Service Area|Px Code|Procedure Description|Alternate CPT/HCPCS Code|Alternate Identification|Alternate Code by Location|Alternate Code by Department|Fee Schedule Group Name|Unit Price
BRYAN HEALTH SERVICE AREA|30000107|CANNABINOIDS NATURAL|G0480|MEDICARE|||RURAL FEE SCHEDULE GROUP|185.00
BRYAN HEALTH SERVICE AREA|30000108|MDA MDEA MDMA|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|77.00
BRYAN HEALTH SERVICE AREA|30000109|COMPLIANCE DRUG SCREEN|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|581.00
BRYAN HEALTH SERVICE AREA|30000110|LASIX FUROSEMIDE|G0483|MEDICARE|||RURAL FEE SCHEDULE GROUP|124.00
BRYAN HEALTH SERVICE AREA|30000417|Hc 21-hydroxylase Antibodies|83516||BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|271.00
BRYAN HEALTH SERVICE AREA|30000495|KAPPA/LAMBDA FREE LIGHT CHAIN|83520||BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|185.00
BRYAN HEALTH SERVICE AREA|30000497|NEPHELOMETRY ANALYTE|83520||BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|185.00
BRYAN HEALTH SERVICE AREA|30001097|GIARDIA AG DFA STOOL|87269||BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|138.00
BRYAN HEALTH SERVICE AREA|30001126|GASTRO INTSNL PATH PNL PCR PEC|0097U||MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|1,445.00
BRYAN HEALTH SERVICE AREA|30001203|CLONAZEPAM SERUM|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|300.00
BRYAN HEALTH SERVICE AREA|30000094|ALCOHOL|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|180.00
BRYAN HEALTH SERVICE AREA|30001204|BENZODIAZAPINE URINE CONFRMTRY|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|230.00
BRYAN HEALTH SERVICE AREA|30001212|NORTRIPTYLINE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|138.00
BRYAN HEALTH SERVICE AREA|30001236|OPIATES 1 OR MORE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|359.00
BRYAN HEALTH SERVICE AREA|32000124|INTRAVENOUS PYELOGRAM|74410,74410|,|CRETE AREA MEDICAL CENTER PARENT HOSPITAL LOCATION [1005],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]|,|RURAL FEE SCHEDULE GROUP|600.00
BRYAN HEALTH SERVICE AREA|32900353|INJ SI JOINT THERAPEUTIC|G0260,G0260|MEDICARE,USGOV|,|,|RURAL FEE SCHEDULE GROUP|534.00
BRYAN HEALTH SERVICE AREA|40100002|MAMMO DIAGNOSTIC UNI 3D|G0279|MEDICARE|||RURAL FEE SCHEDULE GROUP|100.00
BRYAN HEALTH SERVICE AREA|40100003|MAMMO DIAGNOSTIC BIL 3D|G0279|MEDICARE|||RURAL FEE SCHEDULE GROUP|100.00
BRYAN HEALTH SERVICE AREA|42000007|PT ELECTRICAL STIM UNATTENDED|97014,97014,97014,97014,97014|WORKCOMP,UHC,UHC,WORKCOMP,MEDICAID|BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004],CRETE AREA MEDICAL CENTER PARENT HOSPITAL LOCATION [1005],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008],|,,,,|RURAL FEE SCHEDULE GROUP|70.00
BRYAN HEALTH SERVICE AREA|42000027|PT COGNITIVE SKILLS|G0515|MEDICARE|||RURAL FEE SCHEDULE GROUP|89.00
BRYAN HEALTH SERVICE AREA|43000002|OT ELECTRICAL STIM UNATTENDED|97014,97014,97014,97014,97014|WORKCOMP,UHC,UHC,WORKCOMP,MEDICAID|BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004],CRETE AREA MEDICAL CENTER PARENT HOSPITAL LOCATION [1005],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008],|,,,,|RURAL FEE SCHEDULE GROUP|70.00
BRYAN HEALTH SERVICE AREA|30000095|ETHYLENE GLYCOL|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|180.00
BRYAN HEALTH SERVICE AREA|48000073|ECHO W/CONTRAST|93306,93306|MEDICAID,WELLCARE|,|,|RURAL FEE SCHEDULE GROUP|2,069.00
BRYAN HEALTH SERVICE AREA|61000036|MRA LOWER EXTREMITY W/CONTRAST|C8912|MEDICARE|||RURAL FEE SCHEDULE GROUP|3,137.00
BRYAN HEALTH SERVICE AREA|61000040|MRA ABDOMEN W & W/O CONTRAST|C8902|MEDICARE|||RURAL FEE SCHEDULE GROUP|4,195.00
BRYAN HEALTH SERVICE AREA|76100036|OFFICE OUTPATIENT VISIT LEVEL 1|G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,99211|TRICARE,MEDICAID,UHC,MEDICAID,UHC,FACILITY,MEDICARE,USGOV,WELLCARE|BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004],CRETE AREA MEDICAL CENTER PARENT HOSPITAL LOCATION [1005],CRETE AREA MEDICAL CENTER PARENT HOSPITAL LOCATION [1005],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008],,,,|,,,,,,,,|RURAL FEE SCHEDULE GROUP|55.00
BRYAN HEALTH SERVICE AREA|76100047|MNT NON DM/NON RENAL 30M|G0463,G0463,G0463,G0463,99201|TRICARE,MEDICAID,MEDICAID,MEDICARE,WELLCARE|BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004],CRETE AREA MEDICAL CENTER PARENT HOSPITAL LOCATION [1005],MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008],,|,,,,|RURAL FEE SCHEDULE GROUP|50.00
BRYAN HEALTH SERVICE AREA|76100048|MNT NON DM/NON RENAL 60M|G0463,G0463,99201|MEDICARE,TRICARE,WELLCARE|,,|,,|RURAL FEE SCHEDULE GROUP|70.00
BRYAN HEALTH SERVICE AREA|76200001|OBSERVATION|S9484,S9484,S9484,S9484,99218|MEDICAID,MEDICAID,MEDICAID,MEDICAID,|,,,,CRETE AREA MEDICAL CENTER PARENT HOSPITAL LOCATION [1005]|,,,,|RURAL FEE SCHEDULE GROUP|51.00
BRYAN HEALTH SERVICE AREA|77100001|ADMINISTRATION FEE -- INFLUENZA|G0008|MEDICARE|||RURAL FEE SCHEDULE GROUP|21.00
BRYAN HEALTH SERVICE AREA|77100002|ADMINISTRATION FEE -- PNEUMOCOCCAL|G0009|MEDICARE|||RURAL FEE SCHEDULE GROUP|21.00
BRYAN HEALTH SERVICE AREA|77100004|ADMINISTRATION FEE -- HEPATITIS B|G0010|MEDICARE|||RURAL FEE SCHEDULE GROUP|21.00
BRYAN HEALTH SERVICE AREA|30000096|VOLATILES SCREEN|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|180.00
BRYAN HEALTH SERVICE AREA|94200002|Hc Nutr Ther Dm Reas 15m|G0270|MEDICARE|BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|42.00
BRYAN HEALTH SERVICE AREA|94200030|NUTR COUNSEL 30 MIN|G0463,S9470,G0463|TRICARE,MEDICAID,MEDICARE|BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004],,|,,|RURAL FEE SCHEDULE GROUP|48.00
BRYAN HEALTH SERVICE AREA|30001254|SALICYLATE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|136.00
BRYAN HEALTH SERVICE AREA|30001255|ACETOMINOPHEN QUANT|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|258.00
BRYAN HEALTH SERVICE AREA|30001256|PREP PKG MAIL SPEC|36415||BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|36.00
BRYAN HEALTH SERVICE AREA|30001323|OXYCODONE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|200.00
BRYAN HEALTH SERVICE AREA|30001357|NICOTINE METABOLITES URINE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|211.00
BRYAN HEALTH SERVICE AREA|30001373|TRAZADONE URINE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|117.00
BRYAN HEALTH SERVICE AREA|30001404|Hc Amphetamine|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|75.00
BRYAN HEALTH SERVICE AREA|30001403|Hc Nephelometry Each|83520||BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|155.00
BRYAN HEALTH SERVICE AREA|30000097|NICOTINE URINE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|137.00
BRYAN HEALTH SERVICE AREA|30001453|Hc Antipsychotics Not Otherwise Specified 1-3|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|185.00
BRYAN HEALTH SERVICE AREA|76100253|HC MNT FOLLOW-UP EACH 15 MIN|G0270|MEDICARE|BRYAN MEDICAL CENTER PARENT HOSPITAL LOCATION [1004]||RURAL FEE SCHEDULE GROUP|42.00
BRYAN HEALTH SERVICE AREA|30001468|Hc Alkaloids Not Otherwise Specified|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|205.00
BRYAN HEALTH SERVICE AREA|30001470|Hc Sars-cov-2 By Pcr|U0003|MEDICARE|||RURAL FEE SCHEDULE GROUP|100.00
BRYAN HEALTH SERVICE AREA|30001472|Hc Covid-19 Bryan|U0003|MEDICARE|||RURAL FEE SCHEDULE GROUP|100.00
BRYAN HEALTH SERVICE AREA|30001474|Hc Specimen Collect Covid-19|C9803,C9803,C9803|HRSA,MEDICARE,TRICARE|,,|,,|RURAL FEE SCHEDULE GROUP|31.00
BRYAN HEALTH SERVICE AREA|30000098|AMPHETAMINES 1 OR 2|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|62.00
BRYAN HEALTH SERVICE AREA|30000101|FELBAMATE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|311.00
BRYAN HEALTH SERVICE AREA|30000103|METHSUXIMIDE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|311.00
BRYAN HEALTH SERVICE AREA|30000104|THIOTHIXENE NAVENE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|266.00
BRYAN HEALTH SERVICE AREA|30000106|LIBRIUM METABOLITE|G0480|MEDICARE|MERRICK MEDICAL CENTER PARENT HOSPITAL LOCATION [1008]||RURAL FEE SCHEDULE GROUP|132.00