUPERFICIAL,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20245,CPT,BIOPSY BONE OPEN DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20250,CPT,BIOPSY VERTEBRAL BODY OPEN THORACIC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20251,CPT,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20500,CPT,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 20501,CPT,INJECTION SINUS TRACT DIAGNOSTIC,,30,,,"$1,256.87",$0.00,1,0,1,20161001, 20520,CPT,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 20525,CPT,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20526,CPT,INJECTION THERAPEUTIC CARPAL TUNNEL,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20527,CPT,INJECTION ENZYME PALMAR FASCIAL CORD,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20550,CPT,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20551,CPT,INJECTION SINGLE TENDON ORIGIN/INSERTION,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20552,CPT,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20553,CPT,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20555,CPT,PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 20600,CPT,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20604,CPT,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20605,CPT,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20606,CPT,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20610,CPT,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20611,CPT,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20612,CPT,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 20615,CPT,ASPIRATION & INJECTION TREATMENT BONE CYST,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 20650,CPT,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20660,CPT,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 20662,CPT,APPLICATION HALO PELVIC INCLUDING REMOVAL,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 20663,CPT,APPLICATION HALO FEMORAL INCLUDING REMOVAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20665,CPT,REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL,,30,,,$425.53,$0.00,1,0,1,20161001, 20670,CPT,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20680,CPT,REMOVAL IMPLANT DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 20690,CPT,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 20692,CPT,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 20693,CPT,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20694,CPT,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 20696,CPT,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 20697,CPT,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 20822,CPT,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20900,CPT,BONE GRAFT ANY DONOR AREA MINOR/SMALL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20902,CPT,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 20910,CPT,CARTILAGE GRAFT COSTOCHONDRAL,,30,,,"$2,409.56",$0.00,1,0,1,20161001, 20912,CPT,CARTILAGE GRAFT NASAL SEPTUM,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 20920,CPT,FASCIA LATA GRAFT BY STRIPPER,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 20922,CPT,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 20924,CPT,TENDON GRAFT FROM A DISTANCE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20926,CPT,TISSUE GRAFTS OTHER,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 20930,CPT,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,,30,,,"$5,693.70",$0.00,1,0,1,20161001, 20931,CPT,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,,30,,,"$5,618.20",$0.00,1,0,1,20161001, 20936,CPT,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,,30,,,"$5,128.43",$0.00,1,0,1,20161001, 20937,CPT,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,,30,,,"$4,579.53",$0.00,1,0,1,20161001, 20938,CPT,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,,30,,,"$6,792.45",$0.00,1,0,1,20161001, 20950,CPT,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,,30,,,"$3,025.36",$0.00,1,0,1,20161001, 20972,CPT,FREE OSTQ FLAP W/MVASC ANASTOMOSIS METATARSAL,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 20973,CPT,FR OSTQ FLAP W/MVASC ANAST GRT TOE W/WEB SPACE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 20975,CPT,ELECTRICAL STIMULATION BONE HEALING INVASIVE,,30,,,"$8,007.63",$0.00,1,0,1,20161001, 20979,CPT,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,,30,,,$156.54,$0.00,1,0,1,20161001, 20982,CPT,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 20983,CPT,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 20985,CPT,CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS,,30,,,"$4,104.48",$0.00,1,0,1,20161001, 20999,CPT,UNLISTED PROCEDURE MUSCSKELETAL SYSTEM GENERAL,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 21010,CPT,ARTHROTOMY TEMPOROMANDIBULAR JOINT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21011,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 21012,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21013,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 21014,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21015,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21016,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21025,CPT,EXCISION BONE MANDIBLE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21026,CPT,EXCISION FACIAL BONE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21029,CPT,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21030,CPT,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21031,CPT,EXCISION TORUS MANDIBULARIS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21032,CPT,EXCISION MAXILLARY TORUS PALATINUS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21034,CPT,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21040,CPT,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21044,CPT,EXCISION MALIGNANT TUMOR MANDIBLE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21046,CPT,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21047,CPT,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21048,CPT,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21049,CPT,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21050,CPT,CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21060,CPT,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21070,CPT,CORONOIDECTOMY SEPARATE PROCEDURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21073,CPT,MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21076,CPT,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21077,CPT,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21079,CPT,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21080,CPT,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21081,CPT,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21082,CPT,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21083,CPT,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21084,CPT,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21085,CPT,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21086,CPT,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21087,CPT,IMPRESSION & PREPARATION NASAL PROSTHESIS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21088,CPT,IMPRESSION & PREPARATION FACIAL PROSTHESIS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21089,CPT,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,,30,,,$853.29,$0.00,1,0,1,20161001, 21100,CPT,APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21110,CPT,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21116,CPT,INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,,30,,,"$1,098.85",$0.00,1,0,1,20161001, 21120,CPT,GENIOPLASTY AUGMENTATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21121,CPT,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21122,CPT,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21123,CPT,GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21125,CPT,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21127,CPT,AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21137,CPT,REDUCTION FOREHEAD CONTOURING ONLY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21138,CPT,RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21139,CPT,RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21150,CPT,RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21172,CPT,RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21175,CPT,RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21181,CPT,RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21193,CPT,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21195,CPT,RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21198,CPT,OSTEOTOMY MANDIBLE SEGMENTAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21199,CPT,OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21206,CPT,OSTEOTOMY MAXILLA SEGMENTAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21208,CPT,OSTEOPLASTY FACIAL BONES AUGMENTATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21209,CPT,OSTEOPLASTY FACIAL BONES REDUCTION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21210,CPT,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21215,CPT,GRAFT BONE MANDIBLE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21230,CPT,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21235,CPT,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21240,CPT,ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21242,CPT,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21243,CPT,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 21244,CPT,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21245,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21246,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21248,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21249,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21256,CPT,RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21260,CPT,PERIORBITAL OSTEOTOMIES BONE GRAFTS EXTRACRANIAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21261,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21263,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS W/FOREHEAD,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21267,CPT,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21270,CPT,MALAR AUGMENTATION PROSTHETIC MATERIAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21275,CPT,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21280,CPT,MEDIAL CANTHOPEXY SEPARATE PROCEDURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21282,CPT,LATERAL CANTHOPEXY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21295,CPT,REDUCTION MASSETER MUSCLE & BONE EXTRAORAL,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21296,CPT,REDUCTION MASSETER MUSCLE & BONE INTRAORAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21299,CPT,UNLISTED CRANIOFACIAL & MAXILLOFACIAL PROCEDURE,,30,,,$853.29,$0.00,1,0,1,20161001, 21310,CPT,CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION,,30,,,$853.29,$0.00,1,0,1,20161001, 21315,CPT,CLOSED TX NASAL FRACTURE W/O STABILIZATION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21320,CPT,CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21325,CPT,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21330,CPT,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21335,CPT,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21336,CPT,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 21337,CPT,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21338,CPT,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21339,CPT,OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21340,CPT,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21345,CPT,CLOSED TX NASOMAXILLARY COMPLEX FRACTURE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21346,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21355,CPT,PERCUTANEOUS TX MALAR AREA FRACTURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21356,CPT,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21360,CPT,OPEN TX DEPRESSED MALAR FRACTURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21365,CPT,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21385,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21386,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21387,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21390,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21395,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21400,CPT,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21401,CPT,CLOSED TX FX ORBIT EXCEPT BLOWOUT W/MANIPULATION,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21406,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21407,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21408,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21421,CPT,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21440,CPT,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21445,CPT,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21450,CPT,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 21451,CPT,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21452,CPT,PERCUTANEOUS TX MANDIBULAR FX W/EXTERNAL FIXJ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21453,CPT,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21454,CPT,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21461,CPT,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21462,CPT,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21465,CPT,OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21470,CPT,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21480,CPT,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,,30,,,$853.29,$0.00,1,0,1,20161001, 21485,CPT,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21490,CPT,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 21495,CPT,OPEN TREATMENT HYOID FRACTURE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21497,CPT,INTERDENTAL WIRING OTHER THAN FRACTURE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 21499,CPT,UNLISTED MUSCULOSKELETAL PROCEDURE HEAD,,30,,,$853.29,$0.00,1,0,1,20161001, 21501,CPT,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21502,CPT,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 21550,CPT,BIOPSY SOFT TISSUE NECK/THORAX,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 21552,CPT,EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21554,CPT,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21555,CPT,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21556,CPT,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21557,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21558,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21600,CPT,EXCISION RIB PARTIAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 21610,CPT,COSTOTRANSVERSECTOMY SEPARATE PROCEDURE,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 21685,CPT,HYOID MYOTOMY & SUSPENSION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 21700,CPT,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 21720,CPT,DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 21725,CPT,DIVISION STERNOCLEIDOMASTOID OPEN W/CAST,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 21742,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 21743,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 21811,CPT,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 21812,CPT,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 21813,CPT,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 21820,CPT,CLOSED TREATMENT STERNUM FRACTURE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 21899,CPT,UNLISTED PROCEDURE NECK/THORAX,,30,,,$853.29,$0.00,1,0,1,20161001, 21920,CPT,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 21925,CPT,BIOPSY SOFT TISSUE BACK/FLANK DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21930,CPT,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 21931,CPT,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21932,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21933,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21935,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 21936,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 22100,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 22101,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 22102,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 22103,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,,30,,,"$30,351.11",$0.00,1,0,1,20161001, 22305,CPT,CLOSED TX VERTEBRAL PROCESS FRACTURE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 22310,CPT,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 22315,CPT,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 22505,CPT,MANIPULATION SPINE REQUIRING ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 22510,CPT,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 22511,CPT,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 22513,CPT,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 22514,CPT,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 22526,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL,,30,,,"$2,583.02",$0.00,1,0,1,20161001, 22527,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,,30,,,"$2,583.02",$0.00,1,0,1,20161001, 22551,CPT,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 22552,CPT,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,,30,,,"$6,408.82",$0.00,1,0,1,20161001, 22554,CPT,ARTHRD ANT MIN DISCECT INTERBODY CERV BELOW C2,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 22612,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 22614,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL,,30,,,"$30,351.11",$0.00,1,0,1,20161001, 22851,CPT,APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE,,30,,,"$19,314.34",$0.00,1,0,1,20161001, 22856,CPT,TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 22899,CPT,UNLISTED PROCEDURE SPINE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 22900,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 22901,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 22902,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 22903,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 22904,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 22905,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 22999,CPT,UNLISTED PX ABDOMEN MUSCULOSKELETAL SYSTEM,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 23000,CPT,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23020,CPT,CAPSULAR CONTRACTURE RELEASE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23030,CPT,I&D SHOULDER DEEP ABSCESS/HEMATOMA,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23031,CPT,I&D SHOULDER INFECTED BURSA,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23035,CPT,INCISION BONE CORTEX SHOULDER AREA,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 23040,CPT,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23044,CPT,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23065,CPT,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 23066,CPT,BIOPSY SOFT TISSUE SHOULDER DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23071,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23073,CPT,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23075,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23076,CPT,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23077,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23078,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23100,CPT,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 23101,CPT,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23105,CPT,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23106,CPT,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23107,CPT,ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23120,CPT,CLAVICULECTOMY PARTIAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23125,CPT,CLAVICULECTOMY TOTAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23130,CPT,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23140,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 23145,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/AGRFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23146,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 23150,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23155,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23156,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 23170,CPT,SEQUESTRECTOMY CLAVICLE,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 23172,CPT,SEQUESTRECTOMY SCAPULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23174,CPT,SEQUESTRECTOMY HUMERAL HEAD SURGERY NECK,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23180,CPT,PARTIAL EXCISION BONE CLAVICLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23182,CPT,PARTIAL EXCISION BONE SCAPULA,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 23184,CPT,PARTIAL EXCISION BONE PROXIMAL HUMERUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23190,CPT,OSTECTOMY SCAPULA PARTIAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23195,CPT,RESECTION HUMERAL HEAD,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 23330,CPT,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 23333,CPT,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23334,CPT,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23350,CPT,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,,30,,,$838.09,$0.00,1,0,1,20161001, 23395,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 23397,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23400,CPT,SCAPULOPEXY,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 23405,CPT,TENOTOMY SHOULDER AREA 1 TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23406,CPT,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23410,CPT,OPEN REPAIR OF ROTATOR CUFF ACUTE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23412,CPT,OPEN REPAIR OF ROTATOR CUFF CHRONIC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23415,CPT,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23420,CPT,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23430,CPT,TENODESIS LONG TENDON BICEPS,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 23440,CPT,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23450,CPT,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 23455,CPT,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23460,CPT,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 23462,CPT,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23465,CPT,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23466,CPT,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 23470,CPT,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 23473,CPT,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23480,CPT,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23485,CPT,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23490,CPT,PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 23491,CPT,PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23500,CPT,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23505,CPT,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 23515,CPT,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23520,CPT,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 23525,CPT,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23530,CPT,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23532,CPT,OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 23540,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23545,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23550,CPT,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23552,CPT,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23570,CPT,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23575,CPT,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 23585,CPT,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 23600,CPT,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23605,CPT,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 23615,CPT,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23616,CPT,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 23620,CPT,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 23625,CPT,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 23630,CPT,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23650,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23655,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 23660,CPT,OPEN TX ACUTE SHOULDER DISLOCATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 23665,CPT,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 23670,CPT,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 23675,CPT,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 23680,CPT,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23700,CPT,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 23800,CPT,ARTHRODESIS GLENOHUMERAL JOINT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23802,CPT,ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 23921,CPT,DISRTCJ SHOULDER SECONDARY CLSR/SCAR REVISION,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 23929,CPT,UNLISTED PROCEDURE SHOULDER,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 23930,CPT,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 23931,CPT,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 23935,CPT,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 24000,CPT,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24006,CPT,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24065,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24066,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24071,CPT,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24073,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24075,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24076,CPT,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24077,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24079,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24100,CPT,ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 24101,CPT,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24102,CPT,ARTHROTOMY ELBOW W/SYNOVECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24105,CPT,EXCISION OLECRANON BURSA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 24110,CPT,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24115,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24116,CPT,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24120,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 24125,CPT,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/AGRFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24126,CPT,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24130,CPT,EXCISION RADIAL HEAD,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24134,CPT,SEQUESTRECTOMY SHAFT/DISTAL HUMERUS,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 24136,CPT,SEQUESTRECTOMY RADIAL HEAD OR NECK,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24138,CPT,SEQUESTRECTOMY OLECRANON PROCESS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24140,CPT,PARTIAL EXCISION BONE HUMERUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24145,CPT,PARTIAL EXCISION BONE RADIAL HEAD/NECK,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24147,CPT,PARTIAL EXCISION BONE OLECRANON PROCESS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24149,CPT,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24150,CPT,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24152,CPT,RADICAL RESECTION TUMOR RADIAL HEAD/NECK,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24155,CPT,RESECTION ELBOW JOINT ARTHRECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24160,CPT,PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24164,CPT,PROSTHESIS REMOVAL RADIAL HEAD,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24200,CPT,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 24201,CPT,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 24220,CPT,INJECTION ELBOW ARTHROGRAPHY,,30,,,$879.99,$0.00,1,0,1,20161001, 24300,CPT,MANIPULATION ELBOW UNDER ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 24301,CPT,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24305,CPT,TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24310,CPT,TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24320,CPT,TENOPLASTY ELBOW TO SHOULDER SINGLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24330,CPT,FLEXOR-PLASTY ELBOW,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24331,CPT,FLEXOR-PLASTY ELBOW W/EXTENSOR ADVANCEMENT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24332,CPT,TENOLYSIS TRICEPS,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 24340,CPT,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 24341,CPT,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24342,CPT,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24343,CPT,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24344,CPT,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 24345,CPT,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24346,CPT,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24357,CPT,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 24358,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24359,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24360,CPT,ARTHROPLASTY ELBOW W/MEMBRANE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 24361,CPT,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24362,CPT,ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24363,CPT,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24365,CPT,ARTHROPLASTY RADIAL HEAD,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24366,CPT,ARTHROPLASTY RADIAL HEAD W/IMPLANT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24370,CPT,REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24371,CPT,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24400,CPT,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 24410,CPT,MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24420,CPT,OSTEOPLASTY HUMERUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24430,CPT,REPAIR NON/MALUNION HUMERUS W/O GRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24435,CPT,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24470,CPT,HEMIEPIPHYSEAL ARREST,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24495,CPT,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24498,CPT,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24500,CPT,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 24505,CPT,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 24515,CPT,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24516,CPT,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24530,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 24535,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 24538,CPT,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24545,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24546,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24560,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 24565,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 24566,CPT,PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24575,CPT,OPEN TX HUMERAL EPICONDYLAR FRACTURE,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24576,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 24577,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 24579,CPT,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24582,CPT,PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 24586,CPT,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24587,CPT,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 24600,CPT,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 24605,CPT,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 24615,CPT,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 24620,CPT,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 24635,CPT,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 24640,CPT,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 24650,CPT,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 24655,CPT,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 24665,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 24666,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24670,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 24675,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 24685,CPT,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 24800,CPT,ARTHRODESIS ELBOW JOINT LOCAL,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 24802,CPT,ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 24925,CPT,AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 24935,CPT,STUMP ELONGATION UPPER EXTREMITY,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 24999,CPT,UNLISTED PROCEDURE HUMERUS/ELBOW,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 25000,CPT,INCISION EXTENSOR TENDON SHEATH WRIST,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25001,CPT,INCISION FLEXOR TENDON SHEATH WRIST,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25020,CPT,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 25023,CPT,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25024,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25025,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25028,CPT,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25031,CPT,INCISION & DRAINAGE FOREARM&/WRIST BURSA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25035,CPT,INCISION DEEP BONE CORTEX FOREARM&/WRIST,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25040,CPT,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25065,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 25066,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 25071,CPT,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 25073,CPT,EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 25075,CPT,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 25076,CPT,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 25077,CPT,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 25078,CPT,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 25085,CPT,CAPSULOTOMY WRIST,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 25100,CPT,ARTHROTOMY WRIST JOINT WITH BIOPSY,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 25101,CPT,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 25105,CPT,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 25107,CPT,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25109,CPT,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25110,CPT,EXCISION LESION TENDON SHEATH FOREARM&/WRIST,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25111,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25112,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25115,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25116,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25118,CPT,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 25119,CPT,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25120,CPT,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25125,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25126,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25130,CPT,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25135,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25136,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25145,CPT,SEQUESTRECTOMY FOREARM &/WRIST,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25150,CPT,PARTIAL EXCISION BONE ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25151,CPT,PARTIAL EXCISION BONE RADIUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25170,CPT,RADICAL RESECTION TUMOR RADIUS OR ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25210,CPT,CARPECTOMY 1 BONE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25215,CPT,CARPECTOMY ALL BONES PROXIMAL ROW,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25230,CPT,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25240,CPT,EXCISION DISTAL ULNA PARTIAL/COMPLETE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25246,CPT,INJECTION WRIST ARTHROGRAPHY,,30,,,$998.31,$0.00,1,0,1,20161001, 25248,CPT,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25250,CPT,REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 25251,CPT,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25259,CPT,MANIPULATION WRIST UNDER ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 25260,CPT,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 25263,CPT,RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25265,CPT,RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25270,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25272,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25274,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25275,CPT,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25280,CPT,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25290,CPT,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 25295,CPT,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25300,CPT,TENODESIS WRIST FLEXORS FINGERS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25301,CPT,TENODESIS WRIST EXTENSORS FINGERS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25310,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25312,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25315,CPT,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25316,CPT,FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 25320,CPT,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25332,CPT,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25335,CPT,CENTRALIZATION WRST ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25337,CPT,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25350,CPT,OSTEOTOMY RADIUS DISTAL THIRD,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 25355,CPT,OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25360,CPT,OSTEOTOMY ULNA,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 25365,CPT,OSTEOTOMY RADIUS & ULNA,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 25370,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25375,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25390,CPT,OSTEOPLASTY RADIUS/ULNA SHORTENING,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25391,CPT,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 25392,CPT,OSTEOPLASTY RADIUS & ULNA SHORTENING,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25393,CPT,OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25394,CPT,OSTEOPLASTY CARPAL BONE SHORTENING,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25400,CPT,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25405,CPT,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 25415,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25420,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 25425,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS/ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25426,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS&ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25430,CPT,INSERTION VASCULAR PEDICLE CARPAL BONE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25431,CPT,REPAIR NONUNION CARPAL BONE EACH BONE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25440,CPT,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 25441,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 25442,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 25443,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25444,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 25445,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25446,CPT,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 25447,CPT,ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25449,CPT,REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25450,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25455,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25490,CPT,PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25491,CPT,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 25492,CPT,PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25500,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 25505,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 25515,CPT,OPEN TREATMENT RADIAL SHAFT FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25520,CPT,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 25525,CPT,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25526,CPT,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 25530,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 25535,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 25545,CPT,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25560,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 25565,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 25574,CPT,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25575,CPT,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 25600,CPT,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 25605,CPT,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 25606,CPT,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 25607,CPT,OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25608,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25609,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25622,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 25624,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 25628,CPT,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25630,CPT,CLTX CARPAL BONE FX W/O MANJ EACH BONE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 25635,CPT,CLTX CARPAL BONE FX W/MANJ EACH BONE,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 25645,CPT,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25650,CPT,CLOSED TREATMENT ULNAR STYLOID FRACTURE,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 25651,CPT,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25652,CPT,OPEN TREATMENT ULNAR STYLOID FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25660,CPT,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 25670,CPT,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25671,CPT,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25675,CPT,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 25676,CPT,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 25680,CPT,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 25685,CPT,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25690,CPT,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 25695,CPT,OPEN TREATMENT LUNATE DISLOCATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25800,CPT,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 25805,CPT,ARTHRODESIS WRIST W/SLIDING GRAFT,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 25810,CPT,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 25820,CPT,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25825,CPT,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25830,CPT,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 25907,CPT,AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR RE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25909,CPT,AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 25922,CPT,DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25929,CPT,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 25931,CPT,TRANSMETACARPAL AMPUTATION RE-AMPUTATION,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 25999,CPT,UNLISTED PROCEDURE FOREARM/WRIST,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 26010,CPT,DRAINAGE FINGER ABSCESS SIMPLE,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 26011,CPT,DRAINAGE FINGER ABSCESS COMPLICATED,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 26020,CPT,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26025,CPT,DRAINAGE OF PALMAR BURSA SINGLE BURSA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26030,CPT,DRAINAGE OF PALMAR BURSA MULTIPLE BURSA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26034,CPT,INCISION BONE CORTEX HAND/FINGER,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26035,CPT,DECOMPRESSION FINGERS&/HAND INJECTION INJURY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26037,CPT,DECOMPRESSIVE FASCIOTOMY HAND,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26040,CPT,FASCIOTOMY PALMAR PERCUTANEOUS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26045,CPT,FASCIOTOMY PALMAR OPEN PARTIAL,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26055,CPT,TENDON SHEATH INCISION,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26060,CPT,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26070,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26075,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26080,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26100,CPT,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26105,CPT,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26110,CPT,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26111,CPT,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 26113,CPT,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 26115,CPT,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 26116,CPT,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 26117,CPT,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 26118,CPT,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 26121,CPT,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26123,CPT,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26125,CPT,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,,30,,,"$9,583.73",$0.00,1,0,1,20161001, 26130,CPT,SYNOVECTOMY CARPOMETACARPAL JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26135,CPT,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26140,CPT,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26145,CPT,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26160,CPT,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26170,CPT,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26180,CPT,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26185,CPT,SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26200,CPT,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26205,CPT,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26210,CPT,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26215,CPT,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26230,CPT,PARTIAL EXCISION BONE METACARPAL,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26235,CPT,PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26236,CPT,PARTIAL EXCISION DISTAL PHALANX FINGER,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26250,CPT,RADICAL RESECTION TUMOR METACARPAL,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26260,CPT,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26262,CPT,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26320,CPT,REMOVAL IMPLANT FROM FINGER/HAND,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 26340,CPT,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 26341,CPT,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26350,CPT,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26352,CPT,RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26356,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26357,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26358,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26370,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26372,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26373,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26390,CPT,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 26392,CPT,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 26410,CPT,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26412,CPT,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26415,CPT,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26416,CPT,RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26418,CPT,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26420,CPT,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26426,CPT,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26428,CPT,RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26432,CPT,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26433,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26434,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26437,CPT,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26440,CPT,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26442,CPT,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26445,CPT,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26449,CPT,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26450,CPT,TENOTOMY FLEXOR PALM OPEN EACH TENDON,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 26455,CPT,TENOTOMY FLEXOR FINGER OPEN EACH TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26460,CPT,TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26471,CPT,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 26474,CPT,TENODESIS DISTAL JOINT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26476,CPT,LENGTHENING TENDON EXTENSOR HAND/FINGER EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26477,CPT,SHORTENING TENDON EXTENSOR HAND/FINGER EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26478,CPT,LENGTHENING TENDON FLEXOR HAND/FINGER EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26479,CPT,SHORTENING TENDON FLEXOR HAND/FINGER EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26480,CPT,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26483,CPT,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26485,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26489,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26490,CPT,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26492,CPT,OPPONENSPLASTY TDN TR W/GRF EA TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26494,CPT,OPPONENSPLASTY HYPOTHENAR MUSC TR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26496,CPT,OPPONENSPLASTY OTHER METHODS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26497,CPT,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26498,CPT,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26499,CPT,CORRECTION CLAW FINGER OTHER METHODS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26500,CPT,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26502,CPT,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26508,CPT,RELEASE THENAR MUSCLE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26510,CPT,CROSS INTRINSIC TRANSFER EACH TENDON,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26516,CPT,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 26517,CPT,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26518,CPT,CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26520,CPT,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26525,CPT,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26530,CPT,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26531,CPT,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 26535,CPT,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26536,CPT,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 26540,CPT,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26541,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26542,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26545,CPT,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26546,CPT,RPR NON-UNION MTCRPL/PHALANX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26548,CPT,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26550,CPT,POLLICIZATION DIGIT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26555,CPT,TR FNGR AXH POS W/O MVASC ANAST,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26560,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26561,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26562,CPT,REPAIR SYNDACTYLY EACH SPACE COMPLEX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26565,CPT,OSTEOTOMY METACARPAL EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26567,CPT,OSTEOTOMY PHALANX FINGER EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26568,CPT,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26580,CPT,REPAIR CLEFT HAND,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26587,CPT,RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26590,CPT,REPAIR MACRODACTYLIA EACH DIGIT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26591,CPT,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26593,CPT,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 26596,CPT,EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26600,CPT,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 26605,CPT,CLTX METACARPAL FX W/MANIPULATION EACH BONE,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26607,CPT,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 26608,CPT,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26615,CPT,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26641,CPT,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26645,CPT,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 26650,CPT,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26665,CPT,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26670,CPT,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26675,CPT,CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 26676,CPT,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26685,CPT,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26686,CPT,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26700,CPT,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26705,CPT,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 26706,CPT,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 26715,CPT,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 26720,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 26725,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26727,CPT,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26735,CPT,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26740,CPT,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26742,CPT,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 26746,CPT,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26750,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 26755,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 26756,CPT,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26765,CPT,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26770,CPT,CLTX IPHAL JT DISLC W/MANJ W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 26775,CPT,CLTX IPHAL JT DISLC W/MANJ REQ ANES,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 26776,CPT,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26785,CPT,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 26820,CPT,FUSION OPPOSITION THUMB W/AUTOGENOUS GRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26841,CPT,ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26842,CPT,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 26843,CPT,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 26844,CPT,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 26850,CPT,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26852,CPT,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26860,CPT,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26861,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,,30,,,"$8,625.36",$0.00,1,0,1,20161001, 26862,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26863,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,,30,,,"$9,583.73",$0.00,1,0,1,20161001, 26910,CPT,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 26951,CPT,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26952,CPT,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 26989,CPT,UNLISTED PROCEDURE HANDS/FINGERS,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 26990,CPT,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 26991,CPT,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27000,CPT,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27001,CPT,TENOTOMY ADDUCTOR HIP OPEN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27003,CPT,TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27006,CPT,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27027,CPT,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27033,CPT,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27035,CPT,DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27040,CPT,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 27041,CPT,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 27043,CPT,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27045,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27047,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27048,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27049,CPT,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27050,CPT,ARTHROTOMY W/BIOPSY SACROILIAC JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27052,CPT,ARTHROTOMY W/BIOPSY HIP JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27057,CPT,DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27059,CPT,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27060,CPT,EXCISION ISCHIAL BURSA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27062,CPT,EXCISION TROCHANTERIC BURSA/CALCIFICATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27065,CPT,EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27066,CPT,EXCISION BONE CYST/BENIGN TUMOR DEEP,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27067,CPT,EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27080,CPT,COCCYGECTOMY PRIMARY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27086,CPT,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27087,CPT,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27093,CPT,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,,30,,,"$1,256.84",$0.00,1,0,1,20161001, 27095,CPT,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,,30,,,"$2,356.57",$0.00,1,0,1,20161001, 27096,CPT,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,,30,,,"$1,571.05",$0.00,1,0,1,20161001, 27097,CPT,RELEASE/RECESSION HAMSTRING PROXIMAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27098,CPT,TRANSFER ADDUCTOR ISCHIUM,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27100,CPT,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27105,CPT,TR PARASPI MUSC HIP FASC/TDN XTN GRF,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27110,CPT,TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27111,CPT,TRANSFER ILIOPSOAS FEMORAL NECK,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27179,CPT,OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 27193,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27194,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/MANJ ANES,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27200,CPT,CLOSED TREATMENT COCCYGEAL FRACTURE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27202,CPT,OPEN TREATMENT COCCYGEAL FRACTURE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27216,CPT,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS,,30,,,"$18,852.57",$0.00,1,0,1,20161001, 27220,CPT,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27230,CPT,CLTX FEM FX PROX END NCK W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27235,CPT,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27238,CPT,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 27246,CPT,CLTX GREATER TROCHANTERIC FX W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27250,CPT,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27252,CPT,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27256,CPT,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27257,CPT,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 27265,CPT,CLTX POST HIP ARTHRP DISLC W/O ANES,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27266,CPT,CLTX POST HIP ARTHRP DISLC REQ ANES,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27267,CPT,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27275,CPT,MANIPULATION HIP JOINT GENERAL ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27279,CPT,ARTHRODESIS SACROILIAC JOINT PERCUTANEOUS,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27299,CPT,UNLISTED PROCEDURE PELVIS/HIP JOINT,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27301,CPT,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27305,CPT,FASCIOTOMY ILIOTIBIAL OPEN,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27306,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27307,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27310,CPT,ARTHRT KNE W/EXPL DRG/RMVL FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27323,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27324,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27325,CPT,NEURECTOMY HAMSTRING MUSCLE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 27326,CPT,NEURECTOMY POPLITEAL,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 27327,CPT,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27328,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27329,CPT,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27330,CPT,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27331,CPT,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27332,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27333,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27334,CPT,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27335,CPT,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27337,CPT,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27339,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27340,CPT,EXCISION PREPATELLAR BURSA,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27345,CPT,EXCISION SYNOVIAL CYST POPLITEAL SPACE,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27347,CPT,EXCISION LESION MENISCUS/CAPSULE KNEE,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27350,CPT,PATELLECTOMY/HEMIPATELLECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27355,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27356,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27357,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27358,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,,30,,,"$9,426.29",$0.00,1,0,1,20161001, 27360,CPT,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27364,CPT,RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27370,CPT,INJECTION KNEE ARTHROGRAPHY,,30,,,$864.08,$0.00,1,0,1,20161001, 27372,CPT,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27380,CPT,SUTURE INFRAPATELLAR TENDON PRIMARY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27381,CPT,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27385,CPT,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27386,CPT,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27390,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27391,CPT,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27392,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27393,CPT,LENGTHENING HAMSTRING TENDON SINGLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27394,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE 1 LEG,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27395,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE BILATERAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27396,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27397,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27400,CPT,TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27403,CPT,ARTHROTOMY W/MENISCUS REPAIR KNEE,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27405,CPT,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27407,CPT,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27409,CPT,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27412,CPT,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27415,CPT,OSTEOCHONDRAL ALLOGRAFT KNEE OPEN,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27416,CPT,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27418,CPT,ANTERIOR TIBIAL TUBERCLEPLASTY,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27420,CPT,RCNSTJ DISLOCATING PATELLA,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27422,CPT,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27424,CPT,RCNSTJ DISLC PATELLA W/PATELLECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27425,CPT,LATERAL RETINACULAR RELEASE OPEN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27427,CPT,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27428,CPT,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27429,CPT,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27430,CPT,QUADRICEPSPLASTY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27435,CPT,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27437,CPT,ARTHROPLASTY PATELLA W/O PROSTHESIS,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 27438,CPT,ARTHROPLASTY PATELLA W/PROSTHESIS,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27440,CPT,ARTHROPLASTY KNEE TIBIAL PLATEAU,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27441,CPT,ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27442,CPT,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27443,CPT,ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27446,CPT,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27475,CPT,ARREST EPIPHYSEAL DISTAL FEMUR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27477,CPT,ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27479,CPT,ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27485,CPT,ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27496,CPT,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27497,CPT,DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27498,CPT,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27499,CPT,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27500,CPT,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27501,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27502,CPT,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27503,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 27508,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27509,CPT,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27510,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 27516,CPT,CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27517,CPT,CLTX DSTL FEM EPIPHYSL SEP W/MANJ W/WO SKIN/SKEL,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 27520,CPT,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27524,CPT,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27530,CPT,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27532,CPT,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27538,CPT,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27550,CPT,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27552,CPT,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27560,CPT,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27562,CPT,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27566,CPT,OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27570,CPT,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27594,CPT,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27599,CPT,UNLISTED PROCEDURE FEMUR/KNEE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27600,CPT,DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27601,CPT,DCMPRN FASCT LEG POST COMPARTMENT ONLY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27602,CPT,DCMPRN FASCT LEG ANT&/LAT&PST CMPRT,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27603,CPT,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27604,CPT,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27605,CPT,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27606,CPT,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27607,CPT,INCISION LEG/ANKLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27610,CPT,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27612,CPT,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27613,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 27614,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27615,CPT,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27616,CPT,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27618,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27619,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27620,CPT,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27625,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27626,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27630,CPT,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 27632,CPT,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27634,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 27635,CPT,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27637,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27638,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27640,CPT,PARTIAL EXCISION BONE TIBIA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27641,CPT,PARTIAL EXCISION BONE FIBULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27647,CPT,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27648,CPT,INJECTION ANKLE ARTHROGRAPHY,,30,,,"$1,082.47",$0.00,1,0,1,20161001, 27650,CPT,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27652,CPT,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27654,CPT,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27656,CPT,REPAIR FASCIAL DEFECT LEG,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27658,CPT,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27659,CPT,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27664,CPT,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27665,CPT,RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27675,CPT,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27676,CPT,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27680,CPT,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27681,CPT,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27685,CPT,LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27686,CPT,LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27687,CPT,GASTROCNEMIUS RECESSION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27690,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27691,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27692,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,,30,,,"$1,804.12",$0.00,1,0,1,20161001, 27695,CPT,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27696,CPT,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27698,CPT,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27700,CPT,ARTHROPLASTY ANKLE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27704,CPT,REMOVAL ANKLE IMPLANT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27705,CPT,OSTEOTOMY TIBIA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27707,CPT,OSTEOTOMY FIBULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27709,CPT,OSTEOTOMY TIBIA & FIBULA,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 27720,CPT,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27722,CPT,REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 27726,CPT,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27730,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27732,CPT,ARREST EPIPHYSEAL OPEN DISTAL FIBULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27734,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27740,CPT,ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27742,CPT,ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27745,CPT,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27750,CPT,CLTX TIBIAL SHAFT FX W/O MANIPULATION,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27752,CPT,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27756,CPT,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27758,CPT,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27759,CPT,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27760,CPT,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27762,CPT,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27766,CPT,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27767,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27768,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 27769,CPT,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27780,CPT,CLTX PROX FIBULA/SHFT FX W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27781,CPT,CLTX PROX FIBULA/SHFT FX W/MANJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27784,CPT,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27786,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27788,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27792,CPT,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27808,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27810,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27814,CPT,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27816,CPT,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27818,CPT,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27822,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27823,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27824,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 27825,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27826,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 27827,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27828,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27829,CPT,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27830,CPT,CLTX PROX TIBFIB JT DISLC W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27831,CPT,CLTX PROX TIBFIB JT DISLC REQ ANES,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27832,CPT,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 27840,CPT,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 27842,CPT,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27846,CPT,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27848,CPT,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27860,CPT,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 27870,CPT,ARTHRODESIS ANKLE OPEN,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 27871,CPT,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 27884,CPT,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 27889,CPT,ANKLE DISARTICULATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27892,CPT,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27893,CPT,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 27894,CPT,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 27899,CPT,UNLISTED PROCEDURE LEG/ANKLE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28001,CPT,INCISION&DRAINAGE BURSA FOOT,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 28002,CPT,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28003,CPT,I&D BELOW FASCIA FOOT MULTIPLE AREAS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28005,CPT,INCISION BONE CORTEX FOOT,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28008,CPT,FASCIOTOMY FOOT&/TOE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28010,CPT,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28011,CPT,TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28020,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28022,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28024,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28035,CPT,RELEASE TARSAL TUNNEL,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 28039,CPT,EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28041,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28043,CPT,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28045,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28046,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28047,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28050,CPT,ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28052,CPT,ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28054,CPT,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28055,CPT,NEURECTOMY INTRINSIC MUSCULATURE OF FOOT,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 28060,CPT,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28062,CPT,FASCIOTOMY PLANTAR FASCIA RADICAL SPX,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28070,CPT,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28072,CPT,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28080,CPT,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28086,CPT,SYNOVECTOMY TENDON SHEATH FOOT FLEXOR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28088,CPT,SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28090,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28092,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28100,CPT,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28102,CPT,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28103,CPT,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28104,CPT,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28106,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28107,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 28108,CPT,EXC/CURTG CST/B9 TUM PHALANGES FOOT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28110,CPT,OSTECTOMY PRTL 5TH METAR HEAD SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28111,CPT,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28112,CPT,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28113,CPT,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28114,CPT,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28116,CPT,OSTECTOMY TARSAL COALITION,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28118,CPT,OSTECTOMY CALCANEUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28119,CPT,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28120,CPT,PARTIAL EXCISION BONE TALUS/CALCANEUS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28122,CPT,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28124,CPT,PARTICAL EXCISION BONE PHALANX TOE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28126,CPT,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28130,CPT,TALECTOMY ASTRAGALECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28140,CPT,METATARSECTOMY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28150,CPT,PHALANGECTOMY TOE EACH TOE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28153,CPT,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28160,CPT,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28171,CPT,RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28173,CPT,RADICAL RESECTION TUMOR METATARSAL,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28175,CPT,RADICAL RESECTION TUMOR PHALANX OR TOE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28190,CPT,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 28192,CPT,REMOVAL FOREIGN BODY FOOT DEEP,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28193,CPT,REMOVAL FOREIGN BODY FOOT COMPLICATED,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 28200,CPT,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28202,CPT,RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 28208,CPT,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28210,CPT,RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28220,CPT,TENOLYSIS FLEXOR FOOT SINGLE TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28222,CPT,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28225,CPT,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28226,CPT,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 28230,CPT,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28232,CPT,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28234,CPT,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28238,CPT,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28240,CPT,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28250,CPT,DIVISION PLANTAR FASCIA & MUSCLE SPX,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28260,CPT,CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28261,CPT,CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28262,CPT,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 28264,CPT,CAPSULOTOMY MIDTARSAL,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 28270,CPT,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28272,CPT,CAPSULOTOMY IPHAL JOINT EACH JOINT SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28280,CPT,SYNDACTYLIZATION TOES,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28285,CPT,CORRECTION HAMMERTOE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28286,CPT,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28288,CPT,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28289,CPT,HALLUX RIGIDUS CORRECT W/CHEILECTOMY 1ST MP JT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28290,CPT,CORRJ HALLUX VALGUS W/WO SESMDC SMPL EXOSTECTOMY,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28292,CPT,KELLER/MCBRIDE/MAYO PROCEDURE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28293,CPT,CORRJ HALLUX VALGUS W/WO SESMDC RESCJ JT W/IMPLT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 28294,CPT,CORRJ HALLUX VALGUS W/WO SESMDC W/TDN TRNSPLS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28296,CPT,CORRJ HALLUX VALGUS W/WO SESMDC W/METAR OSTEOT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28297,CPT,CORRJ HALLUX VALGUS W/WO SESMDC LAPIDUS-TYP PX,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 28298,CPT,CORRJ HALLUX VALGUS W/WO SESMDC PHALANX OSTEOT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28299,CPT,CORRJ HALLUX VALGUS W/WO SESMDC 2 OSTEOT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28300,CPT,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28302,CPT,OSTEOTOMY TALUS,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28304,CPT,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28305,CPT,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28306,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28307,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28308,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28309,CPT,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28310,CPT,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28312,CPT,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28313,CPT,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28315,CPT,SESAMOIDECTOMY FIRST TOE SPX,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28320,CPT,REPAIR NONUNION/MALUNION TARSAL BONES,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 28322,CPT,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 28340,CPT,RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28341,CPT,RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28344,CPT,RECONSTRUCTION TOE POLYDACTYLY,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28345,CPT,RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28360,CPT,RECONSTRUCTION CLEFT FOOT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28400,CPT,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 28405,CPT,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 28406,CPT,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28415,CPT,OPEN TREATMENT CALCANEAL FRACTURE,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 28420,CPT,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 28430,CPT,CLOSED TX TALUS FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28435,CPT,CLOSED TX TALUS FRACTURE W/MANIPULATION,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 28436,CPT,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28445,CPT,OPEN TREATMENT TALUS FRACTURE,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28446,CPT,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28450,CPT,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 28455,CPT,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,,30,,,"$6,596.94",$0.00,1,0,1,20161001, 28456,CPT,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 28465,CPT,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28470,CPT,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28475,CPT,CLTX METAR FX W/MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28476,CPT,PRQ SKEL FIXJ METAR FX W/MANJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28485,CPT,OPEN TREATMENT METATARSAL FRACTURE EACH,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28490,CPT,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28495,CPT,CLTX FX GRT TOE PHLX/PHLG W/MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28496,CPT,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28505,CPT,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28510,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28515,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 28525,CPT,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28530,CPT,CLOSED TREATMENT SESAMOID FRACTURE,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28531,CPT,OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28540,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28545,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28546,CPT,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 28555,CPT,OPEN TREATMENT TARSAL BONE DISLOCATION,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 28570,CPT,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28575,CPT,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 28576,CPT,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28585,CPT,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28600,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,,30,,,"$1,520.98",$0.00,1,0,1,20161001, 28605,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28606,CPT,PRQ SKEL FIXJ TARS JT DISLC W/MANJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28615,CPT,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28630,CPT,CLTX METATARSOPHLNGL JT DISLC W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28635,CPT,CLTX METATARSOPHLNGL JT DISLC REQ ANES,,30,,,"$6,781.86",$0.00,1,0,1,20161001, 28636,CPT,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28645,CPT,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28660,CPT,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 28665,CPT,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 28666,CPT,PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 28675,CPT,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28705,CPT,ARTHRODESIS PANTALAR,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 28715,CPT,ARTHRODESIS TRIPLE,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 28725,CPT,ARTHRODESIS SUBTALAR,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 28730,CPT,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 28735,CPT,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 28737,CPT,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 28740,CPT,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 28750,CPT,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28755,CPT,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28760,CPT,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 28805,CPT,AMPUTATION FOOT TRANSMETARSAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 28810,CPT,AMPUTATION METATARSAL W/TOE SINGLE,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28820,CPT,AMPUTATION TOE METATARSOPHALANGEAL JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28825,CPT,AMPUTATION TOE INTERPHALANGEAL JOINT,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 28890,CPT,ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 28899,CPT,UNLISTED PROCEDURE FOOT/TOES,,30,,,"$1,190.16",$0.00,1,0,1,20161001, 29000,CPT,APPLICATION HALO TYPE BODY CAST,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29010,CPT,APPLICATION RISSER JACKET LOCALIZER BODY ONLY,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29015,CPT,APPLICATION RISSER JACKET LOCALIZER BODY W/HEAD,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29035,CPT,APPLICATION BODY CAST SHOULDER HIPS,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29040,CPT,APPLICATION BODY CAST SHOULDER HIPS HEAD MINERVA,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29044,CPT,APPLICATION BODY CAST SHOULDER HIPS W/ONE THIGH,,30,,,$571.56,$0.00,1,0,1,20161001, 29046,CPT,APPLICATION BODY CAST SHOULDER HIPS BOTH THIGHS,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29049,CPT,APPLICATION CAST FIGURE-OF-8,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29055,CPT,APPLICATION CAST SHOULDER SPICA,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29058,CPT,APPLICATION CAST PLASTER VELPEAU,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29065,CPT,APPLICATION CAST SHOULDER HAND LONG ARM,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29075,CPT,APPLICATION CAST ELBOW FINGER SHORT ARM,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29085,CPT,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29086,CPT,APPLICATION CAST FINGER,,30,,,$571.56,$0.00,1,0,1,20161001, 29105,CPT,APPLICATION LONG ARM SPLINT SHOULDER HAND,,30,,,$571.56,$0.00,1,0,1,20161001, 29125,CPT,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,,30,,,$425.53,$0.00,1,0,1,20161001, 29126,CPT,APPLICATION SHORT ARM SPLINT DYNAMIC,,30,,,$425.53,$0.00,1,0,1,20161001, 29130,CPT,APPLICATION FINGER SPLINT STATIC,,30,,,$306.21,$0.00,1,0,1,20161001, 29131,CPT,APPLICATION FINGER SPLINT DYNAMIC,,30,,,$306.21,$0.00,1,0,1,20161001, 29200,CPT,STRAPPING THORAX,,30,,,$571.56,$0.00,1,0,1,20161001, 29240,CPT,STRAPPING SHOULDER,,30,,,$306.21,$0.00,1,0,1,20161001, 29260,CPT,STRAPPING ELBOW/WRIST,,30,,,$156.54,$0.00,1,0,1,20161001, 29280,CPT,STRAPPING HAND/FINGER,,30,,,$156.54,$0.00,1,0,1,20161001, 29305,CPT,APPLICATION HIP SPICA CAST 1 LEG,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29325,CPT,APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29345,CPT,APPLICATION LONG LEG CAST THIGH-TOE,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29355,CPT,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29358,CPT,APPLICATION LONG LEG CAST BRACE,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29365,CPT,APPLICATION CYLINDER CAST THIGH ANKLE,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29405,CPT,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29425,CPT,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29435,CPT,APPLICATION PATELLAR TENDON BEARING CAST,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29440,CPT,ADDING WALKER PREVIOUSLY APPLIED CAST,,30,,,$571.56,$0.00,1,0,1,20161001, 29445,CPT,APPLICATION RIGID TOTAL CONTACT LEG CAST,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29450,CPT,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,,30,,,$651.23,$0.00,1,0,1,20161001, 29505,CPT,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,,30,,,$571.56,$0.00,1,0,1,20161001, 29515,CPT,APPLICATION SHORT LEG SPLINT CALF FOOT,,30,,,$571.56,$0.00,1,0,1,20161001, 29520,CPT,STRAPPING HIP,,30,,,$306.21,$0.00,1,0,1,20161001, 29530,CPT,STRAPPING KNEE,,30,,,$306.21,$0.00,1,0,1,20161001, 29540,CPT,STRAPPING ANKLE &/FOOT,,30,,,$571.56,$0.00,1,0,1,20161001, 29550,CPT,STRAPPING TOES,,30,,,$306.21,$0.00,1,0,1,20161001, 29580,CPT,STRAPPING UNNA BOOT,,30,,,$651.23,$0.00,1,0,1,20161001, 29581,CPT,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,,30,,,$651.23,$0.00,1,0,1,20161001, 29582,CPT,APPL MLTLAYR COMPRES THGH LEG ANKLE FT WHEN DONE,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29583,CPT,APPL MLTLAYR COMPRES SYSTEM UPPER & LOWER ARM,,30,,,$571.56,$0.00,1,0,1,20161001, 29584,CPT,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,,30,,,$571.56,$0.00,1,0,1,20161001, 29700,CPT,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29705,CPT,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29710,CPT,RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29720,CPT,REPAIR SPICA BODY CAST/JACKET,,30,,,$571.56,$0.00,1,0,1,20161001, 29730,CPT,WINDOWING CAST,,30,,,$571.56,$0.00,1,0,1,20161001, 29740,CPT,WEDGING CAST EXCEPT CLUBFOOT CASTS,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29750,CPT,WEDGING CLUBFOOT CAST,,30,,,"$1,334.07",$0.00,1,0,1,20161001, 29799,CPT,UNLISTED PROCEDURE CASTING/STRAPPING,,30,,,$571.56,$0.00,1,0,1,20161001, 29800,CPT,ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29804,CPT,ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29805,CPT,ARTHROSCOPY SHOULDER DX W/WO SYNOVIAL BIOPSY SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29806,CPT,ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 29807,CPT,ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 29819,CPT,ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29820,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 29821,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29822,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29823,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29824,CPT,ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29825,CPT,ARTHROSCOPY SHOULDER AHESIOLYSIS W/WO MANIPJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29826,CPT,ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE,,30,,,"$17,750.22",$0.00,1,0,1,20161001, 29827,CPT,ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 29828,CPT,ARTHROSCOPY SHOULDER BICEPS TENODESIS,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 29830,CPT,ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 29834,CPT,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29835,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29836,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29837,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29838,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29840,CPT,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29843,CPT,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29844,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29845,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29846,CPT,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29847,CPT,ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29848,CPT,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 29850,CPT,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 29851,CPT,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 29855,CPT,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 29856,CPT,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 29860,CPT,ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29861,CPT,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29862,CPT,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 29863,CPT,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29866,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 29867,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 29868,CPT,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 29870,CPT,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29871,CPT,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,,30,,,"$13,009.40",$0.00,1,0,1,20161001, 29873,CPT,ARTHROSCOPY KNEE LATERAL RELEASE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29874,CPT,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29875,CPT,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29876,CPT,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29877,CPT,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29879,CPT,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29880,CPT,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29881,CPT,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29882,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29883,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29884,CPT,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29885,CPT,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,,30,,,"$21,216.29",$0.00,1,0,1,20161001, 29886,CPT,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29887,CPT,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29888,CPT,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 29889,CPT,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 29891,CPT,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29892,CPT,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29893,CPT,ENDOSCOPIC PLANTAR FASCIOTOMY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 29894,CPT,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29895,CPT,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29897,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29898,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29899,CPT,ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 29900,CPT,ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29901,CPT,ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29902,CPT,ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 29904,CPT,ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29905,CPT,ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 29906,CPT,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 29907,CPT,ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 29914,CPT,ARTHROSCOPY HIP W/FEMOROPLASTY,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 29915,CPT,ARTHROSCOPY HIP W/ACETABULOPLASTY,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 29916,CPT,ARTHROSCOPY HIP W/LABRAL REPAIR,,30,,,"$23,484.36",$0.00,1,0,1,20161001, 29999,CPT,UNLISTED PROCEDURE ARTHROSCOPY,,30,,,"$8,040.80",$0.00,1,0,1,20161001, 30000,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,,30,,,$853.29,$0.00,1,0,1,20161001, 30020,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 30100,CPT,BIOPSY INTRANASAL,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 30110,CPT,EXCISION NASAL POLYP SIMPLE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 30115,CPT,EXCISION NASAL POLYP EXTENSIVE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30117,CPT,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30118,CPT,EXCISION/DESTRUCTION INTRANASAL LESION XTRNL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30120,CPT,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30124,CPT,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30125,CPT,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30130,CPT,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30140,CPT,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30150,CPT,RHINECTOMY PARTIAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30160,CPT,RHINECTOMY TOTAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30200,CPT,INJECTION TURBINATE THERAPEUTIC,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 30210,CPT,DISPLACEMENT THERAPY PROETZ TYPE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 30220,CPT,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 30300,CPT,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,,30,,,$425.53,$0.00,1,0,1,20161001, 30310,CPT,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30320,CPT,RMVL FOREIGN BODY INTRANASAL LATERAL RHINOTOMY,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 30400,CPT,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30410,CPT,RHINP PRIM COMPLETE XTRNL PARTS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30420,CPT,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30430,CPT,RHINOPLASTY SECONDARY MINOR REVISION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30435,CPT,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30450,CPT,RHINOPLASTY SECONDARY MAJOR REVISION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30460,CPT,RHINP DFRM W/COLUM LNGTH TIP ONLY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30462,CPT,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30465,CPT,REPAIR NASAL VESTIBULAR STENOSIS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30520,CPT,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30540,CPT,REPAIR CHOANAL ATRESIA INTRANASAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30545,CPT,REPAIR CHOANAL ATRESIA TRANSPALATINE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30560,CPT,LYSIS INTRANASAL SYNECHIA,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 30580,CPT,REPAIR FISTULA OROMAXILLARY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30600,CPT,REPAIR FISTULA ORONASAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30620,CPT,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 30630,CPT,REPAIR NASAL SEPTAL PERFORATIONS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30801,CPT,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 30802,CPT,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30901,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,,30,,,$425.53,$0.00,1,0,1,20161001, 30903,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,,30,,,$853.29,$0.00,1,0,1,20161001, 30905,CPT,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,,30,,,$853.29,$0.00,1,0,1,20161001, 30906,CPT,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,,30,,,$853.29,$0.00,1,0,1,20161001, 30915,CPT,LIGATION ARTERIES ETHMOIDAL,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 30920,CPT,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 30930,CPT,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 30999,CPT,UNLISTED PROCEDURE NOSE,,30,,,$853.29,$0.00,1,0,1,20161001, 31000,CPT,LAVAGE CANNULATION MAXILLARY SINUS,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 31002,CPT,LAVAGE CANNULATION SPHENOID SINUS,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 31020,CPT,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31030,CPT,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31032,CPT,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31040,CPT,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31050,CPT,SINUSOTOMY SPHENOID W/WO BIOPSY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31051,CPT,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31070,CPT,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31075,CPT,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31080,CPT,SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31081,CPT,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31084,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP BROW INC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31085,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31086,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31087,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31090,CPT,SINUSOT UNI 3/> PARANSL SINUSES,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31200,CPT,ETHMOIDECTOMY INTRANASAL ANTERIOR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31201,CPT,ETHMOIDECTOMY INTRANASAL TOTAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31205,CPT,ETHMOIDECTOMY EXTRANASAL TOTAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31231,CPT,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,,30,,,$578.94,$0.00,1,0,1,20161001, 31233,CPT,NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY,,30,,,"$2,376.99",$0.00,1,0,1,20161001, 31235,CPT,NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31237,CPT,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31238,CPT,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31239,CPT,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31240,CPT,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,,30,,,"$6,163.92",$0.00,1,0,1,20161001, 31254,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY PARTIAL,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31255,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY TOTAL,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31256,CPT,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31267,CPT,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31276,CPT,NASAL/SINUS NDSC W/FRONTAL SINUS EXPLORATION,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31287,CPT,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31288,CPT,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31292,CPT,NSL/SINUS NDSC SURG W/MEDIAL/INF ORB WALL DCMPRN,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31293,CPT,NASAL/SINUS NDSC MEDIAL ORB&NF ORB WALL DCMPR,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31294,CPT,NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31295,CPT,NASAL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31296,CPT,NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31297,CPT,NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31299,CPT,UNLISTED PROCEDURE ACCESSORY SINUSES,,30,,,$853.29,$0.00,1,0,1,20161001, 31300,CPT,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31320,CPT,LARYNGOTOMY THYROTOMY LARYNGOFISSURE DX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31400,CPT,ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31420,CPT,EPIGLOTTIDECTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31500,CPT,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,,30,,,$853.29,$0.00,1,0,1,20161001, 31502,CPT,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,,30,,,$853.29,$0.00,1,0,1,20161001, 31505,CPT,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,,30,,,$578.94,$0.00,1,0,1,20161001, 31510,CPT,LARYNGOSCOPY INDIRECT W/BIOPSY,,30,,,"$10,075.87",$0.00,1,0,1,20161001, 31511,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,,30,,,$578.94,$0.00,1,0,1,20161001, 31512,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL LESION,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31513,CPT,LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION,,30,,,"$6,163.92",$0.00,1,0,1,20161001, 31515,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,,30,,,"$2,376.99",$0.00,1,0,1,20161001, 31520,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN,,30,,,"$2,376.99",$0.00,1,0,1,20161001, 31525,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31526,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31527,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31528,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31529,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31530,CPT,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31531,CPT,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,,30,,,"$10,075.87",$0.00,1,0,1,20161001, 31535,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31536,CPT,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31540,CPT,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31541,CPT,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31545,CPT,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31546,CPT,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31560,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31561,CPT,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31570,CPT,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31571,CPT,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31575,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC DIAGNOSTIC,,30,,,$578.94,$0.00,1,0,1,20161001, 31576,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC W/BIOPSY,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31577,CPT,LARYNGOSCOPY FLX FIBEROPTIC RMVL FOREIGN BODY,,30,,,"$2,376.99",$0.00,1,0,1,20161001, 31578,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC REMOVAL LESION,,30,,,"$10,075.87",$0.00,1,0,1,20161001, 31579,CPT,LARYNGOSCOPY FLX/RGD FIBOPT W/STROBOSCOPY,,30,,,"$2,376.99",$0.00,1,0,1,20161001, 31580,CPT,LARYNGOPLASTY LARYN WEB 2 STG W/KEEL INSJ&RMVL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31582,CPT,LARYNGP LARYN STENOSIS GRF/CORE MOLD W/TRACHT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31588,CPT,LARYNGOPLASTY NOT OTHERWISE SPECIFIED,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31590,CPT,LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31595,CPT,SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31599,CPT,UNLISTED PROCEDURE LARYNX,,30,,,$853.29,$0.00,1,0,1,20161001, 31600,CPT,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31601,CPT,TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31603,CPT,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 31605,CPT,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 31610,CPT,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31611,CPT,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31612,CPT,TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31613,CPT,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31614,CPT,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31615,CPT,TRACHEOBRNCHSC THRU EST TRACHS INC,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 31622,CPT,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31623,CPT,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31624,CPT,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31625,CPT,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31626,CPT,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31627,CPT,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,,30,,,"$5,758.21",$0.00,1,0,1,20161001, 31628,CPT,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,,30,,,"$10,075.87",$0.00,1,0,1,20161001, 31629,CPT,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31630,CPT,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31631,CPT,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31632,CPT,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,,30,,,"$2,879.10",$0.00,1,0,1,20161001, 31633,CPT,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,,30,,,"$2,879.10",$0.00,1,0,1,20161001, 31634,CPT,BRONCHOSCOPY BALLOON OCCLUSION,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31635,CPT,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31636,CPT,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31637,CPT,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,,30,,,"$5,758.21",$0.00,1,0,1,20161001, 31638,CPT,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,,30,,,"$15,724.61",$0.00,1,0,1,20161001, 31640,CPT,BRONCHOSCOPY W/EXCISION TUMOR,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31641,CPT,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31643,CPT,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31645,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE 1ST,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31646,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE SBSQ,,30,,,"$2,379.09",$0.00,1,0,1,20161001, 31647,CPT,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31648,CPT,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,,30,,,"$11,460.85",$0.00,1,0,1,20161001, 31649,CPT,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,,30,,,"$6,100.92",$0.00,1,0,1,20161001, 31651,CPT,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,,30,,,"$4,203.49",$0.00,1,0,1,20161001, 31652,CPT,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,,30,,,"$10,075.87",$0.00,1,0,1,20161001, 31653,CPT,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,,30,,,"$10,075.87",$0.00,1,0,1,20161001, 31660,CPT,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31661,CPT,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,,30,,,"$17,504.76",$0.00,1,0,1,20161001, 31717,CPT,CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY,,30,,,"$2,376.99",$0.00,1,0,1,20161001, 31720,CPT,CATHETER ASPIRATION NASOTRACHEAL SPX,,30,,,$238.49,$0.00,1,0,1,20161001, 31730,CPT,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,,30,,,"$6,163.92",$0.00,1,0,1,20161001, 31750,CPT,TRACHEOPLASTY CERVICAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31755,CPT,TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 31785,CPT,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31820,CPT,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31825,CPT,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31830,CPT,REVISION TRACHEOSTOMY SCAR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 31899,CPT,UNLISTED PROCEDURE TRACHEA BRONCHI,,30,,,"$3,256.97",$0.00,1,0,1,20161001, 32400,CPT,BIOPSY PLEURA PERCUTANEOUS NEEDLE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 32405,CPT,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 32550,CPT,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,,30,,,"$12,131.57",$0.00,1,0,1,20161001, 32551,CPT,TUBE THORACOSTOMY INCLUDES WATER SEAL,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32552,CPT,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32553,CPT,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,,30,,,"$6,357.83",$0.00,1,0,1,20161001, 32554,CPT,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32555,CPT,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32556,CPT,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,,30,,,"$7,205.95",$0.00,1,0,1,20161001, 32557,CPT,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32560,CPT,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32561,CPT,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32562,CPT,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32601,CPT,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,,30,,,"$16,088.82",$0.00,1,0,1,20161001, 32604,CPT,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,,30,,,"$16,088.82",$0.00,1,0,1,20161001, 32606,CPT,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,,30,,,"$16,088.82",$0.00,1,0,1,20161001, 32607,CPT,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,,30,,,"$16,088.82",$0.00,1,0,1,20161001, 32608,CPT,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,,30,,,"$16,088.82",$0.00,1,0,1,20161001, 32609,CPT,THORACOSCOPY WITH BIOPSYIES OF PLEURA,,30,,,"$16,088.82",$0.00,1,0,1,20161001, 32960,CPT,PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 32998,CPT,ABLATION PULMONARY TUMOR PERQ RADIOFREQUENCY UNI,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 32999,CPT,UNLISTED PROCEDURE LUNGS & PLEURA,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 33010,CPT,PERICARDIOCENTESIS INITIAL,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 33011,CPT,PERICARDIOCENTESIS SUBSEQUENT,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 33206,CPT,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 33207,CPT,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 33208,CPT,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 33210,CPT,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33211,CPT,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33212,CPT,INS PM PLS GEN W/EXIST SINGLE LEAD,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33213,CPT,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 33214,CPT,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 33215,CPT,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 33216,CPT,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33217,CPT,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33218,CPT,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33220,CPT,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33221,CPT,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,,30,,,"$33,969.60",$0.00,1,0,1,20161001, 33222,CPT,RELOCATION OF SKIN POCKET FOR PACEMAKER,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 33223,CPT,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 33224,CPT,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 33225,CPT,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,,30,,,"$19,869.53",$0.00,1,0,1,20161001, 33226,CPT,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 33227,CPT,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33228,CPT,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 33229,CPT,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,,30,,,"$33,969.60",$0.00,1,0,1,20161001, 33230,CPT,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,,30,,,"$44,371.92",$0.00,1,0,1,20161001, 33231,CPT,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,,30,,,"$61,541.58",$0.00,1,0,1,20161001, 33233,CPT,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,,30,,,"$23,372.96",$0.00,1,0,1,20161001, 33234,CPT,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33235,CPT,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33240,CPT,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,,30,,,"$44,371.92",$0.00,1,0,1,20161001, 33241,CPT,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33244,CPT,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33249,CPT,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,,30,,,"$61,541.58",$0.00,1,0,1,20161001, 33262,CPT,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,,30,,,"$44,371.92",$0.00,1,0,1,20161001, 33263,CPT,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,,30,,,"$44,371.92",$0.00,1,0,1,20161001, 33264,CPT,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,,30,,,"$61,541.58",$0.00,1,0,1,20161001, 33270,CPT,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,,30,,,"$61,541.58",$0.00,1,0,1,20161001, 33271,CPT,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33272,CPT,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33273,CPT,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 33282,CPT,IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 33284,CPT,RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 33419,CPT,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,,30,,,"$22,030.41",$0.00,1,0,1,20161001, 33999,CPT,UNLISTED CARDIAC SURGERY,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 34101,CPT,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 34111,CPT,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 34201,CPT,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 34203,CPT,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 34421,CPT,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 34471,CPT,THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 34490,CPT,THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 34501,CPT,VALVULOPLASTY FEMORAL VEIN,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 34510,CPT,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 34520,CPT,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 34530,CPT,SAPHENOPOPLITEAL VEIN ANASTOMOSIS,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35011,CPT,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35045,CPT,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35180,CPT,REPAIR CONGENITAL AV FISTULA HEAD & NECK,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35184,CPT,RPR CONGENITAL AV FISTULA EXTREMITIES,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35188,CPT,RPR/TRAUMATIC AV FISTULA HEAD & NECK,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35190,CPT,RPR/TRAUMATIC AV FISTULA EXTREMITIES,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35201,CPT,REPAIR BLOOD VESSEL DIRECT NECK,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35206,CPT,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35207,CPT,REPAIR BLOOD VESSEL DIRECT HAND FINGER,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35226,CPT,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 35231,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35236,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35256,CPT,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35261,CPT,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35266,CPT,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35286,CPT,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35321,CPT,TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35458,CPT,TRLUML BALO ANGIOP OPN BRCH/CPHLC TRNK/BRNCH EA,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 35460,CPT,TRLUML BALLOON ANGIOPLASTY OPEN VENOUS,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 35471,CPT,TRLUML BALLOON ANGIOP PRQ RENAL/VISCERAL ART,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 35472,CPT,TRLUML BALLOON ANGIOPLASTY PERCUTANEOUS AORTIC,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 35475,CPT,TRLUML BALO ANGIOP PRQ BRCH/CPHLC TRNK/BRNCH EA,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 35476,CPT,TRLUML BALLOON ANGIOPLASTY PERCUTANEOUS VENOUS,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 35500,CPT,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,,30,,,"$9,683.56",$0.00,1,0,1,20161001, 35685,CPT,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,,30,,,"$58,110.18",$0.00,1,0,1,20161001, 35686,CPT,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,,30,,,"$58,110.18",$0.00,1,0,1,20161001, 35761,CPT,EXPL N/FLWD SURG RPR W/WO LYSIS OTHER ARTERY,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35860,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 35875,CPT,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35876,CPT,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35879,CPT,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35881,CPT,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35883,CPT,REVISION FEMORAL ANAST OPEN NONAUTOG GRAFT,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35884,CPT,REVISION FEMORAL ANAST OPEN W/AUTOG GRAFT,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 35903,CPT,EXCISION INFECTED GRAFT EXTREMITY,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36000,CPT,INTRODUCTION NEEDLE/INTRACATHETER VEIN,,30,,,$471.76,$0.00,1,0,1,20161001, 36002,CPT,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,,30,,,"$2,635.53",$0.00,1,0,1,20161001, 36005,CPT,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,,30,,,$687.99,$0.00,1,0,1,20161001, 36010,CPT,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,,30,,,"$4,717.62",$0.00,1,0,1,20161001, 36011,CPT,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36012,CPT,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36013,CPT,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,,30,,,"$8,255.83",$0.00,1,0,1,20161001, 36014,CPT,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36015,CPT,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36100,CPT,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,,30,,,"$4,717.62",$0.00,1,0,1,20161001, 36120,CPT,INTRO NEEDLE/INTRACATH RETROGRADE BRACHIAL ART,,30,,,"$4,717.62",$0.00,1,0,1,20161001, 36140,CPT,INTRO NEEDLE/INTRACATH EXTREMITY ARTERY,,30,,,"$4,717.62",$0.00,1,0,1,20161001, 36147,CPT,INTRO NDL/CATH AV SHUNT IST ACCESS W/ RAD EVAL,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36148,CPT,INTRO NDL/CATH AV SHUNT ADDL ACCESS THER IVNTJ,,30,,,"$4,717.62",$0.00,1,0,1,20161001, 36160,CPT,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,,30,,,"$4,717.62",$0.00,1,0,1,20161001, 36200,CPT,INTRODUCTION CATHETER AORTA,,30,,,"$4,717.62",$0.00,1,0,1,20161001, 36215,CPT,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36216,CPT,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36217,CPT,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36218,CPT,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,,30,,,$786.27,$0.00,1,0,1,20161001, 36221,CPT,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 36222,CPT,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 36223,CPT,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,,30,,,"$18,214.01",$0.00,1,0,1,20161001, 36224,CPT,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36225,CPT,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 36226,CPT,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36227,CPT,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,,30,,,"$10,327.30",$0.00,1,0,1,20161001, 36228,CPT,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,,30,,,"$10,541.65",$0.00,1,0,1,20161001, 36245,CPT,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36246,CPT,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36247,CPT,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,,30,,,"$7,076.43",$0.00,1,0,1,20161001, 36248,CPT,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,,30,,,$638.84,$0.00,1,0,1,20161001, 36251,CPT,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 36252,CPT,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 36253,CPT,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 36254,CPT,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 36260,CPT,INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36261,CPT,REVJ IMPLANTED INTRA-ARTERIAL INFUSION PUMP,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 36262,CPT,REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 36299,CPT,UNLISTED PROCEDURE VASCULAR INJECTION,,30,,,"$4,927.32",$0.00,1,0,1,20161001, 36400,CPT,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,,30,,,$179.59,$0.00,1,0,1,20161001, 36405,CPT,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,,30,,,$134.70,$0.00,1,0,1,20161001, 36406,CPT,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,,30,,,$134.70,$0.00,1,0,1,20161001, 36410,CPT,VNPNXR 3 YEARS/> PHYS/QHP SKILL,,30,,,$134.70,$0.00,1,0,1,20161001, 36415,CPT,COLLECTION VENOUS BLOOD VENIPUNCTURE,,30,,,$35.92,$0.00,1,0,1,20161001, 36416,CPT,COLLECTION CAPILLARY BLOOD SPECIMEN,,30,,,$34.42,$0.00,1,0,1,20161001, 36420,CPT,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,,30,,,$306.21,$0.00,1,0,1,20161001, 36425,CPT,VENIPUNCTURE CUTDOWN AGE 1 YR/>,,30,,,$425.53,$0.00,1,0,1,20161001, 36430,CPT,TRANSFUSION BLOOD/BLOOD COMPONENTS,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 36440,CPT,PUSH TRANSFUSION BLOOD 2 YR/UNDER,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 36450,CPT,EXCHNG TRANSFUSION BLOOD NEWBORN,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 36455,CPT,EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 36460,CPT,TRANSFUSION INTRAUTERINE FETAL,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 36468,CPT,1/MLT NJXS SCLRSG SLNS SPIDER VEINS LIMB/TRUNK,,30,,,$398.75,$0.00,1,0,1,20161001, 36470,CPT,NJX SCLEROSING SOLUTION SINGLE VEIN,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 36471,CPT,NJX SCLEROSING SOLUTION MULTIPLE VEINS SAME LEG,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 36475,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36476,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,,30,,,"$10,921.84",$0.00,1,0,1,20161001, 36478,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36479,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,,30,,,"$10,921.84",$0.00,1,0,1,20161001, 36481,CPT,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,,30,,,"$12,135.38",$0.00,1,0,1,20161001, 36500,CPT,VEN CATHJ SLCTV ORGAN BLD SAMPLING,,30,,,"$9,708.30",$0.00,1,0,1,20161001, 36511,CPT,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 36512,CPT,THERAPEUTIC APHERESIS RED BLOOD CELLS,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 36513,CPT,THERAPEUTIC APHERESIS PLATELETS,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 36514,CPT,THERAPEUTIC APHERESIS PLASMA PHERESIS,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 36515,CPT,THER APHERESIS W/XTRCORP IMMUNODSPTJ& PLSM RENFJ,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 36516,CPT,THER APHRS XTRCORP SLCTV ADSRPJ/FILTRJ & REINFSJ,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 36522,CPT,PHOTOPHERESIS EXTRACORPOREAL,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 36555,CPT,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36556,CPT,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36557,CPT,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36558,CPT,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36560,CPT,INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36561,CPT,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36563,CPT,INSJ TUNNELED CTR VAD W/SUBQ PUMP,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36565,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36566,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,,30,,,"$18,214.01",$0.00,1,0,1,20161001, 36568,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP UNDER 5 YR,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36569,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36570,CPT,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36571,CPT,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36575,CPT,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 36576,CPT,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36578,CPT,RPLCMT CATH CTR VAD SUBQ PORT/PMP,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36580,CPT,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36581,CPT,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36582,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36583,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PMP,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36584,CPT,RPLCMT COMPL PRPH CVC W/O SUBQ PORT/PMP,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36585,CPT,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36589,CPT,RMVL TUN CVC W/O SUBQ PORT/PMP,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 36590,CPT,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36591,CPT,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,,30,,,$425.53,$0.00,1,0,1,20161001, 36592,CPT,COLLECT BLOOD FROM CATHETER VENOUS NOS,,30,,,$425.53,$0.00,1,0,1,20161001, 36593,CPT,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,,30,,,"$1,302.06",$0.00,1,0,1,20161001, 36595,CPT,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36596,CPT,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36597,CPT,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 36598,CPT,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,,30,,,"$1,302.06",$0.00,1,0,1,20161001, 36600,CPT,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,,30,,,$425.53,$0.00,1,0,1,20161001, 36620,CPT,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,,30,,,"$1,719.18",$0.00,1,0,1,20161001, 36625,CPT,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,,30,,,"$1,719.18",$0.00,1,0,1,20161001, 36640,CPT,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36680,CPT,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,,30,,,$425.53,$0.00,1,0,1,20161001, 36800,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36810,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36815,CPT,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36818,CPT,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36819,CPT,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36820,CPT,ARVEN ANAST OPN F/ARM VEIN TRPOS,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36821,CPT,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36825,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36830,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36831,CPT,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36832,CPT,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36833,CPT,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36835,CPT,INSERTION THOMAS SHUNT SEPARATE PROCEDURE,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 36838,CPT,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 36860,CPT,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,,30,,,"$5,280.44",$0.00,1,0,1,20161001, 36861,CPT,XTRNL CANNULA DECLTNG SPX W/BALO CATH,,30,,,"$18,214.01",$0.00,1,0,1,20161001, 36870,CPT,THRMBC PRQ ARVEN FSTL AUTOG/NONAUTOG GRF,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 37183,CPT,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 37184,CPT,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37185,CPT,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,,30,,,"$7,078.97",$0.00,1,0,1,20161001, 37186,CPT,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,,30,,,"$7,078.97",$0.00,1,0,1,20161001, 37187,CPT,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37188,CPT,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37191,CPT,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37192,CPT,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37193,CPT,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37195,CPT,THROMBOLYSIS CEREBRAL IV INFUSION,,30,,,"$1,302.06",$0.00,1,0,1,20161001, 37197,CPT,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37200,CPT,TRANSCATHETER BIOPSY,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37211,CPT,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37212,CPT,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 37213,CPT,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37214,CPT,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37220,CPT,REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 37221,CPT,REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37222,CPT,REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL,,30,,,"$7,887.99",$0.00,1,0,1,20161001, 37223,CPT,REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL,,30,,,"$9,101.53",$0.00,1,0,1,20161001, 37224,CPT,REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 37225,CPT,REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37226,CPT,REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37227,CPT,REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL,,30,,,"$29,536.30",$0.00,1,0,1,20161001, 37228,CPT,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37229,CPT,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL,,30,,,"$29,536.30",$0.00,1,0,1,20161001, 37230,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL,,30,,,"$29,536.30",$0.00,1,0,1,20161001, 37231,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL,,30,,,"$29,536.30",$0.00,1,0,1,20161001, 37232,CPT,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL,,30,,,"$9,204.81",$0.00,1,0,1,20161001, 37233,CPT,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL,,30,,,"$8,090.25",$0.00,1,0,1,20161001, 37234,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL,,30,,,"$7,078.97",$0.00,1,0,1,20161001, 37235,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL,,30,,,"$10,112.81",$0.00,1,0,1,20161001, 37236,CPT,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37237,CPT,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,,30,,,"$21,756.05",$0.00,1,0,1,20161001, 37238,CPT,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37239,CPT,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,,30,,,"$14,615.64",$0.00,1,0,1,20161001, 37241,CPT,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37242,CPT,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37243,CPT,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37244,CPT,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 37500,CPT,VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37501,CPT,UNLISTED VASCULAR ENDOSCOPY PROCEDURE,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 37565,CPT,LIGATION INTERNAL JUGULAR VEIN,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37600,CPT,LIGATION EXTERNAL CAROTID ARTERY,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37605,CPT,LIGATION INTERNAL/COMMON CAROTID ARTERY,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37606,CPT,LIG INT/COMMON CAROTID ART W/GRADUAL OCCLUSION,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37607,CPT,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37609,CPT,LIGATION/BIOPSY TEMPORAL ARTERY,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 37615,CPT,LIGATION MAJOR ARTERY NECK,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37619,CPT,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,,30,,,"$18,610.01",$0.00,1,0,1,20161001, 37650,CPT,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37700,CPT,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37718,CPT,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37722,CPT,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37735,CPT,LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37760,CPT,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37761,CPT,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37765,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37766,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37780,CPT,LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37785,CPT,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 37790,CPT,PENILE VENOUS OCCLUSIVE PROCEDURE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 37799,CPT,UNLISTED PROCEDURE VASCULAR SURGERY,,30,,,"$5,431.93",$0.00,1,0,1,20161001, 38120,CPT,LAPAROSCOPIC SURGICAL SPLENECTOMY,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 38129,CPT,UNLISTED LAPAROSCOPY PROCEDURE SPLEEN,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 38200,CPT,INJECTION PROCEDURE SPLENOPORTOGRAPY,,30,,,"$3,872.40",$0.00,1,0,1,20161001, 38204,CPT,MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ,,30,,,"$2,452.83",$0.00,1,0,1,20161001, 38205,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,,30,,,"$10,933.84",$0.00,1,0,1,20161001, 38206,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38207,CPT,TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 38208,CPT,TRNSPL PREP HEMATOP PROGEN THAW PREV HRV PER DNR,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 38209,CPT,TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 38210,CPT,TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38211,CPT,TRNSPL PREPJ HEMATOP PROGEN TUM CELL DEPLJ,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38212,CPT,TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38213,CPT,TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38214,CPT,TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38215,CPT,TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38220,CPT,MARROW ASPIRATION ONLY,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 38221,CPT,BONE MARROW BIOPSY NEEDLE/TROCAR,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 38230,CPT,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 38232,CPT,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 38240,CPT,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 38241,CPT,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 38242,CPT,ALLOGENEIC LYMPHOCYTE INFUSIONS,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38243,CPT,TRNSPLJ HEMATOPOIETIC CELL BOOST,,30,,,"$6,423.33",$0.00,1,0,1,20161001, 38300,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 38305,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 38308,CPT,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38500,CPT,BX/EXC LYMPH NODE OPEN SUPERFICIAL,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38505,CPT,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 38510,CPT,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38520,CPT,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38525,CPT,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38530,CPT,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38542,CPT,DISSECTION DEEP JUGULAR NODE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 38550,CPT,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38555,CPT,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 38570,CPT,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 38571,CPT,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 38572,CPT,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 38589,CPT,UNLISTED LAPAROSCOPY PX LYMPHATIC SYSTEM,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 38700,CPT,SUPRAHYOID LYMPHADENECTOMY,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 38720,CPT,CERVICAL LYMPHADENECTOMY,,30,,,"$17,848.07",$0.00,1,0,1,20161001, 38740,CPT,AXILLARY LYMPHADENECTOMY SUPERFICIAL,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 38745,CPT,AXILLARY LYMPHADENECTOMY COMPLETE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 38760,CPT,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,,30,,,"$12,201.56",$0.00,1,0,1,20161001, 38790,CPT,INJECTION PROCEDURE LYMPHANGIOGRAPHY,,30,,,"$3,872.40",$0.00,1,0,1,20161001, 38792,CPT,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 38900,CPT,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,,30,,,"$1,822.31",$0.00,1,0,1,20161001, 38999,CPT,UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM,,30,,,"$2,268.27",$0.00,1,0,1,20161001, 39401,CPT,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,,30,,,"$16,044.92",$0.00,1,0,1,20161001, 39402,CPT,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,,30,,,"$16,044.92",$0.00,1,0,1,20161001, 40490,CPT,BIOPSY OF LIP,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 40500,CPT,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40510,CPT,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40520,CPT,EXC LIP V-EXC W/PRIM DIR LINR CLSR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40525,CPT,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40527,CPT,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40530,CPT,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40650,CPT,RPR LIP FULL THICKNESS VERMILION ONLY,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 40652,CPT,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 40654,CPT,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 40700,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40701,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40702,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40720,CPT,PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40761,CPT,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40799,CPT,UNLISTED PROCEDURE LIPS,,30,,,$853.29,$0.00,1,0,1,20161001, 40800,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 40801,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 40804,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,,30,,,$425.53,$0.00,1,0,1,20161001, 40805,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 40806,CPT,INCISION LABIAL FRENUM FRENOTOMY,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 40808,CPT,BIOPSY VESTIBULE MOUTH,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 40810,CPT,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40812,CPT,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40814,CPT,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40816,CPT,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40818,CPT,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 40819,CPT,EXC FRENUM LABIAL/BUCCAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40820,CPT,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40830,CPT,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 40831,CPT,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 40840,CPT,VESTIBULOPLASTY ANTERIOR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40842,CPT,VESTIBULOPLASTY POSTERIOR UNILATERAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40843,CPT,VESTIBULOPLASTY POSTERIOR BILATERAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 40844,CPT,VESTIBULOPLASTY ENTIRE ARCH,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40845,CPT,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 40899,CPT,UNLISTED PROCEDURE VESTIBULE MOUTH,,30,,,$853.29,$0.00,1,0,1,20161001, 41000,CPT,INTRAORAL I&D TONGUE/FLOOR LINGUAL,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41005,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 41006,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41007,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41008,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41009,CPT,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 41010,CPT,INCISION LINGUAL FRENUM FRENOTOMY,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41015,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 41016,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41017,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41018,CPT,XTRORAL I&D FLOOR MASTICATOR SPACE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41019,CPT,PLACEMENT NEEDLE HEAD/NECK RADIOELEMENT APPLICAT,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41100,CPT,BIOPSY TONGUE ANTERIOR TWO-THIRDS,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41105,CPT,BIOPSY TONGUE POSTERIOR ONE-THIRD,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41108,CPT,BIOPSY FLOOR MOUTH,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 41110,CPT,EXCISION LESION TONGUE W/O CLOSURE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41112,CPT,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41113,CPT,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41114,CPT,EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41115,CPT,EXCISION LINGUAL FRENUM FRENECTOMY,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41116,CPT,EXCISION LESION FLOOR MOUTH,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41120,CPT,GLOSSECTOMY 2.6 CM/CPLX,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41500,CPT,FIXJ TONGUE MECHANICAL OTHER/THAN SUTURE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41510,CPT,SUTURE TONGUE LIP MICROGNATHIA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41512,CPT,TONGUE BASE SUSPENSION PERMANENT SUTURE TQ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 41520,CPT,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 41530,CPT,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41599,CPT,UNLISTED PROCEDURE TONGUE FLOOR MOUTH,,30,,,$853.29,$0.00,1,0,1,20161001, 41800,CPT,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,,30,,,$425.53,$0.00,1,0,1,20161001, 41805,CPT,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41806,CPT,RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS BONE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41820,CPT,GINGIVECTOMY EXC GINGIVA EACH QUADRANT,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41821,CPT,OPRCULECTOMY EXC PRICORONAL TISSUE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41822,CPT,EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 41823,CPT,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 41825,CPT,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41826,CPT,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41827,CPT,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 41828,CPT,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41830,CPT,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41850,CPT,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41870,CPT,PERIODONTAL MUCOSAL GRAFTING,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 41872,CPT,GINGIVOPLASTY EACH QUADRANT SPECIFY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 41874,CPT,ALVEOLOPLASTY EACH QUADRANT SPECIFY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 41899,CPT,UNLISTED PROCEDURE DENTOALVEOLAR STRUCTURES,,30,,,$853.29,$0.00,1,0,1,20161001, 42000,CPT,DRAINAGE ABSCESS PALATE UVULA,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 42100,CPT,BIOPSY PALATE UVULA,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 42104,CPT,EXC LESION PALATE UVULA W/O CLOSURE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42106,CPT,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42107,CPT,EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42120,CPT,RESCJ PALATE/EXTENSIVE RESCJ LESION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42140,CPT,UVULECTOMY EXCISION UVULA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42145,CPT,PALATOPHARYNGOPLASTY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42160,CPT,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42180,CPT,REPAIR LACERATION PALATE 2 CM/COMPLEX,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42200,CPT,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42205,CPT,PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42210,CPT,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42215,CPT,PALATOPLASTY CLEFT PALATE MAJOR REVJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42220,CPT,PALATOPLASTY CLEFT PALATE SEC LNGTH PX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42225,CPT,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42226,CPT,LENGTHENING PALATE & PHARYNGEAL FLAP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42227,CPT,LENGTHENING PALATE W/ISLAND FLAP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42235,CPT,REPAIR ANTERIOR PALATE W/VOMER FLAP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42260,CPT,REPAIR NASOLABIAL FISTULA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42280,CPT,MAXILLARY IMPRESJ PALATAL PROSTHESIS,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 42281,CPT,INSJ PIN-RETAINED PALATAL PROSTHESIS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42299,CPT,UNLISTED PROCEDURE PALATE UVULA,,30,,,$853.29,$0.00,1,0,1,20161001, 42300,CPT,DRAINAGE ABSCESS PAROTID SIMPLE,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 42305,CPT,DRAINAGE ABSCESS PAROTID COMPLICATED,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42310,CPT,DRG ABSC SUBMAXILLARY/SUBLINGUAL INTRAORAL,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 42320,CPT,DRAINAGE ABSCESS SUBMAXILLARY INTRAORAL,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 42330,CPT,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42335,CPT,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42340,CPT,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42400,CPT,BIOPSY SALIVARY GLAND NEEDLE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 42405,CPT,BIOPSY SALIVARY GLAND INCISIONAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42408,CPT,EXC SUBLINGUAL SALIVARY CYST RANULA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42409,CPT,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42410,CPT,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42415,CPT,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42420,CPT,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42425,CPT,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42440,CPT,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42450,CPT,EXISION OF SUBLINGUAL GLAND,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42500,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42505,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42507,CPT,PAROTID DUCT DIVERSION BILATERAL WILKE PX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42509,CPT,PAROTID DUCT DVRJ BI W/EXC BOTH SUBMNDBLR GLANDS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42510,CPT,PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42550,CPT,INJECTION PROCEDURE SIALOGRAPHY,,30,,,$477.44,$0.00,1,0,1,20161001, 42600,CPT,CLOSURE SALIVARY FISTULA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42650,CPT,DILATION SALIVARY DUCT,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 42660,CPT,DILAT&CATHJ SALIVARY DUCT W/WO INJECTION,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 42665,CPT,LIGATION SALIVARY DUCT INTRAORAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42699,CPT,UNLISTED PX SALIVARY GLANDS/DUCTS,,30,,,$853.29,$0.00,1,0,1,20161001, 42700,CPT,I&D ABSCESS PERITONSILLAR,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 42720,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42725,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42800,CPT,BIOPSY OROPHARYNX,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 42804,CPT,BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42806,CPT,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42808,CPT,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42809,CPT,REMOVAL FOREIGN BODY PHARYNX,,30,,,$425.53,$0.00,1,0,1,20161001, 42810,CPT,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42815,CPT,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42820,CPT,TONSILLECTOMY & ADENOIDECTOMY ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42825,CPT,TONSILLECTOMY ONE-HALF ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42830,CPT,ADENOIDECTOMY PRIMARY ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42835,CPT,ADENOIDECTOMY SECONDARY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42842,CPT,RADICAL RESECTION TONSIL W/O CLOSURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42844,CPT,RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42860,CPT,EXCISION TONSIL TAGS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42870,CPT,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42890,CPT,LIMITED PHARYNGECTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42892,CPT,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42900,CPT,SUTURE PHARYNX WOUND/INJURY,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 42950,CPT,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 42955,CPT,PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 42960,CPT,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,,30,,,$853.29,$0.00,1,0,1,20161001, 42962,CPT,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42970,CPT,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,,30,,,$853.29,$0.00,1,0,1,20161001, 42972,CPT,CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 42999,CPT,UNLISTED PROCEDURE PHARYNX ADENOIDS/TONSILS,,30,,,$853.29,$0.00,1,0,1,20161001, 43020,CPT,ESOPHAGOTOMY CERVICAL APPR W/RMVL FB,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 43030,CPT,CRICOPHARYNGEAL MYOTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 43130,CPT,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 43180,CPT,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 43191,CPT,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43192,CPT,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43193,CPT,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43194,CPT,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43195,CPT,ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43196,CPT,ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43197,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43198,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43200,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43201,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43202,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43204,CPT,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43205,CPT,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43206,CPT,ESOPHAGOSCOPY TRANSORAL W/OPTICAL ENDOMICROSCOPY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43210,CPT,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,,30,,,"$17,638.18",$0.00,1,0,1,20161001, 43211,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43212,CPT,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 43213,CPT,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43214,CPT,ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43215,CPT,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43216,CPT,ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43217,CPT,ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43220,CPT,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43226,CPT,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43227,CPT,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43229,CPT,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43231,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43232,CPT,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43233,CPT,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43235,CPT,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43236,CPT,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43237,CPT,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43238,CPT,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43239,CPT,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43240,CPT,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43241,CPT,EGD INTRALUMINAL TUBE/CATHETER INSERTION,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43242,CPT,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43243,CPT,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43244,CPT,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43245,CPT,EGD DILATION GASTRIC/DUODENAL STRICTURE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43246,CPT,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43247,CPT,EGD FLEXIBLE FOREIGN BODY REMOVAL,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43248,CPT,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43249,CPT,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43250,CPT,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43251,CPT,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43252,CPT,EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43253,CPT,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43254,CPT,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43255,CPT,EGD TRANSORAL CONTROL BLEEDING ANY METHOD,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43257,CPT,EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43259,CPT,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43260,CPT,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43261,CPT,ERCP W/BIOPSY SINGLE/MULTIPLE,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43262,CPT,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43263,CPT,ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43264,CPT,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43265,CPT,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43266,CPT,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 43270,CPT,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43273,CPT,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,,30,,,"$8,088.39",$0.00,1,0,1,20161001, 43274,CPT,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 43275,CPT,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43276,CPT,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 43277,CPT,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43278,CPT,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43280,CPT,LAPS SURG ESOPG/GSTR FUNDOPLASTY,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 43281,CPT,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 43289,CPT,UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 43420,CPT,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 43450,CPT,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43453,CPT,DILATION ESOPHAGUS GUIDE WIRE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 43499,CPT,UNLISTED PROCEDURE ESOPHAGUS,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43510,CPT,GSTRT W/ESOPHGL DILAT&INSJ PRM INTRAL TUBE,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43647,CPT,LAPS IMPLTJ/RPLCMT GASTRIC NSTIM ELTRD ANTRUM,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 43648,CPT,LAPS REVISION/RMVL GASTRIC NSTIM ELTRD ANTRUM,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 43651,CPT,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 43652,CPT,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 43653,CPT,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 43659,CPT,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 43752,CPT,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 43753,CPT,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,,30,,,"$1,361.23",$0.00,1,0,1,20161001, 43754,CPT,GASTRIC INTUBAT DX W/ASPIRATION SINGLE SPECIMEN,,30,,,"$1,361.23",$0.00,1,0,1,20161001, 43755,CPT,GASTRIC INTUBATION DX & ASPIRATJ MULTIPLE SPEC,,30,,,$666.94,$0.00,1,0,1,20161001, 43756,CPT,DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN,,30,,,$655.16,$0.00,1,0,1,20161001, 43757,CPT,DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43760,CPT,CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE,,30,,,"$1,302.06",$0.00,1,0,1,20161001, 43761,CPT,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43770,CPT,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 43830,CPT,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43831,CPT,GASTROSTOMY OPN NEONATAL FEEDING,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 43842,CPT,GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY,,30,,,$910.72,$0.00,1,0,1,20161001, 43870,CPT,CLOSURE GASTROSTOMY SURG,,30,,,"$11,261.45",$0.00,1,0,1,20161001, 43886,CPT,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 43887,CPT,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,,30,,,"$11,856.65",$0.00,1,0,1,20161001, 43888,CPT,GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 43999,CPT,UNLISTED PROCEDURE STOMACH,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 44100,CPT,BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44180,CPT,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 44186,CPT,LAPAROSCOPY SURGICAL JEJUNOSTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 44238,CPT,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 44312,CPT,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 44340,CPT,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 44360,CPT,ENDOSCOPY UPPER SMALL INTESTINE,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 44361,CPT,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44363,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44364,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44365,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44366,CPT,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44369,CPT,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44370,CPT,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 44372,CPT,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44373,CPT,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44376,CPT,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44377,CPT,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44378,CPT,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 44379,CPT,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 44380,CPT,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 44381,CPT,ILEOSCOPY STOMA W/BALLOON DILATION,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 44382,CPT,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 44384,CPT,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 44385,CPT,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44386,CPT,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44388,CPT,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44389,CPT,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44390,CPT,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44391,CPT,COLONOSCOPY STOMA CONTROL BLEEDING,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44392,CPT,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44394,CPT,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44401,CPT,COLONOSCOPY STOMA ABLATION LESION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44402,CPT,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 44403,CPT,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44404,CPT,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44405,CPT,COLONOSCOPY STOMA W/BALLOON DILATION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44406,CPT,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44407,CPT,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44408,CPT,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 44500,CPT,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 44705,CPT,PREPARE FECAL MICROBIOTA FOR INSTILLATION,,30,,,"$2,534.52",$0.00,1,0,1,20161001, 44799,CPT,UNLISTED PROCEDURE SMALL INTESTINE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 44950,CPT,APPENDECTOMY,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 44955,CPT,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,,30,,,"$5,735.64",$0.00,1,0,1,20161001, 44970,CPT,LAPAROSCOPIC APPENDECTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 44979,CPT,UNLISTED LAPAROSCOPY PROCEDURE APPENDIX,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 45000,CPT,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45005,CPT,I&D SUBMUCOSAL ABSCESS RECTUM,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45020,CPT,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45100,CPT,BX ANORECTAL WALL ANAL APPROACH,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45108,CPT,ANORECTAL MYOMECTOMY,,30,,,"$12,707.33",$0.00,1,0,1,20161001, 45150,CPT,DIVISION STRICTURE RECTUM,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45160,CPT,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45171,CPT,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 45172,CPT,EXC RCT TUM INCL MUSCULARIS PROPRIA,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 45190,CPT,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45300,CPT,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 45303,CPT,PROCTOSGMDSC RIGID W/DILATION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45305,CPT,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 45307,CPT,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45308,CPT,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 45309,CPT,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 45315,CPT,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 45317,CPT,PROCTOSGMDSC RIGID CONTROL BLEEDING,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45320,CPT,PROCTOSGMDSC RIGID ABLATION LESION,,30,,,"$12,707.33",$0.00,1,0,1,20161001, 45321,CPT,PROCTOSGMDSC RIGID DCMPRN VOLVULUS,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45327,CPT,PROCTOSGMDSC RIGID TNDSC STENT PLMT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 45330,CPT,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 45331,CPT,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 45332,CPT,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45333,CPT,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 45334,CPT,SIGMOIDOSCOPY FLX CONTROL BLEEDING,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45335,CPT,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 45337,CPT,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45338,CPT,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45340,CPT,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45341,CPT,SIGMOIDOSCOPY FLX NDSC US XM,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45342,CPT,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 45346,CPT,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45347,CPT,SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 45349,CPT,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45350,CPT,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45378,CPT,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45379,CPT,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45380,CPT,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45381,CPT,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45382,CPT,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45384,CPT,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45385,CPT,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45386,CPT,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45388,CPT,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45389,CPT,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,,30,,,"$17,681.70",$0.00,1,0,1,20161001, 45390,CPT,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45391,CPT,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45392,CPT,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 45393,CPT,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45398,CPT,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45399,CPT,UNLISTED PROCEDURE COLON,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 45499,CPT,UNLISTED LAPAROSCOPY PROCEDURE RECTUM,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 45500,CPT,PROCTOPLASTY STENOSIS,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45505,CPT,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 45520,CPT,PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE,,30,,,$398.75,$0.00,1,0,1,20161001, 45541,CPT,PROCTOPEXY PERINEAL APPROACH,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 45560,CPT,REPAIR RECTOCELE SEPARATE PROCEDURE,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 45900,CPT,RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 45905,CPT,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45910,CPT,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45915,CPT,RMVL FECAL IMPACTION/FB SPX UNDER ANES,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45990,CPT,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 45999,CPT,UNLISTED PROCEDURE RECTUM,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 46020,CPT,PLACEMENT SETON,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46030,CPT,REMOVAL ANAL SETON OTHER MARKER,,30,,,"$4,645.80",$0.00,1,0,1,20161001, 46040,CPT,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46045,CPT,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46050,CPT,I&D PERIANAL ABSCESS SUPERFICIAL,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 46060,CPT,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46070,CPT,INCISION ANAL SEPTUM INFANT,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46080,CPT,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46083,CPT,INCISION THROMBOSED HEMORRHOID EXTERNAL,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 46200,CPT,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46220,CPT,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46221,CPT,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 46230,CPT,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46250,CPT,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46255,CPT,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46257,CPT,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46258,CPT,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,,30,,,"$12,707.33",$0.00,1,0,1,20161001, 46260,CPT,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46261,CPT,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46262,CPT,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,,30,,,"$12,707.33",$0.00,1,0,1,20161001, 46270,CPT,SURG TX ANAL FISTULA SUBQ,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46275,CPT,SURG TX ANAL FISTULA INTERSPHINCTERIC,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46280,CPT,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46285,CPT,SURG TX ANAL FISTULA 2ND STAGE,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46288,CPT,CLSR ANAL FSTL W/RCT ADVMNT FLAP,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46320,CPT,EXC THROMBOSED HEMORRHOID XTRNL,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46500,CPT,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 46505,CPT,CHEMODENERVATION INTERNAL ANAL SPHINCTER,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46600,CPT,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,,30,,,$425.53,$0.00,1,0,1,20161001, 46601,CPT,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,,30,,,$306.21,$0.00,1,0,1,20161001, 46604,CPT,ANOSCOPY W/DILATION,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 46606,CPT,ANOSCOPY W/BX SINGLE/MULTIPLE,,30,,,"$9,573.11",$0.00,1,0,1,20161001, 46607,CPT,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 46608,CPT,ANOSCOPY W/RMVL FOREIGN BODY,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 46610,CPT,ANOSCOPY W/RMVL LESION CAUTERY,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46611,CPT,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 46612,CPT,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46614,CPT,ANOSCOPY CONTROL BLEEDING,,30,,,"$4,726.49",$0.00,1,0,1,20161001, 46615,CPT,ANOSCOPY ABLATION LESION,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46700,CPT,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46706,CPT,REPAIR ANAL FISTULA W/FIBRIN GLUE,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46707,CPT,REPAIR ANORECTAL FISTULA PLUG,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46750,CPT,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46753,CPT,GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46754,CPT,RMVL THIERSCH WIRE/SUTURE ANAL CANAL,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46760,CPT,SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46761,CPT,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46762,CPT,SPHNCTROP ANAL IMPLTJ ARTIF SPHNCTR,,30,,,"$17,638.18",$0.00,1,0,1,20161001, 46900,CPT,DSTRJ LESION ANUS SIMPLE CHEMICAL,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 46910,CPT,DSTRJ LESION ANUS SMPL ELTRDSICCATION,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 46916,CPT,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 46917,CPT,DSTRJ LESION ANUS SIMPLE LASER SURG,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46922,CPT,DSTRJ LESION ANUS SIMPLE SURG EXCISION,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46924,CPT,DSTRJ LESION ANUS EXTENSIVE,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46930,CPT,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 46940,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46942,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 46945,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 1 COL/GRP,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46946,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 2/> COL/GRP,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 46947,CPT,HEMORRHOIDOPEXY STAPLING,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 46999,CPT,UNLISTED PROCEDURE ANUS,,30,,,"$3,147.16",$0.00,1,0,1,20161001, 47000,CPT,BIOPSY LIVER NEEDLE PERCUTANEOUS,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 47001,CPT,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,,30,,,"$6,072.36",$0.00,1,0,1,20161001, 47370,CPT,LAPS SURG ABLTJ 1/> LVR TUM RF,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 47371,CPT,LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 47379,CPT,UNLIS LAPAROSCOPIC PROCEDURE LIVER,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 47382,CPT,ABLTJ 1/> LVR TUM PRQ RF,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 47383,CPT,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 47399,CPT,UNLISTED PROCEDURE LIVER,,30,,,"$1,917.62",$0.00,1,0,1,20161001, 47490,CPT,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,,30,,,"$12,131.57",$0.00,1,0,1,20161001, 47531,CPT,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,,30,,,"$2,033.10",$0.00,1,0,1,20161001, 47532,CPT,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,,30,,,"$12,037.51",$0.00,1,0,1,20161001, 47533,CPT,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,,30,,,"$12,037.51",$0.00,1,0,1,20161001, 47534,CPT,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,,30,,,"$12,037.51",$0.00,1,0,1,20161001, 47535,CPT,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,,30,,,"$12,037.51",$0.00,1,0,1,20161001, 47536,CPT,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,,30,,,"$12,037.51",$0.00,1,0,1,20161001, 47537,CPT,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,,30,,,"$3,038.67",$0.00,1,0,1,20161001, 47538,CPT,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,,30,,,"$19,163.90",$0.00,1,0,1,20161001, 47539,CPT,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,,30,,,"$19,163.90",$0.00,1,0,1,20161001, 47540,CPT,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,,30,,,"$19,163.90",$0.00,1,0,1,20161001, 47541,CPT,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,,30,,,"$12,037.51",$0.00,1,0,1,20161001, 47552,CPT,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,,30,,,"$12,131.57",$0.00,1,0,1,20161001, 47553,CPT,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 47554,CPT,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,,30,,,"$19,163.90",$0.00,1,0,1,20161001, 47555,CPT,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,,30,,,"$12,131.57",$0.00,1,0,1,20161001, 47556,CPT,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 47562,CPT,LAPAROSCOPY SURG CHOLECYSTECTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 47563,CPT,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 47564,CPT,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 47579,CPT,UNLISTED LAPAROSCOPY PROCEDURE BILIARY TRACT,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 47999,CPT,UNLISTED PROCEDURE BILIARY TRACT,,30,,,"$12,131.57",$0.00,1,0,1,20161001, 48102,CPT,BIOPSY PANCREA PERCUTANEOUS NEEDLE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 48999,CPT,UNLISTED PROCEDURE PANCREAS,,30,,,"$1,917.62",$0.00,1,0,1,20161001, 49082,CPT,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 49083,CPT,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 49084,CPT,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 49180,CPT,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 49185,CPT,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,,30,,,"$5,733.20",$0.00,1,0,1,20161001, 49250,CPT,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49320,CPT,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49321,CPT,LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49322,CPT,LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49323,CPT,LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49324,CPT,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49325,CPT,LAPS W/REVISION INTRAPERITONEAL CATHETER,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49326,CPT,LAPAROSCOPY W/OMENTOPEXY,,30,,,"$6,964.71",$0.00,1,0,1,20161001, 49327,CPT,LAPS W/INSERTION NTRSTL DEV W/IMG GUID 1/MLT,,30,,,"$16,368.58",$0.00,1,0,1,20161001, 49329,CPT,UNLISTED LAPAROSCOPIC PX ABD PERTONEUM & OMENTUM,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49400,CPT,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,,30,,,"$2,298.35",$0.00,1,0,1,20161001, 49402,CPT,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49405,CPT,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 49406,CPT,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 49407,CPT,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 49411,CPT,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,,30,,,"$6,357.83",$0.00,1,0,1,20161001, 49418,CPT,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,,30,,,"$12,131.57",$0.00,1,0,1,20161001, 49419,CPT,INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 49421,CPT,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49422,CPT,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 49423,CPT,EXCHNG ABSC/CST DRG CATH RAD GID SPX,,30,,,"$7,207.04",$0.00,1,0,1,20161001, 49424,CPT,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,,30,,,"$1,950.12",$0.00,1,0,1,20161001, 49426,CPT,REVIS PERITONEAL-VENOUS SHUNT,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49427,CPT,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,,30,,,"$1,810.82",$0.00,1,0,1,20161001, 49429,CPT,RMVL PERITONEAL-VENOUS SHUNT,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 49435,CPT,INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER,,30,,,"$6,686.12",$0.00,1,0,1,20161001, 49436,CPT,DELAYED CREATION EXIT SITE EMBEDDED CATHETER,,30,,,"$7,207.04",$0.00,1,0,1,20161001, 49440,CPT,INSERT GASTROSTOMY TUBE PERCUTANEOUS,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 49441,CPT,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 49442,CPT,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,,30,,,"$9,960.92",$0.00,1,0,1,20161001, 49446,CPT,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,,30,,,"$6,638.77",$0.00,1,0,1,20161001, 49450,CPT,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 49451,CPT,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 49452,CPT,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 49460,CPT,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 49465,CPT,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,,30,,,$655.16,$0.00,1,0,1,20161001, 49491,CPT,RPR 1ST INGUN HRNA PRETERM INFT RDC,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49492,CPT,RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49495,CPT,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49496,CPT,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49500,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49501,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49505,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49507,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49520,CPT,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49521,CPT,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49525,CPT,RPR INGUN HERNIA SLIDING ANY AGE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49540,CPT,REPAIR LUMBAR HERNIA,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49550,CPT,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49553,CPT,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49555,CPT,RPR RECRT FEM HERNIA REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49557,CPT,RPR RECRT FEM HRNA INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49560,CPT,REPAIR FIRST ABDOMINAL WALL HERNIA,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49561,CPT,RPR 1ST INCAL/VNT HERNIA INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49565,CPT,RPR RECRT INCAL/VNT HERNIA REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49566,CPT,RPR RECRT INCAL/VNT HERNIA INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49568,CPT,IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE,,30,,,"$6,686.12",$0.00,1,0,1,20161001, 49570,CPT,RPR EPIGASTRIC HERNIA REDUCIBLE SPX,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49572,CPT,RPR EPIGASTRIC HERNIA INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49580,CPT,RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49582,CPT,RPR UMBILICAL HERNIA < 5 YRS INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49585,CPT,RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49587,CPT,RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49590,CPT,RPR SPIGELIAN HERNIA,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49600,CPT,RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 49650,CPT,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49651,CPT,LAPS SURG RPR RECURRENT INGUINAL HERNIA,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49652,CPT,LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49653,CPT,LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49654,CPT,LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 49655,CPT,LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 49656,CPT,LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 49657,CPT,LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 49659,CPT,UNLIS LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 49999,CPT,UNLISTED PROCEDURE ABDOMEN PERITONEUM & OMENTUM,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 50020,CPT,DRAINAGE PERIRENAL/RENAL ABSCESS OPEN,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 50080,CPT,PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY 2 CM,,30,,,"$23,464.65",$0.00,1,0,1,20161001, 50200,CPT,RENAL BIOPSY PRQ TROCAR/NEEDLE,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 50382,CPT,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 50384,CPT,REMOVAL INDWELLING URETERAL STENT PRQ,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 50385,CPT,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 50386,CPT,REMOVE INT DWELL URETERAL STENT TRANSURETHRAL,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 50387,CPT,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,,30,,,"$7,207.04",$0.00,1,0,1,20161001, 50389,CPT,RMVL NFROS TUBE REQ FLUORO GUIDANCE,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 50390,CPT,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 50391,CPT,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 50395,CPT,INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 50396,CPT,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 50430,CPT,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,,30,,,"$3,069.05",$0.00,1,0,1,20161001, 50431,CPT,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,,30,,,"$3,069.05",$0.00,1,0,1,20161001, 50432,CPT,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 50433,CPT,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 50434,CPT,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,,30,,,"$3,069.05",$0.00,1,0,1,20161001, 50435,CPT,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,,30,,,"$3,069.05",$0.00,1,0,1,20161001, 50541,CPT,LAPAROSCOPY SURG ABLATION RENAL CYSTS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 50542,CPT,LAPS ABLTJ RENAL MASS LESION W/INTRAOP US,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 50543,CPT,LAPAROSCOPY SURG PARTIAL NEPHRECTOMY,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 50544,CPT,LAPAROSCOPY SURG PYELOPLASTY,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 50549,CPT,UNLISTED LAPAROSCOPY PROCEDURE RENAL,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 50551,CPT,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,,30,,,"$12,104.95",$0.00,1,0,1,20161001, 50553,CPT,RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 50555,CPT,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,,30,,,"$12,104.95",$0.00,1,0,1,20161001, 50557,CPT,RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI,,30,,,"$23,474.66",$0.00,1,0,1,20161001, 50561,CPT,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 50562,CPT,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,,30,,,"$12,104.95",$0.00,1,0,1,20161001, 50570,CPT,RENAL NDSC NEPHROTOMY W/WO IRRIGATION,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 50572,CPT,RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 50574,CPT,RENAL NDSC NEPHROTOMY W/BIOPSY,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 50575,CPT,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 50576,CPT,RNL NDSC NFROT FULGURATION &/INCISION W/WO BX,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 50580,CPT,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 50590,CPT,LITHOTRIPSY XTRCORP SHOCK WAVE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 50592,CPT,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 50593,CPT,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 50684,CPT,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,,30,,,$924.38,$0.00,1,0,1,20161001, 50686,CPT,MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH,,30,,,$746.33,$0.00,1,0,1,20161001, 50688,CPT,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,,30,,,"$7,207.04",$0.00,1,0,1,20161001, 50690,CPT,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,,30,,,"$1,232.51",$0.00,1,0,1,20161001, 50693,CPT,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,,30,,,"$12,104.95",$0.00,1,0,1,20161001, 50694,CPT,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,,30,,,"$12,104.95",$0.00,1,0,1,20161001, 50695,CPT,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,,30,,,"$12,104.95",$0.00,1,0,1,20161001, 50727,CPT,REVJ URINARY-CUTANEOUS ANASTAMOSIS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 50945,CPT,LAPAROSCOPY URTROLITHOTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 50947,CPT,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 50948,CPT,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 50949,CPT,UNLISTED LAPAROSCOPY PROCEDURE URETER,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 50951,CPT,URETERAL ENDOSCOPY VIA URETEROSTOMY,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 50953,CPT,URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER,,30,,,"$12,104.95",$0.00,1,0,1,20161001, 50955,CPT,URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 50957,CPT,URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 50961,CPT,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 50970,CPT,URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 50972,CPT,NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 50974,CPT,URETERAL ENDOSCOPY VIA URETEROT W/O IMAGING W/BX,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 50976,CPT,URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 50980,CPT,NDSC URETEROTOMY RMVL FB/CALCULUS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 51020,CPT,CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 51030,CPT,CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 51040,CPT,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 51045,CPT,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 51050,CPT,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 51060,CPT,TRANSVESICAL URETROLITHOTOMY,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 51065,CPT,CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 51080,CPT,DRG PRIVESICAL/PREVESICAL SPACE ABSC,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 51100,CPT,ASPIRATION BLADDER NEEDLE,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 51101,CPT,ASPIRATION BLADDER TROCAR/INTRACATHETER,,30,,,"$5,245.62",$0.00,1,0,1,20161001, 51102,CPT,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 51500,CPT,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 51520,CPT,CYSTOTOMY SIMPLE EXCISION VESICAL NECK,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 51535,CPT,CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 51600,CPT,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,,30,,,"$1,155.48",$0.00,1,0,1,20161001, 51605,CPT,NJX & PLACEMENT CHAIN CONTRAST&/URETHROCSTOGRAPY,,30,,,"$1,232.51",$0.00,1,0,1,20161001, 51610,CPT,NJX RETROGRADE URETHROCSTOGRAPY,,30,,,"$1,386.57",$0.00,1,0,1,20161001, 51700,CPT,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 51701,CPT,INSJ NON-NDWELLG BLADDER CATHETER,,30,,,$425.53,$0.00,1,0,1,20161001, 51702,CPT,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,,30,,,$425.53,$0.00,1,0,1,20161001, 51703,CPT,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,,30,,,$746.33,$0.00,1,0,1,20161001, 51705,CPT,CHANGE CYSTOSTOMY TUBE SIMPLE,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 51710,CPT,CHANGE CYSTOSTOMY TUBE COMPLICATED,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 51715,CPT,NDSC NJX IMPLT MATRL URT&/BLDR NCK,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 51720,CPT,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 51725,CPT,SIMPLE CYSTOMETROGRAM,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 51736,CPT,SIMPLE UROFLOMETRY,,30,,,$425.53,$0.00,1,0,1,20161001, 51741,CPT,COMPLEX UROFLOMETRY,,30,,,$666.94,$0.00,1,0,1,20161001, 51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,,30,,,$746.33,$0.00,1,0,1,20161001, 51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 51792,CPT,STIMULUS EVOKED RESPONSE,,30,,,$306.21,$0.00,1,0,1,20161001, 51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,,30,,,"$1,617.67",$0.00,1,0,1,20161001, 51798,CPT,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,,30,,,$425.53,$0.00,1,0,1,20161001, 51845,CPT,ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 51860,CPT,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 51880,CPT,CLOSURE CYSTOSTOMY SEPARATE PROCEDURE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 51990,CPT,LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 51992,CPT,LAPAROSCOPY SLING OPERATION STRESS INCONT,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 51999,CPT,UNLISTED LAPAROSCOPY PROCEDURE BLADDER,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 52000,CPT,CYSTOURETHROSCOPY,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 52001,CPT,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52005,CPT,CYSTO BLADDER W/URETERAL CATHETERIZATION,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52007,CPT,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52010,CPT,CYSTO W/EJACULATORY DUCT CATHETERIZATION,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 52204,CPT,CYSTOURETHROSCOPY WITH BIOPSY,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52214,CPT,CYSTO W/DESTRUCTION OF LESIONS,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52224,CPT,CYSTO W/REMOVAL OF LESIONS SMALL,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52234,CPT,CYSTO W/REMOVAL OF TUMORS SMALL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52235,CPT,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52240,CPT,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52250,CPT,CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52260,CPT,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52265,CPT,CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52270,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52275,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52276,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52277,CPT,CYSTOURETHROSCOPY W/RESECJ EXTERNAL SPHINCTER,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52281,CPT,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52282,CPT,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52283,CPT,CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52285,CPT,CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52287,CPT,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52290,CPT,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52300,CPT,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52301,CPT,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52305,CPT,CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52310,CPT,CYSTO W/SIMPLE REMOVAL STONE & STENT,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52315,CPT,CYSTO W/COMPLEX REMOVAL STONE & STENT,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 52317,CPT,LITHOLAPAXY SMPL/SM <2.5 CM,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52318,CPT,LITHOLAPAXY COMP/LG > 2.5 CM,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52320,CPT,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52325,CPT,CYSTO FRAGMENTATION URETERAL STONE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52327,CPT,CYSTO W/SUBURTRIC NJX IMPLT MATRL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52330,CPT,CYSTO MANJ W/O RMVL URETERAL STONE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52332,CPT,CYSTO W/INSERT URETERAL STENT,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52334,CPT,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52341,CPT,CYSTO W/TX URETERAL STRICTURE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52342,CPT,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52343,CPT,CYSTO W/TX INTRA-RENAL STRICTURE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 52344,CPT,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52345,CPT,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52346,CPT,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52351,CPT,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52352,CPT,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52353,CPT,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52354,CPT,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52355,CPT,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52356,CPT,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 52400,CPT,CYSTO INC FULG/RESCJ URTL VALVES/FOLDS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52402,CPT,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52441,CPT,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,,30,,,"$25,882.65",$0.00,1,0,1,20161001, 52442,CPT,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,,30,,,"$25,882.65",$0.00,1,0,1,20161001, 52450,CPT,TRANSURETHRAL INCISION PROSTATE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52500,CPT,TRANSURETHRAL RESECTION PROSTATE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52601,CPT,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52630,CPT,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52640,CPT,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 52647,CPT,LASER COAGULATION OF PROSTATE FOR URINE FLOW,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52648,CPT,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 52649,CPT,LASER ENUCLEATION PROSTATE W/MORCELLATION,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 52700,CPT,TRURL DRAINAGE PROSTATIC ABSCESS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53000,CPT,URTT/URTS XTRNL SPX PENDULOUS URETHRA,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53010,CPT,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53020,CPT,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53025,CPT,MEATOTOMY CUTTING MEATUS SPX INFANT,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53040,CPT,DRAINAGE DEEP PERIURETHRAL ABSCESS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53060,CPT,DRG OF SKENE'S GLAND ABSCESS OR CYST,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53080,CPT,DRG PERINEAL URINARY XTRVASATION UNCOMP SPX,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53085,CPT,DRG PERINEAL URINARY XTRVASATION COMPLIC,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53200,CPT,BIOPSY URETHRA,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53210,CPT,URETHRECTOMY TOT W/CYSTOST FEMALE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53215,CPT,URETHRECTOMY TOT W/CYSTOST MALE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53220,CPT,EXC/FULGURATION CARCINOMA URETHRA,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53230,CPT,EXC URETHRAL DIVERTICULUM SPX FEMALE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53235,CPT,EXC URETHRAL DIVERTICULUM SPX MALE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53240,CPT,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53250,CPT,EXCISION OF BULBOURETHRAL GLAND,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53260,CPT,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53265,CPT,EXC/FULGURATION URETHRAL CARUNCLE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 53270,CPT,EXCISION OR FULGURATION SKENES GLANDS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53275,CPT,EXCISION/FULGURATION URETHRAL PROLAPSE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53400,CPT,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 53405,CPT,URETHROPLASTY 2ND STAGE W/URINARY DIVERSION,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53410,CPT,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 53420,CPT,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 53425,CPT,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53430,CPT,URETHROPLASTY RCNSTJ FEMALE URETHRA,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53431,CPT,URTP W/TUBULARIZATION POST URT&/LWR BLDR,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53440,CPT,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,,30,,,"$23,464.65",$0.00,1,0,1,20161001, 53442,CPT,RMVL/REVJ SLING MALE URINARY INCONTINENCE,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 53444,CPT,INSERTION TANDEM CUFF,,30,,,"$23,464.65",$0.00,1,0,1,20161001, 53445,CPT,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 53446,CPT,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53447,CPT,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 53449,CPT,RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 53450,CPT,URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53460,CPT,URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53500,CPT,URETHROLSS TRVG SEC OPN W/CSTO,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53502,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 53505,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53510,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53515,CPT,URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 53520,CPT,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53600,CPT,DILAT URETHRAL STRIX DILATOR MALE 1ST,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 53601,CPT,DILAT URETHRAL STRIX DILATOR MALE SBSQ,,30,,,$425.53,$0.00,1,0,1,20161001, 53605,CPT,DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53620,CPT,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 53621,CPT,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 53660,CPT,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,,30,,,$746.33,$0.00,1,0,1,20161001, 53661,CPT,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,,30,,,$425.53,$0.00,1,0,1,20161001, 53665,CPT,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53850,CPT,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 53852,CPT,TRURL DSTRJ PRSTATE TISS RF THERMOTH,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 53855,CPT,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 53860,CPT,TRURL RF FEMALE BLADDER NECK STRS URIN INCONT,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 53899,CPT,UNLISTED PROCEDURE URINARY SYSTEM,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 54000,CPT,SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54001,CPT,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54015,CPT,I&D PENIS DEEP,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 54050,CPT,DSTRJ LESION PENIS SIMPLE CHEMICAL,,30,,,$398.75,$0.00,1,0,1,20161001, 54055,CPT,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 54056,CPT,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,,30,,,$398.75,$0.00,1,0,1,20161001, 54057,CPT,DSTRJ LESION PENIS SIMPLE LASER,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 54060,CPT,DSTRJ LESION PENIS SIMPLE SURG EXCISION,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 54065,CPT,DSTRJ LESION PENIS EXTENSIVE,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 54100,CPT,BIOPSY PENIS SEPARATE PROCEDURE,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 54105,CPT,BIOPSY PENIS DEEP STRUCTURES,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 54110,CPT,EXCISION OF PENILE PLAQUE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54111,CPT,EXC PENILE PLAQUE GRAFT &/5 CM LENGTH,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 54112,CPT,EXC PENILE PLAQUE GRAFT > 5 CM LENGTH,,30,,,"$23,464.65",$0.00,1,0,1,20161001, 54115,CPT,REMOVAL FOREIGN BODY DEEP PENILE TISSUE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 54120,CPT,AMPUTATION PENIS PARTIAL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54150,CPT,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54160,CPT,CIRCUMCISION NEONATE,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54161,CPT,CIRCUMCISION AGE >28 DAYS,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54162,CPT,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54163,CPT,REPAIR INCOMPLETE CIRCUMCISION,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54164,CPT,FRENULOTOMY PENIS,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 54200,CPT,INJECTION PEYRONIE DISEASE,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 54205,CPT,NJX PEYRONIE W/SURG EXPOS PLAQUE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 54220,CPT,IRRIGATION CORPORA CAVERNOSA PRIAPISM,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 54230,CPT,INJECTION CORPORA CAVERNOSOGRAPY,,30,,,"$2,481.75",$0.00,1,0,1,20161001, 54231,CPT,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54235,CPT,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 54240,CPT,PENILE PLETHYSMOGRAPHY,,30,,,$666.94,$0.00,1,0,1,20161001, 54250,CPT,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 54300,CPT,PENIS STRAIGHTENING CHORDEE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54304,CPT,PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54308,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 54312,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54316,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 54318,CPT,URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54322,CPT,1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54324,CPT,1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54326,CPT,1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 54328,CPT,1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54332,CPT,1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54336,CPT,1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54340,CPT,RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54344,CPT,RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 54348,CPT,RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54352,CPT,RPR HYPOSPADIAS CRIPPLE W/DSJ & EXC & GRFS/FLAP,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 54360,CPT,PLASTIC RPR PENIS CORRECT ANGULATION,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54380,CPT,PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54385,CPT,PLASTIC PENIS EPISPADIAS DSTL SPHNCTR W/INCONT,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54400,CPT,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,,30,,,"$23,464.65",$0.00,1,0,1,20161001, 54401,CPT,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 54405,CPT,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 54406,CPT,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54408,CPT,RPR COMPONENT INFLATABLE PENILE PROSTHESIS,,30,,,"$18,503.20",$0.00,1,0,1,20161001, 54410,CPT,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 54411,CPT,RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 54415,CPT,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54416,CPT,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 54417,CPT,RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD,,30,,,"$28,954.76",$0.00,1,0,1,20161001, 54420,CPT,CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 54435,CPT,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 54437,CPT,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),,30,,,"$8,784.97",$0.00,1,0,1,20161001, 54440,CPT,PLASTIC OPERATION PENIS INJURY,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54450,CPT,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 54500,CPT,BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 54505,CPT,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54512,CPT,EXC XTRPARENCHYMAL LESION TESTIS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54520,CPT,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54522,CPT,ORCHIECTOMY PARTIAL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54530,CPT,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 54535,CPT,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54550,CPT,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 54560,CPT,EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54600,CPT,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54620,CPT,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 54640,CPT,ORCHIOPEXY INGUINAL APPROACH W/WO HERNIA RPR,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 54650,CPT,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 54660,CPT,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 54670,CPT,SUTURE/REPAIR TESTICULAR INJURY,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54680,CPT,TRANSPLANTATION TESTIS TO THIGH,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54690,CPT,LAPAROSCOPY SURGICAL ORCHIECTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 54692,CPT,LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 54699,CPT,UNLISTED LAPAROSCOPY PROCEDURE TESTIS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 54700,CPT,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54800,CPT,BIOPSY EPIDIDYMIS NEEDLE,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 54830,CPT,EXCISION LOCAL LESION EPIDIDYMIS,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54840,CPT,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54860,CPT,EPIDIDYMECTOMY UNILATERAL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54861,CPT,EPIDIDYMECTOMY BILATERAL,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54865,CPT,EXPLORATION EPIDIDYMIS W/WO BIOPSY,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 54900,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 54901,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55000,CPT,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 55040,CPT,EXCISION HYDROCELE UNILATERAL,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 55041,CPT,EXCISION HYDROCELE BILATERAL,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 55060,CPT,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55100,CPT,DRAINAGE SCROTAL WALL ABSCESS,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 55110,CPT,SCROTAL EXPLORATION,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55120,CPT,REMOVAL FOREIGN BODY SCROTUM,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 55150,CPT,RESECTION SCROTUM,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55175,CPT,SCROTOPLASTY SIMPLE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55180,CPT,SCROTOPLASTY COMPLICATED,,30,,,"$16,901.70",$0.00,1,0,1,20161001, 55200,CPT,VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 55250,CPT,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 55300,CPT,VASOTOMY VASOGRAMS UNI/BI,,30,,,"$11,345.14",$0.00,1,0,1,20161001, 55400,CPT,VASOVASOSTOMY VASOVASORRHAPHY,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55450,CPT,LIGATION PRQ VAS DEFERENS UNI/BI SPX,,30,,,"$8,784.97",$0.00,1,0,1,20161001, 55500,CPT,EXC HYDROCELE SPRMATIC CORD UNI SPX,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55520,CPT,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55530,CPT,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55535,CPT,EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 55540,CPT,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 55550,CPT,LAPS LIGATION SPERMATIC VEINS VARICOCELE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 55559,CPT,UNLISTED LAPROSCOPY PROCEDURE SPERMATIC CORD,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 55600,CPT,VESICULOTOMY,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 55680,CPT,EXCISION MULLERIAN DUCT CYST,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 55700,CPT,PROSTATE NEEDLE BIOPSY ANY APPROACH,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 55705,CPT,BIOPSY PROSTATE INCISIONAL ANY APPROACH,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55706,CPT,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55720,CPT,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 55725,CPT,PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55860,CPT,EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55870,CPT,ELECTROEJACULATION,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 55873,CPT,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,,30,,,"$23,464.65",$0.00,1,0,1,20161001, 55875,CPT,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 55876,CPT,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,,30,,,"$6,357.83",$0.00,1,0,1,20161001, 55899,CPT,UNLISTED PROCEDURE MALE GENITAL SYSTEM,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 55920,CPT,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,,30,,,"$14,066.64",$0.00,1,0,1,20161001, 55970,CPT,INTERSEX SURG MALE FEMALE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 55980,CPT,INTERSEX SURG FEMALE MALE,,30,,,"$13,584.43",$0.00,1,0,1,20161001, 56405,CPT,I&D VULVA/PERINEAL ABSCESS,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 56420,CPT,I&D OF BARTHOLINS GLAND ABSCESS,,30,,,$916.02,$0.00,1,0,1,20161001, 56440,CPT,MARSUPIALIZATION BARTHOLINS GLAND CYST,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56441,CPT,LYSIS LABIAL ADHESIONS,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56442,CPT,HYMENOTOMY SIMPLE INCISION,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56501,CPT,DESTRUCTION LESIONS VULVA SIMPLE,,30,,,"$6,915.53",$0.00,1,0,1,20161001, 56515,CPT,DESTRUCTION LESIONS VULVA EXTENSIVE,,30,,,"$11,957.43",$0.00,1,0,1,20161001, 56605,CPT,BIOPSY VULVA/PERINEUM 1 LESION SPX,,30,,,"$1,605.28",$0.00,1,0,1,20161001, 56606,CPT,BIOPSY VULVA/PERINEUM EACH ADDL LESION,,30,,,"$1,222.39",$0.00,1,0,1,20161001, 56620,CPT,VULVECTOMY SIMPLE PARTIAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56625,CPT,VULVECTOMY SIMPLE COMPLETE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56700,CPT,PRTL HYMENECTOMY/REVJ HYMENAL RING,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56740,CPT,EXC BARTHOLINS GLAND/CYST,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56800,CPT,PLASTIC REPAIR INTROITUS,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56805,CPT,CLITOROPLASTY INTERSEX STATE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56810,CPT,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 56820,CPT,COLPOSCOPY VULVA,,30,,,$916.02,$0.00,1,0,1,20161001, 56821,CPT,COLPOSCOPY VULVA W/BIOPSY,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 57000,CPT,COLPOTOMY W/EXPLORATION,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57010,CPT,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57020,CPT,COLPOCENTESIS SEPARATE PROCEDURE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57022,CPT,I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 57023,CPT,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 57061,CPT,DESTRUCTION VAGINAL LESIONS SIMPLE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57065,CPT,DESTRUCTION VAGINAL LESIONS EXTENSIVE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57100,CPT,BIOPSY VAGINAL MUCOSA SIMPLE,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 57105,CPT,BIOPSY VAGINAL MUCOSA EXTENSIVE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57106,CPT,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57107,CPT,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57109,CPT,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57120,CPT,COLPOCLEISIS LE FORT TYPE,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57130,CPT,EXCISION VAGINAL SEPTUM,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57135,CPT,EXCISION VAGINAL CYST/TUMOR,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57150,CPT,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,,30,,,$425.53,$0.00,1,0,1,20161001, 57155,CPT,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57156,CPT,INSERTION VAGINAL RADIATION DEVICE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 57160,CPT,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,,30,,,$916.02,$0.00,1,0,1,20161001, 57170,CPT,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,,30,,,$916.02,$0.00,1,0,1,20161001, 57180,CPT,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,,30,,,$916.02,$0.00,1,0,1,20161001, 57200,CPT,COLPORRHAPHY SUTURE INJURY VAGINA,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57210,CPT,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57220,CPT,PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57230,CPT,PLASTIC REPAIR URETHROCELE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57240,CPT,ANT COLPORRHAPHY CYSTOCELE W/WO RPR URETHROCELE,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57250,CPT,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57260,CPT,COMBINED ANTEROPOSTERIOR COLPORRHAPHY,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57265,CPT,CMBND ANTEROPOST COLPORRHAPHY W/ENTEROCELE RPR,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57267,CPT,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,,30,,,"$6,519.39",$0.00,1,0,1,20161001, 57268,CPT,REPAIR ENTEROCELE VAGINAL APPROACH SPX,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57282,CPT,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 57283,CPT,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 57284,CPT,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57285,CPT,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 57287,CPT,RMVL/REVJ SLING STRESS INCONTINENCE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57288,CPT,SLING OPERATION STRESS INCONTINENCE,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57289,CPT,PEREYRA PX W/ANTERIOR COLPORRHAPHY,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 57291,CPT,CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57292,CPT,CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57295,CPT,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57300,CPT,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57310,CPT,CLOSURE URETHROVAGINAL FISTULA,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 57320,CPT,CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57330,CPT,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 57335,CPT,VAGINOPLASTY INTERSEX STATE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57400,CPT,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57410,CPT,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57415,CPT,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57420,CPT,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 57421,CPT,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 57423,CPT,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 57425,CPT,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 57426,CPT,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 57452,CPT,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,,30,,,$916.02,$0.00,1,0,1,20161001, 57454,CPT,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 57455,CPT,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 57456,CPT,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 57460,CPT,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57461,CPT,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57500,CPT,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 57505,CPT,ENDOCERVICAL CURETTAGE W/DILATION & CURETTAGE,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 57510,CPT,CAUTERY CERVIX ELECTRO/THERMAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57511,CPT,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 57513,CPT,CAUTERY CERVIX LASER ABLATION,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57520,CPT,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57522,CPT,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57530,CPT,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57550,CPT,EXCISION CERVICAL STUMP VAGINAL APPROACH,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57555,CPT,EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57556,CPT,EXC CRV STUMP VAG APPR W/RPR NTRCL,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 57558,CPT,DILATION & CURETTAGE CERVICAL STUMP,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57700,CPT,CERCLAGE UTERINE CERVIX NONOBSTETRICAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57720,CPT,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 57800,CPT,DILATION CERVICAL CANAL INSTRUMENTAL SPX,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58100,CPT,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,,30,,,$916.02,$0.00,1,0,1,20161001, 58110,CPT,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,,30,,,"$1,086.56",$0.00,1,0,1,20161001, 58120,CPT,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58145,CPT,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58260,CPT,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58262,CPT,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58263,CPT,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58270,CPT,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58290,CPT,VAGINAL HYSTERECTOMY UTERUS > 250 GM,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 58291,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58292,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 58294,CPT,VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58300,CPT,INSERTION INTRAUTERINE DEVICE IUD,,30,,,"$2,308.95",$0.00,1,0,1,20161001, 58301,CPT,REMOVAL INTRAUTERINE DEVICE IUD,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 58321,CPT,ARTIFICIAL INSEMINATION INTRA-CERVICAL,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 58322,CPT,ARTIFICIAL INSEMINATION INTRA-UTERINE,,30,,,$916.02,$0.00,1,0,1,20161001, 58323,CPT,SPERM WASHING ARTIFICIAL INSEMINATION,,30,,,$916.02,$0.00,1,0,1,20161001, 58340,CPT,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,,30,,,"$2,444.77",$0.00,1,0,1,20161001, 58345,CPT,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58346,CPT,INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58350,CPT,CHROMOTUBATION OVIDUCT W/MATERIALS,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58353,CPT,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58356,CPT,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58541,CPT,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58542,CPT,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58543,CPT,LAPS SUPRACERVICAL HYSTERECTOMY >250,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58544,CPT,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58545,CPT,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58546,CPT,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58550,CPT,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58552,CPT,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58553,CPT,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58554,CPT,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58555,CPT,HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58558,CPT,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58559,CPT,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58560,CPT,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58561,CPT,HYSTEROSCOPY REMOVAL LEIOMYOMATA,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58562,CPT,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58563,CPT,HYSTEROSCOPY ENDOMETRIAL ABLATION,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58565,CPT,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58570,CPT,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58571,CPT,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58572,CPT,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58573,CPT,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 58578,CPT,UNLISTED LAPAROSCOPY PROCEDURE UTERUS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58579,CPT,UNLISTED HYSTEROSCOPY PROCEDURE UTERUS,,30,,,"$3,401.12",$0.00,1,0,1,20161001, 58600,CPT,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58615,CPT,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58660,CPT,LAPAROSCOPY W/LYSIS OF ADHESIONS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58661,CPT,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58662,CPT,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58670,CPT,LAPAROSCOPY FULGURATION OVIDUCTS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58671,CPT,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58672,CPT,LAPAROSCOPY FIMBRIOPLASTY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58673,CPT,LAPAROSCOPY SALPINGOSTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58679,CPT,UNLISTED LAPAROSCOPY PROCEDURE OVIDUCT/OVARY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 58770,CPT,SALPINGOSTOMY,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58800,CPT,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58805,CPT,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58820,CPT,DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58900,CPT,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 58920,CPT,WEDGE RESCJ/BISCTJ OVARY UNI/BI,,30,,,"$22,540.88",$0.00,1,0,1,20161001, 58925,CPT,OVARIAN CYSTECTOMY UNI/BI,,30,,,"$17,955.82",$0.00,1,0,1,20161001, 58970,CPT,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 58974,CPT,EMBRYO TRANSFER INTRAUTERINE,,30,,,"$1,605.28",$0.00,1,0,1,20161001, 58976,CPT,GAMETE ZYGOTE/EMBRYO FALLOPIAN TRANSFER ANY METH,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 58999,CPT,UNLISTED PX FEMALE GENITAL SYSTEM NONOBSTETRICAL,,30,,,$916.02,$0.00,1,0,1,20161001, 59000,CPT,AMNIOCENTESIS DIAGNOSIC,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 59001,CPT,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59012,CPT,CORDOCENTESIS INTRAUTERINE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59015,CPT,CHORIONIC VILLUS SAMPLING,,30,,,"$3,963.68",$0.00,1,0,1,20161001, 59020,CPT,FETAL CONTRACTION STRESS TEST,,30,,,$916.02,$0.00,1,0,1,20161001, 59025,CPT,FETAL NONSTRESS TEST,,30,,,$916.02,$0.00,1,0,1,20161001, 59030,CPT,FETAL SCALP BLOOD SAMPLING,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59050,CPT,FETAL MONITORING LABOR PHYS WRITTEN REPORT,,30,,,$826.80,$0.00,1,0,1,20161001, 59051,CPT,FETAL MONITR LABOR PHYS WRTTN REPRT INTERPJ ONLY,,30,,,$641.23,$0.00,1,0,1,20161001, 59070,CPT,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,,30,,,"$1,605.28",$0.00,1,0,1,20161001, 59072,CPT,FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59074,CPT,FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59076,CPT,FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59100,CPT,HYSTEROTOMY ABDOMINAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59150,CPT,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 59151,CPT,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 59160,CPT,CURETTAGE POSTPARTUM,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59200,CPT,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59300,CPT,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59320,CPT,CERCLAGE CERVIX PREGNANCY VAGINAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59400,CPT,OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM,,30,,,"$6,315.81",$0.00,1,0,1,20161001, 59409,CPT,VAGINAL DELIVERY ONLY,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59410,CPT,VAGINAL DELIVERY ONLY W/POSTPARTUM CARE,,30,,,"$4,019.15",$0.00,1,0,1,20161001, 59412,CPT,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59414,CPT,DELIVERY PLACENTA SEPARATE PROCEDURE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59425,CPT,ANTEPARTUM CARE ONLY 4-6 VISITS,,30,,,$289.38,$0.00,1,0,1,20161001, 59426,CPT,ANTEPARTUM CARE ONLY 7/> VISITS,,30,,,$413.26,$0.00,1,0,1,20161001, 59430,CPT,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,,30,,,$296.96,$0.00,1,0,1,20161001, 59612,CPT,VAGINAL DELIVERY AFTER CESAREAN DELIVERY,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59812,CPT,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59820,CPT,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59821,CPT,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59840,CPT,INDUCED ABORTION DILATION AND CURETTAGE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59841,CPT,INDUCED ABORTION DILATION & EVACUATION,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59866,CPT,MULTIFETAL PREGNANCY REDUCTION,,30,,,"$1,513.74",$0.00,1,0,1,20161001, 59870,CPT,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59871,CPT,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,,30,,,"$10,673.06",$0.00,1,0,1,20161001, 59897,CPT,UNLISTED FETAL INVASIVE PX W/ULTRASOUND,,30,,,$916.02,$0.00,1,0,1,20161001, 59898,CPT,UNLISTED LAPAROSCOPY PX MATERNITY CARE&DELIVERY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 59899,CPT,UNLISTED PROCEDURE MATERNITY CARE & DELIVERY,,30,,,$916.02,$0.00,1,0,1,20161001, 60000,CPT,I&D THYROGLOSSAL DUCT CYST INFECTED,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 60100,CPT,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 60200,CPT,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60210,CPT,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60212,CPT,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60220,CPT,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60225,CPT,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60240,CPT,THYROIDECTOMY TOTAL/COMPLETE,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60252,CPT,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 60260,CPT,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 60271,CPT,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 60280,CPT,EXCISION THYROGLOSSAL DUCT CYST/SINUS,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60281,CPT,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60300,CPT,ASPIRATION AND/OR INJECTION THYROID CYST,,30,,,"$3,058.90",$0.00,1,0,1,20161001, 60500,CPT,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 60502,CPT,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 60512,CPT,PARATHYROID AUTOTRANSPLANTATION ADD-ON,,30,,,"$7,724.99",$0.00,1,0,1,20161001, 60520,CPT,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 60659,CPT,UNLISTED LAPAROSCOPY PROCEDURE ENDOCRINE SYSTEM,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 60699,CPT,UNLISTED PROCEDURE ENDOCRINE SYSTEM,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 61000,CPT,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 61001,CPT,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI SBSQ,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 61020,CPT,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 61026,CPT,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,,30,,,"$2,614.09",$0.00,1,0,1,20161001, 61050,CPT,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 61055,CPT,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 61070,CPT,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,,30,,,"$3,084.03",$0.00,1,0,1,20161001, 61215,CPT,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 61330,CPT,DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 61623,CPT,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 61626,CPT,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 61720,CPT,CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 61770,CPT,STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 61781,CPT,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,,30,,,"$3,198.91",$0.00,1,0,1,20161001, 61782,CPT,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,,30,,,"$3,503.84",$0.00,1,0,1,20161001, 61790,CPT,CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 61791,CPT,CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 61796,CPT,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,,30,,,"$23,200.57",$0.00,1,0,1,20161001, 61797,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,,30,,,"$7,733.52",$0.00,1,0,1,20161001, 61798,CPT,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,,30,,,"$25,133.95",$0.00,1,0,1,20161001, 61799,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,,30,,,"$9,666.90",$0.00,1,0,1,20161001, 61800,CPT,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,,30,,,"$4,833.45",$0.00,1,0,1,20161001, 61880,CPT,REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 61885,CPT,INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR,,30,,,"$34,569.16",$0.00,1,0,1,20161001, 61886,CPT,INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS,,30,,,"$53,493.40",$0.00,1,0,1,20161001, 61888,CPT,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 62000,CPT,ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 62194,CPT,RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 62225,CPT,RPLCMT/IRRIGATION VENTRICULAR CATHETER,,30,,,"$7,207.04",$0.00,1,0,1,20161001, 62230,CPT,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 62252,CPT,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,,30,,,$973.44,$0.00,1,0,1,20161001, 62263,CPT,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 62264,CPT,PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 62267,CPT,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 62268,CPT,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 62269,CPT,BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE,,30,,,"$5,733.20",$0.00,1,0,1,20161001, 62270,CPT,SPINAL PUNCTURE LUMBAR DIAGNOSTIC,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 62272,CPT,SPINAL PUNCTURE THER DRAIN CEREBROSPINAL FLUID,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 62273,CPT,INJECTION EPIDURAL BLOOD/CLOT PATCH,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 62280,CPT,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 62281,CPT,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 62282,CPT,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 62284,CPT,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,,30,,,"$3,286.75",$0.00,1,0,1,20161001, 62287,CPT,DCMPRN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 62290,CPT,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,,30,,,"$3,528.42",$0.00,1,0,1,20161001, 62291,CPT,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,,30,,,"$3,286.75",$0.00,1,0,1,20161001, 62292,CPT,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 62294,CPT,NJX ARTERIAL OCCLUSION ARVEN MALFRMJ SPINAL,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 62302,CPT,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 62303,CPT,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 62304,CPT,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 62305,CPT,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 62310,CPT,NJX DX/THER SBST EPIDURAL/SUBRACH CERV/THORACIC,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 62311,CPT,NJX DX/THER SBST EPIDURAL/SUBARACH LUMBAR/SACRAL,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 62318,CPT,NJXS INFUS/BOLUS DX/SBST EDRL/SUBARACH CRV/THRC,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 62319,CPT,NJX INFUS/BOLUS DX/SBST EDRL/SUBARACH LUM/SACRAL,,30,,,"$5,048.03",$0.00,1,0,1,20161001, 62350,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 62351,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 62355,CPT,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 62360,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,,30,,,"$30,781.06",$0.00,1,0,1,20161001, 62361,CPT,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,,30,,,"$30,781.06",$0.00,1,0,1,20161001, 62362,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,,30,,,"$30,781.06",$0.00,1,0,1,20161001, 62365,CPT,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 62367,CPT,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,,30,,,$973.44,$0.00,1,0,1,20161001, 62368,CPT,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,,30,,,$973.44,$0.00,1,0,1,20161001, 62369,CPT,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL,,30,,,$973.44,$0.00,1,0,1,20161001, 62370,CPT,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP,,30,,,$973.44,$0.00,1,0,1,20161001, 63001,CPT,LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63003,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63005,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63011,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63012,CPT,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63015,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63016,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63017,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63020,CPT,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63030,CPT,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63035,CPT,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,,30,,,"$25,520.62",$0.00,1,0,1,20161001, 63040,CPT,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63042,CPT,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63044,CPT,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,,30,,,"$9,898.77",$0.00,1,0,1,20161001, 63045,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT CERVICAL,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63046,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT THORACIC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63047,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63048,CPT,LAM FACETECTOMY&FORAMTOMY 1 SGM EA CRV THRC/LMBR,,30,,,"$25,520.62",$0.00,1,0,1,20161001, 63055,CPT,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63056,CPT,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63057,CPT,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,,30,,,"$25,520.62",$0.00,1,0,1,20161001, 63064,CPT,COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63066,CPT,COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG,,30,,,"$25,520.62",$0.00,1,0,1,20161001, 63075,CPT,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 63076,CPT,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,,30,,,"$25,520.62",$0.00,1,0,1,20161001, 63600,CPT,CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 63610,CPT,STRTCTC STIMJ SPI CORD PRQ SPX N/FLWD OTH SURG,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 63615,CPT,STRTCTC BX ASPIRAT/EXC LESION SPINAL CORD,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 63620,CPT,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,,30,,,"$20,880.51",$0.00,1,0,1,20161001, 63621,CPT,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,,30,,,"$5,800.14",$0.00,1,0,1,20161001, 63650,CPT,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 63655,CPT,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,,30,,,"$34,569.16",$0.00,1,0,1,20161001, 63661,CPT,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 63662,CPT,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 63663,CPT,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 63664,CPT,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 63685,CPT,INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING,,30,,,"$53,493.40",$0.00,1,0,1,20161001, 63688,CPT,REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GENERATOR,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 63741,CPT,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 63744,CPT,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 63746,CPT,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64400,CPT,NJX ANES TRIGEMINAL NRV ANY DIV/BRANCH,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64402,CPT,INJECTION ANESTHETIC AGENT FACIAL NERVE,,30,,,$425.53,$0.00,1,0,1,20161001, 64405,CPT,INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV,,30,,,"$1,757.91",$0.00,1,0,1,20161001, 64408,CPT,INJECTION ANESTHETIC AGENT VAGUS NERVE,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64410,CPT,INJECTION ANESTHETIC AGENT PHRENIC NERVE,,30,,,"$3,655.73",$0.00,1,0,1,20161001, 64413,CPT,INJECTION ANESTHETIC AGENT CERVICAL PLEXUS,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64415,CPT,SINGLE NERVE BLOCK INJECTION ARM NERVE,,30,,,"$5,048.03",$0.00,1,0,1,20161001, 64416,CPT,INJECTION ANES BRACHIAL PLEXUS CONT NFS CATH,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64417,CPT,INJECTION ANESTHETIC AGENT AXILLARY NERVE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64418,CPT,INJECTION ANESTHETIC AGENT SUPRASCAPULAR NERVE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64420,CPT,INJECTION ANESTHETIC AGENT 1 INTERCOSTAL NERVE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64421,CPT,MULTIPLE NERVE BLOCK INJECTIONS RIB NERVES,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64425,CPT,INJECTION ANES ILIOINGUINAL ILIOHYPOGASTRIC NRVS,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64430,CPT,INJECTION ANESTHETIC AGENT PUDENDAL NERVE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64435,CPT,INJECTION ANESTHETIC PARACERVICAL UTERINE NERVE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64445,CPT,INJECTION ANESTHETIC AGENT SCIATIC NRV SINGLE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64446,CPT,INJECTION ANES SCIATIC NERVE CONT INFUSION CATH,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64447,CPT,INJECTION ANESTHETIC AGENT FEMORAL NERVE SINGLE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64448,CPT,INJECTION ANES FEMORAL NERVE CONT INFUSION CATH,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64449,CPT,INJECTION ANES LUMBAR PLEXUS POST CONT NFS CATH,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64450,CPT,INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH,,30,,,"$1,757.91",$0.00,1,0,1,20161001, 64455,CPT,NJX ANES&/STEROID PLANTAR COMMON DIGITAL NERVE,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64461,CPT,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,,30,,,"$3,655.73",$0.00,1,0,1,20161001, 64463,CPT,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,,30,,,"$3,655.73",$0.00,1,0,1,20161001, 64479,CPT,NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC 1 LVL,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64480,CPT,NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC EA LV,,30,,,"$4,253.44",$0.00,1,0,1,20161001, 64483,CPT,NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64484,CPT,NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC EA LV,,30,,,"$4,253.44",$0.00,1,0,1,20161001, 64486,CPT,TAP BLOCK UNILATERAL BY INJECTION(S),,30,,,"$2,030.05",$0.00,1,0,1,20161001, 64487,CPT,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),,30,,,"$2,030.05",$0.00,1,0,1,20161001, 64488,CPT,TAP BLOCK BILATERAL BY INJECTION(S),,30,,,"$2,030.05",$0.00,1,0,1,20161001, 64489,CPT,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),,30,,,"$2,030.05",$0.00,1,0,1,20161001, 64490,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64491,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,,30,,,"$3,824.51",$0.00,1,0,1,20161001, 64492,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,,30,,,"$3,824.51",$0.00,1,0,1,20161001, 64493,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64494,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,,30,,,"$3,824.51",$0.00,1,0,1,20161001, 64495,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,,30,,,"$3,824.51",$0.00,1,0,1,20161001, 64505,CPT,INJECTION ANES AGENT SPHENOPALATINE GANGLION,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64508,CPT,INJECTION ANESTHETIC AGENT CAROTID SINUS SPX,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64510,CPT,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64517,CPT,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,,30,,,"$5,048.03",$0.00,1,0,1,20161001, 64520,CPT,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64530,CPT,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64550,CPT,APPLICATION SURFACE NEUROSTIMULATOR,,30,,,$676.68,$0.00,1,0,1,20161001, 64553,CPT,PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 64555,CPT,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 64561,CPT,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 64565,CPT,PRQ IMPLTJ NSTIM ELTRD NEUROMUSCULAR,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 64566,CPT,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64568,CPT,INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER,,30,,,"$53,493.40",$0.00,1,0,1,20161001, 64569,CPT,REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 64570,CPT,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64575,CPT,INC IMPLTJ PERIPH NERVE NEUROSTIMULATOR ELTRD,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 64580,CPT,INC IMPLTJ NSTIM ELTRD NEUROMUSCULAR,,30,,,"$34,569.16",$0.00,1,0,1,20161001, 64581,CPT,INC IMPLTJ NEUROSTIMULATOR ELTRD SACRAL NERVE,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 64585,CPT,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 64590,CPT,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,,30,,,"$34,569.16",$0.00,1,0,1,20161001, 64595,CPT,REVISION/RMVL PERIPHERAL/GASTRIC NPGR,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 64600,CPT,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64605,CPT,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64610,CPT,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64611,CPT,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64612,CPT,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64615,CPT,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64616,CPT,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,,30,,,"$1,748.92",$0.00,1,0,1,20161001, 64617,CPT,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,,30,,,"$3,655.73",$0.00,1,0,1,20161001, 64620,CPT,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64630,CPT,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64632,CPT,DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64633,CPT,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64634,CPT,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,,30,,,"$2,432.19",$0.00,1,0,1,20161001, 64635,CPT,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64636,CPT,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,,30,,,"$2,169.25",$0.00,1,0,1,20161001, 64640,CPT,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64642,CPT,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64644,CPT,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64646,CPT,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,,30,,,"$1,757.91",$0.00,1,0,1,20161001, 64647,CPT,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 64650,CPT,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64653,CPT,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 64680,CPT,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64681,CPT,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 64702,CPT,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64704,CPT,NEUROPLASTY NERVE HAND/FOOT,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64708,CPT,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64712,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64713,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64714,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64716,CPT,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64718,CPT,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64719,CPT,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64721,CPT,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64722,CPT,DECOMPRESSION UNSPECIFIED NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64726,CPT,DECOMPRESSION PLANTAR DIGITAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64727,CPT,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,,30,,,"$5,467.77",$0.00,1,0,1,20161001, 64732,CPT,TRANSECTION/AVULSION SUPRAORBITAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64734,CPT,TRANSECTION/AVULSION INFRAORBITAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64736,CPT,TRANSECTION/AVULSION MENTAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64738,CPT,TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64740,CPT,TRANSECTION/AVULSION LINGUAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64742,CPT,TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64744,CPT,TRANSECTION/AVULSION GREATER OCCIPITAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64746,CPT,TRANSECTION/AVULSION PHRENIC NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64763,CPT,TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64766,CPT,TRNSXJ/AVLSN OBTURAT NRV INPELV W/WO TENOTOMY,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64771,CPT,TRANSECTION/AVULSION OTH CRANIAL NRV XDRL,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64772,CPT,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64774,CPT,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64776,CPT,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64778,CPT,EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT,,30,,,"$1,885.05",$0.00,1,0,1,20161001, 64782,CPT,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64783,CPT,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,,30,,,"$9,280.23",$0.00,1,0,1,20161001, 64784,CPT,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64786,CPT,EXCISION NEUROMA SCIATIC NERVE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64787,CPT,IMPLANTATION NERVE END BONE/MUSCLE,,30,,,"$13,920.34",$0.00,1,0,1,20161001, 64788,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64790,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64792,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64795,CPT,BIOPSY NERVE,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64802,CPT,SYMPATHECTOMY CERVICAL,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64804,CPT,SYMPATHECTOMY CERVICOTHORACIC,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64820,CPT,SYMPATHECTOMY DIGITAL ARTERIES EACH DIGIT,,30,,,"$8,377.18",$0.00,1,0,1,20161001, 64821,CPT,SYMPATHECTOMY RADIAL ARTERY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 64822,CPT,SYMPATHECTOMY ULNAR ARTERY,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 64823,CPT,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 64831,CPT,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64832,CPT,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,,30,,,"$9,280.23",$0.00,1,0,1,20161001, 64834,CPT,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64835,CPT,SUTURE 1 NERVE MEDIAN MOTOR THENAR,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64836,CPT,SUTURE 1 NERVE ULNAR MOTOR,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64837,CPT,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,,30,,,"$8,120.20",$0.00,1,0,1,20161001, 64840,CPT,SUTURE POSTERIOR TIBIAL NERVE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64856,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64857,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64858,CPT,SUTURE SCIATIC NERVE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64859,CPT,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,,30,,,"$9,280.23",$0.00,1,0,1,20161001, 64861,CPT,SUTURE BRACHIAL PLEXUS,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64862,CPT,SUTURE LUMBAR PLEXUS,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64864,CPT,SUTURE FACIAL NERVE EXTRACRANIAL,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64865,CPT,SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64872,CPT,SUTURE NERVE REQ SECONDARY/DELAYED SUTURE,,30,,,"$15,050.95",$0.00,1,0,1,20161001, 64874,CPT,SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE,,30,,,"$15,050.95",$0.00,1,0,1,20161001, 64876,CPT,SUTURE NERVE REQ SHORTENING BONE EXTREMITY,,30,,,"$15,050.95",$0.00,1,0,1,20161001, 64885,CPT,NERVE GRAFT HEAD/NECK 4 CM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64890,CPT,NERVE GRAFT 1 STRAND HAND/FOOT 4 CM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64892,CPT,NERVE GRAFT 1 STRAND ARM/LEG <4 CM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64893,CPT,NERVE GRAFT 1 STRAND ARM/LEG >4 CM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64895,CPT,NERVE GRAFT MLT STRANDS HAND/FOOT 4 CM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64897,CPT,NERVE GRAFT MLT STRANDS ARM/LEG 4 CM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64901,CPT,NERVE GRAFT EACH NERVE 1 STRAND,,30,,,"$11,600.28",$0.00,1,0,1,20161001, 64902,CPT,NERVE GRAFT EACH NERVE MULTIPLE STRANDS,,30,,,"$13,920.34",$0.00,1,0,1,20161001, 64905,CPT,NERVE PEDICLE TRANSFER FIRST STAGE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64907,CPT,NERVE PEDICAL TRANSFER SECOND STAGE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64910,CPT,NERVE REPAIR W/CONDUIT EACH NERVE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64911,CPT,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 64999,CPT,UNLISTED PROCEDURE NERVOUS SYSTEM,,30,,,"$1,023.16",$0.00,1,0,1,20161001, 65091,CPT,EVISCERATION OCULAR CONTENTS W/O IMPLANT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65093,CPT,EVISCERATION OCULAR CONTENTS W/IMPLANT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65101,CPT,ENUCLEATION OF EYE W/O IMPLANT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65103,CPT,ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65105,CPT,ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65110,CPT,EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65112,CPT,EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65114,CPT,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65125,CPT,MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65130,CPT,INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65135,CPT,INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65140,CPT,INSJ OC IMPLT AFTER ENCL MUSC ATTACHED,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65150,CPT,REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65155,CPT,REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65175,CPT,REMOVAL OCULAR IMPLANT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65205,CPT,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,,30,,,$425.53,$0.00,1,0,1,20161001, 65210,CPT,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,,30,,,$425.53,$0.00,1,0,1,20161001, 65220,CPT,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,,30,,,$425.53,$0.00,1,0,1,20161001, 65222,CPT,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,,30,,,$425.53,$0.00,1,0,1,20161001, 65235,CPT,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65260,CPT,RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65265,CPT,RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65270,CPT,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65272,CPT,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65275,CPT,RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65280,CPT,RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65285,CPT,RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65286,CPT,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65290,CPT,RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65400,CPT,EXCISION LESION CORNEA XCP PTERYGIUM,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 65410,CPT,BIOPSY CORNEA,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65420,CPT,EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65426,CPT,EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65430,CPT,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,,30,,,$425.53,$0.00,1,0,1,20161001, 65435,CPT,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 65436,CPT,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65450,CPT,DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 65600,CPT,MULTIPLE PUNCTURES ANTERIOR CORNEA,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65710,CPT,KERATOPLASTY ANTERIOR LAMELLAR,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65730,CPT,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65750,CPT,KERATOPLASTY PENETRAING APHAKIA,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65755,CPT,KERATOPLASTY PENETRATING PSEUDOPHAKIA,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65756,CPT,KERATOPLASTY ENDOTHELIAL,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65757,CPT,BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT,,30,,,"$10,902.44",$0.00,1,0,1,20161001, 65760,CPT,KERATOMILEUSIS,,30,,,"$10,902.44",$0.00,1,0,1,20161001, 65765,CPT,KERATOPHAKIA,,30,,,"$10,902.44",$0.00,1,0,1,20161001, 65767,CPT,EPIKERATOPLASTY,,30,,,"$10,902.44",$0.00,1,0,1,20161001, 65770,CPT,KERATOPROSTHESIS,,30,,,"$21,873.82",$0.00,1,0,1,20161001, 65771,CPT,RADIAL KERATOTOMY,,30,,,"$3,964.52",$0.00,1,0,1,20161001, 65772,CPT,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 65775,CPT,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 65778,CPT,PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 65779,CPT,PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65780,CPT,OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65781,CPT,OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65782,CPT,OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 65785,CPT,IMPLANTATION INTRASTROMAL CORNEAL RING SEGMENTS,,30,,,"$16,856.92",$0.00,1,0,1,20161001, 65800,CPT,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65810,CPT,PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65815,CPT,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65820,CPT,GONIOTOMY,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 65850,CPT,TRABECULOTOMY AB EXTERNO,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65855,CPT,TRABECULOPLASTY BY LASER SURGERY,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 65860,CPT,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 65865,CPT,SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65870,CPT,SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65875,CPT,SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65880,CPT,SEVERING ADS ANT SEG INCAL SPX CORNEOVITREAL,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65900,CPT,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65920,CPT,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 65930,CPT,RMVL BLOOD CLOT ANTERIOR SEGMENT EYE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66020,CPT,INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66030,CPT,INJX ANTERIOR CHAMBER EYE MEDICATION SPX,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66130,CPT,EXCISION LESION SCLERA,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 66150,CPT,FSTLJ SCLERA GLAUCOMA TREPHIN W/IRIDECTOMY,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 66155,CPT,FSTLJ SCLERA GLAUCOMA THERMOCAUT IRRIDEC,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66160,CPT,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66170,CPT,FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66172,CPT,FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66174,CPT,TRLUML DILAT AQUEOUS CANAL W/O DEVICE/STENT,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66175,CPT,TRLUML DILAT AQUEOUS CANAL W/DEVICE/STENT,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 66179,CPT,AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 66180,CPT,AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 66183,CPT,INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 66184,CPT,REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66185,CPT,REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66220,CPT,REPAIR SCLERAL STAPHYLOMA W/O GRAFT,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66225,CPT,REPAIR SCLERAL STAPHYLOMA W/GRAFT,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66250,CPT,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,,30,,,"$8,237.67",$0.00,1,0,1,20161001, 66500,CPT,IRIDOTOMY STAB INC SPX XCP TRANSFIXION,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66505,CPT,IRIDOTOMY STAB INC SPX TRANSFIXION,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66600,CPT,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66605,CPT,IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66625,CPT,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66630,CPT,IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66635,CPT,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66680,CPT,REPAIR IRIS CILIARY BODY,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66682,CPT,SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66700,CPT,CILIARY BODY DESTRUCTION DIATHERMY,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66710,CPT,CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 66711,CPT,CILIARY BODY DSTRJ CYCLOPHOTOCOAG ENDOSCOPIC,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66720,CPT,CILIARY BODY DESTRUCTION CRYOTHERAPY,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 66740,CPT,CILIARY BODY DESTRUCTION CYCLODIAL,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 66761,CPT,IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 66762,CPT,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 66770,CPT,DSTRJ CYST/LESION IRIS/CILIARY BODY,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 66820,CPT,DISCISSION SECONDARY MEMBRANOUS CATARACT,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66821,CPT,POST-CATARACT LASER SURGERY,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 66825,CPT,REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66830,CPT,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66840,CPT,RMVL LENS MATERIAL ASPIR TQ 1/> STAGES,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66850,CPT,RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66852,CPT,RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 66920,CPT,RMVL LENS MATERIAL INTRACAPSULAR,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66930,CPT,REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 66940,CPT,REMOVAL LENS MATERIAL EXTRACAPSULAR,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66982,CPT,XCAPSULAR CATARACT RMVL INSJ LENS PROSTH 1 STG,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66983,CPT,ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66984,CPT,CATARACT REMOVAL INSERTION OF LENS,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66985,CPT,INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 66986,CPT,EXCHANGE INTRAOCULAR LENS,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 66990,CPT,USE OPHTHALMIC ENDOSCOPE,,30,,,"$4,646.14",$0.00,1,0,1,20161001, 66999,CPT,UNLISTED PROCEDURE ANTERIOR SEGMENT EYE,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 67005,CPT,RMVL VITREOUS ANT APPR PARTIAL REMOVAL,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67010,CPT,RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67015,CPT,ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67025,CPT,INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67027,CPT,IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS,,30,,,"$21,347.47",$0.00,1,0,1,20161001, 67028,CPT,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,,30,,,"$1,532.23",$0.00,1,0,1,20161001, 67030,CPT,DISCISSION VITREOUS STRANS PARS PLANA APPROACH,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 67031,CPT,SEVERING VITREOUS STRANS LASER 1/> STAGES,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67036,CPT,VITRECTOMY MECHANICAL PARS PLANA,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67039,CPT,VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 67040,CPT,VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 67041,CPT,VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67042,CPT,VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 67043,CPT,VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 67101,CPT,RPR RETINAL DTCHMNT 1/>SES CRYOTX/DTHRM INCL DRG,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 67105,CPT,RPR RETINAL DTCHMNT 1/> SES PC INCL SUBRETI DRG,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67107,CPT,REPAIR RETINAL DETACHMENT SCLERAL BUCKLING,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 67108,CPT,RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 67110,CPT,RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 67113,CPT,RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 67115,CPT,RELEASE ENCIRCLING MATERIAL POSTERIOR SEGMENT,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67120,CPT,RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 67121,CPT,RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67141,CPT,PROPH RTA DTCHMNT W/O DRG 1/> SESS CRTX DTHRM,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67145,CPT,PROPH RTA DTCHMNT W/O DRG 1/> SESS,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67208,CPT,DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67210,CPT,DSTRJ LOCLZD LESION RETINA 1/> SESS PC,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67218,CPT,DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67220,CPT,DSTRJ LESION CHOROID PC 1/> SESS,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67221,CPT,DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67225,CPT,DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION,,30,,,"$6,626.09",$0.00,1,0,1,20161001, 67227,CPT,DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67228,CPT,TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67229,CPT,EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT,,30,,,"$2,637.79",$0.00,1,0,1,20161001, 67250,CPT,SCLERAL REINFORCEMENT SPX W/O GRAFT,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67255,CPT,SCLERAL REINFORCEMENT SPX W/GRAFT,,30,,,"$9,991.94",$0.00,1,0,1,20161001, 67299,CPT,UNLISTED PROCEDURE POSTERIOR SEGMENT,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 67311,CPT,STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67312,CPT,STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67314,CPT,STRABISMUS RECESSION/RESCJ 1 VER MUSC,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67316,CPT,STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67318,CPT,STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67320,CPT,TRANSPOSITION PROCEDURE EXTRAOCULAR MUSC,,30,,,"$6,626.09",$0.00,1,0,1,20161001, 67331,CPT,STRABISMUS PREVIOUS EYE X INVOLVE EO MUSC,,30,,,"$6,626.09",$0.00,1,0,1,20161001, 67332,CPT,STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY,,30,,,"$6,626.09",$0.00,1,0,1,20161001, 67334,CPT,STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION,,30,,,"$6,626.09",$0.00,1,0,1,20161001, 67335,CPT,PLACEMENT ADJUSTABLE SUTURE STRABISMUS,,30,,,"$6,626.09",$0.00,1,0,1,20161001, 67340,CPT,STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC,,30,,,"$6,626.09",$0.00,1,0,1,20161001, 67343,CPT,RLS XTNSV SCAR TISS W/O DETACHING EO MUSC SPX,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67345,CPT,CHEMODENERVATION EXTRAOCULAR MUSCLE,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67346,CPT,BIOPSY EXTRAOCULAR MUSCLE,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67399,CPT,UNLISTED PROCEDURE EXTRAOCULAR MUSCLE,,30,,,"$5,194.08",$0.00,1,0,1,20161001, 67400,CPT,ORBITOTOMY W/O BONE FLAP EXPL W/WO BIOPSY,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67405,CPT,ORBITOTOMY W/O BONE FLAP EXPL W/DRAINAGE ONLY,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67412,CPT,ORBITOTOMY W/O BONE FLAP W/REMOVAL LESION,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67413,CPT,ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67414,CPT,ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67415,CPT,FINE NEEDLE ASPIRATION ORBITAL CONTENTS,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67420,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL LESION,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67430,CPT,ORBITOTOMY BONE FLAP/WINDOW LATERAL RMVL FB,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67440,CPT,ORBITOTOMY BONE FLAP/WINDOW LATERAL W/DRG,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67445,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67450,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67500,CPT,RETROBULBAR INJECTION MEDICATION SPX,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67505,CPT,RETROBULBAR INJECTION ALCOHOL,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67515,CPT,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67550,CPT,ORBITAL IMPLANT INSERTION,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67560,CPT,ORBITAL IMPLANT REMOVAL/REVISION,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67570,CPT,OPTIC NERVE DECOMPRESSION,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 67599,CPT,UNLISTED PROCEDURE ORBIT,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67700,CPT,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67710,CPT,SEVERING TARSORRHAPHY,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 67715,CPT,CANTHOTOMY SEPARATE PROCEDURE,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67800,CPT,EXCISION CHALAZION SINGLE,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67801,CPT,EXCISION CHALAZION MULTIPLE SAME LID,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 67805,CPT,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67808,CPT,EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67810,CPT,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67820,CPT,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,,30,,,$425.53,$0.00,1,0,1,20161001, 67825,CPT,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 67830,CPT,CORRECTION TRICHIASIS INCCISION LID MARGIN,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 67835,CPT,CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67840,CPT,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 67850,CPT,DESTRUCTION LESION LID MARGIN ONE-FOURTH LID MARGIN,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67966,CPT,EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 67971,CPT,RCNSTJ EYELID FULL THICKNESS 1 CM,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68130,CPT,EXCISION LESION CONJUNCTIVA ADJACENT SCLERA,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68135,CPT,DESTRUCTION LESION CONJUNCTIVA,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68200,CPT,SUBCONJUNCTIVAL INJECTION,,30,,,$425.53,$0.00,1,0,1,20161001, 68320,CPT,CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68325,CPT,CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68326,CPT,CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68328,CPT,CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68330,CPT,RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT,,30,,,"$10,028.54",$0.00,1,0,1,20161001, 68335,CPT,RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68340,CPT,RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68360,CPT,CONJUNCTIVAL FLAP BRIDGE/PARTIAL SPX,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68362,CPT,CONJUNCTIVAL FLAP TOTAL,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68371,CPT,HARVESTING CONJUNCIVAL ALLOGRAPHY LIVING DONOR,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68399,CPT,UNLISTED PROCEDURE CONJUNCTIVA,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68400,CPT,INCISION DRAINAGE LACRIMAL GLAND,,30,,,"$4,350.72",$0.00,1,0,1,20161001, 68420,CPT,INCISION DRAINAGE LACRIMAL SAC,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68440,CPT,SNIP INCISION LACRIMAL PUNCTUM,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68500,CPT,EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68505,CPT,EXCISION LACRIMAL GLAND XCPT TUMOR PRTL,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68510,CPT,BIOPSY LACRIMAL GLAND,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68520,CPT,EXCISION LACRIMAL SAC,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68525,CPT,BIOPSY LACRIMAL SAC,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68530,CPT,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68540,CPT,EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68550,CPT,EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68700,CPT,PLASTIC REPAIR CANALICULI,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68705,CPT,CORRECTION EVERTED PUNCTUM CAUTERY,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68720,CPT,DACRYOCSTORHINOSTOMY,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68745,CPT,CONJUNCTIVORHINOSTOMY W/O TUBE,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68750,CPT,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,,30,,,"$13,630.85",$0.00,1,0,1,20161001, 68760,CPT,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68761,CPT,CLSR LACRIMAL PUNCTUM PLUG EACH,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68770,CPT,CLOSURE LACRIMAL FISTULA SPX,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68801,CPT,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,,30,,,$425.53,$0.00,1,0,1,20161001, 68810,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68811,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68815,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68816,CPT,PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 68840,CPT,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 68850,CPT,INJECTION CONTRAST MEDIUM DACRYOCYSTOGRAPY,,30,,,$862.77,$0.00,1,0,1,20161001, 68899,CPT,UNLISTED PROCEDURE LACRIMAL SYSTEM,,30,,,"$1,072.20",$0.00,1,0,1,20161001, 69000,CPT,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 69005,CPT,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,,30,,,"$8,306.43",$0.00,1,0,1,20161001, 69020,CPT,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,,30,,,"$1,462.82",$0.00,1,0,1,20161001, 69100,CPT,BIOPSY EXTERNAL EAR,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 69105,CPT,BIOPSY EXTERNAL AUDITORY CANAL,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69110,CPT,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 69120,CPT,EXCISION EXTERNAL EAR COMPLETE AMPUTATION,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69140,CPT,EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69145,CPT,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,,30,,,"$9,390.88",$0.00,1,0,1,20161001, 69150,CPT,RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69200,CPT,RMVL FB XTRNL AUDITORY CANAL W/O ANES,,30,,,$425.53,$0.00,1,0,1,20161001, 69205,CPT,RMVL FB XTRNL AUDITORY CANAL ANES,,30,,,"$5,767.31",$0.00,1,0,1,20161001, 69209,CPT,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,,30,,,$302.96,$0.00,1,0,1,20161001, 69210,CPT,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,,30,,,$306.21,$0.00,1,0,1,20161001, 69220,CPT,DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE,,30,,,$398.75,$0.00,1,0,1,20161001, 69222,CPT,DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 69300,CPT,OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69310,CPT,RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69320,CPT,RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69399,CPT,UNLISTED PROCEDURE EXTERNAL EAR,,30,,,$853.29,$0.00,1,0,1,20161001, 69420,CPT,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 69421,CPT,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69424,CPT,VENTILATING TUBE RMVL REQUIRING GENERAL ANES,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69433,CPT,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 69436,CPT,TYMPANOSTOMY GENERAL ANESTHESIA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69440,CPT,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69450,CPT,TYMPANOLYSIS TRANSCANAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69501,CPT,TRANSMASTOID ANTROTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69502,CPT,MASTOIDECTOMY COMPLETE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69505,CPT,MASTOIDECTOMY MODIFIED RADICAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69511,CPT,MASTOIDECTOMY RADICAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69530,CPT,PETROUS APICECTOMY RADICAL MASTOIDECTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69540,CPT,EXCISION AURAL POLYP,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69550,CPT,EXCISION AURAL GLOMUS TUMOR TRANSCANAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69552,CPT,EXCISION AURAL GLOMUS TUMOR TRANSMASTOID,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69601,CPT,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69602,CPT,REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69603,CPT,REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69604,CPT,REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69605,CPT,REVJ MASTOIDECTOMY W/APICECTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69610,CPT,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69620,CPT,MYRINGOPLASTY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69631,CPT,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69632,CPT,TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69633,CPT,TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69635,CPT,TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69636,CPT,TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69637,CPT,TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69641,CPT,TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69642,CPT,TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69643,CPT,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69644,CPT,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69645,CPT,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69646,CPT,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69650,CPT,STAPES MOBILIZATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69660,CPT,STAPEDECTOMY/STAPEDOTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69661,CPT,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69662,CPT,REVISION STAPEDECTOMY/STAPEDOTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69666,CPT,REPAIR OVAL WINDOW FISTULA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69667,CPT,REPAIR ROUND WINDOW FISTULA,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69670,CPT,MASTOID OBLITERATION SEPARATE PROCEDURE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69676,CPT,TYMPANIC NEURECTOMY,,30,,,"$9,467.51",$0.00,1,0,1,20161001, 69700,CPT,CLOSURE POSTAURICULAR FISTULA MASTOID SPX,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 69710,CPT,IMPLTJ/RPLCMT EMGNT BONE CNDJ DEV TEMPORAL BONE,,30,,,"$10,501.46",$0.00,1,0,1,20161001, 69711,CPT,RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69714,CPT,IMPLTJ OSSEOINTEGRATED TEMPORAL BONE W/MASTOID,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 69715,CPT,IMPLJ OSSEOINTEGRATED TEMPORAL BONE W/O MASTOID,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 69717,CPT,RPLMCT OSSEOINTEGRATE IMPLNT W/O MASTOIDECTOMY,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 69718,CPT,RPLMCT OSSEOINTEGRATE IMPLNT W/MASTOIDECTOMY,,30,,,"$21,600.69",$0.00,1,0,1,20161001, 69720,CPT,DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69725,CPT,DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69740,CPT,SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69745,CPT,SUTR NRV ITPRL W/WO GRF/DCMPRN MEDIAL GENICULATE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69799,CPT,UNLISTED PROCEDURE MIDDLE EAR,,30,,,$853.29,$0.00,1,0,1,20161001, 69801,CPT,LABYRINTHOTOMY TRANSCANAL,,30,,,"$4,229.51",$0.00,1,0,1,20161001, 69805,CPT,ENDOLYMPHATIC SAC W/O SHUNT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69806,CPT,ENDOLYMPHATIC SAC SHUNT,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69820,CPT,FENESTRATION SEMICIRCULAR CANAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69840,CPT,REVISION FENESTRATION OPERATION,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69905,CPT,LABYRINTHECTOMY TRANSCANAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69910,CPT,LABYRINTHECTOMY W/MASTOIDECTOMY,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69915,CPT,VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69930,CPT,COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY,,30,,,"$60,843.44",$0.00,1,0,1,20161001, 69949,CPT,UNLISTED PROCEDURE INNER EAR,,30,,,$853.29,$0.00,1,0,1,20161001, 69955,CPT,TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69960,CPT,DECOMPRESSION INTERNAL AUDITORY CANAL,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69970,CPT,REMOVAL TUMOR TEMPORAL BONE,,30,,,"$18,828.32",$0.00,1,0,1,20161001, 69979,CPT,UNLISTED PROCEDURE TEMPORAL BONE MIDDLE FOSSA,,30,,,$853.29,$0.00,1,0,1,20161001, 69990,CPT,MICROSURG TQS REQ USE OPERATING MICROSCOPE,,30,,,"$3,159.05",$0.00,1,0,1,20161001, 70010,CPT,MYELOGRAPY POST FOSSA RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 70015,CPT,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 70030,CPT,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,,30,,,$399.19,$0.00,1,0,1,20161001, 70100,CPT,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 70110,CPT,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 70120,CPT,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,,30,,,$399.19,$0.00,1,0,1,20161001, 70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,,30,,,$655.16,$0.00,1,0,1,20161001, 70134,CPT,RADEX INTERNAL AUDITORY MEATI COMPLETE,,30,,,$655.16,$0.00,1,0,1,20161001, 70140,CPT,RADEX FACIAL BONES < 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 70150,CPT,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 70160,CPT,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 70190,CPT,RADEX OPTIC FORAMINA,,30,,,$394.22,$0.00,1,0,1,20161001, 70200,CPT,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 70210,CPT,RADEX SINUSES PARANASAL <3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 70220,CPT,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 70240,CPT,RADIOLOGIC EXAMINATION SELLA TURCICA,,30,,,$399.19,$0.00,1,0,1,20161001, 70250,CPT,RADIOLOGIC EXAMINATION SKULL 4/> VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 70260,CPT,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 70300,CPT,RADIOLOGIC EXAMINATION TEETH 1 VIEW,,30,,,$399.19,$0.00,1,0,1,20161001, 70310,CPT,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 70320,CPT,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 70328,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,,30,,,$399.19,$0.00,1,0,1,20161001, 70330,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,,30,,,$399.19,$0.00,1,0,1,20161001, 70332,CPT,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 70336,CPT,MRI TEMPOROMANDIBULAR JOINT,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70350,CPT,CEPHALOGRAM ORTHODONTIC,,30,,,$399.19,$0.00,1,0,1,20161001, 70355,CPT,ORTHOPANTOGRAM,,30,,,$399.19,$0.00,1,0,1,20161001, 70360,CPT,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,,30,,,$399.19,$0.00,1,0,1,20161001, 70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,,30,,,$399.19,$0.00,1,0,1,20161001, 70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,,30,,,$655.16,$0.00,1,0,1,20161001, 70380,CPT,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,,30,,,$399.19,$0.00,1,0,1,20161001, 70390,CPT,SIALOGRAPHY RS&I,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 70450,CPT,CT HEAD/BRAIN W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 70460,CPT,CT HEAD/BRAIN W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70470,CPT,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,,30,,,$763.01,$0.00,1,0,1,20161001, 70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70486,CPT,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 70487,CPT,CT MAXILLOFACIAL W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70488,CPT,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70490,CPT,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 70491,CPT,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70492,CPT,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70542,CPT,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70543,CPT,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70544,CPT,MRA HEAD W/O CONTRST MATERIAL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70545,CPT,MRA HEAD W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70546,CPT,MRA HEAD W/O & W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70547,CPT,MRA NECK W/O CONTRST MATERIAL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70548,CPT,MRA NECK W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70549,CPT,MRA NECK W/O &W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70551,CPT,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70552,CPT,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70553,CPT,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70557,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 70558,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 70559,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,,30,,,"$14,368.31",$0.00,1,0,1,20161001, 71010,CPT,RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL,,30,,,$399.19,$0.00,1,0,1,20161001, 71015,CPT,RADIOLOGIC EXAMINATION CHEST STERO FRONTAL,,30,,,$399.19,$0.00,1,0,1,20161001, 71020,CPT,RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL,,30,,,$399.19,$0.00,1,0,1,20161001, 71021,CPT,RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX,,30,,,$399.19,$0.00,1,0,1,20161001, 71022,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ,,30,,,$399.19,$0.00,1,0,1,20161001, 71023,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO,,30,,,$655.16,$0.00,1,0,1,20161001, 71030,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 71034,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO,,30,,,$655.16,$0.00,1,0,1,20161001, 71035,CPT,RADEX CHEST SPECIAL VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 71100,CPT,RADEX RIBS UNILATERAL 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 71110,CPT,RADEX RIBS BILATERAL 3 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 71130,CPT,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 71250,CPT,CT THORAX W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 71260,CPT,CT THORAX W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 71270,CPT,CT THORAX W/O & W/CONTRAST MATERIAL,,30,,,"$2,070.63",$0.00,1,0,1,20161001, 71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 71550,CPT,MRI CHEST W/O CONTRAST MATERIAL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 71551,CPT,MRI CHEST W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 71552,CPT,MRI CHEST W/O & W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 71555,CPT,MRA CHEST W/O & W/CONTRAST MATERIAL,,30,,,"$6,207.63",$0.00,1,0,1,20161001, 72020,CPT,RADEX SPINE 1 VIEW SPECIFY LEVEL,,30,,,$399.19,$0.00,1,0,1,20161001, 72040,CPT,RADEX SPINE CERVICAL 2 OR 3 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72050,CPT,RADEX SPINE CERVICAL 4 OR 5 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72052,CPT,RADEX SPINE CERVICAL 6 OR MORE VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72070,CPT,RADEX SPINE THORACIC 2 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72072,CPT,RADEX SPINE THORACIC 3 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72074,CPT,RADEX SPINE THORACIC MINIMUM 4 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72080,CPT,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 72081,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,,30,,,$394.22,$0.00,1,0,1,20161001, 72082,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,,30,,,$651.05,$0.00,1,0,1,20161001, 72083,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 72084,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 72100,CPT,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72110,CPT,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72114,CPT,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,,30,,,$655.16,$0.00,1,0,1,20161001, 72120,CPT,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 72125,CPT,CT CERVICAL SPINE W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 72126,CPT,CT CERVICAL SPINE W/CONTRAST MATERIAL,,30,,,"$2,070.63",$0.00,1,0,1,20161001, 72127,CPT,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 72128,CPT,CT THORACIC SPINE W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 72129,CPT,CT THORACIC SPINE W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 72130,CPT,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 72131,CPT,CT LUMBAR SPINE W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 72132,CPT,CT LUMBAR SPINE W/CONTRAST MATERIAL,,30,,,"$2,070.63",$0.00,1,0,1,20161001, 72133,CPT,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 72141,CPT,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 72142,CPT,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72146,CPT,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 72147,CPT,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72148,CPT,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 72149,CPT,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72156,CPT,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72157,CPT,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72158,CPT,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72159,CPT,MRA SPINAL CANAL W/WO CONTRAST MATERIAL,,30,,,"$6,760.52",$0.00,1,0,1,20161001, 72170,CPT,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72190,CPT,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 72192,CPT,CT PELVIS W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 72193,CPT,CT PELVIS W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 72194,CPT,CT PELVIS W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 72195,CPT,MRI PELVIS W/O CONTRAST MATERIAL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 72196,CPT,MRI PELVIS W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72197,CPT,MRI PELVIS W/O & W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 72198,CPT,MRA PELVIS W/WO CONTRAST MATERIAL,,30,,,"$6,366.47",$0.00,1,0,1,20161001, 72200,CPT,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,,30,,,$651.05,$0.00,1,0,1,20161001, 72202,CPT,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 72220,CPT,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 72240,CPT,MYELOGRAPHY CERVICAL RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 72255,CPT,MYELOGRAPHY THORACIC RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 72265,CPT,MYELOGRAPY LUMBOSACRAL RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 72275,CPT,EPIDUROGRAPY RS&I,,30,,,"$1,791.94",$0.00,1,0,1,20161001, 72285,CPT,DISKOGRAPY CERVICAL/THORACIC RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 72295,CPT,DISKOGRAPY LUMBAR RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 73000,CPT,RADEX CLAVICLE COMPLETE,,30,,,$399.19,$0.00,1,0,1,20161001, 73010,CPT,RADEX SCAPULA COMPLETE,,30,,,$399.19,$0.00,1,0,1,20161001, 73020,CPT,RADEX SHOULDER 1 VIEW,,30,,,$399.19,$0.00,1,0,1,20161001, 73030,CPT,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73040,CPT,RADEX SHOULDER ARTHROGRAPHY RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 73050,CPT,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,,30,,,$399.19,$0.00,1,0,1,20161001, 73060,CPT,RADEX HUMERUS MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73070,CPT,RADEX ELBOW 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73080,CPT,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73085,CPT,RADEX ELBOW ARTHROGRAPHY RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 73090,CPT,RADEX FOREARM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73092,CPT,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 73100,CPT,RADEX WRIST 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73110,CPT,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73115,CPT,RADEX WRIST ARTHROGRAPHY RS&I,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 73120,CPT,RADEX HAND 2 VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 73130,CPT,RADEX HAND MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73140,CPT,RADEX FINGR MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73200,CPT,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 73201,CPT,CT UPPER EXTREMITY W/CONTRAST MATERIAL,,30,,,"$2,070.63",$0.00,1,0,1,20161001, 73202,CPT,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 73218,CPT,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 73219,CPT,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73220,CPT,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73221,CPT,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 73222,CPT,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73223,CPT,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73225,CPT,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,,30,,,"$4,153.24",$0.00,1,0,1,20161001, 73501,CPT,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,,30,,,$394.22,$0.00,1,0,1,20161001, 73502,CPT,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,,30,,,$394.22,$0.00,1,0,1,20161001, 73503,CPT,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,,30,,,$651.05,$0.00,1,0,1,20161001, 73521,CPT,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,,30,,,$651.05,$0.00,1,0,1,20161001, 73522,CPT,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,,30,,,$651.05,$0.00,1,0,1,20161001, 73523,CPT,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 73525,CPT,RADEX HIP ARTHROGRAPHY RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 73551,CPT,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,,30,,,$394.22,$0.00,1,0,1,20161001, 73552,CPT,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,,30,,,$394.22,$0.00,1,0,1,20161001, 73560,CPT,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73562,CPT,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73564,CPT,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,,30,,,$655.16,$0.00,1,0,1,20161001, 73565,CPT,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,,30,,,$399.19,$0.00,1,0,1,20161001, 73580,CPT,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 73590,CPT,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73592,CPT,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73600,CPT,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73610,CPT,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73615,CPT,RADEX ANKLE ARTHROGRAPHY RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 73620,CPT,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73630,CPT,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73660,CPT,RADEX TOE MINIMUM 2 VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 73700,CPT,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 73701,CPT,CT LOWER EXTREMITY W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 73702,CPT,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 73718,CPT,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 73719,CPT,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73720,CPT,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73721,CPT,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 73722,CPT,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73723,CPT,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 73725,CPT,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,,30,,,"$4,538.16",$0.00,1,0,1,20161001, 74000,CPT,RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW,,30,,,$399.19,$0.00,1,0,1,20161001, 74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 74020,CPT,RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS,,30,,,$399.19,$0.00,1,0,1,20161001, 74022,CPT,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,,30,,,$655.16,$0.00,1,0,1,20161001, 74150,CPT,CT ABDOMEN W/O CONTRAST MATERIAL,,30,,,$763.01,$0.00,1,0,1,20161001, 74160,CPT,CT ABDOMEN W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 74170,CPT,CT ABDOMEN W/O & W/CONTRAST MATERIAL,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 74174,CPT,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,,30,,,"$2,070.63",$0.00,1,0,1,20161001, 74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 74176,CPT,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74177,CPT,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,,30,,,"$2,070.63",$0.00,1,0,1,20161001, 74178,CPT,CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,,30,,,"$2,070.63",$0.00,1,0,1,20161001, 74181,CPT,MRI ABDOMEN W/O CONTRAST MATERIAL,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 74182,CPT,MRI ABDOMEN W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 74183,CPT,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 74185,CPT,MRA ABDOMEN W/WO CONTRAST MATERIAL,,30,,,"$13,405.29",$0.00,1,0,1,20161001, 74190,CPT,PERITONEOGRAM RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 74210,CPT,RADEX PHARYNX&/CERVICAL ESOPHAGUS,,30,,,$655.16,$0.00,1,0,1,20161001, 74220,CPT,RADEX ESOPHAGUS,,30,,,$655.16,$0.00,1,0,1,20161001, 74230,CPT,SWALLOWING FUNCJ W/CINERADIOGRAPY/VIDRADIOG,,30,,,$655.16,$0.00,1,0,1,20161001, 74235,CPT,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,,30,,,"$1,543.97",$0.00,1,0,1,20161001, 74240,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/O KUB,,30,,,$655.16,$0.00,1,0,1,20161001, 74241,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB,,30,,,$655.16,$0.00,1,0,1,20161001, 74245,CPT,RADEX GI TRACT UPR W/SM INT W/MULT SERIAL IMAGES,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74246,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMGES W/O KUB,,30,,,$655.16,$0.00,1,0,1,20161001, 74247,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMAGES W/KUB,,30,,,$655.16,$0.00,1,0,1,20161001, 74249,CPT,RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74250,CPT,RADEX SMALL INTESTINE W/MULTIPLE SERIAL IMAGES,,30,,,$655.16,$0.00,1,0,1,20161001, 74251,CPT,RADEX SM INT W/MLT SRL IMGES VIA ENTEROCLSS TUBE,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74260,CPT,DUODENOGRAPY HYPOTONIC,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,,30,,,$726.75,$0.00,1,0,1,20161001, 74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,,30,,,$726.75,$0.00,1,0,1,20161001, 74270,CPT,RADEX COLON BARIUM ENEMA W/WO KUB,,30,,,$655.16,$0.00,1,0,1,20161001, 74280,CPT,RADEX COLON W/SPEC HI DNS BARIUM W/WO GLUCAGON,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74283,CPT,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74290,CPT,CHOLECYSTOGRAPHY ORAL CONTRST,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 74300,CPT,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,,30,,,$690.73,$0.00,1,0,1,20161001, 74301,CPT,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,,30,,,$487.57,$0.00,1,0,1,20161001, 74328,CPT,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,,30,,,"$1,750.25",$0.00,1,0,1,20161001, 74329,CPT,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,,30,,,"$1,324.57",$0.00,1,0,1,20161001, 74330,CPT,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,,30,,,"$2,235.95",$0.00,1,0,1,20161001, 74340,CPT,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,,30,,,"$1,125.16",$0.00,1,0,1,20161001, 74355,CPT,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,,30,,,"$1,642.74",$0.00,1,0,1,20161001, 74360,CPT,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,,30,,,"$1,805.26",$0.00,1,0,1,20161001, 74363,CPT,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,,30,,,"$1,462.71",$0.00,1,0,1,20161001, 74400,CPT,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74410,CPT,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74415,CPT,UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74420,CPT,X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 74425,CPT,UROGRAPHY ANTEGRADE RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 74430,CPT,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74445,CPT,CORPORA CAVERNOSOGRAPY RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 74450,CPT,URETHROCYSTOGRAPHY RETROGRADE RS&I,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 74455,CPT,URETHROCYSTOGRAPHY VOIDING RS&I,,30,,,"$2,033.10",$0.00,1,0,1,20161001, 74470,CPT,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,,30,,,"$2,033.10",$0.00,1,0,1,20161001, 74485,CPT,DILATION NEPHROSTOMY/URETER/URETHRA RS&I,,30,,,"$7,949.04",$0.00,1,0,1,20161001, 74710,CPT,PELVIMETRY W/WOPLACENTAL LOCALIZATION,,30,,,$399.19,$0.00,1,0,1,20161001, 74712,CPT,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,,30,,,"$1,747.34",$0.00,1,0,1,20161001, 74740,CPT,HYSTEROSALPINGOGRAPHY RS&I,,30,,,"$2,033.10",$0.00,1,0,1,20161001, 74742,CPT,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,,30,,,"$1,222.00",$0.00,1,0,1,20161001, 74775,CPT,PERINEOGRAM,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 75559,CPT,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,,30,,,"$2,785.94",$0.00,1,0,1,20161001, 75561,CPT,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,,30,,,"$2,925.81",$0.00,1,0,1,20161001, 75563,CPT,CARDIAC MRI W/W/O CONTRAST W/STRESS,,30,,,"$6,663.20",$0.00,1,0,1,20161001, 75565,CPT,CARDIAC MRI FOR VELOCITY FLOW MAPPING,,30,,,"$1,309.73",$0.00,1,0,1,20161001, 75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,,30,,,$81.90,$0.00,1,0,1,20161001, 75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,,30,,,"$1,516.95",$0.00,1,0,1,20161001, 75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 75600,CPT,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75605,CPT,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75625,CPT,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75630,CPT,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75635,CPT,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,,30,,,"$1,563.84",$0.00,1,0,1,20161001, 75658,CPT,ANIOGRAPHY BRACHIAL RETROGRADE RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75705,CPT,ANGIOGRAPHY SPINAL SELECTIVE RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75710,CPT,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75716,CPT,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75726,CPT,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75731,CPT,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75733,CPT,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75736,CPT,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75741,CPT,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75743,CPT,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75746,CPT,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75756,CPT,ANGIOGRAPHY INTERNAL MAMMARY RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75774,CPT,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,,30,,,"$3,497.86",$0.00,1,0,1,20161001, 75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 75801,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 75803,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 75805,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 75807,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,,30,,,"$14,368.31",$0.00,1,0,1,20161001, 75809,CPT,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,,30,,,$655.16,$0.00,1,0,1,20161001, 75810,CPT,SPLENOPORTOGRAPY RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75820,CPT,VENOGRAPHY EXTREMITY UNILATERAL RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 75822,CPT,VENOGRAPHY EXTREMITY BILATERAL RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 75825,CPT,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75827,CPT,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,,30,,,"$4,147.82",$0.00,1,0,1,20161001, 75831,CPT,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75833,CPT,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75840,CPT,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75842,CPT,VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75860,CPT,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75870,CPT,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,,30,,,"$4,141.97",$0.00,1,0,1,20161001, 75872,CPT,VENOGRAPHY EPIDURAL RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75880,CPT,VENOGRAPHY ORBITAL RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,,30,,,"$4,147.82",$0.00,1,0,1,20161001, 75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75893,CPT,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,,30,,,"$14,454.78",$0.00,1,0,1,20161001, 75894,CPT,TRANSCATHETER EMBOLIZATION ANY METH RS&I,,30,,,"$13,889.24",$0.00,1,0,1,20161001, 75898,CPT,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,,30,,,"$4,147.82",$0.00,1,0,1,20161001, 75901,CPT,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,,30,,,"$1,754.82",$0.00,1,0,1,20161001, 75902,CPT,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,,30,,,"$1,572.07",$0.00,1,0,1,20161001, 75962,CPT,TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI,,30,,,"$11,318.91",$0.00,1,0,1,20161001, 75964,CPT,TRLUML BALOON ANGIOP PERIPHER EA ADDL ART RS&I,,30,,,"$6,160.55",$0.00,1,0,1,20161001, 75966,CPT,TRLUML BALO ANGIOPLASTY RENAL/OTH VISC ART RS&I,,30,,,"$11,053.62",$0.00,1,0,1,20161001, 75968,CPT,TRLUML BALO ANGIOPLASTY EA VISCERAL ART RS&I,,30,,,"$6,160.55",$0.00,1,0,1,20161001, 75970,CPT,TRANSCATHETER BIOPSY RS&I,,30,,,"$7,242.33",$0.00,1,0,1,20161001, 75978,CPT,TRANSLUMINAL BALLOON ANGIOPLASTY VENOUS RS&I,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 75984,CPT,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,,30,,,"$1,670.32",$0.00,1,0,1,20161001, 75989,CPT,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,,30,,,"$2,725.38",$0.00,1,0,1,20161001, 76000,CPT,FLUOROSCOPY SPX UP TO 1 HOUR PHYS/QHP TIME,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 76001,CPT,FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME,,30,,,"$1,691.49",$0.00,1,0,1,20161001, 76010,CPT,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,,30,,,"$1,233.34",$0.00,1,0,1,20161001, 76080,CPT,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 76098,CPT,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,,30,,,"$2,155.12",$0.00,1,0,1,20161001, 76100,CPT,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,,30,,,$655.16,$0.00,1,0,1,20161001, 76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,30,,,$651.05,$0.00,1,0,1,20161001, 76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,30,,,$655.16,$0.00,1,0,1,20161001, 76125,CPT,CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE EXAMINATION,,30,,,$480.66,$0.00,1,0,1,20161001, 76140,CPT,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,,30,,,$304.31,$0.00,1,0,1,20161001, 76376,CPT,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,,30,,,"$1,862.81",$0.00,1,0,1,20161001, 76377,CPT,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,,30,,,"$1,930.99",$0.00,1,0,1,20161001, 76380,CPT,CT LIMITED/LOCALIZED FOLLOW UP STUDY,,30,,,$399.19,$0.00,1,0,1,20161001, 76390,CPT,MRI SPECTROSCOPY,,30,,,"$6,110.61",$0.00,1,0,1,20161001, 76496,CPT,UNLISTED FLUOROSCOPIC PROCEDURE,,30,,,$399.19,$0.00,1,0,1,20161001, 76497,CPT,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,,30,,,$399.19,$0.00,1,0,1,20161001, 76498,CPT,UNLISTED MAGNETIC RESONANCE PROCEDURE,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 76499,CPT,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,,30,,,$399.19,$0.00,1,0,1,20161001, 76506,CPT,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,,30,,,$686.47,$0.00,1,0,1,20161001, 76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,,30,,,$425.53,$0.00,1,0,1,20161001, 76511,CPT,OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY,,30,,,$686.47,$0.00,1,0,1,20161001, 76512,CPT,OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN,,30,,,$686.47,$0.00,1,0,1,20161001, 76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,,30,,,$989.36,$0.00,1,0,1,20161001, 76514,CPT,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,,30,,,$156.54,$0.00,1,0,1,20161001, 76516,CPT,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,,30,,,$686.47,$0.00,1,0,1,20161001, 76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,,30,,,$686.47,$0.00,1,0,1,20161001, 76529,CPT,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,,30,,,$686.47,$0.00,1,0,1,20161001, 76536,CPT,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,,30,,,$989.36,$0.00,1,0,1,20161001, 76604,CPT,US CHEST REAL TIME W/IMAGE DOCUMENTATION,,30,,,$686.47,$0.00,1,0,1,20161001, 76641,CPT,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,,30,,,$686.47,$0.00,1,0,1,20161001, 76642,CPT,US BREAST UNI REAL TIME WITH IMAGE LIMITED,,30,,,$686.47,$0.00,1,0,1,20161001, 76700,CPT,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76705,CPT,US ABDOMINAL REAL TIME W/IMAGE LIMITED,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76770,CPT,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76775,CPT,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,,30,,,$989.36,$0.00,1,0,1,20161001, 76776,CPT,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76800,CPT,ULTRASOUND SPINAL CANAL & CONTENTS,,30,,,$686.47,$0.00,1,0,1,20161001, 76801,CPT,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76802,CPT,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,,30,,,$403.13,$0.00,1,0,1,20161001, 76805,CPT,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76810,CPT,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,,30,,,$387.01,$0.00,1,0,1,20161001, 76811,CPT,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76812,CPT,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,,30,,,$566.81,$0.00,1,0,1,20161001, 76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,,30,,,$686.47,$0.00,1,0,1,20161001, 76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,,30,,,$381.37,$0.00,1,0,1,20161001, 76815,CPT,US PREGNANT UTERUS LIMITED 1/> FETUSES,,30,,,$989.36,$0.00,1,0,1,20161001, 76816,CPT,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,,30,,,$686.47,$0.00,1,0,1,20161001, 76817,CPT,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,,30,,,$989.36,$0.00,1,0,1,20161001, 76818,CPT,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76819,CPT,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76820,CPT,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,,30,,,$686.47,$0.00,1,0,1,20161001, 76821,CPT,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,,30,,,$686.47,$0.00,1,0,1,20161001, 76825,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,,30,,,"$2,635.53",$0.00,1,0,1,20161001, 76826,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,,30,,,"$2,635.53",$0.00,1,0,1,20161001, 76827,CPT,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76828,CPT,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76830,CPT,US TRANSVAGINAL,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76831,CPT,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76856,CPT,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76857,CPT,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,,30,,,$686.47,$0.00,1,0,1,20161001, 76870,CPT,US SCROTUM & CONTENTS,,30,,,$989.36,$0.00,1,0,1,20161001, 76872,CPT,US TRANSRECTAL,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76873,CPT,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76881,CPT,US EXTREMITY NON-VASC REAL-TIME IMG COMPL,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76882,CPT,US EXTREMITY NON-VASC REAL-TIME IMG LMTD,,30,,,$686.47,$0.00,1,0,1,20161001, 76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,,30,,,$686.47,$0.00,1,0,1,20161001, 76886,CPT,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76930,CPT,US GUIDANCE PERICARDIOCENTESIS RS&I,,30,,,$726.37,$0.00,1,0,1,20161001, 76932,CPT,US ENDOMYOCARDIAL BIOPSY RS&I,,30,,,$721.29,$0.00,1,0,1,20161001, 76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 76937,CPT,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,,30,,,$213.66,$0.00,1,0,1,20161001, 76940,CPT,US &MNTR PARENCHYMAL TISSUE ABLATION,,30,,,$796.59,$0.00,1,0,1,20161001, 76941,CPT,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,,30,,,$537.78,$0.00,1,0,1,20161001, 76942,CPT,US GUIDANCE NEEDLE PLACEMENT IMG S&I,,30,,,"$1,194.89",$0.00,1,0,1,20161001, 76945,CPT,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,,30,,,$722.42,$0.00,1,0,1,20161001, 76946,CPT,US GUIDANCE AMNIOCENTESIS IMG S&I,,30,,,$786.11,$0.00,1,0,1,20161001, 76948,CPT,US GUIDANCE ASPIRATION OVA IMG S&I,,30,,,$755.88,$0.00,1,0,1,20161001, 76965,CPT,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,,30,,,"$2,451.06",$0.00,1,0,1,20161001, 76970,CPT,US STUDY FOLLOW UP,,30,,,$686.47,$0.00,1,0,1,20161001, 76975,CPT,GI ENDOSCOPIC US S&I,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 76977,CPT,US BONE DENSITY MEAS & INTERP PERIPH ANY METHO,,30,,,$156.54,$0.00,1,0,1,20161001, 76998,CPT,ULTRASONIC GUIDANCE INTRAOPERATIVE,,30,,,"$1,213.78",$0.00,1,0,1,20161001, 76999,CPT,UNLISTED US PROCEDURE,,30,,,$686.47,$0.00,1,0,1,20161001, 77001,CPT,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,,30,,,$767.25,$0.00,1,0,1,20161001, 77002,CPT,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT,,30,,,$585.35,$0.00,1,0,1,20161001, 77003,CPT,FLUORO NEEDLE/CATH SPINE/PARASPINAL DX/THER,,30,,,$534.88,$0.00,1,0,1,20161001, 77011,CPT,CT GUIDANCE STEREOTACTIC LOCALIZATION,,30,,,"$3,521.78",$0.00,1,0,1,20161001, 77012,CPT,CT GUIDANCE NEEDLE PLACEMENT,,30,,,"$3,529.44",$0.00,1,0,1,20161001, 77013,CPT,CT GUIDANCE &MONITORING VISC TISS ABLATION,,30,,,"$4,582.19",$0.00,1,0,1,20161001, 77014,CPT,CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT,,30,,,"$1,471.44",$0.00,1,0,1,20161001, 77021,CPT,MR GUIDANCE NEEDLE PLACEMENT,,30,,,"$5,350.40",$0.00,1,0,1,20161001, 77022,CPT,MR GUIDANCE &MONITORING TISSUE ABLATION,,30,,,"$5,980.50",$0.00,1,0,1,20161001, 77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,,30,,,"$1,282.31",$0.00,1,0,1,20161001, 77058,CPT,MRI BREAST UNILATERAL,,30,,,"$8,718.59",$0.00,1,0,1,20161001, 77059,CPT,MRI BREAST BILATERAL,,30,,,"$11,868.28",$0.00,1,0,1,20161001, 77061,CPT,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,,30,,,$478.92,$0.00,1,0,1,20161001, 77062,CPT,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,,30,,,$478.92,$0.00,1,0,1,20161001, 77071,CPT,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,,30,,,$399.19,$0.00,1,0,1,20161001, 77072,CPT,BONE AGE STUDIES,,30,,,$655.16,$0.00,1,0,1,20161001, 77073,CPT,BONE LENGTH STUDIES,,30,,,$399.19,$0.00,1,0,1,20161001, 77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,,30,,,$655.16,$0.00,1,0,1,20161001, 77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,,30,,,$655.16,$0.00,1,0,1,20161001, 77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,,30,,,$655.16,$0.00,1,0,1,20161001, 77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,,30,,,$655.16,$0.00,1,0,1,20161001, 77078,CPT,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,,30,,,$399.19,$0.00,1,0,1,20161001, 77080,CPT,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,,30,,,$655.16,$0.00,1,0,1,20161001, 77081,CPT,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,,30,,,$399.19,$0.00,1,0,1,20161001, 77084,CPT,BONE MARROW BLOOD SUPPLY,,30,,,"$1,801.06",$0.00,1,0,1,20161001, 77085,CPT,DXA BONE DENSITY STUDY AXIAL SKELETON,,30,,,$655.16,$0.00,1,0,1,20161001, 77086,CPT,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,,30,,,$399.19,$0.00,1,0,1,20161001, 77280,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,,30,,,"$1,089.87",$0.00,1,0,1,20161001, 77285,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,,30,,,"$1,898.43",$0.00,1,0,1,20161001, 77290,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,,30,,,"$1,898.43",$0.00,1,0,1,20161001, 77295,CPT,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,,30,,,"$6,357.83",$0.00,1,0,1,20161001, 77299,CPT,UNLIS PX THER RADIOL CLINICAL TX PLANNING,,30,,,$710.65,$0.00,1,0,1,20161001, 77300,CPT,BASIC RADIATION DOSIMETRY CALCULATION,,30,,,$710.65,$0.00,1,0,1,20161001, 77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,,30,,,"$6,357.83",$0.00,1,0,1,20161001, 77306,CPT,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,,30,,,"$1,072.58",$0.00,1,0,1,20161001, 77307,CPT,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,,30,,,"$1,861.39",$0.00,1,0,1,20161001, 77316,CPT,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,,30,,,$710.65,$0.00,1,0,1,20161001, 77317,CPT,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,,30,,,"$1,898.43",$0.00,1,0,1,20161001, 77318,CPT,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,,30,,,"$1,898.43",$0.00,1,0,1,20161001, 77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,,30,,,"$1,898.43",$0.00,1,0,1,20161001, 77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,,30,,,$710.65,$0.00,1,0,1,20161001, 77332,CPT,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,,30,,,$710.65,$0.00,1,0,1,20161001, 77333,CPT,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,,30,,,"$1,089.87",$0.00,1,0,1,20161001, 77334,CPT,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,,30,,,"$1,898.43",$0.00,1,0,1,20161001, 77336,CPT,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,,30,,,$710.65,$0.00,1,0,1,20161001, 77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,30,,,"$1,898.43",$0.00,1,0,1,20161001, 77370,CPT,SPEC MEDICAL RADJ PHYSICS CONSLTJ,,30,,,"$1,089.87",$0.00,1,0,1,20161001, 77371,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,,30,,,"$23,491.71",$0.00,1,0,1,20161001, 77372,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,,30,,,"$23,491.71",$0.00,1,0,1,20161001, 77373,CPT,STEREOTACTIC BODY RADIATION DELIVERY,,30,,,"$9,625.24",$0.00,1,0,1,20161001, 77385,CPT,INTENSITY MODULATED RADIATION TX DLVR SIMPLE,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77386,CPT,INTENSITY MODULATED RADIATION TX DLVR COMPLEX,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,30,,,$710.65,$0.00,1,0,1,20161001, 77401,CPT,RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTA,,30,,,$673.77,$0.00,1,0,1,20161001, 77402,CPT,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,,30,,,$673.77,$0.00,1,0,1,20161001, 77407,CPT,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,,30,,,$673.77,$0.00,1,0,1,20161001, 77412,CPT,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,,30,,,"$1,266.48",$0.00,1,0,1,20161001, 77417,CPT,THERAPEUTIC RADIOLOGY PORT IMAGES(S),,30,,,$407.58,$0.00,1,0,1,20161001, 77422,CPT,HIGH ENERGY NEUTRON RADJ TX DLVR 1 TX AREA,,30,,,"$1,266.48",$0.00,1,0,1,20161001, 77423,CPT,HIGH ENERGY NEUTRON RADJ TX DLVR 1/> ISOCENTER,,30,,,"$3,176.23",$0.00,1,0,1,20161001, 77424,CPT,INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION,,30,,,"$23,463.49",$0.00,1,0,1,20161001, 77425,CPT,INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS,,30,,,"$23,463.49",$0.00,1,0,1,20161001, 77435,CPT,STEREOTACTIC BODY RADIATION MANAGEMENT,,30,,,"$5,449.39",$0.00,1,0,1,20161001, 77470,CPT,SPECIAL TREATMENT PROCEDURE,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77499,CPT,UNLISTED PROCEDURE THERAPEUTIC RADIOLOGY TX MGMT,,30,,,$507.68,$0.00,1,0,1,20161001, 77520,CPT,PROTON TX DELIVERY SIMPLE W/O COMPENSATION,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77522,CPT,PROTON TX DELIVERY SIMPLE W/COMPENSATION,,30,,,"$6,895.13",$0.00,1,0,1,20161001, 77523,CPT,PROTON TX DELIVERY INTERMEDIATE,,30,,,"$6,895.13",$0.00,1,0,1,20161001, 77525,CPT,PROTON TX DELIVERY COMPLEX,,30,,,"$6,895.13",$0.00,1,0,1,20161001, 77600,CPT,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,,30,,,"$1,266.48",$0.00,1,0,1,20161001, 77605,CPT,HYPERTHERMIA EXTERNAL GENERATED DEEP,,30,,,"$4,314.55",$0.00,1,0,1,20161001, 77610,CPT,HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77615,CPT,HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77620,CPT,HYPERTHERMIA INTRACAVITARY PROBES,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO FOLLOW-UP CARE,,30,,,"$1,266.48",$0.00,1,0,1,20161001, 77761,CPT,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,,30,,,"$3,256.27",$0.00,1,0,1,20161001, 77762,CPT,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,,30,,,"$3,176.23",$0.00,1,0,1,20161001, 77763,CPT,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,,30,,,"$4,314.55",$0.00,1,0,1,20161001, 77767,CPT,HDR RDNCL SKN SURF BRACHYTX LES 2CM&2CHAN/MLT LES,,30,,,"$1,248.43",$0.00,1,0,1,20161001, 77770,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,,30,,,"$4,314.55",$0.00,1,0,1,20161001, 77771,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,,30,,,"$4,314.55",$0.00,1,0,1,20161001, 77772,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,,30,,,"$4,314.55",$0.00,1,0,1,20161001, 77778,CPT,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,,30,,,"$4,314.55",$0.00,1,0,1,20161001, 77789,CPT,SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE,,30,,,$712.96,$0.00,1,0,1,20161001, 77790,CPT,SUPERVISION HANDLING LOADING RADIATION SOURCE,,30,,,$662.32,$0.00,1,0,1,20161001, 77799,CPT,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,,30,,,$673.77,$0.00,1,0,1,20161001, 78012,CPT,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78013,CPT,THYROID IMAGING WITH VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78014,CPT,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78015,CPT,THYROID CARCINOMA METASTASES IMG LMTD AREA,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78016,CPT,THYROID CARCINOMA METASTASES IMG ADDL STUDY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78018,CPT,THYROID CARCINOMA METASTASES IMG WHOLE BODY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78020,CPT,THYROID CARCINOMA METASTASES UPTAKE,,30,,,$612.04,$0.00,1,0,1,20161001, 78070,CPT,PARATHYROID PLANAR IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78071,CPT,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78072,CPT,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78075,CPT,ADRENAL IMAGING CORTEX &/MEDULLA,,30,,,"$6,663.20",$0.00,1,0,1,20161001, 78099,CPT,UNLISTED ENDOCRINE PX DX NUCLEAR MEDICINE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78102,CPT,BONE MARROW IMAGING LIMITED AREA,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78103,CPT,BONE MARROW IMAGING MULTIPLE AREAS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78104,CPT,BONE MARROW IMAGING WHOLE BODY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78110,CPT,PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78111,CPT,PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78120,CPT,RED CELL VOLUME DETERMINATION SPX 1 SAMPLING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78121,CPT,RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78122,CPT,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78130,CPT,RED CELL SURVIVAL STUDY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78135,CPT,RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78140,CPT,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78185,CPT,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78190,CPT,KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ,,30,,,"$6,663.20",$0.00,1,0,1,20161001, 78191,CPT,PLATELET SURVIVAL STUDY,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78195,CPT,LYMPHATICS & LYMPH NODES IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78201,CPT,LIVER IMAGING STATIC ONLY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78202,CPT,LIVER IMAGING W/VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78205,CPT,LIVER IMAGING SPECT,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78206,CPT,LIVER IMAGING SPECT W/VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78215,CPT,LIVER & SPLEEN IMAGING STATIC ONLY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78216,CPT,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78226,CPT,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78227,CPT,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78230,CPT,SALIVARY GLAND IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78231,CPT,SALIVARY GLAND IMAGING SERIAL IMAGES,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78232,CPT,SALIVARY GLAND FUNCTION STUDY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78258,CPT,ESOPHAGEAL MOTILITY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78261,CPT,GASTRIC MUCOSA IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78262,CPT,GASTROESOPHAGEAL REFLUX STUDY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78264,CPT,GASTRIC EMPTYING IMAGING STUDY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78265,CPT,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78266,CPT,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,,30,,,"$2,785.94",$0.00,1,0,1,20161001, 78270,CPT,VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78271,CPT,VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78272,CPT,VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78278,CPT,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78282,CPT,GASTROINTESTINAL PROTEIN LOSS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78290,CPT,INTESTINE IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78291,CPT,PERITONEAL-VENOUS SHUNT PATENCY TEST,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78299,CPT,UNLISTED GASTROINTESTINAL PX DX NUCLEAR MEDICINE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78300,CPT,BONE &/JOINT IMAGING LIMITED AREA,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78305,CPT,BONE &/JOINT IMAGING MULTIPLE AREAS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78306,CPT,BONE &/JOINT IMAGING WHOLE BODY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78315,CPT,BONE &/JOINT IMAGING 3 PHASE STUDY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78320,CPT,BONE &/JOINT IMAGING TOMOGRAPHIC SPECT,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78350,CPT,BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY,,30,,,$777.17,$0.00,1,0,1,20161001, 78351,CPT,BONE DENSTY 1/> SITES DUAL PHOTON ABSORPTIOMETR,,30,,,$851.70,$0.00,1,0,1,20161001, 78399,CPT,UNLISTED MUSCULOSKELETAL PX DX NUCLEAR MEDICINE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78414,CPT,CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78428,CPT,CARDIAC SHUNT DETECTION,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78445,CPT,NONCARDIAC VASCULAR FLOW IMAGING,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 78456,CPT,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,,30,,,"$6,663.20",$0.00,1,0,1,20161001, 78457,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,,30,,,"$2,785.94",$0.00,1,0,1,20161001, 78458,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78459,CPT,MYOCARDIAL IMAGING PET METABOLIC EVALUATION,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78466,CPT,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78469,CPT,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78472,CPT,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78473,CPT,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78481,CPT,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78483,CPT,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78491,CPT,MYOCRD IMAGE PET PERFUS SINGLE STUDY REST/STRESS,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78492,CPT,MYOCRD IMAGE PET PERFUS MULTPL STUDY REST/STRESS,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78494,CPT,CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78496,CPT,CARD BL POOL GATED 1 STDY REST RT VENT EJCT FRCT,,30,,,"$1,633.13",$0.00,1,0,1,20161001, 78499,CPT,UNLISTED CARDIOVASCULAR PX DX NUCLEAR MEDICINE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78579,CPT,PULMONARY VENTILATION IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78580,CPT,PULMONARY PERFUSION IMAGING PARTICULATE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78582,CPT,PULMONARY VENTILATION & PERFUSION IMAGING,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78597,CPT,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78598,CPT,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78599,CPT,UNLISTED RESPIRATORY PX DX NUCLEAR MEDICINE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78601,CPT,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78605,CPT,BRAIN IMAGING MINIMUM 4 STATIC VIEWS,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 78608,CPT,BRAIN IMAGING PET METABOLIC EVALUATION,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78609,CPT,BRAIN IMAGING PET PERFUSION EVALUATION,,30,,,"$4,998.59",$0.00,1,0,1,20161001, 78610,CPT,BRAIN IMAGING VASCULAR FLOW ONLY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78630,CPT,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78635,CPT,CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78645,CPT,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78647,CPT,CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 78650,CPT,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,,30,,,"$6,663.20",$0.00,1,0,1,20161001, 78660,CPT,RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78699,CPT,UNLISTED NERVOUS SYSTEM PX DX NUCLEAR MEDICINE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78700,CPT,KIDNEY IMAGING MORPHOLOGY,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78701,CPT,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78725,CPT,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 78730,CPT,URINARY BLADDER RESIDUAL STUDY,,30,,,$774.58,$0.00,1,0,1,20161001, 78740,CPT,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78799,CPT,UNLISTED GENITOURINARY PX DX NUCLEAR MEDICINE,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78800,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT LIMITED AREA,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78801,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT MULTIPLE AREAS,,30,,,"$2,141.51",$0.00,1,0,1,20161001, 78802,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT WHOLE BDY 1 DAY,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78803,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT TOMOG SPECT,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78804,CPT,RP LOCLZJ TUMOR/DSTRBJ AGT WHOL BDY REQ 2/> DAY,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA,,30,,,"$6,663.20",$0.00,1,0,1,20161001, 78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY,,30,,,"$6,663.20",$0.00,1,0,1,20161001, 78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,,30,,,"$2,983.65",$0.00,1,0,1,20161001, 78808,CPT,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78813,CPT,PET IMAGING WHOLE BODY,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,,30,,,"$7,622.99",$0.00,1,0,1,20161001, 78999,CPT,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,,30,,,"$2,116.06",$0.00,1,0,1,20161001, 79005,CPT,RP THERAPY ORAL ADMINISTRATION,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 79101,CPT,RP THERAPY INTRAVENOUS ADMINISTRATION,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 79200,CPT,RP THERAPY INRACAVITARY ADMINISTRATION,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 79300,CPT,RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 79440,CPT,RP THERAPY INTRA-ARTICULAR ADMINISTRATION,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 79445,CPT,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 79999,CPT,RP THERAPY UNLISTED PROCEDURE,,30,,,"$1,627.71",$0.00,1,0,1,20161001, 80047,CPT,BASIC METABOLIC PANEL CALCIUM IONIZED,,30,,,$265.31,$0.00,1,0,1,20161001, 80048,CPT,BASIC METABOLIC PANEL CALCIUM TOTAL,,30,,,$265.31,$0.00,1,0,1,20161001, 80050,CPT,GENERAL HEALTH PANEL,,30,,,$608.01,$0.00,1,0,1,20161001, 80051,CPT,ELECTROLYTE PANEL,,30,,,$221.09,$0.00,1,0,1,20161001, 80053,CPT,COMPREHENSIVE METABOLIC PANEL,,30,,,$309.53,$0.00,1,0,1,20161001, 80055,CPT,OBSTETRIC PANEL,,30,,,$884.38,$0.00,1,0,1,20161001, 80061,CPT,LIPID PANEL,,30,,,$353.75,$0.00,1,0,1,20161001, 80069,CPT,RENAL FUNCTION PANEL,,30,,,$331.64,$0.00,1,0,1,20161001, 80074,CPT,ACUTE HEPATITIS PANEL,,30,,,$994.92,$0.00,1,0,1,20161001, 80076,CPT,HEPATIC FUNCTION PANEL,,30,,,$276.37,$0.00,1,0,1,20161001, 80081,CPT,OBSTETRIC PANEL,,30,,,"$1,695.02",$0.00,1,0,1,20161001, 80150,CPT,DRUG SCREEN QUANTITATIVE AMIKACIN,,30,,,$530.63,$0.00,1,0,1,20161001, 80156,CPT,DRUG ASSAY CARBAMAZEPINE TOTAL,,30,,,$530.63,$0.00,1,0,1,20161001, 80157,CPT,DRUG ASSAY CARBAMAZEPINE FREE,,30,,,$486.41,$0.00,1,0,1,20161001, 80158,CPT,DRUG ASSAY CYCLOSPORINE,,30,,,$663.28,$0.00,1,0,1,20161001, 80162,CPT,DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL,,30,,,$497.46,$0.00,1,0,1,20161001, 80163,CPT,DRUG SCREEN QUANTITATIVE DIGOXIN FREE,,30,,,$490.60,$0.00,1,0,1,20161001, 80164,CPT,DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL,,30,,,$519.57,$0.00,1,0,1,20161001, 80165,CPT,DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE,,30,,,$512.41,$0.00,1,0,1,20161001, 80168,CPT,DRUG SCREEN QUANTITATIVE ETHOSUXIMIDE,,30,,,$585.90,$0.00,1,0,1,20161001, 80170,CPT,DRUG SCREEN QUANTITATIVE GENTAMICIN,,30,,,$552.74,$0.00,1,0,1,20161001, 80173,CPT,DRUG SCREEN QUANTITATIVE HALOPRIDOL,,30,,,$486.41,$0.00,1,0,1,20161001, 80176,CPT,DRUG SCREEN QUANTITATIVE LIDOCAINE,,30,,,$375.86,$0.00,1,0,1,20161001, 80178,CPT,DRUG SCREEN QUANTITATIVE LITHIUM,,30,,,$331.64,$0.00,1,0,1,20161001, 80184,CPT,DRUG SCREEN QUANTITATIVE PHENOBARBITAL,,30,,,$442.19,$0.00,1,0,1,20161001, 80185,CPT,DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL,,30,,,$497.46,$0.00,1,0,1,20161001, 80186,CPT,DRUG SCREEN QUANTITATIVE PHENYTOIN FREE,,30,,,$541.68,$0.00,1,0,1,20161001, 80188,CPT,DRUG SCREEN QUANTITATIVE PRIMIDONE,,30,,,$619.06,$0.00,1,0,1,20161001, 80190,CPT,DRUG SCREEN QUANTITATIVE PROCAINAMIDE,,30,,,$619.06,$0.00,1,0,1,20161001, 80192,CPT,DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE,,30,,,$619.06,$0.00,1,0,1,20161001, 80194,CPT,DRUG SCREEN QUANTITATIVE QUINIDINE,,30,,,$530.63,$0.00,1,0,1,20161001, 80195,CPT,DRUG SCREEN QUANTITATIVE SIROLIMUS,,30,,,$685.39,$0.00,1,0,1,20161001, 80197,CPT,DRUG SCREEN QUANTITATIVE TACROLIMUS,,30,,,$685.39,$0.00,1,0,1,20161001, 80198,CPT,DRUG SCREEN QUANTITATIVE THEOPHYLLINE,,30,,,$519.57,$0.00,1,0,1,20161001, 80200,CPT,DRUG SCREEN QUANTITATIVE TOBRAMYCIN,,30,,,$552.74,$0.00,1,0,1,20161001, 80201,CPT,DRUG SCREEN QUANTITATIVE TOPIRAMATE,,30,,,$541.68,$0.00,1,0,1,20161001, 80202,CPT,DRUG SCREEN QUANTITATIVE VANCOMYCIN,,30,,,$497.46,$0.00,1,0,1,20161001, 80299,CPT,QUANTITATION DRUG NOT ELSEWHERE SPECIFIED,,30,,,$552.74,$0.00,1,0,1,20161001, 80300,CPT,DRUG SCREEN LIST A ANY NMBR NON TLC DEVICES,,30,,,$398.52,$0.00,1,0,1,20161001, 80301,CPT,DRUG SCREEN LIST A SINGLE DRUG CLASS METHOD,,30,,,$212.70,$0.00,1,0,1,20161001, 80302,CPT,DRUG SCREEN PRESUMPTIVE 1 CLASS METHOD LIST B,,30,,,$295.95,$0.00,1,0,1,20161001, 80303,CPT,DRUG SCREEN PRSMPTV 1/MULT CLASS METHOD TLC,,30,,,$325.54,$0.00,1,0,1,20161001, 80304,CPT,DRUG SCREEN PRSMPTV 1/MULT CLASS METHOD,,30,,,$332.95,$0.00,1,0,1,20161001, 80320,CPT,DRUG SCREEN QUANTITATIVE ALCOHOLS,,30,,,$221.96,$0.00,1,0,1,20161001, 80321,CPT,DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2,,30,,,$221.96,$0.00,1,0,1,20161001, 80322,CPT,DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 3 OR MORE,,30,,,$244.16,$0.00,1,0,1,20161001, 80323,CPT,ALKALOIDS NOT OTHERWISE SPECIFIED,,30,,,$332.95,$0.00,1,0,1,20161001, 80324,CPT,DRUG SCREEN QUANT AMPHETAMINES 1 OR 2,,30,,,$369.94,$0.00,1,0,1,20161001, 80325,CPT,DRUG SCREEN QUANT AMPHETAMINES 3 OR 4,,30,,,$406.93,$0.00,1,0,1,20161001, 80326,CPT,DRUG SCREEN QUANT AMPHETAMINES 5 OR MORE,,30,,,$443.93,$0.00,1,0,1,20161001, 80327,CPT,DRUG SCREEN QUANT ANABOLIC STEROID 1 OR 2,,30,,,$443.93,$0.00,1,0,1,20161001, 80328,CPT,DRUG SCREEN QUANT ANABOLIC STEROID 3 OR MORE,,30,,,$488.32,$0.00,1,0,1,20161001, 80329,CPT,DRUG SCREEN ANALGESICS NON-OPIOID 1 OR 2,,30,,,$303.35,$0.00,1,0,1,20161001, 80330,CPT,DRUG SCREEN ANALGESICS NON-OPIOID 3-5,,30,,,$333.68,$0.00,1,0,1,20161001, 80331,CPT,DRUG SCREEN ANALGESICS NON-OPIOID 6 OR MORE,,30,,,$364.02,$0.00,1,0,1,20161001, 80332,CPT,ANTIDEPRESSANTS SEROTONERGIC CLASS 1 OR 2,,30,,,$332.95,$0.00,1,0,1,20161001, 80333,CPT,ANTIDEPRESSANTS SEROTONERGIC CLASS 3-5,,30,,,$366.24,$0.00,1,0,1,20161001, 80334,CPT,ANTIDEPRESSANTS SEROTONERGIC CLASS 6 OR MORE,,30,,,$399.54,$0.00,1,0,1,20161001, 80335,CPT,ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2,,30,,,$632.34,$0.00,1,0,1,20161001, 80336,CPT,ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 3-5,,30,,,$695.57,$0.00,1,0,1,20161001, 80337,CPT,ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 6/MORE,,30,,,$758.80,$0.00,1,0,1,20161001, 80338,CPT,ANTIDEPRESSANTS NOT OTHERWISE SPECIFIED,,30,,,$332.95,$0.00,1,0,1,20161001, 80339,CPT,ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 1-3,,30,,,$523.31,$0.00,1,0,1,20161001, 80340,CPT,ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 4-6,,30,,,$575.64,$0.00,1,0,1,20161001, 80341,CPT,ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 7/MORE,,30,,,$627.97,$0.00,1,0,1,20161001, 80345,CPT,DRUG SCREENING BARBITURATES,,30,,,$295.95,$0.00,1,0,1,20161001, 80346,CPT,DRUG SCREENING BENZODIAZEPINES 1-12,,30,,,$632.34,$0.00,1,0,1,20161001, 80347,CPT,DRUG SCREENING BENZODIAZEPINES 13 OR MORE,,30,,,$695.57,$0.00,1,0,1,20161001, 80348,CPT,DRUG SCREENING BUPRENORPHINE,,30,,,$332.95,$0.00,1,0,1,20161001, 80349,CPT,DRUG SCREENING CANNABINOIDS NATURAL,,30,,,$332.95,$0.00,1,0,1,20161001, 80350,CPT,DRUG SCREENING CANNABINOIDS SYNTHETIC 1-3,,30,,,$332.95,$0.00,1,0,1,20161001, 80351,CPT,DRUG SCREENING CANNABINOIDS SYNTHETIC 4-6,,30,,,$366.24,$0.00,1,0,1,20161001, 80352,CPT,DRUG SCREENING CANNABINOIDS SYNTHETIC 7/MORE,,30,,,$399.54,$0.00,1,0,1,20161001, 80353,CPT,DRUG SCREENING COCAINE,,30,,,$355.14,$0.00,1,0,1,20161001, 80354,CPT,DRUG SCREENING FENTANYL,,30,,,$332.95,$0.00,1,0,1,20161001, 80356,CPT,DRUG SCREENING HEROIN METABOLITE,,30,,,$332.95,$0.00,1,0,1,20161001, 80357,CPT,DRUG SCREENING KETAMINE AND NORKETAMINE,,30,,,$332.95,$0.00,1,0,1,20161001, 80358,CPT,DRUG SCREENING METHADONE,,30,,,$325.54,$0.00,1,0,1,20161001, 80359,CPT,DRUG SCREENING METHYLENEDIOXYAMPHETAMINES,,30,,,$369.94,$0.00,1,0,1,20161001, 80360,CPT,DRUG SCREENING METHYLPHENIDATE,,30,,,$332.95,$0.00,1,0,1,20161001, 80361,CPT,DRUG SCREENING OPIATES 1 OR MORE,,30,,,$332.95,$0.00,1,0,1,20161001, 80362,CPT,DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 1 OR 2,,30,,,$332.95,$0.00,1,0,1,20161001, 80363,CPT,DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 3 OR 4,,30,,,$366.24,$0.00,1,0,1,20161001, 80364,CPT,DRUG SCREENING OPIOIDS & OPIATE ANALOGS 5/MORE,,30,,,$399.54,$0.00,1,0,1,20161001, 80365,CPT,DRUG SCREENING OXYCODONE,,30,,,$332.95,$0.00,1,0,1,20161001, 80366,CPT,DRUG SCREENING PREGABALIN,,30,,,$332.95,$0.00,1,0,1,20161001, 80367,CPT,DRUG SCREENING PROPOXYPHENE,,30,,,$332.95,$0.00,1,0,1,20161001, 80368,CPT,DRUG SCREENING SEDATIVE HYPNOTICS,,30,,,$332.95,$0.00,1,0,1,20161001, 80369,CPT,DRUG SCREENING SKELETAL MUSCLE RELAXANTS 1 OR 2,,30,,,$332.95,$0.00,1,0,1,20161001, 80370,CPT,DRUG SCREENING SKEL MUSCLE RELAXANTS 3 OR MORE,,30,,,$366.24,$0.00,1,0,1,20161001, 80371,CPT,DRUG SCREENING STIMULANTS SYNTHETIC,,30,,,$332.95,$0.00,1,0,1,20161001, 80372,CPT,DRUG SCREENING TAPENTADOL,,30,,,$332.95,$0.00,1,0,1,20161001, 80373,CPT,DRUG SCREENING TRAMADOL,,30,,,$332.95,$0.00,1,0,1,20161001, 80374,CPT,DRUG SCREEN STEREOISOMER ANALYSIS 1 DRUG CLASS,,30,,,$332.95,$0.00,1,0,1,20161001, 80375,CPT,DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 1-3,,30,,,$332.95,$0.00,1,0,1,20161001, 80376,CPT,DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 4-6,,30,,,$366.24,$0.00,1,0,1,20161001, 80377,CPT,DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 7/MORE,,30,,,$399.54,$0.00,1,0,1,20161001, 80400,CPT,ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY,,30,,,"$1,039.14",$0.00,1,0,1,20161001, 80402,CPT,ACTH STIMULATION PANEL 21 HYDROXYLASE DEFICIENCY,,30,,,"$1,691.37",$0.00,1,0,1,20161001, 80406,CPT,ACTH STIMJ PANEL 3 BETA-HYDROXYDEHYD DEFNCY,,30,,,"$1,779.81",$0.00,1,0,1,20161001, 80408,CPT,ALDOSTERONE SUPPRESSION EVALUATION PANEL,,30,,,"$1,934.57",$0.00,1,0,1,20161001, 80410,CPT,CALCITONIN STIMULATION PANEL,,30,,,"$1,602.93",$0.00,1,0,1,20161001, 80412,CPT,CORTICOTROPIC RELEASING HORM STIMJ PANEL,,30,,,"$4,974.62",$0.00,1,0,1,20161001, 80414,CPT,CHORNC GONAD STIMJ PANEL TSTOSTERONE RESPONSE,,30,,,$829.10,$0.00,1,0,1,20161001, 80415,CPT,CHORNC GONAD STIMJ PANEL ESTRADIOL RESPONSE,,30,,,$829.10,$0.00,1,0,1,20161001, 80417,CPT,PERIPHERAL VEIN RENIN STIMULATION PANEL,,30,,,"$1,061.25",$0.00,1,0,1,20161001, 80418,CPT,COMBINED RAPID ANT PITUITARY EVALUATION PANEL,,30,,,"$11,054.71",$0.00,1,0,1,20161001, 80420,CPT,DEXMETHASONE SUPPRESSION PANEL 48 HR,,30,,,"$1,381.84",$0.00,1,0,1,20161001, 80422,CPT,GLUCOSE TOLERANCE PANEL INSULINOMA,,30,,,$939.65,$0.00,1,0,1,20161001, 80424,CPT,GLUCOSE TOLERANCE PANEL PHEOCHROMOCYTOMA,,30,,,$939.65,$0.00,1,0,1,20161001, 80426,CPT,GONADOTROPIN RELEASING HORMONE STIMJ PANEL,,30,,,"$2,597.86",$0.00,1,0,1,20161001, 80428,CPT,GROWTH HORMONE STIMULATION PANEL,,30,,,"$1,437.11",$0.00,1,0,1,20161001, 80430,CPT,GROWTH HORMONE SUPRJ PANEL GLUCOSE ADMN,,30,,,"$1,437.11",$0.00,1,0,1,20161001, 80432,CPT,INSULIN-INDUCED C-PEPTIDE SUPRESSION PANEL,,30,,,"$2,818.95",$0.00,1,0,1,20161001, 80434,CPT,INSULIN TOLERANCE PANEL ACTH INSUFFICIENCY,,30,,,"$1,768.75",$0.00,1,0,1,20161001, 80435,CPT,INSULIN TOLERANCE PANEL GROWTH HORM DEFNCY,,30,,,"$1,879.30",$0.00,1,0,1,20161001, 80436,CPT,METYRAPONE PANEL,,30,,,"$1,824.03",$0.00,1,0,1,20161001, 80438,CPT,THYROTROPIN RELEASING HORMONE STMLJ PANEL 1 HR,,30,,,"$1,050.20",$0.00,1,0,1,20161001, 80439,CPT,THYROTROPIN RELEASING HORMONE STMLJ PANEL 2 HR,,30,,,"$1,105.47",$0.00,1,0,1,20161001, 80500,CPT,CLINICAL PATHOLOGY CONSULTATION LIMITED,,30,,,$315.58,$0.00,1,0,1,20161001, 80502,CPT,CLINICAL PATHOLOGY CONSULTATION COMPREHENSIVE,,30,,,$315.58,$0.00,1,0,1,20161001, 81000,CPT,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,,30,,,$113.45,$0.00,1,0,1,20161001, 81001,CPT,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,,30,,,$113.45,$0.00,1,0,1,20161001, 81002,CPT,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,,30,,,$88.79,$0.00,1,0,1,20161001, 81003,CPT,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,,30,,,$93.72,$0.00,1,0,1,20161001, 81005,CPT,URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS,,30,,,$88.79,$0.00,1,0,1,20161001, 81007,CPT,URINALYSIS BACTERIURIA SCR XCPT CULTURE/DIPSTICK,,30,,,$108.52,$0.00,1,0,1,20161001, 81015,CPT,URINALYSIS MICROSCOPIC ONLY,,30,,,$88.79,$0.00,1,0,1,20161001, 81020,CPT,URINALYSIS 2/3 GLASS TEST,,30,,,$108.52,$0.00,1,0,1,20161001, 81025,CPT,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,,30,,,$167.71,$0.00,1,0,1,20161001, 81050,CPT,VOLUME MEASUREMENT TIMED COLLECTION EACH,,30,,,$88.79,$0.00,1,0,1,20161001, 81099,CPT,UNLISTED URINALYSIS PROCEDURE,,30,,,$34.00,$0.00,1,0,1,20161001, 81162,CPT,BRCA1&BRCA2 FULL SEQ ANALYS/FULL DUP/DEL ANALYS,,30,,,"$6,836.57",$0.00,1,0,1,20161001, 81170,CPT,ABL1 GENE ANALYSIS KINASE DOMAIN VARIANTS,,30,,,"$2,076.18",$0.00,1,0,1,20161001, 81201,CPT,APC GENE ANALYSIS FULL GENE SEQUENCE,,30,,,"$8,663.13",$0.00,1,0,1,20161001, 81203,CPT,APC GENE ANALYSIS DUPLICATION/DELETION VARIANTS,,30,,,"$3,066.77",$0.00,1,0,1,20161001, 81211,CPT,BRCA1&BRCA2 FULL SEQ ANALYS/COMM DUP/DEL BRCA,,30,,,"$5,190.44",$0.00,1,0,1,20161001, 81213,CPT,BRCA1&BRCA2 ANAL UNCOMMON DUP/DEL VARIANTS,,30,,,"$2,405.75",$0.00,1,0,1,20161001, 81218,CPT,CEBPA GENE ANALYSIS FULL GENE SEQUENCE,,30,,,"$2,076.18",$0.00,1,0,1,20161001, 81220,CPT,CFTR GENE ANALYSIS COMMON VARIANTS,,30,,,"$3,101.86",$0.00,1,0,1,20161001, 81235,CPT,EGFR GENE ANALYSIS COMMON VARIANTS,,30,,,"$2,076.18",$0.00,1,0,1,20161001, 81256,CPT,HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS,,30,,,$611.60,$0.00,1,0,1,20161001, 81257,CPT,HBA1/HBA2 ANALYSIS FOR COMMON DELETIONS/VARIANT,,30,,,"$1,287.56",$0.00,1,0,1,20161001, 81272,CPT,KIT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,,30,,,"$2,076.18",$0.00,1,0,1,20161001, 81314,CPT,PDGFRA GENE ANALYS TARGETED SEQUENCE ANALYS,,30,,,"$2,076.18",$0.00,1,0,1,20161001, 81324,CPT,PMP22 GENE ANAL DUPLICATION/DELETION ANALYSIS,,30,,,"$2,905.27",$0.00,1,0,1,20161001, 81325,CPT,PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS,,30,,,"$5,770.15",$0.00,1,0,1,20161001, 81417,CPT,EXOME RE-EVAL OF PREVIOUSLY OBTAINED EXOME SEQ,,30,,,$87.34,$0.00,1,0,1,20161001, 81420,CPT,FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS,,30,,,$468.09,$0.00,1,0,1,20161001, 81425,CPT,GENOME SEQUENCE ANALYSIS,,30,,,$87.34,$0.00,1,0,1,20161001, 81426,CPT,GENOME SEQUENCE ANALYSIS EACH COMPARATOR GENOME,,30,,,$87.34,$0.00,1,0,1,20161001, 81427,CPT,GENOME RE-EVALUATION OF PREC OBTAINED GENOME SEQ,,30,,,$87.34,$0.00,1,0,1,20161001, 81479,CPT,UNLISTED MOLELCULAR PATHOLOGY PROCEDURE,,30,,,$437.69,$0.00,1,0,1,20161001, 81490,CPT,AUTOIMMUNE RHEUMATOID ARTHRTS ANALYS 12 BIOMRKRS,,30,,,"$3,078.74",$0.00,1,0,1,20161001, 81503,CPT,ONCO (OVARIAN) BIOCHEMICAL ASSAY FIVE PROTEINS,,30,,,"$1,390.30",$0.00,1,0,1,20161001, 81508,CPT,FETAL CONGENITAL ABNOR ASSAY TWO PROTEINS,,30,,,$231.82,$0.00,1,0,1,20161001, 81509,CPT,FETAL CONGENITAL ABNOR ASSAY 3 PROTEINS,,30,,,$245.74,$0.00,1,0,1,20161001, 81511,CPT,FETAL CONGENITAL ABNOR ASSAY FOUR ANAL,,30,,,$450.14,$0.00,1,0,1,20161001, 81528,CPT,ONCOLOGY COLORECTAL SCREENING QUAN 10 DNA MARKRS,,30,,,$264.11,$0.00,1,0,1,20161001, 81535,CPT,ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP 1ST,,30,,,"$5,796.61",$0.00,1,0,1,20161001, 81536,CPT,ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP ADD,,30,,,$652.12,$0.00,1,0,1,20161001, 81538,CPT,ONCOLOGY LUNG MS 8-PROTEIN SIGNATURE,,30,,,"$2,716.54",$0.00,1,0,1,20161001, 81599,CPT,UNLISTED MULTIANALYTE ASSAY ALGORITHMIC ANALYSIS,,30,,,"$1,894.74",$0.00,1,0,1,20161001, 82009,CPT,KETONE BODIES SERUM QUALITATIVE,,30,,,$113.19,$0.00,1,0,1,20161001, 82010,CPT,KETONE BODIES SERUM QUANTITATIVE,,30,,,$181.10,$0.00,1,0,1,20161001, 82013,CPT,ASSAY OF ACETYLCHOLINESTERASE,,30,,,$286.75,$0.00,1,0,1,20161001, 82016,CPT,ACYLCARNITINES QUALITATIVE EACH SPECIMEN,,30,,,$241.47,$0.00,1,0,1,20161001, 82017,CPT,ACYLCARNITINES QUANTIATIVE EACH SPECIMEN,,30,,,$369.75,$0.00,1,0,1,20161001, 82024,CPT,ADRENOCORTICOTROPIC HORMONE ACTH,,30,,,$679.13,$0.00,1,0,1,20161001, 82030,CPT,ADENOSINE 5-MONOPHOSPHATE CYCLIC,,30,,,$528.22,$0.00,1,0,1,20161001, 82040,CPT,ALBUMIN SERUM PLASMA/WHOLE BLOOD,,30,,,$75.46,$0.00,1,0,1,20161001, 82042,CPT,ALBUMIN URINE/OTHER SOURCE QUAN EACH SPECIMEN,,30,,,$120.74,$0.00,1,0,1,20161001, 82043,CPT,ALBUMIN URINE MICROALBUMIN QUANTIATIVE,,30,,,$264.11,$0.00,1,0,1,20161001, 82044,CPT,ALBUMIN URINE MICROALBUMIN SEMIQUANTITATIVE,,30,,,$128.28,$0.00,1,0,1,20161001, 82075,CPT,ASSAY OF ALCOHOL BREATH,,30,,,$128.28,$0.00,1,0,1,20161001, 82085,CPT,ASSAY OF ALDOLASE,,30,,,$211.29,$0.00,1,0,1,20161001, 82088,CPT,ASSAY OF ALDOSTERONE,,30,,,$603.68,$0.00,1,0,1,20161001, 82103,CPT,ALPHA-1-ANTITRYPSIN TOTAL,,30,,,$301.84,$0.00,1,0,1,20161001, 82104,CPT,ALPHA-1-ANTITRYPSIN PHENOTYPE,,30,,,$430.12,$0.00,1,0,1,20161001, 82105,CPT,ALPHA-FETOPROTEIN SERUM,,30,,,$354.66,$0.00,1,0,1,20161001, 82106,CPT,ALPHA-FETOPROTEIN AMNIOTIC FLUID,,30,,,$354.66,$0.00,1,0,1,20161001, 82107,CPT,AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO,,30,,,$415.03,$0.00,1,0,1,20161001, 82108,CPT,ASSAY OF ALUMINUM,,30,,,$437.66,$0.00,1,0,1,20161001, 82120,CPT,AMINES VAGINAL FLUID QUALITATIVE,,30,,,$63.16,$0.00,1,0,1,20161001, 82127,CPT,AMINO ACIDS 1 QUALITATIVE EACH SPECIMEN,,30,,,$181.10,$0.00,1,0,1,20161001, 82128,CPT,AMINO ACIDS MULTIPLE QUALITATIVE EACH SPECIMEN,,30,,,$188.65,$0.00,1,0,1,20161001, 82131,CPT,AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN,,30,,,$965.88,$0.00,1,0,1,20161001, 82135,CPT,AMINOLEVULINIC ACID DELTA,,30,,,$324.48,$0.00,1,0,1,20161001, 82136,CPT,AMINO ACIDS 2-5 AMINO ACIDS QUANTITATIVE EA SPEC,,30,,,$965.88,$0.00,1,0,1,20161001, 82139,CPT,AMINO ACIDS 6/> AMINO ACIDS QUANTITATIVE EA SPE,,30,,,$965.88,$0.00,1,0,1,20161001, 82140,CPT,ASSAY OF AMMONIA,,30,,,$188.65,$0.00,1,0,1,20161001, 82143,CPT,AMNIOTIC FLU SCAN,,30,,,$286.75,$0.00,1,0,1,20161001, 82150,CPT,ASSAY OF AMYLASE,,30,,,$128.28,$0.00,1,0,1,20161001, 82154,CPT,ANDROSTANEDIOL GLUCURONIDE,,30,,,$505.58,$0.00,1,0,1,20161001, 82157,CPT,ANDROSTENEDIONE,,30,,,$467.85,$0.00,1,0,1,20161001, 82160,CPT,ANDROSTERONE,,30,,,$452.76,$0.00,1,0,1,20161001, 82163,CPT,ANGIOTENSIN II,,30,,,$452.76,$0.00,1,0,1,20161001, 82164,CPT,ANGIOTENSIN I-CONVERTING ENZYME,,30,,,$377.30,$0.00,1,0,1,20161001, 82172,CPT,APOLIPOPROTEIN EACH,,30,,,$249.02,$0.00,1,0,1,20161001, 82175,CPT,ASSAY OF ARSENIC,,30,,,$377.30,$0.00,1,0,1,20161001, 82180,CPT,ASSAY OF ASCORBIC ACID BLOOD,,30,,,$241.47,$0.00,1,0,1,20161001, 82190,CPT,ATOMIC ABSRPJ SPECTROSCOPY EA ANALYTE,,30,,,$452.76,$0.00,1,0,1,20161001, 82232,CPT,BETA-2 MICROGLOBULIN,,30,,,$415.03,$0.00,1,0,1,20161001, 82239,CPT,BILE ACIDS TOTAL,,30,,,$256.56,$0.00,1,0,1,20161001, 82240,CPT,BILE ACIDS CHOLYLGLYCINE,,30,,,$513.12,$0.00,1,0,1,20161001, 82247,CPT,BILIRUBIN TOTAL,,30,,,$83.01,$0.00,1,0,1,20161001, 82248,CPT,BILIRUBIN DIRECT,,30,,,$83.01,$0.00,1,0,1,20161001, 82252,CPT,BILIRUBIN FECES QUALITATIVE,,30,,,$83.01,$0.00,1,0,1,20161001, 82261,CPT,BIOTINIDASE EACH SPECIMEN,,30,,,$83.01,$0.00,1,0,1,20161001, 82270,CPT,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,,30,,,$75.46,$0.00,1,0,1,20161001, 82271,CPT,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,,30,,,$75.46,$0.00,1,0,1,20161001, 82272,CPT,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,,30,,,$67.91,$0.00,1,0,1,20161001, 82274,CPT,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,,30,,,$264.11,$0.00,1,0,1,20161001, 82286,CPT,BRADYKININ,,30,,,$603.68,$0.00,1,0,1,20161001, 82300,CPT,CADMIUM,,30,,,$316.93,$0.00,1,0,1,20161001, 82306,CPT,25 HYDROXY INCLUDES FRACTIONS IF PERFORMED,,30,,,$565.95,$0.00,1,0,1,20161001, 82308,CPT,CALCITONIN,,30,,,$528.22,$0.00,1,0,1,20161001, 82310,CPT,CALCIUM TOTAL,,30,,,$90.55,$0.00,1,0,1,20161001, 82330,CPT,CALCIUM IONIZED,,30,,,$249.02,$0.00,1,0,1,20161001, 82331,CPT,CALCIUM AFTER CALCIUM INFUSION TEST,,30,,,$150.92,$0.00,1,0,1,20161001, 82340,CPT,CALCIUM URINE QUANTITATIVE TIMED SPECIMEN,,30,,,$120.74,$0.00,1,0,1,20161001, 82355,CPT,CALCULUS QUALITATIVE ANALYSIS,,30,,,$233.92,$0.00,1,0,1,20161001, 82360,CPT,CALCULUS QUANTITATIVE CHEMICAL,,30,,,$286.75,$0.00,1,0,1,20161001, 82365,CPT,CALCULUS INFRARED SPECTROSCOPY,,30,,,$271.65,$0.00,1,0,1,20161001, 82370,CPT,CALCULUS XRAY DIFFRACTION,,30,,,$279.20,$0.00,1,0,1,20161001, 82373,CPT,CARBOHYDRATE DEFICIENT TRANSFERRIN,,30,,,$415.03,$0.00,1,0,1,20161001, 82374,CPT,CARBON DIOXIDE BICARBONATE,,30,,,$83.01,$0.00,1,0,1,20161001, 82375,CPT,CARBOXYHEMOGLOBIN QUANTITATIVE,,30,,,$233.92,$0.00,1,0,1,20161001, 82376,CPT,CARBOXYHEMOGLOBIN QUALITATIVE,,30,,,$113.19,$0.00,1,0,1,20161001, 82378,CPT,CARCINOEMBRYONIC ANTIGEN CEA,,30,,,$392.39,$0.00,1,0,1,20161001, 82379,CPT,CARNITINE QUANTITATIVE EACH SPECIMEN,,30,,,$392.39,$0.00,1,0,1,20161001, 82380,CPT,CAROTENE,,30,,,$196.19,$0.00,1,0,1,20161001, 82382,CPT,CATECHOLAMINES TOTAL URINE,,30,,,$339.57,$0.00,1,0,1,20161001, 82383,CPT,CATECHOLAMINES BLOOD,,30,,,$415.03,$0.00,1,0,1,20161001, 82384,CPT,CATECHOLAMINES FRACTIONATED,,30,,,$528.22,$0.00,1,0,1,20161001, 82387,CPT,CATHEPSIN-D,,30,,,$528.22,$0.00,1,0,1,20161001, 82390,CPT,CERULOPLASMIN,,30,,,$241.47,$0.00,1,0,1,20161001, 82397,CPT,CHEMILUMINESCENT ASSAY,,30,,,$211.29,$0.00,1,0,1,20161001, 82415,CPT,CHLORAMPHENICOL,,30,,,$249.02,$0.00,1,0,1,20161001, 82435,CPT,CHLORIDE BLD,,30,,,$75.46,$0.00,1,0,1,20161001, 82436,CPT,CHLORIDE URINE,,30,,,$83.01,$0.00,1,0,1,20161001, 82438,CPT,CHLORIDE OTHER SOURCE,,30,,,$143.37,$0.00,1,0,1,20161001, 82441,CPT,CHLORINATED HYDROCARBONS SCREEN,,30,,,$226.38,$0.00,1,0,1,20161001, 82465,CPT,CHOLESTEROL SERUM/WHOLE BLOOD TOTAL,,30,,,$75.46,$0.00,1,0,1,20161001, 82480,CPT,CHOLINESTERASE SERUM,,30,,,$181.10,$0.00,1,0,1,20161001, 82482,CPT,CHOLINESTERASE RBC,,30,,,$233.92,$0.00,1,0,1,20161001, 82485,CPT,CHONDROITIN B SULFATE QUANTITATIVE,,30,,,$301.84,$0.00,1,0,1,20161001, 82495,CPT,ASSAY OF CHROMIUM,,30,,,$354.66,$0.00,1,0,1,20161001, 82507,CPT,ASSAY OF CITRATE,,30,,,$528.22,$0.00,1,0,1,20161001, 82523,CPT,COLLAGEN CROSS LINKS ANY METHOD,,30,,,$362.21,$0.00,1,0,1,20161001, 82525,CPT,ASSAY OF COPPER,,30,,,$226.38,$0.00,1,0,1,20161001, 82528,CPT,CORTICOSTERONE,,30,,,$415.03,$0.00,1,0,1,20161001, 82530,CPT,CORTISOL FREE,,30,,,$362.21,$0.00,1,0,1,20161001, 82533,CPT,CORTISOL TOTAL,,30,,,$354.66,$0.00,1,0,1,20161001, 82540,CPT,ASSAY OF CREATINE,,30,,,$135.83,$0.00,1,0,1,20161001, 82542,CPT,COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC,,30,,,$339.57,$0.00,1,0,1,20161001, 82550,CPT,CREATINE KINASE TOTAL,,30,,,$98.10,$0.00,1,0,1,20161001, 82552,CPT,CREATINE KINASE ISOENZYMES,,30,,,$271.65,$0.00,1,0,1,20161001, 82553,CPT,CREATINE KINASE MB FRACTION ONLY,,30,,,$173.56,$0.00,1,0,1,20161001, 82554,CPT,CREATINE KINASE ISOFORMS,,30,,,$256.56,$0.00,1,0,1,20161001, 82565,CPT,CREATININE BLOOD,,30,,,$75.46,$0.00,1,0,1,20161001, 82570,CPT,CREATININE OTHER SOURCE,,30,,,$120.74,$0.00,1,0,1,20161001, 82575,CPT,CREATININE CLEARANCE,,30,,,$218.83,$0.00,1,0,1,20161001, 82585,CPT,ASSAY OF CRYOFIBRN,,30,,,$173.56,$0.00,1,0,1,20161001, 82595,CPT,CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE,,30,,,$158.46,$0.00,1,0,1,20161001, 82600,CPT,ASSAY OF CYANIDE,,30,,,$332.02,$0.00,1,0,1,20161001, 82607,CPT,CYANOCOBALAMIN VITAMIN B-12,,30,,,$301.84,$0.00,1,0,1,20161001, 82608,CPT,CYANOCOBALAMIN VIT B-12 UNSAT BINDING CAPACITY,,30,,,$316.93,$0.00,1,0,1,20161001, 82610,CPT,CYSTATIN C,,30,,,$199.26,$0.00,1,0,1,20161001, 82615,CPT,CSTINE&HOMOCSTINE URINE QUALITATIVE,,30,,,$226.38,$0.00,1,0,1,20161001, 82626,CPT,DEHYDROEPIANDROSTERONE,,30,,,$513.12,$0.00,1,0,1,20161001, 82627,CPT,DEHYDROEPIANDROSTERONE-SULFATE,,30,,,$452.76,$0.00,1,0,1,20161001, 82633,CPT,DESOXYCORTICOSTERONE 11-,,30,,,$490.49,$0.00,1,0,1,20161001, 82634,CPT,DEOXYCORTISOL 11-,,30,,,$490.49,$0.00,1,0,1,20161001, 82638,CPT,ASSAY OF DIBUCAINE NUMBER,,30,,,$211.29,$0.00,1,0,1,20161001, 82652,CPT,1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED,,30,,,$603.68,$0.00,1,0,1,20161001, 82656,CPT,ELASTASE PANCREATIC FECAL QUAL/SEMI-QUAN,,30,,,$446.70,$0.00,1,0,1,20161001, 82657,CPT,NZYM ACTIV BLD CELLS/TISS NONRADACT SUBSTRATE EA,,30,,,$322.68,$0.00,1,0,1,20161001, 82658,CPT,NZYM ACTV BLOOD CELLS/TISS RADACT SUBSTRATE EA,,30,,,$452.76,$0.00,1,0,1,20161001, 82664,CPT,ELCTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED,,30,,,$347.11,$0.00,1,0,1,20161001, 82668,CPT,ASSAY OF ERYTHROPOIETIN,,30,,,$490.49,$0.00,1,0,1,20161001, 82670,CPT,ASSAY OF ESTRADIOL,,30,,,$354.66,$0.00,1,0,1,20161001, 82671,CPT,ASSAY OF ESTROGENS FRACTIONATED,,30,,,$664.04,$0.00,1,0,1,20161001, 82672,CPT,ASSAY OF ESTROGENS TOTAL,,30,,,$452.76,$0.00,1,0,1,20161001, 82677,CPT,ASSAY OF ESTRIOL,,30,,,$324.48,$0.00,1,0,1,20161001, 82679,CPT,ASSAY OF ESTRONE,,30,,,$452.76,$0.00,1,0,1,20161001, 82693,CPT,ASSAY OF ETHYLENE GLYCOL,,30,,,$354.66,$0.00,1,0,1,20161001, 82696,CPT,ASSAY OF ETIOCHOLANOLONE,,30,,,$452.76,$0.00,1,0,1,20161001, 82705,CPT,FAT/LIPIDS FECES QUALITATIVE,,30,,,$166.01,$0.00,1,0,1,20161001, 82710,CPT,FAT/LIPIDS FECES QUANTITATIVE,,30,,,$369.75,$0.00,1,0,1,20161001, 82715,CPT,FAT DIFFIAL FECES QUANTITATIVE,,30,,,$181.10,$0.00,1,0,1,20161001, 82725,CPT,FATTY ACIDS NONESTERIFIED,,30,,,$150.92,$0.00,1,0,1,20161001, 82726,CPT,VERY LONG CHAIN FATTY ACIDS,,30,,,$649.95,$0.00,1,0,1,20161001, 82728,CPT,ASSAY OF FERRITIN,,30,,,$279.20,$0.00,1,0,1,20161001, 82731,CPT,FTL FIBRONECTIN CERVICOVAG SECRETIONS SEMI-QUAN,,30,,,$452.76,$0.00,1,0,1,20161001, 82735,CPT,ASSAY OF FLUORIDE,,30,,,$309.38,$0.00,1,0,1,20161001, 82746,CPT,ASSAY OF FOLIC ACID SERUM,,30,,,$309.38,$0.00,1,0,1,20161001, 82747,CPT,ASSAY OF FOLIC ACID RBC,,30,,,$369.75,$0.00,1,0,1,20161001, 82757,CPT,ASSAY OF FRUCTOSE SEMEN,,30,,,$226.38,$0.00,1,0,1,20161001, 82759,CPT,ASSAY OF GALACTOKINASE RBC,,30,,,$286.75,$0.00,1,0,1,20161001, 82760,CPT,ASSAY OF GALACTOSE,,30,,,$181.10,$0.00,1,0,1,20161001, 82775,CPT,GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE QUAN,,30,,,$226.38,$0.00,1,0,1,20161001, 82776,CPT,GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE SCREEN,,30,,,$98.10,$0.00,1,0,1,20161001, 82777,CPT,GALECTIN-3,,30,,,$148.88,$0.00,1,0,1,20161001, 82784,CPT,ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH,,30,,,$241.47,$0.00,1,0,1,20161001, 82785,CPT,ASSAY OF GAMMAGLOBULIN IGE,,30,,,$309.38,$0.00,1,0,1,20161001, 82787,CPT,GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES,,30,,,$679.13,$0.00,1,0,1,20161001, 82800,CPT,GASES BLOOD PH ONLY,,30,,,$158.46,$0.00,1,0,1,20161001, 82803,CPT,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,,30,,,$347.11,$0.00,1,0,1,20161001, 82805,CPT,GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY,,30,,,$354.66,$0.00,1,0,1,20161001, 82810,CPT,GASES BLOOD O2 SATURATION ONLY DIRECT MEAS,,30,,,$196.19,$0.00,1,0,1,20161001, 82820,CPT,HGB-O2 AFFINITY PO2 50% SATURATION OXYGEN,,30,,,$233.92,$0.00,1,0,1,20161001, 82930,CPT,GASTRIC ACID ANALYIS W/PH EACH SPECIMEN,,30,,,$128.28,$0.00,1,0,1,20161001, 82938,CPT,GASTRIN AFTER SECRETIN STIMULATION,,30,,,$399.94,$0.00,1,0,1,20161001, 82941,CPT,ASSAY OF GASTRIN,,30,,,$354.66,$0.00,1,0,1,20161001, 82943,CPT,ASSAY OF GLUCAGON,,30,,,$407.48,$0.00,1,0,1,20161001, 82945,CPT,GLUCOSE BODY FLUID OTHER THAN BLOOD,,30,,,$249.02,$0.00,1,0,1,20161001, 82946,CPT,GLUCOSE TOLERANCE TEST,,30,,,$218.83,$0.00,1,0,1,20161001, 82947,CPT,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,,30,,,$98.10,$0.00,1,0,1,20161001, 82948,CPT,GLUCOSE BLOOD REAGENT STRIP,,30,,,$75.46,$0.00,1,0,1,20161001, 82950,CPT,GLUCOSE POST GLUCOSE DOSE,,30,,,$128.28,$0.00,1,0,1,20161001, 82951,CPT,GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,,30,,,$271.65,$0.00,1,0,1,20161001, 82952,CPT,GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS,,30,,,$83.01,$0.00,1,0,1,20161001, 82955,CPT,GLUC-6-PHOSPHATE DEHYDROGENASE QUANTITATIVE,,30,,,$271.65,$0.00,1,0,1,20161001, 82960,CPT,GLUC-6-PHOSPHATE DEHYDROGENASE SCREEN,,30,,,$143.37,$0.00,1,0,1,20161001, 82962,CPT,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,,30,,,$75.46,$0.00,1,0,1,20161001, 82963,CPT,ASSAY OF GLUCOSIDASE BETA,,30,,,$339.57,$0.00,1,0,1,20161001, 82965,CPT,ASSAY OF GLUTAMATE DEHYDROGENASE,,30,,,$105.64,$0.00,1,0,1,20161001, 82977,CPT,ASSAY OF GLUTAMYLTRASE GAMMA,,30,,,$83.01,$0.00,1,0,1,20161001, 82978,CPT,ASSAY OF GLUTATHIONE,,30,,,$249.02,$0.00,1,0,1,20161001, 82979,CPT,ASSAY OF GLUTATHIONE REDUCTASE RBC,,30,,,$218.83,$0.00,1,0,1,20161001, 82985,CPT,ASSAY OF GLYCATED PROTEIN,,30,,,$150.92,$0.00,1,0,1,20161001, 83001,CPT,GONADOTROPIN FOLLICLE STIMULATING HORMONE,,30,,,$377.30,$0.00,1,0,1,20161001, 83002,CPT,GONADOTROPIN LUTEINIZING HORMONE,,30,,,$377.30,$0.00,1,0,1,20161001, 83003,CPT,ASSAY OF GROWTH HORMONE HUMAN,,30,,,$362.21,$0.00,1,0,1,20161001, 83006,CPT,GROWTH STIMULATION EXPRESSED GENE 2,,30,,,$148.88,$0.00,1,0,1,20161001, 83009,CPT,HPYLORI BLOOD ANAL UREASE ACT NON-RADACT ISOTOPE,,30,,,$438.66,$0.00,1,0,1,20161001, 83010,CPT,ASSAY OF HAPTOGLOBIN QUANTITATIVE,,30,,,$279.20,$0.00,1,0,1,20161001, 83012,CPT,ASSAY OF HAPTOGLOBIN PHENOTYPES,,30,,,$339.57,$0.00,1,0,1,20161001, 83013,CPT,HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,,30,,,$484.51,$0.00,1,0,1,20161001, 83014,CPT,HPYLORI DRUG ADMINISTRATION,,30,,,$103.35,$0.00,1,0,1,20161001, 83015,CPT,HEAVY METAL SCREEN,,30,,,$437.66,$0.00,1,0,1,20161001, 83018,CPT,HEAVY METAL QUANTIATIVE EACH,,30,,,$437.66,$0.00,1,0,1,20161001, 83020,CPT,HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS,,30,,,$264.11,$0.00,1,0,1,20161001, 83021,CPT,HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY,,30,,,$339.57,$0.00,1,0,1,20161001, 83026,CPT,HEMOGLOBIN COPPER SULFATE METHOD NON-AUTOMATED,,30,,,$52.82,$0.00,1,0,1,20161001, 83030,CPT,HEMOGLOBIN F FETAL CHEMICAL,,30,,,$166.01,$0.00,1,0,1,20161001, 83033,CPT,HEMOGLOBIN F FETAL QUALITATIVE,,30,,,$120.74,$0.00,1,0,1,20161001, 83036,CPT,HEMOGLOBIN GLYCOSYLATED A1C,,30,,,$203.74,$0.00,1,0,1,20161001, 83037,CPT,HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE,,30,,,$181.10,$0.00,1,0,1,20161001, 83045,CPT,HEMOGLOBIN METHEMOGLOBIN QUALITATIVE,,30,,,$98.10,$0.00,1,0,1,20161001, 83050,CPT,HEMOGLOBIN METHEMOGLOBIN QUANTITATIVE,,30,,,$128.28,$0.00,1,0,1,20161001, 83051,CPT,ASSAY OF HEMOGLOBIN PLASMA,,30,,,$128.28,$0.00,1,0,1,20161001, 83060,CPT,HEMOGLOBIN SULFHEMOGLOBIN QUANTITATIVE,,30,,,$188.65,$0.00,1,0,1,20161001, 83065,CPT,HEMOGLOBIN THERMOLABILE,,30,,,$150.92,$0.00,1,0,1,20161001, 83068,CPT,HEMOGLOBIN UNSTABLE SCREEN,,30,,,$128.28,$0.00,1,0,1,20161001, 83069,CPT,ASSAY OF HEMOGLOBIN URINE,,30,,,$90.55,$0.00,1,0,1,20161001, 83070,CPT,ASSAY OF HEMOSIDERIN QUALITATIVE,,30,,,$105.64,$0.00,1,0,1,20161001, 83080,CPT,ASSAY OF B-HEXOSAMINIDASE EACH ASSAY,,30,,,$256.56,$0.00,1,0,1,20161001, 83088,CPT,ASSAY OF HISTAMINE,,30,,,$513.12,$0.00,1,0,1,20161001, 83090,CPT,ASSAY OF HOMOCYSTEINE,,30,,,$286.75,$0.00,1,0,1,20161001, 83150,CPT,ASSAY OF HOMOVANILLIC ACID,,30,,,$301.84,$0.00,1,0,1,20161001, 83491,CPT,HYDROXYCORTICOSTEROIDS 17,,30,,,$415.03,$0.00,1,0,1,20161001, 83497,CPT,ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,,30,,,$332.02,$0.00,1,0,1,20161001, 83498,CPT,ASSAY OF HYDROXYPROGESTERONE 17-D,,30,,,$482.94,$0.00,1,0,1,20161001, 83499,CPT,ASSAY OF HYDROXYPROGESTERONE 20-,,30,,,$403.71,$0.00,1,0,1,20161001, 83500,CPT,ASSAY OF HYDROXYPROLINE FREE,,30,,,$369.75,$0.00,1,0,1,20161001, 83505,CPT,ASSAY OF HYDROXYPROLINE TOTAL,,30,,,$490.49,$0.00,1,0,1,20161001, 83516,CPT,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP,,30,,,$226.38,$0.00,1,0,1,20161001, 83518,CPT,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP,,30,,,$150.92,$0.00,1,0,1,20161001, 83519,CPT,IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY,,30,,,$339.57,$0.00,1,0,1,20161001, 83520,CPT,IMMUNOASSAY ANALYTE QUANTITATIVE NOS,,30,,,$256.56,$0.00,1,0,1,20161001, 83525,CPT,ASSAY OF INSULIN TOTAL,,30,,,$286.75,$0.00,1,0,1,20161001, 83527,CPT,ASSAY OF INSULIN FREE,,30,,,$324.48,$0.00,1,0,1,20161001, 83528,CPT,ASSAY OF INTRINSIC FACTOR,,30,,,$377.30,$0.00,1,0,1,20161001, 83540,CPT,ASSAY OF IRON,,30,,,$83.01,$0.00,1,0,1,20161001, 83550,CPT,IRON BINDING CAPACITY,,30,,,$128.28,$0.00,1,0,1,20161001, 83570,CPT,ISOCITRIC DEHYDROGENASE,,30,,,$196.19,$0.00,1,0,1,20161001, 83582,CPT,ASSAY OF KETOGENIC STEROIDS FRACTIONATION,,30,,,$301.84,$0.00,1,0,1,20161001, 83586,CPT,ASSAY OF KETOSTEROIDS 17- TOTAL,,30,,,$301.84,$0.00,1,0,1,20161001, 83593,CPT,KETOSTEROIDS 17- FRACTIONATION,,30,,,$588.58,$0.00,1,0,1,20161001, 83605,CPT,ASSAY OF LACTATE,,30,,,$226.38,$0.00,1,0,1,20161001, 83615,CPT,LACTATE DEHYDROGENASE LDH,,30,,,$83.01,$0.00,1,0,1,20161001, 83625,CPT,LACTATE DEHYDROGENASE ISOENZYMES SEP&QUAN,,30,,,$279.20,$0.00,1,0,1,20161001, 83630,CPT,LACTOFERRIN FECAL QUALITATIVE,,30,,,$226.38,$0.00,1,0,1,20161001, 83631,CPT,LACTOFERRIN FECAL QUANTITATIVE,,30,,,$226.38,$0.00,1,0,1,20161001, 83632,CPT,LACTOGEN HPL HUMAN CHORIONIC SOMATOMAMMOTROPIN,,30,,,$482.94,$0.00,1,0,1,20161001, 83633,CPT,LACTOSE URINE QUALITATIVE,,30,,,$113.19,$0.00,1,0,1,20161001, 83655,CPT,ASSAY OF LEAD,,30,,,$188.65,$0.00,1,0,1,20161001, 83661,CPT,FETAL LUNG MATURITY LECITHIN SPHINGOMYELIN RATIO,,30,,,$648.95,$0.00,1,0,1,20161001, 83662,CPT,FETAL LUNG MATURITY FOAM STABILITY TEST,,30,,,$211.29,$0.00,1,0,1,20161001, 83663,CPT,FETAL LUNG MATURITY FLUORESCENCE POLARIZATION,,30,,,$226.38,$0.00,1,0,1,20161001, 83664,CPT,FETAL LUNG MATURITY LAMELLAR BODY DENSITY,,30,,,$196.19,$0.00,1,0,1,20161001, 83670,CPT,LEUCINE AMINOPEPTIDASE LAP,,30,,,$294.29,$0.00,1,0,1,20161001, 83690,CPT,ASSAY OF LIPASE,,30,,,$166.01,$0.00,1,0,1,20161001, 83695,CPT,LIPOPROTEIN (A),,30,,,$173.56,$0.00,1,0,1,20161001, 83698,CPT,LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2,,30,,,$264.11,$0.00,1,0,1,20161001, 83700,CPT,LIPOPROTEIN BLOOD ELECTROPHORECTIC SEP&QUAN,,30,,,$233.92,$0.00,1,0,1,20161001, 83701,CPT,LIPOPROTEIN BLOOD HIGH RESOLTJ&QUANTJ SUBCLASS,,30,,,$316.93,$0.00,1,0,1,20161001, 83704,CPT,LIPOPROTEIN BLOOD QUAN NUMBERS&SUBCLASSES,,30,,,$354.66,$0.00,1,0,1,20161001, 83718,CPT,LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,,30,,,$143.37,$0.00,1,0,1,20161001, 83719,CPT,LIPOPROTEIN DIRECT MEASUREMENT VLDL CHOLESTEROL,,30,,,$173.56,$0.00,1,0,1,20161001, 83721,CPT,LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,,30,,,$150.92,$0.00,1,0,1,20161001, 83727,CPT,LUTEINIZING RELEASING FACTOR,,30,,,$415.03,$0.00,1,0,1,20161001, 83735,CPT,ASSAY OF MAGNESIUM,,30,,,$120.74,$0.00,1,0,1,20161001, 83775,CPT,ASSAY OF MALATE DEHYDROGENASE,,30,,,$173.56,$0.00,1,0,1,20161001, 83785,CPT,ASSAY OF MANGANESE,,30,,,$301.84,$0.00,1,0,1,20161001, 83789,CPT,MASS SPECT&TANDEM MASS SPECT NONDRG ANAL NES EA,,30,,,$339.57,$0.00,1,0,1,20161001, 83825,CPT,ASSAY OF MERCURY QUANTITATIVE,,30,,,$316.93,$0.00,1,0,1,20161001, 83835,CPT,METANEPHRINES,,30,,,$467.85,$0.00,1,0,1,20161001, 83857,CPT,METHEMALBUMIN,,30,,,$211.29,$0.00,1,0,1,20161001, 83861,CPT,MICROFLUIDIC ANALYSIS TEAR OSMOLARITY,,30,,,$52.59,$0.00,1,0,1,20161001, 83864,CPT,MUCOPOLYSACCHARIDES ACID QUANTITATIVE,,30,,,$392.39,$0.00,1,0,1,20161001, 83872,CPT,MUCIN SYNOVIAL FLUID ROPES TEST,,30,,,$135.83,$0.00,1,0,1,20161001, 83873,CPT,MYELIN BASIC PROTEIN CEREBROSPINAL FLUID,,30,,,$377.30,$0.00,1,0,1,20161001, 83874,CPT,MYOGLOBIN,,30,,,$271.65,$0.00,1,0,1,20161001, 83876,CPT,MYELOPEROXIDASE MPO,,30,,,$415.03,$0.00,1,0,1,20161001, 83880,CPT,NATRIURETIC PEPTIDE,,30,,,$452.76,$0.00,1,0,1,20161001, 83883,CPT,ASSAY OF NEPHELOMETRY EACH ANALYTE NES,,30,,,$279.20,$0.00,1,0,1,20161001, 83885,CPT,ASSAY OF NICKEL,,30,,,$256.56,$0.00,1,0,1,20161001, 83915,CPT,ASSAY OF NUCLEOTIDASE 5'-,,30,,,$241.47,$0.00,1,0,1,20161001, 83916,CPT,OLIGOCLONAL IMMUNE,,30,,,$415.03,$0.00,1,0,1,20161001, 83918,CPT,ORGANIC ACIDS TOTAL QUANTITATIVE EACH SPECIMEN,,30,,,$452.76,$0.00,1,0,1,20161001, 83919,CPT,ORGANIC ACIDS QUALITATIVE EACH SPECIMEN,,30,,,$339.57,$0.00,1,0,1,20161001, 83921,CPT,ORGANIC ACID 1 QUANTITATIVE,,30,,,$301.84,$0.00,1,0,1,20161001, 83930,CPT,ASSAY OF OSMOLALITY BLOOD,,30,,,$143.37,$0.00,1,0,1,20161001, 83935,CPT,ASSAY OF OSMOLALITY URINE,,30,,,$188.65,$0.00,1,0,1,20161001, 83937,CPT,ASSAY OF OSTEOCALCIN,,30,,,$565.95,$0.00,1,0,1,20161001, 83945,CPT,ASSAY OF OXALATE,,30,,,$226.38,$0.00,1,0,1,20161001, 83950,CPT,ONCOPROTEIN HER-2/NEU,,30,,,"$1,207.35",$0.00,1,0,1,20161001, 83951,CPT,ONCOPROTEIN DES-GAMMA-CARBOXY-PROTHROMBIN DCP,,30,,,"$1,207.35",$0.00,1,0,1,20161001, 83970,CPT,ASSAY OF PARATHORMONE,,30,,,$686.68,$0.00,1,0,1,20161001, 83986,CPT,PH BODY FLUID NOT ELSEWHERE SPECIFIED,,30,,,$75.46,$0.00,1,0,1,20161001, 83987,CPT,PH EXHALED BREATH CONDENSATE,,30,,,$75.46,$0.00,1,0,1,20161001, 83992,CPT,ASSAY OF PHENCYCLIDINE,,30,,,$377.30,$0.00,1,0,1,20161001, 83993,CPT,ASSAY OF CALPROTECTIN FECAL,,30,,,$407.48,$0.00,1,0,1,20161001, 84030,CPT,ASSAY OF PHENYLALANINE BLOOD,,30,,,$120.74,$0.00,1,0,1,20161001, 84035,CPT,ASSAY OF PHENYLKETONES QUALITATIVE,,30,,,$86.78,$0.00,1,0,1,20161001, 84060,CPT,ASSAY OF PHOSPHATASE ACID TOTAL,,30,,,$218.83,$0.00,1,0,1,20161001, 84061,CPT,PHOSPHATASE ACID FORENSIC EXAMINATION,,30,,,$264.11,$0.00,1,0,1,20161001, 84066,CPT,ASSAY OF PHOSPHATASE ACID PROSTATIC,,30,,,$226.38,$0.00,1,0,1,20161001, 84075,CPT,ASSAY OF PHOSPHATASE ALKALINE,,30,,,$75.46,$0.00,1,0,1,20161001, 84078,CPT,ASSAY OF PHOSPHATASE ALKALINE HEAT STABLE,,30,,,$196.19,$0.00,1,0,1,20161001, 84080,CPT,ASSAY OF PHOSPHATASE ALKALINE ISOENZYMES,,30,,,$324.48,$0.00,1,0,1,20161001, 84081,CPT,PHOSPHATIDYLGLYCEROL,,30,,,$467.85,$0.00,1,0,1,20161001, 84085,CPT,PHOSPHOGLUCONATE 6-DEHYD RBC,,30,,,$188.65,$0.00,1,0,1,20161001, 84087,CPT,ASSAY OF PHOSPHOHEXOSE ISOMERASE,,30,,,$339.57,$0.00,1,0,1,20161001, 84100,CPT,ASSAY OF PHOSPHORUS INORGANIC,,30,,,$60.37,$0.00,1,0,1,20161001, 84105,CPT,ASSAY OF PHOSPHORUS INORGANIC URINE,,30,,,$120.74,$0.00,1,0,1,20161001, 84106,CPT,PORPHOBILINOGEN URINE QUALITATIVE,,30,,,$150.92,$0.00,1,0,1,20161001, 84110,CPT,ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE,,30,,,$218.83,$0.00,1,0,1,20161001, 84112,CPT,EVAL C/V AMNIOTIC FLUID PROTEIN QUAL EA SPECIMEN,,30,,,$218.83,$0.00,1,0,1,20161001, 84119,CPT,PORPHYRINS URINE QUALITATAIVE,,30,,,$196.19,$0.00,1,0,1,20161001, 84120,CPT,PORPHYRINS URINE QUANTITATION & FRACTIONATION,,30,,,$354.66,$0.00,1,0,1,20161001, 84126,CPT,PORPHYRINS FECES QUANTITATIVE,,30,,,$399.94,$0.00,1,0,1,20161001, 84132,CPT,POTASSIUM SERUM PLASMA/WHOLE BLOOD,,30,,,$67.91,$0.00,1,0,1,20161001, 84133,CPT,POTASSIUM URINE,,30,,,$98.10,$0.00,1,0,1,20161001, 84134,CPT,PREALBUMIN,,30,,,$233.92,$0.00,1,0,1,20161001, 84135,CPT,PREGNANEDIOL,,30,,,$286.75,$0.00,1,0,1,20161001, 84138,CPT,PREGNANETRIOL,,30,,,$316.93,$0.00,1,0,1,20161001, 84140,CPT,PREGNENOLONE,,30,,,$399.94,$0.00,1,0,1,20161001, 84143,CPT,17-HYDROXYPREGNENOLONE,,30,,,$467.85,$0.00,1,0,1,20161001, 84144,CPT,ASSAY OF PROGESTERONE,,30,,,$377.30,$0.00,1,0,1,20161001, 84145,CPT,PROCALCITONIN (PCT),,30,,,$330.14,$0.00,1,0,1,20161001, 84146,CPT,ASSAY OF PROLACTIN,,30,,,$377.30,$0.00,1,0,1,20161001, 84150,CPT,ASSAY OF PROSTAGLNDIN EACH,,30,,,$226.38,$0.00,1,0,1,20161001, 84152,CPT,ASSAY OF PROSTATE SPECIFIC ANTIGEN COMPLEXED,,30,,,$226.38,$0.00,1,0,1,20161001, 84153,CPT,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,,30,,,$362.21,$0.00,1,0,1,20161001, 84154,CPT,ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,,30,,,$301.84,$0.00,1,0,1,20161001, 84155,CPT,PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,,30,,,$83.01,$0.00,1,0,1,20161001, 84156,CPT,PROTEIN TOTAL XCPT REFRACTOMETRY URINE,,30,,,$105.64,$0.00,1,0,1,20161001, 84157,CPT,PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC,,30,,,$98.10,$0.00,1,0,1,20161001, 84160,CPT,PROTEIN TOTAL REFRACTOMETRY ANY SRC,,30,,,$60.37,$0.00,1,0,1,20161001, 84163,CPT,PREGNANCY-ASSOCIATED PLASMA PROTEIN-A,,30,,,$151.58,$0.00,1,0,1,20161001, 84165,CPT,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,,30,,,$271.65,$0.00,1,0,1,20161001, 84166,CPT,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI,,30,,,$286.75,$0.00,1,0,1,20161001, 84181,CPT,PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID,,30,,,$392.39,$0.00,1,0,1,20161001, 84182,CPT,PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL,,30,,,$633.86,$0.00,1,0,1,20161001, 84202,CPT,PROTOPORPHYRIN RBC QUANTITATIVE,,30,,,$264.11,$0.00,1,0,1,20161001, 84203,CPT,PROTOPORPHYRIN RBC SCREEN,,30,,,$143.37,$0.00,1,0,1,20161001, 84206,CPT,ASSAY OF PROINSULIN,,30,,,$581.04,$0.00,1,0,1,20161001, 84207,CPT,ASSAY OF PYRIDOXAL PHOSPHATE,,30,,,$565.95,$0.00,1,0,1,20161001, 84210,CPT,ASSAY OF PYRUVATE,,30,,,$249.02,$0.00,1,0,1,20161001, 84220,CPT,ASSAY OF PYRUVATE KINASE,,30,,,$196.19,$0.00,1,0,1,20161001, 84228,CPT,ASSAY OF QUININE,,30,,,$301.84,$0.00,1,0,1,20161001, 84233,CPT,ASSAY OF RECEPTOR ASSAY ESTROGEN,,30,,,$565.95,$0.00,1,0,1,20161001, 84234,CPT,ASSAY OF RECEPTOR ASSAY PROGESTERONE,,30,,,$565.95,$0.00,1,0,1,20161001, 84235,CPT,RECEPTOR ASSAY ENDOCRINE OTH/THN ESTRGN/PROGST,,30,,,$565.95,$0.00,1,0,1,20161001, 84238,CPT,RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR,,30,,,$830.05,$0.00,1,0,1,20161001, 84244,CPT,ASSAY OF RENIN,,30,,,$520.67,$0.00,1,0,1,20161001, 84252,CPT,ASSAY OF RIBOFLAVIN-VITAMIN B-2,,30,,,$339.57,$0.00,1,0,1,20161001, 84255,CPT,ASSAY OF SELENIUM,,30,,,$339.57,$0.00,1,0,1,20161001, 84260,CPT,ASSAY OF SEROTONIN,,30,,,$641.41,$0.00,1,0,1,20161001, 84270,CPT,ASSAY OF SEX HORMONE BINDING GLOBULIN,,30,,,$437.66,$0.00,1,0,1,20161001, 84275,CPT,ASSAY OF SIALIC ACID,,30,,,$264.11,$0.00,1,0,1,20161001, 84285,CPT,ASSAY OF SILICA,,30,,,$415.03,$0.00,1,0,1,20161001, 84295,CPT,SODIUM SERUM PLASMA OR WHOLE BLOOD,,30,,,$75.46,$0.00,1,0,1,20161001, 84300,CPT,ASSAY OF URINE SODIUM,,30,,,$105.64,$0.00,1,0,1,20161001, 84302,CPT,ASSAY OF SODIUM OTHER SOURCE,,30,,,$105.64,$0.00,1,0,1,20161001, 84305,CPT,ASSAY OF SOMATOMEDIN,,30,,,$603.68,$0.00,1,0,1,20161001, 84307,CPT,ASSAY OF SOMATOSTATIN,,30,,,$467.85,$0.00,1,0,1,20161001, 84311,CPT,SPECTROPHOTOMETRY ANALYT NOT ELSEWHERE SPECIFIED,,30,,,$158.46,$0.00,1,0,1,20161001, 84315,CPT,SPECIFIC GRAVITY EXCEPT URINE,,30,,,$67.91,$0.00,1,0,1,20161001, 84375,CPT,SUGARS CHROMATOGRAPHIC TLC/PAPER CHROMATOGRAPHY,,30,,,$286.75,$0.00,1,0,1,20161001, 84376,CPT,SUGARS MONO DI&OLIGOS 1 QUALITATAIVE EACH SPEC,,30,,,$97.61,$0.00,1,0,1,20161001, 84377,CPT,SUGARS MONO DI&OLIGOS MLT QUALITATIVE EACH SPE,,30,,,$88.42,$0.00,1,0,1,20161001, 84378,CPT,SUGARS MONO DI&OLIGOS 1 QUANTITATIVE EACH SPEC,,30,,,$218.56,$0.00,1,0,1,20161001, 84379,CPT,SUGARS MONO DI&OLIGOS MLT QUANTITATIVE EA SPEC,,30,,,$939.91,$0.00,1,0,1,20161001, 84392,CPT,ASSAY OF SULFATE URINE,,30,,,$72.34,$0.00,1,0,1,20161001, 84402,CPT,ASSAY OF TESTOSTERONE FREE,,30,,,$422.57,$0.00,1,0,1,20161001, 84403,CPT,ASSAY OF TESTOSTERONE TOTAL,,30,,,$339.57,$0.00,1,0,1,20161001, 84425,CPT,ASSAY OF THIAMINE-VITAMIN B-1,,30,,,$384.84,$0.00,1,0,1,20161001, 84430,CPT,ASSAY OF THIOCYANATE,,30,,,$241.47,$0.00,1,0,1,20161001, 84431,CPT,THROMBOXANE METABOLITE W/WO THROMBOXANE URINE,,30,,,$159.70,$0.00,1,0,1,20161001, 84432,CPT,ASSAY OF THYROGLOBULIN,,30,,,$347.11,$0.00,1,0,1,20161001, 84436,CPT,ASSAY OF THYROXINE TOTAL,,30,,,$120.74,$0.00,1,0,1,20161001, 84437,CPT,ASSAY OF THYROXINE REQUIRING ELUTION,,30,,,$135.83,$0.00,1,0,1,20161001, 84439,CPT,ASSAY OF FREE THYROXINE,,30,,,$211.29,$0.00,1,0,1,20161001, 84442,CPT,ASSAY OF THYROXINE BINDING GLOBULIN,,30,,,$271.65,$0.00,1,0,1,20161001, 84443,CPT,ASSAY OF THYROID STIMULATING HORMONE TSH,,30,,,$301.84,$0.00,1,0,1,20161001, 84445,CPT,THYROID STIMULATING IMMUNE GLOBULINS TSI,,30,,,$920.61,$0.00,1,0,1,20161001, 84446,CPT,ASSAY OF TOCOPHEROL ALPHA VITAMIN E,,30,,,$241.47,$0.00,1,0,1,20161001, 84449,CPT,ASSAY OF TRANSCORTIN CORTISOL BINDING GLOBULIN,,30,,,$377.30,$0.00,1,0,1,20161001, 84450,CPT,TRANSFERASE ASPARTATE AMINO AST SGOT,,30,,,$83.01,$0.00,1,0,1,20161001, 84460,CPT,TRANSFERASE ALANINE AMINO ALT SGPT,,30,,,$83.01,$0.00,1,0,1,20161001, 84466,CPT,ASSAY OF L7383TRANSFERRIN,,30,,,$286.75,$0.00,1,0,1,20161001, 84478,CPT,ASSAY OF TRIGLYCERIDES,,30,,,$83.01,$0.00,1,0,1,20161001, 84479,CPT,THYROID HORM UPTK/THYROID HORMONE BINDING RATIO,,30,,,$135.83,$0.00,1,0,1,20161001, 84480,CPT,ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3,,30,,,$301.84,$0.00,1,0,1,20161001, 84481,CPT,ASSAY OF TRIIODOTHYRONINE T3 FREE,,30,,,$399.94,$0.00,1,0,1,20161001, 84482,CPT,TRIIODOTHYRONINE T3 REVERSE,,30,,,$377.30,$0.00,1,0,1,20161001, 84484,CPT,ASSAY OF TROPONIN QUANTITATIVE,,30,,,$295.12,$0.00,1,0,1,20161001, 84485,CPT,ASSAY OF TRYPSIN DUODENAL FLUID,,30,,,$226.38,$0.00,1,0,1,20161001, 84488,CPT,ASSAY OF TRYPSIN FECES QUALITATIVE,,30,,,$226.38,$0.00,1,0,1,20161001, 84490,CPT,TRYPSIN FECES QUANTITATIVE 24-HR COLLECTION,,30,,,$135.83,$0.00,1,0,1,20161001, 84510,CPT,ASSAY OF TYROSINE,,30,,,$150.92,$0.00,1,0,1,20161001, 84512,CPT,ASSAY OF TROPONIN QUALITATIVE,,30,,,$172.47,$0.00,1,0,1,20161001, 84520,CPT,ASSAY OF UREA NITROGEN QUANTITATIVE,,30,,,$83.01,$0.00,1,0,1,20161001, 84525,CPT,ASSAY OF UREA NITROGEN SEMIQUANTITATIVE,,30,,,$90.55,$0.00,1,0,1,20161001, 84540,CPT,ASSAY OF UREA NITROGEN URINE,,30,,,$128.28,$0.00,1,0,1,20161001, 84545,CPT,UREA NITROGEN CLEARANCE,,30,,,$158.46,$0.00,1,0,1,20161001, 84550,CPT,ASSAY OF BLOOD/URIC ACID,,30,,,$83.01,$0.00,1,0,1,20161001, 84560,CPT,ASSAY OF URIC ACID OTHER SOURCE,,30,,,$120.74,$0.00,1,0,1,20161001, 84577,CPT,ASSAY OF UROBILINOGEN FECES QUANTITATIVE,,30,,,$135.83,$0.00,1,0,1,20161001, 84578,CPT,ASSAY OF UROBILINOGEN URINE QUALITATIVE,,30,,,$90.55,$0.00,1,0,1,20161001, 84580,CPT,UROBILINOGEN URINE QUANTITATIVE TIMED SPECIMEN,,30,,,$135.83,$0.00,1,0,1,20161001, 84583,CPT,ASSAY OF UROBILINOGEN URINE SEMIQUANTITATIVE,,30,,,$90.55,$0.00,1,0,1,20161001, 84585,CPT,ASSAY OF VANILLYLMANDELIC ACID URINE,,30,,,$339.57,$0.00,1,0,1,20161001, 84586,CPT,ASSAY OF VASOACTIVE INTESTINAL PEPTIDE,,30,,,$581.04,$0.00,1,0,1,20161001, 84588,CPT,ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE,,30,,,$603.68,$0.00,1,0,1,20161001, 84590,CPT,ASSAY OF VITAMIN A,,30,,,$339.57,$0.00,1,0,1,20161001, 84591,CPT,ASSAY OF VITAMIN NOT OTHERWISE SPECIFIED,,30,,,$324.48,$0.00,1,0,1,20161001, 84597,CPT,ASSAY OF VITAMIN K,,30,,,$437.66,$0.00,1,0,1,20161001, 84600,CPT,ASSAY OF VOLATILES,,30,,,$233.92,$0.00,1,0,1,20161001, 84620,CPT,XYLOSE ABSORPTION TEST BLOOD &/URINE,,30,,,$309.38,$0.00,1,0,1,20161001, 84630,CPT,ASSAY OF ZINC,,30,,,$286.75,$0.00,1,0,1,20161001, 84681,CPT,ASSAY OF C-PEPTIDE,,30,,,$430.12,$0.00,1,0,1,20161001, 84702,CPT,GONADOTROPIN CHORIONIC QUANTITATIVE,,30,,,$286.75,$0.00,1,0,1,20161001, 84703,CPT,GONADOTROPIN CHORIONIC QUALITATIVE,,30,,,$173.56,$0.00,1,0,1,20161001, 84704,CPT,GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN,,30,,,$286.75,$0.00,1,0,1,20161001, 84830,CPT,OVULATION TEST VISUAL COLOR COMPARISON HLH,,30,,,$150.92,$0.00,1,0,1,20161001, 84999,CPT,UNLISTED CHEMISTRY PROCEDURE,,30,,,$643.39,$0.00,1,0,1,20161001, 85002,CPT,BLEEDING TIME TEST,,30,,,$166.85,$0.00,1,0,1,20161001, 85004,CPT,BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT,,30,,,$108.45,$0.00,1,0,1,20161001, 85007,CPT,BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT,,30,,,$100.11,$0.00,1,0,1,20161001, 85008,CPT,BLD COUNT SMEAR MCRSCP W/O MNL DIFRNTL WBC COUNT,,30,,,$83.43,$0.00,1,0,1,20161001, 85009,CPT,BLOOD COUNT MANUAL DIFRNTL WBC COUNT BUFFY COAT,,30,,,$100.11,$0.00,1,0,1,20161001, 85013,CPT,BLOOD COUNT SPUN MICROHEMATOCRIT,,30,,,$75.08,$0.00,1,0,1,20161001, 85014,CPT,BLOOD COUNT HEMATOCRIT,,30,,,$75.08,$0.00,1,0,1,20161001, 85018,CPT,BLOOD COUNT HEMOGLOBIN,,30,,,$75.08,$0.00,1,0,1,20161001, 85025,CPT,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,,30,,,$154.34,$0.00,1,0,1,20161001, 85027,CPT,BLOOD COUNT COMPLETE AUTOMATED,,30,,,$146.00,$0.00,1,0,1,20161001, 85032,CPT,BLOOD COUNT MANUAL CELL COUNT EACH,,30,,,$116.80,$0.00,1,0,1,20161001, 85041,CPT,BLOOD COUNT RED BLOOD CELL AUTOMATED,,30,,,$100.11,$0.00,1,0,1,20161001, 85044,CPT,BLOOD COUNT RETICULOCYTE AUTOMATED,,30,,,$116.80,$0.00,1,0,1,20161001, 85045,CPT,BLOOD COUNT RETICULOCYTE AUTOMATED,,30,,,$125.14,$0.00,1,0,1,20161001, 85046,CPT,BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS,,30,,,$111.62,$0.00,1,0,1,20161001, 85048,CPT,BLOOD COUNT LEUKOCYTE WBC AUTOMATED,,30,,,$100.11,$0.00,1,0,1,20161001, 85049,CPT,BLOOD COUNT PLATELET AUTOMATED,,30,,,$100.11,$0.00,1,0,1,20161001, 85055,CPT,RETICULATED PLATELET ASSAY,,30,,,$159.62,$0.00,1,0,1,20161001, 85060,CPT,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,,30,,,$144.69,$0.00,1,0,1,20161001, 85097,CPT,BONE MARROW SMEAR INTERPRETATION,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 85130,CPT,CHROMOGENIC SUBSTRATE ASSAY,,30,,,$317.02,$0.00,1,0,1,20161001, 85170,CPT,BLOOD CLOT RETRACTION,,30,,,$100.11,$0.00,1,0,1,20161001, 85175,CPT,CLOT LYSIS TIME WHOLE BLOOD DILUTION,,30,,,$183.54,$0.00,1,0,1,20161001, 85210,CPT,CLOTTING FACTOR II PROTHROMBIN SPECIFIC,,30,,,$233.59,$0.00,1,0,1,20161001, 85220,CPT,CLOTTING FACTOR V ACG/PROACCELERIN LABILE FACTOR,,30,,,$500.56,$0.00,1,0,1,20161001, 85230,CPT,CLOTTING FACTOR VII PROCONVERTIN STABLE FACTOR,,30,,,$500.56,$0.00,1,0,1,20161001, 85240,CPT,CLOTTING FACTOR VIII AHG 1 STAGE,,30,,,$542.27,$0.00,1,0,1,20161001, 85244,CPT,CLOTTING FACTOR VIII RELATED ANTIGEN,,30,,,$625.70,$0.00,1,0,1,20161001, 85245,CPT,CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT,,30,,,$450.50,$0.00,1,0,1,20161001, 85246,CPT,CLOTTING FACTOR VIII VW FACTOR ANTIGEN,,30,,,$667.41,$0.00,1,0,1,20161001, 85247,CPT,CLOTTING FACTOR VIII MULTIMETRIC ANALYSIS,,30,,,$684.10,$0.00,1,0,1,20161001, 85250,CPT,CLOTTING FACTOR IX PTC/CHRISTMAS,,30,,,$542.27,$0.00,1,0,1,20161001, 85260,CPT,CLOTTING FACTOR X STUART-PROWER,,30,,,$542.27,$0.00,1,0,1,20161001, 85270,CPT,CLOTTING FACTOR XI PTA,,30,,,$533.93,$0.00,1,0,1,20161001, 85280,CPT,CLOTTING FACTOR XII HAGEMAN,,30,,,$542.27,$0.00,1,0,1,20161001, 85290,CPT,CLOTTING FACTOR XIII FIBRIN STABILIZING,,30,,,$500.56,$0.00,1,0,1,20161001, 85291,CPT,CLOTTING FACTOR XIII FIBRN STABILIZ SCREEN SOLUB,,30,,,$333.71,$0.00,1,0,1,20161001, 85292,CPT,CLOTTING PREKALLIKREIN ASSAY FLETCHER FACT ASSAY,,30,,,$517.24,$0.00,1,0,1,20161001, 85293,CPT,CLOTTING HI MOLEC WEIGHT KININOGEN ASSAY,,30,,,$500.56,$0.00,1,0,1,20161001, 85300,CPT,CLOTTING INHIBITORS ANTITHROMBIN III ACTIVITY,,30,,,$442.16,$0.00,1,0,1,20161001, 85301,CPT,CLOTTING INHIBITRS ANTITHROMBN III ANTIGEN ASSAY,,30,,,$433.82,$0.00,1,0,1,20161001, 85302,CPT,CLOTTING INHIBITORS PROTEIN C ANTIGEN,,30,,,$458.84,$0.00,1,0,1,20161001, 85303,CPT,CLOTTING INHIBITORS PROTEIN C ACTIVITY,,30,,,$517.24,$0.00,1,0,1,20161001, 85305,CPT,CLOTTING INHIBITORS PROTEIN S TOTAL,,30,,,$525.59,$0.00,1,0,1,20161001, 85306,CPT,CLOTTING INHIBITORS PROTEIN S FREE,,30,,,$542.27,$0.00,1,0,1,20161001, 85307,CPT,ACTIVATED PROTEIN C APC RESISTANCE ASSAY,,30,,,$475.53,$0.00,1,0,1,20161001, 85335,CPT,FACTOR INHIBITOR TEST,,30,,,$333.71,$0.00,1,0,1,20161001, 85337,CPT,THROMBOMODULIN,,30,,,$400.45,$0.00,1,0,1,20161001, 85345,CPT,COAGULATION TIME LEE AND WHITE,,30,,,$208.57,$0.00,1,0,1,20161001, 85347,CPT,COAGULATION TIME ACTIVATED,,30,,,$125.14,$0.00,1,0,1,20161001, 85348,CPT,COAGULATION TIME OTHER METHODS,,30,,,$133.48,$0.00,1,0,1,20161001, 85360,CPT,EUGLOBULIN LYSIS,,30,,,$283.65,$0.00,1,0,1,20161001, 85362,CPT,FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN,,30,,,$233.59,$0.00,1,0,1,20161001, 85366,CPT,FIBRIN DGRADJ SPLT PRODUXS PARACOAGJ,,30,,,$250.28,$0.00,1,0,1,20161001, 85370,CPT,FIBRIN DGRADJ SPLT PRODUCTS QUANTITATIVE,,30,,,$308.68,$0.00,1,0,1,20161001, 85378,CPT,FIBRIN DGRADJ PRODUCTS D-DIMER QUAL/SEMIQUAN,,30,,,$233.59,$0.00,1,0,1,20161001, 85379,CPT,FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,,30,,,$291.99,$0.00,1,0,1,20161001, 85380,CPT,FIBRIN DGRADJ PRODUCTS D-DIMER ULTRASENSITIVE,,30,,,$291.99,$0.00,1,0,1,20161001, 85384,CPT,FIBRINOGEN ACTIVITY,,30,,,$208.57,$0.00,1,0,1,20161001, 85385,CPT,FIBRINOGEN ANTIGEN,,30,,,$241.94,$0.00,1,0,1,20161001, 85390,CPT,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,,30,,,$114.83,$0.00,1,0,1,20161001, 85396,CPT,COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY,,30,,,$482.30,$0.00,1,0,1,20161001, 85397,CPT,COAGJ&FIBRINOLYSIS FUNCTIONAL ACTV NOS EA ANAL,,30,,,$333.71,$0.00,1,0,1,20161001, 85400,CPT,FIBRINOLYTIC FACTORS & INHIBITORS PLASMIN,,30,,,$375.42,$0.00,1,0,1,20161001, 85410,CPT,FBRNLYC FACTORS&INHIBITORS ALPHA-2 ANTIPLASMIN,,30,,,$417.13,$0.00,1,0,1,20161001, 85415,CPT,FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR,,30,,,$417.13,$0.00,1,0,1,20161001, 85420,CPT,FBRNLYC FACTORS&INHIBITRS PLSMNG XCPT AGIC ASS,,30,,,$375.42,$0.00,1,0,1,20161001, 85421,CPT,FBRNLYC FACTORS&INHIBITORS PLSMNG AGIC ASSAY,,30,,,$542.27,$0.00,1,0,1,20161001, 85441,CPT,HEINZ BODIES DIRECT,,30,,,$166.85,$0.00,1,0,1,20161001, 85445,CPT,HEINZ BODIES INDUCED ACETYL PHENYLHYDRAZINE,,30,,,$141.82,$0.00,1,0,1,20161001, 85460,CPT,HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS,,30,,,$241.94,$0.00,1,0,1,20161001, 85461,CPT,HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE,,30,,,$200.22,$0.00,1,0,1,20161001, 85475,CPT,HEMOLYSIN ACID,,30,,,$300.33,$0.00,1,0,1,20161001, 85520,CPT,HEPARIN ASSAY,,30,,,$383.76,$0.00,1,0,1,20161001, 85525,CPT,HEPARIN NEUTRALIZATION,,30,,,$308.68,$0.00,1,0,1,20161001, 85530,CPT,HEPARIN-PROTAMINE TOLERANCE TST,,30,,,$291.99,$0.00,1,0,1,20161001, 85536,CPT,IRON STAIN PERIPHERAL BLOOD,,30,,,$158.51,$0.00,1,0,1,20161001, 85540,CPT,WBC ALKALINE PHOSPHATASE COUNT,,30,,,$225.25,$0.00,1,0,1,20161001, 85547,CPT,MECHANICAL FRAGILITY RBC,,30,,,$175.20,$0.00,1,0,1,20161001, 85549,CPT,MURAMIDASE,,30,,,$375.42,$0.00,1,0,1,20161001, 85555,CPT,OSMOTIC FRAGILITY RBC UNINCUBATED,,30,,,$291.99,$0.00,1,0,1,20161001, 85557,CPT,OSMOTIC FRAGILITY RBC INCUBATED,,30,,,$400.45,$0.00,1,0,1,20161001, 85576,CPT,PLATELET AGGREGATION IN VITRO EACH AGENT,,30,,,$255.28,$0.00,1,0,1,20161001, 85597,CPT,PHOSPHOLIPID NEUTRALIZATION PLATELET,,30,,,$350.39,$0.00,1,0,1,20161001, 85598,CPT,PHOSPHOLIPID NEUTRALIZATION HEXAGONAL,,30,,,$350.39,$0.00,1,0,1,20161001, 85610,CPT,PROTHROMBIN TIME,,30,,,$100.11,$0.00,1,0,1,20161001, 85611,CPT,PROTHROMBIN TIME SUBSTITUTION PLASMA FRCTJ EACH,,30,,,$133.48,$0.00,1,0,1,20161001, 85612,CPT,RUSSELL VIPER VENON TIME UNDILUTED,,30,,,$283.65,$0.00,1,0,1,20161001, 85613,CPT,RUSSELL VIPER VENOM TIME DILUTED,,30,,,$258.62,$0.00,1,0,1,20161001, 85635,CPT,REPTILASE TEST,,30,,,$266.96,$0.00,1,0,1,20161001, 85651,CPT,SEDIMENTATION RATE RBC NON-AUTOMATED,,30,,,$104.28,$0.00,1,0,1,20161001, 85652,CPT,SEDIMENTATION RATE RBC AUTOMATED,,30,,,$100.11,$0.00,1,0,1,20161001, 85660,CPT,SICKLING RBC REDUCTION,,30,,,$129.31,$0.00,1,0,1,20161001, 85670,CPT,THROMBIN TIME PLASMA,,30,,,$175.20,$0.00,1,0,1,20161001, 85675,CPT,THROMBIN TIME TITER,,30,,,$191.88,$0.00,1,0,1,20161001, 85705,CPT,THROMBOPLASTIN INHIBITION TISSUE,,30,,,$333.71,$0.00,1,0,1,20161001, 85730,CPT,THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD,,30,,,$141.82,$0.00,1,0,1,20161001, 85732,CPT,THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA,,30,,,$183.54,$0.00,1,0,1,20161001, 85810,CPT,VISCOSITY,,30,,,$208.57,$0.00,1,0,1,20161001, 85999,CPT,UNLISTED HEMATOLOGY & COAGULATION PROCEDURE,,30,,,$104.50,$0.00,1,0,1,20161001, 86000,CPT,AGGLUTININS FEBRILE EACH ANTIGEN,,30,,,$156.56,$0.00,1,0,1,20161001, 86001,CPT,ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN,,30,,,$82.01,$0.00,1,0,1,20161001, 86003,CPT,ALLERGEN SPECIFIC IGE QUAN/SEMIQUAN EA ALLERGEN,,30,,,$82.01,$0.00,1,0,1,20161001, 86005,CPT,ALLERGEN SPECIFIC IGE QUAL MULTIALLERGEN SCREEN,,30,,,$298.22,$0.00,1,0,1,20161001, 86021,CPT,ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES,,30,,,$447.32,$0.00,1,0,1,20161001, 86022,CPT,ANTIBODY IDENTIFICATION PLATELET ANTIBODIES,,30,,,$633.71,$0.00,1,0,1,20161001, 86023,CPT,ANTIBODY IDENTIFICATION PLATELET IMMUNOGL ASSAY,,30,,,$410.05,$0.00,1,0,1,20161001, 86038,CPT,ANTINUCLEAR ANTIBODIES ANA,,30,,,$260.94,$0.00,1,0,1,20161001, 86039,CPT,ANTINUCLEAR ANTIBODIES ANA TITER,,30,,,$260.94,$0.00,1,0,1,20161001, 86060,CPT,ANTISTREPTOLYSIN O TITER,,30,,,$178.93,$0.00,1,0,1,20161001, 86063,CPT,ANTISTREPTOLYSIN O SCREEN,,30,,,$126.74,$0.00,1,0,1,20161001, 86077,CPT,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,,30,,,$156.54,$0.00,1,0,1,20161001, 86078,CPT,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,,30,,,$424.20,$0.00,1,0,1,20161001, 86079,CPT,BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT,,30,,,$424.20,$0.00,1,0,1,20161001, 86140,CPT,C-REACTIVE PROTEIN,,30,,,$149.11,$0.00,1,0,1,20161001, 86141,CPT,C-REACTIVE PROTEIN HIGH SENSITIVITY,,30,,,$193.84,$0.00,1,0,1,20161001, 86146,CPT,BETA 2 GLYCOPROTEIN I ANTIBODY EACH,,30,,,$484.60,$0.00,1,0,1,20161001, 86147,CPT,CARDIOLIPIN ANTIBODY EACH IG CLASS,,30,,,$484.60,$0.00,1,0,1,20161001, 86148,CPT,ANTI-PHOSPHATIDYLSERINE ANTIBODY,,30,,,$206.70,$0.00,1,0,1,20161001, 86152,CPT,CELL ENUMERATION IMMUNE SELECTJ & ID FLUID SPEC,,30,,,$32.21,$0.00,1,0,1,20161001, 86153,CPT,CELL ENUMERATION IMMUNE SELECTJ & ID PHYS INTERP,,30,,,$32.21,$0.00,1,0,1,20161001, 86155,CPT,CHEMOTAXIS ASSAY SPECIFY METHOD,,30,,,$231.12,$0.00,1,0,1,20161001, 86156,CPT,COLD AGGLUTININ SCREEN,,30,,,$141.65,$0.00,1,0,1,20161001, 86157,CPT,COLD AGGLUTININ TITER,,30,,,$171.47,$0.00,1,0,1,20161001, 86160,CPT,COMPLEMENT ANTIGEN EACH COMPONENT,,30,,,$305.67,$0.00,1,0,1,20161001, 86161,CPT,COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT,,30,,,$342.95,$0.00,1,0,1,20161001, 86162,CPT,COMPLEMENT TOTAL HEMOLYTIC,,30,,,$462.24,$0.00,1,0,1,20161001, 86171,CPT,COMPLEMENT FIXATION TESTS EACH ANTIGEN,,30,,,$216.21,$0.00,1,0,1,20161001, 86185,CPT,CNTERIMMUNOELECTROPHORESIS EACH ANTIGEN,,30,,,$186.39,$0.00,1,0,1,20161001, 86200,CPT,CYCLIC CITRULLINATED PEPTIDE ANTIBODY,,30,,,$313.13,$0.00,1,0,1,20161001, 86215,CPT,DEOXYRIBONUCLEASE ANTIBODY,,30,,,$290.76,$0.00,1,0,1,20161001, 86225,CPT,DNA ANTIBODY NATIVE/DOUBLE STRANDED,,30,,,$320.58,$0.00,1,0,1,20161001, 86226,CPT,DNA ANTIBODY SINGLE STRANDED,,30,,,$283.31,$0.00,1,0,1,20161001, 86235,CPT,EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD,,30,,,$283.31,$0.00,1,0,1,20161001, 86243,CPT,FC RECEPTOR,,30,,,$298.22,$0.00,1,0,1,20161001, 86255,CPT,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,,30,,,$117.42,$0.00,1,0,1,20161001, 86256,CPT,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,,30,,,$107.36,$0.00,1,0,1,20161001, 86277,CPT,GROWTH HORMONE HUMAN ANTIBODY,,30,,,$275.85,$0.00,1,0,1,20161001, 86280,CPT,HEMAGGLUTINATION INHIBITION TEST HAI,,30,,,$216.21,$0.00,1,0,1,20161001, 86294,CPT,IMMUNOASSAY TUMOR ANTIGEN QUAL/SEMIQUANTITATIVE,,30,,,$372.77,$0.00,1,0,1,20161001, 86300,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,,30,,,$372.77,$0.00,1,0,1,20161001, 86301,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,,30,,,$357.86,$0.00,1,0,1,20161001, 86304,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,,30,,,$372.77,$0.00,1,0,1,20161001, 86305,CPT,HUMAN EPIDIDYMIS PROTEIN 4 (HE4),,30,,,$358.28,$0.00,1,0,1,20161001, 86308,CPT,HETEROPHILE ANTIBODIES SCREEN,,30,,,$134.20,$0.00,1,0,1,20161001, 86309,CPT,HETEROPHILE ANTIBODIES TITER,,30,,,$186.39,$0.00,1,0,1,20161001, 86310,CPT,HETEROPHILE ANTIBODIES TITER AFTER ABSORPTION,,30,,,$193.84,$0.00,1,0,1,20161001, 86316,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE,,30,,,$387.68,$0.00,1,0,1,20161001, 86317,CPT,IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUAN NOS,,30,,,$178.93,$0.00,1,0,1,20161001, 86318,CPT,IMMUNOASSAY NFCT AGT ANTB QUAL/SEMIQUAN 1 STEP,,30,,,$178.93,$0.00,1,0,1,20161001, 86320,CPT,IMMUNOELECTROPHORESIS SERUM,,30,,,$454.78,$0.00,1,0,1,20161001, 86325,CPT,IMMUNOELECTROPHORESIS OTHER FLUIDS CONCENTRATION,,30,,,$387.68,$0.00,1,0,1,20161001, 86327,CPT,IMMUNOELECTROPHORESIS CROSSED,,30,,,$298.22,$0.00,1,0,1,20161001, 86329,CPT,IMMUNODIFFUSION NOT ELSEWHERE SPECIFIED,,30,,,$305.67,$0.00,1,0,1,20161001, 86331,CPT,IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTBDY,,30,,,$305.67,$0.00,1,0,1,20161001, 86332,CPT,IMMUNE COMPLEX ASSAY,,30,,,$410.05,$0.00,1,0,1,20161001, 86334,CPT,IMMUNOFIXJ ELECTROPHORESIS SERUM,,30,,,$322.07,$0.00,1,0,1,20161001, 86335,CPT,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,,30,,,$322.07,$0.00,1,0,1,20161001, 86336,CPT,INHIBIN A,,30,,,$372.77,$0.00,1,0,1,20161001, 86337,CPT,INSULIN ANTIBODIES,,30,,,$469.69,$0.00,1,0,1,20161001, 86340,CPT,INTRINSIC FACTOR ANTIBODIES,,30,,,$305.67,$0.00,1,0,1,20161001, 86341,CPT,ISLET CELL ANTIBODY,,30,,,$223.66,$0.00,1,0,1,20161001, 86343,CPT,LEUKOCYTE HISTAMINE RELEASE TEST LHR,,30,,,$350.40,$0.00,1,0,1,20161001, 86344,CPT,LEUKOCYTE PHAGOCYTOSIS,,30,,,$335.49,$0.00,1,0,1,20161001, 86352,CPT,CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKE,,30,,,$662.59,$0.00,1,0,1,20161001, 86353,CPT,LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS,,30,,,$820.09,$0.00,1,0,1,20161001, 86355,CPT,B CELLS TOTAL COUNT,,30,,,$402.59,$0.00,1,0,1,20161001, 86356,CPT,MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA,,30,,,$372.77,$0.00,1,0,1,20161001, 86357,CPT,NATURAL KILLER CELLS TOTAL COUNT,,30,,,$447.32,$0.00,1,0,1,20161001, 86359,CPT,T CELLS TOTAL COUNT,,30,,,$372.77,$0.00,1,0,1,20161001, 86360,CPT,T CELLS ABSOLUTE CD4&CD8 COUNT RATIO,,30,,,$447.32,$0.00,1,0,1,20161001, 86361,CPT,T CELLS ABSOLUTE CD4 COUNT,,30,,,$469.69,$0.00,1,0,1,20161001, 86367,CPT,STEM CELLS TOTAL COUNT,,30,,,$469.69,$0.00,1,0,1,20161001, 86376,CPT,MICROSOMAL ANTIBODIES EACH,,30,,,$298.22,$0.00,1,0,1,20161001, 86378,CPT,MIGRATION INHIBITORY FACTOR TEST MIF,,30,,,$372.77,$0.00,1,0,1,20161001, 86382,CPT,NEUTRALIZATION TEST VIRAL,,30,,,$484.60,$0.00,1,0,1,20161001, 86384,CPT,NITROBLUE TETRAZOLIUM DYE TEST NTD,,30,,,$372.77,$0.00,1,0,1,20161001, 86386,CPT,NUCLEAR MATRIX PROTEIN 22 NMP22 QUALITATIVE,,30,,,$162.03,$0.00,1,0,1,20161001, 86403,CPT,PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY,,30,,,$119.29,$0.00,1,0,1,20161001, 86406,CPT,PARTICLE AGGLUTINATION TITER EACH ANTIBODY,,30,,,$193.84,$0.00,1,0,1,20161001, 86430,CPT,RHEUMATOID FACTOR QUALITATIVE,,30,,,$141.65,$0.00,1,0,1,20161001, 86431,CPT,RHEUMATOID FACTOR QUANTITATIVE,,30,,,$149.11,$0.00,1,0,1,20161001, 86480,CPT,TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON,,30,,,$246.03,$0.00,1,0,1,20161001, 86481,CPT,TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP,,30,,,$246.03,$0.00,1,0,1,20161001, 86485,CPT,SKIN TEST CANDIDA,,30,,,$156.54,$0.00,1,0,1,20161001, 86486,CPT,SKIN TEST UNLISTED ANTIGEN EACH,,30,,,$81.90,$0.00,1,0,1,20161001, 86490,CPT,SKIN TEST COCCIDIOIDOMYCOSIS,,30,,,$306.21,$0.00,1,0,1,20161001, 86510,CPT,SKIN TEST HISTOPLASMOSIS,,30,,,$306.21,$0.00,1,0,1,20161001, 86580,CPT,SKIN TEST TUBERCULOSIS INTRADERMAL,,30,,,$81.90,$0.00,1,0,1,20161001, 86590,CPT,STREPTOKINASE ANTIBODY,,30,,,$141.65,$0.00,1,0,1,20161001, 86592,CPT,SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,,30,,,$104.38,$0.00,1,0,1,20161001, 86593,CPT,SYPHILIS TEST QUANTITATIVE,,30,,,$104.38,$0.00,1,0,1,20161001, 86602,CPT,ANTIBODY ACTINOMYCES,,30,,,$260.94,$0.00,1,0,1,20161001, 86603,CPT,ANTIBODY ADENOVIRUS,,30,,,$260.94,$0.00,1,0,1,20161001, 86606,CPT,ANTIBODY ASPERGILLUS,,30,,,$260.94,$0.00,1,0,1,20161001, 86609,CPT,ANTIBODY BACTERIUM NOT ELSEWHERE SPECIFIED,,30,,,$335.49,$0.00,1,0,1,20161001, 86611,CPT,ANTIBODY BARTONELLA,,30,,,$335.49,$0.00,1,0,1,20161001, 86612,CPT,ANTIBODY BLASTOMYCES,,30,,,$328.04,$0.00,1,0,1,20161001, 86615,CPT,ANTIBODY BORDETELLA,,30,,,$372.77,$0.00,1,0,1,20161001, 86617,CPT,ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST,,30,,,$395.14,$0.00,1,0,1,20161001, 86618,CPT,ANTIBODY BORRELIA BURGDORFERI LYME DISEASE,,30,,,$372.77,$0.00,1,0,1,20161001, 86619,CPT,ANTIBODY BORRELIA RELAPSING FEVER,,30,,,$298.22,$0.00,1,0,1,20161001, 86622,CPT,ANTIBODY BRUCELLA,,30,,,$223.66,$0.00,1,0,1,20161001, 86625,CPT,ANTIBODY CAMPYLOBACTER,,30,,,$350.40,$0.00,1,0,1,20161001, 86628,CPT,ANTIBODY CANDIDA,,30,,,$335.49,$0.00,1,0,1,20161001, 86631,CPT,ANTIBODY CHLAMYDIA,,30,,,$231.12,$0.00,1,0,1,20161001, 86632,CPT,ANTIBODY CHLAMYDIA IGM,,30,,,$260.94,$0.00,1,0,1,20161001, 86635,CPT,ANTIBODY COCCIDIOIDES,,30,,,$335.49,$0.00,1,0,1,20161001, 86638,CPT,ANTIBODY COXIELLA BURNETII Q FEVER,,30,,,$283.31,$0.00,1,0,1,20161001, 86641,CPT,ANTIBODY CRYPTOCOCCUS,,30,,,$223.66,$0.00,1,0,1,20161001, 86644,CPT,ANTIBODY CYTOMEGALOVIRUS CMV,,30,,,$342.95,$0.00,1,0,1,20161001, 86645,CPT,ANTIBODY CYTOMEGALOVIRUS CMV IGM,,30,,,$357.86,$0.00,1,0,1,20161001, 86648,CPT,ANTIBODY DIPHTHERIA,,30,,,$313.13,$0.00,1,0,1,20161001, 86651,CPT,ANTIBODY ENCEPHALITIS CALIFORNIA LA CROSSE,,30,,,$268.39,$0.00,1,0,1,20161001, 86652,CPT,ANTIBODY ENCEPHALITIS EASTERN EQUINE,,30,,,$268.39,$0.00,1,0,1,20161001, 86653,CPT,ANTIBODY ENCEPHALITIS ST. LOUIS,,30,,,$268.39,$0.00,1,0,1,20161001, 86654,CPT,ANTIBODY ENCEPHALITIS WESTRN EQUINE,,30,,,$268.39,$0.00,1,0,1,20161001, 86658,CPT,ANTIBODY ENTEROVIRUS,,30,,,$268.39,$0.00,1,0,1,20161001, 86663,CPT,ANTIBODY EPSTEIN-BARR EB VIRUS EARLY ANTIGEN EA,,30,,,$342.95,$0.00,1,0,1,20161001, 86664,CPT,ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA,,30,,,$342.95,$0.00,1,0,1,20161001, 86665,CPT,ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA,,30,,,$387.68,$0.00,1,0,1,20161001, 86666,CPT,ANTIBODY EHRLICHIA,,30,,,$342.95,$0.00,1,0,1,20161001, 86668,CPT,ANTIBODY FRANCISELLA TULARENSIS,,30,,,$268.39,$0.00,1,0,1,20161001, 86671,CPT,ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED,,30,,,$372.77,$0.00,1,0,1,20161001, 86674,CPT,ANTIBODY GIARDIA LAMBLIA,,30,,,$298.22,$0.00,1,0,1,20161001, 86677,CPT,ANTIBODY HELICOBACTER PYLORI,,30,,,$372.77,$0.00,1,0,1,20161001, 86682,CPT,ANTIBODY HELMINTH NOT ELSEWHERE SPECIFIED,,30,,,$372.77,$0.00,1,0,1,20161001, 86684,CPT,ANTIBODY HAEMOPHILUS INFLUENZA,,30,,,$372.77,$0.00,1,0,1,20161001, 86687,CPT,ANTIBODY HTLV-I,,30,,,$298.22,$0.00,1,0,1,20161001, 86688,CPT,ANTIBODY HTLV-II,,30,,,$283.31,$0.00,1,0,1,20161001, 86689,CPT,ANTIBODY HTLV/HIV ANTIBODY CONFIRMATORY TEST,,30,,,$395.14,$0.00,1,0,1,20161001, 86692,CPT,ANTIBODY HEP DELTA AGENT,,30,,,$395.14,$0.00,1,0,1,20161001, 86694,CPT,ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST,,30,,,$328.04,$0.00,1,0,1,20161001, 86695,CPT,ANTIBODY HERPES SMPLX TYPE 1,,30,,,$328.04,$0.00,1,0,1,20161001, 86696,CPT,ANTIBODY HERPES SMPLX TYPE 2,,30,,,$328.04,$0.00,1,0,1,20161001, 86698,CPT,ANTIBODY HISTOPLASMA,,30,,,$298.22,$0.00,1,0,1,20161001, 86701,CPT,ANTIBODY HIV-1,,30,,,$253.48,$0.00,1,0,1,20161001, 86702,CPT,ANTIBODY HIV-2,,30,,,$342.95,$0.00,1,0,1,20161001, 86703,CPT,ANTIBODY HIV-1&HIV-2 SINGLE RESULT,,30,,,$298.22,$0.00,1,0,1,20161001, 86704,CPT,HEPATITIS B CORE ANTIBODY HBCAB TOTAL,,30,,,$260.94,$0.00,1,0,1,20161001, 86705,CPT,HEPATITIS B CORE ANTIBODY HBCAB IGM ANTIBODY,,30,,,$283.31,$0.00,1,0,1,20161001, 86706,CPT,HEPATITIS B SURF ANTIBODY HBSAB,,30,,,$231.12,$0.00,1,0,1,20161001, 86707,CPT,HEPATITIS BE ANTIBODY HBEAB,,30,,,$253.48,$0.00,1,0,1,20161001, 86708,CPT,HEPATITIS A ANTIBODY HAAB,,30,,,$275.85,$0.00,1,0,1,20161001, 86709,CPT,HEPATITIS ANTIBODY HAAB IGM ANTIBODY,,30,,,$260.94,$0.00,1,0,1,20161001, 86710,CPT,ANTIBODY INFLUENZA VIRUS,,30,,,$246.03,$0.00,1,0,1,20161001, 86711,CPT,ANTIBODY JOHN CUNNINGHAM VIRUS,,30,,,$879.21,$0.00,1,0,1,20161001, 86713,CPT,ANTIBODY LEGIONELLA,,30,,,$298.22,$0.00,1,0,1,20161001, 86717,CPT,ANTIBODY LEISHMANIA,,30,,,$246.03,$0.00,1,0,1,20161001, 86720,CPT,ANTIBODY LEPTOSPIRA,,30,,,$246.03,$0.00,1,0,1,20161001, 86723,CPT,ANTIBODY LISTERIA MONOCYTOGENES,,30,,,$246.03,$0.00,1,0,1,20161001, 86727,CPT,ANTIBODY LYMPHOCYTIC CHORIOMENINGITIS,,30,,,$246.03,$0.00,1,0,1,20161001, 86729,CPT,ANTIBODY LYMPHOGRANULOMA VENEREUM,,30,,,$246.03,$0.00,1,0,1,20161001, 86732,CPT,ANTIBODY MUCORMYCOSIS,,30,,,$328.04,$0.00,1,0,1,20161001, 86735,CPT,ANTIBODY MUMPS,,30,,,$298.22,$0.00,1,0,1,20161001, 86738,CPT,ANTIBODY MYCOPLSM,,30,,,$298.22,$0.00,1,0,1,20161001, 86741,CPT,ANTIBODY NEISSERIA MENINGITIDIS,,30,,,$298.22,$0.00,1,0,1,20161001, 86744,CPT,ANTIBODY NOCARDIA,,30,,,$298.22,$0.00,1,0,1,20161001, 86747,CPT,ANTIBODY PARVOVIRUS,,30,,,$350.40,$0.00,1,0,1,20161001, 86750,CPT,ANTIBODY PLASMODIUM MALARIA,,30,,,$328.04,$0.00,1,0,1,20161001, 86753,CPT,ANTIBODY PROTOZOA NES,,30,,,$372.77,$0.00,1,0,1,20161001, 86756,CPT,ANTIBODY RESPIRATORY SYNCTIAL VIRUS,,30,,,$298.22,$0.00,1,0,1,20161001, 86757,CPT,ANTIBODY RICKETTSIA,,30,,,$298.22,$0.00,1,0,1,20161001, 86759,CPT,ANTIBODY ROTAVIRUS,,30,,,$298.22,$0.00,1,0,1,20161001, 86762,CPT,ANTIBODY RUBELLA,,30,,,$178.93,$0.00,1,0,1,20161001, 86765,CPT,ANTIBODY RUBEOLA,,30,,,$313.13,$0.00,1,0,1,20161001, 86768,CPT,ANTIBODY SALMONELLA,,30,,,$246.03,$0.00,1,0,1,20161001, 86771,CPT,ANTIBODY SHIGELLA,,30,,,$246.03,$0.00,1,0,1,20161001, 86774,CPT,ANTIBODY TETANUS,,30,,,$335.49,$0.00,1,0,1,20161001, 86777,CPT,ANTIBODY TOXOPLASMA,,30,,,$246.03,$0.00,1,0,1,20161001, 86778,CPT,ANTIBODY TOXOPLASMA IGM,,30,,,$320.58,$0.00,1,0,1,20161001, 86780,CPT,ANTIBODY TREPONEMA PALLIDUM,,30,,,$253.48,$0.00,1,0,1,20161001, 86784,CPT,ANTIBODY TRICHINELLA,,30,,,$268.39,$0.00,1,0,1,20161001, 86787,CPT,ANTIBODY VARICELLA-ZOSTER,,30,,,$305.67,$0.00,1,0,1,20161001, 86788,CPT,ANTIBODY WEST NILE VIRUS IGM,,30,,,$320.58,$0.00,1,0,1,20161001, 86789,CPT,ANTIBODY WEST NILE VIRUS,,30,,,$320.58,$0.00,1,0,1,20161001, 86790,CPT,ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED,,30,,,$298.22,$0.00,1,0,1,20161001, 86793,CPT,ANTIBODY YERSINIA,,30,,,$260.94,$0.00,1,0,1,20161001, 86800,CPT,THYROGLOBULIN ANTIBODY,,30,,,$320.58,$0.00,1,0,1,20161001, 86803,CPT,HEPATITIS C ANTIBODY,,30,,,$365.31,$0.00,1,0,1,20161001, 86804,CPT,HEPATITIS C ANTIBODY CONFIRMATORY TEST,,30,,,$581.52,$0.00,1,0,1,20161001, 86805,CPT,LYMPHOCYTOTOXICITY ASSAY VIS CROSSMATCH TITRATJ,,30,,,$894.65,$0.00,1,0,1,20161001, 86806,CPT,LMPHOCYTOTOXICITY ASSAY VIS CROSSMTCH W/O TITRAT,,30,,,$894.65,$0.00,1,0,1,20161001, 86807,CPT,SERUM SCREENING % REACTIVE ANTIBODY STANDRD METH,,30,,,$596.43,$0.00,1,0,1,20161001, 86808,CPT,SERUM SCREENING % REACTIVE ANTIBODY QUICK METH,,30,,,$484.60,$0.00,1,0,1,20161001, 86812,CPT,HLA TYPING A/B/C SINGLE ANTIGEN,,30,,,$469.69,$0.00,1,0,1,20161001, 86813,CPT,HLA TYPING A/B/C MULTIPLE ANTIGENS,,30,,,$820.09,$0.00,1,0,1,20161001, 86816,CPT,HLA TYPING DR/DQ SINGLE ANTIGEN,,30,,,$633.71,$0.00,1,0,1,20161001, 86817,CPT,HLA TYPING DR/DQ MULTIPLE ANTIGENS,,30,,,"$1,714.74",$0.00,1,0,1,20161001, 86821,CPT,HLA TYPING LYMPHOCYTE CULTURE MIXED,,30,,,"$1,267.42",$0.00,1,0,1,20161001, 86822,CPT,HLA TYPING LYMPHOCYTE CULTURE PRIMED,,30,,,$521.88,$0.00,1,0,1,20161001, 86825,CPT,HLA CROSSMATCH NONCYTOTOXIC 1ST SERUM/DILUTION,,30,,,$997.90,$0.00,1,0,1,20161001, 86826,CPT,HLA CROSSMATCH NONCYTOTOXIC ADDL SERUM/DILUTION,,30,,,$352.54,$0.00,1,0,1,20161001, 86828,CPT,ANTIBODY HLA CLASS I & CLASS II ANTIGENS QUAL,,30,,,$709.67,$0.00,1,0,1,20161001, 86829,CPT,ANTIBODY HLA CLASS I OR CLASS II ANTIGENS QUAL,,30,,,$486.89,$0.00,1,0,1,20161001, 86830,CPT,ANTIBODY HLA CLASS I PHENOTYPE PANEL QUALITATIVE,,30,,,$621.36,$0.00,1,0,1,20161001, 86831,CPT,ANTIBODY HLA CLASS II PHENOTYPE PANEL QUAL,,30,,,$501.82,$0.00,1,0,1,20161001, 86832,CPT,ANTIBODY HLA CLASS I HIGH DEFINITION PANEL QUAL,,30,,,"$1,248.23",$0.00,1,0,1,20161001, 86833,CPT,ANTIBODY HLA CLASS II HIGH DEFINITION PANEL QUAL,,30,,,"$1,234.45",$0.00,1,0,1,20161001, 86834,CPT,ANTIBODY HLA CLASS I SEMIQUANTITATIVE PANEL,,30,,,"$2,476.13",$0.00,1,0,1,20161001, 86835,CPT,ANTIBODY HLA CLASS II SEMIQUANTITATIVE PANEL,,30,,,"$1,876.37",$0.00,1,0,1,20161001, 86849,CPT,UNLISTED IMMUNOLOGY,,30,,,$329.43,$0.00,1,0,1,20161001, 86850,CPT,ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE,,30,,,$315.58,$0.00,1,0,1,20161001, 86860,CPT,ANTIBODY ELUTION RBC EACH ELUTION,,30,,,$226.03,$0.00,1,0,1,20161001, 86870,CPT,ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 86880,CPT,ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM,,30,,,$306.21,$0.00,1,0,1,20161001, 86885,CPT,ANTIHUMAN GLOBULIN INDIR QUAL EA REAGENT CELL,,30,,,$226.03,$0.00,1,0,1,20161001, 86886,CPT,ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER,,30,,,$424.20,$0.00,1,0,1,20161001, 86890,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE PREDEPOSITED,,30,,,"$1,312.42",$0.00,1,0,1,20161001, 86891,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE SALVAGE,,30,,,"$2,780.86",$0.00,1,0,1,20161001, 86900,CPT,BLOOD TYPING SEROLOGIC ABO,,30,,,$306.21,$0.00,1,0,1,20161001, 86901,CPT,BLOOD TYPING SEROLOGIC RH (D),,30,,,$156.54,$0.00,1,0,1,20161001, 86902,CPT,BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH,,30,,,$226.03,$0.00,1,0,1,20161001, 86904,CPT,BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT,,30,,,$155.67,$0.00,1,0,1,20161001, 86905,CPT,BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH,,30,,,$226.03,$0.00,1,0,1,20161001, 86906,CPT,BLOOD TYPING SEROLOGIC RH PHENOTYPING COMPLETE,,30,,,$156.54,$0.00,1,0,1,20161001, 86910,CPT,BLOOD TYPING PATERNITY PR INDIV ABO RH&MN,,30,,,$164.02,$0.00,1,0,1,20161001, 86911,CPT,BLOOD TYPING PATERNITY INDIV ADDL ANTIGEN SYS,,30,,,$141.65,$0.00,1,0,1,20161001, 86920,CPT,COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE,,30,,,$226.03,$0.00,1,0,1,20161001, 86921,CPT,COMPATIBILITY EACH UNIT INCUBATION,,30,,,$226.03,$0.00,1,0,1,20161001, 86922,CPT,COMPATIBILITY EACH UNIT ANTIGLOBULIN,,30,,,$226.03,$0.00,1,0,1,20161001, 86923,CPT,COMPATIBILITY EACH UNIT ELECTRONIC,,30,,,$226.03,$0.00,1,0,1,20161001, 86927,CPT,FRESH FROZEN PLASMA THAWING EACH UNIT,,30,,,"$1,312.42",$0.00,1,0,1,20161001, 86930,CPT,FROZEN BLOOD EACH UNIT FREEZING,,30,,,$226.03,$0.00,1,0,1,20161001, 86931,CPT,FROZEN BLOOD EACH UNIT THAWING,,30,,,"$1,312.42",$0.00,1,0,1,20161001, 86932,CPT,FROZEN BLOOD EACH UNIT FREEZING & THAWING,,30,,,$156.54,$0.00,1,0,1,20161001, 86940,CPT,HEMOLYSINS&AGGLUTININS AUTO SCREEN EACH,,30,,,$134.20,$0.00,1,0,1,20161001, 86941,CPT,HEMOLYSINS&AGGLUTININS INCUBATED,,30,,,$178.93,$0.00,1,0,1,20161001, 86945,CPT,IRRADIATION BLOOD PRODUCT EACH UNIT,,30,,,$156.54,$0.00,1,0,1,20161001, 86950,CPT,LEUKOCYTE TRANSFUSION,,30,,,$226.03,$0.00,1,0,1,20161001, 86960,CPT,VOLUME REDUCTION BLOOD/BLOOD PRODUCT EACH UNIT,,30,,,$226.03,$0.00,1,0,1,20161001, 86965,CPT,POOLING PLATELETS/OTHER BLOOD PRODUCTS,,30,,,$226.03,$0.00,1,0,1,20161001, 86970,CPT,PRETX RBC ANTIBODY INCUBAT W/CHEM AGNTS/DRUGS EA,,30,,,$155.67,$0.00,1,0,1,20161001, 86971,CPT,PRETX RBC ANTIBODY INCUBAT W/ENZYMES EACH,,30,,,$226.03,$0.00,1,0,1,20161001, 86972,CPT,PRETX RBC ANTIBODY INCUBAT W/DENSITY GRAD SEP,,30,,,$226.03,$0.00,1,0,1,20161001, 86975,CPT,PRETX SERUM RBC ANTIBODY INCUBATION DRUGS EACH,,30,,,$156.54,$0.00,1,0,1,20161001, 86976,CPT,PRETX SERUM RBC ANTIBODY IDENTIFICATION DILUTION,,30,,,$156.54,$0.00,1,0,1,20161001, 86977,CPT,PRETX SERUM RBC ANTB ID INCUBATION INHIBITORS EA,,30,,,$226.03,$0.00,1,0,1,20161001, 86978,CPT,PRETX SERUM RBC ANTIBODY ID DIFFIAL EACH ABSRPJ,,30,,,$82.55,$0.00,1,0,1,20161001, 86985,CPT,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,,30,,,$424.20,$0.00,1,0,1,20161001, 86999,CPT,UNLISTED TRANSFUSION MEDICINE PROCEDURE,,30,,,$81.90,$0.00,1,0,1,20161001, 87003,CPT,ANIMAL INOCULATION SMALL ANIMAL W/OBS&DSJ,,30,,,$253.60,$0.00,1,0,1,20161001, 87015,CPT,CONCENTRATION INFECTIOUS AGENTS,,30,,,$152.16,$0.00,1,0,1,20161001, 87040,CPT,CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES,,30,,,$202.88,$0.00,1,0,1,20161001, 87045,CPT,CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL,,30,,,$202.88,$0.00,1,0,1,20161001, 87046,CPT,CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA,,30,,,$202.88,$0.00,1,0,1,20161001, 87070,CPT,CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL,,30,,,$195.64,$0.00,1,0,1,20161001, 87071,CPT,CUL BACT QUAN AEROBIC ISOL XCPT UR BLOOD/STOOL,,30,,,$202.88,$0.00,1,0,1,20161001, 87073,CPT,CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL,,30,,,$217.37,$0.00,1,0,1,20161001, 87075,CPT,CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID,,30,,,$217.37,$0.00,1,0,1,20161001, 87076,CPT,CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL,,30,,,$217.37,$0.00,1,0,1,20161001, 87077,CPT,CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL,,30,,,$217.37,$0.00,1,0,1,20161001, 87081,CPT,CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ,,30,,,$130.42,$0.00,1,0,1,20161001, 87084,CPT,CUL PRSMPTV PTHGNC ORGANISMS SCR DNS CHART,,30,,,$144.92,$0.00,1,0,1,20161001, 87086,CPT,CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE,,30,,,$181.14,$0.00,1,0,1,20161001, 87088,CPT,CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE,,30,,,$173.90,$0.00,1,0,1,20161001, 87101,CPT,CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL,,30,,,$181.14,$0.00,1,0,1,20161001, 87102,CPT,CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD,,30,,,$188.39,$0.00,1,0,1,20161001, 87103,CPT,CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD,,30,,,$188.39,$0.00,1,0,1,20161001, 87106,CPT,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST,,30,,,$195.64,$0.00,1,0,1,20161001, 87107,CPT,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM MOLD,,30,,,$195.64,$0.00,1,0,1,20161001, 87109,CPT,CULTURE MYCOPLASMA ANY SOURCE,,30,,,$398.52,$0.00,1,0,1,20161001, 87110,CPT,CULTURE CHLAMYDIA ANY SOURCE,,30,,,$275.34,$0.00,1,0,1,20161001, 87116,CPT,CULTURE TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL,,30,,,$217.37,$0.00,1,0,1,20161001, 87118,CPT,CULTURE MYCOBACTERIAL DEFINITIVE ID EA ISOL,,30,,,$202.88,$0.00,1,0,1,20161001, 87140,CPT,CULTURE TYPING IMMUNOFLUORESCENT EACH ANTISERUM,,30,,,$152.16,$0.00,1,0,1,20161001, 87143,CPT,CULTURE TYPING GAS/HIGH PRES LIQ CHROMATOGRAPHY,,30,,,$282.58,$0.00,1,0,1,20161001, 87147,CPT,CULTURE TYPING IMMUNOLOGIC OTH/THN IMMUNOFLUORES,,30,,,$115.93,$0.00,1,0,1,20161001, 87149,CPT,CULTURE TYPING NUCLEIC ACID PROBE DIR EA ORGANSM,,30,,,$275.34,$0.00,1,0,1,20161001, 87150,CPT,CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM,,30,,,$289.83,$0.00,1,0,1,20161001, 87152,CPT,CULTURE TYPING IDENTIFJ PULSE FIELD GEL TYPING,,30,,,$101.44,$0.00,1,0,1,20161001, 87153,CPT,CULTYP NUCLEIC ACID SEQUENCING METH EA ISOLATE,,30,,,$304.32,$0.00,1,0,1,20161001, 87158,CPT,CULTURE TYPING OTHER METHODS,,30,,,$108.69,$0.00,1,0,1,20161001, 87164,CPT,DARK FIELD EXAM ANY SOURCE W/SPECIMEN COLLECTION,,30,,,$43.47,$0.00,1,0,1,20161001, 87166,CPT,DARK FIELD EXAM ANY SOURCE W/O SPECIMEN COLLECT,,30,,,$202.88,$0.00,1,0,1,20161001, 87168,CPT,MACROSCOPIC EXAMINATION ARTHROPOD,,30,,,$108.69,$0.00,1,0,1,20161001, 87169,CPT,MACROSCOPIC EXAMINATION PARASITE,,30,,,$108.69,$0.00,1,0,1,20161001, 87172,CPT,PINWORM EXAMINATION,,30,,,$108.69,$0.00,1,0,1,20161001, 87176,CPT,HOMOGENIZATION TISSUE CULTURE,,30,,,$130.42,$0.00,1,0,1,20161001, 87177,CPT,OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID,,30,,,$195.64,$0.00,1,0,1,20161001, 87181,CPT,SUSCEPTBILTY STDY ANTIMICRBIAL AGNT AGAR DILUTJ,,30,,,$108.69,$0.00,1,0,1,20161001, 87184,CPT,SUSCEPTIBILITY STUDY ANTIMICROBIAL DISK METHOD,,30,,,$144.92,$0.00,1,0,1,20161001, 87185,CPT,SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ,,30,,,$123.18,$0.00,1,0,1,20161001, 87186,CPT,SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ,,30,,,$166.65,$0.00,1,0,1,20161001, 87187,CPT,SUSCEPTIBLTY STDY ANTMCRB MICRO/AGAR DILUTJ EA,,30,,,$166.65,$0.00,1,0,1,20161001, 87188,CPT,SC STD ANTMCRB AGT MACROBROTH DIL METH EA AGT,,30,,,$166.65,$0.00,1,0,1,20161001, 87190,CPT,SUSCEPTIBLTY STDY ANTMCRB MYCOBACT PROPORJ MTHD,,30,,,$115.93,$0.00,1,0,1,20161001, 87197,CPT,SERUM BACTERICIDAL TITER,,30,,,$231.86,$0.00,1,0,1,20161001, 87205,CPT,SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL,,30,,,$108.69,$0.00,1,0,1,20161001, 87206,CPT,SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASIT,,30,,,$130.42,$0.00,1,0,1,20161001, 87207,CPT,SMR PRIM SRC SPEC STAIN BODIES/PARASITS,,30,,,$202.88,$0.00,1,0,1,20161001, 87209,CPT,SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS,,30,,,$130.42,$0.00,1,0,1,20161001, 87210,CPT,SMR PRIM SRC WET MOUNT NFCT AGT,,30,,,$94.19,$0.00,1,0,1,20161001, 87220,CPT,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,,30,,,$108.69,$0.00,1,0,1,20161001, 87230,CPT,TOXIN/ANTITOXIN ASSAY TISSUE CULTURE,,30,,,$326.06,$0.00,1,0,1,20161001, 87250,CPT,VIRUS INOCULATION EGGS/SM ANIMAL OBS&DSJ,,30,,,$362.29,$0.00,1,0,1,20161001, 87252,CPT,VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT,,30,,,$362.29,$0.00,1,0,1,20161001, 87253,CPT,VIRUS TISSUE CULTURE ADDL STDY/ID EACH ISOLATE,,30,,,$362.29,$0.00,1,0,1,20161001, 87254,CPT,VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA,,30,,,$362.29,$0.00,1,0,1,20161001, 87255,CPT,VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,,30,,,$362.29,$0.00,1,0,1,20161001, 87260,CPT,IAADI ADENOVIRUS,,30,,,$289.83,$0.00,1,0,1,20161001, 87265,CPT,IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS,,30,,,$289.83,$0.00,1,0,1,20161001, 87267,CPT,IAADI ENTEROVIRUS DIRECT FLUORESCENT ANTIBODY,,30,,,$289.83,$0.00,1,0,1,20161001, 87269,CPT,IAADI GIARDIA,,30,,,$289.83,$0.00,1,0,1,20161001, 87270,CPT,IAADI CHLAMYDIA TRACHOMATIS,,30,,,$289.83,$0.00,1,0,1,20161001, 87271,CPT,IAADI CYTOMEGALOVIRUS DIR FLUORESCENT ANTIBODY,,30,,,$347.80,$0.00,1,0,1,20161001, 87272,CPT,IAADI CRYPTOSPORIDIUM,,30,,,$289.83,$0.00,1,0,1,20161001, 87273,CPT,IAADI HERPES SMPLX VIRUS TYPE 2,,30,,,$289.83,$0.00,1,0,1,20161001, 87274,CPT,IAADI HERPES SMPLX VIRUS TYPE 1,,30,,,$289.83,$0.00,1,0,1,20161001, 87275,CPT,IAADI INFLUENZA B VIRUS,,30,,,$289.83,$0.00,1,0,1,20161001, 87276,CPT,IAADI INFFLUENZA A VIRUS,,30,,,$289.83,$0.00,1,0,1,20161001, 87277,CPT,IAADI LEGIONELLA MICDADEI,,30,,,$253.60,$0.00,1,0,1,20161001, 87278,CPT,IAADI LEGIONELLA PNEUMOPHILA,,30,,,$289.83,$0.00,1,0,1,20161001, 87279,CPT,IAADI PARAINFLUENZA VIRUS EACH TYPE,,30,,,$289.83,$0.00,1,0,1,20161001, 87280,CPT,IAADI RESPIRATORY SYNCTIAL VIRUS,,30,,,$289.83,$0.00,1,0,1,20161001, 87281,CPT,IAADI PNEUMOCUSTIS CARINII,,30,,,$289.83,$0.00,1,0,1,20161001, 87283,CPT,IAADI RUBEOLA,,30,,,$289.83,$0.00,1,0,1,20161001, 87285,CPT,IAADI TREPONEMA PALLIDUM,,30,,,$326.06,$0.00,1,0,1,20161001, 87290,CPT,IAADI VARICELLA ZOSTER VIRUS,,30,,,$289.83,$0.00,1,0,1,20161001, 87299,CPT,IAADI NOT OTHERWISE SPECIFIED EACH ORGANISM,,30,,,$318.81,$0.00,1,0,1,20161001, 87300,CPT,IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM,,30,,,$231.86,$0.00,1,0,1,20161001, 87301,CPT,IAAD IA ADENOVIRUS ENTERIC TYP 40/41,,30,,,$231.86,$0.00,1,0,1,20161001, 87305,CPT,IAAD IA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS,,30,,,$231.86,$0.00,1,0,1,20161001, 87320,CPT,IAAD IA CHLAMYDIA TRACHOMATIS,,30,,,$231.86,$0.00,1,0,1,20161001, 87324,CPT,IAAD IA CLOSTRIDIUM DIFFICILE TOXIN,,30,,,$231.86,$0.00,1,0,1,20161001, 87327,CPT,IAAD IA CRYPTOCOCCUS NEOFORMANS,,30,,,$231.86,$0.00,1,0,1,20161001, 87328,CPT,IAAD IA CRYPTOSPORIDIUM,,30,,,$231.86,$0.00,1,0,1,20161001, 87329,CPT,IAAD IA GIARDIA,,30,,,$231.86,$0.00,1,0,1,20161001, 87332,CPT,IAAD IA CYTOMEGALOVIRUS,,30,,,$231.86,$0.00,1,0,1,20161001, 87335,CPT,IAAD IA ESCHERICHIA COLI 0157,,30,,,$231.86,$0.00,1,0,1,20161001, 87336,CPT,IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP,,30,,,$231.86,$0.00,1,0,1,20161001, 87337,CPT,IAAD IA ENTAMOEBA HISTOLYTICA GRP,,30,,,$231.86,$0.00,1,0,1,20161001, 87338,CPT,IAAD IA HPYLORI STOOL,,30,,,$231.86,$0.00,1,0,1,20161001, 87339,CPT,IAAD IA HPYLORI,,30,,,$231.86,$0.00,1,0,1,20161001, 87340,CPT,IAAD IA HEPATITIS B SURFACE ANTIGEN,,30,,,$231.86,$0.00,1,0,1,20161001, 87341,CPT,IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION,,30,,,$231.86,$0.00,1,0,1,20161001, 87350,CPT,IAAD IA HEPATITIS BE ANTIGEN,,30,,,$246.36,$0.00,1,0,1,20161001, 87380,CPT,IAAD IA HEPATITIS DELTA ANTIGEN,,30,,,$326.06,$0.00,1,0,1,20161001, 87385,CPT,IAAD IA HISTOPLASM CAPSULATUM,,30,,,$231.86,$0.00,1,0,1,20161001, 87389,CPT,IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE,,30,,,$247.18,$0.00,1,0,1,20161001, 87390,CPT,IAAD IA HIV-1,,30,,,$362.29,$0.00,1,0,1,20161001, 87391,CPT,IAAD IA HIV-2,,30,,,$340.55,$0.00,1,0,1,20161001, 87400,CPT,IAAD IA INFLUENZA A/B EACH,,30,,,$231.86,$0.00,1,0,1,20161001, 87420,CPT,IAAD IA RESPIRATORY SYNCTIAL VIRUS,,30,,,$231.86,$0.00,1,0,1,20161001, 87425,CPT,IAAD IA ROTAVIRUS,,30,,,$231.86,$0.00,1,0,1,20161001, 87427,CPT,IAAD IA SHIGA-LIKE TOXIN,,30,,,$231.86,$0.00,1,0,1,20161001, 87430,CPT,IAAD IA STREPTOCOCCUS GROUP A,,30,,,$173.90,$0.00,1,0,1,20161001, 87449,CPT,IAAD IA MULT STEP METHOD NOS EACH ORGANISM,,30,,,$231.86,$0.00,1,0,1,20161001, 87450,CPT,IAAD IA SINGLE STEP METHOD NOS EA ORGANISM,,30,,,$231.86,$0.00,1,0,1,20161001, 87451,CPT,IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM,,30,,,$231.86,$0.00,1,0,1,20161001, 87470,CPT,IADNA BARTONELLA DIRECT PROBE TECHNIQUE,,30,,,$289.83,$0.00,1,0,1,20161001, 87471,CPT,IADNA BARTONELLA AMPLIFIED PROBE TECHNIQUE,,30,,,$652.12,$0.00,1,0,1,20161001, 87472,CPT,IADNA BARTONELLA HENSELAE&QUINTANA QUANTJ,,30,,,$579.66,$0.00,1,0,1,20161001, 87475,CPT,IADNA BORRELIA BURGDORFERI DIRECT PROBE TQ,,30,,,$362.29,$0.00,1,0,1,20161001, 87476,CPT,IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ,,30,,,$760.81,$0.00,1,0,1,20161001, 87477,CPT,IADNA BORRELIA BURGDORFERI QUANTIFICATION,,30,,,$583.28,$0.00,1,0,1,20161001, 87480,CPT,IADNA CANDIDA SPECIES DIRECT PROBE TQ,,30,,,$362.29,$0.00,1,0,1,20161001, 87481,CPT,IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87482,CPT,IADNA CANDIDA SPECIES QUANTIFICATION,,30,,,$507.20,$0.00,1,0,1,20161001, 87485,CPT,IADNA CHLAMYDIA PNEUMONIAE DIRECT PROBE TQ,,30,,,$326.06,$0.00,1,0,1,20161001, 87486,CPT,IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87487,CPT,IADNA CHLAMYDIA PNEUMONIAE QUANTIFICATION,,30,,,$543.43,$0.00,1,0,1,20161001, 87490,CPT,IADNA CHLAMYDIA TRACHOMATIS DIRECT PROBE TQ,,30,,,$362.29,$0.00,1,0,1,20161001, 87491,CPT,IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ,,30,,,$521.70,$0.00,1,0,1,20161001, 87492,CPT,IADNA CHLAMYDIA TRACHOMATIS QUANTIFICATION,,30,,,$543.43,$0.00,1,0,1,20161001, 87493,CPT,INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE,,30,,,$572.42,$0.00,1,0,1,20161001, 87495,CPT,IADNA CYTOMEGALOVIRUS DIRECT PROBE TQ,,30,,,$543.43,$0.00,1,0,1,20161001, 87496,CPT,IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ,,30,,,$623.14,$0.00,1,0,1,20161001, 87497,CPT,IADNA CYTOMEGALOVIRUS QUANTIFICATION,,30,,,"$1,086.87",$0.00,1,0,1,20161001, 87498,CPT,IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP,,30,,,$797.03,$0.00,1,0,1,20161001, 87500,CPT,INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE,,30,,,$797.03,$0.00,1,0,1,20161001, 87501,CPT,INFECTIOUS AGENT DNA/RNA INFLUENZA EA TYPE,,30,,,$797.03,$0.00,1,0,1,20161001, 87502,CPT,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,,30,,,$797.03,$0.00,1,0,1,20161001, 87503,CPT,NFCT AGENT DNA/RNA INFLUENZA >2 TYPES EA ADDL,,30,,,$194.48,$0.00,1,0,1,20161001, 87505,CPT,NFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN,,30,,,$613.81,$0.00,1,0,1,20161001, 87506,CPT,IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 6-11,,30,,,"$1,016.66",$0.00,1,0,1,20161001, 87507,CPT,IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25,,30,,,"$2,021.61",$0.00,1,0,1,20161001, 87510,CPT,IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ,,30,,,$362.29,$0.00,1,0,1,20161001, 87511,CPT,IADNA GARDNERELLA VAGINALIS AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87512,CPT,IADNA GARDNERELLA VAGINALIS QUANTIFICATION,,30,,,$543.43,$0.00,1,0,1,20161001, 87515,CPT,IADNA HEPATITIS B VIRUS DIRECT PROBE TECHNIQUE,,30,,,$434.75,$0.00,1,0,1,20161001, 87516,CPT,IADNA HEPATITIS B VIRUS AMPLIFIED PROBE TQ,,30,,,$811.53,$0.00,1,0,1,20161001, 87517,CPT,IADNA HEPATITIS B VIRUS QUANTIFICATION,,30,,,$883.98,$0.00,1,0,1,20161001, 87520,CPT,IADNA HEPATITIS C DIRECT PROBE TECHNIQUE,,30,,,$434.75,$0.00,1,0,1,20161001, 87521,CPT,IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR,,30,,,$811.53,$0.00,1,0,1,20161001, 87522,CPT,IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION,,30,,,$811.53,$0.00,1,0,1,20161001, 87525,CPT,IADNA HEPATITIS G DIRECT PROBE TECHNIQUE,,30,,,$362.29,$0.00,1,0,1,20161001, 87526,CPT,IADNA HEPATITIS G AMPLIFIED PROBE TECHNIQUE,,30,,,$652.12,$0.00,1,0,1,20161001, 87527,CPT,IADNA HEPATITIS G QUANTIFICATION,,30,,,$652.12,$0.00,1,0,1,20161001, 87528,CPT,IADNA HERPES SIMPLX VIRUS DIRECT PROBE TQ,,30,,,$362.29,$0.00,1,0,1,20161001, 87529,CPT,IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,,30,,,$652.12,$0.00,1,0,1,20161001, 87530,CPT,IADNA HERPES SOMPLX VIRUS QUANTIFICATION,,30,,,$652.12,$0.00,1,0,1,20161001, 87531,CPT,IADNA HERPES VIRUS-6 DIRECT PROBE TQ,,30,,,$362.29,$0.00,1,0,1,20161001, 87532,CPT,IADNA HERPES VIRUS-6 AMPLIFIED PROBE TQ,,30,,,$652.12,$0.00,1,0,1,20161001, 87533,CPT,IADNA HERPES VIRUS-6 QUANTIFICATION,,30,,,$652.12,$0.00,1,0,1,20161001, 87534,CPT,IADNA HIV-1 DIRECT PROBE TECHNIQUE,,30,,,$362.29,$0.00,1,0,1,20161001, 87535,CPT,IADNA HIV-1 AMPLIFIED PROBE & REVERSE TRANSCRPJ,,30,,,$652.12,$0.00,1,0,1,20161001, 87536,CPT,IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION,,30,,,"$1,014.41",$0.00,1,0,1,20161001, 87537,CPT,IADNA HIV-2 DIRECT PROBE TECHNIQUE,,30,,,$362.29,$0.00,1,0,1,20161001, 87538,CPT,IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ,,30,,,$652.12,$0.00,1,0,1,20161001, 87539,CPT,IADNA HIV-2 QUANT & REVERSE TRANSCRIPTION,,30,,,$724.58,$0.00,1,0,1,20161001, 87540,CPT,IADNA LEGIONELLA PNEUMOPHILA DIRECT PROBE TQ,,30,,,$289.83,$0.00,1,0,1,20161001, 87541,CPT,IADNA LEGIONELLA PNEUMOPHILA AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87542,CPT,IADNA LEGIONELLA PNEUMOPHILA QUANTIFICATION,,30,,,$579.66,$0.00,1,0,1,20161001, 87550,CPT,IADNA MYCOBACTERIA SPECIES DIRECT PROBE TQ,,30,,,$289.83,$0.00,1,0,1,20161001, 87551,CPT,IADNA MYCOBACTERIA SPECIES AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87552,CPT,IADNA MYCOBACTERIA SPECIES QUANTIFICATION,,30,,,$652.12,$0.00,1,0,1,20161001, 87555,CPT,IADNA MYCOBACTERIA TUBERCULOSIS DIR PRB,,30,,,$362.29,$0.00,1,0,1,20161001, 87556,CPT,IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB,,30,,,$652.12,$0.00,1,0,1,20161001, 87557,CPT,IADNA MYCOBACTERIA TUBERCULOSIS QUANTIFICATION,,30,,,$583.28,$0.00,1,0,1,20161001, 87560,CPT,IADNA MYCOBACTERIA AVIUM-INTRACLRE DIR PRB,,30,,,$289.83,$0.00,1,0,1,20161001, 87561,CPT,IADNA MYCOBACTERIA AVIUM-INTRACLRE AMP PRB,,30,,,$652.12,$0.00,1,0,1,20161001, 87562,CPT,IADNA MYCOBACTERIA AVIUM-INTRACELLULARE QUANT,,30,,,$652.12,$0.00,1,0,1,20161001, 87580,CPT,IADNA MYCOPLSM PNEUMONIAE DIRECT PROBE TQ,,30,,,$289.83,$0.00,1,0,1,20161001, 87581,CPT,IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ,,30,,,$652.12,$0.00,1,0,1,20161001, 87582,CPT,IADNA MYCOPLSM PNEUMONIAE QUANTIFICATION,,30,,,$579.66,$0.00,1,0,1,20161001, 87590,CPT,IADNA NEISSERIA GONORRHOEAE DIRECT PROBE TQ,,30,,,$289.83,$0.00,1,0,1,20161001, 87591,CPT,IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87592,CPT,IADNA NEISSERIA GONORRHOEAE QUANTIFICATION,,30,,,$583.28,$0.00,1,0,1,20161001, 87623,CPT,IADNA HUMAN PAPILLOMAVIRUS LOW-RISK TYPES,,30,,,$571.79,$0.00,1,0,1,20161001, 87624,CPT,IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES,,30,,,$571.79,$0.00,1,0,1,20161001, 87625,CPT,IADNA HUMAN PAPILLOMAVIRUS TYPES 16 & 18 ONLY,,30,,,$571.79,$0.00,1,0,1,20161001, 87631,CPT,IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS,,30,,,$533.97,$0.00,1,0,1,20161001, 87632,CPT,IADNA RESPIRATRY PROBE & REV TRNSCR 6-11 TARGETS,,30,,,"$1,395.22",$0.00,1,0,1,20161001, 87633,CPT,IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET,,30,,,"$1,973.98",$0.00,1,0,1,20161001, 87640,CPT,IADNA S AUREUS AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87641,CPT,IADNA S AUREUS METHICILLIN RESIST AMP PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87650,CPT,IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ,,30,,,$289.83,$0.00,1,0,1,20161001, 87651,CPT,IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87652,CPT,IADNA STREPTOCOCCUS GROUP A QUANTIFICATION,,30,,,$583.28,$0.00,1,0,1,20161001, 87653,CPT,IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ,,30,,,$579.66,$0.00,1,0,1,20161001, 87660,CPT,IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ,,30,,,$289.83,$0.00,1,0,1,20161001, 87797,CPT,IADNA NOS DIRECT PROBE TQ EACH ORGANISM,,30,,,$289.83,$0.00,1,0,1,20161001, 87798,CPT,IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM,,30,,,$579.66,$0.00,1,0,1,20161001, 87799,CPT,IADNA NOS QUANTIFICATION EACH ORGANISM,,30,,,$652.12,$0.00,1,0,1,20161001, 87800,CPT,IADNA MULTIPLE ORGANISMS DIRECT PROBE TQ,,30,,,$283.66,$0.00,1,0,1,20161001, 87801,CPT,IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,,30,,,$355.98,$0.00,1,0,1,20161001, 87802,CPT,IAADIADOO STREPTOCOCCUS GROUP B,,30,,,$289.83,$0.00,1,0,1,20161001, 87803,CPT,IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN,,30,,,$289.83,$0.00,1,0,1,20161001, 87804,CPT,IAADIADOO INFLUENZA,,30,,,$253.60,$0.00,1,0,1,20161001, 87806,CPT,IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES,,30,,,$276.08,$0.00,1,0,1,20161001, 87807,CPT,IAADIADOO RESPIRATORY SYNCTIAL VIRUS,,30,,,$289.83,$0.00,1,0,1,20161001, 87808,CPT,IAADIADOO TRICHOMONAS VAGINALIS,,30,,,$289.83,$0.00,1,0,1,20161001, 87809,CPT,INFECTIOUS AGENT IMMUNOASSAY OPTICAL ADENOVIRUS,,30,,,$289.83,$0.00,1,0,1,20161001, 87810,CPT,CHLAMYDIA TRACHOMATIS,,30,,,$289.83,$0.00,1,0,1,20161001, 87850,CPT,IAADIADOO NEISSERIA GONORRHOEAE,,30,,,$289.83,$0.00,1,0,1,20161001, 87880,CPT,IAADIADOO STREPTOCOCCUS GROUP A,,30,,,$253.60,$0.00,1,0,1,20161001, 87899,CPT,IAADIADOO NOT OTHERWISE SPECIFIED,,30,,,$253.60,$0.00,1,0,1,20161001, 87900,CPT,NFCT AGT DRUG SUSCEPT PHENOTYPE PREDICTION,,30,,,$702.78,$0.00,1,0,1,20161001, 87901,CPT,NFCT GEXYP NUCLEIC ACID HIV REV TRNSCR&PROTEAS,,30,,,"$3,217.12",$0.00,1,0,1,20161001, 87902,CPT,NFCT AGNT GENOTYP NUCLEIC ACID HEPATITIS C VIRUS,,30,,,"$3,217.12",$0.00,1,0,1,20161001, 87903,CPT,NFCT PHEXYP RESIST TISS CUL HIV FIRST 1-10 DRUGS,,30,,,"$5,796.61",$0.00,1,0,1,20161001, 87904,CPT,NFCT PHEXYP RESIST TISS CUL HIV EA ADDL DRUG,,30,,,$652.12,$0.00,1,0,1,20161001, 87905,CPT,INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS,,30,,,$362.29,$0.00,1,0,1,20161001, 87906,CPT,NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,,30,,,$362.29,$0.00,1,0,1,20161001, 87910,CPT,NFCT AGT GENOTYPE NUCLEIC ACID CYTOMEGALOVIRUS,,30,,,"$1,470.45",$0.00,1,0,1,20161001, 87912,CPT,NFCT AGENT GENOTYPE HEPATITIS B VIRUS,,30,,,"$1,909.67",$0.00,1,0,1,20161001, 87999,CPT,UNLISTED MICROBIOLOGY,,30,,,$221.26,$0.00,1,0,1,20161001, 88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,,30,,,$156.54,$0.00,1,0,1,20161001, 88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,,30,,,$156.54,$0.00,1,0,1,20161001, 88108,CPT,CYTP CONCENTRATION SMEARS & INTERPRETATION,,30,,,$156.54,$0.00,1,0,1,20161001, 88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,,30,,,$315.58,$0.00,1,0,1,20161001, 88120,CPT,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88121,CPT,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,,30,,,$424.20,$0.00,1,0,1,20161001, 88125,CPT,CYTOPATHOLOGY FORENSIC,,30,,,$315.58,$0.00,1,0,1,20161001, 88130,CPT,SEX CHROMATIN IDENTIFICATION BARR BODIES,,30,,,$124.96,$0.00,1,0,1,20161001, 88140,CPT,SEX CHROMATIN IDENTJ PERIPHERAL BLOOD SMEAR,,30,,,$87.47,$0.00,1,0,1,20161001, 88141,CPT,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,,30,,,$125.17,$0.00,1,0,1,20161001, 88142,CPT,CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN,,30,,,$106.21,$0.00,1,0,1,20161001, 88143,CPT,CYTP C/V FLU AUTO THIN MNL SCR&RESCR PHYS,,30,,,$115.59,$0.00,1,0,1,20161001, 88147,CPT,CYTP SMRS C/V SCR AUTOMATED SYSTEM PHYS SUPV,,30,,,$110.90,$0.00,1,0,1,20161001, 88148,CPT,CYTP SMRS C/V SCR AUTO SYS MNL RESCR PHYS,,30,,,$117.15,$0.00,1,0,1,20161001, 88150,CPT,CYTP SLIDES C/V MNL SCR UNDER PHYS,,30,,,$99.97,$0.00,1,0,1,20161001, 88152,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS,,30,,,$118.71,$0.00,1,0,1,20161001, 88153,CPT,CYTP SLIDES C/V MNL SCR&RESCR PHYS,,30,,,$118.71,$0.00,1,0,1,20161001, 88154,CPT,CYTP SLIDES C/V MNL SCR&CPTR-RESCR CELL S&I,,30,,,$121.83,$0.00,1,0,1,20161001, 88155,CPT,CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL,,30,,,$74.98,$0.00,1,0,1,20161001, 88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,,30,,,$81.90,$0.00,1,0,1,20161001, 88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,,30,,,$156.54,$0.00,1,0,1,20161001, 88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,,30,,,$309.88,$0.00,1,0,1,20161001, 88164,CPT,CYTP SLIDES CERV/VAG MNL SCRN PHYSICIAN SUPV,,30,,,$106.21,$0.00,1,0,1,20161001, 88165,CPT,CYTP SLIDES C/V MNL SCR&RESCR PHYS SUPV,,30,,,$117.15,$0.00,1,0,1,20161001, 88166,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS SUPV,,30,,,$106.21,$0.00,1,0,1,20161001, 88167,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR CELL S&I,,30,,,$137.45,$0.00,1,0,1,20161001, 88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,,30,,,$424.20,$0.00,1,0,1,20161001, 88173,CPT,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,,30,,,$315.58,$0.00,1,0,1,20161001, 88174,CPT,CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS,,30,,,$118.71,$0.00,1,0,1,20161001, 88175,CPT,CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS,,30,,,$121.83,$0.00,1,0,1,20161001, 88177,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,,30,,,$31.81,$0.00,1,0,1,20161001, 88182,CPT,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,,30,,,$424.20,$0.00,1,0,1,20161001, 88184,CPT,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88185,CPT,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA,,30,,,$256.16,$0.00,1,0,1,20161001, 88187,CPT,FLOW CYTOMETRY INTERPJ 2-8 MARKERS,,30,,,$281.34,$0.00,1,0,1,20161001, 88188,CPT,FLOW CYTOMETRY INTERPJ 9-15 MARKERS,,30,,,$325.30,$0.00,1,0,1,20161001, 88189,CPT,FLOW CYTOMETRY INTERPRETATION 16/> MARKERS,,30,,,$767.48,$0.00,1,0,1,20161001, 88199,CPT,UNLISTED CYTOPATHOLOGY PROCEDURE,,30,,,$315.58,$0.00,1,0,1,20161001, 88230,CPT,TISS CUL NON-NEO DISORDERS LYMPHOCYTE,,30,,,$718.51,$0.00,1,0,1,20161001, 88233,CPT,TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX,,30,,,$718.51,$0.00,1,0,1,20161001, 88235,CPT,TISS CUL NON-NEO DISORDERS AMNIOTIC/CHORNC CELLS,,30,,,"$1,249.58",$0.00,1,0,1,20161001, 88237,CPT,TISS CUL NEO DISORDERS BONE MARROW BLOOD CELLS,,30,,,"$1,124.63",$0.00,1,0,1,20161001, 88239,CPT,TISS CUL NEO DISORDERS SOLID TUMOR,,30,,,$718.51,$0.00,1,0,1,20161001, 88240,CPT,CRYOPRSRV FRZING&STORAGE CELLS EA CELL LINE,,30,,,$624.79,$0.00,1,0,1,20161001, 88241,CPT,THAWING&EXPANSION FROZEN CELLS EACH ALIQUOT,,30,,,$468.59,$0.00,1,0,1,20161001, 88245,CPT,CHRMSM BREAKAGE BASELINE SISTER 20-25 CLL,,30,,,$843.47,$0.00,1,0,1,20161001, 88248,CPT,CHRMSM BREAKAGE BASELINE BREAKAGE 50-100 CLL,,30,,,"$1,499.50",$0.00,1,0,1,20161001, 88249,CPT,CHRMSM BREAKAGE SYNDS SCORE 100 CLL,,30,,,"$1,686.94",$0.00,1,0,1,20161001, 88261,CPT,CHRMSM COUNT 5 CELL 1KARYOTYPE BANDING,,30,,,"$1,468.26",$0.00,1,0,1,20161001, 88262,CPT,CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING,,30,,,"$1,968.09",$0.00,1,0,1,20161001, 88263,CPT,CHRMSM COUNT 45 CELL MOSAICISM 2KARYOTYPE,,30,,,"$2,024.33",$0.00,1,0,1,20161001, 88264,CPT,CHRMSM ANALYZE 20-25 CELLS,,30,,,"$1,874.38",$0.00,1,0,1,20161001, 88267,CPT,CHRMSM ALYS AMNIOTIC/VILLUS 15 CELL 1KARYOTYPE,,30,,,"$2,218.01",$0.00,1,0,1,20161001, 88269,CPT,CHRMSM SITU AMNIOTIC CLL 6-12 COLONIES 1KARYOTYP,,30,,,"$1,949.35",$0.00,1,0,1,20161001, 88271,CPT,MOLECULAR CYTOGENETICS DNA PROBE EACH,,30,,,$378.95,$0.00,1,0,1,20161001, 88272,CPT,MOLECULAR CYTOGENETICS CHRMOML ISH 3-5 CELLS,,30,,,$571.52,$0.00,1,0,1,20161001, 88273,CPT,MOLECULAR CYTOGENETICS CHRMOML ISH 10-30 CLL,,30,,,$451.29,$0.00,1,0,1,20161001, 88274,CPT,MOLECULAR CYTOGENETICS INTERPHASE ISH 25-99 CLL,,30,,,$516.75,$0.00,1,0,1,20161001, 88275,CPT,MOLEC CYTG INTERPHASE ISH ANALYZE 100-300 CLL,,30,,,$575.31,$0.00,1,0,1,20161001, 88280,CPT,CHRMSM ANALYSIS ADDL KARYOTYP EACH STUDY,,30,,,$643.54,$0.00,1,0,1,20161001, 88283,CPT,CHRMSM ANALYSIS ADDL SPECIALIZED BANDING,,30,,,$562.31,$0.00,1,0,1,20161001, 88285,CPT,CHRMSM ANALYSIS ADDL CELLS COUNTED EACH STUDY,,30,,,$562.31,$0.00,1,0,1,20161001, 88289,CPT,CHRMSM ANALYSIS ADDL HIGH RESOLUTION STUDY,,30,,,$468.59,$0.00,1,0,1,20161001, 88299,CPT,UNLISTED CYTOGENETIC STUDY,,30,,,$315.58,$0.00,1,0,1,20161001, 88300,CPT,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,,30,,,$156.54,$0.00,1,0,1,20161001, 88302,CPT,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,$156.54,$0.00,1,0,1,20161001, 88304,CPT,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,$315.58,$0.00,1,0,1,20161001, 88305,CPT,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,$315.58,$0.00,1,0,1,20161001, 88307,CPT,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88309,CPT,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 88311,CPT,DECALCIFICATION PROCEDURE,,30,,,$65.29,$0.00,1,0,1,20161001, 88312,CPT,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,,30,,,$309.88,$0.00,1,0,1,20161001, 88313,CPT,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,,30,,,$315.58,$0.00,1,0,1,20161001, 88314,CPT,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,,30,,,$506.01,$0.00,1,0,1,20161001, 88319,CPT,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 88321,CPT,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,,30,,,$156.54,$0.00,1,0,1,20161001, 88323,CPT,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,,30,,,$424.20,$0.00,1,0,1,20161001, 88325,CPT,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,,30,,,$315.58,$0.00,1,0,1,20161001, 88329,CPT,PATHOLOGY CONSULTATION DURING SURGERY,,30,,,$156.54,$0.00,1,0,1,20161001, 88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,,30,,,$424.20,$0.00,1,0,1,20161001, 88332,CPT,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,,30,,,$99.82,$0.00,1,0,1,20161001, 88333,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 88334,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,,30,,,$120.91,$0.00,1,0,1,20161001, 88341,CPT,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,,30,,,$185.67,$0.00,1,0,1,20161001, 88342,CPT,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88344,CPT,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,,30,,,"$1,312.42",$0.00,1,0,1,20161001, 88346,CPT,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88348,CPT,ELECTRON MICROSCOPY DIAGNOSTIC,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 88355,CPT,MORPHOMETRIC ANALYSIS SKELETAL MUSCLE,,30,,,$424.20,$0.00,1,0,1,20161001, 88356,CPT,MORPHOMETRIC ANALYSIS NERVE,,30,,,$424.20,$0.00,1,0,1,20161001, 88358,CPT,MORPHOMETRIC ANALYSIS TUMOR,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88360,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88361,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88362,CPT,NERVE TEASING PREPARATIONS,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 88363,CPT,EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSI,,30,,,$81.90,$0.00,1,0,1,20161001, 88364,CPT,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,,30,,,$221.80,$0.00,1,0,1,20161001, 88365,CPT,IN SITU HYBRIDIZATION 1ST PROBE STAIN,,30,,,$424.20,$0.00,1,0,1,20161001, 88366,CPT,IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN,,30,,,"$1,312.42",$0.00,1,0,1,20161001, 88367,CPT,M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88368,CPT,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 88369,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH,,30,,,$675.30,$0.00,1,0,1,20161001, 88371,CPT,PROTEIN ANAL TISSUE WESTERN BLOT W/INTERP&REPO,,30,,,$580.39,$0.00,1,0,1,20161001, 88372,CPT,PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA,,30,,,$567.05,$0.00,1,0,1,20161001, 88373,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH,,30,,,$675.30,$0.00,1,0,1,20161001, 88374,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB,,30,,,"$1,312.42",$0.00,1,0,1,20161001, 88375,CPT,OPTICAL ENDOMICROSCOPIC IMAGE INTERP & REPORT,,30,,,$202.84,$0.00,1,0,1,20161001, 88377,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,,30,,,"$1,312.42",$0.00,1,0,1,20161001, 88380,CPT,MICRODISSECTION PREP IDENTIFIED TARGET LASER,,30,,,$700.47,$0.00,1,0,1,20161001, 88381,CPT,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,,30,,,"$1,065.71",$0.00,1,0,1,20161001, 88387,CPT,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,,30,,,$53.37,$0.00,1,0,1,20161001, 88388,CPT,MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SE,,30,,,$28.35,$0.00,1,0,1,20161001, 88399,CPT,UNLISTED SURGICAL PATHOLOGY PROCEDURE,,30,,,$315.58,$0.00,1,0,1,20161001, 88720,CPT,BILIRUBIN TOTAL TRANSCUTANEOUS,,30,,,$48.23,$0.00,1,0,1,20161001, 88738,CPT,HGB QUANTITATIVE TRANSCUTANEOUS,,30,,,$53.11,$0.00,1,0,1,20161001, 88740,CPT,HEMOGLOBIN QUAN TC PER DAY CARBOXYHEMOGLOBIN,,30,,,$102.20,$0.00,1,0,1,20161001, 88749,CPT,UNLISTED IN VIVO LABORTORY SERVICE,,30,,,$27.19,$0.00,1,0,1,20161001, 89049,CPT,CAFFEINE HALOTHANE CONTRACTURE TEST,,30,,,$424.20,$0.00,1,0,1,20161001, 89050,CPT,CELL COUNT MISCELLANEOUS BODY FLUIDS,,30,,,$150.10,$0.00,1,0,1,20161001, 89051,CPT,CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT,,30,,,$158.44,$0.00,1,0,1,20161001, 89055,CPT,LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE,,30,,,$133.42,$0.00,1,0,1,20161001, 89060,CPT,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,,30,,,$58.37,$0.00,1,0,1,20161001, 89125,CPT,FAT STAIN FECES URINE/RESPIR SECRETIONS,,30,,,$150.10,$0.00,1,0,1,20161001, 89160,CPT,MEAT FIBERS FECES,,30,,,$100.07,$0.00,1,0,1,20161001, 89190,CPT,NASAL SMEAR EOSINOPHILS,,30,,,$116.74,$0.00,1,0,1,20161001, 89220,CPT,SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX,,30,,,$424.20,$0.00,1,0,1,20161001, 89230,CPT,SWEAT COLLECTION IONTOPHORESIS,,30,,,$315.58,$0.00,1,0,1,20161001, 89240,CPT,UNLIS MISC PATH,,30,,,$315.58,$0.00,1,0,1,20161001, 89250,CPT,CUL OOCYTE/EMBRYO <4 DAYS,,30,,,$424.20,$0.00,1,0,1,20161001, 89251,CPT,CUL OOCYTE/EMBRYO < 4 D CO-CULT OCYTE/EMBRY,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 89253,CPT,ASSTD EMBRYO HATCHING MICROTQS ANY METH,,30,,,$424.20,$0.00,1,0,1,20161001, 89254,CPT,OOCYTE ID FROM FOLLICULAR FLU,,30,,,$424.20,$0.00,1,0,1,20161001, 89255,CPT,PREPJ EMBRYO TR,,30,,,$424.20,$0.00,1,0,1,20161001, 89257,CPT,SPRM ID FROM ASPIR OTH/THN SEMINAL,,30,,,$315.58,$0.00,1,0,1,20161001, 89258,CPT,CRYOPRSRV EMBRYO,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 89259,CPT,CRYOPRSRV SPRM,,30,,,$424.20,$0.00,1,0,1,20161001, 89260,CPT,SPRM ISOL SMPL PREP INSEMINATION/DX SEMEN ALYS,,30,,,$315.58,$0.00,1,0,1,20161001, 89261,CPT,SPRM ISOL CPLX PREP INSEMINATION/DX SEMEN ALYS,,30,,,$315.58,$0.00,1,0,1,20161001, 89264,CPT,SPRM ID FROM TSTIS TISS FRSH/CRYOPRSRVD,,30,,,$424.20,$0.00,1,0,1,20161001, 89268,CPT,INSEMINATION OOCYTES,,30,,,$424.20,$0.00,1,0,1,20161001, 89272,CPT,EXTND CUL OOCYTE/EMBRYO 4-7 DAYS,,30,,,"$2,777.26",$0.00,1,0,1,20161001, 89280,CPT,ASSTD FERTILIZATION MICROTQ 10 OOCYTES,,30,,,$424.20,$0.00,1,0,1,20161001, 89290,CPT,BX OOCYTE MICROTQ 5 EMBRY,,30,,,$424.20,$0.00,1,0,1,20161001, 89300,CPT,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,,30,,,$291.86,$0.00,1,0,1,20161001, 89310,CPT,SEMEN ALYS MOTILITY&CNT X W/HUHNER TST,,30,,,$275.18,$0.00,1,0,1,20161001, 89320,CPT,SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT,,30,,,$525.35,$0.00,1,0,1,20161001, 89321,CPT,SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM,,30,,,$291.86,$0.00,1,0,1,20161001, 89322,CPT,SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA,,30,,,$583.72,$0.00,1,0,1,20161001, 89325,CPT,SPERM ANTIBODIES,,30,,,$583.72,$0.00,1,0,1,20161001, 89329,CPT,SPERM EVALUATION HAMSTER PENETRATION TEST,,30,,,"$1,501.01",$0.00,1,0,1,20161001, 89330,CPT,SPERM EVALUATION CERVICAL MUCOUS PENETRATION,,30,,,$500.34,$0.00,1,0,1,20161001, 89335,CPT,CRYOPRSRV REPRODUCTIVE TISSUE TESTICULAR,,30,,,$315.58,$0.00,1,0,1,20161001, 89337,CPT,CRYOPRESERVATION MATURE OOCYTE(S),,30,,,$424.20,$0.00,1,0,1,20161001, 89342,CPT,STORAGE PER YEAR EMBRYO,,30,,,$424.20,$0.00,1,0,1,20161001, 89343,CPT,STORAGE PER YEAR SPERM/SEMEN,,30,,,$424.20,$0.00,1,0,1,20161001, 89344,CPT,STORAGE PER YR REPRDTVE TISS TSTICULAR/OVARIAN,,30,,,$424.20,$0.00,1,0,1,20161001, 89346,CPT,STORAGE PER YEAR OOCYTE,,30,,,"$1,229.40",$0.00,1,0,1,20161001, 89352,CPT,THAWING CRYOPRESERVED EMBRYO,,30,,,$424.20,$0.00,1,0,1,20161001, 89353,CPT,THAWING CRYOPRESERVED SPERM/SEMEN EACH ALIQUOT,,30,,,$315.58,$0.00,1,0,1,20161001, 89354,CPT,THAWING CRYOPRESERVED TESTICULAR/OVARIAN,,30,,,$424.20,$0.00,1,0,1,20161001, 89356,CPT,THAWING CRYOPRESERVED OOCYTES EACH ALIQUOT,,30,,,$424.20,$0.00,1,0,1,20161001, 89398,CPT,UNLISTED REPRODUCTIVE MEDICINE LAB PROCEDURE,,30,,,$315.58,$0.00,1,0,1,20161001, 90281,CPT,IMMUNE GLOBULIN IG HUMAN IM USE,,30,,,$114.83,$0.00,1,0,1,20161001, 90283,CPT,IMMUNE GLOBULIN IGIV HUMAN IV USE,,30,,,"$3,996.18",$0.00,1,0,1,20161001, 90287,CPT,BOTULINUM ANTITOXIN EQUINE ANY ROUTE,,30,,,"$2,509.86",$0.00,1,0,1,20161001, 90291,CPT,CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN IV,,30,,,$903.69,$0.00,1,0,1,20161001, 90371,CPT,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,,30,,,$675.89,$0.00,1,0,1,20161001, 90375,CPT,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,,30,,,"$1,588.94",$0.00,1,0,1,20161001, 90376,CPT,RABIES IG HEAT-TREATED HUMAN IM/SUBQ,,30,,,"$1,551.76",$0.00,1,0,1,20161001, 90378,CPT,RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E,,30,,,"$10,971.08",$0.00,1,0,1,20161001, 90384,CPT,RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM,,30,,,$438.66,$0.00,1,0,1,20161001, 90385,CPT,RHO(D) IMMUNE GLOBULIN HUMAN MINI-DOSE IM,,30,,,$625.84,$0.00,1,0,1,20161001, 90386,CPT,RHO(D) IMMUNE GLOBULIN HUMAN IV,,30,,,$473.32,$0.00,1,0,1,20161001, 90389,CPT,TETANUS IMMUNE GLOBULIN TIG HUMAN IM,,30,,,$483.24,$0.00,1,0,1,20161001, 90393,CPT,VACCINIA IMMUNE GLOBULIN HUMAN IM,,30,,,$432.78,$0.00,1,0,1,20161001, 90396,CPT,VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM,,30,,,$807.59,$0.00,1,0,1,20161001, 90460,CPT,IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,,30,,,$42.49,$0.00,1,0,1,20161001, 90461,CPT,IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,,30,,,$21.82,$0.00,1,0,1,20161001, 90471,CPT,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,,30,,,$323.92,$0.00,1,0,1,20161001, 90472,CPT,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,,30,,,$64.31,$0.00,1,0,1,20161001, 90473,CPT,IM ADM INTRANSL/ORAL 1 VACCINE,,30,,,$323.92,$0.00,1,0,1,20161001, 90474,CPT,IM ADM INTRANSL/ORAL EA VACCINE,,30,,,$69.57,$0.00,1,0,1,20161001, 90581,CPT,ANTHRAX VACCINE SUBCUTANEOUS/IM USE,,30,,,$636.99,$0.00,1,0,1,20161001, 90585,CPT,BACILLUS CALMETTE-GUERIN VACC FOR TB LIVE PERQ,,30,,,$787.34,$0.00,1,0,1,20161001, 90586,CPT,BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL,,30,,,$914.57,$0.00,1,0,1,20161001, 90620,CPT,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,,30,,,$889.39,$0.00,1,0,1,20161001, 90621,CPT,MENB RECOMBINANT LIPOPROTEIN VACCINE IM,,30,,,$792.14,$0.00,1,0,1,20161001, 90630,CPT,INFLUENZA VACC IIV4 SPLIT VIRUS PRSRV FREE ID,,30,,,$37.11,$0.00,1,0,1,20161001, 90632,CPT,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,,30,,,$226.22,$0.00,1,0,1,20161001, 90633,CPT,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,,30,,,$187.18,$0.00,1,0,1,20161001, 90634,CPT,HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE,,30,,,$107.46,$0.00,1,0,1,20161001, 90636,CPT,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,,30,,,$342.20,$0.00,1,0,1,20161001, 90647,CPT,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,,30,,,$112.28,$0.00,1,0,1,20161001, 90648,CPT,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,,30,,,$140.35,$0.00,1,0,1,20161001, 90649,CPT,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,,30,,,$537.42,$0.00,1,0,1,20161001, 90650,CPT,2VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,,30,,,"$1,002.20",$0.00,1,0,1,20161001, 90651,CPT,9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,,30,,,$474.48,$0.00,1,0,1,20161001, 90653,CPT,IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE,,30,,,$149.82,$0.00,1,0,1,20161001, 90654,CPT,INFLUENZA VACC IIV3 SPLIT VIRUS PRSRV FREE ID,,30,,,$34.69,$0.00,1,0,1,20161001, 90655,CPT,IIV3 VACC PRESRV FREE CHILD 6-35 MONTHS IM USE,,30,,,$39.04,$0.00,1,0,1,20161001, 90656,CPT,IIV3 VACC PRESERVATIVE FREE 3 YRS & OLDER IM USE,,30,,,$76.59,$0.00,1,0,1,20161001, 90657,CPT,IIV3 VACCINE TO CHILD 6-35 MONTHS FOR IM USE,,30,,,$67.75,$0.00,1,0,1,20161001, 90658,CPT,IIV3 VACCINE 3 YRS & OLDER FOR IM USE,,30,,,$62.01,$0.00,1,0,1,20161001, 90660,CPT,LAIV3 VACCINE LIVE FOR INTRANASAL USE,,30,,,$53.97,$0.00,1,0,1,20161001, 90661,CPT,CCIIV3 VACCINE PRESERVATIVE FREE FOR IM USE,,30,,,"$6,056.57",$0.00,1,0,1,20161001, 90662,CPT,IIV VACCINE PRESERV FREE INCREASED AG COUNT IM,,30,,,$70.05,$0.00,1,0,1,20161001, 90666,CPT,INFLUENZA VACCINE PANDEMIC SPLT PRSRV FREE IM,,30,,,$56.62,$0.00,1,0,1,20161001, 90668,CPT,IIV VACCINE PANDEMIC FOR INTRAMUSCULAR USE,,30,,,$35.07,$0.00,1,0,1,20161001, 90670,CPT,PCV13 VACCINE FOR INTRAMUSCULAR USE,,30,,,$498.05,$0.00,1,0,1,20161001, 90672,CPT,LAIV4 VACCINE FOR INTRANASAL USE,,30,,,$40.19,$0.00,1,0,1,20161001, 90675,CPT,RABIES VACCINE INTRAMUSCULAR,,30,,,"$1,520.23",$0.00,1,0,1,20161001, 90676,CPT,RABIES VACCINE INTRADERMAL,,30,,,"$1,108.50",$0.00,1,0,1,20161001, 90680,CPT,RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE,,30,,,$289.38,$0.00,1,0,1,20161001, 90681,CPT,RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE,,30,,,$389.28,$0.00,1,0,1,20161001, 90685,CPT,IIV4 PRESRV FREE VACC CHILD 6-35 MO FOR IM USE,,30,,,$37.89,$0.00,1,0,1,20161001, 90686,CPT,IIV4 VACC PRESRV FREE 3 YRS & OLDER IM USE,,30,,,$40.19,$0.00,1,0,1,20161001, 90687,CPT,IIV4 VACCINE CHILD 6-35 MO FOR IM USE,,30,,,$45.93,$0.00,1,0,1,20161001, 90688,CPT,IIV4 VACCINE 3 YRS & OLDER FOR IM USE,,30,,,$121.13,$0.00,1,0,1,20161001, 90690,CPT,TYPHOID VACCINE LIVE ORAL,,30,,,$146.28,$0.00,1,0,1,20161001, 90691,CPT,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,,30,,,$192.88,$0.00,1,0,1,20161001, 90696,CPT,DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,,30,,,$158.47,$0.00,1,0,1,20161001, 90697,CPT,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,,30,,,$233.06,$0.00,1,0,1,20161001, 90698,CPT,DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE,,30,,,$318.13,$0.00,1,0,1,20161001, 90700,CPT,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,,30,,,$125.34,$0.00,1,0,1,20161001, 90702,CPT,DT VACCINE YOUNGER THAN 7 YRS FOR IM USE,,30,,,$269.86,$0.00,1,0,1,20161001, 90707,CPT,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,,30,,,$215.36,$0.00,1,0,1,20161001, 90710,CPT,MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ,,30,,,$480.35,$0.00,1,0,1,20161001, 90713,CPT,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,,30,,,$150.48,$0.00,1,0,1,20161001, 90714,CPT,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,,30,,,$185.46,$0.00,1,0,1,20161001, 90715,CPT,TDAP VACCINE 7 YRS/> IM,,30,,,$254.52,$0.00,1,0,1,20161001, 90716,CPT,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,,30,,,$372.38,$0.00,1,0,1,20161001, 90717,CPT,YELLOW FEVER VACCINE LIVE SUBQ,,30,,,$288.23,$0.00,1,0,1,20161001, 90723,CPT,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,,30,,,$271.01,$0.00,1,0,1,20161001, 90732,CPT,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,,30,,,$321.55,$0.00,1,0,1,20161001, 90733,CPT,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,,30,,,$688.27,$0.00,1,0,1,20161001, 90734,CPT,MENACWY CONJUGATE VACCINE GROUPS ACYW-135 IM USE,,30,,,$655.35,$0.00,1,0,1,20161001, 90736,CPT,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,,30,,,$342.79,$0.00,1,0,1,20161001, 90738,CPT,JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM,,30,,,$667.58,$0.00,1,0,1,20161001, 90739,CPT,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,,30,,,$196.34,$0.00,1,0,1,20161001, 90740,CPT,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 3 DOSE IM,,30,,,"$1,662.32",$0.00,1,0,1,20161001, 90743,CPT,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,,30,,,$158.47,$0.00,1,0,1,20161001, 90744,CPT,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,,30,,,$141.11,$0.00,1,0,1,20161001, 90746,CPT,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,,30,,,$249.19,$0.00,1,0,1,20161001, 90747,CPT,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,,30,,,"$1,750.68",$0.00,1,0,1,20161001, 90748,CPT,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,,30,,,$258.37,$0.00,1,0,1,20161001, 90749,CPT,UNLISTED VACCINE/TOXOID,,30,,,$383.11,$0.00,1,0,1,20161001, 90785,CPT,PSYCHOTHERAPY COMPLEX INTERACTIVE,,30,,,$689.00,$0.00,1,0,1,20161001, 90791,CPT,PSYCHIATRIC DIAGNOSTIC EVALUATION,,30,,,$479.58,$0.00,1,0,1,20161001, 90792,CPT,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,,30,,,$479.58,$0.00,1,0,1,20161001, 90832,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES,,30,,,$386.27,$0.00,1,0,1,20161001, 90833,CPT,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,,30,,,$386.27,$0.00,1,0,1,20161001, 90834,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES,,30,,,$479.58,$0.00,1,0,1,20161001, 90836,CPT,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,,30,,,$479.58,$0.00,1,0,1,20161001, 90837,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES,,30,,,$479.58,$0.00,1,0,1,20161001, 90838,CPT,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,,30,,,$479.58,$0.00,1,0,1,20161001, 90839,CPT,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,,30,,,$479.58,$0.00,1,0,1,20161001, 90840,CPT,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,,30,,,$386.27,$0.00,1,0,1,20161001, 90845,CPT,PSYCHOANALYSIS,,30,,,$479.58,$0.00,1,0,1,20161001, 90846,CPT,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT,,30,,,$512.50,$0.00,1,0,1,20161001, 90847,CPT,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT,,30,,,$512.50,$0.00,1,0,1,20161001, 90849,CPT,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,,30,,,$348.84,$0.00,1,0,1,20161001, 90853,CPT,GROUP PSYCHOTHERAPY,,30,,,$318.60,$0.00,1,0,1,20161001, 90863,CPT,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,,30,,,$314.72,$0.00,1,0,1,20161001, 90865,CPT,NARCOSYNTHESIS PSYC DX&THER PURPOSES,,30,,,$479.58,$0.00,1,0,1,20161001, 90867,CPT,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 90868,CPT,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 90869,CPT,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 90870,CPT,ELECTROCONVULSIVE THERAPY,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 90875,CPT,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,,30,,,$590.24,$0.00,1,0,1,20161001, 90876,CPT,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,,30,,,$312.87,$0.00,1,0,1,20161001, 90880,CPT,HYPNOTHERAPY,,30,,,$479.58,$0.00,1,0,1,20161001, 90882,CPT,ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT,,30,,,$107.02,$0.00,1,0,1,20161001, 90885,CPT,PSYCHIATRIC EVAL HOSPITAL RECORDS DX PURPOSES,,30,,,$839.30,$0.00,1,0,1,20161001, 90887,CPT,INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY,,30,,,$424.95,$0.00,1,0,1,20161001, 90889,CPT,PREP REPORT PT PSYCH STATUS AGENCY/PAYER,,30,,,$217.00,$0.00,1,0,1,20161001, 90899,CPT,UNLISTED PSYCHIATRIC SERVICE/PROCEDURE,,30,,,$416.51,$0.00,1,0,1,20161001, 90901,CPT,BIOFEEDBACK TRAINING ANY MODALITY,,30,,,$133.33,$0.00,1,0,1,20161001, 90911,CPT,BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,,30,,,$746.33,$0.00,1,0,1,20161001, 90935,CPT,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,,30,,,"$2,673.75",$0.00,1,0,1,20161001, 90937,CPT,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,,30,,,"$1,264.78",$0.00,1,0,1,20161001, 90940,CPT,HEMODIALYSIS ACCESS FLOW STUDY,,30,,,$396.49,$0.00,1,0,1,20161001, 90945,CPT,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,,30,,,"$2,369.96",$0.00,1,0,1,20161001, 90947,CPT,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,,30,,,$731.25,$0.00,1,0,1,20161001, 90954,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS,,30,,,$861.90,$0.00,1,0,1,20161001, 90955,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,,30,,,$490.69,$0.00,1,0,1,20161001, 90956,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,,30,,,$133.61,$0.00,1,0,1,20161001, 90960,CPT,ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS,,30,,,$813.02,$0.00,1,0,1,20161001, 90962,CPT,ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT,,30,,,"$4,162.69",$0.00,1,0,1,20161001, 90964,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD,,30,,,"$1,287.91",$0.00,1,0,1,20161001, 90966,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,,30,,,$552.91,$0.00,1,0,1,20161001, 90968,CPT,ESRD RELATED SVC YR OLD,,30,,,"$1,485.57",$0.00,1,0,1,20161001, 90989,CPT,DIALYSIS TRAINING PATIENT COMPLETED COURSE,,30,,,"$1,016.16",$0.00,1,0,1,20161001, 90993,CPT,DIALYSIS TRAINING PATIENT PER TRAINING SESSION,,30,,,"$4,288.62",$0.00,1,0,1,20161001, 90997,CPT,HEMOPERFUSION,,30,,,$52.38,$0.00,1,0,1,20161001, 90999,CPT,UNLISTED DIALYSIS PROCEDURE INPATIENT/OUTPATIENT,,30,,,"$3,805.56",$0.00,1,0,1,20161001, 91010,CPT,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 91013,CPT,ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,,30,,,$217.58,$0.00,1,0,1,20161001, 91020,CPT,GASTRIC MOTILITY MANOMETRIC STUDIES,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 91022,CPT,DUODENAL MOTILITY MANOMETRIC STUDY,,30,,,"$5,245.62",$0.00,1,0,1,20161001, 91030,CPT,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 91034,CPT,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 91035,CPT,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 91037,CPT,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,,30,,,"$2,510.92",$0.00,1,0,1,20161001, 91040,CPT,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 91065,CPT,BREATH HYDROGEN/METHANE TEST,,30,,,$746.33,$0.00,1,0,1,20161001, 91110,CPT,GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 91112,CPT,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 91117,CPT,COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R,,30,,,"$1,305.73",$0.00,1,0,1,20161001, 91120,CPT,RECTAL SESATION TONE & COMPLIANCE TEST,,30,,,$666.94,$0.00,1,0,1,20161001, 91122,CPT,ANORECTAL MANOMETRY,,30,,,"$3,150.47",$0.00,1,0,1,20161001, 91132,CPT,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,,30,,,$746.33,$0.00,1,0,1,20161001, 91133,CPT,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,,30,,,$425.53,$0.00,1,0,1,20161001, 91200,CPT,LIVER ELASTOGRAPHY W/O IMAG W/I&R,,30,,,$989.36,$0.00,1,0,1,20161001, 91299,CPT,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,,30,,,$746.33,$0.00,1,0,1,20161001, 92002,CPT,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,,30,,,$217.87,$0.00,1,0,1,20161001, 92004,CPT,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,,30,,,$217.87,$0.00,1,0,1,20161001, 92012,CPT,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,,30,,,$217.87,$0.00,1,0,1,20161001, 92014,CPT,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,,30,,,$217.87,$0.00,1,0,1,20161001, 92015,CPT,DETERMINATION REFRACTIVE STATE,,30,,,$57.60,$0.00,1,0,1,20161001, 92018,CPT,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 92019,CPT,OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD,,30,,,"$8,382.04",$0.00,1,0,1,20161001, 92020,CPT,GONIOSCOPY SEPARATE PROCEDURE,,30,,,$425.53,$0.00,1,0,1,20161001, 92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,,30,,,$306.21,$0.00,1,0,1,20161001, 92060,CPT,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,,30,,,$425.53,$0.00,1,0,1,20161001, 92065,CPT,ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ,,30,,,$425.53,$0.00,1,0,1,20161001, 92071,CPT,FIT CONTACT LENS TX OCULAR SURFACE DISEASE,,30,,,$168.80,$0.00,1,0,1,20161001, 92072,CPT,FITTING CONTACT LENS FOR MNGT OF KERATOCONUS,,30,,,$253.78,$0.00,1,0,1,20161001, 92081,CPT,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,,30,,,$425.53,$0.00,1,0,1,20161001, 92082,CPT,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,,30,,,$306.21,$0.00,1,0,1,20161001, 92083,CPT,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,,30,,,$425.53,$0.00,1,0,1,20161001, 92100,CPT,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,,30,,,$150.43,$0.00,1,0,1,20161001, 92132,CPT,CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI,,30,,,$306.21,$0.00,1,0,1,20161001, 92133,CPT,COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE,,30,,,$306.21,$0.00,1,0,1,20161001, 92134,CPT,COMPUTERIZED OPHTHALMIC IMAGING RETINA,,30,,,$306.21,$0.00,1,0,1,20161001, 92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,,30,,,$425.53,$0.00,1,0,1,20161001, 92140,CPT,PROVOCATIVE TESTS GLAUCOMA I&R W/O TONOGRAPHY,,30,,,$425.53,$0.00,1,0,1,20161001, 92145,CPT,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,,30,,,$156.54,$0.00,1,0,1,20161001, 92225,CPT,OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R 1ST,,30,,,$306.21,$0.00,1,0,1,20161001, 92226,CPT,OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R SBS,,30,,,$306.21,$0.00,1,0,1,20161001, 92227,CPT,REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/B,,30,,,$156.54,$0.00,1,0,1,20161001, 92228,CPT,REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B,,30,,,$425.53,$0.00,1,0,1,20161001, 92230,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,,30,,,$425.53,$0.00,1,0,1,20161001, 92235,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 92240,CPT,INDOCYANINE GREEN ANGIOGRAPHY W/INTERP & REPOR,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 92250,CPT,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,,30,,,$425.53,$0.00,1,0,1,20161001, 92260,CPT,OPHTHALMODYNAMOMETRY,,30,,,$156.54,$0.00,1,0,1,20161001, 92265,CPT,NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R,,30,,,$306.21,$0.00,1,0,1,20161001, 92270,CPT,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,,30,,,$425.53,$0.00,1,0,1,20161001, 92275,CPT,ELECTRORETINOGRAPY W/INTERPRETATION & REPORT,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 92283,CPT,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,,30,,,$425.53,$0.00,1,0,1,20161001, 92284,CPT,DARK ADAPTATION XM W/INTERPRETATION & REPORT,,30,,,$425.53,$0.00,1,0,1,20161001, 92285,CPT,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,,30,,,$425.53,$0.00,1,0,1,20161001, 92286,CPT,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,,30,,,$425.53,$0.00,1,0,1,20161001, 92287,CPT,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,,30,,,$425.53,$0.00,1,0,1,20161001, 92310,CPT,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,,30,,,$232.07,$0.00,1,0,1,20161001, 92311,CPT,RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE,,30,,,$425.53,$0.00,1,0,1,20161001, 92312,CPT,RX&FITG CONTACT CORNEAL LENS APHAKIA BOTH EYES,,30,,,$425.53,$0.00,1,0,1,20161001, 92313,CPT,RX&FITG CORNEOSCLERAL LENS,,30,,,$425.53,$0.00,1,0,1,20161001, 92314,CPT,RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA,,30,,,$55.59,$0.00,1,0,1,20161001, 92315,CPT,RX CONTACT CORNEAL LENS APHAKIA 1 EYE,,30,,,$425.53,$0.00,1,0,1,20161001, 92316,CPT,RX CONTACT CORNEAL LENS APHAKIA BOTH EYES,,30,,,$306.21,$0.00,1,0,1,20161001, 92317,CPT,RX CONTACT CORNEOSCLERAL LENS,,30,,,$156.54,$0.00,1,0,1,20161001, 92325,CPT,MODIFICAJ CONTACT LENX SPX SUPVJ ADAPTATION,,30,,,$425.53,$0.00,1,0,1,20161001, 92326,CPT,REPLACEMENT CONTACT LENS,,30,,,$306.21,$0.00,1,0,1,20161001, 92340,CPT,FITTING SPECTACLES XCPT APHAKIA MONOFOCAL,,30,,,$57.03,$0.00,1,0,1,20161001, 92341,CPT,FITTING SPECTACLES XCPT APHAKIA BIFOCAL,,30,,,$86.03,$0.00,1,0,1,20161001, 92352,CPT,FITTING SPECTACLE PROSTH APHAKIA MONOFOCAL,,30,,,$306.21,$0.00,1,0,1,20161001, 92353,CPT,FITTING SPECTACLE PROSTH APHAKIA MULTIFOCAL,,30,,,$306.21,$0.00,1,0,1,20161001, 92354,CPT,FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT,,30,,,$156.54,$0.00,1,0,1,20161001, 92355,CPT,FITTING SPECTACLE MOUNTED LW VIS AID TLSCP,,30,,,$156.54,$0.00,1,0,1,20161001, 92358,CPT,PROSTHESIS SERVICE APHAKIA TEMPORARY,,30,,,$306.21,$0.00,1,0,1,20161001, 92371,CPT,RPR&REFITG SPECTACLE PROSTHESIS APHAKIA,,30,,,$306.21,$0.00,1,0,1,20161001, 92499,CPT,UNLIVSTED OPHTHALMOLOGICAL SERVICE/PROCEDURE,,30,,,$81.90,$0.00,1,0,1,20161001, 92502,CPT,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,,30,,,"$1,960.00",$0.00,1,0,1,20161001, 92504,CPT,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,,30,,,$198.11,$0.00,1,0,1,20161001, 92511,CPT,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,,30,,,$578.94,$0.00,1,0,1,20161001, 92512,CPT,NASAL FUNCTION STUDIES,,30,,,$968.74,$0.00,1,0,1,20161001, 92516,CPT,FACIAL NERVE FUNCTION STUDIES,,30,,,$968.74,$0.00,1,0,1,20161001, 92520,CPT,LARYNGEAL FUNCTION STUDIES,,30,,,$425.53,$0.00,1,0,1,20161001, 92526,CPT,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,,30,,,$222.87,$0.00,1,0,1,20161001, 92531,CPT,SPONTANEOUS NYSTAGMUS W/GAZE,,30,,,$74.29,$0.00,1,0,1,20161001, 92532,CPT,POSITIONAL NYSTAGMUS TEST,,30,,,$86.67,$0.00,1,0,1,20161001, 92533,CPT,CALORIC VESTIBULAR TEST EACH IRRIGATION,,30,,,$140.33,$0.00,1,0,1,20161001, 92534,CPT,OPTOKINETIC NYSTAGMUS TEST,,30,,,$66.04,$0.00,1,0,1,20161001, 92537,CPT,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,,30,,,"$1,361.23",$0.00,1,0,1,20161001, 92538,CPT,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,,30,,,"$1,361.23",$0.00,1,0,1,20161001, 92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK,,30,,,$968.74,$0.00,1,0,1,20161001, 92541,CPT,SPONTANEOUS NYSTAGMUS TEST,,30,,,$425.53,$0.00,1,0,1,20161001, 92542,CPT,POSITIONAL NYSTAGMUS TEST,,30,,,$425.53,$0.00,1,0,1,20161001, 92544,CPT,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,,30,,,$746.33,$0.00,1,0,1,20161001, 92545,CPT,OSCILLATING TRACKING TEST W/RECORDING,,30,,,$746.33,$0.00,1,0,1,20161001, 92546,CPT,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,,30,,,$746.33,$0.00,1,0,1,20161001, 92547,CPT,USE VERTICAL ELECTRODES,,30,,,$132.07,$0.00,1,0,1,20161001, 92548,CPT,COMPUTERIZED DYNAMIC POSTUROGRAPY,,30,,,$425.53,$0.00,1,0,1,20161001, 92550,CPT,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,,30,,,$666.94,$0.00,1,0,1,20161001, 92551,CPT,SCREENING TEST PURE TONE AIR ONLY,,30,,,$36.33,$0.00,1,0,1,20161001, 92552,CPT,PURE TONE AUDIOMETRY AIR ONLY,,30,,,$427.56,$0.00,1,0,1,20161001, 92553,CPT,PURE TONE AUDIOMETRY AIR & BONE,,30,,,$666.94,$0.00,1,0,1,20161001, 92555,CPT,SPEECH AUDIOMETRY THRESHOLD,,30,,,$155.67,$0.00,1,0,1,20161001, 92556,CPT,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,,30,,,$155.67,$0.00,1,0,1,20161001, 92557,CPT,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,,30,,,$666.94,$0.00,1,0,1,20161001, 92558,CPT,EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS,,30,,,$200.96,$0.00,1,0,1,20161001, 92560,CPT,BEKESY AUDIOMETRY SCREENING,,30,,,$205.22,$0.00,1,0,1,20161001, 92561,CPT,BEKESY AUDIOMETRY DIAGNOSTIC,,30,,,$427.56,$0.00,1,0,1,20161001, 92562,CPT,LOUDNESS BALANCE BINAURAL/MONAURAL,,30,,,$666.94,$0.00,1,0,1,20161001, 92563,CPT,TONE DECAY TEST,,30,,,$155.67,$0.00,1,0,1,20161001, 92564,CPT,SHORT INCREMENT SENSITIVITY INDEX,,30,,,$155.67,$0.00,1,0,1,20161001, 92565,CPT,STENGER TEST PURE TONE,,30,,,$155.67,$0.00,1,0,1,20161001, 92567,CPT,TYMPANOMETRY,,30,,,$155.67,$0.00,1,0,1,20161001, 92568,CPT,ACOUSTIC REFLEX THRESHOLD,,30,,,$156.54,$0.00,1,0,1,20161001, 92570,CPT,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,,30,,,$666.94,$0.00,1,0,1,20161001, 92571,CPT,FILTERED SPEECH TEST,,30,,,$155.67,$0.00,1,0,1,20161001, 92572,CPT,STAGGERED SPONDAIC WORD,,30,,,$666.94,$0.00,1,0,1,20161001, 92575,CPT,SENSORINEURAL ACUITY LEVEL,,30,,,$155.67,$0.00,1,0,1,20161001, 92576,CPT,SYNTHETIC SENTENCE IDENTIFICATION TEST,,30,,,$155.67,$0.00,1,0,1,20161001, 92577,CPT,STENGER TEST SPEECH,,30,,,"$2,510.92",$0.00,1,0,1,20161001, 92579,CPT,VISUAL REINFORCEMENT AUDIOMETRY,,30,,,$666.94,$0.00,1,0,1,20161001, 92582,CPT,CONDITIONING PLAY AUDIOMETRY,,30,,,$666.94,$0.00,1,0,1,20161001, 92583,CPT,SELECT PICTURE AUDIOMETRY,,30,,,$155.67,$0.00,1,0,1,20161001, 92584,CPT,ELECTROCOCHLEOGRAPHY,,30,,,$666.94,$0.00,1,0,1,20161001, 92585,CPT,AUDITORY EVOKED POTENTIALS COMPREHENSIVE,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 92586,CPT,AUDITORY EVOKED POTENTIALS LIMITED,,30,,,$666.94,$0.00,1,0,1,20161001, 92587,CPT,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,,30,,,$968.74,$0.00,1,0,1,20161001, 92588,CPT,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,,30,,,$968.74,$0.00,1,0,1,20161001, 92590,CPT,HEARING AID EXAMINATION & SELECTION MONAURAL,,30,,,$169.56,$0.00,1,0,1,20161001, 92591,CPT,HEARING AID EXAMINATION & SELECTION BINAURAL,,30,,,$291.42,$0.00,1,0,1,20161001, 92592,CPT,HEARING AID CHECK MONAURAL,,30,,,$83.68,$0.00,1,0,1,20161001, 92593,CPT,HEARING AID CHECK BINAURAL,,30,,,$144.06,$0.00,1,0,1,20161001, 92594,CPT,ELECTROACOUS EVAL HEARING AID MONAURAL,,30,,,$24.76,$0.00,1,0,1,20161001, 92595,CPT,ELECTROACOUS EVAL HEARING AID BINAURAL,,30,,,$93.00,$0.00,1,0,1,20161001, 92596,CPT,EAR PROTECTOR ATTENUATION MEASUREMENTS,,30,,,$155.67,$0.00,1,0,1,20161001, 92601,CPT,ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG,,30,,,$666.94,$0.00,1,0,1,20161001, 92602,CPT,ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG,,30,,,$666.94,$0.00,1,0,1,20161001, 92603,CPT,ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG,,30,,,$666.94,$0.00,1,0,1,20161001, 92604,CPT,ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG,,30,,,$666.94,$0.00,1,0,1,20161001, 92620,CPT,EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN,,30,,,$666.94,$0.00,1,0,1,20161001, 92621,CPT,EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN,,30,,,$158.25,$0.00,1,0,1,20161001, 92625,CPT,ASSESSMENT TINNITUS,,30,,,$666.94,$0.00,1,0,1,20161001, 92626,CPT,EVALUATION AUDITORY REHAB STATUS 1ST HR,,30,,,$666.94,$0.00,1,0,1,20161001, 92627,CPT,EVALUATION AUDITORY REHAB STATUS EA 15 MIN,,30,,,$123.06,$0.00,1,0,1,20161001, 92630,CPT,AUDITORY REHABILITATION PRELINGUAL HEARING LOSS,,30,,,$386.68,$0.00,1,0,1,20161001, 92633,CPT,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,,30,,,$329.57,$0.00,1,0,1,20161001, 92640,CPT,ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR,,30,,,$666.94,$0.00,1,0,1,20161001, 92700,CPT,UNLISTED OTORHINOLARYNGOLOGICAL SERVICE,,30,,,$82.55,$0.00,1,0,1,20161001, 92920,CPT,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 92921,CPT,PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH,,30,,,"$3,409.31",$0.00,1,0,1,20161001, 92924,CPT,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92925,CPT,PRQ TRLUML CORONARY ANGIO/ATHEREC ADDL ART/BRNCH,,30,,,"$3,546.23",$0.00,1,0,1,20161001, 92928,CPT,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92929,CPT,PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH,,30,,,"$6,990.16",$0.00,1,0,1,20161001, 92933,CPT,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,,30,,,"$29,536.30",$0.00,1,0,1,20161001, 92934,CPT,PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH,,30,,,"$6,990.16",$0.00,1,0,1,20161001, 92937,CPT,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92938,CPT,PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL,,30,,,"$11,078.53",$0.00,1,0,1,20161001, 92941,CPT,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92943,CPT,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92944,CPT,PRQ TRLUML CORONRY CHRNIC OCCLUS REVASC ADDL VSL,,30,,,"$11,078.53",$0.00,1,0,1,20161001, 92950,CPT,CARDIOPULMONARY RESUSCITATION,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 92953,CPT,TEMPORARY TRANSCUTANEOUS PACING,,30,,,"$2,962.78",$0.00,1,0,1,20161001, 92960,CPT,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,,30,,,"$2,962.78",$0.00,1,0,1,20161001, 92961,CPT,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,,30,,,"$2,962.78",$0.00,1,0,1,20161001, 92973,CPT,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,,30,,,"$9,891.70",$0.00,1,0,1,20161001, 92974,CPT,TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX,,30,,,"$7,448.89",$0.00,1,0,1,20161001, 92977,CPT,THROMBOLYSIS CORONARY INTRAVENOUS INFUSION,,30,,,"$1,302.06",$0.00,1,0,1,20161001, 92978,CPT,INTRAVASC US CORONARY INTERP&RPT INITIAL VESSE,,30,,,"$5,906.79",$0.00,1,0,1,20161001, 92979,CPT,INTRAVASC US CORONARY INTERP&RPT ADDL VESSEL,,30,,,"$2,621.84",$0.00,1,0,1,20161001, 92986,CPT,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 92987,CPT,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92990,CPT,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92997,CPT,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 92998,CPT,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,,30,,,"$8,982.22",$0.00,1,0,1,20161001, 93005,CPT,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,,30,,,$306.21,$0.00,1,0,1,20161001, 93017,CPT,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 93024,CPT,ERGONOVINE PROVOCATION TST,,30,,,$425.53,$0.00,1,0,1,20161001, 93025,CPT,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,,30,,,$666.94,$0.00,1,0,1,20161001, 93041,CPT,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,,30,,,$156.54,$0.00,1,0,1,20161001, 93050,CPT,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,,30,,,$155.67,$0.00,1,0,1,20161001, 93225,CPT,XTRNL ECG & 48 HR RECORDING,,30,,,$425.53,$0.00,1,0,1,20161001, 93226,CPT,EXTERNAL ECG SCANNING ANALYSIS REPORT,,30,,,$425.53,$0.00,1,0,1,20161001, 93228,CPT,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,,30,,,$401.91,$0.00,1,0,1,20161001, 93229,CPT,XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 93260,CPT,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,,30,,,$221.12,$0.00,1,0,1,20161001, 93261,CPT,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,,30,,,$221.12,$0.00,1,0,1,20161001, 93270,CPT,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,,30,,,$221.12,$0.00,1,0,1,20161001, 93271,CPT,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,,30,,,$429.61,$0.00,1,0,1,20161001, 93278,CPT,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,,30,,,$306.21,$0.00,1,0,1,20161001, 93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,,30,,,$221.12,$0.00,1,0,1,20161001, 93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,,30,,,$221.12,$0.00,1,0,1,20161001, 93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,,30,,,$221.12,$0.00,1,0,1,20161001, 93282,CPT,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,,30,,,$221.12,$0.00,1,0,1,20161001, 93283,CPT,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,,30,,,$221.12,$0.00,1,0,1,20161001, 93284,CPT,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,,30,,,$221.12,$0.00,1,0,1,20161001, 93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,,30,,,$221.12,$0.00,1,0,1,20161001, 93286,CPT,PERI-PX EVAL&PROGRAM IN PRSN PACEMAKER SYSTEM,,30,,,$288.21,$0.00,1,0,1,20161001, 93287,CPT,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,,30,,,$406.62,$0.00,1,0,1,20161001, 93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,,30,,,$221.12,$0.00,1,0,1,20161001, 93289,CPT,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,,30,,,$221.12,$0.00,1,0,1,20161001, 93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,,30,,,$221.12,$0.00,1,0,1,20161001, 93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,,30,,,$156.54,$0.00,1,0,1,20161001, 93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,,30,,,$221.12,$0.00,1,0,1,20161001, 93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,,30,,,$221.12,$0.00,1,0,1,20161001, 93296,CPT,INTERROGATION REMOTE HR REC ONL,,30,,,$425.53,$0.00,1,0,1,20161001, 93788,CPT,AMBL BLD PRESS W/TAPE/DISK 24/>HR ALYS W/REPRT,,30,,,$425.53,$0.00,1,0,1,20161001, 93797,CPT,OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR,,30,,,$308.06,$0.00,1,0,1,20161001, 93798,CPT,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,,30,,,$308.06,$0.00,1,0,1,20161001, 93799,CPT,UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE,,30,,,$746.33,$0.00,1,0,1,20161001, 93880,CPT,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93882,CPT,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93886,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93888,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93890,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY,,30,,,$989.36,$0.00,1,0,1,20161001, 93892,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,,30,,,$686.47,$0.00,1,0,1,20161001, 93893,CPT,TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ,,30,,,$686.47,$0.00,1,0,1,20161001, 93895,CPT,CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI,,30,,,$542.12,$0.00,1,0,1,20161001, 93922,CPT,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,,30,,,$425.53,$0.00,1,0,1,20161001, 93923,CPT,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,,30,,,$746.33,$0.00,1,0,1,20161001, 93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,,30,,,$666.94,$0.00,1,0,1,20161001, 93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,,30,,,$746.33,$0.00,1,0,1,20161001, 93970,CPT,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93971,CPT,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,,30,,,$989.36,$0.00,1,0,1,20161001, 93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,,30,,,"$1,024.59",$0.00,1,0,1,20161001, 93982,CPT,IMPLANT WIRELESS PRESS SENSOR STUDY ANEURYSM SAC,,30,,,$306.21,$0.00,1,0,1,20161001, 93990,CPT,DUPLEX SCAN HEMODIALYSIS ACCESS,,30,,,$686.47,$0.00,1,0,1,20161001, 93998,CPT,UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,,30,,,$306.21,$0.00,1,0,1,20161001, 94002,CPT,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,,30,,,"$2,787.08",$0.00,1,0,1,20161001, 94003,CPT,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,,30,,,"$2,787.08",$0.00,1,0,1,20161001, 94004,CPT,VENTILATION ASSIST & MGMT NURSING FAC PR DAY,,30,,,$741.00,$0.00,1,0,1,20161001, 94010,CPT,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,,30,,,$746.33,$0.00,1,0,1,20161001, 94011,CPT,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT&/2 Y,,30,,,$746.33,$0.00,1,0,1,20161001, 94012,CPT,MEAS SPIRO FRCD EXP FLO PRE&POST BRONCH INF/2YRS,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94013,CPT,MEASUREMENT LUNG VOLUMES INFANT/CHILD/2 YRS,,30,,,"$2,510.92",$0.00,1,0,1,20161001, 94014,CPT,PT-INITIATE SPIROMETRIC RECORDING PHYS/QHP R&I,,30,,,$425.53,$0.00,1,0,1,20161001, 94015,CPT,PATIENT-INITIATED SPIROMETRIC RECORDING,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94150,CPT,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,,30,,,$746.33,$0.00,1,0,1,20161001, 94200,CPT,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,,30,,,$425.53,$0.00,1,0,1,20161001, 94250,CPT,EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX,,30,,,$306.21,$0.00,1,0,1,20161001, 94375,CPT,RESPIRATORY FLOW VOLUME LOOP,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94400,CPT,BREATHING RESPONSE TO CO2,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94450,CPT,BREATHING RESPONSE TO HYPOXIA,,30,,,$746.33,$0.00,1,0,1,20161001, 94452,CPT,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,,30,,,$425.53,$0.00,1,0,1,20161001, 94453,CPT,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,,30,,,$425.53,$0.00,1,0,1,20161001, 94610,CPT,INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP,,30,,,$238.49,$0.00,1,0,1,20161001, 94620,CPT,PULMONARY STRESS TESTING SIMPLE,,30,,,$425.53,$0.00,1,0,1,20161001, 94621,CPT,PULMONARY STRESS TESTING COMPLEX,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94640,CPT,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,,30,,,$238.49,$0.00,1,0,1,20161001, 94642,CPT,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,,30,,,$238.49,$0.00,1,0,1,20161001, 94644,CPT,CONTINUOUS INHALATION TREATMENT 1ST HR,,30,,,$425.53,$0.00,1,0,1,20161001, 94645,CPT,CONTINUOUS INHALATION TREATMENT EA ADDL HR,,30,,,$339.91,$0.00,1,0,1,20161001, 94660,CPT,CPAP VENTILATION CPAP INITIATION&MGMT,,30,,,$238.49,$0.00,1,0,1,20161001, 94662,CPT,CONTINUOUS NEGATIVE PRESSURE VENTJ INITIAT&MGM,,30,,,"$2,787.08",$0.00,1,0,1,20161001, 94664,CPT,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,,30,,,$238.49,$0.00,1,0,1,20161001, 94667,CPT,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,,30,,,$425.53,$0.00,1,0,1,20161001, 94668,CPT,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,,30,,,$306.21,$0.00,1,0,1,20161001, 94669,CPT,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,,30,,,$238.49,$0.00,1,0,1,20161001, 94680,CPT,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,,30,,,$746.33,$0.00,1,0,1,20161001, 94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94690,CPT,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,,30,,,$156.54,$0.00,1,0,1,20161001, 94726,CPT,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94727,CPT,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,,30,,,$746.33,$0.00,1,0,1,20161001, 94728,CPT,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94729,CPT,CO DIFFUSING CAPACITY,,30,,,$904.41,$0.00,1,0,1,20161001, 94750,CPT,PULMONARY COMPLIANCE STUDY,,30,,,$746.33,$0.00,1,0,1,20161001, 94760,CPT,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,,30,,,$156.56,$0.00,1,0,1,20161001, 94761,CPT,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,,30,,,$260.94,$0.00,1,0,1,20161001, 94762,CPT,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,,30,,,$746.33,$0.00,1,0,1,20161001, 94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 94772,CPT,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 94775,CPT,PEDIATRIC APNEA MONITOR ATTACHMENT,,30,,,$746.33,$0.00,1,0,1,20161001, 94776,CPT,PEDIATRIC APNEA MONITOR ANALYSES COMPUTER,,30,,,$746.33,$0.00,1,0,1,20161001, 94780,CPT,CAR SEAT/BED TESTING W/INTERP & REPORT 60 MIN,,30,,,$156.54,$0.00,1,0,1,20161001, 94781,CPT,CAR SEAT/BED TESTNG W/INTERP & REPORT ADDL 30MIN,,30,,,$236.20,$0.00,1,0,1,20161001, 94799,CPT,UNLISTED PULMONARY SERVICE/PROCEDURE,,30,,,$746.33,$0.00,1,0,1,20161001, 95004,CPT,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,30,,,$425.53,$0.00,1,0,1,20161001, 95012,CPT,NITRIC OXIDE EXPIRED GAS DETERMINATION,,30,,,$156.54,$0.00,1,0,1,20161001, 95017,CPT,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,,30,,,$156.54,$0.00,1,0,1,20161001, 95018,CPT,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,,30,,,$156.54,$0.00,1,0,1,20161001, 95024,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,30,,,$306.21,$0.00,1,0,1,20161001, 95027,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,,30,,,$156.54,$0.00,1,0,1,20161001, 95028,CPT,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,,30,,,$156.54,$0.00,1,0,1,20161001, 95044,CPT,PATCH/APPLICATION TEST SPECIFY NUMBER TESTS,,30,,,$425.53,$0.00,1,0,1,20161001, 95052,CPT,PHOTO PATCH TEST SPECIFY NUMBER TSTS,,30,,,$156.54,$0.00,1,0,1,20161001, 95056,CPT,PHOTO TESTS,,30,,,$306.21,$0.00,1,0,1,20161001, 95060,CPT,OPHTHALMIC MUCOUS MEMBRANE TESTS,,30,,,$425.53,$0.00,1,0,1,20161001, 95065,CPT,DIRECT NASAL MUCOUS MEMBRANE TEST,,30,,,$156.54,$0.00,1,0,1,20161001, 95070,CPT,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95071,CPT,INHLJ BRNCL CHALLENGE TSTG W/AGS/GASES,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95076,CPT,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95079,CPT,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,,30,,,$414.58,$0.00,1,0,1,20161001, 95115,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,,30,,,$223.07,$0.00,1,0,1,20161001, 95117,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,,30,,,$223.07,$0.00,1,0,1,20161001, 95120,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX,,30,,,$79.15,$0.00,1,0,1,20161001, 95125,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJX,,30,,,$83.46,$0.00,1,0,1,20161001, 95130,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 1 STING INSECT,,30,,,$33.46,$0.00,1,0,1,20161001, 95131,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 2 STING INSECT,,30,,,$69.77,$0.00,1,0,1,20161001, 95132,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 3 STING INSECT,,30,,,$89.11,$0.00,1,0,1,20161001, 95133,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 4 STING INSECT,,30,,,$101.28,$0.00,1,0,1,20161001, 95144,CPT,PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO,,30,,,$223.07,$0.00,1,0,1,20161001, 95145,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,,30,,,$223.07,$0.00,1,0,1,20161001, 95146,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,,30,,,$200.57,$0.00,1,0,1,20161001, 95147,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,,30,,,$274.68,$0.00,1,0,1,20161001, 95148,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,,30,,,$323.92,$0.00,1,0,1,20161001, 95149,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,,30,,,$323.92,$0.00,1,0,1,20161001, 95165,CPT,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,,30,,,$223.07,$0.00,1,0,1,20161001, 95170,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,,30,,,$323.92,$0.00,1,0,1,20161001, 95180,CPT,RAPID DESENSITIZATION PROCEDURE EACH HOUR,,30,,,$425.53,$0.00,1,0,1,20161001, 95199,CPT,UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SRVC/PX,,30,,,$81.90,$0.00,1,0,1,20161001, 95250,CPT,GLUC MNTR CONT REC FROM INTERSTITIAL TISS FLUID,,30,,,$217.87,$0.00,1,0,1,20161001, 95782,CPT,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,,30,,,"$5,245.62",$0.00,1,0,1,20161001, 95783,CPT,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95800,CPT,SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME,,30,,,$746.33,$0.00,1,0,1,20161001, 95801,CPT,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,,30,,,$425.53,$0.00,1,0,1,20161001, 95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,,30,,,$425.53,$0.00,1,0,1,20161001, 95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,,30,,,"$5,245.62",$0.00,1,0,1,20161001, 95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,,30,,,$666.94,$0.00,1,0,1,20161001, 95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95808,CPT,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95810,CPT,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95811,CPT,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95812,CPT,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95813,CPT,ELECTROENCEPHALOGRAM EXTND MNTR >1 HR,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95816,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95819,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95822,CPT,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95824,CPT,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95827,CPT,ELECTROENCEPHALOGRAM ALL NIGHT RECORDING,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95830,CPT,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,,30,,,$348.99,$0.00,1,0,1,20161001, 95831,CPT,MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK,,30,,,$203.25,$0.00,1,0,1,20161001, 95832,CPT,MUSC TSTG MNL W/REPRT HAND W/WO CMPRSN NRML SIDE,,30,,,$171.22,$0.00,1,0,1,20161001, 95833,CPT,MUSC TSTG MNL W/REPRT TOTAL EVAL BODY EX HANDS,,30,,,$177.96,$0.00,1,0,1,20161001, 95834,CPT,MUSC TSTG MNL W/REPRT TOTAL EVAL BODY W/HANDS,,30,,,$323.83,$0.00,1,0,1,20161001, 95851,CPT,ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI,,30,,,$117.55,$0.00,1,0,1,20161001, 95852,CPT,ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID,,30,,,$117.55,$0.00,1,0,1,20161001, 95857,CPT,CHOLINESTERASE INHIBITOR CHALLENGE TEST,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95860,CPT,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$425.53,$0.00,1,0,1,20161001, 95861,CPT,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$425.53,$0.00,1,0,1,20161001, 95863,CPT,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$746.33,$0.00,1,0,1,20161001, 95864,CPT,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$746.33,$0.00,1,0,1,20161001, 95865,CPT,NEEDLE ELECTROMYOGRAPHY LARYNX,,30,,,$425.53,$0.00,1,0,1,20161001, 95866,CPT,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,,30,,,$746.33,$0.00,1,0,1,20161001, 95867,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,,30,,,$746.33,$0.00,1,0,1,20161001, 95868,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,,30,,,$746.33,$0.00,1,0,1,20161001, 95869,CPT,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,,30,,,$746.33,$0.00,1,0,1,20161001, 95870,CPT,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,,30,,,$425.53,$0.00,1,0,1,20161001, 95872,CPT,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,,30,,,$746.33,$0.00,1,0,1,20161001, 95873,CPT,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,,30,,,$335.22,$0.00,1,0,1,20161001, 95874,CPT,NEEDLE EMG GUID W/CHEMODENERVATION,,30,,,$329.14,$0.00,1,0,1,20161001, 95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,,30,,,$746.33,$0.00,1,0,1,20161001, 95885,CPT,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,,30,,,"$1,322.06",$0.00,1,0,1,20161001, 95886,CPT,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,,30,,,"$2,071.64",$0.00,1,0,1,20161001, 95887,CPT,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,,30,,,"$1,845.94",$0.00,1,0,1,20161001, 95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,,30,,,$425.53,$0.00,1,0,1,20161001, 95907,CPT,NERVE CONDUCTION STUDIES 1-2 STUDIES,,30,,,$746.33,$0.00,1,0,1,20161001, 95908,CPT,NERVE CONDUCTION STUDIES 3-4 STUDIES,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95909,CPT,NERVE CONDUCTION STUDIES 5-6 STUDIES,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95910,CPT,NERVE CONDUCTION STUDIES 7-8 STUDIES,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95911,CPT,NERVE CONDUCTION STUDIES 9-10 STUDIES,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95912,CPT,NERVE CONDUCTION STUDIES 11-12 STUDIES,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95913,CPT,NERVE CONDUCTION STUDIES 13/> STUDIES,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,,30,,,$746.33,$0.00,1,0,1,20161001, 95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,,30,,,$425.53,$0.00,1,0,1,20161001, 95923,CPT,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,,30,,,$425.53,$0.00,1,0,1,20161001, 95924,CPT,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,,30,,,"$5,245.62",$0.00,1,0,1,20161001, 95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95933,CPT,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,,30,,,$306.21,$0.00,1,0,1,20161001, 95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,,30,,,$746.33,$0.00,1,0,1,20161001, 95938,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95939,CPT,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95940,CPT,IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES,,30,,,$351.39,$0.00,1,0,1,20161001, 95941,CPT,IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR,,30,,,"$1,446.89",$0.00,1,0,1,20161001, 95943,CPT,PARASYMP & SYMP NRV FUNCJ HRT RATE VARIABILITY,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 95950,CPT,MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95951,CPT,LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95953,CPT,LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95954,CPT,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95955,CPT,EEG NONINTRACRANIAL SURGERY,,30,,,"$1,645.71",$0.00,1,0,1,20161001, 95956,CPT,MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 95957,CPT,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,,30,,,"$1,414.53",$0.00,1,0,1,20161001, 95958,CPT,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95961,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,,30,,,"$5,245.62",$0.00,1,0,1,20161001, 95962,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,,30,,,"$1,068.93",$0.00,1,0,1,20161001, 95965,CPT,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95966,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 95967,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,,30,,,"$5,998.57",$0.00,1,0,1,20161001, 95970,CPT,ELEC ALYS NSTIM PLS GEN BRN/SC/PERPH W/O REPRGRM,,30,,,$425.53,$0.00,1,0,1,20161001, 95971,CPT,ELEC ALYS NSTIM PLS GEN SMPL SC/PERPH W/PRGRMG,,30,,,$429.61,$0.00,1,0,1,20161001, 95972,CPT,ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH W/PRGRMG,,30,,,$429.61,$0.00,1,0,1,20161001, 95974,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR,,30,,,$429.61,$0.00,1,0,1,20161001, 95975,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN,,30,,,$881.63,$0.00,1,0,1,20161001, 95978,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN 1ST HR,,30,,,$429.61,$0.00,1,0,1,20161001, 95979,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN EA 30 MIN,,30,,,$881.63,$0.00,1,0,1,20161001, 95981,CPT,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,,30,,,$306.21,$0.00,1,0,1,20161001, 95982,CPT,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,,30,,,$221.12,$0.00,1,0,1,20161001, 95990,CPT,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,,30,,,"$1,527.90",$0.00,1,0,1,20161001, 95991,CPT,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,,30,,,$851.10,$0.00,1,0,1,20161001, 95992,CPT,CANALITH REPOSITIONING PROCEDURE,,30,,,$587.75,$0.00,1,0,1,20161001, 95999,CPT,UNLIS NEUROLOGICAL/NEUROMUSCULAR DX PX,,30,,,$746.33,$0.00,1,0,1,20161001, 96000,CPT,COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS,,30,,,"$2,581.69",$0.00,1,0,1,20161001, 96001,CPT,COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG,,30,,,"$5,245.62",$0.00,1,0,1,20161001, 96002,CPT,DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 96003,CPT,DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC,,30,,,$871.03,$0.00,1,0,1,20161001, 96020,CPT,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,,30,,,"$7,592.75",$0.00,1,0,1,20161001, 96040,CPT,MEDICAL GENETICS COUNSELING EACH 30 MINUTES,,30,,,$360.58,$0.00,1,0,1,20161001, 96101,CPT,PSYCHOLOGICAL TESTING PR HR WITH PATIENT,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 96102,CPT,PSYCHOLOGICAL TESTING ADMN BY TECH PR HR,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 96103,CPT,PSYCHOLOGICAL TESTING COMPUTER W/PROF I&R,,30,,,$425.53,$0.00,1,0,1,20161001, 96105,CPT,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,,30,,,$640.77,$0.00,1,0,1,20161001, 96110,CPT,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,,30,,,$230.81,$0.00,1,0,1,20161001, 96111,CPT,DEVELOPMENTAL TESTING W/INTERP & REPORT,,30,,,$666.94,$0.00,1,0,1,20161001, 96116,CPT,NUBHVL STATUS XM PR HR W/PT INTERPJ&PREPJ,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 96118,CPT,NUROPSYC TESTING PR HR W/PT & INTERPJ TIME,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 96119,CPT,NEUROPSYC TSTG W/PROF I&R ADMN BY TECH PR HR,,30,,,"$1,355.75",$0.00,1,0,1,20161001, 96120,CPT,NEUROPSYCHOLOG TESTING COMPUTER W/PROF I&R,,30,,,$746.33,$0.00,1,0,1,20161001, 96127,CPT,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,,30,,,$81.90,$0.00,1,0,1,20161001, 96150,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT 1ST ASSMT,,30,,,$287.49,$0.00,1,0,1,20161001, 96151,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT RE-ASSMT,,30,,,$287.49,$0.00,1,0,1,20161001, 96152,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN INDIV,,30,,,$287.49,$0.00,1,0,1,20161001, 96153,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN GRP 2/>PTS,,30,,,$108.34,$0.00,1,0,1,20161001, 96154,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/PT,,30,,,$287.49,$0.00,1,0,1,20161001, 96155,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/O PT,,30,,,$132.06,$0.00,1,0,1,20161001, 96360,CPT,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,,30,,,$451.93,$0.00,1,0,1,20161001, 96361,CPT,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,,30,,,$223.07,$0.00,1,0,1,20161001, 96365,CPT,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,,30,,,$851.10,$0.00,1,0,1,20161001, 96366,CPT,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,,30,,,$223.07,$0.00,1,0,1,20161001, 96367,CPT,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,,30,,,$323.92,$0.00,1,0,1,20161001, 96368,CPT,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,,30,,,$276.82,$0.00,1,0,1,20161001, 96369,CPT,SUBCUTANEOUS INFUSION INITIAL 1 HR W/PUMP SET-UP,,30,,,$851.10,$0.00,1,0,1,20161001, 96370,CPT,SUBCUTANEOUS INFUSION EACH ADDITIONAL HOUR,,30,,,$223.07,$0.00,1,0,1,20161001, 96371,CPT,SUBQ INFUSION ADDITIONAL PUMP INFUSION SITE,,30,,,$220.36,$0.00,1,0,1,20161001, 96372,CPT,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,,30,,,$323.92,$0.00,1,0,1,20161001, 96373,CPT,THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL,,30,,,$451.93,$0.00,1,0,1,20161001, 96374,CPT,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,,30,,,$451.93,$0.00,1,0,1,20161001, 96375,CPT,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,,30,,,$274.68,$0.00,1,0,1,20161001, 96376,CPT,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,,30,,,$239.38,$0.00,1,0,1,20161001, 96379,CPT,UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS,,30,,,$223.07,$0.00,1,0,1,20161001, 96401,CPT,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,,30,,,$451.93,$0.00,1,0,1,20161001, 96402,CPT,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,,30,,,$323.92,$0.00,1,0,1,20161001, 96405,CPT,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL 7,,30,,,$851.10,$0.00,1,0,1,20161001, 96409,CPT,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,,30,,,$851.10,$0.00,1,0,1,20161001, 96411,CPT,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,,30,,,$451.93,$0.00,1,0,1,20161001, 96413,CPT,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,,30,,,"$1,532.23",$0.00,1,0,1,20161001, 96415,CPT,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,,30,,,$323.92,$0.00,1,0,1,20161001, 96416,CPT,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,,30,,,"$1,532.23",$0.00,1,0,1,20161001, 96417,CPT,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,,30,,,$323.92,$0.00,1,0,1,20161001, 96420,CPT,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,,30,,,"$1,527.90",$0.00,1,0,1,20161001, 96422,CPT,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS 8 HR PRTBLE IMPLTBL PMP,,30,,,"$1,532.23",$0.00,1,0,1,20161001, 96440,CPT,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,,30,,,"$1,527.90",$0.00,1,0,1,20161001, 96446,CPT,CHEMOTX ADMN PRTL CAVITY PORT/CATH,,30,,,"$1,527.90",$0.00,1,0,1,20161001, 96450,CPT,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,,30,,,"$1,532.23",$0.00,1,0,1,20161001, 96521,CPT,REFILLING & MAINTENANCE PORTABLE PUMP,,30,,,$851.10,$0.00,1,0,1,20161001, 96522,CPT,REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC,,30,,,$851.10,$0.00,1,0,1,20161001, 96523,CPT,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,,30,,,$306.21,$0.00,1,0,1,20161001, 96542,CPT,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,,30,,,$844.33,$0.00,1,0,1,20161001, 96549,CPT,UNLISTED CHEMOTHERAPY PROCEDURE,,30,,,$223.07,$0.00,1,0,1,20161001, 96567,CPT,PDT XTRNL APPL LIGHT DSTR LES SKN BY ACTIVJ RX,,30,,,$398.75,$0.00,1,0,1,20161001, 96570,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,,30,,,$443.96,$0.00,1,0,1,20161001, 96571,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,,30,,,$221.98,$0.00,1,0,1,20161001, 96900,CPT,ACTINOTHERAPY ULTRAVIOLET LIGHT,,30,,,$156.54,$0.00,1,0,1,20161001, 96904,CPT,WHOLE BODY INTEGUMENTARY PHOTOGRAPHY,,30,,,$519.04,$0.00,1,0,1,20161001, 96910,CPT,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,,30,,,$306.21,$0.00,1,0,1,20161001, 96912,CPT,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,,30,,,$306.21,$0.00,1,0,1,20161001, 96913,CPT,PHOTOCHEMOTHERAPY DERMATOSES 4-8 HRS SUPERVISION,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 96920,CPT,LASER SKIN DISEASE PSORIASIS TOT AREA <250 SQ CM,,30,,,$398.75,$0.00,1,0,1,20161001, 96921,CPT,LASER SKIN DISEASE PSORIASIS 250-500 SQ CM,,30,,,$398.75,$0.00,1,0,1,20161001, 96922,CPT,LASER SKIN DISEASE PSORIASIS >500 SQ CM,,30,,,$398.75,$0.00,1,0,1,20161001, 96932,CPT,RCM CELULR & SUBCELULR SKN IMGNG IMG ACQUISITION,,30,,,$155.67,$0.00,1,0,1,20161001, 96999,CPT,UNLISTED SPECIAL DERMATOLOGICAL SERVICE/PROCED,,30,,,$398.75,$0.00,1,0,1,20161001, 97005,CPT,ATHLETIC TRAINING EVALUATION,,30,,,$108.95,$0.00,1,0,1,20161001, 97006,CPT,ATHLETIC TRAINING RE-EVALUATION,,30,,,$72.63,$0.00,1,0,1,20161001, 97014,CPT,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,,30,,,$72.63,$0.00,1,0,1,20161001, 97597,CPT,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 97598,CPT,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 97602,CPT,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,,30,,,$398.75,$0.00,1,0,1,20161001, 97605,CPT,NEGATIVE PRESSURE WOUND THERAPY DME 50 SQ CM,,30,,,$398.75,$0.00,1,0,1,20161001, 97607,CPT,NEG PRESSURE WOUND THERAPY NON DME 50 SQ CM,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 97610,CPT,LOW FREQUENCY NON-THERMAL ULTRASOUND PER DAY,,30,,,$398.75,$0.00,1,0,1,20161001, 97810,CPT,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,,30,,,$123.33,$0.00,1,0,1,20161001, 97811,CPT,ACUPUNCTURE 1/> NDLS W/O ELEC STIMJ EA 15 MIN,,30,,,$102.20,$0.00,1,0,1,20161001, 97813,CPT,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,,30,,,$128.61,$0.00,1,0,1,20161001, 97814,CPT,ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ,,30,,,$118.28,$0.00,1,0,1,20161001, 98925,CPT,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98926,CPT,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98927,CPT,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98928,CPT,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98929,CPT,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98940,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98941,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98942,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS,,30,,,$124.62,$0.00,1,0,1,20161001, 98943,CPT,CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION,,30,,,$62.10,$0.00,1,0,1,20161001, 98960,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT,,30,,,$108.43,$0.00,1,0,1,20161001, 98961,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS,,30,,,$86.99,$0.00,1,0,1,20161001, 98962,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS,,30,,,$107.66,$0.00,1,0,1,20161001, 99000,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,,30,,,$24.38,$0.00,1,0,1,20161001, 99001,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,,30,,,$49.38,$0.00,1,0,1,20161001, 99002,CPT,HANDLE/CONVEY/ANY OTH SVC DEVICE FIT PHYS/QHP,,30,,,$188.40,$0.00,1,0,1,20161001, 99024,CPT,POSTOP FOLLOW UP VISIT RELATED TO ORIGINAL PX,,30,,,$202.04,$0.00,1,0,1,20161001, 99026,CPT,HOSPITAL MANDATED CALL SERVICE IN-HOSPITAL EA HR,,30,,,$65.08,$0.00,1,0,1,20161001, 99050,CPT,SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS,,30,,,$86.40,$0.00,1,0,1,20161001, 99051,CPT,SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS,,30,,,$186.96,$0.00,1,0,1,20161001, 99053,CPT,SERVICES PROVIDED BTW 10 PM&8 AM AT 24-HR FACI,,30,,,$72.55,$0.00,1,0,1,20161001, 99056,CPT,SVC TYPICAL PRV OFFICE PRV OUT OFFICE REQUEST PT,,30,,,$18.37,$0.00,1,0,1,20161001, 99058,CPT,SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS,,30,,,$34.96,$0.00,1,0,1,20161001, 99060,CPT,SVC PRV EMER OUT OFFICE DISRUPTS OFFICE SVC,,30,,,"$1,592.73",$0.00,1,0,1,20161001, 99070,CPT,SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,,30,,,$557.17,$0.00,1,0,1,20161001, 99071,CPT,EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST,,30,,,$97.61,$0.00,1,0,1,20161001, 99078,CPT,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,,30,,,$473.11,$0.00,1,0,1,20161001, 99080,CPT,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,,30,,,$5.74,$0.00,1,0,1,20161001, 99082,CPT,UNUSUAL TRAVEL,,30,,,$140.43,$0.00,1,0,1,20161001, 99090,CPT,ANALYSIS CLINICAL DATA STORED IN COMPUTERS,,30,,,$244.52,$0.00,1,0,1,20161001, 99091,CPT,COLLJ&INTERPJ PHYS/QHP PHYSIO COMPUTR DATA 30 MI,,30,,,$53.40,$0.00,1,0,1,20161001, 99100,CPT,ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<,,30,,,$319.81,$0.00,1,0,1,20161001, 99140,CPT,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,,30,,,$473.97,$0.00,1,0,1,20161001, 99143,CPT,MODERATE SEDATJ SAME PHYS/QHP <5 YRS INIT 30 MIN,,30,,,$682.68,$0.00,1,0,1,20161001, 99144,CPT,MODERATE SEDATJ SAME PHYS/QHP 5/>YRS INIT 30 MIN,,30,,,$556.32,$0.00,1,0,1,20161001, 99145,CPT,MODERATE SEDATJ SAME PHYS/QHP EACH ADDL 15 MIN,,30,,,$215.14,$0.00,1,0,1,20161001, 99148,CPT,MOD SEDATJ DIFF PHYS/QHP <5 YRS INIT 30 MIN,,30,,,$536.27,$0.00,1,0,1,20161001, 99149,CPT,MODERATE SEDATJ DIFF PHYS/QHP 5/>YRS INIT 30 MIN,,30,,,$451.07,$0.00,1,0,1,20161001, 99150,CPT,MODERATE SEDATJ DIFF PHYS/QHP EA ADDL 15 MIN,,30,,,$258.99,$0.00,1,0,1,20161001, 99170,CPT,ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG,,30,,,$916.02,$0.00,1,0,1,20161001, 99172,CPT,VISUAL FUNCT SCRNG AUTO SEMI-AUTO BI QUAN DETERM,,30,,,$283.54,$0.00,1,0,1,20161001, 99173,CPT,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,,30,,,$90.72,$0.00,1,0,1,20161001, 99174,CPT,INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT,,30,,,$82.68,$0.00,1,0,1,20161001, 99175,CPT,IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,,30,,,$287.08,$0.00,1,0,1,20161001, 99183,CPT,PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION,,30,,,"$2,517.14",$0.00,1,0,1,20161001, 99195,CPT,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,,30,,,$425.53,$0.00,1,0,1,20161001, 99199,CPT,UNLISTED SPECIAL SERVICE PROCEDURE/REPORT,,30,,,$287.08,$0.00,1,0,1,20161001, 99201,CPT,OFFICE OUTPATIENT NEW 10 MINUTES,,30,,,$163.44,$0.00,1,0,1,20161001, 99202,CPT,OFFICE OUTPATIENT NEW 20 MINUTES,,30,,,$203.97,$0.00,1,0,1,20161001, 99203,CPT,OFFICE OUTPATIENT NEW 30 MINUTES,,30,,,$310.41,$0.00,1,0,1,20161001, 99204,CPT,OFFICE OUTPATIENT NEW 45 MINUTES,,30,,,$388.83,$0.00,1,0,1,20161001, 99205,CPT,OFFICE OUTPATIENT NEW 60 MINUTES,,30,,,$562.36,$0.00,1,0,1,20161001, 99211,CPT,OFFICE OUTPATIENT VISIT 5 MINUTES,,30,,,$159.38,$0.00,1,0,1,20161001, 99212,CPT,OFFICE OUTPATIENT VISIT 10 MINUTES,,30,,,$196.75,$0.00,1,0,1,20161001, 99213,CPT,OFFICE OUTPATIENT VISIT 15 MINUTES,,30,,,$254.77,$0.00,1,0,1,20161001, 99214,CPT,OFFICE OUTPATIENT VISIT 25 MINUTES,,30,,,$333.05,$0.00,1,0,1,20161001, 99215,CPT,OFFICE OUTPATIENT VISIT 40 MINUTES,,30,,,$399.90,$0.00,1,0,1,20161001, 99217,CPT,OBSERVATION CARE DISCHARGE MANAGEMENT,,30,,,$114.12,$0.00,1,1,1,20161001, 99218,CPT,INITIAL OBSERVATION CARE/DAY 30 MINUTES,,30,,,$114.12,$356.52,2,1,1,20161001, 99219,CPT,INITIAL OBSERVATION CARE/DAY 50 MINUTES,,30,,,$114.12,$356.52,2,1,1,20161001, 99220,CPT,INITIAL OBSERVATION CARE/DAY 70 MINUTES,,30,,,$114.12,$356.52,2,1,1,20161001, 99224,CPT,SBSQ OBSERVATION CARE/DAY 15 MINUTES,,30,,,$114.12,$0.00,1,1,1,20161001, 99225,CPT,SBSQ OBSERVATION CARE/DAY 25 MINUTES,,30,,,$114.12,$0.00,1,1,1,20161001, 99226,CPT,SBSQ OBSERVATION CARE/DAY 35 MINUTES,,30,,,$114.12,$0.00,1,1,1,20161001, 99231,CPT,SBSQ HOSPITAL CARE/DAY 15 MINUTES,,30,,,$39.48,$0.00,1,0,1,20161001, 99232,CPT,SBSQ HOSPITAL CARE/DAY 25 MINUTES,,30,,,$155.69,$0.00,1,0,1,20161001, 99233,CPT,SBSQ HOSPITAL CARE/DAY 35 MINUTES,,30,,,$243.45,$0.00,1,0,1,20161001, 99234,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES,,30,,,$114.12,$356.52,2,1,1,20161001, 99235,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES,,30,,,$114.12,$356.52,2,1,1,20161001, 99236,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES,,30,,,$114.12,$356.52,2,1,1,20161001, 99238,CPT,HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<,,30,,,$288.35,$0.00,1,0,1,20161001, 99239,CPT,HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN,,30,,,$341.63,$0.00,1,0,1,20161001, 99241,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN,,30,,,$190.62,$0.00,1,0,1,20161001, 99242,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 30 MIN,,30,,,$331.21,$0.00,1,0,1,20161001, 99243,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN,,30,,,$409.95,$0.00,1,0,1,20161001, 99244,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN,,30,,,$493.78,$0.00,1,0,1,20161001, 99245,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 80 MIN,,30,,,"$1,055.31",$0.00,1,0,1,20161001, 99252,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 40 MIN,,30,,,$574.16,$0.00,1,0,1,20161001, 99253,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 55 MIN,,30,,,$725.47,$0.00,1,0,1,20161001, 99254,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 80 MIN,,30,,,$887.58,$0.00,1,0,1,20161001, 99281,CPT,EMERGENCY DEPARTMENT VISIT LIMITED/MINOR PROB,,30,,,$243.35,$0.00,1,1,1,20161001, 99282,CPT,EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY,,30,,,$675.16,$0.00,1,1,1,20161001, 99283,CPT,EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY,,30,,,"$1,249.49",$0.00,1,1,1,20161001, 99284,CPT,EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY,,30,,,"$1,780.04",$0.00,1,1,1,20161001, 99285,CPT,EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ,,30,,,"$2,731.45",$0.00,1,1,1,20161001, 99288,CPT,PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS,,30,,,$311.20,$0.00,1,1,1,20161001, 99291,CPT,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,,30,,,"$3,980.92",$0.00,1,1,1,20161001, 99292,CPT,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,,30,,,"$4,542.04",$0.00,1,1,1,20161001, 99304,CPT,INITIAL NURSING FACILITY CARE/DAY 25 MINUTES,,30,,,$186.03,$0.00,1,0,1,20161001, 99305,CPT,INITIAL NURSING FACILITY CARE/DAY 35 MINUTES,,30,,,$222.78,$0.00,1,0,1,20161001, 99306,CPT,INITIAL NURSING FACILITY CARE/DAY 45 MINUTES,,30,,,$311.20,$0.00,1,0,1,20161001, 99307,CPT,SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN,,30,,,$103.35,$0.00,1,0,1,20161001, 99308,CPT,SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN,,30,,,$146.99,$0.00,1,0,1,20161001, 99309,CPT,SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN,,30,,,$197.51,$0.00,1,0,1,20161001, 99310,CPT,SBSQ NURS FACIL CARE/DAY UNSTABL/NEW PROB 35 MIN,,30,,,$271.01,$0.00,1,0,1,20161001, 99315,CPT,NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES,,30,,,$161.91,$0.00,1,0,1,20161001, 99316,CPT,NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES,,30,,,$219.33,$0.00,1,0,1,20161001, 99318,CPT,E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN,,30,,,$204.40,$0.00,1,0,1,20161001, 99324,CPT,DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN,,30,,,$138.60,$0.00,1,0,1,20161001, 99325,CPT,DOMICIL/REST HOME NEW PT VISIT MOD SEVER 30 MIN,,30,,,$218.18,$0.00,1,0,1,20161001, 99326,CPT,DOMICIL/REST HOME NEW PT HI-MOD SEVER 45 MINUTES,,30,,,$235.41,$0.00,1,0,1,20161001, 99334,CPT,DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES,,30,,,$133.21,$0.00,1,0,1,20161001, 99335,CPT,DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES,,30,,,$177.76,$0.00,1,0,1,20161001, 99336,CPT,DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES,,30,,,$252.63,$0.00,1,0,1,20161001, 99337,CPT,DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES,,30,,,$361.15,$0.00,1,0,1,20161001, 99341,CPT,HOME VISIT NEW PATIENT LOW SEVERITY 20 MINUTES,,30,,,$128.62,$0.00,1,0,1,20161001, 99342,CPT,HOME VISIT NEW PATIENT MOD SEVERITY 30 MINUTES,,30,,,$166.93,$0.00,1,0,1,20161001, 99343,CPT,HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES,,30,,,$259.97,$0.00,1,0,1,20161001, 99344,CPT,HOME VISIT NEW PATIENT HI SEVERITY 60 MINUTES,,30,,,$415.96,$0.00,1,0,1,20161001, 99345,CPT,HOME VISIT NEW PT UNSTABL/SIGNIF NEW PROB 75 MIN,,30,,,$503.53,$0.00,1,0,1,20161001, 99347,CPT,HOME VISIT EST PT SELF LIMITED/MINOR 15 MINUTES,,30,,,$127.67,$0.00,1,0,1,20161001, 99348,CPT,HOME VISIT EST PT LOW-MOD SEVERITY 25 MINUTES,,30,,,$178.74,$0.00,1,0,1,20161001, 99349,CPT,HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES,,30,,,$285.99,$0.00,1,0,1,20161001, 99350,CPT,HOME VST EST PT UNSTABLE/SIGNIF NEW PROB 60 MINS,,30,,,$380.47,$0.00,1,0,1,20161001, 99354,CPT,PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON 1ST HR,,30,,,$124.98,$0.00,1,0,1,20161001, 99355,CPT,PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON ADDL 30,,30,,,$523.64,$0.00,1,0,1,20161001, 99358,CPT,PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR,,30,,,"$1,446.89",$0.00,1,0,1,20161001, 99359,CPT,PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES,,30,,,"$1,766.05",$0.00,1,0,1,20161001, 99360,CPT,PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES,,30,,,$299.52,$0.00,1,0,1,20161001, 99363,CPT,ANTICOAGULANT MGMT OUTPATIENT INIT 90 DAYS,,30,,,$158.25,$0.00,1,0,1,20161001, 99364,CPT,ANTICOAGULANT MGMT OUTPATIENT EA SBSQ 90 DAYS,,30,,,$129.76,$0.00,1,0,1,20161001, 99366,CPT,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,,30,,,$229.67,$0.00,1,0,1,20161001, 99367,CPT,TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN,,30,,,$290.53,$0.00,1,0,1,20161001, 99368,CPT,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,,30,,,$315.79,$0.00,1,0,1,20161001, 99375,CPT,SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>,,30,,,$128.44,$0.00,1,0,1,20161001, 99381,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR,,30,,,$230.81,$0.00,1,0,1,20161001, 99382,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS,,30,,,$264.12,$0.00,1,0,1,20161001, 99383,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS,,30,,,$263.20,$0.00,1,0,1,20161001, 99384,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR,,30,,,$297.42,$0.00,1,0,1,20161001, 99385,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,,30,,,$253.78,$0.00,1,0,1,20161001, 99386,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS,,30,,,$362.11,$0.00,1,0,1,20161001, 99387,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,,30,,,$338.76,$0.00,1,0,1,20161001, 99391,CPT,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y,,30,,,$198.66,$0.00,1,0,1,20161001, 99392,CPT,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,,30,,,$230.81,$0.00,1,0,1,20161001, 99393,CPT,PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS,,30,,,$230.81,$0.00,1,0,1,20161001, 99394,CPT,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,,30,,,$264.12,$0.00,1,0,1,20161001, 99395,CPT,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,,30,,,$214.74,$0.00,1,0,1,20161001, 99396,CPT,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,,30,,,$243.45,$0.00,1,0,1,20161001, 99397,CPT,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,,30,,,$284.79,$0.00,1,0,1,20161001, 99401,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,,30,,,$251.78,$0.00,1,0,1,20161001, 99402,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,,30,,,$229.67,$0.00,1,0,1,20161001, 99403,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,,30,,,$458.18,$0.00,1,0,1,20161001, 99404,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,,30,,,$574.16,$0.00,1,0,1,20161001, 99406,CPT,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,,30,,,$108.34,$0.00,1,0,1,20161001, 99407,CPT,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,,30,,,$108.34,$0.00,1,0,1,20161001, 99408,CPT,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,,30,,,$114.83,$0.00,1,0,1,20161001, 99409,CPT,ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN,,30,,,$289.31,$0.00,1,0,1,20161001, 99411,CPT,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M,,30,,,$57.42,$0.00,1,0,1,20161001, 99412,CPT,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M,,30,,,$95.71,$0.00,1,0,1,20161001, 99420,CPT,ADMN & INTERPJ HEALTH RISK ASSESSMENT INSTRUMENT,,30,,,$57.42,$0.00,1,0,1,20161001, 99429,CPT,UNLISTED PREVENTIVE MEDICINE SERVICE,,30,,,$47.08,$0.00,1,0,1,20161001, 99446,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 5-10,,30,,,$118.71,$0.00,1,0,1,20161001, 99447,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 11-20,,30,,,$169.85,$0.00,1,0,1,20161001, 99448,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 21-30,,30,,,$222.03,$0.00,1,0,1,20161001, 99449,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 31/>,,30,,,$266.60,$0.00,1,0,1,20161001, 99456,CPT,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,,30,,,$157.32,$0.00,1,0,1,20161001, 99460,CPT,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,,30,,,$217.87,$0.00,1,0,1,20161001, 99461,CPT,1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER,,30,,,$268.71,$0.00,1,0,1,20161001, 99463,CPT,1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT,,30,,,$217.87,$0.00,1,0,1,20161001, 99465,CPT,DELIVERY/BIRTHING ROOM RESUSCITATION,,30,,,"$2,962.78",$0.00,1,0,1,20161001, 99490,CPT,CHRON CARE MANAGEMENT SRVC 20 MIN PER MONTH,,30,,,$134.54,$0.00,1,0,1,20161001, 99495,CPT,TRANSITIONAL CARE MANAGE SRVC 14 DAY DISCHARGE,,30,,,$217.87,$0.00,1,0,1,20161001, 99496,CPT,TRANSITIONAL CARE MANAGE SRVC 7 DAY DISCHARGE,,30,,,$217.87,$0.00,1,0,1,20161001, 99497,CPT,ADVANCE CARE PLANNING FIRST 30 MINS,,30,,,$131.68,$0.00,1,0,1,20161001, 99499,CPT,UNLISTED EVALUATION AND MANAGEMENT SERVICE,,30,,,$210.21,$0.00,1,0,1,20161001, 99500,CPT,HOME VISIT PRENATAL MONITORING & ASSESSMENT,,30,,,$844.43,$0.00,1,0,1,20161001, 99501,CPT,HOME VISIT POSTNATAL ASSMT&F-UP CARE,,30,,,$344.50,$0.00,1,0,1,20161001, 99502,CPT,HOME VISIT NEWBORN CARE & ASSESSMENT,,30,,,$218.18,$0.00,1,0,1,20161001, 99503,CPT,HOME VISIT RESPIRATORY THERAPY CARE,,30,,,$229.67,$0.00,1,0,1,20161001, 99505,CPT,HOME VISIT STOMA CARE&MAINT CLST&CSTOST,,30,,,$194.16,$0.00,1,0,1,20161001, 99506,CPT,HOME VISIT INTRAMUSCULAR INJECTIONS,,30,,,$401.91,$0.00,1,0,1,20161001, 99507,CPT,HOME VISIT CARE&MAINT CATH,,30,,,$172.25,$0.00,1,0,1,20161001, 99509,CPT,HOME VISIT ASSISTANCE DAILY LIV&PRSONAL CARE,,30,,,$287.08,$0.00,1,0,1,20161001, 99510,CPT,HOME VISIT INDIV FAM/MARRIAGE COUNSELING,,30,,,$321.53,$0.00,1,0,1,20161001, 99512,CPT,HOME VISIT HEMODIALYSIS,,30,,,"$3,582.78",$0.00,1,0,1,20161001, 99600,CPT,UNLISTED HOME VISIT SERVICE/PROCEDURE,,30,,,$246.89,$0.00,1,0,1,20161001, 99601,CPT,HOME NFS/SPECTY DRUG ADMN PR VST /EQUAL 200 CC TISS,,30,,,"$10,555.96",$0.00,1,0,1,20161001, 0085T,CPT,BREATH TEST HEART TRANSPLANT REJECTION,,30,,,$75.48,$0.00,1,0,1,20161001, 0100T,CPT,PLMT SCJNCL RTA PROSTH&PLS&IMPLTJ INTRA-OC RTA,,30,,,"$190,000.00",$0.00,1,0,1,20161001, 0101T,CPT,EXTRCORPL SHOCK WAVE MUSCSKELE NOS HIGH ENERGY,,30,,,"$7,815.00",$0.00,1,0,1,20161001, 0102T,CPT,EXTRCRPL SHOCK WAVE W/ANES LAT HUMERL EPICONDYLE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 0106T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/TOUCH STIMULI,,30,,,$156.54,$0.00,1,0,1,20161001, 0107T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/VIBRJ STIMULI,,30,,,$156.54,$0.00,1,0,1,20161001, 0108T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/COOL STIMULI,,30,,,$306.21,$0.00,1,0,1,20161001, 0109T,CPT,QUANT SENAORY TEST&INTERPJ/XTR W/HT-PN STIMULI,,30,,,$156.54,$0.00,1,0,1,20161001, 0110T,CPT,QUANT SENSORY TEST&INTERPJ/XTR OTHER STIMULI,,30,,,$425.53,$0.00,1,0,1,20161001, 0126T,CPT,COMMON CAROTID INTIMA MEDIA THICKNESS STUDY,,30,,,$156.54,$0.00,1,0,1,20161001, 0159T,CPT,COMPUTER AIDED DETECTION BREAST MRI,,30,,,$429.47,$0.00,1,0,1,20161001, 0171T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR 1 LVL,,30,,,"$21,075.80",$0.00,1,0,1,20161001, 0172T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR EA LVL,,30,,,"$25,892.17",$0.00,1,0,1,20161001, 0174T,CPT,CAD CHEST RADIOGRAPH CONCURRENT W/INTERPRETATION,,30,,,$30.06,$0.00,1,0,1,20161001, 0179T,CPT,64 LEAD ECG W/TRACING & GRAPHICS,,30,,,$156.54,$0.00,1,0,1,20161001, 0184T,CPT,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,,30,,,"$17,638.18",$0.00,1,0,1,20161001, 0190T,CPT,INTRAOCULAR RADIATION SRC APPLICATOR PLACEMENT,,30,,,"$9,145.21",$0.00,1,0,1,20161001, 0191T,CPT,ANT SEGMENT INSERTION DRAINAGE W/O RESERVOIR INT,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 0198T,CPT,MEAS OCULAR BLOOD FLOW REPEAT IO PRES SAMP W/I&R,,30,,,$306.21,$0.00,1,0,1,20161001, 0200T,CPT,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 0201T,CPT,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 0206T,CPT,CPTR DBS ALYS MLT CYCLS CAR ELEC DTA 2/> ECG LDS,,30,,,$306.21,$0.00,1,0,1,20161001, 0207T,CPT,EVAC MEIBOMIAN GLNDS AUTO HT& INTMT PRESS UNI,,30,,,$427.56,$0.00,1,0,1,20161001, 0208T,CPT,PURE TONE AUDIOMETRY AUTOMATED AIR ONLY,,30,,,$155.67,$0.00,1,0,1,20161001, 0209T,CPT,PURE TONE AUDIOMETRY AUTOMATED AIR & BONE,,30,,,$155.67,$0.00,1,0,1,20161001, 0210T,CPT,SPEECH AUDIOMETRY THRESHOLD AUTOMATED,,30,,,$155.67,$0.00,1,0,1,20161001, 0211T,CPT,SPEECH AUDIOM THRESHLD AUTO W/SPEECH RECOGNITION,,30,,,$155.67,$0.00,1,0,1,20161001, 0212T,CPT,COMPRE AUDIOM THRESHOLD EVAL & SPEECH RECOG,,30,,,$666.94,$0.00,1,0,1,20161001, 0213T,CPT,NJX DX/THER PARAVER FCT JT W/US CER/THOR 1 LVL,,30,,,"$5,048.03",$0.00,1,0,1,20161001, 0214T,CPT,NJX DX/THER PARAVER FCT JT W/US CER/THOR 2ND LVL,,30,,,"$1,139.95",$0.00,1,0,1,20161001, 0215T,CPT,NJX PARAVERTBRL FACET JT W/US CER/THOR 3RD&> LVL,,30,,,"$1,139.95",$0.00,1,0,1,20161001, 0216T,CPT,NJX DX/THER PARAVER FCT JT W/US LUMB/SAC 1 LVL,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 0217T,CPT,NJX DX/THER PARAVER FCT JT W/US LUMB/SAC LVL 2,,30,,,"$1,139.95",$0.00,1,0,1,20161001, 0218T,CPT,NJX PARAVERTBRL FCT JT W/US LUMB/SAC 3RD&> LVL,,30,,,"$1,139.95",$0.00,1,0,1,20161001, 0221T,CPT,PLMT POST FACET IMPLT UNI/BI W/IMG & GRFT LUMB,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 0222T,CPT,PLACE POSTERIOR INTRAFACET IMPLANT ADDL SEGMENT,,30,,,"$14,369.34",$0.00,1,0,1,20161001, 0228T,CPT,NJX ANES/STEROID TFRML EDRL W/US CER/THOR 1 LVL,,30,,,"$3,758.87",$0.00,1,0,1,20161001, 0229T,CPT,NJX ANES/STERD TFRML EDRL W/US CER/THOR EA ADDL,,30,,,"$1,822.13",$0.00,1,0,1,20161001, 0230T,CPT,NJX ANES/STEROID TFRML EDRL W/US LUM/SAC 1 LVL,,30,,,"$5,395.03",$0.00,1,0,1,20161001, 0231T,CPT,NJX ANES/STEROID TFRML EDRL W/US LUM/SAC EA ADDL,,30,,,"$1,822.13",$0.00,1,0,1,20161001, 0232T,CPT,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,,30,,,$425.53,$0.00,1,0,1,20161001, 0234T,CPT,TRLUML PERIPHERAL ATHERECTOMY RENAL ARTERY EA,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 0236T,CPT,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 0237T,CPT,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,,30,,,"$20,838.57",$0.00,1,0,1,20161001, 0238T,CPT,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,,30,,,"$29,536.30",$0.00,1,0,1,20161001, 0249T,CPT,LIGATION HEMORRHOID BUNDLE W/US,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 0253T,CPT,INSERT ANT SGM DRAINAGE DEV W/O RESERVR INT APPR,,30,,,"$14,374.95",$0.00,1,0,1,20161001, 0263T,CPT,AUTO BONE MARRW CELL RX COMPLT BONE MARRW HARVST,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 0264T,CPT,AUTO BONE MARRW CELL RX COMP W/O BONE MAR HARVST,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 0265T,CPT,BONE MAR HARVST ONLY FOR INTMUSC AUTOLO CELL RX,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 0267T,CPT,IM/REPL CARTD SINS BAROREFLX ACTIV DEV LEAD ONLY,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 0268T,CPT,IM/REPL CARTD SINS BARREFLX ACT DEV PLS GEN ONLY,,30,,,"$34,569.16",$0.00,1,0,1,20161001, 0269T,CPT,REV/REMVL CARTD SINS BARREFLX ACT DEV TOT SYSTEM,,30,,,"$17,171.61",$0.00,1,0,1,20161001, 0270T,CPT,REV/REMVL CARTD SINS BARREFLX ACT DEV LEAD ONLY,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 0271T,CPT,REV/REM CARTD SINS BARREFLX ACT DEV PLS GEN ONLY,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 0272T,CPT,INTRGORTION DEV EVAL CARTD SINS BARREFLX W/I&R,,30,,,$746.33,$0.00,1,0,1,20161001, 0273T,CPT,INTROGATION DEV EVAL CARTD SINS BARREFLX W/PRGRM,,30,,,$746.33,$0.00,1,0,1,20161001, 0274T,CPT,PERC LAMINO-/LAMINECTOMY IMAGE GUIDE CERV/THORAC,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 0275T,CPT,PERC LAMINO-/LAMINECTOMY INDIR IMAG GUIDE LUMBAR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, 0278T,CPT,TRNSCUT ELECT MODLATION PAIN REPROCES EA TX SESS,,30,,,$746.33,$0.00,1,0,1,20161001, 0282T,CPT,PERC/OPEN IMPLNT NEUROSTIM ELECTRODE SUBQ TRIAL,,30,,,"$21,925.21",$0.00,1,0,1,20161001, 0283T,CPT,PERC/OPEN IMPLNT NEUROSTIM ELECTRODE SUBQ PERM,,30,,,"$53,493.40",$0.00,1,0,1,20161001, 0284T,CPT,REV/REMVL PG/ELCTRODES IMAGNG ADDN NEW ELCTRODES,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 0285T,CPT,ELEC ANLYS IMPLANT SUBQ FIELD STIM PG REPROGRAMM,,30,,,"$5,383.20",$0.00,1,0,1,20161001, 0288T,CPT,ANSCPY W/DELVRY THERMAL ENERGY MUSCLE ANAL CANAL,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 0291T,CPT,INTRAV OPTCL CHERNCE TMGRPHY W/S&I INTL VESL,,30,,,"$6,297.43",$0.00,1,0,1,20161001, 0296T,CPT,EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD,,30,,,$425.53,$0.00,1,0,1,20161001, 0297T,CPT,EXT ECG > 48HR TO 21 DAY SCAN ANALYSIS W/REPORT,,30,,,$425.53,$0.00,1,0,1,20161001, 0298T,CPT,EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN,,30,,,$135.05,$0.00,1,0,1,20161001, 0299T,CPT,ESW HI ENERGY W/TOPCAL APP &DRESNG CARE 1ST WND,,30,,,"$1,129.82",$0.00,1,0,1,20161001, 0300T,CPT,ESW HI ENERGY W/TOPCAL APP &DRESNG CARE ADL WND,,30,,,$632.75,$0.00,1,0,1,20161001, 0301T,CPT,DEST/REDUC MALIG BRST TUMR W/US THRMORX GUIDANCE,,30,,,"$12,086.70",$0.00,1,0,1,20161001, 0302T,CPT,INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS COMPL,,30,,,"$21,356.85",$0.00,1,0,1,20161001, 0303T,CPT,INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS ELTRD,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 0304T,CPT,INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS DEVICE,,30,,,"$23,405.61",$0.00,1,0,1,20161001, 0305T,CPT,PROGRAM EVAL ICAR ISCHM MNTRNG SYS,,30,,,$221.12,$0.00,1,0,1,20161001, 0306T,CPT,INTERROGATION EVAL ICAR ISCHM MNTRNG SYS,,30,,,$221.12,$0.00,1,0,1,20161001, 0307T,CPT,RMVL INTRACARDIAC ISCHEMIA MONITORING DEVICE,,30,,,"$13,414.72",$0.00,1,0,1,20161001, 0308T,CPT,INSJ OC TLSCP PROSTH RMVL CRYSTALLINE/IO LENS,,30,,,"$35,101.66",$0.00,1,0,1,20161001, 0310T,CPT,MOTOR FUNCTION MAPPING NAVIGATED TMS TX PLAN,,30,,,$746.33,$0.00,1,0,1,20161001, 0312T,CPT,LAPS IMPLTJ NSTIM ELTRD ARRAY&PLS GEN VAGUS NRV,,30,,,"$53,456.78",$0.00,1,0,1,20161001, 0313T,CPT,LAPS REVJ/REPLCMT NSTIM ELTRD ARRAY VAGUS NRV,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 0314T,CPT,LAPS RMVL NSTIM ELTRD ARRAY & PLS GEN VAGUS NRV,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 0315T,CPT,REMOVAL PULSE GENERATOR VAGUS NERVE,,30,,,"$12,149.27",$0.00,1,0,1,20161001, 0316T,CPT,REPLACEMENT PULSE GENERATOR VAGUS NERVE,,30,,,"$53,456.78",$0.00,1,0,1,20161001, 0317T,CPT,ELEC ALYS NSTIM PLS GEN VAGUS NRV W/REPRGRMG,,30,,,$221.12,$0.00,1,0,1,20161001, 0330T,CPT,TEAR FILM IMAGING UNILATERAL OR BILATERAL W/I&R,,30,,,$156.54,$0.00,1,0,1,20161001, 0331T,CPT,MYOCRD SYMPATHETIC INNERVAJ IMG PLNR QUAL&QUANT,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 0332T,CPT,MYOCRD SYMP INNERVAJ IMG PLNR QUAL&QUANT W/SPECT,,30,,,"$7,015.43",$0.00,1,0,1,20161001, 0335T,CPT,EXTRA-OSSEOUS JOINT IMPLANT TALOTARSAL STABILIZE,,30,,,"$13,296.11",$0.00,1,0,1,20161001, 0336T,CPT,LAPS ABLATJ UTERINE FIBROIDS W/INTRAOP US GDNC,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 0337T,CPT,ENDOTHELIAL FUNCTION ASSESSMENT NON-INVASIVE,,30,,,$306.21,$0.00,1,0,1,20161001, 0338T,CPT,TRANSCATHETER RENAL SYMPATH DENERVATION UNILAT,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 0339T,CPT,TRANSCATHETER RENAL SYMPATH DENERVATION BILAT,,30,,,"$20,486.16",$0.00,1,0,1,20161001, 0340T,CPT,ABLATE PULM TUMORS W/PLEURA/CHEST WALL EXTSN,,30,,,"$19,258.15",$0.00,1,0,1,20161001, 0342T,CPT,THERAPEUTIC APHERESIS W/SELECTIVE HDL DELIP,,30,,,"$15,645.14",$0.00,1,0,1,20161001, 0347T,CPT,PLACE INTERSTITIAL DEVICE(S) IN BONE FOR RSA,,30,,,$306.21,$0.00,1,0,1,20161001, 0348T,CPT,RADIOSTEREOMETRIC ANALYSIS SPINE EXAM,,30,,,$655.16,$0.00,1,0,1,20161001, 0349T,CPT,RADIOSTEREOMETRIC ANALYSIS UPPER EXTREMITY EXAM,,30,,,$655.16,$0.00,1,0,1,20161001, 0350T,CPT,RADIOSTEREOMETRIC ANALYSIS LOWER EXTREMITY EXAM,,30,,,$399.19,$0.00,1,0,1,20161001, 0355T,CPT,GI TRACT IMAGING INTRALUMINAL COLON WITH I&R,,30,,,"$4,669.88",$0.00,1,0,1,20161001, 0356T,CPT,INSERT DRUG IMPLANT INTO LACRIMAL CANAL FOR IOP,,30,,,$306.21,$0.00,1,0,1,20161001, 0357T,CPT,CRYOPRESERVATION IMMATURE OOCYTE(S),,30,,,$424.20,$0.00,1,0,1,20161001, 0358T,CPT,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,,30,,,$156.54,$0.00,1,0,1,20161001, 0359T,CPT,BEHAVIORAL IDENTIFICATION ASSESSMENT,,30,,,$217.87,$0.00,1,0,1,20161001, 0360T,CPT,OBSERVATIONAL BEHAV ASSESSMENT FIRST 30 MIN,,30,,,$217.87,$0.00,1,0,1,20161001, 0361T,CPT,OBSERVATIONAL BEHAV ASSESSMENT ADDL 30 MIN,,30,,,$209.50,$0.00,1,0,1,20161001, 0362T,CPT,EXPOSURE BEHAV ASSESSMENT FIRST 30 MIN,,30,,,$217.87,$0.00,1,0,1,20161001, 0363T,CPT,EXPOSURE BEHAV ASSESSMENT ADDL 30 MIN,,30,,,$209.50,$0.00,1,0,1,20161001, 0364T,CPT,ADAPTIVE BEHAVIOR TX BY PROTOCOL FIRST 30 MIN,,30,,,$411.86,$0.00,1,0,1,20161001, 0365T,CPT,ADAPTIVE BEHAVIOR TX BY PROTOCOL ADDL 30 MIN,,30,,,$420.74,$0.00,1,0,1,20161001, 0366T,CPT,GROUP BEHAVIOR TREATMENT FIRST 30 MIN,,30,,,$351.69,$0.00,1,0,1,20161001, 0367T,CPT,GROUP BEHAVIOR TREATMENT ADDL 30 MIN,,30,,,$346.76,$0.00,1,0,1,20161001, 0368T,CPT,BEHAVIOR TX WITH MODIFICATION FIRST 30 MIN,,30,,,$411.86,$0.00,1,0,1,20161001, 0369T,CPT,BEHAVIOR TREATMENT WITH MODIFICATION ADDL 30 MIN,,30,,,$420.74,$0.00,1,0,1,20161001, 0370T,CPT,FAMILY BEHAVIOR TREATMENT GUIDANCE,,30,,,$501.07,$0.00,1,0,1,20161001, 0371T,CPT,MULTIPLE FAMILY GROUP BEHAV TREATMENT GUIDANCE,,30,,,$501.07,$0.00,1,0,1,20161001, 0372T,CPT,BEHAVIOR TREATMENT SOCIAL SKILLS TRAINING GROUP,,30,,,$351.69,$0.00,1,0,1,20161001, 0373T,CPT,EXPOSURE BEHAVIOR TREATMENT FIRST 60 MIN,,30,,,$479.14,$0.00,1,0,1,20161001, 0374T,CPT,EXPOSURE BEHAVIOR TREATMENT ADDL 30 MIN,,30,,,$286.35,$0.00,1,0,1,20161001, 0377T,CPT,ANOSCOPY W/BULKING AGENT INJ FOR FECAL INCONT,,30,,,"$12,930.47",$0.00,1,0,1,20161001, 0379T,CPT,VISUAL FIELD ASSESSMENT TECH SUPPORT W/INSTRUCT,,30,,,$156.54,$0.00,1,0,1,20161001, 0380T,CPT,COMP ANIMATION RETINA IMAGE TIME SERIES ANALYSIS,,30,,,$156.54,$0.00,1,0,1,20161001, 0387T,CPT,TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR,,30,,,"$29,536.30",$0.00,1,0,1,20161001, 0388T,CPT,TRANSCATH REMOVAL LEADLESS PM VENTRICULAR,,30,,,"$12,538.22",$0.00,1,0,1,20161001, 0389T,CPT,PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM,,30,,,$221.12,$0.00,1,0,1,20161001, 0391T,CPT,INTERROG DEVICE EVAL IN PERSON LEADLESS PM SYST,,30,,,$221.12,$0.00,1,0,1,20161001, 0392T,CPT,LAPS ESOPHGL SPHINCTER AUGMENT PROC PLACE DEVICE,,30,,,"$23,460.56",$0.00,1,0,1,20161001, 0393T,CPT,ESOPHGL SPHINCTER AUGMENT DEVICE REMOVAL,,30,,,"$16,186.33",$0.00,1,0,1,20161001, 0394T,CPT,HDR ELECTRONIC BRACHYTHERAPY SKIN SURFACE,,30,,,"$1,248.43",$0.00,1,0,1,20161001, 0395T,CPT,HDR ELECTRONIC BRACHYTHERAPY NTRSTL/INTRCAV,,30,,,"$4,314.55",$0.00,1,0,1,20161001, 0402T,CPT,COLLAGEN CROSS-LINKING OF CORNEA,,30,,,"$4,317.49",$0.00,1,0,1,20161001, 0404T,CPT,TRANSCERVICAL UTERINE FIBROID ABLTJ W/US GDN RF,,30,,,"$22,455.71",$0.00,1,0,1,20161001, A0380,HCPCS,BLS MILEAGE (PER MILE),,30,,,$19.19,$0.00,4,1,1,20161001, A0390,HCPCS,ALS MILEAGE (PER MILE),,30,,,$19.19,$0.00,4,1,1,20161001, A0425,HCPCS,"GROUND MILEAGE, PER STATUTE MILE",,30,,,$19.19,$0.00,4,1,1,20161001, A0426,HCPCS,"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NON-EMERGENCY TRANSPORT, LEVEL 1 (ALS 1)",,30,,,"$1,138.59",$0.00,1,1,1,20161001, A0427,HCPCS,"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)",,30,,,"$1,401.25",$0.00,1,1,1,20161001, A0428,HCPCS,"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NON-EMERGENCY TRANSPORT, (BLS)",,30,,,$798.09,$0.00,1,1,1,20161001, A0429,HCPCS,"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS-EMERGENCY)",,30,,,$947.37,$0.00,1,1,1,20161001, A0430,HCPCS,"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (FIXED WING)",,30,,,"$20,850.51",$0.00,1,1,1,20161001, A0431,HCPCS,"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING)",,30,,,"$23,019.98",$0.00,1,1,1,20161001, A0433,HCPCS,"ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)",,30,,,"$1,641.80",$0.00,1,1,1,20161001, A0434,HCPCS,SPECIALTY CARE TRANSPORT (SCT),,30,,,"$2,836.37",$0.00,1,1,1,20161001, A0435,HCPCS,"FIXED WING AIR MILEAGE, PER STATUTE MILE",,30,,,$168.04,$0.00,4,1,1,20161001, A0436,HCPCS,"ROTARY WING AIR MILEAGE, PER STATUTE MILE",,30,,,$284.75,$0.00,4,1,1,20161001, A4641,HCPCS,RADIOPHARM DX AGENT NOC,,30,,,$41.71,$0.00,1,0,1,20161001, A4642,HCPCS,IN111 SATUMOMAB,,30,,,$27.86,$0.00,1,0,1,20161001, A4648,HCPCS,IMPLANTABLE TISSUE MARKER,,30,,,$283.00,$0.00,1,0,1,20161001, A9150,HCPCS,MISC/EXPER NON-PRESCRIPT DRU,,30,,,$20.35,$0.00,1,0,1,20161001, A9152,HCPCS,SINGLE VITAMIN NOS,,30,,,$27.58,$0.00,1,0,1,20161001, A9153,HCPCS,MULTI-VITAMIN NOS,,30,,,$26.89,$0.00,1,0,1,20161001, A9500,HCPCS,TC99M SESTAMIBI,,30,,,$283.00,$0.00,1,0,1,20161001, A9502,HCPCS,TC99M TETROFOSMIN,,30,,,$297.64,$0.00,1,0,1,20161001, A9503,HCPCS,TC99M MEDRONATE,,30,,,$56.60,$0.00,1,0,1,20161001, A9505,HCPCS,TL201 THALLIUM,,30,,,$168.10,$0.00,1,0,1,20161001, A9507,HCPCS,IN111 CAPROMAB,,30,,,"$5,041.47",$0.00,1,0,1,20161001, A9508,HCPCS,"I131 IODOBENGUATE, DX",,30,,,$47.26,$0.00,1,0,1,20161001, A9509,HCPCS,IODINE I-123 SOD IODIDE MIL,,30,,,$137.42,$0.00,1,0,1,20161001, A9510,HCPCS,TC99M DISOFENIN,,30,,,$95.51,$0.00,1,0,1,20161001, A9512,HCPCS,TC99M PERTECHNETATE,,30,,,$5.66,$0.00,1,0,1,20161001, A9516,HCPCS,IODINE I-123 SOD IODIDE MIC,,30,,,$121.69,$0.00,1,0,1,20161001, A9517,HCPCS,"I131 IODIDE CAP, RX",,30,,,$264.26,$0.00,1,0,1,20161001, A9520,HCPCS,TC99 TILMANOCEPT DIAG 0.5MCI,,30,,,"$1,608.95",$0.00,1,0,1,20161001, A9521,HCPCS,TC99M EXAMETAZIME,,30,,,"$1,198.71",$0.00,1,0,1,20161001, A9524,HCPCS,"I131 SERUM ALBUMIN, DX",,30,,,$241.38,$0.00,1,0,1,20161001, A9526,HCPCS,NITROGEN N-13 AMMONIA,,30,,,$707.49,$0.00,1,0,1,20161001, A9527,HCPCS,IODINE I-125 SODIUM IODIDE,,30,,,$46.41,$0.00,1,0,1,20161001, A9528,HCPCS,"IODINE I-131 IODIDE CAP, DX",,30,,,$365.68,$0.00,1,0,1,20161001, A9529,HCPCS,"I131 IODIDE SOL, DX",,30,,,$74.61,$0.00,1,0,1,20161001, A9530,HCPCS,"I131 IODIDE SOL, RX",,30,,,$66.82,$0.00,1,0,1,20161001, A9531,HCPCS,I131 MAX 100UCI,,30,,,$17.26,$0.00,1,0,1,20161001, A9537,HCPCS,TC99M MEBROFENIN,,30,,,$100.46,$0.00,1,0,1,20161001, A9538,HCPCS,TC99M PYROPHOSPHATE,,30,,,$106.12,$0.00,1,0,1,20161001, A9539,HCPCS,TC99M PENTETATE,,30,,,$70.75,$0.00,1,0,1,20161001, A9540,HCPCS,TC99M MAA,,30,,,$36.79,$0.00,1,0,1,20161001, A9541,HCPCS,TC99M SULFUR COLLOID,,30,,,$134.42,$0.00,1,0,1,20161001, A9542,HCPCS,"IN111 IBRITUMOMAB, DX",,30,,,"$14,904.07",$0.00,1,0,1,20161001, A9543,HCPCS,"Y90 IBRITUMOMAB, RX",,30,,,"$90,752.18",$0.00,1,0,1,20161001, A9545,HCPCS,"I131 TOSITUMOMAB, RX",,30,,,"$65,462.68",$0.00,1,0,1,20161001, A9547,HCPCS,IN111 OXYQUINOLINE,,30,,,"$1,142.92",$0.00,1,0,1,20161001, A9548,HCPCS,IN111 PENTETATE,,30,,,$685.75,$0.00,1,0,1,20161001, A9551,HCPCS,TC99M SUCCIMER,,30,,,$409.62,$0.00,1,0,1,20161001, A9552,HCPCS,F18 FDG,,30,,,$778.24,$0.00,1,0,1,20161001, A9553,HCPCS,CR51 CHROMATE,,30,,,"$2,943.11",$0.00,1,0,1,20161001, A9554,HCPCS,"I125 IOTHALAMATE, DX",,30,,,"$1,379.61",$0.00,1,0,1,20161001, A9555,HCPCS,RB82 RUBIDIUM,,30,,,$848.99,$0.00,1,0,1,20161001, A9556,HCPCS,GA67 GALLIUM,,30,,,$85.67,$0.00,1,0,1,20161001, A9557,HCPCS,TC99M BICISATE,,30,,,$365.73,$0.00,1,0,1,20161001, A9558,HCPCS,XE133 XENON 10MCI,,30,,,$124.57,$0.00,1,0,1,20161001, A9560,HCPCS,TC99M LABELED RBC,,30,,,$226.40,$0.00,1,0,1,20161001, A9561,HCPCS,TC99M OXIDRONATE,,30,,,$71.95,$0.00,1,0,1,20161001, A9562,HCPCS,TC99M MERTIATIDE,,30,,,$438.24,$0.00,1,0,1,20161001, A9563,HCPCS,P32 NA PHOSPHATE,,30,,,"$1,369.97",$0.00,1,0,1,20161001, A9564,HCPCS,P32 CHROMIC PHOSPHATE,,30,,,"$5,532.45",$0.00,1,0,1,20161001, A9567,HCPCS,TECHNETIUM TC-99M AEROSOL,,30,,,$59.43,$0.00,1,0,1,20161001, A9568,HCPCS,TECHNETIUM TC99M ARCITUMOMAB,,30,,,$245.74,$0.00,1,0,1,20161001, A9569,HCPCS,TECHNETIUM TC-99M AUTO WBC,,30,,,$3.45,$0.00,1,0,1,20161001, A9570,HCPCS,INDIUM IN-111 AUTO WBC,,30,,,$338.90,$0.00,1,0,1,20161001, A9572,HCPCS,INDIUM IN-111 PENTETREOTIDE,,30,,,"$5,398.15",$0.00,1,0,1,20161001, A9576,HCPCS,INJ PROHANCE MULTIPACK,,30,,,$5.66,$0.00,1,0,1,20161001, A9577,HCPCS,INJ MULTIHANCE,,30,,,$8.49,$0.00,1,0,1,20161001, A9578,HCPCS,INJ MULTIHANCE MULTIPACK,,30,,,$8.49,$0.00,1,0,1,20161001, A9579,HCPCS,"GAD-BASE MR CONTRAST NOS,1ML",,30,,,$8.49,$0.00,1,0,1,20161001, A9580,HCPCS,SODIUM FLUORIDE F-18,,30,,,$690.51,$0.00,1,0,1,20161001, A9582,HCPCS,IODINE I-123 IOBENGUANE,,30,,,"$4,192.45",$0.00,1,0,1,20161001, A9583,HCPCS,GADOFOSVESET TRISODIUM INJ,,30,,,$39.62,$0.00,1,0,1,20161001, A9584,HCPCS,IODINE I-123 IOFLUPANE,,30,,,"$3,361.99",$0.00,1,0,1,20161001, A9585,HCPCS,GADOBUTROL INJECTION,,30,,,$1.56,$0.00,1,0,1,20161001, A9586,HCPCS,FLORBETAPIR F18,,30,,,"$14,518.53",$0.00,1,0,1,20161001, A9599,HCPCS,RADIOPHA DX BETA AMYLOID PET,,30,,,$32.86,$0.00,1,0,1,20161001, A9600,HCPCS,SR89 STRONTIUM,,30,,,"$7,035.60",$0.00,1,0,1,20161001, A9604,HCPCS,SM 153 LEXIDRONAM,,30,,,"$22,779.51",$0.00,1,0,0,20161001, A9606,HCPCS,RADIUM RA223 DICHLORIDE THER,,30,,,$627.35,$0.00,1,0,1,20161001, A9698,HCPCS,NON-RAD CONTRAST MATERIALNOC,,30,,,$32.47,$0.00,1,0,1,20161001, A9699,HCPCS,RADIOPHARM RX AGENT NOC,,30,,,$32.47,$0.00,1,0,1,20161001, A9700,HCPCS,ECHOCARDIOGRAPHY CONTRAST,,30,,,$426.65,$0.00,1,0,1,20161001, B4100,HCPCS,FOOD THICKENER ORAL,,30,,,$0.92,$0.00,1,0,1,20161001, B4102,HCPCS,EF ADULT FLUIDS AND ELECTRO,,30,,,$3.80,$0.00,1,0,1,20161001, B4103,HCPCS,EF PED FLUID AND ELECTROLYTE,,30,,,$12.97,$0.00,1,0,1,20161001, B4104,HCPCS,ADDITIVE FOR ENTERAL FORMULA,,30,,,$10.05,$0.00,1,0,1,20161001, B4149,HCPCS,EF BLENDERIZED FOODS,,30,,,$2.93,$0.00,1,0,1,20161001, B4150,HCPCS,EF COMPLET W/INTACT NUTRIENT,,30,,,$0.85,$0.00,1,0,1,20161001, B4152,HCPCS,EF CALORIE DENSE>/=1.5KCAL,,30,,,$0.69,$0.00,1,0,1,20161001, B4153,HCPCS,EF HYDROLYZED/AMINO ACIDS,,30,,,$3.72,$0.00,1,0,1,20161001, B4154,HCPCS,EF SPEC METABOLIC NONINHERIT,,30,,,$2.10,$0.00,1,0,1,20161001, B4155,HCPCS,EF INCOMPLETE/MODULAR,,30,,,$1.46,$0.00,1,0,1,20161001, B4157,HCPCS,EF SPECIAL METABOLIC INHERIT,,30,,,$10.14,$0.00,1,0,1,20161001, B4158,HCPCS,EF PED COMPLETE INTACT NUT,,30,,,$4.47,$0.00,1,0,1,20161001, B4159,HCPCS,EF PED COMPLETE SOY BASED,,30,,,$4.97,$0.00,1,0,1,20161001, B4160,HCPCS,EF PED CALORIC DENSE>/=0.7KC,,30,,,$4.18,$0.00,1,0,1,20161001, B4161,HCPCS,EF PED HYDROLYZED/AMINO ACID,,30,,,$9.34,$0.00,1,0,1,20161001, B4162,HCPCS,EF PED SPECMETABOLIC INHERIT,,30,,,$15.44,$0.00,1,0,1,20161001, B4164,HCPCS,PARENTERAL 50% DEXTROSE SOLU,,30,,,$43.93,$0.00,1,0,1,20161001, B4168,HCPCS,PARENTERAL SOL AMINO ACID 3.,,30,,,$64.40,$0.00,1,0,1,20161001, B4172,HCPCS,PARENTERAL SOL AMINO ACID 5.,,30,,,$118.95,$0.00,1,0,1,20161001, B4176,HCPCS,PARENTERAL SOL AMINO ACID 7-,,30,,,$125.32,$0.00,1,0,1,20161001, B4178,HCPCS,PARENTERAL SOL AMINO ACID >,,30,,,$150.58,$0.00,1,0,1,20161001, B4180,HCPCS,PARENTERAL SOL CARB > 50%,,30,,,$63.39,$0.00,1,0,1,20161001, B4185,HCPCS,PARENTERAL SOL 10 GM LIPIDS,,30,,,$28.80,$0.00,1,0,1,20161001, B4189,HCPCS,PARENTERAL SOL AMINO ACID &,,30,,,$466.74,$0.00,1,0,1,20161001, B4193,HCPCS,PARENTERAL SOL 52-73 GM PROT,,30,,,$603.30,$0.00,1,0,1,20161001, B4197,HCPCS,PARENTERAL SOL 74-100 GM PRO,,30,,,$734.66,$0.00,1,0,1,20161001, B4199,HCPCS,PARENTERAL SOL > 100GM PROTE,,30,,,$839.57,$0.00,1,0,1,20161001, B5000,HCPCS,PARENTERAL SOL RENAL-AMIROSY,,30,,,$30.51,$0.00,1,0,1,20161001, B5100,HCPCS,PARENTERAL SOLUTION HEPATIC,,30,,,$11.46,$0.00,1,0,1,20161001, B5200,HCPCS,PARENTERAL SOL HEPATIC FREAM,,30,,,$604.83,$0.00,1,0,1,20161001, C1716,HCPCS,"BRACHYTX, NON-STR, GOLD-198",,30,,,$289.98,$0.00,1,0,1,20161001, C1717,HCPCS,"BRACHYTX, NON-STR,HDR IR-192",,30,,,"$1,743.60",$0.00,1,0,1,20161001, C1719,HCPCS,"BRACHYTX, NS, NON-HDRIR-192",,30,,,$593.02,$0.00,1,0,1,20161001, C1749,HCPCS,"ENDO, COLON, RETRO IMAGING",,30,,,"$4,235.04",$0.00,1,0,1,20161001, C1773,HCPCS,"RET DEV, INSERTABLE",,30,,,"$1,600.65",$0.00,1,0,1,20161001, C1814,HCPCS,"RETINAL TAMP, SILICONE OIL",,30,,,"$2,339.14",$0.00,1,0,1,20161001, C1819,HCPCS,TISSUE LOCALIZATION-EXCISION,,30,,,"$1,320.18",$0.00,1,0,1,20161001, C1886,HCPCS,"CATHETER, ABLATION",,30,,,"$5,028.53",$0.00,1,0,1,20161001, C2616,HCPCS,"BRACHYTX, NON-STR,YTTRIUM-90",,30,,,"$31,706.80",$0.00,1,0,1,20161001, C2629,HCPCS,"INTRO/SHEATH, LASER",,30,,,$590.44,$0.00,1,0,1,20161001, C2630,HCPCS,"CATH, EP, COOL-TIP",,30,,,"$9,508.16",$0.00,1,0,1,20161001, C2634,HCPCS,"BRACHYTX, NON-STR, HA, I-125",,30,,,$506.36,$0.00,1,0,1,20161001, C2635,HCPCS,"BRACHYTX, NON-STR, HA, P-103",,30,,,$197.01,$0.00,1,0,1,20161001, C2636,HCPCS,"BRACHY LINEAR, NON-STR,P-103",,30,,,$80.91,$0.00,1,0,1,20161001, C2638,HCPCS,"BRACHYTX, STRANDED, I-125",,30,,,$238.35,$0.00,1,0,1,20161001, C2639,HCPCS,"BRACHYTX, NON-STRANDED,I-125",,30,,,$220.72,$0.00,1,0,1,20161001, C2640,HCPCS,"BRACHYTX, STRANDED, P-103",,30,,,$408.52,$0.00,1,0,1,20161001, C2641,HCPCS,"BRACHYTX, NON-STRANDED,P-103",,30,,,$412.37,$0.00,1,0,1,20161001, C2642,HCPCS,"BRACHYTX, STRANDED, C-131",,30,,,$507.57,$0.00,1,0,1,20161001, C2643,HCPCS,"BRACHYTX, NON-STRANDED,C-131",,30,,,$296.47,$0.00,1,0,1,20161001, C2644,HCPCS,BRACHYTX CESIUM-131 CHLORIDE,,30,,,$73.95,$0.00,1,0,1,20161001, C2698,HCPCS,"BRACHYTX, STRANDED, NOS",,30,,,$238.35,$0.00,1,0,1,20161001, C2699,HCPCS,"BRACHYTX, NON-STRANDED, NOS",,30,,,$197.01,$0.00,1,0,1,20161001, C5271,HCPCS,LOW COST SKIN SUBSTITUTE APP,,30,,,"$2,409.56",$0.00,1,0,1,20161001, C5273,HCPCS,LOW COST SKIN SUBSTITUTE APP,,30,,,"$11,957.43",$0.00,1,0,1,20161001, C5275,HCPCS,LOW COST SKIN SUBSTITUTE APP,,30,,,"$2,409.56",$0.00,1,0,1,20161001, C5277,HCPCS,LOW COST SKIN SUBSTITUTE APP,,30,,,"$6,915.53",$0.00,1,0,1,20161001, C8900,HCPCS,"MRA W/CONT, ABD",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8901,HCPCS,"MRA W/O CONT, ABD",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8902,HCPCS,"MRA W/O FOL W/CONT, ABD",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8903,HCPCS,"MRI W/CONT, BREAST, UNI",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8904,HCPCS,"MRI W/O CONT, BREAST, UNI",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8905,HCPCS,"MRI W/O FOL W/CONT, BRST, UN",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8906,HCPCS,"MRI W/CONT, BREAST, BI",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8907,HCPCS,"MRI W/O CONT, BREAST, BI",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8908,HCPCS,"MRI W/O FOL W/CONT, BREAST,",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8909,HCPCS,"MRA W/CONT, CHEST",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8910,HCPCS,"MRA W/O CONT, CHEST",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8911,HCPCS,"MRA W/O FOL W/CONT, CHEST",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8912,HCPCS,"MRA W/CONT, LWR EXT",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8913,HCPCS,"MRA W/O CONT, LWR EXT",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8914,HCPCS,"MRA W/O FOL W/CONT, LWR EXT",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8918,HCPCS,"MRA W/CONT, PELVIS",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8919,HCPCS,"MRA W/O CONT, PELVIS",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8920,HCPCS,"MRA W/O FOL W/CONT, PELVIS",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8921,HCPCS,"TTE W OR W/O FOL W/CONT, COM",,30,,,"$3,948.25",$0.00,1,0,1,20161001, C8922,HCPCS,"TTE W OR W/O FOL W/CONT, F/U",,30,,,"$1,832.61",$0.00,1,0,1,20161001, C8923,HCPCS,"2D TTE W OR W/O FOL W/CON,CO",,30,,,"$1,832.61",$0.00,1,0,1,20161001, C8924,HCPCS,"2D TTE W OR W/O FOL W/CON,FU",,30,,,"$1,832.61",$0.00,1,0,1,20161001, C8925,HCPCS,"2D TEE W OR W/O FOL W/CON,IN",,30,,,"$3,948.25",$0.00,1,0,1,20161001, C8926,HCPCS,"TEE W OR W/O FOL W/CONT,CONG",,30,,,"$3,948.25",$0.00,1,0,1,20161001, C8927,HCPCS,"TEE W OR W/O FOL W/CONT, MON",,30,,,"$3,948.25",$0.00,1,0,1,20161001, C8928,HCPCS,"TTE W OR W/O FOL W/CON,STRES",,30,,,"$3,948.25",$0.00,1,0,1,20161001, C8929,HCPCS,"TTE W OR WO FOL WCON,DOPPLER",,30,,,"$3,948.25",$0.00,1,0,1,20161001, C8930,HCPCS,"TTE W OR W/O CONTR, CONT ECG",,30,,,"$3,948.25",$0.00,1,0,1,20161001, C8931,HCPCS,"MRA, W/DYE, SPINAL CANAL",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8932,HCPCS,"MRA, W/O DYE, SPINAL CANAL",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8933,HCPCS,"MRA, W/O&W/DYE, SPINAL CANAL",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8934,HCPCS,"MRA, W/DYE, UPPER EXTREMITY",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8935,HCPCS,"MRA, W/O DYE, UPPER EXTR",,30,,,"$1,801.06",$0.00,1,0,1,20161001, C8936,HCPCS,"MRA, W/O&W/DYE, UPPER EXTR",,30,,,"$2,925.81",$0.00,1,0,1,20161001, C8957,HCPCS,"PROLONGED IV INF, REQ PUMP",,30,,,"$1,532.23",$0.00,1,0,1,20161001, C9113,HCPCS,"INJ PANTOPRAZOLE SODIUM, VIA",,30,,,$184.03,$0.00,1,0,1,20161001, C9121,HCPCS,"INJECTION, ARGATROBAN",,30,,,$91.16,$0.00,1,0,1,20161001, C9132,HCPCS,"KCENTRA, PER I.U.",,30,,,$9.05,$0.00,1,0,1,20161001, C9248,HCPCS,"INJ, CLEVIDIPINE BUTYRATE",,30,,,$24.96,$0.00,1,0,1,20161001, C9250,HCPCS,ARTISS FIBRIN SEALANT,,30,,,$775.94,$0.00,1,0,1,20161001, C9254,HCPCS,"INJECTION, LACOSAMIDE",,30,,,$1.21,$0.00,1,0,1,20161001, C9257,HCPCS,BEVACIZUMAB INJECTION,,30,,,$9.55,$0.00,1,0,1,20161001, C9275,HCPCS,HEXAMINOLEVULINATE HCL,,30,,,"$4,001.92",$0.00,1,0,1,20161001, C9285,HCPCS,"PATCH, LIDOCAINE/TETRACAINE",,30,,,$100.18,$0.00,1,0,1,20161001, C9290,HCPCS,"INJ, BUPIVACAINE LIPOSOME",,30,,,$7.75,$0.00,1,0,1,20161001, C9293,HCPCS,"INJECTION, GLUCARPIDASE",,30,,,"$1,439.30",$0.00,1,0,1,20161001, C9349,HCPCS,"PURAPLY, PURAPLY ANTIMIC",,30,,,$656.98,$0.00,1,0,1,20161001, C9352,HCPCS,"NEURAGEN NERVE GUIDE, PER CM",,30,,,"$6,739.46",$0.00,1,0,1,20161001, C9353,HCPCS,"NEURAWRAP NERVE PROTECTOR,CM",,30,,,"$8,140.79",$0.00,1,0,1,20161001, C9354,HCPCS,"VERITAS COLLAGEN MATRIX, CM2",,30,,,"$5,520.01",$0.00,1,0,1,20161001, C9356,HCPCS,"TENOGLIDE TENDON PROT, CM2",,30,,,"$7,801.74",$0.00,1,0,1,20161001, C9447,HCPCS,"INJ, PHENYLEPHRINE KETOROLAC",,30,,,"$3,099.81",$0.00,1,0,1,20161001, C9460,HCPCS,"INJECTION, CANGRELOR",,30,,,$103.22,$0.00,1,0,1,20161001, C9497,HCPCS,"LOXAPINE, INHALATION POWDER",,30,,,$901.71,$0.00,1,0,1,20161001, C9600,HCPCS,PERC DRUG-EL COR STENT SING,,30,,,"$20,838.57",$0.00,1,0,1,20161001, C9601,HCPCS,PERC DRUG-EL COR STENT BRAN,,30,,,"$23,829.36",$0.00,1,0,1,20161001, C9602,HCPCS,PERC D-E COR STENT ATHER S,,30,,,"$29,536.30",$0.00,1,0,1,20161001, C9603,HCPCS,PERC D-E COR STENT ATHER BR,,30,,,"$25,510.10",$0.00,1,0,1,20161001, C9604,HCPCS,PERC D-E COR REVASC T CABG S,,30,,,"$20,838.57",$0.00,1,0,1,20161001, C9605,HCPCS,PERC D-E COR REVASC T CABG B,,30,,,"$25,510.10",$0.00,1,0,1,20161001, C9606,HCPCS,PERC D-E COR REVASC W AMI S,,30,,,"$29,536.30",$0.00,1,0,1,20161001, C9607,HCPCS,PERC D-E COR REVASC CHRO SIN,,30,,,"$29,536.30",$0.00,1,0,1,20161001, C9608,HCPCS,PERC D-E COR REVASC CHRO ADD,,30,,,"$25,510.10",$0.00,1,0,1,20161001, C9725,HCPCS,PLACE ENDORECTAL APP,,30,,,"$3,147.16",$0.00,1,0,1,20161001, C9726,HCPCS,RXT BREAST APPL PLACE/REMOV,,30,,,"$25,674.33",$0.00,1,0,1,20161001, C9727,HCPCS,INSERT PALATE IMPLANTS,,30,,,"$4,229.51",$0.00,1,0,1,20161001, C9728,HCPCS,"PLACE DEVICE/MARKER, NON PRO",,30,,,"$6,357.83",$0.00,1,0,1,20161001, C9733,HCPCS,NON-OPHTHALMIC FVA,,30,,,"$2,033.10",$0.00,1,0,1,20161001, C9734,HCPCS,"U/S TRTMT, NOT LEIOMYOMATA",,30,,,"$13,009.40",$0.00,1,0,1,20161001, C9739,HCPCS,CYSTOSCOPY PROSTATIC IMP 1-3,,30,,,"$16,901.70",$0.00,1,0,1,20161001, C9740,HCPCS,CYSTO IMPL 4 OR MORE,,30,,,"$21,750.00",$0.00,1,0,1,20161001, C9741,HCPCS,IMPL PRESSURE SENSOR W/ANGIO         ,,30,,,"$13,781.56",$0.00,1,0,1,20161001, C9742,HCPCS,LARYNGOSCOPY WITH INJECTION,,30,,,"$6,100.92",$0.00,1,0,1,20161001, C9800,HCPCS,DERMAL FILLER INJ PX/SUPPL,,30,,,"$6,915.53",$0.00,1,0,1,20161001, C9898,HCPCS,INPNT STAY RADIOLABELED ITEM,,30,,,$1.15,$0.00,1,0,1,20161001, G0008,HCPCS,ADMIN INFLUENZA VIRUS VAC,,30,,,$223.07,$0.00,1,0,1,20161001, G0009,HCPCS,ADMIN PNEUMOCOCCAL VACCINE,,30,,,$223.07,$0.00,1,0,1,20161001, G0010,HCPCS,ADMIN HEPATITIS B VACCINE,,30,,,$274.68,$0.00,1,0,1,20161001, G0027,HCPCS,SEMEN ANALYSIS,,30,,,$34.45,$0.00,1,0,1,20161001, G0101,HCPCS,CA SCREEN;PELVIC/BREAST EXAM,,30,,,$134.54,$0.00,1,0,1,20161001, G0102,HCPCS,PROSTATE CA SCREENING; DRE,,30,,,$57.42,$0.00,1,0,1,20161001, G0103,HCPCS,PSA SCREENING,,30,,,$192.59,$0.00,1,0,1,20161001, G0104,HCPCS,CA SCREEN;FLEXI SIGMOIDSCOPE,,30,,,"$3,147.16",$0.00,1,0,1,20161001, G0105,HCPCS,COLORECTAL SCRN; HI RISK IND,,30,,,"$4,726.49",$0.00,1,0,1,20161001, G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,,30,,,"$2,155.12",$0.00,1,0,1,20161001, G0117,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,30,,,$156.54,$0.00,1,0,1,20161001, G0118,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,30,,,$156.54,$0.00,1,0,1,20161001, G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,,30,,,"$2,155.12",$0.00,1,0,1,20161001, G0121,HCPCS,COLON CA SCRN NOT HI RSK IND,,30,,,"$4,726.49",$0.00,1,0,1,20161001, G0123,HCPCS,SCREEN CERV/VAG THIN LAYER,,30,,,$150.43,$0.00,1,0,1,20161001, G0124,HCPCS,SCREEN C/V THIN LAYER BY MD,,30,,,$106.51,$0.00,1,0,1,20161001, G0127,HCPCS,TRIM NAIL(S),,30,,,$306.21,$0.00,1,0,1,20161001, G0128,HCPCS,CORF SKILLED NURSING SERVICE,,30,,,$75.81,$0.00,1,0,1,20161001, G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,,30,,,$399.19,$0.00,1,0,1,20161001, G0141,HCPCS,"SCR C/V CYTO,AUTOSYS AND MD",,30,,,$141.87,$0.00,1,0,1,20161001, G0143,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,30,,,$218.18,$0.00,1,0,1,20161001, G0144,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,30,,,$68.90,$0.00,1,0,1,20161001, G0145,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,30,,,$227.37,$0.00,1,0,1,20161001, G0147,HCPCS,"SCR C/V CYTO, AUTOMATED SYS",,30,,,$133.21,$0.00,1,0,1,20161001, G0148,HCPCS,"SCR C/V CYTO, AUTOSYS, RESCR",,30,,,$143.54,$0.00,1,0,1,20161001, G0151,HCPCS,"HHCP-SERV OF PT,EA 15 MIN",,30,,,$57.42,$0.00,1,0,1,20161001, G0152,HCPCS,"HHCP-SERV OF OT,EA 15 MIN",,30,,,$55.69,$0.00,1,0,1,20161001, G0153,HCPCS,"HHCP-SVS OF S/L PATH,EA 15MN",,30,,,$53.11,$0.00,1,0,1,20161001, G0155,HCPCS,"HHCP-SVS OF CSW,EA 15 MIN",,30,,,$66.03,$0.00,1,0,1,20161001, G0156,HCPCS,"HHCP-SVS OF AIDE,EA 15 MIN",,30,,,$22.97,$0.00,1,0,1,20161001, G0157,HCPCS,HHC PT ASSISTANT EA 15,,30,,,$189.47,$0.00,1,0,1,20161001, G0158,HCPCS,HHC OT ASSISTANT EA 15,,30,,,$223.92,$0.00,1,0,1,20161001, G0159,HCPCS,HHC PT MAINT EA 15 MIN,,30,,,$229.67,$0.00,1,0,1,20161001, G0160,HCPCS,HHC OCCUP THERAPY EA 15,,30,,,$200.96,$0.00,1,0,1,20161001, G0161,HCPCS,HHC SLP EA 15 MIN,,30,,,$143.54,$0.00,1,0,1,20161001, G0162,HCPCS,"HHC RN E&M PLAN SVS, 15 MIN",,30,,,$181.44,$0.00,1,0,1,20161001, G0163,HCPCS,HHC LPN/RN OBS/ASSES EA 15,,30,,,$183.73,$0.00,1,0,1,20161001, G0164,HCPCS,HHC LIS NURSE TRAIN EA 15,,30,,,$172.25,$0.00,1,0,1,20161001, G0166,HCPCS,"EXTRNL COUNTERPULSE, PER TX",,30,,,$425.53,$0.00,1,0,1,20161001, G0168,HCPCS,WOUND CLOSURE BY ADHESIVE,,30,,,$298.75,$0.00,1,0,1,20161001, G0175,HCPCS,"OPPS SERVICE,SCHED TEAM CONF",,30,,,"$2,369.96",$0.00,1,0,1,20161001, G0177,HCPCS,OPPS/PHP; TRAIN & EDUC SERV,,30,,,$284.79,$0.00,1,0,1,20161001, G0179,HCPCS,MD RECERTIFICATION HHA PT,,30,,,$213.59,$0.00,1,0,1,20161001, G0180,HCPCS,MD CERTIFICATION HHA PATIENT,,30,,,$196.89,$0.00,1,0,1,20161001, G0182,HCPCS,HOSPICE CARE SUPERVISION,,30,,,$227.08,$0.00,1,0,1,20161001, G0186,HCPCS,"DSTRY EYE LESN,FDR VSSL TECH",,30,,,"$2,637.79",$0.00,1,0,1,20161001, G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,30,,,$617.80,$0.00,1,0,1,20161001, G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,30,,,$471.96,$0.00,1,0,1,20161001, G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,,30,,,"$2,406.74",$0.00,1,0,1,20161001, G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,,30,,,"$4,502.60",$0.00,1,0,1,20161001, G0237,HCPCS,THERAPEUTIC PROCD STRG ENDUR,,30,,,$425.53,$0.00,1,0,1,20161001, G0238,HCPCS,"OTH RESP PROC, INDIV",,30,,,$306.21,$0.00,1,0,1,20161001, G0239,HCPCS,"OTH RESP PROC, GROUP",,30,,,$156.54,$0.00,1,0,1,20161001, G0245,HCPCS,INITIAL FOOT EXAM PT LOPS,,30,,,$217.87,$0.00,1,0,1,20161001, G0246,HCPCS,FOLLOWUP EVAL OF FOOT PT LOP,,30,,,$217.87,$0.00,1,0,1,20161001, G0247,HCPCS,ROUTINE FOOTCARE PT W LOPS,,30,,,$398.75,$0.00,1,0,1,20161001, G0248,HCPCS,DEMONSTRATE USE HOME INR MON,,30,,,$217.87,$0.00,1,0,1,20161001, G0249,HCPCS,PROVIDE INR TEST MATER/EQUIP,,30,,,$217.87,$0.00,1,0,1,20161001, G0250,HCPCS,MD INR TEST REVIE INTER MGMT,,30,,,$59.89,$0.00,1,0,1,20161001, G0257,HCPCS,UNSCHED DIALYSIS ESRD PT HOS,,30,,,"$2,673.75",$0.00,1,0,1,20161001, G0259,HCPCS,INJECT FOR SACROILIAC JOINT,,30,,,"$2,032.54",$0.00,1,0,1,20161001, G0260,HCPCS,INJ FOR SACROILIAC JT ANESTH,,30,,,"$3,758.87",$0.00,1,0,1,20161001, G0268,HCPCS,REMOVAL OF IMPACTED WAX MD,,30,,,$303.14,$0.00,1,0,1,20161001, G0269,HCPCS,OCCLUSIVE DEVICE IN VEIN ART,,30,,,"$1,147.16",$0.00,1,0,1,20161001, G0276,HCPCS,PILD/PLACEBO CONTROL CLIN TR,,30,,,"$20,802.20",$0.00,1,0,1,20161001, G0277,HCPCS,"HBOT, FULL BODY CHAMBER, 30M",,30,,,$665.04,$0.00,1,0,1,20161001, G0278,HCPCS,"ILIAC ART ANGIO,CARDIAC CATH",,30,,,"$3,272.74",$0.00,1,0,1,20161001, G0282,HCPCS,ELECT STIM WOUND CARE NOT PD,,30,,,$227.66,$0.00,1,0,1,20161001, G0288,HCPCS,"RECON, CTA FOR SURG PLAN",,30,,,"$2,721.25",$0.00,1,0,1,20161001, G0289,HCPCS,"ARTHRO, LOOSE BODY + CHONDRO",,30,,,"$4,988.34",$0.00,1,0,1,20161001, G0293,HCPCS,"NON-COV SURG PROC,CLIN TRIAL",,30,,,$156.54,$0.00,1,0,1,20161001, G0294,HCPCS,"NON-COV PROC, CLINICAL TRIAL",,30,,,$156.54,$0.00,1,0,1,20161001, G0296,HCPCS,VISIT TO DETERM LDCT ELIG,,30,,,$300.64,$0.00,1,0,1,20161001, G0297,HCPCS,LDCT FOR LUNG CA SCREEN,,30,,,$726.75,$0.00,1,0,1,20161001, G0299,HCPCS,HHS/HOSPICE OF RN EA 15 MIN,,30,,,$222.78,$0.00,1,0,1,20161001, G0300,HCPCS,HHS/HOSPICE OF LPN EA 15 MIN,,30,,,$222.78,$0.00,1,0,1,20161001, G0302,HCPCS,PRE-OP SERVICE LVRS COMPLETE,,30,,,"$5,245.62",$0.00,1,0,1,20161001, G0303,HCPCS,PRE-OP SERVICE LVRS 10-15DOS,,30,,,$746.33,$0.00,1,0,1,20161001, G0304,HCPCS,PRE-OP SERVICE LVRS 1-9 DOS,,30,,,"$5,245.62",$0.00,1,0,1,20161001, G0305,HCPCS,POST OP SERVICE LVRS MIN 6,,30,,,"$5,245.62",$0.00,1,0,1,20161001, G0306,HCPCS,CBC/DIFFWBC W/O PLATELET,,30,,,$125.79,$0.00,1,0,1,20161001, G0307,HCPCS,CBC WITHOUT PLATELET,,30,,,$91.67,$0.00,1,0,1,20161001, G0328,HCPCS,FECAL BLOOD SCRN IMMUNOASSAY,,30,,,$102.20,$0.00,1,0,1,20161001, G0339,HCPCS,"ROBOT LIN-RADSURG COM, FIRST",,30,,,"$38,024.60",$0.00,1,0,1,20161001, G0340,HCPCS,ROBT LIN-RADSURG FRACTX 2-5,,30,,,"$26,211.74",$0.00,1,0,1,20161001, G0364,HCPCS,BONE MARROW ASPIRATE &BIOPSY,,30,,,$614.13,$0.00,1,0,1,20161001, G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,,30,,,"$1,024.59",$0.00,1,0,1,20161001, G0378,HCPCS,HOSPITAL OBSERVATION PER HR,,30,,,$114.12,$0.00,1,1,1,20161001, G0379,HCPCS,DIRECT REFER HOSPITAL OBSERV,,30,,,$114.12,$0.00,1,1,1,20161001, G0380,HCPCS,LEV 1 HOSP TYPE B ED VISIT,,30,,,$433.17,$0.00,1,1,1,20161001, G0381,HCPCS,LEV 2 HOSP TYPE B ED VISIT,,30,,,$447.16,$0.00,1,1,1,20161001, G0382,HCPCS,LEV 3 HOSP TYPE B ED VISIT,,30,,,$763.39,$0.00,1,1,1,20161001, G0383,HCPCS,LEV 4 HOSP TYPE B ED VISIT,,30,,,"$1,135.97",$0.00,1,1,1,20161001, G0384,HCPCS,LEV 5 HOSP TYPE B ED VISIT,,30,,,"$1,824.60",$0.00,1,1,1,20161001, G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,,30,,,$686.47,$0.00,1,0,1,20161001, G0390,HCPCS,TRAUMA RESPONS W/HOSP CRITI,,30,,,"$2,460.65",$0.00,1,1,1,20161001, G0396,HCPCS,ALCOHOL/SUBS INTERV 15-30MN,,30,,,$287.49,$0.00,1,0,1,20161001, G0397,HCPCS,ALCOHOL/SUBS INTERV >30 MIN,,30,,,$416.51,$0.00,1,0,1,20161001, G0398,HCPCS,HOME SLEEP TEST/TYPE 2 PORTA,,30,,,$666.94,$0.00,1,0,1,20161001, G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,30,,,$746.33,$0.00,1,0,1,20161001, G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,,30,,,$666.94,$0.00,1,0,1,20161001, G0402,HCPCS,INITIAL PREVENTIVE EXAM,,30,,,$217.87,$0.00,1,0,1,20161001, G0404,HCPCS,EKG TRACING FOR INITIAL PREV,,30,,,$81.90,$0.00,1,0,1,20161001, G0405,HCPCS,EKG INTERPRET & REPORT PREVE,,30,,,$129.76,$0.00,1,0,1,20161001, G0409,HCPCS,CORF RELATED SERV 15 MINS EA,,30,,,$57.42,$0.00,1,0,1,20161001, G0413,HCPCS,PELVIC RING FRACTURE UNI/BIL,,30,,,"$7,815.00",$0.00,1,0,1,20161001, G0416,HCPCS,"PROSTATE BIOPSY, ANY MTHD",,30,,,"$1,229.40",$0.00,1,0,1,20161001, G0422,HCPCS,INTENS CARDIAC REHAB W/EXERC,,30,,,$307.45,$0.00,1,0,1,20161001, G0423,HCPCS,INTENS CARDIAC REHAB NO EXER,,30,,,$307.45,$0.00,1,0,1,20161001, G0424,HCPCS,PULMONARY REHAB W EXER,,30,,,$306.21,$0.00,1,0,1,20161001, G0432,HCPCS,EIA HIV-1/HIV-2 SCREEN,,30,,,$130.16,$0.00,1,0,1,20161001, G0433,HCPCS,ELISA HIV-1/HIV-2 SCREEN,,30,,,$221.63,$0.00,1,0,1,20161001, G0435,HCPCS,ORAL HIV-1/HIV-2 SCREEN,,30,,,$229.67,$0.00,1,0,1,20161001, G0436,HCPCS,TOBACCO-USE COUNSEL 3-10 MIN,,30,,,$108.34,$0.00,1,0,1,20161001, G0437,HCPCS,TOBACCO-USE COUNSEL>10MIN,,30,,,$287.49,$0.00,1,0,1,20161001, G0442,HCPCS,ANNUAL ALCOHOL SCREEN 15 MIN,,30,,,$287.49,$0.00,1,0,1,20161001, G0443,HCPCS,BRIEF ALCOHOL MISUSE COUNSEL,,30,,,$287.49,$0.00,1,0,1,20161001, G0444,HCPCS,DEPRESSION SCREEN ANNUAL,,30,,,$108.34,$0.00,1,0,1,20161001, G0445,HCPCS,HIGH INTEN BEH COUNS STD 30M,,30,,,$108.34,$0.00,1,0,1,20161001, G0446,HCPCS,INTENS BEHAVE THER CARDIO DX,,30,,,$108.34,$0.00,1,0,1,20161001, G0447,HCPCS,BEHAVIOR COUNSEL OBESITY 15M,,30,,,$287.49,$0.00,1,0,1,20161001, G0451,HCPCS,DEVLOPMENT TEST INTERPT&REP,,30,,,$287.49,$0.00,1,0,1,20161001, G0452,HCPCS,MOLECULAR PATHOLOGY INTERPR,,30,,,$258.19,$0.00,1,0,1,20161001, G0453,HCPCS,CONT INTRAOP NEURO MONITOR,,30,,,$219.33,$0.00,1,0,1,20161001, G0454,HCPCS,MD DOCUMENT VISIT BY NPP,,30,,,$160.12,$0.00,1,0,1,20161001, G0455,HCPCS,FECAL MICROBIOTA PREP INSTIL,,30,,,$425.53,$0.00,1,0,1,20161001, G0459,HCPCS,TELEHEALTH INPT PHARM MGMT,,30,,,$194.00,$0.00,1,0,1,20161001, G0460,HCPCS,AUTOLOGOUS PRP FOR ULCERS,,30,,,"$6,908.09",$0.00,1,0,1,20161001, G0463,HCPCS,HOSPITAL OUTPT CLINIC VISIT,,30,,,$217.87,$0.00,1,0,1,20161001, G0473,HCPCS,GROUP BEHAVE COUNS 2-10,,30,,,$280.17,$0.00,1,0,1,20161001, G3001,HCPCS,"ADMIN + SUPPLY, TOSITUMOMAB",,30,,,"$11,108.85",$0.00,1,0,1,20161001, G6001,HCPCS,ECHO GUIDANCE RADIOTHERAPY,,30,,,$676.95,$0.00,1,0,1,20161001, G6002,HCPCS,STEREOSCOPIC X-RAY GUIDANCE,,30,,,"$2,031.87",$0.00,1,0,1,20161001, G6003,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,$690.25,$0.00,1,0,1,20161001, G6004,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,$690.25,$0.00,1,0,1,20161001, G6005,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,$690.25,$0.00,1,0,1,20161001, G6006,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6007,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,$690.25,$0.00,1,0,1,20161001, G6008,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6009,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6010,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6011,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6012,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6013,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6014,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,319.90",$0.00,1,0,1,20161001, G6015,HCPCS,RADIATION TX DELIVERY IMRT,,30,,,"$3,386.02",$0.00,1,0,1,20161001, G6016,HCPCS,DELIVERY COMP IMRT,,30,,,"$3,386.02",$0.00,1,0,1,20161001, G6017,HCPCS,INTRAFRACTION TRACK MOTION,,30,,,$696.78,$0.00,1,0,1,20161001, G8978,HCPCS,MOBILITY CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8979,HCPCS,MOBILITY GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8980,HCPCS,MOBILITY D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8981,HCPCS,BODY POS CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8982,HCPCS,BODY POS GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8983,HCPCS,BODY POS D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8984,HCPCS,CARRY CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8985,HCPCS,CARRY GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8986,HCPCS,CARRY D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8987,HCPCS,SELF CARE CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8988,HCPCS,SELF CARE GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8989,HCPCS,SELF CARE D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8990,HCPCS,OTHER PT/OT CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8991,HCPCS,OTHER PT/OT GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8992,HCPCS,OTHER PT/OT D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8993,HCPCS,SUB PT/OT CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8994,HCPCS,SUB PT/OT GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8995,HCPCS,SUB PT/OT D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8996,HCPCS,SWALLOW CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8997,HCPCS,SWALLOW GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8998,HCPCS,SWALLOW D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G8999,HCPCS,MOTOR SPEECH CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9157,HCPCS,TRANSESOPH DOPPL CARDIAC MON,,30,,,$478.35,$0.00,1,0,1,20161001, G9158,HCPCS,MOTOR SPEECH D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9159,HCPCS,LANG COMP CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9160,HCPCS,LANG COMP GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9161,HCPCS,LANG COMP D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9162,HCPCS,LANG EXPRESS CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9163,HCPCS,LANG EXPRESS GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9164,HCPCS,LANG EXPRESS D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9165,HCPCS,ATTEN CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9166,HCPCS,ATTEN GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9167,HCPCS,ATTEN D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9168,HCPCS,MEMORY CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9169,HCPCS,MEMORY GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9170,HCPCS,MEMORY D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9171,HCPCS,VOICE CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9172,HCPCS,VOICE GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9173,HCPCS,VOICE D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9174,HCPCS,SPEECH LANG CURRENT STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9175,HCPCS,SPEECH LANG GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9176,HCPCS,SPEECH LANG D/C STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, G9186,HCPCS,MOTOR SPEECH GOAL STATUS,,30,,,$0.01,$0.00,1,0,0,20161001, J0120,HCPCS,TETRACYCLIN INJECTION,,30,,,$633.58,$0.00,1,0,0,20161001, J0129,HCPCS,ABATACEPT INJECTION,,30,,,$226.82,$0.00,1,0,0,20161001, J0130,HCPCS,ABCIXIMAB INJECTION,,30,,,"$5,057.72",$0.00,1,0,0,20161001, J0131,HCPCS,ACETAMINOPHEN INJECTION,,30,,,$0.73,$0.00,1,0,0,20161001, J0132,HCPCS,ACETYLCYSTEINE INJECTION,,30,,,$13.65,$0.00,1,0,0,20161001, J0133,HCPCS,ACYCLOVIR INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J0135,HCPCS,ADALIMUMAB INJECTION,,30,,,"$4,093.30",$0.00,1,0,0,20161001, J0153,HCPCS,ADENOSINE INJ 1MG,,30,,,$8.32,$0.00,1,0,0,20161001, J0171,HCPCS,ADRENALIN EPINEPHRINE INJECT,,30,,,$2.80,$0.00,1,0,0,20161001, J0178,HCPCS,AFLIBERCEPT INJECTION,,30,,,"$5,950.60",$0.00,1,0,0,20161001, J0180,HCPCS,AGALSIDASE BETA INJECTION,,30,,,$981.46,$0.00,1,0,0,20161001, J0200,HCPCS,ALATROFLOXACIN MESYLATE,,30,,,$36.25,$0.00,1,0,0,20161001, J0202,HCPCS,"INJECTION, ALEMTUZUMAB",,30,,,"$9,732.12",$0.00,1,0,0,20161001, J0205,HCPCS,ALGLUCERASE INJECTION,,30,,,$87.02,$0.00,1,0,0,20161001, J0207,HCPCS,AMIFOSTINE,,30,,,"$2,296.54",$0.00,1,0,0,20161001, J0210,HCPCS,METHYLDOPATE HCL INJECTION,,30,,,$109.50,$0.00,1,0,0,20161001, J0215,HCPCS,ALEFACEPT,,30,,,$270.35,$0.00,1,0,0,20161001, J0220,HCPCS,ALGLUCOSIDASE ALFA INJECTION,,30,,,"$1,326.16",$0.00,1,0,0,20161001, J0221,HCPCS,LUMIZYME INJECTION,,30,,,$989.55,$0.00,1,0,0,20161001, J0256,HCPCS,ALPHA 1 PROTEINASE INHIBITOR,,30,,,$28.15,$0.00,1,0,0,20161001, J0257,HCPCS,GLASSIA INJECTION,,30,,,$26.13,$0.00,1,0,0,20161001, J0270,HCPCS,ALPROSTADIL FOR INJECTION,,30,,,$12.64,$0.00,1,0,0,20161001, J0275,HCPCS,ALPROSTADIL URETHRAL SUPPOS,,30,,,$62.23,$0.00,1,0,0,20161001, J0278,HCPCS,AMIKACIN SULFATE INJECTION,,30,,,$7.45,$0.00,1,0,0,20161001, J0280,HCPCS,AMINOPHYLLIN 250 MG INJ,,30,,,$14.37,$0.00,1,0,0,20161001, J0282,HCPCS,AMIODARONE HCL,,30,,,$5.59,$0.00,1,0,0,20161001, J0285,HCPCS,AMPHOTERICIN B,,30,,,$47.24,$0.00,1,0,0,20161001, J0287,HCPCS,AMPHOTERICIN B LIPID COMPLEX,,30,,,$75.73,$0.00,1,0,0,20161001, J0288,HCPCS,AMPHO B CHOLESTERYL SULFATE,,30,,,$195.98,$0.00,1,0,0,20161001, J0289,HCPCS,AMPHOTERICIN B LIPOSOME INJ,,30,,,$111.15,$0.00,1,0,0,20161001, J0290,HCPCS,AMPICILLIN 500 MG INJ,,30,,,$7.45,$0.00,1,0,0,20161001, J0295,HCPCS,AMPICILLIN SODIUM PER 1.5 GM,,30,,,$9.03,$0.00,1,0,0,20161001, J0300,HCPCS,AMOBARBITAL 125 MG INJ,,30,,,"$1,247.86",$0.00,1,0,0,20161001, J0330,HCPCS,SUCCINYCHOLINE CHLORIDE INJ,,30,,,$5.59,$0.00,1,0,0,20161001, J0348,HCPCS,ANIDULAFUNGIN INJECTION,,30,,,$5.59,$0.00,1,0,0,20161001, J0360,HCPCS,HYDRALAZINE HCL INJECTION,,30,,,$12.64,$0.00,1,0,0,20161001, J0365,HCPCS,"APROTONIN, 10,000 KIU",,30,,,$596.75,$0.00,1,0,0,20161001, J0380,HCPCS,INJ METARAMINOL BITARTRATE,,30,,,$6.74,$0.00,1,0,0,20161001, J0395,HCPCS,ARBUTAMINE HCL INJECTION,,30,,,$30.33,$0.00,1,0,0,20161001, J0401,HCPCS,INJ ARIPIPRAZOLE EXT REL 1MG,,30,,,$25.87,$0.00,1,0,0,20161001, J0456,HCPCS,AZITHROMYCIN,,30,,,$13.51,$0.00,1,0,0,20161001, J0461,HCPCS,ATROPINE SULFATE INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J0475,HCPCS,BACLOFEN 10 MG INJECTION,,30,,,"$1,092.67",$0.00,1,0,0,20161001, J0476,HCPCS,BACLOFEN INTRATHECAL TRIAL,,30,,,$495.47,$0.00,1,0,0,20161001, J0480,HCPCS,BASILIXIMAB,,30,,,"$14,366.56",$0.00,1,0,0,20161001, J0485,HCPCS,BELATACEPT INJECTION,,30,,,$24.70,$0.00,1,0,0,20161001, J0490,HCPCS,BELIMUMAB INJECTION,,30,,,$259.86,$0.00,1,0,0,20161001, J0500,HCPCS,DICYCLOMINE INJECTION,,30,,,$105.18,$0.00,1,0,0,20161001, J0515,HCPCS,INJ BENZTROPINE MESYLATE,,30,,,$54.15,$0.00,1,0,0,20161001, J0558,HCPCS,PENG BENZATHINE/PROCAINE INJ,,30,,,$19.56,$0.00,1,0,0,20161001, J0561,HCPCS,PENICILLIN G BENZATHINE INJ,,30,,,$22.16,$0.00,1,0,0,20161001, J0583,HCPCS,BIVALIRUDIN,,30,,,$22.75,$0.00,1,0,0,20161001, J0585,HCPCS,"INJECTION,ONABOTULINUMTOXINA",,30,,,$36.21,$0.00,1,0,0,20161001, J0586,HCPCS,ABOBOTULINUMTOXINA,,30,,,$51.68,$0.00,1,0,0,20161001, J0587,HCPCS,"INJ, RIMABOTULINUMTOXINB",,30,,,$73.39,$0.00,1,0,0,20161001, J0588,HCPCS,INCOBOTULINUMTOXIN A,,30,,,$29.97,$0.00,1,0,0,20161001, J0592,HCPCS,BUPRENORPHINE HYDROCHLORIDE,,30,,,$13.51,$0.00,1,0,0,20161001, J0594,HCPCS,BUSULFAN INJECTION,,30,,,$215.87,$0.00,1,0,0,20161001, J0595,HCPCS,BUTORPHANOL TARTRATE 1 MG,,30,,,$9.03,$0.00,1,0,0,20161001, J0596,HCPCS,"INJECTION, RUCONEST",,30,,,$151.39,$0.00,1,0,0,20161001, J0597,HCPCS,"C-1 ESTERASE, BERINERT",,30,,,$250.47,$0.00,1,0,0,20161001, J0598,HCPCS,"C-1 ESTERASE, CINRYZE",,30,,,$336.72,$0.00,1,0,0,20161001, J0600,HCPCS,EDETATE CALCIUM DISODIUM INJ,,30,,,"$19,992.50",$0.00,1,0,0,20161001, J0610,HCPCS,CALCIUM GLUCONATE INJECTION,,30,,,$8.75,$0.00,1,0,0,20161001, J0620,HCPCS,CALCIUM GLYCER & LACT/10 ML,,30,,,$35.99,$0.00,1,0,0,20161001, J0630,HCPCS,CALCITONIN SALMON INJECTION,,30,,,$468.28,$0.00,1,0,0,20161001, J0636,HCPCS,INJ CALCITRIOL PER 0.1 MCG,,30,,,$2.80,$0.00,1,0,0,20161001, J0637,HCPCS,CASPOFUNGIN ACETATE,,30,,,$76.96,$0.00,1,0,0,20161001, J0638,HCPCS,CANAKINUMAB INJECTION,,30,,,$589.37,$0.00,1,0,0,20161001, J0640,HCPCS,LEUCOVORIN CALCIUM INJECTION,,30,,,$16.10,$0.00,1,0,0,20161001, J0641,HCPCS,LEVOLEUCOVORIN INJECTION,,30,,,$11.70,$0.00,1,0,0,20161001, J0670,HCPCS,INJ MEPIVACAINE HCL/10 ML,,30,,,$12.64,$0.00,1,0,0,20161001, J0690,HCPCS,CEFAZOLIN SODIUM INJECTION,,30,,,$6.02,$0.00,1,0,0,20161001, J0692,HCPCS,CEFEPIME HCL FOR INJECTION,,30,,,$12.64,$0.00,1,0,0,20161001, J0694,HCPCS,CEFOXITIN SODIUM INJECTION,,30,,,$18.70,$0.00,1,0,0,20161001, J0695,HCPCS,INJ CEFTOLOZANE TAZOBACTAM,,30,,,$2.34,$0.00,1,0,0,20161001, J0696,HCPCS,CEFTRIAXONE SODIUM INJECTION,,30,,,$5.59,$0.00,1,0,0,20161001, J0697,HCPCS,STERILE CEFUROXIME INJECTION,,30,,,$13.51,$0.00,1,0,0,20161001, J0698,HCPCS,CEFOTAXIME SODIUM INJECTION,,30,,,$9.03,$0.00,1,0,0,20161001, J0702,HCPCS,BETAMETHASONE ACET&SOD PHOSP,,30,,,$20.43,$0.00,1,0,0,20161001, J0706,HCPCS,CAFFEINE CITRATE INJECTION,,30,,,$14.37,$0.00,1,0,0,20161001, J0710,HCPCS,CEPHAPIRIN SODIUM INJECTION,,30,,,$16.05,$0.00,1,0,0,20161001, J0712,HCPCS,CEFTAROLINE FOSAMIL INJ,,30,,,$11.95,$0.00,1,0,0,20161001, J0713,HCPCS,INJ CEFTAZIDIME PER 500 MG,,30,,,$11.78,$0.00,1,0,0,20161001, J0714,HCPCS,CEFTAZIDIME AND AVIBACTAM,,30,,,$421.68,$0.00,1,0,0,20161001, J0715,HCPCS,CEFTIZOXIME SODIUM / 500 MG,,30,,,$36.34,$0.00,1,0,0,20161001, J0716,HCPCS,CENTRUROIDES IMMUNE F(AB),,30,,,"$17,710.23",$0.00,1,0,0,20161001, J0717,HCPCS,CERTOLIZUMAB PEGOL INJ 1MG,,30,,,$33.79,$0.00,1,0,0,20161001, J0720,HCPCS,CHLORAMPHENICOL SODIUM INJEC,,30,,,$83.56,$0.00,1,0,0,20161001, J0725,HCPCS,CHORIONIC GONADOTROPIN/1000U,,30,,,$125.97,$0.00,1,0,0,20161001, J0735,HCPCS,CLONIDINE HYDROCHLORIDE,,30,,,$59.34,$0.00,1,0,0,20161001, J0740,HCPCS,CIDOFOVIR INJECTION,,30,,,"$3,462.84",$0.00,1,0,0,20161001, J0743,HCPCS,CILASTATIN SODIUM INJECTION,,30,,,$18.70,$0.00,1,0,0,20161001, J0744,HCPCS,CIPROFLOXACIN IV,,30,,,$6.74,$0.00,1,0,0,20161001, J0745,HCPCS,INJ CODEINE PHOSPHATE /30 MG,,30,,,$6.74,$0.00,1,0,0,20161001, J0770,HCPCS,COLISTIMETHATE SODIUM INJ,,30,,,$34.26,$0.00,1,0,0,20161001, J0775,HCPCS,"COLLAGENASE, CLOST HIST INJ",,30,,,$249.50,$0.00,1,0,0,20161001, J0780,HCPCS,PROCHLORPERAZINE INJECTION,,30,,,$40.32,$0.00,1,0,0,20161001, J0795,HCPCS,CORTICORELIN OVINE TRIFLUTAL,,30,,,$50.31,$0.00,1,0,0,20161001, J0800,HCPCS,CORTICOTROPIN INJECTION,,30,,,"$16,714.96",$0.00,1,0,0,20161001, J0833,HCPCS,COSYNTROPIN INJECTION NOS,,30,,,$657.40,$0.00,1,0,0,20161001, J0834,HCPCS,COSYNTROPIN CORTROSYN INJ,,30,,,$120.74,$0.00,1,0,0,20161001, J0840,HCPCS,CROTALIDAE POLY IMMUNE FAB,,30,,,"$13,429.35",$0.00,1,0,0,20161001, J0850,HCPCS,CYTOMEGALOVIRUS IMM IV /VIAL,,30,,,"$6,137.86",$0.00,1,0,0,20161001, J0875,HCPCS,"INJECTION, DALBAVANCIN",,30,,,$79.72,$0.00,1,0,0,20161001, J0878,HCPCS,DAPTOMYCIN INJECTION,,30,,,$4.62,$0.00,1,0,0,20161001, J0881,HCPCS,"DARBEPOETIN ALFA, NON-ESRD",,30,,,$24.25,$0.00,1,0,0,20161001, J0882,HCPCS,"DARBEPOETIN ALFA, ESRD USE",,30,,,$22.70,$0.00,1,0,0,20161001, J0885,HCPCS,"EPOETIN ALFA, NON-ESRD",,30,,,$76.96,$0.00,1,0,0,20161001, J0887,HCPCS,EPOETIN BETA ESRD USE,,30,,,$63.03,$0.00,1,0,0,20161001, J0890,HCPCS,PEGINESATIDE INJECTION,,30,,,$26.00,$0.00,1,0,0,20161001, J0894,HCPCS,DECITABINE INJECTION,,30,,,$169.70,$0.00,1,0,0,20161001, J0895,HCPCS,DEFEROXAMINE MESYLATE INJ,,30,,,$28.21,$0.00,1,0,0,20161001, J0897,HCPCS,DENOSUMAB INJECTION,,30,,,$73.78,$0.00,1,0,0,20161001, J1000,HCPCS,DEPO-ESTRADIOL CYPIONATE INJ,,30,,,$33.40,$0.00,1,0,0,20161001, J1020,HCPCS,METHYLPREDNISOLONE 20 MG INJ,,30,,,$15.24,$0.00,1,0,0,20161001, J1030,HCPCS,METHYLPREDNISOLONE 40 MG INJ,,30,,,$14.37,$0.00,1,0,0,20161001, J1040,HCPCS,METHYLPREDNISOLONE 80 MG INJ,,30,,,$21.29,$0.00,1,0,0,20161001, J1050,HCPCS,MEDROXYPROGESTERONE ACETATE,,30,,,$2.80,$0.00,1,0,0,20161001, J1071,HCPCS,INJ TESTOSTERONE CYPIONATE,,30,,,$3.19,$0.00,1,0,0,20161001, J1094,HCPCS,INJ DEXAMETHASONE ACETATE,,30,,,$2.80,$0.00,1,0,0,20161001, J1100,HCPCS,DEXAMETHASONE SODIUM PHOS,,30,,,$2.80,$0.00,1,0,0,20161001, J1110,HCPCS,INJ DIHYDROERGOTAMINE MESYLT,,30,,,$136.31,$0.00,1,0,0,20161001, J1120,HCPCS,ACETAZOLAMID SODIUM INJECTIO,,30,,,$58.48,$0.00,1,0,0,20161001, J1160,HCPCS,DIGOXIN INJECTION,,30,,,$29.08,$0.00,1,0,0,20161001, J1162,HCPCS,DIGOXIN IMMUNE FAB (OVINE),,30,,,"$12,859.75",$0.00,1,0,0,20161001, J1165,HCPCS,PHENYTOIN SODIUM INJECTION,,30,,,$5.59,$0.00,1,0,0,20161001, J1170,HCPCS,HYDROMORPHONE INJECTION,,30,,,$11.78,$0.00,1,0,0,20161001, J1190,HCPCS,DEXRAZOXANE HCL INJECTION,,30,,,$887.22,$0.00,1,0,0,20161001, J1200,HCPCS,DIPHENHYDRAMINE HCL INJECTIO,,30,,,$5.59,$0.00,1,0,0,20161001, J1205,HCPCS,CHLOROTHIAZIDE SODIUM INJ,,30,,,$789.20,$0.00,1,0,0,20161001, J1212,HCPCS,DIMETHYL SULFOXIDE 50% 50 ML,,30,,,$221.06,$0.00,1,0,0,20161001, J1230,HCPCS,METHADONE INJECTION,,30,,,$29.08,$0.00,1,0,0,20161001, J1240,HCPCS,DIMENHYDRINATE INJECTION,,30,,,$19.56,$0.00,1,0,0,20161001, J1245,HCPCS,DIPYRIDAMOLE INJECTION,,30,,,$5.59,$0.00,1,0,0,20161001, J1250,HCPCS,INJ DOBUTAMINE HCL/250 MG,,30,,,$22.16,$0.00,1,0,0,20161001, J1260,HCPCS,DOLASETRON MESYLATE,,30,,,$32.08,$0.00,1,0,0,20161001, J1265,HCPCS,DOPAMINE INJECTION,,30,,,$4.88,$0.00,1,0,0,20161001, J1267,HCPCS,DORIPENEM INJECTION,,30,,,$5.59,$0.00,1,0,0,20161001, J1270,HCPCS,"INJECTION, DOXERCALCIFEROL",,30,,,$10.05,$0.00,1,0,0,20161001, J1290,HCPCS,ECALLANTIDE INJECTION,,30,,,"$2,383.10",$0.00,1,0,0,20161001, J1300,HCPCS,ECULIZUMAB INJECTION,,30,,,"$1,359.42",$0.00,1,0,0,20161001, J1322,HCPCS,"ELOSULFASE ALFA, INJECTION",,30,,,"$1,421.69",$0.00,1,0,0,20161001, J1324,HCPCS,ENFUVIRTIDE INJECTION,,30,,,$121.10,$0.00,1,0,0,20161001, J1325,HCPCS,EPOPROSTENOL INJECTION,,30,,,$43.78,$0.00,1,0,0,20161001, J1327,HCPCS,EPTIFIBATIDE INJECTION,,30,,,$189.55,$0.00,1,0,0,20161001, J1330,HCPCS,ERGONOVINE MALEATE INJECTION,,30,,,$7.91,$0.00,1,0,0,20161001, J1335,HCPCS,ERTAPENEM INJECTION,,30,,,$94.80,$0.00,1,0,0,20161001, J1364,HCPCS,ERYTHRO LACTOBIONATE /500 MG,,30,,,$112.96,$0.00,1,0,0,20161001, J1380,HCPCS,ESTRADIOL VALERATE 10 MG INJ,,30,,,$29.08,$0.00,1,0,0,20161001, J1410,HCPCS,INJ ESTROGEN CONJUGATE 25 MG,,30,,,"$1,225.04",$0.00,1,0,0,20161001, J1430,HCPCS,ETHANOLAMINE OLEATE 100 MG,,30,,,"$2,557.48",$0.00,1,0,0,20161001, J1435,HCPCS,INJECTION ESTRONE PER 1 MG,,30,,,$2.80,$0.00,1,0,0,20161001, J1438,HCPCS,ETANERCEPT INJECTION,,30,,,"$1,927.57",$0.00,1,0,0,20161001, J1439,HCPCS,INJ FERRIC CARBOXYMALTOS 1MG,,30,,,$6.96,$0.00,1,0,0,20161001, J1442,HCPCS,INJ FILGRASTIM EXCL BIOSIMIL,,30,,,$6.44,$0.00,1,0,0,20161001, J1443,HCPCS,INJ FERRIC PYROPHOSPHATE CIT,,30,,,$2.95,$0.00,1,0,0,20161001, J1447,HCPCS,INJ TBO FILGRASTIM 1 MICROG,,30,,,$25.09,$0.00,1,0,0,20161001, J1450,HCPCS,FLUCONAZOLE,,30,,,$16.10,$0.00,1,0,0,20161001, J1451,HCPCS,"FOMEPIZOLE, 15 MG",,30,,,$45.57,$0.00,1,0,0,20161001, J1452,HCPCS,INTRAOCULAR FOMIVIRSEN NA,,30,,,"$2,419.09",$0.00,1,0,0,20161001, J1453,HCPCS,FOSAPREPITANT INJECTION,,30,,,$11.25,$0.00,1,0,0,20161001, J1455,HCPCS,FOSCARNET SODIUM INJECTION,,30,,,$57.61,$0.00,1,0,0,20161001, J1457,HCPCS,GALLIUM NITRATE INJECTION,,30,,,$7.89,$0.00,1,0,0,20161001, J1458,HCPCS,GALSULFASE INJECTION,,30,,,"$2,300.25",$0.00,1,0,0,20161001, J1459,HCPCS,INJ IVIG PRIVIGEN 500 MG,,30,,,$243.21,$0.00,1,0,0,20161001, J1460,HCPCS,GAMMA GLOBULIN 1 CC INJ,,30,,,$76.64,$0.00,1,0,0,20161001, J1556,HCPCS,"INJ, IMM GLOB BIVIGAM, 500MG",,30,,,$236.09,$0.00,1,0,0,20161001, J1557,HCPCS,GAMMAPLEX INJECTION,,30,,,$236.28,$0.00,1,0,0,20161001, J1559,HCPCS,HIZENTRA INJECTION,,30,,,$53.17,$0.00,1,0,0,20161001, J1560,HCPCS,GAMMA GLOBULIN > 10 CC INJ,,30,,,$705.35,$0.00,1,0,0,20161001, J1561,HCPCS,GAMUNEX-C/GAMMAKED,,30,,,$259.15,$0.00,1,0,0,20161001, J1562,HCPCS,"VIVAGLOBIN, INJ",,30,,,$30.81,$0.00,1,0,0,20161001, J1566,HCPCS,"IMMUNE GLOBULIN, POWDER",,30,,,$188.12,$0.00,1,0,0,20161001, J1568,HCPCS,OCTAGAM INJECTION,,30,,,$263.29,$0.00,1,0,0,20161001, J1569,HCPCS,GAMMAGARD LIQUID INJECTION,,30,,,$254.61,$0.00,1,0,0,20161001, J1570,HCPCS,GANCICLOVIR SODIUM INJECTION,,30,,,$189.06,$0.00,1,0,0,20161001, J1571,HCPCS,HEPAGAM B IM INJECTION,,30,,,$349.39,$0.00,1,0,0,20161001, J1572,HCPCS,FLEBOGAMMA INJECTION,,30,,,$230.84,$0.00,1,0,0,20161001, J1573,HCPCS,"HEPAGAM B INTRAVENOUS, INJ",,30,,,$349.39,$0.00,1,0,0,20161001, J1575,HCPCS,HYQVIA 100MG IMMUNEGLOBULIN,,30,,,$71.24,$0.00,1,0,0,20161001, J1580,HCPCS,GARAMYCIN GENTAMICIN INJ,,30,,,$7.17,$0.00,1,0,0,20161001, J1590,HCPCS,GATIFLOXACIN INJECTION,,30,,,$2.92,$0.00,1,0,0,20161001, J1595,HCPCS,INJECTION GLATIRAMER ACETATE,,30,,,"$1,200.44",$0.00,1,0,0,20161001, J1599,HCPCS,"IVIG NON-LYOPHILIZED, NOS",,30,,,$152.65,$0.00,1,0,0,20161001, J1600,HCPCS,GOLD SODIUM THIOMALEATE INJ,,30,,,$42.05,$0.00,1,0,0,20161001, J1602,HCPCS,GOLIMUMAB FOR IV USE 1MG,,30,,,$157.30,$0.00,1,0,0,20161001, J1610,HCPCS,GLUCAGON HYDROCHLORIDE/1 MG,,30,,,"$1,224.66",$0.00,1,0,0,20161001, J1620,HCPCS,GONADORELIN HYDROCH/ 100 MCG,,30,,,$683.93,$0.00,1,0,0,20161001, J1626,HCPCS,GRANISETRON HCL INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J1630,HCPCS,HALOPERIDOL INJECTION,,30,,,$10.33,$0.00,1,0,0,20161001, J1631,HCPCS,HALOPERIDOL DECANOATE INJ,,30,,,$51.56,$0.00,1,0,0,20161001, J1640,HCPCS,"HEMIN, 1 MG",,30,,,$134.75,$0.00,1,0,0,20161001, J1642,HCPCS,INJ HEPARIN SODIUM PER 10 U,,30,,,$2.80,$0.00,1,0,0,20161001, J1644,HCPCS,INJ HEPARIN SODIUM PER 1000U,,30,,,$2.80,$0.00,1,0,0,20161001, J1645,HCPCS,DALTEPARIN SODIUM,,30,,,$37.72,$0.00,1,0,0,20161001, J1650,HCPCS,INJ ENOXAPARIN SODIUM,,30,,,$10.05,$0.00,1,0,0,20161001, J1652,HCPCS,FONDAPARINUX SODIUM,,30,,,$16.10,$0.00,1,0,0,20161001, J1670,HCPCS,TETANUS IMMUNE GLOBULIN INJ,,30,,,"$1,632.36",$0.00,1,0,0,20161001, J1700,HCPCS,HYDROCORTISONE ACETATE INJ,,30,,,$1.24,$0.00,1,0,0,20161001, J1710,HCPCS,HYDROCORTISONE SODIUM PH INJ,,30,,,$21.81,$0.00,1,0,0,20161001, J1720,HCPCS,HYDROCORTISONE SODIUM SUCC I,,30,,,$22.16,$0.00,1,0,0,20161001, J1725,HCPCS,HYDROXYPROGESTERONE CAPROATE,,30,,,$17.16,$0.00,1,0,0,20161001, J1730,HCPCS,DIAZOXIDE INJECTION,,30,,,$269.49,$0.00,1,0,0,20161001, J1740,HCPCS,IBANDRONATE SODIUM INJECTION,,30,,,$801.23,$0.00,1,0,0,20161001, J1741,HCPCS,IBUPROFEN INJECTION,,30,,,$11.53,$0.00,1,0,0,20161001, J1742,HCPCS,IBUTILIDE FUMARATE INJECTION,,30,,,$409.07,$0.00,1,0,0,20161001, J1743,HCPCS,IDURSULFASE INJECTION,,30,,,"$3,128.86",$0.00,1,0,0,20161001, J1744,HCPCS,ICATIBANT INJECTION,,30,,,"$1,764.94",$0.00,1,0,0,20161001, J1745,HCPCS,INFLIXIMAB INJECTION,,30,,,$399.99,$0.00,1,0,0,20161001, J1750,HCPCS,INJ IRON DEXTRAN,,30,,,$78.78,$0.00,1,0,0,20161001, J1756,HCPCS,IRON SUCROSE INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J1786,HCPCS,IMUGLUCERASE INJECTION,,30,,,$272.68,$0.00,1,0,0,20161001, J1790,HCPCS,DROPERIDOL INJECTION,,30,,,$11.78,$0.00,1,0,0,20161001, J1800,HCPCS,PROPRANOLOL INJECTION,,30,,,$8.19,$0.00,1,0,0,20161001, J1810,HCPCS,DROPERIDOL/FENTANYL INJ,,30,,,$130.84,$0.00,1,0,0,20161001, J1815,HCPCS,INSULIN INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J1817,HCPCS,INSULIN FOR INSULIN PUMP USE,,30,,,$19.56,$0.00,1,0,0,20161001, J1826,HCPCS,INTERFERON BETA-1A INJ,,30,,,"$1,512.21",$0.00,1,0,0,20161001, J1830,HCPCS,INTERFERON BETA-1B / .25 MG,,30,,,"$2,238.36",$0.00,1,0,0,20161001, J1833,HCPCS,"INJECTION, ISAVUCONAZONIUM",,30,,,$3.80,$0.00,1,0,0,20161001, J1835,HCPCS,ITRACONAZOLE INJECTION,,30,,,"$2,438.41",$0.00,1,0,0,20161001, J1840,HCPCS,KANAMYCIN SULFATE 500 MG INJ,,30,,,$24.75,$0.00,1,0,0,20161001, J1885,HCPCS,KETOROLAC TROMETHAMINE INJ,,30,,,$2.80,$0.00,1,0,0,20161001, J1890,HCPCS,CEPHALOTHIN SODIUM INJECTION,,30,,,$28.39,$0.00,1,0,0,20161001, J1930,HCPCS,LANREOTIDE INJECTION,,30,,,$302.90,$0.00,1,0,0,20161001, J1931,HCPCS,LARONIDASE INJECTION,,30,,,$191.37,$0.00,1,0,0,20161001, J1940,HCPCS,FUROSEMIDE INJECTION,,30,,,$17.83,$0.00,1,0,0,20161001, J1945,HCPCS,LEPIRUDIN,,30,,,"$1,508.51",$0.00,1,0,0,20161001, J1950,HCPCS,LEUPROLIDE ACETATE /3.75 MG,,30,,,"$4,997.68",$0.00,1,0,0,20161001, J1953,HCPCS,LEVETIRACETAM INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J1955,HCPCS,INJ LEVOCARNITINE PER 1 GM,,30,,,$27.35,$0.00,1,0,0,20161001, J1956,HCPCS,LEVOFLOXACIN INJECTION,,30,,,$11.78,$0.00,1,0,0,20161001, J1980,HCPCS,HYOSCYAMINE SULFATE INJ,,30,,,$51.56,$0.00,1,0,0,20161001, J2001,HCPCS,LIDOCAINE INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J2010,HCPCS,LINCOMYCIN INJECTION,,30,,,$29.94,$0.00,1,0,0,20161001, J2020,HCPCS,LINEZOLID INJECTION,,30,,,$205.44,$0.00,1,0,0,20161001, J2060,HCPCS,LORAZEPAM INJECTION,,30,,,$5.59,$0.00,1,0,0,20161001, J2150,HCPCS,MANNITOL INJECTION,,30,,,$10.91,$0.00,1,0,0,20161001, J2170,HCPCS,MECASERMIN INJECTION,,30,,,$24.75,$0.00,1,0,0,20161001, J2175,HCPCS,MEPERIDINE HYDROCHL /100 MG,,30,,,$18.70,$0.00,1,0,0,20161001, J2180,HCPCS,MEPERIDINE/PROMETHAZINE INJ,,30,,,$26.48,$0.00,1,0,0,20161001, J2185,HCPCS,MEROPENEM,,30,,,$6.74,$0.00,1,0,0,20161001, J2210,HCPCS,METHYLERGONOVIN MALEATE INJ,,30,,,$18.70,$0.00,1,0,0,20161001, J2212,HCPCS,METHYLNALTREXONE INJECTION,,30,,,$0.90,$0.00,1,0,0,20161001, J2248,HCPCS,MICAFUNGIN SODIUM INJECTION,,30,,,$6.74,$0.00,1,0,0,20161001, J2250,HCPCS,INJ MIDAZOLAM HYDROCHLORIDE,,30,,,$2.80,$0.00,1,0,0,20161001, J2260,HCPCS,INJ MILRINONE LACTATE / 5 MG,,30,,,$14.37,$0.00,1,0,0,20161001, J2265,HCPCS,MINOCYCLINE HYDROCHLORIDE,,30,,,$1.38,$0.00,1,0,0,20161001, J2270,HCPCS,MORPHINE SULFATE INJECTION,,30,,,$10.91,$0.00,1,0,0,20161001, J2274,HCPCS,IN MORPHINE PRESERVATIV FREE,,30,,,$29.08,$0.00,1,0,0,20161001, J2278,HCPCS,ZICONOTIDE INJECTION,,30,,,$45.31,$0.00,1,0,0,20161001, J2280,HCPCS,"INJ, MOXIFLOXACIN 100 MG",,30,,,$19.56,$0.00,1,0,0,20161001, J2300,HCPCS,INJ NALBUPHINE HYDROCHLORIDE,,30,,,$12.64,$0.00,1,0,0,20161001, J2310,HCPCS,INJ NALOXONE HYDROCHLORIDE,,30,,,$93.07,$0.00,1,0,0,20161001, J2315,HCPCS,"NALTREXONE, DEPOT FORM",,30,,,$19.31,$0.00,1,0,0,20161001, J2320,HCPCS,NANDROLONE DECANOATE 50 MG,,30,,,$685.83,$0.00,1,0,0,20161001, J2323,HCPCS,NATALIZUMAB INJECTION,,30,,,$102.83,$0.00,1,0,0,20161001, J2325,HCPCS,NESIRITIDE INJECTION,,30,,,$429.78,$0.00,1,0,0,20161001, J2353,HCPCS,"OCTREOTIDE INJECTION, DEPOT",,30,,,$932.67,$0.00,1,0,0,20161001, J2354,HCPCS,"OCTREOTIDE INJ, NON-DEPOT",,30,,,$6.74,$0.00,1,0,0,20161001, J2355,HCPCS,OPRELVEKIN INJECTION,,30,,,"$2,641.60",$0.00,1,0,0,20161001, J2357,HCPCS,OMALIZUMAB INJECTION,,30,,,$187.09,$0.00,1,0,0,20161001, J2358,HCPCS,OLANZAPINE LONG-ACTING INJ,,30,,,$18.98,$0.00,1,0,0,20161001, J2360,HCPCS,ORPHENADRINE INJECTION,,30,,,$20.43,$0.00,1,0,0,20161001, J2370,HCPCS,PHENYLEPHRINE HCL INJECTION,,30,,,$14.37,$0.00,1,0,0,20161001, J2400,HCPCS,CHLOROPROCAINE HCL INJECTION,,30,,,$47.24,$0.00,1,0,0,20161001, J2405,HCPCS,ONDANSETRON HCL INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J2407,HCPCS,"INJECTION, ORITAVANCIN",,30,,,$162.95,$0.00,1,0,0,20161001, J2410,HCPCS,OXYMORPHONE HCL INJECTION,,30,,,$13.51,$0.00,1,0,0,20161001, J2425,HCPCS,PALIFERMIN INJECTION,,30,,,$101.47,$0.00,1,0,0,20161001, J2426,HCPCS,PALIPERIDONE PALMITATE INJ,,30,,,$52.85,$0.00,1,0,0,20161001, J2430,HCPCS,PAMIDRONATE DISODIUM /30 MG,,30,,,$37.72,$0.00,1,0,0,20161001, J2440,HCPCS,PAPAVERIN HCL INJECTION,,30,,,$13.51,$0.00,1,0,0,20161001, J2469,HCPCS,PALONOSETRON HCL,,30,,,$129.68,$0.00,1,0,0,20161001, J2501,HCPCS,PARICALCITOL,,30,,,$10.05,$0.00,1,0,0,20161001, J2502,HCPCS,"INJ, PASIREOTIDE LONG ACTING",,30,,,"$1,402.77",$0.00,1,0,0,20161001, J2503,HCPCS,PEGAPTANIB SODIUM INJECTION,,30,,,"$6,286.63",$0.00,1,0,0,20161001, J2504,HCPCS,"PEGADEMASE BOVINE, 25 IU",,30,,,"$1,758.99",$0.00,1,0,0,20161001, J2505,HCPCS,"INJECTION, PEGFILGRASTIM 6MG",,30,,,"$15,560.09",$0.00,1,0,0,20161001, J2507,HCPCS,PEGLOTICASE INJECTION,,30,,,"$7,375.80",$0.00,1,0,0,20161001, J2510,HCPCS,PENICILLIN G PROCAINE INJ,,30,,,$49.83,$0.00,1,0,0,20161001, J2515,HCPCS,PENTOBARBITAL SODIUM INJ,,30,,,$93.07,$0.00,1,0,0,20161001, J2540,HCPCS,PENICILLIN G POTASSIUM INJ,,30,,,$5.59,$0.00,1,0,0,20161001, J2543,HCPCS,PIPERACILLIN/TAZOBACTAM,,30,,,$7.89,$0.00,1,0,0,20161001, J2545,HCPCS,PENTAMIDINE NON-COMP UNIT,,30,,,$241.82,$0.00,1,0,0,20161001, J2547,HCPCS,"INJECTION, PERAMIVIR",,30,,,$9.38,$0.00,1,0,0,20161001, J2550,HCPCS,PROMETHAZINE HCL INJECTION,,30,,,$7.89,$0.00,1,0,0,20161001, J2560,HCPCS,PHENOBARBITAL SODIUM INJ,,30,,,$63.67,$0.00,1,0,0,20161001, J2562,HCPCS,PLERIXAFOR INJECTION,,30,,,"$1,937.74",$0.00,1,0,0,20161001, J2590,HCPCS,OXYTOCIN INJECTION,,30,,,$16.10,$0.00,1,0,0,20161001, J2597,HCPCS,INJ DESMOPRESSIN ACETATE,,30,,,$58.31,$0.00,1,0,0,20161001, J2650,HCPCS,PREDNISOLONE ACETATE INJ,,30,,,$7.53,$0.00,1,0,0,20161001, J2670,HCPCS,TOTAZOLINE HCL INJECTION,,30,,,"$9,265.18",$0.00,1,0,0,20161001, J2675,HCPCS,INJ PROGESTERONE PER 50 MG,,30,,,$7.17,$0.00,1,0,0,20161001, J2680,HCPCS,FLUPHENAZINE DECANOATE 25 MG,,30,,,$62.80,$0.00,1,0,0,20161001, J2690,HCPCS,PROCAINAMIDE HCL INJECTION,,30,,,$144.96,$0.00,1,0,0,20161001, J2700,HCPCS,OXACILLIN SODIUM INJECITON,,30,,,$9.03,$0.00,1,0,0,20161001, J2710,HCPCS,NEOSTIGMINE METHYLSLFTE INJ,,30,,,$2.80,$0.00,1,0,0,20161001, J2720,HCPCS,INJ PROTAMINE SULFATE/10 MG,,30,,,$6.74,$0.00,1,0,0,20161001, J2724,HCPCS,PROTEIN C CONCENTRATE,,30,,,$98.15,$0.00,1,0,0,20161001, J2725,HCPCS,INJ PROTIRELIN PER 250 MCG,,30,,,$88.98,$0.00,1,0,0,20161001, J2730,HCPCS,PRALIDOXIME CHLORIDE INJ,,30,,,$218.47,$0.00,1,0,0,20161001, J2760,HCPCS,PHENTOLAINE MESYLATE INJ,,30,,,"$1,023.89",$0.00,1,0,0,20161001, J2765,HCPCS,METOCLOPRAMIDE HCL INJECTION,,30,,,$5.59,$0.00,1,0,0,20161001, J2770,HCPCS,QUINUPRISTIN/DALFOPRISTIN,,30,,,"$1,676.24",$0.00,1,0,0,20161001, J2778,HCPCS,RANIBIZUMAB INJECTION,,30,,,"$2,504.89",$0.00,1,0,0,20161001, J2780,HCPCS,RANITIDINE HYDROCHLORIDE INJ,,30,,,$6.74,$0.00,1,0,0,20161001, J2783,HCPCS,RASBURICASE,,30,,,"$1,431.79",$0.00,1,0,0,20161001, J2785,HCPCS,REGADENOSON INJECTION,,30,,,$133.72,$0.00,1,0,0,20161001, J2788,HCPCS,RHO D IMMUNE GLOBULIN 50 MCG,,30,,,$69.72,$0.00,1,0,0,20161001, J2790,HCPCS,RHO D IMMUNE GLOBULIN INJ,,30,,,$207.22,$0.00,1,0,0,20161001, J2791,HCPCS,RHOPHYLAC INJECTION,,30,,,$17.83,$0.00,1,0,0,20161001, J2792,HCPCS,"RHO(D) IMMUNE GLOBULIN H, SD",,30,,,$122.85,$0.00,1,0,0,20161001, J2793,HCPCS,RILONACEPT INJECTION,,30,,,$156.59,$0.00,1,0,0,20161001, J2794,HCPCS,"RISPERIDONE, LONG ACTING",,30,,,$42.45,$0.00,1,0,0,20161001, J2795,HCPCS,ROPIVACAINE HCL INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J2796,HCPCS,ROMIPLOSTIM INJECTION,,30,,,$358.50,$0.00,1,0,0,20161001, J2800,HCPCS,METHOCARBAMOL INJECTION,,30,,,$119.01,$0.00,1,0,0,20161001, J2805,HCPCS,SINCALIDE INJECTION,,30,,,$216.74,$0.00,1,0,0,20161001, J2810,HCPCS,INJ THEOPHYLLINE PER 40 MG,,30,,,$2.80,$0.00,1,0,0,20161001, J2820,HCPCS,SARGRAMOSTIM INJECTION,,30,,,$206.34,$0.00,1,0,0,20161001, J2850,HCPCS,INJ SECRETIN SYNTHETIC HUMAN,,30,,,$225.92,$0.00,1,0,0,20161001, J2860,HCPCS,"INJECTION, SILTUXIMAB",,30,,,$49.69,$0.00,1,0,0,20161001, J2916,HCPCS,NA FERRIC GLUCONATE COMPLEX,,30,,,$13.51,$0.00,1,0,0,20161001, J2920,HCPCS,METHYLPREDNISOLONE INJECTION,,30,,,$9.47,$0.00,1,0,0,20161001, J2930,HCPCS,METHYLPREDNISOLONE INJECTION,,30,,,$13.51,$0.00,1,0,0,20161001, J2940,HCPCS,SOMATREM INJECTION,,30,,,$135.89,$0.00,1,0,0,20161001, J2941,HCPCS,SOMATROPIN INJECTION,,30,,,$495.02,$0.00,1,0,0,20161001, J2950,HCPCS,PROMAZINE HCL INJECTION,,30,,,$35.69,$0.00,1,0,0,20161001, J2993,HCPCS,RETEPLASE INJECTION,,30,,,"$12,597.94",$0.00,1,0,0,20161001, J2997,HCPCS,ALTEPLASE RECOMBINANT,,30,,,$370.04,$0.00,1,0,0,20161001, J3000,HCPCS,STREPTOMYCIN INJECTION,,30,,,$36.86,$0.00,1,0,0,20161001, J3010,HCPCS,FENTANYL CITRATE INJECITON,,30,,,$4.88,$0.00,1,0,0,20161001, J3030,HCPCS,SUMATRIPTAN SUCCINATE / 6 MG,,30,,,$144.96,$0.00,1,0,0,20161001, J3060,HCPCS,"INJ, TALIGLUCERACE ALFA 10 U",,30,,,$228.83,$0.00,1,0,0,20161001, J3070,HCPCS,PENTAZOCINE INJECTION,,30,,,$761.99,$0.00,1,0,0,20161001, J3095,HCPCS,TELAVANCIN INJECTION,,30,,,$29.58,$0.00,1,0,0,20161001, J3101,HCPCS,TENECTEPLASE INJECTION,,30,,,$557.98,$0.00,1,0,0,20161001, J3105,HCPCS,TERBUTALINE SULFATE INJ,,30,,,$17.83,$0.00,1,0,0,20161001, J3110,HCPCS,TERIPARATIDE INJECTION,,30,,,$27.35,$0.00,1,0,0,20161001, J3121,HCPCS,INJ TESTOSTERO ENANTHATE 1MG,,30,,,$3.37,$0.00,1,0,0,20161001, J3145,HCPCS,TESTOSTERONE UNDECANOATE 1MG,,30,,,$7.54,$0.00,1,0,0,20161001, J3230,HCPCS,CHLORPROMAZINE HCL INJECTION,,30,,,$64.53,$0.00,1,0,0,20161001, J3240,HCPCS,THYROTROPIN INJECTION,,30,,,"$8,338.66",$0.00,1,0,0,20161001, J3243,HCPCS,TIGECYCLINE INJECTION,,30,,,$13.52,$0.00,1,0,0,20161001, J3246,HCPCS,TIROFIBAN HCL,,30,,,$57.20,$0.00,1,0,0,20161001, J3250,HCPCS,TRIMETHOBENZAMIDE HCL INJ,,30,,,$56.75,$0.00,1,0,0,20161001, J3260,HCPCS,TOBRAMYCIN SULFATE INJECTION,,30,,,$13.51,$0.00,1,0,0,20161001, J3262,HCPCS,TOCILIZUMAB INJECTION,,30,,,$24.51,$0.00,1,0,0,20161001, J3265,HCPCS,INJECTION TORSEMIDE 10 MG/ML,,30,,,$15.07,$0.00,1,0,0,20161001, J3285,HCPCS,TREPROSTINIL INJECTION,,30,,,$397.06,$0.00,1,0,0,20161001, J3300,HCPCS,TRIAMCINOLONE A INJ PRS-FREE,,30,,,$24.18,$0.00,1,0,0,20161001, J3301,HCPCS,TRIAMCINOLONE ACET INJ NOS,,30,,,$9.03,$0.00,1,0,0,20161001, J3302,HCPCS,TRIAMCINOLONE DIACETATE INJ,,30,,,$2.80,$0.00,1,0,0,20161001, J3303,HCPCS,TRIAMCINOLONE HEXACETONL INJ,,30,,,$9.47,$0.00,1,0,0,20161001, J3305,HCPCS,INJ TRIMETREXATE GLUCORONATE,,30,,,$113.73,$0.00,1,0,0,20161001, J3315,HCPCS,TRIPTORELIN PAMOATE,,30,,,"$1,158.62",$0.00,1,0,0,20161001, J3320,HCPCS,SPECTINOMYCN DI-HCL INJ,,30,,,$91.72,$0.00,1,0,0,20161001, J3350,HCPCS,UREA INJECTION,,30,,,$31.85,$0.00,1,0,0,20161001, J3355,HCPCS,"UROFOLLITROPIN, 75 IU",,30,,,$380.21,$0.00,1,0,0,20161001, J3357,HCPCS,USTEKINUMAB INJECTION,,30,,,"$1,052.34",$0.00,1,0,0,20161001, J3360,HCPCS,DIAZEPAM INJECTION,,30,,,$17.83,$0.00,1,0,0,20161001, J3364,HCPCS,UROKINASE 5000 IU INJECTION,,30,,,$25.17,$0.00,1,0,0,20161001, J3365,HCPCS,"UROKINASE 250,000 IU INJ",,30,,,"$1,239.30",$0.00,1,0,0,20161001, J3370,HCPCS,VANCOMYCIN HCL INJECTION,,30,,,$11.78,$0.00,1,0,0,20161001, J3385,HCPCS,VELAGLUCERASE ALFA,,30,,,"$2,227.34",$0.00,1,0,0,20161001, J3396,HCPCS,VERTEPORFIN INJECTION,,30,,,$70.79,$0.00,1,0,0,20161001, J3410,HCPCS,HYDROXYZINE HCL INJECTION,,30,,,$2.80,$0.00,1,0,0,20161001, J3411,HCPCS,THIAMINE HCL 100 MG,,30,,,$15.24,$0.00,1,0,0,20161001, J3415,HCPCS,PYRIDOXINE HCL 100 MG,,30,,,$23.89,$0.00,1,0,0,20161001, J3420,HCPCS,VITAMIN B12 INJECTION,,30,,,$11.48,$0.00,1,0,0,20161001, J3430,HCPCS,VITAMIN K PHYTONADIONE INJ,,30,,,$8.90,$0.00,1,0,0,20161001, J3465,HCPCS,"INJECTION, VORICONAZOLE",,30,,,$24.12,$0.00,1,0,0,20161001, J3470,HCPCS,HYALURONIDASE INJECTION,,30,,,$67.99,$0.00,1,0,0,20161001, J3471,HCPCS,"OVINE, UP TO 999 USP UNITS",,30,,,$2.80,$0.00,1,0,0,20161001, J3472,HCPCS,"OVINE, 1000 USP UNITS",,30,,,$291.11,$0.00,1,0,0,20161001, J3473,HCPCS,HYALURONIDASE RECOMBINANT,,30,,,$2.80,$0.00,1,0,0,20161001, J3475,HCPCS,INJ MAGNESIUM SULFATE,,30,,,$2.80,$0.00,1,0,0,20161001, J3480,HCPCS,INJ POTASSIUM CHLORIDE,,30,,,$2.80,$0.00,1,0,0,20161001, J3485,HCPCS,ZIDOVUDINE,,30,,,$7.89,$0.00,1,0,0,20161001, J3486,HCPCS,ZIPRASIDONE MESYLATE,,30,,,$36.86,$0.00,1,0,0,20161001, J3489,HCPCS,ZOLEDRONIC ACID 1MG,,30,,,$213.55,$0.00,1,0,0,20161001, J3490,HCPCS,DRUGS UNCLASSIFIED INJECTION,,30,,,$0.69,$0.00,1,0,0,20161001, J3535,HCPCS,METERED DOSE INHALER DRUG,,30,,,$12.85,$0.00,1,0,0,20161001, J3590,HCPCS,UNCLASSIFIED BIOLOGICS,,30,,,$109.03,$0.00,1,0,0,20161001, J7030,HCPCS,NORMAL SALINE SOLUTION INFUS,,30,,,$7.89,$0.00,1,0,0,20161001, J7040,HCPCS,NORMAL SALINE SOLUTION INFUS,,30,,,$5.59,$0.00,1,0,0,20161001, J7042,HCPCS,5% DEXTROSE/NORMAL SALINE,,30,,,$5.59,$0.00,1,0,0,20161001, J7050,HCPCS,NORMAL SALINE SOLUTION INFUS,,30,,,$2.80,$0.00,1,0,0,20161001, J7060,HCPCS,5% DEXTROSE/WATER,,30,,,$7.17,$0.00,1,0,0,20161001, J7070,HCPCS,D5W INFUSION,,30,,,$12.64,$0.00,1,0,0,20161001, J7100,HCPCS,DEXTRAN 40 INFUSION,,30,,,$49.83,$0.00,1,0,0,20161001, J7110,HCPCS,DEXTRAN 75 INFUSION,,30,,,$95.25,$0.00,1,0,0,20161001, J7120,HCPCS,RINGERS LACTATE INFUSION,,30,,,$7.17,$0.00,1,0,0,20161001, J7131,HCPCS,HYPERTONIC SALINE SOL,,30,,,$6.18,$0.00,1,0,0,20161001, J7178,HCPCS,HUMAN FIBRINOGEN CONC INJ,,30,,,$6.57,$0.00,1,0,0,20161001, J7180,HCPCS,FACTOR XIII ANTI-HEM FACTOR,,30,,,$45.83,$0.00,1,0,0,20161001, J7181,HCPCS,FACTOR XIII RECOMB A-SUBUNIT,,30,,,$89.25,$0.00,1,0,0,20161001, J7183,HCPCS,WILATE INJECTION,,30,,,$6.37,$0.00,1,0,0,20161001, J7185,HCPCS,XYNTHA INJ,,30,,,$9.23,$0.00,1,0,0,20161001, J7186,HCPCS,ANTIHEMOPHILIC VIII/VWF COMP,,30,,,$6.24,$0.00,1,0,0,20161001, J7187,HCPCS,"HUMATE-P, INJ",,30,,,$6.44,$0.00,1,0,0,20161001, J7188,HCPCS,FACTOR VIII RECOMB OBIZUR,,30,,,$31.85,$0.00,1,0,0,20161001, J7189,HCPCS,FACTOR VIIA,,30,,,$11.44,$0.00,1,0,0,20161001, J7190,HCPCS,FACTOR VIII,,30,,,$6.11,$0.00,1,0,0,20161001, J7191,HCPCS,FACTOR VIII (PORCINE),,30,,,$6.64,$0.00,1,0,0,20161001, J7192,HCPCS,FACTOR VIII RECOMBINANT NOS,,30,,,$7.48,$0.00,1,0,0,20161001, J7193,HCPCS,FACTOR IX NON-RECOMBINANT,,30,,,$6.83,$0.00,1,0,0,20161001, J7194,HCPCS,FACTOR IX COMPLEX,,30,,,$7.35,$0.00,1,0,0,20161001, J7195,HCPCS,FACTOR IX RECOMBINANT NOS,,30,,,$8.91,$0.00,1,0,0,20161001, J7196,HCPCS,ANTITHROMBIN RECOMBINANT,,30,,,$668.12,$0.00,1,0,0,20161001, J7197,HCPCS,ANTITHROMBIN III INJECTION,,30,,,$21.26,$0.00,1,0,0,20161001, J7198,HCPCS,ANTI-INHIBITOR,,30,,,$11.51,$0.00,1,0,0,20161001, J7199,HCPCS,HEMOPHILIA CLOT FACTOR NOC,,30,,,$1.45,$0.00,1,0,0,20161001, J7200,HCPCS,FACTOR IX RECOMBINAN RIXUBIS,,30,,,$8.06,$0.00,1,0,0,20161001, J7201,HCPCS,FACTOR IX FC FUSION RECOMB,,30,,,$18.33,$0.00,1,0,0,20161001, J7205,HCPCS,FACTOR VIII FC FUSION RECOMB,,30,,,$12.35,$0.00,1,0,0,20161001, J7297,HCPCS,LEVONORGESTREL IU 52MG 3 YR,,30,,,"$2,421.82",$0.00,1,0,0,20161001, J7298,HCPCS,LEVONORGESTREL IU 52MG 5 YR,,30,,,"$2,421.82",$0.00,1,0,0,20161001, J7300,HCPCS,INTRAUT COPPER CONTRACEPTIVE,,30,,,$971.71,$0.00,1,0,0,20161001, J7301,HCPCS,LEVONORGESTREL IU 13.5 MG,,30,,,"$1,452.52",$0.00,1,0,0,20161001, J7306,HCPCS,LEVONORGESTREL IMPLANT SYS,,30,,,"$1,011.49",$0.00,1,0,0,20161001, J7307,HCPCS,ETONOGESTREL IMPLANT SYSTEM,,30,,,"$1,373.82",$0.00,1,0,0,20161001, J7308,HCPCS,AMINOLEVULINIC ACID HCL TOP,,30,,,"$1,876.26",$0.00,1,0,0,20161001, J7309,HCPCS,"METHYL AMINOLEVULINATE, TOP",,30,,,$541.77,$0.00,1,0,0,20161001, J7310,HCPCS,GANCICLOVIR LONG ACT IMPLANT,,30,,,"$33,920.00",$0.00,1,0,0,20161001, J7311,HCPCS,FLUOCINOLONE ACETONIDE IMPLT,,30,,,"$39,421.46",$0.00,1,0,0,20161001, J7312,HCPCS,DEXAMETHASONE INTRA IMPLANT,,30,,,"$1,291.87",$0.00,1,0,0,20161001, J7313,HCPCS,FLUOCINOL ACET INTRAVIT IMP,,30,,,"$3,087.98",$0.00,1,0,0,20161001, J7315,HCPCS,OPHTHALMIC MITOMYCIN,,30,,,$553.22,$0.00,1,0,0,20161001, J7316,HCPCS,"INJ, OCRIPLASMIN, 0.125 MG",,30,,,"$6,321.39",$0.00,1,0,0,20161001, J7321,HCPCS,HYALGAN/SUPARTZ INJ PER DOSE,,30,,,$577.28,$0.00,1,0,0,20161001, J7323,HCPCS,EUFLEXXA INJ PER DOSE,,30,,,$957.04,$0.00,1,0,0,20161001, J7324,HCPCS,ORTHOVISC INJ PER DOSE,,30,,,"$1,138.81",$0.00,1,0,0,20161001, J7325,HCPCS,SYNVISC OR SYNVISC-ONE,,30,,,$82.29,$0.00,1,0,0,20161001, J7326,HCPCS,GEL-ONE,,30,,,"$3,513.43",$0.00,1,0,0,20161001, J7327,HCPCS,MONOVISC INJ PER DOSE,,30,,,"$5,942.22",$0.00,1,0,0,20161001, J7336,HCPCS,CAPSAICIN 8% PATCH,,30,,,$16.43,$0.00,1,0,0,20161001, J7340,HCPCS,CARBIDOPA LEVODOPA ENTERAL,,30,,,$11.95,$0.00,1,0,0,20161001, J7500,HCPCS,AZATHIOPRINE ORAL 50MG,,30,,,$2.80,$0.00,1,0,0,20161001, J7501,HCPCS,AZATHIOPRINE PARENTERAL,,30,,,"$1,393.60",$0.00,1,0,0,20161001, J7502,HCPCS,CYCLOSPORINE ORAL 100 MG,,30,,,$15.24,$0.00,1,0,0,20161001, J7504,HCPCS,LYMPHOCYTE IMMUNE GLOBULIN,,30,,,"$5,502.83",$0.00,1,0,0,20161001, J7505,HCPCS,MONOCLONAL ANTIBODIES,,30,,,"$2,328.58",$0.00,1,0,0,20161001, J7507,HCPCS,TACROLIMUS IMME REL ORAL 1MG,,30,,,$7.45,$0.00,1,0,0,20161001, J7508,HCPCS,TACROL ASTAGRAF EX REL ORAL,,30,,,$2.18,$0.00,1,0,0,20161001, J7509,HCPCS,METHYLPREDNISOLONE ORAL,,30,,,$4.16,$0.00,1,0,0,20161001, J7510,HCPCS,PREDNISOLONE ORAL PER 5 MG,,30,,,$2.80,$0.00,1,0,0,20161001, J7511,HCPCS,ANTITHYMOCYTE GLOBULN RABBIT,,30,,,"$3,708.88",$0.00,1,0,0,20161001, J7513,HCPCS,"DACLIZUMAB, PARENTERAL",,30,,,"$1,008.89",$0.00,1,0,0,20161001, J7515,HCPCS,CYCLOSPORINE ORAL 25 MG,,30,,,$5.59,$0.00,1,0,0,20161001, J7516,HCPCS,CYCLOSPORIN PARENTERAL 250MG,,30,,,$86.15,$0.00,1,0,0,20161001, J7517,HCPCS,MYCOPHENOLATE MOFETIL ORAL,,30,,,$7.89,$0.00,1,0,0,20161001, J7518,HCPCS,MYCOPHENOLIC ACID,,30,,,$14.37,$0.00,1,0,0,20161001, J7520,HCPCS,"SIROLIMUS, ORAL",,30,,,$48.10,$0.00,1,0,0,20161001, J7525,HCPCS,TACROLIMUS INJECTION,,30,,,$960.87,$0.00,1,0,0,20161001, J7527,HCPCS,ORAL EVEROLIMUS,,30,,,$23.02,$0.00,1,0,0,20161001, J7599,HCPCS,IMMUNOSUPPRESSIVE DRUG NOC,,30,,,$8.39,$0.00,1,0,0,20161001, J7606,HCPCS,"FORMOTEROL FUMARATE, INH",,30,,,$25.62,$0.00,1,0,0,20161001, J7607,HCPCS,LEVALBUTEROL COMP CON,,30,,,$34.89,$0.00,1,0,0,20161001, J7608,HCPCS,ACETYLCYSTEINE NON-COMP UNIT,,30,,,$19.56,$0.00,1,0,0,20161001, J7609,HCPCS,ALBUTEROL COMP UNIT,,30,,,$14.54,$0.00,1,0,0,20161001, J7610,HCPCS,ALBUTEROL COMP CON,,30,,,$14.54,$0.00,1,0,0,20161001, J7611,HCPCS,ALBUTEROL NON-COMP CON,,30,,,$2.80,$0.00,1,0,0,20161001, J7612,HCPCS,LEVALBUTEROL NON-COMP CON,,30,,,$2.80,$0.00,1,0,0,20161001, J7613,HCPCS,ALBUTEROL NON-COMP UNIT,,30,,,$2.80,$0.00,1,0,0,20161001, J7614,HCPCS,LEVALBUTEROL NON-COMP UNIT,,30,,,$2.80,$0.00,1,0,0,20161001, J7615,HCPCS,LEVALBUTEROL COMP UNIT,,30,,,$11.78,$0.00,1,0,0,20161001, J7620,HCPCS,ALBUTEROL IPRATROP NON-COMP,,30,,,$2.80,$0.00,1,0,0,20161001, J7626,HCPCS,BUDESONIDE NON-COMP UNIT,,30,,,$19.56,$0.00,1,0,0,20161001, J7627,HCPCS,BUDESONIDE COMP UNIT,,30,,,$18.70,$0.00,1,0,0,20161001, J7633,HCPCS,BUDESONIDE NON-COMP CON,,30,,,$28.36,$0.00,1,0,0,20161001, J7636,HCPCS,ATROPINE COMP UNIT,,30,,,$28.77,$0.00,1,0,0,20161001, J7637,HCPCS,DEXAMETHASONE COMP CON,,30,,,$1.07,$0.00,1,0,0,20161001, J7638,HCPCS,DEXAMETHASONE COMP UNIT,,30,,,$1.07,$0.00,1,0,0,20161001, J7639,HCPCS,DORNASE ALFA NON-COMP UNIT,,30,,,$93.07,$0.00,1,0,0,20161001, J7642,HCPCS,GLYCOPYRROLATE COMP CON,,30,,,$0.79,$0.00,1,0,0,20161001, J7643,HCPCS,GLYCOPYRROLATE COMP UNIT,,30,,,$0.79,$0.00,1,0,0,20161001, J7644,HCPCS,IPRATROPIUM BROMIDE NON-COMP,,30,,,$2.80,$0.00,1,0,0,20161001, J7645,HCPCS,IPRATROPIUM BROMIDE COMP,,30,,,$7.27,$0.00,1,0,0,20161001, J7649,HCPCS,ISOETHARINE NON-COMP UNIT,,30,,,$2.26,$0.00,1,0,0,20161001, J7658,HCPCS,ISOPROTERENOL NON-COMP CON,,30,,,$12.49,$0.00,1,0,0,20161001, J7659,HCPCS,ISOPROTERENOL NON-COMP UNIT,,30,,,$12.49,$0.00,1,0,0,20161001, J7660,HCPCS,ISOPROTERENOL COMP UNIT,,30,,,$1.51,$0.00,1,0,0,20161001, J7665,HCPCS,MANNITOL FOR INHALER,,30,,,$5.59,$0.00,1,0,0,20161001, J7674,HCPCS,"METHACHOLINE CHLORIDE, NEB",,30,,,$2.80,$0.00,1,0,0,20161001, J7676,HCPCS,PENTAMIDINE COMP UNIT DOSE,,30,,,$549.78,$0.00,1,0,0,20161001, J7680,HCPCS,TERBUTALINE SULF COMP CON,,30,,,$40.32,$0.00,1,0,0,20161001, J7682,HCPCS,TOBRAMYCIN NON-COMP UNIT,,30,,,$222.79,$0.00,1,0,0,20161001, J7699,HCPCS,INHALATION SOLUTION FOR DME,,30,,,$5.21,$0.00,1,0,0,20161001, J7799,HCPCS,NON-INHALATION DRUG FOR DME,,30,,,$10.18,$0.00,1,0,0,20161001, J7999,HCPCS,"COMPOUNDED DRUG, NOC",,30,,,$2.95,$0.00,1,0,0,20161001, J8498,HCPCS,ANTIEMETIC RECTAL/SUPP NOS,,30,,,$1.45,$0.00,1,0,0,20161001, J8499,HCPCS,ORAL PRESCRIP DRUG NON CHEMO,,30,,,$1.45,$0.00,1,0,0,20161001, J8501,HCPCS,ORAL APREPITANT,,30,,,$47.37,$0.00,1,0,0,20161001, J8510,HCPCS,ORAL BUSULFAN,,30,,,$59.10,$0.00,1,0,0,20161001, J8520,HCPCS,"CAPECITABINE, ORAL, 150 MG",,30,,,$38.84,$0.00,1,0,0,20161001, J8521,HCPCS,"CAPECITABINE, ORAL, 500 MG",,30,,,$113.86,$0.00,1,0,0,20161001, J8530,HCPCS,CYCLOPHOSPHAMIDE ORAL 25 MG,,30,,,$13.58,$0.00,1,0,0,20161001, J8540,HCPCS,ORAL DEXAMETHASONE,,30,,,$2.80,$0.00,1,0,0,20161001, J8560,HCPCS,ETOPOSIDE ORAL 50 MG,,30,,,$321.19,$0.00,1,0,0,20161001, J8562,HCPCS,ORAL FLUDARABINE PHOSPHATE,,30,,,$271.13,$0.00,1,0,0,20161001, J8565,HCPCS,GEFITINIB ORAL,,30,,,$144.96,$0.00,1,0,0,20161001, J8597,HCPCS,ANTIEMETIC DRUG ORAL NOS,,30,,,$139.92,$0.00,1,0,0,20161001, J8610,HCPCS,METHOTREXATE ORAL 2.5 MG,,30,,,$8.44,$0.00,1,0,0,20161001, J8650,HCPCS,NABILONE ORAL,,30,,,$221.51,$0.00,1,0,0,20161001, J8655,HCPCS,NETUPITANT PALONOSETRON ORAL,,30,,,"$2,651.06",$0.00,1,0,0,20161001, J8700,HCPCS,TEMOZOLOMIDE,,30,,,$14.85,$0.00,1,0,0,20161001, J8705,HCPCS,TOPOTECAN ORAL,,30,,,$545.57,$0.00,1,0,0,20161001, J8999,HCPCS,ORAL PRESCRIPTION DRUG CHEMO,,30,,,$50.99,$0.00,1,0,0,20161001, J9000,HCPCS,DOXORUBICIN HCL INJECTION,,30,,,$16.89,$0.00,1,0,0,20161001, J9015,HCPCS,ALDESLEUKIN INJECTION,,30,,,"$14,158.85",$0.00,1,0,0,20161001, J9017,HCPCS,ARSENIC TRIOXIDE INJECTION,,30,,,$300.80,$0.00,1,0,0,20161001, J9019,HCPCS,ERWINAZE INJECTION,,30,,,"$2,035.03",$0.00,1,0,0,20161001, J9020,HCPCS,"ASPARAGINASE, NOS",,30,,,$245.08,$0.00,1,0,0,20161001, J9025,HCPCS,AZACITIDINE INJECTION,,30,,,$22.49,$0.00,1,0,0,20161001, J9027,HCPCS,CLOFARABINE INJECTION,,30,,,$750.23,$0.00,1,0,0,20161001, J9031,HCPCS,BCG LIVE INTRAVESICAL VAC,,30,,,$681.19,$0.00,1,0,0,20161001, J9032,HCPCS,"INJECTION, BELINOSTAT, 10MG",,30,,,$176.64,$0.00,1,0,0,20161001, J9033,HCPCS,BENDAMUSTINE INJECTION,,30,,,$130.09,$0.00,1,0,0,20161001, J9035,HCPCS,BEVACIZUMAB INJECTION,,30,,,$366.96,$0.00,1,0,0,20161001, J9039,HCPCS,"INJECTION, BLINATUMOMAB",,30,,,$535.96,$0.00,1,0,0,20161001, J9040,HCPCS,BLEOMYCIN SULFATE INJECTION,,30,,,$102.83,$0.00,1,0,0,20161001, J9041,HCPCS,BORTEZOMIB INJECTION,,30,,,$253.59,$0.00,1,0,0,20161001, J9042,HCPCS,BRENTUXIMAB VEDOTIN INJ,,30,,,$743.92,$0.00,1,0,0,20161001, J9043,HCPCS,CABAZITAXEL INJECTION,,30,,,$813.02,$0.00,1,0,0,20161001, J9045,HCPCS,CARBOPLATIN INJECTION,,30,,,$16.89,$0.00,1,0,0,20161001, J9047,HCPCS,"INJECTION, CARFILZOMIB, 1 MG",,30,,,$170.14,$0.00,1,0,0,20161001, J9050,HCPCS,CARMUSTINE INJECTION,,30,,,"$15,371.94",$0.00,1,0,0,20161001, J9055,HCPCS,CETUXIMAB INJECTION,,30,,,$297.56,$0.00,1,0,0,20161001, J9060,HCPCS,CISPLATIN 10 MG INJECTION,,30,,,$10.13,$0.00,1,0,0,20161001, J9065,HCPCS,INJ CLADRIBINE PER 1 MG,,30,,,$128.25,$0.00,1,0,0,20161001, J9070,HCPCS,CYCLOPHOSPHAMIDE 100 MG INJ,,30,,,$208.72,$0.00,1,0,0,20161001, J9098,HCPCS,CYTARABINE LIPOSOME INJ,,30,,,"$3,131.03",$0.00,1,0,0,20161001, J9100,HCPCS,CYTARABINE HCL 100 MG INJ,,30,,,$5.07,$0.00,1,0,0,20161001, J9120,HCPCS,DACTINOMYCIN INJECTION,,30,,,"$6,501.72",$0.00,1,0,0,20161001, J9130,HCPCS,DACARBAZINE 100 MG INJ,,30,,,$20.26,$0.00,1,0,0,20161001, J9150,HCPCS,DAUNORUBICIN INJECTION,,30,,,$146.74,$0.00,1,0,0,20161001, J9151,HCPCS,DAUNORUBICIN CITRATE INJ,,30,,,"$1,335.52",$0.00,1,0,0,20161001, J9155,HCPCS,DEGARELIX INJECTION,,30,,,$19.44,$0.00,1,0,0,20161001, J9160,HCPCS,DENILEUKIN DIFTITOX INJ,,30,,,"$3,372.39",$0.00,1,0,0,20161001, J9165,HCPCS,DIETHYLSTILBESTROL INJECTION,,30,,,$62.19,$0.00,1,0,0,20161001, J9171,HCPCS,DOCETAXEL INJECTION,,30,,,$22.69,$0.00,1,0,0,20161001, J9175,HCPCS,ELLIOTTS B SOLUTION PER ML,,30,,,$16.10,$0.00,1,0,0,20161001, J9178,HCPCS,"INJ, EPIRUBICIN HCL, 2 MG",,30,,,$7.89,$0.00,1,0,0,20161001, J9179,HCPCS,ERIBULIN MESYLATE INJECTION,,30,,,$560.93,$0.00,1,0,0,20161001, J9181,HCPCS,ETOPOSIDE INJECTION,,30,,,$3.38,$0.00,1,0,0,20161001, J9185,HCPCS,FLUDARABINE PHOSPHATE INJ,,30,,,$328.47,$0.00,1,0,0,20161001, J9190,HCPCS,FLUOROURACIL INJECTION,,30,,,$10.13,$0.00,1,0,0,20161001, J9200,HCPCS,FLOXURIDINE INJECTION,,30,,,$377.91,$0.00,1,0,0,20161001, J9201,HCPCS,GEMCITABINE HCL INJECTION,,30,,,$33.77,$0.00,1,0,0,20161001, J9202,HCPCS,GOSERELIN ACETATE IMPLANT,,30,,,"$1,507.73",$0.00,1,0,0,20161001, J9206,HCPCS,IRINOTECAN INJECTION,,30,,,$20.26,$0.00,1,0,0,20161001, J9207,HCPCS,IXABEPILONE INJECTION,,30,,,$396.54,$0.00,1,0,0,20161001, J9208,HCPCS,IFOSFAMIDE INJECTION,,30,,,$181.20,$0.00,1,0,0,20161001, J9209,HCPCS,MESNA INJECTION,,30,,,$13.51,$0.00,1,0,0,20161001, J9211,HCPCS,IDARUBICIN HCL INJECTION,,30,,,$224.27,$0.00,1,0,0,20161001, J9212,HCPCS,INTERFERON ALFACON-1 INJ,,30,,,$23.02,$0.00,1,0,0,20161001, J9213,HCPCS,INTERFERON ALFA-2A INJ,,30,,,"$4,095.47",$0.00,1,0,0,20161001, J9214,HCPCS,INTERFERON ALFA-2B INJ,,30,,,$126.13,$0.00,1,0,0,20161001, J9215,HCPCS,INTERFERON ALFA-N3 INJ,,30,,,$85.66,$0.00,1,0,0,20161001, J9216,HCPCS,INTERFERON GAMMA 1-B INJ,,30,,,"$10,935.08",$0.00,1,0,0,20161001, J9217,HCPCS,LEUPROLIDE ACETATE SUSPNSION,,30,,,"$1,274.52",$0.00,1,0,0,20161001, J9218,HCPCS,LEUPROLIDE ACETATE INJECITON,,30,,,$33.77,$0.00,1,0,0,20161001, J9219,HCPCS,LEUPROLIDE ACETATE IMPLANT,,30,,,"$6,913.10",$0.00,1,0,0,20161001, J9225,HCPCS,VANTAS IMPLANT,,30,,,"$15,398.14",$0.00,1,0,0,20161001, J9226,HCPCS,SUPPRELIN LA IMPLANT,,30,,,"$42,347.28",$0.00,1,0,0,20161001, J9228,HCPCS,IPILIMUMAB INJECTION,,30,,,$757.38,$0.00,1,0,0,20161001, J9230,HCPCS,MECHLORETHAMINE HCL INJ,,30,,,"$1,351.01",$0.00,1,0,0,20161001, J9245,HCPCS,INJ MELPHALAN HYDROCHL 50 MG,,30,,,"$7,219.09",$0.00,1,0,0,20161001, J9250,HCPCS,METHOTREXATE SODIUM INJ,,30,,,$1.69,$0.00,1,0,0,20161001, J9260,HCPCS,METHOTREXATE SODIUM INJ,,30,,,$11.82,$0.00,1,0,0,20161001, J9261,HCPCS,NELARABINE INJECTION,,30,,,$796.88,$0.00,1,0,0,20161001, J9262,HCPCS,"INJ, OMACETAXINE MEP, 0.01MG",,30,,,$13.85,$0.00,1,0,0,20161001, J9263,HCPCS,OXALIPLATIN,,30,,,$3.38,$0.00,1,0,0,20161001, J9264,HCPCS,PACLITAXEL PROTEIN BOUND,,30,,,$54.07,$0.00,1,0,0,20161001, J9266,HCPCS,PEGASPARGASE INJECTION,,30,,,"$23,045.33",$0.00,1,0,0,20161001, J9267,HCPCS,PACLITAXEL INJECTION,,30,,,$1.69,$0.00,1,0,0,20161001, J9268,HCPCS,PENTOSTATIN INJECTION,,30,,,"$8,318.61",$0.00,1,0,0,20161001, J9271,HCPCS,INJ PEMBROLIZUMAB,,30,,,$255.08,$0.00,1,0,0,20161001, J9280,HCPCS,MITOMYCIN INJECTION,,30,,,$367.83,$0.00,1,0,0,20161001, J9293,HCPCS,MITOXANTRONE HYDROCHL / 5 MG,,30,,,$178.47,$0.00,1,0,0,20161001, J9299,HCPCS,"INJECTION, NIVOLUMAB",,30,,,$141.69,$0.00,1,0,0,20161001, J9300,HCPCS,GEMTUZUMAB OZOGAMICIN INJ,,30,,,"$4,528.76",$0.00,1,0,0,20161001, J9301,HCPCS,OBINUTUZUMAB INJ,,30,,,$302.81,$0.00,1,0,0,20161001, J9302,HCPCS,OFATUMUMAB INJECTION,,30,,,$269.91,$0.00,1,0,0,20161001, J9303,HCPCS,PANITUMUMAB INJECTION,,30,,,$543.34,$0.00,1,0,0,20161001, J9305,HCPCS,PEMETREXED INJECTION,,30,,,$339.84,$0.00,1,0,0,20161001, J9306,HCPCS,"INJECTION, PERTUZUMAB, 1 MG",,30,,,$57.09,$0.00,1,0,0,20161001, J9307,HCPCS,PRALATREXATE INJECTION,,30,,,"$1,144.04",$0.00,1,0,0,20161001, J9308,HCPCS,"INJECTION, RAMUCIRUMAB",,30,,,$301.31,$0.00,1,0,0,20161001, J9310,HCPCS,RITUXIMAB INJECTION,,30,,,"$3,191.20",$0.00,1,0,0,20161001, J9315,HCPCS,ROMIDEPSIN INJECTION,,30,,,"$1,556.44",$0.00,1,0,0,20161001, J9320,HCPCS,STREPTOZOCIN INJECTION,,30,,,"$1,881.93",$0.00,1,0,0,20161001, J9328,HCPCS,TEMOZOLOMIDE INJECTION,,30,,,$34.80,$0.00,1,0,0,20161001, J9330,HCPCS,TEMSIROLIMUS INJECTION,,30,,,$335.60,$0.00,1,0,0,20161001, J9340,HCPCS,THIOTEPA INJECTION,,30,,,"$3,522.99",$0.00,1,0,0,20161001, J9351,HCPCS,TOPOTECAN INJECTION,,30,,,$6.75,$0.00,1,0,0,20161001, J9354,HCPCS,"INJ, ADO-TRASTUZUMAB EMT 1MG",,30,,,$163.22,$0.00,1,0,0,20161001, J9355,HCPCS,TRASTUZUMAB INJECTION,,30,,,$384.45,$0.00,1,0,0,20161001, J9357,HCPCS,VALRUBICIN INJECTION,,30,,,"$6,144.65",$0.00,1,0,0,20161001, J9360,HCPCS,VINBLASTINE SULFATE INJ,,30,,,$11.82,$0.00,1,0,0,20161001, J9370,HCPCS,VINCRISTINE SULFATE 1 MG INJ,,30,,,$23.64,$0.00,1,0,0,20161001, J9371,HCPCS,"INJ, VINCRISTINE SUL LIP 1MG",,30,,,"$12,263.19",$0.00,1,0,0,20161001, J9390,HCPCS,VINORELBINE TARTRATE INJ,,30,,,$48.97,$0.00,1,0,0,20161001, J9395,HCPCS,"INJECTION, FULVESTRANT",,30,,,$515.85,$0.00,1,0,0,20161001, J9400,HCPCS,"INJ, ZIV-AFLIBERCEPT, 1MG",,30,,,$45.52,$0.00,1,0,0,20161001, J9600,HCPCS,PORFIMER SODIUM INJECTION,,30,,,"$40,004.40",$0.00,1,0,0,20161001, J9999,HCPCS,CHEMOTHERAPY DRUG,,30,,,$106.33,$0.00,1,0,0,20161001, P3001,HCPCS,SCREENING PAP SMEAR BY PHYS,,30,,,$201.55,$0.00,1,0,1,20161001, P7001,HCPCS,CULTURE BACTERIAL URINE,,30,,,$119.47,$0.00,1,0,1,20161001, P9010,HCPCS,WHOLE BLOOD FOR TRANSFUSION,,30,,,"$1,259.16",$0.00,1,0,1,20161001, P9011,HCPCS,BLOOD SPLIT UNIT,,30,,,$582.36,$0.00,1,0,1,20161001, P9012,HCPCS,CRYOPRECIPITATE EACH UNIT,,30,,,$284.68,$0.00,1,0,1,20161001, P9016,HCPCS,RBC LEUKOCYTES REDUCED,,30,,,$842.12,$0.00,1,0,1,20161001, P9017,HCPCS,PLASMA 1 DONOR FRZ W/IN 8 HR,,30,,,$412.26,$0.00,1,0,1,20161001, P9019,HCPCS,"PLATELETS, EACH UNIT",,30,,,$670.60,$0.00,1,0,1,20161001, P9020,HCPCS,PLAELET RICH PLASMA UNIT,,30,,,$682.70,$0.00,1,0,1,20161001, P9021,HCPCS,RED BLOOD CELLS UNIT,,30,,,$828.32,$0.00,1,0,1,20161001, P9022,HCPCS,WASHED RED BLOOD CELLS UNIT,,30,,,"$1,746.87",$0.00,1,0,1,20161001, P9023,HCPCS,"FROZEN PLASMA, POOLED, SD",,30,,,$426.69,$0.00,1,0,1,20161001, P9031,HCPCS,PLATELETS LEUKOCYTES REDUCED,,30,,,$660.88,$0.00,1,0,1,20161001, P9032,HCPCS,"PLATELETS, IRRADIATED",,30,,,$903.89,$0.00,1,0,1,20161001, P9033,HCPCS,PLATELETS LEUKOREDUCED IRRAD,,30,,,$920.88,$0.00,1,0,1,20161001, P9034,HCPCS,"PLATELETS, PHERESIS",,30,,,"$2,415.54",$0.00,1,0,1,20161001, P9035,HCPCS,PLATELET PHERES LEUKOREDUCED,,30,,,"$2,774.27",$0.00,1,0,1,20161001, P9036,HCPCS,PLATELET PHERESIS IRRADIATED,,30,,,"$3,000.51",$0.00,1,0,1,20161001, P9037,HCPCS,PLATE PHERES LEUKOREDU IRRAD,,30,,,"$3,646.74",$0.00,1,0,1,20161001, P9038,HCPCS,RBC IRRADIATED,,30,,,"$1,169.39",$0.00,1,0,1,20161001, P9039,HCPCS,RBC DEGLYCEROLIZED,,30,,,"$2,160.83",$0.00,1,0,1,20161001, P9040,HCPCS,RBC LEUKOREDUCED IRRADIATED,,30,,,"$1,180.10",$0.00,1,0,1,20161001, P9041,HCPCS,"ALBUMIN (HUMAN),5%, 50ML",,30,,,$65.65,$0.00,1,0,1,20161001, P9043,HCPCS,"PLASMA PROTEIN FRACT,5%,50ML",,30,,,$160.68,$0.00,1,0,1,20161001, P9044,HCPCS,CRYOPRECIPITATEREDUCEDPLASMA,,30,,,$264.40,$0.00,1,0,1,20161001, P9045,HCPCS,"ALBUMIN (HUMAN), 5%, 250 ML",,30,,,$328.19,$0.00,1,0,1,20161001, P9046,HCPCS,"ALBUMIN (HUMAN), 25%, 20 ML",,30,,,$135.33,$0.00,1,0,1,20161001, P9047,HCPCS,"ALBUMIN (HUMAN), 25%, 50ML",,30,,,$321.57,$0.00,1,0,1,20161001, P9048,HCPCS,"PLASMAPROTEIN FRACT,5%,250ML",,30,,,$228.06,$0.00,1,0,1,20161001, P9050,HCPCS,"GRANULOCYTES, PHERESIS UNIT",,30,,,"$8,627.41",$0.00,1,0,1,20161001, P9051,HCPCS,"BLOOD, L/R, CMV-NEG",,30,,,"$1,085.78",$0.00,1,0,1,20161001, P9052,HCPCS,"PLATELETS, HLA-M, L/R, UNIT",,30,,,"$4,005.42",$0.00,1,0,1,20161001, P9053,HCPCS,"PLT, PHER, L/R CMV-NEG, IRR",,30,,,"$3,357.66",$0.00,1,0,1,20161001, P9054,HCPCS,"BLOOD, L/R, FROZ/DEGLY/WASH",,30,,,"$1,825.39",$0.00,1,0,1,20161001, P9055,HCPCS,"PLT, APH/PHER, L/R, CMV-NEG",,30,,,"$2,627.63",$0.00,1,0,1,20161001, P9056,HCPCS,"BLOOD, L/R, IRRADIATED",,30,,,$662.70,$0.00,1,0,1,20161001, P9057,HCPCS,"RBC, FRZ/DEG/WSH, L/R, IRRAD",,30,,,"$1,155.36",$0.00,1,0,1,20161001, P9058,HCPCS,"RBC, L/R, CMV-NEG, IRRAD",,30,,,"$1,416.03",$0.00,1,0,1,20161001, P9059,HCPCS,"PLASMA, FRZ BETWEEN 8-24HOUR",,30,,,$415.21,$0.00,1,0,1,20161001, P9060,HCPCS,FR FRZ PLASMA DONOR RETESTED,,30,,,$243.83,$0.00,1,0,1,20161001, P9070,HCPCS,PATHOGEN REDUCED PLASMA POOL,,30,,,$415.21,$0.00,1,0,1,20161001, P9071,HCPCS,PATHOGEN REDUCED PLASMA SING,,30,,,$412.26,$0.00,1,0,1,20161001, P9072,HCPCS,PATHOGEN REDUCED PLATELETS,,30,,,"$3,646.74",$0.00,1,0,1,20161001, P9615,HCPCS,URINE SPECIMEN COLLECT MULT,,30,,,$17.22,$0.00,1,0,1,20161001, PHOSP,PHOSP,PARTIAL HOSPITALIZATION PER DIEM,,30,,,$515.38,$0.00,1,0,0,20161001, Q0035,HCPCS,CARDIOKYMOGRAPHY,,30,,,$156.54,$0.00,1,0,1,20161001, Q0081,HCPCS,INFUSION THER OTHER THAN CHE,,30,,,$458.24,$0.00,1,0,1,20161001, Q0083,HCPCS,CHEMO BY OTHER THAN INFUSION,,30,,,$183.01,$0.00,1,0,1,20161001, Q0084,HCPCS,CHEMOTHERAPY BY INFUSION,,30,,,$458.87,$0.00,1,0,1,20161001, Q0085,HCPCS,CHEMO BY BOTH INFUSION AND O,,30,,,$436.83,$0.00,1,0,1,20161001, Q0091,HCPCS,OBTAINING SCREEN PAP SMEAR,,30,,,$81.90,$0.00,1,0,1,20161001, Q0092,HCPCS,SET UP PORT XRAY EQUIPMENT,,30,,,$130.91,$0.00,1,0,1,20161001, Q0138,HCPCS,"FERUMOXYTOL, NON-ESRD",,30,,,$4.41,$0.00,1,0,1,20161001, Q0139,HCPCS,"FERUMOXYTOL, ESRD USE",,30,,,$5.14,$0.00,1,0,1,20161001, Q0144,HCPCS,"AZITHROMYCIN DIHYDRATE, ORAL",,30,,,$40.32,$0.00,1,0,0,20161001, Q0162,HCPCS,ONDANSETRON ORAL,,30,,,$1.69,$0.00,1,0,1,20161001, Q0163,HCPCS,DIPHENHYDRAMINE HCL 50MG,,30,,,$1.69,$0.00,1,0,1,20161001, Q0164,HCPCS,PROCHLORPERAZINE MALEATE 5MG,,30,,,$1.69,$0.00,1,0,1,20161001, Q0166,HCPCS,GRANISETRON HCL 1 MG ORAL,,30,,,$6.75,$0.00,1,0,1,20161001, Q0167,HCPCS,DRONABINOL 2.5MG ORAL,,30,,,$32.08,$0.00,1,0,1,20161001, Q0169,HCPCS,PROMETHAZINE HCL 12.5MG ORAL,,30,,,$1.69,$0.00,1,0,1,20161001, Q0175,HCPCS,PERPHENAZINE 4MG ORAL,,30,,,$3.38,$0.00,1,0,1,20161001, Q0177,HCPCS,HYDROXYZINE PAMOATE 25MG,,30,,,$10.13,$0.00,1,0,1,20161001, Q0180,HCPCS,DOLASETRON MESYLATE ORAL,,30,,,$312.52,$0.00,1,0,1,20161001, Q0181,HCPCS,UNSPECIFIED ORAL ANTI-EMETIC,,30,,,$50.47,$0.00,1,0,0,20161001, Q0512,HCPCS,PX SUP FEE ANTI-CAN SUB PRES,,30,,,$23.26,$0.00,1,0,1,20161001, Q0515,HCPCS,SERMORELIN ACETATE INJECTION,,30,,,$7.89,$0.00,1,0,0,20161001, Q2009,HCPCS,FOSPHENYTOIN INJ PE,,30,,,$13.51,$0.00,1,0,1,20161001, Q2017,HCPCS,"TENIPOSIDE, 50 MG",,30,,,"$5,137.97",$0.00,1,0,1,20161001, Q2026,HCPCS,RADIESSE INJECTION,,30,,,$706.82,$0.00,1,0,1,20161001, Q2034,HCPCS,AGRIFLU VACCINE,,30,,,$43.61,$0.00,1,0,1,20161001, Q2035,HCPCS,"AFLURIA VACC, 3 YRS & >, IM",,30,,,$72.69,$0.00,1,0,1,20161001, Q2036,HCPCS,"FLULAVAL VACC, 3 YRS & >, IM",,30,,,$85.44,$0.00,1,0,1,20161001, Q2037,HCPCS,"FLUVIRIN VACC, 3 YRS & >, IM",,30,,,$83.89,$0.00,1,0,1,20161001, Q2038,HCPCS,"FLUZONE VACC, 3 YRS & >, IM",,30,,,$61.49,$0.00,1,0,1,20161001, Q2039,HCPCS,"NOS FLU VACC, 3 YRS & >, IM",,30,,,$83.70,$0.00,1,0,1,20161001, Q2043,HCPCS,SIPULEUCEL-T AUTO CD54+,,30,,,"$71,760.16",$0.00,1,0,1,20161001, Q2049,HCPCS,IMPORTED LIPODOX INJ,,30,,,"$3,193.91",$0.00,1,0,1,20161001, Q2050,HCPCS,DOXORUBICIN INJ 10MG,,30,,,"$2,728.57",$0.00,1,0,1,20161001, Q3001,HCPCS,BRACHYTHERAPY RADIOELEMENTS,,30,,,$141.50,$0.00,1,0,1,20161001, Q3027,HCPCS,INJ BETA INTERFERON IM 1 MCG,,30,,,$215.06,$0.00,1,0,1,20161001, Q3028,HCPCS,INJ BETA INTERFERON SQ 1 MCG,,30,,,$16.58,$0.00,1,0,1,20161001, Q4074,HCPCS,ILOPROST NON-COMP UNIT DOSE,,30,,,$253.06,$0.00,1,0,1,20161001, Q4081,HCPCS,"EPOETIN ALFA, 100 UNITS ESRD",,30,,,$6.74,$0.00,1,0,1,20161001, Q4100,HCPCS,"SKIN SUBSTITUTE, NOS",,30,,,"$8,016.48",$0.00,1,0,1,20161001, Q4101,HCPCS,APLIGRAF,,30,,,$84.42,$0.00,1,0,1,20161001, Q4102,HCPCS,OASIS WOUND MATRIX,,30,,,$28.21,$0.00,1,0,1,20161001, Q4103,HCPCS,OASIS BURN MATRIX,,30,,,$28.21,$0.00,1,0,1,20161001, Q4104,HCPCS,INTEGRA BMWD,,30,,,$67.99,$0.00,1,0,1,20161001, Q4105,HCPCS,INTEGRA DRT,,30,,,$48.97,$0.00,1,0,1,20161001, Q4106,HCPCS,DERMAGRAFT,,30,,,$92.21,$0.00,1,0,1,20161001, Q4107,HCPCS,GRAFTJACKET,,30,,,$238.36,$0.00,1,0,1,20161001, Q4108,HCPCS,INTEGRA MATRIX,,30,,,$79.23,$0.00,1,0,1,20161001, Q4110,HCPCS,PRIMATRIX,,30,,,$96.53,$0.00,1,0,1,20161001, Q4111,HCPCS,GAMMAGRAFT,,30,,,$23.89,$0.00,1,0,1,20161001, Q4112,HCPCS,CYMETRA INJECTABLE,,30,,,$797.02,$0.00,1,0,1,20161001, Q4113,HCPCS,GRAFTJACKET XPRESS,,30,,,$797.02,$0.00,1,0,1,20161001, Q4114,HCPCS,INTEGRA FLOWABLE WOUND MATRI,,30,,,"$3,258.24",$0.00,1,0,1,20161001, Q4115,HCPCS,ALLOSKIN,,30,,,$30.81,$0.00,1,0,1,20161001, Q4116,HCPCS,ALLODERM,,30,,,$85.29,$0.00,1,0,1,20161001, Q4118,HCPCS,MATRISTEM MICROMATRIX,,30,,,$7.27,$0.00,1,0,1,20161001, Q4119,HCPCS,MATRISTEM WOUND MATRIX,,30,,,$14.54,$0.00,1,0,1,20161001, Q4121,HCPCS,THERASKIN,,30,,,$211.39,$0.00,1,0,1,20161001, Q4122,HCPCS,DERMACELL,,30,,,"$1,891.07",$0.00,1,0,1,20161001, Q4123,HCPCS,ALLOSKIN,,30,,,$40.32,$0.00,1,0,1,20161001, Q4124,HCPCS,OASIS TRI-LAYER WOUND MATRIX,,30,,,"$3,858.38",$0.00,1,0,1,20161001, Q4125,HCPCS,ARTHROFLEX,,30,,,"$2,516.40",$0.00,1,0,1,20161001, Q4126,HCPCS,MEMODERM/DERMA/TRANZ/INTEGUP,,30,,,$390.44,$0.00,1,0,1,20161001, Q4127,HCPCS,TALYMED,,30,,,$2.93,$0.00,1,0,1,20161001, Q4128,HCPCS,FLEXHD/ALLOPATCHHD/MATRIXHD,,30,,,$307.19,$0.00,1,0,1,20161001, Q4129,HCPCS,UNITE BIOMATRIX,,30,,,$247.93,$0.00,1,0,1,20161001, Q4130,HCPCS,STRATTICE TM,,30,,,"$18,957.22",$0.00,1,0,1,20161001, Q4131,HCPCS,EPIFIX,,30,,,$529.80,$0.00,1,0,1,20161001, Q4132,HCPCS,GRAFIX CORE,,30,,,"$3,725.23",$0.00,1,0,1,20161001, Q4133,HCPCS,GRAFIX PRIME,,30,,,"$3,692.87",$0.00,1,0,1,20161001, Q4134,HCPCS,HMATRIX,,30,,,"$4,058.23",$0.00,1,0,1,20161001, Q4137,HCPCS,"AMNIOEXCEL OR BIODEXCEL, 1CM",,30,,,"$1,276.61",$0.00,1,0,1,20161001, Q4141,HCPCS,"ALLOSKIN AC, 1 CM",,30,,,$27.70,$0.00,1,0,1,20161001, Q4145,HCPCS,"EPIFIX, INJ, 1MG",,30,,,$60.23,$0.00,1,0,1,20161001, Q4148,HCPCS,"NEOX 1K, 1CM",,30,,,$231.09,$0.00,1,0,1,20161001, Q5001,HCPCS,HOSPICE OR HOME HLTH IN HOME,,30,,,$225.69,$0.00,1,0,1,20161001, Q5002,HCPCS,HOSPICE/HOME HLTH IN ASST LV,,30,,,$344.50,$0.00,1,0,1,20161001, Q5003,HCPCS,HOSPICE IN LT/NON-SKILLED NF,,30,,,$315.79,$0.00,1,0,1,20161001, Q5004,HCPCS,HOSPICE IN SNF,,30,,,$350.24,$0.00,1,0,1,20161001, Q5005,HCPCS,"HOSPICE, INPATIENT HOSPITAL",,30,,,$922.11,$0.00,1,0,1,20161001, Q5006,HCPCS,HOSPICE IN HOSPICE FACILITY,,30,,,$895.70,$0.00,1,0,1,20161001, Q5007,HCPCS,HOSPICE IN LTCH,,30,,,$855.50,$0.00,1,0,1,20161001, Q5009,HCPCS,"HOSPICE/HOME HLTH, PLACE NOS",,30,,,$207.85,$0.00,1,0,1,20161001, Q5010,HCPCS,HOSPICE HOME CARE IN HOSPICE,,30,,,$610.94,$0.00,1,0,1,20161001, Q5101,HCPCS,INJ FILGRASTIM GCSF BIOSIMIL,,30,,,$6.31,$0.00,1,0,1,20161001, Q9950,HCPCS,INJ SULF HEXA LIPID MICROSPH,,30,,,$187.83,$0.00,1,0,1,20161001, Q9951,HCPCS,"LOCM >= 400 MG/ML IODINE,1ML",,30,,,$5.66,$0.00,1,0,1,20161001, Q9953,HCPCS,"INJ FE-BASED MR CONTRAST,1ML",,30,,,$42.45,$0.00,1,0,1,20161001, Q9954,HCPCS,"ORAL MR CONTRAST, 100 ML",,30,,,$14.19,$0.00,1,0,1,20161001, Q9955,HCPCS,"INJ PERFLEXANE LIP MICROS,ML",,30,,,$4.39,$0.00,1,0,1,20161001, Q9956,HCPCS,"INJ OCTAFLUOROPROPANE MIC,ML",,30,,,$106.12,$0.00,1,0,1,20161001, Q9957,HCPCS,"INJ PERFLUTREN LIP MICROS,ML",,30,,,$218.07,$0.00,1,0,1,20161001, Q9958,HCPCS,"HOCM <=149 MG/ML IODINE, 1ML",,30,,,$0.26,$0.00,1,0,1,20161001, Q9959,HCPCS,"HOCM 150-199MG/ML IODINE,1ML",,30,,,$0.55,$0.00,1,0,1,20161001, Q9960,HCPCS,"HOCM 200-249MG/ML IODINE,1ML",,30,,,$1.10,$0.00,1,0,1,20161001, Q9961,HCPCS,"HOCM 250-299MG/ML IODINE,1ML",,30,,,$1.65,$0.00,1,0,1,20161001, Q9962,HCPCS,"HOCM 300-349MG/ML IODINE,1ML",,30,,,$1.70,$0.00,1,0,1,20161001, Q9963,HCPCS,"HOCM 350-399MG/ML IODINE,1ML",,30,,,$2.16,$0.00,1,0,1,20161001, Q9964,HCPCS,"HOCM>= 400MG/ML IODINE, 1ML",,30,,,$2.60,$0.00,1,0,1,20161001, Q9965,HCPCS,"LOCM 100-199MG/ML IODINE,1ML",,30,,,$3.30,$0.00,1,0,1,20161001, Q9966,HCPCS,"LOCM 200-299MG/ML IODINE,1ML",,30,,,$3.73,$0.00,1,0,1,20161001, Q9967,HCPCS,"LOCM 300-399MG/ML IODINE,1ML",,30,,,$3.99,$0.00,1,0,1,20161001, Q9968,HCPCS,VISUALIZATION ADJUNCT,,30,,,$58.43,$0.00,1,0,1,20161001, Q9969,HCPCS,NON-HEU TC-99M ADD-ON/DOSE,,30,,,$65.00,$0.00,1,0,1,20161001, R0070,HCPCS,TRANSPORT PORTABLE X-RAY,,30,,,$227.30,$0.00,1,0,1,20161001, R0075,HCPCS,TRANSPORT PORT X-RAY MULTIPL,,30,,,$57.42,$0.00,1,0,1,20161001, S0017,HCPCS,"INJECTION, AMINOCAPROIC ACID",,30,,,$29.06,$0.00,1,0,0,20161001, S0020,HCPCS,"INJECTION, BUPIVICAINE HYDRO",,30,,,$17.30,$0.00,1,0,1,20161001, S0023,HCPCS,"INJECTION, CIMETIDINE HYDROC",,30,,,$12.36,$0.00,1,0,0,20161001, S0028,HCPCS,"INJECTION, FAMOTIDINE, 20 MG",,30,,,$23.89,$0.00,1,0,0,20161001, S0030,HCPCS,"INJECTION, METRONIDAZOLE",,30,,,$45.68,$0.00,1,0,0,20161001, S0032,HCPCS,"INJECTION, NAFCILLIN SODIUM",,30,,,$106.76,$0.00,1,0,0,20161001, S0034,HCPCS,"INJECTION, OFLOXACIN, 400 MG",,30,,,$33.03,$0.00,1,0,0,20161001, S0039,HCPCS,"INJECTION, SULFAMETHOXAZOLE",,30,,,$23.99,$0.00,1,0,0,20161001, S0040,HCPCS,"INJECTION, TICARCILLIN DISOD",,30,,,$65.68,$0.00,1,0,0,20161001, S0073,HCPCS,"INJECTION, AZTREONAM, 500 MG",,30,,,$81.12,$0.00,1,0,0,20161001, S0074,HCPCS,"INJECTION, CEFOTETAN DISODIU",,30,,,$57.34,$0.00,1,0,0,20161001, S0077,HCPCS,"INJECTION, CLINDAMYCIN PHOSP",,30,,,$20.40,$0.00,1,0,0,20161001, S0078,HCPCS,"INJECTION, FOSPHENYTOIN SODI",,30,,,$795.63,$0.00,1,0,0,20161001, S0080,HCPCS,"INJECTION, PENTAMIDINE ISETH",,30,,,$309.29,$0.00,1,0,0,20161001, S0091,HCPCS,GRANISETRON 1MG,,30,,,$356.70,$0.00,1,0,1,20161001, S0092,HCPCS,HYDROMORPHONE 250 MG,,30,,,$466.58,$0.00,1,0,0,20161001, S0093,HCPCS,MORPHINE 500 MG,,30,,,$553.74,$0.00,1,0,0,20161001, S0106,HCPCS,BUPROPION HCL SR 60 TABLETS,,30,,,$493.57,$0.00,1,0,0,20161001, S0108,HCPCS,MERCAPTOPURINE 50 MG,,30,,,$17.03,$0.00,1,0,0,20161001, S0109,HCPCS,METHADONE ORAL 5MG,,30,,,$1.26,$0.00,1,0,0,20161001, S0119,HCPCS,ONDANSETRON 4 MG,,30,,,$46.45,$0.00,1,0,0,20161001, S0132,HCPCS,INJ GANIRELIX ACETAT 250 MCG,,30,,,$476.78,$0.00,1,0,0,20161001, S0136,HCPCS,"CLOZAPINE, 25 MG",,30,,,$5.85,$0.00,1,0,0,20161001, S0137,HCPCS,"DIDANOSINE, 25 MG",,30,,,$16.53,$0.00,1,0,0,20161001, S0138,HCPCS,"FINASTERIDE, 5 MG",,30,,,$12.72,$0.00,1,0,0,20161001, S0145,HCPCS,PEG INTERFERON ALFA-2A/180,,30,,,$55.33,$0.00,1,0,1,20161001, S0157,HCPCS,"BECAPLERMIN GEL 1%, 0.5 GM",,30,,,$79.38,$0.00,1,0,0,20161001, S0164,HCPCS,INJECTION PANTROPRAZOLE,,30,,,$58.53,$0.00,1,0,0,20161001, S0166,HCPCS,INJ OLANZAPINE 2.5MG,,30,,,$26.58,$0.00,1,0,0,20161001, S0169,HCPCS,CALCITROL,,30,,,$6.82,$0.00,1,0,0,20161001, S0170,HCPCS,ANASTROZOLE 1 MG,,30,,,$36.50,$0.00,1,0,0,20161001, S0171,HCPCS,BUMETANIDE 0.5 MG,,30,,,$5.36,$0.00,1,0,0,20161001, S0174,HCPCS,DOLASETRON 50 MG,,30,,,$233.78,$0.00,1,0,0,20161001, S0179,HCPCS,MEGESTROL 20 MG,,30,,,$2.53,$0.00,1,0,0,20161001, S0183,HCPCS,PROCHLORPERAZINE 5 MG,,30,,,$2.97,$0.00,1,0,0,20161001, S0187,HCPCS,TAMOXIFEN 10 MG,,30,,,$9.39,$0.00,1,0,0,20161001, S0189,HCPCS,TESTOSTERONE PELLET 75 MG,,30,,,$130.63,$0.00,1,0,1,20161001, S0191,HCPCS,"MISOPROSTOL, ORAL, 200 MCG",,30,,,$10.43,$0.00,1,0,0,20161001, S0199,HCPCS,MED ABORTION INC ALL EX DRUG,,30,,,"$1,983.98",$0.00,1,0,1,20161001, S0201,HCPCS,PARTIAL HOSPITALIZATION SERV,,30,,,"$1,487.09",$0.00,1,0,1,20161001, S0208,HCPCS,PARAMED INTRCEPT NONVOL,,30,,,"$1,667.65",$0.00,1,0,1,20161001, S0220,HCPCS,MEDICAL CONFERENCE BY PHYSIC,,30,,,$199.81,$0.00,1,0,1,20161001, S0221,HCPCS,"MEDICAL CONFERENCE, 60 MIN",,30,,,$400.77,$0.00,1,0,1,20161001, S0255,HCPCS,HOSPICE REFER VISIT NONMD,,30,,,$156.93,$0.00,1,0,1,20161001, S0257,HCPCS,END OF LIFE COUNSELING,,30,,,$219.73,$0.00,1,0,1,20161001, S0260,HCPCS,H&P FOR SURGERY,,30,,,$107.73,$0.00,1,0,1,20161001, S0265,HCPCS,GENETIC COUNSEL 15 MINS,,30,,,$107.73,$0.00,1,0,1,20161001, S0302,HCPCS,COMPLETED EPSDT,,30,,,$93.49,$0.00,1,0,1,20161001, S0315,HCPCS,DISEASE MANAGEMENT PROGRAM,,30,,,$107.73,$0.00,1,0,1,20161001, S0316,HCPCS,FOLLOW-UP/REASSESSMENT,,30,,,$241.15,$0.00,1,0,1,20161001, S0320,HCPCS,RN TELEPHONE CALLS TO DMP,,30,,,$101.05,$0.00,1,0,1,20161001, S0390,HCPCS,ROUT FOOT CARE PER VISIT,,30,,,$28.71,$0.00,1,0,1,20161001, S0400,HCPCS,GLOBAL ESWL KIDNEY,,30,,,"$25,649.06",$0.00,1,0,1,20161001, S0512,HCPCS,DAILY CONT LENS,,30,,,$102.49,$0.00,1,0,1,20161001, S0592,HCPCS,COMP CONT LENS EVAL,,30,,,"$1,408.11",$0.00,1,0,1,20161001, S0601,HCPCS,SCREENING PROCTOSCOPY,,30,,,$371.80,$0.00,1,0,1,20161001, S0610,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,30,,,$249.10,$0.00,1,0,1,20161001, S0612,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,30,,,$238.45,$0.00,1,0,1,20161001, S0613,HCPCS,ANN BREAST EXAM,,30,,,$107.73,$0.00,1,0,1,20161001, S0618,HCPCS,AUDIOMETRY FOR HEARING AID,,30,,,$85.58,$0.00,1,0,1,20161001, S0620,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,30,,,$60.96,$0.00,1,0,1,20161001, S0621,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,30,,,$310.77,$0.00,1,0,1,20161001, S0622,HCPCS,PHYS EXAM FOR COLLEGE,,30,,,$107.73,$0.00,1,0,1,20161001, S0630,HCPCS,REMOVAL OF SUTURES,,30,,,$98.47,$0.00,1,0,1,20161001, S0810,HCPCS,PHOTOREFRACTIVE KERATECTOMY,,30,,,"$3,613.63",$0.00,1,0,1,20161001, S0812,HCPCS,PHOTOTHERAP KERATECT,,30,,,"$3,613.63",$0.00,1,0,1,20161001, S1015,HCPCS,IV TUBING EXTENSION SET,,30,,,$39.59,$0.00,1,0,1,20161001, S1016,HCPCS,NON-PVC INTRAVENOUS ADMINIST,,30,,,$55.57,$0.00,1,0,1,20161001, S1040,HCPCS,CRANIAL REMOLDING ORTHOSIS,,30,,,$426.86,$0.00,1,0,1,20161001, S1090,HCPCS,MOMETASONE SINUS IMPLANT,,30,,,"$4,604.80",$0.00,1,0,1,20161001, S2070,HCPCS,CYSTO LASER TX URETERAL CALC,,30,,,"$5,190.46",$0.00,1,0,1,20161001, S2080,HCPCS,LAUP,,30,,,"$12,845.76",$0.00,1,0,1,20161001, S2083,HCPCS,ADJUSTMENT GASTRIC BAND,,30,,,"$1,590.72",$0.00,1,0,1,20161001, S2095,HCPCS,TRANSCATH EMBOLIZ MICROSPHER,,30,,,"$13,162.30",$0.00,1,0,1,20161001, S2117,HCPCS,"ARTHROEREISIS, SUBTALAR",,30,,,"$7,179.92",$0.00,1,0,1,20161001, S2118,HCPCS,TOTAL HIP RESURFACING,,30,,,$166.13,$0.00,1,0,1,20161001, S2120,HCPCS,LOW DENSITY LIPOPROTEIN(LDL),,30,,,"$22,143.81",$0.00,1,0,1,20161001, S2140,HCPCS,CORD BLOOD HARVESTING,,30,,,"$1,517.63",$0.00,1,0,1,20161001, S2142,HCPCS,CORD BLOOD-DERIVED STEM-CELL,,30,,,"$3,623.44",$0.00,1,0,1,20161001, S2150,HCPCS,BMT HARV/TRANSPL 28D PKG,,30,,,"$1,273.11",$0.00,1,0,1,20161001, S2202,HCPCS,ECHOSCLEROTHERAPY,,30,,,$160.10,$0.00,1,0,1,20161001, S2225,HCPCS,MYRINGOTOMY LASER-ASSIST,,30,,,"$8,965.81",$0.00,1,0,1,20161001, S2230,HCPCS,IMPLANT SEMI-IMP HEAR,,30,,,"$5,929.85",$0.00,1,0,1,20161001, S2235,HCPCS,IMPLANT AUDITORY BRAIN IMP,,30,,,"$55,096.51",$0.00,1,0,1,20161001, S2300,HCPCS,"ARTHROSCOPY, SHOULDER, SURGI",,30,,,"$16,106.21",$0.00,1,0,1,20161001, S2325,HCPCS,HIP CORE DECOMPRESSION,,30,,,"$2,733.92",$0.00,1,0,1,20161001, S2340,HCPCS,CHEMODENERVATION OF ABDUCTOR,,30,,,"$8,176.06",$0.00,1,0,1,20161001, S2341,HCPCS,CHEMODENERV ADDUCT VOCAL,,30,,,"$8,176.06",$0.00,1,0,1,20161001, S2342,HCPCS,NASAL ENDOSCOP PO DEBRID,,30,,,"$12,008.70",$0.00,1,0,1,20161001, S2348,HCPCS,DECOMPRESS DISC RF LUMBAR,,30,,,"$9,746.63",$0.00,1,0,1,20161001, S2900,HCPCS,ROBOTIC SURGICAL SYSTEM,,30,,,"$8,246.15",$0.00,1,0,1,20161001, S3005,HCPCS,EVAL SELF-ASSESS DEPRESSION,,30,,,$107.73,$0.00,1,0,1,20161001, S3600,HCPCS,STAT LAB,,30,,,$69.88,$0.00,1,0,1,20161001, S3620,HCPCS,NEWBORN METABOLIC SCREENING,,30,,,$213.30,$0.00,1,0,1,20161001, S3630,HCPCS,EOSINOPHIL BLOOD COUNT,,30,,,$57.05,$0.00,1,0,1,20161001, S3708,HCPCS,GASTROINTESTINAL FAT ABSORPT,,30,,,$474.87,$0.00,1,0,1,20161001, S3870,HCPCS,CGH TEST DEVELOPMENTAL DELAY,,30,,,"$2,433.31",$0.00,1,0,1,20161001, S3900,HCPCS,SURFACE EMG,,30,,,"$1,434.62",$0.00,1,0,1,20161001, S4005,HCPCS,INTERIM LABOR FACILITY GLOBA,,30,,,$501.82,$0.00,1,0,1,20161001, S4011,HCPCS,IVF PACKAGE,,30,,,"$1,722.49",$0.00,1,0,1,20161001, S4015,HCPCS,COMPLETE IVF NOS CASE RATE,,30,,,"$17,466.08",$0.00,1,0,1,20161001, S4021,HCPCS,IVF CANC P ASPIR CASE RATE,,30,,,"$1,263.99",$0.00,1,0,1,20161001, S4981,HCPCS,INSERT LEVONORGESTREL IUS,,30,,,"$1,583.12",$0.00,1,0,1,20161001, S4989,HCPCS,CONTRACEPT IUD,,30,,,$750.24,$0.00,1,0,1,20161001, S4990,HCPCS,NICOTINE PATCH LEGEND,,30,,,$31.69,$0.00,1,0,1,20161001, S4991,HCPCS,NICOTINE PATCH NONLEGEND,,30,,,$28.49,$0.00,1,0,1,20161001, S4993,HCPCS,CONTRACEPTIVE PILLS FOR BC,,30,,,$34.38,$0.00,1,0,1,20161001, S4995,HCPCS,SMOKING CESSATION GUM,,30,,,$67.50,$0.00,1,0,1,20161001, S5000,HCPCS,"PRESCRIPTION DRUG, GENERIC",,30,,,$23.60,$0.00,1,0,1,20161001, S5001,HCPCS,"PRESCRIPTION DRUG,BRAND NAME",,30,,,$100.84,$0.00,1,0,1,20161001, S5010,HCPCS,5% DEXTROSE AND 0.45% SALINE,,30,,,$24.16,$0.00,1,0,1,20161001, S5012,HCPCS,5% DEXTROSE WITH POTASSIUM,,30,,,$84.01,$0.00,1,0,1,20161001, S5013,HCPCS,5%DEXTROSE/0.45%SALINE1000ML,,30,,,$23.43,$0.00,1,0,1,20161001, S5014,HCPCS,D5W/0.45NS W KCL AND MGS04,,30,,,$14.12,$0.00,1,0,1,20161001, S5105,HCPCS,CENTERBASED DAY CARE PERDIEM,,30,,,$363.60,$0.00,1,0,1,20161001, S5130,HCPCS,HOMAKER SERVICE NOS PER 15M,,30,,,$6.10,$0.00,1,0,1,20161001, S5131,HCPCS,HOMEMAKER SERVICE NOS /DIEM,,30,,,$25.26,$0.00,1,0,1,20161001, S5140,HCPCS,ADULT FOSTER CARE PER DIEM,,30,,,$76.33,$0.00,1,0,1,20161001, S5161,HCPCS,EMER RSPNS SYS SERV PERMONTH,,30,,,$52.03,$0.00,1,0,1,20161001, S5190,HCPCS,WELLNESS ASSESSMENT BY NONPH,,30,,,$347.27,$0.00,1,0,1,20161001, S5199,HCPCS,PERSONAL CARE ITEM NOS EACH,,30,,,$48.29,$0.00,1,0,1,20161001, S5497,HCPCS,HIT CATH CARE NOC,,30,,,$48.29,$0.00,1,0,1,20161001, S5498,HCPCS,HIT SIMPLE CATH CARE,,30,,,$40.91,$0.00,1,0,1,20161001, S5501,HCPCS,HIT COMPLEX CATH CARE,,30,,,$44.10,$0.00,1,0,1,20161001, S5502,HCPCS,HIT INTERIM CATH CARE,,30,,,$77.69,$0.00,1,0,1,20161001, S5517,HCPCS,HIT DECLOTTING KIT,,30,,,$89.82,$0.00,1,0,1,20161001, S5520,HCPCS,HIT PICC INSERT KIT,,30,,,$108.74,$0.00,1,0,1,20161001, S5523,HCPCS,HIP MIDLINE CATH INSERT KIT,,30,,,$160.77,$0.00,1,0,1,20161001, S5550,HCPCS,INSULIN RAPID 5 U,,30,,,$0.15,$0.00,1,0,1,20161001, S5551,HCPCS,INSULIN MOST RAPID 5 U,,30,,,$0.15,$0.00,1,0,1,20161001, S5553,HCPCS,INSULIN LONG ACTING 5 U,,30,,,$0.15,$0.00,1,0,1,20161001, S8030,HCPCS,TANTALUM RING APPLICATION,,30,,,"$10,266.59",$0.00,1,0,1,20161001, S8037,HCPCS,MRCP,,30,,,"$6,881.12",$0.00,1,0,1,20161001, S8040,HCPCS,TOPOGRAPHIC BRAIN MAPPING,,30,,,"$1,489.01",$0.00,1,0,1,20161001, S8055,HCPCS,US GUIDANCE FETAL REDUCT,,30,,,"$1,217.90",$0.00,1,0,1,20161001, S8080,HCPCS,SCINTIMAMMOGRAPHY,,30,,,"$1,035.92",$0.00,1,0,1,20161001, S8092,HCPCS,ELECTRON BEAM COMPUTED TOMOG,,30,,,$263.47,$0.00,1,0,1,20161001, S8096,HCPCS,PORTABLE PEAK FLOW METER,,30,,,$58.87,$0.00,1,0,1,20161001, S8100,HCPCS,SPACER WITHOUT MASK,,30,,,$69.27,$0.00,1,0,1,20161001, S8101,HCPCS,SPACER WITH MASK,,30,,,$197.91,$0.00,1,0,1,20161001, S8120,HCPCS,O2 CONTENTS GAS CUBIC FT,,30,,,$28.71,$0.00,1,0,1,20161001, S8210,HCPCS,MUCUS TRAP,,30,,,$1.38,$0.00,1,0,1,20161001, S8423,HCPCS,CUSTOM GRAD SLEEVE HEAVY,,30,,,$225.04,$0.00,1,0,1,20161001, S8424,HCPCS,READY GRADIENT SLEEVE,,30,,,$69.75,$0.00,1,0,1,20161001, S8426,HCPCS,CUSTOM GRAD GLOVE HEAVY,,30,,,$138.15,$0.00,1,0,1,20161001, S8427,HCPCS,READY GRADIENT GLOVE,,30,,,$29.52,$0.00,1,0,1,20161001, S8431,HCPCS,COMPRESSION BANDAGE,,30,,,$17.43,$0.00,1,0,1,20161001, S8450,HCPCS,SPLINT DIGIT,,30,,,$33.02,$0.00,1,0,1,20161001, S8451,HCPCS,SPLINT WRIST OR ANKLE,,30,,,$44.70,$0.00,1,0,1,20161001, S8490,HCPCS,100 INSULIN SYRINGES,,30,,,$1.38,$0.00,1,0,1,20161001, S8948,HCPCS,LOW-LEVEL LASER TRMT 15 MIN,,30,,,$404.63,$0.00,1,0,1,20161001, S8950,HCPCS,"COMPLEX LYMPHEDEMA THERAPY,",,30,,,$134.35,$0.00,1,0,1,20161001, S8990,HCPCS,PT OR MANIP FOR MAINT,,30,,,$75.13,$0.00,1,0,1,20161001, S9024,HCPCS,PARANASAL SINUS ULTRASOUND,,30,,,$791.59,$0.00,1,0,1,20161001, S9034,HCPCS,ESWL FOR GALLSTONES,,30,,,"$4,958.32",$0.00,1,0,1,20161001, S9061,HCPCS,MEDICAL SUPPLIES AND EQUIPME,,30,,,$73.58,$0.00,1,0,1,20161001, S9083,HCPCS,URGENT CARE CENTER GLOBAL,,30,,,$473.43,$0.00,1,0,1,20161001, S9088,HCPCS,SERVICES PROVIDED IN URGENT,,30,,,$640.59,$0.00,1,0,1,20161001, S9097,HCPCS,HOME VISIT WOUND CARE,,30,,,$194.16,$0.00,1,0,1,20161001, S9098,HCPCS,HOME PHOTOTHERAPY VISIT,,30,,,$287.08,$0.00,1,0,1,20161001, S9110,HCPCS,TELEMONITORING/HOME PER MNTH,,30,,,$109.77,$0.00,1,0,1,20161001, S9117,HCPCS,BACK SCHOOL VISIT,,30,,,$107.73,$0.00,1,0,1,20161001, S9122,HCPCS,HOME HEALTH AIDE OR CERTIFIE,,30,,,$103.35,$0.00,1,0,1,20161001, S9123,HCPCS,NURSING CARE IN HOME RN,,30,,,$287.08,$0.00,1,0,1,20161001, S9124,HCPCS,"NURSING CARE, IN THE HOME; B",,30,,,$459.33,$0.00,1,0,1,20161001, S9125,HCPCS,"RESPITE CARE, IN THE HOME, P",,30,,,$182.29,$0.00,1,0,1,20161001, S9126,HCPCS,"HOSPICE CARE, IN THE HOME, P",,30,,,$240.67,$0.00,1,0,1,20161001, S9127,HCPCS,"SOCIAL WORK VISIT, IN THE HO",,30,,,$304.31,$0.00,1,0,1,20161001, S9128,HCPCS,"SPEECH THERAPY, IN THE HOME,",,30,,,$200.96,$0.00,1,0,1,20161001, S9129,HCPCS,"OCCUPATIONAL THERAPY, IN THE",,30,,,$229.67,$0.00,1,0,1,20161001, S9131,HCPCS,PT IN THE HOME PER DIEM,,30,,,$231.96,$0.00,1,0,1,20161001, S9140,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$99.90,$0.00,1,0,1,20161001, S9145,HCPCS,INSULIN PUMP INITIATION,,30,,,$388.43,$0.00,1,0,1,20161001, S9152,HCPCS,"SPEECH THERAPY, RE-EVAL",,30,,,$241.15,$0.00,1,0,1,20161001, S9208,HCPCS,HOME MGMT PRETERM LABOR,,30,,,$275.02,$0.00,1,0,1,20161001, S9211,HCPCS,HOME MGMT GEST HYPERTENSION,,30,,,$116.56,$0.00,1,0,1,20161001, S9213,HCPCS,HM PREECLAMP PER DIEM,,30,,,$271.93,$0.00,1,0,1,20161001, S9214,HCPCS,HM GEST DM PER DIEM,,30,,,$251.80,$0.00,1,0,1,20161001, S9326,HCPCS,HIT CONT PAIN PER DIEM,,30,,,$199.44,$0.00,1,0,1,20161001, S9327,HCPCS,HIT INT PAIN PER DIEM,,30,,,$197.89,$0.00,1,0,1,20161001, S9329,HCPCS,HIT CHEMO PER DIEM,,30,,,$214.46,$0.00,1,0,1,20161001, S9330,HCPCS,HIT CONT CHEM DIEM,,30,,,$210.92,$0.00,1,0,1,20161001, S9331,HCPCS,HIT INTERMIT CHEMO DIEM,,30,,,$234.87,$0.00,1,0,1,20161001, S9335,HCPCS,HT HEMODIALYSIS DIEM,,30,,,$644.03,$0.00,1,0,1,20161001, S9336,HCPCS,HIT CONT ANTICOAG DIEM,,30,,,$201.72,$0.00,1,0,1,20161001, S9338,HCPCS,HIT IMMUNOTHERAPY DIEM,,30,,,$249.93,$0.00,1,0,1,20161001, S9340,HCPCS,HIT ENTERAL PER DIEM,,30,,,$83.36,$0.00,1,0,1,20161001, S9341,HCPCS,HIT ENTERAL GRAV DIEM,,30,,,$57.22,$0.00,1,0,1,20161001, S9342,HCPCS,HIT ENTERAL PUMP DIEM,,30,,,$61.46,$0.00,1,0,1,20161001, S9343,HCPCS,HIT ENTERAL BOLUS NURS,,30,,,$38.13,$0.00,1,0,1,20161001, S9345,HCPCS,HIT ANTI-HEMOPHIL DIEM,,30,,,$127.22,$0.00,1,0,1,20161001, S9346,HCPCS,HIT ALPHA-1-PROTEINAS DIEM,,30,,,$89.03,$0.00,1,0,1,20161001, S9348,HCPCS,HIT SYMPATHOMIM DIEM,,30,,,$220.20,$0.00,1,0,1,20161001, S9349,HCPCS,HIT TOCOLYSIS DIEM,,30,,,$317.61,$0.00,1,0,1,20161001, S9351,HCPCS,HIT CONT ANTIEMETIC DIEM,,30,,,$404.05,$0.00,1,0,1,20161001, S9353,HCPCS,HIT CONT INSULIN DIEM,,30,,,$552.48,$0.00,1,0,1,20161001, S9355,HCPCS,HIT CHELATION DIEM,,30,,,$164.99,$0.00,1,0,1,20161001, S9357,HCPCS,HIT ENZYME REPLACE DIEM,,30,,,$179.28,$0.00,1,0,1,20161001, S9359,HCPCS,HIT ANTI-TNF PER DIEM,,30,,,$328.10,$0.00,1,0,1,20161001, S9364,HCPCS,HIT TPN TOTAL DIEM,,30,,,$375.55,$0.00,1,0,1,20161001, S9365,HCPCS,HIT TPN 1 LITER DIEM,,30,,,$432.82,$0.00,1,0,1,20161001, S9366,HCPCS,HIT TPN 2 LITER DIEM,,30,,,$528.18,$0.00,1,0,1,20161001, S9367,HCPCS,HIT TPN 3 LITER DIEM,,30,,,$588.10,$0.00,1,0,1,20161001, S9368,HCPCS,HIT TPN OVER 3L DIEM,,30,,,$753.43,$0.00,1,0,1,20161001, S9370,HCPCS,HT INJ ANTIEMETIC DIEM,,30,,,$152.62,$0.00,1,0,1,20161001, S9373,HCPCS,HIT HYDRA TOTAL DIEM,,30,,,$115.88,$0.00,1,0,1,20161001, S9374,HCPCS,HIT HYDRA 1 LITER DIEM,,30,,,$167.49,$0.00,1,0,1,20161001, S9375,HCPCS,HIT HYDRA 2 LITER DIEM,,30,,,$214.57,$0.00,1,0,1,20161001, S9376,HCPCS,HIT HYDRA 3 LITER DIEM,,30,,,$233.86,$0.00,1,0,1,20161001, S9377,HCPCS,HIT HYDRA OVER 3L DIEM,,30,,,$253.15,$0.00,1,0,1,20161001, S9379,HCPCS,HIT NOC PER DIEM,,30,,,$48.29,$0.00,1,0,1,20161001, S9401,HCPCS,ANTICOAG CLINIC PER SESSION,,30,,,$160.77,$0.00,1,0,1,20161001, S9430,HCPCS,PHARMACY COMP/DISP SERV,,30,,,$172.25,$0.00,1,0,1,20161001, S9436,HCPCS,LAMAZE CLASS,,30,,,$72.46,$0.00,1,0,1,20161001, S9441,HCPCS,ASTHMA EDUCATION,,30,,,$168.80,$0.00,1,0,1,20161001, S9442,HCPCS,BIRTHING CLASS,,30,,,$148.13,$0.00,1,0,1,20161001, S9443,HCPCS,LACTATION CLASS,,30,,,$234.26,$0.00,1,0,1,20161001, S9444,HCPCS,PARENTING CLASS,,30,,,$81.27,$0.00,1,0,1,20161001, S9445,HCPCS,PT EDUCATION NOC INDIVID,,30,,,$428.33,$0.00,1,0,1,20161001, S9446,HCPCS,PT EDUCATION NOC GROUP,,30,,,$203.18,$0.00,1,0,1,20161001, S9449,HCPCS,WEIGHT MGMT CLASS,,30,,,$101.58,$0.00,1,0,1,20161001, S9451,HCPCS,EXERCISE CLASS,,30,,,$114.74,$0.00,1,0,1,20161001, S9452,HCPCS,NUTRITION CLASS,,30,,,$167.32,$0.00,1,0,1,20161001, S9453,HCPCS,SMOKING CESSATION CLASS,,30,,,$218.07,$0.00,1,0,1,20161001, S9455,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$141.24,$0.00,1,0,1,20161001, S9460,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$227.90,$0.00,1,0,1,20161001, S9465,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$161.91,$0.00,1,0,1,20161001, S9470,HCPCS,"NUTRITIONAL COUNSELING, DIET",,30,,,$125.85,$0.00,1,0,1,20161001, S9472,HCPCS,CARDIAC REHABILITATION PROGR,,30,,,$367.18,$0.00,1,0,0,20161001, S9473,HCPCS,PULMONARY REHABILITATION PRO,,30,,,$273.95,$0.00,1,0,0,20161001, S9474,HCPCS,ENTEROSTOMAL THERAPY BY A RE,,30,,,$258.98,$0.00,1,0,1,20161001, S9475,HCPCS,AMBULATORY SETTING SUBSTANCE,,30,,,$493.78,$0.00,1,0,1,20161001, S9476,HCPCS,VESTIBULAR REHAB PER DIEM,,30,,,$152.73,$0.00,1,0,0,20161001, S9480,HCPCS,INTENSIVE OUTPATIENT PSYCHIA,,30,,,$602.87,$0.00,1,0,1,20161001, S9484,HCPCS,CRISIS INTERVENTION PER HOUR,,30,,,$189.47,$0.00,1,0,1,20161001, S9485,HCPCS,CRISIS INTERVENTION MENTAL H,,30,,,$534.84,$0.00,1,0,1,20161001, S9490,HCPCS,HIT CORTICOSTEROID/DIEM,,30,,,$259.63,$0.00,1,0,1,20161001, S9494,HCPCS,HIT ANTIBIOTIC TOTAL DIEM,,30,,,$207.20,$0.00,1,0,1,20161001, S9497,HCPCS,HIT ANTIBIOTIC Q3H DIEM,,30,,,$258.37,$0.00,1,0,1,20161001, S9500,HCPCS,HIT ANTIBIOTIC Q24H DIEM,,30,,,$296.57,$0.00,1,0,1,20161001, S9501,HCPCS,HIT ANTIBIOTIC Q12H DIEM,,30,,,$289.85,$0.00,1,0,1,20161001, S9502,HCPCS,HIT ANTIBIOTIC Q8H DIEM,,30,,,$361.75,$0.00,1,0,1,20161001, S9503,HCPCS,HIT ANTIBIOTIC Q6H DIEM,,30,,,$333.54,$0.00,1,0,1,20161001, S9504,HCPCS,HIT ANTIBIOTIC Q4H DIEM,,30,,,$307.53,$0.00,1,0,1,20161001, S9529,HCPCS,VENIPUNCTURE HOME/SNF,,30,,,$103.33,$0.00,1,0,1,20161001, S9537,HCPCS,HT HEM HORM INJ DIEM,,30,,,$86.03,$0.00,1,0,1,20161001, S9542,HCPCS,HT INJ NOC PER DIEM,,30,,,$48.29,$0.00,1,0,1,20161001, S9560,HCPCS,HT INJ HORMONE DIEM,,30,,,$95.67,$0.00,1,0,1,20161001, S9562,HCPCS,HT INJ PALIVIZUMAB DIEM,,30,,,$95.67,$0.00,1,0,1,20161001, S9590,HCPCS,HT IRRIGATION DIEM,,30,,,$137.30,$0.00,1,0,1,20161001, V5008,HCPCS,HEARING SCREENING,,30,,,$237.60,$0.00,1,0,1,20161001, V5010,HCPCS,ASSESSMENT FOR HEARING AID,,30,,,$354.41,$0.00,1,0,1,20161001,