Procedure Master # Procedure Record Name Revenue Code CPT Code FSC Method IP/OP/ Both Gross Charges BCBS Negotiated Fee UHC Negotiated Fee Aetna Negotiated Fee Midlands Choice Premier Negotiated Fee De-Identified Minimum Negotiated Charge De-Identified Maximum Negotiated Charge 99800013 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - AGILEMD 999 G1012 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800008 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - AIM SPECIALTY HEALTH 999 G1007 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800001 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - APPLIED PATHWAYS 999 G1000 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800009 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - CRANBERRY PEAK 999 G1008 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800002 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - EVICORE 999 G1001 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800014 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - EVIDENCE CARE 999 G1013 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800018 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - HEALTHHELP 999 G1017 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800019 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - INFINX 999 G1018 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800015 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - INVENIQA 999 G1014 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800020 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - LOGICNETS 999 G1019 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800003 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - MEDCURRENT 999 G1002 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800004 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - MEDICALIS 999 G1003 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800005 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - NATIONAL DECISION SUPPORT COMPANY 999 G1004 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800006 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - NATIONAL IMAGING ASSOCIATES 999 G1005 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800012 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - QUALIFIED TOOL NOT OTHERWISE SPECIFIED 999 G1011 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800016 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - RELIANT MEDICAL GROUP 999 G1015 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800010 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - SAGE HEALTH MANAGEMENT SOLUTIONS 999 G1009 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800017 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - SPEED OF CARE 999 G1016 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800011 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - STANSON 999 G1010 51 N/A Both 0.01 N/A N/A N/A N/A - - 99800007 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - TEST APPROPRIATE 999 G1006 51 N/A Both 0.01 N/A N/A N/A N/A - - 81200001 HC CORNEA 812 51 N/A Both 0.01 N/A N/A N/A N/A - - 34300002 HC RAD/PHARM GIVEN DUR HOSP STAY 343 C9898 51 N/A Both 1.00 N/A N/A N/A N/A - - 27000119 HC CAUTERY FINE HI-TEMP DISP 270 51 N/A Both 3.00 N/A N/A N/A N/A - - 27000021 HC GAUZE PACKING PLAIN 1 IN 270 51 N/A Both 3.00 N/A N/A N/A N/A - - 71000020 HC PHASE II RECOVERY PER MINUTE 710 51 N/A Both 6.00 N/A N/A N/A N/A - - 71000024 HC PHASE II RECOVERY PER MINUTE (CATH LAB) 710 51 N/A Both 6.00 N/A N/A N/A N/A - - 71000026 HC PHASE II RECOVERY PER MINUTE (GI) 710 51 N/A Both 6.00 N/A N/A N/A N/A - - 71000022 HC PHASE II RECOVERY PER MINUTE (PACU) 710 51 N/A Both 6.00 N/A N/A N/A N/A - - 27000068 HC TRAY INSTRUMENT GEN PURPOSE 270 51 N/A Both 6.00 N/A N/A N/A N/A - - 27000024 HC BARRIER SKIN NO STING 3ML 270 51 N/A Both 7.00 N/A N/A N/A N/A - - 27000039 HC KIT CATH FEMALE GLOVE 8FR 270 51 N/A Both 7.00 N/A N/A N/A N/A - - 27000069 HC REMOVER SKIN STAPLE UNIV 270 51 N/A Both 7.00 N/A N/A N/A N/A - - 27200004 HC DRSG MEPILEX 4X4IN 272 51 N/A Both 8.00 N/A N/A N/A N/A - - 27000140 HC TUBE IV EXT 32IN 270 51 N/A Both 9.00 N/A N/A N/A N/A - - 90600001 HC SKILLS TRAINING IOP - 15 MIN 906 H2014 51 N/A Both 10.00 N/A N/A N/A N/A - - 45000028 HC ED MISC PROCEDURE 450 51 N/A Both 10.00 N/A N/A N/A N/A - - 27000043 HC HOLDER TUBE TRACH VELCRO 270 51 N/A Both 10.00 N/A N/A N/A N/A - - 27000134 "HC TAPE CASTING 2"" X 4YD" 270 51 N/A Both 10.00 N/A N/A N/A N/A - - 27000004 HC EXERCISER VOLUMETRIC 270 51 N/A Both 12.00 N/A N/A N/A N/A - - 27000062 HC BAG URINARY CATH LEG 270 51 N/A Both 13.00 N/A N/A N/A N/A - - 27000141 HC BELT GAIT 54IN 270 51 N/A Both 13.00 N/A N/A N/A N/A - - 27000131 HC DEVICE STATLOCK FOLEY 270 51 N/A Both 13.00 N/A N/A N/A N/A - - 71000007 HC PACU LEVEL 1 PER MINUTE 710 51 N/A Both 13.00 N/A N/A N/A N/A - - 27000138 "HC TAPE CASTING 3""X4YD" 270 51 N/A Both 13.00 N/A N/A N/A N/A - - 27000118 HC CATH HOLDER LEG BAND 270 51 N/A Both 14.00 N/A N/A N/A N/A - - 27000137 HC DEVICE STATLOCK PEDI ULTRA 270 51 N/A Both 14.00 N/A N/A N/A N/A - - 27000008 HC TUBE IV BLOOD SET YTYP NV PUMP 270 51 N/A Both 14.00 N/A N/A N/A N/A - - 27000151 HC TUBE IV PRIMARY 80IN VENTED 270 51 N/A Both 14.00 N/A N/A N/A N/A - - 90700001 HC SKILL TRAINING DAY TX - 15 MIN 907 H2027 51 N/A Both 15.00 N/A N/A N/A N/A - - 37000002 HC ANESTHESIA MATERIAL >120/MIN 370 51 N/A Both 15.00 N/A N/A N/A N/A - - 27400045 HC CERVICAL COLLAR - PHILLY 274 L0120 51 N/A Both 15.00 N/A N/A N/A N/A - - 27000228 HC HIRUDOSALT 270 51 N/A Both 15.00 N/A N/A N/A N/A - - 71000008 HC PACU LEVEL 2 PER MINUTE 710 51 N/A Both 15.00 N/A N/A N/A N/A - - 27000100 HC SLING ARM SPECIALITY CHILD 270 51 N/A Both 15.00 N/A N/A N/A N/A - - 27000099 HC SLING ARM STRAP PADDED LG 270 51 N/A Both 15.00 N/A N/A N/A N/A - - 27000098 HC SLING ARM STRAP PADDED MED 270 51 N/A Both 15.00 N/A N/A N/A N/A - - 27000097 HC SLING ARM STRAP PADDED SM 270 51 N/A Both 15.00 N/A N/A N/A N/A - - 27000055 HC SLING STRAP XSM 18IN 270 51 N/A Both 15.00 N/A N/A N/A N/A - - 27000229 HC LEECHES - ORDERED DURING REGULAR HOURS (8:00 AM - 2:45PM CST) 270 51 N/A Both 15.15 N/A N/A N/A N/A - - 27000067 HC BAG URINARY DRAINAGE 2000ML 270 51 N/A Both 16.00 N/A N/A N/A N/A - - 27000149 HC CASSETTE INFUSION PRIMARY 270 51 N/A Both 16.00 N/A N/A N/A N/A - - 27400005 HC COLLAR CERVICAL LG 274 L0120 51 N/A Both 16.00 N/A N/A N/A N/A - - 27400003 HC COLLAR CERVICAL MED 274 L0120 51 N/A Both 16.00 N/A N/A N/A N/A - - 27400002 HC COLLAR CERVICAL SM 274 L0120 51 N/A Both 16.00 N/A N/A N/A N/A - - 27400004 HC COLLAR CERVICAL SM X-LONG 274 L0120 51 N/A Both 16.00 N/A N/A N/A N/A - - 45000022 HC NAIL CARE DRAIN BLOOD 450 51 N/A Both 16.00 N/A N/A N/A N/A - - 91900001 HC PEER SUPPORT SVC PER 15MIN GROUP 919 H0038 51 N/A Both 16.00 N/A N/A N/A N/A - - 27000092 HC SLING ARM INFANT 270 51 N/A Both 16.00 N/A N/A N/A N/A - - 27000095 HC SLING ARM SPECIALITY LG 270 51 N/A Both 16.00 N/A N/A N/A N/A - - 27000094 HC SLING ARM SPECIALITY MED 270 51 N/A Both 16.00 N/A N/A N/A N/A - - 27000093 HC SLING ARM SPECIALITY SM 270 51 N/A Both 16.00 N/A N/A N/A N/A - - 27000096 HC SLING ARM SPECIALITY X-LG 270 51 N/A Both 16.00 N/A N/A N/A N/A - - 27000117 HC SHOE POST-OP FEMALE LG 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000116 HC SHOE POST-OP FEMALE MED 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000115 HC SHOE POST-OP FEMALE SM 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000114 HC SHOE POST-OP MALE LG 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000113 HC SHOE POST-OP MALE MED 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000112 HC SHOE POST-OP MALE SM 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000121 HC SUTURE A 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000135 "HC TAPE CASTING 4""X4YD" 270 51 N/A Both 17.00 N/A N/A N/A N/A - - 27000230 HC LEECHES - ORDERED OUTSIDE OF REGULAR HOURS (8:00AM - 2:45PM) 270 51 N/A Both 17.15 N/A N/A N/A N/A - - 27000101 HC STRAP CLAVICLE INFANT 270 51 N/A Both 18.00 N/A N/A N/A N/A - - 27000104 HC STRAP CLAVICLE LG 270 51 N/A Both 18.00 N/A N/A N/A N/A - - 27000103 HC STRAP CLAVICLE MED 270 51 N/A Both 18.00 N/A N/A N/A N/A - - 27000102 HC STRAP CLAVICLE SM 270 51 N/A Both 18.00 N/A N/A N/A N/A - - 27000139 HC VALVE ANTI REFLUX SALEM SUMP 270 51 N/A Both 18.00 N/A N/A N/A N/A - - 71000009 HC PACU LEVEL 3 PER MINUTE 710 51 N/A Both 19.00 N/A N/A N/A N/A - - 27000111 HC SHOE CAST LG CANVAS 270 51 N/A Both 19.00 N/A N/A N/A N/A - - 27000110 HC SHOE CAST MED CANVAS 270 51 N/A Both 19.00 N/A N/A N/A N/A - - 27000109 HC SHOE CAST SM CANVAS 270 51 N/A Both 19.00 N/A N/A N/A N/A - - 27000013 HC STAPLER SKIN MULTI SHOT STRL 270 51 N/A Both 19.00 N/A N/A N/A N/A - - 30000607 HC ADDITIONAL SGPT 300 84460 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000158 HC ADDL ALBUMIN 300 82040 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000201 HC ADDL BILIRUBIN TOTAL 300 82247 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000618 HC ADDL BUN 300 84520 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000216 HC ADDL CALCIUM 300 82310 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000225 HC ADDL CARBON DIOXIDE 300 82374 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000236 HC ADDL CHLORIDE BLOOD 300 82435 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000245 HC ADDL CHOLESTEROL 300 82465 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000278 HC ADDL CPK CREATINE PHOSP 300 82550 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000282 HC ADDL CREATININE 300 82565 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000349 HC ADDL GGT GAMMA GLUTAMYL 300 82977 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000340 HC ADDL GLUCOSE QUANT 300 82947 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000218 HC ADDL IONIZED CALCIUM 300 82330 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000457 HC ADDL LDH LACTIC DEHYDRO 300 83615 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000526 HC ADDL PHOSPHORUS 300 84100 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000537 HC ADDL POTASSIUM SERUM 300 84132 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000548 HC ADDL PROTEIN TOTAL SERUM 300 84155 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000605 HC ADDL SGOT AST 300 84450 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000577 HC ADDL SODIUM BLOOD 300 84295 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000610 HC ADDL TRIGLYCERIDES 300 84478 51 N/A Both 20.00 N/A N/A N/A N/A - - 30000622 HC ADDL URIC ACID 300 84550 51 N/A Both 20.00 N/A N/A N/A N/A - - 27400046 HC CERVICAL COLLAR - C- COLLAR 274 L0150 51 N/A Both 20.00 N/A N/A N/A N/A - - 27400040 HC CLAVICLE STRAP 274 L3650 51 N/A Both 20.00 N/A N/A N/A N/A - - 27000049 HC STAPLER SKIN PRECISE 15 270 51 N/A Both 20.00 N/A N/A N/A N/A - - 27000136 "HC TAPE CASTING 5"" X 4YD" 270 51 N/A Both 20.00 N/A N/A N/A N/A - - 27000070 HC TUBE ASPIRATING 8CC STRL LUKI 270 51 N/A Both 20.00 N/A N/A N/A N/A - - 27000129 HC GELATIN SURGIFOAM 12-7MM 270 51 N/A Both 21.00 N/A N/A N/A N/A - - 27000038 HC TUBE FEEDING INFANT 5 X 20 270 51 N/A Both 21.00 N/A N/A N/A N/A - - 27000122 HC VALVE LOPEZ 270 51 N/A Both 21.00 N/A N/A N/A N/A - - 27000003 HC AEROCHAMBER FLOWSIGNAL 270 51 N/A Both 22.00 N/A N/A N/A N/A - - 27400006 HC COLLAR CERVICAL UNIVERSAL 274 L0140 51 N/A Both 22.00 N/A N/A N/A N/A - - 27000130 HC DRSG MEPILEX 6X8IN 270 51 N/A Both 22.00 N/A N/A N/A N/A - - 27000091 HC SPLINT WRIST COCK-UP RT X-LG 270 51 N/A Both 22.00 N/A N/A N/A N/A - - 91900002 HC PEER SUPPORT SVC PER 15MIN 919 H0038 51 N/A Both 23.00 N/A N/A N/A N/A - - 27000090 HC SPLINT WRIST COCK-UP LT X-LG 270 51 N/A Both 23.00 N/A N/A N/A N/A - - 27000044 HC TUBE LAVAGE RADIOPAQUE 36FR 270 51 N/A Both 23.00 N/A N/A N/A N/A - - 27000050 HC TUBE SUMP 10FR W/PREVENT 270 51 N/A Both 23.00 N/A N/A N/A N/A - - 27000051 HC TUBE SUMP 12FR W/PREVENT 270 51 N/A Both 23.00 N/A N/A N/A N/A - - 27000052 HC TUBE SUMP 14FR ANTI-REFLUX 270 51 N/A Both 23.00 N/A N/A N/A N/A - - 27000053 HC TUBE SUMP 16FR ANTI-REFLUX 270 51 N/A Both 23.00 N/A N/A N/A N/A - - 27000054 HC TUBE SUMP 18FR ANTI-REFLUX 270 51 N/A Both 23.00 N/A N/A N/A N/A - - 27200006 HC KIT RESUSICATOR INFANT--NEOPUF 272 51 N/A Both 24.00 N/A N/A N/A N/A - - 27000045 HC KIT SUCT TRACH SIZE CLOSED 270 51 N/A Both 24.00 N/A N/A N/A N/A - - 40100004 HC MAMMO DIAGNOSTIC BIL 3D 401 77066 51 N/A Both 25.00 N/A N/A N/A N/A - - 92000028 HC WHOLE BODY COMPOSITION ASSESSMENT W/I&R 920 0358T 51 N/A Both 25.00 N/A N/A N/A N/A - - 30000586 HC SPEC GRAVITY EXCL URINE 300 84315 51 N/A Both 26.00 N/A N/A N/A N/A - - 27000017 HC FLOWMETER PEAK FULL RANGE 270 51 N/A Both 26.00 N/A N/A N/A N/A - - 43000059 HC OT INFRARED THERAPY 1 OR MORE AREAS 430 97026 51 N/A Both 26.00 N/A N/A N/A N/A - - 42000012 HC PT INFRARED THERAPY 1 OR MORE AREAS 420 97026 51 N/A Both 26.00 N/A N/A N/A N/A - - 76100079 HC TB INTRADERMAL TEST 761 86580 51 N/A Both 27.00 N/A N/A N/A N/A - - 91500003 HC CJ IOP LECTURE DIDACTIC 915 90853 51 N/A Both 27.00 N/A N/A N/A N/A - - 30001382 HC C DIFFICILE TOXINS 300 87324 51 N/A Both 27.00 N/A N/A N/A N/A - - 27000005 HC RESUSCITATOR 270 51 N/A Both 27.00 N/A N/A N/A N/A - - 27000012 HC RESUSCITATOR PEDI TODDLER 270 51 N/A Both 27.00 N/A N/A N/A N/A - - 37000003 HC ANESTHESIA MATERIAL 35-120/MIN 370 51 N/A Both 28.00 N/A N/A N/A N/A - - 27000031 HC CATH FOLEY PEDI 10FRX3CC STRL 270 51 N/A Both 28.00 N/A N/A N/A N/A - - 27000030 HC CATH FOLEY PEDI 8FRX3CC STRL 270 51 N/A Both 28.00 N/A N/A N/A N/A - - 27000042 HC HOLDER TUBE ENDOTRACHEAL 270 51 N/A Both 28.00 N/A N/A N/A N/A - - 30000120 HC KETONES UR 300 81003 51 N/A Both 28.00 N/A N/A N/A N/A - - 30000115 HC PH SCREEN URINE 300 81002 51 N/A Both 28.00 N/A N/A N/A N/A - - 30000114 HC PROTEIN URINE QUAL 300 81002 51 N/A Both 28.00 N/A N/A N/A N/A - - 30001185 HC REDUCING SUBSTANCE URINE 300 81005 51 N/A Both 28.00 N/A N/A N/A N/A - - 30000122 HC URINALYSIS MICROSCOPIC ONLY 300 81015 51 N/A Both 28.00 N/A N/A N/A N/A - - 27000057 HC CATH TRACH SUCT CARE DIR TP 270 51 N/A Both 29.00 N/A N/A N/A N/A - - 91500007 HC CJ DAY TX LECTURE DIDACTIC 915 90853 51 N/A Both 30.00 N/A N/A N/A N/A - - 91500006 HC CJ DAY TX GRP THERAPY 60 MIN 915 90853 51 N/A Both 30.00 N/A N/A N/A N/A - - 91500012 HC CJ DAY TX GRP THERAPY 90 MIN 915 90853 51 N/A Both 30.00 N/A N/A N/A N/A - - 91500002 HC CJ IOP GROUP THERAPY 60 MIN 915 90853 51 N/A Both 30.00 N/A N/A N/A N/A - - 91500005 HC CJ IOP GROUP THERAPY 90 MIN 915 90853 51 N/A Both 30.00 N/A N/A N/A N/A - - 91500004 HC CJ IOP LECTURE INTERACTIV GRP 915 90853 51 N/A Both 30.00 N/A N/A N/A N/A - - 39000044 "HC ABO, DONOR" 300 86900 51 N/A Both 30.00 N/A N/A N/A N/A - - 27000034 HC CATH FOLEY 16FRX5CC STRL 270 51 N/A Both 30.00 N/A N/A N/A N/A - - 27000035 HC CATH FOLEY 18FRX5CC STRL 270 51 N/A Both 30.00 N/A N/A N/A N/A - - 30000001 HC COLLECTION BLOOD SPECIMEN 300 36415 51 N/A Both 30.00 N/A N/A N/A N/A - - 27000120 HC INFUSOR PRESSURE 500ML 270 51 N/A Both 30.00 N/A N/A N/A N/A - - 96900015 "HC NDPP PREV BHVR CHGS, IND OR GRP, MINIMUM 60 MIN" 969 0403T 51 N/A Both 30.00 N/A N/A N/A N/A - - 30001256 HC PREP PKG MAIL SPEC 300 99001 51 N/A Both 30.00 N/A N/A N/A N/A - - 39000002 HC RH (D) DONOR 390 86901 51 N/A Both 30.00 N/A N/A N/A N/A - - 30001474 HC SPECIMEN COLLECT COVID-19 300 G2023 51 N/A Both 30.00 N/A N/A N/A N/A - - 27000082 HC STAPLER SURG SKIN PTW35 STRL 270 51 N/A Both 30.00 N/A N/A N/A N/A - - 30000124 HC URINE MEASURE TIMED COLL 300 81050 51 N/A Both 30.00 N/A N/A N/A N/A - - 27400042 HC WRIST SPLINT 274 L3908 51 N/A Both 30.00 N/A N/A N/A N/A - - 30000285 HC URINE CREATININE 300 82570 51 N/A Both 31.00 N/A N/A N/A N/A - - 30001178 HC FAT QUAL URINE 300 89125 51 N/A Both 31.00 N/A N/A N/A N/A - - 27000016 HC NDL HUBER 20GX.75/1/1.5IN BARD 270 51 N/A Both 31.00 N/A N/A N/A N/A - - 30000984 HC POOLING OF PRODUCTS 300 86965 51 N/A Both 31.00 N/A N/A N/A N/A - - 27000032 HC CATH FOLEY 12FRX5CC STRL 270 51 N/A Both 32.00 N/A N/A N/A N/A - - 27000033 HC CATH FOLEY 14FRX5CC STRL 270 51 N/A Both 32.00 N/A N/A N/A N/A - - 27000037 HC CATH FOLEY 18FRX30CC STRL 270 51 N/A Both 32.00 N/A N/A N/A N/A - - 27000073 HC URINEMETER W/DRAIN BAG 270 51 N/A Both 32.00 N/A N/A N/A N/A - - 27400008 HC COLLAR CERVICAL PEDI NO-NECK 274 L0140 51 N/A Both 33.00 N/A N/A N/A N/A - - 27000089 HC SPLINT WRIST COCK-UP LT LG 270 51 N/A Both 33.00 N/A N/A N/A N/A - - 27000088 HC SPLINT WRIST COCK-UP LT MED 270 51 N/A Both 33.00 N/A N/A N/A N/A - - 27000087 HC SPLINT WRIST COCK-UP LT SM 270 51 N/A Both 33.00 N/A N/A N/A N/A - - 27000086 HC SPLINT WRIST COCK-UP RT LG 270 51 N/A Both 33.00 N/A N/A N/A N/A - - 27000085 HC SPLINT WRIST COCK-UP RT MED 270 51 N/A Both 33.00 N/A N/A N/A N/A - - 27000084 HC SPLINT WRIST COCK-UP RT SM 270 51 N/A Both 33.00 N/A N/A N/A N/A - - 27000036 HC CATH FOLEY 16FRX30CC STRL 270 51 N/A Both 34.00 N/A N/A N/A N/A - - 27200015 HC DECANNULIZATION STOP 272 51 N/A Both 34.00 N/A N/A N/A N/A - - 27000147 HC KIT DRSG CHNG 270 51 N/A Both 34.00 N/A N/A N/A N/A - - 27000128 HC CLIP C02 270 51 N/A Both 35.00 N/A N/A N/A N/A - - 27400007 HC COLLAR CERVICAL BABY NO-NECK 274 L0140 51 N/A Both 35.00 N/A N/A N/A N/A - - 94200044 HC ONLINE DIGITAL EVALUATION AND MANAGEMENT SERVICE FOR AN ESTABLISHED PATIENT 5 - 10 MINS 942 99421 51 N/A Both 35.00 N/A N/A N/A N/A - - 27000148 HC CASSETTE INF BLOOD 270 51 N/A Both 36.00 N/A N/A N/A N/A - - 27000133 HC DETECTOR CO2-EASY CAP/PEDI 270 51 N/A Both 36.00 N/A N/A N/A N/A - - 30001027 HC CULTURE MYCOBACT DEFINITIVE ID 300 87118 51 N/A Both 37.00 N/A N/A N/A N/A - - 30000204 HC ADDITIONAL BILIRUBIN DIRECT 300 82248 51 N/A Both 39.00 N/A N/A N/A N/A - - 30000203 HC BILIRUBIN DIRECT 300 82248 51 N/A Both 39.00 N/A N/A N/A N/A - - 27400013 HC DIGIT EXTENSION SPLINT 274 L3929 51 N/A Both 39.00 N/A N/A N/A N/A - - 30000654 HC HEMATOCRIT 300 85014 51 N/A Both 39.00 N/A N/A N/A N/A - - 30000656 HC HEMOGLOBIN 300 85018 51 N/A Both 39.00 N/A N/A N/A N/A - - 30000210 "HC OCCULT BLOOD, STOOL" 300 82272 51 N/A Both 39.00 N/A N/A N/A N/A - - 76100253 HC MNT FOLLOW-UP EACH 15 MIN 761 97803 51 N/A Both 40.00 N/A N/A N/A N/A - - 94200043 HC MNT SUBS TX FOR CHANGE DX 942 G0270 51 N/A Both 40.00 N/A N/A N/A N/A - - 94200002 HC NUTR THER DM REAS 15M 942 97803 51 N/A Both 40.00 N/A N/A N/A N/A - - 27400039 HC ORTHOPEDIC SHOE INSOLE 274 L3510 51 N/A Both 40.00 N/A N/A N/A N/A - - 30000518 HC ADDL ALKALINE PHOSPHATASE 300 84075 51 N/A Both 41.00 N/A N/A N/A N/A - - 27000041 HC CATH IV PERIPHERAL TWO LUMEN 270 51 N/A Both 41.00 N/A N/A N/A N/A - - 30000521 HC PHOSPHATASE ALKALINE 300 84075 51 N/A Both 41.00 N/A N/A N/A N/A - - 45000020 HC LACERATION REPAIR 450 51 N/A Both 42.00 N/A N/A N/A N/A - - 91500008 HC CJ DAY TX LECT INTERACTIV GRP 915 90853 51 N/A Both 42.00 N/A N/A N/A N/A - - 30000655 HC BEDSIDE-HEMATOCRIT 300 85014 51 N/A Both 43.00 N/A N/A N/A N/A - - 27000075 HC TRAY LACERATION STRL 270 51 N/A Both 43.00 N/A N/A N/A N/A - - 30000990 HC CONCENTRATION ACID FAST 300 87015 51 N/A Both 44.00 N/A N/A N/A N/A - - 30001361 HC CONCENTRATION CYCLOSPORA 300 87015 51 N/A Both 44.00 N/A N/A N/A N/A - - 27400018 HC HAND BASED THUMB SPICA 274 L3808 51 N/A Both 44.00 N/A N/A N/A N/A - - 27000132 HC SENSOR SP02 NEO-L/MASIMO 270 51 N/A Both 44.00 N/A N/A N/A N/A - - 27000040 HC SET CATH RADIAL ARTERY 20GA 270 51 N/A Both 44.00 N/A N/A N/A N/A - - 27200010 HC SET INFUSION POWERLOC 272 51 N/A Both 44.00 N/A N/A N/A N/A - - 76100252 HC MNT INITIAL EACH 15 MIN 761 97802 51 N/A Both 45.00 N/A N/A N/A N/A - - 94200001 HC NUTR THER INITIAL DM EA 15M 942 97802 51 N/A Both 45.00 N/A N/A N/A N/A - - 96900005 HC POST CORE MONTHS 10-12 NO WL 969 G9877 51 N/A Both 45.00 N/A N/A N/A N/A - - 96900004 HC POST CORE MONTHS 7-9 NO WL 969 G9876 51 N/A Both 45.00 N/A N/A N/A N/A - - 27000010 HC KIT DRSG CENTRAL LINE 270 51 N/A Both 46.00 N/A N/A N/A N/A - - 27000127 HC AEROCHAMBER MED PEDI YELLOW 270 51 N/A Both 47.00 N/A N/A N/A N/A - - 30000002 HC LEGAL BLOOD COLLECTION 300 36415 51 N/A Both 47.00 N/A N/A N/A N/A - - 30000978 HC RBC ANTIGENS OTHER THAN ABO RH (D) 300 86905 51 N/A Both 47.00 N/A N/A N/A N/A - - 99000012 HC OFFICE OUTPATIENT VISIT 5 MIN 990 99211 51 N/A Both 48.00 N/A N/A N/A N/A - - 27000143 HC PAD COLLAR REPLACEMENT 270 51 N/A Both 48.00 N/A N/A N/A N/A - - 27200008 HC SET FILTER MICROSTREAM ADU/PDI 272 51 N/A Both 49.00 N/A N/A N/A N/A - - 91500016 HC CJ GROUP THERAPY 60 MIN 915 90853 51 N/A Both 50.00 N/A N/A N/A N/A - - 90000011 HC INTERVENTION VISIT RN 900 90832 51 N/A Both 50.00 N/A N/A N/A N/A - - 30000981 HC THAWING FFP SDP OR CRYO 300 86927 51 N/A Both 50.00 N/A N/A N/A N/A - - 30000976 HC ANTIGEN TESTING EACH UNIT 300 86902 51 N/A Both 51.00 N/A N/A N/A N/A - - 27200009 HC SET FILTER/CIRCUIT ETC02 272 51 N/A Both 51.00 N/A N/A N/A N/A - - 30000162 HC MICROALBUMIN URINE QUANTITATIVE 300 82043 51 N/A Both 52.00 N/A N/A N/A N/A - - 30000152 HC ACETONE QUALITATIVE 300 82009 51 N/A Both 52.00 N/A N/A N/A N/A - - 96900014 HC BRIDGE PAYMENT 969 G9890 51 N/A Both 52.00 N/A N/A N/A N/A - - 30001179 HC EOSINOPHIL COUNT NASAL SMEAR 300 89190 51 N/A Both 52.00 N/A N/A N/A N/A - - 30000737 HC EOSINOPHIL URINE 300 85999 51 N/A Both 52.00 N/A N/A N/A N/A - - 30000988 HC SPLITTING OF BLD PROD EA 300 86985 51 N/A Both 52.00 N/A N/A N/A N/A - - 27000072 HC TRAY LUMBAR PUNCTURE PEDI 270 51 N/A Both 52.00 N/A N/A N/A N/A - - 30000121 HC UA W/O MICRO AUTO 300 81003 51 N/A Both 52.00 N/A N/A N/A N/A - - 30000209 "HC OCCULT BLOOD, GASTRIC" 300 82271 51 N/A Both 53.00 N/A N/A N/A N/A - - 30000513 HC PH BODY FLUID 300 83986 51 N/A Both 53.00 N/A N/A N/A N/A - - 30000665 HC PLATELET COUNT AUTOMATED 300 85049 51 N/A Both 53.00 N/A N/A N/A N/A - - 30000344 HC TOL TEST - EA ADDL SPEC > 3 300 82952 51 N/A Both 53.00 N/A N/A N/A N/A - - 30000977 HC SCREEN FOR COMPATIBLE UNITS 300 86904 51 N/A Both 54.00 N/A N/A N/A N/A - - 27000071 HC SPINAL DISP ADULT 270 51 N/A Both 54.00 N/A N/A N/A N/A - - 91500010 HC DAY TX LECTURE DIDACTIC PARTIAL CARE 915 90853 51 N/A Both 55.00 N/A N/A N/A N/A - - 91500011 HC IOP LECTURE DIDACTIC 915 90853 51 N/A Both 55.00 N/A N/A N/A N/A - - 91500009 HC LECTURE DIDACTIC 915 90853 51 N/A Both 55.00 N/A N/A N/A N/A - - 96900009 HC 9% WL BASELINE ACHIEVED 969 G9881 51 N/A Both 55.00 N/A N/A N/A N/A - - 27000007 HC FILTER W/GAS VENT 270 51 N/A Both 55.00 N/A N/A N/A N/A - - 30001066 HC GRAM STAIN SMEAR 300 87205 51 N/A Both 55.00 N/A N/A N/A N/A - - 96900016 "HC NDPP PREV BHVR CHGS, IND, PER 30 DAYS" 969 0488T 51 N/A Both 55.00 N/A N/A N/A N/A - - 27000153 HC SPLINT OCL ARM SHORT 270 51 N/A Both 55.00 N/A N/A N/A N/A - - 30000664 HC WBC 300 85048 51 N/A Both 55.00 N/A N/A N/A N/A - - 30000160 HC ALBUMIN URINE/OTHR QNT EA SPEC 300 82042 51 N/A Both 56.00 N/A N/A N/A N/A - - 27400011 HC COLLAR CERVICAL LG PHILADEL 274 L0150 51 N/A Both 56.00 N/A N/A N/A N/A - - 27400010 HC COLLAR CERVICAL MED PHILADEL 274 L0150 51 N/A Both 56.00 N/A N/A N/A N/A - - 27400009 HC COLLAR CERVICAL SM PHILADEL 274 L0150 51 N/A Both 56.00 N/A N/A N/A N/A - - 27200005 HC KIT CATH LUNG SAMPLE 272 51 N/A Both 56.00 N/A N/A N/A N/A - - 30000453 HC IRON 300 83540 51 N/A Both 57.00 N/A N/A N/A N/A - - 30000663 HC EOSINOPHIL ABSOLUT CT DIR 300 85048 51 N/A Both 57.00 N/A N/A N/A N/A - - 94200045 HC ONLINE DIGITAL EVALUATION AND MANAGEMENT SERVICE FOR AN ESTABLISHED PATIENT 11-20 MINS 942 99422 51 N/A Both 57.00 N/A N/A N/A N/A - - 36000023 HC OR LEVEL 1 PER MINUTE 360 51 N/A Both 57.00 N/A N/A N/A N/A - - 27000006 HC RESUSCITATOR INFANT 270 51 N/A Both 57.00 N/A N/A N/A N/A - - 30000202 HC BILIRUBIN TOTAL 300 82247 51 N/A Both 59.00 N/A N/A N/A N/A - - 30000214 HC CALCIUM 300 82310 51 N/A Both 59.00 N/A N/A N/A N/A - - 30000525 HC PHOSPHORUS 300 84100 51 N/A Both 59.00 N/A N/A N/A N/A - - 30000159 HC ALBUMIN 300 82040 51 N/A Both 59.00 N/A N/A N/A N/A - - 27000221 HC AORTIC PUMP - HOURLY 270 51 N/A Both 59.00 N/A N/A N/A N/A - - 30000346 HC BEDSIDE GLUCOSE 300 82962 51 N/A Both 59.00 N/A N/A N/A N/A - - 30001173 HC BILI TOTAL TRANSCUTANEOUS 300 88720 51 N/A Both 59.00 N/A N/A N/A N/A - - 27000076 HC FILTER BLOOD TRANSFUSION STRL 270 51 N/A Both 59.00 N/A N/A N/A N/A - - 27000107 HC IMMOBILIZER KNEE LG 19IN 270 51 N/A Both 59.00 N/A N/A N/A N/A - - 27000106 HC IMMOBILIZER KNEE MED 19IN 270 51 N/A Both 59.00 N/A N/A N/A N/A - - 27000105 HC IMMOBILIZER KNEE SM 19IN 270 51 N/A Both 59.00 N/A N/A N/A N/A - - 27000108 HC IMMOBILIZER KNEE X-LG 19IN 270 51 N/A Both 59.00 N/A N/A N/A N/A - - 30000666 HC RETICULATED PLATELET ASSAY 300 85055 51 N/A Both 59.00 N/A N/A N/A N/A - - 91400017 HC DAY TX IND THERAPY 30(16-37) 914 90832 51 N/A Both 60.00 N/A N/A N/A N/A - - 91400043 HC INDIV THERAPY 30(16-37)MIN 914 90832 51 N/A Both 60.00 N/A N/A N/A N/A - - 91400016 HC IOP IND THERAPY 30(16-37)MIN 914 90832 51 N/A Both 60.00 N/A N/A N/A N/A - - 30000456 HC BEDSIDE LACTATE 300 83605 51 N/A Both 60.00 N/A N/A N/A N/A - - 27400037 HC KNEE IMMOBILIZER 274 L1830 51 N/A Both 60.00 N/A N/A N/A N/A - - 27000025 HC TROCAR 28FRX16 IN STRL 270 51 N/A Both 60.00 N/A N/A N/A N/A - - 27000126 HC KIT ARTERIAL LINE FEMORAL 270 51 N/A Both 61.00 N/A N/A N/A N/A - - 41000042 HC MDI 410 94640 51 N/A Both 61.00 N/A N/A N/A N/A - - 36000025 HC OR LEVEL 2 PER MINUTE 360 51 N/A Both 61.00 N/A N/A N/A N/A - - 30000281 HC BEDSIDE CREATININE 300 82565 51 N/A Both 62.00 N/A N/A N/A N/A - - 30000550 HC PROTEIN TOTAL OTHER SOURCE 300 84157 51 N/A Both 62.00 N/A N/A N/A N/A - - 30000547 HC PROTEIN TOTAL SERUM 300 84155 51 N/A Both 62.00 N/A N/A N/A N/A - - 30000215 HC CALCIUM CSF 300 82310 51 N/A Both 62.00 N/A N/A N/A N/A - - 30000217 HC CALCIUM URINE 300 82310 51 N/A Both 62.00 N/A N/A N/A N/A - - 27000027 HC CATH FOLEY COUDE 16FRX5CC 270 51 N/A Both 62.00 N/A N/A N/A N/A - - 27000028 HC CATH FOLEY COUDE 18FRX5CC 270 51 N/A Both 62.00 N/A N/A N/A N/A - - 30001381 HC CREATININE 300 82565 51 N/A Both 62.00 N/A N/A N/A N/A - - 30001416 HC CREATININE OTHER SOURCE 300 82570 51 N/A Both 62.00 N/A N/A N/A N/A - - 91400010 HC INTERACTIVE COMPLEXITY 914 90785 51 N/A Both 62.00 N/A N/A N/A N/A - - 41000025 HC NASAL WASHINGS 410 94799 51 N/A Both 62.00 N/A N/A N/A N/A - - 30000534 HC POTASSIUM SERUM 300 84132 51 N/A Both 62.00 N/A N/A N/A N/A - - 30000538 HC POTASSIUM URINE 300 84133 51 N/A Both 62.00 N/A N/A N/A N/A - - 27000169 HC PULSED LAVAGE TRACK TIP 270 51 N/A Both 62.00 N/A N/A N/A N/A - - 30000617 HC UREA NITROGEN BUN 300 84520 51 N/A Both 62.00 N/A N/A N/A N/A - - 45000018 HC FOREIGNBODYREMOV(EYE/EAR/NOSE) 450 51 N/A Both 63.00 N/A N/A N/A N/A - - 30001225 HC BLOOD CULTURE ORG ID PEDS 300 87150 51 N/A Both 64.00 N/A N/A N/A N/A - - 30001437 HC CULTURE TYPING ID BY DNA/RNA PROBE PER CULTRUE OR ISOLATE EA ORGANISM PROBED 300 87150 51 N/A Both 64.00 N/A N/A N/A N/A - - 30001252 HC INFECTIOUS AGENT NOS AMP PRO 300 87798 51 N/A Both 64.00 N/A N/A N/A N/A - - 27000155 HC SPLINT OCL LEG SHORT 270 51 N/A Both 64.00 N/A N/A N/A N/A - - 27000065 HC TRAY CATH FOLEY 16FR W/STATLOC 270 51 N/A Both 64.00 N/A N/A N/A N/A - - 91500015 HC DAY TX GROUP THERAPY 60 MIN-PARTIAL CARE 915 90853 51 N/A Both 65.00 N/A N/A N/A N/A - - 91500013 HC GROUP THERAPY 60 MIN 915 90853 51 N/A Both 65.00 N/A N/A N/A N/A - - 30001436 HC INFECTIOUS AGENT DETECTION DNA/RNA MPNEUMONIAE AMPLIFIED PROBE 300 87581 51 N/A Both 65.00 N/A N/A N/A N/A - - 45000273 HC STRAPPING OF ELBOW OR WRIST 450 29260 51 N/A Both 65.00 N/A N/A N/A N/A - - 45000274 HC STRAPPING OF HAND OR FINGER 450 29280 51 N/A Both 65.00 N/A N/A N/A N/A - - 30000705 HC FETAL SCRN FET MAT BLD 300 85461 51 N/A Both 66.00 N/A N/A N/A N/A - - 94200007 HC GRP COMP DM ED/30M 942 G0109 51 N/A Both 66.00 N/A N/A N/A N/A - - 30000651 HC MANUAL DIFFERENTIAL 300 85007 51 N/A Both 66.00 N/A N/A N/A N/A - - 27000026 HC CATH FOLEY COUDE 14FRX5CC 270 51 N/A Both 67.00 N/A N/A N/A N/A - - 27000125 HC KIT MONITOR CATH LAB TRNSDUCER 270 51 N/A Both 67.00 N/A N/A N/A N/A - - 27000080 HC LENS MEDIFLOW STRL MORGAN 270 51 N/A Both 67.00 N/A N/A N/A N/A - - 30000238 HC CHLORIDE BLOOD 300 82435 51 N/A Both 69.00 N/A N/A N/A N/A - - 30001377 HC GLUCOSE 300 82947 51 N/A Both 69.00 N/A N/A N/A N/A - - 30000339 HC GLUCOSE 2 HR 300 82947 51 N/A Both 69.00 N/A N/A N/A N/A - - 30000623 HC URIC ACID URINE 300 84560 51 N/A Both 70.00 N/A N/A N/A N/A - - 30000606 HC ALT 300 84460 51 N/A Both 70.00 N/A N/A N/A N/A - - 27400043 HC ANKLE BRACE 274 L4350 51 N/A Both 70.00 N/A N/A N/A N/A - - 30000604 HC AST SGOT 300 84450 51 N/A Both 70.00 N/A N/A N/A N/A - - 30000535 HC BEDSIDE POTASSIUM 300 84132 51 N/A Both 70.00 N/A N/A N/A N/A - - 30000123 HC HCG QUAL URINE PREG 300 81025 51 N/A Both 70.00 N/A N/A N/A N/A - - 96100001 HC MCD INPT INTER COMPLEX PSYCH 961 90785 51 N/A Both 70.00 N/A N/A N/A N/A - - 30000725 HC SEDIMENTATION RATE ESR 300 85652 51 N/A Both 70.00 N/A N/A N/A N/A - - 30000621 HC URIC ACID BLOOD 300 84550 51 N/A Both 70.00 N/A N/A N/A N/A - - 30000609 HC TRIGLYCERIDES 300 84478 51 N/A Both 71.00 N/A N/A N/A N/A - - 30000454 HC IRON BINDING CAPACITY 300 83550 51 N/A Both 71.00 N/A N/A N/A N/A - - 27000056 HC BRACE ANKLE LT 270 51 N/A Both 71.00 N/A N/A N/A N/A - - 30000861 HC CRYPTOCOCCUS ANTIGEN TITER 300 86406 51 N/A Both 71.00 N/A N/A N/A N/A - - 47100003 HC NEWBORN AUDITORY PROCESS EVAL EACH ADDL 15 MIN 471 92621 51 N/A Both 71.00 N/A N/A N/A N/A - - 42000084 HC PT BFB TRAINING EA ADDL 15 MIN 420 90913 51 N/A Both 71.00 N/A N/A N/A N/A - - 30000244 HC CHOLESTEROL 300 82465 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000459 HC LACTIC DEHYDROGENASE LD 300 83615 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000219 HC BEDSIDE CALC IONIZE 300 82330 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000237 HC BEDSIDE COMBO CHLORIDE 300 82435 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000536 HC BEDSIDE POTASSIUM 300 84132 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000117 HC GLUCOSE URINE QUAL 300 81002 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000469 HC HDL 300 83718 51 N/A Both 72.00 N/A N/A N/A N/A - - 30001434 HC INFECTIOUS AGENT DETECTION DNA/RNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE 300 87486 51 N/A Both 72.00 N/A N/A N/A N/A - - 96100002 HC INTERACTIVE COMPLEXITY - PSY 961 90785 51 N/A Both 72.00 N/A N/A N/A N/A - - 27000011 HC KIT DRSG CHNG PICC 270 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000721 HC PROTHROMBIN TIME -INR+SEC 300 85610 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000574 HC SODIUM BLOOD 300 84295 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000578 HC SODIUM URINE 300 84300 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000116 HC SPECIFIC GRAVITY UA 300 81002 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000619 HC UREA URINE 300 84540 51 N/A Both 72.00 N/A N/A N/A N/A - - 30000695 HC ACT LOW 300 85347 51 N/A Both 73.00 N/A N/A N/A N/A - - 46000031 HC CAR SEAT/BED TEST + 30 MIN 460 94781 51 N/A Both 73.00 N/A N/A N/A N/A - - 46000030 HC CAR SEAT/BED TEST 60 MIN 460 94780 51 N/A Both 73.00 N/A N/A N/A N/A - - 99000004 HC CASE CONFERENCE - MEDICAID 990 90887 51 N/A Both 73.00 N/A N/A N/A N/A - - 27100012 HC OXYGEN CONSERVING DEVICE 271 51 N/A Both 73.00 N/A N/A N/A N/A - - 30001110 HC STREP GROUP A ANTIGEN 300 87430 51 N/A Both 73.00 N/A N/A N/A N/A - - 94200004 HC TOBACCO CESSATION CONSULT 942 99406 51 N/A Both 73.00 N/A N/A N/A N/A - - 27000020 HC ADH SKIN STRL DERMABOND 270 51 N/A Both 74.00 N/A N/A N/A N/A - - 30000575 HC BEDSIDE SODIUM 300 84295 51 N/A Both 74.00 N/A N/A N/A N/A - - 30000576 HC BEDSIDE SODIUM 300 84295 51 N/A Both 74.00 N/A N/A N/A N/A - - 30000222 HC CALCIUM 24 HOUR URINE 300 82340 51 N/A Both 74.00 N/A N/A N/A N/A - - 30001109 HC E COLI SHIGA TOXINS STOOL 300 87427 51 N/A Both 74.00 N/A N/A N/A N/A - - 42000033 HC PT WRK HARD COND EA AD HR 420 97546 51 N/A Both 74.00 N/A N/A N/A N/A - - 91600018 HC DAY TX FAMILY CONFERENCE 30MIN 916 90847 51 N/A Both 75.00 N/A N/A N/A N/A - - 91600005 HC FAMILY CONFERENCE 30 MIN 916 90847 51 N/A Both 75.00 N/A N/A N/A N/A - - 91600009 HC IOP FAMILY CONFERENCE 30 MIN 916 90847 51 N/A Both 75.00 N/A N/A N/A N/A - - 30000283 HC CREATININE URINE RANDOM 300 82570 51 N/A Both 75.00 N/A N/A N/A N/A - - 30001051 HC BETA LACTAMASE 300 87185 51 N/A Both 76.00 N/A N/A N/A N/A - - 36000027 HC OR LEVEL 3 PER MINUTE 360 51 N/A Both 76.00 N/A N/A N/A N/A - - 30000184 HC AMYLASE 300 82150 51 N/A Both 77.00 N/A N/A N/A N/A - - 30000720 HC PROTHROMBIN TIME 300 85610 51 N/A Both 77.00 N/A N/A N/A N/A - - 30000342 HC GLUCOSE TOLERANCE/SPECI 300 82950 51 N/A Both 77.00 N/A N/A N/A N/A - - 91800020 HC ADAPT BEHAVIOR TX PHYS/QHP 918 97155 51 N/A Both 78.00 N/A N/A N/A N/A - - 91800018 HC ADAPTIVE BEHAVIOR TX BY TECH 918 97153 51 N/A Both 78.00 N/A N/A N/A N/A - - 91800016 HC BHV ID ASSMT BY PHYS/QHP 918 97151 51 N/A Both 78.00 N/A N/A N/A N/A - - 91800017 HC BHV ID SUPRT ASSMT BY 1 TECH 918 97152 51 N/A Both 78.00 N/A N/A N/A N/A - - 30001174 HC CELL CNT BODY FLD NOT BLD 300 89050 51 N/A Both 78.00 N/A N/A N/A N/A - - 30001177 HC CRYSTAL ID SYNOVIAL FLUID 300 89060 51 N/A Both 78.00 N/A N/A N/A N/A - - 91800021 HC FAM ADAPT BHV TX GDN PHY/QHP 918 97156 51 N/A Both 78.00 N/A N/A N/A N/A - - 91800023 HC GRP ADAPT BHV TX BY PHY/QHP 918 97158 51 N/A Both 78.00 N/A N/A N/A N/A - - 91800019 HC GRP ADAPT BHV TX BY TECH 918 97154 51 N/A Both 78.00 N/A N/A N/A N/A - - 91800022 HC MULT FAM ADAPT BHV TX GDN 918 97157 51 N/A Both 78.00 N/A N/A N/A N/A - - 99000007 HC OFFICE OUTPATIENT NEW 10 MIN 990 99201 51 N/A Both 78.00 N/A N/A N/A N/A - - 94200038 HC PUMP TRAIN UPGRADE ME PER HR 942 51 N/A Both 78.00 N/A N/A N/A N/A - - 30001031 HC SEROTYPING 300 87147 51 N/A Both 78.00 N/A N/A N/A N/A - - 30000113 HC UA AUTO WITH MICROSCOPY 300 81001 51 N/A Both 78.00 N/A N/A N/A N/A - - 36000029 HC OR LEVEL 4 PER MINUTE 360 51 N/A Both 79.00 N/A N/A N/A N/A - - 27000074 HC TRAY URINEMETER 18FR W/STATLOC 270 51 N/A Both 79.00 N/A N/A N/A N/A - - 27000066 HC TRAY URINEMETER W/STATLOC 270 51 N/A Both 79.00 N/A N/A N/A N/A - - 30001221 "HC ABO, PATIENT" 300 86900 51 N/A Both 80.00 N/A N/A N/A N/A - - 27100019 HC BILILIGHT SINGLE STRENGTH 271 51 N/A Both 80.00 N/A N/A N/A N/A - - 27400019 HC KNUCKLE BENDER 274 L3925 51 N/A Both 80.00 N/A N/A N/A N/A - - 30000087 HC OPIATES 300 80307 51 N/A Both 80.00 N/A N/A N/A N/A - - 30000975 HC RH (D) PATIENT 300 86901 51 N/A Both 80.00 N/A N/A N/A N/A - - 99000022 HC SBSQ HOSPITAL CARE DAY 15 MIN 990 99231 51 N/A Both 80.00 N/A N/A N/A N/A - - 46000021 HC DISABILITY DLCO 460 94729 51 N/A Both 81.00 N/A N/A N/A N/A - - 30000733 HC PARTIAL THROMBOPLASTIN PTT 300 85730 51 N/A Both 82.00 N/A N/A N/A N/A - - 30000708 HC HEPARIN NEUTRALIZATION 300 85525 51 N/A Both 82.00 N/A N/A N/A N/A - - 30000348 HC GGT 300 82977 51 N/A Both 82.00 N/A N/A N/A N/A - - 30001439 HC INFECTIOUS AGENT DETECTION BY DNA OR RNA NOS AMP PROBE EA ORGANISM 300 87798 51 N/A Both 82.00 N/A N/A N/A N/A - - 36000031 HC OR LEVEL 5 PER MINUTE 360 51 N/A Both 82.00 N/A N/A N/A N/A - - 36000095 HC PRE-SURG CARE - LIMITED 360 51 N/A Both 82.00 N/A N/A N/A N/A - - 30000527 HC TIMED 300 84105 51 N/A Both 82.00 N/A N/A N/A N/A - - 91800013 HC PSYCL/NRPSYC TECH 1ST 918 96138 51 N/A Both 83.00 N/A N/A N/A N/A - - 91800015 HC PSYCL/NRPSYC TST AUTO RESULT 918 96146 51 N/A Both 83.00 N/A N/A N/A N/A - - 91800011 HC PSYCL/NRPSYC TST PHY/QHP 1ST 918 96136 51 N/A Both 83.00 N/A N/A N/A N/A - - 91800012 HC PSYCL/NRPSYC TST PHY/QHP EA 918 96137 51 N/A Both 83.00 N/A N/A N/A N/A - - 91800014 HC PSYCL/NRPSYC TST TECH EA 918 96139 51 N/A Both 83.00 N/A N/A N/A N/A - - 27200011 HC STAPLER SURG 35W MULTIFIRE 272 51 N/A Both 83.00 N/A N/A N/A N/A - - 30000276 HC CREATINE PHOSPHOKINASE 300 82550 51 N/A Both 84.00 N/A N/A N/A N/A - - 32900278 HC INJ PX FOR CYSTOGRAPHY 329 51600 51 N/A Both 84.00 N/A N/A N/A N/A - - 76100047 HC MNT NON DM/NON RENAL 30M 761 99201 51 N/A Both 84.00 N/A N/A N/A N/A - - 36000033 HC OR LEVEL 6 PER MINUTE 360 51 N/A Both 84.00 N/A N/A N/A N/A - - 46000017 HC INCENTIVE SPIROMETRY TX 460 94799 51 N/A Both 85.00 N/A N/A N/A N/A - - 96900007 HC POST CORE MONTHS 10-12 WL 969 G9879 51 N/A Both 85.00 N/A N/A N/A N/A - - 96900006 HC POST CORE MONTHS 7-9 WL 969 G9878 51 N/A Both 85.00 N/A N/A N/A N/A - - 27000168 HC PULSED LAVAGE TIP KIT 270 51 N/A Both 85.00 N/A N/A N/A N/A - - 27000029 HC CATH GLAND BARTHOLIN 10FR X5CC 270 51 N/A Both 86.00 N/A N/A N/A N/A - - 76100058 HC CONSULT FOLLOW UP ROOM 761 51 N/A Both 86.00 N/A N/A N/A N/A - - 40300007 HC MAMMO SCREENING 3D VIEWS BIL 403 77063 51 N/A Both 87.00 N/A N/A N/A N/A - - 40300002 HC MAMMO SCREENING 3D VIEWS UNI 403 77063 51 N/A Both 87.00 N/A N/A N/A N/A - - 30000338 HC GLUCOSE URINE 300 82945 51 N/A Both 87.00 N/A N/A N/A N/A - - 30000474 HC MAGNESIUM SERUM 300 83735 51 N/A Both 87.00 N/A N/A N/A N/A - - 30000595 HC THYROXINE TOTAL 300 84436 51 N/A Both 87.00 N/A N/A N/A N/A - - 30001367 HC GLUCOSE BODY FLUID 300 82945 51 N/A Both 87.00 N/A N/A N/A N/A - - 30000472 HC MAGNESIUM FLUID 300 83735 51 N/A Both 87.00 N/A N/A N/A N/A - - 30000473 HC MAGNESIUM RANDOM URINE 300 83735 51 N/A Both 87.00 N/A N/A N/A N/A - - 30000475 HC MAGNESIUM URINE TIMED 300 83735 51 N/A Both 87.00 N/A N/A N/A N/A - - 41000065 HC NT SUCTIONING 410 31720 51 N/A Both 87.00 N/A N/A N/A N/A - - 27000144 HC COLLAR CHILD ASPEN 270 51 N/A Both 88.00 N/A N/A N/A N/A - - 27000061 HC INTRO CATH SHEATH 8FR 270 51 N/A Both 88.00 N/A N/A N/A N/A - - 30000729 HC THROMBIN TIME 300 85670 51 N/A Both 89.00 N/A N/A N/A N/A - - 76200001 HC OBSERVATION 762 G0378 51 N/A Both 89.00 N/A N/A N/A N/A - - 45000015 HC CLEAN EAR CANAL 450 51 N/A Both 89.00 N/A N/A N/A N/A - - 30001075 HC WET MOUNT 300 87210 51 N/A Both 89.00 N/A N/A N/A N/A - - 77100005 HC IMMUNIZATION ADMINISTRATION EA ADDL 771 90472 51 N/A Both 90.00 N/A N/A N/A N/A - - 30001318 HC CANDIDA DNA DIRECT PROBE 300 87480 51 N/A Both 90.00 N/A N/A N/A N/A - - 30001319 HC GARDNER VAG DNA DIRECT PROBE 300 87510 51 N/A Both 90.00 N/A N/A N/A N/A - - 30001320 HC TRICH VAG DNA DIRECT PROBE 300 87660 51 N/A Both 90.00 N/A N/A N/A N/A - - 30000366 HC HGB A1C 300 83036 51 N/A Both 92.00 N/A N/A N/A N/A - - 30000239 HC CHLORIDE URINE 300 82436 51 N/A Both 92.00 N/A N/A N/A N/A - - 30001176 HC LEUKOCYTES STOOL 300 89055 51 N/A Both 92.00 N/A N/A N/A N/A - - 30000818 HC MONONUCLEOSIS SCREEN 300 86308 51 N/A Both 92.00 N/A N/A N/A N/A - - 99000013 HC OFFICE OUTPATIENT VISIT 10 MIN 990 99212 51 N/A Both 92.00 N/A N/A N/A N/A - - 43000002 HC OT ELECTRICAL STIM UNATTENDED 430 G0283 51 N/A Both 92.00 N/A N/A N/A N/A - - 43000057 HC OT ORTH PROTH TX SUBSEQ E 15MN 430 97763 51 N/A Both 92.00 N/A N/A N/A N/A - - 43000023 HC OT ORTHO FIT TX INITL EA 15MN 430 97760 51 N/A Both 92.00 N/A N/A N/A N/A - - 43000024 HC OT PROSTH TX INITIAL EA 15 MIN 430 97761 51 N/A Both 92.00 N/A N/A N/A N/A - - 42000007 HC PT ELECTRICAL STIM UNATTENDED 420 G0283 51 N/A Both 92.00 N/A N/A N/A N/A - - 42000044 HC PT ORTH PROTH TX SUBSEQ E 15MN 420 97763 51 N/A Both 92.00 N/A N/A N/A N/A - - 42000041 HC PT ORTHO FIT TX INITL EA 15MN 420 97760 51 N/A Both 92.00 N/A N/A N/A N/A - - 42000042 HC PT PROSTH TX INITIAL EA 15MIN 420 97761 51 N/A Both 92.00 N/A N/A N/A N/A - - 30000662 HC RETICULOCYTE AUTOMATED 300 85046 51 N/A Both 92.00 N/A N/A N/A N/A - - 41000072 HC SB ASSIST BRRT 410 94799 51 N/A Both 92.00 N/A N/A N/A N/A - - 30000983 HC VOL REDUC OF BLD OR BLD PROD 300 86960 51 N/A Both 92.00 N/A N/A N/A N/A - - 30000224 HC CARBON DIOXIDE 300 82374 51 N/A Both 93.00 N/A N/A N/A N/A - - 30000973 "HC DAT,ANTI IGG" 300 86880 51 N/A Both 93.00 N/A N/A N/A N/A - - 30001328 "HC DAT,ANTI-C3B -C3D" 300 86880 51 N/A Both 93.00 N/A N/A N/A N/A - - 94200046 HC ONLINE DIGITAL EVALUATION AND MANAGEMENT SERVICE FOR AN ESTABLISHED PATIENT 21 OR MORE MINS 942 99423 51 N/A Both 93.00 N/A N/A N/A N/A - - 46000026 HC OXIMETRY CAPNOGRAPHY Q8 460 94761 51 N/A Both 93.00 N/A N/A N/A N/A - - 27400026 HC WRIST COCK-UP MOLDED 274 L3908 51 N/A Both 94.00 N/A N/A N/A N/A - - 30000549 HC TOTAL PROTEIN URINE 300 84156 51 N/A Both 95.00 N/A N/A N/A N/A - - 30000187 HC AMYLASE URINE RANDOM 300 82150 51 N/A Both 95.00 N/A N/A N/A N/A - - 30000188 HC AMYLASE URINE TIMED 300 82150 51 N/A Both 95.00 N/A N/A N/A N/A - - 30000719 HC BEDSIDE INR 300 85610 51 N/A Both 95.00 N/A N/A N/A N/A - - 30001364 HC CULTURE ANAL GC 300 87081 51 N/A Both 95.00 N/A N/A N/A N/A - - 30001362 HC CULTURE GENITAL GC 300 87081 51 N/A Both 95.00 N/A N/A N/A N/A - - 30001015 HC CULTURE SCREENING 300 87081 51 N/A Both 95.00 N/A N/A N/A N/A - - 30001363 HC CULTURE SCREENING GRP B 300 87081 51 N/A Both 95.00 N/A N/A N/A N/A - - 30001331 HC GRP A STREP CULTURE THROAT 300 87081 51 N/A Both 95.00 N/A N/A N/A N/A - - 36000035 HC OR LEVEL 7 PER MINUTE 360 51 N/A Both 96.00 N/A N/A N/A N/A - - 41000037 HC PEAK FLOW PRE & POST TREATMENT 410 94010 51 N/A Both 96.00 N/A N/A N/A N/A - - 27000014 HC SET DRAINAGE CHEST 270 51 N/A Both 96.00 N/A N/A N/A N/A - - 30001237 HC CREATININE URINE 300 82570 51 N/A Both 97.00 N/A N/A N/A N/A - - 30000008 HC ELECTROLYTE PANEL 300 80051 51 N/A Both 97.00 N/A N/A N/A N/A - - 30000645 HC PCO2 BY ELECTRODE 300 84999 51 N/A Both 97.00 N/A N/A N/A N/A - - 30001067 HC MYCOBACTERIUM STAIN 300 87206 51 N/A Both 98.00 N/A N/A N/A N/A - - 27000146 HC TUBE LINE EXT 270 51 N/A Both 98.00 N/A N/A N/A N/A - - 76900001 HC IC ROOM & BOARD RES 769 51 N/A Both 100.00 N/A N/A N/A N/A - - 36000037 HC OR LEVEL 8 PER MINUTE 360 51 N/A Both 100.00 N/A N/A N/A N/A - - 30000328 HC PH BLOOD 300 82800 51 N/A Both 100.00 N/A N/A N/A N/A - - 99000005 HC PSYCHOLGIST CASE CONF-MEDICAID 990 90887 51 N/A Both 100.00 N/A N/A N/A N/A - - 27400025 HC WRIST & THUMB SPICA 274 L3808 51 N/A Both 100.00 N/A N/A N/A N/A - - 96900010 HC 2 ONGOING MS MO 13-15 WL 969 G9882 51 N/A Both 102.00 N/A N/A N/A N/A - - 96900011 HC 2 ONGOING MS MO 16-18 WL 969 G9883 51 N/A Both 102.00 N/A N/A N/A N/A - - 96900012 HC 2 ONGOING MS MO 19-21 WL 969 G9884 51 N/A Both 102.00 N/A N/A N/A N/A - - 96900013 HC 2 ONGOING MS MO 22-24 WL 969 G9885 51 N/A Both 102.00 N/A N/A N/A N/A - - 30001069 HC GIEMSA STAIN 300 87207 51 N/A Both 102.00 N/A N/A N/A N/A - - 27000081 HC KIT LAVAGE GASTRIC SOL BAG 270 51 N/A Both 102.00 N/A N/A N/A N/A - - 36000039 HC OR LEVEL 9 PER MINUTE 360 51 N/A Both 102.00 N/A N/A N/A N/A - - 76200002 HC PROGRESSIVE OBSERVATION 762 G0378 51 N/A Both 102.00 N/A N/A N/A N/A - - 77100004 HC ADMINISTRATION FEE -- HEPATITIS B 771 90471 51 N/A Both 103.00 N/A N/A N/A N/A - - 77100001 HC ADMINISTRATION FEE -- INFLUENZA 771 90471 51 N/A Both 103.00 N/A N/A N/A N/A - - 77100002 HC ADMINISTRATION FEE -- PNEUMOCOCCAL 771 90471 51 N/A Both 103.00 N/A N/A N/A N/A - - 77100003 HC VACCINE ADMINISTRATION 771 90471 51 N/A Both 103.00 N/A N/A N/A N/A - - 30000466 HC LIPASE 300 83690 51 N/A Both 103.00 N/A N/A N/A N/A - - 91500019 HC DAY TX GROUP THERAPY 90 MIN-PARTIAL CARE 915 90853 51 N/A Both 105.00 N/A N/A N/A N/A - - 91500021 HC DAY TX LECTURE INTERACTIVE GRP-PARTIAL CARE 915 90853 51 N/A Both 105.00 N/A N/A N/A N/A - - 91500017 HC GROUP THERAPY 90 MIN 915 90853 51 N/A Both 105.00 N/A N/A N/A N/A - - 91500020 HC IOP GROUP THERAPY 90 MIN 915 90853 51 N/A Both 105.00 N/A N/A N/A N/A - - 91500022 HC IOP LECTURE INTERACTIVE GRP 915 90853 51 N/A Both 105.00 N/A N/A N/A N/A - - 91500018 HC LECTURE INTERACTIVE GROUP 915 90853 51 N/A Both 105.00 N/A N/A N/A N/A - - 96900001 HC 1ST CORE SESSION 969 G9873 51 N/A Both 105.00 N/A N/A N/A N/A - - 91400045 HC ASSURITY PSYCH IND TH 16-37 914 90832 51 N/A Both 105.00 N/A N/A N/A N/A - - 91400046 HC ASSURITY PSYCH IND TH 38-52 914 90834 51 N/A Both 105.00 N/A N/A N/A N/A - - 91400047 HC ASSURITY PSYCH IND TH 53+ 914 90837 51 N/A Both 105.00 N/A N/A N/A N/A - - 91400005 HC ASSURITY SW IND THERAPY 16-37 914 90832 51 N/A Both 105.00 N/A N/A N/A N/A - - 91400033 HC ASSURITY SW IND THERAPY 38-52 914 90834 51 N/A Both 105.00 N/A N/A N/A N/A - - 91400034 HC ASSURITY SW IND THERAPY 53+ 914 90837 51 N/A Both 105.00 N/A N/A N/A N/A - - 94200041 HC PUMP UPGRADE FROM AN ANIMAS 942 51 N/A Both 105.00 N/A N/A N/A N/A - - 51000027 HC CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT 510 95249 51 N/A Both 106.00 N/A N/A N/A N/A - - 27400024 HC ULNAR GUTTER 274 L3906 51 N/A Both 106.00 N/A N/A N/A N/A - - 76100036 HC OFFICE OUTPATIENT VISIT LEVEL 1 761 99211 51 N/A Both 107.00 N/A N/A N/A N/A - - 39000006 HC CRYOPRECIPITATE SINGLE UNIT 390 P9012 51 N/A Both 107.00 N/A N/A N/A N/A - - 76100012 HC DEVELOPMENTAL CLINIC 761 96110 51 N/A Both 107.00 N/A N/A N/A N/A - - 76100070 HC OP TREATMENT ROOM ASTHMA 510 G0463 51 N/A Both 107.00 N/A N/A N/A N/A - - 46000025 HC RESPIRATORY PARAMETERS 460 94150 51 N/A Both 107.00 N/A N/A N/A N/A - - 30001476 HC SARS-COV-2 TOTAL AB 300 86769 51 N/A Both 107.00 N/A N/A N/A N/A - - 76100031 HC TREATMENT ROOM - LEVEL 1 761 99201 51 N/A Both 107.00 N/A N/A N/A N/A - - 76100018 HC TX RM IV THER CONCUR INF 260 96368 51 N/A Both 109.00 N/A N/A N/A N/A - - 43000008 HC OT ULTRASOUND EA 15 MIN 430 97035 51 N/A Both 109.00 N/A N/A N/A N/A - - 42000017 HC PT ULTRASOUND EA 15 MIN 420 97035 51 N/A Both 109.00 N/A N/A N/A N/A - - 27000152 HC SPLINT OCL ARM LONG 270 51 N/A Both 109.00 N/A N/A N/A N/A - - 27400047 HC CERVICAL COLLAR - ASPEN 274 L0172 51 N/A Both 110.00 N/A N/A N/A N/A - - 30000993 HC CULTURE STOOL SALM/SHIGELLA 300 87045 51 N/A Both 110.00 N/A N/A N/A N/A - - 30000699 HC FIBRINOGEN LEV QUANT CLOT 300 85384 51 N/A Both 110.00 N/A N/A N/A N/A - - 44400007 HC SLP EVAL AUG DEVICE EA ADD 30 444 92608 51 N/A Both 110.00 N/A N/A N/A N/A - - 27000063 HC TRAY CATH 16FR X 5CC W/STATLOC 270 51 N/A Both 110.00 N/A N/A N/A N/A - - 30000601 HC TSH TRIG FRM NEONATAL SCREEN 300 84443 51 N/A Both 110.00 N/A N/A N/A N/A - - 30000969 HC ANTIBODY SCREEN 300 86850 51 N/A Both 111.00 N/A N/A N/A N/A - - 30001327 HC ANTIBODY SCREEN ADDITIONAL 300 86850 51 N/A Both 111.00 N/A N/A N/A N/A - - 43000003 HC OT PARAFFIN BATH 430 97018 51 N/A Both 111.00 N/A N/A N/A N/A - - 30001047 HC OVA AND PARASITES SMEARS 300 87177 51 N/A Both 111.00 N/A N/A N/A N/A - - 42000009 HC PT PARAFFIN BATH 420 97018 51 N/A Both 111.00 N/A N/A N/A N/A - - 30000220 HC BEDSIDE CA IONIZED 300 82330 51 N/A Both 112.00 N/A N/A N/A N/A - - 42000001 HC PT BIOFEEDBACK ANY MODALITY 420 90901 51 N/A Both 112.00 N/A N/A N/A N/A - - 27000079 HC SET DRAINAGE CHEST ADULT PEDI 270 51 N/A Both 112.00 N/A N/A N/A N/A - - 27400022 HC RESTING HAND SPLINT-NOT P 274 L3808 51 N/A Both 113.00 N/A N/A N/A N/A - - 45000271 HC APPLY FINGER SPLINT DYNAMIC 450 29131 51 N/A Both 114.00 N/A N/A N/A N/A - - 45000270 HC APPLY FINGER SPLINT STATIC 450 29130 51 N/A Both 114.00 N/A N/A N/A N/A - - 45000031 HC TRIM NONDYSTROPHIC NAILS ANY NUMBER 450 11719 51 N/A Both 114.00 N/A N/A N/A N/A - - 30001456 HC M. GENITALIUM AMP PROBE 300 87563 51 N/A Both 114.00 N/A N/A N/A N/A - - 30001457 HC M. GENITALIUM AMP PROBE 300 87563 51 N/A Both 114.00 N/A N/A N/A N/A - - 45000282 HC STRAPPING OF TOES 450 29550 51 N/A Both 114.00 N/A N/A N/A N/A - - 27000059 HC TRAY CATH PERC 8FR STRL 270 51 N/A Both 114.00 N/A N/A N/A N/A - - 27000058 HC TRAY CATH PERC ART 6FR 270 51 N/A Both 114.00 N/A N/A N/A N/A - - 91400027 HC DAY TX IND THERAPY 45(38-52) 914 90834 51 N/A Both 115.00 N/A N/A N/A N/A - - 91400026 HC IOP IND THERAPY 45(38-52)MIN 914 90834 51 N/A Both 115.00 N/A N/A N/A N/A - - 27200003 HC CATH CVC TRIPLE LUMEN 7FR MAC 272 51 N/A Both 115.00 N/A N/A N/A N/A - - 46000019 HC DISABILITY PULM BRONCH RESPONS 460 94060 51 N/A Both 115.00 N/A N/A N/A N/A - - 76100094 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT 450 69210 51 N/A Both 115.00 N/A N/A N/A N/A - - 76100093 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT 761 69209 51 N/A Both 115.00 N/A N/A N/A N/A - - 91600006 HC CJ FAMILY CONFERENCE 60 MIN 916 90847 51 N/A Both 117.00 N/A N/A N/A N/A - - 91400018 HC CJ IND THERAPY 30(16-37)MIN 914 90832 51 N/A Both 117.00 N/A N/A N/A N/A - - 91400024 HC CJ IND THERAPY 45(38-52)MIN 914 90834 51 N/A Both 117.00 N/A N/A N/A N/A - - 30000998 HC CULTURE EAR 300 87070 51 N/A Both 118.00 N/A N/A N/A N/A - - 30001076 HC FUNGUS DIRECT KOH 300 87220 51 N/A Both 118.00 N/A N/A N/A N/A - - 92100013 HC INTERROGATION - LOOP RECORDER 921 93291 51 N/A Both 118.00 N/A N/A N/A N/A - - 92100012 HC INTERROGATION ICM 921 93290 51 N/A Both 118.00 N/A N/A N/A N/A - - 92100010 HC INTERROGATION PACER 921 93288 51 N/A Both 118.00 N/A N/A N/A N/A - - 46000011 HC OXIMETRY SINGLE DETERMINATION 460 94760 51 N/A Both 118.00 N/A N/A N/A N/A - - 92100002 HC PROGRAMMING PACER - 1 LEAD 921 93279 51 N/A Both 118.00 N/A N/A N/A N/A - - 92100003 HC PROGRAMMING PACER - 2 LEADS 921 93280 51 N/A Both 118.00 N/A N/A N/A N/A - - 92100004 HC PROGRAMMING PACER - 3+ LEADS 921 93281 51 N/A Both 118.00 N/A N/A N/A N/A - - 41000021 HC SURFACTANT ADMIN ASSIST 410 94799 51 N/A Both 118.00 N/A N/A N/A N/A - - 91400008 HC ALCOHL/DRUG ASSESS15-30MINS BC 914 G0396 51 N/A Both 119.00 N/A N/A N/A N/A - - 30001233 HC CBC WO PLT OR AUTO DIFF 300 G0307 51 N/A Both 119.00 N/A N/A N/A N/A - - 35000026 HC CT HEART COR CALC RESEARCH 350 75571 51 N/A Both 119.00 N/A N/A N/A N/A - - 35000006 HC CT HEART W/O CONT CALC SCORE 350 75571 51 N/A Both 119.00 N/A N/A N/A N/A - - 30001070 HC GMS FUNGAL STAIN 300 87207 51 N/A Both 119.00 N/A N/A N/A N/A - - 30001106 HC INFLUENZA A OR B EACH 300 87400 51 N/A Both 119.00 N/A N/A N/A N/A - - 43000011 HC OT AQUA THER EXER EA 15M 430 97113 51 N/A Both 119.00 N/A N/A N/A N/A - - 43000014 HC OT THERAPEUTIC PROCEDURE GROUP 430 97150 51 N/A Both 119.00 N/A N/A N/A N/A - - 99500001 HC PARENTING ROOM 995 51 N/A Both 119.00 N/A N/A N/A N/A - - 42000020 HC PT AQUA THER EXER EA 15M 420 97113 51 N/A Both 119.00 N/A N/A N/A N/A - - 42000070 HC PT THERAPEUTIC PROCEDURE GROUP 420 97150 51 N/A Both 119.00 N/A N/A N/A N/A - - 27200013 HC TRAY CATH TEMP SENSOR URINMTER 272 51 N/A Both 119.00 N/A N/A N/A N/A - - 30000455 HC LACTATE 300 83605 51 N/A Both 120.00 N/A N/A N/A N/A - - 90000002 HC INTERVENTION CONSULT 900 90791 51 N/A Both 120.00 N/A N/A N/A N/A - - 27100020 HC BILILIGHT DOUBLE STRENGTH 271 51 N/A Both 120.00 N/A N/A N/A N/A - - 30000995 HC CULTURE AEROBIC 300 87070 51 N/A Both 120.00 N/A N/A N/A N/A - - 27100018 HC ISOLETTE 271 51 N/A Both 120.00 N/A N/A N/A N/A - - 75000002 HC PLACE FIDUCIAL MARKERS 750 31626 51 N/A Both 120.00 N/A N/A N/A N/A - - 30001074 HC SMEAR SPECIAL STAINS TRICHROME 300 87209 51 N/A Both 120.00 N/A N/A N/A N/A - - 30001072 HC SPECIAL STAIN 300 87207 51 N/A Both 120.00 N/A N/A N/A N/A - - 27000046 HC KIT CATH CENT VENOUS PEDI 4FR 270 51 N/A Both 121.00 N/A N/A N/A N/A - - 42000003 HC PT CANALITH REPOSITIONING PROC 420 95992 51 N/A Both 122.00 N/A N/A N/A N/A - - 42000081 HC PT CANALITH REPOSITIONING PROC 420 95992 51 N/A Both 122.00 N/A N/A N/A N/A - - 45000037 HC RESUPERF WND BODY <2.5CM 450 12001 51 N/A Both 122.00 N/A N/A N/A N/A - - 32900281 HC INJ HYSTEROSALPINGOGRAPHY 329 58340 51 N/A Both 123.00 N/A N/A N/A N/A - - 91400020 HC MCD INPT IND PSYCH 30 MIN 914 90832 51 N/A Both 124.00 N/A N/A N/A N/A - - 76100001 HC DEBRIDEMENT OF NAIL 1-5 761 11720 51 N/A Both 125.00 N/A N/A N/A N/A - - 45000023 HC OCL LONG LEG BONE SPLINT 450 29505 51 N/A Both 125.00 N/A N/A N/A N/A - - 30001470 HC SARS-COV-2 BY PCR 300 87635 51 N/A Both 125.00 N/A N/A N/A N/A - - 96900002 HC ATTENDANCE CLASS 4TH CORE SESSION 969 G9874 51 N/A Both 125.00 N/A N/A N/A N/A - - 30001472 HC COVID-19 BRYAN 300 87635 51 N/A Both 125.00 N/A N/A N/A N/A - - 71000005 HC ECT RECOVERY 710 51 N/A Both 125.00 N/A N/A N/A N/A - - 41000040 HC INCENTIVE BREATHING 410 94640 51 N/A Both 125.00 N/A N/A N/A N/A - - 45000027 HC TREAT MAJOR JOINT DISLOCATION 450 51 N/A Both 125.00 N/A N/A N/A N/A - - 30001017 HC CULTURE URINE QUANT COLONY CNT 300 87086 51 N/A Both 126.00 N/A N/A N/A N/A - - 30001458 HC HIT ANTIBODY (PF4-H) 300 86022 51 N/A Both 127.00 N/A N/A N/A N/A - - 42000021 HC PT GAIT TRAINING EA 15 MIN 420 97116 51 N/A Both 127.00 N/A N/A N/A N/A - - 27000154 HC SPLINT OCL LEG LONG 270 51 N/A Both 127.00 N/A N/A N/A N/A - - 99000014 HC OFFICE OUTPATIENT VISIT 15 MIN 990 99213 51 N/A Both 128.00 N/A N/A N/A N/A - - 30001006 HC CULTURE ANAEROBIC 300 87075 51 N/A Both 129.00 N/A N/A N/A N/A - - 32900035 HC INJ PX FOR TEMPOROMAN 329 21116 51 N/A Both 129.00 N/A N/A N/A N/A - - 27000145 HC COLLAR ADULT ASPEN 270 51 N/A Both 130.00 N/A N/A N/A N/A - - 91400022 HC IND THERAPY 30 (16-37) MIN 914 90832 51 N/A Both 130.00 N/A N/A N/A N/A - - 91400038 HC IND THERAPY PSYCH 30MIN 914 90832 51 N/A Both 130.00 N/A N/A N/A N/A - - 91400021 HC INDIVIDUAL TELEHEALTH PSYCH 30 914 90832 51 N/A Both 130.00 N/A N/A N/A N/A - - 39000003 HC IRRAD OF BLOOD PRODUCT EA UNIT 390 86945 51 N/A Both 130.00 N/A N/A N/A N/A - - 27000150 HC SET IV PUMP SOLUSET 270 51 N/A Both 130.00 N/A N/A N/A N/A - - 30001238 HC ACT HIGH 300 85347 51 N/A Both 131.00 N/A N/A N/A N/A - - 30000996 HC CULTURE CATH TIP 300 87070 51 N/A Both 131.00 N/A N/A N/A N/A - - 30001000 HC CULTURE EYE 300 87070 51 N/A Both 131.00 N/A N/A N/A N/A - - 30001001 HC CULTURE GENITAL 300 87070 51 N/A Both 131.00 N/A N/A N/A N/A - - 30001003 HC CULTURE NASOPHARYNGEAL 300 87070 51 N/A Both 131.00 N/A N/A N/A N/A - - 30001004 HC CULTURE THROAT 300 87070 51 N/A Both 131.00 N/A N/A N/A N/A - - 30001005 HC CULTURE WOUND SUPERFICIAL 300 87070 51 N/A Both 131.00 N/A N/A N/A N/A - - 30000700 HC FIBRINOLYSIS 300 85390 51 N/A Both 131.00 N/A N/A N/A N/A - - 43000019 HC OT COMM WRK REINTEG-15M 430 97537 51 N/A Both 131.00 N/A N/A N/A N/A - - 43000013 HC OT MANUAL THERAPY EA 15M 430 97140 51 N/A Both 131.00 N/A N/A N/A N/A - - 42000030 HC PT COMM WRK REINTEG-15M 420 97537 51 N/A Both 131.00 N/A N/A N/A N/A - - 42000023 HC PT MANUAL THERAPY EA 15M 420 97140 51 N/A Both 131.00 N/A N/A N/A N/A - - 44000011 HC SLP COMM WRK REINTEG-15M 440 97537 51 N/A Both 131.00 N/A N/A N/A N/A - - 41000007 HC AEROSOL THERAPY 410 94640 51 N/A Both 132.00 N/A N/A N/A N/A - - 41000038 HC AEROSOL TREATMENT 410 94640 51 N/A Both 132.00 N/A N/A N/A N/A - - 91500024 HC OP GROUP THERAPY PSYCH 915 90853 51 N/A Both 132.00 N/A N/A N/A N/A - - 91500023 HC OP GROUP THERAPY SW 915 90853 51 N/A Both 132.00 N/A N/A N/A N/A - - 27200012 HC TRAY CATH TEMP SENSOR DUAL 272 51 N/A Both 132.00 N/A N/A N/A N/A - - 27200017 HC ENDOTRACHEAL TUBES 272 51 N/A Both 134.00 N/A N/A N/A N/A - - 41000052 HC EZ-PAP 410 94667 51 N/A Both 134.00 N/A N/A N/A N/A - - 30001013 HC ID BACTERIAL 300 87077 51 N/A Both 134.00 N/A N/A N/A N/A - - 76100002 HC DEBRIDEMENT OF NAIL >5 761 11721 51 N/A Both 135.00 N/A N/A N/A N/A - - 91600019 HC DAY TX FAMILY CONFERENCE 60MIN 916 90847 51 N/A Both 135.00 N/A N/A N/A N/A - - 91600007 HC FAMILY CONFERENCE 60 MIN 916 90847 51 N/A Both 135.00 N/A N/A N/A N/A - - 91600017 HC IOP FAMILY CONFERENCE 60 MIN 916 90847 51 N/A Both 135.00 N/A N/A N/A N/A - - 30001032 HC CULT DNA/RNA PROBE PER ISOLATE 300 87149 51 N/A Both 135.00 N/A N/A N/A N/A - - 30001034 HC EACH RESISTANCE MARKER 300 87149 51 N/A Both 135.00 N/A N/A N/A N/A - - 30001036 HC ID OF EACH ORGANISM 300 87149 51 N/A Both 135.00 N/A N/A N/A N/A - - 42000006 HC PT TRACTION MECHANICAL 420 97012 51 N/A Both 135.00 N/A N/A N/A N/A - - 30001322 HC TRICYCLIC SCREEN 300 80307 51 N/A Both 135.00 N/A N/A N/A N/A - - 76100016 HC TX RM IV ADL HR SAME DRG 260 96366 51 N/A Both 136.00 N/A N/A N/A N/A - - 76100046 HC TX RM IV THER ADL HR HYD 260 96361 51 N/A Both 136.00 N/A N/A N/A N/A - - 76100017 HC TX RM IV THER ADL INFUS 260 96367 51 N/A Both 136.00 N/A N/A N/A N/A - - 43000018 HC OT SELF CARE MANAGEMENT EA 15M 430 97535 51 N/A Both 136.00 N/A N/A N/A N/A - - 43000020 HC OT WHELCHAIR MGMT TRN 15M 430 97542 51 N/A Both 136.00 N/A N/A N/A N/A - - 42000029 HC PT SELF CARE MANAGEMENT EA 15M 420 97535 51 N/A Both 136.00 N/A N/A N/A N/A - - 42000008 HC PT VASOPNEUMATIC DEVICE APPL 420 97016 51 N/A Both 136.00 N/A N/A N/A N/A - - 42000031 HC PT WHEELCHAIR MGMT TRN 15M 420 97542 51 N/A Both 136.00 N/A N/A N/A N/A - - 30001483 "HC SARS-COV-2 ANTIGEN, RAPID" 300 87426 51 N/A Both 136.00 N/A N/A N/A N/A - - 76100024 HC TX RM CHEMO INJ-HORMONAL 331 96402 51 N/A Both 138.00 N/A N/A N/A N/A - - 48000061 HC CR CONSULT THERAPY 943 93797 51 N/A Both 138.00 N/A N/A N/A N/A - - 92000002 HC ARTERIAL PHLEBOTOMY 920 36600 51 N/A Both 139.00 N/A N/A N/A N/A - - 27100021 HC BILILIGHT TRIPLE STRENGTH 271 51 N/A Both 140.00 N/A N/A N/A N/A - - 27000167 HC PULSED LAVAGE IRRIGATOR KIT 270 51 N/A Both 140.00 N/A N/A N/A N/A - - 99000023 HC SBSQ HOSPITAL CARE DAY 25 MIN 990 99232 51 N/A Both 140.00 N/A N/A N/A N/A - - 41000051 HC OSCILLATORY PEP MIE 410 94667 51 N/A Both 142.00 N/A N/A N/A N/A - - 43000009 HC OT THERAPEUTIC EX EA 15M 430 97110 51 N/A Both 142.00 N/A N/A N/A N/A - - 42000018 HC PT THERAPEUTIC EX EA 15M 420 97110 51 N/A Both 142.00 N/A N/A N/A N/A - - 76100059 HC ENURESIS FOLLOWUP 761 99211 51 N/A Both 143.00 N/A N/A N/A N/A - - 30001054 HC MIC MIN INHIBITORY CONCEN 300 87186 51 N/A Both 143.00 N/A N/A N/A N/A - - 90400001 HC ACTIVITY THERAPY GROUP 904 G0176 51 N/A Both 144.00 N/A N/A N/A N/A - - 94200008 HC COPING SKILLS GROUP 942 G0177 51 N/A Both 144.00 N/A N/A N/A N/A - - 94200009 HC COPING WITH LOSS GROUP 942 G0177 51 N/A Both 144.00 N/A N/A N/A N/A - - 30000024 HC DIGOXIN 300 80162 51 N/A Both 144.00 N/A N/A N/A N/A - - 44000047 HC DYSPHAGIA TRMT 15 440 92526 51 N/A Both 144.00 N/A N/A N/A N/A - - 94200010 HC GOALS & PLANNING GROUP 942 G0177 51 N/A Both 144.00 N/A N/A N/A N/A - - 91500025 HC GROUP THERAPY - 45 MIN 915 90853 51 N/A Both 144.00 N/A N/A N/A N/A - - 94200011 HC MEDICATION TEACHING 942 G0177 51 N/A Both 144.00 N/A N/A N/A N/A - - 94200014 HC NUTRITION EDUCATION 942 97804 51 N/A Both 144.00 N/A N/A N/A N/A - - 76100068 HC PICC TEAM IV PLACEMENT 761 36410 51 N/A Both 144.00 N/A N/A N/A N/A - - 44000038 HC SLP TRMT 15 440 92507 51 N/A Both 144.00 N/A N/A N/A N/A - - 94200012 HC STRESS MANAGEMENT GROUP 942 G0177 51 N/A Both 144.00 N/A N/A N/A N/A - - 96900003 HC ATTENDANCE CLASS 9 CORE SESSION 969 G9875 51 N/A Both 145.00 N/A N/A N/A N/A - - 30001014 HC BACILLUS ANTHRACIS SCREEN 300 87081 51 N/A Both 145.00 N/A N/A N/A N/A - - 43000007 HC OT CONTRAST BATH EA 15M 430 97034 51 N/A Both 145.00 N/A N/A N/A N/A - - 43000015 HC OT THER FUNCT ACT EA 15M 430 97530 51 N/A Both 145.00 N/A N/A N/A N/A - - 42000040 HC PT PHYSICAL PERFORMANCE TEST 420 97750 51 N/A Both 145.00 N/A N/A N/A N/A - - 42000026 HC PT THER FUNCT ACT EA 15M 420 97530 51 N/A Both 145.00 N/A N/A N/A N/A - - 32000005 HC EYE FOREIGN BODY 320 70030 51 N/A Both 147.00 N/A N/A N/A N/A - - 30000613 HC TRIIODOTHYRONINE T3 FREE 300 84481 51 N/A Both 147.00 N/A N/A N/A N/A - - 44000045 HC SLP GROUP TRMT 440 92508 51 N/A Both 147.00 N/A N/A N/A N/A - - 27000083 HC ARM IMMOBILIZER 270 51 N/A Both 148.00 N/A N/A N/A N/A - - 30001084 HC CRYPTOSPORIDIUM AG DFA STOOL 300 87272 51 N/A Both 148.00 N/A N/A N/A N/A - - 30001097 HC GIARDIA AG DFA STOOL 300 87329 51 N/A Both 148.00 N/A N/A N/A N/A - - 43000005 HC OT ELEC STIM ATTND EA 15M 430 97032 51 N/A Both 148.00 N/A N/A N/A N/A - - 42000014 HC PT ELEC STIM ATTND EA 15M 420 97032 51 N/A Both 148.00 N/A N/A N/A N/A - - 42000032 HC PT WRK HARD COND INIT 2HR 420 97545 51 N/A Both 148.00 N/A N/A N/A N/A - - 30000658 HC CBC WITHOUT AUTO DIFF 300 85027 51 N/A Both 150.00 N/A N/A N/A N/A - - 30001021 HC IDENTIFICATION FUNGAL YEAST 300 87106 51 N/A Both 150.00 N/A N/A N/A N/A - - 27000165 HC CONT PASSIVE MOTION DAILY 270 51 N/A Both 151.00 N/A N/A N/A N/A - - 30000368 HC METHEMOGLOBIN QUANT 300 83050 51 N/A Both 152.00 N/A N/A N/A N/A - - 42400013 HC PT RE-EVAL 424 97164 51 N/A Both 152.00 N/A N/A N/A N/A - - 27400023 HC RESTING HAND SPLINT-PREFO 274 L3808 51 N/A Both 152.00 N/A N/A N/A N/A - - 27000022 HC HEMOSTAT SURGICEL SM 2X3 270 51 N/A Both 153.00 N/A N/A N/A N/A - - 30001175 HC CSF CELL CT & ID 300 89051 51 N/A Both 154.00 N/A N/A N/A N/A - - 30001365 HC FLUID CELL CT & ID 300 89051 51 N/A Both 154.00 N/A N/A N/A N/A - - 30000014 HC HEPATIC FUNCTION PANEL 300 80076 51 N/A Both 154.00 N/A N/A N/A N/A - - 30000506 HC OSMOLALITY BLOOD 300 83930 51 N/A Both 154.00 N/A N/A N/A N/A - - 30000643 HC OSMOLALITY FLUID 300 84999 51 N/A Both 154.00 N/A N/A N/A N/A - - 30000507 HC OSMOLALITY URINE 300 83935 51 N/A Both 154.00 N/A N/A N/A N/A - - 30001366 HC SYNOVIAL FLUID CELL CT & ID 300 89051 51 N/A Both 154.00 N/A N/A N/A N/A - - 76100071 HC BLOOD DRAW FROM COMPLETELY IMPLANTABLE DEVICE OR A FISTULA DEVICE 761 36591 51 N/A Both 156.00 N/A N/A N/A N/A - - 30000544 HC PROSTATE SPECIFIC ANTIGN TOTAL 300 84153 51 N/A Both 156.00 N/A N/A N/A N/A - - 30000006 HC BASIC METABOLIC PANEL 300 80048 51 N/A Both 156.00 N/A N/A N/A N/A - - 30000005 HC BEDSIDE BMP WITH IONIZED CALC 300 80047 51 N/A Both 156.00 N/A N/A N/A N/A - - 30000657 HC CBC W/AUTO DIFF 300 85025 51 N/A Both 156.00 N/A N/A N/A N/A - - 73000002 HC ECG RHYTHM STRIP 730 93041 51 N/A Both 156.00 N/A N/A N/A N/A - - 30000033 HC LITHIUM SERUM 300 80178 51 N/A Both 156.00 N/A N/A N/A N/A - - 30000543 HC PROLACTIN 300 84146 51 N/A Both 156.00 N/A N/A N/A N/A - - 45000038 HC RESUP NPTERF WND BODY 2.6-7.5CM 450 12002 51 N/A Both 156.00 N/A N/A N/A N/A - - 76100146 HC CATHERIZATION UMBILICAL VEIN 761 36510 51 N/A Both 157.00 N/A N/A N/A N/A - - 76100106 HC DRAIN BLOOD FROM UNDER NAIL 761 11740 51 N/A Both 157.00 N/A N/A N/A N/A - - 30000639 HC HCG QUAL SERUM PREG 300 84703 51 N/A Both 157.00 N/A N/A N/A N/A - - 30000638 HC HCG TOTAL 300 84702 51 N/A Both 157.00 N/A N/A N/A N/A - - 30001028 HC IDENT MYCOBACT BIOCHEM 300 87118 51 N/A Both 157.00 N/A N/A N/A N/A - - 30001022 HC IDENTIFICATION FUNGAL MOLD 300 87107 51 N/A Both 157.00 N/A N/A N/A N/A - - 91400019 HC INDIVIDUAL TELEHEALTH SW 30 914 90832 51 N/A Both 157.00 N/A N/A N/A N/A - - 45000339 HC MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS 450 99157 51 N/A Both 157.00 N/A N/A N/A N/A - - 30000539 HC PREALBUMIN 300 84134 51 N/A Both 157.00 N/A N/A N/A N/A - - 99000008 HC OFFICE OUTPATIENT NEW 20 MIN 990 99202 51 N/A Both 158.00 N/A N/A N/A N/A - - 30000011 HC LIPID PANEL 300 80061 51 N/A Both 160.00 N/A N/A N/A N/A - - 99000037 HC ADJUSTMENT OF GASTRIC BAND 990 S2083 51 N/A Both 160.00 N/A N/A N/A N/A - - 91400044 HC ASSURITY PSYCH DX INT EXAM 914 90791 51 N/A Both 160.00 N/A N/A N/A N/A - - 91400004 HC ASSURITY SW DX INTERVIEW EXAM 914 90791 51 N/A Both 160.00 N/A N/A N/A N/A - - 27000227 HC NEO/PED INTRODUCER FOR PICC 270 C1894 51 N/A Both 160.00 N/A N/A N/A N/A - - 27400041 HC SHOULDER IMMOBILIZER 274 L3670 51 N/A Both 160.00 N/A N/A N/A N/A - - 44000060 HC ST SPEECH THERAPY RE-EVAL 440 S9152 51 N/A Both 160.00 N/A N/A N/A N/A - - 76100019 HC TX RM INJECT NON CHEMO 260 96372 51 N/A Both 161.00 N/A N/A N/A N/A - - 30000351 HC GONADOTROPIN FOLL STIM HORMONE 300 83001 51 N/A Both 161.00 N/A N/A N/A N/A - - 30000352 HC GONADOTROPIN LUTEINIZING HORM 300 83002 51 N/A Both 161.00 N/A N/A N/A N/A - - 92100015 HC DETERMINE VENOUS PRESSURE 921 93770 51 N/A Both 161.00 N/A N/A N/A N/A - - 32900343 HC INJ CONTRAST DACRYOCYSTOGRAPHY 761 68850 51 N/A Both 161.00 N/A N/A N/A N/A - - 32900273 HC INJECTION ILEAL CONDUIT 761 50690 51 N/A Both 161.00 N/A N/A N/A N/A - - 43400015 HC OT RE-EVAL 434 97168 51 N/A Both 161.00 N/A N/A N/A N/A - - 30000722 HC PT SUBSTITUTIONS 300 85611 51 N/A Both 161.00 N/A N/A N/A N/A - - 27000077 HC KIT THORACENTESIS CATH 8FR 270 51 N/A Both 163.00 N/A N/A N/A N/A - - 30000541 HC PROGESTERONE 300 84144 51 N/A Both 163.00 N/A N/A N/A N/A - - 27200007 HC KIT SHOWER SPRAY PULSAVAC 272 51 N/A Both 164.00 N/A N/A N/A N/A - - 32000018 HC SELLA TURCICA 320 70240 51 N/A Both 165.00 N/A N/A N/A N/A - - 30000305 HC ESTRADIOL 300 82670 51 N/A Both 165.00 N/A N/A N/A N/A - - 30001117 HC CHLAMYDIA BY AMPLIFIED PROBE 300 87491 51 N/A Both 165.00 N/A N/A N/A N/A - - 30001142 HC N GONORRHOEAE AMPLIFIED PROBE 300 87591 51 N/A Both 165.00 N/A N/A N/A N/A - - 39000062 HC PLASMA PED ALIQUOT 390 P9017 51 N/A Both 165.00 N/A N/A N/A N/A - - 39000005 HC RED CELLS LR PED ALIQUOT IRR 390 P9011 51 N/A Both 165.00 N/A N/A N/A N/A - - 30000315 HC FOLIC ACID 300 82746 51 N/A Both 166.00 N/A N/A N/A N/A - - 74000006 HC NEURO MONITORING OR/15 MIN 740 95940 51 N/A Both 166.00 N/A N/A N/A N/A - - 30000334 HC PH AND PCO2 300 82803 51 N/A Both 166.00 N/A N/A N/A N/A - - 43000062 HC OT COG THER IVNTJ EA ADDL 15 MIN 430 97130 51 N/A Both 167.00 N/A N/A N/A N/A - - 43000017 HC OT SENSORY INTEGRAT EA 15M 430 97533 51 N/A Both 167.00 N/A N/A N/A N/A - - 43000026 HC OT THER IVNTJ 1ST 15 MIN 430 97129 51 N/A Both 167.00 N/A N/A N/A N/A - - 44400016 HC SLP ARTICULATION EVAL 15 444 92522 51 N/A Both 167.00 N/A N/A N/A N/A - - 44400020 HC SLP LANGUAGE EVAL 15 444 92523 51 N/A Both 167.00 N/A N/A N/A N/A - - 44400024 HC SLP VOICE EVAL 15 444 92524 51 N/A Both 167.00 N/A N/A N/A N/A - - 44000012 HC ST COG THER IVNTJ EA ADDL 15 MIN 440 97130 51 N/A Both 167.00 N/A N/A N/A N/A - - 44000009 HC ST SENSORY INTERGAT EA 15M 440 97533 51 N/A Both 167.00 N/A N/A N/A N/A - - 44000059 HC ST THER IVNTJ 1ST 15 MIN 440 97129 51 N/A Both 167.00 N/A N/A N/A N/A - - 30000492 HC MYOGLOBIN 300 83874 51 N/A Both 168.00 N/A N/A N/A N/A - - 30000221 HC CALCIUM IONIZED 300 82330 51 N/A Both 168.00 N/A N/A N/A N/A - - 41000068 HC OXIMETER 410 94762 51 N/A Both 168.00 N/A N/A N/A N/A - - 99000020 HC HOSPITAL DISCHARGE DAY <30 MIN 990 99238 51 N/A Both 169.00 N/A N/A N/A N/A - - 96900008 HC 5% WL BASELINE ACHIEVED 969 G9880 51 N/A Both 170.00 N/A N/A N/A N/A - - 32900279 HC INJ PX RETRO URETHROCYSTO 761 51610 51 N/A Both 170.00 N/A N/A N/A N/A - - 27800007 HC PLASTIC EYE SPHERE 278 L8610 51 N/A Both 170.00 N/A N/A N/A N/A - - 27000064 HC TRAY CATH URETHRAL 14FR STRL 270 51 N/A Both 170.00 N/A N/A N/A N/A - - 30000343 HC LACTOSE TOLERANCE 3 SPECIMENS 300 82951 51 N/A Both 171.00 N/A N/A N/A N/A - - 30001360 HC LACTOSE TOLERANCE-3 SPEC 300 82951 51 N/A Both 171.00 N/A N/A N/A N/A - - 76100005 HC INSERT SIMPLE CATH 761 51702 51 N/A Both 172.00 N/A N/A N/A N/A - - 76100004 HC INSERT STRAIGHT CATH 761 51701 51 N/A Both 172.00 N/A N/A N/A N/A - - 76100022 HC SUBS IV PUSH OF SAME DRUG 260 96376 51 N/A Both 172.00 N/A N/A N/A N/A - - 76100048 HC MNT NON DM/NON RENAL 60M 761 99201 51 N/A Both 172.00 N/A N/A N/A N/A - - 43000010 HC OT NEUROMUSC RE-ED EA 15M 430 97112 51 N/A Both 172.00 N/A N/A N/A N/A - - 30000714 HC PLATELET ACTIVITY FUNCTION 300 85576 51 N/A Both 172.00 N/A N/A N/A N/A - - 42000019 HC PT NEUROMUSC RE-ED EA 15M 420 97112 51 N/A Both 172.00 N/A N/A N/A N/A - - 45000001 HC BLADDER SCAN 761 51798 51 N/A Both 173.00 N/A N/A N/A N/A - - 76100027 HC TX RM CHEMO ADL HR SM DRG 335 96415 51 N/A Both 173.00 N/A N/A N/A N/A - - 40200072 HC US OB DOPPLER UMBILICAL (MFM ONLY) 402 76820 51 N/A Both 175.00 N/A N/A N/A N/A - - 41000028 HC PUL EXERCISE CONSULT 410 G0237 51 N/A Both 176.00 N/A N/A N/A N/A - - 32000077 HC HIP UNI W OR WO PEL 1 VIEW 320 73501 51 N/A Both 178.00 N/A N/A N/A N/A - - 76100021 HC TX RM IV PUSH DIFF DRUG 260 96375 51 N/A Both 178.00 N/A N/A N/A N/A - - 27100023 HC AIRVO SUBSEQUENT Q8 271 51 N/A Both 178.00 N/A N/A N/A N/A - - 30001418 HC BHB BETA - HYDROXYBUTYRATE 300 82010 51 N/A Both 178.00 N/A N/A N/A N/A - - 41000070 HC INCENTIVE BREATHING INSTRUCT AND DEMO 410 94664 51 N/A Both 178.00 N/A N/A N/A N/A - - 94200006 HC IND COMP DM ED/30M 942 G0108 51 N/A Both 178.00 N/A N/A N/A N/A - - 27100016 HC OXYGEN SUBSEQUENT Q8 271 51 N/A Both 178.00 N/A N/A N/A N/A - - 42000072 HC PT BALANCE TEST - 15 MIN 420 97750 51 N/A Both 178.00 N/A N/A N/A N/A - - 40200065 HC US TRNSVAG FOLLICLE SUBSEQUENT 402 76830 51 N/A Both 178.00 N/A N/A N/A N/A - - 43400012 HC OT EVAL LOW COMPLEXITY 434 97165 51 N/A Both 180.00 N/A N/A N/A N/A - - 42400010 HC PT EVAL LOW COMPLEXITY 424 97161 51 N/A Both 180.00 N/A N/A N/A N/A - - 30000025 HC VALPROIC ACID - DEPAKENE 300 80164 51 N/A Both 180.00 N/A N/A N/A N/A - - 32900116 HC VENIPUNCTURE DIAG PURPOSE 761 36410 51 N/A Both 180.00 N/A N/A N/A N/A - - 30001049 HC SENSITIVITY DISC 300 87184 51 N/A Both 181.00 N/A N/A N/A N/A - - 39000007 HC CRYOPRECIPITATE POOLED 390 P9012 51 N/A Both 182.00 N/A N/A N/A N/A - - 30000020 HC CARBAMAZEPINE TEGRETOL 300 80156 51 N/A Both 184.00 N/A N/A N/A N/A - - 30000038 HC PHENOBARBITAL QUANT 300 80184 51 N/A Both 184.00 N/A N/A N/A N/A - - 39000065 HC CRYOPRECIPITATE PED ALIQUOT 390 P9012 51 N/A Both 184.00 N/A N/A N/A N/A - - 42000002 HC PT BFB TRAINING 1ST 15 MIN 420 90912 51 N/A Both 184.00 N/A N/A N/A N/A - - 30001419 HC STREPTOCCOCCUS GROUP B PROBE 300 87653 51 N/A Both 184.00 N/A N/A N/A N/A - - 30000600 HC THYROID STIMULATING HORMONE 300 84443 51 N/A Both 184.00 N/A N/A N/A N/A - - 30000312 HC FERRITIN 300 82728 51 N/A Both 185.00 N/A N/A N/A N/A - - 30000698 HC D-DIMER QUANT 300 85379 51 N/A Both 186.00 N/A N/A N/A N/A - - 99000017 HC INITIAL HOSPITAL CARE DAY 30 MIN 990 99221 51 N/A Both 187.00 N/A N/A N/A N/A - - 30000775 HC C-REACTIVE PROTEIN-CRP 300 86140 51 N/A Both 188.00 N/A N/A N/A N/A - - 30000012 HC RENAL FUNCTION PANEL 300 80069 51 N/A Both 188.00 N/A N/A N/A N/A - - 30001262 HC SALICYLATE 300 80307 51 N/A Both 188.00 N/A N/A N/A N/A - - 41000061 HC THERAPY VEST SUBSEQUENT 410 94668 51 N/A Both 188.00 N/A N/A N/A N/A - - 30000598 HC THYROXINE FREE 300 84439 51 N/A Both 188.00 N/A N/A N/A N/A - - 90000010 HC SCREEN COUNSELOR 45(38-52)MIN 900 90834 51 N/A Both 190.00 N/A N/A N/A N/A - - 90000003 HC SCREEN INTERVENTION - RN 900 90791 51 N/A Both 190.00 N/A N/A N/A N/A - - 30000226 HC CARBON MONOXIDE QUANT BLD 300 82375 51 N/A Both 190.00 N/A N/A N/A N/A - - 30000086 HC MARIJUANA URINE QUANT 300 80307 51 N/A Both 190.00 N/A N/A N/A N/A - - 30000335 HC O2 SATURATION BY OXIMETRY 300 82810 51 N/A Both 190.00 N/A N/A N/A N/A - - 30000039 HC PHENYTOIN DILANTIN TOTAL 300 80185 51 N/A Both 190.00 N/A N/A N/A N/A - - 30000986 HC AB NEUTRALIZATION STUDIES 300 86977 51 N/A Both 193.00 N/A N/A N/A N/A - - 30001108 HC ROTAVIRUS AG 300 87425 51 N/A Both 193.00 N/A N/A N/A N/A - - 32000093 HC LOWER EXTREMITY INFANT 320 73592 51 N/A Both 194.00 N/A N/A N/A N/A - - 76100030 HC TX RM IRRG OF IMPL DEVICE 761 96523 51 N/A Both 194.00 N/A N/A N/A N/A - - 41000073 HC AEROGEN AEROSOL 410 94640 51 N/A Both 194.00 N/A N/A N/A N/A - - 99000015 HC OFFICE OUTPATIENT VISIT 25 MIN 990 99214 51 N/A Both 194.00 N/A N/A N/A N/A - - 32000197 HC JOINT SINGLE VIEW 320 77077 51 N/A Both 195.00 N/A N/A N/A N/A - - 32000205 HC ANKLE ONE VIEW 320 73600 51 N/A Both 195.00 N/A N/A N/A N/A - - 30000280 HC CPK MB FRACTION 300 82553 51 N/A Both 195.00 N/A N/A N/A N/A - - 46000028 HC PULMONARY STRESS TESTING 460 94618 51 N/A Both 195.00 N/A N/A N/A N/A - - 30000291 HC VITAMIN B-12 300 82607 51 N/A Both 195.00 N/A N/A N/A N/A - - 32000023 HC TMJ OPEN CLOSED UNI 320 70328 51 N/A Both 196.00 N/A N/A N/A N/A - - 30000531 HC AMNIOTIC FLUID DETECTION 300 84112 51 N/A Both 196.00 N/A N/A N/A N/A - - 32900084 HC INTRO NEEDLE CATH VEIN 761 36000 51 N/A Both 196.00 N/A N/A N/A N/A - - 44400012 HC SLP FLUENCY EVAL 15 444 92521 51 N/A Both 196.00 N/A N/A N/A N/A - - 91400007 HC CONSULTATION-PSYCH 1/2 HOUR 914 90899 51 N/A Both 197.00 N/A N/A N/A N/A - - 32000098 HC CALCANEUS 2+ VIEWS 320 73650 51 N/A Both 198.00 N/A N/A N/A N/A - - 30000182 HC AMMONIA PLASMA 300 82140 51 N/A Both 199.00 N/A N/A N/A N/A - - 27000047 HC KIT CATH CENT VENOUS PEDI 5FR 270 51 N/A Both 199.00 N/A N/A N/A N/A - - 41000041 HC IPPB THERAPY 410 94640 51 N/A Both 200.00 N/A N/A N/A N/A - - 99000024 HC SBSQ HOSPITAL CARE DAY 35 MIN 990 99233 51 N/A Both 200.00 N/A N/A N/A N/A - - 32000071 HC UPPER EXTREMITY INFANT 320 73092 51 N/A Both 201.00 N/A N/A N/A N/A - - 30000051 HC THEOPHYLLINE 300 80198 51 N/A Both 202.00 N/A N/A N/A N/A - - 30000979 "HC CROSSMATCH BLOOD, IS" 300 86920 51 N/A Both 202.00 N/A N/A N/A N/A - - 30001359 HC CROSSMATCH ELECTRONIC 300 86923 51 N/A Both 202.00 N/A N/A N/A N/A - - 27100005 HC HELI OX THERAPY Q8 271 51 N/A Both 202.00 N/A N/A N/A N/A - - 32000076 HC FINGER(S) 2+ VIEWS 320 73140 51 N/A Both 203.00 N/A N/A N/A N/A - - 40100002 HC MAMMO DIAGNOSTIC UNI 3D 401 77061 51 N/A Both 203.00 N/A N/A N/A N/A - - 40100005 HC MAMMO DIAGNOSTIC UNI 3D 401 77061 51 N/A Both 203.00 N/A N/A N/A N/A - - 39000067 HC PLT IRR PED ALIQUOT 390 P9037 51 N/A Both 203.00 N/A N/A N/A N/A - - 32000192 HC BONE AGE STUDIES 320 77072 51 N/A Both 204.00 N/A N/A N/A N/A - - 30000329 HC BEDSIDE BLOOD GAS 300 82803 51 N/A Both 204.00 N/A N/A N/A N/A - - 30000331 HC BLOOD GASES PH PCO2 PO2 300 82803 51 N/A Both 204.00 N/A N/A N/A N/A - - 30000257 HC CORTISOL TOTAL 300 82533 51 N/A Both 204.00 N/A N/A N/A N/A - - 30001435 HC INFECTIOUS AGENT DETECTION DNA/RNA LEGIONELLA PNEUMPPHILIA AMPLIFIED PROBE 300 87541 51 N/A Both 204.00 N/A N/A N/A N/A - - 91400029 HC INDIV THERAPY 45(38-52)MIN 914 90834 51 N/A Both 205.00 N/A N/A N/A N/A - - 91400037 HC INDIVIDUAL TELEHEALTH SW 45 914 90834 51 N/A Both 205.00 N/A N/A N/A N/A - - 92100011 HC INTERROGATION ICD 921 93289 51 N/A Both 205.00 N/A N/A N/A N/A - - 92100005 HC PROGRAMMING ICD - 1 LEAD 921 93282 51 N/A Both 205.00 N/A N/A N/A N/A - - 92100006 HC PROGRAMMING ICD - 2 LEAD 921 93283 51 N/A Both 205.00 N/A N/A N/A N/A - - 92100007 HC PROGRAMMING ICD - 3+ LEADS 921 93284 51 N/A Both 205.00 N/A N/A N/A N/A - - 42000037 HC PT WOUND CARE NON-SELECTIVE 420 97602 51 N/A Both 205.00 N/A N/A N/A N/A - - 40200062 HC US TRNSVG OB LTD 402 76817 51 N/A Both 207.00 N/A N/A N/A N/A - - 91400006 HC FAMILY THERAPY WO PATIENT 916 90846 51 N/A Both 207.00 N/A N/A N/A N/A - - 91600015 HC TELEHEALTH SW FAMILY WO PT 916 90846 51 N/A Both 207.00 N/A N/A N/A N/A - - 30000077 HC ALCOHOL ETHANOL URINE 300 80307 51 N/A Both 208.00 N/A N/A N/A N/A - - 30001261 HC ALCOHOL ETHYL BLOOD 300 80307 51 N/A Both 208.00 N/A N/A N/A N/A - - 46000012 HC AMBULATORY OXIMETRY 460 94761 51 N/A Both 208.00 N/A N/A N/A N/A - - 37100003 HC MOD SEDATION ADDT'L 15 MIN EA 371 99153 51 N/A Both 208.00 N/A N/A N/A N/A - - 76100169 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT EA ADDL 25 SQCM 761 15276 51 N/A Both 209.00 N/A N/A N/A N/A - - 45000266 HC APPLY CAST FINGER (CONTRACTURE) 450 29086 51 N/A Both 209.00 N/A N/A N/A N/A - - 76100087 HC DEBRIDE OPEN WOUND EA ADDL 20 SQ CM 761 97598 51 N/A Both 209.00 N/A N/A N/A N/A - - 51000015 HC CIRCUM 28 DAYS OR OLDER 723 54161 51 N/A Both 209.00 N/A N/A N/A N/A - - 45000337 HC MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS 450 99155 51 N/A Both 209.00 N/A N/A N/A N/A - - 45000336 HC MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS 450 99151 51 N/A Both 209.00 N/A N/A N/A N/A - - 92000009 HC ACTIGRAPHY 920 95803 51 N/A Both 210.00 N/A N/A N/A N/A - - 91600010 HC FAMILY THERAPY WITH PATIENT 916 90847 51 N/A Both 210.00 N/A N/A N/A N/A - - 32000074 HC HAND 2 VIEWS 320 73120 51 N/A Both 211.00 N/A N/A N/A N/A - - 32000072 HC WRIST 2 VIEWS 320 73100 51 N/A Both 211.00 N/A N/A N/A N/A - - 41000015 HC THERAPY VEST 410 94669 51 N/A Both 211.00 N/A N/A N/A N/A - - 45000269 HC APPLY FOREARM SPLINT DYNAMIC 450 29126 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000268 HC APPLY FOREARM SPLINT STATIC 450 29125 51 N/A Both 213.00 N/A N/A N/A N/A - - 30001099 HC HELICOBACTER PYLORI STOOL 300 87338 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000316 HC ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD 450 46600 51 N/A Both 213.00 N/A N/A N/A N/A - - 91300005 HC PARTIAL CARE FULL DAY-MEDICAID 913 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000284 HC REMOVE NASAL FOREIGN BODY 450 30300 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000334 HC REMV EXT CANAL FOREIGN BODY 450 69200 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000328 HC REMV FB EYE CORNEA SLIT LAMP 450 65222 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000325 HC REMV FB EYE SUPERF CONJUNC 450 65205 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000301 HC REPAIR TONGUE LACER <2.6 CM 450 41250 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000280 HC STRAPPING OF KNEE 450 29530 51 N/A Both 213.00 N/A N/A N/A N/A - - 45000272 HC STRAPPING OF SHOULDER 450 29240 51 N/A Both 213.00 N/A N/A N/A N/A - - 40200063 HC US TRANSVAG FOLLICLE INITIAL 402 76830 51 N/A Both 215.00 N/A N/A N/A N/A - - 27100010 HC NON-INVASIVE APPLIANCE ONLY 271 51 N/A Both 216.00 N/A N/A N/A N/A - - 37100001 HC MODERATE SEDATION 371 51 N/A Both 218.00 N/A N/A N/A N/A - - 76100088 HC REMOVAL DEVITALIZED TISSUE PER SESSION 761 97602 51 N/A Both 219.00 N/A N/A N/A N/A - - 36000094 HC PRE-SURG CARE - INTERMEDIATE 360 51 N/A Both 219.00 N/A N/A N/A N/A - - 30000734 HC PTT SUBSTITUTIONS 300 85732 51 N/A Both 220.00 N/A N/A N/A N/A - - 91400009 HC ALCOHOL/DRUG ASSESS>30MINS BC 914 G0397 51 N/A Both 220.00 N/A N/A N/A N/A - - 90000005 HC EVALUATION 900 90791 51 N/A Both 220.00 N/A N/A N/A N/A - - 41000056 HC THERAPY VEST INITIAL 410 94667 51 N/A Both 222.00 N/A N/A N/A N/A - - 30000055 HC VANCOMYCIN 300 80202 51 N/A Both 222.00 N/A N/A N/A N/A - - 43000006 HC OT IONTOPHORESIS EA 15MIN 430 97033 51 N/A Both 223.00 N/A N/A N/A N/A - - 92100009 HC PERI-PROCEDURAL PROGRAM ICD 921 93287 51 N/A Both 223.00 N/A N/A N/A N/A - - 92100008 HC PERI-PROCEDURAL PROGRAM PACER 921 93286 51 N/A Both 223.00 N/A N/A N/A N/A - - 42000015 HC PT IONTOPHORESIS EA 15MIN 420 97033 51 N/A Both 223.00 N/A N/A N/A N/A - - 30001087 HC LEGIONELLA FLUORESCENCE 300 87278 51 N/A Both 224.00 N/A N/A N/A N/A - - 30000972 HC MODIFIED ANTIBODY IDENT 300 86870 51 N/A Both 225.00 N/A N/A N/A N/A - - 30500001 HC NONINVASIVE CARBOXYHEMOGLOBIN 305 88740 51 N/A Both 225.00 N/A N/A N/A N/A - - 30000046 HC PRONESTYL & NAPA 300 80192 51 N/A Both 225.00 N/A N/A N/A N/A - - 40200073 HC US OB DOPPLER MCA (MFM ONLY) 402 76821 51 N/A Both 225.00 N/A N/A N/A N/A - - 76100029 HC TX RM CHEMO IV ADL INFUS 331 96417 51 N/A Both 226.00 N/A N/A N/A N/A - - 30000980 "HC CROSSMATCH BLOOD, AHG" 300 86922 51 N/A Both 226.00 N/A N/A N/A N/A - - 30001025 HC CULTURE ACID-FAST 300 87116 51 N/A Both 226.00 N/A N/A N/A N/A - - 76100190 HC FINE NEEDLE ASP WO GUIDANCE ADDL LESION 761 10004 51 N/A Both 226.00 N/A N/A N/A N/A - - 32000068 HC ELBOW 2 VIEWS 320 73070 51 N/A Both 227.00 N/A N/A N/A N/A - - 32000034 HC X-RAY SPINE ONE VIEW 320 72020 51 N/A Both 228.00 N/A N/A N/A N/A - - 76100050 HC OFFICE OUTPATIENT VISIT LEVEL 2 761 99212 51 N/A Both 228.00 N/A N/A N/A N/A - - 30000052 HC TOBRAMYCIN 300 80200 51 N/A Both 229.00 N/A N/A N/A N/A - - 30001337 HC TOBRAMYCIN KINETIC 300 80200 51 N/A Both 229.00 N/A N/A N/A N/A - - 30001336 HC TOBRAMYCIN TROUGH 300 80200 51 N/A Both 229.00 N/A N/A N/A N/A - - 32000096 HC FOOT 2 VIEWS 320 73620 51 N/A Both 230.00 N/A N/A N/A N/A - - 32000094 HC ANKLE 2 VIEWS 320 73600 51 N/A Both 230.00 N/A N/A N/A N/A - - 30000707 HC HEPARIN PROTAMINE TITRATION 300 85520 51 N/A Both 230.00 N/A N/A N/A N/A - - 30000915 HC HIV 1 AND HIV 2 SINGLE RESULT 300 86703 51 N/A Both 230.00 N/A N/A N/A N/A - - 99000021 HC HOSPITAL DISCHARGE DAY >30 MIN 990 99239 51 N/A Both 230.00 N/A N/A N/A N/A - - 94300005 HC PERIPHERAL ARTERIAL DISEASE (PAD) REHABILITATION PER SESSION 943 93668 51 N/A Both 230.00 N/A N/A N/A N/A - - 27000226 HC THORACENTESIS CATHETER 270 C1729 51 N/A Both 230.00 N/A N/A N/A N/A - - 30000542 HC PROCALCITONIN 300 84145 51 N/A Both 232.00 N/A N/A N/A N/A - - 71000015 HC CLASS 1 GI PROCEDURE RECOVERY 710 51 N/A Both 232.00 N/A N/A N/A N/A - - 30001019 HC CULTURE FUNGUS 300 87102 51 N/A Both 232.00 N/A N/A N/A N/A - - 30001018 HC CULTURE FUNGUS SKIN/NAIL/HAIR 300 87101 51 N/A Both 232.00 N/A N/A N/A N/A - - 32000027 HC SALIVARY GLAND-CALCULUS 320 70380 51 N/A Both 233.00 N/A N/A N/A N/A - - 41000053 HC IPV 410 94667 51 N/A Both 233.00 N/A N/A N/A N/A - - 44000004 HC SLP AAC TREATMENT 440 92609 51 N/A Both 233.00 N/A N/A N/A N/A - - 32000008 HC MASTOIDS 1-2 VIEWS 320 70120 51 N/A Both 233.04 N/A N/A N/A N/A - - 99000009 HC OFFICE OUTPATIENT NEW 30 MIN 990 99203 51 N/A Both 234.00 N/A N/A N/A N/A - - 76100200 HC INCAL BX SKN EA SEP ADDL 761 11107 51 N/A Both 235.00 N/A N/A N/A N/A - - 94200037 HC PUMP TRAIN UPGRADE ANIMAS 942 51 N/A Both 235.00 N/A N/A N/A N/A - - 76100198 HC PUNCH BX SKIN EA SEP ADDL 761 11105 51 N/A Both 236.00 N/A N/A N/A N/A - - 27100014 HC OXYGEN LIMITED 0 TO 4 HOURS 271 51 N/A Both 238.00 N/A N/A N/A N/A - - 27100001 HC OXYGEN LIMITED 0-4 HOURS 271 51 N/A Both 238.00 N/A N/A N/A N/A - - 30000726 HC SICKLE CELL SCREEN 300 85660 51 N/A Both 239.00 N/A N/A N/A N/A - - 30000333 HC CONTINUOUS BLOOD GAS MON SUBSE 300 82803 51 N/A Both 240.00 N/A N/A N/A N/A - - 27400014 HC ELBOW GUTTER 274 L3702 51 N/A Both 240.00 N/A N/A N/A N/A - - 30001007 HC ID BACTERIAL ANAEROBE 300 87076 51 N/A Both 240.00 N/A N/A N/A N/A - - 94200013 HC MULTI-FAMILY GROUP 942 G0177 51 N/A Both 240.00 N/A N/A N/A N/A - - 30001222 HC MYCOBACTERIA CULTURE BLOOD 300 87116 51 N/A Both 240.00 N/A N/A N/A N/A - - 27000009 HC TRAY C SECTION STRL 270 51 N/A Both 240.00 N/A N/A N/A N/A - - 32000052 HC SACROILIAC JOINT 1-2 VIEW 320 72200 51 N/A Both 241.00 N/A N/A N/A N/A - - 32000215 HC ABDOMEN THERAPY PLANNING 320 76499 51 N/A Both 241.00 N/A N/A N/A N/A - - 32000099 HC TOE(S) 2+ VIEWS 320 73660 51 N/A Both 242.00 N/A N/A N/A N/A - - 30001107 HC RSV DIRECT AG EIA 300 87420 51 N/A Both 242.00 N/A N/A N/A N/A - - 40200066 HC US PELVIS FOLLICLE INITIAL 402 76856 51 N/A Both 245.00 N/A N/A N/A N/A - - 27100003 HC AIRVO ASSEMBLY 271 51 N/A Both 245.00 N/A N/A N/A N/A - - 76100037 HC MDAC-PARTIAL ESTABLISHED 761 99214 51 N/A Both 245.00 N/A N/A N/A N/A - - 30000974 HC ANTIBODY TITER 300 86886 51 N/A Both 246.00 N/A N/A N/A N/A - - 30001016 HC LEGIONELLA CULTURE 300 87081 51 N/A Both 246.00 N/A N/A N/A N/A - - 91200006 HC HALF DAY PARTIAL-UHC MILITARY 912 51 N/A Both 246.00 N/A N/A N/A N/A - - 90600002 HC IOP (PC) 3 HRS AM OR PM 906 90853 51 N/A Both 246.00 N/A N/A N/A N/A - - 91200001 HC IOP WKND/HLDYS 912 51 N/A Both 246.00 N/A N/A N/A N/A - - 91600013 HC TELEHEALTH PSYCH FAMILY WO PT 916 90846 51 N/A Both 246.00 N/A N/A N/A N/A - - 27000019 HC TRAY PARACENTESIS 15G 3-.25IN 270 51 N/A Both 248.00 N/A N/A N/A N/A - - 32000050 HC PELVIS 1 OR 2 VIEWS 320 72170 51 N/A Both 249.00 N/A N/A N/A N/A - - 91800024 HC CHRNC CARE MGMT SVC 30 MIN 918 99491 51 N/A Both 249.00 N/A N/A N/A N/A - - 30000970 HC ANTIBODY ELUTION EACH 300 86860 51 N/A Both 249.00 N/A N/A N/A N/A - - 40200019 HC EACH ADDTL GESTATION < 14 WKS 402 76802 51 N/A Both 249.00 N/A N/A N/A N/A - - 32000062 HC CLAVICLE COMPLETE 320 73000 51 N/A Both 250.00 N/A N/A N/A N/A - - 35200004 HC CT LUNG WO CONT CANCER SCR 352 G0297 51 N/A Both 250.00 N/A N/A N/A N/A - - 30000027 HC GENTAMICIN 300 80170 51 N/A Both 250.00 N/A N/A N/A N/A - - 37000021 HC ECT ANESTHESIA 370 51 N/A Both 250.00 N/A N/A N/A N/A - - 91500026 HC GROUP THERAPY - 75 MIN 915 90853 51 N/A Both 250.00 N/A N/A N/A N/A - - 37100002 HC MOD SEDATION INITIAL 15 MIN 371 99152 51 N/A Both 250.00 N/A N/A N/A N/A - - 30000615 HC TROPONIN I 300 84484 51 N/A Both 250.00 N/A N/A N/A N/A - - 27400044 HC WALKING BOOT 274 L4360 51 N/A Both 250.00 N/A N/A N/A N/A - - 32000199 HC DEXA RADIUS WRIST OR HEEL 320 77081 51 N/A Both 253.00 N/A N/A N/A N/A - - 32000019 HC SKULL 1-3 VIEWS 320 70250 51 N/A Both 253.00 N/A N/A N/A N/A - - 32000006 HC MANDIBLE 1-3 VIEWS 320 70100 51 N/A Both 253.00 N/A N/A N/A N/A - - 75000029 HC ANOSCOPY 750 51 N/A Both 253.00 N/A N/A N/A N/A - - 32000025 HC ORTHOPANTOGRAM PANALIPSE 320 70355 51 N/A Both 253.00 N/A N/A N/A N/A - - 41000002 HC TRACH TUBE CHANGE 410 31502 51 N/A Both 254.00 N/A N/A N/A N/A - - 27000220 HC VEST AIRWAY CLEARANCE HILL-ROM 270 51 N/A Both 254.00 N/A N/A N/A N/A - - 30000330 HC BEDSIDE BLOOD GASES 300 82803 51 N/A Both 256.00 N/A N/A N/A N/A - - 30001260 HC DRUG SCR MULT DRUG CLASS 4 OR> 300 80307 51 N/A Both 256.00 N/A N/A N/A N/A - - 41000008 HC FILTRATION AEROSOL 460 94642 51 N/A Both 256.00 N/A N/A N/A N/A - - 91400035 HC FAMILY PSYCHOTHERAPY WO PT 916 90846 51 N/A Both 257.00 N/A N/A N/A N/A - - 41000020 HC MANUAL VENTILATION BVM 410 94799 51 N/A Both 258.00 N/A N/A N/A N/A - - 48000023 HC MILITARY RESEARCH ECHO 480 93306 51 N/A Both 258.00 N/A N/A N/A N/A - - 40100003 HC MAMMO DIAGNOSTIC BIL 3D 401 77062 51 N/A Both 259.00 N/A N/A N/A N/A - - 76100085 HC APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM 761 15272 51 N/A Both 261.00 N/A N/A N/A N/A - - 76100147 HC CATHERIZATION UMBILICAL ARTERY 761 36660 51 N/A Both 261.00 N/A N/A N/A N/A - - 92200008 HC EMG WITH NERVE CONDUCTION 922 95885 51 N/A Both 261.00 N/A N/A N/A N/A - - 91400031 HC INDIVIDUAL TELEHEALTH SW 60 914 90837 51 N/A Both 261.00 N/A N/A N/A N/A - - 99000018 HC INITIAL HOSPITAL CARE DAY 50 MIN 990 99222 51 N/A Both 261.00 N/A N/A N/A N/A - - 91400041 HC INPT SW IND THERAPY 60(53+) 914 90837 51 N/A Both 261.00 N/A N/A N/A N/A - - 76100089 HC INSERT CATH ART CUTDOWN SHORTTERM 761 36625 51 N/A Both 261.00 N/A N/A N/A N/A - - 94200033 HC PUMP ED TRAIN ME 942 51 N/A Both 261.00 N/A N/A N/A N/A - - 94200040 HC PUMP TRAIN UPGRADE TANDEM 942 51 N/A Both 261.00 N/A N/A N/A N/A - - 76100098 HC REPEAT CONTROL OF NOSEBLEED 761 30906 51 N/A Both 261.00 N/A N/A N/A N/A - - 91600012 HC FAMILY PSYCHOTHERAPY W PT 916 90847 51 N/A Both 263.00 N/A N/A N/A N/A - - 32900238 HC INJ OF AIR OR CONTRAST 761 49400 51 N/A Both 263.00 N/A N/A N/A N/A - - 32900024 HC INJECTION SINUS TRACT 761 20501 51 N/A Both 263.00 N/A N/A N/A N/A - - 30000009 HC COMPREHENSIVE METABOLIC PANEL 300 80053 51 N/A Both 264.00 N/A N/A N/A N/A - - 32000216 HC ABDOMEN XRAY ONE VIEW 320 74018 51 N/A Both 265.00 N/A N/A N/A N/A - - 39000011 HC PLASMA FRESH FROZEN 390 P9017 51 N/A Both 265.00 N/A N/A N/A N/A - - 39000070 HC PLASMA THAWED POOL 390 P9017 51 N/A Both 265.00 N/A N/A N/A N/A - - 32000011 HC FACIAL BONES 1-2 VIEWS 320 70140 51 N/A Both 266.00 N/A N/A N/A N/A - - 32000086 HC FEMUR 1 VIEW 320 73551 51 N/A Both 268.00 N/A N/A N/A N/A - - 32400009 HC CHEST XRAY ONE VIEW 324 71045 51 N/A Both 269.00 N/A N/A N/A N/A - - 32000026 HC NECK SOFT TISSUE 320 70360 51 N/A Both 269.00 N/A N/A N/A N/A - - 36900001 HC HEMOCONCENTRATION 369 51 N/A Both 269.00 N/A N/A N/A N/A - - 40200033 HC US HYSTEROSONOGRAPHY 402 76831 51 N/A Both 269.00 N/A N/A N/A N/A - - 27100013 HC OXYGEN INITIAL 271 51 N/A Both 270.00 N/A N/A N/A N/A - - 94800001 HC PULM REHAB NON-COPD 948 94799 51 N/A Both 270.00 N/A N/A N/A N/A - - 30000992 HC CULTURE BLOOD 300 87040 51 N/A Both 271.00 N/A N/A N/A N/A - - 32000070 HC FOREARM 2 VIEWS 320 73090 51 N/A Both 272.00 N/A N/A N/A N/A - - 45000003 HC EMERGENCY ROOM I 450 99281 51 N/A Both 272.00 N/A N/A N/A N/A - - 33100004 HC INJECTION CHEMO RESERVOIR 331 96542 51 N/A Both 272.00 N/A N/A N/A N/A - - 26000005 HC NON-CHEMO IV PUSH 260 96374 51 N/A Both 273.00 N/A N/A N/A N/A - - 41000013 HC OSCILLATORY PEP ACAPELLA 410 94667 51 N/A Both 273.00 N/A N/A N/A N/A - - 76100032 HC TREATMENT ROOM - LEVEL 2 761 99202 51 N/A Both 273.00 N/A N/A N/A N/A - - 30000706 HC HEPARIN ANTI XA LOVENOX L 300 85520 51 N/A Both 274.00 N/A N/A N/A N/A - - 30001118 HC CL DIFF TOXIN AMPLIFIED PROBE 300 87493 51 N/A Both 274.00 N/A N/A N/A N/A - - 32900054 HC INJ PX FOR ANKLE ARTH 329 27648 51 N/A Both 274.00 N/A N/A N/A N/A - - 32900043 HC INJ PX FOR ELBOW ARTH 329 24220 51 N/A Both 274.00 N/A N/A N/A N/A - - 32900052 HC INJ PX FOR KNEE ARTH 329 27369 51 N/A Both 274.00 N/A N/A N/A N/A - - 32900049 HC INJ SI JOINT ARTHROGRAPHY 329 27096 51 N/A Both 274.00 N/A N/A N/A N/A - - 32900048 HC INJECTION HIP ARTHROGRAM 329 27093 51 N/A Both 274.00 N/A N/A N/A N/A - - 32900045 HC INJECTION WRIST ARTHROGRAPHY 329 25246 51 N/A Both 274.00 N/A N/A N/A N/A - - 91800009 HC NRPSYC TST EVAL PHYS/QHP 1ST 918 96132 51 N/A Both 274.00 N/A N/A N/A N/A - - 91800010 HC NRPSYC TST EVAL PHYS/QHP EA 918 96133 51 N/A Both 274.00 N/A N/A N/A N/A - - 30000715 HC PLATELET AGGREGATION 300 85576 51 N/A Both 274.00 N/A N/A N/A N/A - - 91800007 HC PSYCL TST EVAL PHYS/QHP 1ST 918 96130 51 N/A Both 274.00 N/A N/A N/A N/A - - 91800008 HC PSYCL TST EVAL PHYS/QHP EA 918 96131 51 N/A Both 274.00 N/A N/A N/A N/A - - 32000064 HC SHOULDER 1 VIEW 320 73020 51 N/A Both 275.00 N/A N/A N/A N/A - - 45000267 HC APPLY LONG ARM SPLINT 450 29105 51 N/A Both 275.00 N/A N/A N/A N/A - - 45000279 HC APPLY LOWER LEG SPLINT 450 29515 51 N/A Both 275.00 N/A N/A N/A N/A - - 45000283 HC STRAPPING UNNA BOOT 450 29580 51 N/A Both 275.00 N/A N/A N/A N/A - - 40200076 HC DUCTUS VENOSUS FOLLOW UP/REPEAT (MFM ONLY) 402 76828 51 N/A Both 275.00 N/A N/A N/A N/A - - 40200075 HC DUCTUS VENOSUS INITIAL (MFM ONLY) 402 76827 51 N/A Both 275.00 N/A N/A N/A N/A - - 45000281 HC STRAPPING ANKLE &/OR FOOT 450 29540 51 N/A Both 275.00 N/A N/A N/A N/A - - 30000971 HC ANTIBODY IDENTIFICATION 300 86870 51 N/A Both 276.00 N/A N/A N/A N/A - - 32000092 HC TIBIA/FIBULA 2 VIEWS 320 73590 51 N/A Both 277.00 N/A N/A N/A N/A - - 40200035 HC PELVIS LIMITED 402 76857 51 N/A Both 277.00 N/A N/A N/A N/A - - 32900012 HC INJ MAMMARY DUCTOGRAM 329 19030 51 N/A Both 277.00 N/A N/A N/A N/A - - 76100151 HC APPLY CAST FIGURE EIGHT 761 29049 51 N/A Both 277.00 N/A N/A N/A N/A - - 76100150 HC APPLY CAST PLASTER VELPEAU 761 29058 51 N/A Both 277.00 N/A N/A N/A N/A - - 76100149 HC APPLY CAST SHOULDER SPICA 761 29055 51 N/A Both 277.00 N/A N/A N/A N/A - - 45000264 HC APPLY FOREARM CAST 450 29075 51 N/A Both 277.00 N/A N/A N/A N/A - - 45000265 HC APPLY HAND/WRIST CAST 450 29085 51 N/A Both 277.00 N/A N/A N/A N/A - - 76100160 HC APPLY PATELLAR TENDON BEARING CAST 761 29435 51 N/A Both 277.00 N/A N/A N/A N/A - - 45000277 HC APPLY SHORT LEG CAST 450 29405 51 N/A Both 277.00 N/A N/A N/A N/A - - 45000278 HC APPLY SHORT LEG CAST WALKER 450 29425 51 N/A Both 277.00 N/A N/A N/A N/A - - 32000042 HC SPINE ONE VIEW 320 72081 51 N/A Both 279.00 N/A N/A N/A N/A - - 27000023 HC HEMOSTAT SURGICEL LG 4X8 270 51 N/A Both 279.00 N/A N/A N/A N/A - - 99000016 HC OFFICE OUTPATIENT VISIT 40 MIN 990 99215 51 N/A Both 280.00 N/A N/A N/A N/A - - 91400036 HC IND THERAPY PSYCH 45(38-52)MIN 914 90834 51 N/A Both 281.00 N/A N/A N/A N/A - - 91400030 HC INDIVIDUAL TELEHEALTH PSYCH 45 914 90834 51 N/A Both 281.00 N/A N/A N/A N/A - - 91400028 HC MCD INPT IND PSYCH 38 TO 52 MN 914 90834 51 N/A Both 281.00 N/A N/A N/A N/A - - 43400013 HC OT EVAL MODERATE COMPLEXITY 434 97166 51 N/A Both 281.00 N/A N/A N/A N/A - - 27000158 HC RHINO PACK 270 51 N/A Both 281.00 N/A N/A N/A N/A - - 76100096 HC CTRL NOSEBLEED ANTER COMPLEX 761 30903 51 N/A Both 282.00 N/A N/A N/A N/A - - 76100095 HC CTRL NOSEBLEED ANTER SIMPLE 761 30901 51 N/A Both 282.00 N/A N/A N/A N/A - - 76100097 HC CTRL NOSEBLEED POST W/PACKS &/OR CAUT 761 30905 51 N/A Both 282.00 N/A N/A N/A N/A - - 47100002 HC NEWBORN AUDITORY PROCESS EVAL 60 MIN 471 92620 51 N/A Both 282.00 N/A N/A N/A N/A - - 76100060 HC ENURESIS INITIAL 761 99213 51 N/A Both 283.00 N/A N/A N/A N/A - - 41000029 HC O2 EXERCISE 410 G0239 51 N/A Both 283.00 N/A N/A N/A N/A - - 42400011 HC PT EVAL MODERATE COMPLEXITY 424 97162 51 N/A Both 283.00 N/A N/A N/A N/A - - 32000033 HC STERNOCLAVICULAR JOINT 320 71130 51 N/A Both 284.00 N/A N/A N/A N/A - - 32000066 HC AC JOINTS BILATERAL 320 73050 51 N/A Both 285.00 N/A N/A N/A N/A - - 41000001 HC ENDOTRACHEAL INTUBATION 761 31500 51 N/A Both 285.00 N/A N/A N/A N/A - - 91200005 HC PARTIAL CARE HALF DAY-MEDICAID 912 51 N/A Both 285.00 N/A N/A N/A N/A - - 32900125 HC VENOUS CATH SELECT ORGAN 761 36500 51 N/A Both 285.00 N/A N/A N/A N/A - - 32000217 HC ABDOMEN XRAY TWO VIEWS 320 74019 51 N/A Both 292.00 N/A N/A N/A N/A - - 32000063 HC SCAPULA COMPLETE 320 73010 51 N/A Both 294.00 N/A N/A N/A N/A - - 32000054 HC SACRUM/COCCYX 320 72220 51 N/A Both 294.00 N/A N/A N/A N/A - - 32000075 HC HAND 3+ VIEWS 320 73130 51 N/A Both 294.00 N/A N/A N/A N/A - - 32000073 HC WRIST 3+ VIEWS 320 73110 51 N/A Both 294.00 N/A N/A N/A N/A - - 32900027 HC ARTHROCENTESIS SMALL JOINT 761 20600 51 N/A Both 294.00 N/A N/A N/A N/A - - 32900011 HC ASP BREAST CYST ADDTL 329 19001 51 N/A Both 294.00 N/A N/A N/A N/A - - 30000701 HC COAGULATION/FIBRINOLYSIS ASSAY 300 85396 51 N/A Both 294.00 N/A N/A N/A N/A - - 42000034 HC PT WOUND DEBRID < OR 1ST 20CM 420 97597 51 N/A Both 294.00 N/A N/A N/A N/A - - 30000987 HC ANTIBODY ABSORPTION COLD 300 86978 51 N/A Both 296.00 N/A N/A N/A N/A - - 30001329 HC ANTIBODY ABSORPTION WARM 300 86978 51 N/A Both 296.00 N/A N/A N/A N/A - - 30000704 HC KLEIHAUER-BETKE TEST 300 85460 51 N/A Both 296.00 N/A N/A N/A N/A - - 30001393 HC RBC DIFFERENTIAL ABSORPTION 300 86978 51 N/A Both 296.00 N/A N/A N/A N/A - - 30000985 HC RBC PRETX INCUB W CHEMICAL 300 86970 51 N/A Both 296.00 N/A N/A N/A N/A - - 30001394 HC SERUM PRETREATMENT INCUB DRUGS 300 86975 51 N/A Both 296.00 N/A N/A N/A N/A - - 32400010 HC CHEST XRAY TWO VIEWS 324 71046 51 N/A Both 297.00 N/A N/A N/A N/A - - 32000078 HC HIP UNI W OR WO PEL 2-3 VIEWS 320 73502 51 N/A Both 297.00 N/A N/A N/A N/A - - 91600011 HC MCD INPT FAM PSYCH WITH PT 916 90847 51 N/A Both 297.00 N/A N/A N/A N/A - - 91600014 HC TELEHEALTH PSYCH FAMILY W PT 916 90847 51 N/A Both 297.00 N/A N/A N/A N/A - - 91600016 HC TELEHEALTH SW FAMILY W PT 916 90847 51 N/A Both 297.00 N/A N/A N/A N/A - - 32000095 HC ANKLE 3+ VIEWS 320 73610 51 N/A Both 298.00 N/A N/A N/A N/A - - 32000013 HC NASAL BONES 320 70160 51 N/A Both 298.00 N/A N/A N/A N/A - - 32000091 HC KNEES BOTH STANDING AP 320 73565 51 N/A Both 298.00 N/A N/A N/A N/A - - 40200032 HC US TRNSVG NON OB LTD 402 76830 51 N/A Both 298.00 N/A N/A N/A N/A - - 41000055 HC POSTURAL DRAINAGE 410 94667 51 N/A Both 298.00 N/A N/A N/A N/A - - 27800004 HC HDR IR192 NON STRANDED SOURCE 278 C1717 51 N/A Both 300.00 N/A N/A N/A N/A - - 32900042 HC INJECTION PROCEDURE SHOULDER 329 23350 51 N/A Both 301.00 N/A N/A N/A N/A - - 32000016 HC SINUS PARANASAL 1-2 VIEWS 320 70210 51 N/A Both 302.00 N/A N/A N/A N/A - - 32000067 HC HUMERUS 320 73060 51 N/A Both 302.00 N/A N/A N/A N/A - - 30001263 HC ACETAMINOPHEN QUANT 300 80307 51 N/A Both 302.00 N/A N/A N/A N/A - - 32900029 HC ARTHROCENTESIS INTERMED JNT 761 20605 51 N/A Both 303.00 N/A N/A N/A N/A - - 48000062 HC MONITORED EXERCISE ASSESSMENT 943 93798 51 N/A Both 303.00 N/A N/A N/A N/A - - 27100002 HC NITRIC OXIDE SETUP 271 94799 51 N/A Both 303.00 N/A N/A N/A N/A - - 48000077 HC NON MONITORED CARDIAC REHAB 943 93797 51 N/A Both 303.00 N/A N/A N/A N/A - - 32000053 HC SACROILIAC JOINTS 3+ VIEW 320 72202 51 N/A Both 306.00 N/A N/A N/A N/A - - 32000069 HC ELBOW 3+ VIEWS 320 73080 51 N/A Both 310.00 N/A N/A N/A N/A - - 32000097 HC FOOT 3+ VIEWS 320 73630 51 N/A Both 310.00 N/A N/A N/A N/A - - 76100233 HC INSERTION INTRAUTERINE DEVICE IUD 761 58300 51 N/A Both 314.00 N/A N/A N/A N/A - - 30001020 HC CULTURE FUNGUS BLOOD 300 87103 51 N/A Both 314.00 N/A N/A N/A N/A - - 45000086 "HC INCISION OF BURN SCAB, EACH ADDNTL" 450 16036 51 N/A Both 314.00 N/A N/A N/A N/A - - 46000016 HC MEMORY MONITOR RETRIEVAL 460 94776 51 N/A Both 314.00 N/A N/A N/A N/A - - 94200036 HC PUMP TRAIN TANDEM 942 51 N/A Both 314.00 N/A N/A N/A N/A - - 76100023 HC TX RM CHEMO INJECT NON-H 331 96401 51 N/A Both 315.00 N/A N/A N/A N/A - - 99000010 HC OFFICE OUTPATIENT NEW 45 MIN 990 99204 51 N/A Both 315.00 N/A N/A N/A N/A - - 44400029 HC DYSPHAGIA EVAL 30 444 92610 51 N/A Both 316.00 N/A N/A N/A N/A - - 44000048 HC DYSPHAGIA TRMT 30 440 92526 51 N/A Both 316.00 N/A N/A N/A N/A - - 44000039 HC SLP TRMT 30 440 92507 51 N/A Both 316.00 N/A N/A N/A N/A - - 32000032 HC STERNUM 320 71120 51 N/A Both 317.00 N/A N/A N/A N/A - - 74000009 HC DIGITAL ANALYSIS OF EEG 740 95957 51 N/A Both 317.00 N/A N/A N/A N/A - - 27100015 HC OXYGEN LIMITED 4 TO 12 HOURS 271 51 N/A Both 318.00 N/A N/A N/A N/A - - 42000083 HC PT CDP-SOT 6 COND W I&R MCT&ADT 420 92549 51 N/A Both 318.00 N/A N/A N/A N/A - - 42000038 HC PT NEG PRESS WOUND TX < 50CM 420 97605 51 N/A Both 318.00 N/A N/A N/A N/A - - 32000035 HC CERVICAL SPINE 2 OR 3 VIEWS 320 72040 51 N/A Both 319.00 N/A N/A N/A N/A - - 46000005 HC HAST 460 94452 51 N/A Both 319.00 N/A N/A N/A N/A - - 45000285 HC LARYNGOSCOPY INDIRECT+REMV FOR.BODY 450 31511 51 N/A Both 319.00 N/A N/A N/A N/A - - 99000025 HC OBS INPATIENT HOSPITAL CARE 40 MIN 990 99234 51 N/A Both 320.00 N/A N/A N/A N/A - - 76100006 HC INSERT COMPLEX CATH 761 51703 51 N/A Both 321.00 N/A N/A N/A N/A - - 41000033 HC INFANT AIRWAY MANAGEMENT 410 94002 51 N/A Both 322.00 N/A N/A N/A N/A - - 41000034 HC TPIECE RESUSCITATOR BVM 410 94002 51 N/A Both 322.00 N/A N/A N/A N/A - - 91400040 HC IND THER PSYCH INPT 53 PLUS 914 90837 51 N/A Both 324.00 N/A N/A N/A N/A - - 91400039 HC INDIVIDUAL TELEHEALTH PSYCH 60 914 90837 51 N/A Both 324.00 N/A N/A N/A N/A - - 91400032 HC MCD INPT IND PSYCH 53 PLUS MN 914 90837 51 N/A Both 324.00 N/A N/A N/A N/A - - 32900201 HC INJ PX LYMPHANGIOGRAPHY 329 38790 51 N/A Both 326.00 N/A N/A N/A N/A - - 32000088 HC KNEE 1-2 VIEWS 320 73560 51 N/A Both 328.00 N/A N/A N/A N/A - - 32000218 HC ABDOMEN XRAY THREE + VIEWS 320 74021 51 N/A Both 328.00 N/A N/A N/A N/A - - 76100172 HC CHEMICAL CAUTERIZE GRANULATION TISSUE 761 17250 51 N/A Both 329.00 N/A N/A N/A N/A - - 76100086 HC DEBRIDE OPEN WOUND 20 SQ CM< 761 97597 51 N/A Both 329.00 N/A N/A N/A N/A - - 30001395 HC ADDITIONAL RESOURCE CHARGE 300 51 N/A Both 329.00 N/A N/A N/A N/A - - 48300002 HC CARDIAC DOPPLER LIMITED 483 93321 51 N/A Both 329.00 N/A N/A N/A N/A - - 73000001 HC EKG TRACING ONLY 730 93005 51 N/A Both 329.00 N/A N/A N/A N/A - - 76100038 HC MDAC-VISIT ESTABLISHED 761 99215 51 N/A Both 329.00 N/A N/A N/A N/A - - 76100051 HC OFFICE OUTPATIENT VISIT LEVEL 3 761 99213 51 N/A Both 331.00 N/A N/A N/A N/A - - 32000082 HC HIP BIL W OR WO PEL 2 VIEWS 320 73521 51 N/A Both 332.00 N/A N/A N/A N/A - - 94000001 HC THERAPEUTIC PHLEBOTOMY 940 99195 51 N/A Both 332.00 N/A N/A N/A N/A - - 32000087 HC FEMUR 2 VIEWS 320 73552 51 N/A Both 333.00 N/A N/A N/A N/A - - 32400011 HC CHEST APICAL LORDOTIC 324 71045 51 N/A Both 333.00 N/A N/A N/A N/A - - 76100100 HC DRAIN SKIN ABSCESS SIMPLE 761 10060 51 N/A Both 334.00 N/A N/A N/A N/A - - 76100113 HC DRAIN FINGER ABSCESS SIMPLE 761 26010 51 N/A Both 334.00 N/A N/A N/A N/A - - 76100123 HC DRAINAGE OF GUM LESION 761 41800 51 N/A Both 334.00 N/A N/A N/A N/A - - 76100129 HC I&D BARTHOLIN GLAND ABSCESS 761 56420 51 N/A Both 334.00 N/A N/A N/A N/A - - 30000913 HC HIV 1 ANTIBODIES 300 86701 51 N/A Both 339.00 N/A N/A N/A N/A - - 91400003 HC IND THERAPY 60 (53+) MIN 914 90837 51 N/A Both 339.00 N/A N/A N/A N/A - - 91400042 HC IND THERAPY OP 60 (53+) MIN 914 90837 51 N/A Both 339.00 N/A N/A N/A N/A - - 32900396 HC ARTHROCENTESIS MAJOR JOINT 761 20610 51 N/A Both 340.00 N/A N/A N/A N/A - - 41000006 HC HAST WITH 02 TITRATION 410 94453 51 N/A Both 340.00 N/A N/A N/A N/A - - 94200005 HC HOME MONITORING TRAINING 942 93792 51 N/A Both 340.00 N/A N/A N/A N/A - - 32000182 HC FOREIGN BODY EXAM-CHILD 320 76010 51 N/A Both 341.00 N/A N/A N/A N/A - - 32000065 HC SHOULDER 2+ VIEWS 320 73030 51 N/A Both 341.00 N/A N/A N/A N/A - - 45000083 HC DRESS/DEBRID MED BURN NO ANESTH 450 16025 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000082 HC DRESS/DEBRID SMALL BURN NO ANES 450 16020 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000081 HC INITIAL RX BURN(S) 1ST DEGREE 450 16000 51 N/A Both 343.00 N/A N/A N/A N/A - - 48000105 HC PERFUSION - HOURLY 480 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000039 HC RESUPERF WND BODY 7.6-12.5CM 450 12004 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000042 HC RESUPERF WND BODY >30CM 450 12007 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000044 HC RESUPERF WND FACE 2.6-5CM 450 12013 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000045 HC RESUPERF WND FACE 5.1-7.5CM 450 12014 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000046 HC RESUPERF WND FACE 7.6-12.5CM 450 12015 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000043 HC RESUPERF WND FACE <2.5CM 450 12011 51 N/A Both 343.00 N/A N/A N/A N/A - - 45000049 HC RESUPERF WND FACE >30CM 450 12018 51 N/A Both 343.00 N/A N/A N/A N/A - - 44400006 HC SLP EVAL AAC 444 92607 51 N/A Both 343.00 N/A N/A N/A N/A - - 32000007 HC MANDIBLE 4+ VIEWS 320 70110 51 N/A Both 344.00 N/A N/A N/A N/A - - 40200057 HC US THYROID / NECK LTD 402 76536 51 N/A Both 344.00 N/A N/A N/A N/A - - 32900005 HC ASP ABSCESS HEMATOMA CYST 329 10160 51 N/A Both 344.00 N/A N/A N/A N/A - - 45000032 HC REMOVAL OF NAIL PLATE 450 11730 51 N/A Both 344.00 N/A N/A N/A N/A - - 41000003 HC MINI-BAL 410 31720 51 N/A Both 345.00 N/A N/A N/A N/A - - 27400027 HC WRIST SPLINT W DYNAMIC OU 274 L3908 51 N/A Both 345.00 N/A N/A N/A N/A - - 32000024 HC TMJ BILATERAL 320 70330 51 N/A Both 346.00 N/A N/A N/A N/A - - 91200002 HC SHORT-TERM RES - IC WKEND 912 51 N/A Both 346.00 N/A N/A N/A N/A - - 48000100 HC TRANSFUSION - HOURLY 391 51 N/A Both 347.00 N/A N/A N/A N/A - - 32000043 HC SPINE 2-3 VIEWS 320 72082 51 N/A Both 351.00 N/A N/A N/A N/A - - 40300006 HC MAMMOGRAPHY SCREEN UNI 2D 403 77067 51 N/A Both 351.00 N/A N/A N/A N/A - - 40300005 HC MAMMO SCREENING UNI W 3D 403 77067 51 N/A Both 351.00 N/A N/A N/A N/A - - 30000510 HC PARATHORMONE PTH 300 83970 51 N/A Both 351.00 N/A N/A N/A N/A - - 32000051 HC PELVIS COMPLETE 3+ VIEWS 320 72190 51 N/A Both 353.00 N/A N/A N/A N/A - - 42000039 HC PT NEG PRESS WOUND TX > 50CM 420 97606 51 N/A Both 353.00 N/A N/A N/A N/A - - 92200007 HC EMG WITHOUT NERVE CONDUCTION 922 95870 51 N/A Both 354.00 N/A N/A N/A N/A - - 32000079 HC HIP UNI W OR WO PEL 4+ VIEWS 320 73503 51 N/A Both 356.00 N/A N/A N/A N/A - - 32000041 HC SPINE T-L 2 VIEWS 320 72080 51 N/A Both 357.00 N/A N/A N/A N/A - - 43400014 HC OT EVAL HIGH COMPLEXITY 434 97167 51 N/A Both 357.00 N/A N/A N/A N/A - - 36000096 HC PRE-SURG CARE UNIT -EXTEN 360 51 N/A Both 357.00 N/A N/A N/A N/A - - 44400009 HC SLP APHASIA EVAL 30 444 96105 51 N/A Both 358.00 N/A N/A N/A N/A - - 44400032 HC SLP COGNITION EVAL 30 444 96125 51 N/A Both 358.00 N/A N/A N/A N/A - - 32000038 HC SPINE THORACIC 2 VIEWS 320 72070 51 N/A Both 359.00 N/A N/A N/A N/A - - 71000019 HC PHASE II RECOVERY BASE 710 51 N/A Both 359.00 N/A N/A N/A N/A - - 71000023 HC PHASE II RECOVERY BASE (CATH LAB) 710 51 N/A Both 359.00 N/A N/A N/A N/A - - 71000025 HC PHASE II RECOVERY BASE (GI) 710 51 N/A Both 359.00 N/A N/A N/A N/A - - 71000021 HC PHASE II RECOVERY BASE (PACU) 710 51 N/A Both 359.00 N/A N/A N/A N/A - - 42400012 HC PT EVAL HIGH COMPLEXITY 424 97163 51 N/A Both 359.00 N/A N/A N/A N/A - - 27000225 HC BALLOON POWERFLEX 270 C1725 51 N/A Both 360.00 N/A N/A N/A N/A - - 27000156 HC SENSOR ST02 INSPECTRA 270 51 N/A Both 360.00 N/A N/A N/A N/A - - 40200061 HC US SPINE LTD 402 76800 51 N/A Both 363.00 N/A N/A N/A N/A - - 33100001 HC CHEMO INTRA ARTERIAL PUSH 331 96420 51 N/A Both 363.00 N/A N/A N/A N/A - - 45000305 HC DRAINAGE ABSCESS PALATE/UVULA 450 42000 51 N/A Both 363.00 N/A N/A N/A N/A - - 92000004 HC FETAL MONITORING 920 59025 51 N/A Both 363.00 N/A N/A N/A N/A - - 45000297 HC I&D MOUTH/TONG INTRA SUBLING SUPERF 450 41005 51 N/A Both 363.00 N/A N/A N/A N/A - - 45000308 HC INC/DRAIN PERITONSIL ABSCESS 450 42700 51 N/A Both 363.00 N/A N/A N/A N/A - - 45000294 HC REPAIR MOUTH LACERATION <2.5 CM 450 40830 51 N/A Both 363.00 N/A N/A N/A N/A - - 45000302 HC REPAIR TONGUE LACER POST 1/3 450 41251 51 N/A Both 363.00 N/A N/A N/A N/A - - 44400017 HC SLP ARTICULATION EVAL 30 444 92522 51 N/A Both 364.00 N/A N/A N/A N/A - - 44400021 HC SLP LANGUAGE EVAL 30 444 92523 51 N/A Both 364.00 N/A N/A N/A N/A - - 44400025 HC SLP VOICE EVAL 30 444 92524 51 N/A Both 364.00 N/A N/A N/A N/A - - 94800002 HC PULM REHAB COPD 948 G0424 51 N/A Both 365.00 N/A N/A N/A N/A - - 76100119 HC DRAIN ABSCESS/HEMATOMA NASAL 761 30000 51 N/A Both 366.00 N/A N/A N/A N/A - - 51000014 HC CIRCUMCISION NEONATE 723 54160 51 N/A Both 367.00 N/A N/A N/A N/A - - 32900001 HC FINE NEEDLE ASP WO GUIDANCE 329 10021 51 N/A Both 367.00 N/A N/A N/A N/A - - 27100022 HC AIRVO INITIAL 271 51 N/A Both 370.00 N/A N/A N/A N/A - - 32400012 HC CHEST XRAY THREE VIEWS 324 71047 51 N/A Both 373.00 N/A N/A N/A N/A - - 32000089 HC KNEE 3 VIEWS 320 73562 51 N/A Both 373.00 N/A N/A N/A N/A - - 39000031 HC FFP CRYO REDUCED 390 P9044 51 N/A Both 373.00 N/A N/A N/A N/A - - 46000001 HC SPIROMETRY 460 94010 51 N/A Both 373.00 N/A N/A N/A N/A - - 92100036 HC VASC ASSESS-THORAC OUTLT 921 93923 51 N/A Both 373.00 N/A N/A N/A N/A - - 40200011 HC US BREAST LTD 402 76642 51 N/A Both 374.00 N/A N/A N/A N/A - - 71000010 HC RECOVERY ROOM 710 51 N/A Both 376.00 N/A N/A N/A N/A - - 73100001 HC HOLTER MONITOR APPLICATION 731 93225 51 N/A Both 379.00 N/A N/A N/A N/A - - 30000494 HC NT-PROBNP (BRAIN NATRIURETIC PEPTIDE) 300 83880 51 N/A Both 379.00 N/A N/A N/A N/A - - 73100005 HC ZIO PATCH RECORDING 731 0296T 51 N/A Both 379.00 N/A N/A N/A N/A - - 27100008 HC IPV PHASITRON INITIAL ASSBLY 271 51 N/A Both 380.00 N/A N/A N/A N/A - - 76100014 HC TX RM IV THER 31-1HR HYDR 260 96360 51 N/A Both 381.00 N/A N/A N/A N/A - - 99000019 HC INITIAL HOSPITAL CARE DAY 70 MIN 990 99223 51 N/A Both 382.00 N/A N/A N/A N/A - - 91400012 HC INPT SW DX INTV EXAM 914 90791 51 N/A Both 382.00 N/A N/A N/A N/A - - 90000006 HC SW DX INTERVIEW EXAM 900 90791 51 N/A Both 382.00 N/A N/A N/A N/A - - 91400011 HC TELEHEALTH SW DX INTERVIEW 914 90791 51 N/A Both 382.00 N/A N/A N/A N/A - - 32000028 HC RIBS UNILATERAL 2 VIEW 320 71100 51 N/A Both 384.00 N/A N/A N/A N/A - - 76100168 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT 1ST 25 SQCM 761 15275 51 N/A Both 384.00 N/A N/A N/A N/A - - 32000198 HC DEXA AXIAL SKELETON STUDY 320 77080 51 N/A Both 385.00 N/A N/A N/A N/A - - 73100003 HC EVENT MONITOR APPLICATION 731 93270 51 N/A Both 385.00 N/A N/A N/A N/A - - 33300030 HC PORT FILM 333 77417 51 N/A Both 386.00 N/A N/A N/A N/A - - 45000333 HC IRRIGATION CORPORA CAVERNOSA PRIAPISM 450 54220 51 N/A Both 387.00 N/A N/A N/A N/A - - 32000090 HC KNEE COMPLETE 4+ VIEWS 320 73564 51 N/A Both 391.00 N/A N/A N/A N/A - - 46000013 HC OVERNIGHT OXIMETRY MONITORING 460 94762 51 N/A Both 394.00 N/A N/A N/A N/A - - 99000011 HC OFFICE OUTPATIENT NEW 60 MIN 990 99205 51 N/A Both 395.00 N/A N/A N/A N/A - - 76100156 HC APPLY CYLINDER CAST THIGH TO ANKLE 761 29365 51 N/A Both 397.00 N/A N/A N/A N/A - - 76100158 HC APPLY HIP SPICA CAST ONE LEG 761 29305 51 N/A Both 397.00 N/A N/A N/A N/A - - 45000275 HC APPLY LONG LEG CAST 450 29345 51 N/A Both 397.00 N/A N/A N/A N/A - - 76100157 HC APPLY LONG LEG CAST BRACE 761 29358 51 N/A Both 397.00 N/A N/A N/A N/A - - 76100033 HC TREATMENT ROOM - LEVEL 3 761 99203 51 N/A Both 397.00 N/A N/A N/A N/A - - 32400014 HC CHEST XRAY FOUR + VIEWS 324 71048 51 N/A Both 399.00 N/A N/A N/A N/A - - 32000083 HC HIP BIL W OR WO PEL 3-4 VIEWS 320 73522 51 N/A Both 399.00 N/A N/A N/A N/A - - 40100008 HC MAMMOGRAPHY UNI DIAG 401 77065 51 N/A Both 399.00 N/A N/A N/A N/A - - 32000046 HC SPINE LUMBAR 2 OR 3 VIEWS 320 72100 51 N/A Both 403.00 N/A N/A N/A N/A - - 40200040 HC US EXTREMITY NONVASC LTD 402 76882 51 N/A Both 403.00 N/A N/A N/A N/A - - 48000032 HC CARDIAC DOPPLER EXAM 480 93320 51 N/A Both 404.00 N/A N/A N/A N/A - - 73100009 HC MOBILE OUTPATIENT CARDIAC TELEMETRY 731 93229 51 N/A Both 404.00 N/A N/A N/A N/A - - 99000026 HC OBS INPATIENT HOSPITAL CARE 50 MIN 990 99235 51 N/A Both 404.00 N/A N/A N/A N/A - - 76100025 HC TX RM CHEMO IV PUSH-ADL 331 96411 51 N/A Both 405.00 N/A N/A N/A N/A - - 94200016 HC HOME MONITORING TRAINING 942 G0248 51 N/A Both 407.00 N/A N/A N/A N/A - - 32900252 HC INJ CONTRAST EVALUATE G-TUBE 329 49465 51 N/A Both 408.00 N/A N/A N/A N/A - - 32000047 HC SPINE LUMBAR 4+ VIEWS 320 72110 51 N/A Both 409.00 N/A N/A N/A N/A - - 30001114 HC LEGIONELLA ANTIGEN URINE 300 87899 51 N/A Both 409.00 N/A N/A N/A N/A - - 36000108 HC SCHEDULED C-SEC EVAL ROOM 360 51 N/A Both 409.00 N/A N/A N/A N/A - - 32000030 HC RIBS BIL 3 VIEWS 320 71110 51 N/A Both 413.00 N/A N/A N/A N/A - - 40300004 HC MAMMO SCREENING BIL W 3D 403 77067 51 N/A Both 414.00 N/A N/A N/A N/A - - 40300003 HC MAMMOGRAPHY SCREENING BIL 2D 403 77067 51 N/A Both 414.00 N/A N/A N/A N/A - - 32000015 HC ORBITS 4+ VIEWS 320 70200 51 N/A Both 416.00 N/A N/A N/A N/A - - 40200010 HC US BREAST UNI COMPLETE 402 76641 51 N/A Both 416.00 N/A N/A N/A N/A - - 76100159 HC APPLY RIGID TOTAL CONTACT LEG CAST 761 29445 51 N/A Both 416.00 N/A N/A N/A N/A - - 76100174 HC NEG PRESS WOUND THERAPY <= 50 SQCM 761 97607 51 N/A Both 416.00 N/A N/A N/A N/A - - 94000004 HC US WOUND ASSESSMENT PER DAY 940 97610 51 N/A Both 416.00 N/A N/A N/A N/A - - 45000338 HC MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS 450 99156 51 N/A Both 418.00 N/A N/A N/A N/A - - 94200032 HC PUMP ED TRAIN INDIV OP 942 51 N/A Both 418.00 N/A N/A N/A N/A - - 32000136 HC PELVIMETRY 320 74710 51 N/A Both 420.00 N/A N/A N/A N/A - - 33300026 HC GUIDANCE FOR RADIATION TRMT 333 77387 51 N/A Both 420.00 N/A N/A N/A N/A - - 32000044 HC SPINE 4-5 VIEWS 320 72083 51 N/A Both 421.00 N/A N/A N/A N/A - - 32000193 HC BONE LENGTH STUDY 320 77073 51 N/A Both 422.00 N/A N/A N/A N/A - - 44400013 HC SLP FLUENCY EVAL 30 444 92521 51 N/A Both 424.00 N/A N/A N/A N/A - - 32900304 HC INJ FOR DISKOGRAPHY 761 62290 51 N/A Both 425.00 N/A N/A N/A N/A - - 32900305 HC INJ PX CERVICAL 761 62291 51 N/A Both 425.00 N/A N/A N/A N/A - - 12000002 HC R&B HOSPICE SEMI-PRIVATE 120 51 N/A Both 425.00 N/A N/A N/A N/A - - 44400030 HC DYSPHAGIA EVAL 45 444 92610 51 N/A Both 426.00 N/A N/A N/A N/A - - 44000049 HC DYSPHAGIA TRMT 45 440 92526 51 N/A Both 426.00 N/A N/A N/A N/A - - 44000040 HC SLP TRMT 45 440 92507 51 N/A Both 426.00 N/A N/A N/A N/A - - 32000017 HC PARANASAL SINUS 3+ VIEWS 320 70220 51 N/A Both 427.00 N/A N/A N/A N/A - - 32000020 HC SKULL COMPLETE 4+ VIEWS 320 70260 51 N/A Both 427.00 N/A N/A N/A N/A - - 40200029 HC US OB FOLLOW-UP 402 76816 51 N/A Both 427.00 N/A N/A N/A N/A - - 45000344 HC INJECT NERV BLCK FACIAL NERV 450 64999 51 N/A Both 428.00 N/A N/A N/A N/A - - 32900117 HC INJECT SPIDER VEINS 761 36468 51 N/A Both 429.00 N/A N/A N/A N/A - - 32900119 HC SCLEROTHERAPY - MULTIPLE VEINS 761 36471 51 N/A Both 429.00 N/A N/A N/A N/A - - 32900118 HC SCLEROTHERAPY OF SINGLE VEIN 761 36470 51 N/A Both 429.00 N/A N/A N/A N/A - - 32000009 HC MASTOIDS 3 OR MORE VIEWS 320 70130 51 N/A Both 433.00 N/A N/A N/A N/A - - 32000029 HC CHEST W/RIBS UNI 3 VIEW 320 71101 51 N/A Both 435.00 N/A N/A N/A N/A - - 45000004 HC EMERGENCY ROOM II 450 99282 51 N/A Both 435.00 N/A N/A N/A N/A - - 27000123 HC KIT CATH 7FR TWO LUMEN CVL MAC 270 51 N/A Both 435.00 N/A N/A N/A N/A - - 32900303 HC MYELOGRAM INJECTION ONLY 329 62284 51 N/A Both 435.00 N/A N/A N/A N/A - - 76100052 HC OFFICE OUTPATIENT VISIT LEVEL 4 761 99214 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000179 HC CLOSE RX DIST FINGR FX 450 26750 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000180 HC CLOSE RX DIST FINGR FX MANIPULATN 450 26755 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000177 HC CLOSE RX FINGR ARTICULAR FX 450 26740 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000175 HC CLOSE RX PROX/MID FING SHFT FX 450 26720 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000176 HC CLOSE RX PROX/MID FING SHFT FX MANIP 450 26725 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000115 HC CLOSED RX A-C JT DISLOC 450 23540 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000116 HC CLOSED RX A-C JT DISLOC MANIPULATN 450 23545 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000188 HC CLOSED RX ACETABULAR FX 450 27220 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000189 "HC CLOSED RX ACETABULAR FX,MANIPULATN" 450 27222 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000235 HC CLOSED RX ANKLE DISLOCATN 450 27840 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000248 HC CLOSED RX BIG TOE FRACTURE 450 28490 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000249 HC CLOSED RX BIG TOE FX MANIP 450 28495 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000159 HC CLOSED RX CARPAL FX 450 25630 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000171 HC CLOSED RX CARPOMETACAR DISLOC NON-THUMB 450 26670 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000111 HC CLOSED RX CLAVICLE FRACTURE 450 23500 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000187 HC CLOSED RX COCCYGEAL FX 450 27200 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000202 HC CLOSED RX CONDYLAR FX 450 27501 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000207 HC CLOSED RX DIST FEM EPIPHYSIS 450 27516 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000225 HC CLOSED RX DIST FIBULA FX 450 27786 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000226 "HC CLOSED RX DIST FIBULA FX,MANIP" 450 27788 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000155 HC CLOSED RX DIST RAD/ULNA FX 450 25600 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000137 HC CLOSED RX ELBOW DISLOCATION 450 24600 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000205 HC CLOSED RX FEMUR DISTAL 450 27508 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000201 HC CLOSED RX FEMUR SHAFT FX 450 27500 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000121 HC CLOSED RX GR TUBEROSITY HUM FX 450 23620 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000240 HC CLOSED RX HEEL FX 450 28400 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000241 HC CLOSED RX HEEL FX MANIPULATN 450 28405 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000135 HC CLOSED RX HUMER CONDYLR FX 450 24576 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000133 HC CLOSED RX HUMER EPICONDYLR FX 450 24560 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000131 HC CLOSED RX HUMERAL SUPRACONDYLAR FX 450 24530 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000261 HC CLOSED RX I-P JT TOE DISLOCATION 450 28660 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000193 "HC CLOSED RX INTER/SUBTROCH FX,MANIP" 450 27240 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000181 HC CLOSED RX IP JT DISLOCATION 450 26770 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000213 HC CLOSED RX KNEE DISLOCATN 450 27550 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000216 HC CLOSED RX KNEECAP DISLOC+ANESTH 450 27562 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000215 HC CLOSED RX KNEECAP DISLOCATN 450 27560 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000173 HC CLOSED RX MC-P DISLOC 450 26700 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000219 HC CLOSED RX MED MALLEOLUS FX 450 27760 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000167 HC CLOSED RX METACARPAL FX 450 26600 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000168 HC CLOSED RX METACARPAL FX MANIP 450 26605 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000246 HC CLOSED RX METATARSAL FX 450 28470 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000247 HC CLOSED RX METATARSAL FX MANIP 450 28475 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000129 HC CLOSED RX MID HUMERUS FRACTURE 450 24500 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000259 HC CLOSED RX MT-PHAL TOE DISLOCATION 450 28630 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000164 HC CLOSED RX NAVIC/LUNATE FX/DISLOC 450 25680 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000157 HC CLOSED RX NAVICULAR FX 450 25622 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000091 HC CLOSED RX NOSE FRACTURE W/O MANIPULATION 450 21310 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000209 HC CLOSED RX PATELLA FX 450 27520 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000199 HC CLOSED RX POST HIP ARTHRPLAS DISLOC 450 27265 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000119 HC CLOSED RX PROX HUMERUS FRACTURE 450 23600 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000233 HC CLOSED RX PROX TIB/FIB DISLOC 450 27830 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000190 HC CLOSED RX PROX/NECK FEMUR FX 450 27230 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000191 "HC CLOSED RX PROX/NECK FEMUR FX,MANIP" 450 27232 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000223 HC CLOSED RX PROX/SHAFT FIBULA FX 450 27780 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000153 HC CLOSED RX RAD/ULNA SHAFT FX 450 25560 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000140 HC CLOSED RX RADIAL HEAD DISLOC CHILD 450 24640 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000141 HC CLOSED RX RADIAL HEAD/NECK FX 450 24650 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000148 HC CLOSED RX RADIAL SHAFT FX 450 25500 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000163 HC CLOSED RX RADIO-ULNA DISLOCATION 450 25675 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000117 HC CLOSED RX SCAPULA FX 450 23570 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000252 HC CLOSED RX SESAMOID BONE FX 450 28530 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000123 HC CLOSED RX SHLDR DISLOCATION 450 23650 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000197 HC CLOSED RX SPONTANEOUS HIP DISLOC 450 27256 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000114 HC CLOSED RX STERN-CLAV DISLOC MANIP 450 23525 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000105 HC CLOSED RX STERNUM FRACTURE 450 21820 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000255 HC CLOSED RX TALOTARSAL DISLOC 450 28570 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000242 HC CLOSED RX TALUS FX 450 28430 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000258 HC CLOSED RX TAR-METATAR DISLOC ANESTH 450 28605 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000257 HC CLOSED RX TAR-METATAR DISLOCATION 450 28600 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000253 HC CLOSED RX TARSAL DISLOCATION 450 28540 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000244 HC CLOSED RX TARSAL FX EACH 450 28450 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000212 HC CLOSED RX TIB TUBER FX 450 27538 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000217 HC CLOSED RX TIBIA SHAFT FX 450 27750 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000210 HC CLOSED RX TIBIAL PLATEAU FX 450 27530 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000250 HC CLOSED RX TOE FX 450 28510 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000251 HC CLOSED RX TOE FX MANIPULATN 450 28515 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000195 HC CLOSED RX TRAUMATIC HIP DISLOCATN 450 27250 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000229 HC CLOSED RX TRIMALLEOLAR FX 450 27816 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000151 HC CLOSED RX ULNA SHAFT FX 450 25530 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000152 HC CLOSED RX ULNA SHAFT FX MANIPULATN 450 25535 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000161 HC CLOSED RX ULNA STYLOID FX 450 25650 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000231 HC CLOSED RX WEIGHT BEAR DIST TIBIA 450 27824 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000107 HC CLOSED TREAT VERT BODY FRACT 450 22310 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000162 HC CLOSED TREAT WRIST DISLOCATION 450 25660 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000221 HC CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANIP 450 27767 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000227 HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANIP 450 27808 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000143 HC CLOSED TX ULNAR FRACTURE PROX END W/O MANIPULATE 450 24670 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000186 HC CLSD TX PELVIC RING FX W/MANIPULATION W/ANES 450 27198 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000185 HC CLSD TX PELVIC RING FX W/O MANIPULATION 450 27197 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000103 HC REDUCE TEMPOROMANDIBL DISLOC 450 21480 51 N/A Both 436.00 N/A N/A N/A N/A - - 45000169 HC TREAT THUMB DISLOC MANIPULATN 450 26641 51 N/A Both 436.00 N/A N/A N/A N/A - - 76100173 HC APPL MULTI-LAYER COMPRESSION SYS LEG BELOW KNEE 761 29581 51 N/A Both 438.00 N/A N/A N/A N/A - - 39100001 HC BLOOD PRODUCT ADMIN 391 36430 51 N/A Both 438.00 N/A N/A N/A N/A - - 76100090 HC BLADDER IRRIGATION 761 51700 51 N/A Both 439.00 N/A N/A N/A N/A - - 32000039 HC SPINE THORACIC 3 VIEWS 320 72072 51 N/A Both 441.00 N/A N/A N/A N/A - - 40200042 HC US INFANT HIP WO/MANIP 402 76886 51 N/A Both 441.00 N/A N/A N/A N/A - - 92100020 HC ARTERIAL ANKLE ARM INDEX 921 93922 51 N/A Both 441.00 N/A N/A N/A N/A - - 10000001 HC CJ SHORT-TERM RES - IC 1002 H2013 51 N/A Both 443.00 N/A N/A N/A N/A - - 32000206 HC MOD BARIUM SWALLOW UNL STUDY 320 74230 51 N/A Both 443.00 N/A N/A N/A N/A - - 42000035 HC PT WOUND DEBR EA ADD 20CM OR < 420 97598 51 N/A Both 443.00 N/A N/A N/A N/A - - 40100007 HC MAMMOGRAPHY BIL DIAG 401 77066 51 N/A Both 446.00 N/A N/A N/A N/A - - 32900335 HC INJECT SPHENO GANGLION 761 64505 51 N/A Both 450.00 N/A N/A N/A N/A - - 32000012 HC FACIAL BONES 3+ VIEWS 320 70150 51 N/A Both 454.00 N/A N/A N/A N/A - - 48000033 HC CARDIAC DOPPLER - COLOR 480 93325 51 N/A Both 454.00 N/A N/A N/A N/A - - 33100009 HC INTRATHECAL INJECTION ALS STUDY 331 96450 51 N/A Both 454.00 N/A N/A N/A N/A - - 35200040 HC CT PELVIMETRY 350 76380 51 N/A Both 457.00 N/A N/A N/A N/A - - 30000989 HC PROCESSING BLOOD/PLATELETS 300 86999 51 N/A Both 457.00 N/A N/A N/A N/A - - 71000016 HC CLASS 2 GI PROCEDURE RECOVERY 710 51 N/A Both 458.00 N/A N/A N/A N/A - - 92200020 HC MOTOR EVOKED LOWER 922 95929 51 N/A Both 458.00 N/A N/A N/A N/A - - 92200019 HC MOTOR EVOKED UPPER 922 95928 51 N/A Both 458.00 N/A N/A N/A N/A - - 32000040 HC SPINE THORACIC 4+ VIEWS 320 72074 51 N/A Both 459.00 N/A N/A N/A N/A - - 40200041 HC US INFANT HIPS W/MANIP 402 76885 51 N/A Both 460.00 N/A N/A N/A N/A - - 32000105 HC SOFT TISSUE NECK INCLUDING SCOUT W/WO DELAYED IMAGES W CONTRAST 320 74210 51 N/A Both 461.00 N/A N/A N/A N/A - - 33100005 HC CHEMO IV PUSH 331 96409 51 N/A Both 462.00 N/A N/A N/A N/A - - 43000061 HC OT COMPUTERIZED DYNAMIC POSTUROGRAPY 430 92548 51 N/A Both 462.00 N/A N/A N/A N/A - - 42000082 HC PT COMPUTERIZED DYNAMIC POSTUROGRAPY 420 92548 51 N/A Both 462.00 N/A N/A N/A N/A - - 44000058 HC ST COMPUTERIZED DYNAMIC POSTUROGRAPY 440 92548 51 N/A Both 462.00 N/A N/A N/A N/A - - 45000318 "HC CHANGE OF BLADDER TUBE,SIMPLE" 450 51705 51 N/A Both 466.00 N/A N/A N/A N/A - - 76100054 HC OUTPATIENT PROC DIAG 761 51 N/A Both 466.00 N/A N/A N/A N/A - - 27000157 HC KIT CATH CVL MULTI LUMEN 270 C1751 51 N/A Both 467.00 N/A N/A N/A N/A - - 76100015 HC TX RM IV THER 1STHR NON-H 260 96365 51 N/A Both 468.00 N/A N/A N/A N/A - - 41000017 HC PLETHYSMOGRAPHY DILUTION/WO 410 94727 51 N/A Both 468.00 N/A N/A N/A N/A - - 41000016 HC PLETHYSMOGRAPHY FOR LV/AR 410 94726 51 N/A Both 468.00 N/A N/A N/A N/A - - 37000001 HC ANESTHESIA BLOCK 370 51 N/A Both 469.00 N/A N/A N/A N/A - - 37000023 HC EPIDURAL CONTINUOUS 370 51 N/A Both 469.00 N/A N/A N/A N/A - - 37000025 HC EPIDURAL SINGLE 370 51 N/A Both 469.00 N/A N/A N/A N/A - - 37000026 HC EPIDURAL STEROID 370 51 N/A Both 469.00 N/A N/A N/A N/A - - 76100199 HC INCAL BX SKN SINGLE LES 761 11106 51 N/A Both 470.00 N/A N/A N/A N/A - - 76100126 HC INCISE EXTERNAL HEMORRHOID 761 46083 51 N/A Both 470.00 N/A N/A N/A N/A - - 32900319 HC INJECT TRIGEMINAL NERVE COMPLETE 761 64400 51 N/A Both 470.00 N/A N/A N/A N/A - - 94200035 HC PUMP TRAIN ANIMAS 942 51 N/A Both 470.00 N/A N/A N/A N/A - - 32000103 HC ABD 2+ VIEWS INCLUDING SINGLE CHEST XRAY 320 74022 51 N/A Both 473.00 N/A N/A N/A N/A - - 32000048 HC SPINE LUMB COMP W/BENDING 320 72114 51 N/A Both 474.00 N/A N/A N/A N/A - - 32000210 HC FLUORO GUIDE SPHENO CATH 761 77002 51 N/A Both 474.00 N/A N/A N/A N/A - - 27100006 HC INFANT HIFLO DAILY 271 51 N/A Both 476.00 N/A N/A N/A N/A - - 32000084 HC HIP BIL W OR WO PEL 5+ VIEWS 320 73523 51 N/A Both 478.00 N/A N/A N/A N/A - - 76100152 HC APPLY CAST SHOULDER TO HIPS 761 29035 51 N/A Both 481.00 N/A N/A N/A N/A - - 76100155 HC APPLY CAST SHOULDER TO HIPS ONE THIGH 761 29044 51 N/A Both 481.00 N/A N/A N/A N/A - - 45000263 HC APPLY LONG ARM CAST 450 29065 51 N/A Both 481.00 N/A N/A N/A N/A - - 45000276 HC APPLY LONG LEG CAST WALKER 450 29355 51 N/A Both 481.00 N/A N/A N/A N/A - - 46000009 HC CALORIMETRY INDIRECT 460 94690 51 N/A Both 482.00 N/A N/A N/A N/A - - 45000262 HC CLOSED RX I-P JT TOE DISLOC ANESTH 450 28665 51 N/A Both 482.00 N/A N/A N/A N/A - - 45000182 HC CLOSED RX IP JT DISLOCATION ANESTH 450 26775 51 N/A Both 482.00 N/A N/A N/A N/A - - 32000036 HC SPINE CERVICAL 4 OR 5 VIEWS 320 72050 51 N/A Both 488.00 N/A N/A N/A N/A - - 45000002 HC INTRACAVERNOSAL INJ 450 54235 51 N/A Both 491.00 N/A N/A N/A N/A - - 44400018 HC SLP ARTICULATION EVAL 45 444 92522 51 N/A Both 491.00 N/A N/A N/A N/A - - 44400022 HC SLP LANGUAGE EVAL 45 444 92523 51 N/A Both 491.00 N/A N/A N/A N/A - - 44400026 HC SLP VOICE EVAL 45 444 92524 51 N/A Both 491.00 N/A N/A N/A N/A - - 40200028 HC US OB LTD 402 76815 51 N/A Both 492.00 N/A N/A N/A N/A - - 32900026 HC INJ TRIGGER PT 1 OR 2 MUSCLE 761 20552 51 N/A Both 493.00 N/A N/A N/A N/A - - 40200031 HC US FETAL BIOPHYS W/O STRESS 402 76819 51 N/A Both 495.00 N/A N/A N/A N/A - - 32200003 HC ARTHROGRAM WRIST 322 73115 51 N/A Both 495.00 N/A N/A N/A N/A - - 74000018 HC EEG WO VIDEO BY TECH 2-12 HR UNMONITORED 740 95705 51 N/A Both 495.00 N/A N/A N/A N/A - - 74000019 HC ELECTRODE APPLICATION AND REMOVAL 740 95700 51 N/A Both 495.00 N/A N/A N/A N/A - - 30001438 HC INFECTIOUS AGENT DETECTION DNA/FNA PANEL VIRUSES MULTIPLEX AMP PROBE MULT TYPES 6-11 TARGETS 300 87632 51 N/A Both 495.00 N/A N/A N/A N/A - - 74000016 HC VEEG 2-12 HR UNMONITORED 740 95711 51 N/A Both 495.00 N/A N/A N/A N/A - - 45000089 HC ASPIRAT/INJECTION GANGLION CYST(S) 450 20612 51 N/A Both 496.00 N/A N/A N/A N/A - - 45000324 HC NERVOUS SYSTEM SURGERY UNLISTED 450 64999 51 N/A Both 496.00 N/A N/A N/A N/A - - 40200030 HC US TRANSVAGINAL OBSTETRICAL 402 76817 51 N/A Both 498.00 N/A N/A N/A N/A - - 48000085 HC CELERION ECHO 480 93306 51 N/A Both 500.00 N/A N/A N/A N/A - - 27000060 HC SET IV FLUID WARMING LEVEL 1 270 51 N/A Both 500.00 N/A N/A N/A N/A - - 41000064 HC MULTI CHANNEL APNEA MONITOR 410 94775 51 N/A Both 501.00 N/A N/A N/A N/A - - 30000766 HC PF4 ANTIBODIES BY ELISA 300 86022 51 N/A Both 501.00 N/A N/A N/A N/A - - 36000002 HC NORS TISSUE BONE RETRIEVAL 360 51 N/A Both 503.00 N/A N/A N/A N/A - - 30001451 HC RESP VIRAL PANEL BIOFIRE 300 0097U 51 N/A Both 503.00 N/A N/A N/A N/A - - 30001459 HC RESP VIRAL PANEL BIOFIRE - MICRO 300 0097U 51 N/A Both 503.00 N/A N/A N/A N/A - - 32000045 HC SPINE 6 OR MORE VIEWS 320 72084 51 N/A Both 504.00 N/A N/A N/A N/A - - 32900357 HC MUSCLE BX CASTING STUDY 761 20225 51 N/A Both 504.00 N/A N/A N/A N/A - - 34100001 HC THYROID UPTAKE SGL OR MULT 341 78012 51 N/A Both 506.00 N/A N/A N/A N/A - - 74000005 HC ELECTROCORTICOGRAM 740 95829 51 N/A Both 508.00 N/A N/A N/A N/A - - 92100019 HC LTD TRANSCRANIAL DOPPLER TCD 921 93888 51 N/A Both 508.00 N/A N/A N/A N/A - - 99000027 HC OBS INPATIENT HOSPITAL CARE 55 MIN 990 99236 51 N/A Both 510.00 N/A N/A N/A N/A - - 35200041 HC CT TOMOGRAM FOR IVP 350 76380 51 N/A Both 514.00 N/A N/A N/A N/A - - 27800006 HC MULTI-LUMEN CATHETER 278 C1751 51 N/A Both 520.00 N/A N/A N/A N/A - - 27200014 HC NITRIC OXIDE HOURLY 272 94799 51 N/A Both 520.00 N/A N/A N/A N/A - - 76100259 HC REFILLING & MAINTENANCE PORTABLE PUMP 761 96521 51 N/A Both 520.00 N/A N/A N/A N/A - - 76100053 HC OFFICE OUTPATIENT VISIT LEVEL 5 761 99215 51 N/A Both 521.00 N/A N/A N/A N/A - - 76100069 HC PICC TEAM IV PLACE W SONOSITE 761 36410 51 N/A Both 521.00 N/A N/A N/A N/A - - 94000003 HC PLEUREX CATHETER REMOVAL 940 51 N/A Both 521.00 N/A N/A N/A N/A - - 76100171 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT EA ADDL 100 SQCM 761 15278 51 N/A Both 523.00 N/A N/A N/A N/A - - 76100167 HC APPL SKIN GRAFT T/A/L EA ADDL 100 SQCM 761 15274 51 N/A Both 523.00 N/A N/A N/A N/A - - 76100135 HC INJECT NERV BLCK VAGUS NERVE 761 64408 51 N/A Both 523.00 N/A N/A N/A N/A - - 91300001 HC PARTIAL CARE 6-8 HRS 913 90853 51 N/A Both 525.00 N/A N/A N/A N/A - - 40200071 HC US FETAL BIOPHYS W/NON STRESS TESTING (MFM ONLY) 402 76818 51 N/A Both 525.00 N/A N/A N/A N/A - - 32000107 HC SWALLOW FUNCTION W VIDEO 320 74230 51 N/A Both 526.00 N/A N/A N/A N/A - - 90000007 HC MCD INPT PSYCH DX INTER EXAM 900 90791 51 N/A Both 527.00 N/A N/A N/A N/A - - 90000009 HC PSYCHOL DX INTERVIEW EXAM 900 90791 51 N/A Both 527.00 N/A N/A N/A N/A - - 92000021 HC SLEEP STUDY APPLICATION CHARGE 920 95810 51 N/A Both 527.00 N/A N/A N/A N/A - - 90000008 HC TELEHEALTH PSYCH DX INTERVIEW 900 90791 51 N/A Both 527.00 N/A N/A N/A N/A - - 40200008 HC US THYROID/NECK 402 76536 51 N/A Both 529.00 N/A N/A N/A N/A - - 40200052 HC US GUIDANCE VENOUS LOC 402 76999 51 N/A Both 529.00 N/A N/A N/A N/A - - 27200018 HC TRACH BUTTON 272 51 N/A Both 531.00 N/A N/A N/A N/A - - 32000104 HC PERITONEOGRAM 761 74190 51 N/A Both 532.00 N/A N/A N/A N/A - - 27100007 HC INFANT OXYGEN LESS THAN 1 L 271 51 N/A Both 534.00 N/A N/A N/A N/A - - 33900001 HC INSERT VAG RADIATION DEVICE 339 57156 51 N/A Both 534.00 N/A N/A N/A N/A - - 27000048 HC KIT CATH CVL QUAD ARROWGARD 270 51 N/A Both 536.00 N/A N/A N/A N/A - - 27000018 HC KIT CATH CVL QUAD LUMEN 270 51 N/A Both 536.00 N/A N/A N/A N/A - - 32400013 HC CHEST DECUB/SPECIAL ONE VIEW 324 71045 51 N/A Both 537.00 N/A N/A N/A N/A - - 92200005 HC EMG CRANIAL NERVE SUPPLIED UNI 922 95867 51 N/A Both 539.00 N/A N/A N/A N/A - - 32000031 HC CHEST W/RIBS BIL 4+ VIEWS 320 71111 51 N/A Both 540.00 N/A N/A N/A N/A - - 46000010 HC DIFFUSION CAPACITY 460 94729 51 N/A Both 540.00 N/A N/A N/A N/A - - 40200017 HC US SPINAL CANAL AND CONTENTS 402 76800 51 N/A Both 541.00 N/A N/A N/A N/A - - 92000006 HC CONT GLUCOSE MONITORING 920 95250 51 N/A Both 543.00 N/A N/A N/A N/A - - 45000329 HC DRAINAGE OF EYELID ABSCESS 450 67700 51 N/A Both 543.00 N/A N/A N/A N/A - - 76100099 HC GASTRIC INTUBATION ASP THERAPEUTIC 761 43753 51 N/A Both 543.00 N/A N/A N/A N/A - - 45000332 HC REMOVE EYELID FOREIGN BODY EMBEDDED 450 67938 51 N/A Both 543.00 N/A N/A N/A N/A - - 32200002 HC ARTHROGRAM ELBOW 322 73085 51 N/A Both 547.00 N/A N/A N/A N/A - - 32200005 HC ARTHROGRAPHY KNEE 322 73580 51 N/A Both 547.00 N/A N/A N/A N/A - - 32000185 HC BODY SECTION TOMOGRAPHY 320 76100 51 N/A Both 548.00 N/A N/A N/A N/A - - 27400038 HC KNEE ORTHOSIS PREFAB RIGID SUPPORT 274 L1832 51 N/A Both 550.00 N/A N/A N/A N/A - - 48100103 HC REMOVAL INTRA AORTIC BALLOON ASSIST DEVICE 481 33968 51 N/A Both 550.00 N/A N/A N/A N/A - - 92200001 HC EMG - 1 EXTREMITY 922 95860 51 N/A Both 551.00 N/A N/A N/A N/A - - 32000059 HC EPIDUROGRAPHY 761 72275 51 N/A Both 551.00 N/A N/A N/A N/A - - 32900245 HC INJ PERITONEAL VENOUS SHUNT 761 49427 51 N/A Both 551.00 N/A N/A N/A N/A - - 46000029 HC SIX MINUTE WALK TEST 460 94618 51 N/A Both 552.00 N/A N/A N/A N/A - - 32000207 HC SPEECH SWALLOW/ESOPHOGRAM 320 74230 51 N/A Both 554.00 N/A N/A N/A N/A - - 32900244 HC CONTRAST INJ ABSCESS CYST 761 49424 51 N/A Both 556.00 N/A N/A N/A N/A - - 40200064 HC US TRANSVAGINAL NONOBSTETRIC 402 76830 51 N/A Both 558.00 N/A N/A N/A N/A - - 32900152 HC ARTERIAL LINE INSERTION 761 36620 51 N/A Both 559.00 N/A N/A N/A N/A - - 92100035 HC MV ASSESSMENT - TEMP RECOVERY 921 93923 51 N/A Both 559.00 N/A N/A N/A N/A - - 34100050 HC SPECT/CT 341 78999 51 N/A Both 559.00 N/A N/A N/A N/A - - 40200059 HC US ABDOMINAL AORTA LTD 402 76775 51 N/A Both 560.00 N/A N/A N/A N/A - - 40200015 HC US RETROPERITONEAL LTD 402 76775 51 N/A Both 560.00 N/A N/A N/A N/A - - 40200058 HC ABDOMINAL AORTA SCAN - LTD 402 76775 51 N/A Both 560.00 N/A N/A N/A N/A - - 40200013 HC US ABDOMEN LTD 402 76705 51 N/A Both 561.00 N/A N/A N/A N/A - - 44400031 HC DYSPHAGIA EVAL 60 444 92610 51 N/A Both 564.00 N/A N/A N/A N/A - - 44000050 HC DYSPHAGIA TRMT 60 440 92526 51 N/A Both 564.00 N/A N/A N/A N/A - - 44000041 HC SLP TRMT 60 440 92507 51 N/A Both 564.00 N/A N/A N/A N/A - - 32000106 HC ESOPHAGUS SINGLE CONTRAST AGENT 320 74220 51 N/A Both 565.00 N/A N/A N/A N/A - - 35000011 HC 3D IMAGING W POST PROCESSING 350 76377 51 N/A Both 566.00 N/A N/A N/A N/A - - 40200037 HC US PROSTATE/TRANSRECTAL 402 76872 51 N/A Both 568.00 N/A N/A N/A N/A - - 44400014 HC SLP FLUENCY EVAL 45 444 92521 51 N/A Both 573.00 N/A N/A N/A N/A - - 76100154 HC APPLY CAST SHOULDER TO HIPS BOTH THIGHS 761 29046 51 N/A Both 575.00 N/A N/A N/A N/A - - 76100153 HC APPLY CAST SHOULDER TO HIPS HEAD MINERVA 761 29040 51 N/A Both 575.00 N/A N/A N/A N/A - - 76100161 HC APPLY HIP 1.5 SPICA OR BOTH LEGS 761 29325 51 N/A Both 575.00 N/A N/A N/A N/A - - 32000223 HC ESOPHAGUS DOUBLE CONTRAST AGENT 320 74221 51 N/A Both 575.00 N/A N/A N/A N/A - - 92200002 HC EMG - 2 EXTREMITY 922 95861 51 N/A Both 577.00 N/A N/A N/A N/A - - 31000001 HC FECAL MICROBIOTA 750 44705 51 N/A Both 580.00 N/A N/A N/A N/A - - 92000003 HC ANAL URINARY MUSCLE STUDY 920 51785 51 N/A Both 581.00 N/A N/A N/A N/A - - 92200012 HC NERVE CONDUCTION STUDIES 1-2 922 95907 51 N/A Both 582.00 N/A N/A N/A N/A - - 40200039 HC US EXTREMITY NONVASC COMPLETE 402 76881 51 N/A Both 583.00 N/A N/A N/A N/A - - 39000008 HC RED CELLS LR 390 P9016 51 N/A Both 584.00 N/A N/A N/A N/A - - 41000018 HC APNEA MONITOR 410 94775 51 N/A Both 586.00 N/A N/A N/A N/A - - 46000008 HC EXPIRED GAS ANALYSIS OXYGEN 460 94680 51 N/A Both 587.00 N/A N/A N/A N/A - - 40200007 HC US HEAD 402 76506 51 N/A Both 588.00 N/A N/A N/A N/A - - 30000313 HC FETAL FIBRONECTIN SEMIQUANT 300 82731 51 N/A Both 588.00 N/A N/A N/A N/A - - 76100260 HC REFILL & MAINTENANCE PUMP DRUG DLVR SYSTEMIC 761 96522 51 N/A Both 590.00 N/A N/A N/A N/A - - 32000137 HC HYSTEROSALPINOGRAPHY 320 74740 51 N/A Both 591.00 N/A N/A N/A N/A - - 45000026 HC THORACENTESIS 450 51 N/A Both 594.00 N/A N/A N/A N/A - - 32000222 HC UPPER GI W SCOUT W WO DELAYED IMAGES SINGLE CONTRAST AGENT 320 74240 51 N/A Both 594.00 N/A N/A N/A N/A - - 42400008 HC PT HOME EVALUATION 424 97163 51 N/A Both 596.00 N/A N/A N/A N/A - - 32000112 HC SMALL BOWEL SERIES SINGLE CONTRAST AGENT 320 74250 51 N/A Both 602.00 N/A N/A N/A N/A - - 30000007 HC GENERAL HEALTH PANEL 300 80050 51 N/A Both 604.00 N/A N/A N/A N/A - - 33300033 HC INTRACAV RAD-ELE APPL - SIMPLE 333 77761 51 N/A Both 604.00 N/A N/A N/A N/A - - 33100002 HC CHEMO PLEURAL CAV W/THOR 331 96440 51 N/A Both 610.00 N/A N/A N/A N/A - - 32900115 HC ADD 2ND 3RD ORD LOWER EXT 761 36248 51 N/A Both 610.00 N/A N/A N/A N/A - - 32900103 HC ADD 2ND 3RD THORACIC 761 36218 51 N/A Both 610.00 N/A N/A N/A N/A - - 39000063 HC RED CELLS SUPERNATANT REDUCED 390 P9016 51 N/A Both 614.00 N/A N/A N/A N/A - - 32000184 HC SURGICAL SPECIMEN 320 76098 51 N/A Both 614.00 N/A N/A N/A N/A - - 32000194 HC OSSEOUS SURVEY LIMITED 320 77074 51 N/A Both 617.00 N/A N/A N/A N/A - - 45000005 HC EMERGENCY ROOM III 450 99283 51 N/A Both 617.00 N/A N/A N/A N/A - - 40200048 HC US GUIDANCE AMNIOCENTESIS 402 76946 51 N/A Both 618.00 N/A N/A N/A N/A - - 32900010 HC ASPIRATION BREAST CYST 329 19000 51 N/A Both 619.00 N/A N/A N/A N/A - - 32900284 HC AMNIOCENTESIS 329 59000 51 N/A Both 619.00 N/A N/A N/A N/A - - 32000166 HC S & I REMOVAL LUMEN 761 75902 51 N/A Both 619.00 N/A N/A N/A N/A - - 32000116 HC CHOLANGIOGRAPHY OPER 320 74300 51 N/A Both 621.00 N/A N/A N/A N/A - - 33300015 HC TX DEVICE DESIGN/CONST-SIMPLE 333 77332 51 N/A Both 621.00 N/A N/A N/A N/A - - 32000108 HC UPPER GI W/KUB 320 74241 51 N/A Both 621.00 N/A N/A N/A N/A - - 91300002 HC SHORT-TERM RES - IC 913 51 N/A Both 625.00 N/A N/A N/A N/A - - 45000194 HC CLOSED RX GR TROCHANTERIC FX 450 27246 51 N/A Both 627.00 N/A N/A N/A N/A - - 94200034 HC PUMP SYSTEM TRAIN ME 942 51 N/A Both 627.00 N/A N/A N/A N/A - - 46000002 HC BRONCHODILATION RESPONSIVENESS 460 94060 51 N/A Both 629.00 N/A N/A N/A N/A - - 45000084 HC DRESS/DEBRID LARGE BURN NO ANESTH 450 16030 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000085 HC ESCHAROTOMY 450 16035 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000066 HC LAYR CLOS WND FACE FACIAL 12.6-20CM 450 12055 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000063 HC LAYR CLOS WND FACE FACIAL 2.5-5CM 450 12052 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000067 HC LAYR CLOS WND FACE FACIAL 20.1-30CM 450 12056 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000064 HC LAYR CLOS WND FACE FACIAL 5.1-7.5CM 450 12053 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000065 HC LAYR CLOS WND FACE FACIAL 7.6-12.5CM 450 12054 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000062 HC LAYR CLOS WND FACE FACIAL <2.5CM 450 12051 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000068 HC LAYR CLOS WND FACE FACIAL >30CM 450 12057 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000057 HC LAYR CLOS WND REST BODY 2.6-7.5CM 450 12042 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000060 HC LAYR CLOS WND REST BODY 20.1-30CM 450 12046 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000056 HC LAYR CLOS WND REST BODY <2.5CM 450 12041 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000053 HC LAYR CLOS WND TRUNK ARM LEG 12.6-20CM 450 12035 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000051 HC LAYR CLOS WND TRUNK ARM LEG 2.6-7.5CM 450 12032 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000052 HC LAYR CLOS WND TRUNK ARM LEG 7.6-12.5CM 450 12034 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000050 HC LAYR CLOS WND TRUNK ARM LEG <2.5CM 450 12031 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000075 HC RECMPL WND HEAD FAC HAND 1.1-2.5CM 450 13131 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000029 HC REMOVE FOREIGN BODY SIMPLE 450 10120 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000040 HC RESUPERF WND BODY 12.6-20CM 450 12005 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000041 HC RESUPERF WND BODY 20.1-30CM 450 12006 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000047 HC RESUPERF WND FACE 12.6-20CM 450 12016 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000048 HC RESUPERF WND FACE 20.1-30CM 450 12017 51 N/A Both 630.00 N/A N/A N/A N/A - - 45000036 HC EXCISION OF NAIL FOLD TOE 450 11765 51 N/A Both 631.00 N/A N/A N/A N/A - - 45000034 HC REMOVAL OF NAIL BED 450 11750 51 N/A Both 631.00 N/A N/A N/A N/A - - 32000189 HC FLUORO GUIDANCE/LOCAL NDL 320 77003 51 N/A Both 634.00 N/A N/A N/A N/A - - 32900147 HC DECLOT THROMBOLYTIC AGENT 761 36593 51 N/A Both 635.00 N/A N/A N/A N/A - - 76100226 HC CHEMODENERV MUSC NECK DYSTON 761 64616 51 N/A Both 637.00 N/A N/A N/A N/A - - 75000123 HC LARYNGOSCOPY 750 51 N/A Both 645.00 N/A N/A N/A N/A - - 41000043 HC NON-INVASIVE CPAP SUBSEQUENT SIPAP 410 94660 51 N/A Both 647.00 N/A N/A N/A N/A - - 32000049 HC SPINE LUMBAR BEND 2-3 VIEWS 320 72120 51 N/A Both 651.00 N/A N/A N/A N/A - - 32000037 HC SPINE CERVICAL 6 OR MORE VIEWS 320 72052 51 N/A Both 651.00 N/A N/A N/A N/A - - 40200018 HC US OB < 14 WKS 0 DAYS 402 76801 51 N/A Both 651.00 N/A N/A N/A N/A - - 44400019 HC SLP ARTICULATION EVAL 60 444 92522 51 N/A Both 651.00 N/A N/A N/A N/A - - 44400034 HC SLP COGNITION EVAL 60 444 96125 51 N/A Both 651.00 N/A N/A N/A N/A - - 44400023 HC SLP LANGUAGE EVAL 60 444 92523 51 N/A Both 651.00 N/A N/A N/A N/A - - 44400027 HC SLP VOICE EVAL 60 444 92524 51 N/A Both 651.00 N/A N/A N/A N/A - - 44400036 HC ST APHASIA EVAL 60 444 96105 51 N/A Both 651.00 N/A N/A N/A N/A - - 92100045 HC DOPP AB PEL SCROT RET LTD 921 93976 51 N/A Both 652.00 N/A N/A N/A N/A - - 32900197 HC INJ PX SPLENOPORTOGRAPHY 761 38200 51 N/A Both 652.00 N/A N/A N/A N/A - - 40200009 HC US CHEST 402 76604 51 N/A Both 657.00 N/A N/A N/A N/A - - 92100037 HC ERIAL ANKLE ARM INDEX EXER 921 93924 51 N/A Both 660.00 N/A N/A N/A N/A - - 39000069 HC RED CELLS LR IRR ADULT ALIQUOT 390 P9040 51 N/A Both 664.00 N/A N/A N/A N/A - - 75000167 HC A GASTRIC LAVAGE 750 51 N/A Both 666.00 N/A N/A N/A N/A - - 40200038 HC US PROSTATE VOLUME STUDY 402 76873 51 N/A Both 667.00 N/A N/A N/A N/A - - 40200036 HC US SCROTUM 402 76870 51 N/A Both 669.00 N/A N/A N/A N/A - - 76100220 HC THROMBOLYSIS CEREBRAL BY INTRAVENOUS INFUSION 761 37195 51 N/A Both 669.00 N/A N/A N/A N/A - - 76100101 HC DRAIN SKIN ABSCESS COMPLIC 761 10061 51 N/A Both 669.00 N/A N/A N/A N/A - - 76100128 HC I&D OF VULVA/PERINEUM ABSCESS 761 56405 51 N/A Both 669.00 N/A N/A N/A N/A - - 27000078 HC KIT PERICARDIOCENTESIS STRL 270 51 N/A Both 669.00 N/A N/A N/A N/A - - 45000309 HC REMOVE PHARYNX FOREIGN BODY 450 42809 51 N/A Both 670.00 N/A N/A N/A N/A - - 45000327 HC REMV FB EYE CORNEA NO SLIT 450 65220 51 N/A Both 670.00 N/A N/A N/A N/A - - 45000326 HC REMV FB EYE EMBED CONJUNC 450 65210 51 N/A Both 670.00 N/A N/A N/A N/A - - 34100002 HC THYROID IMAGING ONLY 341 78013 51 N/A Both 670.00 N/A N/A N/A N/A - - 33300041 HC RAD THERAPY INTRA-ARTERIAL 333 79445 51 N/A Both 671.00 N/A N/A N/A N/A - - 33300006 HC RADIATION DOSIMETRY CALC 333 77300 51 N/A Both 671.00 N/A N/A N/A N/A - - 34100014 HC NM SALIVARY GLAND 341 78230 51 N/A Both 672.00 N/A N/A N/A N/A - - 75000175 HC A REPLACE GTUBE W REVISION OF GASTRO TRACT 750 51 N/A Both 674.00 N/A N/A N/A N/A - - 44000051 HC DYSPHAGIA TRMT 75 440 92526 51 N/A Both 675.00 N/A N/A N/A N/A - - 32900086 HC INJECT CONTRAST VENOGRAPH 761 36005 51 N/A Both 675.00 N/A N/A N/A N/A - - 44000042 HC SLP TRMT 75 440 92507 51 N/A Both 675.00 N/A N/A N/A N/A - - 30001353 HC GI PANEL 300 87506 51 N/A Both 676.00 N/A N/A N/A N/A - - 32000190 HC DUCTOGRAM SINGLE 320 77053 51 N/A Both 681.00 N/A N/A N/A N/A - - 33300028 HC RAD TX UP TO 5 MEV-INTERM 333 77407 51 N/A Both 681.00 N/A N/A N/A N/A - - 33300027 HC RAD TX UP TO 5 MEV-SIMPLE 333 77402 51 N/A Both 681.00 N/A N/A N/A N/A - - 33300040 HC SURFACE APPL RADIOELEMENT 333 77789 51 N/A Both 681.00 N/A N/A N/A N/A - - 32900061 HC THORACENTESIS WO GUIDANCE 761 32554 51 N/A Both 684.00 N/A N/A N/A N/A - - 32900085 HC INJECT PSEUDOANEURYSM 761 36002 51 N/A Both 684.00 N/A N/A N/A N/A - - 76100026 HC TX RM CHEMO IV 1ST HOUR 335 96413 51 N/A Both 686.00 N/A N/A N/A N/A - - 32900151 HC INJECT CONTRAST W FLUORO 761 36598 51 N/A Both 687.00 N/A N/A N/A N/A - - 32900286 HC THYROID CYST ASPIRATE INJ 329 60300 51 N/A Both 691.00 N/A N/A N/A N/A - - 32000180 HC FLUOROSCOPY < 1 HOUR 320 76000 51 N/A Both 692.00 N/A N/A N/A N/A - - 32000014 HC DACROCYSTOGRAPH NASO DUCT 761 70170 51 N/A Both 694.00 N/A N/A N/A N/A - - 48000111 HC PREOP VESSEL ASSESSMENT FOR HEMODIALYSIS ACCESS COMPLETE UNILATERAL 480 93986 51 N/A Both 700.00 N/A N/A N/A N/A - - 32900285 HC THYROID BIOPSY PERC 329 60100 51 N/A Both 703.00 N/A N/A N/A N/A - - 32000133 HC URETHROCYSTOGRAM VOIDING 320 74455 51 N/A Both 706.00 N/A N/A N/A N/A - - 34000002 HC INJ RADIOPHARM LOCALIZATION NON-IMAGING PROBE STUDY 340 78808 51 N/A Both 708.00 N/A N/A N/A N/A - - 32000221 HC UPPER GI W SCOUT W WO DELAYED IMAGES DOUBLE CONTRAST AGENT 320 74246 51 N/A Both 708.00 N/A N/A N/A N/A - - 32900095 HC ENTRY SITE EXTREMITY 761 36140 51 N/A Both 709.00 N/A N/A N/A N/A - - 76100064 HC THORACENTESIS 761 51 N/A Both 712.00 N/A N/A N/A N/A - - 40200034 HC US PELVIC COMPLETE 402 76856 51 N/A Both 714.00 N/A N/A N/A N/A - - 32200004 HC ARTHROGRAM HIP 322 73525 51 N/A Both 714.00 N/A N/A N/A N/A - - 27000124 HC ORTHOTIC PELV TRAUMA CYBERTECH 270 51 N/A Both 720.00 N/A N/A N/A N/A - - 27100017 HC VDR ASSEMBLY 271 51 N/A Both 720.00 N/A N/A N/A N/A - - 40200078 HC US FETAL NUCHAL TRANSLUCENCY 1ST TRIMESTER EA ADDITIONAL FETUS 402 76814 51 N/A Both 725.00 N/A N/A N/A N/A - - 27100004 HC HELI OX THERAPY INITIAL 271 51 N/A Both 727.00 N/A N/A N/A N/A - - 92200003 HC EMG - 3 EXTREMITY 922 95863 51 N/A Both 728.00 N/A N/A N/A N/A - - 51000013 HC CIRCUMCISION W/REGIONL BLOC 723 54150 51 N/A Both 733.00 N/A N/A N/A N/A - - 27000142 HC KIT PNEUMOTHORAX WAYNE 14FR 270 51 N/A Both 734.00 N/A N/A N/A N/A - - 32000128 HC NEPHROSTOGRAM 761 74425 51 N/A Both 736.00 N/A N/A N/A N/A - - 40200025 HC EACH ADDTL GESTATION > 14 WKS 402 76810 51 N/A Both 738.00 N/A N/A N/A N/A - - 73100002 HC HOLTER 12 HOUR RECORDING 731 93226 51 N/A Both 739.00 N/A N/A N/A N/A - - 34200006 HC INJECT RADIOPHARM NON-IMAGING LOCALIZATION 324 78808 51 N/A Both 740.00 N/A N/A N/A N/A - - 32000110 HC UPPER GI AIR CONTRAST 320 74247 51 N/A Both 740.00 N/A N/A N/A N/A - - 76100175 HC NEG PRESS WOUND THERAPY > 50 SQCM 761 97608 51 N/A Both 742.00 N/A N/A N/A N/A - - 27100009 HC NITRIC OXIDE FOR CATH LAB 271 51 N/A Both 744.00 N/A N/A N/A N/A - - 32900031 HC INJ MAJOR JOINT THERAPEUTIC 761 20610 51 N/A Both 748.00 N/A N/A N/A N/A - - 39000017 HC RED CELLS WASHED 390 P9022 51 N/A Both 749.00 N/A N/A N/A N/A - - 76100227 HC NASAL/OROGASTRIC W/TUBE PLMT 761 43752 51 N/A Both 752.00 N/A N/A N/A N/A - - 92200004 HC EMG - 4 EXTREMITY 922 95864 51 N/A Both 753.00 N/A N/A N/A N/A - - 92200006 HC EMG CRANIAL NERVE BILATERAL 922 95868 51 N/A Both 753.00 N/A N/A N/A N/A - - 32000127 HC RETROGRADE PYELOGRAM 320 74420 51 N/A Both 759.00 N/A N/A N/A N/A - - 44400015 HC SLP FLUENCY EVAL 60 444 92521 51 N/A Both 760.00 N/A N/A N/A N/A - - 45000287 HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S) 450 31577 51 N/A Both 762.00 N/A N/A N/A N/A - - 39000030 HC RED CELLS LR IRRADIATED 390 P9040 51 N/A Both 764.00 N/A N/A N/A N/A - - 32000143 HC SHUNTOGRM PRV PLACE SHUNT 320 75809 51 N/A Both 765.00 N/A N/A N/A N/A - - 76100163 HC DEBRIDE SUBQ TISSUE EA ADDL 20 SQCM 761 11045 51 N/A Both 767.00 N/A N/A N/A N/A - - 92100034 HC ARTERIAL SEGMENTAL UPPER/LOWER 921 93923 51 N/A Both 769.00 N/A N/A N/A N/A - - 32900090 HC INT CATH RT HEART OR PULM 761 36013 51 N/A Both 769.00 N/A N/A N/A N/A - - 40200014 HC US-ABD AORTA RENAL 402 76770 51 N/A Both 775.00 N/A N/A N/A N/A - - 40200054 HC US AAA SCREENING CMS 402 76706 51 N/A Both 775.00 N/A N/A N/A N/A - - 32900330 HC INJ FACET CERV THOR 2ND LEVEL 761 64491 51 N/A Both 775.00 N/A N/A N/A N/A - - 32900331 HC INJ FACET CERV THOR 3RDOR MORE 761 64492 51 N/A Both 775.00 N/A N/A N/A N/A - - 32900333 HC INJ FACET LUMBAR 2ND LEVEL 761 64494 51 N/A Both 775.00 N/A N/A N/A N/A - - 32900334 HC INJ FACET LUMBAR 3RD AND MORE 761 64495 51 N/A Both 775.00 N/A N/A N/A N/A - - 92100030 HC RENAL ARTERY DUPLEX LTD 921 93976 51 N/A Both 775.00 N/A N/A N/A N/A - - 27200002 HC CATH CENTR VENO OPTI HEP COAT 272 51 N/A Both 780.00 N/A N/A N/A N/A - - 73100008 HC EVENT RECORDER RE-ENROLLMENT 731 93271 51 N/A Both 780.00 N/A N/A N/A N/A - - 44000005 HC EVAL SWALLOW BARIUM 444 92611 51 N/A Both 781.00 N/A N/A N/A N/A - - 32000195 HC OSSEOUS SURVEY COMPLETE 320 77075 51 N/A Both 784.00 N/A N/A N/A N/A - - 76100134 HC INSERT NEEDLE INTRAOSSEOUS INFUSN 761 36680 51 N/A Both 784.00 N/A N/A N/A N/A - - 41000046 HC NONINV BILEVEL VENT LIMITED 410 94660 51 N/A Both 784.00 N/A N/A N/A N/A - - 44000052 HC DYSPHAGIA TRMT 90 440 92526 51 N/A Both 786.00 N/A N/A N/A N/A - - 44000043 HC SLP TRMT 90 440 92507 51 N/A Both 786.00 N/A N/A N/A N/A - - 34200001 HC SUPV LOADING RADIOELEMENT 342 77790 51 N/A Both 792.00 N/A N/A N/A N/A - - 33300014 HC SPECIAL DOSIMETRY 333 77331 51 N/A Both 792.00 N/A N/A N/A N/A - - 39000064 HC RED CELLS SUPERNATANT RED IRR 390 P9040 51 N/A Both 793.00 N/A N/A N/A N/A - - 32900209 HC INTRO OF LONG GI TUBE 329 44500 51 N/A Both 794.00 N/A N/A N/A N/A - - 80300001 HC TUBING CHANGE FOR PD 803 51 N/A Both 794.00 N/A N/A N/A N/A - - 40200012 HC US ABDOMEN 402 76700 51 N/A Both 795.00 N/A N/A N/A N/A - - 32900006 HC DEBRIDE SKIN & SUBQ 761 11042 51 N/A Both 798.00 N/A N/A N/A N/A - - 32900098 HC INTRO NEEDLE TRANSLUMBAR 761 36160 51 N/A Both 799.00 N/A N/A N/A N/A - - 33300034 HC INTRACAV RADIOELE APP-INT 333 77762 51 N/A Both 804.00 N/A N/A N/A N/A - - 32400015 HC CHEST DECUBITUS/SPECIAL TWO VIEWS 324 71046 51 N/A Both 806.00 N/A N/A N/A N/A - - 35000010 HC 3D IMAGING W/O POST PROCESSING 350 76376 51 N/A Both 806.00 N/A N/A N/A N/A - - 32000191 HC DUCTOGRAM MULTIPLE 320 77054 51 N/A Both 806.00 N/A N/A N/A N/A - - 32000003 HC PARACENTESIS WO GUIDANCE 761 49082 51 N/A Both 806.00 N/A N/A N/A N/A - - 32900251 HC REPLACE J-G TUBE 761 49452 51 N/A Both 806.00 N/A N/A N/A N/A - - 32900250 HC REPLACE J-TUBE 761 49451 51 N/A Both 806.00 N/A N/A N/A N/A - - 76100034 HC OFFICE OUTPATIENT NEW LEVEL 4 761 99204 51 N/A Both 814.00 N/A N/A N/A N/A - - 72200002 HC INSERTION OF CERVICAL DIALATOR (SEPARATE PROCEDURE) 722 59200 51 N/A Both 816.00 N/A N/A N/A N/A - - 32000196 HC OSSEOUS SURVEY-INFANT 320 77076 51 N/A Both 817.00 N/A N/A N/A N/A - - 91200003 HC PARTIAL CARE 3-6 HOURS 912 51 N/A Both 817.00 N/A N/A N/A N/A - - 48000092 HC ADDITIONAL/OPEN HEART HRS 480 51 N/A Both 818.00 N/A N/A N/A N/A - - 92100018 HC TRANSCRANIAL DOPPLER 921 93886 51 N/A Both 818.00 N/A N/A N/A N/A - - 35100026 HC CT MAX FACIAL LTD 351 70486 51 N/A Both 819.00 N/A N/A N/A N/A - - 32000113 HC BARIUM ENEMA SINGLE CONTRAST AGENT 320 74270 51 N/A Both 819.00 N/A N/A N/A N/A - - 76100080 HC INJECT TRIGGER POINTS > 3 761 20553 51 N/A Both 821.00 N/A N/A N/A N/A - - 33300018 HC CONTINUING RAD PHYSICS CONSULT 333 77336 51 N/A Both 821.00 N/A N/A N/A N/A - - 27200016 HC EDI CATHETER 272 51 N/A Both 823.00 N/A N/A N/A N/A - - 40200074 HC ECHO FETAL (MFM ONLY) 402 76825 51 N/A Both 825.00 N/A N/A N/A N/A - - 48000112 HC PREOP VESSEL ASSESSMENT FOR HEMODIALYSIS ACCESS COMPLETE BILATERAL 480 93985 51 N/A Both 825.00 N/A N/A N/A N/A - - 90100001 HC ECT 1-4 HRS - SINGLE 901 90870 51 N/A Both 827.00 N/A N/A N/A N/A - - 34100037 HC DACROSCINTIGRAPHY SCAN 341 78660 51 N/A Both 832.00 N/A N/A N/A N/A - - 71000006 HC PACU BASE 710 51 N/A Both 834.00 N/A N/A N/A N/A - - 45000192 HC CLOSED RX INTER/SUBTROCH FEMUR FX 450 27238 51 N/A Both 836.00 N/A N/A N/A N/A - - 32000124 HC INTRAVENOUS PYELOGRAM 320 74400 51 N/A Both 838.00 N/A N/A N/A N/A - - 76100245 HC INJECT GENICULAR NERVE COMPLETE 761 64454 51 N/A Both 838.00 N/A N/A N/A N/A - - 76100185 HC NERVE BLOCK OTHER PERIPHERAL 761 64450 51 N/A Both 838.00 N/A N/A N/A N/A - - 71000017 HC CLASS 3 GI PROCEDURE RECOVERY 710 51 N/A Both 840.00 N/A N/A N/A N/A - - 32900299 HC SPINAL PUNC THERAPEUTIC 329 62272 51 N/A Both 841.00 N/A N/A N/A N/A - - 32900298 HC SPINAL PUNCTURE LUMBAR 761 62270 51 N/A Both 841.00 N/A N/A N/A N/A - - 45000021 HC LUMBAR PUNCTURE 450 51 N/A Both 841.00 N/A N/A N/A N/A - - 99000044 HC EGD CONTROL BLEED 990 43255 51 N/A Both 842.00 N/A N/A N/A N/A - - 94700001 HC SPORT ROTATION THERAPY 947 51 N/A Both 842.00 N/A N/A N/A N/A - - 32900204 HC DILATION OF SALIVARY DUCT 761 42660 51 N/A Both 847.00 N/A N/A N/A N/A - - 40200070 HC EACH ADDTL GESTATION DETAILED ANATOMY (MFM ONLY) 402 76812 51 N/A Both 850.00 N/A N/A N/A N/A - - 32000219 HC QUANTIFICATION EACH AREA EACH DAY 320 78835 51 N/A Both 850.00 N/A N/A N/A N/A - - 32000129 HC CYSTOGRAPHY 320 74430 51 N/A Both 854.00 N/A N/A N/A N/A - - 40200060 HC US KIDNEY TRANSPLANT LTD 402 76775 51 N/A Both 855.00 N/A N/A N/A N/A - - 91200004 HC PARTIAL HOSPITALIZATION -3 HRS 912 90853 51 N/A Both 858.00 N/A N/A N/A N/A - - 32900202 HC INJ PX ID SENTINEL NODE 329 38792 51 N/A Both 860.00 N/A N/A N/A N/A - - 76100165 HC DEBRIDE BONE EA ADDL 20 SQCM 761 11047 51 N/A Both 862.00 N/A N/A N/A N/A - - 32000115 HC BARIUM ENEMA INTUSSUSCEPT 320 74283 51 N/A Both 863.00 N/A N/A N/A N/A - - 92100046 HC US DOPP AORTA ILIAC IVC 921 93978 51 N/A Both 865.00 N/A N/A N/A N/A - - 92100031 HC AORTA IVC ILIAC DUPLEX 921 93978 51 N/A Both 865.00 N/A N/A N/A N/A - - 74000011 HC CORTICAL MAPPING 740 95961 51 N/A Both 867.00 N/A N/A N/A N/A - - 40200024 HC US OB >= 14 WK SGL OR 1ST GEST 402 76805 51 N/A Both 869.00 N/A N/A N/A N/A - - 35000027 HC 3-D IMAGING W/POST PROCESSING 350 76377 51 N/A Both 869.00 N/A N/A N/A N/A - - 35000028 HC 3T 3-D IMAGIN W/POST PROCESSI 350 76377 51 N/A Both 869.00 N/A N/A N/A N/A - - 40200053 HC FUSION OF IMAGES 402 76999 51 N/A Both 869.00 N/A N/A N/A N/A - - 40200077 HC US FETAL NUCHAL TRANSLUCENCY 1ST TRIMESTER INTL FETUS 402 76813 51 N/A Both 875.00 N/A N/A N/A N/A - - 99000045 HC NEEDLE BIOPSY LIVER 990 47001 51 N/A Both 879.00 N/A N/A N/A N/A - - 41000032 HC VENTILATOR LIMITED 410 94002 51 N/A Both 882.00 N/A N/A N/A N/A - - 32900087 HC INTRO CATH SUP INF VENA 761 36010 51 N/A Both 885.00 N/A N/A N/A N/A - - 76100131 HC DRAIN EXT EAR ABSC/BLOOD SIMPLE 761 69000 51 N/A Both 888.00 N/A N/A N/A N/A - - 45000071 HC REP SKIN TRUNKCMPLX +5CM/< 450 13102 51 N/A Both 888.00 N/A N/A N/A N/A - - 33100008 HC CHEMO BLADDER INSTILL 761 51720 51 N/A Both 899.00 N/A N/A N/A N/A - - 44000053 HC DYSPHAGIA TRMT 105 440 92526 51 N/A Both 899.00 N/A N/A N/A N/A - - 32900208 HC JEJUNOSTOMY ALIMENTATION 761 44015 51 N/A Both 899.00 N/A N/A N/A N/A - - 32000134 HC RENAL CYST STDY TRANSLUMB 761 74470 51 N/A Both 903.00 N/A N/A N/A N/A - - 40200067 HC US GUIDE VEN ACCESS DEV 402 76937 51 N/A Both 903.00 N/A N/A N/A N/A - - 76100092 HC INJECT NERV BLCK OTHR PERIPH NERV 761 64450 51 N/A Both 909.00 N/A N/A N/A N/A - - 32900320 HC INJECT GREATER OCCIPTAL NERVE 761 64405 51 N/A Both 919.00 N/A N/A N/A N/A - - 32900322 HC NERVE BLOCK INTERCOSTAL SINGLE 761 64420 51 N/A Both 919.00 N/A N/A N/A N/A - - 32900326 HC VERTEBRA INJECTION ADDL 761 64480 51 N/A Both 919.00 N/A N/A N/A N/A - - 32900328 HC VERTEBRA INJECTION ADDL 761 64484 51 N/A Both 919.00 N/A N/A N/A N/A - - 32200006 HC ARTHROGRAM ANKLE 322 73615 51 N/A Both 920.00 N/A N/A N/A N/A - - 35000015 HC CT GUIDE PLACE RAD FIELD 350 77014 51 N/A Both 920.00 N/A N/A N/A N/A - - 76100164 HC DEBRIDE MUSCLE/FASCIAL EA ADDL 20 SQCM 761 11046 51 N/A Both 921.00 N/A N/A N/A N/A - - 32000165 HC S & I REMOVAL CVA DEVICE 761 75901 51 N/A Both 922.00 N/A N/A N/A N/A - - 39000048 HC RED CELLS WASHED IRR 390 P9022 51 N/A Both 923.00 N/A N/A N/A N/A - - 41000011 HC NON-INVASIVE CPAP INITIAL SIPAP 410 94660 51 N/A Both 930.00 N/A N/A N/A N/A - - 40200047 HC US GUIDE NEEDLE PLACEMENT 402 76942 51 N/A Both 931.00 N/A N/A N/A N/A - - 45000096 HC CLOSED RX FX ORBIT 450 21400 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000100 HC CLOSED RX MANDIBLE FX 450 21450 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000296 HC I&D MOUTH/TONG INTRA LINGUAL 450 41000 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000300 HC I&D MOUTH/TONG INTRA MASTICATOR 450 41009 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000293 HC REMOVAL FOREIGN BODY MOUTH COMPLEX 450 40805 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000290 HC REPAIR LIP <1/2 VERT HEIGHT 450 40652 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000289 HC REPAIR LIP FULL THICK VERMILION 450 40650 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000295 HC REPAIR MOUTH LACERATION >2.5 CM 450 40831 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000306 HC REPAIR PALATE LACER <2 CM 450 42180 51 N/A Both 933.00 N/A N/A N/A N/A - - 45000303 HC REPAIR TONGUE LACER 2.6 CM+/COMPLX 450 41252 51 N/A Both 933.00 N/A N/A N/A N/A - - 17100001 HC R&B NEWBORN LEVEL I 171 51 N/A Both 935.00 N/A N/A N/A N/A - - 45000025 HC PERICARDIOCENTESIS 450 51 N/A Both 937.00 N/A N/A N/A N/A - - 27000015 HC TRAY THORACIC VENT 270 51 N/A Both 940.00 N/A N/A N/A N/A - - 45000340 HC CRITICAL CARE ADDL 30 MIN 450 99292 51 N/A Both 941.00 N/A N/A N/A N/A - - 76100120 HC DRAIN ABSCESS/HEMATOMA NASAL SEPTUM 761 30020 51 N/A Both 941.00 N/A N/A N/A N/A - - 76100122 HC DRAIN MOUTH ABSC/CYST/HEMAT COMPLX 761 40801 51 N/A Both 941.00 N/A N/A N/A N/A - - 35200043 HC CTA CHEST ASCENDING AORTA ONLY 352 71275 51 N/A Both 942.00 N/A N/A N/A N/A - - 99000038 HC EGD COMPLETE DIAGNOSTIC 990 43235 51 N/A Both 942.00 N/A N/A N/A N/A - - 32000188 HC FLUORO GUIDE NEEDLE PLACEMENT 320 77002 51 N/A Both 942.00 N/A N/A N/A N/A - - 75000084 HC B ESOPH W BX CYTOLOGY 750 51 N/A Both 944.00 N/A N/A N/A N/A - - 30001341 HC MENING/ENCEPH PANEL BIOFIRE 300 87483 51 N/A Both 944.00 N/A N/A N/A N/A - - 74000015 HC EEG WO VID EA 12-26 HR UNMNTR 740 95708 51 N/A Both 945.00 N/A N/A N/A N/A - - 74000017 HC VEEG EA 12-26 HR UNMNTR 740 95714 51 N/A Both 945.00 N/A N/A N/A N/A - - 37000004 HC ANESTHESIA MATERIAL BASE 370 51 N/A Both 946.00 N/A N/A N/A N/A - - 75000054 HC B-EGD W NG TYPE TUBE PLACEMENT 750 51 N/A Both 949.00 N/A N/A N/A N/A - - 90100002 HC ECT > 4 HRS - SINGLE 901 90870 51 N/A Both 949.00 N/A N/A N/A N/A - - 76100191 HC FINE NEEDLE ASP W US GUIDANCE ADDL LESION 761 10006 51 N/A Both 949.00 N/A N/A N/A N/A - - 45000024 HC PARACENTESIS 450 51 N/A Both 951.00 N/A N/A N/A N/A - - 32900339 HC RHIZOTOMY CERV THOR ADDTL 761 64634 51 N/A Both 955.00 N/A N/A N/A N/A - - 92200024 HC NERVE CONDUCTION STUDIES 3-4 922 95908 51 N/A Both 961.00 N/A N/A N/A N/A - - 32900099 HC INTRO CATH INTO AORTA 761 36200 51 N/A Both 968.00 N/A N/A N/A N/A - - 76100063 HC SPINAL PUNCTURE LUMBAR 761 62270 51 N/A Both 969.00 N/A N/A N/A N/A - - 35200037 HC CT LTD FOLLOW-UP 350 76380 51 N/A Both 971.00 N/A N/A N/A N/A - - 75000124 HC NG FEEDING TUBE PLACEMENT 750 51 N/A Both 974.00 N/A N/A N/A N/A - - 32900205 HC NG OR GASTRIC TUBE PLACEMENT 329 43752 51 N/A Both 974.00 N/A N/A N/A N/A - - 32000109 HC UPPER GI/SM BOWEL SERIES 320 74245 51 N/A Both 974.00 N/A N/A N/A N/A - - 32000220 HC SMALL BOWEL SERIES FOLLOWING UGI 320 74248 51 N/A Both 975.00 N/A N/A N/A N/A - - 40200069 HC US OB DETAILED ANATOMY SGL OR 1ST GESTATION (MFM ONLY) 402 76811 51 N/A Both 975.00 N/A N/A N/A N/A - - 36000111 HC TRANSESOPHAGEAL ECHO BY ANES 360 51 N/A Both 983.00 N/A N/A N/A N/A - - 45000006 HC EMERGENCY ROOM IV 450 99284 51 N/A Both 984.00 N/A N/A N/A N/A - - 45000059 HC LAYR CLOS WND REST BODY 12.6-20CM 450 12045 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000058 HC LAYR CLOS WND REST BODY 7.6-12.5CM 450 12044 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000054 HC LAYR CLOS WND TRUNK ARM LEG 20.1-30CM 450 12036 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000076 HC RECMPL WND HEAD FAC HAND 2.6-7.5CM 450 13132 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000078 HC RECMPL WND LID NOS EAR 1.1-2.5CM 450 13151 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000079 HC RECMPL WND LID NOS EAR 2.5-7.5CM 450 13152 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000072 HC RECMPL WND SCALP EXTR 1.1-2.5CM 450 13120 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000073 HC RECMPL WND SCALP EXTR 2.6-7.5CM 450 13121 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000069 HC RECMPL WND TRUNK 1.1-2.5CM 450 13100 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000070 HC RECMPL WND TRUNK 2.6-7.5CM 450 13101 51 N/A Both 991.00 N/A N/A N/A N/A - - 40200046 HC US GUIDE ABLATION VISCERAL 402 76940 51 N/A Both 991.00 N/A N/A N/A N/A - - 45000035 HC RECONSTRUC OF NAIL BED 450 11760 51 N/A Both 993.00 N/A N/A N/A N/A - - 76100193 HC FINE NEEDLE ASP W FLUORO GUIDANCE ADDL LESION 761 10008 51 N/A Both 998.00 N/A N/A N/A N/A - - 32900007 "HC DEBRIDE SKIN, SUBQ & MUSCLE" 329 11043 51 N/A Both 999.00 N/A N/A N/A N/A - - 41000019 HC AIRWAY MANAGEMENT 410 94799 51 N/A Both 999.00 N/A N/A N/A N/A - - 48100061 HC INJ AORTIC ROOT DURING HC 481 93567 51 N/A Both " 1,002.00 " N/A N/A N/A N/A - - 74000003 HC EEG - DROWSY 740 95816 51 N/A Both " 1,006.00 " N/A N/A N/A N/A - - 74000012 HC EEG APPLICATION 740 95816 51 N/A Both " 1,006.00 " N/A N/A N/A N/A - - 99000043 HC EGD WITH POLYPECTOMY 990 43251 51 N/A Both " 1,008.00 " N/A N/A N/A N/A - - 76100066 HC PICC GROSHONG REPAIR 761 36575 51 N/A Both " 1,009.00 " N/A N/A N/A N/A - - 32900321 HC INJECTION BRACHIAL PLEXUS 761 64415 51 N/A Both " 1,009.00 " N/A N/A N/A N/A - - 32000121 HC PERC PL ENTEROCLYSIS TUBE 320 74355 51 N/A Both " 1,011.00 " N/A N/A N/A N/A - - 75000147 HC B FLEX SIG W SUBMUCOS MRKR INJ 750 51 N/A Both " 1,015.00 " N/A N/A N/A N/A - - 75000093 HC B FLEX SIGMOID W BIOPSY 750 51 N/A Both " 1,015.00 " N/A N/A N/A N/A - - 32000111 HC UPPER GI-SM BOWEL W/AIR 320 74249 51 N/A Both " 1,019.00 " N/A N/A N/A N/A - - 76100239 HC CLOSURE OF SPLIT WOUND 761 12020 51 N/A Both " 1,024.00 " N/A N/A N/A N/A - - 32000114 HC BE AIR CONTRAST DOUBLE AGENT 320 74280 51 N/A Both " 1,024.00 " N/A N/A N/A N/A - - 30000332 HC CONTINUOUS BLOOD GAS MON INITI 300 82803 51 N/A Both " 1,027.00 " N/A N/A N/A N/A - - 27100011 HC NON-INVASIVE VENT ASSEMBLY 271 51 N/A Both " 1,027.00 " N/A N/A N/A N/A - - 92100044 HC US DOPP ABD PEL SCROT RET 921 93975 51 N/A Both " 1,030.00 " N/A N/A N/A N/A - - 34100005 HC PARATHYROID PLANAR IMAGING 341 78070 51 N/A Both " 1,032.00 " N/A N/A N/A N/A - - 32900206 HC CHANGE GASTROSTOMY TUBE 761 43762 51 N/A Both " 1,039.00 " N/A N/A N/A N/A - - 75000168 HC PEG TUBE EXC W/O ENDOSCOPY 750 51 N/A Both " 1,039.00 " N/A N/A N/A N/A - - 73100004 HC EVENT MONITOR SERVICE 731 93271 51 N/A Both " 1,040.00 " N/A N/A N/A N/A - - 76100081 HC EXT CANNULA DECLOTT WO BALLOON CATH 761 36860 51 N/A Both " 1,045.00 " N/A N/A N/A N/A - - 32900300 HC EPIDURAL BLOOD PATCH 370 62273 51 N/A Both " 1,046.00 " N/A N/A N/A N/A - - 92100028 HC DOPPLER - EXT VENOUS LTD 921 93971 51 N/A Both " 1,047.00 " N/A N/A N/A N/A - - 32900249 HC REPLACE G-TUBE 761 49450 51 N/A Both " 1,050.00 " N/A N/A N/A N/A - - 40200016 HC US TRANSPLANTED KIDNEY 402 76776 51 N/A Both " 1,052.00 " N/A N/A N/A N/A - - 75000006 HC B ILEOSCOPY STOMA W BIOPSY 750 51 N/A Both " 1,053.00 " N/A N/A N/A N/A - - 92100022 HC ART SEG STUDY & EXERCISE LOWER 921 93924 51 N/A Both " 1,056.00 " N/A N/A N/A N/A - - 92100021 HC ART SEG STUDY & REAC HYPEREMIA 921 93923 51 N/A Both " 1,056.00 " N/A N/A N/A N/A - - 47100001 HC AUDITORY EVOKED POTENTIAL 471 92585 51 N/A Both " 1,059.00 " N/A N/A N/A N/A - - 92200021 HC VISUAL EVOKED POTENTIAL 922 95930 51 N/A Both " 1,059.00 " N/A N/A N/A N/A - - 32900093 HC INT NDL INTRA CAROTID VRT 761 36100 51 N/A Both " 1,067.00 " N/A N/A N/A N/A - - 32900354 HC PLACE OCCL DEVICE VEIN/ARTERY 761 G0269 51 N/A Both " 1,068.00 " N/A N/A N/A N/A - - 92000015 HC HOME SLEEP TEST/TYPE 3 PORTA 920 G0399 51 N/A Both " 1,069.00 " N/A N/A N/A N/A - - 92000011 HC MULTICHNL SLEEP STUDY UNATTEND 920 95806 51 N/A Both " 1,069.00 " N/A N/A N/A N/A - - 32000120 HC GASTRO TUBE INTRODUCTION 320 74340 51 N/A Both " 1,070.00 " N/A N/A N/A N/A - - 99000041 HC EGD REMOVAL FOREIGN BODY 990 43247 51 N/A Both " 1,074.00 " N/A N/A N/A N/A - - 99000039 HC EGD WITH BIOPSY 990 43239 51 N/A Both " 1,074.00 " N/A N/A N/A N/A - - 99000042 HC EGD WITH CAUTERY 990 43250 51 N/A Both " 1,074.00 " N/A N/A N/A N/A - - 33300032 HC INFUS/INSTILL RADIOELEMENT SOL 333 77750 51 N/A Both " 1,074.00 " N/A N/A N/A N/A - - 40200045 HC US CATHETER PLACEMENT 402 76937 51 N/A Both " 1,077.00 " N/A N/A N/A N/A - - 32000132 HC URETHROCYSTOGRAPHY RETRO 320 74450 51 N/A Both " 1,085.00 " N/A N/A N/A N/A - - 32900207 HC REPOSITION GASTRIC TUBE 761 43761 51 N/A Both " 1,088.00 " N/A N/A N/A N/A - - 32000117 HC ERCP BILIARY ONLY 320 74328 51 N/A Both " 1,089.00 " N/A N/A N/A N/A - - 32900265 HC NEPHROSTOGRAM EXISTING TUBE 761 50431 51 N/A Both " 1,089.00 " N/A N/A N/A N/A - - 32200001 HC ARTHROGRAPHY SHOULDER 322 73040 51 N/A Both " 1,091.00 " N/A N/A N/A N/A - - 76100084 HC APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM 761 15271 51 N/A Both " 1,096.00 " N/A N/A N/A N/A - - 32900136 HC VCAD NT REPAIR 761 36575 51 N/A Both " 1,096.00 " N/A N/A N/A N/A - - 40200044 HC US PSEUDO-ANEURYSM COMP 402 76936 51 N/A Both " 1,113.00 " N/A N/A N/A N/A - - 33300016 HC TX DEVICE DESIGN/CONST-INTERM 333 77333 51 N/A Both " 1,117.00 " N/A N/A N/A N/A - - 32000057 HC MYELOGRAM LUMBOSACRAL S & I 320 72265 51 N/A Both " 1,119.00 " N/A N/A N/A N/A - - 61000240 HC MRI LOWER EXTREMITY W/O CONTRAST STIR IMAGES 610 73718 51 N/A Both " 1,120.00 " N/A N/A N/A N/A - - 48000030 HC ECHO 2D LIMITED 480 93308 51 N/A Both " 1,123.00 " N/A N/A N/A N/A - - 92200023 HC MOTOR EP ALL EXT 922 95939 51 N/A Both " 1,127.00 " N/A N/A N/A N/A - - 32900295 HC BX PERC DISC SPACE 761 62267 51 N/A Both " 1,128.00 " N/A N/A N/A N/A - - 32000138 HC TRANSCRV CATH FALLOP TUBE 761 74742 51 N/A Both " 1,129.00 " N/A N/A N/A N/A - - 37000020 HC CARDIOVERSION ANESTHESIA 370 51 N/A Both " 1,134.00 " N/A N/A N/A N/A - - 27800005 HC ORTHO SCREW 278 C1713 51 N/A Both " 1,137.00 " N/A N/A N/A N/A - - 32900356 HC ATTEMPT BREAST BX STEREO 329 19081 51 N/A Both " 1,143.00 " N/A N/A N/A N/A - - 40200001 HC ATTEMPT BREAST BX ULTRASOUND 402 19083 51 N/A Both " 1,143.00 " N/A N/A N/A N/A - - 32000118 HC ERCP PANCREAS ONLY 320 74329 51 N/A Both " 1,144.00 " N/A N/A N/A N/A - - 32900222 HC REMOVE DRAIN BILIARY 761 47537 51 N/A Both " 1,146.00 " N/A N/A N/A N/A - - 45000319 "HC CHANGE OF BLADDER TUBE,COMPLICATED" 450 51710 51 N/A Both " 1,147.00 " N/A N/A N/A N/A - - 32000055 HC MYELOGRAM CERV S & I 320 72240 51 N/A Both " 1,148.00 " N/A N/A N/A N/A - - 76100145 HC ASPIRATION BLADDER NEEDLE 761 51100 51 N/A Both " 1,150.00 " N/A N/A N/A N/A - - 76100133 HC DRAIN EXT AUD CANAL ABSCESS 761 69020 51 N/A Both " 1,150.00 " N/A N/A N/A N/A - - 76100136 HC INJECT NERV BLCK CERV PLEXUS 761 64999 51 N/A Both " 1,150.00 " N/A N/A N/A N/A - - 76100140 HC INJECT NERV BLCK PARACERVICAL 761 64435 51 N/A Both " 1,150.00 " N/A N/A N/A N/A - - 76100138 HC INJECT NERV BLCK SUPRASCAP N. 761 64418 51 N/A Both " 1,150.00 " N/A N/A N/A N/A - - 45000077 HC REPR FACE GENITAL HAND FT+5CM/< 450 13133 51 N/A Both " 1,150.00 " N/A N/A N/A N/A - - 75000033 HC ATTEMPTED ESO MOTILITY 750 51 N/A Both " 1,152.00 " N/A N/A N/A N/A - - 32000187 HC FLUORO VENOUS ACCESS DEVICE 320 77001 51 N/A Both " 1,156.00 " N/A N/A N/A N/A - - 40200049 HC US GUID PROSTATE NDL PLACEMENT 402 76965 51 N/A Both " 1,158.00 " N/A N/A N/A N/A - - 45000109 HC REMOVE SUBCUT SHOULDER FOREIGN BODY 450 23330 51 N/A Both " 1,162.00 " N/A N/A N/A N/A - - 45000237 "HC REMV FOOT FOREIGN BODY,SUBCUTANEOUS" 450 28190 51 N/A Both " 1,162.00 " N/A N/A N/A N/A - - 32900296 HC PERC ASP SPNL CYST SYRINX 761 62268 51 N/A Both " 1,163.00 " N/A N/A N/A N/A - - 92200018 HC SOMATOSENSORY EVOKED POT-LOWER 922 95926 51 N/A Both " 1,169.00 " N/A N/A N/A N/A - - 92200017 HC SOMATOSENSORY EVOKED POT-UPPER 922 95925 51 N/A Both " 1,169.00 " N/A N/A N/A N/A - - 92200022 HC SSEP ALL EXT 922 95938 51 N/A Both " 1,169.00 " N/A N/A N/A N/A - - 32000122 HC INTRALUM DIL STRICT/OBSTR 761 74360 51 N/A Both " 1,171.00 " N/A N/A N/A N/A - - 75000125 HC B ESOPH W SUBMUCOSAL INJECT 750 51 N/A Both " 1,179.00 " N/A N/A N/A N/A - - 75000082 HC B ESOPH W VARICES INJECTION 750 51 N/A Both " 1,179.00 " N/A N/A N/A N/A - - 40200050 HC INTRA OPERATIVE US 402 76998 51 N/A Both " 1,179.00 " N/A N/A N/A N/A - - 74000004 HC EEG - ASLEEP/AWAKE 740 95819 51 N/A Both " 1,181.00 " N/A N/A N/A N/A - - 76100067 HC MIDLINE INSERT 3 + YRS OLD 761 36410 51 N/A Both " 1,186.00 " N/A N/A N/A N/A - - 75000036 HC B COLON W WO SUBMCOS MRKR INJ 750 51 N/A Both " 1,197.00 " N/A N/A N/A N/A - - 75000042 HC B COLONOSCOPY W BIOPSY 750 51 N/A Both " 1,197.00 " N/A N/A N/A N/A - - 48000113 HC MYOCARDIAL STRAIN IMAGING 480 93356 51 N/A Both " 1,200.00 " N/A N/A N/A N/A - - 76100148 HC CARDIOPULMONARY RESUSCITATION 410 92950 51 N/A Both " 1,202.00 " N/A N/A N/A N/A - - 41000074 HC CPR 410 92950 51 N/A Both " 1,202.00 " N/A N/A N/A N/A - - 34100018 HC BONE JOINT IMAGE LIMITED 341 78300 51 N/A Both " 1,203.00 " N/A N/A N/A N/A - - 48000094 HC AUTOTRANSFUSION ORTHOPAT COLL 480 51 N/A Both " 1,209.00 " N/A N/A N/A N/A - - 76100035 HC OFFICE OUTPATIENT NEW LEVEL 5 761 99205 51 N/A Both " 1,210.00 " N/A N/A N/A N/A - - 75000017 HC A-ESO DIL-MALLONEY 750 51 N/A Both " 1,215.00 " N/A N/A N/A N/A - - 75000021 HC A-ESOPH-SAVARY W O ENDO 750 51 N/A Both " 1,215.00 " N/A N/A N/A N/A - - 34100003 HC THYROID IMAGING W/UPTAKES 341 78014 51 N/A Both " 1,217.00 " N/A N/A N/A N/A - - 33300020 HC PHYSICIST CONSULT LEVEL ONE 333 77370 51 N/A Both " 1,221.00 " N/A N/A N/A N/A - - 32900028 HC DRAIN INJECT SM JOINT W US 761 20604 51 N/A Both " 1,224.00 " N/A N/A N/A N/A - - 92100029 HC RENAL ARTERY DUPLEX COMPLETE 921 93975 51 N/A Both " 1,226.00 " N/A N/A N/A N/A - - 76100020 HC ATTEMPT PICC INSERTION 5+ YRS 761 36569 51 N/A Both " 1,227.00 " N/A N/A N/A N/A - - 76100043 HC ATTEMPT PICC REPLACEMENT 761 36584 51 N/A Both " 1,227.00 " N/A N/A N/A N/A - - 34100033 HC BRAIN IMAGE CP W/VASC FLW 341 78606 51 N/A Both " 1,231.00 " N/A N/A N/A N/A - - 75000032 HC ATTEMPTED EGD MODIFD PROC 750 51 N/A Both " 1,232.00 " N/A N/A N/A N/A - - 73100006 HC HOLTER 24 HOUR RECORDING 731 93226 51 N/A Both " 1,232.00 " N/A N/A N/A N/A - - 32900023 HC INJ SINUS TRACT THERAPEUTIC 761 20500 51 N/A Both " 1,233.00 " N/A N/A N/A N/A - - 92000012 HC MULTICHNL SLEEP STUDY ATTENDED 920 95807 51 N/A Both " 1,233.00 " N/A N/A N/A N/A - - 32900030 HC DRAIN INJECT MED JOINT W US 761 20606 51 N/A Both " 1,234.00 " N/A N/A N/A N/A - - 76100040 HC ATTEMPT PICC INSERTION <5 YRS 761 36568 51 N/A Both " 1,235.00 " N/A N/A N/A N/A - - 61000051 HC MRI BREAST POST CLIP PLACEMENT 610 76498 51 N/A Both " 1,235.00 " N/A N/A N/A N/A - - 33300003 HC THERA SIMULATION-SIMPLE 333 77280 51 N/A Both " 1,241.00 " N/A N/A N/A N/A - - 92100043 HC VENOUS MAPPING LTD 921 93971 51 N/A Both " 1,247.00 " N/A N/A N/A N/A - - 75000034 HC B POUCHOSCOPY W BIOPSY 750 51 N/A Both " 1,249.00 " N/A N/A N/A N/A - - 76100208 HC PUNCTURE RESERVOIR FOR INJECTION PX 761 61070 51 N/A Both " 1,252.00 " N/A N/A N/A N/A - - 48000098 HC CARDIAC ASSIST TRANSPORT 480 51 N/A Both " 1,254.00 " N/A N/A N/A N/A - - 76100121 HC DRAIN MOUTH ABSC/CYST/HEMATOMA SIMPL 761 40800 51 N/A Both " 1,254.00 " N/A N/A N/A N/A - - 76100141 HC INJ ANES AGENT SCIATIC NERVE SINGLE 761 64445 51 N/A Both " 1,254.00 " N/A N/A N/A N/A - - 76100139 HC INJECT NERV BLCK ILIOINGU/ILIOHYP 761 64425 51 N/A Both " 1,254.00 " N/A N/A N/A N/A - - 48100098 HC REMOVE VENTRICULAR ASSIST DEVICE ONLY 481 33992 51 N/A Both " 1,254.00 " N/A N/A N/A N/A - - 45000080 HC REPR EYELID NOSE EAR LIP+5CM 450 13153 51 N/A Both " 1,254.00 " N/A N/A N/A N/A - - 76100102 HC DRAIN PILONIDAL CYST SIMPL 761 10080 51 N/A Both " 1,255.00 " N/A N/A N/A N/A - - 76100103 HC DRAIN PILONIDAL CYST COMPLIC 761 10081 51 N/A Both " 1,255.00 " N/A N/A N/A N/A - - 92000016 HC COMPARTMENT PRESSURE MUSCLE 920 20950 51 N/A Both " 1,268.00 " N/A N/A N/A N/A - - 32900032 HC DRAIN INJECT LRG JOINT W US 761 20611 51 N/A Both " 1,271.00 " N/A N/A N/A N/A - - 92100024 HC ART DUPLEX SCAN LOWER LTD 921 93926 51 N/A Both " 1,275.00 " N/A N/A N/A N/A - - 92100026 HC ART DUPLEX SCAN UPPER LTD 921 93931 51 N/A Both " 1,275.00 " N/A N/A N/A N/A - - 92200013 HC NERVE CONDUCTION STUDIES 5-6 922 95909 51 N/A Both " 1,281.00 " N/A N/A N/A N/A - - 32000004 HC CISTERNOGRAPHY 320 70015 51 N/A Both " 1,283.00 " N/A N/A N/A N/A - - 91300003 HC PARTIAL CARE 6 HRS OR MORE 913 51 N/A Both " 1,287.00 " N/A N/A N/A N/A - - 91300004 HC PARTIAL HOSPITALIZATION -6 HRS 913 90853 51 N/A Both " 1,287.00 " N/A N/A N/A N/A - - 92100032 HC DUPLEX OF HEMODIALYSIS ACCESS 921 93990 51 N/A Both " 1,296.00 " N/A N/A N/A N/A - - 34100009 HC LIVER W/FLOW 341 78202 51 N/A Both " 1,299.00 " N/A N/A N/A N/A - - 71000018 HC CLASS 4 GI PROCEDURE RECOVERY 710 51 N/A Both " 1,305.00 " N/A N/A N/A N/A - - 37000024 HC EPIDURAL LABOR DELIVERY 370 51 N/A Both " 1,306.00 " N/A N/A N/A N/A - - 30001230 HC RESP VIRAL PANEL BIOFIRE 300 87633 51 N/A Both " 1,308.00 " N/A N/A N/A N/A - - 32900065 HC INJ FIBRIN AGENT PLEURAL CATH 761 32561 51 N/A Both " 1,309.00 " N/A N/A N/A N/A - - 34100017 HC BOWEL IMAGING 341 78290 51 N/A Both " 1,313.00 " N/A N/A N/A N/A - - 48200002 HC CARDIAC STRESS TEST 482 93017 51 N/A Both " 1,316.00 " N/A N/A N/A N/A - - 32900324 HC INJECT PUDENDAL NERVE 761 64430 51 N/A Both " 1,316.00 " N/A N/A N/A N/A - - 32900323 "HC NERVE BLOCK INTERCOSTAL ADDITIONAL LEVEL, EACH" 761 64421 51 N/A Both " 1,316.00 " N/A N/A N/A N/A - - 46000020 HC PULM STRESS W MYOCARDIAL PERF 460 94621 51 N/A Both " 1,316.00 " N/A N/A N/A N/A - - 46000006 HC SIMPLE PULMONARY STRESS TEST 460 94617 51 N/A Both " 1,316.00 " N/A N/A N/A N/A - - 12800001 HC R&B SEMI-PRIVATE REHAB 128 51 N/A Both " 1,320.00 " N/A N/A N/A N/A - - 32900145 HC VCAD/T REMOVE WO SUBQ PORT 761 36589 51 N/A Both " 1,338.00 " N/A N/A N/A N/A - - 33300035 HC INTRACAV RADIOELE APP-CPX 333 77763 51 N/A Both " 1,344.00 " N/A N/A N/A N/A - - 34200003 HC INJECT THERAPEUTIC RADPHARM 342 79101 51 N/A Both " 1,349.00 " N/A N/A N/A N/A - - 76100114 HC DRAIN FINGER ABSCESS COMPLICATED 761 26011 51 N/A Both " 1,359.00 " N/A N/A N/A N/A - - 12000001 HC R&B SEMI-PRIVATE 120 51 N/A Both " 1,360.00 " N/A N/A N/A N/A - - 92100038 HC ARTERIAL SCAN LOWER LTD 921 93926 51 N/A Both " 1,362.00 " N/A N/A N/A N/A - - 74000001 HC EEG EXTENDED MONITOR < 1 HOUR 740 95812 51 N/A Both " 1,362.00 " N/A N/A N/A N/A - - 39000023 HC PLT APHERESIS LR 4/5 390 P9035 51 N/A Both " 1,362.00 " N/A N/A N/A N/A - - 92100042 HC VENOUS DUPLEX SCAN UNI LTD 921 93971 51 N/A Both " 1,362.00 " N/A N/A N/A N/A - - 74000010 HC WADA ACTVATON INCL EEG MONITOR 740 95958 51 N/A Both " 1,362.00 " N/A N/A N/A N/A - - 32900003 HC DRAIN ABSC SOFT TISSUE W GUIDE 761 10030 51 N/A Both " 1,363.00 " N/A N/A N/A N/A - - 33100003 HC CHEMO - INTRATHECAL 331 96450 51 N/A Both " 1,365.00 " N/A N/A N/A N/A - - 34100048 HC PERITONEAL VENOUS SHUNT 341 78291 51 N/A Both " 1,370.00 " N/A N/A N/A N/A - - 92100017 HC CAROTID DUPLEX LMT OR UNI 921 93882 51 N/A Both " 1,374.00 " N/A N/A N/A N/A - - 32000119 HC ERCP BILIARY AND PANCREAS 320 74330 51 N/A Both " 1,375.00 " N/A N/A N/A N/A - - 33300010 HC BRACHYTHERAPY ISODOSE SIMPLE 333 77316 51 N/A Both " 1,376.00 " N/A N/A N/A N/A - - 74000014 HC EEG OR NONINTRACRANIAL 740 95955 51 N/A Both " 1,377.00 " N/A N/A N/A N/A - - 32000183 HC ABSCESSOGRAM/FISTULA/SINUS TRACT 320 76080 51 N/A Both " 1,384.00 " N/A N/A N/A N/A - - 34100006 HC PARATHYROID IMAGING W/SPECT 341 78071 51 N/A Both " 1,395.00 " N/A N/A N/A N/A - - 32900260 HC RMV NEPHR TUBE W FLUORO 761 50389 51 N/A Both " 1,395.00 " N/A N/A N/A N/A - - 46000003 HC BRONCHIAL PROVACATION 460 94070 51 N/A Both " 1,403.00 " N/A N/A N/A N/A - - 32900337 "HC CELIAC PLEXUS INJ, ANES AGENT" 761 64530 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900301 HC INJ NEURO SUBSTANCE 761 62280 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900306 HC INJ PX ARTERIAL 761 62294 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900353 HC INJ SI JOINT THERAPEUTIC 761 27096 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900302 HC INJECTION INFUSION LUMB 761 62282 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900407 HC SYMPATHETIC BLOCK CERVICAL 761 64510 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900336 HC SYMPATHETIC BLOCK LUMBAR 761 64520 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900325 HC VERTEBRA INJECTION SINGLE 761 64479 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 32900327 HC VERTEBRA INJECTION SINGLE 761 64483 51 N/A Both " 1,407.00 " N/A N/A N/A N/A - - 45000345 HC EXCISION BENIGN LESION INCL MARGINS T/A/L 450 11402 51 N/A Both " 1,411.00 " N/A N/A N/A N/A - - 32900059 HC REMOVE PLEURX CATHETER 761 32552 51 N/A Both " 1,412.00 " N/A N/A N/A N/A - - 75000011 HC A-ATTEMPTED COLONOSCOPY 750 51 N/A Both " 1,419.00 " N/A N/A N/A N/A - - 76100192 HC FINE NEEDLE ASP W FLUORO GUIDANCE INITIAL LESION 761 10007 51 N/A Both " 1,425.00 " N/A N/A N/A N/A - - 74000002 HC EEG EXTENDED MONITOR > 1 HOUR 740 95813 51 N/A Both " 1,426.00 " N/A N/A N/A N/A - - 35000008 HC CCTA COMPLETE FOR CHD 350 75573 51 N/A Both " 1,431.00 " N/A N/A N/A N/A - - 32900288 HC CERVICAL PUNCTURE W INJ 761 61055 51 N/A Both " 1,434.00 " N/A N/A N/A N/A - - 34200002 HC RADIONUCL THER HYPER INIT 342 79005 51 N/A Both " 1,434.00 " N/A N/A N/A N/A - - 27400036 HC TLS ORTHOTIC SPINAL SYSTEM 274 L0464 51 N/A Both " 1,440.00 " N/A N/A N/A N/A - - 45000317 HC ANOSCOPY REMOVE FOREIGN BODY 450 46608 51 N/A Both " 1,441.00 " N/A N/A N/A N/A - - 45000315 HC RECTUM SURGERY PROCEDURE UNLISTED 450 45999 51 N/A Both " 1,441.00 " N/A N/A N/A N/A - - 80100002 HC HEMODIALYSIS TX RM 821 90935 51 N/A Both " 1,445.00 " N/A N/A N/A N/A - - 34100029 HC PULM VENTILATION ONLY 341 78579 51 N/A Both " 1,447.00 " N/A N/A N/A N/A - - 34100030 HC PULM PERF IMAGE PARTICUL 341 78580 51 N/A Both " 1,447.00 " N/A N/A N/A N/A - - 74000020 HC VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING 740 95713 51 N/A Both " 1,457.00 " N/A N/A N/A N/A - - 76100170 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT 1ST 100 SQCM 761 15277 51 N/A Both " 1,463.00 " N/A N/A N/A N/A - - 76100166 HC APPL SKIN GRAFT TO T/A/L 1ST 100 SQCM 761 15273 51 N/A Both " 1,463.00 " N/A N/A N/A N/A - - 76100142 HC INJ ANES AGENT FEMORAL NERVE SINGLE 761 64447 51 N/A Both " 1,463.00 " N/A N/A N/A N/A - - 76100137 HC INJECT NERV BLCK AXILLARY NERV 761 64417 51 N/A Both " 1,463.00 " N/A N/A N/A N/A - - 45000074 HC REP SKIN SCALP/EXTREM+5CM/< 450 13122 51 N/A Both " 1,463.00 " N/A N/A N/A N/A - - 32900203 HC BIOPSY SALIVARY GLAND NDL 761 42400 51 N/A Both " 1,467.00 " N/A N/A N/A N/A - - 34100007 HC BONE MARROW IMAGING WHOLE BODY 341 78104 51 N/A Both " 1,469.00 " N/A N/A N/A N/A - - 32900020 HC PERC MUSCLE SFT TISSUE BX 761 20206 51 N/A Both " 1,472.00 " N/A N/A N/A N/A - - 76100246 HC INJECT NERVE OF SI JOINT 761 64451 51 N/A Both " 1,475.00 " N/A N/A N/A N/A - - 35200052 HC CT ABD W/O CONT LTD 352 74150 51 N/A Both " 1,494.00 " N/A N/A N/A N/A - - 46000015 HC PNEUMOGRAM 3 CHANNEL 460 94772 51 N/A Both " 1,505.00 " N/A N/A N/A N/A - - 45000310 HC DILATE ESOPHAGUS 450 43450 51 N/A Both " 1,509.00 " N/A N/A N/A N/A - - 45000292 HC REMOVAL FOREIGN BODY MOUTH SIMPLE 450 40804 51 N/A Both " 1,509.00 " N/A N/A N/A N/A - - 35100025 HC CT CATOPSY FACIAL BONES 351 70486 51 N/A Both " 1,515.00 " N/A N/A N/A N/A - - 35200014 HC CT ANGIO PELVIS W/WO CONTRAST 352 72191 51 N/A Both " 1,515.00 " N/A N/A N/A N/A - - 75000063 HC B ENTEROS TO ILIUM W BX 750 51 N/A Both " 1,524.00 " N/A N/A N/A N/A - - 75000068 HC B ENTEROS TO ILM W PEG J TUBE 750 51 N/A Both " 1,524.00 " N/A N/A N/A N/A - - 34100036 HC CSF LEAKAGE DETECT/LOCAL 341 78650 51 N/A Both " 1,524.00 " N/A N/A N/A N/A - - 48000036 HC PULM ART SETUP 480 51 N/A Both " 1,527.00 " N/A N/A N/A N/A - - 32000123 HC PERC TRANS DIL BIL DUCT 761 74363 51 N/A Both " 1,528.00 " N/A N/A N/A N/A - - 32900025 HC FOREIGN BODY REMOVAL 761 20520 51 N/A Both " 1,534.00 " N/A N/A N/A N/A - - 76100228 HC INCISION LINGUAL FRENUM FRENOTOMY 761 41010 51 N/A Both " 1,541.00 " N/A N/A N/A N/A - - 92000001 HC COMPART PRESS MUSCLE W EX 920 20950 51 N/A Both " 1,547.00 " N/A N/A N/A N/A - - 32900002 HC FINE NEEDLE ASP W US GUIDANCE INITIAL LESION 329 10005 51 N/A Both " 1,553.00 " N/A N/A N/A N/A - - 32900329 HC INJ FACET CERV THOR SGL LEVEL 761 64490 51 N/A Both " 1,555.00 " N/A N/A N/A N/A - - 32900332 HC INJ FACET LUMBAR SGL LEVEL 761 64493 51 N/A Both " 1,555.00 " N/A N/A N/A N/A - - 32900309 HC MYELOGRAM LUMBOSACRAL COMP 329 62304 51 N/A Both " 1,555.00 " N/A N/A N/A N/A - - 61000209 HC 3T MR BREAST WO CONTRAST UNI 610 77046 51 N/A Both " 1,559.00 " N/A N/A N/A N/A - - 61000212 HC MR BREAST WO CONTRAST UNI 610 77046 51 N/A Both " 1,559.00 " N/A N/A N/A N/A - - 45000311 "HC ESOPHAGOGASTRIC TAMPONADE,BALLOON" 450 43460 51 N/A Both " 1,568.00 " N/A N/A N/A N/A - - 76100125 HC I&D PERIANAL ABSCESS SUPERFICIAL 761 46050 51 N/A Both " 1,568.00 " N/A N/A N/A N/A - - 33300036 HC HDR BRACHYTX 1 CHANNEL 333 77770 51 N/A Both " 1,569.00 " N/A N/A N/A N/A - - 45000033 HC REMOVE ADDITIONAL NAIL PLATE 450 11732 51 N/A Both " 1,571.00 " N/A N/A N/A N/A - - 75000020 HC A ESOPHAGOSCOPY DIAG 750 51 N/A Both " 1,574.00 " N/A N/A N/A N/A - - 33300029 HC RAD TX UP TO 5 MEV-CPLX 333 77412 51 N/A Both " 1,574.00 " N/A N/A N/A N/A - - 61000239 HC MRI PELVIS W/O CONTRAST STIR IMAGES 610 72195 51 N/A Both " 1,575.00 " N/A N/A N/A N/A - - 32900307 HC MYELOGRAM CERVICAL COMPLETE 329 62302 51 N/A Both " 1,583.00 " N/A N/A N/A N/A - - 32900235 HC PARACENTESIS W GUIDANCE 761 49083 51 N/A Both " 1,588.00 " N/A N/A N/A N/A - - 32000056 HC MYELOGRAM THORACIC S & I 320 72255 51 N/A Both " 1,592.00 " N/A N/A N/A N/A - - 32000164 HC ANGIO THRU EXIST CATH F/U 761 75898 51 N/A Both " 1,593.00 " N/A N/A N/A N/A - - 99000040 HC EGD BALLOON DILATATION 990 43245 51 N/A Both " 1,593.00 " N/A N/A N/A N/A - - 35100027 HC CT MAX FACIAL WO CONTRAST 351 70486 51 N/A Both " 1,594.00 " N/A N/A N/A N/A - - 32900113 HC SEL CATH PLACE ART 2ND 761 36246 51 N/A Both " 1,599.00 " N/A N/A N/A N/A - - 92200014 HC NERVE CONDUCTION STUDIES 7-8 922 95910 51 N/A Both " 1,602.00 " N/A N/A N/A N/A - - 32900063 HC PLEURAL DRAIN PERC WO 761 32556 51 N/A Both " 1,602.00 " N/A N/A N/A N/A - - 32900062 HC THORACENTESIS W GUIDANCE 761 32555 51 N/A Both " 1,608.00 " N/A N/A N/A N/A - - 32900124 HC PERC PORTAL VEIN CATH 761 36481 51 N/A Both " 1,621.00 " N/A N/A N/A N/A - - 80100001 HC HEMODIALYSIS PT ROOM 821 90935 51 N/A Both " 1,622.00 " N/A N/A N/A N/A - - 72400001 HC BIRTHING ROOM 724 51 N/A Both " 1,635.00 " N/A N/A N/A N/A - - 72100001 HC C-SEC LABOR ROOM 721 51 N/A Both " 1,635.00 " N/A N/A N/A N/A - - 48000034 HC ECHO STRESS 480 93350 51 N/A Both " 1,644.00 " N/A N/A N/A N/A - - 30001482 HC RESPIRATORY PATHOGEN PANEL WITH COVID 300 0202U 51 N/A Both " 1,652.00 " N/A N/A N/A N/A - - 45000007 HC EMERGENCY ROOM V 450 99285 51 N/A Both " 1,653.00 " N/A N/A N/A N/A - - 76100197 HC FINE NEEDLE ASP W MR GUIDANCE ADDL LESION 761 10012 51 N/A Both " 1,662.00 " N/A N/A N/A N/A - - 32000154 HC VENOGRAPHY SUP SAG SINUS 761 75870 51 N/A Both " 1,664.00 " N/A N/A N/A N/A - - 76100130 HC INCISE/DRAIN CONJUNCTIVA 761 68020 51 N/A Both " 1,672.00 " N/A N/A N/A N/A - - 48000059 HC TILT TABLE 481 93660 51 N/A Both " 1,676.00 " N/A N/A N/A N/A - - 99000048 HC LAPAROSCOPY SURGICAL ETEROLYSIS 990 44180 51 N/A Both " 1,678.00 " N/A N/A N/A N/A - - 48000016 HC ECMO MONITORING-ARTERIAL 480 33949 51 N/A Both " 1,685.00 " N/A N/A N/A N/A - - 48000015 HC ECMO MONITORING-VENOUS 480 33948 51 N/A Both " 1,685.00 " N/A N/A N/A N/A - - 92100016 HC CAROTID DUPLEX BILATERAL 921 93880 51 N/A Both " 1,687.00 " N/A N/A N/A N/A - - 76100195 HC FINE NEEDLE ASP W CT GUIDANCE ADDL LESION 761 10010 51 N/A Both " 1,690.00 " N/A N/A N/A N/A - - 92100025 HC ARTERIAL DUPLEX SCAN BIL UPPER 921 93930 51 N/A Both " 1,694.00 " N/A N/A N/A N/A - - 92100023 HC ARTERIAL SCAN LOWER BIL 921 93925 51 N/A Both " 1,694.00 " N/A N/A N/A N/A - - 92100039 HC VENOUS DUPLEX SCAN BILATERAL 921 93970 51 N/A Both " 1,694.00 " N/A N/A N/A N/A - - 92100040 HC VENOUS MAPPING BILATERAL 921 93970 51 N/A Both " 1,694.00 " N/A N/A N/A N/A - - 32900371 HC AV FISTULOGRAM ONE ACCESS 761 36901 51 N/A Both " 1,697.00 " N/A N/A N/A N/A - - 39000024 HC PLT APHERESIS LR 390 P9035 51 N/A Both " 1,699.00 " N/A N/A N/A N/A - - 32900194 HC IVUS NON-CORONARY ADDTL 481 37253 51 N/A Both " 1,705.00 " N/A N/A N/A N/A - - 76100249 HC SPINAL PUNCTURE LUMBAR DX W FLUORO GUIDANCE 761 62328 51 N/A Both " 1,706.00 " N/A N/A N/A N/A - - 76100247 HC SPINAL PUNCTURE THERAPEUTIC W FLUORO GUIDANCE 761 62329 51 N/A Both " 1,706.00 " N/A N/A N/A N/A - - 34100042 HC TUMOR IMAGING SPECT SINGLE AREA SINGLE DAY IMAGING 341 78803 51 N/A Both " 1,710.00 " N/A N/A N/A N/A - - 61200024 HC MRI STIR LUMBAR W/O CONTRAST 612 72148 51 N/A Both " 1,712.00 " N/A N/A N/A N/A - - 61200022 HC 3T MRI STIR LUMBAR W/O CONTRAS 612 72148 51 N/A Both " 1,712.00 " N/A N/A N/A N/A - - 35000007 HC CT HEART W/WO CONTRAST 350 75572 51 N/A Both " 1,713.00 " N/A N/A N/A N/A - - 32900248 HC CONVERT G-TUBE TO GJ-TUBE 761 49446 51 N/A Both " 1,713.00 " N/A N/A N/A N/A - - 32000178 HC TUBE CHANGE - PERCUTANEOUS 761 75984 51 N/A Both " 1,713.00 " N/A N/A N/A N/A - - 39000066 HC PLT APHERESIS LR IRR VOL RED 390 P9037 51 N/A Both " 1,719.00 " N/A N/A N/A N/A - - 32900150 HC CENTRAL LINE REPOSITIONING 761 36597 51 N/A Both " 1,720.00 " N/A N/A N/A N/A - - 32900137 HC VCAD T REPAIR W SUBQ PORT 761 36576 51 N/A Both " 1,720.00 " N/A N/A N/A N/A - - 34100008 HC LYMPHATIC GLAND IMAGING 341 78195 51 N/A Both " 1,721.00 " N/A N/A N/A N/A - - 12400001 HC R&B SEMI-PRIVATE PSYCH 124 51 N/A Both " 1,730.00 " N/A N/A N/A N/A - - 39000026 HC PLT APHERESIS LR IRR 4/5 390 P9037 51 N/A Both " 1,734.00 " N/A N/A N/A N/A - - 32900057 HC BIOPSY LUNG MEDIASTINUM 761 32405 51 N/A Both " 1,748.00 " N/A N/A N/A N/A - - 32900056 HC BIOPSY PLEURA; PERCUT 761 32400 51 N/A Both " 1,748.00 " N/A N/A N/A N/A - - 75000066 HC B ENTEROS TO ILM W HOT BX 750 51 N/A Both " 1,756.00 " N/A N/A N/A N/A - - 75000067 HC B ENTEROS W PEG CONV TO J TUBE 750 51 N/A Both " 1,756.00 " N/A N/A N/A N/A - - 35100001 HC CATOPSY HEAD 351 70450 51 N/A Both " 1,774.00 " N/A N/A N/A N/A - - 61000056 HC ATTEMPT BREAST BX MRI 610 19085 51 N/A Both " 1,781.00 " N/A N/A N/A N/A - - 33300017 HC TX DEVICE DESIGN/CONST-COMPLEX 333 77334 51 N/A Both " 1,783.00 " N/A N/A N/A N/A - - 61200019 HC MRI STIR THORA W/O CONTRAST 612 72146 51 N/A Both " 1,787.00 " N/A N/A N/A N/A - - 61200017 HC 3T MRI STIR THORA W/O CONTRAST 612 72146 51 N/A Both " 1,787.00 " N/A N/A N/A N/A - - 35000022 HC CT LOWER EXT W CONTRAST LTD 352 73701 51 N/A Both " 1,788.00 " N/A N/A N/A N/A - - 61000055 HC MR 3T BREAST W/WO CONTRAST W/WO DYNACAD UNI 610 77048 51 N/A Both " 1,795.00 " N/A N/A N/A N/A - - 61000223 HC MR BREAST W/WO CONTRAST W/WO DYNACAD UNI 610 77048 51 N/A Both " 1,795.00 " N/A N/A N/A N/A - - 82000001 HC UNSCHED OTPT DIALYSIS ESRD PT 820 G0257 51 N/A Both " 1,798.00 " N/A N/A N/A N/A - - 12600001 HC R&B DETOX 126 51 N/A Both " 1,800.00 " N/A N/A N/A N/A - - 76100244 HC DESTRUCTION GENICULAR NERVE NEUROLYTIC AGENT COMPLETE 761 64624 51 N/A Both " 1,800.00 " N/A N/A N/A N/A - - 76100243 HC RADIO FREQUENCY ABLATION NERVE OF SI JOINT 761 64625 51 N/A Both " 1,800.00 " N/A N/A N/A N/A - - 46000007 HC PULM STRESS COMPLEX 460 94621 51 N/A Both " 1,801.00 " N/A N/A N/A N/A - - 32900091 HC PULMONARY ART CATH PL 761 36014 51 N/A Both " 1,802.00 " N/A N/A N/A N/A - - 75000059 HC B EGD W SCLEROTHERAPY 750 51 N/A Both " 1,805.00 " N/A N/A N/A N/A - - 75000080 HC B-ESOPH W FB REMOVAL 750 51 N/A Both " 1,812.00 " N/A N/A N/A N/A - - 34100038 HC KIDNEY W/VASC FLOW/FUNCT 341 78707 51 N/A Both " 1,814.00 " N/A N/A N/A N/A - - 75000050 HC B EGD W BIOPSY CYTOLOGY 750 51 N/A Both " 1,825.00 " N/A N/A N/A N/A - - 75000137 HC B EGD W SUBMUCOSAL INJ 750 51 N/A Both " 1,825.00 " N/A N/A N/A N/A - - 92000017 HC MAINTENANCE OF WAKEFULNESS RS 920 95805 51 N/A Both " 1,826.00 " N/A N/A N/A N/A - - 92000019 HC MULTIPLE SLEEP LATENCY TEST RS 920 95805 51 N/A Both " 1,826.00 " N/A N/A N/A N/A - - 35100029 HC CT STLTH SINUS DIR CRNLS WO CONTRAST 351 70486 51 N/A Both " 1,833.00 " N/A N/A N/A N/A - - 34100049 HC PARATHYROID IMAGE W SPECT CT 341 78072 51 N/A Both " 1,833.00 " N/A N/A N/A N/A - - 46000024 HC PNEUMOGRAM 4 CHANNEL 460 94772 51 N/A Both " 1,833.00 " N/A N/A N/A N/A - - 48100028 HC REMOVE SUBQ CARDIAC RHYTHM MONITOR 481 33286 51 N/A Both " 1,833.00 " N/A N/A N/A N/A - - 61200014 HC MRI STIR CERV W/O CONTRAST 612 72141 51 N/A Both " 1,840.00 " N/A N/A N/A N/A - - 61200012 HC 3T MRI STIR CERV W/O CONTRAST 612 72141 51 N/A Both " 1,840.00 " N/A N/A N/A N/A - - 32900258 HC REMOVE URETERAL STENT 761 50386 51 N/A Both " 1,841.00 " N/A N/A N/A N/A - - 32900075 HC OPEN FEMORAL ARTERY EXPOSURE 761 34812 51 N/A Both " 1,845.00 " N/A N/A N/A N/A - - 35200048 HC CATOPSY PELVIS 352 72192 51 N/A Both " 1,859.00 " N/A N/A N/A N/A - - 35000001 HC CT SFT TS NECK W/O CONT 350 70490 51 N/A Both " 1,859.00 " N/A N/A N/A N/A - - 12400003 HC R&B AFFECTIVE DISORDERS SEMI-PRIV 124 51 N/A Both " 1,860.00 " N/A N/A N/A N/A - - 35100012 HC CT HEAD WO CONTRAST 351 70450 51 N/A Both " 1,862.00 " N/A N/A N/A N/A - - 32900264 HC NEPHROSTOGRAM 761 50430 51 N/A Both " 1,866.00 " N/A N/A N/A N/A - - 41000045 HC NONINV BILEVEL VENT SUBS 410 94660 51 N/A Both " 1,867.00 " N/A N/A N/A N/A - - 32900016 HC BREAST NDL LOC MAMMO ADDTL 329 19282 51 N/A Both " 1,877.00 " N/A N/A N/A N/A - - 32900015 HC BREAST NDL LOC MAMMO GUIDE 329 19281 51 N/A Both " 1,877.00 " N/A N/A N/A N/A - - 32000145 HC VENOUS EXT UNILAT S & I 761 75820 51 N/A Both " 1,880.00 " N/A N/A N/A N/A - - 76100144 HC ASPIRATION BLADDER TROCAR/INTRACATHETER 761 51101 51 N/A Both " 1,881.00 " N/A N/A N/A N/A - - 51000016 HC LYSIS PENIL CIRCUMIC LESION 510 54162 51 N/A Both " 1,881.00 " N/A N/A N/A N/A - - 32900338 HC RHIZOTOMY CERV THOR INTL 761 64633 51 N/A Both " 1,881.00 " N/A N/A N/A N/A - - 32900341 HC RHIZOTOMY LUMB SACR ADDTL 761 64636 51 N/A Both " 1,881.00 " N/A N/A N/A N/A - - 32900342 HC RHIZOTOMY PERIPH NERVE 761 64640 51 N/A Both " 1,881.00 " N/A N/A N/A N/A - - 34100013 HC NM GALLBLADDER PIPIDA W CCK 341 78227 51 N/A Both " 1,889.00 " N/A N/A N/A N/A - - 34100012 HC HEPATOBILIARY SYSTEM IMAGING 341 78226 51 N/A Both " 1,889.00 " N/A N/A N/A N/A - - 61000221 HC MRI PELVIS POST GEL PLACEMENT 610 72195 51 N/A Both " 1,891.00 " N/A N/A N/A N/A - - 61000222 HC 3T MRI PELVIS POST GEL PLACMNT 610 72195 51 N/A Both " 1,891.00 " N/A N/A N/A N/A - - 32900088 HC CATH PLACE VEN 1ST 761 36011 51 N/A Both " 1,891.00 " N/A N/A N/A N/A - - 80100003 HC CRRT 801 51 N/A Both " 1,894.00 " N/A N/A N/A N/A - - 34100015 HC GASTRIC EMPTYING STUDY 341 78264 51 N/A Both " 1,895.00 " N/A N/A N/A N/A - - 76100078 HC BONE MARROW BX W ASP SAME SITE 761 38222 51 N/A Both " 1,899.00 " N/A N/A N/A N/A - - 32000135 HC NEPHR/URET DILATION 320 74485 51 N/A Both " 1,899.00 " N/A N/A N/A N/A - - 45000314 HC REMV RECTAL OBSTR FECES/FB W ANEST 450 45915 51 N/A Both " 1,900.00 " N/A N/A N/A N/A - - 45000313 HC SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY 450 45332 51 N/A Both " 1,900.00 " N/A N/A N/A N/A - - 73100007 HC HOLTER 48 HOUR RECORDING 731 93226 51 N/A Both " 1,902.00 " N/A N/A N/A N/A - - 75000079 HC B ESOPH BAND LIGATION 750 51 N/A Both " 1,917.00 " N/A N/A N/A N/A - - 48000070 HC ECHO 2D LTD W CONTRAST 480 C8922 51 N/A Both " 1,919.00 " N/A N/A N/A N/A - - 32900133 HC VCAD PI INSERT WO SUBQ < 5 YR 761 36568 51 N/A Both " 1,921.00 " N/A N/A N/A N/A - - 35200001 HC CATOPSY CHEST 352 71250 51 N/A Both " 1,922.00 " N/A N/A N/A N/A - - 32900200 HC LYMPH NODE BIOPSY 329 38505 51 N/A Both " 1,922.00 " N/A N/A N/A N/A - - 92200015 HC NERVE CONDUCTION STUDIES 9-10 922 95911 51 N/A Both " 1,923.00 " N/A N/A N/A N/A - - 48100099 HC PERICARDIOCENTESIS W FLURO IMAGING 481 33016 51 N/A Both " 1,923.00 " N/A N/A N/A N/A - - 33300039 HC INTERSTI RAD-ELE APPL - COMPLX 333 77778 51 N/A Both " 1,927.00 " N/A N/A N/A N/A - - 32900092 HC CTH PLACE SEG SUBSEG PULM 761 36015 51 N/A Both " 1,931.00 " N/A N/A N/A N/A - - 75000044 HC B COLON REM LES HOT BX FORCEP 750 51 N/A Both " 1,938.00 " N/A N/A N/A N/A - - 12400002 HC R&B SR MENTAL HEALTH SEMI-PRIV 124 51 N/A Both " 1,940.00 " N/A N/A N/A N/A - - 35200051 HC CATOPSY ABDOMEN 352 74150 51 N/A Both " 1,942.00 " N/A N/A N/A N/A - - 32900198 HC BONE MARROW ASPIRATION ONLY 761 38220 51 N/A Both " 1,942.00 " N/A N/A N/A N/A - - 32900199 HC BONE MARROW BX ONLY 761 38221 51 N/A Both " 1,942.00 " N/A N/A N/A N/A - - 48000108 HC PRESSURE MONITORING SET UP 480 51 N/A Both " 1,943.00 " N/A N/A N/A N/A - - 32900236 HC BIOP ABDOMINAL MASS-PERC 761 49180 51 N/A Both " 1,944.00 " N/A N/A N/A N/A - - 48000025 HC CATH PLACEMENT BRACHYTHERAPY 481 92974 51 N/A Both " 1,952.00 " N/A N/A N/A N/A - - 34100032 HC LUNG SCAN QUANTITATIVE 341 78598 51 N/A Both " 1,963.00 " N/A N/A N/A N/A - - 34100040 "HC INJ MAA TUMOR LOCALIZATION SINGLE AREA, SINGLE DAY IMAGING" 341 78800 51 N/A Both " 1,969.00 " N/A N/A N/A N/A - - 61000047 HC MRI GUIDED NEEDLE PLACEMENT 610 77021 51 N/A Both " 1,978.00 " N/A N/A N/A N/A - - 75000091 HC B FLEX SIG REM LES HOT BX 750 51 N/A Both " 1,980.00 " N/A N/A N/A N/A - - 61000062 HC MRI ORBITS ONLY WO CONT 610 70540 51 N/A Both " 1,982.00 " N/A N/A N/A N/A - - 61000061 HC 3T MRI ORBITS ONLY WO CONT 610 70540 51 N/A Both " 1,982.00 " N/A N/A N/A N/A - - 76100124 HC I&D RECTAL SUBMUCOSAL ABSCESS 761 45005 51 N/A Both " 1,986.00 " N/A N/A N/A N/A - - 36000022 HC OR LEVEL 1 BASE 360 51 N/A Both " 1,995.00 " N/A N/A N/A N/A - - 34100004 HC THYROID IMAGE TOTAL BODY 341 78018 51 N/A Both " 1,998.00 " N/A N/A N/A N/A - - 76100044 HC PICC REPLACEMENT 761 36584 51 N/A Both " 2,002.00 " N/A N/A N/A N/A - - 32900047 HC BX PELVIS HIP SOFT DEEP 761 27041 51 N/A Both " 2,006.00 " N/A N/A N/A N/A - - 32900046 HC BX SOFT TISSUE PELVIS 761 27040 51 N/A Both " 2,006.00 " N/A N/A N/A N/A - - 35200042 HC CT THORAX WO CONTRAST 352 71250 51 N/A Both " 2,020.00 " N/A N/A N/A N/A - - 34100027 HC CARD BLD POOL IMAGE GATED 341 78472 51 N/A Both " 2,023.00 " N/A N/A N/A N/A - - 35000013 HC CT GUIDE NEEDLE PLACEMENT 350 77012 51 N/A Both " 2,024.00 " N/A N/A N/A N/A - - 40200004 HC BREAST NDL LOC US ADDTL 402 19286 51 N/A Both " 2,025.00 " N/A N/A N/A N/A - - 40200003 HC BREAST NDL LOC US GUIDE 402 19285 51 N/A Both " 2,025.00 " N/A N/A N/A N/A - - 32900308 HC MYELOGRAM THORACIC COMPLETE 329 62303 51 N/A Both " 2,026.00 " N/A N/A N/A N/A - - 34100011 HC LIVER/SPLEEN W/FLOW 341 78216 51 N/A Both " 2,029.00 " N/A N/A N/A N/A - - 48100100 HC PERICARDIOCENTESIS W US IMAGING 481 33016 51 N/A Both " 2,033.00 " N/A N/A N/A N/A - - 35100002 HC CT HEAD W CONTRAST 351 70460 51 N/A Both " 2,036.00 " N/A N/A N/A N/A - - 32900277 HC DILATION URETER 761 50706 51 N/A Both " 2,037.00 " N/A N/A N/A N/A - - 35000021 HC CT PELVIS W CONTRAST LTD 352 72193 51 N/A Both " 2,039.00 " N/A N/A N/A N/A - - 33300013 HC SPEC TELE PORT PLAN COMPLEX 333 77321 51 N/A Both " 2,039.00 " N/A N/A N/A N/A - - 48000022 HC INTERNAL CARDIOVERSION 481 92961 51 N/A Both " 2,040.00 " N/A N/A N/A N/A - - 32900064 HC PLEURAL DRAIN PERC W GUIDE 761 32557 51 N/A Both " 2,040.00 " N/A N/A N/A N/A - - 75000088 HC B EUS W NEEDLE ASP COLON 750 51 N/A Both " 2,044.00 " N/A N/A N/A N/A - - 33300004 HC THERA SIMULATION-INTERMED 333 77285 51 N/A Both " 2,047.00 " N/A N/A N/A N/A - - 32900100 HC SEL CATH PLACE ART 1ST 761 36215 51 N/A Both " 2,051.00 " N/A N/A N/A N/A - - 32900112 HC SEL CATH PLACE ART 1ST 761 36245 51 N/A Both " 2,051.00 " N/A N/A N/A N/A - - 32900261 HC ASP INJ RENAL CYST PELVIS 761 50390 51 N/A Both " 2,052.00 " N/A N/A N/A N/A - - 32900297 HC SPINAL CORD BX PERC 761 62269 51 N/A Both " 2,052.00 " N/A N/A N/A N/A - - 34200005 HC RADIONUCLID ABLATION/THYR 342 79005 51 N/A Both " 2,054.00 " N/A N/A N/A N/A - - 35000023 HC CT GUIDE FOR ABSCESS DRAIN 350 75989 51 N/A Both " 2,065.00 " N/A N/A N/A N/A - - 32000179 HC FLUORO GUIDE ABSCESS DRAIN 320 75989 51 N/A Both " 2,065.00 " N/A N/A N/A N/A - - 40200056 HC US GUIDE PLEURX CATH PLACEMENT 402 75989 51 N/A Both " 2,065.00 " N/A N/A N/A N/A - - 34100039 HC RENAL FUNCTION W/PHARM 341 78708 51 N/A Both " 2,068.00 " N/A N/A N/A N/A - - 34100016 HC ACUTE GI BLOOD LOSS IMAGE 341 78278 51 N/A Both " 2,068.00 " N/A N/A N/A N/A - - 35200018 HC CT UPPER EXT W/O CONTRAST 352 73200 51 N/A Both " 2,072.00 " N/A N/A N/A N/A - - 32900393 HC INJ EPIDURAL CERV THOR FL 761 62321 51 N/A Both " 2,074.00 " N/A N/A N/A N/A - - 32900395 HC INJ EPIDURAL LUMB SACRAL FL 761 62323 51 N/A Both " 2,074.00 " N/A N/A N/A N/A - - 61000065 HC MRI ORBITS ONLY WITH CONTRAST 610 70542 51 N/A Both " 2,076.00 " N/A N/A N/A N/A - - 61000064 HC 3T MRI ORBITS ONLY WITH CONTRA 610 70542 51 N/A Both " 2,076.00 " N/A N/A N/A N/A - - 48000093 HC AUTO/RAPID TRANSFUSION 391 36430 51 N/A Both " 2,082.00 " N/A N/A N/A N/A - - 75000165 HC B EUS SIGMOID W FNA BX 750 51 N/A Both " 2,094.00 " N/A N/A N/A N/A - - 75000098 HC BRONCH THERAPEUTIC 761 51 N/A Both " 2,094.00 " N/A N/A N/A N/A - - 75000113 HC BRONCHOSCOPY STENT ADD-ON 761 51 N/A Both " 2,094.00 " N/A N/A N/A N/A - - 75000061 HC B EGD DIL W GUIDE W SAVARY 750 51 N/A Both " 2,097.00 " N/A N/A N/A N/A - - 75000040 HC B COLON REM LES SNARE 750 51 N/A Both " 2,100.00 " N/A N/A N/A N/A - - 48000021 HC CARDIOVERSION EXTERNAL 480 92960 51 N/A Both " 2,103.00 " N/A N/A N/A N/A - - 32900149 HC REMOVE CVA LUMEN OBSTRUCT 761 36596 51 N/A Both " 2,104.00 " N/A N/A N/A N/A - - 35100016 HC CT EARS WO CONTRAST 351 70480 51 N/A Both " 2,107.00 " N/A N/A N/A N/A - - 35100018 HC CT SELLA TURCICA WO CONTRAST 351 70480 51 N/A Both " 2,107.00 " N/A N/A N/A N/A - - 35200015 HC CT PELVIS W/O CONTRAST 352 72192 51 N/A Both " 2,109.00 " N/A N/A N/A N/A - - 76100039 HC INFANT BRONCHSCOPY 761 31622 51 N/A Both " 2,114.00 " N/A N/A N/A N/A - - 76100162 HC DEBRIDE BONE 1ST 20 SQCM< 761 11044 51 N/A Both " 2,116.00 " N/A N/A N/A N/A - - 61100019 HC MRI PEDS TRAUMA BRAIN WO CON 611 70551 51 N/A Both " 2,119.00 " N/A N/A N/A N/A - - 61100013 HC 3T MRI PEDS TRAUMA BRAIN WO 611 70551 51 N/A Both " 2,119.00 " N/A N/A N/A N/A - - 61000220 HC 3T MRI PROSTATE LTD 610 72195 51 N/A Both " 2,120.00 " N/A N/A N/A N/A - - 61000219 HC MRI PROSTATE LTD 610 72195 51 N/A Both " 2,120.00 " N/A N/A N/A N/A - - 61100017 HC MRI BRAIN W/O LTD 611 70551 51 N/A Both " 2,121.00 " N/A N/A N/A N/A - - 61100009 HC 3T MRI BRAIN W/O LTD 611 70551 51 N/A Both " 2,121.00 " N/A N/A N/A N/A - - 35200022 HC CT LOWER EXT W/O CONTRAST 352 73700 51 N/A Both " 2,123.00 " N/A N/A N/A N/A - - 48000097 HC CARDIAC ASSIST DEVICE SET UP 480 51 N/A Both " 2,127.00 " N/A N/A N/A N/A - - 75000148 HC B FLEX SIG REM LES SNARE 750 51 N/A Both " 2,131.00 " N/A N/A N/A N/A - - 75000153 HC B FLEX SIG W BAND LIGATION 750 51 N/A Both " 2,131.00 " N/A N/A N/A N/A - - 75000149 HC B FLEX SIG W DILATION 750 51 N/A Both " 2,131.00 " N/A N/A N/A N/A - - 75000152 HC B FLEX SIG W MUCOSAL RESECT 750 51 N/A Both " 2,131.00 " N/A N/A N/A N/A - - 48300003 HC ECHO 2D COMPLETE WO SPECTRAL COLOR DOPPLER 483 93307 51 N/A Both " 2,132.00 " N/A N/A N/A N/A - - 32000140 HC LYMPHANGIOGRAM EXT UNI 761 75801 51 N/A Both " 2,140.00 " N/A N/A N/A N/A - - 12400004 HC R&B YOUTH MH SEMI-PRIVATE 124 51 N/A Both " 2,140.00 " N/A N/A N/A N/A - - 75000025 HC A FLEXIBLE SIGMOIDOSCOPY 750 51 N/A Both " 2,150.00 " N/A N/A N/A N/A - - 32900246 HC PERC PLACEMENT OF GASTRO TUBE 761 49440 51 N/A Both " 2,159.00 " N/A N/A N/A N/A - - 32900247 HC PERC PLACEMENT OF J-TUBE 761 49441 51 N/A Both " 2,159.00 " N/A N/A N/A N/A - - 35100011 HC CT HEAD WO CON SURG PLAN 351 70450 51 N/A Both " 2,165.00 " N/A N/A N/A N/A - - 41000044 HC NONINV BILEVEL VENT INITIAL 410 94660 51 N/A Both " 2,165.00 " N/A N/A N/A N/A - - 32900283 HC OVARIAN CYST ASP 761 58999 51 N/A Both " 2,168.00 " N/A N/A N/A N/A - - 39000027 HC PLT APHERESIS LR IRR 390 P9037 51 N/A Both " 2,169.00 " N/A N/A N/A N/A - - 61000068 HC MRI ORBITS ONLY W/WO CONTRAST 610 70543 51 N/A Both " 2,170.00 " N/A N/A N/A N/A - - 61000067 HC 3T MRI ORBITS ONLY W/WO CONTRA 610 70543 51 N/A Both " 2,170.00 " N/A N/A N/A N/A - - 35100008 HC CT MAX FACIAL W CONTRAST 351 70487 51 N/A Both " 2,191.00 " N/A N/A N/A N/A - - 32900126 HC VCAD NT INSERT < 5 YR 761 36555 51 N/A Both " 2,192.00 " N/A N/A N/A N/A - - 75000126 HC B ESOPH W MUCOSAL RESECTION 750 51 N/A Both " 2,192.00 " N/A N/A N/A N/A - - 33300011 HC BRACHYTHERAPY ISODOSE INTERM 333 77317 51 N/A Both " 2,201.00 " N/A N/A N/A N/A - - 27000166 HC N-TRAINER KIT 270 51 N/A Both " 2,208.00 " N/A N/A N/A N/A - - 32000170 HC THOR STNT GRFT W/LT SUBCL S&I 761 75956 51 N/A Both " 2,215.00 " N/A N/A N/A N/A - - 32000131 HC CORPORA CAVERNOSOGRAPHY 761 74445 51 N/A Both " 2,216.00 " N/A N/A N/A N/A - - 32000130 HC VASO/VESI/EPIDIDYMOGRAPHY 761 74440 51 N/A Both " 2,216.00 " N/A N/A N/A N/A - - 94000002 HC BRONCH THERAPEUTIC 940 31622 51 N/A Both " 2,220.00 " N/A N/A N/A N/A - - 48100062 HC ANGIO PULMONARY DURING HC 481 93568 51 N/A Both " 2,225.00 " N/A N/A N/A N/A - - 32900280 HC PROSTATE NEEDLE BIOPSY 329 55700 51 N/A Both " 2,228.00 " N/A N/A N/A N/A - - 35200026 HC CT ABDOMEN WO CONTRAST 352 74150 51 N/A Both " 2,230.00 " N/A N/A N/A N/A - - 32900232 HC PLACE CHOLEDOCHAL STENT 761 47801 51 N/A Both " 2,231.00 " N/A N/A N/A N/A - - 45000008 HC EMERGENCY ROOM VI 450 99291 51 N/A Both " 2,234.00 " N/A N/A N/A N/A - - 92200025 HC NERVE CONDUCTION STUDIES 11-12 922 95912 51 N/A Both " 2,243.00 " N/A N/A N/A N/A - - 20400001 HC R&B INTENSIVE PSYCH 204 51 N/A Both " 2,245.00 " N/A N/A N/A N/A - - 75000064 HC B ENTEROS TO ILM W FB REMOVAL 750 51 N/A Both " 2,253.00 " N/A N/A N/A N/A - - 35200044 HC CATOPSY SPINE CERVICAL 352 72125 51 N/A Both " 2,265.00 " N/A N/A N/A N/A - - 35000009 HC CCTA W CONT CALC & STRXR 350 75574 51 N/A Both " 2,271.00 " N/A N/A N/A N/A - - 34100019 HC BONE JNT IMAGE WHOLE BODY 341 78306 51 N/A Both " 2,272.00 " N/A N/A N/A N/A - - 35200011 HC CT SPINE LUMBAR W/O CONT 352 72131 51 N/A Both " 2,281.00 " N/A N/A N/A N/A - - 75000130 HC B ESOPH REM LES BX FRCPS 750 51 N/A Both " 2,282.00 " N/A N/A N/A N/A - - 33300008 HC TELETHERAPY ISODOSE SIMPLE 333 77306 51 N/A Both " 2,291.00 " N/A N/A N/A N/A - - 75000135 HC B ESOPH DILATE W DILATOR 750 51 N/A Both " 2,295.00 " N/A N/A N/A N/A - - 76100091 HC TUBE THORACOSTOMY INCLUDES WATER SEAL 761 32551 51 N/A Both " 2,299.00 " N/A N/A N/A N/A - - 45000014 HC CENTRAL LINE INSERTION 450 51 N/A Both " 2,301.00 " N/A N/A N/A N/A - - 61200023 HC MRI PEDS TRAUMA LSPINE WO CON 612 72148 51 N/A Both " 2,305.00 " N/A N/A N/A N/A - - 61200020 HC 3T MRI PEDS TRAUMA LSPINE WO 612 72148 51 N/A Both " 2,305.00 " N/A N/A N/A N/A - - 45000101 HC CLOSED RX MANDIBLE FX+MANIPULATN 450 21451 51 N/A Both " 2,309.00 " N/A N/A N/A N/A - - 45000092 HC CLOSED RX NOSE FRACTURE W/O STABILIZATION 450 21315 51 N/A Both " 2,309.00 " N/A N/A N/A N/A - - 45000095 HC CLOSED RX NOSE/JAW FRAC+WIRES 450 21345 51 N/A Both " 2,309.00 " N/A N/A N/A N/A - - 45000298 HC I&D MOUTH/TONG INTRA SUBMENTAL 450 41007 51 N/A Both " 2,309.00 " N/A N/A N/A N/A - - 45000104 HC REDUCE TEMPOROMANDIBL DISLOC COMPLICATED 450 21485 51 N/A Both " 2,309.00 " N/A N/A N/A N/A - - 45000304 HC REMOVAL FOREIGN BODY GUM 450 41805 51 N/A Both " 2,309.00 " N/A N/A N/A N/A - - 45000291 HC REPAIR LIP >1/2 VERT HEIGHT 450 40654 51 N/A Both " 2,309.00 " N/A N/A N/A N/A - - 32900259 HC RMV&REPL EXT URET STNT W FLUOR 761 50387 51 N/A Both " 2,310.00 " N/A N/A N/A N/A - - 48000052 HC NIPS OF ICD 481 93642 51 N/A Both " 2,318.00 " N/A N/A N/A N/A - - 75000077 HC B ERCP W BIOPSY 750 51 N/A Both " 2,319.00 " N/A N/A N/A N/A - - 99000049 HC LAP LONGITUDINAL GASTRECTOMY ASSISTANT SURGEON 990 43775 51 N/A Both " 2,321.40 " N/A N/A N/A N/A - - 32900089 HC CATH PLACE VEN 2ND 761 36012 51 N/A Both " 2,335.00 " N/A N/A N/A N/A - - 32900193 HC IVUS NON-CORONARY INTL 481 37252 51 N/A Both " 2,335.00 " N/A N/A N/A N/A - - 34100035 HC CEREBROSPNL FLW CSTRNOGRM 341 78630 51 N/A Both " 2,345.00 " N/A N/A N/A N/A - - 48300004 HC ECHO W CONTRAST LTD 483 C8924 51 N/A Both " 2,350.00 " N/A N/A N/A N/A - - 34000004 HC TUMOR IMAGING SPECT 2+ AREAS SINGLE DAY OR SINGLE AREA OVER 2+ DAYS 340 78831 51 N/A Both " 2,350.00 " N/A N/A N/A N/A - - 30000511 HC PTH INTEROPERATIVE 300 83970 51 N/A Both " 2,368.00 " N/A N/A N/A N/A - - 32900019 HC BX MUSCLE SUPERFICIAL 761 20200 51 N/A Both " 2,370.00 " N/A N/A N/A N/A - - 32900022 HC DEEP BONE BX VERT FEMUR 761 20225 51 N/A Both " 2,370.00 " N/A N/A N/A N/A - - 35200019 HC CT UPPER EXT W/CONTRAST 352 73201 51 N/A Both " 2,372.00 " N/A N/A N/A N/A - - 35200005 HC CT SPINE CERVICAL WO CONT 352 72125 51 N/A Both " 2,377.00 " N/A N/A N/A N/A - - 48000066 HC PLACEMENT INNERCOOL CATH 481 37799 51 N/A Both " 2,384.00 " N/A N/A N/A N/A - - 61200018 HC MRI PEDS TRAUMA TSPINE WO CON 612 72146 51 N/A Both " 2,389.00 " N/A N/A N/A N/A - - 61200015 HC 3T MRI PEDS TRAUMA TSPINE WO 612 72146 51 N/A Both " 2,389.00 " N/A N/A N/A N/A - - 75000014 HC A EGD 750 51 N/A Both " 2,391.00 " N/A N/A N/A N/A - - 32000058 HC MYELOGRAM MULTILEVEL S & I 320 72270 51 N/A Both " 2,399.00 " N/A N/A N/A N/A - - 76100076 HC INJ TRUNCAL VEIN FOAM EA ADDTL 761 36466 51 N/A Both " 2,412.00 " N/A N/A N/A N/A - - 76100075 HC INJECT TRUNCAL VEIN FOAM 1ST 761 36465 51 N/A Both " 2,412.00 " N/A N/A N/A N/A - - 33300005 HC THERA SIMULATION-COMPLEX 333 77290 51 N/A Both " 2,412.00 " N/A N/A N/A N/A - - 75000071 HC B-ERCP STONE REM SWEEP 750 51 N/A Both " 2,413.00 " N/A N/A N/A N/A - - 32900139 HC VCAD NT REPLACE 761 36580 51 N/A Both " 2,421.00 " N/A N/A N/A N/A - - 92000010 HC MAINTENANCE OF WAKEFULNESS 920 95805 51 N/A Both " 2,428.00 " N/A N/A N/A N/A - - 92000018 HC MULTIPLE SLEEP LATENCY TEST 920 95805 51 N/A Both " 2,428.00 " N/A N/A N/A N/A - - 32900114 HC SEL CATH PLACE ART 3RD 761 36247 51 N/A Both " 2,428.00 " N/A N/A N/A N/A - - 35200008 HC CT SPINE THORACIC WO CONT 352 72128 51 N/A Both " 2,441.00 " N/A N/A N/A N/A - - 35200049 HC CT ANKLE W/O CON SURG PLAN 352 73700 51 N/A Both " 2,442.00 " N/A N/A N/A N/A - - 35200050 HC CT KNEE W/O CON SURG PLAN 352 73700 51 N/A Both " 2,442.00 " N/A N/A N/A N/A - - 36000109 HC LITHOTRIPSY KIDNEY 360 51 N/A Both " 2,443.00 " N/A N/A N/A N/A - - 20300001 HC R&B PEDIATRIC PROGRESSIVE 203 51 N/A Both " 2,445.00 " N/A N/A N/A N/A - - 20600001 HC R&B PROGRESSIVE 206 51 N/A Both " 2,445.00 " N/A N/A N/A N/A - - 35200002 HC CT THORAX W/CONTRAST 352 71260 51 N/A Both " 2,453.00 " N/A N/A N/A N/A - - 76100042 HC PICC INSERTION 5+ YRS 761 36569 51 N/A Both " 2,455.00 " N/A N/A N/A N/A - - 35100017 HC CT ORBIT WO CONTRAST 351 70480 51 N/A Both " 2,456.00 " N/A N/A N/A N/A - - 32900212 HC NEEDLE BIOPSY LIVER 329 47000 51 N/A Both " 2,457.00 " N/A N/A N/A N/A - - 32900254 HC RENAL BIOPSY PERC 329 50200 51 N/A Both " 2,457.00 " N/A N/A N/A N/A - - 32000158 HC PERC TRAN PORT WO/HEMO EV 761 75887 51 N/A Both " 2,471.00 " N/A N/A N/A N/A - - 61200013 HC MRI PEDS TRAUMA CSPINE WO CON 612 72141 51 N/A Both " 2,472.00 " N/A N/A N/A N/A - - 61200010 HC 3T MRI PEDS TRAUMA CSPINE WO 612 72141 51 N/A Both " 2,472.00 " N/A N/A N/A N/A - - 35100022 HC CT EARS W WO CONTRAST 351 70482 51 N/A Both " 2,475.00 " N/A N/A N/A N/A - - 35100024 HC CT SELLA TURCICA W WO CONTRAST 351 70482 51 N/A Both " 2,475.00 " N/A N/A N/A N/A - - 35100031 HC CT EARS W WO CONTRAST 351 70482 51 N/A Both " 2,475.00 " N/A N/A N/A N/A - - 35100033 HC CT SELLA TURCICA W WO CONTRAST 351 70482 51 N/A Both " 2,475.00 " N/A N/A N/A N/A - - 76100196 HC FINE NEEDLE ASP W MR GUIDANCE INITIAL LESION 761 10011 51 N/A Both " 2,478.00 " N/A N/A N/A N/A - - 35000002 HC CT SFT TS NECK W/CONTRAST 350 70491 51 N/A Both " 2,479.00 " N/A N/A N/A N/A - - 35000014 HC CT GUIDE PARENCHYMAL TIS ABLAT 350 77013 51 N/A Both " 2,479.00 " N/A N/A N/A N/A - - 61000045 HC MRI SPECTROSCOPY 610 76390 51 N/A Both " 2,479.00 " N/A N/A N/A N/A - - 35100013 HC CT HEAD W CON SURG PLAN 351 70460 51 N/A Both " 2,485.00 " N/A N/A N/A N/A - - 32900021 HC BX BONE TROCAR OR NEEDLE 761 20220 51 N/A Both " 2,485.00 " N/A N/A N/A N/A - - 34100031 HC LUNG SCAN VQ (VENT/PERF) 341 78582 51 N/A Both " 2,515.00 " N/A N/A N/A N/A - - 75000069 HC B ENTEROS TO ILM REM LES SNARE 750 51 N/A Both " 2,518.00 " N/A N/A N/A N/A - - 35100014 HC CT STEALTH SINUS DIR CRNLS W CONTRAST 351 70487 51 N/A Both " 2,522.00 " N/A N/A N/A N/A - - 76100194 HC FINE NEEDLE ASP W CT GUIDANCE INITIAL LESION 761 10009 51 N/A Both " 2,522.00 " N/A N/A N/A N/A - - 32900146 HC VCAD T REMOVE W SUBQ PORT 761 36590 51 N/A Both " 2,533.00 " N/A N/A N/A N/A - - 48000028 HC ECHO COMPLETE 480 93306 51 N/A Both " 2,535.00 " N/A N/A N/A N/A - - 35100019 HC CT EARS W CONTRAST 351 70481 51 N/A Both " 2,541.00 " N/A N/A N/A N/A - - 35100021 HC CT SELLA TURCICA W CONTRAST 351 70481 51 N/A Both " 2,541.00 " N/A N/A N/A N/A - - 61000171 HC MRI STIR WAIST TO KNEES 610 73722 51 N/A Both " 2,542.00 " N/A N/A N/A N/A - - 61000169 HC 3T MRI STIR WAIST TO KNEES 610 73722 51 N/A Both " 2,542.00 " N/A N/A N/A N/A - - 32900372 HC AV FISTULOGRAM MULT ACCESS 761 36901 51 N/A Both " 2,547.00 " N/A N/A N/A N/A - - 34100022 HC CARDIAC SHUNT DETECTION 341 78428 51 N/A Both " 2,556.00 " N/A N/A N/A N/A - - 75000154 HC B COLON W RESECTION 750 51 N/A Both " 2,563.00 " N/A N/A N/A N/A - - 92200016 HC NERVE CONDUCTION STUDIES 13 > 922 95913 51 N/A Both " 2,563.00 " N/A N/A N/A N/A - - 32900272 HC CHANGE URETEROSTOMY TUBE 761 50688 51 N/A Both " 2,568.00 " N/A N/A N/A N/A - - 75000170 HC B COLON W BALLOON DILAT 750 51 N/A Both " 2,570.00 " N/A N/A N/A N/A - - 75000156 HC B COLON W BAND LIGATION 750 51 N/A Both " 2,570.00 " N/A N/A N/A N/A - - 75000155 HC B COLON W DECOMPRESSION 750 51 N/A Both " 2,570.00 " N/A N/A N/A N/A - - 32900101 HC SEL CATH PLACE ART 2ND 761 36216 51 N/A Both " 2,570.00 " N/A N/A N/A N/A - - 17200001 HC R&B NEWBORN LEVEL II 172 51 N/A Both " 2,575.00 " N/A N/A N/A N/A - - 76100201 HC PICC INSERTION W GUIDANCE < 5YRS 761 36572 51 N/A Both " 2,577.00 " N/A N/A N/A N/A - - 61000005 HC 3T MRI TMJ UNILATERAL 610 70336 51 N/A Both " 2,578.00 " N/A N/A N/A N/A - - 61000059 HC MRI TMJ UNILATERAL 610 70336 51 N/A Both " 2,578.00 " N/A N/A N/A N/A - - 32000176 HC TRANSCATHETER BIOPSY 761 75970 51 N/A Both " 2,583.00 " N/A N/A N/A N/A - - 75000008 HC 24 48 HR PH MONITORING 750 51 N/A Both " 2,584.00 " N/A N/A N/A N/A - - 35200027 HC CT ABDOMEN W CONTRAST 352 74160 51 N/A Both " 2,603.00 " N/A N/A N/A N/A - - 34100020 HC BONE IMAGE 3 PHASE STUDY 341 78315 51 N/A Both " 2,607.00 " N/A N/A N/A N/A - - 33300024 HC IMRT SIMPLE 333 77385 51 N/A Both " 2,613.00 " N/A N/A N/A N/A - - 32300021 HC EACH ADDTL SELECT VESSEL 761 75774 51 N/A Both " 2,617.00 " N/A N/A N/A N/A - - 35100003 HC CT HEAD W WO CONTRAST 351 70470 51 N/A Both " 2,621.00 " N/A N/A N/A N/A - - 35100030 HC CT HEAD W WO CONTRAST 351 70470 51 N/A Both " 2,621.00 " N/A N/A N/A N/A - - 75000010 HC A-ANAL-RECTAL MOTILITY 750 51 N/A Both " 2,625.00 " N/A N/A N/A N/A - - 61000012 HC MRA NECK W/O CONTRAST 610 70547 51 N/A Both " 2,635.00 " N/A N/A N/A N/A - - 61000088 HC MRV NECK W/O CONTRAST 610 70547 51 N/A Both " 2,635.00 " N/A N/A N/A N/A - - 61000085 HC 3T MRA NECK W/O CONTRAST 610 70547 51 N/A Both " 2,635.00 " N/A N/A N/A N/A - - 61000086 HC 3T MRV NECK W/O CONTRAST 610 70547 51 N/A Both " 2,635.00 " N/A N/A N/A N/A - - 75000081 HC B-ESOPH W HEMOSTASIS 750 51 N/A Both " 2,644.00 " N/A N/A N/A N/A - - 35200012 HC CT SPINE LUMBAR W CONT 352 72132 51 N/A Both " 2,655.00 " N/A N/A N/A N/A - - 32900143 HC TPA SUBSEQ DAY FOLLOW UP 761 37213 51 N/A Both " 2,671.00 " N/A N/A N/A N/A - - 48100058 HC DRUG ADMIN/HEMODYNAMIC MEAS 481 93463 51 N/A Both " 2,676.00 " N/A N/A N/A N/A - - 45000343 HC CLOSED RX SHLDR DISLOC PROX HUM FX 450 23675 51 N/A Both " 2,686.00 " N/A N/A N/A N/A - - 45000286 HC LARYNGOSCOPY DIRCT OP F.B. REMVL 450 31530 51 N/A Both " 2,686.00 " N/A N/A N/A N/A - - 35100028 HC CT STEALTH SINUSES WO CONTRAST 351 70486 51 N/A Both " 2,687.00 " N/A N/A N/A N/A - - 75000134 HC B ESOPH REM LESION SNARE 750 51 N/A Both " 2,691.00 " N/A N/A N/A N/A - - 75000049 HC B EGD W BANDING 750 51 N/A Both " 2,698.00 " N/A N/A N/A N/A - - 32900018 HC BREAST NDL LOC STEREO ADDTL 329 19284 51 N/A Both " 2,702.00 " N/A N/A N/A N/A - - 32900017 HC BREAST NDL LOC STEREO GUIDE 329 19283 51 N/A Both " 2,702.00 " N/A N/A N/A N/A - - 99000036 HC LYSIS OF ADHESIONS 990 44180 51 N/A Both " 2,702.00 " N/A N/A N/A N/A - - 32000141 HC LYMPHANGIOGRAM EXT BIL 761 75803 51 N/A Both " 2,708.00 " N/A N/A N/A N/A - - 75000003 HC ELECTROMAG NAV BRONCH 761 31627 51 N/A Both " 2,711.00 " N/A N/A N/A N/A - - 76100132 HC DRAIN EXT EAR ABSC/BLOOD COMPLIC 761 69005 51 N/A Both " 2,717.00 " N/A N/A N/A N/A - - 76100110 HC INCIS/DRAIN ARM/ELBOW INFECT BURSA 761 23931 51 N/A Both " 2,717.00 " N/A N/A N/A N/A - - 76100112 HC INCIS/DRAIN FOREARM INFECTED BURSA 761 25031 51 N/A Both " 2,717.00 " N/A N/A N/A N/A - - 76100118 HC INCIS/DRAINAGE BURSA OF FOOT 761 28001 51 N/A Both " 2,717.00 " N/A N/A N/A N/A - - 35200023 HC CT LOWER EXT W CONTRAST 352 73701 51 N/A Both " 2,721.00 " N/A N/A N/A N/A - - 35200013 HC CT LUMBAR SPINE W/WO CONT 352 72133 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 45000087 HC EXPLO/DRAIN BREAST ABSCESS 450 19020 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 45000126 HC REMOVAL ARM/ELBOW F.B. SUPERFICIAL 450 24200 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 45000110 HC REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM 450 23333 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 45000030 HC REMOVE FOREIGN BODY COMPLIC 450 10121 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 45000183 HC REMOVE PELV/HIP F.B. SUBCUTANEOUS 450 27086 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 45000239 "HC REMV FOOT FOREIGN BODY,COMPLEX" 450 28193 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 45000238 "HC REMV FOOT FOREIGN BODY,DEEP" 450 28192 51 N/A Both " 2,735.00 " N/A N/A N/A N/A - - 33300009 HC TELETHERAPY ISODOSE COMPLEX 333 77307 51 N/A Both " 2,738.00 " N/A N/A N/A N/A - - 45000112 HC CLOSED RX CLAVICLE FX MANIPULATN 450 23505 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000156 HC CLOSED RX DIST RAD/ULNA FX MANIPUL 450 25605 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000154 HC CLOSED RX RAD/ULNA SHAFT FX MANIP 450 25565 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000178 HC CLOSE RX FINGR ARTICULAR FX MANIP 450 26742 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000236 "HC CLOSED RX ANKLE DISLOCATN,ANESTH" 450 27842 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000172 HC CLOSED RX C-MC DISLOC ANESTH 450 26675 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000160 HC CLOSED RX CARPAL FX MAIPULATN 450 25635 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000204 HC CLOSED RX CONDYLAR FX+MANIP 450 27503 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000208 HC CLOSED RX DIST FEM EPIPHYSIS+MANIP 450 27517 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000138 HC CLOSED RX ELBOW DISLOCATN ANESTHESIA 450 24605 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000206 HC CLOSED RX FEMUR DISTAL+MANIP 450 27510 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000203 HC CLOSED RX FEMUR SHAFT FX+MANIP 450 27502 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000122 HC CLOSED RX GR TUBER HUM FX MANIP 450 23625 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000132 HC CLOSED RX HUM SUPRACONDYLR FX MANIPU 450 24535 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000136 HC CLOSED RX HUMER CONDYLR FX MANIP 450 24577 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000134 HC CLOSED RX HUMER EPICONDYLR FX MANIP 450 24565 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000214 HC CLOSED RX KNEE DISLOC+ANESTH 450 27552 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000165 HC CLOSED RX LUNATE DISLOCATION 450 25690 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000174 HC CLOSED RX MC-P DISLOC ANESTH 450 26705 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000220 "HC CLOSED RX MED MALLEOLUS FX,MANIP" 450 27762 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000130 HC CLOSED RX MID HUMERUS FX MANIPULATN 450 24505 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000139 HC CLOSED RX MONTEGGIA FX/DISLOC ELBOW 450 24620 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000260 HC CLOSED RX MT-PHAL TOE DISLOC ANESTH 450 28635 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000158 HC CLOSED RX NAVICULAR FX MANIPULATN 450 25624 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000200 HC CLOSED RX POST HIP FIX DISLOC ANESTH 450 27266 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000120 HC CLOSED RX PROX HUMERUS FX MANIP 450 23605 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000224 "HC CLOSED RX PROX/SHAFT FIB FX,MANIP" 450 27781 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000142 HC CLOSED RX RADIAL HEAD/NECK FX MANIP 450 24655 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000149 HC CLOSED RX RADIAL SHAFT FX MANIPULATN 450 25505 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000150 HC CLOSED RX RADIAL SHAFT FX W/DISLOCATION 450 25520 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000118 HC CLOSED RX SCAPULA FX MANIPULATN 450 23575 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000124 HC CLOSED RX SHLDR DISLOC ANESTHESIA 450 23655 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000125 HC CLOSED RX SHLDR DISLOC GR TUB FX 450 23665 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000198 HC CLOSED RX SPONT HIP DISLOC ANESTH 450 27257 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000113 HC CLOSED RX STERNO-CLAV DISLOC 450 23520 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000243 HC CLOSED RX TALUS FX MANIPULATN 450 28435 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000245 HC CLOSED RX TARSAL FX MANIP EACH 450 28455 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000218 "HC CLOSED RX TIBIA SHAFT FX,MANIPULATN" 450 27752 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000196 HC CLOSED RX TRAUMA HIP DISLOC ANESTH 450 27252 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000230 "HC CLOSED RX TRIMALLEOLAR FX,MANIP" 450 27818 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000232 "HC CLOSED RX WEIGHT BEAR DIST TIB,MANIP" 450 27825 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000108 HC CLOSED TREAT VERT BODY FX MANIPULATN 450 22315 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000222 HC CLOSED TREATMENT PST MALLEOLUS FRACTURE W MANIP 450 27768 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000228 HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MANIP 450 27810 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000144 HC CLOSED TX ULNAR FRACTURE PROX END W MANIPULATION 450 24675 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000145 HC REMOVE FOREARM/WRIST FOREIGN BODY 450 25248 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000166 HC REPAIR EXTEN TENDON DORSUM FINGR EA 450 26418 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000170 HC TREAT THUMB FX/DISLOC MANIP 450 26645 51 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 76100250 HC SPINAL PUNCTURE LUMBAR DX W CT GUIDANCE 761 62328 51 N/A Both " 2,742.00 " N/A N/A N/A N/A - - 76100248 HC SPINAL PUNCTURE THERAPEUTIC W CT GUIDANCE 761 62329 51 N/A Both " 2,742.00 " N/A N/A N/A N/A - - 75000119 HC B ESOPH TTS BAL DIL 750 51 N/A Both " 2,756.00 " N/A N/A N/A N/A - - 48300001 HC ECHO W/BUBBLE STUDY 483 93306 51 N/A Both " 2,756.00 " N/A N/A N/A N/A - - 48000073 HC ECHO W/CONTRAST 480 C8929 51 N/A Both " 2,756.00 " N/A N/A N/A N/A - - 75000162 HC B ERCP W ABLATION LESION 750 51 N/A Both " 2,757.00 " N/A N/A N/A N/A - - 75000161 HC B ERCP W DUCT BALLOON DILAT 750 51 N/A Both " 2,757.00 " N/A N/A N/A N/A - - 75000159 HC B ERCP W REM FB STENT 750 51 N/A Both " 2,760.00 " N/A N/A N/A N/A - - 75000060 HC B-EGD W TTS BAL DIL OF PYLORUS 750 51 N/A Both " 2,760.00 " N/A N/A N/A N/A - - 75000075 HC B-ERCP W SPHINCTEROTOMY 750 51 N/A Both " 2,760.00 " N/A N/A N/A N/A - - 35200006 HC CT SPINE CERVICAL W CONT 352 72126 51 N/A Both " 2,764.00 " N/A N/A N/A N/A - - 32000171 HC THOR STNT GRFT WO LT SUBCL S&I 761 75957 51 N/A Both " 2,768.00 " N/A N/A N/A N/A - - 75000140 HC B EGD DILATE ESOPH < 30MM 750 51 N/A Both " 2,773.00 " N/A N/A N/A N/A - - 48000031 HC ECHO TRANSESOPHAGEAL 480 93312 51 N/A Both " 2,780.00 " N/A N/A N/A N/A - - 41000036 HC VDR SUBSEQUENT 410 94003 51 N/A Both " 2,785.00 " N/A N/A N/A N/A - - 99000032 HC LAP REMOVAL OF ADJUSTABLE GASTRIC BAND COMPONENT ONLY 990 43772 51 N/A Both " 2,788.00 " N/A N/A N/A N/A - - 35100020 HC CT ORBIT W CONTRAST 351 70481 51 N/A Both " 2,789.00 " N/A N/A N/A N/A - - 35200047 HC CT LUMBAR W/O CON SURG PLAN 352 72131 51 N/A Both " 2,797.00 " N/A N/A N/A N/A - - 99000034 HC LAP REMOVAL OF ADJUST GASTRIC BAND & SUBQ PORT COMPONENTS 990 43774 51 N/A Both " 2,800.00 " N/A N/A N/A N/A - - 48100105 HC PRESSURE VELOCITY STUDY ADDTL 481 93572 51 N/A Both " 2,800.00 " N/A N/A N/A N/A - - 32900166 HC TPA CESSATION 761 37214 51 N/A Both " 2,805.00 " N/A N/A N/A N/A - - 35200009 HC CT SPINE THORACIC W CONT 352 72129 51 N/A Both " 2,826.00 " N/A N/A N/A N/A - - 35000025 HC CTA CHEST W/WO CONT LMTD 350 71275 51 N/A Both " 2,826.00 " N/A N/A N/A N/A - - 76100007 HC IMPLANT LOC DEV PROST IRRAD 761 55876 51 N/A Both " 2,833.00 " N/A N/A N/A N/A - - 32900237 HC SCLEROTHERAPY CYST SEROMA 761 49185 51 N/A Both " 2,835.00 " N/A N/A N/A N/A - - 32900310 HC MYELOGRAM MULTILEVEL COMPLETE 329 62305 51 N/A Both " 2,836.00 " N/A N/A N/A N/A - - 35200007 HC CT SP CERVICAL W/WO CONT 352 72127 51 N/A Both " 2,837.00 " N/A N/A N/A N/A - - 35100023 HC CT ORBIT W WO CONTRAST 351 70482 51 N/A Both " 2,840.00 " N/A N/A N/A N/A - - 35100032 HC CT ORBIT W WO CONTRAST 351 70482 51 N/A Both " 2,840.00 " N/A N/A N/A N/A - - 45000288 HC BRONCHOSCOPY W/REMOVAL FOREIGN BODY 450 31635 51 N/A Both " 2,841.00 " N/A N/A N/A N/A - - 35200045 HC CT CERV SPINE W/O SURG PLAN 352 72125 51 N/A Both " 2,842.00 " N/A N/A N/A N/A - - 32900102 HC SEL CATH PLACE ART 3RD 761 36217 51 N/A Both " 2,843.00 " N/A N/A N/A N/A - - 48100097 HC IVUS CORONARY ADDITIONAL VESSEL EACH 481 92979 51 N/A Both " 2,848.00 " N/A N/A N/A N/A - - 75000052 HC B EGD W FB PEG REMOVAL 750 51 N/A Both " 2,853.00 " N/A N/A N/A N/A - - 61100020 HC MRI PITUITARY W/O CONTRAST 611 70551 51 N/A Both " 2,858.00 " N/A N/A N/A N/A - - 61100014 HC 3T MRI PITUITARY W/O CONTRAST 611 70551 51 N/A Both " 2,858.00 " N/A N/A N/A N/A - - 75000045 HC B COLONOSCOPY REML FB 750 51 N/A Both " 2,861.00 " N/A N/A N/A N/A - - 61000241 HC 3T MRI STIR WAIST TO TOES 610 73722 51 N/A Both " 2,875.00 " N/A N/A N/A N/A - - 61000242 HC MRI STIR WAIST TO TOES 610 73722 51 N/A Both " 2,875.00 " N/A N/A N/A N/A - - 75000122 HC HEMORROID BANDING 750 51 N/A Both " 2,896.00 " N/A N/A N/A N/A - - 35100009 HC CT MAX FACIAL W/WO CONT 351 70488 51 N/A Both " 2,898.00 " N/A N/A N/A N/A - - 35100034 HC CT MAX FACIAL W/WO CONT 351 70488 51 N/A Both " 2,898.00 " N/A N/A N/A N/A - - 99000035 HC LAP LONGITUDINAL GASTRECTOMY (SLEEVE GASTRECTOMY) 990 43775 51 N/A Both " 2,901.00 " N/A N/A N/A N/A - - 35200010 HC CT SPINE THORAC W/WO CONT 352 72130 51 N/A Both " 2,906.00 " N/A N/A N/A N/A - - 35200063 HC CT SPINE THORAC W/WO CONT 352 72130 51 N/A Both " 2,906.00 " N/A N/A N/A N/A - - 32900282 HC TRANSCERV INTRO TUBE CATH 761 58345 51 N/A Both " 2,913.00 " N/A N/A N/A N/A - - 32000146 HC VENOUS EXT BILAT S & I 761 75822 51 N/A Both " 2,915.00 " N/A N/A N/A N/A - - 75000043 HC B-FMT PREP/INSTILLATION 750 51 N/A Both " 2,917.00 " N/A N/A N/A N/A - - 32000148 HC VENOUS SUP CAVAL S & I 761 75827 51 N/A Both " 2,919.00 " N/A N/A N/A N/A - - 32900211 HC INCISE DRAIN RECTAL ABSCESS 761 46040 51 N/A Both " 2,922.00 " N/A N/A N/A N/A - - 32900148 HC REMOVE CVA DEVICE OBSTRUCT 761 36595 51 N/A Both " 2,922.00 " N/A N/A N/A N/A - - 48000076 HC ANGIO ILIAC/FEM NS W/CARD CATH 481 G0278 51 N/A Both " 2,923.00 " N/A N/A N/A N/A - - 75000095 HC B FLEX SIGMOID REML FB 750 51 N/A Both " 2,924.00 " N/A N/A N/A N/A - - 76100127 HC DRAINAGE SCROTAL WALL ABSCESS 761 55100 51 N/A Both " 2,926.00 " N/A N/A N/A N/A - - 48100096 HC ECMO/ECLS INSERT CANNULA 481 33952 51 N/A Both " 2,926.00 " N/A N/A N/A N/A - - 32900340 HC RHIZOTOMY LUMB SACR INTL 761 64635 51 N/A Both " 2,932.00 " N/A N/A N/A N/A - - 40200002 HC BX BREAST US ADDTL 402 19084 51 N/A Both " 2,934.00 " N/A N/A N/A N/A - - 40200055 HC BX BREAST US GUIDE 402 19083 51 N/A Both " 2,934.00 " N/A N/A N/A N/A - - 41000035 HC HFOV SUBSEQUENT 410 94003 51 N/A Both " 2,936.00 " N/A N/A N/A N/A - - 32900243 HC EXCHANGE PREVIOUS CATHETER 761 49423 51 N/A Both " 2,939.00 " N/A N/A N/A N/A - - 35200046 HC CT THORACIC SPINE SURG PLAN 352 72128 51 N/A Both " 2,957.00 " N/A N/A N/A N/A - - 72200001 HC EXTERNAL CEPHALIC VERSION W WO TOCOLYSIS 722 59412 51 N/A Both " 2,957.00 " N/A N/A N/A N/A - - 33300031 HC SPECIAL TREATMENT PROCEDURE 333 77470 51 N/A Both " 2,963.00 " N/A N/A N/A N/A - - 45000346 HC THORACOTOMY W CARDIAC MASSAGE 450 32160 51 N/A Both " 2,971.00 " N/A N/A N/A N/A - - 61000087 HC MRA & MRV NECK W/O CONTRAST 610 70547 51 N/A Both " 2,976.00 " N/A N/A N/A N/A - - 61000084 HC 3T MRA & MRV NECK W/O CONTRAST 610 70547 51 N/A Both " 2,976.00 " N/A N/A N/A N/A - - 32900241 HC PLACE FM ABD PELVIS 761 49411 51 N/A Both " 2,979.00 " N/A N/A N/A N/A - - 32900060 HC PLACE FM THORAX 761 32553 51 N/A Both " 2,979.00 " N/A N/A N/A N/A - - 75000019 HC A-ESOPHAGEAL MOTILITY 750 51 N/A Both " 3,001.00 " N/A N/A N/A N/A - - 75000030 HC ANTRODUODENAL MANOMETRY 750 51 N/A Both " 3,001.00 " N/A N/A N/A N/A - - 61000118 HC MRI SACRUM COCCYX WO CONTRAST 610 72195 51 N/A Both " 3,006.00 " N/A N/A N/A N/A - - 61000117 HC 3T MRI SACRUM COCCYX WO CONTR 610 72195 51 N/A Both " 3,006.00 " N/A N/A N/A N/A - - 92000020 HC POLYSOMNOGRAM RS 920 95810 51 N/A Both " 3,008.00 " N/A N/A N/A N/A - - 41000005 HC VENTILATOR SUBSEQUENT 410 94003 51 N/A Both " 3,010.00 " N/A N/A N/A N/A - - 32900127 HC VCAD NT INSERT > 5 YR 761 36556 51 N/A Both " 3,012.00 " N/A N/A N/A N/A - - 32900111 HC ANGIO VERT CATH IN INTNL 761 36228 51 N/A Both " 3,022.00 " N/A N/A N/A N/A - - 32900144 HC VCAD PI REPLACE W SUBQ COMP 761 36585 51 N/A Both " 3,026.00 " N/A N/A N/A N/A - - 33300042 HC PHYSICIST CONSULT LEVEL TWO 333 77370 51 N/A Both " 3,031.00 " N/A N/A N/A N/A - - 32900234 HC NEEDLE BIOPSY PANCREAS 761 48102 51 N/A Both " 3,051.00 " N/A N/A N/A N/A - - 75000047 HC B DUODENAL WALLSTENT PLMT 750 51 N/A Both " 3,058.00 " N/A N/A N/A N/A - - 75000062 HC B EGD HOT BIOPSY 750 51 N/A Both " 3,058.00 " N/A N/A N/A N/A - - 75000138 HC B EGD W PEG PLACEMENT 750 51 N/A Both " 3,058.00 " N/A N/A N/A N/A - - 76100202 HC PICC INSERTION W GUIDANCE 5+YEARS 761 36573 51 N/A Both " 3,064.00 " N/A N/A N/A N/A - - 61000121 HC MRI SACRUM COCCYX W CONTRAST 610 72196 51 N/A Both " 3,069.00 " N/A N/A N/A N/A - - 61000120 HC 3T MRI SACRUM COCCYX W CONTRAS 610 72196 51 N/A Both " 3,069.00 " N/A N/A N/A N/A - - 35100015 HC CT STEALTH SINUSES W CONTRAST 351 70487 51 N/A Both " 3,082.00 " N/A N/A N/A N/A - - 35000003 HC CT SFT TS NECK W/WO CONT 350 70492 51 N/A Both " 3,103.00 " N/A N/A N/A N/A - - 35000033 HC CT SFT TS NECK W/WO CONT 350 70492 51 N/A Both " 3,103.00 " N/A N/A N/A N/A - - 75000053 HC B EGD W HEMOSTASIS 750 51 N/A Both " 3,107.00 " N/A N/A N/A N/A - - 75000058 HC B EGD W POLYPECTOMY 750 51 N/A Both " 3,107.00 " N/A N/A N/A N/A - - 75000087 HC B EUS W FNA BX STOMCH SM BOWEL 750 51 N/A Both " 3,107.00 " N/A N/A N/A N/A - - 75000145 HC B EUS W FNA BX W WO UPPER 750 51 N/A Both " 3,107.00 " N/A N/A N/A N/A - - 32900228 HC BILIARY ENDOSCOPY W BRUSH BX 761 47552 51 N/A Both " 3,107.00 " N/A N/A N/A N/A - - 75000004 HC B EUS CELIAC PLEXUS INJECTION 750 51 N/A Both " 3,108.00 " N/A N/A N/A N/A - - 75000144 HC B EUS UPPER 750 51 N/A Both " 3,108.00 " N/A N/A N/A N/A - - 75000089 HC B EUS W NEEDLE ASP ESOHAGUS 750 51 N/A Both " 3,108.00 " N/A N/A N/A N/A - - 35200016 HC CT PELVIS W CONTRAST 352 72193 51 N/A Both " 3,115.00 " N/A N/A N/A N/A - - 32900216 HC CHOLANGIOGRAM T-TUBE 761 47531 51 N/A Both " 3,117.00 " N/A N/A N/A N/A - - 61000004 HC BREAST NDL LOC MR ADDTL 610 19288 51 N/A Both " 3,129.00 " N/A N/A N/A N/A - - 61000003 HC BREAST NDL LOC MR GUIDE 610 19287 51 N/A Both " 3,129.00 " N/A N/A N/A N/A - - 32900256 HC REMOVE INT URET STENT PERC 761 50384 51 N/A Both " 3,151.00 " N/A N/A N/A N/A - - 61100001 HC MRI BRAIN WO CONTRAST 611 70551 51 N/A Both " 3,163.00 " N/A N/A N/A N/A - - 61000116 HC 3T MRI PELVIS WO CONTRAST 610 72195 51 N/A Both " 3,163.00 " N/A N/A N/A N/A - - 61000019 HC MRI PELVIS WO CONTRAST 610 72195 51 N/A Both " 3,163.00 " N/A N/A N/A N/A - - 61100008 HC 3T MRI BRAIN W/O CONTRAST 611 70551 51 N/A Both " 3,163.00 " N/A N/A N/A N/A - - 61100004 HC 3T MRI RT PLAN W/O 611 76498 51 N/A Both " 3,163.00 " N/A N/A N/A N/A - - 17300001 HC R&B NEWBORN LEVEL III 173 51 N/A Both " 3,170.00 " N/A N/A N/A N/A - - 75000012 HC A-COLONOSCOPY 750 51 N/A Both " 3,173.00 " N/A N/A N/A N/A - - 92000023 HC NASAL CPAP STUDY RS 920 95811 51 N/A Both " 3,179.00 " N/A N/A N/A N/A - - 75000013 HC A-COLONOSCOPY THR COLOST 750 51 N/A Both " 3,181.00 " N/A N/A N/A N/A - - 33300025 HC IMRT COMPLEX 333 77386 51 N/A Both " 3,181.00 " N/A N/A N/A N/A - - 45000061 HC LAYR CLOS WND REST BODY >30CM 450 12047 51 N/A Both " 3,182.00 " N/A N/A N/A N/A - - 45000055 HC LAYR CLOS WND TRUNK ARM LEG >30CM 450 12037 51 N/A Both " 3,182.00 " N/A N/A N/A N/A - - 32300019 HC ANG PULM NON-SEL CATH/VEN 761 75746 51 N/A Both " 3,186.00 " N/A N/A N/A N/A - - 32300017 HC ANGIO PULMONARY UNI 761 75741 51 N/A Both " 3,186.00 " N/A N/A N/A N/A - - 32300014 HC ANGIOGRAPHY ADRENAL UNI 761 75731 51 N/A Both " 3,186.00 " N/A N/A N/A N/A - - 32000151 HC VENOGRAM ADRENAL UNI 761 75840 51 N/A Both " 3,186.00 " N/A N/A N/A N/A - - 92000022 HC SPLIT NIGHT STUDY RS 920 95810 51 N/A Both " 3,188.00 " N/A N/A N/A N/A - - 61000057 HC 3T MRI TMJ BILATERAL 610 70336 51 N/A Both " 3,200.00 " N/A N/A N/A N/A - - 61000058 HC MRI TMJ BILATERAL 610 70336 51 N/A Both " 3,200.00 " N/A N/A N/A N/A - - 35200020 HC CT UPPER EXT W/WO CONTRAST 352 73202 51 N/A Both " 3,204.00 " N/A N/A N/A N/A - - 35200065 HC CT UPPER EXT W/WO CONTRAST 352 73202 51 N/A Both " 3,204.00 " N/A N/A N/A N/A - - 41000031 HC VDR INITIAL 410 94002 51 N/A Both " 3,204.00 " N/A N/A N/A N/A - - 61100027 HC MRI PITUITARY W/CONTRAST 611 70552 51 N/A Both " 3,205.00 " N/A N/A N/A N/A - - 61100024 HC 3T MRI PITUITARY W/CONTRAST 611 70552 51 N/A Both " 3,205.00 " N/A N/A N/A N/A - - 32000060 HC DISKOGRAM CERVICAL 761 72285 51 N/A Both " 3,205.00 " N/A N/A N/A N/A - - 32000061 HC DISKOGRAM LUMBAR 761 72295 51 N/A Both " 3,205.00 " N/A N/A N/A N/A - - 32000142 HC LYMPHANGIOGRAM PEL/ABD BI 761 75807 51 N/A Both " 3,205.00 " N/A N/A N/A N/A - - 32900210 HC TUBE CHECK NG G OR J 761 44799 51 N/A Both " 3,205.00 " N/A N/A N/A N/A - - 32000156 HC VENOGRAPHY ORBITAL 761 75880 51 N/A Both " 3,205.00 " N/A N/A N/A N/A - - 75000163 HC B ENTEROS TO ILM W ABL LESION 750 51 N/A Both " 3,212.00 " N/A N/A N/A N/A - - 35200028 HC CT ABDOMEN W/WO CONTRAST 352 74170 51 N/A Both " 3,223.00 " N/A N/A N/A N/A - - 61000020 HC MRI PELVIS W CONTRAST 610 72196 51 N/A Both " 3,223.00 " N/A N/A N/A N/A - - 61000119 HC 3T MRI PELVIS W CONTRAST 610 72196 51 N/A Both " 3,223.00 " N/A N/A N/A N/A - - 35200061 HC CT ABDOMEN W/WO CONTRAST 352 74170 51 N/A Both " 3,223.00 " N/A N/A N/A N/A - - 99000030 HC LAP PLACEMENT GASTRIC BAND (MOD 52-INDIVIDUAL COMPONENT) 990 43770 51 N/A Both " 3,238.00 " N/A N/A N/A N/A - - 76100230 HC OSTECTOMY CALCANEOUS 761 28118 51 N/A Both " 3,240.00 " N/A N/A N/A N/A - - 32000144 HC SPLENOPORTOGRAPHY 761 75810 51 N/A Both " 3,250.00 " N/A N/A N/A N/A - - 61000092 HC MRA NECK W/CONTRAST 610 70548 51 N/A Both " 3,253.00 " N/A N/A N/A N/A - - 61000093 HC MRV NECK W/CONTRAST 610 70548 51 N/A Both " 3,253.00 " N/A N/A N/A N/A - - 61000089 HC 3T MRA NECK W/CONTRAST 610 70548 51 N/A Both " 3,253.00 " N/A N/A N/A N/A - - 61000090 HC 3T MRV NECK W/CONTRAST 610 70548 51 N/A Both " 3,253.00 " N/A N/A N/A N/A - - 35200024 HC CT LOWER EXT W/WO CONT 352 73702 51 N/A Both " 3,255.00 " N/A N/A N/A N/A - - 35200064 HC CT LOWER EXT W/WO CONT 352 73702 51 N/A Both " 3,255.00 " N/A N/A N/A N/A - - 32000160 HC HEP VEN WDG/FR WO/HEM EV 761 75891 51 N/A Both " 3,266.00 " N/A N/A N/A N/A - - 32000159 HC HEPATIC VENOGRAM W/HEM EV 761 75889 51 N/A Both " 3,266.00 " N/A N/A N/A N/A - - 32000157 HC PERC TRANS PORT W/HEMO EV 761 75885 51 N/A Both " 3,266.00 " N/A N/A N/A N/A - - 32900123 HC ELVS ADDTL VEIN 761 36479 51 N/A Both " 3,295.00 " N/A N/A N/A N/A - - 61000026 HC MRI JT UPPER EXT W/O CONTRAST 610 73221 51 N/A Both " 3,299.00 " N/A N/A N/A N/A - - 61000023 HC MRI UPPER EXT WO CONTRAST 610 73218 51 N/A Both " 3,299.00 " N/A N/A N/A N/A - - 61000231 HC 3T MRI JT UPPER EXT W/O CONTRAST 610 73221 51 N/A Both " 3,299.00 " N/A N/A N/A N/A - - 61000228 HC 3T MRI UPPER EXT WO CONTRAST 610 73218 51 N/A Both " 3,299.00 " N/A N/A N/A N/A - - 32300005 HC AORTOGRAM THOR W/O SERIAL 761 75600 51 N/A Both " 3,299.00 " N/A N/A N/A N/A - - 35200003 HC CT THORAX W/WO CONTRAST 352 71270 51 N/A Both " 3,314.00 " N/A N/A N/A N/A - - 35200062 HC CT THORAX W/WO CONTRAST 352 71270 51 N/A Both " 3,314.00 " N/A N/A N/A N/A - - 61000217 HC MR BREAST WO CONTRAST BIL 610 77047 51 N/A Both " 3,316.00 " N/A N/A N/A N/A - - 35100010 HC CT ANGIO HEAD W/WO CONTRAST 351 70496 51 N/A Both " 3,316.00 " N/A N/A N/A N/A - - 35000004 HC CT ANGIO NECK W WO CONTRAST 350 70498 51 N/A Both " 3,316.00 " N/A N/A N/A N/A - - 61000214 HC 3T MR BREAST WO CONTRAST BIL 610 77047 51 N/A Both " 3,316.00 " N/A N/A N/A N/A - - 75000005 HC B EGD W ENDO MUCOSAL RESECT 750 51 N/A Both " 3,320.00 " N/A N/A N/A N/A - - 32300020 HC ANGIO INTERNAL MAMMARY 761 75756 51 N/A Both " 3,324.00 " N/A N/A N/A N/A - - 32000153 HC VENOGRAM SINUS/JUG/CATH 761 75860 51 N/A Both " 3,324.00 " N/A N/A N/A N/A - - 32000155 HC VENOGRAPHY EPIDURAL 761 75872 51 N/A Both " 3,324.00 " N/A N/A N/A N/A - - 32000149 HC VENOUS RENAL UNILAT S & I 761 75831 51 N/A Both " 3,324.00 " N/A N/A N/A N/A - - 75000007 HC ANAL RECTAL MOTILITY PUDENDAL 750 91122 51 N/A Both " 3,328.00 " N/A N/A N/A N/A - - 76100104 HC DRAINAGE OF HEMATOMA/FLUID 761 10140 51 N/A Both " 3,344.00 " N/A N/A N/A N/A - - 76100109 HC INCIS/DRAIN ARM DEEP ABSC/HEMATOMA 761 23930 51 N/A Both " 3,344.00 " N/A N/A N/A N/A - - 32900004 HC INCISE DRAIN HEMATOMA 329 10140 51 N/A Both " 3,344.00 " N/A N/A N/A N/A - - 32300011 HC ANGIO EXTREM UNILATERAL 323 75710 51 N/A Both " 3,346.00 " N/A N/A N/A N/A - - 35200025 HC CT ANGIO LOW EXT W/WO CONTRAST 352 73706 51 N/A Both " 3,347.00 " N/A N/A N/A N/A - - 35200021 HC CT ANGIO UPPER EXT W/WO CONTR 352 73206 51 N/A Both " 3,347.00 " N/A N/A N/A N/A - - 21000001 HC R&B CORONARY CARE 210 51 N/A Both " 3,350.00 " N/A N/A N/A N/A - - 20000001 HC R&B INTENSIVE CARE 200 51 N/A Both " 3,350.00 " N/A N/A N/A N/A - - 20800001 HC R&B INTENSIVE CARE TRAUMA 208 51 N/A Both " 3,350.00 " N/A N/A N/A N/A - - 36000024 HC OR LEVEL 2 BASE 360 51 N/A Both " 3,355.00 " N/A N/A N/A N/A - - 32000147 HC VENOUS INF CAVAL S & I 761 75825 51 N/A Both " 3,366.00 " N/A N/A N/A N/A - - 75000027 HC A-ILEOSCOPY THROUGH STOMA 750 51 N/A Both " 3,377.00 " N/A N/A N/A N/A - - 32900050 HC TENOTOMY PERC KNEE SGL 761 27306 51 N/A Both " 3,377.00 " N/A N/A N/A N/A - - 41000030 HC HFOV INITIAL 410 94002 51 N/A Both " 3,384.00 " N/A N/A N/A N/A - - 61000033 HC MRI JT LOWER EXT W/O CONTRAST 610 73721 51 N/A Both " 3,389.00 " N/A N/A N/A N/A - - 61000030 HC MRI LOW EXT W/O CONTRAST 610 73718 51 N/A Both " 3,389.00 " N/A N/A N/A N/A - - 61000164 HC 3T MRI JT LOWER EXT W/O CONTR 610 73721 51 N/A Both " 3,389.00 " N/A N/A N/A N/A - - 61000160 HC 3T MRI LOW EXT W/O CONTRAST 610 73718 51 N/A Both " 3,389.00 " N/A N/A N/A N/A - - 41000004 HC VENTILATOR INITIAL 410 94002 51 N/A Both " 3,435.00 " N/A N/A N/A N/A - - 45000320 "HC INCIS/DRAIN SCROTUM/TESTIS,EPIDIDYM" 450 54700 51 N/A Both " 3,440.00 " N/A N/A N/A N/A - - 45000321 HC REMOVAL OF SCROTAL FOR.BODY 450 55120 51 N/A Both " 3,440.00 " N/A N/A N/A N/A - - 61200005 HC MRI SPINAL CNL LUMBAR WO CONTRAST 612 72148 51 N/A Both " 3,441.00 " N/A N/A N/A N/A - - 61200021 HC 3T MRI SPINAL CNL LUMBAR W/O 612 72148 51 N/A Both " 3,441.00 " N/A N/A N/A N/A - - 32900226 HC BIOPSY BILIARY DUCT 761 47543 51 N/A Both " 3,443.00 " N/A N/A N/A N/A - - 32900121 HC VNUS ADDTL VEIN 761 36476 51 N/A Both " 3,459.00 " N/A N/A N/A N/A - - 48100060 HC ENDOMYOCARDIAL BIOPSY 481 93505 51 N/A Both " 3,462.00 " N/A N/A N/A N/A - - 32900392 HC INJ EPIDURAL CERV THOR CT 761 62321 51 N/A Both " 3,464.00 " N/A N/A N/A N/A - - 32900394 HC INJ EPIDURAL LUMB SACRAL CT 761 62323 51 N/A Both " 3,464.00 " N/A N/A N/A N/A - - 35200057 HC CT RENAL CALC W/O CONT 352 74176 51 N/A Both " 3,466.00 " N/A N/A N/A N/A - - 35200030 HC CT ANGIO ABD W/WO CONTRAST 352 74175 51 N/A Both " 3,467.00 " N/A N/A N/A N/A - - 61100002 HC MRI BRAIN W/CONTRAST 611 70552 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 61000155 HC MRA UPPER EXTREMITY W/O CONT 610 73225 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 61000157 HC MRV UPPER EXT W/O CONTRAST 610 73225 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 61000147 HC 3T MRA UPPER EXTREMITY W/O CON 610 73225 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 61100022 HC 3T MRI BRAIN W/CONTRAST 611 70552 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 61100036 HC 3T MRI RT PLAN 611 76498 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 61000149 HC 3T MRV UPPER EXT W/O CONTRAST 610 73225 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 61100005 HC MRI RT PLAN 610 76498 51 N/A Both " 3,470.00 " N/A N/A N/A N/A - - 32900055 HC FASCIOTOMY 761 28008 51 N/A Both " 3,473.00 " N/A N/A N/A N/A - - 32900053 HC TENOTOMY ACHILLES TENDON 761 27605 51 N/A Both " 3,473.00 " N/A N/A N/A N/A - - 75000139 HC B EGD DILATE ESOPH > 30MM 750 51 N/A Both " 3,475.00 " N/A N/A N/A N/A - - 32900230 HC DIL BIL DCT STRCT WO STNT 761 47555 51 N/A Both " 3,486.00 " N/A N/A N/A N/A - - 48000065 HC INSERT HEART POD LAPTOP 481 33999 51 N/A Both " 3,489.00 " N/A N/A N/A N/A - - 33300012 HC BRACHYTHERAPY ISODOSE COMPLEX 333 77318 51 N/A Both " 3,494.00 " N/A N/A N/A N/A - - 75000142 HC B EGD W ABLATION LESION 750 51 N/A Both " 3,524.00 " N/A N/A N/A N/A - - 32900215 HC PERCUTANEOUS CHOLECYSTOSTOMY 761 47490 51 N/A Both " 3,534.00 " N/A N/A N/A N/A - - 61100016 HC MRI BRAIN W/O CONT SURG PLAN 611 70551 51 N/A Both " 3,543.00 " N/A N/A N/A N/A - - 61100011 HC 3T MRI BRAIN WO CONT SURG PLAN 611 70551 51 N/A Both " 3,543.00 " N/A N/A N/A N/A - - 34000005 HC TUMOR IMAGING SPECT CT SINGLE AREA SINGLE DAY 340 78830 51 N/A Both " 3,550.00 " N/A N/A N/A N/A - - 61000224 HC MR BREAST W/WO CONTRAST W/WO DYNACAD BIL 610 77049 51 N/A Both " 3,552.00 " N/A N/A N/A N/A - - 76100143 HC ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER 761 51102 51 N/A Both " 3,553.00 " N/A N/A N/A N/A - - 48000071 HC TEE W/CONTRAST 480 C8925 51 N/A Both " 3,562.00 " N/A N/A N/A N/A - - 48000072 HC TEE W/CONTRAST & COLOR/DOPPLER 480 C8925 51 N/A Both " 3,562.00 " N/A N/A N/A N/A - - 61200003 HC MRI SPINAL CANAL THOR W/O CONTRAST 612 72146 51 N/A Both " 3,564.00 " N/A N/A N/A N/A - - 61200016 HC 3T MRI SPINAL CANAL THOR W/O 612 72146 51 N/A Both " 3,564.00 " N/A N/A N/A N/A - - 32300007 HC AORTOGRAM ABDOMINAL 761 75625 51 N/A Both " 3,570.00 " N/A N/A N/A N/A - - 32300018 HC ANGIO PULMONARY BIL 761 75743 51 N/A Both " 3,575.00 " N/A N/A N/A N/A - - 32300015 HC ANGIOGRAPHY ADRENAL BILAT 761 75733 51 N/A Both " 3,575.00 " N/A N/A N/A N/A - - 61000014 HC MRA NECK W/WO CONTRAST 610 70549 51 N/A Both " 3,597.00 " N/A N/A N/A N/A - - 61000098 HC MRV NECK W/WO CONTRAST 610 70549 51 N/A Both " 3,597.00 " N/A N/A N/A N/A - - 61000095 HC 3T MRA NECK W/WO CONTRAST 610 70549 51 N/A Both " 3,597.00 " N/A N/A N/A N/A - - 61000096 HC 3T MRV NECK W/WO CONTRAST 610 70549 51 N/A Both " 3,597.00 " N/A N/A N/A N/A - - 75000090 HC B FLEX SIG W HEMOSTASIS 750 51 N/A Both " 3,610.00 " N/A N/A N/A N/A - - 61000139 HC MRA PELVIS W/O CONTRAST 610 72198 51 N/A Both " 3,625.00 " N/A N/A N/A N/A - - 61000141 HC MRV PELVIS W/O CONTRAST 610 72198 51 N/A Both " 3,625.00 " N/A N/A N/A N/A - - 61000130 HC 3T MRA PELVIS W/O CONTRAST 610 72198 51 N/A Both " 3,625.00 " N/A N/A N/A N/A - - 61000132 HC 3T MRV PELVIS W/O CONTRAST 610 72198 51 N/A Both " 3,625.00 " N/A N/A N/A N/A - - 32900138 HC VCAD T REPLACE W SUBQ CATH 761 36578 51 N/A Both " 3,631.00 " N/A N/A N/A N/A - - 35000016 HC CT BRAIN PERFUSION 350 0042T 51 N/A Both " 3,644.00 " N/A N/A N/A N/A - - 61000009 HC MRA HEAD WO CONTRAST 610 70544 51 N/A Both " 3,660.00 " N/A N/A N/A N/A - - 61000073 HC MRV HEAD W/O CONTRAST 610 70544 51 N/A Both " 3,660.00 " N/A N/A N/A N/A - - 61000070 HC 3T MRA HEAD W/O CONTRAST 610 70544 51 N/A Both " 3,660.00 " N/A N/A N/A N/A - - 61000071 HC 3T MRV HEAD W/O CONTRAST 610 70544 51 N/A Both " 3,660.00 " N/A N/A N/A N/A - - 36000110 HC LITHOTRIPSY KIDNEY BILATERAL 360 51 N/A Both " 3,671.00 " N/A N/A N/A N/A - - 45000331 HC SUTURE EYELID WOUND FULL THICK 450 67935 51 N/A Both " 3,675.00 " N/A N/A N/A N/A - - 45000330 HC SUTURE EYELID WOUND PARTIAL THICK 450 67930 51 N/A Both " 3,675.00 " N/A N/A N/A N/A - - 61200001 HC MRI SPINAL CANAL CERV W/O CONTRAST 612 72141 51 N/A Both " 3,690.00 " N/A N/A N/A N/A - - 61200011 HC 3T MRI SPINAL CANAL CERV W/O 612 72141 51 N/A Both " 3,690.00 " N/A N/A N/A N/A - - 32900345 HC MICRO PHLEBECTOMY < 10 761 37799 51 N/A Both " 3,691.00 " N/A N/A N/A N/A - - 61000041 HC MRI CARDIAC W/O CONT 610 75557 51 N/A Both " 3,698.00 " N/A N/A N/A N/A - - 99000031 HC LAP REVISION OF ADJUST GASTRIC BAND COMPONENT ONLY 990 43771 51 N/A Both " 3,700.00 " N/A N/A N/A N/A - - 99000033 HC LAP REMOVE/REPLACEMENT OF ADJUST GASTRIC BAND COMPONENT ONLY 990 43773 51 N/A Both " 3,702.00 " N/A N/A N/A N/A - - 48000091 HC LA RECORD PACING FROM CS OR LA LTD 481 93621 51 N/A Both " 3,703.00 " N/A N/A N/A N/A - - 35200017 HC CT PELVIS W/WO CONTRAST 352 72194 51 N/A Both " 3,710.00 " N/A N/A N/A N/A - - 35200066 HC CT PELVIS W/WO CONTRAST 352 72194 51 N/A Both " 3,710.00 " N/A N/A N/A N/A - - 75000023 HC A EUS ESOPHAGUS 750 51 N/A Both " 3,715.00 " N/A N/A N/A N/A - - 75000164 HC A EUS SIGMOID 750 51 N/A Both " 3,715.00 " N/A N/A N/A N/A - - 61000236 HC 3T MRI ABDOMEN W/O CONTRAST 610 74181 51 N/A Both " 3,716.00 " N/A N/A N/A N/A - - 61000037 HC MRI ABDOMEN W/O CONTRAST 610 74181 51 N/A Both " 3,716.00 " N/A N/A N/A N/A - - 61000091 HC MRA & MRV NECK W/CONTRAST 610 70548 51 N/A Both " 3,718.00 " N/A N/A N/A N/A - - 61100035 HC MRI PITUITARY W/WO CONTRAST 611 70553 51 N/A Both " 3,718.00 " N/A N/A N/A N/A - - 61000013 HC 3T MRA & MRV NECK W/CONTRAST 610 70548 51 N/A Both " 3,718.00 " N/A N/A N/A N/A - - 61100031 HC 3T MRI PITUITARY W/WO CONTRAST 611 70553 51 N/A Both " 3,718.00 " N/A N/A N/A N/A - - 61100018 HC MRI BRAIN/PIT W/O CONTRAST 611 70551 51 N/A Both " 3,724.00 " N/A N/A N/A N/A - - 61100012 HC 3T MRI BRAIN/PIT W/O CONTRAST 611 70551 51 N/A Both " 3,724.00 " N/A N/A N/A N/A - - 35000018 HC CT ANGIO CHEST W/WO CONTRAST 352 71275 51 N/A Both " 3,770.00 " N/A N/A N/A N/A - - 28000001 HC PLASMAPHERESIS 280 36514 51 N/A Both " 3,772.00 " N/A N/A N/A N/A - - 75000009 HC A POUCHOSCOPY 750 51 N/A Both " 3,780.00 " N/A N/A N/A N/A - - 48000064 HC INSERT RESPI CARDIA SYSTEM 481 33999 51 N/A Both " 3,781.00 " N/A N/A N/A N/A - - 32000150 HC VENOUS RENAL BILAT S & I 761 75833 51 N/A Both " 3,790.00 " N/A N/A N/A N/A - - 35200056 HC CATOPSY ABD/PEL 352 74176 51 N/A Both " 3,802.00 " N/A N/A N/A N/A - - 33300001 HC APPLIC STEREOTACTIC FRAME 333 20660 51 N/A Both " 3,802.00 " N/A N/A N/A N/A - - 61100026 HC MRI BRAIN/PIT W/CONTRAST 611 70552 51 N/A Both " 3,805.00 " N/A N/A N/A N/A - - 61100023 HC 3T MRI BRAIN/PIT W/CONTRAST 611 70552 51 N/A Both " 3,805.00 " N/A N/A N/A N/A - - 61000027 HC MRI JOINT UPPER EXT W/CONTRAST 610 73222 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000114 HC MRV CHEST W/O CONTRAST 610 71555 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000188 HC MRA LOWER EXTREMITY W/O CONT 610 73725 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000191 HC MRV LOWER EXT W/O CONTRAST 610 73725 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000024 HC MRI UPPER EXT W/CONTRAST 610 73219 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000103 HC 3T MRA CHEST W/O CONTRAST 610 71555 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000180 HC 3T MRA LOWER EXTREMITY W/O CON 610 73725 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000232 HC 3T MRI JOINT UPPER EXT W/CONTRAST 610 73222 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000229 HC 3T MRI UPPER EXT W/CONTRAST 610 73219 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000105 HC 3T MRV CHEST W/O CONTRAST 610 71555 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000183 HC 3T MRV LOWER EXT W/O CONTRAST 610 73725 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 61000112 HC MRA CHEST W/O CONTRAST 610 71555 51 N/A Both " 3,809.00 " N/A N/A N/A N/A - - 75000065 HC B ENTEROS TO ILM W HEMOSTASIS 750 51 N/A Both " 3,810.00 " N/A N/A N/A N/A - - 75000157 HC B COLON W HEMOSTASIS 750 51 N/A Both " 3,814.00 " N/A N/A N/A N/A - - 32300012 HC ANGIO EXTREM BILATERAL 323 75716 51 N/A Both " 3,822.00 " N/A N/A N/A N/A - - 76100251 HC DILATE BILIARY DUCT/AMPULLA 761 47542 51 N/A Both " 3,825.00 " N/A N/A N/A N/A - - 61100015 HC MRI BRAIN W IACS WO CONT 611 70551 51 N/A Both " 3,839.00 " N/A N/A N/A N/A - - 61100007 HC 3T MRI BRAIN W IACS WO CONT 611 70551 51 N/A Both " 3,839.00 " N/A N/A N/A N/A - - 92000013 HC POLYSOMNOGRAPHY 920 95810 51 N/A Both " 3,840.00 " N/A N/A N/A N/A - - 61200006 HC MRI SPINAL CNL LUMB W/CONTRAST 612 72149 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 61200004 HC MRI SPINL CNL THOR W/CONTRAST 612 72147 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 61200002 HC MRI SPINAL CNL CERV W/CONTRAST 612 72142 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 61000124 HC MRI SACRUM COCCYX W WO 610 72197 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 61000123 HC 3T MRI SACRUM COCCYX W WO 610 72197 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 61200026 HC 3T MRI SPINAL CNL CERV W/CONTRAST 612 72142 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 61200028 HC 3T MRI SPINAL CNL LUMB W/CONTRAST 612 72149 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 61200027 HC 3T MRI SPINL CNL THOR W/CONTRAST 612 72147 51 N/A Both " 3,842.00 " N/A N/A N/A N/A - - 75000076 HC B ERCP LITHOTRIPSY 750 51 N/A Both " 3,849.00 " N/A N/A N/A N/A - - 75000169 HC B ERCP W DUCT STENT PLACEMENT 750 51 N/A Both " 3,849.00 " N/A N/A N/A N/A - - 75000160 HC B ERCP W REM REPL STENT EA 750 51 N/A Both " 3,849.00 " N/A N/A N/A N/A - - 75000120 HC B ERCP W SPY 750 51 N/A Both " 3,849.00 " N/A N/A N/A N/A - - 75000158 HC B ERCP W STENT PLACEMENT IN BILLIARY OR PANCREATIC DUCT EACH STENT 750 51 N/A Both " 3,849.00 " N/A N/A N/A N/A - - 75000099 HC BRONCHOSCOPY W OR WO WASHINGS 761 51 N/A Both " 3,850.00 " N/A N/A N/A N/A - - 75000118 HC BRONCHOSCOPY WITH DILATION 761 51 N/A Both " 3,850.00 " N/A N/A N/A N/A - - 33300037 HC HDR BRACHYTX 2-12 CHANNELS 333 77771 51 N/A Both " 3,856.00 " N/A N/A N/A N/A - - 76100231 HC OSTECTOMY SPUR W OR WO PLANTAR FASCIA RELEASE 761 28119 51 N/A Both " 3,867.00 " N/A N/A N/A N/A - - 32900134 HC VCAD PI INSERT W SUBQ < 5 YR 761 36570 51 N/A Both " 3,887.00 " N/A N/A N/A N/A - - 32900135 HC VCAD PI INSERT W SUBQ > 5 YR 761 36571 51 N/A Both " 3,887.00 " N/A N/A N/A N/A - - 32900140 HC VCAD/T REPLACE WO SUBQ PORT 761 36581 51 N/A Both " 3,887.00 " N/A N/A N/A N/A - - 61000031 HC MRI LOW EXT W/CONTRAST 610 73719 51 N/A Both " 3,899.00 " N/A N/A N/A N/A - - 61000015 HC MRI CHEST W/O CONTRAST 610 71550 51 N/A Both " 3,899.00 " N/A N/A N/A N/A - - 61000034 HC MRI JT LOWER EXT W CONTRAST 610 73722 51 N/A Both " 3,899.00 " N/A N/A N/A N/A - - 61000225 HC 3T MRI CHEST W/O CONTRAST 610 71550 51 N/A Both " 3,899.00 " N/A N/A N/A N/A - - 61000168 HC 3T MRI JT LOWER EXT W/CONTRAST 610 73722 51 N/A Both " 3,899.00 " N/A N/A N/A N/A - - 61000234 HC 3T MRI LOW EXT W/CONTRAST 610 73719 51 N/A Both " 3,899.00 " N/A N/A N/A N/A - - 76100062 HC PLEURX CATH PLACEMENT 761 51 N/A Both " 3,926.00 " N/A N/A N/A N/A - - 75000097 HC BRONCH BRONCHIAL STENT PLACE 761 51 N/A Both " 3,931.00 " N/A N/A N/A N/A - - 75000103 HC BRONCH WITH EXCISION OF TUMOR 761 51 N/A Both " 3,931.00 " N/A N/A N/A N/A - - 75000104 HC BRONCH WITH NEEDLE BIOPSY 761 51 N/A Both " 3,931.00 " N/A N/A N/A N/A - - 61100034 HC MRI BRAIN W/WO CONTRAST 611 70553 51 N/A Both " 3,938.00 " N/A N/A N/A N/A - - 61100006 HC 3T MRI BRAIN W/WO CONT RT PLAN 611 76498 51 N/A Both " 3,938.00 " N/A N/A N/A N/A - - 61100029 HC 3T MRI BRAIN W/WO CONTRAST 611 70553 51 N/A Both " 3,938.00 " N/A N/A N/A N/A - - 61100025 HC MRI BRAIN W/CONT SURG PLAN 611 70552 51 N/A Both " 3,947.00 " N/A N/A N/A N/A - - 61100021 HC 3T MRI BRAIN W/CONT SURG PLAN 611 70552 51 N/A Both " 3,947.00 " N/A N/A N/A N/A - - 35200035 HC CT VIRTUAL CLNGRPHY W CONT DX 352 74262 51 N/A Both " 3,948.00 " N/A N/A N/A N/A - - 35200034 HC CT VIRTUAL CLNGRPHY WO CONT DX 352 74261 51 N/A Both " 3,948.00 " N/A N/A N/A N/A - - 35000005 HC CT VIRTUAL COLONOGRAPHY SCRN 350 74263 51 N/A Both " 3,948.00 " N/A N/A N/A N/A - - 61000042 HC MRI CARDIAC W/O CONT W/STR 610 75559 51 N/A Both " 3,954.00 " N/A N/A N/A N/A - - 75000106 HC BRONCHIAL THERMOPLASTY 1 LOBE 761 51 N/A Both " 3,961.00 " N/A N/A N/A N/A - - 75000107 HC BRONCHIAL THERMOPLASTY 2+ LOBE 761 51 N/A Both " 3,961.00 " N/A N/A N/A N/A - - 75000111 HC BRONCHOSCOPY FOR BALLOON OCCLU 761 51 N/A Both " 3,961.00 " N/A N/A N/A N/A - - 61000006 HC MRI ORBIT FACE NECK WO CONTR 610 70540 51 N/A Both " 3,967.00 " N/A N/A N/A N/A - - 61000154 HC MRA UPPER EXTREMITY W/CONTRAST 610 73225 51 N/A Both " 3,967.00 " N/A N/A N/A N/A - - 61000156 HC MRV UPPER EXT W/CONTRAST 610 73225 51 N/A Both " 3,967.00 " N/A N/A N/A N/A - - 61000146 HC 3T MRA UPPER EXTREMITY W/CONTR 610 73225 51 N/A Both " 3,967.00 " N/A N/A N/A N/A - - 61000060 HC 3T MRI ORBIT FACE NECK WO CON 610 70540 51 N/A Both " 3,967.00 " N/A N/A N/A N/A - - 61000148 HC 3T MRV UPPER EXT W/CONTRAST 610 73225 51 N/A Both " 3,967.00 " N/A N/A N/A N/A - - 35000012 HC CT GUIDE STEREOTAC LOCAL 350 77011 51 N/A Both " 3,974.00 " N/A N/A N/A N/A - - 61000138 HC MRA PELVIS W/CONTRAST 610 72198 51 N/A Both " 3,989.00 " N/A N/A N/A N/A - - 61000140 HC MRV PELVIS W/CONTRAST 610 72198 51 N/A Both " 3,989.00 " N/A N/A N/A N/A - - 61000129 HC 3T MRA PELVIS W/CONTRAST 610 72198 51 N/A Both " 3,989.00 " N/A N/A N/A N/A - - 61000131 HC 3T MRV PELVIS W/CONTRAST 610 72198 51 N/A Both " 3,989.00 " N/A N/A N/A N/A - - 75000100 HC BRONCH W EBUS 1 OR 2 NODES 761 51 N/A Both " 4,016.00 " N/A N/A N/A N/A - - 48000074 HC ECHO STRESS W/CONTRAST 480 C8930 51 N/A Both " 4,030.00 " N/A N/A N/A N/A - - 33300019 HC MLC DEVICE PER IMRT PLAN 333 77338 51 N/A Both " 4,037.00 " N/A N/A N/A N/A - - 75000150 HC B FLEX SIG W ABLATION 750 51 N/A Both " 4,058.00 " N/A N/A N/A N/A - - 32900195 HC MICRO PHLEBECTOMY 10-20 761 37765 51 N/A Both " 4,080.00 " N/A N/A N/A N/A - - 61000237 HC 3T MRI ABD W/CONTRAST 610 74182 51 N/A Both " 4,082.00 " N/A N/A N/A N/A - - 61000038 HC MRI ABD W/CONTRAST 610 74182 51 N/A Both " 4,082.00 " N/A N/A N/A N/A - - 32900129 HC VCAD/T INSERT WO SUBQ > 5 YR 761 36558 51 N/A Both " 4,082.00 " N/A N/A N/A N/A - - 61000021 HC MRI PELVIS W WO CONTRAST 610 72197 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 61000036 HC MRA LOWER EXTREMITY W/CONTRAST 610 73725 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 61000190 HC MRV LOWER EXT W/CONTRAST 610 73725 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 61000152 HC MRA & MRV UPPER EXT W/O CONTRA 610 73225 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 61000143 HC 3T MRA & MRV UPPER EXT W/O CON 610 73225 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 61000179 HC 3T MRA LOWER EXTREMITY W/CONTR 610 73725 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 61000122 HC 3T MRI PELVIS W WO CONTRAST 610 72197 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 61000182 HC 3T MRV LOWER EXT W/CONTRAST 610 73725 51 N/A Both " 4,093.00 " N/A N/A N/A N/A - - 32900014 HC BX BREAST STEREO ADDTL 329 19082 51 N/A Both " 4,102.00 " N/A N/A N/A N/A - - 32900013 HC BX BREAST STEREO GUIDE 329 19081 51 N/A Both " 4,102.00 " N/A N/A N/A N/A - - 75000129 HC B ESOPH DILATE ACHLSIA > 30MM 750 51 N/A Both " 4,103.00 " N/A N/A N/A N/A - - 75000015 HC A ENTEROS DX TO ILIUM 750 51 N/A Both " 4,135.00 " N/A N/A N/A N/A - - 61000007 HC MRI ORBIT/FACE/NECK W/CONTRAST 610 70542 51 N/A Both " 4,154.00 " N/A N/A N/A N/A - - 61000097 HC MRA & MRV NECK W/WO CONTRAST 610 70549 51 N/A Both " 4,154.00 " N/A N/A N/A N/A - - 61000094 HC 3T MRA & MRV NECK W/WO CONTRAS 610 70549 51 N/A Both " 4,154.00 " N/A N/A N/A N/A - - 61000063 HC 3T MRI ORBIT/FACE/NECK W/CONTR 610 70542 51 N/A Both " 4,154.00 " N/A N/A N/A N/A - - 75000096 HC BRONCH - FOREIGN BODY REMOVAL 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000105 HC BRONCH LASER CRYO CAUTERY 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000108 HC BRONCHOSCOPY - BIOPSY 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000112 HC BRONCHOSCOPY REVISION STENT 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000114 HC BRONCHOSCOPY TRACH STENT PLACE 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000115 HC BRONCHOSCOPY W BRACHYTHERAPY 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000001 HC BRONCHOSCOPY WITH BAL 761 31624 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000116 HC BRONCHOSCOPY WITH BAL 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 75000117 HC BRONCHOSCOPY WITH BRUSHINGS 761 51 N/A Both " 4,159.00 " N/A N/A N/A N/A - - 61000113 HC MRV CHEST W/CONTRAST 610 71555 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 61000028 HC MRI JOINT UPPER EXT W/WO CONTRAST 610 73223 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 61000025 HC MRI UPPER EXT W/WO CONTRAST 610 73220 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 61000102 HC 3T MRA CHEST W/CONTRAST 610 71555 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 61000233 HC 3T MRI JOINT UPPER EXT W/WO CONTRAST 610 73223 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 61000230 HC 3T MRI UPPER EXT W/WO CONTRAST 610 73220 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 61000104 HC 3T MRV CHEST W/CONTRAST 610 71555 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 61000111 HC MRA CHEST W/CONTRAST 610 71555 51 N/A Both " 4,171.00 " N/A N/A N/A N/A - - 92000014 HC NASAL CPAP STUDY 920 95811 51 N/A Both " 4,175.00 " N/A N/A N/A N/A - - 92000024 HC POLYSOMNOGRAPHY SPLIT 920 95811 51 N/A Both " 4,175.00 " N/A N/A N/A N/A - - 61000072 HC MRA & MRV HEAD W/O CONTRAST 610 70544 51 N/A Both " 4,185.00 " N/A N/A N/A N/A - - 61000069 HC 3T MRA & MRV HEAD W/O CONTRAST 610 70544 51 N/A Both " 4,185.00 " N/A N/A N/A N/A - - 32000162 HC TRANSCATH THER EMBOLIZE 761 75894 51 N/A Both " 4,189.00 " N/A N/A N/A N/A - - 34100023 HC CARDIAC SGI STUDY SPECT 341 78451 51 N/A Both " 4,209.00 " N/A N/A N/A N/A - - 92000007 HC PSG YOUNGER THAN 6 YRS 920 95782 51 N/A Both " 4,210.00 " N/A N/A N/A N/A - - 61000185 HC MRA & MRV LOWER EXT W/O CONTRA 610 73725 51 N/A Both " 4,216.00 " N/A N/A N/A N/A - - 61000176 HC 3T MRA & MRV LOWER EXT W/O CON 610 73725 51 N/A Both " 4,216.00 " N/A N/A N/A N/A - - 32900141 HC VCAD T REPLACE W SUBQ COMP 761 36582 51 N/A Both " 4,220.00 " N/A N/A N/A N/A - - 75000143 HC B EGD THERMAL TX GERD 750 51 N/A Both " 4,242.00 " N/A N/A N/A N/A - - 61000016 HC MRI CHEST W/CONTRAST 610 71551 51 N/A Both " 4,262.00 " N/A N/A N/A N/A - - 61000226 HC 3T MRI CHEST W/CONTRAST 610 71551 51 N/A Both " 4,262.00 " N/A N/A N/A N/A - - 61000032 HC MRI LOWER EXT W/WO CONTRAST 610 73720 51 N/A Both " 4,272.00 " N/A N/A N/A N/A - - 61000035 HC MRI JT LOWER EXT W/WO CONTRAST 610 73723 51 N/A Both " 4,272.00 " N/A N/A N/A N/A - - 61000173 HC 3T MRI JT LOWER EXT W/WO CONTR 610 73723 51 N/A Both " 4,272.00 " N/A N/A N/A N/A - - 61000235 HC 3T MRI LOWER EXT W/WO CONTRAST 610 73720 51 N/A Both " 4,272.00 " N/A N/A N/A N/A - - 34100043 "HC TUMOR IMAGING PLANAR, WHOLE BODY, 2+ DAYS IMAGING" 341 78804 51 N/A Both " 4,274.00 " N/A N/A N/A N/A - - 61000077 HC MRA HEAD W/CONTRAST 610 70545 51 N/A Both " 4,276.00 " N/A N/A N/A N/A - - 61000078 HC MRV HEAD W/CONTRAST 610 70545 51 N/A Both " 4,276.00 " N/A N/A N/A N/A - - 61000074 HC 3T MRA HEAD W/CONTRAST 610 70545 51 N/A Both " 4,276.00 " N/A N/A N/A N/A - - 61000075 HC 3T MRV HEAD W/CONTRAST 610 70545 51 N/A Both " 4,276.00 " N/A N/A N/A N/A - - 51000017 HC REPAIR OF CIRCUMCISION 510 54163 51 N/A Both " 4,285.00 " N/A N/A N/A N/A - - 99000046 HC LAP PARAESOPHAG HERNIA REPAIR 990 43281 51 N/A Both " 4,294.00 " N/A N/A N/A N/A - - 75000022 HC A EUS COLON 750 51 N/A Both " 4,298.00 " N/A N/A N/A N/A - - 32900058 HC INSERT TUNNELED PLEURAL CATH 761 32550 51 N/A Both " 4,327.00 " N/A N/A N/A N/A - - 35200031 HC CT ABD PEL W/O CONT 352 74176 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000008 HC MRI ORBIT/FACE/NECK W/WO CONTR 610 70543 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000205 HC MRA ABDOMEN W/O CONTRAST 610 74185 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000207 HC MRV ABDOMEN W/O CONTRAST 610 74185 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000029 HC MRA UPPER EXT W & W/O CONTRAST 610 73225 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000158 HC MRV UPPER EXT W/WO CONTRAST 610 73225 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000197 HC 3T MRA ABDOMEN W/O CONTRAST 610 74185 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000145 HC 3T MRA UPPER EXT W/& W/O CONTR 610 73225 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000066 HC 3T MRI ORBIT/FACE/NECK W/WO CO 610 70543 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000199 HC 3T MRV ABDOMEN W/O CONTRAST 610 74185 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000150 HC 3T MRV UPPER EXT W/WO CONTRAST 610 73225 51 N/A Both " 4,339.00 " N/A N/A N/A N/A - - 61000135 HC MRA & MRV PELVIS W/O CONTRAST 610 72198 51 N/A Both " 4,350.00 " N/A N/A N/A N/A - - 61000126 HC 3T MRA & MRV PELVIS W/O CONTRA 610 72198 51 N/A Both " 4,350.00 " N/A N/A N/A N/A - - 61000137 HC MRA PELVIS W W/O CONTRAST 610 72198 51 N/A Both " 4,355.00 " N/A N/A N/A N/A - - 61000022 HC MRV PELVIS W/WO CONTRAST 610 72198 51 N/A Both " 4,355.00 " N/A N/A N/A N/A - - 61000128 HC 3T MRA PELVIS W W/O CONTRAST 610 72198 51 N/A Both " 4,355.00 " N/A N/A N/A N/A - - 61000133 HC 3T MRV PELVIS W/WO CONTRAST 610 72198 51 N/A Both " 4,355.00 " N/A N/A N/A N/A - - 32900294 HC PERC TX GASSERIAN GANGLION 761 61790 51 N/A Both " 4,355.00 " N/A N/A N/A N/A - - 48100066 HC OPTIMIZER EXCHANGE 481 93799 51 N/A Both " 4,404.00 " N/A N/A N/A N/A - - 32900038 HC VERTEBROPLSTY ADDTL LEVEL 761 22512 51 N/A Both " 4,422.00 " N/A N/A N/A N/A - - 32300008 HC AORTOGRAM ABD/LOWER EXT 761 75630 51 N/A Both " 4,430.00 " N/A N/A N/A N/A - - 75000171 HC B COLON W ABLATION 750 51 N/A Both " 4,437.00 " N/A N/A N/A N/A - - 17400001 HC R&B NEWBORN LEVEL IV 174 51 N/A Both " 4,440.00 " N/A N/A N/A N/A - - 61000187 HC MRA LOWER EXT W & W/O CONTRAST 610 73725 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 61000189 HC MRV EXT LOW W/WO CONTRAST 610 73725 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 61000178 HC 3T MRA LOWER EXT W/& W/O CONTR 610 73725 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 61000181 HC 3T MRV EXT LOW W/WO CONTRAST 610 73725 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 45000099 HC CLOSED RX DENTAL RIDGE FX 450 21440 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 45000097 HC CLOSED RX LEFORTE I+WIRES 450 21421 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 45000094 HC CLOSED RX NASAL SEPTAL FRACTURE 450 21337 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 45000093 HC CLOSED RX NOSE FX W STABILIZATN 450 21320 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 45000299 HC I&D MOUTH/TONG INTRA SUBMANDIBULAR 450 41008 51 N/A Both " 4,462.00 " N/A N/A N/A N/A - - 32900409 HC CARPAL TUNNEL RELEASE 761 64721 51 N/A Both " 4,469.00 " N/A N/A N/A N/A - - 32900142 HC VCAD T REPLACE W PUMP COMP 761 36583 51 N/A Both " 4,511.00 " N/A N/A N/A N/A - - 61000115 HC MRV CHEST W/WO CONTRAST 610 71555 51 N/A Both " 4,533.00 " N/A N/A N/A N/A - - 61000101 HC 3T MRA CHEST W/ & W/O CONTRAST 610 71555 51 N/A Both " 4,533.00 " N/A N/A N/A N/A - - 61000106 HC 3T MRV CHEST W/WO CONTRAST 610 71555 51 N/A Both " 4,533.00 " N/A N/A N/A N/A - - 61000110 HC MRA CHEST W & W/O CONTRAST 610 71555 51 N/A Both " 4,533.00 " N/A N/A N/A N/A - - 92000008 HC NCPAP STUDY YOUNGER THAN 6 YRS 920 95783 51 N/A Both " 4,545.00 " N/A N/A N/A N/A - - 36000026 HC OR LEVEL 3 BASE 360 51 N/A Both " 4,560.00 " N/A N/A N/A N/A - - 32900398 HC 3T STEREOTACTIC BRAIN BIOPSY 329 61751 51 N/A Both " 4,565.00 " N/A N/A N/A N/A - - 32900293 HC STEREOTACTIC BRAIN BIOPSY 329 61751 51 N/A Both " 4,565.00 " N/A N/A N/A N/A - - 61000108 HC MRA & MRV CHEST W/O CONTRAST 610 71555 51 N/A Both " 4,572.00 " N/A N/A N/A N/A - - 61000099 HC 3T MRA & MRV CHEST W/O CONTRAS 610 71555 51 N/A Both " 4,572.00 " N/A N/A N/A N/A - - 32900128 HC VCAD/T INSERT WO SUBQ < 5 YR 761 36557 51 N/A Both " 4,575.00 " N/A N/A N/A N/A - - 61000206 HC MRV ABDOMEN W/CONTRAST 610 74185 51 N/A Both " 4,588.00 " N/A N/A N/A N/A - - 61000151 HC MRA & MRV UPPER EXT W/CONTRAST 610 73225 51 N/A Both " 4,588.00 " N/A N/A N/A N/A - - 61000142 HC 3T MRA & MRV UPPER EXT W/CONTR 610 73225 51 N/A Both " 4,588.00 " N/A N/A N/A N/A - - 61000196 HC 3T MRA ABDOMEN W/CONTRAST 610 74185 51 N/A Both " 4,588.00 " N/A N/A N/A N/A - - 61000198 HC 3T MRV ABDOMEN W/CONTRAST 610 74185 51 N/A Both " 4,588.00 " N/A N/A N/A N/A - - 61000204 HC MRA ABDOMEN W/CONTRAST 610 74185 51 N/A Both " 4,588.00 " N/A N/A N/A N/A - - 32300006 HC AORTOGRAM THOR W/SERIAL 761 75605 51 N/A Both " 4,602.00 " N/A N/A N/A N/A - - 45000322 HC MARSUP BARTHOLIN GLAND CYST 450 56440 51 N/A Both " 4,612.00 " N/A N/A N/A N/A - - 45000323 HC REMOVAL VAGINAL FOR.BODY W ANESTH 450 57415 51 N/A Both " 4,612.00 " N/A N/A N/A N/A - - 48000026 HC THROMBOLYSIS INTRACORONARY 481 92975 51 N/A Both " 4,613.00 " N/A N/A N/A N/A - - 61000017 HC MRI CHEST W/WO CONTRAST 610 71552 51 N/A Both " 4,624.00 " N/A N/A N/A N/A - - 61000227 HC 3T MRI CHEST W/WO CONTRAST 610 71552 51 N/A Both " 4,624.00 " N/A N/A N/A N/A - - 75000121 HC GI TRACT CAPSULE ENDOSCOPY 750 51 N/A Both " 4,635.00 " N/A N/A N/A N/A - - 32900239 HC DRAIN ABSC NONPERITONEAL RETRO 761 49405 51 N/A Both " 4,657.00 " N/A N/A N/A N/A - - 48000058 HC ABLATE ADDT'L AFTER PVI 481 93657 51 N/A Both " 4,665.00 " N/A N/A N/A N/A - - 61000002 HC BX BREAST MR ADDTL 610 19086 51 N/A Both " 4,669.00 " N/A N/A N/A N/A - - 61000001 HC BX BREAST MR GUIDE 610 19085 51 N/A Both " 4,669.00 " N/A N/A N/A N/A - - 61100033 HC MRI BRAIN W/PITUITRY W/WO CONT 611 70553 51 N/A Both " 4,681.00 " N/A N/A N/A N/A - - 61200009 HC MRI SPINAL CNL LUMB W/WO 612 72158 51 N/A Both " 4,681.00 " N/A N/A N/A N/A - - 61100028 HC 3T MRI BRAIN W/PITUITRY W/WO C 611 70553 51 N/A Both " 4,681.00 " N/A N/A N/A N/A - - 61200031 HC 3T MRI SPINAL CNL LUMB W/WO 612 72158 51 N/A Both " 4,681.00 " N/A N/A N/A N/A - - 32900196 HC MICRO PHLEBECTOMY > 20 761 37766 51 N/A Both " 4,691.00 " N/A N/A N/A N/A - - 45000312 HC PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY 450 45307 51 N/A Both " 4,698.00 " N/A N/A N/A N/A - - 76100117 HC DRAIN LOWER LEG DEEP ABSC/HEMATOMA 761 27603 51 N/A Both " 4,703.00 " N/A N/A N/A N/A - - 51000018 HC FRENULOTOMY OF PENIS 510 54164 51 N/A Both " 4,703.00 " N/A N/A N/A N/A - - 76100107 HC I&D DEEP ABSC/HEMATOMA NECK/CHEST 761 21501 51 N/A Both " 4,703.00 " N/A N/A N/A N/A - - 76100108 HC INCIS/DRAIN SHLDR ABSC/HEMA DEEP 761 23030 51 N/A Both " 4,703.00 " N/A N/A N/A N/A - - 76100116 HC INCIS/DRAIN THIGH/KNEE ABSCESS DEEP 761 27301 51 N/A Both " 4,703.00 " N/A N/A N/A N/A - - 32900315 HC REMOVAL NEUROSTIM PERC ARRAY 761 63661 51 N/A Both " 4,708.00 " N/A N/A N/A N/A - - 32900316 HC REMOVE NEUROSTIM PLATE PADDLES 761 63662 51 N/A Both " 4,708.00 " N/A N/A N/A N/A - - 61000184 HC MRA & MRV LOWER EXT W/CONTRAST 610 73725 51 N/A Both " 4,710.00 " N/A N/A N/A N/A - - 61000175 HC 3T MRA & MRV LOWER EXT W/CONTR 610 73725 51 N/A Both " 4,710.00 " N/A N/A N/A N/A - - 32300016 HC PELVIC SELECTIVE S&I 761 75736 51 N/A Both " 4,712.00 " N/A N/A N/A N/A - - 32000161 HC VENOUS SMPLNG W/WO ANGIO 761 75893 51 N/A Both " 4,712.00 " N/A N/A N/A N/A - - 45000127 HC REMOVAL ARM/ELBOW F.B. DEEP 450 24201 51 N/A Both " 4,717.00 " N/A N/A N/A N/A - - 45000088 HC REMOVAL OF FOREIGN BODY DEEP/COMPLIC 450 20525 51 N/A Both " 4,717.00 " N/A N/A N/A N/A - - 48000060 HC INTRACARDIAC ULTRASOUND 480 93662 51 N/A Both " 4,719.00 " N/A N/A N/A N/A - - 34000003 HC TUMOR IMAGING SPECT CT 2+ AREAS SINGLE DAY OR SINGLE AREA 2+ DAYS 340 78832 51 N/A Both " 4,720.00 " N/A N/A N/A N/A - - 48000006 HC RELOCATE POCKET FOR ICD 481 33223 51 N/A Both " 4,748.00 " N/A N/A N/A N/A - - 48000005 HC RELOCATE POCKET FOR PACER 481 33222 51 N/A Both " 4,748.00 " N/A N/A N/A N/A - - 61200008 HC MRI SPINAL CNL THOR W/WO 612 72157 51 N/A Both " 4,771.00 " N/A N/A N/A N/A - - 61000039 HC MRI ABD W/WO CONTRAST 610 74183 51 N/A Both " 4,771.00 " N/A N/A N/A N/A - - 61000238 HC 3T MRI ABD W/WO CONTRAST 610 74183 51 N/A Both " 4,771.00 " N/A N/A N/A N/A - - 61200030 HC 3T MRI SPINAL CNL THOR W/WO 612 72157 51 N/A Both " 4,771.00 " N/A N/A N/A N/A - - 61000134 HC MRA & MRV PELVIS W/CONTRAST 610 72198 51 N/A Both " 4,787.00 " N/A N/A N/A N/A - - 61000125 HC 3T MRA & MRV PELVIS W/CONTRAST 610 72198 51 N/A Both " 4,787.00 " N/A N/A N/A N/A - - 32900287 HC BIOPSY ADRENAL GLAND 761 60699 51 N/A Both " 4,787.00 " N/A N/A N/A N/A - - 61000076 HC MRA & MRV HEAD W/CONTRAST 610 70545 51 N/A Both " 4,804.00 " N/A N/A N/A N/A - - 61100032 HC MRI BRAIN W IACS W WO CONT 611 70553 51 N/A Both " 4,804.00 " N/A N/A N/A N/A - - 61000010 HC 3T MRA & MRV HEAD W/CONTRAST 610 70545 51 N/A Both " 4,804.00 " N/A N/A N/A N/A - - 61100003 HC 3T MRI BRAIN W IACS W WO CONT 611 70553 51 N/A Both " 4,804.00 " N/A N/A N/A N/A - - 99000047 HC LAP PARAESOPHAG HERNIA REPAIR W MESH 990 43282 51 N/A Both " 4,826.00 " N/A N/A N/A N/A - - 61200007 HC MRI SPINAL CNL CERV W/WO 612 72156 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 61000082 HC MRA HEAD W/WO CONTRAST 610 70546 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 61000083 HC MRV HEAD W/WO CONTRAST 610 70546 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 61000202 HC MRA & MRV ABDOMEN W/O CONTRAST 610 74185 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 61000193 HC 3T MRA & MRV ABDOMEN W/O CONTR 610 74185 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 61000079 HC 3T MRA HEAD W/WO CONTRAST 610 70546 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 61200029 HC 3T MRI SPINAL CNL CERV W/WO 612 72156 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 61000080 HC 3T MRV HEAD W/WO CONTRAST 610 70546 51 N/A Both " 4,835.00 " N/A N/A N/A N/A - - 32900269 HC EXCHANGE NEPHROSTOMY TUBE 761 50435 51 N/A Both " 4,838.00 " N/A N/A N/A N/A - - 32900229 HC BILIARY ENDOSCOPY W BX 761 47553 51 N/A Both " 4,868.00 " N/A N/A N/A N/A - - 32900257 HC REMOVE REPLACE URETERAL STENT 761 50385 51 N/A Both " 4,876.00 " N/A N/A N/A N/A - - 32900255 HC RMV & RPL INT URET STNT PERC 761 50382 51 N/A Both " 4,876.00 " N/A N/A N/A N/A - - 32000152 HC VENOGRAPHY ADRENAL BILAT 761 75842 51 N/A Both " 4,876.00 " N/A N/A N/A N/A - - 75000128 HC B ESOPH DILATION RETROGRADE 750 51 N/A Both " 4,882.00 " N/A N/A N/A N/A - - 61000053 HC MRA CARDIAC W/WO CONT 618 76498 51 N/A Both " 4,886.00 " N/A N/A N/A N/A - - 61000043 HC MRI CARDIAC W/WO CONT 610 75561 51 N/A Both " 4,886.00 " N/A N/A N/A N/A - - 45000347 HC PERICARDIOCENTESIS W CT IMAGING 450 33016 51 N/A Both " 4,890.00 " N/A N/A N/A N/A - - 48000056 HC ABLAT SPONT ARRHYTHMIA 481 93655 51 N/A Both " 4,892.00 " N/A N/A N/A N/A - - 32900122 HC ELVS VARICOSE VEIN W GUIDANCE 761 36478 51 N/A Both " 4,920.00 " N/A N/A N/A N/A - - 76100235 HC CURETTAGE POSTPARTUM 761 59160 51 N/A Both " 4,922.00 " N/A N/A N/A N/A - - 75000101 HC BRONCH W EBUS 3 OR MORE NODES 761 51 N/A Both " 4,936.00 " N/A N/A N/A N/A - - 75000102 HC BRONCH W EBUS PERIPH LESIONS 761 51 N/A Both " 4,936.00 " N/A N/A N/A N/A - - 61000153 HC MRA & MRV UPPER EXT W/WO CONTR 610 73225 51 N/A Both " 4,961.00 " N/A N/A N/A N/A - - 61000144 HC 3T MRA & MRV UPPER EXT W/WO CO 610 73225 51 N/A Both " 4,961.00 " N/A N/A N/A N/A - - 35200058 HC CT RENAL CALC W/CONT 352 74177 51 N/A Both " 4,993.00 " N/A N/A N/A N/A - - 32300010 HC ANGIOGRAPHY SPINAL SELECT 761 75705 51 N/A Both " 4,999.00 " N/A N/A N/A N/A - - 75000136 HC B ESOPH ABLATE LES 750 51 N/A Both " 5,001.00 " N/A N/A N/A N/A - - 61000107 HC MRA & MRV CHEST W/CONTRAST 610 71555 51 N/A Both " 5,005.00 " N/A N/A N/A N/A - - 61000018 HC 3T MRA & MRV CHEST W/CONTRAST 610 71555 51 N/A Both " 5,005.00 " N/A N/A N/A N/A - - 76100105 "HC COMPLEX DRAINAGE, WOUND" 761 10180 51 N/A Both " 5,016.00 " N/A N/A N/A N/A - - 99000028 HC LAP GASTRIC BYPASS & ROUX-EN Y GASTROENTEROSTOMY 990 43644 51 N/A Both " 5,056.00 " N/A N/A N/A N/A - - 61000186 HC MRA & MRV LOWER EXT W/WO CONTR 610 73725 51 N/A Both " 5,085.00 " N/A N/A N/A N/A - - 61000201 HC MRA & MRV ABDOMEN W/CONTRAST 610 74185 51 N/A Both " 5,085.00 " N/A N/A N/A N/A - - 61200025 HC MRA SPNL CNL CONTENT W WO 612 72159 51 N/A Both " 5,085.00 " N/A N/A N/A N/A - - 61000192 HC 3T MRA & MRV ABDOMEN W/CONTRAS 610 74185 51 N/A Both " 5,085.00 " N/A N/A N/A N/A - - 61000177 HC 3T MRA & MRV LOWER EXT W/WO CO 610 73725 51 N/A Both " 5,085.00 " N/A N/A N/A N/A - - 61000165 HC MRI BILAT HIPS W/O CONTRAST 610 73721 51 N/A Both " 5,087.00 " N/A N/A N/A N/A - - 61000163 HC 3T MRI BILAT HIPS W/O CONTRAST 610 73721 51 N/A Both " 5,087.00 " N/A N/A N/A N/A - - 32300001 HC ANGIO RENAL UNI 1ST ORDER 761 36251 51 N/A Both " 5,087.00 " N/A N/A N/A N/A - - 32900044 HC TENOTOMY ELBOW 761 24357 51 N/A Both " 5,091.00 " N/A N/A N/A N/A - - 32900051 HC TENOTOMY PERC KNEE MULT 761 27307 51 N/A Both " 5,091.00 " N/A N/A N/A N/A - - 75000024 HC A-EUS STOMACH SM BOWEL 750 51 N/A Both " 5,096.00 " N/A N/A N/A N/A - - 75000109 HC BRONCHOSCOPY - TRANSLUNG 761 51 N/A Both " 5,112.00 " N/A N/A N/A N/A - - 75000110 HC BRONCHOSCOPY CATH PLACEMENT 761 51 N/A Both " 5,112.00 " N/A N/A N/A N/A - - 34100024 HC MYOCARD PERF SPECT MULT 341 78452 51 N/A Both " 5,115.00 " N/A N/A N/A N/A - - 36000028 HC OR LEVEL 4 BASE 360 51 N/A Both " 5,135.00 " N/A N/A N/A N/A - - 61000044 HC MRI CARDIAC W/WO CONT W/STR 610 75563 51 N/A Both " 5,148.00 " N/A N/A N/A N/A - - 48000050 HC PROG STIM POST IV 481 93623 51 N/A Both " 5,151.00 " N/A N/A N/A N/A - - 32900120 HC VNUS INITIAL VEIN 761 36475 51 N/A Both " 5,165.00 " N/A N/A N/A N/A - - 32300013 HC ANGIO VISCERAL 761 75726 51 N/A Both " 5,205.00 " N/A N/A N/A N/A - - 61000136 HC MRA & MRV PELVIS W/WO CONTRAST 610 72198 51 N/A Both " 5,225.00 " N/A N/A N/A N/A - - 61000127 HC 3T MRA & MRV PELVIS W/WO CONTR 610 72198 51 N/A Both " 5,225.00 " N/A N/A N/A N/A - - 48100068 HC REMOVE LEADLESS PACER VENT 481 33275 51 N/A Both " 5,234.00 " N/A N/A N/A N/A - - 48900001 HC HEARTFLOW 481 0503T 51 N/A Both " 5,250.00 " N/A N/A N/A N/A - - 61000208 HC MRV ABDOMEN W/WO CONTRAST 610 74185 51 N/A Both " 5,269.00 " N/A N/A N/A N/A - - 61000195 HC 3T MRA ABDOMEN W & W/O CONTRAS 610 74185 51 N/A Both " 5,269.00 " N/A N/A N/A N/A - - 61000200 HC 3T MRV ABDOMEN W/WO CONTRAST 610 74185 51 N/A Both " 5,269.00 " N/A N/A N/A N/A - - 61000040 HC MRA ABDOMEN W & W/O CONTRAST 610 74185 51 N/A Both " 5,269.00 " N/A N/A N/A N/A - - 32900240 HC DRAIN ABSC PERITONEAL RETRO 761 49406 51 N/A Both " 5,276.00 " N/A N/A N/A N/A - - 76100111 HC INCIS/DRAIN FOREARM DEEP ABSCESS 761 25028 51 N/A Both " 5,330.00 " N/A N/A N/A N/A - - 76100115 HC INCIS/DRAIN PELVIS/HIP DEEP ABSCESS 761 26990 51 N/A Both " 5,330.00 " N/A N/A N/A N/A - - 61000081 HC MRA & MRV HEAD W/WO CONTRAST 610 70546 51 N/A Both " 5,362.00 " N/A N/A N/A N/A - - 61000011 HC 3T MRA & MRVHEAD W/WO CONTRAS 610 70546 51 N/A Both " 5,362.00 " N/A N/A N/A N/A - - 45000234 HC CLOSED RX PROX TIB/FIB DISLOC+ANESTH 450 27831 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 45000256 HC CLOSED RX TALOTARSAL DISLOC ANESTH 450 28575 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 45000254 HC CLOSED RX TARSAL DISLOC ANESTH 450 28545 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 45000211 HC CLOSED RX TIB PLAT FX+MANIP 450 27532 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 45000090 HC INSERT AND REMOVE BONE PIN 450 20650 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 45000147 HC REFOREARM TEND/MUSC EXTEN PRIM EA 450 25270 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 45000146 HC REFOREARM TEND/MUSC FLEX PRIM EA 450 25260 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 45000184 HC REMOVE PELV/HIP F.B. DEEP 450 27087 51 N/A Both " 5,367.00 " N/A N/A N/A N/A - - 32900231 HC DIL BIL DUCT STRCT W STNT 761 47556 51 N/A Both " 5,369.00 " N/A N/A N/A N/A - - 32900262 HC DILATE EXIST TRACT ENDOURO PROC 761 50436 51 N/A Both " 5,401.00 " N/A N/A N/A N/A - - 48100013 HC CS LEAD REPOSITION 481 33226 51 N/A Both " 5,406.00 " N/A N/A N/A N/A - - 48100009 HC REPAIR LEAD PACER ICD 481 33218 51 N/A Both " 5,406.00 " N/A N/A N/A N/A - - 48000020 HC IMPL INOVATE STIM VGS NERVE 481 64568 51 N/A Both " 5,416.00 " N/A N/A N/A N/A - - 61000109 HC MRA & MRV CHEST W/WO CONTRAST 610 71555 51 N/A Both " 5,438.00 " N/A N/A N/A N/A - - 61000100 HC 3T MRA & MRV CHEST W/WO CONTRA 610 71555 51 N/A Both " 5,438.00 " N/A N/A N/A N/A - - 99000029 HC LAP GASTRIC BYPASS & SMALL INTESTINE RECONSTRUCTION 990 43645 51 N/A Both " 5,446.00 " N/A N/A N/A N/A - - 32900036 HC VERTEBROPLSTY CERV THORACIC 761 22510 51 N/A Both " 5,471.00 " N/A N/A N/A N/A - - 32900037 HC VERTEBROPLSTY LUMBOSACRAL 761 22511 51 N/A Both " 5,471.00 " N/A N/A N/A N/A - - 48000027 HC IVUS CORONARY INITL VESSEL 481 92978 51 N/A Both " 5,534.00 " N/A N/A N/A N/A - - 48000037 HC PRESSURE/VELOCITY STUDY INT'L 481 93571 51 N/A Both " 5,534.00 " N/A N/A N/A N/A - - 48100032 HC PTCA CORONARY BRANCH 481 92921 51 N/A Both " 5,582.00 " N/A N/A N/A N/A - - 33300038 HC HDR BRACHYTX OVER 12 CHAN 333 77772 51 N/A Both " 5,649.00 " N/A N/A N/A N/A - - 48100007 HC ELECTRODE REPOSITION 481 33215 51 N/A Both " 5,675.00 " N/A N/A N/A N/A - - 48100021 HC ICD REMOVAL 481 33241 51 N/A Both " 5,675.00 " N/A N/A N/A N/A - - 48000009 HC REMOVE ELECTRODE TRANSVENOUS 481 33244 51 N/A Both " 5,675.00 " N/A N/A N/A N/A - - 48000008 HC REMOVE LEAD DUAL CHAMBER PACER 481 33235 51 N/A Both " 5,675.00 " N/A N/A N/A N/A - - 48000007 HC REMOVE LEAD SGL CHAMBER PACER 481 33234 51 N/A Both " 5,675.00 " N/A N/A N/A N/A - - 32900227 HC EXTRACT STONE BILE DUCT T-TUBE 761 47544 51 N/A Both " 5,698.00 " N/A N/A N/A N/A - - 35200032 HC CT ABD PEL WITH CONTRAST 352 74177 51 N/A Both " 5,719.00 " N/A N/A N/A N/A - - 61000203 HC MRA & MRV ABDOMEN W/WO CONTRAS 610 74185 51 N/A Both " 5,765.00 " N/A N/A N/A N/A - - 61000194 HC 3T MRA & MRV ABDOMEN W/WO CONT 610 74185 51 N/A Both " 5,765.00 " N/A N/A N/A N/A - - 48000038 HC HIS RECORDING 481 93600 51 N/A Both " 5,841.00 " N/A N/A N/A N/A - - 48000045 HC INDUCT ARRHYTHMIA ELECT PACING 481 93618 51 N/A Both " 5,841.00 " N/A N/A N/A N/A - - 48000042 HC INTRA-ATRIAL PACING 481 93610 51 N/A Both " 5,841.00 " N/A N/A N/A N/A - - 48000039 HC INTRA-ATRIAL RECORDING 481 93602 51 N/A Both " 5,841.00 " N/A N/A N/A N/A - - 48000043 HC INTRAVENTRICULAR PACING 481 93612 51 N/A Both " 5,841.00 " N/A N/A N/A N/A - - 48000041 HC MAPPING NON 3D 481 93609 51 N/A Both " 5,841.00 " N/A N/A N/A N/A - - 48000040 HC RT VENTRICULAR RECORDING 481 93603 51 N/A Both " 5,841.00 " N/A N/A N/A N/A - - 75000146 HC B EUS W DRN PSEUDOCYST 750 51 N/A Both " 5,844.00 " N/A N/A N/A N/A - - 61000170 HC MRI BILATERAL HIPS W/CONTRAST 610 73722 51 N/A Both " 5,850.00 " N/A N/A N/A N/A - - 61000167 HC 3T MRI BILATERAL HIPS W/CONTRA 610 73722 51 N/A Both " 5,850.00 " N/A N/A N/A N/A - - 35200059 HC CT RENAL CALC W AND W/O CONT 352 74178 51 N/A Both " 5,971.00 " N/A N/A N/A N/A - - 35200067 HC CT RENAL CALC W AND W/O CONT 352 74178 51 N/A Both " 5,971.00 " N/A N/A N/A N/A - - 48100059 HC MED ADMIN & HEMODYNAMIC MSMTS 481 93464 51 N/A Both " 6,034.00 " N/A N/A N/A N/A - - 48100029 HC INSERT IAB PERC 481 33967 51 N/A Both " 6,070.00 " N/A N/A N/A N/A - - 48000044 HC MAPPING 3D 481 93613 51 N/A Both " 6,132.00 " N/A N/A N/A N/A - - 36000030 HC OR LEVEL 5 BASE 360 51 N/A Both " 6,150.00 " N/A N/A N/A N/A - - 48000051 HC ICD TESTING 481 93641 51 N/A Both " 6,224.00 " N/A N/A N/A N/A - - 48000018 HC INSERT LA SENSE LEAD LAPTOP 481 33999 51 N/A Both " 6,227.00 " N/A N/A N/A N/A - - 32900158 HC MECH THROM SECONDARY 761 37186 51 N/A Both " 6,248.00 " N/A N/A N/A N/A - - 61000162 HC MRI LOW EXT BILAT W/O CONTRAST 610 73718 51 N/A Both " 6,364.00 " N/A N/A N/A N/A - - 61000159 HC 3T MRI LOW EXT BILAT W/O CONTR 610 73718 51 N/A Both " 6,364.00 " N/A N/A N/A N/A - - 75000016 HC A ERCP W WO WASH CYTOLOGY 750 51 N/A Both " 6,365.00 " N/A N/A N/A N/A - - 61000174 HC MRI BILAT HIPS W W/O CONTRAST 610 73723 51 N/A Both " 6,413.00 " N/A N/A N/A N/A - - 61000172 HC 3T MRI BILAT HIPS W/WO CONTRA 610 73723 51 N/A Both " 6,413.00 " N/A N/A N/A N/A - - 32900104 HC ANGIO ARCH CATH IN ARCH 761 36221 51 N/A Both " 6,442.00 " N/A N/A N/A N/A - - 32900217 HC CHOLANGIOGRAM TRANSHEPATIC 761 47532 51 N/A Both " 6,458.00 " N/A N/A N/A N/A - - 32900221 HC EXCH DRN BIL INT EXT TO EXT 761 47536 51 N/A Both " 6,458.00 " N/A N/A N/A N/A - - 48100101 HC PERICARDIAL DRAINAGE W INDWELLING CATHETER PERCUTANEOUS W FLUORO GUIDANCE 481 33017 51 N/A Both " 6,458.00 " N/A N/A N/A N/A - - 48100102 HC PERICARDIAL DRAINAGE W INDWELLING CATHETER PERCUTANEOUS W US GUIDANCE 481 33017 51 N/A Both " 6,458.00 " N/A N/A N/A N/A - - 35200036 HC CT ANGIO AO & BIL ILIOFEM W/WO 352 75635 51 N/A Both " 6,524.00 " N/A N/A N/A N/A - - 32900163 HC TPA ARTERY 1ST DAY 761 37211 51 N/A Both " 6,553.00 " N/A N/A N/A N/A - - 32900164 HC TPA VEIN 1ST DAY 761 37212 51 N/A Both " 6,553.00 " N/A N/A N/A N/A - - 32900157 HC MECH THROM SUBSQ ARTERY 761 37185 51 N/A Both " 6,561.00 " N/A N/A N/A N/A - - 32900268 HC NEPH TO NEPHROUR STENT 761 50434 51 N/A Both " 6,678.00 " N/A N/A N/A N/A - - 32900274 HC URE STNT THRU EXT NPH TRACT 761 50693 51 N/A Both " 6,678.00 " N/A N/A N/A N/A - - 36000032 HC OR LEVEL 6 BASE 360 51 N/A Both " 6,720.00 " N/A N/A N/A N/A - - 76100072 HC US GUIDED SPACE OAR GEL 761 55874 51 N/A Both " 6,729.00 " N/A N/A N/A N/A - - 32900162 HC TRANSCATHETER BIOPSY 761 37200 51 N/A Both " 6,763.00 " N/A N/A N/A N/A - - 45000098 HC CLOSED RX LEFORTE III+WIRES 450 21431 51 N/A Both " 6,793.00 " N/A N/A N/A N/A - - 75000127 HC B ESOPH W STENT PLACEMENT 750 51 N/A Both " 6,799.00 " N/A N/A N/A N/A - - 48000017 HC INSERT IMPELLA DEVICE 481 33990 51 N/A Both " 6,821.00 " N/A N/A N/A N/A - - 75000141 HC B EGD W STENT PLACEMENT 750 51 N/A Both " 6,843.00 " N/A N/A N/A N/A - - 75000172 HC B COLON W STENT PLACEMENT 750 51 N/A Both " 6,845.00 " N/A N/A N/A N/A - - 35200060 HC CTA THORA/ABD AORTA W FEM RNFF 352 75635 51 N/A Both " 6,898.00 " N/A N/A N/A N/A - - 35200033 HC CT ABD PEL W AND WO CONTRAST 352 74178 51 N/A Both " 6,931.00 " N/A N/A N/A N/A - - 35200068 HC CT ABD PEL W AND WO CONTRAST 352 74178 51 N/A Both " 6,931.00 " N/A N/A N/A N/A - - 32900171 HC PTA ADDTL VESSEL T1 761 37222 51 N/A Both " 6,933.00 " N/A N/A N/A N/A - - 75000151 HC B FLEX SIG W STENT PLACE 750 51 N/A Both " 7,012.00 " N/A N/A N/A N/A - - 35200029 HC CTA ABD & PELVIS 352 74174 51 N/A Both " 7,031.00 " N/A N/A N/A N/A - - 48000049 HC LV RECORDING AND PACING 481 93622 51 N/A Both " 7,057.00 " N/A N/A N/A N/A - - 40400004 HC PET SCAN LIMITED 404 78814 51 N/A Both " 7,073.00 " N/A N/A N/A N/A - - 40400005 HC PET SCAN SKULL BASE MID-THIGH 404 78815 51 N/A Both " 7,073.00 " N/A N/A N/A N/A - - 40400006 HC PET SCAN WHOLE BODY 404 78816 51 N/A Both " 7,073.00 " N/A N/A N/A N/A - - 40400007 HC PET TUMOR IMAGING OTHER 404 G0235 51 N/A Both " 7,073.00 " N/A N/A N/A N/A - - 76100074 HC ABLATE VV W CHEM ADHES ADDL 761 36483 51 N/A Both " 7,145.00 " N/A N/A N/A N/A - - 76100073 HC ABLATE VV W CHEM ADHES INTL 761 36482 51 N/A Both " 7,145.00 " N/A N/A N/A N/A - - 32300003 HC ANGIO RENAL UNI 2-3 ORDER 761 36253 51 N/A Both " 7,159.00 " N/A N/A N/A N/A - - 76100057 HC AQUAPHERESIS 761 37799 51 N/A Both " 7,182.00 " N/A N/A N/A N/A - - 32900242 HC INSERT TUNNELED ABD CATHETER 761 49418 51 N/A Both " 7,207.00 " N/A N/A N/A N/A - - 32900391 HC EMBOLIZE FISTULA BRANCH 761 36909 51 N/A Both " 7,267.00 " N/A N/A N/A N/A - - 76100241 HC INSERT STABILIZ DEVICE WO DECOMP ADDITIONAL 761 22870 51 N/A Both " 7,315.00 " N/A N/A N/A N/A - - 45000012 HC TRAUMA ACTIVATION LEVEL II 682 G0390 51 N/A Both " 7,395.00 " N/A N/A N/A N/A - - 48000048 HC LA RECORD PACING FROM CS OR LA 481 93621 51 N/A Both " 7,410.00 " N/A N/A N/A N/A - - 76100203 HC DILATE EXIST TRACT ENDOURO PROC W NEW ACCESS 761 50437 51 N/A Both " 7,414.00 " N/A N/A N/A N/A - - 48100048 HC LHC ONLY 481 93452 51 N/A Both " 7,547.00 " N/A N/A N/A N/A - - 34000001 HC 3-D ISODOSE PLANNING 340 77295 51 N/A Both " 7,576.00 " N/A N/A N/A N/A - - 48100065 HC OPTIMIZER STUDY 481 93799 51 N/A Both " 7,598.00 " N/A N/A N/A N/A - - 32900181 HC PTA ADDTL VESSEL T3 761 37232 51 N/A Both " 7,645.00 " N/A N/A N/A N/A - - 32900132 HC VCAD T INSERT W PUMP 761 36563 51 N/A Both " 7,711.00 " N/A N/A N/A N/A - - 32900130 HC VCAD T INSERT W SUBQ < 5 YR 761 36560 51 N/A Both " 7,711.00 " N/A N/A N/A N/A - - 32900220 HC EXCH DRN BIL EXT TO INT EXT 761 47535 51 N/A Both " 7,752.00 " N/A N/A N/A N/A - - 32900218 HC PLACE DRAIN BILIARY EXT 761 47533 51 N/A Both " 7,752.00 " N/A N/A N/A N/A - - 32900219 HC PLACE DRAIN BILIARY INT EXT 761 47534 51 N/A Both " 7,752.00 " N/A N/A N/A N/A - - 40400009 HC PET/CT MYOCARD PERF REST AND STRESS 404 78431 51 N/A Both " 7,790.00 " N/A N/A N/A N/A - - 40400010 HC PET/CT MYOCARD PERF REST OR STRESS 404 78430 51 N/A Both " 7,790.00 " N/A N/A N/A N/A - - 32900110 HC ANGIO EXTNL CATH IN EXTNL 761 36227 51 N/A Both " 8,012.00 " N/A N/A N/A N/A - - 48000046 HC EP EVAL W/O INDUCTION 481 93619 51 N/A Both " 8,030.00 " N/A N/A N/A N/A - - 40400003 HC PET MYOCARD MULTI REST/STRESS 404 78492 51 N/A Both " 8,141.00 " N/A N/A N/A N/A - - 40400002 HC PET MYOCARD PERF REST/STRESS 404 78491 51 N/A Both " 8,141.00 " N/A N/A N/A N/A - - 36000034 HC OR LEVEL 7 BASE 360 51 N/A Both " 8,160.00 " N/A N/A N/A N/A - - 32900267 HC INSRT NEPHROURETERAL STENT 761 50433 51 N/A Both " 8,340.00 " N/A N/A N/A N/A - - 32900275 HC URE STNT NEW ACC WO NEPH 761 50694 51 N/A Both " 8,340.00 " N/A N/A N/A N/A - - 32900131 HC VCAD T INSERT W SUBQ > 5 YR 761 36561 51 N/A Both " 8,364.00 " N/A N/A N/A N/A - - 32300002 HC ANGIO RENAL BIL 1ST ORDER 761 36252 51 N/A Both " 8,406.00 " N/A N/A N/A N/A - - 48000047 HC EP EVAL WITH INDUCTION 481 93620 51 N/A Both " 8,431.00 " N/A N/A N/A N/A - - 48100047 HC RHC ONLY 481 93451 51 N/A Both " 8,446.00 " N/A N/A N/A N/A - - 33300023 HC SBRT PER TX UP TO 5 FRACTIONS 333 77373 51 N/A Both " 8,547.00 " N/A N/A N/A N/A - - 48000035 HC LHC BY TRANSSEPTAL PUNCTURE 481 93462 51 N/A Both " 8,677.00 " N/A N/A N/A N/A - - 45000102 HC CLOSED RX MANDIBLE FX+DENTAL FIX 450 21453 51 N/A Both " 8,803.00 " N/A N/A N/A N/A - - 45000307 HC REPAIR PALATE LACER 2+CM OR COMPLX 450 42182 51 N/A Both " 8,803.00 " N/A N/A N/A N/A - - 32900358 HC TPA EXCHG AND CESSATION 761 37214 51 N/A Both " 8,807.00 " N/A N/A N/A N/A - - 32900165 HC TPA SUBSEQ DAY EXCHG 761 37213 51 N/A Both " 8,807.00 " N/A N/A N/A N/A - - 48000004 HC INSERT ELECTRODE DUAL 481 33217 51 N/A Both " 8,827.00 " N/A N/A N/A N/A - - 32900381 HC FISTGRM W THROMB 1 ACCESS 761 36904 51 N/A Both " 8,964.00 " N/A N/A N/A N/A - - 36000036 HC OR LEVEL 8 BASE 360 51 N/A Both " 9,000.00 " N/A N/A N/A N/A - - 48000024 HC MECHANICAL THROMB CORONARY 481 92973 51 N/A Both " 9,060.00 " N/A N/A N/A N/A - - 32900083 HC THROMBECTOMY ART VEN GRAF 761 35875 51 N/A Both " 9,063.00 " N/A N/A N/A N/A - - 48000053 HC ABLATION AV NODE 481 93650 51 N/A Both " 9,087.00 " N/A N/A N/A N/A - - 48100019 HC REMOVAL PACER 481 33233 51 N/A Both " 9,141.00 " N/A N/A N/A N/A - - 32900266 HC INSERT NEPHROSTOMY TUBE 761 50432 51 N/A Both " 9,200.00 " N/A N/A N/A N/A - - 48100008 HC INSERT SGL LEAD PACER ICD 481 33216 51 N/A Both " 9,268.00 " N/A N/A N/A N/A - - 48000003 HC TEMPORARY PACER W FLUORO 481 33210 51 N/A Both " 9,268.00 " N/A N/A N/A N/A - - 32900290 HC TRANS OCCLUSION EMB CNS 761 61624 51 N/A Both " 9,297.00 " N/A N/A N/A N/A - - 32900314 HC IMPLANT NEUROSTIM PERC 761 63650 51 N/A Both " 9,412.00 " N/A N/A N/A N/A - - 32900253 HC PERC NEPHROSTOLITHOTOMY 761 50080 51 N/A Both " 9,412.00 " N/A N/A N/A N/A - - 48000001 HC INSERT WATCHMAN DEVICE 481 33340 51 N/A Both " 9,700.00 " N/A N/A N/A N/A - - 32900223 HC PLACE STENT BILE DUCT 761 47538 51 N/A Both " 9,778.00 " N/A N/A N/A N/A - - 32900382 HC FISTGRM W THROMB MULT ACCESS 761 36904 51 N/A Both " 9,814.00 " N/A N/A N/A N/A - - 32900161 HC TRANSCATH RETRIEVAL FB 761 37197 51 N/A Both " 9,970.00 " N/A N/A N/A N/A - - 75000166 HC B ENTEROS W STENT PLACEMENT 750 51 N/A Both " 10,085.00 " N/A N/A N/A N/A - - 32900224 HC STENT BILE DUCT NEW ACCESS 761 47539 51 N/A Both " 10,371.00 " N/A N/A N/A N/A - - 32300004 HC ANGIO RENAL BIL 2-3 ORD 1 ACC 761 36254 51 N/A Both " 10,479.00 " N/A N/A N/A N/A - - 32900344 HC REPAIR ENDOLEAK 329 37799 51 N/A Both " 10,514.00 " N/A N/A N/A N/A - - 33300007 HC IMRT PLANNING 333 77301 51 N/A Both " 10,637.00 " N/A N/A N/A N/A - - 48100092 HC REVASC BYPASS GRAFT BRANCH DRUG ELUTING STENT 481 92938 51 N/A Both " 10,751.00 " N/A N/A N/A N/A - - 48100040 HC REVASC BYPASS GRFT BRANCH 481 92938 51 N/A Both " 10,751.00 " N/A N/A N/A N/A - - 32900348 HC SACROPLASTY UNILATERAL 761 0200T 51 N/A Both " 10,759.00 " N/A N/A N/A N/A - - 32900108 HC ANGIO VERT CATH IN SBCLVN 761 36225 51 N/A Both " 10,762.00 " N/A N/A N/A N/A - - 32900109 HC ANGIO VERT CATH IN VERT 761 36226 51 N/A Both " 10,762.00 " N/A N/A N/A N/A - - 32900351 HC MILD CERV/THOR 761 0274T 51 N/A Both " 10,786.00 " N/A N/A N/A N/A - - 32900352 HC MILD LUMBAR 761 0275T 51 N/A Both " 10,786.00 " N/A N/A N/A N/A - - 32000001 HC IVC FILTER INSERTION 761 37191 51 N/A Both " 10,966.00 " N/A N/A N/A N/A - - 48100034 HC ATHRECT CORONARY BRANCH 481 92925 51 N/A Both " 11,030.00 " N/A N/A N/A N/A - - 48100090 HC ATHRECT W DRUG ELUTING STENT COR BRANCH 481 92934 51 N/A Both " 11,030.00 " N/A N/A N/A N/A - - 48100038 HC ATHRECT W/STNT COR BRANCH 481 92934 51 N/A Both " 11,030.00 " N/A N/A N/A N/A - - 32900105 HC ANGIO COMM CATH IN COMM 761 36222 51 N/A Both " 11,150.00 " N/A N/A N/A N/A - - 32900350 HC ATHRECT RENAL ARTERY 329 0234T 51 N/A Both " 11,232.00 " N/A N/A N/A N/A - - 32900289 HC TEMPORARY BALLOON OCCLUSION 761 61623 51 N/A Both " 11,279.00 " N/A N/A N/A N/A - - 48100036 HC STENT CORONARY BRANCH 481 92929 51 N/A Both " 11,288.00 " N/A N/A N/A N/A - - 48100088 HC STENT DRUG ELUTING CORONARY BRANCH 481 92929 51 N/A Both " 11,288.00 " N/A N/A N/A N/A - - 32900271 HC ABLATION RENAL TUMOR CRYO 761 50593 51 N/A Both " 11,334.00 " N/A N/A N/A N/A - - 45000128 HC MUSC/TENDON REPAIR EACH; ARM/ELBOW 450 24341 51 N/A Both " 11,376.00 " N/A N/A N/A N/A - - 32900402 HC PTA ART NON LOWER EXT ADDTL 761 37247 51 N/A Both " 11,444.00 " N/A N/A N/A N/A - - 32900405 HC PTA VEIN ADDITIONAL 761 37249 51 N/A Both " 11,444.00 " N/A N/A N/A N/A - - 32900106 HC ANGIO INTNL CATH IN COMM 761 36223 51 N/A Both " 11,531.00 " N/A N/A N/A N/A - - 48100050 HC CA ONLY 481 93454 51 N/A Both " 11,613.00 " N/A N/A N/A N/A - - 32900034 HC ABLATION BONE TUMOR CRYO 761 20983 51 N/A Both " 11,628.00 " N/A N/A N/A N/A - - 32900033 HC ABLATION BONE TUMOR RF 761 20982 51 N/A Both " 11,628.00 " N/A N/A N/A N/A - - 48100027 HC INSERT SUBQ CARDIAC RHTHYM MONITOR 481 33285 51 N/A Both " 11,865.00 " N/A N/A N/A N/A - - 32900107 HC ANGIO INTNL CATH IN INTNL 761 36224 51 N/A Both " 11,927.00 " N/A N/A N/A N/A - - 32000002 HC IVC FILTER REMOVAL 761 37193 51 N/A Both " 11,955.00 " N/A N/A N/A N/A - - 32900276 HC URE STNT NEW ACC W NEPH 761 50695 51 N/A Both " 11,985.00 " N/A N/A N/A N/A - - 76100077 HC ABLATION PULMONARY TUMOR RF 761 32994 51 N/A Both " 12,009.00 " N/A N/A N/A N/A - - 48100031 HC PTCA CORONARY 481 92920 51 N/A Both " 12,198.00 " N/A N/A N/A N/A - - 36000038 HC OR LEVEL 9 BASE 360 51 N/A Both " 12,240.00 " N/A N/A N/A N/A - - 48100049 HC RHC AND LHC 481 93453 51 N/A Both " 12,287.00 " N/A N/A N/A N/A - - 32900177 HC PTA PRIMARY VESSEL T3 761 37228 51 N/A Both " 12,383.00 " N/A N/A N/A N/A - - 48100051 HC CA WITH GRAFTS 481 93455 51 N/A Both " 12,511.00 " N/A N/A N/A N/A - - 32900169 HC PTA PRIMARY VESSEL T1 761 37220 51 N/A Both " 12,527.00 " N/A N/A N/A N/A - - 32300022 HC ANGIO RENAL BIL 2-3 ORD 2 ACC 761 36254 51 N/A Both " 12,550.00 " N/A N/A N/A N/A - - 32900214 HC ABLATION LIVER TUMOR CRYO 761 47383 51 N/A Both " 12,593.00 " N/A N/A N/A N/A - - 32900213 HC ABLATION LIVER TUMOR RF 761 47382 51 N/A Both " 12,593.00 " N/A N/A N/A N/A - - 32900066 HC ABLATION LUNG TUMOR RF 761 32998 51 N/A Both " 12,593.00 " N/A N/A N/A N/A - - 32900270 HC RF ABLATION RENAL TUMOR(S) 761 50592 51 N/A Both " 12,593.00 " N/A N/A N/A N/A - - 32900291 HC TRANS OCCLUS EMB NON-CNS 761 61626 51 N/A Both " 12,680.00 " N/A N/A N/A N/A - - 48100004 HC INSERT PACER SGL 481 33212 51 N/A Both " 12,694.00 " N/A N/A N/A N/A - - 32900403 HC PTA VISCERAL ADDTL 761 37247 51 N/A Both " 12,796.00 " N/A N/A N/A N/A - - 33300022 HC SRS ONE COMPLETE SESSION 333 77372 51 N/A Both " 12,823.00 " N/A N/A N/A N/A - - 32900173 HC PTA ONE VESSEL T2 761 37224 51 N/A Both " 13,003.00 " N/A N/A N/A N/A - - 32900155 HC REVISION TIPS 761 37183 51 N/A Both " 13,317.00 " N/A N/A N/A N/A - - 32900154 HC TIPS 761 37182 51 N/A Both " 13,317.00 " N/A N/A N/A N/A - - 32900349 HC SACROPLASTY BILATERAL 761 0201T 51 N/A Both " 13,567.00 " N/A N/A N/A N/A - - 48100054 HC LHC W CA 481 93458 51 N/A Both " 13,845.00 " N/A N/A N/A N/A - - 45000011 HC TRAUMA ACTIVATION LEVEL I 681 G0390 51 N/A Both " 14,205.00 " N/A N/A N/A N/A - - 32900182 HC ATHR ADDTL VESSEL T3 761 37233 51 N/A Both " 14,513.00 " N/A N/A N/A N/A - - 32900225 HC STNT BILE DCT NEW ACCESS W DRN 761 47540 51 N/A Both " 14,661.00 " N/A N/A N/A N/A - - 32900400 HC PTA ART NON LOWER EXT 761 37246 51 N/A Both " 14,679.00 " N/A N/A N/A N/A - - 32900404 HC PTA VEIN INITIAL 761 37248 51 N/A Both " 14,679.00 " N/A N/A N/A N/A - - 48100055 HC LHC W CA WITH GRAFTS 481 93459 51 N/A Both " 14,744.00 " N/A N/A N/A N/A - - 32900389 HC PTA CENTRAL SEGMENT 761 36907 51 N/A Both " 15,206.00 " N/A N/A N/A N/A - - 48100002 HC INSRT REPL PACER VENT W FLRO 481 33207 51 N/A Both " 15,255.00 " N/A N/A N/A N/A - - 48100001 HC INSRT REPL PACER ATRIAL 481 33206 51 N/A Both " 15,495.00 " N/A N/A N/A N/A - - 48100005 HC INSERT PACER DUAL 481 33213 51 N/A Both " 15,548.00 " N/A N/A N/A N/A - - 48100014 HC REMOVE REPL PACER SGL LEAD 481 33227 51 N/A Both " 15,548.00 " N/A N/A N/A N/A - - 32900039 HC KYPHOPLSTY THORACIC 761 22513 51 N/A Both " 15,817.00 " N/A N/A N/A N/A - - 32900174 HC PTA ATHR ONE VESSEL T2 761 37225 51 N/A Both " 16,065.00 " N/A N/A N/A N/A - - 32900186 HC STNT ONLY UPPER EXT VISCERAL ART ADDTL 761 37237 51 N/A Both " 16,084.00 " N/A N/A N/A N/A - - 32900188 HC STNT ONLY UPPER EXT VISCERAL VEIN ADDTL 761 37239 51 N/A Both " 16,084.00 " N/A N/A N/A N/A - - 32900156 HC MECH THROM INTL ARTERY 761 37184 51 N/A Both " 16,113.00 " N/A N/A N/A N/A - - 32900159 HC MECH THROM VEIN INTL DAY 761 37187 51 N/A Both " 16,138.00 " N/A N/A N/A N/A - - 32900160 HC MECH THROM VEIN SUBSQT DAY 761 37188 51 N/A Both " 16,138.00 " N/A N/A N/A N/A - - 32900401 HC PTA VISCERAL 761 37246 51 N/A Both " 16,544.00 " N/A N/A N/A N/A - - 48000019 HC PLACE OCCLUSION DEVICE ILIAC 481 34808 51 N/A Both " 16,674.00 " N/A N/A N/A N/A - - 32900390 HC STENT CENTRAL SEGMENT 761 36908 51 N/A Both " 17,205.00 " N/A N/A N/A N/A - - 32900168 HC STENT CAROTID NON-DIST PROTECT 761 37216 51 N/A Both " 17,222.00 " N/A N/A N/A N/A - - 32900185 HC STENT ONLY UPPER EXT VISCERAL ARTERY 761 37236 51 N/A Both " 17,232.00 " N/A N/A N/A N/A - - 32900041 HC KYPHOPLSTY ADDTL LEVEL 761 22515 51 N/A Both " 17,574.00 " N/A N/A N/A N/A - - 32900040 HC KYPHOPLSTY LUMBAR 761 22514 51 N/A Both " 17,574.00 " N/A N/A N/A N/A - - 32900373 HC FISTGRM W PTA MULT ACCESS 761 36902 51 N/A Both " 17,749.00 " N/A N/A N/A N/A - - 32900374 HC FISTGRM W PTA 1 ACCESS 761 36902 51 N/A Both " 17,782.00 " N/A N/A N/A N/A - - 32900187 HC STENT ONLY EXT VISCERAL VEIN 761 37238 51 N/A Both " 18,093.00 " N/A N/A N/A N/A - - 48100015 HC REMOVE REPL PACER DUAL LEAD 481 33228 51 N/A Both " 18,140.00 " N/A N/A N/A N/A - - 32900190 HC EMBO ART NON TUMOR HEMORRHAGE 761 37242 51 N/A Both " 18,151.00 " N/A N/A N/A N/A - - 32900189 HC EMBO VEIN NON TUMOR HEMORRHAGE 761 37241 51 N/A Both " 18,151.00 " N/A N/A N/A N/A - - 32900192 HC EMBOLIZATION HEMORRHAGE 761 37244 51 N/A Both " 18,151.00 " N/A N/A N/A N/A - - 32900191 HC EMBOLIZATION TUMOR 761 37243 51 N/A Both " 18,151.00 " N/A N/A N/A N/A - - 48100091 HC PERC REVASC BYPASS GRAFT DRUG ELUTING STENT 481 92937 51 N/A Both " 18,158.00 " N/A N/A N/A N/A - - 48100039 HC PERC REVASC BYPASS GRFT 481 92937 51 N/A Both " 18,158.00 " N/A N/A N/A N/A - - 48100056 HC RHC AND LHC W CA 481 93460 51 N/A Both " 18,202.00 " N/A N/A N/A N/A - - 48100003 HC INSRT REPL PACER A&V W FLRO 481 33208 51 N/A Both " 18,304.00 " N/A N/A N/A N/A - - 32900379 HC FISTGRM 1 ACCESS W STENT 761 36903 51 N/A Both " 18,903.00 " N/A N/A N/A N/A - - 48100063 HC PFO-TRANSCATHETER CLOSURE PROC 481 93580 51 N/A Both " 18,913.00 " N/A N/A N/A N/A - - 48100064 HC VSD CLOSURE PERCUTANEOUS 481 93581 51 N/A Both " 18,913.00 " N/A N/A N/A N/A - - 48100042 HC REVASC CHRONIC OCCL 481 92943 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100043 HC REVASC CHRONIC OCCL BRNCH 481 92944 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100095 HC REVASC CHRONIC TOTAL OCCL BRANCH DRUG ELUTING STENT 481 92944 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100094 HC REVASC CHRONIC TOTAL OCCL DRUG ELUTING STENT 481 92943 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100041 HC REVASC MI BY GRFT 481 92941 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100093 HC REVASC MI BYPASS GRAFT DRUG ELUTING STENT 481 92941 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100035 HC STENT CORONARY 481 92928 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100087 HC STENT DRUG ELUTING CORONARY 481 92928 51 N/A Both " 19,066.00 " N/A N/A N/A N/A - - 48100057 HC RHC AND LHC W CA WITH GRAFTS 481 93461 51 N/A Both " 19,103.00 " N/A N/A N/A N/A - - 32900178 HC ATHR PRIMARY VESSEL T3 761 37229 51 N/A Both " 19,136.00 " N/A N/A N/A N/A - - 48100084 HC AA/IA EXT DELAYED ADDTL 481 34711 51 N/A Both " 19,527.00 " N/A N/A N/A N/A - - 48100083 HC AA/IA EXT DELAYED INTL 481 34710 51 N/A Both " 19,527.00 " N/A N/A N/A N/A - - 48100082 HC AA/IA EXTENSION ADDTL 481 34709 51 N/A Both " 19,527.00 " N/A N/A N/A N/A - - 48100006 HC PACER-UPGRADE 481 33214 51 N/A Both " 19,551.00 " N/A N/A N/A N/A - - 32900377 HC FISTGRM MULT ACCESS W STENT 761 36903 51 N/A Both " 19,752.00 " N/A N/A N/A N/A - - 32900347 HC STENT VERT ARTERY ADDTL 329 0076T 51 N/A Both " 19,841.00 " N/A N/A N/A N/A - - 32900346 HC STENT VERT ARTERY INITL 329 0075T 51 N/A Both " 19,841.00 " N/A N/A N/A N/A - - 48100010 HC INSERT PACER MULTI 481 33221 51 N/A Both " 19,850.00 " N/A N/A N/A N/A - - 76100240 HC INSERT STABILIZ DEVICE WO DECOMP LUMBAR INITIAL 761 22869 51 N/A Both " 19,855.00 " N/A N/A N/A N/A - - 48000014 HC TMVR PERC ADDTL 481 33419 51 N/A Both " 20,073.00 " N/A N/A N/A N/A - - 48100011 HC CS LEAD REPLACEMENT 481 33224 51 N/A Both " 20,243.00 " N/A N/A N/A N/A - - 32900359 HC PTA TWO OR MORE T2 761 37224 51 N/A Both " 20,495.00 " N/A N/A N/A N/A - - 32900167 HC STENT CAROTID DISTAL PROTECT 761 37215 51 N/A Both " 20,833.00 " N/A N/A N/A N/A - - 48100016 HC REMOVE REPL PACER MULTI LEAD 481 33229 51 N/A Both " 20,841.00 " N/A N/A N/A N/A - - 48100044 HC AORTIC VALVULOPLASTY 481 92986 51 N/A Both " 21,078.00 " N/A N/A N/A N/A - - 48100052 HC RHC WITH CA 481 93456 51 N/A Both " 21,778.00 " N/A N/A N/A N/A - - 48100053 HC RHC WITH CA WITH GRAFTS 481 93457 51 N/A Both " 22,678.00 " N/A N/A N/A N/A - - 48100089 HC ATHRECT W DRUG ELUTING STENT CORONARY 481 92933 51 N/A Both " 23,050.00 " N/A N/A N/A N/A - - 48100037 HC ATHRECT W/STNT COR 481 92933 51 N/A Both " 23,050.00 " N/A N/A N/A N/A - - 32900384 HC FISTGRM W THROMB PTA 1 ACC 761 36905 51 N/A Both " 24,171.00 " N/A N/A N/A N/A - - 48100033 HC ATHRECT CORONARY 481 92924 51 N/A Both " 24,202.00 " N/A N/A N/A N/A - - 48000054 HC COMP EP W/ABLATION SVT 481 93653 51 N/A Both " 24,560.00 " N/A N/A N/A N/A - - 48100046 HC PULMONARY VALVULOPLASTY 481 92990 51 N/A Both " 24,662.00 " N/A N/A N/A N/A - - 48100012 HC CS LEAD PLACEMENT LV 481 33225 51 N/A Both " 24,745.00 " N/A N/A N/A N/A - - 32900383 HC FISTGRM W THROMB PTA MULT ACC 761 36905 51 N/A Both " 25,020.00 " N/A N/A N/A N/A - - 32900361 HC PTA ATHR 1V W ADDTL PTA 329 37225 51 N/A Both " 25,501.00 " N/A N/A N/A N/A - - 32900387 HC FISTGRM W THROMB STENT 1 ACC 761 36906 51 N/A Both " 26,170.00 " N/A N/A N/A N/A - - 32900183 HC PTA STENT ADDTL VESSEL T3 761 37234 51 N/A Both " 26,286.00 " N/A N/A N/A N/A - - 32900292 HC THRMBCTMY TPA ART INTRCRN 761 61645 51 N/A Both " 26,368.00 " N/A N/A N/A N/A - - 32900172 HC PTA STENT ADDTL VESSEL T1 761 37223 51 N/A Both " 26,504.00 " N/A N/A N/A N/A - - 32900385 HC FISTGRM W THROMB STNT MLT ACC 761 36906 51 N/A Both " 27,018.00 " N/A N/A N/A N/A - - 32900367 HC STNT W PTA UPPER EXT VISCERAL ART ADDTL 761 37237 51 N/A Both " 27,189.00 " N/A N/A N/A N/A - - 32900069 HC THOR STNT GRFT W LT SUBCL 761 33880 51 N/A Both " 27,504.00 " N/A N/A N/A N/A - - 48000103 HC EXTRACORPOREAL CIRCULAT. 480 51 N/A Both " 28,154.00 " N/A N/A N/A N/A - - 48100045 HC MITRAL VALVULOPLASTY 481 92987 51 N/A Both " 28,243.00 " N/A N/A N/A N/A - - 32900366 HC STENT W PTA UPPER EXT ARTERY 761 37236 51 N/A Both " 29,105.00 " N/A N/A N/A N/A - - 32900369 HC STNT W PTA VISCERAL VEIN ADDTL 761 37239 51 N/A Both " 29,105.00 " N/A N/A N/A N/A - - 32900410 HC STNT W PTA UPPER EXT VEIN ADDL 761 37239 51 N/A Both " 29,743.00 " N/A N/A N/A N/A - - 32900399 HC STENT W PTA VISCERAL ARTERY 761 37236 51 N/A Both " 30,254.00 " N/A N/A N/A N/A - - 32900368 HC STENT W PTA VISCERAL VEIN 761 37238 51 N/A Both " 30,254.00 " N/A N/A N/A N/A - - 48100080 HC ILIO - ILIAC TUBE GRAFT 481 34707 51 N/A Both " 30,808.00 " N/A N/A N/A N/A - - 48100081 HC ILIO - ILIAC TUBE GRAFT RPT 481 34708 51 N/A Both " 30,808.00 " N/A N/A N/A N/A - - 32900179 HC PTA STENT PRIMARY VESSEL T3 761 37230 51 N/A Both " 31,023.00 " N/A N/A N/A N/A - - 32900360 HC PTA ATHR TWO VESSEL OR MORE T2 761 37225 51 N/A Both " 31,044.00 " N/A N/A N/A N/A - - 32900376 HC FISTGRM W MULT PTA 1 ACCESS 761 36902 51 N/A Both " 32,110.00 " N/A N/A N/A N/A - - 32900397 HC STENT W PTA EXT VEIN 761 37238 51 N/A Both " 32,436.00 " N/A N/A N/A N/A - - 32900175 HC PTA STENT ONE VESSEL T2 761 37226 51 N/A Both " 32,574.00 " N/A N/A N/A N/A - - 32900184 HC STENT ATHR ADDTL VESSEL T3 761 37235 51 N/A Both " 32,624.00 " N/A N/A N/A N/A - - 32900170 HC PTA STENT PRIMARY VESSEL T1 761 37221 51 N/A Both " 32,725.00 " N/A N/A N/A N/A - - 32900375 HC FISTGRM MULT PTA MULT ACCESS 761 36902 51 N/A Both " 32,959.00 " N/A N/A N/A N/A - - 32900070 HC THOR STNT GRFT WO LT SUBCL 761 33881 51 N/A Both " 33,509.00 " N/A N/A N/A N/A - - 32900180 HC STENT ATHR PRIMARY VESSEL T3 761 37231 51 N/A Both " 34,176.00 " N/A N/A N/A N/A - - 32900176 HC STENT ATHR ONE VESSEL T2 761 37227 51 N/A Both " 34,707.00 " N/A N/A N/A N/A - - 33900004 HC INSERT UTERI TANDEM/OVOIDS 339 57155 51 N/A Both " 35,065.00 " N/A N/A N/A N/A - - 48100017 HC ICD INSERTION DUAL 481 33230 51 N/A Both " 35,186.00 " N/A N/A N/A N/A - - 48100067 HC INSERT/REPLACE LEADLESS PACER VENT 481 33274 51 N/A Both " 35,740.00 " N/A N/A N/A N/A - - 48100018 HC ICD INSERTION MULTI 481 33231 51 N/A Both " 35,790.00 " N/A N/A N/A N/A - - 48000110 HC TRANSCATH REPAIR PVL AORTIC 481 93591 51 N/A Both " 36,042.00 " N/A N/A N/A N/A - - 48000109 HC TRANSCATH REPAIR PVL MITRAL 481 93590 51 N/A Both " 36,042.00 " N/A N/A N/A N/A - - 32900380 HC FISTGRM MULT STENT 1 ACCESS 761 36903 51 N/A Both " 36,108.00 " N/A N/A N/A N/A - - 48100074 HC AA/AORTIC TUBE GRAFT 481 34701 51 N/A Both " 36,388.00 " N/A N/A N/A N/A - - 48100075 HC AA/AORTIC TUBE GRAFT RPT 481 34702 51 N/A Both " 36,388.00 " N/A N/A N/A N/A - - 48100079 HC AA/IA BI - ILIAC GRAFT RPT 481 34706 51 N/A Both " 36,388.00 " N/A N/A N/A N/A - - 48100076 HC AA/IA UNI - ILIAC GRAFT 481 34703 51 N/A Both " 36,388.00 " N/A N/A N/A N/A - - 48100077 HC AA/IA UNI - ILIAC GRFT RPT 481 34704 51 N/A Both " 36,388.00 " N/A N/A N/A N/A - - 48000075 HC IMPLANT PRESSURE SENSOR W ANGIO 481 33289 51 N/A Both " 36,704.00 " N/A N/A N/A N/A - - 48100020 HC ICD DEVICE INSERTION - SINGLE 481 33240 51 N/A Both " 36,946.00 " N/A N/A N/A N/A - - 48100024 HC REPLACE ICD GEN ONLY TO DUAL 481 33263 51 N/A Both " 36,946.00 " N/A N/A N/A N/A - - 48100023 HC REPLACE ICD GEN ONLY TO SINGLE 481 33262 51 N/A Both " 36,946.00 " N/A N/A N/A N/A - - 32900378 HC FISTGRM MULT STENT MULT ACCESS 761 36903 51 N/A Both " 36,957.00 " N/A N/A N/A N/A - - 48100025 HC REPLACE ICD GEN ONLY TO MULT 481 33264 51 N/A Both " 37,579.00 " N/A N/A N/A N/A - - 48100078 HC AA/IA BI - ILIAC GRFT 481 34705 51 N/A Both " 38,208.00 " N/A N/A N/A N/A - - 48100085 HC TMVI THORACIC APPROACH 481 0484T 51 N/A Both " 38,234.00 " N/A N/A N/A N/A - - 48000011 HC TAVR OPEN FEMORAL 481 33362 51 N/A Both " 38,742.00 " N/A N/A N/A N/A - - 48000012 HC TAVR OPEN TRANSAPICAL 481 33366 51 N/A Both " 38,742.00 " N/A N/A N/A N/A - - 48000055 HC COMP EP W/ABLATION VT 481 93654 51 N/A Both " 39,033.00 " N/A N/A N/A N/A - - 48000013 HC TMVR PERC INITIAL 481 33418 51 N/A Both " 40,146.00 " N/A N/A N/A N/A - - 32900363 HC PTA STENT 1V W ADDTL PTA 329 37226 51 N/A Both " 40,438.00 " N/A N/A N/A N/A - - 48000010 HC TAVR PERC FEMORAL 481 33361 51 N/A Both " 40,679.00 " N/A N/A N/A N/A - - 48100104 HC TRANSCATH PULMONARY VALVE IMPLANT (TPVI) 481 33477 51 N/A Both " 40,679.00 " N/A N/A N/A N/A - - 48000057 HC COMP EP W/PULM VEIN ISOLAT 481 93656 51 N/A Both " 40,923.00 " N/A N/A N/A N/A - - 48100026 HC INSRT REPL ICD SUBQ ELECTRODE 481 33270 51 N/A Both " 43,262.00 " N/A N/A N/A N/A - - 32900388 HC FISTGRM THROMB STENT 1 ACC MV 761 36906 51 N/A Both " 43,376.00 " N/A N/A N/A N/A - - 32900365 HC STENT ATHR 1V W ADDTL ATHR PTA 329 37227 51 N/A Both " 44,219.00 " N/A N/A N/A N/A - - 32900386 HC FISTGRM THROMB STNT MLT ACC MV 761 36906 51 N/A Both " 44,223.00 " N/A N/A N/A N/A - - 48100022 HC INSRT REPL ICD SINGLE DUAL CHAMBER 481 33249 51 N/A Both " 45,424.00 " N/A N/A N/A N/A - - 33300021 HC GAMMA STEREO RADIOSURG 1 SITE 333 77371 51 N/A Both " 46,690.00 " N/A N/A N/A N/A - - 62400003 FDAIDE G170258 624 C2624 51 N/A Both " 50,000.00 " N/A N/A N/A N/A - - 32900362 HC PTA STENT TWO OR MORE VESSELS T2 761 37226 51 N/A Both " 57,776.00 " N/A N/A N/A N/A - - 32900364 HC STENT ATHR TWO VESSELS T2 761 37227 51 N/A Both " 68,325.00 " N/A N/A N/A N/A - - 33300043 HC GAMMA STEREO RADIOSURG 2 SITES 333 77371 51 N/A Both " 77,083.00 " N/A N/A N/A N/A - - 33300044 HC GAMMA STEREO RADIOSRG 3+ SITES 333 77371 51 N/A Both " 99,107.00 " N/A N/A N/A N/A - - 12600001 HC R&B DETOX 126 52 N/A Both " 1,800.00 " N/A N/A N/A N/A - - 12000003 HC R&B IC SEMI-PRIVATE 120 52 N/A Both " 1,290.00 " N/A N/A N/A N/A - - 91300006 HC ADOLESCENT SHORT-TERM RESIDENTIAL - IC 913 52 N/A Both 625.00 N/A N/A N/A N/A - - 91300002 HC SHORT-TERM RES - IC 913 52 N/A Both 625.00 N/A N/A N/A N/A - - 91300007 HC ADOLESCENT PARTIAL CARE 6-8 HOURS 913 90853 52 N/A Both 525.00 N/A N/A N/A N/A - - 91300001 HC PARTIAL CARE 6-8 HRS 913 90853 52 N/A Both 525.00 N/A N/A N/A N/A - - 10000001 HC CJ SHORT-TERM RES - IC 1002 H2013 52 N/A Both 461.00 N/A N/A N/A N/A - - 91200007 HC ADOLESCENT SHORT-TERM RESIDENTIAL - IC WEEKEND 912 52 N/A Both 346.00 N/A N/A N/A N/A - - 91200002 HC SHORT-TERM RES - IC WKEND 912 52 N/A Both 346.00 N/A N/A N/A N/A - - 91800024 HC CHRNC CARE MGMT SVC 30 MIN 918 99491 52 N/A Both 249.00 N/A N/A N/A N/A - - 91200006 HC HALF DAY PARTIAL-UHC MILITARY 912 52 N/A Both 246.00 N/A N/A N/A N/A - - 90600002 HC IOP (PC) 3 HRS AM OR PM 906 90853 52 N/A Both 246.00 N/A N/A N/A N/A - - 91200001 HC IOP WKND/HLDYS 912 52 N/A Both 246.00 N/A N/A N/A N/A - - 91400009 HC ALCOHOL/DRUG ASSESS>30MINS BC 914 G0397 52 N/A Both 220.00 N/A N/A N/A N/A - - 90000005 HC EVALUATION 900 90791 52 N/A Both 220.00 N/A N/A N/A N/A - - 90000013 HC EVALUATION FOR TELEHEALTH 900 90791 52 N/A Both 220.00 N/A N/A N/A N/A - - 90000012 HC CJ EVALUATION 900 90791 52 N/A Both 216.00 N/A N/A N/A N/A - - 90000014 HC CJ EVALUATION FOR TELEHEALTH 900 90791 52 N/A Both 216.00 N/A N/A N/A N/A - - 90000010 HC SCREEN COUNSELOR 45(38-52)MIN 900 90834 52 N/A Both 190.00 N/A N/A N/A N/A - - 90000003 HC SCREEN INTERVENTION - RN 900 90791 52 N/A Both 190.00 N/A N/A N/A N/A - - 91600019 HC DAY TX FAMILY CONFERENCE 60MIN 916 90847 52 N/A Both 135.00 N/A N/A N/A N/A - - 91600007 HC FAMILY CONFERENCE 60 MIN 916 90847 52 N/A Both 135.00 N/A N/A N/A N/A - - 91600021 HC FAMILY THERAPY FOR TELEHEALTH 60 MIN 916 90847 52 N/A Both 135.00 N/A N/A N/A N/A - - 91600017 HC IOP FAMILY CONFERENCE 60 MIN 916 90847 52 N/A Both 135.00 N/A N/A N/A N/A - - 91400050 HC DAY TX IND THERAPY 60 MIN 914 90837 52 N/A Both 125.00 N/A N/A N/A N/A - - 91400048 HC INDIV THERAPY 60 MIN 914 90837 52 N/A Both 125.00 N/A N/A N/A N/A - - 91400055 HC INDIVIDUAL THERAPY FOR TELEHEALTH 60 MIN 914 90837 52 N/A Both 125.00 N/A N/A N/A N/A - - 91400051 HC IOP IND THERAPY 60 MIN 914 90837 52 N/A Both 125.00 N/A N/A N/A N/A - - 91600006 HC CJ FAMILY CONFERENCE 60 MIN 916 90847 52 N/A Both 122.00 N/A N/A N/A N/A - - 91400018 HC CJ IND THERAPY 30(16-37)MIN 914 90832 52 N/A Both 122.00 N/A N/A N/A N/A - - 91400024 HC CJ IND THERAPY 45(38-52)MIN 914 90834 52 N/A Both 122.00 N/A N/A N/A N/A - - 91400049 HC CJ IND THERAPY 60 MIN 914 90837 52 N/A Both 122.00 N/A N/A N/A N/A - - 91400056 HC CJ INDIVIDUAL THERAPY FOR TELEHEALTH 30 (16-37) MIN 914 90832 52 N/A Both 122.00 N/A N/A N/A N/A - - 91400057 HC CJ INDIVIDUAL THERAPY FOR TELEHEALTH 45 (38-52) MIN 914 90834 52 N/A Both 122.00 N/A N/A N/A N/A - - 91400058 HC CJ INDIVIDUAL THERAPY FOR TELEHEALTH 60 MIN 914 90837 52 N/A Both 122.00 N/A N/A N/A N/A - - 90000002 HC INTERVENTION CONSULT 900 90791 52 N/A Both 120.00 N/A N/A N/A N/A - - 91400008 HC ALCOHL/DRUG ASSESS15-30MINS BC 914 G0396 52 N/A Both 119.00 N/A N/A N/A N/A - - 91400027 HC DAY TX IND THERAPY 45(38-52) 914 90834 52 N/A Both 115.00 N/A N/A N/A N/A - - 91400029 HC INDIV THERAPY 45(38-52)MIN 914 90834 52 N/A Both 115.00 N/A N/A N/A N/A - - 91400054 HC INDIVIDUAL THERAPY FOR TELEHEALTH 45 (38-52) MIN 914 90834 52 N/A Both 115.00 N/A N/A N/A N/A - - 91400026 HC IOP IND THERAPY 45(38-52)MIN 914 90834 52 N/A Both 115.00 N/A N/A N/A N/A - - 91500019 HC DAY TX GROUP THERAPY 90 MIN-PARTIAL CARE 915 90853 52 N/A Both 105.00 N/A N/A N/A N/A - - 91500021 HC DAY TX LECTURE INTERACTIVE GRP-PARTIAL CARE 915 90853 52 N/A Both 105.00 N/A N/A N/A N/A - - 91500017 HC GROUP THERAPY 90 MIN 915 90853 52 N/A Both 105.00 N/A N/A N/A N/A - - 91500020 HC IOP GROUP THERAPY 90 MIN 915 90853 52 N/A Both 105.00 N/A N/A N/A N/A - - 91500022 HC IOP LECTURE INTERACTIVE GRP 915 90853 52 N/A Both 105.00 N/A N/A N/A N/A - - 91500018 HC LECTURE INTERACTIVE GROUP 915 90853 52 N/A Both 105.00 N/A N/A N/A N/A - - 77100004 HC ADMINISTRATION FEE -- HEPATITIS B 771 90471 52 N/A Both 103.00 N/A N/A N/A N/A - - 77100001 HC ADMINISTRATION FEE -- INFLUENZA 771 90471 52 N/A Both 103.00 N/A N/A N/A N/A - - 77100002 HC ADMINISTRATION FEE -- PNEUMOCOCCAL 771 90471 52 N/A Both 103.00 N/A N/A N/A N/A - - 77100003 HC VACCINE ADMINISTRATION 771 90471 52 N/A Both 103.00 N/A N/A N/A N/A - - 76900001 HC IC ROOM & BOARD RES 769 52 N/A Both 100.00 N/A N/A N/A N/A - - 77100005 HC IMMUNIZATION ADMINISTRATION EA ADDL 771 90472 52 N/A Both 90.00 N/A N/A N/A N/A - - 76200001 HC OBSERVATION 762 G0378 52 N/A Both 89.00 N/A N/A N/A N/A - - 91600018 HC DAY TX FAMILY CONFERENCE 30MIN 916 90847 52 N/A Both 75.00 N/A N/A N/A N/A - - 91600005 HC FAMILY CONFERENCE 30 MIN 916 90847 52 N/A Both 75.00 N/A N/A N/A N/A - - 91600020 HC FAMILY THERAPY FOR TELEHEALTH 30 MIN 916 90847 52 N/A Both 75.00 N/A N/A N/A N/A - - 91600009 HC IOP FAMILY CONFERENCE 30 MIN 916 90847 52 N/A Both 75.00 N/A N/A N/A N/A - - 91500015 HC DAY TX GROUP THERAPY 60 MIN-PARTIAL CARE 915 90853 52 N/A Both 65.00 N/A N/A N/A N/A - - 91500013 HC GROUP THERAPY 60 MIN 915 90853 52 N/A Both 65.00 N/A N/A N/A N/A - - 91500029 HC GROUP THERAPY FOR TELEHEALTH 60 MIN 915 90853 52 N/A Both 65.00 N/A N/A N/A N/A - - 91400017 HC DAY TX IND THERAPY 30(16-37) 914 90832 52 N/A Both 60.00 N/A N/A N/A N/A - - 91400043 HC INDIV THERAPY 30(16-37)MIN 914 90832 52 N/A Both 60.00 N/A N/A N/A N/A - - 91400053 HC INDIVIDUAL THERAPY FOR TELEHEALTH 30 (16-37) MIN 914 90832 52 N/A Both 60.00 N/A N/A N/A N/A - - 91400016 HC IOP IND THERAPY 30(16-37)MIN 914 90832 52 N/A Both 60.00 N/A N/A N/A N/A - - 91500010 HC DAY TX LECTURE DIDACTIC PARTIAL CARE 915 90853 52 N/A Both 55.00 N/A N/A N/A N/A - - 91500011 HC IOP LECTURE DIDACTIC 915 90853 52 N/A Both 55.00 N/A N/A N/A N/A - - 91500009 HC LECTURE DIDACTIC 915 90853 52 N/A Both 55.00 N/A N/A N/A N/A - - 91500016 HC CJ GROUP THERAPY 60 MIN 915 90853 52 N/A Both 52.00 N/A N/A N/A N/A - - 90000011 HC INTERVENTION VISIT RN 900 90832 52 N/A Both 50.00 N/A N/A N/A N/A - - 91500008 HC CJ DAY TX LECT INTERACTIV GRP 915 90853 52 N/A Both 42.00 N/A N/A N/A N/A - - 91500007 HC CJ DAY TX LECTURE DIDACTIC 915 90853 52 N/A Both 42.00 N/A N/A N/A N/A - - 91500006 HC CJ DAY TX GRP THERAPY 60 MIN 915 90853 52 N/A Both 31.00 N/A N/A N/A N/A - - 91500012 HC CJ DAY TX GRP THERAPY 90 MIN 915 90853 52 N/A Both 31.00 N/A N/A N/A N/A - - 91500002 HC CJ IOP GROUP THERAPY 60 MIN 915 90853 52 N/A Both 31.00 N/A N/A N/A N/A - - 91500005 HC CJ IOP GROUP THERAPY 90 MIN 915 90853 52 N/A Both 31.00 N/A N/A N/A N/A - - 91500004 HC CJ IOP LECTURE INTERACTIV GRP 915 90853 52 N/A Both 31.00 N/A N/A N/A N/A - - 91500003 HC CJ IOP LECTURE DIDACTIC 915 90853 52 N/A Both 27.00 N/A N/A N/A N/A - - 90700001 HC SKILL TRAINING DAY TX - 15 MIN 907 H2027 52 N/A Both 15.00 N/A N/A N/A N/A - - 90600001 HC SKILLS TRAINING IOP - 15 MIN 906 H2014 52 N/A Both 10.00 N/A N/A N/A N/A - - 30001413 HC MYELOID MALIGNANCY PANEL 300 81455 53 N/A Both " 2,038.00 " N/A N/A N/A N/A - - 30001425 HC NON-INVASIVE PRENATAL TESTING FOR FETAL ANEUPLOIDY 300 81420 53 N/A Both 781.00 N/A N/A N/A N/A - - 30001426 HC NON-INVASIVE PRENATAL TESTING FOR FETAL ANEUPLOIDY W MICRODELETIONS 300 81420 53 N/A Both 781.00 N/A N/A N/A N/A - - 30001427 HC NON-INVASIVE PRENATAL TESTING FOR FETAL ANEUPLOIDY W MICRODELETIONS 300 81422 53 N/A Both 781.00 N/A N/A N/A N/A - - 30000146 HC HLA TYPING 300 81381 53 N/A Both 696.00 N/A N/A N/A N/A - - 30000300 HC TPMT 300 82657 53 N/A Both 695.00 N/A N/A N/A N/A - - 30000139 HC MTHFR GENE ANALYSIS 300 81291 53 N/A Both 679.00 N/A N/A N/A N/A - - 30001396 HC CTFR SEQUENCING 300 81223 53 N/A Both 635.00 N/A N/A N/A N/A - - 30001398 HC CTRC SEQUENCING 300 81405 53 N/A Both 635.00 N/A N/A N/A N/A - - 30001397 HC PRSS1 SEQUENCING 300 81404 53 N/A Both 635.00 N/A N/A N/A N/A - - 30001409 HC SPINK1 SEQUENCING 300 81404 53 N/A Both 635.00 N/A N/A N/A N/A - - 30001135 HC HIV-1 RNA QUANT BY BDNA 300 87536 53 N/A Both 614.00 N/A N/A N/A N/A - - 30001157 HC INFECTIOUS AGENT QUANT 300 87799 53 N/A Both 601.00 N/A N/A N/A N/A - - 30001412 HC MOLECULAR PATHOLOGY PROC LEVEL 3 300 81402 53 N/A Both 583.00 N/A N/A N/A N/A - - 30000150 HC CEBPA GENE ANALYSIS 300 81218 53 N/A Both 576.00 N/A N/A N/A N/A - - 30001165 HC INFECT AGENT GENOTYPE DNA/RNA 300 87901 53 N/A Both 551.00 N/A N/A N/A N/A - - 30001120 HC CMV QUANT 300 87497 53 N/A Both 539.00 N/A N/A N/A N/A - - 30001166 HC INFECT AGENT HEPATITIS C VIRUS 300 87902 53 N/A Both 520.00 N/A N/A N/A N/A - - 30000516 HC CALPROTECTIN 300 83993 53 N/A Both 519.00 N/A N/A N/A N/A - - 30000694 HC BILL BETHF8 300 85335 53 N/A Both 516.00 N/A N/A N/A N/A - - 30001269 HC IMMUN FOR AN OTH INF AB OR AG 300 83516 53 N/A Both 516.00 N/A N/A N/A N/A - - 30000559 HC HEAT SHOCK PROTEIN 70IGG 68KDA 300 84182 53 N/A Both 501.00 N/A N/A N/A N/A - - 30000801 HC PURKINJE CELL ANTIBODY 300 86255 53 N/A Both 501.00 N/A N/A N/A N/A - - 30000702 HC CLOTTING FUNC ACTIVITY NOS EA ANALYT 300 85397 53 N/A Both 477.00 N/A N/A N/A N/A - - 30000504 HC METHYLMALONIC ACID SERUM 300 83921 53 N/A Both 477.00 N/A N/A N/A N/A - - 30000128 HC CFTR GENE ANALYSIS 300 81220 53 N/A Both 471.00 N/A N/A N/A N/A - - 30001443 HC NEURO CSF PRION PROTEIN QUAL 300 0035U 53 N/A Both 470.00 N/A N/A N/A N/A - - 30000908 HC HEPATITIS D VIRAL ANTIBODY 300 86692 53 N/A Both 465.00 N/A N/A N/A N/A - - 30001056 HC MIC PANEL 300 87186 53 N/A Both 465.00 N/A N/A N/A N/A - - 30000502 HC ORGANIC ACIDS TOTAL QUANT 300 83918 53 N/A Both 465.00 N/A N/A N/A N/A - - 30000432 HC TRYPTASE 300 83520 53 N/A Both 461.00 N/A N/A N/A N/A - - 30001042 HC NUCLEIC ACID SEQUENCING EACH 300 87153 53 N/A Both 460.00 N/A N/A N/A N/A - - 30000613 HC TRIIODOTHYRONINE T3 FREE 300 84481 53 N/A Both 454.00 N/A N/A N/A N/A - - 30000132 HC F5 GENE ANALYSIS LEIDEN 300 81241 53 N/A Both 452.00 N/A N/A N/A N/A - - 30000798 HC NEURONAL NUCLEAR ANTIBODY 300 86255 53 N/A Both 439.00 N/A N/A N/A N/A - - 30001141 HC MYCOPLASMA PNEUMONIAE PCR 300 87581 53 N/A Both 436.00 N/A N/A N/A N/A - - 30000137 HC JAK2 GENE ANALYSIS 300 81270 53 N/A Both 427.00 N/A N/A N/A N/A - - 30000557 HC PURKINJE CELL WESTERN BLOT 300 84181 53 N/A Both 427.00 N/A N/A N/A N/A - - 30001270 HC IMMUNO INFECTIOUS AGENT 300 83516 53 N/A Both 425.00 N/A N/A N/A N/A - - 30000602 HC THYROID STIMULATING IMM GLOBUL 300 84445 53 N/A Both 425.00 N/A N/A N/A N/A - - 30001334 HC ENTEROVIRUS PCR 300 87498 53 N/A Both 421.00 N/A N/A N/A N/A - - 30000253 HC COLLAGEN CROSS LINKS SERUM 300 82523 53 N/A Both 416.00 N/A N/A N/A N/A - - 30001119 HC CMV AMPLIFIED PROBE 300 87496 53 N/A Both 409.00 N/A N/A N/A N/A - - 30001153 HC NOROVIRUS BY PCR 300 87798 53 N/A Both 408.00 N/A N/A N/A N/A - - 30001127 HC HEP B DNA 300 87517 53 N/A Both 407.00 N/A N/A N/A N/A - - 30000555 HC MAGM WB 300 84181 53 N/A Both 401.00 N/A N/A N/A N/A - - 30000765 HC AB ID PLATELET ANTIBODIES 300 86022 53 N/A Both 396.00 N/A N/A N/A N/A - - 30001386 HC CALR CALRETICULIN EXON 9 MUT ANALYS 300 81219 53 N/A Both 392.00 N/A N/A N/A N/A - - 30000131 HC F2 GENE ANALYSIS 20210G 300 81240 53 N/A Both 392.00 N/A N/A N/A N/A - - 30000532 HC PORPHYRINS URINE FRACTIONATED 300 84120 53 N/A Both 391.00 N/A N/A N/A N/A - - 30000065 HC DRUG ASSAY INFLIXIMAB 300 80230 53 N/A Both 390.00 N/A N/A N/A N/A - - 30000197 HC ARSENIC FRACTIONATED 300 82175 53 N/A Both 388.00 N/A N/A N/A N/A - - 30000138 HC JAK2 GENE V617F MUTATION QUAL 300 81270 53 N/A Both 378.00 N/A N/A N/A N/A - - 30000231 HC CATECHOLAMINE FRACTIONATED 300 82384 53 N/A Both 373.00 N/A N/A N/A N/A - - 30000488 HC METANEPHRINES 300 83835 53 N/A Both 369.00 N/A N/A N/A N/A - - 30000297 HC VITAMIN D 1 25-DIHYDROXY 300 82652 53 N/A Both 369.00 N/A N/A N/A N/A - - 30001094 HC ASPERGILLUS ANTIGEN 300 87305 53 N/A Both 367.00 N/A N/A N/A N/A - - 30000960 HC HEP C RIBA SUPPLEMENTAL 300 86804 53 N/A Both 367.00 N/A N/A N/A N/A - - 30001223 HC HSV PCR 300 87529 53 N/A Both 367.00 N/A N/A N/A N/A - - 30000429 HC MANNOSE BINDING LECTIN 300 83520 53 N/A Both 367.00 N/A N/A N/A N/A - - 30001115 HC BORRELIA BURGDORFERI AMP PROBE 300 87476 53 N/A Both 366.00 N/A N/A N/A N/A - - 30000556 HC NEURONAL NUCLEAR WESTERN BLOT 300 84181 53 N/A Both 366.00 N/A N/A N/A N/A - - 30000814 HC PURKINJE CELL TITER 300 86256 53 N/A Both 366.00 N/A N/A N/A N/A - - 30000712 HC OSMOTIC FRAG RBC UNINCUBATED 300 85555 53 N/A Both 364.00 N/A N/A N/A N/A - - 30001311 HC INFECTIOUS AGENT BY AMPL PROBE 300 87798 53 N/A Both 359.00 N/A N/A N/A N/A - - 30001312 HC INFECT AGENT DETECT AMP PROBE 300 87798 53 N/A Both 358.00 N/A N/A N/A N/A - - 30000259 HC 18 HYDROXYCORTICOSTERONE 300 82542 53 N/A Both 357.00 N/A N/A N/A N/A - - 30000050 HC TACROLIMUS 300 80197 53 N/A Both 356.00 N/A N/A N/A N/A - - 30001111 HC FUNGITELL 1 & 3 BETA D GLUCAN 300 87449 53 N/A Both 353.00 N/A N/A N/A N/A - - 30000846 HC INFLIXIMAB ACT NEUTRALIZING AB 300 86352 53 N/A Both 352.00 N/A N/A N/A N/A - - 30000181 HC AMINO ACIDS 6 OR MORE QUANT 300 82139 53 N/A Both 348.00 N/A N/A N/A N/A - - 30001273 HC CYTOKINE 300 83520 53 N/A Both 348.00 N/A N/A N/A N/A - - 30000903 HC TOXOCARA ANTIBODY 300 86682 53 N/A Both 344.00 N/A N/A N/A N/A - - 30000169 HC ALPHA-1 ANTITRYPSIN TOTAL 300 82103 53 N/A Both 343.00 N/A N/A N/A N/A - - 30001128 HC HEP C AMPLIFIED PROBE 300 87521 53 N/A Both 343.00 N/A N/A N/A N/A - - 30000142 HC SERPINA-1 GENE ANALYSIS COMMON VAR 300 81332 53 N/A Both 343.00 N/A N/A N/A N/A - - 30000690 HC PROTEIN S FREE 300 85306 53 N/A Both 342.00 N/A N/A N/A N/A - - 30000805 HC ANNA TITER IGG 300 86256 53 N/A Both 332.00 N/A N/A N/A N/A - - 30001279 HC FLUO NONINF AGE ANT SCR EA ANT 300 86255 53 N/A Both 331.00 N/A N/A N/A N/A - - 30000813 HC PURKINJE AB TITER 300 86256 53 N/A Both 331.00 N/A N/A N/A N/A - - 30000522 HC ALK PHOS ISOENZYMES 300 84080 53 N/A Both 326.00 N/A N/A N/A N/A - - 30001284 HC FLUORESCENT NONINFECT AB TITER 300 86256 53 N/A Both 326.00 N/A N/A N/A N/A - - 30000668 HC COAGULATION FACT V ACTIVI 300 85220 53 N/A Both 322.00 N/A N/A N/A N/A - - 30000671 HC FACTOR VIII AHG ONE STAGE 300 85240 53 N/A Both 318.00 N/A N/A N/A N/A - - 30000491 HC MYELIN BASIC PROTEIN 300 83873 53 N/A Both 314.00 N/A N/A N/A N/A - - 30001430 HC ZIKA VIRUS BY PCR BLOOD 300 87662 53 N/A Both 314.00 N/A N/A N/A N/A - - 30001431 HC ZIKA VIRUS BY PCR URINE 300 87662 53 N/A Both 314.00 N/A N/A N/A N/A - - 30000811 HC NEURONAL NUCLEAR TITER 300 86256 53 N/A Both 309.00 N/A N/A N/A N/A - - 30000907 HC HIV-1 AB CONFIRM WESTERN BLOT 300 86689 53 N/A Both 301.00 N/A N/A N/A N/A - - 30000817 HC IMMUNOASSAY TUMOR ANTIGEN CA 125 300 86304 53 N/A Both 301.00 N/A N/A N/A N/A - - 30000842 HC ISLET CELL AB IGG 300 86341 53 N/A Both 301.00 N/A N/A N/A N/A - - 30000692 HC PROTEIN S FUNCTIONAL 300 85306 53 N/A Both 301.00 N/A N/A N/A N/A - - 30000156 HC ACYLCARNITINES QUANTITATIVE 300 82017 53 N/A Both 300.00 N/A N/A N/A N/A - - 30000022 HC CYCLOSPORINE 300 80158 53 N/A Both 300.00 N/A N/A N/A N/A - - 30000102 HC DRUG ASSAY LACOSAMIDE 300 80235 53 N/A Both 300.00 N/A N/A N/A N/A - - 30000581 HC IGF-1 INSULIN-LIKE GROWTH I 300 84305 53 N/A Both 300.00 N/A N/A N/A N/A - - 30000937 HC TYPHUS FEVER AB 300 86757 53 N/A Both 300.00 N/A N/A N/A N/A - - 30000174 HC ALPHA-FETOPROTEIN SERUM 300 82105 53 N/A Both 298.00 N/A N/A N/A N/A - - 30000199 HC BETA 2 MICROGLOBULIN 300 82232 53 N/A Both 297.00 N/A N/A N/A N/A - - 30001163 HC INFECT AGENT DETECT BY IMMUN 300 87899 53 N/A Both 297.00 N/A N/A N/A N/A - - 30000624 HC VMA URINE 300 84585 53 N/A Both 297.00 N/A N/A N/A N/A - - 30000770 HC PLATELET AB DIRECT 300 86023 53 N/A Both 295.00 N/A N/A N/A N/A - - 30001308 HC TISS CULT INOC OBS PRESUM ID 300 87252 53 N/A Both 292.00 N/A N/A N/A N/A - - 30000906 HC HIV AB CONFIRMATION TEST 300 86689 53 N/A Both 285.00 N/A N/A N/A N/A - - 30000480 HC CARNITINE TOTAL 300 83789 53 N/A Both 284.00 N/A N/A N/A N/A - - 30000388 HC IMMUNO QUANT RO SEMI QUANT OTH 300 83516 53 N/A Both 284.00 N/A N/A N/A N/A - - 30000688 HC CLOT INHIB ANTICOAG PROTEIN C 300 85303 53 N/A Both 281.00 N/A N/A N/A N/A - - 30000304 HC ERYTHROPOIETIN 300 82668 53 N/A Both 274.00 N/A N/A N/A N/A - - 30000336 HC GASTRIN 300 82941 53 N/A Both 274.00 N/A N/A N/A N/A - - 30000603 HC VITAMIN E 300 84446 53 N/A Both 274.00 N/A N/A N/A N/A - - 30001410 HC BCR ABL1 MAJOR 300 81206 53 N/A Both 272.00 N/A N/A N/A N/A - - 30001411 HC BCR ABL1 MINOR 300 81207 53 N/A Both 272.00 N/A N/A N/A N/A - - 30000629 HC VITAMIN B3 300 84591 53 N/A Both 272.00 N/A N/A N/A N/A - - 30000594 HC THYROGLOBULIN BY LC-MS/MS 300 84432 53 N/A Both 271.00 N/A N/A N/A N/A - - 30001461 HC PNEUMOCYSTIS JIROVECII 300 87798 53 N/A Both 270.00 N/A N/A N/A N/A - - 30000255 HC ASSAY OF COPPER 300 82525 53 N/A Both 268.00 N/A N/A N/A N/A - - 30001012 HC CULTURE AEROBIC ISOLATE 300 87077 53 N/A Both 264.00 N/A N/A N/A N/A - - 30000838 HC INSULIN ANTIBODY 300 86337 53 N/A Both 264.00 N/A N/A N/A N/A - - 30000056 HC ZONISAMIDE 300 80203 53 N/A Both 263.00 N/A N/A N/A N/A - - 30000382 HC ANNA IGG BY IMMUNOBLOT 300 83516 53 N/A Both 260.00 N/A N/A N/A N/A - - 30000570 HC SEROTONIN 300 84260 53 N/A Both 257.00 N/A N/A N/A N/A - - 30000406 HC ACETYLCHOLINE BINDING AB 300 83519 53 N/A Both 256.00 N/A N/A N/A N/A - - 30000821 HC HEPATITIS B SURFACE AB 300 86317 53 N/A Both 252.00 N/A N/A N/A N/A - - 30000691 HC PROTEIN S FREE AG WITH REFLEX 300 85306 53 N/A Both 251.00 N/A N/A N/A N/A - - 30000375 HC HOMOCYSTEINE TOTAL 300 83090 53 N/A Both 250.00 N/A N/A N/A N/A - - 30000395 HC RNA POLYMERASE III AB IGG 300 83516 53 N/A Both 250.00 N/A N/A N/A N/A - - 30000630 HC VITAMIN K1 SERUM 300 84597 53 N/A Both 250.00 N/A N/A N/A N/A - - 30001058 HC SUSCEPT ANAEROBE BY BROTH DIL 300 87186 53 N/A Both 247.00 N/A N/A N/A N/A - - 30000180 HC AMINOLEVULINIC ACID ALA URINE 300 82135 53 N/A Both 246.00 N/A N/A N/A N/A - - 30000213 HC CALCITONIN 300 82308 53 N/A Both 241.00 N/A N/A N/A N/A - - 30001286 HC LYMPHOCYTE TRANSFORMATION 300 86353 53 N/A Both 241.00 N/A N/A N/A N/A - - 30000190 HC ANGIOTENSIN CONVERTING ENZYME 300 82164 53 N/A Both 240.00 N/A N/A N/A N/A - - 30000369 HC PLASMA HEMOGLOBIN 300 83051 53 N/A Both 240.00 N/A N/A N/A N/A - - 31000083 HC FLOW CYTOMETER 2-8 MARKERS 311 88187 53 N/A Both 238.00 N/A N/A N/A N/A - - 31000085 HC FLOW CYTOMETER 9-15 MARKERS 311 88188 53 N/A Both 238.00 N/A N/A N/A N/A - - 30000874 HC LYME CONFIRMATORY TEST 300 86617 53 N/A Both 235.00 N/A N/A N/A N/A - - 30000785 HC COMPLEMENT ACTIVITY TOTAL EIA 300 86162 53 N/A Both 233.00 N/A N/A N/A N/A - - 30001210 HC VARICELLA ZOSTER PCR 300 87798 53 N/A Both 233.00 N/A N/A N/A N/A - - 30001295 HC EHRLICHIA ANAPLASMA 300 86666 53 N/A Both 232.00 N/A N/A N/A N/A - - 30001423 HC INHIBIN B 300 83520 53 N/A Both 232.00 N/A N/A N/A N/A - - 30000157 HC ACTH 300 82024 53 N/A Both 230.00 N/A N/A N/A N/A - - 30000431 HC PANCREATIC ELASTASE FECAL 300 83520 53 N/A Both 230.00 N/A N/A N/A N/A - - 30001077 HC TISS CULT INOC OBS PRESUM ID 300 87252 53 N/A Both 230.00 N/A N/A N/A N/A - - 30001316 HC FLUORESCENT NONINFECT AB TITER 300 86256 53 N/A Both 227.00 N/A N/A N/A N/A - - 30000819 HC IMMUNO FOR ANTIGEN QUANT 300 86316 53 N/A Both 226.00 N/A N/A N/A N/A - - 30000168 HC ALDOSTERONE SERUM 300 82088 53 N/A Both 225.00 N/A N/A N/A N/A - - 30000896 HC FRANCISELLA TULARENSIS AB 300 86668 53 N/A Both 225.00 N/A N/A N/A N/A - - 30000965 HC HLA-B27 300 86812 53 N/A Both 225.00 N/A N/A N/A N/A - - 30000853 HC TCELL ABSOLUTE CD4 COUNT 300 86361 53 N/A Both 225.00 N/A N/A N/A N/A - - 30001296 HC HIV-1 AB CONFIRMATION 300 86689 53 N/A Both 224.00 N/A N/A N/A N/A - - 30001424 HC INTERLEUKIN-6 SERUM 300 83520 53 N/A Both 222.00 N/A N/A N/A N/A - - 30000926 HC LEGIONELLA PNEUMOPHILA 1-6 IGG 300 86713 53 N/A Both 222.00 N/A N/A N/A N/A - - 30001429 HC ZIKA VIRUS IGM (EUA) 300 86794 53 N/A Both 222.00 N/A N/A N/A N/A - - 30000191 HC ANGIOTENSIN CONVERT ENZYME CSF 300 82164 53 N/A Both 220.00 N/A N/A N/A N/A - - 30000196 HC ARSENIC BLOOD 300 82175 53 N/A Both 220.00 N/A N/A N/A N/A - - 30000228 HC CARCINOEMBRYONIC ANTIGEN CEA 300 82378 53 N/A Both 220.00 N/A N/A N/A N/A - - 30000669 HC COAG FACTOR VII ACTIVE 300 85230 53 N/A Both 220.00 N/A N/A N/A N/A - - 30000882 HC COCCIDIOIDES ANTIBODY 300 86635 53 N/A Both 220.00 N/A N/A N/A N/A - - 30000856 HC THYROID PEROXIDASE TPO AB 300 86376 53 N/A Both 220.00 N/A N/A N/A N/A - - 30000875 HC LYME DISEASE AB 300 86618 53 N/A Both 218.00 N/A N/A N/A N/A - - 30000809 HC FLUOR NONINF AGENT TITER EA 300 86256 53 N/A Both 213.00 N/A N/A N/A N/A - - 30001099 HC HELICOBACTER PYLORI STOOL 300 87338 53 N/A Both 213.00 N/A N/A N/A N/A - - 30001102 HC HEPATITIS BE AG 300 87350 53 N/A Both 213.00 N/A N/A N/A N/A - - 30001059 HC SUSCEPTIBILITY MIC EACH 300 87186 53 N/A Both 213.00 N/A N/A N/A N/A - - 30000677 HC VON WILLEBRAND FACTOR AG 300 85246 53 N/A Both 211.00 N/A N/A N/A N/A - - 30001129 HC HEPATITIS C QUANTIFICATION 300 87522 53 N/A Both 209.00 N/A N/A N/A N/A - - 30001104 HC HISTOPLASMA CAPSULATUM 300 87385 53 N/A Both 209.00 N/A N/A N/A N/A - - 30000774 HC ANTI-STREPTOLYSIN ASO QUA 300 86060 53 N/A Both 208.00 N/A N/A N/A N/A - - 30001300 HC HIV-2 ANTIBODY 300 86702 53 N/A Both 208.00 N/A N/A N/A N/A - - 30001356 HC QUANT OF THERAPEUTIC DRUG 300 80299 53 N/A Both 208.00 N/A N/A N/A N/A - - 30000667 HC FACTOR II 300 85210 53 N/A Both 206.00 N/A N/A N/A N/A - - 30000823 HC IMMUNO INFECTIOUS ANTIBODY QNT 300 86317 53 N/A Both 204.00 N/A N/A N/A N/A - - 30000931 HC PARVO VIRUS AB 300 86747 53 N/A Both 204.00 N/A N/A N/A N/A - - 30000943 HC TOXOPLASMA AB IGM 300 86778 53 N/A Both 204.00 N/A N/A N/A N/A - - 30001043 HC AFB IDENTIFICATION BY MALDI 300 87158 53 N/A Both 203.00 N/A N/A N/A N/A - - 30001338 HC ANAEROBIC ISOLATE IDENT 300 87076 53 N/A Both 203.00 N/A N/A N/A N/A - - 30000316 HC FOLATE RBC 300 82747 53 N/A Both 202.00 N/A N/A N/A N/A - - 30001057 HC SUSCEPT AFB NOCARDIA BY BROTH 300 87186 53 N/A Both 201.00 N/A N/A N/A N/A - - 30001405 HC SUSCEPTIBILITY STUDIES PER AGENT 300 87181 53 N/A Both 201.00 N/A N/A N/A N/A - - 30001219 HC ABO TYPE 300 86900 53 N/A Both 200.00 N/A N/A N/A N/A - - 30000982 HC HEMOLYSINS & AGGL INCUBATED 300 86941 53 N/A Both 200.00 N/A N/A N/A N/A - - 30001088 HC LEGIONELLA PNEUMOPHILA DFA 300 87278 53 N/A Both 200.00 N/A N/A N/A N/A - - 30000031 HC LIDOCAINE 300 80176 53 N/A Both 200.00 N/A N/A N/A N/A - - 30000718 HC HEXAGONAL PHOSPHOLIPID 300 85598 53 N/A Both 199.00 N/A N/A N/A N/A - - 30000030 HC LAMOTRIGINE QUANT 300 80175 53 N/A Both 199.00 N/A N/A N/A N/A - - 30001309 HC SHELL VIAL 300 87254 53 N/A Both 199.00 N/A N/A N/A N/A - - 30000927 HC LEPTOSPIRA ANTIBODY 300 86720 53 N/A Both 195.00 N/A N/A N/A N/A - - 30000345 HC GLUCOSE 6 PHOSPHATE DEHYDROGEN 300 82955 53 N/A Both 194.00 N/A N/A N/A N/A - - 30000709 HC LEUKOCYTE ALKALINE PHOSPHATASE 300 85540 53 N/A Both 194.00 N/A N/A N/A N/A - - 30000452 HC INSULIN TOTAL 300 83525 53 N/A Both 193.00 N/A N/A N/A N/A - - 30000485 HC MERCURY BLOOD 300 83825 53 N/A Both 193.00 N/A N/A N/A N/A - - 30000883 HC Q-FEVER AB 300 86638 53 N/A Both 192.00 N/A N/A N/A N/A - - 30000053 HC TOPIRAMATE 300 80201 53 N/A Both 190.00 N/A N/A N/A N/A - - 30000212 HC VITAMIN D 25-HYDROXY CALCIFEDIOL 300 82306 53 N/A Both 190.00 N/A N/A N/A N/A - - 30000301 HC CHYLOMICRON SCREEN BODY FLUID 300 82664 53 N/A Both 189.00 N/A N/A N/A N/A - - 30000171 HC ALPHA 1 ANTITRYPSIN PHENOTYPE 300 82104 53 N/A Both 188.00 N/A N/A N/A N/A - - 30000170 HC ALPHA-1-ANTITRYPSIN 300 82103 53 N/A Both 188.00 N/A N/A N/A N/A - - 30000672 HC FACTORVIII REFLEX BETH ASSAY 300 85240 53 N/A Both 188.00 N/A N/A N/A N/A - - 30000385 HC GLUTAMIC ACID DECARBOXYLASE 300 83516 53 N/A Both 188.00 N/A N/A N/A N/A - - 30000013 HC HEPATITIS PANEL ACUTE W/REFLEX 300 80074 53 N/A Both 188.00 N/A N/A N/A N/A - - 30000467 HC LIPOPROTEIN A 300 83695 53 N/A Both 188.00 N/A N/A N/A N/A - - 30000693 HC APC RESISTANCE PROFILE 300 85307 53 N/A Both 186.00 N/A N/A N/A N/A - - 30000166 HC ALDOLASE 300 82085 53 N/A Both 185.00 N/A N/A N/A N/A - - 30000434 HC ANTIMULLERIAN HORMONE AMH 300 83520 53 N/A Both 185.00 N/A N/A N/A N/A - - 30000057 HC DIGITOXIN 300 80299 53 N/A Both 185.00 N/A N/A N/A N/A - - 30000356 HC HAPTOGLOBIN QNT 300 83010 53 N/A Both 185.00 N/A N/A N/A N/A - - 30000495 HC KAPPA/LAMBDA FREE LIGHT CHAIN 300 83883 53 N/A Both 185.00 N/A N/A N/A N/A - - 30000223 HC KIDNEY STONE ANALYSIS 300 82365 53 N/A Both 184.00 N/A N/A N/A N/A - - 30000515 HC PHENCYCLIDINE CONFIRM URI 300 83992 53 N/A Both 184.00 N/A N/A N/A N/A - - 30001289 HC ASPERGILLUS ANTIBODY 300 86606 53 N/A Both 177.00 N/A N/A N/A N/A - - 30000673 HC PLASMINOGEN 300 85240 53 N/A Both 177.00 N/A N/A N/A N/A - - 30000675 HC VWF RISTOCETIN COFACTOR 300 85245 53 N/A Both 177.00 N/A N/A N/A N/A - - 30001358 HC PLATELET ANTIBODIES 300 86022 53 N/A Both 175.00 N/A N/A N/A N/A - - 30000377 HC 5 HIAA HYDROXYINDOLACETIC ACID 300 83497 53 N/A Both 173.00 N/A N/A N/A N/A - - 30000461 HC LD ISOENZYMES 300 83625 53 N/A Both 173.00 N/A N/A N/A N/A - - 30000470 HC LDL CHOLESTEROL DIRECT 300 83721 53 N/A Both 173.00 N/A N/A N/A N/A - - 30001134 HC HIV-1 QUANT 300 87536 53 N/A Both 169.00 N/A N/A N/A N/A - - 30000028 HC GABAPENTIN/NEURONTIN QUANT 300 80171 53 N/A Both 168.00 N/A N/A N/A N/A - - 30000492 HC MYOGLOBIN 300 83874 53 N/A Both 168.00 N/A N/A N/A N/A - - 30000612 HC TRIIODOTHYRONINE T3 TOTAL 300 84480 53 N/A Both 168.00 N/A N/A N/A N/A - - 30000167 HC ALDOSTERONE URINE 300 82088 53 N/A Both 166.00 N/A N/A N/A N/A - - 30000878 HC CANIDIA AB BY ID 300 86628 53 N/A Both 166.00 N/A N/A N/A N/A - - 30001313 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 53 N/A Both 166.00 N/A N/A N/A N/A - - 30001335 HC MYCOBACTERIA TB AMPLIF PROBE 300 87556 53 N/A Both 166.00 N/A N/A N/A N/A - - 30000564 HC VITAMIN B6 300 84207 53 N/A Both 166.00 N/A N/A N/A N/A - - 30000954 HC SIM NOMBRE VIRUS 300 86790 53 N/A Both 165.00 N/A N/A N/A N/A - - 30000049 HC SIROLIMUS 300 80195 53 N/A Both 164.00 N/A N/A N/A N/A - - 30000792 HC ANCA 300 86255 53 N/A Both 163.00 N/A N/A N/A N/A - - 30000044 HC PROCAINAMIDE & NAPA 300 80192 53 N/A Both 163.00 N/A N/A N/A N/A - - 30000290 HC CYANIDE 300 82600 53 N/A Both 161.00 N/A N/A N/A N/A - - 30001016 HC LEGIONELLA CULTURE 300 87081 53 N/A Both 161.00 N/A N/A N/A N/A - - 30001444 HC WESTERN BLOT TEST 300 84182 53 N/A Both 161.00 N/A N/A N/A N/A - - 30000074 HC ITRACONAZOLE 300 80299 53 N/A Both 160.00 N/A N/A N/A N/A - - 30000628 HC VITAMIN A 300 84590 53 N/A Both 160.00 N/A N/A N/A N/A - - 30000011 HC LIPID PANEL 300 80061 53 N/A Both 158.00 N/A N/A N/A N/A - - 30000783 HC COMPLEMNT ANTIGEN EA COMPONENT 300 86160 53 N/A Both 157.00 N/A N/A N/A N/A - - 30000929 HC MUMPS 300 86735 53 N/A Both 157.00 N/A N/A N/A N/A - - 30000528 HC PBG URINE 300 84110 53 N/A Both 157.00 N/A N/A N/A N/A - - 30000105 HC PENTOBARB 300 80345 53 N/A Both 157.00 N/A N/A N/A N/A - - 30000569 HC RENIN ACTIVITY 300 84244 53 N/A Both 157.00 N/A N/A N/A N/A - - 30000717 HC BILL PNP 300 85597 53 N/A Both 156.00 N/A N/A N/A N/A - - 30000254 HC COLLAGEN CROSS LINKS URINE 300 82523 53 N/A Both 156.00 N/A N/A N/A N/A - - 30001023 HC CULTURE MYCOPLASMA 300 87109 53 N/A Both 156.00 N/A N/A N/A N/A - - 30000852 HC ABSOLUTE CD4/CD8 COUNT W/RATIO 300 86360 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000233 HC CHEMILUMINESCENT ASSAY 300 82397 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000100 HC DESIPRAMINE 300 80335 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000893 HC EBV AB TO VIRAL CAPSID AG 300 86665 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000900 HC HELICOBACTER PYLORI AB IGG 300 86677 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000839 HC INTRINSIC FACTOR BLOCKING AB 300 86340 53 N/A Both 155.00 N/A N/A N/A N/A - - 31000024 HC LYMPH SUBSET PAN 4 MARKER 1 311 88184 53 N/A Both 155.00 N/A N/A N/A N/A - - 31000076 HC MARKER EACH ADDL 311 88185 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000687 HC PROTEIN C TOTAL AG 300 85302 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000689 HC PROTEIN S TOTAL AG 300 85305 53 N/A Both 155.00 N/A N/A N/A N/A - - 31000025 HC T-CELL IMMUNODEFIC MARKER 1 311 88184 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000851 HC TCELL TOTAL COUNT 300 86359 53 N/A Both 155.00 N/A N/A N/A N/A - - 30000599 HC THYROXINE BINDING GLOBULIN 300 84442 53 N/A Both 155.00 N/A N/A N/A N/A - - 30001272 HC CYTOKINE 300 83520 53 N/A Both 154.00 N/A N/A N/A N/A - - 30001285 HC LYMPHOCYTE TRANSFORMATION 300 86353 53 N/A Both 154.00 N/A N/A N/A N/A - - 30000815 HC CANCER ANTIGEN BREAST CA15-3 300 86300 53 N/A Both 153.00 N/A N/A N/A N/A - - 30000035 HC TRILEPTAL/OXCARBAZEPINE QUANT 300 80183 53 N/A Both 153.00 N/A N/A N/A N/A - - 30000154 HC BETA-HYDROXBUTYRIC ACID 300 82010 53 N/A Both 152.00 N/A N/A N/A N/A - - 30001283 HC FLUORESCENT NONINFECT AB TITER 300 86256 53 N/A Both 152.00 N/A N/A N/A N/A - - 30000371 HC HEMOGLOBIN URINE 300 83069 53 N/A Both 150.00 N/A N/A N/A N/A - - 30000508 HC OXALATE 300 83945 53 N/A Both 147.00 N/A N/A N/A N/A - - 30000205 HC BIOTINIDASE 300 82261 53 N/A Both 145.00 N/A N/A N/A N/A - - 30001477 "HC ALLERGENS, FOOD, NUTS" 300 86003 53 N/A Both 144.00 N/A N/A N/A N/A - - 30000393 HC MYELOPEROXIDASE MPO 300 83516 53 N/A Both 144.00 N/A N/A N/A N/A - - 30000394 HC PROTEASE 3 AB PR3 300 83516 53 N/A Both 144.00 N/A N/A N/A N/A - - 30000161 HC ALBUMIN CSF 300 82042 53 N/A Both 143.00 N/A N/A N/A N/A - - 30000376 HC HOMOVANILLIC ACID HVA 300 83150 53 N/A Both 143.00 N/A N/A N/A N/A - - 30000252 HC CITRIC ACID URINE 300 82507 53 N/A Both 142.00 N/A N/A N/A N/A - - 30000840 HC HEP BE ANTIBODY 300 86340 53 N/A Both 142.00 N/A N/A N/A N/A - - 30000918 HC HEPATITIS B CORE AB IGM 300 86705 53 N/A Both 142.00 N/A N/A N/A N/A - - 30000634 HC ZINC 300 84630 53 N/A Both 142.00 N/A N/A N/A N/A - - 30000293 HC DHEA SULFATE 300 82627 53 N/A Both 139.00 N/A N/A N/A N/A - - 30000424 HC IMMUNO ANALYTE QUANT 300 83520 53 N/A Both 138.00 N/A N/A N/A N/A - - 30000417 HC 21-HYDROXYLASE ANTIBODIES 300 83519 53 N/A Both 137.00 N/A N/A N/A N/A - - 30000292 HC DHEA 300 82626 53 N/A Both 135.00 N/A N/A N/A N/A - - 30000568 HC ACETYLCHOLINE AB 300 84238 53 N/A Both 134.00 N/A N/A N/A N/A - - 30000256 HC CORTISOL FREE 300 82530 53 N/A Both 134.00 N/A N/A N/A N/A - - 30000489 HC METANEPHRINES URINE FRACT 300 83835 53 N/A Both 134.00 N/A N/A N/A N/A - - 30000468 HC NMR LIPOPROFILE 300 83704 53 N/A Both 134.00 N/A N/A N/A N/A - - 30000936 HC ROCKY MTN SPOTTED FEVER AB 300 86757 53 N/A Both 134.00 N/A N/A N/A N/A - - 30000949 HC WEST NILE VIRUS AB 300 86789 53 N/A Both 134.00 N/A N/A N/A N/A - - 30000948 HC WEST NILE VIRUS IGM AB 300 86788 53 N/A Both 134.00 N/A N/A N/A N/A - - 30000125 HC BCR ABL 1 GENE MAJOR BP R 300 81206 53 N/A Both 133.00 N/A N/A N/A N/A - - 30000126 HC BCR ABL 1 GENE MINOR BP R 300 81207 53 N/A Both 133.00 N/A N/A N/A N/A - - 30001460 HC BCR ABL1 OTHER BREAKPOINT 300 81208 53 N/A Both 133.00 N/A N/A N/A N/A - - 30000279 HC CK ISOENZYMES 300 82552 53 N/A Both 133.00 N/A N/A N/A N/A - - 30000635 HC C-PEPTIDE 300 84681 53 N/A Both 131.00 N/A N/A N/A N/A - - 30000892 HC EBV AB TO NUCLEAR AG IGG 300 86664 53 N/A Both 131.00 N/A N/A N/A N/A - - 30000891 HC EBV IGG AB TO EARLY AG 300 86663 53 N/A Both 131.00 N/A N/A N/A N/A - - 30000391 HC IMMUNOASSAY QUANTITATIVE 300 83516 53 N/A Both 131.00 N/A N/A N/A N/A - - 30000551 HC PROTEIN ELECTROPHORESIS CSF 300 84157 53 N/A Both 131.00 N/A N/A N/A N/A - - 30000608 HC TRANSFERRIN 300 84466 53 N/A Both 131.00 N/A N/A N/A N/A - - 30000778 HC CARDIOLIPIN AB EACH CLASS 300 86147 53 N/A Both 130.00 N/A N/A N/A N/A - - 30000776 HC CRP CARDIO 300 86141 53 N/A Both 130.00 N/A N/A N/A N/A - - 30000462 HC LEAD 300 83655 53 N/A Both 130.00 N/A N/A N/A N/A - - 30000711 HC LYSOZYME URINE 300 85549 53 N/A Both 130.00 N/A N/A N/A N/A - - 30000378 HC 17 HYDROXYPROGESTERONE 300 83498 53 N/A Both 129.00 N/A N/A N/A N/A - - 30000311 HC FECAL FAT QUANTITATIVE 300 82710 53 N/A Both 129.00 N/A N/A N/A N/A - - 30001267 HC IMMUNOGLOBULIN E 300 82785 53 N/A Both 129.00 N/A N/A N/A N/A - - 30001462 HC PHOSPHATASE ALKALINE ISOENZYMES 300 84080 53 N/A Both 129.00 N/A N/A N/A N/A - - 30001304 HC THYROGLOBULIN AB 300 86800 53 N/A Both 129.00 N/A N/A N/A N/A - - 30001080 HC TISS CULT DEFINITIVE ID 300 87253 53 N/A Both 129.00 N/A N/A N/A N/A - - 30000947 HC VARICELLA ZOSTER AB 300 86787 53 N/A Both 129.00 N/A N/A N/A N/A - - 30001081 HC VIRUS ISOLATION SHELL VIAL 300 87254 53 N/A Both 129.00 N/A N/A N/A N/A - - 30001078 HC VIRUS ISOLATION TISSUE CULTURE 300 87252 53 N/A Both 129.00 N/A N/A N/A N/A - - 30000957 HC HEP C AB WITH REFLEX TO RIBA 300 86803 53 N/A Both 127.00 N/A N/A N/A N/A - - 30001326 HC HIV-1 ANTIBODY 300 86701 53 N/A Both 127.00 N/A N/A N/A N/A - - 30000914 HC HIV-2 ANTIBODY 300 86702 53 N/A Both 127.00 N/A N/A N/A N/A - - 30001481 "HC ALLERGENS, FOOD, SHELL FISH PROFILE" 300 86003 53 N/A Both 126.00 N/A N/A N/A N/A - - 30000787 HC DNASE B ANTIBODY 300 86215 53 N/A Both 126.00 N/A N/A N/A N/A - - 30001301 HC LEPTOSPIRA AB 300 86720 53 N/A Both 126.00 N/A N/A N/A N/A - - 30000094 HC ALCOHOL 300 80320 53 N/A Both 125.00 N/A N/A N/A N/A - - 30000018 HC CAFFEINE 300 80155 53 N/A Both 125.00 N/A N/A N/A N/A - - 30000079 HC COMP DRUG SCREEN NONFOR URINE 300 80307 53 N/A Both 125.00 N/A N/A N/A N/A - - 30001470 HC SARS-COV-2 BY PCR 300 87635 53 N/A Both 125.00 N/A N/A N/A N/A - - 30000611 HC T3 UPTAKE 300 84479 53 N/A Both 125.00 N/A N/A N/A N/A - - 30001240 HC FLOW CYTOMETRY OR DNA ANALYSIS 300 88182 53 N/A Both 123.00 N/A N/A N/A N/A - - 30000917 HC HEP B CORE AB - TOTAL 300 86704 53 N/A Both 123.00 N/A N/A N/A N/A - - 30000410 HC IMMUNO ANALYTE QUANT BY RIA 300 83519 53 N/A Both 123.00 N/A N/A N/A N/A - - 30000804 HC ANCA TITER 300 86256 53 N/A Both 121.00 N/A N/A N/A N/A - - 30000696 HC FIBRINOGEN DEGRAD PRODUCT 300 85362 53 N/A Both 121.00 N/A N/A N/A N/A - - 30000563 HC PROINSULIN 300 84206 53 N/A Both 121.00 N/A N/A N/A N/A - - 30000582 HC ADA SPECTROPHOTOMERY ANALYTE 300 84311 53 N/A Both 120.00 N/A N/A N/A N/A - - 30000386 HC IMMUN FOR AN OTH INF AB OR AG 300 83516 53 N/A Both 120.00 N/A N/A N/A N/A - - 30000930 HC MYCOPLASMA PNEUMONIA AB 300 86738 53 N/A Both 120.00 N/A N/A N/A N/A - - 30000876 HC BRUCELLA ANTIBODY 300 86622 53 N/A Both 119.00 N/A N/A N/A N/A - - 30000321 HC GAMMAGLOB IGA/IGG/IGM EACH 300 82784 53 N/A Both 119.00 N/A N/A N/A N/A - - 30001302 HC MUMPS 300 86735 53 N/A Both 119.00 N/A N/A N/A N/A - - 30000855 HC LIVER KIDNEY MICROSOME-1AB IGG 300 86376 53 N/A Both 118.00 N/A N/A N/A N/A - - 30000497 HC NEPHELOMETRY ANALYTE 300 83883 53 N/A Both 118.00 N/A N/A N/A N/A - - 30000627 HC VASOPRESSIN ADH 300 84588 53 N/A Both 118.00 N/A N/A N/A N/A - - 30000867 HC VDRL CSF WITH REFLEX TO TITER 300 86592 53 N/A Both 118.00 N/A N/A N/A N/A - - 30001092 HC ADENOVIRUS 40-41 300 87301 53 N/A Both 117.00 N/A N/A N/A N/A - - 30001105 HC HIV-1 AGS W/HIV-1 HIV-2 ABS 300 87389 53 N/A Both 117.00 N/A N/A N/A N/A - - 30001152 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 53 N/A Both 115.00 N/A N/A N/A N/A - - 30000772 HC ANA AB REFLEX 300 86038 53 N/A Both 114.00 N/A N/A N/A N/A - - 30000916 HC HIV-1 AND HIV-2 ANTIBODIES 300 86703 53 N/A Both 112.00 N/A N/A N/A N/A - - 30000909 HC HSV NON SPECIFIC 300 86694 53 N/A Both 112.00 N/A N/A N/A N/A - - 30001291 HC LYME CONFIRMATORY TEST 300 86617 53 N/A Both 111.00 N/A N/A N/A N/A - - 30000862 HC STREPTOCOCCUS TITER 300 86406 53 N/A Both 111.00 N/A N/A N/A N/A - - 30001234 HC ALCOHOL/ETHANOL CONFIRM 300 80321 53 N/A Both 110.00 N/A N/A N/A N/A - - 30001024 HC CHLAMYDIA CULTURE 300 87110 53 N/A Both 110.00 N/A N/A N/A N/A - - 30001030 HC CULTURE TYPING STAIN 300 87140 53 N/A Both 110.00 N/A N/A N/A N/A - - 30000835 HC IMMUNOFIXATION ELECTROPH URINE 300 86335 53 N/A Both 110.00 N/A N/A N/A N/A - - 30000041 HC PHENYTOIN FREE 300 80186 53 N/A Both 110.00 N/A N/A N/A N/A - - 30000040 HC PHENYTOIN TOTAL 300 80185 53 N/A Both 110.00 N/A N/A N/A N/A - - 30000546 HC PSA FREE 300 84154 53 N/A Both 110.00 N/A N/A N/A N/A - - 30000545 HC PSA TOTAL 300 84153 53 N/A Both 110.00 N/A N/A N/A N/A - - 30001406 HC SUSCEPTIBILITY STUDIES DISK 300 87184 53 N/A Both 110.00 N/A N/A N/A N/A - - 30001478 "HC ALLERGENS, FOOD, FISH PROFILE, IGE" 300 86003 53 N/A Both 108.00 N/A N/A N/A N/A - - 30000951 HC HANTAVIRUS ANTIBODY 300 86790 53 N/A Both 108.00 N/A N/A N/A N/A - - 30000784 HC COMPLEMENT FUNCTIONAL ACTIVITY 300 86161 53 N/A Both 106.00 N/A N/A N/A N/A - - 30000902 HC HELMINTH AB 300 86682 53 N/A Both 106.00 N/A N/A N/A N/A - - 30000782 HC COLD AGGLUTININ TITER 300 86157 53 N/A Both 105.00 N/A N/A N/A N/A - - 30000685 HC CLOT INHIBIT ANTITHROMB 3 ACTV 300 85300 53 N/A Both 103.00 N/A N/A N/A N/A - - 30001293 HC Q-FEVER AB 300 86638 53 N/A Both 103.00 N/A N/A N/A N/A - - 30000848 HC BCELL TOTAL COUNT 300 86355 53 N/A Both 102.00 N/A N/A N/A N/A - - 30000850 HC NK CELLS TOTAL COUNT 300 86357 53 N/A Both 102.00 N/A N/A N/A N/A - - 30001408 HC HEPATITIS C ANTIBODY 300 86803 53 N/A Both 101.00 N/A N/A N/A N/A - - 30001288 HC ASPERGILLUS AB 300 86606 53 N/A Both 100.00 N/A N/A N/A N/A - - 30000777 HC BETA 2 GLYCOPROTEIN 1 AB 300 86146 53 N/A Both 100.00 N/A N/A N/A N/A - - 30000872 HC BLASTOMYCOSIS 300 86612 53 N/A Both 100.00 N/A N/A N/A N/A - - 30001292 HC COCCIDIOIDES ANTIBODY 300 86635 53 N/A Both 100.00 N/A N/A N/A N/A - - 30001297 HC HISTOPLASMA ANTIBODY 300 86698 53 N/A Both 100.00 N/A N/A N/A N/A - - 30000894 HC EHRLICHIA ANTIBODY 300 86666 53 N/A Both 99.00 N/A N/A N/A N/A - - 30000523 HC ALKALINE PHOSPHATASE ISOENZYME 300 84080 53 N/A Both 98.00 N/A N/A N/A N/A - - 30000873 HC BORDETELLA AB 300 86615 53 N/A Both 98.00 N/A N/A N/A N/A - - 30001357 HC NICOTINE METABOLITES URINE 300 80323 53 N/A Both 98.00 N/A N/A N/A N/A - - 30000064 HC AMIODARONE 300 80299 53 N/A Both 96.00 N/A N/A N/A N/A - - 30000195 HC ARSENIC 300 82175 53 N/A Both 96.00 N/A N/A N/A N/A - - 30000101 HC FELBAMATE 300 80339 53 N/A Both 96.00 N/A N/A N/A N/A - - 30001275 HC MERCURY QUANT 300 83825 53 N/A Both 96.00 N/A N/A N/A N/A - - 30001485 HC WESTERN BLOT 300 84182 53 N/A Both 96.00 N/A N/A N/A N/A - - 30200001 HC ALLERGEN QUANT SEMIQUANT EACH 302 86008 53 N/A Both 95.00 N/A N/A N/A N/A - - 30001259 HC NICOTINE & COTININE 300 80307 53 N/A Both 95.00 N/A N/A N/A N/A - - 30001484 "HC AGGLUTININS, EACH ANTIGEN" 300 86000 53 N/A Both 93.00 N/A N/A N/A N/A - - 30000921 HC HEPATITIS A PANEL 300 86708 53 N/A Both 93.00 N/A N/A N/A N/A - - 30000800 HC PARANEOPLASTIC PANEL IFA 300 86255 53 N/A Both 93.00 N/A N/A N/A N/A - - 30000047 HC QUINIDINE 300 80194 53 N/A Both 93.00 N/A N/A N/A N/A - - 30000591 HC THIOCYANATE 300 84430 53 N/A Both 93.00 N/A N/A N/A N/A - - 30000773 HC ANA TITER 300 86039 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000423 HC CYTOKINE 300 83520 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000670 HC FACTOR VIII 300 85240 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000676 HC FACTOR VIII VW FACTOR AG 300 85246 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000678 HC FACTOR VIII VW MULTIMERIC 300 85247 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000796 HC FLUO NONINF AGE ANT SCR EA ANT 300 86255 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000895 HC FRANCISELLA TULARENSIS 300 86668 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000898 HC HELICOBACTER PYLORI AB 300 86677 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000847 HC LYMPHOCYTE TRANSFORMATION 300 86353 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000512 HC PTH-FINE NEEDLE ASPIRATION 300 83970 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000674 HC RISTOCETIN COFACTOR 300 85245 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000940 HC RUBEOLA AB IGG 300 86765 53 N/A Both 92.00 N/A N/A N/A N/A - - 30000107 HC CANNABINOIDS NATURAL 300 80349 53 N/A Both 91.00 N/A N/A N/A N/A - - 30001101 HC HEP B SURF ANT HBSAG NEUTRAL 300 87341 53 N/A Both 91.00 N/A N/A N/A N/A - - 30000922 HC HEPATITIS A ANTIBODY IGM 300 86709 53 N/A Both 90.00 N/A N/A N/A N/A - - 30000465 HC LAMELLAR BODY DENSITY - AFL 300 83664 53 N/A Both 90.00 N/A N/A N/A N/A - - 30000590 HC VITAMIN B1 PLASMA 300 84425 53 N/A Both 89.00 N/A N/A N/A N/A - - 30001117 HC CHLAMYDIA BY AMPLIFIED PROBE 300 87491 53 N/A Both 88.00 N/A N/A N/A N/A - - 30001142 HC N GONORRHOEAE AMPLIFIED PROBE 300 87591 53 N/A Both 88.00 N/A N/A N/A N/A - - 30000172 HC A1A PHENOTYPE 300 82104 53 N/A Both 87.00 N/A N/A N/A N/A - - 30000460 HC LD TOTAL 300 83615 53 N/A Both 87.00 N/A N/A N/A N/A - - 30000595 HC THYROXINE TOTAL 300 84436 53 N/A Both 87.00 N/A N/A N/A N/A - - 30000779 HC ANTIPHOSPHATIDYLSERINE AB 300 86148 53 N/A Both 85.00 N/A N/A N/A N/A - - 30000816 HC IMMUNOASSAY TUMOR ANTIGEN CA19-9 300 86301 53 N/A Both 85.00 N/A N/A N/A N/A - - 30000890 HC ENTEROVIRUS ANTIBODY 300 86658 53 N/A Both 82.00 N/A N/A N/A N/A - - 30001282 HC FLUOR NONINF AGENT TITER EA 300 86256 53 N/A Both 82.00 N/A N/A N/A N/A - - 30001463 HC CITRATE 300 82507 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000884 HC CMV ANTIBODY 300 86644 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000885 HC CYTOMEGALOVIRUS AB IGM 300 86645 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000822 HC IMMUN FOR INF AGENT AB QU NOS 300 86317 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000939 HC RUBELLA IGM 300 86762 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000730 HC THROMBIN TIME 1:1 MIX 300 85670 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000397 HC TITIN ANTIBODY 300 83516 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000944 HC TOXOPLASMA IGM 300 86778 53 N/A Both 80.00 N/A N/A N/A N/A - - 30000686 HC ANTITHROMBIN III AG 300 85301 53 N/A Both 78.00 N/A N/A N/A N/A - - 30001268 HC HGB FRACTION & QUANT ELECTRO 300 83020 53 N/A Both 78.00 N/A N/A N/A N/A - - 30001299 HC HIV-1 ANTIBODY 300 86701 53 N/A Both 78.00 N/A N/A N/A N/A - - 30000514 HC PH SCREEN NOT URINE 300 83986 53 N/A Both 78.00 N/A N/A N/A N/A - - 30001050 HC SUSCEPTIBILITY BETA LACTAMASE 300 87185 53 N/A Both 78.00 N/A N/A N/A N/A - - 30000829 HC TEICHOIC ABB IMMUNODIFFUSION 300 86329 53 N/A Both 78.00 N/A N/A N/A N/A - - 30000230 HC CARNITINE SERUM 300 82379 53 N/A Both 77.00 N/A N/A N/A N/A - - 30000723 HC DILUTE RUSSELL VIPER VENOM 300 85613 53 N/A Both 77.00 N/A N/A N/A N/A - - 30000326 HC IGE 300 82785 53 N/A Both 77.00 N/A N/A N/A N/A - - 30000327 HC IMMUNOGLOBULIN G SUBCLASS 300 82787 53 N/A Both 77.00 N/A N/A N/A N/A - - 30000720 HC PROTHROMBIN TIME 300 85610 53 N/A Both 77.00 N/A N/A N/A N/A - - 30001060 HC SUSCEPTIBILITY STUDIES MIC 300 87186 53 N/A Both 77.00 N/A N/A N/A N/A - - 30000361 HC HEMOGLOBIN EVALUATION 300 83021 53 N/A Both 76.00 N/A N/A N/A N/A - - 30000727 HC SICKLING OF RBC REDUCTION 300 85660 53 N/A Both 76.00 N/A N/A N/A N/A - - 30000946 HC TREPONEMA PALLIDUM 300 86780 53 N/A Both 76.00 N/A N/A N/A N/A - - 30000573 HC SHBG 300 84270 53 N/A Both 75.00 N/A N/A N/A N/A - - 30000588 HC TESTOSTERONE FREE 300 84402 53 N/A Both 75.00 N/A N/A N/A N/A - - 30000589 HC TESTOSTERONE TOTAL 300 84403 53 N/A Both 75.00 N/A N/A N/A N/A - - 30000193 HC APOLIPOPROTEIN EACH 300 82172 53 N/A Both 73.00 N/A N/A N/A N/A - - 30000354 HC GROWTH HORMONE HUMAN 300 83003 53 N/A Both 73.00 N/A N/A N/A N/A - - 30000358 HC HGB ELECTROPHORESIS QUANT ACID 300 83020 53 N/A Both 73.00 N/A N/A N/A N/A - - 30000477 HC MANGANESE 300 83785 53 N/A Both 73.00 N/A N/A N/A N/A - - 30001079 HC IP STAIN 300 87253 53 N/A Both 72.00 N/A N/A N/A N/A - - 30000724 HC REPTILASE TEST 300 85635 53 N/A Both 72.00 N/A N/A N/A N/A - - 30000863 HC RHEUMATOID FACTOR QNT 300 86431 53 N/A Both 72.00 N/A N/A N/A N/A - - 30001276 HC THROMBIN TIME 300 85670 53 N/A Both 72.00 N/A N/A N/A N/A - - 30000789 HC DOUBLE STRANDED DNA 300 86225 53 N/A Both 71.00 N/A N/A N/A N/A - - 30001422 HC INHIBIN A ULTRASENSITIVE 300 86336 53 N/A Both 71.00 N/A N/A N/A N/A - - 30000734 HC PTT SUBSTITUTIONS 300 85732 53 N/A Both 71.00 N/A N/A N/A N/A - - 30000186 HC AMYLASE ISOENZYMES OR TOTAL 300 82150 53 N/A Both 70.00 N/A N/A N/A N/A - - 30001346 HC CRYPTOCOCCUS NEOFORMANS 300 87327 53 N/A Both 70.00 N/A N/A N/A N/A - - 30000554 HC ELCTR FRAC QUA OTH FLUID W CON 300 84166 53 N/A Both 70.00 N/A N/A N/A N/A - - 30000710 HC LYSOZYME MURAMIDASE 300 85549 53 N/A Both 70.00 N/A N/A N/A N/A - - 30000646 HC PHENOLPHTHALEIN STOOL 300 84999 53 N/A Both 70.00 N/A N/A N/A N/A - - 30000860 HC STREPTOZYME W/REFLEX TO TITER 300 86403 53 N/A Both 70.00 N/A N/A N/A N/A - - 30000587 HC SUGARS SINGLE QUALITATIVE 300 84376 53 N/A Both 70.00 N/A N/A N/A N/A - - 30000866 HC SYPHILIS TEST QUALITATIVE 300 86592 53 N/A Both 70.00 N/A N/A N/A N/A - - 30000277 HC CK TOTAL 300 82550 53 N/A Both 69.00 N/A N/A N/A N/A - - 30000023 HC CLOZAPINE/CLOZARIL QUANT 300 80159 53 N/A Both 69.00 N/A N/A N/A N/A - - 30000310 HC FAT STOOL QUAL 300 82705 53 N/A Both 69.00 N/A N/A N/A N/A - - 30001473 HC SARS-COV-2 IGG AB 300 86769 53 N/A Both 69.00 N/A N/A N/A N/A - - 30000797 HC FLUORESCENT NONINFECT AB SCRN 300 86255 53 N/A Both 68.00 N/A N/A N/A N/A - - 30000897 HC FUNGUS AB 300 86671 53 N/A Both 68.00 N/A N/A N/A N/A - - 30001100 HC HEP B SURFACE ANTIGEN HBSAG 300 87340 53 N/A Both 67.00 N/A N/A N/A N/A - - 30000923 HC INFLUENZA A/B VIRUS AB IGG IGM 300 86710 53 N/A Both 66.00 N/A N/A N/A N/A - - 30001464 HC OXALATE URINE 300 83945 53 N/A Both 66.00 N/A N/A N/A N/A - - 30000614 HC T-3 REVERSE 300 84482 53 N/A Both 63.00 N/A N/A N/A N/A - - 30000016 HC AMIKACIN 300 80150 53 N/A Both 62.00 N/A N/A N/A N/A - - 30000362 HC HGB FRACT CHROMATOGRAPHY 300 83021 53 N/A Both 62.00 N/A N/A N/A N/A - - 30000387 HC IMMUNO INFECTIOUS AGENT 300 83516 53 N/A Both 62.00 N/A N/A N/A N/A - - 30000928 HC LYMPHOCYTIC CHORIOMENINGITIS 300 86727 53 N/A Both 61.00 N/A N/A N/A N/A - - 30000593 HC THYROGLOBULIN 300 84432 53 N/A Both 61.00 N/A N/A N/A N/A - - 30000938 HC ANTIBODY RUBELLA 300 86762 53 N/A Both 60.00 N/A N/A N/A N/A - - 30000868 HC BILL VDRLCS 300 86593 53 N/A Both 60.00 N/A N/A N/A N/A - - 30000920 HC HEPATITIS BE ANTIBODY 300 86707 53 N/A Both 60.00 N/A N/A N/A N/A - - 30001487 HC HS TROPONIN T 300 84484 53 N/A Both 60.00 N/A N/A N/A N/A - - 30000733 HC PARTIAL THROMBOPLASTIN PTT 300 85730 53 N/A Both 60.00 N/A N/A N/A N/A - - 30000176 HC ALUMINUM 300 82108 53 N/A Both 59.00 N/A N/A N/A N/A - - 30000099 HC AMITRIPTYLINE 300 80335 53 N/A Both 59.00 N/A N/A N/A N/A - - 30001433 HC FREE AND TOTAL INSULIN (FREE) 300 83527 53 N/A Both 59.00 N/A N/A N/A N/A - - 30001432 HC FREE AND TOTAL INSULIN (TOTAL) 300 83525 53 N/A Both 59.00 N/A N/A N/A N/A - - 30000953 HC HTLV ANTIBODIES 300 86790 53 N/A Both 59.00 N/A N/A N/A N/A - - 30000623 HC URIC ACID URINE 300 84560 53 N/A Both 58.00 N/A N/A N/A N/A - - 30001404 HC AMPHETAMINE 300 80325 53 N/A Both 57.00 N/A N/A N/A N/A - - 30000098 HC AMPHETAMINES 1 OR 2 300 80324 53 N/A Both 57.00 N/A N/A N/A N/A - - 30000108 HC MDA MDEA MDMA 300 80359 53 N/A Both 57.00 N/A N/A N/A N/A - - 30001325 HC DRUG TEST PRESUMPTIVE 300 80307 53 N/A Both 55.00 N/A N/A N/A N/A - - 30000637 HC HCG QUANT 300 84704 53 N/A Both 55.00 N/A N/A N/A N/A - - 30000910 HC HSV TYPE 1 GLYCOPROTEIN G-SPECIFIC ANTIBODY IGG BY CIA (REFLEX) 300 86695 53 N/A Both 55.00 N/A N/A N/A N/A - - 30000476 HC MAGNESIUM STOOL 300 83735 53 N/A Both 55.00 N/A N/A N/A N/A - - 30000644 HC OSMOLALITY STOOL 300 84999 53 N/A Both 55.00 N/A N/A N/A N/A - - 30000649 HC POTASSIUM STOOL 300 84999 53 N/A Both 55.00 N/A N/A N/A N/A - - 30000580 HC SODIUM STOOL 300 84302 53 N/A Both 55.00 N/A N/A N/A N/A - - 30000870 HC ASPERGILLUS ANTIBODY 300 86606 53 N/A Both 54.00 N/A N/A N/A N/A - - 30000227 HC CARCINOEMBRYONIC AG CFA 300 82378 53 N/A Both 54.00 N/A N/A N/A N/A - - 30000830 HC IMMUNODIFFUSION GEL DIFF QUAL 300 86331 53 N/A Both 54.00 N/A N/A N/A N/A - - 30001403 HC NEPHELOMETRY EACH 300 83883 53 N/A Both 54.00 N/A N/A N/A N/A - - 30000869 HC ADENOVIRUS ANTIBODY 300 86603 53 N/A Both 53.00 N/A N/A N/A N/A - - 30001465 HC CALCIUM URINE QUANT TIMED 300 82340 53 N/A Both 53.00 N/A N/A N/A N/A - - 30000372 HC HEMOSIDERIN 300 83070 53 N/A Both 53.00 N/A N/A N/A N/A - - 30000708 HC HEPARIN NEUTRALIZATION 300 85525 53 N/A Both 53.00 N/A N/A N/A N/A - - 30001401 HC IMMUNOFIXATION ELECTRO SERUM 300 86334 53 N/A Both 53.00 N/A N/A N/A N/A - - 30001277 HC THROMBOPLASTIN TIME PTT 300 85730 53 N/A Both 53.00 N/A N/A N/A N/A - - 30000360 HC HEMOGLOBIN FRACTION ELECTROPHO 300 83020 53 N/A Both 52.00 N/A N/A N/A N/A - - 30000824 HC IMMUNO INFECTIOUS QUANT AB 300 86317 53 N/A Both 52.00 N/A N/A N/A N/A - - 30001303 HC TREPONEMA PALLIDUM 300 86780 53 N/A Both 52.00 N/A N/A N/A N/A - - 30000735 HC VISCOSITY 300 85810 53 N/A Both 52.00 N/A N/A N/A N/A - - 30000911 HC HSV TYPE 2 GLYCOPROTEIN G-SPECIFIC ANTIBODY IGG BY CIA (REFLEX) 300 86696 53 N/A Both 51.00 N/A N/A N/A N/A - - 30000912 HC HISTOPLASMA ANTIBODY 300 86698 53 N/A Both 50.00 N/A N/A N/A N/A - - 30000103 HC METHSUXIMIDE 300 80339 53 N/A Both 50.00 N/A N/A N/A N/A - - 30000390 HC IMMUNOASSAY MULT STEP 300 83516 53 N/A Both 49.00 N/A N/A N/A N/A - - 30000322 HC IGG 300 82784 53 N/A Both 47.00 N/A N/A N/A N/A - - 30000871 HC BARTONELLA AB 300 86611 53 N/A Both 45.00 N/A N/A N/A N/A - - 30000880 HC CHLAMYDIA ANTIBODY 300 86631 53 N/A Both 45.00 N/A N/A N/A N/A - - 30000881 HC CHLAMYDIA IGM ANTIBODY 300 86632 53 N/A Both 45.00 N/A N/A N/A N/A - - 30001236 HC OPIATES 1 OR MORE 300 80361 53 N/A Both 45.00 N/A N/A N/A N/A - - 30001323 HC OXYCODONE 300 80365 53 N/A Both 45.00 N/A N/A N/A N/A - - 30001317 HC COCCIDIOIDES ANTIBODIES 300 86635 53 N/A Both 44.00 N/A N/A N/A N/A - - 30001258 HC ALCOHOL ETHANOL SCREEN 300 80307 53 N/A Both 42.00 N/A N/A N/A N/A - - 30001305 HC CONCENTRATION FOR INFECT AGENT 300 87015 53 N/A Both 42.00 N/A N/A N/A N/A - - 30000200 HC BILE ACIDS TOTAL 300 82239 53 N/A Both 40.00 N/A N/A N/A N/A - - 30000296 HC DIBUCAINE INDEX 300 82638 53 N/A Both 39.00 N/A N/A N/A N/A - - 30001428 HC HIV COMBO TEST 300 87389 53 N/A Both 39.00 N/A N/A N/A N/A - - 30000246 HC PSEUDOCHOLINESTERASE 300 82480 53 N/A Both 39.00 N/A N/A N/A N/A - - 30001480 "HC ALLERGENS, EGG COMPONENTS IGE" 300 86008 53 N/A Both 38.00 N/A N/A N/A N/A - - 30001421 HC HERPES SIMPLEX VIRUS TYPE 1-2 ABS IGG W REFLEX TYPE 1-2 GLYCOPROTEIN G-SPECIFIC AB IGG 300 86694 53 N/A Both 38.00 N/A N/A N/A N/A - - 30000729 HC THROMBIN TIME 300 85670 53 N/A Both 37.00 N/A N/A N/A N/A - - 30001479 "HC ALLERGENS, FOOD, EGG COMPONENTS IGE" 300 86003 53 N/A Both 36.00 N/A N/A N/A N/A - - 30001083 HC ADENOVIRUS 300 87260 53 N/A Both 34.00 N/A N/A N/A N/A - - 30000934 HC ENTAMOEBA HISTOLYTICA AB IGG 300 86753 53 N/A Both 34.00 N/A N/A N/A N/A - - 30000359 HC HGB ELECTROPHORESIS QUANT ALK 300 83020 53 N/A Both 34.00 N/A N/A N/A N/A - - 30001091 HC HUMAN METAPNEUMOVIRUS 300 87299 53 N/A Both 34.00 N/A N/A N/A N/A - - 30001086 HC INFLUENZA A 300 87276 53 N/A Both 34.00 N/A N/A N/A N/A - - 30001085 HC INFLUENZA B 300 87275 53 N/A Both 34.00 N/A N/A N/A N/A - - 30001089 HC PARAINFLUENZA 1 2 3 300 87279 53 N/A Both 34.00 N/A N/A N/A N/A - - 30000036 HC PHENOBARBITOL 300 80184 53 N/A Both 34.00 N/A N/A N/A N/A - - 30000043 HC PRIMIDONE 300 80188 53 N/A Both 34.00 N/A N/A N/A N/A - - 30001090 HC RSV 300 87280 53 N/A Both 34.00 N/A N/A N/A N/A - - 30000956 HC THYROGLOBULIN ANTIBODY 300 86800 53 N/A Both 34.00 N/A N/A N/A N/A - - 30000549 HC TOTAL PROTEIN URINE 300 84156 53 N/A Both 34.00 N/A N/A N/A N/A - - 30000520 HC ALKP TOTAL 300 84075 53 N/A Both 31.00 N/A N/A N/A N/A - - 30000790 HC EXTRACTABLE NUCLEAR AG AB 300 86235 53 N/A Both 31.00 N/A N/A N/A N/A - - 30001344 HC RHEUMATOID FACTOR QUANTITATIVE 300 86431 53 N/A Both 30.00 N/A N/A N/A N/A - - 30000185 HC AMYLASE FLUID 300 82150 53 N/A Both 29.00 N/A N/A N/A N/A - - 30001467 HC GAMMAGLOBULIN (IMMUMOGLOB) EACH 300 82784 53 N/A Both 29.00 N/A N/A N/A N/A - - 30000487 HC MERCURY QUANT 300 83825 53 N/A Both 29.00 N/A N/A N/A N/A - - 30000739 HC ALLERGEN SPECIFIC IGE EACH 300 86003 53 N/A Both 28.00 N/A N/A N/A N/A - - 30001345 HC SPECTROPHOTOMETRY 300 84311 53 N/A Both 28.00 N/A N/A N/A N/A - - 30000350 HC FRUCTOSAMINE 300 82985 53 N/A Both 27.00 N/A N/A N/A N/A - - 30000365 HC HGB F FETAL QUAL 300 83033 53 N/A Both 27.00 N/A N/A N/A N/A - - 30001352 HC LIPASE 300 83690 53 N/A Both 26.00 N/A N/A N/A N/A - - 30001342 HC ALBUMIN SERUM PLASMA WB 300 82040 53 N/A Both 25.00 N/A N/A N/A N/A - - 30001343 HC ALBUMIN URINE/OTHER QUANT EACH 300 82042 53 N/A Both 25.00 N/A N/A N/A N/A - - 30001351 HC BILIRUBIN TOTAL 300 82247 53 N/A Both 24.00 N/A N/A N/A N/A - - 30001324 HC CERULOPLASMIN 300 82390 53 N/A Both 24.00 N/A N/A N/A N/A - - 30000991 HC CONCENTRATION FOR INFECT AGENT 300 87015 53 N/A Both 24.00 N/A N/A N/A N/A - - 30001073 HC SPECIAL STAIN FOR INCLUSIONS 300 87207 53 N/A Both 24.00 N/A N/A N/A N/A - - 30000616 HC UREA NITROGEN FLUID 300 84520 53 N/A Both 21.00 N/A N/A N/A N/A - - 30001400 HC PROTEIN ELECTROPHORETIC FRAC QUANT 300 84165 53 N/A Both 20.00 N/A N/A N/A N/A - - 30001399 HC PROTEIN TOTAL 300 84160 53 N/A Both 20.00 N/A N/A N/A N/A - - 30000547 HC PROTEIN TOTAL SERUM 300 84155 53 N/A Both 20.00 N/A N/A N/A N/A - - 30001466 HC CRYOGLOBULIN QUAL OR SEMI QUANT 300 82595 53 N/A Both 19.00 N/A N/A N/A N/A - - 30000738 HC ALLERGEN SPECIFIC - IGE 300 86003 53 N/A Both 18.00 N/A N/A N/A N/A - - 30001402 HC GAMMAGLOBULIN EACH 300 82784 53 N/A Both 14.00 N/A N/A N/A N/A - - 30000825 HC IMMUNOA INFEC AGENT AB QUANT 300 86317 53 N/A Both 7.00 N/A N/A N/A N/A - - 30001441 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS 300 81420 54 N/A Both " 1,388.00 " N/A N/A N/A N/A - - 30000613 HC TRIIODOTHYRONINE T3 FREE 300 84481 54 N/A Both 454.00 N/A N/A N/A N/A - - 30000357 HC HELICOBACTER PLYORI BREATH TST 300 83013 54 N/A Both 388.00 N/A N/A N/A N/A - - 30000013 HC HEPATITIS PANEL ACUTE W/REFLEX 300 80074 54 N/A Both 376.00 N/A N/A N/A N/A - - 30000050 HC TACROLIMUS 300 80197 54 N/A Both 356.00 N/A N/A N/A N/A - - 30000501 HC OLIGOCLONAL IMMUNE OLIG BANDS 300 83916 54 N/A Both 325.00 N/A N/A N/A N/A - - 30000679 HC FACTOR IX PTC OR CHRISTMAS 300 85250 54 N/A Both 322.00 N/A N/A N/A N/A - - 30000680 HC FACTOR X STUART-PROWER 300 85260 54 N/A Both 322.00 N/A N/A N/A N/A - - 30000671 HC FACTOR VIII AHG ONE STAGE 300 85240 54 N/A Both 318.00 N/A N/A N/A N/A - - 30000464 HC FETAL LUNG MATURITY FLUOR POLR 300 83663 54 N/A Both 316.00 N/A N/A N/A N/A - - 30000817 HC IMMUNOASSAY TUMOR ANTIGEN CA 125 300 86304 54 N/A Both 301.00 N/A N/A N/A N/A - - 30000174 HC ALPHA-FETOPROTEIN SERUM 300 82105 54 N/A Both 298.00 N/A N/A N/A N/A - - 30000918 HC HEPATITIS B CORE AB IGM 300 86705 54 N/A Both 284.00 N/A N/A N/A N/A - - 30000688 HC CLOT INHIB ANTICOAG PROTEIN C 300 85303 54 N/A Both 281.00 N/A N/A N/A N/A - - 30000816 HC IMMUNOASSAY TUMOR ANTIGEN CA19-9 300 86301 54 N/A Both 278.00 N/A N/A N/A N/A - - 30001216 HC IMMUNOASSAY TUMOR ANTIGEN QNT 300 86300 54 N/A Both 278.00 N/A N/A N/A N/A - - 30000834 HC IMMUNOFIX ELECTRO OTHER FLUID 300 86335 54 N/A Both 265.00 N/A N/A N/A N/A - - 30000832 HC IMMUNOFIXATION ELECTROPHORESIS 300 86334 54 N/A Both 265.00 N/A N/A N/A N/A - - 30000510 HC PARATHORMONE PTH 300 83970 54 N/A Both 235.00 N/A N/A N/A N/A - - 30000228 HC CARCINOEMBRYONIC ANTIGEN CEA 300 82378 54 N/A Both 220.00 N/A N/A N/A N/A - - 30000041 HC PHENYTOIN FREE 300 80186 54 N/A Both 220.00 N/A N/A N/A N/A - - 30000589 HC TESTOSTERONE TOTAL 300 84403 54 N/A Both 218.00 N/A N/A N/A N/A - - 30000958 HC HEPATITIS C AB 300 86803 54 N/A Both 204.00 N/A N/A N/A N/A - - 30000305 HC ESTRADIOL 300 82670 54 N/A Both 194.00 N/A N/A N/A N/A - - 30000452 HC INSULIN TOTAL 300 83525 54 N/A Both 193.00 N/A N/A N/A N/A - - 30000356 HC HAPTOGLOBIN QNT 300 83010 54 N/A Both 185.00 N/A N/A N/A N/A - - 30001442 HC FETAL CHROMOSOMAL MICRODELTJ GENOMIC SEQ ANALYS 300 81422 54 N/A Both 183.00 N/A N/A N/A N/A - - 30000685 HC CLOT INHIBIT ANTITHROMB 3 ACTV 300 85300 54 N/A Both 172.00 N/A N/A N/A N/A - - 30000351 HC GONADOTROPIN FOLL STIM HORMONE 300 83001 54 N/A Both 172.00 N/A N/A N/A N/A - - 30000352 HC GONADOTROPIN LUTEINIZING HORM 300 83002 54 N/A Both 172.00 N/A N/A N/A N/A - - 30000612 HC TRIIODOTHYRONINE T3 TOTAL 300 84480 54 N/A Both 168.00 N/A N/A N/A N/A - - 30001117 HC CHLAMYDIA BY AMPLIFIED PROBE 300 87491 54 N/A Both 165.00 N/A N/A N/A N/A - - 30001142 HC N GONORRHOEAE AMPLIFIED PROBE 300 87591 54 N/A Both 165.00 N/A N/A N/A N/A - - 30000919 HC HEP B SURFACE ANTIBODY HBSAB 300 86706 54 N/A Both 153.00 N/A N/A N/A N/A - - 30001100 HC HEP B SURFACE ANTIGEN HBSAG 300 87340 54 N/A Both 134.00 N/A N/A N/A N/A - - 30000608 HC TRANSFERRIN 300 84466 54 N/A Both 131.00 N/A N/A N/A N/A - - 30000232 HC CERULOPLASMIN 300 82390 54 N/A Both 131.00 N/A N/A N/A N/A - - 30000776 HC CRP CARDIO 300 86141 54 N/A Both 130.00 N/A N/A N/A N/A - - 30000058 HC QUANTITATION OF DRUG NES 300 80299 54 N/A Both 129.00 N/A N/A N/A N/A - - 30001470 HC SARS-COV-2 BY PCR 300 87635 54 N/A Both 125.00 N/A N/A N/A N/A - - 30000553 HC PROTEIN ELECTRO OTHER FLUID 300 84166 54 N/A Both 123.00 N/A N/A N/A N/A - - 30000552 HC PROTEIN ELECTROPH FRACTION QNT 300 84165 54 N/A Both 123.00 N/A N/A N/A N/A - - 30000930 HC MYCOPLASMA PNEUMONIA AB 300 86738 54 N/A Both 120.00 N/A N/A N/A N/A - - 30000321 HC GAMMAGLOB IGA/IGG/IGM EACH 300 82784 54 N/A Both 119.00 N/A N/A N/A N/A - - 30001101 HC HEP B SURF ANT HBSAG NEUTRAL 300 87341 54 N/A Both 119.00 N/A N/A N/A N/A - - 30000498 HC NEPHELOMETRY EACH ANALYTE NES 300 83883 54 N/A Both 118.00 N/A N/A N/A N/A - - 30000465 HC LAMELLAR BODY DENSITY - AFL 300 83664 54 N/A Both 110.00 N/A N/A N/A N/A - - 30000783 HC COMPLEMNT ANTIGEN EA COMPONENT 300 86160 54 N/A Both 99.00 N/A N/A N/A N/A - - 30000366 HC HGB A1C 300 83036 54 N/A Both 92.00 N/A N/A N/A N/A - - 30000458 HC LACTIC DEHYDROGENAS FLUID 300 83615 54 N/A Both 73.00 N/A N/A N/A N/A - - 30000863 HC RHEUMATOID FACTOR QNT 300 86431 54 N/A Both 72.00 N/A N/A N/A N/A - - 30000454 HC IRON BINDING CAPACITY 300 83550 54 N/A Both 71.00 N/A N/A N/A N/A - - 30000455 HC LACTATE 300 83605 54 N/A Both 71.00 N/A N/A N/A N/A - - 30000866 HC SYPHILIS TEST QUALITATIVE 300 86592 54 N/A Both 70.00 N/A N/A N/A N/A - - 30000938 HC ANTIBODY RUBELLA 300 86762 54 N/A Both 60.00 N/A N/A N/A N/A - - 30000549 HC TOTAL PROTEIN URINE 300 84156 54 N/A Both 59.00 N/A N/A N/A N/A - - 30000547 HC PROTEIN TOTAL SERUM 300 84155 54 N/A Both 59.00 N/A N/A N/A N/A - - 30000159 HC ALBUMIN 300 82040 54 N/A Both 59.00 N/A N/A N/A N/A - - 30000160 HC ALBUMIN URINE/OTHR QNT EA SPEC 300 82042 54 N/A Both 59.00 N/A N/A N/A N/A - - 30000453 HC IRON 300 83540 54 N/A Both 57.00 N/A N/A N/A N/A - - 30000162 HC MICROALBUMIN URINE QUANTITATIVE 300 82043 54 N/A Both 52.00 N/A N/A N/A N/A - - 30000586 HC SPEC GRAVITY EXCL URINE 300 84315 54 N/A Both 52.00 N/A N/A N/A N/A - - 30000284 HC URINE CREATININE TIMED 300 82570 54 N/A Both 31.00 N/A N/A N/A N/A - - 30000286 HC CREATININE OTHER SOURCE 300 82570 54 N/A Both 29.00 N/A N/A N/A N/A - - 30000826 HC IMMUNOA INFECT AGENT AB QUANT 300 86317 55 N/A Both 7.00 N/A N/A N/A N/A - - 30000827 HC IMMUNOASSAY INFECT AGENT AB 300 86317 55 N/A Both 26.00 N/A N/A N/A N/A - - 30001447 HC FLUORESCENT NONINF AGENT AB 300 86255 55 N/A Both 36.00 N/A N/A N/A N/A - - 30001205 HC FLOW CYTOMETRY EA ADDIT MARKER 300 88185 55 N/A Both 39.00 N/A N/A N/A N/A - - 30001167 HC FLOW CYTOMETRY RBC MARKER 1 300 88184 55 N/A Both 39.00 N/A N/A N/A N/A - - 30001168 HC FLOW CYTOMETRY WBC MARKER 1 300 88184 55 N/A Both 39.00 N/A N/A N/A N/A - - 30000425 HC IMMUNOASSAY ANALYTE QUANT 300 83520 55 N/A Both 45.00 N/A N/A N/A N/A - - 30000411 HC IMMUNOASSAY QUANT BY RIA 300 83519 55 N/A Both 49.00 N/A N/A N/A N/A - - 30000323 HC IGA 300 82784 55 N/A Both 50.00 N/A N/A N/A N/A - - 30001008 HC ADDITIONAL ID PROCEDURE 300 87077 55 N/A Both 51.00 N/A N/A N/A N/A - - 30001283 HC FLUORESCENT NONINFECT AB TITER 300 86256 55 N/A Both 54.00 N/A N/A N/A N/A - - 30000399 HC CENTROMERE AB IGG 300 83516 55 N/A Both 59.00 N/A N/A N/A N/A - - 30001056 HC MIC PANEL 300 87186 55 N/A Both 60.00 N/A N/A N/A N/A - - 30001011 HC CULTURE AEROBIC ID 300 87077 55 N/A Both 60.00 N/A N/A N/A N/A - - 30000262 HC COLUMN CHROMATOGRAPHY EACH SP 300 82542 55 N/A Both 61.00 N/A N/A N/A N/A - - 30000396 HC TISSUE TRANSGLUT IGA OR IGG 300 83516 55 N/A Both 62.00 N/A N/A N/A N/A - - 30000500 HC OLIGOCLONAL BANDS 300 83916 55 N/A Both 64.00 N/A N/A N/A N/A - - 30001350 HC LACTATE 300 83605 55 N/A Both 72.00 N/A N/A N/A N/A - - 30000586 HC SPEC GRAVITY EXCL URINE 300 84315 55 N/A Both 73.00 N/A N/A N/A N/A - - 30000289 HC ASSAY OF CRYOGLOBULIN 300 82595 55 N/A Both 76.00 N/A N/A N/A N/A - - 30001278 HC EXTRACTABLE NUCLEAR AG AB 300 86235 55 N/A Both 76.00 N/A N/A N/A N/A - - 30000430 HC NEURON-SPECIFIC ENOLASE 300 83520 55 N/A Both 76.00 N/A N/A N/A N/A - - 30000843 HC ISLET CELL ANTIBODY 300 86341 55 N/A Both 77.00 N/A N/A N/A N/A - - 30000288 HC CRYOFIBRINOGEN 300 82585 55 N/A Both 82.00 N/A N/A N/A N/A - - 30000384 HC DEAMINATED GLIADEN IGA OR IGG 300 83516 55 N/A Both 82.00 N/A N/A N/A N/A - - 30001271 HC IMMUNOASSAY QUANT BY RIA 300 83519 55 N/A Both 82.00 N/A N/A N/A N/A - - 30001279 HC FLUO NONINF AGE ANT SCR EA ANT 300 86255 55 N/A Both 89.00 N/A N/A N/A N/A - - 30001333 HC CULTURE FUNGI ID MOLD 300 87107 55 N/A Both 90.00 N/A N/A N/A N/A - - 30001306 HC CULTURE FUNGI ID YEAST 300 87106 55 N/A Both 90.00 N/A N/A N/A N/A - - 30001009 HC AEROBIC ID 300 87077 55 N/A Both 92.00 N/A N/A N/A N/A - - 30001010 HC AEROBIC ISOLATE - EACH ISOLATE 300 87077 55 N/A Both 92.00 N/A N/A N/A N/A - - 30000788 HC DNA ANTIBODY 300 86225 55 N/A Both 92.00 N/A N/A N/A N/A - - 31000074 HC FLOW CYT CELL SURF EACH ADDL 311 88185 55 N/A Both 92.00 N/A N/A N/A N/A - - 31000098 HC FLOW CYT NUCLEAR MARKER 1 311 88184 55 N/A Both 92.00 N/A N/A N/A N/A - - 30000636 HC GONADOTROPIN CHORONC HCG QUANT 300 84702 55 N/A Both 96.00 N/A N/A N/A N/A - - 30000836 HC INHIBIN A 300 86336 55 N/A Both 96.00 N/A N/A N/A N/A - - 30000173 HC ALPHA-FETOPROTEIN AFP 300 82105 55 N/A Both 103.00 N/A N/A N/A N/A - - 30000810 HC FLUORESCENT NONINFECT AB TITER 300 86256 55 N/A Both 106.00 N/A N/A N/A N/A - - 30001473 HC SARS-COV-2 IGG AB 300 86769 55 N/A Both 107.00 N/A N/A N/A N/A - - 30001048 HC SUSCEPTIBILITY STUDIES 300 87181 55 N/A Both 109.00 N/A N/A N/A N/A - - 30000780 HC ANTI-PHOSPHOLIPID 300 86148 55 N/A Both 111.00 N/A N/A N/A N/A - - 30000558 HC AMPHIPHYSIN WESTERN BLOT 300 84182 55 N/A Both 122.00 N/A N/A N/A N/A - - 30001470 HC SARS-COV-2 BY PCR 300 87635 55 N/A Both 125.00 N/A N/A N/A N/A - - 30000062 HC 5 FLUCYTOSINE 300 80299 55 N/A Both 126.00 N/A N/A N/A N/A - - 30000644 HC OSMOLALITY STOOL 300 84999 55 N/A Both 129.00 N/A N/A N/A N/A - - 30000307 HC ESTRIOL 300 82677 55 N/A Both 130.00 N/A N/A N/A N/A - - 30000095 HC ETHYLENE GLYCOL 300 80320 55 N/A Both 132.00 N/A N/A N/A N/A - - 30000795 HC ENDOMYSIAL AB IGA SCREEN 300 86255 55 N/A Both 133.00 N/A N/A N/A N/A - - 30001420 HC FETAL CONGENITAL ABNORMALITIES BIOCHEM 4 ANALYTES 300 81511 55 N/A Both 133.00 N/A N/A N/A N/A - - 30000771 HC ANA 300 86038 55 N/A Both 142.00 N/A N/A N/A N/A - - 30000786 HC IMMUNOASSAY PEPTIDE AB 300 86200 55 N/A Both 142.00 N/A N/A N/A N/A - - 30000021 HC CARBAMAZEPINE FREE 300 80157 55 N/A Both 145.00 N/A N/A N/A N/A - - 30000019 HC CARBAMAZEPINE TOTAL 300 80156 55 N/A Both 145.00 N/A N/A N/A N/A - - 30000808 HC ENDOMYSIAL ANTIBODIES IGA 300 86256 55 N/A Both 148.00 N/A N/A N/A N/A - - 30001037 HC ID BY NUCLEIC ACID AMPL PROBE 300 87150 55 N/A Both 152.00 N/A N/A N/A N/A - - 30000389 HC IMMUNOASSAY FOR PR3 AB 300 83516 55 N/A Both 154.00 N/A N/A N/A N/A - - 30000206 HC BIOTINIDASE QUANT 300 82261 55 N/A Both 156.00 N/A N/A N/A N/A - - 30000583 HC PORPHYRIN TOTAL 300 84311 55 N/A Both 157.00 N/A N/A N/A N/A - - 30000096 HC VOLATILES SCREEN 300 80320 55 N/A Both 159.00 N/A N/A N/A N/A - - 30000740 HC ALLERGY LATEX RAST 300 86003 55 N/A Both 163.00 N/A N/A N/A N/A - - 30000790 HC EXTRACTABLE NUCLEAR AG AB 300 86235 55 N/A Both 168.00 N/A N/A N/A N/A - - 31000071 HC CELL MARKER EACH ADDL 311 88185 55 N/A Both 171.00 N/A N/A N/A N/A - - 30001257 HC DRUG SCREEN QUALITATIVE 300 80307 55 N/A Both 176.00 N/A N/A N/A N/A - - 30000426 HC IMMUNOASSAY QUANT 300 83520 55 N/A Both 180.00 N/A N/A N/A N/A - - 30000812 HC NMO-AQP4-FACS-TITER 300 86256 55 N/A Both 180.00 N/A N/A N/A N/A - - 31000021 HC FLOW CYT CELL SURF MARKER 1 311 88184 55 N/A Both 181.00 N/A N/A N/A N/A - - 30000234 HC PTH RELATED PEPTIDE 300 82397 55 N/A Both 184.00 N/A N/A N/A N/A - - 30000625 HC VASOACTIVE INTEST POLYPEP 300 84586 55 N/A Both 184.00 N/A N/A N/A N/A - - 30000305 HC ESTRADIOL 300 82670 55 N/A Both 186.00 N/A N/A N/A N/A - - 30000298 HC ENZYME ACTIVITY EACH SPECIMEN 300 82657 55 N/A Both 188.00 N/A N/A N/A N/A - - 30000318 HC GALACTOSE 300 82760 55 N/A Both 194.00 N/A N/A N/A N/A - - 30001332 HC CULTURE ID FUNGI-YEAST 300 87106 55 N/A Both 195.00 N/A N/A N/A N/A - - 30000392 HC MYELOPEROXIDASE AB 300 83516 55 N/A Both 196.00 N/A N/A N/A N/A - - 30001307 HC MIC PANEL 300 87186 55 N/A Both 208.00 N/A N/A N/A N/A - - 30000974 HC ANTIBODY TITER 300 86886 55 N/A Both 222.00 N/A N/A N/A N/A - - 30000533 HC HEMOQUANT FECES 300 84126 55 N/A Both 223.00 N/A N/A N/A N/A - - 30001026 HC BILL ID BY MALDI-TOF MS AFB 300 87118 55 N/A Both 226.00 N/A N/A N/A N/A - - 30001044 HC MYCOBATERIUM ID 300 87158 55 N/A Both 226.00 N/A N/A N/A N/A - - 30000649 HC POTASSIUM STOOL 300 84999 55 N/A Both 238.00 N/A N/A N/A N/A - - 30000580 HC SODIUM STOOL 300 84302 55 N/A Both 238.00 N/A N/A N/A N/A - - 30000858 HC RABIES REFIT ENDPOINT 300 86382 55 N/A Both 243.00 N/A N/A N/A N/A - - 30000380 HC HYDROPROGESTERONE 17-D 300 83498 55 N/A Both 246.00 N/A N/A N/A N/A - - 30001281 HC FLUORESCENT NONINFECTION AB SC 300 86255 55 N/A Both 256.00 N/A N/A N/A N/A - - 30000189 HC ANDROSTENEDIONE 300 82157 55 N/A Both 265.00 N/A N/A N/A N/A - - 30000319 HC GALACTOSE-1-PHOS URIDYLTRANS 300 82775 55 N/A Both 268.00 N/A N/A N/A N/A - - 30000048 HC RAPAMYCIN SIROLIMUS 300 80195 55 N/A Both 268.00 N/A N/A N/A N/A - - 30000032 HC KEPPRA/LEVETIRACETAM QUANT 300 80177 55 N/A Both 285.00 N/A N/A N/A N/A - - 30001349 HC FLUORESCENT NONINFECT AGENT AB 300 86255 55 N/A Both 293.00 N/A N/A N/A N/A - - 30001040 HC ID BY NUCLEIC SEQUENCING 300 87153 55 N/A Both 295.00 N/A N/A N/A N/A - - 30001041 HC MYCOBACT ID SEQUENCING 300 87153 55 N/A Both 295.00 N/A N/A N/A N/A - - 30000941 HC TETANUS AB 300 86774 55 N/A Both 301.00 N/A N/A N/A N/A - - 30001448 HC WESTERN BLOT WITH INTERP 300 84182 55 N/A Both 304.00 N/A N/A N/A N/A - - 30000833 HC IMMUNOFIXATION ELECTROPH SERUM 300 86334 55 N/A Both 306.00 N/A N/A N/A N/A - - 30001038 HC AEROBE ID SEQUENCING 300 87153 55 N/A Both 309.00 N/A N/A N/A N/A - - 31000022 HC FLOW CYT NUCLEAR MARKER 1 311 88184 55 N/A Both 325.00 N/A N/A N/A N/A - - 30000560 HC WB W INTERP/REPORT 300 84182 55 N/A Both 328.00 N/A N/A N/A N/A - - 30000136 HC HFE GENE ANALYSIS 300 81256 55 N/A Both 332.00 N/A N/A N/A N/A - - 30001055 HC MIC NOCARDIA 300 87186 55 N/A Both 333.00 N/A N/A N/A N/A - - 30000844 HC LEUK HISTAMINE RELEASE TST LHR 300 86343 55 N/A Both 334.00 N/A N/A N/A N/A - - 30001241 HC FLOW CYTO INTERPRET 9-15 MRKS 300 88188 55 N/A Both 341.00 N/A N/A N/A N/A - - 31000020 HC CELL MARKERS MARKER 1 311 88184 55 N/A Both 342.00 N/A N/A N/A N/A - - 30000566 HC PYRUVATE 300 84210 55 N/A Both 348.00 N/A N/A N/A N/A - - 30000567 HC PYRUVATE KINASE RBC 300 84220 55 N/A Both 358.00 N/A N/A N/A N/A - - 30000799 HC NMO-AQP4-IGG-FACS 300 86255 55 N/A Both 384.00 N/A N/A N/A N/A - - 30000845 HC ASSAY CELLULAR FUNCTION 300 86352 55 N/A Both 386.00 N/A N/A N/A N/A - - 30001274 HC IMMUNOASSAY QUANT 300 83520 55 N/A Both 394.00 N/A N/A N/A N/A - - 30001415 HC JAK2 SEQUENCING 300 0027U 55 N/A Both 402.00 N/A N/A N/A N/A - - 30001132 HC HERPES VIRUS 6 AMPLIFIED PROBE 300 87532 55 N/A Both 409.00 N/A N/A N/A N/A - - 30000059 HC GANCICLOVIR CYTOVENE 300 80299 55 N/A Both 431.00 N/A N/A N/A N/A - - 30001152 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 55 N/A Both 519.00 N/A N/A N/A N/A - - 30001280 HC FLUORESCENT NONINFECT AG AB 300 86255 55 N/A Both 521.00 N/A N/A N/A N/A - - 30000398 HC TYSABRI AB 300 83516 55 N/A Both 551.00 N/A N/A N/A N/A - - 30000408 HC GASTRIC INHIB POLYPEPTIDE 300 83519 55 N/A Both 559.00 N/A N/A N/A N/A - - 30000034 HC MYCOPHENOLIC ACID QUANT 300 80180 55 N/A Both 576.00 N/A N/A N/A N/A - - 30001414 HC JAK2 GENE ANALYSIS 300 81270 55 N/A Both 581.00 N/A N/A N/A N/A - - 30000641 HC NITROGEN FECAL 300 84999 55 N/A Both 588.00 N/A N/A N/A N/A - - 30000797 HC FLUORESCENT NONINFECT AB SCRN 300 86255 55 N/A Both 609.00 N/A N/A N/A N/A - - 30000147 HC HLA CLASS II TYPING 300 81383 55 N/A Both 618.00 N/A N/A N/A N/A - - 30000483 HC THIOPUR METHYLT TPMT-IMUR 300 83789 55 N/A Both 679.00 N/A N/A N/A N/A - - 30000412 HC RIA FOR NON-INFECTIOUS AGENT 300 83519 55 N/A Both 834.00 N/A N/A N/A N/A - - 30000303 HC GALACTOSEMIA GENOTYPING 300 82664 55 N/A Both " 1,040.00 " N/A N/A N/A N/A - - 30000642 HC ONCOTYPE BREAST CANCER ASSAY 300 84999 67 N/A Both " 5,419.00 " N/A N/A N/A N/A - - 30000640 HC CANCER TYPE ID 300 84999 67 N/A Both " 5,128.00 " N/A N/A N/A N/A - - 30000129 HC CYTO MICROARRAY COPY AND SNP 300 81229 67 N/A Both " 1,839.00 " N/A N/A N/A N/A - - 30000130 HC CYTOGENETIC MICROARRAY 300 81229 67 N/A Both " 1,801.00 " N/A N/A N/A N/A - - 30001164 HC HIV-1 GENOTYPING-DRUG RESIST 300 87901 67 N/A Both " 1,368.00 " N/A N/A N/A N/A - - 31000089 HC TISS CULT AMN FLD/CHOR VILLUS 319 88235 67 N/A Both " 1,362.00 " N/A N/A N/A N/A - - 30000967 HC HLA W/O DR ANTIGEN 300 86813 67 N/A Both " 1,031.00 " N/A N/A N/A N/A - - 30001137 HC HIV-1 RNA PCR 2ND GEN 300 87536 67 N/A Both 855.00 N/A N/A N/A N/A - - 30000767 HC PLATELET AB AB ID 300 86022 67 N/A Both 807.00 N/A N/A N/A N/A - - 30001136 HC HIV-1 RNA QUANT PCR 300 87536 67 N/A Both 789.00 N/A N/A N/A N/A - - 31000090 HC CHRM ANLY AMN FLD/CHOR VIL 15C 319 88267 67 N/A Both 760.00 N/A N/A N/A N/A - - 30001170 HC CHROMOSOME ANALYSIS 15-20 CELL 300 88262 67 N/A Both 753.00 N/A N/A N/A N/A - - 30000963 HC LYMPHOCYTOTOXIC ANTIBODY 300 86807 67 N/A Both 751.00 N/A N/A N/A N/A - - 30001266 HC CHROMATOGRAPHY MASS SPEC QUANT 300 82542 67 N/A Both 717.00 N/A N/A N/A N/A - - 30001130 HC HEPATITIS C QUANT 300 87522 67 N/A Both 698.00 N/A N/A N/A N/A - - 30000145 HC HLA CLASS I TESTING - LOW RES 300 81372 67 N/A Both 698.00 N/A N/A N/A N/A - - 30001169 HC CHROMOSOME ANALYSIS 5 CELLS 300 88261 67 N/A Both 670.00 N/A N/A N/A N/A - - 31000042 HC SURGICAL PATH LEVEL VI 310 88309 67 N/A Both 664.00 N/A N/A N/A N/A - - 30000769 HC PLATELET CROSSMATCH 300 86022 67 N/A Both 660.00 N/A N/A N/A N/A - - 30000134 HC FMR1 GENE ANALYSIS CHARAC 300 81244 67 N/A Both 658.00 N/A N/A N/A N/A - - 31000081 HC SURG PATH PROSTATE NEEDLE BIOP 310 G0416 67 N/A Both 647.00 N/A N/A N/A N/A - - 31000047 HC HISTO OR CYTO ENZYME ID 310 88319 67 N/A Both 640.00 N/A N/A N/A N/A - - 31000051 HC PATH CONSULT CYTO EXAM FIRST 310 88333 67 N/A Both 640.00 N/A N/A N/A N/A - - 30000571 HC SEROTONIN BLOOD 300 84260 67 N/A Both 625.00 N/A N/A N/A N/A - - 30000765 HC AB ID PLATELET ANTIBODIES 300 86022 67 N/A Both 607.00 N/A N/A N/A N/A - - 30001310 HC INFECT AGENT DETECT RNA DNA 300 87798 67 N/A Both 584.00 N/A N/A N/A N/A - - 31000036 HC TISSUE CULTURE BONE MARROW/BLD 319 88237 67 N/A Both 583.00 N/A N/A N/A N/A - - 30000167 HC ALDOSTERONE URINE 300 82088 67 N/A Both 582.00 N/A N/A N/A N/A - - 31000056 HC ELECTRON MICROSCOPY 310 88348 67 N/A Both 582.00 N/A N/A N/A N/A - - 30000837 HC INSULIN AB RIA 300 86337 67 N/A Both 581.00 N/A N/A N/A N/A - - 30001133 HC HIV-1 DNA/PCR QUAL 300 87535 67 N/A Both 580.00 N/A N/A N/A N/A - - 30000968 HC HLA DR/DQ MULTIPLE ANTIGENS 300 86817 67 N/A Both 580.00 N/A N/A N/A N/A - - 31000030 HC TISSUE CULTURE SKIN BIOPSY 319 88233 67 N/A Both 580.00 N/A N/A N/A N/A - - 30000133 HC FMR1 ANALYSIS EVAL TO DET 300 81243 67 N/A Both 571.00 N/A N/A N/A N/A - - 30000135 HC FLT3 GENE ANALYSIS 300 81245 67 N/A Both 561.00 N/A N/A N/A N/A - - 30000572 HC SEROTONIN SERUM 300 84260 67 N/A Both 556.00 N/A N/A N/A N/A - - 30000768 HC PLATELET COMPATIBILITY PANEL 300 86022 67 N/A Both 551.00 N/A N/A N/A N/A - - 31000029 HC TISSUE CULT NON-NEOPLASTIC 319 88230 67 N/A Both 544.00 N/A N/A N/A N/A - - 30001081 HC VIRUS ISOLATION SHELL VIAL 300 87254 67 N/A Both 539.00 N/A N/A N/A N/A - - 30001407 HC MOLECULAR PATH PROC LEVEL 4 300 81403 67 N/A Both 537.00 N/A N/A N/A N/A - - 30000626 HC ARGININE VASOPRESSIN 300 84588 67 N/A Both 536.00 N/A N/A N/A N/A - - 30000428 HC INFLIXIMAB/HACA MEASUREMENT 300 83520 67 N/A Both 527.00 N/A N/A N/A N/A - - 30001440 HC INFECTIOUS DISEASE CHRONIC HEPATITIS C SIX BIOCHEM ASSAYS 300 81596 67 N/A Both 520.00 N/A N/A N/A N/A - - 31000064 HC IN SITU HYBRIDIZATION EACH 310 88365 67 N/A Both 517.00 N/A N/A N/A N/A - - 30000081 HC DRUG SCREEN SINGLE DRUG 300 80307 67 N/A Both 514.00 N/A N/A N/A N/A - - 30000290 HC CYANIDE 300 82600 67 N/A Both 511.00 N/A N/A N/A N/A - - 31000087 HC TISSUE CULTURE LYMPHOCYTE 319 88230 67 N/A Both 511.00 N/A N/A N/A N/A - - 30000015 HC OBSTETRIC PANEL W/HIV1/2 300 80081 67 N/A Both 502.00 N/A N/A N/A N/A - - 30000407 HC GAD-65 300 83519 67 N/A Both 501.00 N/A N/A N/A N/A - - 30000140 HC NPMI GENE ANALYSIS 300 81310 67 N/A Both 497.00 N/A N/A N/A N/A - - 30000677 HC VON WILLEBRAND FACTOR AG 300 85246 67 N/A Both 481.00 N/A N/A N/A N/A - - 30000565 HC VIT B-6 PLASMA PYRODOXINE 300 84207 67 N/A Both 478.00 N/A N/A N/A N/A - - 31000041 HC SURGICAL PATH LEVEL V 310 88307 67 N/A Both 467.00 N/A N/A N/A N/A - - 30000505 HC ORGANIC ACID SINGLE QUANT 300 83921 67 N/A Both 466.00 N/A N/A N/A N/A - - 30000675 HC VWF RISTOCETIN COFACTOR 300 85245 67 N/A Both 460.00 N/A N/A N/A N/A - - 30000961 HC HEPATITIS C RIBA CONF 300 86804 67 N/A Both 458.00 N/A N/A N/A N/A - - 30000844 HC LEUK HISTAMINE RELEASE TST LHR 300 86343 67 N/A Both 457.00 N/A N/A N/A N/A - - 30000884 HC CMV ANTIBODY 300 86644 67 N/A Both 457.00 N/A N/A N/A N/A - - 30001138 HC MYCOBACTERIA PCR CSF 300 87556 67 N/A Both 444.00 N/A N/A N/A N/A - - 30001264 HC DRUG SCREEN MULTI DRUG 300 80307 67 N/A Both 439.00 N/A N/A N/A N/A - - 30000031 HC LIDOCAINE 300 80176 67 N/A Both 433.00 N/A N/A N/A N/A - - 30001245 HC CHRM ANLY AMN FLD/CHOR VIL 15C 300 88267 67 N/A Both 425.00 N/A N/A N/A N/A - - 30000063 HC DRUG ASSAY VORICONAZOLE 300 80285 67 N/A Both 425.00 N/A N/A N/A N/A - - 30001121 HC ENTEROVIRUS AMPLIFIED PROBE 300 87498 67 N/A Both 421.00 N/A N/A N/A N/A - - 30001152 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 67 N/A Both 409.00 N/A N/A N/A N/A - - 30000631 HC ALCOHOL ISOPROPYL 300 84600 67 N/A Both 409.00 N/A N/A N/A N/A - - 30000309 HC ETHYLENE GLYCOL SERUM 300 82693 67 N/A Both 409.00 N/A N/A N/A N/A - - 31000049 HC PATH CONSLT FIRST TISSUE BLOCK 310 88331 67 N/A Both 405.00 N/A N/A N/A N/A - - 30001033 HC CULTURE TYPING ID NUCLEI PROBE 300 87149 67 N/A Both 402.00 N/A N/A N/A N/A - - 31000017 HC CYTO FNA INTERP AND REPORT 310 88173 67 N/A Both 402.00 N/A N/A N/A N/A - - 30000632 HC METHANOL 300 84600 67 N/A Both 399.00 N/A N/A N/A N/A - - 30001039 HC CULTURE ID BY SEQUENCING 300 87153 67 N/A Both 397.00 N/A N/A N/A N/A - - 30000196 HC ARSENIC BLOOD 300 82175 67 N/A Both 394.00 N/A N/A N/A N/A - - 30000592 HC THIOCYANATE SERUM 300 84430 67 N/A Both 389.00 N/A N/A N/A N/A - - 31000016 HC CYTO FNA FIRST EVAL EACH SITE 310 88172 67 N/A Both 387.00 N/A N/A N/A N/A - - 30000010 HC OBSTETRIC PANEL 300 80055 67 N/A Both 386.00 N/A N/A N/A N/A - - 31000103 HC CHROMOSOME ANALYSIS 5 CELLS 319 88261 67 N/A Both 377.00 N/A N/A N/A N/A - - 31000088 HC TISSUE CULTURE; LYMPHOCYTE 319 88230 67 N/A Both 377.00 N/A N/A N/A N/A - - 30001131 HC HERPES AB TYPE 1&2 DNAPCR 300 87529 67 N/A Both 367.00 N/A N/A N/A N/A - - 30000864 HC TB INTERFANTIGEN 300 86480 67 N/A Both 367.00 N/A N/A N/A N/A - - 31000094 HC GROSS & MICRO LEVEL IV 319 88305 67 N/A Both 366.00 N/A N/A N/A N/A - - 30000176 HC ALUMINUM 300 82108 67 N/A Both 359.00 N/A N/A N/A N/A - - 30000966 HC HLA TYPE A B OR C 300 86813 67 N/A Both 357.00 N/A N/A N/A N/A - - 30000904 HC HEM INF B VAC RESP 300 86684 67 N/A Both 343.00 N/A N/A N/A N/A - - 31000062 HC MA TUMOR IMMUNOHISTOCHEM AUTO 310 88361 67 N/A Both 334.00 N/A N/A N/A N/A - - 30000703 HC PLASMINOGEN FUNCTIONAL 300 85420 67 N/A Both 332.00 N/A N/A N/A N/A - - 30000965 HC HLA-B27 300 86812 67 N/A Both 326.00 N/A N/A N/A N/A - - 30000519 HC ALK PHOS-BONE SPECIFIC 300 84075 67 N/A Both 324.00 N/A N/A N/A N/A - - 31000040 HC SURGICAL PATH LEVEL III 310 88304 67 N/A Both 324.00 N/A N/A N/A N/A - - 31000095 HC SURGICAL PATH LEVEL IV 310 88305 67 N/A Both 324.00 N/A N/A N/A N/A - - 31000061 HC MA TUMOR IMMUNOHISTOCHEM 310 88360 67 N/A Both 320.00 N/A N/A N/A N/A - - 30001172 HC TUMOR ENRICHMENT 300 88360 67 N/A Both 320.00 N/A N/A N/A N/A - - 30000110 HC LASIX FUROSEMIDE 300 80375 67 N/A Both 318.00 N/A N/A N/A N/A - - 30001093 HC ASPERGILLUS 300 87305 67 N/A Both 316.00 N/A N/A N/A N/A - - 30000178 HC TRYPTOPHAN 300 82131 67 N/A Both 314.00 N/A N/A N/A N/A - - 30000093 HC SYNTHETIC CANNABINOIDS URINE 300 80307 67 N/A Both 309.00 N/A N/A N/A N/A - - 30000667 HC FACTOR II 300 85210 67 N/A Both 307.00 N/A N/A N/A N/A - - 30000080 HC DRUG SCREEN MULTI DRUG 300 80307 67 N/A Both 300.00 N/A N/A N/A N/A - - 30000486 HC MERCURY BLOOD QUANT 300 83825 67 N/A Both 299.00 N/A N/A N/A N/A - - 31000068 HC MICRODISSECTION MANUAL 310 88381 67 N/A Both 299.00 N/A N/A N/A N/A - - 30000599 HC THYROXINE BINDING GLOBULIN 300 84442 67 N/A Both 297.00 N/A N/A N/A N/A - - 30001311 HC INFECTIOUS AGENT BY AMPL PROBE 300 87798 67 N/A Both 295.00 N/A N/A N/A N/A - - 30000207 HC BIOTINIDASE SERUM QUANT 300 82261 67 N/A Both 295.00 N/A N/A N/A N/A - - 30001053 HC FUNGAL YEAST SUSCEPTIBILITY 300 87186 67 N/A Both 293.00 N/A N/A N/A N/A - - 31000053 HC IMMUNOSTAIN ADDITIONAL 310 88341 67 N/A Both 293.00 N/A N/A N/A N/A - - 31000054 HC IMMUNOSTAIN INITIAL 310 88342 67 N/A Both 293.00 N/A N/A N/A N/A - - 30001113 HC INFECTIOUS AGENT AG DETECTION 300 87449 67 N/A Both 292.00 N/A N/A N/A N/A - - 30000153 HC BETA-HYDROXYBUTYRATE 300 82010 67 N/A Both 285.00 N/A N/A N/A N/A - - 30000061 HC FELBAMATE 300 80299 67 N/A Both 284.00 N/A N/A N/A N/A - - 30000409 HC IMMUNO ANALY QUANT RADRX TECH 300 83519 67 N/A Both 283.00 N/A N/A N/A N/A - - 30000478 HC MANGANESE SERUM 300 83785 67 N/A Both 281.00 N/A N/A N/A N/A - - 30000292 HC DHEA 300 82626 67 N/A Both 274.00 N/A N/A N/A N/A - - 30001321 HC DRUG SCREEN SINGLE DRUG 300 80307 67 N/A Both 274.00 N/A N/A N/A N/A - - 30001112 HC INFCT AGNT ENZY IMMUN MUL STEP 300 87449 67 N/A Both 272.00 N/A N/A N/A N/A - - 30000831 HC IMMUNE COMPLEX C1Q BIND 300 86332 67 N/A Both 269.00 N/A N/A N/A N/A - - 30000255 HC ASSAY OF COPPER 300 82525 67 N/A Both 268.00 N/A N/A N/A N/A - - 30001103 HC HISTOPLASMA AG ANY SOURCE 300 87385 67 N/A Both 266.00 N/A N/A N/A N/A - - 30000787 HC DNASE B ANTIBODY 300 86215 67 N/A Both 264.00 N/A N/A N/A N/A - - 30000427 HC INFLIXIMAB MEASUREMENT 300 83520 67 N/A Both 264.00 N/A N/A N/A N/A - - 30000877 HC CANDIDA ANTIBODY 300 86628 67 N/A Both 261.00 N/A N/A N/A N/A - - 30001235 HC COMPAZINE 300 G0480 67 N/A Both 261.00 N/A N/A N/A N/A - - 30000104 HC THIOTHIXENE NAVENE 300 80342 67 N/A Both 261.00 N/A N/A N/A N/A - - 30001287 HC ADENOVIRUS ANTIBODY 300 86603 67 N/A Both 257.00 N/A N/A N/A N/A - - 30000894 HC EHRLICHIA ANTIBODY 300 86666 67 N/A Both 256.00 N/A N/A N/A N/A - - 30001274 HC IMMUNOASSAY QUANT 300 83520 67 N/A Both 252.00 N/A N/A N/A N/A - - 30000839 HC INTRINSIC FACTOR BLOCKING AB 300 86340 67 N/A Both 252.00 N/A N/A N/A N/A - - 30000879 HC CHLAMYDIA AB IGG ONLY 300 86631 67 N/A Both 252.00 N/A N/A N/A N/A - - 30000060 HC GABAPENTIN 300 80299 67 N/A Both 252.00 N/A N/A N/A N/A - - 31000034 HC CYTOGENETICS 25-99 CELLS 319 88274 67 N/A Both 251.00 N/A N/A N/A N/A - - 30000027 HC GENTAMICIN 300 80170 67 N/A Both 250.00 N/A N/A N/A N/A - - 30000054 HC TOPIRAMATE TOPAMAX 300 80201 67 N/A Both 250.00 N/A N/A N/A N/A - - 30000251 HC CITRATE 24 HR URINE 300 82507 67 N/A Both 247.00 N/A N/A N/A N/A - - 30000381 HC NEONATAL 17 OHP 300 83498 67 N/A Both 247.00 N/A N/A N/A N/A - - 31000033 HC CYTOGENETICS 10-30 CELLS 319 88273 67 N/A Both 243.00 N/A N/A N/A N/A - - 31000045 HC SPECIAL STAINS GRP 2 ALL OTHER 310 88313 67 N/A Both 243.00 N/A N/A N/A N/A - - 30001157 HC INFECTIOUS AGENT QUANT 300 87799 67 N/A Both 240.00 N/A N/A N/A N/A - - 30000179 HC ALA AMINOLEV ACID 300 82135 67 N/A Both 240.00 N/A N/A N/A N/A - - 31000027 HC CELL MARKERS INTERP 16 OR MORE 311 88189 67 N/A Both 240.00 N/A N/A N/A N/A - - 30000353 HC GROWTH HORMONE 300 83003 67 N/A Both 238.00 N/A N/A N/A N/A - - 30000932 HC PARVOVIRUS B-19 IGG 300 86747 67 N/A Both 235.00 N/A N/A N/A N/A - - 30001243 HC TISS CULT AMN FLD/CHOR VILLUS 300 88235 67 N/A Both 234.00 N/A N/A N/A N/A - - 30000542 HC PROCALCITONIN 300 84145 67 N/A Both 232.00 N/A N/A N/A N/A - - 31000039 HC SURGICAL PATH LEVEL II 310 88302 67 N/A Both 232.00 N/A N/A N/A N/A - - 30000865 HC TSPOT TUBERCULOSIS TEST 300 86481 67 N/A Both 232.00 N/A N/A N/A N/A - - 31000035 HC CYTOGENETICS 100-300 CELLS 319 88275 67 N/A Both 224.00 N/A N/A N/A N/A - - 30001024 HC CHLAMYDIA CULTURE 300 87110 67 N/A Both 223.00 N/A N/A N/A N/A - - 30000882 HC COCCIDIOIDES ANTIBODY 300 86635 67 N/A Both 220.00 N/A N/A N/A N/A - - 30000017 HC AMIKACIN TROUGH 300 80150 67 N/A Both 220.00 N/A N/A N/A N/A - - 31000048 HC CONSULT AND REPORT SLIDES 310 88323 67 N/A Both 220.00 N/A N/A N/A N/A - - 30000509 HC OXALATE 24 HR URINE 300 83945 67 N/A Both 220.00 N/A N/A N/A N/A - - 30000262 HC COLUMN CHROMATOGRAPHY EACH SP 300 82542 67 N/A Both 216.00 N/A N/A N/A N/A - - 30000920 HC HEPATITIS BE ANTIBODY 300 86707 67 N/A Both 213.00 N/A N/A N/A N/A - - 31000084 HC CELL MARKERS INTERP 9-15 311 88188 67 N/A Both 211.00 N/A N/A N/A N/A - - 30000057 HC DIGITOXIN 300 80299 67 N/A Both 210.00 N/A N/A N/A N/A - - 30000192 HC APOLIPOPROTEIN 300 82172 67 N/A Both 205.00 N/A N/A N/A N/A - - 30000299 HC ENZYME ACTIVITY IN BLOOD CELLS 300 82657 67 N/A Both 205.00 N/A N/A N/A N/A - - 30000347 HC GGT 300 82977 67 N/A Both 205.00 N/A N/A N/A N/A - - 30000355 HC HAPTOGLOBIN 300 83010 67 N/A Both 205.00 N/A N/A N/A N/A - - 30000496 HC NEPHELOMETRY 304 83883 67 N/A Both 205.00 N/A N/A N/A N/A - - 31000050 HC PATH CONSLT ADD TISSUE BLOCK 310 88332 67 N/A Both 204.00 N/A N/A N/A N/A - - 30000045 HC PROCAINAMIDE W METABOLITES 300 80192 67 N/A Both 203.00 N/A N/A N/A N/A - - 30000933 HC PARVOVIRUS B-19 IGM 300 86747 67 N/A Both 202.00 N/A N/A N/A N/A - - 30000051 HC THEOPHYLLINE 300 80198 67 N/A Both 202.00 N/A N/A N/A N/A - - 30000198 HC VITAMIN C ASCORBIC ACID 300 82180 67 N/A Both 199.00 N/A N/A N/A N/A - - 31000097 HC CHROMO ANALY HIGH RESOL STUDY 319 88289 67 N/A Both 196.00 N/A N/A N/A N/A - - 30000927 HC LEPTOSPIRA ANTIBODY 300 86720 67 N/A Both 195.00 N/A N/A N/A N/A - - 30000337 HC GLUCOGON 300 82943 67 N/A Both 195.00 N/A N/A N/A N/A - - 30000194 HC ASSAY OF APOLIPOPROTEIN 300 82172 67 N/A Both 194.00 N/A N/A N/A N/A - - 30000229 HC PANCREATIC CEA 300 82378 67 N/A Both 193.00 N/A N/A N/A N/A - - 30000529 HC PORPHOBILINOGEN QT URINE 300 84110 67 N/A Both 190.00 N/A N/A N/A N/A - - 31000002 HC CYTO FLUID WASHING OR BRUSHING 310 88104 67 N/A Both 186.00 N/A N/A N/A N/A - - 30000042 HC ASSAY OF PRIMIDONE 300 80188 67 N/A Both 185.00 N/A N/A N/A N/A - - 31000026 HC CELL MARKERS 2-8 311 88187 67 N/A Both 185.00 N/A N/A N/A N/A - - 30000020 HC CARBAMAZEPINE TEGRETOL 300 80156 67 N/A Both 184.00 N/A N/A N/A N/A - - 31000072 HC CELL MARKER STUDY ADD MARKER 310 88185 67 N/A Both 184.00 N/A N/A N/A N/A - - 30000038 HC PHENOBARBITAL QUANT 300 80184 67 N/A Both 184.00 N/A N/A N/A N/A - - 30001063 HC MOLD SUSCEPTIBILITY 300 87188 67 N/A Both 183.00 N/A N/A N/A N/A - - 31000019 HC CELL MARKER STUDY MARKER 1 310 88184 67 N/A Both 177.00 N/A N/A N/A N/A - - 30000869 HC ADENOVIRUS ANTIBODY 300 86603 67 N/A Both 165.00 N/A N/A N/A N/A - - 30000530 HC PORPHOBILINOGEN QUANT UR 300 84110 67 N/A Both 165.00 N/A N/A N/A N/A - - 30001147 HC AMPLIFIED PROBE TECHNIQUE 300 87798 67 N/A Both 164.00 N/A N/A N/A N/A - - 30001116 HC CHLAMYDIA PNEUMONIAE 300 87486 67 N/A Both 164.00 N/A N/A N/A N/A - - 30001140 HC MYCOPLASMA PNEUMONIAE 300 87581 67 N/A Both 164.00 N/A N/A N/A N/A - - 30001146 HC RESPIRATORY PATHOGEN PANEL 300 0099U 67 N/A Both 164.00 N/A N/A N/A N/A - - 30000964 HC CYTOTOXIC AB QUICK 300 86808 67 N/A Both 163.00 N/A N/A N/A N/A - - 30000962 HC CYTOTOXIC AB STD 300 86807 67 N/A Both 163.00 N/A N/A N/A N/A - - 31000044 HC SPECIAL STAINS GRP 1 MICROORG 310 88312 67 N/A Both 163.00 N/A N/A N/A N/A - - 30000546 HC PSA FREE 300 84154 67 N/A Both 156.00 N/A N/A N/A N/A - - 30000544 HC PROSTATE SPECIFIC ANTIGN TOTAL 300 84153 67 N/A Both 156.00 N/A N/A N/A N/A - - 30000942 HC TOXOPLASMA AB 300 86777 67 N/A Both 156.00 N/A N/A N/A N/A - - 30000945 HC TOXOPLASMA IGM AB 300 86778 67 N/A Both 156.00 N/A N/A N/A N/A - - 30001139 HC MYCOBACT TUBERCUL AMPLIF PROBE 300 87556 67 N/A Both 154.00 N/A N/A N/A N/A - - 31000096 HC CHROMOSOME COUNT ADDL 319 88285 67 N/A Both 152.00 N/A N/A N/A N/A - - 31000093 HC CYTOGENETICS INTERP & REPORT 319 88291 67 N/A Both 152.00 N/A N/A N/A N/A - - 31000010 HC THIN LAYER PREP PAP SMEAR 311 88142 67 N/A Both 152.00 N/A N/A N/A N/A - - 31000020 HC CELL MARKERS MARKER 1 311 88184 67 N/A Both 150.00 N/A N/A N/A N/A - - 30000885 HC CYTOMEGALOVIRUS AB IGM 300 86645 67 N/A Both 148.00 N/A N/A N/A N/A - - 30000928 HC LYMPHOCYTIC CHORIOMENINGITIS 300 86727 67 N/A Both 148.00 N/A N/A N/A N/A - - 30001294 HC CYTOMEGALOVIRUS AB IGG 300 86644 67 N/A Both 148.00 N/A N/A N/A N/A - - 30000924 HC INFLUENZA VIRUS ANTIBODY 300 86710 67 N/A Both 148.00 N/A N/A N/A N/A - - 31000004 HC CYTO CONC SMEAR W INTERP 310 88108 67 N/A Both 147.00 N/A N/A N/A N/A - - 30001354 HC NOROVIRUS GI 300 87798 67 N/A Both 147.00 N/A N/A N/A N/A - - 30001355 HC NOROVIRUS GII 300 87798 67 N/A Both 147.00 N/A N/A N/A N/A - - 31000055 HC IMMUNOFLUOR AB DIRECT 310 88346 67 N/A Both 145.00 N/A N/A N/A N/A - - 30000696 HC FIBRINOGEN DEGRAD PRODUCT 300 85362 67 N/A Both 144.00 N/A N/A N/A N/A - - 30000683 HC FACTOR XIII FUNCTIONAL 300 85290 67 N/A Both 144.00 N/A N/A N/A N/A - - 30000912 HC HISTOPLASMA ANTIBODY 300 86698 67 N/A Both 142.00 N/A N/A N/A N/A - - 31000092 HC CHROMO ANALY ADDL KARYOTYPE 319 88280 67 N/A Both 140.00 N/A N/A N/A N/A - - 30000872 HC BLASTOMYCOSIS 300 86612 67 N/A Both 139.00 N/A N/A N/A N/A - - 30001244 HC CHROM ANALY 5 COUNT 300 88261 67 N/A Both 139.00 N/A N/A N/A N/A - - 30001246 HC CHROMO ANALY ADDL KARYOTYPES 300 88280 67 N/A Both 139.00 N/A N/A N/A N/A - - 30001315 HC CYTOGENETICS INTERP & REPORT 300 88291 67 N/A Both 139.00 N/A N/A N/A N/A - - 30001242 HC TISSUE CULTURE LYMPHOCYTE 300 88230 67 N/A Both 139.00 N/A N/A N/A N/A - - 30001064 HC MYCOBACTERIUM SENSITIVITY 300 87188 67 N/A Both 133.00 N/A N/A N/A N/A - - 30000776 HC CRP CARDIO 300 86141 67 N/A Both 130.00 N/A N/A N/A N/A - - 31000037 HC CRYOPRESERVATION FREEZE STORAG 319 88240 67 N/A Both 130.00 N/A N/A N/A N/A - - 30000106 HC LIBRIUM METABOLITE 300 80346 67 N/A Both 130.00 N/A N/A N/A N/A - - 30000736 HC VISCOSITY SERUM 300 85810 67 N/A Both 130.00 N/A N/A N/A N/A - - 30000037 HC ASSAY OF PHENOBARBITAL 300 80184 67 N/A Both 129.00 N/A N/A N/A N/A - - 30000706 HC HEPARIN ANTI XA LOVENOX L 300 85520 67 N/A Both 129.00 N/A N/A N/A N/A - - 30001035 HC ID MYCOBACT DNA PROBE 300 87149 67 N/A Both 127.00 N/A N/A N/A N/A - - 30001486 HC CHROMOSOME IN SITU 3-5 CELLS 300 88272 67 N/A Both 123.00 N/A N/A N/A N/A - - 30001298 HC HISTOPLASMA ANTIBODY 300 86698 67 N/A Both 123.00 N/A N/A N/A N/A - - 31000005 HC CYTO SELECTIVE CELL ENHANCE 310 88112 67 N/A Both 122.00 N/A N/A N/A N/A - - 30001248 HC GROSS & MICRO LEVEL IV 300 88305 67 N/A Both 122.00 N/A N/A N/A N/A - - 31000038 HC SURGICAL PATH LEVEL I 310 88300 67 N/A Both 122.00 N/A N/A N/A N/A - - 31000031 HC CYTOGENETICS DNA 319 88271 67 N/A Both 119.00 N/A N/A N/A N/A - - 30000716 HC PLATELET AGGREGATION - EACH 300 85576 67 N/A Both 114.00 N/A N/A N/A N/A - - 31000079 HC CYTO MOLECULAR REPORT 319 88291 67 N/A Both 112.00 N/A N/A N/A N/A - - 30000466 HC LIPASE 300 83690 67 N/A Both 103.00 N/A N/A N/A N/A - - 30000728 HC SICKLING SOLUBILITY 300 85660 67 N/A Both 103.00 N/A N/A N/A N/A - - 30001288 HC ASPERGILLUS AB 300 86606 67 N/A Both 102.00 N/A N/A N/A N/A - - 30001292 HC COCCIDIOIDES ANTIBODY 300 86635 67 N/A Both 102.00 N/A N/A N/A N/A - - 30001297 HC HISTOPLASMA ANTIBODY 300 86698 67 N/A Both 102.00 N/A N/A N/A N/A - - 30001290 HC BLASTOMYCES AB 300 86612 67 N/A Both 102.00 N/A N/A N/A N/A - - 31000015 HC PAP SMEAR 2 SLIDE 311 88164 67 N/A Both 99.00 N/A N/A N/A N/A - - 31000043 HC DECALCIFICATION PROCEDURE 310 88311 67 N/A Both 98.00 N/A N/A N/A N/A - - 30000286 HC CREATININE OTHER SOURCE 300 82570 67 N/A Both 97.00 N/A N/A N/A N/A - - 30000360 HC HEMOGLOBIN FRACTION ELECTROPHO 300 83020 67 N/A Both 95.00 N/A N/A N/A N/A - - 30000185 HC AMYLASE FLUID 300 82150 67 N/A Both 95.00 N/A N/A N/A N/A - - 30000364 HC HEMOGLOBIN F CHEMICAL 300 83030 67 N/A Both 95.00 N/A N/A N/A N/A - - 30000363 HC HGB FRACTIONATION QUANT CHRO 300 83021 67 N/A Both 95.00 N/A N/A N/A N/A - - 30000058 HC QUANTITATION OF DRUG NES 300 80299 67 N/A Both 94.00 N/A N/A N/A N/A - - 30000240 HC CHLORIDE FLUID 300 82438 67 N/A Both 92.00 N/A N/A N/A N/A - - 30001023 HC CULTURE MYCOPLASMA 300 87109 67 N/A Both 87.00 N/A N/A N/A N/A - - 30000241 HC CHLORIDE SPINAL FLUID 300 82438 67 N/A Both 87.00 N/A N/A N/A N/A - - 30000338 HC GLUCOSE URINE 300 82945 67 N/A Both 87.00 N/A N/A N/A N/A - - 30000474 HC MAGNESIUM SERUM 300 83735 67 N/A Both 87.00 N/A N/A N/A N/A - - 30001317 HC COCCIDIOIDES ANTIBODIES 300 86635 67 N/A Both 85.00 N/A N/A N/A N/A - - 31000011 HC CYTO SMEARS OTHER SOURCE 310 88160 67 N/A Both 85.00 N/A N/A N/A N/A - - 30000184 HC AMYLASE 300 82150 67 N/A Both 77.00 N/A N/A N/A N/A - - 30000302 HC ELECTROPHORETIC TECHNIQUE 300 82664 67 N/A Both 76.00 N/A N/A N/A N/A - - 31000099 HC CELL MARKER STUDY EACH ADDL 311 88185 67 N/A Both 74.00 N/A N/A N/A N/A - - 30000244 HC CHOLESTEROL 300 82465 67 N/A Both 72.00 N/A N/A N/A N/A - - 30000459 HC LACTIC DEHYDROGENASE LD 300 83615 67 N/A Both 72.00 N/A N/A N/A N/A - - 30000579 HC SODIUM FLUID 300 84302 67 N/A Both 72.00 N/A N/A N/A N/A - - 30000732 HC THROMBIN TIME SINGLE 300 85670 67 N/A Both 72.00 N/A N/A N/A N/A - - 30000285 HC URINE CREATININE 300 82570 67 N/A Both 72.00 N/A N/A N/A N/A - - 30000870 HC ASPERGILLUS ANTIBODY 300 86606 67 N/A Both 71.00 N/A N/A N/A N/A - - 30000609 HC TRIGLYCERIDES 300 84478 67 N/A Both 71.00 N/A N/A N/A N/A - - 30000623 HC URIC ACID URINE 300 84560 67 N/A Both 70.00 N/A N/A N/A N/A - - 30000260 HC CHROMATO MASS SPEC QUANT 300 82542 67 N/A Both 70.00 N/A N/A N/A N/A - - 31000014 HC PAP SMEAR 1 SLIDE 311 88164 67 N/A Both 70.00 N/A N/A N/A N/A - - 30000648 HC POTASSIUM FLUID 300 84999 67 N/A Both 70.00 N/A N/A N/A N/A - - 30000310 HC FAT STOOL QUAL 300 82705 67 N/A Both 69.00 N/A N/A N/A N/A - - 30001314 HC CHROMO ANALY ADDL KARYOTYPES 300 88280 67 N/A Both 69.00 N/A N/A N/A N/A - - 30001471 HC COVID-19-RPS 300 U0003 67 N/A Both 65.00 N/A N/A N/A N/A - - 30000306 HC ESTROGEN TOTAL 300 82672 67 N/A Both 65.00 N/A N/A N/A N/A - - 30000625 HC VASOACTIVE INTEST POLYPEP 300 84586 67 N/A Both 62.00 N/A N/A N/A N/A - - 30000616 HC UREA NITROGEN FLUID 300 84520 67 N/A Both 62.00 N/A N/A N/A N/A - - 31000052 HC PATH CONSULT CYTO EXAM ADD 310 88334 67 N/A Both 62.00 N/A N/A N/A N/A - - 30000550 HC PROTEIN TOTAL OTHER SOURCE 300 84157 67 N/A Both 62.00 N/A N/A N/A N/A - - 31000032 HC MOLECULAR CYTOGEN DNA PROBE EA 319 88271 67 N/A Both 60.00 N/A N/A N/A N/A - - 30000160 HC ALBUMIN URINE/OTHR QNT EA SPEC 300 82042 67 N/A Both 59.00 N/A N/A N/A N/A - - 30000202 HC BILIRUBIN TOTAL 300 82247 67 N/A Both 59.00 N/A N/A N/A N/A - - 30000214 HC CALCIUM 300 82310 67 N/A Both 59.00 N/A N/A N/A N/A - - 30001029 HC CULTURE TYPING 300 87140 67 N/A Both 59.00 N/A N/A N/A N/A - - 30000525 HC PHOSPHORUS 300 84100 67 N/A Both 59.00 N/A N/A N/A N/A - - 30000373 HC HEMOSIDERIN QUAL URINE 300 83070 67 N/A Both 55.00 N/A N/A N/A N/A - - 30000890 HC ENTEROVIRUS ANTIBODY 300 86658 67 N/A Both 50.00 N/A N/A N/A N/A - - 30000597 HC T-4 ASSAY FREE 300 84439 67 N/A Both 42.00 N/A N/A N/A N/A - - 30001247 HC CYTOGENETICS INTERP & REPORT 300 88291 67 N/A Both 40.00 N/A N/A N/A N/A - - 30000585 HC SPECTROPHOTOMETRY 300 84311 67 N/A Both 40.00 N/A N/A N/A N/A - - 30001052 HC ANTIMICRO SUSCEPTIB MICRODILUT 300 87186 67 N/A Both 39.00 N/A N/A N/A N/A - - 31000101 HC CELL MARKER STUDY EACH ADDL 311 88185 67 N/A Both 34.00 N/A N/A N/A N/A - - 30001027 HC CULTURE MYCOBACT DEFINITIVE ID 300 87118 67 N/A Both 29.00 N/A N/A N/A N/A - - 31000100 HC CELL MARKER STUDY EACH ADDL 311 88185 67 N/A Both 28.00 N/A N/A N/A N/A - - 30000517 HC ASSAY OF BLOOD PKU 300 84030 67 N/A Both 27.00 N/A N/A N/A N/A - - 31000073 HC CELL MARKER STUDY EACH ADDL 311 88185 67 N/A Both 27.00 N/A N/A N/A N/A - - 30001065 HC MYCOBACTERIA SUSCEPTIBILITY 300 87190 67 N/A Both 25.00 N/A N/A N/A N/A - - 31000102 HC CELL MARKER STUDY EACH ADDL 311 88185 67 N/A Both 24.00 N/A N/A N/A N/A - - 30000606 HC ALT 300 84460 67 N/A Both 20.00 N/A N/A N/A N/A - - 30100001 HC BILIRUBIN TOTAL 301 82247 67 N/A Both 20.00 N/A N/A N/A N/A - - 31000018 HC CYTO FNA ADD EPISODE SAME SITE 310 88177 67 N/A Both 19.00 N/A N/A N/A N/A - - 30000360 HC HEMOGLOBIN FRACTION ELECTROPHO 300 83020 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000318 HC GALACTOSE 300 82760 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000205 HC BIOTINIDASE 300 82261 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000379 HC CONGENTL ADREN HYPRPLSIC SCREN 300 83498 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000383 HC CYSTIC FIBROSIS SCREEN 300 83516 68 N/A Both 23.00 N/A N/A N/A N/A - - 30001379 HC ENZYME ACTIVITY - HURLER 300 82657 68 N/A Both 23.00 N/A N/A N/A N/A - - 30001378 HC ENZYME ACTIVITY - POMPE 300 82657 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000320 HC GALACTOSE-1-PHOS URIDYL TRANSF 300 82776 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000481 HC MASS AND TANDEM SPEC NES EACH 300 83789 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000149 HC SEVERE COMB IMMUNE DEFICIENCY 300 81479 68 N/A Both 23.00 N/A N/A N/A N/A - - 30001495 HC SPINAL MUSCULAR ATROPHY 300 81401 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000596 HC THYROXINE TOTAL NEONATAL 300 84437 68 N/A Both 23.00 N/A N/A N/A N/A - - 30001380 HC VERY LONG CHAIN FATTY ACID-X-LINKED ADRENOLEUKODYSTROPHY 300 82726 68 N/A Both 23.00 N/A N/A N/A N/A - - 30000482 HC PKU DIET SPOT MONITORING 300 84030 68 N/A Both 74.00 N/A N/A N/A N/A - - 76100079 HC TB INTRADERMAL TEST 761 86580 234 N/A Both 27.00 N/A N/A N/A N/A - - 63600008 HC OASIS ULTRA 5X7CM TRI-LAYER 636 Q4124 234 N/A Both 36.50 N/A N/A N/A N/A - - 76100045 HC BLOOD DRAW VIA PICC/PORT ACCESS 761 36592 234 N/A Both 39.00 N/A N/A N/A N/A - - 45000020 HC LACERATION REPAIR 450 234 N/A Both 42.00 N/A N/A N/A N/A - - 63600012 HC OASIS FENESTRATED 3X7CM 636 Q4102 234 N/A Both 43.91 N/A N/A N/A N/A - - 63600011 HC OASIS FENESTRATED 3X3.5CM 636 Q4102 234 N/A Both 43.95 N/A N/A N/A N/A - - 76100225 HC OBTAINING SCREEN PAP SMEAR 761 Q0091 234 N/A Both 47.00 N/A N/A N/A N/A - - 63600006 HC OASIS ULTRA 7X10CM TRI-LAYER 636 Q4124 234 N/A Both 48.67 N/A N/A N/A N/A - - 63600007 HC OASIS ULTRA 7X20CM TRI-LAYER 636 Q4124 234 N/A Both 48.67 N/A N/A N/A N/A - - 51000020 HC IMMUNOTX NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS 2+ INJ 510 95117 234 N/A Both 52.00 N/A N/A N/A N/A - - 51000019 HC IMMUNOTX NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS SINGLE INJ 510 95115 234 N/A Both 52.00 N/A N/A N/A N/A - - 63600010 HC OASIS ULTRA 3X7CM TRI-LAYER 636 Q4124 234 N/A Both 55.30 N/A N/A N/A N/A - - 63600009 HC OASIS ULTRA 3X3.5CM TRI-LAYER 636 Q4124 234 N/A Both 61.45 N/A N/A N/A N/A - - 27400048 HC OSTOMY BELT WITH PERISTOMAL HERNIA SUPPORT 274 A4396 234 N/A Both 65.00 N/A N/A N/A N/A - - 76100186 HC UNLISTED CHEMOTHERAPY PROCEDURE 761 96549 234 N/A Both 75.00 N/A N/A N/A N/A - - 77100005 HC IMMUNIZATION ADMINISTRATION EA ADDL 771 90472 234 N/A Both 90.00 N/A N/A N/A N/A - - 77100004 HC ADMINISTRATION FEE -- HEPATITIS B 771 90471 234 N/A Both 103.00 N/A N/A N/A N/A - - 77100001 HC ADMINISTRATION FEE -- INFLUENZA 771 90471 234 N/A Both 103.00 N/A N/A N/A N/A - - 77100002 HC ADMINISTRATION FEE -- PNEUMOCOCCAL 771 90471 234 N/A Both 103.00 N/A N/A N/A N/A - - 77100003 HC VACCINE ADMINISTRATION 771 90471 234 N/A Both 103.00 N/A N/A N/A N/A - - 76100036 HC OFFICE OUTPATIENT VISIT LEVEL 1 761 99211 234 N/A Both 107.00 N/A N/A N/A N/A - - 76100018 HC TX RM IV THER CONCUR INF 260 96368 234 N/A Both 109.00 N/A N/A N/A N/A - - 45000271 HC APPLY FINGER SPLINT DYNAMIC 450 29131 234 N/A Both 114.00 N/A N/A N/A N/A - - 45000270 HC APPLY FINGER SPLINT STATIC 450 29130 234 N/A Both 114.00 N/A N/A N/A N/A - - 45000031 HC TRIM NONDYSTROPHIC NAILS ANY NUMBER 450 11719 234 N/A Both 114.00 N/A N/A N/A N/A - - 76100001 HC DEBRIDEMENT OF NAIL 1-5 761 11720 234 N/A Both 125.00 N/A N/A N/A N/A - - 45000023 HC OCL LONG LEG BONE SPLINT 450 29505 234 N/A Both 125.00 N/A N/A N/A N/A - - 76100181 HC TRIM BENIGN HYPERKERATOTIC SKIN LESION 2-4 761 11056 234 N/A Both 127.00 N/A N/A N/A N/A - - 76100002 HC DEBRIDEMENT OF NAIL >5 761 11721 234 N/A Both 135.00 N/A N/A N/A N/A - - 76100016 HC TX RM IV ADL HR SAME DRG 260 96366 234 N/A Both 136.00 N/A N/A N/A N/A - - 76100046 HC TX RM IV THER ADL HR HYD 260 96361 234 N/A Both 136.00 N/A N/A N/A N/A - - 76100017 HC TX RM IV THER ADL INFUS 260 96367 234 N/A Both 136.00 N/A N/A N/A N/A - - 76100024 HC TX RM CHEMO INJ-HORMONAL 331 96402 234 N/A Both 138.00 N/A N/A N/A N/A - - 76100071 HC BLOOD DRAW FROM COMPLETELY IMPLANTABLE DEVICE OR A FISTULA DEVICE 761 36591 234 N/A Both 156.00 N/A N/A N/A N/A - - 76100028 HC CHEMO IV PUMP INITIATION 761 96416 234 N/A Both 156.00 N/A N/A N/A N/A - - 77000001 HC PREV VISIT EST AGE 40-64 770 99396 234 N/A Both 157.00 N/A N/A N/A N/A - - 76100019 HC TX RM INJECT NON CHEMO 260 96372 234 N/A Both 161.00 N/A N/A N/A N/A - - 76100005 HC INSERT SIMPLE CATH 761 51702 234 N/A Both 172.00 N/A N/A N/A N/A - - 76100004 HC INSERT STRAIGHT CATH 761 51701 234 N/A Both 172.00 N/A N/A N/A N/A - - 76100022 HC SUBS IV PUSH OF SAME DRUG 260 96376 234 N/A Both 172.00 N/A N/A N/A N/A - - 45000001 HC BLADDER SCAN 761 51798 234 N/A Both 173.00 N/A N/A N/A N/A - - 76100027 HC TX RM CHEMO ADL HR SM DRG 335 96415 234 N/A Both 173.00 N/A N/A N/A N/A - - 63600013 HC RESTRATA WOUND MATRIX PER SQ CM 278 C1849 234 N/A Both 175.00 N/A N/A N/A N/A - - 32000077 HC HIP UNI W OR WO PEL 1 VIEW 320 73501 234 N/A Both 178.00 N/A N/A N/A N/A - - 76100021 HC TX RM IV PUSH DIFF DRUG 260 96375 234 N/A Both 178.00 N/A N/A N/A N/A - - 76100030 HC TX RM IRRG OF IMPL DEVICE 761 96523 234 N/A Both 194.00 N/A N/A N/A N/A - - 32000098 HC CALCANEUS 2+ VIEWS 320 73650 234 N/A Both 198.00 N/A N/A N/A N/A - - 76100169 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT EA ADDL 25 SQCM 761 15276 234 N/A Both 209.00 N/A N/A N/A N/A - - 45000266 HC APPLY CAST FINGER (CONTRACTURE) 450 29086 234 N/A Both 209.00 N/A N/A N/A N/A - - 76100087 HC DEBRIDE OPEN WOUND EA ADDL 20 SQ CM 761 97598 234 N/A Both 209.00 N/A N/A N/A N/A - - 32000072 HC WRIST 2 VIEWS 320 73100 234 N/A Both 211.00 N/A N/A N/A N/A - - 45000269 HC APPLY FOREARM SPLINT DYNAMIC 450 29126 234 N/A Both 213.00 N/A N/A N/A N/A - - 45000268 HC APPLY FOREARM SPLINT STATIC 450 29125 234 N/A Both 213.00 N/A N/A N/A N/A - - 76100088 HC REMOVAL DEVITALIZED TISSUE PER SESSION 761 97602 234 N/A Both 219.00 N/A N/A N/A N/A - - 76100029 HC TX RM CHEMO IV ADL INFUS 331 96417 234 N/A Both 226.00 N/A N/A N/A N/A - - 32000068 HC ELBOW 2 VIEWS 320 73070 234 N/A Both 227.00 N/A N/A N/A N/A - - 76100050 HC OFFICE OUTPATIENT VISIT LEVEL 2 761 99212 234 N/A Both 228.00 N/A N/A N/A N/A - - 32000094 HC ANKLE 2 VIEWS 320 73600 234 N/A Both 230.00 N/A N/A N/A N/A - - 76100207 HC ENDOMETRIAL SAMPL W/WO ENDOCERV SAMPL WO CERV DILATION ANY METHOD 761 58100 234 N/A Both 230.00 N/A N/A N/A N/A - - 32000096 HC FOOT 2 VIEWS 320 73620 234 N/A Both 230.00 N/A N/A N/A N/A - - 76100200 HC INCAL BX SKN EA SEP ADDL 761 11107 234 N/A Both 235.00 N/A N/A N/A N/A - - 76100198 HC PUNCH BX SKIN EA SEP ADDL 761 11105 234 N/A Both 236.00 N/A N/A N/A N/A - - 27100014 HC OXYGEN LIMITED 0 TO 4 HOURS 271 234 N/A Both 238.00 N/A N/A N/A N/A - - 32000062 HC CLAVICLE COMPLETE 320 73000 234 N/A Both 250.00 N/A N/A N/A N/A - - 76100085 HC APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM 761 15272 234 N/A Both 261.00 N/A N/A N/A N/A - - 76100180 HC TRIM HYPERKERATOTIC SKIN LESION ONE 761 11055 234 N/A Both 268.00 N/A N/A N/A N/A - - 32400009 HC CHEST XRAY ONE VIEW 324 71045 234 N/A Both 269.00 N/A N/A N/A N/A - - 32000070 HC FOREARM 2 VIEWS 320 73090 234 N/A Both 272.00 N/A N/A N/A N/A - - 26000005 HC NON-CHEMO IV PUSH 260 96374 234 N/A Both 273.00 N/A N/A N/A N/A - - 45000267 HC APPLY LONG ARM SPLINT 450 29105 234 N/A Both 275.00 N/A N/A N/A N/A - - 45000279 HC APPLY LOWER LEG SPLINT 450 29515 234 N/A Both 275.00 N/A N/A N/A N/A - - 32000064 HC SHOULDER 1 VIEW 320 73020 234 N/A Both 275.00 N/A N/A N/A N/A - - 45000283 HC STRAPPING UNNA BOOT 450 29580 234 N/A Both 275.00 N/A N/A N/A N/A - - 76100151 HC APPLY CAST FIGURE EIGHT 761 29049 234 N/A Both 277.00 N/A N/A N/A N/A - - 76100150 HC APPLY CAST PLASTER VELPEAU 761 29058 234 N/A Both 277.00 N/A N/A N/A N/A - - 76100149 HC APPLY CAST SHOULDER SPICA 761 29055 234 N/A Both 277.00 N/A N/A N/A N/A - - 45000264 HC APPLY FOREARM CAST 450 29075 234 N/A Both 277.00 N/A N/A N/A N/A - - 45000265 HC APPLY HAND/WRIST CAST 450 29085 234 N/A Both 277.00 N/A N/A N/A N/A - - 76100160 HC APPLY PATELLAR TENDON BEARING CAST 761 29435 234 N/A Both 277.00 N/A N/A N/A N/A - - 45000277 HC APPLY SHORT LEG CAST 450 29405 234 N/A Both 277.00 N/A N/A N/A N/A - - 45000278 HC APPLY SHORT LEG CAST WALKER 450 29425 234 N/A Both 277.00 N/A N/A N/A N/A - - 32000092 HC TIBIA/FIBULA 2 VIEWS 320 73590 234 N/A Both 277.00 N/A N/A N/A N/A - - 32000033 HC STERNOCLAVICULAR JOINT 320 71130 234 N/A Both 284.00 N/A N/A N/A N/A - - 32000066 HC AC JOINTS BILATERAL 320 73050 234 N/A Both 285.00 N/A N/A N/A N/A - - 32900027 HC ARTHROCENTESIS SMALL JOINT 761 20600 234 N/A Both 294.00 N/A N/A N/A N/A - - 32000063 HC SCAPULA COMPLETE 320 73010 234 N/A Both 294.00 N/A N/A N/A N/A - - 32000078 HC HIP UNI W OR WO PEL 2-3 VIEWS 320 73502 234 N/A Both 297.00 N/A N/A N/A N/A - - 32000095 HC ANKLE 3+ VIEWS 320 73610 234 N/A Both 298.00 N/A N/A N/A N/A - - 32000067 HC HUMERUS 320 73060 234 N/A Both 302.00 N/A N/A N/A N/A - - 32900029 HC ARTHROCENTESIS INTERMED JNT 761 20605 234 N/A Both 303.00 N/A N/A N/A N/A - - 32000097 HC FOOT 3+ VIEWS 320 73630 234 N/A Both 310.00 N/A N/A N/A N/A - - 76100233 HC INSERTION INTRAUTERINE DEVICE IUD 761 58300 234 N/A Both 314.00 N/A N/A N/A N/A - - 76100023 HC TX RM CHEMO INJECT NON-H 331 96401 234 N/A Both 315.00 N/A N/A N/A N/A - - 27100015 HC OXYGEN LIMITED 4 TO 12 HOURS 271 234 N/A Both 318.00 N/A N/A N/A N/A - - 76100006 HC INSERT COMPLEX CATH 761 51703 234 N/A Both 321.00 N/A N/A N/A N/A - - 32000088 HC KNEE 1-2 VIEWS 320 73560 234 N/A Both 328.00 N/A N/A N/A N/A - - 76100172 HC CHEMICAL CAUTERIZE GRANULATION TISSUE 761 17250 234 N/A Both 329.00 N/A N/A N/A N/A - - 76100086 HC DEBRIDE OPEN WOUND 20 SQ CM< 761 97597 234 N/A Both 329.00 N/A N/A N/A N/A - - 76100051 HC OFFICE OUTPATIENT VISIT LEVEL 3 761 99213 234 N/A Both 331.00 N/A N/A N/A N/A - - 94000001 HC THERAPEUTIC PHLEBOTOMY 940 99195 234 N/A Both 332.00 N/A N/A N/A N/A - - 32000087 HC FEMUR 2 VIEWS 320 73552 234 N/A Both 333.00 N/A N/A N/A N/A - - 76100100 HC DRAIN SKIN ABSCESS SIMPLE 761 10060 234 N/A Both 334.00 N/A N/A N/A N/A - - 32000065 HC SHOULDER 2+ VIEWS 320 73030 234 N/A Both 341.00 N/A N/A N/A N/A - - 32900005 HC ASP ABSCESS HEMATOMA CYST 329 10160 234 N/A Both 344.00 N/A N/A N/A N/A - - 32000051 HC PELVIS COMPLETE 3+ VIEWS 320 72190 234 N/A Both 353.00 N/A N/A N/A N/A - - 32000079 HC HIP UNI W OR WO PEL 4+ VIEWS 320 73503 234 N/A Both 356.00 N/A N/A N/A N/A - - 76100204 HC COLPOSC CERVIX W ADJ VAG W BX & CURRETAG 761 57454 234 N/A Both 366.00 N/A N/A N/A N/A - - 76100206 HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAG 761 57456 234 N/A Both 366.00 N/A N/A N/A N/A - - 76100014 HC TX RM IV THER 31-1HR HYDR 260 96360 234 N/A Both 381.00 N/A N/A N/A N/A - - 76100168 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT 1ST 25 SQCM 761 15275 234 N/A Both 384.00 N/A N/A N/A N/A - - 76100178 HC NEG PRESS WOUND TX < 50CM 761 97605 234 N/A Both 394.00 N/A N/A N/A N/A - - 76100179 HC NEG PRESS WOUND TX > 50CM 761 97606 234 N/A Both 394.00 N/A N/A N/A N/A - - 76100156 HC APPLY CYLINDER CAST THIGH TO ANKLE 761 29365 234 N/A Both 397.00 N/A N/A N/A N/A - - 76100158 HC APPLY HIP SPICA CAST ONE LEG 761 29305 234 N/A Both 397.00 N/A N/A N/A N/A - - 45000275 HC APPLY LONG LEG CAST 450 29345 234 N/A Both 397.00 N/A N/A N/A N/A - - 76100157 HC APPLY LONG LEG CAST BRACE 761 29358 234 N/A Both 397.00 N/A N/A N/A N/A - - 76100232 HC UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE 761 17999 234 N/A Both 397.00 N/A N/A N/A N/A - - 76100025 HC TX RM CHEMO IV PUSH-ADL 331 96411 234 N/A Both 405.00 N/A N/A N/A N/A - - 76100261 HC INSERT PESSARY/OTHER DEVICE 761 57160 234 N/A Both 415.00 N/A N/A N/A N/A - - 76100159 HC APPLY RIGID TOTAL CONTACT LEG CAST 761 29445 234 N/A Both 416.00 N/A N/A N/A N/A - - 76100174 HC NEG PRESS WOUND THERAPY <= 50 SQCM 761 97607 234 N/A Both 416.00 N/A N/A N/A N/A - - 94000004 HC US WOUND ASSESSMENT PER DAY 940 97610 234 N/A Both 416.00 N/A N/A N/A N/A - - 76100052 HC OFFICE OUTPATIENT VISIT LEVEL 4 761 99214 234 N/A Both 436.00 N/A N/A N/A N/A - - 76100173 HC APPL MULTI-LAYER COMPRESSION SYS LEG BELOW KNEE 761 29581 234 N/A Both 438.00 N/A N/A N/A N/A - - 39100001 HC BLOOD PRODUCT ADMIN 391 36430 234 N/A Both 438.00 N/A N/A N/A N/A - - 76100090 HC BLADDER IRRIGATION 761 51700 234 N/A Both 439.00 N/A N/A N/A N/A - - 76100238 HC DESTRUCTION BENIGN LESIONS UP TO 14 761 17110 234 N/A Both 444.00 N/A N/A N/A N/A - - 76100218 HC PUNCH BIOPSY SKIN SINGLE LESION 761 11104 234 N/A Both 460.00 N/A N/A N/A N/A - - 33100005 HC CHEMO IV PUSH 331 96409 234 N/A Both 462.00 N/A N/A N/A N/A - - 45000318 "HC CHANGE OF BLADDER TUBE,SIMPLE" 450 51705 234 N/A Both 466.00 N/A N/A N/A N/A - - 76100015 HC TX RM IV THER 1STHR NON-H 260 96365 234 N/A Both 468.00 N/A N/A N/A N/A - - 76100199 HC INCAL BX SKN SINGLE LES 761 11106 234 N/A Both 470.00 N/A N/A N/A N/A - - 76100258 HC REMOVE INTRAUTERINE DEVICE 761 58301 234 N/A Both 479.00 N/A N/A N/A N/A - - 76100152 HC APPLY CAST SHOULDER TO HIPS 761 29035 234 N/A Both 481.00 N/A N/A N/A N/A - - 76100155 HC APPLY CAST SHOULDER TO HIPS ONE THIGH 761 29044 234 N/A Both 481.00 N/A N/A N/A N/A - - 45000263 HC APPLY LONG ARM CAST 450 29065 234 N/A Both 481.00 N/A N/A N/A N/A - - 45000276 HC APPLY LONG LEG CAST WALKER 450 29355 234 N/A Both 481.00 N/A N/A N/A N/A - - 76100184 HC CLOSED REDUCTION OF FRACTURE 761 234 N/A Both 488.00 N/A N/A N/A N/A - - 32900026 HC INJ TRIGGER PT 1 OR 2 MUSCLE 761 20552 234 N/A Both 493.00 N/A N/A N/A N/A - - 76100053 HC OFFICE OUTPATIENT VISIT LEVEL 5 761 99215 234 N/A Both 521.00 N/A N/A N/A N/A - - 76100171 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT EA ADDL 100 SQCM 761 15278 234 N/A Both 523.00 N/A N/A N/A N/A - - 76100167 HC APPL SKIN GRAFT T/A/L EA ADDL 100 SQCM 761 15274 234 N/A Both 523.00 N/A N/A N/A N/A - - 76100188 HC COLPOSCOPY ENTIRE VAGINA 761 57420 234 N/A Both 533.00 N/A N/A N/A N/A - - 76100189 HC CHEMODENERVATION PAROTID SUBMANDIBULAR SALIVARY GLANDS BILATERAL 761 64611 234 N/A Both 549.00 N/A N/A N/A N/A - - 76100154 HC APPLY CAST SHOULDER TO HIPS BOTH THIGHS 761 29046 234 N/A Both 575.00 N/A N/A N/A N/A - - 76100153 HC APPLY CAST SHOULDER TO HIPS HEAD MINERVA 761 29040 234 N/A Both 575.00 N/A N/A N/A N/A - - 76100161 HC APPLY HIP 1.5 SPICA OR BOTH LEGS 761 29325 234 N/A Both 575.00 N/A N/A N/A N/A - - 51000013 HC CIRCUMCISION W/REGIONL BLOC 723 54150 234 N/A Both 575.00 N/A N/A N/A N/A - - 76100182 HC INCISION & DRAINAGE SIMPLE 761 234 N/A Both 575.00 N/A N/A N/A N/A - - 33100002 HC CHEMO PLEURAL CAV W/THOR 331 96440 234 N/A Both 610.00 N/A N/A N/A N/A - - 32900147 HC DECLOT THROMBOLYTIC AGENT 761 36593 234 N/A Both 635.00 N/A N/A N/A N/A - - 76100226 HC CHEMODENERV MUSC NECK DYSTON 761 64616 234 N/A Both 637.00 N/A N/A N/A N/A - - 76100220 HC THROMBOLYSIS CEREBRAL BY INTRAVENOUS INFUSION 761 37195 234 N/A Both 669.00 N/A N/A N/A N/A - - 51000012 HC FETAL FLUID DRAINAGE W US 510 59074 234 N/A Both 670.00 N/A N/A N/A N/A - - 32900061 HC THORACENTESIS WO GUIDANCE 761 32554 234 N/A Both 684.00 N/A N/A N/A N/A - - 76100026 HC TX RM CHEMO IV 1ST HOUR 335 96413 234 N/A Both 686.00 N/A N/A N/A N/A - - 63600003 HC EPIFIX PER SQ CM 636 Q4186 234 N/A Both 691.00 N/A N/A N/A N/A - - 76100064 HC THORACENTESIS 761 234 N/A Both 712.00 N/A N/A N/A N/A - - 76100175 HC NEG PRESS WOUND THERAPY > 50 SQCM 761 97608 234 N/A Both 742.00 N/A N/A N/A N/A - - 32900031 HC INJ MAJOR JOINT THERAPEUTIC 761 20610 234 N/A Both 748.00 N/A N/A N/A N/A - - 76100163 HC DEBRIDE SUBQ TISSUE EA ADDL 20 SQCM 761 11045 234 N/A Both 767.00 N/A N/A N/A N/A - - 76100205 HC COLPOSCOPY ENTIRE VAGINA W BIOPSY(S) 761 57421 234 N/A Both 784.00 N/A N/A N/A N/A - - 32900006 HC DEBRIDE SKIN & SUBQ 761 11042 234 N/A Both 798.00 N/A N/A N/A N/A - - 32000003 HC PARACENTESIS WO GUIDANCE 761 49082 234 N/A Both 806.00 N/A N/A N/A N/A - - 76100080 HC INJECT TRIGGER POINTS > 3 761 20553 234 N/A Both 821.00 N/A N/A N/A N/A - - 32900299 HC SPINAL PUNC THERAPEUTIC 329 62272 234 N/A Both 841.00 N/A N/A N/A N/A - - 32900298 HC SPINAL PUNCTURE LUMBAR 761 62270 234 N/A Both 841.00 N/A N/A N/A N/A - - 76100187 HC ELECTRONIC ANALYSIS INTRATHECAL/EPIDURAL DRUG INFUSION 761 62369 234 N/A Both 846.00 N/A N/A N/A N/A - - 76100165 HC DEBRIDE BONE EA ADDL 20 SQCM 761 11047 234 N/A Both 862.00 N/A N/A N/A N/A - - 76100101 HC DRAIN SKIN ABSCESS COMPLIC 761 10061 234 N/A Both 862.00 N/A N/A N/A N/A - - 33100008 HC CHEMO BLADDER INSTILL 761 51720 234 N/A Both 899.00 N/A N/A N/A N/A - - 32900320 HC INJECT GREATER OCCIPTAL NERVE 761 64405 234 N/A Both 919.00 N/A N/A N/A N/A - - 76100164 HC DEBRIDE MUSCLE/FASCIAL EA ADDL 20 SQCM 761 11046 234 N/A Both 921.00 N/A N/A N/A N/A - - 51000021 HC UNLISTED PROCEDURE SMALL INTESTINE 510 44799 234 N/A Both 941.00 N/A N/A N/A N/A - - 51000026 HC INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE 510 10120 234 N/A Both 945.00 N/A N/A N/A N/A - - 76100063 HC SPINAL PUNCTURE LUMBAR 761 62270 234 N/A Both 969.00 N/A N/A N/A N/A - - 76100215 HC APPL LOW COST SKIN SUB (FACE/SCALP/EYE/MOUTH/NECK) 1ST 100 SQ CM 761 C5277 234 N/A Both 982.00 N/A N/A N/A N/A - - 76100214 HC APPL LOW COST SKIN SUB (FACE/SCALP/EYE/MOUTH/NECK) EA ADDL 25 SQ CM 761 C5276 234 N/A Both 982.00 N/A N/A N/A N/A - - 76100216 HC APPL LOW COST SKIN SUB (FACE/SCALP/EYE/MOUTH/NECK) EA ADL 100 SQ CM 761 C5278 234 N/A Both 982.00 N/A N/A N/A N/A - - 76100213 HC APPL LOW COST SKIN SUB (FACE/SCALP/EYE/MOUTH/NECK/ORB) 1ST 25 SQ CM 761 C5275 234 N/A Both 982.00 N/A N/A N/A N/A - - 76100209 HC APPL LOW COST SKIN SUB (T/A/L) 1ST 25 SQ CM 761 C5271 234 N/A Both 982.00 N/A N/A N/A N/A - - 76100212 HC APPL LOW COST SKIN SUB (T/A/L) EA ADDL 100 SQ CM 761 C5274 234 N/A Both 982.00 N/A N/A N/A N/A - - 76100210 HC APPL LOW COST SKIN SUB (T/A/L) EA ADDL 25 SQ CM 761 C5272 234 N/A Both 982.00 N/A N/A N/A N/A - - 76100183 HC INCISION & DRAINAGE COMPLICATED 761 234 N/A Both 982.00 N/A N/A N/A N/A - - 32900007 "HC DEBRIDE SKIN, SUBQ & MUSCLE" 329 11043 234 N/A Both 999.00 N/A N/A N/A N/A - - 76100066 HC PICC GROSHONG REPAIR 761 36575 234 N/A Both " 1,009.00 " N/A N/A N/A N/A - - 76100239 HC CLOSURE OF SPLIT WOUND 761 12020 234 N/A Both " 1,024.00 " N/A N/A N/A N/A - - 32900206 HC CHANGE GASTROSTOMY TUBE 761 43762 234 N/A Both " 1,039.00 " N/A N/A N/A N/A - - 76100081 HC EXT CANNULA DECLOTT WO BALLOON CATH 761 36860 234 N/A Both " 1,045.00 " N/A N/A N/A N/A - - 32900300 HC EPIDURAL BLOOD PATCH 370 62273 234 N/A Both " 1,046.00 " N/A N/A N/A N/A - - 76100084 HC APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM 761 15271 234 N/A Both " 1,096.00 " N/A N/A N/A N/A - - 76100020 HC ATTEMPT PICC INSERTION 5+ YRS 761 36569 234 N/A Both " 1,227.00 " N/A N/A N/A N/A - - 76100102 HC DRAIN PILONIDAL CYST SIMPL 761 10080 234 N/A Both " 1,255.00 " N/A N/A N/A N/A - - 32900065 HC INJ FIBRIN AGENT PLEURAL CATH 761 32561 234 N/A Both " 1,309.00 " N/A N/A N/A N/A - - 76100170 HC APPL SKIN GRAFT FACE SCALP GENITAL HANDS FT 1ST 100 SQCM 761 15277 234 N/A Both " 1,463.00 " N/A N/A N/A N/A - - 76100166 HC APPL SKIN GRAFT TO T/A/L 1ST 100 SQCM 761 15273 234 N/A Both " 1,463.00 " N/A N/A N/A N/A - - 76100224 "HC EPI AUTOGRFT FACE/NCK/HND/FT/GEN , EA 100 SQCM" 761 15116 234 N/A Both " 1,568.00 " N/A N/A N/A N/A - - 32900235 HC PARACENTESIS W GUIDANCE 761 49083 234 N/A Both " 1,588.00 " N/A N/A N/A N/A - - 76100177 HC PERIOTONEAL LAVAGE W WO IMAGING GUIDANCE 761 49084 234 N/A Both " 1,593.00 " N/A N/A N/A N/A - - 76100254 HC INJECTION EPIDURAL CERVICAL OR THORACIC WITHOUT IMAGING GUIDANCE 761 62320 234 N/A Both " 1,926.00 " N/A N/A N/A N/A - - 76100256 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN 761 62322 234 N/A Both " 1,957.00 " N/A N/A N/A N/A - - 32900393 HC INJ EPIDURAL CERV THOR FL 761 62321 234 N/A Both " 2,074.00 " N/A N/A N/A N/A - - 76100222 "HC EPIDRM AUTOGRFT TRNK/ARM/LEG, EACH 100 SQCM" 761 15111 234 N/A Both " 2,090.00 " N/A N/A N/A N/A - - 76100257 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN 761 62323 234 N/A Both " 2,110.00 " N/A N/A N/A N/A - - 76100162 HC DEBRIDE BONE 1ST 20 SQCM< 761 11044 234 N/A Both " 2,116.00 " N/A N/A N/A N/A - - 32900126 HC VCAD NT INSERT < 5 YR 761 36555 234 N/A Both " 2,192.00 " N/A N/A N/A N/A - - 76100091 HC TUBE THORACOSTOMY INCLUDES WATER SEAL 761 32551 234 N/A Both " 2,299.00 " N/A N/A N/A N/A - - 76100042 HC PICC INSERTION 5+ YRS 761 36569 234 N/A Both " 2,455.00 " N/A N/A N/A N/A - - 76100237 HC TENOTOMY OPEN TENDON FLEXOR FOOT SINGLE OR MULTIPLE 761 28230 234 N/A Both " 2,675.00 " N/A N/A N/A N/A - - 45000112 HC CLOSED RX CLAVICLE FX MANIPULATN 450 23505 234 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000156 HC CLOSED RX DIST RAD/ULNA FX MANIPUL 450 25605 234 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 45000154 HC CLOSED RX RAD/ULNA SHAFT FX MANIP 450 25565 234 N/A Both " 2,739.00 " N/A N/A N/A N/A - - 76100236 HC COMP EXT FIXATE STRUT CHANGE 761 20697 234 N/A Both " 2,853.00 " N/A N/A N/A N/A - - 76100234 HC REMOVAL SUPERFICIAL IMPLANT 761 20670 234 N/A Both " 3,031.00 " N/A N/A N/A N/A - - 76100223 HC EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100 SQCM 761 15115 234 N/A Both " 3,135.00 " N/A N/A N/A N/A - - 76100211 HC APPL LOW COST SKIN SUB (T/A/L) 1ST 100 SQ CM 761 C5273 234 N/A Both " 3,177.00 " N/A N/A N/A N/A - - 76100104 HC DRAINAGE OF HEMATOMA/FLUID 761 10140 234 N/A Both " 3,344.00 " N/A N/A N/A N/A - - 51000009 HC PARACENTESIS ANT CHAMB EYE ASPIR AQUEOUS SPX 510 65800 234 N/A Both " 4,175.00 " N/A N/A N/A N/A - - 51000010 HC DRAIN ANT CHMBR REMV BLOOD 510 65815 234 N/A Both " 4,186.00 " N/A N/A N/A N/A - - 51000011 HC DRAIN ANT CHMBR REMV VITREOUS 510 65810 234 N/A Both " 4,186.00 " N/A N/A N/A N/A - - 32900058 HC INSERT TUNNELED PLEURAL CATH 761 32550 234 N/A Both " 4,327.00 " N/A N/A N/A N/A - - 76100221 HC EPIDRM AUTOGRFT TRNK/ARM/LEG <100 SQCM 761 15110 234 N/A Both " 4,441.00 " N/A N/A N/A N/A - - 76100255 HC SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE EXTENSIVE OR COMPLICATED 761 13160 234 N/A Both " 6,200.00 " N/A N/A N/A N/A - - 99800013 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - AGILEMD 999 G1012 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800008 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - AIM SPECIALTY HEALTH 999 G1007 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800001 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - APPLIED PATHWAYS 999 G1000 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800009 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - CRANBERRY PEAK 999 G1008 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800002 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - EVICORE 999 G1001 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800014 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - EVIDENCE CARE 999 G1013 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800018 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - HEALTHHELP 999 G1017 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800019 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - INFINX 999 G1018 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800015 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - INVENIQA 999 G1014 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800020 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - LOGICNETS 999 G1019 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800003 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - MEDCURRENT 999 G1002 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800004 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - MEDICALIS 999 G1003 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800005 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - NATIONAL DECISION SUPPORT COMPANY 999 G1004 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800006 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - NATIONAL IMAGING ASSOCIATES 999 G1005 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800012 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - QUALIFIED TOOL NOT OTHERWISE SPECIFIED 999 G1011 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800016 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - RELIANT MEDICAL GROUP 999 G1015 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800010 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - SAGE HEALTH MANAGEMENT SOLUTIONS 999 G1009 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800017 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - SPEED OF CARE 999 G1016 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800011 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - STANSON 999 G1010 295 N/A Both 0.01 N/A N/A N/A N/A - - 99800007 HC RADIOLOGY CLINICAL DECISION SUPPORT MECHANISM - TEST APPROPRIATE 999 G1006 295 N/A Both 0.01 N/A N/A N/A N/A - - 30000281 HC BEDSIDE CREATININE 300 82565 295 N/A Both 13.00 N/A N/A N/A N/A - - 32000064 HC SHOULDER 1 VIEW 320 73020 295 N/A Both 31.00 N/A N/A N/A N/A - - 34200001 HC SUPV LOADING RADIOELEMENT 342 77790 295 N/A Both 35.00 N/A N/A N/A N/A - - 32000192 HC BONE AGE STUDIES 320 77072 295 N/A Both 36.00 N/A N/A N/A N/A - - 32000034 HC X-RAY SPINE ONE VIEW 320 72020 295 N/A Both 36.00 N/A N/A N/A N/A - - 32400009 HC CHEST XRAY ONE VIEW 324 71045 295 N/A Both 37.00 N/A N/A N/A N/A - - 32400013 HC CHEST DECUB/SPECIAL ONE VIEW 324 71045 295 N/A Both 37.00 N/A N/A N/A N/A - - 32000063 HC SCAPULA COMPLETE 320 73010 295 N/A Both 42.00 N/A N/A N/A N/A - - 32000098 HC CALCANEUS 2+ VIEWS 320 73650 295 N/A Both 45.00 N/A N/A N/A N/A - - 32000068 HC ELBOW 2 VIEWS 320 73070 295 N/A Both 45.00 N/A N/A N/A N/A - - 32000096 HC FOOT 2 VIEWS 320 73620 295 N/A Both 45.00 N/A N/A N/A N/A - - 32000216 HC ABDOMEN XRAY ONE VIEW 320 74018 295 N/A Both 45.00 N/A N/A N/A N/A - - 32000182 HC FOREIGN BODY EXAM-CHILD 320 76010 295 N/A Both 45.00 N/A N/A N/A N/A - - 32000050 HC PELVIS 1 OR 2 VIEWS 320 72170 295 N/A Both 45.00 N/A N/A N/A N/A - - 32000070 HC FOREARM 2 VIEWS 320 73090 295 N/A Both 46.00 N/A N/A N/A N/A - - 32000086 HC FEMUR 1 VIEW 320 73551 295 N/A Both 47.00 N/A N/A N/A N/A - - 32000011 HC FACIAL BONES 1-2 VIEWS 320 70140 295 N/A Both 48.00 N/A N/A N/A N/A - - 32000066 HC AC JOINTS BILATERAL 320 73050 295 N/A Both 49.00 N/A N/A N/A N/A - - 32400015 HC CHEST DECUBITUS/SPECIAL TWO VIEWS 324 71046 295 N/A Both 49.00 N/A N/A N/A N/A - - 32400010 HC CHEST XRAY TWO VIEWS 324 71046 295 N/A Both 49.00 N/A N/A N/A N/A - - 32000074 HC HAND 2 VIEWS 320 73120 295 N/A Both 49.00 N/A N/A N/A N/A - - 32000026 HC NECK SOFT TISSUE 320 70360 295 N/A Both 49.00 N/A N/A N/A N/A - - 32000038 HC SPINE THORACIC 2 VIEWS 320 72070 295 N/A Both 49.00 N/A N/A N/A N/A - - 32000099 HC TOE(S) 2+ VIEWS 320 73660 295 N/A Both 49.00 N/A N/A N/A N/A - - 32000077 HC HIP UNI W OR WO PEL 1 VIEW 320 73501 295 N/A Both 50.00 N/A N/A N/A N/A - - 32000199 HC DEXA RADIUS WRIST OR HEEL 320 77081 295 N/A Both 50.00 N/A N/A N/A N/A - - 32000069 HC ELBOW 3+ VIEWS 320 73080 295 N/A Both 50.00 N/A N/A N/A N/A - - 32000093 HC LOWER EXTREMITY INFANT 320 73592 295 N/A Both 50.00 N/A N/A N/A N/A - - 32000016 HC SINUS PARANASAL 1-2 VIEWS 320 70210 295 N/A Both 50.00 N/A N/A N/A N/A - - 32000071 HC UPPER EXTREMITY INFANT 320 73092 295 N/A Both 50.00 N/A N/A N/A N/A - - 32000092 HC TIBIA/FIBULA 2 VIEWS 320 73590 295 N/A Both 51.00 N/A N/A N/A N/A - - 32000005 HC EYE FOREIGN BODY 320 70030 295 N/A Both 51.00 N/A N/A N/A N/A - - 32000136 HC PELVIMETRY 320 74710 295 N/A Both 51.00 N/A N/A N/A N/A - - 32000054 HC SACRUM/COCCYX 320 72220 295 N/A Both 51.00 N/A N/A N/A N/A - - 32000032 HC STERNUM 320 71120 295 N/A Both 51.00 N/A N/A N/A N/A - - 32000062 HC CLAVICLE COMPLETE 320 73000 295 N/A Both 52.00 N/A N/A N/A N/A - - 32000067 HC HUMERUS 320 73060 295 N/A Both 52.00 N/A N/A N/A N/A - - 32000094 HC ANKLE 2 VIEWS 320 73600 295 N/A Both 53.00 N/A N/A N/A N/A - - 32000052 HC SACROILIAC JOINT 1-2 VIEW 320 72200 295 N/A Both 53.00 N/A N/A N/A N/A - - 32000041 HC SPINE T-L 2 VIEWS 320 72080 295 N/A Both 53.00 N/A N/A N/A N/A - - 32000065 HC SHOULDER 2+ VIEWS 320 73030 295 N/A Both 54.00 N/A N/A N/A N/A - - 40200035 HC PELVIS LIMITED 402 76857 295 N/A Both 54.00 N/A N/A N/A N/A - - 32000018 HC SELLA TURCICA 320 70240 295 N/A Both 54.00 N/A N/A N/A N/A - - 32000072 HC WRIST 2 VIEWS 320 73100 295 N/A Both 55.00 N/A N/A N/A N/A - - 32000097 HC FOOT 3+ VIEWS 320 73630 295 N/A Both 55.00 N/A N/A N/A N/A - - 32000217 HC ABDOMEN XRAY TWO VIEWS 320 74019 295 N/A Both 55.00 N/A N/A N/A N/A - - 32000028 HC RIBS UNILATERAL 2 VIEW 320 71100 295 N/A Both 55.00 N/A N/A N/A N/A - - 32000023 HC TMJ OPEN CLOSED UNI 320 70328 295 N/A Both 55.00 N/A N/A N/A N/A - - 32000088 HC KNEE 1-2 VIEWS 320 73560 295 N/A Both 57.00 N/A N/A N/A N/A - - 40100003 HC MAMMO DIAGNOSTIC BIL 3D 401 77062 295 N/A Both 57.00 N/A N/A N/A N/A - - 40300007 HC MAMMO SCREENING 3D VIEWS BIL 403 77063 295 N/A Both 57.00 N/A N/A N/A N/A - - 40300002 HC MAMMO SCREENING 3D VIEWS UNI 403 77063 295 N/A Both 57.00 N/A N/A N/A N/A - - 32000087 HC FEMUR 2 VIEWS 320 73552 295 N/A Both 58.00 N/A N/A N/A N/A - - 32000017 HC PARANASAL SINUS 3+ VIEWS 320 70220 295 N/A Both 58.00 N/A N/A N/A N/A - - 32000019 HC SKULL 1-3 VIEWS 320 70250 295 N/A Both 58.00 N/A N/A N/A N/A - - 32000095 HC ANKLE 3+ VIEWS 320 73610 295 N/A Both 59.00 N/A N/A N/A N/A - - 32000075 HC HAND 3+ VIEWS 320 73130 295 N/A Both 59.00 N/A N/A N/A N/A - - 32000053 HC SACROILIAC JOINTS 3+ VIEW 320 72202 295 N/A Both 60.00 N/A N/A N/A N/A - - 32000035 HC CERVICAL SPINE 2 OR 3 VIEWS 320 72040 295 N/A Both 61.00 N/A N/A N/A N/A - - 32000046 HC SPINE LUMBAR 2 OR 3 VIEWS 320 72100 295 N/A Both 61.00 N/A N/A N/A N/A - - 32000039 HC SPINE THORACIC 3 VIEWS 320 72072 295 N/A Both 61.00 N/A N/A N/A N/A - - 32000051 HC PELVIS COMPLETE 3+ VIEWS 320 72190 295 N/A Both 63.00 N/A N/A N/A N/A - - 32400011 HC CHEST APICAL LORDOTIC 324 71045 295 N/A Both 63.00 N/A N/A N/A N/A - - 32000029 HC CHEST W/RIBS UNI 3 VIEW 320 71101 295 N/A Both 63.00 N/A N/A N/A N/A - - 32400012 HC CHEST XRAY THREE VIEWS 324 71047 295 N/A Both 63.00 N/A N/A N/A N/A - - 32000006 HC MANDIBLE 1-3 VIEWS 320 70100 295 N/A Both 63.00 N/A N/A N/A N/A - - 32000008 HC MASTOIDS 1-2 VIEWS 320 70120 295 N/A Both 63.00 N/A N/A N/A N/A - - 32000013 HC NASAL BONES 320 70160 295 N/A Both 63.00 N/A N/A N/A N/A - - 32000218 HC ABDOMEN XRAY THREE + VIEWS 320 74021 295 N/A Both 64.00 N/A N/A N/A N/A - - 32000030 HC RIBS BIL 3 VIEWS 320 71110 295 N/A Both 64.00 N/A N/A N/A N/A - - 32000049 HC SPINE LUMBAR BEND 2-3 VIEWS 320 72120 295 N/A Both 64.00 N/A N/A N/A N/A - - 32000042 HC SPINE ONE VIEW 320 72081 295 N/A Both 64.00 N/A N/A N/A N/A - - 32000033 HC STERNOCLAVICULAR JOINT 320 71130 295 N/A Both 65.00 N/A N/A N/A N/A - - 32400014 HC CHEST XRAY FOUR + VIEWS 324 71048 295 N/A Both 65.00 N/A N/A N/A N/A - - 32000076 HC FINGER(S) 2+ VIEWS 320 73140 295 N/A Both 65.00 N/A N/A N/A N/A - - 32000082 HC HIP BIL W OR WO PEL 2 VIEWS 320 73521 295 N/A Both 65.00 N/A N/A N/A N/A - - 32000197 HC JOINT SINGLE VIEW 320 77077 295 N/A Both 65.00 N/A N/A N/A N/A - - 32000198 HC DEXA AXIAL SKELETON STUDY 320 77080 295 N/A Both 68.00 N/A N/A N/A N/A - - 32000089 HC KNEE 3 VIEWS 320 73562 295 N/A Both 68.00 N/A N/A N/A N/A - - 32000091 HC KNEES BOTH STANDING AP 320 73565 295 N/A Both 68.00 N/A N/A N/A N/A - - 32000007 HC MANDIBLE 4+ VIEWS 320 70110 295 N/A Both 68.00 N/A N/A N/A N/A - - 32000020 HC SKULL COMPLETE 4+ VIEWS 320 70260 295 N/A Both 68.00 N/A N/A N/A N/A - - 40200059 HC US ABDOMINAL AORTA LTD 402 76775 295 N/A Both 68.00 N/A N/A N/A N/A - - 40200060 HC US KIDNEY TRANSPLANT LTD 402 76775 295 N/A Both 68.00 N/A N/A N/A N/A - - 40200015 HC US RETROPERITONEAL LTD 402 76775 295 N/A Both 68.00 N/A N/A N/A N/A - - 32000073 HC WRIST 3+ VIEWS 320 73110 295 N/A Both 68.00 N/A N/A N/A N/A - - 32000193 HC BONE LENGTH STUDY 320 77073 295 N/A Both 69.00 N/A N/A N/A N/A - - 32000040 HC SPINE THORACIC 4+ VIEWS 320 72074 295 N/A Both 70.00 N/A N/A N/A N/A - - 35000011 HC 3D IMAGING W POST PROCESSING 350 76377 295 N/A Both 73.00 N/A N/A N/A N/A - - 35000010 HC 3D IMAGING W/O POST PROCESSING 350 76376 295 N/A Both 73.00 N/A N/A N/A N/A - - 32000103 HC ABD 2+ VIEWS INCLUDING SINGLE CHEST XRAY 320 74022 295 N/A Both 74.00 N/A N/A N/A N/A - - 32000012 HC FACIAL BONES 3+ VIEWS 320 70150 295 N/A Both 74.00 N/A N/A N/A N/A - - 32000090 HC KNEE COMPLETE 4+ VIEWS 320 73564 295 N/A Both 74.00 N/A N/A N/A N/A - - 32000015 HC ORBITS 4+ VIEWS 320 70200 295 N/A Both 74.00 N/A N/A N/A N/A - - 40200040 HC US EXTREMITY NONVASC LTD 402 76882 295 N/A Both 75.00 N/A N/A N/A N/A - - 32000078 HC HIP UNI W OR WO PEL 2-3 VIEWS 320 73502 295 N/A Both 77.00 N/A N/A N/A N/A - - 32000031 HC CHEST W/RIBS BIL 4+ VIEWS 320 71111 295 N/A Both 80.00 N/A N/A N/A N/A - - 32000047 HC SPINE LUMBAR 4+ VIEWS 320 72110 295 N/A Both 81.00 N/A N/A N/A N/A - - 32000036 HC SPINE CERVICAL 4 OR 5 VIEWS 320 72050 295 N/A Both 84.00 N/A N/A N/A N/A - - 32000083 HC HIP BIL W OR WO PEL 3-4 VIEWS 320 73522 295 N/A Both 85.00 N/A N/A N/A N/A - - 32000024 HC TMJ BILATERAL 320 70330 295 N/A Both 90.00 N/A N/A N/A N/A - - 32000194 HC OSSEOUS SURVEY LIMITED 320 77074 295 N/A Both 94.00 N/A N/A N/A N/A - - 32000079 HC HIP UNI W OR WO PEL 4+ VIEWS 320 73503 295 N/A Both 96.00 N/A N/A N/A N/A - - 32000009 HC MASTOIDS 3 OR MORE VIEWS 320 70130 295 N/A Both 97.00 N/A N/A N/A N/A - - 32000084 HC HIP BIL W OR WO PEL 5+ VIEWS 320 73523 295 N/A Both 99.00 N/A N/A N/A N/A - - 32000037 HC SPINE CERVICAL 6 OR MORE VIEWS 320 72052 295 N/A Both 101.00 N/A N/A N/A N/A - - 32000048 HC SPINE LUMB COMP W/BENDING 320 72114 295 N/A Both 101.00 N/A N/A N/A N/A - - 40200039 HC US EXTREMITY NONVASC COMPLETE 402 76881 295 N/A Both 106.00 N/A N/A N/A N/A - - 40200031 HC US FETAL BIOPHYS W/O STRESS 402 76819 295 N/A Both 111.00 N/A N/A N/A N/A - - 40200009 HC US CHEST 402 76604 295 N/A Both 115.00 N/A N/A N/A N/A - - 32000191 HC DUCTOGRAM MULTIPLE 320 77054 295 N/A Both 117.00 N/A N/A N/A N/A - - 32000190 HC DUCTOGRAM SINGLE 320 77053 295 N/A Both 117.00 N/A N/A N/A N/A - - 34200003 HC INJECT THERAPEUTIC RADPHARM 342 79101 295 N/A Both 117.00 N/A N/A N/A N/A - - 32000043 HC SPINE 2-3 VIEWS 320 72082 295 N/A Both 118.00 N/A N/A N/A N/A - - 40200028 HC US OB LTD 402 76815 295 N/A Both 118.00 N/A N/A N/A N/A - - 35200020 HC CT UPPER EXT W/WO CONTRAST 352 73202 295 N/A Both 122.00 N/A N/A N/A N/A - - 40200011 HC US BREAST LTD 402 76642 295 N/A Both 123.00 N/A N/A N/A N/A - - 33300041 HC RAD THERAPY INTRA-ARTERIAL 333 79445 295 N/A Both 132.00 N/A N/A N/A N/A - - 40200030 HC US TRANSVAGINAL OBSTETRICAL 402 76817 295 N/A Both 134.00 N/A N/A N/A N/A - - 40200062 HC US TRNSVG OB LTD 402 76817 295 N/A Both 134.00 N/A N/A N/A N/A - - 32000044 HC SPINE 4-5 VIEWS 320 72083 295 N/A Both 138.00 N/A N/A N/A N/A - - 40200013 HC US ABDOMEN LTD 402 76705 295 N/A Both 142.00 N/A N/A N/A N/A - - 32000105 HC SOFT TISSUE NECK INCLUDING SCOUT W/WO DELAYED IMAGES W CONTRAST 320 74210 295 N/A Both 149.00 N/A N/A N/A N/A - - 32000185 HC BODY SECTION TOMOGRAPHY 320 76100 295 N/A Both 153.00 N/A N/A N/A N/A - - 32000195 HC OSSEOUS SURVEY COMPLETE 320 77075 295 N/A Both 154.00 N/A N/A N/A N/A - - 32000196 HC OSSEOUS SURVEY-INFANT 320 77076 295 N/A Both 156.00 N/A N/A N/A N/A - - 40200010 HC US BREAST UNI COMPLETE 402 76641 295 N/A Both 163.00 N/A N/A N/A N/A - - 40200029 HC US OB FOLLOW-UP 402 76816 295 N/A Both 163.00 N/A N/A N/A N/A - - 32000045 HC SPINE 6 OR MORE VIEWS 320 72084 295 N/A Both 166.00 N/A N/A N/A N/A - - 35100001 HC CATOPSY HEAD 351 70450 295 N/A Both 167.00 N/A N/A N/A N/A - - 35100011 HC CT HEAD WO CON SURG PLAN 351 70450 295 N/A Both 167.00 N/A N/A N/A N/A - - 35100012 HC CT HEAD WO CONTRAST 351 70450 295 N/A Both 167.00 N/A N/A N/A N/A - - 40200018 HC US OB < 14 WKS 0 DAYS 402 76801 295 N/A Both 167.00 N/A N/A N/A N/A - - 40200036 HC US SCROTUM 402 76870 295 N/A Both 168.00 N/A N/A N/A N/A - - 40200042 HC US INFANT HIP WO/MANIP 402 76886 295 N/A Both 171.00 N/A N/A N/A N/A - - 40200034 HC US PELVIC COMPLETE 402 76856 295 N/A Both 173.00 N/A N/A N/A N/A - - 40200066 HC US PELVIS FOLLICLE INITIAL 402 76856 295 N/A Both 173.00 N/A N/A N/A N/A - - 40200014 HC US-ABD AORTA RENAL 402 76770 295 N/A Both 176.00 N/A N/A N/A N/A - - 35200037 HC CT LTD FOLLOW-UP 350 76380 295 N/A Both 181.00 N/A N/A N/A N/A - - 35200040 HC CT PELVIMETRY 350 76380 295 N/A Both 181.00 N/A N/A N/A N/A - - 40200041 HC US INFANT HIPS W/MANIP 402 76885 295 N/A Both 181.00 N/A N/A N/A N/A - - 40200012 HC US ABDOMEN 402 76700 295 N/A Both 189.00 N/A N/A N/A N/A - - 40200007 HC US HEAD 402 76506 295 N/A Both 191.00 N/A N/A N/A N/A - - 40200017 HC US SPINAL CANAL AND CONTENTS 402 76800 295 N/A Both 195.00 N/A N/A N/A N/A - - 40200061 HC US SPINE LTD 402 76800 295 N/A Both 195.00 N/A N/A N/A N/A - - 40200054 HC US AAA SCREENING CMS 402 76706 295 N/A Both 199.00 N/A N/A N/A N/A - - 40200057 HC US THYROID / NECK LTD 402 76536 295 N/A Both 202.00 N/A N/A N/A N/A - - 40200008 HC US THYROID/NECK 402 76536 295 N/A Both 202.00 N/A N/A N/A N/A - - 40200063 HC US TRANSVAG FOLLICLE INITIAL 402 76830 295 N/A Both 204.00 N/A N/A N/A N/A - - 40200064 HC US TRANSVAGINAL NONOBSTETRIC 402 76830 295 N/A Both 204.00 N/A N/A N/A N/A - - 40200032 HC US TRNSVG NON OB LTD 402 76830 295 N/A Both 204.00 N/A N/A N/A N/A - - 35200051 HC CATOPSY ABDOMEN 352 74150 295 N/A Both 205.00 N/A N/A N/A N/A - - 35200052 HC CT ABD W/O CONT LTD 352 74150 295 N/A Both 205.00 N/A N/A N/A N/A - - 35200026 HC CT ABDOMEN WO CONTRAST 352 74150 295 N/A Both 205.00 N/A N/A N/A N/A - - 40200024 HC US OB >= 14 WK SGL OR 1ST GEST 402 76805 295 N/A Both 208.00 N/A N/A N/A N/A - - 35200048 HC CATOPSY PELVIS 352 72192 295 N/A Both 209.00 N/A N/A N/A N/A - - 35200015 HC CT PELVIS W/O CONTRAST 352 72192 295 N/A Both 209.00 N/A N/A N/A N/A - - 40100002 HC MAMMO DIAGNOSTIC UNI 3D 401 77061 295 N/A Both 214.00 N/A N/A N/A N/A - - 40100008 HC MAMMOGRAPHY UNI DIAG 401 77065 295 N/A Both 214.00 N/A N/A N/A N/A - - 32000027 HC SALIVARY GLAND-CALCULUS 320 70380 295 N/A Both 214.00 N/A N/A N/A N/A - - 35100025 HC CT CATOPSY FACIAL BONES 351 70486 295 N/A Both 221.00 N/A N/A N/A N/A - - 35100026 HC CT MAX FACIAL LTD 351 70486 295 N/A Both 221.00 N/A N/A N/A N/A - - 35100027 HC CT MAX FACIAL WO CONTRAST 351 70486 295 N/A Both 221.00 N/A N/A N/A N/A - - 40300004 HC MAMMO SCREENING BIL W 3D 403 77067 295 N/A Both 227.00 N/A N/A N/A N/A - - 40300006 HC MAMMOGRAPHY SCREEN UNI 2D 403 77067 295 N/A Both 227.00 N/A N/A N/A N/A - - 40300003 HC MAMMOGRAPHY SCREENING BIL 2D 403 77067 295 N/A Both 227.00 N/A N/A N/A N/A - - 35200001 HC CATOPSY CHEST 352 71250 295 N/A Both 230.00 N/A N/A N/A N/A - - 35000001 HC CT SFT TS NECK W/O CONT 350 70490 295 N/A Both 230.00 N/A N/A N/A N/A - - 35200042 HC CT THORAX WO CONTRAST 352 71250 295 N/A Both 230.00 N/A N/A N/A N/A - - 92100028 HC DOPPLER - EXT VENOUS LTD 921 93971 295 N/A Both 230.00 N/A N/A N/A N/A - - 32000124 HC INTRAVENOUS PYELOGRAM 320 74400 295 N/A Both 238.00 N/A N/A N/A N/A - - 35200022 HC CT LOWER EXT W/O CONTRAST 352 73700 295 N/A Both 241.00 N/A N/A N/A N/A - - 35200011 HC CT SPINE LUMBAR W/O CONT 352 72131 295 N/A Both 241.00 N/A N/A N/A N/A - - 35200044 HC CATOPSY SPINE CERVICAL 352 72125 295 N/A Both 242.00 N/A N/A N/A N/A - - 35200005 HC CT SPINE CERVICAL WO CONT 352 72125 295 N/A Both 242.00 N/A N/A N/A N/A - - 35200008 HC CT SPINE THORACIC WO CONT 352 72128 295 N/A Both 242.00 N/A N/A N/A N/A - - 35100013 HC CT HEAD W CON SURG PLAN 351 70460 295 N/A Both 245.00 N/A N/A N/A N/A - - 35100002 HC CT HEAD W CONTRAST 351 70460 295 N/A Both 245.00 N/A N/A N/A N/A - - 35200004 HC CT LUNG WO CONT CANCER SCR 352 G0297 295 N/A Both 250.00 N/A N/A N/A N/A - - 35100008 HC CT MAX FACIAL W CONTRAST 351 70487 295 N/A Both 254.00 N/A N/A N/A N/A - - 92100045 HC DOPP AB PEL SCROT RET LTD 921 93976 295 N/A Both 254.00 N/A N/A N/A N/A - - 35100016 HC CT EARS WO CONTRAST 351 70480 295 N/A Both 255.00 N/A N/A N/A N/A - - 35100017 HC CT ORBIT WO CONTRAST 351 70480 295 N/A Both 255.00 N/A N/A N/A N/A - - 35100018 HC CT SELLA TURCICA WO CONTRAST 351 70480 295 N/A Both 255.00 N/A N/A N/A N/A - - 35200018 HC CT UPPER EXT W/O CONTRAST 352 73200 295 N/A Both 255.00 N/A N/A N/A N/A - - 40200037 HC US PROSTATE/TRANSRECTAL 402 76872 295 N/A Both 255.00 N/A N/A N/A N/A - - 35200056 HC CATOPSY ABD/PEL 352 74176 295 N/A Both 259.00 N/A N/A N/A N/A - - 35200031 HC CT ABD PEL W/O CONT 352 74176 295 N/A Both 259.00 N/A N/A N/A N/A - - 35200057 HC CT RENAL CALC W/O CONT 352 74176 295 N/A Both 259.00 N/A N/A N/A N/A - - 40200016 HC US TRANSPLANTED KIDNEY 402 76776 295 N/A Both 271.00 N/A N/A N/A N/A - - 40100007 HC MAMMOGRAPHY BIL DIAG 401 77066 295 N/A Both 273.00 N/A N/A N/A N/A - - 32900202 HC INJ PX ID SENTINEL NODE 329 38792 295 N/A Both 274.00 N/A N/A N/A N/A - - 34100039 HC RENAL FUNCTION W/PHARM 341 78708 295 N/A Both 275.00 N/A N/A N/A N/A - - 40300005 HC MAMMO SCREENING UNI W 3D 403 77067 295 N/A Both 284.00 N/A N/A N/A N/A - - 35100003 HC CT HEAD W WO CONTRAST 351 70470 295 N/A Both 293.00 N/A N/A N/A N/A - - 35200002 HC CT THORAX W/CONTRAST 352 71260 295 N/A Both 307.00 N/A N/A N/A N/A - - 35200006 HC CT SPINE CERVICAL W CONT 352 72126 295 N/A Both 309.00 N/A N/A N/A N/A - - 35200012 HC CT SPINE LUMBAR W CONT 352 72132 295 N/A Both 309.00 N/A N/A N/A N/A - - 35200023 HC CT LOWER EXT W CONTRAST 352 73701 295 N/A Both 312.00 N/A N/A N/A N/A - - 35000022 HC CT LOWER EXT W CONTRAST LTD 352 73701 295 N/A Both 312.00 N/A N/A N/A N/A - - 35200009 HC CT SPINE THORACIC W CONT 352 72129 295 N/A Both 312.00 N/A N/A N/A N/A - - 35100009 HC CT MAX FACIAL W/WO CONT 351 70488 295 N/A Both 322.00 N/A N/A N/A N/A - - 61200013 HC MRI PEDS TRAUMA CSPINE WO CON 612 72141 295 N/A Both 327.00 N/A N/A N/A N/A - - 61200018 HC MRI PEDS TRAUMA TSPINE WO CON 612 72146 295 N/A Both 327.00 N/A N/A N/A N/A - - 61200001 HC MRI SPINAL CANAL CERV W/O CONTRAST 612 72141 295 N/A Both 327.00 N/A N/A N/A N/A - - 61200003 HC MRI SPINAL CANAL THOR W/O CONTRAST 612 72146 295 N/A Both 327.00 N/A N/A N/A N/A - - 61200014 HC MRI STIR CERV W/O CONTRAST 612 72141 295 N/A Both 327.00 N/A N/A N/A N/A - - 61200019 HC MRI STIR THORA W/O CONTRAST 612 72146 295 N/A Both 327.00 N/A N/A N/A N/A - - 61200023 HC MRI PEDS TRAUMA LSPINE WO CON 612 72148 295 N/A Both 328.00 N/A N/A N/A N/A - - 61200005 HC MRI SPINAL CNL LUMBAR WO CONTRAST 612 72148 295 N/A Both 328.00 N/A N/A N/A N/A - - 61200024 HC MRI STIR LUMBAR W/O CONTRAST 612 72148 295 N/A Both 328.00 N/A N/A N/A N/A - - 61100015 HC MRI BRAIN W IACS WO CONT 611 70551 295 N/A Both 341.00 N/A N/A N/A N/A - - 61100016 HC MRI BRAIN W/O CONT SURG PLAN 611 70551 295 N/A Both 341.00 N/A N/A N/A N/A - - 61100017 HC MRI BRAIN W/O LTD 611 70551 295 N/A Both 341.00 N/A N/A N/A N/A - - 61100001 HC MRI BRAIN WO CONTRAST 611 70551 295 N/A Both 341.00 N/A N/A N/A N/A - - 61100018 HC MRI BRAIN/PIT W/O CONTRAST 611 70551 295 N/A Both 341.00 N/A N/A N/A N/A - - 61100019 HC MRI PEDS TRAUMA BRAIN WO CON 611 70551 295 N/A Both 341.00 N/A N/A N/A N/A - - 61100020 HC MRI PITUITARY W/O CONTRAST 611 70551 295 N/A Both 341.00 N/A N/A N/A N/A - - 92100046 HC US DOPP AORTA ILIAC IVC 921 93978 295 N/A Both 343.00 N/A N/A N/A N/A - - 32900010 HC ASPIRATION BREAST CYST 329 19000 295 N/A Both 360.00 N/A N/A N/A N/A - - 34100037 HC DACROSCINTIGRAPHY SCAN 341 78660 295 N/A Both 369.00 N/A N/A N/A N/A - - 61000165 HC MRI BILAT HIPS W/O CONTRAST 610 73721 295 N/A Both 370.00 N/A N/A N/A N/A - - 61000033 HC MRI JT LOWER EXT W/O CONTRAST 610 73721 295 N/A Both 370.00 N/A N/A N/A N/A - - 61000026 HC MRI JT UPPER EXT W/O CONTRAST 610 73221 295 N/A Both 370.00 N/A N/A N/A N/A - - 35000007 HC CT HEART W/WO CONTRAST 350 75572 295 N/A Both 372.00 N/A N/A N/A N/A - - 35000003 HC CT SFT TS NECK W/WO CONT 350 70492 295 N/A Both 375.00 N/A N/A N/A N/A - - 35200003 HC CT THORAX W/WO CONTRAST 352 71270 295 N/A Both 375.00 N/A N/A N/A N/A - - 35200019 HC CT UPPER EXT W/CONTRAST 352 73201 295 N/A Both 378.00 N/A N/A N/A N/A - - 35200013 HC CT LUMBAR SPINE W/WO CONT 352 72133 295 N/A Both 382.00 N/A N/A N/A N/A - - 34100029 HC PULM VENTILATION ONLY 341 78579 295 N/A Both 382.00 N/A N/A N/A N/A - - 35200007 HC CT SP CERVICAL W/WO CONT 352 72127 295 N/A Both 383.00 N/A N/A N/A N/A - - 35100019 HC CT EARS W CONTRAST 351 70481 295 N/A Both 384.00 N/A N/A N/A N/A - - 35100020 HC CT ORBIT W CONTRAST 351 70481 295 N/A Both 384.00 N/A N/A N/A N/A - - 35100021 HC CT SELLA TURCICA W CONTRAST 351 70481 295 N/A Both 384.00 N/A N/A N/A N/A - - 35200010 HC CT SPINE THORAC W/WO CONT 352 72130 295 N/A Both 384.00 N/A N/A N/A N/A - - 35200063 HC CT SPINE THORAC W/WO CONT 352 72130 295 N/A Both 384.00 N/A N/A N/A N/A - - 32900286 HC THYROID CYST ASPIRATE INJ 329 60300 295 N/A Both 388.00 N/A N/A N/A N/A - - 61000217 HC MR BREAST WO CONTRAST BIL 610 77047 295 N/A Both 394.00 N/A N/A N/A N/A - - 35200024 HC CT LOWER EXT W/WO CONT 352 73702 295 N/A Both 396.00 N/A N/A N/A N/A - - 92100044 HC US DOPP ABD PEL SCROT RET 921 93975 295 N/A Both 405.00 N/A N/A N/A N/A - - 35200033 HC CT ABD PEL W AND WO CONTRAST 352 74178 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200028 HC CT ABDOMEN W/WO CONTRAST 352 74170 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200030 HC CT ANGIO ABD W/WO CONTRAST 352 74175 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200036 HC CT ANGIO AO & BIL ILIOFEM W/WO 352 75635 295 N/A Both 413.00 N/A N/A N/A N/A - - 35000018 HC CT ANGIO CHEST W/WO CONTRAST 352 71275 295 N/A Both 413.00 N/A N/A N/A N/A - - 35100010 HC CT ANGIO HEAD W/WO CONTRAST 351 70496 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200025 HC CT ANGIO LOW EXT W/WO CONTRAST 352 73706 295 N/A Both 413.00 N/A N/A N/A N/A - - 35000004 HC CT ANGIO NECK W WO CONTRAST 350 70498 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200014 HC CT ANGIO PELVIS W/WO CONTRAST 352 72191 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200021 HC CT ANGIO UPPER EXT W/WO CONTR 352 73206 295 N/A Both 413.00 N/A N/A N/A N/A - - 35100022 HC CT EARS W WO CONTRAST 351 70482 295 N/A Both 413.00 N/A N/A N/A N/A - - 35100023 HC CT ORBIT W WO CONTRAST 351 70482 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200017 HC CT PELVIS W/WO CONTRAST 352 72194 295 N/A Both 413.00 N/A N/A N/A N/A - - 35100024 HC CT SELLA TURCICA W WO CONTRAST 351 70482 295 N/A Both 413.00 N/A N/A N/A N/A - - 35000002 HC CT SFT TS NECK W/CONTRAST 350 70491 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200043 HC CTA CHEST ASCENDING AORTA ONLY 352 71275 295 N/A Both 413.00 N/A N/A N/A N/A - - 35000025 HC CTA CHEST W/WO CONT LMTD 350 71275 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200060 HC CTA THORA/ABD AORTA W FEM RNFF 352 75635 295 N/A Both 413.00 N/A N/A N/A N/A - - 35200027 HC CT ABDOMEN W CONTRAST 352 74160 295 N/A Both 414.00 N/A N/A N/A N/A - - 35200016 HC CT PELVIS W CONTRAST 352 72193 295 N/A Both 414.00 N/A N/A N/A N/A - - 61000072 HC MRA & MRV HEAD W/O CONTRAST 610 70544 295 N/A Both 425.00 N/A N/A N/A N/A - - 61000009 HC MRA HEAD WO CONTRAST 610 70544 295 N/A Both 425.00 N/A N/A N/A N/A - - 61000073 HC MRV HEAD W/O CONTRAST 610 70544 295 N/A Both 425.00 N/A N/A N/A N/A - - 61000087 HC MRA & MRV NECK W/O CONTRAST 610 70547 295 N/A Both 427.00 N/A N/A N/A N/A - - 61000012 HC MRA NECK W/O CONTRAST 610 70547 295 N/A Both 427.00 N/A N/A N/A N/A - - 61000088 HC MRV NECK W/O CONTRAST 610 70547 295 N/A Both 427.00 N/A N/A N/A N/A - - 34100038 HC KIDNEY W/VASC FLOW/FUNCT 341 78707 295 N/A Both 434.00 N/A N/A N/A N/A - - 61000162 HC MRI LOW EXT BILAT W/O CONTRAST 610 73718 295 N/A Both 437.00 N/A N/A N/A N/A - - 61000030 HC MRI LOW EXT W/O CONTRAST 610 73718 295 N/A Both 437.00 N/A N/A N/A N/A - - 61000116 HC 3T MRI PELVIS WO CONTRAST 610 72195 295 N/A Both 443.00 N/A N/A N/A N/A - - 61000221 HC MRI PELVIS POST GEL PLACEMENT 610 72195 295 N/A Both 443.00 N/A N/A N/A N/A - - 61000019 HC MRI PELVIS WO CONTRAST 610 72195 295 N/A Both 443.00 N/A N/A N/A N/A - - 61000118 HC MRI SACRUM COCCYX WO CONTRAST 610 72195 295 N/A Both 443.00 N/A N/A N/A N/A - - 61000006 HC MRI ORBIT FACE NECK WO CONTR 610 70540 295 N/A Both 445.00 N/A N/A N/A N/A - - 61000062 HC MRI ORBITS ONLY WO CONT 610 70540 295 N/A Both 445.00 N/A N/A N/A N/A - - 61000076 HC MRA & MRV HEAD W/CONTRAST 610 70545 295 N/A Both 451.00 N/A N/A N/A N/A - - 61000077 HC MRA HEAD W/CONTRAST 610 70545 295 N/A Both 451.00 N/A N/A N/A N/A - - 61000078 HC MRV HEAD W/CONTRAST 610 70545 295 N/A Both 451.00 N/A N/A N/A N/A - - 32900285 HC THYROID BIOPSY PERC 329 60100 295 N/A Both 456.00 N/A N/A N/A N/A - - 32900284 HC AMNIOCENTESIS 329 59000 295 N/A Both 457.00 N/A N/A N/A N/A - - 61000091 HC MRA & MRV NECK W/CONTRAST 610 70548 295 N/A Both 459.00 N/A N/A N/A N/A - - 61000092 HC MRA NECK W/CONTRAST 610 70548 295 N/A Both 459.00 N/A N/A N/A N/A - - 61000093 HC MRV NECK W/CONTRAST 610 70548 295 N/A Both 459.00 N/A N/A N/A N/A - - 32900200 HC LYMPH NODE BIOPSY 329 38505 295 N/A Both 463.00 N/A N/A N/A N/A - - 34100007 HC BONE MARROW IMAGING WHOLE BODY 341 78104 295 N/A Both 493.00 N/A N/A N/A N/A - - 61100025 HC MRI BRAIN W/CONT SURG PLAN 611 70552 295 N/A Both 504.00 N/A N/A N/A N/A - - 61100002 HC MRI BRAIN W/CONTRAST 611 70552 295 N/A Both 504.00 N/A N/A N/A N/A - - 61100026 HC MRI BRAIN/PIT W/CONTRAST 611 70552 295 N/A Both 504.00 N/A N/A N/A N/A - - 61100027 HC MRI PITUITARY W/CONTRAST 611 70552 295 N/A Both 504.00 N/A N/A N/A N/A - - 61200006 HC MRI SPINAL CNL LUMB W/CONTRAST 612 72149 295 N/A Both 508.00 N/A N/A N/A N/A - - 61000031 HC MRI LOW EXT W/CONTRAST 610 73719 295 N/A Both 513.00 N/A N/A N/A N/A - - 61000020 HC MRI PELVIS W CONTRAST 610 72196 295 N/A Both 514.00 N/A N/A N/A N/A - - 61000121 HC MRI SACRUM COCCYX W CONTRAST 610 72196 295 N/A Both 514.00 N/A N/A N/A N/A - - 61200004 HC MRI SPINL CNL THOR W/CONTRAST 612 72147 295 N/A Both 515.00 N/A N/A N/A N/A - - 61200002 HC MRI SPINAL CNL CERV W/CONTRAST 612 72142 295 N/A Both 519.00 N/A N/A N/A N/A - - 61000007 HC MRI ORBIT/FACE/NECK W/CONTRAST 610 70542 295 N/A Both 525.00 N/A N/A N/A N/A - - 61000065 HC MRI ORBITS ONLY WITH CONTRAST 610 70542 295 N/A Both 525.00 N/A N/A N/A N/A - - 61000015 HC MRI CHEST W/O CONTRAST 610 71550 295 N/A Both 528.00 N/A N/A N/A N/A - - 61000023 HC MRI UPPER EXT WO CONTRAST 610 73218 295 N/A Both 529.00 N/A N/A N/A N/A - - 34100040 "HC INJ MAA TUMOR LOCALIZATION SINGLE AREA, SINGLE DAY IMAGING" 341 78800 295 N/A Both 531.00 N/A N/A N/A N/A - - 35200032 HC CT ABD PEL WITH CONTRAST 352 74177 295 N/A Both 542.00 N/A N/A N/A N/A - - 35200058 HC CT RENAL CALC W/CONT 352 74177 295 N/A Both 542.00 N/A N/A N/A N/A - - 61100032 HC MRI BRAIN W IACS W WO CONT 611 70553 295 N/A Both 575.00 N/A N/A N/A N/A - - 61100033 HC MRI BRAIN W/PITUITRY W/WO CONT 611 70553 295 N/A Both 575.00 N/A N/A N/A N/A - - 61100034 HC MRI BRAIN W/WO CONTRAST 611 70553 295 N/A Both 575.00 N/A N/A N/A N/A - - 61100035 HC MRI PITUITARY W/WO CONTRAST 611 70553 295 N/A Both 575.00 N/A N/A N/A N/A - - 61200009 HC MRI SPINAL CNL LUMB W/WO 612 72158 295 N/A Both 580.00 N/A N/A N/A N/A - - 61200007 HC MRI SPINAL CNL CERV W/WO 612 72156 295 N/A Both 581.00 N/A N/A N/A N/A - - 61200008 HC MRI SPINAL CNL THOR W/WO 612 72157 295 N/A Both 583.00 N/A N/A N/A N/A - - 32900012 HC INJ MAMMARY DUCTOGRAM 329 19030 295 N/A Both 586.00 N/A N/A N/A N/A - - 35200059 HC CT RENAL CALC W AND W/O CONT 352 74178 295 N/A Both 615.00 N/A N/A N/A N/A - - 61000021 HC MRI PELVIS W WO CONTRAST 610 72197 295 N/A Both 646.00 N/A N/A N/A N/A - - 61000124 HC MRI SACRUM COCCYX W WO 610 72197 295 N/A Both 646.00 N/A N/A N/A N/A - - 61000039 HC MRI ABD W/WO CONTRAST 610 74183 295 N/A Both 648.00 N/A N/A N/A N/A - - 61000224 HC MR BREAST W/WO CONTRAST W/WO DYNACAD BIL 610 77049 295 N/A Both 649.00 N/A N/A N/A N/A - - 61000008 HC MRI ORBIT/FACE/NECK W/WO CONTR 610 70543 295 N/A Both 649.00 N/A N/A N/A N/A - - 61000068 HC MRI ORBITS ONLY W/WO CONTRAST 610 70543 295 N/A Both 649.00 N/A N/A N/A N/A - - 61000032 HC MRI LOWER EXT W/WO CONTRAST 610 73720 295 N/A Both 651.00 N/A N/A N/A N/A - - 61000027 HC MRI JOINT UPPER EXT W/CONTRAST 610 73222 295 N/A Both 653.00 N/A N/A N/A N/A - - 61000170 HC MRI BILATERAL HIPS W/CONTRAST 610 73722 295 N/A Both 654.00 N/A N/A N/A N/A - - 61000034 HC MRI JT LOWER EXT W CONTRAST 610 73722 295 N/A Both 654.00 N/A N/A N/A N/A - - 61000171 HC MRI STIR WAIST TO KNEES 610 73722 295 N/A Both 654.00 N/A N/A N/A N/A - - 61000107 HC MRA & MRV CHEST W/CONTRAST 610 71555 295 N/A Both 677.00 N/A N/A N/A N/A - - 61000108 HC MRA & MRV CHEST W/O CONTRAST 610 71555 295 N/A Both 677.00 N/A N/A N/A N/A - - 61000109 HC MRA & MRV CHEST W/WO CONTRAST 610 71555 295 N/A Both 677.00 N/A N/A N/A N/A - - 61000113 HC MRV CHEST W/CONTRAST 610 71555 295 N/A Both 677.00 N/A N/A N/A N/A - - 61000114 HC MRV CHEST W/O CONTRAST 610 71555 295 N/A Both 677.00 N/A N/A N/A N/A - - 61000115 HC MRV CHEST W/WO CONTRAST 610 71555 295 N/A Both 677.00 N/A N/A N/A N/A - - 35200029 HC CTA ABD & PELVIS 352 74174 295 N/A Both 679.00 N/A N/A N/A N/A - - 61000184 HC MRA & MRV LOWER EXT W/CONTRAST 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000185 HC MRA & MRV LOWER EXT W/O CONTRA 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000186 HC MRA & MRV LOWER EXT W/WO CONTR 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000187 HC MRA LOWER EXT W & W/O CONTRAST 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000036 HC MRA LOWER EXTREMITY W/CONTRAST 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000188 HC MRA LOWER EXTREMITY W/O CONT 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000189 HC MRV EXT LOW W/WO CONTRAST 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000190 HC MRV LOWER EXT W/CONTRAST 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000191 HC MRV LOWER EXT W/O CONTRAST 610 73725 295 N/A Both 681.00 N/A N/A N/A N/A - - 61000134 HC MRA & MRV PELVIS W/CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000135 HC MRA & MRV PELVIS W/O CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000136 HC MRA & MRV PELVIS W/WO CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000137 HC MRA PELVIS W W/O CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000138 HC MRA PELVIS W/CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000139 HC MRA PELVIS W/O CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000140 HC MRV PELVIS W/CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000141 HC MRV PELVIS W/O CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000022 HC MRV PELVIS W/WO CONTRAST 610 72198 295 N/A Both 682.00 N/A N/A N/A N/A - - 61000081 HC MRA & MRV HEAD W/WO CONTRAST 610 70546 295 N/A Both 683.00 N/A N/A N/A N/A - - 61000082 HC MRA HEAD W/WO CONTRAST 610 70546 295 N/A Both 683.00 N/A N/A N/A N/A - - 61000083 HC MRV HEAD W/WO CONTRAST 610 70546 295 N/A Both 683.00 N/A N/A N/A N/A - - 61000201 HC MRA & MRV ABDOMEN W/CONTRAST 610 74185 295 N/A Both 686.00 N/A N/A N/A N/A - - 61000202 HC MRA & MRV ABDOMEN W/O CONTRAST 610 74185 295 N/A Both 686.00 N/A N/A N/A N/A - - 61000203 HC MRA & MRV ABDOMEN W/WO CONTRAS 610 74185 295 N/A Both 686.00 N/A N/A N/A N/A - - 61000205 HC MRA ABDOMEN W/O CONTRAST 610 74185 295 N/A Both 686.00 N/A N/A N/A N/A - - 61000206 HC MRV ABDOMEN W/CONTRAST 610 74185 295 N/A Both 686.00 N/A N/A N/A N/A - - 61000207 HC MRV ABDOMEN W/O CONTRAST 610 74185 295 N/A Both 686.00 N/A N/A N/A N/A - - 61000208 HC MRV ABDOMEN W/WO CONTRAST 610 74185 295 N/A Both 686.00 N/A N/A N/A N/A - - 61000097 HC MRA & MRV NECK W/WO CONTRAST 610 70549 295 N/A Both 688.00 N/A N/A N/A N/A - - 61000014 HC MRA NECK W/WO CONTRAST 610 70549 295 N/A Both 688.00 N/A N/A N/A N/A - - 61000098 HC MRV NECK W/WO CONTRAST 610 70549 295 N/A Both 688.00 N/A N/A N/A N/A - - 34100008 HC LYMPHATIC GLAND IMAGING 341 78195 295 N/A Both 694.00 N/A N/A N/A N/A - - 61000151 HC MRA & MRV UPPER EXT W/CONTRAST 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000152 HC MRA & MRV UPPER EXT W/O CONTRA 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000153 HC MRA & MRV UPPER EXT W/WO CONTR 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61200025 HC MRA SPNL CNL CONTENT W WO 612 72159 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000029 HC MRA UPPER EXT W & W/O CONTRAST 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000154 HC MRA UPPER EXTREMITY W/CONTRAST 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000155 HC MRA UPPER EXTREMITY W/O CONT 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000024 HC MRI UPPER EXT W/CONTRAST 610 73219 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000156 HC MRV UPPER EXT W/CONTRAST 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000157 HC MRV UPPER EXT W/O CONTRAST 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000158 HC MRV UPPER EXT W/WO CONTRAST 610 73225 295 N/A Both 709.00 N/A N/A N/A N/A - - 61000174 HC MRI BILAT HIPS W W/O CONTRAST 610 73723 295 N/A Both 791.00 N/A N/A N/A N/A - - 61000035 HC MRI JT LOWER EXT W/WO CONTRAST 610 73723 295 N/A Both 791.00 N/A N/A N/A N/A - - 61000028 HC MRI JOINT UPPER EXT W/WO CONTRAST 610 73223 295 N/A Both 793.00 N/A N/A N/A N/A - - 61000016 HC MRI CHEST W/CONTRAST 610 71551 295 N/A Both 808.00 N/A N/A N/A N/A - - 61000025 HC MRI UPPER EXT W/WO CONTRAST 610 73220 295 N/A Both 855.00 N/A N/A N/A N/A - - 61000017 HC MRI CHEST W/WO CONTRAST 610 71552 295 N/A Both 866.00 N/A N/A N/A N/A - - 32900018 HC BREAST NDL LOC STEREO ADDTL 329 19284 295 N/A Both 886.00 N/A N/A N/A N/A - - 32900017 HC BREAST NDL LOC STEREO GUIDE 329 19283 295 N/A Both 886.00 N/A N/A N/A N/A - - 61000047 HC MRI GUIDED NEEDLE PLACEMENT 610 77021 295 N/A Both 903.00 N/A N/A N/A N/A - - 34100013 HC NM GALLBLADDER PIPIDA W CCK 341 78227 295 N/A Both 932.00 N/A N/A N/A N/A - - 40200002 HC BX BREAST US ADDTL 402 19084 295 N/A Both " 1,796.00 " N/A N/A N/A N/A - - 40200055 HC BX BREAST US GUIDE 402 19083 295 N/A Both " 1,796.00 " N/A N/A N/A N/A - - 32900014 HC BX BREAST STEREO ADDTL 329 19082 295 N/A Both " 1,835.00 " N/A N/A N/A N/A - - 32900013 HC BX BREAST STEREO GUIDE 329 19081 295 N/A Both " 1,835.00 " N/A N/A N/A N/A - - 61000004 HC BREAST NDL LOC MR ADDTL 610 19288 295 N/A Both " 2,134.00 " N/A N/A N/A N/A - - 61000003 HC BREAST NDL LOC MR GUIDE 610 19287 295 N/A Both " 2,134.00 " N/A N/A N/A N/A - - 61000002 HC BX BREAST MR ADDTL 610 19086 295 N/A Both " 2,606.00 " N/A N/A N/A N/A - - 61000001 HC BX BREAST MR GUIDE 610 19085 295 N/A Both " 2,606.00 " N/A N/A N/A N/A - - 1-1 LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 146,898.59 " N/A N/A N/A " 146,898.59 " " 146,898.59 " 1-2 LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 195,808.22 " N/A N/A N/A " 195,808.22 " " 195,808.22 " 1-3 LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 358,272.10 " N/A N/A N/A " 358,272.10 " " 358,272.10 " 1-4 LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 462,948.95 " N/A N/A N/A " 462,948.95 " " 462,948.95 " 2-1 HEART &/OR LUNG TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 157,484.33 " N/A N/A N/A " 157,484.33 " " 157,484.33 " 2-2 HEART &/OR LUNG TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 213,477.23 " N/A N/A N/A " 213,477.23 " " 213,477.23 " 2-3 HEART &/OR LUNG TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 386,715.21 " N/A N/A N/A " 386,715.21 " " 386,715.21 " 2-4 HEART &/OR LUNG TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 530,848.01 " N/A N/A N/A " 530,848.01 " " 530,848.01 " 4-1 TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 91,556.58 " N/A N/A N/A " 91,556.58 " " 91,556.58 " 4-2 TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 101,940.90 " N/A N/A N/A " 101,940.90 " " 101,940.90 " 4-3 TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 133,994.66 " N/A N/A N/A " 133,994.66 " " 133,994.66 " 4-4 TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 270,242.23 " N/A N/A N/A " 270,242.23 " " 270,242.23 " 5-1 TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 79,113.30 " N/A N/A N/A " 79,113.30 " " 79,113.30 " 5-2 TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 84,478.91 " N/A N/A N/A " 84,478.91 " " 84,478.91 " 5-3 TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 115,424.85 " N/A N/A N/A " 115,424.85 " " 115,424.85 " 5-4 TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE N/A N/A N/A APR-DRG IP N/A " 172,665.43 " N/A N/A N/A " 172,665.43 " " 172,665.43 " 6-1 PANCREAS TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 108,302.42 " N/A N/A N/A " 108,302.42 " " 108,302.42 " 6-2 PANCREAS TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 157,991.61 " N/A N/A N/A " 157,991.61 " " 157,991.61 " 6-3 PANCREAS TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 196,591.52 " N/A N/A N/A " 196,591.52 " " 196,591.52 " 6-4 PANCREAS TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 267,786.03 " N/A N/A N/A " 267,786.03 " " 267,786.03 " 7-1 ALLOGENEIC BONE MARROW TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 167,271.85 " N/A N/A N/A " 167,271.85 " " 167,271.85 " 7-2 ALLOGENEIC BONE MARROW TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 247,550.78 " N/A N/A N/A " 247,550.78 " " 247,550.78 " 7-3 ALLOGENEIC BONE MARROW TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 271,368.69 " N/A N/A N/A " 271,368.69 " " 271,368.69 " 7-4 ALLOGENEIC BONE MARROW TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 347,317.09 " N/A N/A N/A " 347,317.09 " " 347,317.09 " 8-1 AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY N/A N/A N/A APR-DRG IP N/A " 85,484.14 " N/A N/A N/A " 85,484.14 " " 85,484.14 " 8-2 AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY N/A N/A N/A APR-DRG IP N/A " 142,849.68 " N/A N/A N/A " 142,849.68 " " 142,849.68 " 8-3 AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY N/A N/A N/A APR-DRG IP N/A " 186,746.18 " N/A N/A N/A " 186,746.18 " " 186,746.18 " 8-4 AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY N/A N/A N/A APR-DRG IP N/A " 282,245.37 " N/A N/A N/A " 282,245.37 " " 282,245.37 " 9-1 EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) N/A N/A N/A APR-DRG IP N/A " 73,729.05 " N/A N/A N/A " 73,729.05 " " 73,729.05 " 9-2 EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) N/A N/A N/A APR-DRG IP N/A " 94,894.93 " N/A N/A N/A " 94,894.93 " " 94,894.93 " 9-3 EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) N/A N/A N/A APR-DRG IP N/A " 113,041.38 " N/A N/A N/A " 113,041.38 " " 113,041.38 " 9-4 EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) N/A N/A N/A APR-DRG IP N/A " 337,822.37 " N/A N/A N/A " 337,822.37 " " 337,822.37 " 20-1 OPEN CRANIOTOMY FOR TRAUMA N/A N/A N/A APR-DRG IP N/A " 25,537.45 " N/A N/A N/A " 25,537.45 " " 25,537.45 " 20-2 OPEN CRANIOTOMY FOR TRAUMA N/A N/A N/A APR-DRG IP N/A " 38,661.45 " N/A N/A N/A " 38,661.45 " " 38,661.45 " 20-3 OPEN CRANIOTOMY FOR TRAUMA N/A N/A N/A APR-DRG IP N/A " 49,586.62 " N/A N/A N/A " 49,586.62 " " 49,586.62 " 20-4 OPEN CRANIOTOMY FOR TRAUMA N/A N/A N/A APR-DRG IP N/A " 131,661.54 " N/A N/A N/A " 131,661.54 " " 131,661.54 " 21-1 OPEN CRANIOTOMY EXCEPT TRAUMA N/A N/A N/A APR-DRG IP N/A " 29,353.24 " N/A N/A N/A " 29,353.24 " " 29,353.24 " 21-2 OPEN CRANIOTOMY EXCEPT TRAUMA N/A N/A N/A APR-DRG IP N/A " 39,536.14 " N/A N/A N/A " 39,536.14 " " 39,536.14 " 21-3 OPEN CRANIOTOMY EXCEPT TRAUMA N/A N/A N/A APR-DRG IP N/A " 70,866.27 " N/A N/A N/A " 70,866.27 " " 70,866.27 " 21-4 OPEN CRANIOTOMY EXCEPT TRAUMA N/A N/A N/A APR-DRG IP N/A " 113,069.36 " N/A N/A N/A " 113,069.36 " " 113,069.36 " 22-1 VENTRICULAR SHUNT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 18,735.79 " N/A N/A N/A " 18,735.79 " " 18,735.79 " 22-2 VENTRICULAR SHUNT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 26,262.93 " N/A N/A N/A " 26,262.93 " " 26,262.93 " 22-3 VENTRICULAR SHUNT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 37,650.62 " N/A N/A N/A " 37,650.62 " " 37,650.62 " 22-4 VENTRICULAR SHUNT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 71,468.67 " N/A N/A N/A " 71,468.67 " " 71,468.67 " 23-1 SPINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 16,428.79 " N/A N/A N/A " 16,428.79 " " 16,428.79 " 23-2 SPINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 31,315.22 " N/A N/A N/A " 31,315.22 " " 31,315.22 " 23-3 SPINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 61,323.07 " N/A N/A N/A " 61,323.07 " " 61,323.07 " 23-4 SPINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 109,037.23 " N/A N/A N/A " 109,037.23 " " 109,037.23 " 24-1 OPEN EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 13,672.32 " N/A N/A N/A " 13,672.32 " " 13,672.32 " 24-2 OPEN EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 18,485.88 " N/A N/A N/A " 18,485.88 " " 18,485.88 " 24-3 OPEN EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 41,369.43 " N/A N/A N/A " 41,369.43 " " 41,369.43 " 24-4 OPEN EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 72,572.75 " N/A N/A N/A " 72,572.75 " " 72,572.75 " 26-1 OTHER NERVOUS SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 16,432.52 " N/A N/A N/A " 16,432.52 " " 16,432.52 " 26-2 OTHER NERVOUS SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 28,463.63 " N/A N/A N/A " 28,463.63 " " 28,463.63 " 26-3 OTHER NERVOUS SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 40,270.95 " N/A N/A N/A " 40,270.95 " " 40,270.95 " 26-4 OTHER NERVOUS SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 85,970.91 " N/A N/A N/A " 85,970.91 " " 85,970.91 " 27-1 OTHER OPEN CRANIOTOMY N/A N/A N/A APR-DRG IP N/A " 32,223.47 " N/A N/A N/A " 32,223.47 " " 32,223.47 " 27-2 OTHER OPEN CRANIOTOMY N/A N/A N/A APR-DRG IP N/A " 33,797.53 " N/A N/A N/A " 33,797.53 " " 33,797.53 " 27-3 OTHER OPEN CRANIOTOMY N/A N/A N/A APR-DRG IP N/A " 48,075.97 " N/A N/A N/A " 48,075.97 " " 48,075.97 " 27-4 OTHER OPEN CRANIOTOMY N/A N/A N/A APR-DRG IP N/A " 91,674.08 " N/A N/A N/A " 91,674.08 " " 91,674.08 " 29-1 OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 22,540.39 " N/A N/A N/A " 22,540.39 " " 22,540.39 " 29-2 OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 25,908.58 " N/A N/A N/A " 25,908.58 " " 25,908.58 " 29-3 OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 48,372.51 " N/A N/A N/A " 48,372.51 " " 48,372.51 " 29-4 OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 88,870.98 " N/A N/A N/A " 88,870.98 " " 88,870.98 " 30-1 PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 35,283.94 " N/A N/A N/A " 35,283.94 " " 35,283.94 " 30-2 PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 35,688.64 " N/A N/A N/A " 35,688.64 " " 35,688.64 " 30-3 PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 51,050.65 " N/A N/A N/A " 51,050.65 " " 51,050.65 " 30-4 PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 97,047.14 " N/A N/A N/A " 97,047.14 " " 97,047.14 " 40-1 SPINAL DISORDERS & INJURIES N/A N/A N/A APR-DRG IP N/A " 19,177.80 " N/A N/A N/A " 19,177.80 " " 19,177.80 " 40-2 SPINAL DISORDERS & INJURIES N/A N/A N/A APR-DRG IP N/A " 21,895.10 " N/A N/A N/A " 21,895.10 " " 21,895.10 " 40-3 SPINAL DISORDERS & INJURIES N/A N/A N/A APR-DRG IP N/A " 28,562.48 " N/A N/A N/A " 28,562.48 " " 28,562.48 " 40-4 SPINAL DISORDERS & INJURIES N/A N/A N/A APR-DRG IP N/A " 42,221.74 " N/A N/A N/A " 42,221.74 " " 42,221.74 " 41-1 NERVOUS SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 11,852.08 " N/A N/A N/A " 11,852.08 " " 11,852.08 " 41-2 NERVOUS SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 13,144.52 " N/A N/A N/A " 13,144.52 " " 13,144.52 " 41-3 NERVOUS SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 17,913.33 " N/A N/A N/A " 17,913.33 " " 17,913.33 " 41-4 NERVOUS SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 31,680.76 " N/A N/A N/A " 31,680.76 " " 31,680.76 " 42-1 DEGENERATIVE NERVOUS SYSTEM DISORDERS EXC MULT SCLEROSIS N/A N/A N/A APR-DRG IP N/A " 11,344.80 " N/A N/A N/A " 11,344.80 " " 11,344.80 " 42-2 DEGENERATIVE NERVOUS SYSTEM DISORDERS EXC MULT SCLEROSIS N/A N/A N/A APR-DRG IP N/A " 16,512.71 " N/A N/A N/A " 16,512.71 " " 16,512.71 " 42-3 DEGENERATIVE NERVOUS SYSTEM DISORDERS EXC MULT SCLEROSIS N/A N/A N/A APR-DRG IP N/A " 28,215.59 " N/A N/A N/A " 28,215.59 " " 28,215.59 " 42-4 DEGENERATIVE NERVOUS SYSTEM DISORDERS EXC MULT SCLEROSIS N/A N/A N/A APR-DRG IP N/A " 43,394.82 " N/A N/A N/A " 43,394.82 " " 43,394.82 " 43-1 MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES N/A N/A N/A APR-DRG IP N/A " 15,899.13 " N/A N/A N/A " 15,899.13 " " 15,899.13 " 43-2 MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES N/A N/A N/A APR-DRG IP N/A " 17,493.70 " N/A N/A N/A " 17,493.70 " " 17,493.70 " 43-3 MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES N/A N/A N/A APR-DRG IP N/A " 25,571.02 " N/A N/A N/A " 25,571.02 " " 25,571.02 " 43-4 MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES N/A N/A N/A APR-DRG IP N/A " 46,153.16 " N/A N/A N/A " 46,153.16 " " 46,153.16 " 44-1 INTRACRANIAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 15,421.69 " N/A N/A N/A " 15,421.69 " " 15,421.69 " 44-2 INTRACRANIAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 17,212.09 " N/A N/A N/A " 17,212.09 " " 17,212.09 " 44-3 INTRACRANIAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 37,454.80 " N/A N/A N/A " 37,454.80 " " 37,454.80 " 44-4 INTRACRANIAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 47,867.09 " N/A N/A N/A " 47,867.09 " " 47,867.09 " 45-1 CVA & PRECEREBRAL OCCLUSION W INFARCT N/A N/A N/A APR-DRG IP N/A " 12,391.06 " N/A N/A N/A " 12,391.06 " " 12,391.06 " 45-2 CVA & PRECEREBRAL OCCLUSION W INFARCT N/A N/A N/A APR-DRG IP N/A " 15,127.02 " N/A N/A N/A " 15,127.02 " " 15,127.02 " 45-3 CVA & PRECEREBRAL OCCLUSION W INFARCT N/A N/A N/A APR-DRG IP N/A " 23,060.73 " N/A N/A N/A " 23,060.73 " " 23,060.73 " 45-4 CVA & PRECEREBRAL OCCLUSION W INFARCT N/A N/A N/A APR-DRG IP N/A " 36,570.79 " N/A N/A N/A " 36,570.79 " " 36,570.79 " 46-1 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT N/A N/A N/A APR-DRG IP N/A " 9,671.89 " N/A N/A N/A " 9,671.89 " " 9,671.89 " 46-2 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT N/A N/A N/A APR-DRG IP N/A " 12,012.47 " N/A N/A N/A " 12,012.47 " " 12,012.47 " 46-3 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT N/A N/A N/A APR-DRG IP N/A " 13,883.06 " N/A N/A N/A " 13,883.06 " " 13,883.06 " 46-4 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT N/A N/A N/A APR-DRG IP N/A " 34,868.04 " N/A N/A N/A " 34,868.04 " " 34,868.04 " 47-1 TRANSIENT ISCHEMIA N/A N/A N/A APR-DRG IP N/A " 9,285.84 " N/A N/A N/A " 9,285.84 " " 9,285.84 " 47-2 TRANSIENT ISCHEMIA N/A N/A N/A APR-DRG IP N/A " 10,955.01 " N/A N/A N/A " 10,955.01 " " 10,955.01 " 47-3 TRANSIENT ISCHEMIA N/A N/A N/A APR-DRG IP N/A " 16,184.47 " N/A N/A N/A " 16,184.47 " " 16,184.47 " 47-4 TRANSIENT ISCHEMIA N/A N/A N/A APR-DRG IP N/A " 30,311.85 " N/A N/A N/A " 30,311.85 " " 30,311.85 " 48-1 "PERIPHERAL, CRANIAL & AUTONOMIC NERVE DISORDERS" N/A N/A N/A APR-DRG IP N/A " 9,985.21 " N/A N/A N/A " 9,985.21 " " 9,985.21 " 48-2 "PERIPHERAL, CRANIAL & AUTONOMIC NERVE DISORDERS" N/A N/A N/A APR-DRG IP N/A " 11,290.71 " N/A N/A N/A " 11,290.71 " " 11,290.71 " 48-3 "PERIPHERAL, CRANIAL & AUTONOMIC NERVE DISORDERS" N/A N/A N/A APR-DRG IP N/A " 21,648.92 " N/A N/A N/A " 21,648.92 " " 21,648.92 " 48-4 "PERIPHERAL, CRANIAL & AUTONOMIC NERVE DISORDERS" N/A N/A N/A APR-DRG IP N/A " 36,272.39 " N/A N/A N/A " 36,272.39 " " 36,272.39 " 49-1 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 16,124.79 " N/A N/A N/A " 16,124.79 " " 16,124.79 " 49-2 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 38,808.79 " N/A N/A N/A " 38,808.79 " " 38,808.79 " 49-3 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 38,959.85 " N/A N/A N/A " 38,959.85 " " 38,959.85 " 49-4 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 74,907.73 " N/A N/A N/A " 74,907.73 " " 74,907.73 " 50-1 NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXC VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 11,852.08 " N/A N/A N/A " 11,852.08 " " 11,852.08 " 50-2 NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXC VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 19,321.40 " N/A N/A N/A " 19,321.40 " " 19,321.40 " 50-3 NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXC VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 28,286.46 " N/A N/A N/A " 28,286.46 " " 28,286.46 " 50-4 NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXC VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 43,021.82 " N/A N/A N/A " 43,021.82 " " 43,021.82 " 51-1 VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 8,556.62 " N/A N/A N/A " 8,556.62 " " 8,556.62 " 51-2 VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 14,295.23 " N/A N/A N/A " 14,295.23 " " 14,295.23 " 51-3 VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 25,559.83 " N/A N/A N/A " 25,559.83 " " 25,559.83 " 51-4 VIRAL MENINGITIS N/A N/A N/A APR-DRG IP N/A " 52,303.93 " N/A N/A N/A " 52,303.93 " " 52,303.93 " 52-1 ALTERATION IN CONSCIOUSNESS N/A N/A N/A APR-DRG IP N/A " 7,698.72 " N/A N/A N/A " 7,698.72 " " 7,698.72 " 52-2 ALTERATION IN CONSCIOUSNESS N/A N/A N/A APR-DRG IP N/A " 10,692.05 " N/A N/A N/A " 10,692.05 " " 10,692.05 " 52-3 ALTERATION IN CONSCIOUSNESS N/A N/A N/A APR-DRG IP N/A " 17,833.13 " N/A N/A N/A " 17,833.13 " " 17,833.13 " 52-4 ALTERATION IN CONSCIOUSNESS N/A N/A N/A APR-DRG IP N/A " 51,212.90 " N/A N/A N/A " 51,212.90 " " 51,212.90 " 53-1 SEIZURE N/A N/A N/A APR-DRG IP N/A " 12,920.72 " N/A N/A N/A " 12,920.72 " " 12,920.72 " 53-2 SEIZURE N/A N/A N/A APR-DRG IP N/A " 16,240.42 " N/A N/A N/A " 16,240.42 " " 16,240.42 " 53-3 SEIZURE N/A N/A N/A APR-DRG IP N/A " 20,914.11 " N/A N/A N/A " 20,914.11 " " 20,914.11 " 53-4 SEIZURE N/A N/A N/A APR-DRG IP N/A " 30,017.18 " N/A N/A N/A " 30,017.18 " " 30,017.18 " 54-1 MIGRAINE & OTHER HEADACHES N/A N/A N/A APR-DRG IP N/A " 8,275.01 " N/A N/A N/A " 8,275.01 " " 8,275.01 " 54-2 MIGRAINE & OTHER HEADACHES N/A N/A N/A APR-DRG IP N/A " 10,837.52 " N/A N/A N/A " 10,837.52 " " 10,837.52 " 54-3 MIGRAINE & OTHER HEADACHES N/A N/A N/A APR-DRG IP N/A " 13,575.34 " N/A N/A N/A " 13,575.34 " " 13,575.34 " 54-4 MIGRAINE & OTHER HEADACHES N/A N/A N/A APR-DRG IP N/A " 28,133.53 " N/A N/A N/A " 28,133.53 " " 28,133.53 " 55-1 HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 8,092.24 " N/A N/A N/A " 8,092.24 " " 8,092.24 " 55-2 HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 13,955.80 " N/A N/A N/A " 13,955.80 " " 13,955.80 " 55-3 HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 30,835.91 " N/A N/A N/A " 30,835.91 " " 30,835.91 " 55-4 HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 63,870.66 " N/A N/A N/A " 63,870.66 " " 63,870.66 " 56-1 "BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 10,550.31 " N/A N/A N/A " 10,550.31 " " 10,550.31 " 56-2 "BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 15,587.67 " N/A N/A N/A " 15,587.67 " " 15,587.67 " 56-3 "BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 22,396.79 " N/A N/A N/A " 22,396.79 " " 22,396.79 " 56-4 "BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 42,188.17 " N/A N/A N/A " 42,188.17 " " 42,188.17 " 57-1 "CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 7,275.37 " N/A N/A N/A " 7,275.37 " " 7,275.37 " 57-2 "CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 11,175.08 " N/A N/A N/A " 11,175.08 " " 11,175.08 " 57-3 "CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 16,712.27 " N/A N/A N/A " 16,712.27 " " 16,712.27 " 57-4 "CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA" N/A N/A N/A APR-DRG IP N/A " 32,305.53 " N/A N/A N/A " 32,305.53 " " 32,305.53 " 58-1 OTHER DISORDERS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 12,639.11 " N/A N/A N/A " 12,639.11 " " 12,639.11 " 58-2 OTHER DISORDERS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 17,999.12 " N/A N/A N/A " 17,999.12 " " 17,999.12 " 58-3 OTHER DISORDERS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 23,217.39 " N/A N/A N/A " 23,217.39 " " 23,217.39 " 58-4 OTHER DISORDERS OF NERVOUS SYSTEM N/A N/A N/A APR-DRG IP N/A " 24,371.82 " N/A N/A N/A " 24,371.82 " " 24,371.82 " 59-1 ANOXIC & OTHER SEVERE BRAIN DAMAGE N/A N/A N/A APR-DRG IP N/A " 12,833.07 " N/A N/A N/A " 12,833.07 " " 12,833.07 " 59-2 ANOXIC & OTHER SEVERE BRAIN DAMAGE N/A N/A N/A APR-DRG IP N/A " 16,068.84 " N/A N/A N/A " 16,068.84 " " 16,068.84 " 59-3 ANOXIC & OTHER SEVERE BRAIN DAMAGE N/A N/A N/A APR-DRG IP N/A " 29,771.00 " N/A N/A N/A " 29,771.00 " " 29,771.00 " 59-4 ANOXIC & OTHER SEVERE BRAIN DAMAGE N/A N/A N/A APR-DRG IP N/A " 32,749.40 " N/A N/A N/A " 32,749.40 " " 32,749.40 " 73-1 ORBIT & EYE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 16,992.02 " N/A N/A N/A " 16,992.02 " " 16,992.02 " 73-2 ORBIT & EYE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 24,474.40 " N/A N/A N/A " 24,474.40 " " 24,474.40 " 73-3 ORBIT & EYE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 33,967.25 " N/A N/A N/A " 33,967.25 " " 33,967.25 " 73-4 ORBIT & EYE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 67,526.06 " N/A N/A N/A " 67,526.06 " " 67,526.06 " 82-1 EYE INFECTIONS & OTHER EYE DISORDERS N/A N/A N/A APR-DRG IP N/A " 7,499.17 " N/A N/A N/A " 7,499.17 " " 7,499.17 " 82-2 EYE INFECTIONS & OTHER EYE DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,806.53 " N/A N/A N/A " 8,806.53 " " 8,806.53 " 82-3 EYE INFECTIONS & OTHER EYE DISORDERS N/A N/A N/A APR-DRG IP N/A " 14,479.86 " N/A N/A N/A " 14,479.86 " " 14,479.86 " 82-4 EYE INFECTIONS & OTHER EYE DISORDERS N/A N/A N/A APR-DRG IP N/A " 42,165.79 " N/A N/A N/A " 42,165.79 " " 42,165.79 " 89-1 MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 25,671.73 " N/A N/A N/A " 25,671.73 " " 25,671.73 " 89-2 MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 36,311.55 " N/A N/A N/A " 36,311.55 " " 36,311.55 " 89-3 MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 40,584.27 " N/A N/A N/A " 40,584.27 " " 40,584.27 " 89-4 MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 110,670.97 " N/A N/A N/A " 110,670.97 " " 110,670.97 " 91-1 OTHER MAJOR HEAD & NECK PROCEDURES N/A N/A N/A APR-DRG IP N/A " 19,360.57 " N/A N/A N/A " 19,360.57 " " 19,360.57 " 91-2 OTHER MAJOR HEAD & NECK PROCEDURES N/A N/A N/A APR-DRG IP N/A " 29,060.43 " N/A N/A N/A " 29,060.43 " " 29,060.43 " 91-3 OTHER MAJOR HEAD & NECK PROCEDURES N/A N/A N/A APR-DRG IP N/A " 62,882.21 " N/A N/A N/A " 62,882.21 " " 62,882.21 " 91-4 OTHER MAJOR HEAD & NECK PROCEDURES N/A N/A N/A APR-DRG IP N/A " 233,097.03 " N/A N/A N/A " 233,097.03 " " 233,097.03 " 92-1 FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 23,459.84 " N/A N/A N/A " 23,459.84 " " 23,459.84 " 92-2 FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 29,028.73 " N/A N/A N/A " 29,028.73 " " 29,028.73 " 92-3 FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 45,485.49 " N/A N/A N/A " 45,485.49 " " 45,485.49 " 92-4 FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 107,379.24 " N/A N/A N/A " 107,379.24 " " 107,379.24 " 95-1 CLEFT LIP & PALATE REPAIR N/A N/A N/A APR-DRG IP N/A " 14,854.73 " N/A N/A N/A " 14,854.73 " " 14,854.73 " 95-2 CLEFT LIP & PALATE REPAIR N/A N/A N/A APR-DRG IP N/A " 18,827.18 " N/A N/A N/A " 18,827.18 " " 18,827.18 " 95-3 CLEFT LIP & PALATE REPAIR N/A N/A N/A APR-DRG IP N/A " 27,320.39 " N/A N/A N/A " 27,320.39 " " 27,320.39 " 95-4 CLEFT LIP & PALATE REPAIR N/A N/A N/A APR-DRG IP N/A " 47,576.15 " N/A N/A N/A " 47,576.15 " " 47,576.15 " 97-1 TONSIL & ADENOID PROCEDURES N/A N/A N/A APR-DRG IP N/A " 8,810.26 " N/A N/A N/A " 8,810.26 " " 8,810.26 " 97-2 TONSIL & ADENOID PROCEDURES N/A N/A N/A APR-DRG IP N/A " 11,348.53 " N/A N/A N/A " 11,348.53 " " 11,348.53 " 97-3 TONSIL & ADENOID PROCEDURES N/A N/A N/A APR-DRG IP N/A " 19,323.27 " N/A N/A N/A " 19,323.27 " " 19,323.27 " 97-4 TONSIL & ADENOID PROCEDURES N/A N/A N/A APR-DRG IP N/A " 44,306.81 " N/A N/A N/A " 44,306.81 " " 44,306.81 " 98-1 "OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 19,890.23 " N/A N/A N/A " 19,890.23 " " 19,890.23 " 98-2 "OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 23,131.60 " N/A N/A N/A " 23,131.60 " " 23,131.60 " 98-3 "OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 39,276.90 " N/A N/A N/A " 39,276.90 " " 39,276.90 " 98-4 "OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 54,206.23 " N/A N/A N/A " 54,206.23 " " 54,206.23 " 110-1 "EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES" N/A N/A N/A APR-DRG IP N/A " 12,465.66 " N/A N/A N/A " 12,465.66 " " 12,465.66 " 110-2 "EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES" N/A N/A N/A APR-DRG IP N/A " 14,576.84 " N/A N/A N/A " 14,576.84 " " 14,576.84 " 110-3 "EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES" N/A N/A N/A APR-DRG IP N/A " 16,609.69 " N/A N/A N/A " 16,609.69 " " 16,609.69 " 110-4 "EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES" N/A N/A N/A APR-DRG IP N/A " 35,724.08 " N/A N/A N/A " 35,724.08 " " 35,724.08 " 111-1 VERTIGO & OTHER LABYRINTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,836.37 " N/A N/A N/A " 8,836.37 " " 8,836.37 " 111-2 VERTIGO & OTHER LABYRINTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 9,405.20 " N/A N/A N/A " 9,405.20 " " 9,405.20 " 111-3 VERTIGO & OTHER LABYRINTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 14,274.71 " N/A N/A N/A " 14,274.71 " " 14,274.71 " 111-4 VERTIGO & OTHER LABYRINTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 21,136.05 " N/A N/A N/A " 21,136.05 " " 21,136.05 " 113-1 INFECTIONS OF UPPER RESPIRATORY TRACT N/A N/A N/A APR-DRG IP N/A " 6,743.84 " N/A N/A N/A " 6,743.84 " " 6,743.84 " 113-2 INFECTIONS OF UPPER RESPIRATORY TRACT N/A N/A N/A APR-DRG IP N/A " 10,097.11 " N/A N/A N/A " 10,097.11 " " 10,097.11 " 113-3 INFECTIONS OF UPPER RESPIRATORY TRACT N/A N/A N/A APR-DRG IP N/A " 15,921.51 " N/A N/A N/A " 15,921.51 " " 15,921.51 " 113-4 INFECTIONS OF UPPER RESPIRATORY TRACT N/A N/A N/A APR-DRG IP N/A " 40,591.73 " N/A N/A N/A " 40,591.73 " " 40,591.73 " 114-1 DENTAL DISEASES & DISORDERS N/A N/A N/A APR-DRG IP N/A " 7,118.71 " N/A N/A N/A " 7,118.71 " " 7,118.71 " 114-2 DENTAL DISEASES & DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,005.73 " N/A N/A N/A " 10,005.73 " " 10,005.73 " 114-3 DENTAL DISEASES & DISORDERS N/A N/A N/A APR-DRG IP N/A " 15,831.99 " N/A N/A N/A " 15,831.99 " " 15,831.99 " 114-4 DENTAL DISEASES & DISORDERS N/A N/A N/A APR-DRG IP N/A " 38,068.38 " N/A N/A N/A " 38,068.38 " " 38,068.38 " 115-1 "OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 8,741.26 " N/A N/A N/A " 8,741.26 " " 8,741.26 " 115-2 "OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 9,500.31 " N/A N/A N/A " 9,500.31 " " 9,500.31 " 115-3 "OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 21,563.13 " N/A N/A N/A " 21,563.13 " " 21,563.13 " 115-4 "OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 55,198.41 " N/A N/A N/A " 55,198.41 " " 55,198.41 " 120-1 MAJOR RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 35,145.93 " N/A N/A N/A " 35,145.93 " " 35,145.93 " 120-2 MAJOR RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 43,646.60 " N/A N/A N/A " 43,646.60 " " 43,646.60 " 120-3 MAJOR RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 50,306.51 " N/A N/A N/A " 50,306.51 " " 50,306.51 " 120-4 MAJOR RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 115,033.20 " N/A N/A N/A " 115,033.20 " " 115,033.20 " 121-1 OTHER RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 23,575.47 " N/A N/A N/A " 23,575.47 " " 23,575.47 " 121-2 OTHER RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 30,641.95 " N/A N/A N/A " 30,641.95 " " 30,641.95 " 121-3 OTHER RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 44,789.84 " N/A N/A N/A " 44,789.84 " " 44,789.84 " 121-4 OTHER RESPIRATORY & CHEST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 82,608.31 " N/A N/A N/A " 82,608.31 " " 82,608.31 " 130-1 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS N/A N/A N/A APR-DRG IP N/A " 62,669.60 " N/A N/A N/A " 62,669.60 " " 62,669.60 " 130-2 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS N/A N/A N/A APR-DRG IP N/A " 69,915.12 " N/A N/A N/A " 69,915.12 " " 69,915.12 " 130-3 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS N/A N/A N/A APR-DRG IP N/A " 93,701.33 " N/A N/A N/A " 93,701.33 " " 93,701.33 " 130-4 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS N/A N/A N/A APR-DRG IP N/A " 119,514.80 " N/A N/A N/A " 119,514.80 " " 119,514.80 " 131-1 CYSTIC FIBROSIS - PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 23,633.28 " N/A N/A N/A " 23,633.28 " " 23,633.28 " 131-2 CYSTIC FIBROSIS - PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 28,946.67 " N/A N/A N/A " 28,946.67 " " 28,946.67 " 131-3 CYSTIC FIBROSIS - PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 39,909.14 " N/A N/A N/A " 39,909.14 " " 39,909.14 " 131-4 CYSTIC FIBROSIS - PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 59,394.66 " N/A N/A N/A " 59,394.66 " " 59,394.66 " 132-1 BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD N/A N/A N/A APR-DRG IP N/A " 3,707.62 " N/A N/A N/A " 3,707.62 " " 3,707.62 " 132-2 BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD N/A N/A N/A APR-DRG IP N/A " 4,975.82 " N/A N/A N/A " 4,975.82 " " 4,975.82 " 132-3 BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD N/A N/A N/A APR-DRG IP N/A " 8,267.55 " N/A N/A N/A " 8,267.55 " " 8,267.55 " 132-4 BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD N/A N/A N/A APR-DRG IP N/A " 12,764.06 " N/A N/A N/A " 12,764.06 " " 12,764.06 " 133-1 RESPIRATORY FAILURE N/A N/A N/A APR-DRG IP N/A " 7,698.72 " N/A N/A N/A " 7,698.72 " " 7,698.72 " 133-2 RESPIRATORY FAILURE N/A N/A N/A APR-DRG IP N/A " 14,561.92 " N/A N/A N/A " 14,561.92 " " 14,561.92 " 133-3 RESPIRATORY FAILURE N/A N/A N/A APR-DRG IP N/A " 22,689.59 " N/A N/A N/A " 22,689.59 " " 22,689.59 " 133-4 RESPIRATORY FAILURE N/A N/A N/A APR-DRG IP N/A " 38,266.07 " N/A N/A N/A " 38,266.07 " " 38,266.07 " 134-1 PULMONARY EMBOLISM N/A N/A N/A APR-DRG IP N/A " 9,244.81 " N/A N/A N/A " 9,244.81 " " 9,244.81 " 134-2 PULMONARY EMBOLISM N/A N/A N/A APR-DRG IP N/A " 12,260.51 " N/A N/A N/A " 12,260.51 " " 12,260.51 " 134-3 PULMONARY EMBOLISM N/A N/A N/A APR-DRG IP N/A " 20,337.83 " N/A N/A N/A " 20,337.83 " " 20,337.83 " 134-4 PULMONARY EMBOLISM N/A N/A N/A APR-DRG IP N/A " 31,524.10 " N/A N/A N/A " 31,524.10 " " 31,524.10 " 135-1 MAJOR CHEST & RESPIRATORY TRAUMA N/A N/A N/A APR-DRG IP N/A " 11,025.88 " N/A N/A N/A " 11,025.88 " " 11,025.88 " 135-2 MAJOR CHEST & RESPIRATORY TRAUMA N/A N/A N/A APR-DRG IP N/A " 12,027.39 " N/A N/A N/A " 12,027.39 " " 12,027.39 " 135-3 MAJOR CHEST & RESPIRATORY TRAUMA N/A N/A N/A APR-DRG IP N/A " 15,192.29 " N/A N/A N/A " 15,192.29 " " 15,192.29 " 135-4 MAJOR CHEST & RESPIRATORY TRAUMA N/A N/A N/A APR-DRG IP N/A " 29,265.58 " N/A N/A N/A " 29,265.58 " " 29,265.58 " 136-1 RESPIRATORY MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 14,024.80 " N/A N/A N/A " 14,024.80 " " 14,024.80 " 136-2 RESPIRATORY MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 14,502.24 " N/A N/A N/A " 14,502.24 " " 14,502.24 " 136-3 RESPIRATORY MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 31,678.89 " N/A N/A N/A " 31,678.89 " " 31,678.89 " 136-4 RESPIRATORY MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 48,637.34 " N/A N/A N/A " 48,637.34 " " 48,637.34 " 137-1 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS N/A N/A N/A APR-DRG IP N/A " 12,458.20 " N/A N/A N/A " 12,458.20 " " 12,458.20 " 137-2 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS N/A N/A N/A APR-DRG IP N/A " 17,881.62 " N/A N/A N/A " 17,881.62 " " 17,881.62 " 137-3 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS N/A N/A N/A APR-DRG IP N/A " 21,951.05 " N/A N/A N/A " 21,951.05 " " 21,951.05 " 137-4 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS N/A N/A N/A APR-DRG IP N/A " 37,868.83 " N/A N/A N/A " 37,868.83 " " 37,868.83 " 138-1 BRONCHIOLITIS & RSV PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 7,959.82 " N/A N/A N/A " 7,959.82 " " 7,959.82 " 138-2 BRONCHIOLITIS & RSV PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 10,611.85 " N/A N/A N/A " 10,611.85 " " 10,611.85 " 138-3 BRONCHIOLITIS & RSV PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 13,828.98 " N/A N/A N/A " 13,828.98 " " 13,828.98 " 138-4 BRONCHIOLITIS & RSV PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 21,697.41 " N/A N/A N/A " 21,697.41 " " 21,697.41 " 139-1 OTHER PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 9,265.32 " N/A N/A N/A " 9,265.32 " " 9,265.32 " 139-2 OTHER PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 11,473.48 " N/A N/A N/A " 11,473.48 " " 11,473.48 " 139-3 OTHER PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 17,363.15 " N/A N/A N/A " 17,363.15 " " 17,363.15 " 139-4 OTHER PNEUMONIA N/A N/A N/A APR-DRG IP N/A " 28,265.94 " N/A N/A N/A " 28,265.94 " " 28,265.94 " 140-1 CHRONIC OBSTRUCTIVE PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 11,466.02 " N/A N/A N/A " 11,466.02 " " 11,466.02 " 140-2 CHRONIC OBSTRUCTIVE PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 13,012.11 " N/A N/A N/A " 13,012.11 " " 13,012.11 " 140-3 CHRONIC OBSTRUCTIVE PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 16,950.99 " N/A N/A N/A " 16,950.99 " " 16,950.99 " 140-4 CHRONIC OBSTRUCTIVE PULMONARY DISEASE N/A N/A N/A APR-DRG IP N/A " 29,474.46 " N/A N/A N/A " 29,474.46 " " 29,474.46 " 141-1 ASTHMA N/A N/A N/A APR-DRG IP N/A " 8,254.49 " N/A N/A N/A " 8,254.49 " " 8,254.49 " 141-2 ASTHMA N/A N/A N/A APR-DRG IP N/A " 11,311.23 " N/A N/A N/A " 11,311.23 " " 11,311.23 " 141-3 ASTHMA N/A N/A N/A APR-DRG IP N/A " 14,547.00 " N/A N/A N/A " 14,547.00 " " 14,547.00 " 141-4 ASTHMA N/A N/A N/A APR-DRG IP N/A " 21,193.86 " N/A N/A N/A " 21,193.86 " " 21,193.86 " 142-1 INTERSTITIAL & ALVEOLAR LUNG DISEASES N/A N/A N/A APR-DRG IP N/A " 12,812.55 " N/A N/A N/A " 12,812.55 " " 12,812.55 " 142-2 INTERSTITIAL & ALVEOLAR LUNG DISEASES N/A N/A N/A APR-DRG IP N/A " 13,254.56 " N/A N/A N/A " 13,254.56 " " 13,254.56 " 142-3 INTERSTITIAL & ALVEOLAR LUNG DISEASES N/A N/A N/A APR-DRG IP N/A " 16,158.36 " N/A N/A N/A " 16,158.36 " " 16,158.36 " 142-4 INTERSTITIAL & ALVEOLAR LUNG DISEASES N/A N/A N/A APR-DRG IP N/A " 39,114.65 " N/A N/A N/A " 39,114.65 " " 39,114.65 " 143-1 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 11,786.80 " N/A N/A N/A " 11,786.80 " " 11,786.80 " 143-2 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 12,363.09 " N/A N/A N/A " 12,363.09 " " 12,363.09 " 143-3 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 17,419.10 " N/A N/A N/A " 17,419.10 " " 17,419.10 " 143-4 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 41,680.89 " N/A N/A N/A " 41,680.89 " " 41,680.89 " 144-1 "RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 7,760.27 " N/A N/A N/A " 7,760.27 " " 7,760.27 " 144-2 "RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 10,171.71 " N/A N/A N/A " 10,171.71 " " 10,171.71 " 144-3 "RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 15,749.93 " N/A N/A N/A " 15,749.93 " " 15,749.93 " 144-4 "RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 30,837.78 " N/A N/A N/A " 30,837.78 " " 30,837.78 " 145-1 ACUTE BRONCHITIS & RELATED SYMPTOMS N/A N/A N/A APR-DRG IP N/A " 8,256.36 " N/A N/A N/A " 8,256.36 " " 8,256.36 " 145-2 ACUTE BRONCHITIS & RELATED SYMPTOMS N/A N/A N/A APR-DRG IP N/A " 9,537.61 " N/A N/A N/A " 9,537.61 " " 9,537.61 " 145-3 ACUTE BRONCHITIS & RELATED SYMPTOMS N/A N/A N/A APR-DRG IP N/A " 10,787.16 " N/A N/A N/A " 10,787.16 " " 10,787.16 " 145-4 ACUTE BRONCHITIS & RELATED SYMPTOMS N/A N/A N/A APR-DRG IP N/A " 20,533.65 " N/A N/A N/A " 20,533.65 " " 20,533.65 " 160-1 MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY N/A N/A N/A APR-DRG IP N/A " 41,419.79 " N/A N/A N/A " 41,419.79 " " 41,419.79 " 160-2 MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY N/A N/A N/A APR-DRG IP N/A " 47,602.26 " N/A N/A N/A " 47,602.26 " " 47,602.26 " 160-3 MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY N/A N/A N/A APR-DRG IP N/A " 79,217.74 " N/A N/A N/A " 79,217.74 " " 79,217.74 " 160-4 MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY N/A N/A N/A APR-DRG IP N/A " 249,531.41 " N/A N/A N/A " 249,531.41 " " 249,531.41 " 161-1 IMPLANTABLE HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 191,386.30 " N/A N/A N/A " 191,386.30 " " 191,386.30 " 161-2 IMPLANTABLE HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 226,233.83 " N/A N/A N/A " 226,233.83 " " 226,233.83 " 161-3 IMPLANTABLE HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 241,056.85 " N/A N/A N/A " 241,056.85 " " 241,056.85 " 161-4 IMPLANTABLE HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 458,991.42 " N/A N/A N/A " 458,991.42 " " 458,991.42 " 162-1 CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 83,410.26 " N/A N/A N/A " 83,410.26 " " 83,410.26 " 162-2 CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 88,253.67 " N/A N/A N/A " 88,253.67 " " 88,253.67 " 162-3 CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 118,638.25 " N/A N/A N/A " 118,638.25 " " 118,638.25 " 162-4 CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 130,589.17 " N/A N/A N/A " 130,589.17 " " 130,589.17 " 163-1 CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 59,226.81 " N/A N/A N/A " 59,226.81 " " 59,226.81 " 163-2 CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 66,233.61 " N/A N/A N/A " 66,233.61 " " 66,233.61 " 163-3 CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 80,084.97 " N/A N/A N/A " 80,084.97 " " 80,084.97 " 163-4 CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 129,156.85 " N/A N/A N/A " 129,156.85 " " 129,156.85 " 165-1 CORONARY BYPASS W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 67,246.31 " N/A N/A N/A " 67,246.31 " " 67,246.31 " 165-2 CORONARY BYPASS W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 68,982.62 " N/A N/A N/A " 68,982.62 " " 68,982.62 " 165-3 CORONARY BYPASS W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 81,174.13 " N/A N/A N/A " 81,174.13 " " 81,174.13 " 165-4 CORONARY BYPASS W AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 96,890.48 " N/A N/A N/A " 96,890.48 " " 96,890.48 " 166-1 CORONARY BYPASS W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 51,427.38 " N/A N/A N/A " 51,427.38 " " 51,427.38 " 166-2 CORONARY BYPASS W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 58,257.01 " N/A N/A N/A " 58,257.01 " " 58,257.01 " 166-3 CORONARY BYPASS W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 69,948.69 " N/A N/A N/A " 69,948.69 " " 69,948.69 " 166-4 CORONARY BYPASS W/O AMI OR COMPLEX PDX N/A N/A N/A APR-DRG IP N/A " 94,999.37 " N/A N/A N/A " 94,999.37 " " 94,999.37 " 167-1 OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 33,439.45 " N/A N/A N/A " 33,439.45 " " 33,439.45 " 167-2 OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 43,197.13 " N/A N/A N/A " 43,197.13 " " 43,197.13 " 167-3 OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 55,879.13 " N/A N/A N/A " 55,879.13 " " 55,879.13 " 167-4 OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 164,112.54 " N/A N/A N/A " 164,112.54 " " 164,112.54 " 169-1 MAJOR ABDOMINAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 40,060.20 " N/A N/A N/A " 40,060.20 " " 40,060.20 " 169-2 MAJOR ABDOMINAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 48,023.75 " N/A N/A N/A " 48,023.75 " " 48,023.75 " 169-3 MAJOR ABDOMINAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 65,064.26 " N/A N/A N/A " 65,064.26 " " 65,064.26 " 169-4 MAJOR ABDOMINAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 121,260.44 " N/A N/A N/A " 121,260.44 " " 121,260.44 " 170-1 "PERMANENT CARDIAC PACEMAKER IMPLANT W AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 38,829.30 " N/A N/A N/A " 38,829.30 " " 38,829.30 " 170-2 "PERMANENT CARDIAC PACEMAKER IMPLANT W AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 42,962.14 " N/A N/A N/A " 42,962.14 " " 42,962.14 " 170-3 "PERMANENT CARDIAC PACEMAKER IMPLANT W AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 52,768.31 " N/A N/A N/A " 52,768.31 " " 52,768.31 " 170-4 "PERMANENT CARDIAC PACEMAKER IMPLANT W AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 73,522.03 " N/A N/A N/A " 73,522.03 " " 73,522.03 " 171-1 "PERM CARDIAC PACEMAKER IMPLANT W/O AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 26,820.57 " N/A N/A N/A " 26,820.57 " " 26,820.57 " 171-2 "PERM CARDIAC PACEMAKER IMPLANT W/O AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 30,470.37 " N/A N/A N/A " 30,470.37 " " 30,470.37 " 171-3 "PERM CARDIAC PACEMAKER IMPLANT W/O AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 47,941.69 " N/A N/A N/A " 47,941.69 " " 47,941.69 " 171-4 "PERM CARDIAC PACEMAKER IMPLANT W/O AMI, HEART FAILURE OR SHOCK" N/A N/A N/A APR-DRG IP N/A " 71,435.10 " N/A N/A N/A " 71,435.10 " " 71,435.10 " 174-1 PERCUTANEOUS CARDIAC INTERVENTION W AMI N/A N/A N/A APR-DRG IP N/A " 30,929.16 " N/A N/A N/A " 30,929.16 " " 30,929.16 " 174-2 PERCUTANEOUS CARDIAC INTERVENTION W AMI N/A N/A N/A APR-DRG IP N/A " 37,206.75 " N/A N/A N/A " 37,206.75 " " 37,206.75 " 174-3 PERCUTANEOUS CARDIAC INTERVENTION W AMI N/A N/A N/A APR-DRG IP N/A " 38,238.10 " N/A N/A N/A " 38,238.10 " " 38,238.10 " 174-4 PERCUTANEOUS CARDIAC INTERVENTION W AMI N/A N/A N/A APR-DRG IP N/A " 50,075.25 " N/A N/A N/A " 50,075.25 " " 50,075.25 " 175-1 PERCUTANEOUS CARDIAC INTERVENTION W/O AMI N/A N/A N/A APR-DRG IP N/A " 30,774.37 " N/A N/A N/A " 30,774.37 " " 30,774.37 " 175-2 PERCUTANEOUS CARDIAC INTERVENTION W/O AMI N/A N/A N/A APR-DRG IP N/A " 40,440.66 " N/A N/A N/A " 40,440.66 " " 40,440.66 " 175-3 PERCUTANEOUS CARDIAC INTERVENTION W/O AMI N/A N/A N/A APR-DRG IP N/A " 43,217.65 " N/A N/A N/A " 43,217.65 " " 43,217.65 " 175-4 PERCUTANEOUS CARDIAC INTERVENTION W/O AMI N/A N/A N/A APR-DRG IP N/A " 77,061.80 " N/A N/A N/A " 77,061.80 " " 77,061.80 " 176-1 "INSERTION, REVISION & REPLACEMENTS OF PACEMAKER & OTHER CARDIAC DEVICES" N/A N/A N/A APR-DRG IP N/A " 31,173.48 " N/A N/A N/A " 31,173.48 " " 31,173.48 " 176-2 "INSERTION, REVISION & REPLACEMENTS OF PACEMAKER & OTHER CARDIAC DEVICES" N/A N/A N/A APR-DRG IP N/A " 34,636.78 " N/A N/A N/A " 34,636.78 " " 34,636.78 " 176-3 "INSERTION, REVISION & REPLACEMENTS OF PACEMAKER & OTHER CARDIAC DEVICES" N/A N/A N/A APR-DRG IP N/A " 73,251.61 " N/A N/A N/A " 73,251.61 " " 73,251.61 " 176-4 "INSERTION, REVISION & REPLACEMENTS OF PACEMAKER & OTHER CARDIAC DEVICES" N/A N/A N/A APR-DRG IP N/A " 97,440.66 " N/A N/A N/A " 97,440.66 " " 97,440.66 " 177-1 CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 21,609.76 " N/A N/A N/A " 21,609.76 " " 21,609.76 " 177-2 CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 34,618.13 " N/A N/A N/A " 34,618.13 " " 34,618.13 " 177-3 CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 39,536.14 " N/A N/A N/A " 39,536.14 " " 39,536.14 " 177-4 CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 53,698.95 " N/A N/A N/A " 53,698.95 " " 53,698.95 " 178-1 EXTERNAL HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 84,986.19 " N/A N/A N/A " 84,986.19 " " 84,986.19 " 178-2 EXTERNAL HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 94,395.11 " N/A N/A N/A " 94,395.11 " " 94,395.11 " 178-3 EXTERNAL HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 110,087.22 " N/A N/A N/A " 110,087.22 " " 110,087.22 " 178-4 EXTERNAL HEART ASSIST SYSTEMS N/A N/A N/A APR-DRG IP N/A " 134,196.08 " N/A N/A N/A " 134,196.08 " " 134,196.08 " 179-1 DEFIBRILLATOR IMPLANTS N/A N/A N/A APR-DRG IP N/A " 56,889.96 " N/A N/A N/A " 56,889.96 " " 56,889.96 " 179-2 DEFIBRILLATOR IMPLANTS N/A N/A N/A APR-DRG IP N/A " 60,383.11 " N/A N/A N/A " 60,383.11 " " 60,383.11 " 179-3 DEFIBRILLATOR IMPLANTS N/A N/A N/A APR-DRG IP N/A " 94,639.43 " N/A N/A N/A " 94,639.43 " " 94,639.43 " 179-4 DEFIBRILLATOR IMPLANTS N/A N/A N/A APR-DRG IP N/A " 110,471.41 " N/A N/A N/A " 110,471.41 " " 110,471.41 " 180-1 OTHER CIRCULATORY SYSTEM PROCEDURES N/A N/A N/A APR-DRG IP N/A " 12,999.05 " N/A N/A N/A " 12,999.05 " " 12,999.05 " 180-2 OTHER CIRCULATORY SYSTEM PROCEDURES N/A N/A N/A APR-DRG IP N/A " 24,446.42 " N/A N/A N/A " 24,446.42 " " 24,446.42 " 180-3 OTHER CIRCULATORY SYSTEM PROCEDURES N/A N/A N/A APR-DRG IP N/A " 35,828.52 " N/A N/A N/A " 35,828.52 " " 35,828.52 " 180-4 OTHER CIRCULATORY SYSTEM PROCEDURES N/A N/A N/A APR-DRG IP N/A " 89,702.77 " N/A N/A N/A " 89,702.77 " " 89,702.77 " 181-1 LOWER EXTREMITY ARTERIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 21,406.47 " N/A N/A N/A " 21,406.47 " " 21,406.47 " 181-2 LOWER EXTREMITY ARTERIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 33,292.12 " N/A N/A N/A " 33,292.12 " " 33,292.12 " 181-3 LOWER EXTREMITY ARTERIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 68,454.83 " N/A N/A N/A " 68,454.83 " " 68,454.83 " 181-4 LOWER EXTREMITY ARTERIAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 106,060.69 " N/A N/A N/A " 106,060.69 " " 106,060.69 " 182-1 OTHER PERIPHERAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 35,505.87 " N/A N/A N/A " 35,505.87 " " 35,505.87 " 182-2 OTHER PERIPHERAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 43,366.85 " N/A N/A N/A " 43,366.85 " " 43,366.85 " 182-3 OTHER PERIPHERAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 51,022.67 " N/A N/A N/A " 51,022.67 " " 51,022.67 " 182-4 OTHER PERIPHERAL VASCULAR PROCEDURES N/A N/A N/A APR-DRG IP N/A " 126,152.33 " N/A N/A N/A " 126,152.33 " " 126,152.33 " 183-1 PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 65,717.01 " N/A N/A N/A " 65,717.01 " " 65,717.01 " 183-2 PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 70,317.96 " N/A N/A N/A " 70,317.96 " " 70,317.96 " 183-3 PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 88,233.15 " N/A N/A N/A " 88,233.15 " " 88,233.15 " 183-4 PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 133,920.06 " N/A N/A N/A " 133,920.06 " " 133,920.06 " 190-1 ACUTE MYOCARDIAL INFARCTION N/A N/A N/A APR-DRG IP N/A " 14,216.90 " N/A N/A N/A " 14,216.90 " " 14,216.90 " 190-2 ACUTE MYOCARDIAL INFARCTION N/A N/A N/A APR-DRG IP N/A " 16,702.94 " N/A N/A N/A " 16,702.94 " " 16,702.94 " 190-3 ACUTE MYOCARDIAL INFARCTION N/A N/A N/A APR-DRG IP N/A " 20,302.39 " N/A N/A N/A " 20,302.39 " " 20,302.39 " 190-4 ACUTE MYOCARDIAL INFARCTION N/A N/A N/A APR-DRG IP N/A " 36,037.40 " N/A N/A N/A " 36,037.40 " " 36,037.40 " 191-1 CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE N/A N/A N/A APR-DRG IP N/A " 15,970.00 " N/A N/A N/A " 15,970.00 " " 15,970.00 " 191-2 CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE N/A N/A N/A APR-DRG IP N/A " 18,590.32 " N/A N/A N/A " 18,590.32 " " 18,590.32 " 191-3 CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE N/A N/A N/A APR-DRG IP N/A " 26,387.89 " N/A N/A N/A " 26,387.89 " " 26,387.89 " 191-4 CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE N/A N/A N/A APR-DRG IP N/A " 40,394.04 " N/A N/A N/A " 40,394.04 " " 40,394.04 " 192-1 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 15,151.26 " N/A N/A N/A " 15,151.26 " " 15,151.26 " 192-2 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 19,630.99 " N/A N/A N/A " 19,630.99 " " 19,630.99 " 192-3 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 31,734.84 " N/A N/A N/A " 31,734.84 " " 31,734.84 " 192-4 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 43,808.85 " N/A N/A N/A " 43,808.85 " " 43,808.85 " 193-1 ACUTE & SUBACUTE ENDOCARDITIS N/A N/A N/A APR-DRG IP N/A " 16,104.28 " N/A N/A N/A " 16,104.28 " " 16,104.28 " 193-2 ACUTE & SUBACUTE ENDOCARDITIS N/A N/A N/A APR-DRG IP N/A " 17,120.70 " N/A N/A N/A " 17,120.70 " " 17,120.70 " 193-3 ACUTE & SUBACUTE ENDOCARDITIS N/A N/A N/A APR-DRG IP N/A " 27,615.06 " N/A N/A N/A " 27,615.06 " " 27,615.06 " 193-4 ACUTE & SUBACUTE ENDOCARDITIS N/A N/A N/A APR-DRG IP N/A " 46,464.61 " N/A N/A N/A " 46,464.61 " " 46,464.61 " 194-1 HEART FAILURE N/A N/A N/A APR-DRG IP N/A " 10,119.49 " N/A N/A N/A " 10,119.49 " " 10,119.49 " 194-2 HEART FAILURE N/A N/A N/A APR-DRG IP N/A " 13,280.67 " N/A N/A N/A " 13,280.67 " " 13,280.67 " 194-3 HEART FAILURE N/A N/A N/A APR-DRG IP N/A " 19,808.17 " N/A N/A N/A " 19,808.17 " " 19,808.17 " 194-4 HEART FAILURE N/A N/A N/A APR-DRG IP N/A " 32,012.73 " N/A N/A N/A " 32,012.73 " " 32,012.73 " 196-1 CARDIAC ARREST & SHOCK N/A N/A N/A APR-DRG IP N/A " 7,314.53 " N/A N/A N/A " 7,314.53 " " 7,314.53 " 196-2 CARDIAC ARREST & SHOCK N/A N/A N/A APR-DRG IP N/A " 10,570.82 " N/A N/A N/A " 10,570.82 " " 10,570.82 " 196-3 CARDIAC ARREST & SHOCK N/A N/A N/A APR-DRG IP N/A " 21,553.81 " N/A N/A N/A " 21,553.81 " " 21,553.81 " 196-4 CARDIAC ARREST & SHOCK N/A N/A N/A APR-DRG IP N/A " 30,951.54 " N/A N/A N/A " 30,951.54 " " 30,951.54 " 197-1 PERIPHERAL & OTHER VASCULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 9,330.60 " N/A N/A N/A " 9,330.60 " " 9,330.60 " 197-2 PERIPHERAL & OTHER VASCULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,798.35 " N/A N/A N/A " 10,798.35 " " 10,798.35 " 197-3 PERIPHERAL & OTHER VASCULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 14,931.19 " N/A N/A N/A " 14,931.19 " " 14,931.19 " 197-4 PERIPHERAL & OTHER VASCULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 26,372.97 " N/A N/A N/A " 26,372.97 " " 26,372.97 " 198-1 ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS N/A N/A N/A APR-DRG IP N/A " 7,504.76 " N/A N/A N/A " 7,504.76 " " 7,504.76 " 198-2 ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS N/A N/A N/A APR-DRG IP N/A " 7,937.44 " N/A N/A N/A " 7,937.44 " " 7,937.44 " 198-3 ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS N/A N/A N/A APR-DRG IP N/A " 13,666.72 " N/A N/A N/A " 13,666.72 " " 13,666.72 " 198-4 ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS N/A N/A N/A APR-DRG IP N/A " 21,184.54 " N/A N/A N/A " 21,184.54 " " 21,184.54 " 199-1 HYPERTENSION N/A N/A N/A APR-DRG IP N/A " 7,831.14 " N/A N/A N/A " 7,831.14 " " 7,831.14 " 199-2 HYPERTENSION N/A N/A N/A APR-DRG IP N/A " 11,272.06 " N/A N/A N/A " 11,272.06 " " 11,272.06 " 199-3 HYPERTENSION N/A N/A N/A APR-DRG IP N/A " 14,211.30 " N/A N/A N/A " 14,211.30 " " 14,211.30 " 199-4 HYPERTENSION N/A N/A N/A APR-DRG IP N/A " 21,938.00 " N/A N/A N/A " 21,938.00 " " 21,938.00 " 200-1 CARDIAC STRUCTURAL & VALVULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,130.68 " N/A N/A N/A " 10,130.68 " " 10,130.68 " 200-2 CARDIAC STRUCTURAL & VALVULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 12,180.32 " N/A N/A N/A " 12,180.32 " " 12,180.32 " 200-3 CARDIAC STRUCTURAL & VALVULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 19,414.65 " N/A N/A N/A " 19,414.65 " " 19,414.65 " 200-4 CARDIAC STRUCTURAL & VALVULAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 47,329.97 " N/A N/A N/A " 47,329.97 " " 47,329.97 " 201-1 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,237.71 " N/A N/A N/A " 8,237.71 " " 8,237.71 " 201-2 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS N/A N/A N/A APR-DRG IP N/A " 9,839.74 " N/A N/A N/A " 9,839.74 " " 9,839.74 " 201-3 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS N/A N/A N/A APR-DRG IP N/A " 18,901.78 " N/A N/A N/A " 18,901.78 " " 18,901.78 " 201-4 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS N/A N/A N/A APR-DRG IP N/A " 33,128.00 " N/A N/A N/A " 33,128.00 " " 33,128.00 " 203-1 CHEST PAIN N/A N/A N/A APR-DRG IP N/A " 7,170.93 " N/A N/A N/A " 7,170.93 " " 7,170.93 " 203-2 CHEST PAIN N/A N/A N/A APR-DRG IP N/A " 8,513.73 " N/A N/A N/A " 8,513.73 " " 8,513.73 " 203-3 CHEST PAIN N/A N/A N/A APR-DRG IP N/A " 8,717.01 " N/A N/A N/A " 8,717.01 " " 8,717.01 " 203-4 CHEST PAIN N/A N/A N/A APR-DRG IP N/A " 18,871.94 " N/A N/A N/A " 18,871.94 " " 18,871.94 " 204-1 SYNCOPE & COLLAPSE N/A N/A N/A APR-DRG IP N/A " 8,386.91 " N/A N/A N/A " 8,386.91 " " 8,386.91 " 204-2 SYNCOPE & COLLAPSE N/A N/A N/A APR-DRG IP N/A " 11,363.45 " N/A N/A N/A " 11,363.45 " " 11,363.45 " 204-3 SYNCOPE & COLLAPSE N/A N/A N/A APR-DRG IP N/A " 15,483.23 " N/A N/A N/A " 15,483.23 " " 15,483.23 " 204-4 SYNCOPE & COLLAPSE N/A N/A N/A APR-DRG IP N/A " 22,848.12 " N/A N/A N/A " 22,848.12 " " 22,848.12 " 205-1 CARDIOMYOPATHY N/A N/A N/A APR-DRG IP N/A " 10,007.59 " N/A N/A N/A " 10,007.59 " " 10,007.59 " 205-2 CARDIOMYOPATHY N/A N/A N/A APR-DRG IP N/A " 12,169.13 " N/A N/A N/A " 12,169.13 " " 12,169.13 " 205-3 CARDIOMYOPATHY N/A N/A N/A APR-DRG IP N/A " 14,172.14 " N/A N/A N/A " 14,172.14 " " 14,172.14 " 205-4 CARDIOMYOPATHY N/A N/A N/A APR-DRG IP N/A " 37,999.38 " N/A N/A N/A " 37,999.38 " " 37,999.38 " 206-1 "MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 15,749.93 " N/A N/A N/A " 15,749.93 " " 15,749.93 " 206-2 "MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 15,802.15 " N/A N/A N/A " 15,802.15 " " 15,802.15 " 206-3 "MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 18,036.42 " N/A N/A N/A " 18,036.42 " " 18,036.42 " 206-4 "MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 57,339.43 " N/A N/A N/A " 57,339.43 " " 57,339.43 " 207-1 OTHER CIRCULATORY SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 8,851.29 " N/A N/A N/A " 8,851.29 " " 8,851.29 " 207-2 OTHER CIRCULATORY SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 12,747.28 " N/A N/A N/A " 12,747.28 " " 12,747.28 " 207-3 OTHER CIRCULATORY SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 16,453.03 " N/A N/A N/A " 16,453.03 " " 16,453.03 " 207-4 OTHER CIRCULATORY SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 29,140.63 " N/A N/A N/A " 29,140.63 " " 29,140.63 " 220-1 "MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 26,214.44 " N/A N/A N/A " 26,214.44 " " 26,214.44 " 220-2 "MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 41,117.66 " N/A N/A N/A " 41,117.66 " " 41,117.66 " 220-3 "MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 68,618.95 " N/A N/A N/A " 68,618.95 " " 68,618.95 " 220-4 "MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 171,831.78 " N/A N/A N/A " 171,831.78 " " 171,831.78 " 222-1 "OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 9,168.34 " N/A N/A N/A " 9,168.34 " " 9,168.34 " 222-2 "OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 25,559.83 " N/A N/A N/A " 25,559.83 " " 25,559.83 " 222-3 "OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 29,806.43 " N/A N/A N/A " 29,806.43 " " 29,806.43 " 222-4 "OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 69,269.83 " N/A N/A N/A " 69,269.83 " " 69,269.83 " 223-1 OTHER SMALL & LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 18,674.25 " N/A N/A N/A " 18,674.25 " " 18,674.25 " 223-2 OTHER SMALL & LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 29,340.18 " N/A N/A N/A " 29,340.18 " " 29,340.18 " 223-3 OTHER SMALL & LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 49,114.78 " N/A N/A N/A " 49,114.78 " " 49,114.78 " 223-4 OTHER SMALL & LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 62,272.35 " N/A N/A N/A " 62,272.35 " " 62,272.35 " 224-1 PERITONEAL ADHESIOLYSIS N/A N/A N/A APR-DRG IP N/A " 24,466.94 " N/A N/A N/A " 24,466.94 " " 24,466.94 " 224-2 PERITONEAL ADHESIOLYSIS N/A N/A N/A APR-DRG IP N/A " 26,399.08 " N/A N/A N/A " 26,399.08 " " 26,399.08 " 224-3 PERITONEAL ADHESIOLYSIS N/A N/A N/A APR-DRG IP N/A " 42,874.49 " N/A N/A N/A " 42,874.49 " " 42,874.49 " 224-4 PERITONEAL ADHESIOLYSIS N/A N/A N/A APR-DRG IP N/A " 80,728.39 " N/A N/A N/A " 80,728.39 " " 80,728.39 " 226-1 ANAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 15,934.56 " N/A N/A N/A " 15,934.56 " " 15,934.56 " 226-2 ANAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 19,998.40 " N/A N/A N/A " 19,998.40 " " 19,998.40 " 226-3 ANAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 25,447.93 " N/A N/A N/A " 25,447.93 " " 25,447.93 " 226-4 ANAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 54,696.72 " N/A N/A N/A " 54,696.72 " " 54,696.72 " 227-1 "HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL" N/A N/A N/A APR-DRG IP N/A " 23,362.86 " N/A N/A N/A " 23,362.86 " " 23,362.86 " 227-2 "HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL" N/A N/A N/A APR-DRG IP N/A " 29,084.68 " N/A N/A N/A " 29,084.68 " " 29,084.68 " 227-3 "HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL" N/A N/A N/A APR-DRG IP N/A " 42,337.37 " N/A N/A N/A " 42,337.37 " " 42,337.37 " 227-4 "HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL" N/A N/A N/A APR-DRG IP N/A " 91,767.33 " N/A N/A N/A " 91,767.33 " " 91,767.33 " 228-1 "INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 13,590.26 " N/A N/A N/A " 13,590.26 " " 13,590.26 " 228-2 "INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 15,630.57 " N/A N/A N/A " 15,630.57 " " 15,630.57 " 228-3 "INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 24,300.95 " N/A N/A N/A " 24,300.95 " " 24,300.95 " 228-4 "INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 69,786.44 " N/A N/A N/A " 69,786.44 " " 69,786.44 " 229-1 OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 23,694.83 " N/A N/A N/A " 23,694.83 " " 23,694.83 " 229-2 OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 29,271.18 " N/A N/A N/A " 29,271.18 " " 29,271.18 " 229-3 OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 51,082.35 " N/A N/A N/A " 51,082.35 " " 51,082.35 " 229-4 OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 76,410.92 " N/A N/A N/A " 76,410.92 " " 76,410.92 " 230-1 MAJOR SMALL BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 26,134.25 " N/A N/A N/A " 26,134.25 " " 26,134.25 " 230-2 MAJOR SMALL BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 36,429.05 " N/A N/A N/A " 36,429.05 " " 36,429.05 " 230-3 MAJOR SMALL BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 58,096.62 " N/A N/A N/A " 58,096.62 " " 58,096.62 " 230-4 MAJOR SMALL BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 98,535.41 " N/A N/A N/A " 98,535.41 " " 98,535.41 " 231-1 MAJOR LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 26,755.29 " N/A N/A N/A " 26,755.29 " " 26,755.29 " 231-2 MAJOR LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 34,910.94 " N/A N/A N/A " 34,910.94 " " 34,910.94 " 231-3 MAJOR LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 54,099.92 " N/A N/A N/A " 54,099.92 " " 54,099.92 " 231-4 MAJOR LARGE BOWEL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 85,622.15 " N/A N/A N/A " 85,622.15 " " 85,622.15 " 232-1 GASTRIC FUNDOPLICATION N/A N/A N/A APR-DRG IP N/A " 20,130.81 " N/A N/A N/A " 20,130.81 " " 20,130.81 " 232-2 GASTRIC FUNDOPLICATION N/A N/A N/A APR-DRG IP N/A " 20,830.19 " N/A N/A N/A " 20,830.19 " " 20,830.19 " 232-3 GASTRIC FUNDOPLICATION N/A N/A N/A APR-DRG IP N/A " 30,860.16 " N/A N/A N/A " 30,860.16 " " 30,860.16 " 232-4 GASTRIC FUNDOPLICATION N/A N/A N/A APR-DRG IP N/A " 78,921.21 " N/A N/A N/A " 78,921.21 " " 78,921.21 " 233-1 APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 16,958.45 " N/A N/A N/A " 16,958.45 " " 16,958.45 " 233-2 APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 23,786.21 " N/A N/A N/A " 23,786.21 " " 23,786.21 " 233-3 APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 34,243.27 " N/A N/A N/A " 34,243.27 " " 34,243.27 " 233-4 APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 62,076.53 " N/A N/A N/A " 62,076.53 " " 62,076.53 " 234-1 APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 13,625.69 " N/A N/A N/A " 13,625.69 " " 13,625.69 " 234-2 APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 19,824.95 " N/A N/A N/A " 19,824.95 " " 19,824.95 " 234-3 APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 24,396.07 " N/A N/A N/A " 24,396.07 " " 24,396.07 " 234-4 APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 48,758.56 " N/A N/A N/A " 48,758.56 " " 48,758.56 " 240-1 DIGESTIVE MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 14,606.68 " N/A N/A N/A " 14,606.68 " " 14,606.68 " 240-2 DIGESTIVE MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 15,222.13 " N/A N/A N/A " 15,222.13 " " 15,222.13 " 240-3 DIGESTIVE MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 30,356.61 " N/A N/A N/A " 30,356.61 " " 30,356.61 " 240-4 DIGESTIVE MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 53,044.33 " N/A N/A N/A " 53,044.33 " " 53,044.33 " 241-1 PEPTIC ULCER & GASTRITIS N/A N/A N/A APR-DRG IP N/A " 10,468.25 " N/A N/A N/A " 10,468.25 " " 10,468.25 " 241-2 PEPTIC ULCER & GASTRITIS N/A N/A N/A APR-DRG IP N/A " 12,948.70 " N/A N/A N/A " 12,948.70 " " 12,948.70 " 241-3 PEPTIC ULCER & GASTRITIS N/A N/A N/A APR-DRG IP N/A " 18,301.25 " N/A N/A N/A " 18,301.25 " " 18,301.25 " 241-4 PEPTIC ULCER & GASTRITIS N/A N/A N/A APR-DRG IP N/A " 38,536.50 " N/A N/A N/A " 38,536.50 " " 38,536.50 " 242-1 MAJOR ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 9,485.39 " N/A N/A N/A " 9,485.39 " " 9,485.39 " 242-2 MAJOR ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,924.81 " N/A N/A N/A " 11,924.81 " " 11,924.81 " 242-3 MAJOR ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 13,698.43 " N/A N/A N/A " 13,698.43 " " 13,698.43 " 242-4 MAJOR ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 42,369.07 " N/A N/A N/A " 42,369.07 " " 42,369.07 " 243-1 OTHER ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,896.05 " N/A N/A N/A " 8,896.05 " " 8,896.05 " 243-2 OTHER ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,915.49 " N/A N/A N/A " 11,915.49 " " 11,915.49 " 243-3 OTHER ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 15,878.61 " N/A N/A N/A " 15,878.61 " " 15,878.61 " 243-4 OTHER ESOPHAGEAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 36,505.51 " N/A N/A N/A " 36,505.51 " " 36,505.51 " 244-1 DIVERTICULITIS & DIVERTICULOSIS N/A N/A N/A APR-DRG IP N/A " 9,114.26 " N/A N/A N/A " 9,114.26 " " 9,114.26 " 244-2 DIVERTICULITIS & DIVERTICULOSIS N/A N/A N/A APR-DRG IP N/A " 11,855.81 " N/A N/A N/A " 11,855.81 " " 11,855.81 " 244-3 DIVERTICULITIS & DIVERTICULOSIS N/A N/A N/A APR-DRG IP N/A " 19,265.45 " N/A N/A N/A " 19,265.45 " " 19,265.45 " 244-4 DIVERTICULITIS & DIVERTICULOSIS N/A N/A N/A APR-DRG IP N/A " 37,686.06 " N/A N/A N/A " 37,686.06 " " 37,686.06 " 245-1 INFLAMMATORY BOWEL DISEASE N/A N/A N/A APR-DRG IP N/A " 10,171.71 " N/A N/A N/A " 10,171.71 " " 10,171.71 " 245-2 INFLAMMATORY BOWEL DISEASE N/A N/A N/A APR-DRG IP N/A " 14,983.41 " N/A N/A N/A " 14,983.41 " " 14,983.41 " 245-3 INFLAMMATORY BOWEL DISEASE N/A N/A N/A APR-DRG IP N/A " 21,029.74 " N/A N/A N/A " 21,029.74 " " 21,029.74 " 245-4 INFLAMMATORY BOWEL DISEASE N/A N/A N/A APR-DRG IP N/A " 22,689.59 " N/A N/A N/A " 22,689.59 " " 22,689.59 " 246-1 GASTROINTESTINAL VASCULAR INSUFFICIENCY N/A N/A N/A APR-DRG IP N/A " 10,175.44 " N/A N/A N/A " 10,175.44 " " 10,175.44 " 246-2 GASTROINTESTINAL VASCULAR INSUFFICIENCY N/A N/A N/A APR-DRG IP N/A " 12,620.46 " N/A N/A N/A " 12,620.46 " " 12,620.46 " 246-3 GASTROINTESTINAL VASCULAR INSUFFICIENCY N/A N/A N/A APR-DRG IP N/A " 45,933.09 " N/A N/A N/A " 45,933.09 " " 45,933.09 " 246-4 GASTROINTESTINAL VASCULAR INSUFFICIENCY N/A N/A N/A APR-DRG IP N/A " 72,591.40 " N/A N/A N/A " 72,591.40 " " 72,591.40 " 247-1 INTESTINAL OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 8,317.90 " N/A N/A N/A " 8,317.90 " " 8,317.90 " 247-2 INTESTINAL OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 11,085.56 " N/A N/A N/A " 11,085.56 " " 11,085.56 " 247-3 INTESTINAL OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 19,578.77 " N/A N/A N/A " 19,578.77 " " 19,578.77 " 247-4 INTESTINAL OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 52,779.50 " N/A N/A N/A " 52,779.50 " " 52,779.50 " 248-1 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS N/A N/A N/A APR-DRG IP N/A " 8,226.52 " N/A N/A N/A " 8,226.52 " " 8,226.52 " 248-2 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS N/A N/A N/A APR-DRG IP N/A " 12,295.95 " N/A N/A N/A " 12,295.95 " " 12,295.95 " 248-3 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS N/A N/A N/A APR-DRG IP N/A " 18,498.94 " N/A N/A N/A " 18,498.94 " " 18,498.94 " 248-4 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS N/A N/A N/A APR-DRG IP N/A " 43,663.38 " N/A N/A N/A " 43,663.38 " " 43,663.38 " 249-1 "OTHER GASTROENTERITIS, NAUSEA & VOMITING" N/A N/A N/A APR-DRG IP N/A " 8,159.38 " N/A N/A N/A " 8,159.38 " " 8,159.38 " 249-2 "OTHER GASTROENTERITIS, NAUSEA & VOMITING" N/A N/A N/A APR-DRG IP N/A " 9,681.22 " N/A N/A N/A " 9,681.22 " " 9,681.22 " 249-3 "OTHER GASTROENTERITIS, NAUSEA & VOMITING" N/A N/A N/A APR-DRG IP N/A " 17,116.97 " N/A N/A N/A " 17,116.97 " " 17,116.97 " 249-4 "OTHER GASTROENTERITIS, NAUSEA & VOMITING" N/A N/A N/A APR-DRG IP N/A " 35,205.61 " N/A N/A N/A " 35,205.61 " " 35,205.61 " 251-1 ABDOMINAL PAIN N/A N/A N/A APR-DRG IP N/A " 8,713.28 " N/A N/A N/A " 8,713.28 " " 8,713.28 " 251-2 ABDOMINAL PAIN N/A N/A N/A APR-DRG IP N/A " 11,027.75 " N/A N/A N/A " 11,027.75 " " 11,027.75 " 251-3 ABDOMINAL PAIN N/A N/A N/A APR-DRG IP N/A " 14,989.01 " N/A N/A N/A " 14,989.01 " " 14,989.01 " 251-4 ABDOMINAL PAIN N/A N/A N/A APR-DRG IP N/A " 24,438.96 " N/A N/A N/A " 24,438.96 " " 24,438.96 " 252-1 "MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 11,613.36 " N/A N/A N/A " 11,613.36 " " 11,613.36 " 252-2 "MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 14,953.57 " N/A N/A N/A " 14,953.57 " " 14,953.57 " 252-3 "MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 27,915.32 " N/A N/A N/A " 27,915.32 " " 27,915.32 " 252-4 "MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 80,748.91 " N/A N/A N/A " 80,748.91 " " 80,748.91 " 253-1 OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 10,399.24 " N/A N/A N/A " 10,399.24 " " 10,399.24 " 253-2 OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 12,767.79 " N/A N/A N/A " 12,767.79 " " 12,767.79 " 253-3 OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 19,651.51 " N/A N/A N/A " 19,651.51 " " 19,651.51 " 253-4 OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE N/A N/A N/A APR-DRG IP N/A " 58,326.01 " N/A N/A N/A " 58,326.01 " " 58,326.01 " 254-1 OTHER DIGESTIVE SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 10,805.81 " N/A N/A N/A " 10,805.81 " " 10,805.81 " 254-2 OTHER DIGESTIVE SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 13,745.05 " N/A N/A N/A " 13,745.05 " " 13,745.05 " 254-3 OTHER DIGESTIVE SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 17,514.22 " N/A N/A N/A " 17,514.22 " " 17,514.22 " 254-4 OTHER DIGESTIVE SYSTEM DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 31,274.19 " N/A N/A N/A " 31,274.19 " " 31,274.19 " 260-1 "MAJOR PANCREAS, LIVER & SHUNT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 30,060.07 " N/A N/A N/A " 30,060.07 " " 30,060.07 " 260-2 "MAJOR PANCREAS, LIVER & SHUNT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 40,645.81 " N/A N/A N/A " 40,645.81 " " 40,645.81 " 260-3 "MAJOR PANCREAS, LIVER & SHUNT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 67,628.63 " N/A N/A N/A " 67,628.63 " " 67,628.63 " 260-4 "MAJOR PANCREAS, LIVER & SHUNT PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 126,476.84 " N/A N/A N/A " 126,476.84 " " 126,476.84 " 261-1 MAJOR BILIARY TRACT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 24,412.85 " N/A N/A N/A " 24,412.85 " " 24,412.85 " 261-2 MAJOR BILIARY TRACT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 35,306.32 " N/A N/A N/A " 35,306.32 " " 35,306.32 " 261-3 MAJOR BILIARY TRACT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 45,336.29 " N/A N/A N/A " 45,336.29 " " 45,336.29 " 261-4 MAJOR BILIARY TRACT PROCEDURES N/A N/A N/A APR-DRG IP N/A " 101,726.43 " N/A N/A N/A " 101,726.43 " " 101,726.43 " 263-1 CHOLECYSTECTOMY N/A N/A N/A APR-DRG IP N/A " 17,113.24 " N/A N/A N/A " 17,113.24 " " 17,113.24 " 263-2 CHOLECYSTECTOMY N/A N/A N/A APR-DRG IP N/A " 20,095.38 " N/A N/A N/A " 20,095.38 " " 20,095.38 " 263-3 CHOLECYSTECTOMY N/A N/A N/A APR-DRG IP N/A " 26,995.88 " N/A N/A N/A " 26,995.88 " " 26,995.88 " 263-4 CHOLECYSTECTOMY N/A N/A N/A APR-DRG IP N/A " 103,401.20 " N/A N/A N/A " 103,401.20 " " 103,401.20 " 264-1 "OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 22,876.09 " N/A N/A N/A " 22,876.09 " " 22,876.09 " 264-2 "OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 24,366.23 " N/A N/A N/A " 24,366.23 " " 24,366.23 " 264-3 "OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 41,613.75 " N/A N/A N/A " 41,613.75 " " 41,613.75 " 264-4 "OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 144,692.30 " N/A N/A N/A " 144,692.30 " " 144,692.30 " 279-1 HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,004.58 " N/A N/A N/A " 8,004.58 " " 8,004.58 " 279-2 HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,585.38 " N/A N/A N/A " 11,585.38 " " 11,585.38 " 279-3 HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS N/A N/A N/A APR-DRG IP N/A " 18,269.54 " N/A N/A N/A " 18,269.54 " " 18,269.54 " 279-4 HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS N/A N/A N/A APR-DRG IP N/A " 62,600.59 " N/A N/A N/A " 62,600.59 " " 62,600.59 " 280-1 ALCOHOLIC LIVER DISEASE N/A N/A N/A APR-DRG IP N/A " 10,727.48 " N/A N/A N/A " 10,727.48 " " 10,727.48 " 280-2 ALCOHOLIC LIVER DISEASE N/A N/A N/A APR-DRG IP N/A " 12,282.89 " N/A N/A N/A " 12,282.89 " " 12,282.89 " 280-3 ALCOHOLIC LIVER DISEASE N/A N/A N/A APR-DRG IP N/A " 17,633.58 " N/A N/A N/A " 17,633.58 " " 17,633.58 " 280-4 ALCOHOLIC LIVER DISEASE N/A N/A N/A APR-DRG IP N/A " 45,522.79 " N/A N/A N/A " 45,522.79 " " 45,522.79 " 281-1 MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS N/A N/A N/A APR-DRG IP N/A " 12,517.88 " N/A N/A N/A " 12,517.88 " " 12,517.88 " 281-2 MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS N/A N/A N/A APR-DRG IP N/A " 14,159.08 " N/A N/A N/A " 14,159.08 " " 14,159.08 " 281-3 MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS N/A N/A N/A APR-DRG IP N/A " 20,369.53 " N/A N/A N/A " 20,369.53 " " 20,369.53 " 281-4 MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS N/A N/A N/A APR-DRG IP N/A " 38,100.09 " N/A N/A N/A " 38,100.09 " " 38,100.09 " 282-1 DISORDERS OF PANCREAS EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 9,198.18 " N/A N/A N/A " 9,198.18 " " 9,198.18 " 282-2 DISORDERS OF PANCREAS EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 12,282.89 " N/A N/A N/A " 12,282.89 " " 12,282.89 " 282-3 DISORDERS OF PANCREAS EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 24,612.41 " N/A N/A N/A " 24,612.41 " " 24,612.41 " 282-4 DISORDERS OF PANCREAS EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 44,053.17 " N/A N/A N/A " 44,053.17 " " 44,053.17 " 283-1 OTHER DISORDERS OF THE LIVER N/A N/A N/A APR-DRG IP N/A " 8,239.57 " N/A N/A N/A " 8,239.57 " " 8,239.57 " 283-2 OTHER DISORDERS OF THE LIVER N/A N/A N/A APR-DRG IP N/A " 10,902.79 " N/A N/A N/A " 10,902.79 " " 10,902.79 " 283-3 OTHER DISORDERS OF THE LIVER N/A N/A N/A APR-DRG IP N/A " 15,582.08 " N/A N/A N/A " 15,582.08 " " 15,582.08 " 283-4 OTHER DISORDERS OF THE LIVER N/A N/A N/A APR-DRG IP N/A " 36,393.61 " N/A N/A N/A " 36,393.61 " " 36,393.61 " 284-1 DISORDERS OF GALLBLADDER & BILIARY TRACT N/A N/A N/A APR-DRG IP N/A " 11,065.05 " N/A N/A N/A " 11,065.05 " " 11,065.05 " 284-2 DISORDERS OF GALLBLADDER & BILIARY TRACT N/A N/A N/A APR-DRG IP N/A " 13,196.74 " N/A N/A N/A " 13,196.74 " " 13,196.74 " 284-3 DISORDERS OF GALLBLADDER & BILIARY TRACT N/A N/A N/A APR-DRG IP N/A " 22,650.43 " N/A N/A N/A " 22,650.43 " " 22,650.43 " 284-4 DISORDERS OF GALLBLADDER & BILIARY TRACT N/A N/A N/A APR-DRG IP N/A " 39,666.69 " N/A N/A N/A " 39,666.69 " " 39,666.69 " 301-1 HIP JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 27,064.88 " N/A N/A N/A " 27,064.88 " " 27,064.88 " 301-2 HIP JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 28,006.71 " N/A N/A N/A " 28,006.71 " " 28,006.71 " 301-3 HIP JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 32,751.27 " N/A N/A N/A " 32,751.27 " " 32,751.27 " 301-4 HIP JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 72,117.69 " N/A N/A N/A " 72,117.69 " " 72,117.69 " 302-1 KNEE JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 29,670.29 " N/A N/A N/A " 29,670.29 " " 29,670.29 " 302-2 KNEE JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 32,038.84 " N/A N/A N/A " 32,038.84 " " 32,038.84 " 302-3 KNEE JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 40,071.39 " N/A N/A N/A " 40,071.39 " " 40,071.39 " 302-4 KNEE JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 62,725.55 " N/A N/A N/A " 62,725.55 " " 62,725.55 " 303-1 DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 73,546.28 " N/A N/A N/A " 73,546.28 " " 73,546.28 " 303-2 DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 95,655.85 " N/A N/A N/A " 95,655.85 " " 95,655.85 " 303-3 DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 123,666.29 " N/A N/A N/A " 123,666.29 " " 123,666.29 " 303-4 DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 180,431.29 " N/A N/A N/A " 180,431.29 " " 180,431.29 " 304-1 DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 47,563.10 " N/A N/A N/A " 47,563.10 " " 47,563.10 " 304-2 DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 56,675.49 " N/A N/A N/A " 56,675.49 " " 56,675.49 " 304-3 DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 76,082.68 " N/A N/A N/A " 76,082.68 " " 76,082.68 " 304-4 DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK N/A N/A N/A APR-DRG IP N/A " 117,571.47 " N/A N/A N/A " 117,571.47 " " 117,571.47 " 305-1 AMPUTATION OF LOWER LIMB EXCEPT TOES N/A N/A N/A APR-DRG IP N/A " 17,641.04 " N/A N/A N/A " 17,641.04 " " 17,641.04 " 305-2 AMPUTATION OF LOWER LIMB EXCEPT TOES N/A N/A N/A APR-DRG IP N/A " 21,309.49 " N/A N/A N/A " 21,309.49 " " 21,309.49 " 305-3 AMPUTATION OF LOWER LIMB EXCEPT TOES N/A N/A N/A APR-DRG IP N/A " 31,186.53 " N/A N/A N/A " 31,186.53 " " 31,186.53 " 305-4 AMPUTATION OF LOWER LIMB EXCEPT TOES N/A N/A N/A APR-DRG IP N/A " 74,523.54 " N/A N/A N/A " 74,523.54 " " 74,523.54 " 308-1 HIP & FEMUR FRACTURE REPAIR N/A N/A N/A APR-DRG IP N/A " 20,434.81 " N/A N/A N/A " 20,434.81 " " 20,434.81 " 308-2 HIP & FEMUR FRACTURE REPAIR N/A N/A N/A APR-DRG IP N/A " 29,780.32 " N/A N/A N/A " 29,780.32 " " 29,780.32 " 308-3 HIP & FEMUR FRACTURE REPAIR N/A N/A N/A APR-DRG IP N/A " 33,698.69 " N/A N/A N/A " 33,698.69 " " 33,698.69 " 308-4 HIP & FEMUR FRACTURE REPAIR N/A N/A N/A APR-DRG IP N/A " 55,845.56 " N/A N/A N/A " 55,845.56 " " 55,845.56 " 309-1 OTHER SIGNIFICANT HIP & FEMUR SURGERY N/A N/A N/A APR-DRG IP N/A " 24,854.86 " N/A N/A N/A " 24,854.86 " " 24,854.86 " 309-2 OTHER SIGNIFICANT HIP & FEMUR SURGERY N/A N/A N/A APR-DRG IP N/A " 29,946.31 " N/A N/A N/A " 29,946.31 " " 29,946.31 " 309-3 OTHER SIGNIFICANT HIP & FEMUR SURGERY N/A N/A N/A APR-DRG IP N/A " 46,397.47 " N/A N/A N/A " 46,397.47 " " 46,397.47 " 309-4 OTHER SIGNIFICANT HIP & FEMUR SURGERY N/A N/A N/A APR-DRG IP N/A " 71,985.27 " N/A N/A N/A " 71,985.27 " " 71,985.27 " 310-1 INTERVERTEBRAL DISC EXCISION & DECOMPRESSION N/A N/A N/A APR-DRG IP N/A " 16,867.06 " N/A N/A N/A " 16,867.06 " " 16,867.06 " 310-2 INTERVERTEBRAL DISC EXCISION & DECOMPRESSION N/A N/A N/A APR-DRG IP N/A " 23,368.45 " N/A N/A N/A " 23,368.45 " " 23,368.45 " 310-3 INTERVERTEBRAL DISC EXCISION & DECOMPRESSION N/A N/A N/A APR-DRG IP N/A " 41,697.67 " N/A N/A N/A " 41,697.67 " " 41,697.67 " 310-4 INTERVERTEBRAL DISC EXCISION & DECOMPRESSION N/A N/A N/A APR-DRG IP N/A " 59,737.82 " N/A N/A N/A " 59,737.82 " " 59,737.82 " 312-1 "SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 18,674.25 " N/A N/A N/A " 18,674.25 " " 18,674.25 " 312-2 "SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 34,170.53 " N/A N/A N/A " 34,170.53 " " 34,170.53 " 312-3 "SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 48,609.36 " N/A N/A N/A " 48,609.36 " " 48,609.36 " 312-4 "SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 100,057.25 " N/A N/A N/A " 100,057.25 " " 100,057.25 " 313-1 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT N/A N/A N/A APR-DRG IP N/A " 22,394.92 " N/A N/A N/A " 22,394.92 " " 22,394.92 " 313-2 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT N/A N/A N/A APR-DRG IP N/A " 28,974.64 " N/A N/A N/A " 28,974.64 " " 28,974.64 " 313-3 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT N/A N/A N/A APR-DRG IP N/A " 43,432.12 " N/A N/A N/A " 43,432.12 " " 43,432.12 " 313-4 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT N/A N/A N/A APR-DRG IP N/A " 61,470.40 " N/A N/A N/A " 61,470.40 " " 61,470.40 " 314-1 FOOT & TOE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 20,427.35 " N/A N/A N/A " 20,427.35 " " 20,427.35 " 314-2 FOOT & TOE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 21,415.80 " N/A N/A N/A " 21,415.80 " " 21,415.80 " 314-3 FOOT & TOE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 25,886.20 " N/A N/A N/A " 25,886.20 " " 25,886.20 " 314-4 FOOT & TOE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 62,132.48 " N/A N/A N/A " 62,132.48 " " 62,132.48 " 315-1 "SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT" N/A N/A N/A APR-DRG IP N/A " 19,970.42 " N/A N/A N/A " 19,970.42 " " 19,970.42 " 315-2 "SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT" N/A N/A N/A APR-DRG IP N/A " 24,479.99 " N/A N/A N/A " 24,479.99 " " 24,479.99 " 315-3 "SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT" N/A N/A N/A APR-DRG IP N/A " 42,891.27 " N/A N/A N/A " 42,891.27 " " 42,891.27 " 315-4 "SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT" N/A N/A N/A APR-DRG IP N/A " 62,406.63 " N/A N/A N/A " 62,406.63 " " 62,406.63 " 316-1 HAND & WRIST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 17,447.08 " N/A N/A N/A " 17,447.08 " " 17,447.08 " 316-2 HAND & WRIST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 22,269.97 " N/A N/A N/A " 22,269.97 " " 22,269.97 " 316-3 HAND & WRIST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 42,318.72 " N/A N/A N/A " 42,318.72 " " 42,318.72 " 316-4 HAND & WRIST PROCEDURES N/A N/A N/A APR-DRG IP N/A " 68,643.19 " N/A N/A N/A " 68,643.19 " " 68,643.19 " 317-1 "TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 16,973.37 " N/A N/A N/A " 16,973.37 " " 16,973.37 " 317-2 "TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 21,441.91 " N/A N/A N/A " 21,441.91 " " 21,441.91 " 317-3 "TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 40,326.90 " N/A N/A N/A " 40,326.90 " " 40,326.90 " 317-4 "TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 77,438.53 " N/A N/A N/A " 77,438.53 " " 77,438.53 " 320-1 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 16,658.18 " N/A N/A N/A " 16,658.18 " " 16,658.18 " 320-2 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 28,344.27 " N/A N/A N/A " 28,344.27 " " 28,344.27 " 320-3 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 43,769.69 " N/A N/A N/A " 43,769.69 " " 43,769.69 " 320-4 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 71,054.64 " N/A N/A N/A " 71,054.64 " " 71,054.64 " 321-1 CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP N/A N/A N/A APR-DRG IP N/A " 26,240.55 " N/A N/A N/A " 26,240.55 " " 26,240.55 " 321-2 CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP N/A N/A N/A APR-DRG IP N/A " 32,706.51 " N/A N/A N/A " 32,706.51 " " 32,706.51 " 321-3 CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP N/A N/A N/A APR-DRG IP N/A " 53,437.85 " N/A N/A N/A " 53,437.85 " " 53,437.85 " 321-4 CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP N/A N/A N/A APR-DRG IP N/A " 82,919.77 " N/A N/A N/A " 82,919.77 " " 82,919.77 " 322-1 SHOULDER & ELBOW JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 30,628.90 " N/A N/A N/A " 30,628.90 " " 30,628.90 " 322-2 SHOULDER & ELBOW JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 31,486.80 " N/A N/A N/A " 31,486.80 " " 31,486.80 " 322-3 SHOULDER & ELBOW JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 39,925.92 " N/A N/A N/A " 39,925.92 " " 39,925.92 " 322-4 SHOULDER & ELBOW JOINT REPLACEMENT N/A N/A N/A APR-DRG IP N/A " 67,402.97 " N/A N/A N/A " 67,402.97 " " 67,402.97 " 340-1 FRACTURE OF FEMUR N/A N/A N/A APR-DRG IP N/A " 8,933.35 " N/A N/A N/A " 8,933.35 " " 8,933.35 " 340-2 FRACTURE OF FEMUR N/A N/A N/A APR-DRG IP N/A " 10,507.41 " N/A N/A N/A " 10,507.41 " " 10,507.41 " 340-3 FRACTURE OF FEMUR N/A N/A N/A APR-DRG IP N/A " 13,961.39 " N/A N/A N/A " 13,961.39 " " 13,961.39 " 340-4 FRACTURE OF FEMUR N/A N/A N/A APR-DRG IP N/A " 23,224.85 " N/A N/A N/A " 23,224.85 " " 23,224.85 " 341-1 FRACTURE OF PELVIS OR DISLOCATION OF HIP N/A N/A N/A APR-DRG IP N/A " 9,729.71 " N/A N/A N/A " 9,729.71 " " 9,729.71 " 341-2 FRACTURE OF PELVIS OR DISLOCATION OF HIP N/A N/A N/A APR-DRG IP N/A " 12,900.21 " N/A N/A N/A " 12,900.21 " " 12,900.21 " 341-3 FRACTURE OF PELVIS OR DISLOCATION OF HIP N/A N/A N/A APR-DRG IP N/A " 16,779.41 " N/A N/A N/A " 16,779.41 " " 16,779.41 " 341-4 FRACTURE OF PELVIS OR DISLOCATION OF HIP N/A N/A N/A APR-DRG IP N/A " 28,620.29 " N/A N/A N/A " 28,620.29 " " 28,620.29 " 342-1 "FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK" N/A N/A N/A APR-DRG IP N/A " 7,961.69 " N/A N/A N/A " 7,961.69 " " 7,961.69 " 342-2 "FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK" N/A N/A N/A APR-DRG IP N/A " 12,322.06 " N/A N/A N/A " 12,322.06 " " 12,322.06 " 342-3 "FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK" N/A N/A N/A APR-DRG IP N/A " 54,737.75 " N/A N/A N/A " 54,737.75 " " 54,737.75 " 342-4 "FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK" N/A N/A N/A APR-DRG IP N/A " 97,379.11 " N/A N/A N/A " 97,379.11 " " 97,379.11 " 343-1 MUSCULOSKELETAL MALIGNANCY & PATHOL FRACTURE D/T MUSCSKEL MALIG N/A N/A N/A APR-DRG IP N/A " 11,915.49 " N/A N/A N/A " 11,915.49 " " 11,915.49 " 343-2 MUSCULOSKELETAL MALIGNANCY & PATHOL FRACTURE D/T MUSCSKEL MALIG N/A N/A N/A APR-DRG IP N/A " 14,017.34 " N/A N/A N/A " 14,017.34 " " 14,017.34 " 343-3 MUSCULOSKELETAL MALIGNANCY & PATHOL FRACTURE D/T MUSCSKEL MALIG N/A N/A N/A APR-DRG IP N/A " 26,281.58 " N/A N/A N/A " 26,281.58 " " 26,281.58 " 343-4 MUSCULOSKELETAL MALIGNANCY & PATHOL FRACTURE D/T MUSCSKEL MALIG N/A N/A N/A APR-DRG IP N/A " 37,391.39 " N/A N/A N/A " 37,391.39 " " 37,391.39 " 344-1 "OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 10,421.62 " N/A N/A N/A " 10,421.62 " " 10,421.62 " 344-2 "OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 13,868.14 " N/A N/A N/A " 13,868.14 " " 13,868.14 " 344-3 "OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 21,147.24 " N/A N/A N/A " 21,147.24 " " 21,147.24 " 344-4 "OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 31,979.16 " N/A N/A N/A " 31,979.16 " " 31,979.16 " 346-1 CONNECTIVE TISSUE DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,221.71 " N/A N/A N/A " 11,221.71 " " 11,221.71 " 346-2 CONNECTIVE TISSUE DISORDERS N/A N/A N/A APR-DRG IP N/A " 15,339.63 " N/A N/A N/A " 15,339.63 " " 15,339.63 " 346-3 CONNECTIVE TISSUE DISORDERS N/A N/A N/A APR-DRG IP N/A " 33,693.09 " N/A N/A N/A " 33,693.09 " " 33,693.09 " 346-4 CONNECTIVE TISSUE DISORDERS N/A N/A N/A APR-DRG IP N/A " 42,115.43 " N/A N/A N/A " 42,115.43 " " 42,115.43 " 347-1 "OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES" N/A N/A N/A APR-DRG IP N/A " 8,830.78 " N/A N/A N/A " 8,830.78 " " 8,830.78 " 347-2 "OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES" N/A N/A N/A APR-DRG IP N/A " 10,887.87 " N/A N/A N/A " 10,887.87 " " 10,887.87 " 347-3 "OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES" N/A N/A N/A APR-DRG IP N/A " 17,389.26 " N/A N/A N/A " 17,389.26 " " 17,389.26 " 347-4 "OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES" N/A N/A N/A APR-DRG IP N/A " 39,161.27 " N/A N/A N/A " 39,161.27 " " 39,161.27 " 349-1 "MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 6,053.79 " N/A N/A N/A " 6,053.79 " " 6,053.79 " 349-2 "MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 12,325.79 " N/A N/A N/A " 12,325.79 " " 12,325.79 " 349-3 "MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 23,077.51 " N/A N/A N/A " 23,077.51 " " 23,077.51 " 349-4 "MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 37,719.63 " N/A N/A N/A " 37,719.63 " " 37,719.63 " 351-1 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 9,088.15 " N/A N/A N/A " 9,088.15 " " 9,088.15 " 351-2 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 11,040.80 " N/A N/A N/A " 11,040.80 " " 11,040.80 " 351-3 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 38,271.67 " N/A N/A N/A " 38,271.67 " " 38,271.67 " 351-4 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 69,564.50 " N/A N/A N/A " 69,564.50 " " 69,564.50 " 361-1 SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 24,685.14 " N/A N/A N/A " 24,685.14 " " 24,685.14 " 361-2 SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 30,352.88 " N/A N/A N/A " 30,352.88 " " 30,352.88 " 361-3 SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 42,087.46 " N/A N/A N/A " 42,087.46 " " 42,087.46 " 361-4 SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 91,787.84 " N/A N/A N/A " 91,787.84 " " 91,787.84 " 362-1 MASTECTOMY PROCEDURES N/A N/A N/A APR-DRG IP N/A " 34,159.34 " N/A N/A N/A " 34,159.34 " " 34,159.34 " 362-2 MASTECTOMY PROCEDURES N/A N/A N/A APR-DRG IP N/A " 43,234.43 " N/A N/A N/A " 43,234.43 " " 43,234.43 " 362-3 MASTECTOMY PROCEDURES N/A N/A N/A APR-DRG IP N/A " 51,130.84 " N/A N/A N/A " 51,130.84 " " 51,130.84 " 362-4 MASTECTOMY PROCEDURES N/A N/A N/A APR-DRG IP N/A " 65,133.26 " N/A N/A N/A " 65,133.26 " " 65,133.26 " 363-1 BREAST PROCEDURES EXCEPT MASTECTOMY N/A N/A N/A APR-DRG IP N/A " 29,769.13 " N/A N/A N/A " 29,769.13 " " 29,769.13 " 363-2 BREAST PROCEDURES EXCEPT MASTECTOMY N/A N/A N/A APR-DRG IP N/A " 55,534.11 " N/A N/A N/A " 55,534.11 " " 55,534.11 " 363-3 BREAST PROCEDURES EXCEPT MASTECTOMY N/A N/A N/A APR-DRG IP N/A " 71,147.89 " N/A N/A N/A " 71,147.89 " " 71,147.89 " 363-4 BREAST PROCEDURES EXCEPT MASTECTOMY N/A N/A N/A APR-DRG IP N/A " 80,866.40 " N/A N/A N/A " 80,866.40 " " 80,866.40 " 364-1 "OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 13,776.76 " N/A N/A N/A " 13,776.76 " " 13,776.76 " 364-2 "OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 17,764.13 " N/A N/A N/A " 17,764.13 " " 17,764.13 " 364-3 "OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 45,340.02 " N/A N/A N/A " 45,340.02 " " 45,340.02 " 364-4 "OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 46,363.90 " N/A N/A N/A " 46,363.90 " " 46,363.90 " 380-1 SKIN ULCERS N/A N/A N/A APR-DRG IP N/A " 9,683.08 " N/A N/A N/A " 9,683.08 " " 9,683.08 " 380-2 SKIN ULCERS N/A N/A N/A APR-DRG IP N/A " 12,215.75 " N/A N/A N/A " 12,215.75 " " 12,215.75 " 380-3 SKIN ULCERS N/A N/A N/A APR-DRG IP N/A " 21,376.63 " N/A N/A N/A " 21,376.63 " " 21,376.63 " 380-4 SKIN ULCERS N/A N/A N/A APR-DRG IP N/A " 32,423.03 " N/A N/A N/A " 32,423.03 " " 32,423.03 " 381-1 MAJOR SKIN DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,748.72 " N/A N/A N/A " 8,748.72 " " 8,748.72 " 381-2 MAJOR SKIN DISORDERS N/A N/A N/A APR-DRG IP N/A " 15,720.09 " N/A N/A N/A " 15,720.09 " " 15,720.09 " 381-3 MAJOR SKIN DISORDERS N/A N/A N/A APR-DRG IP N/A " 22,202.83 " N/A N/A N/A " 22,202.83 " " 22,202.83 " 381-4 MAJOR SKIN DISORDERS N/A N/A N/A APR-DRG IP N/A " 49,021.53 " N/A N/A N/A " 49,021.53 " " 49,021.53 " 382-1 MALIGNANT BREAST DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,565.23 " N/A N/A N/A " 10,565.23 " " 10,565.23 " 382-2 MALIGNANT BREAST DISORDERS N/A N/A N/A APR-DRG IP N/A " 12,176.59 " N/A N/A N/A " 12,176.59 " " 12,176.59 " 382-3 MALIGNANT BREAST DISORDERS N/A N/A N/A APR-DRG IP N/A " 21,387.82 " N/A N/A N/A " 21,387.82 " " 21,387.82 " 382-4 MALIGNANT BREAST DISORDERS N/A N/A N/A APR-DRG IP N/A " 29,218.96 " N/A N/A N/A " 29,218.96 " " 29,218.96 " 383-1 CELLULITIS & OTHER SKIN INFECTIONS N/A N/A N/A APR-DRG IP N/A " 8,830.78 " N/A N/A N/A " 8,830.78 " " 8,830.78 " 383-2 CELLULITIS & OTHER SKIN INFECTIONS N/A N/A N/A APR-DRG IP N/A " 11,977.03 " N/A N/A N/A " 11,977.03 " " 11,977.03 " 383-3 CELLULITIS & OTHER SKIN INFECTIONS N/A N/A N/A APR-DRG IP N/A " 21,824.23 " N/A N/A N/A " 21,824.23 " " 21,824.23 " 383-4 CELLULITIS & OTHER SKIN INFECTIONS N/A N/A N/A APR-DRG IP N/A " 26,134.25 " N/A N/A N/A " 26,134.25 " " 26,134.25 " 384-1 "CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE" N/A N/A N/A APR-DRG IP N/A " 7,834.87 " N/A N/A N/A " 7,834.87 " " 7,834.87 " 384-2 "CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE" N/A N/A N/A APR-DRG IP N/A " 10,289.21 " N/A N/A N/A " 10,289.21 " " 10,289.21 " 384-3 "CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE" N/A N/A N/A APR-DRG IP N/A " 15,846.91 " N/A N/A N/A " 15,846.91 " " 15,846.91 " 384-4 "CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE" N/A N/A N/A APR-DRG IP N/A " 40,709.22 " N/A N/A N/A " 40,709.22 " " 40,709.22 " 385-1 "OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS" N/A N/A N/A APR-DRG IP N/A " 7,385.40 " N/A N/A N/A " 7,385.40 " " 7,385.40 " 385-2 "OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS" N/A N/A N/A APR-DRG IP N/A " 9,136.64 " N/A N/A N/A " 9,136.64 " " 9,136.64 " 385-3 "OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS" N/A N/A N/A APR-DRG IP N/A " 23,249.09 " N/A N/A N/A " 23,249.09 " " 23,249.09 " 385-4 "OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS" N/A N/A N/A APR-DRG IP N/A " 29,866.11 " N/A N/A N/A " 29,866.11 " " 29,866.11 " 401-1 ADRENAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 24,161.08 " N/A N/A N/A " 24,161.08 " " 24,161.08 " 401-2 ADRENAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 45,892.06 " N/A N/A N/A " 45,892.06 " " 45,892.06 " 401-3 ADRENAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 54,314.40 " N/A N/A N/A " 54,314.40 " " 54,314.40 " 401-4 ADRENAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 80,170.76 " N/A N/A N/A " 80,170.76 " " 80,170.76 " 403-1 PROCEDURES FOR OBESITY N/A N/A N/A APR-DRG IP N/A " 24,938.78 " N/A N/A N/A " 24,938.78 " " 24,938.78 " 403-2 PROCEDURES FOR OBESITY N/A N/A N/A APR-DRG IP N/A " 27,932.11 " N/A N/A N/A " 27,932.11 " " 27,932.11 " 403-3 PROCEDURES FOR OBESITY N/A N/A N/A APR-DRG IP N/A " 35,304.45 " N/A N/A N/A " 35,304.45 " " 35,304.45 " 403-4 PROCEDURES FOR OBESITY N/A N/A N/A APR-DRG IP N/A " 92,584.20 " N/A N/A N/A " 92,584.20 " " 92,584.20 " 404-1 "THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 16,421.33 " N/A N/A N/A " 16,421.33 " " 16,421.33 " 404-2 "THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 23,347.94 " N/A N/A N/A " 23,347.94 " " 23,347.94 " 404-3 "THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 44,230.34 " N/A N/A N/A " 44,230.34 " " 44,230.34 " 404-4 "THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 82,173.77 " N/A N/A N/A " 82,173.77 " " 82,173.77 " 405-1 "OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS" N/A N/A N/A APR-DRG IP N/A " 23,948.47 " N/A N/A N/A " 23,948.47 " " 23,948.47 " 405-2 "OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS" N/A N/A N/A APR-DRG IP N/A " 26,294.64 " N/A N/A N/A " 26,294.64 " " 26,294.64 " 405-3 "OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS" N/A N/A N/A APR-DRG IP N/A " 47,536.99 " N/A N/A N/A " 47,536.99 " " 47,536.99 " 405-4 "OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS" N/A N/A N/A APR-DRG IP N/A " 77,587.73 " N/A N/A N/A " 77,587.73 " " 77,587.73 " 420-1 DIABETES N/A N/A N/A APR-DRG IP N/A " 8,019.50 " N/A N/A N/A " 8,019.50 " " 8,019.50 " 420-2 DIABETES N/A N/A N/A APR-DRG IP N/A " 9,783.79 " N/A N/A N/A " 9,783.79 " " 9,783.79 " 420-3 DIABETES N/A N/A N/A APR-DRG IP N/A " 15,332.17 " N/A N/A N/A " 15,332.17 " " 15,332.17 " 420-4 DIABETES N/A N/A N/A APR-DRG IP N/A " 48,400.48 " N/A N/A N/A " 48,400.48 " " 48,400.48 " 421-1 "MALNUTRITION, FAILURE TO THRIVE & OTHER NUTRITIONAL DISORDERS" N/A N/A N/A APR-DRG IP N/A " 10,119.49 " N/A N/A N/A " 10,119.49 " " 10,119.49 " 421-2 "MALNUTRITION, FAILURE TO THRIVE & OTHER NUTRITIONAL DISORDERS" N/A N/A N/A APR-DRG IP N/A " 13,687.24 " N/A N/A N/A " 13,687.24 " " 13,687.24 " 421-3 "MALNUTRITION, FAILURE TO THRIVE & OTHER NUTRITIONAL DISORDERS" N/A N/A N/A APR-DRG IP N/A " 20,539.25 " N/A N/A N/A " 20,539.25 " " 20,539.25 " 421-4 "MALNUTRITION, FAILURE TO THRIVE & OTHER NUTRITIONAL DISORDERS" N/A N/A N/A APR-DRG IP N/A " 96,228.41 " N/A N/A N/A " 96,228.41 " " 96,228.41 " 422-1 HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 6,700.95 " N/A N/A N/A " 6,700.95 " " 6,700.95 " 422-2 HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,972.52 " N/A N/A N/A " 8,972.52 " " 8,972.52 " 422-3 HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 18,847.69 " N/A N/A N/A " 18,847.69 " " 18,847.69 " 422-4 HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 23,838.43 " N/A N/A N/A " 23,838.43 " " 23,838.43 " 423-1 INBORN ERRORS OF METABOLISM N/A N/A N/A APR-DRG IP N/A " 10,475.71 " N/A N/A N/A " 10,475.71 " " 10,475.71 " 423-2 INBORN ERRORS OF METABOLISM N/A N/A N/A APR-DRG IP N/A " 26,505.38 " N/A N/A N/A " 26,505.38 " " 26,505.38 " 423-3 INBORN ERRORS OF METABOLISM N/A N/A N/A APR-DRG IP N/A " 39,646.17 " N/A N/A N/A " 39,646.17 " " 39,646.17 " 423-4 INBORN ERRORS OF METABOLISM N/A N/A N/A APR-DRG IP N/A " 68,439.91 " N/A N/A N/A " 68,439.91 " " 68,439.91 " 424-1 OTHER ENDOCRINE DISORDERS N/A N/A N/A APR-DRG IP N/A " 6,876.26 " N/A N/A N/A " 6,876.26 " " 6,876.26 " 424-2 OTHER ENDOCRINE DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,825.97 " N/A N/A N/A " 11,825.97 " " 11,825.97 " 424-3 OTHER ENDOCRINE DISORDERS N/A N/A N/A APR-DRG IP N/A " 24,274.84 " N/A N/A N/A " 24,274.84 " " 24,274.84 " 424-4 OTHER ENDOCRINE DISORDERS N/A N/A N/A APR-DRG IP N/A " 30,919.84 " N/A N/A N/A " 30,919.84 " " 30,919.84 " 425-1 OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 6,900.50 " N/A N/A N/A " 6,900.50 " " 6,900.50 " 425-2 OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,684.23 " N/A N/A N/A " 11,684.23 " " 11,684.23 " 425-3 OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 17,558.98 " N/A N/A N/A " 17,558.98 " " 17,558.98 " 425-4 OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS N/A N/A N/A APR-DRG IP N/A " 25,322.97 " N/A N/A N/A " 25,322.97 " " 25,322.97 " 426-1 NON-HYPOVOLEMIC SODIUM DISORDERS N/A N/A N/A APR-DRG IP N/A " 7,993.39 " N/A N/A N/A " 7,993.39 " " 7,993.39 " 426-2 NON-HYPOVOLEMIC SODIUM DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,171.71 " N/A N/A N/A " 10,171.71 " " 10,171.71 " 426-3 NON-HYPOVOLEMIC SODIUM DISORDERS N/A N/A N/A APR-DRG IP N/A " 15,707.03 " N/A N/A N/A " 15,707.03 " " 15,707.03 " 426-4 NON-HYPOVOLEMIC SODIUM DISORDERS N/A N/A N/A APR-DRG IP N/A " 22,305.40 " N/A N/A N/A " 22,305.40 " " 22,305.40 " 427-1 THYROID DISORDERS N/A N/A N/A APR-DRG IP N/A " 7,331.32 " N/A N/A N/A " 7,331.32 " " 7,331.32 " 427-2 THYROID DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,468.25 " N/A N/A N/A " 10,468.25 " " 10,468.25 " 427-3 THYROID DISORDERS N/A N/A N/A APR-DRG IP N/A " 15,516.80 " N/A N/A N/A " 15,516.80 " " 15,516.80 " 427-4 THYROID DISORDERS N/A N/A N/A APR-DRG IP N/A " 31,792.66 " N/A N/A N/A " 31,792.66 " " 31,792.66 " 440-1 KIDNEY TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 157,435.84 " N/A N/A N/A " 157,435.84 " " 157,435.84 " 440-2 KIDNEY TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 174,890.38 " N/A N/A N/A " 174,890.38 " " 174,890.38 " 440-3 KIDNEY TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 209,325.74 " N/A N/A N/A " 209,325.74 " " 209,325.74 " 440-4 KIDNEY TRANSPLANT N/A N/A N/A APR-DRG IP N/A " 313,198.78 " N/A N/A N/A " 313,198.78 " " 313,198.78 " 441-1 MAJOR BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 26,645.26 " N/A N/A N/A " 26,645.26 " " 26,645.26 " 441-2 MAJOR BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 38,411.54 " N/A N/A N/A " 38,411.54 " " 38,411.54 " 441-3 MAJOR BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 47,184.50 " N/A N/A N/A " 47,184.50 " " 47,184.50 " 441-4 MAJOR BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 108,298.69 " N/A N/A N/A " 108,298.69 " " 108,298.69 " 442-1 KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 22,710.11 " N/A N/A N/A " 22,710.11 " " 22,710.11 " 442-2 KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 28,157.77 " N/A N/A N/A " 28,157.77 " " 28,157.77 " 442-3 KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 32,930.31 " N/A N/A N/A " 32,930.31 " " 32,930.31 " 442-4 KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 88,621.07 " N/A N/A N/A " 88,621.07 " " 88,621.07 " 443-1 KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY N/A N/A N/A APR-DRG IP N/A " 19,593.69 " N/A N/A N/A " 19,593.69 " " 19,593.69 " 443-2 KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY N/A N/A N/A APR-DRG IP N/A " 22,064.82 " N/A N/A N/A " 22,064.82 " " 22,064.82 " 443-3 KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY N/A N/A N/A APR-DRG IP N/A " 27,956.35 " N/A N/A N/A " 27,956.35 " " 27,956.35 " 443-4 KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY N/A N/A N/A APR-DRG IP N/A " 62,904.59 " N/A N/A N/A " 62,904.59 " " 62,904.59 " 444-1 RENAL DIALYSIS ACCESS DEVICE PROCEDURES & VESSEL REPAIR N/A N/A N/A APR-DRG IP N/A " 18,780.55 " N/A N/A N/A " 18,780.55 " " 18,780.55 " 444-2 RENAL DIALYSIS ACCESS DEVICE PROCEDURES & VESSEL REPAIR N/A N/A N/A APR-DRG IP N/A " 20,768.64 " N/A N/A N/A " 20,768.64 " " 20,768.64 " 444-3 RENAL DIALYSIS ACCESS DEVICE PROCEDURES & VESSEL REPAIR N/A N/A N/A APR-DRG IP N/A " 39,524.95 " N/A N/A N/A " 39,524.95 " " 39,524.95 " 444-4 RENAL DIALYSIS ACCESS DEVICE PROCEDURES & VESSEL REPAIR N/A N/A N/A APR-DRG IP N/A " 68,300.03 " N/A N/A N/A " 68,300.03 " " 68,300.03 " 445-1 OTHER BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 19,149.82 " N/A N/A N/A " 19,149.82 " " 19,149.82 " 445-2 OTHER BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 24,780.26 " N/A N/A N/A " 24,780.26 " " 24,780.26 " 445-3 OTHER BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 32,007.13 " N/A N/A N/A " 32,007.13 " " 32,007.13 " 445-4 OTHER BLADDER PROCEDURES N/A N/A N/A APR-DRG IP N/A " 58,465.89 " N/A N/A N/A " 58,465.89 " " 58,465.89 " 446-1 URETHRAL & TRANSURETHRAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 12,611.13 " N/A N/A N/A " 12,611.13 " " 12,611.13 " 446-2 URETHRAL & TRANSURETHRAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 14,136.70 " N/A N/A N/A " 14,136.70 " " 14,136.70 " 446-3 URETHRAL & TRANSURETHRAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 29,931.39 " N/A N/A N/A " 29,931.39 " " 29,931.39 " 446-4 URETHRAL & TRANSURETHRAL PROCEDURES N/A N/A N/A APR-DRG IP N/A " 52,109.97 " N/A N/A N/A " 52,109.97 " " 52,109.97 " 447-1 "OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 23,092.43 " N/A N/A N/A " 23,092.43 " " 23,092.43 " 447-2 "OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 29,444.62 " N/A N/A N/A " 29,444.62 " " 29,444.62 " 447-3 "OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 61,293.23 " N/A N/A N/A " 61,293.23 " " 61,293.23 " 447-4 "OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 75,068.12 " N/A N/A N/A " 75,068.12 " " 75,068.12 " 461-1 KIDNEY & URINARY TRACT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 20,852.57 " N/A N/A N/A " 20,852.57 " " 20,852.57 " 461-2 KIDNEY & URINARY TRACT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 23,398.29 " N/A N/A N/A " 23,398.29 " " 23,398.29 " 461-3 KIDNEY & URINARY TRACT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 34,375.68 " N/A N/A N/A " 34,375.68 " " 34,375.68 " 461-4 KIDNEY & URINARY TRACT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 36,345.12 " N/A N/A N/A " 36,345.12 " " 36,345.12 " 462-1 NEPHRITIS & NEPHROSIS N/A N/A N/A APR-DRG IP N/A " 9,401.47 " N/A N/A N/A " 9,401.47 " " 9,401.47 " 462-2 NEPHRITIS & NEPHROSIS N/A N/A N/A APR-DRG IP N/A " 12,724.90 " N/A N/A N/A " 12,724.90 " " 12,724.90 " 462-3 NEPHRITIS & NEPHROSIS N/A N/A N/A APR-DRG IP N/A " 24,023.07 " N/A N/A N/A " 24,023.07 " " 24,023.07 " 462-4 NEPHRITIS & NEPHROSIS N/A N/A N/A APR-DRG IP N/A " 65,053.07 " N/A N/A N/A " 65,053.07 " " 65,053.07 " 463-1 KIDNEY & URINARY TRACT INFECTIONS N/A N/A N/A APR-DRG IP N/A " 8,465.24 " N/A N/A N/A " 8,465.24 " " 8,465.24 " 463-2 KIDNEY & URINARY TRACT INFECTIONS N/A N/A N/A APR-DRG IP N/A " 10,632.37 " N/A N/A N/A " 10,632.37 " " 10,632.37 " 463-3 KIDNEY & URINARY TRACT INFECTIONS N/A N/A N/A APR-DRG IP N/A " 15,563.43 " N/A N/A N/A " 15,563.43 " " 15,563.43 " 463-4 KIDNEY & URINARY TRACT INFECTIONS N/A N/A N/A APR-DRG IP N/A " 21,770.15 " N/A N/A N/A " 21,770.15 " " 21,770.15 " 465-1 URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 5,977.33 " N/A N/A N/A " 5,977.33 " " 5,977.33 " 465-2 URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 9,636.46 " N/A N/A N/A " 9,636.46 " " 9,636.46 " 465-3 URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 20,623.17 " N/A N/A N/A " 20,623.17 " " 20,623.17 " 465-4 URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION N/A N/A N/A APR-DRG IP N/A " 33,655.79 " N/A N/A N/A " 33,655.79 " " 33,655.79 " 466-1 "MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC" N/A N/A N/A APR-DRG IP N/A " 7,922.52 " N/A N/A N/A " 7,922.52 " " 7,922.52 " 466-2 "MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC" N/A N/A N/A APR-DRG IP N/A " 10,720.02 " N/A N/A N/A " 10,720.02 " " 10,720.02 " 466-3 "MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC" N/A N/A N/A APR-DRG IP N/A " 16,969.64 " N/A N/A N/A " 16,969.64 " " 16,969.64 " 466-4 "MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC" N/A N/A N/A APR-DRG IP N/A " 51,587.77 " N/A N/A N/A " 51,587.77 " " 51,587.77 " 468-1 "OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS" N/A N/A N/A APR-DRG IP N/A " 8,754.31 " N/A N/A N/A " 8,754.31 " " 8,754.31 " 468-2 "OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS" N/A N/A N/A APR-DRG IP N/A " 9,849.07 " N/A N/A N/A " 9,849.07 " " 9,849.07 " 468-3 "OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS" N/A N/A N/A APR-DRG IP N/A " 18,745.12 " N/A N/A N/A " 18,745.12 " " 18,745.12 " 468-4 "OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS" N/A N/A N/A APR-DRG IP N/A " 30,697.90 " N/A N/A N/A " 30,697.90 " " 30,697.90 " 469-1 ACUTE KIDNEY INJURY N/A N/A N/A APR-DRG IP N/A " 7,495.44 " N/A N/A N/A " 7,495.44 " " 7,495.44 " 469-2 ACUTE KIDNEY INJURY N/A N/A N/A APR-DRG IP N/A " 11,885.65 " N/A N/A N/A " 11,885.65 " " 11,885.65 " 469-3 ACUTE KIDNEY INJURY N/A N/A N/A APR-DRG IP N/A " 19,914.47 " N/A N/A N/A " 19,914.47 " " 19,914.47 " 469-4 ACUTE KIDNEY INJURY N/A N/A N/A APR-DRG IP N/A " 48,376.24 " N/A N/A N/A " 48,376.24 " " 48,376.24 " 470-1 CHRONIC KIDNEY DISEASE N/A N/A N/A APR-DRG IP N/A " 9,192.59 " N/A N/A N/A " 9,192.59 " " 9,192.59 " 470-2 CHRONIC KIDNEY DISEASE N/A N/A N/A APR-DRG IP N/A " 14,026.67 " N/A N/A N/A " 14,026.67 " " 14,026.67 " 470-3 CHRONIC KIDNEY DISEASE N/A N/A N/A APR-DRG IP N/A " 17,033.05 " N/A N/A N/A " 17,033.05 " " 17,033.05 " 470-4 CHRONIC KIDNEY DISEASE N/A N/A N/A APR-DRG IP N/A " 26,675.10 " N/A N/A N/A " 26,675.10 " " 26,675.10 " 480-1 MAJOR MALE PELVIC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 22,271.83 " N/A N/A N/A " 22,271.83 " " 22,271.83 " 480-2 MAJOR MALE PELVIC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 25,160.72 " N/A N/A N/A " 25,160.72 " " 25,160.72 " 480-3 MAJOR MALE PELVIC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 36,141.84 " N/A N/A N/A " 36,141.84 " " 36,141.84 " 480-4 MAJOR MALE PELVIC PROCEDURES N/A N/A N/A APR-DRG IP N/A " 79,842.52 " N/A N/A N/A " 79,842.52 " " 79,842.52 " 482-1 TRANSURETHRAL PROSTATECTOMY N/A N/A N/A APR-DRG IP N/A " 11,822.24 " N/A N/A N/A " 11,822.24 " " 11,822.24 " 482-2 TRANSURETHRAL PROSTATECTOMY N/A N/A N/A APR-DRG IP N/A " 14,332.53 " N/A N/A N/A " 14,332.53 " " 14,332.53 " 482-3 TRANSURETHRAL PROSTATECTOMY N/A N/A N/A APR-DRG IP N/A " 28,873.93 " N/A N/A N/A " 28,873.93 " " 28,873.93 " 482-4 TRANSURETHRAL PROSTATECTOMY N/A N/A N/A APR-DRG IP N/A " 52,072.67 " N/A N/A N/A " 52,072.67 " " 52,072.67 " 483-1 "PENIS, TESTES & SCROTAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 17,635.44 " N/A N/A N/A " 17,635.44 " " 17,635.44 " 483-2 "PENIS, TESTES & SCROTAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 35,026.57 " N/A N/A N/A " 35,026.57 " " 35,026.57 " 483-3 "PENIS, TESTES & SCROTAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 47,348.62 " N/A N/A N/A " 47,348.62 " " 47,348.62 " 483-4 "PENIS, TESTES & SCROTAL PROCEDURES" N/A N/A N/A APR-DRG IP N/A " 67,371.26 " N/A N/A N/A " 67,371.26 " " 67,371.26 " 484-1 OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 20,835.78 " N/A N/A N/A " 20,835.78 " " 20,835.78 " 484-2 OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 23,842.16 " N/A N/A N/A " 23,842.16 " " 23,842.16 " 484-3 OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 30,655.01 " N/A N/A N/A " 30,655.01 " " 30,655.01 " 484-4 OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 62,671.46 " N/A N/A N/A " 62,671.46 " " 62,671.46 " 500-1 "MALIGNANCY, MALE REPRODUCTIVE SYSTEM" N/A N/A N/A APR-DRG IP N/A " 11,589.11 " N/A N/A N/A " 11,589.11 " " 11,589.11 " 500-2 "MALIGNANCY, MALE REPRODUCTIVE SYSTEM" N/A N/A N/A APR-DRG IP N/A " 12,131.83 " N/A N/A N/A " 12,131.83 " " 12,131.83 " 500-3 "MALIGNANCY, MALE REPRODUCTIVE SYSTEM" N/A N/A N/A APR-DRG IP N/A " 19,254.26 " N/A N/A N/A " 19,254.26 " " 19,254.26 " 500-4 "MALIGNANCY, MALE REPRODUCTIVE SYSTEM" N/A N/A N/A APR-DRG IP N/A " 29,474.46 " N/A N/A N/A " 29,474.46 " " 29,474.46 " 501-1 MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 9,339.92 " N/A N/A N/A " 9,339.92 " " 9,339.92 " 501-2 MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 14,256.06 " N/A N/A N/A " 14,256.06 " " 14,256.06 " 501-3 MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 21,288.98 " N/A N/A N/A " 21,288.98 " " 21,288.98 " 501-4 MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 30,455.45 " N/A N/A N/A " 30,455.45 " " 30,455.45 " 510-1 "PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS" N/A N/A N/A APR-DRG IP N/A " 15,535.45 " N/A N/A N/A " 15,535.45 " " 15,535.45 " 510-2 "PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS" N/A N/A N/A APR-DRG IP N/A " 19,705.59 " N/A N/A N/A " 19,705.59 " " 19,705.59 " 510-3 "PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS" N/A N/A N/A APR-DRG IP N/A " 45,205.74 " N/A N/A N/A " 45,205.74 " " 45,205.74 " 510-4 "PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS" N/A N/A N/A APR-DRG IP N/A " 80,055.13 " N/A N/A N/A " 80,055.13 " " 80,055.13 " 511-1 UTERINE & ADNEXA PROCEDURES FOR OVARIAN & ADNEXAL MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 18,864.48 " N/A N/A N/A " 18,864.48 " " 18,864.48 " 511-2 UTERINE & ADNEXA PROCEDURES FOR OVARIAN & ADNEXAL MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 22,952.56 " N/A N/A N/A " 22,952.56 " " 22,952.56 " 511-3 UTERINE & ADNEXA PROCEDURES FOR OVARIAN & ADNEXAL MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 40,983.38 " N/A N/A N/A " 40,983.38 " " 40,983.38 " 511-4 UTERINE & ADNEXA PROCEDURES FOR OVARIAN & ADNEXAL MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 85,349.86 " N/A N/A N/A " 85,349.86 " " 85,349.86 " 512-1 UTERINE & ADNEXA PROCEDURES FOR NON-OVARIAN & NON-ADNEXAL MALIG N/A N/A N/A APR-DRG IP N/A " 19,727.97 " N/A N/A N/A " 19,727.97 " " 19,727.97 " 512-2 UTERINE & ADNEXA PROCEDURES FOR NON-OVARIAN & NON-ADNEXAL MALIG N/A N/A N/A APR-DRG IP N/A " 21,356.12 " N/A N/A N/A " 21,356.12 " " 21,356.12 " 512-3 UTERINE & ADNEXA PROCEDURES FOR NON-OVARIAN & NON-ADNEXAL MALIG N/A N/A N/A APR-DRG IP N/A " 41,447.76 " N/A N/A N/A " 41,447.76 " " 41,447.76 " 512-4 UTERINE & ADNEXA PROCEDURES FOR NON-OVARIAN & NON-ADNEXAL MALIG N/A N/A N/A APR-DRG IP N/A " 68,076.23 " N/A N/A N/A " 68,076.23 " " 68,076.23 " 513-1 UTERINE & ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 16,363.51 " N/A N/A N/A " 16,363.51 " " 16,363.51 " 513-2 UTERINE & ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 18,605.24 " N/A N/A N/A " 18,605.24 " " 18,605.24 " 513-3 UTERINE & ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 28,446.85 " N/A N/A N/A " 28,446.85 " " 28,446.85 " 513-4 UTERINE & ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 49,584.76 " N/A N/A N/A " 49,584.76 " " 49,584.76 " 514-1 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 17,172.92 " N/A N/A N/A " 17,172.92 " " 17,172.92 " 514-2 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 23,568.01 " N/A N/A N/A " 23,568.01 " " 23,568.01 " 514-3 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 38,834.90 " N/A N/A N/A " 38,834.90 " " 38,834.90 " 514-4 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES N/A N/A N/A APR-DRG IP N/A " 68,971.43 " N/A N/A N/A " 68,971.43 " " 68,971.43 " 517-1 DILATION & CURETTAGE FOR NON-OBSTETRIC DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 13,849.49 " N/A N/A N/A " 13,849.49 " " 13,849.49 " 517-2 DILATION & CURETTAGE FOR NON-OBSTETRIC DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 18,206.13 " N/A N/A N/A " 18,206.13 " " 18,206.13 " 517-3 DILATION & CURETTAGE FOR NON-OBSTETRIC DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 25,334.16 " N/A N/A N/A " 25,334.16 " " 25,334.16 " 517-4 DILATION & CURETTAGE FOR NON-OBSTETRIC DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 57,378.59 " N/A N/A N/A " 57,378.59 " " 57,378.59 " 518-1 OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 18,922.29 " N/A N/A N/A " 18,922.29 " " 18,922.29 " 518-2 OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 21,594.84 " N/A N/A N/A " 21,594.84 " " 21,594.84 " 518-3 OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 44,064.36 " N/A N/A N/A " 44,064.36 " " 44,064.36 " 518-4 OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES N/A N/A N/A APR-DRG IP N/A " 70,676.04 " N/A N/A N/A " 70,676.04 " " 70,676.04 " 519-1 UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 14,808.10 " N/A N/A N/A " 14,808.10 " " 14,808.10 " 519-2 UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 18,700.36 " N/A N/A N/A " 18,700.36 " " 18,700.36 " 519-3 UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 37,462.26 " N/A N/A N/A " 37,462.26 " " 37,462.26 " 519-4 UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA N/A N/A N/A APR-DRG IP N/A " 65,183.62 " N/A N/A N/A " 65,183.62 " " 65,183.62 " 530-1 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 11,494.00 " N/A N/A N/A " 11,494.00 " " 11,494.00 " 530-2 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 17,040.51 " N/A N/A N/A " 17,040.51 " " 17,040.51 " 530-3 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 23,273.34 " N/A N/A N/A " 23,273.34 " " 23,273.34 " 530-4 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY N/A N/A N/A APR-DRG IP N/A " 32,020.19 " N/A N/A N/A " 32,020.19 " " 32,020.19 " 531-1 FEMALE REPRODUCTIVE SYSTEM INFECTIONS N/A N/A N/A APR-DRG IP N/A " 10,768.51 " N/A N/A N/A " 10,768.51 " " 10,768.51 " 531-2 FEMALE REPRODUCTIVE SYSTEM INFECTIONS N/A N/A N/A APR-DRG IP N/A " 13,079.25 " N/A N/A N/A " 13,079.25 " " 13,079.25 " 531-3 FEMALE REPRODUCTIVE SYSTEM INFECTIONS N/A N/A N/A APR-DRG IP N/A " 18,834.64 " N/A N/A N/A " 18,834.64 " " 18,834.64 " 531-4 FEMALE REPRODUCTIVE SYSTEM INFECTIONS N/A N/A N/A APR-DRG IP N/A " 33,092.56 " N/A N/A N/A " 33,092.56 " " 33,092.56 " 532-1 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS N/A N/A N/A APR-DRG IP N/A " 8,634.95 " N/A N/A N/A " 8,634.95 " " 8,634.95 " 532-2 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS N/A N/A N/A APR-DRG IP N/A " 9,901.29 " N/A N/A N/A " 9,901.29 " " 9,901.29 " 532-3 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS N/A N/A N/A APR-DRG IP N/A " 15,624.97 " N/A N/A N/A " 15,624.97 " " 15,624.97 " 532-4 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS N/A N/A N/A APR-DRG IP N/A " 31,473.74 " N/A N/A N/A " 31,473.74 " " 31,473.74 " 539-1 CESAREAN SECTION W STERILIZATION N/A N/A N/A APR-DRG IP N/A " 11,158.30 " N/A N/A N/A " 11,158.30 " " 11,158.30 " 539-2 CESAREAN SECTION W STERILIZATION N/A N/A N/A APR-DRG IP N/A " 13,116.55 " N/A N/A N/A " 13,116.55 " " 13,116.55 " 539-3 CESAREAN SECTION W STERILIZATION N/A N/A N/A APR-DRG IP N/A " 23,679.91 " N/A N/A N/A " 23,679.91 " " 23,679.91 " 539-4 CESAREAN SECTION W STERILIZATION N/A N/A N/A APR-DRG IP N/A " 38,769.62 " N/A N/A N/A " 38,769.62 " " 38,769.62 " 540-1 CESAREAN SECTION W/O STERILIZATION N/A N/A N/A APR-DRG IP N/A " 11,329.88 " N/A N/A N/A " 11,329.88 " " 11,329.88 " 540-2 CESAREAN SECTION W/O STERILIZATION N/A N/A N/A APR-DRG IP N/A " 14,427.64 " N/A N/A N/A " 14,427.64 " " 14,427.64 " 540-3 CESAREAN SECTION W/O STERILIZATION N/A N/A N/A APR-DRG IP N/A " 19,811.90 " N/A N/A N/A " 19,811.90 " " 19,811.90 " 540-4 CESAREAN SECTION W/O STERILIZATION N/A N/A N/A APR-DRG IP N/A " 27,169.32 " N/A N/A N/A " 27,169.32 " " 27,169.32 " 541-1 VAGINAL DELIVERY W STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 9,427.58 " N/A N/A N/A " 9,427.58 " " 9,427.58 " 541-2 VAGINAL DELIVERY W STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 10,365.67 " N/A N/A N/A " 10,365.67 " " 10,365.67 " 541-3 VAGINAL DELIVERY W STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 14,643.98 " N/A N/A N/A " 14,643.98 " " 14,643.98 " 541-4 VAGINAL DELIVERY W STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 24,991.00 " N/A N/A N/A " 24,991.00 " " 24,991.00 " 542-1 VAGINAL DELIVERY W O.R. PROCEDURE EXCEPT STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 8,131.40 " N/A N/A N/A " 8,131.40 " " 8,131.40 " 542-2 VAGINAL DELIVERY W O.R. PROCEDURE EXCEPT STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 8,879.27 " N/A N/A N/A " 8,879.27 " " 8,879.27 " 542-3 VAGINAL DELIVERY W O.R. PROCEDURE EXCEPT STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 12,564.51 " N/A N/A N/A " 12,564.51 " " 12,564.51 " 542-4 VAGINAL DELIVERY W O.R. PROCEDURE EXCEPT STERILIZATION &/OR D&C N/A N/A N/A APR-DRG IP N/A " 30,587.87 " N/A N/A N/A " 30,587.87 " " 30,587.87 " 543-1 "ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 7,422.70 " N/A N/A N/A " 7,422.70 " " 7,422.70 " 543-2 "ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 11,988.22 " N/A N/A N/A " 11,988.22 " " 11,988.22 " 543-3 "ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 16,563.07 " N/A N/A N/A " 16,563.07 " " 16,563.07 " 543-4 "ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 46,699.60 " N/A N/A N/A " 46,699.60 " " 46,699.60 " 547-1 ANTEPARTUM W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 9,862.12 " N/A N/A N/A " 9,862.12 " " 9,862.12 " 547-2 ANTEPARTUM W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 15,992.38 " N/A N/A N/A " 15,992.38 " " 15,992.38 " 547-3 ANTEPARTUM W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 22,124.50 " N/A N/A N/A " 22,124.50 " " 22,124.50 " 547-4 ANTEPARTUM W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 52,165.92 " N/A N/A N/A " 52,165.92 " " 52,165.92 " 548-1 POSTPARTUM & POST ABORTION DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 8,056.80 " N/A N/A N/A " 8,056.80 " " 8,056.80 " 548-2 POSTPARTUM & POST ABORTION DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 11,499.59 " N/A N/A N/A " 11,499.59 " " 11,499.59 " 548-3 POSTPARTUM & POST ABORTION DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 32,639.37 " N/A N/A N/A " 32,639.37 " " 32,639.37 " 548-4 POSTPARTUM & POST ABORTION DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 54,217.42 " N/A N/A N/A " 54,217.42 " " 54,217.42 " 560-1 VAGINAL DELIVERY N/A N/A N/A APR-DRG IP N/A " 7,109.38 " N/A N/A N/A " 7,109.38 " " 7,109.38 " 560-2 VAGINAL DELIVERY N/A N/A N/A APR-DRG IP N/A " 8,164.97 " N/A N/A N/A " 8,164.97 " " 8,164.97 " 560-3 VAGINAL DELIVERY N/A N/A N/A APR-DRG IP N/A " 10,876.68 " N/A N/A N/A " 10,876.68 " " 10,876.68 " 560-4 VAGINAL DELIVERY N/A N/A N/A APR-DRG IP N/A " 11,779.34 " N/A N/A N/A " 11,779.34 " " 11,779.34 " 561-1 POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE N/A N/A N/A APR-DRG IP N/A " 6,809.12 " N/A N/A N/A " 6,809.12 " " 6,809.12 " 561-2 POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE N/A N/A N/A APR-DRG IP N/A " 7,625.99 " N/A N/A N/A " 7,625.99 " " 7,625.99 " 561-3 POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE N/A N/A N/A APR-DRG IP N/A " 13,138.93 " N/A N/A N/A " 13,138.93 " " 13,138.93 " 561-4 POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE N/A N/A N/A APR-DRG IP N/A " 30,720.28 " N/A N/A N/A " 30,720.28 " " 30,720.28 " 564-1 "ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 6,555.48 " N/A N/A N/A " 6,555.48 " " 6,555.48 " 564-2 "ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 6,945.26 " N/A N/A N/A " 6,945.26 " " 6,945.26 " 564-3 "ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 11,158.30 " N/A N/A N/A " 11,158.30 " " 11,158.30 " 564-4 "ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A APR-DRG IP N/A " 18,648.14 " N/A N/A N/A " 18,648.14 " " 18,648.14 " 566-1 ANTEPARTUM W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 6,378.30 " N/A N/A N/A " 6,378.30 " " 6,378.30 " 566-2 ANTEPARTUM W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 7,280.96 " N/A N/A N/A " 7,280.96 " " 7,280.96 " 566-3 ANTEPARTUM W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 13,733.86 " N/A N/A N/A " 13,733.86 " " 13,733.86 " 566-4 ANTEPARTUM W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 24,625.46 " N/A N/A N/A " 24,625.46 " " 24,625.46 " 580-1 "NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE" N/A N/A N/A APR-DRG IP N/A " 4,518.90 " N/A N/A N/A " 4,518.90 " " 4,518.90 " 580-2 "NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE" N/A N/A N/A APR-DRG IP N/A " 5,779.64 " N/A N/A N/A " 5,779.64 " " 5,779.64 " 580-3 "NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE" N/A N/A N/A APR-DRG IP N/A " 10,997.91 " N/A N/A N/A " 10,997.91 " " 10,997.91 " 580-4 "NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE" N/A N/A N/A APR-DRG IP N/A " 15,990.51 " N/A N/A N/A " 15,990.51 " " 15,990.51 " 581-1 "NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE" N/A N/A N/A APR-DRG IP N/A " 2,252.92 " N/A N/A N/A " 2,252.92 " " 2,252.92 " 581-2 "NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE" N/A N/A N/A APR-DRG IP N/A " 3,716.95 " N/A N/A N/A " 3,716.95 " " 3,716.95 " 581-3 "NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE" N/A N/A N/A APR-DRG IP N/A " 5,643.49 " N/A N/A N/A " 5,643.49 " " 5,643.49 " 581-4 "NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE" N/A N/A N/A APR-DRG IP N/A " 9,919.94 " N/A N/A N/A " 9,919.94 " " 9,919.94 " 583-1 NEONATE W ECMO N/A N/A N/A APR-DRG IP N/A " 197,848.53 " N/A N/A N/A " 197,848.53 " " 197,848.53 " 583-2 NEONATE W ECMO N/A N/A N/A APR-DRG IP N/A " 327,480.95 " N/A N/A N/A " 327,480.95 " " 327,480.95 " 583-3 NEONATE W ECMO N/A N/A N/A APR-DRG IP N/A " 340,239.41 " N/A N/A N/A " 340,239.41 " " 340,239.41 " 583-4 NEONATE W ECMO N/A N/A N/A APR-DRG IP N/A " 605,884.42 " N/A N/A N/A " 605,884.42 " " 605,884.42 " 588-1 NEONATE BWT <1500G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 128,903.21 " N/A N/A N/A " 128,903.21 " " 128,903.21 " 588-2 NEONATE BWT <1500G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 186,483.22 " N/A N/A N/A " 186,483.22 " " 186,483.22 " 588-3 NEONATE BWT <1500G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 260,846.36 " N/A N/A N/A " 260,846.36 " " 260,846.36 " 588-4 NEONATE BWT <1500G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 514,534.85 " N/A N/A N/A " 514,534.85 " " 514,534.85 " 589-1 "NEONATE BWT < 500G, OR BWT 500-999G & GESTATIONAL AGE <24 WKS, OR BWT 500-749G W MAJOR ANOMALY OR W/O LIFE SUSTAINING IN" N/A N/A N/A APR-DRG IP N/A " 277,265.82 " N/A N/A N/A " 277,265.82 " " 277,265.82 " 589-2 "NEONATE BWT < 500G, OR BWT 500-999G & GESTATIONAL AGE <24 WKS, OR BWT 500-749G W MAJOR ANOMALY OR W/O LIFE SUSTAINING IN" N/A N/A N/A APR-DRG IP N/A " 252,060.35 " N/A N/A N/A " 252,060.35 " " 252,060.35 " 589-3 "NEONATE BWT < 500G, OR BWT 500-999G & GESTATIONAL AGE <24 WKS, OR BWT 500-749G W MAJOR ANOMALY OR W/O LIFE SUSTAINING IN" N/A N/A N/A APR-DRG IP N/A " 240,057.21 " N/A N/A N/A " 240,057.21 " " 240,057.21 " 589-4 "NEONATE BWT < 500G, OR BWT 500-999G & GESTATIONAL AGE <24 WKS, OR BWT 500-749G W MAJOR ANOMALY OR W/O LIFE SUSTAINING IN" N/A N/A N/A APR-DRG IP N/A " 73,374.70 " N/A N/A N/A " 73,374.70 " " 73,374.70 " 591-1 NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 264,999.72 " N/A N/A N/A " 264,999.72 " " 264,999.72 " 591-2 NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 294,444.34 " N/A N/A N/A " 294,444.34 " " 294,444.34 " 591-3 NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 333,613.07 " N/A N/A N/A " 333,613.07 " " 333,613.07 " 591-4 NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 448,991.29 " N/A N/A N/A " 448,991.29 " " 448,991.29 " 593-1 NEONATE BIRTHWT 750-999G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 160,748.08 " N/A N/A N/A " 160,748.08 " " 160,748.08 " 593-2 NEONATE BIRTHWT 750-999G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 178,609.19 " N/A N/A N/A " 178,609.19 " " 178,609.19 " 593-3 NEONATE BIRTHWT 750-999G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 207,143.69 " N/A N/A N/A " 207,143.69 " " 207,143.69 " 593-4 NEONATE BIRTHWT 750-999G W/O MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 291,575.97 " N/A N/A N/A " 291,575.97 " " 291,575.97 " 602-1 NEONATE BWT 1000-1249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 76,138.63 " N/A N/A N/A " 76,138.63 " " 76,138.63 " 602-2 NEONATE BWT 1000-1249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 167,564.66 " N/A N/A N/A " 167,564.66 " " 167,564.66 " 602-3 NEONATE BWT 1000-1249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 184,096.02 " N/A N/A N/A " 184,096.02 " " 184,096.02 " 602-4 NEONATE BWT 1000-1249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 214,452.62 " N/A N/A N/A " 214,452.62 " " 214,452.62 " 603-1 NEONATE BIRTHWT 1000-1249G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 31,591.24 " N/A N/A N/A " 31,591.24 " " 31,591.24 " 603-2 NEONATE BIRTHWT 1000-1249G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 108,511.30 " N/A N/A N/A " 108,511.30 " " 108,511.30 " 603-3 NEONATE BIRTHWT 1000-1249G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 152,238.09 " N/A N/A N/A " 152,238.09 " " 152,238.09 " 603-4 NEONATE BIRTHWT 1000-1249G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 198,516.20 " N/A N/A N/A " 198,516.20 " " 198,516.20 " 607-1 NEONATE BWT 1250-1499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 82,513.20 " N/A N/A N/A " 82,513.20 " " 82,513.20 " 607-2 NEONATE BWT 1250-1499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 115,818.37 " N/A N/A N/A " 115,818.37 " " 115,818.37 " 607-3 NEONATE BWT 1250-1499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 147,243.62 " N/A N/A N/A " 147,243.62 " " 147,243.62 " 607-4 NEONATE BWT 1250-1499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM N/A N/A N/A APR-DRG IP N/A " 225,381.52 " N/A N/A N/A " 225,381.52 " " 225,381.52 " 608-1 NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 55,547.16 " N/A N/A N/A " 55,547.16 " " 55,547.16 " 608-2 NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 72,518.66 " N/A N/A N/A " 72,518.66 " " 72,518.66 " 608-3 NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 125,063.17 " N/A N/A N/A " 125,063.17 " " 125,063.17 " 608-4 NEONATE BWT 1250-1499G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 219,665.30 " N/A N/A N/A " 219,665.30 " " 219,665.30 " 609-1 NEONATE BWT 1500-2499G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 31,729.25 " N/A N/A N/A " 31,729.25 " " 31,729.25 " 609-2 NEONATE BWT 1500-2499G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 98,768.54 " N/A N/A N/A " 98,768.54 " " 98,768.54 " 609-3 NEONATE BWT 1500-2499G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 140,958.57 " N/A N/A N/A " 140,958.57 " " 140,958.57 " 609-4 NEONATE BWT 1500-2499G W MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 247,787.63 " N/A N/A N/A " 247,787.63 " " 247,787.63 " 611-1 NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 26,113.73 " N/A N/A N/A " 26,113.73 " " 26,113.73 " 611-2 NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 50,528.45 " N/A N/A N/A " 50,528.45 " " 50,528.45 " 611-3 NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 99,736.47 " N/A N/A N/A " 99,736.47 " " 99,736.47 " 611-4 NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 168,858.97 " N/A N/A N/A " 168,858.97 " " 168,858.97 " 612-1 NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 76,276.64 " N/A N/A N/A " 76,276.64 " " 76,276.64 " 612-2 NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 86,448.35 " N/A N/A N/A " 86,448.35 " " 86,448.35 " 612-3 NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 106,441.15 " N/A N/A N/A " 106,441.15 " " 106,441.15 " 612-4 NEONATE BWT 1500-1999G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 146,467.78 " N/A N/A N/A " 146,467.78 " " 146,467.78 " 613-1 NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 34,381.28 " N/A N/A N/A " 34,381.28 " " 34,381.28 " 613-2 NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 57,990.31 " N/A N/A N/A " 57,990.31 " " 57,990.31 " 613-3 NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 80,400.15 " N/A N/A N/A " 80,400.15 " " 80,400.15 " 613-4 NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 100,562.67 " N/A N/A N/A " 100,562.67 " " 100,562.67 " 614-1 NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 35,627.10 " N/A N/A N/A " 35,627.10 " " 35,627.10 " 614-2 NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 56,487.12 " N/A N/A N/A " 56,487.12 " " 56,487.12 " 614-3 NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 79,303.53 " N/A N/A N/A " 79,303.53 " " 79,303.53 " 614-4 NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 134,929.02 " N/A N/A N/A " 134,929.02 " " 134,929.02 " 621-1 NEONATE BWT 2000-2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 16,939.80 " N/A N/A N/A " 16,939.80 " " 16,939.80 " 621-2 NEONATE BWT 2000-2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 36,608.09 " N/A N/A N/A " 36,608.09 " " 36,608.09 " 621-3 NEONATE BWT 2000-2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 66,656.97 " N/A N/A N/A " 66,656.97 " " 66,656.97 " 621-4 NEONATE BWT 2000-2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 117,817.65 " N/A N/A N/A " 117,817.65 " " 117,817.65 " 622-1 NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 54,249.12 " N/A N/A N/A " 54,249.12 " " 54,249.12 " 622-2 NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 56,339.79 " N/A N/A N/A " 56,339.79 " " 56,339.79 " 622-3 NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 67,082.19 " N/A N/A N/A " 67,082.19 " " 67,082.19 " 622-4 NEONATE BWT 2000-2499G W RESP DIST SYND/OTH MAJ RESP COND N/A N/A N/A APR-DRG IP N/A " 92,766.97 " N/A N/A N/A " 92,766.97 " " 92,766.97 " 623-1 NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 22,081.60 " N/A N/A N/A " 22,081.60 " " 22,081.60 " 623-2 NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 35,888.20 " N/A N/A N/A " 35,888.20 " " 35,888.20 " 623-3 NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 54,942.90 " N/A N/A N/A " 54,942.90 " " 54,942.90 " 623-4 NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 66,009.81 " N/A N/A N/A " 66,009.81 " " 66,009.81 " 625-1 NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 35,839.71 " N/A N/A N/A " 35,839.71 " " 35,839.71 " 625-2 NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 52,404.64 " N/A N/A N/A " 52,404.64 " " 52,404.64 " 625-3 NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 80,806.72 " N/A N/A N/A " 80,806.72 " " 80,806.72 " 625-4 NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 89,210.41 " N/A N/A N/A " 89,210.41 " " 89,210.41 " 626-1 "NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 4,727.78 " N/A N/A N/A " 4,727.78 " " 4,727.78 " 626-2 "NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 8,330.96 " N/A N/A N/A " 8,330.96 " " 8,330.96 " 626-3 "NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 25,388.25 " N/A N/A N/A " 25,388.25 " " 25,388.25 " 626-4 "NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 53,434.12 " N/A N/A N/A " 53,434.12 " " 53,434.12 " 630-1 NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 53,827.63 " N/A N/A N/A " 53,827.63 " " 53,827.63 " 630-2 NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 88,915.74 " N/A N/A N/A " 88,915.74 " " 88,915.74 " 630-3 NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 102,929.35 " N/A N/A N/A " 102,929.35 " " 102,929.35 " 630-4 NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 205,582.68 " N/A N/A N/A " 205,582.68 " " 205,582.68 " 631-1 NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 30,848.97 " N/A N/A N/A " 30,848.97 " " 30,848.97 " 631-2 NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 53,191.67 " N/A N/A N/A " 53,191.67 " " 53,191.67 " 631-3 NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 87,196.21 " N/A N/A N/A " 87,196.21 " " 87,196.21 " 631-4 NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE N/A N/A N/A APR-DRG IP N/A " 188,995.37 " N/A N/A N/A " 188,995.37 " " 188,995.37 " 633-1 NEONATE BIRTHWT >2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 6,451.04 " N/A N/A N/A " 6,451.04 " " 6,451.04 " 633-2 NEONATE BIRTHWT >2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 26,887.71 " N/A N/A N/A " 26,887.71 " " 26,887.71 " 633-3 NEONATE BIRTHWT >2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 74,933.84 " N/A N/A N/A " 74,933.84 " " 74,933.84 " 633-4 NEONATE BIRTHWT >2499G W MAJOR ANOMALY N/A N/A N/A APR-DRG IP N/A " 188,626.10 " N/A N/A N/A " 188,626.10 " " 188,626.10 " 634-1 "NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND" N/A N/A N/A APR-DRG IP N/A " 19,259.86 " N/A N/A N/A " 19,259.86 " " 19,259.86 " 634-2 "NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND" N/A N/A N/A APR-DRG IP N/A " 32,758.73 " N/A N/A N/A " 32,758.73 " " 32,758.73 " 634-3 "NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND" N/A N/A N/A APR-DRG IP N/A " 39,086.67 " N/A N/A N/A " 39,086.67 " " 39,086.67 " 634-4 "NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND" N/A N/A N/A APR-DRG IP N/A " 77,876.81 " N/A N/A N/A " 77,876.81 " " 77,876.81 " 636-1 NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 14,949.84 " N/A N/A N/A " 14,949.84 " " 14,949.84 " 636-2 NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 21,568.73 " N/A N/A N/A " 21,568.73 " " 21,568.73 " 636-3 NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 47,883.88 " N/A N/A N/A " 47,883.88 " " 47,883.88 " 636-4 NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION N/A N/A N/A APR-DRG IP N/A " 63,286.91 " N/A N/A N/A " 63,286.91 " " 63,286.91 " 639-1 NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 12,777.12 " N/A N/A N/A " 12,777.12 " " 12,777.12 " 639-2 NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 26,483.00 " N/A N/A N/A " 26,483.00 " " 26,483.00 " 639-3 NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 47,555.64 " N/A N/A N/A " 47,555.64 " " 47,555.64 " 639-4 NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION N/A N/A N/A APR-DRG IP N/A " 58,756.83 " N/A N/A N/A " 58,756.83 " " 58,756.83 " 640-1 "NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 2,482.32 " N/A N/A N/A " 2,482.32 " " 2,482.32 " 640-2 "NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 4,134.71 " N/A N/A N/A " 4,134.71 " " 4,134.71 " 640-3 "NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 13,385.11 " N/A N/A N/A " 13,385.11 " " 13,385.11 " 640-4 "NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM" N/A N/A N/A APR-DRG IP N/A " 55,220.79 " N/A N/A N/A " 55,220.79 " " 55,220.79 " 650-1 SPLENECTOMY N/A N/A N/A APR-DRG IP N/A " 23,754.51 " N/A N/A N/A " 23,754.51 " " 23,754.51 " 650-2 SPLENECTOMY N/A N/A N/A APR-DRG IP N/A " 37,128.42 " N/A N/A N/A " 37,128.42 " " 37,128.42 " 650-3 SPLENECTOMY N/A N/A N/A APR-DRG IP N/A " 45,933.09 " N/A N/A N/A " 45,933.09 " " 45,933.09 " 650-4 SPLENECTOMY N/A N/A N/A APR-DRG IP N/A " 82,994.37 " N/A N/A N/A " 82,994.37 " " 82,994.37 " 651-1 OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 16,977.10 " N/A N/A N/A " 16,977.10 " " 16,977.10 " 651-2 OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 23,922.36 " N/A N/A N/A " 23,922.36 " " 23,922.36 " 651-3 OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 48,624.28 " N/A N/A N/A " 48,624.28 " " 48,624.28 " 651-4 OTHER PROCEDURES OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 90,827.37 " N/A N/A N/A " 90,827.37 " " 90,827.37 " 660-1 MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL N/A N/A N/A APR-DRG IP N/A " 10,445.87 " N/A N/A N/A " 10,445.87 " " 10,445.87 " 660-2 MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL N/A N/A N/A APR-DRG IP N/A " 14,147.89 " N/A N/A N/A " 14,147.89 " " 14,147.89 " 660-3 MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL N/A N/A N/A APR-DRG IP N/A " 32,516.28 " N/A N/A N/A " 32,516.28 " " 32,516.28 " 660-4 MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL N/A N/A N/A APR-DRG IP N/A " 76,722.37 " N/A N/A N/A " 76,722.37 " " 76,722.37 " 661-1 COAGULATION & PLATELET DISORDERS N/A N/A N/A APR-DRG IP N/A " 13,273.21 " N/A N/A N/A " 13,273.21 " " 13,273.21 " 661-2 COAGULATION & PLATELET DISORDERS N/A N/A N/A APR-DRG IP N/A " 16,956.58 " N/A N/A N/A " 16,956.58 " " 16,956.58 " 661-3 COAGULATION & PLATELET DISORDERS N/A N/A N/A APR-DRG IP N/A " 24,133.10 " N/A N/A N/A " 24,133.10 " " 24,133.10 " 661-4 COAGULATION & PLATELET DISORDERS N/A N/A N/A APR-DRG IP N/A " 55,573.27 " N/A N/A N/A " 55,573.27 " " 55,573.27 " 662-1 SICKLE CELL ANEMIA CRISIS N/A N/A N/A APR-DRG IP N/A " 12,640.97 " N/A N/A N/A " 12,640.97 " " 12,640.97 " 662-2 SICKLE CELL ANEMIA CRISIS N/A N/A N/A APR-DRG IP N/A " 20,785.43 " N/A N/A N/A " 20,785.43 " " 20,785.43 " 662-3 SICKLE CELL ANEMIA CRISIS N/A N/A N/A APR-DRG IP N/A " 32,706.51 " N/A N/A N/A " 32,706.51 " " 32,706.51 " 662-4 SICKLE CELL ANEMIA CRISIS N/A N/A N/A APR-DRG IP N/A " 40,511.53 " N/A N/A N/A " 40,511.53 " " 40,511.53 " 663-1 OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 9,339.92 " N/A N/A N/A " 9,339.92 " " 9,339.92 " 663-2 OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 11,406.34 " N/A N/A N/A " 11,406.34 " " 11,406.34 " 663-3 OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 18,398.23 " N/A N/A N/A " 18,398.23 " " 18,398.23 " 663-4 OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS N/A N/A N/A APR-DRG IP N/A " 36,705.07 " N/A N/A N/A " 36,705.07 " " 36,705.07 " 680-1 MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 28,081.31 " N/A N/A N/A " 28,081.31 " " 28,081.31 " 680-2 MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 38,956.12 " N/A N/A N/A " 38,956.12 " " 38,956.12 " 680-3 MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 80,124.13 " N/A N/A N/A " 80,124.13 " " 80,124.13 " 680-4 MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 110,223.37 " N/A N/A N/A " 110,223.37 " " 110,223.37 " 681-1 OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 19,981.61 " N/A N/A N/A " 19,981.61 " " 19,981.61 " 681-2 OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 31,537.15 " N/A N/A N/A " 31,537.15 " " 31,537.15 " 681-3 OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 48,527.30 " N/A N/A N/A " 48,527.30 " " 48,527.30 " 681-4 OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS N/A N/A N/A APR-DRG IP N/A " 98,169.87 " N/A N/A N/A " 98,169.87 " " 98,169.87 " 690-1 ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 22,540.39 " N/A N/A N/A " 22,540.39 " " 22,540.39 " 690-2 ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 64,564.44 " N/A N/A N/A " 64,564.44 " " 64,564.44 " 690-3 ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 91,763.60 " N/A N/A N/A " 91,763.60 " " 91,763.60 " 690-4 ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 124,285.47 " N/A N/A N/A " 124,285.47 " " 124,285.47 " 691-1 "LYMPHOMA, MYELOMA & NON-ACUTE LEUKEMIA" N/A N/A N/A APR-DRG IP N/A " 15,434.74 " N/A N/A N/A " 15,434.74 " " 15,434.74 " 691-2 "LYMPHOMA, MYELOMA & NON-ACUTE LEUKEMIA" N/A N/A N/A APR-DRG IP N/A " 28,150.31 " N/A N/A N/A " 28,150.31 " " 28,150.31 " 691-3 "LYMPHOMA, MYELOMA & NON-ACUTE LEUKEMIA" N/A N/A N/A APR-DRG IP N/A " 40,173.97 " N/A N/A N/A " 40,173.97 " " 40,173.97 " 691-4 "LYMPHOMA, MYELOMA & NON-ACUTE LEUKEMIA" N/A N/A N/A APR-DRG IP N/A " 101,651.83 " N/A N/A N/A " 101,651.83 " " 101,651.83 " 692-1 RADIOTHERAPY N/A N/A N/A APR-DRG IP N/A " 14,250.47 " N/A N/A N/A " 14,250.47 " " 14,250.47 " 692-2 RADIOTHERAPY N/A N/A N/A APR-DRG IP N/A " 23,247.23 " N/A N/A N/A " 23,247.23 " " 23,247.23 " 692-3 RADIOTHERAPY N/A N/A N/A APR-DRG IP N/A " 35,627.10 " N/A N/A N/A " 35,627.10 " " 35,627.10 " 692-4 RADIOTHERAPY N/A N/A N/A APR-DRG IP N/A " 70,262.01 " N/A N/A N/A " 70,262.01 " " 70,262.01 " 694-1 LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR N/A N/A N/A APR-DRG IP N/A " 10,943.82 " N/A N/A N/A " 10,943.82 " " 10,943.82 " 694-2 LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR N/A N/A N/A APR-DRG IP N/A " 20,722.02 " N/A N/A N/A " 20,722.02 " " 20,722.02 " 694-3 LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR N/A N/A N/A APR-DRG IP N/A " 22,525.47 " N/A N/A N/A " 22,525.47 " " 22,525.47 " 694-4 LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR N/A N/A N/A APR-DRG IP N/A " 67,934.49 " N/A N/A N/A " 67,934.49 " " 67,934.49 " 695-1 CHEMOTHERAPY FOR ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 14,034.13 " N/A N/A N/A " 14,034.13 " " 14,034.13 " 695-2 CHEMOTHERAPY FOR ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 17,064.75 " N/A N/A N/A " 17,064.75 " " 17,064.75 " 695-3 CHEMOTHERAPY FOR ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 39,912.87 " N/A N/A N/A " 39,912.87 " " 39,912.87 " 695-4 CHEMOTHERAPY FOR ACUTE LEUKEMIA N/A N/A N/A APR-DRG IP N/A " 110,726.92 " N/A N/A N/A " 110,726.92 " " 110,726.92 " 696-1 OTHER CHEMOTHERAPY N/A N/A N/A APR-DRG IP N/A " 14,472.40 " N/A N/A N/A " 14,472.40 " " 14,472.40 " 696-2 OTHER CHEMOTHERAPY N/A N/A N/A APR-DRG IP N/A " 19,086.41 " N/A N/A N/A " 19,086.41 " " 19,086.41 " 696-3 OTHER CHEMOTHERAPY N/A N/A N/A APR-DRG IP N/A " 33,937.41 " N/A N/A N/A " 33,937.41 " " 33,937.41 " 696-4 OTHER CHEMOTHERAPY N/A N/A N/A APR-DRG IP N/A " 74,415.37 " N/A N/A N/A " 74,415.37 " " 74,415.37 " 710-1 INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 18,359.06 " N/A N/A N/A " 18,359.06 " " 18,359.06 " 710-2 INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 26,055.92 " N/A N/A N/A " 26,055.92 " " 26,055.92 " 710-3 INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 42,029.64 " N/A N/A N/A " 42,029.64 " " 42,029.64 " 710-4 INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 115,506.91 " N/A N/A N/A " 115,506.91 " " 115,506.91 " 711-1 "POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 17,251.25 " N/A N/A N/A " 17,251.25 " " 17,251.25 " 711-2 "POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 24,166.67 " N/A N/A N/A " 24,166.67 " " 24,166.67 " 711-3 "POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 40,550.70 " N/A N/A N/A " 40,550.70 " " 40,550.70 " 711-4 "POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE" N/A N/A N/A APR-DRG IP N/A " 69,889.01 " N/A N/A N/A " 69,889.01 " " 69,889.01 " 720-1 SEPTICEMIA & DISSEMINATED INFECTIONS N/A N/A N/A APR-DRG IP N/A " 10,186.63 " N/A N/A N/A " 10,186.63 " " 10,186.63 " 720-2 SEPTICEMIA & DISSEMINATED INFECTIONS N/A N/A N/A APR-DRG IP N/A " 13,752.51 " N/A N/A N/A " 13,752.51 " " 13,752.51 " 720-3 SEPTICEMIA & DISSEMINATED INFECTIONS N/A N/A N/A APR-DRG IP N/A " 21,699.28 " N/A N/A N/A " 21,699.28 " " 21,699.28 " 720-4 SEPTICEMIA & DISSEMINATED INFECTIONS N/A N/A N/A APR-DRG IP N/A " 47,660.08 " N/A N/A N/A " 47,660.08 " " 47,660.08 " 721-1 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 9,455.55 " N/A N/A N/A " 9,455.55 " " 9,455.55 " 721-2 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 14,649.58 " N/A N/A N/A " 14,649.58 " " 14,649.58 " 721-3 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 22,335.24 " N/A N/A N/A " 22,335.24 " " 22,335.24 " 721-4 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS" N/A N/A N/A APR-DRG IP N/A " 32,706.51 " N/A N/A N/A " 32,706.51 " " 32,706.51 " 722-1 FEVER & INFLAMMATORY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 7,767.73 " N/A N/A N/A " 7,767.73 " " 7,767.73 " 722-2 FEVER & INFLAMMATORY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 9,880.77 " N/A N/A N/A " 9,880.77 " " 9,880.77 " 722-3 FEVER & INFLAMMATORY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 13,381.38 " N/A N/A N/A " 13,381.38 " " 13,381.38 " 722-4 FEVER & INFLAMMATORY CONDITIONS N/A N/A N/A APR-DRG IP N/A " 21,704.87 " N/A N/A N/A " 21,704.87 " " 21,704.87 " 723-1 VIRAL ILLNESS N/A N/A N/A APR-DRG IP N/A " 7,586.82 " N/A N/A N/A " 7,586.82 " " 7,586.82 " 723-2 VIRAL ILLNESS N/A N/A N/A APR-DRG IP N/A " 10,044.89 " N/A N/A N/A " 10,044.89 " " 10,044.89 " 723-3 VIRAL ILLNESS N/A N/A N/A APR-DRG IP N/A " 14,008.02 " N/A N/A N/A " 14,008.02 " " 14,008.02 " 723-4 VIRAL ILLNESS N/A N/A N/A APR-DRG IP N/A " 26,507.25 " N/A N/A N/A " 26,507.25 " " 26,507.25 " 724-1 OTHER INFECTIOUS & PARASITIC DISEASES N/A N/A N/A APR-DRG IP N/A " 12,818.15 " N/A N/A N/A " 12,818.15 " " 12,818.15 " 724-2 OTHER INFECTIOUS & PARASITIC DISEASES N/A N/A N/A APR-DRG IP N/A " 17,739.88 " N/A N/A N/A " 17,739.88 " " 17,739.88 " 724-3 OTHER INFECTIOUS & PARASITIC DISEASES N/A N/A N/A APR-DRG IP N/A " 23,249.09 " N/A N/A N/A " 23,249.09 " " 23,249.09 " 724-4 OTHER INFECTIOUS & PARASITIC DISEASES N/A N/A N/A APR-DRG IP N/A " 68,335.47 " N/A N/A N/A " 68,335.47 " " 68,335.47 " 740-1 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 22,917.12 " N/A N/A N/A " 22,917.12 " " 22,917.12 " 740-2 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 35,310.05 " N/A N/A N/A " 35,310.05 " " 35,310.05 " 740-3 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 48,316.56 " N/A N/A N/A " 48,316.56 " " 48,316.56 " 740-4 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 182,003.49 " N/A N/A N/A " 182,003.49 " " 182,003.49 " 750-1 SCHIZOPHRENIA N/A N/A N/A APR-DRG IP N/A " 16,122.93 " N/A N/A N/A " 16,122.93 " " 16,122.93 " 750-2 SCHIZOPHRENIA N/A N/A N/A APR-DRG IP N/A " 24,834.34 " N/A N/A N/A " 24,834.34 " " 24,834.34 " 750-3 SCHIZOPHRENIA N/A N/A N/A APR-DRG IP N/A " 37,361.55 " N/A N/A N/A " 37,361.55 " " 37,361.55 " 750-4 SCHIZOPHRENIA N/A N/A N/A APR-DRG IP N/A " 38,471.22 " N/A N/A N/A " 38,471.22 " " 38,471.22 " 751-1 MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES N/A N/A N/A APR-DRG IP N/A " 9,319.41 " N/A N/A N/A " 9,319.41 " " 9,319.41 " 751-2 MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES N/A N/A N/A APR-DRG IP N/A " 11,516.38 " N/A N/A N/A " 11,516.38 " " 11,516.38 " 751-3 MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES N/A N/A N/A APR-DRG IP N/A " 22,527.34 " N/A N/A N/A " 22,527.34 " " 22,527.34 " 751-4 MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES N/A N/A N/A APR-DRG IP N/A " 33,154.11 " N/A N/A N/A " 33,154.11 " " 33,154.11 " 752-1 DISORDERS OF PERSONALITY & IMPULSE CONTROL N/A N/A N/A APR-DRG IP N/A " 6,956.45 " N/A N/A N/A " 6,956.45 " " 6,956.45 " 752-2 DISORDERS OF PERSONALITY & IMPULSE CONTROL N/A N/A N/A APR-DRG IP N/A " 13,064.33 " N/A N/A N/A " 13,064.33 " " 13,064.33 " 752-3 DISORDERS OF PERSONALITY & IMPULSE CONTROL N/A N/A N/A APR-DRG IP N/A " 15,488.83 " N/A N/A N/A " 15,488.83 " " 15,488.83 " 752-4 DISORDERS OF PERSONALITY & IMPULSE CONTROL N/A N/A N/A APR-DRG IP N/A " 64,803.16 " N/A N/A N/A " 64,803.16 " " 64,803.16 " 753-1 BIPOLAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,098.98 " N/A N/A N/A " 10,098.98 " " 10,098.98 " 753-2 BIPOLAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 13,722.67 " N/A N/A N/A " 13,722.67 " " 13,722.67 " 753-3 BIPOLAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 28,430.06 " N/A N/A N/A " 28,430.06 " " 28,430.06 " 753-4 BIPOLAR DISORDERS N/A N/A N/A APR-DRG IP N/A " 35,435.00 " N/A N/A N/A " 35,435.00 " " 35,435.00 " 754-1 DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER N/A N/A N/A APR-DRG IP N/A " 7,704.32 " N/A N/A N/A " 7,704.32 " " 7,704.32 " 754-2 DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER N/A N/A N/A APR-DRG IP N/A " 10,339.56 " N/A N/A N/A " 10,339.56 " " 10,339.56 " 754-3 DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER N/A N/A N/A APR-DRG IP N/A " 11,747.64 " N/A N/A N/A " 11,747.64 " " 11,747.64 " 754-4 DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER N/A N/A N/A APR-DRG IP N/A " 29,149.95 " N/A N/A N/A " 29,149.95 " " 29,149.95 " 755-1 ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 6,848.28 " N/A N/A N/A " 6,848.28 " " 6,848.28 " 755-2 ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 9,088.15 " N/A N/A N/A " 9,088.15 " " 9,088.15 " 755-3 ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 15,367.60 " N/A N/A N/A " 15,367.60 " " 15,367.60 " 755-4 ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES N/A N/A N/A APR-DRG IP N/A " 22,930.18 " N/A N/A N/A " 22,930.18 " " 22,930.18 " 756-1 ACUTE ANXIETY & DELIRIUM STATES N/A N/A N/A APR-DRG IP N/A " 9,114.26 " N/A N/A N/A " 9,114.26 " " 9,114.26 " 756-2 ACUTE ANXIETY & DELIRIUM STATES N/A N/A N/A APR-DRG IP N/A " 11,400.75 " N/A N/A N/A " 11,400.75 " " 11,400.75 " 756-3 ACUTE ANXIETY & DELIRIUM STATES N/A N/A N/A APR-DRG IP N/A " 12,521.61 " N/A N/A N/A " 12,521.61 " " 12,521.61 " 756-4 ACUTE ANXIETY & DELIRIUM STATES N/A N/A N/A APR-DRG IP N/A " 24,724.31 " N/A N/A N/A " 24,724.31 " " 24,724.31 " 757-1 ORGANIC MENTAL HEALTH DISTURBANCES N/A N/A N/A APR-DRG IP N/A " 7,197.04 " N/A N/A N/A " 7,197.04 " " 7,197.04 " 757-2 ORGANIC MENTAL HEALTH DISTURBANCES N/A N/A N/A APR-DRG IP N/A " 11,880.05 " N/A N/A N/A " 11,880.05 " " 11,880.05 " 757-3 ORGANIC MENTAL HEALTH DISTURBANCES N/A N/A N/A APR-DRG IP N/A " 22,010.73 " N/A N/A N/A " 22,010.73 " " 22,010.73 " 757-4 ORGANIC MENTAL HEALTH DISTURBANCES N/A N/A N/A APR-DRG IP N/A " 39,847.59 " N/A N/A N/A " 39,847.59 " " 39,847.59 " 758-1 BEHAVIORAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 10,658.48 " N/A N/A N/A " 10,658.48 " " 10,658.48 " 758-2 BEHAVIORAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,169.49 " N/A N/A N/A " 11,169.49 " " 11,169.49 " 758-3 BEHAVIORAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 14,179.60 " N/A N/A N/A " 14,179.60 " " 14,179.60 " 758-4 BEHAVIORAL DISORDERS N/A N/A N/A APR-DRG IP N/A " 18,112.88 " N/A N/A N/A " 18,112.88 " " 18,112.88 " 759-1 EATING DISORDERS N/A N/A N/A APR-DRG IP N/A " 13,834.57 " N/A N/A N/A " 13,834.57 " " 13,834.57 " 759-2 EATING DISORDERS N/A N/A N/A APR-DRG IP N/A " 16,094.95 " N/A N/A N/A " 16,094.95 " " 16,094.95 " 759-3 EATING DISORDERS N/A N/A N/A APR-DRG IP N/A " 17,695.12 " N/A N/A N/A " 17,695.12 " " 17,695.12 " 759-4 EATING DISORDERS N/A N/A N/A APR-DRG IP N/A " 44,138.96 " N/A N/A N/A " 44,138.96 " " 44,138.96 " 760-1 OTHER MENTAL HEALTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 11,426.86 " N/A N/A N/A " 11,426.86 " " 11,426.86 " 760-2 OTHER MENTAL HEALTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 18,752.58 " N/A N/A N/A " 18,752.58 " " 18,752.58 " 760-3 OTHER MENTAL HEALTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 28,096.23 " N/A N/A N/A " 28,096.23 " " 28,096.23 " 760-4 OTHER MENTAL HEALTH DISORDERS N/A N/A N/A APR-DRG IP N/A " 32,672.94 " N/A N/A N/A " 32,672.94 " " 32,672.94 " 770-1 "DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE" N/A N/A N/A APR-DRG IP N/A " 6,044.47 " N/A N/A N/A " 6,044.47 " " 6,044.47 " 770-2 "DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE" N/A N/A N/A APR-DRG IP N/A " 9,395.87 " N/A N/A N/A " 9,395.87 " " 9,395.87 " 770-3 "DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE" N/A N/A N/A APR-DRG IP N/A " 10,751.73 " N/A N/A N/A " 10,751.73 " " 10,751.73 " 770-4 "DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE" N/A N/A N/A APR-DRG IP N/A " 25,171.91 " N/A N/A N/A " 25,171.91 " " 25,171.91 " 772-1 ALCOHOL & DRUG DEPENDENCE W REHAB OR REHAB/DETOX THERAPY N/A N/A N/A APR-DRG IP N/A " 9,425.71 " N/A N/A N/A " 9,425.71 " " 9,425.71 " 772-2 ALCOHOL & DRUG DEPENDENCE W REHAB OR REHAB/DETOX THERAPY N/A N/A N/A APR-DRG IP N/A " 12,327.65 " N/A N/A N/A " 12,327.65 " " 12,327.65 " 772-3 ALCOHOL & DRUG DEPENDENCE W REHAB OR REHAB/DETOX THERAPY N/A N/A N/A APR-DRG IP N/A " 16,191.93 " N/A N/A N/A " 16,191.93 " " 16,191.93 " 772-4 ALCOHOL & DRUG DEPENDENCE W REHAB OR REHAB/DETOX THERAPY N/A N/A N/A APR-DRG IP N/A " 44,262.05 " N/A N/A N/A " 44,262.05 " " 44,262.05 " 773-1 OPIOID ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 6,152.64 " N/A N/A N/A " 6,152.64 " " 6,152.64 " 773-2 OPIOID ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 14,248.60 " N/A N/A N/A " 14,248.60 " " 14,248.60 " 773-3 OPIOID ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 26,475.54 " N/A N/A N/A " 26,475.54 " " 26,475.54 " 773-4 OPIOID ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 31,695.68 " N/A N/A N/A " 31,695.68 " " 31,695.68 " 774-1 COCAINE ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 7,493.57 " N/A N/A N/A " 7,493.57 " " 7,493.57 " 774-2 COCAINE ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 8,776.69 " N/A N/A N/A " 8,776.69 " " 8,776.69 " 774-3 COCAINE ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 13,278.80 " N/A N/A N/A " 13,278.80 " " 13,278.80 " 774-4 COCAINE ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 37,290.68 " N/A N/A N/A " 37,290.68 " " 37,290.68 " 775-1 ALCOHOL ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 9,164.61 " N/A N/A N/A " 9,164.61 " " 9,164.61 " 775-2 ALCOHOL ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 10,432.81 " N/A N/A N/A " 10,432.81 " " 10,432.81 " 775-3 ALCOHOL ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 15,956.94 " N/A N/A N/A " 15,956.94 " " 15,956.94 " 775-4 ALCOHOL ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 27,736.28 " N/A N/A N/A " 27,736.28 " " 27,736.28 " 776-1 OTHER DRUG ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 9,932.99 " N/A N/A N/A " 9,932.99 " " 9,932.99 " 776-2 OTHER DRUG ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 11,531.30 " N/A N/A N/A " 11,531.30 " " 11,531.30 " 776-3 OTHER DRUG ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 13,110.95 " N/A N/A N/A " 13,110.95 " " 13,110.95 " 776-4 OTHER DRUG ABUSE & DEPENDENCE N/A N/A N/A APR-DRG IP N/A " 27,896.67 " N/A N/A N/A " 27,896.67 " " 27,896.67 " 792-1 EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 33,146.65 " N/A N/A N/A " 33,146.65 " " 33,146.65 " 792-2 EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 33,389.10 " N/A N/A N/A " 33,389.10 " " 33,389.10 " 792-3 EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 38,721.13 " N/A N/A N/A " 38,721.13 " " 38,721.13 " 792-4 EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 111,064.48 " N/A N/A N/A " 111,064.48 " " 111,064.48 " 793-1 MODERATELY EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 17,877.89 " N/A N/A N/A " 17,877.89 " " 17,877.89 " 793-2 MODERATELY EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 24,371.82 " N/A N/A N/A " 24,371.82 " " 24,371.82 " 793-3 MODERATELY EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 31,925.07 " N/A N/A N/A " 31,925.07 " " 31,925.07 " 793-4 MODERATELY EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 146,749.39 " N/A N/A N/A " 146,749.39 " " 146,749.39 " 794-1 NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 13,696.56 " N/A N/A N/A " 13,696.56 " " 13,696.56 " 794-2 NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 19,039.79 " N/A N/A N/A " 19,039.79 " " 19,039.79 " 794-3 NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 28,098.09 " N/A N/A N/A " 28,098.09 " " 28,098.09 " 794-4 NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 58,406.21 " N/A N/A N/A " 58,406.21 " " 58,406.21 " 810-1 HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION N/A N/A N/A APR-DRG IP N/A " 9,860.26 " N/A N/A N/A " 9,860.26 " " 9,860.26 " 810-2 HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION N/A N/A N/A APR-DRG IP N/A " 13,398.16 " N/A N/A N/A " 13,398.16 " " 13,398.16 " 810-3 HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION N/A N/A N/A APR-DRG IP N/A " 18,657.46 " N/A N/A N/A " 18,657.46 " " 18,657.46 " 810-4 HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION N/A N/A N/A APR-DRG IP N/A " 33,579.33 " N/A N/A N/A " 33,579.33 " " 33,579.33 " 811-1 ALLERGIC REACTIONS N/A N/A N/A APR-DRG IP N/A " 5,387.99 " N/A N/A N/A " 5,387.99 " " 5,387.99 " 811-2 ALLERGIC REACTIONS N/A N/A N/A APR-DRG IP N/A " 10,018.78 " N/A N/A N/A " 10,018.78 " " 10,018.78 " 811-3 ALLERGIC REACTIONS N/A N/A N/A APR-DRG IP N/A " 14,270.98 " N/A N/A N/A " 14,270.98 " " 14,270.98 " 811-4 ALLERGIC REACTIONS N/A N/A N/A APR-DRG IP N/A " 30,641.95 " N/A N/A N/A " 30,641.95 " " 30,641.95 " 812-1 POISONING OF MEDICINAL AGENTS N/A N/A N/A APR-DRG IP N/A " 5,749.80 " N/A N/A N/A " 5,749.80 " " 5,749.80 " 812-2 POISONING OF MEDICINAL AGENTS N/A N/A N/A APR-DRG IP N/A " 8,064.26 " N/A N/A N/A " 8,064.26 " " 8,064.26 " 812-3 POISONING OF MEDICINAL AGENTS N/A N/A N/A APR-DRG IP N/A " 12,465.66 " N/A N/A N/A " 12,465.66 " " 12,465.66 " 812-4 POISONING OF MEDICINAL AGENTS N/A N/A N/A APR-DRG IP N/A " 20,158.79 " N/A N/A N/A " 20,158.79 " " 20,158.79 " 813-1 OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 8,726.34 " N/A N/A N/A " 8,726.34 " " 8,726.34 " 813-2 OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 9,819.23 " N/A N/A N/A " 9,819.23 " " 9,819.23 " 813-3 OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 14,565.65 " N/A N/A N/A " 14,565.65 " " 14,565.65 " 813-4 OTHER COMPLICATIONS OF TREATMENT N/A N/A N/A APR-DRG IP N/A " 63,583.45 " N/A N/A N/A " 63,583.45 " " 63,583.45 " 815-1 "OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 6,978.83 " N/A N/A N/A " 6,978.83 " " 6,978.83 " 815-2 "OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 10,854.30 " N/A N/A N/A " 10,854.30 " " 10,854.30 " 815-3 "OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 14,998.33 " N/A N/A N/A " 14,998.33 " " 14,998.33 " 815-4 "OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES" N/A N/A N/A APR-DRG IP N/A " 37,290.68 " N/A N/A N/A " 37,290.68 " " 37,290.68 " 816-1 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES N/A N/A N/A APR-DRG IP N/A " 10,294.80 " N/A N/A N/A " 10,294.80 " " 10,294.80 " 816-2 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES N/A N/A N/A APR-DRG IP N/A " 11,438.05 " N/A N/A N/A " 11,438.05 " " 11,438.05 " 816-3 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES N/A N/A N/A APR-DRG IP N/A " 15,266.89 " N/A N/A N/A " 15,266.89 " " 15,266.89 " 816-4 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES N/A N/A N/A APR-DRG IP N/A " 26,212.58 " N/A N/A N/A " 26,212.58 " " 26,212.58 " 817-1 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE N/A N/A N/A APR-DRG IP N/A " 6,859.47 " N/A N/A N/A " 6,859.47 " " 6,859.47 " 817-2 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE N/A N/A N/A APR-DRG IP N/A " 8,730.07 " N/A N/A N/A " 8,730.07 " " 8,730.07 " 817-3 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE N/A N/A N/A APR-DRG IP N/A " 12,633.51 " N/A N/A N/A " 12,633.51 " " 12,633.51 " 817-4 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE N/A N/A N/A APR-DRG IP N/A " 25,084.25 " N/A N/A N/A " 25,084.25 " " 25,084.25 " 841-1 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 61,520.76 " N/A N/A N/A " 61,520.76 " " 61,520.76 " 841-2 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 70,027.02 " N/A N/A N/A " 70,027.02 " " 70,027.02 " 841-3 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 139,242.77 " N/A N/A N/A " 139,242.77 " " 139,242.77 " 841-4 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 294,034.04 " N/A N/A N/A " 294,034.04 " " 294,034.04 " 842-1 BURNS W SKIN GRAFT EXCEPT EXTENSIVE 3RD DEGREE BURNS N/A N/A N/A APR-DRG IP N/A " 10,248.18 " N/A N/A N/A " 10,248.18 " " 10,248.18 " 842-2 BURNS W SKIN GRAFT EXCEPT EXTENSIVE 3RD DEGREE BURNS N/A N/A N/A APR-DRG IP N/A " 25,697.84 " N/A N/A N/A " 25,697.84 " " 25,697.84 " 842-3 BURNS W SKIN GRAFT EXCEPT EXTENSIVE 3RD DEGREE BURNS N/A N/A N/A APR-DRG IP N/A " 52,725.42 " N/A N/A N/A " 52,725.42 " " 52,725.42 " 842-4 BURNS W SKIN GRAFT EXCEPT EXTENSIVE 3RD DEGREE BURNS N/A N/A N/A APR-DRG IP N/A " 165,533.67 " N/A N/A N/A " 165,533.67 " " 165,533.67 " 843-1 EXTENSIVE 3RD DEGREE BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 9,606.62 " N/A N/A N/A " 9,606.62 " " 9,606.62 " 843-2 EXTENSIVE 3RD DEGREE BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 14,224.36 " N/A N/A N/A " 14,224.36 " " 14,224.36 " 843-3 EXTENSIVE 3RD DEGREE BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 15,110.23 " N/A N/A N/A " 15,110.23 " " 15,110.23 " 843-4 EXTENSIVE 3RD DEGREE BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 36,442.10 " N/A N/A N/A " 36,442.10 " " 36,442.10 " 844-1 PARTIAL THICKNESS BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 5,434.61 " N/A N/A N/A " 5,434.61 " " 5,434.61 " 844-2 PARTIAL THICKNESS BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 10,932.63 " N/A N/A N/A " 10,932.63 " " 10,932.63 " 844-3 PARTIAL THICKNESS BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 17,986.06 " N/A N/A N/A " 17,986.06 " " 17,986.06 " 844-4 PARTIAL THICKNESS BURNS W/O SKIN GRAFT N/A N/A N/A APR-DRG IP N/A " 39,510.03 " N/A N/A N/A " 39,510.03 " " 39,510.03 " 850-1 "PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE" N/A N/A N/A APR-DRG IP N/A " 28,068.25 " N/A N/A N/A " 28,068.25 " " 28,068.25 " 850-2 "PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE" N/A N/A N/A APR-DRG IP N/A " 40,203.81 " N/A N/A N/A " 40,203.81 " " 40,203.81 " 850-3 "PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE" N/A N/A N/A APR-DRG IP N/A " 51,673.56 " N/A N/A N/A " 51,673.56 " " 51,673.56 " 850-4 "PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE" N/A N/A N/A APR-DRG IP N/A " 180,108.65 " N/A N/A N/A " 180,108.65 " " 180,108.65 " 860-1 REHABILITATION N/A N/A N/A APR-DRG IP N/A " 12,851.72 " N/A N/A N/A " 12,851.72 " " 12,851.72 " 860-2 REHABILITATION N/A N/A N/A APR-DRG IP N/A " 13,985.64 " N/A N/A N/A " 13,985.64 " " 13,985.64 " 860-3 REHABILITATION N/A N/A N/A APR-DRG IP N/A " 17,120.70 " N/A N/A N/A " 17,120.70 " " 17,120.70 " 860-4 REHABILITATION N/A N/A N/A APR-DRG IP N/A " 28,879.53 " N/A N/A N/A " 28,879.53 " " 28,879.53 " 861-1 "SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS" N/A N/A N/A APR-DRG IP N/A " 8,381.31 " N/A N/A N/A " 8,381.31 " " 8,381.31 " 861-2 "SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS" N/A N/A N/A APR-DRG IP N/A " 14,084.48 " N/A N/A N/A " 14,084.48 " " 14,084.48 " 861-3 "SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS" N/A N/A N/A APR-DRG IP N/A " 21,169.62 " N/A N/A N/A " 21,169.62 " " 21,169.62 " 861-4 "SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS" N/A N/A N/A APR-DRG IP N/A " 26,753.43 " N/A N/A N/A " 26,753.43 " " 26,753.43 " 862-1 OTHER AFTERCARE & CONVALESCENCE N/A N/A N/A APR-DRG IP N/A " 9,157.15 " N/A N/A N/A " 9,157.15 " " 9,157.15 " 862-2 OTHER AFTERCARE & CONVALESCENCE N/A N/A N/A APR-DRG IP N/A " 13,269.48 " N/A N/A N/A " 13,269.48 " " 13,269.48 " 862-3 OTHER AFTERCARE & CONVALESCENCE N/A N/A N/A APR-DRG IP N/A " 19,336.32 " N/A N/A N/A " 19,336.32 " " 19,336.32 " 862-4 OTHER AFTERCARE & CONVALESCENCE N/A N/A N/A APR-DRG IP N/A " 22,605.67 " N/A N/A N/A " 22,605.67 " " 22,605.67 " 863-1 NEONATAL AFTERCARE N/A N/A N/A APR-DRG IP N/A " 16,408.27 " N/A N/A N/A " 16,408.27 " " 16,408.27 " 863-2 NEONATAL AFTERCARE N/A N/A N/A APR-DRG IP N/A " 35,131.01 " N/A N/A N/A " 35,131.01 " " 35,131.01 " 863-3 NEONATAL AFTERCARE N/A N/A N/A APR-DRG IP N/A " 99,839.05 " N/A N/A N/A " 99,839.05 " " 99,839.05 " 863-4 NEONATAL AFTERCARE N/A N/A N/A APR-DRG IP N/A " 174,396.15 " N/A N/A N/A " 174,396.15 " " 174,396.15 " 890-1 HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 15,921.51 " N/A N/A N/A " 15,921.51 " " 15,921.51 " 890-2 HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 15,958.81 " N/A N/A N/A " 15,958.81 " " 15,958.81 " 890-3 HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 43,070.31 " N/A N/A N/A " 43,070.31 " " 43,070.31 " 890-4 HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 70,097.89 " N/A N/A N/A " 70,097.89 " " 70,097.89 " 892-1 HIV W MAJOR HIV RELATED CONDITION N/A N/A N/A APR-DRG IP N/A " 10,731.21 " N/A N/A N/A " 10,731.21 " " 10,731.21 " 892-2 HIV W MAJOR HIV RELATED CONDITION N/A N/A N/A APR-DRG IP N/A " 12,463.80 " N/A N/A N/A " 12,463.80 " " 12,463.80 " 892-3 HIV W MAJOR HIV RELATED CONDITION N/A N/A N/A APR-DRG IP N/A " 13,569.74 " N/A N/A N/A " 13,569.74 " " 13,569.74 " 892-4 HIV W MAJOR HIV RELATED CONDITION N/A N/A N/A APR-DRG IP N/A " 28,970.91 " N/A N/A N/A " 28,970.91 " " 28,970.91 " 893-1 HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 11,820.37 " N/A N/A N/A " 11,820.37 " " 11,820.37 " 893-2 HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 14,513.43 " N/A N/A N/A " 14,513.43 " " 14,513.43 " 893-3 HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 19,666.43 " N/A N/A N/A " 19,666.43 " " 19,666.43 " 893-4 HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS N/A N/A N/A APR-DRG IP N/A " 32,680.40 " N/A N/A N/A " 32,680.40 " " 32,680.40 " 894-1 HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND N/A N/A N/A APR-DRG IP N/A " 10,609.99 " N/A N/A N/A " 10,609.99 " " 10,609.99 " 894-2 HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND N/A N/A N/A APR-DRG IP N/A " 11,266.47 " N/A N/A N/A " 11,266.47 " " 11,266.47 " 894-3 HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND N/A N/A N/A APR-DRG IP N/A " 15,783.50 " N/A N/A N/A " 15,783.50 " " 15,783.50 " 894-4 HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND N/A N/A N/A APR-DRG IP N/A " 20,720.15 " N/A N/A N/A " 20,720.15 " " 20,720.15 " 910-1 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 39,181.79 " N/A N/A N/A " 39,181.79 " " 39,181.79 " 910-2 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 50,938.75 " N/A N/A N/A " 50,938.75 " " 50,938.75 " 910-3 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 62,997.84 " N/A N/A N/A " 62,997.84 " " 62,997.84 " 910-4 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 115,874.32 " N/A N/A N/A " 115,874.32 " " 115,874.32 " 911-1 EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 30,464.78 " N/A N/A N/A " 30,464.78 " " 30,464.78 " 911-2 EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 39,163.14 " N/A N/A N/A " 39,163.14 " " 39,163.14 " 911-3 EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 71,440.69 " N/A N/A N/A " 71,440.69 " " 71,440.69 " 911-4 EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 121,284.68 " N/A N/A N/A " 121,284.68 " " 121,284.68 " 912-1 MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 35,595.39 " N/A N/A N/A " 35,595.39 " " 35,595.39 " 912-2 MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 37,025.85 " N/A N/A N/A " 37,025.85 " " 37,025.85 " 912-3 MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 64,633.44 " N/A N/A N/A " 64,633.44 " " 64,633.44 " 912-4 MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A APR-DRG IP N/A " 100,654.05 " N/A N/A N/A " 100,654.05 " " 100,654.05 " 930-1 MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 9,763.28 " N/A N/A N/A " 9,763.28 " " 9,763.28 " 930-2 MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 11,641.33 " N/A N/A N/A " 11,641.33 " " 11,641.33 " 930-3 MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 22,521.74 " N/A N/A N/A " 22,521.74 " " 22,521.74 " 930-4 MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE N/A N/A N/A APR-DRG IP N/A " 38,277.26 " N/A N/A N/A " 38,277.26 " " 38,277.26 " 950-1 EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 29,284.23 " N/A N/A N/A " 29,284.23 " " 29,284.23 " 950-2 EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 34,692.73 " N/A N/A N/A " 34,692.73 " " 34,692.73 " 950-3 EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 49,526.94 " N/A N/A N/A " 49,526.94 " " 49,526.94 " 950-4 EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 135,003.62 " N/A N/A N/A " 135,003.62 " " 135,003.62 " 951-1 MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 22,077.87 " N/A N/A N/A " 22,077.87 " " 22,077.87 " 951-2 MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 26,734.78 " N/A N/A N/A " 26,734.78 " " 26,734.78 " 951-3 MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 40,399.63 " N/A N/A N/A " 40,399.63 " " 40,399.63 " 951-4 MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 99,501.48 " N/A N/A N/A " 99,501.48 " " 99,501.48 " 952-1 NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 14,261.66 " N/A N/A N/A " 14,261.66 " " 14,261.66 " 952-2 NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 17,848.05 " N/A N/A N/A " 17,848.05 " " 17,848.05 " 952-3 NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 36,604.36 " N/A N/A N/A " 36,604.36 " " 36,604.36 " 952-4 NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS N/A N/A N/A APR-DRG IP N/A " 133,231.87 " N/A N/A N/A " 133,231.87 " " 133,231.87 " Rehab Inpatient Rehab Per Diem 128 N/A N/A Per Diem IP N/A N/A " 2,122.00 " N/A N/A " 2,122.00 " " 2,122.00 " 1 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 443,166.03 " " 406,351.39 " " 290,519.95 " " 290,519.95 " " 443,166.03 " 2 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 243,744.30 " " 223,496.00 " " 159,787.93 " " 159,787.93 " " 243,744.30 " 3 "ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES" N/A N/A N/A MS-DRG IP N/A N/A " 290,563.83 " " 266,426.14 " " 190,480.73 " " 190,480.73 " " 290,563.83 " 4 "TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES" N/A N/A N/A MS-DRG IP N/A N/A " 181,488.60 " " 166,412.00 " " 118,975.86 " " 118,975.86 " " 181,488.60 " 5 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT N/A N/A N/A MS-DRG IP N/A N/A " 156,416.49 " " 143,422.68 " " 102,539.70 " " 102,539.70 " " 156,416.49 " 6 LIVER TRANSPLANT WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 71,783.01 " " 65,819.86 " " 47,057.75 " " 47,057.75 " " 71,783.01 " 7 LUNG TRANSPLANT N/A N/A N/A MS-DRG IP N/A N/A " 177,086.79 " " 162,375.85 " " 116,090.23 " " 116,090.23 " " 177,086.79 " 8 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT N/A N/A N/A MS-DRG IP N/A N/A " 83,030.04 " " 76,132.58 " " 54,430.80 " " 54,430.80 " " 83,030.04 " 10 PANCREAS TRANSPLANT N/A N/A N/A MS-DRG IP N/A N/A " 55,350.81 " " 50,752.71 " " 36,285.53 " " 36,285.53 " " 55,350.81 " 11 "TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 76,750.92 " " 70,375.08 " " 50,314.49 " " 50,314.49 " " 76,750.92 " 12 "TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 58,628.07 " " 53,757.73 " " 38,433.96 " " 38,433.96 " " 58,628.07 " 13 "TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 41,623.65 " " 38,165.89 " " 27,286.62 " " 27,286.62 " " 41,623.65 " 14 ALLOGENEIC BONE MARROW TRANSPLANT N/A N/A N/A MS-DRG IP N/A N/A " 195,515.64 " " 179,273.79 " " 128,171.36 " " 128,171.36 " " 195,515.64 " 16 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 102,910.86 " " 94,361.86 " " 67,463.79 " " 67,463.79 " " 102,910.86 " 17 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 73,902.06 " " 67,762.88 " " 48,446.91 " " 48,446.91 " " 73,902.06 " 18 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY N/A N/A N/A MS-DRG IP N/A N/A " 571,133.70 " " 523,688.54 " " 374,409.87 " " 374,409.87 " " 571,133.70 " 19 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS N/A N/A N/A MS-DRG IP N/A N/A " 101,927.07 " " 93,459.80 " " 66,818.86 " " 66,818.86 " " 101,927.07 " 20 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 157,897.53 " " 144,780.68 " " 103,510.60 " " 103,510.60 " " 157,897.53 " 21 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 115,233.48 " " 105,660.82 " " 75,541.95 " " 75,541.95 " " 115,233.48 " 22 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 74,351.88 " " 68,175.33 " " 48,741.79 " " 48,741.79 " " 74,351.88 " 23 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR N/A N/A N/A MS-DRG IP N/A N/A " 86,633.19 " " 79,436.41 " " 56,792.87 " " 56,792.87 " " 86,633.19 " 24 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 60,167.25 " " 55,169.04 " " 39,442.98 " " 39,442.98 " " 60,167.25 " 25 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 68,723.01 " " 63,014.06 " " 45,051.75 " " 45,051.75 " " 68,723.01 " 26 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 46,787.40 " " 42,900.68 " " 30,671.74 " " 30,671.74 " " 46,787.40 " 27 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 38,430.54 " " 35,238.04 " " 25,193.35 " " 25,193.35 " " 38,430.54 " 28 SPINAL PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 89,046.00 " " 81,648.78 " " 58,374.60 " " 58,374.60 " " 89,046.00 " 29 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS N/A N/A N/A MS-DRG IP N/A N/A " 50,413.50 " " 46,225.56 " " 33,048.85 " " 33,048.85 " " 50,413.50 " 30 SPINAL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 36,063.63 " " 33,067.76 " " 23,641.71 " " 23,641.71 " " 36,063.63 " 31 VENTRICULAR SHUNT PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 66,801.33 " " 61,252.02 " " 43,791.98 " " 43,791.98 " " 66,801.33 " 32 VENTRICULAR SHUNT PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 33,846.66 " " 31,034.95 " " 22,188.37 " " 22,188.37 " " 33,846.66 " 33 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,326.71 " " 24,139.70 " " 17,258.62 " " 17,258.62 " " 26,326.71 " 34 CAROTID ARTERY STENT PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 60,811.38 " " 55,759.66 " " 39,865.24 " " 39,865.24 " " 60,811.38 " 35 CAROTID ARTERY STENT PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 35,757.63 " " 32,787.18 " " 23,441.11 " " 23,441.11 " " 35,757.63 " 36 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,323.36 " " 25,970.48 " " 18,567.54 " " 18,567.54 " " 28,323.36 " 37 EXTRACRANIAL PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 50,102.91 " " 45,940.77 " " 32,845.24 " " 32,845.24 " " 50,102.91 " 38 EXTRACRANIAL PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 25,356.69 " " 23,250.26 " " 16,622.72 " " 16,622.72 " " 25,356.69 " 39 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,426.70 " " 15,979.03 " " 11,424.17 " " 11,424.17 " " 17,426.70 " 40 "PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 60,554.34 " " 55,523.98 " " 39,696.73 " " 39,696.73 " " 60,554.34 " 41 "PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR" N/A N/A N/A MS-DRG IP N/A N/A " 35,971.83 " " 32,983.58 " " 23,581.53 " " 23,581.53 " " 35,971.83 " 42 "PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 28,838.97 " " 26,443.26 " " 18,905.55 " " 18,905.55 " " 28,838.97 " 52 SPINAL DISORDERS AND INJURIES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,230.03 " " 25,884.91 " " 18,506.35 " " 18,506.35 " " 28,230.03 " 53 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,382.33 " " 15,938.35 " " 11,395.08 " " 11,395.08 " " 17,382.33 " 54 NERVOUS SYSTEM NEOPLASMS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,896.74 " " 19,160.81 " " 13,698.97 " " 13,698.97 " " 20,896.74 " 55 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,964.02 " " 14,637.86 " " 10,465.30 " " 10,465.30 " " 15,964.02 " 56 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 33,465.69 " " 30,685.63 " " 21,938.62 " " 21,938.62 " " 33,465.69 " 57 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,342.26 " " 17,735.46 " " 12,679.93 " " 12,679.93 " " 19,342.26 " 58 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,571.51 " " 24,364.16 " " 17,419.10 " " 17,419.10 " " 26,571.51 " 59 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 17,235.45 " " 15,803.67 " " 11,298.80 " " 11,298.80 " " 17,235.45 " 60 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,008.68 " " 12,844.95 " " 9,183.47 " " 9,183.47 " " 14,008.68 " 61 "ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 44,189.46 " " 40,518.56 " " 28,968.65 " " 28,968.65 " " 44,189.46 " 62 "ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 30,404.16 " " 27,878.43 " " 19,931.62 " " 19,931.62 " " 30,404.16 " 63 "ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 26,161.47 " " 23,988.19 " " 17,150.30 " " 17,150.30 " " 26,161.47 " 64 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,268.90 " " 26,837.48 " " 19,187.39 " " 19,187.39 " " 29,268.90 " 65 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS N/A N/A N/A MS-DRG IP N/A N/A " 15,578.46 " " 14,284.33 " " 10,212.55 " " 10,212.55 " " 15,578.46 " 66 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,876.77 " " 9,973.22 " " 7,130.33 " " 7,130.33 " " 10,876.77 " 67 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,796.38 " " 19,985.71 " " 14,288.74 " " 14,288.74 " " 21,796.38 " 68 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,595.58 " " 12,466.17 " " 8,912.66 " " 8,912.66 " " 13,595.58 " 69 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC N/A N/A N/A MS-DRG IP N/A N/A " 12,027.33 " " 11,028.20 " " 7,884.58 " " 7,884.58 " " 12,027.33 " 70 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,648.92 " " 23,518.22 " " 16,814.29 " " 16,814.29 " " 25,648.92 " 71 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,465.24 " " 14,180.51 " " 10,138.32 " " 10,138.32 " " 15,465.24 " 72 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,799.36 " " 10,819.16 " " 7,735.14 " " 7,735.14 " " 11,799.36 " 73 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,175.82 " " 20,333.63 " " 14,537.48 " " 14,537.48 " " 22,175.82 " 74 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,581.52 " " 14,287.13 " " 10,214.55 " " 10,214.55 " " 15,581.52 " 75 VIRAL MENINGITIS WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,877.80 " " 22,811.15 " " 16,308.78 " " 16,308.78 " " 24,877.80 " 76 VIRAL MENINGITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,007.77 " " 13,761.05 " " 9,838.43 " " 9,838.43 " " 15,007.77 " 77 HYPERTENSIVE ENCEPHALOPATHY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,438.07 " " 21,491.03 " " 15,364.96 " " 15,364.96 " " 23,438.07 " 78 HYPERTENSIVE ENCEPHALOPATHY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 14,519.70 " " 13,313.52 " " 9,518.47 " " 9,518.47 " " 14,519.70 " 79 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,120.04 " " 10,196.28 " " 7,289.80 " " 7,289.80 " " 11,120.04 " 80 NONTRAUMATIC STUPOR AND COMA WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 32,007.60 " " 29,348.67 " " 20,982.76 " " 20,982.76 " " 32,007.60 " 81 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,811.60 " " 10,830.39 " " 7,743.16 " " 7,743.16 " " 11,811.60 " 82 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 34,548.93 " " 31,678.88 " " 22,648.74 " " 22,648.74 " " 34,548.93 " 83 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 20,528.01 " " 18,822.71 " " 13,457.25 " " 13,457.25 " " 20,528.01 " 84 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,834.26 " " 12,685.02 " " 9,069.13 " " 9,069.13 " " 13,834.26 " 85 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 35,287.92 " " 32,356.49 " " 23,133.19 " " 23,133.19 " " 35,287.92 " 86 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 19,475.37 " " 17,857.51 " " 12,767.19 " " 12,767.19 " " 19,475.37 " 87 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,197.78 " " 12,101.42 " " 8,651.88 " " 8,651.88 " " 13,197.78 " 88 CONCUSSION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,327.29 " " 20,472.52 " " 14,636.78 " " 14,636.78 " " 22,327.29 " 89 CONCUSSION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 16,236.36 " " 14,887.57 " " 10,643.84 " " 10,643.84 " " 16,236.36 " 90 CONCUSSION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,078.44 " " 11,991.99 " " 8,573.64 " " 8,573.64 " " 13,078.44 " 91 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,228.17 " " 23,132.42 " " 16,538.47 " " 16,538.47 " " 25,228.17 " 92 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,087.33 " " 13,834.00 " " 9,890.58 " " 9,890.58 " " 15,087.33 " 93 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,953.89 " " 10,960.86 " " 7,836.44 " " 7,836.44 " " 11,953.89 " 94 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 55,586.43 " " 50,968.76 " " 36,439.99 " " 36,439.99 " " 55,586.43 " 95 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 38,372.40 " " 35,184.73 " " 25,155.24 " " 25,155.24 " " 38,372.40 " 96 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 35,671.95 " " 32,708.61 " " 23,384.95 " " 23,384.95 " " 35,671.95 " 97 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 57,414.78 " " 52,645.23 " " 37,638.58 " " 37,638.58 " " 57,414.78 " 98 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,296.77 " " 29,613.82 " " 21,172.33 " " 21,172.33 " " 32,296.77 " 99 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,378.69 " " 19,602.72 " " 14,014.92 " " 14,014.92 " " 21,378.69 " 100 SEIZURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,666.08 " " 26,284.73 " " 18,792.21 " " 18,792.21 " " 28,666.08 " 101 SEIZURES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,571.10 " " 12,443.72 " " 8,896.61 " " 8,896.61 " " 13,571.10 " 102 HEADACHES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,621.01 " " 16,157.20 " " 11,551.55 " " 11,551.55 " " 17,621.01 " 103 HEADACHES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,671.46 " " 11,618.82 " " 8,306.85 " " 8,306.85 " " 12,671.46 " 113 ORBITAL PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 33,534.54 " " 30,748.76 " " 21,983.75 " " 21,983.75 " " 33,534.54 " 114 ORBITAL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,116.15 " " 20,278.92 " " 14,498.37 " " 14,498.37 " " 22,116.15 " 115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT N/A N/A N/A MS-DRG IP N/A N/A " 22,235.49 " " 20,388.35 " " 14,576.60 " " 14,576.60 " " 22,235.49 " 116 INTRAOCULAR PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,721.16 " " 26,335.24 " " 18,828.32 " " 18,828.32 " " 28,721.16 " 117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,895.17 " " 14,574.73 " " 10,420.17 " " 10,420.17 " " 15,895.17 " 121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,187.11 " " 16,676.27 " " 11,922.66 " " 11,922.66 " " 18,187.11 " 122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,850.14 " " 9,031.87 " " 6,457.31 " " 6,457.31 " " 9,850.14 " 123 NEUROLOGICAL EYE DISORDERS N/A N/A N/A MS-DRG IP N/A N/A " 11,709.09 " " 10,736.39 " " 7,675.96 " " 7,675.96 " " 11,709.09 " 124 OTHER DISORDERS OF THE EYE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,401.64 " " 19,623.77 " " 14,029.96 " " 14,029.96 " " 21,401.64 " 125 OTHER DISORDERS OF THE EYE WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,781.62 " " 11,719.83 " " 8,379.06 " " 8,379.06 " " 12,781.62 " 135 SINUS AND MASTOID PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 32,751.18 " " 30,030.48 " " 21,470.22 " " 21,470.22 " " 32,751.18 " 136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,209.15 " " 17,613.41 " " 12,592.67 " " 12,592.67 " " 19,209.15 " 137 MOUTH PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,469.58 " " 20,602.99 " " 14,730.06 " " 14,730.06 " " 22,469.58 " 138 MOUTH PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,899.43 " " 11,827.85 " " 8,456.29 " " 8,456.29 " " 12,899.43 " 139 SALIVARY GLAND PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 18,770.04 " " 17,210.78 " " 12,304.80 " " 12,304.80 " " 18,770.04 " 140 MAJOR HEAD AND NECK PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 60,903.18 " " 55,843.84 " " 39,925.42 " " 39,925.42 " " 60,903.18 " 141 MAJOR HEAD AND NECK PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 33,774.75 " " 30,969.02 " " 22,141.23 " " 22,141.23 " " 33,774.75 " 142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,614.64 " " 22,569.86 " " 16,136.26 " " 16,136.26 " " 24,614.64 " 143 "OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 45,346.14 " " 41,579.15 " " 29,726.91 " " 29,726.91 " " 45,346.14 " 144 "OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 26,782.65 " " 24,557.76 " " 17,557.52 " " 17,557.52 " " 26,782.65 " 145 "OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 18,566.55 " " 17,024.19 " " 12,171.41 " " 12,171.41 " " 18,566.55 " 146 "EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 31,106.43 " " 28,522.36 " " 20,391.99 " " 20,391.99 " " 31,106.43 " 147 "EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 19,906.83 " " 18,253.13 " " 13,050.03 " " 13,050.03 " " 19,906.83 " 148 "EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 12,030.39 " " 11,031.00 " " 7,886.59 " " 7,886.59 " " 12,030.39 " 149 DYSEQUILIBRIUM N/A N/A N/A MS-DRG IP N/A N/A " 11,253.15 " " 10,318.33 " " 7,377.07 " " 7,377.07 " " 11,253.15 " 150 EPISTAXIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,267.91 " " 18,584.22 " " 13,286.74 " " 13,286.74 " " 20,267.91 " 151 EPISTAXIS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,276.10 " " 10,339.37 " " 7,392.11 " " 7,392.11 " " 11,276.10 " 152 OTITIS MEDIA AND URI WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,476.57 " " 15,107.83 " " 10,801.31 " " 10,801.31 " " 16,476.57 " 153 OTITIS MEDIA AND URI WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,872.18 " " 9,969.01 " " 7,127.32 " " 7,127.32 " " 10,872.18 " 154 "OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 23,600.25 " " 21,639.73 " " 15,471.28 " " 15,471.28 " " 23,600.25 " 155 "OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 13,874.04 " " 12,721.50 " " 9,095.20 " " 9,095.20 " " 13,874.04 " 156 "OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 10,061.28 " " 9,225.47 " " 6,595.73 " " 6,595.73 " " 10,061.28 " 157 DENTAL AND ORAL DISEASES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,057.72 " " 22,059.20 " " 15,771.17 " " 15,771.17 " " 24,057.72 " 158 DENTAL AND ORAL DISEASES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 13,603.23 " " 12,473.18 " " 8,917.67 " " 8,917.67 " " 13,603.23 " 159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,033.74 " " 9,200.22 " " 6,577.67 " " 6,577.67 " " 10,033.74 " 163 MAJOR CHEST PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 75,904.83 " " 69,599.27 " " 49,759.83 " " 49,759.83 " " 75,904.83 " 164 MAJOR CHEST PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 40,379.76 " " 37,025.34 " " 26,471.18 " " 26,471.18 " " 40,379.76 " 165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,278.08 " " 26,845.89 " " 19,193.41 " " 19,193.41 " " 29,278.08 " 166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 58,006.89 " " 53,188.15 " " 38,026.74 " " 38,026.74 " " 58,006.89 " 167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 28,487.07 " " 26,120.60 " " 18,674.86 " " 18,674.86 " " 28,487.07 " 168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,947.23 " " 19,207.10 " " 13,732.07 " " 13,732.07 " " 20,947.23 " 175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE N/A N/A N/A MS-DRG IP N/A N/A " 23,626.26 " " 21,663.58 " " 15,488.33 " " 15,488.33 " " 23,626.26 " 176 PULMONARY EMBOLISM WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,566.51 " " 12,439.51 " " 8,893.60 " " 8,893.60 " " 13,566.51 " 177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,233.09 " " 25,887.71 " " 18,508.36 " " 18,508.36 " " 28,233.09 " 178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 18,450.27 " " 16,917.57 " " 12,095.18 " " 12,095.18 " " 18,450.27 " 179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,327.83 " " 12,220.66 " " 8,737.13 " " 8,737.13 " " 13,327.83 " 180 RESPIRATORY NEOPLASMS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,588.34 " " 24,379.60 " " 17,430.13 " " 17,430.13 " " 26,588.34 " 181 RESPIRATORY NEOPLASMS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 17,149.77 " " 15,725.11 " " 11,242.63 " " 11,242.63 " " 17,149.77 " 182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,048.75 " " 11,047.84 " " 7,898.63 " " 7,898.63 " " 12,048.75 " 183 MAJOR CHEST TRAUMA WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,800.68 " " 21,823.51 " " 15,602.67 " " 15,602.67 " " 23,800.68 " 184 MAJOR CHEST TRAUMA WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,902.82 " " 14,581.74 " " 10,425.18 " " 10,425.18 " " 15,902.82 " 185 MAJOR CHEST TRAUMA WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,836.08 " " 10,852.83 " " 7,759.21 " " 7,759.21 " " 11,836.08 " 186 PLEURAL EFFUSION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,610.96 " " 21,649.55 " " 15,478.30 " " 15,478.30 " " 23,610.96 " 187 PLEURAL EFFUSION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,792.66 " " 14,480.73 " " 10,352.97 " " 10,352.97 " " 15,792.66 " 188 PLEURAL EFFUSION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,139.93 " " 10,214.51 " " 7,302.84 " " 7,302.84 " " 11,139.93 " 189 PULMONARY EDEMA AND RESPIRATORY FAILURE N/A N/A N/A MS-DRG IP N/A N/A " 18,739.44 " " 17,182.72 " " 12,284.74 " " 12,284.74 " " 18,739.44 " 190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,195.67 " " 15,767.19 " " 11,272.72 " " 11,272.72 " " 17,195.67 " 191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 13,511.43 " " 12,389.01 " " 8,857.49 " " 8,857.49 " " 13,511.43 " 192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,631.97 " " 9,748.75 " " 6,969.85 " " 6,969.85 " " 10,631.97 " 193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,053.71 " " 18,387.81 " " 13,146.32 " " 13,146.32 " " 20,053.71 " 194 SIMPLE PNEUMONIA AND PLEURISY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 13,203.90 " " 12,107.03 " " 8,655.89 " " 8,655.89 " " 13,203.90 " 195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,174.50 " " 9,329.29 " " 6,669.95 " " 6,669.95 " " 10,174.50 " 196 INTERSTITIAL LUNG DISEASE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,562.33 " " 24,355.75 " " 17,413.08 " " 17,413.08 " " 26,562.33 " 197 INTERSTITIAL LUNG DISEASE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,385.68 " " 14,107.56 " " 10,086.17 " " 10,086.17 " " 15,385.68 " 198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,357.19 " " 10,413.73 " " 7,445.27 " " 7,445.27 " " 11,357.19 " 199 PNEUMOTHORAX WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,350.28 " " 25,078.24 " " 17,929.63 " " 17,929.63 " " 27,350.28 " 200 PNEUMOTHORAX WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 16,447.50 " " 15,081.18 " " 10,782.25 " " 10,782.25 " " 16,447.50 " 201 PNEUMOTHORAX WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,855.35 " " 9,953.58 " " 7,116.29 " " 7,116.29 " " 10,855.35 " 202 BRONCHITIS AND ASTHMA WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,773.68 " " 13,546.40 " " 9,684.97 " " 9,684.97 " " 14,773.68 " 203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,794.15 " " 9,897.46 " " 7,076.17 " " 7,076.17 " " 10,794.15 " 204 RESPIRATORY SIGNS AND SYMPTOMS N/A N/A N/A MS-DRG IP N/A N/A " 12,125.25 " " 11,117.98 " " 7,948.78 " " 7,948.78 " " 12,125.25 " 205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,739.19 " " 23,600.99 " " 16,873.47 " " 16,873.47 " " 25,739.19 " 206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,528.26 " " 12,404.44 " " 8,868.53 " " 8,868.53 " " 13,528.26 " 207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS N/A N/A N/A MS-DRG IP N/A N/A " 87,613.92 " " 80,335.67 " " 57,435.79 " " 57,435.79 " " 87,613.92 " 208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS N/A N/A N/A MS-DRG IP N/A N/A " 38,897.19 " " 35,665.93 " " 25,499.27 " " 25,499.27 " " 38,897.19 " 215 OTHER HEART ASSIST SYSTEM IMPLANT N/A N/A N/A MS-DRG IP N/A N/A " 170,715.87 " " 156,534.18 " " 111,913.74 " " 111,913.74 " " 170,715.87 " 216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 159,580.53 " " 146,323.87 " " 104,613.90 " " 104,613.90 " " 159,580.53 " 217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 99,339.84 " " 91,087.49 " " 65,122.78 " " 65,122.78 " " 99,339.84 " 218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 78,690.96 " " 72,153.95 " " 51,586.30 " " 51,586.30 " " 78,690.96 " 219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 123,243.03 " " 113,005.00 " " 80,792.65 " " 80,792.65 " " 123,243.03 " 220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 82,618.47 " " 75,755.20 " " 54,161.00 " " 54,161.00 " " 82,618.47 " 221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 69,650.19 " " 63,864.22 " " 45,659.57 " " 45,659.57 " " 69,650.19 " 222 "CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 128,842.83 " " 118,139.61 " " 84,463.63 " " 84,463.63 " " 128,842.83 " 223 "CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 95,045.13 " " 87,149.55 " " 62,307.36 " " 62,307.36 " " 95,045.13 " 224 "CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 112,641.66 " " 103,284.30 " " 73,842.87 " " 73,842.87 " " 112,641.66 " 225 "CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 86,090.04 " " 78,938.38 " " 56,436.80 " " 56,436.80 " " 86,090.04 " 226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 101,160.54 " " 92,756.94 " " 66,316.35 " " 66,316.35 " " 101,160.54 " 227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 80,354.07 " " 73,678.91 " " 52,676.56 " " 52,676.56 " " 80,354.07 " 228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 95,094.09 " " 87,194.44 " " 62,339.46 " " 62,339.46 " " 95,094.09 " 229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 61,016.40 " " 55,947.65 " " 39,999.64 " " 39,999.64 " " 61,016.40 " 231 CORONARY BYPASS WITH PTCA WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 129,900.06 " " 119,109.02 " " 85,156.71 " " 85,156.71 " " 129,900.06 " 232 CORONARY BYPASS WITH PTCA WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 90,243.99 " " 82,747.25 " " 59,159.95 " " 59,159.95 " " 90,243.99 " 233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 119,228.31 " " 109,323.79 " " 78,160.78 " " 78,160.78 " " 119,228.31 " 234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 81,356.22 " " 74,597.80 " " 53,333.52 " " 53,333.52 " " 81,356.22 " 235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 92,262.06 " " 84,597.68 " " 60,482.91 " " 60,482.91 " " 92,262.06 " 236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 62,436.24 " " 57,249.54 " " 40,930.42 " " 40,930.42 " " 62,436.24 " 239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 73,573.11 " " 67,461.25 " " 48,231.26 " " 48,231.26 " " 73,573.11 " 240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 42,685.47 " " 39,139.51 " " 27,982.70 " " 27,982.70 " " 42,685.47 " 241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,348.42 " " 22,325.75 " " 15,961.74 " " 15,961.74 " " 24,348.42 " 242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 56,954.25 " " 52,222.95 " " 37,336.68 " " 37,336.68 " " 56,954.25 " 243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 38,748.78 " " 35,529.85 " " 25,401.98 " " 25,401.98 " " 38,748.78 " 244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 31,605.21 " " 28,979.71 " " 20,718.97 " " 20,718.97 " " 31,605.21 " 245 AICD GENERATOR PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 82,834.20 " " 75,953.01 " " 54,302.42 " " 54,302.42 " " 82,834.20 " 246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS N/A N/A N/A MS-DRG IP N/A N/A " 47,823.21 " " 43,850.45 " " 31,350.77 " " 31,350.77 " " 47,823.21 " 247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 30,419.46 " " 27,892.46 " " 19,941.65 " " 19,941.65 " " 30,419.46 " 248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS N/A N/A N/A MS-DRG IP N/A N/A " 48,560.67 " " 44,526.64 " " 31,834.22 " " 31,834.22 " " 48,560.67 " 249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,753.29 " " 26,364.70 " " 18,849.38 " " 18,849.38 " " 28,753.29 " 250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 38,598.84 " " 35,392.36 " " 25,303.68 " " 25,303.68 " " 38,598.84 " 251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,394.94 " " 23,285.33 " " 16,647.79 " " 16,647.79 " " 25,394.94 " 252 OTHER VASCULAR PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 50,806.71 " " 46,586.10 " " 33,306.62 " " 33,306.62 " " 50,806.71 " 253 OTHER VASCULAR PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 40,601.61 " " 37,228.76 " " 26,616.61 " " 26,616.61 " " 40,601.61 " 254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,685.35 " " 25,385.48 " " 18,149.29 " " 18,149.29 " " 27,685.35 " 255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 38,907.90 " " 35,675.75 " " 25,506.29 " " 25,506.29 " " 38,907.90 " 256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 25,139.43 " " 23,051.05 " " 16,480.29 " " 16,480.29 " " 25,139.43 " 257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,763.30 " " 16,287.67 " " 11,644.83 " " 11,644.83 " " 17,763.30 " 258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 48,979.89 " " 44,911.04 " " 32,109.04 " " 32,109.04 " " 48,979.89 " 259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 32,439.06 " " 29,744.29 " " 21,265.61 " " 21,265.61 " " 32,439.06 " 260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 54,838.26 " " 50,282.74 " " 35,949.53 " " 35,949.53 " " 54,838.26 " 261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 30,466.89 " " 27,935.95 " " 19,972.74 " " 19,972.74 " " 30,466.89 " 262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,133.93 " " 23,962.93 " " 17,132.24 " " 17,132.24 " " 26,133.93 " 263 VEIN LIGATION AND STRIPPING N/A N/A N/A MS-DRG IP N/A N/A " 35,271.09 " " 32,341.05 " " 23,122.16 " " 23,122.16 " " 35,271.09 " 264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 49,691.34 " " 45,563.39 " " 32,575.43 " " 32,575.43 " " 49,691.34 " 265 AICD LEAD PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 51,449.31 " " 47,175.32 " " 33,727.88 " " 33,727.88 " " 51,449.31 " 266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 108,587.16 " " 99,566.62 " " 71,184.92 " " 71,184.92 " " 108,587.16 " 267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 85,693.77 " " 78,575.03 " " 56,177.03 " " 56,177.03 " " 85,693.77 " 268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 106,405.38 " " 97,566.08 " " 69,754.64 " " 69,754.64 " " 106,405.38 " 269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 66,013.38 " " 60,529.52 " " 43,275.44 " " 43,275.44 " " 66,013.38 " 270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 79,278.48 " " 72,692.67 " " 51,971.45 " " 51,971.45 " " 79,278.48 " 271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 54,538.38 " " 50,007.77 " " 35,752.94 " " 35,752.94 " " 54,538.38 " 272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 41,138.64 " " 37,721.18 " " 26,968.66 " " 26,968.66 " " 41,138.64 " 273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 58,709.16 " " 53,832.08 " " 38,487.12 " " 38,487.12 " " 58,709.16 " 274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 50,266.62 " " 46,090.88 " " 32,952.56 " " 32,952.56 " " 50,266.62 " 280 "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 24,880.86 " " 22,813.96 " " 16,310.79 " " 16,310.79 " " 24,880.86 " 281 "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 14,261.13 " " 13,076.43 " " 9,348.96 " " 9,348.96 " " 14,261.13 " 282 "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 11,100.15 " " 10,178.04 " " 7,276.77 " " 7,276.77 " " 11,100.15 " 283 "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 28,528.38 " " 26,158.47 " " 18,701.94 " " 18,701.94 " " 28,528.38 " 284 "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 11,233.26 " " 10,300.09 " " 7,364.03 " " 7,364.03 " " 11,233.26 " 285 "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 7,594.92 " " 6,964.00 " " 4,978.89 " " 4,978.89 " " 7,594.92 " 286 "CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 33,875.73 " " 31,061.61 " " 22,207.42 " " 22,207.42 " " 33,875.73 " 287 "CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 17,595.00 " " 16,133.35 " " 11,534.50 " " 11,534.50 " " 17,595.00 " 288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 41,019.30 " " 37,611.75 " " 26,890.43 " " 26,890.43 " " 41,019.30 " 289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 25,131.78 " " 23,044.04 " " 16,475.28 " " 16,475.28 " " 25,131.78 " 290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,661.08 " " 14,360.08 " " 10,266.71 " " 10,266.71 " " 15,661.08 " 291 HEART FAILURE AND SHOCK WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,515.77 " " 18,811.49 " " 13,449.23 " " 13,449.23 " " 20,515.77 " 292 HEART FAILURE AND SHOCK WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 13,695.03 " " 12,557.36 " " 8,977.85 " " 8,977.85 " " 13,695.03 " 293 HEART FAILURE AND SHOCK WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,984.78 " " 9,155.33 " " 6,545.58 " " 6,545.58 " " 9,984.78 " 294 DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,616.13 " " 17,986.58 " " 12,859.46 " " 12,859.46 " " 19,616.13 " 295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,013.89 " " 13,766.66 " " 9,842.44 " " 9,842.44 " " 15,013.89 " 296 "CARDIAC ARREST, UNEXPLAINED WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 24,400.44 " " 22,373.45 " " 15,995.84 " " 15,995.84 " " 24,400.44 " 297 "CARDIAC ARREST, UNEXPLAINED WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 10,780.38 " " 9,884.83 " " 7,067.14 " " 7,067.14 " " 10,780.38 " 298 "CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 7,469.46 " " 6,848.96 " " 4,896.65 " " 4,896.65 " " 7,469.46 " 299 PERIPHERAL VASCULAR DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,430.42 " " 21,484.01 " " 15,359.94 " " 15,359.94 " " 23,430.42 " 300 PERIPHERAL VASCULAR DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,945.66 " " 14,621.02 " " 10,453.27 " " 10,453.27 " " 15,945.66 " 301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,360.25 " " 10,416.53 " " 7,447.28 " " 7,447.28 " " 11,360.25 " 302 ATHEROSCLEROSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,730.55 " " 15,340.71 " " 10,967.81 " " 10,967.81 " " 16,730.55 " 303 ATHEROSCLEROSIS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,348.92 " " 9,489.22 " " 6,784.29 " " 6,784.29 " " 10,348.92 " 304 HYPERTENSION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,762.68 " " 15,370.17 " " 10,988.87 " " 10,988.87 " " 16,762.68 " 305 HYPERTENSION WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,299.05 " " 10,360.42 " " 7,407.16 " " 7,407.16 " " 11,299.05 " 306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,006.61 " " 21,095.41 " " 15,082.11 " " 15,082.11 " " 23,006.61 " 307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,286.52 " " 12,182.78 " " 8,710.05 " " 8,710.05 " " 13,286.52 " 308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,349.29 " " 16,824.98 " " 12,028.98 " " 12,028.98 " " 18,349.29 " 309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 11,465.82 " " 10,513.33 " " 7,516.48 " " 7,516.48 " " 11,465.82 " 310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 8,543.52 " " 7,833.79 " " 5,600.75 " " 5,600.75 " " 8,543.52 " 311 ANGINA PECTORIS N/A N/A N/A MS-DRG IP N/A N/A " 10,664.10 " " 9,778.21 " " 6,990.91 " " 6,990.91 " " 10,664.10 " 312 SYNCOPE AND COLLAPSE N/A N/A N/A MS-DRG IP N/A N/A " 12,809.16 " " 11,745.08 " " 8,397.12 " " 8,397.12 " " 12,809.16 " 313 CHEST PAIN N/A N/A N/A MS-DRG IP N/A N/A " 11,028.24 " " 10,112.10 " " 7,229.62 " " 7,229.62 " " 11,028.24 " 314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 31,876.02 " " 29,228.02 " " 20,896.50 " " 20,896.50 " " 31,876.02 " 315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 14,920.56 " " 13,681.08 " " 9,781.26 " " 9,781.26 " " 14,920.56 " 316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,467.35 " " 10,514.74 " " 7,517.49 " " 7,517.49 " " 11,467.35 " 319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 66,031.74 " " 60,546.36 " " 43,287.47 " " 43,287.47 " " 66,031.74 " 320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 37,388.61 " " 34,282.67 " " 24,510.31 " " 24,510.31 " " 37,388.61 " 326 "STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 82,278.81 " " 75,443.75 " " 53,938.33 " " 53,938.33 " " 82,278.81 " 327 "STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 39,926.88 " " 36,610.08 " " 26,174.29 " " 26,174.29 " " 39,926.88 " 328 "STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 25,482.15 " " 23,365.30 " " 16,704.97 " " 16,704.97 " " 25,482.15 " 329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 74,209.59 " " 68,044.86 " " 48,648.51 " " 48,648.51 " " 74,209.59 " 330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 38,846.70 " " 35,619.63 " " 25,466.17 " " 25,466.17 " " 38,846.70 " 331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,164.53 " " 23,990.99 " " 17,152.30 " " 17,152.30 " " 26,164.53 " 332 RECTAL RESECTION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 63,643.41 " " 58,356.43 " " 41,721.79 " " 41,721.79 " " 63,643.41 " 333 RECTAL RESECTION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,757.30 " " 30,036.09 " " 21,474.23 " " 21,474.23 " " 32,757.30 " 334 RECTAL RESECTION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,620.76 " " 22,575.47 " " 16,140.28 " " 16,140.28 " " 24,620.76 " 335 PERITONEAL ADHESIOLYSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 59,523.12 " " 54,578.42 " " 39,020.71 " " 39,020.71 " " 59,523.12 " 336 PERITONEAL ADHESIOLYSIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 34,928.37 " " 32,026.80 " " 22,897.49 " " 22,897.49 " " 34,928.37 " 337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,978.78 " " 22,903.75 " " 16,374.98 " " 16,374.98 " " 24,978.78 " 338 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 42,821.64 " " 39,264.37 " " 28,071.96 " " 28,071.96 " " 42,821.64 " 339 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 25,933.50 " " 23,779.16 " " 17,000.85 " " 17,000.85 " " 25,933.50 " 340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,794.52 " " 17,233.22 " " 12,320.85 " " 12,320.85 " " 18,794.52 " 341 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 35,437.86 " " 32,493.97 " " 23,231.49 " " 23,231.49 " " 35,437.86 " 342 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 21,926.43 " " 20,104.96 " " 14,373.99 " " 14,373.99 " " 21,926.43 " 343 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,973.82 " " 15,563.77 " " 11,127.28 " " 11,127.28 " " 16,973.82 " 344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 42,853.77 " " 39,293.83 " " 28,093.03 " " 28,093.03 " " 42,853.77 " 345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 24,138.81 " " 22,133.55 " " 15,824.33 " " 15,824.33 " " 24,138.81 " 346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,507.50 " " 17,886.98 " " 12,788.25 " " 12,788.25 " " 19,507.50 " 347 ANAL AND STOMAL PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 37,662.48 " " 34,533.79 " " 24,689.85 " " 24,689.85 " " 37,662.48 " 348 ANAL AND STOMAL PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 20,538.72 " " 18,832.53 " " 13,464.27 " " 13,464.27 " " 20,538.72 " 349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,983.29 " " 13,738.60 " " 9,822.38 " " 9,822.38 " " 14,983.29 " 350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 37,521.72 " " 34,404.72 " " 24,597.57 " " 24,597.57 " " 37,521.72 " 351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 22,803.12 " " 20,908.82 " " 14,948.71 " " 14,948.71 " " 22,803.12 " 352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,875.90 " " 15,473.99 " " 11,063.09 " " 11,063.09 " " 16,875.90 " 353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 46,026.99 " " 42,203.44 " " 30,173.25 " " 30,173.25 " " 46,026.99 " 354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 27,279.90 " " 25,013.71 " " 17,883.49 " " 17,883.49 " " 27,279.90 " 355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,795.76 " " 19,068.22 " " 13,632.78 " " 13,632.78 " " 20,795.76 " 356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 65,658.42 " " 60,204.05 " " 43,042.74 " " 43,042.74 " " 65,658.42 " 357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 34,481.61 " " 31,617.16 " " 22,604.61 " " 22,604.61 " " 34,481.61 " 358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,486.70 " " 18,784.83 " " 13,430.17 " " 13,430.17 " " 20,486.70 " 368 MAJOR ESOPHAGEAL DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,717.19 " " 27,248.53 " " 19,481.27 " " 19,481.27 " " 29,717.19 " 369 MAJOR ESOPHAGEAL DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 16,475.04 " " 15,106.43 " " 10,800.30 " " 10,800.30 " " 16,475.04 " 370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,438.28 " " 10,488.08 " " 7,498.43 " " 7,498.43 " " 11,438.28 " 371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,442.99 " " 24,246.32 " " 17,334.85 " " 17,334.85 " " 26,442.99 " 372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,722.28 " " 14,416.20 " " 10,306.83 " " 10,306.83 " " 15,722.28 " 373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,375.55 " " 10,430.56 " " 7,457.31 " " 7,457.31 " " 11,375.55 " 374 DIGESTIVE MALIGNANCY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 31,638.87 " " 29,010.57 " " 20,741.04 " " 20,741.04 " " 31,638.87 " 375 DIGESTIVE MALIGNANCY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 18,434.97 " " 16,903.54 " " 12,085.15 " " 12,085.15 " " 18,434.97 " 376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,696.56 " " 12,558.76 " " 8,978.86 " " 8,978.86 " " 13,696.56 " 377 GASTROINTESTINAL HEMORRHAGE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,523.17 " " 25,236.77 " " 18,042.97 " " 18,042.97 " " 27,523.17 " 378 GASTROINTESTINAL HEMORRHAGE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,195.96 " " 13,933.60 " " 9,961.80 " " 9,961.80 " " 15,195.96 " 379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,747.63 " " 8,937.88 " " 6,390.11 " " 6,390.11 " " 9,747.63 " 380 COMPLICATED PEPTIC ULCER WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,811.43 " " 26,418.01 " " 18,887.49 " " 18,887.49 " " 28,811.43 " 381 COMPLICATED PEPTIC ULCER WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 16,213.41 " " 14,866.53 " " 10,628.79 " " 10,628.79 " " 16,213.41 " 382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,754.99 " " 10,778.48 " " 7,706.05 " " 7,706.05 " " 11,754.99 " 383 UNCOMPLICATED PEPTIC ULCER WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,056.77 " " 18,390.62 " " 13,148.33 " " 13,148.33 " " 20,056.77 " 384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,653.72 " " 12,519.48 " " 8,950.77 " " 8,950.77 " " 13,653.72 " 385 INFLAMMATORY BOWEL DISEASE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,772.23 " " 22,714.35 " " 16,239.57 " " 16,239.57 " " 24,772.23 " 386 INFLAMMATORY BOWEL DISEASE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,200.55 " " 13,937.81 " " 9,964.81 " " 9,964.81 " " 15,200.55 " 387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,916.55 " " 10,009.69 " " 7,156.41 " " 7,156.41 " " 10,916.55 " 388 GASTROINTESTINAL OBSTRUCTION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,130.54 " " 21,209.04 " " 15,163.35 " " 15,163.35 " " 23,130.54 " 389 GASTROINTESTINAL OBSTRUCTION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 12,573.54 " " 11,529.03 " " 8,242.65 " " 8,242.65 " " 12,573.54 " 390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 8,913.78 " " 8,173.30 " " 5,843.48 " " 5,843.48 " " 8,913.78 " 391 "ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 19,039.32 " " 17,457.69 " " 12,481.33 " " 12,481.33 " " 19,039.32 " 392 "ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 11,695.32 " " 10,723.77 " " 7,666.93 " " 7,666.93 " " 11,695.32 " 393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,300.08 " " 23,198.35 " " 16,585.61 " " 16,585.61 " " 25,300.08 " 394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 14,360.58 " " 13,167.62 " " 9,414.16 " " 9,414.16 " " 14,360.58 " 395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,940.41 " " 9,114.64 " " 6,516.49 " " 6,516.49 " " 9,940.41 " 405 "PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 87,676.65 " " 80,393.18 " " 57,476.92 " " 57,476.92 " " 87,676.65 " 406 "PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 44,018.10 " " 40,361.43 " " 28,856.31 " " 28,856.31 " " 44,018.10 " 407 "PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 32,374.80 " " 29,685.36 " " 21,223.48 " " 21,223.48 " " 32,374.80 " 408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 57,367.35 " " 52,601.74 " " 37,607.49 " " 37,607.49 " " 57,367.35 " 409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,348.79 " " 29,661.51 " " 21,206.43 " " 21,206.43 " " 32,348.79 " 410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,955.21 " " 21,965.21 " " 15,703.97 " " 15,703.97 " " 23,955.21 " 411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 57,411.72 " " 52,642.42 " " 37,636.57 " " 37,636.57 " " 57,411.72 " 412 CHOLECYSTECTOMY WITH C.D.E. WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 34,818.21 " " 31,925.80 " " 22,825.27 " " 22,825.27 " " 34,818.21 " 413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,490.42 " " 24,289.81 " " 17,365.94 " " 17,365.94 " " 26,490.42 " 414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 55,470.15 " " 50,862.14 " " 36,363.77 " " 36,363.77 " " 55,470.15 " 415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 31,088.07 " " 28,505.53 " " 20,379.96 " " 20,379.96 " " 31,088.07 " 416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,759.66 " " 19,952.04 " " 14,264.67 " " 14,264.67 " " 21,759.66 " 417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 37,079.55 " " 33,999.28 " " 24,307.71 " " 24,307.71 " " 37,079.55 " 418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 25,827.93 " " 23,682.35 " " 16,931.64 " " 16,931.64 " " 25,827.93 " 419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,122.56 " " 18,450.94 " " 13,191.46 " " 13,191.46 " " 20,122.56 " 420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 53,765.73 " " 49,299.31 " " 35,246.42 " " 35,246.42 " " 53,765.73 " 421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 29,206.17 " " 26,779.96 " " 19,146.27 " " 19,146.27 " " 29,206.17 " 422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,206.42 " " 20,361.69 " " 14,557.54 " " 14,557.54 " " 22,206.42 " 423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 63,938.70 " " 58,627.19 " " 41,915.37 " " 41,915.37 " " 63,938.70 " 424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 34,908.48 " " 32,008.57 " " 22,884.45 " " 22,884.45 " " 34,908.48 " 425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,612.49 " " 21,650.96 " " 15,479.30 " " 15,479.30 " " 23,612.49 " 432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,796.13 " " 26,403.98 " " 18,877.46 " " 18,877.46 " " 28,796.13 " 433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,736.05 " " 14,428.83 " " 10,315.86 " " 10,315.86 " " 15,736.05 " 434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,479.88 " " 8,692.37 " " 6,214.59 " " 6,214.59 " " 9,479.88 " 435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,817.84 " " 24,590.03 " " 17,580.58 " " 17,580.58 " " 26,817.84 " 436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 17,139.06 " " 15,715.29 " " 11,235.61 " " 11,235.61 " " 17,139.06 " 437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,685.85 " " 12,548.94 " " 8,971.84 " " 8,971.84 " " 13,685.85 " 438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,423.39 " " 22,394.49 " " 16,010.89 " " 16,010.89 " " 24,423.39 " 439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 12,919.32 " " 11,846.09 " " 8,469.33 " " 8,469.33 " " 12,919.32 " 440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,270.27 " " 8,500.17 " " 6,077.18 " " 6,077.18 " " 9,270.27 " 441 "DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 28,820.61 " " 26,426.43 " " 18,893.51 " " 18,893.51 " " 28,820.61 " 442 "DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 14,253.48 " " 13,069.42 " " 9,343.95 " " 9,343.95 " " 14,253.48 " 443 "DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 10,140.84 " " 9,298.42 " " 6,647.88 " " 6,647.88 " " 10,140.84 " 444 DISORDERS OF THE BILIARY TRACT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,532.64 " " 23,411.60 " " 16,738.06 " " 16,738.06 " " 25,532.64 " 445 DISORDERS OF THE BILIARY TRACT WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 16,475.04 " " 15,106.43 " " 10,800.30 " " 10,800.30 " " 16,475.04 " 446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,487.86 " " 11,450.47 " " 8,186.49 " " 8,186.49 " " 12,487.86 " 453 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 140,662.08 " " 128,977.01 " " 92,211.81 " " 92,211.81 " " 140,662.08 " 454 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 93,300.93 " " 85,550.24 " " 61,163.94 " " 61,163.94 " " 93,300.93 " 455 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 73,302.30 " " 67,212.94 " " 48,053.73 " " 48,053.73 " " 73,302.30 " 456 "SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 131,550.93 " " 120,622.74 " " 86,238.94 " " 86,238.94 " " 131,550.93 " 457 "SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 99,480.60 " " 91,216.56 " " 65,215.06 " " 65,215.06 " " 99,480.60 " 458 "SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 76,766.22 " " 70,389.10 " " 50,324.52 " " 50,324.52 " " 76,766.22 " 459 SPINAL FUSION EXCEPT CERVICAL WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 102,996.54 " " 94,440.42 " " 67,519.95 " " 67,519.95 " " 102,996.54 " 460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 60,170.31 " " 55,171.85 " " 39,444.98 " " 39,444.98 " " 60,170.31 " 461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 92,965.86 " " 85,243.01 " " 60,944.29 " " 60,944.29 " " 92,965.86 " 462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 48,106.26 " " 44,109.98 " " 31,536.33 " " 31,536.33 " " 48,106.26 " 463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 82,090.62 " " 75,271.20 " " 53,814.96 " " 53,814.96 " " 82,090.62 " 464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 45,509.85 " " 41,729.26 " " 29,834.24 " " 29,834.24 " " 45,509.85 " 465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,207.08 " " 25,863.86 " " 18,491.31 " " 18,491.31 " " 28,207.08 " 466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 81,778.50 " " 74,985.01 " " 53,610.35 " " 53,610.35 " " 81,778.50 " 467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 54,715.86 " " 50,170.51 " " 35,869.29 " " 35,869.29 " " 54,715.86 " 468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 42,901.20 " " 39,337.32 " " 28,124.12 " " 28,124.12 " " 42,901.20 " 469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT N/A N/A N/A MS-DRG IP N/A N/A " 47,191.32 " " 43,271.05 " " 30,936.53 " " 30,936.53 " " 47,191.32 " 470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,068.47 " " 26,653.70 " " 19,056.00 " " 19,056.00 " " 29,068.47 " 471 CERVICAL SPINAL FUSION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 76,757.04 " " 70,380.69 " " 50,318.50 " " 50,318.50 " " 76,757.04 " 472 CERVICAL SPINAL FUSION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 46,713.96 " " 42,833.34 " " 30,623.60 " " 30,623.60 " " 46,713.96 " 473 CERVICAL SPINAL FUSION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 38,865.06 " " 35,636.47 " " 25,478.21 " " 25,478.21 " " 38,865.06 " 474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 62,313.84 " " 57,137.31 " " 40,850.18 " " 40,850.18 " " 62,313.84 " 475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 33,562.08 " " 30,774.01 " " 22,001.81 " " 22,001.81 " " 33,562.08 " 476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,744.94 " " 16,270.83 " " 11,632.79 " " 11,632.79 " " 17,744.94 " 477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 51,360.57 " " 47,093.95 " " 33,669.71 " " 33,669.71 " " 51,360.57 " 478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 36,060.57 " " 33,064.95 " " 23,639.71 " " 23,639.71 " " 36,060.57 " 479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,682.29 " " 25,382.67 " " 18,147.28 " " 18,147.28 " " 27,682.29 " 480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 46,274.85 " " 42,430.71 " " 30,335.74 " " 30,335.74 " " 46,274.85 " 481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,061.15 " " 29,397.77 " " 21,017.87 " " 21,017.87 " " 32,061.15 " 482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,196.04 " " 23,102.96 " " 16,517.40 " " 16,517.40 " " 25,196.04 " 483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES N/A N/A N/A MS-DRG IP N/A N/A " 36,510.39 " " 33,477.40 " " 23,934.59 " " 23,934.59 " " 36,510.39 " 485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 52,136.28 " " 47,805.22 " " 34,178.23 " " 34,178.23 " " 52,136.28 " 486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,870.52 " " 30,139.90 " " 21,548.45 " " 21,548.45 " " 32,870.52 " 487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,096.59 " " 23,011.77 " " 16,452.21 " " 16,452.21 " " 25,096.59 " 488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 30,211.38 " " 27,701.66 " " 19,805.24 " " 19,805.24 " " 30,211.38 " 489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,862.46 " " 18,212.45 " " 13,020.95 " " 13,020.95 " " 19,862.46 " 492 "LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 53,063.46 " " 48,655.38 " " 34,786.05 " " 34,786.05 " " 53,063.46 " 493 "LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 35,575.56 " " 32,620.23 " " 23,321.76 " " 23,321.76 " " 35,575.56 " 494 "LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 28,334.07 " " 25,980.31 " " 18,574.56 " " 18,574.56 " " 28,334.07 " 495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 55,603.26 " " 50,984.19 " " 36,451.03 " " 36,451.03 " " 55,603.26 " 496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 30,379.68 " " 27,855.98 " " 19,915.57 " " 19,915.57 " " 30,379.68 " 497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,318.11 " " 20,464.10 " " 14,630.76 " " 14,630.76 " " 22,318.11 " 498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 39,539.79 " " 36,255.14 " " 25,920.53 " " 25,920.53 " " 39,539.79 " 499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,340.11 " " 16,816.56 " " 12,022.96 " " 12,022.96 " " 18,340.11 " 500 SOFT TISSUE PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 48,254.67 " " 44,246.06 " " 31,633.62 " " 31,633.62 " " 48,254.67 " 501 SOFT TISSUE PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 26,698.50 " " 24,480.61 " " 17,502.35 " " 17,502.35 " " 26,698.50 " 502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,361.24 " " 18,669.79 " " 13,347.92 " " 13,347.92 " " 20,361.24 " 503 FOOT PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 40,219.11 " " 36,878.03 " " 26,365.86 " " 26,365.86 " " 40,219.11 " 504 FOOT PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 27,140.67 " " 24,886.04 " " 17,792.22 " " 17,792.22 " " 27,140.67 " 505 FOOT PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,140.67 " " 24,886.04 " " 17,792.22 " " 17,792.22 " " 27,140.67 " 506 MAJOR THUMB OR JOINT PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 22,578.21 " " 20,702.60 " " 14,801.27 " " 14,801.27 " " 22,578.21 " 507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 30,941.19 " " 28,370.85 " " 20,283.67 " " 20,283.67 " " 30,941.19 " 508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,634.20 " " 19,837.01 " " 14,182.42 " " 14,182.42 " " 21,634.20 " 509 ARTHROSCOPY N/A N/A N/A MS-DRG IP N/A N/A " 25,609.14 " " 23,481.74 " " 16,788.21 " " 16,788.21 " " 25,609.14 " 510 "SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 41,779.71 " " 38,308.99 " " 27,388.92 " " 27,388.92 " " 41,779.71 " 511 "SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 30,118.05 " " 27,616.09 " " 19,744.06 " " 19,744.06 " " 30,118.05 " 512 "SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 23,809.86 " " 21,831.93 " " 15,608.69 " " 15,608.69 " " 23,809.86 " 513 "HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 23,852.70 " " 21,871.21 " " 15,636.77 " " 15,636.77 " " 23,852.70 " 514 "HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 15,211.26 " " 13,947.63 " " 9,971.83 " " 9,971.83 " " 15,211.26 " 515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 47,996.10 " " 44,008.97 " " 31,464.11 " " 31,464.11 " " 47,996.10 " 516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 30,004.83 " " 27,512.27 " " 19,669.83 " " 19,669.83 " " 30,004.83 " 517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,369.51 " " 19,594.30 " " 14,008.90 " " 14,008.90 " " 21,369.51 " 518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR N/A N/A N/A MS-DRG IP N/A N/A " 54,839.79 " " 50,284.14 " " 35,950.53 " " 35,950.53 " " 54,839.79 " 519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 29,952.81 " " 27,464.57 " " 19,635.73 " " 19,635.73 " " 29,952.81 " 520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,686.22 " " 19,884.70 " " 14,216.52 " " 14,216.52 " " 21,686.22 " 521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 46,870.02 " " 42,976.44 " " 30,725.90 " " 30,725.90 " " 46,870.02 " 522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 33,493.23 " " 30,710.88 " " 21,956.67 " " 21,956.67 " " 33,493.23 " 533 FRACTURES OF FEMUR WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,612.78 " " 19,817.37 " " 14,168.38 " " 14,168.38 " " 21,612.78 " 534 FRACTURES OF FEMUR WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,065.58 " " 11,063.27 " " 7,909.66 " " 7,909.66 " " 12,065.58 " 535 FRACTURES OF HIP AND PELVIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,877.14 " " 17,308.98 " " 12,375.01 " " 12,375.01 " " 18,877.14 " 536 FRACTURES OF HIP AND PELVIS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,805.48 " " 10,824.78 " " 7,739.15 " " 7,739.15 " " 11,805.48 " 537 "SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 14,277.96 " " 13,091.86 " " 9,360.00 " " 9,360.00 " " 14,277.96 " 538 "SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 11,037.42 " " 10,120.52 " " 7,235.64 " " 7,235.64 " " 11,037.42 " 539 OSTEOMYELITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,700.36 " " 27,233.09 " " 19,470.24 " " 19,470.24 " " 29,700.36 " 540 OSTEOMYELITIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 19,818.09 " " 18,171.76 " " 12,991.86 " " 12,991.86 " " 19,818.09 " 541 OSTEOMYELITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,861.18 " " 11,792.78 " " 8,431.22 " " 8,431.22 " " 12,861.18 " 542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,621.09 " " 25,326.55 " " 18,107.16 " " 18,107.16 " " 27,621.09 " 543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,962.49 " " 14,636.46 " " 10,464.30 " " 10,464.30 " " 15,962.49 " 544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,875.86 " " 10,889.31 " " 7,785.29 " " 7,785.29 " " 11,875.86 " 545 CONNECTIVE TISSUE DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 38,242.35 " " 35,065.49 " " 25,069.99 " " 25,069.99 " " 38,242.35 " 546 CONNECTIVE TISSUE DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 18,460.98 " " 16,927.39 " " 12,102.20 " " 12,102.20 " " 18,460.98 " 547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,744.90 " " 11,686.16 " " 8,354.99 " " 8,354.99 " " 12,744.90 " 548 SEPTIC ARTHRITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 31,052.88 " " 28,473.26 " " 20,356.89 " " 20,356.89 " " 31,052.88 " 549 SEPTIC ARTHRITIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 19,077.57 " " 17,492.76 " " 12,506.41 " " 12,506.41 " " 19,077.57 " 550 SEPTIC ARTHRITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,505.31 " " 12,383.40 " " 8,853.48 " " 8,853.48 " " 13,505.31 " 551 MEDICAL BACK PROBLEMS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,833.43 " " 22,770.47 " " 16,279.69 " " 16,279.69 " " 24,833.43 " 552 MEDICAL BACK PROBLEMS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,412.60 " " 13,215.32 " " 9,448.26 " " 9,448.26 " " 14,412.60 " 553 BONE DISEASES AND ARTHROPATHIES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,404.99 " " 17,792.98 " " 12,721.05 " " 12,721.05 " " 19,404.99 " 554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,093.12 " " 11,088.52 " " 7,927.71 " " 7,927.71 " " 12,093.12 " 555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,850.84 " " 19,118.72 " " 13,668.88 " " 13,668.88 " " 20,850.84 " 556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,336.39 " " 11,311.58 " " 8,087.19 " " 8,087.19 " " 12,336.39 " 557 "TENDONITIS, MYOSITIS AND BURSITIS WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 21,326.67 " " 19,555.02 " " 13,980.82 " " 13,980.82 " " 21,326.67 " 558 "TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 13,131.99 " " 12,041.09 " " 8,608.75 " " 8,608.75 " " 13,131.99 " 559 "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 28,578.87 " " 26,204.77 " " 18,735.04 " " 18,735.04 " " 28,578.87 " 560 "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 16,468.92 " " 15,100.82 " " 10,796.29 " " 10,796.29 " " 16,468.92 " 561 "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 12,103.83 " " 11,098.34 " " 7,934.73 " " 7,934.73 " " 12,103.83 " 562 "FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 21,542.40 " " 19,752.83 " " 14,122.24 " " 14,122.24 " " 21,542.40 " 563 "FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 13,323.24 " " 12,216.45 " " 8,734.12 " " 8,734.12 " " 13,323.24 " 564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,161.14 " " 21,237.10 " " 15,183.41 " " 15,183.41 " " 23,161.14 " 565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,396.39 " " 14,117.38 " " 10,093.19 " " 10,093.19 " " 15,396.39 " 566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,497.95 " " 10,542.79 " " 7,537.55 " " 7,537.55 " " 11,497.95 " 570 SKIN DEBRIDEMENT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 43,395.39 " " 39,790.45 " " 28,448.09 " " 28,448.09 " " 43,395.39 " 571 SKIN DEBRIDEMENT WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 24,981.84 " " 22,906.55 " " 16,376.98 " " 16,376.98 " " 24,981.84 " 572 SKIN DEBRIDEMENT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,869.78 " " 15,468.38 " " 11,059.08 " " 11,059.08 " " 16,869.78 " 573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 84,720.69 " " 77,682.78 " " 55,539.12 " " 55,539.12 " " 84,720.69 " 574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 49,671.45 " " 45,545.15 " " 32,562.40 " " 32,562.40 " " 49,671.45 " 575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,950.95 " " 24,712.08 " " 17,667.85 " " 17,667.85 " " 26,950.95 " 576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 77,419.53 " " 70,988.14 " " 50,752.80 " " 50,752.80 " " 77,419.53 " 577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 38,975.22 " " 35,737.47 " " 25,550.42 " " 25,550.42 " " 38,975.22 " 578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,398.91 " " 22,372.05 " " 15,994.84 " " 15,994.84 " " 24,398.91 " 579 "OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 44,795.34 " " 41,074.11 " " 29,365.83 " " 29,365.83 " " 44,795.34 " 580 "OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 24,527.43 " " 22,489.89 " " 16,079.09 " " 16,079.09 " " 24,527.43 " 581 "OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 19,276.47 " " 17,675.14 " " 12,636.80 " " 12,636.80 " " 19,276.47 " 582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,116.48 " " 23,030.01 " " 16,465.25 " " 16,465.25 " " 25,116.48 " 583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,586.48 " " 21,627.11 " " 15,462.25 " " 15,462.25 " " 23,586.48 " 584 "BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 28,003.59 " " 25,677.28 " " 18,357.91 " " 18,357.91 " " 28,003.59 " 585 "BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 26,657.19 " " 24,442.73 " " 17,475.27 " " 17,475.27 " " 26,657.19 " 592 SKIN ULCERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,806.51 " " 23,662.71 " " 16,917.60 " " 16,917.60 " " 25,806.51 " 593 SKIN ULCERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 17,393.04 " " 15,948.17 " " 11,402.10 " " 11,402.10 " " 17,393.04 " 594 SKIN ULCERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,526.11 " " 11,485.54 " " 8,211.56 " " 8,211.56 " " 12,526.11 " 595 MAJOR SKIN DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 30,785.13 " " 28,227.75 " " 20,181.36 " " 20,181.36 " " 30,785.13 " 596 MAJOR SKIN DISORDERS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,134.76 " " 13,877.49 " " 9,921.68 " " 9,921.68 " " 15,134.76 " 597 MALIGNANT BREAST DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,041.51 " " 22,961.26 " " 16,416.10 " " 16,416.10 " " 25,041.51 " 598 MALIGNANT BREAST DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 17,001.36 " " 15,589.02 " " 11,145.34 " " 11,145.34 " " 17,001.36 " 599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,269.36 " " 9,416.26 " " 6,732.14 " " 6,732.14 " " 10,269.36 " 600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,234.21 " " 13,968.68 " " 9,986.87 " " 9,986.87 " " 15,234.21 " 601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,520.28 " " 9,646.34 " " 6,896.63 " " 6,896.63 " " 10,520.28 " 602 CELLULITIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,979.98 " " 20,154.06 " " 14,409.10 " " 14,409.10 " " 21,979.98 " 603 CELLULITIS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,925.44 " " 11,851.70 " " 8,473.34 " " 8,473.34 " " 12,925.44 " 604 "TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 22,816.89 " " 20,921.45 " " 14,957.74 " " 14,957.74 " " 22,816.89 " 605 "TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 13,910.76 " " 12,755.17 " " 9,119.28 " " 9,119.28 " " 13,910.76 " 606 MINOR SKIN DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 23,118.30 " " 21,197.82 " " 15,155.33 " " 15,155.33 " " 23,118.30 " 607 MINOR SKIN DISORDERS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,631.68 " " 11,582.34 " " 8,280.77 " " 8,280.77 " " 12,631.68 " 614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 36,518.04 " " 33,484.42 " " 23,939.60 " " 23,939.60 " " 36,518.04 " 615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,083.73 " " 22,083.05 " " 15,788.22 " " 15,788.22 " " 24,083.73 " 616 "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 61,028.64 " " 55,958.88 " " 40,007.66 " " 40,007.66 " " 61,028.64 " 617 "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 31,121.73 " " 28,536.39 " " 20,402.02 " " 20,402.02 " " 31,121.73 " 618 "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 19,935.90 " " 18,279.79 " " 13,069.09 " " 13,069.09 " " 19,935.90 " 619 O.R. PROCEDURES FOR OBESITY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 46,834.83 " " 42,944.17 " " 30,702.83 " " 30,702.83 " " 46,834.83 " 620 O.R. PROCEDURES FOR OBESITY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 26,944.83 " " 24,706.47 " " 17,663.83 " " 17,663.83 " " 26,944.83 " 621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,424.92 " " 22,395.90 " " 16,011.89 " " 16,011.89 " " 24,424.92 " 622 "SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 55,275.84 " " 50,683.97 " " 36,236.38 " " 36,236.38 " " 55,275.84 " 623 "SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 28,655.37 " " 26,274.91 " " 18,785.19 " " 18,785.19 " " 28,655.37 " 624 "SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 16,742.79 " " 15,351.93 " " 10,975.83 " " 10,975.83 " " 16,742.79 " 625 "THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 43,470.36 " " 39,859.19 " " 28,497.24 " " 28,497.24 " " 43,470.36 " 626 "THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 25,280.19 " " 23,180.12 " " 16,572.57 " " 16,572.57 " " 25,280.19 " 627 "THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 18,081.54 " " 16,579.47 " " 11,853.45 " " 11,853.45 " " 18,081.54 " 628 "OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 56,580.93 " " 51,880.64 " " 37,091.94 " " 37,091.94 " " 56,580.93 " 629 "OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 35,906.04 " " 32,923.26 " " 23,538.40 " " 23,538.40 " " 35,906.04 " 630 "OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 21,525.57 " " 19,737.40 " " 14,111.21 " " 14,111.21 " " 21,525.57 " 637 DIABETES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,032.91 " " 19,285.67 " " 13,788.24 " " 13,788.24 " " 21,032.91 " 638 DIABETES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 13,454.82 " " 12,337.10 " " 8,820.38 " " 8,820.38 " " 13,454.82 " 639 DIABETES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,322.29 " " 8,547.87 " " 6,111.28 " " 6,111.28 " " 9,322.29 " 640 "MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 18,785.34 " " 17,224.81 " " 12,314.83 " " 12,314.83 " " 18,785.34 " 641 "MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 11,520.90 " " 10,563.84 " " 7,552.59 " " 7,552.59 " " 11,520.90 " 642 INBORN AND OTHER DISORDERS OF METABOLISM N/A N/A N/A MS-DRG IP N/A N/A " 19,698.75 " " 18,062.34 " " 12,913.63 " " 12,913.63 " " 19,698.75 " 643 ENDOCRINE DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,448.49 " " 23,334.44 " " 16,682.90 " " 16,682.90 " " 25,448.49 " 644 ENDOCRINE DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,579.99 " " 14,285.73 " " 10,213.55 " " 10,213.55 " " 15,579.99 " 645 ENDOCRINE DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,747.34 " " 10,771.47 " " 7,701.03 " " 7,701.03 " " 11,747.34 " 650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 69,050.43 " " 63,314.28 " " 45,266.39 " " 45,266.39 " " 69,050.43 " 651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 56,512.08 " " 51,817.51 " " 37,046.81 " " 37,046.81 " " 56,512.08 " 652 KIDNEY TRANSPLANT N/A N/A N/A MS-DRG IP N/A N/A " 48,683.07 " " 44,638.88 " " 31,914.46 " " 31,914.46 " " 48,683.07 " 653 MAJOR BLADDER PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 83,372.76 " " 76,446.83 " " 54,655.48 " " 54,655.48 " " 83,372.76 " 654 MAJOR BLADDER PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 44,373.06 " " 40,686.91 " " 29,089.01 " " 29,089.01 " " 44,373.06 " 655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 31,825.53 " " 29,181.72 " " 20,863.40 " " 20,863.40 " " 31,825.53 " 656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 50,210.01 " " 46,038.97 " " 32,915.45 " " 32,915.45 " " 50,210.01 " 657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 29,591.73 " " 27,133.49 " " 19,399.02 " " 19,399.02 " " 29,591.73 " 658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,160.23 " " 22,153.19 " " 15,838.37 " " 15,838.37 " " 24,160.23 " 659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 40,771.44 " " 37,384.48 " " 26,727.94 " " 26,727.94 " " 40,771.44 " 660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 22,084.02 " " 20,249.46 " " 14,477.30 " " 14,477.30 " " 22,084.02 " 661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,285.32 " " 14,932.47 " " 10,675.93 " " 10,675.93 " " 16,285.32 " 662 MINOR BLADDER PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 44,825.94 " " 41,102.16 " " 29,385.89 " " 29,385.89 " " 44,825.94 " 663 MINOR BLADDER PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 24,401.97 " " 22,374.85 " " 15,996.85 " " 15,996.85 " " 24,401.97 " 664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,118.26 " " 16,613.14 " " 11,877.53 " " 11,877.53 " " 18,118.26 " 665 PROSTATECTOMY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 46,461.51 " " 42,601.86 " " 30,458.10 " " 30,458.10 " " 46,461.51 " 666 PROSTATECTOMY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 26,534.79 " " 24,330.49 " " 17,395.03 " " 17,395.03 " " 26,534.79 " 667 PROSTATECTOMY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,221.97 " " 13,957.45 " " 9,978.85 " " 9,978.85 " " 15,221.97 " 668 TRANSURETHRAL PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 42,153.03 " " 38,651.30 " " 27,633.65 " " 27,633.65 " " 42,153.03 " 669 TRANSURETHRAL PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 23,438.07 " " 21,491.03 " " 15,364.96 " " 15,364.96 " " 23,438.07 " 670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,940.45 " " 13,699.32 " " 9,794.30 " " 9,794.30 " " 14,940.45 " 671 URETHRAL PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,183.51 " " 24,925.32 " " 17,820.30 " " 17,820.30 " " 27,183.51 " 672 URETHRAL PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,608.77 " " 16,145.98 " " 11,543.53 " " 11,543.53 " " 17,608.77 " 673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 52,985.43 " " 48,583.83 " " 34,734.89 " " 34,734.89 " " 52,985.43 " 674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 36,420.12 " " 33,394.63 " " 23,875.41 " " 23,875.41 " " 36,420.12 " 675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,805.60 " " 24,578.81 " " 17,572.56 " " 17,572.56 " " 26,805.60 " 682 RENAL FAILURE WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,494.06 " " 20,625.44 " " 14,746.11 " " 14,746.11 " " 22,494.06 " 683 RENAL FAILURE WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 13,434.93 " " 12,318.86 " " 8,807.34 " " 8,807.34 " " 13,434.93 " 684 RENAL FAILURE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,294.75 " " 8,522.62 " " 6,093.23 " " 6,093.23 " " 9,294.75 " 686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,659.96 " " 26,279.12 " " 18,788.20 " " 18,788.20 " " 28,659.96 " 687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 16,031.34 " " 14,699.59 " " 10,509.43 " " 10,509.43 " " 16,031.34 " 688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,485.09 " " 9,614.07 " " 6,873.56 " " 6,873.56 " " 10,485.09 " 689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,002.89 " " 15,590.43 " " 11,146.34 " " 11,146.34 " " 17,002.89 " 690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,120.66 " " 11,113.77 " " 7,945.77 " " 7,945.77 " " 12,120.66 " 693 URINARY STONES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,412.64 " " 17,800.00 " " 12,726.06 " " 12,726.06 " " 19,412.64 " 694 URINARY STONES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,158.29 " " 10,231.35 " " 7,314.88 " " 7,314.88 " " 11,158.29 " 695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,385.39 " " 15,941.15 " " 11,397.09 " " 11,397.09 " " 17,385.39 " 696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,552.41 " " 9,675.80 " " 6,917.69 " " 6,917.69 " " 10,552.41 " 697 URETHRAL STRICTURE N/A N/A N/A MS-DRG IP N/A N/A " 15,254.10 " " 13,986.91 " " 9,999.91 " " 9,999.91 " " 15,254.10 " 698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,582.51 " " 22,540.39 " " 16,115.20 " " 16,115.20 " " 24,582.51 " 699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,685.56 " " 14,382.53 " " 10,282.76 " " 10,282.76 " " 15,685.56 " 700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,395.44 " " 10,448.80 " " 7,470.34 " " 7,470.34 " " 11,395.44 " 707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,385.18 " " 26,944.10 " " 19,263.62 " " 19,263.62 " " 29,385.18 " 708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,818.42 " " 20,922.85 " " 14,958.74 " " 14,958.74 " " 22,818.42 " 709 PENIS PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 35,372.07 " " 32,433.65 " " 23,188.36 " " 23,188.36 " " 35,372.07 " 710 PENIS PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 24,478.47 " " 22,445.00 " " 16,047.00 " " 16,047.00 " " 24,478.47 " 711 TESTES PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 32,593.59 " " 29,885.98 " " 21,366.91 " " 21,366.91 " " 32,593.59 " 712 TESTES PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,179.75 " " 14,835.67 " " 10,606.73 " " 10,606.73 " " 16,179.75 " 713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,821.48 " " 20,925.66 " " 14,960.75 " " 14,960.75 " " 22,821.48 " 714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,206.05 " " 13,025.93 " " 9,312.86 " " 9,312.86 " " 14,206.05 " 715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 30,889.17 " " 28,323.15 " " 20,249.57 " " 20,249.57 " " 30,889.17 " 716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,530.45 " " 17,908.02 " " 12,803.30 " " 12,803.30 " " 19,530.45 " 717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 27,517.05 " " 25,231.16 " " 18,038.96 " " 18,038.96 " " 27,517.05 " 718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,913.86 " " 17,342.65 " " 12,399.09 " " 12,399.09 " " 18,913.86 " 722 "MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 26,147.70 " " 23,975.56 " " 17,141.27 " " 17,141.27 " " 26,147.70 " 723 "MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 16,663.23 " " 15,278.98 " " 10,923.67 " " 10,923.67 " " 16,663.23 " 724 "MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 9,935.82 " " 9,110.43 " " 6,513.48 " " 6,513.48 " " 9,935.82 " 725 BENIGN PROSTATIC HYPERTROPHY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,613.07 " " 17,983.78 " " 12,857.46 " " 12,857.46 " " 19,613.07 " 726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,372.49 " " 10,427.76 " " 7,455.30 " " 7,455.30 " " 11,372.49 " 727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,696.93 " " 19,894.52 " " 14,223.54 " " 14,223.54 " " 21,696.93 " 728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,293.55 " " 11,272.30 " " 8,059.11 " " 8,059.11 " " 12,293.55 " 729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,373.44 " " 14,096.34 " " 10,078.14 " " 10,078.14 " " 15,373.44 " 730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 8,655.21 " " 7,936.21 " " 5,673.97 " " 5,673.97 " " 8,655.21 " 734 "PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 34,008.84 " " 31,183.66 " " 22,294.68 " " 22,294.68 " " 34,008.84 " 735 "PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 21,626.55 " " 19,829.99 " " 14,177.41 " " 14,177.41 " " 21,626.55 " 736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 65,150.46 " " 59,738.29 " " 42,709.75 " " 42,709.75 " " 65,150.46 " 737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 31,490.46 " " 28,874.49 " " 20,643.75 " " 20,643.75 " " 31,490.46 " 738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,591.98 " " 20,715.22 " " 14,810.30 " " 14,810.30 " " 22,591.98 " 739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 58,472.01 " " 53,614.63 " " 38,331.65 " " 38,331.65 " " 58,472.01 " 740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 27,540.00 " " 25,252.20 " " 18,054.00 " " 18,054.00 " " 27,540.00 " 741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,576.35 " " 17,950.11 " " 12,833.39 " " 12,833.39 " " 19,576.35 " 742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 26,270.10 " " 24,087.79 " " 17,221.51 " " 17,221.51 " " 26,270.10 " 743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,324.19 " " 15,885.04 " " 11,356.97 " " 11,356.97 " " 17,324.19 " 744 "D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 27,448.20 " " 25,168.03 " " 17,993.82 " " 17,993.82 " " 27,448.20 " 745 "D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 17,908.65 " " 16,420.94 " " 11,740.12 " " 11,740.12 " " 17,908.65 " 746 "VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 24,623.82 " " 22,578.27 " " 16,142.28 " " 16,142.28 " " 24,623.82 " 747 "VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 14,351.40 " " 13,159.20 " " 9,408.14 " " 9,408.14 " " 14,351.40 " 748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 20,628.99 " " 18,915.30 " " 13,523.45 " " 13,523.45 " " 20,628.99 " 749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 41,423.22 " " 37,982.11 " " 27,155.22 " " 27,155.22 " " 41,423.22 " 750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,428.27 " " 20,565.11 " " 14,702.98 " " 14,702.98 " " 22,428.27 " 754 "MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 27,861.30 " " 25,546.81 " " 18,264.63 " " 18,264.63 " " 27,861.30 " 755 "MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 17,252.28 " " 15,819.10 " " 11,309.83 " " 11,309.83 " " 17,252.28 " 756 "MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 14,016.33 " " 12,851.97 " " 9,188.48 " " 9,188.48 " " 14,016.33 " 757 "INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 23,288.13 " " 21,353.54 " " 15,266.66 " " 15,266.66 " " 23,288.13 " 758 "INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC" N/A N/A N/A MS-DRG IP N/A N/A " 14,795.10 " " 13,566.04 " " 9,699.01 " " 9,699.01 " " 14,795.10 " 759 "INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC" N/A N/A N/A MS-DRG IP N/A N/A " 10,452.96 " " 9,584.61 " " 6,852.50 " " 6,852.50 " " 10,452.96 " 760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,115.78 " " 12,943.16 " " 9,253.68 " " 9,253.68 " " 14,115.78 " 761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,027.00 " " 8,277.11 " " 5,917.70 " " 5,917.70 " " 9,027.00 " 768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C N/A N/A N/A MS-DRG IP N/A N/A " 10,986.79 " " 16,425.15 " " 11,743.12 " " 10,986.79 " " 16,425.15 " 769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 24,792.12 " " 22,732.59 " " 16,252.61 " " 16,252.61 " " 24,792.12 " 770 "ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY" N/A N/A N/A MS-DRG IP N/A N/A " 13,587.93 " " 12,459.15 " " 8,907.64 " " 8,907.64 " " 13,587.93 " 776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES N/A N/A N/A MS-DRG IP N/A N/A " 11,762.64 " " 10,785.50 " " 7,711.06 " " 7,711.06 " " 11,762.64 " 779 ABORTION WITHOUT D&C N/A N/A N/A MS-DRG IP N/A N/A " 15,918.12 " " 14,595.77 " " 10,435.21 " " 10,435.21 " " 15,918.12 " 783 CESAREAN SECTION WITH STERILIZATION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,573.42 " N/A " 18,783.18 " " 17,573.42 " " 18,783.18 " 783 CESAREAN SECTION WITH STERILIZATION WITH MCC N/A N/A N/A Per Case IP N/A N/A N/A " 5,233.00 " N/A " 5,233.00 " " 5,233.00 " 784 CESAREAN SECTION WITH STERILIZATION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 10,274.54 " N/A " 10,981.85 " " 10,274.54 " " 10,981.85 " 784 CESAREAN SECTION WITH STERILIZATION WITH CC N/A N/A N/A Per Case IP N/A N/A N/A " 5,233.00 " N/A " 5,233.00 " " 5,233.00 " 785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 8,589.18 " N/A " 9,180.46 " " 8,589.18 " " 9,180.46 " 785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC N/A N/A N/A Per Case IP N/A N/A N/A " 3,802.00 " N/A " 3,802.00 " " 3,802.00 " 786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,930.88 " N/A " 15,958.73 " " 14,930.88 " " 15,958.73 " 786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC N/A N/A N/A Per Case IP N/A N/A N/A " 5,233.00 " N/A " 5,233.00 " " 5,233.00 " 787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 9,972.38 " N/A " 10,658.88 " " 9,972.38 " " 10,658.88 " 787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC N/A N/A N/A Per Case IP N/A N/A N/A " 5,233.00 " N/A " 5,233.00 " " 5,233.00 " 788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 8,324.55 " N/A " 8,897.61 " " 8,324.55 " " 8,897.61 " 788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC N/A N/A N/A Per Case IP N/A N/A N/A " 3,802.00 " N/A " 3,802.00 " " 3,802.00 " 789 "NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY" N/A N/A N/A MS-DRG IP N/A N/A N/A " 24,108.84 " " 17,236.56 " " 17,236.56 " " 24,108.84 " 789 "NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY" N/A N/A N/A Per Diem IP N/A N/A " 1,530.00 " " 1,800.00 " N/A " 1,530.00 " " 1,800.00 " 790 "EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE" N/A N/A N/A MS-DRG IP N/A N/A N/A N/A " 56,841.01 " " 56,841.01 " " 56,841.01 " 790 "EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE" N/A N/A N/A Per Diem IP N/A N/A " 3,468.00 " " 1,800.00 " N/A " 1,800.00 " " 3,468.00 " 791 PREMATURITY WITH MAJOR PROBLEMS N/A N/A N/A MS-DRG IP N/A N/A N/A N/A " 38,820.11 " " 38,820.11 " " 38,820.11 " 791 PREMATURITY WITH MAJOR PROBLEMS N/A N/A N/A Per Diem IP N/A N/A " 2,244.00 " " 1,800.00 " N/A " 1,800.00 " " 2,244.00 " 792 PREMATURITY WITHOUT MAJOR PROBLEMS N/A N/A N/A MS-DRG IP N/A N/A N/A N/A " 23,423.06 " " 23,423.06 " " 23,423.06 " 792 PREMATURITY WITHOUT MAJOR PROBLEMS N/A N/A N/A Per Diem IP N/A N/A " 1,530.00 " " 1,800.00 " N/A " 1,530.00 " " 1,800.00 " 793 FULL TERM NEONATE WITH MAJOR PROBLEMS N/A N/A N/A MS-DRG IP N/A N/A N/A N/A " 39,876.27 " " 39,876.27 " " 39,876.27 " 793 FULL TERM NEONATE WITH MAJOR PROBLEMS N/A N/A N/A Per Diem IP N/A N/A " 2,244.00 " " 1,800.00 " N/A " 1,800.00 " " 2,244.00 " 794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS N/A N/A N/A MS-DRG IP N/A N/A N/A N/A " 14,114.22 " " 14,114.22 " " 14,114.22 " 794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS N/A N/A N/A Per Diem IP N/A N/A " 1,530.00 " " 1,800.00 " N/A " 1,530.00 " " 1,800.00 " 795 NORMAL NEWBORN N/A N/A N/A MS-DRG IP N/A N/A N/A N/A " 1,910.72 " " 1,910.72 " " 1,910.72 " 795 NORMAL NEWBORN N/A N/A N/A Per Diem IP N/A N/A " 1,020.00 " 422.00 N/A 422.00 " 1,020.00 " 796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,021.17 " N/A " 10,711.04 " " 10,021.17 " " 10,711.04 " 796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC N/A N/A N/A Per Case IP N/A N/A N/A " 5,703.00 " N/A " 5,703.00 " " 5,703.00 " 797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 8,632.34 " N/A " 9,226.60 " " 8,632.34 " " 9,226.60 " 796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC N/A N/A N/A Per Case IP N/A N/A N/A " 5,703.00 " N/A " 5,703.00 " " 5,703.00 " 798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 7,763.38 " N/A " 8,297.82 " " 7,763.38 " " 8,297.82 " 796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC N/A N/A N/A Per Case IP N/A N/A N/A " 5,703.00 " N/A " 5,703.00 " " 5,703.00 " 799 SPLENECTOMY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 78,701.67 " " 72,163.77 " " 51,593.32 " " 51,593.32 " " 78,701.67 " 800 SPLENECTOMY WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 45,156.42 " " 41,405.19 " " 29,602.54 " " 29,602.54 " " 45,156.42 " 801 SPLENECTOMY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,757.55 " " 23,617.82 " " 16,885.51 " " 16,885.51 " " 25,757.55 " 802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 56,743.11 " " 52,029.35 " " 37,198.26 " " 37,198.26 " " 56,743.11 " 803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 28,837.44 " " 26,441.86 " " 18,904.54 " " 18,904.54 " " 28,837.44 " 804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,872.26 " " 19,138.36 " " 13,682.93 " " 13,682.93 " " 20,872.26 " 805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 9,635.49 " N/A " 10,298.80 " " 9,635.49 " " 10,298.80 " N/A N/A N/A Per Case IP N/A N/A N/A " 3,467.00 " N/A " 3,467.00 " " 3,467.00 " 806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 6,886.92 " N/A " 7,361.02 " " 6,886.92 " " 7,361.02 " N/A N/A N/A Per Case IP N/A N/A N/A " 3,467.00 " N/A " 3,467.00 " " 3,467.00 " 807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 6,016.08 " N/A " 6,430.23 " " 6,016.08 " " 6,430.23 " N/A N/A N/A Per Case IP N/A N/A N/A " 2,852.00 " N/A " 2,852.00 " " 2,852.00 " 808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 33,321.87 " " 30,553.76 " " 21,844.34 " " 21,844.34 " " 33,321.87 " 809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 18,692.01 " " 17,139.23 " " 12,253.65 " " 12,253.65 " " 18,692.01 " 810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,698.71 " " 13,477.66 " " 9,635.82 " " 9,635.82 " " 14,698.71 " 811 RED BLOOD CELL DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,077.28 " " 19,326.35 " " 13,817.33 " " 13,817.33 " " 21,077.28 " 812 RED BLOOD CELL DISORDERS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,459.41 " " 12,341.31 " " 8,823.39 " " 8,823.39 " " 13,459.41 " 813 COAGULATION DISORDERS N/A N/A N/A MS-DRG IP N/A N/A " 23,633.91 " " 21,670.60 " " 15,493.34 " " 15,493.34 " " 23,633.91 " 814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,927.71 " " 26,524.63 " " 18,963.72 " " 18,963.72 " " 28,927.71 " 815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,185.25 " " 13,923.78 " " 9,954.78 " " 9,954.78 " " 15,185.25 " 816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,111.77 " " 9,271.77 " " 6,628.83 " " 6,628.83 " " 10,111.77 " 817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 35,217.54 " " 32,291.95 " " 23,087.05 " " 23,087.05 " " 35,217.54 " 818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 20,142.45 " " 18,469.18 " " 13,204.50 " " 13,204.50 " " 20,142.45 " 819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,267.87 " " 13,999.54 " " 10,008.94 " " 10,008.94 " " 15,267.87 " 820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 87,015.69 " " 79,787.13 " " 57,043.62 " " 57,043.62 " " 87,015.69 " 821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,973.03 " " 30,233.90 " " 21,615.65 " " 21,615.65 " " 32,973.03 " 822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 19,149.48 " " 17,558.70 " " 12,553.55 " " 12,553.55 " " 19,149.48 " 823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 68,805.63 " " 63,089.82 " " 45,105.91 " " 45,105.91 " " 68,805.63 " 824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 36,149.31 " " 33,146.32 " " 23,697.88 " " 23,697.88 " " 36,149.31 " 825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,430.71 " " 19,650.42 " " 14,049.02 " " 14,049.02 " " 21,430.71 " 826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 77,063.04 " " 70,661.27 " " 50,519.10 " " 50,519.10 " " 77,063.04 " 827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 38,213.28 " " 35,038.83 " " 25,050.93 " " 25,050.93 " " 38,213.28 " 828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,668.81 " " 23,536.45 " " 16,827.33 " " 16,827.33 " " 25,668.81 " 829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 49,047.21 " " 44,972.77 " " 32,153.17 " " 32,153.17 " " 49,047.21 " 830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,590.45 " " 20,713.82 " " 14,809.30 " " 14,809.30 " " 22,590.45 " 831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,152.83 " " 15,727.91 " " 11,244.63 " " 11,244.63 " " 17,152.83 " 832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 11,930.94 " " 10,939.81 " " 7,821.39 " " 7,821.39 " " 11,930.94 " 833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 8,200.80 " " 7,519.54 " " 5,376.08 " " 5,376.08 " " 8,200.80 " 834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 92,566.53 " " 84,876.85 " " 60,682.50 " " 60,682.50 " " 92,566.53 " 835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,339.61 " " 29,653.10 " " 21,200.41 " " 21,200.41 " " 32,339.61 " 836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,894.88 " " 16,408.32 " " 11,731.09 " " 11,731.09 " " 17,894.88 " 837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 87,196.23 " " 79,952.67 " " 57,161.97 " " 57,161.97 " " 87,196.23 " 838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT N/A N/A N/A MS-DRG IP N/A N/A " 34,559.64 " " 31,688.71 " " 22,655.76 " " 22,655.76 " " 34,559.64 " 839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,740.39 " " 20,851.30 " " 14,907.59 " " 14,907.59 " " 22,740.39 " 840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 49,200.21 " " 45,113.06 " " 32,253.47 " " 32,253.47 " " 49,200.21 " 841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 24,798.24 " " 22,738.20 " " 16,256.62 " " 16,256.62 " " 24,798.24 " 842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,758.09 " " 15,365.96 " " 10,985.86 " " 10,985.86 " " 16,758.09 " 843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,114.37 " " 26,695.78 " " 19,086.09 " " 19,086.09 " " 29,114.37 " 844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 18,061.65 " " 16,561.23 " " 11,840.42 " " 11,840.42 " " 18,061.65 " 845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,965.22 " " 11,888.17 " " 8,499.42 " " 8,499.42 " " 12,965.22 " 846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 40,849.47 " " 37,456.03 " " 26,779.10 " " 26,779.10 " " 40,849.47 " 847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 20,428.56 " " 18,731.52 " " 13,392.06 " " 13,392.06 " " 20,428.56 " 848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,743.70 " " 14,435.84 " " 10,320.87 " " 10,320.87 " " 15,743.70 " 849 RADIOTHERAPY N/A N/A N/A MS-DRG IP N/A N/A " 38,058.75 " " 34,897.14 " " 24,949.63 " " 24,949.63 " " 38,058.75 " 853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 75,652.38 " " 69,367.79 " " 49,594.34 " " 49,594.34 " " 75,652.38 " 854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 32,044.32 " " 29,382.34 " " 21,006.83 " " 21,006.83 " " 32,044.32 " 855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,873.50 " " 20,973.36 " " 14,994.85 " " 14,994.85 " " 22,873.50 " 856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 69,549.21 " " 63,771.63 " " 45,593.37 " " 45,593.37 " " 69,549.21 " 857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 31,130.91 " " 28,544.81 " " 20,408.04 " " 20,408.04 " " 31,130.91 " 858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 20,630.52 " " 18,916.70 " " 13,524.45 " " 13,524.45 " " 20,630.52 " 862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,745.64 " " 26,357.69 " " 18,844.36 " " 18,844.36 " " 28,745.64 " 863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,954.22 " " 13,711.94 " " 9,803.32 " " 9,803.32 " " 14,954.22 " 864 FEVER AND INFLAMMATORY CONDITIONS N/A N/A N/A MS-DRG IP N/A N/A " 13,387.50 " " 12,275.38 " " 8,776.25 " " 8,776.25 " " 13,387.50 " 865 VIRAL ILLNESS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,627.17 " " 20,747.49 " " 14,833.37 " " 14,833.37 " " 22,627.17 " 866 VIRAL ILLNESS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,809.16 " " 11,745.08 " " 8,397.12 " " 8,397.12 " " 12,809.16 " 867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 34,111.35 " " 31,277.66 " " 22,361.89 " " 22,361.89 " " 34,111.35 " 868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 16,193.52 " " 14,848.29 " " 10,615.75 " " 10,615.75 " " 16,193.52 " 869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,107.80 " " 10,185.05 " " 7,281.78 " " 7,281.78 " " 11,107.80 " 870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS N/A N/A N/A MS-DRG IP N/A N/A " 98,299.44 " " 90,133.52 " " 64,440.74 " " 64,440.74 " " 98,299.44 " 871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,583.46 " " 26,208.98 " " 18,738.05 " " 18,738.05 " " 28,583.46 " 872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 15,630.48 " " 14,332.03 " " 10,246.65 " " 10,246.65 " " 15,630.48 " 876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS N/A N/A N/A MS-DRG IP N/A N/A " 49,897.89 " " 45,752.78 " " 32,710.84 " " 32,710.84 " " 49,897.89 " 880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION N/A N/A N/A MS-DRG IP N/A N/A " 13,213.08 " " 12,115.44 " " 8,661.91 " " 8,661.91 " " 13,213.08 " 881 DEPRESSIVE NEUROSES N/A N/A N/A MS-DRG IP N/A N/A " 12,261.42 " " 11,242.84 " " 8,038.04 " " 8,038.04 " " 12,261.42 " 882 NEUROSES EXCEPT DEPRESSIVE N/A N/A N/A MS-DRG IP N/A N/A " 12,591.90 " " 11,545.87 " " 8,254.69 " " 8,254.69 " " 12,591.90 " 883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL N/A N/A N/A MS-DRG IP N/A N/A " 24,147.99 " " 22,141.97 " " 15,830.35 " " 15,830.35 " " 24,147.99 " 884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY N/A N/A N/A MS-DRG IP N/A N/A " 22,090.14 " " 20,255.07 " " 14,481.31 " " 14,481.31 " " 22,090.14 " 885 PSYCHOSES N/A N/A N/A MS-DRG IP N/A N/A " 18,927.63 " " 17,355.28 " " 12,408.11 " " 12,408.11 " " 18,927.63 " 886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS N/A N/A N/A MS-DRG IP N/A N/A " 18,688.95 " " 17,136.42 " " 12,251.65 " " 12,251.65 " " 18,688.95 " 887 OTHER MENTAL DISORDER DIAGNOSES N/A N/A N/A MS-DRG IP N/A N/A " 16,504.11 " " 15,133.08 " " 10,819.36 " " 10,819.36 " " 16,504.11 " 894 "ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA" N/A N/A N/A MS-DRG IP N/A N/A " 8,376.75 " " 7,680.88 " " 5,491.43 " " 5,491.43 " " 8,376.75 " 895 "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY" N/A N/A N/A MS-DRG IP N/A N/A " 24,357.60 " " 22,334.17 " " 15,967.76 " " 15,967.76 " " 24,357.60 " 896 "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 27,188.10 " " 24,929.53 " " 17,823.31 " " 17,823.31 " " 27,188.10 " 897 "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 12,630.15 " " 11,580.94 " " 8,279.77 " " 8,279.77 " " 12,630.15 " 901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 65,211.66 " " 59,794.40 " " 42,749.87 " " 42,749.87 " " 65,211.66 " 902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 30,024.72 " " 27,530.51 " " 19,682.87 " " 19,682.87 " " 30,024.72 " 903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,356.32 " " 15,914.50 " " 11,378.03 " " 11,378.03 " " 17,356.32 " 904 SKIN GRAFTS FOR INJURIES WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 56,937.42 " " 52,207.52 " " 37,325.64 " " 37,325.64 " " 56,937.42 " 905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,192.98 " " 23,100.15 " " 16,515.40 " " 16,515.40 " " 25,192.98 " 906 HAND PROCEDURES FOR INJURIES N/A N/A N/A MS-DRG IP N/A N/A " 27,445.14 " " 25,165.22 " " 17,991.81 " " 17,991.81 " " 27,445.14 " 907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 60,543.63 " " 55,514.16 " " 39,689.71 " " 39,689.71 " " 60,543.63 " 908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 31,218.12 " " 28,624.77 " " 20,465.21 " " 20,465.21 " " 31,218.12 " 909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 21,031.38 " " 19,284.26 " " 13,787.24 " " 13,787.24 " " 21,031.38 " 913 TRAUMATIC INJURY WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,036.92 " " 22,957.06 " " 16,413.09 " " 16,413.09 " " 25,036.92 " 914 TRAUMATIC INJURY WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,595.58 " " 12,466.17 " " 8,912.66 " " 8,912.66 " " 13,595.58 " 915 ALLERGIC REACTIONS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,973.28 " " 23,815.63 " " 17,026.93 " " 17,026.93 " " 25,973.28 " 916 ALLERGIC REACTIONS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,056.69 " " 9,221.26 " " 6,592.72 " " 6,592.72 " " 10,056.69 " 917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,605.75 " " 20,727.85 " " 14,819.33 " " 14,819.33 " " 22,605.75 " 918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,103.83 " " 11,098.34 " " 7,934.73 " " 7,934.73 " " 12,103.83 " 919 COMPLICATIONS OF TREATMENT WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 28,066.32 " " 25,734.80 " " 18,399.03 " " 18,399.03 " " 28,066.32 " 920 COMPLICATIONS OF TREATMENT WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 15,717.69 " " 14,411.99 " " 10,303.82 " " 10,303.82 " " 15,717.69 " 921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 10,578.42 " " 9,699.65 " " 6,934.74 " " 6,934.74 " " 10,578.42 " 922 "OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC" N/A N/A N/A MS-DRG IP N/A N/A " 24,290.28 " " 22,272.44 " " 15,923.63 " " 15,923.63 " " 24,290.28 " 923 "OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC" N/A N/A N/A MS-DRG IP N/A N/A " 14,235.12 " " 13,052.58 " " 9,331.91 " " 9,331.91 " " 14,235.12 " 927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT N/A N/A N/A MS-DRG IP N/A N/A " 321,772.77 " " 295,042.50 " " 210,939.93 " " 210,939.93 " " 321,772.77 " 928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 99,850.86 " " 91,556.06 " " 65,457.79 " " 65,457.79 " " 99,850.86 " 929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 46,036.17 " " 42,211.86 " " 30,179.27 " " 30,179.27 " " 46,036.17 " 933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT N/A N/A N/A MS-DRG IP N/A N/A " 34,541.28 " " 31,671.87 " " 22,643.73 " " 22,643.73 " " 34,541.28 " 934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY N/A N/A N/A MS-DRG IP N/A N/A " 29,686.59 " " 27,220.47 " " 19,461.21 " " 19,461.21 " " 29,686.59 " 935 NON-EXTENSIVE BURNS N/A N/A N/A MS-DRG IP N/A N/A " 29,579.49 " " 27,122.27 " " 19,391.00 " " 19,391.00 " " 29,579.49 " 939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 51,808.86 " " 47,505.00 " " 33,963.59 " " 33,963.59 " " 51,808.86 " 940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 33,929.28 " " 31,110.71 " " 22,242.53 " " 22,242.53 " " 33,929.28 " 941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 29,447.91 " " 27,001.62 " " 19,304.74 " " 19,304.74 " " 29,447.91 " 945 REHABILITATION WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 22,715.91 " " 20,828.86 " " 14,891.54 " " 14,891.54 " " 22,715.91 " 946 REHABILITATION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,246.16 " " 15,813.49 " " 11,305.82 " " 11,305.82 " " 17,246.16 " 947 SIGNS AND SYMPTOMS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 18,208.53 " " 16,695.91 " " 11,936.70 " " 11,936.70 " " 18,208.53 " 948 SIGNS AND SYMPTOMS WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 12,019.68 " " 11,021.18 " " 7,879.57 " " 7,879.57 " " 12,019.68 " 949 AFTERCARE WITH CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 16,938.63 " " 15,531.51 " " 11,104.21 " " 11,104.21 " " 16,938.63 " 950 AFTERCARE WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 11,305.17 " " 10,366.03 " " 7,411.17 " " 7,411.17 " " 11,305.17 " 951 OTHER FACTORS INFLUENCING HEALTH STATUS N/A N/A N/A MS-DRG IP N/A N/A " 8,540.46 " " 7,830.99 " " 5,598.75 " " 5,598.75 " " 8,540.46 " 955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA N/A N/A N/A MS-DRG IP N/A N/A " 96,206.40 " " 88,214.35 " " 63,068.64 " " 63,068.64 " " 96,206.40 " 956 "LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA" N/A N/A N/A MS-DRG IP N/A N/A " 58,886.64 " " 53,994.82 " " 38,603.46 " " 38,603.46 " " 58,886.64 " 957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 113,538.24 " " 104,106.40 " " 74,430.62 " " 74,430.62 " " 113,538.24 " 958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 64,342.62 " " 58,997.56 " " 42,180.16 " " 42,180.16 " " 64,342.62 " 959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 41,833.26 " " 38,358.09 " " 27,424.03 " " 27,424.03 " " 41,833.26 " 963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 41,680.26 " " 38,217.80 " " 27,323.73 " " 27,323.73 " " 41,680.26 " 964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 22,772.52 " " 20,880.76 " " 14,928.65 " " 14,928.65 " " 22,772.52 " 965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 13,967.37 " " 12,807.07 " " 9,156.39 " " 9,156.39 " " 13,967.37 " 969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 88,547.22 " " 81,191.43 " " 58,047.62 " " 58,047.62 " " 88,547.22 " 970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC N/A N/A N/A MS-DRG IP N/A N/A " 45,060.03 " " 41,316.81 " " 29,539.35 " " 29,539.35 " " 45,060.03 " 974 HIV WITH MAJOR RELATED CONDITION WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 41,091.21 " " 37,677.69 " " 26,937.57 " " 26,937.57 " " 41,091.21 " 975 HIV WITH MAJOR RELATED CONDITION WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 19,570.23 " " 17,944.49 " " 12,829.37 " " 12,829.37 " " 19,570.23 " 976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 14,521.23 " " 13,314.92 " " 9,519.47 " " 9,519.47 " " 14,521.23 " 977 HIV WITH OR WITHOUT OTHER RELATED CONDITION N/A N/A N/A MS-DRG IP N/A N/A " 20,208.24 " " 18,529.50 " " 13,247.62 " " 13,247.62 " " 20,208.24 " 981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 70,499.34 " " 64,642.83 " " 46,216.23 " " 46,216.23 " " 70,499.34 " 982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 38,880.36 " " 35,650.49 " " 25,488.24 " " 25,488.24 " " 38,880.36 " 983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 25,318.44 " " 23,215.19 " " 16,597.64 " " 16,597.64 " " 25,318.44 " 987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC N/A N/A N/A MS-DRG IP N/A N/A " 49,910.13 " " 45,764.00 " " 32,718.86 " " 32,718.86 " " 49,910.13 " 988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC N/A N/A N/A MS-DRG IP N/A N/A " 25,714.71 " " 23,578.54 " " 16,857.42 " " 16,857.42 " " 25,714.71 " 989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC N/A N/A N/A MS-DRG IP N/A N/A " 17,073.27 " " 15,654.96 " " 11,192.48 " " 11,192.48 " " 17,073.27 " 12000002 HC R&B HOSPICE SEMI-PRIVATE 120 51 % of Charges OP 425.00 284.75 284.75 276.25 284.75 276.25 284.75 12000003 HC R&B IC SEMI-PRIVATE 120 52 % of Charges OP " 1,290.00 " 864.30 864.30 838.50 864.30 838.50 864.30 12000001 HC R&B SEMI-PRIVATE 120 51 % of Charges OP " 1,360.00 " 911.20 911.20 884.00 911.20 884.00 911.20 12400001 HC R&B SEMI-PRIVATE PSYCH 124 51 % of Charges OP " 1,730.00 " " 1,159.10 " " 1,159.10 " " 1,124.50 " " 1,159.10 " " 1,124.50 " " 1,159.10 " 12400003 HC R&B AFFECTIVE DISORDERS SEMI-PRIV 124 51 % of Charges OP " 1,860.00 " " 1,246.20 " " 1,246.20 " " 1,209.00 " " 1,246.20 " " 1,209.00 " " 1,246.20 " 12400002 HC R&B SR MENTAL HEALTH SEMI-PRIV 124 51 % of Charges OP " 1,940.00 " " 1,299.80 " " 1,299.80 " " 1,261.00 " " 1,299.80 " " 1,261.00 " " 1,299.80 " 12400004 HC R&B YOUTH MH SEMI-PRIVATE 124 51 % of Charges OP " 2,140.00 " " 1,433.80 " " 1,433.80 " " 1,391.00 " " 1,433.80 " " 1,391.00 " " 1,433.80 " 12600001 HC R&B DETOX 126 51 % of Charges OP " 1,800.00 " " 1,206.00 " " 1,206.00 " " 1,170.00 " " 1,206.00 " " 1,170.00 " " 1,206.00 " 12600001 HC R&B DETOX 126 52 % of Charges OP " 1,800.00 " " 1,206.00 " " 1,206.00 " " 1,170.00 " " 1,206.00 " " 1,170.00 " " 1,206.00 " 12800001 HC R&B SEMI-PRIVATE REHAB 128 51 % of Charges OP " 1,320.00 " 884.40 884.40 858.00 884.40 858.00 884.40 17100001 HC R&B NEWBORN LEVEL I 171 51 % of Charges OP 935.00 626.45 626.45 607.75 626.45 607.75 626.45 17200001 HC R&B NEWBORN LEVEL II 172 51 % of Charges OP " 2,575.00 " " 1,725.25 " " 1,725.25 " " 1,673.75 " " 1,725.25 " " 1,673.75 " " 1,725.25 " 17300001 HC R&B NEWBORN LEVEL III 173 51 % of Charges OP " 3,170.00 " " 2,123.90 " " 2,123.90 " " 2,060.50 " " 2,123.90 " " 2,060.50 " " 2,123.90 " 17400001 HC R&B NEWBORN LEVEL IV 174 51 % of Charges OP " 4,440.00 " " 2,974.80 " " 2,974.80 " " 2,886.00 " " 2,974.80 " " 2,886.00 " " 2,974.80 " 20000001 HC R&B INTENSIVE CARE 200 51 % of Charges OP " 3,350.00 " " 2,244.50 " " 2,244.50 " " 2,177.50 " " 2,244.50 " " 2,177.50 " " 2,244.50 " 20300001 HC R&B PEDIATRIC PROGRESSIVE 203 51 % of Charges OP " 2,445.00 " " 1,638.15 " " 1,638.15 " " 1,589.25 " " 1,638.15 " " 1,589.25 " " 1,638.15 " 20400001 HC R&B INTENSIVE PSYCH 204 51 % of Charges OP " 2,245.00 " " 1,504.15 " " 1,504.15 " " 1,459.25 " " 1,504.15 " " 1,459.25 " " 1,504.15 " 20600001 HC R&B PROGRESSIVE 206 51 % of Charges OP " 2,445.00 " " 1,638.15 " " 1,638.15 " " 1,589.25 " " 1,638.15 " " 1,589.25 " " 1,638.15 " 20800001 HC R&B INTENSIVE CARE TRAUMA 208 51 % of Charges OP " 3,350.00 " " 2,244.50 " " 2,244.50 " " 2,177.50 " " 2,244.50 " " 2,177.50 " " 2,244.50 " 21000001 HC R&B CORONARY CARE 210 51 % of Charges OP " 3,350.00 " " 2,244.50 " " 2,244.50 " " 2,177.50 " " 2,244.50 " " 2,177.50 " " 2,244.50 " 76100014 HC TX RM IV THER 31-1HR HYDR 260 96360 51 % of Charges OP 381.00 410.84 255.27 247.65 440.00 247.65 440.00 76100014 HC TX RM IV THER 31-1HR HYDR 260 96360 234 % of Charges OP 381.00 410.84 255.27 247.65 440.00 247.65 440.00 76100046 HC TX RM IV THER ADL HR HYD 260 96361 51 % of Charges OP 136.00 79.61 91.12 88.40 85.00 79.61 91.12 76100046 HC TX RM IV THER ADL HR HYD 260 96361 234 % of Charges OP 136.00 79.61 91.12 88.40 85.00 79.61 91.12 76100015 HC TX RM IV THER 1STHR NON-H 260 96365 51 % of Charges OP 468.00 410.84 313.56 304.20 440.00 304.20 440.00 76100015 HC TX RM IV THER 1STHR NON-H 260 96365 234 % of Charges OP 468.00 410.84 313.56 304.20 440.00 304.20 440.00 76100016 HC TX RM IV ADL HR SAME DRG 260 96366 51 % of Charges OP 136.00 79.61 91.12 88.40 85.00 79.61 91.12 76100016 HC TX RM IV ADL HR SAME DRG 260 96366 234 % of Charges OP 136.00 79.61 91.12 88.40 85.00 79.61 91.12 76100017 HC TX RM IV THER ADL INFUS 260 96367 51 % of Charges OP 136.00 125.13 91.12 88.40 134.00 88.40 134.00 76100017 HC TX RM IV THER ADL INFUS 260 96367 234 % of Charges OP 136.00 125.13 91.12 88.40 134.00 88.40 134.00 76100018 HC TX RM IV THER CONCUR INF 260 96368 51 % of Charges OP 109.00 75.00 73.03 70.85 80.00 70.85 80.00 76100018 HC TX RM IV THER CONCUR INF 260 96368 234 % of Charges OP 109.00 75.00 73.03 70.85 80.00 70.85 80.00 76100019 HC TX RM INJECT NON CHEMO 260 96372 51 % of Charges OP 161.00 125.13 107.87 104.65 134.00 104.65 134.00 76100019 HC TX RM INJECT NON CHEMO 260 96372 234 % of Charges OP 161.00 125.13 107.87 104.65 134.00 104.65 134.00 26000005 HC NON-CHEMO IV PUSH 260 96374 51 % of Charges OP 273.00 410.84 182.91 177.45 440.00 177.45 440.00 26000005 HC NON-CHEMO IV PUSH 260 96374 234 % of Charges OP 273.00 410.84 182.91 177.45 440.00 177.45 440.00 76100021 HC TX RM IV PUSH DIFF DRUG 260 96375 51 % of Charges OP 178.00 79.61 119.26 115.70 85.00 79.61 119.26 76100021 HC TX RM IV PUSH DIFF DRUG 260 96375 234 % of Charges OP 178.00 79.61 119.26 115.70 85.00 79.61 119.26 76100022 HC SUBS IV PUSH OF SAME DRUG 260 96376 51 % of Charges OP 172.00 69.00 115.24 111.80 74.00 69.00 115.24 76100022 HC SUBS IV PUSH OF SAME DRUG 260 96376 234 % of Charges OP 172.00 69.00 115.24 111.80 74.00 69.00 115.24 27000225 HC BALLOON POWERFLEX 270 C1725 51 % of Charges OP 360.00 180.00 241.20 234.00 180.00 180.00 241.20 27000226 HC THORACENTESIS CATHETER 270 C1729 51 % of Charges OP 230.00 115.00 154.10 149.50 115.00 115.00 154.10 27000157 HC KIT CATH CVL MULTI LUMEN 270 C1751 51 % of Charges OP 467.00 233.50 312.89 303.55 233.50 233.50 312.89 27000227 HC NEO/PED INTRODUCER FOR PICC 270 C1894 51 % of Charges OP 160.00 80.00 107.20 104.00 80.00 80.00 107.20 27000119 HC CAUTERY FINE HI-TEMP DISP 270 51 % of Charges OP 3.00 1.50 2.01 1.95 1.50 1.50 2.01 27000021 HC GAUZE PACKING PLAIN 1 IN 270 51 % of Charges OP 3.00 1.50 2.01 1.95 1.50 1.50 2.01 27000068 HC TRAY INSTRUMENT GEN PURPOSE 270 51 % of Charges OP 6.00 3.00 4.02 3.90 3.00 3.00 4.02 27000024 HC BARRIER SKIN NO STING 3ML 270 51 % of Charges OP 7.00 3.50 4.69 4.55 3.50 3.50 4.69 27000039 HC KIT CATH FEMALE GLOVE 8FR 270 51 % of Charges OP 7.00 3.50 4.69 4.55 3.50 3.50 4.69 27000069 HC REMOVER SKIN STAPLE UNIV 270 51 % of Charges OP 7.00 3.50 4.69 4.55 3.50 3.50 4.69 27000140 HC TUBE IV EXT 32IN 270 51 % of Charges OP 9.00 4.50 6.03 5.85 4.50 4.50 6.03 27000043 HC HOLDER TUBE TRACH VELCRO 270 51 % of Charges OP 10.00 5.00 6.70 6.50 5.00 5.00 6.70 27000134 "HC TAPE CASTING 2"" X 4YD" 270 51 % of Charges OP 10.00 5.00 6.70 6.50 5.00 5.00 6.70 27000004 HC EXERCISER VOLUMETRIC 270 51 % of Charges OP 12.00 6.00 8.04 7.80 6.00 6.00 8.04 27000062 HC BAG URINARY CATH LEG 270 51 % of Charges OP 13.00 6.50 8.71 8.45 6.50 6.50 8.71 27000141 HC BELT GAIT 54IN 270 51 % of Charges OP 13.00 6.50 8.71 8.45 6.50 6.50 8.71 27000131 HC DEVICE STATLOCK FOLEY 270 51 % of Charges OP 13.00 6.50 8.71 8.45 6.50 6.50 8.71 27000138 "HC TAPE CASTING 3""X4YD" 270 51 % of Charges OP 13.00 6.50 8.71 8.45 6.50 6.50 8.71 27000118 HC CATH HOLDER LEG BAND 270 51 % of Charges OP 14.00 7.00 9.38 9.10 7.00 7.00 9.38 27000137 HC DEVICE STATLOCK PEDI ULTRA 270 51 % of Charges OP 14.00 7.00 9.38 9.10 7.00 7.00 9.38 27000008 HC TUBE IV BLOOD SET YTYP NV PUMP 270 51 % of Charges OP 14.00 7.00 9.38 9.10 7.00 7.00 9.38 27000151 HC TUBE IV PRIMARY 80IN VENTED 270 51 % of Charges OP 14.00 7.00 9.38 9.10 7.00 7.00 9.38 27000228 HC HIRUDOSALT 270 51 % of Charges OP 15.00 7.50 10.05 9.75 7.50 7.50 10.05 27000100 HC SLING ARM SPECIALITY CHILD 270 51 % of Charges OP 15.00 7.50 10.05 9.75 7.50 7.50 10.05 27000099 HC SLING ARM STRAP PADDED LG 270 51 % of Charges OP 15.00 7.50 10.05 9.75 7.50 7.50 10.05 27000098 HC SLING ARM STRAP PADDED MED 270 51 % of Charges OP 15.00 7.50 10.05 9.75 7.50 7.50 10.05 27000097 HC SLING ARM STRAP PADDED SM 270 51 % of Charges OP 15.00 7.50 10.05 9.75 7.50 7.50 10.05 27000055 HC SLING STRAP XSM 18IN 270 51 % of Charges OP 15.00 7.50 10.05 9.75 7.50 7.50 10.05 27000229 HC LEECHES - ORDERED DURING REGULAR HOURS (8:00 AM - 2:45PM CST) 270 51 % of Charges OP 15.15 7.58 10.15 9.85 7.58 7.58 10.15 27000067 HC BAG URINARY DRAINAGE 2000ML 270 51 % of Charges OP 16.00 8.00 10.72 10.40 8.00 8.00 10.72 27000149 HC CASSETTE INFUSION PRIMARY 270 51 % of Charges OP 16.00 8.00 10.72 10.40 8.00 8.00 10.72 27000092 HC SLING ARM INFANT 270 51 % of Charges OP 16.00 8.00 10.72 10.40 8.00 8.00 10.72 27000095 HC SLING ARM SPECIALITY LG 270 51 % of Charges OP 16.00 8.00 10.72 10.40 8.00 8.00 10.72 27000094 HC SLING ARM SPECIALITY MED 270 51 % of Charges OP 16.00 8.00 10.72 10.40 8.00 8.00 10.72 27000093 HC SLING ARM SPECIALITY SM 270 51 % of Charges OP 16.00 8.00 10.72 10.40 8.00 8.00 10.72 27000096 HC SLING ARM SPECIALITY X-LG 270 51 % of Charges OP 16.00 8.00 10.72 10.40 8.00 8.00 10.72 27000117 HC SHOE POST-OP FEMALE LG 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000116 HC SHOE POST-OP FEMALE MED 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000115 HC SHOE POST-OP FEMALE SM 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000114 HC SHOE POST-OP MALE LG 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000113 HC SHOE POST-OP MALE MED 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000112 HC SHOE POST-OP MALE SM 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000121 HC SUTURE A 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000135 "HC TAPE CASTING 4""X4YD" 270 51 % of Charges OP 17.00 8.50 11.39 11.05 8.50 8.50 11.39 27000230 HC LEECHES - ORDERED OUTSIDE OF REGULAR HOURS (8:00AM - 2:45PM) 270 51 % of Charges OP 17.15 8.58 11.49 11.15 8.58 8.58 11.49 27000101 HC STRAP CLAVICLE INFANT 270 51 % of Charges OP 18.00 9.00 12.06 11.70 9.00 9.00 12.06 27000104 HC STRAP CLAVICLE LG 270 51 % of Charges OP 18.00 9.00 12.06 11.70 9.00 9.00 12.06 27000103 HC STRAP CLAVICLE MED 270 51 % of Charges OP 18.00 9.00 12.06 11.70 9.00 9.00 12.06 27000102 HC STRAP CLAVICLE SM 270 51 % of Charges OP 18.00 9.00 12.06 11.70 9.00 9.00 12.06 27000139 HC VALVE ANTI REFLUX SALEM SUMP 270 51 % of Charges OP 18.00 9.00 12.06 11.70 9.00 9.00 12.06 27000111 HC SHOE CAST LG CANVAS 270 51 % of Charges OP 19.00 9.50 12.73 12.35 9.50 9.50 12.73 27000110 HC SHOE CAST MED CANVAS 270 51 % of Charges OP 19.00 9.50 12.73 12.35 9.50 9.50 12.73 27000109 HC SHOE CAST SM CANVAS 270 51 % of Charges OP 19.00 9.50 12.73 12.35 9.50 9.50 12.73 27000013 HC STAPLER SKIN MULTI SHOT STRL 270 51 % of Charges OP 19.00 9.50 12.73 12.35 9.50 9.50 12.73 27000049 HC STAPLER SKIN PRECISE 15 270 51 % of Charges OP 20.00 10.00 13.40 13.00 10.00 10.00 13.40 27000136 "HC TAPE CASTING 5"" X 4YD" 270 51 % of Charges OP 20.00 10.00 13.40 13.00 10.00 10.00 13.40 27000070 HC TUBE ASPIRATING 8CC STRL LUKI 270 51 % of Charges OP 20.00 10.00 13.40 13.00 10.00 10.00 13.40 27000129 HC GELATIN SURGIFOAM 12-7MM 270 51 % of Charges OP 21.00 10.50 14.07 13.65 10.50 10.50 14.07 27000038 HC TUBE FEEDING INFANT 5 X 20 270 51 % of Charges OP 21.00 10.50 14.07 13.65 10.50 10.50 14.07 27000122 HC VALVE LOPEZ 270 51 % of Charges OP 21.00 10.50 14.07 13.65 10.50 10.50 14.07 27000003 HC AEROCHAMBER FLOWSIGNAL 270 51 % of Charges OP 22.00 11.00 14.74 14.30 11.00 11.00 14.74 27000130 HC DRSG MEPILEX 6X8IN 270 51 % of Charges OP 22.00 11.00 14.74 14.30 11.00 11.00 14.74 27000091 HC SPLINT WRIST COCK-UP RT X-LG 270 51 % of Charges OP 22.00 11.00 14.74 14.30 11.00 11.00 14.74 27000090 HC SPLINT WRIST COCK-UP LT X-LG 270 51 % of Charges OP 23.00 11.50 15.41 14.95 11.50 11.50 15.41 27000044 HC TUBE LAVAGE RADIOPAQUE 36FR 270 51 % of Charges OP 23.00 11.50 15.41 14.95 11.50 11.50 15.41 27000050 HC TUBE SUMP 10FR W/PREVENT 270 51 % of Charges OP 23.00 11.50 15.41 14.95 11.50 11.50 15.41 27000051 HC TUBE SUMP 12FR W/PREVENT 270 51 % of Charges OP 23.00 11.50 15.41 14.95 11.50 11.50 15.41 27000052 HC TUBE SUMP 14FR ANTI-REFLUX 270 51 % of Charges OP 23.00 11.50 15.41 14.95 11.50 11.50 15.41 27000053 HC TUBE SUMP 16FR ANTI-REFLUX 270 51 % of Charges OP 23.00 11.50 15.41 14.95 11.50 11.50 15.41 27000054 HC TUBE SUMP 18FR ANTI-REFLUX 270 51 % of Charges OP 23.00 11.50 15.41 14.95 11.50 11.50 15.41 27000045 HC KIT SUCT TRACH SIZE CLOSED 270 51 % of Charges OP 24.00 12.00 16.08 15.60 12.00 12.00 16.08 27000017 HC FLOWMETER PEAK FULL RANGE 270 51 % of Charges OP 26.00 13.00 17.42 16.90 13.00 13.00 17.42 27000005 HC RESUSCITATOR 270 51 % of Charges OP 27.00 13.50 18.09 17.55 13.50 13.50 18.09 27000012 HC RESUSCITATOR PEDI TODDLER 270 51 % of Charges OP 27.00 13.50 18.09 17.55 13.50 13.50 18.09 27000031 HC CATH FOLEY PEDI 10FRX3CC STRL 270 51 % of Charges OP 28.00 14.00 18.76 18.20 14.00 14.00 18.76 27000030 HC CATH FOLEY PEDI 8FRX3CC STRL 270 51 % of Charges OP 28.00 14.00 18.76 18.20 14.00 14.00 18.76 27000042 HC HOLDER TUBE ENDOTRACHEAL 270 51 % of Charges OP 28.00 14.00 18.76 18.20 14.00 14.00 18.76 27000057 HC CATH TRACH SUCT CARE DIR TP 270 51 % of Charges OP 29.00 14.50 19.43 18.85 14.50 14.50 19.43 27000034 HC CATH FOLEY 16FRX5CC STRL 270 51 % of Charges OP 30.00 15.00 20.10 19.50 15.00 15.00 20.10 27000035 HC CATH FOLEY 18FRX5CC STRL 270 51 % of Charges OP 30.00 15.00 20.10 19.50 15.00 15.00 20.10 27000120 HC INFUSOR PRESSURE 500ML 270 51 % of Charges OP 30.00 15.00 20.10 19.50 15.00 15.00 20.10 27000082 HC STAPLER SURG SKIN PTW35 STRL 270 51 % of Charges OP 30.00 15.00 20.10 19.50 15.00 15.00 20.10 27000016 HC NDL HUBER 20GX.75/1/1.5IN BARD 270 51 % of Charges OP 31.00 15.50 20.77 20.15 15.50 15.50 20.77 27000032 HC CATH FOLEY 12FRX5CC STRL 270 51 % of Charges OP 32.00 16.00 21.44 20.80 16.00 16.00 21.44 27000033 HC CATH FOLEY 14FRX5CC STRL 270 51 % of Charges OP 32.00 16.00 21.44 20.80 16.00 16.00 21.44 27000037 HC CATH FOLEY 18FRX30CC STRL 270 51 % of Charges OP 32.00 16.00 21.44 20.80 16.00 16.00 21.44 27000073 HC URINEMETER W/DRAIN BAG 270 51 % of Charges OP 32.00 16.00 21.44 20.80 16.00 16.00 21.44 27000089 HC SPLINT WRIST COCK-UP LT LG 270 51 % of Charges OP 33.00 16.50 22.11 21.45 16.50 16.50 22.11 27000088 HC SPLINT WRIST COCK-UP LT MED 270 51 % of Charges OP 33.00 16.50 22.11 21.45 16.50 16.50 22.11 27000087 HC SPLINT WRIST COCK-UP LT SM 270 51 % of Charges OP 33.00 16.50 22.11 21.45 16.50 16.50 22.11 27000086 HC SPLINT WRIST COCK-UP RT LG 270 51 % of Charges OP 33.00 16.50 22.11 21.45 16.50 16.50 22.11 27000085 HC SPLINT WRIST COCK-UP RT MED 270 51 % of Charges OP 33.00 16.50 22.11 21.45 16.50 16.50 22.11 27000084 HC SPLINT WRIST COCK-UP RT SM 270 51 % of Charges OP 33.00 16.50 22.11 21.45 16.50 16.50 22.11 27000036 HC CATH FOLEY 16FRX30CC STRL 270 51 % of Charges OP 34.00 17.00 22.78 22.10 17.00 17.00 22.78 27000147 HC KIT DRSG CHNG 270 51 % of Charges OP 34.00 17.00 22.78 22.10 17.00 17.00 22.78 27000128 HC CLIP C02 270 51 % of Charges OP 35.00 17.50 23.45 22.75 17.50 17.50 23.45 27000148 HC CASSETTE INF BLOOD 270 51 % of Charges OP 36.00 18.00 24.12 23.40 18.00 18.00 24.12 27000133 HC DETECTOR CO2-EASY CAP/PEDI 270 51 % of Charges OP 36.00 18.00 24.12 23.40 18.00 18.00 24.12 27000041 HC CATH IV PERIPHERAL TWO LUMEN 270 51 % of Charges OP 41.00 20.50 27.47 26.65 20.50 20.50 27.47 27000075 HC TRAY LACERATION STRL 270 51 % of Charges OP 43.00 21.50 28.81 27.95 21.50 21.50 28.81 27000132 HC SENSOR SP02 NEO-L/MASIMO 270 51 % of Charges OP 44.00 22.00 29.48 28.60 22.00 22.00 29.48 27000040 HC SET CATH RADIAL ARTERY 20GA 270 51 % of Charges OP 44.00 22.00 29.48 28.60 22.00 22.00 29.48 27000010 HC KIT DRSG CENTRAL LINE 270 51 % of Charges OP 46.00 23.00 30.82 29.90 23.00 23.00 30.82 27000127 HC AEROCHAMBER MED PEDI YELLOW 270 51 % of Charges OP 47.00 23.50 31.49 30.55 23.50 23.50 31.49 27000143 HC PAD COLLAR REPLACEMENT 270 51 % of Charges OP 48.00 24.00 32.16 31.20 24.00 24.00 32.16 27000072 HC TRAY LUMBAR PUNCTURE PEDI 270 51 % of Charges OP 52.00 26.00 34.84 33.80 26.00 26.00 34.84 27000071 HC SPINAL DISP ADULT 270 51 % of Charges OP 54.00 27.00 36.18 35.10 27.00 27.00 36.18 27000007 HC FILTER W/GAS VENT 270 51 % of Charges OP 55.00 27.50 36.85 35.75 27.50 27.50 36.85 27000153 HC SPLINT OCL ARM SHORT 270 51 % of Charges OP 55.00 27.50 36.85 35.75 27.50 27.50 36.85 27000006 HC RESUSCITATOR INFANT 270 51 % of Charges OP 57.00 28.50 38.19 37.05 28.50 28.50 38.19 27000221 HC AORTIC PUMP - HOURLY 270 51 % of Charges OP 59.00 29.50 39.53 38.35 29.50 29.50 39.53 27000076 HC FILTER BLOOD TRANSFUSION STRL 270 51 % of Charges OP 59.00 29.50 39.53 38.35 29.50 29.50 39.53 27000107 HC IMMOBILIZER KNEE LG 19IN 270 51 % of Charges OP 59.00 29.50 39.53 38.35 29.50 29.50 39.53 27000106 HC IMMOBILIZER KNEE MED 19IN 270 51 % of Charges OP 59.00 29.50 39.53 38.35 29.50 29.50 39.53 27000105 HC IMMOBILIZER KNEE SM 19IN 270 51 % of Charges OP 59.00 29.50 39.53 38.35 29.50 29.50 39.53 27000108 HC IMMOBILIZER KNEE X-LG 19IN 270 51 % of Charges OP 59.00 29.50 39.53 38.35 29.50 29.50 39.53 27000025 HC TROCAR 28FRX16 IN STRL 270 51 % of Charges OP 60.00 30.00 40.20 39.00 30.00 30.00 40.20 27000126 HC KIT ARTERIAL LINE FEMORAL 270 51 % of Charges OP 61.00 30.50 40.87 39.65 30.50 30.50 40.87 27000027 HC CATH FOLEY COUDE 16FRX5CC 270 51 % of Charges OP 62.00 31.00 41.54 40.30 31.00 31.00 41.54 27000028 HC CATH FOLEY COUDE 18FRX5CC 270 51 % of Charges OP 62.00 31.00 41.54 40.30 31.00 31.00 41.54 27000169 HC PULSED LAVAGE TRACK TIP 270 51 % of Charges OP 62.00 31.00 41.54 40.30 31.00 31.00 41.54 27000155 HC SPLINT OCL LEG SHORT 270 51 % of Charges OP 64.00 32.00 42.88 41.60 32.00 32.00 42.88 27000065 HC TRAY CATH FOLEY 16FR W/STATLOC 270 51 % of Charges OP 64.00 32.00 42.88 41.60 32.00 32.00 42.88 27000026 HC CATH FOLEY COUDE 14FRX5CC 270 51 % of Charges OP 67.00 33.50 44.89 43.55 33.50 33.50 44.89 27000125 HC KIT MONITOR CATH LAB TRNSDUCER 270 51 % of Charges OP 67.00 33.50 44.89 43.55 33.50 33.50 44.89 27000080 HC LENS MEDIFLOW STRL MORGAN 270 51 % of Charges OP 67.00 33.50 44.89 43.55 33.50 33.50 44.89 27000056 HC BRACE ANKLE LT 270 51 % of Charges OP 71.00 35.50 47.57 46.15 35.50 35.50 47.57 27000011 HC KIT DRSG CHNG PICC 270 51 % of Charges OP 72.00 36.00 48.24 46.80 36.00 36.00 48.24 27000020 HC ADH SKIN STRL DERMABOND 270 51 % of Charges OP 74.00 37.00 49.58 48.10 37.00 37.00 49.58 27000074 HC TRAY URINEMETER 18FR W/STATLOC 270 51 % of Charges OP 79.00 39.50 52.93 51.35 39.50 39.50 52.93 27000066 HC TRAY URINEMETER W/STATLOC 270 51 % of Charges OP 79.00 39.50 52.93 51.35 39.50 39.50 52.93 27000168 HC PULSED LAVAGE TIP KIT 270 51 % of Charges OP 85.00 42.50 56.95 55.25 42.50 42.50 56.95 27000029 HC CATH GLAND BARTHOLIN 10FR X5CC 270 51 % of Charges OP 86.00 43.00 57.62 55.90 43.00 43.00 57.62 27000144 HC COLLAR CHILD ASPEN 270 51 % of Charges OP 88.00 44.00 58.96 57.20 44.00 44.00 58.96 27000061 HC INTRO CATH SHEATH 8FR 270 51 % of Charges OP 88.00 44.00 58.96 57.20 44.00 44.00 58.96 27000014 HC SET DRAINAGE CHEST 270 51 % of Charges OP 96.00 48.00 64.32 62.40 48.00 48.00 64.32 27000146 HC TUBE LINE EXT 270 51 % of Charges OP 98.00 49.00 65.66 63.70 49.00 49.00 65.66 27000081 HC KIT LAVAGE GASTRIC SOL BAG 270 51 % of Charges OP 102.00 51.00 68.34 66.30 51.00 51.00 68.34 27000152 HC SPLINT OCL ARM LONG 270 51 % of Charges OP 109.00 54.50 73.03 70.85 54.50 54.50 73.03 27000063 HC TRAY CATH 16FR X 5CC W/STATLOC 270 51 % of Charges OP 110.00 55.00 73.70 71.50 55.00 55.00 73.70 27000079 HC SET DRAINAGE CHEST ADULT PEDI 270 51 % of Charges OP 112.00 56.00 75.04 72.80 56.00 56.00 75.04 27000059 HC TRAY CATH PERC 8FR STRL 270 51 % of Charges OP 114.00 57.00 76.38 74.10 57.00 57.00 76.38 27000058 HC TRAY CATH PERC ART 6FR 270 51 % of Charges OP 114.00 57.00 76.38 74.10 57.00 57.00 76.38 27000046 HC KIT CATH CENT VENOUS PEDI 4FR 270 51 % of Charges OP 121.00 60.50 81.07 78.65 60.50 60.50 81.07 27000154 HC SPLINT OCL LEG LONG 270 51 % of Charges OP 127.00 63.50 85.09 82.55 63.50 63.50 85.09 27000145 HC COLLAR ADULT ASPEN 270 51 % of Charges OP 130.00 65.00 87.10 84.50 65.00 65.00 87.10 27000150 HC SET IV PUMP SOLUSET 270 51 % of Charges OP 130.00 65.00 87.10 84.50 65.00 65.00 87.10 27000167 HC PULSED LAVAGE IRRIGATOR KIT 270 51 % of Charges OP 140.00 70.00 93.80 91.00 70.00 70.00 93.80 27000083 HC ARM IMMOBILIZER 270 51 % of Charges OP 148.00 74.00 99.16 96.20 74.00 74.00 99.16 27000165 HC CONT PASSIVE MOTION DAILY 270 51 % of Charges OP 151.00 75.50 101.17 98.15 75.50 75.50 101.17 27000022 HC HEMOSTAT SURGICEL SM 2X3 270 51 % of Charges OP 153.00 76.50 102.51 99.45 76.50 76.50 102.51 27000077 HC KIT THORACENTESIS CATH 8FR 270 51 % of Charges OP 163.00 81.50 109.21 105.95 81.50 81.50 109.21 27000064 HC TRAY CATH URETHRAL 14FR STRL 270 51 % of Charges OP 170.00 85.00 113.90 110.50 85.00 85.00 113.90 27000047 HC KIT CATH CENT VENOUS PEDI 5FR 270 51 % of Charges OP 199.00 99.50 133.33 129.35 99.50 99.50 133.33 27000009 HC TRAY C SECTION STRL 270 51 % of Charges OP 240.00 120.00 160.80 156.00 120.00 120.00 160.80 27000019 HC TRAY PARACENTESIS 15G 3-.25IN 270 51 % of Charges OP 248.00 124.00 166.16 161.20 124.00 124.00 166.16 27000220 HC VEST AIRWAY CLEARANCE HILL-ROM 270 51 % of Charges OP 254.00 127.00 170.18 165.10 127.00 127.00 170.18 27000023 HC HEMOSTAT SURGICEL LG 4X8 270 51 % of Charges OP 279.00 139.50 186.93 181.35 139.50 139.50 186.93 27000158 HC RHINO PACK 270 51 % of Charges OP 281.00 140.50 188.27 182.65 140.50 140.50 188.27 27000156 HC SENSOR ST02 INSPECTRA 270 51 % of Charges OP 360.00 180.00 241.20 234.00 180.00 180.00 241.20 27000123 HC KIT CATH 7FR TWO LUMEN CVL MAC 270 51 % of Charges OP 435.00 217.50 291.45 282.75 217.50 217.50 291.45 27000060 HC SET IV FLUID WARMING LEVEL 1 270 51 % of Charges OP 500.00 250.00 335.00 325.00 250.00 250.00 335.00 27000048 HC KIT CATH CVL QUAD ARROWGARD 270 51 % of Charges OP 536.00 268.00 359.12 348.40 268.00 268.00 359.12 27000018 HC KIT CATH CVL QUAD LUMEN 270 51 % of Charges OP 536.00 268.00 359.12 348.40 268.00 268.00 359.12 27000078 HC KIT PERICARDIOCENTESIS STRL 270 51 % of Charges OP 669.00 334.50 448.23 434.85 334.50 334.50 448.23 27000124 HC ORTHOTIC PELV TRAUMA CYBERTECH 270 51 % of Charges OP 720.00 360.00 482.40 468.00 360.00 360.00 482.40 27000142 HC KIT PNEUMOTHORAX WAYNE 14FR 270 51 % of Charges OP 734.00 367.00 491.78 477.10 367.00 367.00 491.78 27000015 HC TRAY THORACIC VENT 270 51 % of Charges OP 940.00 470.00 629.80 611.00 470.00 470.00 629.80 27000166 HC N-TRAINER KIT 270 51 % of Charges OP " 2,208.00 " " 1,104.00 " " 1,479.36 " " 1,435.20 " " 1,104.00 " " 1,104.00 " " 1,479.36 " 27100002 HC NITRIC OXIDE SETUP 271 94799 51 % of Charges OP 303.00 203.01 203.01 196.95 203.01 196.95 203.01 27100012 HC OXYGEN CONSERVING DEVICE 271 51 % of Charges OP 73.00 48.91 48.91 47.45 48.91 47.45 48.91 27100019 HC BILILIGHT SINGLE STRENGTH 271 51 % of Charges OP 80.00 53.60 53.60 52.00 53.60 52.00 53.60 27100020 HC BILILIGHT DOUBLE STRENGTH 271 51 % of Charges OP 120.00 80.40 80.40 78.00 80.40 78.00 80.40 27100018 HC ISOLETTE 271 51 % of Charges OP 120.00 80.40 80.40 78.00 80.40 78.00 80.40 27100021 HC BILILIGHT TRIPLE STRENGTH 271 51 % of Charges OP 140.00 93.80 93.80 91.00 93.80 91.00 93.80 27100023 HC AIRVO SUBSEQUENT Q8 271 51 % of Charges OP 178.00 119.26 119.26 115.70 119.26 115.70 119.26 27100016 HC OXYGEN SUBSEQUENT Q8 271 51 % of Charges OP 178.00 119.26 119.26 115.70 119.26 115.70 119.26 27100005 HC HELI OX THERAPY Q8 271 51 % of Charges OP 202.00 135.34 135.34 131.30 135.34 131.30 135.34 27100010 HC NON-INVASIVE APPLIANCE ONLY 271 51 % of Charges OP 216.00 144.72 144.72 140.40 144.72 140.40 144.72 27100014 HC OXYGEN LIMITED 0 TO 4 HOURS 271 51 % of Charges OP 238.00 159.46 159.46 154.70 159.46 154.70 159.46 27100001 HC OXYGEN LIMITED 0-4 HOURS 271 51 % of Charges OP 238.00 159.46 159.46 154.70 159.46 154.70 159.46 27100014 HC OXYGEN LIMITED 0 TO 4 HOURS 271 234 % of Charges OP 238.00 159.46 159.46 154.70 159.46 154.70 159.46 27100003 HC AIRVO ASSEMBLY 271 51 % of Charges OP 245.00 164.15 164.15 159.25 164.15 159.25 164.15 27100013 HC OXYGEN INITIAL 271 51 % of Charges OP 270.00 180.90 180.90 175.50 180.90 175.50 180.90 27100015 HC OXYGEN LIMITED 4 TO 12 HOURS 271 51 % of Charges OP 318.00 213.06 213.06 206.70 213.06 206.70 213.06 27100015 HC OXYGEN LIMITED 4 TO 12 HOURS 271 234 % of Charges OP 318.00 213.06 213.06 206.70 213.06 206.70 213.06 27100022 HC AIRVO INITIAL 271 51 % of Charges OP 370.00 247.90 247.90 240.50 247.90 240.50 247.90 27100008 HC IPV PHASITRON INITIAL ASSBLY 271 51 % of Charges OP 380.00 254.60 254.60 247.00 254.60 247.00 254.60 27100006 HC INFANT HIFLO DAILY 271 51 % of Charges OP 476.00 318.92 318.92 309.40 318.92 309.40 318.92 27100007 HC INFANT OXYGEN LESS THAN 1 L 271 51 % of Charges OP 534.00 357.78 357.78 347.10 357.78 347.10 357.78 27100017 HC VDR ASSEMBLY 271 51 % of Charges OP 720.00 482.40 482.40 468.00 482.40 468.00 482.40 27100004 HC HELI OX THERAPY INITIAL 271 51 % of Charges OP 727.00 487.09 487.09 472.55 487.09 472.55 487.09 27100009 HC NITRIC OXIDE FOR CATH LAB 271 51 % of Charges OP 744.00 498.48 498.48 483.60 498.48 483.60 498.48 27100011 HC NON-INVASIVE VENT ASSEMBLY 271 51 % of Charges OP " 1,027.00 " 688.09 688.09 667.55 688.09 667.55 688.09 27200014 HC NITRIC OXIDE HOURLY 272 94799 51 % of Charges OP 520.00 348.40 348.40 338.00 348.40 338.00 348.40 27200004 HC DRSG MEPILEX 4X4IN 272 51 % of Charges OP 8.00 5.36 5.36 5.20 5.36 5.20 5.36 27200006 HC KIT RESUSICATOR INFANT--NEOPUF 272 51 % of Charges OP 24.00 16.08 16.08 15.60 16.08 15.60 16.08 27200015 HC DECANNULIZATION STOP 272 51 % of Charges OP 34.00 22.78 22.78 22.10 22.78 22.10 22.78 27200010 HC SET INFUSION POWERLOC 272 51 % of Charges OP 44.00 29.48 29.48 28.60 29.48 28.60 29.48 27200008 HC SET FILTER MICROSTREAM ADU/PDI 272 51 % of Charges OP 49.00 32.83 32.83 31.85 32.83 31.85 32.83 27200009 HC SET FILTER/CIRCUIT ETC02 272 51 % of Charges OP 51.00 34.17 34.17 33.15 34.17 33.15 34.17 27200005 HC KIT CATH LUNG SAMPLE 272 51 % of Charges OP 56.00 37.52 37.52 36.40 37.52 36.40 37.52 27200011 HC STAPLER SURG 35W MULTIFIRE 272 51 % of Charges OP 83.00 55.61 55.61 53.95 55.61 53.95 55.61 27200003 HC CATH CVC TRIPLE LUMEN 7FR MAC 272 51 % of Charges OP 115.00 77.05 77.05 74.75 77.05 74.75 77.05 27200013 HC TRAY CATH TEMP SENSOR URINMTER 272 51 % of Charges OP 119.00 79.73 79.73 77.35 79.73 77.35 79.73 27200012 HC TRAY CATH TEMP SENSOR DUAL 272 51 % of Charges OP 132.00 88.44 88.44 85.80 88.44 85.80 88.44 27200017 HC ENDOTRACHEAL TUBES 272 51 % of Charges OP 134.00 89.78 89.78 87.10 89.78 87.10 89.78 27200007 HC KIT SHOWER SPRAY PULSAVAC 272 51 % of Charges OP 164.00 109.88 109.88 106.60 109.88 106.60 109.88 27200018 HC TRACH BUTTON 272 51 % of Charges OP 531.00 355.77 355.77 345.15 355.77 345.15 355.77 27200002 HC CATH CENTR VENO OPTI HEP COAT 272 51 % of Charges OP 780.00 522.60 522.60 507.00 522.60 507.00 522.60 27200016 HC EDI CATHETER 272 51 % of Charges OP 823.00 551.41 551.41 534.95 551.41 534.95 551.41 27400048 HC OSTOMY BELT WITH PERISTOMAL HERNIA SUPPORT 274 A4396 234 % of Charges OP 65.00 43.55 43.55 42.25 43.55 42.25 43.55 27400045 HC CERVICAL COLLAR - PHILLY 274 L0120 51 % of Charges OP 15.00 10.05 10.05 9.75 10.05 9.75 10.05 27400005 HC COLLAR CERVICAL LG 274 L0120 51 % of Charges OP 16.00 10.72 10.72 10.40 10.72 10.40 10.72 27400003 HC COLLAR CERVICAL MED 274 L0120 51 % of Charges OP 16.00 10.72 10.72 10.40 10.72 10.40 10.72 27400002 HC COLLAR CERVICAL SM 274 L0120 51 % of Charges OP 16.00 10.72 10.72 10.40 10.72 10.40 10.72 27400004 HC COLLAR CERVICAL SM X-LONG 274 L0120 51 % of Charges OP 16.00 10.72 10.72 10.40 10.72 10.40 10.72 27400006 HC COLLAR CERVICAL UNIVERSAL 274 L0140 51 % of Charges OP 22.00 14.74 14.74 14.30 14.74 14.30 14.74 27400008 HC COLLAR CERVICAL PEDI NO-NECK 274 L0140 51 % of Charges OP 33.00 22.11 22.11 21.45 22.11 21.45 22.11 27400007 HC COLLAR CERVICAL BABY NO-NECK 274 L0140 51 % of Charges OP 35.00 23.45 23.45 22.75 23.45 22.75 23.45 27400046 HC CERVICAL COLLAR - C- COLLAR 274 L0150 51 % of Charges OP 20.00 13.40 13.40 13.00 13.40 13.00 13.40 27400011 HC COLLAR CERVICAL LG PHILADEL 274 L0150 51 % of Charges OP 56.00 37.52 37.52 36.40 37.52 36.40 37.52 27400010 HC COLLAR CERVICAL MED PHILADEL 274 L0150 51 % of Charges OP 56.00 37.52 37.52 36.40 37.52 36.40 37.52 27400009 HC COLLAR CERVICAL SM PHILADEL 274 L0150 51 % of Charges OP 56.00 37.52 37.52 36.40 37.52 36.40 37.52 27400047 HC CERVICAL COLLAR - ASPEN 274 L0172 51 % of Charges OP 110.00 73.70 73.70 71.50 73.70 71.50 73.70 27400036 HC TLS ORTHOTIC SPINAL SYSTEM 274 L0464 51 % of Charges OP " 1,440.00 " 964.80 964.80 936.00 964.80 936.00 964.80 27400037 HC KNEE IMMOBILIZER 274 L1830 51 % of Charges OP 60.00 40.20 40.20 39.00 40.20 39.00 40.20 27400038 HC KNEE ORTHOSIS PREFAB RIGID SUPPORT 274 L1832 51 % of Charges OP 550.00 368.50 368.50 357.50 368.50 357.50 368.50 27400039 HC ORTHOPEDIC SHOE INSOLE 274 L3510 51 % of Charges OP 40.00 26.80 26.80 26.00 26.80 26.00 26.80 27400040 HC CLAVICLE STRAP 274 L3650 51 % of Charges OP 20.00 13.40 13.40 13.00 13.40 13.00 13.40 27400041 HC SHOULDER IMMOBILIZER 274 L3670 51 % of Charges OP 160.00 107.20 107.20 104.00 107.20 104.00 107.20 27400014 HC ELBOW GUTTER 274 L3702 51 % of Charges OP 240.00 160.80 160.80 156.00 160.80 156.00 160.80 27400018 HC HAND BASED THUMB SPICA 274 L3808 51 % of Charges OP 44.00 29.48 29.48 28.60 29.48 28.60 29.48 27400025 HC WRIST & THUMB SPICA 274 L3808 51 % of Charges OP 100.00 67.00 67.00 65.00 67.00 65.00 67.00 27400022 HC RESTING HAND SPLINT-NOT P 274 L3808 51 % of Charges OP 113.00 75.71 75.71 73.45 75.71 73.45 75.71 27400023 HC RESTING HAND SPLINT-PREFO 274 L3808 51 % of Charges OP 152.00 101.84 101.84 98.80 101.84 98.80 101.84 27400024 HC ULNAR GUTTER 274 L3906 51 % of Charges OP 106.00 71.02 71.02 68.90 71.02 68.90 71.02 27400042 HC WRIST SPLINT 274 L3908 51 % of Charges OP 30.00 20.10 20.10 19.50 20.10 19.50 20.10 27400026 HC WRIST COCK-UP MOLDED 274 L3908 51 % of Charges OP 94.00 62.98 62.98 61.10 62.98 61.10 62.98 27400027 HC WRIST SPLINT W DYNAMIC OU 274 L3908 51 % of Charges OP 345.00 231.15 231.15 224.25 231.15 224.25 231.15 27400019 HC KNUCKLE BENDER 274 L3925 51 % of Charges OP 80.00 53.60 53.60 52.00 53.60 52.00 53.60 27400013 HC DIGIT EXTENSION SPLINT 274 L3929 51 % of Charges OP 39.00 26.13 26.13 25.35 26.13 25.35 26.13 27400043 HC ANKLE BRACE 274 L4350 51 % of Charges OP 70.00 46.90 46.90 45.50 46.90 45.50 46.90 27400044 HC WALKING BOOT 274 L4360 51 % of Charges OP 250.00 167.50 167.50 162.50 167.50 162.50 167.50 27800005 HC ORTHO SCREW 278 C1713 51 % of Charges OP " 1,137.00 " " 1,414.00 " 761.79 739.05 761.79 739.05 " 1,414.00 " 27800004 HC HDR IR192 NON STRANDED SOURCE 278 C1717 51 % of Charges OP 300.00 99.00 201.00 195.00 201.00 99.00 201.00 27800006 HC MULTI-LUMEN CATHETER 278 C1751 51 % of Charges OP 520.00 171.60 348.40 338.00 348.40 171.60 348.40 63600013 HC RESTRATA WOUND MATRIX PER SQ CM 278 C1849 234 % of Charges OP 175.00 57.75 117.25 113.75 117.25 57.75 117.25 27800007 HC PLASTIC EYE SPHERE 278 L8610 51 % of Charges OP 170.00 56.10 113.90 110.50 113.90 56.10 113.90 28000001 HC PLASMAPHERESIS 280 36514 51 % of Charges OP " 3,772.00 " " 1,343.91 " " 2,527.24 " " 2,451.80 " " 2,527.24 " " 1,343.91 " " 2,527.24 " 30000001 HC COLLECTION BLOOD SPECIMEN 300 36415 51 % of Charges OP 30.00 9.00 20.10 19.50 10.00 9.00 20.10 30000002 HC LEGAL BLOOD COLLECTION 300 36415 51 % of Charges OP 47.00 9.00 31.49 30.55 10.00 9.00 31.49 30000005 HC BEDSIDE BMP WITH IONIZED CALC 300 80047 51 % of Charges OP 156.00 64.00 104.52 101.40 68.00 64.00 104.52 30000006 HC BASIC METABOLIC PANEL 300 80048 51 % of Charges OP 156.00 64.00 104.52 101.40 68.00 64.00 104.52 30000007 HC GENERAL HEALTH PANEL 300 80050 51 % of Charges OP 604.00 95.00 404.68 392.60 102.00 95.00 404.68 30000008 HC ELECTROLYTE PANEL 300 80051 51 % of Charges OP 97.00 53.00 64.99 63.05 64.99 53.00 64.99 30000009 HC COMPREHENSIVE METABOLIC PANEL 300 80053 51 % of Charges OP 264.00 80.00 176.88 171.60 86.00 80.00 176.88 30000010 HC OBSTETRIC PANEL 300 80055 67 % of Charges OP 386.00 343.00 258.62 250.90 258.62 250.90 343.00 30000011 HC LIPID PANEL 300 80061 53 % of Charges OP 158.00 102.00 105.86 102.70 109.00 102.00 109.00 30000011 HC LIPID PANEL 300 80061 51 % of Charges OP 160.00 102.00 107.20 104.00 109.00 102.00 109.00 30000012 HC RENAL FUNCTION PANEL 300 80069 51 % of Charges OP 188.00 66.00 125.96 122.20 71.00 66.00 125.96 30000013 HC HEPATITIS PANEL ACUTE W/REFLEX 300 80074 53 % of Charges OP 188.00 322.00 125.96 122.20 345.00 122.20 345.00 30000013 HC HEPATITIS PANEL ACUTE W/REFLEX 300 80074 54 % of Charges OP 376.00 322.00 251.92 244.40 345.00 244.40 345.00 30000014 HC HEPATIC FUNCTION PANEL 300 80076 51 % of Charges OP 154.00 62.00 103.18 100.10 66.00 62.00 103.18 30000015 HC OBSTETRIC PANEL W/HIV1/2 300 80081 67 % of Charges OP 502.00 113.00 336.34 326.30 121.00 113.00 336.34 30000016 HC AMIKACIN 300 80150 53 % of Charges OP 62.00 45.00 41.54 40.30 41.54 40.30 45.00 30000017 HC AMIKACIN TROUGH 300 80150 67 % of Charges OP 220.00 45.00 147.40 143.00 147.40 45.00 147.40 30000018 HC CAFFEINE 300 80155 53 % of Charges OP 125.00 19.00 83.75 81.25 83.75 19.00 83.75 30000019 HC CARBAMAZEPINE TOTAL 300 80156 55 % of Charges OP 145.00 94.00 97.15 94.25 101.00 94.00 101.00 30000020 HC CARBAMAZEPINE TEGRETOL 300 80156 51 % of Charges OP 184.00 94.00 123.28 119.60 101.00 94.00 123.28 30000020 HC CARBAMAZEPINE TEGRETOL 300 80156 67 % of Charges OP 184.00 94.00 123.28 119.60 101.00 94.00 123.28 30000021 HC CARBAMAZEPINE FREE 300 80157 55 % of Charges OP 145.00 41.00 97.15 94.25 97.15 41.00 97.15 30000022 HC CYCLOSPORINE 300 80158 53 % of Charges OP 300.00 137.00 201.00 195.00 147.00 137.00 201.00 30000023 HC CLOZAPINE/CLOZARIL QUANT 300 80159 53 % of Charges OP 69.00 27.00 46.23 44.85 46.23 27.00 46.23 30000024 HC DIGOXIN 300 80162 51 % of Charges OP 144.00 100.00 96.48 93.60 107.00 93.60 107.00 30000025 HC VALPROIC ACID - DEPAKENE 300 80164 51 % of Charges OP 180.00 103.00 120.60 117.00 110.00 103.00 120.60 30000027 HC GENTAMICIN 300 80170 51 % of Charges OP 250.00 50.00 167.50 162.50 54.00 50.00 167.50 30000027 HC GENTAMICIN 300 80170 67 % of Charges OP 250.00 50.00 167.50 162.50 54.00 50.00 167.50 30000028 HC GABAPENTIN/NEURONTIN QUANT 300 80171 53 % of Charges OP 168.00 20.00 112.56 109.20 112.56 20.00 112.56 30000030 HC LAMOTRIGINE QUANT 300 80175 53 % of Charges OP 199.00 20.00 133.33 129.35 21.00 20.00 133.33 30000031 HC LIDOCAINE 300 80176 53 % of Charges OP 200.00 44.00 134.00 130.00 134.00 44.00 134.00 30000031 HC LIDOCAINE 300 80176 67 % of Charges OP 433.00 44.00 290.11 281.45 290.11 44.00 290.11 30000032 HC KEPPRA/LEVETIRACETAM QUANT 300 80177 55 % of Charges OP 285.00 20.00 190.95 185.25 21.00 20.00 190.95 30000033 HC LITHIUM SERUM 300 80178 51 % of Charges OP 156.00 50.00 104.52 101.40 54.00 50.00 104.52 30000034 HC MYCOPHENOLIC ACID QUANT 300 80180 55 % of Charges OP 576.00 27.00 385.92 374.40 385.92 27.00 385.92 30000035 HC TRILEPTAL/OXCARBAZEPINE QUANT 300 80183 53 % of Charges OP 153.00 20.00 102.51 99.45 102.51 20.00 102.51 30000036 HC PHENOBARBITOL 300 80184 53 % of Charges OP 34.00 86.00 22.78 22.10 92.00 22.10 92.00 30000037 HC ASSAY OF PHENOBARBITAL 300 80184 67 % of Charges OP 129.00 86.00 86.43 83.85 92.00 83.85 92.00 30000038 HC PHENOBARBITAL QUANT 300 80184 51 % of Charges OP 184.00 86.00 123.28 119.60 92.00 86.00 123.28 30000038 HC PHENOBARBITAL QUANT 300 80184 67 % of Charges OP 184.00 86.00 123.28 119.60 92.00 86.00 123.28 30000040 HC PHENYTOIN TOTAL 300 80185 53 % of Charges OP 110.00 100.00 73.70 71.50 107.00 71.50 107.00 30000039 HC PHENYTOIN DILANTIN TOTAL 300 80185 51 % of Charges OP 190.00 100.00 127.30 123.50 107.00 100.00 127.30 30000041 HC PHENYTOIN FREE 300 80186 53 % of Charges OP 110.00 42.00 73.70 71.50 73.70 42.00 73.70 30000041 HC PHENYTOIN FREE 300 80186 54 % of Charges OP 220.00 42.00 147.40 143.00 147.40 42.00 147.40 30000043 HC PRIMIDONE 300 80188 53 % of Charges OP 34.00 50.00 22.78 22.10 22.78 22.10 50.00 30000042 HC ASSAY OF PRIMIDONE 300 80188 67 % of Charges OP 185.00 50.00 123.95 120.25 123.95 50.00 123.95 30000044 HC PROCAINAMIDE & NAPA 300 80192 53 % of Charges OP 163.00 43.00 109.21 105.95 109.21 43.00 109.21 30000045 HC PROCAINAMIDE W METABOLITES 300 80192 67 % of Charges OP 203.00 43.00 136.01 131.95 136.01 43.00 136.01 30000046 HC PRONESTYL & NAPA 300 80192 51 % of Charges OP 225.00 43.00 150.75 146.25 150.75 43.00 150.75 30000047 HC QUINIDINE 300 80194 53 % of Charges OP 93.00 45.00 62.31 60.45 62.31 45.00 62.31 30000049 HC SIROLIMUS 300 80195 53 % of Charges OP 164.00 104.00 109.88 106.60 109.88 104.00 109.88 30000048 HC RAPAMYCIN SIROLIMUS 300 80195 55 % of Charges OP 268.00 104.00 179.56 174.20 179.56 104.00 179.56 30000050 HC TACROLIMUS 300 80197 53 % of Charges OP 356.00 104.00 238.52 231.40 111.00 104.00 238.52 30000050 HC TACROLIMUS 300 80197 54 % of Charges OP 356.00 104.00 238.52 231.40 111.00 104.00 238.52 30000051 HC THEOPHYLLINE 300 80198 51 % of Charges OP 202.00 96.00 135.34 131.30 135.34 96.00 135.34 30000051 HC THEOPHYLLINE 300 80198 67 % of Charges OP 202.00 96.00 135.34 131.30 135.34 96.00 135.34 30000052 HC TOBRAMYCIN 300 80200 51 % of Charges OP 229.00 49.00 153.43 148.85 153.43 49.00 153.43 30001337 HC TOBRAMYCIN KINETIC 300 80200 51 % of Charges OP 229.00 49.00 153.43 148.85 153.43 49.00 153.43 30001336 HC TOBRAMYCIN TROUGH 300 80200 51 % of Charges OP 229.00 49.00 153.43 148.85 153.43 49.00 153.43 30000053 HC TOPIRAMATE 300 80201 53 % of Charges OP 190.00 90.00 127.30 123.50 96.00 90.00 127.30 30000054 HC TOPIRAMATE TOPAMAX 300 80201 67 % of Charges OP 250.00 90.00 167.50 162.50 96.00 90.00 167.50 30000055 HC VANCOMYCIN 300 80202 51 % of Charges OP 222.00 42.00 148.74 144.30 45.00 42.00 148.74 30000056 HC ZONISAMIDE 300 80203 53 % of Charges OP 263.00 20.00 176.21 170.95 176.21 20.00 176.21 30000065 HC DRUG ASSAY INFLIXIMAB 300 80230 53 % of Charges OP 390.00 261.30 261.30 253.50 261.30 253.50 261.30 30000102 HC DRUG ASSAY LACOSAMIDE 300 80235 53 % of Charges OP 300.00 201.00 201.00 195.00 201.00 195.00 201.00 30000063 HC DRUG ASSAY VORICONAZOLE 300 80285 67 % of Charges OP 425.00 284.75 284.75 276.25 284.75 276.25 284.75 30000058 HC QUANTITATION OF DRUG NES 300 80299 67 % of Charges OP 94.00 104.00 62.98 61.10 111.00 61.10 111.00 30000064 HC AMIODARONE 300 80299 53 % of Charges OP 96.00 104.00 64.32 62.40 111.00 62.40 111.00 30000062 HC 5 FLUCYTOSINE 300 80299 55 % of Charges OP 126.00 104.00 84.42 81.90 111.00 81.90 111.00 30000058 HC QUANTITATION OF DRUG NES 300 80299 54 % of Charges OP 129.00 104.00 86.43 83.85 111.00 83.85 111.00 30000074 HC ITRACONAZOLE 300 80299 53 % of Charges OP 160.00 104.00 107.20 104.00 111.00 104.00 111.00 30000057 HC DIGITOXIN 300 80299 53 % of Charges OP 185.00 104.00 123.95 120.25 111.00 104.00 123.95 30001356 HC QUANT OF THERAPEUTIC DRUG 300 80299 53 % of Charges OP 208.00 104.00 139.36 135.20 111.00 104.00 139.36 30000057 HC DIGITOXIN 300 80299 67 % of Charges OP 210.00 104.00 140.70 136.50 111.00 104.00 140.70 30000060 HC GABAPENTIN 300 80299 67 % of Charges OP 252.00 104.00 168.84 163.80 111.00 104.00 168.84 30000061 HC FELBAMATE 300 80299 67 % of Charges OP 284.00 104.00 190.28 184.60 111.00 104.00 190.28 30000059 HC GANCICLOVIR CYTOVENE 300 80299 55 % of Charges OP 431.00 104.00 288.77 280.15 111.00 104.00 288.77 30001258 HC ALCOHOL ETHANOL SCREEN 300 80307 53 % of Charges OP 42.00 150.00 28.14 27.30 161.00 27.30 161.00 30001325 HC DRUG TEST PRESUMPTIVE 300 80307 53 % of Charges OP 55.00 150.00 36.85 35.75 161.00 35.75 161.00 30000087 HC OPIATES 300 80307 51 % of Charges OP 80.00 150.00 53.60 52.00 161.00 52.00 161.00 30001259 HC NICOTINE & COTININE 300 80307 53 % of Charges OP 95.00 150.00 63.65 61.75 161.00 61.75 161.00 30000079 HC COMP DRUG SCREEN NONFOR URINE 300 80307 53 % of Charges OP 125.00 150.00 83.75 81.25 161.00 81.25 161.00 30001322 HC TRICYCLIC SCREEN 300 80307 51 % of Charges OP 135.00 150.00 90.45 87.75 161.00 87.75 161.00 30001257 HC DRUG SCREEN QUALITATIVE 300 80307 55 % of Charges OP 176.00 150.00 117.92 114.40 161.00 114.40 161.00 30001262 HC SALICYLATE 300 80307 51 % of Charges OP 188.00 150.00 125.96 122.20 161.00 122.20 161.00 30000086 HC MARIJUANA URINE QUANT 300 80307 51 % of Charges OP 190.00 150.00 127.30 123.50 161.00 123.50 161.00 30000077 HC ALCOHOL ETHANOL URINE 300 80307 51 % of Charges OP 208.00 150.00 139.36 135.20 161.00 135.20 161.00 30001261 HC ALCOHOL ETHYL BLOOD 300 80307 51 % of Charges OP 208.00 150.00 139.36 135.20 161.00 135.20 161.00 30001260 HC DRUG SCR MULT DRUG CLASS 4 OR> 300 80307 51 % of Charges OP 256.00 150.00 171.52 166.40 161.00 150.00 171.52 30001321 HC DRUG SCREEN SINGLE DRUG 300 80307 67 % of Charges OP 274.00 150.00 183.58 178.10 161.00 150.00 183.58 30000080 HC DRUG SCREEN MULTI DRUG 300 80307 67 % of Charges OP 300.00 150.00 201.00 195.00 161.00 150.00 201.00 30001263 HC ACETAMINOPHEN QUANT 300 80307 51 % of Charges OP 302.00 150.00 202.34 196.30 161.00 150.00 202.34 30000093 HC SYNTHETIC CANNABINOIDS URINE 300 80307 67 % of Charges OP 309.00 150.00 207.03 200.85 161.00 150.00 207.03 30001264 HC DRUG SCREEN MULTI DRUG 300 80307 67 % of Charges OP 439.00 150.00 294.13 285.35 161.00 150.00 294.13 30000081 HC DRUG SCREEN SINGLE DRUG 300 80307 67 % of Charges OP 514.00 150.00 344.38 334.10 161.00 150.00 344.38 30000094 HC ALCOHOL 300 80320 53 % of Charges OP 125.00 24.00 83.75 81.25 83.75 24.00 83.75 30000095 HC ETHYLENE GLYCOL 300 80320 55 % of Charges OP 132.00 24.00 88.44 85.80 88.44 24.00 88.44 30000096 HC VOLATILES SCREEN 300 80320 55 % of Charges OP 159.00 24.00 106.53 103.35 106.53 24.00 106.53 30001234 HC ALCOHOL/ETHANOL CONFIRM 300 80321 53 % of Charges OP 110.00 73.70 73.70 71.50 73.70 71.50 73.70 30001357 HC NICOTINE METABOLITES URINE 300 80323 53 % of Charges OP 98.00 24.00 65.66 63.70 65.66 24.00 65.66 30000098 HC AMPHETAMINES 1 OR 2 300 80324 53 % of Charges OP 57.00 24.00 38.19 37.05 38.19 24.00 38.19 30001404 HC AMPHETAMINE 300 80325 53 % of Charges OP 57.00 38.19 38.19 37.05 38.19 37.05 38.19 30000099 HC AMITRIPTYLINE 300 80335 53 % of Charges OP 59.00 24.00 39.53 38.35 39.53 24.00 39.53 30000100 HC DESIPRAMINE 300 80335 53 % of Charges OP 155.00 24.00 103.85 100.75 103.85 24.00 103.85 30000103 HC METHSUXIMIDE 300 80339 53 % of Charges OP 50.00 24.00 33.50 32.50 26.00 24.00 33.50 30000101 HC FELBAMATE 300 80339 53 % of Charges OP 96.00 24.00 64.32 62.40 26.00 24.00 64.32 30000104 HC THIOTHIXENE NAVENE 300 80342 67 % of Charges OP 261.00 24.00 174.87 169.65 174.87 24.00 174.87 30000105 HC PENTOBARB 300 80345 53 % of Charges OP 157.00 24.00 105.19 102.05 105.19 24.00 105.19 30000106 HC LIBRIUM METABOLITE 300 80346 67 % of Charges OP 130.00 24.00 87.10 84.50 87.10 24.00 87.10 30000107 HC CANNABINOIDS NATURAL 300 80349 53 % of Charges OP 91.00 24.00 60.97 59.15 26.00 24.00 60.97 30000108 HC MDA MDEA MDMA 300 80359 53 % of Charges OP 57.00 24.00 38.19 37.05 38.19 24.00 38.19 30001236 HC OPIATES 1 OR MORE 300 80361 53 % of Charges OP 45.00 24.00 30.15 29.25 26.00 24.00 30.15 30001323 HC OXYCODONE 300 80365 53 % of Charges OP 45.00 24.00 30.15 29.25 26.00 24.00 30.15 30000110 HC LASIX FUROSEMIDE 300 80375 67 % of Charges OP 318.00 24.00 213.06 206.70 26.00 24.00 213.06 30000113 HC UA AUTO WITH MICROSCOPY 300 81001 51 % of Charges OP 78.00 24.00 52.26 50.70 26.00 24.00 52.26 30000115 HC PH SCREEN URINE 300 81002 51 % of Charges OP 28.00 8.00 18.76 18.20 18.76 8.00 18.76 30000114 HC PROTEIN URINE QUAL 300 81002 51 % of Charges OP 28.00 8.00 18.76 18.20 18.76 8.00 18.76 30000117 HC GLUCOSE URINE QUAL 300 81002 51 % of Charges OP 72.00 8.00 48.24 46.80 48.24 8.00 48.24 30000116 HC SPECIFIC GRAVITY UA 300 81002 51 % of Charges OP 72.00 8.00 48.24 46.80 48.24 8.00 48.24 30000120 HC KETONES UR 300 81003 51 % of Charges OP 28.00 17.00 18.76 18.20 18.00 17.00 18.76 30000121 HC UA W/O MICRO AUTO 300 81003 51 % of Charges OP 52.00 17.00 34.84 33.80 18.00 17.00 34.84 30001185 HC REDUCING SUBSTANCE URINE 300 81005 51 % of Charges OP 28.00 7.00 18.76 18.20 18.76 7.00 18.76 30000122 HC URINALYSIS MICROSCOPIC ONLY 300 81015 51 % of Charges OP 28.00 9.00 18.76 18.20 10.00 9.00 18.76 30000123 HC HCG QUAL URINE PREG 300 81025 51 % of Charges OP 70.00 48.00 46.90 45.50 51.00 45.50 51.00 30000124 HC URINE MEASURE TIMED COLL 300 81050 51 % of Charges OP 30.00 22.00 20.10 19.50 24.00 19.50 24.00 30000125 HC BCR ABL 1 GENE MAJOR BP R 300 81206 53 % of Charges OP 133.00 247.00 89.11 86.45 264.00 86.45 264.00 30001410 HC BCR ABL1 MAJOR 300 81206 53 % of Charges OP 272.00 247.00 182.24 176.80 264.00 176.80 264.00 30000126 HC BCR ABL 1 GENE MINOR BP R 300 81207 53 % of Charges OP 133.00 218.00 89.11 86.45 89.11 86.45 218.00 30001411 HC BCR ABL1 MINOR 300 81207 53 % of Charges OP 272.00 218.00 182.24 176.80 182.24 176.80 218.00 30001460 HC BCR ABL1 OTHER BREAKPOINT 300 81208 53 % of Charges OP 133.00 243.00 89.11 86.45 89.11 86.45 243.00 30000150 HC CEBPA GENE ANALYSIS 300 81218 53 % of Charges OP 576.00 364.00 385.92 374.40 385.92 364.00 385.92 30001386 HC CALR CALRETICULIN EXON 9 MUT ANALYS 300 81219 53 % of Charges OP 392.00 183.00 262.64 254.80 262.64 183.00 262.64 30000128 HC CFTR GENE ANALYSIS 300 81220 53 % of Charges OP 471.00 847.00 315.57 306.15 315.57 306.15 847.00 30001396 HC CTFR SEQUENCING 300 81223 53 % of Charges OP 635.00 425.45 425.45 412.75 425.45 412.75 425.45 30000130 HC CYTOGENETIC MICROARRAY 300 81229 67 % of Charges OP " 1,801.00 " " 1,764.00 " " 1,206.67 " " 1,170.65 " " 1,887.00 " " 1,170.65 " " 1,887.00 " 30000129 HC CYTO MICROARRAY COPY AND SNP 300 81229 67 % of Charges OP " 1,839.00 " " 1,764.00 " " 1,232.13 " " 1,195.35 " " 1,887.00 " " 1,195.35 " " 1,887.00 " 30000131 HC F2 GENE ANALYSIS 20210G 300 81240 53 % of Charges OP 392.00 74.00 262.64 254.80 79.00 74.00 262.64 30000132 HC F5 GENE ANALYSIS LEIDEN 300 81241 53 % of Charges OP 452.00 92.00 302.84 293.80 98.00 92.00 302.84 30000133 HC FMR1 ANALYSIS EVAL TO DET 300 81243 67 % of Charges OP 571.00 87.00 382.57 371.15 382.57 87.00 382.57 30000134 HC FMR1 GENE ANALYSIS CHARAC 300 81244 67 % of Charges OP 658.00 440.86 440.86 427.70 440.86 427.70 440.86 30000135 HC FLT3 GENE ANALYSIS 300 81245 67 % of Charges OP 561.00 183.00 375.87 364.65 375.87 183.00 375.87 30000136 HC HFE GENE ANALYSIS 300 81256 55 % of Charges OP 332.00 98.00 222.44 215.80 222.44 98.00 222.44 30000138 HC JAK2 GENE V617F MUTATION QUAL 300 81270 53 % of Charges OP 378.00 138.00 253.26 245.70 253.26 138.00 253.26 30000137 HC JAK2 GENE ANALYSIS 300 81270 53 % of Charges OP 427.00 138.00 286.09 277.55 286.09 138.00 286.09 30001414 HC JAK2 GENE ANALYSIS 300 81270 55 % of Charges OP 581.00 138.00 389.27 377.65 389.27 138.00 389.27 30000139 HC MTHFR GENE ANALYSIS 300 81291 53 % of Charges OP 679.00 66.00 454.93 441.35 71.00 66.00 454.93 30000140 HC NPMI GENE ANALYSIS 300 81310 67 % of Charges OP 497.00 273.00 332.99 323.05 332.99 273.00 332.99 30000142 HC SERPINA-1 GENE ANALYSIS COMMON VAR 300 81332 53 % of Charges OP 343.00 66.00 229.81 222.95 229.81 66.00 229.81 30000145 HC HLA CLASS I TESTING - LOW RES 300 81372 67 % of Charges OP 698.00 333.00 467.66 453.70 467.66 333.00 467.66 30000146 HC HLA TYPING 300 81381 53 % of Charges OP 696.00 142.00 466.32 452.40 152.00 142.00 466.32 30000147 HC HLA CLASS II TYPING 300 81383 55 % of Charges OP 618.00 164.00 414.06 401.70 414.06 164.00 414.06 30001495 HC SPINAL MUSCULAR ATROPHY 300 81401 68 % of Charges OP 23.00 209.00 15.41 14.95 224.00 14.95 224.00 30001412 HC MOLECULAR PATHOLOGY PROC LEVEL 3 300 81402 53 % of Charges OP 583.00 390.61 390.61 378.95 390.61 378.95 390.61 30001407 HC MOLECULAR PATH PROC LEVEL 4 300 81403 67 % of Charges OP 537.00 282.00 359.79 349.05 359.79 282.00 359.79 30001397 HC PRSS1 SEQUENCING 300 81404 53 % of Charges OP 635.00 418.00 425.45 412.75 447.00 412.75 447.00 30001409 HC SPINK1 SEQUENCING 300 81404 53 % of Charges OP 635.00 418.00 425.45 412.75 447.00 412.75 447.00 30001398 HC CTRC SEQUENCING 300 81405 53 % of Charges OP 635.00 459.00 425.45 412.75 491.00 412.75 491.00 30001425 HC NON-INVASIVE PRENATAL TESTING FOR FETAL ANEUPLOIDY 300 81420 53 % of Charges OP 781.00 523.27 523.27 507.65 523.27 507.65 523.27 30001426 HC NON-INVASIVE PRENATAL TESTING FOR FETAL ANEUPLOIDY W MICRODELETIONS 300 81420 53 % of Charges OP 781.00 523.27 523.27 507.65 523.27 507.65 523.27 30001441 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS 300 81420 54 % of Charges OP " 1,388.00 " 929.96 929.96 902.20 929.96 902.20 929.96 30001442 HC FETAL CHROMOSOMAL MICRODELTJ GENOMIC SEQ ANALYS 300 81422 54 % of Charges OP 183.00 122.61 122.61 118.95 122.61 118.95 122.61 30001427 HC NON-INVASIVE PRENATAL TESTING FOR FETAL ANEUPLOIDY W MICRODELETIONS 300 81422 53 % of Charges OP 781.00 523.27 523.27 507.65 523.27 507.65 523.27 30001413 HC MYELOID MALIGNANCY PANEL 300 81455 53 % of Charges OP " 2,038.00 " " 1,365.46 " " 1,365.46 " " 1,324.70 " " 1,365.46 " " 1,324.70 " " 1,365.46 " 30000149 HC SEVERE COMB IMMUNE DEFICIENCY 300 81479 68 % of Charges OP 23.00 26.00 15.41 14.95 28.00 14.95 28.00 30001420 HC FETAL CONGENITAL ABNORMALITIES BIOCHEM 4 ANALYTES 300 81511 55 % of Charges OP 133.00 89.11 89.11 86.45 89.11 86.45 89.11 30001440 HC INFECTIOUS DISEASE CHRONIC HEPATITIS C SIX BIOCHEM ASSAYS 300 81596 67 % of Charges OP 520.00 348.40 348.40 338.00 348.40 338.00 348.40 30000152 HC ACETONE QUALITATIVE 300 82009 51 % of Charges OP 52.00 14.00 34.84 33.80 34.84 14.00 34.84 30000154 HC BETA-HYDROXBUTYRIC ACID 300 82010 53 % of Charges OP 152.00 13.00 101.84 98.80 14.00 13.00 101.84 30001418 HC BHB BETA - HYDROXYBUTYRATE 300 82010 51 % of Charges OP 178.00 13.00 119.26 115.70 14.00 13.00 119.26 30000153 HC BETA-HYDROXYBUTYRATE 300 82010 67 % of Charges OP 285.00 13.00 190.95 185.25 14.00 13.00 190.95 30000156 HC ACYLCARNITINES QUANTITATIVE 300 82017 53 % of Charges OP 300.00 52.00 201.00 195.00 201.00 52.00 201.00 30000157 HC ACTH 300 82024 53 % of Charges OP 230.00 186.00 154.10 149.50 199.00 149.50 199.00 30000158 HC ADDL ALBUMIN 300 82040 51 % of Charges OP 20.00 38.00 13.40 13.00 41.00 13.00 41.00 30001342 HC ALBUMIN SERUM PLASMA WB 300 82040 53 % of Charges OP 25.00 38.00 16.75 16.25 41.00 16.25 41.00 30000159 HC ALBUMIN 300 82040 51 % of Charges OP 59.00 38.00 39.53 38.35 41.00 38.00 41.00 30000159 HC ALBUMIN 300 82040 54 % of Charges OP 59.00 38.00 39.53 38.35 41.00 38.00 41.00 30001343 HC ALBUMIN URINE/OTHER QUANT EACH 300 82042 53 % of Charges OP 25.00 40.00 16.75 16.25 43.00 16.25 43.00 30000160 HC ALBUMIN URINE/OTHR QNT EA SPEC 300 82042 51 % of Charges OP 56.00 40.00 37.52 36.40 43.00 36.40 43.00 30000160 HC ALBUMIN URINE/OTHR QNT EA SPEC 300 82042 54 % of Charges OP 59.00 40.00 39.53 38.35 43.00 38.35 43.00 30000160 HC ALBUMIN URINE/OTHR QNT EA SPEC 300 82042 67 % of Charges OP 59.00 40.00 39.53 38.35 43.00 38.35 43.00 30000161 HC ALBUMIN CSF 300 82042 53 % of Charges OP 143.00 40.00 95.81 92.95 43.00 40.00 95.81 30000162 HC MICROALBUMIN URINE QUANTITATIVE 300 82043 51 % of Charges OP 52.00 44.00 34.84 33.80 47.00 33.80 47.00 30000162 HC MICROALBUMIN URINE QUANTITATIVE 300 82043 54 % of Charges OP 52.00 44.00 34.84 33.80 47.00 33.80 47.00 30000166 HC ALDOLASE 300 82085 53 % of Charges OP 185.00 73.00 123.95 120.25 78.00 73.00 123.95 30000167 HC ALDOSTERONE URINE 300 82088 53 % of Charges OP 166.00 165.00 111.22 107.90 177.00 107.90 177.00 30000168 HC ALDOSTERONE SERUM 300 82088 53 % of Charges OP 225.00 165.00 150.75 146.25 177.00 146.25 177.00 30000167 HC ALDOSTERONE URINE 300 82088 67 % of Charges OP 582.00 165.00 389.94 378.30 177.00 165.00 389.94 30000170 HC ALPHA-1-ANTITRYPSIN 300 82103 53 % of Charges OP 188.00 41.00 125.96 122.20 44.00 41.00 125.96 30000169 HC ALPHA-1 ANTITRYPSIN TOTAL 300 82103 53 % of Charges OP 343.00 41.00 229.81 222.95 44.00 41.00 229.81 30000172 HC A1A PHENOTYPE 300 82104 53 % of Charges OP 87.00 44.00 58.29 56.55 47.00 44.00 58.29 30000171 HC ALPHA 1 ANTITRYPSIN PHENOTYPE 300 82104 53 % of Charges OP 188.00 44.00 125.96 122.20 47.00 44.00 125.96 30000173 HC ALPHA-FETOPROTEIN AFP 300 82105 55 % of Charges OP 103.00 127.00 69.01 66.95 136.00 66.95 136.00 30000174 HC ALPHA-FETOPROTEIN SERUM 300 82105 53 % of Charges OP 298.00 127.00 199.66 193.70 136.00 127.00 199.66 30000174 HC ALPHA-FETOPROTEIN SERUM 300 82105 54 % of Charges OP 298.00 127.00 199.66 193.70 136.00 127.00 199.66 30000176 HC ALUMINUM 300 82108 53 % of Charges OP 59.00 78.00 39.53 38.35 39.53 38.35 78.00 30000176 HC ALUMINUM 300 82108 67 % of Charges OP 359.00 78.00 240.53 233.35 240.53 78.00 240.53 30000178 HC TRYPTOPHAN 300 82131 67 % of Charges OP 314.00 52.00 210.38 204.10 56.00 52.00 210.38 30000179 HC ALA AMINOLEV ACID 300 82135 67 % of Charges OP 240.00 50.00 160.80 156.00 54.00 50.00 160.80 30000180 HC AMINOLEVULINIC ACID ALA URINE 300 82135 53 % of Charges OP 246.00 50.00 164.82 159.90 54.00 50.00 164.82 30000181 HC AMINO ACIDS 6 OR MORE QUANT 300 82139 53 % of Charges OP 348.00 128.00 233.16 226.20 137.00 128.00 233.16 30000182 HC AMMONIA PLASMA 300 82140 51 % of Charges OP 199.00 89.00 133.33 129.35 95.00 89.00 133.33 30000185 HC AMYLASE FLUID 300 82150 53 % of Charges OP 29.00 49.00 19.43 18.85 52.00 18.85 52.00 30000186 HC AMYLASE ISOENZYMES OR TOTAL 300 82150 53 % of Charges OP 70.00 49.00 46.90 45.50 52.00 45.50 52.00 30000184 HC AMYLASE 300 82150 51 % of Charges OP 77.00 49.00 51.59 50.05 52.00 49.00 52.00 30000184 HC AMYLASE 300 82150 67 % of Charges OP 77.00 49.00 51.59 50.05 52.00 49.00 52.00 30000187 HC AMYLASE URINE RANDOM 300 82150 51 % of Charges OP 95.00 49.00 63.65 61.75 52.00 49.00 63.65 30000188 HC AMYLASE URINE TIMED 300 82150 51 % of Charges OP 95.00 49.00 63.65 61.75 52.00 49.00 63.65 30000185 HC AMYLASE FLUID 300 82150 67 % of Charges OP 95.00 49.00 63.65 61.75 52.00 49.00 63.65 30000189 HC ANDROSTENEDIONE 300 82157 55 % of Charges OP 265.00 221.00 177.55 172.25 236.00 172.25 236.00 30000191 HC ANGIOTENSIN CONVERT ENZYME CSF 300 82164 53 % of Charges OP 220.00 111.00 147.40 143.00 119.00 111.00 147.40 30000190 HC ANGIOTENSIN CONVERTING ENZYME 300 82164 53 % of Charges OP 240.00 111.00 160.80 156.00 119.00 111.00 160.80 30000193 HC APOLIPOPROTEIN EACH 300 82172 53 % of Charges OP 73.00 48.00 48.91 47.45 51.00 47.45 51.00 30000194 HC ASSAY OF APOLIPOPROTEIN 300 82172 67 % of Charges OP 194.00 48.00 129.98 126.10 51.00 48.00 129.98 30000192 HC APOLIPOPROTEIN 300 82172 67 % of Charges OP 205.00 48.00 137.35 133.25 51.00 48.00 137.35 30000195 HC ARSENIC 300 82175 53 % of Charges OP 96.00 82.00 64.32 62.40 88.00 62.40 88.00 30000196 HC ARSENIC BLOOD 300 82175 53 % of Charges OP 220.00 82.00 147.40 143.00 88.00 82.00 147.40 30000197 HC ARSENIC FRACTIONATED 300 82175 53 % of Charges OP 388.00 82.00 259.96 252.20 88.00 82.00 259.96 30000196 HC ARSENIC BLOOD 300 82175 67 % of Charges OP 394.00 82.00 263.98 256.10 88.00 82.00 263.98 30000198 HC VITAMIN C ASCORBIC ACID 300 82180 67 % of Charges OP 199.00 30.00 133.33 129.35 133.33 30.00 133.33 30000199 HC BETA 2 MICROGLOBULIN 300 82232 53 % of Charges OP 297.00 42.00 198.99 193.05 45.00 42.00 198.99 30000200 HC BILE ACIDS TOTAL 300 82239 53 % of Charges OP 40.00 52.00 26.80 26.00 26.80 26.00 52.00 30000201 HC ADDL BILIRUBIN TOTAL 300 82247 51 % of Charges OP 20.00 38.00 13.40 13.00 41.00 13.00 41.00 30001351 HC BILIRUBIN TOTAL 300 82247 53 % of Charges OP 24.00 38.00 16.08 15.60 41.00 15.60 41.00 30000202 HC BILIRUBIN TOTAL 300 82247 51 % of Charges OP 59.00 38.00 39.53 38.35 41.00 38.00 41.00 30000202 HC BILIRUBIN TOTAL 300 82247 67 % of Charges OP 59.00 38.00 39.53 38.35 41.00 38.00 41.00 30000204 HC ADDITIONAL BILIRUBIN DIRECT 300 82248 51 % of Charges OP 39.00 38.00 26.13 25.35 41.00 25.35 41.00 30000203 HC BILIRUBIN DIRECT 300 82248 51 % of Charges OP 39.00 38.00 26.13 25.35 41.00 25.35 41.00 30000205 HC BIOTINIDASE 300 82261 68 % of Charges OP 23.00 52.00 15.41 14.95 56.00 14.95 56.00 30000205 HC BIOTINIDASE 300 82261 53 % of Charges OP 145.00 52.00 97.15 94.25 56.00 52.00 97.15 30000206 HC BIOTINIDASE QUANT 300 82261 55 % of Charges OP 156.00 52.00 104.52 101.40 56.00 52.00 104.52 30000207 HC BIOTINIDASE SERUM QUANT 300 82261 67 % of Charges OP 295.00 52.00 197.65 191.75 56.00 52.00 197.65 30000209 "HC OCCULT BLOOD, GASTRIC" 300 82271 51 % of Charges OP 53.00 20.00 35.51 34.45 21.00 20.00 35.51 30000210 "HC OCCULT BLOOD, STOOL" 300 82272 51 % of Charges OP 39.00 20.00 26.13 25.35 21.00 20.00 26.13 30000212 HC VITAMIN D 25-HYDROXY CALCIFEDIOL 300 82306 53 % of Charges OP 190.00 154.00 127.30 123.50 165.00 123.50 165.00 30000213 HC CALCITONIN 300 82308 53 % of Charges OP 241.00 49.00 161.47 156.65 161.47 49.00 161.47 30000216 HC ADDL CALCIUM 300 82310 51 % of Charges OP 20.00 39.00 13.40 13.00 42.00 13.00 42.00 30000214 HC CALCIUM 300 82310 51 % of Charges OP 59.00 39.00 39.53 38.35 42.00 38.35 42.00 30000214 HC CALCIUM 300 82310 67 % of Charges OP 59.00 39.00 39.53 38.35 42.00 38.35 42.00 30000215 HC CALCIUM CSF 300 82310 51 % of Charges OP 62.00 39.00 41.54 40.30 42.00 39.00 42.00 30000217 HC CALCIUM URINE 300 82310 51 % of Charges OP 62.00 39.00 41.54 40.30 42.00 39.00 42.00 30000218 HC ADDL IONIZED CALCIUM 300 82330 51 % of Charges OP 20.00 90.00 13.40 13.00 96.00 13.00 96.00 30000219 HC BEDSIDE CALC IONIZE 300 82330 51 % of Charges OP 72.00 90.00 48.24 46.80 96.00 46.80 96.00 30000220 HC BEDSIDE CA IONIZED 300 82330 51 % of Charges OP 112.00 90.00 75.04 72.80 96.00 72.80 96.00 30000221 HC CALCIUM IONIZED 300 82330 51 % of Charges OP 168.00 90.00 112.56 109.20 96.00 90.00 112.56 30001465 HC CALCIUM URINE QUANT TIMED 300 82340 53 % of Charges OP 53.00 46.00 35.51 34.45 49.00 34.45 49.00 30000222 HC CALCIUM 24 HOUR URINE 300 82340 51 % of Charges OP 74.00 46.00 49.58 48.10 49.00 46.00 49.58 30000223 HC KIDNEY STONE ANALYSIS 300 82365 53 % of Charges OP 184.00 88.00 123.28 119.60 94.00 88.00 123.28 30000225 HC ADDL CARBON DIOXIDE 300 82374 51 % of Charges OP 20.00 15.00 13.40 13.00 16.00 13.00 16.00 30000224 HC CARBON DIOXIDE 300 82374 51 % of Charges OP 93.00 15.00 62.31 60.45 16.00 15.00 62.31 30000226 HC CARBON MONOXIDE QUANT BLD 300 82375 51 % of Charges OP 190.00 93.00 127.30 123.50 100.00 93.00 127.30 30000227 HC CARCINOEMBRYONIC AG CFA 300 82378 53 % of Charges OP 54.00 144.00 36.18 35.10 154.00 35.10 154.00 30000229 HC PANCREATIC CEA 300 82378 67 % of Charges OP 193.00 144.00 129.31 125.45 154.00 125.45 154.00 30000228 HC CARCINOEMBRYONIC ANTIGEN CEA 300 82378 53 % of Charges OP 220.00 144.00 147.40 143.00 154.00 143.00 154.00 30000228 HC CARCINOEMBRYONIC ANTIGEN CEA 300 82378 54 % of Charges OP 220.00 144.00 147.40 143.00 154.00 143.00 154.00 30000230 HC CARNITINE SERUM 300 82379 53 % of Charges OP 77.00 52.00 51.59 50.05 56.00 50.05 56.00 30000231 HC CATECHOLAMINE FRACTIONATED 300 82384 53 % of Charges OP 373.00 139.00 249.91 242.45 149.00 139.00 249.91 30001324 HC CERULOPLASMIN 300 82390 53 % of Charges OP 24.00 81.00 16.08 15.60 87.00 15.60 87.00 30000232 HC CERULOPLASMIN 300 82390 54 % of Charges OP 131.00 81.00 87.77 85.15 87.00 81.00 87.77 30000233 HC CHEMILUMINESCENT ASSAY 300 82397 53 % of Charges OP 155.00 7.00 103.85 100.75 7.00 7.00 103.85 30000234 HC PTH RELATED PEPTIDE 300 82397 55 % of Charges OP 184.00 7.00 123.28 119.60 7.00 7.00 123.28 30000236 HC ADDL CHLORIDE BLOOD 300 82435 51 % of Charges OP 20.00 14.00 13.40 13.00 13.40 13.00 14.00 30000238 HC CHLORIDE BLOOD 300 82435 51 % of Charges OP 69.00 14.00 46.23 44.85 46.23 14.00 46.23 30000237 HC BEDSIDE COMBO CHLORIDE 300 82435 51 % of Charges OP 72.00 14.00 48.24 46.80 48.24 14.00 48.24 30000239 HC CHLORIDE URINE 300 82436 51 % of Charges OP 92.00 15.00 61.64 59.80 61.64 15.00 61.64 30000241 HC CHLORIDE SPINAL FLUID 300 82438 67 % of Charges OP 87.00 15.00 58.29 56.55 58.29 15.00 58.29 30000240 HC CHLORIDE FLUID 300 82438 67 % of Charges OP 92.00 15.00 61.64 59.80 61.64 15.00 61.64 30000245 HC ADDL CHOLESTEROL 300 82465 51 % of Charges OP 20.00 32.00 13.40 13.00 34.00 13.00 34.00 30000244 HC CHOLESTEROL 300 82465 51 % of Charges OP 72.00 32.00 48.24 46.80 34.00 32.00 48.24 30000244 HC CHOLESTEROL 300 82465 67 % of Charges OP 72.00 32.00 48.24 46.80 34.00 32.00 48.24 30000246 HC PSEUDOCHOLINESTERASE 300 82480 53 % of Charges OP 39.00 24.00 26.13 25.35 26.13 24.00 26.13 30001463 HC CITRATE 300 82507 53 % of Charges OP 80.00 53.00 53.60 52.00 53.60 52.00 53.60 30000252 HC CITRIC ACID URINE 300 82507 53 % of Charges OP 142.00 53.00 95.14 92.30 95.14 53.00 95.14 30000251 HC CITRATE 24 HR URINE 300 82507 67 % of Charges OP 247.00 53.00 165.49 160.55 165.49 53.00 165.49 30000254 HC COLLAGEN CROSS LINKS URINE 300 82523 53 % of Charges OP 156.00 57.00 104.52 101.40 104.52 57.00 104.52 30000253 HC COLLAGEN CROSS LINKS SERUM 300 82523 53 % of Charges OP 416.00 57.00 278.72 270.40 278.72 57.00 278.72 30000255 HC ASSAY OF COPPER 300 82525 53 % of Charges OP 268.00 94.00 179.56 174.20 101.00 94.00 179.56 30000255 HC ASSAY OF COPPER 300 82525 67 % of Charges OP 268.00 94.00 179.56 174.20 101.00 94.00 179.56 30000256 HC CORTISOL FREE 300 82530 53 % of Charges OP 134.00 102.00 89.78 87.10 109.00 87.10 109.00 30000257 HC CORTISOL TOTAL 300 82533 51 % of Charges OP 204.00 102.00 136.68 132.60 109.00 102.00 136.68 30000262 HC COLUMN CHROMATOGRAPHY EACH SP 300 82542 55 % of Charges OP 61.00 55.00 40.87 39.65 59.00 39.65 59.00 30000260 HC CHROMATO MASS SPEC QUANT 300 82542 67 % of Charges OP 70.00 55.00 46.90 45.50 59.00 45.50 59.00 30000262 HC COLUMN CHROMATOGRAPHY EACH SP 300 82542 67 % of Charges OP 216.00 55.00 144.72 140.40 59.00 55.00 144.72 30000259 HC 18 HYDROXYCORTICOSTERONE 300 82542 53 % of Charges OP 357.00 55.00 239.19 232.05 59.00 55.00 239.19 30001266 HC CHROMATOGRAPHY MASS SPEC QUANT 300 82542 67 % of Charges OP 717.00 55.00 480.39 466.05 59.00 55.00 480.39 30000278 HC ADDL CPK CREATINE PHOSP 300 82550 51 % of Charges OP 20.00 50.00 13.40 13.00 54.00 13.00 54.00 30000277 HC CK TOTAL 300 82550 53 % of Charges OP 69.00 50.00 46.23 44.85 54.00 44.85 54.00 30000276 HC CREATINE PHOSPHOKINASE 300 82550 51 % of Charges OP 84.00 50.00 56.28 54.60 54.00 50.00 56.28 30000279 HC CK ISOENZYMES 300 82552 53 % of Charges OP 133.00 41.00 89.11 86.45 89.11 41.00 89.11 30000280 HC CPK MB FRACTION 300 82553 51 % of Charges OP 195.00 87.00 130.65 126.75 93.00 87.00 130.65 30000281 HC BEDSIDE CREATININE 300 82565 295 % of Charges OP 13.00 39.00 8.71 8.45 42.00 8.45 42.00 30000282 HC ADDL CREATININE 300 82565 51 % of Charges OP 20.00 39.00 13.40 13.00 42.00 13.00 42.00 30000281 HC BEDSIDE CREATININE 300 82565 51 % of Charges OP 62.00 39.00 41.54 40.30 42.00 39.00 42.00 30001381 HC CREATININE 300 82565 51 % of Charges OP 62.00 39.00 41.54 40.30 42.00 39.00 42.00 30000286 HC CREATININE OTHER SOURCE 300 82570 54 % of Charges OP 29.00 29.00 19.43 18.85 31.00 18.85 31.00 30000285 HC URINE CREATININE 300 82570 51 % of Charges OP 31.00 29.00 20.77 20.15 31.00 20.15 31.00 30000284 HC URINE CREATININE TIMED 300 82570 54 % of Charges OP 31.00 29.00 20.77 20.15 31.00 20.15 31.00 30001416 HC CREATININE OTHER SOURCE 300 82570 51 % of Charges OP 62.00 29.00 41.54 40.30 31.00 29.00 41.54 30000285 HC URINE CREATININE 300 82570 67 % of Charges OP 72.00 29.00 48.24 46.80 31.00 29.00 48.24 30000283 HC CREATININE URINE RANDOM 300 82570 51 % of Charges OP 75.00 29.00 50.25 48.75 31.00 29.00 50.25 30001237 HC CREATININE URINE 300 82570 51 % of Charges OP 97.00 29.00 64.99 63.05 31.00 29.00 64.99 30000286 HC CREATININE OTHER SOURCE 300 82570 67 % of Charges OP 97.00 29.00 64.99 63.05 31.00 29.00 64.99 30000288 HC CRYOFIBRINOGEN 300 82585 55 % of Charges OP 82.00 9.00 54.94 53.30 10.00 9.00 54.94 30001466 HC CRYOGLOBULIN QUAL OR SEMI QUANT 300 82595 53 % of Charges OP 19.00 19.00 12.73 12.35 20.00 12.35 20.00 30000289 HC ASSAY OF CRYOGLOBULIN 300 82595 55 % of Charges OP 76.00 19.00 50.92 49.40 20.00 19.00 50.92 30000290 HC CYANIDE 300 82600 53 % of Charges OP 161.00 59.00 107.87 104.65 63.00 59.00 107.87 30000290 HC CYANIDE 300 82600 67 % of Charges OP 511.00 59.00 342.37 332.15 63.00 59.00 342.37 30000291 HC VITAMIN B-12 300 82607 51 % of Charges OP 195.00 114.00 130.65 126.75 122.00 114.00 130.65 30000292 HC DHEA 300 82626 53 % of Charges OP 135.00 49.00 90.45 87.75 90.45 49.00 90.45 30000292 HC DHEA 300 82626 67 % of Charges OP 274.00 49.00 183.58 178.10 183.58 49.00 183.58 30000293 HC DHEA SULFATE 300 82627 53 % of Charges OP 139.00 121.00 93.13 90.35 129.00 90.35 129.00 30000296 HC DIBUCAINE INDEX 300 82638 53 % of Charges OP 39.00 38.00 26.13 25.35 26.13 25.35 38.00 30000297 HC VITAMIN D 1 25-DIHYDROXY 300 82652 53 % of Charges OP 369.00 291.00 247.23 239.85 311.00 239.85 311.00 30001379 HC ENZYME ACTIVITY - HURLER 300 82657 68 % of Charges OP 23.00 137.00 15.41 14.95 147.00 14.95 147.00 30001378 HC ENZYME ACTIVITY - POMPE 300 82657 68 % of Charges OP 23.00 137.00 15.41 14.95 147.00 14.95 147.00 30000298 HC ENZYME ACTIVITY EACH SPECIMEN 300 82657 55 % of Charges OP 188.00 137.00 125.96 122.20 147.00 122.20 147.00 30000299 HC ENZYME ACTIVITY IN BLOOD CELLS 300 82657 67 % of Charges OP 205.00 137.00 137.35 133.25 147.00 133.25 147.00 30000300 HC TPMT 300 82657 53 % of Charges OP 695.00 137.00 465.65 451.75 147.00 137.00 465.65 30000302 HC ELECTROPHORETIC TECHNIQUE 300 82664 67 % of Charges OP 76.00 105.00 50.92 49.40 50.92 49.40 105.00 30000301 HC CHYLOMICRON SCREEN BODY FLUID 300 82664 53 % of Charges OP 189.00 105.00 126.63 122.85 126.63 105.00 126.63 30000303 HC GALACTOSEMIA GENOTYPING 300 82664 55 % of Charges OP " 1,040.00 " 105.00 696.80 676.00 696.80 105.00 696.80 30000304 HC ERYTHROPOIETIN 300 82668 53 % of Charges OP 274.00 51.00 183.58 178.10 183.58 51.00 183.58 30000305 HC ESTRADIOL 300 82670 51 % of Charges OP 165.00 156.00 110.55 107.25 167.00 107.25 167.00 30000305 HC ESTRADIOL 300 82670 55 % of Charges OP 186.00 156.00 124.62 120.90 167.00 120.90 167.00 30000305 HC ESTRADIOL 300 82670 54 % of Charges OP 194.00 156.00 129.98 126.10 167.00 126.10 167.00 30000306 HC ESTROGEN TOTAL 300 82672 67 % of Charges OP 65.00 109.00 43.55 42.25 117.00 42.25 117.00 30000307 HC ESTRIOL 300 82677 55 % of Charges OP 130.00 74.00 87.10 84.50 87.10 74.00 87.10 30000309 HC ETHYLENE GLYCOL SERUM 300 82693 67 % of Charges OP 409.00 46.00 274.03 265.85 274.03 46.00 274.03 30000310 HC FAT STOOL QUAL 300 82705 53 % of Charges OP 69.00 8.00 46.23 44.85 9.00 8.00 46.23 30000310 HC FAT STOOL QUAL 300 82705 67 % of Charges OP 69.00 8.00 46.23 44.85 9.00 8.00 46.23 30000311 HC FECAL FAT QUANTITATIVE 300 82710 53 % of Charges OP 129.00 51.00 86.43 83.85 86.43 51.00 86.43 30001380 HC VERY LONG CHAIN FATTY ACID-X-LINKED ADRENOLEUKODYSTROPHY 300 82726 68 % of Charges OP 23.00 55.00 15.41 14.95 59.00 14.95 59.00 30000312 HC FERRITIN 300 82728 51 % of Charges OP 185.00 104.00 123.95 120.25 111.00 104.00 123.95 30000313 HC FETAL FIBRONECTIN SEMIQUANT 300 82731 51 % of Charges OP 588.00 487.00 393.96 382.20 521.00 382.20 521.00 30000315 HC FOLIC ACID 300 82746 51 % of Charges OP 166.00 112.00 111.22 107.90 120.00 107.90 120.00 30000316 HC FOLATE RBC 300 82747 53 % of Charges OP 202.00 53.00 135.34 131.30 57.00 53.00 135.34 30000318 HC GALACTOSE 300 82760 68 % of Charges OP 23.00 26.00 15.41 14.95 28.00 14.95 28.00 30000318 HC GALACTOSE 300 82760 55 % of Charges OP 194.00 26.00 129.98 126.10 28.00 26.00 129.98 30000319 HC GALACTOSE-1-PHOS URIDYLTRANS 300 82775 55 % of Charges OP 268.00 63.00 179.56 174.20 179.56 63.00 179.56 30000320 HC GALACTOSE-1-PHOS URIDYL TRANSF 300 82776 68 % of Charges OP 23.00 25.00 15.41 14.95 27.00 14.95 27.00 30001402 HC GAMMAGLOBULIN EACH 300 82784 53 % of Charges OP 14.00 70.00 9.38 9.10 75.00 9.10 75.00 30001467 HC GAMMAGLOBULIN (IMMUMOGLOB) EACH 300 82784 53 % of Charges OP 29.00 70.00 19.43 18.85 75.00 18.85 75.00 30000322 HC IGG 300 82784 53 % of Charges OP 47.00 70.00 31.49 30.55 75.00 30.55 75.00 30000323 HC IGA 300 82784 55 % of Charges OP 50.00 70.00 33.50 32.50 75.00 32.50 75.00 30000321 HC GAMMAGLOB IGA/IGG/IGM EACH 300 82784 53 % of Charges OP 119.00 70.00 79.73 77.35 75.00 70.00 79.73 30000321 HC GAMMAGLOB IGA/IGG/IGM EACH 300 82784 54 % of Charges OP 119.00 70.00 79.73 77.35 75.00 70.00 79.73 30000326 HC IGE 300 82785 53 % of Charges OP 77.00 102.00 51.59 50.05 109.00 50.05 109.00 30001267 HC IMMUNOGLOBULIN E 300 82785 53 % of Charges OP 129.00 102.00 86.43 83.85 109.00 83.85 109.00 30000327 HC IMMUNOGLOBULIN G SUBCLASS 300 82787 53 % of Charges OP 77.00 61.00 51.59 50.05 65.00 50.05 65.00 30000328 HC PH BLOOD 300 82800 51 % of Charges OP 100.00 25.00 67.00 65.00 67.00 25.00 67.00 30000334 HC PH AND PCO2 300 82803 51 % of Charges OP 166.00 146.00 111.22 107.90 156.00 107.90 156.00 30000329 HC BEDSIDE BLOOD GAS 300 82803 51 % of Charges OP 204.00 146.00 136.68 132.60 156.00 132.60 156.00 30000331 HC BLOOD GASES PH PCO2 PO2 300 82803 51 % of Charges OP 204.00 146.00 136.68 132.60 156.00 132.60 156.00 30000333 HC CONTINUOUS BLOOD GAS MON SUBSE 300 82803 51 % of Charges OP 240.00 146.00 160.80 156.00 156.00 146.00 160.80 30000330 HC BEDSIDE BLOOD GASES 300 82803 51 % of Charges OP 256.00 146.00 171.52 166.40 156.00 146.00 171.52 30000332 HC CONTINUOUS BLOOD GAS MON INITI 300 82803 51 % of Charges OP " 1,027.00 " 146.00 688.09 667.55 156.00 146.00 688.09 30000335 HC O2 SATURATION BY OXIMETRY 300 82810 51 % of Charges OP 190.00 21.00 127.30 123.50 127.30 21.00 127.30 30000336 HC GASTRIN 300 82941 53 % of Charges OP 274.00 45.00 183.58 178.10 183.58 45.00 183.58 30000337 HC GLUCOGON 300 82943 67 % of Charges OP 195.00 44.00 130.65 126.75 130.65 44.00 130.65 30000338 HC GLUCOSE URINE 300 82945 51 % of Charges OP 87.00 29.00 58.29 56.55 31.00 29.00 58.29 30001367 HC GLUCOSE BODY FLUID 300 82945 51 % of Charges OP 87.00 29.00 58.29 56.55 31.00 29.00 58.29 30000338 HC GLUCOSE URINE 300 82945 67 % of Charges OP 87.00 29.00 58.29 56.55 31.00 29.00 58.29 30000340 HC ADDL GLUCOSE QUANT 300 82947 51 % of Charges OP 20.00 29.00 13.40 13.00 31.00 13.00 31.00 30001377 HC GLUCOSE 300 82947 51 % of Charges OP 69.00 29.00 46.23 44.85 31.00 29.00 46.23 30000339 HC GLUCOSE 2 HR 300 82947 51 % of Charges OP 69.00 29.00 46.23 44.85 31.00 29.00 46.23 30000342 HC GLUCOSE TOLERANCE/SPECI 300 82950 51 % of Charges OP 77.00 36.00 51.59 50.05 39.00 36.00 51.59 30000343 HC LACTOSE TOLERANCE 3 SPECIMENS 300 82951 51 % of Charges OP 171.00 97.00 114.57 111.15 104.00 97.00 114.57 30001360 HC LACTOSE TOLERANCE-3 SPEC 300 82951 51 % of Charges OP 171.00 97.00 114.57 111.15 104.00 97.00 114.57 30000344 HC TOL TEST - EA ADDL SPEC > 3 300 82952 51 % of Charges OP 53.00 19.00 35.51 34.45 20.00 19.00 35.51 30000345 HC GLUCOSE 6 PHOSPHATE DEHYDROGEN 300 82955 53 % of Charges OP 194.00 36.00 129.98 126.10 39.00 36.00 129.98 30000346 HC BEDSIDE GLUCOSE 300 82962 51 % of Charges OP 59.00 17.00 39.53 38.35 18.00 17.00 39.53 30000349 HC ADDL GGT GAMMA GLUTAMYL 300 82977 51 % of Charges OP 20.00 55.00 13.40 13.00 59.00 13.00 59.00 30000348 HC GGT 300 82977 51 % of Charges OP 82.00 55.00 54.94 53.30 59.00 53.30 59.00 30000347 HC GGT 300 82977 67 % of Charges OP 205.00 55.00 137.35 133.25 59.00 55.00 137.35 30000350 HC FRUCTOSAMINE 300 82985 53 % of Charges OP 27.00 46.00 18.09 17.55 18.09 17.55 46.00 30000351 HC GONADOTROPIN FOLL STIM HORMONE 300 83001 51 % of Charges OP 161.00 141.00 107.87 104.65 151.00 104.65 151.00 30000351 HC GONADOTROPIN FOLL STIM HORMONE 300 83001 54 % of Charges OP 172.00 141.00 115.24 111.80 151.00 111.80 151.00 30000352 HC GONADOTROPIN LUTEINIZING HORM 300 83002 51 % of Charges OP 161.00 140.00 107.87 104.65 150.00 104.65 150.00 30000352 HC GONADOTROPIN LUTEINIZING HORM 300 83002 54 % of Charges OP 172.00 140.00 115.24 111.80 150.00 111.80 150.00 30000354 HC GROWTH HORMONE HUMAN 300 83003 53 % of Charges OP 73.00 51.00 48.91 47.45 48.91 47.45 51.00 30000353 HC GROWTH HORMONE 300 83003 67 % of Charges OP 238.00 51.00 159.46 154.70 159.46 51.00 159.46 30000356 HC HAPTOGLOBIN QNT 300 83010 53 % of Charges OP 185.00 39.00 123.95 120.25 42.00 39.00 123.95 30000356 HC HAPTOGLOBIN QNT 300 83010 54 % of Charges OP 185.00 39.00 123.95 120.25 42.00 39.00 123.95 30000355 HC HAPTOGLOBIN 300 83010 67 % of Charges OP 205.00 39.00 137.35 133.25 42.00 39.00 137.35 30000357 HC HELICOBACTER PLYORI BREATH TST 300 83013 54 % of Charges OP 388.00 177.00 259.96 252.20 189.00 177.00 259.96 30000360 HC HEMOGLOBIN FRACTION ELECTROPHO 300 83020 68 % of Charges OP 23.00 40.00 15.41 14.95 43.00 14.95 43.00 30000359 HC HGB ELECTROPHORESIS QUANT ALK 300 83020 53 % of Charges OP 34.00 40.00 22.78 22.10 43.00 22.10 43.00 30000360 HC HEMOGLOBIN FRACTION ELECTROPHO 300 83020 53 % of Charges OP 52.00 40.00 34.84 33.80 43.00 33.80 43.00 30000358 HC HGB ELECTROPHORESIS QUANT ACID 300 83020 53 % of Charges OP 73.00 40.00 48.91 47.45 43.00 40.00 48.91 30001268 HC HGB FRACTION & QUANT ELECTRO 300 83020 53 % of Charges OP 78.00 40.00 52.26 50.70 43.00 40.00 52.26 30000360 HC HEMOGLOBIN FRACTION ELECTROPHO 300 83020 67 % of Charges OP 95.00 40.00 63.65 61.75 43.00 40.00 63.65 30000362 HC HGB FRACT CHROMATOGRAPHY 300 83021 53 % of Charges OP 62.00 55.00 41.54 40.30 59.00 40.30 59.00 30000361 HC HEMOGLOBIN EVALUATION 300 83021 53 % of Charges OP 76.00 55.00 50.92 49.40 59.00 49.40 59.00 30000363 HC HGB FRACTIONATION QUANT CHRO 300 83021 67 % of Charges OP 95.00 55.00 63.65 61.75 59.00 55.00 63.65 30000364 HC HEMOGLOBIN F CHEMICAL 300 83030 67 % of Charges OP 95.00 20.00 63.65 61.75 63.65 20.00 63.65 30000365 HC HGB F FETAL QUAL 300 83033 53 % of Charges OP 27.00 18.00 18.09 17.55 18.09 17.55 18.09 30000366 HC HGB A1C 300 83036 51 % of Charges OP 92.00 73.00 61.64 59.80 78.00 59.80 78.00 30000366 HC HGB A1C 300 83036 54 % of Charges OP 92.00 73.00 61.64 59.80 78.00 59.80 78.00 30000368 HC METHEMOGLOBIN QUANT 300 83050 51 % of Charges OP 152.00 22.00 101.84 98.80 101.84 22.00 101.84 30000369 HC PLASMA HEMOGLOBIN 300 83051 53 % of Charges OP 240.00 56.00 160.80 156.00 60.00 56.00 160.80 30000371 HC HEMOGLOBIN URINE 300 83069 53 % of Charges OP 150.00 12.00 100.50 97.50 100.50 12.00 100.50 30000372 HC HEMOSIDERIN 300 83070 53 % of Charges OP 53.00 7.00 35.51 34.45 35.51 7.00 35.51 30000373 HC HEMOSIDERIN QUAL URINE 300 83070 67 % of Charges OP 55.00 7.00 36.85 35.75 36.85 7.00 36.85 30000375 HC HOMOCYSTEINE TOTAL 300 83090 53 % of Charges OP 250.00 128.00 167.50 162.50 137.00 128.00 167.50 30000376 HC HOMOVANILLIC ACID HVA 300 83150 53 % of Charges OP 143.00 59.00 95.81 92.95 95.81 59.00 95.81 30000377 HC 5 HIAA HYDROXYINDOLACETIC ACID 300 83497 53 % of Charges OP 173.00 66.00 115.91 112.45 71.00 66.00 115.91 30000379 HC CONGENTL ADREN HYPRPLSIC SCREN 300 83498 68 % of Charges OP 23.00 148.00 15.41 14.95 158.00 14.95 158.00 30000378 HC 17 HYDROXYPROGESTERONE 300 83498 53 % of Charges OP 129.00 148.00 86.43 83.85 158.00 83.85 158.00 30000380 HC HYDROPROGESTERONE 17-D 300 83498 55 % of Charges OP 246.00 148.00 164.82 159.90 158.00 148.00 164.82 30000381 HC NEONATAL 17 OHP 300 83498 67 % of Charges OP 247.00 148.00 165.49 160.55 158.00 148.00 165.49 30000383 HC CYSTIC FIBROSIS SCREEN 300 83516 68 % of Charges OP 23.00 87.00 15.41 14.95 93.00 14.95 93.00 30000390 HC IMMUNOASSAY MULT STEP 300 83516 53 % of Charges OP 49.00 87.00 32.83 31.85 93.00 31.85 93.00 30000399 HC CENTROMERE AB IGG 300 83516 55 % of Charges OP 59.00 87.00 39.53 38.35 93.00 38.35 93.00 30000387 HC IMMUNO INFECTIOUS AGENT 300 83516 53 % of Charges OP 62.00 87.00 41.54 40.30 93.00 40.30 93.00 30000396 HC TISSUE TRANSGLUT IGA OR IGG 300 83516 55 % of Charges OP 62.00 87.00 41.54 40.30 93.00 40.30 93.00 30000397 HC TITIN ANTIBODY 300 83516 53 % of Charges OP 80.00 87.00 53.60 52.00 93.00 52.00 93.00 30000384 HC DEAMINATED GLIADEN IGA OR IGG 300 83516 55 % of Charges OP 82.00 87.00 54.94 53.30 93.00 53.30 93.00 30000386 HC IMMUN FOR AN OTH INF AB OR AG 300 83516 53 % of Charges OP 120.00 87.00 80.40 78.00 93.00 78.00 93.00 30000391 HC IMMUNOASSAY QUANTITATIVE 300 83516 53 % of Charges OP 131.00 87.00 87.77 85.15 93.00 85.15 93.00 30000393 HC MYELOPEROXIDASE MPO 300 83516 53 % of Charges OP 144.00 87.00 96.48 93.60 93.00 87.00 96.48 30000394 HC PROTEASE 3 AB PR3 300 83516 53 % of Charges OP 144.00 87.00 96.48 93.60 93.00 87.00 96.48 30000389 HC IMMUNOASSAY FOR PR3 AB 300 83516 55 % of Charges OP 154.00 87.00 103.18 100.10 93.00 87.00 103.18 30000385 HC GLUTAMIC ACID DECARBOXYLASE 300 83516 53 % of Charges OP 188.00 87.00 125.96 122.20 93.00 87.00 125.96 30000392 HC MYELOPEROXIDASE AB 300 83516 55 % of Charges OP 196.00 87.00 131.32 127.40 93.00 87.00 131.32 30000395 HC RNA POLYMERASE III AB IGG 300 83516 53 % of Charges OP 250.00 87.00 167.50 162.50 93.00 87.00 167.50 30000382 HC ANNA IGG BY IMMUNOBLOT 300 83516 53 % of Charges OP 260.00 87.00 174.20 169.00 93.00 87.00 174.20 30000388 HC IMMUNO QUANT RO SEMI QUANT OTH 300 83516 53 % of Charges OP 284.00 87.00 190.28 184.60 93.00 87.00 190.28 30001270 HC IMMUNO INFECTIOUS AGENT 300 83516 53 % of Charges OP 425.00 87.00 284.75 276.25 93.00 87.00 284.75 30001269 HC IMMUN FOR AN OTH INF AB OR AG 300 83516 53 % of Charges OP 516.00 87.00 345.72 335.40 93.00 87.00 345.72 30000398 HC TYSABRI AB 300 83516 55 % of Charges OP 551.00 87.00 369.17 358.15 93.00 87.00 369.17 30000411 HC IMMUNOASSAY QUANT BY RIA 300 83519 55 % of Charges OP 49.00 87.00 32.83 31.85 93.00 31.85 93.00 30001271 HC IMMUNOASSAY QUANT BY RIA 300 83519 55 % of Charges OP 82.00 87.00 54.94 53.30 93.00 53.30 93.00 30000410 HC IMMUNO ANALYTE QUANT BY RIA 300 83519 53 % of Charges OP 123.00 87.00 82.41 79.95 93.00 79.95 93.00 30000417 HC 21-HYDROXYLASE ANTIBODIES 300 83519 53 % of Charges OP 137.00 87.00 91.79 89.05 93.00 87.00 93.00 30000406 HC ACETYLCHOLINE BINDING AB 300 83519 53 % of Charges OP 256.00 87.00 171.52 166.40 93.00 87.00 171.52 30000409 HC IMMUNO ANALY QUANT RADRX TECH 300 83519 67 % of Charges OP 283.00 87.00 189.61 183.95 93.00 87.00 189.61 30000407 HC GAD-65 300 83519 67 % of Charges OP 501.00 87.00 335.67 325.65 93.00 87.00 335.67 30000408 HC GASTRIC INHIB POLYPEPTIDE 300 83519 55 % of Charges OP 559.00 87.00 374.53 363.35 93.00 87.00 374.53 30000412 HC RIA FOR NON-INFECTIOUS AGENT 300 83519 55 % of Charges OP 834.00 87.00 558.78 542.10 93.00 87.00 558.78 30000425 HC IMMUNOASSAY ANALYTE QUANT 300 83520 55 % of Charges OP 45.00 98.00 30.15 29.25 105.00 29.25 105.00 30000430 HC NEURON-SPECIFIC ENOLASE 300 83520 55 % of Charges OP 76.00 98.00 50.92 49.40 105.00 49.40 105.00 30000423 HC CYTOKINE 300 83520 53 % of Charges OP 92.00 98.00 61.64 59.80 105.00 59.80 105.00 30000424 HC IMMUNO ANALYTE QUANT 300 83520 53 % of Charges OP 138.00 98.00 92.46 89.70 105.00 89.70 105.00 30001272 HC CYTOKINE 300 83520 53 % of Charges OP 154.00 98.00 103.18 100.10 105.00 98.00 105.00 30000426 HC IMMUNOASSAY QUANT 300 83520 55 % of Charges OP 180.00 98.00 120.60 117.00 105.00 98.00 120.60 30000434 HC ANTIMULLERIAN HORMONE AMH 300 83520 53 % of Charges OP 185.00 98.00 123.95 120.25 105.00 98.00 123.95 30001424 HC INTERLEUKIN-6 SERUM 300 83520 53 % of Charges OP 222.00 98.00 148.74 144.30 105.00 98.00 148.74 30000431 HC PANCREATIC ELASTASE FECAL 300 83520 53 % of Charges OP 230.00 98.00 154.10 149.50 105.00 98.00 154.10 30001423 HC INHIBIN B 300 83520 53 % of Charges OP 232.00 98.00 155.44 150.80 105.00 98.00 155.44 30001274 HC IMMUNOASSAY QUANT 300 83520 67 % of Charges OP 252.00 98.00 168.84 163.80 105.00 98.00 168.84 30000427 HC INFLIXIMAB MEASUREMENT 300 83520 67 % of Charges OP 264.00 98.00 176.88 171.60 105.00 98.00 176.88 30001273 HC CYTOKINE 300 83520 53 % of Charges OP 348.00 98.00 233.16 226.20 105.00 98.00 233.16 30000429 HC MANNOSE BINDING LECTIN 300 83520 53 % of Charges OP 367.00 98.00 245.89 238.55 105.00 98.00 245.89 30001274 HC IMMUNOASSAY QUANT 300 83520 55 % of Charges OP 394.00 98.00 263.98 256.10 105.00 98.00 263.98 30000432 HC TRYPTASE 300 83520 53 % of Charges OP 461.00 98.00 308.87 299.65 105.00 98.00 308.87 30000428 HC INFLIXIMAB/HACA MEASUREMENT 300 83520 67 % of Charges OP 527.00 98.00 353.09 342.55 105.00 98.00 353.09 30001432 HC FREE AND TOTAL INSULIN (TOTAL) 300 83525 53 % of Charges OP 59.00 86.00 39.53 38.35 92.00 38.35 92.00 30000452 HC INSULIN TOTAL 300 83525 53 % of Charges OP 193.00 86.00 129.31 125.45 92.00 86.00 129.31 30000452 HC INSULIN TOTAL 300 83525 54 % of Charges OP 193.00 86.00 129.31 125.45 92.00 86.00 129.31 30001433 HC FREE AND TOTAL INSULIN (FREE) 300 83527 53 % of Charges OP 59.00 40.00 39.53 38.35 39.53 38.35 40.00 30000453 HC IRON 300 83540 51 % of Charges OP 57.00 49.00 38.19 37.05 52.00 37.05 52.00 30000453 HC IRON 300 83540 54 % of Charges OP 57.00 49.00 38.19 37.05 52.00 37.05 52.00 30000454 HC IRON BINDING CAPACITY 300 83550 51 % of Charges OP 71.00 59.00 47.57 46.15 63.00 46.15 63.00 30000454 HC IRON BINDING CAPACITY 300 83550 54 % of Charges OP 71.00 59.00 47.57 46.15 63.00 46.15 63.00 30000456 HC BEDSIDE LACTATE 300 83605 51 % of Charges OP 60.00 65.00 40.20 39.00 70.00 39.00 70.00 30000455 HC LACTATE 300 83605 54 % of Charges OP 71.00 65.00 47.57 46.15 70.00 46.15 70.00 30001350 HC LACTATE 300 83605 55 % of Charges OP 72.00 65.00 48.24 46.80 70.00 46.80 70.00 30000455 HC LACTATE 300 83605 51 % of Charges OP 120.00 65.00 80.40 78.00 70.00 65.00 80.40 30000457 HC ADDL LDH LACTIC DEHYDRO 300 83615 51 % of Charges OP 20.00 46.00 13.40 13.00 49.00 13.00 49.00 30000459 HC LACTIC DEHYDROGENASE LD 300 83615 51 % of Charges OP 72.00 46.00 48.24 46.80 49.00 46.00 49.00 30000459 HC LACTIC DEHYDROGENASE LD 300 83615 67 % of Charges OP 72.00 46.00 48.24 46.80 49.00 46.00 49.00 30000458 HC LACTIC DEHYDROGENAS FLUID 300 83615 54 % of Charges OP 73.00 46.00 48.91 47.45 49.00 46.00 49.00 30000460 HC LD TOTAL 300 83615 53 % of Charges OP 87.00 46.00 58.29 56.55 49.00 46.00 58.29 30000461 HC LD ISOENZYMES 300 83625 53 % of Charges OP 173.00 96.00 115.91 112.45 115.91 96.00 115.91 30000462 HC LEAD 300 83655 53 % of Charges OP 130.00 91.00 87.10 84.50 97.00 84.50 97.00 30000464 HC FETAL LUNG MATURITY FLUOR POLR 300 83663 54 % of Charges OP 316.00 9.00 211.72 205.40 211.72 9.00 211.72 30000465 HC LAMELLAR BODY DENSITY - AFL 300 83664 53 % of Charges OP 90.00 9.00 60.30 58.50 60.30 9.00 60.30 30000465 HC LAMELLAR BODY DENSITY - AFL 300 83664 54 % of Charges OP 110.00 9.00 73.70 71.50 73.70 9.00 73.70 30001352 HC LIPASE 300 83690 53 % of Charges OP 26.00 52.00 17.42 16.90 56.00 16.90 56.00 30000466 HC LIPASE 300 83690 51 % of Charges OP 103.00 52.00 69.01 66.95 56.00 52.00 69.01 30000466 HC LIPASE 300 83690 67 % of Charges OP 103.00 52.00 69.01 66.95 56.00 52.00 69.01 30000467 HC LIPOPROTEIN A 300 83695 53 % of Charges OP 188.00 40.00 125.96 122.20 125.96 40.00 125.96 30000468 HC NMR LIPOPROFILE 300 83704 53 % of Charges OP 134.00 96.00 89.78 87.10 103.00 87.10 103.00 30000469 HC HDL 300 83718 51 % of Charges OP 72.00 62.00 48.24 46.80 48.24 46.80 62.00 30000470 HC LDL CHOLESTEROL DIRECT 300 83721 53 % of Charges OP 173.00 72.00 115.91 112.45 77.00 72.00 115.91 30000476 HC MAGNESIUM STOOL 300 83735 53 % of Charges OP 55.00 51.00 36.85 35.75 55.00 35.75 55.00 30000474 HC MAGNESIUM SERUM 300 83735 51 % of Charges OP 87.00 51.00 58.29 56.55 55.00 51.00 58.29 30000472 HC MAGNESIUM FLUID 300 83735 51 % of Charges OP 87.00 51.00 58.29 56.55 55.00 51.00 58.29 30000473 HC MAGNESIUM RANDOM URINE 300 83735 51 % of Charges OP 87.00 51.00 58.29 56.55 55.00 51.00 58.29 30000475 HC MAGNESIUM URINE TIMED 300 83735 51 % of Charges OP 87.00 51.00 58.29 56.55 55.00 51.00 58.29 30000474 HC MAGNESIUM SERUM 300 83735 67 % of Charges OP 87.00 51.00 58.29 56.55 55.00 51.00 58.29 30000477 HC MANGANESE 300 83785 53 % of Charges OP 73.00 53.00 48.91 47.45 57.00 47.45 57.00 30000478 HC MANGANESE SERUM 300 83785 67 % of Charges OP 281.00 53.00 188.27 182.65 57.00 53.00 188.27 30000481 HC MASS AND TANDEM SPEC NES EACH 300 83789 68 % of Charges OP 23.00 137.00 15.41 14.95 147.00 14.95 147.00 30000480 HC CARNITINE TOTAL 300 83789 53 % of Charges OP 284.00 137.00 190.28 184.60 147.00 137.00 190.28 30000483 HC THIOPUR METHYLT TPMT-IMUR 300 83789 55 % of Charges OP 679.00 137.00 454.93 441.35 147.00 137.00 454.93 30000487 HC MERCURY QUANT 300 83825 53 % of Charges OP 29.00 123.00 19.43 18.85 132.00 18.85 132.00 30001275 HC MERCURY QUANT 300 83825 53 % of Charges OP 96.00 123.00 64.32 62.40 132.00 62.40 132.00 30000485 HC MERCURY BLOOD 300 83825 53 % of Charges OP 193.00 123.00 129.31 125.45 132.00 123.00 132.00 30000486 HC MERCURY BLOOD QUANT 300 83825 67 % of Charges OP 299.00 123.00 200.33 194.35 132.00 123.00 200.33 30000489 HC METANEPHRINES URINE FRACT 300 83835 53 % of Charges OP 134.00 128.00 89.78 87.10 137.00 87.10 137.00 30000488 HC METANEPHRINES 300 83835 53 % of Charges OP 369.00 128.00 247.23 239.85 137.00 128.00 247.23 30000491 HC MYELIN BASIC PROTEIN 300 83873 53 % of Charges OP 314.00 130.00 210.38 204.10 139.00 130.00 210.38 30000492 HC MYOGLOBIN 300 83874 51 % of Charges OP 168.00 97.00 112.56 109.20 104.00 97.00 112.56 30000492 HC MYOGLOBIN 300 83874 53 % of Charges OP 168.00 97.00 112.56 109.20 104.00 97.00 112.56 30000494 HC NT-PROBNP (BRAIN NATRIURETIC PEPTIDE) 300 83880 51 % of Charges OP 379.00 257.00 253.93 246.35 275.00 246.35 275.00 30001403 HC NEPHELOMETRY EACH 300 83883 53 % of Charges OP 54.00 3.00 36.18 35.10 3.00 3.00 36.18 30000497 HC NEPHELOMETRY ANALYTE 300 83883 53 % of Charges OP 118.00 3.00 79.06 76.70 3.00 3.00 79.06 30000498 HC NEPHELOMETRY EACH ANALYTE NES 300 83883 54 % of Charges OP 118.00 3.00 79.06 76.70 3.00 3.00 79.06 30000495 HC KAPPA/LAMBDA FREE LIGHT CHAIN 300 83883 53 % of Charges OP 185.00 3.00 123.95 120.25 3.00 3.00 123.95 30000500 HC OLIGOCLONAL BANDS 300 83916 55 % of Charges OP 64.00 152.00 42.88 41.60 163.00 41.60 163.00 30000501 HC OLIGOCLONAL IMMUNE OLIG BANDS 300 83916 54 % of Charges OP 325.00 152.00 217.75 211.25 163.00 152.00 217.75 30000502 HC ORGANIC ACIDS TOTAL QUANT 300 83918 53 % of Charges OP 465.00 125.00 311.55 302.25 134.00 125.00 311.55 30000505 HC ORGANIC ACID SINGLE QUANT 300 83921 67 % of Charges OP 466.00 50.00 312.22 302.90 54.00 50.00 312.22 30000504 HC METHYLMALONIC ACID SERUM 300 83921 53 % of Charges OP 477.00 50.00 319.59 310.05 54.00 50.00 319.59 30000506 HC OSMOLALITY BLOOD 300 83930 51 % of Charges OP 154.00 50.00 103.18 100.10 54.00 50.00 103.18 30000507 HC OSMOLALITY URINE 300 83935 51 % of Charges OP 154.00 52.00 103.18 100.10 56.00 52.00 103.18 30001464 HC OXALATE URINE 300 83945 53 % of Charges OP 66.00 40.00 44.22 42.90 43.00 40.00 44.22 30000508 HC OXALATE 300 83945 53 % of Charges OP 147.00 40.00 98.49 95.55 43.00 40.00 98.49 30000509 HC OXALATE 24 HR URINE 300 83945 67 % of Charges OP 220.00 40.00 147.40 143.00 43.00 40.00 147.40 30000512 HC PTH-FINE NEEDLE ASPIRATION 300 83970 53 % of Charges OP 92.00 313.00 61.64 59.80 335.00 59.80 335.00 30000510 HC PARATHORMONE PTH 300 83970 54 % of Charges OP 235.00 313.00 157.45 152.75 335.00 152.75 335.00 30000510 HC PARATHORMONE PTH 300 83970 51 % of Charges OP 351.00 313.00 235.17 228.15 335.00 228.15 335.00 30000511 HC PTH INTEROPERATIVE 300 83970 51 % of Charges OP " 2,368.00 " 313.00 " 1,586.56 " " 1,539.20 " 335.00 313.00 " 1,586.56 " 30000513 HC PH BODY FLUID 300 83986 51 % of Charges OP 53.00 27.00 35.51 34.45 29.00 27.00 35.51 30000514 HC PH SCREEN NOT URINE 300 83986 53 % of Charges OP 78.00 27.00 52.26 50.70 29.00 27.00 52.26 30000515 HC PHENCYCLIDINE CONFIRM URI 300 83992 53 % of Charges OP 184.00 26.00 123.28 119.60 123.28 26.00 123.28 30000516 HC CALPROTECTIN 300 83993 53 % of Charges OP 519.00 148.00 347.73 337.35 158.00 148.00 347.73 30000517 HC ASSAY OF BLOOD PKU 300 84030 67 % of Charges OP 27.00 17.00 18.09 17.55 18.09 17.00 18.09 30000482 HC PKU DIET SPOT MONITORING 300 84030 68 % of Charges OP 74.00 17.00 49.58 48.10 49.58 17.00 49.58 30000520 HC ALKP TOTAL 300 84075 53 % of Charges OP 31.00 40.00 20.77 20.15 43.00 20.15 43.00 30000518 HC ADDL ALKALINE PHOSPHATASE 300 84075 51 % of Charges OP 41.00 40.00 27.47 26.65 43.00 26.65 43.00 30000521 HC PHOSPHATASE ALKALINE 300 84075 51 % of Charges OP 41.00 40.00 27.47 26.65 43.00 26.65 43.00 30000519 HC ALK PHOS-BONE SPECIFIC 300 84075 67 % of Charges OP 324.00 40.00 217.08 210.60 43.00 40.00 217.08 30000523 HC ALKALINE PHOSPHATASE ISOENZYME 300 84080 53 % of Charges OP 98.00 80.00 65.66 63.70 65.66 63.70 80.00 30001462 HC PHOSPHATASE ALKALINE ISOENZYMES 300 84080 53 % of Charges OP 129.00 80.00 86.43 83.85 86.43 80.00 86.43 30000522 HC ALK PHOS ISOENZYMES 300 84080 53 % of Charges OP 326.00 80.00 218.42 211.90 218.42 80.00 218.42 30000526 HC ADDL PHOSPHORUS 300 84100 51 % of Charges OP 20.00 36.00 13.40 13.00 39.00 13.00 39.00 30000525 HC PHOSPHORUS 300 84100 51 % of Charges OP 59.00 36.00 39.53 38.35 39.00 36.00 39.53 30000525 HC PHOSPHORUS 300 84100 67 % of Charges OP 59.00 36.00 39.53 38.35 39.00 36.00 39.53 30000527 HC TIMED 300 84105 51 % of Charges OP 82.00 16.00 54.94 53.30 54.94 16.00 54.94 30000528 HC PBG URINE 300 84110 53 % of Charges OP 157.00 30.00 105.19 102.05 105.19 30.00 105.19 30000530 HC PORPHOBILINOGEN QUANT UR 300 84110 67 % of Charges OP 165.00 30.00 110.55 107.25 110.55 30.00 110.55 30000529 HC PORPHOBILINOGEN QT URINE 300 84110 67 % of Charges OP 190.00 30.00 127.30 123.50 127.30 30.00 127.30 30000531 HC AMNIOTIC FLUID DETECTION 300 84112 51 % of Charges OP 196.00 191.00 131.32 127.40 204.00 127.40 204.00 30000532 HC PORPHYRINS URINE FRACTIONATED 300 84120 53 % of Charges OP 391.00 30.00 261.97 254.15 261.97 30.00 261.97 30000533 HC HEMOQUANT FECES 300 84126 55 % of Charges OP 223.00 21.00 149.41 144.95 149.41 21.00 149.41 30000537 HC ADDL POTASSIUM SERUM 300 84132 51 % of Charges OP 20.00 35.00 13.40 13.00 37.00 13.00 37.00 30000534 HC POTASSIUM SERUM 300 84132 51 % of Charges OP 62.00 35.00 41.54 40.30 37.00 35.00 41.54 30000535 HC BEDSIDE POTASSIUM 300 84132 51 % of Charges OP 70.00 35.00 46.90 45.50 37.00 35.00 46.90 30000536 HC BEDSIDE POTASSIUM 300 84132 51 % of Charges OP 72.00 35.00 48.24 46.80 37.00 35.00 48.24 30000538 HC POTASSIUM URINE 300 84133 51 % of Charges OP 62.00 13.00 41.54 40.30 14.00 13.00 41.54 30000539 HC PREALBUMIN 300 84134 51 % of Charges OP 157.00 111.00 105.19 102.05 119.00 102.05 119.00 30000541 HC PROGESTERONE 300 84144 51 % of Charges OP 163.00 132.00 109.21 105.95 141.00 105.95 141.00 30000542 HC PROCALCITONIN 300 84145 51 % of Charges OP 232.00 121.00 155.44 150.80 129.00 121.00 155.44 30000542 HC PROCALCITONIN 300 84145 67 % of Charges OP 232.00 121.00 155.44 150.80 129.00 121.00 155.44 30000543 HC PROLACTIN 300 84146 51 % of Charges OP 156.00 125.00 104.52 101.40 134.00 101.40 134.00 30000545 HC PSA TOTAL 300 84153 53 % of Charges OP 110.00 139.00 73.70 71.50 149.00 71.50 149.00 30000544 HC PROSTATE SPECIFIC ANTIGN TOTAL 300 84153 51 % of Charges OP 156.00 139.00 104.52 101.40 149.00 101.40 149.00 30000544 HC PROSTATE SPECIFIC ANTIGN TOTAL 300 84153 67 % of Charges OP 156.00 139.00 104.52 101.40 149.00 101.40 149.00 30000546 HC PSA FREE 300 84154 53 % of Charges OP 110.00 56.00 73.70 71.50 60.00 56.00 73.70 30000546 HC PSA FREE 300 84154 67 % of Charges OP 156.00 56.00 104.52 101.40 60.00 56.00 104.52 30000548 HC ADDL PROTEIN TOTAL SERUM 300 84155 51 % of Charges OP 20.00 27.00 13.40 13.00 29.00 13.00 29.00 30000547 HC PROTEIN TOTAL SERUM 300 84155 53 % of Charges OP 20.00 27.00 13.40 13.00 29.00 13.00 29.00 30000547 HC PROTEIN TOTAL SERUM 300 84155 54 % of Charges OP 59.00 27.00 39.53 38.35 29.00 27.00 39.53 30000547 HC PROTEIN TOTAL SERUM 300 84155 51 % of Charges OP 62.00 27.00 41.54 40.30 29.00 27.00 41.54 30000549 HC TOTAL PROTEIN URINE 300 84156 53 % of Charges OP 34.00 27.00 22.78 22.10 29.00 22.10 29.00 30000549 HC TOTAL PROTEIN URINE 300 84156 54 % of Charges OP 59.00 27.00 39.53 38.35 29.00 27.00 39.53 30000549 HC TOTAL PROTEIN URINE 300 84156 51 % of Charges OP 95.00 27.00 63.65 61.75 29.00 27.00 63.65 30000550 HC PROTEIN TOTAL OTHER SOURCE 300 84157 51 % of Charges OP 62.00 27.00 41.54 40.30 29.00 27.00 41.54 30000550 HC PROTEIN TOTAL OTHER SOURCE 300 84157 67 % of Charges OP 62.00 27.00 41.54 40.30 29.00 27.00 41.54 30000551 HC PROTEIN ELECTROPHORESIS CSF 300 84157 53 % of Charges OP 131.00 27.00 87.77 85.15 29.00 27.00 87.77 30001399 HC PROTEIN TOTAL 300 84160 53 % of Charges OP 20.00 16.00 13.40 13.00 17.00 13.00 17.00 30001400 HC PROTEIN ELECTROPHORETIC FRAC QUANT 300 84165 53 % of Charges OP 20.00 81.00 13.40 13.00 87.00 13.00 87.00 30000552 HC PROTEIN ELECTROPH FRACTION QNT 300 84165 54 % of Charges OP 123.00 81.00 82.41 79.95 87.00 79.95 87.00 30000554 HC ELCTR FRAC QUA OTH FLUID W CON 300 84166 53 % of Charges OP 70.00 99.00 46.90 45.50 106.00 45.50 106.00 30000553 HC PROTEIN ELECTRO OTHER FLUID 300 84166 54 % of Charges OP 123.00 99.00 82.41 79.95 106.00 79.95 106.00 30000556 HC NEURONAL NUCLEAR WESTERN BLOT 300 84181 53 % of Charges OP 366.00 52.00 245.22 237.90 56.00 52.00 245.22 30000555 HC MAGM WB 300 84181 53 % of Charges OP 401.00 52.00 268.67 260.65 56.00 52.00 268.67 30000557 HC PURKINJE CELL WESTERN BLOT 300 84181 53 % of Charges OP 427.00 52.00 286.09 277.55 56.00 52.00 286.09 30001485 HC WESTERN BLOT 300 84182 53 % of Charges OP 96.00 55.00 64.32 62.40 59.00 55.00 64.32 30000558 HC AMPHIPHYSIN WESTERN BLOT 300 84182 55 % of Charges OP 122.00 55.00 81.74 79.30 59.00 55.00 81.74 30001444 HC WESTERN BLOT TEST 300 84182 53 % of Charges OP 161.00 55.00 107.87 104.65 59.00 55.00 107.87 30001448 HC WESTERN BLOT WITH INTERP 300 84182 55 % of Charges OP 304.00 55.00 203.68 197.60 59.00 55.00 203.68 30000560 HC WB W INTERP/REPORT 300 84182 55 % of Charges OP 328.00 55.00 219.76 213.20 59.00 55.00 219.76 30000559 HC HEAT SHOCK PROTEIN 70IGG 68KDA 300 84182 53 % of Charges OP 501.00 55.00 335.67 325.65 59.00 55.00 335.67 30000563 HC PROINSULIN 300 84206 53 % of Charges OP 121.00 55.00 81.07 78.65 81.07 55.00 81.07 30000564 HC VITAMIN B6 300 84207 53 % of Charges OP 166.00 45.00 111.22 107.90 48.00 45.00 111.22 30000565 HC VIT B-6 PLASMA PYRODOXINE 300 84207 67 % of Charges OP 478.00 45.00 320.26 310.70 48.00 45.00 320.26 30000566 HC PYRUVATE 300 84210 55 % of Charges OP 348.00 33.00 233.16 226.20 233.16 33.00 233.16 30000567 HC PYRUVATE KINASE RBC 300 84220 55 % of Charges OP 358.00 28.00 239.86 232.70 239.86 28.00 239.86 30000568 HC ACETYLCHOLINE AB 300 84238 53 % of Charges OP 134.00 112.00 89.78 87.10 120.00 87.10 120.00 30000569 HC RENIN ACTIVITY 300 84244 53 % of Charges OP 157.00 127.00 105.19 102.05 136.00 102.05 136.00 30000570 HC SEROTONIN 300 84260 53 % of Charges OP 257.00 71.00 172.19 167.05 172.19 71.00 172.19 30000572 HC SEROTONIN SERUM 300 84260 67 % of Charges OP 556.00 71.00 372.52 361.40 372.52 71.00 372.52 30000571 HC SEROTONIN BLOOD 300 84260 67 % of Charges OP 625.00 71.00 418.75 406.25 418.75 71.00 418.75 30000573 HC SHBG 300 84270 53 % of Charges OP 75.00 92.00 50.25 48.75 98.00 48.75 98.00 30000577 HC ADDL SODIUM BLOOD 300 84295 51 % of Charges OP 20.00 37.00 13.40 13.00 40.00 13.00 40.00 30000574 HC SODIUM BLOOD 300 84295 51 % of Charges OP 72.00 37.00 48.24 46.80 40.00 37.00 48.24 30000575 HC BEDSIDE SODIUM 300 84295 51 % of Charges OP 74.00 37.00 49.58 48.10 40.00 37.00 49.58 30000576 HC BEDSIDE SODIUM 300 84295 51 % of Charges OP 74.00 37.00 49.58 48.10 40.00 37.00 49.58 30000578 HC SODIUM URINE 300 84300 51 % of Charges OP 72.00 21.00 48.24 46.80 22.00 21.00 48.24 30000580 HC SODIUM STOOL 300 84302 53 % of Charges OP 55.00 9.00 36.85 35.75 10.00 9.00 36.85 30000579 HC SODIUM FLUID 300 84302 67 % of Charges OP 72.00 9.00 48.24 46.80 10.00 9.00 48.24 30000580 HC SODIUM STOOL 300 84302 55 % of Charges OP 238.00 9.00 159.46 154.70 10.00 9.00 159.46 30000581 HC IGF-1 INSULIN-LIKE GROWTH I 300 84305 53 % of Charges OP 300.00 161.00 201.00 195.00 172.00 161.00 201.00 30001345 HC SPECTROPHOTOMETRY 300 84311 53 % of Charges OP 28.00 19.00 18.76 18.20 18.76 18.20 19.00 30000585 HC SPECTROPHOTOMETRY 300 84311 67 % of Charges OP 40.00 19.00 26.80 26.00 26.80 19.00 26.80 30000582 HC ADA SPECTROPHOTOMERY ANALYTE 300 84311 53 % of Charges OP 120.00 19.00 80.40 78.00 80.40 19.00 80.40 30000583 HC PORPHYRIN TOTAL 300 84311 55 % of Charges OP 157.00 19.00 105.19 102.05 105.19 19.00 105.19 30000586 HC SPEC GRAVITY EXCL URINE 300 84315 51 % of Charges OP 26.00 19.00 17.42 16.90 20.00 16.90 20.00 30000586 HC SPEC GRAVITY EXCL URINE 300 84315 54 % of Charges OP 52.00 19.00 34.84 33.80 20.00 19.00 34.84 30000586 HC SPEC GRAVITY EXCL URINE 300 84315 55 % of Charges OP 73.00 19.00 48.91 47.45 20.00 19.00 48.91 30000587 HC SUGARS SINGLE QUALITATIVE 300 84376 53 % of Charges OP 70.00 16.00 46.90 45.50 46.90 16.00 46.90 30000588 HC TESTOSTERONE FREE 300 84402 53 % of Charges OP 75.00 78.00 50.25 48.75 50.25 48.75 78.00 30000589 HC TESTOSTERONE TOTAL 300 84403 53 % of Charges OP 75.00 129.00 50.25 48.75 138.00 48.75 138.00 30000589 HC TESTOSTERONE TOTAL 300 84403 54 % of Charges OP 218.00 129.00 146.06 141.70 138.00 129.00 146.06 30000590 HC VITAMIN B1 PLASMA 300 84425 53 % of Charges OP 89.00 70.00 59.63 57.85 75.00 57.85 75.00 30000591 HC THIOCYANATE 300 84430 53 % of Charges OP 93.00 23.00 62.31 60.45 62.31 23.00 62.31 30000592 HC THIOCYANATE SERUM 300 84430 67 % of Charges OP 389.00 23.00 260.63 252.85 260.63 23.00 260.63 30000593 HC THYROGLOBULIN 300 84432 53 % of Charges OP 61.00 89.00 40.87 39.65 95.00 39.65 95.00 30000594 HC THYROGLOBULIN BY LC-MS/MS 300 84432 53 % of Charges OP 271.00 89.00 181.57 176.15 95.00 89.00 181.57 30000595 HC THYROXINE TOTAL 300 84436 51 % of Charges OP 87.00 52.00 58.29 56.55 56.00 52.00 58.29 30000595 HC THYROXINE TOTAL 300 84436 53 % of Charges OP 87.00 52.00 58.29 56.55 56.00 52.00 58.29 30000596 HC THYROXINE TOTAL NEONATAL 300 84437 68 % of Charges OP 23.00 19.00 15.41 14.95 20.00 14.95 20.00 30000597 HC T-4 ASSAY FREE 300 84439 67 % of Charges OP 42.00 66.00 28.14 27.30 71.00 27.30 71.00 30000598 HC THYROXINE FREE 300 84439 51 % of Charges OP 188.00 66.00 125.96 122.20 71.00 66.00 125.96 30000599 HC THYROXINE BINDING GLOBULIN 300 84442 53 % of Charges OP 155.00 45.00 103.85 100.75 103.85 45.00 103.85 30000599 HC THYROXINE BINDING GLOBULIN 300 84442 67 % of Charges OP 297.00 45.00 198.99 193.05 198.99 45.00 198.99 30000601 HC TSH TRIG FRM NEONATAL SCREEN 300 84443 51 % of Charges OP 110.00 127.00 73.70 71.50 136.00 71.50 136.00 30000600 HC THYROID STIMULATING HORMONE 300 84443 51 % of Charges OP 184.00 127.00 123.28 119.60 136.00 119.60 136.00 30000602 HC THYROID STIMULATING IMM GLOBUL 300 84445 53 % of Charges OP 425.00 155.00 284.75 276.25 166.00 155.00 284.75 30000603 HC VITAMIN E 300 84446 53 % of Charges OP 274.00 33.00 183.58 178.10 35.00 33.00 183.58 30000605 HC ADDL SGOT AST 300 84450 51 % of Charges OP 20.00 40.00 13.40 13.00 43.00 13.00 43.00 30000604 HC AST SGOT 300 84450 51 % of Charges OP 70.00 40.00 46.90 45.50 43.00 40.00 46.90 30000607 HC ADDITIONAL SGPT 300 84460 51 % of Charges OP 20.00 40.00 13.40 13.00 43.00 13.00 43.00 30000606 HC ALT 300 84460 67 % of Charges OP 20.00 40.00 13.40 13.00 43.00 13.00 43.00 30000606 HC ALT 300 84460 51 % of Charges OP 70.00 40.00 46.90 45.50 43.00 40.00 46.90 30000608 HC TRANSFERRIN 300 84466 53 % of Charges OP 131.00 96.00 87.77 85.15 103.00 85.15 103.00 30000608 HC TRANSFERRIN 300 84466 54 % of Charges OP 131.00 96.00 87.77 85.15 103.00 85.15 103.00 30000610 HC ADDL TRIGLYCERIDES 300 84478 51 % of Charges OP 20.00 44.00 13.40 13.00 47.00 13.00 47.00 30000609 HC TRIGLYCERIDES 300 84478 51 % of Charges OP 71.00 44.00 47.57 46.15 47.00 44.00 47.57 30000609 HC TRIGLYCERIDES 300 84478 67 % of Charges OP 71.00 44.00 47.57 46.15 47.00 44.00 47.57 30000611 HC T3 UPTAKE 300 84479 53 % of Charges OP 125.00 49.00 83.75 81.25 52.00 49.00 83.75 30000612 HC TRIIODOTHYRONINE T3 TOTAL 300 84480 53 % of Charges OP 168.00 66.00 112.56 109.20 71.00 66.00 112.56 30000612 HC TRIIODOTHYRONINE T3 TOTAL 300 84480 54 % of Charges OP 168.00 66.00 112.56 109.20 71.00 66.00 112.56 30000613 HC TRIIODOTHYRONINE T3 FREE 300 84481 51 % of Charges OP 147.00 66.00 98.49 95.55 71.00 66.00 98.49 30000613 HC TRIIODOTHYRONINE T3 FREE 300 84481 53 % of Charges OP 454.00 66.00 304.18 295.10 71.00 66.00 304.18 30000613 HC TRIIODOTHYRONINE T3 FREE 300 84481 54 % of Charges OP 454.00 66.00 304.18 295.10 71.00 66.00 304.18 30000614 HC T-3 REVERSE 300 84482 53 % of Charges OP 63.00 26.00 42.21 40.95 28.00 26.00 42.21 30001487 HC HS TROPONIN T 300 84484 53 % of Charges OP 60.00 74.00 40.20 39.00 79.00 39.00 79.00 30000615 HC TROPONIN I 300 84484 51 % of Charges OP 250.00 74.00 167.50 162.50 79.00 74.00 167.50 30000618 HC ADDL BUN 300 84520 51 % of Charges OP 20.00 29.00 13.40 13.00 31.00 13.00 31.00 30000616 HC UREA NITROGEN FLUID 300 84520 53 % of Charges OP 21.00 29.00 14.07 13.65 31.00 13.65 31.00 30000617 HC UREA NITROGEN BUN 300 84520 51 % of Charges OP 62.00 29.00 41.54 40.30 31.00 29.00 41.54 30000616 HC UREA NITROGEN FLUID 300 84520 67 % of Charges OP 62.00 29.00 41.54 40.30 31.00 29.00 41.54 30000619 HC UREA URINE 300 84540 51 % of Charges OP 72.00 14.00 48.24 46.80 48.24 14.00 48.24 30000622 HC ADDL URIC ACID 300 84550 51 % of Charges OP 20.00 35.00 13.40 13.00 37.00 13.00 37.00 30000621 HC URIC ACID BLOOD 300 84550 51 % of Charges OP 70.00 35.00 46.90 45.50 37.00 35.00 46.90 30000623 HC URIC ACID URINE 300 84560 53 % of Charges OP 58.00 14.00 38.86 37.70 38.86 14.00 38.86 30000623 HC URIC ACID URINE 300 84560 51 % of Charges OP 70.00 14.00 46.90 45.50 46.90 14.00 46.90 30000623 HC URIC ACID URINE 300 84560 67 % of Charges OP 70.00 14.00 46.90 45.50 46.90 14.00 46.90 30000624 HC VMA URINE 300 84585 53 % of Charges OP 297.00 118.00 198.99 193.05 198.99 118.00 198.99 30000625 HC VASOACTIVE INTEST POLYPEP 300 84586 67 % of Charges OP 62.00 108.00 41.54 40.30 41.54 40.30 108.00 30000625 HC VASOACTIVE INTEST POLYPEP 300 84586 55 % of Charges OP 184.00 108.00 123.28 119.60 123.28 108.00 123.28 30000627 HC VASOPRESSIN ADH 300 84588 53 % of Charges OP 118.00 104.00 79.06 76.70 79.06 76.70 104.00 30000626 HC ARGININE VASOPRESSIN 300 84588 67 % of Charges OP 536.00 104.00 359.12 348.40 359.12 104.00 359.12 30000628 HC VITAMIN A 300 84590 53 % of Charges OP 160.00 88.00 107.20 104.00 94.00 88.00 107.20 30000629 HC VITAMIN B3 300 84591 53 % of Charges OP 272.00 36.00 182.24 176.80 39.00 36.00 182.24 30000630 HC VITAMIN K1 SERUM 300 84597 53 % of Charges OP 250.00 104.00 167.50 162.50 111.00 104.00 167.50 30000632 HC METHANOL 300 84600 67 % of Charges OP 399.00 49.00 267.33 259.35 267.33 49.00 267.33 30000631 HC ALCOHOL ISOPROPYL 300 84600 67 % of Charges OP 409.00 49.00 274.03 265.85 274.03 49.00 274.03 30000634 HC ZINC 300 84630 53 % of Charges OP 142.00 41.00 95.14 92.30 44.00 41.00 95.14 30000635 HC C-PEPTIDE 300 84681 53 % of Charges OP 131.00 64.00 87.77 85.15 68.00 64.00 87.77 30000636 HC GONADOTROPIN CHORONC HCG QUANT 300 84702 55 % of Charges OP 96.00 114.00 64.32 62.40 122.00 62.40 122.00 30000638 HC HCG TOTAL 300 84702 51 % of Charges OP 157.00 114.00 105.19 102.05 122.00 102.05 122.00 30000639 HC HCG QUAL SERUM PREG 300 84703 51 % of Charges OP 157.00 57.00 105.19 102.05 105.19 57.00 105.19 30000637 HC HCG QUANT 300 84704 53 % of Charges OP 55.00 46.00 36.85 35.75 36.85 35.75 46.00 30000644 HC OSMOLALITY STOOL 300 84999 53 % of Charges OP 55.00 36.85 36.85 35.75 36.85 35.75 36.85 30000649 HC POTASSIUM STOOL 300 84999 53 % of Charges OP 55.00 36.85 36.85 35.75 36.85 35.75 36.85 30000646 HC PHENOLPHTHALEIN STOOL 300 84999 53 % of Charges OP 70.00 46.90 46.90 45.50 46.90 45.50 46.90 30000648 HC POTASSIUM FLUID 300 84999 67 % of Charges OP 70.00 46.90 46.90 45.50 46.90 45.50 46.90 30000645 HC PCO2 BY ELECTRODE 300 84999 51 % of Charges OP 97.00 64.99 64.99 63.05 64.99 63.05 64.99 30000644 HC OSMOLALITY STOOL 300 84999 55 % of Charges OP 129.00 86.43 86.43 83.85 86.43 83.85 86.43 30000643 HC OSMOLALITY FLUID 300 84999 51 % of Charges OP 154.00 103.18 103.18 100.10 103.18 100.10 103.18 30000649 HC POTASSIUM STOOL 300 84999 55 % of Charges OP 238.00 159.46 159.46 154.70 159.46 154.70 159.46 30000641 HC NITROGEN FECAL 300 84999 55 % of Charges OP 588.00 393.96 393.96 382.20 393.96 382.20 393.96 30000640 HC CANCER TYPE ID 300 84999 67 % of Charges OP " 5,128.00 " " 3,435.76 " " 3,435.76 " " 3,333.20 " " 3,435.76 " " 3,333.20 " " 3,435.76 " 30000642 HC ONCOTYPE BREAST CANCER ASSAY 300 84999 67 % of Charges OP " 5,419.00 " " 3,630.73 " " 3,630.73 " " 3,522.35 " " 3,630.73 " " 3,522.35 " " 3,630.73 " 30000651 HC MANUAL DIFFERENTIAL 300 85007 51 % of Charges OP 66.00 26.00 44.22 42.90 44.22 26.00 44.22 30000654 HC HEMATOCRIT 300 85014 51 % of Charges OP 39.00 18.00 26.13 25.35 19.00 18.00 26.13 30000655 HC BEDSIDE-HEMATOCRIT 300 85014 51 % of Charges OP 43.00 18.00 28.81 27.95 19.00 18.00 28.81 30000656 HC HEMOGLOBIN 300 85018 51 % of Charges OP 39.00 18.00 26.13 25.35 19.00 18.00 26.13 30000657 HC CBC W/AUTO DIFF 300 85025 51 % of Charges OP 156.00 36.00 104.52 101.40 39.00 36.00 104.52 30000658 HC CBC WITHOUT AUTO DIFF 300 85027 51 % of Charges OP 150.00 49.00 100.50 97.50 52.00 49.00 100.50 30000662 HC RETICULOCYTE AUTOMATED 300 85046 51 % of Charges OP 92.00 43.00 61.64 59.80 46.00 43.00 61.64 30000664 HC WBC 300 85048 51 % of Charges OP 55.00 19.00 36.85 35.75 20.00 19.00 36.85 30000663 HC EOSINOPHIL ABSOLUT CT DIR 300 85048 51 % of Charges OP 57.00 19.00 38.19 37.05 20.00 19.00 38.19 30000665 HC PLATELET COUNT AUTOMATED 300 85049 51 % of Charges OP 53.00 33.00 35.51 34.45 35.00 33.00 35.51 30000666 HC RETICULATED PLATELET ASSAY 300 85055 51 % of Charges OP 59.00 50.00 39.53 38.35 39.53 38.35 50.00 30000667 HC FACTOR II 300 85210 53 % of Charges OP 206.00 16.00 138.02 133.90 138.02 16.00 138.02 30000667 HC FACTOR II 300 85210 67 % of Charges OP 307.00 16.00 205.69 199.55 205.69 16.00 205.69 30000668 HC COAGULATION FACT V ACTIVI 300 85220 53 % of Charges OP 322.00 59.00 215.74 209.30 63.00 59.00 215.74 30000669 HC COAG FACTOR VII ACTIVE 300 85230 53 % of Charges OP 220.00 23.00 147.40 143.00 147.40 23.00 147.40 30000670 HC FACTOR VIII 300 85240 53 % of Charges OP 92.00 59.00 61.64 59.80 63.00 59.00 63.00 30000673 HC PLASMINOGEN 300 85240 53 % of Charges OP 177.00 59.00 118.59 115.05 63.00 59.00 118.59 30000672 HC FACTORVIII REFLEX BETH ASSAY 300 85240 53 % of Charges OP 188.00 59.00 125.96 122.20 63.00 59.00 125.96 30000671 HC FACTOR VIII AHG ONE STAGE 300 85240 53 % of Charges OP 318.00 59.00 213.06 206.70 63.00 59.00 213.06 30000671 HC FACTOR VIII AHG ONE STAGE 300 85240 54 % of Charges OP 318.00 59.00 213.06 206.70 63.00 59.00 213.06 30000674 HC RISTOCETIN COFACTOR 300 85245 53 % of Charges OP 92.00 125.00 61.64 59.80 134.00 59.80 134.00 30000675 HC VWF RISTOCETIN COFACTOR 300 85245 53 % of Charges OP 177.00 125.00 118.59 115.05 134.00 115.05 134.00 30000675 HC VWF RISTOCETIN COFACTOR 300 85245 67 % of Charges OP 460.00 125.00 308.20 299.00 134.00 125.00 308.20 30000676 HC FACTOR VIII VW FACTOR AG 300 85246 53 % of Charges OP 92.00 122.00 61.64 59.80 131.00 59.80 131.00 30000677 HC VON WILLEBRAND FACTOR AG 300 85246 53 % of Charges OP 211.00 122.00 141.37 137.15 131.00 122.00 141.37 30000677 HC VON WILLEBRAND FACTOR AG 300 85246 67 % of Charges OP 481.00 122.00 322.27 312.65 131.00 122.00 322.27 30000678 HC FACTOR VIII VW MULTIMERIC 300 85247 53 % of Charges OP 92.00 73.00 61.64 59.80 78.00 59.80 78.00 30000679 HC FACTOR IX PTC OR CHRISTMAS 300 85250 54 % of Charges OP 322.00 23.00 215.74 209.30 25.00 23.00 215.74 30000680 HC FACTOR X STUART-PROWER 300 85260 54 % of Charges OP 322.00 23.00 215.74 209.30 25.00 23.00 215.74 30000683 HC FACTOR XIII FUNCTIONAL 300 85290 67 % of Charges OP 144.00 41.00 96.48 93.60 96.48 41.00 96.48 30000685 HC CLOT INHIBIT ANTITHROMB 3 ACTV 300 85300 53 % of Charges OP 103.00 89.00 69.01 66.95 95.00 66.95 95.00 30000685 HC CLOT INHIBIT ANTITHROMB 3 ACTV 300 85300 54 % of Charges OP 172.00 89.00 115.24 111.80 95.00 89.00 115.24 30000686 HC ANTITHROMBIN III AG 300 85301 53 % of Charges OP 78.00 32.00 52.26 50.70 34.00 32.00 52.26 30000687 HC PROTEIN C TOTAL AG 300 85302 53 % of Charges OP 155.00 37.00 103.85 100.75 40.00 37.00 103.85 30000688 HC CLOT INHIB ANTICOAG PROTEIN C 300 85303 53 % of Charges OP 281.00 98.00 188.27 182.65 105.00 98.00 188.27 30000688 HC CLOT INHIB ANTICOAG PROTEIN C 300 85303 54 % of Charges OP 281.00 98.00 188.27 182.65 105.00 98.00 188.27 30000689 HC PROTEIN S TOTAL AG 300 85305 53 % of Charges OP 155.00 36.00 103.85 100.75 39.00 36.00 103.85 30000691 HC PROTEIN S FREE AG WITH REFLEX 300 85306 53 % of Charges OP 251.00 98.00 168.17 163.15 105.00 98.00 168.17 30000692 HC PROTEIN S FUNCTIONAL 300 85306 53 % of Charges OP 301.00 98.00 201.67 195.65 105.00 98.00 201.67 30000690 HC PROTEIN S FREE 300 85306 53 % of Charges OP 342.00 98.00 229.14 222.30 105.00 98.00 229.14 30000693 HC APC RESISTANCE PROFILE 300 85307 53 % of Charges OP 186.00 40.00 124.62 120.90 124.62 40.00 124.62 30000694 HC BILL BETHF8 300 85335 53 % of Charges OP 516.00 40.00 345.72 335.40 345.72 40.00 345.72 30000695 HC ACT LOW 300 85347 51 % of Charges OP 73.00 19.00 48.91 47.45 20.00 19.00 48.91 30001238 HC ACT HIGH 300 85347 51 % of Charges OP 131.00 19.00 87.77 85.15 20.00 19.00 87.77 30000696 HC FIBRINOGEN DEGRAD PRODUCT 300 85362 53 % of Charges OP 121.00 21.00 81.07 78.65 81.07 21.00 81.07 30000696 HC FIBRINOGEN DEGRAD PRODUCT 300 85362 67 % of Charges OP 144.00 21.00 96.48 93.60 96.48 21.00 96.48 30000698 HC D-DIMER QUANT 300 85379 51 % of Charges OP 186.00 54.00 124.62 120.90 58.00 54.00 124.62 30000699 HC FIBRINOGEN LEV QUANT CLOT 300 85384 51 % of Charges OP 110.00 64.00 73.70 71.50 68.00 64.00 73.70 30000700 HC FIBRINOLYSIS 300 85390 51 % of Charges OP 131.00 8.00 87.77 85.15 87.77 8.00 87.77 30000701 HC COAGULATION/FIBRINOLYSIS ASSAY 300 85396 51 % of Charges OP 294.00 42.00 196.98 191.10 196.98 42.00 196.98 30000702 HC CLOTTING FUNC ACTIVITY NOS EA ANALYT 300 85397 53 % of Charges OP 477.00 62.00 319.59 310.05 66.00 62.00 319.59 30000703 HC PLASMINOGEN FUNCTIONAL 300 85420 67 % of Charges OP 332.00 20.00 222.44 215.80 222.44 20.00 222.44 30000704 HC KLEIHAUER-BETKE TEST 300 85460 51 % of Charges OP 296.00 46.00 198.32 192.40 49.00 46.00 198.32 30000705 HC FETAL SCRN FET MAT BLD 300 85461 51 % of Charges OP 66.00 18.00 44.22 42.90 19.00 18.00 44.22 30000706 HC HEPARIN ANTI XA LOVENOX L 300 85520 67 % of Charges OP 129.00 19.00 86.43 83.85 20.00 19.00 86.43 30000707 HC HEPARIN PROTAMINE TITRATION 300 85520 51 % of Charges OP 230.00 19.00 154.10 149.50 20.00 19.00 154.10 30000706 HC HEPARIN ANTI XA LOVENOX L 300 85520 51 % of Charges OP 274.00 19.00 183.58 178.10 20.00 19.00 183.58 30000708 HC HEPARIN NEUTRALIZATION 300 85525 53 % of Charges OP 53.00 19.00 35.51 34.45 35.51 19.00 35.51 30000708 HC HEPARIN NEUTRALIZATION 300 85525 51 % of Charges OP 82.00 19.00 54.94 53.30 54.94 19.00 54.94 30000709 HC LEUKOCYTE ALKALINE PHOSPHATASE 300 85540 53 % of Charges OP 194.00 26.00 129.98 126.10 129.98 26.00 129.98 30000710 HC LYSOZYME MURAMIDASE 300 85549 53 % of Charges OP 70.00 38.00 46.90 45.50 46.90 38.00 46.90 30000711 HC LYSOZYME URINE 300 85549 53 % of Charges OP 130.00 38.00 87.10 84.50 87.10 38.00 87.10 30000712 HC OSMOTIC FRAG RBC UNINCUBATED 300 85555 53 % of Charges OP 364.00 20.00 243.88 236.60 243.88 20.00 243.88 30000716 HC PLATELET AGGREGATION - EACH 300 85576 67 % of Charges OP 114.00 162.00 76.38 74.10 173.00 74.10 173.00 30000714 HC PLATELET ACTIVITY FUNCTION 300 85576 51 % of Charges OP 172.00 162.00 115.24 111.80 173.00 111.80 173.00 30000715 HC PLATELET AGGREGATION 300 85576 51 % of Charges OP 274.00 162.00 183.58 178.10 173.00 162.00 183.58 30000717 HC BILL PNP 300 85597 53 % of Charges OP 156.00 55.00 104.52 101.40 104.52 55.00 104.52 30000718 HC HEXAGONAL PHOSPHOLIPID 300 85598 53 % of Charges OP 199.00 55.00 133.33 129.35 133.33 55.00 133.33 30000721 HC PROTHROMBIN TIME -INR+SEC 300 85610 51 % of Charges OP 72.00 29.00 48.24 46.80 31.00 29.00 48.24 30000720 HC PROTHROMBIN TIME 300 85610 51 % of Charges OP 77.00 29.00 51.59 50.05 31.00 29.00 51.59 30000720 HC PROTHROMBIN TIME 300 85610 53 % of Charges OP 77.00 29.00 51.59 50.05 31.00 29.00 51.59 30000719 HC BEDSIDE INR 300 85610 51 % of Charges OP 95.00 29.00 63.65 61.75 31.00 29.00 63.65 30000722 HC PT SUBSTITUTIONS 300 85611 51 % of Charges OP 161.00 12.00 107.87 104.65 107.87 12.00 107.87 30000723 HC DILUTE RUSSELL VIPER VENOM 300 85613 53 % of Charges OP 77.00 66.00 51.59 50.05 71.00 50.05 71.00 30000724 HC REPTILASE TEST 300 85635 53 % of Charges OP 72.00 13.00 48.24 46.80 48.24 13.00 48.24 30000725 HC SEDIMENTATION RATE ESR 300 85652 51 % of Charges OP 70.00 20.00 46.90 45.50 21.00 20.00 46.90 30000727 HC SICKLING OF RBC REDUCTION 300 85660 53 % of Charges OP 76.00 16.00 50.92 49.40 50.92 16.00 50.92 30000728 HC SICKLING SOLUBILITY 300 85660 67 % of Charges OP 103.00 16.00 69.01 66.95 69.01 16.00 69.01 30000726 HC SICKLE CELL SCREEN 300 85660 51 % of Charges OP 239.00 16.00 160.13 155.35 160.13 16.00 160.13 30000729 HC THROMBIN TIME 300 85670 53 % of Charges OP 37.00 17.00 24.79 24.05 18.00 17.00 24.79 30001276 HC THROMBIN TIME 300 85670 53 % of Charges OP 72.00 17.00 48.24 46.80 18.00 17.00 48.24 30000732 HC THROMBIN TIME SINGLE 300 85670 67 % of Charges OP 72.00 17.00 48.24 46.80 18.00 17.00 48.24 30000730 HC THROMBIN TIME 1:1 MIX 300 85670 53 % of Charges OP 80.00 17.00 53.60 52.00 18.00 17.00 53.60 30000729 HC THROMBIN TIME 300 85670 51 % of Charges OP 89.00 17.00 59.63 57.85 18.00 17.00 59.63 30001277 HC THROMBOPLASTIN TIME PTT 300 85730 53 % of Charges OP 53.00 46.00 35.51 34.45 49.00 34.45 49.00 30000733 HC PARTIAL THROMBOPLASTIN PTT 300 85730 53 % of Charges OP 60.00 46.00 40.20 39.00 49.00 39.00 49.00 30000733 HC PARTIAL THROMBOPLASTIN PTT 300 85730 51 % of Charges OP 82.00 46.00 54.94 53.30 49.00 46.00 54.94 30000734 HC PTT SUBSTITUTIONS 300 85732 53 % of Charges OP 71.00 19.00 47.57 46.15 20.00 19.00 47.57 30000734 HC PTT SUBSTITUTIONS 300 85732 51 % of Charges OP 220.00 19.00 147.40 143.00 20.00 19.00 147.40 30000735 HC VISCOSITY 300 85810 53 % of Charges OP 52.00 44.00 34.84 33.80 47.00 33.80 47.00 30000736 HC VISCOSITY SERUM 300 85810 67 % of Charges OP 130.00 44.00 87.10 84.50 47.00 44.00 87.10 30000737 HC EOSINOPHIL URINE 300 85999 51 % of Charges OP 52.00 34.84 34.84 33.80 34.84 33.80 34.84 30001484 "HC AGGLUTININS, EACH ANTIGEN" 300 86000 53 % of Charges OP 93.00 11.00 62.31 60.45 62.31 11.00 62.31 30000738 HC ALLERGEN SPECIFIC - IGE 300 86003 53 % of Charges OP 18.00 15.00 12.06 11.70 16.00 11.70 16.00 30000739 HC ALLERGEN SPECIFIC IGE EACH 300 86003 53 % of Charges OP 28.00 15.00 18.76 18.20 16.00 15.00 18.76 30001479 "HC ALLERGENS, FOOD, EGG COMPONENTS IGE" 300 86003 53 % of Charges OP 36.00 15.00 24.12 23.40 16.00 15.00 24.12 30001478 "HC ALLERGENS, FOOD, FISH PROFILE, IGE" 300 86003 53 % of Charges OP 108.00 15.00 72.36 70.20 16.00 15.00 72.36 30001481 "HC ALLERGENS, FOOD, SHELL FISH PROFILE" 300 86003 53 % of Charges OP 126.00 15.00 84.42 81.90 16.00 15.00 84.42 30001477 "HC ALLERGENS, FOOD, NUTS" 300 86003 53 % of Charges OP 144.00 15.00 96.48 93.60 16.00 15.00 96.48 30000740 HC ALLERGY LATEX RAST 300 86003 55 % of Charges OP 163.00 15.00 109.21 105.95 16.00 15.00 109.21 30001480 "HC ALLERGENS, EGG COMPONENTS IGE" 300 86008 53 % of Charges OP 38.00 34.00 25.46 24.70 36.00 24.70 36.00 30001458 HC HIT ANTIBODY (PF4-H) 300 86022 51 % of Charges OP 127.00 139.00 85.09 82.55 149.00 82.55 149.00 30001358 HC PLATELET ANTIBODIES 300 86022 53 % of Charges OP 175.00 139.00 117.25 113.75 149.00 113.75 149.00 30000765 HC AB ID PLATELET ANTIBODIES 300 86022 53 % of Charges OP 396.00 139.00 265.32 257.40 149.00 139.00 265.32 30000766 HC PF4 ANTIBODIES BY ELISA 300 86022 51 % of Charges OP 501.00 139.00 335.67 325.65 149.00 139.00 335.67 30000768 HC PLATELET COMPATIBILITY PANEL 300 86022 67 % of Charges OP 551.00 139.00 369.17 358.15 149.00 139.00 369.17 30000765 HC AB ID PLATELET ANTIBODIES 300 86022 67 % of Charges OP 607.00 139.00 406.69 394.55 149.00 139.00 406.69 30000769 HC PLATELET CROSSMATCH 300 86022 67 % of Charges OP 660.00 139.00 442.20 429.00 149.00 139.00 442.20 30000767 HC PLATELET AB AB ID 300 86022 67 % of Charges OP 807.00 139.00 540.69 524.55 149.00 139.00 540.69 30000770 HC PLATELET AB DIRECT 300 86023 53 % of Charges OP 295.00 38.00 197.65 191.75 197.65 38.00 197.65 30000772 HC ANA AB REFLEX 300 86038 53 % of Charges OP 114.00 91.00 76.38 74.10 97.00 74.10 97.00 30000771 HC ANA 300 86038 55 % of Charges OP 142.00 91.00 95.14 92.30 97.00 91.00 97.00 30000773 HC ANA TITER 300 86039 53 % of Charges OP 92.00 74.00 61.64 59.80 79.00 59.80 79.00 30000774 HC ANTI-STREPTOLYSIN ASO QUA 300 86060 53 % of Charges OP 208.00 55.00 139.36 135.20 59.00 55.00 139.36 30000775 HC C-REACTIVE PROTEIN-CRP 300 86140 51 % of Charges OP 188.00 40.00 125.96 122.20 43.00 40.00 125.96 30000776 HC CRP CARDIO 300 86141 53 % of Charges OP 130.00 98.00 87.10 84.50 105.00 84.50 105.00 30000776 HC CRP CARDIO 300 86141 54 % of Charges OP 130.00 98.00 87.10 84.50 105.00 84.50 105.00 30000776 HC CRP CARDIO 300 86141 67 % of Charges OP 130.00 98.00 87.10 84.50 105.00 84.50 105.00 30000777 HC BETA 2 GLYCOPROTEIN 1 AB 300 86146 53 % of Charges OP 100.00 84.00 67.00 65.00 90.00 65.00 90.00 30000778 HC CARDIOLIPIN AB EACH CLASS 300 86147 53 % of Charges OP 130.00 105.00 87.10 84.50 112.00 84.50 112.00 30000779 HC ANTIPHOSPHATIDYLSERINE AB 300 86148 53 % of Charges OP 85.00 68.00 56.95 55.25 73.00 55.25 73.00 30000780 HC ANTI-PHOSPHOLIPID 300 86148 55 % of Charges OP 111.00 68.00 74.37 72.15 73.00 68.00 74.37 30000782 HC COLD AGGLUTININ TITER 300 86157 53 % of Charges OP 105.00 20.00 70.35 68.25 21.00 20.00 70.35 30000783 HC COMPLEMNT ANTIGEN EA COMPONENT 300 86160 54 % of Charges OP 99.00 85.00 66.33 64.35 91.00 64.35 91.00 30000783 HC COMPLEMNT ANTIGEN EA COMPONENT 300 86160 53 % of Charges OP 157.00 85.00 105.19 102.05 91.00 85.00 105.19 30000784 HC COMPLEMENT FUNCTIONAL ACTIVITY 300 86161 53 % of Charges OP 106.00 35.00 71.02 68.90 71.02 35.00 71.02 30000785 HC COMPLEMENT ACTIVITY TOTAL EIA 300 86162 53 % of Charges OP 233.00 114.00 156.11 151.45 156.11 114.00 156.11 30000786 HC IMMUNOASSAY PEPTIDE AB 300 86200 55 % of Charges OP 142.00 98.00 95.14 92.30 105.00 92.30 105.00 30000787 HC DNASE B ANTIBODY 300 86215 53 % of Charges OP 126.00 26.00 84.42 81.90 28.00 26.00 84.42 30000787 HC DNASE B ANTIBODY 300 86215 67 % of Charges OP 264.00 26.00 176.88 171.60 28.00 26.00 176.88 30000789 HC DOUBLE STRANDED DNA 300 86225 53 % of Charges OP 71.00 59.00 47.57 46.15 63.00 46.15 63.00 30000788 HC DNA ANTIBODY 300 86225 55 % of Charges OP 92.00 59.00 61.64 59.80 63.00 59.00 63.00 30000790 HC EXTRACTABLE NUCLEAR AG AB 300 86235 53 % of Charges OP 31.00 53.00 20.77 20.15 57.00 20.15 57.00 30001278 HC EXTRACTABLE NUCLEAR AG AB 300 86235 55 % of Charges OP 76.00 53.00 50.92 49.40 57.00 49.40 57.00 30000790 HC EXTRACTABLE NUCLEAR AG AB 300 86235 55 % of Charges OP 168.00 53.00 112.56 109.20 57.00 53.00 112.56 30001447 HC FLUORESCENT NONINF AGENT AB 300 86255 55 % of Charges OP 36.00 91.00 24.12 23.40 97.00 23.40 97.00 30000797 HC FLUORESCENT NONINFECT AB SCRN 300 86255 53 % of Charges OP 68.00 91.00 45.56 44.20 97.00 44.20 97.00 30001279 HC FLUO NONINF AGE ANT SCR EA ANT 300 86255 55 % of Charges OP 89.00 91.00 59.63 57.85 97.00 57.85 97.00 30000796 HC FLUO NONINF AGE ANT SCR EA ANT 300 86255 53 % of Charges OP 92.00 91.00 61.64 59.80 97.00 59.80 97.00 30000800 HC PARANEOPLASTIC PANEL IFA 300 86255 53 % of Charges OP 93.00 91.00 62.31 60.45 97.00 60.45 97.00 30000795 HC ENDOMYSIAL AB IGA SCREEN 300 86255 55 % of Charges OP 133.00 91.00 89.11 86.45 97.00 86.45 97.00 30000792 HC ANCA 300 86255 53 % of Charges OP 163.00 91.00 109.21 105.95 97.00 91.00 109.21 30001281 HC FLUORESCENT NONINFECTION AB SC 300 86255 55 % of Charges OP 256.00 91.00 171.52 166.40 97.00 91.00 171.52 30001349 HC FLUORESCENT NONINFECT AGENT AB 300 86255 55 % of Charges OP 293.00 91.00 196.31 190.45 97.00 91.00 196.31 30001279 HC FLUO NONINF AGE ANT SCR EA ANT 300 86255 53 % of Charges OP 331.00 91.00 221.77 215.15 97.00 91.00 221.77 30000799 HC NMO-AQP4-IGG-FACS 300 86255 55 % of Charges OP 384.00 91.00 257.28 249.60 97.00 91.00 257.28 30000798 HC NEURONAL NUCLEAR ANTIBODY 300 86255 53 % of Charges OP 439.00 91.00 294.13 285.35 97.00 91.00 294.13 30000801 HC PURKINJE CELL ANTIBODY 300 86255 53 % of Charges OP 501.00 91.00 335.67 325.65 97.00 91.00 335.67 30001280 HC FLUORESCENT NONINFECT AG AB 300 86255 55 % of Charges OP 521.00 91.00 349.07 338.65 97.00 91.00 349.07 30000797 HC FLUORESCENT NONINFECT AB SCRN 300 86255 55 % of Charges OP 609.00 91.00 408.03 395.85 97.00 91.00 408.03 30001283 HC FLUORESCENT NONINFECT AB TITER 300 86256 55 % of Charges OP 54.00 46.00 36.18 35.10 49.00 35.10 49.00 30001282 HC FLUOR NONINF AGENT TITER EA 300 86256 53 % of Charges OP 82.00 46.00 54.94 53.30 49.00 46.00 54.94 30000810 HC FLUORESCENT NONINFECT AB TITER 300 86256 55 % of Charges OP 106.00 46.00 71.02 68.90 49.00 46.00 71.02 30000804 HC ANCA TITER 300 86256 53 % of Charges OP 121.00 46.00 81.07 78.65 49.00 46.00 81.07 30000808 HC ENDOMYSIAL ANTIBODIES IGA 300 86256 55 % of Charges OP 148.00 46.00 99.16 96.20 49.00 46.00 99.16 30001283 HC FLUORESCENT NONINFECT AB TITER 300 86256 53 % of Charges OP 152.00 46.00 101.84 98.80 49.00 46.00 101.84 30000812 HC NMO-AQP4-FACS-TITER 300 86256 55 % of Charges OP 180.00 46.00 120.60 117.00 49.00 46.00 120.60 30000809 HC FLUOR NONINF AGENT TITER EA 300 86256 53 % of Charges OP 213.00 46.00 142.71 138.45 49.00 46.00 142.71 30001316 HC FLUORESCENT NONINFECT AB TITER 300 86256 53 % of Charges OP 227.00 46.00 152.09 147.55 49.00 46.00 152.09 30000811 HC NEURONAL NUCLEAR TITER 300 86256 53 % of Charges OP 309.00 46.00 207.03 200.85 49.00 46.00 207.03 30001284 HC FLUORESCENT NONINFECT AB TITER 300 86256 53 % of Charges OP 326.00 46.00 218.42 211.90 49.00 46.00 218.42 30000813 HC PURKINJE AB TITER 300 86256 53 % of Charges OP 331.00 46.00 221.77 215.15 49.00 46.00 221.77 30000805 HC ANNA TITER IGG 300 86256 53 % of Charges OP 332.00 46.00 222.44 215.80 49.00 46.00 222.44 30000814 HC PURKINJE CELL TITER 300 86256 53 % of Charges OP 366.00 46.00 245.22 237.90 49.00 46.00 245.22 30000815 HC CANCER ANTIGEN BREAST CA15-3 300 86300 53 % of Charges OP 153.00 64.00 102.51 99.45 102.51 64.00 102.51 30001216 HC IMMUNOASSAY TUMOR ANTIGEN QNT 300 86300 54 % of Charges OP 278.00 64.00 186.26 180.70 186.26 64.00 186.26 30000816 HC IMMUNOASSAY TUMOR ANTIGEN CA19-9 300 86301 53 % of Charges OP 85.00 64.00 56.95 55.25 68.00 55.25 68.00 30000816 HC IMMUNOASSAY TUMOR ANTIGEN CA19-9 300 86301 54 % of Charges OP 278.00 64.00 186.26 180.70 68.00 64.00 186.26 30000817 HC IMMUNOASSAY TUMOR ANTIGEN CA 125 300 86304 53 % of Charges OP 301.00 157.00 201.67 195.65 168.00 157.00 201.67 30000817 HC IMMUNOASSAY TUMOR ANTIGEN CA 125 300 86304 54 % of Charges OP 301.00 157.00 201.67 195.65 168.00 157.00 201.67 30000818 HC MONONUCLEOSIS SCREEN 300 86308 51 % of Charges OP 92.00 40.00 61.64 59.80 43.00 40.00 61.64 30000819 HC IMMUNO FOR ANTIGEN QUANT 300 86316 53 % of Charges OP 226.00 64.00 151.42 146.90 68.00 64.00 151.42 30000825 HC IMMUNOA INFEC AGENT AB QUANT 300 86317 53 % of Charges OP 7.00 45.00 4.69 4.55 48.00 4.55 48.00 30000826 HC IMMUNOA INFECT AGENT AB QUANT 300 86317 55 % of Charges OP 7.00 45.00 4.69 4.55 48.00 4.55 48.00 30000827 HC IMMUNOASSAY INFECT AGENT AB 300 86317 55 % of Charges OP 26.00 45.00 17.42 16.90 48.00 16.90 48.00 30000824 HC IMMUNO INFECTIOUS QUANT AB 300 86317 53 % of Charges OP 52.00 45.00 34.84 33.80 48.00 33.80 48.00 30000822 HC IMMUN FOR INF AGENT AB QU NOS 300 86317 53 % of Charges OP 80.00 45.00 53.60 52.00 48.00 45.00 53.60 30000823 HC IMMUNO INFECTIOUS ANTIBODY QNT 300 86317 53 % of Charges OP 204.00 45.00 136.68 132.60 48.00 45.00 136.68 30000821 HC HEPATITIS B SURFACE AB 300 86317 53 % of Charges OP 252.00 45.00 168.84 163.80 48.00 45.00 168.84 30000829 HC TEICHOIC ABB IMMUNODIFFUSION 300 86329 53 % of Charges OP 78.00 43.00 52.26 50.70 52.26 43.00 52.26 30000830 HC IMMUNODIFFUSION GEL DIFF QUAL 300 86331 53 % of Charges OP 54.00 36.00 36.18 35.10 36.18 35.10 36.18 30000831 HC IMMUNE COMPLEX C1Q BIND 300 86332 67 % of Charges OP 269.00 74.00 180.23 174.85 180.23 74.00 180.23 30001401 HC IMMUNOFIXATION ELECTRO SERUM 300 86334 53 % of Charges OP 53.00 170.00 35.51 34.45 182.00 34.45 182.00 30000832 HC IMMUNOFIXATION ELECTROPHORESIS 300 86334 54 % of Charges OP 265.00 170.00 177.55 172.25 182.00 170.00 182.00 30000833 HC IMMUNOFIXATION ELECTROPH SERUM 300 86334 55 % of Charges OP 306.00 170.00 205.02 198.90 182.00 170.00 205.02 30000835 HC IMMUNOFIXATION ELECTROPH URINE 300 86335 53 % of Charges OP 110.00 222.00 73.70 71.50 238.00 71.50 238.00 30000834 HC IMMUNOFIX ELECTRO OTHER FLUID 300 86335 54 % of Charges OP 265.00 222.00 177.55 172.25 238.00 172.25 238.00 30001422 HC INHIBIN A ULTRASENSITIVE 300 86336 53 % of Charges OP 71.00 48.00 47.57 46.15 47.57 46.15 48.00 30000836 HC INHIBIN A 300 86336 55 % of Charges OP 96.00 48.00 64.32 62.40 64.32 48.00 64.32 30000838 HC INSULIN ANTIBODY 300 86337 53 % of Charges OP 264.00 65.00 176.88 171.60 176.88 65.00 176.88 30000837 HC INSULIN AB RIA 300 86337 67 % of Charges OP 581.00 65.00 389.27 377.65 389.27 65.00 389.27 30000840 HC HEP BE ANTIBODY 300 86340 53 % of Charges OP 142.00 114.00 95.14 92.30 122.00 92.30 122.00 30000839 HC INTRINSIC FACTOR BLOCKING AB 300 86340 53 % of Charges OP 155.00 114.00 103.85 100.75 122.00 100.75 122.00 30000839 HC INTRINSIC FACTOR BLOCKING AB 300 86340 67 % of Charges OP 252.00 114.00 168.84 163.80 122.00 114.00 168.84 30000843 HC ISLET CELL ANTIBODY 300 86341 55 % of Charges OP 77.00 60.00 51.59 50.05 64.00 50.05 64.00 30000842 HC ISLET CELL AB IGG 300 86341 53 % of Charges OP 301.00 60.00 201.67 195.65 64.00 60.00 201.67 30000844 HC LEUK HISTAMINE RELEASE TST LHR 300 86343 55 % of Charges OP 334.00 38.00 223.78 217.10 223.78 38.00 223.78 30000844 HC LEUK HISTAMINE RELEASE TST LHR 300 86343 67 % of Charges OP 457.00 38.00 306.19 297.05 306.19 38.00 306.19 30000846 HC INFLIXIMAB ACT NEUTRALIZING AB 300 86352 53 % of Charges OP 352.00 289.00 235.84 228.80 309.00 228.80 309.00 30000845 HC ASSAY CELLULAR FUNCTION 300 86352 55 % of Charges OP 386.00 289.00 258.62 250.90 309.00 250.90 309.00 30000847 HC LYMPHOCYTE TRANSFORMATION 300 86353 53 % of Charges OP 92.00 142.00 61.64 59.80 152.00 59.80 152.00 30001285 HC LYMPHOCYTE TRANSFORMATION 300 86353 53 % of Charges OP 154.00 142.00 103.18 100.10 152.00 100.10 152.00 30001286 HC LYMPHOCYTE TRANSFORMATION 300 86353 53 % of Charges OP 241.00 142.00 161.47 156.65 152.00 142.00 161.47 30000848 HC BCELL TOTAL COUNT 300 86355 53 % of Charges OP 102.00 112.00 68.34 66.30 120.00 66.30 120.00 30000850 HC NK CELLS TOTAL COUNT 300 86357 53 % of Charges OP 102.00 112.00 68.34 66.30 120.00 66.30 120.00 30000851 HC TCELL TOTAL COUNT 300 86359 53 % of Charges OP 155.00 115.00 103.85 100.75 123.00 100.75 123.00 30000852 HC ABSOLUTE CD4/CD8 COUNT W/RATIO 300 86360 53 % of Charges OP 155.00 139.00 103.85 100.75 149.00 100.75 149.00 30000853 HC TCELL ABSOLUTE CD4 COUNT 300 86361 53 % of Charges OP 225.00 124.00 150.75 146.25 133.00 124.00 150.75 30000855 HC LIVER KIDNEY MICROSOME-1AB IGG 300 86376 53 % of Charges OP 118.00 110.00 79.06 76.70 118.00 76.70 118.00 30000856 HC THYROID PEROXIDASE TPO AB 300 86376 53 % of Charges OP 220.00 110.00 147.40 143.00 118.00 110.00 147.40 30000858 HC RABIES REFIT ENDPOINT 300 86382 55 % of Charges OP 243.00 42.00 162.81 157.95 162.81 42.00 162.81 30000860 HC STREPTOZYME W/REFLEX TO TITER 300 86403 53 % of Charges OP 70.00 31.00 46.90 45.50 46.90 31.00 46.90 30000861 HC CRYPTOCOCCUS ANTIGEN TITER 300 86406 51 % of Charges OP 71.00 32.00 47.57 46.15 47.57 32.00 47.57 30000862 HC STREPTOCOCCUS TITER 300 86406 53 % of Charges OP 111.00 32.00 74.37 72.15 74.37 32.00 74.37 30001344 HC RHEUMATOID FACTOR QUANTITATIVE 300 86431 53 % of Charges OP 30.00 43.00 20.10 19.50 46.00 19.50 46.00 30000863 HC RHEUMATOID FACTOR QNT 300 86431 53 % of Charges OP 72.00 43.00 48.24 46.80 46.00 43.00 48.24 30000863 HC RHEUMATOID FACTOR QNT 300 86431 54 % of Charges OP 72.00 43.00 48.24 46.80 46.00 43.00 48.24 30000864 HC TB INTERFANTIGEN 300 86480 67 % of Charges OP 367.00 300.00 245.89 238.55 245.89 238.55 300.00 30000865 HC TSPOT TUBERCULOSIS TEST 300 86481 67 % of Charges OP 232.00 228.00 155.44 150.80 244.00 150.80 244.00 30000866 HC SYPHILIS TEST QUALITATIVE 300 86592 53 % of Charges OP 70.00 31.00 46.90 45.50 33.00 31.00 46.90 30000866 HC SYPHILIS TEST QUALITATIVE 300 86592 54 % of Charges OP 70.00 31.00 46.90 45.50 33.00 31.00 46.90 30000867 HC VDRL CSF WITH REFLEX TO TITER 300 86592 53 % of Charges OP 118.00 31.00 79.06 76.70 33.00 31.00 79.06 30000868 HC BILL VDRLCS 300 86593 53 % of Charges OP 60.00 13.00 40.20 39.00 40.20 13.00 40.20 30000869 HC ADENOVIRUS ANTIBODY 300 86603 53 % of Charges OP 53.00 18.00 35.51 34.45 35.51 18.00 35.51 30000869 HC ADENOVIRUS ANTIBODY 300 86603 67 % of Charges OP 165.00 18.00 110.55 107.25 110.55 18.00 110.55 30001287 HC ADENOVIRUS ANTIBODY 300 86603 67 % of Charges OP 257.00 18.00 172.19 167.05 172.19 18.00 172.19 30000870 HC ASPERGILLUS ANTIBODY 300 86606 53 % of Charges OP 54.00 66.00 36.18 35.10 36.18 35.10 66.00 30000870 HC ASPERGILLUS ANTIBODY 300 86606 67 % of Charges OP 71.00 66.00 47.57 46.15 47.57 46.15 66.00 30001288 HC ASPERGILLUS AB 300 86606 53 % of Charges OP 100.00 66.00 67.00 65.00 67.00 65.00 67.00 30001288 HC ASPERGILLUS AB 300 86606 67 % of Charges OP 102.00 66.00 68.34 66.30 68.34 66.00 68.34 30001289 HC ASPERGILLUS ANTIBODY 300 86606 53 % of Charges OP 177.00 66.00 118.59 115.05 118.59 66.00 118.59 30000871 HC BARTONELLA AB 300 86611 53 % of Charges OP 45.00 31.00 30.15 29.25 33.00 29.25 33.00 30000872 HC BLASTOMYCOSIS 300 86612 53 % of Charges OP 100.00 45.00 67.00 65.00 67.00 45.00 67.00 30001290 HC BLASTOMYCES AB 300 86612 67 % of Charges OP 102.00 45.00 68.34 66.30 68.34 45.00 68.34 30000872 HC BLASTOMYCOSIS 300 86612 67 % of Charges OP 139.00 45.00 93.13 90.35 93.13 45.00 93.13 30000873 HC BORDETELLA AB 300 86615 53 % of Charges OP 98.00 41.00 65.66 63.70 65.66 41.00 65.66 30001291 HC LYME CONFIRMATORY TEST 300 86617 53 % of Charges OP 111.00 20.00 74.37 72.15 21.00 20.00 74.37 30000874 HC LYME CONFIRMATORY TEST 300 86617 53 % of Charges OP 235.00 20.00 157.45 152.75 21.00 20.00 157.45 30000875 HC LYME DISEASE AB 300 86618 53 % of Charges OP 218.00 129.00 146.06 141.70 138.00 129.00 146.06 30000876 HC BRUCELLA ANTIBODY 300 86622 53 % of Charges OP 119.00 28.00 79.73 77.35 30.00 28.00 79.73 30000878 HC CANIDIA AB BY ID 300 86628 53 % of Charges OP 166.00 36.00 111.22 107.90 111.22 36.00 111.22 30000877 HC CANDIDA ANTIBODY 300 86628 67 % of Charges OP 261.00 36.00 174.87 169.65 174.87 36.00 174.87 30000880 HC CHLAMYDIA ANTIBODY 300 86631 53 % of Charges OP 45.00 37.00 30.15 29.25 30.15 29.25 37.00 30000879 HC CHLAMYDIA AB IGG ONLY 300 86631 67 % of Charges OP 252.00 37.00 168.84 163.80 168.84 37.00 168.84 30000881 HC CHLAMYDIA IGM ANTIBODY 300 86632 53 % of Charges OP 45.00 37.00 30.15 29.25 30.15 29.25 37.00 30001317 HC COCCIDIOIDES ANTIBODIES 300 86635 53 % of Charges OP 44.00 45.00 29.48 28.60 29.48 28.60 45.00 30001317 HC COCCIDIOIDES ANTIBODIES 300 86635 67 % of Charges OP 85.00 45.00 56.95 55.25 56.95 45.00 56.95 30001292 HC COCCIDIOIDES ANTIBODY 300 86635 53 % of Charges OP 100.00 45.00 67.00 65.00 67.00 45.00 67.00 30001292 HC COCCIDIOIDES ANTIBODY 300 86635 67 % of Charges OP 102.00 45.00 68.34 66.30 68.34 45.00 68.34 30000882 HC COCCIDIOIDES ANTIBODY 300 86635 53 % of Charges OP 220.00 45.00 147.40 143.00 147.40 45.00 147.40 30000882 HC COCCIDIOIDES ANTIBODY 300 86635 67 % of Charges OP 220.00 45.00 147.40 143.00 147.40 45.00 147.40 30001293 HC Q-FEVER AB 300 86638 53 % of Charges OP 103.00 18.00 69.01 66.95 19.00 18.00 69.01 30000883 HC Q-FEVER AB 300 86638 53 % of Charges OP 192.00 18.00 128.64 124.80 19.00 18.00 128.64 30000884 HC CMV ANTIBODY 300 86644 53 % of Charges OP 80.00 65.00 53.60 52.00 70.00 52.00 70.00 30001294 HC CYTOMEGALOVIRUS AB IGG 300 86644 67 % of Charges OP 148.00 65.00 99.16 96.20 70.00 65.00 99.16 30000884 HC CMV ANTIBODY 300 86644 67 % of Charges OP 457.00 65.00 306.19 297.05 70.00 65.00 306.19 30000885 HC CYTOMEGALOVIRUS AB IGM 300 86645 53 % of Charges OP 80.00 65.00 53.60 52.00 70.00 52.00 70.00 30000885 HC CYTOMEGALOVIRUS AB IGM 300 86645 67 % of Charges OP 148.00 65.00 99.16 96.20 70.00 65.00 99.16 30000890 HC ENTEROVIRUS ANTIBODY 300 86658 67 % of Charges OP 50.00 18.00 33.50 32.50 33.50 18.00 33.50 30000890 HC ENTEROVIRUS ANTIBODY 300 86658 53 % of Charges OP 82.00 18.00 54.94 53.30 54.94 18.00 54.94 30000891 HC EBV IGG AB TO EARLY AG 300 86663 53 % of Charges OP 131.00 46.00 87.77 85.15 49.00 46.00 87.77 30000892 HC EBV AB TO NUCLEAR AG IGG 300 86664 53 % of Charges OP 131.00 46.00 87.77 85.15 49.00 46.00 87.77 30000893 HC EBV AB TO VIRAL CAPSID AG 300 86665 53 % of Charges OP 155.00 46.00 103.85 100.75 49.00 46.00 103.85 30000894 HC EHRLICHIA ANTIBODY 300 86666 53 % of Charges OP 99.00 31.00 66.33 64.35 33.00 31.00 66.33 30001295 HC EHRLICHIA ANAPLASMA 300 86666 53 % of Charges OP 232.00 31.00 155.44 150.80 33.00 31.00 155.44 30000894 HC EHRLICHIA ANTIBODY 300 86666 67 % of Charges OP 256.00 31.00 171.52 166.40 33.00 31.00 171.52 30000895 HC FRANCISELLA TULARENSIS 300 86668 53 % of Charges OP 92.00 18.00 61.64 59.80 19.00 18.00 61.64 30000896 HC FRANCISELLA TULARENSIS AB 300 86668 53 % of Charges OP 225.00 18.00 150.75 146.25 19.00 18.00 150.75 30000897 HC FUNGUS AB 300 86671 53 % of Charges OP 68.00 45.00 45.56 44.20 48.00 44.20 48.00 30000898 HC HELICOBACTER PYLORI AB 300 86677 53 % of Charges OP 92.00 77.00 61.64 59.80 61.64 59.80 77.00 30000900 HC HELICOBACTER PYLORI AB IGG 300 86677 53 % of Charges OP 155.00 77.00 103.85 100.75 103.85 77.00 103.85 30000902 HC HELMINTH AB 300 86682 53 % of Charges OP 106.00 40.00 71.02 68.90 43.00 40.00 71.02 30000903 HC TOXOCARA ANTIBODY 300 86682 53 % of Charges OP 344.00 40.00 230.48 223.60 43.00 40.00 230.48 30000904 HC HEM INF B VAC RESP 300 86684 67 % of Charges OP 343.00 49.00 229.81 222.95 229.81 49.00 229.81 30001296 HC HIV-1 AB CONFIRMATION 300 86689 53 % of Charges OP 224.00 20.00 150.08 145.60 150.08 20.00 150.08 30000906 HC HIV AB CONFIRMATION TEST 300 86689 53 % of Charges OP 285.00 20.00 190.95 185.25 190.95 20.00 190.95 30000907 HC HIV-1 AB CONFIRM WESTERN BLOT 300 86689 53 % of Charges OP 301.00 20.00 201.67 195.65 201.67 20.00 201.67 30000908 HC HEPATITIS D VIRAL ANTIBODY 300 86692 53 % of Charges OP 465.00 53.00 311.55 302.25 311.55 53.00 311.55 30001421 HC HERPES SIMPLEX VIRUS TYPE 1-2 ABS IGG W REFLEX TYPE 1-2 GLYCOPROTEIN G-SPECIFIC AB IGG 300 86694 53 % of Charges OP 38.00 91.00 25.46 24.70 97.00 24.70 97.00 30000909 HC HSV NON SPECIFIC 300 86694 53 % of Charges OP 112.00 91.00 75.04 72.80 97.00 72.80 97.00 30000910 HC HSV TYPE 1 GLYCOPROTEIN G-SPECIFIC ANTIBODY IGG BY CIA (REFLEX) 300 86695 53 % of Charges OP 55.00 18.00 36.85 35.75 36.85 18.00 36.85 30000911 HC HSV TYPE 2 GLYCOPROTEIN G-SPECIFIC ANTIBODY IGG BY CIA (REFLEX) 300 86696 53 % of Charges OP 51.00 20.00 34.17 33.15 34.17 20.00 34.17 30000912 HC HISTOPLASMA ANTIBODY 300 86698 53 % of Charges OP 50.00 88.00 33.50 32.50 94.00 32.50 94.00 30001297 HC HISTOPLASMA ANTIBODY 300 86698 53 % of Charges OP 100.00 88.00 67.00 65.00 94.00 65.00 94.00 30001297 HC HISTOPLASMA ANTIBODY 300 86698 67 % of Charges OP 102.00 88.00 68.34 66.30 94.00 66.30 94.00 30001298 HC HISTOPLASMA ANTIBODY 300 86698 67 % of Charges OP 123.00 88.00 82.41 79.95 94.00 79.95 94.00 30000912 HC HISTOPLASMA ANTIBODY 300 86698 67 % of Charges OP 142.00 88.00 95.14 92.30 94.00 88.00 95.14 30001299 HC HIV-1 ANTIBODY 300 86701 53 % of Charges OP 78.00 51.00 52.26 50.70 55.00 50.70 55.00 30001326 HC HIV-1 ANTIBODY 300 86701 53 % of Charges OP 127.00 51.00 85.09 82.55 55.00 51.00 85.09 30000913 HC HIV 1 ANTIBODIES 300 86701 51 % of Charges OP 339.00 51.00 227.13 220.35 55.00 51.00 227.13 30000914 HC HIV-2 ANTIBODY 300 86702 53 % of Charges OP 127.00 20.00 85.09 82.55 85.09 20.00 85.09 30001300 HC HIV-2 ANTIBODY 300 86702 53 % of Charges OP 208.00 20.00 139.36 135.20 139.36 20.00 139.36 30000916 HC HIV-1 AND HIV-2 ANTIBODIES 300 86703 53 % of Charges OP 112.00 51.00 75.04 72.80 55.00 51.00 75.04 30000915 HC HIV 1 AND HIV 2 SINGLE RESULT 300 86703 51 % of Charges OP 230.00 51.00 154.10 149.50 55.00 51.00 154.10 30000917 HC HEP B CORE AB - TOTAL 300 86704 53 % of Charges OP 123.00 91.00 82.41 79.95 97.00 79.95 97.00 30000918 HC HEPATITIS B CORE AB IGM 300 86705 53 % of Charges OP 142.00 51.00 95.14 92.30 55.00 51.00 95.14 30000918 HC HEPATITIS B CORE AB IGM 300 86705 54 % of Charges OP 284.00 51.00 190.28 184.60 55.00 51.00 190.28 30000919 HC HEP B SURFACE ANTIBODY HBSAB 300 86706 54 % of Charges OP 153.00 81.00 102.51 99.45 102.51 81.00 102.51 30000920 HC HEPATITIS BE ANTIBODY 300 86707 53 % of Charges OP 60.00 36.00 40.20 39.00 39.00 36.00 40.20 30000920 HC HEPATITIS BE ANTIBODY 300 86707 67 % of Charges OP 213.00 36.00 142.71 138.45 39.00 36.00 142.71 30000921 HC HEPATITIS A PANEL 300 86708 53 % of Charges OP 93.00 38.00 62.31 60.45 41.00 38.00 62.31 30000922 HC HEPATITIS A ANTIBODY IGM 300 86709 53 % of Charges OP 90.00 85.00 60.30 58.50 91.00 58.50 91.00 30000923 HC INFLUENZA A/B VIRUS AB IGG IGM 300 86710 53 % of Charges OP 66.00 18.00 44.22 42.90 44.22 18.00 44.22 30000924 HC INFLUENZA VIRUS ANTIBODY 300 86710 67 % of Charges OP 148.00 18.00 99.16 96.20 99.16 18.00 99.16 30000926 HC LEGIONELLA PNEUMOPHILA 1-6 IGG 300 86713 53 % of Charges OP 222.00 18.00 148.74 144.30 19.00 18.00 148.74 30001301 HC LEPTOSPIRA AB 300 86720 53 % of Charges OP 126.00 45.00 84.42 81.90 84.42 45.00 84.42 30000927 HC LEPTOSPIRA ANTIBODY 300 86720 53 % of Charges OP 195.00 45.00 130.65 126.75 130.65 45.00 130.65 30000927 HC LEPTOSPIRA ANTIBODY 300 86720 67 % of Charges OP 195.00 45.00 130.65 126.75 130.65 45.00 130.65 30000928 HC LYMPHOCYTIC CHORIOMENINGITIS 300 86727 53 % of Charges OP 61.00 18.00 40.87 39.65 40.87 18.00 40.87 30000928 HC LYMPHOCYTIC CHORIOMENINGITIS 300 86727 67 % of Charges OP 148.00 18.00 99.16 96.20 99.16 18.00 99.16 30001302 HC MUMPS 300 86735 53 % of Charges OP 119.00 18.00 79.73 77.35 79.73 18.00 79.73 30000929 HC MUMPS 300 86735 53 % of Charges OP 157.00 18.00 105.19 102.05 105.19 18.00 105.19 30000930 HC MYCOPLASMA PNEUMONIA AB 300 86738 53 % of Charges OP 120.00 46.00 80.40 78.00 80.40 46.00 80.40 30000930 HC MYCOPLASMA PNEUMONIA AB 300 86738 54 % of Charges OP 120.00 46.00 80.40 78.00 80.40 46.00 80.40 30000933 HC PARVOVIRUS B-19 IGM 300 86747 67 % of Charges OP 202.00 46.00 135.34 131.30 49.00 46.00 135.34 30000931 HC PARVO VIRUS AB 300 86747 53 % of Charges OP 204.00 46.00 136.68 132.60 49.00 46.00 136.68 30000932 HC PARVOVIRUS B-19 IGG 300 86747 67 % of Charges OP 235.00 46.00 157.45 152.75 49.00 46.00 157.45 30000934 HC ENTAMOEBA HISTOLYTICA AB IGG 300 86753 53 % of Charges OP 34.00 33.00 22.78 22.10 35.00 22.10 35.00 30000936 HC ROCKY MTN SPOTTED FEVER AB 300 86757 53 % of Charges OP 134.00 20.00 89.78 87.10 21.00 20.00 89.78 30000937 HC TYPHUS FEVER AB 300 86757 53 % of Charges OP 300.00 20.00 201.00 195.00 21.00 20.00 201.00 30000938 HC ANTIBODY RUBELLA 300 86762 53 % of Charges OP 60.00 48.00 40.20 39.00 51.00 39.00 51.00 30000938 HC ANTIBODY RUBELLA 300 86762 54 % of Charges OP 60.00 48.00 40.20 39.00 51.00 39.00 51.00 30000939 HC RUBELLA IGM 300 86762 53 % of Charges OP 80.00 48.00 53.60 52.00 51.00 48.00 53.60 30000940 HC RUBEOLA AB IGG 300 86765 53 % of Charges OP 92.00 40.00 61.64 59.80 61.64 40.00 61.64 30001473 HC SARS-COV-2 IGG AB 300 86769 53 % of Charges OP 69.00 46.23 46.23 44.85 46.23 44.85 46.23 30001476 HC SARS-COV-2 TOTAL AB 300 86769 51 % of Charges OP 107.00 71.69 71.69 69.55 71.69 69.55 71.69 30001473 HC SARS-COV-2 IGG AB 300 86769 55 % of Charges OP 107.00 71.69 71.69 69.55 71.69 69.55 71.69 30000941 HC TETANUS AB 300 86774 55 % of Charges OP 301.00 112.00 201.67 195.65 201.67 112.00 201.67 30000942 HC TOXOPLASMA AB 300 86777 67 % of Charges OP 156.00 44.00 104.52 101.40 104.52 44.00 104.52 30000944 HC TOXOPLASMA IGM 300 86778 53 % of Charges OP 80.00 44.00 53.60 52.00 47.00 44.00 53.60 30000945 HC TOXOPLASMA IGM AB 300 86778 67 % of Charges OP 156.00 44.00 104.52 101.40 47.00 44.00 104.52 30000943 HC TOXOPLASMA AB IGM 300 86778 53 % of Charges OP 204.00 44.00 136.68 132.60 47.00 44.00 136.68 30001303 HC TREPONEMA PALLIDUM 300 86780 53 % of Charges OP 52.00 45.00 34.84 33.80 48.00 33.80 48.00 30000946 HC TREPONEMA PALLIDUM 300 86780 53 % of Charges OP 76.00 45.00 50.92 49.40 48.00 45.00 50.92 30000947 HC VARICELLA ZOSTER AB 300 86787 53 % of Charges OP 129.00 18.00 86.43 83.85 19.00 18.00 86.43 30000948 HC WEST NILE VIRUS IGM AB 300 86788 53 % of Charges OP 134.00 111.00 89.78 87.10 119.00 87.10 119.00 30000949 HC WEST NILE VIRUS AB 300 86789 53 % of Charges OP 134.00 109.00 89.78 87.10 117.00 87.10 117.00 30000953 HC HTLV ANTIBODIES 300 86790 53 % of Charges OP 59.00 97.00 39.53 38.35 39.53 38.35 97.00 30000951 HC HANTAVIRUS ANTIBODY 300 86790 53 % of Charges OP 108.00 97.00 72.36 70.20 72.36 70.20 97.00 30000954 HC SIM NOMBRE VIRUS 300 86790 53 % of Charges OP 165.00 97.00 110.55 107.25 110.55 97.00 110.55 30001429 HC ZIKA VIRUS IGM (EUA) 300 86794 53 % of Charges OP 222.00 32.00 148.74 144.30 148.74 32.00 148.74 30000956 HC THYROGLOBULIN ANTIBODY 300 86800 53 % of Charges OP 34.00 36.00 22.78 22.10 39.00 22.10 39.00 30001304 HC THYROGLOBULIN AB 300 86800 53 % of Charges OP 129.00 36.00 86.43 83.85 39.00 36.00 86.43 30001408 HC HEPATITIS C ANTIBODY 300 86803 53 % of Charges OP 101.00 108.00 67.67 65.65 116.00 65.65 116.00 30000957 HC HEP C AB WITH REFLEX TO RIBA 300 86803 53 % of Charges OP 127.00 108.00 85.09 82.55 116.00 82.55 116.00 30000958 HC HEPATITIS C AB 300 86803 54 % of Charges OP 204.00 108.00 136.68 132.60 116.00 108.00 136.68 30000960 HC HEP C RIBA SUPPLEMENTAL 300 86804 53 % of Charges OP 367.00 20.00 245.89 238.55 245.89 20.00 245.89 30000961 HC HEPATITIS C RIBA CONF 300 86804 67 % of Charges OP 458.00 20.00 306.86 297.70 306.86 20.00 306.86 30000962 HC CYTOTOXIC AB STD 300 86807 67 % of Charges OP 163.00 35.00 109.21 105.95 109.21 35.00 109.21 30000963 HC LYMPHOCYTOTOXIC ANTIBODY 300 86807 67 % of Charges OP 751.00 35.00 503.17 488.15 503.17 35.00 503.17 30000964 HC CYTOTOXIC AB QUICK 300 86808 67 % of Charges OP 163.00 25.00 109.21 105.95 109.21 25.00 109.21 30000965 HC HLA-B27 300 86812 53 % of Charges OP 225.00 195.00 150.75 146.25 209.00 146.25 209.00 30000965 HC HLA-B27 300 86812 67 % of Charges OP 326.00 195.00 218.42 211.90 209.00 195.00 218.42 30000966 HC HLA TYPE A B OR C 300 86813 67 % of Charges OP 357.00 177.00 239.19 232.05 239.19 177.00 239.19 30000967 HC HLA W/O DR ANTIGEN 300 86813 67 % of Charges OP " 1,031.00 " 177.00 690.77 670.15 690.77 177.00 690.77 30000968 HC HLA DR/DQ MULTIPLE ANTIGENS 300 86817 67 % of Charges OP 580.00 196.00 388.60 377.00 388.60 196.00 388.60 30000969 HC ANTIBODY SCREEN 300 86850 51 % of Charges OP 111.00 67.05 74.37 72.15 72.00 67.05 74.37 30001327 HC ANTIBODY SCREEN ADDITIONAL 300 86850 51 % of Charges OP 111.00 67.05 74.37 72.15 72.00 67.05 74.37 30000970 HC ANTIBODY ELUTION EACH 300 86860 51 % of Charges OP 249.00 193.77 166.83 161.85 207.00 161.85 207.00 30000972 HC MODIFIED ANTIBODY IDENT 300 86870 51 % of Charges OP 225.00 323.15 150.75 146.25 346.00 146.25 346.00 30000971 HC ANTIBODY IDENTIFICATION 300 86870 51 % of Charges OP 276.00 323.15 184.92 179.40 346.00 179.40 346.00 30000973 "HC DAT,ANTI IGG" 300 86880 51 % of Charges OP 93.00 47.70 62.31 60.45 51.00 47.70 62.31 30001328 "HC DAT,ANTI-C3B -C3D" 300 86880 51 % of Charges OP 93.00 47.70 62.31 60.45 51.00 47.70 62.31 30000974 HC ANTIBODY TITER 300 86886 55 % of Charges OP 222.00 193.77 148.74 144.30 148.74 144.30 193.77 30000974 HC ANTIBODY TITER 300 86886 51 % of Charges OP 246.00 193.77 164.82 159.90 164.82 159.90 193.77 39000044 "HC ABO, DONOR" 300 86900 51 % of Charges OP 30.00 157.56 20.10 19.50 169.00 19.50 169.00 30001221 "HC ABO, PATIENT" 300 86900 51 % of Charges OP 80.00 157.56 53.60 52.00 169.00 52.00 169.00 30001219 HC ABO TYPE 300 86900 53 % of Charges OP 200.00 157.56 134.00 130.00 169.00 130.00 169.00 30000975 HC RH (D) PATIENT 300 86901 51 % of Charges OP 80.00 47.70 53.60 52.00 51.00 47.70 53.60 30000976 HC ANTIGEN TESTING EACH UNIT 300 86902 51 % of Charges OP 51.00 323.15 34.17 33.15 346.00 33.15 346.00 30000977 HC SCREEN FOR COMPATIBLE UNITS 300 86904 51 % of Charges OP 54.00 47.70 36.18 35.10 36.18 35.10 47.70 30000978 HC RBC ANTIGENS OTHER THAN ABO RH (D) 300 86905 51 % of Charges OP 47.00 323.15 31.49 30.55 31.49 30.55 323.15 30000979 "HC CROSSMATCH BLOOD, IS" 300 86920 51 % of Charges OP 202.00 193.77 135.34 131.30 207.00 131.30 207.00 30000980 "HC CROSSMATCH BLOOD, AHG" 300 86922 51 % of Charges OP 226.00 193.77 151.42 146.90 207.00 146.90 207.00 30001359 HC CROSSMATCH ELECTRONIC 300 86923 51 % of Charges OP 202.00 193.77 135.34 131.30 207.00 131.30 207.00 30000981 HC THAWING FFP SDP OR CRYO 300 86927 51 % of Charges OP 50.00 323.15 33.50 32.50 33.50 32.50 323.15 30000982 HC HEMOLYSINS & AGGL INCUBATED 300 86941 53 % of Charges OP 200.00 37.00 134.00 130.00 134.00 37.00 134.00 30000983 HC VOL REDUC OF BLD OR BLD PROD 300 86960 51 % of Charges OP 92.00 193.77 61.64 59.80 61.64 59.80 193.77 30000984 HC POOLING OF PRODUCTS 300 86965 51 % of Charges OP 31.00 193.77 20.77 20.15 20.77 20.15 193.77 30000985 HC RBC PRETX INCUB W CHEMICAL 300 86970 51 % of Charges OP 296.00 47.70 198.32 192.40 198.32 47.70 198.32 30001394 HC SERUM PRETREATMENT INCUB DRUGS 300 86975 51 % of Charges OP 296.00 47.70 198.32 192.40 198.32 47.70 198.32 30000986 HC AB NEUTRALIZATION STUDIES 300 86977 51 % of Charges OP 193.00 193.77 129.31 125.45 129.31 125.45 193.77 30000987 HC ANTIBODY ABSORPTION COLD 300 86978 51 % of Charges OP 296.00 47.70 198.32 192.40 198.32 47.70 198.32 30001329 HC ANTIBODY ABSORPTION WARM 300 86978 51 % of Charges OP 296.00 47.70 198.32 192.40 198.32 47.70 198.32 30001393 HC RBC DIFFERENTIAL ABSORPTION 300 86978 51 % of Charges OP 296.00 47.70 198.32 192.40 198.32 47.70 198.32 30000988 HC SPLITTING OF BLD PROD EA 300 86985 51 % of Charges OP 52.00 193.77 34.84 33.80 34.84 33.80 193.77 30000989 HC PROCESSING BLOOD/PLATELETS 300 86999 51 % of Charges OP 457.00 26.21 306.19 297.05 306.19 26.21 306.19 30000991 HC CONCENTRATION FOR INFECT AGENT 300 87015 53 % of Charges OP 24.00 36.00 16.08 15.60 39.00 15.60 39.00 30001305 HC CONCENTRATION FOR INFECT AGENT 300 87015 53 % of Charges OP 42.00 36.00 28.14 27.30 39.00 27.30 39.00 30000990 HC CONCENTRATION ACID FAST 300 87015 51 % of Charges OP 44.00 36.00 29.48 28.60 39.00 28.60 39.00 30001361 HC CONCENTRATION CYCLOSPORA 300 87015 51 % of Charges OP 44.00 36.00 29.48 28.60 39.00 28.60 39.00 30000992 HC CULTURE BLOOD 300 87040 51 % of Charges OP 271.00 78.00 181.57 176.15 83.00 78.00 181.57 30000993 HC CULTURE STOOL SALM/SHIGELLA 300 87045 51 % of Charges OP 110.00 71.00 73.70 71.50 73.70 71.00 73.70 30000998 HC CULTURE EAR 300 87070 51 % of Charges OP 118.00 65.00 79.06 76.70 70.00 65.00 79.06 30000995 HC CULTURE AEROBIC 300 87070 51 % of Charges OP 120.00 65.00 80.40 78.00 70.00 65.00 80.40 30000996 HC CULTURE CATH TIP 300 87070 51 % of Charges OP 131.00 65.00 87.77 85.15 70.00 65.00 87.77 30001000 HC CULTURE EYE 300 87070 51 % of Charges OP 131.00 65.00 87.77 85.15 70.00 65.00 87.77 30001001 HC CULTURE GENITAL 300 87070 51 % of Charges OP 131.00 65.00 87.77 85.15 70.00 65.00 87.77 30001003 HC CULTURE NASOPHARYNGEAL 300 87070 51 % of Charges OP 131.00 65.00 87.77 85.15 70.00 65.00 87.77 30001004 HC CULTURE THROAT 300 87070 51 % of Charges OP 131.00 65.00 87.77 85.15 70.00 65.00 87.77 30001005 HC CULTURE WOUND SUPERFICIAL 300 87070 51 % of Charges OP 131.00 65.00 87.77 85.15 70.00 65.00 87.77 30001006 HC CULTURE ANAEROBIC 300 87075 51 % of Charges OP 129.00 72.00 86.43 83.85 77.00 72.00 86.43 30001338 HC ANAEROBIC ISOLATE IDENT 300 87076 53 % of Charges OP 203.00 61.00 136.01 131.95 65.00 61.00 136.01 30001007 HC ID BACTERIAL ANAEROBE 300 87076 51 % of Charges OP 240.00 61.00 160.80 156.00 65.00 61.00 160.80 30001008 HC ADDITIONAL ID PROCEDURE 300 87077 55 % of Charges OP 51.00 61.00 34.17 33.15 65.00 33.15 65.00 30001011 HC CULTURE AEROBIC ID 300 87077 55 % of Charges OP 60.00 61.00 40.20 39.00 65.00 39.00 65.00 30001009 HC AEROBIC ID 300 87077 55 % of Charges OP 92.00 61.00 61.64 59.80 65.00 59.80 65.00 30001010 HC AEROBIC ISOLATE - EACH ISOLATE 300 87077 55 % of Charges OP 92.00 61.00 61.64 59.80 65.00 59.80 65.00 30001013 HC ID BACTERIAL 300 87077 51 % of Charges OP 134.00 61.00 89.78 87.10 65.00 61.00 89.78 30001012 HC CULTURE AEROBIC ISOLATE 300 87077 53 % of Charges OP 264.00 61.00 176.88 171.60 65.00 61.00 176.88 30001364 HC CULTURE ANAL GC 300 87081 51 % of Charges OP 95.00 50.00 63.65 61.75 54.00 50.00 63.65 30001362 HC CULTURE GENITAL GC 300 87081 51 % of Charges OP 95.00 50.00 63.65 61.75 54.00 50.00 63.65 30001015 HC CULTURE SCREENING 300 87081 51 % of Charges OP 95.00 50.00 63.65 61.75 54.00 50.00 63.65 30001363 HC CULTURE SCREENING GRP B 300 87081 51 % of Charges OP 95.00 50.00 63.65 61.75 54.00 50.00 63.65 30001331 HC GRP A STREP CULTURE THROAT 300 87081 51 % of Charges OP 95.00 50.00 63.65 61.75 54.00 50.00 63.65 30001014 HC BACILLUS ANTHRACIS SCREEN 300 87081 51 % of Charges OP 145.00 50.00 97.15 94.25 54.00 50.00 97.15 30001016 HC LEGIONELLA CULTURE 300 87081 53 % of Charges OP 161.00 50.00 107.87 104.65 54.00 50.00 107.87 30001016 HC LEGIONELLA CULTURE 300 87081 51 % of Charges OP 246.00 50.00 164.82 159.90 54.00 50.00 164.82 30001017 HC CULTURE URINE QUANT COLONY CNT 300 87086 51 % of Charges OP 126.00 61.00 84.42 81.90 65.00 61.00 84.42 30001018 HC CULTURE FUNGUS SKIN/NAIL/HAIR 300 87101 51 % of Charges OP 232.00 23.00 155.44 150.80 155.44 23.00 155.44 30001019 HC CULTURE FUNGUS 300 87102 51 % of Charges OP 232.00 64.00 155.44 150.80 68.00 64.00 155.44 30001020 HC CULTURE FUNGUS BLOOD 300 87103 51 % of Charges OP 314.00 68.00 210.38 204.10 210.38 68.00 210.38 30001306 HC CULTURE FUNGI ID YEAST 300 87106 55 % of Charges OP 90.00 78.00 60.30 58.50 83.00 58.50 83.00 30001021 HC IDENTIFICATION FUNGAL YEAST 300 87106 51 % of Charges OP 150.00 78.00 100.50 97.50 83.00 78.00 100.50 30001332 HC CULTURE ID FUNGI-YEAST 300 87106 55 % of Charges OP 195.00 78.00 130.65 126.75 83.00 78.00 130.65 30001333 HC CULTURE FUNGI ID MOLD 300 87107 55 % of Charges OP 90.00 31.00 60.30 58.50 33.00 31.00 60.30 30001022 HC IDENTIFICATION FUNGAL MOLD 300 87107 51 % of Charges OP 157.00 31.00 105.19 102.05 33.00 31.00 105.19 30001023 HC CULTURE MYCOPLASMA 300 87109 67 % of Charges OP 87.00 42.00 58.29 56.55 58.29 42.00 58.29 30001023 HC CULTURE MYCOPLASMA 300 87109 53 % of Charges OP 156.00 42.00 104.52 101.40 104.52 42.00 104.52 30001024 HC CHLAMYDIA CULTURE 300 87110 53 % of Charges OP 110.00 60.00 73.70 71.50 73.70 60.00 73.70 30001024 HC CHLAMYDIA CULTURE 300 87110 67 % of Charges OP 223.00 60.00 149.41 144.95 149.41 60.00 149.41 30001025 HC CULTURE ACID-FAST 300 87116 51 % of Charges OP 226.00 82.00 151.42 146.90 88.00 82.00 151.42 30001222 HC MYCOBACTERIA CULTURE BLOOD 300 87116 51 % of Charges OP 240.00 82.00 160.80 156.00 88.00 82.00 160.80 30001027 HC CULTURE MYCOBACT DEFINITIVE ID 300 87118 67 % of Charges OP 29.00 21.00 19.43 18.85 19.43 18.85 21.00 30001027 HC CULTURE MYCOBACT DEFINITIVE ID 300 87118 51 % of Charges OP 37.00 21.00 24.79 24.05 24.79 21.00 24.79 30001028 HC IDENT MYCOBACT BIOCHEM 300 87118 51 % of Charges OP 157.00 21.00 105.19 102.05 105.19 21.00 105.19 30001026 HC BILL ID BY MALDI-TOF MS AFB 300 87118 55 % of Charges OP 226.00 21.00 151.42 146.90 151.42 21.00 151.42 30001029 HC CULTURE TYPING 300 87140 67 % of Charges OP 59.00 17.00 39.53 38.35 39.53 17.00 39.53 30001030 HC CULTURE TYPING STAIN 300 87140 53 % of Charges OP 110.00 17.00 73.70 71.50 73.70 17.00 73.70 30001031 HC SEROTYPING 300 87147 51 % of Charges OP 78.00 40.00 52.26 50.70 52.26 40.00 52.26 30001035 HC ID MYCOBACT DNA PROBE 300 87149 67 % of Charges OP 127.00 61.00 85.09 82.55 65.00 61.00 85.09 30001032 HC CULT DNA/RNA PROBE PER ISOLATE 300 87149 51 % of Charges OP 135.00 61.00 90.45 87.75 65.00 61.00 90.45 30001034 HC EACH RESISTANCE MARKER 300 87149 51 % of Charges OP 135.00 61.00 90.45 87.75 65.00 61.00 90.45 30001036 HC ID OF EACH ORGANISM 300 87149 51 % of Charges OP 135.00 61.00 90.45 87.75 65.00 61.00 90.45 30001033 HC CULTURE TYPING ID NUCLEI PROBE 300 87149 67 % of Charges OP 402.00 61.00 269.34 261.30 65.00 61.00 269.34 30001225 HC BLOOD CULTURE ORG ID PEDS 300 87150 51 % of Charges OP 64.00 107.00 42.88 41.60 42.88 41.60 107.00 30001437 HC CULTURE TYPING ID BY DNA/RNA PROBE PER CULTRUE OR ISOLATE EA ORGANISM PROBED 300 87150 51 % of Charges OP 64.00 107.00 42.88 41.60 42.88 41.60 107.00 30001037 HC ID BY NUCLEIC ACID AMPL PROBE 300 87150 55 % of Charges OP 152.00 107.00 101.84 98.80 101.84 98.80 107.00 30001040 HC ID BY NUCLEIC SEQUENCING 300 87153 55 % of Charges OP 295.00 352.00 197.65 191.75 197.65 191.75 352.00 30001041 HC MYCOBACT ID SEQUENCING 300 87153 55 % of Charges OP 295.00 352.00 197.65 191.75 197.65 191.75 352.00 30001038 HC AEROBE ID SEQUENCING 300 87153 55 % of Charges OP 309.00 352.00 207.03 200.85 207.03 200.85 352.00 30001039 HC CULTURE ID BY SEQUENCING 300 87153 67 % of Charges OP 397.00 352.00 265.99 258.05 265.99 258.05 352.00 30001042 HC NUCLEIC ACID SEQUENCING EACH 300 87153 53 % of Charges OP 460.00 352.00 308.20 299.00 308.20 299.00 352.00 30001043 HC AFB IDENTIFICATION BY MALDI 300 87158 53 % of Charges OP 203.00 40.00 136.01 131.95 136.01 40.00 136.01 30001044 HC MYCOBATERIUM ID 300 87158 55 % of Charges OP 226.00 40.00 151.42 146.90 151.42 40.00 151.42 30001047 HC OVA AND PARASITES SMEARS 300 87177 51 % of Charges OP 111.00 67.00 74.37 72.15 72.00 67.00 74.37 30001048 HC SUSCEPTIBILITY STUDIES 300 87181 55 % of Charges OP 109.00 14.00 73.03 70.85 73.03 14.00 73.03 30001405 HC SUSCEPTIBILITY STUDIES PER AGENT 300 87181 53 % of Charges OP 201.00 14.00 134.67 130.65 134.67 14.00 134.67 30001406 HC SUSCEPTIBILITY STUDIES DISK 300 87184 53 % of Charges OP 110.00 52.00 73.70 71.50 56.00 52.00 73.70 30001049 HC SENSITIVITY DISC 300 87184 51 % of Charges OP 181.00 52.00 121.27 117.65 56.00 52.00 121.27 30001051 HC BETA LACTAMASE 300 87185 51 % of Charges OP 76.00 36.00 50.92 49.40 39.00 36.00 50.92 30001050 HC SUSCEPTIBILITY BETA LACTAMASE 300 87185 53 % of Charges OP 78.00 36.00 52.26 50.70 39.00 36.00 52.26 30001052 HC ANTIMICRO SUSCEPTIB MICRODILUT 300 87186 67 % of Charges OP 39.00 65.00 26.13 25.35 70.00 25.35 70.00 30001056 HC MIC PANEL 300 87186 55 % of Charges OP 60.00 65.00 40.20 39.00 70.00 39.00 70.00 30001060 HC SUSCEPTIBILITY STUDIES MIC 300 87186 53 % of Charges OP 77.00 65.00 51.59 50.05 70.00 50.05 70.00 30001054 HC MIC MIN INHIBITORY CONCEN 300 87186 51 % of Charges OP 143.00 65.00 95.81 92.95 70.00 65.00 95.81 30001057 HC SUSCEPT AFB NOCARDIA BY BROTH 300 87186 53 % of Charges OP 201.00 65.00 134.67 130.65 70.00 65.00 134.67 30001307 HC MIC PANEL 300 87186 55 % of Charges OP 208.00 65.00 139.36 135.20 70.00 65.00 139.36 30001059 HC SUSCEPTIBILITY MIC EACH 300 87186 53 % of Charges OP 213.00 65.00 142.71 138.45 70.00 65.00 142.71 30001058 HC SUSCEPT ANAEROBE BY BROTH DIL 300 87186 53 % of Charges OP 247.00 65.00 165.49 160.55 70.00 65.00 165.49 30001053 HC FUNGAL YEAST SUSCEPTIBILITY 300 87186 67 % of Charges OP 293.00 65.00 196.31 190.45 70.00 65.00 196.31 30001055 HC MIC NOCARDIA 300 87186 55 % of Charges OP 333.00 65.00 223.11 216.45 70.00 65.00 223.11 30001056 HC MIC PANEL 300 87186 53 % of Charges OP 465.00 65.00 311.55 302.25 70.00 65.00 311.55 30001064 HC MYCOBACTERIUM SENSITIVITY 300 87188 67 % of Charges OP 133.00 20.00 89.11 86.45 89.11 20.00 89.11 30001063 HC MOLD SUSCEPTIBILITY 300 87188 67 % of Charges OP 183.00 20.00 122.61 118.95 122.61 20.00 122.61 30001065 HC MYCOBACTERIA SUSCEPTIBILITY 300 87190 67 % of Charges OP 25.00 17.00 16.75 16.25 16.75 16.25 17.00 30001066 HC GRAM STAIN SMEAR 300 87205 51 % of Charges OP 55.00 32.00 36.85 35.75 34.00 32.00 36.85 30001067 HC MYCOBACTERIUM STAIN 300 87206 51 % of Charges OP 98.00 41.00 65.66 63.70 44.00 41.00 65.66 30001073 HC SPECIAL STAIN FOR INCLUSIONS 300 87207 53 % of Charges OP 24.00 46.00 16.08 15.60 49.00 15.60 49.00 30001069 HC GIEMSA STAIN 300 87207 51 % of Charges OP 102.00 46.00 68.34 66.30 49.00 46.00 68.34 30001070 HC GMS FUNGAL STAIN 300 87207 51 % of Charges OP 119.00 46.00 79.73 77.35 49.00 46.00 79.73 30001072 HC SPECIAL STAIN 300 87207 51 % of Charges OP 120.00 46.00 80.40 78.00 49.00 46.00 80.40 30001074 HC SMEAR SPECIAL STAINS TRICHROME 300 87209 51 % of Charges OP 120.00 97.00 80.40 78.00 104.00 78.00 104.00 30001075 HC WET MOUNT 300 87210 51 % of Charges OP 89.00 32.00 59.63 57.85 59.63 32.00 59.63 30001076 HC FUNGUS DIRECT KOH 300 87220 51 % of Charges OP 118.00 13.00 79.06 76.70 14.00 13.00 79.06 30001078 HC VIRUS ISOLATION TISSUE CULTURE 300 87252 53 % of Charges OP 129.00 197.00 86.43 83.85 211.00 83.85 211.00 30001077 HC TISS CULT INOC OBS PRESUM ID 300 87252 53 % of Charges OP 230.00 197.00 154.10 149.50 211.00 149.50 211.00 30001308 HC TISS CULT INOC OBS PRESUM ID 300 87252 53 % of Charges OP 292.00 197.00 195.64 189.80 211.00 189.80 211.00 30001079 HC IP STAIN 300 87253 53 % of Charges OP 72.00 60.00 48.24 46.80 64.00 46.80 64.00 30001080 HC TISS CULT DEFINITIVE ID 300 87253 53 % of Charges OP 129.00 60.00 86.43 83.85 64.00 60.00 86.43 30001081 HC VIRUS ISOLATION SHELL VIAL 300 87254 53 % of Charges OP 129.00 148.00 86.43 83.85 158.00 83.85 158.00 30001309 HC SHELL VIAL 300 87254 53 % of Charges OP 199.00 148.00 133.33 129.35 158.00 129.35 158.00 30001081 HC VIRUS ISOLATION SHELL VIAL 300 87254 67 % of Charges OP 539.00 148.00 361.13 350.35 158.00 148.00 361.13 30001083 HC ADENOVIRUS 300 87260 53 % of Charges OP 34.00 36.00 22.78 22.10 39.00 22.10 39.00 30001084 HC CRYPTOSPORIDIUM AG DFA STOOL 300 87272 51 % of Charges OP 148.00 90.00 99.16 96.20 96.00 90.00 99.16 30001085 HC INFLUENZA B 300 87275 53 % of Charges OP 34.00 36.00 22.78 22.10 39.00 22.10 39.00 30001086 HC INFLUENZA A 300 87276 53 % of Charges OP 34.00 36.00 22.78 22.10 39.00 22.10 39.00 30001088 HC LEGIONELLA PNEUMOPHILA DFA 300 87278 53 % of Charges OP 200.00 90.00 134.00 130.00 96.00 90.00 134.00 30001087 HC LEGIONELLA FLUORESCENCE 300 87278 51 % of Charges OP 224.00 90.00 150.08 145.60 96.00 90.00 150.08 30001089 HC PARAINFLUENZA 1 2 3 300 87279 53 % of Charges OP 34.00 36.00 22.78 22.10 39.00 22.10 39.00 30001090 HC RSV 300 87280 53 % of Charges OP 34.00 36.00 22.78 22.10 39.00 22.10 39.00 30001091 HC HUMAN METAPNEUMOVIRUS 300 87299 53 % of Charges OP 34.00 36.00 22.78 22.10 39.00 22.10 39.00 30001092 HC ADENOVIRUS 40-41 300 87301 53 % of Charges OP 117.00 37.00 78.39 76.05 40.00 37.00 78.39 30001093 HC ASPERGILLUS 300 87305 67 % of Charges OP 316.00 37.00 211.72 205.40 211.72 37.00 211.72 30001094 HC ASPERGILLUS ANTIGEN 300 87305 53 % of Charges OP 367.00 37.00 245.89 238.55 245.89 37.00 245.89 30001382 HC C DIFFICILE TOXINS 300 87324 51 % of Charges OP 27.00 37.00 18.09 17.55 18.09 17.55 37.00 30001346 HC CRYPTOCOCCUS NEOFORMANS 300 87327 53 % of Charges OP 70.00 37.00 46.90 45.50 40.00 37.00 46.90 30001097 HC GIARDIA AG DFA STOOL 300 87329 51 % of Charges OP 148.00 80.00 99.16 96.20 86.00 80.00 99.16 30001099 HC HELICOBACTER PYLORI STOOL 300 87338 51 % of Charges OP 213.00 109.00 142.71 138.45 117.00 109.00 142.71 30001099 HC HELICOBACTER PYLORI STOOL 300 87338 53 % of Charges OP 213.00 109.00 142.71 138.45 117.00 109.00 142.71 30001100 HC HEP B SURFACE ANTIGEN HBSAG 300 87340 53 % of Charges OP 67.00 78.00 44.89 43.55 83.00 43.55 83.00 30001100 HC HEP B SURFACE ANTIGEN HBSAG 300 87340 54 % of Charges OP 134.00 78.00 89.78 87.10 83.00 78.00 89.78 30001101 HC HEP B SURF ANT HBSAG NEUTRAL 300 87341 53 % of Charges OP 91.00 31.00 60.97 59.15 33.00 31.00 60.97 30001101 HC HEP B SURF ANT HBSAG NEUTRAL 300 87341 54 % of Charges OP 119.00 31.00 79.73 77.35 33.00 31.00 79.73 30001102 HC HEPATITIS BE AG 300 87350 53 % of Charges OP 213.00 87.00 142.71 138.45 93.00 87.00 142.71 30001104 HC HISTOPLASMA CAPSULATUM 300 87385 53 % of Charges OP 209.00 90.00 140.03 135.85 96.00 90.00 140.03 30001103 HC HISTOPLASMA AG ANY SOURCE 300 87385 67 % of Charges OP 266.00 90.00 178.22 172.90 96.00 90.00 178.22 30001428 HC HIV COMBO TEST 300 87389 53 % of Charges OP 39.00 73.00 26.13 25.35 78.00 25.35 78.00 30001105 HC HIV-1 AGS W/HIV-1 HIV-2 ABS 300 87389 53 % of Charges OP 117.00 73.00 78.39 76.05 78.00 73.00 78.39 30001106 HC INFLUENZA A OR B EACH 300 87400 51 % of Charges OP 119.00 90.00 79.73 77.35 96.00 77.35 96.00 30001107 HC RSV DIRECT AG EIA 300 87420 51 % of Charges OP 242.00 90.00 162.14 157.30 96.00 90.00 162.14 30001108 HC ROTAVIRUS AG 300 87425 51 % of Charges OP 193.00 90.00 129.31 125.45 129.31 90.00 129.31 30001483 "HC SARS-COV-2 ANTIGEN, RAPID" 300 87426 51 % of Charges OP 136.00 91.12 91.12 88.40 91.12 88.40 91.12 30001109 HC E COLI SHIGA TOXINS STOOL 300 87427 51 % of Charges OP 74.00 90.00 49.58 48.10 49.58 48.10 90.00 30001110 HC STREP GROUP A ANTIGEN 300 87430 51 % of Charges OP 73.00 60.00 48.91 47.45 64.00 47.45 64.00 30001112 HC INFCT AGNT ENZY IMMUN MUL STEP 300 87449 67 % of Charges OP 272.00 37.00 182.24 176.80 182.24 37.00 182.24 30001113 HC INFECTIOUS AGENT AG DETECTION 300 87449 67 % of Charges OP 292.00 37.00 195.64 189.80 195.64 37.00 195.64 30001111 HC FUNGITELL 1 & 3 BETA D GLUCAN 300 87449 53 % of Charges OP 353.00 37.00 236.51 229.45 236.51 37.00 236.51 30001115 HC BORRELIA BURGDORFERI AMP PROBE 300 87476 53 % of Charges OP 366.00 107.00 245.22 237.90 114.00 107.00 245.22 30001318 HC CANDIDA DNA DIRECT PROBE 300 87480 51 % of Charges OP 90.00 61.00 60.30 58.50 65.00 58.50 65.00 30001341 HC MENING/ENCEPH PANEL BIOFIRE 300 87483 51 % of Charges OP 944.00 783.00 632.48 613.60 838.00 613.60 838.00 30001434 HC INFECTIOUS AGENT DETECTION DNA/RNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE 300 87486 51 % of Charges OP 72.00 107.00 48.24 46.80 48.24 46.80 107.00 30001116 HC CHLAMYDIA PNEUMONIAE 300 87486 67 % of Charges OP 164.00 107.00 109.88 106.60 109.88 106.60 109.88 30001117 HC CHLAMYDIA BY AMPLIFIED PROBE 300 87491 53 % of Charges OP 88.00 134.00 58.96 57.20 143.00 57.20 143.00 30001117 HC CHLAMYDIA BY AMPLIFIED PROBE 300 87491 51 % of Charges OP 165.00 134.00 110.55 107.25 143.00 107.25 143.00 30001117 HC CHLAMYDIA BY AMPLIFIED PROBE 300 87491 54 % of Charges OP 165.00 134.00 110.55 107.25 143.00 107.25 143.00 30001118 HC CL DIFF TOXIN AMPLIFIED PROBE 300 87493 51 % of Charges OP 274.00 222.00 183.58 178.10 238.00 178.10 238.00 30001119 HC CMV AMPLIFIED PROBE 300 87496 53 % of Charges OP 409.00 107.00 274.03 265.85 274.03 107.00 274.03 30001120 HC CMV QUANT 300 87497 53 % of Charges OP 539.00 131.00 361.13 350.35 361.13 131.00 361.13 30001334 HC ENTEROVIRUS PCR 300 87498 53 % of Charges OP 421.00 107.00 282.07 273.65 282.07 107.00 282.07 30001121 HC ENTEROVIRUS AMPLIFIED PROBE 300 87498 67 % of Charges OP 421.00 107.00 282.07 273.65 282.07 107.00 282.07 30001353 HC GI PANEL 300 87506 51 % of Charges OP 676.00 322.00 452.92 439.40 345.00 322.00 452.92 30001319 HC GARDNER VAG DNA DIRECT PROBE 300 87510 51 % of Charges OP 90.00 61.00 60.30 58.50 65.00 58.50 65.00 30001127 HC HEP B DNA 300 87517 53 % of Charges OP 407.00 324.00 272.69 264.55 347.00 264.55 347.00 30001128 HC HEP C AMPLIFIED PROBE 300 87521 53 % of Charges OP 343.00 107.00 229.81 222.95 229.81 107.00 229.81 30001129 HC HEPATITIS C QUANTIFICATION 300 87522 53 % of Charges OP 209.00 324.00 140.03 135.85 347.00 135.85 347.00 30001130 HC HEPATITIS C QUANT 300 87522 67 % of Charges OP 698.00 324.00 467.66 453.70 347.00 324.00 467.66 30001223 HC HSV PCR 300 87529 53 % of Charges OP 367.00 266.00 245.89 238.55 285.00 238.55 285.00 30001131 HC HERPES AB TYPE 1&2 DNAPCR 300 87529 67 % of Charges OP 367.00 266.00 245.89 238.55 285.00 238.55 285.00 30001132 HC HERPES VIRUS 6 AMPLIFIED PROBE 300 87532 55 % of Charges OP 409.00 107.00 274.03 265.85 114.00 107.00 274.03 30001133 HC HIV-1 DNA/PCR QUAL 300 87535 67 % of Charges OP 580.00 107.00 388.60 377.00 388.60 107.00 388.60 30001134 HC HIV-1 QUANT 300 87536 53 % of Charges OP 169.00 398.00 113.23 109.85 426.00 109.85 426.00 30001135 HC HIV-1 RNA QUANT BY BDNA 300 87536 53 % of Charges OP 614.00 398.00 411.38 399.10 426.00 398.00 426.00 30001136 HC HIV-1 RNA QUANT PCR 300 87536 67 % of Charges OP 789.00 398.00 528.63 512.85 426.00 398.00 528.63 30001137 HC HIV-1 RNA PCR 2ND GEN 300 87536 67 % of Charges OP 855.00 398.00 572.85 555.75 426.00 398.00 572.85 30001435 HC INFECTIOUS AGENT DETECTION DNA/RNA LEGIONELLA PNEUMPPHILIA AMPLIFIED PROBE 300 87541 51 % of Charges OP 204.00 107.00 136.68 132.60 136.68 107.00 136.68 30001139 HC MYCOBACT TUBERCUL AMPLIF PROBE 300 87556 67 % of Charges OP 154.00 107.00 103.18 100.10 114.00 100.10 114.00 30001335 HC MYCOBACTERIA TB AMPLIF PROBE 300 87556 53 % of Charges OP 166.00 107.00 111.22 107.90 114.00 107.00 114.00 30001138 HC MYCOBACTERIA PCR CSF 300 87556 67 % of Charges OP 444.00 107.00 297.48 288.60 114.00 107.00 297.48 30001456 HC M. GENITALIUM AMP PROBE 300 87563 51 % of Charges OP 114.00 76.38 76.38 74.10 76.38 74.10 76.38 30001457 HC M. GENITALIUM AMP PROBE 300 87563 51 % of Charges OP 114.00 76.38 76.38 74.10 76.38 74.10 76.38 30001436 HC INFECTIOUS AGENT DETECTION DNA/RNA MPNEUMONIAE AMPLIFIED PROBE 300 87581 51 % of Charges OP 65.00 107.00 43.55 42.25 43.55 42.25 107.00 30001140 HC MYCOPLASMA PNEUMONIAE 300 87581 67 % of Charges OP 164.00 107.00 109.88 106.60 109.88 106.60 109.88 30001141 HC MYCOPLASMA PNEUMONIAE PCR 300 87581 53 % of Charges OP 436.00 107.00 292.12 283.40 292.12 107.00 292.12 30001142 HC N GONORRHOEAE AMPLIFIED PROBE 300 87591 53 % of Charges OP 88.00 134.00 58.96 57.20 143.00 57.20 143.00 30001142 HC N GONORRHOEAE AMPLIFIED PROBE 300 87591 51 % of Charges OP 165.00 134.00 110.55 107.25 143.00 107.25 143.00 30001142 HC N GONORRHOEAE AMPLIFIED PROBE 300 87591 54 % of Charges OP 165.00 134.00 110.55 107.25 143.00 107.25 143.00 30001438 HC INFECTIOUS AGENT DETECTION DNA/FNA PANEL VIRUSES MULTIPLEX AMP PROBE MULT TYPES 6-11 TARGETS 300 87632 51 % of Charges OP 495.00 651.00 331.65 321.75 331.65 321.75 651.00 30001230 HC RESP VIRAL PANEL BIOFIRE 300 87633 51 % of Charges OP " 1,308.00 " " 1,271.00 " 876.36 850.20 " 1,360.00 " 850.20 " 1,360.00 " 30001470 HC SARS-COV-2 BY PCR 300 87635 51 % of Charges OP 125.00 83.75 83.75 81.25 83.75 81.25 83.75 30001472 HC COVID-19 BRYAN 300 87635 51 % of Charges OP 125.00 83.75 83.75 81.25 83.75 81.25 83.75 30001470 HC SARS-COV-2 BY PCR 300 87635 53 % of Charges OP 125.00 83.75 83.75 81.25 83.75 81.25 83.75 30001470 HC SARS-COV-2 BY PCR 300 87635 54 % of Charges OP 125.00 83.75 83.75 81.25 83.75 81.25 83.75 30001470 HC SARS-COV-2 BY PCR 300 87635 55 % of Charges OP 125.00 83.75 83.75 81.25 83.75 81.25 83.75 30001419 HC STREPTOCCOCCUS GROUP B PROBE 300 87653 51 % of Charges OP 184.00 107.00 123.28 119.60 123.28 107.00 123.28 30001320 HC TRICH VAG DNA DIRECT PROBE 300 87660 51 % of Charges OP 90.00 61.00 60.30 58.50 65.00 58.50 65.00 30001430 HC ZIKA VIRUS BY PCR BLOOD 300 87662 53 % of Charges OP 314.00 210.38 210.38 204.10 210.38 204.10 210.38 30001431 HC ZIKA VIRUS BY PCR URINE 300 87662 53 % of Charges OP 314.00 210.38 210.38 204.10 210.38 204.10 210.38 30001252 HC INFECTIOUS AGENT NOS AMP PRO 300 87798 51 % of Charges OP 64.00 193.00 42.88 41.60 207.00 41.60 207.00 30001439 HC INFECTIOUS AGENT DETECTION BY DNA OR RNA NOS AMP PROBE EA ORGANISM 300 87798 51 % of Charges OP 82.00 193.00 54.94 53.30 207.00 53.30 207.00 30001152 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 53 % of Charges OP 115.00 193.00 77.05 74.75 207.00 74.75 207.00 30001354 HC NOROVIRUS GI 300 87798 67 % of Charges OP 147.00 193.00 98.49 95.55 207.00 95.55 207.00 30001355 HC NOROVIRUS GII 300 87798 67 % of Charges OP 147.00 193.00 98.49 95.55 207.00 95.55 207.00 30001147 HC AMPLIFIED PROBE TECHNIQUE 300 87798 67 % of Charges OP 164.00 193.00 109.88 106.60 207.00 106.60 207.00 30001313 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 53 % of Charges OP 166.00 193.00 111.22 107.90 207.00 107.90 207.00 30001210 HC VARICELLA ZOSTER PCR 300 87798 53 % of Charges OP 233.00 193.00 156.11 151.45 207.00 151.45 207.00 30001461 HC PNEUMOCYSTIS JIROVECII 300 87798 53 % of Charges OP 270.00 193.00 180.90 175.50 207.00 175.50 207.00 30001311 HC INFECTIOUS AGENT BY AMPL PROBE 300 87798 67 % of Charges OP 295.00 193.00 197.65 191.75 207.00 191.75 207.00 30001312 HC INFECT AGENT DETECT AMP PROBE 300 87798 53 % of Charges OP 358.00 193.00 239.86 232.70 207.00 193.00 239.86 30001311 HC INFECTIOUS AGENT BY AMPL PROBE 300 87798 53 % of Charges OP 359.00 193.00 240.53 233.35 207.00 193.00 240.53 30001153 HC NOROVIRUS BY PCR 300 87798 53 % of Charges OP 408.00 193.00 273.36 265.20 207.00 193.00 273.36 30001152 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 67 % of Charges OP 409.00 193.00 274.03 265.85 207.00 193.00 274.03 30001152 HC INFECTIOUS AGENT AMPLIF PROBE 300 87798 55 % of Charges OP 519.00 193.00 347.73 337.35 207.00 193.00 347.73 30001310 HC INFECT AGENT DETECT RNA DNA 300 87798 67 % of Charges OP 584.00 193.00 391.28 379.60 207.00 193.00 391.28 30001157 HC INFECTIOUS AGENT QUANT 300 87799 67 % of Charges OP 240.00 131.00 160.80 156.00 140.00 131.00 160.80 30001157 HC INFECTIOUS AGENT QUANT 300 87799 53 % of Charges OP 601.00 131.00 402.67 390.65 140.00 131.00 402.67 30001163 HC INFECT AGENT DETECT BY IMMUN 300 87899 53 % of Charges OP 297.00 90.00 198.99 193.05 96.00 90.00 198.99 30001114 HC LEGIONELLA ANTIGEN URINE 300 87899 51 % of Charges OP 409.00 90.00 274.03 265.85 96.00 90.00 274.03 30001165 HC INFECT AGENT GENOTYPE DNA/RNA 300 87901 53 % of Charges OP 551.00 786.00 369.17 358.15 841.00 358.15 841.00 30001164 HC HIV-1 GENOTYPING-DRUG RESIST 300 87901 67 % of Charges OP " 1,368.00 " 786.00 916.56 889.20 841.00 786.00 916.56 30001166 HC INFECT AGENT HEPATITIS C VIRUS 300 87902 53 % of Charges OP 520.00 786.00 348.40 338.00 348.40 338.00 786.00 30001240 HC FLOW CYTOMETRY OR DNA ANALYSIS 300 88182 53 % of Charges OP 123.00 67.05 82.41 79.95 82.41 67.05 82.41 30001167 HC FLOW CYTOMETRY RBC MARKER 1 300 88184 55 % of Charges OP 39.00 323.15 26.13 25.35 346.00 25.35 346.00 30001168 HC FLOW CYTOMETRY WBC MARKER 1 300 88184 55 % of Charges OP 39.00 323.15 26.13 25.35 346.00 25.35 346.00 30001205 HC FLOW CYTOMETRY EA ADDIT MARKER 300 88185 55 % of Charges OP 39.00 106.00 26.13 25.35 113.00 25.35 113.00 30001241 HC FLOW CYTO INTERPRET 9-15 MRKS 300 88188 55 % of Charges OP 341.00 184.00 228.47 221.65 228.47 184.00 228.47 30001242 HC TISSUE CULTURE LYMPHOCYTE 300 88230 67 % of Charges OP 139.00 355.00 93.13 90.35 380.00 90.35 380.00 30001243 HC TISS CULT AMN FLD/CHOR VILLUS 300 88235 67 % of Charges OP 234.00 449.00 156.78 152.10 480.00 152.10 480.00 30001244 HC CHROM ANALY 5 COUNT 300 88261 67 % of Charges OP 139.00 540.00 93.13 90.35 578.00 90.35 578.00 30001169 HC CHROMOSOME ANALYSIS 5 CELLS 300 88261 67 % of Charges OP 670.00 540.00 448.90 435.50 578.00 435.50 578.00 30001170 HC CHROMOSOME ANALYSIS 15-20 CELL 300 88262 67 % of Charges OP 753.00 381.00 504.51 489.45 408.00 381.00 504.51 30001245 HC CHRM ANLY AMN FLD/CHOR VIL 15C 300 88267 67 % of Charges OP 425.00 548.00 284.75 276.25 586.00 276.25 586.00 30001486 HC CHROMOSOME IN SITU 3-5 CELLS 300 88272 67 % of Charges OP 123.00 81.00 82.41 79.95 82.41 79.95 82.41 30001314 HC CHROMO ANALY ADDL KARYOTYPES 300 88280 67 % of Charges OP 69.00 113.00 46.23 44.85 121.00 44.85 121.00 30001246 HC CHROMO ANALY ADDL KARYOTYPES 300 88280 67 % of Charges OP 139.00 113.00 93.13 90.35 121.00 90.35 121.00 30001247 HC CYTOGENETICS INTERP & REPORT 300 88291 67 % of Charges OP 40.00 64.00 26.80 26.00 68.00 26.00 68.00 30001315 HC CYTOGENETICS INTERP & REPORT 300 88291 67 % of Charges OP 139.00 64.00 93.13 90.35 68.00 64.00 93.13 30001248 HC GROSS & MICRO LEVEL IV 300 88305 67 % of Charges OP 122.00 67.05 81.74 79.30 72.00 67.05 81.74 30001172 HC TUMOR ENRICHMENT 300 88360 67 % of Charges OP 320.00 323.15 214.40 208.00 214.40 208.00 323.15 30001173 HC BILI TOTAL TRANSCUTANEOUS 300 88720 51 % of Charges OP 59.00 15.00 39.53 38.35 39.53 15.00 39.53 30001174 HC CELL CNT BODY FLD NOT BLD 300 89050 51 % of Charges OP 78.00 27.00 52.26 50.70 29.00 27.00 52.26 30001175 HC CSF CELL CT & ID 300 89051 51 % of Charges OP 154.00 42.00 103.18 100.10 45.00 42.00 103.18 30001365 HC FLUID CELL CT & ID 300 89051 51 % of Charges OP 154.00 42.00 103.18 100.10 45.00 42.00 103.18 30001366 HC SYNOVIAL FLUID CELL CT & ID 300 89051 51 % of Charges OP 154.00 42.00 103.18 100.10 45.00 42.00 103.18 30001176 HC LEUKOCYTES STOOL 300 89055 51 % of Charges OP 92.00 32.00 61.64 59.80 34.00 32.00 61.64 30001177 HC CRYSTAL ID SYNOVIAL FLUID 300 89060 51 % of Charges OP 78.00 54.00 52.26 50.70 58.00 50.70 58.00 30001178 HC FAT QUAL URINE 300 89125 51 % of Charges OP 31.00 13.00 20.77 20.15 20.77 13.00 20.77 30001179 HC EOSINOPHIL COUNT NASAL SMEAR 300 89190 51 % of Charges OP 52.00 14.00 34.84 33.80 34.84 14.00 34.84 30001256 HC PREP PKG MAIL SPEC 300 99001 51 % of Charges OP 30.00 12.00 20.10 19.50 20.10 12.00 20.10 30001415 HC JAK2 SEQUENCING 300 0027U 55 % of Charges OP 402.00 269.34 269.34 261.30 269.34 261.30 269.34 30001443 HC NEURO CSF PRION PROTEIN QUAL 300 0035U 53 % of Charges OP 470.00 314.90 314.90 305.50 314.90 305.50 314.90 30001451 HC RESP VIRAL PANEL BIOFIRE 300 0097U 51 % of Charges OP 503.00 337.01 337.01 326.95 337.01 326.95 337.01 30001459 HC RESP VIRAL PANEL BIOFIRE - MICRO 300 0097U 51 % of Charges OP 503.00 337.01 337.01 326.95 337.01 326.95 337.01 30001146 HC RESPIRATORY PATHOGEN PANEL 300 0099U 67 % of Charges OP 164.00 109.88 109.88 106.60 109.88 106.60 109.88 30001482 HC RESPIRATORY PATHOGEN PANEL WITH COVID 300 0202U 51 % of Charges OP " 1,652.00 " " 1,106.84 " " 1,106.84 " " 1,073.80 " " 1,106.84 " " 1,073.80 " " 1,106.84 " 30001233 HC CBC WO PLT OR AUTO DIFF 300 G0307 51 % of Charges OP 119.00 19.00 79.73 77.35 20.00 19.00 79.73 30001235 HC COMPAZINE 300 G0480 67 % of Charges OP 261.00 174.87 174.87 169.65 174.87 169.65 174.87 30001474 HC SPECIMEN COLLECT COVID-19 300 G2023 51 % of Charges OP 30.00 20.10 20.10 19.50 20.10 19.50 20.10 30001471 HC COVID-19-RPS 300 U0003 67 % of Charges OP 65.00 43.55 43.55 42.25 43.55 42.25 43.55 30001395 HC ADDITIONAL RESOURCE CHARGE 300 51 % of Charges OP 329.00 220.43 220.43 213.85 220.43 213.85 220.43 30100001 HC BILIRUBIN TOTAL 301 82247 67 % of Charges OP 20.00 38.00 13.40 13.00 41.00 13.00 41.00 30200001 HC ALLERGEN QUANT SEMIQUANT EACH 302 86008 53 % of Charges OP 95.00 34.00 63.65 61.75 36.00 34.00 63.65 30000496 HC NEPHELOMETRY 304 83883 67 % of Charges OP 205.00 3.00 137.35 133.25 3.00 3.00 137.35 30500001 HC NONINVASIVE CARBOXYHEMOGLOBIN 305 88740 51 % of Charges OP 225.00 15.00 150.75 146.25 16.00 15.00 150.75 31000002 HC CYTO FLUID WASHING OR BRUSHING 310 88104 67 % of Charges OP 186.00 47.70 124.62 120.90 124.62 47.70 124.62 31000004 HC CYTO CONC SMEAR W INTERP 310 88108 67 % of Charges OP 147.00 47.70 98.49 95.55 98.49 47.70 98.49 31000005 HC CYTO SELECTIVE CELL ENHANCE 310 88112 67 % of Charges OP 122.00 67.05 81.74 79.30 72.00 67.05 81.74 31000011 HC CYTO SMEARS OTHER SOURCE 310 88160 67 % of Charges OP 85.00 26.21 56.95 55.25 56.95 26.21 56.95 31000016 HC CYTO FNA FIRST EVAL EACH SITE 310 88172 67 % of Charges OP 387.00 193.77 259.29 251.55 259.29 193.77 259.29 31000017 HC CYTO FNA INTERP AND REPORT 310 88173 67 % of Charges OP 402.00 67.05 269.34 261.30 269.34 67.05 269.34 31000018 HC CYTO FNA ADD EPISODE SAME SITE 310 88177 67 % of Charges OP 19.00 15.00 12.73 12.35 12.73 12.35 15.00 31000019 HC CELL MARKER STUDY MARKER 1 310 88184 67 % of Charges OP 177.00 323.15 118.59 115.05 346.00 115.05 346.00 31000072 HC CELL MARKER STUDY ADD MARKER 310 88185 67 % of Charges OP 184.00 106.00 123.28 119.60 113.00 106.00 123.28 31000038 HC SURGICAL PATH LEVEL I 310 88300 67 % of Charges OP 122.00 26.21 81.74 79.30 81.74 26.21 81.74 31000039 HC SURGICAL PATH LEVEL II 310 88302 67 % of Charges OP 232.00 47.70 155.44 150.80 155.44 47.70 155.44 31000040 HC SURGICAL PATH LEVEL III 310 88304 67 % of Charges OP 324.00 67.05 217.08 210.60 72.00 67.05 217.08 31000095 HC SURGICAL PATH LEVEL IV 310 88305 67 % of Charges OP 324.00 67.05 217.08 210.60 72.00 67.05 217.08 31000041 HC SURGICAL PATH LEVEL V 310 88307 67 % of Charges OP 467.00 323.15 312.89 303.55 346.00 303.55 346.00 31000042 HC SURGICAL PATH LEVEL VI 310 88309 67 % of Charges OP 664.00 811.44 444.88 431.60 444.88 431.60 811.44 31000043 HC DECALCIFICATION PROCEDURE 310 88311 67 % of Charges OP 98.00 16.00 65.66 63.70 17.00 16.00 65.66 31000044 HC SPECIAL STAINS GRP 1 MICROORG 310 88312 67 % of Charges OP 163.00 67.05 109.21 105.95 109.21 67.05 109.21 31000045 HC SPECIAL STAINS GRP 2 ALL OTHER 310 88313 67 % of Charges OP 243.00 47.70 162.81 157.95 51.00 47.70 162.81 31000047 HC HISTO OR CYTO ENZYME ID 310 88319 67 % of Charges OP 640.00 811.44 428.80 416.00 428.80 416.00 811.44 31000048 HC CONSULT AND REPORT SLIDES 310 88323 67 % of Charges OP 220.00 67.05 147.40 143.00 147.40 67.05 147.40 31000049 HC PATH CONSLT FIRST TISSUE BLOCK 310 88331 67 % of Charges OP 405.00 193.77 271.35 263.25 207.00 193.77 271.35 31000050 HC PATH CONSLT ADD TISSUE BLOCK 310 88332 67 % of Charges OP 204.00 26.00 136.68 132.60 136.68 26.00 136.68 31000051 HC PATH CONSULT CYTO EXAM FIRST 310 88333 67 % of Charges OP 640.00 811.44 428.80 416.00 428.80 416.00 811.44 31000052 HC PATH CONSULT CYTO EXAM ADD 310 88334 67 % of Charges OP 62.00 54.00 41.54 40.30 41.54 40.30 54.00 31000053 HC IMMUNOSTAIN ADDITIONAL 310 88341 67 % of Charges OP 293.00 92.00 196.31 190.45 98.00 92.00 196.31 31000054 HC IMMUNOSTAIN INITIAL 310 88342 67 % of Charges OP 293.00 323.15 196.31 190.45 346.00 190.45 346.00 31000055 HC IMMUNOFLUOR AB DIRECT 310 88346 67 % of Charges OP 145.00 323.15 97.15 94.25 97.15 94.25 323.15 31000056 HC ELECTRON MICROSCOPY 310 88348 67 % of Charges OP 582.00 811.44 389.94 378.30 389.94 378.30 811.44 31000061 HC MA TUMOR IMMUNOHISTOCHEM 310 88360 67 % of Charges OP 320.00 323.15 214.40 208.00 214.40 208.00 323.15 31000062 HC MA TUMOR IMMUNOHISTOCHEM AUTO 310 88361 67 % of Charges OP 334.00 323.15 223.78 217.10 223.78 217.10 323.15 31000064 HC IN SITU HYBRIDIZATION EACH 310 88365 67 % of Charges OP 517.00 193.77 346.39 336.05 346.39 193.77 346.39 31000068 HC MICRODISSECTION MANUAL 310 88381 67 % of Charges OP 299.00 204.00 200.33 194.35 200.33 194.35 204.00 31000081 HC SURG PATH PROSTATE NEEDLE BIOP 310 G0416 67 % of Charges OP 647.00 323.15 433.49 420.55 433.49 323.15 433.49 31000010 HC THIN LAYER PREP PAP SMEAR 311 88142 67 % of Charges OP 152.00 47.00 101.84 98.80 101.84 47.00 101.84 31000014 HC PAP SMEAR 1 SLIDE 311 88164 67 % of Charges OP 70.00 32.00 46.90 45.50 46.90 32.00 46.90 31000015 HC PAP SMEAR 2 SLIDE 311 88164 67 % of Charges OP 99.00 32.00 66.33 64.35 66.33 32.00 66.33 31000098 HC FLOW CYT NUCLEAR MARKER 1 311 88184 55 % of Charges OP 92.00 323.15 61.64 59.80 346.00 59.80 346.00 31000020 HC CELL MARKERS MARKER 1 311 88184 67 % of Charges OP 150.00 323.15 100.50 97.50 346.00 97.50 346.00 31000024 HC LYMPH SUBSET PAN 4 MARKER 1 311 88184 53 % of Charges OP 155.00 323.15 103.85 100.75 346.00 100.75 346.00 31000025 HC T-CELL IMMUNODEFIC MARKER 1 311 88184 53 % of Charges OP 155.00 323.15 103.85 100.75 346.00 100.75 346.00 31000021 HC FLOW CYT CELL SURF MARKER 1 311 88184 55 % of Charges OP 181.00 323.15 121.27 117.65 346.00 117.65 346.00 31000022 HC FLOW CYT NUCLEAR MARKER 1 311 88184 55 % of Charges OP 325.00 323.15 217.75 211.25 346.00 211.25 346.00 31000020 HC CELL MARKERS MARKER 1 311 88184 55 % of Charges OP 342.00 323.15 229.14 222.30 346.00 222.30 346.00 31000102 HC CELL MARKER STUDY EACH ADDL 311 88185 67 % of Charges OP 24.00 106.00 16.08 15.60 113.00 15.60 113.00 31000073 HC CELL MARKER STUDY EACH ADDL 311 88185 67 % of Charges OP 27.00 106.00 18.09 17.55 113.00 17.55 113.00 31000100 HC CELL MARKER STUDY EACH ADDL 311 88185 67 % of Charges OP 28.00 106.00 18.76 18.20 113.00 18.20 113.00 31000101 HC CELL MARKER STUDY EACH ADDL 311 88185 67 % of Charges OP 34.00 106.00 22.78 22.10 113.00 22.10 113.00 31000099 HC CELL MARKER STUDY EACH ADDL 311 88185 67 % of Charges OP 74.00 106.00 49.58 48.10 113.00 48.10 113.00 31000074 HC FLOW CYT CELL SURF EACH ADDL 311 88185 55 % of Charges OP 92.00 106.00 61.64 59.80 113.00 59.80 113.00 31000076 HC MARKER EACH ADDL 311 88185 53 % of Charges OP 155.00 106.00 103.85 100.75 113.00 100.75 113.00 31000071 HC CELL MARKER EACH ADDL 311 88185 55 % of Charges OP 171.00 106.00 114.57 111.15 113.00 106.00 114.57 31000026 HC CELL MARKERS 2-8 311 88187 67 % of Charges OP 185.00 144.00 123.95 120.25 123.95 120.25 144.00 31000083 HC FLOW CYTOMETER 2-8 MARKERS 311 88187 53 % of Charges OP 238.00 144.00 159.46 154.70 159.46 144.00 159.46 31000084 HC CELL MARKERS INTERP 9-15 311 88188 67 % of Charges OP 211.00 184.00 141.37 137.15 141.37 137.15 184.00 31000085 HC FLOW CYTOMETER 9-15 MARKERS 311 88188 53 % of Charges OP 238.00 184.00 159.46 154.70 159.46 154.70 184.00 31000027 HC CELL MARKERS INTERP 16 OR MORE 311 88189 67 % of Charges OP 240.00 224.00 160.80 156.00 160.80 156.00 224.00 31000088 HC TISSUE CULTURE; LYMPHOCYTE 319 88230 67 % of Charges OP 377.00 355.00 252.59 245.05 380.00 245.05 380.00 31000087 HC TISSUE CULTURE LYMPHOCYTE 319 88230 67 % of Charges OP 511.00 355.00 342.37 332.15 380.00 332.15 380.00 31000029 HC TISSUE CULT NON-NEOPLASTIC 319 88230 67 % of Charges OP 544.00 355.00 364.48 353.60 380.00 353.60 380.00 31000030 HC TISSUE CULTURE SKIN BIOPSY 319 88233 67 % of Charges OP 580.00 429.00 388.60 377.00 388.60 377.00 429.00 31000089 HC TISS CULT AMN FLD/CHOR VILLUS 319 88235 67 % of Charges OP " 1,362.00 " 449.00 912.54 885.30 480.00 449.00 912.54 31000036 HC TISSUE CULTURE BONE MARROW/BLD 319 88237 67 % of Charges OP 583.00 470.00 390.61 378.95 503.00 378.95 503.00 31000037 HC CRYOPRESERVATION FREEZE STORAG 319 88240 67 % of Charges OP 130.00 19.00 87.10 84.50 87.10 19.00 87.10 31000103 HC CHROMOSOME ANALYSIS 5 CELLS 319 88261 67 % of Charges OP 377.00 540.00 252.59 245.05 578.00 245.05 578.00 31000090 HC CHRM ANLY AMN FLD/CHOR VIL 15C 319 88267 67 % of Charges OP 760.00 548.00 509.20 494.00 586.00 494.00 586.00 31000032 HC MOLECULAR CYTOGEN DNA PROBE EA 319 88271 67 % of Charges OP 60.00 65.00 40.20 39.00 70.00 39.00 70.00 31000031 HC CYTOGENETICS DNA 319 88271 67 % of Charges OP 119.00 65.00 79.73 77.35 70.00 65.00 79.73 31000033 HC CYTOGENETICS 10-30 CELLS 319 88273 67 % of Charges OP 243.00 98.00 162.81 157.95 162.81 98.00 162.81 31000034 HC CYTOGENETICS 25-99 CELLS 319 88274 67 % of Charges OP 251.00 107.00 168.17 163.15 168.17 107.00 168.17 31000035 HC CYTOGENETICS 100-300 CELLS 319 88275 67 % of Charges OP 224.00 123.00 150.08 145.60 132.00 123.00 150.08 31000092 HC CHROMO ANALY ADDL KARYOTYPE 319 88280 67 % of Charges OP 140.00 113.00 93.80 91.00 121.00 91.00 121.00 31000096 HC CHROMOSOME COUNT ADDL 319 88285 67 % of Charges OP 152.00 121.00 101.84 98.80 129.00 98.80 129.00 31000097 HC CHROMO ANALY HIGH RESOL STUDY 319 88289 67 % of Charges OP 196.00 67.00 131.32 127.40 131.32 67.00 131.32 31000079 HC CYTO MOLECULAR REPORT 319 88291 67 % of Charges OP 112.00 64.00 75.04 72.80 68.00 64.00 75.04 31000093 HC CYTOGENETICS INTERP & REPORT 319 88291 67 % of Charges OP 152.00 64.00 101.84 98.80 68.00 64.00 101.84 31000094 HC GROSS & MICRO LEVEL IV 319 88305 67 % of Charges OP 366.00 67.05 245.22 237.90 72.00 67.05 245.22 32000004 HC CISTERNOGRAPHY 320 70015 51 % of Charges OP " 1,283.00 " " 3,341.21 " 859.61 833.95 859.61 833.95 " 3,341.21 " 32000005 HC EYE FOREIGN BODY 320 70030 295 % of Charges OP 51.00 304.39 34.17 33.15 34.17 33.15 304.39 32000005 HC EYE FOREIGN BODY 320 70030 51 % of Charges OP 147.00 304.39 98.49 95.55 98.49 95.55 304.39 32000006 HC MANDIBLE 1-3 VIEWS 320 70100 295 % of Charges OP 63.00 304.39 42.21 40.95 326.00 40.95 326.00 32000006 HC MANDIBLE 1-3 VIEWS 320 70100 51 % of Charges OP 253.00 304.39 169.51 164.45 326.00 164.45 326.00 32000007 HC MANDIBLE 4+ VIEWS 320 70110 295 % of Charges OP 68.00 560.85 45.56 44.20 600.00 44.20 600.00 32000007 HC MANDIBLE 4+ VIEWS 320 70110 51 % of Charges OP 344.00 560.85 230.48 223.60 600.00 223.60 600.00 32000008 HC MASTOIDS 1-2 VIEWS 320 70120 295 % of Charges OP 63.00 560.85 42.21 40.95 42.21 40.95 560.85 32000008 HC MASTOIDS 1-2 VIEWS 320 70120 51 % of Charges OP 233.04 560.85 156.14 151.48 156.14 151.48 560.85 32000009 HC MASTOIDS 3 OR MORE VIEWS 320 70130 295 % of Charges OP 97.00 560.85 64.99 63.05 64.99 63.05 560.85 32000009 HC MASTOIDS 3 OR MORE VIEWS 320 70130 51 % of Charges OP 433.00 560.85 290.11 281.45 290.11 281.45 560.85 32000011 HC FACIAL BONES 1-2 VIEWS 320 70140 295 % of Charges OP 48.00 304.39 32.16 31.20 326.00 31.20 326.00 32000011 HC FACIAL BONES 1-2 VIEWS 320 70140 51 % of Charges OP 266.00 304.39 178.22 172.90 326.00 172.90 326.00 32000012 HC FACIAL BONES 3+ VIEWS 320 70150 295 % of Charges OP 74.00 560.85 49.58 48.10 600.00 48.10 600.00 32000012 HC FACIAL BONES 3+ VIEWS 320 70150 51 % of Charges OP 454.00 560.85 304.18 295.10 600.00 295.10 600.00 32000013 HC NASAL BONES 320 70160 295 % of Charges OP 63.00 304.39 42.21 40.95 326.00 40.95 326.00 32000013 HC NASAL BONES 320 70160 51 % of Charges OP 298.00 304.39 199.66 193.70 326.00 193.70 326.00 32000015 HC ORBITS 4+ VIEWS 320 70200 295 % of Charges OP 74.00 560.85 49.58 48.10 49.58 48.10 560.85 32000015 HC ORBITS 4+ VIEWS 320 70200 51 % of Charges OP 416.00 560.85 278.72 270.40 278.72 270.40 560.85 32000016 HC SINUS PARANASAL 1-2 VIEWS 320 70210 295 % of Charges OP 50.00 304.39 33.50 32.50 326.00 32.50 326.00 32000016 HC SINUS PARANASAL 1-2 VIEWS 320 70210 51 % of Charges OP 302.00 304.39 202.34 196.30 326.00 196.30 326.00 32000017 HC PARANASAL SINUS 3+ VIEWS 320 70220 295 % of Charges OP 58.00 304.39 38.86 37.70 326.00 37.70 326.00 32000017 HC PARANASAL SINUS 3+ VIEWS 320 70220 51 % of Charges OP 427.00 304.39 286.09 277.55 326.00 277.55 326.00 32000018 HC SELLA TURCICA 320 70240 295 % of Charges OP 54.00 304.39 36.18 35.10 36.18 35.10 304.39 32000018 HC SELLA TURCICA 320 70240 51 % of Charges OP 165.00 304.39 110.55 107.25 110.55 107.25 304.39 32000019 HC SKULL 1-3 VIEWS 320 70250 295 % of Charges OP 58.00 560.85 38.86 37.70 600.00 37.70 600.00 32000019 HC SKULL 1-3 VIEWS 320 70250 51 % of Charges OP 253.00 560.85 169.51 164.45 600.00 164.45 600.00 32000020 HC SKULL COMPLETE 4+ VIEWS 320 70260 295 % of Charges OP 68.00 560.85 45.56 44.20 600.00 44.20 600.00 32000020 HC SKULL COMPLETE 4+ VIEWS 320 70260 51 % of Charges OP 427.00 560.85 286.09 277.55 600.00 277.55 600.00 32000023 HC TMJ OPEN CLOSED UNI 320 70328 295 % of Charges OP 55.00 304.39 36.85 35.75 36.85 35.75 304.39 32000023 HC TMJ OPEN CLOSED UNI 320 70328 51 % of Charges OP 196.00 304.39 131.32 127.40 131.32 127.40 304.39 32000024 HC TMJ BILATERAL 320 70330 295 % of Charges OP 90.00 304.39 60.30 58.50 60.30 58.50 304.39 32000024 HC TMJ BILATERAL 320 70330 51 % of Charges OP 346.00 304.39 231.82 224.90 231.82 224.90 304.39 32000025 HC ORTHOPANTOGRAM PANALIPSE 320 70355 51 % of Charges OP 253.00 304.39 169.51 164.45 326.00 164.45 326.00 32000026 HC NECK SOFT TISSUE 320 70360 295 % of Charges OP 49.00 304.39 32.83 31.85 326.00 31.85 326.00 32000026 HC NECK SOFT TISSUE 320 70360 51 % of Charges OP 269.00 304.39 180.23 174.85 326.00 174.85 326.00 32000027 HC SALIVARY GLAND-CALCULUS 320 70380 295 % of Charges OP 214.00 304.39 143.38 139.10 143.38 139.10 304.39 32000027 HC SALIVARY GLAND-CALCULUS 320 70380 51 % of Charges OP 233.00 304.39 156.11 151.45 156.11 151.45 304.39 32000028 HC RIBS UNILATERAL 2 VIEW 320 71100 295 % of Charges OP 55.00 304.39 36.85 35.75 326.00 35.75 326.00 32000028 HC RIBS UNILATERAL 2 VIEW 320 71100 51 % of Charges OP 384.00 304.39 257.28 249.60 326.00 249.60 326.00 32000029 HC CHEST W/RIBS UNI 3 VIEW 320 71101 295 % of Charges OP 63.00 560.85 42.21 40.95 600.00 40.95 600.00 32000029 HC CHEST W/RIBS UNI 3 VIEW 320 71101 51 % of Charges OP 435.00 560.85 291.45 282.75 600.00 282.75 600.00 32000030 HC RIBS BIL 3 VIEWS 320 71110 295 % of Charges OP 64.00 560.85 42.88 41.60 600.00 41.60 600.00 32000030 HC RIBS BIL 3 VIEWS 320 71110 51 % of Charges OP 413.00 560.85 276.71 268.45 600.00 268.45 600.00 32000031 HC CHEST W/RIBS BIL 4+ VIEWS 320 71111 295 % of Charges OP 80.00 560.85 53.60 52.00 600.00 52.00 600.00 32000031 HC CHEST W/RIBS BIL 4+ VIEWS 320 71111 51 % of Charges OP 540.00 560.85 361.80 351.00 600.00 351.00 600.00 32000032 HC STERNUM 320 71120 295 % of Charges OP 51.00 304.39 34.17 33.15 326.00 33.15 326.00 32000032 HC STERNUM 320 71120 51 % of Charges OP 317.00 304.39 212.39 206.05 326.00 206.05 326.00 32000033 HC STERNOCLAVICULAR JOINT 320 71130 295 % of Charges OP 65.00 304.39 43.55 42.25 326.00 42.25 326.00 32000033 HC STERNOCLAVICULAR JOINT 320 71130 51 % of Charges OP 284.00 304.39 190.28 184.60 326.00 184.60 326.00 32000033 HC STERNOCLAVICULAR JOINT 320 71130 234 % of Charges OP 284.00 304.39 190.28 184.60 326.00 184.60 326.00 32000034 HC X-RAY SPINE ONE VIEW 320 72020 295 % of Charges OP 36.00 304.39 24.12 23.40 326.00 23.40 326.00 32000034 HC X-RAY SPINE ONE VIEW 320 72020 51 % of Charges OP 228.00 304.39 152.76 148.20 326.00 148.20 326.00 32000035 HC CERVICAL SPINE 2 OR 3 VIEWS 320 72040 295 % of Charges OP 61.00 304.39 40.87 39.65 326.00 39.65 326.00 32000035 HC CERVICAL SPINE 2 OR 3 VIEWS 320 72040 51 % of Charges OP 319.00 304.39 213.73 207.35 326.00 207.35 326.00 32000036 HC SPINE CERVICAL 4 OR 5 VIEWS 320 72050 295 % of Charges OP 84.00 560.85 56.28 54.60 600.00 54.60 600.00 32000036 HC SPINE CERVICAL 4 OR 5 VIEWS 320 72050 51 % of Charges OP 488.00 560.85 326.96 317.20 600.00 317.20 600.00 32000037 HC SPINE CERVICAL 6 OR MORE VIEWS 320 72052 295 % of Charges OP 101.00 560.85 67.67 65.65 600.00 65.65 600.00 32000037 HC SPINE CERVICAL 6 OR MORE VIEWS 320 72052 51 % of Charges OP 651.00 560.85 436.17 423.15 600.00 423.15 600.00 32000038 HC SPINE THORACIC 2 VIEWS 320 72070 295 % of Charges OP 49.00 560.85 32.83 31.85 600.00 31.85 600.00 32000038 HC SPINE THORACIC 2 VIEWS 320 72070 51 % of Charges OP 359.00 560.85 240.53 233.35 600.00 233.35 600.00 32000039 HC SPINE THORACIC 3 VIEWS 320 72072 295 % of Charges OP 61.00 560.85 40.87 39.65 600.00 39.65 600.00 32000039 HC SPINE THORACIC 3 VIEWS 320 72072 51 % of Charges OP 441.00 560.85 295.47 286.65 600.00 286.65 600.00 32000040 HC SPINE THORACIC 4+ VIEWS 320 72074 295 % of Charges OP 70.00 560.85 46.90 45.50 600.00 45.50 600.00 32000040 HC SPINE THORACIC 4+ VIEWS 320 72074 51 % of Charges OP 459.00 560.85 307.53 298.35 600.00 298.35 600.00 32000041 HC SPINE T-L 2 VIEWS 320 72080 295 % of Charges OP 53.00 304.39 35.51 34.45 326.00 34.45 326.00 32000041 HC SPINE T-L 2 VIEWS 320 72080 51 % of Charges OP 357.00 304.39 239.19 232.05 326.00 232.05 326.00 32000042 HC SPINE ONE VIEW 320 72081 295 % of Charges OP 64.00 304.39 42.88 41.60 326.00 41.60 326.00 32000042 HC SPINE ONE VIEW 320 72081 51 % of Charges OP 279.00 304.39 186.93 181.35 326.00 181.35 326.00 32000043 HC SPINE 2-3 VIEWS 320 72082 295 % of Charges OP 118.00 560.85 79.06 76.70 600.00 76.70 600.00 32000043 HC SPINE 2-3 VIEWS 320 72082 51 % of Charges OP 351.00 560.85 235.17 228.15 600.00 228.15 600.00 32000044 HC SPINE 4-5 VIEWS 320 72083 295 % of Charges OP 138.00 560.85 92.46 89.70 92.46 89.70 560.85 32000044 HC SPINE 4-5 VIEWS 320 72083 51 % of Charges OP 421.00 560.85 282.07 273.65 282.07 273.65 560.85 32000045 HC SPINE 6 OR MORE VIEWS 320 72084 295 % of Charges OP 166.00 560.85 111.22 107.90 111.22 107.90 560.85 32000045 HC SPINE 6 OR MORE VIEWS 320 72084 51 % of Charges OP 504.00 560.85 337.68 327.60 337.68 327.60 560.85 32000046 HC SPINE LUMBAR 2 OR 3 VIEWS 320 72100 295 % of Charges OP 61.00 560.85 40.87 39.65 600.00 39.65 600.00 32000046 HC SPINE LUMBAR 2 OR 3 VIEWS 320 72100 51 % of Charges OP 403.00 560.85 270.01 261.95 600.00 261.95 600.00 32000047 HC SPINE LUMBAR 4+ VIEWS 320 72110 295 % of Charges OP 81.00 560.85 54.27 52.65 600.00 52.65 600.00 32000047 HC SPINE LUMBAR 4+ VIEWS 320 72110 51 % of Charges OP 409.00 560.85 274.03 265.85 600.00 265.85 600.00 32000048 HC SPINE LUMB COMP W/BENDING 320 72114 295 % of Charges OP 101.00 560.85 67.67 65.65 600.00 65.65 600.00 32000048 HC SPINE LUMB COMP W/BENDING 320 72114 51 % of Charges OP 474.00 560.85 317.58 308.10 600.00 308.10 600.00 32000049 HC SPINE LUMBAR BEND 2-3 VIEWS 320 72120 295 % of Charges OP 64.00 560.85 42.88 41.60 42.88 41.60 560.85 32000049 HC SPINE LUMBAR BEND 2-3 VIEWS 320 72120 51 % of Charges OP 651.00 560.85 436.17 423.15 436.17 423.15 560.85 32000050 HC PELVIS 1 OR 2 VIEWS 320 72170 295 % of Charges OP 45.00 560.85 30.15 29.25 600.00 29.25 600.00 32000050 HC PELVIS 1 OR 2 VIEWS 320 72170 51 % of Charges OP 249.00 560.85 166.83 161.85 600.00 161.85 600.00 32000051 HC PELVIS COMPLETE 3+ VIEWS 320 72190 295 % of Charges OP 63.00 560.85 42.21 40.95 600.00 40.95 600.00 32000051 HC PELVIS COMPLETE 3+ VIEWS 320 72190 51 % of Charges OP 353.00 560.85 236.51 229.45 600.00 229.45 600.00 32000051 HC PELVIS COMPLETE 3+ VIEWS 320 72190 234 % of Charges OP 353.00 560.85 236.51 229.45 600.00 229.45 600.00 32000052 HC SACROILIAC JOINT 1-2 VIEW 320 72200 295 % of Charges OP 53.00 560.85 35.51 34.45 600.00 34.45 600.00 32000052 HC SACROILIAC JOINT 1-2 VIEW 320 72200 51 % of Charges OP 241.00 560.85 161.47 156.65 600.00 156.65 600.00 32000053 HC SACROILIAC JOINTS 3+ VIEW 320 72202 295 % of Charges OP 60.00 560.85 40.20 39.00 600.00 39.00 600.00 32000053 HC SACROILIAC JOINTS 3+ VIEW 320 72202 51 % of Charges OP 306.00 560.85 205.02 198.90 600.00 198.90 600.00 32000054 HC SACRUM/COCCYX 320 72220 295 % of Charges OP 51.00 304.39 34.17 33.15 326.00 33.15 326.00 32000054 HC SACRUM/COCCYX 320 72220 51 % of Charges OP 294.00 304.39 196.98 191.10 326.00 191.10 326.00 32000055 HC MYELOGRAM CERV S & I 320 72240 51 % of Charges OP " 1,148.00 " " 3,341.21 " 769.16 746.20 769.16 746.20 " 3,341.21 " 32000056 HC MYELOGRAM THORACIC S & I 320 72255 51 % of Charges OP " 1,592.00 " " 3,341.21 " " 1,066.64 " " 1,034.80 " " 1,066.64 " " 1,034.80 " " 3,341.21 " 32000057 HC MYELOGRAM LUMBOSACRAL S & I 320 72265 51 % of Charges OP " 1,119.00 " " 3,341.21 " 749.73 727.35 749.73 727.35 " 3,341.21 " 32000058 HC MYELOGRAM MULTILEVEL S & I 320 72270 51 % of Charges OP " 2,399.00 " " 3,341.21 " " 1,607.33 " " 1,559.35 " " 1,607.33 " " 1,559.35 " " 3,341.21 " 32000062 HC CLAVICLE COMPLETE 320 73000 295 % of Charges OP 52.00 304.39 34.84 33.80 326.00 33.80 326.00 32000062 HC CLAVICLE COMPLETE 320 73000 51 % of Charges OP 250.00 304.39 167.50 162.50 326.00 162.50 326.00 32000062 HC CLAVICLE COMPLETE 320 73000 234 % of Charges OP 250.00 304.39 167.50 162.50 326.00 162.50 326.00 32000063 HC SCAPULA COMPLETE 320 73010 295 % of Charges OP 42.00 560.85 28.14 27.30 600.00 27.30 600.00 32000063 HC SCAPULA COMPLETE 320 73010 51 % of Charges OP 294.00 560.85 196.98 191.10 600.00 191.10 600.00 32000063 HC SCAPULA COMPLETE 320 73010 234 % of Charges OP 294.00 560.85 196.98 191.10 600.00 191.10 600.00 32000064 HC SHOULDER 1 VIEW 320 73020 295 % of Charges OP 31.00 304.39 20.77 20.15 326.00 20.15 326.00 32000064 HC SHOULDER 1 VIEW 320 73020 51 % of Charges OP 275.00 304.39 184.25 178.75 326.00 178.75 326.00 32000064 HC SHOULDER 1 VIEW 320 73020 234 % of Charges OP 275.00 304.39 184.25 178.75 326.00 178.75 326.00 32000065 HC SHOULDER 2+ VIEWS 320 73030 295 % of Charges OP 54.00 304.39 36.18 35.10 326.00 35.10 326.00 32000065 HC SHOULDER 2+ VIEWS 320 73030 51 % of Charges OP 341.00 304.39 228.47 221.65 326.00 221.65 326.00 32000065 HC SHOULDER 2+ VIEWS 320 73030 234 % of Charges OP 341.00 304.39 228.47 221.65 326.00 221.65 326.00 32000066 HC AC JOINTS BILATERAL 320 73050 295 % of Charges OP 49.00 304.39 32.83 31.85 32.83 31.85 304.39 32000066 HC AC JOINTS BILATERAL 320 73050 51 % of Charges OP 285.00 304.39 190.95 185.25 190.95 185.25 304.39 32000066 HC AC JOINTS BILATERAL 320 73050 234 % of Charges OP 285.00 304.39 190.95 185.25 190.95 185.25 304.39 32000067 HC HUMERUS 320 73060 295 % of Charges OP 52.00 304.39 34.84 33.80 326.00 33.80 326.00 32000067 HC HUMERUS 320 73060 51 % of Charges OP 302.00 304.39 202.34 196.30 326.00 196.30 326.00 32000067 HC HUMERUS 320 73060 234 % of Charges OP 302.00 304.39 202.34 196.30 326.00 196.30 326.00 32000068 HC ELBOW 2 VIEWS 320 73070 295 % of Charges OP 45.00 304.39 30.15 29.25 326.00 29.25 326.00 32000068 HC ELBOW 2 VIEWS 320 73070 51 % of Charges OP 227.00 304.39 152.09 147.55 326.00 147.55 326.00 32000068 HC ELBOW 2 VIEWS 320 73070 234 % of Charges OP 227.00 304.39 152.09 147.55 326.00 147.55 326.00 32000069 HC ELBOW 3+ VIEWS 320 73080 295 % of Charges OP 50.00 304.39 33.50 32.50 326.00 32.50 326.00 32000069 HC ELBOW 3+ VIEWS 320 73080 51 % of Charges OP 310.00 304.39 207.70 201.50 326.00 201.50 326.00 32000070 HC FOREARM 2 VIEWS 320 73090 295 % of Charges OP 46.00 304.39 30.82 29.90 326.00 29.90 326.00 32000070 HC FOREARM 2 VIEWS 320 73090 51 % of Charges OP 272.00 304.39 182.24 176.80 326.00 176.80 326.00 32000070 HC FOREARM 2 VIEWS 320 73090 234 % of Charges OP 272.00 304.39 182.24 176.80 326.00 176.80 326.00 32000071 HC UPPER EXTREMITY INFANT 320 73092 295 % of Charges OP 50.00 560.85 33.50 32.50 33.50 32.50 560.85 32000071 HC UPPER EXTREMITY INFANT 320 73092 51 % of Charges OP 201.00 560.85 134.67 130.65 134.67 130.65 560.85 32000072 HC WRIST 2 VIEWS 320 73100 295 % of Charges OP 55.00 304.39 36.85 35.75 326.00 35.75 326.00 32000072 HC WRIST 2 VIEWS 320 73100 51 % of Charges OP 211.00 304.39 141.37 137.15 326.00 137.15 326.00 32000072 HC WRIST 2 VIEWS 320 73100 234 % of Charges OP 211.00 304.39 141.37 137.15 326.00 137.15 326.00 32000073 HC WRIST 3+ VIEWS 320 73110 295 % of Charges OP 68.00 304.39 45.56 44.20 326.00 44.20 326.00 32000073 HC WRIST 3+ VIEWS 320 73110 51 % of Charges OP 294.00 304.39 196.98 191.10 326.00 191.10 326.00 32000074 HC HAND 2 VIEWS 320 73120 295 % of Charges OP 49.00 560.85 32.83 31.85 600.00 31.85 600.00 32000074 HC HAND 2 VIEWS 320 73120 51 % of Charges OP 211.00 560.85 141.37 137.15 600.00 137.15 600.00 32000075 HC HAND 3+ VIEWS 320 73130 295 % of Charges OP 59.00 304.39 39.53 38.35 326.00 38.35 326.00 32000075 HC HAND 3+ VIEWS 320 73130 51 % of Charges OP 294.00 304.39 196.98 191.10 326.00 191.10 326.00 32000076 HC FINGER(S) 2+ VIEWS 320 73140 295 % of Charges OP 65.00 304.39 43.55 42.25 326.00 42.25 326.00 32000076 HC FINGER(S) 2+ VIEWS 320 73140 51 % of Charges OP 203.00 304.39 136.01 131.95 326.00 131.95 326.00 32000077 HC HIP UNI W OR WO PEL 1 VIEW 320 73501 295 % of Charges OP 50.00 304.39 33.50 32.50 326.00 32.50 326.00 32000077 HC HIP UNI W OR WO PEL 1 VIEW 320 73501 51 % of Charges OP 178.00 304.39 119.26 115.70 326.00 115.70 326.00 32000077 HC HIP UNI W OR WO PEL 1 VIEW 320 73501 234 % of Charges OP 178.00 304.39 119.26 115.70 326.00 115.70 326.00 32000078 HC HIP UNI W OR WO PEL 2-3 VIEWS 320 73502 295 % of Charges OP 77.00 304.39 51.59 50.05 326.00 50.05 326.00 32000078 HC HIP UNI W OR WO PEL 2-3 VIEWS 320 73502 51 % of Charges OP 297.00 304.39 198.99 193.05 326.00 193.05 326.00 32000078 HC HIP UNI W OR WO PEL 2-3 VIEWS 320 73502 234 % of Charges OP 297.00 304.39 198.99 193.05 326.00 193.05 326.00 32000079 HC HIP UNI W OR WO PEL 4+ VIEWS 320 73503 295 % of Charges OP 96.00 560.85 64.32 62.40 64.32 62.40 560.85 32000079 HC HIP UNI W OR WO PEL 4+ VIEWS 320 73503 51 % of Charges OP 356.00 560.85 238.52 231.40 238.52 231.40 560.85 32000079 HC HIP UNI W OR WO PEL 4+ VIEWS 320 73503 234 % of Charges OP 356.00 560.85 238.52 231.40 238.52 231.40 560.85 32000082 HC HIP BIL W OR WO PEL 2 VIEWS 320 73521 295 % of Charges OP 65.00 560.85 43.55 42.25 43.55 42.25 560.85 32000082 HC HIP BIL W OR WO PEL 2 VIEWS 320 73521 51 % of Charges OP 332.00 560.85 222.44 215.80 222.44 215.80 560.85 32000083 HC HIP BIL W OR WO PEL 3-4 VIEWS 320 73522 295 % of Charges OP 85.00 560.85 56.95 55.25 600.00 55.25 600.00 32000083 HC HIP BIL W OR WO PEL 3-4 VIEWS 320 73522 51 % of Charges OP 399.00 560.85 267.33 259.35 600.00 259.35 600.00 32000084 HC HIP BIL W OR WO PEL 5+ VIEWS 320 73523 295 % of Charges OP 99.00 560.85 66.33 64.35 600.00 64.35 600.00 32000084 HC HIP BIL W OR WO PEL 5+ VIEWS 320 73523 51 % of Charges OP 478.00 560.85 320.26 310.70 600.00 310.70 600.00 32000086 HC FEMUR 1 VIEW 320 73551 295 % of Charges OP 47.00 304.39 31.49 30.55 31.49 30.55 304.39 32000086 HC FEMUR 1 VIEW 320 73551 51 % of Charges OP 268.00 304.39 179.56 174.20 179.56 174.20 304.39 32000087 HC FEMUR 2 VIEWS 320 73552 295 % of Charges OP 58.00 304.39 38.86 37.70 326.00 37.70 326.00 32000087 HC FEMUR 2 VIEWS 320 73552 51 % of Charges OP 333.00 304.39 223.11 216.45 326.00 216.45 326.00 32000087 HC FEMUR 2 VIEWS 320 73552 234 % of Charges OP 333.00 304.39 223.11 216.45 326.00 216.45 326.00 32000088 HC KNEE 1-2 VIEWS 320 73560 295 % of Charges OP 57.00 304.39 38.19 37.05 326.00 37.05 326.00 32000088 HC KNEE 1-2 VIEWS 320 73560 51 % of Charges OP 328.00 304.39 219.76 213.20 326.00 213.20 326.00 32000088 HC KNEE 1-2 VIEWS 320 73560 234 % of Charges OP 328.00 304.39 219.76 213.20 326.00 213.20 326.00 32000089 HC KNEE 3 VIEWS 320 73562 295 % of Charges OP 68.00 304.39 45.56 44.20 326.00 44.20 326.00 32000089 HC KNEE 3 VIEWS 320 73562 51 % of Charges OP 373.00 304.39 249.91 242.45 326.00 242.45 326.00 32000090 HC KNEE COMPLETE 4+ VIEWS 320 73564 295 % of Charges OP 74.00 560.85 49.58 48.10 600.00 48.10 600.00 32000090 HC KNEE COMPLETE 4+ VIEWS 320 73564 51 % of Charges OP 391.00 560.85 261.97 254.15 600.00 254.15 600.00 32000091 HC KNEES BOTH STANDING AP 320 73565 295 % of Charges OP 68.00 304.39 45.56 44.20 326.00 44.20 326.00 32000091 HC KNEES BOTH STANDING AP 320 73565 51 % of Charges OP 298.00 304.39 199.66 193.70 326.00 193.70 326.00 32000092 HC TIBIA/FIBULA 2 VIEWS 320 73590 295 % of Charges OP 51.00 304.39 34.17 33.15 326.00 33.15 326.00 32000092 HC TIBIA/FIBULA 2 VIEWS 320 73590 51 % of Charges OP 277.00 304.39 185.59 180.05 326.00 180.05 326.00 32000092 HC TIBIA/FIBULA 2 VIEWS 320 73590 234 % of Charges OP 277.00 304.39 185.59 180.05 326.00 180.05 326.00 32000093 HC LOWER EXTREMITY INFANT 320 73592 295 % of Charges OP 50.00 304.39 33.50 32.50 326.00 32.50 326.00 32000093 HC LOWER EXTREMITY INFANT 320 73592 51 % of Charges OP 194.00 304.39 129.98 126.10 326.00 126.10 326.00 32000094 HC ANKLE 2 VIEWS 320 73600 295 % of Charges OP 53.00 304.39 35.51 34.45 326.00 34.45 326.00 32000205 HC ANKLE ONE VIEW 320 73600 51 % of Charges OP 195.00 304.39 130.65 126.75 326.00 126.75 326.00 32000094 HC ANKLE 2 VIEWS 320 73600 51 % of Charges OP 230.00 304.39 154.10 149.50 326.00 149.50 326.00 32000094 HC ANKLE 2 VIEWS 320 73600 234 % of Charges OP 230.00 304.39 154.10 149.50 326.00 149.50 326.00 32000095 HC ANKLE 3+ VIEWS 320 73610 295 % of Charges OP 59.00 304.39 39.53 38.35 326.00 38.35 326.00 32000095 HC ANKLE 3+ VIEWS 320 73610 51 % of Charges OP 298.00 304.39 199.66 193.70 326.00 193.70 326.00 32000095 HC ANKLE 3+ VIEWS 320 73610 234 % of Charges OP 298.00 304.39 199.66 193.70 326.00 193.70 326.00 32000096 HC FOOT 2 VIEWS 320 73620 295 % of Charges OP 45.00 304.39 30.15 29.25 326.00 29.25 326.00 32000096 HC FOOT 2 VIEWS 320 73620 51 % of Charges OP 230.00 304.39 154.10 149.50 326.00 149.50 326.00 32000096 HC FOOT 2 VIEWS 320 73620 234 % of Charges OP 230.00 304.39 154.10 149.50 326.00 149.50 326.00 32000097 HC FOOT 3+ VIEWS 320 73630 295 % of Charges OP 55.00 304.39 36.85 35.75 326.00 35.75 326.00 32000097 HC FOOT 3+ VIEWS 320 73630 51 % of Charges OP 310.00 304.39 207.70 201.50 326.00 201.50 326.00 32000097 HC FOOT 3+ VIEWS 320 73630 234 % of Charges OP 310.00 304.39 207.70 201.50 326.00 201.50 326.00 32000098 HC CALCANEUS 2+ VIEWS 320 73650 295 % of Charges OP 45.00 304.39 30.15 29.25 326.00 29.25 326.00 32000098 HC CALCANEUS 2+ VIEWS 320 73650 51 % of Charges OP 198.00 304.39 132.66 128.70 326.00 128.70 326.00 32000098 HC CALCANEUS 2+ VIEWS 320 73650 234 % of Charges OP 198.00 304.39 132.66 128.70 326.00 128.70 326.00 32000099 HC TOE(S) 2+ VIEWS 320 73660 295 % of Charges OP 49.00 304.39 32.83 31.85 326.00 31.85 326.00 32000099 HC TOE(S) 2+ VIEWS 320 73660 51 % of Charges OP 242.00 304.39 162.14 157.30 326.00 157.30 326.00 32000216 HC ABDOMEN XRAY ONE VIEW 320 74018 295 % of Charges OP 45.00 155.07 30.15 29.25 166.00 29.25 166.00 32000216 HC ABDOMEN XRAY ONE VIEW 320 74018 51 % of Charges OP 265.00 155.07 177.55 172.25 166.00 155.07 177.55 32000217 HC ABDOMEN XRAY TWO VIEWS 320 74019 295 % of Charges OP 55.00 170.77 36.85 35.75 183.00 35.75 183.00 32000217 HC ABDOMEN XRAY TWO VIEWS 320 74019 51 % of Charges OP 292.00 170.77 195.64 189.80 183.00 170.77 195.64 32000218 HC ABDOMEN XRAY THREE + VIEWS 320 74021 295 % of Charges OP 64.00 190.24 42.88 41.60 204.00 41.60 204.00 32000218 HC ABDOMEN XRAY THREE + VIEWS 320 74021 51 % of Charges OP 328.00 190.24 219.76 213.20 204.00 190.24 219.76 32000103 HC ABD 2+ VIEWS INCLUDING SINGLE CHEST XRAY 320 74022 295 % of Charges OP 74.00 560.85 49.58 48.10 600.00 48.10 600.00 32000103 HC ABD 2+ VIEWS INCLUDING SINGLE CHEST XRAY 320 74022 51 % of Charges OP 473.00 560.85 316.91 307.45 600.00 307.45 600.00 32000105 HC SOFT TISSUE NECK INCLUDING SCOUT W/WO DELAYED IMAGES W CONTRAST 320 74210 295 % of Charges OP 149.00 " 1,238.43 " 99.83 96.85 99.83 96.85 " 1,238.43 " 32000105 HC SOFT TISSUE NECK INCLUDING SCOUT W/WO DELAYED IMAGES W CONTRAST 320 74210 51 % of Charges OP 461.00 " 1,238.43 " 308.87 299.65 308.87 299.65 " 1,238.43 " 32000106 HC ESOPHAGUS SINGLE CONTRAST AGENT 320 74220 51 % of Charges OP 565.00 " 1,238.43 " 378.55 367.25 " 1,325.00 " 367.25 " 1,325.00 " 32000223 HC ESOPHAGUS DOUBLE CONTRAST AGENT 320 74221 51 % of Charges OP 575.00 385.25 385.25 373.75 385.25 373.75 385.25 32000206 HC MOD BARIUM SWALLOW UNL STUDY 320 74230 51 % of Charges OP 443.00 560.85 296.81 287.95 600.00 287.95 600.00 32000107 HC SWALLOW FUNCTION W VIDEO 320 74230 51 % of Charges OP 526.00 560.85 352.42 341.90 600.00 341.90 600.00 32000207 HC SPEECH SWALLOW/ESOPHOGRAM 320 74230 51 % of Charges OP 554.00 560.85 371.18 360.10 600.00 360.10 600.00 32000222 HC UPPER GI W SCOUT W WO DELAYED IMAGES SINGLE CONTRAST AGENT 320 74240 51 % of Charges OP 594.00 " 1,238.43 " 397.98 386.10 397.98 386.10 " 1,238.43 " 32000108 HC UPPER GI W/KUB 320 74241 51 % of Charges OP 621.00 " 1,238.43 " 416.07 403.65 " 1,325.00 " 403.65 " 1,325.00 " 32000109 HC UPPER GI/SM BOWEL SERIES 320 74245 51 % of Charges OP 974.00 " 1,138.32 " 652.58 633.10 " 1,218.00 " 633.10 " 1,218.00 " 32000221 HC UPPER GI W SCOUT W WO DELAYED IMAGES DOUBLE CONTRAST AGENT 320 74246 51 % of Charges OP 708.00 " 1,238.43 " 474.36 460.20 474.36 460.20 " 1,238.43 " 32000110 HC UPPER GI AIR CONTRAST 320 74247 51 % of Charges OP 740.00 " 1,238.43 " 495.80 481.00 " 1,325.00 " 481.00 " 1,325.00 " 32000220 HC SMALL BOWEL SERIES FOLLOWING UGI 320 74248 51 % of Charges OP 975.00 653.25 653.25 633.75 653.25 633.75 653.25 32000111 HC UPPER GI-SM BOWEL W/AIR 320 74249 51 % of Charges OP " 1,019.00 " " 1,238.43 " 682.73 662.35 " 1,325.00 " 662.35 " 1,325.00 " 32000112 HC SMALL BOWEL SERIES SINGLE CONTRAST AGENT 320 74250 51 % of Charges OP 602.00 560.85 403.34 391.30 600.00 391.30 600.00 32000113 HC BARIUM ENEMA SINGLE CONTRAST AGENT 320 74270 51 % of Charges OP 819.00 " 1,238.43 " 548.73 532.35 " 1,325.00 " 532.35 " 1,325.00 " 32000114 HC BE AIR CONTRAST DOUBLE AGENT 320 74280 51 % of Charges OP " 1,024.00 " " 1,238.43 " 686.08 665.60 686.08 665.60 " 1,238.43 " 32000115 HC BARIUM ENEMA INTUSSUSCEPT 320 74283 51 % of Charges OP 863.00 " 1,238.43 " 578.21 560.95 578.21 560.95 " 1,238.43 " 32000116 HC CHOLANGIOGRAPHY OPER 320 74300 51 % of Charges OP 621.00 345.00 416.07 403.65 369.00 345.00 416.07 32000117 HC ERCP BILIARY ONLY 320 74328 51 % of Charges OP " 1,089.00 " 505.00 729.63 707.85 729.63 505.00 729.63 32000118 HC ERCP PANCREAS ONLY 320 74329 51 % of Charges OP " 1,144.00 " 505.00 766.48 743.60 766.48 505.00 766.48 32000119 HC ERCP BILIARY AND PANCREAS 320 74330 51 % of Charges OP " 1,375.00 " " 1,010.00 " 921.25 893.75 " 1,081.00 " 893.75 " 1,081.00 " 32000120 HC GASTRO TUBE INTRODUCTION 320 74340 51 % of Charges OP " 1,070.00 " 399.00 716.90 695.50 716.90 399.00 716.90 32000121 HC PERC PL ENTEROCLYSIS TUBE 320 74355 51 % of Charges OP " 1,011.00 " 421.00 677.37 657.15 677.37 421.00 677.37 32000124 HC INTRAVENOUS PYELOGRAM 320 74400 295 % of Charges OP 238.00 " 1,238.43 " 159.46 154.70 " 1,325.00 " 154.70 " 1,325.00 " 32000124 HC INTRAVENOUS PYELOGRAM 320 74400 51 % of Charges OP 838.00 " 1,238.43 " 561.46 544.70 " 1,325.00 " 544.70 " 1,325.00 " 32000127 HC RETROGRADE PYELOGRAM 320 74420 51 % of Charges OP 759.00 " 2,236.21 " 508.53 493.35 " 2,393.00 " 493.35 " 2,393.00 " 32000129 HC CYSTOGRAPHY 320 74430 51 % of Charges OP 854.00 " 1,238.43 " 572.18 555.10 " 1,325.00 " 555.10 " 1,325.00 " 32000132 HC URETHROCYSTOGRAPHY RETRO 320 74450 51 % of Charges OP " 1,085.00 " " 1,138.32 " 726.95 705.25 726.95 705.25 " 1,138.32 " 32000133 HC URETHROCYSTOGRAM VOIDING 320 74455 51 % of Charges OP 706.00 " 1,138.32 " 473.02 458.90 " 1,218.00 " 458.90 " 1,218.00 " 32000135 HC NEPHR/URET DILATION 320 74485 51 % of Charges OP " 1,899.00 " " 8,308.83 " " 1,272.33 " " 1,234.35 " " 1,272.33 " " 1,234.35 " " 8,308.83 " 32000136 HC PELVIMETRY 320 74710 295 % of Charges OP 51.00 304.39 34.17 33.15 34.17 33.15 304.39 32000136 HC PELVIMETRY 320 74710 51 % of Charges OP 420.00 304.39 281.40 273.00 281.40 273.00 304.39 32000137 HC HYSTEROSALPINOGRAPHY 320 74740 51 % of Charges OP 591.00 " 1,138.32 " 395.97 384.15 " 1,218.00 " 384.15 " 1,218.00 " 32000143 HC SHUNTOGRM PRV PLACE SHUNT 320 75809 51 % of Charges OP 765.00 560.85 512.55 497.25 600.00 497.25 600.00 32000179 HC FLUORO GUIDE ABSCESS DRAIN 320 75989 51 % of Charges OP " 2,065.00 " 451.00 " 1,383.55 " " 1,342.25 " 483.00 451.00 " 1,383.55 " 32000180 HC FLUOROSCOPY < 1 HOUR 320 76000 51 % of Charges OP 692.00 " 1,138.32 " 463.64 449.80 " 1,218.00 " 449.80 " 1,218.00 " 32000182 HC FOREIGN BODY EXAM-CHILD 320 76010 295 % of Charges OP 45.00 304.39 30.15 29.25 326.00 29.25 326.00 32000182 HC FOREIGN BODY EXAM-CHILD 320 76010 51 % of Charges OP 341.00 304.39 228.47 221.65 326.00 221.65 326.00 32000183 HC ABSCESSOGRAM/FISTULA/SINUS TRACT 320 76080 51 % of Charges OP " 1,384.00 " " 1,138.32 " 927.28 899.60 " 1,218.00 " 899.60 " 1,218.00 " 32000184 HC SURGICAL SPECIMEN 320 76098 51 % of Charges OP 614.00 " 2,384.78 " 411.38 399.10 " 2,552.00 " 399.10 " 2,552.00 " 32000185 HC BODY SECTION TOMOGRAPHY 320 76100 295 % of Charges OP 153.00 560.85 102.51 99.45 102.51 99.45 560.85 32000185 HC BODY SECTION TOMOGRAPHY 320 76100 51 % of Charges OP 548.00 560.85 367.16 356.20 367.16 356.20 560.85 32000215 HC ABDOMEN THERAPY PLANNING 320 76499 51 % of Charges OP 241.00 161.47 161.47 156.65 161.47 156.65 161.47 32000187 HC FLUORO VENOUS ACCESS DEVICE 320 77001 51 % of Charges OP " 1,156.00 " 664.00 774.52 751.40 710.00 664.00 774.52 32000188 HC FLUORO GUIDE NEEDLE PLACEMENT 320 77002 51 % of Charges OP 942.00 341.00 631.14 612.30 365.00 341.00 631.14 32000189 HC FLUORO GUIDANCE/LOCAL NDL 320 77003 51 % of Charges OP 634.00 419.00 424.78 412.10 448.00 412.10 448.00 32000190 HC DUCTOGRAM SINGLE 320 77053 295 % of Charges OP 117.00 " 1,138.32 " 78.39 76.05 " 1,218.00 " 76.05 " 1,218.00 " 32000190 HC DUCTOGRAM SINGLE 320 77053 51 % of Charges OP 681.00 " 1,138.32 " 456.27 442.65 " 1,218.00 " 442.65 " 1,218.00 " 32000191 HC DUCTOGRAM MULTIPLE 320 77054 295 % of Charges OP 117.00 " 1,138.32 " 78.39 76.05 78.39 76.05 " 1,138.32 " 32000191 HC DUCTOGRAM MULTIPLE 320 77054 51 % of Charges OP 806.00 " 1,138.32 " 540.02 523.90 540.02 523.90 " 1,138.32 " 32000192 HC BONE AGE STUDIES 320 77072 295 % of Charges OP 36.00 560.85 24.12 23.40 600.00 23.40 600.00 32000192 HC BONE AGE STUDIES 320 77072 51 % of Charges OP 204.00 560.85 136.68 132.60 600.00 132.60 600.00 32000193 HC BONE LENGTH STUDY 320 77073 295 % of Charges OP 69.00 560.85 46.23 44.85 600.00 44.85 600.00 32000193 HC BONE LENGTH STUDY 320 77073 51 % of Charges OP 422.00 560.85 282.74 274.30 600.00 274.30 600.00 32000194 HC OSSEOUS SURVEY LIMITED 320 77074 295 % of Charges OP 94.00 560.85 62.98 61.10 62.98 61.10 560.85 32000194 HC OSSEOUS SURVEY LIMITED 320 77074 51 % of Charges OP 617.00 560.85 413.39 401.05 413.39 401.05 560.85 32000195 HC OSSEOUS SURVEY COMPLETE 320 77075 295 % of Charges OP 154.00 560.85 103.18 100.10 600.00 100.10 600.00 32000195 HC OSSEOUS SURVEY COMPLETE 320 77075 51 % of Charges OP 784.00 560.85 525.28 509.60 600.00 509.60 600.00 32000196 HC OSSEOUS SURVEY-INFANT 320 77076 295 % of Charges OP 156.00 560.85 104.52 101.40 600.00 101.40 600.00 32000196 HC OSSEOUS SURVEY-INFANT 320 77076 51 % of Charges OP 817.00 560.85 547.39 531.05 600.00 531.05 600.00 32000197 HC JOINT SINGLE VIEW 320 77077 295 % of Charges OP 65.00 560.85 43.55 42.25 43.55 42.25 560.85 32000197 HC JOINT SINGLE VIEW 320 77077 51 % of Charges OP 195.00 560.85 130.65 126.75 130.65 126.75 560.85 32000198 HC DEXA AXIAL SKELETON STUDY 320 77080 295 % of Charges OP 68.00 560.85 45.56 44.20 600.00 44.20 600.00 32000198 HC DEXA AXIAL SKELETON STUDY 320 77080 51 % of Charges OP 385.00 560.85 257.95 250.25 600.00 250.25 600.00 32000199 HC DEXA RADIUS WRIST OR HEEL 320 77081 295 % of Charges OP 50.00 304.39 33.50 32.50 33.50 32.50 304.39 32000199 HC DEXA RADIUS WRIST OR HEEL 320 77081 51 % of Charges OP 253.00 304.39 169.51 164.45 169.51 164.45 304.39 32000219 HC QUANTIFICATION EACH AREA EACH DAY 320 78835 51 % of Charges OP 850.00 569.50 569.50 552.50 569.50 552.50 569.50 32200001 HC ARTHROGRAPHY SHOULDER 322 73040 51 % of Charges OP " 1,091.00 " " 2,236.21 " 730.97 709.15 730.97 709.15 " 2,236.21 " 32200002 HC ARTHROGRAM ELBOW 322 73085 51 % of Charges OP 547.00 " 2,236.21 " 366.49 355.55 366.49 355.55 " 2,236.21 " 32200003 HC ARTHROGRAM WRIST 322 73115 51 % of Charges OP 495.00 " 1,238.43 " 331.65 321.75 331.65 321.75 " 1,238.43 " 32200004 HC ARTHROGRAM HIP 322 73525 51 % of Charges OP 714.00 " 2,236.21 " 478.38 464.10 478.38 464.10 " 2,236.21 " 32200005 HC ARTHROGRAPHY KNEE 322 73580 51 % of Charges OP 547.00 " 2,236.21 " 366.49 355.55 366.49 355.55 " 2,236.21 " 32200006 HC ARTHROGRAM ANKLE 322 73615 51 % of Charges OP 920.00 " 2,236.21 " 616.40 598.00 616.40 598.00 " 2,236.21 " 32300011 HC ANGIO EXTREM UNILATERAL 323 75710 51 % of Charges OP " 3,346.00 " " 12,214.43 " " 2,241.82 " " 2,174.90 " " 13,069.00 " " 2,174.90 " " 13,069.00 " 32300012 HC ANGIO EXTREM BILATERAL 323 75716 51 % of Charges OP " 3,822.00 " " 12,214.43 " " 2,560.74 " " 2,484.30 " " 13,069.00 " " 2,484.30 " " 13,069.00 " 32400009 HC CHEST XRAY ONE VIEW 324 71045 295 % of Charges OP 37.00 156.90 24.79 24.05 168.00 24.05 168.00 32400013 HC CHEST DECUB/SPECIAL ONE VIEW 324 71045 295 % of Charges OP 37.00 156.90 24.79 24.05 168.00 24.05 168.00 32400011 HC CHEST APICAL LORDOTIC 324 71045 295 % of Charges OP 63.00 156.90 42.21 40.95 168.00 40.95 168.00 32400009 HC CHEST XRAY ONE VIEW 324 71045 51 % of Charges OP 269.00 156.90 180.23 174.85 168.00 156.90 180.23 32400009 HC CHEST XRAY ONE VIEW 324 71045 234 % of Charges OP 269.00 156.90 180.23 174.85 168.00 156.90 180.23 32400011 HC CHEST APICAL LORDOTIC 324 71045 51 % of Charges OP 333.00 156.90 223.11 216.45 168.00 156.90 223.11 32400013 HC CHEST DECUB/SPECIAL ONE VIEW 324 71045 51 % of Charges OP 537.00 156.90 359.79 349.05 168.00 156.90 359.79 32400015 HC CHEST DECUBITUS/SPECIAL TWO VIEWS 324 71046 295 % of Charges OP 49.00 172.96 32.83 31.85 185.00 31.85 185.00 32400010 HC CHEST XRAY TWO VIEWS 324 71046 295 % of Charges OP 49.00 172.96 32.83 31.85 185.00 31.85 185.00 32400010 HC CHEST XRAY TWO VIEWS 324 71046 51 % of Charges OP 297.00 172.96 198.99 193.05 185.00 172.96 198.99 32400015 HC CHEST DECUBITUS/SPECIAL TWO VIEWS 324 71046 51 % of Charges OP 806.00 172.96 540.02 523.90 185.00 172.96 540.02 32400012 HC CHEST XRAY THREE VIEWS 324 71047 295 % of Charges OP 63.00 63.73 42.21 40.95 68.00 40.95 68.00 32400012 HC CHEST XRAY THREE VIEWS 324 71047 51 % of Charges OP 373.00 63.73 249.91 242.45 68.00 63.73 249.91 32400014 HC CHEST XRAY FOUR + VIEWS 324 71048 295 % of Charges OP 65.00 125.40 43.55 42.25 134.00 42.25 134.00 32400014 HC CHEST XRAY FOUR + VIEWS 324 71048 51 % of Charges OP 399.00 125.40 267.33 259.35 134.00 125.40 267.33 34200006 HC INJECT RADIOPHARM NON-IMAGING LOCALIZATION 324 78808 51 % of Charges OP 740.00 " 1,712.26 " 495.80 481.00 495.80 481.00 " 1,712.26 " 32900002 HC FINE NEEDLE ASP W US GUIDANCE INITIAL LESION 329 10005 51 % of Charges OP " 1,553.00 " " 1,040.51 " " 1,040.51 " " 1,009.45 " " 1,040.51 " " 1,009.45 " " 1,040.51 " 32900001 HC FINE NEEDLE ASP WO GUIDANCE 329 10021 51 % of Charges OP 367.00 245.89 245.89 238.55 245.89 238.55 245.89 32900004 HC INCISE DRAIN HEMATOMA 329 10140 51 % of Charges OP " 3,344.00 " " 2,240.48 " " 2,240.48 " " 2,173.60 " " 2,240.48 " " 2,173.60 " " 2,240.48 " 32900005 HC ASP ABSCESS HEMATOMA CYST 329 10160 51 % of Charges OP 344.00 230.48 230.48 223.60 230.48 223.60 230.48 32900005 HC ASP ABSCESS HEMATOMA CYST 329 10160 234 % of Charges OP 344.00 230.48 230.48 223.60 230.48 223.60 230.48 32900007 "HC DEBRIDE SKIN, SUBQ & MUSCLE" 329 11043 51 % of Charges OP 999.00 669.33 669.33 649.35 669.33 649.35 669.33 32900007 "HC DEBRIDE SKIN, SUBQ & MUSCLE" 329 11043 234 % of Charges OP 999.00 669.33 669.33 649.35 669.33 649.35 669.33 32900010 HC ASPIRATION BREAST CYST 329 19000 295 % of Charges OP 360.00 241.20 241.20 234.00 241.20 234.00 241.20 32900010 HC ASPIRATION BREAST CYST 329 19000 51 % of Charges OP 619.00 414.73 414.73 402.35 414.73 402.35 414.73 32900011 HC ASP BREAST CYST ADDTL 329 19001 51 % of Charges OP 294.00 196.98 196.98 191.10 196.98 191.10 196.98 32900012 HC INJ MAMMARY DUCTOGRAM 329 19030 51 % of Charges OP 277.00 185.59 185.59 180.05 185.59 180.05 185.59 32900012 HC INJ MAMMARY DUCTOGRAM 329 19030 295 % of Charges OP 586.00 392.62 392.62 380.90 392.62 380.90 392.62 32900356 HC ATTEMPT BREAST BX STEREO 329 19081 51 % of Charges OP " 1,143.00 " " 1,482.83 " 765.81 742.95 765.81 742.95 " 1,482.83 " 32900013 HC BX BREAST STEREO GUIDE 329 19081 295 % of Charges OP " 1,835.00 " " 1,482.83 " " 1,229.45 " " 1,192.75 " " 1,229.45 " " 1,192.75 " " 1,482.83 " 32900013 HC BX BREAST STEREO GUIDE 329 19081 51 % of Charges OP " 4,102.00 " " 1,482.83 " " 2,748.34 " " 2,666.30 " " 2,748.34 " " 1,482.83 " " 2,748.34 " 32900014 HC BX BREAST STEREO ADDTL 329 19082 295 % of Charges OP " 1,835.00 " " 1,229.45 " " 1,229.45 " " 1,192.75 " " 1,229.45 " " 1,192.75 " " 1,229.45 " 32900014 HC BX BREAST STEREO ADDTL 329 19082 51 % of Charges OP " 4,102.00 " " 2,748.34 " " 2,748.34 " " 2,666.30 " " 2,748.34 " " 2,666.30 " " 2,748.34 " 32900015 HC BREAST NDL LOC MAMMO GUIDE 329 19281 51 % of Charges OP " 1,877.00 " 630.14 " 1,257.59 " " 1,220.05 " " 1,257.59 " 630.14 " 1,257.59 " 32900016 HC BREAST NDL LOC MAMMO ADDTL 329 19282 51 % of Charges OP " 1,877.00 " " 1,257.59 " " 1,257.59 " " 1,220.05 " " 1,257.59 " " 1,220.05 " " 1,257.59 " 32900017 HC BREAST NDL LOC STEREO GUIDE 329 19283 295 % of Charges OP 886.00 593.62 593.62 575.90 593.62 575.90 593.62 32900017 HC BREAST NDL LOC STEREO GUIDE 329 19283 51 % of Charges OP " 2,702.00 " " 1,810.34 " " 1,810.34 " " 1,756.30 " " 1,810.34 " " 1,756.30 " " 1,810.34 " 32900018 HC BREAST NDL LOC STEREO ADDTL 329 19284 295 % of Charges OP 886.00 593.62 593.62 575.90 593.62 575.90 593.62 32900018 HC BREAST NDL LOC STEREO ADDTL 329 19284 51 % of Charges OP " 2,702.00 " " 1,810.34 " " 1,810.34 " " 1,756.30 " " 1,810.34 " " 1,756.30 " " 1,810.34 " 32900035 HC INJ PX FOR TEMPOROMAN 329 21116 51 % of Charges OP 129.00 86.43 86.43 83.85 86.43 83.85 86.43 32900042 HC INJECTION PROCEDURE SHOULDER 329 23350 51 % of Charges OP 301.00 201.67 201.67 195.65 201.67 195.65 201.67 32900043 HC INJ PX FOR ELBOW ARTH 329 24220 51 % of Charges OP 274.00 183.58 183.58 178.10 183.58 178.10 183.58 32900045 HC INJECTION WRIST ARTHROGRAPHY 329 25246 51 % of Charges OP 274.00 183.58 183.58 178.10 183.58 178.10 183.58 32900048 HC INJECTION HIP ARTHROGRAM 329 27093 51 % of Charges OP 274.00 183.58 183.58 178.10 183.58 178.10 183.58 32900049 HC INJ SI JOINT ARTHROGRAPHY 329 27096 51 % of Charges OP 274.00 183.58 183.58 178.10 183.58 178.10 183.58 32900052 HC INJ PX FOR KNEE ARTH 329 27369 51 % of Charges OP 274.00 183.58 183.58 178.10 183.58 178.10 183.58 32900054 HC INJ PX FOR ANKLE ARTH 329 27648 51 % of Charges OP 274.00 183.58 183.58 178.10 183.58 178.10 183.58 32900361 HC PTA ATHR 1V W ADDTL PTA 329 37225 51 % of Charges OP " 25,501.00 " " 17,085.67 " " 17,085.67 " " 16,575.65 " " 17,085.67 " " 16,575.65 " " 17,085.67 " 32900363 HC PTA STENT 1V W ADDTL PTA 329 37226 51 % of Charges OP " 40,438.00 " " 11,561.51 " " 27,093.46 " " 26,284.70 " " 27,093.46 " " 11,561.51 " " 27,093.46 " 32900365 HC STENT ATHR 1V W ADDTL ATHR PTA 329 37227 51 % of Charges OP " 44,219.00 " " 29,626.73 " " 29,626.73 " " 28,742.35 " " 29,626.73 " " 28,742.35 " " 29,626.73 " 32900344 HC REPAIR ENDOLEAK 329 37799 51 % of Charges OP " 10,514.00 " " 7,044.38 " " 7,044.38 " " 6,834.10 " " 7,044.38 " " 6,834.10 " " 7,044.38 " 32900200 HC LYMPH NODE BIOPSY 329 38505 295 % of Charges OP 463.00 310.21 310.21 300.95 310.21 300.95 310.21 32900200 HC LYMPH NODE BIOPSY 329 38505 51 % of Charges OP " 1,922.00 " " 1,287.74 " " 1,287.74 " " 1,249.30 " " 1,287.74 " " 1,249.30 " " 1,287.74 " 32900201 HC INJ PX LYMPHANGIOGRAPHY 329 38790 51 % of Charges OP 326.00 218.42 218.42 211.90 218.42 211.90 218.42 32900202 HC INJ PX ID SENTINEL NODE 329 38792 295 % of Charges OP 274.00 183.58 183.58 178.10 183.58 178.10 183.58 32900202 HC INJ PX ID SENTINEL NODE 329 38792 51 % of Charges OP 860.00 576.20 576.20 559.00 576.20 559.00 576.20 32900205 HC NG OR GASTRIC TUBE PLACEMENT 329 43752 51 % of Charges OP 974.00 652.58 652.58 633.10 652.58 633.10 652.58 32900209 HC INTRO OF LONG GI TUBE 329 44500 51 % of Charges OP 794.00 531.98 531.98 516.10 531.98 516.10 531.98 32900212 HC NEEDLE BIOPSY LIVER 329 47000 51 % of Charges OP " 2,457.00 " " 1,482.83 " " 1,646.19 " " 1,597.05 " " 1,646.19 " " 1,482.83 " " 1,646.19 " 32900252 HC INJ CONTRAST EVALUATE G-TUBE 329 49465 51 % of Charges OP 408.00 273.36 273.36 265.20 273.36 265.20 273.36 32900254 HC RENAL BIOPSY PERC 329 50200 51 % of Charges OP " 2,457.00 " " 1,646.19 " " 1,646.19 " " 1,597.05 " " 1,646.19 " " 1,597.05 " " 1,646.19 " 32900278 HC INJ PX FOR CYSTOGRAPHY 329 51600 51 % of Charges OP 84.00 56.28 56.28 54.60 56.28 54.60 56.28 32900280 HC PROSTATE NEEDLE BIOPSY 329 55700 51 % of Charges OP " 2,228.00 " " 1,492.76 " " 1,492.76 " " 1,448.20 " " 1,492.76 " " 1,448.20 " " 1,492.76 " 32900281 HC INJ HYSTEROSALPINGOGRAPHY 329 58340 51 % of Charges OP 123.00 82.41 82.41 79.95 82.41 79.95 82.41 32900284 HC AMNIOCENTESIS 329 59000 295 % of Charges OP 457.00 306.19 306.19 297.05 306.19 297.05 306.19 32900284 HC AMNIOCENTESIS 329 59000 51 % of Charges OP 619.00 414.73 414.73 402.35 414.73 402.35 414.73 32900285 HC THYROID BIOPSY PERC 329 60100 295 % of Charges OP 456.00 305.52 305.52 296.40 305.52 296.40 305.52 32900285 HC THYROID BIOPSY PERC 329 60100 51 % of Charges OP 703.00 471.01 471.01 456.95 471.01 456.95 471.01 32900286 HC THYROID CYST ASPIRATE INJ 329 60300 295 % of Charges OP 388.00 259.96 259.96 252.2