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
10004,CPT,FNA BX W/O IMG GDN EA ADDL,,30,,,"$3,271.05",$0.00,1,0,1,20210101,
10005,CPT,FNA BX W/US GDN 1ST LES,,30,,,"$3,124.33",$0.00,1,0,1,20210101,
10006,CPT,FNA BX W/US GDN EA ADDL,,30,,,"$2,350.03",$0.00,1,0,1,20210101,
10007,CPT,FNA BX W/FLUOR GDN 1ST LES,,30,,,"$3,124.33",$0.00,1,0,1,20210101,
10008,CPT,FNA BX W/FLUOR GDN EA ADDL,,30,,,"$3,293.17",$0.00,1,0,1,20210101,
10009,CPT,FNA BX W/CT GDN 1ST LES,,30,,,"$3,124.33",$0.00,1,0,1,20210101,
10010,CPT,FNA BX W/CT GDN EA ADDL,,30,,,"$2,827.37",$0.00,1,0,1,20210101,
10011,CPT,FNA BX W/MR GDN 1ST LES,,30,,,"$3,124.33",$0.00,1,0,1,20210101,
10012,CPT,FNA BX W/MR GDN EA ADDL,,30,,,"$2,880.85",$0.00,1,0,1,20210101,
10021,CPT,FNA BX W/O IMG GDN 1ST LES,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
10030,CPT,GUIDE CATHET FLUID DRAINAGE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
10035,CPT,PERQ DEV SOFT TISS 1ST IMAG,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
10036,CPT,PERQ DEV SOFT TISS ADD IMAG,,30,,,"$2,586.17",$0.00,1,0,1,20210101,
10040,CPT,ACNE SURGERY,,30,,,$677.96,$0.00,1,0,1,20210101,
10060,CPT,DRAINAGE OF SKIN ABSCESS,,30,,,$677.96,$0.00,1,0,1,20210101,
10061,CPT,DRAINAGE OF SKIN ABSCESS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
10080,CPT,DRAINAGE OF PILONIDAL CYST,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
10081,CPT,DRAINAGE OF PILONIDAL CYST,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
10120,CPT,REMOVE FOREIGN BODY,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
10121,CPT,REMOVE FOREIGN BODY,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
10140,CPT,DRAINAGE OF HEMATOMA/FLUID,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
10160,CPT,PUNCTURE DRAINAGE OF LESION,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
10180,CPT,COMPLEX DRAINAGE WOUND,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11000,CPT,DEBRIDE INFECTED SKIN,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
11001,CPT,DEBRIDE INFECTED SKIN ADD-ON,,30,,,$356.08,$0.00,1,0,1,20210101,
11010,CPT,DEBRIDE SKIN AT FX SITE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11011,CPT,DEBRIDE SKIN MUSC AT FX SITE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11012,CPT,DEB SKIN BONE AT FX SITE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11042,CPT,DEB SUBQ TISSUE 20 SQ CM/<,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11043,CPT,DEB MUSC/FASCIA 20 SQ CM/<,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
11044,CPT,DEB BONE 20 SQ CM/<,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11045,CPT,DEB SUBQ TISSUE ADD-ON,,30,,,"$1,212.08",$0.00,1,0,1,20210101,
11046,CPT,DEB MUSC/FASCIA ADD-ON,,30,,,"$1,470.17",$0.00,1,0,1,20210101,
11047,CPT,DEB BONE ADD-ON,,30,,,"$2,772.29",$0.00,1,0,1,20210101,
11055,CPT,TRIM SKIN LESION,,30,,,$677.96,$0.00,1,0,1,20210101,
11056,CPT,TRIM SKIN LESIONS 2 TO 4,,30,,,$677.96,$0.00,1,0,1,20210101,
11057,CPT,TRIM SKIN LESIONS OVER 4,,30,,,$677.96,$0.00,1,0,1,20210101,
11102,CPT,TANGNTL BX SKIN SINGLE LES,,30,,,$875.87,$0.00,1,0,1,20210101,
11103,CPT,TANGNTL BX SKIN EA SEP/ADDL,,30,,,$388.78,$0.00,1,0,1,20210101,
11104,CPT,PUNCH BX SKIN SINGLE LESION,,30,,,"$1,342.55",$0.00,1,0,1,20210101,
11105,CPT,PUNCH BX SKIN EA SEP/ADDL,,30,,,$388.78,$0.00,1,0,1,20210101,
11106,CPT,INCAL BX SKN SINGLE LES,,30,,,"$2,069.20",$0.00,1,0,1,20210101,
11107,CPT,INCAL BX SKN EA SEP/ADDL,,30,,,$847.22,$0.00,1,0,1,20210101,
11200,CPT,REMOVAL OF SKIN TAGS <W/15,,30,,,$677.96,$0.00,1,0,1,20210101,
11201,CPT,REMOVE SKIN TAGS ADD-ON,,30,,,$170.37,$0.00,1,0,1,20210101,
11300,CPT,SHAVE SKIN LESION 0.5 CM/<,,30,,,$847.76,$0.00,1,0,1,20210101,
11301,CPT,SHAVE SKIN LESION 0.6-1.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
11302,CPT,SHAVE SKIN LESION 1.1-2.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
11303,CPT,SHAVE SKIN LESION >2.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11305,CPT,SHAVE SKIN LESION 0.5 CM/<,,30,,,$677.96,$0.00,1,0,1,20210101,
11306,CPT,SHAVE SKIN LESION 0.6-1.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
11307,CPT,SHAVE SKIN LESION 1.1-2.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
11308,CPT,SHAVE SKIN LESION >2.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11310,CPT,SHAVE SKIN LESION 0.5 CM/<,,30,,,$677.96,$0.00,1,0,1,20210101,
11311,CPT,SHAVE SKIN LESION 0.6-1.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
11312,CPT,SHAVE SKIN LESION 1.1-2.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11313,CPT,SHAVE SKIN LESION >2.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11400,CPT,EXC TR-EXT B9+MARG 0.5 CM<,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11401,CPT,EXC TR-EXT B9+MARG 0.6-1 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11402,CPT,EXC TR-EXT B9+MARG 1.1-2 CM,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11403,CPT,EXC TR-EXT B9+MARG 2.1-3CM,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11404,CPT,EXC TR-EXT B9+MARG 3.1-4 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11406,CPT,EXC TR-EXT B9+MARG >4.0 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11420,CPT,EXC H-F-NK-SP B9+MARG 0.5/<,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11421,CPT,EXC H-F-NK-SP B9+MARG 0.6-1,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11422,CPT,EXC H-F-NK-SP B9+MARG 1.1-2,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11423,CPT,EXC H-F-NK-SP B9+MARG 2.1-3,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11424,CPT,EXC H-F-NK-SP B9+MARG 3.1-4,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11426,CPT,EXC H-F-NK-SP B9+MARG >4 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11440,CPT,EXC FACE-MM B9+MARG 0.5 CM/<,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11441,CPT,EXC FACE-MM B9+MARG 0.6-1 CM,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11442,CPT,EXC FACE-MM B9+MARG 1.1-2 CM,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11443,CPT,EXC FACE-MM B9+MARG 2.1-3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11444,CPT,EXC FACE-MM B9+MARG 3.1-4 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11446,CPT,EXC FACE-MM B9+MARG >4 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11450,CPT,REMOVAL SWEAT GLAND LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11451,CPT,REMOVAL SWEAT GLAND LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11462,CPT,REMOVAL SWEAT GLAND LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11463,CPT,REMOVAL SWEAT GLAND LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11470,CPT,REMOVAL SWEAT GLAND LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11471,CPT,REMOVAL SWEAT GLAND LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11600,CPT,EXC TR-EXT MAL+MARG 0.5 CM/<,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11601,CPT,EXC TR-EXT MAL+MARG 0.6-1 CM,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11602,CPT,EXC TR-EXT MAL+MARG 1.1-2 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11603,CPT,EXC TR-EXT MAL+MARG 2.1-3 CM,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11604,CPT,EXC TR-EXT MAL+MARG 3.1-4 CM,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11606,CPT,EXC TR-EXT MAL+MARG >4 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11620,CPT,EXC H-F-NK-SP MAL+MARG 0.5/<,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11621,CPT,EXC S/N/H/F/G MAL+MRG 0.6-1,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11622,CPT,EXC S/N/H/F/G MAL+MRG 1.1-2,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11623,CPT,EXC S/N/H/F/G MAL+MRG 2.1-3,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11624,CPT,EXC S/N/H/F/G MAL+MRG 3.1-4,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11626,CPT,EXC S/N/H/F/G MAL+MRG >4 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11640,CPT,EXC F/E/E/N/L MAL+MRG 0.5CM<,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11641,CPT,EXC F/E/E/N/L MAL+MRG 0.6-1,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11642,CPT,EXC F/E/E/N/L MAL+MRG 1.1-2,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11643,CPT,EXC F/E/E/N/L MAL+MRG 2.1-3,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11644,CPT,EXC F/E/E/N/L MAL+MRG 3.1-4,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
11646,CPT,EXC F/E/E/N/L MAL+MRG >4 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11719,CPT,TRIM NAIL(S) ANY NUMBER,,30,,,$373.96,$0.00,1,0,1,20210101,
11720,CPT,DEBRIDE NAIL 1-5,,30,,,$373.96,$0.00,1,0,1,20210101,
11721,CPT,DEBRIDE NAIL 6 OR MORE,,30,,,$373.96,$0.00,1,0,1,20210101,
11730,CPT,REMOVAL OF NAIL PLATE,,30,,,$677.96,$0.00,1,0,1,20210101,
11732,CPT,REMOVE NAIL PLATE ADD-ON,,30,,,$325.09,$0.00,1,0,1,20210101,
11740,CPT,DRAIN BLOOD FROM UNDER NAIL,,30,,,$584.38,$0.00,1,0,1,20210101,
11750,CPT,REMOVAL OF NAIL BED,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11755,CPT,BIOPSY NAIL UNIT,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11760,CPT,REPAIR OF NAIL BED,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
11762,CPT,RECONSTRUCTION OF NAIL BED,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
11765,CPT,EXCISION OF NAIL FOLD TOE,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
11770,CPT,REMOVE PILONIDAL CYST SIMPLE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11771,CPT,REMOVE PILONIDAL CYST EXTEN,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11772,CPT,REMOVE PILONIDAL CYST COMPL,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11900,CPT,INJECT SKIN LESIONS </W 7,,30,,,$677.96,$0.00,1,0,1,20210101,
11901,CPT,INJECT SKIN LESIONS >7,,30,,,$677.96,$0.00,1,0,1,20210101,
11920,CPT,CORRECT SKIN COLOR 6.0 CM/<,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
11921,CPT,CORRECT SKN COLOR 6.1-20.0CM,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
11922,CPT,CORRECT SKIN COLOR EA 20.0CM,,30,,,"$2,988.54",$0.00,1,0,1,20210101,
11950,CPT,TX CONTOUR DEFECTS 1 CC/<,,30,,,$677.96,$0.00,1,0,1,20210101,
11951,CPT,TX CONTOUR DEFECTS 1.1-5.0CC,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
11952,CPT,TX CONTOUR DEFECTS 5.1-10CC,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
11954,CPT,TX CONTOUR DEFECTS >10.0 CC,,30,,,"$2,401.64",$0.00,1,0,1,20210101,
11960,CPT,INSERT TISSUE EXPANDER(S),,30,,,"$13,682.36",$0.00,1,0,1,20210101,
11970,CPT,RPLCMT TISS XPNDR PERM IMPLT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
11971,CPT,RMVL TIS XPNDR WO INSJ IMPLT,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
11976,CPT,REMOVE CONTRACEPTIVE CAPSULE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
11980,CPT,IMPLANT HORMONE PELLET(S),,30,,,"$1,796.69",$0.00,1,0,1,20210101,
11981,CPT,INSERT DRUG IMPLANT DEVICE,,30,,,$584.38,$0.00,1,0,1,20210101,
11982,CPT,REMOVE DRUG IMPLANT DEVICE,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
11983,CPT,REMOVE/INSERT DRUG IMPLANT,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
12001,CPT,RPR S/N/AX/GEN/TRNK 2.5CM/<,,30,,,$677.96,$0.00,1,0,1,20210101,
12002,CPT,RPR S/N/AX/GEN/TRNK2.6-7.5CM,,30,,,$677.96,$0.00,1,0,1,20210101,
12004,CPT,RPR S/N/AX/GEN/TRK7.6-12.5CM,,30,,,$677.96,$0.00,1,0,1,20210101,
12005,CPT,RPR S/N/A/GEN/TRK12.6-20.0CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12006,CPT,RPR S/N/A/GEN/TRK20.1-30.0CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12007,CPT,RPR S/N/AX/GEN/TRNK >30.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
12011,CPT,RPR F/E/E/N/L/M 2.5 CM/<,,30,,,$677.96,$0.00,1,0,1,20210101,
12013,CPT,RPR F/E/E/N/L/M 2.6-5.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
12014,CPT,RPR F/E/E/N/L/M 5.1-7.5 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
12015,CPT,RPR F/E/E/N/L/M 7.6-12.5 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
12016,CPT,RPR FE/E/EN/L/M 12.6-20.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12017,CPT,RPR FE/E/EN/L/M 20.1-30.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12018,CPT,RPR F/E/E/N/L/M >30.0 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
12020,CPT,CLOSURE OF SPLIT WOUND,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
12021,CPT,CLOSURE OF SPLIT WOUND,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12031,CPT,INTMD RPR S/A/T/EXT 2.5 CM/<,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12032,CPT,INTMD RPR S/A/T/EXT 2.6-7.5,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12034,CPT,INTMD RPR S/TR/EXT 7.6-12.5,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12035,CPT,INTMD RPR S/A/T/EXT 12.6-20,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12036,CPT,INTMD RPR S/A/T/EXT 20.1-30,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
12037,CPT,INTMD RPR S/TR/EXT >30.0 CM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
12041,CPT,INTMD RPR N-HF/GENIT 2.5CM/<,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12042,CPT,INTMD RPR N-HF/GENIT2.6-7.5,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12044,CPT,INTMD RPR N-HF/GENIT7.6-12.5,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
12045,CPT,INTMD RPR N-HF/GENIT12.6-20,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
12046,CPT,INTMD RPR N-HF/GENIT20.1-30,,30,,,"$2,401.64",$0.00,1,0,1,20210101,
12047,CPT,INTMD RPR N-HF/GENIT >30.0CM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
12051,CPT,INTMD RPR FACE/MM 2.5 CM/<,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12052,CPT,INTMD RPR FACE/MM 2.6-5.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12053,CPT,INTMD RPR FACE/MM 5.1-7.5 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12054,CPT,INTMD RPR FACE/MM 7.6-12.5CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12055,CPT,INTMD RPR FACE/MM 12.6-20 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12056,CPT,INTMD RPR FACE/MM 20.1-30.0,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
12057,CPT,INTMD RPR FACE/MM >30.0 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
13100,CPT,CMPLX RPR TRUNK 1.1-2.5 CM,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
13101,CPT,CMPLX RPR TRUNK 2.6-7.5 CM,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
13102,CPT,CMPLX RPR TRUNK ADDL 5CM/<,,30,,,"$2,361.00",$0.00,1,0,1,20210101,
13120,CPT,CMPLX RPR S/A/L 1.1-2.5 CM,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
13121,CPT,CMPLX RPR S/A/L 2.6-7.5 CM,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
13122,CPT,CMPLX RPR S/A/L ADDL 5 CM/>,,30,,,"$1,876.01",$0.00,1,0,1,20210101,
13131,CPT,CMPLX RPR F/C/C/M/N/AX/G/H/F,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
13132,CPT,CMPLX RPR F/C/C/M/N/AX/G/H/F,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
13133,CPT,CMPLX RPR F/C/C/M/N/AX/G/H/F,,30,,,"$1,438.66",$0.00,1,0,1,20210101,
13151,CPT,CMPLX RPR E/N/E/L 1.1-2.5 CM,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
13152,CPT,CMPLX RPR E/N/E/L 2.6-7.5 CM,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
13153,CPT,CMPLX RPR E/N/E/L ADDL 5CM/<,,30,,,"$1,817.74",$0.00,1,0,1,20210101,
13160,CPT,LATE CLOSURE OF WOUND,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14000,CPT,TIS TRNFR TRUNK 10 SQ CM/<,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14001,CPT,TIS TRNFR TRUNK 10.1-30SQCM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14020,CPT,TIS TRNFR S/A/L 10 SQ CM/<,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14021,CPT,TIS TRNFR S/A/L 10.1-30 SQCM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14040,CPT,TIS TRNFR F/C/C/M/N/A/G/H/F,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14041,CPT,TIS TRNFR F/C/C/M/N/A/G/H/F,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14060,CPT,TIS TRNFR E/N/E/L 10 SQ CM/<,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14061,CPT,TIS TRNFR E/N/E/L10.1-30SQCM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
14301,CPT,TIS TRNFR ANY 30.1-60 SQ CM,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
14302,CPT,TIS TRNFR ADDL 30 SQ CM,,30,,,"$4,035.51",$0.00,1,0,1,20210101,
14350,CPT,FILLETED FINGER/TOE FLAP,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15002,CPT,WOUND PREP TRK/ARM/LEG,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15003,CPT,WOUND PREP ADDL 100 CM,,30,,,"$2,012.07",$0.00,1,0,1,20210101,
15004,CPT,WOUND PREP F/N/HF/G,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
15005,CPT,WND PREP F/N/HF/G ADDL CM,,30,,,"$2,946.62",$0.00,1,0,1,20210101,
15040,CPT,HARVEST CULTURED SKIN GRAFT,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15050,CPT,SKIN PINCH GRAFT,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
15100,CPT,SKIN SPLT GRFT TRNK/ARM/LEG,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15101,CPT,SKIN SPLT GRFT T/A/L ADD-ON,,30,,,"$4,016.24",$0.00,1,0,1,20210101,
15110,CPT,EPIDRM AUTOGRFT TRNK/ARM/LEG,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15111,CPT,EPIDRM AUTOGRFT T/A/L ADD-ON,,30,,,"$2,292.76",$0.00,1,0,1,20210101,
15115,CPT,EPIDRM A-GRFT FACE/NCK/HF/G,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15116,CPT,EPIDRM A-GRFT F/N/HF/G ADDL,,30,,,"$1,637.84",$0.00,1,0,1,20210101,
15120,CPT,SKN SPLT A-GRFT FAC/NCK/HF/G,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15121,CPT,SKN SPLT A-GRFT F/N/HF/G ADD,,30,,,"$4,520.26",$0.00,1,0,1,20210101,
15130,CPT,DERM AUTOGRAFT TRNK/ARM/LEG,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15131,CPT,DERM AUTOGRAFT T/A/L ADD-ON,,30,,,"$5,009.92",$0.00,1,0,1,20210101,
15135,CPT,DERM AUTOGRAFT FACE/NCK/HF/G,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15136,CPT,DERM AUTOGRAFT F/N/HF/G ADD,,30,,,"$5,009.92",$0.00,1,0,1,20210101,
15150,CPT,CULT SKIN GRFT T/ARM/LEG,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15151,CPT,CULT SKIN GRFT T/A/L ADDL,,30,,,"$1,637.84",$0.00,1,0,1,20210101,
15152,CPT,CULT SKIN GRAFT T/A/L +%,,30,,,"$1,637.84",$0.00,1,0,1,20210101,
15155,CPT,CULT SKIN GRAFT F/N/HF/G,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15156,CPT,CULT SKIN GRFT F/N/HFG ADD,,30,,,"$1,637.84",$0.00,1,0,1,20210101,
15157,CPT,CULT EPIDERM GRFT F/N/HFG +%,,30,,,"$1,637.84",$0.00,1,0,1,20210101,
15200,CPT,SKIN FULL GRAFT TRUNK,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15201,CPT,SKIN FULL GRAFT TRUNK ADD-ON,,30,,,"$3,336.80",$0.00,1,0,1,20210101,
15220,CPT,SKIN FULL GRAFT SCLP/ARM/LEG,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15221,CPT,SKIN FULL GRAFT ADD-ON,,30,,,"$3,040.40",$0.00,1,0,1,20210101,
15240,CPT,SKIN FULL GRFT FACE/GENIT/HF,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15241,CPT,SKIN FULL GRAFT ADD-ON,,30,,,"$5,074.51",$0.00,1,0,1,20210101,
15260,CPT,SKIN FULL GRAFT EEN & LIPS,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15261,CPT,SKIN FULL GRAFT ADD-ON,,30,,,"$4,454.58",$0.00,1,0,1,20210101,
15271,CPT,SKIN SUB GRAFT TRNK/ARM/LEG,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15272,CPT,SKIN SUB GRAFT T/A/L ADD-ON,,30,,,"$1,314.39",$0.00,1,0,1,20210101,
15273,CPT,SKIN SUB GRFT T/ARM/LG CHILD,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15274,CPT,SKN SUB GRFT T/A/L CHILD ADD,,30,,,"$2,108.49",$0.00,1,0,1,20210101,
15275,CPT,SKIN SUB GRAFT FACE/NK/HF/G,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15276,CPT,SKIN SUB GRAFT F/N/HF/G ADDL,,30,,,"$1,441.89",$0.00,1,0,1,20210101,
15277,CPT,SKN SUB GRFT F/N/HF/G CHILD,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15278,CPT,SKN SUB GRFT F/N/HF/G CH ADD,,30,,,"$2,467.14",$0.00,1,0,1,20210101,
15570,CPT,SKIN PEDICLE FLAP TRUNK,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15572,CPT,SKIN PEDICLE FLAP ARMS/LEGS,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15574,CPT,PEDCLE FH/CH/CH/M/N/AX/G/H/F,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15576,CPT,PEDICLE E/N/E/L/NTRORAL,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15600,CPT,DELAY FLAP TRUNK,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15610,CPT,DELAY FLAP ARMS/LEGS,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15620,CPT,DELAY FLAP F/C/C/N/AX/G/H/F,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15630,CPT,DELAY FLAP EYE/NOS/EAR/LIP,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15650,CPT,TRANSFER SKIN PEDICLE FLAP,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15730,CPT,MDFC FLAP W/PRSRV VASC PEDCL,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15731,CPT,FOREHEAD FLAP W/VASC PEDICLE,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15733,CPT,MUSC MYOQ/FSCQ FLP H&N PEDCL,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15734,CPT,MUSCLE-SKIN GRAFT TRUNK,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15736,CPT,MUSCLE-SKIN GRAFT ARM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15738,CPT,MUSCLE-SKIN GRAFT LEG,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15740,CPT,ISLAND PEDICLE FLAP GRAFT,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15750,CPT,NEUROVASCULAR PEDICLE FLAP,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15760,CPT,COMPOSITE SKIN GRAFT,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15769,CPT,GRFG AUTOL SOFT TISS DIR EXC,,30,,,"$13,294.62",$0.00,1,0,1,20210101,
15770,CPT,DERMA-FAT-FASCIA GRAFT,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15771,CPT,GRFG AUTOL FAT LIPO 50 CC/<,,30,,,"$13,294.62",$0.00,1,0,1,20210101,
15773,CPT,GRFG AUTOL FAT LIPO 25 CC/<,,30,,,"$7,320.27",$0.00,1,0,1,20210101,
15775,CPT,HAIR TRNSPL 1-15 PUNCH GRFTS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
15776,CPT,HAIR TRNSPL >15 PUNCH GRAFTS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
15777,CPT,ACELLULAR DERM MATRIX IMPLT,,30,,,"$8,892.61",$0.00,1,0,1,20210101,
15780,CPT,DERMABRASION TOTAL FACE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15781,CPT,DERMABRASION SEGMENTAL FACE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
15782,CPT,DERMABRASION OTHER THAN FACE,,30,,,"$11,770.39",$0.00,1,0,1,20210101,
15783,CPT,DERMABRASION SUPRFL ANY SITE,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
15786,CPT,ABRASION LESION SINGLE,,30,,,$677.96,$0.00,1,0,1,20210101,
15787,CPT,ABRASION LESIONS ADD-ON,,30,,,$636.07,$0.00,1,0,1,20210101,
15788,CPT,CHEMICAL PEEL FACE EPIDERM,,30,,,$847.76,$0.00,1,0,1,20210101,
15789,CPT,CHEMICAL PEEL FACE DERMAL,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
15792,CPT,CHEMICAL PEEL NONFACIAL,,30,,,"$2,401.64",$0.00,1,0,1,20210101,
15793,CPT,CHEMICAL PEEL NONFACIAL,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
15819,CPT,PLASTIC SURGERY NECK,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15820,CPT,REVISION OF LOWER EYELID,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15821,CPT,REVISION OF LOWER EYELID,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15822,CPT,REVISION OF UPPER EYELID,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15823,CPT,REVISION OF UPPER EYELID,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15824,CPT,REMOVAL OF FOREHEAD WRINKLES,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15825,CPT,REMOVAL OF NECK WRINKLES,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15826,CPT,REMOVAL OF BROW WRINKLES,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15828,CPT,REMOVAL OF FACE WRINKLES,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15829,CPT,REMOVAL OF SKIN WRINKLES,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15830,CPT,EXC SKIN ABD,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
15832,CPT,EXCISE EXCESSIVE SKIN THIGH,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15833,CPT,EXCISE EXCESSIVE SKIN LEG,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15834,CPT,EXCISE EXCESSIVE SKIN HIP,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15835,CPT,EXCISE EXCESSIVE SKIN BUTTCK,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15836,CPT,EXCISE EXCESSIVE SKIN ARM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15837,CPT,EXCISE EXCESS SKIN ARM/HAND,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15838,CPT,EXCISE EXCESS SKIN FAT PAD,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15839,CPT,EXCISE EXCESS SKIN & TISSUE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15840,CPT,NERVE PALSY FASCIAL GRAFT,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15841,CPT,NERVE PALSY MUSCLE GRAFT,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15842,CPT,NERVE PALSY MICROSURG GRAFT,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15845,CPT,SKIN AND MUSCLE REPAIR FACE,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15847,CPT,EXC SKIN ABD ADD-ON,,30,,,"$9,042.60",$0.00,1,0,1,20210101,
15850,CPT,REMOVE SUTURES SAME SURGEON,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
15851,CPT,REMOVE SUTURES DIFF SURGEON,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15852,CPT,DRESSING CHANGE NOT FOR BURN,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
15860,CPT,TEST FOR BLOOD FLOW IN GRAFT,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
15876,CPT,SUCTION LIPECTOMY HEAD&NECK,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15877,CPT,SUCTION LIPECTOMY TRUNK,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15878,CPT,SUCTION LIPECTOMY UPR EXTREM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15879,CPT,SUCTION LIPECTOMY LWR EXTREM,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15920,CPT,REMOVAL OF TAIL BONE ULCER,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15922,CPT,REMOVAL OF TAIL BONE ULCER,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15931,CPT,REMOVE SACRUM PRESSURE SORE,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
15933,CPT,REMOVE SACRUM PRESSURE SORE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15934,CPT,REMOVE SACRUM PRESSURE SORE,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15935,CPT,REMOVE SACRUM PRESSURE SORE,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15936,CPT,REMOVE SACRUM PRESSURE SORE,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15937,CPT,REMOVE SACRUM PRESSURE SORE,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15940,CPT,REMOVE HIP PRESSURE SORE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15941,CPT,REMOVE HIP PRESSURE SORE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15944,CPT,REMOVE HIP PRESSURE SORE,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15945,CPT,REMOVE HIP PRESSURE SORE,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15946,CPT,REMOVE HIP PRESSURE SORE,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15950,CPT,REMOVE THIGH PRESSURE SORE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
15951,CPT,REMOVE THIGH PRESSURE SORE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
15952,CPT,REMOVE THIGH PRESSURE SORE,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15953,CPT,REMOVE THIGH PRESSURE SORE,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15956,CPT,REMOVE THIGH PRESSURE SORE,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
15958,CPT,REMOVE THIGH PRESSURE SORE,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
15999,CPT,REMOVAL OF PRESSURE SORE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
16000,CPT,INITIAL TREATMENT OF BURN(S),,30,,,$677.96,$0.00,1,0,1,20210101,
16020,CPT,DRESS/DEBRID P-THICK BURN S,,30,,,$677.96,$0.00,1,0,1,20210101,
16025,CPT,DRESS/DEBRID P-THICK BURN M,,30,,,$677.96,$0.00,1,0,1,20210101,
16030,CPT,DRESS/DEBRID P-THICK BURN L,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
16035,CPT,INCISION OF BURN SCAB INITI,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17000,CPT,DESTRUCT PREMALG LESION,,30,,,$677.96,$0.00,1,0,1,20210101,
17003,CPT,DESTRUCT PREMALG LES 2-14,,30,,,$130.66,$0.00,1,0,1,20210101,
17004,CPT,DESTROY PREMAL LESIONS 15/>,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17106,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17107,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
17108,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
17110,CPT,DESTRUCT B9 LESION 1-14,,30,,,$677.96,$0.00,1,0,1,20210101,
17111,CPT,DESTRUCT LESION 15 OR MORE,,30,,,$677.96,$0.00,1,0,1,20210101,
17250,CPT,CHEM CAUT OF GRANLTJ TISSUE,,30,,,$677.96,$0.00,1,0,1,20210101,
17260,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17261,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17262,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17263,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17264,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17266,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17270,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17271,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17272,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17273,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17274,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17276,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17280,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,$677.96,$0.00,1,0,1,20210101,
17281,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17282,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17283,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
17284,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
17286,CPT,DESTRUCTION OF SKIN LESIONS,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
17311,CPT,MOHS 1 STAGE H/N/HF/G,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
17312,CPT,MOHS ADDL STAGE,,30,,,"$1,541.90",$0.00,1,0,1,20210101,
17313,CPT,MOHS 1 STAGE T/A/L,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
17314,CPT,MOHS ADDL STAGE T/A/L,,30,,,"$1,591.40",$0.00,1,0,1,20210101,
17315,CPT,MOHS SURG ADDL BLOCK,,30,,,"$1,238.54",$0.00,1,0,1,20210101,
17340,CPT,CRYOTHERAPY OF SKIN,,30,,,$224.79,$0.00,1,0,1,20210101,
17360,CPT,SKIN PEEL THERAPY,,30,,,$677.96,$0.00,1,0,1,20210101,
17380,CPT,HAIR REMOVAL BY ELECTROLYSIS,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
17999,CPT,SKIN TISSUE PROCEDURE,,30,,,$677.96,$0.00,1,0,1,20210101,
19000,CPT,DRAINAGE OF BREAST LESION,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
19001,CPT,DRAIN BREAST LESION ADD-ON,,30,,,$708.04,$0.00,1,0,1,20210101,
19020,CPT,INCISION OF BREAST LESION,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
19030,CPT,INJECTION FOR BREAST X-RAY,,30,,,$767.33,$0.00,1,0,1,20210101,
19081,CPT,BX BREAST 1ST LESION STRTCTC,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
19082,CPT,BX BREAST ADD LESION STRTCTC,,30,,,"$4,746.96",$0.00,1,0,1,20210101,
19083,CPT,BX BREAST 1ST LESION US IMAG,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
19084,CPT,BX BREAST ADD LESION US IMAG,,30,,,"$3,600.05",$0.00,1,0,1,20210101,
19085,CPT,BX BREAST 1ST LESION MR IMAG,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
19086,CPT,BX BREAST ADD LESION MR IMAG,,30,,,"$6,149.33",$0.00,1,0,1,20210101,
19100,CPT,BX BREAST PERCUT W/O IMAGE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
19101,CPT,BIOPSY OF BREAST OPEN,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19105,CPT,CRYOSURG ABLATE FA EACH,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19110,CPT,NIPPLE EXPLORATION,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19112,CPT,EXCISE BREAST DUCT FISTULA,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19120,CPT,REMOVAL OF BREAST LESION,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19125,CPT,EXCISION BREAST LESION,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19126,CPT,EXCISION ADDL BREAST LESION,,30,,,"$4,860.87",$0.00,1,0,1,20210101,
19281,CPT,PERQ DEVICE BREAST 1ST IMAG,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
19282,CPT,PERQ DEVICE BREAST EA IMAG,,30,,,"$2,124.24",$0.00,1,0,1,20210101,
19283,CPT,PERQ DEV BREAST 1ST STRTCTC,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
19284,CPT,PERQ DEV BREAST ADD STRTCTC,,30,,,"$3,308.22",$0.00,1,0,1,20210101,
19285,CPT,PERQ DEV BREAST 1ST US IMAG,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
19286,CPT,PERQ DEV BREAST ADD US IMAG,,30,,,"$1,973.17",$0.00,1,0,1,20210101,
19287,CPT,PERQ DEV BREAST 1ST MR GUIDE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
19288,CPT,PERQ DEV BREAST ADD MR GUIDE,,30,,,"$6,245.24",$0.00,1,0,1,20210101,
19294,CPT,PREP TUM CAV IORT PRTL MAST,,30,,,"$9,617.69",$0.00,1,0,1,20210101,
19296,CPT,PLACE PO BREAST CATH FOR RAD,,30,,,"$23,368.53",$0.00,1,0,1,20210101,
19297,CPT,PLACE BREAST CATH FOR RAD,,30,,,"$11,245.66",$0.00,1,0,1,20210101,
19298,CPT,PLACE BREAST RAD TUBE/CATHS,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19300,CPT,REMOVAL OF BREAST TISSUE,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19301,CPT,PARTIAL MASTECTOMY,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19302,CPT,P-MASTECTOMY W/LN REMOVAL,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19303,CPT,MAST SIMPLE COMPLETE,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19307,CPT,MAST MOD RAD,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19316,CPT,SUSPENSION OF BREAST,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19318,CPT,BREAST REDUCTION,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19325,CPT,BREAST AUGMENTATION W/IMPLT,,30,,,"$23,368.53",$0.00,1,0,1,20210101,
19328,CPT,RMVL INTACT BREAST IMPLANT,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19330,CPT,RMVL RUPTURED BREAST IMPLANT,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19340,CPT,INSJ BREAST IMPLT SM D MAST,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19342,CPT,INSJ/RPLCMT BRST IMPLT SEP D,,30,,,"$23,368.53",$0.00,1,0,1,20210101,
19350,CPT,BREAST RECONSTRUCTION,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19355,CPT,CORRECT INVERTED NIPPLE(S),,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19357,CPT,TISS XPNDR PLMT BRST RCNSTJ,,30,,,"$28,449.99",$0.00,1,0,1,20210101,
19370,CPT,REVJ PERI-IMPLT CAPSULE BRST,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19371,CPT,PERI-IMPLT CAPSLC BRST COMPL,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19380,CPT,REVJ RECONSTRUCTED BREAST,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
19396,CPT,DESIGN CUSTOM BREAST IMPLANT,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
19499,CPT,BREAST SURGERY PROCEDURE,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
20100,CPT,EXPLORE WOUND NECK,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
20101,CPT,EXPLORE WOUND CHEST,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
20102,CPT,EXPLORE WOUND ABDOMEN,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
20103,CPT,EXPLORE WOUND EXTREMITY,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
20150,CPT,EXCISE EPIPHYSEAL BAR,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
20200,CPT,MUSCLE BIOPSY,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
20205,CPT,DEEP MUSCLE BIOPSY,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
20206,CPT,NEEDLE BIOPSY MUSCLE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
20220,CPT,BONE BIOPSY TROCAR/NEEDLE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
20225,CPT,BONE BIOPSY TROCAR/NEEDLE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
20240,CPT,BONE BIOPSY OPEN SUPERFICIAL,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
20245,CPT,BONE BIOPSY OPEN DEEP,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
20250,CPT,OPEN BONE BIOPSY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
20251,CPT,OPEN BONE BIOPSY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20500,CPT,INJECTION OF SINUS TRACT,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
20501,CPT,INJECT SINUS TRACT FOR X-RAY,,30,,,$959.66,$0.00,1,0,1,20210101,
20520,CPT,REMOVAL OF FOREIGN BODY,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
20525,CPT,REMOVAL OF FOREIGN BODY,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
20526,CPT,THER INJECTION CARP TUNNEL,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20527,CPT,INJ DUPUYTREN CORD W/ENZYME,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20550,CPT,INJ TENDON SHEATH/LIGAMENT,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20551,CPT,INJ TENDON ORIGIN/INSERTION,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20552,CPT,INJ TRIGGER POINT 1/2 MUSCL,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20553,CPT,INJECT TRIGGER POINTS 3/>,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20555,CPT,PLACE NDL MUSC/TIS FOR RT,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
20560,CPT,NDL INSJ W/O NJX 1 OR 2 MUSC,,30,,,$164.25,$0.00,1,0,1,20210101,
20561,CPT,NDL INSJ W/O NJX 3+ MUSC,,30,,,$164.25,$0.00,1,0,1,20210101,
20600,CPT,DRAIN/INJ JOINT/BURSA W/O US,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20604,CPT,DRAIN/INJ JOINT/BURSA W/US,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20605,CPT,DRAIN/INJ JOINT/BURSA W/O US,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20606,CPT,DRAIN/INJ JOINT/BURSA W/US,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
20610,CPT,DRAIN/INJ JOINT/BURSA W/O US,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20611,CPT,DRAIN/INJ JOINT/BURSA W/US,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20612,CPT,ASPIRATE/INJ GANGLION CYST,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
20615,CPT,TREATMENT OF BONE CYST,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
20650,CPT,INSERT AND REMOVE BONE PIN,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
20660,CPT,APPLY REM FIXATION DEVICE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
20661,CPT,APPLICATION OF HEAD BRACE,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
20662,CPT,APPLICATION OF PELVIS BRACE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
20663,CPT,APPLICATION OF THIGH BRACE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
20664,CPT,APPLICATION OF HALO,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
20665,CPT,REMOVAL OF FIXATION DEVICE,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
20670,CPT,REMOVAL OF SUPPORT IMPLANT,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
20680,CPT,REMOVAL OF SUPPORT IMPLANT,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
20690,CPT,APPLY BONE FIXATION DEVICE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20692,CPT,APPLY BONE FIXATION DEVICE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
20693,CPT,ADJUST BONE FIXATION DEVICE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20694,CPT,REMOVE BONE FIXATION DEVICE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
20696,CPT,COMP MULTIPLANE EXT FIXATION,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
20697,CPT,COMP EXT FIXATE STRUT CHANGE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
20802,CPT,REPLANTATION ARM COMPLETE,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
20805,CPT,REPLANT FOREARM COMPLETE,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
20808,CPT,REPLANTATION HAND COMPLETE,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
20816,CPT,REPLANTATION DIGIT COMPLETE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20822,CPT,REPLANTATION DIGIT COMPLETE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
20824,CPT,REPLANTATION THUMB COMPLETE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20827,CPT,REPLANTATION THUMB COMPLETE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20838,CPT,REPLANTATION FOOT COMPLETE,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
20900,CPT,REMOVAL OF BONE FOR GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20902,CPT,REMOVAL OF BONE FOR GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20910,CPT,REMOVE CARTILAGE FOR GRAFT,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
20912,CPT,REMOVE CARTILAGE FOR GRAFT,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
20920,CPT,REMOVAL OF FASCIA FOR GRAFT,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
20922,CPT,REMOVAL OF FASCIA FOR GRAFT,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
20924,CPT,REMOVAL OF TENDON FOR GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20930,CPT,SP BONE ALGRFT MORSEL ADD-ON,,30,,,"$7,225.53",$0.00,1,0,1,20210101,
20931,CPT,SP BONE ALGRFT STRUCT ADD-ON,,30,,,"$7,991.67",$0.00,1,0,1,20210101,
20936,CPT,SP BONE AGRFT LOCAL ADD-ON,,30,,,"$7,670.01",$0.00,1,0,1,20210101,
20937,CPT,SP BONE AGRFT MORSEL ADD-ON,,30,,,"$6,356.68",$0.00,1,0,1,20210101,
20938,CPT,SP BONE AGRFT STRUCT ADD-ON,,30,,,"$11,028.99",$0.00,1,0,1,20210101,
20939,CPT,BONE MARROW ASPIR BONE GRFG,,30,,,"$7,058.66",$0.00,1,0,1,20210101,
20950,CPT,FLUID PRESSURE MUSCLE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
20955,CPT,FIBULA BONE GRAFT MICROVASC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20956,CPT,ILIAC BONE GRAFT MICROVASC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20957,CPT,MT BONE GRAFT MICROVASC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20962,CPT,OTHER BONE GRAFT MICROVASC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20969,CPT,BONE/SKIN GRAFT MICROVASC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20970,CPT,BONE/SKIN GRAFT ILIAC CREST,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
20972,CPT,BONE/SKIN GRAFT METATARSAL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20973,CPT,BONE/SKIN GRAFT GREAT TOE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20975,CPT,ELECTRICAL BONE STIMULATION,,30,,,"$8,848.58",$0.00,1,0,1,20210101,
20979,CPT,US BONE STIMULATION,,30,,,$152.35,$0.00,1,0,1,20210101,
20982,CPT,ABLATE BONE TUMOR(S) PERQ,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20983,CPT,ABLATE BONE TUMOR(S) PERQ,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
20985,CPT,CPTR-ASST DIR MS PX,,30,,,"$14,810.98",$0.00,1,0,1,20210101,
20999,CPT,MUSCULOSKELETAL SURGERY,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
21010,CPT,INCISION OF JAW JOINT,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21011,CPT,EXC FACE LES SC <2 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21012,CPT,EXC FACE LES SBQ 2 CM/>,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21013,CPT,EXC FACE TUM DEEP < 2 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21014,CPT,EXC FACE TUM DEEP 2 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21015,CPT,RESECT FACE/SCALP TUM < 2 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21016,CPT,RESECT FACE/SCALP TUM 2 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21025,CPT,EXCISION OF BONE LOWER JAW,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21026,CPT,EXCISION OF FACIAL BONE(S),,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21029,CPT,CONTOUR OF FACE BONE LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21030,CPT,EXCISE MAX/ZYGOMA B9 TUMOR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21031,CPT,REMOVE EXOSTOSIS MANDIBLE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21032,CPT,REMOVE EXOSTOSIS MAXILLA,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21034,CPT,EXCISE MAX/ZYGOMA MAL TUMOR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21040,CPT,EXCISE MANDIBLE LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21044,CPT,REMOVAL OF JAW BONE LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21045,CPT,EXTENSIVE JAW SURGERY,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21046,CPT,REMOVE MANDIBLE CYST COMPLEX,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21047,CPT,EXCISE LWR JAW CYST W/REPAIR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21048,CPT,REMOVE MAXILLA CYST COMPLEX,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21049,CPT,EXCIS UPPR JAW CYST W/REPAIR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21050,CPT,REMOVAL OF JAW JOINT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21060,CPT,REMOVE JAW JOINT CARTILAGE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21070,CPT,REMOVE CORONOID PROCESS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21073,CPT,MNPJ OF TMJ W/ANESTH,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21076,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21077,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21079,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21080,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21081,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21082,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21083,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21084,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21085,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$1,490.05",$0.00,1,0,1,20210101,
21086,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21087,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21088,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21089,CPT,PREPARE FACE/ORAL PROSTHESIS,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
21100,CPT,MAXILLOFACIAL FIXATION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21110,CPT,INTERDENTAL FIXATION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21116,CPT,INJECTION JAW JOINT X-RAY,,30,,,$429.46,$0.00,1,0,1,20210101,
21120,CPT,RECONSTRUCTION OF CHIN,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21121,CPT,RECONSTRUCTION OF CHIN,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21122,CPT,RECONSTRUCTION OF CHIN,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21123,CPT,RECONSTRUCTION OF CHIN,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21125,CPT,AUGMENTATION LOWER JAW BONE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21127,CPT,AUGMENTATION LOWER JAW BONE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21137,CPT,REDUCTION OF FOREHEAD,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21138,CPT,REDUCTION OF FOREHEAD,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21139,CPT,REDUCTION OF FOREHEAD,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21141,CPT,LEFORT I-1 PIECE W/O GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21142,CPT,LEFORT I-2 PIECE W/O GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21143,CPT,LEFORT I-3/> PIECE W/O GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21145,CPT,LEFORT I-1 PIECE W/ GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21146,CPT,LEFORT I-2 PIECE W/ GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21147,CPT,LEFORT I-3/> PIECE W/ GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21150,CPT,LEFORT II ANTERIOR INTRUSION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21151,CPT,LEFORT II W/BONE GRAFTS,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21154,CPT,LEFORT III W/O LEFORT I,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21155,CPT,LEFORT III W/ LEFORT I,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21159,CPT,LEFORT III W/FHDW/O LEFORT I,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21160,CPT,LEFORT III W/FHD W/ LEFORT I,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21172,CPT,RECONSTRUCT ORBIT/FOREHEAD,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21175,CPT,RECONSTRUCT ORBIT/FOREHEAD,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21179,CPT,RECONSTRUCT ENTIRE FOREHEAD,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21180,CPT,RECONSTRUCT ENTIRE FOREHEAD,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21181,CPT,CONTOUR CRANIAL BONE LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21182,CPT,RECONSTRUCT CRANIAL BONE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21183,CPT,RECONSTRUCT CRANIAL BONE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21184,CPT,RECONSTRUCT CRANIAL BONE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21188,CPT,RECONSTRUCTION OF MIDFACE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21193,CPT,RECONST LWR JAW W/O GRAFT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21194,CPT,RECONST LWR JAW W/GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21195,CPT,RECONST LWR JAW W/O FIXATION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21196,CPT,RECONST LWR JAW W/FIXATION,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21198,CPT,RECONSTR LWR JAW SEGMENT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21199,CPT,RECONSTR LWR JAW W/ADVANCE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21206,CPT,RECONSTRUCT UPPER JAW BONE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21208,CPT,AUGMENTATION OF FACIAL BONES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21209,CPT,REDUCTION OF FACIAL BONES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21210,CPT,FACE BONE GRAFT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21215,CPT,LOWER JAW BONE GRAFT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21230,CPT,RIB CARTILAGE GRAFT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21235,CPT,EAR CARTILAGE GRAFT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21240,CPT,RECONSTRUCTION OF JAW JOINT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21242,CPT,RECONSTRUCTION OF JAW JOINT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21243,CPT,RECONSTRUCTION OF JAW JOINT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
21244,CPT,RECONSTRUCTION OF LOWER JAW,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21245,CPT,RECONSTRUCTION OF JAW,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21246,CPT,RECONSTRUCTION OF JAW,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21247,CPT,RECONSTRUCT LOWER JAW BONE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21248,CPT,RECONSTRUCTION OF JAW,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21249,CPT,RECONSTRUCTION OF JAW,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21255,CPT,RECONSTRUCT LOWER JAW BONE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21256,CPT,RECONSTRUCTION OF ORBIT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21260,CPT,REVISE EYE SOCKETS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21261,CPT,REVISE EYE SOCKETS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21263,CPT,REVISE EYE SOCKETS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21267,CPT,REVISE EYE SOCKETS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21268,CPT,REVISE EYE SOCKETS,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21270,CPT,AUGMENTATION CHEEK BONE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21275,CPT,REVISION ORBITOFACIAL BONES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21280,CPT,REVISION OF EYELID,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21282,CPT,REVISION OF EYELID,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21295,CPT,REVISION OF JAW MUSCLE/BONE,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21296,CPT,REVISION OF JAW MUSCLE/BONE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21299,CPT,CRANIO/MAXILLOFACIAL SURGERY,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
21310,CPT,CLOSED TX NOSE FX W/O MANJ,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
21315,CPT,CLOSED TX NOSE FX W/O STABLJ,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21320,CPT,CLOSED TX NOSE FX W/ STABLJ,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21325,CPT,OPEN TX NOSE FX UNCOMPLICATD,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21330,CPT,OPEN TX NOSE FX W/SKELE FIXJ,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21335,CPT,OPEN TX NOSE & SEPTAL FX,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21336,CPT,OPEN TX SEPTAL FX W/WO STABJ,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
21337,CPT,CLOSED TX SEPTAL&NOSE FX,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21338,CPT,OPEN NASOETHMOID FX W/O FIXJ,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21339,CPT,OPEN NASOETHMOID FX W/ FIXJ,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21340,CPT,PERQ TX NASOETHMOID FX,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21343,CPT,OPEN TX DPRSD FRONT SINUS FX,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21344,CPT,OPEN TX COMPL FRONT SINUS FX,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21345,CPT,CLOSED TX NOSE/JAW FX,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21346,CPT,OPN TX NASOMAX FX W/FIXJ,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21347,CPT,OPN TX NASOMAX FX MULTPLE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21348,CPT,OPN TX NASOMAX FX W/GRAFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21355,CPT,PERQ TX MALAR FRACTURE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21356,CPT,OPN TX DPRSD ZYGOMATIC ARCH,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21360,CPT,OPN TX DPRSD MALAR FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21365,CPT,OPN TX COMPLX MALAR FX,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21366,CPT,OPN TX COMPLX MALAR W/GRFT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21385,CPT,OPN TX ORBIT FX TRANSANTRAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21386,CPT,OPN TX ORBIT FX PERIORBITAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21387,CPT,OPN TX ORBIT FX COMBINED,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21390,CPT,OPN TX ORBIT PERIORBTL IMPLT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21395,CPT,OPN TX ORBIT PERIORBT W/GRFT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21400,CPT,CLOSED TX ORBIT W/O MANIPULJ,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
21401,CPT,CLOSED TX ORBIT W/MANIPULJ,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21406,CPT,OPN TX ORBIT FX W/O IMPLANT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21407,CPT,OPN TX ORBIT FX W/IMPLANT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21408,CPT,OPN TX ORBIT FX W/BONE GRFT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21421,CPT,TREAT MOUTH ROOF FRACTURE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21422,CPT,TREAT MOUTH ROOF FRACTURE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21423,CPT,TREAT MOUTH ROOF FRACTURE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21431,CPT,TREAT CRANIOFACIAL FRACTURE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21432,CPT,TREAT CRANIOFACIAL FRACTURE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21433,CPT,TREAT CRANIOFACIAL FRACTURE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21435,CPT,TREAT CRANIOFACIAL FRACTURE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21436,CPT,TREAT CRANIOFACIAL FRACTURE,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
21440,CPT,TREAT DENTAL RIDGE FRACTURE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21445,CPT,TREAT DENTAL RIDGE FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21450,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
21451,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21452,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21453,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21454,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21461,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21462,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21465,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21470,CPT,TREAT LOWER JAW FRACTURE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21480,CPT,RESET DISLOCATED JAW,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
21485,CPT,RESET DISLOCATED JAW,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21490,CPT,REPAIR DISLOCATED JAW,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
21497,CPT,INTERDENTAL WIRING,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
21499,CPT,HEAD SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
21501,CPT,DRAIN NECK/CHEST LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21502,CPT,DRAIN CHEST LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
21510,CPT,DRAINAGE OF BONE LESION,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21550,CPT,BIOPSY OF NECK/CHEST,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21552,CPT,EXC NECK LES SC 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21554,CPT,EXC NECK TUM DEEP 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21555,CPT,EXC NECK LES SC < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21556,CPT,EXC NECK TUM DEEP < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21557,CPT,RESECT NECK THORAX TUMOR<5CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21558,CPT,RESECT NECK TUMOR 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21600,CPT,PARTIAL REMOVAL OF RIB,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
21601,CPT,EXC CHEST WALL TUMOR W/RIBS,,30,,,"$13,070.86",$0.00,1,0,1,20210101,
21602,CPT,EXC CH WAL TUM W/O LYMPHADEC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21603,CPT,EXC CH WAL TUM W/LYMPHADEC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21610,CPT,PARTIAL REMOVAL OF RIB,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
21615,CPT,REMOVAL OF RIB,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21616,CPT,REMOVAL OF RIB AND NERVES,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21620,CPT,PARTIAL REMOVAL OF STERNUM,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21627,CPT,STERNAL DEBRIDEMENT,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21630,CPT,EXTENSIVE STERNUM SURGERY,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21632,CPT,EXTENSIVE STERNUM SURGERY,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21685,CPT,HYOID MYOTOMY & SUSPENSION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
21700,CPT,REVISION OF NECK MUSCLE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
21705,CPT,REVISION OF NECK MUSCLE/RIB,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21720,CPT,REVISION OF NECK MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
21725,CPT,REVISION OF NECK MUSCLE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
21740,CPT,RECONSTRUCTION OF STERNUM,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21742,CPT,REPAIR STERN/NUSS W/O SCOPE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
21743,CPT,REPAIR STERNUM/NUSS W/SCOPE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
21750,CPT,REPAIR OF STERNUM SEPARATION,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21811,CPT,OPTX OF RIB FX W/FIXJ SCOPE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
21812,CPT,TREATMENT OF RIB FRACTURE,,30,,,"$20,116.91",$0.00,1,0,1,20210101,
21813,CPT,TREATMENT OF RIB FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
21820,CPT,TREAT STERNUM FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
21825,CPT,TREAT STERNUM FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
21899,CPT,NECK/CHEST SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
21920,CPT,BIOPSY SOFT TISSUE OF BACK,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21925,CPT,BIOPSY SOFT TISSUE OF BACK,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21930,CPT,EXC BACK LES SC < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21931,CPT,EXC BACK LES SC 3 CM/>,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
21932,CPT,EXC BACK TUM DEEP < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21933,CPT,EXC BACK TUM DEEP 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21935,CPT,RESECT BACK TUM < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
21936,CPT,RESECT BACK TUM 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
22010,CPT,I&D P-SPINE C/T/CERV-THOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22015,CPT,I&D ABSCESS P-SPINE L/S/LS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22100,CPT,REMOVE PART OF NECK VERTEBRA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
22101,CPT,REMOVE PART THORAX VERTEBRA,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
22102,CPT,REMOVE PART LUMBAR VERTEBRA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
22103,CPT,REMOVE EXTRA SPINE SEGMENT,,30,,,"$6,510.23",$0.00,1,0,1,20210101,
22110,CPT,REMOVE PART OF NECK VERTEBRA,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22112,CPT,REMOVE PART THORAX VERTEBRA,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22114,CPT,REMOVE PART LUMBAR VERTEBRA,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22206,CPT,INCIS SPINE 3 COLUMN THORAC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22207,CPT,INCIS SPINE 3 COLUMN LUMBAR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22210,CPT,INCIS 1 VERTEBRAL SEG CERV,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22212,CPT,INCIS 1 VERTEBRAL SEG THORAC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22214,CPT,INCIS 1 VERTEBRAL SEG LUMBAR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22220,CPT,INCIS W/DISCECTOMY CERVICAL,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22222,CPT,INCIS W/DISCECTOMY THORACIC,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22224,CPT,INCIS W/DISCECTOMY LUMBAR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
22310,CPT,CLOSED TX VERT FX W/O MANJ,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
22315,CPT,CLOSED TX VERT FX W/MANJ,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
22318,CPT,TREAT ODONTOID FX W/O GRAFT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22319,CPT,TREAT ODONTOID FX W/GRAFT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22325,CPT,TREAT SPINE FRACTURE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22326,CPT,TREAT NECK SPINE FRACTURE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22327,CPT,TREAT THORAX SPINE FRACTURE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22505,CPT,MANIPULATION OF SPINE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
22510,CPT,PERQ CERVICOTHORACIC INJECT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
22511,CPT,PERQ LUMBOSACRAL INJECTION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
22512,CPT,VERTEBROPLASTY ADDL INJECT,,30,,,"$8,505.08",$0.00,1,0,1,20210101,
22513,CPT,PERQ VERTEBRAL AUGMENTATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
22514,CPT,PERQ VERTEBRAL AUGMENTATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
22515,CPT,PERQ VERTEBRAL AUGMENTATION,,30,,,"$12,248.70",$0.00,1,0,1,20210101,
22526,CPT,IDET SINGLE LEVEL,,30,,,"$7,285.51",$0.00,1,0,1,20210101,
22527,CPT,IDET 1 OR MORE LEVELS,,30,,,"$3,187.12",$0.00,1,0,1,20210101,
22532,CPT,LAT THORAX SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22533,CPT,LAT LUMBAR SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22548,CPT,NECK SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22551,CPT,NECK SPINE FUSE&REMOV BEL C2,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
22552,CPT,ADDL NECK SPINE FUSION,,30,,,"$7,181.08",$0.00,1,0,1,20210101,
22554,CPT,NECK SPINE FUSION,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
22556,CPT,THORAX SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22558,CPT,LUMBAR SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22585,CPT,ADDITIONAL SPINAL FUSION,,30,,,"$6,957.83",$0.00,1,0,1,20210101,
22586,CPT,PRESCRL FUSE W/ INSTR L5-S1,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22590,CPT,SPINE & SKULL SPINAL FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22595,CPT,NECK SPINAL FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22600,CPT,NECK SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22610,CPT,THORAX SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22612,CPT,LUMBAR SPINE FUSION,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
22614,CPT,SPINE FUSION EXTRA SEGMENT,,30,,,"$10,123.02",$0.00,1,0,1,20210101,
22630,CPT,LUMBAR SPINE FUSION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22632,CPT,SPINE FUSION EXTRA SEGMENT,,30,,,"$11,352.81",$0.00,1,0,1,20210101,
22633,CPT,LUMBAR SPINE FUSION COMBINED,,30,,,"$24,961.34",$0.00,1,0,1,20210101,
22634,CPT,SPINE FUSION EXTRA SEGMENT,,30,,,"$15,417.08",$0.00,1,0,1,20210101,
22800,CPT,POST FUSION </6 VERT SEG,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22802,CPT,POST FUSION 7-12 VERT SEG,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22804,CPT,POST FUSION 13/> VERT SEG,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22808,CPT,ANT FUSION 2-3 VERT SEG,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22810,CPT,ANT FUSION 4-7 VERT SEG,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22812,CPT,ANT FUSION 8/> VERT SEG,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22818,CPT,KYPHECTOMY 1-2 SEGMENTS,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22819,CPT,KYPHECTOMY 3 OR MORE,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22830,CPT,EXPLORATION OF SPINAL FUSION,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22840,CPT,INSERT SPINE FIXATION DEVICE,,30,,,"$10,947.25",$0.00,1,0,1,20210101,
22842,CPT,INSERT SPINE FIXATION DEVICE,,30,,,"$9,796.71",$0.00,1,0,1,20210101,
22845,CPT,INSERT SPINE FIXATION DEVICE,,30,,,"$7,098.15",$0.00,1,0,1,20210101,
22846,CPT,INSERT SPINE FIXATION DEVICE,,30,,,"$10,409.71",$0.00,1,0,1,20210101,
22849,CPT,REINSERT SPINAL FIXATION,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22850,CPT,REMOVE SPINE FIXATION DEVICE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22852,CPT,REMOVE SPINE FIXATION DEVICE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22853,CPT,INSJ BIOMECHANICAL DEVICE,,30,,,"$6,794.15",$0.00,1,0,1,20210101,
22854,CPT,INSJ BIOMECHANICAL DEVICE,,30,,,"$7,129.67",$0.00,1,0,1,20210101,
22855,CPT,REMOVE SPINE FIXATION DEVICE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22856,CPT,CERV ARTIFIC DISKECTOMY,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
22857,CPT,LUMBAR ARTIF DISKECTOMY,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22858,CPT,SECOND LEVEL CER DISKECTOMY,,30,,,"$11,994.17",$0.00,1,0,1,20210101,
22859,CPT,INSJ BIOMECHANICAL DEVICE,,30,,,"$7,161.96",$0.00,1,0,1,20210101,
22861,CPT,REVISE CERV ARTIFIC DISC,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22862,CPT,REVISE LUMBAR ARTIF DISC,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
22864,CPT,REMOVE CERV ARTIF DISC,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22865,CPT,REMOVE LUMB ARTIF DISC,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
22867,CPT,INSJ STABLJ DEV W/DCMPRN,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
22868,CPT,INSJ STABLJ DEV W/DCMPRN,,30,,,"$10,087.14",$0.00,1,0,1,20210101,
22869,CPT,INSJ STABLJ DEV W/O DCMPRN,,30,,,"$27,099.10",$0.00,1,0,1,20210101,
22870,CPT,INSJ STABLJ DEV W/O DCMPRN,,30,,,"$11,401.19",$0.00,1,0,1,20210101,
22899,CPT,SPINE SURGERY PROCEDURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
22900,CPT,EXC ABDL TUM DEEP < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
22901,CPT,EXC ABDL TUM DEEP 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
22902,CPT,EXC ABD LES SC < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
22903,CPT,EXC ABD LES SC 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
22904,CPT,RADICAL RESECT ABD TUMOR<5CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
22905,CPT,RAD RESECT ABD TUMOR 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
22999,CPT,ABDOMEN SURGERY PROCEDURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23000,CPT,REMOVAL OF CALCIUM DEPOSITS,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23020,CPT,RELEASE SHOULDER JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23030,CPT,DRAIN SHOULDER LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23031,CPT,DRAIN SHOULDER BURSA,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
23035,CPT,DRAIN SHOULDER BONE LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23040,CPT,EXPLORATORY SHOULDER SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23044,CPT,EXPLORATORY SHOULDER SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23065,CPT,BIOPSY SHOULDER TISSUES,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
23066,CPT,BIOPSY SHOULDER TISSUES,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23071,CPT,EXC SHOULDER LES SC 3 CM/>,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
23073,CPT,EXC SHOULDER TUM DEEP 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23075,CPT,EXC SHOULDER LES SC < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
23076,CPT,EXC SHOULDER TUM DEEP < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23077,CPT,RESECT SHOULDER TUMOR < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23078,CPT,RESECT SHOULDER TUMOR 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23100,CPT,BIOPSY OF SHOULDER JOINT,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
23101,CPT,SHOULDER JOINT SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23105,CPT,REMOVE SHOULDER JOINT LINING,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23106,CPT,INCISION OF COLLARBONE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23107,CPT,EXPLORE TREAT SHOULDER JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23120,CPT,PARTIAL REMOVAL COLLAR BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23125,CPT,REMOVAL OF COLLAR BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23130,CPT,REMOVE SHOULDER BONE PART,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23140,CPT,REMOVAL OF BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23145,CPT,REMOVAL OF BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23146,CPT,REMOVAL OF BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23150,CPT,REMOVAL OF HUMERUS LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23155,CPT,REMOVAL OF HUMERUS LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23156,CPT,REMOVAL OF HUMERUS LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23170,CPT,REMOVE COLLAR BONE LESION,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
23172,CPT,REMOVE SHOULDER BLADE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23174,CPT,REMOVE HUMERUS LESION,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
23180,CPT,REMOVE COLLAR BONE LESION,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
23182,CPT,REMOVE SHOULDER BLADE LESION,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
23184,CPT,REMOVE HUMERUS LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23190,CPT,PARTIAL REMOVAL OF SCAPULA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
23195,CPT,REMOVAL OF HEAD OF HUMERUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23200,CPT,RESECT CLAVICLE TUMOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
23210,CPT,RESECT SCAPULA TUMOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
23220,CPT,RESECT PROX HUMERUS TUMOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
23330,CPT,REMOVE SHOULDER FOREIGN BODY,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
23333,CPT,REMOVE SHOULDER FB DEEP,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
23334,CPT,SHOULDER PROSTHESIS REMOVAL,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
23335,CPT,SHOULDER PROSTHESIS REMOVAL,,30,,,"$12,937.72",$0.00,1,0,1,20210101,
23350,CPT,INJECTION FOR SHOULDER X-RAY,,30,,,$957.52,$0.00,1,0,1,20210101,
23395,CPT,MUSCLE TRANSFER SHOULDER/ARM,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23397,CPT,MUSCLE TRANSFERS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23400,CPT,FIXATION OF SHOULDER BLADE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23405,CPT,INCISION OF TENDON & MUSCLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23406,CPT,INCISE TENDON(S) & MUSCLE(S),,30,,,"$20,909.50",$0.00,1,0,1,20210101,
23410,CPT,REPAIR ROTATOR CUFF ACUTE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23412,CPT,REPAIR ROTATOR CUFF CHRONIC,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23415,CPT,RELEASE OF SHOULDER LIGAMENT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23420,CPT,REPAIR OF SHOULDER,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23430,CPT,REPAIR BICEPS TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23440,CPT,REMOVE/TRANSPLANT TENDON,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
23450,CPT,REPAIR SHOULDER CAPSULE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23455,CPT,REPAIR SHOULDER CAPSULE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23460,CPT,REPAIR SHOULDER CAPSULE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23462,CPT,REPAIR SHOULDER CAPSULE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23465,CPT,REPAIR SHOULDER CAPSULE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23466,CPT,REPAIR SHOULDER CAPSULE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23470,CPT,RECONSTRUCT SHOULDER JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
23472,CPT,RECONSTRUCT SHOULDER JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
23473,CPT,REVIS RECONST SHOULDER JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
23474,CPT,REVIS RECONST SHOULDER JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
23480,CPT,REVISION OF COLLAR BONE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23485,CPT,REVISION OF COLLAR BONE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
23490,CPT,REINFORCE CLAVICLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23491,CPT,REINFORCE SHOULDER BONES,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
23500,CPT,TREAT CLAVICLE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23505,CPT,TREAT CLAVICLE FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23515,CPT,TREAT CLAVICLE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23520,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23525,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23530,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23532,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23540,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23545,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23550,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23552,CPT,TREAT CLAVICLE DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23570,CPT,TREAT SHOULDER BLADE FX,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23575,CPT,TREAT SHOULDER BLADE FX,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23585,CPT,TREAT SCAPULA FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23600,CPT,TREAT HUMERUS FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23605,CPT,TREAT HUMERUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23615,CPT,TREAT HUMERUS FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
23616,CPT,TREAT HUMERUS FRACTURE,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
23620,CPT,TREAT HUMERUS FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23625,CPT,TREAT HUMERUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23630,CPT,TREAT HUMERUS FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23650,CPT,TREAT SHOULDER DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23655,CPT,TREAT SHOULDER DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23660,CPT,TREAT SHOULDER DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23665,CPT,TREAT DISLOCATION/FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23670,CPT,TREAT DISLOCATION/FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23675,CPT,TREAT DISLOCATION/FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23680,CPT,TREAT DISLOCATION/FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
23700,CPT,FIXATION OF SHOULDER,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
23800,CPT,FUSION OF SHOULDER JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
23802,CPT,FUSION OF SHOULDER JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
23900,CPT,AMPUTATION OF ARM & GIRDLE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
23920,CPT,AMPUTATION AT SHOULDER JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
23921,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
23929,CPT,SHOULDER SURGERY PROCEDURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
23930,CPT,DRAINAGE OF ARM LESION,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
23931,CPT,DRAINAGE OF ARM BURSA,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
23935,CPT,DRAIN ARM/ELBOW BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24000,CPT,EXPLORATORY ELBOW SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24006,CPT,RELEASE ELBOW JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24065,CPT,BIOPSY ARM/ELBOW SOFT TISSUE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
24066,CPT,BIOPSY ARM/ELBOW SOFT TISSUE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
24071,CPT,EXC ARM/ELBOW LES SC 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
24073,CPT,EX ARM/ELBOW TUM DEEP 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
24075,CPT,EXC ARM/ELBOW LES SC < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
24076,CPT,EX ARM/ELBOW TUM DEEP < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
24077,CPT,RESECT ARM/ELBOW TUM < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
24079,CPT,RESECT ARM/ELBOW TUM 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
24100,CPT,BIOPSY ELBOW JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24101,CPT,EXPLORE/TREAT ELBOW JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24102,CPT,REMOVE ELBOW JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24105,CPT,REMOVAL OF ELBOW BURSA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24110,CPT,REMOVE HUMERUS LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24115,CPT,REMOVE/GRAFT BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24116,CPT,REMOVE/GRAFT BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24120,CPT,REMOVE ELBOW LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24125,CPT,REMOVE/GRAFT BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24126,CPT,REMOVE/GRAFT BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24130,CPT,REMOVAL OF HEAD OF RADIUS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24134,CPT,REMOVAL OF ARM BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24136,CPT,REMOVE RADIUS BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24138,CPT,REMOVE ELBOW BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24140,CPT,PARTIAL REMOVAL OF ARM BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24145,CPT,PARTIAL REMOVAL OF RADIUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24147,CPT,PARTIAL REMOVAL OF ELBOW,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24149,CPT,RADICAL RESECTION OF ELBOW,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24150,CPT,RESECT DISTAL HUMERUS TUMOR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24152,CPT,RESECT RADIUS TUMOR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24155,CPT,REMOVAL OF ELBOW JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24160,CPT,REMOVE ELBOW JOINT IMPLANT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24164,CPT,REMOVE RADIUS HEAD IMPLANT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24200,CPT,REMOVAL OF ARM FOREIGN BODY,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
24201,CPT,REMOVAL OF ARM FOREIGN BODY,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
24220,CPT,INJECTION FOR ELBOW X-RAY,,30,,,"$1,010.84",$0.00,1,0,1,20210101,
24300,CPT,MANIPULATE ELBOW W/ANESTH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24301,CPT,MUSCLE/TENDON TRANSFER,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24305,CPT,ARM TENDON LENGTHENING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24310,CPT,REVISION OF ARM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24320,CPT,REPAIR OF ARM TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24330,CPT,REVISION OF ARM MUSCLES,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
24331,CPT,REVISION OF ARM MUSCLES,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24332,CPT,TENOLYSIS TRICEPS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24340,CPT,REPAIR OF BICEPS TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24341,CPT,REPAIR ARM TENDON/MUSCLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24342,CPT,REPAIR OF RUPTURED TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24343,CPT,REPR ELBOW LAT LIGMNT W/TISS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24344,CPT,RECONSTRUCT ELBOW LAT LIGMNT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24345,CPT,REPR ELBW MED LIGMNT W/TISSU,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24346,CPT,RECONSTRUCT ELBOW MED LIGMNT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24357,CPT,REPAIR ELBOW PERC,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
24358,CPT,REPAIR ELBOW W/DEB OPEN,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24359,CPT,REPAIR ELBOW DEB/ATTCH OPEN,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24360,CPT,RECONSTRUCT ELBOW JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24361,CPT,RECONSTRUCT ELBOW JOINT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
24362,CPT,RECONSTRUCT ELBOW JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24363,CPT,REPLACE ELBOW JOINT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
24365,CPT,RECONSTRUCT HEAD OF RADIUS,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24366,CPT,RECONSTRUCT HEAD OF RADIUS,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24370,CPT,REVISE RECONST ELBOW JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24371,CPT,REVISE RECONST ELBOW JOINT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
24400,CPT,REVISION OF HUMERUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24410,CPT,REVISION OF HUMERUS,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24420,CPT,REVISION OF HUMERUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24430,CPT,REPAIR OF HUMERUS,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24435,CPT,REPAIR HUMERUS WITH GRAFT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24470,CPT,REVISION OF ELBOW JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24495,CPT,DECOMPRESSION OF FOREARM,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24498,CPT,REINFORCE HUMERUS,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24500,CPT,TREAT HUMERUS FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24505,CPT,TREAT HUMERUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24515,CPT,TREAT HUMERUS FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24516,CPT,TREAT HUMERUS FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24530,CPT,TREAT HUMERUS FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24535,CPT,TREAT HUMERUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24538,CPT,TREAT HUMERUS FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24545,CPT,TREAT HUMERUS FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24546,CPT,TREAT HUMERUS FRACTURE,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
24560,CPT,TREAT HUMERUS FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24565,CPT,TREAT HUMERUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24566,CPT,TREAT HUMERUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24575,CPT,TREAT HUMERUS FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24576,CPT,TREAT HUMERUS FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24577,CPT,TREAT HUMERUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24579,CPT,TREAT HUMERUS FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24582,CPT,TREAT HUMERUS FRACTURE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
24586,CPT,TREAT ELBOW FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24587,CPT,TREAT ELBOW FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24600,CPT,TREAT ELBOW DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24605,CPT,TREAT ELBOW DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24615,CPT,TREAT ELBOW DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24620,CPT,TREAT ELBOW FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24635,CPT,TREAT ELBOW FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24640,CPT,TREAT ELBOW DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24650,CPT,TREAT RADIUS FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24655,CPT,TREAT RADIUS FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24665,CPT,TREAT RADIUS FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24666,CPT,TREAT RADIUS FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24670,CPT,TREAT ULNAR FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
24675,CPT,TREAT ULNAR FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
24685,CPT,TREAT ULNAR FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24800,CPT,FUSION OF ELBOW JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24802,CPT,FUSION/GRAFT OF ELBOW JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
24900,CPT,AMPUTATION OF UPPER ARM,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
24920,CPT,AMPUTATION OF UPPER ARM,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
24925,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
24930,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
24931,CPT,AMPUTATE UPPER ARM & IMPLANT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
24935,CPT,REVISION OF AMPUTATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
24940,CPT,REVISION OF UPPER ARM,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
24999,CPT,UPPER ARM/ELBOW SURGERY,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25000,CPT,INCISION OF TENDON SHEATH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25001,CPT,INCISE FLEXOR CARPI RADIALIS,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
25020,CPT,DECOMPRESS FOREARM 1 SPACE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25023,CPT,DECOMPRESS FOREARM 1 SPACE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25024,CPT,DECOMPRESS FOREARM 2 SPACES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25025,CPT,DECOMPRESS FOREARM 2 SPACES,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25028,CPT,DRAINAGE OF FOREARM LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25031,CPT,DRAINAGE OF FOREARM BURSA,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25035,CPT,TREAT FOREARM BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25040,CPT,EXPLORE/TREAT WRIST JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25065,CPT,BIOPSY FOREARM SOFT TISSUES,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
25066,CPT,BIOPSY FOREARM SOFT TISSUES,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
25071,CPT,EXC FOREARM LES SC 3 CM/>,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
25073,CPT,EXC FOREARM TUM DEEP 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
25075,CPT,EXC FOREARM LES SC < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
25076,CPT,EXC FOREARM TUM DEEP < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
25077,CPT,RESECT FOREARM/WRIST TUM<3CM,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
25078,CPT,RESECT FORARM/WRIST TUM 3CM>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
25085,CPT,INCISION OF WRIST CAPSULE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25100,CPT,BIOPSY OF WRIST JOINT,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
25101,CPT,EXPLORE/TREAT WRIST JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25105,CPT,REMOVE WRIST JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25107,CPT,REMOVE WRIST JOINT CARTILAGE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25109,CPT,EXCISE TENDON FOREARM/WRIST,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25110,CPT,REMOVE WRIST TENDON LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25111,CPT,REMOVE WRIST TENDON LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25112,CPT,REREMOVE WRIST TENDON LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25115,CPT,REMOVE WRIST/FOREARM LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25116,CPT,REMOVE WRIST/FOREARM LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25118,CPT,EXCISE WRIST TENDON SHEATH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25119,CPT,PARTIAL REMOVAL OF ULNA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25120,CPT,REMOVAL OF FOREARM LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25125,CPT,REMOVE/GRAFT FOREARM LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25126,CPT,REMOVE/GRAFT FOREARM LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25130,CPT,REMOVAL OF WRIST LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25135,CPT,REMOVE & GRAFT WRIST LESION,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
25136,CPT,REMOVE & GRAFT WRIST LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25145,CPT,REMOVE FOREARM BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25150,CPT,PARTIAL REMOVAL OF ULNA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25151,CPT,PARTIAL REMOVAL OF RADIUS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25170,CPT,RESECT RADIUS/ULNAR TUMOR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25210,CPT,REMOVAL OF WRIST BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25215,CPT,REMOVAL OF WRIST BONES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25230,CPT,PARTIAL REMOVAL OF RADIUS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25240,CPT,PARTIAL REMOVAL OF ULNA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25246,CPT,INJECTION FOR WRIST X-RAY,,30,,,$889.05,$0.00,1,0,1,20210101,
25248,CPT,REMOVE FOREARM FOREIGN BODY,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25250,CPT,REMOVAL OF WRIST PROSTHESIS,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25251,CPT,REMOVAL OF WRIST PROSTHESIS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25259,CPT,MANIPULATE WRIST W/ANESTHES,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25260,CPT,REPAIR FOREARM TENDON/MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25263,CPT,REPAIR FOREARM TENDON/MUSCLE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
25265,CPT,REPAIR FOREARM TENDON/MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25270,CPT,REPAIR FOREARM TENDON/MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25272,CPT,REPAIR FOREARM TENDON/MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25274,CPT,REPAIR FOREARM TENDON/MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25275,CPT,REPAIR FOREARM TENDON SHEATH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25280,CPT,REVISE WRIST/FOREARM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25290,CPT,INCISE WRIST/FOREARM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25295,CPT,RELEASE WRIST/FOREARM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25300,CPT,FUSION OF TENDONS AT WRIST,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25301,CPT,FUSION OF TENDONS AT WRIST,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25310,CPT,TRANSPLANT FOREARM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25312,CPT,TRANSPLANT FOREARM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25315,CPT,REVISE PALSY HAND TENDON(S),,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25316,CPT,REVISE PALSY HAND TENDON(S),,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25320,CPT,REPAIR/REVISE WRIST JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25332,CPT,REVISE WRIST JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25335,CPT,REALIGNMENT OF HAND,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25337,CPT,RECONSTRUCT ULNA/RADIOULNAR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25350,CPT,REVISION OF RADIUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25355,CPT,REVISION OF RADIUS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25360,CPT,REVISION OF ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25365,CPT,REVISE RADIUS & ULNA,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
25370,CPT,REVISE RADIUS OR ULNA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25375,CPT,REVISE RADIUS & ULNA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25390,CPT,SHORTEN RADIUS OR ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25391,CPT,LENGTHEN RADIUS OR ULNA,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
25392,CPT,SHORTEN RADIUS & ULNA,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
25393,CPT,LENGTHEN RADIUS & ULNA,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
25394,CPT,REPAIR CARPAL BONE SHORTEN,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25400,CPT,REPAIR RADIUS OR ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25405,CPT,REPAIR/GRAFT RADIUS OR ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25415,CPT,REPAIR RADIUS & ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25420,CPT,REPAIR/GRAFT RADIUS & ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25425,CPT,REPAIR/GRAFT RADIUS OR ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25426,CPT,REPAIR/GRAFT RADIUS & ULNA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25430,CPT,VASC GRAFT INTO CARPAL BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25431,CPT,REPAIR NONUNION CARPAL BONE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25440,CPT,REPAIR/GRAFT WRIST BONE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25441,CPT,RECONSTRUCT WRIST JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
25442,CPT,RECONSTRUCT WRIST JOINT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
25443,CPT,RECONSTRUCT WRIST JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25444,CPT,RECONSTRUCT WRIST JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
25445,CPT,RECONSTRUCT WRIST JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25446,CPT,WRIST REPLACEMENT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
25447,CPT,REPAIR WRIST JOINTS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25449,CPT,REMOVE WRIST JOINT IMPLANT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25450,CPT,REVISION OF WRIST JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25455,CPT,REVISION OF WRIST JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25490,CPT,REINFORCE RADIUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25491,CPT,REINFORCE ULNA,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
25492,CPT,REINFORCE RADIUS AND ULNA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25500,CPT,TREAT FRACTURE OF RADIUS,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25505,CPT,TREAT FRACTURE OF RADIUS,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25515,CPT,TREAT FRACTURE OF RADIUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25520,CPT,TREAT FRACTURE OF RADIUS,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25525,CPT,TREAT FRACTURE OF RADIUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25526,CPT,TREAT FRACTURE OF RADIUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25530,CPT,TREAT FRACTURE OF ULNA,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25535,CPT,TREAT FRACTURE OF ULNA,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25545,CPT,TREAT FRACTURE OF ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25560,CPT,TREAT FRACTURE RADIUS & ULNA,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25565,CPT,TREAT FRACTURE RADIUS & ULNA,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25574,CPT,TREAT FRACTURE RADIUS & ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25575,CPT,TREAT FRACTURE RADIUS/ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25600,CPT,TREAT FRACTURE RADIUS/ULNA,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25605,CPT,TREAT FRACTURE RADIUS/ULNA,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25606,CPT,TREAT FX DISTAL RADIAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25607,CPT,TREAT FX RAD EXTRA-ARTICUL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25608,CPT,TREAT FX RAD INTRA-ARTICUL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25609,CPT,TREAT FX RADIAL 3+ FRAG,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25622,CPT,TREAT WRIST BONE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25624,CPT,TREAT WRIST BONE FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25628,CPT,TREAT WRIST BONE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25630,CPT,TREAT WRIST BONE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25635,CPT,TREAT WRIST BONE FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25645,CPT,TREAT WRIST BONE FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25650,CPT,TREAT WRIST BONE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25651,CPT,PIN ULNAR STYLOID FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25652,CPT,TREAT FRACTURE ULNAR STYLOID,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25660,CPT,TREAT WRIST DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25670,CPT,TREAT WRIST DISLOCATION,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
25671,CPT,PIN RADIOULNAR DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25675,CPT,TREAT WRIST DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25676,CPT,TREAT WRIST DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25680,CPT,TREAT WRIST FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
25685,CPT,TREAT WRIST FRACTURE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
25690,CPT,TREAT WRIST DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25695,CPT,TREAT WRIST DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25800,CPT,FUSION OF WRIST JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25805,CPT,FUSION/GRAFT OF WRIST JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25810,CPT,FUSION/GRAFT OF WRIST JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
25820,CPT,FUSION OF HAND BONES,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25825,CPT,FUSE HAND BONES WITH GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25830,CPT,FUSION RADIOULNAR JNT/ULNA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
25900,CPT,AMPUTATION OF FOREARM,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
25905,CPT,AMPUTATION OF FOREARM,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
25907,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25909,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
25915,CPT,AMPUTATION OF FOREARM,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
25920,CPT,AMPUTATE HAND AT WRIST,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
25922,CPT,AMPUTATE HAND AT WRIST,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
25924,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
25927,CPT,AMPUTATION OF HAND,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
25929,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
25931,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
25999,CPT,FOREARM OR WRIST SURGERY,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26010,CPT,DRAINAGE OF FINGER ABSCESS,,30,,,$677.96,$0.00,1,0,1,20210101,
26011,CPT,DRAINAGE OF FINGER ABSCESS,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
26020,CPT,DRAIN HAND TENDON SHEATH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26025,CPT,DRAINAGE OF PALM BURSA,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26030,CPT,DRAINAGE OF PALM BURSAS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26034,CPT,TREAT HAND BONE LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26035,CPT,DECOMPRESS FINGERS/HAND,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26037,CPT,DECOMPRESS FINGERS/HAND,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26040,CPT,RELEASE PALM CONTRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26045,CPT,RELEASE PALM CONTRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26055,CPT,INCISE FINGER TENDON SHEATH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26060,CPT,INCISION OF FINGER TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26070,CPT,EXPLORE/TREAT HAND JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26075,CPT,EXPLORE/TREAT FINGER JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26080,CPT,EXPLORE/TREAT FINGER JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26100,CPT,BIOPSY HAND JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26105,CPT,BIOPSY FINGER JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26110,CPT,BIOPSY FINGER JOINT LINING,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26111,CPT,EXC HAND LES SC 1.5 CM/>,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
26113,CPT,EXC HAND TUM DEEP 1.5 CM/>,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
26115,CPT,EXC HAND LES SC < 1.5 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
26116,CPT,EXC HAND TUM DEEP < 1.5 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
26117,CPT,RAD RESECT HAND TUMOR < 3 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
26118,CPT,RAD RESECT HAND TUMOR 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
26121,CPT,RELEASE PALM CONTRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26123,CPT,RELEASE PALM CONTRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26125,CPT,RELEASE PALM CONTRACTURE,,30,,,"$4,889.91",$0.00,1,0,1,20210101,
26130,CPT,REMOVE WRIST JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26135,CPT,REVISE FINGER JOINT EACH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26140,CPT,REVISE FINGER JOINT EACH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26145,CPT,TENDON EXCISION PALM/FINGER,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26160,CPT,REMOVE TENDON SHEATH LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26170,CPT,REMOVAL OF PALM TENDON EACH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26180,CPT,REMOVAL OF FINGER TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26185,CPT,REMOVE FINGER BONE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26200,CPT,REMOVE HAND BONE LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26205,CPT,REMOVE/GRAFT BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26210,CPT,REMOVAL OF FINGER LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26215,CPT,REMOVE/GRAFT FINGER LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26230,CPT,PARTIAL REMOVAL OF HAND BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26235,CPT,PARTIAL REMOVAL FINGER BONE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26236,CPT,PARTIAL REMOVAL FINGER BONE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26250,CPT,EXTENSIVE HAND SURGERY,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26260,CPT,RESECT PROX FINGER TUMOR,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26262,CPT,RESECT DISTAL FINGER TUMOR,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26320,CPT,REMOVAL OF IMPLANT FROM HAND,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
26340,CPT,MANIPULATE FINGER W/ANESTH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26341,CPT,MANIPULAT PALM CORD POST INJ,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26350,CPT,REPAIR FINGER/HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26352,CPT,REPAIR/GRAFT HAND TENDON,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
26356,CPT,REPAIR FINGER/HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26357,CPT,REPAIR FINGER/HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26358,CPT,REPAIR/GRAFT HAND TENDON,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
26370,CPT,REPAIR FINGER/HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26372,CPT,REPAIR/GRAFT HAND TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26373,CPT,REPAIR FINGER/HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26390,CPT,REVISE HAND/FINGER TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26392,CPT,REPAIR/GRAFT HAND TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26410,CPT,REPAIR HAND TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26412,CPT,REPAIR/GRAFT HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26415,CPT,EXCISION HAND/FINGER TENDON,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26416,CPT,GRAFT HAND OR FINGER TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26418,CPT,REPAIR FINGER TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26420,CPT,REPAIR/GRAFT FINGER TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26426,CPT,REPAIR FINGER/HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26428,CPT,REPAIR/GRAFT FINGER TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26432,CPT,REPAIR FINGER TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26433,CPT,REPAIR FINGER TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26434,CPT,REPAIR/GRAFT FINGER TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26437,CPT,REALIGNMENT OF TENDONS,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26440,CPT,RELEASE PALM/FINGER TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26442,CPT,RELEASE PALM & FINGER TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26445,CPT,RELEASE HAND/FINGER TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26449,CPT,RELEASE FOREARM/HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26450,CPT,INCISION OF PALM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26455,CPT,INCISION OF FINGER TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26460,CPT,INCISE HAND/FINGER TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26471,CPT,FUSION OF FINGER TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26474,CPT,FUSION OF FINGER TENDONS,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26476,CPT,TENDON LENGTHENING,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26477,CPT,TENDON SHORTENING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26478,CPT,LENGTHENING OF HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26479,CPT,SHORTENING OF HAND TENDON,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26480,CPT,TRANSPLANT HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26483,CPT,TRANSPLANT/GRAFT HAND TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26485,CPT,TRANSPLANT PALM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26489,CPT,TRANSPLANT/GRAFT PALM TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26490,CPT,REVISE THUMB TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26492,CPT,TENDON TRANSFER WITH GRAFT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26494,CPT,HAND TENDON/MUSCLE TRANSFER,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26496,CPT,REVISE THUMB TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26497,CPT,FINGER TENDON TRANSFER,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26498,CPT,FINGER TENDON TRANSFER,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26499,CPT,REVISION OF FINGER,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26500,CPT,HAND TENDON RECONSTRUCTION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26502,CPT,HAND TENDON RECONSTRUCTION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26508,CPT,RELEASE THUMB CONTRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26510,CPT,THUMB TENDON TRANSFER,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26516,CPT,FUSION OF KNUCKLE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26517,CPT,FUSION OF KNUCKLE JOINTS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26518,CPT,FUSION OF KNUCKLE JOINTS,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
26520,CPT,RELEASE KNUCKLE CONTRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26525,CPT,RELEASE FINGER CONTRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26530,CPT,REVISE KNUCKLE JOINT,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
26531,CPT,REVISE KNUCKLE WITH IMPLANT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26535,CPT,REVISE FINGER JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26536,CPT,REVISE/IMPLANT FINGER JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26540,CPT,REPAIR HAND JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26541,CPT,REPAIR HAND JOINT WITH GRAFT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26542,CPT,REPAIR HAND JOINT WITH GRAFT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26545,CPT,RECONSTRUCT FINGER JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26546,CPT,REPAIR NONUNION HAND,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26548,CPT,RECONSTRUCT FINGER JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26550,CPT,CONSTRUCT THUMB REPLACEMENT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26551,CPT,GREAT TOE-HAND TRANSFER,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
26553,CPT,SINGLE TRANSFER TOE-HAND,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
26554,CPT,DOUBLE TRANSFER TOE-HAND,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
26555,CPT,POSITIONAL CHANGE OF FINGER,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26556,CPT,TOE JOINT TRANSFER,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
26560,CPT,REPAIR OF WEB FINGER,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26561,CPT,REPAIR OF WEB FINGER,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26562,CPT,REPAIR OF WEB FINGER,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26565,CPT,CORRECT METACARPAL FLAW,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26567,CPT,CORRECT FINGER DEFORMITY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26568,CPT,LENGTHEN METACARPAL/FINGER,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26580,CPT,REPAIR HAND DEFORMITY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26587,CPT,RECONSTRUCT EXTRA FINGER,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26590,CPT,REPAIR FINGER DEFORMITY,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26591,CPT,REPAIR MUSCLES OF HAND,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26593,CPT,RELEASE MUSCLES OF HAND,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26596,CPT,EXCISION CONSTRICTING TISSUE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26600,CPT,TREAT METACARPAL FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26605,CPT,TREAT METACARPAL FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26607,CPT,TREAT METACARPAL FRACTURE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
26608,CPT,TREAT METACARPAL FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26615,CPT,TREAT METACARPAL FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26641,CPT,TREAT THUMB DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26645,CPT,TREAT THUMB FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26650,CPT,TREAT THUMB FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26665,CPT,TREAT THUMB FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26670,CPT,TREAT HAND DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26675,CPT,TREAT HAND DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26676,CPT,PIN HAND DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26685,CPT,TREAT HAND DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26686,CPT,TREAT HAND DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26700,CPT,TREAT KNUCKLE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26705,CPT,TREAT KNUCKLE DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26706,CPT,PIN KNUCKLE DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26715,CPT,TREAT KNUCKLE DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26720,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26725,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26727,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26735,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26740,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26742,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26746,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26750,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26755,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26756,CPT,PIN FINGER FRACTURE EACH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26765,CPT,TREAT FINGER FRACTURE EACH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26770,CPT,TREAT FINGER DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26775,CPT,TREAT FINGER DISLOCATION,,30,,,$946.79,$0.00,1,0,1,20210101,
26776,CPT,PIN FINGER DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26785,CPT,TREAT FINGER DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26820,CPT,THUMB FUSION WITH GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26841,CPT,FUSION OF THUMB,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26842,CPT,THUMB FUSION WITH GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26843,CPT,FUSION OF HAND JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26844,CPT,FUSION/GRAFT OF HAND JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26850,CPT,FUSION OF KNUCKLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26852,CPT,FUSION OF KNUCKLE WITH GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
26860,CPT,FUSION OF FINGER JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26861,CPT,FUSION OF FINGER JNT ADD-ON,,30,,,"$5,852.03",$0.00,1,0,1,20210101,
26862,CPT,FUSION/GRAFT OF FINGER JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26863,CPT,FUSE/GRAFT ADDED JOINT,,30,,,"$5,237.74",$0.00,1,0,1,20210101,
26910,CPT,AMPUTATE METACARPAL BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26951,CPT,AMPUTATION OF FINGER/THUMB,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26952,CPT,AMPUTATION OF FINGER/THUMB,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26989,CPT,HAND/FINGER SURGERY,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
26990,CPT,DRAINAGE OF PELVIS LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
26991,CPT,DRAINAGE OF PELVIS BURSA,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
26992,CPT,DRAINAGE OF BONE LESION,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27000,CPT,INCISION OF HIP TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27001,CPT,INCISION OF HIP TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27003,CPT,INCISION OF HIP TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27005,CPT,INCISION OF HIP TENDON,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27006,CPT,INCISION OF HIP TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27025,CPT,INCISION OF HIP/THIGH FASCIA,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27027,CPT,BUTTOCK FASCIOTOMY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27030,CPT,DRAINAGE OF HIP JOINT,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27033,CPT,EXPLORATION OF HIP JOINT,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27035,CPT,DENERVATION OF HIP JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27036,CPT,EXCISION OF HIP JOINT/MUSCLE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27040,CPT,BIOPSY OF SOFT TISSUES,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
27041,CPT,BIOPSY OF SOFT TISSUES,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
27043,CPT,EXC HIP PELVIS LES SC 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27045,CPT,EXC HIP/PELV TUM DEEP 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27047,CPT,EXC HIP/PELVIS LES SC < 3 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27048,CPT,EXC HIP/PELV TUM DEEP < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27049,CPT,RESECT HIP/PELV TUM < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27050,CPT,BIOPSY OF SACROILIAC JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27052,CPT,BIOPSY OF HIP JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27054,CPT,REMOVAL OF HIP JOINT LINING,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
27057,CPT,BUTTOCK FASCIOTOMY W/DBRDMT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27059,CPT,RESECT HIP/PELV TUM 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27060,CPT,REMOVAL OF ISCHIAL BURSA,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27062,CPT,REMOVE FEMUR LESION/BURSA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27065,CPT,REMOVE HIP BONE LES SUPER,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27066,CPT,REMOVE HIP BONE LES DEEP,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27067,CPT,REMOVE/GRAFT HIP BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27070,CPT,PART REMOVE HIP BONE SUPER,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27071,CPT,PART REMOVAL HIP BONE DEEP,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27075,CPT,RESECT HIP TUMOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27076,CPT,RESECT HIP TUM INCL ACETABUL,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27077,CPT,RESECT HIP TUM W/INNOM BONE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27078,CPT,RSECT HIP TUM INCL FEMUR,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27080,CPT,REMOVAL OF TAIL BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27086,CPT,REMOVE HIP FOREIGN BODY,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
27087,CPT,REMOVE HIP FOREIGN BODY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27090,CPT,REMOVAL OF HIP PROSTHESIS,,30,,,"$12,937.72",$0.00,1,0,1,20210101,
27091,CPT,REMOVAL OF HIP PROSTHESIS,,30,,,"$12,937.72",$0.00,1,0,1,20210101,
27093,CPT,INJECTION FOR HIP X-RAY,,30,,,$988.59,$0.00,1,0,1,20210101,
27095,CPT,INJECTION FOR HIP X-RAY,,30,,,"$2,408.00",$0.00,1,0,1,20210101,
27096,CPT,INJECT SACROILIAC JOINT,,30,,,"$2,159.21",$0.00,1,0,1,20210101,
27097,CPT,REVISION OF HIP TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27098,CPT,TRANSFER TENDON TO PELVIS,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
27100,CPT,TRANSFER OF ABDOMINAL MUSCLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27105,CPT,TRANSFER OF SPINAL MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27110,CPT,TRANSFER OF ILIOPSOAS MUSCLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27111,CPT,TRANSFER OF ILIOPSOAS MUSCLE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27120,CPT,RECONSTRUCTION OF HIP SOCKET,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27122,CPT,RECONSTRUCTION OF HIP SOCKET,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27125,CPT,PARTIAL HIP REPLACEMENT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27130,CPT,TOTAL HIP ARTHROPLASTY,,30,,,"$24,961.34",$0.00,1,0,1,20210101,
27132,CPT,TOTAL HIP ARTHROPLASTY,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27134,CPT,REVISE HIP JOINT REPLACEMENT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27137,CPT,REVISE HIP JOINT REPLACEMENT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27138,CPT,REVISE HIP JOINT REPLACEMENT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27140,CPT,TRANSPLANT FEMUR RIDGE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27146,CPT,INCISION OF HIP BONE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27147,CPT,REVISION OF HIP BONE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27151,CPT,INCISION OF HIP BONES,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27156,CPT,REVISION OF HIP BONES,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27158,CPT,REVISION OF PELVIS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27161,CPT,INCISION OF NECK OF FEMUR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27165,CPT,INCISION/FIXATION OF FEMUR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27170,CPT,REPAIR/GRAFT FEMUR HEAD/NECK,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27175,CPT,TREAT SLIPPED EPIPHYSIS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27176,CPT,TREAT SLIPPED EPIPHYSIS,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27177,CPT,TREAT SLIPPED EPIPHYSIS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27178,CPT,TREAT SLIPPED EPIPHYSIS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27179,CPT,REVISE HEAD/NECK OF FEMUR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27181,CPT,TREAT SLIPPED EPIPHYSIS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27185,CPT,REVISION OF FEMUR EPIPHYSIS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27187,CPT,REINFORCE HIP BONES,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27197,CPT,CLSD TX PELVIC RING FX,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27198,CPT,CLSD TX PELVIC RING FX,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27200,CPT,TREAT TAIL BONE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27202,CPT,TREAT TAIL BONE FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27216,CPT,TREAT PELVIC RING FRACTURE,,30,,,"$4,272.76",$0.00,1,0,1,20210101,
27217,CPT,TREAT PELVIC RING FRACTURE,,30,,,"$4,074.15",$0.00,1,0,1,20210101,
27220,CPT,TREAT HIP SOCKET FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27222,CPT,TREAT HIP SOCKET FRACTURE,,30,,,"$1,375.72",$0.00,1,0,1,20210101,
27226,CPT,TREAT HIP WALL FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27227,CPT,TREAT HIP FRACTURE(S),,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27228,CPT,TREAT HIP FRACTURE(S),,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27230,CPT,TREAT THIGH FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27232,CPT,TREAT THIGH FRACTURE,,30,,,"$8,331.60",$0.00,1,0,1,20210101,
27235,CPT,TREAT THIGH FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27236,CPT,TREAT THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27238,CPT,TREAT THIGH FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27240,CPT,TREAT THIGH FRACTURE,,30,,,"$8,331.60",$0.00,1,0,1,20210101,
27244,CPT,TREAT THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27245,CPT,TREAT THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27246,CPT,TREAT THIGH FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27248,CPT,TREAT THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27250,CPT,TREAT HIP DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27252,CPT,TREAT HIP DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27253,CPT,TREAT HIP DISLOCATION,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
27254,CPT,TREAT HIP DISLOCATION,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
27256,CPT,TREAT HIP DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27257,CPT,TREAT HIP DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27258,CPT,TREAT HIP DISLOCATION,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
27259,CPT,TREAT HIP DISLOCATION,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
27265,CPT,TREAT HIP DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27266,CPT,TREAT HIP DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27267,CPT,CLTX THIGH FX,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
27268,CPT,CLTX THIGH FX W/MNPJ,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
27269,CPT,OPTX THIGH FX,,30,,,"$8,331.60",$0.00,1,0,1,20210101,
27275,CPT,MANIPULATION OF HIP JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27279,CPT,ARTHRODESIS SACROILIAC JOINT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
27280,CPT,FUSION OF SACROILIAC JOINT,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27282,CPT,FUSION OF PUBIC BONES,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27284,CPT,FUSION OF HIP JOINT,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27286,CPT,FUSION OF HIP JOINT,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27290,CPT,AMPUTATION OF LEG AT HIP,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27295,CPT,AMPUTATION OF LEG AT HIP,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27299,CPT,PELVIS/HIP JOINT SURGERY,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27301,CPT,DRAIN THIGH/KNEE LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27303,CPT,DRAINAGE OF BONE LESION,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27305,CPT,INCISE THIGH TENDON & FASCIA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27306,CPT,INCISION OF THIGH TENDON,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
27307,CPT,INCISION OF THIGH TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27310,CPT,EXPLORATION OF KNEE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27323,CPT,BIOPSY THIGH SOFT TISSUES,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
27324,CPT,BIOPSY THIGH SOFT TISSUES,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27325,CPT,NEURECTOMY HAMSTRING,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
27326,CPT,NEURECTOMY POPLITEAL,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
27327,CPT,EXC THIGH/KNEE LES SC < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
27328,CPT,EXC THIGH/KNEE TUM DEEP <5CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27329,CPT,RESECT THIGH/KNEE TUM < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27330,CPT,BIOPSY KNEE JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27331,CPT,EXPLORE/TREAT KNEE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27332,CPT,REMOVAL OF KNEE CARTILAGE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27333,CPT,REMOVAL OF KNEE CARTILAGE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27334,CPT,REMOVE KNEE JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27335,CPT,REMOVE KNEE JOINT LINING,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27337,CPT,EXC THIGH/KNEE LES SC 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27339,CPT,EXC THIGH/KNEE TUM DEP 5CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27340,CPT,REMOVAL OF KNEECAP BURSA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27345,CPT,REMOVAL OF KNEE CYST,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27347,CPT,REMOVE KNEE CYST,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27350,CPT,REMOVAL OF KNEECAP,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27355,CPT,REMOVE FEMUR LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27356,CPT,REMOVE FEMUR LESION/GRAFT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27357,CPT,REMOVE FEMUR LESION/GRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27358,CPT,REMOVE FEMUR LESION/FIXATION,,30,,,"$8,608.94",$0.00,1,0,1,20210101,
27360,CPT,PARTIAL REMOVAL LEG BONE(S),,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27364,CPT,RESECT THIGH/KNEE TUM 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27365,CPT,RESECT FEMUR/KNEE TUMOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27369,CPT,NJX CNTRST KNE ARTHG/CT/MRI,,30,,,$978.71,$0.00,1,0,1,20210101,
27372,CPT,REMOVAL OF FOREIGN BODY,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27380,CPT,REPAIR OF KNEECAP TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27381,CPT,REPAIR/GRAFT KNEECAP TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27385,CPT,REPAIR OF THIGH MUSCLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27386,CPT,REPAIR/GRAFT OF THIGH MUSCLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27390,CPT,INCISION OF THIGH TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27391,CPT,INCISION OF THIGH TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27392,CPT,INCISION OF THIGH TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27393,CPT,LENGTHENING OF THIGH TENDON,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27394,CPT,LENGTHENING OF THIGH TENDONS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27395,CPT,LENGTHENING OF THIGH TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27396,CPT,TRANSPLANT OF THIGH TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27397,CPT,TRANSPLANTS OF THIGH TENDONS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27400,CPT,REVISE THIGH MUSCLES/TENDONS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27403,CPT,REPAIR OF KNEE CARTILAGE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27405,CPT,REPAIR OF KNEE LIGAMENT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27407,CPT,REPAIR OF KNEE LIGAMENT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27409,CPT,REPAIR OF KNEE LIGAMENTS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27412,CPT,AUTOCHONDROCYTE IMPLANT KNEE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27415,CPT,OSTEOCHONDRAL KNEE ALLOGRAFT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27416,CPT,OSTEOCHONDRAL KNEE AUTOGRAFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27418,CPT,REPAIR DEGENERATED KNEECAP,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27420,CPT,REVISION OF UNSTABLE KNEECAP,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27422,CPT,REVISION OF UNSTABLE KNEECAP,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27424,CPT,REVISION/REMOVAL OF KNEECAP,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27425,CPT,LAT RETINACULAR RELEASE OPEN,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27427,CPT,RECONSTRUCTION KNEE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27428,CPT,RECONSTRUCTION KNEE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27429,CPT,RECONSTRUCTION KNEE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27430,CPT,REVISION OF THIGH MUSCLES,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27435,CPT,INCISION OF KNEE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27437,CPT,REVISE KNEECAP,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27438,CPT,REVISE KNEECAP WITH IMPLANT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27440,CPT,REVISION OF KNEE JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27441,CPT,REVISION OF KNEE JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27442,CPT,REVISION OF KNEE JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27443,CPT,REVISION OF KNEE JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27445,CPT,REVISION OF KNEE JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27446,CPT,REVISION OF KNEE JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27447,CPT,TOTAL KNEE ARTHROPLASTY,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27448,CPT,INCISION OF THIGH,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27450,CPT,INCISION OF THIGH,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27454,CPT,REALIGNMENT OF THIGH BONE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27455,CPT,REALIGNMENT OF KNEE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27457,CPT,REALIGNMENT OF KNEE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27465,CPT,SHORTENING OF THIGH BONE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27466,CPT,LENGTHENING OF THIGH BONE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27468,CPT,SHORTEN/LENGTHEN THIGHS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27470,CPT,REPAIR OF THIGH,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27472,CPT,REPAIR/GRAFT OF THIGH,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27475,CPT,SURGERY TO STOP LEG GROWTH,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27477,CPT,SURGERY TO STOP LEG GROWTH,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27479,CPT,SURGERY TO STOP LEG GROWTH,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27485,CPT,SURGERY TO STOP LEG GROWTH,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27486,CPT,REVISE/REPLACE KNEE JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27487,CPT,REVISE/REPLACE KNEE JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27488,CPT,REMOVAL OF KNEE PROSTHESIS,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27495,CPT,REINFORCE THIGH,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27496,CPT,DECOMPRESSION OF THIGH/KNEE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27497,CPT,DECOMPRESSION OF THIGH/KNEE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27498,CPT,DECOMPRESSION OF THIGH/KNEE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27499,CPT,DECOMPRESSION OF THIGH/KNEE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27500,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27501,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27502,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27503,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27506,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27507,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27508,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27509,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27510,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27511,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27513,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27514,CPT,TREATMENT OF THIGH FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27516,CPT,TREAT THIGH FX GROWTH PLATE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27517,CPT,TREAT THIGH FX GROWTH PLATE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27519,CPT,TREAT THIGH FX GROWTH PLATE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27520,CPT,TREAT KNEECAP FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27524,CPT,TREAT KNEECAP FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27530,CPT,TREAT KNEE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27532,CPT,TREAT KNEE FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27535,CPT,TREAT KNEE FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27536,CPT,TREAT KNEE FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27538,CPT,TREAT KNEE FRACTURE(S),,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27540,CPT,TREAT KNEE FRACTURE,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27550,CPT,TREAT KNEE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27552,CPT,TREAT KNEE DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27556,CPT,TREAT KNEE DISLOCATION,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27557,CPT,TREAT KNEE DISLOCATION,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27558,CPT,TREAT KNEE DISLOCATION,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27560,CPT,TREAT KNEECAP DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27562,CPT,TREAT KNEECAP DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27566,CPT,TREAT KNEECAP DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27570,CPT,FIXATION OF KNEE JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27580,CPT,FUSION OF KNEE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27590,CPT,AMPUTATE LEG AT THIGH,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27591,CPT,AMPUTATE LEG AT THIGH,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27592,CPT,AMPUTATE LEG AT THIGH,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27594,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27596,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27598,CPT,AMPUTATE LOWER LEG AT KNEE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27599,CPT,LEG SURGERY PROCEDURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27600,CPT,DECOMPRESSION OF LOWER LEG,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27601,CPT,DECOMPRESSION OF LOWER LEG,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27602,CPT,DECOMPRESSION OF LOWER LEG,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27603,CPT,DRAIN LOWER LEG LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27604,CPT,DRAIN LOWER LEG BURSA,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
27605,CPT,INCISION OF ACHILLES TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27606,CPT,INCISION OF ACHILLES TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27607,CPT,TREAT LOWER LEG BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27610,CPT,EXPLORE/TREAT ANKLE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27612,CPT,EXPLORATION OF ANKLE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27613,CPT,BIOPSY LOWER LEG SOFT TISSUE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
27614,CPT,BIOPSY LOWER LEG SOFT TISSUE,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27615,CPT,RESECT LEG/ANKLE TUM < 5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27616,CPT,RESECT LEG/ANKLE TUM 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27618,CPT,EXC LEG/ANKLE TUM < 3 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
27619,CPT,EXC LEG/ANKLE TUM DEEP <5 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27620,CPT,EXPLORE/TREAT ANKLE JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27625,CPT,REMOVE ANKLE JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27626,CPT,REMOVE ANKLE JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27630,CPT,REMOVAL OF TENDON LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27632,CPT,EXC LEG/ANKLE LES SC 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27634,CPT,EXC LEG/ANKLE TUM DEP 5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
27635,CPT,REMOVE LOWER LEG BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27637,CPT,REMOVE/GRAFT LEG BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27638,CPT,REMOVE/GRAFT LEG BONE LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27640,CPT,PARTIAL REMOVAL OF TIBIA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27641,CPT,PARTIAL REMOVAL OF FIBULA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27645,CPT,RESECT TIBIA TUMOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27646,CPT,RESECT FIBULA TUMOR,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27647,CPT,RESECT TALUS/CALCANEUS TUM,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27648,CPT,INJECTION FOR ANKLE X-RAY,,30,,,$984.60,$0.00,1,0,1,20210101,
27650,CPT,REPAIR ACHILLES TENDON,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
27652,CPT,REPAIR/GRAFT ACHILLES TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27654,CPT,REPAIR OF ACHILLES TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27656,CPT,REPAIR LEG FASCIA DEFECT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27658,CPT,REPAIR OF LEG TENDON EACH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27659,CPT,REPAIR OF LEG TENDON EACH,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27664,CPT,REPAIR OF LEG TENDON EACH,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27665,CPT,REPAIR OF LEG TENDON EACH,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27675,CPT,REPAIR LOWER LEG TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27676,CPT,REPAIR LOWER LEG TENDONS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27680,CPT,RELEASE OF LOWER LEG TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27681,CPT,RELEASE OF LOWER LEG TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27685,CPT,REVISION OF LOWER LEG TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27686,CPT,REVISE LOWER LEG TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27687,CPT,REVISION OF CALF TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27690,CPT,REVISE LOWER LEG TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27691,CPT,REVISE LOWER LEG TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27692,CPT,REVISE ADDITIONAL LEG TENDON,,30,,,"$4,491.65",$0.00,1,0,1,20210101,
27695,CPT,REPAIR OF ANKLE LIGAMENT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27696,CPT,REPAIR OF ANKLE LIGAMENTS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27698,CPT,REPAIR OF ANKLE LIGAMENT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27700,CPT,REVISION OF ANKLE JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27702,CPT,RECONSTRUCT ANKLE JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27703,CPT,RECONSTRUCTION ANKLE JOINT,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27704,CPT,REMOVAL OF ANKLE IMPLANT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27705,CPT,INCISION OF TIBIA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27707,CPT,INCISION OF FIBULA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27709,CPT,INCISION OF TIBIA & FIBULA,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27712,CPT,REALIGNMENT OF LOWER LEG,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27715,CPT,REVISION OF LOWER LEG,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27720,CPT,REPAIR OF TIBIA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27722,CPT,REPAIR/GRAFT OF TIBIA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27724,CPT,REPAIR/GRAFT OF TIBIA,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27725,CPT,REPAIR OF LOWER LEG,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27726,CPT,REPAIR FIBULA NONUNION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27727,CPT,REPAIR OF LOWER LEG,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27730,CPT,REPAIR OF TIBIA EPIPHYSIS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27732,CPT,REPAIR OF FIBULA EPIPHYSIS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27734,CPT,REPAIR LOWER LEG EPIPHYSES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27740,CPT,REPAIR OF LEG EPIPHYSES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27742,CPT,REPAIR OF LEG EPIPHYSES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27745,CPT,REINFORCE TIBIA,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27750,CPT,TREATMENT OF TIBIA FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27752,CPT,TREATMENT OF TIBIA FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27756,CPT,TREATMENT OF TIBIA FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27758,CPT,TREATMENT OF TIBIA FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27759,CPT,TREATMENT OF TIBIA FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27760,CPT,CLTX MEDIAL ANKLE FX,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27762,CPT,CLTX MED ANKLE FX W/MNPJ,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27766,CPT,OPTX MEDIAL ANKLE FX,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27767,CPT,CLTX POST ANKLE FX,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27768,CPT,CLTX POST ANKLE FX W/MNPJ,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27769,CPT,OPTX POST ANKLE FX,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27780,CPT,TREATMENT OF FIBULA FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27781,CPT,TREATMENT OF FIBULA FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27784,CPT,TREATMENT OF FIBULA FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27786,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27788,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27792,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27808,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27810,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27814,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27816,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27818,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27822,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27823,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27824,CPT,TREAT LOWER LEG FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27825,CPT,TREAT LOWER LEG FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27826,CPT,TREAT LOWER LEG FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27827,CPT,TREAT LOWER LEG FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27828,CPT,TREAT LOWER LEG FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27829,CPT,TREAT LOWER LEG JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27830,CPT,TREAT LOWER LEG DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27831,CPT,TREAT LOWER LEG DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27832,CPT,TREAT LOWER LEG DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27840,CPT,TREAT ANKLE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
27842,CPT,TREAT ANKLE DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
27846,CPT,TREAT ANKLE DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27848,CPT,TREAT ANKLE DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27860,CPT,FIXATION OF ANKLE JOINT,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
27870,CPT,FUSION OF ANKLE JOINT OPEN,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27871,CPT,FUSION OF TIBIOFIBULAR JOINT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
27880,CPT,AMPUTATION OF LOWER LEG,,30,,,"$32,611.92",$0.00,1,0,1,20210101,
27881,CPT,AMPUTATION OF LOWER LEG,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27882,CPT,AMPUTATION OF LOWER LEG,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27884,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27886,CPT,AMPUTATION FOLLOW-UP SURGERY,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
27888,CPT,AMPUTATION OF FOOT AT ANKLE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
27889,CPT,AMPUTATION OF FOOT AT ANKLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27892,CPT,DECOMPRESSION OF LEG,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
27893,CPT,DECOMPRESSION OF LEG,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
27894,CPT,DECOMPRESSION OF LEG,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
27899,CPT,LEG/ANKLE SURGERY PROCEDURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28001,CPT,DRAINAGE OF BURSA OF FOOT,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
28002,CPT,TREATMENT OF FOOT INFECTION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28003,CPT,TREATMENT OF FOOT INFECTION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28005,CPT,TREAT FOOT BONE LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28008,CPT,INCISION OF FOOT FASCIA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28010,CPT,INCISION OF TOE TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28011,CPT,INCISION OF TOE TENDONS,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28020,CPT,EXPLORATION OF FOOT JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28022,CPT,EXPLORATION OF FOOT JOINT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28024,CPT,EXPLORATION OF TOE JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28035,CPT,DECOMPRESSION OF TIBIA NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
28039,CPT,EXC FOOT/TOE TUM SC 1.5 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
28041,CPT,EXC FOOT/TOE TUM DEP 1.5CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
28043,CPT,EXC FOOT/TOE TUM SC < 1.5 CM,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
28045,CPT,EXC FOOT/TOE TUM DEEP <1.5CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
28046,CPT,RESECT FOOT/TOE TUMOR < 3 CM,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
28047,CPT,RESECT FOOT/TOE TUMOR 3 CM/>,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
28050,CPT,BIOPSY OF FOOT JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28052,CPT,BIOPSY OF FOOT JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28054,CPT,BIOPSY OF TOE JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28055,CPT,NEURECTOMY FOOT,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
28060,CPT,PARTIAL REMOVAL FOOT FASCIA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28062,CPT,REMOVAL OF FOOT FASCIA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28070,CPT,REMOVAL OF FOOT JOINT LINING,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
28072,CPT,REMOVAL OF FOOT JOINT LINING,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28080,CPT,REMOVAL OF FOOT LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28086,CPT,EXCISE FOOT TENDON SHEATH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28088,CPT,EXCISE FOOT TENDON SHEATH,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28090,CPT,REMOVAL OF FOOT LESION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28092,CPT,REMOVAL OF TOE LESIONS,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28100,CPT,REMOVAL OF ANKLE/HEEL LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28102,CPT,REMOVE/GRAFT FOOT LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28103,CPT,REMOVE/GRAFT FOOT LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28104,CPT,REMOVAL OF FOOT LESION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28106,CPT,REMOVE/GRAFT FOOT LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28107,CPT,REMOVE/GRAFT FOOT LESION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28108,CPT,REMOVAL OF TOE LESIONS,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28110,CPT,PART REMOVAL OF METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28111,CPT,PART REMOVAL OF METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28112,CPT,PART REMOVAL OF METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28113,CPT,PART REMOVAL OF METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28114,CPT,REMOVAL OF METATARSAL HEADS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28116,CPT,REVISION OF FOOT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28118,CPT,REMOVAL OF HEEL BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28119,CPT,REMOVAL OF HEEL SPUR,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28120,CPT,PART REMOVAL OF ANKLE/HEEL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28122,CPT,PARTIAL REMOVAL OF FOOT BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28124,CPT,PARTIAL REMOVAL OF TOE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28126,CPT,PARTIAL REMOVAL OF TOE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28130,CPT,REMOVAL OF ANKLE BONE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
28140,CPT,REMOVAL OF METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28150,CPT,REMOVAL OF TOE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28153,CPT,PARTIAL REMOVAL OF TOE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28160,CPT,PARTIAL REMOVAL OF TOE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28171,CPT,RESECT TARSAL TUMOR,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28173,CPT,RESECT METATARSAL TUMOR,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28175,CPT,RESECT PHALANX OF TOE TUMOR,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28190,CPT,REMOVAL OF FOOT FOREIGN BODY,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
28192,CPT,REMOVAL OF FOOT FOREIGN BODY,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
28193,CPT,REMOVAL OF FOOT FOREIGN BODY,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
28200,CPT,REPAIR OF FOOT TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28202,CPT,REPAIR/GRAFT OF FOOT TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28208,CPT,REPAIR OF FOOT TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28210,CPT,REPAIR/GRAFT OF FOOT TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28220,CPT,RELEASE OF FOOT TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28222,CPT,RELEASE OF FOOT TENDONS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28225,CPT,RELEASE OF FOOT TENDON,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28226,CPT,RELEASE OF FOOT TENDONS,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28230,CPT,INCISION OF FOOT TENDON(S),,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28232,CPT,INCISION OF TOE TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28234,CPT,INCISION OF FOOT TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28238,CPT,REVISION OF FOOT TENDON,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28240,CPT,RELEASE OF BIG TOE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28250,CPT,REVISION OF FOOT FASCIA,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28260,CPT,RELEASE OF MIDFOOT JOINT,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28261,CPT,REVISION OF FOOT TENDON,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28262,CPT,REVISION OF FOOT AND ANKLE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28264,CPT,RELEASE OF MIDFOOT JOINT,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28270,CPT,RELEASE OF FOOT CONTRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28272,CPT,RELEASE OF TOE JOINT EACH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28280,CPT,FUSION OF TOES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28285,CPT,REPAIR OF HAMMERTOE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28286,CPT,REPAIR OF HAMMERTOE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28288,CPT,PARTIAL REMOVAL OF FOOT BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28289,CPT,CORRJ HALUX RIGDUS W/O IMPLT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28291,CPT,CORRJ HALUX RIGDUS W/IMPLT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28292,CPT,CORRECTION HALLUX VALGUS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28295,CPT,CORRECTION HALLUX VALGUS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28296,CPT,CORRECTION HALLUX VALGUS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28297,CPT,CORRECTION HALLUX VALGUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28298,CPT,CORRECTION HALLUX VALGUS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28299,CPT,CORRECTION HALLUX VALGUS,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
28300,CPT,INCISION OF HEEL BONE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28302,CPT,INCISION OF ANKLE BONE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28304,CPT,INCISION OF MIDFOOT BONES,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28305,CPT,INCISE/GRAFT MIDFOOT BONES,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28306,CPT,INCISION OF METATARSAL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28307,CPT,INCISION OF METATARSAL,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
28308,CPT,INCISION OF METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28309,CPT,INCISION OF METATARSALS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28310,CPT,REVISION OF BIG TOE,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
28312,CPT,REVISION OF TOE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28313,CPT,REPAIR DEFORMITY OF TOE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28315,CPT,REMOVAL OF SESAMOID BONE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28320,CPT,REPAIR OF FOOT BONES,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
28322,CPT,REPAIR OF METATARSALS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28340,CPT,RESECT ENLARGED TOE TISSUE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28341,CPT,RESECT ENLARGED TOE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28344,CPT,REPAIR EXTRA TOE(S),,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28345,CPT,REPAIR WEBBED TOE(S),,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28360,CPT,RECONSTRUCT CLEFT FOOT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28400,CPT,TREATMENT OF HEEL FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28405,CPT,TREATMENT OF HEEL FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28406,CPT,TREATMENT OF HEEL FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28415,CPT,TREAT HEEL FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28420,CPT,TREAT/GRAFT HEEL FRACTURE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
28430,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28435,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28436,CPT,TREATMENT OF ANKLE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28445,CPT,TREAT ANKLE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28446,CPT,OSTEOCHONDRAL TALUS AUTOGRFT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28450,CPT,TREAT MIDFOOT FRACTURE EACH,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28455,CPT,TREAT MIDFOOT FRACTURE EACH,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28456,CPT,TREAT MIDFOOT FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28465,CPT,TREAT MIDFOOT FRACTURE EACH,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28470,CPT,TREAT METATARSAL FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28475,CPT,TREAT METATARSAL FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28476,CPT,TREAT METATARSAL FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28485,CPT,TREAT METATARSAL FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28490,CPT,TREAT BIG TOE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28495,CPT,TREAT BIG TOE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28496,CPT,TREAT BIG TOE FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28505,CPT,TREAT BIG TOE FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28510,CPT,TREATMENT OF TOE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28515,CPT,TREATMENT OF TOE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28525,CPT,TREAT TOE FRACTURE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28530,CPT,TREAT SESAMOID BONE FRACTURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28531,CPT,TREAT SESAMOID BONE FRACTURE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28540,CPT,TREAT FOOT DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28545,CPT,TREAT FOOT DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28546,CPT,TREAT FOOT DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28555,CPT,REPAIR FOOT DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28570,CPT,TREAT FOOT DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28575,CPT,TREAT FOOT DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28576,CPT,TREAT FOOT DISLOCATION,,30,,,"$20,116.91",$0.00,1,0,1,20210101,
28585,CPT,REPAIR FOOT DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28600,CPT,TREAT FOOT DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28605,CPT,TREAT FOOT DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28606,CPT,TREAT FOOT DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28615,CPT,REPAIR FOOT DISLOCATION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28630,CPT,TREAT TOE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28635,CPT,TREAT TOE DISLOCATION,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28636,CPT,TREAT TOE DISLOCATION,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28645,CPT,REPAIR TOE DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28660,CPT,TREAT TOE DISLOCATION,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
28665,CPT,TREAT TOE DISLOCATION,,30,,,$946.79,$0.00,1,0,1,20210101,
28666,CPT,TREAT TOE DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28675,CPT,REPAIR OF TOE DISLOCATION,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28705,CPT,FUSION OF FOOT BONES,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
28715,CPT,FUSION OF FOOT BONES,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
28725,CPT,FUSION OF FOOT BONES,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
28730,CPT,FUSION OF FOOT BONES,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
28735,CPT,FUSION OF FOOT BONES,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
28737,CPT,REVISION OF FOOT BONES,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
28740,CPT,FUSION OF FOOT BONES,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28750,CPT,FUSION OF BIG TOE JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28755,CPT,FUSION OF BIG TOE JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28760,CPT,FUSION OF BIG TOE JOINT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
28800,CPT,AMPUTATION OF MIDFOOT,,30,,,"$15,018.78",$0.00,1,0,1,20210101,
28805,CPT,AMPUTATION THRU METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28810,CPT,AMPUTATION TOE & METATARSAL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
28820,CPT,AMPUTATION OF TOE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28825,CPT,PARTIAL AMPUTATION OF TOE,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
28890,CPT,HI ENRGY ESWT PLANTAR FASCIA,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
28899,CPT,FOOT/TOES SURGERY PROCEDURE,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
29000,CPT,APPLICATION OF BODY CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29010,CPT,APPLICATION OF BODY CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29015,CPT,APPLICATION OF BODY CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29035,CPT,APPLICATION OF BODY CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29040,CPT,APPLICATION OF BODY CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29044,CPT,APPLICATION OF BODY CAST,,30,,,$786.82,$0.00,1,0,1,20210101,
29046,CPT,APPLICATION OF BODY CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29049,CPT,APPLICATION OF FIGURE EIGHT,,30,,,$946.79,$0.00,1,0,1,20210101,
29055,CPT,APPLICATION OF SHOULDER CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29058,CPT,APPLICATION OF SHOULDER CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29065,CPT,APPLICATION OF LONG ARM CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29075,CPT,APPLICATION OF FOREARM CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29085,CPT,APPLY HAND/WRIST CAST,,30,,,$786.82,$0.00,1,0,1,20210101,
29086,CPT,APPLY FINGER CAST,,30,,,$786.82,$0.00,1,0,1,20210101,
29105,CPT,APPLY LONG ARM SPLINT,,30,,,$786.82,$0.00,1,0,1,20210101,
29125,CPT,APPLY FOREARM SPLINT,,30,,,$584.38,$0.00,1,0,1,20210101,
29126,CPT,APPLY FOREARM SPLINT,,30,,,$584.38,$0.00,1,0,1,20210101,
29130,CPT,APPLICATION OF FINGER SPLINT,,30,,,$476.84,$0.00,1,0,1,20210101,
29131,CPT,APPLICATION OF FINGER SPLINT,,30,,,$373.96,$0.00,1,0,1,20210101,
29200,CPT,STRAPPING OF CHEST,,30,,,$786.82,$0.00,1,0,1,20210101,
29240,CPT,STRAPPING OF SHOULDER,,30,,,$584.38,$0.00,1,0,1,20210101,
29260,CPT,STRAPPING OF ELBOW OR WRIST,,30,,,$282.49,$0.00,1,0,1,20210101,
29280,CPT,STRAPPING OF HAND OR FINGER,,30,,,$282.49,$0.00,1,0,1,20210101,
29305,CPT,APPLICATION OF HIP CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29325,CPT,APPLICATION OF HIP CASTS,,30,,,$946.79,$0.00,1,0,1,20210101,
29345,CPT,APPLICATION OF LONG LEG CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29355,CPT,APPLICATION OF LONG LEG CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29358,CPT,APPLY LONG LEG CAST BRACE,,30,,,$946.79,$0.00,1,0,1,20210101,
29365,CPT,APPLICATION OF LONG LEG CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29405,CPT,APPLY SHORT LEG CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29425,CPT,APPLY SHORT LEG CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29435,CPT,APPLY SHORT LEG CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29440,CPT,ADDITION OF WALKER TO CAST,,30,,,$786.82,$0.00,1,0,1,20210101,
29445,CPT,APPLY RIGID LEG CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29450,CPT,APPLICATION OF LEG CAST,,30,,,$786.82,$0.00,1,0,1,20210101,
29505,CPT,APPLICATION LONG LEG SPLINT,,30,,,$786.82,$0.00,1,0,1,20210101,
29515,CPT,APPLICATION LOWER LEG SPLINT,,30,,,$786.82,$0.00,1,0,1,20210101,
29520,CPT,STRAPPING OF HIP,,30,,,$476.84,$0.00,1,0,1,20210101,
29530,CPT,STRAPPING OF KNEE,,30,,,$584.38,$0.00,1,0,1,20210101,
29540,CPT,STRAPPING OF ANKLE AND/OR FT,,30,,,$786.82,$0.00,1,0,1,20210101,
29550,CPT,STRAPPING OF TOES,,30,,,$373.96,$0.00,1,0,1,20210101,
29580,CPT,APPLICATION OF PASTE BOOT,,30,,,$786.82,$0.00,1,0,1,20210101,
29581,CPT,APPLY MULTLAY COMPRS LWR LEG,,30,,,$786.82,$0.00,1,0,1,20210101,
29584,CPT,APPL MULTLAY COMPRS ARM/HAND,,30,,,$786.82,$0.00,1,0,1,20210101,
29700,CPT,REMOVAL/REVISION OF CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29705,CPT,REMOVAL/REVISION OF CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29710,CPT,REMOVAL/REVISION OF CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29720,CPT,REPAIR OF BODY CAST,,30,,,$786.82,$0.00,1,0,1,20210101,
29730,CPT,WINDOWING OF CAST,,30,,,$786.82,$0.00,1,0,1,20210101,
29740,CPT,WEDGING OF CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29750,CPT,WEDGING OF CLUBFOOT CAST,,30,,,$946.79,$0.00,1,0,1,20210101,
29799,CPT,CASTING/STRAPPING PROCEDURE,,30,,,$786.82,$0.00,1,0,1,20210101,
29800,CPT,JAW ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29804,CPT,JAW ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29805,CPT,SHO ARTHRS DX +- SYNOVIAL BX,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29806,CPT,SHO ARTHRS SRG CAPSULORPAPHY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29807,CPT,SHO ARTHRS SRG RPR SLAP LES,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29819,CPT,SHO ARTHRS SRG RMVL LOOSE/FB,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29820,CPT,SHO ARTHRS SRG PRTL SYNVCT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29821,CPT,SHO ARTHRS SRG COMPL SYNVCT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29822,CPT,SHO ARTHRS SRG LMTD DBRDMT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29823,CPT,SHO ARTHRS SRG XTNSV DBRDMT,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29824,CPT,SHO ARTHRS SRG DSTL CLAVICLC,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29825,CPT,SHO ARTHRS SRG LSS&RESCJ ADS,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29826,CPT,SHO ARTHRS SRG DECOMPRESSION,,30,,,"$8,739.18",$0.00,1,0,1,20210101,
29827,CPT,SHO ARTHRS SRG RT8TR CUF RPR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29828,CPT,SHO ARTHRS SRG BICP TENODSIS,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29830,CPT,ELBOW ARTHROSCOPY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29834,CPT,ELBOW ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29835,CPT,ELBOW ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29836,CPT,ELBOW ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29837,CPT,ELBOW ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29838,CPT,ELBOW ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29840,CPT,WRIST ARTHROSCOPY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29843,CPT,WRIST ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29844,CPT,WRIST ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29845,CPT,WRIST ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29846,CPT,WRIST ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29847,CPT,WRIST ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29848,CPT,WRIST ENDOSCOPY/SURGERY,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
29850,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
29851,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
29855,CPT,TIBIAL ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29856,CPT,TIBIAL ARTHROSCOPY/SURGERY,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
29860,CPT,HIP ARTHROSCOPY DX,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29861,CPT,HIP ARTHRO W/FB REMOVAL,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
29862,CPT,HIP ARTHR0 W/DEBRIDEMENT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29863,CPT,HIP ARTHR0 W/SYNOVECTOMY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29866,CPT,AUTGRFT IMPLNT KNEE W/SCOPE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29867,CPT,ALLGRFT IMPLNT KNEE W/SCOPE,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
29868,CPT,MENISCAL TRNSPL KNEE W/SCPE,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29870,CPT,KNEE ARTHROSCOPY DX,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29871,CPT,KNEE ARTHROSCOPY/DRAINAGE,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29873,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29874,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29875,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29876,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29877,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29879,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29880,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29881,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29882,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29883,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29884,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29885,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29886,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29887,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29888,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29889,CPT,KNEE ARTHROSCOPY/SURGERY,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
29891,CPT,ANKLE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29892,CPT,ANKLE ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29893,CPT,SCOPE PLANTAR FASCIOTOMY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29894,CPT,ANKLE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29895,CPT,ANKLE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29897,CPT,ANKLE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29898,CPT,ANKLE ARTHROSCOPY/SURGERY,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29899,CPT,ANKLE ARTHROSCOPY/SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29900,CPT,MCP JOINT ARTHROSCOPY DX,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29901,CPT,MCP JOINT ARTHROSCOPY SURG,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29902,CPT,MCP JOINT ARTHROSCOPY SURG,,30,,,"$8,352.00",$0.00,1,0,1,20210101,
29904,CPT,SUBTALAR ARTHRO W/FB RMVL,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29905,CPT,SUBTALAR ARTHRO W/EXC,,30,,,"$20,909.50",$0.00,1,0,1,20210101,
29906,CPT,SUBTALAR ARTHRO W/DEB,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
29907,CPT,SUBTALAR ARTHRO W/FUSION,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
29914,CPT,HIP ARTHRO W/FEMOROPLASTY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29915,CPT,HIP ARTHRO ACETABULOPLASTY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29916,CPT,HIP ARTHRO W/LABRAL REPAIR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
29999,CPT,ARTHROSCOPY OF JOINT,,30,,,"$1,434.36",$0.00,1,0,1,20210101,
30000,CPT,DRAINAGE OF NOSE LESION,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
30020,CPT,DRAINAGE OF NOSE LESION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
30100,CPT,INTRANASAL BIOPSY,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30110,CPT,REMOVAL OF NOSE POLYP(S),,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30115,CPT,REMOVAL OF NOSE POLYP(S),,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30117,CPT,REMOVAL OF INTRANASAL LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30118,CPT,REMOVAL OF INTRANASAL LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30120,CPT,REVISION OF NOSE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30124,CPT,REMOVAL OF NOSE LESION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30125,CPT,REMOVAL OF NOSE LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30130,CPT,EXCISE INFERIOR TURBINATE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30140,CPT,RESECT INFERIOR TURBINATE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30150,CPT,PARTIAL REMOVAL OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30160,CPT,REMOVAL OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30200,CPT,INJECTION TREATMENT OF NOSE,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
30210,CPT,NASAL SINUS THERAPY,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30220,CPT,INSERT NASAL SEPTAL BUTTON,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30300,CPT,REMOVE NASAL FOREIGN BODY,,30,,,$584.38,$0.00,1,0,1,20210101,
30310,CPT,REMOVE NASAL FOREIGN BODY,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30320,CPT,REMOVE NASAL FOREIGN BODY,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30400,CPT,RECONSTRUCTION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30410,CPT,RECONSTRUCTION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30420,CPT,RECONSTRUCTION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30430,CPT,REVISION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30435,CPT,REVISION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30450,CPT,REVISION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30460,CPT,REVISION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30462,CPT,REVISION OF NOSE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30465,CPT,REPAIR NASAL STENOSIS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30468,CPT,RPR NSL VLV COLLAPSE W/IMPLT,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
30520,CPT,REPAIR OF NASAL SEPTUM,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30540,CPT,REPAIR NASAL DEFECT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30545,CPT,REPAIR NASAL DEFECT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30560,CPT,RELEASE OF NASAL ADHESIONS,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
30580,CPT,REPAIR UPPER JAW FISTULA,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30600,CPT,REPAIR MOUTH/NOSE FISTULA,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30620,CPT,INTRANASAL RECONSTRUCTION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
30630,CPT,REPAIR NASAL SEPTUM DEFECT,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30801,CPT,ABLATE INF TURBINATE SUPERF,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30802,CPT,ABLATE INF TURBINATE SUBMUC,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
30901,CPT,CONTROL OF NOSEBLEED,,30,,,$584.38,$0.00,1,0,1,20210101,
30903,CPT,CONTROL OF NOSEBLEED,,30,,,$584.38,$0.00,1,0,1,20210101,
30905,CPT,CONTROL OF NOSEBLEED,,30,,,$584.38,$0.00,1,0,1,20210101,
30906,CPT,REPEAT CONTROL OF NOSEBLEED,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
30915,CPT,LIGATION NASAL SINUS ARTERY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
30920,CPT,LIGATION UPPER JAW ARTERY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
30930,CPT,THER FX NASAL INF TURBINATE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
30999,CPT,NASAL SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
31000,CPT,IRRIGATION MAXILLARY SINUS,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
31002,CPT,IRRIGATION SPHENOID SINUS,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
31020,CPT,EXPLORATION MAXILLARY SINUS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31030,CPT,EXPLORATION MAXILLARY SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31032,CPT,EXPLORE SINUS REMOVE POLYPS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31040,CPT,EXPLORATION BEHIND UPPER JAW,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31050,CPT,EXPLORATION SPHENOID SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31051,CPT,SPHENOID SINUS SURGERY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31070,CPT,EXPLORATION OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31075,CPT,EXPLORATION OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31080,CPT,REMOVAL OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31081,CPT,REMOVAL OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31084,CPT,REMOVAL OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31085,CPT,REMOVAL OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31086,CPT,REMOVAL OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31087,CPT,REMOVAL OF FRONTAL SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31090,CPT,EXPLORATION OF SINUSES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31200,CPT,REMOVAL OF ETHMOID SINUS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31201,CPT,REMOVAL OF ETHMOID SINUS,,30,,,"$8,629.17",$0.00,1,0,1,20210101,
31205,CPT,REMOVAL OF ETHMOID SINUS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31231,CPT,NASAL ENDOSCOPY DX,,30,,,$725.01,$0.00,1,0,1,20210101,
31233,CPT,NSL/SINS NDSC DX MAX SINUSC,,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31235,CPT,NSL/SINS NDSC DX SPHN SINUSC,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31237,CPT,NASAL/SINUS ENDOSCOPY SURG,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31238,CPT,NASAL/SINUS ENDOSCOPY SURG,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31239,CPT,NASAL/SINUS ENDOSCOPY SURG,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31240,CPT,NASAL/SINUS ENDOSCOPY SURG,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31241,CPT,NSL/SINS NDSC W/ARTERY LIG,,30,,,"$8,790.44",$0.00,1,0,1,20210101,
31253,CPT,NSL/SINS NDSC TOTAL,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31254,CPT,NSL/SINS NDSC W/PRTL ETHMDCT,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31255,CPT,NSL/SINS NDSC W/TOT ETHMDCT,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31256,CPT,EXPLORATION MAXILLARY SINUS,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31257,CPT,NSL/SINS NDSC TOT W/SPHENDT,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31259,CPT,NSL/SINS NDSC SPHN TISS RMVL,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31267,CPT,ENDOSCOPY MAXILLARY SINUS,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31276,CPT,NSL/SINS NDSC FRNT TISS RMVL,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31287,CPT,NASAL/SINUS ENDOSCOPY SURG,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31288,CPT,NASAL/SINUS ENDOSCOPY SURG,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31292,CPT,NSL/SINS NDSC MED/INF DCMPRN,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31293,CPT,NSL/SINS NDSC MED&INF DCMPRN,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31294,CPT,NSL/SINS NDSC SURG ON DCMPRN,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31295,CPT,NSL/SINS NDSC SURG MAX SINS,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31296,CPT,NSL/SINS NDSC SURG FRNT SINS,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31297,CPT,NSL/SINS NDSC SURG SPHN SINS,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31298,CPT,NSL/SINS NDSC SURG FRNT&SPHN,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31299,CPT,SINUS SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
31300,CPT,REMOVAL OF LARYNX LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31400,CPT,REVISION OF LARYNX,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31420,CPT,REMOVAL OF EPIGLOTTIS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31500,CPT,INSERT EMERGENCY AIRWAY,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
31502,CPT,CHANGE OF WINDPIPE AIRWAY,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
31505,CPT,DIAGNOSTIC LARYNGOSCOPY,,30,,,$725.01,$0.00,1,0,1,20210101,
31510,CPT,LARYNGOSCOPY WITH BIOPSY,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31511,CPT,REMOVE FOREIGN BODY LARYNX,,30,,,$725.01,$0.00,1,0,1,20210101,
31512,CPT,REMOVAL OF LARYNX LESION,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31513,CPT,INJECTION INTO VOCAL CORD,,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31515,CPT,LARYNGOSCOPY FOR ASPIRATION,,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31520,CPT,DX LARYNGOSCOPY NEWBORN,,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31525,CPT,DX LARYNGOSCOPY EXCL NB,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31526,CPT,DX LARYNGOSCOPY W/OPER SCOPE,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31527,CPT,LARYNGOSCOPY FOR TREATMENT,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31528,CPT,LARYNGOSCOPY AND DILATION,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31529,CPT,LARYNGOSCOPY AND DILATION,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31530,CPT,LARYNGOSCOPY W/FB REMOVAL,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31531,CPT,LARYNGOSCOPY W/FB & OP SCOPE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31535,CPT,LARYNGOSCOPY W/BIOPSY,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31536,CPT,LARYNGOSCOPY W/BX & OP SCOPE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31540,CPT,LARYNGOSCOPY W/EXC OF TUMOR,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31541,CPT,LARYNSCOP W/TUMR EXC + SCOPE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31545,CPT,REMOVE VC LESION W/SCOPE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31546,CPT,REMOVE VC LESION SCOPE/GRAFT,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31551,CPT,LARYNGOPLASTY LARYNGEAL STEN,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31552,CPT,LARYNGOPLASTY LARYNGEAL STEN,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31553,CPT,LARYNGOPLASTY LARYNGEAL STEN,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31554,CPT,LARYNGOPLASTY LARYNGEAL STEN,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31560,CPT,LARYNGOSCOP W/ARYTENOIDECTOM,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31561,CPT,LARYNSCOP REMVE CART + SCOP,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31570,CPT,LARYNGOSCOPE W/VC INJ,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31571,CPT,LARYNGOSCOP W/VC INJ + SCOPE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31572,CPT,LARGSC W/LASER DSTRJ LES,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31573,CPT,LARGSC W/THER INJECTION,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31574,CPT,LARGSC W/NJX AUGMENTATION,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31575,CPT,DIAGNOSTIC LARYNGOSCOPY,,30,,,$725.01,$0.00,1,0,1,20210101,
31576,CPT,LARYNGOSCOPY WITH BIOPSY,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31577,CPT,LARGSC W/RMVL FOREIGN BDY(S),,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31578,CPT,LARGSC W/REMOVAL LESION,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31579,CPT,LARYNGOSCOPY TELESCOPIC,,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31580,CPT,LARYNGOPLASTY LARYNGEAL WEB,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31584,CPT,LARYNGOPLASTY FX RDCTJ FIXJ,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31587,CPT,LARYNGOPLASTY CRICOID SPLIT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31590,CPT,REINNERVATE LARYNX,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31591,CPT,LARYNGOPLASTY MEDIALIZATION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31592,CPT,CRICOTRACHEAL RESECTION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31599,CPT,LARYNX SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
31600,CPT,INCISION OF WINDPIPE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31601,CPT,INCISION OF WINDPIPE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31603,CPT,INCISION OF WINDPIPE,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
31605,CPT,INCISION OF WINDPIPE,,30,,,"$1,490.05",$0.00,1,0,1,20210101,
31610,CPT,INCISION OF WINDPIPE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31611,CPT,SURGERY/SPEECH PROSTHESIS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31612,CPT,PUNCTURE/CLEAR WINDPIPE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31613,CPT,REPAIR WINDPIPE OPENING,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31614,CPT,REPAIR WINDPIPE OPENING,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31615,CPT,VISUALIZATION OF WINDPIPE,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
31622,CPT,DX BRONCHOSCOPE/WASH,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31623,CPT,DX BRONCHOSCOPE/BRUSH,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31624,CPT,DX BRONCHOSCOPE/LAVAGE,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31625,CPT,BRONCHOSCOPY W/BIOPSY(S),,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31626,CPT,BRONCHOSCOPY W/MARKERS,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31627,CPT,NAVIGATIONAL BRONCHOSCOPY,,30,,,"$3,580.48",$0.00,1,0,1,20210101,
31628,CPT,BRONCHOSCOPY/LUNG BX EACH,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31629,CPT,BRONCHOSCOPY/NEEDLE BX EACH,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31630,CPT,BRONCHOSCOPY DILATE/FX REPR,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31631,CPT,BRONCHOSCOPY DILATE W/STENT,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31632,CPT,BRONCHOSCOPY/LUNG BX ADDL,,30,,,"$2,774.78",$0.00,1,0,1,20210101,
31633,CPT,BRONCHOSCOPY/NEEDLE BX ADDL,,30,,,"$3,310.39",$0.00,1,0,1,20210101,
31634,CPT,BRONCH W/BALLOON OCCLUSION,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31635,CPT,BRONCHOSCOPY W/FB REMOVAL,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31636,CPT,BRONCHOSCOPY BRONCH STENTS,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31637,CPT,BRONCHOSCOPY STENT ADD-ON,,30,,,"$3,738.94",$0.00,1,0,1,20210101,
31638,CPT,BRONCHOSCOPY REVISE STENT,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31640,CPT,BRONCHOSCOPY W/TUMOR EXCISE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31641,CPT,BRONCHOSCOPY TREAT BLOCKAGE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31643,CPT,DIAG BRONCHOSCOPE/CATHETER,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31645,CPT,BRNCHSC W/THER ASPIR 1ST,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31646,CPT,BRNCHSC W/THER ASPIR SBSQ,,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31647,CPT,BRONCHIAL VALVE INIT INSERT,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31648,CPT,BRONCHIAL VALVE REMOV INIT,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31649,CPT,BRONCHIAL VALVE REMOV ADDL,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31651,CPT,BRONCHIAL VALVE ADDL INSERT,,30,,,"$6,452.29",$0.00,1,0,1,20210101,
31652,CPT,BRONCH EBUS SAMPLNG 1/2 NODE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31653,CPT,BRONCH EBUS SAMPLNG 3/> NODE,,30,,,"$15,770.84",$0.00,1,0,1,20210101,
31654,CPT,BRONCH EBUS IVNTJ PERPH LES,,30,,,"$3,840.40",$0.00,1,0,1,20210101,
31660,CPT,BRONCH THERMOPLSTY 1 LOBE,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31661,CPT,BRONCH THERMOPLSTY 2/> LOBES,,30,,,"$22,771.90",$0.00,1,0,1,20210101,
31717,CPT,BRONCHIAL BRUSH BIOPSY,,30,,,"$1,488.13",$0.00,1,0,1,20210101,
31720,CPT,CLEARANCE OF AIRWAYS,,30,,,$465.55,$0.00,1,0,1,20210101,
31730,CPT,INTRO WINDPIPE WIRE/TUBE,,30,,,"$8,756.99",$0.00,1,0,1,20210101,
31750,CPT,REPAIR OF WINDPIPE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31755,CPT,REPAIR OF WINDPIPE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31785,CPT,REMOVE WINDPIPE LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
31820,CPT,CLOSURE OF WINDPIPE LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31825,CPT,REPAIR OF WINDPIPE DEFECT,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31830,CPT,REVISE WINDPIPE SCAR,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
31899,CPT,AIRWAYS SURGICAL PROCEDURE,,30,,,$725.01,$0.00,1,0,1,20210101,
32400,CPT,NEEDLE BIOPSY CHEST LINING,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
32408,CPT,CORE NDL BX LNG/MED PERQ,,30,,,"$8,380.16",$0.00,1,0,1,20210101,
32550,CPT,INSERT PLEURAL CATH,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
32551,CPT,INSERTION OF CHEST TUBE,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
32552,CPT,REMOVE LUNG CATHETER,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
32553,CPT,INS MARK THOR FOR RT PERQ,,30,,,"$7,691.66",$0.00,1,0,1,20210101,
32554,CPT,ASPIRATE PLEURA W/O IMAGING,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
32555,CPT,ASPIRATE PLEURA W/ IMAGING,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
32556,CPT,INSERT CATH PLEURA W/O IMAGE,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
32557,CPT,INSERT CATH PLEURA W/ IMAGE,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
32560,CPT,TREAT PLEURODESIS W/AGENT,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
32561,CPT,LYSE CHEST FIBRIN INIT DAY,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
32562,CPT,LYSE CHEST FIBRIN SUBQ DAY,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
32601,CPT,THORACOSCOPY DIAGNOSTIC,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32604,CPT,THORACOSCOPY WBX SAC,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32606,CPT,THORACOSCOPY W/BX MED SPACE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32607,CPT,THORACOSCOPY W/BX INFILTRATE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32608,CPT,THORACOSCOPY W/BX NODULE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32609,CPT,THORACOSCOPY W/BX PLEURA,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32701,CPT,THORAX STEREO RAD TARGETW/TX,,30,,,"$1,483.87",$0.00,1,0,1,20210101,
32960,CPT,THERAPEUTIC PNEUMOTHORAX,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
32994,CPT,ABLATE PULM TUMOR PERQ CRYBL,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32998,CPT,ABLATE PULM TUMOR PERQ RF,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
32999,CPT,CHEST SURGERY PROCEDURE,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
33016,CPT,PERICARDIOCENTESIS W/IMAGING,,30,,,"$8,996.76",$0.00,1,0,1,20210101,
33206,CPT,INSERT HEART PM ATRIAL,,30,,,"$21,593.81",$0.00,1,0,1,20210101,
33207,CPT,INSERT HEART PM VENTRICULAR,,30,,,"$21,593.81",$0.00,1,0,1,20210101,
33208,CPT,INSRT HEART PM ATRIAL & VENT,,30,,,"$21,593.81",$0.00,1,0,1,20210101,
33210,CPT,INSERT ELECTRD/PM CATH SNGL,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33211,CPT,INSERT CARD ELECTRODES DUAL,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33212,CPT,INSERT PULSE GEN SNGL LEAD,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33213,CPT,INSERT PULSE GEN DUAL LEADS,,30,,,"$21,593.81",$0.00,1,0,1,20210101,
33214,CPT,UPGRADE OF PACEMAKER SYSTEM,,30,,,"$21,593.81",$0.00,1,0,1,20210101,
33215,CPT,REPOSITION PACING-DEFIB LEAD,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
33216,CPT,INSERT 1 ELECTRODE PM-DEFIB,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33217,CPT,INSERT 2 ELECTRODE PM-DEFIB,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33218,CPT,REPAIR LEAD PACE-DEFIB ONE,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33220,CPT,REPAIR LEAD PACE-DEFIB DUAL,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33221,CPT,INSERT PULSE GEN MULT LEADS,,30,,,"$38,086.31",$0.00,1,0,1,20210101,
33222,CPT,RELOCATION POCKET PACEMAKER,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
33223,CPT,RELOCATE POCKET FOR DEFIB,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
33224,CPT,INSERT PACING LEAD & CONNECT,,30,,,"$21,593.81",$0.00,1,0,1,20210101,
33225,CPT,L VENTRIC PACING LEAD ADD-ON,,30,,,"$26,464.60",$0.00,1,0,1,20210101,
33226,CPT,REPOSITION L VENTRIC LEAD,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
33227,CPT,REMOVE&REPLACE PM GEN SINGL,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33228,CPT,REMV&REPLC PM GEN DUAL LEAD,,30,,,"$21,593.81",$0.00,1,0,1,20210101,
33229,CPT,REMV&REPLC PM GEN MULT LEADS,,30,,,"$38,086.31",$0.00,1,0,1,20210101,
33230,CPT,INSRT PULSE GEN W/DUAL LEADS,,30,,,"$47,537.74",$0.00,1,0,1,20210101,
33231,CPT,INSRT PULSE GEN W/MULT LEADS,,30,,,"$67,126.47",$0.00,1,0,1,20210101,
33233,CPT,REMOVAL OF PM GENERATOR,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33234,CPT,REMOVAL OF PACEMAKER SYSTEM,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33235,CPT,REMOVAL PACEMAKER ELECTRODE,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33240,CPT,INSRT PULSE GEN W/SINGL LEAD,,30,,,"$47,537.74",$0.00,1,0,1,20210101,
33241,CPT,REMOVE PULSE GENERATOR,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33244,CPT,REMOVE ELCTRD TRANSVENOUSLY,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33249,CPT,INSJ/RPLCMT DEFIB W/LEAD(S),,30,,,"$67,126.47",$0.00,1,0,1,20210101,
33262,CPT,RMVL& REPLC PULSE GEN 1 LEAD,,30,,,"$47,537.74",$0.00,1,0,1,20210101,
33263,CPT,RMVL & RPLCMT DFB GEN 2 LEAD,,30,,,"$47,537.74",$0.00,1,0,1,20210101,
33264,CPT,RMVL & RPLCMT DFB GEN MLT LD,,30,,,"$67,126.47",$0.00,1,0,1,20210101,
33270,CPT,INS/REP SUBQ DEFIBRILLATOR,,30,,,"$67,126.47",$0.00,1,0,1,20210101,
33271,CPT,INSJ SUBQ IMPLTBL DFB ELCTRD,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
33272,CPT,RMVL OF SUBQ DEFIBRILLATOR,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33273,CPT,REPOS PREV IMPLTBL SUBQ DFB,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
33274,CPT,TCAT INSJ/RPL PERM LDLS PM,,30,,,"$33,317.60",$0.00,1,0,1,20210101,
33275,CPT,TCAT RMVL PERM LDLS PM W/IMG,,30,,,"$14,905.19",$0.00,1,0,1,20210101,
33285,CPT,INSJ SUBQ CAR RHYTHM MNTR,,30,,,"$22,704.41",$0.00,1,0,1,20210101,
33286,CPT,RMVL SUBQ CAR RHYTHM MNTR,,30,,,"$3,524.56",$0.00,1,0,1,20210101,
33289,CPT,TCAT IMPL WRLS P-ART PRS SNR,,30,,,"$59,627.33",$0.00,1,0,1,20210101,
33419,CPT,REPAIR TCAT MITRAL VALVE,,30,,,"$27,182.65",$0.00,1,0,1,20210101,
33508,CPT,ENDOSCOPIC VEIN HARVEST,,30,,,$208.62,$0.00,1,0,1,20210101,
33999,CPT,CARDIAC SURGERY PROCEDURE,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
34101,CPT,REMOVAL OF ARTERY CLOT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
34111,CPT,REMOVAL OF ARM ARTERY CLOT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
34201,CPT,REMOVAL OF ARTERY CLOT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
34203,CPT,REMOVAL OF LEG ARTERY CLOT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
34421,CPT,REMOVAL OF VEIN CLOT,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
34471,CPT,REMOVAL OF VEIN CLOT,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
34490,CPT,REMOVAL OF VEIN CLOT,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
34501,CPT,REPAIR VALVE FEMORAL VEIN,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
34510,CPT,TRANSPOSITION OF VEIN VALVE,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
34520,CPT,CROSS-OVER VEIN GRAFT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
34530,CPT,LEG VEIN FUSION,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
34713,CPT,PERQ ACCESS & CLSR FEM ART,,30,,,"$14,800.94",$0.00,1,0,1,20210101,
35011,CPT,REPAIR DEFECT OF ARTERY,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35045,CPT,REPAIR DEFECT OF ARM ARTERY,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35180,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$5,150.45",$0.00,1,0,1,20210101,
35184,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
35188,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35190,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35201,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35206,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
35207,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
35226,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
35231,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
35236,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35256,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35261,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
35266,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35286,CPT,REPAIR BLOOD VESSEL LESION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35321,CPT,RECHANNELING OF ARTERY,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35372,CPT,RECHANNELING OF ARTERY,,30,,,"$20,945.36",$0.00,1,0,1,20210101,
35500,CPT,HARVEST VEIN FOR BYPASS,,30,,,"$7,542.77",$0.00,1,0,1,20210101,
35572,CPT,HARVEST FEMOROPOPLITEAL VEIN,,30,,,"$2,125.82",$0.00,1,0,1,20210101,
35685,CPT,BYPASS GRAFT PATENCY/PATCH,,30,,,"$10,281.48",$0.00,1,0,1,20210101,
35686,CPT,BYPASS GRAFT/AV FIST PATENCY,,30,,,"$10,281.48",$0.00,1,0,1,20210101,
35800,CPT,EXPLORE NECK VESSELS,,30,,,"$20,945.36",$0.00,1,0,1,20210101,
35860,CPT,EXPLORE LIMB VESSELS,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
35875,CPT,REMOVAL OF CLOT IN GRAFT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35876,CPT,REMOVAL OF CLOT IN GRAFT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35879,CPT,REVISE GRAFT W/VEIN,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35881,CPT,REVISE GRAFT W/VEIN,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35883,CPT,REVISE GRAFT W/NONAUTO GRAFT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35884,CPT,REVISE GRAFT W/VEIN,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
35903,CPT,EXCISION GRAFT EXTREMITY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36000,CPT,PLACE NEEDLE IN VEIN,,30,,,$221.03,$0.00,1,0,1,20210101,
36002,CPT,PSEUDOANEURYSM INJECTION TRT,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
36005,CPT,INJECTION EXT VENOGRAPHY,,30,,,"$1,943.03",$0.00,1,0,1,20210101,
36010,CPT,PLACE CATHETER IN VEIN,,30,,,"$3,356.58",$0.00,1,0,1,20210101,
36011,CPT,PLACE CATHETER IN VEIN,,30,,,"$2,944.70",$0.00,1,0,1,20210101,
36012,CPT,PLACE CATHETER IN VEIN,,30,,,"$3,391.21",$0.00,1,0,1,20210101,
36013,CPT,PLACE CATHETER IN ARTERY,,30,,,"$2,887.28",$0.00,1,0,1,20210101,
36014,CPT,PLACE CATHETER IN ARTERY,,30,,,"$3,393.83",$0.00,1,0,1,20210101,
36015,CPT,PLACE CATHETER IN ARTERY,,30,,,"$3,753.24",$0.00,1,0,1,20210101,
36100,CPT,ESTABLISH ACCESS TO ARTERY,,30,,,$688.44,$0.00,1,0,1,20210101,
36140,CPT,INTRO NDL ICATH UPR/LXTR ART,,30,,,"$2,854.28",$0.00,1,0,1,20210101,
36160,CPT,ESTABLISH ACCESS TO AORTA,,30,,,"$2,813.61",$0.00,1,0,1,20210101,
36200,CPT,PLACE CATHETER IN AORTA,,30,,,"$3,784.33",$0.00,1,0,1,20210101,
36215,CPT,PLACE CATHETER IN ARTERY,,30,,,"$3,922.94",$0.00,1,0,1,20210101,
36216,CPT,PLACE CATHETER IN ARTERY,,30,,,"$3,954.08",$0.00,1,0,1,20210101,
36217,CPT,PLACE CATHETER IN ARTERY,,30,,,"$4,508.94",$0.00,1,0,1,20210101,
36218,CPT,PLACE CATHETER IN ARTERY,,30,,,"$2,698.86",$0.00,1,0,1,20210101,
36221,CPT,PLACE CATH THORACIC AORTA,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36222,CPT,PLACE CATH CAROTID/INOM ART,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36223,CPT,PLACE CATH CAROTID/INOM ART,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36224,CPT,PLACE CATH CAROTD ART,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36225,CPT,PLACE CATH SUBCLAVIAN ART,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36226,CPT,PLACE CATH VERTEBRAL ART,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36227,CPT,PLACE CATH XTRNL CAROTID,,30,,,"$10,587.93",$0.00,1,0,1,20210101,
36228,CPT,PLACE CATH INTRACRANIAL ART,,30,,,"$8,826.32",$0.00,1,0,1,20210101,
36245,CPT,INS CATH ABD/L-EXT ART 1ST,,30,,,"$4,444.75",$0.00,1,0,1,20210101,
36246,CPT,INS CATH ABD/L-EXT ART 2ND,,30,,,"$4,784.48",$0.00,1,0,1,20210101,
36247,CPT,INS CATH ABD/L-EXT ART 3RD,,30,,,"$5,488.77",$0.00,1,0,1,20210101,
36248,CPT,INS CATH ABD/L-EXT ART ADDL,,30,,,"$2,970.35",$0.00,1,0,1,20210101,
36251,CPT,INS CATH REN ART 1ST UNILAT,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36252,CPT,INS CATH REN ART 1ST BILAT,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36253,CPT,INS CATH REN ART 2ND+ UNILAT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36254,CPT,INS CATH REN ART 2ND+ BILAT,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36260,CPT,INSERTION OF INFUSION PUMP,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36261,CPT,REVISION OF INFUSION PUMP,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
36262,CPT,REMOVAL OF INFUSION PUMP,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
36299,CPT,VESSEL INJECTION PROCEDURE,,30,,,"$6,079.67",$0.00,1,0,1,20210101,
36400,CPT,BL DRAW < 3 YRS FEM/JUGULAR,,30,,,$239.42,$0.00,1,0,1,20210101,
36405,CPT,BL DRAW <3 YRS SCALP VEIN,,30,,,$211.75,$0.00,1,0,1,20210101,
36406,CPT,BL DRAW <3 YRS OTHER VEIN,,30,,,$83.64,$0.00,1,0,1,20210101,
36410,CPT,NON-ROUTINE BL DRAW 3/> YRS,,30,,,$316.26,$0.00,1,0,1,20210101,
36415,CPT,ROUTINE VENIPUNCTURE,,30,,,$38.70,$0.00,1,0,1,20210101,
36416,CPT,CAPILLARY BLOOD DRAW,,30,,,$32.50,$0.00,1,0,1,20210101,
36420,CPT,VEIN ACCESS CUTDOWN < 1 YR,,30,,,$476.84,$0.00,1,0,1,20210101,
36425,CPT,VEIN ACCESS CUTDOWN > 1 YR,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
36430,CPT,BLOOD TRANSFUSION SERVICE,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
36440,CPT,BL PUSH TRANSFUSE 2 YR/<,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
36450,CPT,BL EXCHANGE/TRANSFUSE NB,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
36455,CPT,BL EXCHANGE/TRANSFUSE NON-NB,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
36456,CPT,PRTL EXCHANGE TRANSFUSE NB,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
36460,CPT,TRANSFUSION SERVICE FETAL,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
36465,CPT,NJX NONCMPND SCLRSNT 1 VEIN,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
36466,CPT,NJX NONCMPND SCLRSNT MLT VN,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
36468,CPT,NJX SCLRSNT SPIDER VEINS,,30,,,$847.76,$0.00,1,0,1,20210101,
36470,CPT,NJX SCLRSNT 1 INCMPTNT VEIN,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
36471,CPT,NJX SCLRSNT MLT INCMPTNT VN,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
36473,CPT,ENDOVENOUS MCHNCHEM 1ST VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36474,CPT,ENDOVENOUS MCHNCHEM ADD-ON,,30,,,"$3,878.22",$0.00,1,0,1,20210101,
36475,CPT,ENDOVENOUS RF 1ST VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36476,CPT,ENDOVENOUS RF VEIN ADD-ON,,30,,,"$5,906.40",$0.00,1,0,1,20210101,
36478,CPT,ENDOVENOUS LASER 1ST VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36479,CPT,ENDOVENOUS LASER VEIN ADDON,,30,,,"$6,181.56",$0.00,1,0,1,20210101,
36481,CPT,INSERTION OF CATHETER VEIN,,30,,,"$4,891.52",$0.00,1,0,1,20210101,
36482,CPT,ENDOVEN THER CHEM ADHES 1ST,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36483,CPT,ENDOVEN THER CHEM ADHES SBSQ,,30,,,"$8,749.98",$0.00,1,0,1,20210101,
36500,CPT,INSERTION OF CATHETER VEIN,,30,,,"$4,124.60",$0.00,1,0,1,20210101,
36510,CPT,INSERTION OF CATHETER VEIN,,30,,,$560.79,$0.00,1,0,1,20210101,
36511,CPT,APHERESIS WBC,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
36512,CPT,APHERESIS RBC,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
36513,CPT,APHERESIS PLATELETS,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
36514,CPT,APHERESIS PLASMA,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
36516,CPT,APHERESIS IMMUNOADS SLCTV,,30,,,"$12,674.77",$0.00,1,0,1,20210101,
36522,CPT,PHOTOPHERESIS,,30,,,"$12,674.77",$0.00,1,0,1,20210101,
36555,CPT,INSERT NON-TUNNEL CV CATH,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
36556,CPT,INSERT NON-TUNNEL CV CATH,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
36557,CPT,INSERT TUNNELED CV CATH,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36558,CPT,INSERT TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36560,CPT,INSERT TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36561,CPT,INSERT TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36563,CPT,INSERT TUNNELED CV CATH,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36565,CPT,INSERT TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36566,CPT,INSERT TUNNELED CV CATH,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36568,CPT,INSJ PICC <5 YR W/O IMAGING,,30,,,"$5,150.45",$0.00,1,0,1,20210101,
36569,CPT,INSJ PICC 5 YR+ W/O IMAGING,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
36570,CPT,INSERT PICVAD CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36571,CPT,INSERT PICVAD CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36572,CPT,INSJ PICC RS&I <5 YR,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
36573,CPT,INSJ PICC RS&I 5 YR+,,30,,,"$8,035.87",$0.00,1,0,1,20210101,
36575,CPT,REPAIR TUNNELED CV CATH,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
36576,CPT,REPAIR TUNNELED CV CATH,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
36578,CPT,REPLACE TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36580,CPT,REPLACE CVAD CATH,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
36581,CPT,REPLACE TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36582,CPT,REPLACE TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36583,CPT,REPLACE TUNNELED CV CATH,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36584,CPT,COMPL RPLCMT PICC RS&I,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
36585,CPT,REPLACE PICVAD CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36589,CPT,REMOVAL TUNNELED CV CATH,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
36590,CPT,REMOVAL TUNNELED CV CATH,,30,,,"$5,150.45",$0.00,1,0,1,20210101,
36591,CPT,DRAW BLOOD OFF VENOUS DEVICE,,30,,,$584.38,$0.00,1,0,1,20210101,
36592,CPT,COLLECT BLOOD FROM PICC,,30,,,$584.38,$0.00,1,0,1,20210101,
36593,CPT,DECLOT VASCULAR DEVICE,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
36595,CPT,MECH REMOV TUNNELED CV CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36596,CPT,MECH REMOV TUNNELED CV CATH,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
36597,CPT,REPOSITION VENOUS CATHETER,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
36598,CPT,INJ W/FLUOR EVAL CV DEVICE,,30,,,$923.68,$0.00,1,0,1,20210101,
36600,CPT,WITHDRAWAL OF ARTERIAL BLOOD,,30,,,$584.38,$0.00,1,0,1,20210101,
36620,CPT,INSERTION CATHETER ARTERY,,30,,,"$1,148.44",$0.00,1,0,1,20210101,
36625,CPT,INSERTION CATHETER ARTERY,,30,,,"$2,295.85",$0.00,1,0,1,20210101,
36640,CPT,INSERTION CATHETER ARTERY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36680,CPT,INSERT NEEDLE BONE CAVITY,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
36800,CPT,INSERTION OF CANNULA,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36810,CPT,INSERTION OF CANNULA,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36815,CPT,INSERTION OF CANNULA,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36818,CPT,AV FUSE UPPR ARM CEPHALIC,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36819,CPT,AV FUSE UPPR ARM BASILIC,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36820,CPT,AV FUSION/FOREARM VEIN,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36821,CPT,AV FUSION DIRECT ANY SITE,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36825,CPT,ARTERY-VEIN AUTOGRAFT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36830,CPT,ARTERY-VEIN NONAUTOGRAFT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36831,CPT,OPEN THROMBECT AV FISTULA,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36832,CPT,AV FISTULA REVISION OPEN,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36833,CPT,AV FISTULA REVISION,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36835,CPT,ARTERY TO VEIN SHUNT,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
36838,CPT,DIST REVAS LIGATION HEMO,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36860,CPT,EXTERNAL CANNULA DECLOTTING,,30,,,"$5,150.45",$0.00,1,0,1,20210101,
36861,CPT,CANNULA DECLOTTING,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
36901,CPT,INTRO CATH DIALYSIS CIRCUIT,,30,,,"$7,218.75",$0.00,1,0,1,20210101,
36902,CPT,INTRO CATH DIALYSIS CIRCUIT,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
36903,CPT,INTRO CATH DIALYSIS CIRCUIT,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
36904,CPT,THRMBC/NFS DIALYSIS CIRCUIT,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
36905,CPT,THRMBC/NFS DIALYSIS CIRCUIT,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
36906,CPT,THRMBC/NFS DIALYSIS CIRCUIT,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
36907,CPT,BALO ANGIOP CTR DIALYSIS SEG,,30,,,"$10,446.82",$0.00,1,0,1,20210101,
36908,CPT,STENT PLMT CTR DIALYSIS SEG,,30,,,"$22,062.70",$0.00,1,0,1,20210101,
36909,CPT,DIALYSIS CIRCUIT EMBOLJ,,30,,,"$17,363.29",$0.00,1,0,1,20210101,
37182,CPT,INSERT HEPATIC SHUNT (TIPS),,30,,,"$20,444.64",$0.00,1,0,1,20210101,
37183,CPT,REMOVE HEPATIC SHUNT (TIPS),,30,,,"$21,919.09",$0.00,1,0,1,20210101,
37184,CPT,PRIM ART M-THRMBC 1ST VSL,,30,,,"$21,131.14",$0.00,1,0,1,20210101,
37185,CPT,PRIM ART M-THRMBC SBSQ VSL,,30,,,"$11,871.41",$0.00,1,0,1,20210101,
37186,CPT,SEC ART THROMBECTOMY ADD-ON,,30,,,"$11,707.76",$0.00,1,0,1,20210101,
37187,CPT,VENOUS MECH THROMBECTOMY,,30,,,"$21,453.98",$0.00,1,0,1,20210101,
37188,CPT,VEN MECHNL THRMBC REPEAT TX,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37191,CPT,INS ENDOVAS VENA CAVA FILTR,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
37192,CPT,REDO ENDOVAS VENA CAVA FILTR,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37193,CPT,REM ENDOVAS VENA CAVA FILTER,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37195,CPT,THROMBOLYTIC THERAPY STROKE,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
37197,CPT,REMOVE INTRVAS FOREIGN BODY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37200,CPT,TRANSCATHETER BIOPSY,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
37211,CPT,THROMBOLYTIC ART THERAPY,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
37212,CPT,THROMBOLYTIC VENOUS THERAPY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37213,CPT,THROMBLYTIC ART/VEN THERAPY,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
37214,CPT,CESSJ THERAPY CATH REMOVAL,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
37216,CPT,TRANSCATH STENT CCA W/O EPS,,30,,,"$13,042.81",$0.00,1,0,1,20210101,
37220,CPT,ILIAC REVASC,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
37221,CPT,ILIAC REVASC W/STENT,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37222,CPT,ILIAC REVASC ADD-ON,,30,,,"$15,827.00",$0.00,1,0,1,20210101,
37223,CPT,ILIAC REVASC W/STENT ADD-ON,,30,,,"$21,343.95",$0.00,1,0,1,20210101,
37224,CPT,FEM/POPL REVAS W/TLA,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
37225,CPT,FEM/POPL REVAS W/ATHER,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37226,CPT,FEM/POPL REVASC W/STENT,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37227,CPT,FEM/POPL REVASC STNT & ATHER,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
37228,CPT,TIB/PER REVASC W/TLA,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37229,CPT,TIB/PER REVASC W/ATHER,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
37230,CPT,TIB/PER REVASC W/STENT,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
37231,CPT,TIB/PER REVASC STENT & ATHER,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
37232,CPT,TIB/PER REVASC ADD-ON,,30,,,"$16,187.08",$0.00,1,0,1,20210101,
37233,CPT,TIBPER REVASC W/ATHER ADD-ON,,30,,,"$28,825.65",$0.00,1,0,1,20210101,
37234,CPT,REVSC OPN/PRQ TIB/PERO STENT,,30,,,"$21,701.88",$0.00,1,0,1,20210101,
37235,CPT,TIB/PER REVASC STNT & ATHER,,30,,,"$13,122.08",$0.00,1,0,1,20210101,
37236,CPT,OPEN/PERQ PLACE STENT 1ST,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37237,CPT,OPEN/PERQ PLACE STENT EA ADD,,30,,,"$20,747.78",$0.00,1,0,1,20210101,
37238,CPT,OPEN/PERQ PLACE STENT SAME,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37239,CPT,OPEN/PERQ PLACE STENT EA ADD,,30,,,"$16,429.78",$0.00,1,0,1,20210101,
37241,CPT,VASC EMBOLIZE/OCCLUDE VENOUS,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37242,CPT,VASC EMBOLIZE/OCCLUDE ARTERY,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37243,CPT,VASC EMBOLIZE/OCCLUDE ORGAN,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37244,CPT,VASC EMBOLIZE/OCCLUDE BLEED,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
37246,CPT,TRLUML BALO ANGIOP 1ST ART,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
37247,CPT,TRLUML BALO ANGIOP ADDL ART,,30,,,"$9,607.91",$0.00,1,0,1,20210101,
37248,CPT,TRLUML BALO ANGIOP 1ST VEIN,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
37249,CPT,TRLUML BALO ANGIOP ADDL VEIN,,30,,,"$7,516.71",$0.00,1,0,1,20210101,
37252,CPT,INTRVASC US NONCORONARY 1ST,,30,,,"$11,430.65",$0.00,1,0,1,20210101,
37253,CPT,INTRVASC US NONCORONARY ADDL,,30,,,"$4,919.52",$0.00,1,0,1,20210101,
37500,CPT,ENDOSCOPY LIGATE PERF VEINS,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
37501,CPT,VASCULAR ENDOSCOPY PROCEDURE,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
37565,CPT,LIGATION OF NECK VEIN,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
37600,CPT,LIGATION OF NECK ARTERY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37605,CPT,LIGATION OF NECK ARTERY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37606,CPT,LIGATION OF NECK ARTERY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37607,CPT,LIGATION OF A-V FISTULA,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37609,CPT,TEMPORAL ARTERY PROCEDURE,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
37615,CPT,LIGATION OF NECK ARTERY,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
37617,CPT,LIGATION OF ABDOMEN ARTERY,,30,,,"$15,117.60",$0.00,1,0,1,20210101,
37619,CPT,LIGATION OF INF VENA CAVA,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
37650,CPT,REVISION OF MAJOR VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37700,CPT,REVISE LEG VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37718,CPT,LIGATE/STRIP SHORT LEG VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37722,CPT,LIGATE/STRIP LONG LEG VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37735,CPT,REMOVAL OF LEG VEINS/LESION,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37760,CPT,LIGATE LEG VEINS RADICAL,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37761,CPT,LIGATE LEG VEINS OPEN,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
37765,CPT,STAB PHLEB VEINS XTR 10-20,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37766,CPT,PHLEB VEINS - EXTREM 20+,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37780,CPT,REVISION OF LEG VEIN,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
37785,CPT,LIGATE/DIVIDE/EXCISE VEIN,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
37790,CPT,PENILE VENOUS OCCLUSION,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
37799,CPT,VASCULAR SURGERY PROCEDURE,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
38120,CPT,LAPAROSCOPY SPLENECTOMY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
38129,CPT,LAPAROSCOPE PROC SPLEEN,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
38200,CPT,INJECTION FOR SPLEEN X-RAY,,30,,,"$1,067.93",$0.00,1,0,1,20210101,
38204,CPT,BL DONOR SEARCH MANAGEMENT,,30,,,"$3,418.91",$0.00,1,0,1,20210101,
38205,CPT,HARVEST ALLOGENEIC STEM CELL,,30,,,"$5,769.94",$0.00,1,0,1,20210101,
38206,CPT,HARVEST AUTO STEM CELLS,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
38207,CPT,CRYOPRESERVE STEM CELLS,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38208,CPT,THAW PRESERVED STEM CELLS,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38209,CPT,WASH HARVEST STEM CELLS,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38210,CPT,T-CELL DEPLETION OF HARVEST,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38211,CPT,TUMOR CELL DEPLETE OF HARVST,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38212,CPT,RBC DEPLETION OF HARVEST,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38213,CPT,PLATELET DEPLETE OF HARVEST,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38214,CPT,VOLUME DEPLETE OF HARVEST,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38215,CPT,HARVEST STEM CELL CONCENTRTE,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
38220,CPT,DX BONE MARROW ASPIRATIONS,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
38221,CPT,DX BONE MARROW BIOPSIES,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
38222,CPT,DX BONE MARROW BX & ASPIR,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
38230,CPT,BONE MARROW HARVEST ALLOGEN,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
38232,CPT,BONE MARROW HARVEST AUTOLOG,,30,,,"$12,674.77",$0.00,1,0,1,20210101,
38240,CPT,TRANSPLT ALLO HCT/DONOR,,30,,,"$76,191.34",$0.00,1,0,1,20210101,
38241,CPT,TRANSPLT AUTOL HCT/DONOR,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
38242,CPT,TRANSPLT ALLO LYMPHOCYTES,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
38243,CPT,TRANSPLJ HEMATOPOIETIC BOOST,,30,,,"$6,261.26",$0.00,1,0,1,20210101,
38300,CPT,DRAINAGE LYMPH NODE LESION,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
38305,CPT,DRAINAGE LYMPH NODE LESION,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
38308,CPT,INCISION OF LYMPH CHANNELS,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
38500,CPT,BIOPSY/REMOVAL LYMPH NODES,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
38505,CPT,NEEDLE BIOPSY LYMPH NODES,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
38510,CPT,BIOPSY/REMOVAL LYMPH NODES,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
38520,CPT,BIOPSY/REMOVAL LYMPH NODES,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
38525,CPT,BIOPSY/REMOVAL LYMPH NODES,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
38530,CPT,BIOPSY/REMOVAL LYMPH NODES,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
38531,CPT,OPEN BX/EXC INGUINOFEM NODES,,30,,,"$16,285.84",$0.00,1,0,1,20210101,
38542,CPT,EXPLORE DEEP NODE(S) NECK,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
38550,CPT,REMOVAL NECK/ARMPIT LESION,,30,,,"$16,112.39",$0.00,1,0,1,20210101,
38555,CPT,REMOVAL NECK/ARMPIT LESION,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
38562,CPT,REMOVAL PELVIC LYMPH NODES,,30,,,"$21,991.87",$0.00,1,0,1,20210101,
38570,CPT,LAPAROSCOPY LYMPH NODE BIOP,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
38571,CPT,LAPAROSCOPY LYMPHADENECTOMY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
38572,CPT,LAPAROSCOPY LYMPHADENECTOMY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
38573,CPT,LAPS PELVIC LYMPHADEC,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
38589,CPT,LAPAROSCOPE PROC LYMPHATIC,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
38700,CPT,REMOVAL OF LYMPH NODES NECK,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
38720,CPT,REMOVAL OF LYMPH NODES NECK,,30,,,"$23,368.53",$0.00,1,0,1,20210101,
38740,CPT,REMOVE ARMPIT LYMPH NODES,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
38745,CPT,REMOVE ARMPIT LYMPH NODES,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
38760,CPT,REMOVE GROIN LYMPH NODES,,30,,,"$22,494.77",$0.00,1,0,1,20210101,
38790,CPT,INJECT FOR LYMPHATIC X-RAY,,30,,,"$1,433.91",$0.00,1,0,1,20210101,
38792,CPT,RA TRACER ID OF SENTINL NODE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
38900,CPT,IO MAP OF SENT LYMPH NODE,,30,,,"$5,208.34",$0.00,1,0,1,20210101,
38999,CPT,BLOOD/LYMPH SYSTEM PROCEDURE,,30,,,"$2,417.35",$0.00,1,0,1,20210101,
39401,CPT,MEDIASTINOSCPY W/MEDSTNL BX,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
39402,CPT,MEDIASTINOSCPY W/LMPH NOD BX,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
40490,CPT,BIOPSY OF LIP,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
40500,CPT,PARTIAL EXCISION OF LIP,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40510,CPT,PARTIAL EXCISION OF LIP,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40520,CPT,PARTIAL EXCISION OF LIP,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40525,CPT,RECONSTRUCT LIP WITH FLAP,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40527,CPT,RECONSTRUCT LIP WITH FLAP,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40530,CPT,PARTIAL REMOVAL OF LIP,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40650,CPT,REPAIR LIP,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40652,CPT,REPAIR LIP,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40654,CPT,REPAIR LIP,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
40700,CPT,REPAIR CLEFT LIP/NASAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40701,CPT,REPAIR CLEFT LIP/NASAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40702,CPT,REPAIR CLEFT LIP/NASAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40720,CPT,REPAIR CLEFT LIP/NASAL,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40761,CPT,REPAIR CLEFT LIP/NASAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40799,CPT,LIP SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
40800,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
40801,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40804,CPT,REMOVAL FOREIGN BODY MOUTH,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
40805,CPT,REMOVAL FOREIGN BODY MOUTH,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40806,CPT,INCISION OF LIP FOLD,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40808,CPT,BIOPSY OF MOUTH LESION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40810,CPT,EXCISION OF MOUTH LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40812,CPT,EXCISE/REPAIR MOUTH LESION,,30,,,"$8,629.17",$0.00,1,0,1,20210101,
40814,CPT,EXCISE/REPAIR MOUTH LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40816,CPT,EXCISION OF MOUTH LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40818,CPT,EXCISE ORAL MUCOSA FOR GRAFT,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40819,CPT,EXCISE LIP OR CHEEK FOLD,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
40820,CPT,TREATMENT OF MOUTH LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
40830,CPT,REPAIR MOUTH LACERATION,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
40831,CPT,REPAIR MOUTH LACERATION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
40840,CPT,RECONSTRUCTION OF MOUTH,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40842,CPT,RECONSTRUCTION OF MOUTH,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40843,CPT,RECONSTRUCTION OF MOUTH,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40844,CPT,RECONSTRUCTION OF MOUTH,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40845,CPT,RECONSTRUCTION OF MOUTH,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
40899,CPT,MOUTH SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
41000,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
41005,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
41006,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41007,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41008,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41009,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
41010,CPT,INCISION OF TONGUE FOLD,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41015,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
41016,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
41017,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41018,CPT,DRAINAGE OF MOUTH LESION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41019,CPT,PLACE NEEDLES H&N FOR RT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
41100,CPT,BIOPSY OF TONGUE,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
41105,CPT,BIOPSY OF TONGUE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41108,CPT,BIOPSY OF FLOOR OF MOUTH,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
41110,CPT,EXCISION OF TONGUE LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41112,CPT,EXCISION OF TONGUE LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41113,CPT,EXCISION OF TONGUE LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41114,CPT,EXCISION OF TONGUE LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41115,CPT,EXCISION OF TONGUE FOLD,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41116,CPT,EXCISION OF MOUTH LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41120,CPT,PARTIAL REMOVAL OF TONGUE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
41250,CPT,REPAIR TONGUE LACERATION,,30,,,$737.09,$0.00,1,0,1,20210101,
41251,CPT,REPAIR TONGUE LACERATION,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
41252,CPT,REPAIR TONGUE LACERATION,,30,,,"$1,490.05",$0.00,1,0,1,20210101,
41510,CPT,TONGUE TO LIP SURGERY,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41512,CPT,TONGUE SUSPENSION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
41520,CPT,RECONSTRUCTION TONGUE FOLD,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41530,CPT,TONGUE BASE VOL REDUCTION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41599,CPT,TONGUE AND MOUTH SURGERY,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
41800,CPT,DRAINAGE OF GUM LESION,,30,,,$584.38,$0.00,1,0,1,20210101,
41805,CPT,REMOVAL FOREIGN BODY GUM,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41806,CPT,REMOVAL FOREIGN BODY JAWBONE,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41820,CPT,EXCISION GUM EACH QUADRANT,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41821,CPT,EXCISION OF GUM FLAP,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41822,CPT,EXCISION OF GUM LESION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41823,CPT,EXCISION OF GUM LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
41825,CPT,EXCISION OF GUM LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41826,CPT,EXCISION OF GUM LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41827,CPT,EXCISION OF GUM LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
41828,CPT,EXCISION OF GUM LESION,,30,,,"$8,629.17",$0.00,1,0,1,20210101,
41830,CPT,REMOVAL OF GUM TISSUE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41850,CPT,TREATMENT OF GUM LESION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
41870,CPT,GUM GRAFT,,30,,,"$8,629.17",$0.00,1,0,1,20210101,
41872,CPT,REPAIR GUM,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41874,CPT,REPAIR TOOTH SOCKET,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
41899,CPT,DENTAL SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
42000,CPT,DRAINAGE MOUTH ROOF LESION,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
42100,CPT,BIOPSY ROOF OF MOUTH,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
42104,CPT,EXCISION LESION MOUTH ROOF,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42106,CPT,EXCISION LESION MOUTH ROOF,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42107,CPT,EXCISION LESION MOUTH ROOF,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42120,CPT,REMOVE PALATE/LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42140,CPT,EXCISION OF UVULA,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42145,CPT,REPAIR PALATE PHARYNX/UVULA,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42160,CPT,TREATMENT MOUTH ROOF LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42180,CPT,REPAIR PALATE,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
42182,CPT,REPAIR PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42200,CPT,RECONSTRUCT CLEFT PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42205,CPT,RECONSTRUCT CLEFT PALATE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42210,CPT,RECONSTRUCT CLEFT PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42215,CPT,RECONSTRUCT CLEFT PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42220,CPT,RECONSTRUCT CLEFT PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42225,CPT,RECONSTRUCT CLEFT PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42226,CPT,LENGTHENING OF PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42227,CPT,LENGTHENING OF PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42235,CPT,REPAIR PALATE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42260,CPT,REPAIR NOSE TO LIP FISTULA,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42280,CPT,PREPARATION PALATE MOLD,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
42281,CPT,INSERTION PALATE PROSTHESIS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42299,CPT,PALATE/UVULA SURGERY,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
42300,CPT,DRAINAGE OF SALIVARY GLAND,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
42305,CPT,DRAINAGE OF SALIVARY GLAND,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42310,CPT,DRAINAGE OF SALIVARY GLAND,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
42320,CPT,DRAINAGE OF SALIVARY GLAND,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
42330,CPT,REMOVAL OF SALIVARY STONE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42335,CPT,REMOVAL OF SALIVARY STONE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42340,CPT,REMOVAL OF SALIVARY STONE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42400,CPT,BIOPSY OF SALIVARY GLAND,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
42405,CPT,BIOPSY OF SALIVARY GLAND,,30,,,"$8,629.17",$0.00,1,0,1,20210101,
42408,CPT,EXCISION OF SALIVARY CYST,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42409,CPT,DRAINAGE OF SALIVARY CYST,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42410,CPT,EXCISE PAROTID GLAND/LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42415,CPT,EXCISE PAROTID GLAND/LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42420,CPT,EXCISE PAROTID GLAND/LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42425,CPT,EXCISE PAROTID GLAND/LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42440,CPT,EXCISE SUBMAXILLARY GLAND,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42450,CPT,EXCISE SUBLINGUAL GLAND,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42500,CPT,REPAIR SALIVARY DUCT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42505,CPT,REPAIR SALIVARY DUCT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42507,CPT,PAROTID DUCT DIVERSION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42509,CPT,PAROTID DUCT DIVERSION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42510,CPT,PAROTID DUCT DIVERSION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42550,CPT,INJECTION FOR SALIVARY X-RAY,,30,,,$722.78,$0.00,1,0,1,20210101,
42600,CPT,CLOSURE OF SALIVARY FISTULA,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42650,CPT,DILATION OF SALIVARY DUCT,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
42660,CPT,DILATION OF SALIVARY DUCT,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
42665,CPT,LIGATION OF SALIVARY DUCT,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42699,CPT,SALIVARY SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
42700,CPT,DRAINAGE OF TONSIL ABSCESS,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
42720,CPT,DRAINAGE OF THROAT ABSCESS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42725,CPT,DRAINAGE OF THROAT ABSCESS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42800,CPT,BIOPSY OF THROAT,,30,,,"$8,629.17",$0.00,1,0,1,20210101,
42804,CPT,BIOPSY OF UPPER NOSE/THROAT,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42806,CPT,BIOPSY OF UPPER NOSE/THROAT,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42808,CPT,EXCISE PHARYNX LESION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42809,CPT,REMOVE PHARYNX FOREIGN BODY,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
42810,CPT,EXCISION OF NECK CYST,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42815,CPT,EXCISION OF NECK CYST,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42820,CPT,REMOVE TONSILS AND ADENOIDS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42821,CPT,REMOVE TONSILS AND ADENOIDS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42825,CPT,REMOVAL OF TONSILS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42826,CPT,REMOVAL OF TONSILS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42830,CPT,REMOVAL OF ADENOIDS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42831,CPT,REMOVAL OF ADENOIDS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42835,CPT,REMOVAL OF ADENOIDS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42836,CPT,REMOVAL OF ADENOIDS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42842,CPT,EXTENSIVE SURGERY OF THROAT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42844,CPT,EXTENSIVE SURGERY OF THROAT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42860,CPT,EXCISION OF TONSIL TAGS,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42870,CPT,EXCISION OF LINGUAL TONSIL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42890,CPT,PARTIAL REMOVAL OF PHARYNX,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42892,CPT,REVISION OF PHARYNGEAL WALLS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42900,CPT,REPAIR THROAT WOUND,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
42950,CPT,RECONSTRUCTION OF THROAT,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
42955,CPT,SURGICAL OPENING OF THROAT,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
42960,CPT,CONTROL THROAT BLEEDING,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
42962,CPT,CONTROL THROAT BLEEDING,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42970,CPT,CONTROL NOSE/THROAT BLEEDING,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
42972,CPT,CONTROL NOSE/THROAT BLEEDING,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
42999,CPT,THROAT SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
43020,CPT,INCISION OF ESOPHAGUS,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
43030,CPT,THROAT MUSCLE SURGERY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
43130,CPT,REMOVAL OF ESOPHAGUS POUCH,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
43180,CPT,ESOPHAGOSCOPY RIGID TRNSO,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
43191,CPT,ESOPHAGOSCOPY RIGID TRNSO DX,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43192,CPT,ESOPHAGOSCP RIG TRNSO INJECT,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43193,CPT,ESOPHAGOSCP RIG TRNSO BIOPSY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43194,CPT,ESOPHAGOSCP RIG TRNSO REM FB,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43195,CPT,ESOPHAGOSCOPY RIGID BALLOON,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43196,CPT,ESOPHAGOSCP GUIDE WIRE DILAT,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43197,CPT,ESOPHAGOSCOPY FLEX DX BRUSH,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43198,CPT,ESOPHAGOSC FLEX TRNSN BIOPSY,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43200,CPT,ESOPHAGOSCOPY FLEXIBLE BRUSH,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43201,CPT,ESOPH SCOPE W/SUBMUCOUS INJ,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43202,CPT,ESOPHAGOSCOPY FLEX BIOPSY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43204,CPT,ESOPH SCOPE W/SCLEROSIS INJ,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43205,CPT,ESOPHAGUS ENDOSCOPY/LIGATION,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43206,CPT,ESOPH OPTICAL ENDOMICROSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43210,CPT,EGD ESOPHAGOGASTRC FNDOPLSTY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
43211,CPT,ESOPHAGOSCOP MUCOSAL RESECT,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43212,CPT,ESOPHAGOSCOP STENT PLACEMENT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
43213,CPT,ESOPHAGOSCOPY RETRO BALLOON,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43214,CPT,ESOPHAGOSC DILATE BALLOON 30,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43215,CPT,ESOPHAGOSCOPY FLEX REMOVE FB,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43216,CPT,ESOPHAGOSCOPY LESION REMOVAL,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43217,CPT,ESOPHAGOSCOPY SNARE LES REMV,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43220,CPT,ESOPHAGOSCOPY BALLOON <30MM,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43226,CPT,ESOPH ENDOSCOPY DILATION,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43227,CPT,ESOPHAGOSCOPY CONTROL BLEED,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43229,CPT,ESOPHAGOSCOPY LESION ABLATE,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43231,CPT,ESOPHAGOSCOP ULTRASOUND EXAM,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43232,CPT,ESOPHAGOSCOPY W/US NEEDLE BX,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43233,CPT,EGD BALLOON DIL ESOPH30 MM/>,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43235,CPT,EGD DIAGNOSTIC BRUSH WASH,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43236,CPT,UPPR GI SCOPE W/SUBMUC INJ,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43237,CPT,ENDOSCOPIC US EXAM ESOPH,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43238,CPT,EGD US FINE NEEDLE BX/ASPIR,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43239,CPT,EGD BIOPSY SINGLE/MULTIPLE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43240,CPT,EGD W/TRANSMURAL DRAIN CYST,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43241,CPT,EGD TUBE/CATH INSERTION,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43242,CPT,EGD US FINE NEEDLE BX/ASPIR,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43243,CPT,EGD INJECTION VARICES,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43244,CPT,EGD VARICES LIGATION,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43245,CPT,EGD DILATE STRICTURE,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43246,CPT,EGD PLACE GASTROSTOMY TUBE,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43247,CPT,EGD REMOVE FOREIGN BODY,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43248,CPT,EGD GUIDE WIRE INSERTION,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43249,CPT,ESOPH EGD DILATION <30 MM,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43250,CPT,EGD CAUTERY TUMOR POLYP,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43251,CPT,EGD REMOVE LESION SNARE,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43252,CPT,EGD OPTICAL ENDOMICROSCOPY,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43253,CPT,EGD US TRANSMURAL INJXN/MARK,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43254,CPT,EGD ENDO MUCOSAL RESECTION,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43255,CPT,EGD CONTROL BLEEDING ANY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43257,CPT,EGD W/THRML TXMNT GERD,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43259,CPT,EGD US EXAM DUODENUM/JEJUNUM,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43260,CPT,ERCP W/SPECIMEN COLLECTION,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43261,CPT,ENDO CHOLANGIOPANCREATOGRAPH,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43262,CPT,ENDO CHOLANGIOPANCREATOGRAPH,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43263,CPT,ERCP SPHINCTER PRESSURE MEAS,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43264,CPT,ERCP REMOVE DUCT CALCULI,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43265,CPT,ERCP LITHOTRIPSY CALCULI,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
43266,CPT,EGD ENDOSCOPIC STENT PLACE,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
43270,CPT,EGD LESION ABLATION,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43273,CPT,ENDOSCOPIC PANCREATOSCOPY,,30,,,"$4,567.61",$0.00,1,0,1,20210101,
43274,CPT,ERCP DUCT STENT PLACEMENT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
43275,CPT,ERCP REMOVE FORGN BODY DUCT,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43276,CPT,ERCP STENT EXCHANGE W/DILATE,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
43277,CPT,ERCP EA DUCT/AMPULLA DILATE,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43278,CPT,ERCP LESION ABLATE W/DILATE,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43280,CPT,LAPAROSCOPY FUNDOPLASTY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
43281,CPT,LAP PARAESOPHAG HERN REPAIR,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
43282,CPT,LAP PARAESOPH HER RPR W/MESH,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
43284,CPT,LAPS ESOPHGL SPHNCTR AGMNTJ,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
43285,CPT,RMVL ESOPHGL SPHNCTR DEV,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43289,CPT,LAPAROSCOPE PROC ESOPH,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43420,CPT,REPAIR ESOPHAGUS OPENING,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
43450,CPT,DILATE ESOPHAGUS 1/MULT PASS,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43453,CPT,DILATE ESOPHAGUS,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43499,CPT,ESOPHAGUS SURGERY PROCEDURE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43510,CPT,SURGICAL OPENING OF STOMACH,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43647,CPT,LAP IMPL ELECTRODE ANTRUM,,30,,,"$25,001.07",$0.00,1,0,1,20210101,
43648,CPT,LAP REVISE/REMV ELTRD ANTRUM,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43651,CPT,LAPAROSCOPY VAGUS NERVE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43652,CPT,LAPAROSCOPY VAGUS NERVE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43653,CPT,LAPAROSCOPY GASTROSTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43659,CPT,LAPAROSCOPE PROC STOM,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43752,CPT,NASAL/OROGASTRIC W/TUBE PLMT,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
43753,CPT,TX GASTRO INTUB W/ASP,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
43754,CPT,DX GASTR INTUB W/ASP SPEC,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
43755,CPT,DX GASTR INTUB W/ASP SPECS,,30,,,$888.86,$0.00,1,0,1,20210101,
43756,CPT,DX DUOD INTUB W/ASP SPEC,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43757,CPT,DX DUOD INTUB W/ASP SPECS,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43761,CPT,REPOSITION GASTROSTOMY TUBE,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
43762,CPT,RPLC GTUBE NO REVJ TRC,,30,,,"$1,421.74",$0.00,1,0,1,20210101,
43763,CPT,RPLC GTUBE REVJ GSTRST TRC,,30,,,"$1,421.74",$0.00,1,0,1,20210101,
43770,CPT,LAP PLACE GASTR ADJ DEVICE,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
43772,CPT,LAP RMVL GASTR ADJ DEVICE,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43773,CPT,LAP REPLACE GASTR ADJ DEVICE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
43774,CPT,LAP RMVL GASTR ADJ ALL PARTS,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43830,CPT,PLACE GASTROSTOMY TUBE,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
43831,CPT,PLACE GASTROSTOMY TUBE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
43840,CPT,REPAIR OF STOMACH LESION,,30,,,"$21,477.20",$0.00,1,0,1,20210101,
43842,CPT,V-BAND GASTROPLASTY,,30,,,"$5,163.91",$0.00,1,0,1,20210101,
43870,CPT,REPAIR STOMACH OPENING,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
43886,CPT,REVISE GASTRIC PORT OPEN,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
43887,CPT,REMOVE GASTRIC PORT OPEN,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
43888,CPT,CHANGE GASTRIC PORT OPEN,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
43999,CPT,STOMACH SURGERY PROCEDURE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
44100,CPT,BIOPSY OF BOWEL,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
44180,CPT,LAP ENTEROLYSIS,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
44186,CPT,LAP JEJUNOSTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
44238,CPT,LAPAROSCOPE PROC INTESTINE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
44300,CPT,OPEN BOWEL TO SKIN,,30,,,"$9,423.20",$0.00,1,0,1,20210101,
44312,CPT,REVISION OF ILEOSTOMY,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
44314,CPT,REVISION OF ILEOSTOMY,,30,,,"$13,148.60",$0.00,1,0,1,20210101,
44340,CPT,REVISION OF COLOSTOMY,,30,,,"$13,682.36",$0.00,1,0,1,20210101,
44345,CPT,REVISION OF COLOSTOMY,,30,,,"$16,307.19",$0.00,1,0,1,20210101,
44346,CPT,REVISION OF COLOSTOMY,,30,,,"$16,307.19",$0.00,1,0,1,20210101,
44360,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44361,CPT,SMALL BOWEL ENDOSCOPY/BIOPSY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44363,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44364,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44365,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44366,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44369,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44370,CPT,SMALL BOWEL ENDOSCOPY/STENT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
44372,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44373,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44376,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44377,CPT,SMALL BOWEL ENDOSCOPY/BIOPSY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44378,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44379,CPT,S BOWEL ENDOSCOPE W/STENT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
44380,CPT,SMALL BOWEL ENDOSCOPY BR/WA,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
44381,CPT,SMALL BOWEL ENDOSCOPY BR/WA,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
44382,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
44384,CPT,SMALL BOWEL ENDOSCOPY,,30,,,"$15,470.32",$0.00,1,0,1,20210101,
44385,CPT,ENDOSCOPY OF BOWEL POUCH,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
44386,CPT,ENDOSCOPY BOWEL POUCH/BIOP,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
44388,CPT,COLONOSCOPY THRU STOMA SPX,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
44389,CPT,COLONOSCOPY WITH BIOPSY,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44390,CPT,COLONOSCOPY FOR FOREIGN BODY,,30,,,"$4,640.00",$0.00,1,0,1,20210101,
44391,CPT,COLONOSCOPY FOR BLEEDING,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44392,CPT,COLONOSCOPY & POLYPECTOMY,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44394,CPT,COLONOSCOPY W/SNARE,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44401,CPT,COLONOSCOPY WITH ABLATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44402,CPT,COLONOSCOPY W/STENT PLCMT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
44403,CPT,COLONOSCOPY W/RESECTION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44404,CPT,COLONOSCOPY W/INJECTION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44405,CPT,COLONOSCOPY W/DILATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44406,CPT,COLONOSCOPY W/ULTRASOUND,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44407,CPT,COLONOSCOPY W/NDL ASPIR/BX,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
44408,CPT,COLONOSCOPY W/DECOMPRESSION,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
44500,CPT,INTRO GASTROINTESTINAL TUBE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
44602,CPT,SUTURE SMALL INTESTINE,,30,,,"$15,057.31",$0.00,1,0,1,20210101,
44701,CPT,INTRAOP COLON LAVAGE ADD-ON,,30,,,"$1,196.87",$0.00,1,0,1,20210101,
44705,CPT,PREPARE FECAL MICROBIOTA,,30,,,"$1,676.31",$0.00,1,0,1,20210101,
44799,CPT,UNLISTED PX SMALL INTESTINE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
44950,CPT,APPENDECTOMY,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
44955,CPT,APPENDECTOMY ADD-ON,,30,,,"$11,654.99",$0.00,1,0,1,20210101,
44970,CPT,LAPAROSCOPY APPENDECTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
44979,CPT,LAPAROSCOPE PROC APP,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
45000,CPT,DRAINAGE OF PELVIC ABSCESS,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45005,CPT,DRAINAGE OF RECTAL ABSCESS,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45020,CPT,DRAINAGE OF RECTAL ABSCESS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45100,CPT,BIOPSY OF RECTUM,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45108,CPT,REMOVAL OF ANORECTAL LESION,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45150,CPT,EXCISION OF RECTAL STRICTURE,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45160,CPT,EXCISION OF RECTAL LESION,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45171,CPT,EXC RECT TUM TRANSANAL PART,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45172,CPT,EXC RECT TUM TRANSANAL FULL,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45190,CPT,DESTRUCTION RECTAL TUMOR,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45300,CPT,PROCTOSIGMOIDOSCOPY DX,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45303,CPT,PROCTOSIGMOIDOSCOPY DILATE,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45305,CPT,PROCTOSIGMOIDOSCOPY W/BX,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45307,CPT,PROCTOSIGMOIDOSCOPY FB,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45308,CPT,PROCTOSIGMOIDOSCOPY REMOVAL,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45309,CPT,PROCTOSIGMOIDOSCOPY REMOVAL,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45315,CPT,PROCTOSIGMOIDOSCOPY REMOVAL,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45317,CPT,PROCTOSIGMOIDOSCOPY BLEED,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45320,CPT,PROCTOSIGMOIDOSCOPY ABLATE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45321,CPT,PROCTOSIGMOIDOSCOPY VOLVUL,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45327,CPT,PROCTOSIGMOIDOSCOPY W/STENT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
45330,CPT,DIAGNOSTIC SIGMOIDOSCOPY,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45331,CPT,SIGMOIDOSCOPY AND BIOPSY,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45332,CPT,SIGMOIDOSCOPY W/FB REMOVAL,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45333,CPT,SIGMOIDOSCOPY & POLYPECTOMY,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45334,CPT,SIGMOIDOSCOPY FOR BLEEDING,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45335,CPT,SIGMOIDOSCOPY W/SUBMUC INJ,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45337,CPT,SIGMOIDOSCOPY & DECOMPRESS,,30,,,"$4,640.00",$0.00,1,0,1,20210101,
45338,CPT,SIGMOIDOSCOPY W/TUMR REMOVE,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45340,CPT,SIG W/TNDSC BALLOON DILATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45341,CPT,SIGMOIDOSCOPY W/ULTRASOUND,,30,,,"$4,640.00",$0.00,1,0,1,20210101,
45342,CPT,SIGMOIDOSCOPY W/US GUIDE BX,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45346,CPT,SIGMOIDOSCOPY W/ABLATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45347,CPT,SIGMOIDOSCOPY W/PLCMT STENT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
45349,CPT,SIGMOIDOSCOPY W/RESECTION,,30,,,"$8,500.46",$0.00,1,0,1,20210101,
45350,CPT,SGMDSC W/BAND LIGATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45378,CPT,DIAGNOSTIC COLONOSCOPY,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45379,CPT,COLONOSCOPY W/FB REMOVAL,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45380,CPT,COLONOSCOPY AND BIOPSY,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45381,CPT,COLONOSCOPY SUBMUCOUS NJX,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45382,CPT,COLONOSCOPY W/CONTROL BLEED,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45384,CPT,COLONOSCOPY W/LESION REMOVAL,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45385,CPT,COLONOSCOPY W/LESION REMOVAL,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45386,CPT,COLONOSCOPY W/BALLOON DILAT,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45388,CPT,COLONOSCOPY W/ABLATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45389,CPT,COLONOSCOPY W/STENT PLCMT,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
45390,CPT,COLONOSCOPY W/RESECTION,,30,,,"$8,500.46",$0.00,1,0,1,20210101,
45391,CPT,COLONOSCOPY W/ENDOSCOPE US,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45392,CPT,COLONOSCOPY W/ENDOSCOPIC FNB,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45393,CPT,COLONOSCOPY W/DECOMPRESSION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45398,CPT,COLONOSCOPY W/BAND LIGATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45399,CPT,UNLISTED PROCEDURE COLON,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45499,CPT,LAPAROSCOPE PROC RECTUM,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
45500,CPT,REPAIR OF RECTUM,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45505,CPT,REPAIR OF RECTUM,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45520,CPT,TREATMENT OF RECTAL PROLAPSE,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45541,CPT,CORRECT RECTAL PROLAPSE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45560,CPT,REPAIR OF RECTOCELE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45900,CPT,REDUCTION OF RECTAL PROLAPSE,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
45905,CPT,DILATION OF ANAL SPHINCTER,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45910,CPT,DILATION OF RECTAL NARROWING,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45915,CPT,REMOVE RECTAL OBSTRUCTION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
45990,CPT,SURG DX EXAM ANORECTAL,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
45999,CPT,RECTUM SURGERY PROCEDURE,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
46020,CPT,PLACEMENT OF SETON,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46030,CPT,REMOVAL OF RECTAL MARKER,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46040,CPT,INCISION OF RECTAL ABSCESS,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46045,CPT,INCISION OF RECTAL ABSCESS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46050,CPT,INCISION OF ANAL ABSCESS,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
46060,CPT,INCISION OF RECTAL ABSCESS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46070,CPT,INCISION OF ANAL SEPTUM,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46080,CPT,INCISION OF ANAL SPHINCTER,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46083,CPT,INCISE EXTERNAL HEMORRHOID,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
46200,CPT,REMOVAL OF ANAL FISSURE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46220,CPT,EXCISE ANAL EXT TAG/PAPILLA,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46221,CPT,LIGATION OF HEMORRHOID(S),,30,,,"$4,390.27",$0.00,1,0,1,20210101,
46230,CPT,REMOVAL OF ANAL TAGS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46250,CPT,REMOVE EXT HEM GROUPS 2+,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46255,CPT,REMOVE INT/EXT HEM 1 GROUP,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46257,CPT,REMOVE IN/EX HEM GRP & FISS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46258,CPT,REMOVE IN/EX HEM GRP W/FISTU,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46260,CPT,REMOVE IN/EX HEM GROUPS 2+,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46261,CPT,REMOVE IN/EX HEM GRPS & FISS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46262,CPT,REMOVE IN/EX HEM GRPS W/FIST,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46270,CPT,REMOVE ANAL FIST SUBQ,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46275,CPT,REMOVE ANAL FIST INTER,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46280,CPT,REMOVE ANAL FIST COMPLEX,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46285,CPT,REMOVE ANAL FIST 2 STAGE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46288,CPT,REPAIR ANAL FISTULA,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46320,CPT,REMOVAL OF HEMORRHOID CLOT,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46500,CPT,INJECTION INTO HEMORRHOID(S),,30,,,"$4,390.27",$0.00,1,0,1,20210101,
46505,CPT,CHEMODENERVATION ANAL MUSC,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46600,CPT,DIAGNOSTIC ANOSCOPY SPX,,30,,,$584.38,$0.00,1,0,1,20210101,
46601,CPT,DIAGNOSTIC ANOSCOPY,,30,,,$584.38,$0.00,1,0,1,20210101,
46604,CPT,ANOSCOPY AND DILATION,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46606,CPT,ANOSCOPY AND BIOPSY,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46607,CPT,DIAGNOSTIC ANOSCOPY & BIOPSY,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46608,CPT,ANOSCOPY REMOVE FOR BODY,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
46610,CPT,ANOSCOPY REMOVE LESION,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46611,CPT,ANOSCOPY,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
46612,CPT,ANOSCOPY REMOVE LESIONS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46614,CPT,ANOSCOPY CONTROL BLEEDING,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46615,CPT,ANOSCOPY,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46700,CPT,REPAIR OF ANAL STRICTURE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46706,CPT,REPR OF ANAL FISTULA W/GLUE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46707,CPT,REPAIR ANORECTAL FIST W/PLUG,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46750,CPT,REPAIR OF ANAL SPHINCTER,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46753,CPT,RECONSTRUCTION OF ANUS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46754,CPT,REMOVAL OF SUTURE FROM ANUS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46760,CPT,REPAIR OF ANAL SPHINCTER,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46761,CPT,REPAIR OF ANAL SPHINCTER,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46900,CPT,DESTRUCTION ANAL LESION(S),,30,,,"$1,898.89",$0.00,1,0,1,20210101,
46910,CPT,DESTRUCTION ANAL LESION(S),,30,,,"$7,789.31",$0.00,1,0,1,20210101,
46916,CPT,CRYOSURGERY ANAL LESION(S),,30,,,$677.96,$0.00,1,0,1,20210101,
46917,CPT,LASER SURGERY ANAL LESIONS,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46922,CPT,EXCISION OF ANAL LESION(S),,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46924,CPT,DESTRUCTION ANAL LESION(S),,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46930,CPT,DESTROY INTERNAL HEMORRHOIDS,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
46940,CPT,TREATMENT OF ANAL FISSURE,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46942,CPT,TREATMENT OF ANAL FISSURE,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
46945,CPT,INT HRHC LIG 1 HROID W/O IMG,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46946,CPT,INT HRHC LIG 2+HROID W/O IMG,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46947,CPT,HEMORRHOIDOPEXY BY STAPLING,,30,,,"$11,599.94",$0.00,1,0,1,20210101,
46948,CPT,INT HRHC TRANAL DARTLZJ 2+,,30,,,"$11,415.11",$0.00,1,0,1,20210101,
46999,CPT,ANUS SURGERY PROCEDURE,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
47000,CPT,NEEDLE BIOPSY OF LIVER,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
47001,CPT,NEEDLE BIOPSY LIVER ADD-ON,,30,,,"$6,742.45",$0.00,1,0,1,20210101,
47370,CPT,LAPARO ABLATE LIVER TUMOR RF,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
47371,CPT,LAPARO ABLATE LIVER CRYOSURG,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
47379,CPT,LAPAROSCOPE PROCEDURE LIVER,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47382,CPT,PERCUT ABLATE LIVER RF,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47383,CPT,PERQ ABLTJ LVR CRYOABLATION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47399,CPT,LIVER SURGERY PROCEDURE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
47490,CPT,INCISION OF GALLBLADDER,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47531,CPT,INJECTION FOR CHOLANGIOGRAM,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47532,CPT,INJECTION FOR CHOLANGIOGRAM,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47533,CPT,PLMT BILIARY DRAINAGE CATH,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47534,CPT,PLMT BILIARY DRAINAGE CATH,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47535,CPT,CONVERSION EXT BIL DRG CATH,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47536,CPT,EXCHANGE BILIARY DRG CATH,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47537,CPT,REMOVAL BILIARY DRG CATH,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
47538,CPT,PERQ PLMT BILE DUCT STENT,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47539,CPT,PERQ PLMT BILE DUCT STENT,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47540,CPT,PERQ PLMT BILE DUCT STENT,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47541,CPT,PLMT ACCESS BIL TREE SM BWL,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47542,CPT,DILATE BILIARY DUCT/AMPULLA,,30,,,"$6,099.86",$0.00,1,0,1,20210101,
47543,CPT,ENDOLUMINAL BX BILIARY TREE,,30,,,"$6,423.98",$0.00,1,0,1,20210101,
47544,CPT,REMOVAL DUCT GLBLDR CALCULI,,30,,,"$9,087.69",$0.00,1,0,1,20210101,
47552,CPT,BILIARY ENDO PERQ DX W/SPECI,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47553,CPT,BILIARY ENDOSCOPY THRU SKIN,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47554,CPT,BILIARY ENDOSCOPY THRU SKIN,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47555,CPT,BILIARY ENDOSCOPY THRU SKIN,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
47556,CPT,BILIARY ENDOSCOPY THRU SKIN,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47562,CPT,LAPAROSCOPIC CHOLECYSTECTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47563,CPT,LAPARO CHOLECYSTECTOMY/GRAPH,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47564,CPT,LAPARO CHOLECYSTECTOMY/EXPLR,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47579,CPT,LAPAROSCOPE PROC BILIARY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
47999,CPT,BILE TRACT SURGERY PROCEDURE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
48102,CPT,NEEDLE BIOPSY PANCREAS,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
48999,CPT,PANCREAS SURGERY PROCEDURE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
49010,CPT,EXPLORATION BEHIND ABDOMEN,,30,,,"$16,307.19",$0.00,1,0,1,20210101,
49082,CPT,ABD PARACENTESIS,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
49083,CPT,ABD PARACENTESIS W/IMAGING,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
49084,CPT,PERITONEAL LAVAGE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
49180,CPT,BIOPSY ABDOMINAL MASS,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
49185,CPT,SCLEROTX FLUID COLLECTION,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
49250,CPT,EXCISION OF UMBILICUS,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49255,CPT,REMOVAL OF OMENTUM,,30,,,"$16,307.19",$0.00,1,0,1,20210101,
49320,CPT,DIAG LAPARO SEPARATE PROC,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49321,CPT,LAPAROSCOPY BIOPSY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49322,CPT,LAPAROSCOPY ASPIRATION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49323,CPT,LAPARO DRAIN LYMPHOCELE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49324,CPT,LAP INSERT TUNNEL IP CATH,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49325,CPT,LAP REVISION PERM IP CATH,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49326,CPT,LAP W/OMENTOPEXY ADD-ON,,30,,,"$7,144.65",$0.00,1,0,1,20210101,
49327,CPT,LAP INS DEVICE FOR RT,,30,,,"$9,772.54",$0.00,1,0,1,20210101,
49329,CPT,LAPARO PROC ABDM/PER/OMENT,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49400,CPT,AIR INJECTION INTO ABDOMEN,,30,,,"$1,159.50",$0.00,1,0,1,20210101,
49402,CPT,REMOVE FOREIGN BODY ADBOMEN,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49405,CPT,IMAGE CATH FLUID COLXN VISC,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
49406,CPT,IMAGE CATH FLUID PERI/RETRO,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
49407,CPT,IMAGE CATH FLUID TRNS/VGNL,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
49411,CPT,INS MARK ABD/PEL FOR RT PERQ,,30,,,"$7,691.66",$0.00,1,0,1,20210101,
49418,CPT,INSERT TUN IP CATH PERC,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49419,CPT,INSERT TUN IP CATH W/PORT,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
49421,CPT,INS TUN IP CATH FOR DIAL OPN,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49422,CPT,REMOVE TUNNELED IP CATH,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
49423,CPT,EXCHANGE DRAINAGE CATHETER,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
49424,CPT,ASSESS CYST CONTRAST INJECT,,30,,,"$1,171.58",$0.00,1,0,1,20210101,
49426,CPT,REVISE ABDOMEN-VENOUS SHUNT,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49427,CPT,INJECTION ABDOMINAL SHUNT,,30,,,"$1,304.57",$0.00,1,0,1,20210101,
49429,CPT,REMOVAL OF SHUNT,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
49435,CPT,INSERT SUBQ EXTEN TO IP CATH,,30,,,"$7,434.49",$0.00,1,0,1,20210101,
49436,CPT,EMBEDDED IP CATH EXIT-SITE,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
49440,CPT,PLACE GASTROSTOMY TUBE PERC,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
49441,CPT,PLACE DUOD/JEJ TUBE PERC,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
49442,CPT,PLACE CECOSTOMY TUBE PERC,,30,,,"$5,376.98",$0.00,1,0,1,20210101,
49446,CPT,CHANGE G-TUBE TO G-J PERC,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
49450,CPT,REPLACE G/C TUBE PERC,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
49451,CPT,REPLACE DUOD/JEJ TUBE PERC,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
49452,CPT,REPLACE G-J TUBE PERC,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
49460,CPT,FIX G/COLON TUBE W/DEVICE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
49465,CPT,FLUORO EXAM OF G/COLON TUBE,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
49491,CPT,RPR HERN PREEMIE REDUC,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49492,CPT,RPR ING HERN PREMIE BLOCKED,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49495,CPT,RPR ING HERNIA BABY REDUC,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49496,CPT,RPR ING HERNIA BABY BLOCKED,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49500,CPT,RPR ING HERNIA INIT REDUCE,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49501,CPT,RPR ING HERNIA INIT BLOCKED,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49505,CPT,PRP I/HERN INIT REDUC >5 YR,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49507,CPT,PRP I/HERN INIT BLOCK >5 YR,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49520,CPT,REREPAIR ING HERNIA REDUCE,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49521,CPT,REREPAIR ING HERNIA BLOCKED,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49525,CPT,REPAIR ING HERNIA SLIDING,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49540,CPT,REPAIR LUMBAR HERNIA,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49550,CPT,RPR REM HERNIA INIT REDUCE,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49553,CPT,RPR FEM HERNIA INIT BLOCKED,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49555,CPT,REREPAIR FEM HERNIA REDUCE,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49557,CPT,REREPAIR FEM HERNIA BLOCKED,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49560,CPT,RPR VENTRAL HERN INIT REDUC,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49561,CPT,RPR VENTRAL HERN INIT BLOCK,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49565,CPT,REREPAIR VENTRL HERN REDUCE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49566,CPT,REREPAIR VENTRL HERN BLOCK,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49568,CPT,HERNIA REPAIR W/MESH,,30,,,"$6,926.14",$0.00,1,0,1,20210101,
49570,CPT,RPR EPIGASTRIC HERN REDUCE,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49572,CPT,RPR EPIGASTRIC HERN BLOCKED,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49580,CPT,RPR UMBIL HERN REDUC < 5 YR,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49582,CPT,RPR UMBIL HERN BLOCK < 5 YR,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49585,CPT,RPR UMBIL HERN REDUC > 5 YR,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49587,CPT,RPR UMBIL HERN BLOCK > 5 YR,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49590,CPT,REPAIR SPIGELIAN HERNIA,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49600,CPT,REPAIR UMBILICAL LESION,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
49650,CPT,LAP ING HERNIA REPAIR INIT,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49651,CPT,LAP ING HERNIA REPAIR RECUR,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49652,CPT,LAP VENT/ABD HERNIA REPAIR,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49653,CPT,LAP VENT/ABD HERN PROC COMP,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49654,CPT,LAP INC HERNIA REPAIR,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
49655,CPT,LAP INC HERN REPAIR COMP,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
49656,CPT,LAP INC HERNIA REPAIR RECUR,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
49657,CPT,LAP INC HERN RECUR COMP,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
49659,CPT,LAPARO PROC HERNIA REPAIR,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
49999,CPT,ABDOMEN SURGERY PROCEDURE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
50020,CPT,RENAL ABSCESS OPEN DRAIN,,30,,,"$10,890.06",$0.00,1,0,1,20210101,
50080,CPT,REMOVAL OF KIDNEY STONE,,30,,,"$23,787.30",$0.00,1,0,1,20210101,
50081,CPT,REMOVAL OF KIDNEY STONE,,30,,,"$23,787.30",$0.00,1,0,1,20210101,
50200,CPT,RENAL BIOPSY PERQ,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
50382,CPT,CHANGE URETER STENT PERCUT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50384,CPT,REMOVE URETER STENT PERCUT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50385,CPT,CHANGE STENT VIA TRANSURETH,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50386,CPT,REMOVE STENT VIA TRANSURETH,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50387,CPT,CHANGE NEPHROURETERAL CATH,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50389,CPT,REMOVE RENAL TUBE W/FLUORO,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
50390,CPT,DRAINAGE OF KIDNEY LESION,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
50391,CPT,INSTLL RX AGNT INTO RNAL TUB,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
50396,CPT,MEASURE KIDNEY PRESSURE,,30,,,"$4,436.09",$0.00,1,0,1,20210101,
50430,CPT,NJX PX NFROSGRM &/URTRGRM,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
50431,CPT,NJX PX NFROSGRM &/URTRGRM,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
50432,CPT,PLMT NEPHROSTOMY CATHETER,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50433,CPT,PLMT NEPHROURETERAL CATHETER,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
50434,CPT,CONVERT NEPHROSTOMY CATHETER,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50435,CPT,EXCHANGE NEPHROSTOMY CATH,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50436,CPT,DILAT XST TRC NDURLGC PX,,30,,,"$12,646.05",$0.00,1,0,1,20210101,
50437,CPT,DILAT XST TRC NEW ACCESS RCS,,30,,,"$16,107.97",$0.00,1,0,1,20210101,
50541,CPT,LAPARO ABLATE RENAL CYST,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
50542,CPT,LAPARO ABLATE RENAL MASS,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
50543,CPT,LAPARO PARTIAL NEPHRECTOMY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
50544,CPT,LAPAROSCOPY PYELOPLASTY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
50549,CPT,LAPAROSCOPE PROC RENAL,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
50551,CPT,KIDNEY ENDOSCOPY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50553,CPT,KIDNEY ENDOSCOPY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50555,CPT,KIDNEY ENDOSCOPY & BIOPSY,,30,,,"$22,270.96",$0.00,1,0,1,20210101,
50557,CPT,KIDNEY ENDOSCOPY & TREATMENT,,30,,,"$23,787.30",$0.00,1,0,1,20210101,
50561,CPT,KIDNEY ENDOSCOPY & TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50562,CPT,RENAL SCOPE W/TUMOR RESECT,,30,,,"$23,787.30",$0.00,1,0,1,20210101,
50570,CPT,KIDNEY ENDOSCOPY,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
50572,CPT,KIDNEY ENDOSCOPY,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
50574,CPT,KIDNEY ENDOSCOPY & BIOPSY,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
50575,CPT,KIDNEY ENDOSCOPY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50576,CPT,KIDNEY ENDOSCOPY & TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50580,CPT,KIDNEY ENDOSCOPY & TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50590,CPT,FRAGMENTING OF KIDNEY STONE,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
50592,CPT,PERC RF ABLATE RENAL TUMOR,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
50593,CPT,PERC CRYO ABLATE RENAL TUM,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
50606,CPT,ENDOLUMINAL BX URTR RNL PLVS,,30,,,"$3,295.15",$0.00,1,0,1,20210101,
50684,CPT,INJECTION FOR URETER X-RAY,,30,,,"$1,154.96",$0.00,1,0,1,20210101,
50686,CPT,MEASURE URETER PRESSURE,,30,,,$888.86,$0.00,1,0,1,20210101,
50688,CPT,CHANGE OF URETER TUBE/STENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
50690,CPT,INJECTION FOR URETER X-RAY,,30,,,$990.60,$0.00,1,0,1,20210101,
50693,CPT,PLMT URETERAL STENT PRQ,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
50694,CPT,PLMT URETERAL STENT PRQ,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
50695,CPT,PLMT URETERAL STENT PRQ,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
50705,CPT,URETERAL EMBOLIZATION/OCCL,,30,,,"$7,104.27",$0.00,1,0,1,20210101,
50706,CPT,BALLOON DILATE URTRL STRIX,,30,,,"$3,830.50",$0.00,1,0,1,20210101,
50727,CPT,REVISE URETER,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
50945,CPT,LAPAROSCOPY URETEROLITHOTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
50947,CPT,LAPARO NEW URETER/BLADDER,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
50948,CPT,LAPARO NEW URETER/BLADDER,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
50949,CPT,LAPAROSCOPE PROC URETER,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
50951,CPT,ENDOSCOPY OF URETER,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
50953,CPT,ENDOSCOPY OF URETER,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
50955,CPT,URETER ENDOSCOPY & BIOPSY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50957,CPT,URETER ENDOSCOPY & TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50961,CPT,URETER ENDOSCOPY & TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50970,CPT,URETER ENDOSCOPY,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
50972,CPT,URETER ENDOSCOPY & CATHETER,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
50974,CPT,URETER ENDOSCOPY & BIOPSY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50976,CPT,URETER ENDOSCOPY & TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
50980,CPT,URETER ENDOSCOPY & TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
51020,CPT,INCISE & TREAT BLADDER,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
51030,CPT,INCISE & TREAT BLADDER,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
51040,CPT,INCISE & DRAIN BLADDER,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
51045,CPT,INCISE BLADDER/DRAIN URETER,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
51050,CPT,REMOVAL OF BLADDER STONE,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
51060,CPT,REMOVAL OF URETER STONE,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
51065,CPT,REMOVE URETER CALCULUS,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
51080,CPT,DRAINAGE OF BLADDER ABSCESS,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
51100,CPT,DRAIN BLADDER BY NEEDLE,,30,,,"$1,642.52",$0.00,1,0,1,20210101,
51101,CPT,DRAIN BLADDER BY TROCAR/CATH,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
51102,CPT,DRAIN BL W/CATH INSERTION,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
51500,CPT,REMOVAL OF BLADDER CYST,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
51520,CPT,REMOVAL OF BLADDER LESION,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
51535,CPT,REPAIR OF URETER LESION,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
51600,CPT,INJECTION FOR BLADDER X-RAY,,30,,,"$1,118.66",$0.00,1,0,1,20210101,
51605,CPT,PREPARATION FOR BLADDER XRAY,,30,,,"$2,143.63",$0.00,1,0,1,20210101,
51610,CPT,INJECTION FOR BLADDER X-RAY,,30,,,"$1,089.61",$0.00,1,0,1,20210101,
51700,CPT,IRRIGATION OF BLADDER,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
51701,CPT,INSERT BLADDER CATHETER,,30,,,$584.38,$0.00,1,0,1,20210101,
51702,CPT,INSERT TEMP BLADDER CATH,,30,,,$584.38,$0.00,1,0,1,20210101,
51703,CPT,INSERT BLADDER CATH COMPLEX,,30,,,$888.86,$0.00,1,0,1,20210101,
51705,CPT,CHANGE OF BLADDER TUBE,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
51710,CPT,CHANGE OF BLADDER TUBE,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
51715,CPT,ENDOSCOPIC INJECTION/IMPLANT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
51720,CPT,TREATMENT OF BLADDER LESION,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
51725,CPT,SIMPLE CYSTOMETROGRAM,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
51726,CPT,COMPLEX CYSTOMETROGRAM,,30,,,"$1,642.52",$0.00,1,0,1,20210101,
51727,CPT,CYSTOMETROGRAM W/UP,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
51728,CPT,CYSTOMETROGRAM W/VP,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
51729,CPT,CYSTOMETROGRAM W/VP&UP,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
51736,CPT,URINE FLOW MEASUREMENT,,30,,,$584.38,$0.00,1,0,1,20210101,
51741,CPT,ELECTRO-UROFLOWMETRY FIRST,,30,,,$888.86,$0.00,1,0,1,20210101,
51784,CPT,ANAL/URINARY MUSCLE STUDY,,30,,,$888.86,$0.00,1,0,1,20210101,
51785,CPT,ANAL/URINARY MUSCLE STUDY,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
51792,CPT,URINARY REFLEX STUDY,,30,,,$373.96,$0.00,1,0,1,20210101,
51797,CPT,INTRAABDOMINAL PRESSURE TEST,,30,,,$872.64,$0.00,1,0,1,20210101,
51798,CPT,US URINE CAPACITY MEASURE,,30,,,$373.96,$0.00,1,0,1,20210101,
51840,CPT,ATTACH BLADDER/URETHRA,,30,,,"$20,142.38",$0.00,1,0,1,20210101,
51845,CPT,REPAIR BLADDER NECK,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
51860,CPT,REPAIR OF BLADDER WOUND,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
51880,CPT,REPAIR OF BLADDER OPENING,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
51990,CPT,LAPARO URETHRAL SUSPENSION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
51992,CPT,LAPARO SLING OPERATION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
51999,CPT,LAPAROSCOPE PROC BLA,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
52000,CPT,CYSTOSCOPY,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
52001,CPT,CYSTOSCOPY REMOVAL OF CLOTS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52005,CPT,CYSTOSCOPY & URETER CATHETER,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52007,CPT,CYSTOSCOPY AND BIOPSY,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52010,CPT,CYSTOSCOPY & DUCT CATHETER,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
52204,CPT,CYSTOSCOPY W/BIOPSY(S),,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52214,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
52224,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
52234,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52235,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52240,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52250,CPT,CYSTOSCOPY AND RADIOTRACER,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
52260,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52265,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52270,CPT,CYSTOSCOPY & REVISE URETHRA,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52275,CPT,CYSTOSCOPY & REVISE URETHRA,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52276,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52277,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52281,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52282,CPT,CYSTOSCOPY IMPLANT STENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52283,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52285,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$4,436.09",$0.00,1,0,1,20210101,
52287,CPT,CYSTOSCOPY CHEMODENERVATION,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52290,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52300,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52301,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52305,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52310,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52315,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
52317,CPT,REMOVE BLADDER STONE,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52318,CPT,REMOVE BLADDER STONE,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
52320,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
52325,CPT,CYSTOSCOPY STONE REMOVAL,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52327,CPT,CYSTOSCOPY INJECT MATERIAL,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52330,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52332,CPT,CYSTOSCOPY AND TREATMENT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52334,CPT,CREATE PASSAGE TO KIDNEY,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52341,CPT,CYSTO W/URETER STRICTURE TX,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
52342,CPT,CYSTO W/UP STRICTURE TX,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
52343,CPT,CYSTO W/RENAL STRICTURE TX,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
52344,CPT,CYSTO/URETERO STRICTURE TX,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52345,CPT,CYSTO/URETERO W/UP STRICTURE,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
52346,CPT,CYSTOURETERO W/RENAL STRICT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52351,CPT,CYSTOURETERO & OR PYELOSCOPE,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
52352,CPT,CYSTOURETERO W/STONE REMOVE,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
52353,CPT,CYSTOURETERO W/LITHOTRIPSY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52354,CPT,CYSTOURETERO W/BIOPSY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52355,CPT,CYSTOURETERO W/EXCISE TUMOR,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52356,CPT,CYSTO/URETERO W/LITHOTRIPSY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52400,CPT,CYSTOURETERO W/CONGEN REPR,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
52402,CPT,CYSTOURETHRO CUT EJACUL DUCT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52441,CPT,CYSTOURETHRO W/IMPLANT,,30,,,"$7,898.07",$0.00,1,0,1,20210101,
52442,CPT,CYSTOURETHRO W/ADDL IMPLANT,,30,,,"$3,306.06",$0.00,1,0,1,20210101,
52450,CPT,INCISION OF PROSTATE,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52500,CPT,REVISION OF BLADDER NECK,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52601,CPT,PROSTATECTOMY (TURP),,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52630,CPT,REMOVE PROSTATE REGROWTH,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52640,CPT,RELIEVE BLADDER CONTRACTURE,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
52647,CPT,LASER SURGERY OF PROSTATE,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52648,CPT,LASER SURGERY OF PROSTATE,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52649,CPT,PROSTATE LASER ENUCLEATION,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
52700,CPT,DRAINAGE OF PROSTATE ABSCESS,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
53000,CPT,INCISION OF URETHRA,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53010,CPT,INCISION OF URETHRA,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53020,CPT,INCISION OF URETHRA,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53025,CPT,INCISION OF URETHRA,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53040,CPT,DRAINAGE OF URETHRA ABSCESS,,30,,,"$14,259.78",$0.00,1,0,1,20210101,
53060,CPT,DRAINAGE OF URETHRA ABSCESS,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53080,CPT,DRAINAGE OF URINARY LEAKAGE,,30,,,"$4,436.09",$0.00,1,0,1,20210101,
53085,CPT,DRAINAGE OF URINARY LEAKAGE,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53200,CPT,BIOPSY OF URETHRA,,30,,,"$10,890.06",$0.00,1,0,1,20210101,
53210,CPT,REMOVAL OF URETHRA,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
53215,CPT,REMOVAL OF URETHRA,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53220,CPT,TREATMENT OF URETHRA LESION,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
53230,CPT,REMOVAL OF URETHRA LESION,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53235,CPT,REMOVAL OF URETHRA LESION,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53240,CPT,SURGERY FOR URETHRA POUCH,,30,,,"$15,800.11",$0.00,1,0,1,20210101,
53250,CPT,REMOVAL OF URETHRA GLAND,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
53260,CPT,TREATMENT OF URETHRA LESION,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
53265,CPT,TREATMENT OF URETHRA LESION,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53270,CPT,REMOVAL OF URETHRA GLAND,,30,,,"$13,669.38",$0.00,1,0,1,20210101,
53275,CPT,REPAIR OF URETHRA DEFECT,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
53400,CPT,REVISE URETHRA STAGE 1,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53405,CPT,REVISE URETHRA STAGE 2,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53410,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53420,CPT,RECONSTRUCT URETHRA STAGE 1,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53425,CPT,RECONSTRUCT URETHRA STAGE 2,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53430,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53431,CPT,RECONSTRUCT URETHRA/BLADDER,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53440,CPT,MALE SLING PROCEDURE,,30,,,"$24,054.79",$0.00,1,0,1,20210101,
53442,CPT,REMOVE/REVISE MALE SLING,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53444,CPT,INSERT TANDEM CUFF,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
53445,CPT,INSERT URO/VES NCK SPHINCTER,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
53446,CPT,REMOVE URO SPHINCTER,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53447,CPT,REMOVE/REPLACE UR SPHINCTER,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
53449,CPT,REPAIR URO SPHINCTER,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53450,CPT,REVISION OF URETHRA,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
53460,CPT,REVISION OF URETHRA,,30,,,"$15,800.11",$0.00,1,0,1,20210101,
53500,CPT,URETHRLYS TRANSVAG W/ SCOPE,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
53502,CPT,REPAIR OF URETHRA INJURY,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
53505,CPT,REPAIR OF URETHRA INJURY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53510,CPT,REPAIR OF URETHRA INJURY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53515,CPT,REPAIR OF URETHRA INJURY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53520,CPT,REPAIR OF URETHRA DEFECT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
53600,CPT,DILATE URETHRA STRICTURE,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
53601,CPT,DILATE URETHRA STRICTURE,,30,,,$584.38,$0.00,1,0,1,20210101,
53605,CPT,DILATE URETHRA STRICTURE,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
53620,CPT,DILATE URETHRA STRICTURE,,30,,,"$2,659.36",$0.00,1,0,1,20210101,
53621,CPT,DILATE URETHRA STRICTURE,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
53660,CPT,DILATION OF URETHRA,,30,,,$888.86,$0.00,1,0,1,20210101,
53661,CPT,DILATION OF URETHRA,,30,,,$584.38,$0.00,1,0,1,20210101,
53665,CPT,DILATION OF URETHRA,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53850,CPT,PROSTATIC MICROWAVE THERMOTX,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
53852,CPT,PROSTATIC RF THERMOTX,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
53854,CPT,TRURL DSTRJ PRST8 TISS RF WV,,30,,,"$10,247.99",$0.00,1,0,1,20210101,
53855,CPT,INSERT PROST URETHRAL STENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53860,CPT,TRANSURETHRAL RF TREATMENT,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
53899,CPT,UROLOGY SURGERY PROCEDURE,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
54000,CPT,SLITTING OF PREPUCE,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
54001,CPT,SLITTING OF PREPUCE,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54015,CPT,DRAIN PENIS LESION,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
54050,CPT,DESTRUCTION PENIS LESION(S),,30,,,"$1,898.89",$0.00,1,0,1,20210101,
54055,CPT,DESTRUCTION PENIS LESION(S),,30,,,"$7,789.31",$0.00,1,0,1,20210101,
54056,CPT,CRYOSURGERY PENIS LESION(S),,30,,,$677.96,$0.00,1,0,1,20210101,
54057,CPT,LASER SURG PENIS LESION(S),,30,,,"$7,789.31",$0.00,1,0,1,20210101,
54060,CPT,EXCISION OF PENIS LESION(S),,30,,,"$7,789.31",$0.00,1,0,1,20210101,
54065,CPT,DESTRUCTION PENIS LESION(S),,30,,,"$7,789.31",$0.00,1,0,1,20210101,
54100,CPT,BIOPSY OF PENIS,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
54105,CPT,BIOPSY OF PENIS,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
54110,CPT,TREATMENT OF PENIS LESION,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
54111,CPT,TREAT PENIS LESION GRAFT,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54112,CPT,TREAT PENIS LESION GRAFT,,30,,,"$23,787.30",$0.00,1,0,1,20210101,
54115,CPT,TREATMENT OF PENIS LESION,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
54120,CPT,PARTIAL REMOVAL OF PENIS,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
54150,CPT,CIRCUMCISION W/REGIONL BLOCK,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54160,CPT,CIRCUMCISION NEONATE,,30,,,"$4,436.09",$0.00,1,0,1,20210101,
54161,CPT,CIRCUM 28 DAYS OR OLDER,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54162,CPT,LYSIS PENIL CIRCUMIC LESION,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54163,CPT,REPAIR OF CIRCUMCISION,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54164,CPT,FRENULOTOMY OF PENIS,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54200,CPT,TREATMENT OF PENIS LESION,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
54205,CPT,TREATMENT OF PENIS LESION,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54220,CPT,TREATMENT OF PENIS LESION,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
54230,CPT,PREPARE PENIS STUDY,,30,,,$722.04,$0.00,1,0,1,20210101,
54231,CPT,DYNAMIC CAVERNOSOMETRY,,30,,,"$3,510.41",$0.00,1,0,1,20210101,
54235,CPT,PENILE INJECTION,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
54240,CPT,PENIS STUDY,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
54250,CPT,PENIS STUDY,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
54300,CPT,REVISION OF PENIS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54304,CPT,REVISION OF PENIS,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
54308,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54312,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54316,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54318,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54322,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
54324,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
54326,CPT,RECONSTRUCTION OF URETHRA,,30,,,"$14,259.78",$0.00,1,0,1,20210101,
54328,CPT,REVISE PENIS/URETHRA,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54332,CPT,REVISE PENIS/URETHRA,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
54336,CPT,REVISE PENIS/URETHRA,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54340,CPT,SECONDARY URETHRAL SURGERY,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54344,CPT,SECONDARY URETHRAL SURGERY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54348,CPT,SECONDARY URETHRAL SURGERY,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54352,CPT,RECONSTRUCT URETHRA/PENIS,,30,,,"$20,688.27",$0.00,1,0,1,20210101,
54360,CPT,PENIS PLASTIC SURGERY,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54380,CPT,REPAIR PENIS,,30,,,"$10,890.06",$0.00,1,0,1,20210101,
54385,CPT,REPAIR PENIS,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54400,CPT,INSERT SEMI-RIGID PROSTHESIS,,30,,,"$29,307.13",$0.00,1,0,1,20210101,
54401,CPT,INSERT SELF-CONTD PROSTHESIS,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
54405,CPT,INSERT MULTI-COMP PENIS PROS,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
54406,CPT,REMOVE MUTI-COMP PENIS PROS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54408,CPT,REPAIR MULTI-COMP PENIS PROS,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54410,CPT,REMOVE/REPLACE PENIS PROSTH,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
54411,CPT,REMOV/REPLC PENIS PROS COMP,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
54415,CPT,REMOVE SELF-CONTD PENIS PROS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54416,CPT,REMV/REPL PENIS CONTAIN PROS,,30,,,"$36,302.35",$0.00,1,0,1,20210101,
54417,CPT,REMV/REPLC PENIS PROS COMPL,,30,,,"$29,307.13",$0.00,1,0,1,20210101,
54420,CPT,REVISION OF PENIS,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
54435,CPT,REVISION OF PENIS,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
54437,CPT,REPAIR CORPOREAL TEAR,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
54440,CPT,REPAIR OF PENIS,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
54450,CPT,PREPUTIAL STRETCHING,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
54500,CPT,BIOPSY OF TESTIS,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
54505,CPT,BIOPSY OF TESTIS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54512,CPT,EXCISE LESION TESTIS,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
54520,CPT,REMOVAL OF TESTIS,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
54522,CPT,ORCHIECTOMY PARTIAL,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
54530,CPT,REMOVAL OF TESTIS,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
54535,CPT,EXTENSIVE TESTIS SURGERY,,30,,,"$16,411.76",$0.00,1,0,1,20210101,
54550,CPT,EXPLORATION FOR TESTIS,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
54560,CPT,EXPLORATION FOR TESTIS,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54600,CPT,REDUCE TESTIS TORSION,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
54620,CPT,SUSPENSION OF TESTIS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54640,CPT,ORCHIOPEXY INGUN/SCROT APPR,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
54650,CPT,ORCHIOPEXY (FOWLER-STEPHENS),,30,,,"$16,182.79",$0.00,1,0,1,20210101,
54660,CPT,REVISION OF TESTIS,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
54670,CPT,REPAIR TESTIS INJURY,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
54680,CPT,RELOCATION OF TESTIS(ES),,30,,,"$14,555.89",$0.00,1,0,1,20210101,
54690,CPT,LAPAROSCOPY ORCHIECTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
54692,CPT,LAPAROSCOPY ORCHIOPEXY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
54699,CPT,LAPAROSCOPE PROC TESTIS,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
54700,CPT,DRAINAGE OF SCROTUM,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54800,CPT,BIOPSY OF EPIDIDYMIS,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
54830,CPT,REMOVE EPIDIDYMIS LESION,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
54840,CPT,REMOVE EPIDIDYMIS LESION,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54860,CPT,REMOVAL OF EPIDIDYMIS,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
54861,CPT,REMOVAL OF EPIDIDYMIS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
54865,CPT,EXPLORE EPIDIDYMIS,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
54900,CPT,FUSION OF SPERMATIC DUCTS,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
54901,CPT,FUSION OF SPERMATIC DUCTS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
55000,CPT,DRAINAGE OF HYDROCELE,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
55040,CPT,REMOVAL OF HYDROCELE,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
55041,CPT,REMOVAL OF HYDROCELES,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
55060,CPT,REPAIR OF HYDROCELE,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
55100,CPT,DRAINAGE OF SCROTUM ABSCESS,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
55110,CPT,EXPLORE SCROTUM,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
55120,CPT,REMOVAL OF SCROTUM LESION,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
55150,CPT,REMOVAL OF SCROTUM,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
55175,CPT,REVISION OF SCROTUM,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
55180,CPT,REVISION OF SCROTUM,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
55200,CPT,INCISION OF SPERM DUCT,,30,,,"$14,555.89",$0.00,1,0,1,20210101,
55250,CPT,REMOVAL OF SPERM DUCT(S),,30,,,"$10,353.58",$0.00,1,0,1,20210101,
55300,CPT,PREPARE SPERM DUCT X-RAY,,30,,,"$1,368.78",$0.00,1,0,1,20210101,
55400,CPT,REPAIR OF SPERM DUCT,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
55500,CPT,REMOVAL OF HYDROCELE,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
55520,CPT,REMOVAL OF SPERM CORD LESION,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
55530,CPT,REVISE SPERMATIC CORD VEINS,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
55535,CPT,REVISE SPERMATIC CORD VEINS,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
55540,CPT,REVISE HERNIA & SPERM VEINS,,30,,,"$16,182.79",$0.00,1,0,1,20210101,
55550,CPT,LAPARO LIGATE SPERMATIC VEIN,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
55559,CPT,LAPARO PROC SPERMATIC CORD,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
55600,CPT,INCISE SPERM DUCT POUCH,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
55680,CPT,REMOVE SPERM POUCH LESION,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
55700,CPT,BIOPSY OF PROSTATE,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
55705,CPT,BIOPSY OF PROSTATE,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
55706,CPT,PROSTATE SATURATION SAMPLING,,30,,,"$15,209.71",$0.00,1,0,1,20210101,
55720,CPT,DRAINAGE OF PROSTATE ABSCESS,,30,,,"$12,910.03",$0.00,1,0,1,20210101,
55725,CPT,DRAINAGE OF PROSTATE ABSCESS,,30,,,"$15,284.88",$0.00,1,0,1,20210101,
55860,CPT,SURGICAL EXPOSURE PROSTATE,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
55866,CPT,LAPARO RADICAL PROSTATECTOMY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
55870,CPT,ELECTROEJACULATION,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
55873,CPT,CRYOABLATE PROSTATE,,30,,,"$23,787.30",$0.00,1,0,1,20210101,
55874,CPT,TPRNL PLMT BIODEGRDABL MATRL,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
55875,CPT,TRANSPERI NEEDLE PLACE PROS,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
55876,CPT,PLACE RT DEVICE/MARKER PROS,,30,,,"$7,691.66",$0.00,1,0,1,20210101,
55880,CPT,ABLTJ MAL PRST8 TISS HIFU,,30,,,"$20,135.61",$0.00,1,0,1,20210101,
55899,CPT,GENITAL SURGERY PROCEDURE,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
55920,CPT,PLACE NEEDLES PELVIC FOR RT,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
55970,CPT,SEX TRANSFORMATION M TO F,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
55980,CPT,SEX TRANSFORMATION F TO M,,30,,,"$15,821.36",$0.00,1,0,1,20210101,
56405,CPT,I & D OF VULVA/PERINEUM,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
56420,CPT,DRAINAGE OF GLAND ABSCESS,,30,,,$895.91,$0.00,1,0,1,20210101,
56440,CPT,SURGERY FOR VULVA LESION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56441,CPT,LYSIS OF LABIAL LESION(S),,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56442,CPT,HYMENOTOMY,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56501,CPT,DESTROY VULVA LESIONS SIM,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
56515,CPT,DESTROY VULVA LESION/S COMPL,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
56605,CPT,BIOPSY OF VULVA/PERINEUM,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
56606,CPT,BIOPSY OF VULVA/PERINEUM,,30,,,"$1,504.73",$0.00,1,0,1,20210101,
56620,CPT,PARTIAL REMOVAL OF VULVA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56625,CPT,COMPLETE REMOVAL OF VULVA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56630,CPT,EXTENSIVE VULVA SURGERY,,30,,,"$20,142.38",$0.00,1,0,1,20210101,
56700,CPT,PARTIAL REMOVAL OF HYMEN,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56740,CPT,REMOVE VAGINA GLAND LESION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56800,CPT,REPAIR OF VAGINA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56805,CPT,REPAIR CLITORIS,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56810,CPT,REPAIR OF PERINEUM,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
56820,CPT,EXAM OF VULVA W/SCOPE,,30,,,$895.91,$0.00,1,0,1,20210101,
56821,CPT,EXAM/BIOPSY OF VULVA W/SCOPE,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
57000,CPT,EXPLORATION OF VAGINA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57010,CPT,DRAINAGE OF PELVIC ABSCESS,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57020,CPT,DRAINAGE OF PELVIC FLUID,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
57022,CPT,I & D VAGINAL HEMATOMA PP,,30,,,"$11,890.47",$0.00,1,0,1,20210101,
57023,CPT,I & D VAG HEMATOMA NON-OB,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
57061,CPT,DESTROY VAG LESIONS SIMPLE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57065,CPT,DESTROY VAG LESIONS COMPLEX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57100,CPT,BIOPSY OF VAGINA,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
57105,CPT,BIOPSY OF VAGINA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57106,CPT,REMOVE VAGINA WALL PARTIAL,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57107,CPT,REMOVE VAGINA TISSUE PART,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57109,CPT,VAGINECTOMY PARTIAL W/NODES,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57120,CPT,CLOSURE OF VAGINA,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57130,CPT,REMOVE VAGINA LESION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57135,CPT,REMOVE VAGINA LESION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57150,CPT,TREAT VAGINA INFECTION,,30,,,$426.56,$0.00,1,0,1,20210101,
57155,CPT,INSERT UTERI TANDEM/OVOIDS,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
57156,CPT,INS VAG BRACHYTX DEVICE,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
57160,CPT,INSERT PESSARY/OTHER DEVICE,,30,,,$895.91,$0.00,1,0,1,20210101,
57170,CPT,FITTING OF DIAPHRAGM/CAP,,30,,,$895.91,$0.00,1,0,1,20210101,
57180,CPT,TREAT VAGINAL BLEEDING,,30,,,$895.91,$0.00,1,0,1,20210101,
57200,CPT,REPAIR OF VAGINA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57210,CPT,REPAIR VAGINA/PERINEUM,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57220,CPT,REVISION OF URETHRA,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57230,CPT,REPAIR OF URETHRAL LESION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57240,CPT,ANTERIOR COLPORRHAPHY,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57250,CPT,REPAIR RECTUM & VAGINA,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57260,CPT,CMBN ANT PST COLPRHY,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57265,CPT,CMBN AP COLPRHY W/NTRCL RPR,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57267,CPT,INSERT MESH/PELVIC FLR ADDON,,30,,,"$6,339.50",$0.00,1,0,1,20210101,
57268,CPT,REPAIR OF BOWEL BULGE,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
57282,CPT,COLPOPEXY EXTRAPERITONEAL,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
57283,CPT,COLPOPEXY INTRAPERITONEAL,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
57284,CPT,REPAIR PARAVAG DEFECT OPEN,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57285,CPT,REPAIR PARAVAG DEFECT VAG,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
57287,CPT,REVISE/REMOVE SLING REPAIR,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57288,CPT,REPAIR BLADDER DEFECT,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57289,CPT,REPAIR BLADDER & VAGINA,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
57291,CPT,CONSTRUCTION OF VAGINA,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
57292,CPT,CONSTRUCT VAGINA WITH GRAFT,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57295,CPT,REVISE VAG GRAFT VIA VAGINA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57300,CPT,REPAIR RECTUM-VAGINA FISTULA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57310,CPT,REPAIR URETHROVAGINAL LESION,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
57320,CPT,REPAIR BLADDER-VAGINA LESION,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57330,CPT,REPAIR BLADDER-VAGINA LESION,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
57335,CPT,REPAIR VAGINA,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
57400,CPT,DILATION OF VAGINA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57410,CPT,PELVIC EXAMINATION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57415,CPT,REMOVE VAGINAL FOREIGN BODY,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57420,CPT,EXAM OF VAGINA W/SCOPE,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
57421,CPT,EXAM/BIOPSY OF VAG W/SCOPE,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
57423,CPT,REPAIR PARAVAG DEFECT LAP,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
57425,CPT,LAPAROSCOPY SURG COLPOPEXY,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
57426,CPT,REVISE PROSTH VAG GRAFT LAP,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
57452,CPT,EXAM OF CERVIX W/SCOPE,,30,,,$895.91,$0.00,1,0,1,20210101,
57454,CPT,BX/CURETT OF CERVIX W/SCOPE,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
57455,CPT,BIOPSY OF CERVIX W/SCOPE,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
57456,CPT,ENDOCERV CURETTAGE W/SCOPE,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
57460,CPT,BX OF CERVIX W/SCOPE LEEP,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57461,CPT,CONZ OF CERVIX W/SCOPE LEEP,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57500,CPT,BIOPSY OF CERVIX,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
57505,CPT,ENDOCERVICAL CURETTAGE,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
57510,CPT,CAUTERIZATION OF CERVIX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57511,CPT,CRYOCAUTERY OF CERVIX,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
57513,CPT,LASER SURGERY OF CERVIX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57520,CPT,CONIZATION OF CERVIX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57522,CPT,CONIZATION OF CERVIX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57530,CPT,REMOVAL OF CERVIX,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
57550,CPT,REMOVAL OF RESIDUAL CERVIX,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
57555,CPT,REMOVE CERVIX/REPAIR VAGINA,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57556,CPT,REMOVE CERVIX REPAIR BOWEL,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
57558,CPT,D&C OF CERVICAL STUMP,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57700,CPT,REVISION OF CERVIX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57720,CPT,REVISION OF CERVIX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
57800,CPT,DILATION OF CERVICAL CANAL,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58100,CPT,BIOPSY OF UTERUS LINING,,30,,,$895.91,$0.00,1,0,1,20210101,
58110,CPT,BX DONE W/COLPOSCOPY ADD-ON,,30,,,"$1,067.49",$0.00,1,0,1,20210101,
58120,CPT,DILATION AND CURETTAGE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58145,CPT,MYOMECTOMY VAG METHOD,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58260,CPT,VAGINAL HYSTERECTOMY,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58262,CPT,VAG HYST INCLUDING T/O,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58263,CPT,VAG HYST W/T/O & VAG REPAIR,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58270,CPT,VAG HYST W/ENTEROCELE REPAIR,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58290,CPT,VAG HYST COMPLEX,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
58291,CPT,VAG HYST INCL T/O COMPLEX,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58292,CPT,VAG HYST T/O & REPAIR COMPL,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
58294,CPT,VAG HYST W/ENTEROCELE COMPL,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58300,CPT,INSERT INTRAUTERINE DEVICE,,30,,,"$1,452.06",$0.00,1,0,1,20210101,
58301,CPT,REMOVE INTRAUTERINE DEVICE,,30,,,"$1,543.19",$0.00,1,0,1,20210101,
58321,CPT,ARTIFICIAL INSEMINATION,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
58322,CPT,ARTIFICIAL INSEMINATION,,30,,,$895.91,$0.00,1,0,1,20210101,
58323,CPT,SPERM WASHING,,30,,,$895.91,$0.00,1,0,1,20210101,
58340,CPT,CATHETER FOR HYSTEROGRAPHY,,30,,,$918.50,$0.00,1,0,1,20210101,
58345,CPT,REOPEN FALLOPIAN TUBE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58346,CPT,INSERT HEYMAN UTERI CAPSULE,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
58350,CPT,REOPEN FALLOPIAN TUBE,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58353,CPT,ENDOMETR ABLATE THERMAL,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58356,CPT,ENDOMETRIAL CRYOABLATION,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58541,CPT,LSH UTERUS 250 G OR LESS,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58542,CPT,LSH W/T/O UT 250 G OR LESS,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58543,CPT,LSH UTERUS ABOVE 250 G,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58544,CPT,LSH W/T/O UTERUS ABOVE 250 G,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58545,CPT,LAPAROSCOPIC MYOMECTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58546,CPT,LAPARO-MYOMECTOMY COMPLEX,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58550,CPT,LAPARO-ASST VAG HYSTERECTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58552,CPT,LAPARO-VAG HYST INCL T/O,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58553,CPT,LAPARO-VAG HYST COMPLEX,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58554,CPT,LAPARO-VAG HYST W/T/O COMPL,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58555,CPT,HYSTEROSCOPY DX SEP PROC,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58558,CPT,HYSTEROSCOPY BIOPSY,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58559,CPT,HYSTEROSCOPY LYSIS,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58560,CPT,HYSTEROSCOPY RESECT SEPTUM,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58561,CPT,HYSTEROSCOPY REMOVE MYOMA,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58562,CPT,HYSTEROSCOPY REMOVE FB,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58563,CPT,HYSTEROSCOPY ABLATION,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58565,CPT,HYSTEROSCOPY STERILIZATION,,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58570,CPT,TLH UTERUS 250 G OR LESS,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58571,CPT,TLH W/T/O 250 G OR LESS,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58572,CPT,TLH UTERUS OVER 250 G,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58573,CPT,TLH W/T/O UTERUS OVER 250 G,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58578,CPT,LAPARO PROC UTERUS,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58579,CPT,HYSTEROSCOPE PROCEDURE,,30,,,$895.91,$0.00,1,0,1,20210101,
58600,CPT,DIVISION OF FALLOPIAN TUBE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58615,CPT,OCCLUDE FALLOPIAN TUBE(S),,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58660,CPT,LAPAROSCOPY LYSIS,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58661,CPT,LAPAROSCOPY REMOVE ADNEXA,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58662,CPT,LAPAROSCOPY EXCISE LESIONS,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58670,CPT,LAPAROSCOPY TUBAL CAUTERY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58671,CPT,LAPAROSCOPY TUBAL BLOCK,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58672,CPT,LAPAROSCOPY FIMBRIOPLASTY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58673,CPT,LAPAROSCOPY SALPINGOSTOMY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58674,CPT,LAPS ABLTJ UTERINE FIBROIDS,,30,,,"$23,258.62",$0.00,1,0,1,20210101,
58679,CPT,LAPARO PROC OVIDUCT-OVARY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
58770,CPT,CREATE NEW TUBAL OPENING,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58800,CPT,DRAINAGE OF OVARIAN CYST(S),,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58805,CPT,DRAINAGE OF OVARIAN CYST(S),,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58820,CPT,DRAIN OVARY ABSCESS OPEN,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58900,CPT,BIOPSY OF OVARY(S),,30,,,"$12,390.47",$0.00,1,0,1,20210101,
58920,CPT,PARTIAL REMOVAL OF OVARY(S),,30,,,"$24,043.39",$0.00,1,0,1,20210101,
58925,CPT,REMOVAL OF OVARIAN CYST(S),,30,,,"$20,392.74",$0.00,1,0,1,20210101,
58970,CPT,RETRIEVAL OF OOCYTE,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
58974,CPT,TRANSFER OF EMBRYO,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
58976,CPT,TRANSFER OF EMBRYO,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
58999,CPT,GENITAL SURGERY PROCEDURE,,30,,,$895.91,$0.00,1,0,1,20210101,
59000,CPT,AMNIOCENTESIS DIAGNOSTIC,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
59001,CPT,AMNIOCENTESIS THERAPEUTIC,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59012,CPT,FETAL CORD PUNCTURE PRENATAL,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59015,CPT,CHORION BIOPSY,,30,,,"$2,908.44",$0.00,1,0,1,20210101,
59020,CPT,FETAL CONTRACT STRESS TEST,,30,,,$895.91,$0.00,1,0,1,20210101,
59025,CPT,FETAL NON-STRESS TEST,,30,,,$895.91,$0.00,1,0,1,20210101,
59030,CPT,FETAL SCALP BLOOD SAMPLE,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59050,CPT,FETAL MONITOR W/REPORT,,30,,,$825.25,$0.00,1,0,1,20210101,
59051,CPT,FETAL MONITOR/INTERPRET ONLY,,30,,,$434.66,$0.00,1,0,1,20210101,
59070,CPT,TRANSABDOM AMNIOINFUS W/US,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59072,CPT,UMBILICAL CORD OCCLUD W/US,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59074,CPT,FETAL FLUID DRAINAGE W/US,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59076,CPT,FETAL SHUNT PLACEMENT W/US,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59100,CPT,REMOVE UTERUS LESION,,30,,,"$17,932.12",$0.00,1,0,1,20210101,
59150,CPT,TREAT ECTOPIC PREGNANCY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
59151,CPT,TREAT ECTOPIC PREGNANCY,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
59160,CPT,D & C AFTER DELIVERY,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59200,CPT,INSERT CERVICAL DILATOR,,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59300,CPT,EPISIOTOMY OR VAGINAL REPAIR,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59320,CPT,REVISION OF CERVIX,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59400,CPT,OBSTETRICAL CARE,,30,,,"$8,564.54",$0.00,1,0,1,20210101,
59409,CPT,OBSTETRICAL CARE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59410,CPT,OBSTETRICAL CARE,,30,,,"$5,058.42",$0.00,1,0,1,20210101,
59412,CPT,ANTEPARTUM MANIPULATION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59414,CPT,DELIVER PLACENTA,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59425,CPT,ANTEPARTUM CARE ONLY,,30,,,$861.23,$0.00,1,0,1,20210101,
59426,CPT,ANTEPARTUM CARE ONLY,,30,,,"$1,719.06",$0.00,1,0,1,20210101,
59430,CPT,CARE AFTER DELIVERY,,30,,,$442.94,$0.00,1,0,1,20210101,
59510,CPT,CESAREAN DELIVERY,,30,,,"$9,250.43",$0.00,1,0,1,20210101,
59515,CPT,CESAREAN DELIVERY,,30,,,"$5,851.29",$0.00,1,0,1,20210101,
59612,CPT,VBAC DELIVERY ONLY,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59812,CPT,TREATMENT OF MISCARRIAGE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59820,CPT,CARE OF MISCARRIAGE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59821,CPT,TREATMENT OF MISCARRIAGE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59840,CPT,ABORTION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59841,CPT,ABORTION,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59866,CPT,ABORTION (MPR),,30,,,"$1,744.43",$0.00,1,0,1,20210101,
59870,CPT,EVACUATE MOLE OF UTERUS,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59871,CPT,REMOVE CERCLAGE SUTURE,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
59897,CPT,FETAL INVAS PX W/US,,30,,,$895.91,$0.00,1,0,1,20210101,
59898,CPT,LAPARO PROC OB CARE/DELIVER,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
59899,CPT,MATERNITY CARE PROCEDURE,,30,,,$895.91,$0.00,1,0,1,20210101,
60000,CPT,DRAIN THYROID/TONGUE CYST,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
60100,CPT,BIOPSY OF THYROID,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
60200,CPT,REMOVE THYROID LESION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60210,CPT,PARTIAL THYROID EXCISION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60212,CPT,PARTIAL THYROID EXCISION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60220,CPT,PARTIAL REMOVAL OF THYROID,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60225,CPT,PARTIAL REMOVAL OF THYROID,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60240,CPT,REMOVAL OF THYROID,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60252,CPT,REMOVAL OF THYROID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
60260,CPT,REPEAT THYROID SURGERY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
60271,CPT,REMOVAL OF THYROID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
60280,CPT,REMOVE THYROID DUCT LESION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60281,CPT,REMOVE THYROID DUCT LESION,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60300,CPT,ASPIR/INJ THYROID CYST,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
60500,CPT,EXPLORE PARATHYROID GLANDS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
60502,CPT,RE-EXPLORE PARATHYROIDS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
60512,CPT,AUTOTRANSPLANT PARATHYROID,,30,,,"$9,198.68",$0.00,1,0,1,20210101,
60520,CPT,REMOVAL OF THYMUS GLAND,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
60659,CPT,LAPARO PROC ENDOCRINE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
60699,CPT,ENDOCRINE SURGERY PROCEDURE,,30,,,"$21,710.02",$0.00,1,0,1,20210101,
61000,CPT,REMOVE CRANIAL CAVITY FLUID,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
61001,CPT,REMOVE CRANIAL CAVITY FLUID,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
61020,CPT,REMOVE BRAIN CAVITY FLUID,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
61026,CPT,INJECTION INTO BRAIN CANAL,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
61050,CPT,REMOVE BRAIN CANAL FLUID,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
61055,CPT,INJECTION INTO BRAIN CANAL,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
61070,CPT,BRAIN CANAL SHUNT PROCEDURE,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
61215,CPT,INSERT BRAIN-FLUID DEVICE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
61330,CPT,DECOMPRESS EYE SOCKET,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
61623,CPT,ENDOVASC TEMPORY VESSEL OCCL,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
61624,CPT,TRANSCATH OCCLUSION CNS,,30,,,"$32,697.32",$0.00,1,0,1,20210101,
61626,CPT,TRANSCATH OCCLUSION NON-CNS,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
61640,CPT,DILATE IC VASOSPASM INIT,,30,,,"$3,067.56",$0.00,1,0,1,20210101,
61720,CPT,INCISE SKULL/BRAIN SURGERY,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
61770,CPT,INCISE SKULL FOR TREATMENT,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
61781,CPT,SCAN PROC CRANIAL INTRA,,30,,,"$3,700.55",$0.00,1,0,1,20210101,
61782,CPT,SCAN PROC CRANIAL EXTRA,,30,,,"$4,488.34",$0.00,1,0,1,20210101,
61783,CPT,SCAN PROC SPINAL,,30,,,"$5,611.01",$0.00,1,0,1,20210101,
61790,CPT,TREAT TRIGEMINAL NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
61791,CPT,TREAT TRIGEMINAL TRACT,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
61796,CPT,SRS CRANIAL LESION SIMPLE,,30,,,"$23,059.28",$0.00,1,0,1,20210101,
61797,CPT,SRS CRAN LES SIMPLE ADDL,,30,,,"$1,452.20",$0.00,1,0,1,20210101,
61798,CPT,SRS CRANIAL LESION COMPLEX,,30,,,"$25,084.89",$0.00,1,0,1,20210101,
61799,CPT,SRS CRAN LES COMPLEX ADDL,,30,,,"$1,745.93",$0.00,1,0,1,20210101,
61800,CPT,APPLY SRS HEADFRAME ADD-ON,,30,,,"$22,153.21",$0.00,1,0,1,20210101,
61880,CPT,REVISE/REMOVE NEUROELECTRODE,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
61885,CPT,INSRT/REDO NEUROSTIM 1 ARRAY,,30,,,"$40,805.33",$0.00,1,0,1,20210101,
61886,CPT,IMPLANT NEUROSTIM ARRAYS,,30,,,"$59,911.81",$0.00,1,0,1,20210101,
61888,CPT,REVISE/REMOVE NEURORECEIVER,,30,,,"$25,001.07",$0.00,1,0,1,20210101,
62000,CPT,TREAT SKULL FRACTURE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
62160,CPT,NEUROENDOSCOPY ADD-ON,,30,,,"$1,237.76",$0.00,1,0,1,20210101,
62194,CPT,REPLACE/IRRIGATE CATHETER,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
62225,CPT,REPLACE/IRRIGATE CATHETER,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
62230,CPT,REPLACE/REVISE BRAIN SHUNT,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
62252,CPT,CSF SHUNT REPROGRAM,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
62263,CPT,EPIDURAL LYSIS MULT SESSIONS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62264,CPT,EPIDURAL LYSIS ON SINGLE DAY,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62267,CPT,INTERDISCAL PERQ ASPIR DX,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
62268,CPT,DRAIN SPINAL CORD CYST,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62269,CPT,NEEDLE BIOPSY SPINAL CORD,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
62270,CPT,DX LMBR SPI PNXR,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
62272,CPT,THER SPI PNXR DRG CSF,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
62273,CPT,INJECT EPIDURAL PATCH,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
62280,CPT,TREAT SPINAL CORD LESION,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62281,CPT,TREAT SPINAL CORD LESION,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62282,CPT,TREAT SPINAL CANAL LESION,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62284,CPT,INJECTION FOR MYELOGRAM,,30,,,"$1,942.94",$0.00,1,0,1,20210101,
62287,CPT,PERCUTANEOUS DISKECTOMY,,30,,,"$13,329.98",$0.00,1,0,1,20210101,
62290,CPT,NJX PX DISCOGRAPHY LUMBAR,,30,,,"$3,186.15",$0.00,1,0,1,20210101,
62291,CPT,NJX PX DISCOGRAPHY CRV/THRC,,30,,,"$3,010.78",$0.00,1,0,1,20210101,
62292,CPT,NJX CHEMONUCLEOLYSIS LMBR,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
62294,CPT,INJECTION INTO SPINAL ARTERY,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62302,CPT,MYELOGRAPHY LUMBAR INJECTION,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
62303,CPT,MYELOGRAPHY LUMBAR INJECTION,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
62304,CPT,MYELOGRAPHY LUMBAR INJECTION,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
62305,CPT,MYELOGRAPHY LUMBAR INJECTION,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
62320,CPT,NJX INTERLAMINAR CRV/THRC,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
62321,CPT,NJX INTERLAMINAR CRV/THRC,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
62322,CPT,NJX INTERLAMINAR LMBR/SAC,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
62323,CPT,NJX INTERLAMINAR LMBR/SAC,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
62324,CPT,NJX INTERLAMINAR CRV/THRC,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62325,CPT,NJX INTERLAMINAR CRV/THRC,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62326,CPT,NJX INTERLAMINAR LMBR/SAC,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62327,CPT,NJX INTERLAMINAR LMBR/SAC,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
62328,CPT,DX LMBR SPI PNXR W/FLUOR/CT,,30,,,"$3,349.94",$0.00,1,0,1,20210101,
62329,CPT,THER SPI PNXR CSF FLUOR/CT,,30,,,"$3,349.94",$0.00,1,0,1,20210101,
62350,CPT,IMPLANT SPINAL CANAL CATH,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
62351,CPT,IMPLANT SPINAL CANAL CATH,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
62355,CPT,REMOVE SPINAL CANAL CATHETER,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
62360,CPT,INSERT SPINE INFUSION DEVICE,,30,,,"$34,472.27",$0.00,1,0,1,20210101,
62361,CPT,IMPLANT SPINE INFUSION PUMP,,30,,,"$34,472.27",$0.00,1,0,1,20210101,
62362,CPT,IMPLANT SPINE INFUSION PUMP,,30,,,"$34,472.27",$0.00,1,0,1,20210101,
62365,CPT,REMOVE SPINE INFUSION DEVICE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
62367,CPT,ANALYZE SPINE INFUS PUMP,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
62368,CPT,ANALYZE SP INF PUMP W/REPROG,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
62369,CPT,ANAL SP INF PMP W/REPRG&FILL,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
62370,CPT,ANL SP INF PMP W/MDREPRG&FIL,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
62380,CPT,NDSC DCMPRN 1 NTRSPC LUMBAR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63001,CPT,REMOVE SPINE LAMINA 1/2 CRVL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63003,CPT,REMOVE SPINE LAMINA 1/2 THRC,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63005,CPT,REMOVE SPINE LAMINA 1/2 LMBR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63011,CPT,REMOVE SPINE LAMINA 1/2 SCRL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63012,CPT,REMOVE LAMINA/FACETS LUMBAR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63015,CPT,REMOVE SPINE LAMINA >2 CRVCL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63016,CPT,REMOVE SPINE LAMINA >2 THRC,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63017,CPT,REMOVE SPINE LAMINA >2 LMBR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63020,CPT,NECK SPINE DISK SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63030,CPT,LOW BACK DISK SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63035,CPT,SPINAL DISK SURGERY ADD-ON,,30,,,"$10,812.05",$0.00,1,0,1,20210101,
63040,CPT,LAMINOTOMY SINGLE CERVICAL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63042,CPT,LAMINOTOMY SINGLE LUMBAR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63044,CPT,LAMINOTOMY ADDL LUMBAR,,30,,,"$9,991.33",$0.00,1,0,1,20210101,
63045,CPT,REMOVE SPINE LAMINA 1 CRVL,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63046,CPT,REMOVE SPINE LAMINA 1 THRC,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63047,CPT,REMOVE SPINE LAMINA 1 LMBR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63048,CPT,REMOVE SPINAL LAMINA ADD-ON,,30,,,"$10,540.33",$0.00,1,0,1,20210101,
63055,CPT,DECOMPRESS SPINAL CORD THRC,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63056,CPT,DECOMPRESS SPINAL CORD LMBR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63057,CPT,DECOMPRESS SPINE CORD ADD-ON,,30,,,"$10,271.41",$0.00,1,0,1,20210101,
63064,CPT,DECOMPRESS SPINAL CORD THRC,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63066,CPT,DECOMPRESS SPINE CORD ADD-ON,,30,,,"$11,658.67",$0.00,1,0,1,20210101,
63075,CPT,NECK SPINE DISK SURGERY,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
63076,CPT,NECK SPINE DISK SURGERY,,30,,,"$11,658.67",$0.00,1,0,1,20210101,
63265,CPT,EXCISE INTRASPINL LESION CRV,,30,,,"$23,448.00",$0.00,1,0,1,20210101,
63266,CPT,EXCISE INTRSPINL LESION THRC,,30,,,"$23,448.00",$0.00,1,0,1,20210101,
63267,CPT,EXCISE INTRSPINL LESION LMBR,,30,,,"$23,448.00",$0.00,1,0,1,20210101,
63268,CPT,EXCISE INTRSPINL LESION SCRL,,30,,,"$23,448.00",$0.00,1,0,1,20210101,
63600,CPT,REMOVE SPINAL CORD LESION,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
63610,CPT,STIMULATION OF SPINAL CORD,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
63620,CPT,SRS SPINAL LESION,,30,,,"$8,630.06",$0.00,1,0,1,20210101,
63621,CPT,SRS SPINAL LESION ADDL,,30,,,"$1,517.69",$0.00,1,0,1,20210101,
63650,CPT,IMPLANT NEUROELECTRODES,,30,,,"$23,792.60",$0.00,1,0,1,20210101,
63655,CPT,IMPLANT NEUROELECTRODES,,30,,,"$40,805.33",$0.00,1,0,1,20210101,
63661,CPT,REMOVE SPINE ELTRD PERQ ARAY,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
63662,CPT,REMOVE SPINE ELTRD PLATE,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
63663,CPT,REVISE SPINE ELTRD PERQ ARAY,,30,,,"$23,792.60",$0.00,1,0,1,20210101,
63664,CPT,REVISE SPINE ELTRD PLATE,,30,,,"$32,796.42",$0.00,1,0,1,20210101,
63685,CPT,INSRT/REDO SPINE N GENERATOR,,30,,,"$59,911.81",$0.00,1,0,1,20210101,
63688,CPT,REVISE/REMOVE NEURORECEIVER,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
63741,CPT,INSTALL SPINAL SHUNT,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
63744,CPT,REVISION OF SPINAL SHUNT,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
63746,CPT,REMOVAL OF SPINAL SHUNT,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64400,CPT,NJX AA&/STRD TRIGEMINAL NRV,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64405,CPT,NJX AA&/STRD GR OCPL NRV,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64408,CPT,NJX AA&/STRD VAGUS NRV,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64415,CPT,NJX AA&/STRD BRACH PLEXUS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64416,CPT,NJX AA&/STRD BRACH PLEX NFS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64417,CPT,NJX AA&/STRD AXILLARY NRV,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64418,CPT,NJX AA&/STRD SPRSCAP NRV,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64420,CPT,NJX AA&/STRD NTRCOST NRV 1,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64421,CPT,NJX AA&/STRD NTRCOST NRV EA,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64425,CPT,NJX AA&/STRD II IH NERVES,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64430,CPT,NJX AA&/STRD PUDENDAL NERVE,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64435,CPT,NJX AA&/STRD PARACRV NRV,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64445,CPT,NJX AA&/STRD SCIATIC NERVE,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64446,CPT,NJX AA&/STRD SCIATIC NRV NFS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64447,CPT,NJX AA&/STRD FEMORAL NERVE,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64448,CPT,NJX AA&/STRD FEM NERVE NFS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64449,CPT,NJX AA&/STRD LMBR PLEX NFS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64450,CPT,NJX AA&/STRD OTHER PN/BRANCH,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64451,CPT,NJX AA&/STRD NRV NRVTG SI JT,,30,,,"$3,349.94",$0.00,1,0,1,20210101,
64454,CPT,NJX AA&/STRD GNCLR NRV BRNCH,,30,,,"$3,349.94",$0.00,1,0,1,20210101,
64455,CPT,NJX AA&/STRD PLTR COM DG NRV,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64461,CPT,PVB THORACIC SINGLE INJ SITE,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64462,CPT,PVB THORACIC 2ND+ INJ SITE,,30,,,"$2,006.64",$0.00,1,0,1,20210101,
64463,CPT,PVB THORACIC CONT INFUSION,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64479,CPT,NJX AA&/STRD TFRM EPI C/T 1,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64480,CPT,NJX AA&/STRD TFRM EPI C/T EA,,30,,,"$2,699.78",$0.00,1,0,1,20210101,
64483,CPT,NJX AA&/STRD TFRM EPI L/S 1,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64484,CPT,NJX AA&/STRD TFRM EPI L/S EA,,30,,,"$2,248.92",$0.00,1,0,1,20210101,
64486,CPT,TAP BLOCK UNIL BY INJECTION,,30,,,"$2,841.41",$0.00,1,0,1,20210101,
64487,CPT,TAP BLOCK UNI BY INFUSION,,30,,,"$3,414.22",$0.00,1,0,1,20210101,
64488,CPT,TAP BLOCK BI INJECTION,,30,,,"$4,830.23",$0.00,1,0,1,20210101,
64489,CPT,TAP BLOCK BI BY INFUSION,,30,,,$882.99,$0.00,1,0,1,20210101,
64490,CPT,INJ PARAVERT F JNT C/T 1 LEV,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64491,CPT,INJ PARAVERT F JNT C/T 2 LEV,,30,,,"$2,241.77",$0.00,1,0,1,20210101,
64492,CPT,INJ PARAVERT F JNT C/T 3 LEV,,30,,,"$2,102.20",$0.00,1,0,1,20210101,
64493,CPT,INJ PARAVERT F JNT L/S 1 LEV,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64494,CPT,INJ PARAVERT F JNT L/S 2 LEV,,30,,,"$2,257.05",$0.00,1,0,1,20210101,
64495,CPT,INJ PARAVERT F JNT L/S 3 LEV,,30,,,"$2,130.36",$0.00,1,0,1,20210101,
64505,CPT,N BLOCK SPENOPALATINE GANGL,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64510,CPT,N BLOCK STELLATE GANGLION,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64517,CPT,N BLOCK INJ HYPOGAS PLXS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64520,CPT,N BLOCK LUMBAR/THORACIC,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64530,CPT,N BLOCK INJ CELIAC PELUS,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64553,CPT,IMPLANT NEUROELECTRODES,,30,,,"$25,001.07",$0.00,1,0,1,20210101,
64555,CPT,IMPLANT NEUROELECTRODES,,30,,,"$23,792.60",$0.00,1,0,1,20210101,
64561,CPT,IMPLANT NEUROELECTRODES,,30,,,"$23,792.60",$0.00,1,0,1,20210101,
64566,CPT,NEUROELTRD STIM POST TIBIAL,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64568,CPT,INC FOR VAGUS N ELECT IMPL,,30,,,"$59,911.81",$0.00,1,0,1,20210101,
64569,CPT,REVISE/REPL VAGUS N ELTRD,,30,,,"$25,001.07",$0.00,1,0,1,20210101,
64570,CPT,REMOVE VAGUS N ELTRD,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64575,CPT,IMPLANT NEUROELECTRODES,,30,,,"$32,796.42",$0.00,1,0,1,20210101,
64580,CPT,IMPLANT NEUROELECTRODES,,30,,,"$40,805.33",$0.00,1,0,1,20210101,
64581,CPT,IMPLANT NEUROELECTRODES,,30,,,"$23,792.60",$0.00,1,0,1,20210101,
64585,CPT,REVISE/REMOVE NEUROELECTRODE,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
64590,CPT,INSRT/REDO PN/GASTR STIMUL,,30,,,"$40,805.33",$0.00,1,0,1,20210101,
64595,CPT,REVISE/RMV PN/GASTR STIMUL,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
64600,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64605,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64610,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64611,CPT,CHEMODENERV SALIV GLANDS,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64612,CPT,DESTROY NERVE FACE MUSCLE,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64615,CPT,CHEMODENERV MUSC MIGRAINE,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64616,CPT,CHEMODENERV MUSC NECK DYSTON,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64617,CPT,CHEMODENER MUSCLE LARYNX EMG,,30,,,"$1,472.76",$0.00,1,0,1,20210101,
64620,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64624,CPT,DSTRJ NULYT AGT GNCLR NRV,,30,,,"$9,906.60",$0.00,1,0,1,20210101,
64625,CPT,RF ABLTJ NRV NRVTG SI JT,,30,,,"$9,906.60",$0.00,1,0,1,20210101,
64630,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64632,CPT,N BLOCK INJ COMMON DIGIT,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64633,CPT,DESTROY CERV/THOR FACET JNT,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64634,CPT,DESTROY C/TH FACET JNT ADDL,,30,,,"$2,520.83",$0.00,1,0,1,20210101,
64635,CPT,DESTROY LUMB/SAC FACET JNT,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64636,CPT,DESTROY L/S FACET JNT ADDL,,30,,,"$3,021.15",$0.00,1,0,1,20210101,
64640,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64642,CPT,CHEMODENERV 1 EXTREMITY 1-4,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64643,CPT,CHEMODENERV 1 EXTREM 1-4 EA,,30,,,"$1,036.76",$0.00,1,0,1,20210101,
64644,CPT,CHEMODENERV 1 EXTREM 5/> MUS,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64645,CPT,CHEMODENERV 1 EXTREM 5/> EA,,30,,,"$1,135.40",$0.00,1,0,1,20210101,
64646,CPT,CHEMODENERV TRUNK MUSC 1-5,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64647,CPT,CHEMODENERV TRUNK MUSC 6/>,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
64650,CPT,CHEMODENERV ECCRINE GLANDS,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64653,CPT,CHEMODENERV ECCRINE GLANDS,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
64680,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64681,CPT,INJECTION TREATMENT OF NERVE,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
64702,CPT,REVISE FINGER/TOE NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64704,CPT,REVISE HAND/FOOT NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64708,CPT,REVISE ARM/LEG NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64712,CPT,REVISION OF SCIATIC NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64713,CPT,REVISION OF ARM NERVE(S),,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64714,CPT,REVISE LOW BACK NERVE(S),,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64716,CPT,REVISION OF CRANIAL NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64718,CPT,REVISE ULNAR NERVE AT ELBOW,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64719,CPT,REVISE ULNAR NERVE AT WRIST,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64721,CPT,CARPAL TUNNEL SURGERY,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64722,CPT,RELIEVE PRESSURE ON NERVE(S),,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64726,CPT,RELEASE FOOT/TOE NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64727,CPT,INTERNAL NERVE REVISION,,30,,,"$4,528.31",$0.00,1,0,1,20210101,
64732,CPT,INCISION OF BROW NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64734,CPT,INCISION OF CHEEK NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64736,CPT,INCISION OF CHIN NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64738,CPT,INCISION OF JAW NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64740,CPT,INCISION OF TONGUE NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64742,CPT,INCISION OF FACIAL NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64744,CPT,INCISE NERVE BACK OF HEAD,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64746,CPT,INCISE DIAPHRAGM NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64763,CPT,INCISE HIP/THIGH NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64766,CPT,INCISE HIP/THIGH NERVE,,30,,,"$13,329.98",$0.00,1,0,1,20210101,
64771,CPT,SEVER CRANIAL NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64772,CPT,INCISION OF SPINAL NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64774,CPT,REMOVE SKIN NERVE LESION,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64776,CPT,REMOVE DIGIT NERVE LESION,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64778,CPT,DIGIT NERVE SURGERY ADD-ON,,30,,,"$5,381.16",$0.00,1,0,1,20210101,
64782,CPT,REMOVE LIMB NERVE LESION,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64783,CPT,LIMB NERVE SURGERY ADD-ON,,30,,,"$3,604.67",$0.00,1,0,1,20210101,
64784,CPT,REMOVE NERVE LESION,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64786,CPT,REMOVE SCIATIC NERVE LESION,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64787,CPT,IMPLANT NERVE END,,30,,,"$3,972.85",$0.00,1,0,1,20210101,
64788,CPT,REMOVE SKIN NERVE LESION,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64790,CPT,REMOVAL OF NERVE LESION,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64792,CPT,REMOVAL OF NERVE LESION,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64795,CPT,BIOPSY OF NERVE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64802,CPT,SYMPATHECTOMY CERVICAL,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64804,CPT,REMOVE SYMPATHETIC NERVES,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64820,CPT,SYMPATHECTOMY DIGITAL ARTERY,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
64821,CPT,REMOVE SYMPATHETIC NERVES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
64822,CPT,REMOVE SYMPATHETIC NERVES,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
64823,CPT,SYMPATHECTOMY SUPFC PALMAR,,30,,,"$13,826.35",$0.00,1,0,1,20210101,
64831,CPT,REPAIR OF DIGIT NERVE,,30,,,"$13,329.98",$0.00,1,0,1,20210101,
64832,CPT,REPAIR NERVE ADD-ON,,30,,,"$5,121.70",$0.00,1,0,1,20210101,
64834,CPT,REPAIR OF HAND OR FOOT NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64835,CPT,REPAIR OF HAND OR FOOT NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64836,CPT,REPAIR OF HAND OR FOOT NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64837,CPT,REPAIR NERVE ADD-ON,,30,,,"$8,531.62",$0.00,1,0,1,20210101,
64840,CPT,REPAIR OF LEG NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64856,CPT,REPAIR/TRANSPOSE NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64857,CPT,REPAIR ARM/LEG NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64858,CPT,REPAIR SCIATIC NERVE,,30,,,"$13,329.98",$0.00,1,0,1,20210101,
64859,CPT,NERVE SURGERY,,30,,,"$8,531.62",$0.00,1,0,1,20210101,
64861,CPT,REPAIR OF ARM NERVES,,30,,,"$13,329.98",$0.00,1,0,1,20210101,
64862,CPT,REPAIR OF LOW BACK NERVES,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64864,CPT,REPAIR OF FACIAL NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64865,CPT,REPAIR OF FACIAL NERVE,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64872,CPT,SUBSEQUENT REPAIR OF NERVE,,30,,,"$8,531.62",$0.00,1,0,1,20210101,
64874,CPT,REPAIR & REVISE NERVE ADD-ON,,30,,,"$8,531.62",$0.00,1,0,1,20210101,
64876,CPT,REPAIR NERVE/SHORTEN BONE,,30,,,"$8,531.62",$0.00,1,0,1,20210101,
64885,CPT,NERVE GRAFT HEAD/NECK </4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64886,CPT,NERVE GRAFT HEAD/NECK >4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64890,CPT,NERVE GRAFT HAND/FOOT </4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64891,CPT,NERVE GRAFT HAND/FOOT >4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64892,CPT,NERVE GRAFT ARM/LEG <4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64893,CPT,NERVE GRAFT ARM/LEG >4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64895,CPT,NERVE GRAFT HAND/FOOT </4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64896,CPT,NERVE GRAFT HAND/FOOT >4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64897,CPT,NERVE GRAFT ARM/LEG </4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64898,CPT,NERVE GRAFT ARM/LEG >4 CM,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64901,CPT,NERVE GRAFT ADD-ON,,30,,,"$8,531.62",$0.00,1,0,1,20210101,
64902,CPT,NERVE GRAFT ADD-ON,,30,,,"$8,531.62",$0.00,1,0,1,20210101,
64905,CPT,NERVE PEDICLE TRANSFER,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64907,CPT,NERVE PEDICLE TRANSFER,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64910,CPT,NERVE REPAIR W/ALLOGRAFT,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64911,CPT,NEURORRAPHY W/VEIN AUTOGRAFT,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64912,CPT,NRV RPR W/NRV ALGRFT 1ST,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
64913,CPT,NRV RPR W/NRV ALGRFT EA ADDL,,30,,,"$7,772.21",$0.00,1,0,1,20210101,
64999,CPT,NERVOUS SYSTEM SURGERY,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
65091,CPT,REVISE EYE,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65093,CPT,REVISE EYE WITH IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65101,CPT,REMOVAL OF EYE,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65103,CPT,REMOVE EYE/INSERT IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65105,CPT,REMOVE EYE/ATTACH IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65110,CPT,REMOVAL OF EYE,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65112,CPT,REMOVE EYE/REVISE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65114,CPT,REMOVE EYE/REVISE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65125,CPT,REVISE OCULAR IMPLANT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65130,CPT,INSERT OCULAR IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65135,CPT,INSERT OCULAR IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65140,CPT,ATTACH OCULAR IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65150,CPT,REVISE OCULAR IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65155,CPT,REINSERT OCULAR IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65175,CPT,REMOVAL OF OCULAR IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65205,CPT,REMOVE FOREIGN BODY FROM EYE,,30,,,$584.38,$0.00,1,0,1,20210101,
65210,CPT,REMOVE FOREIGN BODY FROM EYE,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
65220,CPT,REMOVE FOREIGN BODY FROM EYE,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
65222,CPT,REMOVE FOREIGN BODY FROM EYE,,30,,,$584.38,$0.00,1,0,1,20210101,
65235,CPT,REMOVE FOREIGN BODY FROM EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65260,CPT,REMOVE FOREIGN BODY FROM EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65265,CPT,REMOVE FOREIGN BODY FROM EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65270,CPT,REPAIR OF EYE WOUND,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65272,CPT,REPAIR OF EYE WOUND,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65275,CPT,REPAIR OF EYE WOUND,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65280,CPT,REPAIR OF EYE WOUND,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65285,CPT,REPAIR OF EYE WOUND,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65286,CPT,REPAIR OF EYE WOUND,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65290,CPT,REPAIR OF EYE SOCKET WOUND,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65400,CPT,REMOVAL OF EYE LESION,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
65410,CPT,BIOPSY OF CORNEA,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65420,CPT,REMOVAL OF EYE LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65426,CPT,REMOVAL OF EYE LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65430,CPT,CORNEAL SMEAR,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
65435,CPT,CURETTE/TREAT CORNEA,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
65436,CPT,CURETTE/TREAT CORNEA,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65450,CPT,TREATMENT OF CORNEAL LESION,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
65600,CPT,REVISION OF CORNEA,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65710,CPT,CORNEAL TRANSPLANT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65730,CPT,CORNEAL TRANSPLANT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65750,CPT,CORNEAL TRANSPLANT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65755,CPT,CORNEAL TRANSPLANT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65756,CPT,CORNEAL TRNSPL ENDOTHELIAL,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65757,CPT,PREP CORNEAL ENDO ALLOGRAFT,,30,,,"$4,742.46",$0.00,1,0,1,20210101,
65760,CPT,REVISION OF CORNEA,,30,,,"$6,215.20",$0.00,1,0,1,20210101,
65765,CPT,REVISION OF CORNEA,,30,,,"$6,648.82",$0.00,1,0,1,20210101,
65767,CPT,CORNEAL TISSUE TRANSPLANT,,30,,,"$5,622.48",$0.00,1,0,1,20210101,
65770,CPT,REVISE CORNEA WITH IMPLANT,,30,,,"$22,063.98",$0.00,1,0,1,20210101,
65771,CPT,RADIAL KERATOTOMY,,30,,,"$4,606.34",$0.00,1,0,1,20210101,
65772,CPT,CORRECTION OF ASTIGMATISM,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
65775,CPT,CORRECTION OF ASTIGMATISM,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
65778,CPT,COVER EYE W/MEMBRANE,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
65779,CPT,COVER EYE W/MEMBRANE SUTURE,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65780,CPT,OCULAR RECONST TRANSPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65781,CPT,OCULAR RECONST TRANSPLANT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65782,CPT,OCULAR RECONST TRANSPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
65785,CPT,IMPLTJ NTRSTRML CRNL RNG SEG,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65800,CPT,DRAINAGE OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65810,CPT,DRAINAGE OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65815,CPT,DRAINAGE OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65820,CPT,RELIEVE INNER EYE PRESSURE,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65850,CPT,INCISION OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65855,CPT,TRABECULOPLASTY LASER SURG,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
65860,CPT,INCISE INNER EYE ADHESIONS,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
65865,CPT,INCISE INNER EYE ADHESIONS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65870,CPT,INCISE INNER EYE ADHESIONS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65875,CPT,INCISE INNER EYE ADHESIONS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65880,CPT,INCISE INNER EYE ADHESIONS,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
65900,CPT,REMOVE EYE LESION,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65920,CPT,REMOVE IMPLANT OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
65930,CPT,REMOVE BLOOD CLOT FROM EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66020,CPT,INJECTION TREATMENT OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66030,CPT,INJECTION TREATMENT OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66130,CPT,REMOVE EYE LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
66150,CPT,GLAUCOMA SURGERY,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66155,CPT,GLAUCOMA SURGERY,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66160,CPT,GLAUCOMA SURGERY,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66170,CPT,GLAUCOMA SURGERY,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66172,CPT,INCISION OF EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66174,CPT,TRANSLUM DIL EYE CANAL,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66175,CPT,TRNSLUM DIL EYE CANAL W/STNT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66179,CPT,AQUEOUS SHUNT EYE W/O GRAFT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66180,CPT,AQUEOUS SHUNT EYE W/GRAFT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66183,CPT,INSERT ANT DRAINAGE DEVICE,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66184,CPT,REVISION OF AQUEOUS SHUNT,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66185,CPT,REVISE AQUEOUS SHUNT EYE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66225,CPT,REPAIR/GRAFT EYE LESION,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66250,CPT,FOLLOW-UP SURGERY OF EYE,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
66500,CPT,INCISION OF IRIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66505,CPT,INCISION OF IRIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66600,CPT,REMOVE IRIS AND LESION,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66605,CPT,REMOVAL OF IRIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66625,CPT,REMOVAL OF IRIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66630,CPT,REMOVAL OF IRIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66635,CPT,REMOVAL OF IRIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66680,CPT,REPAIR IRIS & CILIARY BODY,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66682,CPT,REPAIR IRIS & CILIARY BODY,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66700,CPT,DESTRUCTION CILIARY BODY,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66710,CPT,CILIARY TRANSSLERAL THERAPY,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
66711,CPT,ECP CILIARY BODY DESTRUCTION,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66720,CPT,DESTRUCTION CILIARY BODY,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
66740,CPT,DESTRUCTION CILIARY BODY,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
66761,CPT,REVISION OF IRIS,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
66762,CPT,REVISION OF IRIS,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
66770,CPT,REMOVAL OF INNER EYE LESION,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
66820,CPT,INCISION SECONDARY CATARACT,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66821,CPT,AFTER CATARACT LASER SURGERY,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
66825,CPT,REPOSITION INTRAOCULAR LENS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66830,CPT,REMOVAL OF LENS LESION,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66840,CPT,REMOVAL OF LENS MATERIAL,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66850,CPT,REMOVAL OF LENS MATERIAL,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66852,CPT,REMOVAL OF LENS MATERIAL,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66920,CPT,EXTRACTION OF LENS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66930,CPT,EXTRACTION OF LENS,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
66940,CPT,EXTRACTION OF LENS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66982,CPT,XCAPSL CTRC RMVL CPLX WO ECP,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66983,CPT,CATARACT SURG W/IOL 1 STAGE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66984,CPT,XCAPSL CTRC RMVL W/O ECP,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66985,CPT,INSERT LENS PROSTHESIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66986,CPT,EXCHANGE LENS PROSTHESIS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
66987,CPT,XCAPSL CTRC RMVL CPLX W/ECP,,30,,,"$15,032.60",$0.00,1,0,1,20210101,
66988,CPT,XCAPSL CTRC RMVL W/ECP,,30,,,"$15,032.60",$0.00,1,0,1,20210101,
66990,CPT,OPHTHALMIC ENDOSCOPE ADD-ON,,30,,,"$7,519.28",$0.00,1,0,1,20210101,
66999,CPT,EYE SURGERY PROCEDURE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67005,CPT,PARTIAL REMOVAL OF EYE FLUID,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67010,CPT,PARTIAL REMOVAL OF EYE FLUID,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67015,CPT,RELEASE OF EYE FLUID,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67025,CPT,REPLACE EYE FLUID,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67027,CPT,IMPLANT EYE DRUG SYSTEM,,30,,,"$28,636.08",$0.00,1,0,1,20210101,
67028,CPT,INJECTION EYE DRUG,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
67030,CPT,INCISE INNER EYE STRANDS,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67031,CPT,LASER SURGERY EYE STRANDS,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67036,CPT,REMOVAL OF INNER EYE FLUID,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67039,CPT,LASER TREATMENT OF RETINA,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67040,CPT,LASER TREATMENT OF RETINA,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67041,CPT,VIT FOR MACULAR PUCKER,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67042,CPT,VIT FOR MACULAR HOLE,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67043,CPT,VIT FOR MEMBRANE DISSECT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67101,CPT,REPAIR DETACHED RETINA CRTX,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67105,CPT,REPAIR DETACHED RETINA PC,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67107,CPT,REPAIR DETACHED RETINA,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67108,CPT,REPAIR DETACHED RETINA,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67110,CPT,REPAIR DETACHED RETINA,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67113,CPT,REPAIR RETINAL DETACH CPLX,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67115,CPT,RELEASE ENCIRCLING MATERIAL,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
67120,CPT,REMOVE EYE IMPLANT MATERIAL,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67121,CPT,REMOVE EYE IMPLANT MATERIAL,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67141,CPT,TREATMENT OF RETINA,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67145,CPT,TREATMENT OF RETINA,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67208,CPT,TREATMENT OF RETINAL LESION,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67210,CPT,TREATMENT OF RETINAL LESION,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67218,CPT,TREATMENT OF RETINAL LESION,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67220,CPT,TREATMENT OF CHOROID LESION,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67221,CPT,OCULAR PHOTODYNAMIC THER,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67225,CPT,EYE PHOTODYNAMIC THER ADD-ON,,30,,,"$2,373.47",$0.00,1,0,1,20210101,
67227,CPT,DSTRJ EXTENSIVE RETINOPATHY,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67228,CPT,TREATMENT X10SV RETINOPATHY,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67229,CPT,TR RETINAL LES PRETERM INF,,30,,,"$2,731.26",$0.00,1,0,1,20210101,
67250,CPT,REINFORCE EYE WALL,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67255,CPT,REINFORCE/GRAFT EYE WALL,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67299,CPT,EYE SURGERY PROCEDURE,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
67311,CPT,REVISE EYE MUSCLE,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67312,CPT,REVISE TWO EYE MUSCLES,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67314,CPT,REVISE EYE MUSCLE,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67316,CPT,REVISE TWO EYE MUSCLES,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67318,CPT,REVISE EYE MUSCLE(S),,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67320,CPT,REVISE EYE MUSCLE(S) ADD-ON,,30,,,"$4,672.30",$0.00,1,0,1,20210101,
67331,CPT,EYE SURGERY FOLLOW-UP ADD-ON,,30,,,"$3,606.99",$0.00,1,0,1,20210101,
67332,CPT,REREVISE EYE MUSCLES ADD-ON,,30,,,"$4,221.63",$0.00,1,0,1,20210101,
67334,CPT,REVISE EYE MUSCLE W/SUTURE,,30,,,"$4,235.40",$0.00,1,0,1,20210101,
67335,CPT,EYE SUTURE DURING SURGERY,,30,,,"$4,067.70",$0.00,1,0,1,20210101,
67340,CPT,REVISE EYE MUSCLE ADD-ON,,30,,,"$7,121.22",$0.00,1,0,1,20210101,
67343,CPT,RELEASE EYE TISSUE,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67345,CPT,DESTROY NERVE OF EYE MUSCLE,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67346,CPT,BIOPSY EYE MUSCLE,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67399,CPT,UNLISTED PX EXTRAOCULAR MUSC,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67400,CPT,EXPLORE/BIOPSY EYE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67405,CPT,EXPLORE/DRAIN EYE SOCKET,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67412,CPT,EXPLORE/TREAT EYE SOCKET,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67413,CPT,EXPLORE/TREAT EYE SOCKET,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67414,CPT,EXPLR/DECOMPRESS EYE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67415,CPT,ASPIRATION ORBITAL CONTENTS,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67420,CPT,EXPLORE/TREAT EYE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67430,CPT,EXPLORE/TREAT EYE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67440,CPT,EXPLORE/DRAIN EYE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67445,CPT,EXPLR/DECOMPRESS EYE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67450,CPT,EXPLORE/BIOPSY EYE SOCKET,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67500,CPT,INJECT/TREAT EYE SOCKET,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67505,CPT,INJECT/TREAT EYE SOCKET,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67515,CPT,INJECT/TREAT EYE SOCKET,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67550,CPT,INSERT EYE SOCKET IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67560,CPT,REVISE EYE SOCKET IMPLANT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67570,CPT,DECOMPRESS OPTIC NERVE,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67599,CPT,ORBIT SURGERY PROCEDURE,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67700,CPT,DRAINAGE OF EYELID ABSCESS,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67710,CPT,INCISION OF EYELID,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
67715,CPT,INCISION OF EYELID FOLD,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67800,CPT,REMOVE EYELID LESION,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67801,CPT,REMOVE EYELID LESIONS,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
67805,CPT,REMOVE EYELID LESIONS,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67808,CPT,REMOVE EYELID LESION(S),,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67810,CPT,BIOPSY EYELID & LID MARGIN,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67820,CPT,REVISE EYELASHES,,30,,,$584.38,$0.00,1,0,1,20210101,
67825,CPT,REVISE EYELASHES,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67830,CPT,REVISE EYELASHES,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
67835,CPT,REVISE EYELASHES,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67840,CPT,REMOVE EYELID LESION,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
67850,CPT,TREAT EYELID LESION,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
67875,CPT,CLOSURE OF EYELID BY SUTURE,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
67880,CPT,REVISION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67882,CPT,REVISION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67900,CPT,REPAIR BROW DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67901,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67902,CPT,REPAIR EYELID DEFECT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67903,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67904,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67906,CPT,REPAIR EYELID DEFECT,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67908,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67909,CPT,REVISE EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67911,CPT,REVISE EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67912,CPT,CORRECTION EYELID W/IMPLANT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67914,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67915,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67916,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67917,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67921,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67922,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67923,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67924,CPT,REPAIR EYELID DEFECT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67930,CPT,REPAIR EYELID WOUND,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67935,CPT,REPAIR EYELID WOUND,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67938,CPT,REMOVE EYELID FOREIGN BODY,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
67950,CPT,REVISION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67961,CPT,REVISION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67966,CPT,REVISION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67971,CPT,RECONSTRUCTION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67973,CPT,RECONSTRUCTION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67974,CPT,RECONSTRUCTION OF EYELID,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
67975,CPT,RECONSTRUCTION OF EYELID,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
67999,CPT,REVISION OF EYELID,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68020,CPT,INCISE/DRAIN EYELID LINING,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
68040,CPT,TREATMENT OF EYELID LESIONS,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68100,CPT,BIOPSY OF EYELID LINING,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68110,CPT,REMOVE EYELID LINING LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68115,CPT,REMOVE EYELID LINING LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68130,CPT,REMOVE EYELID LINING LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68135,CPT,REMOVE EYELID LINING LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68200,CPT,TREAT EYELID BY INJECTION,,30,,,$737.09,$0.00,1,0,1,20210101,
68320,CPT,REVISE/GRAFT EYELID LINING,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68325,CPT,REVISE/GRAFT EYELID LINING,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68326,CPT,REVISE/GRAFT EYELID LINING,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68328,CPT,REVISE/GRAFT EYELID LINING,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68330,CPT,REVISE EYELID LINING,,30,,,"$8,318.30",$0.00,1,0,1,20210101,
68335,CPT,REVISE/GRAFT EYELID LINING,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68340,CPT,SEPARATE EYELID ADHESIONS,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68360,CPT,REVISE EYELID LINING,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68362,CPT,REVISE EYELID LINING,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68371,CPT,HARVEST EYE TISSUE ALOGRAFT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68399,CPT,EYELID LINING SURGERY,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68400,CPT,INCISE/DRAIN TEAR GLAND,,30,,,"$5,215.48",$0.00,1,0,1,20210101,
68420,CPT,INCISE/DRAIN TEAR SAC,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68440,CPT,INCISE TEAR DUCT OPENING,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68500,CPT,REMOVAL OF TEAR GLAND,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68505,CPT,PARTIAL REMOVAL TEAR GLAND,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68510,CPT,BIOPSY OF TEAR GLAND,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68520,CPT,REMOVAL OF TEAR SAC,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68525,CPT,BIOPSY OF TEAR SAC,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68530,CPT,CLEARANCE OF TEAR DUCT,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68540,CPT,REMOVE TEAR GLAND LESION,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68550,CPT,REMOVE TEAR GLAND LESION,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68700,CPT,REPAIR TEAR DUCTS,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68705,CPT,REVISE TEAR DUCT OPENING,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68720,CPT,CREATE TEAR SAC DRAIN,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68745,CPT,CREATE TEAR DUCT DRAIN,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68750,CPT,CREATE TEAR DUCT DRAIN,,30,,,"$16,594.10",$0.00,1,0,1,20210101,
68760,CPT,CLOSE TEAR DUCT OPENING,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68761,CPT,CLOSE TEAR DUCT OPENING,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68770,CPT,CLOSE TEAR SYSTEM FISTULA,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68801,CPT,DILATE TEAR DUCT OPENING,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
68810,CPT,PROBE NASOLACRIMAL DUCT,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68811,CPT,PROBE NASOLACRIMAL DUCT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68815,CPT,PROBE NASOLACRIMAL DUCT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68816,CPT,PROBE NL DUCT W/BALLOON,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
68840,CPT,EXPLORE/IRRIGATE TEAR DUCTS,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
68850,CPT,INJECTION FOR TEAR SAC X-RAY,,30,,,"$2,053.92",$0.00,1,0,1,20210101,
68899,CPT,TEAR DUCT SYSTEM SURGERY,,30,,,"$1,042.96",$0.00,1,0,1,20210101,
69000,CPT,DRAIN EXTERNAL EAR LESION,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
69005,CPT,DRAIN EXTERNAL EAR LESION,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
69020,CPT,DRAIN OUTER EAR CANAL LESION,,30,,,"$3,317.56",$0.00,1,0,1,20210101,
69090,CPT,PIERCE EARLOBES,,30,,,$408.67,$0.00,1,0,1,20210101,
69100,CPT,BIOPSY OF EXTERNAL EAR,,30,,,"$1,490.05",$0.00,1,0,1,20210101,
69105,CPT,BIOPSY OF EXTERNAL EAR CANAL,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
69110,CPT,REMOVE EXTERNAL EAR PARTIAL,,30,,,"$13,119.80",$0.00,1,0,1,20210101,
69120,CPT,REMOVAL OF EXTERNAL EAR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69140,CPT,REMOVE EAR CANAL LESION(S),,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69145,CPT,REMOVE EAR CANAL LESION(S),,30,,,"$13,119.80",$0.00,1,0,1,20210101,
69150,CPT,EXTENSIVE EAR CANAL SURGERY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69200,CPT,CLEAR OUTER EAR CANAL,,30,,,$584.38,$0.00,1,0,1,20210101,
69205,CPT,CLEAR OUTER EAR CANAL,,30,,,"$8,521.98",$0.00,1,0,1,20210101,
69209,CPT,REMOVE IMPACTED EAR WAX UNI,,30,,,$373.96,$0.00,1,0,1,20210101,
69210,CPT,REMOVE IMPACTED EAR WAX UNI,,30,,,$373.96,$0.00,1,0,1,20210101,
69220,CPT,CLEAN OUT MASTOID CAVITY,,30,,,$677.96,$0.00,1,0,1,20210101,
69222,CPT,CLEAN OUT MASTOID CAVITY,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
69300,CPT,REVISE EXTERNAL EAR,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69310,CPT,REBUILD OUTER EAR CANAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69320,CPT,REBUILD OUTER EAR CANAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69399,CPT,OUTER EAR SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
69420,CPT,INCISION OF EARDRUM,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
69421,CPT,INCISION OF EARDRUM,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69424,CPT,REMOVE VENTILATING TUBE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69433,CPT,CREATE EARDRUM OPENING,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
69436,CPT,CREATE EARDRUM OPENING,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
69440,CPT,EXPLORATION OF MIDDLE EAR,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69450,CPT,EARDRUM REVISION,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69501,CPT,MASTOIDECTOMY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69502,CPT,MASTOIDECTOMY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69505,CPT,REMOVE MASTOID STRUCTURES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69511,CPT,EXTENSIVE MASTOID SURGERY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69530,CPT,EXTENSIVE MASTOID SURGERY,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69540,CPT,REMOVE EAR LESION,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
69550,CPT,REMOVE EAR LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69552,CPT,REMOVE EAR LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69601,CPT,MASTOID SURGERY REVISION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69602,CPT,MASTOID SURGERY REVISION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69603,CPT,MASTOID SURGERY REVISION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69604,CPT,MASTOID SURGERY REVISION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69610,CPT,REPAIR OF EARDRUM,,30,,,"$8,629.17",$0.00,1,0,1,20210101,
69620,CPT,REPAIR OF EARDRUM,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69631,CPT,REPAIR EARDRUM STRUCTURES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69632,CPT,REBUILD EARDRUM STRUCTURES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69633,CPT,REBUILD EARDRUM STRUCTURES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69635,CPT,REPAIR EARDRUM STRUCTURES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69636,CPT,REBUILD EARDRUM STRUCTURES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69637,CPT,REBUILD EARDRUM STRUCTURES,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69641,CPT,REVISE MIDDLE EAR & MASTOID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69642,CPT,REVISE MIDDLE EAR & MASTOID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69643,CPT,REVISE MIDDLE EAR & MASTOID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69644,CPT,REVISE MIDDLE EAR & MASTOID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69645,CPT,REVISE MIDDLE EAR & MASTOID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69646,CPT,REVISE MIDDLE EAR & MASTOID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69650,CPT,RELEASE MIDDLE EAR BONE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69660,CPT,REVISE MIDDLE EAR BONE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69661,CPT,REVISE MIDDLE EAR BONE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69662,CPT,REVISE MIDDLE EAR BONE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69666,CPT,REPAIR MIDDLE EAR STRUCTURES,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69667,CPT,REPAIR MIDDLE EAR STRUCTURES,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69670,CPT,REMOVE MASTOID AIR CELLS,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69676,CPT,REMOVE MIDDLE EAR NERVE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69700,CPT,CLOSE MASTOID FISTULA,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
69705,CPT,NPS SURG DILAT EUST TUBE UNI,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
69706,CPT,NPS SURG DILAT EUST TUBE BI,,30,,,"$21,569.16",$0.00,1,0,1,20210101,
69710,CPT,IMPLANT/REPLACE HEARING AID,,30,,,"$12,349.29",$0.00,1,0,1,20210101,
69711,CPT,REMOVE/REPAIR HEARING AID,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69714,CPT,IMPLANT TEMPLE BONE W/STIMUL,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
69715,CPT,TEMPLE BNE IMPLNT W/STIMULAT,,30,,,"$33,012.99",$0.00,1,0,1,20210101,
69717,CPT,TEMPLE BONE IMPLANT REVISION,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
69718,CPT,REVISE TEMPLE BONE IMPLANT,,30,,,"$24,424.72",$0.00,1,0,1,20210101,
69720,CPT,RELEASE FACIAL NERVE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69725,CPT,RELEASE FACIAL NERVE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69740,CPT,REPAIR FACIAL NERVE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69745,CPT,REPAIR FACIAL NERVE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69799,CPT,MIDDLE EAR SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
69801,CPT,INCISE INNER EAR,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
69805,CPT,EXPLORE INNER EAR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69806,CPT,EXPLORE INNER EAR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69905,CPT,REMOVE INNER EAR,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69910,CPT,REMOVE INNER EAR & MASTOID,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69915,CPT,INCISE INNER EAR NERVE,,30,,,"$13,140.85",$0.00,1,0,1,20210101,
69930,CPT,IMPLANT COCHLEAR DEVICE,,30,,,"$69,632.96",$0.00,1,0,1,20210101,
69949,CPT,INNER EAR SURGERY PROCEDURE,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
69955,CPT,RELEASE FACIAL NERVE,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69960,CPT,RELEASE INNER EAR CANAL,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69970,CPT,REMOVE INNER EAR LESION,,30,,,"$21,569.89",$0.00,1,0,1,20210101,
69979,CPT,TEMPORAL BONE SURGERY,,30,,,"$1,373.99",$0.00,1,0,1,20210101,
69990,CPT,MICROSURGERY ADD-ON,,30,,,"$4,851.36",$0.00,1,0,1,20210101,
70010,CPT,CONTRAST X-RAY OF BRAIN,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
70015,CPT,CONTRAST X-RAY OF BRAIN,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
70030,CPT,X-RAY EYE FOR FOREIGN BODY,,30,,,$509.87,$0.00,1,0,1,20210101,
70100,CPT,X-RAY EXAM OF JAW <4VIEWS,,30,,,$509.87,$0.00,1,0,1,20210101,
70110,CPT,X-RAY EXAM OF JAW 4/> VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
70120,CPT,X-RAY EXAM OF MASTOIDS,,30,,,$750.13,$0.00,1,0,1,20210101,
70130,CPT,X-RAY EXAM OF MASTOIDS,,30,,,$750.13,$0.00,1,0,1,20210101,
70134,CPT,X-RAY EXAM OF MIDDLE EAR,,30,,,"$2,861.95",$0.00,1,0,1,20210101,
70140,CPT,X-RAY EXAM OF FACIAL BONES,,30,,,$509.87,$0.00,1,0,1,20210101,
70150,CPT,X-RAY EXAM OF FACIAL BONES,,30,,,$750.13,$0.00,1,0,1,20210101,
70160,CPT,X-RAY EXAM OF NASAL BONES,,30,,,$509.87,$0.00,1,0,1,20210101,
70170,CPT,X-RAY EXAM OF TEAR DUCT,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70190,CPT,X-RAY EXAM OF EYE SOCKETS,,30,,,$509.87,$0.00,1,0,1,20210101,
70200,CPT,X-RAY EXAM OF EYE SOCKETS,,30,,,$750.13,$0.00,1,0,1,20210101,
70210,CPT,X-RAY EXAM OF SINUSES,,30,,,$509.87,$0.00,1,0,1,20210101,
70220,CPT,X-RAY EXAM OF SINUSES,,30,,,$509.87,$0.00,1,0,1,20210101,
70240,CPT,X-RAY EXAM PITUITARY SADDLE,,30,,,$509.87,$0.00,1,0,1,20210101,
70250,CPT,X-RAY EXAM OF SKULL,,30,,,$750.13,$0.00,1,0,1,20210101,
70260,CPT,X-RAY EXAM OF SKULL,,30,,,$750.13,$0.00,1,0,1,20210101,
70300,CPT,X-RAY EXAM OF TEETH,,30,,,$509.87,$0.00,1,0,1,20210101,
70310,CPT,X-RAY EXAM OF TEETH,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70320,CPT,FULL MOUTH X-RAY OF TEETH,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70328,CPT,X-RAY EXAM OF JAW JOINT,,30,,,$509.87,$0.00,1,0,1,20210101,
70330,CPT,X-RAY EXAM OF JAW JOINTS,,30,,,$509.87,$0.00,1,0,1,20210101,
70332,CPT,X-RAY EXAM OF JAW JOINT,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70336,CPT,MAGNETIC IMAGE JAW JOINT,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70350,CPT,X-RAY HEAD FOR ORTHODONTIA,,30,,,$509.87,$0.00,1,0,1,20210101,
70355,CPT,PANORAMIC X-RAY OF JAWS,,30,,,$509.87,$0.00,1,0,1,20210101,
70360,CPT,X-RAY EXAM OF NECK,,30,,,$509.87,$0.00,1,0,1,20210101,
70370,CPT,THROAT X-RAY & FLUOROSCOPY,,30,,,$509.87,$0.00,1,0,1,20210101,
70371,CPT,SPEECH EVALUATION COMPLEX,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70380,CPT,X-RAY EXAM OF SALIVARY GLAND,,30,,,$509.87,$0.00,1,0,1,20210101,
70390,CPT,X-RAY EXAM OF SALIVARY DUCT,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70450,CPT,CT HEAD/BRAIN W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
70460,CPT,CT HEAD/BRAIN W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70470,CPT,CT HEAD/BRAIN W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70480,CPT,CT ORBIT/EAR/FOSSA W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
70481,CPT,CT ORBIT/EAR/FOSSA W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70482,CPT,CT ORBIT/EAR/FOSSA W/O&W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70486,CPT,CT MAXILLOFACIAL W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
70487,CPT,CT MAXILLOFACIAL W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70488,CPT,CT MAXILLOFACIAL W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70490,CPT,CT SOFT TISSUE NECK W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
70491,CPT,CT SOFT TISSUE NECK W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70492,CPT,CT SFT TSUE NCK W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70496,CPT,CT ANGIOGRAPHY HEAD,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70498,CPT,CT ANGIOGRAPHY NECK,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70540,CPT,MRI ORBIT/FACE/NECK W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70542,CPT,MRI ORBIT/FACE/NECK W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
70543,CPT,MRI ORBT/FAC/NCK W/O &W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
70544,CPT,MR ANGIOGRAPHY HEAD W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70545,CPT,MR ANGIOGRAPHY HEAD W/DYE,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
70546,CPT,MR ANGIOGRAPH HEAD W/O&W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
70547,CPT,MR ANGIOGRAPHY NECK W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70548,CPT,MR ANGIOGRAPHY NECK W/DYE,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
70549,CPT,MR ANGIOGRAPH NECK W/O&W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
70551,CPT,MRI BRAIN STEM W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70552,CPT,MRI BRAIN STEM W/DYE,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
70553,CPT,MRI BRAIN STEM W/O & W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
70554,CPT,FMRI BRAIN BY TECH,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70555,CPT,FMRI BRAIN BY PHYS/PSYCH,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
70557,CPT,MRI BRAIN W/O DYE,,30,,,"$2,861.95",$0.00,1,0,1,20210101,
70558,CPT,MRI BRAIN W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
70559,CPT,MRI BRAIN W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
71045,CPT,X-RAY EXAM CHEST 1 VIEW,,30,,,$509.87,$0.00,1,0,1,20210101,
71046,CPT,X-RAY EXAM CHEST 2 VIEWS,,30,,,$509.87,$0.00,1,0,1,20210101,
71047,CPT,X-RAY EXAM CHEST 3 VIEWS,,30,,,$509.87,$0.00,1,0,1,20210101,
71048,CPT,X-RAY EXAM CHEST 4+ VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
71100,CPT,X-RAY EXAM RIBS UNI 2 VIEWS,,30,,,$509.87,$0.00,1,0,1,20210101,
71101,CPT,X-RAY EXAM UNILAT RIBS/CHEST,,30,,,$750.13,$0.00,1,0,1,20210101,
71110,CPT,X-RAY EXAM RIBS BIL 3 VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
71111,CPT,X-RAY EXAM RIBS/CHEST4/> VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
71120,CPT,X-RAY EXAM BREASTBONE 2/>VWS,,30,,,$509.87,$0.00,1,0,1,20210101,
71130,CPT,X-RAY STRENOCLAVIC JT 3/>VWS,,30,,,$509.87,$0.00,1,0,1,20210101,
71250,CPT,CT THORAX DX C-,,30,,,$750.13,$0.00,1,0,1,20210101,
71260,CPT,CT THORAX DX C+,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
71270,CPT,CT THORAX DX C-/C+,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
71271,CPT,CT THORAX LUNG CANCER SCR C-,,30,,,$531.86,$0.00,1,0,1,20210101,
71275,CPT,CT ANGIOGRAPHY CHEST,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
71550,CPT,MRI CHEST W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
71551,CPT,MRI CHEST W/DYE,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
71552,CPT,MRI CHEST W/O & W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
71555,CPT,MRI ANGIO CHEST W OR W/O DYE,,30,,,"$3,913.85",$0.00,1,0,1,20210101,
72020,CPT,X-RAY EXAM OF SPINE 1 VIEW,,30,,,$509.87,$0.00,1,0,1,20210101,
72040,CPT,X-RAY EXAM NECK SPINE 2-3 VW,,30,,,$509.87,$0.00,1,0,1,20210101,
72050,CPT,X-RAY EXAM NECK SPINE 4/5VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
72052,CPT,X-RAY EXAM NECK SPINE 6/>VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
72070,CPT,X-RAY EXAM THORAC SPINE 2VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
72072,CPT,X-RAY EXAM THORAC SPINE 3VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
72074,CPT,X-RAY EXAM THORAC SPINE4/>VW,,30,,,$750.13,$0.00,1,0,1,20210101,
72080,CPT,X-RAY EXAM THORACOLMB 2/> VW,,30,,,$509.87,$0.00,1,0,1,20210101,
72081,CPT,X-RAY EXAM ENTIRE SPI 1 VW,,30,,,$509.87,$0.00,1,0,1,20210101,
72082,CPT,X-RAY EXAM ENTIRE SPI 2/3 VW,,30,,,$750.13,$0.00,1,0,1,20210101,
72083,CPT,X-RAY EXAM ENTIRE SPI 4/5 VW,,30,,,$750.13,$0.00,1,0,1,20210101,
72084,CPT,X-RAY EXAM ENTIRE SPI 6/> VW,,30,,,$750.13,$0.00,1,0,1,20210101,
72100,CPT,X-RAY EXAM L-S SPINE 2/3 VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
72110,CPT,X-RAY EXAM L-2 SPINE 4/>VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
72114,CPT,X-RAY EXAM L-S SPINE BENDING,,30,,,$750.13,$0.00,1,0,1,20210101,
72120,CPT,X-RAY BEND ONLY L-S SPINE,,30,,,$750.13,$0.00,1,0,1,20210101,
72125,CPT,CT NECK SPINE W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
72126,CPT,CT NECK SPINE W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72127,CPT,CT NECK SPINE W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
72128,CPT,CT CHEST SPINE W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
72129,CPT,CT CHEST SPINE W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
72130,CPT,CT CHEST SPINE W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
72131,CPT,CT LUMBAR SPINE W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
72132,CPT,CT LUMBAR SPINE W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72133,CPT,CT LUMBAR SPINE W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
72141,CPT,MRI NECK SPINE W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
72142,CPT,MRI NECK SPINE W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72146,CPT,MRI CHEST SPINE W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
72147,CPT,MRI CHEST SPINE W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72148,CPT,MRI LUMBAR SPINE W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
72149,CPT,MRI LUMBAR SPINE W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72156,CPT,MRI NECK SPINE W/O & W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72157,CPT,MRI CHEST SPINE W/O & W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72158,CPT,MRI LUMBAR SPINE W/O & W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72159,CPT,MR ANGIO SPINE W/O&W/DYE,,30,,,"$4,086.25",$0.00,1,0,1,20210101,
72170,CPT,X-RAY EXAM OF PELVIS,,30,,,$750.13,$0.00,1,0,1,20210101,
72190,CPT,X-RAY EXAM OF PELVIS,,30,,,$750.13,$0.00,1,0,1,20210101,
72191,CPT,CT ANGIOGRAPH PELV W/O&W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
72192,CPT,CT PELVIS W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
72193,CPT,CT PELVIS W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
72194,CPT,CT PELVIS W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
72195,CPT,MRI PELVIS W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
72196,CPT,MRI PELVIS W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72197,CPT,MRI PELVIS W/O & W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
72198,CPT,MR ANGIO PELVIS W/O & W/DYE,,30,,,"$4,466.35",$0.00,1,0,1,20210101,
72200,CPT,X-RAY EXAM SI JOINTS,,30,,,$750.13,$0.00,1,0,1,20210101,
72202,CPT,X-RAY EXAM SI JOINTS 3/> VWS,,30,,,$750.13,$0.00,1,0,1,20210101,
72220,CPT,X-RAY EXAM SACRUM TAILBONE,,30,,,$509.87,$0.00,1,0,1,20210101,
72240,CPT,MYELOGRAPHY NECK SPINE,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
72255,CPT,MYELOGRAPHY THORACIC SPINE,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
72265,CPT,MYELOGRAPHY L-S SPINE,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
72270,CPT,MYELOGPHY 2/> SPINE REGIONS,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
72275,CPT,EPIDUROGRAPHY,,30,,,"$1,636.71",$0.00,1,0,1,20210101,
72285,CPT,DISCOGRAPHY CERV/THOR SPINE,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
72295,CPT,X-RAY OF LOWER SPINE DISK,,30,,,"$9,958.65",$0.00,1,0,1,20210101,
73000,CPT,X-RAY EXAM OF COLLAR BONE,,30,,,$509.87,$0.00,1,0,1,20210101,
73010,CPT,X-RAY EXAM OF SHOULDER BLADE,,30,,,$750.13,$0.00,1,0,1,20210101,
73020,CPT,X-RAY EXAM OF SHOULDER,,30,,,$509.87,$0.00,1,0,1,20210101,
73030,CPT,X-RAY EXAM OF SHOULDER,,30,,,$509.87,$0.00,1,0,1,20210101,
73040,CPT,CONTRAST X-RAY OF SHOULDER,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73050,CPT,X-RAY EXAM OF SHOULDERS,,30,,,$509.87,$0.00,1,0,1,20210101,
73060,CPT,X-RAY EXAM OF HUMERUS,,30,,,$509.87,$0.00,1,0,1,20210101,
73070,CPT,X-RAY EXAM OF ELBOW,,30,,,$509.87,$0.00,1,0,1,20210101,
73080,CPT,X-RAY EXAM OF ELBOW,,30,,,$509.87,$0.00,1,0,1,20210101,
73085,CPT,CONTRAST X-RAY OF ELBOW,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73090,CPT,X-RAY EXAM OF FOREARM,,30,,,$509.87,$0.00,1,0,1,20210101,
73092,CPT,X-RAY EXAM OF ARM INFANT,,30,,,$750.13,$0.00,1,0,1,20210101,
73100,CPT,X-RAY EXAM OF WRIST,,30,,,$509.87,$0.00,1,0,1,20210101,
73110,CPT,X-RAY EXAM OF WRIST,,30,,,$509.87,$0.00,1,0,1,20210101,
73115,CPT,CONTRAST X-RAY OF WRIST,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
73120,CPT,X-RAY EXAM OF HAND,,30,,,$750.13,$0.00,1,0,1,20210101,
73130,CPT,X-RAY EXAM OF HAND,,30,,,$509.87,$0.00,1,0,1,20210101,
73140,CPT,X-RAY EXAM OF FINGER(S),,30,,,$509.87,$0.00,1,0,1,20210101,
73200,CPT,CT UPPER EXTREMITY W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
73201,CPT,CT UPPER EXTREMITY W/DYE,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
73202,CPT,CT UPPR EXTREMITY W/O&W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
73206,CPT,CT ANGIO UPR EXTRM W/O&W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
73218,CPT,MRI UPPER EXTREMITY W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
73219,CPT,MRI UPPER EXTREMITY W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73220,CPT,MRI UPPR EXTREMITY W/O&W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73221,CPT,MRI JOINT UPR EXTREM W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
73222,CPT,MRI JOINT UPR EXTREM W/DYE,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
73223,CPT,MRI JOINT UPR EXTR W/O&W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73225,CPT,MR ANGIO UPR EXTR W/O&W/DYE,,30,,,"$5,240.17",$0.00,1,0,1,20210101,
73501,CPT,X-RAY EXAM HIP UNI 1 VIEW,,30,,,$509.87,$0.00,1,0,1,20210101,
73502,CPT,X-RAY EXAM HIP UNI 2-3 VIEWS,,30,,,$509.87,$0.00,1,0,1,20210101,
73503,CPT,X-RAY EXAM HIP UNI 4/> VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
73521,CPT,X-RAY EXAM HIPS BI 2 VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
73522,CPT,X-RAY EXAM HIPS BI 3-4 VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
73523,CPT,X-RAY EXAM HIPS BI 5/> VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
73525,CPT,CONTRAST X-RAY OF HIP,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73551,CPT,X-RAY EXAM OF FEMUR 1,,30,,,$509.87,$0.00,1,0,1,20210101,
73552,CPT,X-RAY EXAM OF FEMUR 2/>,,30,,,$509.87,$0.00,1,0,1,20210101,
73560,CPT,X-RAY EXAM OF KNEE 1 OR 2,,30,,,$509.87,$0.00,1,0,1,20210101,
73562,CPT,X-RAY EXAM OF KNEE 3,,30,,,$509.87,$0.00,1,0,1,20210101,
73564,CPT,X-RAY EXAM KNEE 4 OR MORE,,30,,,$750.13,$0.00,1,0,1,20210101,
73565,CPT,X-RAY EXAM OF KNEES,,30,,,$509.87,$0.00,1,0,1,20210101,
73580,CPT,CONTRAST X-RAY OF KNEE JOINT,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73590,CPT,X-RAY EXAM OF LOWER LEG,,30,,,$509.87,$0.00,1,0,1,20210101,
73592,CPT,X-RAY EXAM OF LEG INFANT,,30,,,$509.87,$0.00,1,0,1,20210101,
73600,CPT,X-RAY EXAM OF ANKLE,,30,,,$509.87,$0.00,1,0,1,20210101,
73610,CPT,X-RAY EXAM OF ANKLE,,30,,,$509.87,$0.00,1,0,1,20210101,
73615,CPT,CONTRAST X-RAY OF ANKLE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73620,CPT,X-RAY EXAM OF FOOT,,30,,,$509.87,$0.00,1,0,1,20210101,
73630,CPT,X-RAY EXAM OF FOOT,,30,,,$509.87,$0.00,1,0,1,20210101,
73650,CPT,X-RAY EXAM OF HEEL,,30,,,$509.87,$0.00,1,0,1,20210101,
73660,CPT,X-RAY EXAM OF TOE(S),,30,,,$509.87,$0.00,1,0,1,20210101,
73700,CPT,CT LOWER EXTREMITY W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
73701,CPT,CT LOWER EXTREMITY W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
73702,CPT,CT LWR EXTREMITY W/O&W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
73706,CPT,CT ANGIO LWR EXTR W/O&W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
73718,CPT,MRI LOWER EXTREMITY W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
73719,CPT,MRI LOWER EXTREMITY W/DYE,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
73720,CPT,MRI LWR EXTREMITY W/O&W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73721,CPT,MRI JNT OF LWR EXTRE W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
73722,CPT,MRI JOINT OF LWR EXTR W/DYE,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
73723,CPT,MRI JOINT LWR EXTR W/O&W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
73725,CPT,MR ANG LWR EXT W OR W/O DYE,,30,,,"$4,335.36",$0.00,1,0,1,20210101,
74018,CPT,X-RAY EXAM ABDOMEN 1 VIEW,,30,,,$509.87,$0.00,1,0,1,20210101,
74019,CPT,X-RAY EXAM ABDOMEN 2 VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
74021,CPT,X-RAY EXAM ABDOMEN 3+ VIEWS,,30,,,$750.13,$0.00,1,0,1,20210101,
74022,CPT,X-RAY EXAM COMPLETE ABDOMEN,,30,,,$750.13,$0.00,1,0,1,20210101,
74150,CPT,CT ABDOMEN W/O DYE,,30,,,$750.13,$0.00,1,0,1,20210101,
74160,CPT,CT ABDOMEN W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74170,CPT,CT ABDOMEN W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74174,CPT,CT ANGIO ABD&PELV W/O&W/DYE,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
74175,CPT,CT ANGIO ABDOM W/O & W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74176,CPT,CT ABD & PELVIS W/O CONTRAST,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
74177,CPT,CT ABD & PELV W/CONTRAST,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
74178,CPT,CT ABD & PELV 1/> REGNS,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
74181,CPT,MRI ABDOMEN W/O DYE,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
74182,CPT,MRI ABDOMEN W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
74183,CPT,MRI ABDOMEN W/O & W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
74185,CPT,MRI ANGIO ABDOM W ORW/O DYE,,30,,,"$5,265.50",$0.00,1,0,1,20210101,
74190,CPT,X-RAY EXAM OF PERITONEUM,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
74210,CPT,X-RAY XM PHRNX&/CRV ESOPH C+,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74220,CPT,X-RAY XM ESOPHAGUS 1CNTRST,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74221,CPT,X-RAY XM ESOPHAGUS 2CNTRST,,30,,,"$1,183.00",$0.00,1,0,1,20210101,
74230,CPT,X-RAY XM SWLNG FUNCJ C+,,30,,,"$1,087.38",$0.00,1,0,1,20210101,
74235,CPT,REMOVE ESOPHAGUS OBSTRUCTION,,30,,,"$1,635.78",$0.00,1,0,1,20210101,
74240,CPT,X-RAY XM UPR GI TRC 1CNTRST,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74246,CPT,X-RAY XM UPR GI TRC 2CNTRST,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74250,CPT,X-RAY XM SM INT 1CNTRST STD,,30,,,"$1,087.38",$0.00,1,0,1,20210101,
74251,CPT,X-RAY XM SM INT 2CNTRST STD,,30,,,"$1,149.20",$0.00,1,0,1,20210101,
74261,CPT,CT COLONOGRAPHY DX,,30,,,$750.13,$0.00,1,0,1,20210101,
74262,CPT,CT COLONOGRAPHY DX W/DYE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74263,CPT,CT COLONOGRAPHY SCREENING,,30,,,"$1,845.22",$0.00,1,0,1,20210101,
74270,CPT,X-RAY XM COLON 1CNTRST STD,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74280,CPT,X-RAY XM COLON 2CNTRST STD,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74283,CPT,THER NMA RDCTJ INTUS/OBSTRCJ,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74290,CPT,CONTRAST X-RAY GALLBLADDER,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74300,CPT,X-RAY BILE DUCTS/PANCREAS,,30,,,"$1,281.14",$0.00,1,0,1,20210101,
74301,CPT,X-RAYS AT SURGERY ADD-ON,,30,,,$708.69,$0.00,1,0,1,20210101,
74328,CPT,X-RAY BILE DUCT ENDOSCOPY,,30,,,"$1,650.63",$0.00,1,0,1,20210101,
74329,CPT,X-RAY FOR PANCREAS ENDOSCOPY,,30,,,"$1,647.36",$0.00,1,0,1,20210101,
74330,CPT,X-RAY BILE/PANC ENDOSCOPY,,30,,,"$1,993.61",$0.00,1,0,1,20210101,
74340,CPT,X-RAY GUIDE FOR GI TUBE,,30,,,"$1,313.32",$0.00,1,0,1,20210101,
74355,CPT,X-RAY GUIDE INTESTINAL TUBE,,30,,,"$1,763.79",$0.00,1,0,1,20210101,
74360,CPT,X-RAY GUIDE GI DILATION,,30,,,"$1,288.82",$0.00,1,0,1,20210101,
74363,CPT,X-RAY BILE DUCT DILATION,,30,,,"$3,537.91",$0.00,1,0,1,20210101,
74400,CPT,UROGRAPHY IV +-KUB TOMOG,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74410,CPT,UROGRAPHY NFS DRIP&/BOLUS,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74415,CPT,UROGRAPHY NFS DRIP&/BLS W/NF,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
74420,CPT,UROGRAPHY RTRGR +-KUB,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
74425,CPT,UROGRAPHY ANTEGRADE RS&I,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
74430,CPT,CONTRAST X-RAY BLADDER,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
74440,CPT,X-RAY MALE GENITAL TRACT,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
74445,CPT,X-RAY EXAM OF PENIS,,30,,,$750.13,$0.00,1,0,1,20210101,
74450,CPT,X-RAY URETHRA/BLADDER,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
74455,CPT,X-RAY URETHRA/BLADDER,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
74470,CPT,X-RAY EXAM OF KIDNEY LESION,,30,,,"$2,861.95",$0.00,1,0,1,20210101,
74485,CPT,DILATION URTR/URT RS&I,,30,,,"$10,353.58",$0.00,1,0,1,20210101,
74710,CPT,X-RAY MEASUREMENT OF PELVIS,,30,,,$509.87,$0.00,1,0,1,20210101,
74712,CPT,MRI FETAL SNGL/1ST GESTATION,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
74713,CPT,MRI FETAL EA ADDL GESTATION,,30,,,"$2,072.79",$0.00,1,0,1,20210101,
74740,CPT,X-RAY FEMALE GENITAL TRACT,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
74742,CPT,X-RAY FALLOPIAN TUBE,,30,,,"$1,385.78",$0.00,1,0,1,20210101,
74775,CPT,X-RAY EXAM OF PERINEUM,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
75557,CPT,CARDIAC MRI FOR MORPH,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
75559,CPT,CARDIAC MRI W/STRESS IMG,,30,,,"$2,861.95",$0.00,1,0,1,20210101,
75561,CPT,CARDIAC MRI FOR MORPH W/DYE,,30,,,"$2,531.48",$0.00,1,0,1,20210101,
75563,CPT,CARD MRI W/STRESS IMG & DYE,,30,,,"$4,487.22",$0.00,1,0,1,20210101,
75565,CPT,CARD MRI VELOC FLOW MAPPING,,30,,,"$1,281.77",$0.00,1,0,1,20210101,
75571,CPT,CT HRT W/O DYE W/CA TEST,,30,,,$509.87,$0.00,1,0,1,20210101,
75572,CPT,CT HRT W/3D IMAGE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
75573,CPT,CT HRT W/3D IMAGE CONGEN,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
75574,CPT,CT ANGIO HRT W/3D IMAGE,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
75600,CPT,CONTRAST EXAM THORACIC AORTA,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75605,CPT,CONTRAST EXAM THORACIC AORTA,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
75625,CPT,CONTRAST EXAM ABDOMINL AORTA,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75630,CPT,X-RAY AORTA LEG ARTERIES,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75635,CPT,CT ANGIO ABDOMINAL ARTERIES,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
75705,CPT,ARTERY X-RAYS SPINE,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
75710,CPT,ARTERY X-RAYS ARM/LEG,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75716,CPT,ARTERY X-RAYS ARMS/LEGS,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75726,CPT,ARTERY X-RAYS ABDOMEN,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
75731,CPT,ARTERY X-RAYS ADRENAL GLAND,,30,,,"$7,729.00",$0.00,1,0,1,20210101,
75733,CPT,ARTERY X-RAYS ADRENALS,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75736,CPT,ARTERY X-RAYS PELVIS,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
75741,CPT,ARTERY X-RAYS LUNG,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75743,CPT,ARTERY X-RAYS LUNGS,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75746,CPT,ARTERY X-RAYS LUNG,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
75756,CPT,ARTERY X-RAYS CHEST,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75774,CPT,ARTERY X-RAY EACH VESSEL,,30,,,"$3,660.89",$0.00,1,0,1,20210101,
75801,CPT,LYMPH VESSEL X-RAY ARM/LEG,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
75803,CPT,LYMPH VESSEL X-RAY ARMS/LEGS,,30,,,"$7,218.75",$0.00,1,0,1,20210101,
75805,CPT,LYMPH VESSEL X-RAY TRUNK,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
75807,CPT,LYMPH VESSEL X-RAY TRUNK,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75809,CPT,NONVASCULAR SHUNT X-RAY,,30,,,$750.13,$0.00,1,0,1,20210101,
75810,CPT,VEIN X-RAY SPLEEN/LIVER,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
75820,CPT,VEIN X-RAY ARM/LEG,,30,,,"$5,150.45",$0.00,1,0,1,20210101,
75822,CPT,VEIN X-RAY ARMS/LEGS,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
75825,CPT,VEIN X-RAY TRUNK,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75827,CPT,VEIN X-RAY CHEST,,30,,,"$5,150.45",$0.00,1,0,1,20210101,
75831,CPT,VEIN X-RAY KIDNEY,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75833,CPT,VEIN X-RAY KIDNEYS,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75840,CPT,VEIN X-RAY ADRENAL GLAND,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75842,CPT,VEIN X-RAY ADRENAL GLANDS,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
75860,CPT,VEIN X-RAY NECK,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75870,CPT,VEIN X-RAY SKULL,,30,,,"$7,729.00",$0.00,1,0,1,20210101,
75872,CPT,VEIN X-RAY SKULL EPIDURAL,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
75880,CPT,VEIN X-RAY EYE SOCKET,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
75885,CPT,VEIN X-RAY LIVER W/HEMODYNAM,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75887,CPT,VEIN X-RAY LIVER W/O HEMODYN,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
75889,CPT,VEIN X-RAY LIVER W/HEMODYNAM,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75891,CPT,VEIN X-RAY LIVER,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
75893,CPT,VENOUS SAMPLING BY CATHETER,,30,,,"$21,085.45",$0.00,1,0,1,20210101,
75894,CPT,X-RAYS TRANSCATH THERAPY,,30,,,"$8,400.01",$0.00,1,0,1,20210101,
75898,CPT,FOLLOW-UP ANGIOGRAPHY,,30,,,"$9,211.98",$0.00,1,0,1,20210101,
75901,CPT,REMOVE CVA DEVICE OBSTRUCT,,30,,,"$2,265.39",$0.00,1,0,1,20210101,
75902,CPT,REMOVE CVA LUMEN OBSTRUCT,,30,,,$903.11,$0.00,1,0,1,20210101,
75970,CPT,VASCULAR BIOPSY,,30,,,"$5,195.08",$0.00,1,0,1,20210101,
75984,CPT,XRAY CONTROL CATHETER CHANGE,,30,,,"$1,580.71",$0.00,1,0,1,20210101,
75989,CPT,ABSCESS DRAINAGE UNDER X-RAY,,30,,,"$2,256.74",$0.00,1,0,1,20210101,
76000,CPT,FLUOROSCOPY <1 HR PHYS/QHP,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
76010,CPT,X-RAY NOSE TO RECTUM,,30,,,$509.87,$0.00,1,0,1,20210101,
76080,CPT,X-RAY EXAM OF FISTULA,,30,,,"$2,861.95",$0.00,1,0,1,20210101,
76098,CPT,X-RAY EXAM SURGICAL SPECIMEN,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
76100,CPT,X-RAY EXAM OF BODY SECTION,,30,,,$750.13,$0.00,1,0,1,20210101,
76101,CPT,COMPLEX BODY SECTION X-RAY,,30,,,$750.13,$0.00,1,0,1,20210101,
76102,CPT,COMPLEX BODY SECTION X-RAYS,,30,,,$750.13,$0.00,1,0,1,20210101,
76120,CPT,CINE/VIDEO X-RAYS,,30,,,$750.13,$0.00,1,0,1,20210101,
76125,CPT,CINE/VIDEO X-RAYS ADD-ON,,30,,,$401.95,$0.00,1,0,1,20210101,
76140,CPT,X-RAY CONSULTATION,,30,,,$136.14,$0.00,1,0,1,20210101,
76145,CPT,MED PHYSIC DOS EVAL RAD EXPS,,30,,,$837.95,$0.00,1,0,1,20210101,
76376,CPT,3D RENDER W/INTRP POSTPROCES,,30,,,"$1,020.21",$0.00,1,0,1,20210101,
76377,CPT,3D RENDER W/INTRP POSTPROCES,,30,,,"$1,152.72",$0.00,1,0,1,20210101,
76380,CPT,CAT SCAN FOLLOW-UP STUDY,,30,,,$509.87,$0.00,1,0,1,20210101,
76390,CPT,MR SPECTROSCOPY,,30,,,"$3,001.13",$0.00,1,0,1,20210101,
76391,CPT,MR ELASTOGRAPHY,,30,,,"$1,521.09",$0.00,1,0,1,20210101,
76496,CPT,FLUOROSCOPIC PROCEDURE,,30,,,$509.87,$0.00,1,0,1,20210101,
76497,CPT,CT PROCEDURE,,30,,,$509.87,$0.00,1,0,1,20210101,
76498,CPT,MRI PROCEDURE,,30,,,$509.87,$0.00,1,0,1,20210101,
76499,CPT,RADIOGRAPHIC PROCEDURE,,30,,,$509.87,$0.00,1,0,1,20210101,
76506,CPT,ECHO EXAM OF HEAD,,30,,,$750.13,$0.00,1,0,1,20210101,
76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN,,30,,,$584.38,$0.00,1,0,1,20210101,
76511,CPT,OPH US DX QUAN A-SCAN ONLY,,30,,,$750.13,$0.00,1,0,1,20210101,
76512,CPT,OPH US DX B-SCAN,,30,,,$750.13,$0.00,1,0,1,20210101,
76513,CPT,OPH US DX ANT SGM US UNI/BI,,30,,,$750.13,$0.00,1,0,1,20210101,
76514,CPT,ECHO EXAM OF EYE THICKNESS,,30,,,$152.35,$0.00,1,0,1,20210101,
76516,CPT,ECHO EXAM OF EYE,,30,,,$750.13,$0.00,1,0,1,20210101,
76519,CPT,ECHO EXAM OF EYE,,30,,,$750.13,$0.00,1,0,1,20210101,
76529,CPT,ECHO EXAM OF EYE,,30,,,$509.87,$0.00,1,0,1,20210101,
76536,CPT,US EXAM OF HEAD AND NECK,,30,,,$750.13,$0.00,1,0,1,20210101,
76604,CPT,US EXAM CHEST,,30,,,$750.13,$0.00,1,0,1,20210101,
76641,CPT,ULTRASOUND BREAST COMPLETE,,30,,,$750.13,$0.00,1,0,1,20210101,
76642,CPT,ULTRASOUND BREAST LIMITED,,30,,,$509.87,$0.00,1,0,1,20210101,
76700,CPT,US EXAM ABDOM COMPLETE,,30,,,$750.13,$0.00,1,0,1,20210101,
76705,CPT,ECHO EXAM OF ABDOMEN,,30,,,$750.13,$0.00,1,0,1,20210101,
76706,CPT,US ABDL AORTA SCREEN AAA,,30,,,$750.13,$0.00,1,0,1,20210101,
76770,CPT,US EXAM ABDO BACK WALL COMP,,30,,,$750.13,$0.00,1,0,1,20210101,
76775,CPT,US EXAM ABDO BACK WALL LIM,,30,,,$750.13,$0.00,1,0,1,20210101,
76776,CPT,US EXAM K TRANSPL W/DOPPLER,,30,,,$750.13,$0.00,1,0,1,20210101,
76800,CPT,US EXAM SPINAL CANAL,,30,,,$750.13,$0.00,1,0,1,20210101,
76801,CPT,OB US < 14 WKS SINGLE FETUS,,30,,,$750.13,$0.00,1,0,1,20210101,
76802,CPT,OB US < 14 WKS ADDL FETUS,,30,,,$736.42,$0.00,1,0,1,20210101,
76805,CPT,OB US >= 14 WKS SNGL FETUS,,30,,,$750.13,$0.00,1,0,1,20210101,
76810,CPT,OB US >= 14 WKS ADDL FETUS,,30,,,"$1,204.01",$0.00,1,0,1,20210101,
76811,CPT,OB US DETAILED SNGL FETUS,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
76812,CPT,OB US DETAILED ADDL FETUS,,30,,,$847.24,$0.00,1,0,1,20210101,
76813,CPT,OB US NUCHAL MEAS 1 GEST,,30,,,$750.13,$0.00,1,0,1,20210101,
76814,CPT,OB US NUCHAL MEAS ADD-ON,,30,,,$563.00,$0.00,1,0,1,20210101,
76815,CPT,OB US LIMITED FETUS(S),,30,,,$750.13,$0.00,1,0,1,20210101,
76816,CPT,OB US FOLLOW-UP PER FETUS,,30,,,$750.13,$0.00,1,0,1,20210101,
76817,CPT,TRANSVAGINAL US OBSTETRIC,,30,,,$750.13,$0.00,1,0,1,20210101,
76818,CPT,FETAL BIOPHYS PROFILE W/NST,,30,,,$750.13,$0.00,1,0,1,20210101,
76819,CPT,FETAL BIOPHYS PROFIL W/O NST,,30,,,$750.13,$0.00,1,0,1,20210101,
76820,CPT,UMBILICAL ARTERY ECHO,,30,,,$750.13,$0.00,1,0,1,20210101,
76821,CPT,MIDDLE CEREBRAL ARTERY ECHO,,30,,,$750.13,$0.00,1,0,1,20210101,
76825,CPT,ECHO EXAM OF FETAL HEART,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
76826,CPT,ECHO EXAM OF FETAL HEART,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
76827,CPT,ECHO EXAM OF FETAL HEART,,30,,,$750.13,$0.00,1,0,1,20210101,
76828,CPT,ECHO EXAM OF FETAL HEART,,30,,,$750.13,$0.00,1,0,1,20210101,
76830,CPT,TRANSVAGINAL US NON-OB,,30,,,$750.13,$0.00,1,0,1,20210101,
76831,CPT,ECHO EXAM UTERUS,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
76856,CPT,US EXAM PELVIC COMPLETE,,30,,,$750.13,$0.00,1,0,1,20210101,
76857,CPT,US EXAM PELVIC LIMITED,,30,,,$750.13,$0.00,1,0,1,20210101,
76870,CPT,US EXAM SCROTUM,,30,,,$750.13,$0.00,1,0,1,20210101,
76872,CPT,US TRANSRECTAL,,30,,,$750.13,$0.00,1,0,1,20210101,
76873,CPT,ECHOGRAP TRANS R PROS STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
76881,CPT,US COMPL JOINT R-T W/IMG,,30,,,$750.13,$0.00,1,0,1,20210101,
76882,CPT,US LMTD JT/NONVASC XTR STRUX,,30,,,$750.13,$0.00,1,0,1,20210101,
76885,CPT,US EXAM INFANT HIPS DYNAMIC,,30,,,$509.87,$0.00,1,0,1,20210101,
76886,CPT,US EXAM INFANT HIPS STATIC,,30,,,$509.87,$0.00,1,0,1,20210101,
76932,CPT,ECHO GUIDE FOR HEART BIOPSY,,30,,,"$1,223.52",$0.00,1,0,1,20210101,
76936,CPT,ECHO GUIDE FOR ARTERY REPAIR,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
76937,CPT,US GUIDE VASCULAR ACCESS,,30,,,$915.30,$0.00,1,0,1,20210101,
76940,CPT,US GUIDE TISSUE ABLATION,,30,,,"$1,453.58",$0.00,1,0,1,20210101,
76941,CPT,ECHO GUIDE FOR TRANSFUSION,,30,,,"$1,208.47",$0.00,1,0,1,20210101,
76942,CPT,ECHO GUIDE FOR BIOPSY,,30,,,"$1,387.89",$0.00,1,0,1,20210101,
76945,CPT,ECHO GUIDE VILLUS SAMPLING,,30,,,$958.74,$0.00,1,0,1,20210101,
76946,CPT,ECHO GUIDE FOR AMNIOCENTESIS,,30,,,$968.85,$0.00,1,0,1,20210101,
76948,CPT,ECHO GUIDE OVA ASPIRATION,,30,,,$477.58,$0.00,1,0,1,20210101,
76965,CPT,ECHO GUIDANCE RADIOTHERAPY,,30,,,"$1,684.75",$0.00,1,0,1,20210101,
76975,CPT,GI ENDOSCOPIC ULTRASOUND,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
76977,CPT,US BONE DENSITY MEASURE,,30,,,$750.13,$0.00,1,0,1,20210101,
76978,CPT,US TRGT DYN MBUBB 1ST LES,,30,,,"$1,183.00",$0.00,1,0,1,20210101,
76979,CPT,US TRGT DYN MBUBB EA ADDL,,30,,,"$1,065.03",$0.00,1,0,1,20210101,
76981,CPT,USE PARENCHYMA,,30,,,$731.85,$0.00,1,0,1,20210101,
76982,CPT,USE 1ST TARGET LESION,,30,,,$731.85,$0.00,1,0,1,20210101,
76983,CPT,USE EA ADDL TARGET LESION,,30,,,$374.31,$0.00,1,0,1,20210101,
76998,CPT,US GUIDE INTRAOP,,30,,,"$1,334.04",$0.00,1,0,1,20210101,
76999,CPT,ECHO EXAMINATION PROCEDURE,,30,,,$509.87,$0.00,1,0,1,20210101,
77001,CPT,FLUOROGUIDE FOR VEIN DEVICE,,30,,,"$1,174.15",$0.00,1,0,1,20210101,
77002,CPT,NEEDLE LOCALIZATION BY XRAY,,30,,,"$1,106.17",$0.00,1,0,1,20210101,
77003,CPT,FLUOROGUIDE FOR SPINE INJECT,,30,,,"$1,020.74",$0.00,1,0,1,20210101,
77011,CPT,CT SCAN FOR LOCALIZATION,,30,,,"$3,672.08",$0.00,1,0,1,20210101,
77012,CPT,CT SCAN FOR NEEDLE BIOPSY,,30,,,"$3,110.19",$0.00,1,0,1,20210101,
77013,CPT,CT GUIDE FOR TISSUE ABLATION,,30,,,"$3,252.39",$0.00,1,0,1,20210101,
77014,CPT,CT SCAN FOR THERAPY GUIDE,,30,,,"$1,728.91",$0.00,1,0,1,20210101,
77021,CPT,MRI GUIDANCE NDL PLMT RS&I,,30,,,"$3,984.08",$0.00,1,0,1,20210101,
77022,CPT,MRI GDN PARNCHYMA TISS ABLTJ,,30,,,"$6,763.68",$0.00,1,0,1,20210101,
77046,CPT,MRI BREAST C- UNILATERAL,,30,,,"$2,297.38",$0.00,1,0,1,20210101,
77047,CPT,MRI BREAST C- BILATERAL,,30,,,"$2,939.74",$0.00,1,0,1,20210101,
77048,CPT,MRI BREAST C-+ W/CAD UNI,,30,,,"$5,105.28",$0.00,1,0,1,20210101,
77049,CPT,MRI BREAST C-+ W/CAD BI,,30,,,"$6,163.76",$0.00,1,0,1,20210101,
77053,CPT,X-RAY OF MAMMARY DUCT,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
77054,CPT,X-RAY OF MAMMARY DUCTS,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
77061,CPT,BREAST TOMOSYNTHESIS UNI,,30,,,$201.65,$0.00,1,0,1,20210101,
77062,CPT,BREAST TOMOSYNTHESIS BI,,30,,,$218.21,$0.00,1,0,1,20210101,
77065,CPT,DX MAMMO INCL CAD UNI,,30,,,"$1,158.12",$0.00,1,0,1,20210101,
77066,CPT,DX MAMMO INCL CAD BI,,30,,,"$1,428.52",$0.00,1,0,1,20210101,
77067,CPT,SCR MAMMO BI INCL CAD,,30,,,"$1,191.13",$0.00,1,0,1,20210101,
77071,CPT,X-RAY STRESS VIEW,,30,,,$509.87,$0.00,1,0,1,20210101,
77072,CPT,X-RAYS FOR BONE AGE,,30,,,$750.13,$0.00,1,0,1,20210101,
77073,CPT,X-RAYS BONE LENGTH STUDIES,,30,,,$750.13,$0.00,1,0,1,20210101,
77074,CPT,X-RAYS BONE SURVEY LIMITED,,30,,,$750.13,$0.00,1,0,1,20210101,
77075,CPT,X-RAYS BONE SURVEY COMPLETE,,30,,,$750.13,$0.00,1,0,1,20210101,
77076,CPT,X-RAYS BONE SURVEY INFANT,,30,,,$750.13,$0.00,1,0,1,20210101,
77077,CPT,JOINT SURVEY SINGLE VIEW,,30,,,$750.13,$0.00,1,0,1,20210101,
77078,CPT,CT BONE DENSITY AXIAL,,30,,,$509.87,$0.00,1,0,1,20210101,
77080,CPT,DXA BONE DENSITY AXIAL,,30,,,$750.13,$0.00,1,0,1,20210101,
77081,CPT,DXA BONE DENSITY/PERIPHERAL,,30,,,$509.87,$0.00,1,0,1,20210101,
77084,CPT,MAGNETIC IMAGE BONE MARROW,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
77085,CPT,DXA BONE DENSITY STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
77086,CPT,FRACTURE ASSESSMENT VIA DXA,,30,,,$509.87,$0.00,1,0,1,20210101,
77261,CPT,RADIATION THERAPY PLANNING,,30,,,$819.07,$0.00,1,0,1,20210101,
77262,CPT,RADIATION THERAPY PLANNING,,30,,,"$1,099.13",$0.00,1,0,1,20210101,
77280,CPT,SET RADIATION THERAPY FIELD,,30,,,$851.52,$0.00,1,0,1,20210101,
77285,CPT,SET RADIATION THERAPY FIELD,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77290,CPT,SET RADIATION THERAPY FIELD,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77293,CPT,RESPIRATOR MOTION MGMT SIMUL,,30,,,"$2,533.59",$0.00,1,0,1,20210101,
77295,CPT,3-D RADIOTHERAPY PLAN,,30,,,"$7,691.66",$0.00,1,0,1,20210101,
77299,CPT,RADIATION THERAPY PLANNING,,30,,,$851.52,$0.00,1,0,1,20210101,
77300,CPT,RADIATION THERAPY DOSE PLAN,,30,,,$851.52,$0.00,1,0,1,20210101,
77301,CPT,RADIOTHERAPY DOSE PLAN IMRT,,30,,,"$7,691.66",$0.00,1,0,1,20210101,
77306,CPT,TELETHX ISODOSE PLAN SIMPLE,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77307,CPT,TELETHX ISODOSE PLAN CPLX,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77316,CPT,BRACHYTX ISODOSE PLAN SIMPLE,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77317,CPT,BRACHYTX ISODOSE INTERMED,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77318,CPT,BRACHYTX ISODOSE COMPLEX,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77321,CPT,SPECIAL TELETX PORT PLAN,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77331,CPT,SPECIAL RADIATION DOSIMETRY,,30,,,$851.52,$0.00,1,0,1,20210101,
77332,CPT,RADIATION TREATMENT AID(S),,30,,,$851.52,$0.00,1,0,1,20210101,
77333,CPT,RADIATION TREATMENT AID(S),,30,,,$851.52,$0.00,1,0,1,20210101,
77334,CPT,RADIATION TREATMENT AID(S),,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77336,CPT,RADIATION PHYSICS CONSULT,,30,,,$851.52,$0.00,1,0,1,20210101,
77338,CPT,DESIGN MLC DEVICE FOR IMRT,,30,,,"$2,215.66",$0.00,1,0,1,20210101,
77370,CPT,RADIATION PHYSICS CONSULT,,30,,,$851.52,$0.00,1,0,1,20210101,
77371,CPT,SRS MULTISOURCE,,30,,,"$24,010.57",$0.00,1,0,1,20210101,
77372,CPT,SRS LINEAR BASED,,30,,,"$24,010.57",$0.00,1,0,1,20210101,
77373,CPT,SBRT DELIVERY,,30,,,"$10,292.31",$0.00,1,0,1,20210101,
77385,CPT,NTSTY MODUL RAD TX DLVR SMPL,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77386,CPT,NTSTY MODUL RAD TX DLVR CPLX,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77387,CPT,GUIDANCE FOR RADJ TX DLVR,,30,,,"$1,048.41",$0.00,1,0,1,20210101,
77399,CPT,EXTERNAL RADIATION DOSIMETRY,,30,,,$851.52,$0.00,1,0,1,20210101,
77401,CPT,RADIATION TREATMENT DELIVERY,,30,,,$825.52,$0.00,1,0,1,20210101,
77402,CPT,RADIATION TREATMENT DELIVERY,,30,,,$825.52,$0.00,1,0,1,20210101,
77407,CPT,RADIATION TREATMENT DELIVERY,,30,,,"$1,468.60",$0.00,1,0,1,20210101,
77412,CPT,RADIATION TREATMENT DELIVERY,,30,,,"$1,573.82",$0.00,1,0,1,20210101,
77417,CPT,RADIOLOGY PORT IMAGES(S),,30,,,$487.96,$0.00,1,0,1,20210101,
77423,CPT,NEUTRON BEAM TX COMPLEX,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77424,CPT,IO RAD TX DELIVERY BY X-RAY,,30,,,"$24,010.57",$0.00,1,0,1,20210101,
77425,CPT,IO RAD TX DELIVER BY ELCTRNS,,30,,,"$24,010.57",$0.00,1,0,1,20210101,
77431,CPT,RADIATION THERAPY MANAGEMENT,,30,,,"$1,028.04",$0.00,1,0,1,20210101,
77435,CPT,SBRT MANAGEMENT,,30,,,"$3,356.59",$0.00,1,0,1,20210101,
77469,CPT,IO RADIATION TX MANAGEMENT,,30,,,"$2,310.48",$0.00,1,0,1,20210101,
77470,CPT,SPECIAL RADIATION TREATMENT,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77499,CPT,RADIATION THERAPY MANAGEMENT,,30,,,$626.42,$0.00,1,0,1,20210101,
77520,CPT,PROTON TRMT SIMPLE W/O COMP,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77522,CPT,PROTON TRMT SIMPLE W/COMP,,30,,,"$7,250.78",$0.00,1,0,1,20210101,
77523,CPT,PROTON TRMT INTERMEDIATE,,30,,,"$7,250.78",$0.00,1,0,1,20210101,
77525,CPT,PROTON TREATMENT COMPLEX,,30,,,"$7,250.78",$0.00,1,0,1,20210101,
77600,CPT,HYPERTHERMIA TREATMENT,,30,,,"$1,573.82",$0.00,1,0,1,20210101,
77605,CPT,HYPERTHERMIA TREATMENT,,30,,,"$4,663.42",$0.00,1,0,1,20210101,
77610,CPT,HYPERTHERMIA TREATMENT,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77615,CPT,HYPERTHERMIA TREATMENT,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77620,CPT,HYPERTHERMIA TREATMENT,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77750,CPT,INFUSE RADIOACTIVE MATERIALS,,30,,,"$1,573.82",$0.00,1,0,1,20210101,
77761,CPT,APPLY INTRCAV RADIAT SIMPLE,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77762,CPT,APPLY INTRCAV RADIAT INTERM,,30,,,"$3,513.15",$0.00,1,0,1,20210101,
77763,CPT,APPLY INTRCAV RADIAT COMPL,,30,,,"$4,663.42",$0.00,1,0,1,20210101,
77767,CPT,HDR RDNCL SKN SURF BRACHYTX,,30,,,"$1,573.82",$0.00,1,0,1,20210101,
77768,CPT,HDR RDNCL SKN SURF BRACHYTX,,30,,,"$1,573.82",$0.00,1,0,1,20210101,
77770,CPT,HDR RDNCL NTRSTL/ICAV BRCHTX,,30,,,"$4,663.42",$0.00,1,0,1,20210101,
77771,CPT,HDR RDNCL NTRSTL/ICAV BRCHTX,,30,,,"$4,663.42",$0.00,1,0,1,20210101,
77772,CPT,HDR RDNCL NTRSTL/ICAV BRCHTX,,30,,,"$4,663.42",$0.00,1,0,1,20210101,
77778,CPT,APPLY INTERSTIT RADIAT COMPL,,30,,,"$4,663.42",$0.00,1,0,1,20210101,
77789,CPT,APPLY SURF LDR RADIONUCLIDE,,30,,,$825.52,$0.00,1,0,1,20210101,
77790,CPT,RADIATION HANDLING,,30,,,$926.20,$0.00,1,0,1,20210101,
77799,CPT,RADIUM/RADIOISOTOPE THERAPY,,30,,,$825.52,$0.00,1,0,1,20210101,
78012,CPT,THYROID UPTAKE MEASUREMENT,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78013,CPT,THYROID IMAGING W/BLOOD FLOW,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78014,CPT,THYROID IMAGING W/BLOOD FLOW,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78015,CPT,THYROID MET IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78016,CPT,THYROID MET IMAGING/STUDIES,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78018,CPT,THYROID MET IMAGING BODY,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78020,CPT,THYROID MET UPTAKE,,30,,,"$1,039.98",$0.00,1,0,1,20210101,
78070,CPT,PARATHYROID PLANAR IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78071,CPT,PARATHYRD PLANAR W/WO SUBTRJ,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78072,CPT,PARATHYRD PLANAR W/SPECT&CT,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78075,CPT,ADRENAL CORTEX & MEDULLA IMG,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78099,CPT,ENDOCRINE NUCLEAR PROCEDURE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78102,CPT,BONE MARROW IMAGING LTD,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78103,CPT,BONE MARROW IMAGING MULT,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78104,CPT,BONE MARROW IMAGING BODY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78110,CPT,PLASMA VOLUME SINGLE,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78111,CPT,PLASMA VOLUME MULTIPLE,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78120,CPT,RED CELL MASS SINGLE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78121,CPT,RED CELL MASS MULTIPLE,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78122,CPT,BLOOD VOLUME,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78130,CPT,RED CELL SURVIVAL STUDY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78140,CPT,RED CELL SEQUESTRATION,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78185,CPT,SPLEEN IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78191,CPT,PLATELET SURVIVAL,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78195,CPT,LYMPH SYSTEM IMAGING,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78199,CPT,BLOOD/LYMPH NUCLEAR EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78201,CPT,LIVER IMAGING,,30,,,"$5,891.51",$0.00,1,0,1,20210101,
78202,CPT,LIVER IMAGING WITH FLOW,,30,,,"$5,891.51",$0.00,1,0,1,20210101,
78215,CPT,LIVER AND SPLEEN IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78216,CPT,LIVER & SPLEEN IMAGE/FLOW,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78226,CPT,HEPATOBILIARY SYSTEM IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78227,CPT,HEPATOBIL SYST IMAGE W/DRUG,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78230,CPT,SALIVARY GLAND IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78231,CPT,SERIAL SALIVARY IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78232,CPT,SALIVARY GLAND FUNCTION EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78258,CPT,ESOPHAGEAL MOTILITY STUDY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78261,CPT,GASTRIC MUCOSA IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78262,CPT,GASTROESOPHAGEAL REFLUX EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78264,CPT,GASTRIC EMPTYING IMAG STUDY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78265,CPT,GASTRIC EMPTYING IMAG STUDY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78266,CPT,GASTRIC EMPTYING IMAG STUDY,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78278,CPT,ACUTE GI BLOOD LOSS IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78282,CPT,GI PROTEIN LOSS EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78290,CPT,MECKELS DIVERT EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78291,CPT,LEVEEN/SHUNT PATENCY EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78299,CPT,GI NUCLEAR PROCEDURE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78300,CPT,BONE IMAGING LIMITED AREA,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78305,CPT,BONE IMAGING MULTIPLE AREAS,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78306,CPT,BONE IMAGING WHOLE BODY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78315,CPT,BONE IMAGING 3 PHASE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78350,CPT,BONE MINERAL SINGLE PHOTON,,30,,,$129.96,$0.00,1,0,1,20210101,
78351,CPT,BONE MINERAL DUAL PHOTON,,30,,,$154.37,$0.00,1,0,1,20210101,
78399,CPT,MUSCULOSKELETAL NUCLEAR EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78414,CPT,NON-IMAGING HEART FUNCTION,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78428,CPT,CARDIAC SHUNT IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78429,CPT,MYOCRD IMG PET 1 STD W/CT,,30,,,"$8,838.44",$0.00,1,0,1,20210101,
78430,CPT,MYOCRD IMG PET RST/STRS W/CT,,30,,,"$8,838.44",$0.00,1,0,1,20210101,
78431,CPT,MYOCRD IMG PET RST&STRS CT,,30,,,"$12,597.60",$0.00,1,0,1,20210101,
78432,CPT,MYOCRD IMG PET 2RTRACER,,30,,,"$14,764.57",$0.00,1,0,1,20210101,
78433,CPT,MYOCRD IMG PET 2RTRACER CT,,30,,,"$14,764.57",$0.00,1,0,1,20210101,
78445,CPT,VASCULAR FLOW IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78451,CPT,HT MUSCLE IMAGE SPECT SING,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78452,CPT,HT MUSCLE IMAGE SPECT MULT,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78453,CPT,HT MUSCLE IMAGE PLANAR SING,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78454,CPT,HT MUSC IMAGE PLANAR MULT,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78456,CPT,ACUTE VENOUS THROMBUS IMAGE,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78457,CPT,VENOUS THROMBOSIS IMAGING,,30,,,"$5,891.51",$0.00,1,0,1,20210101,
78458,CPT,VEN THROMBOSIS IMAGES BILAT,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78459,CPT,MYOCRD IMG PET SINGLE STUDY,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78466,CPT,HEART INFARCT IMAGE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78468,CPT,HEART INFARCT IMAGE (EF),,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78469,CPT,HEART INFARCT IMAGE (3D),,30,,,"$5,891.51",$0.00,1,0,1,20210101,
78472,CPT,GATED HEART PLANAR SINGLE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78473,CPT,GATED HEART MULTIPLE,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78481,CPT,HEART FIRST PASS SINGLE,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78483,CPT,HEART FIRST PASS MULTIPLE,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78491,CPT,MYOCRD IMG PET 1STD RST/STRS,,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78492,CPT,MYOCRD IMG PET MLT RST&STRS,,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78494,CPT,HEART IMAGE SPECT,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78496,CPT,HEART FIRST PASS ADD-ON,,30,,,"$1,675.32",$0.00,1,0,1,20210101,
78499,CPT,CARDIOVASCULAR NUCLEAR EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78579,CPT,LUNG VENTILATION IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78580,CPT,LUNG PERFUSION IMAGING,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78582,CPT,LUNG VENTILAT&PERFUS IMAGING,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78597,CPT,LUNG PERFUSION DIFFERENTIAL,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78598,CPT,LUNG PERF&VENTILAT DIFERENTL,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78599,CPT,RESPIRATORY NUCLEAR EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78600,CPT,BRAIN IMAGE < 4 VIEWS,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78601,CPT,BRAIN IMAGE W/FLOW < 4 VIEWS,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78605,CPT,BRAIN IMAGE 4+ VIEWS,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78606,CPT,BRAIN IMAGE W/FLOW 4 + VIEWS,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78608,CPT,BRAIN IMAGING (PET),,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78609,CPT,BRAIN IMAGING (PET),,30,,,"$11,262.72",$0.00,1,0,1,20210101,
78610,CPT,BRAIN FLOW IMAGING ONLY,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78630,CPT,CEREBROSPINAL FLUID SCAN,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78635,CPT,CSF VENTRICULOGRAPHY,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78645,CPT,CSF SHUNT EVALUATION,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78650,CPT,CSF LEAKAGE IMAGING,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78660,CPT,NUCLEAR EXAM OF TEAR FLOW,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78699,CPT,NERVOUS SYSTEM NUCLEAR EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78700,CPT,KIDNEY IMAGING MORPHOL,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78701,CPT,KIDNEY IMAGING WITH FLOW,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78707,CPT,K FLOW/FUNCT IMAGE W/O DRUG,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78708,CPT,K FLOW/FUNCT IMAGE W/DRUG,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78709,CPT,K FLOW/FUNCT IMAGE MULTIPLE,,30,,,"$3,130.60",$0.00,1,0,1,20210101,
78725,CPT,KIDNEY FUNCTION STUDY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78730,CPT,URINARY BLADDER RETENTION,,30,,,"$1,142.09",$0.00,1,0,1,20210101,
78740,CPT,URETERAL REFLUX STUDY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78761,CPT,TESTICULAR IMAGING W/FLOW,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78799,CPT,GENITOURINARY NUCLEAR EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78800,CPT,RP LOCLZJ TUM 1 AREA 1 D IMG,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78801,CPT,RP LOCLZJ TUM 2+AREA 1+D IMG,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78802,CPT,RP LOCLZJ TUM WHBDY 1 D IMG,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78803,CPT,RP LOCLZJ TUM SPECT 1 AREA,,30,,,"$4,798.19",$0.00,1,0,1,20210101,
78804,CPT,RP LOCLZJ TUM WHBDY 2+D IMG,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78808,CPT,IV INJ RA DRUG DX STUDY,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
78811,CPT,PET IMAGE LTD AREA,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
78812,CPT,PET IMAGE SKULL-THIGH,,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78813,CPT,PET IMAGE FULL BODY,,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78814,CPT,PET IMAGE W/CT LMTD,,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78815,CPT,PET IMAGE W/CT SKULL-THIGH,,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78816,CPT,PET IMAGE W/CT FULL BODY,,30,,,"$8,791.88",$0.00,1,0,1,20210101,
78830,CPT,RP LOCLZJ TUM SPECT W/CT 1,,30,,,"$7,922.82",$0.00,1,0,1,20210101,
78831,CPT,RP LOCLZJ TUM SPECT 2 AREAS,,30,,,"$7,922.82",$0.00,1,0,1,20210101,
78832,CPT,RP LOCLZJ TUM SPECT W/CT 2,,30,,,"$8,838.44",$0.00,1,0,1,20210101,
78999,CPT,NUCLEAR DIAGNOSTIC EXAM,,30,,,"$2,429.10",$0.00,1,0,1,20210101,
79005,CPT,NUCLEAR RX ORAL ADMIN,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
79101,CPT,NUCLEAR RX IV ADMIN,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
79200,CPT,NUCLEAR RX INTRACAV ADMIN,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
79300,CPT,NUCLR RX INTERSTIT COLLOID,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
79403,CPT,HEMATOPOIETIC NUCLEAR TX,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
79440,CPT,NUCLEAR RX INTRA-ARTICULAR,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
79445,CPT,NUCLEAR RX INTRA-ARTERIAL,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
79999,CPT,NUCLEAR MEDICINE THERAPY,,30,,,"$1,610.43",$0.00,1,0,1,20210101,
80047,CPT,METABOLIC PANEL IONIZED CA,,30,,,$381.49,$0.00,1,0,1,20210101,
80048,CPT,METABOLIC PANEL TOTAL CA,,30,,,$306.14,$0.00,1,0,1,20210101,
80050,CPT,GENERAL HEALTH PANEL,,30,,,$627.79,$0.00,1,0,1,20210101,
80051,CPT,ELECTROLYTE PANEL,,30,,,$207.50,$0.00,1,0,1,20210101,
80053,CPT,COMPREHEN METABOLIC PANEL,,30,,,$400.37,$0.00,1,0,1,20210101,
80055,CPT,OBSTETRIC PANEL,,30,,,$537.16,$0.00,1,0,1,20210101,
80061,CPT,LIPID PANEL,,30,,,$228.11,$0.00,1,0,1,20210101,
80069,CPT,RENAL FUNCTION PANEL,,30,,,$689.52,$0.00,1,0,1,20210101,
80074,CPT,ACUTE HEPATITIS PANEL,,30,,,$628.32,$0.00,1,0,1,20210101,
80076,CPT,HEPATIC FUNCTION PANEL,,30,,,$291.08,$0.00,1,0,1,20210101,
80081,CPT,OBSTETRIC PANEL,,30,,,$742.54,$0.00,1,0,1,20210101,
80145,CPT,DRUG ASSAY ADALIMUMAB,,30,,,$224.12,$0.00,1,0,1,20210101,
80150,CPT,ASSAY OF AMIKACIN,,30,,,$250.39,$0.00,1,0,1,20210101,
80155,CPT,DRUG ASSAY CAFFEINE,,30,,,$241.32,$0.00,1,0,1,20210101,
80156,CPT,ASSAY CARBAMAZEPINE TOTAL,,30,,,$264.64,$0.00,1,0,1,20210101,
80157,CPT,ASSAY CARBAMAZEPINE FREE,,30,,,$234.89,$0.00,1,0,1,20210101,
80158,CPT,DRUG ASSAY CYCLOSPORINE,,30,,,$309.80,$0.00,1,0,1,20210101,
80159,CPT,DRUG ASSAY CLOZAPINE,,30,,,$213.43,$0.00,1,0,1,20210101,
80162,CPT,ASSAY OF DIGOXIN TOTAL,,30,,,$228.34,$0.00,1,0,1,20210101,
80163,CPT,ASSAY OF DIGOXIN FREE,,30,,,$439.63,$0.00,1,0,1,20210101,
80164,CPT,ASSAY DIPROPYLACETIC ACD TOT,,30,,,$247.47,$0.00,1,0,1,20210101,
80165,CPT,DIPROPYLACETIC ACID FREE,,30,,,$250.60,$0.00,1,0,1,20210101,
80168,CPT,ASSAY OF ETHOSUXIMIDE,,30,,,$227.55,$0.00,1,0,1,20210101,
80169,CPT,DRUG ASSAY EVEROLIMUS,,30,,,$302.97,$0.00,1,0,1,20210101,
80170,CPT,ASSAY OF GENTAMICIN,,30,,,$308.93,$0.00,1,0,1,20210101,
80171,CPT,DRUG SCREEN QUANT GABAPENTIN,,30,,,$203.97,$0.00,1,0,1,20210101,
80173,CPT,ASSAY OF HALOPERIDOL,,30,,,$170.40,$0.00,1,0,1,20210101,
80175,CPT,DRUG SCREEN QUAN LAMOTRIGINE,,30,,,$193.73,$0.00,1,0,1,20210101,
80176,CPT,ASSAY OF LIDOCAINE,,30,,,$310.81,$0.00,1,0,1,20210101,
80177,CPT,DRUG SCRN QUAN LEVETIRACETAM,,30,,,$203.59,$0.00,1,0,1,20210101,
80178,CPT,ASSAY OF LITHIUM,,30,,,$161.25,$0.00,1,0,1,20210101,
80180,CPT,DRUG SCRN QUAN MYCOPHENOLATE,,30,,,$294.15,$0.00,1,0,1,20210101,
80183,CPT,DRUG SCRN QUANT OXCARBAZEPIN,,30,,,$229.82,$0.00,1,0,1,20210101,
80184,CPT,ASSAY OF PHENOBARBITAL,,30,,,$240.51,$0.00,1,0,1,20210101,
80185,CPT,ASSAY OF PHENYTOIN TOTAL,,30,,,$262.64,$0.00,1,0,1,20210101,
80186,CPT,ASSAY OF PHENYTOIN FREE,,30,,,$220.23,$0.00,1,0,1,20210101,
80188,CPT,ASSAY OF PRIMIDONE,,30,,,$209.65,$0.00,1,0,1,20210101,
80190,CPT,ASSAY OF PROCAINAMIDE,,30,,,$192.92,$0.00,1,0,1,20210101,
80192,CPT,ASSAY OF PROCAINAMIDE,,30,,,$288.25,$0.00,1,0,1,20210101,
80194,CPT,ASSAY OF QUINIDINE,,30,,,$324.42,$0.00,1,0,1,20210101,
80195,CPT,ASSAY OF SIROLIMUS,,30,,,$277.78,$0.00,1,0,1,20210101,
80197,CPT,ASSAY OF TACROLIMUS,,30,,,$308.47,$0.00,1,0,1,20210101,
80198,CPT,ASSAY OF THEOPHYLLINE,,30,,,$250.77,$0.00,1,0,1,20210101,
80199,CPT,DRUG SCREEN QUANT TIAGABINE,,30,,,$250.18,$0.00,1,0,1,20210101,
80200,CPT,ASSAY OF TOBRAMYCIN,,30,,,$329.57,$0.00,1,0,1,20210101,
80201,CPT,ASSAY OF TOPIRAMATE,,30,,,$238.90,$0.00,1,0,1,20210101,
80202,CPT,ASSAY OF VANCOMYCIN,,30,,,$298.53,$0.00,1,0,1,20210101,
80203,CPT,DRUG SCREEN QUANT ZONISAMIDE,,30,,,$245.27,$0.00,1,0,1,20210101,
80299,CPT,QUANTITATIVE ASSAY DRUG,,30,,,$250.91,$0.00,1,0,1,20210101,
80305,CPT,DRUG TEST PRSMV DIR OPT OBS,,30,,,$362.04,$0.00,1,0,1,20210101,
80306,CPT,DRUG TEST PRSMV INSTRMNT,,30,,,$349.55,$0.00,1,0,1,20210101,
80307,CPT,DRUG TEST PRSMV CHEM ANLYZR,,30,,,$644.31,$0.00,1,0,1,20210101,
80320,CPT,DRUG SCREEN QUANTALCOHOLS,,30,,,$277.14,$0.00,1,0,1,20210101,
80321,CPT,ALCOHOLS BIOMARKERS 1OR 2,,30,,,$211.56,$0.00,1,0,1,20210101,
80322,CPT,ALCOHOLS BIOMARKERS 3/MORE,,30,,,$368.35,$0.00,1,0,1,20210101,
80323,CPT,ALKALOIDS NOS,,30,,,$234.47,$0.00,1,0,1,20210101,
80324,CPT,DRUG SCREEN AMPHETAMINES 1/2,,30,,,$159.56,$0.00,1,0,1,20210101,
80325,CPT,AMPHETAMINES 3OR 4,,30,,,$268.85,$0.00,1,0,1,20210101,
80326,CPT,AMPHETAMINES 5 OR MORE,,30,,,$278.47,$0.00,1,0,1,20210101,
80327,CPT,ANABOLIC STEROID 1 OR 2,,30,,,$321.96,$0.00,1,0,1,20210101,
80328,CPT,ANABOLIC STEROID 3 OR MORE,,30,,,$602.53,$0.00,1,0,1,20210101,
80329,CPT,ANALGESICS NON-OPIOID 1 OR 2,,30,,,$317.11,$0.00,1,0,1,20210101,
80330,CPT,ANALGESICS NON-OPIOID 3-5,,30,,,$320.99,$0.00,1,0,1,20210101,
80331,CPT,ANALGESICS NON-OPIOID 6/MORE,,30,,,$320.99,$0.00,1,0,1,20210101,
80332,CPT,ANTIDEPRESSANTS CLASS 1 OR 2,,30,,,$237.42,$0.00,1,0,1,20210101,
80333,CPT,ANTIDEPRESSANTS CLASS 3-5,,30,,,$267.16,$0.00,1,0,1,20210101,
80334,CPT,ANTIDEPRESSANTS CLASS 6/MORE,,30,,,$237.42,$0.00,1,0,1,20210101,
80335,CPT,ANTIDEPRESSANT TRICYCLIC 1/2,,30,,,$269.29,$0.00,1,0,1,20210101,
80336,CPT,ANTIDEPRESSANT TRICYCLIC 3-5,,30,,,$286.51,$0.00,1,0,1,20210101,
80337,CPT,TRICYCLIC & CYCLICALS 6/MORE,,30,,,$308.77,$0.00,1,0,1,20210101,
80338,CPT,ANTIDEPRESSANT NOT SPECIFIED,,30,,,$62.52,$0.00,1,0,1,20210101,
80339,CPT,ANTIEPILEPTICS NOS 1-3,,30,,,$233.08,$0.00,1,0,1,20210101,
80340,CPT,ANTIEPILEPTICS NOS 4-6,,30,,,$294.75,$0.00,1,0,1,20210101,
80341,CPT,ANTIEPILEPTICS NOS 7/MORE,,30,,,$233.08,$0.00,1,0,1,20210101,
80342,CPT,ANTIPSYCHOTICS NOS 1-3,,30,,,$199.15,$0.00,1,0,1,20210101,
80343,CPT,ANTIPSYCHOTICS NOS 4-6,,30,,,$271.00,$0.00,1,0,1,20210101,
80344,CPT,ANTIPSYCHOTICS NOS 7/MORE,,30,,,$271.00,$0.00,1,0,1,20210101,
80345,CPT,DRUG SCREENING BARBITURATES,,30,,,$215.01,$0.00,1,0,1,20210101,
80346,CPT,BENZODIAZEPINES1-12,,30,,,$234.60,$0.00,1,0,1,20210101,
80347,CPT,BENZODIAZEPINES 13 OR MORE,,30,,,$298.05,$0.00,1,0,1,20210101,
80348,CPT,DRUG SCREENING BUPRENORPHINE,,30,,,$201.91,$0.00,1,0,1,20210101,
80349,CPT,CANNABINOIDS NATURAL,,30,,,$145.18,$0.00,1,0,1,20210101,
80350,CPT,CANNABINOIDS SYNTHETIC 1-3,,30,,,$209.67,$0.00,1,0,1,20210101,
80351,CPT,CANNABINOIDS SYNTHETIC 4-6,,30,,,$358.86,$0.00,1,0,1,20210101,
80352,CPT,CANNABINOID SYNTHETIC 7/MORE,,30,,,$405.45,$0.00,1,0,1,20210101,
80353,CPT,DRUG SCREENING COCAINE,,30,,,$137.11,$0.00,1,0,1,20210101,
80354,CPT,DRUG SCREENING FENTANYL,,30,,,$128.12,$0.00,1,0,1,20210101,
80355,CPT,GABAPENTIN NON-BLOOD,,30,,,$67.31,$0.00,1,0,1,20210101,
80356,CPT,HEROIN METABOLITE,,30,,,$172.11,$0.00,1,0,1,20210101,
80357,CPT,KETAMINE AND NORKETAMINE,,30,,,$148.76,$0.00,1,0,1,20210101,
80358,CPT,DRUG SCREENING METHADONE,,30,,,$197.95,$0.00,1,0,1,20210101,
80359,CPT,METHYLENEDIOXYAMPHETAMINES,,30,,,$182.48,$0.00,1,0,1,20210101,
80360,CPT,METHYLPHENIDATE,,30,,,$207.74,$0.00,1,0,1,20210101,
80361,CPT,OPIATES 1 OR MORE,,30,,,$209.64,$0.00,1,0,1,20210101,
80362,CPT,OPIOIDS & OPIATE ANALOGS 1/2,,30,,,$248.91,$0.00,1,0,1,20210101,
80363,CPT,OPIOIDS & OPIATE ANALOGS 3/4,,30,,,$294.54,$0.00,1,0,1,20210101,
80364,CPT,OPIOID &OPIATE ANALOG 5/MORE,,30,,,$294.54,$0.00,1,0,1,20210101,
80365,CPT,DRUG SCREENING OXYCODONE,,30,,,$197.24,$0.00,1,0,1,20210101,
80366,CPT,DRUG SCREENING PREGABALIN,,30,,,$169.03,$0.00,1,0,1,20210101,
80367,CPT,DRUG SCREENING PROPOXYPHENE,,30,,,$85.48,$0.00,1,0,1,20210101,
80368,CPT,SEDATIVE HYPNOTICS,,30,,,$214.45,$0.00,1,0,1,20210101,
80369,CPT,SKELETAL MUSCLE RELAXANT 1/2,,30,,,$204.54,$0.00,1,0,1,20210101,
80370,CPT,SKEL MUSC RELAXANT 3 OR MORE,,30,,,$248.97,$0.00,1,0,1,20210101,
80371,CPT,STIMULANTS SYNTHETIC,,30,,,$82.86,$0.00,1,0,1,20210101,
80372,CPT,DRUG SCREENING TAPENTADOL,,30,,,$117.23,$0.00,1,0,1,20210101,
80373,CPT,DRUG SCREENING TRAMADOL,,30,,,$124.25,$0.00,1,0,1,20210101,
80374,CPT,STEREOISOMER ANALYSIS,,30,,,$219.12,$0.00,1,0,1,20210101,
80375,CPT,DRUG/SUBSTANCE NOS 1-3,,30,,,$113.46,$0.00,1,0,1,20210101,
80376,CPT,DRUG/SUBSTANCE NOS 4-6,,30,,,$113.46,$0.00,1,0,1,20210101,
80377,CPT,DRUG/SUBSTANCE NOS 7/MORE,,30,,,$155.27,$0.00,1,0,1,20210101,
80400,CPT,ACTH STIMULATION PANEL,,30,,,$593.22,$0.00,1,0,1,20210101,
80402,CPT,ACTH STIMULATION PANEL,,30,,,$775.60,$0.00,1,0,1,20210101,
80406,CPT,ACTH STIMULATION PANEL,,30,,,$728.43,$0.00,1,0,1,20210101,
80408,CPT,ALDOSTERONE SUPPRESSION EVAL,,30,,,$967.51,$0.00,1,0,1,20210101,
80410,CPT,CALCITONIN STIMUL PANEL,,30,,,$739.60,$0.00,1,0,1,20210101,
80412,CPT,CRH STIMULATION PANEL,,30,,,"$1,728.34",$0.00,1,0,1,20210101,
80414,CPT,TESTOSTERONE RESPONSE PANEL,,30,,,$569.03,$0.00,1,0,1,20210101,
80415,CPT,TOT ESTRADIOL RESPONSE PANEL,,30,,,$741.81,$0.00,1,0,1,20210101,
80416,CPT,RENIN STIMULATION PANEL,,30,,,$996.56,$0.00,1,0,1,20210101,
80417,CPT,RENIN STIMULATION PANEL,,30,,,$515.04,$0.00,1,0,1,20210101,
80418,CPT,PITUITARY EVALUATION PANEL,,30,,,"$2,421.08",$0.00,1,0,1,20210101,
80420,CPT,DEXAMETHASONE PANEL,,30,,,$692.05,$0.00,1,0,1,20210101,
80422,CPT,GLUCAGON TOLERANCE PANEL,,30,,,$485.97,$0.00,1,0,1,20210101,
80424,CPT,GLUCAGON TOLERANCE PANEL,,30,,,$697.03,$0.00,1,0,1,20210101,
80426,CPT,GONADOTROPIN HORMONE PANEL,,30,,,"$1,070.10",$0.00,1,0,1,20210101,
80428,CPT,GROWTH HORMONE PANEL,,30,,,"$1,034.43",$0.00,1,0,1,20210101,
80430,CPT,GROWTH HORMONE PANEL,,30,,,$729.55,$0.00,1,0,1,20210101,
80432,CPT,INSULIN SUPPRESSION PANEL,,30,,,"$1,010.87",$0.00,1,0,1,20210101,
80434,CPT,INSULIN TOLERANCE PANEL,,30,,,$849.09,$0.00,1,0,1,20210101,
80435,CPT,INSULIN TOLERANCE PANEL,,30,,,"$1,375.38",$0.00,1,0,1,20210101,
80436,CPT,METYRAPONE PANEL,,30,,,$797.70,$0.00,1,0,1,20210101,
80438,CPT,TRH STIMULATION PANEL,,30,,,$559.73,$0.00,1,0,1,20210101,
80439,CPT,TRH STIMULATION PANEL,,30,,,$664.67,$0.00,1,0,1,20210101,
80500,CPT,LAB PATHOLOGY CONSULTATION,,30,,,$332.59,$0.00,1,0,1,20210101,
80502,CPT,LAB PATHOLOGY CONSULTATION,,30,,,$419.05,$0.00,1,0,1,20210101,
81000,CPT,URINALYSIS NONAUTO W/SCOPE,,30,,,$96.19,$0.00,1,0,1,20210101,
81001,CPT,URINALYSIS AUTO W/SCOPE,,30,,,$139.69,$0.00,1,0,1,20210101,
81002,CPT,URINALYSIS NONAUTO W/O SCOPE,,30,,,$48.04,$0.00,1,0,1,20210101,
81003,CPT,URINALYSIS AUTO W/O SCOPE,,30,,,$95.84,$0.00,1,0,1,20210101,
81005,CPT,URINALYSIS,,30,,,$80.24,$0.00,1,0,1,20210101,
81007,CPT,URINE SCREEN FOR BACTERIA,,30,,,$101.39,$0.00,1,0,1,20210101,
81015,CPT,MICROSCOPIC EXAM OF URINE,,30,,,$63.30,$0.00,1,0,1,20210101,
81020,CPT,URINALYSIS GLASS TEST,,30,,,$116.14,$0.00,1,0,1,20210101,
81025,CPT,URINE PREGNANCY TEST,,30,,,$181.49,$0.00,1,0,1,20210101,
81050,CPT,URINALYSIS VOLUME MEASURE,,30,,,$47.14,$0.00,1,0,1,20210101,
81099,CPT,URINALYSIS TEST PROCEDURE,,30,,,$41.94,$0.00,1,0,1,20210101,
81162,CPT,BRCA1&2 GEN FULL SEQ DUP/DEL,,30,,,"$6,134.70",$0.00,1,0,1,20210101,
81163,CPT,BRCA1&2 GENE FULL SEQ ALYS,,30,,,"$6,332.08",$0.00,1,0,1,20210101,
81164,CPT,BRCA1&2 GEN FUL DUP/DEL ALYS,,30,,,"$3,094.29",$0.00,1,0,1,20210101,
81165,CPT,BRCA1 GENE FULL SEQ ALYS,,30,,,"$3,493.52",$0.00,1,0,1,20210101,
81166,CPT,BRCA1 GENE FULL DUP/DEL ALYS,,30,,,"$3,493.52",$0.00,1,0,1,20210101,
81170,CPT,ABL1 GENE,,30,,,"$1,617.64",$0.00,1,0,1,20210101,
81176,CPT,ASXL1 GENE TARGET SEQ ALYS,,30,,,"$1,519.95",$0.00,1,0,1,20210101,
81201,CPT,APC GENE FULL SEQUENCE,,30,,,"$2,248.35",$0.00,1,0,1,20210101,
81203,CPT,APC GENE DUP/DELET VARIANTS,,30,,,"$1,304.45",$0.00,1,0,1,20210101,
81218,CPT,CEBPA GENE FULL SEQUENCE,,30,,,"$1,597.47",$0.00,1,0,1,20210101,
81220,CPT,CFTR GENE COM VARIANTS,,30,,,"$1,751.62",$0.00,1,0,1,20210101,
81235,CPT,EGFR GENE COM VARIANTS,,30,,,"$2,440.67",$0.00,1,0,1,20210101,
81256,CPT,HFE GENE,,30,,,$685.89,$0.00,1,0,1,20210101,
81257,CPT,HBA1/HBA2 GENE,,30,,,"$1,553.61",$0.00,1,0,1,20210101,
81272,CPT,KIT GENE TARGETED SEQ ANALYS,,30,,,"$1,605.77",$0.00,1,0,1,20210101,
81314,CPT,PDGFRA GENE,,30,,,"$1,635.84",$0.00,1,0,1,20210101,
81324,CPT,PMP22 GENE DUP/DELET,,30,,,"$3,181.84",$0.00,1,0,1,20210101,
81325,CPT,PMP22 GENE FULL SEQUENCE,,30,,,"$3,256.72",$0.00,1,0,1,20210101,
81417,CPT,EXOME RE-EVALUATION,,30,,,$107.77,$0.00,1,0,1,20210101,
81420,CPT,FETAL CHRMOML ANEUPLOIDY,,30,,,"$2,664.56",$0.00,1,0,1,20210101,
81425,CPT,GENOME SEQUENCE ANALYSIS,,30,,,$107.77,$0.00,1,0,1,20210101,
81426,CPT,GENOME SEQUENCE ANALYSIS,,30,,,$107.77,$0.00,1,0,1,20210101,
81427,CPT,GENOME RE-EVALUATION,,30,,,$107.77,$0.00,1,0,1,20210101,
81479,CPT,UNLISTED MOLECULAR PATHOLOGY,,30,,,"$1,416.60",$0.00,1,0,1,20210101,
81490,CPT,AUTOIMMUNE RHEUMATOID ARTHR,,30,,,"$3,367.82",$0.00,1,0,1,20210101,
81500,CPT,ONCO (OVAR) TWO PROTEINS,,30,,,"$1,042.26",$0.00,1,0,1,20210101,
81503,CPT,ONCO (OVAR) FIVE PROTEINS,,30,,,"$1,519.17",$0.00,1,0,1,20210101,
81506,CPT,ENDO ASSAY SEVEN ANAL,,30,,,"$1,132.20",$0.00,1,0,1,20210101,
81508,CPT,FTL CGEN ABNOR TWO PROTEINS,,30,,,$374.58,$0.00,1,0,1,20210101,
81509,CPT,FTL CGEN ABNOR 3 PROTEINS,,30,,,$303.21,$0.00,1,0,1,20210101,
81511,CPT,FTL CGEN ABNOR FOUR ANAL,,30,,,$579.71,$0.00,1,0,1,20210101,
81528,CPT,ONCOLOGY COLORECTAL SCR,,30,,,"$2,169.08",$0.00,1,0,1,20210101,
81535,CPT,ONCOLOGY GYNECOLOGIC,,30,,,"$2,361.80",$0.00,1,0,1,20210101,
81536,CPT,ONCOLOGY GYNECOLOGIC,,30,,,"$1,081.47",$0.00,1,0,1,20210101,
81538,CPT,ONCOLOGY LUNG,,30,,,"$3,351.84",$0.00,1,0,1,20210101,
81539,CPT,ONCOLOGY PROSTATE PROB SCORE,,30,,,"$2,522.33",$0.00,1,0,1,20210101,
81599,CPT,UNLISTED MAAA,,30,,,"$2,514.96",$0.00,1,0,1,20210101,
82009,CPT,TEST FOR ACETONE/KETONES,,30,,,$127.46,$0.00,1,0,1,20210101,
82010,CPT,ACETONE ASSAY,,30,,,$155.48,$0.00,1,0,1,20210101,
82013,CPT,ACETYLCHOLINESTERASE ASSAY,,30,,,$502.39,$0.00,1,0,1,20210101,
82016,CPT,ACYLCARNITINES QUAL,,30,,,$254.06,$0.00,1,0,1,20210101,
82017,CPT,ACYLCARNITINES QUANT,,30,,,$408.60,$0.00,1,0,1,20210101,
82024,CPT,ASSAY OF ACTH,,30,,,$393.00,$0.00,1,0,1,20210101,
82030,CPT,ASSAY OF ADP & AMP,,30,,,$410.58,$0.00,1,0,1,20210101,
82040,CPT,ASSAY OF SERUM ALBUMIN,,30,,,$145.99,$0.00,1,0,1,20210101,
82042,CPT,OTHER SOURCE ALBUMIN QUAN EA,,30,,,$108.13,$0.00,1,0,1,20210101,
82043,CPT,UR ALBUMIN QUANTITATIVE,,30,,,$116.97,$0.00,1,0,1,20210101,
82044,CPT,UR ALBUMIN SEMIQUANTITATIVE,,30,,,$77.80,$0.00,1,0,1,20210101,
82045,CPT,ALBUMIN ISCHEMIA MODIFIED,,30,,,$484.93,$0.00,1,0,1,20210101,
82075,CPT,ASSAY OF BREATH ETHANOL,,30,,,$166.85,$0.00,1,0,1,20210101,
82085,CPT,ASSAY OF ALDOLASE,,30,,,$135.42,$0.00,1,0,1,20210101,
82088,CPT,ASSAY OF ALDOSTERONE,,30,,,$372.59,$0.00,1,0,1,20210101,
82103,CPT,ALPHA-1-ANTITRYPSIN TOTAL,,30,,,$184.76,$0.00,1,0,1,20210101,
82104,CPT,ALPHA-1-ANTITRYPSIN PHENO,,30,,,$242.19,$0.00,1,0,1,20210101,
82105,CPT,ALPHA-FETOPROTEIN SERUM,,30,,,$230.49,$0.00,1,0,1,20210101,
82106,CPT,ALPHA-FETOPROTEIN AMNIOTIC,,30,,,$248.69,$0.00,1,0,1,20210101,
82107,CPT,ALPHA-FETOPROTEIN L3,,30,,,$520.05,$0.00,1,0,1,20210101,
82108,CPT,ASSAY OF ALUMINUM,,30,,,$686.97,$0.00,1,0,1,20210101,
82120,CPT,AMINES VAGINAL FLUID QUAL,,30,,,$59.02,$0.00,1,0,1,20210101,
82127,CPT,AMINO ACID SINGLE QUAL,,30,,,$319.48,$0.00,1,0,1,20210101,
82128,CPT,AMINO ACIDS MULT QUAL,,30,,,$330.52,$0.00,1,0,1,20210101,
82131,CPT,AMINO ACIDS SINGLE QUANT,,30,,,$424.07,$0.00,1,0,1,20210101,
82135,CPT,ASSAY AMINOLEVULINIC ACID,,30,,,$382.64,$0.00,1,0,1,20210101,
82136,CPT,AMINO ACIDS QUANT 2-5,,30,,,$460.29,$0.00,1,0,1,20210101,
82139,CPT,AMINO ACIDS QUAN 6 OR MORE,,30,,,$741.82,$0.00,1,0,1,20210101,
82140,CPT,ASSAY OF AMMONIA,,30,,,$257.96,$0.00,1,0,1,20210101,
82143,CPT,AMNIOTIC FLUID SCAN,,30,,,$425.24,$0.00,1,0,1,20210101,
82150,CPT,ASSAY OF AMYLASE,,30,,,$196.29,$0.00,1,0,1,20210101,
82154,CPT,ANDROSTANEDIOL GLUCURONIDE,,30,,,$163.00,$0.00,1,0,1,20210101,
82157,CPT,ASSAY OF ANDROSTENEDIONE,,30,,,$385.80,$0.00,1,0,1,20210101,
82160,CPT,ASSAY OF ANDROSTERONE,,30,,,$366.12,$0.00,1,0,1,20210101,
82163,CPT,ASSAY OF ANGIOTENSIN II,,30,,,$414.22,$0.00,1,0,1,20210101,
82164,CPT,ANGIOTENSIN I ENZYME TEST,,30,,,$200.45,$0.00,1,0,1,20210101,
82172,CPT,ASSAY OF APOLIPOPROTEIN,,30,,,$161.44,$0.00,1,0,1,20210101,
82175,CPT,ASSAY OF ARSENIC,,30,,,$188.26,$0.00,1,0,1,20210101,
82180,CPT,ASSAY OF ASCORBIC ACID,,30,,,$175.41,$0.00,1,0,1,20210101,
82190,CPT,ATOMIC ABSORPTION,,30,,,$269.03,$0.00,1,0,1,20210101,
82232,CPT,ASSAY OF BETA-2 PROTEIN,,30,,,$196.12,$0.00,1,0,1,20210101,
82239,CPT,BILE ACIDS TOTAL,,30,,,$174.11,$0.00,1,0,1,20210101,
82240,CPT,BILE ACIDS CHOLYLGLYCINE,,30,,,$380.06,$0.00,1,0,1,20210101,
82247,CPT,BILIRUBIN TOTAL,,30,,,$104.75,$0.00,1,0,1,20210101,
82248,CPT,BILIRUBIN DIRECT,,30,,,$101.10,$0.00,1,0,1,20210101,
82252,CPT,FECAL BILIRUBIN TEST,,30,,,$131.84,$0.00,1,0,1,20210101,
82261,CPT,ASSAY OF BIOTINIDASE,,30,,,$166.81,$0.00,1,0,1,20210101,
82270,CPT,OCCULT BLOOD FECES,,30,,,$77.72,$0.00,1,0,1,20210101,
82271,CPT,OCCULT BLOOD OTHER SOURCES,,30,,,$83.40,$0.00,1,0,1,20210101,
82272,CPT,OCCULT BLD FECES 1-3 TESTS,,30,,,$77.12,$0.00,1,0,1,20210101,
82274,CPT,ASSAY TEST FOR BLOOD FECAL,,30,,,$125.11,$0.00,1,0,1,20210101,
82286,CPT,ASSAY OF BRADYKININ,,30,,,$79.33,$0.00,1,0,1,20210101,
82300,CPT,ASSAY OF CADMIUM,,30,,,$192.89,$0.00,1,0,1,20210101,
82306,CPT,VITAMIN D 25 HYDROXY,,30,,,$293.99,$0.00,1,0,1,20210101,
82308,CPT,ASSAY OF CALCITONIN,,30,,,$342.56,$0.00,1,0,1,20210101,
82310,CPT,ASSAY OF CALCIUM,,30,,,$158.25,$0.00,1,0,1,20210101,
82330,CPT,ASSAY OF CALCIUM,,30,,,$218.44,$0.00,1,0,1,20210101,
82331,CPT,CALCIUM INFUSION TEST,,30,,,$31.29,$0.00,1,0,1,20210101,
82340,CPT,ASSAY OF CALCIUM IN URINE,,30,,,$106.58,$0.00,1,0,1,20210101,
82355,CPT,CALCULUS ANALYSIS QUAL,,30,,,$287.00,$0.00,1,0,1,20210101,
82360,CPT,CALCULUS ASSAY QUANT,,30,,,$250.99,$0.00,1,0,1,20210101,
82365,CPT,CALCULUS SPECTROSCOPY,,30,,,$167.30,$0.00,1,0,1,20210101,
82370,CPT,X-RAY ASSAY CALCULUS,,30,,,$210.57,$0.00,1,0,1,20210101,
82373,CPT,ASSAY C-D TRANSFER MEASURE,,30,,,$395.25,$0.00,1,0,1,20210101,
82374,CPT,ASSAY BLOOD CARBON DIOXIDE,,30,,,$128.24,$0.00,1,0,1,20210101,
82375,CPT,ASSAY CARBOXYHB QUANT,,30,,,$185.62,$0.00,1,0,1,20210101,
82376,CPT,ASSAY CARBOXYHB QUAL,,30,,,$223.66,$0.00,1,0,1,20210101,
82378,CPT,CARCINOEMBRYONIC ANTIGEN,,30,,,$270.80,$0.00,1,0,1,20210101,
82379,CPT,ASSAY OF CARNITINE,,30,,,$353.97,$0.00,1,0,1,20210101,
82380,CPT,ASSAY OF CAROTENE,,30,,,$139.70,$0.00,1,0,1,20210101,
82382,CPT,ASSAY URINE CATECHOLAMINES,,30,,,$362.30,$0.00,1,0,1,20210101,
82383,CPT,ASSAY BLOOD CATECHOLAMINES,,30,,,$518.67,$0.00,1,0,1,20210101,
82384,CPT,ASSAY THREE CATECHOLAMINES,,30,,,$311.19,$0.00,1,0,1,20210101,
82387,CPT,ASSAY OF CATHEPSIN-D,,30,,,$218.56,$0.00,1,0,1,20210101,
82390,CPT,ASSAY OF CERULOPLASMIN,,30,,,$162.72,$0.00,1,0,1,20210101,
82397,CPT,CHEMILUMINESCENT ASSAY,,30,,,$235.60,$0.00,1,0,1,20210101,
82415,CPT,ASSAY OF CHLORAMPHENICOL,,30,,,$243.50,$0.00,1,0,1,20210101,
82435,CPT,ASSAY OF BLOOD CHLORIDE,,30,,,$101.95,$0.00,1,0,1,20210101,
82436,CPT,ASSAY OF URINE CHLORIDE,,30,,,$105.86,$0.00,1,0,1,20210101,
82438,CPT,ASSAY OTHER FLUID CHLORIDES,,30,,,$125.91,$0.00,1,0,1,20210101,
82441,CPT,TEST FOR CHLOROHYDROCARBONS,,30,,,$74.94,$0.00,1,0,1,20210101,
82465,CPT,ASSAY BLD/SERUM CHOLESTEROL,,30,,,$90.41,$0.00,1,0,1,20210101,
82480,CPT,ASSAY SERUM CHOLINESTERASE,,30,,,$167.63,$0.00,1,0,1,20210101,
82482,CPT,ASSAY RBC CHOLINESTERASE,,30,,,$205.48,$0.00,1,0,1,20210101,
82485,CPT,ASSAY CHONDROITIN SULFATE,,30,,,$327.36,$0.00,1,0,1,20210101,
82495,CPT,ASSAY OF CHROMIUM,,30,,,$224.21,$0.00,1,0,1,20210101,
82507,CPT,ASSAY OF CITRATE,,30,,,$281.51,$0.00,1,0,1,20210101,
82523,CPT,COLLAGEN CROSSLINKS,,30,,,$251.06,$0.00,1,0,1,20210101,
82525,CPT,ASSAY OF COPPER,,30,,,$154.93,$0.00,1,0,1,20210101,
82528,CPT,ASSAY OF CORTICOSTERONE,,30,,,$300.43,$0.00,1,0,1,20210101,
82530,CPT,CORTISOL FREE,,30,,,$241.87,$0.00,1,0,1,20210101,
82533,CPT,TOTAL CORTISOL,,30,,,$239.76,$0.00,1,0,1,20210101,
82540,CPT,ASSAY OF CREATINE,,30,,,$101.05,$0.00,1,0,1,20210101,
82542,CPT,COL CHROMOTOGRAPHY QUAL/QUAN,,30,,,$286.54,$0.00,1,0,1,20210101,
82550,CPT,ASSAY OF CK (CPK),,30,,,$173.48,$0.00,1,0,1,20210101,
82552,CPT,ASSAY OF CPK IN BLOOD,,30,,,$224.79,$0.00,1,0,1,20210101,
82553,CPT,CREATINE MB FRACTION,,30,,,$287.21,$0.00,1,0,1,20210101,
82554,CPT,CREATINE ISOFORMS,,30,,,$234.75,$0.00,1,0,1,20210101,
82565,CPT,ASSAY OF CREATININE,,30,,,$131.51,$0.00,1,0,1,20210101,
82570,CPT,ASSAY OF URINE CREATININE,,30,,,$95.72,$0.00,1,0,1,20210101,
82575,CPT,CREATININE CLEARANCE TEST,,30,,,$263.68,$0.00,1,0,1,20210101,
82585,CPT,ASSAY OF CRYOFIBRINOGEN,,30,,,$143.90,$0.00,1,0,1,20210101,
82595,CPT,ASSAY OF CRYOGLOBULIN,,30,,,$123.63,$0.00,1,0,1,20210101,
82600,CPT,ASSAY OF CYANIDE,,30,,,$275.96,$0.00,1,0,1,20210101,
82607,CPT,VITAMIN B-12,,30,,,$221.14,$0.00,1,0,1,20210101,
82608,CPT,B-12 BINDING CAPACITY,,30,,,$217.77,$0.00,1,0,1,20210101,
82610,CPT,CYSTATIN C,,30,,,$207.64,$0.00,1,0,1,20210101,
82615,CPT,TEST FOR URINE CYSTINES,,30,,,$128.49,$0.00,1,0,1,20210101,
82626,CPT,DEHYDROEPIANDROSTERONE,,30,,,$272.03,$0.00,1,0,1,20210101,
82627,CPT,DEHYDROEPIANDROSTERONE,,30,,,$252.23,$0.00,1,0,1,20210101,
82633,CPT,DESOXYCORTICOSTERONE,,30,,,$449.37,$0.00,1,0,1,20210101,
82634,CPT,DEOXYCORTISOL,,30,,,$272.14,$0.00,1,0,1,20210101,
82638,CPT,ASSAY OF DIBUCAINE NUMBER,,30,,,$135.19,$0.00,1,0,1,20210101,
82642,CPT,DIHYDROTESTOSTERONE,,30,,,$267.51,$0.00,1,0,1,20210101,
82652,CPT,VIT D 1 25-DIHYDROXY,,30,,,$426.39,$0.00,1,0,1,20210101,
82656,CPT,PANCREATIC ELASTASE FECAL,,30,,,$436.27,$0.00,1,0,1,20210101,
82657,CPT,ENZYME CELL ACTIVITY,,30,,,$454.34,$0.00,1,0,1,20210101,
82658,CPT,ENZYME CELL ACTIVITY RA,,30,,,$616.49,$0.00,1,0,1,20210101,
82664,CPT,ELECTROPHORETIC TEST,,30,,,$276.76,$0.00,1,0,1,20210101,
82668,CPT,ASSAY OF ERYTHROPOIETIN,,30,,,$232.86,$0.00,1,0,1,20210101,
82670,CPT,ASSAY OF TOTAL ESTRADIOL,,30,,,$301.30,$0.00,1,0,1,20210101,
82671,CPT,ASSAY OF ESTROGENS,,30,,,$268.80,$0.00,1,0,1,20210101,
82672,CPT,ASSAY OF ESTROGEN,,30,,,$282.54,$0.00,1,0,1,20210101,
82677,CPT,ASSAY OF ESTRIOL,,30,,,$232.07,$0.00,1,0,1,20210101,
82679,CPT,ASSAY OF ESTRONE,,30,,,$221.68,$0.00,1,0,1,20210101,
82693,CPT,ASSAY OF ETHYLENE GLYCOL,,30,,,$275.91,$0.00,1,0,1,20210101,
82696,CPT,ASSAY OF ETIOCHOLANOLONE,,30,,,$354.16,$0.00,1,0,1,20210101,
82705,CPT,FATS/LIPIDS FECES QUAL,,30,,,$107.90,$0.00,1,0,1,20210101,
82710,CPT,FATS/LIPIDS FECES QUANT,,30,,,$292.18,$0.00,1,0,1,20210101,
82715,CPT,ASSAY OF FECAL FAT,,30,,,$287.08,$0.00,1,0,1,20210101,
82725,CPT,ASSAY OF BLOOD FATTY ACIDS,,30,,,$261.87,$0.00,1,0,1,20210101,
82726,CPT,LONG CHAIN FATTY ACIDS,,30,,,$640.58,$0.00,1,0,1,20210101,
82728,CPT,ASSAY OF FERRITIN,,30,,,$311.19,$0.00,1,0,1,20210101,
82731,CPT,ASSAY OF FETAL FIBRONECTIN,,30,,,"$1,019.46",$0.00,1,0,1,20210101,
82735,CPT,ASSAY OF FLUORIDE,,30,,,$194.40,$0.00,1,0,1,20210101,
82746,CPT,ASSAY OF FOLIC ACID SERUM,,30,,,$242.71,$0.00,1,0,1,20210101,
82747,CPT,ASSAY OF FOLIC ACID RBC,,30,,,$210.26,$0.00,1,0,1,20210101,
82757,CPT,ASSAY OF SEMEN FRUCTOSE,,30,,,$294.95,$0.00,1,0,1,20210101,
82759,CPT,ASSAY OF RBC GALACTOKINASE,,30,,,$335.17,$0.00,1,0,1,20210101,
82760,CPT,ASSAY OF GALACTOSE,,30,,,$225.80,$0.00,1,0,1,20210101,
82775,CPT,ASSAY GALACTOSE TRANSFERASE,,30,,,$331.53,$0.00,1,0,1,20210101,
82776,CPT,GALACTOSE TRANSFERASE TEST,,30,,,$120.87,$0.00,1,0,1,20210101,
82777,CPT,GALECTIN-3,,30,,,$362.73,$0.00,1,0,1,20210101,
82784,CPT,ASSAY IGA/IGD/IGG/IGM EACH,,30,,,$149.74,$0.00,1,0,1,20210101,
82785,CPT,ASSAY OF IGE,,30,,,$194.71,$0.00,1,0,1,20210101,
82787,CPT,IGG 1 2 3 OR 4 EACH,,30,,,$137.90,$0.00,1,0,1,20210101,
82800,CPT,BLOOD PH,,30,,,$181.14,$0.00,1,0,1,20210101,
82803,CPT,BLOOD GASES ANY COMBINATION,,30,,,$440.02,$0.00,1,0,1,20210101,
82805,CPT,BLOOD GASES W/O2 SATURATION,,30,,,$467.22,$0.00,1,0,1,20210101,
82810,CPT,BLOOD GASES O2 SAT ONLY,,30,,,$209.03,$0.00,1,0,1,20210101,
82820,CPT,HEMOGLOBIN-OXYGEN AFFINITY,,30,,,$203.94,$0.00,1,0,1,20210101,
82930,CPT,GASTRIC ANALY W/PH EA SPEC,,30,,,$150.40,$0.00,1,0,1,20210101,
82938,CPT,GASTRIN TEST,,30,,,$297.14,$0.00,1,0,1,20210101,
82941,CPT,ASSAY OF GASTRIN,,30,,,$231.58,$0.00,1,0,1,20210101,
82943,CPT,ASSAY OF GLUCAGON,,30,,,$255.72,$0.00,1,0,1,20210101,
82945,CPT,GLUCOSE OTHER FLUID,,30,,,$129.14,$0.00,1,0,1,20210101,
82946,CPT,GLUCAGON TOLERANCE TEST,,30,,,$270.25,$0.00,1,0,1,20210101,
82947,CPT,ASSAY GLUCOSE BLOOD QUANT,,30,,,$84.62,$0.00,1,0,1,20210101,
82948,CPT,REAGENT STRIP/BLOOD GLUCOSE,,30,,,$55.73,$0.00,1,0,1,20210101,
82950,CPT,GLUCOSE TEST,,30,,,$94.88,$0.00,1,0,1,20210101,
82951,CPT,GLUCOSE TOLERANCE TEST (GTT),,30,,,$225.05,$0.00,1,0,1,20210101,
82952,CPT,GTT-ADDED SAMPLES,,30,,,$77.01,$0.00,1,0,1,20210101,
82955,CPT,ASSAY OF G6PD ENZYME,,30,,,$156.08,$0.00,1,0,1,20210101,
82960,CPT,TEST FOR G6PD ENZYME,,30,,,$127.98,$0.00,1,0,1,20210101,
82962,CPT,GLUCOSE BLOOD TEST,,30,,,$63.84,$0.00,1,0,1,20210101,
82963,CPT,ASSAY OF GLUCOSIDASE,,30,,,$134.07,$0.00,1,0,1,20210101,
82965,CPT,ASSAY OF GDH ENZYME,,30,,,$43.23,$0.00,1,0,1,20210101,
82977,CPT,ASSAY OF GGT,,30,,,$122.59,$0.00,1,0,1,20210101,
82978,CPT,ASSAY OF GLUTATHIONE,,30,,,$305.28,$0.00,1,0,1,20210101,
82979,CPT,ASSAY RBC GLUTATHIONE,,30,,,$168.71,$0.00,1,0,1,20210101,
82985,CPT,ASSAY OF GLYCATED PROTEIN,,30,,,$140.77,$0.00,1,0,1,20210101,
83001,CPT,ASSAY OF GONADOTROPIN (FSH),,30,,,$249.27,$0.00,1,0,1,20210101,
83002,CPT,ASSAY OF GONADOTROPIN (LH),,30,,,$254.48,$0.00,1,0,1,20210101,
83003,CPT,ASSAY GROWTH HORMONE (HGH),,30,,,$222.66,$0.00,1,0,1,20210101,
83006,CPT,GROWTH STIMULATION GENE 2,,30,,,$496.85,$0.00,1,0,1,20210101,
83009,CPT,H PYLORI (C-13) BLOOD,,30,,,$563.63,$0.00,1,0,1,20210101,
83010,CPT,ASSAY OF HAPTOGLOBIN QUANT,,30,,,$186.47,$0.00,1,0,1,20210101,
83012,CPT,ASSAY OF HAPTOGLOBINS,,30,,,$291.45,$0.00,1,0,1,20210101,
83013,CPT,H PYLORI (C-13) BREATH,,30,,,$439.41,$0.00,1,0,1,20210101,
83014,CPT,H PYLORI DRUG ADMIN,,30,,,$127.94,$0.00,1,0,1,20210101,
83015,CPT,HEAVY METAL QUAL ANY ANAL,,30,,,$425.25,$0.00,1,0,1,20210101,
83018,CPT,HEAVY METAL QUANT EACH NES,,30,,,$263.36,$0.00,1,0,1,20210101,
83020,CPT,HEMOGLOBIN ELECTROPHORESIS,,30,,,$240.49,$0.00,1,0,1,20210101,
83021,CPT,HEMOGLOBIN CHROMOTOGRAPHY,,30,,,$191.58,$0.00,1,0,1,20210101,
83026,CPT,HEMOGLOBIN COPPER SULFATE,,30,,,$36.60,$0.00,1,0,1,20210101,
83030,CPT,FETAL HEMOGLOBIN CHEMICAL,,30,,,$243.69,$0.00,1,0,1,20210101,
83033,CPT,FETAL HEMOGLOBIN ASSAY QUAL,,30,,,$240.98,$0.00,1,0,1,20210101,
83036,CPT,GLYCOSYLATED HEMOGLOBIN TEST,,30,,,$151.86,$0.00,1,0,1,20210101,
83037,CPT,GLYCOSYLATED HB HOME DEVICE,,30,,,$97.77,$0.00,1,0,1,20210101,
83045,CPT,BLOOD METHEMOGLOBIN TEST,,30,,,$162.29,$0.00,1,0,1,20210101,
83050,CPT,BLOOD METHEMOGLOBIN ASSAY,,30,,,$130.57,$0.00,1,0,1,20210101,
83051,CPT,ASSAY OF PLASMA HEMOGLOBIN,,30,,,$166.05,$0.00,1,0,1,20210101,
83060,CPT,BLOOD SULFHEMOGLOBIN ASSAY,,30,,,$165.08,$0.00,1,0,1,20210101,
83065,CPT,ASSAY OF HEMOGLOBIN HEAT,,30,,,$44.70,$0.00,1,0,1,20210101,
83068,CPT,HEMOGLOBIN STABILITY SCREEN,,30,,,$176.12,$0.00,1,0,1,20210101,
83069,CPT,ASSAY OF URINE HEMOGLOBIN,,30,,,$62.48,$0.00,1,0,1,20210101,
83070,CPT,ASSAY OF HEMOSIDERIN QUAL,,30,,,$122.07,$0.00,1,0,1,20210101,
83080,CPT,ASSAY OF B HEXOSAMINIDASE,,30,,,$494.59,$0.00,1,0,1,20210101,
83088,CPT,ASSAY OF HISTAMINE,,30,,,$397.97,$0.00,1,0,1,20210101,
83090,CPT,ASSAY OF HOMOCYSTINE,,30,,,$259.58,$0.00,1,0,1,20210101,
83150,CPT,ASSAY OF HOMOVANILLIC ACID,,30,,,$198.96,$0.00,1,0,1,20210101,
83491,CPT,ASSAY OF CORTICOSTEROIDS 17,,30,,,$305.34,$0.00,1,0,1,20210101,
83497,CPT,ASSAY OF 5-HIAA,,30,,,$193.59,$0.00,1,0,1,20210101,
83498,CPT,ASSAY OF PROGESTERONE 17-D,,30,,,$296.12,$0.00,1,0,1,20210101,
83500,CPT,ASSAY FREE HYDROXYPROLINE,,30,,,$315.90,$0.00,1,0,1,20210101,
83505,CPT,ASSAY TOTAL HYDROXYPROLINE,,30,,,$360.27,$0.00,1,0,1,20210101,
83516,CPT,IMMUNOASSAY NONANTIBODY,,30,,,$165.15,$0.00,1,0,1,20210101,
83518,CPT,IMMUNOASSAY DIPSTICK,,30,,,$81.58,$0.00,1,0,1,20210101,
83519,CPT,RIA NONANTIBODY,,30,,,$278.93,$0.00,1,0,1,20210101,
83520,CPT,IMMUNOASSAY QUANT NOS NONAB,,30,,,$226.56,$0.00,1,0,1,20210101,
83525,CPT,ASSAY OF INSULIN,,30,,,$153.65,$0.00,1,0,1,20210101,
83527,CPT,ASSAY OF INSULIN,,30,,,$183.89,$0.00,1,0,1,20210101,
83528,CPT,ASSAY OF INTRINSIC FACTOR,,30,,,$279.31,$0.00,1,0,1,20210101,
83540,CPT,ASSAY OF IRON,,30,,,$177.40,$0.00,1,0,1,20210101,
83550,CPT,IRON BINDING TEST,,30,,,$222.80,$0.00,1,0,1,20210101,
83570,CPT,ASSAY OF IDH ENZYME,,30,,,$143.01,$0.00,1,0,1,20210101,
83582,CPT,ASSAY OF KETOGENIC STEROIDS,,30,,,$261.43,$0.00,1,0,1,20210101,
83586,CPT,ASSAY 17- KETOSTEROIDS,,30,,,$243.98,$0.00,1,0,1,20210101,
83593,CPT,FRACTIONATION KETOSTEROIDS,,30,,,$378.74,$0.00,1,0,1,20210101,
83605,CPT,ASSAY OF LACTIC ACID,,30,,,$231.85,$0.00,1,0,1,20210101,
83615,CPT,LACTATE (LD) (LDH) ENZYME,,30,,,$118.84,$0.00,1,0,1,20210101,
83625,CPT,ASSAY OF LDH ENZYMES,,30,,,$194.11,$0.00,1,0,1,20210101,
83630,CPT,LACTOFERRIN FECAL (QUAL),,30,,,$184.03,$0.00,1,0,1,20210101,
83631,CPT,LACTOFERRIN FECAL (QUANT),,30,,,$308.95,$0.00,1,0,1,20210101,
83632,CPT,PLACENTAL LACTOGEN,,30,,,$322.88,$0.00,1,0,1,20210101,
83633,CPT,TEST URINE FOR LACTOSE,,30,,,$147.48,$0.00,1,0,1,20210101,
83655,CPT,ASSAY OF LEAD,,30,,,$139.08,$0.00,1,0,1,20210101,
83661,CPT,L/S RATIO FETAL LUNG,,30,,,$339.64,$0.00,1,0,1,20210101,
83662,CPT,FOAM STABILITY FETAL LUNG,,30,,,$310.59,$0.00,1,0,1,20210101,
83663,CPT,FLUORO POLARIZE FETAL LUNG,,30,,,$310.59,$0.00,1,0,1,20210101,
83664,CPT,LAMELLAR BDY FETAL LUNG,,30,,,$230.13,$0.00,1,0,1,20210101,
83670,CPT,ASSAY OF LAP ENZYME,,30,,,$336.28,$0.00,1,0,1,20210101,
83690,CPT,ASSAY OF LIPASE,,30,,,$221.49,$0.00,1,0,1,20210101,
83695,CPT,ASSAY OF LIPOPROTEIN(A),,30,,,$149.90,$0.00,1,0,1,20210101,
83698,CPT,ASSAY LIPOPROTEIN PLA2,,30,,,$407.56,$0.00,1,0,1,20210101,
83700,CPT,LIPOPRO BLD ELECTROPHORETIC,,30,,,$229.67,$0.00,1,0,1,20210101,
83701,CPT,LIPOPROTEIN BLD HR FRACTION,,30,,,$198.66,$0.00,1,0,1,20210101,
83704,CPT,LIPOPROTEIN BLD QUAN PART,,30,,,$255.42,$0.00,1,0,1,20210101,
83718,CPT,ASSAY OF LIPOPROTEIN,,30,,,$141.29,$0.00,1,0,1,20210101,
83719,CPT,ASSAY OF BLOOD LIPOPROTEIN,,30,,,$219.84,$0.00,1,0,1,20210101,
83721,CPT,ASSAY OF BLOOD LIPOPROTEIN,,30,,,$126.40,$0.00,1,0,1,20210101,
83722,CPT,LIPOPRTN DIR MEAS SD LDL CHL,,30,,,$192.20,$0.00,1,0,1,20210101,
83727,CPT,ASSAY OF LRH HORMONE,,30,,,$599.45,$0.00,1,0,1,20210101,
83735,CPT,ASSAY OF MAGNESIUM,,30,,,$164.00,$0.00,1,0,1,20210101,
83775,CPT,ASSAY MALATE DEHYDROGENASE,,30,,,$176.52,$0.00,1,0,1,20210101,
83785,CPT,ASSAY OF MANGANESE,,30,,,$256.93,$0.00,1,0,1,20210101,
83789,CPT,MASS SPECTROMETRY QUAL/QUAN,,30,,,$299.95,$0.00,1,0,1,20210101,
83825,CPT,ASSAY OF MERCURY,,30,,,$172.35,$0.00,1,0,1,20210101,
83835,CPT,ASSAY OF METANEPHRINES,,30,,,$297.09,$0.00,1,0,1,20210101,
83857,CPT,ASSAY OF METHEMALBUMIN,,30,,,$221.21,$0.00,1,0,1,20210101,
83861,CPT,MICROFLUID ANALY TEARS,,30,,,$129.29,$0.00,1,0,1,20210101,
83864,CPT,MUCOPOLYSACCHARIDES,,30,,,$513.29,$0.00,1,0,1,20210101,
83872,CPT,ASSAY SYNOVIAL FLUID MUCIN,,30,,,$91.47,$0.00,1,0,1,20210101,
83873,CPT,ASSAY OF CSF PROTEIN,,30,,,$273.32,$0.00,1,0,1,20210101,
83874,CPT,ASSAY OF MYOGLOBIN,,30,,,$252.07,$0.00,1,0,1,20210101,
83876,CPT,ASSAY MYELOPEROXIDASE,,30,,,$293.59,$0.00,1,0,1,20210101,
83880,CPT,ASSAY OF NATRIURETIC PEPTIDE,,30,,,$398.75,$0.00,1,0,1,20210101,
83883,CPT,ASSAY NEPHELOMETRY NOT SPEC,,30,,,$174.65,$0.00,1,0,1,20210101,
83885,CPT,ASSAY OF NICKEL,,30,,,$257.59,$0.00,1,0,1,20210101,
83915,CPT,ASSAY OF NUCLEOTIDASE,,30,,,$162.23,$0.00,1,0,1,20210101,
83916,CPT,OLIGOCLONAL BANDS,,30,,,$273.88,$0.00,1,0,1,20210101,
83918,CPT,ORGANIC ACIDS TOTAL QUANT,,30,,,$564.91,$0.00,1,0,1,20210101,
83919,CPT,ORGANIC ACIDS QUAL EACH,,30,,,$477.05,$0.00,1,0,1,20210101,
83921,CPT,ORGANIC ACID SINGLE QUANT,,30,,,$271.24,$0.00,1,0,1,20210101,
83930,CPT,ASSAY OF BLOOD OSMOLALITY,,30,,,$155.35,$0.00,1,0,1,20210101,
83935,CPT,ASSAY OF URINE OSMOLALITY,,30,,,$147.76,$0.00,1,0,1,20210101,
83937,CPT,ASSAY OF OSTEOCALCIN,,30,,,$294.22,$0.00,1,0,1,20210101,
83945,CPT,ASSAY OF OXALATE,,30,,,$158.42,$0.00,1,0,1,20210101,
83950,CPT,ONCOPROTEIN HER-2/NEU,,30,,,"$1,158.14",$0.00,1,0,1,20210101,
83951,CPT,ONCOPROTEIN DCP,,30,,,$484.08,$0.00,1,0,1,20210101,
83970,CPT,ASSAY OF PARATHORMONE,,30,,,"$1,008.37",$0.00,1,0,1,20210101,
83986,CPT,ASSAY PH BODY FLUID NOS,,30,,,$86.60,$0.00,1,0,1,20210101,
83987,CPT,EXHALED BREATH CONDENSATE,,30,,,$272.84,$0.00,1,0,1,20210101,
83992,CPT,ASSAY FOR PHENCYCLIDINE,,30,,,$155.45,$0.00,1,0,1,20210101,
83993,CPT,ASSAY FOR CALPROTECTIN FECAL,,30,,,$387.88,$0.00,1,0,1,20210101,
84030,CPT,ASSAY OF BLOOD PKU,,30,,,$236.06,$0.00,1,0,1,20210101,
84035,CPT,ASSAY OF PHENYLKETONES,,30,,,$115.72,$0.00,1,0,1,20210101,
84060,CPT,ASSAY ACID PHOSPHATASE,,30,,,$220.33,$0.00,1,0,1,20210101,
84066,CPT,ASSAY PROSTATE PHOSPHATASE,,30,,,$181.21,$0.00,1,0,1,20210101,
84075,CPT,ASSAY ALKALINE PHOSPHATASE,,30,,,$150.79,$0.00,1,0,1,20210101,
84078,CPT,ASSAY ALKALINE PHOSPHATASE,,30,,,$197.33,$0.00,1,0,1,20210101,
84080,CPT,ASSAY ALKALINE PHOSPHATASES,,30,,,$184.31,$0.00,1,0,1,20210101,
84081,CPT,ASSAY PHOSPHATIDYLGLYCEROL,,30,,,$220.06,$0.00,1,0,1,20210101,
84085,CPT,ASSAY OF RBC PG6D ENZYME,,30,,,$166.47,$0.00,1,0,1,20210101,
84087,CPT,ASSAY PHOSPHOHEXOSE ENZYMES,,30,,,$345.97,$0.00,1,0,1,20210101,
84100,CPT,ASSAY OF PHOSPHORUS,,30,,,$138.56,$0.00,1,0,1,20210101,
84105,CPT,ASSAY OF URINE PHOSPHORUS,,30,,,$93.20,$0.00,1,0,1,20210101,
84106,CPT,TEST FOR PORPHOBILINOGEN,,30,,,$121.76,$0.00,1,0,1,20210101,
84110,CPT,ASSAY OF PORPHOBILINOGEN,,30,,,$162.25,$0.00,1,0,1,20210101,
84112,CPT,EVAL AMNIOTIC FLUID PROTEIN,,30,,,$460.75,$0.00,1,0,1,20210101,
84119,CPT,TEST URINE FOR PORPHYRINS,,30,,,$207.81,$0.00,1,0,1,20210101,
84120,CPT,ASSAY OF URINE PORPHYRINS,,30,,,$258.39,$0.00,1,0,1,20210101,
84126,CPT,ASSAY OF FECES PORPHYRINS,,30,,,$367.46,$0.00,1,0,1,20210101,
84132,CPT,ASSAY OF SERUM POTASSIUM,,30,,,$130.57,$0.00,1,0,1,20210101,
84133,CPT,ASSAY OF URINE POTASSIUM,,30,,,$103.18,$0.00,1,0,1,20210101,
84134,CPT,ASSAY OF PREALBUMIN,,30,,,$209.70,$0.00,1,0,1,20210101,
84135,CPT,ASSAY OF PREGNANEDIOL,,30,,,$312.83,$0.00,1,0,1,20210101,
84138,CPT,ASSAY OF PREGNANETRIOL,,30,,,$310.59,$0.00,1,0,1,20210101,
84140,CPT,ASSAY OF PREGNENOLONE,,30,,,$227.49,$0.00,1,0,1,20210101,
84143,CPT,ASSAY OF 17-HYDROXYPREGNENO,,30,,,$269.56,$0.00,1,0,1,20210101,
84144,CPT,ASSAY OF PROGESTERONE,,30,,,$246.83,$0.00,1,0,1,20210101,
84145,CPT,PROCALCITONIN (PCT),,30,,,$350.23,$0.00,1,0,1,20210101,
84146,CPT,ASSAY OF PROLACTIN,,30,,,$275.64,$0.00,1,0,1,20210101,
84150,CPT,ASSAY OF PROSTAGLANDIN,,30,,,$756.66,$0.00,1,0,1,20210101,
84152,CPT,ASSAY OF PSA COMPLEXED,,30,,,$264.99,$0.00,1,0,1,20210101,
84153,CPT,ASSAY OF PSA TOTAL,,30,,,$226.34,$0.00,1,0,1,20210101,
84154,CPT,ASSAY OF PSA FREE,,30,,,$185.82,$0.00,1,0,1,20210101,
84155,CPT,ASSAY OF PROTEIN SERUM,,30,,,$109.91,$0.00,1,0,1,20210101,
84156,CPT,ASSAY OF PROTEIN URINE,,30,,,$110.07,$0.00,1,0,1,20210101,
84157,CPT,ASSAY OF PROTEIN OTHER,,30,,,$141.07,$0.00,1,0,1,20210101,
84160,CPT,ASSAY OF PROTEIN ANY SOURCE,,30,,,$58.83,$0.00,1,0,1,20210101,
84163,CPT,PAPPA SERUM,,30,,,$254.94,$0.00,1,0,1,20210101,
84165,CPT,PROTEIN E-PHORESIS SERUM,,30,,,$189.77,$0.00,1,0,1,20210101,
84166,CPT,PROTEIN E-PHORESIS/URINE/CSF,,30,,,$220.55,$0.00,1,0,1,20210101,
84181,CPT,WESTERN BLOT TEST,,30,,,$408.12,$0.00,1,0,1,20210101,
84182,CPT,PROTEIN WESTERN BLOT TEST,,30,,,$351.95,$0.00,1,0,1,20210101,
84202,CPT,ASSAY RBC PROTOPORPHYRIN,,30,,,$225.81,$0.00,1,0,1,20210101,
84203,CPT,TEST RBC PROTOPORPHYRIN,,30,,,$146.33,$0.00,1,0,1,20210101,
84206,CPT,ASSAY OF PROINSULIN,,30,,,$288.81,$0.00,1,0,1,20210101,
84207,CPT,ASSAY OF VITAMIN B-6,,30,,,$260.50,$0.00,1,0,1,20210101,
84210,CPT,ASSAY OF PYRUVATE,,30,,,$249.57,$0.00,1,0,1,20210101,
84220,CPT,ASSAY OF PYRUVATE KINASE,,30,,,$264.55,$0.00,1,0,1,20210101,
84228,CPT,ASSAY OF QUININE,,30,,,$231.22,$0.00,1,0,1,20210101,
84233,CPT,ASSAY OF ESTROGEN,,30,,,"$1,181.75",$0.00,1,0,1,20210101,
84234,CPT,ASSAY OF PROGESTERONE,,30,,,$875.94,$0.00,1,0,1,20210101,
84235,CPT,ASSAY OF ENDOCRINE HORMONE,,30,,,$873.89,$0.00,1,0,1,20210101,
84238,CPT,ASSAY NONENDOCRINE RECEPTOR,,30,,,$410.83,$0.00,1,0,1,20210101,
84244,CPT,ASSAY OF RENIN,,30,,,$246.08,$0.00,1,0,1,20210101,
84252,CPT,ASSAY OF VITAMIN B-2,,30,,,$279.01,$0.00,1,0,1,20210101,
84255,CPT,ASSAY OF SELENIUM,,30,,,$251.73,$0.00,1,0,1,20210101,
84260,CPT,ASSAY OF SEROTONIN,,30,,,$363.66,$0.00,1,0,1,20210101,
84270,CPT,ASSAY OF SEX HORMONE GLOBUL,,30,,,$170.13,$0.00,1,0,1,20210101,
84275,CPT,ASSAY OF SIALIC ACID,,30,,,$270.11,$0.00,1,0,1,20210101,
84285,CPT,ASSAY OF SILICA,,30,,,$354.00,$0.00,1,0,1,20210101,
84295,CPT,ASSAY OF SERUM SODIUM,,30,,,$110.22,$0.00,1,0,1,20210101,
84300,CPT,ASSAY OF URINE SODIUM,,30,,,$109.00,$0.00,1,0,1,20210101,
84302,CPT,ASSAY OF SWEAT SODIUM,,30,,,$95.50,$0.00,1,0,1,20210101,
84305,CPT,ASSAY OF SOMATOMEDIN,,30,,,$265.75,$0.00,1,0,1,20210101,
84307,CPT,ASSAY OF SOMATOSTATIN,,30,,,$455.98,$0.00,1,0,1,20210101,
84311,CPT,SPECTROPHOTOMETRY,,30,,,$136.39,$0.00,1,0,1,20210101,
84315,CPT,BODY FLUID SPECIFIC GRAVITY,,30,,,$70.13,$0.00,1,0,1,20210101,
84375,CPT,CHROMATOGRAM ASSAY SUGARS,,30,,,$495.36,$0.00,1,0,1,20210101,
84376,CPT,SUGARS SINGLE QUAL,,30,,,$146.85,$0.00,1,0,1,20210101,
84377,CPT,SUGARS MULTIPLE QUAL,,30,,,$142.14,$0.00,1,0,1,20210101,
84378,CPT,SUGARS SINGLE QUANT,,30,,,$199.29,$0.00,1,0,1,20210101,
84379,CPT,SUGARS MULTIPLE QUANT,,30,,,$134.74,$0.00,1,0,1,20210101,
84392,CPT,ASSAY OF URINE SULFATE,,30,,,$78.80,$0.00,1,0,1,20210101,
84402,CPT,ASSAY OF FREE TESTOSTERONE,,30,,,$259.56,$0.00,1,0,1,20210101,
84403,CPT,ASSAY OF TOTAL TESTOSTERONE,,30,,,$277.73,$0.00,1,0,1,20210101,
84410,CPT,TESTOSTERONE BIOAVAILABLE,,30,,,$336.43,$0.00,1,0,1,20210101,
84425,CPT,ASSAY OF VITAMIN B-1,,30,,,$216.97,$0.00,1,0,1,20210101,
84430,CPT,ASSAY OF THIOCYANATE,,30,,,$193.74,$0.00,1,0,1,20210101,
84431,CPT,THROMBOXANE URINE,,30,,,$314.71,$0.00,1,0,1,20210101,
84432,CPT,ASSAY OF THYROGLOBULIN,,30,,,$197.53,$0.00,1,0,1,20210101,
84436,CPT,ASSAY OF TOTAL THYROXINE,,30,,,$136.86,$0.00,1,0,1,20210101,
84437,CPT,ASSAY OF NEONATAL THYROXINE,,30,,,$94.98,$0.00,1,0,1,20210101,
84439,CPT,ASSAY OF FREE THYROXINE,,30,,,$176.02,$0.00,1,0,1,20210101,
84442,CPT,ASSAY OF THYROID ACTIVITY,,30,,,$206.51,$0.00,1,0,1,20210101,
84443,CPT,ASSAY THYROID STIM HORMONE,,30,,,$238.43,$0.00,1,0,1,20210101,
84445,CPT,ASSAY OF TSI GLOBULIN,,30,,,$455.58,$0.00,1,0,1,20210101,
84446,CPT,ASSAY OF VITAMIN E,,30,,,$174.92,$0.00,1,0,1,20210101,
84449,CPT,ASSAY OF TRANSCORTIN,,30,,,$230.16,$0.00,1,0,1,20210101,
84450,CPT,TRANSFERASE (AST) (SGOT),,30,,,$104.10,$0.00,1,0,1,20210101,
84460,CPT,ALANINE AMINO (ALT) (SGPT),,30,,,$109.56,$0.00,1,0,1,20210101,
84466,CPT,ASSAY OF TRANSFERRIN,,30,,,$313.74,$0.00,1,0,1,20210101,
84478,CPT,ASSAY OF TRIGLYCERIDES,,30,,,$122.33,$0.00,1,0,1,20210101,
84479,CPT,ASSAY OF THYROID (T3 OR T4),,30,,,$129.53,$0.00,1,0,1,20210101,
84480,CPT,ASSAY TRIIODOTHYRONINE (T3),,30,,,$197.73,$0.00,1,0,1,20210101,
84481,CPT,FREE ASSAY (FT-3),,30,,,$226.52,$0.00,1,0,1,20210101,
84482,CPT,T3 REVERSE,,30,,,$212.68,$0.00,1,0,1,20210101,
84484,CPT,ASSAY OF TROPONIN QUANT,,30,,,$310.36,$0.00,1,0,1,20210101,
84485,CPT,ASSAY DUODENAL FLUID TRYPSIN,,30,,,$177.69,$0.00,1,0,1,20210101,
84488,CPT,TEST FECES FOR TRYPSIN,,30,,,$151.92,$0.00,1,0,1,20210101,
84490,CPT,ASSAY OF FECES FOR TRYPSIN,,30,,,$179.88,$0.00,1,0,1,20210101,
84510,CPT,ASSAY OF TYROSINE,,30,,,$188.39,$0.00,1,0,1,20210101,
84512,CPT,ASSAY OF TROPONIN QUAL,,30,,,$237.90,$0.00,1,0,1,20210101,
84520,CPT,ASSAY OF UREA NITROGEN,,30,,,$115.42,$0.00,1,0,1,20210101,
84525,CPT,UREA NITROGEN SEMI-QUANT,,30,,,$129.35,$0.00,1,0,1,20210101,
84540,CPT,ASSAY OF URINE/UREA-N,,30,,,$104.00,$0.00,1,0,1,20210101,
84545,CPT,UREA-N CLEARANCE TEST,,30,,,$199.58,$0.00,1,0,1,20210101,
84550,CPT,ASSAY OF BLOOD/URIC ACID,,30,,,$101.13,$0.00,1,0,1,20210101,
84560,CPT,ASSAY OF URINE/URIC ACID,,30,,,$102.15,$0.00,1,0,1,20210101,
84577,CPT,ASSAY OF FECES/UROBILINOGEN,,30,,,$241.32,$0.00,1,0,1,20210101,
84578,CPT,TEST URINE UROBILINOGEN,,30,,,$63.70,$0.00,1,0,1,20210101,
84580,CPT,ASSAY OF URINE UROBILINOGEN,,30,,,$276.40,$0.00,1,0,1,20210101,
84583,CPT,ASSAY OF URINE UROBILINOGEN,,30,,,$139.66,$0.00,1,0,1,20210101,
84585,CPT,ASSAY OF URINE VMA,,30,,,$238.44,$0.00,1,0,1,20210101,
84586,CPT,ASSAY OF VIP,,30,,,$425.71,$0.00,1,0,1,20210101,
84588,CPT,ASSAY OF VASOPRESSIN,,30,,,$333.14,$0.00,1,0,1,20210101,
84590,CPT,ASSAY OF VITAMIN A,,30,,,$175.86,$0.00,1,0,1,20210101,
84591,CPT,ASSAY OF NOS VITAMIN,,30,,,$265.31,$0.00,1,0,1,20210101,
84597,CPT,ASSAY OF VITAMIN K,,30,,,$280.23,$0.00,1,0,1,20210101,
84600,CPT,ASSAY OF VOLATILES,,30,,,$258.54,$0.00,1,0,1,20210101,
84620,CPT,XYLOSE TOLERANCE TEST,,30,,,$204.47,$0.00,1,0,1,20210101,
84630,CPT,ASSAY OF ZINC,,30,,,$142.94,$0.00,1,0,1,20210101,
84681,CPT,ASSAY OF C-PEPTIDE,,30,,,$217.67,$0.00,1,0,1,20210101,
84702,CPT,CHORIONIC GONADOTROPIN TEST,,30,,,$329.05,$0.00,1,0,1,20210101,
84703,CPT,CHORIONIC GONADOTROPIN ASSAY,,30,,,$230.88,$0.00,1,0,1,20210101,
84704,CPT,HCG FREE BETACHAIN TEST,,30,,,$234.71,$0.00,1,0,1,20210101,
84830,CPT,OVULATION TESTS,,30,,,$212.27,$0.00,1,0,1,20210101,
84999,CPT,CLINICAL CHEMISTRY TEST,,30,,,$654.98,$0.00,1,0,1,20210101,
85002,CPT,BLEEDING TIME TEST,,30,,,$198.87,$0.00,1,0,1,20210101,
85004,CPT,AUTOMATED DIFF WBC COUNT,,30,,,$93.18,$0.00,1,0,1,20210101,
85007,CPT,BL SMEAR W/DIFF WBC COUNT,,30,,,$84.54,$0.00,1,0,1,20210101,
85008,CPT,BL SMEAR W/O DIFF WBC COUNT,,30,,,$69.28,$0.00,1,0,1,20210101,
85009,CPT,MANUAL DIFF WBC COUNT B-COAT,,30,,,$83.16,$0.00,1,0,1,20210101,
85013,CPT,SPUN MICROHEMATOCRIT,,30,,,$53.48,$0.00,1,0,1,20210101,
85014,CPT,HEMATOCRIT,,30,,,$76.89,$0.00,1,0,1,20210101,
85018,CPT,HEMOGLOBIN,,30,,,$84.67,$0.00,1,0,1,20210101,
85025,CPT,COMPLETE CBC W/AUTO DIFF WBC,,30,,,$174.91,$0.00,1,0,1,20210101,
85027,CPT,COMPLETE CBC AUTOMATED,,30,,,$176.42,$0.00,1,0,1,20210101,
85032,CPT,MANUAL CELL COUNT EACH,,30,,,$143.08,$0.00,1,0,1,20210101,
85041,CPT,AUTOMATED RBC COUNT,,30,,,$54.33,$0.00,1,0,1,20210101,
85044,CPT,MANUAL RETICULOCYTE COUNT,,30,,,$100.04,$0.00,1,0,1,20210101,
85045,CPT,AUTOMATED RETICULOCYTE COUNT,,30,,,$94.32,$0.00,1,0,1,20210101,
85046,CPT,RETICYTE/HGB CONCENTRATE,,30,,,$149.43,$0.00,1,0,1,20210101,
85048,CPT,AUTOMATED LEUKOCYTE COUNT,,30,,,$46.28,$0.00,1,0,1,20210101,
85049,CPT,AUTOMATED PLATELET COUNT,,30,,,$115.32,$0.00,1,0,1,20210101,
85055,CPT,RETICULATED PLATELET ASSAY,,30,,,$182.22,$0.00,1,0,1,20210101,
85060,CPT,BLOOD SMEAR INTERPRETATION,,30,,,$181.80,$0.00,1,0,1,20210101,
85097,CPT,BONE MARROW INTERPRETATION,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
85130,CPT,CHROMOGENIC SUBSTRATE ASSAY,,30,,,$287.07,$0.00,1,0,1,20210101,
85170,CPT,BLOOD CLOT RETRACTION,,30,,,$114.47,$0.00,1,0,1,20210101,
85175,CPT,BLOOD CLOT LYSIS TIME,,30,,,$162.61,$0.00,1,0,1,20210101,
85210,CPT,CLOT FACTOR II PROTHROM SPEC,,30,,,$253.52,$0.00,1,0,1,20210101,
85220,CPT,BLOOC CLOT FACTOR V TEST,,30,,,$440.64,$0.00,1,0,1,20210101,
85230,CPT,CLOT FACTOR VII PROCONVERTIN,,30,,,$465.30,$0.00,1,0,1,20210101,
85240,CPT,CLOT FACTOR VIII AHG 1 STAGE,,30,,,$391.77,$0.00,1,0,1,20210101,
85244,CPT,CLOT FACTOR VIII RELTD ANTGN,,30,,,$486.19,$0.00,1,0,1,20210101,
85245,CPT,CLOT FACTOR VIII VW RISTOCTN,,30,,,$426.30,$0.00,1,0,1,20210101,
85246,CPT,CLOT FACTOR VIII VW ANTIGEN,,30,,,$397.61,$0.00,1,0,1,20210101,
85247,CPT,CLOT FACTOR VIII MULTIMETRIC,,30,,,$392.31,$0.00,1,0,1,20210101,
85250,CPT,CLOT FACTOR IX PTC/CHRSTMAS,,30,,,$457.93,$0.00,1,0,1,20210101,
85260,CPT,CLOT FACTOR X STUART-POWER,,30,,,$408.62,$0.00,1,0,1,20210101,
85270,CPT,CLOT FACTOR XI PTA,,30,,,$438.45,$0.00,1,0,1,20210101,
85280,CPT,CLOT FACTOR XII HAGEMAN,,30,,,$420.27,$0.00,1,0,1,20210101,
85290,CPT,CLOT FACTOR XIII FIBRIN STAB,,30,,,$399.20,$0.00,1,0,1,20210101,
85291,CPT,CLOT FACTOR XIII FIBRIN SCRN,,30,,,$210.01,$0.00,1,0,1,20210101,
85292,CPT,CLOT FACTOR FLETCHER FACT,,30,,,$464.77,$0.00,1,0,1,20210101,
85293,CPT,CLOT FACTOR WGHT KININOGEN,,30,,,$310.59,$0.00,1,0,1,20210101,
85300,CPT,ANTITHROMBIN III ACTIVITY,,30,,,$281.31,$0.00,1,0,1,20210101,
85301,CPT,ANTITHROMBIN III ANTIGEN,,30,,,$233.30,$0.00,1,0,1,20210101,
85302,CPT,CLOT INHIBIT PROT C ANTIGEN,,30,,,$267.38,$0.00,1,0,1,20210101,
85303,CPT,CLOT INHIBIT PROT C ACTIVITY,,30,,,$339.28,$0.00,1,0,1,20210101,
85305,CPT,CLOT INHIBIT PROT S TOTAL,,30,,,$288.26,$0.00,1,0,1,20210101,
85306,CPT,CLOT INHIBIT PROT S FREE,,30,,,$315.55,$0.00,1,0,1,20210101,
85307,CPT,ASSAY ACTIVATED PROTEIN C,,30,,,$349.16,$0.00,1,0,1,20210101,
85335,CPT,FACTOR INHIBITOR TEST,,30,,,$425.62,$0.00,1,0,1,20210101,
85337,CPT,THROMBOMODULIN,,30,,,$216.74,$0.00,1,0,1,20210101,
85345,CPT,COAGULATION TIME LEE & WHITE,,30,,,$149.41,$0.00,1,0,1,20210101,
85347,CPT,COAGULATION TIME ACTIVATED,,30,,,$151.59,$0.00,1,0,1,20210101,
85348,CPT,COAGULATION TIME OTR METHOD,,30,,,$201.18,$0.00,1,0,1,20210101,
85360,CPT,EUGLOBULIN LYSIS,,30,,,$176.28,$0.00,1,0,1,20210101,
85362,CPT,FIBRIN DEGRADATION PRODUCTS,,30,,,$224.04,$0.00,1,0,1,20210101,
85366,CPT,FIBRINOGEN TEST,,30,,,$148.93,$0.00,1,0,1,20210101,
85370,CPT,FIBRINOGEN TEST,,30,,,$183.60,$0.00,1,0,1,20210101,
85378,CPT,FIBRIN DEGRADE SEMIQUANT,,30,,,$239.50,$0.00,1,0,1,20210101,
85379,CPT,FIBRIN DEGRADATION QUANT,,30,,,$281.46,$0.00,1,0,1,20210101,
85380,CPT,FIBRIN DEGRADJ D-DIMER,,30,,,$278.20,$0.00,1,0,1,20210101,
85384,CPT,FIBRINOGEN ACTIVITY,,30,,,$207.17,$0.00,1,0,1,20210101,
85385,CPT,FIBRINOGEN ANTIGEN,,30,,,$210.98,$0.00,1,0,1,20210101,
85390,CPT,FIBRINOLYSINS SCREEN I&R,,30,,,$167.42,$0.00,1,0,1,20210101,
85396,CPT,CLOTTING ASSAY WHOLE BLOOD,,30,,,$377.64,$0.00,1,0,1,20210101,
85397,CPT,CLOTTING FUNCT ACTIVITY,,30,,,$493.79,$0.00,1,0,1,20210101,
85400,CPT,FIBRINOLYTIC PLASMIN,,30,,,$196.63,$0.00,1,0,1,20210101,
85410,CPT,FIBRINOLYTIC ANTIPLASMIN,,30,,,$326.24,$0.00,1,0,1,20210101,
85415,CPT,FIBRINOLYTIC PLASMINOGEN,,30,,,$337.61,$0.00,1,0,1,20210101,
85420,CPT,FIBRINOLYTIC PLASMINOGEN,,30,,,$258.49,$0.00,1,0,1,20210101,
85421,CPT,FIBRINOLYTIC PLASMINOGEN,,30,,,$213.26,$0.00,1,0,1,20210101,
85441,CPT,HEINZ BODIES DIRECT,,30,,,$126.25,$0.00,1,0,1,20210101,
85445,CPT,HEINZ BODIES INDUCED,,30,,,$167.59,$0.00,1,0,1,20210101,
85460,CPT,HEMOGLOBIN FETAL,,30,,,$276.16,$0.00,1,0,1,20210101,
85461,CPT,HEMOGLOBIN FETAL,,30,,,$201.40,$0.00,1,0,1,20210101,
85475,CPT,HEMOLYSIN ACID,,30,,,$196.61,$0.00,1,0,1,20210101,
85520,CPT,HEPARIN ASSAY,,30,,,$310.68,$0.00,1,0,1,20210101,
85525,CPT,HEPARIN NEUTRALIZATION,,30,,,$243.53,$0.00,1,0,1,20210101,
85530,CPT,HEPARIN-PROTAMINE TOLERANCE,,30,,,$261.20,$0.00,1,0,1,20210101,
85536,CPT,IRON STAIN PERIPHERAL BLOOD,,30,,,$162.70,$0.00,1,0,1,20210101,
85540,CPT,WBC ALKALINE PHOSPHATASE,,30,,,$230.61,$0.00,1,0,1,20210101,
85547,CPT,RBC MECHANICAL FRAGILITY,,30,,,$193.28,$0.00,1,0,1,20210101,
85549,CPT,MURAMIDASE,,30,,,$237.04,$0.00,1,0,1,20210101,
85555,CPT,RBC OSMOTIC FRAGILITY,,30,,,$263.13,$0.00,1,0,1,20210101,
85557,CPT,RBC OSMOTIC FRAGILITY,,30,,,$330.24,$0.00,1,0,1,20210101,
85576,CPT,BLOOD PLATELET AGGREGATION,,30,,,$284.21,$0.00,1,0,1,20210101,
85597,CPT,PHOSPHOLIPID PLTLT NEUTRALIZ,,30,,,$247.04,$0.00,1,0,1,20210101,
85598,CPT,HEXAGNAL PHOSPH PLTLT NEUTRL,,30,,,$242.78,$0.00,1,0,1,20210101,
85610,CPT,PROTHROMBIN TIME,,30,,,$123.84,$0.00,1,0,1,20210101,
85611,CPT,PROTHROMBIN TEST,,30,,,$118.04,$0.00,1,0,1,20210101,
85612,CPT,VIPER VENOM PROTHROMBIN TIME,,30,,,$193.59,$0.00,1,0,1,20210101,
85613,CPT,RUSSELL VIPER VENOM DILUTED,,30,,,$166.59,$0.00,1,0,1,20210101,
85635,CPT,REPTILASE TEST,,30,,,$236.44,$0.00,1,0,1,20210101,
85651,CPT,RBC SED RATE NONAUTOMATED,,30,,,$113.70,$0.00,1,0,1,20210101,
85652,CPT,RBC SED RATE AUTOMATED,,30,,,$87.72,$0.00,1,0,1,20210101,
85660,CPT,RBC SICKLE CELL TEST,,30,,,$130.71,$0.00,1,0,1,20210101,
85670,CPT,THROMBIN TIME PLASMA,,30,,,$136.71,$0.00,1,0,1,20210101,
85675,CPT,THROMBIN TIME TITER,,30,,,$168.75,$0.00,1,0,1,20210101,
85705,CPT,THROMBOPLASTIN INHIBITION,,30,,,$178.14,$0.00,1,0,1,20210101,
85730,CPT,THROMBOPLASTIN TIME PARTIAL,,30,,,$184.89,$0.00,1,0,1,20210101,
85732,CPT,THROMBOPLASTIN TIME PARTIAL,,30,,,$158.64,$0.00,1,0,1,20210101,
85810,CPT,BLOOD VISCOSITY EXAMINATION,,30,,,$171.15,$0.00,1,0,1,20210101,
85999,CPT,HEMATOLOGY PROCEDURE,,30,,,$165.80,$0.00,1,0,1,20210101,
86000,CPT,AGGLUTININS FEBRILE ANTIGEN,,30,,,$184.27,$0.00,1,0,1,20210101,
86001,CPT,ALLERGEN SPECIFIC IGG,,30,,,$65.15,$0.00,1,0,1,20210101,
86003,CPT,ALLG SPEC IGE CRUDE XTRC EA,,30,,,$55.28,$0.00,1,0,1,20210101,
86005,CPT,ALLG SPEC IGE MULTIALLG SCR,,30,,,$99.81,$0.00,1,0,1,20210101,
86008,CPT,ALLG SPEC IGE RECOMB EA,,30,,,$147.71,$0.00,1,0,1,20210101,
86021,CPT,WBC ANTIBODY IDENTIFICATION,,30,,,$284.61,$0.00,1,0,1,20210101,
86022,CPT,PLATELET ANTIBODIES,,30,,,$459.57,$0.00,1,0,1,20210101,
86023,CPT,IMMUNOGLOBULIN ASSAY,,30,,,$214.32,$0.00,1,0,1,20210101,
86038,CPT,ANTINUCLEAR ANTIBODIES,,30,,,$179.08,$0.00,1,0,1,20210101,
86039,CPT,ANTINUCLEAR ANTIBODIES (ANA),,30,,,$159.98,$0.00,1,0,1,20210101,
86060,CPT,ANTISTREPTOLYSIN O TITER,,30,,,$147.64,$0.00,1,0,1,20210101,
86063,CPT,ANTISTREPTOLYSIN O SCREEN,,30,,,$171.92,$0.00,1,0,1,20210101,
86077,CPT,PHYS BLOOD BANK SERV XMATCH,,30,,,$177.03,$0.00,1,0,1,20210101,
86078,CPT,PHYS BLOOD BANK SERV REACTJ,,30,,,$696.68,$0.00,1,0,1,20210101,
86079,CPT,PHYS BLOOD BANK SERV AUTHRJ,,30,,,$332.59,$0.00,1,0,1,20210101,
86140,CPT,C-REACTIVE PROTEIN,,30,,,$141.77,$0.00,1,0,1,20210101,
86141,CPT,C-REACTIVE PROTEIN HS,,30,,,$175.00,$0.00,1,0,1,20210101,
86146,CPT,BETA-2 GLYCOPROTEIN ANTIBODY,,30,,,$177.23,$0.00,1,0,1,20210101,
86147,CPT,CARDIOLIPIN ANTIBODY EA IG,,30,,,$215.52,$0.00,1,0,1,20210101,
86148,CPT,ANTI-PHOSPHOLIPID ANTIBODY,,30,,,$208.05,$0.00,1,0,1,20210101,
86152,CPT,CELL ENUMERATION & ID,,30,,,"$2,132.29",$0.00,1,0,1,20210101,
86153,CPT,CELL ENUMERATION PHYS INTERP,,30,,,$649.93,$0.00,1,0,1,20210101,
86155,CPT,CHEMOTAXIS ASSAY,,30,,,$280.43,$0.00,1,0,1,20210101,
86156,CPT,COLD AGGLUTININ SCREEN,,30,,,$136.45,$0.00,1,0,1,20210101,
86157,CPT,COLD AGGLUTININ TITER,,30,,,$157.32,$0.00,1,0,1,20210101,
86160,CPT,COMPLEMENT ANTIGEN,,30,,,$185.25,$0.00,1,0,1,20210101,
86161,CPT,COMPLEMENT/FUNCTION ACTIVITY,,30,,,$215.84,$0.00,1,0,1,20210101,
86162,CPT,COMPLEMENT TOTAL (CH50),,30,,,$274.88,$0.00,1,0,1,20210101,
86171,CPT,COMPLEMENT FIXATION EACH,,30,,,$152.16,$0.00,1,0,1,20210101,
86200,CPT,CCP ANTIBODY,,30,,,$164.92,$0.00,1,0,1,20210101,
86215,CPT,DEOXYRIBONUCLEASE ANTIBODY,,30,,,$193.09,$0.00,1,0,1,20210101,
86225,CPT,DNA ANTIBODY NATIVE,,30,,,$186.79,$0.00,1,0,1,20210101,
86226,CPT,DNA ANTIBODY SINGLE STRAND,,30,,,$258.28,$0.00,1,0,1,20210101,
86235,CPT,NUCLEAR ANTIGEN ANTIBODY,,30,,,$166.38,$0.00,1,0,1,20210101,
86255,CPT,FLUORESCENT ANTIBODY SCREEN,,30,,,$221.44,$0.00,1,0,1,20210101,
86256,CPT,FLUORESCENT ANTIBODY TITER,,30,,,$187.81,$0.00,1,0,1,20210101,
86277,CPT,GROWTH HORMONE ANTIBODY,,30,,,$174.29,$0.00,1,0,1,20210101,
86280,CPT,HEMAGGLUTINATION INHIBITION,,30,,,$187.65,$0.00,1,0,1,20210101,
86294,CPT,IMMUNOASSAY TUMOR QUAL,,30,,,$159.69,$0.00,1,0,1,20210101,
86300,CPT,IMMUNOASSAY TUMOR CA 15-3,,30,,,$239.13,$0.00,1,0,1,20210101,
86301,CPT,IMMUNOASSAY TUMOR CA 19-9,,30,,,$244.82,$0.00,1,0,1,20210101,
86304,CPT,IMMUNOASSAY TUMOR CA 125,,30,,,$269.86,$0.00,1,0,1,20210101,
86305,CPT,HUMAN EPIDIDYMIS PROTEIN 4,,30,,,$517.00,$0.00,1,0,1,20210101,
86308,CPT,HETEROPHILE ANTIBODY SCREEN,,30,,,$170.16,$0.00,1,0,1,20210101,
86309,CPT,HETEROPHILE ANTIBODY TITER,,30,,,$205.33,$0.00,1,0,1,20210101,
86310,CPT,HETEROPHILE ANTIBODY ABSRBJ,,30,,,$194.25,$0.00,1,0,1,20210101,
86316,CPT,IMMUNOASSAY TUMOR OTHER,,30,,,$252.05,$0.00,1,0,1,20210101,
86317,CPT,IMMUNOASSAY INFECTIOUS AGENT,,30,,,$140.83,$0.00,1,0,1,20210101,
86318,CPT,IA INFECTIOUS AGENT ANTIBODY,,30,,,$229.75,$0.00,1,0,1,20210101,
86320,CPT,SERUM IMMUNOELECTROPHORESIS,,30,,,$459.64,$0.00,1,0,1,20210101,
86325,CPT,OTHER IMMUNOELECTROPHORESIS,,30,,,$476.00,$0.00,1,0,1,20210101,
86327,CPT,IMMUNOELECTROPHORESIS ASSAY,,30,,,$280.43,$0.00,1,0,1,20210101,
86329,CPT,IMMUNODIFFUSION NES,,30,,,$362.02,$0.00,1,0,1,20210101,
86331,CPT,IMMUNODIFFUSION OUCHTERLONY,,30,,,$113.13,$0.00,1,0,1,20210101,
86332,CPT,IMMUNE COMPLEX ASSAY,,30,,,$313.77,$0.00,1,0,1,20210101,
86334,CPT,IMMUNOFIX E-PHORESIS SERUM,,30,,,$293.81,$0.00,1,0,1,20210101,
86335,CPT,IMMUNFIX E-PHORSIS/URINE/CSF,,30,,,$318.48,$0.00,1,0,1,20210101,
86336,CPT,INHIBIN A,,30,,,$263.27,$0.00,1,0,1,20210101,
86337,CPT,INSULIN ANTIBODIES,,30,,,$311.48,$0.00,1,0,1,20210101,
86340,CPT,INTRINSIC FACTOR ANTIBODY,,30,,,$196.02,$0.00,1,0,1,20210101,
86341,CPT,ISLET CELL ANTIBODY,,30,,,$257.51,$0.00,1,0,1,20210101,
86343,CPT,LEUKOCYTE HISTAMINE RELEASE,,30,,,$309.59,$0.00,1,0,1,20210101,
86344,CPT,LEUKOCYTE PHAGOCYTOSIS,,30,,,$218.41,$0.00,1,0,1,20210101,
86352,CPT,CELL FUNCTION ASSAY W/STIM,,30,,,$858.32,$0.00,1,0,1,20210101,
86353,CPT,LYMPHOCYTE TRANSFORMATION,,30,,,"$1,007.77",$0.00,1,0,1,20210101,
86355,CPT,B CELLS TOTAL COUNT,,30,,,$302.82,$0.00,1,0,1,20210101,
86356,CPT,MONONUCLEAR CELL ANTIGEN,,30,,,$296.14,$0.00,1,0,1,20210101,
86357,CPT,NK CELLS TOTAL COUNT,,30,,,$295.53,$0.00,1,0,1,20210101,
86359,CPT,T CELLS TOTAL COUNT,,30,,,$304.59,$0.00,1,0,1,20210101,
86360,CPT,T CELL ABSOLUTE COUNT/RATIO,,30,,,$385.09,$0.00,1,0,1,20210101,
86361,CPT,T CELL ABSOLUTE COUNT,,30,,,$336.82,$0.00,1,0,1,20210101,
86367,CPT,STEM CELLS TOTAL COUNT,,30,,,$650.04,$0.00,1,0,1,20210101,
86376,CPT,MICROSOMAL ANTIBODY EACH,,30,,,$169.23,$0.00,1,0,1,20210101,
86382,CPT,NEUTRALIZATION TEST VIRAL,,30,,,$353.29,$0.00,1,0,1,20210101,
86384,CPT,NITROBLUE TETRAZOLIUM DYE,,30,,,$228.91,$0.00,1,0,1,20210101,
86386,CPT,NUCLEAR MATRIX PROTEIN 22,,30,,,$190.35,$0.00,1,0,1,20210101,
86403,CPT,PARTICLE AGGLUT ANTBDY SCRN,,30,,,$179.47,$0.00,1,0,1,20210101,
86406,CPT,PARTICLE AGGLUT ANTBDY TITR,,30,,,$390.34,$0.00,1,0,1,20210101,
86430,CPT,RHEUMATOID FACTOR TEST QUAL,,30,,,$130.78,$0.00,1,0,1,20210101,
86431,CPT,RHEUMATOID FACTOR QUANT,,30,,,$112.76,$0.00,1,0,1,20210101,
86480,CPT,TB TEST CELL IMMUN MEASURE,,30,,,$368.30,$0.00,1,0,1,20210101,
86481,CPT,TB AG RESPONSE T-CELL SUSP,,30,,,$463.69,$0.00,1,0,1,20210101,
86485,CPT,SKIN TEST CANDIDA,,30,,,$177.03,$0.00,1,0,1,20210101,
86486,CPT,SKIN TEST NOS ANTIGEN,,30,,,$152.35,$0.00,1,0,1,20210101,
86490,CPT,COCCIDIOIDOMYCOSIS SKIN TEST,,30,,,$373.96,$0.00,1,0,1,20210101,
86510,CPT,HISTOPLASMOSIS SKIN TEST,,30,,,$373.96,$0.00,1,0,1,20210101,
86580,CPT,TB INTRADERMAL TEST,,30,,,$152.35,$0.00,1,0,1,20210101,
86590,CPT,STREPTOKINASE ANTIBODY,,30,,,$279.86,$0.00,1,0,1,20210101,
86592,CPT,SYPHILIS TEST NON-TREP QUAL,,30,,,$101.92,$0.00,1,0,1,20210101,
86593,CPT,SYPHILIS TEST NON-TREP QUANT,,30,,,$93.20,$0.00,1,0,1,20210101,
86602,CPT,ANTINOMYCES ANTIBODY,,30,,,$147.38,$0.00,1,0,1,20210101,
86603,CPT,ADENOVIRUS ANTIBODY,,30,,,$204.73,$0.00,1,0,1,20210101,
86606,CPT,ASPERGILLUS ANTIBODY,,30,,,$141.67,$0.00,1,0,1,20210101,
86609,CPT,BACTERIUM ANTIBODY,,30,,,$118.22,$0.00,1,0,1,20210101,
86611,CPT,BARTONELLA ANTIBODY,,30,,,$138.66,$0.00,1,0,1,20210101,
86612,CPT,BLASTOMYCES ANTIBODY,,30,,,$167.10,$0.00,1,0,1,20210101,
86615,CPT,BORDETELLA ANTIBODY,,30,,,$169.15,$0.00,1,0,1,20210101,
86617,CPT,LYME DISEASE ANTIBODY,,30,,,$229.75,$0.00,1,0,1,20210101,
86618,CPT,LYME DISEASE ANTIBODY,,30,,,$220.24,$0.00,1,0,1,20210101,
86619,CPT,BORRELIA ANTIBODY,,30,,,$204.46,$0.00,1,0,1,20210101,
86622,CPT,BRUCELLA ANTIBODY,,30,,,$162.77,$0.00,1,0,1,20210101,
86625,CPT,CAMPYLOBACTER ANTIBODY,,30,,,$197.99,$0.00,1,0,1,20210101,
86628,CPT,CANDIDA ANTIBODY,,30,,,$146.45,$0.00,1,0,1,20210101,
86631,CPT,CHLAMYDIA ANTIBODY,,30,,,$99.22,$0.00,1,0,1,20210101,
86632,CPT,CHLAMYDIA IGM ANTIBODY,,30,,,$104.34,$0.00,1,0,1,20210101,
86635,CPT,COCCIDIOIDES ANTIBODY,,30,,,$132.09,$0.00,1,0,1,20210101,
86638,CPT,Q FEVER ANTIBODY,,30,,,$154.11,$0.00,1,0,1,20210101,
86641,CPT,CRYPTOCOCCUS ANTIBODY,,30,,,$242.36,$0.00,1,0,1,20210101,
86644,CPT,CMV ANTIBODY,,30,,,$198.63,$0.00,1,0,1,20210101,
86645,CPT,CMV ANTIBODY IGM,,30,,,$221.47,$0.00,1,0,1,20210101,
86648,CPT,DIPHTHERIA ANTIBODY,,30,,,$255.81,$0.00,1,0,1,20210101,
86651,CPT,ENCEPHALITIS CALIFORN ANTBDY,,30,,,$121.93,$0.00,1,0,1,20210101,
86652,CPT,ENCEPHALTIS EAST EQNE ANBDY,,30,,,$194.91,$0.00,1,0,1,20210101,
86653,CPT,ENCEPHALTIS ST LOUIS ANTBODY,,30,,,$188.92,$0.00,1,0,1,20210101,
86654,CPT,ENCEPHALTIS WEST EQNE ANTBDY,,30,,,$182.21,$0.00,1,0,1,20210101,
86658,CPT,ENTEROVIRUS ANTIBODY,,30,,,$151.34,$0.00,1,0,1,20210101,
86663,CPT,EPSTEIN-BARR ANTIBODY,,30,,,$181.44,$0.00,1,0,1,20210101,
86664,CPT,EPSTEIN-BARR NUCLEAR ANTIGEN,,30,,,$179.89,$0.00,1,0,1,20210101,
86665,CPT,EPSTEIN-BARR CAPSID VCA,,30,,,$201.62,$0.00,1,0,1,20210101,
86666,CPT,EHRLICHIA ANTIBODY,,30,,,$222.35,$0.00,1,0,1,20210101,
86668,CPT,FRANCISELLA TULARENSIS,,30,,,$234.84,$0.00,1,0,1,20210101,
86671,CPT,FUNGUS NES ANTIBODY,,30,,,$181.95,$0.00,1,0,1,20210101,
86674,CPT,GIARDIA LAMBLIA ANTIBODY,,30,,,$232.85,$0.00,1,0,1,20210101,
86677,CPT,HELICOBACTER PYLORI ANTIBODY,,30,,,$219.74,$0.00,1,0,1,20210101,
86682,CPT,HELMINTH ANTIBODY,,30,,,$239.47,$0.00,1,0,1,20210101,
86684,CPT,HEMOPHILUS INFLUENZA ANTIBDY,,30,,,$347.55,$0.00,1,0,1,20210101,
86687,CPT,HTLV-I ANTIBODY,,30,,,$167.86,$0.00,1,0,1,20210101,
86688,CPT,HTLV-II ANTIBODY,,30,,,$147.54,$0.00,1,0,1,20210101,
86689,CPT,HTLV/HIV CONFIRMJ ANTIBODY,,30,,,$331.19,$0.00,1,0,1,20210101,
86692,CPT,HEPATITIS DELTA AGENT ANTBDY,,30,,,$258.32,$0.00,1,0,1,20210101,
86694,CPT,HERPES SIMPLEX NES ANTBDY,,30,,,$174.74,$0.00,1,0,1,20210101,
86695,CPT,HERPES SIMPLEX TYPE 1 TEST,,30,,,$154.30,$0.00,1,0,1,20210101,
86696,CPT,HERPES SIMPLEX TYPE 2 TEST,,30,,,$170.40,$0.00,1,0,1,20210101,
86698,CPT,HISTOPLASMA ANTIBODY,,30,,,$132.39,$0.00,1,0,1,20210101,
86701,CPT,HIV-1ANTIBODY,,30,,,$184.61,$0.00,1,0,1,20210101,
86702,CPT,HIV-2 ANTIBODY,,30,,,$208.61,$0.00,1,0,1,20210101,
86703,CPT,HIV-1/HIV-2 1 RESULT ANTBDY,,30,,,$207.87,$0.00,1,0,1,20210101,
86704,CPT,HEP B CORE ANTIBODY TOTAL,,30,,,$309.98,$0.00,1,0,1,20210101,
86705,CPT,HEP B CORE ANTIBODY IGM,,30,,,$234.50,$0.00,1,0,1,20210101,
86706,CPT,HEP B SURFACE ANTIBODY,,30,,,$304.52,$0.00,1,0,1,20210101,
86707,CPT,HEPATITIS BE ANTIBODY,,30,,,$158.25,$0.00,1,0,1,20210101,
86708,CPT,HEPATITIS A ANTIBODY,,30,,,$173.66,$0.00,1,0,1,20210101,
86709,CPT,HEPATITIS A IGM ANTIBODY,,30,,,$183.87,$0.00,1,0,1,20210101,
86710,CPT,INFLUENZA VIRUS ANTIBODY,,30,,,$218.28,$0.00,1,0,1,20210101,
86711,CPT,JOHN CUNNINGHAM ANTIBODY,,30,,,"$2,266.55",$0.00,1,0,1,20210101,
86713,CPT,LEGIONELLA ANTIBODY,,30,,,$220.73,$0.00,1,0,1,20210101,
86717,CPT,LEISHMANIA ANTIBODY,,30,,,$210.66,$0.00,1,0,1,20210101,
86720,CPT,LEPTOSPIRA ANTIBODY,,30,,,$207.77,$0.00,1,0,1,20210101,
86723,CPT,LISTERIA MONOCYTOGENES,,30,,,$250.26,$0.00,1,0,1,20210101,
86727,CPT,LYMPH CHORIOMENINGITIS AB,,30,,,$128.64,$0.00,1,0,1,20210101,
86732,CPT,MUCORMYCOSIS ANTIBODY,,30,,,$251.26,$0.00,1,0,1,20210101,
86735,CPT,MUMPS ANTIBODY,,30,,,$168.31,$0.00,1,0,1,20210101,
86738,CPT,MYCOPLASMA ANTIBODY,,30,,,$201.98,$0.00,1,0,1,20210101,
86741,CPT,NEISSERIA MENINGITIDIS,,30,,,$197.45,$0.00,1,0,1,20210101,
86744,CPT,NOCARDIA ANTIBODY,,30,,,$107.89,$0.00,1,0,1,20210101,
86747,CPT,PARVOVIRUS ANTIBODY,,30,,,$200.72,$0.00,1,0,1,20210101,
86750,CPT,MALARIA ANTIBODY,,30,,,$205.36,$0.00,1,0,1,20210101,
86753,CPT,PROTOZOA ANTIBODY NOS,,30,,,$204.55,$0.00,1,0,1,20210101,
86756,CPT,RESPIRATORY VIRUS ANTIBODY,,30,,,$218.85,$0.00,1,0,1,20210101,
86757,CPT,RICKETTSIA ANTIBODY,,30,,,$230.79,$0.00,1,0,1,20210101,
86759,CPT,ROTAVIRUS ANTIBODY,,30,,,$270.04,$0.00,1,0,1,20210101,
86762,CPT,RUBELLA ANTIBODY,,30,,,$157.84,$0.00,1,0,1,20210101,
86765,CPT,RUBEOLA ANTIBODY,,30,,,$171.34,$0.00,1,0,1,20210101,
86768,CPT,SALMONELLA ANTIBODY,,30,,,$121.68,$0.00,1,0,1,20210101,
86771,CPT,SHIGELLA ANTIBODY,,30,,,$230.66,$0.00,1,0,1,20210101,
86774,CPT,TETANUS ANTIBODY,,30,,,$254.00,$0.00,1,0,1,20210101,
86777,CPT,TOXOPLASMA ANTIBODY,,30,,,$228.92,$0.00,1,0,1,20210101,
86778,CPT,TOXOPLASMA ANTIBODY IGM,,30,,,$240.70,$0.00,1,0,1,20210101,
86780,CPT,TREPONEMA PALLIDUM,,30,,,$131.66,$0.00,1,0,1,20210101,
86784,CPT,TRICHINELLA ANTIBODY,,30,,,$253.80,$0.00,1,0,1,20210101,
86787,CPT,VARICELLA-ZOSTER ANTIBODY,,30,,,$175.32,$0.00,1,0,1,20210101,
86788,CPT,WEST NILE VIRUS AB IGM,,30,,,$200.85,$0.00,1,0,1,20210101,
86789,CPT,WEST NILE VIRUS ANTIBODY,,30,,,$191.46,$0.00,1,0,1,20210101,
86790,CPT,VIRUS ANTIBODY NOS,,30,,,$221.18,$0.00,1,0,1,20210101,
86793,CPT,YERSINIA ANTIBODY,,30,,,$201.88,$0.00,1,0,1,20210101,
86794,CPT,ZIKA VIRUS IGM ANTIBODY,,30,,,$293.43,$0.00,1,0,1,20210101,
86800,CPT,THYROGLOBULIN ANTIBODY,,30,,,$172.73,$0.00,1,0,1,20210101,
86803,CPT,HEPATITIS C AB TEST,,30,,,$219.91,$0.00,1,0,1,20210101,
86804,CPT,HEP C AB TEST CONFIRM,,30,,,$384.98,$0.00,1,0,1,20210101,
86805,CPT,LYMPHOCYTOTOXICITY ASSAY,,30,,,$998.48,$0.00,1,0,1,20210101,
86806,CPT,LYMPHOCYTOTOXICITY ASSAY,,30,,,$820.48,$0.00,1,0,1,20210101,
86807,CPT,CYTOTOXIC ANTIBODY SCREENING,,30,,,"$1,289.21",$0.00,1,0,1,20210101,
86808,CPT,CYTOTOXIC ANTIBODY SCREENING,,30,,,$811.95,$0.00,1,0,1,20210101,
86812,CPT,HLA TYPING A B OR C,,30,,,$337.50,$0.00,1,0,1,20210101,
86813,CPT,HLA TYPING A B OR C,,30,,,$997.12,$0.00,1,0,1,20210101,
86816,CPT,HLA TYPING DR/DQ,,30,,,$626.76,$0.00,1,0,1,20210101,
86817,CPT,HLA TYPING DR/DQ,,30,,,"$1,316.94",$0.00,1,0,1,20210101,
86821,CPT,LYMPHOCYTE CULTURE MIXED,,30,,,"$1,776.25",$0.00,1,0,1,20210101,
86825,CPT,HLA X-MATH NON-CYTOTOXIC,,30,,,"$1,147.13",$0.00,1,0,1,20210101,
86826,CPT,HLA X-MATCH NONCYTOTOXC ADDL,,30,,,$479.69,$0.00,1,0,1,20210101,
86828,CPT,HLA CLASS I&II ANTIBODY QUAL,,30,,,"$1,070.70",$0.00,1,0,1,20210101,
86829,CPT,HLA CLASS I/II ANTIBODY QUAL,,30,,,$475.05,$0.00,1,0,1,20210101,
86830,CPT,HLA CLASS I PHENOTYPE QUAL,,30,,,$818.37,$0.00,1,0,1,20210101,
86831,CPT,HLA CLASS II PHENOTYPE QUAL,,30,,,$752.58,$0.00,1,0,1,20210101,
86832,CPT,HLA CLASS I HIGH DEFIN QUAL,,30,,,"$1,257.71",$0.00,1,0,1,20210101,
86833,CPT,HLA CLASS II HIGH DEFIN QUAL,,30,,,"$1,197.56",$0.00,1,0,1,20210101,
86834,CPT,HLA CLASS I SEMIQUANT PANEL,,30,,,"$3,049.78",$0.00,1,0,1,20210101,
86835,CPT,HLA CLASS II SEMIQUANT PANEL,,30,,,"$2,805.07",$0.00,1,0,1,20210101,
86849,CPT,IMMUNOLOGY PROCEDURE,,30,,,$532.08,$0.00,1,0,1,20210101,
86850,CPT,RBC ANTIBODY SCREEN,,30,,,$332.59,$0.00,1,0,1,20210101,
86860,CPT,RBC ANTIBODY ELUTION,,30,,,$696.68,$0.00,1,0,1,20210101,
86870,CPT,RBC ANTIBODY IDENTIFICATION,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
86880,CPT,COOMBS TEST DIRECT,,30,,,$282.49,$0.00,1,0,1,20210101,
86885,CPT,COOMBS TEST INDIRECT QUAL,,30,,,$696.68,$0.00,1,0,1,20210101,
86886,CPT,COOMBS TEST INDIRECT TITER,,30,,,$696.68,$0.00,1,0,1,20210101,
86890,CPT,AUTOLOGOUS BLOOD PROCESS,,30,,,$789.37,$0.00,1,0,1,20210101,
86891,CPT,AUTOLOGOUS BLOOD OP SALVAGE,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
86900,CPT,BLOOD TYPING SEROLOGIC ABO,,30,,,$584.38,$0.00,1,0,1,20210101,
86901,CPT,BLOOD TYPING SEROLOGIC RH(D),,30,,,$224.79,$0.00,1,0,1,20210101,
86902,CPT,BLOOD TYPE ANTIGEN DONOR EA,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
86904,CPT,BLOOD TYPING PATIENT SERUM,,30,,,$224.79,$0.00,1,0,1,20210101,
86905,CPT,BLOOD TYPING RBC ANTIGENS,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
86906,CPT,BLD TYPING SEROLOGIC RH PHNT,,30,,,$224.79,$0.00,1,0,1,20210101,
86910,CPT,BLOOD TYPING PATERNITY TEST,,30,,,$467.00,$0.00,1,0,1,20210101,
86911,CPT,BLOOD TYPING ANTIGEN SYSTEM,,30,,,$192.17,$0.00,1,0,1,20210101,
86920,CPT,COMPATIBILITY TEST SPIN,,30,,,$696.68,$0.00,1,0,1,20210101,
86921,CPT,COMPATIBILITY TEST INCUBATE,,30,,,$696.68,$0.00,1,0,1,20210101,
86922,CPT,COMPATIBILITY TEST ANTIGLOB,,30,,,$696.68,$0.00,1,0,1,20210101,
86923,CPT,COMPATIBILITY TEST ELECTRIC,,30,,,$696.68,$0.00,1,0,1,20210101,
86927,CPT,PLASMA FRESH FROZEN,,30,,,$789.37,$0.00,1,0,1,20210101,
86930,CPT,FROZEN BLOOD PREP,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
86931,CPT,FROZEN BLOOD THAW,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
86932,CPT,FROZEN BLOOD FREEZE/THAW,,30,,,$224.79,$0.00,1,0,1,20210101,
86940,CPT,HEMOLYSINS/AGGLUTININS AUTO,,30,,,$178.66,$0.00,1,0,1,20210101,
86941,CPT,HEMOLYSINS/AGGLUTININS,,30,,,$216.54,$0.00,1,0,1,20210101,
86945,CPT,BLOOD PRODUCT/IRRADIATION,,30,,,$224.79,$0.00,1,0,1,20210101,
86950,CPT,LEUKACYTE TRANSFUSION,,30,,,$696.68,$0.00,1,0,1,20210101,
86960,CPT,VOL REDUCTION OF BLOOD/PROD,,30,,,$696.68,$0.00,1,0,1,20210101,
86965,CPT,POOLING BLOOD PLATELETS,,30,,,$696.68,$0.00,1,0,1,20210101,
86970,CPT,RBC PRETX INCUBATJ W/CHEMICL,,30,,,$224.79,$0.00,1,0,1,20210101,
86971,CPT,RBC PRETX INCUBATJ W/ENZYMES,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
86972,CPT,RBC PRETX INCUBATJ W/DENSITY,,30,,,$696.68,$0.00,1,0,1,20210101,
86975,CPT,RBC SERUM PRETX INCUBJ DRUGS,,30,,,$344.90,$0.00,1,0,1,20210101,
86976,CPT,RBC SERUM PRETX ID DILUTION,,30,,,$152.35,$0.00,1,0,1,20210101,
86977,CPT,RBC SERUM PRETX INCUBJ/INHIB,,30,,,$696.68,$0.00,1,0,1,20210101,
86978,CPT,RBC PRETREATMENT SERUM,,30,,,$224.79,$0.00,1,0,1,20210101,
86985,CPT,SPLIT BLOOD OR PRODUCTS,,30,,,$696.68,$0.00,1,0,1,20210101,
86999,CPT,TRANSFUSION PROCEDURE,,30,,,$152.35,$0.00,1,0,1,20210101,
87003,CPT,SMALL ANIMAL INOCULATION,,30,,,$289.36,$0.00,1,0,1,20210101,
87015,CPT,SPECIMEN INFECT AGNT CONCNTJ,,30,,,$100.80,$0.00,1,0,1,20210101,
87040,CPT,BLOOD CULTURE FOR BACTERIA,,30,,,$361.62,$0.00,1,0,1,20210101,
87045,CPT,FECES CULTURE AEROBIC BACT,,30,,,$244.37,$0.00,1,0,1,20210101,
87046,CPT,STOOL CULTR AEROBIC BACT EA,,30,,,$111.63,$0.00,1,0,1,20210101,
87070,CPT,CULTURE OTHR SPECIMN AEROBIC,,30,,,$286.08,$0.00,1,0,1,20210101,
87071,CPT,CULTURE AEROBIC QUANT OTHER,,30,,,$224.34,$0.00,1,0,1,20210101,
87073,CPT,CULTURE BACTERIA ANAEROBIC,,30,,,$257.10,$0.00,1,0,1,20210101,
87075,CPT,CULTR BACTERIA EXCEPT BLOOD,,30,,,$314.60,$0.00,1,0,1,20210101,
87076,CPT,CULTURE ANAEROBE IDENT EACH,,30,,,$161.56,$0.00,1,0,1,20210101,
87077,CPT,CULTURE AEROBIC IDENTIFY,,30,,,$138.78,$0.00,1,0,1,20210101,
87081,CPT,CULTURE SCREEN ONLY,,30,,,$165.08,$0.00,1,0,1,20210101,
87084,CPT,CULTURE OF SPECIMEN BY KIT,,30,,,$147.16,$0.00,1,0,1,20210101,
87086,CPT,URINE CULTURE/COLONY COUNT,,30,,,$196.36,$0.00,1,0,1,20210101,
87088,CPT,URINE BACTERIA CULTURE,,30,,,$152.10,$0.00,1,0,1,20210101,
87101,CPT,SKIN FUNGI CULTURE,,30,,,$185.93,$0.00,1,0,1,20210101,
87102,CPT,FUNGUS ISOLATION CULTURE,,30,,,$256.90,$0.00,1,0,1,20210101,
87103,CPT,BLOOD FUNGUS CULTURE,,30,,,$296.12,$0.00,1,0,1,20210101,
87106,CPT,FUNGI IDENTIFICATION YEAST,,30,,,$164.58,$0.00,1,0,1,20210101,
87107,CPT,FUNGI IDENTIFICATION MOLD,,30,,,$181.56,$0.00,1,0,1,20210101,
87109,CPT,MYCOPLASMA,,30,,,$296.39,$0.00,1,0,1,20210101,
87110,CPT,CHLAMYDIA CULTURE,,30,,,$317.02,$0.00,1,0,1,20210101,
87116,CPT,MYCOBACTERIA CULTURE,,30,,,$244.49,$0.00,1,0,1,20210101,
87118,CPT,MYCOBACTERIC IDENTIFICATION,,30,,,$225.00,$0.00,1,0,1,20210101,
87140,CPT,CULTURE TYPE IMMUNOFLUORESC,,30,,,$109.37,$0.00,1,0,1,20210101,
87143,CPT,CULTURE TYPING GLC/HPLC,,30,,,$218.31,$0.00,1,0,1,20210101,
87147,CPT,CULTURE TYPE IMMUNOLOGIC,,30,,,$86.12,$0.00,1,0,1,20210101,
87149,CPT,DNA/RNA DIRECT PROBE,,30,,,$214.00,$0.00,1,0,1,20210101,
87150,CPT,DNA/RNA AMPLIFIED PROBE,,30,,,$455.96,$0.00,1,0,1,20210101,
87152,CPT,CULTURE TYPE PULSE FIELD GEL,,30,,,$143.01,$0.00,1,0,1,20210101,
87153,CPT,DNA/RNA SEQUENCING,,30,,,$761.68,$0.00,1,0,1,20210101,
87158,CPT,CULTURE TYPING ADDED METHOD,,30,,,$190.49,$0.00,1,0,1,20210101,
87164,CPT,DARK FIELD EXAMINATION,,30,,,$117.66,$0.00,1,0,1,20210101,
87166,CPT,DARK FIELD EXAMINATION,,30,,,$108.39,$0.00,1,0,1,20210101,
87168,CPT,MACROSCOPIC EXAM ARTHROPOD,,30,,,$103.64,$0.00,1,0,1,20210101,
87169,CPT,MACROSCOPIC EXAM PARASITE,,30,,,$112.12,$0.00,1,0,1,20210101,
87172,CPT,PINWORM EXAM,,30,,,$115.43,$0.00,1,0,1,20210101,
87176,CPT,TISSUE HOMOGENIZATION CULTR,,30,,,$104.65,$0.00,1,0,1,20210101,
87177,CPT,OVA AND PARASITES SMEARS,,30,,,$161.88,$0.00,1,0,1,20210101,
87181,CPT,MICROBE SUSCEPTIBLE DIFFUSE,,30,,,$96.93,$0.00,1,0,1,20210101,
87184,CPT,MICROBE SUSCEPTIBLE DISK,,30,,,$137.61,$0.00,1,0,1,20210101,
87185,CPT,MICROBE SUSCEPTIBLE ENZYME,,30,,,$72.99,$0.00,1,0,1,20210101,
87186,CPT,MICROBE SUSCEPTIBLE MIC,,30,,,$183.81,$0.00,1,0,1,20210101,
87187,CPT,MICROBE SUSCEPTIBLE MLC,,30,,,$164.72,$0.00,1,0,1,20210101,
87188,CPT,MICROBE SUSCEPT MACROBROTH,,30,,,$137.61,$0.00,1,0,1,20210101,
87190,CPT,MICROBE SUSCEPT MYCOBACTERI,,30,,,$93.44,$0.00,1,0,1,20210101,
87197,CPT,BACTERICIDAL LEVEL SERUM,,30,,,$496.01,$0.00,1,0,1,20210101,
87205,CPT,SMEAR GRAM STAIN,,30,,,$117.37,$0.00,1,0,1,20210101,
87206,CPT,SMEAR FLUORESCENT/ACID STAI,,30,,,$130.32,$0.00,1,0,1,20210101,
87207,CPT,SMEAR SPECIAL STAIN,,30,,,$157.57,$0.00,1,0,1,20210101,
87209,CPT,SMEAR COMPLEX STAIN,,30,,,$152.71,$0.00,1,0,1,20210101,
87210,CPT,SMEAR WET MOUNT SALINE/INK,,30,,,$119.29,$0.00,1,0,1,20210101,
87220,CPT,TISSUE EXAM FOR FUNGI,,30,,,$101.65,$0.00,1,0,1,20210101,
87230,CPT,ASSAY TOXIN OR ANTITOXIN,,30,,,$311.27,$0.00,1,0,1,20210101,
87250,CPT,VIRUS INOCULATE EGGS/ANIMAL,,30,,,$418.72,$0.00,1,0,1,20210101,
87252,CPT,VIRUS INOCULATION TISSUE,,30,,,$357.56,$0.00,1,0,1,20210101,
87253,CPT,VIRUS INOCULATE TISSUE ADDL,,30,,,$336.00,$0.00,1,0,1,20210101,
87254,CPT,VIRUS INOCULATION SHELL VIA,,30,,,$217.90,$0.00,1,0,1,20210101,
87255,CPT,GENET VIRUS ISOLATE HSV,,30,,,$361.27,$0.00,1,0,1,20210101,
87260,CPT,ADENOVIRUS AG IF,,30,,,$204.36,$0.00,1,0,1,20210101,
87265,CPT,PERTUSSIS AG IF,,30,,,$283.67,$0.00,1,0,1,20210101,
87267,CPT,ENTEROVIRUS ANTIBODY DFA,,30,,,$164.21,$0.00,1,0,1,20210101,
87269,CPT,GIARDIA AG IF,,30,,,$157.88,$0.00,1,0,1,20210101,
87270,CPT,CHLAMYDIA TRACHOMATIS AG IF,,30,,,$344.20,$0.00,1,0,1,20210101,
87271,CPT,CYTOMEGALOVIRUS DFA,,30,,,$481.27,$0.00,1,0,1,20210101,
87272,CPT,CRYPTOSPORIDIUM AG IF,,30,,,$164.03,$0.00,1,0,1,20210101,
87273,CPT,HERPES SIMPLEX 2 AG IF,,30,,,$220.81,$0.00,1,0,1,20210101,
87274,CPT,HERPES SIMPLEX 1 AG IF,,30,,,$242.91,$0.00,1,0,1,20210101,
87275,CPT,INFLUENZA B AG IF,,30,,,$169.29,$0.00,1,0,1,20210101,
87276,CPT,INFLUENZA A AG IF,,30,,,$175.78,$0.00,1,0,1,20210101,
87278,CPT,LEGION PNEUMOPHILIA AG IF,,30,,,$296.71,$0.00,1,0,1,20210101,
87279,CPT,PARAINFLUENZA AG IF,,30,,,$159.60,$0.00,1,0,1,20210101,
87280,CPT,RESPIRATORY SYNCYTIAL AG IF,,30,,,$198.77,$0.00,1,0,1,20210101,
87281,CPT,PNEUMOCYSTIS CARINII AG IF,,30,,,$272.19,$0.00,1,0,1,20210101,
87283,CPT,RUBEOLA AG IF,,30,,,$235.74,$0.00,1,0,1,20210101,
87285,CPT,TREPONEMA PALLIDUM AG IF,,30,,,$234.06,$0.00,1,0,1,20210101,
87290,CPT,VARICELLA ZOSTER AG IF,,30,,,$224.33,$0.00,1,0,1,20210101,
87299,CPT,ANTIBODY DETECTION NOS IF,,30,,,$197.75,$0.00,1,0,1,20210101,
87300,CPT,AG DETECTION POLYVAL IF,,30,,,$211.09,$0.00,1,0,1,20210101,
87301,CPT,ADENOVIRUS AG IA,,30,,,$171.04,$0.00,1,0,1,20210101,
87305,CPT,ASPERGILLUS AG IA,,30,,,$228.24,$0.00,1,0,1,20210101,
87320,CPT,CHYLMD TRACH AG IA,,30,,,$258.46,$0.00,1,0,1,20210101,
87324,CPT,CLOSTRIDIUM AG IA,,30,,,$207.24,$0.00,1,0,1,20210101,
87327,CPT,CRYPTOCOCCUS NEOFORM AG IA,,30,,,$200.97,$0.00,1,0,1,20210101,
87328,CPT,CRYPTOSPORIDIUM AG IA,,30,,,$160.16,$0.00,1,0,1,20210101,
87329,CPT,GIARDIA AG IA,,30,,,$155.81,$0.00,1,0,1,20210101,
87332,CPT,CYTOMEGALOVIRUS AG IA,,30,,,$142.96,$0.00,1,0,1,20210101,
87335,CPT,E COLI 0157 AG IA,,30,,,$189.92,$0.00,1,0,1,20210101,
87336,CPT,ENTAMOEB HIST DISPR AG IA,,30,,,$223.19,$0.00,1,0,1,20210101,
87337,CPT,ENTAMOEB HIST GROUP AG IA,,30,,,$163.00,$0.00,1,0,1,20210101,
87338,CPT,HPYLORI STOOL AG IA,,30,,,$218.67,$0.00,1,0,1,20210101,
87339,CPT,H PYLORI AG IA,,30,,,$239.15,$0.00,1,0,1,20210101,
87340,CPT,HEPATITIS B SURFACE AG IA,,30,,,$302.89,$0.00,1,0,1,20210101,
87341,CPT,HEPATITIS B SURFACE AG IA,,30,,,$198.07,$0.00,1,0,1,20210101,
87350,CPT,HEPATITIS BE AG IA,,30,,,$156.53,$0.00,1,0,1,20210101,
87380,CPT,HEPATITIS DELTA AGENT AG IA,,30,,,$279.66,$0.00,1,0,1,20210101,
87385,CPT,HISTOPLASMA CAPSUL AG IA,,30,,,$372.78,$0.00,1,0,1,20210101,
87389,CPT,HIV-1 AG W/HIV-1&2 AB AG IA,,30,,,$185.57,$0.00,1,0,1,20210101,
87390,CPT,HIV-1 AG IA,,30,,,$213.63,$0.00,1,0,1,20210101,
87391,CPT,HIV-2 AG IA,,30,,,$214.25,$0.00,1,0,1,20210101,
87400,CPT,INFLUENZA A/B EACH AG IA,,30,,,$177.24,$0.00,1,0,1,20210101,
87420,CPT,RESP SYNCYTIAL VIRUS AG IA,,30,,,$311.86,$0.00,1,0,1,20210101,
87425,CPT,ROTAVIRUS AG IA,,30,,,$219.76,$0.00,1,0,1,20210101,
87427,CPT,SHIGA-LIKE TOXIN AG IA,,30,,,$129.75,$0.00,1,0,1,20210101,
87430,CPT,STREP A AG IA,,30,,,$177.88,$0.00,1,0,1,20210101,
87449,CPT,NOS EACH ORGANISM AG IA,,30,,,$186.32,$0.00,1,0,1,20210101,
87451,CPT,POLYVALENT MULT ORG EA AG IA,,30,,,$182.51,$0.00,1,0,1,20210101,
87471,CPT,BARTONELLA DNA AMP PROBE,,30,,,$789.70,$0.00,1,0,1,20210101,
87472,CPT,BARTONELLA DNA QUANT,,30,,,$507.22,$0.00,1,0,1,20210101,
87475,CPT,LYME DIS DNA DIR PROBE,,30,,,$321.76,$0.00,1,0,1,20210101,
87476,CPT,LYME DIS DNA AMP PROBE,,30,,,$691.62,$0.00,1,0,1,20210101,
87480,CPT,CANDIDA DNA DIR PROBE,,30,,,$166.87,$0.00,1,0,1,20210101,
87481,CPT,CANDIDA DNA AMP PROBE,,30,,,$285.40,$0.00,1,0,1,20210101,
87482,CPT,CANDIDA DNA QUANT,,30,,,$499.40,$0.00,1,0,1,20210101,
87483,CPT,CNS DNA AMP PROBE TYPE 12-25,,30,,,"$2,309.85",$0.00,1,0,1,20210101,
87485,CPT,CHYLMD PNEUM DNA DIR PROBE,,30,,,$499.83,$0.00,1,0,1,20210101,
87486,CPT,CHYLMD PNEUM DNA AMP PROBE,,30,,,$326.57,$0.00,1,0,1,20210101,
87487,CPT,CHYLMD PNEUM DNA QUANT,,30,,,$504.16,$0.00,1,0,1,20210101,
87490,CPT,CHYLMD TRACH DNA DIR PROBE,,30,,,$227.10,$0.00,1,0,1,20210101,
87491,CPT,CHYLMD TRACH DNA AMP PROBE,,30,,,$266.63,$0.00,1,0,1,20210101,
87492,CPT,CHYLMD TRACH DNA QUANT,,30,,,$273.18,$0.00,1,0,1,20210101,
87493,CPT,C DIFF AMPLIFIED PROBE,,30,,,$300.79,$0.00,1,0,1,20210101,
87495,CPT,CYTOMEG DNA DIR PROBE,,30,,,$697.02,$0.00,1,0,1,20210101,
87496,CPT,CYTOMEG DNA AMP PROBE,,30,,,$696.40,$0.00,1,0,1,20210101,
87497,CPT,CYTOMEG DNA QUANT,,30,,,$591.93,$0.00,1,0,1,20210101,
87498,CPT,ENTEROVIRUS PROBE&REVRS TRNS,,30,,,$512.49,$0.00,1,0,1,20210101,
87500,CPT,VANOMYCIN DNA AMP PROBE,,30,,,$353.66,$0.00,1,0,1,20210101,
87501,CPT,INFLUENZA DNA AMP PROB 1+,,30,,,$684.04,$0.00,1,0,1,20210101,
87502,CPT,INFLUENZA DNA AMP PROBE,,30,,,$562.33,$0.00,1,0,1,20210101,
87503,CPT,INFLUENZA DNA AMP PROB ADDL,,30,,,$214.19,$0.00,1,0,1,20210101,
87505,CPT,NFCT AGENT DETECTION GI,,30,,,$719.23,$0.00,1,0,1,20210101,
87506,CPT,IADNA-DNA/RNA PROBE TQ 6-11,,30,,,"$1,190.55",$0.00,1,0,1,20210101,
87507,CPT,IADNA-DNA/RNA PROBE TQ 12-25,,30,,,"$1,506.67",$0.00,1,0,1,20210101,
87510,CPT,GARDNER VAG DNA DIR PROBE,,30,,,$167.76,$0.00,1,0,1,20210101,
87511,CPT,GARDNER VAG DNA AMP PROBE,,30,,,$215.02,$0.00,1,0,1,20210101,
87512,CPT,GARDNER VAG DNA QUANT,,30,,,$334.11,$0.00,1,0,1,20210101,
87516,CPT,HEPATITIS B DNA AMP PROBE,,30,,,$534.74,$0.00,1,0,1,20210101,
87517,CPT,HEPATITIS B DNA QUANT,,30,,,$559.45,$0.00,1,0,1,20210101,
87520,CPT,HEPATITIS C RNA DIR PROBE,,30,,,$826.74,$0.00,1,0,1,20210101,
87521,CPT,HEPATITIS C PROBE&RVRS TRNSC,,30,,,$575.05,$0.00,1,0,1,20210101,
87522,CPT,HEPATITIS C REVRS TRNSCRPJ,,30,,,$577.38,$0.00,1,0,1,20210101,
87525,CPT,HEPATITIS G DNA DIR PROBE,,30,,,$321.83,$0.00,1,0,1,20210101,
87526,CPT,HEPATITIS G DNA AMP PROBE,,30,,,$450.24,$0.00,1,0,1,20210101,
87527,CPT,HEPATITIS G DNA QUANT,,30,,,$499.40,$0.00,1,0,1,20210101,
87528,CPT,HSV DNA DIR PROBE,,30,,,$911.27,$0.00,1,0,1,20210101,
87529,CPT,HSV DNA AMP PROBE,,30,,,$388.42,$0.00,1,0,1,20210101,
87530,CPT,HSV DNA QUANT,,30,,,$477.00,$0.00,1,0,1,20210101,
87531,CPT,HHV-6 DNA DIR PROBE,,30,,,$321.76,$0.00,1,0,1,20210101,
87532,CPT,HHV-6 DNA AMP PROBE,,30,,,$541.54,$0.00,1,0,1,20210101,
87533,CPT,HHV-6 DNA QUANT,,30,,,$870.38,$0.00,1,0,1,20210101,
87534,CPT,HIV-1 DNA DIR PROBE,,30,,,$210.03,$0.00,1,0,1,20210101,
87535,CPT,HIV-1 PROBE&REVERSE TRNSCRPJ,,30,,,$463.60,$0.00,1,0,1,20210101,
87536,CPT,HIV-1 QUANT&REVRSE TRNSCRPJ,,30,,,$659.79,$0.00,1,0,1,20210101,
87537,CPT,HIV-2 DNA DIR PROBE,,30,,,$225.69,$0.00,1,0,1,20210101,
87538,CPT,HIV-2 PROBE&REVRSE TRNSCRIPJ,,30,,,$653.23,$0.00,1,0,1,20210101,
87539,CPT,HIV-2 QUANT&REVRSE TRNSCRIPJ,,30,,,$633.53,$0.00,1,0,1,20210101,
87540,CPT,LEGION PNEUMO DNA DIR PROB,,30,,,$424.23,$0.00,1,0,1,20210101,
87541,CPT,LEGION PNEUMO DNA AMP PROB,,30,,,$539.47,$0.00,1,0,1,20210101,
87542,CPT,LEGION PNEUMO DNA QUANT,,30,,,$499.17,$0.00,1,0,1,20210101,
87550,CPT,MYCOBACTERIA DNA DIR PROBE,,30,,,$316.11,$0.00,1,0,1,20210101,
87551,CPT,MYCOBACTERIA DNA AMP PROBE,,30,,,$525.17,$0.00,1,0,1,20210101,
87552,CPT,MYCOBACTERIA DNA QUANT,,30,,,$371.95,$0.00,1,0,1,20210101,
87555,CPT,M.TUBERCULO DNA DIR PROBE,,30,,,$398.27,$0.00,1,0,1,20210101,
87556,CPT,M.TUBERCULO DNA AMP PROBE,,30,,,$578.75,$0.00,1,0,1,20210101,
87557,CPT,M.TUBERCULO DNA QUANT,,30,,,$346.35,$0.00,1,0,1,20210101,
87560,CPT,M.AVIUM-INTRA DNA DIR PROB,,30,,,$341.38,$0.00,1,0,1,20210101,
87561,CPT,M.AVIUM-INTRA DNA AMP PROB,,30,,,$685.43,$0.00,1,0,1,20210101,
87562,CPT,M.AVIUM-INTRA DNA QUANT,,30,,,$507.22,$0.00,1,0,1,20210101,
87580,CPT,M.PNEUMON DNA DIR PROBE,,30,,,$321.76,$0.00,1,0,1,20210101,
87581,CPT,M.PNEUMON DNA AMP PROBE,,30,,,$328.42,$0.00,1,0,1,20210101,
87582,CPT,M.PNEUMON DNA QUANT,,30,,,$499.40,$0.00,1,0,1,20210101,
87590,CPT,N.GONORRHOEAE DNA DIR PROB,,30,,,$233.99,$0.00,1,0,1,20210101,
87591,CPT,N.GONORRHOEAE DNA AMP PROB,,30,,,$262.50,$0.00,1,0,1,20210101,
87592,CPT,N.GONORRHOEAE DNA QUANT,,30,,,$339.82,$0.00,1,0,1,20210101,
87623,CPT,HPV LOW-RISK TYPES,,30,,,$255.22,$0.00,1,0,1,20210101,
87624,CPT,HPV HIGH-RISK TYPES,,30,,,$254.72,$0.00,1,0,1,20210101,
87625,CPT,HPV TYPES 16 & 18 ONLY,,30,,,$237.63,$0.00,1,0,1,20210101,
87631,CPT,RESP VIRUS 3-5 TARGETS,,30,,,$703.16,$0.00,1,0,1,20210101,
87632,CPT,RESP VIRUS 6-11 TARGETS,,30,,,"$2,157.41",$0.00,1,0,1,20210101,
87633,CPT,RESP VIRUS 12-25 TARGETS,,30,,,"$2,026.55",$0.00,1,0,1,20210101,
87634,CPT,RSV DNA/RNA AMP PROBE,,30,,,$662.85,$0.00,1,0,1,20210101,
87640,CPT,STAPH A DNA AMP PROBE,,30,,,$328.75,$0.00,1,0,1,20210101,
87641,CPT,MR-STAPH DNA AMP PROBE,,30,,,$315.33,$0.00,1,0,1,20210101,
87650,CPT,STREP A DNA DIR PROBE,,30,,,$229.45,$0.00,1,0,1,20210101,
87651,CPT,STREP A DNA AMP PROBE,,30,,,$236.67,$0.00,1,0,1,20210101,
87652,CPT,STREP A DNA QUANT,,30,,,$499.27,$0.00,1,0,1,20210101,
87653,CPT,STREP B DNA AMP PROBE,,30,,,$343.23,$0.00,1,0,1,20210101,
87660,CPT,TRICHOMONAS VAGIN DIR PROBE,,30,,,$162.44,$0.00,1,0,1,20210101,
87661,CPT,TRICHOMONAS VAGINALIS AMPLIF,,30,,,$343.38,$0.00,1,0,1,20210101,
87662,CPT,ZIKA VIRUS DNA/RNA AMP PROBE,,30,,,$598.58,$0.00,1,0,1,20210101,
87797,CPT,DETECT AGENT NOS DNA DIR,,30,,,$307.56,$0.00,1,0,1,20210101,
87798,CPT,DETECT AGENT NOS DNA AMP,,30,,,$329.74,$0.00,1,0,1,20210101,
87799,CPT,DETECT AGENT NOS DNA QUANT,,30,,,$558.84,$0.00,1,0,1,20210101,
87800,CPT,DETECT AGNT MULT DNA DIREC,,30,,,$403.60,$0.00,1,0,1,20210101,
87801,CPT,DETECT AGNT MULT DNA AMPLI,,30,,,$552.19,$0.00,1,0,1,20210101,
87802,CPT,STREP B ASSAY W/OPTIC,,30,,,$211.81,$0.00,1,0,1,20210101,
87803,CPT,CLOSTRIDIUM TOXIN A W/OPTIC,,30,,,$292.47,$0.00,1,0,1,20210101,
87804,CPT,INFLUENZA ASSAY W/OPTIC,,30,,,$169.92,$0.00,1,0,1,20210101,
87806,CPT,HIV W/HIV1&2 ANTB W/OPTIC,,30,,,$227.29,$0.00,1,0,1,20210101,
87807,CPT,RSV ASSAY W/OPTIC,,30,,,$214.87,$0.00,1,0,1,20210101,
87808,CPT,TRICHOMONAS ASSAY W/OPTIC,,30,,,$147.09,$0.00,1,0,1,20210101,
87809,CPT,ADENOVIRUS ASSAY W/OPTIC,,30,,,$235.55,$0.00,1,0,1,20210101,
87810,CPT,CHYLMD TRACH ASSAY W/OPTIC,,30,,,$310.29,$0.00,1,0,1,20210101,
87850,CPT,N. GONORRHOEAE ASSAY W/OPTIC,,30,,,$234.39,$0.00,1,0,1,20210101,
87880,CPT,STREP A ASSAY W/OPTIC,,30,,,$158.54,$0.00,1,0,1,20210101,
87899,CPT,AGENT NOS ASSAY W/OPTIC,,30,,,$130.19,$0.00,1,0,1,20210101,
87900,CPT,PHENOTYPE INFECT AGENT DRUG,,30,,,"$1,164.44",$0.00,1,0,1,20210101,
87901,CPT,GENOTYPE DNA HIV REVERSE T,,30,,,"$1,914.02",$0.00,1,0,1,20210101,
87902,CPT,GENOTYPE DNA/RNA HEP C,,30,,,"$1,437.62",$0.00,1,0,1,20210101,
87903,CPT,PHENOTYPE DNA HIV W/CULTURE,,30,,,"$3,230.96",$0.00,1,0,1,20210101,
87904,CPT,PHENOTYPE DNA HIV W/CLT ADD,,30,,,$294.42,$0.00,1,0,1,20210101,
87905,CPT,SIALIDASE ENZYME ASSAY,,30,,,$212.12,$0.00,1,0,1,20210101,
87906,CPT,GENOTYPE DNA/RNA HIV,,30,,,"$1,125.66",$0.00,1,0,1,20210101,
87910,CPT,GENOTYPE CYTOMEGALOVIRUS,,30,,,"$1,971.59",$0.00,1,0,1,20210101,
87912,CPT,GENOTYPE DNA HEPATITIS B,,30,,,"$2,285.57",$0.00,1,0,1,20210101,
87999,CPT,MICROBIOLOGY PROCEDURE,,30,,,$391.82,$0.00,1,0,1,20210101,
88005,CPT,AUTOPSY (NECROPSY) GROSS,,30,,,"$1,784.20",$0.00,1,0,1,20210101,
88007,CPT,AUTOPSY (NECROPSY) GROSS,,30,,,"$1,900.39",$0.00,1,0,1,20210101,
88025,CPT,AUTOPSY (NECROPSY) COMPLETE,,30,,,"$2,012.12",$0.00,1,0,1,20210101,
88027,CPT,AUTOPSY (NECROPSY) COMPLETE,,30,,,"$2,120.48",$0.00,1,0,1,20210101,
88036,CPT,LIMITED AUTOPSY,,30,,,"$1,736.17",$0.00,1,0,1,20210101,
88037,CPT,LIMITED AUTOPSY,,30,,,"$1,532.83",$0.00,1,0,1,20210101,
88104,CPT,CYTOPATH FL NONGYN SMEARS,,30,,,$224.79,$0.00,1,0,1,20210101,
88106,CPT,CYTOPATH FL NONGYN FILTER,,30,,,$152.35,$0.00,1,0,1,20210101,
88108,CPT,CYTOPATH CONCENTRATE TECH,,30,,,$224.79,$0.00,1,0,1,20210101,
88112,CPT,CYTOPATH CELL ENHANCE TECH,,30,,,$332.59,$0.00,1,0,1,20210101,
88120,CPT,CYTP URNE 3-5 PROBES EA SPEC,,30,,,$696.68,$0.00,1,0,1,20210101,
88121,CPT,CYTP URINE 3-5 PROBES CMPTR,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88125,CPT,FORENSIC CYTOPATHOLOGY,,30,,,$332.59,$0.00,1,0,1,20210101,
88130,CPT,SEX CHROMATIN IDENTIFICATION,,30,,,$270.37,$0.00,1,0,1,20210101,
88140,CPT,SEX CHROMATIN IDENTIFICATION,,30,,,$136.88,$0.00,1,0,1,20210101,
88141,CPT,CYTOPATH C/V INTERPRET,,30,,,$155.23,$0.00,1,0,1,20210101,
88142,CPT,CYTOPATH C/V THIN LAYER,,30,,,$177.32,$0.00,1,0,1,20210101,
88143,CPT,CYTOPATH C/V THIN LAYER REDO,,30,,,$324.40,$0.00,1,0,1,20210101,
88147,CPT,CYTOPATH C/V AUTOMATED,,30,,,$98.17,$0.00,1,0,1,20210101,
88148,CPT,CYTOPATH C/V AUTO RESCREEN,,30,,,$272.63,$0.00,1,0,1,20210101,
88150,CPT,CYTOPATH C/V MANUAL,,30,,,$122.25,$0.00,1,0,1,20210101,
88152,CPT,CYTOPATH C/V AUTO REDO,,30,,,$218.98,$0.00,1,0,1,20210101,
88153,CPT,CYTOPATH C/V REDO,,30,,,$218.98,$0.00,1,0,1,20210101,
88155,CPT,CYTOPATH C/V INDEX ADD-ON,,30,,,$49.16,$0.00,1,0,1,20210101,
88160,CPT,CYTOPATH SMEAR OTHER SOURCE,,30,,,$152.35,$0.00,1,0,1,20210101,
88161,CPT,CYTOPATH SMEAR OTHER SOURCE,,30,,,$177.03,$0.00,1,0,1,20210101,
88162,CPT,CYTOPATH SMEAR OTHER SOURCE,,30,,,$332.59,$0.00,1,0,1,20210101,
88164,CPT,CYTOPATH TBS C/V MANUAL,,30,,,$115.90,$0.00,1,0,1,20210101,
88165,CPT,CYTOPATH TBS C/V REDO,,30,,,$234.66,$0.00,1,0,1,20210101,
88166,CPT,CYTOPATH TBS C/V AUTO REDO,,30,,,$218.98,$0.00,1,0,1,20210101,
88167,CPT,CYTOPATH TBS C/V SELECT,,30,,,$218.98,$0.00,1,0,1,20210101,
88172,CPT,CYTP DX EVAL FNA 1ST EA SITE,,30,,,$696.68,$0.00,1,0,1,20210101,
88173,CPT,CYTOPATH EVAL FNA REPORT,,30,,,$332.59,$0.00,1,0,1,20210101,
88174,CPT,CYTOPATH C/V AUTO IN FLUID,,30,,,$239.07,$0.00,1,0,1,20210101,
88175,CPT,CYTOPATH C/V AUTO FLUID REDO,,30,,,$219.14,$0.00,1,0,1,20210101,
88177,CPT,CYTP FNA EVAL EA ADDL,,30,,,$166.09,$0.00,1,0,1,20210101,
88182,CPT,CELL MARKER STUDY,,30,,,$332.59,$0.00,1,0,1,20210101,
88184,CPT,FLOWCYTOMETRY/ TC 1 MARKER,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88185,CPT,FLOWCYTOMETRY/TC ADD-ON,,30,,,$187.43,$0.00,1,0,1,20210101,
88187,CPT,FLOWCYTOMETRY/READ 2-8,,30,,,$238.62,$0.00,1,0,1,20210101,
88188,CPT,FLOWCYTOMETRY/READ 9-15,,30,,,$348.73,$0.00,1,0,1,20210101,
88189,CPT,FLOWCYTOMETRY/READ 16 & >,,30,,,$333.21,$0.00,1,0,1,20210101,
88199,CPT,CYTOPATHOLOGY PROCEDURE,,30,,,$332.59,$0.00,1,0,1,20210101,
88230,CPT,TISSUE CULTURE LYMPHOCYTE,,30,,,"$1,014.14",$0.00,1,0,1,20210101,
88233,CPT,TISSUE CULTURE SKIN/BIOPSY,,30,,,"$1,150.06",$0.00,1,0,1,20210101,
88235,CPT,TISSUE CULTURE PLACENTA,,30,,,"$1,253.37",$0.00,1,0,1,20210101,
88237,CPT,TISSUE CULTURE BONE MARROW,,30,,,$919.78,$0.00,1,0,1,20210101,
88239,CPT,TISSUE CULTURE TUMOR,,30,,,"$1,480.01",$0.00,1,0,1,20210101,
88240,CPT,CELL CRYOPRESERVE/STORAGE,,30,,,$231.60,$0.00,1,0,1,20210101,
88241,CPT,FROZEN CELL PREPARATION,,30,,,$470.35,$0.00,1,0,1,20210101,
88245,CPT,CHROMOSOME ANALYSIS 20-25,,30,,,"$1,071.39",$0.00,1,0,1,20210101,
88248,CPT,CHROMOSOME ANALYSIS 50-100,,30,,,"$1,463.35",$0.00,1,0,1,20210101,
88249,CPT,CHROMOSOME ANALYSIS 100,,30,,,"$1,466.73",$0.00,1,0,1,20210101,
88261,CPT,CHROMOSOME ANALYSIS 5,,30,,,"$2,199.49",$0.00,1,0,1,20210101,
88262,CPT,CHROMOSOME ANALYSIS 15-20,,30,,,"$1,596.79",$0.00,1,0,1,20210101,
88263,CPT,CHROMOSOME ANALYSIS 45,,30,,,"$1,076.92",$0.00,1,0,1,20210101,
88264,CPT,CHROMOSOME ANALYSIS 20-25,,30,,,"$1,012.73",$0.00,1,0,1,20210101,
88267,CPT,CHROMOSOME ANALYS PLACENTA,,30,,,"$1,890.64",$0.00,1,0,1,20210101,
88269,CPT,CHROMOSOME ANALYS AMNIOTIC,,30,,,"$1,547.13",$0.00,1,0,1,20210101,
88271,CPT,CYTOGENETICS DNA PROBE,,30,,,$331.07,$0.00,1,0,1,20210101,
88272,CPT,CYTOGENETICS 3-5,,30,,,$467.56,$0.00,1,0,1,20210101,
88273,CPT,CYTOGENETICS 10-30,,30,,,$671.84,$0.00,1,0,1,20210101,
88274,CPT,CYTOGENETICS 25-99,,30,,,$549.61,$0.00,1,0,1,20210101,
88275,CPT,CYTOGENETICS 100-300,,30,,,$492.04,$0.00,1,0,1,20210101,
88280,CPT,CHROMOSOME KARYOTYPE STUDY,,30,,,$315.49,$0.00,1,0,1,20210101,
88283,CPT,CHROMOSOME BANDING STUDY,,30,,,$749.64,$0.00,1,0,1,20210101,
88285,CPT,CHROMOSOME COUNT ADDITIONAL,,30,,,$276.13,$0.00,1,0,1,20210101,
88289,CPT,CHROMOSOME STUDY ADDITIONAL,,30,,,$640.23,$0.00,1,0,1,20210101,
88299,CPT,CYTOGENETIC STUDY,,30,,,$332.59,$0.00,1,0,1,20210101,
88300,CPT,SURGICAL PATH GROSS,,30,,,$152.35,$0.00,1,0,1,20210101,
88302,CPT,TISSUE EXAM BY PATHOLOGIST,,30,,,$177.03,$0.00,1,0,1,20210101,
88304,CPT,TISSUE EXAM BY PATHOLOGIST,,30,,,$332.59,$0.00,1,0,1,20210101,
88305,CPT,TISSUE EXAM BY PATHOLOGIST,,30,,,$332.59,$0.00,1,0,1,20210101,
88307,CPT,TISSUE EXAM BY PATHOLOGIST,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88309,CPT,TISSUE EXAM BY PATHOLOGIST,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
88311,CPT,DECALCIFY TISSUE,,30,,,$144.90,$0.00,1,0,1,20210101,
88312,CPT,SPECIAL STAINS GROUP 1,,30,,,$332.59,$0.00,1,0,1,20210101,
88313,CPT,SPECIAL STAINS GROUP 2,,30,,,$224.79,$0.00,1,0,1,20210101,
88314,CPT,HISTOCHEMICAL STAINS ADD-ON,,30,,,$366.94,$0.00,1,0,1,20210101,
88319,CPT,ENZYME HISTOCHEMISTRY,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
88321,CPT,MICROSLIDE CONSULTATION,,30,,,$224.79,$0.00,1,0,1,20210101,
88323,CPT,MICROSLIDE CONSULTATION,,30,,,$332.59,$0.00,1,0,1,20210101,
88325,CPT,COMPREHENSIVE REVIEW OF DATA,,30,,,$419.05,$0.00,1,0,1,20210101,
88329,CPT,PATH CONSULT INTROP,,30,,,$224.79,$0.00,1,0,1,20210101,
88331,CPT,PATH CONSULT INTRAOP 1 BLOC,,30,,,$696.68,$0.00,1,0,1,20210101,
88332,CPT,PATH CONSULT INTRAOP ADDL,,30,,,$228.20,$0.00,1,0,1,20210101,
88333,CPT,INTRAOP CYTO PATH CONSULT 1,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
88334,CPT,INTRAOP CYTO PATH CONSULT 2,,30,,,$189.08,$0.00,1,0,1,20210101,
88341,CPT,IMMUNOHISTO ANTB ADDL SLIDE,,30,,,$372.37,$0.00,1,0,1,20210101,
88342,CPT,IMMUNOHISTO ANTB 1ST STAIN,,30,,,$789.37,$0.00,1,0,1,20210101,
88344,CPT,IMMUNOHISTO ANTIBODY SLIDE,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88346,CPT,IMMUNOFLUOR ANTB 1ST STAIN,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88348,CPT,ELECTRON MICROSCOPY,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
88350,CPT,IMMUNOFLUOR ANTB ADDL STAIN,,30,,,$389.59,$0.00,1,0,1,20210101,
88355,CPT,ANALYSIS SKELETAL MUSCLE,,30,,,$696.68,$0.00,1,0,1,20210101,
88356,CPT,ANALYSIS NERVE,,30,,,$332.59,$0.00,1,0,1,20210101,
88358,CPT,ANALYSIS TUMOR,,30,,,$914.29,$0.00,1,0,1,20210101,
88360,CPT,TUMOR IMMUNOHISTOCHEM/MANUAL,,30,,,$789.37,$0.00,1,0,1,20210101,
88361,CPT,TUMOR IMMUNOHISTOCHEM/COMPUT,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88362,CPT,NERVE TEASING PREPARATIONS,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
88363,CPT,XM ARCHIVE TISSUE MOLEC ANAL,,30,,,$152.35,$0.00,1,0,1,20210101,
88364,CPT,INSITU HYBRIDIZATION (FISH),,30,,,$520.52,$0.00,1,0,1,20210101,
88365,CPT,INSITU HYBRIDIZATION (FISH),,30,,,$696.68,$0.00,1,0,1,20210101,
88366,CPT,INSITU HYBRIDIZATION (FISH),,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88367,CPT,INSITU HYBRIDIZATION AUTO,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88368,CPT,INSITU HYBRIDIZATION MANUAL,,30,,,"$1,570.78",$0.00,1,0,1,20210101,
88369,CPT,M/PHMTRC ALYSISHQUANT/SEMIQ,,30,,,$705.46,$0.00,1,0,1,20210101,
88371,CPT,PROTEIN WESTERN BLOT TISSUE,,30,,,$341.87,$0.00,1,0,1,20210101,
88372,CPT,PROTEIN ANALYSIS W/PROBE,,30,,,$346.34,$0.00,1,0,1,20210101,
88373,CPT,M/PHMTRC ALYS ISHQUANT/SEMIQ,,30,,,$492.29,$0.00,1,0,1,20210101,
88374,CPT,M/PHMTRC ALYS ISHQUANT/SEMIQ,,30,,,$696.68,$0.00,1,0,1,20210101,
88375,CPT,OPTICAL ENDOMICROSCPY INTERP,,30,,,$196.82,$0.00,1,0,1,20210101,
88377,CPT,M/PHMTRC ALYS ISHQUANT/SEMIQ,,30,,,$696.68,$0.00,1,0,1,20210101,
88380,CPT,MICRODISSECTION LASER,,30,,,"$1,375.79",$0.00,1,0,1,20210101,
88381,CPT,MICRODISSECTION MANUAL,,30,,,$664.84,$0.00,1,0,1,20210101,
88387,CPT,TISS EXAM MOLECULAR STUDY,,30,,,$155.16,$0.00,1,0,1,20210101,
88388,CPT,TISS EX MOLECUL STUDY ADD-ON,,30,,,$174.93,$0.00,1,0,1,20210101,
88399,CPT,SURGICAL PATHOLOGY PROCEDURE,,30,,,$332.59,$0.00,1,0,1,20210101,
88720,CPT,BILIRUBIN TOTAL TRANSCUT,,30,,,$131.04,$0.00,1,0,1,20210101,
88738,CPT,HGB QUANT TRANSCUTANEOUS,,30,,,$59.91,$0.00,1,0,1,20210101,
88740,CPT,TRANSCUTANEOUS CARBOXYHB,,30,,,$107.11,$0.00,1,0,1,20210101,
88741,CPT,TRANSCUTANEOUS METHB,,30,,,$139.62,$0.00,1,0,1,20210101,
88749,CPT,IN VIVO LAB SERVICE,,30,,,$33.55,$0.00,1,0,1,20210101,
89049,CPT,CHCT FOR MAL HYPERTHERMIA,,30,,,$696.68,$0.00,1,0,1,20210101,
89050,CPT,BODY FLUID CELL COUNT,,30,,,$159.83,$0.00,1,0,1,20210101,
89051,CPT,BODY FLUID CELL COUNT,,30,,,$219.15,$0.00,1,0,1,20210101,
89055,CPT,LEUKOCYTE ASSESSMENT FECAL,,30,,,$103.47,$0.00,1,0,1,20210101,
89060,CPT,EXAM SYNOVIAL FLUID CRYSTALS,,30,,,$144.95,$0.00,1,0,1,20210101,
89125,CPT,SPECIMEN FAT STAIN,,30,,,$133.44,$0.00,1,0,1,20210101,
89160,CPT,EXAM FECES FOR MEAT FIBERS,,30,,,$75.17,$0.00,1,0,1,20210101,
89190,CPT,NASAL SMEAR FOR EOSINOPHILS,,30,,,$104.17,$0.00,1,0,1,20210101,
89220,CPT,SPUTUM SPECIMEN COLLECTION,,30,,,$696.68,$0.00,1,0,1,20210101,
89230,CPT,COLLECT SWEAT FOR TEST,,30,,,$332.59,$0.00,1,0,1,20210101,
89240,CPT,PATHOLOGY LAB PROCEDURE,,30,,,$332.59,$0.00,1,0,1,20210101,
89250,CPT,CULTR OOCYTE/EMBRYO <4 DAYS,,30,,,$696.68,$0.00,1,0,1,20210101,
89251,CPT,CULTR OOCYTE/EMBRYO <4 DAYS,,30,,,$914.29,$0.00,1,0,1,20210101,
89253,CPT,EMBRYO HATCHING,,30,,,$696.68,$0.00,1,0,1,20210101,
89254,CPT,OOCYTE IDENTIFICATION,,30,,,$696.68,$0.00,1,0,1,20210101,
89255,CPT,PREPARE EMBRYO FOR TRANSFER,,30,,,$332.59,$0.00,1,0,1,20210101,
89257,CPT,SPERM IDENTIFICATION,,30,,,$332.59,$0.00,1,0,1,20210101,
89258,CPT,CRYOPRESERVATION EMBRYO(S),,30,,,"$1,863.84",$0.00,1,0,1,20210101,
89259,CPT,CRYOPRESERVATION SPERM,,30,,,$696.68,$0.00,1,0,1,20210101,
89260,CPT,SPERM ISOLATION SIMPLE,,30,,,$332.59,$0.00,1,0,1,20210101,
89261,CPT,SPERM ISOLATION COMPLEX,,30,,,$332.59,$0.00,1,0,1,20210101,
89264,CPT,IDENTIFY SPERM TISSUE,,30,,,$332.59,$0.00,1,0,1,20210101,
89268,CPT,INSEMINATION OF OOCYTES,,30,,,$696.68,$0.00,1,0,1,20210101,
89272,CPT,EXTENDED CULTURE OF OOCYTES,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
89280,CPT,ASSIST OOCYTE FERTILIZATION,,30,,,"$1,863.84",$0.00,1,0,1,20210101,
89281,CPT,ASSIST OOCYTE FERTILIZATION,,30,,,$696.68,$0.00,1,0,1,20210101,
89290,CPT,BIOPSY OOCYTE POLAR BODY,,30,,,$696.68,$0.00,1,0,1,20210101,
89291,CPT,BIOPSY OOCYTE POLAR BODY,,30,,,$696.68,$0.00,1,0,1,20210101,
89300,CPT,SEMEN ANALYSIS W/HUHNER,,30,,,$196.33,$0.00,1,0,1,20210101,
89310,CPT,SEMEN ANALYSIS W/COUNT,,30,,,$181.37,$0.00,1,0,1,20210101,
89320,CPT,SEMEN ANAL VOL/COUNT/MOT,,30,,,$305.84,$0.00,1,0,1,20210101,
89321,CPT,SEMEN ANAL SPERM DETECTION,,30,,,$201.37,$0.00,1,0,1,20210101,
89322,CPT,SEMEN ANAL STRICT CRITERIA,,30,,,$481.23,$0.00,1,0,1,20210101,
89325,CPT,SPERM ANTIBODY TEST,,30,,,$219.94,$0.00,1,0,1,20210101,
89329,CPT,SPERM EVALUATION TEST,,30,,,$250.40,$0.00,1,0,1,20210101,
89330,CPT,EVALUATION CERVICAL MUCUS,,30,,,$210.04,$0.00,1,0,1,20210101,
89331,CPT,RETROGRADE EJACULATION ANAL,,30,,,$316.18,$0.00,1,0,1,20210101,
89335,CPT,CRYOPRESERVE TESTICULAR TISS,,30,,,$332.59,$0.00,1,0,1,20210101,
89337,CPT,CRYOPRESERVATION OOCYTE(S),,30,,,$696.68,$0.00,1,0,1,20210101,
89342,CPT,STORAGE/YEAR EMBRYO(S),,30,,,$696.68,$0.00,1,0,1,20210101,
89343,CPT,STORAGE/YEAR SPERM/SEMEN,,30,,,$696.68,$0.00,1,0,1,20210101,
89344,CPT,STORAGE/YEAR REPROD TISSUE,,30,,,$696.68,$0.00,1,0,1,20210101,
89346,CPT,STORAGE/YEAR OOCYTE(S),,30,,,"$1,570.78",$0.00,1,0,1,20210101,
89352,CPT,THAWING CRYOPRESRVED EMBRYO,,30,,,$696.68,$0.00,1,0,1,20210101,
89353,CPT,THAWING CRYOPRESRVED SPERM,,30,,,$332.59,$0.00,1,0,1,20210101,
89354,CPT,THAW CRYOPRSVRD REPROD TISS,,30,,,$696.68,$0.00,1,0,1,20210101,
89356,CPT,THAWING CRYOPRESRVED OOCYTE,,30,,,$696.68,$0.00,1,0,1,20210101,
89398,CPT,UNLISTED REPROD MED LAB PROC,,30,,,$332.59,$0.00,1,0,1,20210101,
90281,CPT,HUMAN IG IM,,30,,,$119.20,$0.00,1,0,1,20210101,
90283,CPT,HUMAN IG IV,,30,,,$377.49,$0.00,1,0,1,20210101,
90287,CPT,BOTULINUM ANTITOXIN,,30,,,$119.21,$0.00,1,0,1,20210101,
90291,CPT,CMV IG IV,,30,,,$119.21,$0.00,1,0,1,20210101,
90296,CPT,DIPHTHERIA ANTITOXIN,,30,,,$85.47,$0.00,1,0,1,20210101,
90371,CPT,HEP B IG IM,,30,,,$782.08,$0.00,1,0,1,20210101,
90375,CPT,RABIES IG IM/SC,,30,,,"$1,875.62",$0.00,1,0,1,20210101,
90376,CPT,RABIES IG HEAT TREATED,,30,,,"$1,966.44",$0.00,1,0,1,20210101,
90378,CPT,RSV MAB IM 50MG,,30,,,"$9,455.02",$0.00,1,0,1,20210101,
90384,CPT,RH IG FULL-DOSE IM,,30,,,$447.56,$0.00,1,0,1,20210101,
90385,CPT,RH IG MINIDOSE IM,,30,,,$219.19,$0.00,1,0,1,20210101,
90386,CPT,RH IG IV,,30,,,$584.02,$0.00,1,0,1,20210101,
90389,CPT,TETANUS IG IM,,30,,,$427.65,$0.00,1,0,1,20210101,
90393,CPT,VACCINA IG IM,,30,,,$534.00,$0.00,1,0,1,20210101,
90396,CPT,VARICELLA-ZOSTER IG IM,,30,,,"$8,443.79",$0.00,1,0,1,20210101,
90460,CPT,IM ADMIN 1ST/ONLY COMPONENT,,30,,,$101.29,$0.00,1,0,1,20210101,
90461,CPT,IM ADMIN EACH ADDL COMPONENT,,30,,,$36.33,$0.00,1,0,1,20210101,
90471,CPT,IMMUNIZATION ADMIN,,30,,,$407.84,$0.00,1,0,1,20210101,
90472,CPT,IMMUNIZATION ADMIN EACH ADD,,30,,,$72.71,$0.00,1,0,1,20210101,
90473,CPT,IMMUNE ADMIN ORAL/NASAL,,30,,,$407.84,$0.00,1,0,1,20210101,
90474,CPT,IMMUNE ADMIN ORAL/NASAL ADDL,,30,,,$52.67,$0.00,1,0,1,20210101,
90476,CPT,ADENOVIRUS VACCINE TYPE 4,,30,,,$119.31,$0.00,1,0,1,20210101,
90581,CPT,ANTHRAX VACCINE SC OR IM,,30,,,$711.11,$0.00,1,0,1,20210101,
90585,CPT,BCG VACCINE PERCUT,,30,,,"$1,093.29",$0.00,1,0,1,20210101,
90586,CPT,BCG VACCINE INTRAVESICAL,,30,,,"$1,023.22",$0.00,1,0,1,20210101,
90620,CPT,MENB-4C VACC 2 DOSE IM,,30,,,$920.39,$0.00,1,0,1,20210101,
90621,CPT,MENB-FHBP VACC 2/3 DOSE IM,,30,,,$676.13,$0.00,1,0,1,20210101,
90625,CPT,CHOLERA VACCINE LIVE ORAL,,30,,,$999.53,$0.00,1,0,1,20210101,
90630,CPT,FLU VACC IIV4 NO PRESERV ID,,30,,,$60.37,$0.00,1,0,1,20210101,
90632,CPT,HEPA VACCINE ADULT IM,,30,,,$236.48,$0.00,1,0,1,20210101,
90633,CPT,HEPA VACC PED/ADOL 2 DOSE IM,,30,,,$150.95,$0.00,1,0,1,20210101,
90634,CPT,HEPA VACC PED/ADOL 3 DOSE,,30,,,$236.64,$0.00,1,0,1,20210101,
90636,CPT,HEP A/HEP B VACC ADULT IM,,30,,,$380.43,$0.00,1,0,1,20210101,
90644,CPT,HIB-MENCY VACC 6WK-18M0 IM,,30,,,$307.87,$0.00,1,0,1,20210101,
90647,CPT,HIB PRP-OMP VACC 3 DOSE IM,,30,,,$186.71,$0.00,1,0,1,20210101,
90648,CPT,HIB PRP-T VACCINE 4 DOSE IM,,30,,,$174.81,$0.00,1,0,1,20210101,
90649,CPT,4VHPV VACCINE 3 DOSE IM,,30,,,$584.78,$0.00,1,0,1,20210101,
90650,CPT,2VHPV VACCINE 3 DOSE IM,,30,,,$779.78,$0.00,1,0,1,20210101,
90651,CPT,9VHPV VACCINE 2/3 DOSE IM,,30,,,$688.69,$0.00,1,0,1,20210101,
90653,CPT,IIV ADJUVANT VACCINE IM,,30,,,$97.53,$0.00,1,0,1,20210101,
90654,CPT,FLU VACC IIV3 NO PRESERV ID,,30,,,$63.94,$0.00,1,0,1,20210101,
90655,CPT,IIV3 VACC NO PRSV 0.25 ML IM,,30,,,$53.03,$0.00,1,0,1,20210101,
90656,CPT,IIV3 VACC NO PRSV 0.5 ML IM,,30,,,$80.93,$0.00,1,0,1,20210101,
90657,CPT,IIV3 VACCINE SPLT 0.25 ML IM,,30,,,$44.29,$0.00,1,0,1,20210101,
90658,CPT,IIV3 VACCINE SPLT 0.5 ML IM,,30,,,$50.28,$0.00,1,0,1,20210101,
90660,CPT,LAIV3 VACCINE INTRANASAL,,30,,,$303.01,$0.00,1,0,1,20210101,
90661,CPT,CCIIV3 VAC NO PRSV 0.5 ML IM,,30,,,$114.75,$0.00,1,0,1,20210101,
90662,CPT,IIV NO PRSV INCREASED AG IM,,30,,,$190.60,$0.00,1,0,1,20210101,
90664,CPT,LAIV VACC PANDEMIC INTRANASL,,30,,,$188.67,$0.00,1,0,1,20210101,
90666,CPT,FLU VAC PANDEM PRSRV FREE IM,,30,,,$187.63,$0.00,1,0,1,20210101,
90667,CPT,IIV VACC PANDEMIC ADJUVT IM,,30,,,$60.65,$0.00,1,0,1,20210101,
90668,CPT,IIV VACCINE PANDEMIC IM,,30,,,$43.27,$0.00,1,0,1,20210101,
90670,CPT,PCV13 VACCINE IM,,30,,,$645.85,$0.00,1,0,1,20210101,
90672,CPT,LAIV4 VACCINE INTRANASAL,,30,,,$71.27,$0.00,1,0,1,20210101,
90673,CPT,RIV3 VACCINE NO PRESERV IM,,30,,,$90.02,$0.00,1,0,1,20210101,
90674,CPT,CCIIV4 VAC NO PRSV 0.5 ML IM,,30,,,$143.35,$0.00,1,0,1,20210101,
90675,CPT,RABIES VACCINE IM,,30,,,"$1,662.36",$0.00,1,0,1,20210101,
90676,CPT,RABIES VACCINE ID,,30,,,"$1,138.40",$0.00,1,0,1,20210101,
90680,CPT,RV5 VACC 3 DOSE LIVE ORAL,,30,,,$495.71,$0.00,1,0,1,20210101,
90681,CPT,RV1 VACC 2 DOSE LIVE ORAL,,30,,,$640.51,$0.00,1,0,1,20210101,
90682,CPT,RIV4 VACC RECOMBINANT DNA IM,,30,,,$127.00,$0.00,1,0,1,20210101,
90685,CPT,IIV4 VACC NO PRSV 0.25 ML IM,,30,,,$108.77,$0.00,1,0,1,20210101,
90686,CPT,IIV4 VACC NO PRSV 0.5 ML IM,,30,,,$96.27,$0.00,1,0,1,20210101,
90687,CPT,IIV4 VACCINE SPLT 0.25 ML IM,,30,,,$66.49,$0.00,1,0,1,20210101,
90688,CPT,IIV4 VACCINE SPLT 0.5 ML IM,,30,,,$146.01,$0.00,1,0,1,20210101,
90689,CPT,VACC IIV4 NO PRSRV 0.25ML IM,,30,,,$121.38,$0.00,1,0,1,20210101,
90690,CPT,TYPHOID VACCINE ORAL,,30,,,$144.93,$0.00,1,0,1,20210101,
90691,CPT,TYPHOID VACCINE IM,,30,,,$260.13,$0.00,1,0,1,20210101,
90696,CPT,DTAP-IPV VACCINE 4-6 YRS IM,,30,,,$194.11,$0.00,1,0,1,20210101,
90697,CPT,DTAP-IPV-HIB-HEPB VACCINE IM,,30,,,$324.78,$0.00,1,0,1,20210101,
90698,CPT,DTAP-IPV/HIB VACCINE IM,,30,,,$415.28,$0.00,1,0,1,20210101,
90700,CPT,DTAP VACCINE < 7 YRS IM,,30,,,$179.15,$0.00,1,0,1,20210101,
90702,CPT,DT VACCINE UNDER 7 YRS IM,,30,,,$259.02,$0.00,1,0,1,20210101,
90707,CPT,MMR VACCINE SC,,30,,,$294.65,$0.00,1,0,1,20210101,
90710,CPT,MMRV VACCINE SC,,30,,,$578.61,$0.00,1,0,1,20210101,
90713,CPT,POLIOVIRUS IPV SC/IM,,30,,,$243.14,$0.00,1,0,1,20210101,
90714,CPT,TD VACC NO PRESV 7 YRS+ IM,,30,,,$185.56,$0.00,1,0,1,20210101,
90715,CPT,TDAP VACCINE 7 YRS/> IM,,30,,,$275.41,$0.00,1,0,1,20210101,
90716,CPT,VAR VACCINE LIVE SUBQ,,30,,,$416.52,$0.00,1,0,1,20210101,
90717,CPT,YELLOW FEVER VACCINE SUBQ,,30,,,$362.72,$0.00,1,0,1,20210101,
90723,CPT,DTAP-HEP B-IPV VACCINE IM,,30,,,$316.48,$0.00,1,0,1,20210101,
90732,CPT,PPSV23 VACC 2 YRS+ SUBQ/IM,,30,,,$378.41,$0.00,1,0,1,20210101,
90733,CPT,MPSV4 VACCINE SUBQ,,30,,,$675.43,$0.00,1,0,1,20210101,
90734,CPT,MENACWYD/MENACWYCRM VACC IM,,30,,,$559.93,$0.00,1,0,1,20210101,
90736,CPT,HZV VACCINE LIVE SUBQ,,30,,,$597.39,$0.00,1,0,1,20210101,
90738,CPT,INACTIVATED JE VACC IM,,30,,,$934.38,$0.00,1,0,1,20210101,
90739,CPT,HEPB VACC 2 DOSE ADULT IM,,30,,,$513.00,$0.00,1,0,1,20210101,
90740,CPT,HEPB VACC 3 DOSE IMMUNSUP IM,,30,,,"$2,740.52",$0.00,1,0,1,20210101,
90743,CPT,HEPB VACC 2 DOSE ADOLESC IM,,30,,,$271.03,$0.00,1,0,1,20210101,
90744,CPT,HEPB VACC 3 DOSE PED/ADOL IM,,30,,,$220.02,$0.00,1,0,1,20210101,
90746,CPT,HEPB VACCINE 3 DOSE ADULT IM,,30,,,$257.70,$0.00,1,0,1,20210101,
90747,CPT,HEPB VACC 4 DOSE IMMUNSUP IM,,30,,,"$2,373.75",$0.00,1,0,1,20210101,
90748,CPT,HIB-HEPB VACCINE IM,,30,,,$309.70,$0.00,1,0,1,20210101,
90749,CPT,VACCINE TOXOID,,30,,,$472.70,$0.00,1,0,1,20210101,
90750,CPT,HZV VACC RECOMBINANT IM,,30,,,$523.34,$0.00,1,0,1,20210101,
90756,CPT,CCIIV4 VACC ABX FREE IM,,30,,,$94.91,$0.00,1,0,1,20210101,
90785,CPT,PSYTX COMPLEX INTERACTIVE,,30,,,$227.48,$0.00,1,0,1,20210101,
90791,CPT,PSYCH DIAGNOSTIC EVALUATION,,30,,,$339.50,$0.00,1,0,1,20210101,
90792,CPT,PSYCH DIAG EVAL W/MED SRVCS,,30,,,$339.50,$0.00,1,0,1,20210101,
90832,CPT,PSYTX W PT 30 MINUTES,,30,,,$339.50,$0.00,1,0,1,20210101,
90833,CPT,PSYTX W PT W E/M 30 MIN,,30,,,$196.77,$0.00,1,0,1,20210101,
90834,CPT,PSYTX W PT 45 MINUTES,,30,,,$339.50,$0.00,1,0,1,20210101,
90836,CPT,PSYTX W PT W E/M 45 MIN,,30,,,$333.01,$0.00,1,0,1,20210101,
90837,CPT,PSYTX W PT 60 MINUTES,,30,,,$339.50,$0.00,1,0,1,20210101,
90838,CPT,PSYTX W PT W E/M 60 MIN,,30,,,$408.59,$0.00,1,0,1,20210101,
90839,CPT,PSYTX CRISIS INITIAL 60 MIN,,30,,,$339.50,$0.00,1,0,1,20210101,
90840,CPT,PSYTX CRISIS EA ADDL 30 MIN,,30,,,$348.69,$0.00,1,0,1,20210101,
90845,CPT,PSYCHOANALYSIS,,30,,,$339.50,$0.00,1,0,1,20210101,
90846,CPT,FAMILY PSYTX W/O PT 50 MIN,,30,,,$339.50,$0.00,1,0,1,20210101,
90847,CPT,FAMILY PSYTX W/PT 50 MIN,,30,,,$339.50,$0.00,1,0,1,20210101,
90849,CPT,MULTIPLE FAMILY GROUP PSYTX,,30,,,$339.50,$0.00,1,0,1,20210101,
90853,CPT,GROUP PSYCHOTHERAPY,,30,,,$318.68,$0.00,1,0,1,20210101,
90863,CPT,PHARMACOLOGIC MGMT W/PSYTX,,30,,,$265.85,$0.00,1,0,1,20210101,
90865,CPT,NARCOSYNTHESIS,,30,,,$339.50,$0.00,1,0,1,20210101,
90867,CPT,TCRANIAL MAGN STIM TX PLAN,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
90868,CPT,TCRANIAL MAGN STIM TX DELI,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
90869,CPT,TCRAN MAGN STIM REDETEMINE,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
90870,CPT,ELECTROCONVULSIVE THERAPY,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
90875,CPT,PSYCHOPHYSIOLOGICAL THERAPY,,30,,,$385.15,$0.00,1,0,1,20210101,
90876,CPT,PSYCHOPHYSIOLOGICAL THERAPY,,30,,,$958.22,$0.00,1,0,1,20210101,
90880,CPT,HYPNOTHERAPY,,30,,,$318.68,$0.00,1,0,1,20210101,
90882,CPT,ENVIRONMENTAL MANIPULATION,,30,,,$262.20,$0.00,1,0,1,20210101,
90885,CPT,PSY EVALUATION OF RECORDS,,30,,,$641.89,$0.00,1,0,1,20210101,
90887,CPT,CONSULTATION WITH FAMILY,,30,,,$337.62,$0.00,1,0,1,20210101,
90889,CPT,PREPARATION OF REPORT,,30,,,$323.65,$0.00,1,0,1,20210101,
90899,CPT,PSYCHIATRIC SERVICE/THERAPY,,30,,,$112.93,$0.00,1,0,1,20210101,
90901,CPT,BIOFEEDBACK TRAIN ANY METH,,30,,,$257.32,$0.00,1,0,1,20210101,
90935,CPT,HEMODIALYSIS ONE EVALUATION,,30,,,"$4,138.92",$0.00,1,0,1,20210101,
90937,CPT,HEMODIALYSIS REPEATED EVAL,,30,,,"$3,088.76",$0.00,1,0,1,20210101,
90940,CPT,HEMODIALYSIS ACCESS STUDY,,30,,,$884.65,$0.00,1,0,1,20210101,
90945,CPT,DIALYSIS ONE EVALUATION,,30,,,"$2,383.10",$0.00,1,0,1,20210101,
90947,CPT,DIALYSIS REPEATED EVAL,,30,,,"$1,348.40",$0.00,1,0,1,20210101,
90954,CPT,ESRD SERV 4 VSTS P MO 2-11,,30,,,"$1,063.47",$0.00,1,0,1,20210101,
90955,CPT,ESRD SRV 2-3 VSTS P MO 2-11,,30,,,$605.44,$0.00,1,0,1,20210101,
90956,CPT,ESRD SRV 1 VISIT P MO 2-11,,30,,,$164.85,$0.00,1,0,1,20210101,
90960,CPT,ESRD SRV 4 VISITS P MO 20+,,30,,,"$1,243.81",$0.00,1,0,1,20210101,
90961,CPT,ESRD SRV 2-3 VSTS P MO 20+,,30,,,$994.80,$0.00,1,0,1,20210101,
90962,CPT,ESRD SERV 1 VISIT P MO 20+,,30,,,"$6,531.82",$0.00,1,0,1,20210101,
90963,CPT,ESRD HOME PT SERV P MO <2YRS,,30,,,"$1,819.81",$0.00,1,0,1,20210101,
90964,CPT,ESRD HOME PT SERV P MO 2-11,,30,,,"$1,916.85",$0.00,1,0,1,20210101,
90965,CPT,ESRD HOME PT SERV P MO 12-19,,30,,,"$1,995.23",$0.00,1,0,1,20210101,
90966,CPT,ESRD HOME PT SERV P MO 20+,,30,,,$897.17,$0.00,1,0,1,20210101,
90967,CPT,ESRD SVC PR DAY PT <2,,30,,,"$2,412.36",$0.00,1,0,1,20210101,
90968,CPT,ESRD SVC PR DAY PT 2-11,,30,,,"$4,839.78",$0.00,1,0,1,20210101,
90969,CPT,ESRD SVC PR DAY PT 12-19,,30,,,"$5,630.39",$0.00,1,0,1,20210101,
90970,CPT,ESRD SVC PR DAY PT 20+,,30,,,"$1,592.90",$0.00,1,0,1,20210101,
90989,CPT,DIALYSIS TRAINING COMPLETE,,30,,,"$1,249.27",$0.00,1,0,1,20210101,
90993,CPT,DIALYSIS TRAINING INCOMPL,,30,,,"$6,598.92",$0.00,1,0,1,20210101,
90997,CPT,HEMOPERFUSION,,30,,,$570.13,$0.00,1,0,1,20210101,
90999,CPT,DIALYSIS PROCEDURE,,30,,,"$6,044.82",$0.00,1,0,1,20210101,
91010,CPT,ESOPHAGUS MOTILITY STUDY,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
91013,CPT,ESOPHGL MOTIL W/STIM/PERFUS,,30,,,"$1,487.91",$0.00,1,0,1,20210101,
91020,CPT,GASTRIC MOTILITY STUDIES,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
91022,CPT,DUODENAL MOTILITY STUDY,,30,,,"$3,046.46",$0.00,1,0,1,20210101,
91030,CPT,ACID PERFUSION OF ESOPHAGUS,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
91034,CPT,GASTROESOPHAGEAL REFLUX TEST,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
91035,CPT,G-ESOPH REFLX TST W/ELECTROD,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
91037,CPT,ESOPH IMPED FUNCTION TEST,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
91038,CPT,ESOPH IMPED FUNCT TEST > 1HR,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
91040,CPT,ESOPH BALLOON DISTENSION TST,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
91065,CPT,BREATH HYDROGEN/METHANE TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
91110,CPT,GI TRACT CAPSULE ENDOSCOPY,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
91111,CPT,ESOPHAGEAL CAPSULE ENDOSCOPY,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
91112,CPT,GI WIRELESS CAPSULE MEASURE,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
91117,CPT,COLON MOTILITY 6 HR STUDY,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
91120,CPT,RECTAL SENSATION TEST,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
91122,CPT,ANAL PRESSURE RECORD,,30,,,"$1,448.07",$0.00,1,0,1,20210101,
91132,CPT,ELECTROGASTROGRAPHY,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
91133,CPT,ELECTROGASTROGRAPHY W/TEST,,30,,,$584.38,$0.00,1,0,1,20210101,
91200,CPT,LIVER ELASTOGRAPHY,,30,,,$888.86,$0.00,1,0,1,20210101,
91299,CPT,GASTROENTEROLOGY PROCEDURE,,30,,,$888.86,$0.00,1,0,1,20210101,
91300,CPT,SARSCOV2 VAC 30MCG/0.3ML IM,,30,,,$0.01,$0.00,1,0,1,20210101,
91301,CPT,SARSCOV2 VAC 100MCG/0.5ML IM,,30,,,$0.01,$0.00,1,0,1,20210101,
92002,CPT,EYE EXAM NEW PATIENT,,30,,,$358.48,$0.00,1,0,1,20210101,
92004,CPT,EYE EXAM NEW PATIENT,,30,,,$358.48,$0.00,1,0,1,20210101,
92012,CPT,EYE EXAM ESTABLISH PATIENT,,30,,,$358.48,$0.00,1,0,1,20210101,
92014,CPT,EYE EXAM&TX ESTAB PT 1/>VST,,30,,,$358.48,$0.00,1,0,1,20210101,
92015,CPT,DETERMINE REFRACTIVE STATE,,30,,,$84.16,$0.00,1,0,1,20210101,
92018,CPT,NEW EYE EXAM & TREATMENT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
92019,CPT,EYE EXAM & TREATMENT,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
92020,CPT,SPECIAL EYE EVALUATION,,30,,,$584.38,$0.00,1,0,1,20210101,
92025,CPT,CORNEAL TOPOGRAPHY,,30,,,$373.96,$0.00,1,0,1,20210101,
92060,CPT,SPECIAL EYE EVALUATION,,30,,,$373.96,$0.00,1,0,1,20210101,
92065,CPT,ORTHOPTIC/PLEOPTIC TRAINING,,30,,,$373.96,$0.00,1,0,1,20210101,
92071,CPT,CONTACT LENS FITTING FOR TX,,30,,,$227.40,$0.00,1,0,1,20210101,
92072,CPT,FIT CONTAC LENS FOR MANAGMNT,,30,,,$380.92,$0.00,1,0,1,20210101,
92081,CPT,VISUAL FIELD EXAMINATION(S),,30,,,$373.96,$0.00,1,0,1,20210101,
92082,CPT,VISUAL FIELD EXAMINATION(S),,30,,,$373.96,$0.00,1,0,1,20210101,
92083,CPT,VISUAL FIELD EXAMINATION(S),,30,,,$584.38,$0.00,1,0,1,20210101,
92100,CPT,SERIAL TONOMETRY EXAM(S),,30,,,$277.81,$0.00,1,0,1,20210101,
92132,CPT,CMPTR OPHTH DX IMG ANT SEGMT,,30,,,$373.96,$0.00,1,0,1,20210101,
92133,CPT,CMPTR OPHTH IMG OPTIC NERVE,,30,,,$373.96,$0.00,1,0,1,20210101,
92134,CPT,CPTR OPHTH DX IMG POST SEGMT,,30,,,$373.96,$0.00,1,0,1,20210101,
92136,CPT,OPHTHALMIC BIOMETRY,,30,,,$584.38,$0.00,1,0,1,20210101,
92145,CPT,CORNEAL HYSTERESIS DETER,,30,,,$224.79,$0.00,1,0,1,20210101,
92201,CPT,OPSCPY EXTND RTA DRAW UNI/BI,,30,,,$371.12,$0.00,1,0,1,20210101,
92202,CPT,OPSCPY EXTND ON/MAC DRAW,,30,,,$371.12,$0.00,1,0,1,20210101,
92227,CPT,IMG RTA DETCJ/MNTR DS STAFF,,30,,,$224.79,$0.00,1,0,1,20210101,
92228,CPT,IMG RTA DETC/MNTR DS PHY/QHP,,30,,,"$1,320.43",$0.00,1,0,1,20210101,
92229,CPT,IMG RTA DETC/MNTR DS POC ALY,,30,,,$366.45,$0.00,1,0,1,20210101,
92230,CPT,EYE EXAM WITH PHOTOS,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
92235,CPT,FLUORESCEIN ANGRPH UNI/BI,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
92240,CPT,ICG ANGIOGRAPHY UNI/BI,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
92242,CPT,FLUORESCEIN ICG ANGIOGRAPHY,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
92250,CPT,EYE EXAM WITH PHOTOS,,30,,,$584.38,$0.00,1,0,1,20210101,
92260,CPT,OPHTHALMOSCOPY/DYNAMOMETRY,,30,,,$224.79,$0.00,1,0,1,20210101,
92265,CPT,EYE MUSCLE EVALUATION,,30,,,$373.96,$0.00,1,0,1,20210101,
92270,CPT,ELECTRO-OCULOGRAPHY,,30,,,$584.38,$0.00,1,0,1,20210101,
92273,CPT,FULL FIELD ERG W/I&R,,30,,,"$1,667.99",$0.00,1,0,1,20210101,
92274,CPT,MULTIFOCAL ERG W/I&R,,30,,,"$1,039.29",$0.00,1,0,1,20210101,
92283,CPT,COLOR VISION EXAMINATION,,30,,,$426.56,$0.00,1,0,1,20210101,
92284,CPT,DARK ADAPTATION EYE EXAM,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
92285,CPT,EYE PHOTOGRAPHY,,30,,,$373.96,$0.00,1,0,1,20210101,
92286,CPT,INTERNAL EYE PHOTOGRAPHY,,30,,,$584.38,$0.00,1,0,1,20210101,
92287,CPT,INTERNAL EYE PHOTOGRAPHY,,30,,,$584.38,$0.00,1,0,1,20210101,
92310,CPT,CONTACT LENS FITTING,,30,,,$167.60,$0.00,1,0,1,20210101,
92311,CPT,CONTACT LENS FITTING,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
92312,CPT,CONTACT LENS FITTING,,30,,,$584.38,$0.00,1,0,1,20210101,
92313,CPT,CONTACT LENS FITTING,,30,,,$584.38,$0.00,1,0,1,20210101,
92314,CPT,PRESCRIPTION OF CONTACT LENS,,30,,,$250.68,$0.00,1,0,1,20210101,
92315,CPT,RX CNTACT LENS APHAKIA 1 EYE,,30,,,$584.38,$0.00,1,0,1,20210101,
92316,CPT,RX CNTACT LENS APHAKIA 2 EYE,,30,,,$476.84,$0.00,1,0,1,20210101,
92317,CPT,RX CORNEOSCLERAL CNTACT LENS,,30,,,$224.79,$0.00,1,0,1,20210101,
92325,CPT,MODIFICATION OF CONTACT LENS,,30,,,$584.38,$0.00,1,0,1,20210101,
92326,CPT,REPLACEMENT OF CONTACT LENS,,30,,,$426.56,$0.00,1,0,1,20210101,
92340,CPT,FIT SPECTACLES MONOFOCAL,,30,,,$90.60,$0.00,1,0,1,20210101,
92341,CPT,FIT SPECTACLES BIFOCAL,,30,,,$102.37,$0.00,1,0,1,20210101,
92342,CPT,FIT SPECTACLES MULTIFOCAL,,30,,,$144.51,$0.00,1,0,1,20210101,
92352,CPT,FIT APHAKIA SPECTCL MONOFOCL,,30,,,$373.96,$0.00,1,0,1,20210101,
92353,CPT,FIT APHAKIA SPECTCL MULTIFOC,,30,,,$373.96,$0.00,1,0,1,20210101,
92354,CPT,FIT SPECTACLES SINGLE SYSTEM,,30,,,$224.79,$0.00,1,0,1,20210101,
92355,CPT,FIT SPECTACLES COMPOUND LENS,,30,,,$224.79,$0.00,1,0,1,20210101,
92358,CPT,APHAKIA PROSTH SERVICE TEMP,,30,,,$373.96,$0.00,1,0,1,20210101,
92370,CPT,REPAIR & ADJUST SPECTACLES,,30,,,$126.11,$0.00,1,0,1,20210101,
92371,CPT,REPAIR & ADJUST SPECTACLES,,30,,,$373.96,$0.00,1,0,1,20210101,
92499,CPT,EYE SERVICE OR PROCEDURE,,30,,,$152.35,$0.00,1,0,1,20210101,
92502,CPT,EAR AND THROAT EXAMINATION,,30,,,"$2,265.47",$0.00,1,0,1,20210101,
92504,CPT,EAR MICROSCOPY EXAMINATION,,30,,,$114.68,$0.00,1,0,1,20210101,
92511,CPT,NASOPHARYNGOSCOPY,,30,,,$725.01,$0.00,1,0,1,20210101,
92512,CPT,NASAL FUNCTION STUDIES,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
92516,CPT,FACIAL NERVE FUNCTION TEST,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
92517,CPT,VEMP TEST I&R CERVICAL,,30,,,$860.46,$0.00,1,0,1,20210101,
92518,CPT,VEMP TEST I&R OCULAR,,30,,,$860.46,$0.00,1,0,1,20210101,
92519,CPT,VEMP TST I&R CERVICAL&OCULAR,,30,,,"$1,724.22",$0.00,1,0,1,20210101,
92520,CPT,LARYNGEAL FUNCTION STUDIES,,30,,,$584.38,$0.00,1,0,1,20210101,
92526,CPT,ORAL FUNCTION THERAPY,,30,,,$180.84,$0.00,1,0,1,20210101,
92531,CPT,SPONTANEOUS NYSTAGMUS STUDY,,30,,,$453.38,$0.00,1,0,1,20210101,
92532,CPT,POSITIONAL NYSTAGMUS TEST,,30,,,$213.03,$0.00,1,0,1,20210101,
92533,CPT,CALORIC VESTIBULAR TEST,,30,,,$331.71,$0.00,1,0,1,20210101,
92534,CPT,OPTOKINETIC NYSTAGMUS TEST,,30,,,$668.73,$0.00,1,0,1,20210101,
92537,CPT,CALORIC VSTBLR TEST W/REC,,30,,,$888.86,$0.00,1,0,1,20210101,
92538,CPT,CALORIC VSTBLR TEST W/REC,,30,,,$888.86,$0.00,1,0,1,20210101,
92540,CPT,BASIC VESTIBULAR EVALUATION,,30,,,$888.86,$0.00,1,0,1,20210101,
92541,CPT,SPONTANEOUS NYSTAGMUS TEST,,30,,,$584.38,$0.00,1,0,1,20210101,
92542,CPT,POSITIONAL NYSTAGMUS TEST,,30,,,$584.38,$0.00,1,0,1,20210101,
92544,CPT,OPTOKINETIC NYSTAGMUS TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
92545,CPT,OSCILLATING TRACKING TEST,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
92546,CPT,SINUSOIDAL ROTATIONAL TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
92547,CPT,SUPPLEMENTAL ELECTRICAL TEST,,30,,,$378.22,$0.00,1,0,1,20210101,
92548,CPT,CDP-SOT 6 COND W/I&R,,30,,,$584.38,$0.00,1,0,1,20210101,
92549,CPT,CDP-SOT 6 COND W/I&R MCT&ADT,,30,,,$580.45,$0.00,1,0,1,20210101,
92550,CPT,TYMPANOMETRY & REFLEX THRESH,,30,,,$888.86,$0.00,1,0,0,20210101,
92551,CPT,PURE TONE HEARING TEST AIR,,30,,,$79.09,$0.00,1,0,0,20210101,
92552,CPT,PURE TONE AUDIOMETRY AIR,,30,,,$584.38,$0.00,1,0,0,20210101,
92553,CPT,AUDIOMETRY AIR & BONE,,30,,,$888.86,$0.00,1,0,0,20210101,
92555,CPT,SPEECH THRESHOLD AUDIOMETRY,,30,,,$224.79,$0.00,1,0,0,20210101,
92556,CPT,SPEECH AUDIOMETRY COMPLETE,,30,,,$282.49,$0.00,1,0,0,20210101,
92557,CPT,COMPREHENSIVE HEARING TEST,,30,,,$888.86,$0.00,1,0,0,20210101,
92558,CPT,EVOKED AUDITORY TEST QUAL,,30,,,$386.06,$0.00,1,0,0,20210101,
92559,CPT,GROUP AUDIOMETRIC TESTING,,30,,,$114.03,$0.00,1,0,0,20210101,
92560,CPT,BEKESY AUDIOMETRY SCREEN,,30,,,$68.42,$0.00,1,0,0,20210101,
92561,CPT,BEKESY AUDIOMETRY DIAGNOSIS,,30,,,$584.38,$0.00,1,0,0,20210101,
92562,CPT,LOUDNESS BALANCE TEST,,30,,,$888.86,$0.00,1,0,0,20210101,
92563,CPT,TONE DECAY HEARING TEST,,30,,,$224.79,$0.00,1,0,0,20210101,
92564,CPT,SISI HEARING TEST,,30,,,$152.35,$0.00,1,0,0,20210101,
92565,CPT,STENGER TEST PURE TONE,,30,,,$224.79,$0.00,1,0,0,20210101,
92567,CPT,TYMPANOMETRY,,30,,,$224.79,$0.00,1,0,0,20210101,
92568,CPT,ACOUSTIC REFL THRESHOLD TST,,30,,,$224.79,$0.00,1,0,0,20210101,
92570,CPT,ACOUSTIC IMMITANCE TESTING,,30,,,$888.86,$0.00,1,0,0,20210101,
92571,CPT,FILTERED SPEECH HEARING TEST,,30,,,$224.79,$0.00,1,0,0,20210101,
92572,CPT,STAGGERED SPONDAIC WORD TEST,,30,,,$888.86,$0.00,1,0,0,20210101,
92575,CPT,SENSORINEURAL ACUITY TEST,,30,,,$224.79,$0.00,1,0,0,20210101,
92576,CPT,SYNTHETIC SENTENCE TEST,,30,,,$224.79,$0.00,1,0,0,20210101,
92577,CPT,STENGER TEST SPEECH,,30,,,"$2,621.70",$0.00,1,0,0,20210101,
92579,CPT,VISUAL AUDIOMETRY (VRA),,30,,,$888.86,$0.00,1,0,0,20210101,
92582,CPT,CONDITIONING PLAY AUDIOMETRY,,30,,,$888.86,$0.00,1,0,0,20210101,
92583,CPT,SELECT PICTURE AUDIOMETRY,,30,,,$282.49,$0.00,1,0,0,20210101,
92584,CPT,ELECTROCOCHLEOGRAPHY,,30,,,$888.86,$0.00,1,0,0,20210101,
92587,CPT,EVOKED AUDITORY TEST LIMITED,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
92588,CPT,EVOKED AUDITORY TST COMPLETE,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
92590,CPT,HEARING AID EXAM ONE EAR,,30,,,$271.86,$0.00,1,0,0,20210101,
92591,CPT,HEARING AID EXAM BOTH EARS,,30,,,$428.07,$0.00,1,0,0,20210101,
92592,CPT,HEARING AID CHECK ONE EAR,,30,,,$165.21,$0.00,1,0,0,20210101,
92593,CPT,HEARING AID CHECK BOTH EARS,,30,,,$211.99,$0.00,1,0,0,20210101,
92594,CPT,ELECTRO HEARNG AID TEST ONE,,30,,,$137.20,$0.00,1,0,0,20210101,
92595,CPT,ELECTRO HEARNG AID TST BOTH,,30,,,$208.50,$0.00,1,0,0,20210101,
92596,CPT,EAR PROTECTOR EVALUATION,,30,,,$224.79,$0.00,1,0,0,20210101,
92601,CPT,COCHLEAR IMPLT F/UP EXAM <7,,30,,,$888.86,$0.00,1,0,0,20210101,
92602,CPT,REPROGRAM COCHLEAR IMPLT <7,,30,,,$888.86,$0.00,1,0,0,20210101,
92603,CPT,COCHLEAR IMPLT F/UP EXAM 7/>,,30,,,$888.86,$0.00,1,0,0,20210101,
92604,CPT,REPROGRAM COCHLEAR IMPLT 7/>,,30,,,$888.86,$0.00,1,0,0,20210101,
92613,CPT,ENDOSCOPY SWALLOW (FEES) I&R,,30,,,$265.76,$0.00,1,0,1,20210101,
92615,CPT,LARYNGOSCOPIC SENSORY I&R,,30,,,$234.28,$0.00,1,0,1,20210101,
92617,CPT,FEES W/LARYNGEAL SENSE I&R,,30,,,$286.11,$0.00,1,0,1,20210101,
92620,CPT,AUDITORY FUNCTION 60 MIN,,30,,,$888.86,$0.00,1,0,1,20210101,
92621,CPT,AUDITORY FUNCTION + 15 MIN,,30,,,$138.00,$0.00,1,0,1,20210101,
92625,CPT,TINNITUS ASSESSMENT,,30,,,$888.86,$0.00,1,0,1,20210101,
92626,CPT,EVAL AUD FUNCJ 1ST HOUR,,30,,,$888.86,$0.00,1,0,1,20210101,
92627,CPT,EVAL AUD FUNCJ EA ADDL 15,,30,,,$159.33,$0.00,1,0,1,20210101,
92630,CPT,AUD REHAB PRE-LING HEAR LOSS,,30,,,$659.27,$0.00,1,0,1,20210101,
92633,CPT,AUD REHAB POSTLING HEAR LOSS,,30,,,$414.65,$0.00,1,0,1,20210101,
92640,CPT,AUD BRAINSTEM IMPLT PROGRAMG,,30,,,$888.86,$0.00,1,0,1,20210101,
92651,CPT,AEP HEARING STATUS DETER I&R,,30,,,$860.46,$0.00,1,0,1,20210101,
92652,CPT,AEP THRSHLD EST MLT FREQ I&R,,30,,,"$1,724.22",$0.00,1,0,1,20210101,
92653,CPT,AEP NEURODIAGNOSTIC I&R,,30,,,"$1,724.22",$0.00,1,0,1,20210101,
92700,CPT,ENT PROCEDURE/SERVICE,,30,,,$152.35,$0.00,1,0,1,20210101,
92920,CPT,PRQ CARDIAC ANGIOPLAST 1 ART,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
92921,CPT,PRQ CARDIAC ANGIO ADDL ART,,30,,,"$15,098.63",$0.00,1,0,1,20210101,
92924,CPT,PRQ CARD ANGIO/ATHRECT 1 ART,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
92925,CPT,PRQ CARD ANGIO/ATHRECT ADDL,,30,,,"$33,711.72",$0.00,1,0,1,20210101,
92928,CPT,PRQ CARD STENT W/ANGIO 1 VSL,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
92929,CPT,PRQ CARD STENT W/ANGIO ADDL,,30,,,"$23,463.95",$0.00,1,0,1,20210101,
92933,CPT,PRQ CARD STENT/ATH/ANGIO,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
92934,CPT,PRQ CARD STENT/ATH/ANGIO,,30,,,"$24,995.86",$0.00,1,0,1,20210101,
92937,CPT,PRQ REVASC BYP GRAFT 1 VSL,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
92938,CPT,PRQ REVASC BYP GRAFT ADDL,,30,,,"$27,935.10",$0.00,1,0,1,20210101,
92941,CPT,PRQ CARD REVASC MI 1 VSL,,30,,,"$31,923.96",$0.00,1,0,1,20210101,
92943,CPT,PRQ CARD REVASC CHRONIC 1VSL,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
92944,CPT,PRQ CARD REVASC CHRONIC ADDL,,30,,,"$25,640.51",$0.00,1,0,1,20210101,
92950,CPT,HEART/LUNG RESUSCITATION CPR,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
92953,CPT,TEMPORARY EXTERNAL PACING,,30,,,"$3,539.33",$0.00,1,0,1,20210101,
92960,CPT,CARDIOVERSION ELECTRIC EXT,,30,,,"$3,539.33",$0.00,1,0,1,20210101,
92961,CPT,CARDIOVERSION ELECTRIC INT,,30,,,"$3,539.33",$0.00,1,0,1,20210101,
92973,CPT,PRQ CORONARY MECH THROMBECT,,30,,,"$11,255.95",$0.00,1,0,1,20210101,
92974,CPT,CATH PLACE CARDIO BRACHYTX,,30,,,"$12,340.72",$0.00,1,0,1,20210101,
92977,CPT,DISSOLVE CLOT HEART VESSEL,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
92978,CPT,ENDOLUMINL IVUS OCT C 1ST,,30,,,"$7,097.59",$0.00,1,0,1,20210101,
92979,CPT,ENDOLUMINL IVUS OCT C EA,,30,,,"$4,749.50",$0.00,1,0,1,20210101,
92986,CPT,REVISION OF AORTIC VALVE,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
92987,CPT,REVISION OF MITRAL VALVE,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
92990,CPT,REVISION OF PULMONARY VALVE,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
92997,CPT,PUL ART BALLOON REPR PERCUT,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
92998,CPT,PUL ART BALLOON REPR PERCUT,,30,,,"$17,012.62",$0.00,1,0,1,20210101,
93005,CPT,ELECTROCARDIOGRAM TRACING,,30,,,$373.96,$0.00,1,0,1,20210101,
93017,CPT,CARDIOVASCULAR STRESS TEST,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
93024,CPT,CARDIAC DRUG STRESS TEST,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
93025,CPT,MICROVOLT T-WAVE ASSESS,,30,,,$888.86,$0.00,1,0,1,20210101,
93041,CPT,RHYTHM ECG TRACING,,30,,,$373.96,$0.00,1,0,1,20210101,
93050,CPT,ART PRESSURE WAVEFORM ANALYS,,30,,,$177.03,$0.00,1,0,1,20210101,
93225,CPT,ECG MONIT/REPRT UP TO 48 HRS,,30,,,$584.38,$0.00,1,0,1,20210101,
93226,CPT,ECG MONIT/REPRT UP TO 48 HRS,,30,,,$584.38,$0.00,1,0,1,20210101,
93228,CPT,REMOTE 30 DAY ECG REV/REPORT,,30,,,$439.18,$0.00,1,0,1,20210101,
93229,CPT,REMOTE 30 DAY ECG TECH SUPP,,30,,,$888.86,$0.00,1,0,1,20210101,
93242,CPT,EXT ECG>48HR<7D RECORDING,,30,,,$223.58,$0.00,1,0,1,20210101,
93243,CPT,EXT ECG>48HR<7D SCAN A/R,,30,,,$366.45,$0.00,1,0,1,20210101,
93246,CPT,EXT ECG>7D<15D RECORDING,,30,,,$366.45,$0.00,1,0,1,20210101,
93247,CPT,EXT ECG>7D<15D SCAN A/R,,30,,,$579.09,$0.00,1,0,1,20210101,
93260,CPT,PRGRMG DEV EVAL IMPLTBL SYS,,30,,,$249.57,$0.00,1,0,1,20210101,
93261,CPT,INTERROGATE SUBQ DEFIB,,30,,,$249.57,$0.00,1,0,1,20210101,
93270,CPT,REMOTE 30 DAY ECG REV/REPORT,,30,,,$249.57,$0.00,1,0,1,20210101,
93271,CPT,ECG/MONITORING AND ANALYSIS,,30,,,$718.73,$0.00,1,0,1,20210101,
93278,CPT,ECG/SIGNAL-AVERAGED,,30,,,$373.96,$0.00,1,0,1,20210101,
93279,CPT,PRGRMG DEV EVAL PM/LDLS PM,,30,,,$249.57,$0.00,1,0,1,20210101,
93280,CPT,PM DEVICE PROGR EVAL DUAL,,30,,,$249.57,$0.00,1,0,1,20210101,
93281,CPT,PM DEVICE PROGR EVAL MULTI,,30,,,$249.57,$0.00,1,0,1,20210101,
93282,CPT,PRGRMG EVAL IMPLANTABLE DFB,,30,,,$249.57,$0.00,1,0,1,20210101,
93283,CPT,PRGRMG EVAL IMPLANTABLE DFB,,30,,,$249.57,$0.00,1,0,1,20210101,
93284,CPT,PRGRMG EVAL IMPLANTABLE DFB,,30,,,$249.57,$0.00,1,0,1,20210101,
93285,CPT,PRGRMG DEV EVAL SCRMS IP,,30,,,$249.57,$0.00,1,0,1,20210101,
93286,CPT,PERI-PX EVAL PM/LDLS PM IP,,30,,,$401.98,$0.00,1,0,1,20210101,
93287,CPT,PERI-PX DEVICE EVAL & PRGR,,30,,,$344.90,$0.00,1,0,1,20210101,
93288,CPT,INTERROG EVL PM/LDLS PM IP,,30,,,$249.57,$0.00,1,0,1,20210101,
93289,CPT,INTERROG DEVICE EVAL HEART,,30,,,$249.57,$0.00,1,0,1,20210101,
93290,CPT,INTERROG DEV EVAL ICPMS IP,,30,,,$249.57,$0.00,1,0,1,20210101,
93291,CPT,INTERROG DEV EVAL SCRMS IP,,30,,,$152.35,$0.00,1,0,1,20210101,
93292,CPT,WCD DEVICE INTERROGATE,,30,,,$249.57,$0.00,1,0,1,20210101,
93293,CPT,PM PHONE R-STRIP DEVICE EVAL,,30,,,$249.57,$0.00,1,0,1,20210101,
93296,CPT,REM INTERROG EVL PM/IDS,,30,,,$249.57,$0.00,1,0,1,20210101,
93297,CPT,REM INTERROG DEV EVAL ICPMS,,30,,,$109.88,$0.00,1,0,1,20210101,
93298,CPT,REM INTERROG DEV EVAL SCRMS,,30,,,$184.94,$0.00,1,0,1,20210101,
93303,CPT,ECHO TRANSTHORACIC,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93304,CPT,ECHO TRANSTHORACIC,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93306,CPT,TTE W/DOPPLER COMPLETE,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93307,CPT,TTE W/O DOPPLER COMPLETE,,30,,,"$1,774.51",$0.00,1,0,1,20210101,
93308,CPT,TTE F-UP OR LMTD,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
93312,CPT,ECHO TRANSESOPHAGEAL,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93313,CPT,ECHO TRANSESOPHAGEAL,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93314,CPT,ECHO TRANSESOPHAGEAL,,30,,,"$4,311.00",$0.00,1,0,1,20210101,
93315,CPT,ECHO TRANSESOPHAGEAL,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93316,CPT,ECHO TRANSESOPHAGEAL,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93317,CPT,ECHO TRANSESOPHAGEAL,,30,,,"$1,752.89",$0.00,1,0,1,20210101,
93318,CPT,ECHO TRANSESOPHAGEAL INTRAOP,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93320,CPT,DOPPLER ECHO EXAM HEART,,30,,,"$1,055.46",$0.00,1,0,1,20210101,
93321,CPT,DOPPLER ECHO EXAM HEART,,30,,,$674.49,$0.00,1,0,1,20210101,
93325,CPT,DOPPLER COLOR FLOW ADD-ON,,30,,,$939.32,$0.00,1,0,1,20210101,
93350,CPT,STRESS TTE ONLY,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93351,CPT,STRESS TTE COMPLETE,,30,,,"$3,155.49",$0.00,1,0,1,20210101,
93352,CPT,ADMIN ECG CONTRAST AGENT,,30,,,$616.56,$0.00,1,0,1,20210101,
93355,CPT,ECHO TRANSESOPHAGEAL (TEE),,30,,,"$4,674.08",$0.00,1,0,1,20210101,
93451,CPT,RIGHT HEART CATH,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93452,CPT,LEFT HRT CATH W/VENTRCLGRPHY,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93453,CPT,R&L HRT CATH W/VENTRICLGRPHY,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93454,CPT,CORONARY ARTERY ANGIO S&I,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93455,CPT,CORONARY ART/GRFT ANGIO S&I,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93456,CPT,R HRT CORONARY ARTERY ANGIO,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93457,CPT,R HRT ART/GRFT ANGIO,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93458,CPT,L HRT ARTERY/VENTRICLE ANGIO,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93459,CPT,L HRT ART/GRFT ANGIO,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93460,CPT,R&L HRT ART/VENTRICLE ANGIO,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93461,CPT,R&L HRT ART/VENTRICLE ANGIO,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93462,CPT,L HRT CATH TRNSPTL PUNCTURE,,30,,,"$13,784.10",$0.00,1,0,1,20210101,
93463,CPT,DRUG ADMIN & HEMODYNMIC MEAS,,30,,,"$1,686.66",$0.00,1,0,1,20210101,
93464,CPT,EXERCISE W/HEMODYNAMIC MEAS,,30,,,"$1,905.11",$0.00,1,0,1,20210101,
93503,CPT,INSERT/PLACE HEART CATHETER,,30,,,"$7,811.94",$0.00,1,0,1,20210101,
93505,CPT,BIOPSY OF HEART LINING,,30,,,"$15,006.83",$0.00,1,0,1,20210101,
93530,CPT,RT HEART CATH CONGENITAL,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93531,CPT,R & L HEART CATH CONGENITAL,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93532,CPT,R & L HEART CATH CONGENITAL,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93533,CPT,R & L HEART CATH CONGENITAL,,30,,,"$15,580.94",$0.00,1,0,1,20210101,
93561,CPT,CARDIAC OUTPUT MEASUREMENT,,30,,,$666.07,$0.00,1,0,1,20210101,
93562,CPT,CARD OUTPUT MEASURE SUBSQ,,30,,,$140.54,$0.00,1,0,1,20210101,
93563,CPT,INJECT CONGENITAL CARD CATH,,30,,,"$4,108.63",$0.00,1,0,1,20210101,
93564,CPT,INJECT HRT CONGNTL ART/GRFT,,30,,,$362.91,$0.00,1,0,1,20210101,
93565,CPT,INJECT L VENTR/ATRIAL ANGIO,,30,,,"$2,491.07",$0.00,1,0,1,20210101,
93566,CPT,INJECT R VENTR/ATRIAL ANGIO,,30,,,"$3,337.44",$0.00,1,0,1,20210101,
93567,CPT,INJECT SUPRVLV AORTOGRAPHY,,30,,,"$3,052.11",$0.00,1,0,1,20210101,
93568,CPT,INJECT PULM ART HRT CATH,,30,,,"$3,207.51",$0.00,1,0,1,20210101,
93571,CPT,HEART FLOW RESERVE MEASURE,,30,,,"$5,462.53",$0.00,1,0,1,20210101,
93572,CPT,HEART FLOW RESERVE MEASURE,,30,,,"$3,173.58",$0.00,1,0,1,20210101,
93580,CPT,TRANSCATH CLOSURE OF ASD,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
93581,CPT,TRANSCATH CLOSURE OF VSD,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
93582,CPT,PERQ TRANSCATH CLOSURE PDA,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
93590,CPT,PERQ TRANSCATH CLS MITRAL,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
93591,CPT,PERQ TRANSCATH CLS AORTIC,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
93592,CPT,PERQ TRANSCATH CLOSURE EACH,,30,,,"$4,345.77",$0.00,1,0,1,20210101,
93600,CPT,BUNDLE OF HIS RECORDING,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93602,CPT,INTRA-ATRIAL RECORDING,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93603,CPT,RIGHT VENTRICULAR RECORDING,,30,,,"$4,312.69",$0.00,1,0,1,20210101,
93609,CPT,MAP TACHYCARDIA ADD-ON,,30,,,"$8,928.74",$0.00,1,0,1,20210101,
93610,CPT,INTRA-ATRIAL PACING,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93612,CPT,INTRAVENTRICULAR PACING,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93613,CPT,ELECTROPHYS MAP 3D ADD-ON,,30,,,"$12,114.20",$0.00,1,0,1,20210101,
93615,CPT,ESOPHAGEAL RECORDING,,30,,,"$4,312.69",$0.00,1,0,1,20210101,
93616,CPT,ESOPHAGEAL RECORDING,,30,,,"$4,312.69",$0.00,1,0,1,20210101,
93618,CPT,HEART RHYTHM PACING,,30,,,"$4,312.69",$0.00,1,0,1,20210101,
93619,CPT,ELECTROPHYSIOLOGY EVALUATION,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93620,CPT,ELECTROPHYSIOLOGY EVALUATION,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93621,CPT,ELECTROPHYSIOLOGY EVALUATION,,30,,,"$11,581.11",$0.00,1,0,1,20210101,
93622,CPT,ELECTROPHYSIOLOGY EVALUATION,,30,,,"$15,814.92",$0.00,1,0,1,20210101,
93623,CPT,STIMULATION PACING HEART,,30,,,"$7,916.98",$0.00,1,0,1,20210101,
93624,CPT,ELECTROPHYSIOLOGIC STUDY,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93631,CPT,HEART PACING MAPPING,,30,,,"$10,747.68",$0.00,1,0,1,20210101,
93640,CPT,EVALUATION HEART DEVICE,,30,,,"$4,672.40",$0.00,1,0,1,20210101,
93641,CPT,ELECTROPHYSIOLOGY EVALUATION,,30,,,"$5,222.39",$0.00,1,0,1,20210101,
93642,CPT,ELECTROPHYSIOLOGY EVALUATION,,30,,,"$4,312.69",$0.00,1,0,1,20210101,
93644,CPT,ELECTROPHYSIOLOGY EVALUATION,,30,,,"$5,195.92",$0.00,1,0,1,20210101,
93650,CPT,ABLATE HEART DYSRHYTHM FOCUS,,30,,,"$23,379.42",$0.00,1,0,1,20210101,
93653,CPT,EP & ABLATE SUPRAVENT ARRHYT,,30,,,"$42,620.41",$0.00,1,0,1,20210101,
93654,CPT,EP & ABLATE VENTRIC TACHY,,30,,,"$42,620.41",$0.00,1,0,1,20210101,
93655,CPT,ABLATE ARRHYTHMIA ADD ON,,30,,,"$16,370.52",$0.00,1,0,1,20210101,
93656,CPT,TX ATRIAL FIB PULM VEIN ISOL,,30,,,"$42,620.41",$0.00,1,0,1,20210101,
93657,CPT,TX L/R ATRIAL FIB ADDL,,30,,,"$14,825.87",$0.00,1,0,1,20210101,
93660,CPT,TILT TABLE EVALUATION,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
93662,CPT,INTRACARDIAC ECG (ICE),,30,,,"$7,506.95",$0.00,1,0,1,20210101,
93668,CPT,PERIPHERAL VASCULAR REHAB,,30,,,$373.96,$0.00,1,0,1,20210101,
93701,CPT,BIOIMPEDANCE CV ANALYSIS,,30,,,$584.38,$0.00,1,0,1,20210101,
93702,CPT,BIS XTRACELL FLUID ANALYSIS,,30,,,$888.86,$0.00,1,0,1,20210101,
93724,CPT,ANALYZE PACEMAKER SYSTEM,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
93740,CPT,TEMPERATURE GRADIENT STUDIES,,30,,,$888.86,$0.00,1,0,1,20210101,
93745,CPT,SET-UP CARDIOVERT-DEFIBRILL,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
93750,CPT,INTERROGATION VAD IN PERSON,,30,,,$718.73,$0.00,1,0,1,20210101,
93770,CPT,MEASURE VENOUS PRESSURE,,30,,,$255.94,$0.00,1,0,1,20210101,
93786,CPT,AMBL BP MNTR W/SW REC ONLY,,30,,,$584.38,$0.00,1,0,1,20210101,
93788,CPT,AMBL BP MNTR W/SW A/R,,30,,,$584.38,$0.00,1,0,1,20210101,
93790,CPT,AMBL BP MNTR W/SW I&R,,30,,,$109.10,$0.00,1,0,1,20210101,
93792,CPT,PT/CAREGIVER TRAING HOME INR,,30,,,$332.24,$0.00,1,0,1,20210101,
93793,CPT,ANTICOAG MGMT PT WARFARIN,,30,,,$138.23,$0.00,1,0,1,20210101,
93797,CPT,CARDIAC REHAB,,30,,,$383.01,$0.00,1,0,1,20210101,
93798,CPT,CARDIAC REHAB/MONITOR,,30,,,$383.01,$0.00,1,0,1,20210101,
93799,CPT,CARDIOVASCULAR PROCEDURE,,30,,,$888.86,$0.00,1,0,1,20210101,
93880,CPT,EXTRACRANIAL BILAT STUDY,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
93882,CPT,EXTRACRANIAL UNI/LTD STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93886,CPT,INTRACRANIAL COMPLETE STUDY,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
93888,CPT,INTRACRANIAL LIMITED STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93890,CPT,TCD VASOREACTIVITY STUDY,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
93892,CPT,TCD EMBOLI DETECT W/O INJ,,30,,,$750.13,$0.00,1,0,1,20210101,
93893,CPT,TCD EMBOLI DETECT W/INJ,,30,,,$750.13,$0.00,1,0,1,20210101,
93895,CPT,CAROTID INTIMA ATHEROMA EVAL,,30,,,$357.46,$0.00,1,0,1,20210101,
93922,CPT,UPR/L XTREMITY ART 2 LEVELS,,30,,,$584.38,$0.00,1,0,1,20210101,
93923,CPT,UPR/LXTR ART STDY 3+ LVLS,,30,,,$888.86,$0.00,1,0,1,20210101,
93924,CPT,LWR XTR VASC STDY BILAT,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
93925,CPT,LOWER EXTREMITY STUDY,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
93926,CPT,LOWER EXTREMITY STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93930,CPT,UPPER EXTREMITY STUDY,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
93931,CPT,UPPER EXTREMITY STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93970,CPT,EXTREMITY STUDY,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
93971,CPT,EXTREMITY STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93975,CPT,VASCULAR STUDY,,30,,,"$1,552.47",$0.00,1,0,1,20210101,
93976,CPT,VASCULAR STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93978,CPT,VASCULAR STUDY,,30,,,"$1,403.04",$0.00,1,0,1,20210101,
93979,CPT,VASCULAR STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93980,CPT,PENILE VASCULAR STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93981,CPT,PENILE VASCULAR STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
93985,CPT,DUP-SCAN HEMO COMPL BI STD,,30,,,"$1,521.09",$0.00,1,0,1,20210101,
93986,CPT,DUP-SCAN HEMO COMPL UNI STD,,30,,,$731.85,$0.00,1,0,1,20210101,
93990,CPT,DOPPLER FLOW TESTING,,30,,,$750.13,$0.00,1,0,1,20210101,
93998,CPT,NONINVAS VASC DX STUDY PROC,,30,,,$152.35,$0.00,1,0,1,20210101,
94002,CPT,VENT MGMT INPAT INIT DAY,,30,,,"$3,109.04",$0.00,1,0,1,20210101,
94003,CPT,VENT MGMT INPAT SUBQ DAY,,30,,,"$3,109.04",$0.00,1,0,1,20210101,
94004,CPT,VENT MGMT NF PER DAY,,30,,,$218.44,$0.00,1,0,1,20210101,
94005,CPT,HOME VENT MGMT SUPERVISION,,30,,,$559.00,$0.00,1,0,1,20210101,
94010,CPT,BREATHING CAPACITY TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
94011,CPT,SPIROMETRY UP TO 2 YRS OLD,,30,,,$888.86,$0.00,1,0,1,20210101,
94012,CPT,SPIRMTRY W/BRNCHDIL INF-2 YR,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94013,CPT,MEAS LUNG VOL THRU 2 YRS,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
94014,CPT,PATIENT RECORDED SPIROMETRY,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
94015,CPT,PATIENT RECORDED SPIROMETRY,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94060,CPT,EVALUATION OF WHEEZING,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94070,CPT,EVALUATION OF WHEEZING,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94150,CPT,VITAL CAPACITY TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
94200,CPT,LUNG FUNCTION TEST (MBC/MVV),,30,,,$426.56,$0.00,1,0,1,20210101,
94375,CPT,RESPIRATORY FLOW VOLUME LOOP,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94450,CPT,HYPOXIA RESPONSE CURVE,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
94452,CPT,HAST W/REPORT,,30,,,$584.38,$0.00,1,0,1,20210101,
94453,CPT,HAST W/OXYGEN TITRATE,,30,,,$584.38,$0.00,1,0,1,20210101,
94610,CPT,SURFACTANT ADMIN THRU TUBE,,30,,,$465.55,$0.00,1,0,1,20210101,
94617,CPT,EXERCISE TST BRNCSPSM W/ECG,,30,,,$584.38,$0.00,1,0,1,20210101,
94618,CPT,PULMONARY STRESS TESTING,,30,,,$584.38,$0.00,1,0,1,20210101,
94619,CPT,EXERCISE TST BRNCSPSM WO ECG,,30,,,$366.45,$0.00,1,0,1,20210101,
94621,CPT,CARDIOPULM EXERCISE TESTING,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94640,CPT,AIRWAY INHALATION TREATMENT,,30,,,$465.55,$0.00,1,0,0,20210101,
94642,CPT,AEROSOL INHALATION TREATMENT,,30,,,$465.55,$0.00,1,0,0,20210101,
94644,CPT,CBT 1ST HOUR,,30,,,$584.38,$0.00,1,0,0,20210101,
94645,CPT,CBT EACH ADDL HOUR,,30,,,$395.66,$0.00,1,0,0,20210101,
94660,CPT,POS AIRWAY PRESSURE CPAP,,30,,,$465.55,$0.00,1,0,1,20210101,
94662,CPT,NEG PRESS VENTILATION CNP,,30,,,"$3,109.04",$0.00,1,0,1,20210101,
94664,CPT,EVALUATE PT USE OF INHALER,,30,,,$465.55,$0.00,1,0,0,20210101,
94667,CPT,CHEST WALL MANIPULATION,,30,,,$584.38,$0.00,1,0,0,20210101,
94668,CPT,CHEST WALL MANIPULATION,,30,,,$584.38,$0.00,1,0,0,20210101,
94669,CPT,MECHANICAL CHEST WALL OSCILL,,30,,,$465.55,$0.00,1,0,0,20210101,
94680,CPT,EXHALED AIR ANALYSIS O2,,30,,,$888.86,$0.00,1,0,1,20210101,
94681,CPT,EXHALED AIR ANALYSIS O2/CO2,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94690,CPT,EXHALED AIR ANALYSIS,,30,,,$282.49,$0.00,1,0,1,20210101,
94726,CPT,PULM FUNCT TST PLETHYSMOGRAP,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94727,CPT,PULM FUNCTION TEST BY GAS,,30,,,$888.86,$0.00,1,0,1,20210101,
94728,CPT,AIRWY RESIST BY OSCILLOMETRY,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
94729,CPT,CO/MEMBANE DIFFUSE CAPACITY,,30,,,$611.09,$0.00,1,0,1,20210101,
94760,CPT,MEASURE BLOOD OXYGEN LEVEL,,30,,,$146.20,$0.00,1,0,1,20210101,
94761,CPT,MEASURE BLOOD OXYGEN LEVEL,,30,,,$276.59,$0.00,1,0,1,20210101,
94762,CPT,MEASURE BLOOD OXYGEN LEVEL,,30,,,$888.86,$0.00,1,0,1,20210101,
94772,CPT,BREATH RECORDING INFANT,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
94775,CPT,PED HOME APNEA REC HK-UP,,30,,,$888.86,$0.00,1,0,1,20210101,
94776,CPT,PED HOME APNEA REC DOWNLD,,30,,,$888.86,$0.00,1,0,1,20210101,
94780,CPT,CARS/BD TST INFT-12MO 60 MIN,,30,,,$224.79,$0.00,1,0,1,20210101,
94781,CPT,CARS/BD TST INFT-12MO +30MIN,,30,,,$337.93,$0.00,1,0,1,20210101,
94799,CPT,PULMONARY SERVICE/PROCEDURE,,30,,,$888.86,$0.00,1,0,1,20210101,
95004,CPT,PERCUT ALLERGY SKIN TESTS,,30,,,$97.12,$0.00,1,0,1,20210101,
95012,CPT,EXHALED NITRIC OXIDE MEAS,,30,,,$224.79,$0.00,1,0,1,20210101,
95017,CPT,PERQ & ICUT ALLG TEST VENOMS,,30,,,$177.03,$0.00,1,0,1,20210101,
95018,CPT,PERQ&IC ALLG TEST DRUGS/BIOL,,30,,,$224.79,$0.00,1,0,1,20210101,
95024,CPT,ICUT ALLERGY TEST DRUG/BUG,,30,,,$373.96,$0.00,1,0,1,20210101,
95027,CPT,ICUT ALLERGY TITRATE-AIRBORN,,30,,,$152.35,$0.00,1,0,1,20210101,
95028,CPT,ICUT ALLERGY TEST-DELAYED,,30,,,$224.79,$0.00,1,0,1,20210101,
95044,CPT,ALLERGY PATCH TESTS,,30,,,$109.66,$0.00,1,0,1,20210101,
95052,CPT,PHOTO PATCH TEST,,30,,,$282.49,$0.00,1,0,1,20210101,
95056,CPT,PHOTOSENSITIVITY TESTS,,30,,,$584.38,$0.00,1,0,1,20210101,
95060,CPT,EYE ALLERGY TESTS,,30,,,$584.38,$0.00,1,0,1,20210101,
95065,CPT,NOSE ALLERGY TEST,,30,,,$224.79,$0.00,1,0,1,20210101,
95070,CPT,BRONCHIAL ALLERGY TESTS,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95076,CPT,INGEST CHALLENGE INI 120 MIN,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95079,CPT,INGEST CHALLENGE ADDL 60 MIN,,30,,,$495.87,$0.00,1,0,1,20210101,
95115,CPT,IMMUNOTHERAPY ONE INJECTION,,30,,,$260.94,$0.00,1,0,1,20210101,
95117,CPT,IMMUNOTHERAPY INJECTIONS,,30,,,$260.94,$0.00,1,0,1,20210101,
95120,CPT,IMMUNOTHERAPY ONE INJECTION,,30,,,$209.18,$0.00,1,0,1,20210101,
95125,CPT,IMMUNOTHERAPY 2/> INJECTIONS,,30,,,$179.94,$0.00,1,0,1,20210101,
95130,CPT,IMMNTX 1 STING INSECT,,30,,,$41.28,$0.00,1,0,1,20210101,
95131,CPT,IMMNTX 2 STING INSECTS,,30,,,$86.08,$0.00,1,0,1,20210101,
95132,CPT,IMMNTX 3 STING INSECTS,,30,,,$109.95,$0.00,1,0,1,20210101,
95133,CPT,IMMNTX 4 STING INSECTS,,30,,,$124.97,$0.00,1,0,1,20210101,
95144,CPT,ANTIGEN THERAPY SERVICES,,30,,,$260.94,$0.00,1,0,1,20210101,
95145,CPT,ANTIGEN THERAPY SERVICES,,30,,,$260.94,$0.00,1,0,1,20210101,
95146,CPT,ANTIGEN THERAPY SERVICES,,30,,,$260.94,$0.00,1,0,1,20210101,
95147,CPT,ANTIGEN THERAPY SERVICES,,30,,,$407.84,$0.00,1,0,1,20210101,
95148,CPT,ANTIGEN THERAPY SERVICES,,30,,,$407.84,$0.00,1,0,1,20210101,
95149,CPT,ANTIGEN THERAPY SERVICES,,30,,,$407.84,$0.00,1,0,1,20210101,
95165,CPT,ANTIGEN THERAPY SERVICES,,30,,,$260.94,$0.00,1,0,1,20210101,
95170,CPT,ANTIGEN THERAPY SERVICES,,30,,,$260.94,$0.00,1,0,1,20210101,
95180,CPT,RAPID DESENSITIZATION,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
95199,CPT,ALLERGY IMMUNOLOGY SERVICES,,30,,,$152.35,$0.00,1,0,1,20210101,
95249,CPT,CONT GLUC MNTR PT PROV EQP,,30,,,$373.96,$0.00,1,0,1,20210101,
95250,CPT,CONT GLUC MNTR PHYS/QHP EQP,,30,,,$358.48,$0.00,1,0,1,20210101,
95251,CPT,CONT GLUC MNTR ANALYSIS I&R,,30,,,$156.75,$0.00,1,0,1,20210101,
95700,CPT,EEG CONT REC W/VID EEG TECH,,30,,,"$1,713.02",$0.00,1,0,1,20210101,
95705,CPT,EEG W/O VID 2-12 HR UNMNTR,,30,,,"$1,713.02",$0.00,1,0,1,20210101,
95706,CPT,EEG WO VID 2-12HR INTMT MNTR,,30,,,"$1,713.02",$0.00,1,0,1,20210101,
95707,CPT,EEG W/O VID 2-12HR CONT MNTR,,30,,,"$1,713.02",$0.00,1,0,1,20210101,
95708,CPT,EEG WO VID EA 12-26HR UNMNTR,,30,,,"$2,543.06",$0.00,1,0,1,20210101,
95709,CPT,EEG W/O VID EA 12-26HR INTMT,,30,,,"$2,543.06",$0.00,1,0,1,20210101,
95710,CPT,EEG W/O VID EA 12-26HR CONT,,30,,,"$2,543.06",$0.00,1,0,1,20210101,
95711,CPT,VEEG 2-12 HR UNMONITORED,,30,,,"$1,713.02",$0.00,1,0,1,20210101,
95712,CPT,VEEG 2-12 HR INTMT MNTR,,30,,,"$1,713.02",$0.00,1,0,1,20210101,
95713,CPT,VEEG 2-12 HR CONT MNTR,,30,,,"$2,543.06",$0.00,1,0,1,20210101,
95714,CPT,VEEG EA 12-26 HR UNMNTR,,30,,,"$2,543.06",$0.00,1,0,1,20210101,
95715,CPT,VEEG EA 12-26HR INTMT MNTR,,30,,,"$2,543.06",$0.00,1,0,1,20210101,
95716,CPT,VEEG EA 12-26HR CONT MNTR,,30,,,"$5,761.62",$0.00,1,0,1,20210101,
95719,CPT,EEG PHYS/QHP EA INCR W/O VID,,30,,,"$6,027.48",$0.00,1,0,1,20210101,
95720,CPT,EEG PHY/QHP EA INCR W/VEEG,,30,,,"$6,982.99",$0.00,1,0,1,20210101,
95782,CPT,POLYSOM <6 YRS 4/> PARAMTRS,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95783,CPT,POLYSOM <6 YRS CPAP/BILVL,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95800,CPT,SLP STDY UNATTENDED,,30,,,$888.86,$0.00,1,0,1,20210101,
95801,CPT,SLP STDY UNATND W/ANAL,,30,,,$584.38,$0.00,1,0,1,20210101,
95803,CPT,ACTIGRAPHY TESTING,,30,,,$373.96,$0.00,1,0,1,20210101,
95805,CPT,MULTIPLE SLEEP LATENCY TEST,,30,,,"$3,046.46",$0.00,1,0,1,20210101,
95806,CPT,SLEEP STUDY UNATT&RESP EFFT,,30,,,$888.86,$0.00,1,0,1,20210101,
95807,CPT,SLEEP STUDY ATTENDED,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95808,CPT,POLYSOM ANY AGE 1-3> PARAM,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95810,CPT,POLYSOM 6/> YRS 4/> PARAM,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95811,CPT,POLYSOM 6/>YRS CPAP 4/> PARM,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95812,CPT,EEG 41-60 MINUTES,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95813,CPT,EEG EXTND MNTR 61-119 MIN,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95816,CPT,EEG AWAKE AND DROWSY,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95819,CPT,EEG AWAKE AND ASLEEP,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95822,CPT,EEG COMA OR SLEEP ONLY,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95824,CPT,EEG CEREBRAL DEATH ONLY,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95829,CPT,SURGERY ELECTROCORTICOGRAM,,30,,,"$5,726.96",$0.00,1,0,1,20210101,
95830,CPT,INSERT ELECTRODES FOR EEG,,30,,,$585.39,$0.00,1,0,1,20210101,
95836,CPT,ECOG IMPLTD BRN NPGT <30 D,,30,,,$246.57,$0.00,1,0,1,20210101,
95851,CPT,RANGE OF MOTION MEASUREMENTS,,30,,,$123.77,$0.00,1,0,1,20210101,
95852,CPT,RANGE OF MOTION MEASUREMENTS,,30,,,$96.57,$0.00,1,0,1,20210101,
95857,CPT,CHOLINESTERASE CHALLENGE,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95860,CPT,MUSCLE TEST ONE LIMB,,30,,,$584.38,$0.00,1,0,1,20210101,
95861,CPT,MUSCLE TEST 2 LIMBS,,30,,,$584.38,$0.00,1,0,1,20210101,
95863,CPT,MUSCLE TEST 3 LIMBS,,30,,,$888.86,$0.00,1,0,1,20210101,
95864,CPT,MUSCLE TEST 4 LIMBS,,30,,,$888.86,$0.00,1,0,1,20210101,
95865,CPT,MUSCLE TEST LARYNX,,30,,,$584.38,$0.00,1,0,1,20210101,
95866,CPT,MUSCLE TEST HEMIDIAPHRAGM,,30,,,$888.86,$0.00,1,0,1,20210101,
95867,CPT,MUSCLE TEST CRAN NERV UNILAT,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
95868,CPT,MUSCLE TEST CRAN NERVE BILAT,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
95869,CPT,MUSCLE TEST THOR PARASPINAL,,30,,,$888.86,$0.00,1,0,1,20210101,
95870,CPT,MUSCLE TEST NONPARASPINAL,,30,,,$476.84,$0.00,1,0,1,20210101,
95872,CPT,MUSCLE TEST ONE FIBER,,30,,,$888.86,$0.00,1,0,1,20210101,
95873,CPT,GUIDE NERV DESTR ELEC STIM,,30,,,$345.89,$0.00,1,0,1,20210101,
95874,CPT,GUIDE NERV DESTR NEEDLE EMG,,30,,,$363.88,$0.00,1,0,1,20210101,
95875,CPT,LIMB EXERCISE TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
95885,CPT,MUSC TST DONE W/NERV TST LIM,,30,,,$528.35,$0.00,1,0,1,20210101,
95886,CPT,MUSC TEST DONE W/N TEST COMP,,30,,,$590.59,$0.00,1,0,1,20210101,
95887,CPT,MUSC TST DONE W/N TST NONEXT,,30,,,$472.60,$0.00,1,0,1,20210101,
95905,CPT,MOTOR &/ SENS NRVE CNDJ TEST,,30,,,$737.09,$0.00,1,0,1,20210101,
95907,CPT,NVR CNDJ TST 1-2 STUDIES,,30,,,$888.86,$0.00,1,0,1,20210101,
95908,CPT,NRV CNDJ TST 3-4 STUDIES,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95909,CPT,NRV CNDJ TST 5-6 STUDIES,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95910,CPT,NRV CNDJ TEST 7-8 STUDIES,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95911,CPT,NRV CNDJ TEST 9-10 STUDIES,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95912,CPT,NRV CNDJ TEST 11-12 STUDIES,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95913,CPT,NRV CNDJ TEST 13/> STUDIES,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95921,CPT,AUTONOMIC NRV PARASYM INERVJ,,30,,,$888.86,$0.00,1,0,1,20210101,
95922,CPT,AUTONOMIC NRV ADRENRG INERVJ,,30,,,$584.38,$0.00,1,0,1,20210101,
95923,CPT,AUTONOMIC NRV SYST FUNJ TEST,,30,,,$584.38,$0.00,1,0,1,20210101,
95924,CPT,ANS PARASYMP & SYMP W/TILT,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
95925,CPT,SOMATOSENSORY TESTING,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95926,CPT,SOMATOSENSORY TESTING,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
95927,CPT,SOMATOSENSORY TESTING,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
95928,CPT,C MOTOR EVOKED UPPR LIMBS,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95929,CPT,C MOTOR EVOKED LWR LIMBS,,30,,,"$3,046.46",$0.00,1,0,1,20210101,
95930,CPT,VISUAL EP TEST CNS W/I&R,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
95933,CPT,BLINK REFLEX TEST,,30,,,$426.56,$0.00,1,0,1,20210101,
95937,CPT,NEUROMUSCULAR JUNCTION TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
95938,CPT,SOMATOSENSORY TESTING,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95939,CPT,C MOTOR EVOKED UPR&LWR LIMBS,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95940,CPT,IONM IN OPERATNG ROOM 15 MIN,,30,,,$415.87,$0.00,1,0,1,20210101,
95941,CPT,IONM REMOTE/>1 PT OR PER HR,,30,,,"$1,720.29",$0.00,1,0,1,20210101,
95943,CPT,PARASYMP&SYMP HRT RATE TEST,,30,,,$888.86,$0.00,1,0,1,20210101,
95954,CPT,EEG MONITORING/GIVING DRUGS,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
95955,CPT,EEG DURING SURGERY,,30,,,"$2,427.44",$0.00,1,0,1,20210101,
95957,CPT,EEG DIGITAL ANALYSIS,,30,,,"$1,124.50",$0.00,1,0,1,20210101,
95958,CPT,EEG MONITORING/FUNCTION TEST,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95961,CPT,ELECTRODE STIMULATION BRAIN,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95962,CPT,ELECTRODE STIM BRAIN ADD-ON,,30,,,"$1,320.38",$0.00,1,0,1,20210101,
95965,CPT,MEG SPONTANEOUS,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95966,CPT,MEG EVOKED SINGLE,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
95967,CPT,MEG EVOKED EACH ADDL,,30,,,"$5,938.53",$0.00,1,0,1,20210101,
95970,CPT,ALYS NPGT W/O PRGRMG,,30,,,$584.38,$0.00,1,0,1,20210101,
95971,CPT,ALYS SMPL SP/PN NPGT W/PRGRM,,30,,,$718.73,$0.00,1,0,1,20210101,
95972,CPT,ALYS CPLX SP/PN NPGT W/PRGRM,,30,,,$718.73,$0.00,1,0,1,20210101,
95976,CPT,ALYS SMPL CN NPGT PRGRMG,,30,,,$246.57,$0.00,1,0,1,20210101,
95977,CPT,ALYS CPLX CN NPGT PRGRMG,,30,,,$709.67,$0.00,1,0,1,20210101,
95980,CPT,IO ANAL GAST N-STIM INIT,,30,,,"$6,266.75",$0.00,1,0,1,20210101,
95981,CPT,IO ANAL GAST N-STIM SUBSQ,,30,,,$584.38,$0.00,1,0,1,20210101,
95982,CPT,IO GA N-STIM SUBSQ W/REPROG,,30,,,$249.57,$0.00,1,0,1,20210101,
95983,CPT,ALYS BRN NPGT PRGRMG 15 MIN,,30,,,$709.67,$0.00,1,0,1,20210101,
95984,CPT,ALYS BRN NPGT PRGRMG ADDL 15,,30,,,$301.01,$0.00,1,0,1,20210101,
95990,CPT,SPIN/BRAIN PUMP REFIL & MAIN,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
95991,CPT,SPIN/BRAIN PUMP REFIL & MAIN,,30,,,"$1,107.35",$0.00,1,0,1,20210101,
95992,CPT,CANALITH REPOSITIONING PROC,,30,,,$202.98,$0.00,1,0,1,20210101,
95999,CPT,NEUROLOGICAL PROCEDURE,,30,,,$888.86,$0.00,1,0,1,20210101,
96000,CPT,MOTION ANALYSIS VIDEO/3D,,30,,,"$2,621.70",$0.00,1,0,1,20210101,
96001,CPT,MOTION TEST W/FT PRESS MEAS,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
96002,CPT,DYNAMIC SURFACE EMG,,30,,,$888.86,$0.00,1,0,1,20210101,
96003,CPT,DYNAMIC FINE WIRE EMG,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
96004,CPT,PHYS REVIEW OF MOTION TESTS,,30,,,$465.80,$0.00,1,0,1,20210101,
96020,CPT,FUNCTIONAL BRAIN MAPPING,,30,,,"$2,404.95",$0.00,1,0,1,20210101,
96040,CPT,GENETIC COUNSELING 30 MIN,,30,,,$280.42,$0.00,1,0,1,20210101,
96105,CPT,ASSESSMENT OF APHASIA,,30,,,$601.29,$0.00,1,0,1,20210101,
96110,CPT,DEVELOPMENTAL SCREEN W/SCORE,,30,,,$209.49,$0.00,1,0,1,20210101,
96112,CPT,DEVEL TST PHYS/QHP 1ST HR,,30,,,"$1,143.19",$0.00,1,0,1,20210101,
96113,CPT,DEVEL TST PHYS/QHP EA ADDL,,30,,,$403.17,$0.00,1,0,1,20210101,
96116,CPT,NUBHVL XM PHYS/QHP 1ST HR,,30,,,"$1,716.57",$0.00,1,0,1,20210101,
96121,CPT,NUBHVL XM PHY/QHP EA ADDL HR,,30,,,$548.19,$0.00,1,0,1,20210101,
96127,CPT,BRIEF EMOTIONAL/BEHAV ASSMT,,30,,,$224.79,$0.00,1,0,1,20210101,
96130,CPT,PSYCL TST EVAL PHYS/QHP 1ST,,30,,,"$1,143.19",$0.00,1,0,1,20210101,
96131,CPT,PSYCL TST EVAL PHYS/QHP EA,,30,,,$500.86,$0.00,1,0,1,20210101,
96132,CPT,NRPSYC TST EVAL PHYS/QHP 1ST,,30,,,"$1,143.19",$0.00,1,0,1,20210101,
96133,CPT,NRPSYC TST EVAL PHYS/QHP EA,,30,,,$453.43,$0.00,1,0,1,20210101,
96136,CPT,PSYCL/NRPSYC TST PHY/QHP 1ST,,30,,,$198.60,$0.00,1,0,1,20210101,
96137,CPT,PSYCL/NRPSYC TST PHY/QHP EA,,30,,,$220.21,$0.00,1,0,1,20210101,
96138,CPT,PSYCL/NRPSYC TECH 1ST,,30,,,$198.60,$0.00,1,0,1,20210101,
96139,CPT,PSYCL/NRPSYC TST TECH EA,,30,,,$266.62,$0.00,1,0,1,20210101,
96146,CPT,PSYCL/NRPSYC TST AUTO RESULT,,30,,,$161.57,$0.00,1,0,1,20210101,
96156,CPT,HLTH BHV ASSMT/REASSESSMENT,,30,,,$314.64,$0.00,1,0,1,20210101,
96158,CPT,HLTH BHV IVNTJ INDIV 1ST 30,,30,,,$314.64,$0.00,1,0,1,20210101,
96159,CPT,HLTH BHV IVNTJ INDIV EA ADDL,,30,,,$164.06,$0.00,1,0,1,20210101,
96160,CPT,PT-FOCUSED HLTH RISK ASSMT,,30,,,$112.93,$0.00,1,0,1,20210101,
96161,CPT,CAREGIVER HEALTH RISK ASSMT,,30,,,$112.93,$0.00,1,0,1,20210101,
96164,CPT,HLTH BHV IVNTJ GRP 1ST 30,,30,,,$95.79,$0.00,1,0,1,20210101,
96165,CPT,HLTH BHV IVNTJ GRP EA ADDL,,30,,,$46.09,$0.00,1,0,1,20210101,
96167,CPT,HLTH BHV IVNTJ FAM 1ST 30,,30,,,$95.79,$0.00,1,0,1,20210101,
96360,CPT,HYDRATION IV INFUSION INIT,,30,,,$923.68,$0.00,1,0,0,20210101,
96361,CPT,HYDRATE IV INFUSION ADD-ON,,30,,,$260.94,$0.00,1,0,0,20210101,
96365,CPT,THER/PROPH/DIAG IV INF INIT,,30,,,$923.68,$0.00,1,0,0,20210101,
96366,CPT,THER/PROPH/DIAG IV INF ADDON,,30,,,$260.94,$0.00,1,0,0,20210101,
96367,CPT,TX/PROPH/DG ADDL SEQ IV INF,,30,,,$407.84,$0.00,1,0,0,20210101,
96368,CPT,THER/DIAG CONCURRENT INF,,30,,,$346.39,$0.00,1,0,0,20210101,
96369,CPT,SC THER INFUSION UP TO 1 HR,,30,,,$923.68,$0.00,1,0,0,20210101,
96370,CPT,SC THER INFUSION ADDL HR,,30,,,$260.94,$0.00,1,0,0,20210101,
96371,CPT,SC THER INFUSION RESET PUMP,,30,,,$407.84,$0.00,1,0,0,20210101,
96372,CPT,THER/PROPH/DIAG INJ SC/IM,,30,,,$407.84,$0.00,1,0,0,20210101,
96373,CPT,THER/PROPH/DIAG INJ IA,,30,,,$923.68,$0.00,1,0,0,20210101,
96374,CPT,THER/PROPH/DIAG INJ IV PUSH,,30,,,$923.68,$0.00,1,0,0,20210101,
96375,CPT,TX/PRO/DX INJ NEW DRUG ADDON,,30,,,$260.94,$0.00,1,0,0,20210101,
96376,CPT,TX/PRO/DX INJ SAME DRUG ADON,,30,,,$299.24,$0.00,1,0,0,20210101,
96377,CPT,APPLICATON ON-BODY INJECTOR,,30,,,$260.94,$0.00,1,0,1,20210101,
96379,CPT,THER/PROP/DIAG INJ/INF PROC,,30,,,$260.94,$0.00,1,0,1,20210101,
96401,CPT,CHEMO ANTI-NEOPL SQ/IM,,30,,,$407.84,$0.00,1,0,1,20210101,
96402,CPT,CHEMO HORMON ANTINEOPL SQ/IM,,30,,,$407.84,$0.00,1,0,1,20210101,
96405,CPT,CHEMO INTRALESIONAL UP TO 7,,30,,,$407.84,$0.00,1,0,1,20210101,
96406,CPT,CHEMO INTRALESIONAL OVER 7,,30,,,$923.68,$0.00,1,0,1,20210101,
96409,CPT,CHEMO IV PUSH SNGL DRUG,,30,,,$923.68,$0.00,1,0,1,20210101,
96411,CPT,CHEMO IV PUSH ADDL DRUG,,30,,,$407.84,$0.00,1,0,1,20210101,
96413,CPT,CHEMO IV INFUSION 1 HR,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
96415,CPT,CHEMO IV INFUSION ADDL HR,,30,,,$407.84,$0.00,1,0,1,20210101,
96416,CPT,CHEMO PROLONG INFUSE W/PUMP,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
96417,CPT,CHEMO IV INFUS EACH ADDL SEQ,,30,,,$407.84,$0.00,1,0,1,20210101,
96420,CPT,CHEMO IA PUSH TECNIQUE,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
96422,CPT,CHEMO IA INFUSION UP TO 1 HR,,30,,,$923.68,$0.00,1,0,1,20210101,
96423,CPT,CHEMO IA INFUSE EACH ADDL HR,,30,,,$260.94,$0.00,1,0,1,20210101,
96425,CPT,CHEMOTHERAPY INFUSION METHOD,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
96440,CPT,CHEMOTHERAPY INTRACAVITARY,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
96446,CPT,CHEMOTX ADMN PRTL CAVITY,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
96450,CPT,CHEMOTHERAPY INTO CNS,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
96521,CPT,REFILL/MAINT PORTABLE PUMP,,30,,,$923.68,$0.00,1,1,1,20210101,
96522,CPT,REFILL/MAINT PUMP/RESVR SYST,,30,,,$923.68,$0.00,1,1,1,20210101,
96523,CPT,IRRIG DRUG DELIVERY DEVICE,,30,,,$373.96,$0.00,1,1,1,20210101,
96542,CPT,CHEMOTHERAPY INJECTION,,30,,,$923.68,$0.00,1,0,1,20210101,
96549,CPT,CHEMOTHERAPY UNSPECIFIED,,30,,,$260.94,$0.00,1,0,1,20210101,
96567,CPT,PDT DSTR PRMLG LES SKN,,30,,,$677.96,$0.00,1,0,1,20210101,
96570,CPT,PHOTODYNMC TX 30 MIN ADD-ON,,30,,,"$1,608.80",$0.00,1,0,1,20210101,
96571,CPT,PHOTODYNAMIC TX ADDL 15 MIN,,30,,,$676.90,$0.00,1,0,1,20210101,
96573,CPT,PDT DSTR PRMLG LES PHYS/QHP,,30,,,$677.96,$0.00,1,0,1,20210101,
96574,CPT,DBRDMT PRMLG LES W/PDT,,30,,,$677.96,$0.00,1,0,1,20210101,
96900,CPT,ULTRAVIOLET LIGHT THERAPY,,30,,,$224.79,$0.00,1,0,1,20210101,
96904,CPT,WHOLE BODY PHOTOGRAPHY,,30,,,$462.15,$0.00,1,0,1,20210101,
96910,CPT,PHOTOCHEMOTHERAPY WITH UV-B,,30,,,$373.96,$0.00,1,0,1,20210101,
96912,CPT,PHOTOCHEMOTHERAPY WITH UV-A,,30,,,$373.96,$0.00,1,0,1,20210101,
96913,CPT,PHOTOCHEMOTHERAPY UV-A OR B,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
96920,CPT,LASER TX SKIN < 250 SQ CM,,30,,,$677.96,$0.00,1,0,1,20210101,
96921,CPT,LASER TX SKIN 250-500 SQ CM,,30,,,$677.96,$0.00,1,0,1,20210101,
96922,CPT,LASER TX SKIN >500 SQ CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
96932,CPT,RCM CELULR SUBCELULR IMG SKN,,30,,,$175.56,$0.00,1,0,1,20210101,
96999,CPT,DERMATOLOGICAL PROCEDURE,,30,,,$677.96,$0.00,1,0,1,20210101,
97014,CPT,ELECTRIC STIMULATION THERAPY,,30,,,$131.48,$0.00,1,0,0,20210101,
97151,CPT,BHV ID ASSMT BY PHYS/QHP,,30,,,$161.29,$0.00,1,0,0,20210101,
97152,CPT,BHV ID SUPRT ASSMT BY 1 TECH,,30,,,$149.85,$0.00,1,0,0,20210101,
97153,CPT,ADAPTIVE BEHAVIOR TX BY TECH,,30,,,$207.69,$0.00,1,0,0,20210101,
97154,CPT,GRP ADAPT BHV TX BY TECH,,30,,,$124.21,$0.00,1,0,0,20210101,
97155,CPT,ADAPT BEHAVIOR TX PHYS/QHP,,30,,,$207.69,$0.00,1,0,0,20210101,
97156,CPT,FAM ADAPT BHV TX GDN PHY/QHP,,30,,,$118.61,$0.00,1,0,0,20210101,
97157,CPT,MULT FAM ADAPT BHV TX GDN,,30,,,$118.61,$0.00,1,0,0,20210101,
97158,CPT,GRP ADAPT BHV TX BY PHY/QHP,,30,,,$118.61,$0.00,1,0,0,20210101,
97161,CPT,PT EVAL LOW COMPLEX 20 MIN,,30,,,$524.80,$0.00,1,0,0,20210101,
97162,CPT,PT EVAL MOD COMPLEX 30 MIN,,30,,,$533.04,$0.00,1,0,0,20210101,
97163,CPT,PT EVAL HIGH COMPLEX 45 MIN,,30,,,$555.04,$0.00,1,0,0,20210101,
97164,CPT,PT RE-EVAL EST PLAN CARE,,30,,,$341.64,$0.00,1,0,0,20210101,
97165,CPT,OT EVAL LOW COMPLEX 30 MIN,,30,,,$348.93,$0.00,1,0,0,20210101,
97166,CPT,OT EVAL MOD COMPLEX 45 MIN,,30,,,$354.41,$0.00,1,0,0,20210101,
97167,CPT,OT EVAL HIGH COMPLEX 60 MIN,,30,,,$369.03,$0.00,1,0,0,20210101,
97168,CPT,OT RE-EVAL EST PLAN CARE,,30,,,$381.00,$0.00,1,0,0,20210101,
97169,CPT,ATHLETIC TRN EVAL LOW CMPLX,,30,,,$235.99,$0.00,1,0,0,20210101,
97170,CPT,ATHLETIC TRN EVAL MOD CMPLX,,30,,,$464.61,$0.00,1,0,0,20210101,
97171,CPT,ATHLETIC TRN EVAL HIGH CMPLX,,30,,,$145.14,$0.00,1,0,0,20210101,
97172,CPT,ATHLETIC TRN RE-EVAL PLAN CR,,30,,,$172.53,$0.00,1,0,0,20210101,
97597,CPT,RMVL DEVITAL TIS 20 CM/<,,30,,,$677.96,$0.00,1,0,1,20210101,
97598,CPT,RMVL DEVITAL TIS ADDL 20CM/<,,30,,,$553.71,$0.00,1,0,1,20210101,
97602,CPT,WOUND(S) CARE NON-SELECTIVE,,30,,,$677.96,$0.00,1,0,1,20210101,
97605,CPT,NEG PRESS WOUND TX <=50 CM,,30,,,$677.96,$0.00,1,0,1,20210101,
97606,CPT,NEG PRESS WOUND TX >50 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
97607,CPT,NEG PRESS WND TX <=50 SQ CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
97608,CPT,NEG PRESS WOUND TX >50 CM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
97610,CPT,LOW FREQUENCY NON-THERMAL US,,30,,,$677.96,$0.00,1,0,0,20210101,
97810,CPT,ACUPUNCT W/O STIMUL 15 MIN,,30,,,$133.45,$0.00,1,0,1,20210101,
97811,CPT,ACUPUNCT W/O STIMUL ADDL 15M,,30,,,$87.33,$0.00,1,0,1,20210101,
97813,CPT,ACUPUNCT W/STIMUL 15 MIN,,30,,,$128.71,$0.00,1,0,1,20210101,
97814,CPT,ACUPUNCT W/STIMUL ADDL 15M,,30,,,$111.78,$0.00,1,0,1,20210101,
98925,CPT,OSTEOPATH MANJ 1-2 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98926,CPT,OSTEOPATH MANJ 3-4 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98927,CPT,OSTEOPATH MANJ 5-6 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98928,CPT,OSTEOPATH MANJ 7-8 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98929,CPT,OSTEOPATH MANJ 9-10 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98940,CPT,CHIROPRACT MANJ 1-2 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98941,CPT,CHIROPRACT MANJ 3-4 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98942,CPT,CHIROPRACTIC MANJ 5 REGIONS,,30,,,$93.35,$0.00,1,0,1,20210101,
98943,CPT,CHIROPRACT MANJ XTRSPINL 1/>,,30,,,$86.87,$0.00,1,0,1,20210101,
98960,CPT,SELF-MGMT EDUC & TRAIN 1 PT,,30,,,$191.90,$0.00,1,0,1,20210101,
98961,CPT,SELF-MGMT EDUC/TRAIN 2-4 PT,,30,,,$92.15,$0.00,1,0,1,20210101,
98962,CPT,SELF-MGMT EDUC/TRAIN 5-8 PT,,30,,,$91.41,$0.00,1,0,1,20210101,
98966,CPT,HC PRO PHONE CALL 5-10 MIN,,30,,,$53.00,$0.00,1,0,1,20210101,
98967,CPT,HC PRO PHONE CALL 11-20 MIN,,30,,,$100.70,$0.00,1,0,1,20210101,
98968,CPT,HC PRO PHONE CALL 21-30 MIN,,30,,,$153.71,$0.00,1,0,1,20210101,
98970,CPT,QNHP OL DIG ASSMT&MGMT 5-10,,30,,,$32.23,$0.00,1,0,1,20210101,
98971,CPT,QNHP OL DIG ASSMT&MGMT 11-20,,30,,,$56.65,$0.00,1,0,1,20210101,
98972,CPT,QNHP OL DIG ASSMT&MGMT 21+,,30,,,$88.88,$0.00,1,0,1,20210101,
99000,CPT,SPECIMEN HANDLING OFFICE-LAB,,30,,,$51.06,$0.00,1,0,1,20210101,
99001,CPT,SPECIMEN HANDLING PT-LAB,,30,,,$60.49,$0.00,1,0,1,20210101,
99002,CPT,DEVICE HANDLING PHYS/QHP,,30,,,$164.55,$0.00,1,0,1,20210101,
99024,CPT,POSTOP FOLLOW-UP VISIT,,30,,,$372.98,$0.00,1,0,1,20210101,
99026,CPT,IN-HOSPITAL ON CALL SERVICE,,30,,,$80.31,$0.00,1,0,1,20210101,
99050,CPT,MEDICAL SERVICES AFTER HRS,,30,,,$118.42,$0.00,1,0,1,20210101,
99051,CPT,MED SERV EVE/WKEND/HOLIDAY,,30,,,$97.02,$0.00,1,0,1,20210101,
99053,CPT,MED SERV 10PM-8AM 24 HR FAC,,30,,,$165.05,$0.00,1,0,1,20210101,
99056,CPT,MED SERVICE OUT OF OFFICE,,30,,,$28.73,$0.00,1,0,1,20210101,
99058,CPT,OFFICE EMERGENCY CARE,,30,,,$108.81,$0.00,1,0,1,20210101,
99060,CPT,OUT OF OFFICE EMERG MED SERV,,30,,,"$1,965.22",$0.00,1,0,1,20210101,
99070,CPT,SPECIAL SUPPLIES PHYS/QHP,,30,,,$212.93,$0.00,1,0,0,20210101,
99071,CPT,PATIENT EDUCATION MATERIALS,,30,,,$70.76,$0.00,1,0,0,20210101,
99075,CPT,MEDICAL TESTIMONY,,30,,,$427.08,$0.00,1,0,1,20210101,
99078,CPT,GROUP HEALTH EDUCATION,,30,,,$220.40,$0.00,1,0,1,20210101,
99080,CPT,SPECIAL REPORTS OR FORMS,,30,,,$37.26,$0.00,1,0,1,20210101,
99082,CPT,UNUSUAL PHYSICIAN TRAVEL,,30,,,$366.55,$0.00,1,0,1,20210101,
99091,CPT,COLLJ & INTERPJ DATA EA 30 D,,30,,,$340.09,$0.00,1,0,1,20210101,
99100,CPT,SPECIAL ANESTHESIA SERVICE,,30,,,$255.75,$0.00,1,0,1,20210101,
99116,CPT,ANESTHESIA WITH HYPOTHERMIA,,30,,,$552.70,$0.00,1,0,1,20210101,
99140,CPT,EMERGENCY ANESTHESIA,,30,,,$400.25,$0.00,1,0,1,20210101,
99151,CPT,MOD SED SAME PHYS/QHP <5 YRS,,30,,,$584.03,$0.00,1,0,1,20210101,
99152,CPT,MOD SED SAME PHYS/QHP 5/>YRS,,30,,,$512.15,$0.00,1,0,1,20210101,
99153,CPT,MOD SED SAME PHYS/QHP EA,,30,,,$212.26,$0.00,1,0,1,20210101,
99155,CPT,MOD SED OTH PHYS/QHP <5 YRS,,30,,,"$1,011.64",$0.00,1,0,1,20210101,
99156,CPT,MOD SED OTH PHYS/QHP 5/>YRS,,30,,,$699.65,$0.00,1,0,1,20210101,
99157,CPT,MOD SED OTHER PHYS/QHP EA,,30,,,$538.96,$0.00,1,0,1,20210101,
99170,CPT,ANOGENITAL EXAM CHILD W IMAG,,30,,,$895.91,$0.00,1,0,1,20210101,
99172,CPT,OCULAR FUNCTION SCREEN,,30,,,$149.97,$0.00,1,0,1,20210101,
99173,CPT,VISUAL ACUITY SCREEN,,30,,,$41.99,$0.00,1,0,1,20210101,
99174,CPT,OCULAR INSTRUMNT SCREEN BIL,,30,,,$121.53,$0.00,1,0,1,20210101,
99175,CPT,INDUCTION OF VOMITING,,30,,,$128.54,$0.00,1,0,1,20210101,
99177,CPT,OCULAR INSTRUMNT SCREEN BIL,,30,,,$62.03,$0.00,1,0,1,20210101,
99183,CPT,HYPERBARIC OXYGEN THERAPY,,30,,,"$2,722.96",$0.00,1,0,1,20210101,
99188,CPT,APP TOPICAL FLUORIDE VARNISH,,30,,,$109.51,$0.00,1,0,1,20210101,
99195,CPT,PHLEBOTOMY,,30,,,$584.38,$0.00,1,0,1,20210101,
99199,CPT,SPECIAL SERVICE/PROC/REPORT,,30,,,$450.14,$0.00,1,0,1,20210101,
99202,CPT,OFFICE O/P NEW SF 15-29 MIN,,30,,,$267.17,$0.00,1,0,1,20210101,
99203,CPT,OFFICE O/P NEW LOW 30-44 MIN,,30,,,$342.59,$0.00,1,0,1,20210101,
99204,CPT,OFFICE O/P NEW MOD 45-59 MIN,,30,,,$468.51,$0.00,1,0,1,20210101,
99205,CPT,OFFICE O/P NEW HI 60-74 MIN,,30,,,$634.67,$0.00,1,0,1,20210101,
99211,CPT,OFFICE O/P EST MINIMAL PROB,,30,,,$210.24,$0.00,1,0,1,20210101,
99212,CPT,OFFICE O/P EST SF 10-19 MIN,,30,,,$222.28,$0.00,1,0,1,20210101,
99213,CPT,OFFICE O/P EST LOW 20-29 MIN,,30,,,$233.75,$0.00,1,0,1,20210101,
99214,CPT,OFFICE O/P EST MOD 30-39 MIN,,30,,,$305.99,$0.00,1,0,1,20210101,
99215,CPT,OFFICE O/P EST HI 40-54 MIN,,30,,,$456.38,$0.00,1,0,1,20210101,
99217,CPT,OBSERVATION CARE DISCHARGE,,30,,,$172.12,$0.00,1,1,1,20210101,
99218,CPT,INITIAL OBSERVATION CARE,,30,,,$172.12,$0.00,2,1,1,20210101,
99219,CPT,INITIAL OBSERVATION CARE,,30,,,$172.12,$0.00,2,1,1,20210101,
99220,CPT,INITIAL OBSERVATION CARE,,30,,,$172.12,$0.00,2,1,1,20210101,
99224,CPT,SUBSEQUENT OBSERVATION CARE,,30,,,$172.12,$0.00,1,1,1,20210101,
99225,CPT,SUBSEQUENT OBSERVATION CARE,,30,,,$172.12,$0.00,1,1,1,20210101,
99226,CPT,SUBSEQUENT OBSERVATION CARE,,30,,,$172.12,$0.00,1,1,1,20210101,
99231,CPT,SUBSEQUENT HOSPITAL CARE,,30,,,$150.30,$0.00,1,0,1,20210101,
99232,CPT,SUBSEQUENT HOSPITAL CARE,,30,,,$329.38,$0.00,1,0,1,20210101,
99233,CPT,SUBSEQUENT HOSPITAL CARE,,30,,,$424.07,$0.00,1,0,1,20210101,
99234,CPT,OBSERV/HOSP SAME DATE,,30,,,$172.12,$0.00,2,1,1,20210101,
99235,CPT,OBSERV/HOSP SAME DATE,,30,,,$172.12,$0.00,2,1,1,20210101,
99236,CPT,OBSERV/HOSP SAME DATE,,30,,,$172.12,$0.00,2,1,1,20210101,
99238,CPT,HOSPITAL DISCHARGE DAY,,30,,,$308.31,$0.00,1,0,1,20210101,
99239,CPT,HOSPITAL DISCHARGE DAY,,30,,,$462.10,$0.00,1,0,1,20210101,
99241,CPT,OFFICE CONSULTATION,,30,,,$282.26,$0.00,1,0,1,20210101,
99242,CPT,OFFICE CONSULTATION,,30,,,$414.53,$0.00,1,0,1,20210101,
99243,CPT,OFFICE CONSULTATION,,30,,,$451.20,$0.00,1,0,1,20210101,
99244,CPT,OFFICE CONSULTATION,,30,,,$620.62,$0.00,1,0,1,20210101,
99245,CPT,OFFICE CONSULTATION,,30,,,$799.34,$0.00,1,0,1,20210101,
99251,CPT,INPATIENT CONSULTATION,,30,,,$209.45,$0.00,1,0,1,20210101,
99252,CPT,INPATIENT CONSULTATION,,30,,,$708.45,$0.00,1,0,1,20210101,
99253,CPT,INPATIENT CONSULTATION,,30,,,$742.04,$0.00,1,0,1,20210101,
99254,CPT,INPATIENT CONSULTATION,,30,,,$895.37,$0.00,1,0,1,20210101,
99255,CPT,INPATIENT CONSULTATION,,30,,,"$1,388.13",$0.00,1,0,1,20210101,
99281,CPT,EMERGENCY DEPT VISIT,,30,,,$272.51,$0.00,1,1,1,20210101,
99282,CPT,EMERGENCY DEPT VISIT,,30,,,$806.03,$0.00,1,1,1,20210101,
99283,CPT,EMERGENCY DEPT VISIT,,30,,,"$1,519.88",$0.00,1,1,1,20210101,
99284,CPT,EMERGENCY DEPT VISIT,,30,,,"$2,383.10",$0.00,1,1,1,20210101,
99285,CPT,EMERGENCY DEPT VISIT,,30,,,"$3,398.59",$0.00,1,1,1,20210101,
99288,CPT,DIRECT ADVANCED LIFE SUPPORT,,30,,,$719.06,$0.00,1,1,1,20210101,
99291,CPT,CRITICAL CARE FIRST HOUR,,30,,,"$4,523.26",$0.00,1,1,1,20210101,
99292,CPT,CRITICAL CARE ADDL 30 MIN,,30,,,"$1,537.44",$0.00,1,1,1,20210101,
99304,CPT,NURSING FACILITY CARE INIT,,30,,,$290.30,$0.00,1,0,1,20210101,
99305,CPT,NURSING FACILITY CARE INIT,,30,,,$376.50,$0.00,1,0,1,20210101,
99306,CPT,NURSING FACILITY CARE INIT,,30,,,$446.35,$0.00,1,0,1,20210101,
99307,CPT,NURSING FAC CARE SUBSEQ,,30,,,$158.17,$0.00,1,0,1,20210101,
99308,CPT,NURSING FAC CARE SUBSEQ,,30,,,$213.25,$0.00,1,0,1,20210101,
99309,CPT,NURSING FAC CARE SUBSEQ,,30,,,$284.90,$0.00,1,0,1,20210101,
99310,CPT,NURSING FAC CARE SUBSEQ,,30,,,$401.42,$0.00,1,0,1,20210101,
99315,CPT,NURSING FAC DISCHARGE DAY,,30,,,$259.42,$0.00,1,0,1,20210101,
99316,CPT,NURSING FAC DISCHARGE DAY,,30,,,$332.25,$0.00,1,0,1,20210101,
99318,CPT,ANNUAL NURSING FAC ASSESSMNT,,30,,,$302.09,$0.00,1,0,1,20210101,
99324,CPT,DOMICIL/R-HOME VISIT NEW PAT,,30,,,$199.98,$0.00,1,0,1,20210101,
99325,CPT,DOMICIL/R-HOME VISIT NEW PAT,,30,,,$345.18,$0.00,1,0,1,20210101,
99326,CPT,DOMICIL/R-HOME VISIT NEW PAT,,30,,,$426.67,$0.00,1,0,1,20210101,
99327,CPT,DOMICIL/R-HOME VISIT NEW PAT,,30,,,$662.62,$0.00,1,0,1,20210101,
99328,CPT,DOMICIL/R-HOME VISIT NEW PAT,,30,,,$653.98,$0.00,1,0,1,20210101,
99334,CPT,DOMICIL/R-HOME VISIT EST PAT,,30,,,$204.81,$0.00,1,0,1,20210101,
99335,CPT,DOMICIL/R-HOME VISIT EST PAT,,30,,,$275.18,$0.00,1,0,1,20210101,
99336,CPT,DOMICIL/R-HOME VISIT EST PAT,,30,,,$372.48,$0.00,1,0,1,20210101,
99337,CPT,DOMICIL/R-HOME VISIT EST PAT,,30,,,$442.21,$0.00,1,0,1,20210101,
99339,CPT,DOMICIL/R-HOME CARE SUPERVIS,,30,,,$324.25,$0.00,1,0,1,20210101,
99340,CPT,DOMICIL/R-HOME CARE SUPERVIS,,30,,,$405.24,$0.00,1,0,1,20210101,
99341,CPT,HOME VISIT NEW PATIENT,,30,,,$229.53,$0.00,1,0,1,20210101,
99342,CPT,HOME VISIT NEW PATIENT,,30,,,$353.52,$0.00,1,0,1,20210101,
99343,CPT,HOME VISIT NEW PATIENT,,30,,,$486.04,$0.00,1,0,1,20210101,
99344,CPT,HOME VISIT NEW PATIENT,,30,,,$614.74,$0.00,1,0,1,20210101,
99345,CPT,HOME VISIT NEW PATIENT,,30,,,$738.34,$0.00,1,0,1,20210101,
99347,CPT,HOME VISIT EST PATIENT,,30,,,$232.66,$0.00,1,0,1,20210101,
99348,CPT,HOME VISIT EST PATIENT,,30,,,$292.91,$0.00,1,0,1,20210101,
99349,CPT,HOME VISIT EST PATIENT,,30,,,$435.00,$0.00,1,0,1,20210101,
99350,CPT,HOME VISIT EST PATIENT,,30,,,$588.82,$0.00,1,0,1,20210101,
99354,CPT,PROLNG SVC O/P 1ST HOUR,,30,,,$357.21,$0.00,1,0,1,20210101,
99355,CPT,PROLNG SVC O/P EA ADDL 30,,30,,,$242.80,$0.00,1,0,1,20210101,
99358,CPT,PROLONG SERVICE W/O CONTACT,,30,,,$468.97,$0.00,1,0,1,20210101,
99359,CPT,PROLONG SERV W/O CONTACT ADD,,30,,,$197.15,$0.00,1,0,1,20210101,
99360,CPT,PHYSICIAN STANDBY SERVICES,,30,,,$239.53,$0.00,1,0,1,20210101,
99366,CPT,TEAM CONF W/PAT BY HC PROF,,30,,,$394.26,$0.00,1,0,1,20210101,
99367,CPT,TEAM CONF W/O PAT BY PHYS,,30,,,$344.29,$0.00,1,0,1,20210101,
99368,CPT,TEAM CONF W/O PAT BY HC PRO,,30,,,$370.59,$0.00,1,0,1,20210101,
99374,CPT,HOME HEALTH CARE SUPERVISION,,30,,,$167.88,$0.00,1,0,1,20210101,
99375,CPT,HOME HEALTH CARE SUPERVISION,,30,,,$257.94,$0.00,1,0,1,20210101,
99381,CPT,INIT PM E/M NEW PAT INFANT,,30,,,$310.25,$0.00,1,0,1,20210101,
99382,CPT,INIT PM E/M NEW PAT 1-4 YRS,,30,,,$330.90,$0.00,1,0,1,20210101,
99383,CPT,PREV VISIT NEW AGE 5-11,,30,,,$356.65,$0.00,1,0,1,20210101,
99384,CPT,PREV VISIT NEW AGE 12-17,,30,,,$433.47,$0.00,1,0,1,20210101,
99385,CPT,PREV VISIT NEW AGE 18-39,,30,,,$390.64,$0.00,1,0,1,20210101,
99386,CPT,PREV VISIT NEW AGE 40-64,,30,,,$413.13,$0.00,1,0,1,20210101,
99387,CPT,INIT PM E/M NEW PAT 65+ YRS,,30,,,$455.23,$0.00,1,0,1,20210101,
99391,CPT,PER PM REEVAL EST PAT INFANT,,30,,,$271.01,$0.00,1,0,1,20210101,
99392,CPT,PREV VISIT EST AGE 1-4,,30,,,$299.13,$0.00,1,0,1,20210101,
99393,CPT,PREV VISIT EST AGE 5-11,,30,,,$341.35,$0.00,1,0,1,20210101,
99394,CPT,PREV VISIT EST AGE 12-17,,30,,,$318.90,$0.00,1,0,1,20210101,
99395,CPT,PREV VISIT EST AGE 18-39,,30,,,$344.59,$0.00,1,0,1,20210101,
99396,CPT,PREV VISIT EST AGE 40-64,,30,,,$323.12,$0.00,1,0,1,20210101,
99397,CPT,PER PM REEVAL EST PAT 65+ YR,,30,,,$333.30,$0.00,1,0,1,20210101,
99401,CPT,PREVENTIVE COUNSELING INDIV,,30,,,$235.88,$0.00,1,0,1,20210101,
99402,CPT,PREVENTIVE COUNSELING INDIV,,30,,,$325.75,$0.00,1,0,1,20210101,
99403,CPT,PREVENTIVE COUNSELING INDIV,,30,,,$361.80,$0.00,1,0,1,20210101,
99404,CPT,PREVENTIVE COUNSELING INDIV,,30,,,$428.32,$0.00,1,0,1,20210101,
99406,CPT,BEHAV CHNG SMOKING 3-10 MIN,,30,,,$112.93,$0.00,1,0,0,20210101,
99407,CPT,BEHAV CHNG SMOKING > 10 MIN,,30,,,$112.93,$0.00,1,0,0,20210101,
99408,CPT,AUDIT/DAST 15-30 MIN,,30,,,$163.90,$0.00,1,0,1,20210101,
99409,CPT,AUDIT/DAST OVER 30 MIN,,30,,,$388.49,$0.00,1,0,1,20210101,
99411,CPT,PREVENTIVE COUNSELING GROUP,,30,,,$190.71,$0.00,1,0,1,20210101,
99412,CPT,PREVENTIVE COUNSELING GROUP,,30,,,$309.07,$0.00,1,0,1,20210101,
99415,CPT,PROLNG CLIN STAFF SVC 1ST HR,,30,,,$253.33,$0.00,1,0,1,20210101,
99429,CPT,UNLISTED PREVENTIVE SERVICE,,30,,,$58.08,$0.00,1,0,1,20210101,
99439,CPT,CHRNC CARE MGMT SVC EA ADDL,,30,,,$160.81,$0.00,1,0,1,20210101,
99441,CPT,PHONE E/M PHYS/QHP 5-10 MIN,,30,,,$55.80,$0.00,1,0,1,20210101,
99442,CPT,PHONE E/M PHYS/QHP 11-20 MIN,,30,,,$122.78,$0.00,1,0,1,20210101,
99443,CPT,PHONE E/M PHYS/QHP 21-30 MIN,,30,,,$132.81,$0.00,1,0,1,20210101,
99446,CPT,NTRPROF PH1/NTRNET/EHR 5-10,,30,,,$146.48,$0.00,1,0,1,20210101,
99447,CPT,NTRPROF PH1/NTRNET/EHR 11-20,,30,,,$209.57,$0.00,1,0,1,20210101,
99448,CPT,NTRPROF PH1/NTRNET/EHR 21-30,,30,,,$273.95,$0.00,1,0,1,20210101,
99449,CPT,NTRPROF PH1/NTRNET/EHR 31/>,,30,,,$328.96,$0.00,1,0,1,20210101,
99450,CPT,BASIC LIFE DISABILITY EXAM,,30,,,$850.27,$0.00,1,0,1,20210101,
99453,CPT,REM MNTR PHYSIOL PARAM SETUP,,30,,,$354.04,$0.00,1,0,1,20210101,
99454,CPT,REM MNTR PHYSIOL PARAM DEV,,30,,,$246.57,$0.00,1,0,1,20210101,
99455,CPT,WORK RELATED DISABILITY EXAM,,30,,,$220.72,$0.00,1,0,1,20210101,
99456,CPT,DISABILITY EXAMINATION,,30,,,$561.72,$0.00,1,0,1,20210101,
99460,CPT,INIT NB EM PER DAY HOSP,,30,,,$358.48,$0.00,1,0,1,20210101,
99461,CPT,INIT NB EM PER DAY NON-FAC,,30,,,$331.55,$0.00,1,0,1,20210101,
99463,CPT,SAME DAY NB DISCHARGE,,30,,,$358.48,$0.00,1,0,1,20210101,
99465,CPT,NB RESUSCITATION,,30,,,"$3,539.33",$0.00,1,0,1,20210101,
99473,CPT,SELF-MEAS BP PT EDUCAJ/TRAIN,,30,,,$161.57,$0.00,1,0,1,20210101,
99483,CPT,ASSMT & CARE PLN PT COG IMP,,30,,,$318.68,$0.00,1,0,1,20210101,
99484,CPT,CARE MGMT SVC BHVL HLTH COND,,30,,,$112.93,$0.00,1,0,1,20210101,
99487,CPT,CPLX CHRNC CARE 1ST 60 MIN,,30,,,$294.61,$0.00,1,0,1,20210101,
99489,CPT,CPLX CHRNC CARE EA ADDL 30,,30,,,$174.72,$0.00,1,0,1,20210101,
99490,CPT,CHRNC CARE MGMT SVC 1ST 20,,30,,,$279.68,$0.00,1,0,1,20210101,
99491,CPT,CHRNC CARE MGMT SVC 30 MIN,,30,,,$617.41,$0.00,1,0,1,20210101,
99492,CPT,1ST PSYC COLLAB CARE MGMT,,30,,,$318.68,$0.00,1,0,1,20210101,
99493,CPT,SBSQ PSYC COLLAB CARE MGMT,,30,,,$318.68,$0.00,1,0,1,20210101,
99494,CPT,1ST/SBSQ PSYC COLLAB CARE,,30,,,$200.19,$0.00,1,0,1,20210101,
99495,CPT,TRANS CARE MGMT 14 DAY DISCH,,30,,,$358.48,$0.00,1,0,1,20210101,
99496,CPT,TRANS CARE MGMT 7 DAY DISCH,,30,,,$358.48,$0.00,1,0,1,20210101,
99497,CPT,ADVNCD CARE PLAN 30 MIN,,30,,,$318.68,$0.00,1,0,1,20210101,
99498,CPT,ADVNCD CARE PLAN ADDL 30 MIN,,30,,,$238.15,$0.00,1,0,1,20210101,
99499,CPT,UNLISTED E&M SERVICE,,30,,,$484.10,$0.00,1,0,1,20210101,
99500,CPT,HOME VISIT PRENATAL,,30,,,"$1,041.92",$0.00,1,1,1,20210101,
99501,CPT,HOME VISIT POSTNATAL,,30,,,$323.66,$0.00,1,1,1,20210101,
99502,CPT,HOME VISIT NB CARE,,30,,,$291.31,$0.00,1,1,1,20210101,
99503,CPT,HOME VISIT RESP THERAPY,,30,,,$253.25,$0.00,1,1,1,20210101,
99504,CPT,HOME VISIT MECH VENTILATOR,,30,,,$556.54,$0.00,1,1,1,20210101,
99505,CPT,HOME VISIT STOMA CARE,,30,,,$239.57,$0.00,1,1,1,20210101,
99506,CPT,HOME VISIT IM INJECTION,,30,,,$495.90,$0.00,1,1,1,20210101,
99507,CPT,HOME VISIT CATH MAINTAIN,,30,,,$212.53,$0.00,1,1,1,20210101,
99509,CPT,HOME VISIT DAY LIFE ACTIVITY,,30,,,$295.26,$0.00,1,1,1,20210101,
99510,CPT,HOME VISIT SING/M/FAM COUNS,,30,,,$396.73,$0.00,1,1,1,20210101,
99512,CPT,HOME VISIT FOR HEMODIALYSIS,,30,,,"$6,354.34",$0.00,1,1,1,20210101,
99600,CPT,HOME VISIT NOS,,30,,,$395.72,$0.00,1,1,1,20210101,
99601,CPT,HOME INFUSION/VISIT 2 HRS,,30,,,$398.98,$0.00,1,1,1,20210101,
99602,CPT,HOME INFUSION EACH ADDTL HR,,30,,,$360.77,$0.00,1,1,1,20210101,
99605,CPT,MTMS BY PHARM NP 15 MIN,,30,,,$272.34,$0.00,1,0,0,20210101,
99606,CPT,MTMS BY PHARM EST 15 MIN,,30,,,$272.34,$0.00,1,0,0,20210101,
99607,CPT,MTMS BY PHARM ADDL 15 MIN,,30,,,$272.34,$0.00,1,0,0,20210101,
0001A,CPT,ADM SARSCOV2 30MCG/0.3ML 1ST,,30,,,$100.75,$0.00,1,0,1,20210101,
0002A,CPT,ADM SARSCOV2 30MCG/0.3ML 2ND,,30,,,$165.74,$0.00,1,0,1,20210101,
0011A,CPT,ADM SARSCOV2 100MCG/0.5ML1ST,,30,,,$100.75,$0.00,1,0,1,20210101,
0012A,CPT,ADM SARSCOV2 100MCG/0.5ML2ND,,30,,,$165.74,$0.00,1,0,1,20210101,
0042T,CPT,CT PERFUSION W/CONTRAST CBF,,30,,,"$3,731.21",$0.00,1,0,1,20210101,
0054T,CPT,BONE SRGRY CMPTR FLUOR IMAGE,,30,,,$486.17,$0.00,1,0,1,20210101,
0055T,CPT,BONE SRGRY CMPTR CT/MRI IMAG,,30,,,"$2,530.45",$0.00,1,0,1,20210101,
0071T,CPT,US LEIOMYOMATA ABLATE <200,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
0072T,CPT,US LEIOMYOMATA ABLATE >200,,30,,,"$12,390.47",$0.00,1,0,1,20210101,
0100T,CPT,PROSTH RETINA RECEIVE&GEN,,30,,,"$306,176.01",$0.00,1,0,1,20210101,
0101T,CPT,EXTRACORP SHOCKWV TX HI ENRG,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
0102T,CPT,EXTRACORP SHOCKWV TX ANESTH,,30,,,"$14,955.76",$0.00,1,0,1,20210101,
0106T,CPT,TOUCH QUANT SENSORY TEST,,30,,,$224.79,$0.00,1,0,1,20210101,
0107T,CPT,VIBRATE QUANT SENSORY TEST,,30,,,$224.79,$0.00,1,0,1,20210101,
0108T,CPT,COOL QUANT SENSORY TEST,,30,,,$373.96,$0.00,1,0,1,20210101,
0174T,CPT,CAD CXR WITH INTERP,,30,,,$37.09,$0.00,1,0,1,20210101,
0184T,CPT,EXC RECTAL TUMOR ENDOSCOPIC,,30,,,"$21,482.40",$0.00,1,0,1,20210101,
0191T,CPT,INSERT ANT SEGMENT DRAIN INT,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
0198T,CPT,OCULAR BLOOD FLOW MEASURE,,30,,,$584.38,$0.00,1,0,1,20210101,
0200T,CPT,PERQ SACRAL AUGMT UNILAT INJ,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
0201T,CPT,PERQ SACRAL AUGMT BILAT INJ,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
0202T,CPT,POST VERT ARTHRPLST 1 LUMBAR,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
0207T,CPT,CLEAR EYELID GLAND W/HEAT,,30,,,$476.84,$0.00,1,0,1,20210101,
0208T,CPT,AUDIOMETRY AIR ONLY,,30,,,$224.79,$0.00,1,0,1,20210101,
0209T,CPT,AUDIOMETRY AIR & BONE,,30,,,$224.79,$0.00,1,0,1,20210101,
0210T,CPT,SPEECH AUDIOMETRY THRESHOLD,,30,,,$224.79,$0.00,1,0,1,20210101,
0211T,CPT,SPEECH AUDIOM THRESH & RECOG,,30,,,$224.79,$0.00,1,0,1,20210101,
0212T,CPT,COMPRE AUDIOMETRY EVALUATION,,30,,,$888.86,$0.00,1,0,1,20210101,
0213T,CPT,NJX PARAVERT W/US CER/THOR,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
0214T,CPT,NJX PARAVERT W/US CER/THOR,,30,,,"$1,406.55",$0.00,1,0,1,20210101,
0215T,CPT,NJX PARAVERT W/US CER/THOR,,30,,,"$1,406.55",$0.00,1,0,1,20210101,
0216T,CPT,NJX PARAVERT W/US LUMB/SAC,,30,,,"$5,054.41",$0.00,1,0,1,20210101,
0217T,CPT,NJX PARAVERT W/US LUMB/SAC,,30,,,"$1,406.55",$0.00,1,0,1,20210101,
0218T,CPT,NJX PARAVERT W/US LUMB/SAC,,30,,,"$1,406.55",$0.00,1,0,1,20210101,
0219T,CPT,PLMT POST FACET IMPLT CERV,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
0220T,CPT,PLMT POST FACET IMPLT THOR,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
0221T,CPT,PLMT POST FACET IMPLT LUMB,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
0222T,CPT,PLMT POST FACET IMPLT ADDL,,30,,,"$17,729.89",$0.00,1,0,1,20210101,
0232T,CPT,NJX PLATELET PLASMA,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
0234T,CPT,TRLUML PERIP ATHRC RENAL ART,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
0236T,CPT,TRLUML PERIP ATHRC ABD AORTA,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
0237T,CPT,TRLUML PERIP ATHRC BRCHIOCPH,,30,,,"$20,988.08",$0.00,1,0,1,20210101,
0238T,CPT,TRLUML PERIP ATHRC ILIAC ART,,30,,,"$33,120.94",$0.00,1,0,1,20210101,
0253T,CPT,INSERT AQUEOUS DRAIN DEVICE,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
0263T,CPT,IM B1 MRW CEL THER CMPL,,30,,,"$12,674.77",$0.00,1,0,1,20210101,
0264T,CPT,IM B1 MRW CEL THER XCL HRVST,,30,,,"$12,674.77",$0.00,1,0,1,20210101,
0265T,CPT,IM B1 MRW CEL THER HRVST ONL,,30,,,"$12,674.77",$0.00,1,0,1,20210101,
0266T,CPT,IMPLT/RPL CRTD SNS DEV TOTAL,,30,,,"$54,880.70",$0.00,1,0,1,20210101,
0267T,CPT,IMPLT/RPL CRTD SNS DEV LEAD,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0268T,CPT,IMPLT/RPL CRTD SNS DEV GEN,,30,,,"$54,897.14",$0.00,1,0,1,20210101,
0269T,CPT,REV/REMVL CRTD SNS DEV TOTAL,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
0270T,CPT,REV/REMVL CRTD SNS DEV LEAD,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0271T,CPT,REV/REMVL CRTD SNS DEV GEN,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0272T,CPT,INTERROGATE CRTD SNS DEV,,30,,,$888.86,$0.00,1,0,1,20210101,
0273T,CPT,INTERROGATE CRTD SNS W/PGRMG,,30,,,$888.86,$0.00,1,0,1,20210101,
0274T,CPT,PERQ LAMOT/LAM CRV/THRC,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
0275T,CPT,PERQ LAMOT/LAM LUMBAR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
0278T,CPT,TEMPR,,30,,,$888.86,$0.00,1,0,1,20210101,
0308T,CPT,INSJ OCULAR TELESCOPE PROSTH,,30,,,"$40,260.69",$0.00,1,0,1,20210101,
0312T,CPT,LAPS IMPLTJ NSTIM VAGUS,,30,,,"$59,911.81",$0.00,1,0,1,20210101,
0313T,CPT,LAPS RMVL NSTIM ARRAY VAGUS,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0314T,CPT,LAPS RMVL VGL ARRY&PLS GEN,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0315T,CPT,RMVL VAGUS NERVE PLS GEN,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0316T,CPT,REPLC VAGUS NERVE PLS GEN,,30,,,"$54,897.14",$0.00,1,0,1,20210101,
0317T,CPT,ELEC ALYS VAGUS NRV PLS GEN,,30,,,$249.57,$0.00,1,0,1,20210101,
0330T,CPT,TEAR FILM IMG UNI/BI W/I&R,,30,,,$224.79,$0.00,1,0,1,20210101,
0331T,CPT,HEART SYMP IMAGE PLNR,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
0332T,CPT,HEART SYMP IMAGE PLNR SPECT,,30,,,"$7,875.34",$0.00,1,0,1,20210101,
0335T,CPT,INSJ SINUS TARSI IMPLANT,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
0338T,CPT,TRNSCTH RENAL SYMP DENRV UNL,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
0339T,CPT,TRNSCTH RENAL SYMP DENRV BIL,,30,,,"$21,919.09",$0.00,1,0,1,20210101,
0342T,CPT,THXP APHERESIS W/HDL DELIP,,30,,,"$12,674.77",$0.00,1,0,1,20210101,
0347T,CPT,INS BONE DEVICE FOR RSA,,30,,,$373.96,$0.00,1,0,1,20210101,
0348T,CPT,RSA SPINE EXAM,,30,,,$750.13,$0.00,1,0,1,20210101,
0349T,CPT,RSA UPPER EXTR EXAM,,30,,,$750.13,$0.00,1,0,1,20210101,
0350T,CPT,RSA LOWER EXTR EXAM,,30,,,$509.87,$0.00,1,0,1,20210101,
0355T,CPT,GI TRACT CAPSULE ENDOSCOPY,,30,,,"$9,291.07",$0.00,1,0,1,20210101,
0356T,CPT,INSRT DRUG DEVICE FOR IOP,,30,,,$402.25,$0.00,1,0,1,20210101,
0358T,CPT,BIA WHOLE BODY,,30,,,$177.03,$0.00,1,0,1,20210101,
0362T,CPT,BHV ID SUPRT ASSMT EA 15 MIN,,30,,,$142.99,$0.00,1,0,1,20210101,
0373T,CPT,ADAPT BHV TX EA 15 MIN,,30,,,$154.83,$0.00,1,0,1,20210101,
0379T,CPT,VIS FIELD ASSMNT TECH SUPPT,,30,,,$224.79,$0.00,1,0,1,20210101,
0394T,CPT,HDR ELCTRNC SKN SURF BRCHYTX,,30,,,"$1,573.82",$0.00,1,0,1,20210101,
0395T,CPT,HDR ELCTR NTRST/NTRCV BRCHTX,,30,,,"$4,663.42",$0.00,1,0,1,20210101,
0398T,CPT,MRGFUS STRTCTC LES ABLTJ,,30,,,"$27,448.63",$0.00,1,0,1,20210101,
0402T,CPT,COLGN CROSS-LINK CRN MED SEP,,30,,,"$9,994.11",$0.00,1,0,1,20210101,
0403T,CPT,DIABETES PREV STANDARD CURR,,30,,,$53.91,$0.00,1,0,1,20210101,
0404T,CPT,TRNSCRV UTERIN FIBROID ABLTJ,,30,,,"$24,043.39",$0.00,1,0,1,20210101,
0408T,CPT,INSJ/RPLC CARDIAC MODULJ SYS,,30,,,"$47,537.74",$0.00,1,0,1,20210101,
0409T,CPT,INSJ/RPLC CAR MODULJ PLS GN,,30,,,"$47,537.74",$0.00,1,0,1,20210101,
0410T,CPT,INSJ/RPLC CAR MODULJ ATR ELT,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
0411T,CPT,INSJ/RPLC CAR MODULJ VNT ELT,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
0412T,CPT,RMVL CARDIAC MODULJ PLS GEN,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
0413T,CPT,RMVL CAR MODULJ TRANVNS ELT,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
0414T,CPT,RMVL & RPL CAR MODULJ PLS GN,,30,,,"$47,537.74",$0.00,1,0,1,20210101,
0415T,CPT,REPOS CAR MODULJ TRANVNS ELT,,30,,,"$3,781.26",$0.00,1,0,1,20210101,
0416T,CPT,RELOC SKIN POCKET PLS GEN,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
0417T,CPT,PRGRMG EVAL CARDIAC MODULJ,,30,,,$249.57,$0.00,1,0,1,20210101,
0418T,CPT,INTERRO EVAL CARDIAC MODULJ,,30,,,$249.57,$0.00,1,0,1,20210101,
0419T,CPT,DSTRJ NEUROFIBROMA XTNSV,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
0420T,CPT,DSTRJ NEUROFIBROMA XTNSV,,30,,,"$2,970.07",$0.00,1,0,1,20210101,
0421T,CPT,WATERJET PROSTATE ABLTJ CMPL,,30,,,"$22,270.96",$0.00,1,0,1,20210101,
0422T,CPT,TACTILE BREAST IMG UNI/BI,,30,,,$509.87,$0.00,1,0,1,20210101,
0424T,CPT,INSJ/RPLC NSTIM APNEA COMPL,,30,,,"$59,911.81",$0.00,1,0,1,20210101,
0425T,CPT,INSJ/RPLC NSTIM APNEA SEN LD,,30,,,"$25,001.07",$0.00,1,0,1,20210101,
0426T,CPT,INSJ/RPLC NSTIM APNEA STM LD,,30,,,"$32,796.42",$0.00,1,0,1,20210101,
0427T,CPT,INSJ/RPLC NSTIM APNEA PLS GN,,30,,,"$54,897.14",$0.00,1,0,1,20210101,
0428T,CPT,RMVL NSTIM APNEA PLS GEN,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0429T,CPT,RMVL NSTIM APNEA SEN LD,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0430T,CPT,RMVL NSTIM APNEA STIMJ LD,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0431T,CPT,RMVL/RPLC NSTIM APNEA PLS GN,,30,,,"$54,897.14",$0.00,1,0,1,20210101,
0432T,CPT,REPOS NSTIM APNEA STIMJ LD,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0433T,CPT,REPOS NSTIM APNEA SENSING LD,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0434T,CPT,INTERRO EVAL NPGS APNEA,,30,,,$718.73,$0.00,1,0,1,20210101,
0435T,CPT,PRGRMG EVAL NPGS APNEA 1 SES,,30,,,$718.73,$0.00,1,0,1,20210101,
0436T,CPT,PRGRMG EVAL NPGS APNEA STUDY,,30,,,"$5,796.50",$0.00,1,0,1,20210101,
0440T,CPT,ABLTJ PERC UXTR/PERPH NRV,,30,,,"$13,329.98",$0.00,1,0,1,20210101,
0441T,CPT,ABLTJ PERC LXTR/PERPH NRV,,30,,,"$13,329.98",$0.00,1,0,1,20210101,
0442T,CPT,ABLTJ PERC PLEX/TRNCL NRV,,30,,,"$22,667.58",$0.00,1,0,1,20210101,
0443T,CPT,R-T SPCTRL ALYS PRST8 TISS,,30,,,"$10,533.91",$0.00,1,0,1,20210101,
0446T,CPT,INSJ IMPLTBL GLUCOSE SENSOR,,30,,,"$3,495.95",$0.00,1,0,1,20210101,
0447T,CPT,RMVL IMPLTBL GLUCOSE SENSOR,,30,,,$677.96,$0.00,1,0,1,20210101,
0448T,CPT,REMVL INSJ IMPLTBL GLUC SENS,,30,,,"$3,495.95",$0.00,1,0,1,20210101,
0449T,CPT,INSJ AQUEOUS DRAIN DEV 1ST,,30,,,"$15,246.42",$0.00,1,0,1,20210101,
0453T,CPT,INSJ/RPLCMT MECH-ELEC NTRFCE,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
0454T,CPT,INSJ/RPLCMT SUBQ ELECTRODE,,30,,,"$23,921.53",$0.00,1,0,1,20210101,
0457T,CPT,REMVL MECH-ELEC SKIN NTRFCE,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
0458T,CPT,REMVL SUBQ ELECTRODE,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
0460T,CPT,REPOS AORTIC VENTR DEV ELTRD,,30,,,"$17,305.01",$0.00,1,0,1,20210101,
0462T,CPT,PRGRMG EVAL AORTIC VENTR SYS,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
0463T,CPT,INTERROG AORTIC VENTR SYS,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
0464T,CPT,VISUAL EP TEST FOR GLAUCOMA,,30,,,$888.86,$0.00,1,0,1,20210101,
0465T,CPT,SUPCHRDL NJX RX W/O SUPPLY,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
0467T,CPT,REVJ/RPLMNT CH RESPIR ELTRD,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0468T,CPT,RMVL CH WAL RESPIR ELTRD/RA,,30,,,"$16,703.28",$0.00,1,0,1,20210101,
0472T,CPT,PRGRMG IO RTA ELTRD RA,,30,,,"$1,228.46",$0.00,1,0,1,20210101,
0473T,CPT,REPRGRMG IO RTA ELTRD RA,,30,,,$718.73,$0.00,1,0,1,20210101,
0474T,CPT,INSJ AQUEOUS DRG DEV IO RSVR,,30,,,"$15,619.85",$0.00,1,0,1,20210101,
0476T,CPT,REC FTL CAR SGL ELEC TR DATA,,30,,,$584.38,$0.00,1,0,1,20210101,
0477T,CPT,REC FTL CAR SGL XRTJ ALYS,,30,,,$584.38,$0.00,1,0,1,20210101,
0479T,CPT,FXJL ABL LSR 1ST 100 SQ CM,,30,,,"$2,401.64",$0.00,1,0,1,20210101,
0480T,CPT,FXJL ABL LSR EA ADDL 100SQCM,,30,,,"$1,719.78",$0.00,1,0,1,20210101,
0481T,CPT,NJX AUTOL WBC CONCENTRATE,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
0485T,CPT,OCT MID EAR I&R UNILATERAL,,30,,,$224.79,$0.00,1,0,1,20210101,
0486T,CPT,OCT MID EAR I&R BILATERAL,,30,,,$224.79,$0.00,1,0,1,20210101,
0487T,CPT,TRVG BIOMCHN MAPG W/REPRT,,30,,,$584.38,$0.00,1,0,1,20210101,
0491T,CPT,ABL LSR OPN WND 1ST 20 SQCM,,30,,,"$1,898.89",$0.00,1,0,1,20210101,
0497T,CPT,XTRNL PT ACT ECG IN-OFF CONN,,30,,,$249.57,$0.00,1,0,1,20210101,
0499T,CPT,CYSTO F/URTL STRIX/STENOSIS,,30,,,"$14,570.91",$0.00,1,0,1,20210101,
0503T,CPT,COR FFR ALYS GNRJ FFR MDL,,30,,,"$6,699.54",$0.00,1,0,1,20210101,
0505T,CPT,EV FEMPOP ARTL REVSC,,30,,,"$21,069.07",$0.00,1,0,1,20210101,
0506T,CPT,MAC PGMT OPT DNS MEAS HFP,,30,,,$376.42,$0.00,1,0,1,20210101,
0507T,CPT,NEAR IFR 2IMG MIBMN GLND I&R,,30,,,$376.42,$0.00,1,0,1,20210101,
0508T,CPT,PLS ECHO US B1 DNS MEAS TIB,,30,,,$750.13,$0.00,1,0,1,20210101,
0509T,CPT,PATTERN ERG W/I&R,,30,,,"$1,144.10",$0.00,1,0,1,20210101,
0510T,CPT,RMVL SINUS TARSI IMPLANT,,30,,,"$14,948.14",$0.00,1,0,1,20210101,
0511T,CPT,RMVL&RINSJ SINUS TARSI IMPLT,,30,,,"$23,498.70",$0.00,1,0,1,20210101,
0512T,CPT,ESW INTEG WND HLG 1ST WND,,30,,,"$1,461.43",$0.00,1,0,1,20210101,
0515T,CPT,INSJ WCS LV COMPL SYS,,30,,,"$47,391.52",$0.00,1,0,1,20210101,
0516T,CPT,INSJ WCS LV ELTRD ONLY,,30,,,"$23,783.74",$0.00,1,0,1,20210101,
0517T,CPT,INSJ WCS LV PG COMPNT,,30,,,"$23,783.74",$0.00,1,0,1,20210101,
0518T,CPT,RMVL PG COMPNT WCS,,30,,,"$17,531.59",$0.00,1,0,1,20210101,
0519T,CPT,RMVL & RPLCMT PG COMPNT WCS,,30,,,"$17,531.59",$0.00,1,0,1,20210101,
0520T,CPT,RMVL&RPLCMT PG WCS NEW ELTRD,,30,,,"$47,391.52",$0.00,1,0,1,20210101,
0521T,CPT,INTERROG DEV EVAL WCS IP,,30,,,$151.33,$0.00,1,0,1,20210101,
0522T,CPT,PRGRMG DEV EVAL WCS IP,,30,,,$248.37,$0.00,1,0,1,20210101,
0524T,CPT,EV CATH DIR CHEM ABLTJ W/IMG,,30,,,"$15,108.46",$0.00,1,0,1,20210101,
0525T,CPT,INSJ/RPLCMT COMPL IIMS,,30,,,"$21,335.14",$0.00,1,0,1,20210101,
0526T,CPT,INSJ/RPLCMT IIMS ELTRD ONLY,,30,,,"$23,783.74",$0.00,1,0,1,20210101,
0527T,CPT,INSJ/RPLCMT IIMS IMPLT MNTR,,30,,,"$23,783.74",$0.00,1,0,1,20210101,
0528T,CPT,PRGRMG DEV EVAL IIMS IP,,30,,,$248.37,$0.00,1,0,1,20210101,
0529T,CPT,INTERROG DEV EVAL IIMS IP,,30,,,$248.37,$0.00,1,0,1,20210101,
0530T,CPT,REMOVAL COMPLETE IIMS,,30,,,"$17,531.59",$0.00,1,0,1,20210101,
0531T,CPT,REMOVAL IIMS ELECTRODE ONLY,,30,,,"$17,531.59",$0.00,1,0,1,20210101,
0532T,CPT,REMOVAL IIMS IMPLT MNTR ONLY,,30,,,"$17,531.59",$0.00,1,0,1,20210101,
0534T,CPT,CONT REC MVMT DO SETUP&TRAIN,,30,,,$248.37,$0.00,1,0,1,20210101,
0535T,CPT,CONT REC MVMT DO REPRT CNFIG,,30,,,$248.37,$0.00,1,0,1,20210101,
0540T,CPT,CAR-T CLL ADMN AUTOLOGOUS,,30,,,"$1,686.06",$0.00,1,0,1,20210101,
0541T,CPT,MYOCARDIAL IMAGING MCG,,30,,,"$2,543.06",$0.00,1,0,1,20210101,
0548T,CPT,TPRNL BALO CNTNC DEV BI,,30,,,"$26,369.03",$0.00,1,0,1,20210101,
0549T,CPT,TPRNL BALO CNTNC DEV UNI,,30,,,"$20,041.21",$0.00,1,0,1,20210101,
0550T,CPT,TPRNL BALO CNTNC DEV RMVL EA,,30,,,"$16,082.62",$0.00,1,0,1,20210101,
0551T,CPT,TPRNL BALO CNTNC DEV ADJMT,,30,,,"$1,432.07",$0.00,1,0,1,20210101,
0555T,CPT,B1 STR&FX RSK TRANSMIS DATA,,30,,,$151.56,$0.00,1,0,1,20210101,
0556T,CPT,B1 STR & FX RSK ASSESSMENT,,30,,,"$1,530.16",$0.00,1,0,1,20210101,
0558T,CPT,CT SCAN F/BIOMCHN CT ALYS,,30,,,$509.88,$0.00,1,0,1,20210101,
0559T,CPT,ANTMC MDL 3D PRINT 1ST CMPNT,,30,,,$373.69,$0.00,1,0,1,20210101,
0561T,CPT,ANTMC GUIDE 3D PRINT 1ST GD,,30,,,$373.69,$0.00,1,0,1,20210101,
0563T,CPT,EVAC MEIBOMIAN GLND HEAT BI,,30,,,$371.12,$0.00,1,0,1,20210101,
0564T,CPT,ONC CHEMO RX CYTOTOX CSC 14,,30,,,$335.00,$0.00,1,0,1,20210101,
0565T,CPT,AUTOL CELL IMPLT ADPS HRVG,,30,,,$371.12,$0.00,1,0,1,20210101,
0566T,CPT,AUTOL CELL IMPLT ADPS NJX,,30,,,"$1,077.08",$0.00,1,0,1,20210101,
0567T,CPT,PERM FLP TUBE OCCLS W/IMPLT,,30,,,"$12,648.38",$0.00,1,0,1,20210101,
0568T,CPT,INTRO MIX SALINE&AIR F/SSG,,30,,,$231.25,$0.00,1,0,1,20210101,
0571T,CPT,INSJ/RPLCMT ICDS SS ELTRD,,30,,,"$66,954.96",$0.00,1,0,1,20210101,
0572T,CPT,INSERTION SS DFB ELECTRODE,,30,,,"$22,970.28",$0.00,1,0,1,20210101,
0573T,CPT,REMOVAL SS DFB ELECTRODE,,30,,,"$17,521.92",$0.00,1,0,1,20210101,
0574T,CPT,REPOS PREV SS IMPL DFB ELTRD,,30,,,"$17,521.92",$0.00,1,0,1,20210101,
0575T,CPT,PRGRMG DEV EVAL ICDS SS IP,,30,,,$246.57,$0.00,1,0,1,20210101,
0576T,CPT,INTERROG DEV EVAL ICDS SS IP,,30,,,"$12,617.17",$0.00,1,0,1,20210101,
0577T,CPT,EPHYS EVAL ICDS SS,,30,,,"$10,916.32",$0.00,1,0,1,20210101,
0578T,CPT,REM INTERROG DEV ICDS PHYS,,30,,,"$17,365.84",$0.00,1,0,1,20210101,
0579T,CPT,REM INTERROG DEV ICDS TECH,,30,,,"$7,566.82",$0.00,1,0,1,20210101,
0580T,CPT,RMVL SS IMPL DFB PG ONLY,,30,,,"$20,822.55",$0.00,1,0,1,20210101,
0583T,CPT,TMPST AUTO TUBE DLVR SYS,,30,,,"$6,647.15",$0.00,1,0,0,20210101,
0587T,CPT,PERQ IMPLTJ/RPLCMT ISDNS PTN,,30,,,"$4,171.58",$0.00,1,0,1,20210101,
0588T,CPT,REVISION/REMOVAL ISDNS PTN,,30,,,"$1,337.73",$0.00,1,0,1,20210101,
0589T,CPT,ELEC ALYS SMPL PRGRMG IINS,,30,,,$709.67,$0.00,1,0,1,20210101,
0590T,CPT,ELEC ALYS CPLX PRGRMG IINS,,30,,,$709.67,$0.00,1,0,1,20210101,
0591T,CPT,HLTH&WB COACHING INDIV 1ST,,30,,,$255.10,$0.00,1,0,1,20210101,
0594T,CPT,OSTEOT HUM XTRNL LNGTH DEV,,30,,,"$23,448.00",$0.00,1,0,0,20210101,
0596T,CPT,TEMP FML IU VLV-PMP 1ST INSJ,,30,,,"$2,592.19",$0.00,1,0,0,20210101,
0597T,CPT,TEMP FML IU VALVE-PMP RPLCMT,,30,,,"$2,592.19",$0.00,1,0,0,20210101,
0598T,CPT,NCNTC R-T FLUOR WND IMG 1ST,,30,,,"$1,713.02",$0.00,1,0,0,20210101,
0600T,CPT,IRE ABLTJ 1+TUM ORGAN PERQ,,30,,,"$21,931.31",$0.00,1,0,0,20210101,
0601T,CPT,IRE ABLTJ 1+TUMORS OPEN,,30,,,"$21,931.31",$0.00,1,0,0,20210101,
0604T,CPT,REM OCT RTA DEV SETUP&EDUCAJ,,30,,,$354.04,$0.00,1,0,0,20210101,
0605T,CPT,REM OCT RTA TECHL SPRT MIN 8,,30,,,$246.57,$0.00,1,0,0,20210101,
0607T,CPT,REM MNTR PULM FLU MNTR SETUP,,30,,,$354.04,$0.00,1,0,0,20210101,
0608T,CPT,REM MNTR PULM FLU MNTR ALYS,,30,,,$246.57,$0.00,1,0,0,20210101,
0609T,CPT,MRS DISC PAIN ACQUISJ DATA,,30,,,"$1,505.55",$0.00,1,0,1,20210101,
0611T,CPT,MRS DISC PAIN ALG ALYS DATA,,30,,,"$1,505.55",$0.00,1,0,1,20210101,
0614T,CPT,RMVL&RPLCMT SS IMPL DFB PG,,30,,,"$47,556.28",$0.00,1,0,0,20210101,
0615T,CPT,EYE MVMT ALYS W/O CALBRJ I&R,,30,,,$580.45,$0.00,1,0,0,20210101,
0616T,CPT,INSERTION OF IRIS PROSTHESIS,,30,,,"$8,183.69",$0.00,1,0,0,20210101,
0617T,CPT,INSJ IRIS PROSTH W/RMVL&INSJ,,30,,,"$15,032.60",$0.00,1,0,0,20210101,
0618T,CPT,INSJ IRIS PROSTH SEC IO LENS,,30,,,"$15,032.60",$0.00,1,0,0,20210101,
0619T,CPT,CYSTO W/PRST8 COMMISSUROTOMY,,30,,,"$19,959.92",$0.00,1,0,0,20210101,
0620T,CPT,EVASC VEN ARTLZ TIBL/PRNL VN,,30,,,"$32,697.32",$0.00,1,0,1,20210101,
0627T,CPT,PERQ NJX ALGC FLUOR LMBR 1ST,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
0629T,CPT,PERQ NJX ALGC CT LMBR 1ST,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
0631T,CPT,TC VIS LIT HYPERSPECTRAL IMG,,30,,,$164.25,$0.00,1,0,1,20210101,
0633T,CPT,CT BREAST W/3D UNI C-,,30,,,$719.69,$0.00,1,0,1,20210101,
0634T,CPT,CT BREAST W/3D UNI C+,,30,,,"$1,166.36",$0.00,1,0,1,20210101,
0635T,CPT,CT BREAST W/3D UNI C-/C+,,30,,,"$1,166.36",$0.00,1,0,1,20210101,
0636T,CPT,CT BREAST W/3D BI C-,,30,,,"$1,505.55",$0.00,1,0,1,20210101,
0637T,CPT,CT BREAST W/3D BI C+,,30,,,"$2,380.33",$0.00,1,0,1,20210101,
0638T,CPT,CT BREAST W/3D BI C-/C+,,30,,,"$2,380.33",$0.00,1,0,1,20210101,
A0380,HCPCS,BLS MILEAGE (PER MILE),,30,,,$22.77,$0.00,4,1,1,20210101,
A0382,HCPCS,BLS ROUTINE DISPOSABLE SUPPLIES,,30,,,$107.26,$0.00,1,1,1,20210101,
A0384,HCPCS,BLS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; DEFIBRILLATION (USED BY ALS AMBULANCES AND BLS AMBULANCES IN JURISDICTIONS WHERE DEFIBRILLATION IS PERMITTED IN BLS AMBULANCES),,30,,,$89.02,$0.00,1,1,1,20210101,
A0390,HCPCS,ALS MILEAGE (PER MILE),,30,,,$22.77,$0.00,4,1,1,20210101,
A0392,HCPCS,ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; DEFIBRILLATION (TO BE USED ONLY IN JURISDICTIONS WHERE DEFIBRILLATION CANNOT BE PERFORMED IN BLS AMBULANCES),,30,,,$111.05,$0.00,1,1,1,20210101,
A0394,HCPCS,ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; IV DRUG THERAPY,,30,,,$146.13,$0.00,1,1,1,20210101,
A0396,HCPCS,ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; ESOPHAGEAL INTUBATION,,30,,,$229.27,$0.00,1,1,1,20210101,
A0420,HCPCS,"AMBULANCE WAITING TIME (ALS OR BLS), ONE HALF (1/2) HOUR INCREMENTS",,30,,,$242.78,$0.00,1,1,1,20210101,
A0424,HCPCS,"EXTRA AMBULANCE ATTENDANT, GROUND (ALS OR BLS) OR AIR (FIXED OR ROTARY WINGED); (REQUIRES MEDICAL REVIEW)",,30,,,$559.41,$0.00,1,1,1,20210101,
A0425,HCPCS,"GROUND MILEAGE, PER STATUTE MILE",,30,,,$22.77,$0.00,4,1,1,20210101,
A0426,HCPCS,"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NON-EMERGENCY TRANSPORT, LEVEL 1 (ALS 1)",,30,,,"$1,423.39",$0.00,1,1,1,20210101,
A0427,HCPCS,"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)",,30,,,"$1,652.56",$0.00,1,1,1,20210101,
A0428,HCPCS,"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NON-EMERGENCY TRANSPORT, (BLS)",,30,,,"$1,013.10",$0.00,1,1,1,20210101,
A0429,HCPCS,"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS-EMERGENCY)",,30,,,"$1,162.26",$0.00,1,1,1,20210101,
A0430,HCPCS,"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (FIXED WING)",,30,,,"$31,808.29",$0.00,1,1,1,20210101,
A0431,HCPCS,"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING)",,30,,,"$35,822.49",$0.00,1,1,1,20210101,
A0432,HCPCS,"PARAMEDIC INTERCEPT (PI), RURAL AREA, TRANSPORT FURNISHED BY A VOLUNTEER AMBULANCE COMPANY WHICH IS PROHIBITED BY STATE LAW FROM BILLING THIRD PARTY PAYERS",,30,,,"$1,217.67",$0.00,1,1,1,20210101,
A0433,HCPCS,"ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)",,30,,,"$1,866.62",$0.00,1,1,1,20210101,
A0434,HCPCS,SPECIALTY CARE TRANSPORT (SCT),,30,,,"$3,643.83",$0.00,1,1,1,20210101,
A0435,HCPCS,"FIXED WING AIR MILEAGE, PER STATUTE MILE",,30,,,$263.14,$0.00,4,1,1,20210101,
A0436,HCPCS,"ROTARY WING AIR MILEAGE, PER STATUTE MILE",,30,,,$348.78,$0.00,4,1,1,20210101,
A0998,HCPCS,"AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT",,30,,,$401.70,$0.00,1,1,1,20210101,
A0999,HCPCS,UNLISTED AMBULANCE SERVICE,,30,,,$845.03,$0.00,1,1,1,20210101,
A9513,HCPCS,LUTETIUM LU 177 DOTATAT THER,,30,,,"$1,698.17",$0.00,1,0,0,20210101,
A9517,HCPCS,"I131 IODIDE CAP, RX",,30,,,$143.22,$0.00,1,0,0,20210101,
A9527,HCPCS,IODINE I-125 SODIUM IODIDE,,30,,,$195.65,$0.00,1,0,0,20210101,
A9530,HCPCS,"I131 IODIDE SOL, RX",,30,,,$87.90,$0.00,1,0,0,20210101,
A9542,HCPCS,"IN111 IBRITUMOMAB, DX",,30,,,"$18,389.68",$0.00,1,0,0,20210101,
A9543,HCPCS,"Y90 IBRITUMOMAB, RX",,30,,,"$109,190.16",$0.00,1,0,0,20210101,
A9553,HCPCS,CR51 CHROMATE,,30,,,"$3,631.42",$0.00,1,0,0,20210101,
A9563,HCPCS,P32 NA PHOSPHATE,,30,,,"$2,902.74",$0.00,1,0,0,20210101,
A9568,HCPCS,TECHNETIUM TC99M ARCITUMOMAB,,30,,,$303.21,$0.00,1,0,0,20210101,
A9590,HCPCS,IODINE I-131 IOBENGUANE 1MCI,,30,,,"$2,046.62",$0.00,1,0,0,20210101,
A9591,HCPCS,FLUOROESTRADIOL F 18,,30,,,$4.89,$0.00,1,0,0,20210101,
A9600,HCPCS,SR89 STRONTIUM,,30,,,"$10,908.27",$0.00,1,0,0,20210101,
A9604,HCPCS,SM 153 LEXIDRONAM,,30,,,"$31,760.28",$0.00,1,0,0,20210101,
A9606,HCPCS,RADIUM RA223 DICHLORIDE THER,,30,,,$543.24,$0.00,1,0,0,20210101,
A9999,HCPCS,"DME SUPPLY OR ACCESSORY, NOS",,30,,,$534.04,$0.00,1,0,0,20210101,
C1734,HCPCS,"ORTH/DEVIC/DRUG BN/BN,TIS/BN",,30,,,"$11,768.96",$0.00,1,0,0,20210101,
C1749,HCPCS,"ENDO, COLON, RETRO IMAGING",,30,,,"$5,225.48",$0.00,1,0,1,20210101,
C1819,HCPCS,TISSUE LOCALIZATION-EXCISION,,30,,,"$2,224.00",$0.00,1,0,0,20210101,
C1824,HCPCS,"GENERATOR, CCM, IMPLANT",,30,,,"$27,233.17",$0.00,1,0,0,20210101,
C1839,HCPCS,IRIS PROSTHESIS,,30,,,$615.54,$0.00,1,0,0,20210101,
C1982,HCPCS,"CATH, PRESSURE,VALVE-OCCLU",,30,,,"$4,373.74",$0.00,1,0,0,20210101,
C2629,HCPCS,"INTRO/SHEATH, LASER",,30,,,$929.03,$0.00,1,0,0,20210101,
C2630,HCPCS,"CATH, EP, COOL-TIP",,30,,,"$13,164.17",$0.00,1,0,0,20210101,
C8900,HCPCS,"MRA W/CONT, ABD",,30,,,"$2,309.90",$0.00,1,0,1,20210101,
C8901,HCPCS,"MRA W/O CONT, ABD",,30,,,"$1,552.47",$0.00,1,0,1,20210101,
C8902,HCPCS,"MRA W/O FOL W/CONT, ABD",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8903,HCPCS,"MRI W/CONT, BREAST,  UNI",,30,,,"$1,258.98",$0.00,1,0,1,20210101,
C8905,HCPCS,"MRI W/O FOL W/CONT, BRST, UN",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8906,HCPCS,"MRI W/CONT, BREAST,  BI",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8908,HCPCS,"MRI W/O FOL W/CONT, BREAST,",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8909,HCPCS,"MRA W/CONT, CHEST",,30,,,"$2,309.90",$0.00,1,0,1,20210101,
C8910,HCPCS,"MRA W/O CONT, CHEST",,30,,,"$1,552.47",$0.00,1,0,1,20210101,
C8911,HCPCS,"MRA W/O FOL W/CONT, CHEST",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8912,HCPCS,"MRA W/CONT, LWR EXT",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8913,HCPCS,"MRA W/O CONT, LWR EXT",,30,,,"$1,552.47",$0.00,1,0,1,20210101,
C8914,HCPCS,"MRA W/O FOL W/CONT, LWR EXT",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8918,HCPCS,"MRA W/CONT, PELVIS",,30,,,"$2,309.90",$0.00,1,0,1,20210101,
C8919,HCPCS,"MRA W/O CONT, PELVIS",,30,,,"$1,552.47",$0.00,1,0,1,20210101,
C8920,HCPCS,"MRA W/O FOL W/CONT, PELVIS",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8921,HCPCS,"TTE W OR W/O FOL W/CONT, COM",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8922,HCPCS,"TTE W OR W/O FOL W/CONT, F/U",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8923,HCPCS,"2D TTE W OR W/O FOL W/CON,CO",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8924,HCPCS,"2D TTE W OR W/O FOL W/CON,FU",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8925,HCPCS,"2D TEE W OR W/O FOL W/CON,IN",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8926,HCPCS,"TEE W OR W/O FOL W/CONT,CONG",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8927,HCPCS,"TEE W OR W/O FOL W/CONT, MON",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8928,HCPCS,"TTE W OR W/O FOL W/CON,STRES",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8929,HCPCS,"TTE W OR WO FOL WCON,DOPPLER",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8930,HCPCS,"TTE W OR W/O CONTR, CONT ECG",,30,,,"$4,487.22",$0.00,1,0,1,20210101,
C8931,HCPCS,"MRA, W/DYE, SPINAL CANAL",,30,,,"$2,531.48",$0.00,1,0,1,20210101,
C8932,HCPCS,"MRA, W/O DYE, SPINAL CANAL",,30,,,"$1,552.47",$0.00,1,0,1,20210101,
C8933,HCPCS,"MRA, W/O&W/DYE, SPINAL CANAL",,30,,,"$2,309.90",$0.00,1,0,1,20210101,
C8934,HCPCS,"MRA, W/DYE, UPPER EXTREMITY",,30,,,"$2,309.90",$0.00,1,0,1,20210101,
C8935,HCPCS,"MRA, W/O DYE, UPPER EXTR",,30,,,"$1,403.04",$0.00,1,0,1,20210101,
C8936,HCPCS,"MRA, W/O&W/DYE, UPPER EXTR",,30,,,"$2,309.90",$0.00,1,0,1,20210101,
C8937,HCPCS,CAD BREAST MRI,,30,,,$456.83,$0.00,1,0,1,20210101,
C8957,HCPCS,"PROLONGED IV INF, REQ PUMP",,30,,,"$1,689.00",$0.00,1,0,1,20210101,
C9046,HCPCS,COCAINE HCL NASAL SOLUTION,,30,,,$8.32,$0.00,1,0,0,20210101,
C9047,HCPCS,"INJECTION, CAPLACIZUMAB-YHDP",,30,,,"$4,372.49",$0.00,1,0,0,20210101,
C9065,HCPCS,ROMIDEPSIN NON-LYOPHILIZED,,30,,,"$2,096.21",$0.00,1,0,0,20210101,
C9067,HCPCS,GALLIUM GA-68 DOTATOC,,30,,,$56.16,$0.00,1,0,0,20210101,
C9068,HCPCS,"COPPER CU-64, DOTATATE, DX",,30,,,"$5,501.86",$0.00,1,0,0,20210101,
C9069,HCPCS,BELANTAMAB MAFODONTIN-BLMF,,30,,,$276.74,$0.00,1,0,0,20210101,
C9070,HCPCS,"INJECTION, TAFASITAMAB-CXIX",,30,,,$40.17,$0.00,1,0,0,20210101,
C9071,HCPCS,"INJECTION, VILTOLARSEN",,30,,,$376.73,$0.00,1,0,0,20210101,
C9072,HCPCS,"INJ, IMM GLOB ASCENIV",,30,,,"$3,032.23",$0.00,1,0,0,20210101,
C9073,HCPCS,BREXUCABTAGENE AUTOLEUCEL CA,,30,,,"$768,380.00",$0.00,1,0,0,20210101,
C9122,HCPCS,MOMETASONE FUROATE (SINUVA),,30,,,$67.48,$0.00,1,0,0,20210101,
C9132,HCPCS,"KCENTRA, PER I.U.",,30,,,$13.40,$0.00,1,0,0,20210101,
C9248,HCPCS,"INJ, CLEVIDIPINE BUTYRATE",,30,,,$19.81,$0.00,1,0,0,20210101,
C9250,HCPCS,ARTISS FIBRIN SEALANT,,30,,,"$1,017.04",$0.00,1,0,0,20210101,
C9257,HCPCS,BEVACIZUMAB INJECTION,,30,,,$13.12,$0.00,1,0,0,20210101,
C9353,HCPCS,"NEURAWRAP NERVE PROTECTOR,CM",,30,,,"$10,044.67",$0.00,1,0,0,20210101,
C9354,HCPCS,"VERITAS COLLAGEN MATRIX, CM2",,30,,,"$6,810.97",$0.00,1,0,0,20210101,
C9356,HCPCS,"TENOGLIDE TENDON PROT, CM2",,30,,,"$9,626.34",$0.00,1,0,0,20210101,
C9460,HCPCS,"INJECTION, CANGRELOR",,30,,,$102.93,$0.00,1,0,0,20210101,
C9462,HCPCS,"INJECTION, DELAFLOXACIN",,30,,,$3.14,$0.00,1,0,0,20210101,
C9482,HCPCS,SOTALOL HYDROCHLORIDE IV,,30,,,$86.19,$0.00,1,0,0,20210101,
C9488,HCPCS,CONIVAPTAN HCL,,30,,,$215.60,$0.00,1,0,0,20210101,
C9601,HCPCS,PERC DRUG-EL COR STENT BRAN,,30,,,"$30,104.46",$0.00,1,0,0,20210101,
C9603,HCPCS,PERC D-E COR STENT ATHER BR,,30,,,"$31,476.13",$0.00,1,0,0,20210101,
C9605,HCPCS,PERC D-E COR REVASC T CABG B,,30,,,"$31,476.13",$0.00,1,0,0,20210101,
C9608,HCPCS,PERC D-E COR REVASC CHRO ADD,,30,,,"$31,476.13",$0.00,1,0,0,20210101,
C9725,HCPCS,PLACE ENDORECTAL APP,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
C9726,HCPCS,RXT BREAST APPL PLACE/REMOV,,30,,,"$31,678.78",$0.00,1,0,1,20210101,
C9727,HCPCS,INSERT PALATE IMPLANTS,,30,,,"$6,889.21",$0.00,1,0,1,20210101,
C9728,HCPCS,"PLACE DEVICE/MARKER, NON PRO",,30,,,"$7,691.66",$0.00,1,0,1,20210101,
C9733,HCPCS,NON-OPHTHALMIC FVA,,30,,,"$2,348.97",$0.00,1,0,1,20210101,
C9734,HCPCS,"U/S TRTMT, NOT LEIOMYOMATA",,30,,,"$24,669.85",$0.00,1,0,1,20210101,
C9738,HCPCS,BLUE LIGHT CYSTO IMAG AGENT,,30,,,"$4,937.84",$0.00,1,0,1,20210101,
C9739,HCPCS,CYSTOSCOPY PROSTATIC IMP 1-3,,30,,,"$19,871.42",$0.00,1,0,1,20210101,
C9740,HCPCS,CYSTO IMPL 4 OR MORE,,30,,,"$23,787.30",$0.00,1,0,1,20210101,
C9751,HCPCS,"MICROWAVE BRONCH, 3D, EBUS",,30,,,"$21,129.17",$0.00,1,0,1,20210101,
C9752,HCPCS,INTRAOSSEOUS DES LUMB/SACRUM,,30,,,"$24,496.08",$0.00,1,0,1,20210101,
C9757,HCPCS,SPINE/LUMBAR DISK SURGERY,,30,,,"$24,961.34",$0.00,1,0,1,20210101,
C9758,HCPCS,INTERATRIAL SHUNT IDE,,30,,,"$30,463.52",$0.00,1,0,1,20210101,
C9760,HCPCS,NON-BLIND INTERATRIAL SHUNT,,30,,,"$32,407.55",$0.00,1,0,1,20210101,
C9761,HCPCS,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy",,30,,,"$20,135.61",$0.00,1,0,1,20210101,
C9762,HCPCS,CARDIAC MRI SEG DYS STRAIN,,30,,,"$3,091.79",$0.00,1,0,1,20210101,
C9763,HCPCS,CARDIAC MRI SEG DYS STRESS,,30,,,"$3,091.79",$0.00,1,0,1,20210101,
C9764,HCPCS,REVASC INTRAVASC LITHOTRIPSY,,30,,,"$21,716.86",$0.00,1,0,1,20210101,
C9765,HCPCS,REVASC INTRA LITHOTRIP-STENT,,30,,,"$20,606.06",$0.00,1,0,1,20210101,
C9766,HCPCS,REVASC INTRA LITHOTRIP-ATHER,,30,,,"$20,606.06",$0.00,1,0,1,20210101,
C9767,HCPCS,REVASC LITHOTRIP-STENT-ATHER,,30,,,"$32,992.23",$0.00,1,0,1,20210101,
C9769,HCPCS,"Cystourethroscopy, with insertion of temporary prostatic implant/stent",,30,,,"$20,135.61",$0.00,1,0,1,20210101,
C9770,HCPCS,"VITREC/MECH PARS, SUBRET INJ",,30,,,"$16,398.41",$0.00,1,0,1,20210101,
C9771,HCPCS,NSL/SINS CRYO POST NASAL TIS,,30,,,"$12,771.72",$0.00,1,0,1,20210101,
C9772,HCPCS,REVASC LITHOTRIP TIBI/PERONE,,30,,,"$20,444.64",$0.00,1,0,1,20210101,
C9773,HCPCS,REVASC LITHOTR-STENT TIB/PER,,30,,,"$32,697.32",$0.00,1,0,1,20210101,
C9774,HCPCS,REVASC LITHOTR-ATHER TIB/PER,,30,,,"$32,697.32",$0.00,1,0,1,20210101,
C9775,HCPCS,REVASC LITH-STEN-ATH TIB/PER,,30,,,"$32,697.32",$0.00,1,0,1,20210101,
C9803,HCPCS,HOPD COVID-19 SPEC COLLECT,,30,,,$161.57,$0.00,1,0,1,20210101,
C9898,HCPCS,INPNT STAY RADIOLABELED ITEM,,30,,,$1.25,$0.00,1,0,1,20210101,
G0008,HCPCS,ADMIN INFLUENZA VIRUS VAC,,30,,,$260.94,$0.00,1,0,1,20210101,
G0009,HCPCS,ADMIN PNEUMOCOCCAL VACCINE,,30,,,$260.94,$0.00,1,0,1,20210101,
G0010,HCPCS,ADMIN HEPATITIS B VACCINE,,30,,,$260.94,$0.00,1,0,1,20210101,
G0027,HCPCS,SEMEN ANALYSIS,,30,,,$42.51,$0.00,1,0,1,20210101,
G0101,HCPCS,CA SCREEN;PELVIC/BREAST EXAM,,30,,,$318.68,$0.00,1,0,1,20210101,
G0102,HCPCS,PROSTATE CA SCREENING; DRE,,30,,,$65.47,$0.00,1,0,1,20210101,
G0103,HCPCS,PSA SCREENING,,30,,,$205.84,$0.00,1,0,1,20210101,
G0104,HCPCS,CA SCREEN;FLEXI SIGMOIDSCOPE,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
G0105,HCPCS,COLORECTAL SCRN; HI RISK IND,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,,30,,,"$1,258.98",$0.00,1,0,1,20210101,
G0117,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,30,,,$177.03,$0.00,1,0,1,20210101,
G0118,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,30,,,$224.79,$0.00,1,0,1,20210101,
G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,,30,,,"$2,309.90",$0.00,1,0,1,20210101,
G0121,HCPCS,COLON CA SCRN NOT HI RSK IND,,30,,,"$4,390.27",$0.00,1,0,1,20210101,
G0123,HCPCS,SCREEN CERV/VAG THIN LAYER,,30,,,$152.76,$0.00,1,0,1,20210101,
G0124,HCPCS,SCREEN C/V THIN LAYER BY MD,,30,,,$166.46,$0.00,1,0,1,20210101,
G0127,HCPCS,TRIM NAIL(S),,30,,,$373.96,$0.00,1,0,1,20210101,
G0128,HCPCS,CORF SKILLED NURSING SERVICE,,30,,,"$1,209.96",$0.00,1,0,1,20210101,
G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,,30,,,$750.13,$0.00,1,0,1,20210101,
G0141,HCPCS,"SCR C/V CYTO,AUTOSYS AND MD",,30,,,$175.05,$0.00,1,0,1,20210101,
G0143,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,30,,,$258.54,$0.00,1,0,1,20210101,
G0144,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,30,,,$182.18,$0.00,1,0,1,20210101,
G0145,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,30,,,$194.40,$0.00,1,0,1,20210101,
G0147,HCPCS,"SCR C/V CYTO, AUTOMATED SYS",,30,,,$98.27,$0.00,1,0,1,20210101,
G0148,HCPCS,"SCR C/V CYTO, AUTOSYS, RESCR",,30,,,$245.41,$0.00,1,0,1,20210101,
G0151,HCPCS,"HHCP-SERV OF PT,EA 15 MIN",,30,,,$68.67,$0.00,1,0,0,20210101,
G0152,HCPCS,"HHCP-SERV OF OT,EA 15 MIN",,30,,,$67.53,$0.00,1,0,0,20210101,
G0153,HCPCS,"HHCP-SVS OF S/L PATH,EA 15MN",,30,,,$67.82,$0.00,1,0,0,20210101,
G0155,HCPCS,"HHCP-SVS OF CSW,EA 15 MIN",,30,,,$81.82,$0.00,1,1,1,20210101,
G0156,HCPCS,"HHCP-SVS OF AIDE,EA 15 MIN",,30,,,$33.85,$0.00,1,1,1,20210101,
G0157,HCPCS,HHC PT ASSISTANT EA 15,,30,,,$62.77,$0.00,1,1,1,20210101,
G0158,HCPCS,HHC OT ASSISTANT EA 15,,30,,,$60.59,$0.00,1,1,1,20210101,
G0159,HCPCS,HHC PT MAINT EA 15 MIN,,30,,,$60.90,$0.00,1,1,1,20210101,
G0160,HCPCS,HHC OCCUP THERAPY EA 15,,30,,,$67.53,$0.00,1,1,1,20210101,
G0161,HCPCS,HHC SLP EA 15 MIN,,30,,,$77.61,$0.00,1,1,1,20210101,
G0162,HCPCS,"HHC RN E&M PLAN SVS, 15 MIN",,30,,,$68.20,$0.00,1,1,1,20210101,
G0166,HCPCS,"EXTRNL COUNTERPULSE, PER TX",,30,,,$584.38,$0.00,1,0,0,20210101,
G0168,HCPCS,WOUND CLOSURE BY ADHESIVE,,30,,,$371.02,$0.00,1,0,1,20210101,
G0175,HCPCS,"OPPS SERVICE,SCHED TEAM CONF",,30,,,"$2,383.10",$0.00,1,0,1,20210101,
G0177,HCPCS,OPPS/PHP; TRAIN & EDUC SERV,,30,,,$404.30,$0.00,1,0,1,20210101,
G0179,HCPCS,MD RECERTIFICATION HHA PT,,30,,,$263.53,$0.00,1,0,1,20210101,
G0180,HCPCS,MD CERTIFICATION HHA PATIENT,,30,,,$242.95,$0.00,1,0,1,20210101,
G0182,HCPCS,HOSPICE CARE SUPERVISION,,30,,,$280.19,$0.00,1,0,1,20210101,
G0186,HCPCS,"DSTRY EYE LESN,FDR VSSL TECH",,30,,,"$2,731.26",$0.00,1,0,1,20210101,
G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,,30,,,"$2,969.59",$0.00,1,0,1,20210101,
G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,,30,,,"$4,166.71",$0.00,1,0,1,20210101,
G0237,HCPCS,THERAPEUTIC PROCD STRG ENDUR,,30,,,$177.03,$0.00,1,0,0,20210101,
G0238,HCPCS,"OTH RESP PROC, INDIV",,30,,,$177.03,$0.00,1,0,0,20210101,
G0239,HCPCS,"OTH RESP PROC, GROUP",,30,,,$224.79,$0.00,1,0,0,20210101,
G0245,HCPCS,INITIAL FOOT EXAM PT LOPS,,30,,,$358.48,$0.00,1,0,1,20210101,
G0246,HCPCS,FOLLOWUP EVAL OF FOOT PT LOP,,30,,,$358.48,$0.00,1,0,1,20210101,
G0247,HCPCS,ROUTINE FOOTCARE PT W LOPS,,30,,,$677.96,$0.00,1,0,1,20210101,
G0248,HCPCS,DEMONSTRATE USE HOME INR MON,,30,,,$358.48,$0.00,1,0,1,20210101,
G0249,HCPCS,PROVIDE INR TEST MATER/EQUIP,,30,,,$358.48,$0.00,1,0,1,20210101,
G0250,HCPCS,MD INR TEST REVIE INTER MGMT,,30,,,$73.90,$0.00,1,0,1,20210101,
G0257,HCPCS,UNSCHED DIALYSIS ESRD PT HOS,,30,,,"$4,138.92",$0.00,1,0,1,20210101,
G0259,HCPCS,INJECT FOR SACROILIAC JOINT,,30,,,"$2,507.90",$0.00,1,0,1,20210101,
G0260,HCPCS,INJ FOR SACROILIAC JT ANESTH,,30,,,"$3,353.45",$0.00,1,0,1,20210101,
G0268,HCPCS,REMOVAL OF IMPACTED WAX MD,,30,,,$374.03,$0.00,1,0,1,20210101,
G0269,HCPCS,OCCLUSIVE DEVICE IN VEIN ART,,30,,,"$2,001.90",$0.00,1,0,1,20210101,
G0276,HCPCS,PILD/PLACEBO CONTROL CLIN TR,,30,,,"$23,559.08",$0.00,1,0,1,20210101,
G0277,HCPCS,"HBOT, FULL BODY CHAMBER, 30M",,30,,,$786.73,$0.00,1,0,1,20210101,
G0278,HCPCS,"ILIAC ART ANGIO,CARDIAC CATH",,30,,,"$3,741.20",$0.00,1,0,1,20210101,
G0282,HCPCS,ELECT STIM WOUND CARE NOT PD,,30,,,$280.90,$0.00,1,0,0,20210101,
G0288,HCPCS,"RECON, CTA FOR SURG PLAN",,30,,,"$2,119.33",$0.00,1,0,1,20210101,
G0289,HCPCS,"ARTHRO, LOOSE BODY + CHONDRO",,30,,,"$8,209.20",$0.00,1,0,1,20210101,
G0293,HCPCS,"NON-COV SURG PROC,CLIN TRIAL",,30,,,$224.79,$0.00,1,0,1,20210101,
G0294,HCPCS,"NON-COV PROC, CLINICAL TRIAL",,30,,,$224.79,$0.00,1,0,1,20210101,
G0296,HCPCS,VISIT TO DETERM LDCT ELIG,,30,,,$318.68,$0.00,1,0,1,20210101,
G0299,HCPCS,HHS/HOSPICE OF RN EA 15 MIN,,30,,,$270.58,$0.00,1,1,1,20210101,
G0300,HCPCS,HHS/HOSPICE OF LPN EA 15 MIN,,30,,,$292.58,$0.00,1,1,1,20210101,
G0302,HCPCS,PRE-OP SERVICE LVRS COMPLETE,,30,,,"$3,046.46",$0.00,1,0,1,20210101,
G0303,HCPCS,PRE-OP SERVICE LVRS 10-15DOS,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
G0304,HCPCS,PRE-OP SERVICE LVRS 1-9 DOS,,30,,,"$3,046.46",$0.00,1,0,1,20210101,
G0305,HCPCS,POST OP SERVICE LVRS MIN 6,,30,,,"$3,046.46",$0.00,1,0,1,20210101,
G0306,HCPCS,CBC/DIFFWBC W/O PLATELET,,30,,,$197.28,$0.00,1,0,1,20210101,
G0307,HCPCS,CBC WITHOUT PLATELET,,30,,,$168.51,$0.00,1,0,1,20210101,
G0328,HCPCS,FECAL BLOOD SCRN IMMUNOASSAY,,30,,,$118.98,$0.00,1,0,1,20210101,
G0339,HCPCS,"ROBOT LIN-RADSURG COM, FIRST",,30,,,"$45,022.56",$0.00,1,0,1,20210101,
G0340,HCPCS,ROBT LIN-RADSURG FRACTX 2-5,,30,,,"$26,392.51",$0.00,1,0,1,20210101,
G0378,HCPCS,HOSPITAL OBSERVATION PER HR,,30,,,$172.12,$0.00,1,1,1,20210101,
G0379,HCPCS,DIRECT REFER HOSPITAL OBSERV,,30,,,$172.12,$0.00,1,1,1,20210101,
G0380,HCPCS,LEV 1 HOSP TYPE B ED VISIT,,30,,,$330.73,$0.00,1,1,1,20210101,
G0381,HCPCS,LEV 2 HOSP TYPE B ED VISIT,,30,,,$563.91,$0.00,1,1,1,20210101,
G0382,HCPCS,LEV 3 HOSP TYPE B ED VISIT,,30,,,"$1,063.24",$0.00,1,1,1,20210101,
G0383,HCPCS,LEV 4 HOSP TYPE B ED VISIT,,30,,,"$1,394.23",$0.00,1,1,1,20210101,
G0384,HCPCS,LEV 5 HOSP TYPE B ED VISIT,,30,,,"$1,919.06",$0.00,1,1,1,20210101,
G0390,HCPCS,TRAUMA RESPONS W/HOSP CRITI,,30,,,"$5,792.94",$0.00,1,1,1,20210101,
G0396,HCPCS,ALCOHOL/SUBS INTERV 15-30MN,,30,,,$112.93,$0.00,1,0,1,20210101,
G0397,HCPCS,ALCOHOL/SUBS INTERV >30 MIN,,30,,,$330.34,$0.00,1,0,1,20210101,
G0398,HCPCS,HOME SLEEP TEST/TYPE 2 PORTA,,30,,,$888.86,$0.00,1,0,1,20210101,
G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,30,,,$888.86,$0.00,1,0,1,20210101,
G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,,30,,,"$1,146.58",$0.00,1,0,1,20210101,
G0402,HCPCS,INITIAL PREVENTIVE EXAM,,30,,,$358.48,$0.00,1,0,1,20210101,
G0404,HCPCS,EKG TRACING FOR INITIAL PREV,,30,,,$152.35,$0.00,1,0,1,20210101,
G0405,HCPCS,EKG INTERPRET & REPORT PREVE,,30,,,$160.10,$0.00,1,0,1,20210101,
G0409,HCPCS,CORF RELATED SERV 15 MINS EA,,30,,,$70.84,$0.00,1,0,1,20210101,
G0412,HCPCS,OPEN TX ILIAC SPINE UNI/BIL,,30,,,"$23,170.39",$0.00,1,0,1,20210101,
G0413,HCPCS,PELVIC RING FRACTURE UNI/BIL,,30,,,"$20,116.91",$0.00,1,0,1,20210101,
G0414,HCPCS,PELVIC RING FX TREAT INT FIX,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
G0415,HCPCS,OPEN TX POST PELVIC FXCTURE,,30,,,"$25,117.12",$0.00,1,0,1,20210101,
G0416,HCPCS,"PROSTATE BIOPSY, ANY MTHD",,30,,,"$1,570.78",$0.00,1,0,1,20210101,
G0422,HCPCS,INTENS CARDIAC REHAB W/EXERC,,30,,,$383.01,$0.00,1,0,1,20210101,
G0423,HCPCS,INTENS CARDIAC REHAB NO EXER,,30,,,$383.01,$0.00,1,0,1,20210101,
G0424,HCPCS,PULMONARY REHAB W EXER,,30,,,$373.96,$0.00,1,0,1,20210101,
G0429,HCPCS,DERMAL FILLER INJECTION(S),,30,,,"$7,789.31",$0.00,1,0,0,20210101,
G0432,HCPCS,EIA HIV-1/HIV-2 SCREEN,,30,,,$202.98,$0.00,1,0,1,20210101,
G0433,HCPCS,ELISA HIV-1/HIV-2 SCREEN,,30,,,$260.59,$0.00,1,0,1,20210101,
G0435,HCPCS,ORAL HIV-1/HIV-2 SCREEN,,30,,,$348.00,$0.00,1,0,1,20210101,
G0442,HCPCS,ANNUAL ALCOHOL SCREEN 15 MIN,,30,,,$112.93,$0.00,1,0,1,20210101,
G0443,HCPCS,BRIEF ALCOHOL MISUSE COUNSEL,,30,,,$318.68,$0.00,1,0,1,20210101,
G0444,HCPCS,DEPRESSION SCREEN ANNUAL,,30,,,$112.93,$0.00,1,0,1,20210101,
G0445,HCPCS,HIGH INTEN BEH COUNS STD 30M,,30,,,$318.68,$0.00,1,0,1,20210101,
G0446,HCPCS,INTENS BEHAVE THER CARDIO DX,,30,,,$112.93,$0.00,1,0,1,20210101,
G0447,HCPCS,BEHAVIOR COUNSEL OBESITY 15M,,30,,,$318.68,$0.00,1,0,1,20210101,
G0451,HCPCS,DEVLOPMENT TEST INTERPT&REP,,30,,,$318.68,$0.00,1,0,1,20210101,
G0452,HCPCS,MOLECULAR PATHOLOGY INTERPR,,30,,,$318.57,$0.00,1,0,1,20210101,
G0453,HCPCS,CONT INTRAOP NEURO MONITOR,,30,,,$270.63,$0.00,1,0,1,20210101,
G0454,HCPCS,MD DOCUMENT VISIT BY NPP,,30,,,$197.57,$0.00,1,0,1,20210101,
G0455,HCPCS,FECAL MICROBIOTA PREP INSTIL,,30,,,"$4,852.30",$0.00,1,0,1,20210101,
G0459,HCPCS,TELEHEALTH INPT PHARM MGMT,,30,,,$239.38,$0.00,1,0,1,20210101,
G0460,HCPCS,AUTOLOGOUS PRP FOR ULCERS,,30,,,"$7,789.31",$0.00,1,0,1,20210101,
G0463,HCPCS,HOSPITAL OUTPT CLINIC VISIT,,30,,,$358.48,$0.00,1,0,1,20210101,
G0473,HCPCS,GROUP BEHAVE COUNS 2-10,,30,,,$193.65,$0.00,1,0,1,20210101,
G0476,HCPCS,HPV COMBO ASSAY CA SCREEN,,30,,,$329.48,$0.00,1,0,1,20210101,
G0480,HCPCS,DRUG TEST DEF 1-7 CLASSES,,30,,,$490.11,$0.00,1,0,1,20210101,
G0481,HCPCS,DRUG TEST DEF 8-14 CLASSES,,30,,,"$1,457.85",$0.00,1,0,1,20210101,
G0482,HCPCS,DRUG TEST DEF 15-21 CLASSES,,30,,,"$2,116.86",$0.00,1,0,1,20210101,
G0483,HCPCS,DRUG TEST DEF 22+ CLASSES,,30,,,"$2,028.75",$0.00,1,0,1,20210101,
G0491,HCPCS,DIALYSIS ACU KIDNEY NO ESRD,,30,,,"$5,735.54",$0.00,1,0,1,20210101,
G0493,HCPCS,RN CARE EA 15 MIN HH/HOSPICE,,30,,,$200.54,$0.00,1,1,1,20210101,
G0495,HCPCS,RN CARE TRAIN/EDU IN HH,,30,,,$273.42,$0.00,1,1,1,20210101,
G0496,HCPCS,LPN CARE TRAIN/EDU IN HH,,30,,,$215.63,$0.00,1,1,1,20210101,
G0498,HCPCS,CHEMO EXTEND IV INFUS W/PUMP,,30,,,"$1,689.00",$0.00,1,0,1,20210101,
G0500,HCPCS,MOD SEDAT ENDO SERVICE >5YRS,,30,,,$475.47,$0.00,1,0,1,20210101,
G0516,HCPCS,"INSERT DRUG DEL IMPLANT, >=4",,30,,,"$1,796.69",$0.00,1,0,1,20210101,
G0517,HCPCS,REMOVE DRUG IMPLANT,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
G0518,HCPCS,REMOVE W INSERT DRUG IMPLANT,,30,,,"$1,796.69",$0.00,1,0,1,20210101,
G0659,HCPCS,DRUG TEST DEF SIMPLE ALL CL,,30,,,$669.92,$0.00,1,0,1,20210101,
G2000,HCPCS,BLINDED CONV. TX MDD CLIN TR,,30,,,"$2,651.81",$0.00,1,0,1,20210101,
G2001,HCPCS,POST D/C H VST NEW PT 20 M,,30,,,$219.65,$0.00,1,0,1,20210101,
G2002,HCPCS,POST-D/C H VST NEW PT 30 M,,30,,,$338.54,$0.00,1,0,1,20210101,
G2003,HCPCS,POST-D/C H VST NEW PT 45 M,,30,,,$465.07,$0.00,1,0,1,20210101,
G2004,HCPCS,POST-D/C H VST NEW PT 60 M,,30,,,$587.43,$0.00,1,0,1,20210101,
G2005,HCPCS,POST-D/C H VST NEW PT 75 M,,30,,,$707.01,$0.00,1,0,1,20210101,
G2006,HCPCS,POST-D/C H VST EXT PT 20 M,,30,,,$226.18,$0.00,1,0,1,20210101,
G2007,HCPCS,POST-D/C H VST EXT PT 30 M,,30,,,$282.92,$0.00,1,0,1,20210101,
G2008,HCPCS,POST-D/C H VST EXT PT 45 M,,30,,,$424.93,$0.00,1,0,1,20210101,
G2009,HCPCS,POST-D/C H VST EXT PT 60 M,,30,,,$565.29,$0.00,1,0,1,20210101,
G2011,HCPCS,ALCOHOL/SUB MISUSE ASSESS,,30,,,$151.33,$0.00,1,0,1,20210101,
G2012,HCPCS,BRIEF CHECK IN BY MD/QHP,,30,,,$55.80,$0.00,1,0,1,20210101,
G2013,HCPCS,POST-D/C H VST EXT PT 75 M,,30,,,$707.01,$0.00,1,0,1,20210101,
G2014,HCPCS,POST-D/C CARE PLAN OVERS 30M,,30,,,$310.34,$0.00,1,0,1,20210101,
G2015,HCPCS,POST-D/C CARE PLAN OVERS 60M,,30,,,$405.24,$0.00,1,0,1,20210101,
G2065,HCPCS,CLIN MANG H RISK DX 30,,30,,,$314.64,$0.00,1,0,1,20210101,
G2066,HCPCS,INTER DEVC REMOTE 30D,,30,,,$246.57,$0.00,1,0,1,20210101,
G2076,HCPCS,INTAKE ACT W/MED EXAM,,30,,,$874.15,$0.00,1,0,1,20210101,
G2077,HCPCS,PERIODIC ASSESSMENT,,30,,,$285.12,$0.00,1,0,1,20210101,
G2082,HCPCS,VISIT ESKETAMINE 56M OR LESS,,30,,,"$4,119.52",$0.00,1,0,1,20210101,
G2083,HCPCS,"VISIT ESKETAMINE, > 56M",,30,,,"$5,888.36",$0.00,1,0,1,20210101,
G2086,HCPCS,OFF BASE OPIOID TX 70MIN,,30,,,"$1,317.02",$0.00,1,0,1,20210101,
G2087,HCPCS,"OFF BASE OPIOID TX, 60 M",,30,,,"$1,317.02",$0.00,1,0,1,20210101,
G2088,HCPCS,"OFF BASE OPIOID TX, ADD30",,30,,,$195.03,$0.00,1,0,1,20210101,
G2170,HCPCS,AVF BY TISSUE W THERMAL E,,30,,,"$32,992.23",$0.00,1,0,1,20210101,
G2171,HCPCS,AVF USE MAGNETIC/ART/VEN,,30,,,"$32,992.23",$0.00,1,0,1,20210101,
G2213,HCPCS,INITIAT MED ASSIST TX IN ER,,30,,,$324.48,$0.00,1,0,1,20210101,
G2214,HCPCS,INIT/SUB PSYCH CARE M 1ST 30,,30,,,$301.16,$0.00,1,0,1,20210101,
G6001,HCPCS,ECHO GUIDANCE RADIOTHERAPY,,30,,,$835.26,$0.00,1,0,1,20210101,
G6002,HCPCS,STEREOSCOPIC X-RAY GUIDANCE,,30,,,"$2,004.73",$0.00,1,0,1,20210101,
G6003,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,$851.69,$0.00,1,0,1,20210101,
G6004,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,$851.69,$0.00,1,0,1,20210101,
G6005,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,$851.69,$0.00,1,0,1,20210101,
G6006,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,228.93",$0.00,1,0,1,20210101,
G6007,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,221.04",$0.00,1,0,1,20210101,
G6008,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,628.58",$0.00,1,0,1,20210101,
G6009,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,628.58",$0.00,1,0,1,20210101,
G6010,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,628.58",$0.00,1,0,1,20210101,
G6011,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,128.74",$0.00,1,0,1,20210101,
G6012,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,628.58",$0.00,1,0,1,20210101,
G6013,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,393.80",$0.00,1,0,1,20210101,
G6014,HCPCS,RADIATION TREATMENT DELIVERY,,30,,,"$1,628.58",$0.00,1,0,1,20210101,
G6015,HCPCS,RADIATION TX DELIVERY IMRT,,30,,,"$7,112.22",$0.00,1,0,1,20210101,
G6016,HCPCS,DELIVERY COMP IMRT,,30,,,"$4,177.91",$0.00,1,0,1,20210101,
G6017,HCPCS,INTRAFRACTION TRACK MOTION,,30,,,$859.74,$0.00,1,0,1,20210101,
G9157,HCPCS,TRANSESOPH DOPPL CARDIAC MON,,30,,,$590.22,$0.00,1,0,1,20210101,
G9187,HCPCS,BPCI HOME VISIT,,30,,,$395.72,$0.00,1,0,1,20210101,
G9679,HCPCS,ACUTE CARE PNEUMONIA,,30,,,$238.94,$0.00,1,0,1,20210101,
G9682,HCPCS,ACUTE CARE SKIN INFECTION,,30,,,$240.02,$0.00,1,0,1,20210101,
G9684,HCPCS,ACUTE CARE URINARY TRACT INF,,30,,,$238.94,$0.00,1,0,1,20210101,
J0121,HCPCS,"INJ., OMADACYCLINE, 1 MG",,30,,,$22.41,$0.00,1,0,0,20210101,
J0129,HCPCS,ABATACEPT INJECTION,,30,,,$214.30,$0.00,1,0,0,20210101,
J0135,HCPCS,ADALIMUMAB INJECTION,,30,,,"$8,395.60",$0.00,1,0,0,20210101,
J0178,HCPCS,AFLIBERCEPT INJECTION,,30,,,"$3,663.19",$0.00,1,0,0,20210101,
J0179,HCPCS,"INJ, BROLUCIZUMAB-DBLL, 1 MG",,30,,,"$2,055.32",$0.00,1,0,0,20210101,
J0180,HCPCS,AGALSIDASE BETA INJECTION,,30,,,$753.52,$0.00,1,0,0,20210101,
J0185,HCPCS,"INJ., APREPITANT, 1 MG",,30,,,$14.03,$0.00,1,0,0,20210101,
J0202,HCPCS,"INJECTION, ALEMTUZUMAB",,30,,,"$11,097.50",$0.00,1,0,0,20210101,
J0207,HCPCS,AMIFOSTINE,,30,,,"$6,541.16",$0.00,1,0,0,20210101,
J0220,HCPCS,ALGLUCOSIDASE ALFA INJECTION,,30,,,$835.34,$0.00,1,0,0,20210101,
J0221,HCPCS,LUMIZYME INJECTION,,30,,,"$1,117.00",$0.00,1,0,0,20210101,
J0222,HCPCS,"INJ., PATISIRAN, 0.1 MG",,30,,,$647.52,$0.00,1,0,0,20210101,
J0223,HCPCS,INJ GIVOSIRAN 0.5 MG,,30,,,$705.50,$0.00,1,0,0,20210101,
J0256,HCPCS,ALPHA 1 PROTEINASE INHIBITOR,,30,,,$22.90,$0.00,1,0,0,20210101,
J0257,HCPCS,GLASSIA INJECTION,,30,,,$18.38,$0.00,1,0,0,20210101,
J0287,HCPCS,AMPHOTERICIN B LIPID COMPLEX,,30,,,$70.61,$0.00,1,0,0,20210101,
J0289,HCPCS,AMPHOTERICIN B LIPOSOME INJ,,30,,,$170.61,$0.00,1,0,0,20210101,
J0291,HCPCS,"INJ., PLAZOMICIN, 5 MG",,30,,,$20.64,$0.00,1,0,0,20210101,
J0300,HCPCS,AMOBARBITAL 125 MG INJ,,30,,,$697.52,$0.00,1,0,0,20210101,
J0390,HCPCS,CHLOROQUINE INJECTION,,30,,,"$1,018.73",$0.00,1,0,0,20210101,
J0401,HCPCS,INJ ARIPIPRAZOLE EXT REL 1MG,,30,,,$36.18,$0.00,1,0,0,20210101,
J0475,HCPCS,BACLOFEN 10 MG INJECTION,,30,,,"$1,126.33",$0.00,1,0,0,20210101,
J0480,HCPCS,BASILIXIMAB,,30,,,"$18,720.34",$0.00,1,0,0,20210101,
J0485,HCPCS,BELATACEPT INJECTION,,30,,,$21.44,$0.00,1,0,0,20210101,
J0490,HCPCS,BELIMUMAB INJECTION,,30,,,$270.36,$0.00,1,0,0,20210101,
J0517,HCPCS,"INJ., BENRALIZUMAB, 1 MG",,30,,,"$1,119.05",$0.00,1,0,0,20210101,
J0558,HCPCS,PENG BENZATHINE/PROCAINE INJ,,30,,,$66.96,$0.00,1,0,0,20210101,
J0561,HCPCS,PENICILLIN G BENZATHINE INJ,,30,,,$88.90,$0.00,1,0,0,20210101,
J0565,HCPCS,"INJ, BEZLOTOXUMAB, 10 MG",,30,,,$267.27,$0.00,1,0,0,20210101,
J0570,HCPCS,BUPRENORPHINE IMPLANT 74.2MG,,30,,,"$7,732.06",$0.00,1,0,0,20210101,
J0584,HCPCS,"INJECTION, BUROSUMAB-TWZA 1M",,30,,,"$2,339.34",$0.00,1,0,0,20210101,
J0585,HCPCS,"INJECTION,ONABOTULINUMTOXINA",,30,,,$32.47,$0.00,1,0,0,20210101,
J0586,HCPCS,ABOBOTULINUMTOXINA,,30,,,$55.71,$0.00,1,0,0,20210101,
J0587,HCPCS,"INJ, RIMABOTULINUMTOXINB",,30,,,$80.06,$0.00,1,0,0,20210101,
J0588,HCPCS,INCOBOTULINUMTOXIN A,,30,,,$33.73,$0.00,1,0,0,20210101,
J0594,HCPCS,BUSULFAN INJECTION,,30,,,$69.00,$0.00,1,0,0,20210101,
J0596,HCPCS,"INJECTION, RUCONEST",,30,,,$190.34,$0.00,1,0,0,20210101,
J0597,HCPCS,"C-1 ESTERASE, BERINERT",,30,,,$334.75,$0.00,1,0,0,20210101,
J0598,HCPCS,"C-1 ESTERASE, CINRYZE",,30,,,$372.85,$0.00,1,0,0,20210101,
J0599,HCPCS,"INJ., HAEGARDA 10 UNITS",,30,,,$64.44,$0.00,1,0,0,20210101,
J0600,HCPCS,EDETATE CALCIUM DISODIUM INJ,,30,,,"$23,002.77",$0.00,1,0,0,20210101,
J0630,HCPCS,CALCITONIN SALMON INJECTION,,30,,,"$14,566.88",$0.00,1,0,0,20210101,
J0638,HCPCS,CANAKINUMAB INJECTION,,30,,,$727.93,$0.00,1,0,0,20210101,
J0641,HCPCS,INJ LEVOLEUCOVORIN NOS 0.5MG,,30,,,$2.60,$0.00,1,0,0,20210101,
J0642,HCPCS,"INJECTION, KHAPZORY, 0.5 MG",,30,,,$13.20,$0.00,1,0,0,20210101,
J0691,HCPCS,INJ LEFAMULIN 1 MG,,30,,,$4.73,$0.00,1,0,0,20210101,
J0693,HCPCS,"INJ., CEFIDEROCOL, 5 MG",,30,,,$6.32,$0.00,1,0,0,20210101,
J0695,HCPCS,INJ CEFTOLOZANE TAZOBACTAM,,30,,,$39.07,$0.00,1,0,0,20210101,
J0712,HCPCS,CEFTAROLINE FOSAMIL INJ,,30,,,$14.73,$0.00,1,0,0,20210101,
J0714,HCPCS,CEFTAZIDIME AND AVIBACTAM,,30,,,$574.28,$0.00,1,0,0,20210101,
J0716,HCPCS,CENTRUROIDES IMMUNE F(AB),,30,,,"$21,315.02",$0.00,1,0,0,20210101,
J0717,HCPCS,CERTOLIZUMAB PEGOL INJ 1MG,,30,,,$32.57,$0.00,1,0,0,20210101,
J0740,HCPCS,CIDOFOVIR INJECTION,,30,,,"$3,646.32",$0.00,1,0,0,20210101,
J0742,HCPCS,INJ IMIP 4 CILAS 4 RELEB 2MG,,30,,,$14.60,$0.00,1,0,0,20210101,
J0745,HCPCS,INJ CODEINE PHOSPHATE /30 MG,,30,,,$17.08,$0.00,1,0,0,20210101,
J0775,HCPCS,"COLLAGENASE, CLOST HIST INJ",,30,,,$317.83,$0.00,1,0,0,20210101,
J0791,HCPCS,INJ CRIZANLIZUMAB-TMCA 5MG,,30,,,$805.09,$0.00,1,0,0,20210101,
J0795,HCPCS,CORTICORELIN OVINE TRIFLUTAL,,30,,,$60.49,$0.00,1,0,0,20210101,
J0840,HCPCS,CROTALIDAE POLY IMMUNE FAB,,30,,,"$16,421.67",$0.00,1,0,0,20210101,
J0841,HCPCS,INJ CROTALIDAE IM F(AB')2 EQ,,30,,,"$10,428.43",$0.00,1,0,0,20210101,
J0850,HCPCS,CYTOMEGALOVIRUS IMM IV /VIAL,,30,,,"$7,922.21",$0.00,1,0,0,20210101,
J0875,HCPCS,"INJECTION, DALBAVANCIN",,30,,,$100.34,$0.00,1,0,0,20210101,
J0881,HCPCS,"DARBEPOETIN ALFA, NON-ESRD",,30,,,$24.72,$0.00,1,0,0,20210101,
J0882,HCPCS,"DARBEPOETIN ALFA, ESRD USE",,30,,,$25.74,$0.00,1,0,0,20210101,
J0883,HCPCS,ARGATROBAN NONESRD USE 1MG,,30,,,$8.60,$0.00,1,0,0,20210101,
J0884,HCPCS,ARGATROBAN ESRD DIALYSIS 1MG,,30,,,$8.60,$0.00,1,0,0,20210101,
J0885,HCPCS,"EPOETIN ALFA, NON-ESRD",,30,,,$74.82,$0.00,1,0,0,20210101,
J0888,HCPCS,EPOETIN BETA NON ESRD,,30,,,$12.36,$0.00,1,0,0,20210101,
J0894,HCPCS,DECITABINE INJECTION,,30,,,$68.43,$0.00,1,0,0,20210101,
J0896,HCPCS,INJ LUSPATERCEPT-AAMT 0.25MG,,30,,,$240.66,$0.00,1,0,0,20210101,
J0897,HCPCS,DENOSUMAB INJECTION,,30,,,$102.35,$0.00,1,0,0,20210101,
J1095,HCPCS,"INJECTION, DEXAMETHASONE 9%",,30,,,$7.42,$0.00,1,0,0,20210101,
J1096,HCPCS,DEXAMETHA OPTH INSERT 0.1 MG,,30,,,$914.71,$0.00,1,0,0,20210101,
J1162,HCPCS,DIGOXIN IMMUNE FAB (OVINE),,30,,,"$18,660.81",$0.00,1,0,0,20210101,
J1190,HCPCS,DEXRAZOXANE HCL INJECTION,,30,,,"$1,421.10",$0.00,1,0,0,20210101,
J1201,HCPCS,INJ. CETIRIZINE HCL 0.5MG,,30,,,$102.29,$0.00,1,0,0,20210101,
J1212,HCPCS,DIMETHYL SULFOXIDE 50% 50 ML,,30,,,"$3,786.75",$0.00,1,0,0,20210101,
J1290,HCPCS,ECALLANTIDE INJECTION,,30,,,"$3,063.99",$0.00,1,0,0,20210101,
J1300,HCPCS,ECULIZUMAB INJECTION,,30,,,$980.04,$0.00,1,0,0,20210101,
J1301,HCPCS,"INJECTION, EDARAVONE, 1 MG",,30,,,$130.73,$0.00,1,0,0,20210101,
J1303,HCPCS,"INJ., RAVULIZUMAB-CWVZ 10 MG",,30,,,"$1,456.12",$0.00,1,0,0,20210101,
J1322,HCPCS,"ELOSULFASE ALFA, INJECTION",,30,,,"$1,577.34",$0.00,1,0,0,20210101,
J1364,HCPCS,ERYTHRO LACTOBIONATE /500 MG,,30,,,$338.02,$0.00,1,0,0,20210101,
J1410,HCPCS,INJ ESTROGEN CONJUGATE 25 MG,,30,,,"$2,040.12",$0.00,1,0,0,20210101,
J1429,HCPCS,INJ GOLODIRSEN 10 MG,,30,,,"$1,089.76",$0.00,1,0,0,20210101,
J1430,HCPCS,ETHANOLAMINE OLEATE 100 MG,,30,,,"$2,871.56",$0.00,1,0,0,20210101,
J1437,HCPCS,"Injection, ferric derisomaltose, 10 mg",,30,,,$164.98,$0.00,1,0,0,20210101,
J1438,HCPCS,ETANERCEPT INJECTION,,30,,,"$4,421.83",$0.00,1,0,0,20210101,
J1439,HCPCS,INJ FERRIC CARBOXYMALTOS 1MG,,30,,,$7.32,$0.00,1,0,0,20210101,
J1442,HCPCS,INJ FILGRASTIM EXCL BIOSIMIL,,30,,,$6.46,$0.00,1,0,0,20210101,
J1447,HCPCS,INJ TBO FILGRASTIM 1 MICROG,,30,,,$3.63,$0.00,1,0,0,20210101,
J1451,HCPCS,"FOMEPIZOLE, 15 MG",,30,,,$54.74,$0.00,1,0,0,20210101,
J1453,HCPCS,FOSAPREPITANT INJECTION,,30,,,$10.54,$0.00,1,0,0,20210101,
J1454,HCPCS,"INJ FOSNETUPITANT, PALONOSET",,30,,,"$2,774.92",$0.00,1,0,0,20210101,
J1455,HCPCS,FOSCARNET SODIUM INJECTION,,30,,,$542.88,$0.00,1,0,0,20210101,
J1458,HCPCS,GALSULFASE INJECTION,,30,,,"$2,571.07",$0.00,1,0,0,20210101,
J1459,HCPCS,INJ IVIG PRIVIGEN 500 MG,,30,,,$270.04,$0.00,1,0,0,20210101,
J1460,HCPCS,GAMMA GLOBULIN 1 CC INJ,,30,,,$270.34,$0.00,1,0,0,20210101,
J1555,HCPCS,"INJ CUVITRU, 100 MG",,30,,,$91.02,$0.00,1,0,0,20210101,
J1556,HCPCS,"INJ, IMM GLOB BIVIGAM, 500MG",,30,,,$303.24,$0.00,1,0,0,20210101,
J1557,HCPCS,GAMMAPLEX INJECTION,,30,,,$330.49,$0.00,1,0,0,20210101,
J1558,HCPCS,"INJ. XEMBIFY, 100 MG",,30,,,$111.50,$0.00,1,0,0,20210101,
J1559,HCPCS,HIZENTRA INJECTION,,30,,,$69.63,$0.00,1,0,0,20210101,
J1560,HCPCS,GAMMA GLOBULIN > 10 CC INJ,,30,,,"$2,634.83",$0.00,1,0,0,20210101,
J1561,HCPCS,GAMUNEX-C/GAMMAKED,,30,,,$265.00,$0.00,1,0,0,20210101,
J1566,HCPCS,"IMMUNE GLOBULIN, POWDER",,30,,,$264.67,$0.00,1,0,0,20210101,
J1568,HCPCS,OCTAGAM INJECTION,,30,,,$246.45,$0.00,1,0,0,20210101,
J1569,HCPCS,GAMMAGARD LIQUID INJECTION,,30,,,$272.00,$0.00,1,0,0,20210101,
J1571,HCPCS,HEPAGAM B IM INJECTION,,30,,,$421.43,$0.00,1,0,0,20210101,
J1572,HCPCS,FLEBOGAMMA INJECTION,,30,,,$193.46,$0.00,1,0,0,20210101,
J1573,HCPCS,"HEPAGAM B INTRAVENOUS, INJ",,30,,,$429.42,$0.00,1,0,0,20210101,
J1575,HCPCS,HYQVIA 100MG IMMUNEGLOBULIN,,30,,,$93.18,$0.00,1,0,0,20210101,
J1595,HCPCS,INJECTION GLATIRAMER ACETATE,,30,,,"$1,172.32",$0.00,1,0,0,20210101,
J1602,HCPCS,GOLIMUMAB FOR IV USE 1MG,,30,,,$143.13,$0.00,1,0,0,20210101,
J1610,HCPCS,GLUCAGON HYDROCHLORIDE/1 MG,,30,,,"$1,210.35",$0.00,1,0,0,20210101,
J1628,HCPCS,"INJ., GUSELKUMAB, 1 MG",,30,,,$647.80,$0.00,1,0,0,20210101,
J1632,HCPCS,"Injection, brexanolone, 1 mg",,30,,,$498.92,$0.00,1,0,0,20210101,
J1640,HCPCS,"HEMIN, 1 MG",,30,,,$157.80,$0.00,1,0,0,20210101,
J1670,HCPCS,TETANUS IMMUNE GLOBULIN INJ,,30,,,"$3,076.11",$0.00,1,0,0,20210101,
J1726,HCPCS,"MAKENA, 10 MG",,30,,,$97.77,$0.00,1,0,0,20210101,
J1729,HCPCS,INJ HYDROXYPROGST CAPOAT NOS,,30,,,$71.57,$0.00,1,0,0,20210101,
J1738,HCPCS,"Injection, meloxicam, 1 mg",,30,,,$20.98,$0.00,1,0,0,20210101,
J1740,HCPCS,IBANDRONATE SODIUM INJECTION,,30,,,$348.07,$0.00,1,0,0,20210101,
J1742,HCPCS,IBUTILIDE FUMARATE INJECTION,,30,,,"$1,600.35",$0.00,1,0,0,20210101,
J1744,HCPCS,ICATIBANT INJECTION,,30,,,"$2,147.36",$0.00,1,0,0,20210101,
J1745,HCPCS,INFLIXIMAB NOT BIOSIMIL 10MG,,30,,,$429.28,$0.00,1,0,0,20210101,
J1746,HCPCS,"INJ., IBALIZUMAB-UIYK, 10 MG",,30,,,$397.16,$0.00,1,0,0,20210101,
J1750,HCPCS,INJ IRON DEXTRAN,,30,,,$94.32,$0.00,1,0,0,20210101,
J1786,HCPCS,IMUGLUCERASE INJECTION,,30,,,$284.82,$0.00,1,0,0,20210101,
J1823,HCPCS,"INJ. INEBILIZUMAB-CDON, 1 MG",,30,,,"$2,837.30",$0.00,1,0,0,20210101,
J1826,HCPCS,INTERFERON BETA-1A INJ,,30,,,"$11,091.07",$0.00,1,0,0,20210101,
J1830,HCPCS,INTERFERON BETA-1B / .25 MG,,30,,,"$2,530.90",$0.00,1,0,0,20210101,
J1833,HCPCS,"INJECTION, ISAVUCONAZONIUM",,30,,,$5.00,$0.00,1,0,0,20210101,
J1930,HCPCS,LANREOTIDE INJECTION,,30,,,$274.98,$0.00,1,0,0,20210101,
J1931,HCPCS,LARONIDASE INJECTION,,30,,,$213.68,$0.00,1,0,0,20210101,
J1943,HCPCS,"INJ., ARISTADA INITIO, 1 MG",,30,,,$18.10,$0.00,1,0,0,20210101,
J1944,HCPCS,ARIPIRAZOLE LAUROXIL 1 MG,,30,,,$17.46,$0.00,1,0,0,20210101,
J1950,HCPCS,LEUPROLIDE ACETATE /3.75 MG,,30,,,"$7,278.32",$0.00,1,0,0,20210101,
J2182,HCPCS,"INJECTION, MEPOLIZUMAB, 1MG",,30,,,$177.18,$0.00,1,0,0,20210101,
J2186,HCPCS,"INJ., MEROPENEM, VABORBACTAM",,30,,,$11.44,$0.00,1,0,0,20210101,
J2248,HCPCS,MICAFUNGIN SODIUM INJECTION,,30,,,$10.25,$0.00,1,0,0,20210101,
J2265,HCPCS,MINOCYCLINE HYDROCHLORIDE,,30,,,$11.94,$0.00,1,0,0,20210101,
J2278,HCPCS,ZICONOTIDE INJECTION,,30,,,$53.05,$0.00,1,0,0,20210101,
J2315,HCPCS,"NALTREXONE, DEPOT FORM",,30,,,$21.73,$0.00,1,0,0,20210101,
J2323,HCPCS,NATALIZUMAB INJECTION,,30,,,$117.27,$0.00,1,0,0,20210101,
J2326,HCPCS,"INJ, NUSINERSEN, 0.1MG",,30,,,"$6,893.58",$0.00,1,0,0,20210101,
J2350,HCPCS,"INJECTION, OCRELIZUMAB, 1 MG",,30,,,$344.21,$0.00,1,0,0,20210101,
J2353,HCPCS,"OCTREOTIDE INJECTION, DEPOT",,30,,,$943.04,$0.00,1,0,0,20210101,
J2357,HCPCS,OMALIZUMAB INJECTION,,30,,,$192.39,$0.00,1,0,0,20210101,
J2358,HCPCS,OLANZAPINE LONG-ACTING INJ,,30,,,$18.29,$0.00,1,0,0,20210101,
J2407,HCPCS,"INJECTION, ORITAVANCIN",,30,,,$160.66,$0.00,1,0,0,20210101,
J2425,HCPCS,PALIFERMIN INJECTION,,30,,,$140.65,$0.00,1,0,0,20210101,
J2426,HCPCS,PALIPERIDONE PALMITATE INJ,,30,,,$45.40,$0.00,1,0,0,20210101,
J2502,HCPCS,"INJ, PASIREOTIDE LONG ACTING",,30,,,"$1,998.43",$0.00,1,0,0,20210101,
J2504,HCPCS,"PEGADEMASE BOVINE, 25 IU",,30,,,"$3,033.13",$0.00,1,0,0,20210101,
J2505,HCPCS,"INJECTION, PEGFILGRASTIM 6MG",,30,,,"$19,821.87",$0.00,1,0,0,20210101,
J2507,HCPCS,PEGLOTICASE INJECTION,,30,,,"$13,566.87",$0.00,1,0,0,20210101,
J2515,HCPCS,PENTOBARBITAL SODIUM INJ,,30,,,$277.63,$0.00,1,0,0,20210101,
J2547,HCPCS,"INJECTION, PERAMIVIR",,30,,,$10.99,$0.00,1,0,0,20210101,
J2560,HCPCS,PHENOBARBITAL SODIUM INJ,,30,,,$185.38,$0.00,1,0,0,20210101,
J2562,HCPCS,PLERIXAFOR INJECTION,,30,,,"$2,243.63",$0.00,1,0,0,20210101,
J2597,HCPCS,INJ DESMOPRESSIN ACETATE,,30,,,$79.89,$0.00,1,0,0,20210101,
J2724,HCPCS,PROTEIN C CONCENTRATE,,30,,,$101.31,$0.00,1,0,0,20210101,
J2760,HCPCS,PHENTOLAINE MESYLATE INJ,,30,,,"$2,439.37",$0.00,1,0,0,20210101,
J2770,HCPCS,QUINUPRISTIN/DALFOPRISTIN,,30,,,"$2,862.55",$0.00,1,0,0,20210101,
J2778,HCPCS,RANIBIZUMAB INJECTION,,30,,,"$1,460.99",$0.00,1,0,0,20210101,
J2783,HCPCS,RASBURICASE,,30,,,"$1,883.89",$0.00,1,0,0,20210101,
J2786,HCPCS,"INJECTION, RESLIZUMAB, 1MG",,30,,,$62.58,$0.00,1,0,0,20210101,
J2792,HCPCS,"RHO(D) IMMUNE GLOBULIN H, SD",,30,,,$186.26,$0.00,1,0,0,20210101,
J2794,HCPCS,"INJ RISPERDAL CONSTA, 0.5 MG",,30,,,$50.93,$0.00,1,0,0,20210101,
J2796,HCPCS,ROMIPLOSTIM INJECTION,,30,,,$343.03,$0.00,1,0,0,20210101,
J2798,HCPCS,"INJ., PERSERIS, 0.5 MG",,30,,,$66.09,$0.00,1,0,0,20210101,
J2820,HCPCS,SARGRAMOSTIM INJECTION,,30,,,$288.23,$0.00,1,0,0,20210101,
J2840,HCPCS,INJ SEBELIPASE ALFA 1 MG,,30,,,"$3,478.79",$0.00,1,0,0,20210101,
J2850,HCPCS,INJ SECRETIN SYNTHETIC HUMAN,,30,,,$232.96,$0.00,1,0,0,20210101,
J2860,HCPCS,"INJECTION, SILTUXIMAB",,30,,,$686.38,$0.00,1,0,0,20210101,
J2941,HCPCS,SOMATROPIN INJECTION,,30,,,$316.88,$0.00,1,0,0,20210101,
J2993,HCPCS,RETEPLASE INJECTION,,30,,,"$7,078.02",$0.00,1,0,0,20210101,
J2997,HCPCS,ALTEPLASE RECOMBINANT,,30,,,$577.48,$0.00,1,0,0,20210101,
J3031,HCPCS,"INJ., FREMANEZUMAB-VFRM 1 MG",,30,,,$16.42,$0.00,1,0,0,20210101,
J3032,HCPCS,"Injection, eptinezumab-jjmr, 1 mg",,30,,,$100.09,$0.00,1,0,0,20210101,
J3060,HCPCS,"INJ, TALIGLUCERASE ALFA 10 U",,30,,,$271.07,$0.00,1,0,0,20210101,
J3090,HCPCS,INJ TEDIZOLID PHOSPHATE,,30,,,$9.92,$0.00,1,0,0,20210101,
J3095,HCPCS,TELAVANCIN INJECTION,,30,,,$33.85,$0.00,1,0,0,20210101,
J3101,HCPCS,TENECTEPLASE INJECTION,,30,,,$808.15,$0.00,1,0,0,20210101,
J3111,HCPCS,INJ. ROMOSOZUMAB-AQQG 1 MG,,30,,,$59.57,$0.00,1,0,0,20210101,
J3145,HCPCS,TESTOSTERONE UNDECANOATE 1MG,,30,,,$9.56,$0.00,1,0,0,20210101,
J3240,HCPCS,THYROTROPIN INJECTION,,30,,,"$8,305.21",$0.00,1,0,0,20210101,
J3241,HCPCS,"Injection, teprotumumab-trbw, 10 mg""",,30,,,"$1,956.07",$0.00,1,0,0,20210101,
J3243,HCPCS,TIGECYCLINE INJECTION,,30,,,$12.35,$0.00,1,0,0,20210101,
J3245,HCPCS,"INJ., TILDRAKIZUMAB, 1 MG",,30,,,$896.35,$0.00,1,0,0,20210101,
J3246,HCPCS,TIROFIBAN HCL,,30,,,$45.25,$0.00,1,0,0,20210101,
J3262,HCPCS,TOCILIZUMAB INJECTION,,30,,,$29.68,$0.00,1,0,0,20210101,
J3285,HCPCS,TREPROSTINIL INJECTION,,30,,,$418.13,$0.00,1,0,0,20210101,
J3304,HCPCS,INJ TRIAMCINOLONE ACE XR 1MG,,30,,,$124.00,$0.00,1,0,0,20210101,
J3315,HCPCS,TRIPTORELIN PAMOATE,,30,,,"$1,787.74",$0.00,1,0,0,20210101,
J3316,HCPCS,"INJ., TRIPTORELIN XR 3.75 MG",,30,,,"$15,527.58",$0.00,1,0,0,20210101,
J3357,HCPCS,"USTEKINUMAB SUB CU INJ, 1 MG",,30,,,"$1,044.04",$0.00,1,0,0,20210101,
J3358,HCPCS,"USTEKINUMAB, IV INJECT, 1 MG",,30,,,$82.43,$0.00,1,0,0,20210101,
J3380,HCPCS,"INJECTION, VEDOLIZUMAB",,30,,,$99.44,$0.00,1,0,0,20210101,
J3385,HCPCS,VELAGLUCERASE ALFA,,30,,,"$2,262.34",$0.00,1,0,0,20210101,
J3396,HCPCS,VERTEPORFIN INJECTION,,30,,,$73.96,$0.00,1,0,0,20210101,
J3398,HCPCS,INJ LUXTURNA 1 BILLION VEC G,,30,,,"$15,613.93",$0.00,1,0,0,20210101,
J7169,HCPCS,"INJ ANDEXXA, 10 MG",,30,,,"$1,894.11",$0.00,1,0,0,20210101,
J7170,HCPCS,"INJ., EMICIZUMAB-KXWH 0.5 MG",,30,,,$321.22,$0.00,1,0,0,20210101,
J7175,HCPCS,"INJ, FACTOR X, (HUMAN), 1IU",,30,,,$49.49,$0.00,1,0,0,20210101,
J7178,HCPCS,INJ HUMAN FIBRINOGEN CON NOS,,30,,,$8.11,$0.00,1,0,0,20210101,
J7179,HCPCS,VONVENDI INJ 1 IU VWF:RCO,,30,,,$13.10,$0.00,1,0,0,20210101,
J7180,HCPCS,FACTOR XIII ANTI-HEM FACTOR,,30,,,$57.32,$0.00,1,0,0,20210101,
J7181,HCPCS,FACTOR XIII RECOMB A-SUBUNIT,,30,,,$101.69,$0.00,1,0,0,20210101,
J7182,HCPCS,FACTOR VIII RECOMB NOVOEIGHT,,30,,,$8.71,$0.00,1,0,0,20210101,
J7183,HCPCS,WILATE INJECTION,,30,,,$6.63,$0.00,1,0,0,20210101,
J7185,HCPCS,XYNTHA INJ,,30,,,$8.36,$0.00,1,0,0,20210101,
J7186,HCPCS,ANTIHEMOPHILIC VIII/VWF COMP,,30,,,$7.09,$0.00,1,0,0,20210101,
J7187,HCPCS,"HUMATE-P, INJ",,30,,,$7.83,$0.00,1,0,0,20210101,
J7188,HCPCS,FACTOR VIII RECOMB OBIZUR,,30,,,$23.01,$0.00,1,0,0,20210101,
J7189,HCPCS,FACTOR VIIA RECOMB NOVOSEVEN,,30,,,$14.31,$0.00,1,0,0,20210101,
J7190,HCPCS,FACTOR VIII,,30,,,$7.45,$0.00,1,0,0,20210101,
J7192,HCPCS,FACTOR VIII RECOMBINANT NOS,,30,,,$8.82,$0.00,1,0,0,20210101,
J7193,HCPCS,FACTOR IX NON-RECOMBINANT,,30,,,$7.74,$0.00,1,0,0,20210101,
J7194,HCPCS,FACTOR IX COMPLEX,,30,,,$9.74,$0.00,1,0,0,20210101,
J7195,HCPCS,FACTOR IX RECOMBINANT NOS,,30,,,$10.20,$0.00,1,0,0,20210101,
J7197,HCPCS,ANTITHROMBIN III INJECTION,,30,,,$23.03,$0.00,1,0,0,20210101,
J7198,HCPCS,ANTI-INHIBITOR,,30,,,$13.31,$0.00,1,0,0,20210101,
J7200,HCPCS,FACTOR IX RECOMBINAN RIXUBIS,,30,,,$9.23,$0.00,1,0,0,20210101,
J7201,HCPCS,FACTOR IX ALPROLIX RECOMB,,30,,,$20.89,$0.00,1,0,0,20210101,
J7202,HCPCS,FACTOR IX IDELVION INJ,,30,,,$29.07,$0.00,1,0,0,20210101,
J7203,HCPCS,FACTOR IX RECOMB GLY REBINYN,,30,,,$27.09,$0.00,1,0,0,20210101,
J7204,HCPCS,INJ RECOMBIN ESPEROCT PER IU,,30,,,$16.71,$0.00,1,0,0,20210101,
J7205,HCPCS,FACTOR VIII FC FUSION RECOMB,,30,,,$13.97,$0.00,1,0,0,20210101,
J7207,HCPCS,FACTOR VIII PEGYLATED RECOMB,,30,,,$11.91,$0.00,1,0,0,20210101,
J7208,HCPCS,INJ. JIVI 1 IU,,30,,,$13.48,$0.00,1,0,0,20210101,
J7209,HCPCS,FACTOR VIII NUWIQ RECOMB 1IU,,30,,,$9.32,$0.00,1,0,0,20210101,
J7210,HCPCS,"INJ, AFSTYLA, 1 I.U.",,30,,,$9.14,$0.00,1,0,0,20210101,
J7211,HCPCS,"INJ, KOVALTRY, 1 I.U.",,30,,,$6.76,$0.00,1,0,0,20210101,
J7212,HCPCS,FACTOR VIIA RECOMB SEVENFACT,,30,,,$16.80,$0.00,1,0,0,20210101,
J7308,HCPCS,AMINOLEVULINIC ACID HCL TOP,,30,,,"$1,059.60",$0.00,1,0,0,20210101,
J7311,HCPCS,"INJ., RETISERT, 0.01 MG",,30,,,"$22,474.27",$0.00,1,0,0,20210101,
J7312,HCPCS,DEXAMETHASONE INTRA IMPLANT,,30,,,"$1,325.70",$0.00,1,0,0,20210101,
J7313,HCPCS,"INJ., ILUVIEN, 0.01 MG",,30,,,"$3,182.99",$0.00,1,0,0,20210101,
J7314,HCPCS,"INJ., YUTIQ, 0.01 MG",,30,,,"$3,146.24",$0.00,1,0,0,20210101,
J7316,HCPCS,"INJ, OCRIPLASMIN, 0.125 MG",,30,,,"$6,512.54",$0.00,1,0,0,20210101,
J7318,HCPCS,"INJ, DUROLANE 1 MG",,30,,,$114.82,$0.00,1,0,0,20210101,
J7320,HCPCS,"GENVISC 850, INJ, 1MG",,30,,,$94.65,$0.00,1,0,0,20210101,
J7322,HCPCS,HYMOVIS INJECTION 1 MG,,30,,,$188.00,$0.00,1,0,0,20210101,
J7323,HCPCS,EUFLEXXA INJ PER DOSE,,30,,,$751.00,$0.00,1,0,0,20210101,
J7324,HCPCS,ORTHOVISC INJ PER DOSE,,30,,,$745.62,$0.00,1,0,0,20210101,
J7325,HCPCS,SYNVISC OR SYNVISC-ONE,,30,,,$77.20,$0.00,1,0,0,20210101,
J7326,HCPCS,GEL-ONE,,30,,,"$4,705.05",$0.00,1,0,0,20210101,
J7327,HCPCS,MONOVISC INJ PER DOSE,,30,,,"$5,015.63",$0.00,1,0,0,20210101,
J7328,HCPCS,GELSYN-3 INJECTION 0.1 MG,,30,,,$14.60,$0.00,1,0,0,20210101,
J7329,HCPCS,"INJ, TRIVISC 1 MG",,30,,,$47.62,$0.00,1,0,0,20210101,
J7331,HCPCS,"SYNOJOYNT, INJ., 1 MG",,30,,,$36.81,$0.00,1,0,0,20210101,
J7336,HCPCS,CAPSAICIN 8% PATCH,,30,,,$21.28,$0.00,1,0,0,20210101,
J7340,HCPCS,CARBIDOPA LEVODOPA ENT 100ML,,30,,,$716.05,$0.00,1,0,0,20210101,
J7342,HCPCS,CIPROFLOXACIN OTIC SUSP 6 MG,,30,,,$200.80,$0.00,1,0,0,20210101,
J7345,HCPCS,"AMINOLEVULINIC ACID, 10% GEL",,30,,,$9.89,$0.00,1,0,0,20210101,
J7351,HCPCS,"Injection, bimatoprost, intracameral implant, 1 microgram",,30,,,"$1,289.59",$0.00,1,0,0,20210101,
J7352,HCPCS,"AFAMELANOTIDE IMPLANT, 1 MG",,30,,,"$16,284.86",$0.00,1,0,0,20210101,
J7501,HCPCS,AZATHIOPRINE PARENTERAL,,30,,,"$1,518.35",$0.00,1,0,0,20210101,
J7504,HCPCS,LYMPHOCYTE IMMUNE GLOBULIN,,30,,,"$11,777.25",$0.00,1,0,0,20210101,
J7511,HCPCS,ANTITHYMOCYTE GLOBULN RABBIT,,30,,,"$4,764.04",$0.00,1,0,0,20210101,
J7525,HCPCS,TACROLIMUS INJECTION,,30,,,"$1,340.80",$0.00,1,0,0,20210101,
J8560,HCPCS,ETOPOSIDE ORAL 50 MG,,30,,,$502.37,$0.00,1,0,0,20210101,
J8655,HCPCS,"ORAL NETUPITANT, PALONOSETRO",,30,,,"$1,886.06",$0.00,1,0,0,20210101,
J8670,HCPCS,"ROLAPITANT, ORAL, 1MG",,30,,,$16.37,$0.00,1,0,0,20210101,
J9015,HCPCS,ALDESLEUKIN INJECTION,,30,,,"$20,327.49",$0.00,1,0,0,20210101,
J9017,HCPCS,ARSENIC TRIOXIDE INJECTION,,30,,,$258.67,$0.00,1,0,0,20210101,
J9019,HCPCS,ERWINAZE INJECTION,,30,,,"$2,700.88",$0.00,1,0,0,20210101,
J9022,HCPCS,"INJ, ATEZOLIZUMAB,10 MG",,30,,,$454.01,$0.00,1,0,0,20210101,
J9023,HCPCS,"INJECTION, AVELUMAB, 10 MG",,30,,,$553.49,$0.00,1,0,0,20210101,
J9025,HCPCS,AZACITIDINE INJECTION,,30,,,$8.57,$0.00,1,0,0,20210101,
J9027,HCPCS,CLOFARABINE INJECTION,,30,,,$559.00,$0.00,1,0,0,20210101,
J9032,HCPCS,"INJECTION, BELINOSTAT, 10MG",,30,,,$265.44,$0.00,1,0,0,20210101,
J9033,HCPCS,"INJ., TREANDA 1 MG",,30,,,$129.49,$0.00,1,0,0,20210101,
J9034,HCPCS,"INJ., BENDEKA 1 MG",,30,,,$148.54,$0.00,1,0,0,20210101,
J9035,HCPCS,BEVACIZUMAB INJECTION,,30,,,$482.69,$0.00,1,0,0,20210101,
J9036,HCPCS,INJ. BELRAPZO/BENDAMUSTINE,,30,,,$152.42,$0.00,1,0,0,20210101,
J9039,HCPCS,"INJECTION, BLINATUMOMAB",,30,,,$746.19,$0.00,1,0,0,20210101,
J9041,HCPCS,"INJ., VELCADE 0.1 MG",,30,,,$299.21,$0.00,1,0,0,20210101,
J9042,HCPCS,BRENTUXIMAB VEDOTIN INJ,,30,,,$687.22,$0.00,1,0,0,20210101,
J9043,HCPCS,CABAZITAXEL INJECTION,,30,,,$765.00,$0.00,1,0,0,20210101,
J9044,HCPCS,"INJ, BORTEZOMIB, NOS, 0.1 MG",,30,,,$196.65,$0.00,1,0,0,20210101,
J9047,HCPCS,"INJECTION, CARFILZOMIB, 1 MG",,30,,,$192.47,$0.00,1,0,0,20210101,
J9050,HCPCS,CARMUSTINE INJECTION,,30,,,"$15,337.14",$0.00,1,0,0,20210101,
J9055,HCPCS,CETUXIMAB INJECTION,,30,,,$347.55,$0.00,1,0,0,20210101,
J9057,HCPCS,"INJ., COPANLISIB, 1 MG",,30,,,$509.72,$0.00,1,0,0,20210101,
J9065,HCPCS,INJ CLADRIBINE PER 1 MG,,30,,,$142.12,$0.00,1,0,0,20210101,
J9070,HCPCS,CYCLOPHOSPHAMIDE 100 MG INJ,,30,,,$249.63,$0.00,1,0,0,20210101,
J9119,HCPCS,"INJ., CEMIPLIMAB-RWLC, 1 MG",,30,,,$181.65,$0.00,1,0,0,20210101,
J9120,HCPCS,DACTINOMYCIN INJECTION,,30,,,"$7,517.16",$0.00,1,0,0,20210101,
J9144,HCPCS,"DARATUMUMAB, HYALURONIDASE",,30,,,$281.35,$0.00,1,0,0,20210101,
J9145,HCPCS,"INJECTION, DARATUMUMAB 10 MG",,30,,,$300.38,$0.00,1,0,0,20210101,
J9150,HCPCS,DAUNORUBICIN INJECTION,,30,,,$308.23,$0.00,1,0,0,20210101,
J9153,HCPCS,"INJ DAUNORUBICIN, CYTARABINE",,30,,,"$1,275.72",$0.00,1,0,0,20210101,
J9155,HCPCS,DEGARELIX INJECTION,,30,,,$25.83,$0.00,1,0,0,20210101,
J9173,HCPCS,"INJ., DURVALUMAB, 10 MG",,30,,,$497.51,$0.00,1,0,0,20210101,
J9176,HCPCS,"INJECTION, ELOTUZUMAB, 1MG",,30,,,$36.04,$0.00,1,0,0,20210101,
J9177,HCPCS,INJ ENFORT VEDO-EJFV 0.25MG,,30,,,$185.05,$0.00,1,0,0,20210101,
J9179,HCPCS,ERIBULIN MESYLATE INJECTION,,30,,,$612.88,$0.00,1,0,0,20210101,
J9198,HCPCS,"INJ. INFUGEM, 100 MG",,30,,,$254.16,$0.00,1,0,0,20210101,
J9202,HCPCS,GOSERELIN ACETATE IMPLANT,,30,,,"$2,572.16",$0.00,1,0,0,20210101,
J9203,HCPCS,GEMTUZUMAB OZOGAMICIN 0.1 MG,,30,,,"$1,316.67",$0.00,1,0,0,20210101,
J9204,HCPCS,"INJ MOGAMULIZUMAB-KPKC, 1 MG",,30,,,"$1,321.05",$0.00,1,0,0,20210101,
J9205,HCPCS,INJ IRINOTECAN LIPOSOME 1 MG,,30,,,$255.03,$0.00,1,0,0,20210101,
J9207,HCPCS,IXABEPILONE INJECTION,,30,,,$594.15,$0.00,1,0,0,20210101,
J9210,HCPCS,"INJ., EMAPALUMAB-LZSG, 1 MG",,30,,,"$3,756.95",$0.00,1,0,0,20210101,
J9214,HCPCS,INTERFERON ALFA-2B INJ,,30,,,$221.06,$0.00,1,0,0,20210101,
J9217,HCPCS,LEUPROLIDE ACETATE SUSPNSION,,30,,,"$1,404.54",$0.00,1,0,0,20210101,
J9223,HCPCS,"INJ. LURBINECTEDIN, 0.1 MG",,30,,,"$1,098.97",$0.00,1,0,0,20210101,
J9225,HCPCS,VANTAS IMPLANT,,30,,,"$19,170.81",$0.00,1,0,0,20210101,
J9226,HCPCS,SUPPRELIN LA IMPLANT,,30,,,"$72,319.44",$0.00,1,0,0,20210101,
J9227,HCPCS,"Injection, isatuximab-irfc, 10 mg",,30,,,$432.10,$0.00,1,0,0,20210101,
J9228,HCPCS,IPILIMUMAB INJECTION,,30,,,$708.59,$0.00,1,0,0,20210101,
J9229,HCPCS,INJ INOTUZUMAB OZOGAM 0.1 MG,,30,,,"$12,759.87",$0.00,1,0,0,20210101,
J9230,HCPCS,MECHLORETHAMINE HCL INJ,,30,,,"$2,059.69",$0.00,1,0,0,20210101,
J9245,HCPCS,INJ MELPHALAN HYDROCHL 50 MG,,30,,,"$4,360.51",$0.00,1,0,0,20210101,
J9246,HCPCS,"INJ., EVOMELA, 1 MG",,30,,,$203.78,$0.00,1,0,0,20210101,
J9261,HCPCS,NELARABINE INJECTION,,30,,,"$1,011.27",$0.00,1,0,0,20210101,
J9262,HCPCS,"INJ, OMACETAXINE MEP, 0.01MG",,30,,,$20.69,$0.00,1,0,0,20210101,
J9264,HCPCS,PACLITAXEL PROTEIN BOUND,,30,,,$73.79,$0.00,1,0,0,20210101,
J9266,HCPCS,PEGASPARGASE INJECTION,,30,,,"$35,325.42",$0.00,1,0,0,20210101,
J9268,HCPCS,PENTOSTATIN INJECTION,,30,,,"$11,676.06",$0.00,1,0,0,20210101,
J9269,HCPCS,INJ. TAGRAXOFUSP-ERZS 10 MCG,,30,,,"$1,699.21",$0.00,1,0,0,20210101,
J9270,HCPCS,PLICAMYCIN (MITHRAMYCIN) INJ,,30,,,$474.08,$0.00,1,0,0,20210101,
J9271,HCPCS,INJ PEMBROLIZUMAB,,30,,,$271.12,$0.00,1,0,0,20210101,
J9280,HCPCS,MITOMYCIN INJECTION,,30,,,$490.73,$0.00,1,0,0,20210101,
J9281,HCPCS,MITOMYCIN INSTILLATION,,30,,,"$1,757.84",$0.00,1,0,0,20210101,
J9285,HCPCS,"INJ, OLARATUMAB, 10 MG",,30,,,$305.40,$0.00,1,0,0,20210101,
J9293,HCPCS,MITOXANTRONE HYDROCHL / 5 MG,,30,,,$209.30,$0.00,1,0,0,20210101,
J9295,HCPCS,"INJECTION, NECITUMUMAB, 1 MG",,30,,,$37.50,$0.00,1,0,0,20210101,
J9299,HCPCS,"INJECTION, NIVOLUMAB",,30,,,$154.69,$0.00,1,0,0,20210101,
J9301,HCPCS,OBINUTUZUMAB INJ,,30,,,$393.60,$0.00,1,0,0,20210101,
J9302,HCPCS,OFATUMUMAB INJECTION,,30,,,$395.62,$0.00,1,0,0,20210101,
J9303,HCPCS,PANITUMUMAB INJECTION,,30,,,$628.24,$0.00,1,0,0,20210101,
J9305,HCPCS,PEMETREXED INJECTION,,30,,,$367.60,$0.00,1,0,0,20210101,
J9306,HCPCS,"INJECTION, PERTUZUMAB, 1 MG",,30,,,$69.12,$0.00,1,0,0,20210101,
J9307,HCPCS,PRALATREXATE INJECTION,,30,,,"$1,875.29",$0.00,1,0,0,20210101,
J9308,HCPCS,"INJECTION, RAMUCIRUMAB",,30,,,$318.03,$0.00,1,0,0,20210101,
J9309,HCPCS,"INJ, POLATUZUMAB VEDOTIN 1MG",,30,,,$729.29,$0.00,1,0,0,20210101,
J9311,HCPCS,"INJ RITUXIMAB, HYALURONIDASE",,30,,,$290.82,$0.00,1,0,0,20210101,
J9312,HCPCS,"INJ., RITUXIMAB, 10 MG",,30,,,$620.06,$0.00,1,0,0,20210101,
J9313,HCPCS,"INJ., LUMOXITI, 0.01 MG",,30,,,$145.29,$0.00,1,0,0,20210101,
J9315,HCPCS,ROMIDEPSIN INJECTION,,30,,,"$2,133.92",$0.00,1,0,0,20210101,
J9316,HCPCS,"PERTUZU, TRASTUZU, 10 MG",,30,,,$471.04,$0.00,1,0,0,20210101,
J9317,HCPCS,SACITUZUMAB GOVITECAN-HZIY,,30,,,$187.09,$0.00,1,0,0,20210101,
J9320,HCPCS,STREPTOZOCIN INJECTION,,30,,,"$2,262.41",$0.00,1,0,0,20210101,
J9325,HCPCS,INJ TALIMOGENE LAHERPAREPVEC,,30,,,$340.98,$0.00,1,0,0,20210101,
J9328,HCPCS,TEMOZOLOMIDE INJECTION,,30,,,$67.58,$0.00,1,0,0,20210101,
J9330,HCPCS,TEMSIROLIMUS INJECTION,,30,,,$344.73,$0.00,1,0,0,20210101,
J9340,HCPCS,THIOTEPA INJECTION,,30,,,"$3,391.35",$0.00,1,0,0,20210101,
J9352,HCPCS,INJECTION TRABECTEDIN 0.1MG,,30,,,"$2,010.86",$0.00,1,0,0,20210101,
J9354,HCPCS,"INJ, ADO-TRASTUZUMAB EMT 1MG",,30,,,$176.18,$0.00,1,0,0,20210101,
J9355,HCPCS,INJ TRASTUZUMAB EXCL BIOSIMI,,30,,,$542.00,$0.00,1,0,0,20210101,
J9356,HCPCS,"INJ. HERCEPTIN HYLECTA, 10MG",,30,,,$522.46,$0.00,1,0,0,20210101,
J9357,HCPCS,VALRUBICIN INJECTION,,30,,,"$8,220.75",$0.00,1,0,0,20210101,
J9358,HCPCS,INJ FAM-TRASTU DERU-NXKI 1MG,,30,,,$160.15,$0.00,1,0,0,20210101,
J9371,HCPCS,"INJ, VINCRISTINE SUL LIP 1MG",,30,,,"$16,027.75",$0.00,1,0,0,20210101,
J9395,HCPCS,"INJECTION, FULVESTRANT",,30,,,$465.95,$0.00,1,0,0,20210101,
J9400,HCPCS,"INJ, ZIV-AFLIBERCEPT, 1MG",,30,,,$54.48,$0.00,1,0,0,20210101,
J9600,HCPCS,PORFIMER SODIUM INJECTION,,30,,,"$44,398.35",$0.00,1,0,0,20210101,
M0239,HCPCS,BAMLANIVIMAB-XXXX INFUSION,,30,,,"$1,689.85",$0.00,1,0,1,20210101,
M0243,HCPCS,CASIRIVI AND IMDEVI INFUSION,,30,,,"$1,689.85",$0.00,1,0,1,20210101,
P2031,HCPCS,HAIR ANALYSIS,,30,,,$124.62,$0.00,1,0,1,20210101,
P3001,HCPCS,SCREENING PAP SMEAR BY PHYS,,30,,,$248.69,$0.00,1,0,1,20210101,
P7001,HCPCS,CULTURE BACTERIAL URINE,,30,,,$147.41,$0.00,1,0,1,20210101,
P9010,HCPCS,WHOLE BLOOD FOR TRANSFUSION,,30,,,$924.17,$0.00,1,0,1,20210101,
P9011,HCPCS,BLOOD SPLIT UNIT,,30,,,$949.81,$0.00,1,0,1,20210101,
P9012,HCPCS,CRYOPRECIPITATE EACH UNIT,,30,,,$396.24,$0.00,1,0,1,20210101,
P9016,HCPCS,RBC LEUKOCYTES REDUCED,,30,,,"$1,261.53",$0.00,1,0,1,20210101,
P9017,HCPCS,PLASMA 1 DONOR FRZ W/IN 8 HR,,30,,,$456.18,$0.00,1,0,1,20210101,
P9019,HCPCS,"PLATELETS, EACH UNIT",,30,,,$627.46,$0.00,1,0,1,20210101,
P9020,HCPCS,PLAELET RICH PLASMA UNIT,,30,,,"$1,118.60",$0.00,1,0,1,20210101,
P9021,HCPCS,RED BLOOD CELLS UNIT,,30,,,$943.81,$0.00,1,0,1,20210101,
P9022,HCPCS,WASHED RED BLOOD CELLS UNIT,,30,,,"$2,396.09",$0.00,1,0,1,20210101,
P9023,HCPCS,"FROZEN PLASMA, POOLED, SD",,30,,,$533.39,$0.00,1,0,1,20210101,
P9031,HCPCS,PLATELETS LEUKOCYTES REDUCED,,30,,,$950.87,$0.00,1,0,1,20210101,
P9032,HCPCS,"PLATELETS, IRRADIATED",,30,,,$999.13,$0.00,1,0,1,20210101,
P9033,HCPCS,PLATELETS LEUKOREDUCED IRRAD,,30,,,"$1,243.25",$0.00,1,0,1,20210101,
P9034,HCPCS,"PLATELETS, PHERESIS",,30,,,"$2,231.84",$0.00,1,0,1,20210101,
P9035,HCPCS,PLATELET PHERES LEUKOREDUCED,,30,,,"$2,934.82",$0.00,1,0,1,20210101,
P9036,HCPCS,PLATELET PHERESIS IRRADIATED,,30,,,"$4,046.97",$0.00,1,0,1,20210101,
P9037,HCPCS,PLATE PHERES LEUKOREDU IRRAD,,30,,,"$3,430.63",$0.00,1,0,1,20210101,
P9038,HCPCS,RBC IRRADIATED,,30,,,"$1,247.21",$0.00,1,0,1,20210101,
P9039,HCPCS,RBC DEGLYCEROLIZED,,30,,,"$2,598.36",$0.00,1,0,1,20210101,
P9040,HCPCS,RBC LEUKOREDUCED IRRADIATED,,30,,,"$1,635.63",$0.00,1,0,1,20210101,
P9041,HCPCS,"ALBUMIN (HUMAN),5%, 50ML",,30,,,$72.63,$0.00,1,0,1,20210101,
P9043,HCPCS,"PLASMA PROTEIN FRACT,5%,50ML",,30,,,$97.73,$0.00,1,0,1,20210101,
P9044,HCPCS,CRYOPRECIPITATEREDUCEDPLASMA,,30,,,$551.40,$0.00,1,0,1,20210101,
P9045,HCPCS,"ALBUMIN (HUMAN), 5%, 250 ML",,30,,,$354.87,$0.00,1,0,1,20210101,
P9046,HCPCS,"ALBUMIN (HUMAN), 25%, 20 ML",,30,,,$143.29,$0.00,1,0,1,20210101,
P9047,HCPCS,"ALBUMIN (HUMAN), 25%, 50ML",,30,,,$352.62,$0.00,1,0,1,20210101,
P9048,HCPCS,"PLASMAPROTEIN FRACT,5%,250ML",,30,,,$666.83,$0.00,1,0,1,20210101,
P9050,HCPCS,"GRANULOCYTES, PHERESIS UNIT",,30,,,"$10,645.10",$0.00,1,0,1,20210101,
P9051,HCPCS,"BLOOD, L/R, CMV-NEG",,30,,,"$1,356.88",$0.00,1,0,1,20210101,
P9052,HCPCS,"PLATELETS, HLA-M, L/R, UNIT",,30,,,"$5,186.28",$0.00,1,0,1,20210101,
P9053,HCPCS,"PLT, PHER, L/R CMV-NEG, IRR",,30,,,"$3,154.94",$0.00,1,0,1,20210101,
P9054,HCPCS,"BLOOD, L/R, FROZ/DEGLY/WASH",,30,,,"$2,016.67",$0.00,1,0,1,20210101,
P9055,HCPCS,"PLT, APH/PHER, L/R, CMV-NEG",,30,,,"$3,002.98",$0.00,1,0,1,20210101,
P9056,HCPCS,"BLOOD, L/R, IRRADIATED",,30,,,"$1,181.89",$0.00,1,0,1,20210101,
P9057,HCPCS,"RBC, FRZ/DEG/WSH, L/R, IRRAD",,30,,,"$1,720.56",$0.00,1,0,1,20210101,
P9058,HCPCS,"RBC, L/R, CMV-NEG, IRRAD",,30,,,"$1,617.93",$0.00,1,0,1,20210101,
P9059,HCPCS,"PLASMA, FRZ BETWEEN 8-24HOUR",,30,,,$495.20,$0.00,1,0,1,20210101,
P9060,HCPCS,FR FRZ PLASMA DONOR RETESTED,,30,,,$403.33,$0.00,1,0,1,20210101,
P9070,HCPCS,PATHOGEN REDUCED PLASMA POOL,,30,,,$353.19,$0.00,1,0,1,20210101,
P9071,HCPCS,PATHOGEN REDUCED PLASMA SING,,30,,,$714.77,$0.00,1,0,1,20210101,
P9073,HCPCS,PLATELETS PHERESIS PATH REDU,,30,,,"$3,049.16",$0.00,1,0,1,20210101,
P9099,HCPCS,BLOOD COMPONENT/PRODUCT NOC,,30,,,$51.94,$0.00,1,0,1,20210101,
P9100,HCPCS,PATHOGEN TEST FOR PLATELETS,,30,,,$216.64,$0.00,1,0,1,20210101,
P9615,HCPCS,URINE SPECIMEN COLLECT MULT,,30,,,$24.38,$0.00,1,0,1,20210101,
PHOSP,PHOSP,PARTIAL HOSPITALIZATION,,30,,,$546.88,$0.00,1,0,0,20210101,
Q0035,HCPCS,CARDIOKYMOGRAPHY,,30,,,$224.79,$0.00,1,0,1,20210101,
Q0081,HCPCS,INFUSION THER OTHER THAN CHE,,30,,,$379.27,$0.00,1,0,0,20210101,
Q0083,HCPCS,CHEMO BY OTHER THAN INFUSION,,30,,,$225.82,$0.00,1,0,1,20210101,
Q0084,HCPCS,CHEMOTHERAPY BY INFUSION,,30,,,$566.18,$0.00,1,0,1,20210101,
Q0085,HCPCS,CHEMO BY BOTH INFUSION AND O,,30,,,$538.99,$0.00,1,0,1,20210101,
Q0091,HCPCS,OBTAINING SCREEN PAP SMEAR,,30,,,$152.35,$0.00,1,0,1,20210101,
Q0092,HCPCS,SET UP PORT XRAY EQUIPMENT,,30,,,$125.21,$0.00,1,0,1,20210101,
Q0138,HCPCS,"FERUMOXYTOL, NON-ESRD",,30,,,$6.69,$0.00,1,0,0,20210101,
Q0139,HCPCS,"FERUMOXYTOL, ESRD USE",,30,,,$6.69,$0.00,1,0,0,20210101,
Q2017,HCPCS,"TENIPOSIDE, 50 MG",,30,,,"$14,418.54",$0.00,1,0,0,20210101,
Q2026,HCPCS,RADIESSE INJECTION,,30,,,"$1,985.95",$0.00,1,0,0,20210101,
Q2028,HCPCS,"INJ, SCULPTRA, 0.5MG",,30,,,$21.77,$0.00,1,0,0,20210101,
Q2035,HCPCS,"AFLURIA VACC, 3 YRS & >, IM",,30,,,$83.09,$0.00,1,0,1,20210101,
Q2036,HCPCS,"FLULAVAL VACC, 3 YRS & >, IM",,30,,,$43.41,$0.00,1,0,1,20210101,
Q2037,HCPCS,"FLUVIRIN VACC, 3 YRS & >, IM",,30,,,$82.07,$0.00,1,0,1,20210101,
Q2038,HCPCS,"FLUZONE VACC, 3 YRS & >, IM",,30,,,$154.57,$0.00,1,0,1,20210101,
Q2039,HCPCS,"INFLUENZA VIRUS VACCINE, NOS",,30,,,$162.69,$0.00,1,0,1,20210101,
Q2041,HCPCS,AXICABTAGENE CILOLEUCEL CAR+,,30,,,"$815,400.56",$0.00,1,0,0,20210101,
Q2042,HCPCS,TISAGENLECLEUCEL CAR-POS T,,30,,,"$921,447.77",$0.00,1,0,0,20210101,
Q2043,HCPCS,SIPULEUCEL-T AUTO CD54+,,30,,,"$93,181.39",$0.00,1,0,0,20210101,
Q2049,HCPCS,IMPORTED LIPODOX INJ,,30,,,"$3,122.92",$0.00,1,0,0,20210101,
Q2050,HCPCS,DOXORUBICIN INJ 10MG,,30,,,"$2,282.27",$0.00,1,0,0,20210101,
Q3014,HCPCS,TELEHEALTH FACILITY FEE,,30,,,$82.68,$0.00,1,0,1,20210101,
Q3027,HCPCS,INJ BETA INTERFERON IM 1 MCG,,30,,,$259.99,$0.00,1,0,0,20210101,
Q4135,HCPCS,MEDISKIN,,30,,,"$5,548.08",$0.00,1,0,0,20210101,
Q5001,HCPCS,HOSPICE OR HOME HLTH IN HOME,,30,,,$272.49,$0.00,1,1,1,20210101,
Q5002,HCPCS,HOSPICE/HOME HLTH IN ASST LV,,30,,,$350.42,$0.00,1,1,1,20210101,
Q5003,HCPCS,HOSPICE IN LT/NON-SKILLED NF,,30,,,$295.82,$0.00,1,1,1,20210101,
Q5004,HCPCS,HOSPICE IN SNF,,30,,,$687.96,$0.00,1,1,1,20210101,
Q5005,HCPCS,"HOSPICE, INPATIENT HOSPITAL",,30,,,"$1,129.68",$0.00,1,1,1,20210101,
Q5006,HCPCS,HOSPICE IN HOSPICE FACILITY,,30,,,"$1,237.79",$0.00,1,1,1,20210101,
Q5007,HCPCS,HOSPICE IN LTCH,,30,,,"$1,055.58",$0.00,1,1,1,20210101,
Q5009,HCPCS,"HOSPICE/HOME HLTH, PLACE NOS",,30,,,$256.47,$0.00,1,1,1,20210101,
Q5010,HCPCS,HOSPICE HOME CARE IN HOSPICE,,30,,,$338.60,$0.00,1,0,1,20210101,
Q5101,HCPCS,"INJECTION, ZARXIO",,30,,,$3.85,$0.00,1,0,0,20210101,
Q5103,HCPCS,"INJECTION, INFLECTRA",,30,,,$375.20,$0.00,1,0,0,20210101,
Q5104,HCPCS,"INJECTION, RENFLEXIS",,30,,,$381.45,$0.00,1,0,0,20210101,
Q5105,HCPCS,INJ RETACRIT ESRD ON DIALYSI,,30,,,$6.78,$0.00,1,0,0,20210101,
Q5106,HCPCS,INJ RETACRIT NON-ESRD USE,,30,,,$68.96,$0.00,1,0,0,20210101,
Q5107,HCPCS,INJ MVASI 10 MG,,30,,,$436.77,$0.00,1,0,0,20210101,
Q5108,HCPCS,"INJECTION, FULPHILA",,30,,,"$2,138.29",$0.00,1,0,0,20210101,
Q5110,HCPCS,NIVESTYM,,30,,,$4.58,$0.00,1,0,0,20210101,
Q5111,HCPCS,"INJECTION, UDENYCA 0.5 MG",,30,,,"$2,157.59",$0.00,1,0,0,20210101,
Q5112,HCPCS,INJ ONTRUZANT 10 MG,,30,,,$588.53,$0.00,1,0,0,20210101,
Q5113,HCPCS,INJ HERZUMA 10 MG,,30,,,$634.41,$0.00,1,0,0,20210101,
Q5114,HCPCS,INJ OGIVRI 10 MG,,30,,,$614.82,$0.00,1,0,0,20210101,
Q5115,HCPCS,INJ TRUXIMA 10 MG,,30,,,$456.68,$0.00,1,0,0,20210101,
Q5116,HCPCS,"INJ., TRAZIMERA, 10 MG",,30,,,$548.33,$0.00,1,0,0,20210101,
Q5117,HCPCS,"INJ., KANJINTI, 10 MG",,30,,,$566.15,$0.00,1,0,0,20210101,
Q5118,HCPCS,"INJ., ZIRABEV, 10 MG",,30,,,$417.16,$0.00,1,0,0,20210101,
Q5119,HCPCS,"INJ RUXIENCE, 10 MG",,30,,,$487.12,$0.00,1,0,0,20210101,
Q5120,HCPCS,INJ PEGFILGRASTIM-BMEZ 0.5MG,,30,,,"$2,057.88",$0.00,1,0,0,20210101,
Q5121,HCPCS,"INJ. AVSOLA, 10 MG",,30,,,$334.13,$0.00,1,0,0,20210101,
Q9968,HCPCS,VISUALIZATION ADJUNCT,,30,,,$34.13,$0.00,1,0,0,20210101,
Q9969,HCPCS,NON-HEU TC-99M ADD-ON/DOSE,,30,,,$20.12,$0.00,1,0,0,20210101,
Q9991,HCPCS,BUPRENORPH XR 100 MG OR LESS,,30,,,"$10,113.30",$0.00,1,0,0,20210101,
Q9992,HCPCS,BUPRENORPHINE XR OVER 100 MG,,30,,,"$10,113.30",$0.00,1,0,0,20210101,
R0070,HCPCS,TRANSPORT PORTABLE X-RAY,,30,,,$280.46,$0.00,1,0,1,20210101,
R0075,HCPCS,TRANSPORT PORT X-RAY MULTIPL,,30,,,$70.84,$0.00,1,0,1,20210101,
S0199,HCPCS,MED ABORTION INC ALL EX DRUG,,30,,,"$2,447.97",$0.00,1,0,1,20210101,
S0201,HCPCS,PARTIAL HOSPITALIZATION SERV,,30,,,"$2,582.65",$0.00,1,0,0,20210101,
S0208,HCPCS,PARAMED INTRCEPT NONVOL,,30,,,"$2,057.66",$0.00,1,0,1,20210101,
S0220,HCPCS,MEDICAL CONFERENCE BY PHYSIC,,30,,,$246.55,$0.00,1,0,1,20210101,
S0221,HCPCS,"MEDICAL CONFERENCE, 60 MIN",,30,,,$494.50,$0.00,1,0,1,20210101,
S0255,HCPCS,HOSPICE REFER VISIT NONMD,,30,,,$193.63,$0.00,1,0,1,20210101,
S0257,HCPCS,END OF LIFE COUNSELING,,30,,,$271.11,$0.00,1,0,1,20210101,
S0260,HCPCS,H&P FOR SURGERY,,30,,,$132.93,$0.00,1,0,1,20210101,
S0265,HCPCS,GENETIC COUNSEL 15 MINS,,30,,,$132.93,$0.00,1,0,1,20210101,
S0302,HCPCS,COMPLETED EPSDT,,30,,,$55.71,$0.00,1,0,1,20210101,
S0315,HCPCS,DISEASE MANAGEMENT PROGRAM,,30,,,$132.93,$0.00,1,0,1,20210101,
S0316,HCPCS,FOLLOW-UP/REASSESSMENT,,30,,,$274.99,$0.00,1,0,1,20210101,
S0320,HCPCS,RN TELEPHONE CALLS TO DMP,,30,,,$124.69,$0.00,1,0,1,20210101,
S0390,HCPCS,ROUT FOOT CARE PER VISIT,,30,,,$35.42,$0.00,1,0,1,20210101,
S0400,HCPCS,GLOBAL ESWL KIDNEY,,30,,,"$31,647.60",$0.00,1,0,1,20210101,
S0592,HCPCS,COMP CONT LENS EVAL,,30,,,"$1,737.42",$0.00,1,0,1,20210101,
S0601,HCPCS,SCREENING PROCTOSCOPY,,30,,,$458.75,$0.00,1,0,1,20210101,
S0610,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,30,,,$416.09,$0.00,1,0,1,20210101,
S0612,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,30,,,$363.27,$0.00,1,0,1,20210101,
S0613,HCPCS,ANN BREAST EXAM,,30,,,$132.93,$0.00,1,0,1,20210101,
S0618,HCPCS,AUDIOMETRY FOR HEARING AID,,30,,,$105.60,$0.00,1,0,0,20210101,
S0620,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,30,,,$75.21,$0.00,1,0,1,20210101,
S0621,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,30,,,$383.46,$0.00,1,0,1,20210101,
S0622,HCPCS,PHYS EXAM FOR COLLEGE,,30,,,$132.93,$0.00,1,0,1,20210101,
S0630,HCPCS,REMOVAL OF SUTURES,,30,,,$121.49,$0.00,1,0,1,20210101,
S0810,HCPCS,PHOTOREFRACTIVE KERATECTOMY,,30,,,"$4,458.74",$0.00,1,0,1,20210101,
S0812,HCPCS,PHOTOTHERAP KERATECT,,30,,,"$4,458.74",$0.00,1,0,1,20210101,
S2070,HCPCS,CYSTO LASER TX URETERAL CALC,,30,,,"$6,404.36",$0.00,1,0,1,20210101,
S2080,HCPCS,LAUP,,30,,,"$15,849.99",$0.00,1,0,1,20210101,
S2083,HCPCS,ADJUSTMENT GASTRIC BAND,,30,,,"$6,134.80",$0.00,1,0,1,20210101,
S2095,HCPCS,TRANSCATH EMBOLIZ MICROSPHER,,30,,,"$16,240.57",$0.00,1,0,1,20210101,
S2117,HCPCS,"ARTHROEREISIS, SUBTALAR",,30,,,"$8,859.08",$0.00,1,0,1,20210101,
S2118,HCPCS,TOTAL HIP RESURFACING,,30,,,$204.98,$0.00,1,0,1,20210101,
S2120,HCPCS,LOW DENSITY LIPOPROTEIN(LDL),,30,,,"$27,322.58",$0.00,1,0,1,20210101,
S2140,HCPCS,CORD BLOOD HARVESTING,,30,,,"$1,872.56",$0.00,1,0,1,20210101,
S2142,HCPCS,CORD BLOOD-DERIVED STEM-CELL,,30,,,"$4,470.84",$0.00,1,0,1,20210101,
S2150,HCPCS,BMT HARV/TRANSPL 28D PKG,,30,,,"$1,570.85",$0.00,1,0,1,20210101,
S2202,HCPCS,ECHOSCLEROTHERAPY,,30,,,$197.54,$0.00,1,0,1,20210101,
S2225,HCPCS,MYRINGOTOMY LASER-ASSIST,,30,,,"$11,062.65",$0.00,1,0,1,20210101,
S2230,HCPCS,IMPLANT SEMI-IMP HEAR,,30,,,"$7,316.67",$0.00,1,0,1,20210101,
S2235,HCPCS,IMPLANT AUDITORY BRAIN IMP,,30,,,"$67,981.93",$0.00,1,0,1,20210101,
S2300,HCPCS,"ARTHROSCOPY, SHOULDER, SURGI",,30,,,"$19,872.96",$0.00,1,0,1,20210101,
S2325,HCPCS,HIP CORE DECOMPRESSION,,30,,,"$3,373.30",$0.00,1,0,1,20210101,
S2340,HCPCS,CHEMODENERVATION OF ABDUCTOR,,30,,,"$10,088.20",$0.00,1,0,1,20210101,
S2341,HCPCS,CHEMODENERV ADDUCT VOCAL,,30,,,"$10,088.20",$0.00,1,0,1,20210101,
S2342,HCPCS,NASAL ENDOSCOP PO DEBRID,,30,,,"$14,817.17",$0.00,1,0,1,20210101,
S2348,HCPCS,DECOMPRESS DISC RF LUMBAR,,30,,,"$12,026.07",$0.00,1,0,1,20210101,
S2900,HCPCS,ROBOTIC SURGICAL SYSTEM,,30,,,"$16,504.86",$0.00,1,0,1,20210101,
S3000,HCPCS,BILAT DIL RETINAL EXAM,,30,,,$364.71,$0.00,1,0,1,20210101,
S3005,HCPCS,EVAL SELF-ASSESS DEPRESSION,,30,,,$132.93,$0.00,1,0,1,20210101,
S3600,HCPCS,STAT LAB,,30,,,$83.69,$0.00,1,0,1,20210101,
S3620,HCPCS,NEWBORN METABOLIC SCREENING,,30,,,$255.24,$0.00,1,0,1,20210101,
S3630,HCPCS,EOSINOPHIL BLOOD COUNT,,30,,,$70.39,$0.00,1,0,1,20210101,
S3708,HCPCS,GASTROINTESTINAL FAT ABSORPT,,30,,,$585.93,$0.00,1,0,1,20210101,
S3870,HCPCS,CGH TEST DEVELOPMENTAL DELAY,,30,,,"$3,002.38",$0.00,1,0,1,20210101,
S3900,HCPCS,SURFACE EMG,,30,,,"$1,770.13",$0.00,1,0,1,20210101,
S4005,HCPCS,INTERIM LABOR FACILITY GLOBA,,30,,,$979.50,$0.00,1,0,1,20210101,
S4011,HCPCS,IVF PACKAGE,,30,,,"$2,125.33",$0.00,1,0,1,20210101,
S4015,HCPCS,COMPLETE IVF NOS CASE RATE,,30,,,"$21,550.87",$0.00,1,0,1,20210101,
S4021,HCPCS,IVF CANC P ASPIR CASE RATE,,30,,,"$1,559.61",$0.00,1,0,1,20210101,
S4981,HCPCS,INSERT LEVONORGESTREL IUS,,30,,,"$1,953.36",$0.00,1,0,1,20210101,
S4991,HCPCS,NICOTINE PATCH NONLEGEND,,30,,,$35.14,$0.00,1,0,0,20210101,
S5101,HCPCS,ADULT DAY CARE PER HALF DAY,,30,,,$65.54,$0.00,1,1,1,20210101,
S5102,HCPCS,ADULT DAY CARE PER DIEM,,30,,,$131.06,$0.00,1,1,1,20210101,
S5105,HCPCS,CENTERBASED DAY CARE PERDIEM,,30,,,$448.64,$0.00,1,1,1,20210101,
S5130,HCPCS,HOMAKER SERVICE NOS PER 15M,,30,,,$104.84,$0.00,1,1,1,20210101,
S5131,HCPCS,HOMEMAKER SERVICE NOS /DIEM,,30,,,$31.16,$0.00,1,1,1,20210101,
S5140,HCPCS,ADULT FOSTER CARE PER DIEM,,30,,,$94.18,$0.00,1,1,1,20210101,
S5161,HCPCS,EMER RSPNS SYS SERV PERMONTH,,30,,,$64.20,$0.00,1,1,1,20210101,
S5190,HCPCS,WELLNESS ASSESSMENT BY NONPH,,30,,,$428.49,$0.00,1,0,0,20210101,
S5523,HCPCS,HIP MIDLINE CATH INSERT KIT,,30,,,$198.37,$0.00,1,1,1,20210101,
S8030,HCPCS,TANTALUM RING APPLICATION,,30,,,"$12,667.64",$0.00,1,0,1,20210101,
S8037,HCPCS,MRCP,,30,,,"$5,181.29",$0.00,1,0,1,20210101,
S8040,HCPCS,TOPOGRAPHIC BRAIN MAPPING,,30,,,"$1,837.25",$0.00,1,0,1,20210101,
S8042,HCPCS,MRI LOW FIELD,,30,,,"$2,908.86",$0.00,1,0,1,20210101,
S8055,HCPCS,US GUIDANCE FETAL REDUCT,,30,,,"$1,502.74",$0.00,1,0,1,20210101,
S8080,HCPCS,SCINTIMAMMOGRAPHY,,30,,,"$1,278.18",$0.00,1,0,1,20210101,
S8092,HCPCS,ELECTRON BEAM COMPUTED TOMOG,,30,,,$325.09,$0.00,1,0,1,20210101,
S8948,HCPCS,LOW-LEVEL LASER TRMT 15 MIN,,30,,,$499.26,$0.00,1,0,0,20210101,
S8950,HCPCS,"COMPLEX LYMPHEDEMA THERAPY,",,30,,,$165.77,$0.00,1,0,0,20210101,
S8990,HCPCS,PT OR MANIP FOR MAINT,,30,,,$92.70,$0.00,1,0,0,20210101,
S9024,HCPCS,PARANASAL SINUS ULTRASOUND,,30,,,$976.72,$0.00,1,0,0,20210101,
S9034,HCPCS,ESWL FOR GALLSTONES,,30,,,"$6,117.93",$0.00,1,0,0,20210101,
S9083,HCPCS,URGENT CARE CENTER GLOBAL,,30,,,$495.30,$0.00,1,0,0,20210101,
S9088,HCPCS,SERVICES PROVIDED IN URGENT,,30,,,$96.28,$0.00,1,0,0,20210101,
S9097,HCPCS,HOME VISIT WOUND CARE,,30,,,$207.78,$0.00,1,1,1,20210101,
S9098,HCPCS,HOME PHOTOTHERAPY VISIT,,30,,,$354.22,$0.00,1,1,1,20210101,
S9110,HCPCS,TELEMONITORING/HOME PER MNTH,,30,,,$135.44,$0.00,1,1,1,20210101,
S9117,HCPCS,BACK SCHOOL VISIT,,30,,,$132.93,$0.00,1,0,0,20210101,
S9122,HCPCS,HOME HEALTH AIDE OR CERTIFIE,,30,,,$211.40,$0.00,1,1,1,20210101,
S9123,HCPCS,NURSING CARE IN HOME RN,,30,,,$306.09,$0.00,1,1,1,20210101,
S9124,HCPCS,"NURSING CARE, IN THE HOME; B",,30,,,"$1,065.66",$0.00,1,1,1,20210101,
S9125,HCPCS,"RESPITE CARE, IN THE HOME, P",,30,,,$224.91,$0.00,1,1,1,20210101,
S9126,HCPCS,"HOSPICE CARE, IN THE HOME, P",,30,,,$267.96,$0.00,1,1,1,20210101,
S9127,HCPCS,"SOCIAL WORK VISIT, IN THE HO",,30,,,$372.74,$0.00,1,0,0,20210101,
S9128,HCPCS,"SPEECH THERAPY, IN THE HOME,",,30,,,$269.03,$0.00,1,0,0,20210101,
S9129,HCPCS,"OCCUPATIONAL THERAPY, IN THE",,30,,,$269.19,$0.00,1,0,0,20210101,
S9131,HCPCS,PT IN THE HOME PER DIEM,,30,,,$259.13,$0.00,1,0,0,20210101,
S9140,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$123.26,$0.00,1,1,1,20210101,
S9145,HCPCS,INSULIN PUMP INITIATION,,30,,,$479.27,$0.00,1,1,1,20210101,
S9152,HCPCS,"SPEECH THERAPY, RE-EVAL",,30,,,$297.55,$0.00,1,0,0,20210101,
S9401,HCPCS,ANTICOAG CLINIC PER SESSION,,30,,,$256.93,$0.00,1,0,0,20210101,
S9430,HCPCS,PHARMACY COMP/DISP SERV,,30,,,$212.53,$0.00,1,0,0,20210101,
S9436,HCPCS,LAMAZE CLASS,,30,,,$89.41,$0.00,1,0,0,20210101,
S9441,HCPCS,ASTHMA EDUCATION,,30,,,$208.27,$0.00,1,0,0,20210101,
S9442,HCPCS,BIRTHING CLASS,,30,,,$182.77,$0.00,1,0,0,20210101,
S9443,HCPCS,LACTATION CLASS,,30,,,$306.05,$0.00,1,0,0,20210101,
S9444,HCPCS,PARENTING CLASS,,30,,,$100.28,$0.00,1,0,1,20210101,
S9445,HCPCS,PT EDUCATION NOC INDIVID,,30,,,$377.91,$0.00,1,0,1,20210101,
S9446,HCPCS,PT EDUCATION NOC GROUP,,30,,,$250.71,$0.00,1,0,1,20210101,
S9449,HCPCS,WEIGHT MGMT CLASS,,30,,,$76.14,$0.00,1,0,0,20210101,
S9451,HCPCS,EXERCISE CLASS,,30,,,$141.57,$0.00,1,0,0,20210101,
S9452,HCPCS,NUTRITION CLASS,,30,,,$206.46,$0.00,1,0,0,20210101,
S9453,HCPCS,SMOKING CESSATION CLASS,,30,,,$269.07,$0.00,1,0,0,20210101,
S9454,HCPCS,STRESS MGMT CLASS,,30,,,$185.60,$0.00,1,0,0,20210101,
S9455,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$267.30,$0.00,1,1,1,20210101,
S9460,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$281.20,$0.00,1,1,1,20210101,
S9465,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$202.31,$0.00,1,1,1,20210101,
S9470,HCPCS,"NUTRITIONAL COUNSELING, DIET",,30,,,$263.89,$0.00,1,0,1,20210101,
S9472,HCPCS,CARDIAC REHABILITATION PROGR,,30,,,"$1,356.54",$0.00,1,0,0,20210101,
S9473,HCPCS,PULMONARY REHABILITATION PRO,,30,,,$157.25,$0.00,1,0,0,20210101,
S9474,HCPCS,ENTEROSTOMAL THERAPY BY A RE,,30,,,$319.54,$0.00,1,0,1,20210101,
S9475,HCPCS,AMBULATORY SETTING SUBSTANCE,,30,,,"$2,079.04",$0.00,1,0,1,20210101,
S9476,HCPCS,VESTIBULAR REHAB PER DIEM,,30,,,$188.45,$0.00,1,0,0,20210101,
S9480,HCPCS,INTENSIVE OUTPATIENT PSYCHIA,,30,,,$871.75,$0.00,1,0,1,20210101,
S9484,HCPCS,CRISIS INTERVENTION PER HOUR,,30,,,$638.12,$0.00,1,0,1,20210101,
S9485,HCPCS,CRISIS INTERVENTION MENTAL H,,30,,,"$1,458.47",$0.00,1,0,1,20210101,
U0001,HCPCS,2019-NCOV DIAGNOSTIC P,,30,,,$209.45,$0.00,1,0,1,20210101,
U0002,HCPCS,COVID-19 LAB TEST NON-CDC,,30,,,$297.42,$0.00,1,0,1,20210101,
V5008,HCPCS,HEARING SCREENING,,30,,,$293.17,$0.00,1,0,0,20210101,
V5010,HCPCS,ASSESSMENT FOR HEARING AID,,30,,,$437.29,$0.00,1,0,0,20210101,
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